Anatomy Exam 2 – 2019

1. A patient comes in saying they can’t feel their hand. Due to a language barrier, they cannot articulate where their hand is numb. Upon physical examination, you note that they are able to grasp a paper between their first and second distal phalange but not between their third and fourth phalange. Which nerve are you concerned with?

1. Median Nerve

2. Radial Nerve

3. Ulnar Nerve

4. Recurrent branch of the medial nerve

5. Deep branch of the ulnar nerve

2. An inability to feel the skin on the dorsal surface of the base of the thumb would result from which of the following?

1. Damage to the deep ulnar nerve

2. Damage to the radial nerve

3. Damage to the recurrent branch of the median nerve

4. Damage to the median nerve

5. Damage to the ulnar nerve

3. During the first day of anatomy dissection, Dr. Throckmorton cut the tip of his finger requiring stitches. Which of the following explains why it bled like the dickens?

1. There are lots of recurrent arteries in the hand

2. He nicked his superficial palmar arch

3. He nicked his deep palmar arch

4. The capillary beds have more blood in them

5. There are more proprioceptors in the fingertips

4. An inability to abduct the thumb would result from which of the following?

1. Damage to the deep ulnar nerve

2. Damage to the superficial branch of the radial nerve

3. Damage to the recurrent branch of the median nerve

4. Damage to the median nerve

5. Damage to the ulnar nerve

5. Which of the following is a cause of clubbed nails?

1. COPD

2. Leprosy

3. Cystic fibrosis

4. Kidney failure

5. Type II diabetes

6. A T1 weighted MRI shows the following issue.  Which of the following actions would they not be able to do?

1. Extend their pinky

2. Adduct their wrist

3. Extend their index finger

4. Supinate their wrist

5. Extend their thumb

7. A patient presents to the ED after a game of intramural flag football and is unable to extend their DIP joint on their right 2nd finger. During their physical exam you also notice that they have blood visible beneath their nailbed. Which of the following injuries did they most likely sustain?

1. Extensor tendon rupture

2. Avulsion injury of the distal manual phalanx 

3. Avulsion injury of the distal pedal phalanx

4. Dislocation

5. Sesamoid formation

8. While performing a physical exam on your patient you notice what appears to be a bruise under the patient’s nail. The patient doesn’t remember any trauma that occurred to the phalange. You decide to trephinate it. It bleeds, but does not clear. This is most likely:

1. Indication of subungual hematoma

2. Indication of subungual melanoma

3. Indication of kidney problems

4. Indication of liver disease

5. Indication of heavy metal poisoning

9. Delilah just found out she’s pregnant. She has struggled with migraines since college and was put on Depakote, a valproic acid derivative. Her doctor tells her that she can no longer take this medication. Which of the following is an explanation as to why?

1. It affects the closing of the primitive streak resulting in a sacrococcygeal teratoma

2. It causes the notochord to pinch off into three pieces essentially resulting in three non-functional spinal cords

3. It could cause anencephaly from the neural tube not closing completely 

4. It could cause the fetus to not form an axial skeleton

5. It could cause the fetus to form two extra arm buds in place of their leg buds

10. Janis went into her OBGYN after getting a positive pregnancy test. Her hCG levels were elevated but a transvaginal ultrasound did not show an embryo. Upon further examination, a hydatidiform mole was discovered. How did this happen?

1. The female pronucleus did not participate in development

2. The male pronucleus did not participate in development

3. More than one sperm got through the zona pellucida

4. She has miscarried after the embryo was attached to the uterine lining

5. The embryo did not form enough primary chorionic villi so it did not receive the proper nutrients for development

11. Which of the following happens during week two of human development?

1. Neural tube formation

2. Gastrulation

3. Hypoblast forms

4. Amniotic cavity forms

5. Fertilization

12. You and a classmate know that the bladder arises from the mesodermal layer of the embryo but are arguing over which division it comes from. Which of the following is the correct origin of the bladder?

1. Paraxial mesoderm

2. Intermediate mesoderm

3. Mesodermal cells of the parietal layer (lateral plate)

4. Mesodermal cells of the visceral layer (lateral plate)

5. Cardiogenic mesoderm

13. Patients with Cystic Fibrosis (CF) often produce an increase in respiratory mucous due to a genetic disorder and increased chloride ion pumping into the extracellular fluid. An increase in this respiratory mucous makes it difficult for which of the following structures to function properly?

