SURGERY Most effective surgical treatment for GERD?

Most common type of esophageal Nissen fundoplication

diverticula? 18
Pharyngoesophageal ( Zenker's Diverticula) Gold standard in the diagnosis of GERD?
1 24 hour pH monitoring
Most common cause of esophageal 19
perforation? Most common organism responsible for
Iatrogenic acute otitis externa?
2 Pseudomonas aeruginosa
Most potent physiologic stimulus for 20
pepsinogen release? Most common primary tumor of the middle
Food ear?
3 Glomus jugulare/ glomus tympanicum
The highest perforation rate after a caustic 21
esophageal injury occurs during? Nasopharyngeal carcinoma is best treated
Ulceration and granulation phase by?
4 Chemo-radiotherapy (Cisplatin/5-FU)
Surgical management of uncomplicated 22
Barrett's esophagus? Structures preserved in a modified radical
Anti-reflux procedure neck dissection?
5 Sternocleidomastoid muscle
The most effective surgical treatment for
GERD? Internal jugular vein
Nissen fundoplication
6 Spinal accessory nerve
Surgical treatment for ACHALASIA? 23
Heller's myotomy +/- Partial fundoplication A "butterfly shaped" ulcer involving the hard
7 palate?
Most common primary esophageal motility Necrotizing sialometaplasia
disorder? 24
Nutcraker/Supersqueezer esophagus Otologic meningitis is usually due to?
8 H. Influenza type B
The only tumor virtually restricted to the 25
Parotid gland? Painless mass of the jaw associated with an
Warthin's tumor (Papillary cystadenoma impacted teeth?
lymphomatosum) Ameloblastoma (Adamantinoma)
9 26
Where are foreign bodies in the head and Form of mucus retention cyst that involves
neck most commonly found? th sublingual gland?
Ear Ranula
10 27
A deep neck infection may extend down to Single most important predictor of survival
the mediastinum through? in breast cancer?
Substernal space of Burns Axillary lymph node metastasis
11 28
Most common malignant tumor of the Breast cancer type confirmed by the
parotid gland? presence of intracytoplasmic mucin?
Mucoepidermoid carcinoma Lobular CA
12
Most common malignant tumor of the minor "Indian file configuration"
salivary glands? 29
Adenoid cystic carcinoma Paget's disease may be confused with type
13 of melanoma?
Most common brachial cleft anomaly? Superficial spreading melanoma
2nd brachial cleft 30
14 Most frequent site of metastasis for breast
Most common type of malignancy arising cancer?
from a thyroglossal duct cyst? Bone (vertebra)
Papillary carcinoma 31
15 Most important risk factor in the
Highest perforation rate after a caustic development of breast CA?
esophageal injury occurs during? Gender
Ulceration and granulation phase 32
16 The level of axillary lymph nodes are based
Surgical treatment of uncomplicated on this structure?
Barrett's esophagus? Pectoralis minor
Anti-reflux procedure 33
17
Chronic inflammatory condition of the nipple 49
areola complex that originates from areolar Basic caloric requirement of a normal
glands? healthy adult?
Hidradenitis suppurativa 25 kcal/kg per day
34 50
Epidemic puerperal mastitis is most often Reduced REE is characteristic of this phase
transmitted via? of surgical metabolism?
Suckling neonate Ebb phase
35 51
Kaposi's sarcoma is treated primarily by? The primary source of energy during the
Radiation stressed state?
36 Fat (50-80%)
A rare but aggressive cutaneous 52
malignancy arising from neuroendocrine Stressed induced hyperglycemia is primarily
cells? due to?
Merkel cell carcinoma Peripheral resistance to insulin
37 53
Tumors arising from areas of previous Basal caloric requirement of a normal
radiation/lymphedema? healthy adult?
Angiosarcoma (Stewart-Treves Syndrome) 25 kcal/kg per day
38
Mainstay of treatment for severe necrotizing Mild stress - 25-30
soft tissue infections? Moderate stress - 30
Wide debridement Severe stress - 30-35
39 Burns - 35-40
Gold standard in the diagnosis of 54
Pulmonary Embolism? A 60-year-old man with carcinoma of the
Pulmonary Angiogram esophagus is admitted with severe
40 malnutrition. Nutritional support is to be
Most dreaded complication of placing a initiated. What should be his daily caloric
Swan Ganz catheter? intake?
Pulmonary artery rupture 30 kcal/kg body weight/day
41 55
Most common cause of graft loss post Reduced REE (resting energy expenditure)
kidney transplant? is characteristic of this phase of surgical
Recipient death (Cardiovascular causes) - metabolism?
1st EBB phase
56
Allograft nephropathy - 2nd The primary source of energy during the
42 stressed state?
A lethal and rapidly progressive soft tissue Fat (50-80%)
infection caused by microaerophilic 57
streptococcus? How many kilocalories does Liter of D5LR
Meleney's synergistic gangrene provides?
43 170kcal
Microsatellite instability is the hallmark of 58
what hereditary cancer syndrome? Systemic proteolysis following injury is
Lynch Syndrome (HNPCC) mediated primarily by?
44 Glucocorticoids
Organism most elevated in primary liver 59
cancer and germ cell tumors? Development of dry, scaly dermatitis and
AFP alopecia while on prolonged par enteral
45 treatment is most likely due to?
Most commonly mutated gene in human EFA deficiency
cancer?
P53 Differentiate VS Zinc deficiency
46 -----"Eczematoid rash",
Earliest known genetic alteration in diffuse/intertrigenous areas
colorectal cancer? 60
APC gene A 42 y/o man with small-bowel fistula has
47 been receiving TON within standard
The sudden multiple appearance of hypertonic glucose-amino acid solution for 3
seborrheic keratoses? weeks. The patient is noticed to have scaly,
Lesser Trelat sign hyperpigmented lesions over the acral
48 surfaces of elbows and knees, similar to
Stressed induced hyperglycemia is primarily enterohepatic acrodermatitis. What is the
due to? most likely cause of the condition?
Peripheral resistance to insulin Zinc deficiency
61 A complete history and physical
The most common fluid disorder in surgical examination
patients? 75
Extracellular volume deficit The most common indication for blood
62 transfusion in surgical patients?
A 30 y/o man with a history of Crohn's Volume replacement
disease of the small bowel is admitted with 76
enterocutaneous fistula. The daily output After undergoing a transurethral resection of
from the fistula is 2L. The approximate the prostate, a 65 y/o man experiences
composition of the fluids in mEq/L is which excessive bleeding attributed to fibrinolysis.
of the following? It is appropriate to administer which of the
Na - 140 following?
K-5 Aminocaproic acid
Cl - 104 77
HCO3 - 30 A 22 y/o man is brought into the emergency
63 department in profound shock after a fall
In cases of persistnt from the fourth floor of a building. After
hypocalcemia/hypokalemia, one should resuscitation, small bowel resection and
request for? hepatic segmentectomy are performed at
Serum magnesium levels laparotomy. He receives 15 U of packed
64 RBCs, 4 U of fresh-frozen plasma, and 8 L
The most important treatment of metabolic of Ringer's lactate. On closure, diffuse
acidosis? oozing of blood is noted. What is the most
Restore perfusion with volume resuscitation likely cause?
65 Platelet deficiency
Characteristic early acid base picture of 78
sepsis? Most important management of immediate
Respiratory alkalosis transfusion reaction?
66 Stop the transfusion
Following an infection, a 68 y/o woman 79
developed gram-negative septicemia. A 64 y/o woman undergoing radical
Which statement is true for gram-negative hysterectomy under general anesthesia is
bacterial septicemia? transfused with 2 U of packed RBCs. A
Adverse changes can be accounted for lipid hemolytic transfusion reaction during
A release anesthesia will be characterized by which of
67 the following?
IVF of choice for patients with closed head Bleeding and hypotension
injuries? 80
Hypertonic saline Shock that occurs in the setting of adequate
68 intravascular volume?
The earliest stage of hemostasis? Cardiogenic shock
Vascular constriction 81
69 A 30 y/o man is brought to the emergency
The average lifespan of platelets? department following a high-speed car
7-10 days accident. He was the driver, and the
70 windshield of the car was broken. On
Inherited platelet disorder of adhesion? examination, he is alert, awake, oriented,
Bernard-Soulier syndrome and in no respiratory distress. He is unable
71 to move any of his four extremities;
A 75 y/o man is found to have prolonged however, his extremities are warm and pink.
bleeding from intravenous puncture sites. His vital signs on admission are HR 54 bpm
Platelet aggregation is inhibited by which of and BP 70/40 mmHg. What is the
the following? diagnosis?
Aspirin Neurogenic shock
72 82
The most common abnormality of The preferred test in the diagnosis of
hemostasis in surgical patients? cardiac tamponade?
Thrombocytopenia Echocardiography
73 83
Treatment of choice for patients with Von Persistently elevated base deficit in a
Willebrand's disease? trauma patient is usually due to?
Intermediate purity Factor 8/ DDAVP Ongoing bleeding
74 84
A 24 y/o woman is scheduled for an elective First priority in the treatment of trauma?
cholecystectomy. The best method of Ensuring an adequate airway
identifying a potential bleeder is which of the 85
following? A 32 y/o female falls from the tenth floor of
her apartment building in an apparent
suicide attempt. Upon presentation, the 95
patient has obvious head and extremity The most reliable indicator for organ
injuries. Primary survey reveals that the perfusion during resuscitation?
patient is totally apneic. By which method is Urine output
the immediate need for a definitive airway in 96
this patient best provided? The most common cause of cardiogenic
Orotracheal intubation shock/cardiac failure in trauma patients?
86 Tension pneumothorax
The most common indication for intubation? 97
Altered mental status Prior to catheterization in stable patients at
87 risk for urethral injury, one should perform?
Surgical airway of choice in patients with Urethrogram
laryngeal fractures? 98
Tracheostomy Gold standard in the diagnosis of presence
88 of intra-abdominal injuries?
An 85 y/o ventilator-dependent male was DPL
endotracheally intubated 10 days ago. He 99
remains unresponsive and is not a Hemobilia is characterized by the triad of?
candidate for early extubation. The intensive RUQ pain
care unit (ICU) attending elects to perform UGIB
tracheostomy at the bedside. During the Jaundice
procedure, copious dark bold is
encountered. This is most likely due to QUINCKE's triad
transection of which of the following: 100
Anterior jugular vein Most commonly injured part of the
89 diaphragm?
Tracheostomy is performed uneventfully in Left hemidiaphragm
a 79 year old ventilator-dependent 101
encephalopathic male. After several Duodenal hematoma is best diagnosed by?
spontaneous breaths, however, the patient Barium/contrast study (coiled spring sign)
stops breathing. The anaesthesiologist 102
continues to assist the patient's breathing A 60 y/o man is attacked with a baseball bat
for several minutes, after which the patient and sustains multiple blows to the
again breathes spontaneously. The most abdomen. He presents to the emergency
likely cause of apnea is: department in shock and is brought to the
Preoperative respiration was driven by operating room (OR), where a laparotomy
hypoxia reveals massive hemoperitoneum and a
90 stellate fracture of the right and left lobes of
Immediate management of patients with the liver. Which of the following, techniques
tension pneumothorax? should be used immediately?
Needle thoracostomy (2nd ICS MCL) Packing the liver
91 103
Thoracostomy The Pringle maneuver is used to control
4th or 5th ICS MAL bleeding coming from?
92 Liver
Tube thoracostomy is employed in each of 104
the following conditions EXCEPT: A 33 y/o man presents to the emergency
A. Total right pneumonectomy department with a gunshot injury to the
B. Chylothorax abdomen. At laparotomy, a deep laceration
C. Hemothorax from rib fracture is found in the pancreas just to the left of the
D. Spontaneous pneumothorax vertebral column with severance of the
E. After an Ivor-Lewis procedure pancreatic duct. What is the next step in
A. Total right pneumonectomy management?
93 Distal pancreatectomy
A 70 y/o man is brought into the emergency 105
department following his injury as a Left sided medial visceral rotation
passenger in a car crash. He complains of Mattox maneuver
right side chest pain. Physical examination 106
reveals a respiratory rate of 42 breaths per Right sided medial visceral rotation
minute and multiple broken ribs of a Catell Maneuver
segment of the chest wall that moves 107
paradoxically with respiration. What should Anatomic structure violated in penetrating
the next step be? neck injuries?
Needle thoracostomy Platysma
94 108
Trauma patients with hypotension have lost Neck region easiest to evaluate?
approximately how much of blood volume? Zone II
30-40% (Class III shock) 109
The most sensitive CXR finding suggesting The first cells to enter the wound site during
tear of the aorta? wound repair?
Widened mediastinum Neutrophils
110 124
The safest way to lower down ICP? The mechanical strength of a scar is
Ventriculostomy regained after?
111 NEVER
Single most important factor predicting burn 125
related mortality? Non-absorbable sutures
Burn size - not biodegradable and permanent
112
Burns that extend into the reticular layers of NYLON
the dermis? PROLENE
2nd degree (Deep Partial Thickness Burn) STAINLESS STEEL
113 SILK (Natural, can break down over years)
The standard technique for determining 126
