ABSITE EXAM QUESTIONS AND ANSWERS
2 weeks after a whipple operation, your patient continues to have early satiety with oral
intake. You decide to start metoglopramide (Reglan) and erythromycin. What receptor
does erythromycin bind to increase gastrointestinal motility? - Answers-Motilin (found
primarily in the stomach, duodenum, and colon)
Proteins are synthesized from:
a. mRNA
b. tRNA
c. dsDNA
d. ssDNA - Answers-mRNA
1 week after an APR, our patient develops urosepsis requiring volume resuscitation,
antibiotics, and moderate amounts of levophed and vasopressin. E. coli grows out from
the blood cultures. What portion of the lipopolysaccharide complex accounts for its
toxicity - Answers-Lipid A (with gram negative sepsis; stimulator of TNFα)
Steroid hormones:
a. Bind a receptor on the plasma membrane and activate a plasma membrane enzyme
b. Bind a cytoplasmic receptor, enter the nucleus, and affect transcription of proteins
c. Bind a receptor in the nucleus and affect transcription of proteins
d. Do not enter the cell - Answers-(b)
Bind a receptor in the cell cytoplasm, enter the nucleus as a steroid-receptor complex,
and affect transcription of proteins
4 days after an Ivor-Lewis esophagectomy, you decide to start enteral tube feeding
through a J-tube. The long chain fatty acids contained in the tube feeds:
a. Enter the circulation via the portal system
b. Enter the circulation via lymphatics
c. Are only synthesized in the body
d. Are not found in chylomicrons - Answers-(b)
Long-chain FAs enter the body through terminal lacteals (absorption through the
lymphatic system) either as free LCFAs or as chylomicrons
Medium- and short-chain FAs along with proteins/CHO enter through the portal
circulation
Cells divide during what phase of the cell cycle?
a. G1
,b. S
c. G2
d. M - Answers-(d)
Cells divide during the M phase (most radiosensitive)
Cell cycle length is determined by what phase of the cell cycle?
7 days after a kidney transplant, your patient develops severe acute rejection with
vasculitis on biopsy. You decide to start the monoclonal antibody OKT3. Monoclonal
antibodies:
a. Bind 1 epitope at one site
b. Bind 1 epitope at multiple sites
c. Bind multiple epitopes on a single antigen
d. Bind multiple epitopes on multiple antigens - Answers-(a)
They bind one epitope at the exact same binding site
, You start coumadin on a patient with a pulmonary embolus. Three days later, he starts
sloughing off skin across his arms and legs. All of the following are true of this patients
most likely condition except:
a. This likely would have been prevented by starting heparin before coumadin
b. Patients with protein C deficiency are more susceptible to this problem
c. The skin sloughing is caused by skin necrosis
d. This is likely due to hemophilia A - Answers-(d)
Coumadin-induced skin necrosis occurs in patients started on coumadin without being
given heparin first. It results from a relatively hypercoagulable state that can occur in
some individuals because of the shorter half-life of protein C & S compared to factors II,
VII, IX, and X. Protein C & S ↓ after coumadin before the other factors ↓, resulting in a
relatively hypercoagulable state.
While performing a LAR for colon cancer in a patient on chronic dialysis, you notice a
significant amount of bloody oozing from your dissection plane. All of the following are
true of uremic induced platelet dysfunction except:
a. Down regulates GpIb
b. Down regulates GpIIb/IIIa
c. Stimulates von Willebrand's factor release
d. Treatment of choice is dialysis - Answers-(c)
Uremia downregulates GpIb, GpIIb/IIIa, and vWF
Dialysis is the initial treatment of choice for uremic coagulopathy. Other therapeutic
options include DDAVP and conjugated estrogens (which stimulate the release of factor
VIII and vWF).
The most common blood transfusion reaction is:
a. Clerical error leading to ABO incompatibility
b. Transfusion related ALI
c. Delayed hemolysis from reaction to minor antigens
d. Febrile non-hemolytic transfusion reaction - Answers-(d)
Occurs from WBCs in the donor blood
Clerical error leading to ABO incompatibility is the most common transfusion reaction
leading to DEATH
Prevention of febrile non-hemolytic transfusion reaction in patients requiring blood
involves:
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