MCQ Book Questions

Q60222. A 75-year-old man who had worked in a shipyard for 25 years dies of a thoracic tumor. Autopsy reveals a pleural tumor that encases the lung. Interstitial pulmonary fi brosis and multiple pleural plaques are noted. Numerous, brown, beaded ferrugi- nous bodies are also found in the lungs (shown in the image). Which of the following agents is most likely associated with the pathogenesis of the cancer in this patient?

Q60223. A 47-year-old man presents with a 6-week history of increas- ing fatigue and dark-colored stools. Complete blood count shows hemoglobin of 8.6 g/dL and microcytic, hypochro- mic RBCs. Upper gastrointestinal endoscopy reveals a peptic ulcer along the lesser curvature of the stomach. This patient’s anemia is most likely caused by defi ciency of which of the following?

Q60224. A 12-year-old boy is rescued 2 days after becoming lost in the Canadian woods in February. Physical examination shows he has gangrene of his fi ngers and toes. Which of the following mechanisms of cell injury played the most impor- tant role in mediating necrosis in the fi ngers and toes of this patient?

Q60225. A 35-year-old man is hospitalized with third-degree burns after being rescued from a house fi re. Initially, he suffers from shock and oliguria, but his renal function returns to normal within a few days. Which of the following would be the most likely cause of death if complications were to arise?

Q60226. A healthy adult runs a marathon in the summer and develops hot dry skin, cessation of sweating, lactic acidosis, hypocal- cemia, and muscle necrosis (rhabdomyolysis). Which of the following is the appropriate diagnosis?

Q60227. A 26-year-old electrician is found unconscious in his backyard beside a metal ladder and an exposed electrical wire, suffering from a deep burn on his right hand. Resuscitation attempts are unsuccessful. Which of the following was the most likely cause of death?

Q60228. A sailor on a nuclear-powered submarine is seen by a physi- cian after a breach in the reactor containment system. Physical examination is unremarkable, but the patient subsequently develops profound pancytopenia. Hemoglobin is 7.8 g/dL, WBC count is 900/μL, and platelets are 20,000/μL. How many rads of acute total-body radiation did this patient most likely receive?

Q60229. Another sailor on the submarine (see Question 14) dies 10 days after the accident as a result of severe diarrhea and dehydration. Which of the following doses (in rads) of acute total-body radiation did this sailor most likely receive?

Q60230. A neonate was noted to have mild growth retardation and facial dysmorphology. The mother was a known abuser of several substances. This infant’s problem most likely resulted from maternal intake of which of the following?

Q60231. A 10-year-old boy presents with irritability and ataxia. He is subsequently found to have anemia, basophilic stippling of erythrocytes, and dark-gray pigmentation of the gums. Exposure to which of the following chemical agents is most likely associated with this disease?

Q60232. A 50-year-old man presents for a routine physical examination, which demonstrates an enlarged liver. During the visit, he describes memos from his supervisor at work regarding chronic exposure to vinyl chloride. The patient has an elevated risk for which of the following tumors?

Q60233. A severely depressed 32-year-old man commits suicide by running his car motor in his closed garage for several hours. The mechanism of death in this case of carbon monoxide (CO) poisoning is through which of the following mechanisms?

Q60234. A Japanese fi sherman who lives in the vicinity of a plastics factory develops severe neurologic symptoms, including constriction of visual fi elds, paresthesias, ataxia, dysarthria, and hearing loss. Public health authorities fi nd a number of similar cases in the local village. Exposure to which of the following chemical agents is most likely associated with the pathogenesis of this man’s neurologic disease?

Q60235. A 40-year-old, malnourished woman presents with a 6-month history of night blindness. Physical examination reveals kera- tomalacia and corneal ulceration. Which of the following vita- min defi ciencies would be suspected in this patient?

Q60236. A 26-year-old woman presents to the emergency room with fever and shaking chills. Her temperature is 38.7°C (103°F), pulse 120 per minute, and blood pressure 140/80 mm Hg. Physical examination reveals a harsh systolic murmur. The patient devel- ops a headache, slips into a coma and expires. The aortic valve is examined at autopsy (shown in the image). Which of the follow- ing is the most important risk factor for this pathologic fi nding?

Q60237. A 50-year-old woman presents with easy fatigability, a smooth sore tongue, numbness and tingling of the feet, and weakness of the legs. A complete blood count shows a megaloblastic anemia that is not reversed by folate therapy. Hemoglobin is 5.6 g/dL, WBC count is 5,100/μL, and platelets are 240,000/ μL. This patient most likely has a defi ciency of which of the following vitamins?

Q60238. A 66-year-old woman presents with a 6-month history of scal- ing and abnormal pigmentation of the skin. Her past medical history is signifi cant for the treatment of thyroid cancer 1 year ago. Biopsy of lesional skin shows atrophy of the epidermis and dense fi brosis of the dermis, which displays dilated super- fi cial blood vessels. These pathologic fi ndings are most likely caused by previous exposure to which of the following?

Q60239. A 28-year-old radar technician aboard an aircraft carrier has been subjected to intense microwave radiation for 7 years. He has an elevated risk for developing which of the following?

Q60240. A 15-year-old African boy has a history of tooth loss, gingivitis, skin hemorrhages, multiple infections, and poor wound heal- ing. Physical examination shows that the child is in the 20th percentile for height and 10th percentile for weight. This patient most likely has which of the following underlying conditions?

Q60241. A 24-year-old woman, who is a food faddist, eats only corn- based foods. She presents with dermatitis, diarrhea, and dementia. This patient most likely suffers from which of the following conditions?