Cardiac Arrest
07-10-2006, 06:30 AM
1- A 10-year-old male presents to the pediatrician because of problems while eating. He can chew food but has problems swallowing the chewed
pieces, and feels them in his throat. A radiographic study is performed that shows normal musculature but abnormal esophageal peristalsis. No masses are seen. Which of the following nerves should be tested for abnormalities?
A. Hypoglossal and phrenic
B. Hypoglossal and splanchnic
C. Glossopharyngeal and vagus
D. Phrenic and vagus
E. Splanchnic and vagus
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2- A 40-year-old man with adult polycystic kidney disease is brought to the emergency room in a coma. CT scan of the head demonstrates a subarachnoid hemorrhage without parenchymal hemorrhage. Which of the following is the most likely source of the bleeding?
A. AV malformation
B. Bridging veins
C. Charcot-Bouchard aneurysm
D. Circle of Willis
E. Middle meningeal artery
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3- An unconscious patient with sepsis in the intensive care unit undergoes a 2-hour period of severe hypotension. Blood chemistries taken during the following 48 hours show rising creatine kinase MB fraction (CK-MB), peaking at 5 times the upper limit of normal. ECG findings are equivocal, with some degree of flat S-T segment depression over several leads. Which of the following is the most likely diagnosis?
A. Prinzmetal angina
B. Stable angina
C. Subendocardial infarction
D. Transmural infarction
E. Unstable angina
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4- A 65 year-old man is admitted to the coronary care unit with a diagnosis of a large myocardial infarct (MI) of the left ventricle. On his 6th postinfarct day, he goes into shock and dies, manifesting signs and symptoms of cardiac tamponade. Which of the following complications is the most likely cause of this patient's death?
A. Aortic dissection
B. Extension of previous MI
C. Fatal arrhythmia
D. Rupture of the left ventricular wall
E. Rupture of papillary muscle
--------------------------------------------------------------------------------
5- A newborn appears normal at birth, but develops vomiting and diarrhea accompanied by jaundice and hepatomegaly within the first few weeks of life. Within months, the baby has obvious cataracts and ascites. The infant is switched to a milk-free diet, which stabilizes but does not completely reverse his condition. By one year of age, he has developed mental retardation. Which of the following is the most likely diagnosis?
A. Cystic fibrosis
B. Galactosemia
C. McArdle's disease
D. Von Gierke's disease
E. Wilson's disease
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6- A 25-year-old man presents with headache, dizziness, and claudication. Blood pressure measurements reveal hypertension in the upper limbs nd
hypotension in the lower limbs. Which of the following additional findings would be most likely in this case?
A. Aortic valvular stenosis
B. Notching of inferior margins of ribs
C. Patent ductus arteriosus
D. Pulmonary valvular stenosis
E. Vasculitis involving the aortic arch
--------------------------------------------------------------------------------
7- A patient has a tiny (0.2 cm), but exquisitely painful tumor under the nail of her index finger. Prior to surgery to remove it, local anesthetic block to a branch of which of the following nerves would be most likely to achieve adequate anesthesia?
A. Axillary nerve
B. Median nerve
C. Musculocutaneous nerve
D. Radial nerve
E. Ulnar nerve
--------------------------------------------------------------------------------
8- Tissue from a spontaneous abortion is submitted to the laboratory, where an astute pathologist notes the presence of mature fetal tissue that contains Barr bodies. The fetus may have had which of the following genotypes?
A. Classic Turner syndrome (45, X)
B. Edward's syndrome (47, XY+1
C. Klinefelter's syndrome (47, XXY)
D. Normal male (46, XY)
E. XYY syndrome (47, XYY)
--------------------------------------------------------------------------------
9- A 78-year-old woman is brought to the emergency department because of slowly developing confusion over the past ten days. Careful physical examination demonstrates a relatively small laceration of the scalp.
CT of the head would be most likely to reveal which of the following?
A. Epidural hematoma
B. Mixed parenchymal and subarachnoid hemorrhage
C. Multiple tiny hemorrhages of the putamen
D. Subarachnoid hemorrhage
E. Subdural hematoma
--------------------------------------------------------------------------------
10- A 22-year-old woman presents to her physician with amenorrhea, weight loss, anxiety, tremor, heat intolerance and palpitations. Laboratory examination is consistent with hyperthyroidism, and the physician prescribes propylthiouracil. The patient's response to propylthiouracil is disappointing, and the symptoms recur, then worsen. Subtotal thyroidectomy is successfully performed, but following the surgery, the woman is extremely hoarse, and can barely speak above a whisper. This hoarseness is most probably related to damage to a branch which of the following cranial nerves?
