Final 2013 Flashcards
The picture represents which mechanism?
a. Cooperativity
b. Potentiation
c. Summation
d. Synergism
a. Cooperativity
What is the diagnosis according to the ECG shown?
a. Anterior STEMI (ST elevation in V2-V4)
b. Angina pectoralis
c. Pericarditis
d. Inferior STEMI
a. Anterior STEMI (ST elevation in V2-V4)
What does the figure represent?
a. aortic insufficiency
b. mitral stenosis
c. Severe LV dysfunction, often in advanced aortic stenosis
d. Bigeminal pulse
e. Cardiac tamponade
f. Heart failure
a. aortic insufficiency
What does the figure represent? a. aortic insufficiency b. mitral stenosis c. Severe LV dysfunction, often in advanced aortic stenosis d. Bigeminal pulse e. Cardiac tamponade f. Heart failure
c. Severe LV dysfunction, often in advanced aortic stenosis
EBM question had a description of a study with similar table
-
What is associated with an immediate acute blood transfusion reaction?
a. IgE
b. IgG
c. IgM
d. IgA
c. IgM
A patient came with fatigue & fever, CBC showed high WBCs, & blood smear shower Auer rods. What is the diagnosis?
a. AML
b. CML
c. ALL
d. CLL
a. AML
A Rhesus factor positive test refers to the presence of which antigen on the RBCs?
a. A antigen
b. B antigen
c. O antigen
d. D antigen
e. AB antigen
d. D antigen
What results in type 2 hypersensitivity reaction following blood transfusion?
- Antibodies adsorbed on RBC membrane
- Immune complex deposition
- Cytokines releas
- Antibodies adsorbed on RBC membrane
What is the main enzyme for fibrinolytic action?
- Thrombin
- Plasmin
- Fibrinogen
- Plasmin
A patient with a history of recurrent infections presented with fever & sore throat, what would you find in his blood smear?
a. Eosinophilia
b. Basophilia
c. Leukocytosis
d. Thrombocytosis
c. Leukocytosis
Which of the following acts as a substrate for plasmin & thrombin?
a. Fibrinogen
b. Plasmin
c. Factor Xlll
d. Factor V
a. Fibrinogen
What serves as the main hematopoietic organ in the 8th month of gestation of a fetus? Lymph nodes Spleen Bone marrow Yolk sac Placenta
Bone marrow (Hematopoiesis starts in the spleen during the 3rd month, peaks in the 5th, and ceases by the 7th)
What is not a characteristic with extravascular hemolysis?
High bilirubin
Decreased haptoglobin
Splenomegaly
Reticulocytopenia
Decreased haptoglobin (I understand the note has this in the table but all others are absolutely wrong and this is not a characteristic)
Drug that bind to G11b/111a receptors and inhibits their activation?
a. Otamixaban
b. Abciximab
c. Aspirin
d. Clopedogril
e. Rituximab
b. Abciximab
Drug that do not have an antidote in case of bleeding?
a. Otamixaban
b. Abciximab
c. Aspirin
d. Clopedogril
e. Rituximab
a. Otamixaban
Patient presented with macrocytic anemia, thrombocytopenia, and hypo-segmented neutrophils.
a. Megaloblastic Anemia
b. MDS
c. IDA
d. Aplastic anemia
b. MDS
Which drug is a direct inhibitor of thrombin?
a. Dabigatran
b. Aspirin
c. Heparin
d. Warfarin
a. Dabigatran
which phospholipid is exposed on the surface of damaged RBCs
a. Phosphatidylserine
b. Phosphatidylcholine
a. Phosphatidylserine
Which drug cause hemorrhagic cystitis as a side-effect?
Cyclophosphomide
Doxarubicin
Cisplatin
Methotrexate
Cyclophosphomide
What is the mechanism of action of Doxarubicin as a cytotoxic antibody?
Depletes cell metabolites
Intercalates RNA and DNA
Prevents cell membrane synthesis
Mitotic poison
Intercalates RNA and DNA
A patient admitted for infection with high PT, APTT, & D-dimers. What is the cause?
DIC
Hemolytic anemia Hemophilia C
DIC
What is the mechanism of action of deferoxamine?
Cross links DNA
Binds to iron and enhances its excretion
Regulate DNA expression
It has an unknown mechanism of action
Binds to iron and enhances its excretion
How do phagocytes help in anti-bacterial defense?
a. Release of cytokines
b. Release of reactive oxygen species
c. Release of histamine
b. Release of reactive oxygen species
An 8 year old child presented with prolonged bleeding while brushing teeth and after minor cuts, normal APTT, normal PT. What is the cause?
a. VW disease
b. Isolated factor 8 deficiency
c. Hemophilia
a. VW disease
A young girl with history of menorrhagia and nose bleeds. Her PT, APTT, and BT were normal. Her mother mentioned a similar bleeding disorder in her uncle. What will you find?
