70yo M dies in a motor vehicle collision. Was undergoing evaluation

for

occult blood in the stool. Photo of transverse colon shown. Dx? -

ANSWER- Tubular adenoma

38yo M with 1-week hx of watery, itchy eyes and a runny nose.

Physical

shows inflamed nasal mucosa. No congestion in lower lung.

Pharmacotherapy? - ANSWER- Loratadine

agglutination? - ANSWER-IgM

24yo M with small tender blisters on his penis 3 days after

unprotected

sex. Photograph shown. Causal agent? - ANSWER- HSV-2

42yo F with 3-year hx of an intermittent facial rash, including the

forehead, eyelids, nose, and cheeks. Rash seems to be getting worse

since she moved from New York to Florida last year. Spicy foods

 1 / 4

of adenylyl cyclase

35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had

profuse, watery diarrhea for 8 hours despite a lack of oral intake.

Recently returned from a medical relief trip to a remove village in

Honduras. T 36.7 C, P 122/min, BP 90/50. PE shows dry skin and

decreased capillary refill. Stool for occult blood is negative; stool is gray

and turbid. Gram stain shows gram-negative, comma-shaped bacteria;

no erythrocytes of leukocytes. MOA of toxin? - ANSWER- Activation

precipitate a flushing reaction that seems to exacerbate the rash. 

PE shows erythema over the nose and cheeks, with scattered

telangiectasiasand a few papules. Dx? - ANSWER- Rosacea

53yo M returned from Africa, has fever, headache, and abdominal

discomfort. Received appropriate vaccinations prior to the trip. T

39.4C.

A wright-stained peripheral smear shown. Dx? - ANSWER- Malaria

68yo F with T2DM and hypertension that has been poorly

controlled

despite hydrochlorothiazide treatment. BP 150/96, Labs show

serum

glucose concentration of 130 and proteinuria. In addition to

current Rx,

which is most appropriate pharmacotherapy? - ANSWER- Lisinopril

66yo M with stage IV colon cancer with 3-day hx of severe diarrhea

after receiving chemotherapy with fluorouracil, leucovorin, and

Irinotecan. prescribed opioid antidiarrheal agent with no CNS

effects.Which med? - ANSWER- Loperamide

59yo F with gradual onset of lack of muscle control in her left arm and

of left upper and lower extremities. Muscle strength, DTR, sensation,

proprioception normal. Metastatic tumor in which location? -

ANSWER- cerebellum

leg. Sx 1 mo ago after dx with metastatic breast cancer. PE shows ataxia

 2 / 4

 3 / 4

min. PE shows a bulging, fluod0filled mass approximately 5 cm in

diameter in the midline over the lumbosacral region. No spontaneous

movements of the lower extremities. Abnormality most likely occurred

because of abnormal development during which periods of

6 hours? - ANSWER- torsades de pointes

64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has

ischemic heart disease. P 125/min, BP 105/60. ECG shows atrial

fibrillation. Intravenous ibutilide is administered. Ten minutes later,

ECG shows normal sinus rhythm. Risk for which drug effect in the next

Newborn delivered at 38 weeks' gestation weighs 1800 g. PE 

shows petechial rash, microcephaly, and hepatosplenomegaly.

Serologic testfor CMV: IgG + in mother, + in newborn; IGM - in 

mother, + in newborn. Explanation? - ANSWER- Congenital 

cytomegalovirus infection

Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at

1/5

postconception (in days)? - ANSWER- 15 to 40

65yo F with 20-year hx of osteoarthritis of the hands now has 

pain radiating down the distal anterior thigh, knee, medial leg, 

and food. Bony outgrowth of vertebrae compressing one of the

spinal nerves issuspected. Nerve root in which intervertebral 

foramina is effected? -ANSWER- L3 to L4

38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic

agent, he has tried diet and exercise. BMI 32. PE normal. Hb A1c is

10%. Physician recommends initiation of insulin injections. 

Responds,"I know that insulin would help control my blood sugar. 

But a lot of people in my family have diabetes, and insulin made

them really sick attimes. Patient is at which stage of change? -

ANSWER- contemplation

24yo M with 2-day history of an itchy rash on his arms and legs.

Returned from a camping trip in the woods 5 days ago. PE shows