29. Essential diagnostic criteria of metabolic syndrome: a. fasting blood glucose: > 5.6 mM b. Se HDL in men: 102 cm; in woman: > 88 cm d. Se TG: < 1.7 mM

a. fasting blood glucose: > 5.6 mM b. Se HDL in men: 102 cm; in woman: > 88 cm (Slide 100)

Pathophys-Written Questions - Semester 1 Flashcards by Guy Ben Arie

Immediate compensation mechanism in heart failure
a. Sympathetic stimulation
b. Salt and water retention
c. Frank – Starling mechanism
d. Hypertrophy of the myocardium

a. Sympathetic stimulation

c. Frank – Starling mechanism

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3 What are the features of celiac disease?
a. dermatitis herpetiformis
b. steatorrhea
c. high tissue transglutaminase (tTG) IgG/IgA antibody titer
d. Intestinal villi flattening

a. dermatitis herpetiformis
b. steatorrhea
c. high tissue transglutaminase (tTG) IgG/IgA antibody titer
d. Intestinal villi flattening
(Slides 28-30)

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As a result of prolonged hypertension, which alterations affect the vessel wall:
a. increasing endothelial damage
b. decreasing vessel wall permeability
c. increasing vessel wall elasticity
d. increasing shear stress at blood flow

a. increasing endothelial damage

d. increasing shear stress at blood flow

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Which lipoprotein plasma level is the most frequently elevated in diabetes mellitus? Select one:
a. CHY-VLDL-LDL
b. LDL-CHY
c. VLDL-CHY
d. VLDL-HDL
e. CHY-IDL

a. CHY-VLDL-LDL

Slide 46

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Characteristic signs of diabetes insipidus:
a. hyperhidrosis
b. nycturia or nocturnal enuresis
c. hyponatremic dehydration
d. polyuria, polydipsia, thirst

b. nycturia or nocturnal enuresis

d. polyuria, polydipsia, thirst

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Clinical signs of pheochromocytoma:
a. cold limbs
b. sweating
c. headache
d. palpitation

a. cold limbs
b. sweating
c. headache
d. palpitation
Slide 48

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Causes of Cardiogenic Shock:
a. Asthma cardiale
b. Excessive burn
c. Pericardial tamponade
d. Valvular regurgitation or stenosis

a. Asthma cardiale
c. Pericardial tamponade
d. Valvular regurgitation or stenosis
(Slide 30)

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1 Clinical signs of Cushing-syndrome, except: (1)
a. hirsutism
b. dysmenorrhea
c. osteoporosis
d. depression
e. Amenorrhea

b. dysmenorrhea

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Essential diagnostic criteria of metabolic syndrome:
a. fasting blood glucose: > 5.6 mM
b. Se HDL in men: < 1.0 mM; in woman: < 1.3 mM
c. waist circumference in men > 102 cm; in woman: > 88 cm
d. Se TG: < 1.7 mM

a. fasting blood glucose: > 5.6 mM
b. Se HDL in men: < 1.0 mM; in woman: < 1.3 mM
c. waist circumference in men > 102 cm; in woman: > 88 cm
(Slide 100)

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What does “honeymoon phase” mean in type 1 diabetes?
a. A phase of low insulin requirement following the start of insulin treatment, when the preserved beta cells still produce insulin
b. A phase when the patient has no symptoms
c. A phase when the patient does not require insulin treatment
d. A stage when the autoantibodies disappear

a. A phase of low insulin requirement following the start of insulin treatment, when the preserved beta cells still produce insulin

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Clinical signs of endometriosis:
a. Hirsutismus
b. Dyspareunia (painful sexual intercourse)
c. Infertility
d. Dysmenorrhea

b. Dyspareunia (painful sexual intercourse)
c. Infertility
d. Dysmenorrhea
(Slide 87)

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What kind of autoantibodies are commonly found in type 1 diabetes?
a. Glutamic acid decarboxylase autoantibodies
b. Insulin receptor autoantibodies are the most common autoantibodies
c. islet cell autoantibodies
d. insulin autoantibodies (IAAs)

a. Glutamic acid decarboxylase autoantibodies
c. islet cell autoantibodies
d. insulin autoantibodies (IAAs)

https://en.wikipedia.org/wiki/Type_1_diabetes#Autoantibodies

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FALSE statements for postpartum thyroiditis:
a. may cause hyper- or hypothyroidism, as well
b. the presence of anti-TPO Ab and/or anti-TG Ab indicate the development of permanent hypothyroidism.
c. a type of Hashimoto’s thyroiditis that develops in pregnancy.
d. lymphocytic thyroiditis.
e. observed following pregnancy.

c. a type of Hashimoto’s thyroiditis that develops in pregnancy.

(Slides 21-22 - All other answers are true!)

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Which are the acute complications of diabetes?
a. Lactic acidosis
b. diabetic ketoacidotic coma
c. renal failure
d. diabetic hyperosmolar (non-ketotic) coma

b. diabetic ketoacidotic coma

d. diabetic hyperosmolar (non-ketotic) coma

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Which treatments are used in chronic heart failure:
a) Digitalis to increase contractility
b) Vasoconstrictors to increase BP
c) Diuretic therapy to induce fluid retention
d) ACE inhibitors to decrease aldosterone effect
e) certain vasodilators

d) ACE inhibitors to decrease aldosterone effect

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Factors involved in the mechanism of reperfusion injury:
a. increased sympathetic tone
b. tissue hypoxia
c. endothelial cell damage
d. activation of the renin-angiotensin-aldosterone system (RAAS)

b. tissue hypoxia

c. endothelial cell damage

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Cause(s) of hypovolemic shock:
a. adrenocortical failure
b. diabetes insipidus
c. acute pancreatitis
d. generalized exfoliative dermatitis

a. adrenocortical failure
b. diabetes insipidus
c. acute pancreatitis
d. generalized exfoliative dermatitis

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2 Risk factors of endometriosis:
a. caffeine consumption
b. short menstrual cycle
c. multiple pregnancy
d. late menarche

a. caffeine consumption
b. short menstrual cycle
(Slide 88)

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25. Shows decreased activity in patients with diabetes mellitus:
A.adhesion 
B.wound healing 
C.chemotaxis 
D.phagocytosis

A.adhesion
B.wound healing
C.chemotaxis
D.phagocytosis

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Role of acute phase proteins:
A.Ceruloplasmin - binding of free radicals
B.Fibrinogen - inhibits spreading of bacteria
C.CRP- agglutination of bacteria
D.Alpha1-antitrypsin - inhibition of proteases
E.Ferritin - chemotactic activity

A.Ceruloplasmin - binding of free radicals
B.Fibrinogen - inhibits spreading of bacteria
C.CRP- agglutination of bacteria
D.Alpha1-antitrypsin - inhibition of proteases

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Possible causes of Conn’s syndrome:
a. 17α-hydroxylase-deficiency
b. adrenocortical hyperplasia
d. 21α-hydroxylase-deficiency
c. Bartter-syndrome

a. 17α-hydroxylase-deficiency

b. adrenocortical hyperplasia

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The atherogenic effect of homocysteine:
a. it inhibits platelet aggregation
b. it increases the amount of ox-LDL by lipid peroxidation
c. it inhibits the migration and the proliferation of smooth muscle cells
d. it increases collagen synthesis in vessels

b. it increases the amount of ox-LDL by lipid peroxidation

d. it increases collagen synthesis in vessels

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Symptoms of hepatic encephalopathy, EXCEPT 1:
a. foetor hepatitis
b. vomiting
c. paralysis
d. asterixis
e. reversal of sleep/wake cycle

c. paralysis

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Cirrhosis may cause the following EXCEPT (1):
a. bleeding tendency
b. spontaneous bacterial peritonitis
c. hepatocellular carcinoma
d. hepatorenal syndrome
e. iron deficiency

e. iron deficiency

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14. The most important risk associated with atrial fibrillation: a. ventricular hypertrophy b. embolization c. syncope due to insufficient ventricular filling d. development of heart failure

b. embolization

22. Possible cause of polyuria: a. diabetes mellitus b. central diabetes insipidus c. nephrogenic diabetes insipidus d. renal failure

a. diabetes mellitus b. central diabetes insipidus c. nephrogenic diabetes insipidus d. renal failure (In initial Part there is polyuria - Wiki)

12. The recommended salt intake in hypertension is 10-12 g/day. True/False

False

16. Mechanism of hypertension formation in obesity: a. Elevated serum triglyceride level b. Decreased physical activity c. The increased amount of adipose tissue increases peripheral resistance d. Enhanced propensity to diabetes mellitus

a. Elevated serum triglyceride level | d. Enhanced propensity to diabetes mellitus

33. Characteristic symptoms of right sided heart failure: a. Nycturia b. Edema c. Hepatomegaly d. distended neck veins e. dyspnea

b. Edema c. Hepatomegaly d. distended neck veins (Slide 10)

5. How much calcium is present in the bones and teeth in the form of hydroxyapatite? a. 750 g b. 2000 g c. 1100 g d. 1500 g

c. 1100 g

7. 2 Arrhythmias may cause: a. fatigue b. palpitation c. dizziness, confusion d. no symptoms

a. fatigue b. palpitation c. dizziness, confusion d. no symptoms

32. Typical alteration in metabolic syndrome, except: a. Hyperthyroidism b. Obesity c. Hypertension d. Plasma lipid level alterations e. Hyperglycemia

a. Hyperthyroidism

18. What is the likelihood that an HBV infection become chronic in a newborn? a. 0% b. 1-10% c. 10-20% d. 40-50% e. 90%

e.90%

26. 3 The basal metabolic rate is influenced by: (1) a. blood pressure b. body surface c. heart rate d. autoimmune disease e. all of the above

a. blood pressure b. body surface c. heart rate d. autoimmune disease e. all of the above - That's the one - https://en.wikipedia.org/wiki/Basal_metabolic_rate

23. Hyperaldosteronism may develop due to a. Tuberculosis b. Cirrhosis c. Bartter-syndrome d. Estrogen therapy

b. Cirrhosis c. Bartter-syndrome d. Estrogen therapy

5. Which ones are the microvascular complications of diabetes? a. Retinopathy b. Nephropathy c. Coronary sclerosis d. Neuropathy

a. Retinopathy b. Nephropathy d. Neuropathy Slide 45 "Google - Microvascular complications of diabetes are those long-term complications that affect small blood vessels. These typically include retinopathy, nephropathy, and neuropathy."

7. The possible causes of the endothelial dysfunction based on the response to injury hypothesis: a. Increased serum VLDL concentration b. Micro-injuries on vascular intima promote platelet adhesion and aggregation c. Mechanical injuries d. Increased serum homocysteine concentration

d. Increased serum homocysteine concentration | Slide 90-91, ther rest refer to the injury in context of the THROMBOGENIC HYPOTHESIS

12. Typical sign of pheochromocytoma, except: (1) a. constipation b. hypertension developed in paroxysm c. nausea, vomiting d. hyperhidrosis e. 24 hours urine VMA↑

a. constipation | Slide 48

10. The most common cause of severe acute parenchymal liver lesion in the US: a. acute alcohol intoxication b. mushroom poisoning c. paracetamol overdose d. viral hepatitis e. cocaine overdose

c. paracetamol overdose

8. Increasing preload in a healthy subject results in: a. Increased end diastolic pressure b. increased duration of diastole c. decreased stroke volume d. increased end diastolic volume

a. Increased end diastolic pressure | d. increased end diastolic volume

3. Which materials are primarily excreted in the liver? a. bilirubin b. cholesterol c. copper d. iron

a. bilirubin b. cholesterol c. copper

29. The tolerance for barbiturates in alcoholics is: a. decreased in the drunken state b. decreased in the sober state c. increased in the drunken state d. increased in the sober state

a. decreased in the drunken state d. increased in the sober state (Slide 20)

21. Causes of distributive shock: e. systemic acidosis caused by poisoning f. spinal cord injury g. Addison’s disease h. chronic heart failure

f. spinal cord injury

1. Hypertension is defined by the following parameters: A. Systolic value > 140 mmHg, diastolic value > 90 mmHg B. Systolic value> 130 mmHg, diastolic value > 80 mmHg C. Systolic value > 145 mmHg, diastolic value > 95 mmHg D. Systolic value > 135 mmHg, diastolic value > 85 mmHg

A. Systolic value > 140 mmHg, | Diastolic value > 90 mmHg

19. Vagal manoeuvres are useful to terminate: a. Ventricular tachycardia b. Atrial flutter c. AVRT d. Atrial fibrillation

c. AVRT | It is useful only to slow temporarily and diagnose Atrial Flutter

12. Atrial fibrillation can be caused by: a. Hyperthyroidism b. Coronary heart disease c. Mitral stenosis d. Hypokalemia

a. Hyperthyroidism b. Coronary heart disease c. Mitral stenosis d. Hypokalemia

13. Factors contributing to the development of atrial fibrillation: a. dilation of the atrium b. decreased refractory time in the atrium c. increased conduction speed in the atrium d. increased vagal tone

a. dilation of the atrium b. decreased refractory time in the atrium d. increased vagal tone

11. Causes of Secondary Amenorrhea: a. Prolactinoma b. Kallmann syndrome c. Pregnancy d. Artificial abortion

a. Prolactinoma c. Pregnancy https: //en.wikipedia.org/wiki/Amenorrhea#Secondary_amenorrhea

17. What are the consensus criteria of ketoacidosis in children? a. Ketosis or ketonuria b. Blood sugar> 11.0 mmol/l c. pH<7.3 or plasma bicarbonate <15 mmol/l d. Detectable GAD antibody

a. Ketosis or ketonuria b. Blood sugar> 11.0 mmol/l c. pH<7.3 or plasma bicarbonate <15 mmol/l

8. Evidence supporting the response to injury hypothesis: a. Atherosclerotic plaques contain lymphocytes b. Plaques develop in areas with increased shear stress c. The risk to develop atherosclerosis is higher in those diseases which cause endothelial dysfunction d. Atherosclerotic plaques contain cholesterol crystals

a. Atherosclerotic plaques contain lymphocytes b. Plaques develop in areas with increased shear stress c. The risk to develop atherosclerosis is higher in those diseases which cause endothelial dysfunction d. Atherosclerotic plaques contain cholesterol crystals

20. Which diseases are linked to H pylori infection? a. Gastric cancer b. Duodenal ulcer c. Mucosa associated (MALT) lymphoma d. Gastric ulcer

a. Gastric cancer b. Duodenal ulcer c. Mucosa associated (MALT) lymphoma d. Gastric ulcer

14. Alterations of bowel function in shock: a. increased permeability b. mesenteric vasoconstriction c. increased peristaltic activity d. bacteria invade into the blood or lymph

a. increased permeability b. mesenteric vasoconstriction d. bacteria invade into the blood or lymph

``` 7. Participates in the inflammatory process: A.platelet B.endothelial cells C.mast cell D.eosinophil granulocyte ```

A.platelet B.endothelial cells C.mast cell D.eosinophil granulocyte

15,2 Precipitating causes of heart failure include: a. increased fat intake b. fever c. Hyperthyroidism d. increased salt intake

b. fever c. Hyperthyroidism d. increased salt intake

21. Which drug is NOT used in H pylori eradication protocols? (1) a. clarithromycin+amoxicillin (combined antibiotics treatment) b. Proton pump inhibitor c. Bismuth d. metronidazole (antibiotic covering the anaerobic bacteria) e. NSAIDs

e. NSAIDs

34. hypertension can develop due to: a. conn-syndrome b. 11-b-hydroxylase deficiency c. sheehan-syndrome d. hyperthyroidism

a. conn-syndrome b. 11-b-hydroxylase deficiency d. hyperthyroidism

17. Characteristic findings in Cushing-syndrome: a. random secretion of ACTH b. absence of normal diurnal rhythm c. TSH-, GH-, LH-, FSH-secretion are increased d. Hyperpigmentation

a. random secretion of ACTH b. absence of normal diurnal rhythm (Slide 23)

4. Processes important in the formation of pro-inflammatory HDL particle: Select one or more: a. Glycation occuring in diabetes mellitus b. Chronic inflammatory processes c. Apo A-1 modifying effect of myeloperoxidase d. Hypertension

b. Chronic inflammatory processes | c. Apo A-1 modifying effect of myeloperoxidase

14. Decompensation of heart failure may be caused by: a) Pulmonary embolism b) Intercurrent infection c) Increased dietary salt intake d) Atrial fibrillation

a) Pulmonary embolism b) Intercurrent infection c) Increased dietary salt intake d) Atrial fibrillation

9. Clinical manifestation of Prolactinoma in women: a. Gynecomastia b. Amenorrhea c. Hirsutism d. Virilization

b. Amenorrhea | c. Hirsutism

26. Obstructive shock can be caused by: c. heart tamponade d. pulmonary embolization e. ventricular fibrillation f. acute pancreatitis

c. heart tamponade | d. pulmonary embolization

28. Signs of primary adrenocortical insufficiency: a. hypertension b. GI disturbances c. vitiligo d. weakness, fatigue, losing weight

b. GI disturbances c. Vitiligo (Associated with Addison's - Wiki) d. weakness, fatigue, losing weight

8. 1 Evidence supporting the response to injury hypothesis: a. Decreased endothelial production of NO/PGI2 b. Atherosclerotic plaques contain cholesterol crystals c. The uptake of modified LDL by macrophages d. Distribution of the atherosclerotic plaques

a. Decreased endothelial production of NO/PGI2 b. Atherosclerotic plaques contain cholesterol crystals c. The uptake of modified LDL by macrophages d. Distribution of the atherosclerotic plaques

22. Which therapy improves/prolongs survival in heart failure patients: a. ACE inhibitors b. ARBs c. ß blockers d. any vasodilator

a. ACE inhibitors b. ARBs (Angiotensin receptor blockers) c. ß blockers

17. Chronic heart failure may be caused by: a. hyperkalemia b. hypertension c. valvular heart disease d. CHD

b. hypertension c. valvular heart disease d. CHD

2. Synthesized by the zona reticularis cells in the adrenal cortex: (1) a. cortisol b. 11-deoxycortisol c. corticosterone d. dehydroepiandrosterone e. aldosterone

d. Dehydroepiandrosterone

16. Plasmin causes vasodilation through FDPs (fibrin degradation products): True/False

False

15. Typical complication of obesity: a. Haemolytic anaemia b. Hypertension c. Type 2 diabetes mellitus d. Lung fibrosis

b. Hypertension | c. Type 2 diabetes mellitus

6. early, non adapted starvation (few days) is characterized by : a. decreased ketone body utilization in the brain b. decreased glucose utilization in RBC c. gluconeogenesis in the liver and kidney cortex d. enhanced glycogenolysis in the liver

c. gluconeogenesis in the liver and kidney cortex

31. Energy need is increased in: a. Ascites b. Wound healing c. Apathy d. Decreased thyroid function

a. Ascites | b. Wound healing

39. It may cause sudden cardiac death: a. torsade de pointes tachycardia b. ventricular fibrillation c. ventricular tachycardia d. atrial fibrillation

a. torsade de pointes tachycardia | b. ventricular fibrillation