1. Microvilli

2. Stereocilia

3. Cilia

4. Flagella

5. All of the above

14. Medications work by being able to get into the bloodstream, however many of these drugs would be lethal if they were to cross the blood-brain barrier. Which of the following junctions makes it so that these drugs cannot affect the integrity of the brain?

1. Adherent junctions

2. Desmosome

3. Hemidesmosomes

4. Tight junctions

5. Gap Junctions

15. Rachel comes in to your office saying that almost everything she is eating is either giving her diarrhea or making her constipated. She has lost almost 15 pounds this month without trying. A blood test confirms that she has celiac disease. Why would changing her diet help to alleviate her symptoms?

1. The cilia in her digestive tract are unable to move the types of food that she is consuming causing damage, so changing her diet would help with repairing the cilia

2. The microvilli were unable to absorb the foods that she was consuming, but after a week of a changed diet she should have new microvilli that has replaced the non-functioning microvilli.

3. The microvilli in her digestive tract are unable to move the types of food that she is consuming causing damage, so changing her diet would help with repairing the microvilli

4. The cilia were unable to absorb the foods that she was consuming, but after a week of a changed diet she should have new microvilli that has replaced the non-functioning cilia

16. Pemphigus foliaceus is a dyshessive skin disorder caused by an autoimmune disease in which IgG autoantibodies from patients recognize desmogleins (Dsg), which are cadherin-type cell–cell adhesion molecules found in which of the following junctions: 

1. Zonula adherens

2. Macula adherens

3. Hemidesmosome

4. Tight junction

5. Gap junctions

17. Which of the following is the least stable joint?

1. Glenohumeral joint

2. Sternoclavicular joint

3. Acromioclavicular joint

4. Humeroradial joint

5. Proximal radioulnar joint

18. While cheering, Kali is dropped from a stunt landing directly on her shoulder, which of the following is the most likely injury:

1. Tear of her glenohumeral ligament

2. Tear of her coracohumeral ligament

3. Fracture of her humeral diaphysis

4. Tear of her transverse humeral ligament

5. Dislocation of her shoulder

19. A 12 year old male patient presents to the emergency department after following an ATV accident. Imaging confirms avulsion of the medial epicondyle of the humerus. The patient complains of paresthesia in the fifth digit and the medial half of the fourth digit. Which action of the thumb is most likely weakened or absent in this patient?

A.             Adduction

B.             Adduction

C.             Extension

D.             Flexion

E.             None of the above.

20. A patient presents to your clinic after a recent wrist injury and you notice they are able to hyper-abduct their wrist. What structures are likely to be involved in this injury?

A.             Posterior radiocarpal and anterior joint capsule

B.             Radial collateral and lateral part of joint capsule

C.             Bony apposition between styloid process of radius and scaphoid

D.             Bony apposition between radius and carpal bones

E.             Anterior radiocarpal and anterior part of joint capsule

21. Which of the following is NOT a function of the Sartoris?

1. Flexion at the hip

2. Lateral Rotation of the Thigh

3. Extension at the knee

4. Medial Rotation of the Leg

5. Flexion at the knee

22. Edna was carrying in her groceries when she slipped and fell on the ice hitting the posterolateral aspect of her hip and buttocks. She is unable to rotate her toes inward with her leg straight from a standing position. Which of the following muscles is likely injured?

1. Tensor Fasciae Latae

2. Gluteus maximus

3. Piriformis

4. Pectinius

5. Obturator externus

23. Which of the quadriceps muscles has a primary function other than extension at the knee joint?

1. Vastus Lateralis

2. Vastus Medialis

3. Vastus Intermedius

4. Vastus Outermedius

5. Rectus Femoris

24. Which of the following is not a component of the Femoral Triangle?

1. Sartorius

2. Iliopsoas

3. Inguinal Ligament 

4. Gracilis

5. Adductor Longus

25. Chloe suffers from chronic kidney infections usually brought about from UTIs. She usually gets Doribax, an IM-injected antibiotic, at the first sign of a UTI to prevent it from becoming a kidney infection. While at the doctor’s office, a new nurse is training and begins to prep the lower lateral quadrant of her left buttcheck when her trainer stops her. Why shouldn’t the shot be injected there?