A. Facial
B. Glossopharyngeal
C. Hypoglossal
D. Trigeminal
E. Vagus
pieces, and feels them in his throat. A radiographic study is performed that shows normal musculature but abnormal esophageal peristalsis. No masses are seen. Which of the following nerves should be tested for abnormalities?
A. Hypoglossal and phrenic
B. Hypoglossal and splanchnic
C. Glossopharyngeal and vagus
D. Phrenic and vagus
E. Splanchnic and vagus
--------------------------------------------------------------------------------
2- A 40-year-old man with adult polycystic kidney disease is brought to the emergency room in a coma. CT scan of the head demonstrates a subarachnoid hemorrhage without parenchymal hemorrhage. Which of the following is the most likely source of the bleeding?
A. AV malformation
B. Bridging veins
C. Charcot-Bouchard aneurysm
D. Circle of Willis
E. Middle meningeal artery
--------------------------------------------------------------------------------
3- An unconscious patient with sepsis in the intensive care unit undergoes a 2-hour period of severe hypotension. Blood chemistries taken during the following 48 hours show rising creatine kinase MB fraction (CK-MB), peaking at 5 times the upper limit of normal. ECG findings are equivocal, with some degree of flat S-T segment depression over several leads. Which of the following is the most likely diagnosis?
A. Prinzmetal angina
B. Stable angina
C. Subendocardial infarction
D. Transmural infarction
E. Unstable angina
--------------------------------------------------------------------------------
4- A 65 year-old man is admitted to the coronary care unit with a diagnosis of a large myocardial infarct (MI) of the left ventricle. On his 6th postinfarct day, he goes into shock and dies, manifesting signs and symptoms of cardiac tamponade. Which of the following complications is the most likely cause of this patient's death?
A. Aortic dissection
B. Extension of previous MI
C. Fatal arrhythmia
D. Rupture of the left ventricular wall
E. Rupture of papillary muscle
--------------------------------------------------------------------------------
5- A newborn appears normal at birth, but develops vomiting and diarrhea accompanied by jaundice and hepatomegaly within the first few weeks of life. Within months, the baby has obvious cataracts and ascites. The infant is switched to a milk-free diet, which stabilizes but does not completely reverse his condition. By one year of age, he has developed mental retardation. Which of the following is the most likely diagnosis?
A. Cystic fibrosis
B. Galactosemia
C. McArdle's disease
D. Von Gierke's disease
E. Wilson's disease
--------------------------------------------------------------------------------
6- A 25-year-old man presents with headache, dizziness, and claudication. Blood pressure measurements reveal hypertension in the upper limbs nd
hypotension in the lower limbs. Which of the following additional findings would be most likely in this case?
A. Aortic valvular stenosis
B. Notching of inferior margins of ribs
C. Patent ductus arteriosus
D. Pulmonary valvular stenosis
E. Vasculitis involving the aortic arch
--------------------------------------------------------------------------------
7- A patient has a tiny (0.2 cm), but exquisitely painful tumor under the nail of her index finger. Prior to surgery to remove it, local anesthetic block to a branch of which of the following nerves would be most likely to achieve adequate anesthesia?
A. Axillary nerve
B. Median nerve
C. Musculocutaneous nerve
D. Radial nerve
E. Ulnar nerve
--------------------------------------------------------------------------------
8- Tissue from a spontaneous abortion is submitted to the laboratory, where an astute pathologist notes the presence of mature fetal tissue that contains Barr bodies. The fetus may have had which of the following genotypes?
A. Classic Turner syndrome (45, X)
B. Edward's syndrome (47, XY+1
C. Klinefelter's syndrome (47, XXY)
D. Normal male (46, XY)
E. XYY syndrome (47, XYY)
--------------------------------------------------------------------------------
9- A 78-year-old woman is brought to the emergency department because of slowly developing confusion over the past ten days. Careful physical examination demonstrates a relatively small laceration of the scalp.
CT of the head would be most likely to reveal which of the following?
A. Epidural hematoma
B. Mixed parenchymal and subarachnoid hemorrhage
C. Multiple tiny hemorrhages of the putamen
D. Subarachnoid hemorrhage
E. Subdural hematoma
--------------------------------------------------------------------------------
10- A 22-year-old woman presents to her physician with amenorrhea, weight loss, anxiety, tremor, heat intolerance and palpitations. Laboratory examination is consistent with hyperthyroidism, and the physician prescribes propylthiouracil. The patient's response to propylthiouracil is disappointing, and the symptoms recur, then worsen. Subtotal thyroidectomy is successfully performed, but following the surgery, the woman is extremely hoarse, and can barely speak above a whisper. This hoarseness is most probably related to damage to a branch which of the following cranial nerves?
A. Facial
B. Glossopharyngeal
C. Hypoglossal
D. Trigeminal
E. Vagus