``` 12. Mediators increasing the inflammatory reaction: A.IL-2 B.IL-1 C.IL-6 D.IL-10 ```

A.IL-2 B.IL-1 C.IL-6

3. What is the shock index? a. pulse rate (bpm) / RRsys (mmHg) b. respiratory rate (1/min) / mean arterial pressure (mmHg) c. pulse rate (bpm) / mean arterial pressure (mmHg) d. respiratory rate (1/min) / RRdias (mmHg)

a. pulse rate (bpm) / RRsys (mmHg)

15. 2 Changes of microcirculation in shock: e. edema f. hemoconcentration g. arterial/arteriolar vasoconstriction h. resistance of post capillary vessels are increased

e. edema f. hemoconcentration g. arterial/arteriolar vasoconstriction h. resistance of post capillary vessels are increased (Slide 39 and https://www.ncbi.nlm.nih.gov/pubmed/22189462)

7. Preload is determined by: a. TPR (total peripheral resistance) b. total blood volume c. ventricular function d. venous return

b. total blood volume | d. venous return

26. Which deficiency causes recurrent pyogenic infections? A.Deficient phagocyte function B.Deficient complement function C.Deficient killer T lymphocyte function D.Deficient antibody production

A.Deficient phagocyte function B.Deficient complement function D.Deficient antibody production

23. Which one is not the function of parathormone: a. Inhibition of osteoclasts b. Stimulation of calcitriol production c. Inhibition of osteoblasts d. Stimulation of Ca2+ reabsorption in the renal tubules

a. Inhibition of osteoclasts

25. Clinical signs of chronic primary adrenocortical insufficiency, except: (1) a. GI disturbances b. hyperpigmentation c. muscle weakness d. hypotension e. hypernatremia

e. hypernatremia

19. Which statements are true about Idiopathic type 1 diabetes? a. No evidence of autoimmunity is present b. It is a rare disease c. The etiology is well known d. Severe insulin deficiency may be present, but insulin requirement widely varies

a. No evidence of autoimmunity is present b. It is a rare disease d. Severe insulin deficiency may be present, but insulin requirement widely varies

6. The ammonia level of plasma is decreased by the: a. decreased activity of glutamine synthetase in the muscle b. increased activity of glutamine synthetase in the liver c. increased activity of urea cycle d. increased intake of proteins

b. increased activity of glutamine synthetase in the liver | c. increased activity of urea cycle

18. signs of acute Addisonian crisis, except: a. Fever b. Hypotension and shock c. Hypoglycemia d. Edema

d. Edema

18. Which statement is true regarding calcium and phosphate metabolism? a. Vitamin D synthesis is induced by increased serum phosphate level in kidney. b. FGF-23 blocks the synthesis of vitamin D in the kidney. c. PTH secretion is induced by increased serum phosphate level. d. FGF-23 synthesis is induced by 1,25-Dihydroxy Vit-D

b. FGF-23 blocks the synthesis of vitamin D in the kidney. c. PTH secretion is induced by increased serum phosphate level. d. FGF-23 synthesis is induced by 1,25-Dihydroxy Vit-D (Slide 18)

6. Arrhythmias of genetic origin: a. CPVT (catecholaminergic polymorphic ventricular tachycardia) b. ZiehI-Neelsen syndrome c. Brugada syndrome d. Bermuda syndrome

a. CPVT (catecholaminergic polymorphic ventricular tachycardia) c. Brugada syndrome

``` 28. Effective therapies against hereditary angioedema (HAE) A. Intravenous adrenalin B. Na-cromoglycate C. C1q-inhibitor D. Intravenous corticosteroid E. Antihistamin ```

C. C1q-inhibitor

15. Which of the following statements are NOT true? a. Arteriosclerosis is a general term describing any hardening of medium or large arteries b. Arteriolosclerosis is a hardening of medium arteries c. Atherosclerosis is a hardening of an artery specifically due to an atheromatous plaque formation d. Arteriosclerosis is a general term describing any hardening of small arteries

b. Arteriolosclerosis is a hardening of medium arteries | d. Arteriosclerosis is a general term describing any hardening of small arteries

9. Which lipoprotein plasma level is the most frequently elevated in Hypothyroidism? Select one: a. HDL b. CHY c. VLDL d. IDL e. LDL

e. LDL | Slide 47 -IDL is well but seems like that one is a better answer

22. What can cause colorectal cancer in young adults (<40 years)? a. Lynch syndrome b. familial adenomatous polyposis c. somatic mutations of the APC gene d. hereditary nonpolyposis colorectal cancer (HNPCC) linked mutations

a. Lynch syndrome b. familial adenomatous polyposis c. somatic mutations of the APC gene d. hereditary nonpolyposis colorectal cancer (HNPCC) linked mutations

18. Which of the following contributes to the development of atrial flutter? a. decreased conduction speed in the atrial muscle b. dilation of the atria c. decreased refractoriness in the atrial muscle d. increased sympathetic tone

a. decreased conduction speed in the atrial muscle b. dilation of the atria c. decreased refractoriness in the atrial muscle

12. Evidence supporting the lipid or infiltration theory: a. intervention studies b. epidemiologic observations c. evidence of animal experiments d. cholesterol is found in the atherosclerotic vessel wall

a. intervention studies b. epidemiologic observations c. evidence of animal experiments d. cholesterol is found in the atherosclerotic vessel wall

12. 2 Causes of primary amenorrhea: a. Turner syndrome b. hypopituitarism c. artificial abortion d. Pregnancy

a. Turner syndrome | b. hypopituitarism

22. Foetor hepaticus is the name of: a. alcoholic cirrhosis b. the characteristic smell of the breath of cirrhotic patients c. alcoholic steatohepatitis d. alcoholic steatosis e. the fetal liver

b. the characteristic smell of the breath of cirrhotic patients

17. Plasmin activates the complement system through C3 cleavage . True/False

True

15. 2 Hypertension may lead to the following complications: a. glomerulopathy b. retinal hemorrhage c. cataract d. left ventricular hypertrophy

a. glomerulopathy b. retinal hemorrhage c. cataract d. left ventricular hypertrophy

25. Clinical signs characteristic to compensated phase of hypovolemic shock: a. cold, pale extremities b. bradycardia c. tachypnea d. SBP < 70 mmHg

a. cold, pale extremities c. tachypnea (Slide 24-27)

3. Corticotropin-related peptides, except: a. MSH b. LPH c. endorphins d. ACTH e. Prolactin

e. Prolactin | Slide 4

28. The consequence of an increased NADH/NAD ratio in the liver of alcoholic patients: a. MEOS is induced b. beta-oxidation of fatty acids is inhibited c. citrate cycle is inhibited d. gluconeogenesis is inhibited

b. beta-oxidation of fatty acids is inhibited c. citrate cycle is inhibited d. gluconeogenesis is inhibited

12. Which drug classes are used to block the hyperacidity? a. Proton pump inhibitors b. Histamine H2 antagonists c. Prostaglandin analogs d. Gastrin

a. Proton pump inhibitors b. Histamine H2 antagonists c. Prostaglandin analogs

27. It is true about the loss of myocardial cells in heart failure: a. it may be caused by apoptosis b. its speed is 10-100 times higher than in healthy subjects c. it may be caused by autolysis d. Its speed is faster only if the heart failure is caused by ischemic heart disease

a. it may be caused by apoptosis

14. Possible clinical symptom(s) of familial hypercholesterolemia: Select one or more: a. tuberous xanthomas b. xanthoma tendinosum c. tuberoeruptive xanthomas d. arcus corneae

a. tuberous xanthomas b. xanthoma tendinosum d. arcus corneae

14. High risk groups for hypothyroidism: a. women b. type 1 DM c. age between 45-65 d. patients with Graves-Basedow disease or postpartum thyroid dysfunction in the anamnesis

a. women b. type 1 DM c. age between 45-65 d. patients with Graves-Basedow disease or postpartum thyroid dysfunction in the anamnesis

25. Caput medusae” is the name: a. for dilated capillaries b. for spider nevi c. of the dying jellyfish d. periumbilical dilated veins

d. periumbilical dilated veins

21. Which statements are true about type 1 diabetes? a. Since insulin is administered, no dietary changes are necessary b. Genetic determination of susceptibility plays a key role in the pathogenesis of the disease c. The disease mostly occurs in children of in the youth d. Patients are prone to ketosis

b. Genetic determination of susceptibility plays a key role in the pathogenesis of the disease (HLA DR3) c. The disease mostly occurs in children of in the youth d. Patients are prone to ketosis

4. Liver disease may cause a. Fatty liver b. Hyperglycemia c. Hypoglycemia d. Bleeding tendency

a.Fatty liver b.Hyperglycemia (postprandial) c.Hypoglycemia (in alcoholics, after prolonged fasting) d.Bleeding tendency (Slide 9)

9. 2 Heart failure may be caused by/ Underlying causes of heart failure include/Possible causative agents: a. pulmonary embolism b. Alcoholism c. Myocarditis d. hypertension

a. pulmonary embolism b. Alcoholism c. Myocarditis d. hypertension

11. 2 True statement(s) about obesity types: a. Android type obesity is a risk factor for diabetes mellitus type 1 b. Hyperplastic type is typically formed in adulthood c. Apple type obesity has worse prognosis compared to pear type d. Its prevalence increases in the last year in developed countries

c. Apple type obesity has worse prognosis compared to pear type d. Its prevalence increases in the last year in developed countries

``` 24. Clinical signs characteristic to progressive phase of hypovolemic shock: a. tissue acidosis b. decreased capillary filling c. oliguria/anuria d. acrocyanosis ```

a. tissue acidosis b. decreased capillary filling c. oliguria/anuria d. acrocyanosis

19. ADH release is stimulated by: a. Histamine b. Emotional factors and stress c. Plasma osmolality > 280 mosm/l d. Sleep

a. Histamine b. Emotional factors and stress c. Plasma osmolality > 280 mosm/l d. Sleep

8. Which statements are true about irritable bowel syndrome? a. Organic diseases must be excluded before making a diagnosis b. It is an absorption disorder c. It causes a complex problem for differential diagnosis d. It accounts for 20% of gastrointestinal symptoms

a. Organic diseases must be excluded before making a diagnosis c. It causes a complex problem for differential diagnosis (Slide 53)

10. Possible causes of secondary hypertension: a. primary hyperaldosteronism b. increased salt intake c. Sleep apnea d. Cushing’s syndrome

a. primary hyperaldosteronism c. Sleep apnea d. Cushing’s syndrome (Slide 33)

32. The prognosis of proximal AV blocks is significantly worse than that of the distal AV blocks. True/False

False

24. The most common cause of chronic primary adrenocortical insufficiency: a. tumor metastasis b. hemorrhagic necrosis c. tuberculosis d. fungal infection e. autoimmune

e. autoimmune

7. 2 Preload is determined by: a. Lusitropy of the ventricles (distention capability of ventricles) b. Ventricular function c. CVP (central venous pressure) d. Blood volume

a. Lusitropy of the ventricles (distention capability of ventricles) c. CVP (central venous pressure) d. Blood volume

7. The possible causes of the endothelial dysfunction based on the response to injury hypothesis: a. Genetic alterations b. Modified LDL (ox-LDL, small-LDL) c. Pathogenic microorganisms (CMV, Chlamydia pneumoniae, etc) d. Increased serum HDL concentration

a. Genetic alterations b. Modified LDL (ox-LDL, small-LDL) c. Pathogenic microorganisms (CMV, Chlamydia pneumoniae, etc)

3. What features or stages may occur in Crohn's disease? a. fibrostenotic form b. it might be asymptomatic in remission c. fistulizing Crohn's disease d. Reflux-type disease

a. fibrostenotic form b. it might be asymptomatic in remission c. fistulizing Crohn's disease

36. Left sided heart failure may cause a) Distended neck veins b) Fatigue c) Nycturia d) Pulmonary congestion e) weakness

b) Fatigue c) Nycturia d) Pulmonary congestion e) weakness (Slide 8)

22. Which Non-HLA gene does NOT play a role in the development of type 1 diabetes? a. IL2RA b. IL2RB c. Insulin d. PTPN22 e. CTLA4

b. IL2RB

4. The post-absorption stage (6-24hr) of the feeding cycle is characterized by: a. unchanged glucose utilization in the medulla of the kidneys b. increasing ketone body production in the liver c. in the muscles, glucose uptake is reduced d. the brain primarily uses fatty acids as energy source

a. unchanged glucose utilization in the medulla of the kidneys b. increasing ketone body production in the liver c. in the muscles, glucose uptake is reduced

25. 2 Clinical signs characteristic to compensated phase of hypovolemic shock: e. acrocyanosis f. decreased capillary filling g. oliguria/anuria h. tissue acidosis

f. Decreased capillary filling g. Oliguria/ Anuria (Slide 24-27)

21. Causes of distributive shock: a. spinal cord injury b. allergic reaction triggered by penicillin c. pulmonary embolism d. sepsis

a. spinal cord injury b. allergic reaction triggered by penicillin d. sepsis

19. Diagnostic procedures applied in testing for obesity, except: (1) a. electromyography b. measuring waist circumference c. measuring skin folding thickness d. Body mass index (BMI) calculation

a. electromyography

13. Which drug classes can reduce the hyperacidity? a. Histamine H2 receptor antagonists b. NSAIDs c. Antacids d. Gastrin

a. Histamine H2 receptor antagonists | c. Antacids

15. Sheehan’s syndrome may develop, due to:(1) a. adenoma b. brain edema c. infection d. hypophysectomy e. increased blood loss at birth

e. increased blood loss at birth

1. Increased radioactive iodine intake in thyroid gland: a. Iodine deficiency b. Hashimoto’s thyroiditis c. Toxic adenoma d. thyrotoxicosis factitia

a. Iodine deficiency | c. Toxic adenoma

8. Hypoglycemia may cause the following: a. Dry, warm skin b. Confusion c. Muscle cramps d. Tachycardia

b. Confusion c. Muscle cramps d. Tachycardia

6. How much of the circulating T4 is free? a. 5-10 % b. 20-50 % c. 0.01-0.05% d. 1-3 % e. 0.1-0.3 %

c. 0.01-0.05%

40. Daily energy need of a 25 year old, healthy man with 75 kg body weight with average physical activity: a. 1700 kcal/day b. 2600 kcal/day c. 2000 kcal/day d. 2300 kcal/day e. 3000 kcal/day

b. 2600 kcal/day

32. Cause of Nanosomia, except: (1) a. achondroplasia b. McCune–Albright syndrome c. Turner syndrome d. hypothyroidism e. osteogenesis imperfecta

b. McCune–Albright syndrome

37. It is true for Brugada syndrome: a. PSVTs are common in these patients b. it is inherited c. coved ST elevation is seen in the right precordial leads d. the arrhythmias causing sudden death originate from the left ventricle

b. it is inherited | c. coved ST elevation is seen in the right precordial leads

5. Which of the following factors contribute to the development of atherosclerosis according to the aging theory: a. The endothelial endothelin production is increased by aging b. The uptake of modified LDL by macrophages c. The endothelial NO production is decreased by aging d. The component of connective tissue of vessels and other tissues change by aging

d. The component of connective tissue of vessels and other tissues change by aging

36. Correct statements about substrate level regulation of the caloric cycle: a. elevated glucose level inhibits fatty acid synthesis b. products of β-oxidation inhibit gluconeogenesis c. elevated fatty acid levels enhance glycogenolysis d. Elevated fatty acid levels inhibits cellular glucose uptake

c. Elevated fatty acid levels enhance glycogenolysis | d. Elevated fatty acid levels inhibits cellular glucose uptake

27. It is true about leukocyte adhesion deficiency type 1 (LAD1) : A. a problem of the cytoplasmic component of NADPH oxidases B. a lack of the MPO-H2O2 system C. it is a defect of CD11/ CD18 integrins D. it is a defect of the selectin receptors E. a problem of the membrane component of NADPH oxidases

C. it is a defect of CD11/ CD18 integrins

5. Clinical signs indicating circulatory shock: a. pallor b. redness, fever c. respiratory rate < 7/min d. respiratory rate > 29/min

a. pallor b. redness, fever c. respiratory rate < 7/min d. respiratory rate > 29/min

6. Which of the following factors contribute to the development of atherosclerosis according to the response to injury hypothesis: a. Endothelial injury induces platelet activation b. Composition of EC matrix is changed due to chronic inflammation c. Mediators released from activated platelets induce smooth muscle cell migration from the media into the intima d. The changed EC matrix causes lipid deposition

a. Endothelial injury induces platelet activation b. Composition of EC matrix is changed due to chronic inflammation c. Mediators released from activated platelets induce smooth muscle cell migration from the media into the intima d. The changed EC matrix causes lipid deposition

24. If an examined person's BMI is 32.1 kg / m2 , his / her classification: a. pre-obesity b. normal body weight c. obesity grade I d. obesity grade II

c. obesity grade I | Slide 41

2. Osteoporosis may develop due to a. renal disease b. glucocorticoids c. epilepsy d. mineralocorticoids

a. Renal disease b. Glucocorticoids (RANKL elevation) c. Epilepsy (Assuming the patient wants to live and takes medications for it) (Slides 65-66)