1. There isn’t enough subcutaneous fat in this region so it would cause unnecessary pain

2. This region is highly vascular and would cause bleeding

3. This region has large nerves passing through that could be punctured causing nerve damage

4. This drug should be given IV and not IM

5. There is too much subcutaneous fat in this area and it would not be well-absorbed.

26. Vivian is an avid rock-climber. While rappelling down, her cable was too loose causing her to rappel down very quickly. On her rapid dissent, she was punctured in her right gluteal region with a very sharp stick which went into the thickest part of her right glute about two inches. While in the ER, she is asked to stand on her left leg and her right hip veers up. Which of the following nerves did Vivian injure?

1. Sciatic

2. Superior gluteal

3. Inferior gluteal

4. N. to quadratus femoris

5. N. to obturator internus

27. A patient comes into the ER and has reportedly injured his pudendal nerve. Your attending tells you that he is concerned for the injury but also other possible injuries in the roots in the Sacral Plexus. What roots might be of concern?

A.             L5-S3

B.             L4-S4

C.             L4-S5

D.             L2-S2

E.             S1-S4

28. Respectively, which of the following muscle-nerve pairs is incorrect. 

A.             Gluteus Maximus/Inferior Gluteal Nerve

B.             Gluteus Medius/Superior Gluteal Nerve

C.             Gluteus Minimus/Superior Gluteal Nerve

D.             Inferior Gemelli/Nerve to Obturator internus

E.             Superior Gemelli/Nerve to Obturator internus

29. Which of the following nerves is sensory only?

1. Sciatic

2. Common Fibular

3. Tibial

4. Sural

5. All of the above are mixed (sensory and motor) nerves

30. Which of the following muscles makes up a part of the floor for the popliteal fossa?

1. Semitendinosus 

2. Biceps Femoris

3. Plantaris 

4. Gastrocnemius

5. Soleus

31. A blockage is discovered in the popliteal artery just after it has passed through the adductor hiatus. Which of the following blood vessels will receive blood and then be able to bypass the blockage to allow blood flow inferior to the knee?

1. Superior medial genicular artery

2. Middle genicular artery

3. Inferior lateral genicular artery

4. Anterior tibial recurrent artery

5. Descending genicular artery

32. A soccer player comes into the ED with pain in her posterior thigh after injuring herself in a game earlier that night. When looking at the patients MRI T2 scan you notice a large white area where she is feeling pain. What does the large white area represent?

1. Hematoma

2. Edema

3. Muscle Strain

4. Ischial tuberosity avulsion

5. Tumor

33. The lining of the bronchi allows for the exchange of oxygen across the membrane through the function of epithelial cells. Which of the following is the origin of this layer?

1. Endoderm

2. Paraxial mesoderm

3. Intermediate mesoderm

4. Surface ectoderm

5. Lateral mesoderm

34. A mother brings her baby to the clinic that you are working at. You take note of the fact that the baby displays thin lip, flat nose bridge, and a short nose. Following your observations, if the baby has fetal alcohol syndrome, what is the time period during which it was most likely exposed to ethanol?

1. The entire first trimester

2.  Weeks 1-2

3. Weeks 3-8

4. Weeks 8-12

5. Ethanol would not have an impact on embryonic development

35. Cleft lip is a common craniofacial defect in which the roof of the mouth and  the lip does not fully fuse. Although it is easily identifiable appearance-wise it generally is asymptomatic. Which layer of the trilaminar disc is affected by this defect?

1. Endoderm

2. Head mesoderm

3. Intermediate mesoderm

4. Lateral mesoderm

5. Neuroectoderm 

36. Defective enamel development can be the result of an inherited condition called amelogenesis imperfecta, or congenital enamel hypoplasia, which is estimated to affect about 1 in 14,000 people in the United States. This condition can also cause unusually small teeth and a variety of dental problems. Which layer of  the trilaminar disc is affected by this defect?

1. Endoderm

2. Head mesoderm

3. Intermediate mesoderm

4. Lateral mesoderm

5. Neuroectoderm 

37. A patient presents to the ED in severe distress after a ruptured aortic aneurysm. While rushing the patient to the OR you notice they are quite tall with very slender limbs and unusually long fingers. After looking at the patient’s chart, you’re not surprised to find out they have which of the following conditions?

1. Hurler’s Syndrome

2. Kniest Dysplasia

3. Alport Syndrome

4. Marfan Syndrome

5. Ehlers-Danlos Syndrome

38. Studies have found that pericyte loss in adults and aging brain can lead to neurodegeneration and neuroinflammation. Which of the following explain the cellular basis of this?

