Basic(51-100)

The first (S1, or “lub”) heart sound and the second (S2, or “dup”) heart sound originate, respectively, from which of the following?

Structure(s) that normally transit the diaphragm by way of the esophageal hiatus include which of the following

Gallbladder pain often presents as epigastric pain that then migrates towards the patient’s right side and can even wrap around to the posterior. The referred pain is not the site of the problem. Anatomically where is the gallbladder located?

A 65-year-old male presents with jaundice for 2–3 weeks, fatigue and increasing epigastric pain. He has no history of peptic ulcers and says the pain does not relate to eating in anyway. His epigastric pain is midline and he has had some recent back pain. His urinary bilirubinogen and serum bilirubin are elevated (serum bilirubin 5.8 mg/dl). Helical CT reveals a suspicious mass in the head of the pancreas adjacent to the descending duodenum. The gallbladder is significantly enlarged. Which of the following is the likely cause of the elevated bilirubin?

A full-term male infant displays projectile vomiting 1 h after suck- ling. There is failure to gain weight during the first 48 hours. The vomitus is not bile-stained and no respiratory difficulty is evident. Examination reveals an abdomen neither tense nor bloated. Which of the following is the most probable explanation?

A 19-year-old teenager is brought to the emergency room after a single-car accident just 20 minutes earlier in which she lost control of her car on black ice and hit a retaining column of an overpass at about 45 miles per hour. She was wearing a seat belt but looks pale, has tachy- cardia and positional hypotension, is extremely nauseated, and is lying in the fetal position due to increasingly severe abdominal pain. She has no fractures and a cranial nerve test is normal. You order an abdominal CT because you suspect which of the following?

A 55-year-old woman arrives at the emergency room the day after St. Patrick’s Day coughing up bright red blood. She has frequented your emergency room before. History includes excessive alcohol consumption. Using abdominal percussion you determine that her liver extends 5 cm below the right costal margin at the midclavicular line. You call in a gas- troenterologist because you suspect that the bright red blood is most likely the result of which of the following?

A 24-year old man was a passenger in an automobile broadsided by another vehicle. Although he was wearing a seat belt he felt “terrible,” and had left sided abdominal, flank, and shoulder pain. During the ambulance ride into the emergency room his blood pressure kept dropping, he appeared pale, had a rapid heartbeat, with otherwise normal lung and heart sounds. Intravenous saline was started en route. Which of the following abdominal organs is most likely damaged?

Which of the following is the principal supply to the body and tail of the pancreas?

During the physical exam of a 52-year-old man you note internal hemorrhoids. He complains of blood in his stool. Which of the following arteries could be the source of his rectal bleeding?

Benign prostatic hypertrophy results in obstruction of the urinary tract. Patients present with weak urine flow, increased difficulty initiating urination, and increase frequency of urination since the bladder often is not fully emptied. Benign prostatic hypertrophy is associated with enlargement of which of the following?

Which structure is most susceptible to unintentional damage during a hysterectomy?

Which of the following locations is optimal for fertilization of an ovulated egg by sperm to occur?

An HIV-positive patient asks you if you can tell him the chances of him progressing to symptomatic AIDS. Which one of the following tests would be most useful?

Which of the following viruses causes an acute febrile rash and produces disease in immunocompetent children but has been associated with transient aplastic crises in persons with sickle cell disease?

Infection with herpes simplex virus, a common human pathogen, is best described by which of the following statements?

An HIV-positive patient prior to being treated with AZT, DDI, and saquinavir has a CD4 lymphocyte count and an HIV RNA viral load test done. Results are as follows: CD4: 50 CD4 lymphocytes per microliter, HIV RNA: 750,000 copies per ml. Which of the following statements best describes the above patient?

Infectious mononucleosis, a viral disorder that can be debilitating, is Characterized by which of the following statements?