10. True statements about the leptin gene: a. it is produced in insufficient amounts in obesity b. leptin-resistance is presumed in obesity c. it affects hypophysis function d. it is coded by the ob-gene

b. leptin-resistance is presumed in obesity d. it is coded by the ob-gene Slide 71

16. Response(s) in heart failure a. Water retention b. Appearance of fetal myosin-forms c. Remodeling of the myocardium d. Increases in parasympathetic tone

a. Water retention b. Appearance of fetal myosin-forms c. Remodeling of the myocardium

8. Possible symptoms of arrhythmias: a. warm flushing b. dizziness, syncope c. palpitation d. headache

b. dizziness, syncope | c. palpitation

17. Possible cause of primary hypothyroidism: a. Irradiation (radioactive iodine therapy of hyperthyroidism) b. lithium therapy c. Hashimoto’s thyroiditis d. Plummer’s disease

a. Irradiation (radioactive iodine therapy of hyperthyroidism) b. lithium therapy c. Hashimoto’s thyroiditis

14. Which are the symptoms of hyperacidity: a. Pain relief after eating b. Nausea c. Chest pain d. Heartburn

b. Nausea c. Chest pain d. Heartburn

21. Possible causes of euthyroid goiter: a. Hashimoto’s thyroiditis b. Graves-Basedow disease c. iodine deficiency d. subacute thyroiditis

a. Hashimoto’s thyroiditis c. iodine deficiency d. subacute thyroiditis

34. The impulse following a nonconducted one must be conducted in case of a high grade block. True/False

False

``` 6. Somatomammotropin peptides: A. hCG B. LH C. LPH D. Prolactin E. MSH ```

D. Prolactin | Slide 4

20. typical for anaphylaxis: a. systemic reaction of sepsis b. triggered by allergic reaction c. allergen can be food d. the consequence of vomiting or diarrhea or dehydration

b. triggered by allergic reaction | c. allergen can be food

24. False statement for dwarfism: a. connective tissue disorders can also cause b. the most common cause is achondroplasia formed as a result of FGFR3 mutation c. adult height < 147 cm d. can develop even with an increased secretion of GH e. Se GH-level is always low

e. Se GH-level is always low

10. The most common arrhythmia that needs treatment(1): a. atrial fibrillation b. LBBB c. ventricular premature contraction d. ventricular fibrillation

a. atrial fibrillation

22. What are the characteristics of renal failure-induced secondary hyperparathyroidism? a. Increased vitamin D level b. Hyperphosphatemia c. Parathyroid hyperplasia d. Reduction of PTH reactivity in the bones

b. Hyperphosphatemia c. Parathyroid hyperplasia d. Reduction of PTH reactivity in the bones (Slide 32)

22. 2 Cause of secondary mineralocorticoid excess with hypertension,except: a. Cirrhosis b. Bartter-syndrome c. renovascular disease d. estrogen therapy

a. Cirrhosis (Edematous not Hypertensive) | b. Bartter-syndrome (Edematous not Hypertensive)

15. Which statements are true about LADA? a. Autoantibodies are never detectable b. Its clinical presentation resembles type 2 diabetes c. LADA patients will require insulin treatment during their lifetime d. It occurs only in Asian people

b. Its clinical presentation resembles type 2 diabetes c. LADA patients will require insulin treatment during their lifetime (Slide 18)

30. Essential diagnostic criteria of metabolic syndrome: a. RR: > 135/85 mmHg b. Se TG: < 1.7 mM c. waist circumference in men: > 102 cm; in women: > 88 cm d. Se HDL in men: < 1.0 mM; in women: < 1.3 mM

c. waist circumference in men: > 102 cm; in women: > 88 cm d. Se HDL in men: < 1.0 mM; in women: < 1.3 mM (Slide 100)

8. Integrins play an important role in extravasation. | True/False

True

24. What are the potential symptoms of colon cancer? a. alternating diarrhea and constipation b. jaundice c. bloody stools d. anemia

a. alternating diarrhea and constipation c. bloody stools d. anemia

28. True statements about the metabolic syndrome: a. Se LDL concentration is essential to diagnose metabolic syndrome b. It is not a disease, but rather a cluster of disorders of your body’s metabolism c. concomitance of certain risk factors dramatically increases the risk for ischemic heart diseases d. the pear type obesity has higher risk

b. It is not a disease, but rather a cluster of disorders of your body’s metabolism c. concomitance of certain risk factors dramatically increases the risk for ischemic heart diseases

41. Clinical signs of androgen excess in women: a. gynecomastia b. hirsutism c. alopecia d. hypertension

b. hirsutism c. alopecia (Spot baldness) d. hypertension

23. What is the mechanism of hyperaldosteronism induced hypertension? a. increased intracellular calcium levels in smooth muscle cells b. increased sodium retention thereby increasing a intravascular volume c. decreased potassium secretion in the kidney d. Increased plasma potassium levels

b. increased sodium retention thereby increasing a intravascular volume

1. 4 Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the vessels? a. Hypertension → mechanical compression of vascular wall b. Hyperlipidemia → spasm of vasal vasodilation → hypoxia c. Smoking - nicotine → potentiates catecholamine effect → spasm of vasalum → hypoxia d. Stress → spasm of vasal vasodilation → hypoxia

a. Hypertension → mechanical compression of vascular wall c. Smoking - nicotine → potentiates catecholamine effect → spasm of vasalum → hypoxia (Slide 84)

9. Which drug does NOT cause hyperglycemia? (1) a. Glucocorticoid steroids b. Nicotinic acid c. Beta agonists d. Interferon (IFN)-alpha e. pentamidine

d. Interferon (IFN)-alpha | IFN-Alpha inhibit the auto-antibody against beta cells.

21. What is hepatorenal syndrome? a. Severe impairment of liver function seen in kidney disease b. Severe impairment of renal function seen in liver disease c. Severe lesion of the liver parenchyma seen in kidney disease d. Any condition in which there is a simultaneous liver and kidney dysfunction e. Severe lesion of the kidney parenchyma seen in liver disease

b.Severe impairment of renal function seen in liver disease

29. May play a role in the catabolic processes characterizing Cachexia : (1) a. Complement activation b. Increased glycation c. Ubiquitin-proteasome system d. Mitochondrial terminal oxidation e. Fatty acid oxidation

c. Ubiquitin-proteasome system

5. Clinical signs of liver disease include: a. palmar erythema b. koilonychia c. hypertrichosis d. spider nevi

a. palmar erythema | d. spider nevi

2. the only FALSE one: a. amino acids are metabolized to pyruvate b. triglycerides are hydrolyzed to fatty acids and glycerol c. the mass of stored fat exceeds that of stored protein d. fatty acids can be transformed to glucose e. the mass of glycogen stores does not reach the of 1/20 of stored fat

d. fatty acids can be transformed to glucose

27. Causes of Cardiogenic Shock: a. rupture of the septum b. embolism c. ventricular fibrillation d. pneumothorax e. acute myocardial infarction

a. rupture of the septum b. embolism c. ventricular fibrillation d. pneumothorax e. acute myocardial infarction (Slide 30)

14. Which genetic syndromes are sometimes associated with diabetes? a. Turner syndrome b. Duchenne syndrome c. Klinefelter syndrome d. Down syndrome

a. Turner syndrome b. Duchenne syndrome (Muscular Dystrophy) c. Klinefelter syndrome d. Down syndrome For Duchenne: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452344/

37. 17-ketosteroids in urine are the metabolite of: a. androgens b. estrogens c. mineralocorticoids d. none of them e. glucocorticoid

a. androgens

40. Clinical symptoms of Turner syndrome: a. Obesity b. Short neck, shield shape chest c. Short statured d. Hashimoto’s thyroiditis

a. Obesity b. Short neck, shield shape chest c. Short statured d. Hashimoto’s thyroiditis (Slide 54)

12. Which of the following may be signs of severe hypocalcemia: a. tetany b. peptic ulcer c. QT interval prolongation d. diabetes insipidus

a. tetany | c. QT interval prolongation

4. 2 Which of the following factors contribute to the development of atherosclerosis according to thrombogenic theory? a. Changes of the TXA2 / PGI2 ratio b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation c. Infiltration of LDL into the arterial wall d. The absorption of modified LDL by macrophages

a. Changes of the TXA2 / PGI2 ratio | b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation

21. PTH directly causes the following, except:(1) a. Inhibition of Osteogenesis b. Smooth Muscle Contraction c. Cardiac Hypertrophy d. Positive Chronotropy

b. Smooth Muscle Contraction | Relaxation - Slide 13

9. Which one is isolated hypertension? a. hypertension in the pulmonary circulation b. hypertension in the systemic circulation c. portal hypertension d. renovascular hypertension

c. portal hypertension | d. renovascular hypertension

32. Right sided heart failure may cause: a. abdominal discomfort b. pulmonary edema c. distended neck veins d. hydrothorax

a. abdominal discomfort c. distended neck veins d. hydrothorax (Slide 10)

13. Which statements are FALSE regarding vitamin D? a. It decreases the expression of PTH in the parathyroid gland. b. It regulates gene expression. c. It stimulates the secretion of renin in the kidney. d. It decreases the expression of osteopontin

c. It stimulates the secretion of renin in the kidney. | d. It decreases the expression of osteopontin

14. Possible mechanism(s) for obesity formation: a. decreases in energy consumption b. blood supply alterations of adipose tissue c. decreases in heat generation d. excess food intake

a. decreases in energy consumption c. decreases in heat generation d. excess food intake

20. Cardiovascular protective functions of the HDL particle: a. HDL decreases the receptor mediated endocytosis of CHY- and VLDL- remnant particles b. Enhances the peripheral uptake of LDL particles by its APO-E content c. Macrophage presence is decreased in the vessel wall as a result of HDL-effect d. HDL has antioxidant activity

c. Macrophage presence is decreased in the vessel wall as a result of HDL-effect d. HDL has antioxidant activity

26. True statement for Hashimoto’s thyroiditis: a. often occurs together with type 1 DM b. anti-Tg Ab usually negative c. anti-TPO Ab often increased significantly d. patients usually have painless goiter

a. often occurs together with type 1 DM c. anti-TPO Ab often increased significantly d. patients usually have painless goiter

``` 20. Chemotactic agent of endogenous origin A.C5a, C3a B. LPS C.IL-8 D.LTB4 ```

A.C5a, C3a C.IL-8 D.LTB4

15. Plasmin enhances the removal of deposited fibrin. | True/False

True

18. (Characteristic) metabolic alterations in shock: e. Increased ketogenesis f. Decreased glucose oxidation in muscle cells h. Decreased lipolysis in adipose tissue g. Decreased serum glucocorticoid level

e. Increased ketogenesis f. Decreased glucose oxidation in muscle cells (slide 54)

9. Which disease is not characterized by hypercalcemia? a. Granulomatous diseases b. Secondary hyperparathyroidism c. Paget disease d. Primary hyperparathyroidism

b. Secondary hyperparathyroidism | Slide 32 - Cause and Effect might be mixed up

21. True statement for secondary mineralocorticoid-excess: (1) a. all of them b. se renin level is low c. can occur in liver-cirrhosis d. can be due to 11β-hydroxylase deficiency e. can be due to SIADH

c. can occur in liver-cirrhosis

20. AVNRT should be terminated by: a. Carotid massage b. Cardioversion c. PCI (percutaneous coronary intervention) d. Valsalva maneuver

a. Carotid massage | d. Valsalva maneuver

9.The selectins play an important role in extravasation. | True/False

True | Although extravasation in the non-medical literal way means squeezing out - Rolling is a Phase of Extravasation

24. Antidromic AVRT can always be clearly differentiated from ventricular tachycardias. True/False

False | Can Mimc VT

25. Characteristic findings in Hashimoto’s thyroiditis, except (1): a. hyperthyroidism is observed usually at the beginning of the disease b. enlarged multinodular goiter c. histologically lymphocytic/plasmacytic infiltration in the thyroid gland d. genetically transmitted e. more common in women

b. enlarged multinodular goiter

17. 2 Which ones are the potential complications of gastroesophageal reflux? a. Duodenal ulcer b. Esophageal cancer c. Barrett metaplasia d. nutcracker esophagus

b. Esophageal cancer c. Barrett metaplasia d. Nutcracker esophagus - (Wiki - GERD)

16. Clinical signs of hypothyroidism, except: (1) a. Carotenoderma b. Tachycardia c. Myxedema d. Constipation e. Anemia

b. Tachycardia

25. Which statement is true about cardiac hypertrophy? a) Cardiac hypertrophy is always abnormal b) Hypertrophy in heart failure is harmful in the long run, because it increases the risk for sudden death c) Hypertrophy in heart failure beneficial in the short run, because it increases contractility d) Hypertrophy is not correlated with the risk for arrhythmias

b) Hypertrophy in heart failure is harmful in the long run, because it increases the risk for sudden death c) Hypertrophy in heart failure beneficial in the short run, because it increases contractility

5. In starvation, it is true in relation to the dynamics of nutrient loss Except (1): a. the reduction of stored protein is initially slower than that of stored fat b. the reduction of stored protein is accelerated towards the very end of starvation c. decreases in stored fat is more rapid compared to that of stored protein d. after 8 weeks, the amount of stored fat does not exceed 15% of the starting amount e. stored carbohydrate becomes extinct within a few days

c. decreases in stored fat is more rapid compared to that of stored protein (Slide 13)

29. The PR intervals are always constant and prolonged in Mobitz type II second degree AV Block. True/False

True | PR Constant = Mobitz type II

40. Increased atrial rate may cause: a. impaired coronary perfusion b. appearance of non-conducted beats c. P pulmonale d. palpitation

b. appearance of non-conducted beats | d. palpitation

9. possible cause of Conn's syndrome, Except: a. Adrenocortical hyperplasia b. 17-alpha-hydroxylase deficiency c. 21-alpha-hydroxylase deficiency d. Bartter syndrome

c. 21-alpha-hydroxylase deficiency | d. Bartter syndrome

7. Compensatory mechanism in shock: a. Chemoreceptor reflexes b. Baroreceptor reflexes c. Reabsorption of tissue fluid d. Cerebral ischemia

a. Chemoreceptor reflexes b. Baroreceptor reflexes c. Reabsorption of tissue fluid d. Cerebral ischemia

1. 1 Which of the following plays a role in the development of Crohn's Disease? a. gut flora (microbiota) b. autoantibodies c. Inflammation d. intestinal immune system

a. gut flora (microbiota) b. autoantibodies c. Inflammation d. intestinal immune system

15. 2 Typical complication of obesity: a. Disease of the skeletal system b. malignancy c. autoimmune disease d. gallstone

a. Disease of the skeletal system b. malignancy d. gallstone

9. Heart failure may be caused by/ Underlying causes of heart failure include/Possible causative agents: a. Orthostatic hypotension b. Valvular heart disease c. Increased salt intake d. Alcoholism

b. Valvular heart disease c. Increased salt intake d. Alcoholism

4. Effects of TSH: a. increase the size of thyroid gland b. reduces the vascularization of thyroid gland c. increase the synthesis and release of T4 / T3 via Ca2+-intracellular signaling d. enhance iodine uptake

a. increase the size of thyroid gland d. enhance iodine uptake (In b it is done by cAMP mechanism not calcium)

35. Causes of primary hypogonadism: a. Mumps viral infection b. Klinefelter syndrome c. Seminoma d. Cryptorchidism

b. Klinefelter syndrome | d. Cryptorchidism

15. Clinical signs of hypothyroidism: a. Pretibial myxedema b. Anemia c. Hypertriglyceridemia d. Carotenoderma

a. Pretibial myxedema (General Skin Sign) b. Anemia c. Hypertriglyceridemia d. Carotenoderma Slide 13 https://en.wikipedia.org/wiki/Hypothyroidism

3.Characteristics of chronic inflammation : A.Edema formation B.Angiogenesis C.Vasodilation D.Accumulation of lymphocytes and macrophages

B.Angiogenesis | D.Accumulation of lymphocytes and macrophages

4. What are the chronic complications of diabetes? a. Retinopathy b. Nephropathy c. Idiopathic myelofibrosis d. Ischemic heart disease

a. Retinopathy b. Nephropathy d. Ischemic heart disease

2. Indicative of irreversible phase of shock a. gray, cyanotic skin b. weak, suppressible pulse c. comatose stage d. sweating

b. weak, suppressible pulse | c. comatose stage

13. Plasminogen activator: A.Activators of plasma origin (e.g. Trypsin) B.Hageman (XII) factor C.Macrophage plasminogen-activator D.Bacterial compounds (e.g. Streptokinase)

A.Activators of plasma origin (e.g. Trypsin) B.Hageman (XII) factor C.Macrophage plasminogen-activator D.Bacterial compounds (e.g. Streptokinase)

18. (Characteristic) metabolic alterations in shock: a. increased glucose uptake by muscle cells b. decreased glucose oxidation in muscle cells c. increased serum glucose level d. increased proteolysis in the muscle

a. increased glucose uptake by muscle cells b. decreased glucose oxidation in muscle cells c. increased serum glucose level d. increased proteolysis in the muscle (slide 54)

30. Second degree Wenckebach type blocks occur not only in the AV junction. True/False

True | Wenckebach type = Mobitz type I

19. Select the right treatment - Choose the matching drug-effect pairs in patients with heart failure: a. diuretics – to decrease afterload b. β blocker – to decrease sympathetic activity c. ACE inhibitor – to decrease the activity of RAAS d. digitalis – positive inotropic effect

a. diuretics – to decrease afterload b. β blocker – to decrease sympathetic activity c. ACE inhibitor – to decrease the activity of RAAS d. digitalis – positive inotropic effect

3. The postabsorptive stage (6-24hr) of the alimentation cycle is characterized by: a. low insulin/glucagon ratio b. in the muscles, the energy source tissue is primarily glucose c. glycogenolysis d. decreasing fatty acid supply

a. low insulin/glucagon ratio | c. glycogenolysis

13. 1 Possible mechanism(s) for obesity formation except: a. glomerulonephritis b. alteration in leptin regulation c. decreases in heat generation capability d. decreases in energy consumption e. excess food intake

a. glomerulonephritis | Slide 55

28. May play a role in Cachexia formation: a. decreased thyroid function b. increased red blood cell production c. diabetes mellitus type 2 d. advanced cancer e. acute myocardial infarction

d. advanced cancer

30. Which statements are true about gestational diabetes? a. The prevalence of gestational diabetes is 2-4% b. It is a risk factor for type 2 diabetes c. Blood glucose levels usually normalize after the birth of the baby d. Recurrence rate during a subsequent pregnancy is 1%

b. It is a risk factor for type 2 diabetes c. Blood glucose levels usually normalize after the birth of the baby (a - 5-9% and d - 30-69%)

