front 1 A patient reports that swallowing does not proceed appropriately.
This symptom is called: | back 1 B. Dysphagia |
front 2 A patient has pain specifically as the food bolus traverses the
esophagus. This is: | back 2 A. Odynophagia |
front 3 Which tissue generates the peristaltic contraction
in the esophageal body? | back 3 C. Smooth muscle |
front 4 Which esophageal sphincter relaxes to allow food
into the gastric fundus?
| back 4 D. Lower esophageal sphincter |
front 5 A Schatzki ring is best described as: | back 5 A. Distal esophageal narrowing ring |
front 6 Schatzki rings are usually located: | back 6 C. Near stomach in lower esophagus |
front 7 Esophageal squamous cell carcinoma is most commonly found in
the: | back 7 B. Upper and middle sections |
front 8 Esophageal adenocarcinoma is most commonly found in the: | back 8 C. Lower section |
front 9 A patient cannot swallow, coughs with attempts, and has
hoarseness. The problem is most likely: | back 9 B. Oropharyngeal |
front 10 A patient says food gets stuck below the sternal notch. This
localizes best to: | back 10 C. Esophageal disease |
front 11 Myasthenia gravis is which hypersensitivity type? | back 11 B. Type II |
front 12 Symptoms of myasthenia gravis are usually worst: | back 12 D. End of day |
front 13 Deep tendon reflexes in myasthenia gravis are typically: | back 13 C. Normal |
front 14 Muscle atrophy in myasthenia gravis is generally: | back 14 B. Rare |
front 15 Myasthenia gravis incidence classically peaks around which age in
women? | back 15 B. 25 |
front 16 Myasthenia gravis incidence classically peaks around which age in
men? | back 16 D. 65 |
front 17
Leather, rubber, and tire manufacturing are classic
risk factors for: | back 17 B. Transitional cell carcinoma |
front 18 A patient taking rifampin notices urine
discoloration. Which color is most expected? | back 18 C. Reddish |
front 19 Which additional substance can also cause reddish urine? | back 19 B. Blackberries |
front 20
Hematuria is more likely glomerular when accompanied
by: | back 20 A. RBC casts |
front 21 Which finding also points toward glomerular
hematuria? | back 21 A. Proteinuria |
front 22 In a patient with hematuria but no clear glomerular features, the
next step is: | back 22 C. Perform systemic evaluation |
front 23 In patient communication, legitimization primarily: | back 23 B. Validates patient choices |
front 24 A DNRO in Florida is best defined as: | back 24 C. Department-issued no-resuscitation identifier |
front 25 A living will is best described as a document that: | back 25 B. Directs care under circumstances |
front 26 Can an out-of-state DNR be used in Florida? | back 26 C. No |
front 27 Which is another name for pre-formed vitamin A? | back 27 B. Retinol |
front 28 Retinol is the: | back 28 B. Most active vitamin A form |
front 29 Retinol is found mostly in foods of: | back 29 A. Animal origin |
front 30 Beta-carotenes are cleaved to form: | back 30 C. Retinol |
front 31 In circulation, retinol is primarily bound to: | back 31 C. Retinol-binding protein |
front 32 In rod cells, all-trans retinal combines with a
protein to form: | back 32 B. Rhodopsin |
front 33 In cone cells, all-trans retinal combines with a
protein to form: | back 33 C. Iodopsin |
front 34 Rod photopigment is primarily required for: | back 34 B. Night vision |
front 35 Cone photopigment is most important for: | back 35 C. Color vision in light |
front 36 A child with xerophthalmia and recurrent
infections most likely lacks: | back 36 D. Vitamin A |
front 37 Which skin finding is classically associated with vitamin A
deficiency? | back 37 B. Perifollicular hyperkeratosis |
front 38 Which visual complaint is an early clue to vitamin A
deficiency? | back 38 C. Night blindness |
front 39 Xerophthalmia from vitamin A deficiency can progress to: | back 39 B. Corneal ulceration |
front 40 Severe xerophthalmia may ultimately lead to: | back 40 C. Irreversible blindness |
front 41 Vitamin A deficiency impairs which immune functions? | back 41 A. Humoral and cell-mediated |
front 42 In developing countries, vitamin A deficiency increases mortality
from: | back 42 C. Measles |
front 43 A woman taking high-dose vitamin A for acne needs reliable
contraception because vitamin A is: | back 43 B. Teratogenic |
front 44 Vitamin A exposure is especially dangerous during which time? | back 44 C. First trimester |
front 45 Children with sickle cell disease tend to have what serum vitamin A
pattern? | back 45 B. Slightly lower |
front 46 Which form of vitamin D is plant- or yeast-derived?
