Some Pathophysiology questions... test your medical knowledge!

[missDDS]

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1.Jane is a compulsive jogger, jogging for 2 hours daily. She is underweight. You would expect her to have
a) heavy menstrual flow
b) painful cramps
c)amenorrhea
d) elevated levels of LH,FSH, Cortisol
e) none of the above

2.Dan was lost in the desert for 2 days and didnt drink for 54 hours. After he is brought to the hospital his diagnostics evaluations will rveeal:
a) increased blood volume
b) elevated ADH
c) normal urine production
d) decreased blood osmolarity
e) elevated BUN, Na+ and K+

3.Jill has anorexia nervosa. She was rushed to the ER because of cardias arrhythmias. Blood and urine specimens indicate Ketonemia and Ketonuria. The arrythmias are due to:
a) elevated levels of Plasma ph
b)metabolic alkalosis
c)ketoacidosis
d) high blood pressure
e) hypoglycemia

4. Joe is playing football. During tackle he breaks a rib and is having difficulty breathing Joe is probably suffering from
a) collapsed trachea
b) a bruised diaphragm
c) pnuemothorax
d)obstruction of bronchi
e) all of the above


5. Dr. H prescribed a broad spectrum antibiotic for Kim's nose infection. 3 weeks later Kim complained of nosebleeds. Which is a possible cause:
a) the treatment caused widespread damage to nose vessels
b) the antibiotic caused damage to the nose epithilium
c) board spectrum antibiotic killed the normal microbial flora that synthesize vitamin K , a precursor of prothrombin used for blood clottting
d) all of the above
e) none of the above


Try to answer as many as you can. Thanks!

 

[niranjan162]

r u trying to get someone to do ur homework for you?

 

[missDDS]

r u trying to get someone to do ur homework for you?

no i did a lot of research on these and have narrowed most of them down to 2 but cant decide between the last 2 so i thought maybe someone would like to help me 🙂

 

[JaggerPlate]

Pre-dental huh .... maybe you can help me with one:

Joe's Mommy brings him into the local dental office complaining about a tooth ache. Joe tells Dr Crentist, DDS, that he drinks a ton of soda, eats loads of sugar, and isn't fond of brushing his teeth. What should Dr Crentist tell Joe to stop doing:

a. Drinking soda
b. Eating candy
c. Never brushing his teeth
d. a, b, and c
e. Eating vegetables.

hehehehe just kidding. I didn't think those questions were very hard actually, but I'm WAY to scared to answer them (plus I looked over them fast) because I don't want a med student beat down.

 

[DannMann99]

1.Jane is a compulsive jogger, jogging for 2 hours daily. She is underweight. You would expect her to have
a) heavy menstrual flow
b) painful cramps
c)amenorrhea
d) elevated levels of LH,FSH, Cortisol
e) none of the above
**depends how underweight we are talking about though

2.Dan was lost in the desert for 2 days and didnt drink for 54 hours. After he is brought to the hospital his diagnostics evaluations will rveeal:
a) increased blood volume
b) elevated ADH
c) normal urine production
d) decreased blood osmolarity
e) elevated BUN, Na+ and K+

3.Jill has anorexia nervosa. She was rushed to the ER because of cardias arrhythmias. Blood and urine specimens indicate Ketonemia and Ketonuria. The arrythmias are due to:
a) elevated levels of Plasma ph
b)metabolic alkalosis
c)ketoacidosis
d) high blood pressure
e) hypoglycemia

4. Joe is playing football. During tackle he breaks a rib and is having difficulty breathing Joe is probably suffering from
a) collapsed trachea
b) a bruised diaphragm
c) pnuemothorax
d)obstruction of bronchi
e) all of the above


5. Dr. H prescribed a broad spectrum antibiotic for Kim's nose infection. 3 weeks later Kim complained of nosebleeds. Which is a possible cause:
a) the treatment caused widespread damage to nose vessels
b) the antibiotic caused damage to the nose epithilium
c) board spectrum antibiotic killed the normal microbial flora that synthesize vitamin K , a precursor of prothrombin used for blood clottting
d) all of the above
e) none of the above

birthday cake

 

[missDDS]

Thank you very much,
for 4 i was thinking that any of those conditions such as obstruction of bronchi or bruised diapragm could occur, while collapsed trachea is very rare. for the last one I was between b and c for this one, as i thought that it was possible to have antibiotic damage to the epithilium as well, although i wasnt sure.

Thank you again for your help, it is greatly appreciated 🙂

 

[spicedmanna]

for 4 i was thinking that any of those conditions such as obstruction of bronchi or bruised diapragm could occur, while collapsed trachea is very rare.