49. Ketosis can be formed as a consequence of: a. vomiting b. alcoholism c. diabetes mellitus type 2 d. starvation

a. vomiting b. alcoholism c. diabetes mellitus type 2 (More common in type 1) d. starvation (Slide 17 energy balance)

22. Aldosterone function, effects: a. Regulation of potassium balance b. Regulation of extracellular volume c. Transformation of angiotensinogen produced by the liver to angiotensin I which will change to angiotensin II in the lungs d. Increases liquid intake by affecting thirst center in the hypothalamus

a. Regulation of potassium balance | b. Regulation of extracellular volume

5. Effects of TSH, except(1): a. increases the mass of thyroid gland b. potentiate the release of TRH c. increases the vascularization of thyroid gland d. increases iodine uptake e. increases the synthesis of T4/T3

b. potentiate the release of TRH

4. Indicative finding for shock if the shock index is: a. ≤ 0.5 b. ≥ 1 c. ≤ 1 d. 0.5 e. BLANK - NO NUMBER

c. ≤ 1

9. 4 What are the features of celiac disease? a. weight loss b. type 1 hypersensitivity reaction c. it may develop at any age d. constipation

a. weight loss | Slide 30

``` 11. What percentage of hypertension results from a secondary cause? A. 80-90% B. 5-10% C. 1-2% D. 30-40% ```

B. 5-10%

2. 2 Which of the following factors contribute to the development of atherosclerosis according to mesenchymal theory? a. hyaluronic acid of intracellular matrix decrease b. changes of the TXA2/PGI2 ratio c. changes of the composition of extracellular matrix in vascular intimate and media d. micro-injuries of the vascular intimate promote platelet adhesion and aggregation

a. hyaluronic acid of intracellular matrix decrease | c. changes of the composition of extracellular matrix in vascular intimate and media

``` 23. Which disease is associated with elevated serum triglyceride (TG): level Select one or more: a. Cushing syndrome b. Chronic renal failure c. Von Gierke disease d. Diabetes mellitus ```

``` a. Cushing syndrome b. Chronic renal failure c. Von Gierke disease d. Diabetes mellitus (Slides 46-50) ```

1. Synthesized by the zona glomerulosa cells in the adrenal cortex: (1) a. cortisol b. androgens c. 11-deoxycortisol d. dehydroepiandrosterone e. aldosterone

e. Aldosterone

3. 2 What stages may occur in Crohn's disease? a. Reflux- type disease b. muscular hypertrophy may occur in the intestines c. the inflammation may penetrate deep into the tissues of the intestines d. dysmotility

c. the inflammation may penetrate deep into the tissues of the intestines b. muscular hypertrophy may occur in the intestines

25. Typical features of Laron-dwarfs, except: a. decreased Se IGF-I b. GH secretion cannot be inhibited with glucose c. hereditary disorder d. decreased Se GH e. extreme short stature

d. decreased Se GH

9. 1 True about leptin : a. It decreased hunger sensation b. Small steran frame molecule c. It is synthesized in the liver d. Kidney transformation is needed for its activity e. It influences hypophysis function

a. It decreased hunger sensation

6. Which of the following does NOT promote the development of diabetic complications?(1) a. Reduced levels of AGEs b. Polyol pathway c. Altered expression of HSPG d. Reduced tPA level e. Increased PAI-1 production

a. REDUCED levels of AGEs b - inhibits Na+/K+ ATPase c -if decreased synthesis, albumin and Ig can cross the glomerular basement mb d+e - altered haemostasis

11. What is C peptide? a. A synonym of C-reactive protein b. A synonym of the anticoagulant Protein C c. A cleavage product of proinsulin d. It is synonymous to anti-insulin antibody

c. A cleavage product of proinsulin

45. Characteristic laboratory findings in Polycystic Ovary Syndrome: a. Se estrogen↑ b. Se insulin ↓ c. Se FSH↑ d. Se LH↑

a. Se estrogen↑ | d. Se LH↑

13. Decompensation of heart failure may be caused by: a. Arrhythmia b. Infection c. severe anemia d. myocardial ischemia

a. Arrhythmia b. Infection c. severe anemia d. myocardial ischemia

16. Factors enhancing the development of ARDS in shock a. tachypnea b. over activation of the immune system c. bronchoconstriction d. alveolar fluid accumulation

b. over activation of the immune system (Locally) | d. alveolar fluid accumulation

11. 2 True statements for pheochromocytoma: a. warm, red limbs b. hypertension develops in paroxysm c. weight gain d. orthostatic hypotension can be observed between attacks

b. hypertension develops in paroxysm d. orthostatic hypotension can be observed between attacks (Slide 48 )

9. Which of the following pathogens play an important role in the development of atherosclerosis according to the inflammation theory? a. Cytomegalovirus (CMV) b. HBV c. Herpes simplex virus (HSV1, HSV2) d. Chlamydia pneumoniae

a. Cytomegalovirus (CMV) c. Herpes simplex virus (HSV1, HSV2) d. Chlamydia pneumoniae (Slide - 88)

16. 2 Clinical signs of Cushing-syndrome, except: (1) a. depression b. livid striae c. amenorrhea d. virilization e. central obesity

d. virilization

48. Correct statements about ketone bodies: a. The smell of exhaled air can indicate their presence during physical examination b. Neurons are capable to generate acetyl CoA from ketone bodies c. Their concentration is the highest in postabsorptive stage of starvation d. The largest ketone body user is the liver

a. The smell of exhaled air can indicate their presence during physical examination b. Neurons are capable to generate acetyl CoA from ketone bodies

``` 21. Chemical mediators increasing vascular permeability: A.C3a and C5a B.vasoactive amines C.bradykinin D.PGI2, TXA2 ```

A.C3a and C5a B.vasoactive amines - Meaning Histamine! C.bradykinin

``` 29. Characteristic findings in toxic adenoma (Plummer’s disease), except: (1) a. More frequent in women b. Exophthalmos c. Hyperthyroidism d. Se TSH ↓ e. Goiter 24 ```

b. Exophthalmos | https: //www.britannica.com/science/Plummer-disease

23. Consequence of cirrhosis in the liver a. More collagen production b. Fewer microvilli on the liver cells c. Capillarization of sinusoids d. Loss of parenchyma

a.More collagen production b.Fewer microvilli on the liver cells c.Capillarization of sinusoids d.Loss of parenchyma (Slide 37)

12. Causes of primary amenorrhea: a. Kallmann syndrome b. chromosomal abnormality c. Müllerian duct agenesis d. anorexia nervosa

a. Kallmann syndrome b. chromosomal abnormality c. Müllerian duct agenesis (https: //en.wikipedia.org/wiki/Amenorrhea - Anorexia is Secondary)

10. 2 which of the following pathogens do NOT play a role in the development of atherosclerosis according to the inflammation theory? a. Cytomegalovirus (CMV) b. herpes simplex virus (HSV1, HSV2) c. Chlamydia pneumoniae d. HBV

d. HBV | Slide - 88

47. During evolutionary selection those individuals stayed longer alive with a better chance who had an inferior energy storing capacity. True/False

False

25. Intensification of the basal metabolic rate can be observed: a. in adrenal gland hypofunction b. in adapted starvation c. in inherited metabolic disorder d. in autoimmune disease e. in hyperthyroidism

d. in autoimmune disease e. in hyperthyroidism https://www.sciencedirect.com/science/article/pii/S1110116416300849

24. Which mechanisms contribute to increased cardiovascular risk in chronic kidney disease? a. Low serum phosphate level b. Increased level of FGF-23 c. Accelerated atherosclerosis d. Increased deposition of cholesterol, calcium and phosphate in vessel walls

b. Increased level of FGF-23 c. Accelerated atherosclerosis d. Increased deposition of cholesterol, calcium and phosphate in vessel walls

18. Pathogenic factors of H pylori: a. Hyperacidity b. Cytotoxin associated gene a (Caga) c. Inflammation d. Endotoxin (LPS)

b. Cytotoxin associated gene a (Caga) | d. Endotoxin (LPS)

3. 1 The postabsorptive stage (6-24hr) of the alimentation cycle is characterized by: a. in the muscles, glucose uptake is decreased b. the brain primarily utilizes fatty acids as energy source c. increasing ketone body production in the liver d. unchanged glucose utilization in the medulla of the kidneys

a. In the muscles, glucose uptake is decreased c. increasing ketone body production in the liver d. Unchanged glucose utilization in the medulla of the kidneys

9. 1 Alterations of kidney function in shock: a. Na+ retention b. oliguria/anuria c. If RR < 60 mmHg, high chance for tubular necrosis d. decreased concentrating ability

b. oliguria/anuria | d. decreased concentrating ability

16. Which ones are NOT potential complications of GERD: a. Gastric ulcer b. Esophagus varices c. Weight loss d. Esophageal strictures

a. Gastric ulcer b. Esophagus varices c. Weight loss

3. The value of cardiac output in a healthy adult person: a. 2.5 l/min b. 3 l/min c. 4 l/min d. 5 l/min

d. 5 l/min

38. 17-OH-corticosteroids are the metabolite of: a. mineralocorticoids b. none of them c. androgens d. Glucocorticoids e. estrogens

d. Glucocorticoids

6. A third of patients with high blood pressure are overweight. True/False

False | 50-60%

2. Which is true of the following statements? Select one or more: a. HDL is exclusively formed in hepatocytes b. The nascent discoid shaped HDL consists of cholesterol, phospholipid and apo A c. Protein constituents of apo C an apo E are synthesized in the liver and associate to HDL particles in the circulation d. HDL also contains apo B-48

b. The nascent discoid shaped HDL consists of cholesterol, phospholipid and apo A c. Protein constituents of apo C an apo E are synthesized in the liver and associate to HDL particles in the circulation (Slide 9 and 20)

``` 27. Which factors inhibit the proliferation of smooth muscle cells? A. Kinins(bradykinin and kallidin) B. Prostacyclin C. Angiotensin II D. Fibroblast Growth Factor(FGF) ```

A. Kinins(bradykinin and kallidin) B. Prostacyclin -Googled: Prostacyclin and Kinins

34. Causes of Precocious Puberty can be: a. Regular use of marijuana b. hCG-secreting tumor c. Congenital adrenal hyperplasia d. McCune–Albright syndrome

a. Regular use of marijuana b. hCG-secreting tumor c. Congenital adrenal hyperplasia d. McCune–Albright syndrome (Slide 58)

2. Which statements are true about diabetes? a. It is the main cause of end stage renal disease b. It is a risk factor for cardiovascular disease c. It is the main cause of blindness in adults d. It is a major cause of non-traumatic limb amputation

a. It is the main cause of end stage renal disease b. It is a risk factor for cardiovascular disease c. It is the main cause of blindness in adults d. It is a major cause of non-traumatic limb amputation

23. What is the dimension of body mass index a. Kg/dm3 b. kg/l c. g/l d. kg/m2 e. m/cm

d. kg/m2

21. It may be beneficial in heart failure: a. inhibitor of the If current b. selective COX-2 inhibitor c. aldosterone antagonist d. sildenafil (Viagra)

a. inhibitor of the If current (Ivabradine) - Slide 43 c. aldosterone antagonist - Slide 42 d. sildenafil (Viagra) - Slide 48

18. A healthy person and a patient with heart failure produces a higher cardiac output during walking compared to the resting state. Which statement is true? a. The sympathetic tone is not increased in the healthy subject, because he can adequately increase his cardiac output using the Frank–Starling mechanism b. The increased sympathetic tone contributes to the higher cardiac output to a significant degree in the patient c. They produce similar cardiac output d. The patient uses the Frank–Starling mechanism to a significant degree

b. The increased sympathetic tone contributes to the higher cardiac output to a significant degree in the patient d. The patient uses the Frank–Starling mechanism to a significant degree

10. Clinical manifestation of prolactinoma in women, except: a. hirsutismus b. amenorrhea c. gynecomastia d. Headache

c. gynecomastia

21. Cardiovascular protective functions of the HDL particle, EXCEPT: Select one or more: a. Macrophage presence is enhanced in the vessel wall by the anti-apoptotic effect of HDL b. Enhances the receptor mediated endocytosis of CHY- and VLDL-remnant particles by its apo C and apo E content c. HDL enhances the PGI2 production of endothelial cell thereby inhibiting platelet adhesion d. Enhances the peripheral uptake of LDL particles by its apo E content

a. Macrophage presence is enhanced in the vessel wall by the anti-apoptotic effect of HDL d. Enhances the peripheral uptake of LDL particles by its apo E content

27. Causes of Cardiogenic Shock: e. Addison’s disease f. severe systemic acidosis g. pump function failure h. spinal cord injury

f. severe systemic acidosis g. pump function failure (Slide 30)

18. Assessment options of obesity, except (1): a. Metabolic Index b. Relative body mass (%) c. Measuring waist circumference d. Broca-index e. Body mass index (BMI)

a. Metabolic Index | Broca-index Ideal body weight

40. It is true about EAD (early afterdepolarization): a. it may cause TdP tachycardia b. tachycardia may contribute to its development c. hypokalemia may contribute to its development d. it may be suppressed by administering MgSO4

a. it may cause TdP tachycardia c. hypokalemia may contribute to its development d. it may be suppressed by administering MgSO4 (Slide 18 -Low HR contributes to it)

11. Characteristic for arrhythmias caused by DADS (delayed afterdepolarizations): a. they are not terminated by overdrive pacing b. digitalis toxicity may cause them c. catecholamines make them worse d. Ca antagonists are an option for treatment

a. they are not terminated by overdrive pacing b. digitalis toxicity may cause them c. catecholamines make them worse d. Ca antagonists are an option for treatment (DADS is caused by accumulation of Ca intracellular - Slides 19-20)

16. Atherosclerotic lesions may be visualized in the carotid artery by ultrasound imaging. True/False

True

15. Clinical signs of Cushing-syndrome: a. central obesity b. hypotension c. virilization d. psychological disorders

a. central obesity | d. psychological disorders

``` 5. Glycoprotein hormones, except:(1) a. Testosterone b. FSH c. LH d. hCG e. TSH ```

a. Testosterone | Slide 4

3. Which of the following factors contribute to the development of atherosclerosis according to thrombogenic theory? a. The uptake of modified LDL by macrophages b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation c. Infiltration of LDL into the arterial wall d. Changes of the TXA2/PGI2 ratio

b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation d. Changes of the TXA2/PGI2 ratio

1. Formed in the frontal lobe of hypophysis, except: (1) a. LH b. TSH c. prolactin d. oxytocin e. GH

d. oxytocin

11. Which of the following plays a role in the regulation of gastric acid production? a. gastrin b. histamine c. acetylcholine d. thromboxane

a. gastrin b. histamine c. acetylcholine

37. Possible causes of Gynecomastia: a. Cirrhosis of the liver b. Hyperthyroidism c. 11b-hydroxylase deficiency d. Puberty

9a. Cirrhosis of the liver b. Hyperthyroidism d. Puberty (wiki)

1. 3 Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the vessels? a. Hyperlipidemia → spasm of vasa vasorum → hypoxia b. Hypertension → mechanical compression of vascular wall c. Catecholamine → spasm of vasa vasorum → hypoxia d. Smoking - nicotine → decreased NO production → hypoxia

b. Hypertension → mechanical compression of vascular wall | c. Catecholamine → spasm of vasa vasorum → hypoxia

30. Laënnec cirrhosis is caused by a. Biliary obstruction b. Congestive heart failure c. Alcohol d. Wilson ́s disease e. Drug effect

c.Alcohol

8. Effect(s) of leptin: a. increases heat emission b. increases physical activity c. decreases heat generation d. decrease hunger sensation

a. increases heat emission | d. decrease hunger sensation

27. Alcohol consumption is toxic to the: a. gastrointestinal tract b. nervous system c. liver d. muscle

a. gastrointestinal tract b. nervous system c. liver d. muscle

18. Effects of ADH: a. Vasoconstriction b. Enhances reabsorption of urea increasing tonicity of the renal medulla allowing more water to be reabsorbed c. During hypovolemia high plasma levels of AVP help maintain tissue perfusion d. Stimulates the synthesis and release of factor VIII and von-Willebrand factor via V2 non-renal receptors

a. Vasoconstriction b. Enhances reabsorption of urea increasing tonicity of the renal medulla allowing more water to be reabsorbed c. During hypovolemia high plasma levels of AVP help maintain tissue perfusion d. Stimulates the synthesis and release of factor VIII and von-Willebrand factor via V2 non-renal receptors

2. Which of the following factors contribute to the development of atherosclerosis according to mesenchymal theory? a. Collagen fiber content is increased, while elastic fiber content is decreased in the intima and in the media b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation c. The uptake of modified LDL by macrophages d. Decrease of the heparin/heparan sulphate content of vessels

a. Collagen fiber content is increased, while elastic fiber content is decreased in the intima and in the media d. Decrease of the heparin/heparan sulphate content of vessels (Slide 84)

8. Characteristic findings in subclinical hyperthyroidism, except: (1) a. normal Se FT3 b. anti-TPO Ab is not typical c. normal Se FT4 d. Se FT4 ↓ and normal FT3 e. Se TSH ↓

d. Se FT4 ↓ and normal FT3

14. Effects of plasmin: A.it removes the fibrin mesh B.activates the complement system by cleaving C3 C.fibrin degradation products (FDP) production and vasodilation as a result D.increases venular permeability

A.it removes the fibrin mesh B.activates the complement system by cleaving C3 D.increases venular permeability

23. Which methods can be used for colorectal cancer screening? a. Hemoccult test b. colonoscopy c. Tumor marker tests d. ERCP

a. Hemoccult test b. colonoscopy c. Tumor marker tests

1. Which of the following may be a symptom of diabetes? a. Unconsciousness b. Recurring candida infections in infants c. Pruritus vulvae d. Ketosis

a. Unconsciousness b. Recurring candida infections in infants c. Pruritus vulvae d. Ketosis

3. An electric impulse is not conducted if it arrives at a part of the conduction system during the relative refractory period. True/False

False | Relative = Strong enough impulse could pass - like in initiations of arrhythmias

30. Clinical signs of chronic adrenocortical insufficiency, except; (1) a. Hyperglycemia b. Weight loss c. Hyponatremia d. Abdominal pain e. orthostatic hypotension

a. Hyperglycemia

