Y3 Master Physiology Review Exam | Questions & Answers (Verified) | Latest Update | Graded A+

1 Y3 MASTER PHYSIOLOGY REVIEW EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+ A 16 year old girl recently started her periods (almost 5 months). At the end of each cycle she experiences mild abdominal pain, slight mood changes, and irritability. She is able to function well and her symptoms do not affect her activities of daily living or relationship with her family. She has a healthy lifestyle and does not take any medications other than birth control pills. Her last menstrual period was 5 days ago. How would you treat this patient? A - Advise her it is a normal phenomen Correct Answer: A - Advise her it is a normal phenomenon A 52 year old woman reports that she has been noticing hot flashes, sweating, and increased heart rate. She does not report any specific triggering factors for her symptoms. Her sleep has been disrupted and she is more irritable. Her menstrual cycles are getting irregular for the last 8 months. She feels mild pain during intercourse and also less desire for the sex. She has high blood pressure, which is well controlled with her medications for the last 5 years. What is her most probably diagnosi Correct Answer: D - Menopause 2 A 20 year old woman recently got sexually active. She tries the withdrawal method for the birth control. Her menstrual cycles were regular previously, now she hasn't had a period for the last 6 weeks. Her past medical history is non-significant for any medical conditions. She only takes multivitamins in a routine. What will be the most common cause of her missed period? A - She is pregnant B - Multivitamins C - She is experiencing premature ovarian failure D - Polycystic ovarian syndrome Correct Answer: A - She is pregnant A 20 year old man fell from 100 feet height and fractured his L2-3 vertebrae. After the fall patient is unable to urinate and needs catheterization. On catheterization, 1500mL of urine flows into the urine bag. What is the possible cause of his urinary retention? A - Urinary retention due to the L2-3 lesion of the spinal cord B - Reduced urine production from the kidney C - Pain medications such as opioids to reduce the pain D - Psychological urinary retention Correct Answer: A - Urinary retention due to the L2-3 lesion of the spinal cord A 52 year old woman reports that she has been noticing hot flashes, sweating, and increased heart rate. She does not report any specific triggering factors for her symptoms. Her sleep has been disrupted and she is more irritable. Her menstrual 3 cycles are getting irregular for the last 8 months. In your opinion she is developing menopause and you ordered blood work for hormonal analysis and electrolytes and ECG. What will you find in the blood work of this woman? A - High progesterone and low est Correct Answer: B - Low estrogen and high FSH A 15 year old child had a urinary tract infection. Doctor prescribed him gentamicin antibiotic to treat the infection. After few days patient reported ringing in his ears and urine color has changed. His urine output has decreased. What is the possible cause of his decreased urine output and ringing in the ears? A - It is a normal phenomenon B - Gentamicin (antibiotic) C - Decreased fluid intake D - Infection caused stricture/narrowing in ureters due to which urine outflow has decreased Correct Answer: B - Gentamicin (antibiotic) The term micturition refers to: A - the process of urine extraction (should be excretion) B - None of the above C - Process to concentrate urine D - The process of urine formation Correct Answer: A - the process of urine extraction (should be excretion) 4 A 30 year old man experiences new onset fatigability, low grade fever, loss of appetite. He has lost 20 lbs over the last 2 months. He is prone to get sick easily and over the last 2 months, he has experienced 6 upper respiratory tract infections. He is sexually active and has had multiple sexual partners. He also reports that on many occasions he had unprotected sex with his clients. What infection will you be worried for? A - Cystitis (infection of the bladder) B - HIV infection C - Urethritis Correct Answer: B - HIV infection A 16 year old girl recently started her periods (almost 5 months). At the end of each cycle she experiences mild