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Trinity College Courses
Kenneth Lam

1. The lung that has fluid in the pleural space is termed and if it occurs because disease of the lung has disrupted the Starling forces, it is most likely . a. Pleural Effusion, Exudative b. Pneumothroax, Transudative c. Pleural Effusion, Transudative d. Pneumothroax, Exudative 2. Which cell covers most of the alveolar surface? a. Type I Pneumocyte b. Type II Pneumocyte c. Avleolar Epithelial Cells d. Macrophages 3. From the alveolus lumen to the blood vessel lumen the layers are as follows in order: a. Surfactant, basement membrane, interstitial tissue, alveolar epithelium, capillary endothelium b. Alveolar epithelium, surfactant, basement membrane, interstitial tissue, capillary endothelium c. Surfactant, alveolar epithelium, basement membrane, interstitial tissue, capillary endothelium d. Alveolar epithelium, basement membrane, surfactant, interstitial tissue, capillary endothelium 4. The local or generalized fibrotic changes in the lung or pleura will cause which type of Atelectasis? a. Resorbtion b. Compression c. Contraction 5. Choose the incorrect statement about pulmonary disease: a. Bronchitis, Asthma, Emphysema are all Obstructive Pulmonary Diseases. b. Obstructive Pulmonary disease is due to the reduced expansion of the lung alveolar tissue (parenchyma). c. Poliomyelitis, silicosis and kyphoscoliosis are all Restrictive Lung diseases. d. When having trouble breathing due to COPD it is not useful to try breathing harder. 6. When a person presents with a fever of unknown origin, this is a medical emergency and you most likely suspect: a. Heart Failure b. COPD c. Inflammatory Bowel Disease d. Vasculitis 7. IgG and IgM can get lodged in the walls of the blood vessels and cause vasculitis, what happens normally to stop this from happening? a. These complexes are not formed b. The endothelial cells have tight junctions c. They are phagocytosed by macrophages in the spleen d. Neutrophils are not activated 8. When should you not give steroids if you suspect vasculitis? a. When the person has an infection b. When the person has vasculitis caused by immune cross-reactivity c. When the person has a fever of unknown origin d. When the person has vasculitis is caused by p-ANCA e. When the person has primary vasculitis 9. Which statement about ANCA is incorrect? a. c-ANCA’s antigen is proteinase 3 in the neutrophil b. c-ANCA is associated with Giant Cell Arteritis c. p-ANCA is expressed in the rare form of vasculitis called Polyarteritis nodosa d. ANCA formation precedes neutrophil activation 10. T/F Heart failure occurs more in men than women. 11. T/F Right sided heart failure rarely occurs by itself. 12. T/F When you press on the abdomen, a positive reflex is when the jugular venous pressure elevates and becomes more pronounced. 13. Which statement is false regarding heart failure? a. The elderly typically have diastolic dysfunction b. Mitral regurgitation occurs because of the sphericity of the heart c. The cardiac myocytes undergo hypotrophy leading to heart failure d. ADH is a powerful vasoconstrictor 14. How many patients die within 1 year of diagnosis? a. 10-20% b. 30-40% c. 40-50% d. 60-70% 15. Reduced ejection fraction is associated with: a. Systolic heart failure b. Diastolic heart failure 16. T/F A persons ability to participate in physical activity is commonly used to determine the stage of heart failure. 17. What is not one of the common etiologies of systolic heart failure. a. Myocardial hypertrophy b. Coronary artery disease c. Myocardial ischemia d. Dilated cardiomyopathy 18. When does dyspnea occur during lung function decline? a. FEV < 4L b. FEV <1L c. FEV <2L d. FEV <6L 19. T/F Forced Expiratory Volume normally declines with age. 20. What is mainly responsible for the destruction of the lungs? a. Oxidative stress which destroys the protease inhibitors b. The macrophages that secrete IL-8 and destroy the epithelial cells c. Methacholine causing hyperresponsiveness of epithelial cells d. The imbalance of protease to protease inhibitors in the lung 21. Which statement is false regarding emphysema? a. Centracinar emphysema is typically associated with COPD b. Paracinar emphysema damages the most distal part of the alveolus c. The upper lung lobes are commonly affected by centracinar emphysema. d. It is common for the alveoli to be spared in asthma 22. What is not one of the most commonly involved sinuses in sinusitis? a. Sphenoid b. Maxillary c. Anterior ethmoidal d. Frontal 23. Identify the correct statement of the following regarding sinusitis: a. Mucocele is when the sinus cavity is infected b. Empyema is when the sinus cavity is non-infectious c. The most common cause of acute sinusitis is a UTRI of bacterial origin d. Optic neuritis is associated with the ethmoidal sinuses e. Acute sinusitis is commonly preceded by rhinitis 24. T/F The loss of alveolar attachments due to ECM destructions is a feature in large airway changes. 