Dashboard / My courses / GENPATH / Week 4- Hemodynamic Disorders, Thromboembolic Disease, and Shock

/ Quiz- Hemodynamic Disorders, Thromboembolic Disease, and Shock II

Started on Friday, 21 October 2022, 7:00 AM

State Finished
Completed on Friday, 21 October 2022, 7:45 AM
Time taken 45 mins 48 secs
Marks 59.00/77.00
Grade 7.66 out of 10.00 (77%)

Question 1
In an experiment, platelet function is analyzed. A sub
Correct
stance is obtained from the dense body granules of normal
Mark 1.00 out pooled platelets from healthy blood donors. When this sub
of 1.00
stance is added to platelets obtained from patients with a
bleeding disorder, no platelet aggregation occurs. Adding the
substance to platelets from a normal control group induces
platelet aggregation. Which of the following substances is
most likely to produce these effects?

a.
Antithrombin III

b.
Fibronectin

c. Thromboxane A2

d. 
Adenosine diphosphate

e.
Fibrinogen

f.
Plasminogen

Your answer is correct.

The correct answer is:
Adenosine diphosphate
Question 2
A 66-year-old woman has the sudden onset of chest pain
Correct
that radiates to her neck and left arm. On examination 30 min
Mark 1.00 out utes later, she is diaphoretic and hypotensive. Her serum tro
of 1.00
ponin I level is elevated. Which of the following drugs is most
likely to be administered emergently as thrombolytic therapy
for this woman?

a.
Nitric oxide

b.
Acetylsalicylic acid (aspirin)

c. Low-molecular-weight heparin

d. 
Tissue plasminogen activator

e.
Vitamin K

Your answer is correct.

The correct answer is:
Tissue plasminogen activator

Question 3 Liver, hand and forearm are all relatively prone to infarction
Incorrect

Mark 0.00 out Select one:

of 1.00
True 

False

The correct answer is 'False'.

Question 4
In an experiment, thrombus formation is studied in ar
Correct
eas of vascular damage. The propagation of a thrombus in an
Mark 1.00 out area of vascular injury to adjacent normal arteries is prevent
of 1.00
ed. Which of the following substances diminishes thrombus
propagation by activating protein C?

a.
Prothrombin

b.
Tumor necrosis factor (TNF)

c. Thrombomodulin 

d.
Fibrin

e.
Platelet factor 4

f.
Calcium

Your answer is correct.

The correct answer is:
Thrombomodulin
Question 5
A 26-year-old woman has a history of frequent nose
Correct
bleeds and increased menstrual blood flow. On physical exam
Mark 1.00 out ination, petechiae and purpura are present on the skin of her
of 1.00
extremities. Laboratory studies show normal partial thrombo
plastin time (PTT), prothrombin time (PT), and platelet count,
but decreased von Willebrand factor activity. This patient
most likely has a derangement in which of the following steps
in hemostasis?

a.
Prothrombin generation

b.
Platelet aggregation

c. Vasoconstriction

d. 
Platelet adhesion

e.
Prothrombin generation

f.
Fibrin polymerization

Your answer is correct.

The correct answer is:
Platelet adhesion
Question 6
A superficial puncture wound from a needlestick injury
Correct
leads to a small amount of bleeding in a healthy person. Sec
Mark 1.00 out onds after this injury occurs, the bleeding stops. Which of the
of 1.00
following mechanisms is most likely to stop small arteriolar
blood loss from this injury?

a.
Platelet aggregation

b.
Protein C activation

c. Vasoconstriction 

d.
Neutrophil chemotaxis

e.
Fibrin polymerization

Your answer is correct.

The correct answer is:
Vasoconstriction

Question 7
A 44-year-old man with dilated cardiomyopathy and
Correct
heart failure develops left atrial mural thrombosis. He develops
Mark 1.00 out the complication shown in the figure, manifested by hematuria.
of 1.00
Which of the following is the best term for this complication?
a. 
Ischemic infarct

b.
Multiorgan failure

c.
Liquefactive necrosis

d.
Abscess
 e.
Venous thrombosis

Your answer is correct.