abdominal pain, slight mood changes, and irritability. She is able to function well and her symptoms do not affect her activities of daily living or relationship with her family. She has a healthy lifestyle and does not take and medications other than birth control pills. Her last menstrual period was 5 days ago. What is the most common cause of her symptoms? A - Ovarian failure B - N Correct Answer: B - Normal premenstrual symptoms A 30 year old woman with a very healthy lifestyle recently got married. During her honeymoon, she begins to experience burning with urination and increased urinary 5 urgency. She has no other symptoms such as fever, vaginal discharge (absent). What is your most probable diagnosis? A - Pelvic inflammatory disease (PID) B - Pyelonephritis (infection of kidney) C - Vaginitis (infection of the vagina) D - Cystitis (infection of the urinary bladder) Correct Answer: D - Cystitis (infection of the urinary bladder) The rate of water reabsorption from the collecting duct is determined by the hormone: A - Cortisone B - Oxytocin C - Antidiuretic hormone D - Lactogenic hormone Correct Answer: C - Antidiuretic hormone A 22 year old woman, Ms Green, has experienced 3 early first trimester abortions. She wants to get pregnant but is curious and wants investigations to find out why she has experienced three abortions. If the cause of her abortion is hormonal, which hormone could possibly be deficient? A - Low progesterone levels B - Low estrogen levels C - Low oxytocin levels D - Low growth hormone levels 6 Correct Answer: A - Low progesterone levels A 20 year old woman recently got sexually active. She tries the withdrawal method for the birth control. Her menstrual cycles were regular previously, now she hasn't had a period for the last 6 weeks. Her post medical history is non-significant for any medical conditions. She only takes multivitamins in a routine. What investigation must you order include/in your plan" A - Electrolytes and vitamin levels B - Pregnancy test C - Do nothing - it is normal for a woman to be late for her periods D - Correct Answer: B - Pregnancy test A 20 year old man reports erectile dysfunction. Recently, he became involved in a new relationship and worries that this relationship may end quickly as the last two relationships in the last five months. He reports that he does not have an erection during sexual activity, but has early morning erection. What is your most probable diagnosis? A - Erectile dysfunction due to infection B - Erectile dysfunction due to medications C - Psychogenic erectile dysfunction D - Organic erectile dysfunction Correct Answer: C - Psychogenic erectile dysfunction 7 The kidney structure in which urine is formed is known as the: A - Nephrons B - Calyx C - Ureters D - Neuron Correct Answer: A - Nephrons A 29 year old man is working out in a sunny day. He is thirst by did not have a chance to drink enough water. His urine output has decreased. Which hormone is mainly responsible for decreased urine production or regulation of fluids in this person? A - Renin B - Antidiuretic hormone (ADH) C - Angiotensin D - Aldosterone Correct Answer: B - Antidiuretic hormone (ADH) All of the following are functions of the hormone Aldosterone except: A - It stimulates the reabsorption of water in the nephrons B - It stimulates the secretion of potassium from the blood C - It regulates the excretion of calcium from the peritubular capillary D - It stimulates the reabsorption of sodium ions from the distal convoluted tubule Correct Answer: C - It regulates the excretion of calcium from the peritubular capillary 8 An 18 year old girl, Miss Green, has never had menstrual cycles, whereas all girls in her class have normal menstrual cycles. What is your most probable diagnosis? A - Early menopause B - Primary amenorrhea C - Ovarian failure D - Secondary amenorrhea Correct Answer: B - Primary amenorrhea A 56 year old man underwent gastrectomy (surgical removal of the stomach) for gastric cancer. The abnormality of which chemical/factor can cause deficient vitamin B12 absorption? A - Intrinsic factor B - Gastrin C - Pepsin D - Hydrochloric acid Correct Answer: A - Intrinsic factor A 56 year old woman presents to the ER with epigastric pain. Pain is very severe and radiates to back. Patient has recurrent vomiting. The