ANATOMY AND PHYSIOLOGY. Q-Bank World Questions And Answer 2023.

ANATOMY AND PHYSIOLOGY. Q-Bank World Questions And Answer 2023. The neural crest cells must migrate into the truncal and bulbar ridges of the truncus arteriosus and bulbus cordis to grow and spiral to separate the aorta and pulmonary artery. This is a defect in what major disorders? (3) – CORRECT ANSWER - Tetralogy of Fallot - Truncus arteriosus - Transposition of the Great Vessels Endocardial cushion defect would produce what? – CORRECT ANSWER - Atrioventricular septal defects In what condition is aortic arch constriction seen? – CORRECT ANSWER - Coarctation of the Aorta What segment of the intestine is unique for the presence of Brunner glands which are deep to the muscularis mucosae and secrete an alkaline mucous into the ducts that tracks upward toward the muscularis mucosae? – CORRECT ANSWER - The duodenum How might the villi found in the jejunum differ from the duodenum? – CORRECT ANSWER - They contain MORE goblet cells How does the colon differ from the stomach and small intestine? - CORRECT ANSWER - The colon has NO pits or villi and has many goblet cells What region of the intestine are Peyers patches specific to? - CORRECT ANSWER - Ileum Patient presents with oropharyngeal dysphagia, coughing, choking, and recurrent aspiration pneumonia. She has a lateral mass in the neck. What is the dx? - CORRECT ANSWER - Zenker (Pulsion) diverticulum (false) caused by a CRICOPHARYNGEAL muscle dysfunction** that results in diminished relaxation of the pharyngeal muscles during swallowing. This results in a subsequent INCREASE in intraluminal pressure in the oropharynx which causes the mucosa to herniate through a point of weakness (thus only mucosa/submucosa involvement and not a true diverticulum) Diverticula in the mid-esophageal area caused by mediastinal lymphadenitis is a true or false diverticulum? - CORRECT ANSWER - True; Diverticulum caused by scarring or traction are true diverticula What is a retention cyst? - CORRECT ANSWER - This is formed by the trapped secretions of a blocked duct from a gland What is the best way to increase Foward systolic volume (FSV) - more so than RSV (reverse systolic volume - back into the LA) in a patient with mitral regurgitation. - CORRECT ANSWER Arteriolar vasodilation = DECREASED afterload In a patient with mitral regurgitation, the forward systolic volume is the volume ejected from the LV into the aorta. The reverse systolic volume is the volume ejected from the LV to the LA. If the systolic retrograde flow resistance between LV to LA, preload, and contractility remain the same - the major determinant to cause more blood to flow into the aorta than the LA will be afterload pressure (decreased afterload means more blood can go to the aorta). This would increase the foward-to-regurgitant volume ratio. D1 receptor stimulation as by Fendolopam results in what? - CORRECT ANSWER - elevation of cAMP and arteriole vasodilation of most arteriolar beds (especially renal, mesenteric, and coronary beds). How is loss of consciousness precipitated by hypoglycemia treated in the non-medical setting vs medical setting? - CORRECT ANSWER - Non medical = IM glucagon - Medical = IV glucose Desmopressin has what effects? - CORRECT ANSWER - This is recombinant ADH and is used to tread central diabetes insipidus, noturnal enuresis, and increases circulating levels of vWF (factor VIII:F) and promotes the coagulant activity of factor VIII:C What is the most common embryological cause of urine outflow obstruction? - CORRECT ANSWER - The uretropelvic obstruction (Because this is the last region to canalize) In normal fetal development, the ureters are fully canalized before the metanephros begins to produce urine (8-10 weeks). Inadequate recanalization of the ureteropelvic junction, the junction between the kidney and ureter, is the MOST COMMON cause of the fetal antenatal hydronephrosis. At high altutudes, what is the approximate paO2 level? - CORRECT ANSWER - It declines VERY low to around 60 mm Hg and thus stimulates the carotid and aortic body chemoreceptors - this increases ventilatory drive. This results in decrease in pCO2 and an increase in blood pH. The kidneys compensate by increased excretion of HCO3 and thus blood HCO3 will be decreased. In hypoxic conditions, the kidney begins to release EPO and this stimulates increased red cell production in about how long? - CORRECT ANSWER -10-14 days The appearance of vacuoles and phospholipid contaiing amorphous densities within the mitochondria generally signifies what? What does mitochondrial swelling indicates? - CORRECT ANSWER signifies irrveversible injury swelling = REVERSIBLE injury Disaggregation of polysomes is a sign of what and leads to what? - CORRECT ANSWER - Reversible cell injury means that there is dissociation of rRNA from mRNA and indicates reversible hypoxic injury Disaggregation of granular and fibrillar elements of the nucleus is assoc w/ what? What about clumping of nuclear chromatin - CORRECT ANSWER - BOTH are REVERSIBLE CELL INJURY Superior sulcus tumor = ? - CORRECT ANSWER Pancoast tumor What are the major symptoms of a Pancoast tumor? - CORRECT ANSWER 1) Severe pain in the shoulder that radiates to the axilla and scapula (**most common presenting sx**) - due to involvement of the brachial plexus. Also causes paresthesia, arm weakness, muscle atrophy, etc. 2) Horner syndrome 3) Edema of the upper extremity due to subclavian vessel compression 4) Extension into intervertebral foramina causing spinal cord compression and paraplegia 5.) Horseness due to recurrent laryngeal nerve involvement 4 Situations to violate patient confidentiality? - CORRECT ANSWER 1. When child/elder abuse