Nokea
In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:
- A. eosinophils
- B. neutrophils
- C. monocytes
- D. cells
Correct Answer: B
Rationale: In chronic obstructive pulmonary disease, the inflammatory response predominantly involves neutrophils. Neutrophils play a key role in COPD due to their involvement in initiating and sustaining the inflammatory process. Eosinophils are more commonly associated with asthma rather than COPD. Monocytes are less involved in the inflammatory response in COPD compared to neutrophils. The choice 'cells' is too broad and vague to be a specific answer in this context.
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Which of the following patients are at higher risk for developing oral cancer?
- A. A female who has taken oral contraceptives for the last 4 years
- B. Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe
- C. An adult female who eats spicy foods regularly
- D. An older adult female who chews gum frequently
Correct Answer: B
Rationale: The correct answer is 'Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe.' Alcohol consumption and tobacco use, such as smoking a pipe, are well-known risk factors for developing oral cancer. These two factors significantly increase the likelihood of developing oral cancer compared to the other choices. Taking oral contraceptives, eating spicy foods regularly, and chewing gum frequently are not established risk factors for oral cancer, making them less likely to lead to the development of this type of cancer.
In which patients would the manifestation of a headache be a sign of a serious underlying disorder?
- A. A 55-year-old man with new onset of headaches that are worse at night and reported mood swings according to his family
- B. A 30-year-old woman with a unilateral throbbing headache with photophobia and nausea
- C. A 60-year-old man with his head feeling full and throbbing and muscle aching around his neck and shoulders
- D. A 40-year-old woman who experiences food cravings, gets irritable, and then develops a pulsatile-like headache on the right side of her head
Correct Answer: A
Rationale: In this scenario, the correct answer is the 55-year-old man with new onset headaches that worsen at night and reported mood swings according to his family. These symptoms, especially when combined with nighttime worsening and mood changes, could indicate a serious underlying disorder such as a brain tumor or increased intracranial pressure. Choice B is incorrect as the unilateral throbbing headache with photophobia and nausea is suggestive of migraine headaches, which are usually not associated with serious underlying disorders. Choice C describes symptoms that are more indicative of tension-type headaches rather than a serious underlying disorder. Choice D presents symptoms that are more likely related to hormonal changes and migraines rather than a serious underlying disorder.
Which of the following eye disorders manifests with red eye, pain, and visual acuity changes?
- A. Bacterial conjunctivitis
- B. Acute closed-angle glaucoma
- C. Chronic open-angle glaucoma
- D. Blepharitis
Correct Answer: B
Rationale: Acute closed-angle glaucoma presents with symptoms such as a red eye, severe pain, and rapid visual acuity changes due to increased intraocular pressure. This condition is considered an ophthalmologic emergency. Bacterial conjunctivitis typically presents with redness, discharge, and irritation but is not associated with severe pain or visual changes. Chronic open-angle glaucoma is usually asymptomatic until advanced stages and does not typically present with acute pain. Blepharitis involves inflammation of the eyelid margins and is characterized by redness and irritation, but it does not cause severe pain or acute visual changes.
Which of the following statements describes an active cellular membrane exchange process?
- A. Sodium moving out of cells and potassium moving into cells
- B. The movement of water from an area of low solute concentration to an area of high solute concentration
- C. The movement of insulin using a protein to travel across the cell membrane
- D. Oxygen moving across the pulmonary capillaries to an area of high carbon dioxide
Correct Answer: A
Rationale: The correct answer is A. In active transport, energy is expended to move substances against their concentration gradient. Sodium moving out of cells and potassium moving into cells is an example of active transport because it requires energy to pump these ions across the cell membrane against their concentration gradients. Choices B, C, and D describe passive processes where substances move along their concentration gradients without the input of energy.
What is the pathophysiologic process responsible for the decreased glomerular filtration rate in a patient with acute glomerulonephritis?
- A. Decreased renal-induced constriction of the renal arteries
- B. Immune complex deposition, increased capillary permeability, and cellular proliferation
- C. Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure
- D. Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis
Correct Answer: B
Rationale: The correct answer is B: Immune complex deposition, increased capillary permeability, and cellular proliferation. Acute glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys. This inflammation leads to the deposition of immune complexes, increased capillary permeability, and cellular proliferation, which collectively contribute to a decreased glomerular filtration rate. Choice A is incorrect as decreased renal-induced constriction of the renal arteries would not directly result in decreased glomerular filtration rate. Choice C is incorrect as necrosis of nephrons due to increased kidney interstitial hydrostatic pressure would affect kidney function differently. Choice D is incorrect as scar tissue formation in the proximal convoluted tubule due to toxin-induced collagen synthesis is not a typical feature of acute glomerulonephritis.