krok 6

25-year-old male presents to an emergency department with suddenonset right-sided pleuritic chest pain and breathlessness. On examination, he has arterial blood saturation of 90% in air and is afebrile. An X- ray shows a lung edge visible in the right hemithorax, beyond which no lung markings are seen. Which of the following conditions has most likely occured in this patient?

• Pleurisy

• Pneumothorax

• Rib fracture

• Aerophagy

24-year-old man undergoes surgery and during the operation, an organ is excised and sent for histological evaluation. A light microscopic examination roved s Ihe organ encased by thin connective tissue capsule that enters the substance oi the lobes to further subdivide the organ into irregular lobular units. Bach lobule contains a cluster of follicles filled with colloid. Follicular epithelium consists of low columnar, cuboidal or squamous cells depending on the level of activity of the follicle. Which of the following organs does this tissue most likely belong to?

• Parotid gland

• Parathyroid gland

• Thymus

• Thyroid gland

A 38-year-old woman, who was diagnosed with systemic lupus erythematosus (SLE) 3 years ago, comes to her physician with a complaint of facial swelling and decreased urination that she first noticed 2 weeks ago. She currently takes azathioprine and corticosteroid. Her vital signs show blood pressure 150/90 mm Hg, pulse – 91/min., temperature – 36.8 C and respiratory rate – 15/min. On physical examination, the doctor notices erythematous rash on her face exhibiting a butterfly pattern. The laboratory studies reveal hypertriglyceridemia and proteinuria. Which of the following is the most likely mechanism of SLE`s complication in this patient?

• Acute infection of the kidney

• Decrease in renal blood flow (ischemic nephropathy)

• Increased plasma oncotic pressure

• Immune complex-mediated glomerular disease

A 37-year-old man is admitted to hospital with mental confusion and disorientation. His wile reports he became more irritable and forgetlul in the past year. In addition, she notes that be became a vegan a year ago and currently, his diet consists of starchy foods like potatoes, corn and leafy vegetables. GI symptoms include anorexia, diarrhea and vomiting. He has glossitis and skin lesions that appear as vesicles over the extremities. Eczemalike lesions around the mouth, as well as desquamation and roughened skin over the hands are also present. Neurologic examination reveals symmetrical hypesthesia for all types of sensation in both upper and lower extremities in a ’’gloves and socks” distribution. Deficiency in diet of which of the following amino acids is the most likely cause of this condition?

• Lysine

• Threonine

• Histidine

• Tryptophan

A 34-year-old-man visits dentist complaining of toothache. After a dental procedure that involved

extraction of several teeth, he develops severe bleeding lasting more than 15 minutes. He has a

history of chronic hepatitis. Which of the following is the most likely cause of prolonged bleeding in

this patient?

• Trombocytopenia

• Hypoalbuminemia

• Hypocalcemia

• Hypofibrinogenemia

A 43-year-old man seeks evaluation at emergency department with complaints of fever with chills, melaise, diffuse abdominal pain for over a week, diarrhea and loss of appetite. He says that his symptoms are progressively getting worse. He recalls that the fever began slowly and climbed its way- up stepwise to the current 39.8°C. His blood pressure is 110/70 mm Hg. A physical exam reveals a coated tongue, enlarged spleen and rose spots on the abdomen. Serologic study shows the agglutinin O titre of 1:200 by the Widal test. Which of the following is the most likely causative organism for this patient's condition?

• Vibrio cholerae

• Salmonella typhi

• Mycobacterium tuberculosis

• Enterohemorrhagic E. coli

A 14-year-old girl presents to the emergency department for evaluation of an "infected leg". She states there is no history of trauma but mentions she had a history of sickle cell disease/ On physical examination, her upper part of the right shin is very painful, red, swollen, and hot. Her temperature is 39.2°An X-ray shows focal bony lysis and loss of trabecular architecture in the metaphysis of the right tibiIncreased activity of which of the following cells is the most likely cause of bone reabsorption in this patient?

• Osteoblasts

• Chondrocytes

• Osteocytes

• Osteoclasts

The doctor evaluates his patient’s spyrography. One of the evaluation parameters represents the

normal amount of air displaced between normal inhalation and exhalation without any extra efforts or

appointments. Which of the following is being evaluated in this case?

• Inspiratory capacity

• Residual volume

• Total lung capacity

• Tidal volume

A 27-year-old female presents with a severe sore throat, hoarseness, painful swallowing and lowgrade fever. On intraoral examination, a large grey membrane is noticed on the oropharynx. Removal of the membrane reveals a bleeding oedematous mucosa. Which of the following is the most likely diagnosis?

• Diphtheria

• Scarlet fever

• Streptococcal pharyngitis

• Meningococcal disease

A group of researchers aimed to study cardiac physiology found that overstretching of atria in the heart leads to decreased sodium reabsorption in the distal convoluted tubule and increase in glomerular filtration rate. Which of the following is the most likely cause of physiologic effects discovered by researchers?

• Aldosterone

• Angiotensin

• Antidiuretic hormone

• Natriuretic peptide