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____ is the transfer of gases between the alveoli and the pulmonary capillaries. - correct answer- Diffusion
______ is the flow of gases into and out of the alveoli of the lungs. - correct answer- Ventilation
- __________ is a systemic treatment that enables drugs to reach the site of the tumor as well as other distant sites
- The profound weight loss and wasting of fat and tissue that accompany cancer is known as ______. - correct answer- 1. Chemotherapy
- Cancer anorexia-cachexia syndrome
6 y/o Tommy is brought in by his mom today for complaints of vomiting and diarrhea. He does not have a fever. His stool is hemoccult negative (no blood). His younger sibling has similar symptoms. You diagnose Tommy with viral gastroenteritis. What is the best treatment plan for this patient? Explain your reasoning. - correct answer- Fluid and electrolyte replacement to prevent dehydration. Most acute episodes of diarrhea will subside on their own and require no treatment.
(An answer of dehydration prevention should be awarded 3.5 points. Full credit should be awarded if preventative measures are listed and the fact that this typically resolves on its own.)
6 y/o Tommy is brought in by his mom today for complaints of vomiting and diarrhea. He does not have a fever. His stool is hemoccult negative (no blood). His younger sibling has similar symptoms. You diagnose Tommy with viral gastroenteritis. Would you categorize this condition as inflammatory or non-inflammatory? - correct answer- Non- inflammatory
A 10-year-old boy who is having an acute asthma attack is brought to the ER. He is observed to be sitting up and struggling to breathe. His breathing is accompanied by use of accessory muscles, a weak cough, and audible wheezing sounds. His pulse is rapid and weak, and both heart and breath sounds are distant on auscultation. His parents relate that his asthma began to worsen after he developed a "cold," and now he doesn't get relief from his albuterol inhaler.
Explain the changes in physiologic function underlying his signs and symptoms. - correct answer- Recruitment of inflammatory cells from the bloodstream into the bronchial wall, where they directly attack the invading organisms and secrete inflammatory chemicals that are toxic to the organisms causes airway inflammation. Swelling of the bronchial wall, mucus secretion, constriction of the airway; bronchial hyper-responsiveness to stimuli causes airway obstruction or narrowing. They may discuss on a cellular level as well:
Upon a trigger, the cascade of neutrophils, eosinophils, lymphocytes, and mast cells cause epithelial injury. This causes airway inflammation, which further increases hyperresponsiveess and decreased airflow. Mast cells release histamine
- What type of treatment should be given? - correct answer- 1. Hypothyroidism
- Synthetic T4 thyroid hormone, thyroxine
A 72-year-old male is said to be in phase 3 of gout. He is obese and has a history of alcohol abuse. Develop a treatment plan including specific pharmacologic intervention and a non-pharmacologic recommendation to manage his disease. - correct answer- Phase 3 of gout is called inter-critical gout. The patient is asymptomatic, and no joint abnormalities are present. The goal of treatment in this phase is to maintain normal uric acid levels and prevent progression of the disease. Allopurinol is a prescription drug that is used to reduce uric acid levels. This patient should be encouraged to lose weight and decrease his alcohol consumption. He should also avoid purine-rich foods such as fish, bacon, and liver.
A 75-year-old male is brought to the emergency department by his spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire right side of his face felt numb. She reports that he is very active, but he has a past medical history of atrial fibrillation. A CT scan confirms that this patient has suffered from an ischemic CVA. What is the best treatment plan for this patient? Explain your reasoning. - correct answer- This patient should receive tPA drugs, as they are within the 3-4.5 hour treatment window.
A 75-year-old male is brought to the emergency department by his spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire right side of his face felt numb. She
reports that he is very active, but he has a past medical history of atrial fibrillation. Given the patient's past medical history and presentation, what is your initial diagnosis? - correct answer- Stroke or CVA
A 75-year-old male is brought to the emergency department by his spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire right side of his face felt numb. She reports that he is very active, but he has a past medical history of atrial fibrillation. What do you suspect this patient is experiencing? Specifically, categorize the disease process based upon his past medical history and his current presentation and explain how you arrived at this specific diagnosis. - correct answer- He is more than likely experiencing an ischemic stroke. A past medical history of atrial fibrillation puts him at an increased risk for clots.