lab investigation shows elevated pancreatic amylase and lipases and reduced calcium levels in the blood. Patient A - Acute cholecystitis B - small bowel obstruction C - Acute pancreatitis 9 D - Chronic pancreatitis Correct Answer: C - Acute pancreatitis A mother of 9 year old child brings her child with recurrent abdominal pain and diarrhea. Mother reports that her son develops symptoms when he eats food such as wheat cereal and oat meal. Child weight is below his desired percentile for his age. What is the most probably diagnosis? A - Ulcerative colitis B - Crohn's disease C - Celiac disease D - Irritable bowel syndrome Correct Answer: C - Celiac disease What is produced by the liver and helps fat metabolism? A - Bile B - Appendix C - Chyme D - Bolus Correct Answer: A - Bile A 25 year old man presents to a family physician with yellow discolouration and right upper quadrant pain. Patient has loss of appetite, vomiting, body aches, and low grade fever. Patient is note sexually active and has never received a blood transfusion. He 10 lives in suburban community with very limited resources. Doctor tells the patient he has hepatitis. What organism is mainly responsible for the patient's symptoms? A - Hepatitis A B - Hepatitis D C - Hepatitis B D - Hepatitis c Correct Answer: A - Hepatitis A A 25 year old man suffers with a bacterial infection for which patient received antibiotics. Patient was prescribed clindamycin antibiotic for the infection. After the treatment, the patient has developed bloody diarrhea. The endoscopic examination showed a whitish membrane on the large intestine. What is the most probable cause of the patient's symptoms? A - Irritable bowel syndrome IBS B - Colorectal cancer C - Pseudomembranous colitis (C Diff infection) D - Inflammatory bowel disease (Crohn's Correct Answer: C - Pseudomembranous colitis (C Diff infection) A 28 year old man presents with jaundice (yellow discolouration of the skin). The lab test shows patient is positive for hepatitis D. What other infection must the patient have with the hepatitis D? A - Hepatitis B 11 B - Hepatitis C C - Hepatitis E D - Hepatitis A Correct Answer: A - Hepatitis B A 28 year old man presents to ED with bloody diarrhea. Which of the following is NOT the probable cause of the patient's symptoms? A - Entameoba histolytica B - Campylobacter jejuni C - Shigella D - Cholera Correct Answer: D - Cholera A 48 year old man, previously diagnosed with hepatitis C, presents to doctor with jaundice, abdominal swelling, ankle swelling and muscle wasting. Patient has fruity smell and gynecomastia (development of breast in man). Patient has multiple bruises on the skin and spider angiomas. What is the possible state of the patient's condition? A - Heart failure B - Kidney failure C - Hepatitis A virus D - Liver cirrhosis secondary to hepatitis C Correct Answer: D - Liver cirrhosis secondary to hepatitis C 12 A 25 year old woman presents to a family physician with yellow discolouration and right upper quadrant abdominal pain. Patient has loss of appetite, vomiting, body aches, and low grade fever. Doctor tells patient has hepatitis A. What is the most probably mode of transmission for hepatitis A infection? A - Blood transfusion B - Sexual transmission C - Co-infection with another viral illness D - Fecal-oral route Correct Answer: D - Fecal-oral route Which hormone stimulates the production of pancreatic juice and bicarbonate? A - Bile B - Cholecystokinin and secretin C - Hydrochloric acid HCl D - Gastrin Correct Answer: B - Cholecystokinin and secretin Which of the following is not the function of bile? A - Solubilization and transport of lipids in an aqueous environment B - It plays a role in the digestion of carbohydrates C - Emulsification of fat molecules D - Functions as a hormone in cholesterol synthesis Correct Answer: B - It plays a role in the digestion of carbohydrates 13 A 56 year old man presents to ED with recurrent epigastric pain. Pain is very severe and radiates to back. Patient has loss of appetite, flatulence, and stool is bulky and hard to flush. The MRI shows calcification in the pancreas. Patient is alcoholic and drinks excessively every day. What is the most probably diagnosis? A - Acute pancreatitis B - Chronic pancreatitis C - Small bowel obstruction D - Acute cholecystitis