``` 3.Characteristics of chronic inflammation : A.connective tissue growth B.lymphocyte infiltration C.increased number of macrophages D.lasts for several weeks ```

A.connective tissue growth B.lymphocyte infiltration C.increased number of macrophages D.lasts for several weeks

7. Which serum calcium level may cause Laryngospasm? a. 4 mM b. 1,4 mM c. 1 mM d. 6 mM

c. 1 mM

27. Typical clinical findings in Graves-Basedow disease: a. Fatigue b. euthyroid goiter c. HLA-B8 and DR3 association d. Atrial fibrillation

a. Fatigue c. HLA-B8 and DR3 association d. Atrial fibrillation

11. 1 True statements for pheochromocytoma: a. extramedullary in 10% b. malignant in 10% c. unilateral in 10% d. acquired in 10%

a. extramedullary in 10% b. malignant in 10% (Slide 47)

21. 2 The atherogenic effect of homocysteine: a. it damages the endothelium b. it inhibits the proliferation of smooth muscle cells c. it is prothrombotic d. it decreases collagen synthesis in vessels

a. it damages the endothelium | c. it is prothrombotic

6. What is the Total Calcium Reference Range? a. 5-3 mmol/l b. 0-1 mmol/l c. 2-6 mmol/l d. 2-8 mmol/l

c. 2-6 mmol/l

``` 15. Potential cause(es) of familial hypercholesterolemia: Select one or more: a. Gain of function mutation of PCSK9 b. Apo E mutation c. LDL receptor mutation d.Apo B-48 deficiency ```

a. Gain of function mutation of PCSK9 | c. LDL receptor mutation

15. ECG signs of atrial fibrillation: a. absence of P waves b. f waves c. ventricular tachycardia d. absolute arrhythmia

a. absence of P waves b. f waves (Although hardly detectable in real life) d. absolute arrhythmia

2. What is isolated systolic hypertension? Select one: a. systolic ≤120 mmHg, diastolic ≤70 mmHg b. systolic ≤125 mmHg, diastolic ≤75 mmHg c. systolic ≤130 mmHg, diastolic ≤80 mmHg d. systolic ≥ 140 mmHg, diastolic <90 mmHg

d. systolic ≥ 140 mmHg, diastolic <90 mmHg

9. Which of the following pathogens play an important role in the development of atherosclerosis according to the inflammation theory? a. Helicobacter pylori b. Chlamydia pneumoniae c. HCV d. HBV

a. Helicobacter pylori | b. Chlamydia pneumoniae

22. The respective person is overweight if his/her BMI: a. 21 kg/m2 b. 27 kg/m2 c. 35 kg/m2 d. 31 kg/m2 e. 24 kg/m2

b. 27 kg/m2 c. 35 kg/m2 d. 31 kg/m2

``` 5. Lipoproteins rich in cholesterol: Select one: a. HDL-LDL b. VLD-IDL c. CHY-IDL d. CHY-LDL e. CHY-VLDL ```

a. HDL-LDL

2. Abnormal automaticity usually occurs if the resting membrane potential is between -60 mV and -10 mV. True/False

True | Slide 13

19. Which one plays a role in H pylori toxin production? a. gastrin hypersecretion b. Hyperacidity c. Cytotoxin associated gene A (CagA) d. gastroesophageal reflux e. NOD-CARD mutation

c. Cytotoxin associated gene A (CagA)

44. Clinical signs of Polycystic Ovary Syndrome: a. hirsutismus b. amenorrhea c. acne d. smaller ovaries

a. hirsutismus c. acne (Large ovaries and oligomenorrhea)

33. Most common causes of Hypertrichosis: a. Polycystic ovary syndrome b. Paraneoplastic syndrome c. Hypothyroidism d. Klinefelter syndrome

a. Polycystic ovary syndrome | b. Paraneoplastic syndrome

20. Primary hyperparathyroidism is characterized by the following, except:(1) a. hypocalcemia b. pancreatitis c. nephrolithiasis d. hypercalciuria

a. hypocalcemia

1. 1. Risk factors of arrhythmia a. Dilatative cardiomyopathy b. Heart failure c. Potassium imbalance d. Coronary sclerosis

a. Dilatative cardiomyopathy b. Heart failure c. Potassium imbalance d. Coronary sclerosis

3. Approximate weight of the thyroid gland: a. 100-150 g b. 25-30 g c. 250-300 g d. 25-30 mg e. 1-3 g

b. 25-30 g

28. Causes of acromegaly: a. pituitary adenoma b. Cushing-disease c. paraneoplastic syndrome d. McCune–Albright syndrome

a. pituitary adenoma c. Paraneoplastic syndrome d. McCune–Albright syndrome (MAS is an extremely rare disorder that classically affects the bones, skin, and endocrine system. Endocrine can be associated with Acromegaly.)

19. What are the potential central nervous system disorders in hypertension? a. Ruptured brain aneurysm b. Huntington's disease c. Parkinson's disease d. Hemorrhagic stroke

a. Ruptured brain aneurysm | d. Hemorrhagic stroke

``` 1.Phases of inflammation: A.stasis B.proliferation C.reparation D.vascular reaction ```

C.reparation | Repair in Chronic Inflammation

8. Compensatory mechanisms in shock EXCEPT: a. immune system activation b. baroreceptor reflex c. chemoreceptor reflex d. cerebral ischemic reflex

a. immune system activation | It is happening but it is NOT a compensatory mechanism but a system going out of control

7. Characteristic of late adapted fasting (-several weeks) a. unchanged glucose utilization in erythrocytes b. decreased glucose utilization in the brain c. decreased ketone body utilization in the brain d. significant glycogenolysis in the liver

a. unchanged glucose utilization in erythrocytes | b. decreased glucose utilization in the brain

45. Marasmus is characterized by: a. lack of edema formation b. simultaneous inflammation c. anorexia nervosa and cachexia represent marasmus type diseases in developed countries d. significantly decreased albumin level

a. lack of edema formation c. anorexia nervosa and cachexia represent marasmus type diseases in developed countries (Low albumin in Kwashiorkor )

30. Clinical symptoms of Acromegaly: a. hypogonadism b. hyperostosis c. cardiomegaly d. barrel chest

a. hypogonadism b. hyperostosis c. cardiomegaly d. barrel chest

26. Waist circumference for clinical diagnosis of metabolic syndrome: a. in women: 88 cm b. in men: 105 cm c. in women: 80 cm d. in men: 102 cm

a. in women: 88 cm d. in men: 102 cm (Slide 100)

22. Causative factors of hyperdynamic stage in distributive shock: a. accumulation of lactic acid b. increased NO production due to iNOS activity c. hypothermia d. accumulation of octopamine

a. accumulation of lactic acid b. increased NO production due to iNOS activity d. accumulation of octopamine (Slide 35)

39. Clinical signs of Turner syndrome: a. gynecomastia b. progressive testicular damage c. hypertension, renal abnormalities d. coarctation of the aorta

c. hypertension, renal abnormalities d. coarctation of the aorta (Slide 54)

19. Cardiovascular protective functions of the HDL particle: a. Enhances the peripheral uptake of LDL particles by its APO-E content b. Macrophage presence is enhanced in the vessel wall by the anti-apoptotic effect of HDL c. HDL enhances the PGI2 production of endothelial cell thereby inhibiting platelet adhesion d. Enhances the receptor mediated endocytosis of CHY- and VLDL-remnant particles by its APO-C and APO-E content

c. HDL enhances the PGI2 production of endothelial cell thereby inhibiting platelet adhesion d. Enhances the receptor mediated endocytosis of CHY- and VLDL-remnant particles by its APO-C and APO-E content

42. Which of the following diseases can cause hirsutism? a. hyperparathyroidism b. Cushing’s syndrome c. congenital adrenal hyperplasia d. polycystic ovary syndrome

b. Cushing’s syndrome c. congenital adrenal hyperplasia d. polycystic ovary syndrome

4. Cardiac output may be increased by: a. increasing cortisol secretion b. the Frank-Starling mechanism c. increasing the EF (ejection fraction) d. shortening the duration of diastole

a. increasing cortisol secretion b. the Frank-Starling mechanism c. increasing the EF (ejection fraction)

17. It is true about atrial flutter: a. the F waves cause absolute arrhythmia b. in its most common form positive F waves are seen in the inferior leads c. its most common form can be terminated by catheter ablation d. it is originated most commonly in the right atrium

c. its most common form can be terminated by catheter ablation d. it is originated most commonly in the right atrium

3. Which is false of the following statements? Select one or more: a. The nascent discoid shaped HDL consists of cholesterol, phospholipid and apo A b. HDL also contains apo B-48 c. Protein constituents of apo C an apo E are synthesized in the liver and associate to HDL particles in the circulation d. HDL is exclusively formed in hepatocytes

b. HDL also contains apo B-48 | d. HDL is exclusively formed in hepatocytes

21. It is true about AVNRT: a. it may be terminated by vagal maneuvers b. it may be permanently prevented by catheter ablation c. it may easily turn into a ventricular fibrillation d. it is the most common cause of PSVTs

a. it may be terminated by vagal maneuvers b. it may be permanently prevented by catheter ablation d. it is the most common cause of PSVTs

12. Criteria for appropriate tissue perfusion: a. structurally and functionally intact vasculature b. appropriate cardiac function c. normal volume and composition of perfusion fluid (Hb, plasma proteins, corpuscular elements etc.) d. normal lung function

a. structurally and functionally intact vasculature b. appropriate cardiac function c. normal volume and composition of perfusion fluid (Hb, plasma proteins, corpuscular elements etc.) d. normal lung function

6. Which ones are commonly seen in ulcerative colitis? a. anemia b. diarrhea, colic c. inflammation of the mucosa, predominantly localized to the colon d. superficial damage occurs to the mucosa layer

a. anemia b. diarrhea, colic c. inflammation of the mucosa, predominantly localized to the colon d. superficial damage occurs to the mucosa layer (Slide 45)

22. 2 Causative factors of hyperdynamic stage in distributive shock: e. Severe hypotension f. Normovolemia g. Decreased TPR h. Increased cardiac output

f. Normovolemia g. Decreased TPR h. Increased cardiac output

11. Clinical signs of hyperthyroidism: a. hoarseness b. abnormal menstrual cycles d. von Graefe's sign c. bradycardia

a. hoarseness b. abnormal menstrual cycles d. von Graefe's sign

1. Which of the following is induced or activated by immobilization? a. Wnt transmission b. RANKL c. osteoprotegerin d. sclerostin

b. RANKL | d. sclerostin

2. Which nutrients coming through the portal vein are filtered and stored in the liver? a. fatty acids and monoglycerides b. ketone bodies c. amino acids d. glucose

c. amino acids | d. glucose

14. Which of the following statements are true? a. Atherosclerosis is a hardening of an artery specifically due to an atheromatous plaque formation b. Arteriosclerosis is a hardening of small arteries c. Arteriolosclerosis is a general term describing any hardening of small arteries d. Arteriosclerosis is a general term describing any hardening of medium or large arteries

a. Atherosclerosis is a hardening of an artery specifically due to an atheromatous plaque formation c. Arteriolosclerosis is a general term describing any hardening of small arteries d. Arteriosclerosis is a general term describing any hardening of medium or large arteries

29. The duration of the action potential in myocytes is prolonged in heart failure, increasing the risk of dangerous arrhythmias. True/False

True

9. 2 Alterations of kidney function in shock: e. decreased GFR f. decreased concentrating ability g. polyuria h. If RR < 60 mmHg, high risk for glomerular damage

e. decreased GFR | f. decreased concentrating ability

4. Which statements are true about the treatment of hypertension? A. A combination of lifestyle changes and drug treatment may be necessary B. A healthy diet is recommended: low salt and fat content but rich in dietary fiber C. Treating the secondary causes of hypertension is necessary D. The therapeutic target value is 150/90 mmHg

A. A combination of lifestyle changes and drug treatment may be necessary B. A healthy diet is recommended: low salt and fat content but rich in dietary fiber C. Treating the secondary causes of hypertension is necessary

10. Which of the following plays a role in gastric acid production? a. enterochromaffin-like (ECL) cells b. somatostatin c. acetylcholine d. prostacyclin

a. enterochromaffin-like (ECL) cells | c. acetylcholine

4. Which of the following factors contribute to the development of atherosclerosis according to thrombogenic theory? a. Changes of the composition of extracellular matrix in vascular intima and media b. Changes of the TXA2/PGI2 ratio c. Hyaluronic acid content of intracellular matrix decreases d. Micro-injuries of the vascular intima promote platelet adhesion and aggregation

b. Changes of the TXA2/PGI2 ratio | d. Micro-injuries of the vascular intima promote platelet adhesion and aggregation

``` 5. Positive acute phase proteins: A.haptgoblobin B.albumin C.coeruloplasmin D.Transferrin ```

A.haptoglobin | C.ceruloplasmin

25. Essential parameters to diagnose metabolic syndrome: a. Se LDL: > 2.4 mM b. visceral obesity c. Se TG: > 1.7 mM d. Se HDL: > 1.4 mM

b. visceral obesity | c. Se TG: > 1.7 mM

33. the first therapeutic choice if metabolic syndrome is suspected: a. decrease of heart rate b. lifestyle changes c. decrease of blood pressure with ACE-inhibitors d. decrease of blood pressure with diuretics e. decrease blood glucose level with insulin

b. lifestyle changes

20. Which statements are FALSE? a. The conversion of renin to angiotensin I is catalyzed by the ACE b. angiotensin I is the only known substrate of renin c. angiotensin II is a strong vasopressor: it induces arterial contraction and increases the blood pressure d. ACE inhibitors are antihypertensive drugs

FALSE: a. The conversion of renin to angiotensin I is catalyzed by the ACE b. angiotensin I is the only known substrate of renin

12. 1 FALSE statement(s) regarding obesity: a. Android type obesity is a risk factor for diabetes mellitus type I b. Apple type obesity has worse prognosis compared to pear type c. It belongs to alterations related to civilization d. Its prevalence increases in the last year in developed countries e. Hyperplastic type is typically formed in childhood

a. Android type obesity is a risk factor for diabetes mellitus type I

14. Which of the tests can be used to diagnose pheochromocytoma? a. Chromogranin A b. Se metanephrine, normetanephrine c. Clonidine suppression test d. 131-I-MIBG scan

a. Chromogranin A c. Clonidine suppression test d. 131-I-MIBG scan (metanephrine, normetanephrine tested in urine as VMA)

25. Which is true of the following statements? Select one or more: a. In man, approximately 70% of LDL is taken up in the liver and 30% in extrahepatic tissues b. The main function of LDL is to transport the high energy content triglyceride c. LDL-receptors are located on the surfaces of liver and most other cells d. Binding to LDL-receptors is regulated by apo B-100 and apo E

a. In man, approximately 70% of LDL is taken up in the liver and 30% in extrahepatic tissues c. LDL-receptors are located on the surfaces of liver and most other cells d. Binding to LDL-receptors is regulated by apo B-100 and apo E

31. characteristic finding in ectopic ACTH-syndrome: a. Hyperkalemia b. Hyperpigmentation c. Usually the typical symptoms of Cushing syndrome are missing d. Random secretion of ACTH

b. Hyperpigmentation c. Usually the typical symptoms of Cushing syndrome are missing d. Random secretion of ACTH (Lecture slide 25)

11. Which lipoprotein plasma level is the most frequently decreased in diabetes mellitus? Select one: a.LDL b. CHY c. IDL d. VLDL e. HDL

e. HDL

27. Clinical signs of growth hormone deficiency, except:(1) a. Growth retardation (in childhood) b. Decreased BMD c. Se HDL↑ d. Muscle weakness e. Central obesity

c. Se HDL↑

44. Kwashiorkor is characterized by: a. apathia b. decreased serum albumin level c. liver steatosis d. ascites

a. apathia b. decreased serum albumin level c. liver steatosis d. ascites

16. 2 It is true for both atrial and ventricular fibrillation: a. the longer it persists, the more difficult it becomes to terminate b. it may be terminated by carotid massage c. it is an immediate danger for life d. it may be frequently terminated by a cardioverter-defibrillator

a. the longer it persists, the more difficult it becomes to terminate d. it may be frequently terminated by a cardioverter-defibrillator

34. True statements about hormones participating in the regulation of the caloric cycle except: a. insulin has lipolytic effect b. glucagon stimulates gluconeogenesis c. cortisol stimulates proteolysis d. thyroid hormone inhibits lipolysis

a. insulin has lipolytic effect | d. thyroid hormone inhibits lipolysis

14. Which of the following statements is FALSE about Paget’s disease?(1) a. It is characterized by enhanced bone remodeling b. Affected bones are weaker and pathologic fractures often occur c. The pelvis, long tubular bones (e.g. femur), skull and vertebrae are commonly affected d. All bones are affected, in a generalized fashion

d. All bones are affected, in a generalized fashion

13. Which statements are true about glycemic index? a. high glycemic food increase the blood sugar for a longer period b. high glycemic foods increase the blood sugar faster than low glycemic foods. c. it is important to know the glycemic index of foods in diabetes. d. only the glycemic index is important in the diet of diabetic patients and not the absolute amount of carbohydrates.

b. high glycemic foods increase the blood sugar faster than low glycemic foods. c. it is important to know the glycemic index of foods in diabetes.

