Nokea
The patient returned from a 6-week mission trip to Somalia with complaints of nausea, malaise, fatigue, and achy muscles. Which type of hepatitis is this patient most likely to have contracted?
- A. Hepatitis B (HBV)
- B. Hepatitis C (HCV)
- C. Hepatitis D (HDV)
- D. Hepatitis E (HEV)
Correct Answer: D
Rationale: The correct answer is D: Hepatitis E (HEV). The patient's symptoms of nausea, malaise, fatigue, and muscle aches are consistent with acute hepatitis, and HEV is commonly transmitted through contaminated water in developing countries like Somalia. Hepatitis B (HBV) and C (HCV) are more commonly transmitted through blood or body fluids. Hepatitis D (HDV) requires HBV for replication, making it less likely in this case. In summary, based on the patient's symptoms and travel history, Hepatitis E (HEV) is the most likely cause of the illness.
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Cholesterol is a major component of atherosclerotic plaque. Cholesterol carried by ______ is linked to coronary heart disease.
- A. micelle
- B. chylomicron
- C. low-density lipoprotein (LDL)
- D. high-density lipoprotein (HDL)
Correct Answer: C
Rationale: The correct answer is C: low-density lipoprotein (LDL). LDL is often referred to as "bad cholesterol" because it carries cholesterol from the liver to the cells, leading to the buildup of plaque in the arteries, which can result in coronary heart disease. Micelles are small lipid structures, not carriers of cholesterol. Chylomicrons are large lipoprotein particles that transport dietary fats, not primarily cholesterol. HDL is known as "good cholesterol" as it helps remove cholesterol from the bloodstream back to the liver for excretion, reducing the risk of atherosclerosis.
The intestinal flora is:
- A. Mainly viruses
- B. Mainly found in the duodenum
- C. Needed for normal digestion
- D. Mainly found in the colon
Correct Answer: D
Rationale: The correct answer is D: Mainly found in the colon. Intestinal flora, also known as gut microbiota, is primarily located in the colon. This is because the colon provides an ideal environment for the growth and survival of the diverse array of beneficial bacteria that make up the intestinal flora. These bacteria play a crucial role in various physiological functions, such as digestion, immune system regulation, and vitamin production. Choices A, B, and C are incorrect because intestinal flora are predominantly bacteria (not viruses), are not solely located in the duodenum but throughout the gastrointestinal tract, and are essential for normal digestion, not just needed.
Saliva is needed for:
- A. Digestion of sucrose
- B. Digestion of phospholipids
- C. Ability to speak
- D. Breaking food down into small pieces
Correct Answer: A
Rationale: Saliva contains an enzyme called amylase, which helps break down sucrose (a type of sugar) into glucose and fructose for digestion. Therefore, the correct answer is A. Saliva does not play a significant role in the digestion of phospholipids (B), speaking ability (C), or breaking food down into small pieces (D).
Which of the following mechanisms most accurately describes how pseudo-membranous colitis caused by Clostridium difficile is produced?
- A. elaboration of an enterotoxin following colonization of the colon
- B. ingestion of a preformed toxin
- C. invasion and destruction of mucosa by the organism
- D. host immune response to the organism
Correct Answer: A
Rationale: The correct answer is A because Clostridium difficile produces toxins, specifically enterotoxins, which cause damage to the intestinal mucosa leading to pseudo-membranous colitis. The organism colonizes the colon and then elaborates the toxins, which disrupt the mucosal barrier.
Choice B is incorrect as there is no preformed toxin ingested; the toxin is produced by the organism after colonization. Choice C is incorrect as Clostridium difficile does not invade and destroy the mucosa directly. Choice D is incorrect as the host immune response is a consequence of the toxin production, not the primary mechanism of disease.
The small intestine:
- A. Is shorter than the large intestine
- B. Its internal surface area is smaller than the large intestine
- C. It absorbs less water than the large intestine
- D. It contains bacteria as found in the large intestine
Correct Answer: B
Rationale: The correct answer is B because the small intestine has a larger internal surface area compared to the large intestine due to its extensive folding and villi. This increased surface area enhances nutrient absorption efficiency. Choice A is incorrect as the small intestine is longer than the large intestine. Choice C is incorrect as the small intestine absorbs more water than the large intestine. Choice D is incorrect as the small intestine typically does not contain the same amount of bacteria as the large intestine, which is known for its significant bacterial population.