1. They are involved in the formation of the blood-brain barrier

2. They are involved at the neuromuscular junctions

3. They are involved in moving nutrients to the brain

4. They are involved in blood circulation to the brain

5. They are involved in the process of AChE degeneration

39. An unlabelled slide appears as above. Given that this is connective tissue, what is its most likely function?

1. Support

2. Resistance to stress in one direction

3. Resistance to stress in multiple directions

4. Flexible support

5. Providing oxygen and nutrients

40. Which of the following is derived from antigen-stimulated b-lymphocytes, primary producers of circulating antibodies and has a clock face nucleus?

1. Plasma cells

2. Fibroblasts

3. Pericytes

4. Mast cells

5. Basophiles

41. A patient present after a motorcycle accident in which they injured their medial malleolus and the contents of the tarsal tunnel. Which of the following actions would this patient have reduced capability?

1. Dorsiflexion

2. Plantarflexion

3. Extension of DIP and PIP joints

4. Eversion of the Foot

5. Adduction of the 1st Toe

42. A patient presents with the inability to dorsiflex their foot. Which of the following nerves is most likely damaged?

1. Tibial

2. Anterior Tibial

3. Common Fibular

4. Deep Fibular

5. Superficial Fibular

43. Which of the following plantarflexion muscles is least important in that action?

1. Gastrocnemius

2. Soleus

3. Plantaris

4. Tibialis Posterior

5. Flexor Digitorum Longus

44. A Jones Fracture of the tuberosity of the 5th metatarsal would likely damage the tendon of which muscle?

1. Tibialis Anterior

2. Tibialis Posterior

3. Extensor Digitorum Brevis

4. Fibularis Longus

5. Fibularis Brevis

45. Which of the following is true for both the hand and the foot?

1. Centered around the 3rd ray axis

2. TMT joints/CMC joints will dorsiflex/extend

3. Dorsal Interossei are bipennate 

4. 8 tarsal/carpal bones

5. Each digit has 3 phalanges 

46. Which of the following is innervated by the lateral plantar nerve?

1. Flexor Digitorum Brevis 

2. Adductor Hallucis 

3. Abductor Hallucis

4. Extensor Digitorum Brevis

5. First Lumbrical 

47. Bethany was doing a fouetté turn when she lost her balance and fell onto the outside of her foot. She thought she had just twisted her ankle or sprained her foot, but after a week of it hurting decided to go to the clinic. Her doctor tells her that she has a Jones fracture. This means that she fractured her:

1. Calcaneus

2. Cuboid

3. Fifth metatarsal tuberosity

4. Fifth distal pedal phalange

5. Fifth intermediate pedal phalange

48. After a pick up game of basketball over the weekend, Robert believes he has sprained his ankle. He is unable to rotate his foot in or out. Which type of sprain does he likely have?

1. Tibiotalar

2. Subtalar

3. Talonavicular

4. Calcaneocuboid

5. Naviculocuneiform

49. An unlabeled tissue sample slide was found as seen above. Where in the body could this have come from?

1. Dorsum of hand

2. Fingernail

3. Bladder

4. Plantar surface of foot

5. Cornea 

50. Mutations in the gene OCA2 cause an autosomal recessive disorder that affects tyrosinase. Which of the following would you expect a patient with this mutation to present with?

1. Excessive pigmentation

2. Lack of melanocytes

3. Increased risk of blindness

4. Decreased risk of melanoma

5. Severe skin flaking

51. As we age, type I collagen in which layer of skin begins to break down causing skin to lose its elasticity and become wrinkled?

1. Papillary layer of dermis

2. Reticular layer of dermis

3. Stratum spinosum of epidermis

4. Stratum corneum of epidermis

5. Stratum granulosum of epidermis

52. Ta mako is a traditional Maori tattooing practice in which deep cuts are incised and then a chisel is dipped into pigment and tapped into cuts. This process leaves the tattoos with textured grooves instead of smooth skin seen in traditional tattooing. In which layer does this pigment reside?

1. Subcutaneous

2. Papillary dermis

3. Reticular dermis

4. Stratum basale

5. Stratum spinosum

53. Morphea is a form of localized scleroderma where waxy patches of varying sizes appear on the skin with thickened skin below. The skin in these areas are not able to feel a bug land on them. Which of the following mechanoreceptors is affected in morphea?

1. Meissner Corpuscles

2. Pacinian Corpuscles

3. Krause end bulbs

4. Ruffini Corpuscles

5. Lamellated Corpuscles

54. Which of the following is a difference between eccrine and apocrine sweat glands?

1. Eccrine are found in the armpits and genitalia whereas apocrine is found all over the body

2. Eccrine are simple cuboidal whereas apocrine are stratified cuboidal

3. Eccrine receive cholinergic fibers whereas apocrine are innervated by adrenergic nerve fibers.

4. Eccrine open onto the skin surface whereas apocrine open into a lumen within the body

5. Eccrine sweat glands utilize holocrine secretion whereas apocrine sweat glands utilize apocrine secretion

55. Epidermolysis bullosa is a disease that causes hemidesmosomes to break down causing formation of blisters and sloughing of skin. Which of the following stains would allow pathologists to see the hemidesmosomes?

1. Hematoxylin/Eosin

2. Toluidine Blue

3. Periodic Acid Schiff

4. Osmium tetroxide

5. Masson’s Trichrome

56. Heavily glycosylated proteins would be expected to be released from which of the following?

1.  Holocrine Glands

2. Apocrine Glands

3. Mucosal Merocrine Glands

4. Serous Merocrine Glands

5. Sweat Glands

57. A 13 year old boy in the 95th percentile for weight presents to your clinic limping and complaining of pain in his groin. Which of the following would you expect to see on his x-ray?

1. Avascular necrosis of the femoral head

2. Traumatic hip dislocation

3. Slipped Capital Femoral Epiphysis

4. Fracture of the pubis

5. Leg-Cath-Perth disease

58. Legg-Calvé-Perthes disease (LCPD) is avascular necrosis of the femoral head resulting from compromise of the blood supply to this area. Which of the following arteries would be affected?

1. Obturator Artery

2. Lateral circumflex femoral artery

3. Medial circumflex femoral artery

4. Profunda femoral artery

5. Inferior gluteal artery

59. Female sports players frequently laterally dislocate the patella. Which of the following is an explanation of why?

1. The lateral groove is smaller than the medial groove so it is more likely to dislocate that direction

2. Female hips are wider offset so they are more susceptible to a lateral dislocation

3. Female patellas are much less tightly associated with the femur and tibia than their male counterparts

4. The grooves of female patellas are not as large so they are more likely to dislocate in either direction than male patellas 

5. Male patellas have an extra lip on the groove that help to keep them in place than female patellas.

60. While performing an anterior drawer test on one of your patients you note that excessive movement is present. On that same patient you observe that there is a normal amount of “give” in the posterior drawer test. Which of the following ligaments might you expect to be damaged?

1. ACL

2. PCL

3. Medial Meniscus

4. Lateral Meniscus

5. Both A and B

61. Which of the following could have caused the abnormality in the image above?

6. Splenomegaly 

7. Paralysis of the left phrenic nerve

8. Paralysis of the right phrenic nerve

9. Paralysis of both phrenic nerves

10. Pericardial effusion
    

    Reveal Answer
    Answer C.

62. When attempting to do a thoracentesis in the 8th intercostal space, where will you anesthetize?

1. Only the 8th intercostal space

2. The 8th and the 9th intercostal space

3. Only the 9th intercostal space

4. The phrenic nerve/diaphragm interaction

5. All 12 intercostal spaces

63. Which of the following rib abnormalities would be the most problematic?

1. Absence of the 12th 

2. Absence of the 11th

3. Cervical Rib

4. Lumbar Rib

5. None of the above would cause any problem

64.  The first rib is atypical in that it can be described as the broad and sharpest of the 12 ribs. It also is noted to have grooves for both the _____ and _____. 

1. First Intercostal Nerve, First Intercostal Artery

2. First Subcostal Muscles, First Innermost Intercostal Muscles

3. Subclavian Vein, Subclavian Artery

4. Manubrium, Costoclavicular Cartilage 

5. Intercostal Vasculature, Collateral Vasculature

65. Donald has bacterial bronchitis. This has caused an excess of non-serous fluid to build up in his lungs causing him tightness in his chest and a persistent productive cough. Which of the following categories can bronchitis be classified as?