burn depth? Absorbable sutures
Clinical observation - Degraded via inflammatory response
114
Recommended fluid resuscitation solution VICRYL
for burns? MONOCRYL
PLR PDS
115 CHROMIC
Management of patients with significant CAT GUT (natural)
intra oral/pharyngeal burns? 127
Immediate ET intubation NATURAL SUTURES
116 - biological
The definitive diagnosis of burn wound - cause inflammatory reaction
sepsis can be made by?
Wound culture CATGUT (intestine of cow or sheep)
SILK (silkworm fibers)
Tx: CHROMIC CATGUT
parenteral antibiotics 128
Early wound excision and grafting SYNTHETIC SUTURES
117 - synthetic polymers
Early signs of sepsis - do not cause inflammatory response
Sudden glucose intolerance
NYLON
Hypothermia VICRYL
MONOCRYL
Thrombocytopenia PDS
118 PROLENE
Predominant organism causing fatal burn 129
wound infection? MONOFILAMENT SUTURES
Pseudomonas sp. - single stranded of suture material
- minimal tissue trauma
Differentiate VS Melting graft wound - smooth tying but more knots needed
syndrome - examples: NYLON, MONOCRYL,
PROLENE, PDS
Melting graft wound syndrome is due to 130
STAPHYLOCOCCUS AUREUS MULTIFILAMENT (braided)
119 - fibers are braided or twisted together
Antidote for chemical burns caused by - more tissues resistance
hydrofluoric acid? - easier to handle
Calcium - fewer knots needed
120 - examples: VICRYL, SILK, CHROMIC
Malignancy most commonly developing 131
from a Marjolin's ulcer? The layer of the GIT that imparts the
Squamous Cell CA greatest tensile strength and greatest suture
121 holding capacity?
Impaired wound healing due to Zinc Submucosa
deficiency is called? 132
Acrodermatitis Enteropathica The main characteristic that distinguishes
122 the healing of fetal wounds?
Major cell responsible for wound Lack of scar formation
contraction? 133
Myofibroblast Pressure ulcer stage when there is partial
123 thickness skin loss?
Stage II 142
A 68 y/o man has a history of myocardial
Stages: infarction. He undergoes uneventful left
I - nonblanchable erythema of intact skin hemicolectomy for carcinoma of the colon.
II - full thickness skin loss, not thru fascia In the recovery room, he is hypotension and
III - FT skin loss + muscle and bone given a fluid bolus of 500mL Ringer's lactate
involvement over 30 minutes. He is intubated, and his
134 neck veins are distended. His HR is
Suture removal 130bpm, his BP is 80/60mmHg, and his
Average time frame is 7-10 DAYS. urine output is 20mL over the last hour.
What should be the next step in his
Face: 3-5 DAYS management?
Neck: 5-7 DAYS Insertion of a Swan-Ganz catheter
Scalp: 7-12 DAYS 143
Upper extremity, trunk: 10-14 DAYS The sudden multiple appearance of
Lower extremity: 14-28 DAYS seborrheic keratoses?
Soles, palms, back or over joints: 10 DAYS Lesser Trelat sign
144
(Note: any suture with pus or signs of A 29 y/o female develops a pigmented
infections should be removed immediately) lesion on the right thigh. With reference to a
135 pigmented lesion, there is an increased risk
Virus implicated in the development of of developing melanoma if it is identified
Burkitt's lymphoma? with which of the following?
EBV Congenital nevocellular nevi
136 145
The most common arrhythmia seen during Type of nevus that most often occur in a
laparoscopy procedures? "bathing trunk" distribution?
Bradycardia Giant hairy nevus (congenital)
137 146
Organism most commonly implicated in Most common skin malignancy?
human bite wounds? Basal Cell CA
Eikenella corrodens 147
A method of serially excising a tumor until it
Differentiate VS Animal bites is entirely removed?
Moh's micrographic surgery
Animal bites (Pasteurella multocida) 148
138 A 65 y/o light complexioned male presents
Taxanes blocks tumor growth at mitosis with a solitary scaly plaque like lesion on his
through? forearm present for many years. The lesion
Formation of excess microtubule is 0.5 cm in diameter. Shave biopsy reveals
polymerization intraepithelial squamous cell carcinoma.
139 (Bowen's disease) incompletely excised.
A lethal and rapidly progressive soft tissue Excision and repair of this area, ensuring
infection caused by microaerophilic clear surgical margins
Streptococcus? 149
Meleney's synergistic gangrene Type of melanoma with the best prognosis?
Lentigo maligna
Differentiate VS Fournier's Gangrene 150
Treatment of melanoma?
(Fournier's gangrene - polymicrobial, Surgical
involves genitalia, perineum or abdominal 151
wall) Extent of lymph node dissection
140
Most common complication after placing a Groin?
central venous line? Axilla?
Arrhythmia Face, ear, anterior scalp?
141 Groin - removal of SUPERFICIAL (inguinal)
An 85 y/o male is admitted to the ICU in and DEEP (iliac) nodes
septic shock. A pulmonary artery (PA)
catheter is placed. The PA catheter does Axilla - removal of LEVELS I, II, III
not directly measure which one of the
following? Face, Ear, Anterior scalp - plus
A. PA systolic pressure SUPERFICIAL PAROTIDECTOMY and
B. PCWP MRND
C. Systemic vascular resistance 152
D. Right ventricular diastolic pressure A 40 y/o premenopausal patient has a
E. Right atrial pressure biopsy showing focal lobular carcinoma in
C. Systemic vascular resistance situ (LCIS) in the area of calcification. With
regard to the LCIS, you should tell the metastatic cancer. What is the most likely
patient which of the following? site of the primary tumor?
She should just be observed closely Piriform fossa
153 161
A 46 y/o woman presents to you for A 16 y/o boy complains of difficulty in
evaluation of a breast mass. The patient breathing through his nose. Endoscopy
does not perform breast self-examination reveals a tumor infiltrating the nasopharynx.
and she had never noticed the mass prior to Histology reports this as a juvenile
this time. Her past medical history is nasopharyngeal angiofibroma. The boy's
unremarkable. She has no prior history of anxious mother requests information
breast complaints or trauma. The findings concerning the lesion. What should she be
from the physical examination is told?
unremarkable except for the breast It may proceed to destroy surrounding bone
examination. A hard, nontender 4 cm mass 162
in the upper outer quadrant of her left A 9 month old girl is brought to the
breast. The left axilla is without physician's office for noisy breathing. The
abnormalities. Examination of the right child is otherwise healthy, and her gestation
breast without abnormalities. Examination of and delivery were uncomplicated. On
the right breast reveals no dominant mass physical examination, mild inspiratory stridor
or axillary adenopathy. What is your next is heard. What is the most likely cause of
step? stridor in an infant?
Bilateral diagnostic mammogram Laryngomalacia
154 163
Form of mucus retention cyst that involves Triad of ACHALASIA
the sublingual gland? Hypertensive LES
RANULA
Aperistalsis of esophageal body
Differentiate VS Epulis
Failure of LES to relax
(Congenital Epulis - MAXILLA) 164
(Epulis Gravidarum - GINGIVA, RESOLVES Adenocarcinoma is the predominant
POST PARTUM) malignant lesion in which of the following?
155 Hard palate
A 41 y/o patient presents to your office with 165
a biopsy proven invasive ductal cancer in There is immune mediated destruction of
the upper outer aspect of her left breast, a myelin confined to the CNS leading to
suspicious palpable left axillary lymph node, slowing of conduction and neurological
and diffuse calcifications throughout the rest dysfunction
of the breast proven to be DIC on MULTIPLE SCLEROSIS
stereotactic biopsy. The best surgical option 166
is: There is immune mediated destruction of
Modified radical mastectomy myelin in the PNS; illness is often triggered
156 by an infection
A 36 y/o woman presents with a substantial Gullain-Barré syndrome
unilateral breast enlargement. She had 167
presumed that this was normal, but on Gold standard in the diagnosis of GERD?
examination, a large, firm tumor is palpated 24 hour pH monitoring
by the attending physician. There is early 168
erosion on the skin. A favourable outlook Surgical treatment of choice for
can be anticipated if the lesion is which of ACHALASIA?
the following? Heller's myotomy +/- partial fundoplication
Cystosarcoma phyllodes 169
157 A 48 year old man presents for evaluation of
A 62 y/o man undergoes excision of a burning epigastric and substernal pain that
cylindroma of the submandibular gland. He has recurred almost daily for the past 4
is most likely to have an injury to which? months. He says that these symptoms
Lingual nerve seem to be worse when he lies down and
158 after meals. He denies difficulty swallowing
Painless mass of the jaw associated with an or weight loss. The patient has been taking
impacted teeth? a proton pump inhibitor regularly over the
Ameloblastoma (Adamantinoma) past 12 weeks with partial resolution of his
symptoms. His past medical history is
X-ray appearance: "soap bubble sign" significant for frequent early morning
159 wheezing and hoarseness that have been
A 58 y/o woman undergoes excision biopsy present for the past few months. The patient
of a tumor in the left posterior triangle of her has no other known medical problems and
neck. Histology suggests that this is a he has had no prior surgeries. He
consumes alcohol occasionally but does not
use tobacco. On examination, he is Most common presentation of Meckel's
moderately obese. No abnormalities are Diverticula in adults?
identified on the cardiopulmonary or Intestinal obstruction
abdominal examination. What is the most 180
likely diagnosis? Hallmark clinical presentation of acute
Barrett's esophagus mesenteric ischemia?
170 Abdominal pain
A 43 year old man presents to the ER with 181
severe abdominal pain and substernal chest A 66 year old man is admitted to the
pain. The symptoms began 12 hours earlier coronary care unit because of new-onset
after he consumed a large amount of atrial fibrillation. After 24 hours, he develops
alcohol. Subsequently, he vomited several acute onset of abdominal pain and
times and then went to sleep. A short time distention, and on examination he is found
thereafter, he was awakened with severe to have diffuse peritonitis. The patient
pain in the upper abdomen and substernal undergoes exploratory laparotomy with
area. On PE, the patient appears resection of necrotic bowel. Post operative
uncomfortable and anxious. His treatment for this patient?
temperature is 38.8C, Pr 120 b/min, BP Systemic heparinization
126/80 and RR 36/min. The lungs are clear 182
bilaterally with decreased breath sounds on Most common cause of obscure GI bleeding
the left side. The cardiac examination in adults
reveals tachycardia and no murmurs. The Small intestinal dysplasia
abdomen is tender to palpitation in the 183
epigastric region, with involuntary guarding. The most sensitive test in the diagnosis of
Laboratory studies reveal that his WBC is iatrogenic duodenal perforation
26,000 and that his Hgb, Hct, and CT scan with contrast
electrolyte levels are normal. The serum 184
amylase, Bilirubin, AST, ALT, and alkaline Earliest lesion characteristic of Crohn's
phosphatase values are within normal limits. disease?
A 12-lead ECF shoes sinus tachycardia. His Aphthous ulcer
chest radiograph reveals moderate left 185
pleural effusion, a left pneumothorax, and The area of colon most susceptible to
pneumomediastinum. What is the most ischemia
likely diagnosis? Splenic flexure (Griffith's point)
Boerhaave's syndrome 186
171 The transition point between columnar
The highest perforation rate after a caustic rectal mucosa and squamous anoderm
esophageal injury occurs during? Dentate line/ Pectinate line
Ulceration and granulation phase 187
172 Predominant bacterial isolate in the colon
Most frequent encountered surgical disorder Anaerobes
of the small intestine? 188
Mechanical small bowel obstruction A 62 year old man presents to the ER with a
173 1-week history of left lower quadrant
Diagnosis of small bowel obstruction abdominal pain and diarrhea. He complains
CT scan - 70-90% of increased pain, nausea, vomiting and
174 fever. He has had two prior episodes of
Standard treatment for small bowel similar left lower quadrant pain that resolved
obstruction with antibiotic treatment alone. He has no
Expeditious surgery cardiac or pulmonary risk factors. On
175 examination, his blood pressure is 140/180,
Post operative ileus is said to be prolonged heart rate 100/min and temperature 37C.
when the duration exceeds His abdomen is soft and mildly distended
3 days with left lower quadrant tenderness to
176 palpation. He does not have evidence of
To distinguish post operative ileus from post generalized peritonitis. His write blood cell
operative SBO, it is best request for count is 20,000/mm3. How would you
CT scan confirm the diagnosis?
177 Whole abdominal CT scan
Initial test in the diagnosis of intestinal 189
fistulas? Most common site of diverticulitis
CT scan with contrast Sigmoid colon
178 190
Spontaneous closure of fistulas usually The safest procedure to perform on
occurs in? unstable patients with St. IV diverticulitis
2-3 months Sigmoid colectomy with end colostomy
179 191
Most common complication of colostomy
Parastomal hernia 206
192 The most critical treatment of acute variceal
A "lead pipe" colon is characteristic of? bleeding
Advanced ulcerative colitis Prompt endoscopic intervention
193 207
Surgical procedure of choice for chronic Selective shunt that is contraindicated in
ulcerative colitis patients with as cites
Restorative pronto elections with ideal- Distal splenorenal shunt (Warren Shunt)
pouch anastomosis 208
194 A 43 year old woman prevents with a
Poplyposis syndrome with melanin spots on sudden onset of abdominal pain. She
lips and buccal mucosa denies abdominal complaints. Her systolic
Puts-Jeghers Syndrome blood pressure is 88mmHg on evaluation
195 and becomes stable at 120mmHg after the
Colorectal carcinomas most commonly infusion of 2 L of intravenous fluid. The
metastasize to the? abdominal examination demonstrates no
Liver peritoneal signs. Her bowel sounds are
196 hypoactive and there is mild right upper
First line of treatment for anal epidermoid quadrant tenderness. The hematocrit value
carcinoma? is 22%. A computed tomography (CT) scan
Chemo-radiotherapy is performed and demonstrates free
197 intraabdominal blood and a 5-cm solid mass
Primary peritonitis is diagnosed by? in the right hepatic lobe with evidence of
Peritoneal aspiration GSCS recent bleeding into the mass. The patient
198 denies recent trauma, weight loss, a change
At open operation a normal appendix is in bowel habits, hematemesis, or
found. What is the most common procedure hematochezia. No prior history of oral
a surgeon should do if he finds a normal contraceptive pills intake. What is the most
appendix likely diagnosis
Removal of appendix Liver hematoma with hemorrhage
199 209
Most common cause of appendicitis in Most common benign tumor of the liver
children Simple hepatic cyst
Lymphoid hyperplasia 210
200 Benign solid liver tumor associated with a
The most accurate way of diagnosing acute central scar
appendicitis Focal modular hyperplasia (FNH)
None. 211
Hepatocellular cancer variant with the best
History and PE must be at least 85% prognosis
accurate Fibrolamellar variant
CT scan and ultrasound 212
201 Recommended treatment for solitary
The single most sensitive test of liver pyogenic liver abscesses
function Percutaneous drainage
INR/FVII/F5 - coagulation function 213
202 Maximum amount of diseased liver that can
Vitamin K is most effective in what type of be resected
jaundice? 60%
Post-hepatic cause (obstructive) 214
203 Initial imaging modality of choice in patients
Rare cause of post-sinusoidal cirrhosis due with biliary tract disease
to hepatic vein thrombosis? Ultrasound
Budd Chiari Syndrome 215
204 Gallstones that occurs in patients with
A 42 year old woman with a known history cirrhosis/hemolytic disorders
of esophageal varices secondary to Black pigment stones
hepatitis and cirrhosis is admitted with 216
severe hematemesis from esophageal Most common indication for
varices. Bleeding persists after pitressin cholecystectomy
therapy. What would the next step in Recurrent biliary colic
management involve? 217
Transjugular intrahepatic portasystemic A 46 year old woman presents with a 5-hour
shunt ( TIPS) history of abdominal pain that began
205 approximately 1 hour after a large dinner.
The risk of first variceal bleeding is best The pain initially began as dull ache in the
prevented by? epigastrium but then localized in the RUQ.
B-blockers She describes some nausea but no
vomiting. Since her presentation to the 228
emergency department, the pain has Most common cause of chronic pancreatitis
improved significantly to the point of her Alcohol consumption and abuse
being nearly pain free. She describes 229
having had similar pain in the past with all Most common complication of chronic
previous episodes being self-limited. Her pancreatitis
past medical history is significant for type II Pseudocyst
diabetes mellitus. On physical examination, 230
her temperature is 38C, and the rest of her Most commonly mutated gene in pancreatic
vital signs are normal. The abdomen is non adenocarcinoma
distended with minimal tenderness in the K-ras
RUQ. Findings from liver examination 231
appear normal. The rectal and pelvic A palpable nontender gallbladder seen in
examinations reveal no abnormalities. Her patients with peri-ampullary tumor?
CBC reveals a WBC count of 13,000 serum Courvossier's gallbladder
chemistry studies demonstrate total bilirubin 232
0.8 mg/dL, direct bilirubin 0.6mg/dL, alkaline The current diagnostic and staging test of
phosphatase 100 UIL, AST 45 UIL, and ALT choice for pancreatic cancer?
30 U/L. Ultrasonography of the RUQ Spiral CT scan with contrast
demonstrates stones in the gallbladder, a 233
thickened gallbladder wall, and a common Etiology for the severe pain experienced by
bile duct diameter of 4.0 mm. What should patients with pancreatic cancer
you tell the patient? Invasion of retroperitoneal nerve
She should be scheduled for an elective 234
laparoscopic cholecystectomy Drug used for palliative treatment of
218 advanced pancreatic cancer
Gold standard in the diagnosis of Gemcitabine
choledocholithiasis? 235
ERCP Most dreaded complication of Whipple's
219 procedure
A CBD stone diagnosed 1 year after Disruption of the pancreatic-jejunostomy
cholecystectomy is classified as? 236
Retained stone Most common pancreatic endocrine
220 neoplasm
Initial treatment of patients with cholangitis Insulinoma
IV antibiotics and fluid resuscitation (85% 237
response) Endocrine tumor of the pancreas with
necrolytic migratory erythema
Elective decompression Glucagonoma
221 238
Most dreaded complication of laparoscopic Most common islet cell tumor after
cholecystectomy insulinoma
CBD injury Non functioning Islet-cell tumor
222 239
Surgical management of choice for acute Most common anomaly of the spleen
acalculous cholecystitis Accessory spleen
Percutaneous US/CT guided 240
cholecystostomy The process by which the spleen removes
223 intracellular substances
Cholangiocarcinoma most commonly Pitting
involves 241
Hepatic duct bifurcation "Klatskin tumor" The most common indication for
224 splenectomy
Most common cause of acute pancreatitis Trauma
worldwide 242
Gallstones Test that will distinguish auto-immune from
225 other hemolytic anemias
Most specific serum marker for acute (+) direct Coombs tests
pancreatitis 243
Serum lipase Gold standard in the diagnosis of GERD?
226 24 hour pH monitoring
Gold standard test for the assessment of 244
severity of acute pancreatitis Surgical treatment of choice for
CT scan with contrast ACHALASIA?
227 Heller's myotomy +/- partial fundoplication
Most common cause of death in acute 245
pancreatitis A 48 year old man presents for evaluation of
Infection burning epigastric and substernal pain that
has recurred almost daily for the past 4 D. All cells rest on the basement membrane
months. He says that these symptoms C. It has regenerative capacity
seem to be worse when he lies down and 2
after meals. He denies difficulty swallowing Type of epithelium wherein the number of
or weight loss. The patient has been taking cell layers varies according to the functional
a proton pump inhibitor regularly over the state of the organ:
past 12 weeks with partial resolution of his A. Simple
symptoms. His past medical history is B. Transitional
significant for frequent early morning C. Stratified
wheezing and hoarseness that have been D. Pseudostratified
present for the past few months. The patient B. Transitional
has no other known medical problems and 3
he has had no prior surgeries. He Simple squamous epithelium is prevalent
consumes alcohol occasionally but does not throughout the body and organ system.
use tobacco. On examination, he is Which of the following is a primary function
moderately obese. No abnormalities are of this type of epithelium?
identified on the cardiopulmonary or A. Secretion
abdominal examination. What is the most B. Lubrication
likely diagnosis? C. Absorption
Barrett's esophagus D. Protection
246 E. Excretion
A 43 year old man presents to the ER with B. Lubrication
severe abdominal pain and substernal chest 4
pain. The symptoms began 12 hours earlier The layer of cells that lines the outer surface
after he consumed a large amount of of the lungs can be irritated by inhaled
alcohol. Subsequently, he vomited several asbestos particles. Which of the following is
times and then went to sleep. A short time the cell layer being described?
thereafter, he was awakened with severe A. Simple squamous - mesothelium
pain in the upper abdomen and substernal B. Simple squamous - endothelium
area. On PE, the patient appears C. Transitional epithelium
uncomfortable and anxious. His D. Simple cuboidal epithelium
temperature is 38.8C, Pr 120 b/min, BP E. Simple columnar epithelium
126/80 and RR 36/min. The lungs are clear A. Simple squamous - mesothelium
bilaterally with decreased breath sounds on 5
the left side. The cardiac examination Which of the following is a characteristic
reveals tachycardia and no murmurs. The typical of Simple epithelium?
abdomen is tender to palpitation in the A. All the cells border an open lumen
epigastric region, with involuntary guarding. B. All the cells function to prevent abrasion
Laboratory studies reveal that his WBC is C. All the cells rest on a basal lamina
26,000 and that his Hgb, Hct, and D. All the cells are joined by zonula
electrolyte levels are normal. The serum occludens
amylase, Bilirubin, AST, ALT, and alkaline E. All the cells have microvilli
phosphatase values are within normal limits. C. All the cells rest on a basal lamina
A 12-lead ECF shoes sinus tachycardia. His 6
chest radiograph reveals moderate left Corneal endothelium is an example of what
pleural effusion, a left pneumothorax, and type of Epithelium?
pneumomediastinum. What is the most A. Transitional
likely diagnosis? B. Stratified
Boerhaave's syndrome C. Pseudostratified
247 D. Simple
The highest perforation rate after a caustic D. Simple
esophageal injury occurs during? 7
Lining of Lens is an example of what type of
Epithelium?
ANATOMY A. Stratified squamous
Bones, muscles and cartilages are derived B. Simple columnar
from what germ layer? C. Simple squamous
A. Ectoderm D. Simple cuboidal
B. Epiderm D. Simple cuboidal
C. Endoderm 8
D. Mesoderm What organ system contains transitional
D. Mesoderm epithelium?
1 A. Cardiovascular
Which of the following statements is B. Gastrointestinal
CORRECT about the Epithelial tissue? C. Nervous
A. It is highly vascular D. Urinary
B. It has abundant intercellular substance D. Urinary
C. It has regenerative capacity 9
Respiratory epithelium is: Nervous
A. Pseudostratified columnar ciliated with 16
goblet cell Connective tissue are entirely MESODERM
B. Pseudostratified columnar ciliated without in origin
goblet cell
C. Stratified squamous non-cornified Muscular tissue MESODERM in origin
D. Simple squamous
A. Pseudostratified columnar ciliated with Nervous tissue ECTODERM in origin
Goblet cells
10 Epithelial tissue ECTODERM,
Type of epithelium well-adapted for MESODERM, ENDODERM in origin
exchange of substances between two sides:
A. Simple Germ layers according to location
B. Pseudostratified 17
C. Transitional Layer of epidermis composed of cells which
D. Stratified are continuously shed:
A. Simple A. Stratum basale
11 B. Stratum lucidum
Microvilli are essential components of C. Stratum granulosum
epithelial cells of the small intestine. Which D. Stratum corneum
of the following functions would be defective D. Stratum corneum
resulting from a lack of microvilli on 18
epithelia? Layers of epidermis
A. Stretching
B. Movement (Outside to inside)
C. Protection 1. Stratum Corneum
D. Secretion 2. Stratum Lucidum
E. Absorption 3. Stratum granulosum
E. Absorption 4. Stratum spinosum
12 5. Stratum basale/germanitivum
A 40 y/o man has a history of smoking. He 19
complaints of mucus accumulation and Which if the following layers is NOT found in
constant cough. A biopsy reveals that the thin skin?
epithelial lining of the tracheal lumen is A. Stratum basale
stratified squamous epithelium. Which of the B. Stratum spinosum
following terms describes the process of C. Stratum granulosum
change to another epithelial type? D. Stratum lucidum
A. Metastasis E. Stratum corneum
B. Neoplasia D. Stratum lucidum
C. Metaplasia 20
D. Hyperplasia Langerhan's cells are found in which of the
C. Metaplasia following layers of the epidermis?
13 A. Stratum basale
Junctions are essential in maintaining the B. Stratum spinosum
close association of the cells within the C. Stratum corneum
epidermis. Which of the following junctions D. Stratum lucidum
is important in maintaining cell adherence in E. Stratum granulosum
all layers of the epidermis? B. Stratum spinosum
A. Gap junctions 21
B. Zonula adherens Protective barrier of the skin against UV
C. Zonula occludens radiation is:
D. Macula adherens A. Langerhan's cell
D. Macula adherens B. Merkel cell
14 C. Melanocytes
Lining epithelium of skin is: D. Keratinocyte
A. Stratified squamous keratinized C. Melanocyte
B. Pseudostratified columnar 22
C. Stratified squamous non-keratinized Type of tissue composed of cells that are
D. Stratified columnar relatively few and far apart, with abundant
A. Stratified squamous keratinized intercellular substance containing tissue
15 fluid and fibers:
4 fundamental types of tissue A. Epithelial
Epithelial B. Muscular
C. Connective
Connective D. Nervous
C. Connective
Muscular 23
Tendons and ligaments are sample of:
A. Dense, irregular connective B. Fibroblast
B. Dense, regular connective C. Mast cell
C. Loose connective D. Macrophages
D. Mucous connective E. Adipose cell
B. Dense, regular connective C. Mast cell
24 32
Which of the following types of collagen is Histologically, plasma cells can be
the most widely distributed and abundant recognized by the arrangement of the:
within the body? A. Cytoplasmic granules
A. Type I B. Mitochondria
B. Type II C. Heterochromatin granules
C. Type III D. Nucleoli
D. Type IV C. Heterochromatin granules
E. Type V 33
A. Type I The activity of osteoclasts in releasing
25 Calcium from bones is a result of stimulation
Type of collagen present in bones: of what hormone?
A. Type I A. Calcitonin
B. Type II B. TSH
C. Type III C. Thyroxine
D. Type IV D. PTH
A. Type I D. PTH
26 34
Argyrophilic fiber supporting hematopoietic A blood analysis of your patient shows an
and lymphoid organs is also called as: increased level of parathyroid hormone.
A. Reticular Which of the following would result from
B. Elastic increased levels of this hormone?
C. Collagenous A. Increased mitotic activity of
D. Hyaline esteoprogenitor cells
A. Reticular B. Decreased serum calcium levels
27 C. Increased bone formation
Histologically, bone is classified according D. Increased serum calcium levels
to its collagenous organization as woven or: E. Increased hydroxyapatite crystal
A. Lamellar formation
B. Calcified D. Increased serum calcium levels
C. Hyalinized fibrous tissue 35
D. Osteoid tissue Osteoclasts would be found at which of the
A. Lamellar following sites in bone?
28 A. Howship's lacuna
Parts of an Osteon except: B. Haversian canal
A. Osteocytes C. Canaliculi
B. Concentric lamellae D. Endosteum
C. Canaliculi E. Periosteum
D. Volkmann's canal A. Howship's lacuna
D. Volkmann's canal 36
29 Bone of a 75 y/o man shows a decreased
Macrophages would be most abundant in number of osteoblasts. However, the
which of the following tissues? number of osteoclasts is greatly increased.
A. Loose areole connective tissue This individual bones are easily fractured.
B. Dense regular connective tissue Which of the following disease conditions
C. Adipose tissue would you expect?
D. Dense irregular connective tissue A. Osteoporosis
E. Embryonic tissue B. Osteomalacia
A. Loose areolar connective tissue C. Osteochondrosis
30 D. Rickets
The stem cell precursor of most of the B. Osteomalacia
connective tissue cells is the: 37
A. Fibroblast The growth of cartilage resulting from
B. Macrophage mitosis of pre-exiting chondrocytes is called
C. Mesenchymal as ____ growth:
D. Adipocyte A. Interstitial
C. Mesenchymal B. Apposition
31 C. Endochondral
Your patient suffers from an immediate D. Intramembranous
hypersensitivity reaction. Which of the C. Endochondral
following cell types is responsible for this 38
condition?
A. Plasma cell
In which of the following zones of Which of the following are components that
endochondral ossifications would cells form valves in medium and large veins?
accumulate Gylcogen? A. Tunica intima only
A. Resting zone B. Tunica intima and media
B. Zone of hypertrophy C. Tunica media and adventitious
C. Zone of ossification D. Tunica media only
D. Zone of proliferation A. Tunica intima only
E. Zone of calcification 47
B. Zone of hypertrophy While examining a tissue with a light
39 microscope, you note a vessel that has no
Which of the following best characterized smooth muscle. However, you note a large
hyaline cartilage? amount of I connective tissue at the
A. No perichondrium periphery. Which of the following vessels
B. Single chondrocytes are you examining?
C. Found between vertebral bodies A. Arteriole
D. Least resilient of all forms of cartilages B. Venule
E. Abundant matrix C. Capillary
E. Abundant matrix D. Elastic artery
40 B. Venule
Elastic cartilage is found in which of the 48
following body structures? While examining a tissue with a light
A. Intervertebral discs microscope, you notice a small vessel that
B. Epiglottis has 2 circular layers of smooth muscle in
C. Tracheal rings the tunica media. The lumen of this vessel
D. Cartilage at pubic symphysis is only slightly larger than the diameter of an
E. Costal cartilage erythrocyte. Which of the following vessels
B. Epiglottis are you examining?
41 A. Arteriole
Given the same extent of injury, which one B. Venule
will heal first? C. Capillary
A. Bones D. Muscular artery
B. Ligaments A. Arteriole
C. Tendons 49
D. Muscles The area in the sarcomere containing only
D. Muscles actin filaments is known as:
42 A. A band
Which of the following is multinucleated? B. H band
A. Cardiac muscle C. I band
B. Skeletal muscle D. Z band
C. Smooth muscle C. I band
D. Both cardiac and smooth 50
B. Skeletal muscle Which of the following regions contains the
43 Z lines in skeletal muscle?
Which of the following best characterizes a A. H band
cardia muscle fiber? B. A band
A. Multiple nuclei C. I band
B. Lack of striations D. M band
C. Spindle shaped fiber C. I band
D. Intercalated disks 51
D. Intercalated disks During contraction of skeletal muscle, which
44 of the following does not change in length?
Which of the following layers of the cardia A. H band
wall has fat deposits specially seen at the B. A band
sulci? C. I band
A. Endocardium D. Sarcomere
B. Sub endocardium B. A band
C. Epicardium 52
D. Myocardium Which of the following events occurs during
C. Epicardium the process of contraction of skeletal
45 muscle?
Which of the following is found within the A. Release of calcium ions by sarcoplasmic
tunica media of large arteries? reticulum
A. Vasa vasorum B. Calcium ions bind to tropomyosin
B. Elastic fibers C. Actin filaments shorten
C. Mast cells D. Z line disappears
D. Fibroblasts E. Sarcomeres lengthens
B. Elastic fibers A. Release of calcium ions by sarcoplasmic
46 reticulum
53 B. Type II alveolar cells
A 5 year old boy presents with wasting of 61
muscles of the extremities and was The non-ciliated secretory cells which
diagnosed to have Duchenne's dystrophy. randomly interrupts the ciliated epithelial
Which of the following would be deficient in lining of the bronchiolar mucosa are known
this patient? as
A. Actin A. Kulchitsky cell
B. Myosin B. Clara cell
C. Collagen C. Type I pneumocyte
D. Dystrophin D. Type II pneumocyte
E. Tropomyosin B. Clara cell
D. Dystrophin 62
54 A coal miner presents with a chronic cough.
Which of the following histologic A lung biopsy reveals cells with large black
characteristics distinguishes a bronchus deposits. Which of the following are the
within the lung from Primary bronchus? cells containing this inhaled material?
A. Glands in the submucosa A. Type II alveolar cells
B. PSCCE B. Type I alveolar cells
C. Smooth muscle in the walls C. Ciliated columnar epithelial cells
D. Irregular plates of hyaline cartilage D. Goblet cells
E. Goblet cells in the mucosa E. Alveolar macrophages
D. Irregular plates of hyaline cartilage E. Alveolar macrophages
55 63
Epithelial lining of BRONCHUS Choose the correct statement regarding the
Pseudostratified columnar ciliated histology of the esophagus:
epithelium with a goblet cells A. It is lined by non-keratinized simple
56 squamous epithelium
Segments of respiratory tract with a B. It is entirely covered by adventitia
diameter of 1mm or less without cartilage C. Mucus secreting glands are found in the
and glands lamina propria and submucosa
A. Bronchioles D. The distal 1/3 is made up of skeletal
B. Bronchus muscle
C. Alveolus C. Mucus secreting glands are found in the
D. Trachea lamina propria and submucosa
A. Bronchioles 64
57 The neuroendocrine cells located in lamina
Which statement does NOT characterize propria of gastrointestinal tract is known as:
the respiratory bronchiole? A. Kulchitsky cells
A. Lined by simple columnar epithelium B. Paneth cells
B. Has Goblet cells C. Argentaffin cells
C. Has no glands and cartilages D. Goblet cells
D. Has abundant smooth muscle C. Argentaffin cells
B. Has Goblet cells 65
58 Which of the following cell type is most
Which of the following conducting airways of prevalent within the gastric pit of the
things is characterized by a predominantly stomach?
thick muscularis layer? A. Columnar absorptive cells
A. Primary bronchus B. Enteroendocrine cells
B. Bronchiole C. Mucus secreting cells
C. Lobar bronchus D. Paneth cells
D. Segmental bronchus E. Parietal cell
B. Bronchiole C. Mucus secreting cells
59 66
This condition results to reduction of the Hyperacidity of stomach is a result of
total surface area available for gas hypersecretion of what cell?
exchange in which many of the alveoli A. Zymogenic cell
beyond the terminal bronchioles coalesce? B. Parietal cell
A. Bronchitis C. Columnar cell
B. Tuberculosis D. Mucous neck
C. Emphysema B. Parietal cell
D. Pneumonia 67
C. Emphysema Permanent mucosal folds in the wall of the
60 small intestine:
Secretes surfactant A. Haustra
A. Type I alveolar cells B. Valves of Kerckring
B. Type II alveolar cells C. Valves of Houston
C. Goblet cells D. Plicae transversalis
D. Clara cells B. Valves of Kerckring
68 D. Hexagonal with a central portal triad and
In the GIT tract, where are the cells that 6 central veins
secrete antibacterial enzymes? E. Hexagonal with a central vein and 6
A. in Peter Patches portal triads
B. On intestinal villi E. Hexagonal with a central vein and 6
C. In crypts of Lieberkuhn portal triads
D. In the lamina propria 76
E. In rugae The liver lobule that is consistent with
C. In crypts of Lieberkuhn lobules in typical exocrine glands:
69 A. Portal lobule
Which of the following would result in the B. Rappaport's lobule
reduction in the number of Paneth's cells? C. Liver acinus
A. Increased levels of intestinal fats D. Classical lobule
B. Reduced breakdown of sugars A. Portal lobule
C. Elevated levels of undigested proteins 77
D. Decreased mucus in the intestine Which of the following are components of a
E. Increased number of intestinal bacteria portal triad within the liver?
E. Increased number of intestinal bacteria A. Bile canaliculi and lymphatic vessels
70 B. Three central veins
Which of the following is the primary C. Central vein and hepatic sinuses
function of lacteals in the small intestine? D. Hepatic artery, portal vein and bile duct
A. Absorption of glucose E. Common bile, hepatic bile and cystic
B. Absorption of amino acids ducts
C. Absorption of chylomicrons D. Hepatic artery, portal vein and bile duct
D. Absorption of salts 78
E. Absorption of water Within the liver, blood within the sinusoids
C. Absorption of chylomicrons drains into which of the following?
71 A. Central vein
Brunner's gland is a histologic feature of: B. Portal lobule
A. Duodenum C. Bile canaliculi
B. Gallbladder D. Hepatic arteriole
C. Ileum A. Central vein
D. Liver 79
A. Duodenum Bile formed within the liver is transported via
72 canaliculi to bile ducts. Which of the
Plexus of nerves responsible for controlling following form the canaliculi?
the secretion of glands in GIT is known as: A. Central veins
A. Auerbach's B. Endothelia
B. Merkel's C. Kupffer's cell
C. Meissner's D. Hepatocytes
D. Ruffini's D. Hepatocytes
C. Meissner's 80
73 Which of the following organelles within the
Disse's space is associated with: hepatocyte functions to detoxify drugs?
A. Pancreas A. Rough endoplasmic reticulum
B. Liver B. Smooth endoplasmic reticulum
C. Gallbladder C. Golgi apparatus
D. Parotid D. Lysosomes
B. Liver E. Peroxisome
74 B. Smooth endoplasmic reticulum
Which of the following form the space of 81
Disse within the liver? Rokitansky aschoff sinuses are features of:
A. Adjacent hepatocytes A. Pancreas
B. Adjacent endothelia of liver sinuses B. Liver
C. Between venules, arterioles and C. Gallbladder
lymphatics of a portal triad D. Parotid
D. Kupffer's cells and sinus endothelium C. Gallbladder
E. Sinus endothelium and hepatocytes 82
E. Sinus endothelium and hepatocytes The contents of Zymogen granules within
75 acinar cells of the pancreas are secreted
Which of the following defines the classic into the intercalated duct. Which of the
liver lobule? following provide the primary stimulation for
A. Triangular with a central vein and 3 portal the secretion?
triads A. Secretin
B. Triangular with a central portal triad and B. Cholecystokinin
3 central veins C. Acid chyme
C. Quadrangular with 2 central veins and 2 D. Digestive enzyme
portal triads D. Digestive enzyme
83 NISSLE's BODY
Centroacinar cells are found in which of the 93
following glands: Nissle's granules are actually:
A. Pancreas A. Golgi apparatus
B. Parotid gland B. Mitochondria
C. Sublingual gland C. Lysosomes
D. Submaxillary gland D. Rough Endoplasmic Reticulum
A. Pancreas D. Rough Endoplasmic Reticulum
84 94
Which of the following cells within the The smallest of the neuroglial cells that form
glomerulus form the filtration slits? part of the mononuclear phagocytic system
A. Podocytes MICROGLIA (mesoderm)
B. Mesangial cells 95
C. Juxtaglomerular cells The most important supporting cell of the
D. Extraglomerular cells CNS important for nutrition and protection
A. Podocytes Protoplasmic astrocyte
85 96
The pathologist is examining renal tissue The cell considered as the source of myelin
with a light microscope. He notices a tubular in peripheral nervous system
structure that has a brush border. Which of Schwann cell
the following structures is the pathologist 97
examining? Destruction of these cells will lead to a
A. Distal convoluted tubule clinical condition known as Multiple
B. Proximal convoluted tubule Sclerosis
C. Thin loop of Henle Oligodendrocytes
D. Collecting tubule 98
B. Proximal convoluted tubule The phase of menstrual cycle that coincides
86 with the functional activity of the corpus
Which is characteristic of the proximal lutetium and primarily influenced by
convoluted tubule? progesterone secretion
A. Lining epithelium is simple cuboidal Secretory
B. Smaller cell size 99
C. Larger lumen Stratum functionalism of endometrium that
D. Less acidophilic staining undergoes changes during menstrual cycle
A. Lining epithelium is simple cuboidal and is shed during menstruation

Is histologically and functionally made up of

Proximal - SIMPLE CUBOIDAL WITH what layers?
BRUSH BORDERS (acidophilic) Stratum compactum & stratum spongiosum
100
Distal - SIMPLE CUBOIDAL (basophilic) Histologist is examining cells arrested at
87 various stages of oogenesis
Secretes RENIN Primary follicle
101
Modified smooth muscle cells afferent Tissue from an 80 year old man is
arteriole examined by electron microscope. Cells in
J-G cells this tissue sample have several residual
88 bodies and lipofuscin within their cytoplasm.
In the kidney, which cells produce Which of the following cells are being
erythropoietin? described?
Mesangial cells A. Astrocytes
89 B. Neurons
Modified portion of DCT C. Oligodendrocytes
D. Fibroblasts
Adjacent to the vascular pole B. Neurons
102
Monitors the Na+ within the tubular fluid In the peripheral nervous system, which of
MACULA DENSA the following helps promote regeneration of
90 severed axons?
Lacis cells / Polkissen cells A. Endoneurium
EXTRACELLULAR MESANGIAL CELLS B. Schmidt Lanterman cleft
91 C. Epineurium
Sensory portion of a nerve cell D. Nodes of Ranvier
Dendrite E. Perineum
92 A. Endoneurium
In cases of nerve fibers injury, what 103
structure in the perikaryon will be decreased Which of the following is the most critical
in number? event in regeneration of a peripheral nerve?
A. Chromatolysis of the damaged Pigment epithelium
perikaryon 118
B. Proliferation of Schwann cells The organ of Corti lies on which of the
C. Phagocytic activity of macrophages following structures
D. Distal axon degeneration Basilar membrane
B. Proliferation of Schwann cells 119
104 A victim of an automobile accident is unable
FSH and LH are creations of what cells? to abduct her left arm. This indicates
Basophils damage to which of the following parts of
105 the brachial plexus?
Th cell that secretes growth hormone and is Upper trunk and posterior cord
considered as the most numerous, making 120
up almost half of the bulk of the Anterior A 21 year old patient has a lesion of the
Pituitary gland upper trunk of the brachial plexus. Which of
Somatotrophs the following will be seen in this patient?
106 Arm tending to lie in medial rotation
Cells that are found in the neurohypophysis 121
Pituicytes A 12 year old is diagnosed with an upper
brachial plexus injury after falling from a
107 tree. He presents with his right upper arm at
Melatonin which regulates daily body his side due to loss of abduction. The
rhythms and day/night cycle is secreted by muscles primarily responsible for abduction
what endocrine gland of the arm at the shoulder
Pineal gland Deltoid and Supraspinatus
108 122
The cells that secretes Calcitonin which Injury to the lateral cord of the brachial
lowers blood calcium level by inhibiting the plexus will also injure its continuation, the
rate of decalcification of bone is MUSCULOCUTANEOUS nerve. Which of
Parafollicular the following findings would you observe in
109 a patient with this injury?
In Grave's disease, these cells are Weakness of flexion of the forearm at the
stimulated and increased in number and elbow
size leading to abnormal secretions of 123
thyroid hormones A 22 year old mam is brought into the ER
Follicular with a knife injury to the axilla. The
110 physician suspects injury to the lower
Lymphatic organ considered as the brachial plexus. Which of the following
"graveyard of worn-out RBCs" nerves is most likely to be affected?
Spleen Ulnar
111 124
structure that contains Hassal's corpuscles An 18 year old patient has been improperly
Thymus fitted with crutches which put pressure on
112 the posterior cord of the brachial plexus.
Hassal's corpuscle is characteristic feature Which of the following terminal nerves
of what part would most likely be affected?
Thymic medilla Radial
113 125
Lymphoid nodules and germinal centers are Which of the following muscle tests would
typically absent in which organ you perform to test the integrity of the radial
Thymus nerve?
114 Extension of the hand at the wrist
Periarterial lymphoid sheath (PALS) is 126
characteristic of A 19 year old woman was thrown while
Spleen riding a bicycle. She attempted to break her
115 fall with wn outstretched hand and suffered
What is the first site of hematopoiesis in a fracture. In the ER, an examination
utero? revealed an inability to extend the hand at
Yolk sac the wrist?
116 Midshaft of the humerus
Glaucoma is a clinical condition resulting 127
from increased intraocular pressure as a A 12 year old boy fell out of a tree and
result of obstruction of the drainage or fractured the upper portion of the humerus.
excessive secretion of Aqueous humor. The Which of the following nerves are intimately
structure that secretes Aqueous humor? related to the humerus and are most likely
Ciliary process to be inured by such fracture?
117 Radial and Axillary
Retinal detachment involves separation of 128
the neural retina from what structure?
A 36 year old woman suffers a traumatic following is characteristic of this type of
injury to the upper limb that lesions a nerve. hernia?
The lesions results in an inability to spread
and extend her fingers, and a "clawing" of A. Has protruded through the anterior
the ring and little fingers. What two spinal abdominal wall medial to the inferior
cord segments contribute to the nerve that epigastric vessels
is damaged? B. May tear through the internal spermatic
C8 and T1 and cremaster in fascia that cover the
129 spermatic cord
Your patient has radial deviation of the hand C. May pass posterior to the inguinal
at the wrist when he attempts to flex the ligament into the anterior thigh
wrist and altered sensation in the skin D. May pass through the superficial inguinal
covering the hypothenar eminence. ring but not through the deep inguinal ring
Fracture of the medial epicondyle of the E. Most likely covered by all of the same
humerus layers that cover the spermatic cord
130 E. Most likely covered by all of the same
A patient with a severe tear of the medial layers that cover the spermatic cord
collateral ligament of the wrist would most 138
likely display which of the following During surgery, you must incise the anterior
increased wrist movements? rectus sheath between the xiphoid process
Abduction and the umbilicus. In this region, the sheath
131 is derived from the aponeurosis of the ?
A patient suffers a fracture of the External and internal oblique
SUPRACONDYLAR part of the humerus, 139
which compresses a nerve and an During a laparoscopic procedure, you
accompanying artery observe the inferior epigastric vessels
A hand of benediction ascending on the posterior surface of the
132 rectus abdominal muscle. They suddenly
A 14 year old boy falls on the outstretched disappear from view by passing superior to
hand and has a fracture of the scaphoid the:
bone. The fracture is most likely Arcuate line
accompanied by a rupture of which of the
following arteries ( rectus abdominis is lateral to the
Radial umbilicus)
133 140
A man who works as a cartoonist begins to A surgeon entering the abdominal cavity
develop pain and paresthesia in his right through the abdominal wall will take care to
hand at night. The altered sensation is most avoid injury to the vessels and nerves within
evident on the palmar aspects of the index the wall. The main portion of these vessels
and middle fingers and nerves will be found immediately deep
Atrophy of the thenar eminence to the?
134 Internal abdo
A 31 year old patient complains of sensory
loss over the anterior and posterior surfaces PHYSIOLOGY
of the medial one and one half fingers. He is
diagnosed by a physician as having "funny Contains DNA, histones & chromosomes
bone" symptoms. What nerve is injured?
Ulnar Has nucleolus
135 NUCLEUS
A 23 year old woman receives a deep cut of 1
her ring finger by a kitchen knife is unable to Powerhouse of the cell
move the Metacarpopharyngeal joint. Which Mitochondria
of the following pairs of nerves are 2
damaged? Involve in detoxification,lipid synthesis, lipid-
Ulnar and Radial soluble substances ---> water-soluble
136 substances
A 16 year old patient has weakness flexing SER or Agranular
the MCP joint of the ring finger and is 3
unable to adduct the same finger. Which of For synthesis of proteins bound for the cell
the following muscles is most likely membrane, lysosomes, outside of the cell
paralyzed? RER
Palmar interosseous 4
137 For synthesis of proteins bound for the
A male construction worker complaints of cytoplasm and mitochondria
groin pain and a bulge that appears when Free-floating ribosomes
he lifts heavy objects. When the patient lies 5
down, the bulge disappears. A diagnosis of
an Indirect hernia is made. Which of the
For packaging, molecular tagging and What is the common component of the cell
synthesis of hyaluronic acid & chondroitin membrane
sulfate Protein
Golgi Apparatus 21
6 The cell membrane is permeable to NON-
Replenishes the cell membrane POLAR molecules
True
May contain proenzymes, NTs 22
Disk-shaped
Secretory vesicles
7 For firm intercellular adhesion (eg
For regression of tissues and AUTOLYSIS epithelium)
Macula adherens
suicide bags of the cells 23
For communication (eg cardiac and smooth
Destroys FBs muscle cells)
Lysosomes Unitary smooth muscle
8 Gap junctions
Degrades membrane-associated proteins 24
Ring-shaped
Not membrane bound
Proteosome Increases surface area contact
9 Zonula adherens
Contains oxidases, catalases 25
Reticular
For detoxification
Peroxisome Either "tight" (BBB, CD, terminal colon) or
10 "leaky" (PCT, jejunum); divides cell into
SER & RER is abundant apical and basolateral borders
Liver Zonula occludens
11 26
Specialized SER in the skeletal muscles Functional unit of a gap junction
Sarcoplasmic reticulum Connexon
12 27
Specialized RER in the neuron Movement of substances in both apical side
Nissl substance and basolateral side
13 Transcellular transport
Only substance modified in the RER, not in 28
Golgi Movement of substances through tight
Collagen junctions
14 Paracellular transport
Found in lysosome-bound proteins 29
Mannose 6-phosphate Clathrin
15
Lipofuscin accumulates in this organelle SNARE proteins
Lysosomes Endocytosis
16
Lysosomes & Exocytosis
30
Peroxisome origins What's the most common compound on
Golgi apparatus your body?
Water
SER 31
17 What's the most common protein in your
Motor protein causing transport from the cell body?
body to the neural fibril Collagen
Kinesin 32
18 What's the most common amino acid in
"Whip-like" movement on the cell surface your body?
found in the respiratory airways and Glycine
Fallopian tubes 33
Ciliary movement Which of the following has a reflection
19 coefficient closer to one?
What is the common component of the Albumin
protoplasm 34
Water Passive, downhill, non-carrier-mediated
20
Gases, alcohol, steroid hormones
Simple diffusion EEG wave: relaxed
35 Alpha wave
Passive, downhill, carrier-mediated 50
EEG wave: alert ; REM sleep
Glut-1,2,3,4,5 Beta wave
Facilitated diffusion 51
36 EEG wave: deep sleep
Active, uphill, carrier-mediated, uses ATP Delta wave
52
Na-K-ATPase pump, proton pump Substance suspected to induce sleep
Primary active transport Muramyl peptide
37 53
Active, uphill, carrier-mediated, uses Na Percentage of REM sleep in newborns
gradient 50%
54
SGLT-1, SGLT-2, Na-K-2Cl Master clock
Secondary active transport Suprachiasmatic nucleus (SCN)
38 55
Example of IMPERMEANT solute Regulates master clock
Glucose Pineal gland
39 56
Example of PERMEANT solute Detects movement of objects name low-
UREA frequency vibration; found in glabrous skin
40 Meissner's corpuscle
Effective osmole used in the treatment of 57
brain edema For continuous touch; grouped into Iggo
Mannitol Dome Receptors
41 Merkel's disks
Osmotic pressure from large molecules 58
(protein) Detects movement of objects in skin
Oncotic pressure Hair-end organ
42 59
Weight of the volume of a solution divided For pressure; for heavy and prolonged
by weight of equal volume of distilled (pure) touch; found in deep skin, internal tissues
water and joint capsules
Specific gravity Ruffini's end organ
43 60
Stereospecificity, Saturation and For high-frequency vibration; onion-like in
Competition are hallmarks of carrier- or non- structure
carrier mediated transport? Pacinian corpuscle
Carrier-Mediated Transport 61
44 Retinal glial cells that maintain internal
Ca-ATPase pump in the cell membrane: geometry
PMCA Ca-ATPase in the SR & ER: SERCA. Mueller cells
TRUE OR FALSE? 62
True Retinal output cells whose axons from the
45 optic nerve
Osmoles per Liter of Water: osmolaRITY or Ganglion cells
osmolaLITY? 63
osmolaRITY Interneurons that connect rods & cones;
46
Normal osmolarity of both ECF & ICF Contrast detectors
(including CSF)? Bipolar cells
300 mOsm/L 64
47 Absorbs stray light and prevent them from
A RBC has an osmolarity of 300 mOsm/L. scattering
What will happen to the RBC if it's places in
a solution of: Site of macular degeneration & retinal
1. 300 mOsm/L Sucrose detachment
2. 300 mOsm/L Urea Pigment epithelium
No change swell 65
48 The first and most powerful structure of the
Activates G-proteins: Guanine Nucleotide optical system
Exchange (GEFs), GTPase-accelerating Cornea
proteins (GAPS), regulation of protein 66
signaling (RGS protein) Center of our central vision
GEFs Fovea
49 67
Enable the lens to change its shape 84
Zonula An increase venous return will increase the
68 HEART RATE
Middle vascular layer of the eye Bainbridge reflex
Uvea 85
69 An increase in venous return will increase
Film of the eye the STROKE VOLUME
Retina Frank-Starling mechanism
70 86
Area of the eyes with no sensory cells AV block that cause fainting in patients due
Optic disk to the initially suppressed state of the
71 Purkinje fibers
First part of brain to receive visual input Strokes-Adams Syndrome
Optic chiasm 87
72 Powerful systemic vasoconstriction that
Relay station of the virtual cortex starts at a BP<60 and optimal at BP=15
Lateral geniculate body CNS Ischemic Response
73 88
Keep images focused in the retina Hypertension
Lens
74 Irregular respiration and bradycardia due to
Layer of blood vessel that supplies blood to activation of the CNS ischemic response
the retina and baroreceptor reflex
Choroid Cushion reaction/reflex
75 89
Where aqueous humor is produced Atrial contraction (distal 3rd of diastole)
Ciliary body
76 Contraction of ventricles (isovolumic
In glaucoma, these structures are blocked contraction)
Canal of SCHLEMM
77 Venous blood going to the atrium
Voluntary (isovolumic relaxation)
A wave, C wave, V wave
Most number of SR 90
Caused by attempted backflow of blood
No surface calcium channels during isovolumic relaxation
Skeletal muscle Incisura/Dicrotic notch
78 91
Contains gap junctions Increased ventricular pressure but same
ventricular volume
Contains surface Ca-ATPase and Na-Ca Isovolumic contraction
exchanger 92
Cardiac muscle Decreases ventricular pressure but same
79 ventricular volume
Uses MLCK, Calmodulim, Caldesmon Isovolumic relaxation
93
Contains surface Ca-ATPase and Na-Ca Closure of AV valves
exchanger S1
94
No Sarcomeres, striations, troponin Closure of semilunar valves
S2
Myosin-based regulation 95
Rapid ventricular filling (flow of blood from
Contains dense bodies, caveoli, atrium to ventricles)
rudimentary SR S3
Smooth muscle 96
80 Atrial contraction/atrial systole
Peak or tall T waves S4
Hyperkalemia 97
81 Control conduits
Prolonged QT interval
Hypocalcemia May rapidly dilate and constrict
82
Prolonged PR interval A1-vasoconstricts
Heart blocks
83 B2-vasodilates
ST segment elevation Arterioles
Q wave MI or STEMI 98
Stressed volume 2/3 diastole + 1/3 systole
MAP
Highest pressure
Arteries Mean arterial pressure
99 116
Large cross-sectional area Used to estimate L arterial pressure
PCWP
Endothelial cells only
Capillaries Pulmonary capillary wedge pressure
100 117
Capacitance vessels, 64% of blood found Changes in HR
here! with one-way valves Chronotrope
Veins 118
101 Changes in cardiac contractility
Drains proteins and fluids from the Into rope
interstitium, carries chylomicrons and 119
involved in immunity and cancer Changes in conduction velocity
Lymphatic vessels Dromotrope
102 120
Forced exerted by blood against the blood Changes in rate of relaxation
vessel wall Lusitrope
Blood pressure 121
103 Workhouse of the nephron
Amount of blood pumped by the heart per Proximal convoluted tubule
unit of time 122
Cardiac output Impermeable to water
104 Ascending limb
Amount of blood pumped per heart beat 123
Systolic volume Impermeable to solutes
105 Descending limb
Pressure at the level of arteries and 124
arterioles that opposes blood coming out of Site of aldosterone action
the heart Distal tubule
TPR/SVR 125
Total peripheral resistance/systemic Site of ADH action
vascular resistance Collecting duct
106 126
Number of heartbeats per minute Countercurrent multiplier
Heart rate
107 Creates the gradient
Amount of blood in the ventricle immediately Loop of Henle
before systole 127
End diastolic volume Countercurrent exchanger
108
Amount of blood in the ventricle immediately Preserves the gradient
before diastole Vasa recta
End systolic volume 128
109 What are the 3 urinary buffers?
Ventricular contraction NaHCO3
Systole NaHPO4
110 NH4
Ventricular relaxation 129
Diastole Insulin, aldosterone, B-adrenergic
111 stimulation, alkalosis
Low volume end diastolic volume Potassium influx
Preload 130
112 Insulin deficiency, Addison's disease, B-
Aortic pressure adrenergic blockage, acidosis, cell lysis,
Afterload strenuous exercise, increase ECF
113 osmolarity
Systole-Diastole Potassium efflux
Pulse pressure 131
114 Effect on GFR in afferent vasodilation
Right atrial pressure = 0mmHg Increases
CVP 132
Effect on GFR in moderate efferent
Central venous pressure vasoconstriction
115 Increases
133 Arteriolar dilation, venous constriction
Effect on GFR in afferent vasoconstriction, Bradykinin, Histamine
efferent vasodilation, severe efferent 149
vasoconstriction Counteracts TXA2
Decreases PGI2
134 150
What is the formula for Reynold's Number? What causes phase 2 in cardiac action
RN= (diameter) (velocity) (density) / potential?
(viscosity)
135 What causes depolarization in SA node
What is the significance of a high Reynold's action potential?
number? Calcium influx
Higher possibility of turbulence 151
136 Which Na+ channel accounts for SA node
What would happen to the Reynold's automaticity?
number if there is decreased blood viscosity If channels (slow "funny" Na channels)
or increased blood velocity? 152
Increase Fastest conduction velocity
137 Bundle of His
What coronary artery is most susceptible to 153
atherosclerosis? Conduction velocity is dependent on
LAD Size of inward current
138 154
Vif that occurs after blunt trauma to the What is the normal Ejection fraction?
heart immediately before the peak of the T 55% (EF=SV/EDV)
wave 155
Commotio Cordis Local control of blood flow
139 Metabolic hypothesis
What is the effect of endurance training and 156
strength exercises on LV volume and LV First two events in hemostasis
wall thickness? Vasoconstriction
Endurance training: increase LV volume
alone Formation of platelet plug
157
Strength exercises: increase LV wall Last two events in hemostasis
thickness alone Blood coagulation
140
Reservoir of blood in the circulatory system Resolution
158
Has greater capacitance/compliance Lyses Fibrin
Veins Plasmin
141 159
What is the hormone that counteracts the Vit K dependent clotting factors
effect of aldosterone and ADH? Factor X, IX, VII, II, Protein C and S
ANP 160
Atrial natriuretic peptide Responsible for platelet ADHESION
142 vWF, Gp 1b
The plateau in cardiac action potential is 161
found in what phase? Responsible for AGGREGATION
Phase 2 Fibrinogen, Gp IIb-IIIa
143 162
Most potent vasoconstrictor Initiates EXTRINSIC pathway
ADH Tissue factor (Factor III)
144 163
Substance involved in vasodilator theory Initiates INTRINSIC pathway
(Metabolic theory) Hagemann Factor (Factor XII)
Adenosine 164
145 Which substance is released due to shear
Vasoconstrictor, involved in migraine stress on endothelial cells and dilates
Serotonin upstream blood vessels?
146 EDRF/NO
Responsible for angiogenesis Endothelium-derived relaxing factor/ nitric
VEGF oxide
147 165
Vasoconstrictor; released by damaged Which prostaglandins act as
endothelium vasoconstrictors?
Endothelin PGF, TXA2/PGA2
148 166
Which prostaglandins act as vasodilators?
PGE, PGI Also has anti-inflammatory effects and
167 upregulates alpha-1 receptors on arterioles
4 causes of high-output cardiac failure Cortisol
Beri-beri 183
AV fistula What is the specific site of production of
Hyperthyroidism cortisol
Anemia
168 Has the largest area of the adrenal cortex
BP from sitting to standing position Zona fasciculata of the adrenal cortex
184
TPR during exercise Chronic high cortisol levels may cause
diabetes and HPN
Venous blood volume during hemorrhage True
Decrease 185
169 Addison's disease is due to high levels of
HR from sitting to standing position aldosterone
Increase False
170 186
Sites of production of RBCs in order 21B hydroxylase deficiency causes
Yolk sac/AGM (3rd week) virilization
Liver (3 mos) True
Spleen 187
Bone marrow Which substance is released due to shear
171 stress on endothelial cells and dilates
Substrates for heme synthesis upstream blood vessels?
TCA intermediate succinyl CoA and amino EDRF/NO
acid glycine Endothelium-derived relaxing factor/ nitric
172 oxide
"Constant load delivered to distal tubule" 188
Tubuloglomerular feedback Which prostaglandins act as
173 vasoconstrictors?
"Percentage of solute reabsorbed is held PGF, TXA2/PGA2
constant" 189
Glomerulotubular balance Which prostaglandins act as vasodilators?
174 PGE, PGI
In tubuloglomerular feedback, the substrate 190
that VASOCONSTRICTS afferent arterioles 4 causes of high-output cardiac failure
Adenosine Beri-beri
175 AV fistula
What is the renal threshold for glucose Hyperthyroidism
200mg/dL Anemia
176 191
Which substances do not have transport BP from sitting to standing position
maximum and renal threshold?
Sodium, and all passively transported TPR during exercise
solutes
(Chloride and urea) Venous blood volume during hemorrhage
177 Decrease
Absorb Na and H2O and secrete K 192
Principal cells HR from sitting to standing position
178 Increase
Absorb K and secrete H 193
Intercalated cells (interstitial cells) Sites of production of RBCs in order
179 Yolk sac/AGM (3rd week)
Secrete EPO Liver (3 mos)
Peritubular capillaries Spleen
180 Bone marrow
Detects changes in sodium concentration in 194
the distal tubule Substrates for heme synthesis
Macula Densa TCA intermediate succinyl CoA and amino
181 acid glycine
Triggers for aldosterone secretion 195
Decreased ECF volume "Constant load delivered to distal tubule"
Hyperkalemia Tubuloglomerular feedback
182 196
Increases gluconeogenesis, insulin "Percentage of solute reabsorbed is held
sensitivity, lipolysis, blood amino acids constant"
Glomerulotubular balance Which prostaglandins act as vasodilators?
197 PGE, PGI
In tubuloglomerular feedback, the substrate 213
that VASOCONSTRICTS afferent arterioles 4 causes of high-output cardiac failure
Adenosine Beri-beri
198 AV fistula
What is the renal threshold for glucose Hyperthyroidism
200mg/dL Anemia
199 214
Which substances do not have transport BP from sitting to standing position
maximum and renal threshold?
Sodium, and all passively transported TPR during exercise
solutes
(Chloride and urea) Venous blood volume during hemorrhage
200 Decrease
Absorb Na and H2O and secrete K 215
Principal cells HR from sitting to standing position
201 Increase
Absorb K and secrete H 216
Intercalated cells (interstitial cells) Sites of production of RBCs in order
202 Yolk sac/AGM (3rd week)
Secrete EPO Liver (3 mos)
Peritubular capillaries Spleen
203 Bone marrow
Detects changes in sodium concentration in 217
the distal tubule Substrates for heme synthesis
Macula Densa TCA intermediate succinyl CoA and amino
204 acid glycine
Triggers for aldosterone secretion 218
Decreased ECF volume "Constant load delivered to distal tubule"
Hyperkalemia Tubuloglomerular feedback
205 219
Increases gluconeogenesis, insulin "Percentage of solute reabsorbed is held
sensitivity, lipolysis, blood amino acids constant"
Glomerulotubular balance
Also has anti-inflammatory effects and 220
upregulates alpha-1 receptors on arterioles In tubuloglomerular feedback, the substrate
Cortisol that VASOCONSTRICTS afferent arterioles
206 Adenosine
What is the specific site of production of 221
cortisol What is the renal threshold for glucose
200mg/dL
Has the largest area of the adrenal cortex 222
Zona fasciculata of the adrenal cortex Which substances do not have transport
207 maximum and renal threshold?
Chronic high cortisol levels may cause Sodium, and all passively transported
diabetes and HPN solutes
True (Chloride and urea)
208 223
Addison's disease is due to high levels of Absorb Na and H2O and secrete K
aldosterone Principal cells
False 224
209 Absorb K and secrete H
21B hydroxylase deficiency causes Intercalated cells (interstitial cells)
virilization 225
True Secrete EPO
210 Peritubular capillaries
Which substance is released due to shear 226
stress on endothelial cells and dilates Detects changes in sodium concentration in
upstream blood vessels? the distal tubule
EDRF/NO Macula Densa
Endothelium-derived relaxing factor/ nitric 227
oxide Triggers for aldosterone secretion
211 Decreased ECF volume
Which prostaglandins act as Hyperkalemia
vasoconstrictors? 228
PGF, TXA2/PGA2 Increases gluconeogenesis, insulin
212 sensitivity, lipolysis, blood amino acids
 Autosomal recessive disorder causing zinc
Also has anti-inflammatory effects and deficiency leading to with dermatitis,
upregulates alpha-1 receptors on arterioles diarrhea, alopecia
Cortisol Acrodermatitis Enteropathica
229 242
What is the specific site of production of Proximal half of the colon
cortisol Absorption
243
Has the largest area of the adrenal cortex Location of the chemoreceptors trigger zone
Zona fasciculata of the adrenal cortex Area postrema
230 244
Chronic high cortisol levels may cause Slow waves are generated by what type of
diabetes and HPN pacemaker cells
True Interstitial cells of Cajal
231 245
Addison's disease is due to high levels of Enzyme converts pancreatic trypsinogen to
aldosterone trypsin
False Enterokinase
232 246
21B hydroxylase deficiency causes Part of liver stores vitamins
virilization Ito cells
True 247
233 Functional unit of the liver
Which hormone is responsible for milk Liver acinus model
production 248
Prolactin 4 basic layers of the GI tract
234 Mucosa
Which hormone is responsible for milk
secretion Submucosa
Oxytocin
235 Muscularis
Where is ADH synthesized, stored and
secreted? Serosa
Synthesized in hypothalamus, stored and 249
secreted in posterior pituitary Layer NOT seen in the esophagus
236 Serosa
Where will you find your thyroglobulin? 250
Thyroid gland Stronger layer of the esophagus
237 Submucosa
Thyroid hormone predominant in the plasma 251
T4 3 layers of the stomach
238 Inner oblique
93% TH
Middle circular
Half-life: more (6 days)
Outer longitudinal
More affinity for binding plasma protein 252
Contraction of inner circular, outer
Less to bind to nuclear receptor (10%) longitudinal muscle layer
Auerbach's plexus
4x slower (2 days) 253
T4 Contraction of muscularis mucosa
239 Meissner's plexus
7% TH 254
Absent in Hirchsprung's disease
Half-life: less (1 day) Both Auerbach's and Meissner's plexus
255
Less affinity for binding plasma protein Most common symptom of decompression
sickness
More binding to nuclear receptor (90%) "Bends"
256
4x faster (12hours) First symptom at 120 feet below sea level
T3 Joviality
240 257
Skin ulcer, depressed immune response Effect of weightlessness on the bones
and hypo gonadal dwarfism Loss of calcium and phosphate
Zinc deficiency 258
241
Maximum positive at force before you lose 276
consciousness Sperm motility
+6G Epididymis
259 277
5 mechanisms for acclimatization too low Sperm storage
PO2 Vas deferens
Inc RR, polycythemia, inc diffusing capacity 278
of O2, inc vascularity, inc ability of cell to Production of fructose, prostaglandin
use O2 Seminal vesicle
260 279
Naturally acclimatized people have _ hearts, Contributes to semen alkalinity
_ chest, _ body mass Prostate gland
Larger, larger, smaller 280
261 Supplies mucus
Promotes front of fetus, maternal insulin Bulbourethral
resistance, maternal lipolysis and is an Urethral glands
index of placental well being 281
Human Chorionic Somatomammotropin Responsible for bone deposition
(HCS) Osteoblast
262 282
What is the strength per square centimeter Responsible for bone resorption; secretes
of x-sec area for both men and women? lysosomal enzymes (for organic matrix),
3-4 kg/cm2 citric acid, lactic acid (both for calcium salts)
263 Osteoclast
During exercise, when is power maximal? 283
During the first 8-10 seconds Who among the ff is in negative calcium
264 balance-pregnant women, children or post-
Energy system used in the first 10 seconds op patients
of an athletic event Post-op patients
Phosphagn energy system 284
265 Hormone suspected to initiate puberty
Anaerobic energy system utilized for 1.3 - Melatonin
1.6 mins in sports like tennis and soccer 285
Glycogen-lactic acid system First event in puberty
266 Testicular enlargement
Energy system used in marathon and long
distance swimming Breast enlargement
Aerobic system 286
267 Active form of vitamin D
Cardiac reserve 1,25 dihydroxycholecalciferol
400-600% 287
268 What is the effect of testosterone on athletic
Acute effects of hypoxia begin at _ feet performance?
12,000 feet Increases muscle size, muscle strength and
269 aggression
Seizures begin at _ feet 288
18,000 feet Increases intestinal calcium absorption
270
Most powerful Decreases calcium and phosphate
Estradiol excretion but increases urinary calcium
271
Main hormone involved in the follicular Calcium deposition at RDA levels
phase
Estrogen Calcium resorption if >RDA levels
272
Initiates spermatogenesis Calcium and phosphate reabsorption
FSH (kidneys)
273 VITAMIN D
Absence of this hormone is responsive for 289
the development of female external genitalia Decreases calcium excretion
Testosterone
274 Increase phosphate excretion
How many degree Celsius cooler os the
testes compared to the abdominal cavity Calcium and phosphate resorption
2 degrees Celsius cooler (BONES)
275 PTH
Sperm formation
Seminiferous tubules GYNECOLOGY
 OBSTETRICS
0 Pregnancy 20-36 weeks
Presents as virilization
Sertoli-Leydig tumor > 3 contractions in 30 minutes
1
Call Exner bodies Dilated >2cm or changing
Preterm labor
Presents as precocious puberty in children 1
Pregnancy 20-36 weeks

Presents as vaginal bleeding in adults > 3 contractions in 30 minutes

Eosinophilic bodies surrounded by Dilated <2cm and no change

granulosa cells Preterm contractions
Granulosa-Theca tumor 2
2 Pregnant 18-22 weeks
Tumor marker is HCG
Painless cervical dilatation
Composed of malignant syncitiotrophoblast
and cytotrophoblast Delivery of previable baby
Choriocarcinoma Cervical insufficiency
3 3
Tumor marker is AFP Menopause
Mean age is 51 years old
Schiller duval bodies
Perimenopausal is about 4 years
Numerous hyaline droplets
Yolk sac tumor The age at which menopause occurs
4 determined by genetics
Tumor marker is LH

Analogous to seminoma in males

4
Most common malignant tumor in patients What is the initial endocronologic change in
less than 30 years old menopause?
Dysgerminoma ⬆️ FSH, ⬇️ INHIBIN
5 5
Most common tumor in patients less than 30 Pathognomonic sign of menopause?
years old Hot flushes
Dermoid 6
6 All menopausal effects and complications
Presence of thyroid tissue in the ovary are relieved by estrogen except?
Struma ovarii Loss of libido
7
Nipple projections in dermoids Tx: IM testosterone
Tubercle of rokitansky 7
8 ESTROGEN
Pelvic mass in reproductive years
Continuous administration at physiologic
B-hGc (-) replacement dose
0.625mg of conjugated equine estrogen
Sonogram: fluid-filled ovarian simple cyst
Functional ovarian cyst 0.625mg of estrogen sulfate
9
Solid pelvic mass in reproductive years 0.5mg of micronized estradiol