| back 46 B. Vitamin D2 |
front 47 Which form of vitamin D is produced in skin with sunlight? | back 47 C. Vitamin D3 |
front 48 Which vitamin D form is commonly used to fortify milk?
| back 48 A. Vitamin D2 |
front 49 Vitamin D deficiency in children causes: | back 49 D. Rickets |
front 50 Vitamin D deficiency in adults causes: | back 50 B. Osteomalacia |
front 51 A child has bowed legs, frontal
bossing, and rachitic rosary. The diagnosis
is: | back 51 C. Rickets |
front 52 Delay in closure of skull bones in infancy most
strongly suggests: | back 52 B. Vitamin D deficiency |
front 53 An adult with vitamin D deficiency is most likely to have: | back 53 B. Bone pain, fragile bones |
front 54 Long-term phenobarbital therapy may cause
osteomalacia because it: | back 54 B. Increases vitamin D breakdown |
front 55 Which anticonvulsant is also linked to
osteomalacia? | back 55 C. Phenytoin |
front 56 Which tocopherol has the highest biologic activity?
| back 56 D. Alpha-tocopherol |
front 57 Which tocopherol isomer is physiologically effective?
| back 57 B. d-isomer |
front 58
Alpha-tocopherol inhibits which enzyme? | back 58 A. Protein kinase C |
front 59 Vitamin E is best known as the body’s major: | back 59 B. Lipid-soluble antioxidant |
front 60
Vitamin E deficiency is uncommon except in patients
who cannot: | back 60 A. Absorb fat |
front 61 Which disorder predisposes to vitamin E deficiency?
| back 61 B. Cystic fibrosis |
front 62 Which other condition predisposes to vitamin E deficiency?
| back 62 A. Pancreatic insufficiency |
front 63
Vitamin E deficiency classically causes: | back 63 B. Lost reflexes, sensory loss |
front 64 Which sensory deficit fits vitamin E deficiency?
| back 64 B. Decreased vibration sense |
front 65 Premature infants given oxygen may develop
retrolental fibroplasia. What may help prevent
this? | back 65 C. Vitamin E |
front 66 Very large doses of vitamin E may cause: | back 66 A. Hemorrhage |
front 67 Excess vitamin E promotes bleeding mainly by interfering with: | back 67 B. Vitamin K clotting function |
front 68 The predominant dietary form of vitamin
K is: | back 68 B. Phylloquinone |
front 69 Which vitamin K form is produced by gut microflora?
| back 69 C. Menaquinone |
front 70
Vitamin K is absorbed primarily in
the: | back 70 C. Proximal small bowel |
front 71 Normal vitamin K absorption requires: | back 71 C. Bile salts |
front 72 Which vitamin is least stable and easily destroyed
during cooking? | back 72 B. Vitamin C |
front 73 Vitamin C is efficiently absorbed in the: | back 73 C. Jejunum and ileum |
front 74 A patient with recurrent calcium oxalate stones
should avoid high doses of: | back 74 C. Vitamin C |
front 75
High-dose vitamin C can raise urinary
oxalate because it is metabolized to: | back 75 B. Oxalic acid |
front 76 Thiamin is primarily absorbed in the: | back 76 B. Jejunum |
front 77 Thiamin deficiency is especially common in alcoholics and patients
with: | back 77 B. Folate deficiency |
front 78 A patient with glossitis and
cheilosis is found to have deficiency of which
vitamin also known as vitamin B2?
