Transcript ARS questions from M..

Department of Pathology
An autopsy demonstrates fluid in the pulmonary alveoli of a patient who
died of bacterial pneumonia. Which one of the following is a true
statement regarding this clinical situation:
A. In this patient, we would expect a diminished
serum concentration of C-reactive protein.
20% 20% 20% 20% 20%
B. The predominant type of leukocyte in the
inflammatory response will be mononuclear
leukocytes.
C. In this clinical context, the fluid in the lungs
will be an exudate.
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E. 80-90% of the acute inflammatory responses
to bacterial infections, in the lung, are
granulomatous.
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D. In this context, important opsonins for
directing phagocytosis against the bacteria
are interleukin-5 and eotaxin.
Which of the following cell types is most important in the
pathophysiology of early atherosclerotic lesions:
A. Mast cells
20% 20% 20% 20% 20%
B. Fibroblasts
C. Macrophages
D. Red blood cells
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E. Stem cells
A 70-year-old man is found to have an abdominal aortic
aneurysm. Which of the following factors is most predictive of
aneurysm rupture in the next 3 months:
A. Aneurysm length
20% 20% 20% 20% 20%
B. Aneurysm diameter
C. Serum level of C reactive
protein
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E. Serum level of LDL
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D. Serum level of Cholesterol
A 70-year-old man is found to have an atherosclerotic plaque producing
90% luminal stenosis. Which of the following blood vessels is most
likely involved:
A. Vena cava
25% 25% 25% 25%
B. Jugular vein
C. Popliteal artery
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Department of Pathology
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D. Ocular capillaries
A 70-year-old man has a posterior wall transmural myocardial infarction
and dies 72 hours after the onset of symptoms as a result of
cardiogenic shock. At post mortem, examination of his heart would
show:
A. Circumferential infarction of the left
ventricular subendocardium only
20% 20% 20% 20% 20%
B. Predominantly chronic
inflammation in the infarct
C. A ventricular aneurysm
D. Coagulative necrosis with acute
inflammation
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Department of Pathology
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E. Predominantly macrophages and
granulation tissue
A 62-year-old man has a 40% decrease in the crossectional area of his
Left anterior descending artery at a point 1 cm from its origin. He is
normotensive and otherwise in normal health. Based on these findings
you would expect a moderate exercise challenge to:
A. Cause a transmural myocardial
infarct
20%
18%
B. Cause a subendocardial
myocardial infarct
16%
14%
12%
C. Cause anginal pain
10%
8%
6%
D. Precipitate an acute coronary
syndrome
4%
2%
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E. Cause no symptoms
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The collagen that forms the fibrous cap of a mature atheroma is
thought to be produced predominantly by:
A. Neutrophils
20% 20% 20% 20% 20%
B. Platelets
C. Smooth muscle cells
D. Macrophages
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E. Endothelial cells
A 19-year-old woman comes to the ED in acute distress. Her blood
pressure is 80/ 60 with a pulse of 180 beats per minute. Her skin is
warm and dry. Body temperature was 39 degrees C, and the
WBC = 15,000 with 90% neutrophils.
You suspect:
33%
33%
33%
A. Hypovolemic shock
B. Septic shock
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C. Cardiogenic shock
In arteries supplying an end organ, occlusive thrombi typically:
A. Are characterized as red, or
stasis, thrombi
20% 20% 20% 20% 20%
B. Propagate (extend) in direction
of blood flow
C. Are asymptomatic
D. Result in infarction
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E. Are due to infectious organisms
A previously healthy, tall, and slender 19-year old woman has the sudden
onset of right-sided chest pain followed by progressive dyspnea. Ten hours
later, an x-ray of the chest shows a collapsed right lung and air in the right
pleural space. Which of the following is the most likely underlying condition?
A. Bronchiectasis
20% 20% 20% 20% 20%
B. Lung abscess
C. Panacinar emphysema
D. Pulmonary sequestration
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E. Subpleural blebs
A 12-year-old girl is admitted to the hospital because of marked shortness
of breath, an erythematous rash, and painful, swollen hip and knee joints.
She is agitated. A chest x-ray shows an enlarged heart and changes
consistent with pulmonary edema. Intractable congestive heart failure
develops, and she dies on the second hospital day. This child most likely
had a recent history of which of the following?20%
18%
A. Cyanosis with chest pain
16%
14%
12%
B. Jaundice
10%
8%
C. Meningitis
6%
4%
D. Pharyngitis
2%
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E. Skin infection
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A 55-year-old woman with breast cancer develops shortness of breath
and poor exercise tolerance while being treated with doxorubicin.
Which of the following is the most likely cause of these symptoms?
A. Dilated cardiomyopathy
20% 20% 20% 20% 20%
B. Obstructive pulmonary disease
C. Pulmonary hypertension
D. Restrictive cardiomyopathy
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E. Restrictive pulmonary disease
A 72 year old man collapses while playing golf. He has a long
history of diabetes mellitus. EKG showed asystole.
Paramedics arrive and resuscitation measures are initiated
without success. Which of the following is the most likely
cause of his death?
20% 20% 20% 20% 20%
A. Cardiac Tamponade
B. Embolus to right middle cerebral
artery
C. Myocardial necrosis
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E. Ventricular fibrillation
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D. Papillary muscle rupture