2. Which statement is FALSE about Crohn's disease?(1) a. It has extraintestinal manifestations b. It starts in the rectum and proceeds proximally c. it often affects the terminal ileum d. a fistula may develop e. it may cause damage to any part of the gastrointestinal tract

b. It starts in the rectum and proceeds proximally

10. The selectins play an important role in the initiation of the ""rolling"" process. True/False

True

27. Clinical signs of the secondary adrenocortical insufficiency, except;(1) a. Anemia b. Lymphocytosis c. Dehydration d. Eosinophilia e. Low ACTH

c. Dehydration | Slide 14

13. Clinical manifestations of Prolactinoma in men: a. Hirsutism b. Virilization c. Headache d. Gynecomastia

c. Headache | d. Gynecomastia

10. Possible causes of the decompensation in the late phase of shock: a. metabolic acidosis b. endothelial injury c. respiratory alkalosis d. tachypnea

a. metabolic acidosis b. endothelial injury (Slide 29)

24. 2The clinical manifestations of atherosclerosis: a. myocardial infarction b. acute mesenteric ischemia c. Waterhouse-Friderichsen syndrome d. Addison's disease

a. myocardial infarction | b. acute mesenteric ischemia

26. which of the followings cannot cause secondary adrenocortical insufficiency? a. Sheehan syndrome b. Glucocorticoid therapy c. Addison's disease d. Waterhouse-Friderichsen syndrome

c. Addison's disease d. Waterhouse-Friderichsen syndrome (Sheehan syndrome is a condition when the pituitary gland is damaged during childbirth - Secondary)

9. Asterixis is a symptom occurring in hepatic encephalopathy. What is it? a. visual disturbance: seeing star-like lights b. the name of convulsions seen in this state c. momentarily losing the ability to hyperextend the wrist joint d. reading cartoons obsessively e. reversal of the sleep/wake pattern

b. the name of convulsions seen in this state | c. momentarily losing the ability to hyperextend the wrist joint

31. It is true about Mobitz type I second degree AV blocks: a. The P wave following the nonconducted one gets always conducted b. Urgent pacemaker implantation is necessary c. If one P wave is not conducted out of three then the conduction ratio is: 3:1 d. the PR intervals are constant

a. The P wave following the nonconducted one gets always conducted (Pacemaker is an Indication in Type II Mobitz and 1:2 AV block)

8. Signs of Hypercalcemia: a. Muscle weakness b. Tremor c. Atrial fibrillation d. Cardiac arrest

a. Muscle weakness c. Atrial fibrillation d. Cardiac arrest

5. Which statements are true about ulcerative colitis (UC)? a. Colonoscopy and biopsy are necessary for the diagnosis b. Smoking may provoke a relapse c. an autoimmune mechanism is involved in the pathogenesis of UC d. It may be treated with antacids

a. Colonoscopy and biopsy are necessary for the diagnosis c. an autoimmune mechanism is involved in the pathogenesis of UC (Slide 45)

11. Heart failure results in: a. myocardial remodeling b. appearance of fetal myosin isoforms c. water retention d. increased parasympathetic tone

a. myocardial remodeling b. appearance of fetal myosin isoforms c. water retention

35. As a result of applying carotid massage in atrial flutter: a. the arrhythmia is terminated in the majority of the cases b. it is easier to recognize the F waves c. the rate of F waves decreases d. the ventricular rate decreases

b. it is easier to recognize the F waves | d. the ventricular rate decreases

20. The most common causes of euthyroid goiter: a. subacute thyroiditis b. Plummer’s disease c. congenital T4 receptor deficiency d. struma ovarii

a. subacute thyroiditis c. congenital T4 receptor deficiency lecture p.41

7. Thyroid nodule is rather benign, if: a. thyroid scintigraphy shows a cold nodule b. thyroid antibody titer is elevated c. develops in young men d. it is soft to touch

d. it is soft to touch

17. It is true about HCV infection: a. there is no effective vaccine against it b. there is not effective antiviral drug against it c. it is most likely to turn into chronic hepatitis d. fulminant course is common

a. there is no effective vaccine against it | c. it is most likely to turn into chronic hepatitis

45. Characteristic laboratory findings in Polycystic Ovary Syndrome: a. Se testosterone↑ b. Se prolactin↓ c. Se SHBG ↓ d. Se insulin ↓

a. Se testosterone↑ | c. Se SHBG ↓

15. Changes of microcirculation in shock: a. hemodilution b. venoconstriction c. arterial/arteriolar vasoconstriction d. resistance of post-capillary vessels are decreased

b. venoconstriction | c. arterial/arteriolar vasoconstriction

14. Chronic Hepatitis is never caused by: a. HDV b. HBV c. HAV D. HCV

c. HAV

``` 2.Characteristics of acute inflammation: A.connective tissue proliferation B.lymphocytic infiltration C.fast course D.macrophage infiltration ```

C.fast course | D.macrophage infiltration

25. Which statement is FALSE about medial vascular sclerosis?(1) a. It is characterized by increased pulse pressure b. It leads to left ventricular hypertrophy c. The severity shows positive correlation with serum Fetuin-A level d. The severity shows positive correlation with serum osteopontin level

c. The severity shows positive correlation with serum Fetuin-A level Slide 39

25. Which statements are true about bradykinin? a. It relaxes the blood vessels b. It is a vasoconstrictor c. It promotes the production of NO and prostaglandin in endothelial cells d. It increases the blood pressure

a. It relaxes the blood vessels | c. It promotes the production of NO and prostaglandin in endothelial cells

4. Tropic hormones, except: (1) a. TSH b. FSH c. LPH d. LH e. ACTH

d. LH

8. Signs of Conn's syndrome: a. metabolic acidosis b. hypertonia c. hyperkalemia d. polyuria, polydipsia

b. hypertonia | d. polyuria, polydipsia

11. 1 True statement(s) about obesity types: a. Android type obesity is a risk factor for diabetes mellitus b. Hypertrophic type is typically formed in adulthood c. In apple type obesity, the ratio of waist to hip circumference is elevated d. Apple type obesity is predominantly characteristic to men

a. Android type obesity is a risk factor for diabetes mellitus b. Hypertrophic type is typically formed in adulthood c. In apple type obesity, the ratio of waist to hip circumference is elevated d. Apple type obesity is predominantly characteristic to men

20. It is true about the therapy of heart failure: a. the use of diuretics is not necessary any more b. digitalis improves symptoms c. β blockers are contraindicated, because of their negative inotropic effect d. ARBs improve survival

b. digitalis improves symptoms | d. ARBs improve survival

33. 1 Which endocrine disease can cause hypotension? a. 21-hydroxylase deficiency b. Sheehan-syndrome c. hypothyroidism d. 11-β-hydroxylase deficiency

a. 21-hydroxylase deficiency b. Sheehan-syndrome c. hypothyroidism

22. Which arrhythmia is known to be caused by a simple re-entry (1)? a. Atrial fibrillation b. AVRT c. Ventricular fibrillation d. Torsade de Pointes ventricular tachycardia

b. AVRT

15. Precipitating causes of heart failure include: a. Myocarditis b. Arrhythmia c. drug effect d. myocardial ischemia

a. Myocarditis b. Arrhythmia c. drug effect d. myocardial ischemia

20. Causes of secondary hyperaldosteronism: a. cardiac decompensation b. liver cirrhosis c. nephrotic syndrome d. diuretic therapy

a. cardiac decompensation b. liver cirrhosis c. nephrotic syndrome d. diuretic therapy (Slide 33 and https://www.ncbi.nlm.nih.gov/pubmed/2725277)

27. Which statements are true about type 2 diabetes? a. There is strong correlation between type 2 diabetes and specific HLA haplotypes b. It often cause ketoacidosis c. Insulin level may be low, normal or elevated d. Many patients are overweight or obese

c. Insulin level may be low, normal or elevated | d. Many patients are overweight or obese

9. Heterotropic disorder of impulse formation: a. paroxysmal supraventricular tachycardia b. atrial fibrillation c. AV block d. sick sinus syndrome

a. paroxysmal supraventricular tachycardia | b. atrial fibrillation

35. Typical signs of 11-b-hydroxylase deficiency a. Hypokalemia b. Hypertonia c. Hirsutism d. Early adrenarche

a. Hypokalemia b. Hypertonia c. Hirsutism d. Early adrenarche (Non-Classical Type Con's Symptoms)

25. Orthodromic AVRT is more common than the antidromic one in patients with WPW syndrome, because the refractoriness of the accessory bundle is usually longer than that of the AV junction." True/False

True

35. Correct statements about hormonal level regulation of the caloric cycle: a. insulin inhibits protein synthesis b. epinephrine (adrenalin) has a lipolytic effect c. insulin has a lipolytic effect d. glucagon enhances gluconeogenesis

b. epinephrine (adrenalin) has a lipolytic effect | d. glucagon enhances gluconeogenesis

28. Carotid massage may terminate the tachycardia if: a. the patient is not unconscious b. the heart rate does not exceed 180 bpm c. the AV node is included in the reentry pathway d. the Tawara branches are not included in the reentry pathway

a. the patient is not unconscious | c. the AV node is included in the reentry pathway

38. Compensatory mechanisms in heart failure: a. Anemia b. Left ventricular hypertrophy c. peripheral vasodilation d. increased salt and water retention

b. Left ventricular hypertrophy | d. increased salt and water retention

16. 1 It is true for both atrial and ventricular fibrillation: a. the longer it persists, the more difficult it becomes to terminate b. it Is an Immediate danger for life c. it may be frequently terminated by a cardioverter-defibrillator d. it may be terminated by carotid massage

a. the longer it persists, the more difficult it becomes to terminate c. it may be frequently terminated by a cardioverter-defibrillator

9. 3 Heart failure may be caused by/ Underlying causes of heart failure include/Possible causative agents: a. hypertension b. valvular heart disease c. Cardiomyopathy d. renal failure

a. hypertension b. valvular heart disease c. Cardiomyopathy d. renal failure

15. Paget disease is characterized by the following, except:(1) a. hypervascular bones b. hypocalcemia c. pain, pathologic fractures d. bone deformity

b. hypocalcemia

23. Dyslipidemia which promotes atherosclerosis: a. HDL ↓ b. VLDL↑ c. IDL↑ d. LDL↑

a. HDL ↓ | d. LDL↑

19. 1 Modifiable risk factors of atherosclerosis: a. diabetes mellitus b. heavy alcohol drinking c. sedentary lifestyle d. smoking

a. diabetes mellitus b. heavy alcohol drinking c. sedentary lifestyle d. smoking

22. 1 Cause of secondary mineralocorticoid excess with hypertension,except: (1) a. accelerated hypertension b. Bartter-syndrome c. renovascular disease d. estrogen therapy e. reninoma

b. Bartter-syndrome (Normal-Hypotension state)

31. The most frequent cause of Nanosomia: (1) a. connective tissue diseases b. hypothyroidism c. achondroplasia d. GH-related disorders e. psychogenic causes

c. achondroplasia | 70% - FGD3R Mutation

13. Essential hypertension accounts for 5% of all cases of hypertension. True/False

False | 95-90%

33. Characteristic for proximal AV block a. They occur in the AV node b. They are likely to turn into a third degree block c. They are more common than the distal ones d. They have worse prognosis than the distal ones

a. They occur in the AV node

10. The following mechanisms may contribute to cancer-associated hypercalcemia. Which statement is false?(1) a. tumor cells produce osteoprotegerin (OPG) b. tumor cells produce PTHrP c. cancer may induce local osteolysis d. tumor cells produce RANKL

a. tumor cells produce osteoprotegerin (OPG) - False | Slide 29

36. Which statements are true about abnormal automaticity? a. it is the most common cause of bradyarrhythmias. b. a reduced resting membrane potential may contribute to its development . c. it has a role in the development of parasystole. d. it does not occur in ventricular cells because they lack the If current.

c. it has a role in the development of parasystole. | Slide 13

16. The role of ox-LDL in the development of atherosclerosis: a. it stimulates the migration and the proliferation of smooth muscle cells b. it decreases the endothelial PGI2/NO synthesis c. it increases the proliferation of macrophages d. it has chemotactic effect

a. it stimulates the migration and the proliferation of smooth muscle cells b. it decreases the endothelial PGI2/NO synthesis c. it increases the proliferation of macrophages d. it has chemotactic effect

5. Which factors affect the blood pressure? a. Heart rate b. serum ALP activity c. renal function d. sympathetic nervous system activity

a. Heart rate c. renal function d. sympathetic nervous system activity

17. Obesity is in bidirectional risk relationship with the following disease(s): a. type I diabetes mellitus b. ischemic heart disease c. malignancies d. liver diseases

b. ischemic heart disease c. malignancies d. liver diseases

20. Causes of SIADH: a. myocardial infarct b. pneumonia c. small cell carcinoma of the lung d. subarachnoid bleeding

b. pneumonia c. small cell carcinoma of the lung d. subarachnoid bleeding

41. Anorexia nervosa is characterized by: a. Highest frequency in Adolescence b. Decreased Cortisol level c. Increased Body Temperature d. Tachycardia

a. Highest frequency in Adolescence

24. Both portal hypertension and decreased parenchyma contribute in cirrhotic patients to the development of: a. prolonged prothrombin time b. ascites c. hepatic encephalopathy d. splenomegaly

b. ascites c. hepatic encephalopathy (Slide 40)

18. Possible cause of hypothyroidism, except (1): a. increased iodine uptake b. iodine deficiency c. subacute thyroiditis d. Hashimoto’s thyroiditis e. Graves-Basedow disease

a. increased iodine uptake

14. Hypertension may cause the following: A. Chest pain B. Dizziness C. Positional Vertigo and blurred vision D. Fatigue

A. Chest pain C. Positional Vertigo and blurred vision D. Fatigue

26. There are no δ waves during an orthodromic AVRT in patients with WPW syndrome. True/False

True

24. The clinical manifestations of atherosclerosis: a. diabetes mellitus b. dissection of the aorta c. arteriosclerosis obliterans d. stroke

b. dissection of the aorta c. arteriosclerosis obliterans d. stroke

27. Apo B-48 is present in the following lipoproteins: Select one or more: a. LDL b. CHY c. VLDL d. IDL

b. CHY | Wiki - "ApoB 48 is a unique protein to chylomicrons from the small intestine."

15. 2 Hypertension may lead to the following complications: a. Retinopathy and blindness b. Heart failure c. Stroke d. Polycystic renal disease

a. Retinopathy and Blindness b. Heart failure c. Stroke

1. 5 Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the vessels? a. Smoking - nicotine → potentiates catecholamine effect → spasm of vasa vasorum → hypoxia b. Catecholamine → spasm of vasa vasorum → hypoxia c. Hypertension → increased elasticity of vascular wall d. Caffeine → dilation of vasa vasorum → increased collagen synthesis

a. Smoking - nicotine → potentiates catecholamine effect → spasm of vasa vasorum → hypoxia b. Catecholamine → spasm of vasa vasorum → hypoxia

13. Possible clinical symptom(s) of familial hyperchylomicronemia: Select one or more: a. lipemia retinalis b. acute pancreatitis c. hepatosplenomegaly d. xanthoma tendinosum

a. lipemia retinalis b. acute pancreatitis c. hepatosplenomegaly (Type I Dyslipidemia - https://www.youtube.com/watch?v=vGoA_EPEw-M&t=777s)

12. The increase of which enzyme activity indicates the lesion of liver parenchyma? (1) a. ALAT b. GGT C. ALP d. LDH e. CPK

a. ALAT

18. Potential cause(es) of familial dysbetalipoproteinemia: Select one or more: a. Homozygous apoE2 genotype b. Apo A mutation c. Apo B mutation d. ApoE4 mutation

a. Homozygous apoE2 genotype -This is Type 3 Dyslipidemia "1LP, 2LD, b adds v, E is 3, 4 adds more"

``` 26. Which factors promote the proliferation of smooth muscle cells? A. NO B. Prostacyclin C. Epidermal Growth Factor(EGF) D. Endothelin ```

C. Epidermal Growth Factor(EGF) | D. Endothelin

42. .Malnutrition can be suspected except: a. skin-hair-nail alterations b. elevated lymphocyte c. count BMI<18.5 kg/m2 d. vitamin deficiency

b. elevated lymphocyte | Decreased

26. 1 The basal metabolic rate is influenced by: (1) a. none of the statements b. hormonal metabolism c. age d. body surface e. all 3 statements are valid

e. all 3 statements are valid b. hormonal metabolism c. age d. body surface - https://en.wikipedia.org/wiki/Basal_metabolic_rate

19. Modifiable risk factors of atherosclerosis: a. age b. obesity c. dyslipidemia d. hypertension

b. obesity c. dyslipidemia d. hypertension

20. Assessment options of obesity? a. Electromyography b. measuring skin folding thickness c. Body mass index (BMI) d. Measuring waist circumference

b. measuring skin folding thickness c. Body mass index (BMI) d. Measuring waist circumference

