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Question 1 of 20
1. Question
What endothelial-leukocyte adhesion molecule has a major role in adhesion, arrest and transmigration of neutrophils, monocytes and lymphocytes?
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Question 2 of 20
2. Question
Mrs. Kaka Awa, 32 y/o presented to the ED because she passed blood instead of urine morning PTA after aerobics the night before. She also had 3-day history of recurrent attacks of tolerable abdominal pain and vomiting. Physical examination revealed mild jaundice, abdominal distention, and bilateral lower extremity edema. Laboratory evaluation revealed hemoglobin level of 7.0 g/dL, pancytopenia, total serum bilirubin level 4.4 mg/dL, ALT = 51 51 U/L, AST = 17 U/L, serum creatinine normal. Initial screening with sugar water hemolysis test was positive. Findings at abdominal radiography showed a small amount of bowel gas but disclosed no other abnormalities. US and CT findings included inferior vena caval, hepatic venous, and portal venous thrombosis, with an associated BuddChiari Syndrome. Further studies revealed acquired mutations in the phosphatidylinositol glycan complementation group A gene (PIGA). In the absence of liver disease, this raises the suspicion of what condition?
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Question 3 of 20
3. Question
Which of the following is most likely associated with the Philadelphia chromosome?
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Question 4 of 20
4. Question
After a week in the hospital for treatment of an upper respiratory infection complicated by pneumonia, a 43 y/o female develops skin lesions that are 2 to 4 mm in diameter. These lesions are red, papulovesicular, oozing, and crusted and are located on her trunk and extremities. The lesions begin to disappear after she is discharged from the hospital a week later. What is the most likely pathogenesis for her skin lesions?
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Question 5 of 20
5. Question
A 45 y/o female complained of headaches for about a month. She then suffered a generalized seizure and became obtunded. Her serum calcium concentration was found to be markedly elevated at 15.4 mg/dL, with a serum phosphorus level of only 1.9 mg/dL. The serum albumin level was 4.2 g/dL. A chest radiograph showed multiple lung masses, and there appeared to be lytic lesions of the vertebral column. Which of the following conditions best accounts for these findings?
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Question 6 of 20
6. Question
In the third trimester of pregnancy, a 28 y/o woman discovers a lump in her right breast. Her physician palpates a 2-cm, discrete, freely movable mass beneath the nipple. After delivery of a term infant, the mass appears to decrease slightly in size. The infant breast-feeds without difficulty. This breast lesion is most likely to be a (an)
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Question 7 of 20
7. Question
An otherwise healthy 72 y/o male has increasing difficulty with urination. He has to get up several times each night because of a feeling of urgency, but each time, the urine volume is not great. He has difficulty starting and stopping urination. This problem has gotten worse over the last few years. His serum PSA level is slightly increased but stable over this time. A biopsy of the prostate is most likely to reveal which of the following?
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Question 8 of 20
8. Question
This Term refers to an increase in white blood cells in cerebrospinal fluid
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Question 9 of 20
9. Question
A 60 y/o male who has terminal carcinoma of the colon develops widespread ecchymoses over his skin surface. The PT is 3 seconds, PTT is 55 seconds, platelet count is 15,200/uL, fibrinogen level is 75mg/dL, and fibrin split products levels are very elevated. Which of the following morphologic findings would you most expect to find on examination of the PBS?
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Question 10 of 20
10. Question
Mutya, a 3 y/o girl presents with dark precipitates along gingival margins, radiopaque deposits in the epiphyses of her bones, and urinary excretion of delta-aminolaevulinic acid (delta-ALA). Her father states that they live in an old house that has chipped paint. The child’s blood would most likely have which of the following?
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Question 11 of 20
11. Question
A 35-year-old woman who has been taking oral contraceptives for many years presents with acute abdominal pain and fullness. Paracentesis harvests 200 ml of bloody fluid. Imaging studies show a 6-cm mass in the liver that is subsequently resected. Histologic exam of this specimen would most likely reveal this to be which of the following?
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Question 12 of 20
12. Question
The alterations in the hemodynamic, metabolic and immune responses evident in stressed patients are orchestrated by endogenous polypeptides known as cytokines. They are produced by immune cells in direct response to injury, with levels correlating with the degree of tissue damage. Despite considerable overlap in bioactivity among cytokines, they are commonly classified by their predominant effect as proinflammatory or anti-inflammatory. Which is not considered as the former?
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Question 13 of 20
13. Question
Malignancy is second only to trauma as the leading cause of death in children. In infants, it is the most frequent cause of death after prematurity and congenital anomalies. Approximately 40% of childhood anomalies are
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Question 14 of 20
14. Question
Upon investigation, a farmer was diagnosed to be infected with actinomycetes. His lung was noted to have local, subacute hypersensitivity reaction characterized by edema and necrosis along with complement activation. Your impression is:
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Question 15 of 20
15. Question
A 70 y/o man with sepsis has a pH of 7.18. which of the following statements is true regarding his metabolic acidosis?
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Question 16 of 20
16. Question
In differentiating obstructive from restrictive lung diseases, this spirometry criteria characterizes the former:
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Question 17 of 20
17. Question
An 85 y/o male patient was recently found to have an apical lung mass. A few months after, patient was noted to have episodes of drooping of eyelids, pupillary constriction and anhidrosis. This condition is due to
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Question 18 of 20
18. Question
The least important independent risk factor associated with increased risk for DVT:
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Question 19 of 20
19. Question
Most tumors tend to metastasize via the lymphatics or blood vessels. Which among these deviates from the more common pattern of spread and metastasize over the surface of viscera or body cavities?
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Question 20 of 20
20. Question
A 30-year-old woman presents to her physician complaining of a recent nodular growth on her left neck. Further history reveals a 16-lbs weight loss and intermittent fevers over the past3-6 months. Physical examination reveals the presence of a firm, mobile, non-tender, 2.5 cm lower cervical lymph node, left neck. A biopsy is performed and pathology report indicates the presence of large cells with multilobate nuclei, abundant pale cytoplasm and significant band of sclerosis. Immunohistochemistry is positive for the presence of CD15 and CD30 cell markers. These findings are most consistent with which of the following neoplasms?
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