1. Hemothorax

2. Hydrothorax

3. Pyothorax

4. Chylothorax

5. Pneumothorax

66. Which of the following is an example of a parasympathetic function of the pulmonary plexus?

1. Increasing airflow

2. Decreasing blood flow to lungs

3. Coughing when there is an irritation

4. Sensing stretch to prevent overfilling of lungs

5. Increased oral secretions

67. After running a marathon, Mary was in tripod position heavily breathing. Which of the following is ensuring that she is not rupturing a lung by overfilling it?

1. Vagus Nerve

2. Cough reflex

3. Chemoreception

4. Hering Breuer Reflex

5. Nociception

68. Which of the following would cause hilar lymphadenopathy?

1. Breast cancer

2. Tuberculosis

3. Punctured lung

4. Hemothorax

5. Smoking

69. Walter is in the ER with chest pain from a possible myocardial infarction and claims that he has shooting pains down his left arm. Which of the following explain this?

1. The electrical impulses of the heart are firing rapidly causing pain to shoot along the pathway taken from the left ventricle which goes down the left arm

2. The vagus nerve in the superior mediastinum is sending signals to the abdominal viscera which is causing a viscerosomatic pain as it passes the dermatome of the left arm

3. The phrenic nerves in the middle mediastinum is sending signals to the diaphragm which is causing a viscerosomatic pain as it passes the dermatome of the left arm

4. The splanchnic nerves in the posterior mediastinum is sending signals to the abdomen which is causing a viscerosomatic pain as it passes the dermatome of the left arm

5. The electrical impulses are causing the vessels of the arm to constrict and blood pressure to increase. This causes pain as the blood rushes through the now narrower blood vessels. 

70. A problem in the maturation of the pleuropericardial membrane is a defect that is not compatible with life. This is because the pleuropericardial membrane:

1. Becomes the fibrous pericardium and without it, the heart would not stay in place

2. Becomes the serous pericardium and without it, the heart would rub against the cavity wall

3. Is involved in the formation of the divisions of the heart and without it, the heart would not be able to compartmentalize

4. It is involved in the separation of heart from lungs and without it, neither one would be functioning

5. It is involved in responsible for drainage of fluids around the heart and without it they would accumulate and have nowhere to go.

71.  While performing a pericardiocentesis in your very first clinical rotation the attending ask you what an alternative approach would be to the procedure, rather than entering “through the 5th or 6th intercostal space, proximal to the sternum”. You respond by telling him:

1. Enter at the infrasternal angle and pass the needle inferoposteriorly 

2. Enter the needle at the suprasternal notch and pass the needle superoposteriorly

3. Enter the needle from the intervertebral space of T1-T2 passing the needle inferoanteriorly

4. Enter at the infrasternal angle and pass the needle superoposteriorly

5. There is no alternative approach

72. Which of the following structures would you expect to find in the anterior mediastinum?

1. Esophagus 

2. Trachea

3. Thymus Remnants 

4. All of the above

5. Both B and C

73. Samuel presents to your clinic with a runny nose, sore throat, and cough. After running basic blood test you note that his eosinophil count is extremely elevated. What type of infection should be of primary concern?

A.             Bacterial

B.            Viral

C.            Parasitic

D.             None of the above.

E.             Both A and B

74. While on your pathology rotation you are asked to observe a particular leukocyte that is noted to lack granules. Which of the following cells could you potentially be viewing?

A.             Monocyte

B.             Neutrophil

C.            Eosinophil

D.             Lymphocyte

E.             Basophil

75. What type of granulocyte is known as the “first responders” concerning infection sites and is expected to dye “neutral pink” when exposed to H&E staining?

A.             Monocyte

B.             Neutrophil

C.            Eosinophil

D.             Lymphocyte

E.             None of the above

76. Tommy presents to your clinic after his recent hunting trip in North Dakota. Tommy is noted to have a reduction in his number of both erythrocytes and thrombocytes. What pathology should be included in your differential diagnosis?

A.             Babesiosis

B.             Thalassemia β

C.            Poryphyria

D.             Thalassemia ⍺

E.             Both B and D

77. A patient comes to your office after being exposed to poison ivy. Which of the following progenitor cells would you expect to be in excess in your patient?

1. Megakaryocyte

2. Erythrocyte

3. Myeloblast

4. Natural killer cell

5. Plasma cell

78. Natalie has megaloblastic anemia due to her vegan lifestyle and lack of red meat over the past five years. Which of the following would you expect her to be elevated due to it not being utilized?

