VERIFIED ANSWERS.
Which nutrient is poorly absorbed in achlorhydria?
a.) Vitamin D
b.) Vitamin B12
c.) Bile salts
d.) Proteins
e.) Fats - ANSWERS(b)
Vitamin B12
Hypophosphatemia has been associated with all of the following EXCEPT:
a.) impaired diaphragmatic contractility
b.) treated diabetic ketoacidosis
c.) malabsorption coupled with carbohydrate refeeding
d.) chronic alcoholism
e.) respiratory muscle hyperresponsiveness - ANSWERS(e)
It is seen in patients with chronic alcoholism, diabetic ketoacidosis, sepsis, and severe
malnutrition after carbohydrate refeeding. It can also be seen in surgical patients who
are not receiving enough phosphate repletion from parenteral nutrition.
Hypophosphatemia causes muscle weakness, and probably affects the diaphragm
more than other muscles, therefore leading to respiratory failure. Studies have shown
lower contractility of the diaphragm
Phosphorus deficiency may lead to insulin resistance as well
What is the main nutrient for colonocytes?
a.) Glutamine
b.) Alanine
c.) Short chain fatty acids
d.) Glucose - ANSWERS(c)
Short chain fatty acids
(Note: the primary fuel source though for enterocytes is glutamine)
What chemotherapy agent leads to pulmonary fibrosis?
a.) Doxorubicin
b.) Methotrexate
,c.) Bleomycin
d.) Vincristine
e.) Cyclophosphamide - ANSWERS(c)
What is the cause of hypotension and decreased EtCO2 during laparoscopic surgery
a.) Tension pneumothorax
b.) Inferior vena cava compression
c.) CO2 embolus
d.) Anesthetic overdose - ANSWERS(c)
Increased levels of glutamine are associated with all of the following EXCEPT:
a.) decreased incidence of clinical infections in patients receiving bone marrow
transplantation
b.) vitro suppression of hepatoma growth
c.) alleviation of depletion of muscle glutamine stores
d.) decreased glutathione levels in tumor cells during radiation therapy or chemotherapy
e.) increased tumor growth in patients with advanced malignant disease - ANSWERS(e)
Glutamine, the most abundant amino acid in the body, can be trapped by a growing
tumor, depleting the body's glutamine stores and producing cachexia. A prospective,
randomized, double-blind trial demonstrated that patients undergoing bone marrow
transplantation had significantly decreased clinical infections when they received
supplemental glutamine. Glutamine also reduced the glutathione levels in tumor cells of
patients undergoing chemotherapy or radiation therapy. The concern that administering
glutamine would promote tumor growth has proven unfounded.
Which of the following is an inhibitor of wound contraction?
a.) Aspirin
b.) d-penicillamine
c.) Colchicine
d.) Glucocorticoids - ANSWERS(c)
In contrast to adults, fetal wound healing biochemistry is characterized by which of the
following?
a.) ↑ inflmmatory phase
b.) ↑ content of type III collagen
c.) ↑ level of transforming growth factor-B
d.) ↓ hyaluronic acid synthesis - ANSWERS(a)
Death from postoperative renal failure is most commonly due to?
a.) Myocardial infarction
,b.) Bleeding
c.) Sepsis
d.) Liver failure - ANSWERS(c) What is the most useful serum marker for cancer
screening?
a.) PSA
b.) CEA
c.) AFP
d.) CA 19-9
e.) CA 15-3 - ANSWERS(a)
All others are used for follow-up or diagnosis
What is the embryologic origin of the inferior parathyroid gland?
a.) 4th arch
b.) 4th pouch
c.) 3rd arch
d.) 3rd pouch - ANSWERS(d)
Derivatives of the 3rd pouch include the inferior parathyroid glands and the thymus. The
main nerve supply is the glossopharyngeal nerve. Superior parathyroids come from the
4th pouch
In hyperacute rejection of a recently transplanted kidney, the event associated with
organ loss is:
a.) Direct antibody effect on interstitial stromal cells.
b.) Ischemia.
c.) Antigen antibody complexes obstructing the proximal convoluted tubule.
d.) Direct antibody effect on the glomerulus.
e.) Destruction of the Loop of Henle. - ANSWERS(b)
Preformed anti-donor antibodies that then target the surface of vascular endothelial
cells and graft parenchymal cells. (occurs with minutes to hours and treatment is
removal of organ) Circulating complement is fixed in the vascular compartment and the
environment changes from anticoagulant to procoagulant and vascular thrombosis
occurs. Death of the organ is secondary to ischemia.
Which of the following statements about fetal circulation are true?
a.) Approximately 25% of all blood volume is passed through the fetal lung; the
remainder is shunted into the left ventricle.
b.) The umbilical arteries carry oxygenated blood from the placenta to the fetus.
, c.) Failure of pulmonary vascular resistance to fall immediately following birth will result
in neonatal respiratory failure.
d.) The ductus arteriosus closes anatomically in the first hour of life. - ANSWERS(c)
With the first breath, the oxygen delivered to the neonatal lung stimulates a fall in
pulmonary vascular resistance. This results in a decrease, then obliterated, right-to-left
shunt through the foramen ovule and ductus arteriosus.
Only 7% of blood is sent to the lungs in utero
Follicular thyroid carcinoma
a.) Is the most common thyroid cancer
b.) Is readily diagnosed with FNA
c.) Spreds via the hematogenous route
d.) Is commonly multifocal - ANSWERS(c)
What genetic mutation is associated with MEN syndromes?
a.) RET
b.) APC
c.) MSH2
d.) p53
e.) N-myc - ANSWERS(a)
RET-proto-oncogene
What is the treatment of failed chemo/radiation for anal canal cloacogenic carcinoma?
(a) LAR
(b) More chemo/radiation
(c) APR
(d) Sigmoid colectomy - ANSWERS(c)
In cases followed up with surveillance bipsies, if positive can undergo salvage APR
(abdomino-perineal resection)
Most common groin hernia in women?
a.) Direct inguinal
b.) Femoral
c.) Indirect inguinal
d.) Obturator - ANSWERS(c)
Indirect inguinal hernia is still the most common, even in women
What is the most common visceral arterial aneurysm?