Block 5 DPS Ime & Pancreas MCQ's
- 1.
The gait in a patient with established neuro syphilis with damage to the spinal cord is which of the following?
- A.
Staggering
- B.
Shuffling
- C.
Drags one feet
- D.
High stepping
- E.
Scissors like
Correct Answer
D. High steppingExplanation
In patients with established neurosyphilis and damage to the spinal cord, a high stepping gait may be observed. This gait abnormality is characterized by exaggerated lifting of the legs, resulting in a higher than normal stepping motion. It is often seen in patients with spasticity or weakness in the lower extremities due to spinal cord involvement. The high stepping gait is a compensatory mechanism to overcome the impaired muscle function and maintain balance while walking.Rate this question:
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- 2.
Which of the following would be an iatrogenic cause for a spinal cord injury?
- A.
Neurosyphilis
- B.
Meningitis
- C.
Motor vehicle accident
- D.
Osteoporosis
- E.
Lumbar puncture
Correct Answer
E. Lumbar punctureExplanation
Lumbar puncture can be considered an iatrogenic cause for a spinal cord injury because it involves the insertion of a needle into the spinal canal, which can potentially damage the spinal cord if not performed correctly. While neurosyphilis, meningitis, motor vehicle accidents, and osteoporosis can all lead to spinal cord injuries, they are not considered iatrogenic causes as they are not directly caused by medical intervention or treatment.Rate this question:
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- 3.
The incidence of spinal cord injuries in the USA is
- A.
10% of the population
- B.
Approximately 250,00 cases at any point in time in the population
- C.
About 12,000 new cases per year
- D.
Prevalent among young males
- E.
Mostly caused by motor vehicle accidents
Correct Answer
C. About 12,000 new cases per yearExplanation
The correct answer is "About 12,000 new cases per year". This answer is supported by the information provided in the question, which states that there are approximately 12,000 new cases of spinal cord injuries per year. The other options mentioned in the question, such as the incidence being 10% of the population or the number of cases at any point in time being 250,000, are not supported by the given information. Additionally, the question does not provide any information about the prevalence of spinal cord injuries among young males or their cause being mostly motor vehicle accidents.Rate this question:
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- 4.
Your patient is a 37 year-old Caucasian male who has a BMI of 30 (Kg/m2). He is committed to losing weight but wants you to give him encouragement by providing evidence that losing weight will improve his health. He wants to know by what percentage his all- cause mortality would decrease if he could decrease his BMI to 25 (Kg/m2). The best answer is:
- A.
It would decrease by 10%
- B.
It would decrease by 20%
- C.
It would decrease by 30%
- D.
It would decrease by 40%
- E.
There is no evidence correlating BMI as an independent risk for increased mortality
Correct Answer
C. It would decrease by 30% -
- 5.
You are seeing an otherwise healthy 45-year-old patient who measures 5'9" and weighs 200 lbs. (BMI 29.6 Kg/m2). She wants you to help her reduce her BMI to 25 Kg/m2 since she heard she has about 30 % increased risk of dying at her current weight. Which of the following evidence-based therapies would be appropriate to prescribe to your patient?
- A.
Acupuncture
- B.
Gastric by-pass surgery
- C.
Caffeine to increase metabolic rate
- D.
Orlistat to reduce fat absorption
- E.
Exercise 4 times a week
Correct Answer
E. Exercise 4 times a weekExplanation
Exercise is an evidence-based therapy that would be appropriate to prescribe to the patient. Regular exercise has been shown to have numerous health benefits, including weight loss, improved cardiovascular health, and reduced risk of chronic diseases such as diabetes and certain types of cancer. By engaging in exercise 4 times a week, the patient can increase their physical activity level, burn calories, and potentially achieve their goal of reducing their BMI to a healthier range.Rate this question:
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- 6.