9. 1 What are the features of celiac disease? a. familial prevalence is low b. The most sensitive screening test is tTG IgG c. Megaloblastic anemia d. A prevalence of 10% in IgA deficiency

b. The most sensitive screening test is tTG IgG | Slide 26

8. Clinical signs of prolactinoma: a. infertility b. hypertension c. primary or secondary amenorrhea d. decreased libido

a. infertility c. primary or secondary amenorrhea d. decreased libido

29. Characteristic signs of Acromegaly, EXCEPT: a. obesity b. macroglossia c. tall stature d. prognathism

a. obesity | c. tall stature

34. :forward failure” in left sided heart failure may result in: a. hepatomegaly b. weakness, fatigue c. pulmonary congestion, dyspnea d. orthopnea

b. weakness, fatigue | Slide 8

``` 19. Hageman (XII) factor activators A.Collagen B.C3a C.Kallikrein D.Basement membrane ```

A.Collagen C.Kallikrein D.Basement membrane (Collagen Type 4)

1. 2 Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the vessels? a. Hypertension → mechanical compression of vascular wall b. Caffeine → dilation of vasa vasorum → increased collagen synthesis c. Hyperlipidemia → spasm of vasa vasorum → hypoxia d. Smoking - nicotine → decreased NO production → hypoxia

a. Hypertension → mechanical compression of vascular wall

4. Which medication is NOT used for osteoporosis treatment? a. selective estrogen receptor modulators (SERMs) b. RANKL agonists c. vitamin K2 d. rhPTH

b. RANKL agonists | Antagonists are needed

22. Possible cause of euthyroid goiter, except (1): a. subacute thyroiditis b. iodine deficiency c. Hashimoto’s thyroiditis d. excessive consumption of brassica e. Graves-Basedow disease

e. Graves-Basedow disease | https: //www.sciencedirect.com/topics/veterinary-science-and-veterinary-medicine/goitrogen

17. Components of the atherosclerotic plaque: a. foam cells b. calcium c. dendritic cells d. eosinophilic granulocytes

a. foam cells | b. calcium

19. What are common complications of thyroidectomy? a. injury of the recurrent laryngeal nerve b. Hungry bone syndrome c. DiGeorge syndrome d. hypoparathyroidism

a. injury of the recurrent laryngeal nerve b. Hungry bone syndrome d. hypoparathyroidism

1. Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the vessels? a. Hyperlipidemia → spasm of vasa vasorum → hypoxia b. Hypertension → mechanical compression of vascular wall c. Smoking - nicotine → potentiates catecholamine effect → spasm of vasa vasorum → hypoxia d. Stress → spasm of vasa vasorum → hypoxia

b. Hypertension → mechanical compression of vascular wall c. Smoking - nicotine → potentiates catecholamine effect → spasm of vasa vasorum → hypoxia d. Stress → spasm of vasa vasorum → hypoxia

1. 2 Which of the following plays a role in the development of Crohn's Disease? a. hereditary factors b. gut flora (microbiota) c. reduced gastric acidity d. intestinal immune system

a. hereditary factors b. gut flora (microbiota) d. intestinal immune system

16. First symptom of Sheehan-syndrome could be: a. impotence b. vitiligo c. loss of pubic hair d. anemia e. failure of lactation

e. failure of lactation

23. True statements for subacute thyroiditis: a. RAIU increased b. symptoms include fever and thyroid tenderness c. it is probably due to a viral infection d. always causes hypothyroidism

b. symptoms include fever and thyroid tenderness | c. it is probably due to a viral infection

30. Patients who live with new type of LVAD (left ventricular assist device) have no pulse. True/False

False

2. The following hormones synthetized by adenohypophysis, except: a. GH b. ADH c. TSH d. GnRH

b. ADH | d. GnRH

8. Which lipoprotein plasma level is the most frequently elevated in nephrotic syndrome? Select one: a. CHY b. VLDL c. LDL d. IDL e. HDL

c. LDL | Wiki - "elevated LDL, usually with concomitantly elevated VLDL, is indicative of nephrotic syndrome."

24. Diseases associated with the deficiency of the complement system: A.C1q inhibitor deficiency - angioedema (HAE) B.C3 deficiency - severe bacterial infections C.C1, C2, C4 deficiency - autoimmune diseases D.Decay accelerating factor (DAF) deficiency -paroxysmal nocturnal hemoglobinuria (PNH)

A.C1q inhibitor deficiency - angioedema (HAE) B.C3 deficiency - severe bacterial infections C.C1, C2, C4 deficiency - autoimmune diseases D.Decay accelerating factor (DAF) deficiency -paroxysmal nocturnal hemoglobinuria (PNH)

13. Pathological changes of adipose tissue in shock: a. Increased lipolysis b. Increased glucose uptake in adipose tissue c. Development of hypoxia due to centralization of circulation d. Increased formation of ketone bodies in adipose tissue

c. Development of hypoxia due to centralization of circulation d. Increased formation of ketone bodies in adipose tissue (Slide 58 and 59)

10. Which statements are true about GLUT4 translocation in skeletal muscle cells? a. Insulin binding to insulin receptor stimulates the translocation of GLUT4 transporters responsible for. b. Physical exercise promotes GLUT4 translocation via an insulin-dependent mechanism c. Physical exercise promotes GLUT4 translocation in an insulin-independent fashion d. Physical exercise does not affect the translocation of GLUT4 transporters

a. Insulin binding to insulin receptor stimulates the translocation of GLUT4 transporters responsible for. c. Physical exercise promotes GLUT4 translocation in an insulin-independent fashion

11. Which of the following factors contribute to the development of atherosclerosis according to lipid theory? a. The absorption/uptake of modified LDL by macrophages b. Micro-injuries of the vascular intima promote platelet adhesion and aggregation c. The change of the TXA2 / PGI2 ratio d. Infiltration of LDL into the arterial wall

a. The absorption/uptake of modified LDL by macrophages | d. Infiltration of LDL into the arterial wall

1. Which materials are stored in the liver? a. nutrients b. ketone bodies c. iron d. vitamines

a. nutrients c. iron d. vitamines

26. Which statements are true about type 2 diabetes? a. Ketoacidosis mostly occurs in patients who have other diseases b. Mumps and Coxsackievirus infections play a significant role in the development of type 2 diabetes c. Its prevalence increases in younger patients d. It increases the risk of cardiovascular diseases

a. Ketoacidosis mostly occurs in patients who have other diseases c. Its prevalence increases in younger patients d. It increases the risk of cardiovascular diseases

9. Possible cause of hyperthyroidism, except:(1) a. Iodine deficiency b. Hashimoto’s thyroiditis c. struma ovarii d. thyrotoxicosis factitia e. Subacute thyroiditis

a. Iodine deficiency

``` 6. Negative acute phase proteins: A.α1-protease inhibitor B.transferrin C.albumin D.ceruloplasmin ```

B.transferrin | C.albumin

29. clinical signs of acute adrenocortical insufficiency, except:(1) a. Dehydration b. Hypoglycemia c. Hypotension d. Hypernatremia e. Nausea

d. Hypernatremia

35. Symptoms of left sided heart failure: a. dyspnea b. pulmonary congestion c. hepatomegaly e. peripheral edema

a. dyspnea b. pulmonary congestion (Slide 8)

17. Components of the atherosclerotic plaque: a. macrophages b. smooth muscle cells c. lymphocytes d. cholesterol crystals

a. macrophages b. smooth muscle cells c. lymphocytes d. cholesterol crystals

23. Characteristic finding in Pygmy dwarfism a. complete lack of IGF-II b. failure of IGF-I to increase at puberty c. extreme short stature (<120 cm) d. reduced serum GH level e. IGF-I receptor deficiency

b. failure of IGF-I to increase at puberty

5. A common cause of arrhythmias: a. Ischemic heart disease b. Hypertension c. Drug effect d. Dilation of the atria

a. Ischemic heart disease b. Hypertension c. Drug effect d. Dilation of the atria

38. What is the main organ of the regulation of the energetic (caloric) cycle? a. the kidneys b. the brain c. the bone tissue d. the adipose tissue e. the lungs

d. the adipose tissue

37. The caloric cycle is characterized, EXCEPT :(1) a. amino acids are metabolized to pyruvate b. the mass of stored fat exceeds that of stored protein c. triglycerides are hydrolyzed to fatty acids and glycerol d. the mass of glycogen stores does not reach the of 1/20 of stored e. fat fatty acids can be transformed to glucose

e. fat fatty acids can be transformed to glucose

7. In patients with liver failure who have high levels of ammonia in the plasma: a. The activity of glutamine synthetase is increased in the muscle b. The activity of glutamine synthetase is increased in the liver c. The amount of glutamate is increased in the synapses of the brain d. The amount of glutamate is increased in the astrocytes

a.The activity of glutamine synthetase is increased in the muscle (GABA is elevated in the synapses - Wiki+ Slide 48-49)

7. What are the actions of insulin? a. It increases the glucose uptake in beta cells in the pancreas b. It inhibits the production of ketone bodies in the liver c. It increases the glycogen synthesis in muscle d. It increases triglyceride synthesis in the adipose tissue

b. It inhibits the production of ketone bodies in the liver c. It increases the glycogen synthesis in muscle d. It increases triglyceride synthesis in the adipose tissue

30. Conditions associated with increased energy need: a. Febrile state b. Malignancy c. Trauma d. Pre-obesity

a. Febrile state b. Malignancy c. Trauma

4. It may cause arrhythmia or may increase the risk for it: a. Defibrillation b. High blood pressure c. Electrolyte imbalance d. Coronary heart disease

a. Defibrillation b. High blood pressure c. Electrolyte imbalance d. Coronary heart disease

7. Which is false of the following statements? Select one or more: a. Lipoproteins are coated by a phospholipid bilayer b. Cholesterol molecules are located on the surface of lipoproteins c. Triglycerides and cholesterol esters are located in the nuclei of lipoproteins d. Apoproteins are located in the nuclei of lipoproteins

a. Lipoproteins are coated by a phospholipid bilayer | d. Apoproteins are located in the nuclei of lipoproteins

13. True statements about the unifying hypothesis: a. Smooth muscle cells in the plaque have clonal origin b. The hypothesis unifies the lipid and the response to injury theories c. The essence of this hypothesis is: the thrombogenic- and mesenchymal theories have common components d. Modified LDL can also cause endothelial dysfunction

b. The hypothesis unifies the lipid and the response to injury theories d. Modified LDL can also cause endothelial dysfunction (Slide 106)

22. Function of apoprotein: Select one or more: a. Potential activation of lipoprotein metabolism enzymes b. Stabilization of lipoprotein structure c. Regulation of receptor binding of lipoproteins d. Potential inhibition of lipoprotein metabolism enzymes

a. Potential activation of lipoprotein metabolism enzymes b. Stabilization of lipoprotein structure c. Regulation of receptor binding of lipoproteins d. Potential inhibition of lipoprotein metabolism enzymes (Lecture Slide 9)

``` 15.1 What are the complications of hypertension?/ A. Stroke B. Heart Failure C. Chronic Renal Failure D. Peripheral vascular disease ```

A. Stroke B. Heart Failure C. Chronic Renal Failure D. Peripheral vascular disease

13. What is the idiosyncratic reaction? a. severe adverse effect resulting from the interaction of more than two drugs b. severe adverse effect resulting from the interaction of two drugs c. when two different drugs have the same adverse effect d. drug poisoning of mentally retarded people e. severe adverse effect of a drug administered at the usual dose

e. severe adverse effect of a drug administered at the usual dose

42. Which of the following diseases can cause hirsutism? a. Hypothyroidism b. Cushing’s syndrome c. polycystic ovary syndrome d. Klinefelter syndrome

b. Cushing’s syndrome | c. polycystic ovary syndrome

38. True statements for Klinefelter Syndrome: a. The most common cause of Primary Hypogonadism b. Tall stature c. Breast cancer often develops d. Karyotype: XX0

a. The most common cause of Primary Hypogonadism b. Tall stature c. Breast cancer often develops

11. Which hereditary condition may cause progressive parenchymal lesion in the liver? a. Gilbert’s syndrome b. hemochromatosis c. Wilson’s disease d. hemophilia

b. hemochromatosis | c. Wilson’s disease

21. True statement(s) about obesity classification according to BMI: a. 25 ≤ BMI ≤29,9 pre-obesity b. 35≤ BMI ≤ 39,9 is obesity grade I c. BMI ≤18,5 malnutrition d. BMI ≥ 40 extreme obesity

a. 25 ≤ BMI ≤29,9 pre-obesity c. BMI ≤18,5 malnutrition d. BMI ≥ 40 extreme obesity

26. Correct statements for Laron dwarfism: a. the incidence of malignancy and DM is increased in these patients b. GH receptor defect c. extreme short (<120 cm) stature d. GH secretion is suppressed by glucose

a. the incidence of malignancy and DM is increased in these patients b. GH receptor defect

46. 1 Risk factors of endometriosis: a. early menarche b. long menstrual cycle c. smoking d. alcohol consumption

a. early menarche d. alcohol consumption (smoking - a protecting factor!?!) (Slide 88)

17. FGF23 may cause the following a. cardiac hypertrophy b. stimulation of 1-alpha-hydroxylase activity c. tachycardia d. stimulation of 24-hydroxylase

a. cardiac hypertrophy | d. stimulation of 24-hydroxylase

7. Conn-syndrome is NOT associated with: (1) a. Adenoma b. 21-hydroxylase deficiency c. 17α-hydroxylase deficiency d. hyperplasia e. 11ß-hydroxylase deficiency

b. 21-hydroxylase deficiency

5. Effects of glucocorticoids, except: (1) a. gluconeogenesis b. se glucose↑ c. collagen synthesis ↑ d. GFR↑ e. eosinopenia

c. collagen synthesis ↑

33. 2 Which endocrine disease can cause hypotension? a. Sheehan-syndrome b. Addison-disease c. Waterhouse–Friderichsen-syndrome d. Cushing-syndrome

a. Sheehan-syndrome b. Addison-disease c. Waterhouse–Friderichsen-syndrome

43. May indicate Polycystic Ovary syndrome: a. dyslipidemia b. oligomenorrhea c. weight loss d. IGT / IFG

a. dyslipidemia b. oligomenorrhea d. IGT / IFG

16. Which infection cannot be prevented by vaccination? a. HDV b. HAV d. HCV e. HBV

c. HCV | HEV Vaccine available only in china - extra

11. Which of the following may not be a result of elevated serum calcium level? a. nephrocalcinosis b. hypertension c. pancreatitis d. accelerated drug metabolism

b. hypertension all of the others are an optional result of Hypercalcemia: https://en.wikipedia.org/wiki/Pancreatitis https://en.wikipedia.org/wiki/Hypercalcaemia

16. Potential cause(es) of familial hypercholesterolemia: Select one or more: a. Apo B mutation b. Loss of function mutation of PCSK9 c. Apo B-48 deficiency d. LDL receptor mutation

a. Apo B mutation | d. LDL receptor mutation

1. 2. Risk factors of arrhythmia a. drug effects b. cardiomyopathies c. certain endocrine diseases d. electrolyte abnormalities

a. drug effects b. cardiomyopathies c. certain endocrine diseases d. electrolyte abnormalities

28. Which statements are true about hyperosmolar non-ketotic coma? a. Severe acidosis develops due to lactic acid production b. Blood sugar levels may reach 80-100 mmol/l values c. Its mortality is high d. It mostly occurs in type 2 diabetes patients

b. Blood sugar levels may reach 80-100 mmol/l values c. Its mortality is high d. It mostly occurs in type 2 diabetes patients

``` 23. Effects of bradykinin A.Plasminogen activation B.Increases in venule permeability C.Arteriole dilatation D.C1q activation ```

B.Increases in venule permeability | C.Arteriole dilatation

20. Non-modifiable risk factors of atherosclerosis: a. family history b. gender c. Caucasian race d. age

a. family history b. gender c. Caucasian race d. age

21. Main effects of angiotensin II through AT1 receptors: a. vasoconstriction resulting in blood pressure increases b. enhances renin production c. decreases of aldosterone secretion d. increases kidney blood flow

a. vasoconstriction resulting in blood pressure increases

7. What is used in the treatment of IBD? a. antacids b. surgical resection c. immune suppression d. Biological drugs (anti-TNF ab)

b. surgical resection c. immune suppression d. Biological drugs (anti-TNF ab)

18. Plasmin activates the complement system through C1 cleavage. True/False

False

17. Possible clinical symptom(s) of familiar dys-beta-hyperlipidemia Select one or more: a. tuberoeruptive xanthomas b. xanthoma tendinosum c. yellowish xanthomas in palm wrinkles d. tuberous xanthomas

a. tuberoeruptive xanthomas c. yellowish xanthomas in palm wrinkles d. tuberous xanthomas -This is Type 3 Dyslipidemia "1LP, 2LD, b adds v, E is 3, 4 adds more"

12. Which symptoms in patient history may suggest heart failure? a. Dyspnea b. Nycturia c. orthopnea d. Burning pain at the apex of the heart

a. Dyspnea b. Nycturia c. orthopnea

12 Which lipoprotein plasma level is the most frequently elevated in obesity? a. CHY-IDL b. CHY-VLDL-LDL c. VLDL-HDL d. VLDL-CHY e. LDL-CHY

d. VLDL-CHY

3. synthesized by the zona fasciculata cells in the adrenal cortex: (1) a. Dehydroepiandrosterone b. Corticosterone c. Aldosterone d. Androgens e. Cortisol

e. Cortisol

4. Lipoproteins rich in triglycerides: Select one: a. LDL-IDL b. CHY-LDL c. CHY-VLDL d. HDL-LDL e. HDL-IDL

c. CHY-VLDL

7. Which pituitary hormone level will decrease first due to a progressive loss of pituitary function? a. LH b. ADH c. TSH d. ACTH e. Prolactin

a. LH

13. Incidence of hypothyroidism in the population: a. 20-30% b. 0.1-0.5 % c. 30-40 % d. 3-5 % e. 10-20 %

d. 3-5 %

24. False statement for subacute thyroiditis (1): a. fever, pain b. absence of anti-thyroidal antibodies c. viral infection is involved in the etiology d. increased RAIU e. enlargement of thyroid gland

d. increased RAIU | https: //www.endocrineweb.com/conditions/thyroid/thyroiditis

16. Which statement is FALSE regarding FGF-23?(1) a. It is secreted by osteocytes in the bones. b. Calcitriol and hyperphosphatemia stimulate FGF23 expression c. FGF-23 induces left ventricular hypertrophy. d. FGF-23 stimulates the tubular phosphate reabsorption.

d. FGF-23 stimulates the tubular phosphate reabsorption.