The correct answer is:
Ischemic infarct

Question 8
A 59-year-old woman with a history of diabetes mellitus
Correct
had a myocardial infarction 3 months ago. Her BMI is 35. She
Mark 1.00 out is now taking a low dose of aspirin to reduce the risk for recur
of 1.00
rent arterial thrombosis. On which of the following steps in
hemostasis does aspirin have its greatest effect?

a. 
Aggregation of platelets

b.
Synthesis of von Willebrand factor

c.
Adhesion of platelets to collagen

d.
Production of tissue factor

e.
Synthesis of antithrombin III

Your answer is correct.

The correct answer is:
Aggregation of platelets
Question 9
A 21-year-old woman has had multiple episodes of deep
Correct
venous thrombosis during the past 10 years and one episode
Mark 1.00 out of pulmonary thromboembolism during the past year. Labora
of 1.00
tory tests show that her prothrombin time (PT), partial throm
boplastin time (PTT), platelet count, and platelet function
studies all are normal. Which of the following risk factors is
the most common cause for such a coagulopathy?

a.
Hyperhomocysteinemia

b.
Smoking cigarettes

c. Mutation in protein C

d. 
Factor V mutation

e.
Oral contraceptive use

f.
Occult malignancy

g.
Antithrombin III deficiency

Your answer is correct.

The correct answer is:
Factor V mutation

Question 10 It takes 24 hours for the dead tissue to show microscopic evidence of necrosis
Incorrect

Mark 0.00 out Select one:

of 1.00
True 

False

The correct answer is 'False'.

Question 11 In hypovolemic and cardiogenic shock, patients exhibit hypotension, a weak rapid pulse, tachypnea, and cool,
Correct clammy, cyanotic skin
Mark 1.00 out
of 1.00 Select one:
True 

False

The correct answer is 'True'.

Question 12
A 45-year-old woman who works while standing for
Correct
long periods notices at the end of her 8-hour shift that her
Mark 1.00 out lower legs and feet are swollen, although there was no swell
of 1.00
ing at the beginning of the day. There is no pain or erythema
associated with this swelling. She is otherwise healthy and
takes no medications; laboratory testing reveals normal liver
and renal function. Which of the following mechanisms best
explains this phenomenon?

a.
Excessive free water intake

b.
Secondary aldosteronism

c.
Lymphatic obstruction

d. 
Increased hydrostatic pressure

e.
Hypoalbuminemia

Your answer is correct.

The correct answer is:
Increased hydrostatic pressure
Question 13
A 75-year-old man is hospitalized after falling and frac
Correct
turing his left femoral trochanter. Two weeks later, the left leg
Mark 1.00 out is swollen, particularly below the knee. He experiences pain
of 1.00
on movement of the leg; on palpation, there is swelling and
tenderness. Which of the following complications is most like
ly to occur in this man?

a.
Hematoma of the thigh

b.
Disseminated intravascular coagulation

c. Pulmonary thromboembolism 

d.
Fat embolism syndrome

e.
Gangrenous necrosis of the foot

Your answer is correct.

The correct answer is:
Pulmonary thromboembolism
Question 14
A 20-year-old man develops palpitations within 1 hour
Correct
after a gunshot wound to the abdomen. On examination his
Mark 1.00 out heart rate is 112/minute and blood pressure 80/30 mm Hg.
of 1.00
His skin is cool and clammy to the touch. Which of the fol
lowing organ-specific changes is most likely to occur within
2 days after this injury?

a. 
Pulmonary diffuse alveolar damage

b.
Gangrenous necrosis of the lower legs

c. Renal passive congestion

d.
Cerebral basal ganglia hemorrhage

e.
Acute hepatic infarction

Your answer is correct.

The correct answer is:
Pulmonary diffuse alveolar damage

Question 15 Arterial emboli come to rest in the lower extremities (75%) or the brain (10%)
Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 16 A large volume of air, generally more than 100 mL, is necessary to produce a clinical effect in the pulmonary
Incorrect circulation
Mark 0.00 out
of 1.00 Select one:
True

False 

The correct answer is 'True'.