A 75-year-old male is brought to the emergency department by his spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire right side of his face felt numb. She reports that he is very active, but he has a past medical history of atrial fibrillation. You suspect this patient has suffered an ischemic CVA. What diagnostic test would you run to confirm your diagnosis? - correct answer- A CT scan and MRI would be needed to determine if a clot is blocking blood flow to the brain tissue and to rule out a hemorrhagic stroke.
A 75-year-old male is brought to the emergency department via ambulance at 5 pm. The patient's spouse reports that when they woke up (approximately at 6 am) he reported to her that he was having some blurred vision but decided to
(2) No
(3) Epinephrine
(4) Identification about allergy, EpiPen
A decrease in the size of an organ or tissue resulting from a decrease in the mass of pre-existing cells is called: - correct answer- Atrophy
A patient experiences a seizure that manifests with motor weakness on the right side, a tingling sensation on the right side, and flushing. They have experienced which type of seizure? - correct answer- Focal seizure without impairment of consciousness or awareness
A patient experiences a seizure that manifests with repetitive hand rubbing and reports of hallucinations right before the seizure occurred. They have experienced which type of seizure? - correct answer- Focal seizure with impairment of consciousness or awareness
A patient has experienced a seizure affecting the left temporal lobe. The family reports that the patient exhibited repetitive lip smacking and hand rubbing followed by a period of great fear and insecurity. They have experienced which type of seizure? - correct answer- Focal seizure with impairment of consciousness or awareness
A patient is admitted to the hospital with pneumonia. The following are the results of their blood work: pH = 6.9, PCO = 52 mm, and HCO3- = 30 mEq/L. Based upon these results, what type of acid-base disorder are they experiencing? Is compensation occurring? Describe a treatment intervention for this disorder. Normal values are as follows: pH = 7.35- 7.45, PCO2 = 35-45 mm, HCO3 - = 22-26 mEq/L. - correct answer- The patient is in respiratory acidosis. The renal system is attempting to compensate as HCO3- concentration is elevated above normal limits. The goal of treatment for respiratory acidosis is improving ventilation. Supplemental O2 can be administered; in severe cases mechanical ventilation may be indicated.
A patient is experiencing a severe reduction in GFR, and their GFR is 15-29 mL/min/1.73m2. What stage of kidney disease are they in? - correct answer- 4
A patient is experiencing kidney damage with a mild decrease in GFR, and their GFR is 60-89 mL/min/1.73m². What stage of kidney disease are they in? - correct answer- 2
A patient is said to be in stage 2 kidney disease. What would you expect their GFR to be? - correct answer- 70 mL/min/1.73m
A patient is said to be in stage 4 kidney disease. What would you expect their GFR to be? - correct answer- 25 mL/min/1.73m
A patient presents to the emergency department with complaints of sharp pain that comes in waves in the upper lateral quadrant of the abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day long. They have a history of UTIs. Urinalysis reveals that the pH of their urine is 7.8. Given the patient's past medical history and presentation, what is your initial diagnosis? - correct answer- Kidney stones or renal calculi
A patient presents to the emergency department with complaints of sharp pain that comes in waves in the upper lateral quadrant of the abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day long. They have a history of UTIs. Urinalysis reveals that the pH of their urine is 7.8. You suspect that the patient may have a kidney stone. What diagnostic test would you run to confirm your diagnosis? - correct answer- In addition to the urinalysis already run, a CT scan would be needed to confirm your diagnosis and determine the size of the stone.
A triglyceride reading of 175 would be considered: - correct answer- Borderline high
An abnormal cellular growth, resulting in cells that vary in size, shape, and organization is called: - correct answer- Dysplasia
An endocrine hormone is released into circulation to act on a target organ. - correct answer- True
An increase in the size of an organ or tissue due to the increase in size of the cells that comprise it is called: - correct answer- Hypertrophy
An LDL cholesterol reading of 90 would be considered: - correct answer- Optimal
Anne is a 48 y/o female who presents with excessive vaginal bleeding x 6 months. Her skin is pale, she reports feeling fatigued, and often craves a large cup of Sonic crushed ice. A quick in-office H&H shows a hemoglobin of 9 and hematocrit of 30%. Given the patient's past medical history and presentation, what is your initial diagnosis? - correct answer- Anemia
Anne is a 48 y/o female who presents with excessive vaginal bleeding x 6 months. Her skin is pale, she reports feeling fatigued, and often craves a large cup of Sonic crushed ice. A quick in-office H&H shows a hemoglobin of 9 and hematocrit of 30%. She is given a diagnosis of blood loss or iron deficiency anemia. What is the best treatment plan for this patient? Explain your reasoning. - correct answer- If low ferritin, she would need iron supplementation. Also find the cause of the bleeding and try to control.
