1. Which of the following best describes the underlying mechanism of
edema in congestive heart failure (CHF)?
a) Increased capillary permeability
b) Increased capillary hydrostatic pressure
c) Decreased lymphatic drainage
d) Decreased plasma oncotic pressure
Answer: b) Increased capillary hydrostatic pressure
Rationale: In CHF, the heart’s reduced ability to pump blood leads to
increased pressure in the venous system, which causes fluid to leak out
of the capillaries into the surrounding tissues, resulting in edema.
Increased capillary hydrostatic pressure is the primary mechanism in
CHF-induced edema.
2. In systemic inflammatory response syndrome (SIRS), the cytokine
most responsible for inducing fever is:
a) Interleukin-1 (IL-1)
b) Tumor necrosis factor (TNF)
c) Interleukin-6 (IL-6)
d) Interferon-gamma (IFN-γ)
Answer: a) Interleukin-1 (IL-1)
Rationale: IL-1 plays a key role in the inflammatory response and is
primarily responsible for the fever response in SIRS. It acts on the
hypothalamus, triggering the production of prostaglandins that raise
the body’s temperature.
,3. A 45-year-old patient with a history of hypertension and smoking
presents with sudden severe chest pain, radiating to the back. What is
the most likely cause of the pain?
a) Myocardial infarction
b) Pulmonary embolism
c) Aortic dissection
d) Gastroesophageal reflux disease (GERD)
Answer: c) Aortic dissection
Rationale: The patient's history of hypertension and smoking, along
with sudden severe chest pain radiating to the back, is highly suggestive
of aortic dissection. This condition involves a tear in the aortic wall,
leading to a separation of the layers of the vessel.
4. The "tubular maximum" for glucose reabsorption refers to:
a) The maximum amount of glucose that can be absorbed by the
kidneys in a given period
b) The maximal amount of glucose that can be stored in the liver
c) The maximum concentration of glucose that can be filtered by the
glomerulus
d) The rate at which glucose is metabolized in the brain
Answer: a) The maximum amount of glucose that can be absorbed by
the kidneys in a given period
Rationale: The "tubular maximum" (Tm) for glucose refers to the
maximum rate at which glucose can be reabsorbed from the filtrate in
the renal tubules. Once the glucose concentration exceeds Tm, glucose
will appear in the urine.
, 5. Which of the following is a characteristic feature of diabetic
ketoacidosis (DKA)?
a) Metabolic alkalosis
b) Increased serum bicarbonate levels
c) Anion gap metabolic acidosis
d) Hypoglycemia
Answer: c) Anion gap metabolic acidosis
Rationale: DKA is characterized by an anion gap metabolic acidosis due
to the accumulation of ketone bodies (acetoacetate, beta-
hydroxybutyrate). This results from uncontrolled hyperglycemia and
insulin deficiency in diabetic patients.
6. A decrease in the number of erythrocytes and a decrease in
hemoglobin concentration are characteristic of:
a) Iron-deficiency anemia
b) Aplastic anemia
c) Hemolytic anemia
d) Vitamin B12 deficiency
Answer: b) Aplastic anemia
Rationale: Aplastic anemia is characterized by pancytopenia (reduced
numbers of all blood cells, including erythrocytes) due to failure of the
bone marrow to produce blood cells. This leads to both decreased
erythrocytes and hemoglobin levels.
7. The classic triad of symptoms seen in nephrotic syndrome includes
all of the following except:
edema in congestive heart failure (CHF)?
a) Increased capillary permeability
b) Increased capillary hydrostatic pressure
c) Decreased lymphatic drainage
d) Decreased plasma oncotic pressure
Answer: b) Increased capillary hydrostatic pressure
Rationale: In CHF, the heart’s reduced ability to pump blood leads to
increased pressure in the venous system, which causes fluid to leak out
of the capillaries into the surrounding tissues, resulting in edema.
Increased capillary hydrostatic pressure is the primary mechanism in
CHF-induced edema.
2. In systemic inflammatory response syndrome (SIRS), the cytokine
most responsible for inducing fever is:
a) Interleukin-1 (IL-1)
b) Tumor necrosis factor (TNF)
c) Interleukin-6 (IL-6)
d) Interferon-gamma (IFN-γ)
Answer: a) Interleukin-1 (IL-1)
Rationale: IL-1 plays a key role in the inflammatory response and is
primarily responsible for the fever response in SIRS. It acts on the
hypothalamus, triggering the production of prostaglandins that raise
the body’s temperature.
,3. A 45-year-old patient with a history of hypertension and smoking
presents with sudden severe chest pain, radiating to the back. What is
the most likely cause of the pain?
a) Myocardial infarction
b) Pulmonary embolism
c) Aortic dissection
d) Gastroesophageal reflux disease (GERD)
Answer: c) Aortic dissection
Rationale: The patient's history of hypertension and smoking, along
with sudden severe chest pain radiating to the back, is highly suggestive
of aortic dissection. This condition involves a tear in the aortic wall,
leading to a separation of the layers of the vessel.
4. The "tubular maximum" for glucose reabsorption refers to:
a) The maximum amount of glucose that can be absorbed by the
kidneys in a given period
b) The maximal amount of glucose that can be stored in the liver
c) The maximum concentration of glucose that can be filtered by the
glomerulus
d) The rate at which glucose is metabolized in the brain
Answer: a) The maximum amount of glucose that can be absorbed by
the kidneys in a given period
Rationale: The "tubular maximum" (Tm) for glucose refers to the
maximum rate at which glucose can be reabsorbed from the filtrate in
the renal tubules. Once the glucose concentration exceeds Tm, glucose
will appear in the urine.
, 5. Which of the following is a characteristic feature of diabetic
ketoacidosis (DKA)?
a) Metabolic alkalosis
b) Increased serum bicarbonate levels
c) Anion gap metabolic acidosis
d) Hypoglycemia
Answer: c) Anion gap metabolic acidosis
Rationale: DKA is characterized by an anion gap metabolic acidosis due
to the accumulation of ketone bodies (acetoacetate, beta-
hydroxybutyrate). This results from uncontrolled hyperglycemia and
insulin deficiency in diabetic patients.
6. A decrease in the number of erythrocytes and a decrease in
hemoglobin concentration are characteristic of:
a) Iron-deficiency anemia
b) Aplastic anemia
c) Hemolytic anemia
d) Vitamin B12 deficiency
Answer: b) Aplastic anemia
Rationale: Aplastic anemia is characterized by pancytopenia (reduced
numbers of all blood cells, including erythrocytes) due to failure of the
bone marrow to produce blood cells. This leads to both decreased
erythrocytes and hemoglobin levels.
7. The classic triad of symptoms seen in nephrotic syndrome includes
all of the following except:
