MDS PREP
A patient with a deficiency of which coagulation factor will have a prolonged PT and a normal aPTT?
1) Factor II
2) Factor V
3) Factor X
4) Factor XII
Factor II (prothrombin) deficiency leads to a prolonged PT (Prothrombin Time) because it is involved in the extrinsic pathway of the coagulation cascade, which is assessed by the PT test. The aPTT (activated Partial Thromboplastin Time) is normal because the intrinsic pathway is not affected.
A patient presents with prolonged bleeding following a surgery. His family history reveals that his mother is a carrier of a rare bleeding disorder, but his father does not have it. Which of the following conditions is the patient most likely to have?
1) Hemophilia A
2) Hemophilia B
3) Christmas disease
4) Hageman trait
Hemophilia A is an X-linked recessive disorder, caused by a deficiency of factor VIII. Since the patient's mother is a carrier, she must have one defective X chromosome and one normal X chromosome. The patient, being a male, has a 50% chance of inheriting the disorder from his mother, which is the most likely scenario given the family history and the X-linked inheritance pattern. Hemophilia B is also X-linked but would be mentioned as Christmas disease if it were the correct answer. Hageman trait is an autosomal recessive disorder related to factor XII, which is less common than Hemophilia A and B.
What is the most common malignancy associated with Zollinger Ellison syndrome?
1) Pancreatic adenocarcinoma
2) Gastric adenocarcinoma
3) Small intestine adenocarcinoma
4) Hepatic metastasis
While Zollinger Ellison syndrome is primarily associated with gastrinomas, these tumors can be malignant and can metastasize. The most common malignant counterpart is pancreatic adenocarcinoma, which can be found in about 25% of cases.
What is the most common cause of acute peptic ulcers in hospitalized patients?
1) Helicobacter pylori infection
2) Non-steroidal anti-inflammatory drugs (NSAIDs)
3) Psychological stress
4) Alcohol intake
While psychological stress, NSAIDs, and alcohol can contribute to the development of acute peptic ulcers, Helicobacter pylori is the most common causative agent, particularly in hospitalized patients who may experience increased stress and receive medications that can exacerbate the condition.
A 45-year-old male presents with severe epigastric pain radiating to the back, nausea, vomiting, and malaise after consuming a large meal at a buffet. His stool is watery and non-bloody. His blood pressure is normal. Which of the following is the most likely diagnosis?
1) Peptic ulcer
2) Gallstones
3) Pancreatitis
4) Clostridium perfringens food poisoning
The rapid onset of symptoms after a large meal at a buffet, along with the presence of severe epigastric pain and watery diarrhea, suggests a gastrointestinal infection. Clostridium perfringens is a common cause of foodborne illness and typically presents within 8 to 16 hours of ingestion. The condition is usually self-limiting and improves with supportive care.
What is the rationale behind administering hydrocortisone in the treatment of anaphylactic shock?
1) It directly blocks histamine receptors
2) It reduces vascular permeability and suppresses the inflammatory response
3) It is a bronchodilator
4) It is an antihypertensive agent
Hydrocortisone, a glucocorticoid, is administered to reduce vascular permeability and suppress the systemic inflammatory response in anaphylaxis. Its effects are not immediate but can help in preventing a biphasic reaction and prolonging symptoms.
What is the primary function of the glomerular basement membrane (GBM) in the nephrotic syndrome?
1) Preventing the passage of red blood cells
2) Regulating ion transport
3) Preventing the passage of proteins
4) Maintaining the structure of the renal corpuscle
The GBM is a critical component of the glomerular filtration barrier that normally prevents the passage of proteins into the urine. In the nephrotic syndrome, there are alterations in the GBM that lead to increased permeability and loss of proteins, particularly albumin, into the glomerular filtrate.
What is the primary function of transferrin in the body?
1) Transport of iron
2) Transport of copper
3) Binding and transport of thyroid hormones
4) Lipoprotein assembly
Transferrin is a glycoprotein synthesized by the liver that acts as the primary iron-transport protein in the blood. It binds to iron and transfers it to cells that require it, such as erythrocytes for hemoglobin synthesis.