1. Which of the following is the most common cause of nephrotic
syndrome in adults?
A) Systemic lupus erythematosus
B) Focal segmental glomerulosclerosis
C) Diabetic nephropathy
D) Minimal change disease
Answer: C) Diabetic nephropathy
Rationale: Diabetic nephropathy is the most common cause of
nephrotic syndrome in adults, primarily due to chronic hyperglycemia
leading to glomerular damage, increased filtration pressure, and
proteinuria. Systemic lupus erythematosus and minimal change disease
are more common causes in children, while focal segmental
glomerulosclerosis is associated with both adult and pediatric nephrotic
syndromes but is less frequent than diabetic nephropathy.
2. A patient with acute respiratory distress syndrome (ARDS) is most
likely to present with which of the following?
A) Increased tidal volume
B) Hypoxemia
C) Hypercapnia
D) Decreased work of breathing
Answer: B) Hypoxemia
Rationale: ARDS is characterized by hypoxemia due to impaired oxygen
exchange, resulting from alveolar-capillary membrane damage,
inflammation, and fluid accumulation in the alveoli. ARDS typically leads
to difficulty in oxygenating the blood, causing significant hypoxemia.
Increased tidal volume and decreased work of breathing are not
,characteristic features of ARDS, and hypercapnia can develop later due
to impaired ventilation.
3. In the context of atherosclerosis, what is the primary mechanism
responsible for plaque rupture and thrombosis?
A) Increased smooth muscle proliferation
B) Inflammation and endothelial dysfunction
C) Decreased cholesterol deposition in arterial walls
D) Calcification of the plaque
Answer: B) Inflammation and endothelial dysfunction
Rationale: Plaque rupture and thrombosis in atherosclerosis are
primarily caused by inflammation and endothelial dysfunction.
Inflammatory cells (e.g., macrophages) release enzymes that destabilize
the plaque, making it more prone to rupture. When the plaque
ruptures, thrombosis occurs due to exposure of the underlying tissue to
circulating blood, leading to clot formation. Smooth muscle
proliferation and calcification contribute to plaque stability, but they are
not the primary causes of rupture.
4. In which condition would you expect to find the "chronic
inflammation" of the liver that leads to cirrhosis?
A) Acute viral hepatitis
B) Alcoholic liver disease
C) Fatty liver disease
D) Hepatitis B virus infection
Answer: B) Alcoholic liver disease
, Rationale: Chronic inflammation in the liver leading to cirrhosis is most
commonly associated with alcoholic liver disease. Chronic alcohol use
leads to hepatocyte injury, inflammation, and fibrosis, which eventually
progress to cirrhosis. Fatty liver disease and viral hepatitis (such as
Hepatitis B) can also contribute to cirrhosis, but alcohol-related damage
is the most common cause in developed countries.
5. In a patient with autoimmune hemolytic anemia (AIHA), which of
the following mechanisms is responsible for red blood cell
destruction?
A) Complement activation leading to cell lysis
B) Red blood cell phagocytosis by the spleen
C) Antibody-mediated destruction by natural killer (NK) cells
D) Inhibition of red blood cell production by cytokines
Answer: B) Red blood cell phagocytosis by the spleen
Rationale: In AIHA, antibodies bind to red blood cells, leading to their
destruction. This is primarily mediated by phagocytosis of the antibody-
coated red blood cells by macrophages in the spleen, a process known
as extravascular hemolysis. Complement activation may contribute, but
phagocytosis is the main mechanism of RBC destruction in AIHA.
6. Which of the following is a key pathological feature of Crohn's
disease?
A) Continuous colonic involvement
B) Inflammation restricted to the mucosa
C) Formation of granulomas
D) Presence of crypt abscesses
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