Question 17 Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection
Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 18 Shock is a state of circulatory failure that impairs tissue perfusion and leads to cellular hypoxia
Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 19
A 28-year-old woman with a 15-year history of recur
Correct
rent thrombosis from a prothrombin gene mutation develops
Mark 1.00 out septicemia after a urinary tract infection with Pseudomonas
of 1.00
aeruginosa. She develops multiple infarcts and organ failure
over the next 2 weeks. Which of the following organs is most
likely to be spared from the effects of ischemic injury in this
woman?

a. 
Liver

b.
Kidney

c.
Spleen

d.
Brain

e.
Heart

Your answer is correct.

The correct answer is:
Liver
Question 20
A 94-year-old woman has dyspnea and an increasing
Correct
cough with frothy sputum production for the past month. She
Mark 1.00 out is afebrile. A chest radiograph shows the findings in the figure.
of 1.00
Which of the following is the most likely mechanism for
development of her pulmonary infiltrates?

a.
Hypoalbuminemia


 b. 
Increased hydrostatic pressure

c.
Pulmonary venous obstruction

d.
Decreased sodium intake

e.
Inflammation

Your answer is correct.

The correct answer is:
Increased hydrostatic pressure

Question 21 The pathogenesis of fat embolism syndrome involves only mechanical obstruction
Incorrect

Mark 0.00 out Select one:

of 1.00
True 

False

The correct answer is 'False'.

Question 22
A 77-year-old woman has a brief fainting episode. She
Correct
was diagnosed 1 year ago with pancreatic adenocarcinoma.
Mark 1.00 out On auscultation of her chest, a heart murmur is heard. Echo
of 1.00
cardiography shows a 1-cm nodular lesion on the superior as
pect of an intact anterior mitral valve leaflet. A blood culture
is negative. Which of the following terms best describes this
mitral valve lesion?

a. 
Vegetation

b.
Mural thrombus

c. Chronic passive congestion

d.
Atheroma

e.
Myxoma

f.
Myxoma

Your answer is correct.

The correct answer is:
Vegetation
Question 23
A 15-year-old girl incurs a cut to the sole of her foot
Correct
after stepping on a piece of broken glass. On examination, a
Mark 1.00 out superficial 0.5-cm laceration ceases to bleed within 5 minutes
of 1.00
after application of local pressure. Which of the following
substances is released by endothelium and is most likely to
counteract platelet aggregation near this site of injury?

a.
Thromboxane

b.
Thrombomodulin

c. Platelet-activating factor

d.
Glycoprotein IIb/IIIa

e. 
Prostacyclin

f.
Tissue-type plasminogen activator

Your answer is correct.

The correct answer is:
Prostacyclin
Question 24
A 7-year-old boy has had increasing lethargy for a week.
Correct
On physical examination, he has periorbital edema and pit
Mark 1.00 out ting edema at the ankles, but is normotensive and afebrile.
of 1.00
Laboratory studies show marked albuminuria. He is given a
thiazide diuretic and his urine output increases and his edema
resolves. Which of the following changes most likely potenti
ated his edema?

a. 
Increased salt retention

b.
Decreased renin

c. Decreased antidiuretic hormone

d.
Increased cortisol

e.
Increased albumin

f.
Decreased aldosterone

Your answer is correct.

The correct answer is:
Increased salt retention
Question 25
A 23-year-old woman has had altered consciousness and
Correct
slurred speech for the past 24 hours. A head CT scan shows a
Mark 1.00 out right temporal hemorrhagic infarction. Cerebral angiography
of 1.00
shows a distal right middle cerebral arterial occlusion. Within
the past 3 years, she has had an episode of pulmonary embo
lism. A pregnancy 18 months ago ended in miscarriage. Labo
ratory studies show a false-positive serologic test for syphilis,
normal prothrombin time (PT), elevated partial thromboplas
tin time (PTT), and normal platelet count. Which of the follow
ing is the most likely cause of these findings?

a.
Hypercholesterolemia

b.
Disseminated intravascular coagulation

c. Factor V mutation

d.
Von Willebrand disease

e. 
Antiphospholipid antibody

Your answer is correct.