a. Thrombocytopenia
b. Low factor 9
c. Low Ristocetin Factor
d. Vascular disorder
c. Low Ristocetin Factor
A patient presented with meningococcal infection and recurrent bleeding into skin and mucosal membranes, his blood film showed schistocytes. What is the cause?
a. DIC
b. Hemophilia
c. Vw disease
a. DIC
A man presented with symptoms of anemia and massive hepatosplenomegaly. Blood film showed nucleated RBS and tear drop cells. What is the cause?
a. CML
b. PV
c. AML
d. Primary myelofibrosis
d. Primary myelofibrosis
A patient presented with pancytopenia with no blast cells in his peripheral blood smear. What is the underlying pathology?
a. CML
b. ALL
c. Multiple Myeloma
d. Aplastic anemia
d. Aplastic anemia
Young girl presented with anemia following an upper respiratory tract infection. Her mother reported she had leg ulcers as a child. What is the diagnosis?
a. B thalassemia
b. SCA
c. IDA
d. Anemia of chronic disease
b. SCA
Male with a history of colectomy presented with splenomegaly, high MCV, retics, LDH, and unsteady gait and numbness. What’s the cause?
a. B12 deficiency
b. Folate deficiency
c. IDA
a. B12 deficiency
How does 2,3-BPG change the affinity of Hb?
a. By forming covalent bonds with beta chains
b. By changing affinity of unbound chains to O2
c. By stabilizing the R state
b. By changing affinity of unbound chains to O2
What leads to a shift of HB saturation curve to the right?
a. High 02
b. Low 2,3,BPG
c. H+
c. H+
Which protein is found bound to collagen and circulation in the blood?
a. Vw factor
b. C protein
c. Factor 10
d. Factor 5
a. Vw factor
A mutation of which of these leads to thrombophilia?
a. Vw factor
b. C protein
c. Factor 10
d. Factor 5
d. Factor 5
What helps the binding of Gla protein to the plasma membrane by the help of Calcium?
a. Acidic phospholipid
b. Collagen
a. Acidic phospholipid
Which test is prolonged in SLE patient with lupus anticoagulant and repeated abortions?
a. PT
b. APTT
c. BT
b. APTT
64 year old man was found to have high platelet count in CBC?
a. Polycethemia vera
b. CML
c. MDS
d. Essential thrombocythemia
d. Essential thrombocythemia
What type of hemoglobin is found in a newborn with alpha thalassemia trait?
HbA2 HbF HbA HbH Hb barts
Hb barts
What is found in B thalassemia
HbA2 HbF HbA HbH Hb barts
HbF
Which drug is a tyrosine kinase inhibitor?
a. Imitanib
Which drug inhibits DHFR
Methotrexate
Patient with bleeding after tooth extraction. His CBC, PT, APTT, and bleeding time were all normal. What is he suffering from?
a. Thrombocytopenia
b. Aplastic anemia
c. AML
d. CML
e. Platelet dysfunction
e. Platelet dysfunction
Deficiency of which of the following will be seen in HJE deficiency?
a. Ceruloplasmin
b. BMP
c. Hepcidin
d. Iron
e. IL6
c. Hepcidin
RA patient was found to be anemic. Inhibition of which of the following will improve his condition?
a. Hepcidin
b. BMP
c. Ceruloplasmin
d. Transferrin
a. Hepcidin
What antagonizes plasmin function?
a. TXA2
b. TF
c. PAI
d. PLG
c. PAI
Chinese boy presented with respiratory tract infection, fever, and fatigue. His peripheral blood smear showed atypical lymphocytes. What is the infective agent?
a. CMV
b. EBV
c. S. Pneumonia
d. Candida
b. EBV
A young female presented with anemia and thrombocytopenia. Peripheral blood smear showed spherocytosis. How to confirm the diagnosis?
a. Osmotic fragility test
b. DAT
c. BM examination
d. CBC
b. DAT
Patient presented with symptoms of IDA. What would you expect?
a. Low Fe, Ferritin, TSAT, and high TIBC
A 70 year old patient diagnosed with ischemic heart disease and anemia with normal APTT, PTT, platelet count what is the cause of bleeding?
Platelet dysfunction
Aspirin therapy
Hemophilia
Cirrhosis
Aspirin therapy
What is the most important mechanism of producing energy in an ischemic heart?
Fatty acids -> TCA cycle
Glucose -> TCA cycle
Glucose -> Glycolysis
Ketone bodes -> TCA cycle
Glucose -> Glycolysis
Which of the followings antigens mimics cardiomyocytes in S. pyogenes?
a. Lipopolysaccharides
b. M protein
c. Flagella
d. Peptidoglycan
b. M protein
What is meant by “transient ischemic attack”?
a. Pain in the leg while walking that resolves on rest
b. Short-lived unstable angina
c. Occurrence of chest pain without increase of troponin
d. Sudden leg hemiplegia that is completely resolved within 24 hours
d. Sudden leg hemiplegia that is completely resolved within 24 hours
Which gene cause familial hypertrophic cardiomyopathy?