Correct Answer: B - Chronic pancreatitis Chyme in the intestines stimulated the release of which two hormones? A - Bile B - Gastrin C - Secretin and cholecystokinin D - Correct Answer: C - Secretin and cholecystokinin A 25 year old man presents with epigastric pain that starts 2 hrs after eating. Which stomach cells are mainly involved in the production of increased hydrochloric acid HCl? A - G cells B - Parietal cells C - Mucus cells 14 D - Chief cells Correct Answer: B - Parietal cells A 50 year old man undergoes intestinal resection of the ileum. He is prone to develop the deficiency of which vitamins? A - Water, B12, and B6 X B - Folic acid, iron, and calcium C - Carbohydrate, protein, lipids D - Vitamin D, protein, lipids Correct Answer: A - Water, B12, and B6 X A 19 year old woman presents to her family physician with mild abdominal pain. Her appetite and weight are normal. She denies nausea, vomiting, or sleep disruption. The abdominal pain is released with bowel movements. Her past history is significant for psychological stress. What is the most probably diagnosis? A - Colon cancer B - Crohn's disease C - Irritable bowel syndrome D - Ulcerative colitis Correct Answer: C - Irritable bowel syndrome A 58 year old man presents to family doctor with loss of appetite and unintentional weight loss. Patient's stool caliber has changed with time and reports abdominal 15 discomfort. Recent blood work shows iron deficiency anemia. His father has the similar symptoms but he does recall the diagnosis of his father. The imaging is shown below. What is the most probably diagnosis? A - Crohn's disease B - Colon cancer with apple core appearance C - Small bowel obstruction D - Irritable bowel syndrome Correct Answer: B - Colon cancer with apple core appearance Bile is stored and concentrated in the: A - Pancreas B - Intestinal glands C - Gall bladder D - Liver Correct Answer: C - Gall bladder A 64 year old man presents to family physician with progressive dysphagia. Which of the following is not the possible cause of the dysphagia (difficulty in swallowing)? A - Esophageal stricture B - Esophageal varices C - Barrett's esophagus X D - Esophageal cancer Correct Answer: C - Barrett's esophagus X 16 The branches that emerge from the trachea and lead to the lungs are known as? A - Alveolar tubes B - Terminal bronchi C - Alveolar ducts D - Bronchus Correct Answer: D - Bronchus A 53 year old man works in the glass industry. He presents to his family physician with progressive shortness of breath for 6 months. The chest x-ray shows egg shell calcification. What is the most probable diagnosis? A - Coal miner disease B - Berylliosis C - Asbestosis D - Silicosis Correct Answer: D - Silicosis The spasm in the smooth muscle in the bronchial tree may be triggered by an allergy and may cause: A - Hay fever B - Cystic fibrosis C - Asthma D - Pneumoconiosis 17 Correct Answer: C - Asthma A 45 year old patient has a productive cough for the last 3 years but over the last 5 months it has now progressed. Patient also experiences shortness of breath. On examination, he has cyanosed peripheries. Patient smokes 2.5 pack of cigarette daily for the last 20 years. The chest x-ray shows increased lung marking. What is the most probable diagnosis? A - Bronchogenic cancer B - Chronic bronchitis C - Pneumoconiosis D - Emphysema Correct Answer: B - Chronic bronchitis A 53 year old man works in the glass industry. He presents to his family physician with progressive shortness of breath for 6 months. The chest x-ray shows egg shell calcification. Based upon the scenario, what other condition is the patient prone to develop? A - Mesothelioma B - Tuberculosis C - Bronchogenic cancer D - Acute bacterial pneumonia Correct Answer: B - Tuberculosis 18 A 6 year old boy is diagnosed with cystic fibrosis. He has recurrent chest infections. What is the underlying pathology in cystic fibrosis patients? A - Sodium shift dysfunction B - Chloride shift dysfunction C - Carbonic acid shift dysfunction D - Potassium shift dysfunction Correct Answer: B - Chloride shift dysfunction All of the following have an effect on the control of breathing except: A - Chemical receptors in the carotid arteries B - Amount of blood flowing into the lungs C - Respiratory control centre in the brain stem D - The level of