The correct answer is:
Antiphospholipid antibody

Question 26 Most pulmonary emboli (60% to 80%) are clinically manifested because they are big
Incorrect

Mark 0.00 out Select one:

of 1.00
True 

False

The correct answer is 'False'.

Question 27
A 30-year-old man is cutting wood alone in the forest
Correct
and incurs a deep cut to his leg from his chain saw. He loses a
Mark 1.00 out large amount of blood. He is not found until the next day. A
of 1.00
marked increase in which of the following blood analytes is
most likely to indicate that he has reached an irreversible stage
of shock?

a.
Antidiuretic hormone

b.
Prothrombin

c. Catecholamines

d.
Bicarbonate

e. 
Lactate dehydrogenase

Your answer is correct.

The correct answer is:
Lactate dehydrogenase
Question 28
Stages of Shock
Correct

Mark 3.00 out

of 3.00
reflex compensatory mechanisms are activated and vital organ
An initial nonprogressive stage
perfusion is maintained


tissue hypoperfusion and onset of worsening circulatory and metabolic

derange A progressive stage
ment 

cellular and tissue injury is so severe An irreversible stage



Your answer is correct.

The correct answer is:
reflex compensatory mechanisms are activated and vital organ
perfusion is maintained
→ An initial nonprogressive stage,
tissue hypoperfusion and onset of worsening circulatory and metabolic derange
ment
→ A progressive stage,
cellular and tissue injury is so severe
→ An irreversible stage

Question 29 Systemic inflammatory response syndrome (SIRS) is a sepsis-like condition associated with systemic
Incorrect inflammation that may be triggered by a variety of microbial insults
Mark 0.00 out
of 1.00 Select one:
True 

False

The correct answer is 'False'.

Question 30 White infarcts occur with arterial occlusions in solid organs with end-arterial circulation
Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 31 In general, the patient who has had one PE is at high risk for more emboli
Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 32
A 59-year-old woman with hyperlipidemia has had
Correct
anginal pain for the past 24 hours. Laboratory findings show
Mark 1.00 out no increase in serum troponin I or creatine kinase–MB. She is
of 1.00
in stable condition 2 weeks later and has no chest pain, but
a small artery in the epicardium has undergone the changes
seen in the figure. Which of the following terms best describes
this finding in this epicardial artery?

a.
Mural thrombosis
 b.
Cholesterol embolization

c. 
Organization with occlusion

d.
Chronic passive congestion

e.
Fat embolism syndrome

f. Air embolus

g.
Phlebothrombosis

Your answer is correct.

The correct answer is:
Organization with occlusion

Question 33
Factors That Influence Development of an Infarct
Correct

Mark 1.00 out

of 1.00
a. Rate of occlusion

b.
Anatomy of the vascular supply

c.
Hypoxemia

d. All the above are correct 

e.
Tissue vulnerability to hypoxia

Your answer is correct.

The correct answer is:
All the above are correct
Question 34
A 55-year-old woman following major abdominal sur
Correct
gery has had discomfort and swelling of her left leg for the
Mark 1.00 out past week. On physical examination, the leg is slightly diffi
of 1.00
cult to move, and on palpation there is tenderness. A Doppler
sonogram shows thrombosis of deep left leg veins. Which of
the following mechanisms is most likely to contribute to her
condition?

a. 
Immobilization

b.
Hypercalcemia

c. Ingestion of aspirin

d. Nitric oxide release

e.
Turbulent blood flow

Your answer is correct.

The correct answer is:
Immobilization

Question 35 Renal and splenic circulations are end-arterial, and vascular obstruction generally causes tissue death
Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 36 Pulmonary emboli originate from DVT and are the most common form of thromboembolic disease
Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 37
Major Types of Shock
Partially
correct

Mark 2.00 out

of 3.00 toxic shock syndrome
anaphylactic 

Fluid loss
Hypovolemic 

Pulmonary embolism
Cardiogenic 

Your answer is partially correct.