Anne is a 48 y/o female who presents with excessive vaginal bleeding x 6 months. Her skin is pale, she reports feeling fatigued, and often craves a large cup of Sonic crushed ice. A quick in-office H&H shows a hemoglobin of 9 and hematocrit of 30%. You suspect Anne is anemic. What diagnostic test would you run to confirm your diagnosis? What would her red blood cells look like on the slide? (size and color) - correct answer- CBC with peripheral smear and ferritin level. RBCs would appear microcytic and hypochromic.
Alzheimer's Disease. Changes in sleep, changes in mood, and wandering episodes are all characteristic of moderate Alzheimer's.
Bill and Angela have brought their mom into your office today. They tell you that their mom has experienced dementia for some time now, but they have not been too concerned because, for the most part, she has been able to care for herself, only needing assistance here and there for her daily activities. However, recently things have changed. Her ability to recall recent events has drastically decreased; she is experiencing difficulty with sleep; they've noticed some mood changes, and the most alarming thing is that she has started to wander outside of her home. They are concerned for her safety. You suspect the patient has Alzheimer's. What are the diagnostic criteria or processes for your suspected diagnosis? - correct answer- A neurologic exam will determine if there are other disease processes that may be causing symptoms such as Parkinson's disease, hydrocephalus, small or large vessel strokes, or the presence of a tumor. The Mini Mental State Exam (MMSE) or the Mini-Cog test are standardized tests used to determine whether someone has dementia and the severity of it. MRI and CT scans are primarily used to eliminate other disease processes as a diagnosis but can be used to measure levels of Aβ. As previously discussed, higher levels of Aβ would indicate Alzheimer's disease as a diagnosis while normal levels would suggest it is not the cause of the presenting dementia.
Blood circulates through bone by what means? (mark all that apply) - correct answer- Via the central Haversian and Volkmann canals
An anastomosis between perforating and nutrient arteries
Diffusion through the endosteal surface of the bone and the canaliculi
Bob is a 55 y/o male here for his annual physical exam. He has no current complaints. His BMI is 31, BP 150/90, HR 72, RR 16. He does not smoke, drinks alcohol occasionally, and has a family history of cardiovascular disease. His BP was retaken in the opposite arm and was 155/86. Given the patient's past medical history and presentation, what is your initial diagnosis? - correct answer- Hypertension
Bob is a 55 y/o male here for his annual physical exam. He has no current complaints. His BMI is 31, BP 150/90, HR 72, RR 16. He does not smoke, drinks alcohol occasionally, and has a family history of cardiovascular disease. His BP was retaken in the opposite arm and was 155/86. How would you stage Bob's hypertension? - correct answer- Stage 2, > 140/
Briefly explain why autoimmune diseases are difficult to diagnose - correct answer- There are over 80 identified autoimmune disorders identified, many with overlapping and/or nonspecific presentations, making an accurate diagnosis can be quite challenging.
