A young man presents with central chest pain presumed to beassociated with vasoconstriction. The most likely cause of the pain is local
1.hypoxia
2. decreased ATP
3.increased CO2
4.catecholamines acting on alpha 1 receptors
Acute compensatory mechanisms in shock include all of the following except
1.Baroreceptor reflexes B. D.
2.Reverse stress-relaxation of vascular smooth muscle
3.The effects of increased aldosterone secretion
4.Activation of the renin-angiotensin system
In cirrhosis
1. fibrosis is confined to the delicate bands around central veins
2.nodularity is uncommon
3.vascular architecture is preserved
4. the left lobe of the liver is most affected
In pyelonephritis
1.85 % of infections are caused by G-ve bacteria
2.uretral obstruction makes haematogenous infection less likely
3.infection is less likely during pregnancy
4.papillary necrosis and perinephric abscess are common seqelae
Ischaemic tubular necrosis is associated with
1.maintenance stage with polyuria
2. predominantly proximal necrosis
3.intact basement membranes
4.tubular cast obstruction
Oesophageal varices
1. occur in one third of all cirrhosis patients
2.account for more than 50 % of episodes of haematemesis
3.are most often associated with hepatitis C cirrhosis
4.have a 40 % mortality during the first episode of rupture
Regarding pericarditis
1.constrictive pericarditis only rarely follows suppurative pericarditis
2.primary pericarditis is usually bacterial in origin
3.serous pericarditis may be due to ureamia
4.haemorrhagic pericarditis is most commonly due to Klebsiella infection
A performed mediator of inflammation is
1.Prostaglandin
2.Histamine
3.Leukotriene
4.Nitric oxide
Acute endocarditis
1. has a less than 20 % mortality
2. is caused by virulent micro-organisms
3.30 % is caused bacteria
4. none of these
All of the following are major risk factors for atherosclerosis EXCEPT
1.obesity
2.hyperlipidemia
3.smoking
4.hypertension
An adult male with an ejection fraction of 80 % could be due to
1.myocardial ischaemia
2.arrhythmia
3. thiamine deficiency
4.None of these
Bradykinin
1.causes smooth muscle dilatation
2.kallikrein causes prohormone degredation to produce bradykinin
3.both (a) and (b)
4.None of these
Concerning acute tubular necrosis
1.cephalosporins are not a causative agent
2.nephrotoxic causes are associated with a poor prognosis
3. casts are found in the loop of Henle
4. rhabdomyolysis is not a cause
Congestive cardiac failure may be caused by
1.vitamin A deficiency
2.niacin deficiency
3.vitamin D deficiency
4.thiamine deficiency
Cushing syndrome is associated with
1.osteoporosis
2.general obesity
3.hypotension
4.All of the above
Diabetes is associated with
1. carbuncles
2.mucormycosis
3.all of the above
4.None of These
Endocarditis in IV drug abusers typically
1. is caused by candida albicans
2.has a better prognosis than other types of endocarditis
3.does not cause fever
4.is caused by staph aureus
Hypothyroidism is associated with all of the following EXCEPT
1. cretinism
2.cold intolerance
3.decreased hair growth
4.None of These
In acute pancreatitis
1. fat necrosis occurs in other intra-abdominal fatty deposits
2.trauma is the precipitating cause in 30 % of cases
3. alcohol is directly toxic to the Islets of Langerhans
4.Kallikrein converts trypsin to activate the complement system
In atherosclerosis the cells at the centre of the plaque are
1.macrophages
2.foam cells
3.leukocytes
4.smooth muscle cells
In compensated cardiac hypertrophy changes include
1.diffuse fibrosis
2.hyperplasia
3.decreased sarcomeres
4. increased capillary density
In normal haemostasis
1.Factor V inhibits thrombosis
2.Alpha 2 microglobulin is antithrombotic
3.PGI2 favours platelet aggregation
4.Platelet aggregation is inhibited by von Willebrand factor
In pulmonary tuberculosis
1.the Ghon complex is a parenchymal peri-hilar lesion
2.bacilli establish themselves in sites of low oxygen tension
3.liquefactive necrosis precedes granuloma formation
4. Langhans cells occur in coalescent granulomas
In type 1 diabetes
1.associated organ-specific auto-immune disorders are common
2.a genetic susceptibility is not supported by evidence
3. Finnish children have a 70 fold increase compared with Korean children