You have correctly selected 2.
The correct answer is:
toxic shock syndrome
→ Septic,
Fluid loss
→ Hypovolemic,
Pulmonary embolism
→ Cardiogenic

Question 38 Thrombi from DVT are carried through progressively larger veins and the left side of the heart before
Incorrect slamming into the pulmonary arterial vasculature
Mark 0.00 out
of 1.00 Select one:
True 

False

The correct answer is 'False'.

Question 39 Red infarcts occur when flow is reestablished to a site of previous arterial occlusion and necrosis (e.g.,
Correct following angioplasty of an arterial obstruction)
Mark 1.00 out
of 1.00 Select one:
True 

False

The correct answer is 'True'.

Question 40 Neurons undergo irreversible damage when deprived of their blood supply for only 3 to 4 minutes
Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 41
A 12-year-old boy has a 10-year history of multiple soft
Correct
tissue hemorrhages and acute upper airway obstruction from
Mark 1.00 out hematoma formation in the neck. On physical examination, he
of 1.00
has decreased range of motion of the large joints, particularly
the knees and ankles. He has no petechiae or purpura of the
skin. Laboratory studies show normal prothrombin time, el
evated partial thromboplastin time (PTT), and normal platelet
count, but markedly decreased factor VIII activity. Which of
the following mechanisms best describes the development of
his disease?

a.
Decrease in membrane phospholipid

b.
Inability to neutralize antithrombin III

c.
Failure of fibrin polymerization

d.
Inability of platelets to release thromboxane A2

e. 
Decrease in production of thrombin

f.
Failure of platelet aggregation

Your answer is correct.

The correct answer is:
Decrease in production of thrombin
Question 42 An infarct is an area of ischemic necrosis caused by occlu sion of either the arterial supply only
Correct

Mark 1.00 out Select one:

of 1.00
True

False 

The correct answer is 'False'.

Question 43
An 85-year-old man falls in the bathtub and strikes the
Correct
back of his head. Over the next 24 hours, he becomes increas
Mark 1.00 out ingly somnolent. A head CT scan shows an accumulation of
of 1.00
fluid beneath the dura, compressing the left cerebral hemi
sphere. Which of the following terms best describes this col
lection of fluid?

a.
Congestion

b.
Ecchymosis

c.
Petechiae

d.
Purpura

e. 
Hematoma

Your answer is correct.

The correct answer is:
Hematoma
Question 44
A 31-year-old man is on a scuba diving trip and de
Correct
scends to a depth of 50 m in the Blue Hole off the coast of Be
Mark 1.00 out lize. After 30 minutes, he has a malfunction in his equipment
of 1.00
and quickly returns to the boat on the surface. He develops
difficulty breathing within 5 minutes, with dyspnea and sub
sternal chest pain, followed by a severe headache and vertigo.
An hour later, he develops severe, painful myalgias and ar
thralgias. These symptoms abate within 24 hours. Which of
the following occluding his arterioles is the most likely cause
of his findings?

a.
Ruptured atheromatous plaque

b. 
Nitrogen gas bubbles

c. Platelet thrombi

d. Fat globules

e.
Fibrin clots

Your answer is correct.

The correct answer is:
Nitrogen gas bubbles
Question 45
A 37-year-old woman has noticed a lump in her left
Correct
breast over the past 2 months. On physical examination, the
Mark 1.00 out skin overlying the left breast is thickened, reddish orange,
of 1.00
and pitted. Mammography shows a 3-cm underlying density.
A fine-needle aspirate of the density is performed and on mi
croscopic examination shows carcinoma. Which of the follow
ing mechanisms best explains the gross appearance of the skin
of her left breast?

a.
Chronic inflammation

b.
Ischemic necrosis

c. Venous thrombosis

d. 
Lymphatic obstruction

e.
Chronic passive congestion

Your answer is correct.

The correct answer is:
Lymphatic obstruction

Question 46 The central nervous system infarction results in liquefactive necrosis

Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 47
A 32-year-old man is involved in a vehicular accident
Correct
and sustains fractures of the right femur and tibia and the left
Mark 1.00 out humerus. The fractures are stabilized surgically. He is in stable
of 1.00
condition for 2 days, but then suddenly becomes severely dys
pneic. Which of the following complications from his injuries
is the most likely cause of his sudden respiratory difficulty?

a.
Cardiac tamponade

b. 
Fat embolism

c. Pulmonary edema

d.
Right hemothorax

e.
Pulmonary infarction

Your answer is correct.