hydrogen ions in the CSF (increased acidity) Correct Answer: B - Amount of blood flowing into the lungs A 47 year old man presents to his family physician with progressive shortness of breath and minimal cough. Patient has reduced exercise tolerance. On examination patient has pursed lip breathing and pink extremities. Patient uses accessory muscles of respiration. Chest x ray is shown above - which is significant for hyperinflation of the chest, decreased breath sounds and hyper resonant percussion noted. What is the most probably diagnosis? A - Chronic asthma B - Chronic bronchitis 19 C - Emphysema Correct Answer: C - Emphysema A 6 year old boy is diagnosed with bronchiectasis. Patient has multiple recurrent purulent chest infections. Chest x-ray shows tram track and honey comb appearance. What other condition can be possible associated with bronchiectasis? A - Cystic fibrosis B - Emphysema C - Chronic asthma D - Chronic bronchitis Correct Answer: A - Cystic fibrosis The vital capacity is? A - Amount of air left in the lung after forceful expiration B - Amount of air that can be inspired during forceful inspiration C - Largest amount of air that can be expelled from the lungs D - Volume of air left in the lungs after expiration Correct Answer: C - Largest amount of air that can be expelled from the lungs A 29 year old patient had a baby delivered via caesarean section. On postoperative day 2, the patient developed sudden onset right sided chest pain and cough with blood in the sputum. The patient is immobile and obese. Patient's initial x-ray is normal. Which of the following will you not include as a differential diagnosis? 20 A - Traumatic rib fracture B - Myocardial infarction C - Pneumonia D - Pulmonary embolism Correct Answer: A - Traumatic rib fracture A 29 year old patient had a baby delivered via caesarean section. On postoperative day 2, the patient developed sudden onset right sided chest pain and cough with blood in the sputum. The patient is immobile and obese. Patient's initial x-ray is normal. What is the most probably diagnosis? A - Pneumonia B - Pulmonary embolism with primary in the deep veins of the leg C - No abnormality, patient is functional as her chest x-ray is normal D - Lung cancer Correct Answer: B - Pulmonary embolism with primary in the deep veins of the leg A 45 year old man present to doctor with productive cough. Patient has a productive cough for the last 3 years, but over the last 5 months it has progressed. Patient also experiences shortness of breath. On examination, he has cyanosed peripheries. Patient smokes 2.5 packs of cigarettes daily for the last 20 years. The chest x-ray shows increased lung marking. What is the nature of pathology given in the above scenario? A - Restrictive B - Infectious 21 C - Obstructive D - Cancerous Correct Answer: C - Obstructive Patient's chest x-ray is shown above - which is significant for popcorn calcifications. Patient is asymptomatic. What is the most probably diagnosis? A - Pulmonary hamartoma - benign condition B - Bronchogenic cancer C - Pulmonary cyst D - Aspergilloma Correct Answer: A - Pulmonary hamartoma - benign condition The pressure changes occurring in the lungs during inspiration are due to all of the following except: A - Nerve impulses reaching the lungs from the brain B - The elasticity of the lungs C - The firm attachment of the pleural membranes D - The closed thoracic compartment enclosing the lungs Correct Answer: A - Nerve impulses reaching the lungs from the brain A 53 year old man works in a construction and demolition industry. He presented to his family physician with progressive shortness of breath for 6 months. The lung biopsy 22 shows asbestosis fibres. Patient history is significant for smoking 2.5 packs of cigarettes per day for the last 20 years. What other condition is the patient prone to develop? A - Tuberculosis B - Acute bacterial pneumonia C - Mesothelioma D - Bronchiectasis Correct Answer: C - Mesothelioma Carbon dioxide can be carried in the blood stream by all of the following methods except: A - Bicarbonate ions B - In the bound form with hemoglobin C - Dissolved gas in the plasma D - Attached to hormone molecules in the blood Correct Answer: D - Attached to hormone molecules in the blood Contraction of the respiratory muscles results in: A - Decrease in the volume of the thorax B - Increased in the blood volume flowing through the lungs C - Decrease blood volume flowing through the lungs D - Increase in the volume of the thorax Correct Answer: D - Increase in the volume of the thorax 23 A 47 year old man has a chest x-ray which is significant for popcorn calcification. The patient is asymptomatic and the x-ray finding is incidental. Based on the x-ray, what is the nature of the condition? A - Malignant cancerous B - Infectious C - Benign lesion only requiring follow ups D - Traumatic Correct Answer: C - Benign lesion only requiring follow ups A 6 year old boy is diagnosed with cystic fibrosis. He has recurrent chest infections. What organism is the most common known bacteria to cause recurrent chest infections in the cystic fibrosis patients? A - Aspergillus B - Pseudomonas aeruginosa C - Pneumococcal bacterial D - Staph aureus Correct Answer: B - Pseudomonas aeruginosa A 55 year old man presents to you with recurrent abdominal pain. Abdominal pain increases with eating. He lost 20lbs in t he last 3 months. He also passed kidney stones three times over the last 5 months. He suffered multiple fractures. His blood work is significant for elevated blood calcium levels. What is the most probable cause of his symptoms? 24 A - Thyroid dysfunction B - Pituitary gland abnormality C - Peptic ulcer due to increased gastrin levels (gastrinoma) D - Increased parathyroid hormo Correct Answer: D - Increased parathyroid hormone secretion 29 year old woman consulted a gynecologist for infertility. She and her partner have been trying to conceive for the last 2 years. She reported her menstrual cycles have become irregular from the last 12 months. Her voice has changed and she noticed hair growth on her face. Her blood work is significant for abnormal LH:FSH ratios, high blood sugar, and elevated insulin levels. She is obese. Laparoscopy shows pearl like ovaries. What is the most probable case of infertility? A - Polycystic ovaria Correct Answer: A - Polycystic ovarian syndrome (PCOS) A 22 year old woman, Ms Green, has experienced 3 early first trimester abortions. She wants to get pregnant but is curious and wants investigations to find out which she has experienced three abortions. If the cause of her abortion is hormonal, which hormone could possibly be deficient? A - Low estrogen levels B - Low growth hormone levels C - Low progesterone levels D- Low oxytocin levels 25 Correct Answer: C - Low progesterone levels A 19 year old woman had a delivery after prolonged labour. Nurse misread doctors note and infused half of the intravenous fluids the doctor ordered. After delivery, the woman experienced sudden headaches and she is unable to lactate. Which hormone gland is mainly involved in this patient? A - Adrenal cortex B - Placenta C - Pituitary gland D - Ovaries Correct Answer: C - Pituitary gland A 29 year old man consulted endocrinologist as he and his girlfriend are trying to start a family for the last 3 years. Couple does not use protection. The hormonal analysis is the following: Decreased LH and FSH, decreased testosterone. Where is the problem on the hormonal axis? A - Testis B - Pituitary gland C - Adrenal cortex D - Thyroid gland Correct Answer: B - Pituitary gland 26 A 27 year old main presented with headaches and sweating. He is more anxious and reports increased heart rate. He has collapsed multiple times when he goes to urinate. On examination patient has thin structure, his pulse rate is 180 beats per minute. His father also suffered with similar symptoms but he is unable to recall the name of the condition. What is the most probable cause of his symptoms? A - Cushing's disease B - Hyperthyroidism C - Phenochromocytoma D - Increased parathyroid hormone s Correct Answer: C - Phenochromocytoma A 37 year old man presents to family physician with increased appetite for the last 9 months. Although he does not want to lose weight, he has lost almost 50lbs in the last 6-7 months. The frequency of his bowel movement has increased and he feels hotter as compared to people around him. On examination he has sinus tachycardia and sweaty palms. What is the most probably cause of his symptoms? A - Hyperthyroidism B - Adrenal cortisol insufficiency C - Pituitary gland dysfunction D - Hypoglycemia Correct