Quiz Questions

Question 1

Iron must be bound to something because free iron is toxic: T/F

Answer 1

True

Question 2

The two places that transferrin can pick up iron are through duodenal absorption and from neutrophils. T/F

Answer 2

False: from duodenal absorption and Macrophages

Question 3

Transferrin saturation= serum Iron/ TIBC x 100. T/F

Answer 3

True

Question 4

Transferrin is manufactured by the liver. If significant liver damage is present, the transferring level will be decreased. This will cause the transferrin saturation to decrease. T/F

Answer 4

False: Transferring decreases, the saturation increases

Question 5

Anything that decreases serum iron (like IDA) or that increases the amount of transferring will decrease the transferring saturation. T/F

Answer 5

true

Question 6

Many bacteria require iron, so in chronic disease, iron is locked away and bount to it’s storage form called ferritin. This is important because in anemia of chronic disease the ferritin will go up, because iron is being locked away to bacteria don’t have access to it. T/F

Answer 6

True

Question 7

The duodenum usually absorbs 1-2mg/day of iron. One unit of transfused blood delivers 250mg of iron. People that get frequent blood transfusions can become iron overloaded. T/F

Answer 7

True

Question 8

Conditions like thalassemia, that are characterized by ineffective erythropoiesis, cause increased amounts of iron to be absorbed, so the transferrin saturation will be increased. T/F

Answer 8

True

Question 9

TIBC and Transferrin saturation are the same thing. T/F

Answer 9

False

Question 10

Which of the following is incorrect regarding epiglottitis?

a. some people have a high-riding epiglottitis
b. the causal organisms in many cases is H. influenzae
c. S/Sxs can be remembered as the 4Ds
d. It produces a steeple sign on XRAY
e. children 2-5 are most susceptible

Answer 10

d. steeple sign is croup. epiglottitis produces the thumbprint sign

Question 11

Which of the following is incorrect regarding larygnitis and laryngeal polyps?

a. larygneal polyps essentially never transform into malignancies
b. laryngotracheobronchitis produces a steeple sign on XRAY
c. can be caused by GERD
d. Singers nodules are unilateral, whereas polyps are bilateral
e. Laryngotracheobronchitis is often caused by parainfluenza virus

Answer 11

d. (singers nodules are usu bilateral, polyps are unilateral)

Question 12

Which of the following is not true of pharyngitis?

a. GABHS typically causes anterior cervical LA
b. viral pharyngitis produces no exudate, proven by mono
c. diptheriae often causes grey exudate
d. n. gonorrhea pharyngitis often produced greenish exudate
e. mono causes posterior LA

Answer 12

b

Question 13

Which of the following is not true of bacterial pharyngitis or ARF?

a. ARF results from GAS pharyngitis only
b. ARF is the leading cause of CVD-related death in the first five decades of life
c. ARF is though to be caused when Ag cross-reacts with M proteins on GABHS and epitopes of cardiac myosin and laminin.
d. Peritonsilar abscesses produce a hot potato voice
e. peritonislar abscesses have a greater potential for airway obstruction than retropharyngeal/parapharygeal abscesses

Answer 13

e.

Question 14

Which of the following statements about vertigo is false?

a. BPPV can be confused with Menieres bc both can cause hearing loss
b. Ramsay Hunt syndrom can also cause vertigo
c. BPPV is the most common cause of recurrent vertigo from the middle ear
d. displaced otoliths stimulate CN VIII hair cells and create the sensation of movement.
e. one difference distinguishin btwn labrythitis and BPPV is based on if the person has had a viral infx preceeding.

Answer 14

a.

Question 15

Which of the following is false regarding oral pathologies?

a. irritation fibromas can be differentiated from pyrogenic granulomas by the abscence or presence of blanching
b. leukoplakia is a clinical description, not a clinical entity
c. Tzanck smears may show large squamous cells with inclusions when herps infx is present
d. all of the above are correct
e. PAS staining detects polysaccharides present in hyphae of budding candida yeast

Answer 15

d

Question 16

Which of the following is incorrect?

a. In poorly differentiated SCC, you cant even tell the cells are of squamous origin.
b. in well differentiated SCC you can see keratin pearls.
c. in moderately differentiated SCC you see intercellular bridges, no pearls.
d. all are correct
e. SCC is differentiated into 3 categories: well, moderate and poor

Answer 16

d

Question 17

Which of the following is incorrect regarding salivary gland pathology?