The correct answer is:
Fat embolism

Question 48 Multiple emboli over time may cause pulmonary hypertension and right ventricular failure
Incorrect

Mark 0.00 out Select one:

of 1.00
True

False 

The correct answer is 'True'.

Question 49
A 50-year-old man suffers an infarction of the anterior
Correct
left ventricular wall. He receives therapy with anti-arrhythmic
Mark 1.00 out and pressor agents. He is in stable condition until he develops
of 1.00
severe breathlessness 3 days later. An echocardiogram shows
a markedly decreased ejection fraction. Representative chest
radiographic findings are shown in the figure above. Which of
the following microscopic changes is most likely to be present
in his lungs?

a.
Alveolar wall fibrosis

b.
Alveolar neutrophilic exudate

c. Pleural fibrosis

d.
Pleural space transudate

e.
Pleural space neutrophilic exudate

f. 
Alveolar transudate

Your answer is correct.

The correct answer is:
Alveolar transudate

Question 50
A 65-year-old woman sustained fractures of the right fe
Correct
mur, pelvis, and left humerus in a motor vehicle collision. The
Mark 1.00 out fractures were stabilized, and the patient’s recovery was un
of 1.00
eventful. During a physical examination 3 weeks later, while
still in the hospital, she has swelling and warmth in the left
leg, and there is local pain and tenderness in the left thigh.
Which of the following processes, as shown in the figure, is
most likely occurring in her left femoral vein?
 a. Inflammation

b.
Mural thrombosis

c. 
Phlebothrombosis

d. Chronic passive congestion

e.
Atherosclerosis

f.
Vegetation

Your answer is correct.

The correct answer is:
Phlebothrombosis
Question 51
A 60-year-old woman with a history of diabetes mellitus
Correct
has had left-sided chest pain radiating to the arm for the past 5
Mark 1.00 out hours. Serial measurements of serum creatine kinase–MB lev
of 1.00
els show an elevated level 24 hours after the onset of pain. Par
tial thromboplastin time (PTT) and prothrombin time (PT) are
normal. Coronary angiography shows occlusion of the left an
terior descending artery. Which of the following mechanisms
is the most likely cause of thrombosis in this patient?

a.
Stasis of blood flow

b.
Decreased antithrombin III level

c. Antibody inhibitor to coagulation

d.
Decreased tissue plasminogen activator

e. 
Damage to endothelium

f.
Mutation in factor V gene

Your answer is correct.

The correct answer is:
Damage to endothelium
Question 52
A 58-year-old man has had episodes of prolonged epi
Correct
staxis in the past 6 months. On examination he has occult
Mark 1.00 out blood detected in his stool. Coagulation studies show that his
of 1.00
prothrombin time is elevated, but his partial thromboplastin
time (PTT), platelet count, and platelet function are all normal.
When his plasma is mixed with an equal amount of normal
plasma, the prothrombin time corrects to normal. Which of the
following underlying diseases is most likely to be associated
with these findings?

a. 
Vitamin K deficiency

b.
Sepsis with Escherichia coli

c. Hemophilia A

d.
Scurvy

e.
Antiphospholipid syndrome

f.
Factor V Leiden mutation

Your answer is correct.

The correct answer is:
Vitamin K deficiency

Question 53
A 71-year-old man with a history of diabetes mellitus
Correct
died of an acute myocardial infarction. At autopsy, the aorta,
Mark 1.00 out opened longitudinally and with the superior aspect of the
of 1.00
kidneys below the forceps, appeared as shown in the figure.
Which of the following complications associated with this aor
tic disease would most likely have been present during his life?
 a.
Renal infarction

b.
Thrombocytopenia

c. 
Gangrene of the foot

d.
Pulmonary thromboembolism

e.
Edema of the left leg

Your answer is correct.