Your patient is seeing you for a health maintenance physical and has no complaints. He is 55 years old, measures 5'6" and weighs 160 lbs. (BMI 25.9 Kg/m2) with a waist circumference of 42". You recommend that you patient start a diet program with the goal to lose 1 Lb. a week for the next 6 weeks and schedule a follow-up visit. The patient goes home and tells his wife that his doctor was rude and he was offended by the suggestion that he needs to lose weight. He does not follow your recommendation or keep his follow-up appointment. If the patient does not lose weight, what is his risk for developing an obesity related disease?
- A.
Below normal
- B.
Normal
- C.
Intermediate
- D.
High
- E.
Very high
- F.
Extremely high
Correct Answer
D. HighExplanation
Based on the information provided, the patient has a BMI of 25.9, which falls within the overweight range. Additionally, his waist circumference is 42 inches, which indicates abdominal obesity. These factors suggest that the patient is at a higher risk for developing obesity-related diseases such as diabetes, heart disease, and certain types of cancer. Therefore, the correct answer is "High" as the patient's risk for developing an obesity-related disease is elevated.Rate this question:
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- 7.
A 21 year old man from Germany who is attending graduate school in the United States comes to the physician complaining of headaches. He states that the headaches began 6 months earlier when an important experiment he was working on failed, and have continued 2-3 times a week since then. They are sometimes relieved with aspirin. One month ago the patient states that he began smoking cigarettes and found that using them when he had headaches produced some relief. Physical examination is unremarkable and the physician concludes that the headaches are due to tension and stress. In counseling the patient about his use of tobacco, the most appropriate statement for the physician to make is:
- A.
"I am concerned because your smoking behavior is potentially addictive and would affect your health in the long run."
- B.
"What ideas do you have about the relationship between your tobacco use and other things going on in your life."
- C.
"As your physician, I must warn you about the dangers of tobacco and advise you to quit immediately."
- D.
"I'd like to refer you to a smoke-enders program that will help you to stop using tobacco."
- E.
"Does anyone else in your family or peer group use tobacco products."
Correct Answer
B. "What ideas do you have about the relationship between your tobacco use and other things going on in your life."Explanation
The most appropriate statement for the physician to make is "What ideas do you have about the relationship between your tobacco use and other things going on in your life." This statement encourages the patient to reflect on the connection between his tobacco use and his headaches, as well as other factors in his life. It allows the patient to explore his own thoughts and beliefs about the situation, which can help in understanding the underlying reasons for his tobacco use. This approach promotes patient-centered care and empowers the patient to take an active role in his own healthcare decisions.Rate this question:
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- 8.
A 22 year old woman who is a 2nd year medical student comes to the physician complaining of loose stools and excessive flatulence over a 3 week period. She reports that her symptoms began shortly after returning from a visit to her family in a nearby state. Since that time she has gained 10 pounds while studying for exams and found herself snacking frequently on cakes, cookies and candy that her family put together for her in a large "care package." History and physical exam reveal a normally healthy 22 year old female who appears tense and anxious. Which of the following is the most appropriate next step for the physician to take.
- A.
Refer the patient for short term psychotherapy.
- B.
Encourage the patient to enroll in a mindfulness meditation class.
- C.
Prescribe a weight loss program.
- D.
Gently but firmly insist that the patient stop snacking between meals.
- E.
Recommend that the patient begin a high fiber diet.
Correct Answer
B. Encourage the patient to enroll in a mindfulness meditation class.Explanation
The patient's symptoms of loose stools and excessive flatulence may be related to stress and anxiety, as she appears tense and anxious. The fact that her symptoms started after returning from a visit to her family and gaining weight while studying for exams suggests a possible emotional component to her symptoms. Encouraging the patient to enroll in a mindfulness meditation class can help her manage her stress and anxiety, which may in turn alleviate her gastrointestinal symptoms. This approach addresses the underlying cause of her symptoms rather than simply treating the symptoms themselves.Rate this question:
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- 9.
Pancreas The synthesis of insulin requires
- A.
Formation of disulfide bonds
- B.
The proteasome
- C.
A protein kinase
- D.
Glycosyl-transferases
- E.