a. Mucoceles produce fluctuant swellings of the lower lip, often with a blue translucent hue.
b. in Mikulicz syndrome gland enlargement is usually painless but produces xerostomia
c. mikulicz syndrome is a combination of salivary and lacrimal gland enlargment
d. the most common form of viral sialadenitis is secondary to measles infection
e. mucoceles are often due to trauma causing blockage or rupture of a salivary gland duct

Answer 17

d

Question 18

Which of the following is not true of pleomorphic adenoma?

a. when removed by enucleation, its recurrence rate is 4%
b. all of the above are correct
c. pleomorphic adenomas can progress to adenocarcinomas, a risk that increases with time
d. pleomorphic adenomas make up the majority of parotid gland tumors
e. it presents as painless, slow-growing mobile mass within the parotid or submandibular areas or in the buccal cavity

Answer 18

a

Question 19

Which answer is just plain wrong?

a. branchial cleft cysts present as lateral neck masses.
b. posterios cervical LA is common
c. thyroglossal duct cysts present as midline masses
d. odontogenic cysts that are malignant are rare and of ameloblastic origin.
e. infectious rhinitis is usually viral

Answer 19

b

Question 20

Which of the following is incorrect regarding lung cancer?

a. small cell carcinomas are worse, but they respond to chemotherapy better.
b. NSCLC behave similarly and are treated similarly
c. SCLC are more common, make up 80% of cases
d. it can divided into two major groups which make up 90% of lung cancer cases: SCLC and NSCLC.
e. all are correct

Answer 20

c

Question 21

Which of the following is incorrect regarding lung cancers?

a. SCLC is often called “oat cell” carcinoma
b. all are correct
c. SCLC tends to grow faster than NSCLC
d. 3 major types: adenocarcinoma, squamous cell carcinoma and large cell undifferentiated carcinoma.
e. SCLC carries a greater risk of metastasis than NSCLC

Answer 21

b

Question 22

What is not true about smoking?

a. as a general rule, 5-year survival rate for lung cancer is 35%
b. quitting for 10 years reduces risk, but not to the level of a non-smoker
c. bronchogenic carcinoma is any malignant neoplasm that arises in lung tissue
d. the younger a person is when they start smoking, the greater risk of getting lung cancer

Answer 22

a

Question 23

Which of the following is incorrect regarding small cell carcinoma?

a. the first sign of SCLC may be a paraneoplastic syndrome
b. SCLC has a better prognosis that most lung cancers
c. all are correct
d. paraneoplastic syndromes are common with SCLC
e. histologially, SCLC shows small dark staining epithelial cells with scant neoplasm

Answer 23

b. sclc has a better prognosis that most lung cancers

Question 24

Which of the following is incorrect regarding lung cancer symptoms?

a. the usual clinical presentation of a patient with lung cancer is someone in their 50s whose sxs are several mos duration.
b. dyspnea occurs in 20% of patients
c. Cough is the most common sx, in 75% of patients
d. chest pain occurs in 10% of patients
e. weight loss occurs in about 40% of patients

Answer 24

d

Question 25

which is incorrect about the location of certain types of cancers?

a. squamous cell carcinomas usu present centrally
b. large cell undifferentiated carcinomas can occur anywhere in the lung
c. SCLC may occur anywhere, but most commonly found centrally near the hilum
d. all are correct
e. adenocarcinomas usu occur in the periphery

Answer 25

d

Question 26

Which of the following is false regarding adenocarcinoma of the lung?

a. Adenocarc is really a glandular epithelium tumor that produces mucin
b. Adenocarc can be described with the three Ps: peripheral, pigmented, puckered
c. adenocarc may first come to the physician attention on routine CXR, but not before cancer has spread
d. adenocarc is most frequently dx’d type of lung cancer, about 1/3rd of cases
e. Adenocarc tends to be poorly circumscribed and grows outwardly with finger-like projections

Answer 26

e

Question 27

Which of the following is incorrect regarding squamous cell carcinoma of the lung?

a. all are correct
b. squamous cell carc is characterized by presence of keritinization in the form of pearls or individual cells with eosinophilic dense cytoplasm.
c. squamous cell carcinoma arise from either the main, lobar or seqmented bronchi
d. its thought to be related to chronic inflammation and injury of bronchial ciliated columnar epithelium
e. when central, squamcc of the lung present later with sxs that when it occurs in the periphery

Answer 27

e

Question 28

Which of the following is incorrect regarding large cell carcinomas?

a. LCC is an epithelial tumor with large nuclei and moderate amounts of cytoplasm
b. its also called large cell undifferentiated carcinoma
c. LCC is found in sheets as SCLC often is
d. All are correct

Answer 28

c is false

Question 29

Which of the following is incorrect regarding bronchila carcinoid tumors?

