Which of the following statements characterizes irritable bowel syndrome?
- A. Typically does not cause anemia
- B. Not generally associated with intestinal E. coli
- C. Can be associated with anxiety and/or depression
- D. Not often associated with bloody diarrhea
Correct Answer: C
Rationale: Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. While IBS can lead to symptoms like diarrhea or constipation, it typically does not cause anemia (choice A), is not generally associated with intestinal E. coli (choice B), and is not often associated with bloody diarrhea (choice D). However, IBS can indeed be associated with anxiety and/or depression (choice C) due to the gut-brain axis, a bidirectional communication system between the gut and the brain. This association is well-documented in IBS patients, highlighting the importance of considering psychological factors in managing the condition.
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Why does multiple sclerosis manifest as asymmetrical and in different parts of the body?
- A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
- B. Acetylcholine receptors are destroyed by immunoglobulin G.
- C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
- D. Cortical motor cells degenerate.
Correct Answer: C
Rationale: Multiple sclerosis is characterized by the immune system mistakenly attacking the myelin sheath in the central nervous system. This results in the formation of lesions that can occur in different parts of the central nervous system, leading to varied symptoms depending on the location of the damage. Choice A is the correct answer because it accurately describes the pathophysiology of multiple sclerosis. Choices B, C, and D are incorrect because they describe mechanisms or locations that are not associated with the pathogenesis of multiple sclerosis.
What are the signs of thyroid crisis resulting from Graves' disease?
- A. Constipation with gastric distension.
- B. Bradycardia and bradypnea.
- C. Hyperthermia and tachycardia.
- D. Constipation and lethargy.
Correct Answer: C
Rationale: In a thyroid crisis resulting from Graves' disease, the patient typically experiences symptoms such as hyperthermia (elevated body temperature) and tachycardia (rapid heart rate). These symptoms are indicative of the hypermetabolic state seen in thyroid storm. Choices A and D are incorrect as constipation and lethargy are not typical signs of a thyroid crisis; instead, patients with hyperthyroidism often experience diarrhea and agitation. Choice B is incorrect because bradycardia (slow heart rate) and bradypnea (slow breathing rate) are more commonly associated with hypothyroidism rather than a thyroid crisis in Graves' disease.
What is the primary cause of primary hypercholesteremia?
- A. High-density lipoprotein (HDL) defects
- B. Monogenic mutations, sedentary lifestyle, and high cholesterol diet
- C. Polygenic mutations and environmental factors
- D. Low-density lipoprotein (LDL) receptor mutation with defects in breakdown
Correct Answer: D
Rationale: The correct answer is 'Low-density lipoprotein (LDL) receptor mutation with defects in breakdown.' Primary hypercholesteremia is mainly caused by mutations in the LDL receptor, leading to impaired clearance of LDL cholesterol from the blood. This results in high levels of LDL cholesterol in the bloodstream. Choices A, B, and C are incorrect because they do not directly relate to the primary cause of primary hypercholesteremia.
Which of the following birthmarks usually fade or regress as the child gets older?
- A. Hemangiomas
- B. Congenital dermal melanocytosis (i.e., Mongolian spots)
- C. Macular stains
- D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains
Correct Answer: D
Rationale: The correct answer is Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains. These three types of birthmarks are known to fade or regress as the child gets older. Hemangiomas are vascular birthmarks that often shrink and disappear over time. Congenital dermal melanocytosis, commonly known as Mongolian spots, usually fade by adolescence. Macular stains, also called salmon patches, tend to lighten and fade as a child grows. The other choices are incorrect because they do not typically fade or regress with age.
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.