25. The diagram below is an illustration of which inflammatory bowel disease? a. Ulcerative colitis b. Crohn’s disease c. Small bowel disease 26. T/F IBD is on the rise 27. T/F IBD is an autoimmune disease and involves GALT 28. Who should begin smoking? a. Carl with Crohn’s disease b. Ursula with Ulcerative colitis 29. How often do patients with IBD have ocular complications like scleritis or uveitis? a. 1-10% b. 5-15% c. 15-20% d. 20-30% 30. Identify the false statement regarding Crohn’s disease: a. CD4+ T cells are involved in the inflammation b. The NOD2 protein is overactive leading to inflammation c. Cytokines becomes unregulated d. The rectum is spared usually e. The death of a loved one is a risk factor f. Formation of small superficial ulcers 31. Identify the false statement regarding ulcerative colitis: a. Always occurs in the rectum b. Hereditary tight junction defects is a risk factor c. Formation of broad based ulcers d. Typically involves mucosa and submucosa e. Tenesmus is a symptom 32. Zone 1 Hepatocytes: a. Are active in glycolysis and lipogenesis b. Are active in gluconeogenesis and oxidative energy metabolism c. Are near the central vein d. Are furtheset from the portal triad 33. Which zone are the hepatocytes most susceptible to a) direct poision and b) hypoxia a. Zone 1, Zone 2 b. Zone 2, Zone 1 c. Zone 3, Zone 1 d. Zone 1, Zone 3 34. T/F Apoptosis of liver cells can be detected biochemically by ALT, AST and GGT in serum. 35. T/F Cholestatic injury is characterized by a decrease in the volume of bile produced and thus a decrease in bilirubin concentration as well. 36. In Acute liver failure: Reduced albumin the blood leads to . Increased ammonia in the blood leads to . a. chronic liver disease, GI bleeding b. jaundice, dark yellow-brown urine c. peripheral swelling, cerebral dysfunction d. portal hypertension, steatosis 37. T/F The process involved in Intrahepatic Jaundice is: hemolytic anemia 38. In which condition are the feces dark coloured? a. Prehepatic Jaundice b. Intrahepatic Jaundice c. Posthepatic Jaundice 39. What is not one of the 3 important characteristics of cirrhosis? a. Fibrotic scars b. Nodular surface c. Vascular dilation d. Disorganized architecture 40. Which vein does not drain into the portal vein? a. Inferior vena cava b. Splenic vein c. Superior mesenteric vein d. Inferior mesenteric vein 41. Which statements correctly describe post-hepatic portal hypertension? a. It is commonly caused by left-sided heart failure b. It is characterized by an increase in F, from the equation P=FxR c. Portal vein thrombosis can lead to post-hepatic portal hypertension d. Hepatic veins are blocked 42. Which statement is true about portal hypertension? a. Sinusoidal remodeling in fibrous septa between arterial and portal circulation is accompanied by an increase in diameter of the blood vessels b. Nitric oxide is the molecule acting on the liver sinusoids, and increases in concentration c. Endothelin-1 is responsible for enhancing inflammation in the liver sinusoids d. The accumulation of fluid in the peritoneum is because blood beings to flow backwards in the vein e. The vasoconstriction of splanchnic arteries leads to an increased speed of blood flow to the liver, which is mediated by nitric oxide 43. T/F A result of cirrhosis of the liver is the venous and arterial system anastomosing. 44. What is not one of the 4 major features of portal hypertension? a. Liver Nodules b. Hepatic encephalopathy c. Esophageal Varices d. Splenomegaly e. Ascites 45. What area is not commonly affected when blood that should drain into the portal vein choose to reroute to a lower pressure capillary bed. a. Esophagus b. Kidney c. Abdominal wall d. Rectum 46. Which system in the liver is responsible for the production of heme and globin metabolites a. Hepatocytes b. Biliary system c. Reticuloendothelial system d. Kupffer cells 47. Which enzyme is released as a result of mitochondrial injury? a. AST b. ALT c. GGT d. ALP 48. Which 2 enzymes are normally cytoplasmic but are released into the blood upon insult. a. AST b. ALT c. GGT d. ALP e. A and B f. C and D g. A and D h. B and C 49. Which liver disease is characterized by a fall in liver enzymes? a. Necrotic lesions b. Acute fulminant hepatitis c. Cirrhosis d. Viral Hepatitis e. Portal Hypertension 50. What is not commonly measured to check for biliary tract injuries like cholestasis? a. Serum bilirubin b. ALP c. Serum albumin d. Serum bile acids e. Urine bilirubin 51. Wilson’s disease is a congenital disorder with low levels of ceruloplasmin, which is responsible for: a. Binding copper b. Promoting iron secr
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