Answer: A - Hyperthyroidism 27 A 69 year old patient has trouble falling asleep at night. The dysfunction of which hormone is the cause of the patient's sleep pattern disruption? A - Melatonin B - Melanin C - Oxytocin D - Serotonin Correct Answer: A - Melatonin A 37 year old man presents to family physician with decreased appetite for the last 9 months. He has gained almost 50lbs in the last 6-7 months. He also complained that he gets constipated easily and he feels cold as compared to people around him. On examination he has dry skin and his pulse rate is 40 beats per minute. What is the most probably cause of his symptoms? A - Hypothyroidism B - Hypoglycemia cause sympathetic activation C - Adrenal cortisol insufficiency D - Pituitary gland dysfuncti Correct Answer: A - Hypothyroidism A 29 year old man consulted endocrinologist as he and his girlfriend are trying to start a family for the last 3 years. Couple does not use protection. The hormonal analysis is the following: Elevated LH and FSH, decreased testosterone. Where is the problem on the hormonal axis? 28 A - Pituitary gland B - Adrenal cortex C - Testis D - Thyroid gland Correct Answer: C - Testis 28 year old woman is diagnosed with hypothyroidism. Thyroid function tests are as follows: decreased TSH, decreased T3/T3. Where is the main pathology on the hormonal axis? A - Thyroid gland B - Pituitary gland C - Due to antibodies D - The blood work does not explain the hormonal axis Correct Answer: B - Pituitary gland 28 year old woman is diagnosed with hypothyroidism. Thyroid function tests are as follows: Elevated TSH, decreased T3/T3. Where is the main pathology on the hormonal axis? A - Pituitary gland B - Thyroid dysfunction C - The blood work does not explain the hormonal axis D - Due to antibodies Correct Answer: B - Thyroid dysfunction 29 A 29 year old man is working out in a sunny day. He is thirst by did not have a chance to drink enough water. His urine output has decreased. Which hormone is mainly responsible regulation of sodium in this person? A - Renin B - Aldosterone C - Angiotensin D - Antidiuretic hormone Correct Answer: B - Aldosterone A 20 year old man had 3 accidents in the last 5 months. He tells doctor that he follows all driving rules: he signals before changing lanes, checks mirror and blind spots, but he is unable to see the car in his blind spot. His history is significant for type I diabetes mellitus. Pathology of which gland is responsible for patient's symptoms? A - Diabetes mellitus due to insulin deficiency leading to blindness B - Testis C - Prolactin secreting pituitary gland tumor D - Adrenal gland Correct Answer: C - Prolactin secreting pituitary gland tumor A 36 year old woman presents to endocrinologist with weight gain. She also experiences depression. From the last few months she has experienced menstrual abnormality. Her skin has become thing and she bruises easily. She has also been 30 diagnosed with diabetes recently. Her pictures are show in the following. What is the most probable diagnosis? A - Prolactinoma B - Hyperthyroidism C - Insulinoma D - Cushing's disease Correct Answer: D - Cushing's disease A 29 year old woman had her thyroid removed for Graves' disease. On second postoperative day, when the nurse was checking patient's blood pressure her fingers began to spasm. When patient's facial nerve is tapped, nurse noticed puckering movements on the patient's face. Patient's blood work is significant for reduced blood calcium levels. What is the probable cause of patient's symptoms? A - Decreased dietary calcium intake B - Iatrogenic removal of parathyroid glands C - Idiopathic calcium defi Correct Answer: B - Iatrogenic removal of parathyroid glands A 29 year old man is working out in a sunny day. He is thirst by did not have a chance to drink enough water. His urine output has decreased. Which hormone is mainly responsible for decreased urine production or regulation of fluids in this person? A - Angiotensin B - Antidiuretic hormone 31 C - Renin D - Aldosterone Correct Answer: B - Antidiuretic hormone A 57 year old man presents to family physician with shortness of breath, cough with sputum mixed with blood. His history is significant for myocardial infarction 6 months ago. On examination patient has one high amplitude pulse, alternated with weak