Property:Prompt
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A 15-year-old girl is brought by her parents to the physician’s office for a routine check-up. The patient's past medical history is remarkable for congenital hip dislocation and bicuspid aortic valve. The patient appears short with low-set ears, a webbed neck with redundant neck folds, and a broad-shield chest. Physical examination is remarkable for delayed femoral pulses. Which of the following conditions is associated with this patient's disease? +
Following delivery, a 28-year-old woman states that her newborn boy is continuously dripping urine. On physical examination, the pediatrician notes the newborn has an abnormal opening of the penile urethra on the dorsal side of his penis. When asked, the physician explains that the condition is caused by the faulty positioning of the genital tubercle during development and states that the patient will require surgical management. Which of the following conditions is this patient's most likely diagnosis? +
A 6-month-old boy is brought by his mother to the physician's office for failure to thrive. Following appropriate work-up, the patient is diagnosed with a disease that is characterized by an inability to phosphorylate mannose residues on glycoproteins and results in the aggregation of a variety of substrates in the extracellular matrix. Which of the following clinical features are associated with this patient's condition? +
A 67-year-old man presents to the physician's office with complaints of weight loss, fever, and night sweats. Following appropriate work-up,you diagnose him with acute myelogenous leukemia (AML) and start him on scheduled chemotherapy sessions. Three weeks into the treatment, you detect that patient is profoundly thrombocytopenic and requires a platelet transfusion. During the transfusion, the patient develops fever, chills, and intense flushing, but denies any itching or shortness of breath. On physical exam, you find that the patient has a temperature of 38.5 °C (101.3 °F) , heart rate of 108 bpm, respiratory rate of 18/min, and blood pressure of 128/78 mmHg. What is the most likely cause of this patient's reaction to the platelet transfusion? +
A researcher, studying the regulation of transcription in mice, shows that core histones undergo molecular changes at particular lysine residues, in order to neutralize their positively charged tail and to decrease their affinity for DNA. These changes enable regulatory proteins to access chromatin templates, which are required for transcription. Which of the following molecular changes is most likely to impact the histones in the researcher's observations? +
A geneticist studying the process of aging in rat cells reports the discovery of specific G-rich regions that undergo single strand breaks following oxidative damage. In his experiment, he shows that these regions reflect the replicative potential and the biological age based on the cumulative oxidative damage sustained by these somatic cells. Which of the following regions of DNA are most likely referred to by the geneticist? +
A 13-year-old girl presents to the physician's office for excessive thirst, frequent urination, and weight loss. She reports that she recently noticed several raised scalp lesions that have been increasing in number. On physical examination, you observe extensive scalp lesions, cervical lymphadenopathy, and exophthalmus. A CT scan displays coalescent osteolytic lesions of the skull with a geographical appearance. Biopsy of the skin lesions demonstrates dermal infiltration of clustering cells, with large ovoid pink cytoplasm under light microscopy with positive immunofluorescence staining for S100 and CD1a. Electron microscopy of the sample reveals the presence of pentalaminar membranous organelles, resembling tennis rackets, near the nuclear membrane. What is the most likely diagnosis based on the findings? +
A 3-year-old African American boy is brought by his parents to the emergency department for irritability and swelling in the hands and feet. A thorough work-up reveals that the patient has a mutation in the hemoglobin gene that renders red blood cells susceptible to low oxygen tension. The attending physician explains to the mother that the child will likely need treatment with a chemotherapeutic agent to control his disorder. By which of the following mechanisms does this agent help relieve the patient's symptoms? +
A 42-year-old man presents to the physician's office with complaints of right shoulder pain radiating to the neck and upper back for the past 3 weeks. He reports that the pain started after getting hit on the neck during a recent basketball game. Physical exam reveals normal passive motion but limited sustained abduction and elevation of the shoulder. Which other finding is most likely to be present in this patient? +