a. theyre the most common primary lung neoplasm in children
b. theyre considered a separate type of lung neoplasm
c. may present with diarrhea, facial flushing, wheezing, but usually only if the patient has liver metastasis
d. all are correct
e. strongly associated with smoking

Answer 29

e is false

Question 30

Which of the following is false regarding bronchiectasis?

a. a specific disease and “ectasis” means constriction
b. may also be found in assoc with autoimmune dz like RA and SLE
c. a dilation of bronchus associated with necrotizing inflammation
d. presents with cough, fever, foul-smelling purulent sputum
e. often caused by cystic fibrosis and post infection with Hflu, Aspergillus, TB, adenovirus, pseudomonas

Answer 30

a is false

Question 31

Which of the following is false regarding idiopathic pulmonary fibrosis?

a. all are correct
b. usu requires lung biopsy for dx
c. results from chronic inflammation of alveolar walls with progressive fibrosis.
d. shows fine linear opacities on a CXR and honey-comb on CT
e. though to result from malfunction of alveolar macrophages where lung epithelial cells produce abnml amts of PDGF and dec alveolar glutathione levels
f. clinically IPF presents as progressive DOE, non-productive cough, crackles, a cor pulmonale

Answer 31

a. all are correct

Question 32

Which of the following is incorrect regarding non-specific interstitial pneumonia?

a. wastebasket dx of any pneumonia/itis of unknown etiology that produces fibrosis
b. non-specific biopsy with distinct radiologic/histologic features and better prognosis that IPF
c. a concept that emerged when it was realized that patients with IPF failed to show dx features
d. all are correct
e. cellular infiltrate of non specific interstitial pneumonia made of lymphocytes and plasma cells

Answer 32

d. all are correct

Question 33

Which is incorrect regarding pneumoconiosis?

a. asbestosis, involvement of interstitium with resulting pulmonary fibrosis usu preceeds the development of pleural/subpleural fibrosis
b. asbestos crystals are spiral/straight and traverse the lung, enter the interstitiu, and impale the pleural lining
c. mesothelioma is almost always assoc with asbestosis exposure but smoking with asbestos doesnt seem to increase risk of developing mesothelioma
d. when pneumoconiosis is accompanied with RA, its known as caplans syndrom
e. mesothelioma can encase the entire lung with thick whitish tumor, spreading along the pleura

Answer 33

a is false

Question 34

Which of the following is incorrect regarding pneumoconiosis?

a. Silicosis generally develops very slowly over years to decades
b. Silicosis (sand crystals) create “egg shell” calcifications OF THE HILAR LYMPH NODES visible on CXR
c. in pneumoconiosis, particles greater than 5um or less than 1um are the most dangerous
d. The size and shape of the particulate matter as well as the amount of dust retained in the lungs and airways seems to be important
e. They tend to produce restrictive lung diseases through an inflammatory response of varing severity

Answer 34

c is false

Question 35

Which of the following is incorrect regarding granulomatous diseases?

a. The most common skin lesion in sarcoid patients is erythema nodosum
b. 70% of sarcoid patients will have hepatic granulomas, but rarely is the heart affected
c. Granulomatous disesases include systemic fungal diseases like an Aspergilloma
d. Sarcoidosis produces enlarged hilar lymph nodes (adenopathy) without “egg-shell calcifications”
e. Sarcoidosis is a mult-system granulomatous disorder of unknown etiology

Answer 35

c is false

Question 36

Which of the following is incorrect regarding pulmonary hypertension?

a. Persistently elevated pulmonary pressure can cause enlargement of the left ventricle (cor pulmonale)
b. All of the above are correct!
c. Recurrent thromboemboli can cause pulmonary hypertension due to alveolar damage and increased pulmonary vascular resistance
d. Primary pulmonary hypertension is a result of arterial wall thickening and obliteration of the lumen of medium ans mall pulmonary arteries
e. Can be caused by autoimmune diseases affecting the pulmonary vasculature (fibrosis of blood vessels)
f. Secondary pulmonary hypertension accounts for the majority of cases and is usually do to other cardiac or pulmonary conditions

Answer 36

a is false

Question 37

Regarding pneumonia, which of the following is incorrect?

a. Symptoms include cough, fever, myalgia, sputum, and pleuritic chest pain
b. Signs of consolidation include dullness to percussion, crackles, egophany, and absent breath sounds
c. Although pneumonia is a common cause of death, it usually does not occur in healthy people spontaneously
d. Atypical pneumonia is also called “walking pneumonia”
e. Atypical pneumonias are those caused by less typical pathogens like Haemophilus Pneumonia

Answer 37

e. is false

Question 38

Which of the following is incorrect regarding pneumonias?