Cancellous bone receives its blood supply by what means? - correct answer- Diffusion through the endosteal surface of the bone and the canaliculi
Chad, a 20 y/o male, presents with episodes of diarrhea with mucus and rectal bleeding. A colonoscopy and biopsy are done to confirm ulcerative colitis. How does this disease differ from Crohn disease? - correct answer- Crohns disease has granulomatous inflammation, involvement primarily submucosal, extent of involvement- skip lesions,
Each of the following can lead to atelectasis except: - correct answer- Thrombus
Each of the following factors are associated with increased incidence of peptic ulcer EXCEPT: - correct answer- Dietary history
Each of the following is characteristic of Addison's Disease except? - correct answer- Emotional disturbances
Each of the following is true of apoptosis except: - correct answer- It sets off an inflammatory immune response
Each of the following is true of necrosis except: - correct answer- It is also referred to as programmed cell death
Eva, a 53 y/o female, has a chief complaint of constipation after starting on a calcium supplement for osteopenia. If constipation occurs as a change from a person's normal bowel habits, and no new meds have been started, what should you suspect? - correct answer- Colorectal cancer
Explain how the kidney can maintain a constant GFR despite variations in the arterial blood pressure of the rest of the body. - correct answer- The renal autoregulatory system causes the efferent arteriole to constrict leading to an increased resistance to outflow from the glomeruli with a subsequent increase in glomerular pressure and the GFR. When the afferent arteriole constricts, there is a reduction in renal blood flow, glomerular pressure, and the GFR
Explain how the skin's physical barrier makes it inhospitable to microorganisms - correct answer- Our skin is comprised of closely packed cells in multiple layers. Keratin is what covers the skin and makes it a salty acidic inhospitable environment to microbes with the use of proteins and lysozymes.
Explain one reason why obesity puts someone at increased risk for cancer. - correct answer- Obesity is associated with insulin resistance and increased production of pancreatic insulin, both of which can have a carcinogenic effect. It is associated with increased levels of sex hormones, androgens, and estrogens. These stimulate cell proliferation, inhibit apoptosis, and increase the chance of malignant cell transformation, especially of the endometrial and breast tissue. Lastly, obesity has been related to chronic inflammation, which can lead to the development of malignancies.
Explain the challenges of diagnosing autoimmune disorders - correct answer- There are over 80 identified, many with overlapping presentations. Many manifestations are nonspecific and are seen in other non-autoimmune diseases. Blood testing isn't perfect either, as some tests are more generic and can be elevated in the presence of other diseases.
Explain the diagnostic criteria required for an autoimmune disease to be concluded. - correct answer- In order for an autoimmune disorder to be concluded, the following criteria must be met: evidence of an autoimmune reaction, the immunologic findings are not secondary to another condition, and no other identifiable causes are found.
If constipation occurs as a change from a person's normal bowel habits, and no new meds have been started, what should you suspect? - correct answer- Colorectal cancer
If someone loses their balance when walking on uneven terrain, explain how tendons and ligaments work to protect the joint and structures within it. - correct answer- The tendons and ligaments of joints serve in proprioception (the awareness of ones'
position in space or movement of the body). When these structures undergo stretch or torsional
strain, these
proprioceptive
nerve fibers will cause a reflexive response
to adjust the tension on the muscles (to maintain balance and not fall over) that support the joint
protecting the
capsule and other joint
structures
Jake is a 12 y/o male who is brought in by his mom. He complains of coughing fits when he plays sports and has to catch his breath a lot. He also feels "tight" with breathing when he's around cats and dogs. His mom is also allergic to
certain animals. Jake is diagnosed with exercise-induced and/or allergic asthma. What is the best treatment plan for him? - correct answer- Short-acting beta agonist / Albuterol before exercise or when around pets.
Jake is a 12 y/o male, who is brought in by his mom. He complains of coughing fits when he plays sports and has to catch his breath a lot. He also feels "tight" with breathing when he's around cats and dogs. His mom is also allergic to certain animals. Given the patient's presentation, what is your initial diagnosis? - correct answer- Asthma
Jake is a 12 y/o male, who is brought in by his mom. He complains of coughing fits when he plays sports and has to catch his breath a lot. He also feels "tight" with breathing when he's around cats and dogs. His mom is also allergic to certain animals. You suspect Jake is asthmatic. What about his current presentation leads you to this conclusion? - correct answer- Exercise-induced and/or allergic asthma; coughing and chest tightness
Jake is a 12 y/o male, who is brought in by his mom. He complains of coughing fits when he plays sports and has to catch his breath a lot. He also feels "tight" with breathing when he's around cats and dogs. His mom is also allergic to certain animals. You suspect that Jake is asthmatic. What diagnostic test would you run to confirm your diagnosis? - correct answer- Pulmonary function test or peak flows
James is being seen for his first colonoscopy. He turned 50 this year, and his father recently passed away from colon cancer at age 85. This would be an example of: - correct answer- Secondary prevention
