Questions and Solutions
Graded A+
32 yo man with subQ nodule on his hand, larger nodule on achilles tendon, and small yellow
papules on his lower eyelid. What is decreased? - Answer: Familial hypercholesterolemia
Decreased LDL R
Decreased lipoprotein lipase - Answer: Familial chylomicronemia
At risk for acute pancreatitis
Defective ApoE - Answer: Familial dysbetalipoproteinemia
Increases chylomicron and VLDL remnants
A 32 yo male presents to clinic with occasional mid-abdominal pain that is gnawing. It wakes
him up during the night and dan be relieved by eating a light meal. What should you test for? -
Answer: Urease--> H. pylori
Patient from Eastern Europe has increasing dyspnea. She has a noctural cough and blood-tinged
sputum. When the patient lies in the LLD position and exhales fully, there is a low-pitched, mid-
diastolic murmur at the cardiac apex. Cause? - Answer: MS--> Rheumatic fever
,STK11 gene mutation - Answer: Peutz-Jegher syndrome
Liposarcoma - Answer: Round cells with multiple mitoses that create a painful lesion. Cause
nuclear indentations and scalloping of the nuclear membrane.
Desmoid tumors - Answer: Benign growths composed of broad fasicles and rounded fibroblasts
with abundant cytoplasm
Fibrosarcomas - Answer: Marked diarray, pleomorphism, mitotic activity, hemorrhage, and
necrosis
Lipoma - Answer: SubQ nodules that car composed on mature fat cells without pleomorphism
Where are immunoglobulin deposits in pemphigus vulgaris? - Answer: Between keratinocytes-->
anti-desmosomes which form desmosomal junctions
Deposits of IgG autoantibodies against the BM - Answer: Bullous pemphigoid
A lesion where causes Horner's syndrome? - Answer: Cervical chain ganglion
Ciliary ganglion - Answer: Controls CN III
Patient with a long history of alcohol abuse comes to the ED due to frequent falls. He feels
unsteady, has blurred vision, and has a course postural tremor. Where is the lesion? - Answer:
Cerebellum
Alcoholic cerebellar degeneration--> most prominent in the cerebellar vermis.
, Defect with nephrogenic diabetes insipidus - Answer: Dysfunction of the collecting tubules
Impaired ADH production - Answer: Central DI
Psychogenic polydipsia - Answer: Urine specific gravity will rise appropriately is response to fluid
restriction
Anemia due to brisk and painless lower GI bleeding - Answer: Meckel's diverticulum
(heterotopic mucosa)
Failed obliteration of the omphalomesenteric duct - Answer: Meckel's diverticulum
Bilious emesis, abdominal pain, and bloody stools - Answer: Volvulus--> bowel may rotate
incompletely round the SMA
Severe intermittent abdominal pain, vomiting, bloody stools, and palpable abdominal mass -
Answer: Intussusception
Finding in HCM - Answer: Thickened IV septum
Normal coronary arteries
Disordered arrangement of cardiac myofibrils
AS murmur that increases with standing
A widely split heart sound is heard at the upper sternal border that is accentuated with
inspiration. Where will it be heart on the curve? - Answer: When the aortic valve closes
A wide split S2 can occur with delayed closure of the pulmonic valve--> RBBB, pulmonic
stenosis, and P HTN. Heard with the closure of the AV.