The correct answer is:
Gangrene of the foot
Question 54
An 80-year-old woman with dysuria for 1 week now
Correct
has a fever. On examination, her temperature is 37.9° C, pulse
Mark 1.00 out 103/min, and blood pressure 80/40 mm Hg. She has right
of 1.00
flank pain. A urinalysis shows numerous WBCs. Her plasma
lactate is increased. Urine culture and blood culture grow
Escherichia coli. Which of the following is most likely to con
tribute to her cardiovascular collapse by triggering Toll-like
cell receptors?

a.
Complement C3b

b.
Platelet-activating factor

c. Nitric oxide

d. 
Lipopolysaccharide

e.
Toxic shock syndrome toxin-1

Your answer is correct.

The correct answer is:
Lipopolysaccharide
Question 55
A 22-year-old woman with an uncomplicated pregnan
Correct
cy develops sudden dyspnea with cyanosis and hypotension
Mark 1.00 out intrapartum during routine ***l delivery of a term infant.
of 1.00
She has a generalized seizure and becomes comatose. Her con
dition does not improve over the next 2 days. Which of the fol
lowing findings is most likely to be present in her peripheral
pulmonary arteries?

a. 
Amniotic fluid

b.
Gas bubbles

c. Fat globules

d.
Thromboemboli

e.
Aggregates of platelets

Your answer is correct.

The correct answer is:
Amniotic fluid

Question 56 Septic patients exhibit insulin sensitive and hypoglycemia

Incorrect

Mark 0.00 out Select one:

of 1.00
True 

False

The correct answer is 'False'.

Question 57 Infusion of amniotic fluid or fetal tissue into the maternal circulation via a tear in the placental membranes or
Correct rupture of uterine veins is the underlying cause
Mark 1.00 out
of 1.00 Select one:
True 

False

The correct answer is 'True'.

Question 58
A 58-year-old man with pulmonary emphysema has a
Correct
10-year history of congestive heart failure. On physical exami
Mark 1.00 out nation, he has lower leg swelling with grade 2 pitting edema
of 1.00
to the knees and prominent jugular venous distention to the
level of the mandible. His serum levels of AST and ALT are
increased. The representative gross appearance of his liver is
shown in the figure. Which of the following underlying condi
tions is most likely to be present in this man?

a.
Chronic renal failure


 b. 
Congestive heart failure

c.
Thrombocytopenia

d.
Common bile duct obstruction

e.
Portal vein thrombosis

Your answer is correct.

The correct answer is:
Congestive heart failure

Question 59 An embolus is a detached intravascular solid that is carried by the blood from its point of origin to a distant
Incorrect site
Mark 0.00 out
of 1.00 Select one:
True 

False

The correct answer is 'False'.

Question 60
A 56-year-old woman diagnosed with cancer in her left
Correct
breast underwent a mastectomy with axillary lymph node
Mark 1.00 out dissection. Postoperatively, she develops marked swelling of
of 1.00
the left arm that has persisted for 6 months. Now on physical
examination, her temperature is 36.9° C. Her left arm is not
tender or erythematous, and it is not painful with movement
or to touch, but it is enlarged with a doughy consistency.
Which of the following is the most likely mechanism for these
findings?

a.
Cellulitis

b.
Sodium and water retention

c. Phlebothrombosis

d. 
Lymphedema

e.
Congestive heart failure

f.
Decreased plasma oncotic pressure

Your answer is correct.

The correct answer is:
Lymphedema

Question 61 In caisson disease, persistence of gas emboli in the skeletal system leads to multiple foci of ischemic necrosis;
Correct the more common sites are the femoral heads, tibia, and humeri
Mark 1.00 out
of 1.00 Select one:
True 

False

The correct answer is 'True'.

Question 62 The dominant histologic characteristic of infarction is ischemic coagulative necrosis
Correct

Mark 1.00 out Select one:

of 1.00
True 

False

The correct answer is 'True'.