A mannose-6-phosphate transferase
Correct Answer
A. Formation of disulfide bondsExplanation
The synthesis of insulin requires the formation of disulfide bonds. Disulfide bonds play a crucial role in stabilizing the structure of insulin, a hormone produced by the pancreas. These bonds are formed between two cysteine amino acids, where the sulfur atoms from each cysteine form a covalent bond. This process is essential for the proper folding and function of insulin, allowing it to regulate blood sugar levels in the body. Without the formation of disulfide bonds, insulin would not be able to maintain its structure and function effectively.Rate this question:
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- 10.
It is the family July 4th picnic and Aunt Judy has forgotten her insulin injection. Her personal blood glucose monitoring device shows dangerously high glucose concentrations in her blood. Uncle Tommy comes to the rescue (he is also a diabetic) with his insulin kit, and Aunt Judy recovers except for the embarrassment she suffers from becoming drenched in perspiration in front of her entire extended family. How does insulin help to normalize her blood glucose levels?
- A.
Insulin stimulates glycogen synthase and phosphofructokinase-1
- B.
Insulin inhibits hexokinase and GLUT 4 transport of glucose
- C.
Insulin stimulates Glycogen Synthase Kinase-3 activity
- D.
Insulin stimulates bypass enzymes of gluconeogenesis
- E.
Insulin inhibits the activity of Pyruvate Kinase
Correct Answer
A. Insulin stimulates glycogen synthase and pHospHofructokinase-1Explanation
Insulin stimulates glycogen synthase and phosphofructokinase-1, which are enzymes involved in the regulation of glucose metabolism. Glycogen synthase promotes the conversion of glucose into glycogen for storage, while phosphofructokinase-1 stimulates the breakdown of glucose to produce energy. By activating these enzymes, insulin helps to lower blood glucose levels by promoting the storage and utilization of glucose.Rate this question:
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- 11.
Insulin and glucagon are counteracting hormones in so far as their actions on plasma glucose levels. However, it can be demonstrated that glucagon stimulates insulin release. What is the most likely explanation for the ability of glucagon to stimulate insulin release?
- A.
Glucagon antagonizes the insulin receptor.
- B.
Glucagon blocks oxidative phosphorylation
- C.
Glucagon increases the availability of glucose
- D.
Glucagon inhibits glycogenolysis.
- E.
Glucagon changes the phenotype of pancreatic alpha cells.
Correct Answer
C. Glucagon increases the availability of glucoseExplanation
Glucagon increases the availability of glucose, which is the most likely explanation for its ability to stimulate insulin release. When glucagon is released, it signals the liver to break down glycogen into glucose, increasing the amount of glucose available in the bloodstream. This increase in glucose levels then triggers the release of insulin, which helps to lower blood sugar levels. Therefore, by increasing the availability of glucose, glucagon indirectly stimulates insulin release.Rate this question:
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- 12.
A 14 yo male presents at the clinic with a nonfasting plasma glucose level of 220 mg/dL and a strong thirst. You give him a tentative diagnosis of Type I diabetes mellitus and schedule an oral glucose tolerance test (OGTT) for the next morning. If your diagnosis is correct, what would you expect to see I this patient during the two hours after ingestion of 75 ml of dextrose?
- A.
A strong, long surge in plasma glucose from a high baseline, with very little surge in plasma insulin
- B.
A weak, short surge in plasma glucose from a low baseline, with a strong surge in plasma insulin
- C.
A weak, long surge in plasma glucose from a low baseline, with very little surge in plasma insulin
- D.
A strong, short surge in plasma glucose from a low baseline, with a weak surge in plasma insulin
- E.
A strong, long surge in plasma glucose from a low baseline, with very little surge in plasma insulin
Correct Answer
A. A strong, long surge in plasma glucose from a high baseline, with very little surge in plasma insulinExplanation
In Type I diabetes mellitus, the body is unable to produce insulin. Therefore, when the patient ingests dextrose during the OGTT, there will be a strong, long surge in plasma glucose from a high baseline because there is no insulin to help regulate the glucose levels. Additionally, there will be very little surge in plasma insulin because the patient is not producing insulin.Rate this question:
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- 13.