a. Viral pneumonias are frequently alveolar, not interstitial
b. With atypical pneumonias, cultures usually are required to identify the organism
c. All of these are incorrect
d. Mycoplasma pneumoniae is typically a disease of older adults
e. Atypical pneumonias are typically not community aquired

Answer 38

c. all are correct

Question 39

Which of the following is incorrect regarding SARS?

a. Is considered a atypical pneumonia
b. Like most other non-bacterial pneumonias, it is confirmed by PCR
c. Like most viral pneumonias, the interstitium is infiltrated, and giant cells are often present
d. Caused by a Corona virus
e. All these are correct

Answer 39

e. all are correct

Question 40

Which of the following is not correct regarding emphysema?
A. Centrilobular emphysema occurs predominantly in heavy smokers, where as panacinar is particularly note worthy to occur in cases of alpha 1 antitrypsin deficiency
B. In centrilobular emphysema the central parts of the acini are affected while the distal alveoli are spared - this is in contrast to panacinar where the acini tend to be uniformly enlarded
C. Bullae, or peripheral blebs, are hallmarks of chronic obstructive lung disease
D. Again, all seem to be correct
E. In centrilobular emphysema the damage seems to be more severe in the upper lobes, while in panacinar the damage seems to be more severe in the lower lobes

Answer 40

d. all are correct

Question 41

Which is not a characteristic of chronic bronchitis?
A. It often exists concomitant with emphysema
B. It tends to produce “pink puffers”
C. It inhibits the function of bronchial and aveolar macrophages
D. It damages airway epithelium and results in increased mucus production
E. The hypersecretion of mucus tends to occur in the large airways before the small airways

Answer 41

B is false. bronchitis –> blue bloaters

emphysema–> pink puffers

Question 42

Which form of TE fistula is most common?
A. A
B. E
C. B
D. C
E. D

Answer 42

D. TE fistula C is the most common

Question 43

Which of the following is not correct of exercise induced asthma?
A. All of the above are correct
B. There is thought that it might be caused by warmed and humidified air entering the lungs on a hot day
C. It can be treated with the mast cell stabilizer Intal before exercise
D. It often occurs in people who do not experience asthma under other condtions
E. It seems to lack the inflammatory changes that accompany other types of asthma

Answer 43

B is false

Question 44

The classical classifications of pulmonary pathology includes all of the following except?
A. Degenerative
B. Inflammatory
C. All of the following Are classical classifications
D. Pleural
E. Neoplastic

Answer 44

C. all are correct

Question 45

Reactive pulmonary diseases are synonymous with restrictive pulmonary diseases T/F

Answer 45

F! Reactive is like asthma, restrictive is like fibrosis

Question 46

Which of the following is not true of atelectasis?
A. It can be caused by shallow inspirations and prevented with incentive spirometry
B. It is often seen with bronchial obstruction, outside or pleural compression, and contraction as in a fibrotic process
C. Atelectasis is not really a disease but a concept
D. It tends to expand the affected side
E. There seem to be two spellings: Atalectasis and Atelectasis

Answer 46

D is false

Question 47

Which of the following is not true of ARDS?
A. ARDS often progresses to multi-system organ failure and death
B. The exudates and diffuse tissue destruction in ARDS resolve quickly when the underlying disease process is found and treated
C. Most deaths are due to sepsis
D. Mortality increases with age
E. The mortality rate is 30-70%

Answer 47

B is false

Question 48

Which of the following is not correct of asthma?
A. It is similar to chronic bronchitis, but instead of excess mucus being produced in the large airways, its hallmark is bronchospasm and wheezing from the small airways
B. It is thought to result from decreased airway responsiveness to a variety of stimuli
C. The chronic small airway obstruction often leads to repeated infections
D. It is typically divided into atopic and non-atopic etiologies
E. If caused by an atopic etiology, they may be an elevated eosinophil count in the peripheral blood

Answer 48

B is false- INCREASED responsiveness

Question 49

Which of the following is not correct regarding the differences between obstructive and restrictive pulmonary diseases?
A. Obstructive diseases tend to produce hyperexpansion when seen on a CXR, whereas restrictive diseases tend to produce a ground glass appearance on CXR
B. Obstructive diseases tend to produce wheezing whereas restrictive diseases tend to produce cyanosis - both can produce dyspnea
C. These all seem to be correct relationships
D. Obstructive diseases result in small airway expiration obstruction whereas rescrictive diseases result in reduced lung volumes
E. In obstructive disease you should see more lucency and less density while in restrictive disease you see more opacity and more density

Answer 49

C- all are correct