Question 63
A 53-year-old man with congestive heart failure devel
Correct
ops pulmonary Streptococcus pneumoniae infection after a bout
Mark 1.00 out of influenza. After recuperating for 2 weeks, he notes pleuritic
of 1.00
chest pain. The pain is caused by the development of the lesion
shown in the figure. Which of the following events has most
likely occurred in this man?
a.
Pulmonary venous thrombosis

b.
Chronic pulmonary congestion

c.
Acute pulmonary congestion

d.
Pulmonary edema


 e. 
Pulmonary infarction

Your answer is correct.

The correct answer is:
Pulmonary infarction

Question 64 Cardiovascular collapse occurs when emboli obstruct 60% or more of the pulmonary circulation
Incorrect

Mark 0.00 out Select one:

of 1.00
True

False 

The correct answer is 'True'.

Question 65 One effect of inflammatory cytokines is to loosen endothelial cell tight junctions, making vessels leaky and
Incorrect resulting in the accumulation of protein-poor edema fluid throughout the body
Mark 0.00 out
of 1.00 Select one:
True 

False

The correct answer is 'False'.

Question 66 Amniotic fluid embolism stems from the mechanical obstruction of pulmonary vessels by amniotic Debris
Incorrect

Mark 0.00 out Select one:

of 1.00
True 

False

The correct answer is 'False'.

Question 67
A 63-year-old woman has had a fever and felt faint for
Correct
the past 2 days. On physical examination, her temperature is
Mark 1.00 out 38.4° C, pulse is 101/min, respirations are 17/min, and blood
of 1.00
pressure is 85/40 mm Hg. She has marked peripheral vaso
dilation. The serum lactic acid level is 6.8 mg/dL. Which of
the following laboratory findings is most likely related to the
cause of her clinical condition?

a. 
Blood culture positive for Citrobacter

b.
Elevated serum creatine kinase

c. Increased blood urea nitrogen

d.
Reduced Po2 on blood gas measurement

e.
Decreased hematocrit

Your answer is correct.

The correct answer is:
Blood culture positive for Citrobacter

Question 68
A 70-year-old man was hospitalized 3 weeks ago for a
Correct
cerebral infarction. He is now is ambulating for the first time.
Mark 1.00 out Within minutes of returning to his hospital room, he has sud
of 1.00
den onset of dyspnea with diaphoresis. He cannot be resus
citated. The gross appearance of the hilum of the left lung at
autopsy is shown in the figure. Which of the following risk
factors most likely contributed to this finding?
 a.
Pulmonary arterial atherosclerosis

b.
Bronchopneumonia

c.
Factor V mutation

d.
Antiphospholipid antibody

e. 
Leg vein thrombosis

Your answer is correct.

The correct answer is:
Leg vein thrombosis
 An autopsy study is performed to correlate patterns of
Question 69
hemorrhage with underlying causes. Patients with the gross
Correct
appearance of hemorrhage shown in the figure had minimal
Mark 1.00 out blood volume loss, but an appearance similar to this in many
of 1.00
other organs. Which of the following terms best describes this
pattern?
a.
Congestion
 b.
Purpura

c. 
Petechiae

d.
Ecchymosis

e.
Hematoma

Your answer is correct.

The correct answer is:
Petechiae

Question 70 Gas embolism also called decompression sickness, occurs when individuals experience sudden increases in
Incorrect atmospheric pressure
Mark 0.00 out
of 1.00 Select one:
True 

False

The correct answer is 'False'.

Question 71 Fat embolism syndrome is characterized by pulmonary insufficiency, neurologic symptoms, anemia, and
Incorrect thrombo cytopenia, and is fatal in 50% of cases
Mark 0.00 out
of 1.00 Select one:
True 

False

The correct answer is 'False'.

Question 72 Superantigens are polyclonal B-lymphocyte activators that induce the release of high levels of cytokines
Incorrect

Mark 0.00 out Select one:

of 1.00
True 

False

The correct answer is 'False'.

Question 73 Embolic obstruction of small end-arteriolar pulmonary branches always produce hemorrhage or infarction
Incorrect

Mark 0.00 out Select one:

of 1.00
True 

False

The correct answer is 'False'.

◀︎ Quiz: Hemodynamic Disorders,

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