a. Pln
b. Myh7
c. Mh3
d. Tnn1
b. Myh7
What is the main ligand of scavenger receptor type b 1?
a. large HDL
b. small HDL
c. Oxidized LDL
d. Oxidized vLDL
a. large HDL
Which of the following if increased results in turbulence flow in a large artery like a renal artery?
a. Resistance
b. CO
c. Blood viscosity
d. Hematocrit
b. CO (A is wrong bc he mentioned ‘large artery’)
- Patient came with Blindness, ( autopsy from temporal artery) shows granulomatous
a. Giant cell arteritis
b. Polyartritis nodosa
c. Takayaso
a. Giant cell arteritis
A 65 year old patient with a blood pressure of 168/75, with the same measurement over the next week. How would you describe his risk for CHD?
a. Lower than normal because SBP and DBP are in the normal range
b. Normal because SBP isn’t important when DBP is normal
c. Slightly increased because the SBP is slightly increased
d. Double the risk because abnormal SBP conquers even higher risk than abnormal DBP
d. Double the risk because abnormal SBP conquers even higher risk than abnormal DBP
Why are anti-fibrinolytic agents used in ACS?
a. Relieve pain
b. Decrease oxygen demand
c. Reopen occluded artery
d. As an anticoagulant
c. Reopen occluded artery
Patient with old MI is given this drug to protect him from another MI
a. CCB
b. Aspirin
c. ACEI
b. Aspirin
A 53 year old male developed massive left ventricular MI, on admission his renal function tests revealed elevated creatinine & elevated BUN suggestive of renal insufficiency. His condition is:
a. Nephrotic syndrome
b. Crescentic glomerulonephritis
c. Acute tubular necrosis.
d. Tubular interstitial fibrosis
c. Acute tubular necrosis.
Which of these occurs due to aortic regurgitation?
a. Increased aortic EDP
b. Increased ventricular EDP
c. Decreased ventricular filling
d. Decreased preload
e. Decreased ejection fraction
b. Increased ventricular EDP
What passes with the aorta through aortic hiatus?
Azygous vein
Splanchnic nerve Vagus nerve Phrenic nerve
Azygous vein
What is the likely frequency of genetic polymorphism of a low penetrance disease like cardiovascular disease? 0.0001
- 0005
- 1
- 0
- 00001
0.1
What is the characteristic of Clopidogrel?
a. Requires the activation by CYP2C19
b. Requires the activation of CYP2C9
a. Requires the activation by CYP2C19
Muscle fatigue is characterized by?
a. Depletion of muscle ATP and glycogen
What is the mechanism of Aliskirin?
a. Renin inhibitor
What is heard during -Mitral regurgitation?
a. pan systolic murmur
b. early diastolic murmur
c. loud S1
d. loud S2
e. loud S3 (it works for 67 but A is better)
a. pan systolic murmur
Aortic regurgitation?
a. pan systolic murmur
b. early diastolic murmur
c. loud S1
d. loud S2
e. loud S3 (it works for 67 but A is better)
b. early diastolic murmur
A 40 year old man presented with complains of chest pain for the best 2 years that occurs on exertion and is relieved by rest. He presented to the doctor now as it used to happen after walking 200m but now 100 m. what is the underlying pathology?
a. Narrowing of coronary vessel lumen more than 75%
b. Ruptured coronary plaque
c. Severe calcification of a plaque
d. Thin injury of fibrous cap of a 50% occluded vessel
a. Narrowing of coronary vessel lumen more than 75%
A patient had recent surgery and a prosthetic valve was placed, he developed infective endocarditis. What’s the causative organism?
a. S. epidermidis
b. S. viridans
c. S. aureus
a. S. epidermidis
Unstable angina
a. ST segment elevation in leads I II and Avf
b. ST segment elevation in leads V2 to V5
c. ST segment depression in leads V3 to V5
d. Irregular QRS complexes
e. Low Voltage in all chest leads
f. ST segment elevation in all leads
c. ST segment depression in leads V3 to V5
Pericarditis
a. ST segment elevation in leads I II and Avf
b. ST segment elevation in leads V2 to V5
c. ST segment depression in leads V3 to V5
d. Irregular QRS complexes
e. Low Voltage in all chest leads
f. ST segment elevation in all leads
f. ST segment elevation in all leads
What is a prerequisite for reentry?
a. Reduced conduction velocity in retrograde direction
b. Decreased AP
c. Increased AP
d. Hyperpolarization of myocytes
e. Bidirectional block
a. Reduced conduction velocity in retrograde direction
Which drug may cause myopathy as an adverse effect?
a. Simvastatin
b. ACEI
c. Losartan
d. Niacin
e. Cholestyramine
a. Simvastatin
Cardiac fuel in prolonged starvation?
a. Ketone bodies
b. Fatty acids
c. Glucose
d. Amino acids
a. Ketone bodies
In which of the following can we find discontinuous capillaries?
a. Liver
b. Muscle tissue
c. Exocrine glands
a. Liver