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Which of the following clinical findings in a 51-year-old woman is consistent with Graves disease?
- A. Thin hair, exophthalmos, hyperreflexia, and pretibial edema.
- B. Thin hair, exophthalmos, weight gain, and constipation.
- C. Thick hair, bradycardia, weight loss, and dry skin.
- D. Thick hair, bradycardia, weight gain, and constipation.
Correct Answer: A
Rationale: The clinical findings of thin hair, exophthalmos (bulging eyes), hyperreflexia, and pretibial edema are classic manifestations of Graves disease, an autoimmune condition that results in hyperthyroidism. Choice B is incorrect because weight gain and constipation are more indicative of hypothyroidism, not hyperthyroidism seen in Graves disease. Choice C is incorrect as the symptoms described are more characteristic of hypothyroidism, not hyperthyroidism. Choice D is also incorrect as the symptoms listed are not consistent with Graves disease but rather suggest hypothyroidism.
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Anemia of chronic inflammation is generally classified as:
- A. Hypochromic and microcytic.
- B. Hypochromic and macrocytic.
- C. Normochromic and microcytic.
- D. Normochromic and normocytic.
Correct Answer: D
Rationale: Anemia of chronic inflammation is typically characterized by normochromic (normal hemoglobin content) and normocytic (normal cell size) red blood cells. Choice A, hypochromic and microcytic, is incorrect because hypochromic refers to reduced hemoglobin content and microcytic refers to smaller than normal red blood cells, which are not typically seen in anemia of chronic inflammation. Choice B, hypochromic and macrocytic, is also incorrect as macrocytic refers to larger than normal red blood cells. Choice C, normochromic and microcytic, is incorrect because microcytic red blood cells are smaller than normal. Therefore, the correct classification for anemia of chronic inflammation is normochromic and normocytic.
Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?
- A. Eosinophils
- B. Neutrophils
- C. Leukotrienes
- D. Monocytes
Correct Answer: B
Rationale: Neutrophils are the first responders to a bacterial infection. They are phagocytes that engulf and destroy bacteria, playing a crucial role in the early stages of the immune response. Eosinophils are primarily involved in combating parasitic infections and allergic reactions, not bacterial infections. Leukotrienes are signaling molecules that contribute to inflammation and immune responses, but they are not cells. Monocytes are another type of white blood cell that differentiates into macrophages and dendritic cells, playing a role in immune response but not as immediate as neutrophils.
The early stages of atheroma development are characterized by:
- A. macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
- B. accumulation of lipids in the intima (i.e., fatty streak)
- C. accumulation of proteins such as collagen and elastin (i.e., fibrous cap)
- D. development of calcium and a necrotic lipid core
Correct Answer: A
Rationale: The correct answer is A. In the early stages of atheroma development, macrophages accumulate oxidized low-density lipoprotein (LDL) and transform into foam cells, leading to the formation of fatty streaks in the intima of blood vessels. This process is a hallmark of the initial stages of atherosclerosis. Choice B is incorrect as it describes the accumulation of lipids in the intima, which is a later event following foam cell formation. Choice C is also incorrect as it refers to the accumulation of proteins forming the fibrous cap, which occurs at a later stage to stabilize the atheroma. Choice D is incorrect as it describes the development of calcium and a necrotic lipid core, typically seen in advanced atherosclerosis rather than the early stages.
When does pain in the lower extremities due to peripheral artery disease usually worsen?
- A. with rest because blood flow decreases.
- B. with elevation of the extremity because blood is diverted away.
- C. when the leg is in a dependent position because blood pools.
- D. when the leg is touched or massaged because cytokines are released.
Correct Answer: B
Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.
Rhabdomyolysis can result in serious complications. In addition to muscle pain and weakness, a patient will complain of:
- A. paresthesias.
- B. bone pain.
- C. dark urine.
- D. diarrhea.
Correct Answer: C
Rationale: The correct answer is dark urine. Rhabdomyolysis is a condition characterized by the breakdown of muscle tissue, leading to the release of myoglobin into the bloodstream. Myoglobin can cause the urine to appear dark or tea-colored, a condition known as myoglobinuria. This is a classic symptom of rhabdomyolysis. Choices A, B, and D are incorrect as they do not typically present as direct symptoms of rhabdomyolysis. Paresthesias refer to abnormal sensations like tingling or numbness, bone pain is not a primary symptom of rhabdomyolysis, and diarrhea is not a common complaint associated with this condition.