The most likely scenario is damage to the lung parenchyma secondary to the rib fx, which can lead to a pneumothorax, or air entering the pleural space. This results in dyspnea (difficulty breathing). Depending on the conditions, this may develop into a tension pneumo, where air becomes trapped and accumulates in the pleural cavity. This can cause compression of the lung on the side of the trauma, leading to the subsequent complete collapse of the lung and tracheal deviation to the opposite side of the injury. The solution for a tension pneumo is emergent thoracocentesis (usually done in the prehospital setting) and insertion of a chest tube to decompress the space.

 

[DannMann99]

4. Joe is playing football. During tackle he breaks a rib and is having difficulty breathing Joe is probably suffering from
a) collapsed trachea
-hes having difficulty breathing... collapsed trachea he wouldn't breath at all
b) a bruised diaphragm
-bruised diaphragm could probably be diagnosed (depending on which rib was fractured) but it probably wouldn't give him trouble breathing only minor pain, also i would imagine it would present with other findings...
c) pnuemothorax
-one of your lungs or lobes flattens out and cant reexpand to let air in... fairly common in these situations, would give him trouble breathing.
d)obstruction of bronchi
obstructed with what... bronchi are big enough to fit a finger in and surrounded by cartilage which is pretty darn tough, too big to be obstructed by edema... and where would the foreign body have come from. Either way he'll probably need a chest Xray but id be working with the assumption that it was a pneumo. (though there is some insignificant chance it was a FBO)
e) all of the above
-dummy answer

5. Dr. H prescribed a broad spectrum antibiotic for Kim's nose infection. 3 weeks later Kim complained of nosebleeds. Which is a possible cause:
a) the treatment caused widespread damage to nose vessels
-antibiotics fight bacteria by interrupting key processes that differ between eukaryotic (our) cells, and prokaryotic (bac) cells... there may be some side effects but i doubt you'll see widespread capillary damage in an antibiotic
b) the antibiotic caused damage to the nose epithilium
-again... widespread epithelial damage? really? I doubt they would give such a HARSH treatment for a bac they haven't even identified yet (they gave broad spec)
c) board spectrum antibiotic killed the normal microbial flora that synthesize vitamin K , a precursor of prothrombin used for blood clottting
-now this is CERTAINLY the best possible choice. Bacs synthesize vitamin K, and Vit K is an important pro-clot factor, the doc probably also wants to reassure her about her GI issues she's too embarrassed to tell the doc about.
d) all of the above
e) none of the above
-dummy answers

hope that helped.

So what was this for anyway out of curiosity

 

[spicedmanna]

Well, you can get sometimes get pretty bad reactions to ABx's, such as Stevens-Johnson Syndrome, but this is a systemic hypersensitivity reaction rather than local. I've never heard of a localized nasal epithelial or blood vessel damage as the result of general ABx use. I agree that the most likely answer is destruction of the intestinal bacteria which produces vitamin K. Some ABx, for instance clindamycin, really wreck havoc on your intestinal flora. It's common to recommend the use of probiotics to recolonize the gut. In our patient's case, a simple vitamin K shot, avoidance of ASA and other similar anti-clotting agents, and a probiotic regimen would probably go a long way.

 

[missDDS]

Thank you very much, really cleared a lot of things up.
Its for a pathophysiology class..

 

[Dmitry Malayev]

2.Dan was lost in the desert for 2 days and didnt drink for 54 hours. After he is brought to the hospital his diagnostics evaluations will rveeal:
a) increased blood volume
b) elevated ADH
c) normal urine production
d) decreased blood osmolarity
e) elevated BUN, Na+ and K+

For #2 why can't it be E?

 

[bkpa2med]

For #2 why can't it be E?

Because he's not in kidney failure.

 

[DannMann99]

ah pre-dents make me lol

 

[DannMann99]

2.Dan was lost in the desert for 2 days and didnt drink for 54 hours. After he is brought to the hospital his diagnostics evaluations will rveeal:
a) increased blood volume
-no. dehydration presents with hypotension
b) elevated ADH
-antidiuretic hormone? I can believe that, you don't want to pee if you dont have lots of water, so concentrate that urine!
c) normal urine production
-again... it would be more concentrated
d) decreased blood osmolarity
-no
e) elevated BUN, Na+ and K+
-BUN would be elevated
-Na could be elevated
-as far as I know dehydration can present with hypokalemia (low K)

Hope that clears it up.

 

[USArmyDoc]

Because he's not in kidney failure.

The dehydration will put him into kidney failure. It will put him into pre-renal failure with a BUN:Creatinine ratio of 20:1. So, it can be E OF hypokalemia was substituted for hyperk. I was debating between the two as well. It is obvious that elevated ADH is correct, but taking the other choices into account E is possible if there was hypokalemia. Again, the person will have decreased blood flow to the kidney secondary to dehydration causing a decrease in GFR.....prerenal failure

BUN & Creatinine will tell you whether or not you are kidney failure. If you do not know those lab values, then how can you say for sure that he is "not in kidney failure?" You can use your clincal suspicion, but still it would be weak. You know he is dehydrated so there is a strong possibility that he is in ARF.