An unconscious 67-year-old man with no advance directive is brought to the emergency department by EMS. Following appropriate work-up, the patient is diagnosed with an acute MI and is admitted for appropriate management. Several days later, the physician in charge informs the family that the patient is on life support. The patient has no attorney for healthcare and has no court-appointed legal guardian. When informed, the patient's family members start to discuss among themselves the possibility of taking the patient off life support. His wife states that her husband "would have wanted to stop life support right away". On the other hand, the patient's children and siblings argue that his wife's decision is not in the patient's best interest. They all agree that based on previous decisions made by the patient, "he would do anything to stay alive". The family members ultimately fail to reach a unanimous decision. Which of the following is the most appropriate way to proceed with this patient's case? +
A 52-year-old man presents to the physician's office for fatigue and feelings of guilt and hopelessness. Upon questioning, the patient explains that he has been unemployed for several years, and has been drinking whiskey in excess for the past 2 months. He cannot concentrate on daily activities, has had little appetite, and has been having difficulty falling asleep. Which of the following questions is most important to ask during the assessment of this patient? +
A geneticist, conducting an experiment using rat cells to study the mechanisms of DNA repair, exposes the cells to high doses of radiation and induces DNA single-strand breaks in the double-stranded DNA. He observes that ATP consumption increases and phosphodiester bonds begin to form. Which of the following enzymes is most likely involved in this process? +
A researcher inactivates the components of the ectoderm rimming of the distal tip of a limb bud, from a mouse, at an early stage. He finds that only the proximal skeletal segment develops with a complete absence of the middle and the distal segments. Then, he applies beads soaked in recombinant proteins at the tip of the limb buds and observes that normal limb development occurs successfully. Protein is most likely expressed by which of the following genes in the recombinant-soaked beads? +
A pregnant 28-year-old female presents to her gynecologist's office for a routine pregnancy visit. In the office, the gynecologist performs a pregnancy ultrasound. He informs the patient that she has twins. Then he explains to the patient that the cleavage of the fertilized egg likely occurred between day 4 and day 8 post-fertilization. Which of the following ultrasound findings is most likely present in this patient? +
During development, in-utero testosterone secretion by the testes act directly on the Wolffian ducts and play an important role in the differentiation of external and internal male organs. Similarly, dihydrotestosterone (DHT), a more potent androgen derived from testosterone by the action of 5-alpha-reductase, is also involved in the differentiation of male organs. Which of the following processes is a function of DHT? +
A researcher studying the process of ovulation in human females recruits 10 female volunteers. He injects subcutaneously human chorionic gonadotropin (hCG) hormone and retrieves the eggs 35 hours later. Using the appropriate technique, he views the eggs under fluorescence microscopy. Under fluorescence microscopy, which of the following findings does the researcher most likely observe? +
In order to study cellular responses, a student exposes two groups of mice to an influenza virus infection: A control group with intact bone marrow and another group with completely ablated bone marrow. The student observes that in the control group, concentrations of an intracellular protein (Protein A) in muscle cells rise in parallel with the intracellular activity of 2'-5′ oligoadenylate synthetase and the serum concentration of IFN-α/β. In contrast, the influenza viral load is much more elevated in the group with the ablated bone marrow, while no rise in protein A concentrations is observed. Which of the following is the most likely function of protein A? +
Human Immunodeficiency Virus (HIV) is a spherical retrovirus surrounded by an envelope composed of a phospholipid bilayer. It is a diploid virus composed of positive single-stranded RNA that codes for 9 viral genes. Two proteins on the surface of the viral envelope are derived from the ''env'' gene, which is essential for viral tropism. Which of the following proteins are required for viral attachment to host T-cell and entry, respectively? +
Viral hepatitis is a prevalent infectious disease that is associated with significant worldwide morbidity and mortality. Despite being a relatively common disease, prognosis differs greatly and depends on the host immunity, viral type, and strain. Which of the following viral type and host combinations is associated with a high mortality rate? +
A student is conducting an experiment to test optimal bacterial survival environments. She begins by plating a mixture of bacterial organisms on blood agar and allowing them to grow for several days in an incubator at 37 °C with ample oxygen. She then places the plate in an airtight container with an alkaline solution containing pyrogallic acid, which absorbs any oxygen from the container, and allows the plate to stand for several days. Which of the following organisms is most likely to survive both steps? +