6. The stroke volume is decreased in patients with myocardial ischemia due to: a. shorter duration of diastole b. decreased inotropy c. decreased lusitropy d. decreased preload

b. decreased inotropy

29. What is the role of IRS (insulin receptor substrate) in the development of insulin resistance: a. Excessive amount of fatty acids induce serine phosphorylation of IRS1 and cause insulin resistance b. TNF-alpha induces IRS-1 phosphorylation at serine residues that cause insulin resistance c. IRS1 plays a key role in insulin signaling but it is not involved in the pathogenesis of insulin resistance d. If IRS1 is phosphorylated at any site it will cause insulin resistance

a. Excessive amount of fatty acids induce serine phosphorylation of IRS1 and cause insulin resistance b. TNF-alpha induces IRS-1 phosphorylation at serine residues that cause insulin resistance

12. 2 FALSE statement(s) regarding obesity: a. May be caused by increased food intake as a consequence of civilization b. Obesity formed in older age has worse prognosis c. It is more frequent in low income populations d. May be caused by decreased physical activity as a consequence of lifestyle changes e. Inherited components play important role in its formation

b. Obesity formed in older age has worse prognosis | c. It is more frequent in low income populations

11. Immediate compensatory mechanisms induced by fluid depletion (BP 90 mmHg): a. activation of low pressure receptors b. activation of the renin-angiotensin system c. activation of peripheral chemoreceptors d. central nervous system ischemic response

a. activation of low pressure receptors c. activation of peripheral chemoreceptors d. central nervous system ischemic response

38. The treatment of choice in Torsade de pointes tachycardia: a. Mg infusion b. Ca infusion c. Beta blockers d. Ca antagonists

a. Mg infusion

1. 5 Based on the mesenchymal theory, what will induce the changes of extracellular matrix component in the vessels? a. Hypertension → mechanical compression of vascular wall b. Hyperlipidemia → spasm of vasal vasodilation → hypoxia c. Catecholamine → spasm of vasal vasodilation → hypoxia d. Smoking - nicotine → decreased NO production → hypoxia

a. Hypertension → mechanical compression of vascular wall c. Catecholamine → spasm of vasal vasodilation → hypoxia (Slide 84)

10. 1 which of the following pathogens do NOT play a role in the development of atherosclerosis according to the inflammation theory? a. Helicobacter pylori b. Chlamydia pneumoniae c. HBV d. HCV

c. HBV | d. HCV

28. Which parameter is NOT altered in Graves-Basedow’s disease? (1) a. thyroglobulin (Tg) b. Se FT4 c. anti-TPO Ab d. anti-TR Ab e. RAIU

a. Thyroglobulin (Tg)

4. Which statements are true about ulcerative colitis (UC)? a. Biopsy is needed for the diagnosis b. The sigmoid colon and the rectum are affected in most cases c. An autoimmune mechanism is involved in the pathogenesis of UC d. Colonoscopy is needed for the diagnosis

a. Biopsy is needed for the diagnosis b. The sigmoid colon and the rectum are affected in most cases c. An autoimmune mechanism is involved in the pathogenesis of UC d. Colonoscopy is needed for the diagnosis (Slide 45)

18. Which gene’s polymorphism affect the susceptibility to type 1 diabetes? a. PMN2 b. IFIH1 c. MDA5 d. OAS1

b. IFIH1 c. MDA5 d. OAS1

36. Typical signs of 21-hydroxylase deficiency: a. early menarche b. hypokalemia c. hirsutism d. hypertonia

a. early menarche c. hirsutism (Congenital Adrenal Hyperplasia)

16. Which statements are true about MODY? a. Mutations in the glucokinase gene are the most common cause b. It is a subtype of type 1 diabetes c. It accounts for a low percentage of diabetes d. It is a synonym of juvenile onset diabetes

a. Mutations in the glucokinase gene are the most common cause c. It accounts for a low percentage of diabetes The two most common MODY types are GCK-MODY (MODY2) and HNF1A-MODY (MODY1) https://www.ncbi.nlm.nih.gov/books/NBK500456/

``` 24. Choose the correct order of lipoproteins according to increasing density Select one: a. CHY-IDL-VLDL-LDL-HDL b. CHY-VLDL-IDL-LDL-HDL c. VLDL-CHY-HDL-LDL-IDL d. LDL-IDL-VLDL-HDL-CHY e. HDL-LDL-IDL-VLDL-CHY ```

b. CHY-VLDL-IDL-LDL-HDL

17. 1 Which ones are the potential complications of gastroesophageal reflux? a. Barrett's esophageal ulcer b. Esophageal cancer c. Achalasia d. Barrett metaplasia

a. Barrett's esophageal ulcer b. Esophageal cancer d. Barrett metaplasia (Achalasia is the differential)

17. Mechanisms leading to the irreversible phase of hemorrhagic shock: a. increased sympathetic tone b. accumulation acidic metabolites c. contraction of precapillary sphincters d. microembolization

b. accumulation acidic metabolites | d. microembolization

1. Optimal value of serum triglyceride (TG): Select one: a. 3.0-4.5 mmol/l b. 2.3-5.6 mmol/l c. < 1.7 mmol/l d. 5.0-6.5 mmol/l e. 4.1-4.9 mmol/l

c. < 1.7 mmol/l

1. The normal value of CVP a. 4 mmhg b. 7 mmhg c. 11 mmhg d. 15 mmhg e. 20 mmhg

a. 4 mmhg

2. Radioactive iodine uptake is increased in the following diseases: a. Exogenous thyroid hormone therapy b. Graves-Basedow disease c. Multinodular goiter d. Thyroiditis

b. Graves-Basedow disease | c. Multinodular goiter

39. Possible consequence of increased atrial frequency: a. appearance of non-conducted beats b. Deterioration of coronary blood filling c. palpitation d. p-pulmonale

a. appearance of non-conducted beats | c. palpitation

27. Conditions associated with increased energy need except: a. pre-obesity b. trauma c. malignancy d. febrile state

a. pre-obesity

18. Which statements are true about renovascular hypertension? A. Secondary hyperaldosteronism decreases the sodium reabsorption in the kidney B. Renin reduces the blood pressure C. In renovascular hypertension, plasma renin activity can be normal or elevated in response to reduced renal blood flow. D. In the pathomechanism of renovascular hypertension, the renin-angiotensin-Aldosterone-system (RAAS) plays a decisive role

D. In the pathomechanism of renovascular hypertension, the renin-angiotensin-Aldosterone-system (RAAS) plays a decisive role

26. Obstructive shock can be caused by: a. Pneumothorax b. diabetes mellitus c. heart tamponade d. pulmonary embolization

a. Pneumothorax c. heart tamponade d. pulmonary embolization

9. 2 True about leptin : a. it is produced by the adipose tissue b. it indirectly increases sympathetic activity c. it decreases food intake d. it inhibits heat generation

a. it is produced by the adipose tissue b. it indirectly increases sympathetic activity c. it decreases food intake

27. Which factors increase the risk of developing metabolic syndrome? a. polycystic ovarian syndrome b. hyperthyroidism c. smoking d. age

a. polycystic ovarian syndrome (LH overactivity - Testosterone) c. smoking d. age

21. 3 The atherogenic effect of homocysteine: a. Homocysteine stimulates the proliferation of smooth muscle cells b. Homocysteine inhibits binding of tPA and decreases fibrinolysis c. It inhibits endothelial functions d. Homocysteine increases thrombomodulin expression and activity, therefore increases the activation of protein C

a. Homocysteine stimulates the proliferation of smooth muscle cells b. Homocysteine inhibits binding of tPA and decreases fibrinolysis c. It inhibits endothelial functions

23. Cause(s) of hypovolemic shock: e. Diarrhea f. penicillin allergy g. diabetes mellitus h pneumothorax

e. Diarrhea g. diabetes mellitus (Penicillin - Anaphylactic)

1. Type of shock in which in the early phase the pale and sweaty skin is typical? a. Septic b. Hypovolemic c. Cardiogenic d. Neurogenic

b. Hypovolemic c. Cardiogenic (Slide 21)

26. What percentage of deaths occurring under 70 years of aging Hungary are related to alcohol consumption: a. 5% b. 10% c. 15% d. 20% E. 25%

d. 20%

6. Which is true of the following statements? Select one or more: a. Triglycerides and cholesterol esters are located in the nuclei of lipoproteins b. Apoproteins are located in the nuclei of lipoproteins c. Lipoproteins are coated by a phospholipid bilayer d. Cholesterol molecules are located on the surface of lipoproteins

a. Triglycerides and cholesterol esters are located in the nuclei of lipoproteins d. Cholesterol molecules are located on the surface of lipoproteins

``` 8. Factors/causes influencing essential hypertension: A. kidney disease B. excessive alcohol consumption C. high NaCl-intake D. psychosocial stress ```

A. kidney disease B. excessive alcohol consumption C. high NaCl-intake D. psychosocial stress

``` 3. Factors influencing Mean Arterial Pressure (MAP): A. Contractility B. Cardiac output C. Heart rate D. Total peripheral resistance ```

B. Cardiac output (CO) | D. Total peripheral resistance (TPR)

28. Myosin, actin and titin isoforms characteristic of fetal life appear in patients with heart failure. True/False

True

26. Which is FALSE of the following statements? Select one or more: a. LDL-receptors are located on the surfaces of liver and most other cells b. Binding to LDL-receptors is regulated by apo B-100 and apo E c. In man, approximately 70% of LDL is taken up in the liver and 30% in extrahepatic tissues d. The main function of LDL is to transport the high energy content triglyceride

d. The main function of LDL is to transport the high energy content triglyceride

25. Which statements are true about type 2 diabetes? a. Late complications may be detectable at the time of diagnosis b. It never occurs in children c. Insulin resistance is a characteristic feature of the disease d. Genetic predisposition is stronger for type 2 than type 1 diabetes

a. Late complications may be detectable at the time of diagnosis c. Insulin resistance is a characteristic feature of the disease d. Genetic predisposition is stronger for type 2 than type 1 diabetes

27. Sudden death of a patient with WPW syndrome is probably caused by: a. orthodromic AVRT b. FBI tachycardia c. sinus arrest d. antidromic AVRT

b. FBI tachycardia

15. 2 Which statements are true about LADA? a. It is synonymous to MODY b. Autoantibodies are detectable in LADA c. It begins over the age of 30-35 years d. Oral antidiabetics may be sufficient in the beginning of the disease

b. Autoantibodies are detectable in LADA c. It begins over the age of 30-35 years d. Oral antidiabetics may be sufficient in the beginning of the disease (Slide 18)

36. Possible cause of pseudohermaphroditism in men: a. testicular feminization b. failure of secretion of testosterone or Müllerian duct inhibitory factors c. failure of conversion of testosterone to DHT d. Turner syndrome

b. failure of secretion of testosterone or Müllerian duct inhibitory factors c. failure of conversion of testosterone to DHT

46. During the differentiation process of adipose tissue, the ratio between the white and the brown adipose tissue can be altered. True/False

True

``` 17. Hypothalamic hormones, except: Select one:(1) a. GnRH b. hCG c. Vasopressin d. CRH e. TRH ```

b. hCG

7. Which factors play role in the pathogenesis of hypertension: a. physical inactivity b. smoking c. genetic factors d. high salt intake

a. physical inactivity b. smoking c. genetic factors d. high salt intake

3. Which one is incorrect? Secondary osteoporosis may occur due to: a. Postmenopause b. Drugs c. Alcohol use disorder d. Anorexia nervosa

a. Postmenopause (Primary)

26. 2 The basal metabolic rate is influenced by: (1) a. body surface b. heart rate c. autoimmune disease d. all of the above

a. body surface b. heart rate c. autoimmune disease d. all of the above - That's the one! - https://en.wikipedia.org/wiki/Basal_metabolic_rate

5. Stroke volume is influenced by: a. sympathetic tone b. digitalis effect c. Preload d. contractility of the ventricles

a. sympathetic tone b. digitalis effect c. Preload d. contractility of the ventricles

4. True statements: a. glucocorticoids are synthesized in zona glomerulosa b. mineralocorticoids are synthesized in zona fasciculata c. mineralocorticoids are synthesized in zona glomerulosa d. glucocorticoids are synthesized in zona fasciculata

c. mineralocorticoids are synthesized in zona glomerulosa | d. glucocorticoids are synthesized in zona fasciculata

43. Characteristic laboratory alterations in malnutrition (1) a. Decreased lymphocyte count b. Decreased plasma zinc level c. Decreased serum albumin levels d. None of mentioned e. All mentioned above

a. Decreased lymphocyte count b. Decreased plasma zinc level c. Decreased serum albumin levels e. All mentioned above

10. Which of the following physical findings may suggest heart failure? a) Edema b) Distended neck veins c) Crepitation at the base of the lungs d) Hepatomegaly

a) Edema b) Distended neck veins c) Crepitation at the base of the lungs d) Hepatomegaly

5. 1 Which of the following factors contribute to the development of atherosclerosis according to the aging theory: a. The changed composition of EC matrix potentiates platelets adhesion and aggregation b. The uptake of modified LDL by macrophages c. Micro-injuries on vascular intima promote platelet adhesion and aggregation d. The component of connective tissue of vessels and other tissues change by aging

d. The component of connective tissue of vessels and other tissues change by aging

15. In which Viral hepatitis is pregnancy a risk factor for a fulminant course? a. HEV b. HCV c. HDV d. HAV e. HBV

a. HEV

23. Which of the following causes paroxysmal supraventricular tachycardia? a. AVNRT b. atrial flutter c. torsades de poIntes tachycardia d. AVRT

a. AVNRT | d. AVRT

2. The value of ejection fraction in a healthy person is: a. 35–55% b. 55–75% c. 75-95% d. 95–100%

b. 55–75%

31. Hemodynamic defense reaction includes: a. vasodilation b. hypertrophy of the myocardium c. salt and water retention d. cardiac stimulation

c. salt and water retention | d. cardiac stimulation

20. Which statements are true about type 1 diabetes? a. Insulin resistance is the chief characteristic b. It accounts for 20% of diabetes c. It starts with a sudden onset d. Insulin is needed for survival

c. It starts with a sudden onset d. Insulin is needed for survival (Slide 9)

7. 1 Arrhythmias may cause: a. Confusion b. Syncope c. Fatigue d. Circulatory collapse

a. Confusion b. Syncope c. Fatigue d. Circulatory collapse

1. The postprandial period is characterized by: a. decreased protein synthesis b. glycogen break down c. triglyceride-synthesis d. endogenous glucose source e. lipolysis

c. triglyceride-synthesis

``` 11. Mediators playing a role in fever formation A.IL-1 B.PGI2 C.bacterial LPS D.TNFα ```

A.IL-1 C.bacterial LPS D.TNFα

6. Effects of glucocorticoids: a. stimulate bone resorption b. increase protein synthesis c. increase gluconeogenesis d. increase water and Na+-excretion

a. stimulate bone resorption | c. increase gluconeogenesis

21. Characteristic signs of diabetes insipidus, except: a. nocturia or nocturnal enuresis b. polyuria, polydipsia, thirst c. hyperhidrosis d. hyponatremic dehydration

c. hyperhidrosis | d. hyponatremic dehydration

19. Signs of primary hyperaldosteronism: a. hypokalemia b. edema c. polyuria d. acidosis

a. hypokalemia c. polyuria https: //en.wikipedia.org/wiki/Primary_aldosteronism

24. Atrial natriuretic peptide (ANP) may have the following effects: a. urinary sodium loss with fluid retention b. diuretic effect c. urinary sodium loss d. antiproliferative effect

b. diuretic effect | c. urinary sodium loss

7. What is used in the treatment of IBD? a. Glucocorticoid steroids b. Proton pump inhibitors c. Biological drugs (anti-TNF ab) d. NSAIDs

a. Glucocorticoid steroids | c. Biological drugs (anti-TNF ab)

15. What are the potential complications of reflux disease? a. peptic ulcer b. weight loss c. achalasia d. esophageal strictures

ed. esophageal strictures

22. Characteristic features of atherogenic dyslipidemia: a. presence of small LDL in the serum b. decreased serum level of HDL c. elevated serum TG level d. dysfibrinogenemia

a. presence of small LDL in the serum b. decreased serum level of HDL c. elevated serum TG level

14. Loss of pituitary function develops due to, except:(1) a. Aplasia b. Craniopharyngioma c. Iatrogenic d. Addison’s disease e. Adenoma

d. Addison’s disease

6. Changes of laboratory parameters observed in shock: a. decreased serum phenylalanine and tyrosine levels b. increased blood urea nitrogen (BUN) c. decreased serum lactate level d. increased serum alanine and glutamine levels e. increased serum fibrinogen level f. increased serum glucose level g. decreased levels of acute phase proteins h. increased serum leu/tyr, leu/phe ratio

a. decreased serum phenylalanine and tyrosine levels b. increased blood urea nitrogen (BUN) d. increased serum alanine and glutamine levels e. increased serum fibrinogen level f. increased serum glucose level h. increased serum leu/tyr, leu/phe ratio

19. Observations in iodine deficiency(1): a. RAIU ↓ b. Se FT4 ↓, and FT3 ↑ c. Se TSH ↓ d. Se FT4 ↑ and FT3 ↑ e. Se FT4 ↑ and FT3 ↓

b. Se FT4 ↓, and FT3 ↑

26. In the myocardium of patients with heart failure: a. Phosphocreatine level is decreased b. ATP level is decreased c. the ratio of fatty acid oxidation is decreased d. the ratio of glucose oxidation is decreased

a. Phosphocreatine level is decreased b. ATP level is decreased c. the ratio of fatty acid oxidation is decreased

10. Possible cause of hyperthyroidism: a. subacute thyroiditis b. struma ovarii c. toxic uninodular or multinodular goiter d. toxic diffuse goiter

a. subacute thyroiditis (Transient by Lysis) b. struma ovarii c. toxic uninodular or multinodular goiter d. toxic diffuse goiter (Slide 32)

32. Which endocrine disease can cause hypertension? a. Cushing-syndrome b. Acromegaly c. Hyperprolactinemia d. Diabetes insipidus

a. Cushing-syndrome | b. Acromegaly

20. Which clinical states are associated with a higher risk for hepatocellular carcinoma? a. NAFLD b. cirrhosis c. NASH d. chronic HBV infection

b. cirrhosis | d. chronic HBV infection

24. Which therapy is known to improve survival of patients with chronic heart failure? a. ACE inhibitors b. Digitalis c. Diuretics d. beta agonists

a. ACE inhibitors

9. 2 What are the features of celiac disease? a. bloody, mucous diarrhea b. Subfebrility/fever c. Chronic diarrhea, abdominal pain d. prevalence of 1%

b. Subfebrility/fever c. Chronic diarrhea, abdominal pain d. prevalence of 1% (Slide 26 - 1:70 -1:300 which is around 1%)

28. Which statements are true about growth factors? a. They increase the body height b. They increase the blood flow c. they promote the thickening of vessel walls d. They increase the diameter of blood vessels

c. they promote the thickening of vessel walls

26. What is the disadvantage of calcium containing phosphate binders in SHPT treatment? a. they often induce anaphylactic shock b. the drugs are expensive c. they promote the development of tertiary hyperparathyroidism d. they worsen the calciphylaxis

d. they worsen the calciphylaxis

Pathophys-Written Questions - Semester 1 Flashcards

(551 cards)