Anatomy NBME questions (A+ solutions)

A homeless man has a 3-month history of decreased a-peptide, generalized wasting, low grade fever , worsening cough productive of blood, mucopurulent sputum. He has a 3-year history of alcohol abuse. Xray films of the chest show consolidation and cavitary lesions in the apices of the lungs. Which of the following is most likely inflammatory and/or immune response in the lung? A. Endothelial cell proliferation, vascular budding, fibroblasts B. Epithelioid cells, multinucleate giant cells, caseation necrosis C. Fibroblasts, collagen deposition, replacement of intrinsic tissue D. Macrophages, lymphocytes, hypergammaglobulinemia E. Neutrophils, vascular congestion, exudate correct answers B. Epithelioid cells, multinucleate giant cells, caseation necrosis 82 year old man comes to the physician for evaluation of chest pain. He lives with his daughters family. He has numerous welts and abrasions and appears to be malnourished. He says his diet is fine. Which of the following is the most appropriate next step in patient care? A. confront his family about the abuse B. enroll the family in family counseling C. notify social services of potential abuse D. place him in a nursing home E. refer him to a residential community correct answers C. notify social services of potential abuse 67 year old woman has the sudden onset of dyspnea and chest pain and dies within minutes. Stage IV ovarian cancer was diagnosed 1 year ago, and she has been bedridden for 2 months. Which of the following is most likely to be found on autopsy? A. Acute myocardial infarction B. Deep venous thrombosis C. Dissecting aortic aneurysm D. Renal papillary necrosis E. Rupttured berry aneurysm correct answers B. Deep venous thrombosis 45 year old man has a 6-month history of burning pain that begins in the epigastric area and ascends into the chest. Episodes occur most frequently after large meals and at night. Endoscopic examination shows moderately severe inflammation in the distal 3cm of the esophagus. Which of the following is the most likely cause of this condition? A. Diffuse spasm of the esophageal musculature B. Failure of the lower sphincter to relax after a swallow C. Helicobacter pylori infection D. Hypersection of gastric acid E. Inappropriate relaxation of the lower esophageal sphincter correct answers E. Inappropriate relaxation of the lower esophageal sphincter