4. Influenza and varicella viruses are suspected as initiators of the disease
Interleukin 1 causes
1. Neutropaenia
2. Decreased sleep
3. Decreased prostaglandin synthesis
4. Increased collagen synthesis
Macrocytic anaemia is associated with all the following except
1.Hyperthyroidism
2.Neoplasm
3.Folate and B12 deficiency
4.EBV
Malignant hypertension
1.75 % recover with no loss of renal function
2.is associated with abnormal renin levels
3.affects 1 to 5 % of sufferers
4.None of These
Mononuclear phagocytes
1.Are the predominant cells in three day old wounds
2.Are common in liver, spleen and pancreas
3.Produce fibroblast growth factor
4. Secrete interferon Y
Myelefibrosis
1.causes decreased megakaryocytes
2.stimulates erythropoetin production
3.causes leukoerythroblastic anaemia
4.None of these
Myositis ossificans
1. Morphologically resembles osteosarcoma
2. Resembles the repair process following a muscle tear
3.both (a) and (b)
4.None of These
Normal endothelial cells decrease platelet aggregation by secreting
1.Interleukin 1
2.von Willebrand factor
3.Prostacyclin
4.Factor V
Pathogenesis of type 1 diabetes is associated with
1.decreased insulin sensitivity
2.abnormal glucokinase activity
3.no antibodies found at diagnosis
4.auto-immune insulitis
Patient who has a normal blood pressure post MI must have
1.increased cardiac output
2. increased systolic filling pressure
3. increased right atrial pressure
4.None of These
Regarding acute tubular necrosis
1. it is associated with hyperkalemia not hypokalemia in recovery
2.non-oliguric has a better recovery
3. it is associated with ischaemic cortical cells
4.80 % are associated with anuria
Regarding pancreatitis
1.the second most common cause is infectious agents
2. trypsin is implicated as an activator of the kinin system
3. the chronic form is usually due to gallstones
4.duct obstruction is not the mechanism in alcoholic pancreatitis
Regarding the changes to myocardium after MI
1. pallor at 24 hours
2.wavy fibres are found centrally
3.decreased contractility after 5 minutes
4. liquefactive necrosis is typical
Regarding the hepatorenal syndrome
1. it is irreversible
2.one loses the ability to concentrate urine
3.urine has a high sodium concentration
4.the urine is hyperosmolar
Rheumatic carditis is associated with
1.Curschmann spirals
2.Ito cells
3. Aschoff bodies
4.Nutmeg cells
Smoking is associated with all the following diseases EXCEPT
1. spontaneous abortion
2.atherosclerosis
3. bladder carcinoma
4.chronic liver disease
Stress fractures
1.do not incite a paracortical reaction
2.result from repetitive stresses or abnormal axial loading
3.both a and b
4.None of these
The cause of fluid retention peripherally with congestive cardiac failureis
1.increased renin
2.increased GFR
3.increased angiotensin 2
4.increased aldosterone
The commonest cause of fungal endocarditis is
1.as
2.blatomycosis
3.as D. candida
4.candida
The commonest cause of thyroid carcinoma is
1. medullary
2.follicular
3.papillary
4.anaplastic
The commonest site of primary TB lesion in lung is
1.apex
2.base
3.hilum
4.peripherally
The following are primary mediators of type I hypersensitivity reactions except
1.Adenosine
2.Neutrophil chemotactic factor
3.Heparin
4. Platelet activating factor
Thromboctopenia
1.occurs commonly in HIV
2.causes spontaneous bleeding at levels of less than 90,000/mm
3.occurs with hyposplenism
4.is related to platelet survival in paroxysmal nocturnal haemoglobinuria
Thrombosis is potentiated by all of the following except
1.von Willebrand factor deficiency
2.Protein S deficiency
3. Antithrombin III deficiency
4.Thrombotic thrombocytopenia
Urolithiasis A.
1. presence of hypercalcemia implies renal insufficiency
2.a patient with leukemia is likely to make cystine calculi
3.calcium is the major component of 35% of calculi
4.struvite stones are made up of magnesium-ammonium-phosphate
Which of the following reactions is cell mediated
1.SLE
2.Arthus reaction
3.Anaphylaxis
4.Graft rejection
With regards to jaundice
1.Conjugated bilirubin causes kernicterus in adults
2.Unconjugated bilirubin does not colour sclera
3.Unconjugated bilirubin is tightly bound to albumin
4.Unconjugated bilirubin produces bilirubin in urine