1. Thrombopoetin

2. Erythropoietin

3. Tumor Necrosis factor-alpha

4. FMS-tyrosine kinase-like ligand 3

5. Transforming growth factor

79. While playing with your new kitten, Dwight, he scratched you out of the blue for no reason, as kittens often do. Your hand starts bleeding. Which of the following parts of the body would you expect to ramp up its thrombopoietin production in response?

1. Stromal cells of bone marrow

2. Endothelial cells of bone marrow

3. Macrophages

4. Helper-T cells

5. Hepatic cells 

80. As an embryo develops it goes through the following phases of fetal hemopoiesis:

I.               Hepatosplenothymic

II.              Medullolymphatic

III.            Pre-hepatic

IV.            Medullary

Which of the following has the phases in the correct chronological order?

A.             IV-III-II-I

B.             III-II-I-IV

C.              III-I-IV-II

D.             IV-I-II-III

E.              III-I-II-IV

81. In which structure would you find deoxygenated blood from the entire body?

1. Superior vena cava

2. Inferior vena cava

3. Coronary sinus

4. Azygous vein

5. Sinus of venarum

82. After an acute myocardial infarction some patients will develop a murmur that they didn’t previously have. Which of the following is a potential reason as to why this is?

1. The myocardial infarction caused papillary muscle dysfunction 

2. The blood now pumps through the heart at a slower rate

3. The myocardial infarction created a hole in the interventricular septum

4. The dead tissue of the heart slows down the blood through the valves

5. The valves have become paralyzed and remain open. 

83. A baby is born with patent fossa ovalis meaning that their fossa ovalis did not fully fuse. What problems would you expect this child to have if left untreated

1. They would not be able to efficiently pump blood throughout their body

2. They would not be able to efficiently pump blood to their lungs 

3. They would not be able to perfuse their tissues efficiently

4. They would have a mitral murmur

5. They would have a tricuspid murmur

84. In which layer of the heart is the conduction system?

1. Epicardium

2. Myocardium

3. Endocardium

4. Subendothelial connective tissue

5. Subcardium 

86. The circumflex artery has an almost complete occlusion. Which of the following anastomoses ensures that the left atrium is still receiving adequate blood flow?

1. Posterior Interventricular artery

2. Anterior Interventricular artery

3. Right coronary artery

4. Left marginal artery

5. Right marginal artery

87. After running from a vicious chiwawa, which of the following is triggering your SA node to decrease your heart rate back to normal?

1. Vagus nerve

2. Neurons from the lateral horn of T1-T4

3. Preganglionic sympathetic fibers

4. Left recurrent laryngeal nerve

5. Cardiac plexus

88.  In the event of observing a bull charge towards you in a closed-off alleyway, you notice your heart rate has started to increase. Which of the following would you expect to be involved in signaling for this physiological event?

1. The Vagus nerve

2. Neurons from the lateral horn of T1-T4

3. Preganglionic sympathetic fibers

4. Both B & C

5. The Phrenic Nerve

89. Which of the following is the most anterior?

1. Brachiocephalic trunk

2. Left common carotid artery

3. Left subclavian artery

4. Left brachiocephalic vein

5. Thymus

90. Which of the following is true regarding the thymus

1. It increases hormonal secretion at puberty

2. It is located posterior to the great arteries of the heart

3. It is located in the pericardium

4. It is bilobar

5. It produces B-cells

91. Chris is a patient of yours that has recently suffered from an aneurysm is his ascending aorta. Which of the following anatomical factors makes it more likely for a patient to have such an event?

1. Serous pericardium covers the entire heart

2. Fibrous pericardium reinforcement is only found on the surfaces of the heart

3. Fibrous pericardium reinforcement doesn’t begin until the start of the aortic arch

4. The endothelial lining of the distal ascending aorta sustains a great deal of thrust during each phase of systole

5. Both C & D

92. While obtaining a history from a new patient of yours, you ask about any prior medical history. They state that they had an aortic coarctation 1 year earlier. What would be the most probable location of such pathology. 

1. At the start of the ascending aorta

2. As the descending aorta bifurcates 

3. The likelihood of coarctation remains constant throughout the entire aorta

4. At the site of the ligamentum arteriosum

5. The aortic root