The clinical picture of arbovirus infection fits one of three categories: encephalitis, hemorrhagic fever, or fever with myalgia. One of the characteristics of arboviruses is that they

Delta hepatitis only occurs in patients who also have either acute or chronic infection with hepatitis B virus. The delta agent is

The most sensitive test for the diagnosis of herpes simplex (HSV) meningitis in a newborn infant is

Mumps virus accounts for 10 to 15% of all cases of aseptic meningitis in the United States. Infection with mumps virus

The serum of a newborn infant reveals a 1:32 cytomegalovirus (CMV) titer. The child is clinically asymptomatic. Which of the following courses of action would be advisable?

A 3-year-old child presents at the physician’s office with symptoms of coryza, conjunctivitis, low-grade fever, and Koplik’s spots. The causative agent of this disease belongs to which group of viruses?

One of the most common sexually transmitted diseases that may lead to cervical carcinoma is caused by which of the following viruses?

Which virus is the leading cause of the croup syndrome in young children and, when infecting mammalian cells in culture, will hemabsorb red blood cells?

Hepatitis E, a recently characterized hepatitis virus, is best described by which of the following statements?

Meningitis is characterized by the acute onset of fever and stiff neck. Aseptic meningitis may be caused by a variety of microbial agents. During the initial 24 h of the course of aseptic meningitis, an affected person’s cerebrospinal fluid is characterized by

Infection with hepatitis D virus (HDV; delta agent) can occur simulta- neously with infection with hepatitis B virus (HBV) or in a carrier of hepati- tis B virus because HDV is a defective virus that requires HBV for its replicative function. What serologic test can be used to determine whether a patient with HDV is an HBV carrier?

Eastern equine encephalitis virus is associated with a high fatality rate. Control of the disease could be possible by eradication of

Adults who have had varicella as children occasionally suffer a recurrent form of the disease, shingles. The agent causing these diseases is a member of which of the following viral families?

German measles virus (rubella), a common cause of exanthems in children, is best described by which of the following statements?

The presence of Negri inclusion bodies in host cells is characteristic of

A hospital worker is found to have hepatitis B surface antigen. Subsequent tests reveal the presence of e antigen as well. The worker most likely

An immunocompromised person with history of seizures had an MRI that revealed a temporal lobe lesion. Brain biopsy results showed multinucleated giant cells with intranuclear inclusions. The most probable cause of the lesion is

An infant, seen in the ER, presents with a fever and persistent cough. Physical examination and a chest x-ray suggest pneumonia. Which of the following is most likely the cause of this infection?

Which one of the following groups of people may be at increased risk for HIV infection?

A patient has all the gastrointestinal symptoms of infection with hepatitis A virus (HAV), yet all the tests for HAV-IgG and HAV-IgM are non- reactive. A possible cause of this infection is

Erythema infectiosum (fifth disease), a self-limited disease of children, is caused by

Which one of the following viruses may be human tumor virus?

Cytomegalovirus (CMV) infection is common. Which one of the fol- lowing statements best characterizes CMV?

There is considerable overlap of signs and symptoms seen in congenital and perinatal infections. In a neonate with “classic” symptoms of congenital cytomegalovirus (CMV) infection, which one of the following tests would be most useful in establishing a diagnosis?

Which one of the following viruses would be most likely to establish a latent infection?

A regimen that includes appropriately administered gamma globulin may be contraindicated in which one of the following diseases?

Atypical lymphocytosis is most likely to be found in which one of the following diseases?

A patient has arthralgia, a rash, lymphadenopathy, pneumonia but no fever. Which of the following diseases is most likely based on these symptoms?

Hepatitis C (HCV) is usually a clinically mild disease, with only minimal elevation of liver enzymes. Hospitalization is unusual. Which one of the following statements best characterizes HCV?

Which of the following markers is usually the first viral marker detected after hepatitis B infection?

Which of the following may be the only detectable serological marker during the early convalescent phase of HBV infection (window phase)?

Which one of the following markers is closely associated with HBV infectivity and DNA polymerase activity?