amplitude pulse. What is characteristic of the pulse? A - Pulsus bigeminus B - Thready pulse C - Pulsus alternans D - Anacrotic pulse Correct Answer: C - Pulsus alternans A 20 year old man had 3 accidents in the last 5 months. He tells doctor that he follows all driving rules: he signals before changing lanes, checks mirror and blind spots, but he is unable to see the car in his blind spot. His history is significant for type I diabetes mellitus. CT of the head showed mass lesion of the pituitary gland. Lesion at what level can give rise to the symptoms described? A - A (L optic nerve) B - B (optic chiasm) C - C D - D 32 Correct Answer: B - B (optic chiasm) A 29 year old man consulted and endocrinologist for swelling in the front of the neck. He reported that he lost 20 lbs in the last 3 months. Patient reported difficulty swallowing, difficulty breathing and hoarseness of voice. Patient also reported that he has suffered a femoral fracture and L4 vertebral body fracture a few months ago. His blood pressure is elevated 199/11 mmHg, his pulse rate is increased and face is sweating. What is the most probable diagnosis? A - Renal failure B - Multiple Correct Answer: B - Multiple endocrine neoplasia (MEN) II An 18 year old woman was treated for tuberculosis with Isoniazid (INH), ethambutol, pyrazinamide, and rifampin. One month after treatment started, patient started to notice paraesthesia in her fingers and toes. Deficient of which vitamin can cause paraesthesia in this patient? A - Pyridoxine (B6) B - Thiamine (B1) C - Biotin (B7) D - Folic acid deficiency Correct Answer: A - Pyridoxine (B6) All of the following are associated with glycolysis except for: 33 A - There is a net gain of 2 ATP molecules B - ATP is supplied to the process C - Citric acid is an important component of all processes D - Glucose is broken down to pyruvic acid Correct Answer: C - Citric acid is an important component of all processes Fatty acid enters the kreb cycle as a molecule of: A - Urea B - Acetoacetic acid C - Acetyl-CoA D - Glutamine acid Correct Answer: C - Acetyl-CoA A high concentration of HDL is associated with: A - High incidence of infertility B - High incidence of heart disease C - High incidence of arthrosclerosis D - Low incidence of heart disease Correct Answer: D - Low incidence of heart disease A 20 year old man has difficulty seeing in dim lighting. He also noticed that his eyes are dry most of the time. On examination, cloudiness of the cornea s noticed. Deficiency of which vitamin can cause patient's symptoms? 34 A - Vitamin K B - Vitamin E C - Vitamin A D - Vitamin B Correct Answer: C - Vitamin A From one molecule of glucose, the reactions of the kreb cycle yield enough energy to synthesize: A - About 29 molecules of NAD B - About 15 molecules of glucose C - About 10 molecules of water?? D - About 34 molecules of ATP Correct Answer: D - About 34 molecules of ATP Which of the following vitamin is an important component of co-enzymes for the metabolic pathways? A - Vitamin E B - Vitamin B complex series C - Vitamin A D - Vitamin K Correct Answer: B - Vitamin B complex series High levels of ketone bodies in the blood stream reflect high rate of: 35 A - Fat catabolism B - Amino acid utilization C - Mineral absorption D - Gluconeogenesis Correct Answer: A - Fat catabolism What three mechanisms take place both in the cytoplasm and mitochondria? A - Fatty acid oxidation, kreb cycle, and ketogenesis B - Heme synthesis, steroid synthesis, and HMP shunt C - Heme synthesis, urea cycle, and gluconeogenesis D - Glycolysis, steroid synthesis, and HMP shunt Correct Answer: C - Heme synthesis, urea cycle, and gluconeogenesis A 7 year old boy has swollen gums, petechial hemorrhages on his gums, petechial bleeds of the hair follicles. He had right humerus fracture in his house struck against the side of the couch. Deficiency of which vitamin can cause these symptoms? A - Vitamin E B - Vitamin D C - Vitamin C D - Vitamin K Correct Answer: C - Vitamin C 36 When body utilizes ATP as an energy source, the molecule releases its energy and breaks down into the following: A - Adenine and phosphorus B - Adenosine diphosphate and phosphate ion C - Adenine, phosphorus and monosodium ion D - Adenine monophosphate and phosphorus ion Correct Answer: B - Adenosine diphosphate and phosphate ion