Deck 3: Hemodynamic Disorders, Thromboembolism, and Shock

Question 1

A 63-year-old woman died 2 days after the onset of severe myocardial ischemia caused by coronary thrombosis. At autopsy, the lungs were heavy. Upon sectioning of the lungs, frothy fluid was seen oozing from the cut surface of the parenchyma. Which of the following is the most likely diagnosis?

A) Pulmonary embolism
B) Pulmonary infarction
C) Pulmonary edema
D) Atelectasis
E) Lobar pneumonia

Answer 1

Pulmonary edema

Question 2

Most cases of septic shock are caused by endotoxin-producing bacteria, which are classified as

A) pyogenic
B) gram-positive
C) gram-negative
D) encapsulated
E) acid fast

Answer 2

gram-negative

Question 3

A 60-year-old man had congestive heart failure and sodium retention. Pitting edema of the lower extremities in this patient is most likely associated with an increased blood level of

A) albumin
B) globulin
C) aldosterone
D) troponin
E) plasminogen

Answer 3

aldosterone

Question 4

A 60-year-old man who had longstanding congestive heart failure complained of pain under the right costal margin. He died of worsening heart failure. At autopsy, the liver appeared enlarged and congested, showing a "nutmeg pattern" on cross section. Histologically this liver will show

A) atrophy of bile ducts
B) dilatation of bile ducts
C) intralobular cholestasis
D) centrolobular necrosis and loss of hepatocytes
E) fibrosis of the Glisson capsule

Question 5

Bernard-Soulier syndrome is a bleeding disorder caused by a defect of glycoprotein Ib (GpIb) on platelets. Platelets lacking GpIb cannot adhere to the wall of the damaged blood vessels, because GpIb is the receptor for which essential coagulation protein?

A) Hageman factor (factor XII)
B) Von Willebrand factor
C) Fibrinogen
D) Factor VIII
E) Thrombin

Question 6

In the antiphospholipid syndrome of systemic lupus erythematosus, arterial thrombi occur most often in the arteries of the

A) brain
B) heart
C) kidneys
D) intestines
E) bronchi

Question 7

Which of the following substances is an anticoagulant secreted by endothelial cells?

A) Von Willebrand factor
B) Prothrombin
C) Inhibitor of plasminogen activator
D) Thrombomodulin
E) Tissue factor

Question 8

Which of the following is the most common site for arteriolar thromboembolization?

A) Brain
B) Heart
C) Kidneys
D) Lower extremities
E) Eyes

Question 9

Which form of hemorrhage is most typical of defective platelet function seen in uremia (end stage kidney failure)?

A) Multiple petechiae
B) Multiple ecchymoses
C) Solitary ecchymoses
D) Hematoma
E) Hemarthrosis

Question 10

A 30-year-old woman fractured her leg, and a few days later developed a diffuse petechial rash in the nondependent areas of the body. She was short of breath and had minor neurologic symptoms. Laboratory studies showed thrombocytopenia. These findings are most consistent with

A) air embolism
B) bone marrow embolism
C) fat embolism
D) talc embolism
E) cholesterol crystal embolism

Question 11

A 60-year-old woman had a mastectomy for advanced cancer in her left breast, followed by chemotherapy and radiation therapy. She developed edema of the left arm. This edema is caused by

A) obstruction of the lymph flow
B) arterial thrombosis
C) venous thrombosis
D) spread of cancer into the soft tissue of the arm
E) hypoalbuminemia secondary to liver injury caused by hepatic metastases

Question 12

The most common form of congenital coagulopathy, factor V mutation (Leyden mutation), causes the altered coagulation factor V to be resistant to the action of which enzyme?

A) Protein C
B) Protein S
C) Antithrombin III
D) Plasmin
E) Thrombin