B-hGc (-) 0.05 transdermal estrogen

8
Increase LDH level Peak of LH
Dysgerminoma 10-12 hours prior
10 9
Pelvic mass in reproductive years Due to estrogen
Ferning
B-hGc (-) 10
Seen in the proliferative of the menstruak
Sonogram: complex mass, calcific cycle
Benign cystic Ferning
11
Due to progesterone Nulligravida
Beading
12 MICROBIOLOGY
Seen in the secretory phase of the Primary syphilis: reaches inguinal lymph
menstrual cycle and pregnancy nodes within hours, characteristic lesion is
Beading painless chancre
13
Most predominant estrogen in pregnancy Secondary syphilis: characteristic lesion -
and serves as an indicator of fetal well condylomata lata, lymphadenopathy,
being malaise, anorexia
Estriol
14 Tertiary syphilis: characteristic lesion -
Substance responsible for the migration of gummas, dorsal columns affected (tabes
the active follicle to the surface of the ovary dorsalis), CNS involvement (demential
as well rupture paralytica), argyll-robertson pupil, aortitis
Estrogen due to invasion of vasa vasorum
15
Hormone of pregnancy is considered Congenital syphilis: snuffles/saddle nose,
diabetogenic because of its antagonism on mulberry molars, Hutchinson's triad
the cellular action of insulin, decreasing (Hutchinson teeth, deafness, keratitis),
insulin utilization sabre shins, rhagades (angle of mouth),
Human placental lactogen/Human chorionic Higoumenakis sign (clavicle), Clutton's
somatotropin joints (synovitis), pulmonary hemorrhage
16 Treponema pallidum
Nonpregnant reproductive years 1
Estradiol Trachoma: C. Trachomatis types A-C,
17 chronic keratoconjunctivitis
Production site of estradiol
Ovary Genital tract infections: C. Trachomatis
18 types D-K, most common cause of STDs,
Type of estrogen in pregnancy associated with Reiter's syndrome
Estriol
19 Late-onset neonatal pneumonia: C.
Production site of pregnancy Trachomatis types D-K, staccato cough
Placenta
20 Lymphogranuloma venereum: C.
Type of estrogen after menopause Trachomatis types L1-L3, suppurative
Estrone inguinal lymphadenitis (buboes), positive
21 FREI test
Production site of estrone Chlamydia trachomatis
Adipose 2
22 UTI: most common cause of community
Marker of fetal well being acquired UTIs
Estriol
23 Neonatal meningitis: 2nd most common
Produced exclusively by the fetus cause
Estriol
24 Traveler's diarrhea: causative agent: ETEC
Pregnancy of hormone
hCG HEMOLYTIC UREMIC SYNDROME:
25 causative strain - EHEC, E. coli 0157:H7;
Proposed mechanism for GDM toxin- verotoxin (Shiga-like); triad-
Human placental lactogen thrombocytopenia, anemia, renal failure;
26 associated food- undercooked beef
Diabetogenic hormone Escherichia coli
Human placental lactogen 3
27 Enterocolitis: causative strain: salmonella
Chorionic growth hormone enteriditis; abdominal pain and nonbloody
Human placenta lactogen diarrhea
28
Chorionic somatomammotropin Typhoid fever: causative strain- salmonella
Human placenta lactogen typhi; W1-stepladder fever, relative
29 bradycardia (pulse fever disproportion)
Has growth hormone like activity W2- rose spots, abdominal pain
Human placenta lactogen W3- bleeding, eleitis
30 W4- death or recovery
Woman who has never completed a
pregnancy to a stage of viability
Sepsis: causative strain- salmonella Listeria monocytogenes
cholerasois, osteomyelitis in patients with 20
sickle cell Toxin: tetanospasmin
Salmonella spp
4 Strong muscle spasm (spastic paralysis,
Pruritis of scalp on trunk; nits seen on hair tetany)
shaft
Pediculus humanus (lice) Lockjaw (trismus)
5
Pruritis in pubic area; nits seen on hair shaft Risus sardonicus
Phthirus pubis (lice)
6 Opisthotonos
Pruritic, painful and erythematous nodule;
larva may be seen emerging from nodule Respiratory failure
Dermatitis hominis (flies) Clostridium tetani
7 21
Pruritic, erythematous wheal Gas gangrene (clostridial myenecrosis)
Cimex lectularius (bedbugs) -pain, edema and cellulitis with crepitation
8 - hemolysis and jaundice are common
Pruritic, erythematous papules, and linear (alpha toxin)
tracks Clostridium perfringens
Sarcoptes scabei (mites) 22
9 Bright red cheek rash (slapped cheeks)
Ascending paralysis Erythema infectiosum (fifth disease)
Dermacentor (ticks)
10 ParvovirusB19
Wading in floodwaters 23
Leptospira interrogans In children with sickle cell
11 Aplastic crisis
Swimming in lakes
Naegleria fowleri Parvovirus B19
12 24
Unpasteurized milk 2nd trimester: hydrops fetalis
Listeria monocytogenes Fetal infection
13
AIDS Parvovirus B19
Cryptococcus neoformans 25
14 Formation of cytoplasmic vacuole
Ventriculoperitoneal shunt (koilocytes)
Staphylococcus epidermidis Human papilloma virus
15 26
Head trauma Skin and plantar warts
HPV 1-4
Otitis media 27
Streptococcus pneumoniae Anogenital warts (condylomata acuminata)
16
Living in close quarters Most common viral STD
Neisseria meningitidis HPV-6 and 11
17 28
Unvaccinated children Carcinoma of cervix, penis and anus, vulva
Haemophilus influenzae HPV-16,18,31,33
18 29
Prominent thick, gray, pseudomembranes Multinucleated giant cells on Tzanck smear
over tonsils and throat
COWDRY type A bodies on brain biopsy
Complications: airway obstruction, Herpes simplex virus
myocarditis, cranial nerve and/or muscle 30
paralysis Gingivostomatitis, herpes labialis,
Corynebacterium diphtheriae keratoconjunctivitis, temporal lobe
19 encephalitis, herpes whitlow (fingers),
Tumbling motility herpes gladiatorum (trunk)
HSV-1
Early-onset neonatal listeriosis 31
(granulomatosis infantiseptica) Genital herpes
HSV-2
Late-onset neonatal meningitis 32
Replicates in motor neurons in anterior
Adult meningitis horm cells of spinal cord, causing paralysis
Poliovirus Clinical presentation: fever, myalgias,
33 headache, pharyngitis, and cough
Herpangina, hand-foot-and-mouth disease,
hemorrhagic conjunctivitis Complications: staphylococcal pneumonia,
Coxsackie virus type A Reye's syndrome
34 Influenza virus
Myocarditis and pericarditis 45
HP: Warthin-Finkeldey bodies
Most common cause of aseptic meningitis
(most common cause is enterovirus) Pathognomonic Koplik spots (brightn red
Coxsackie virus type B lesions with a white, central dot on buccal
35 mucosa
Centrifugal rash 2 weeks after respiratory
infection (dewdrop on a rose appearance) Maculopapular rash

SHINGLES occurs during reactivation Complications: encephalitis, pneumonia,

subacute sclerosing, panencephalitis
Site of latency: dorsal root ganglion Measles virus
Varicella zoster virus 46
36 Tender swelling of the parotid glands
Most common cause of congenital (parotitis)
abnormalities Increase in pain when drinking citrus fruits
Congenital CMV infection
37 Complications: orchitis, meningitis
Heterophil-negative mononucleosis Mumps virus
47
CMV Most important cause of pneumonia and
bronchiolitis in infants
Systemic CMV infections in
immunocompromised patients Severe disease in infants due to
38 immunologic cross reaction with maternal
Kissing disease antibodies

Splenic rupture is a rare complication DOC: Ribovirin

Infectious mononucleosis (EBV) Respiratory syncitial virus
39 48
Malignancies: Burkitt's lymphoma Most prevalent blood-borne pathogen
(Africans), B-cell lymphomas,
nasopharyngeal carcinoma (Chinese), hairy Autoimmune reactions (thyroiditis,
leukoplakia in AIDS patients autoantibodies, MPGN, PCT, DM
EBV
40 Main cause of essential mixed
Infective form: Dane particle cryoglobulinemia

Necrotic hepatocytes (Councilmam bodies) Tx: Ribovirin

Hepatitis C
Cirrhosis and hepatocellular carcinoma 49
Posterior auricular LAD
Associate with autoimmune vasculitides
(polyarthritis nodosa) Immune-complex polyarthritis in adults
Hepatitis B German measles (rubella)
41 50
No chronic carrier state PDA, congenital cataracts, sensorineural
No cirrhosis deafness, mental retardation
No hepatocellular carcinoma Congenital rubella syndrome
High mortality in pregnant woman 51
Hepatitis E Vector: aedes aegypti
42
Most common cause of nonbacterial Influenza like syndrome with maculopapular
diarrhea in adults rash and severe pains in muscles and joints
Norwalk virus (Norovirus) (breakbone fever)
43
Most common cause of childhood diarrhea Hemorrhagic shock due to cross-reacting
Rotavirus antibody during 2nd dengue infection
44 Dengue virus
Capable of undergoing antigenic shifts and 52
drifts Animal reservoir: horseshoe bat
Atypical pneumonia rapidly progressing to
ARDS Sporadic fatal insomnia
Prions
Virus binds to ACE-2 receptor 60
Hypopigmented areas
Chest x-ray: non cavitary "ground glass"
infiltrates Spaghetti and meatballs appearance on
Severe acute respiratory syndrome (SARS) 10% KOH
(Coronavirus) Malassezia Furfur
53 61
HP: Negri bodies Associated occupation: gardener
Sporothrix Schenckii
Confusion, lethargy, hypersalivation, 62
laryngospasm leads to hydrophobia Lung infiltrates, adenopathy or effusions

Invariably fatal when encephalitis develops Erythema nodosum (dessert bumps)

Rabies virus
54 Arthralgias
Characterized by inspiratory stridor, cough
and hoarseness Meningitis
Laryngotracheobronchitis (croup) Coccidioides immitis
63
Parainfluenza virus 1 & 2 Closely mimics TB
55 Chronic pneumonia
Steeple X-ray sign Erythema nodosum
Tongue ulcerations in AIDS patients
Stenosis on subglottic swelling Histoplasma capsulatum
Parainfluenza 1 & 2 64
56 Dimorphic yeast
Infectious proteins route agents Chronic pneumonia
Ulcerated granulomas
Creutzfeldt-Jakob disease (CJD) Lytic bone lesions
Prostatis
Kuru - kuria/guria = to shake Blastomyces dermatidis
65
Variant CJD (vCJD) Oral thrush
Vulvovaginitis (curd-like discharge)
Gerstmann-Straussler-Scheinker (GSS Intertrigo
syndrome) Skin infections (satellite lesions)
Onchomycosis
Fetal familial insomnia Esophagitis
Candida albicans
Sporadic fatal insomnia 66
Prions Primary infection: asymptomatic pneumonia
57 Meningitis
Characterized by inspiratory stridor, cough Encephalitis
and hoarseness India ink
Laryngotracheobronchitis (croup) Thick gelatinous lesion
Soap-bubble lesion in the meninges or
Parainfluenza virus 1 & 2 Virchow-Robin spaces
58 Cryptococcus neoformans
Steeple X-ray sign 67
Aspergilloma (fungus ball) lung cavities
Stenosis on subglottic swelling
Parainfluenza 1 & 2 Allergic bronchopulmonary aspergillosis
59 (ABPA)
Infectious proteins route agents Aspergillus fumigatus
68
Creutzfeldt-Jakob disease (CJD) Mild disease: fever, muscle pain, periorbital
edema, eosinophilia and hemorrhagic
Kuru - kuria/guria = to shake phenomena (subconjunctival, splinter)

Variant CJD (vCJD) Severe disease: myocarditis, encephalitis,

pneumonia, respiratory myositis
Gerstmann-Straussler-Scheinker (GSS Trichinella spiralis
syndrome) 69
Hypopigmented areas
Fetal familial insomnia
Spaghetti and meatballs appearance on Coccidioides immitis
10% KOH 80
Malassezia Furfur Closely mimics TB
70 Chronic pneumonia
Associated occupation: gardener Erythema nodosum
Sporothrix Schenckii Tongue ulcerations in AIDS patients
71 Histoplasma capsulatum
Lung infiltrates, adenopathy or effusions 81
Dimorphic yeast
Erythema nodosum (dessert bumps) Chronic pneumonia
Ulcerated granulomas
Arthralgias Lytic bone lesions
Prostatis
Meningitis Blastomyces dermatidis
Coccidioides immitis 82
72 Oral thrush
Closely mimics TB Vulvovaginitis (curd-like discharge)
Chronic pneumonia Intertrigo
Erythema nodosum Skin infections (satellite lesions)
Tongue ulcerations in AIDS patients Onchomycosis
Histoplasma capsulatum Esophagitis
73 Candida albicans
Dimorphic yeast 83
Chronic pneumonia Primary infection: asymptomatic pneumonia
Ulcerated granulomas Meningitis
Lytic bone lesions Encephalitis
Prostatis India ink
Blastomyces dermatidis Thick gelatinous lesion
74 Soap-bubble lesion in the meninges or
Oral thrush Virchow-Robin spaces
Vulvovaginitis (curd-like discharge) Cryptococcus neoformans
Intertrigo 84
Skin infections (satellite lesions) Aspergilloma (fungus ball) lung cavities
Onchomycosis
Esophagitis Allergic bronchopulmonary aspergillosis
Candida albicans (ABPA)
75 Aspergillus fumigatus
Primary infection: asymptomatic pneumonia 85
Meningitis Hypopigmented areas
Encephalitis
India ink Spaghetti and meatballs appearance on
Thick gelatinous lesion 10% KOH
Soap-bubble lesion in the meninges or Malassezia Furfur
Virchow-Robin spaces 86
Cryptococcus neoformans Associated occupation: gardener
76 Sporothrix Schenckii
Aspergilloma (fungus ball) lung cavities 87
Lung infiltrates, adenopathy or effusions
Allergic bronchopulmonary aspergillosis
(ABPA) Erythema nodosum (dessert bumps)
Aspergillus fumigatus
77 Arthralgias
Hypopigmented areas
Meningitis
Spaghetti and meatballs appearance on Coccidioides immitis
10% KOH 88
Malassezia Furfur Closely mimics TB
78 Chronic pneumonia
Associated occupation: gardener Erythema nodosum
Sporothrix Schenckii Tongue ulcerations in AIDS patients
79 Histoplasma capsulatum
Lung infiltrates, adenopathy or effusions 89
Dimorphic yeast
Erythema nodosum (dessert bumps) Chronic pneumonia
Ulcerated granulomas
Arthralgias Lytic bone lesions
Prostatis
Meningitis Blastomyces dermatidis
90
Oral thrush
Vulvovaginitis (curd-like discharge)
Intertrigo
Skin infections (satellite lesions)
Onchomycosis
Esophagitis
Candida albicans
91
Primary infection: asymptomatic pneumonia
Meningitis
Encephalitis
India ink
Thick gelatinous lesion
Soap-bubble lesion in the meninges or
Virchow-Robin spaces
Cryptococcus neoformans
92
Aspergilloma (fungus ball) lung cavities

Allergic bronchopulmonary aspergillosis

(ABPA)
Aspergillu