| back 78 A. Riboflavin Randy call Gill at 2! |
front 79
Free riboflavin released from food is primarily
absorbed by an ATP-dependent process in the:
| back 79 C. Jejunum |
front 80 A malnourished patient has diarrhea, sun-exposed dermatitis,
and confusion. Which deficiency is most likely? | back 80 B. Niacin deficiency 3 Ds- dementia, dermatitis, diarrhea |
front 81 If untreated, severe pellagra classically progresses to: | back 81 C. Death |
front 82 Pantothenic acid is a precursor of: | back 82 D. CoA |
front 83 Biotin | back 83 B7 |
front 84 Folate | back 84 B9 |
front 85 Niacin | back 85 B3 |
front 86 Riboflavin | back 86 B2 |
front 87 Cobalamin | back 87 B12 |
front 88 Thiamin | back 88 B1 |
front 89 Pantothenic acid | back 89 B5 |
front 90 A patient with dermatitis, alopecia, myalgias, nausea, and
mental changes most likely has deficiency of: | back 90 B. Biotin BAD MNM |
front 91 Which additional finding is associated with biotin deficiency? | back 91 D. High cholesterol |
front 92
Vitamin B6 deficiency can occur with use of: | back 92 B. Isoniazid |
front 93 Which other drug may also precipitate vitamin B6 deficiency?
| back 93 A. Penicillamine |
front 94 A patient with pyridoxine deficiency is most likely
to have: | back 94 A. Pellagra-like dermatitis |
front 95 Which neuropsychiatric feature may occur in vitamin B6
deficiency? | back 95 B. Depression |
front 96 Long-term proton pump inhibitor use may predispose to deficiency
of: | back 96 C. Vitamin B12 |
front 97 A patient has megaloblastic anemia,
paresthesias, and a swollen painful red
tongue. Which deficiency best explains this? | back 97 C. Vitamin B12 deficiency |
front 98
Untreated vitamin B12 deficiency may cause
irreversible injury to the: | back 98 A. Peripheral nerves and cord |
front 99 A patient with B12 deficiency is most likely to
develop which sensory deficit? | back 99 A. Loss of vibration sense |
front 100 According to your notes, folate deficiency is
associated with: | back 100 B. Elevated homocysteine |
front 101 When serum calcium rises, which hormone is released
to reduce bone calcium release and promote excretion? | back 101 C. Calcitonin |
front 102
Calcitonin is released from which thyroid
cells? | back 102 B. Parafollicular C cells |
front 103 A patient has paresthesias, tetany, and seizures.
Which deficiency is most likely? | back 103 A. Calcium deficiency CAP TS |
front 104
Osteoporosis is defined as a reduction in: | back 104 B. Bone density |
front 105 A patient with hypercalcemia is most likely to
have: | back 105 B. Lethargy and dehydration |
front 106 A premenopausal woman has chronic heavy prolonged
menses and iron deficiency anemia. Which
condition most likely contributes? | back 106 C. Uterine fibroids |
front 107
Atrophy of the lingual papillae is a classic sign of
deficiency of: | back 107 A. Iron |
front 108 A patient with microcytic anemia feels unusually: | back 108 A. Cold |
front 109 A patient with iron deficiency reports compulsive ice eating. This is
called: | back 109 D. Pagophagia |
front 110 Which test is the single best noninvasive marker of iron stores?
| back 110 C. Serum ferritin |
front 111 A patient with chronic inflammation may have
iron deficiency masked because inflammation
can: | back 111 B. Raise ferritin |
front 112 Transferrin saturation is calculated as: | back 112 D. Serum iron divided by TIBC |
front 113 Serum iron levels are typically: | back 113 C. Higher in the a.m. |
front 114 Which condition tends to reduce
TIBC? | back 114 B. Nephrotic syndrome |
front 115 Which situation tends to increase TIBC? | back 115 D. Pregnancy |
front 116
Protoporphyrin remains elevated when: | back 116 A. Iron cannot enter hemoglobin |
front 117 Which substance enhances iron
absorption by forming soluble complexes at low pH? | back 117 C. Ascorbic acid |
front 118 Iron is best absorbed in which form? | back 118 B. Ferrous, Fe2+ |
front 119 A patient taking oral iron develops constipation and
GI upset. The best next step is to: | back 119 C. Reduce dose by one-half |
front 120 The most serious adverse effect of parenteral iron is: | back 120 B. Anaphylaxis |