48-year old man with a long history of alcohol abuse has painless vomiting of large
amounts of bright red blood. Heart rate is 110/min and blood pressure is 80/0mmHg. He
dies despite rapid transfusion of packed erythrocytes. At autopsy, the source of the
hemorrhage is found in the lower esophagus. A photograph of the site is shown. Which
of the following mechanisms most likely caused the hemorrhage?
A. alcohol induced esophagitis
B. Deficiency in hepatic synthesis of vitamin K dependent coagulation proteins
C. Mechanical tearing of the esophageal mucosa during vomiting
D. Peptic ulceration of esophageal mucosa due to reflux of gastric acid
E. Transmission of portal hypertension to esophageal veins
Give this one a try later!
E. Transmission of portal hypertension to esophageal veins
,Asymptomatic 42 year old man with essential hypertension is started on an angiotensin-
converting enzyme inhibitor. Which of the following shows the most likely effect of
treatment on circulating levels of aldosterone, renin, and bradykinin?
A. Aldosterone lowered, Renin lowered, Bradykinin lowered
B. Aldosterone lowered, Renin lowered, Bradykinin higher
C. Aldosterone lowered, Renin higher, Bradykinin higher
D. Aldosterone higher, Renin higher, Bradykinin no change
E. Aldosterone higher, Renin higher, Bradykinin higher
F. Aldosterone higher, Renin higher, Bradykinin lowered
Give this one a try later!
C. Aldosterone lowered, Renin higher, Bradykinin higher
obese 82- year old woman with a 20 year history of type 2 diabetes mellitus has been
taking glyburide orally for the past 5 years. Metformin is added to her regimen. Bc she is
taking metformin, she is at increased risk for which of the following?
A. diabetic ketoacidosis
B. lactic acidosis
C. metabolic alkalosis
D. renal tubular acidosis
E. respiratory alkalosis
Give this one a try later!
B. lactic acidosis
,65 year old woman develops a proximal deep venous thrombosis 1 week after an
elective total hip replacement. What is the mechanism of intravenous heparin in treating
this disorder?
A. Activation of plasmin
B. Facilitation of inactivation of thrombin by antithrombin III
C. Inhibition of activation of tissue plasminogen
D. Inhibition of vitamin K dependent coagulation factors
E. Reversible inhibition of protein C and protein S activity
Give this one a try later!
B. Facilitation of inactivation of thrombin by antithrombin III
23 year old man who recently emigrated from Costa Rica is admitted to the ED with
seizures. Findings on examination of his cerebrospinal fluid are within reference range. a
CT scan of the head shows numerous cortical lesions with calcifications, some have
surrounding edema. The life cycle of the parasite causing these lesions involves:
A. the bite of a blackly to human
B. the bite of a mosquito to human
C. the bite of a sandfly to human
D. passage through cows
E. passage through pigs
Give this one a try later!
E. passage through pigs
, 3- year old boy has an abdominal cryptorchid testis that cannot be brought down into
the scrotal sac. The testis should be removed to decrease his risk for which of the
following?
A. abnormal hormonal secretion
B. infection
C. intestinal obstruction
D. malignancy
E. Psychological impairment
Give this one a try later!
D. malignancy
27 year old man with recurrent peptic ulcer disease has a small pancreatic neoplasm that
produces large amounts of gastrin. While awaiting operation, the patient should be
treated with:
A. chenodeoxycholic acid
B. methacholine
C metoclopramide
D. omeprazole
E. sucralfate
Give this one a try later!
D. omeprazole
50 year old woman is evaluated for occult blood in the stool. Colonoscopy shows a 5cm
sessile mass with a velvety surface that projects about 2cm above the mucosa of the
amounts of bright red blood. Heart rate is 110/min and blood pressure is 80/0mmHg. He
dies despite rapid transfusion of packed erythrocytes. At autopsy, the source of the
hemorrhage is found in the lower esophagus. A photograph of the site is shown. Which
of the following mechanisms most likely caused the hemorrhage?
A. alcohol induced esophagitis
B. Deficiency in hepatic synthesis of vitamin K dependent coagulation proteins
C. Mechanical tearing of the esophageal mucosa during vomiting
D. Peptic ulceration of esophageal mucosa due to reflux of gastric acid
E. Transmission of portal hypertension to esophageal veins
Give this one a try later!
E. Transmission of portal hypertension to esophageal veins
,Asymptomatic 42 year old man with essential hypertension is started on an angiotensin-
converting enzyme inhibitor. Which of the following shows the most likely effect of
treatment on circulating levels of aldosterone, renin, and bradykinin?
A. Aldosterone lowered, Renin lowered, Bradykinin lowered
B. Aldosterone lowered, Renin lowered, Bradykinin higher
C. Aldosterone lowered, Renin higher, Bradykinin higher
D. Aldosterone higher, Renin higher, Bradykinin no change
E. Aldosterone higher, Renin higher, Bradykinin higher
F. Aldosterone higher, Renin higher, Bradykinin lowered
Give this one a try later!
C. Aldosterone lowered, Renin higher, Bradykinin higher
obese 82- year old woman with a 20 year history of type 2 diabetes mellitus has been
taking glyburide orally for the past 5 years. Metformin is added to her regimen. Bc she is
taking metformin, she is at increased risk for which of the following?
A. diabetic ketoacidosis
B. lactic acidosis
C. metabolic alkalosis
D. renal tubular acidosis
E. respiratory alkalosis
Give this one a try later!
B. lactic acidosis
,65 year old woman develops a proximal deep venous thrombosis 1 week after an
elective total hip replacement. What is the mechanism of intravenous heparin in treating
this disorder?
A. Activation of plasmin
B. Facilitation of inactivation of thrombin by antithrombin III
C. Inhibition of activation of tissue plasminogen
D. Inhibition of vitamin K dependent coagulation factors
E. Reversible inhibition of protein C and protein S activity
Give this one a try later!
B. Facilitation of inactivation of thrombin by antithrombin III
23 year old man who recently emigrated from Costa Rica is admitted to the ED with
seizures. Findings on examination of his cerebrospinal fluid are within reference range. a
CT scan of the head shows numerous cortical lesions with calcifications, some have
surrounding edema. The life cycle of the parasite causing these lesions involves:
A. the bite of a blackly to human
B. the bite of a mosquito to human
C. the bite of a sandfly to human
D. passage through cows
E. passage through pigs
Give this one a try later!
E. passage through pigs
, 3- year old boy has an abdominal cryptorchid testis that cannot be brought down into
the scrotal sac. The testis should be removed to decrease his risk for which of the
following?
A. abnormal hormonal secretion
B. infection
C. intestinal obstruction
D. malignancy
E. Psychological impairment
Give this one a try later!
D. malignancy
27 year old man with recurrent peptic ulcer disease has a small pancreatic neoplasm that
produces large amounts of gastrin. While awaiting operation, the patient should be
treated with:
A. chenodeoxycholic acid
B. methacholine
C metoclopramide
D. omeprazole
E. sucralfate
Give this one a try later!
D. omeprazole
50 year old woman is evaluated for occult blood in the stool. Colonoscopy shows a 5cm
sessile mass with a velvety surface that projects about 2cm above the mucosa of the