During the absorptive state, which hormone has the ability to stimulate growth of muscle tissue while preventing excessive glucose levels in the plasma?
- A.
Glucagon
- B.
Cortisol
- C.
Insulin
- D.
Leptin
- E.
Growth hormone
Correct Answer
C. InsulinExplanation
Insulin is the correct answer because during the absorptive state, insulin is released by the pancreas in response to high levels of glucose in the blood. Insulin promotes the uptake of glucose by muscle cells, thereby preventing excessive glucose levels in the plasma. Additionally, insulin stimulates the synthesis of proteins, including muscle tissue, promoting growth.Rate this question:
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- 14.
Which of the following is characteristic of the acinar cells of the pancreas?
- A.
They secrete lysozyme
- B.
They secrete glucagon
- C.
They secrete insulin
- D.
They produce and secrete proteases
- E.
They are lined by fenestrated endothelial cells
Correct Answer
D. They produce and secrete proteasesExplanation
Acinar cells of the pancreas are responsible for producing and secreting proteases. Proteases are enzymes that help in the digestion of proteins. These enzymes are important for breaking down proteins into smaller peptides and amino acids, which can be absorbed by the body. Therefore, the characteristic of acinar cells producing and secreting proteases is essential for proper digestion and nutrient absorption in the body.Rate this question:
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- 15.
Which of the following antidiabetic drugs can cause hypoglycemia when used as monotherapy in a patient with type 2 diabetes?
- A.
Glyburide
- B.
Metformin
- C.
Acarbose
- D.
Rosiglitazone
Correct Answer
A. GlyburideExplanation
Glyburide is an antidiabetic drug that can cause hypoglycemia when used as monotherapy in a patient with type 2 diabetes. This is because Glyburide stimulates the release of insulin from the pancreas, which can lead to a decrease in blood sugar levels. Hypoglycemia occurs when blood sugar levels drop too low, causing symptoms such as dizziness, confusion, and sweating. Therefore, Glyburide should be used with caution and the patient should be closely monitored for signs of hypoglycemia.Rate this question:
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- 16.
A 17-year-old girl with type-1 diabetes mellitus is on insulin therapy. Which of the following type of insulin is she taking before meal to control her postprandial hyperglycemia?
- A.
Insulin aspart
- B.
Insulin ultralente
- C.
Insulin glargine
- D.
Insulin NPH
Correct Answer
A. Insulin aspartExplanation
Insulin aspart is a rapid-acting insulin analog that is commonly used to control postprandial hyperglycemia in patients with type-1 diabetes mellitus. It has a fast onset of action, typically within 15 minutes, and a shorter duration of action compared to other types of insulin. This allows for better control of blood sugar levels after meals. Insulin ultralente, insulin glargine, and insulin NPH are not typically used before meals as they have slower onsets of action and longer durations of action.Rate this question:
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- 17.
A 48-year-old man with type 1 diabetes is started on an intensive therapy with insulin in order to achieve a tight control his blood glucose levels. He will most likely have an increased risk of which of the following condition?
- A.
Hypertension
- B.
Hypoglycemia
- C.
Neuropathy
- D.
Nephropathy
- E.
Weight loss
Correct Answer
B. HypoglycemiaExplanation
A 48-year-old man with type 1 diabetes who is started on intensive therapy with insulin to achieve tight control of his blood glucose levels is at an increased risk of hypoglycemia. Intensive insulin therapy aims to maintain blood glucose levels within a narrow range, which can increase the risk of hypoglycemia, or low blood sugar. This is because insulin helps to lower blood glucose levels, and if too much insulin is administered or if the timing of insulin and meals is not properly coordinated, it can result in hypoglycemia. Hypoglycemia can cause symptoms such as dizziness, confusion, sweating, and in severe cases, loss of consciousness. It is important for individuals on intensive insulin therapy to monitor their blood glucose levels closely and take necessary precautions to prevent hypoglycemia.Rate this question:
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Mar 16, 2023Quiz Edited by
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Feb 16, 2012Quiz Created by
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