D236 Pathophysiology - Set 5 - Part 2

Correct Answer: Water retention

Excess ADH causes water retention diluting sodium concentration despite normal total body sodium, requiring fluid restriction.
Option a is incorrect because sodium isn't lost; it becomes diluted from excessive water retention in SIADH.
Option c is incorrect because sodium doesn't shift into cells; dilution from water retention causes hyponatremia described.
Option d is incorrect because SIADH causes water retention, not loss; this retention dilutes sodium concentration.

Correct Answer: Chromosomal translocation

Philadelphia chromosome results from translocation between chromosomes nine and twenty-two creating BCR-ABL fusion driving leukemia proliferation.
Option a is incorrect because Philadelphia chromosome involves large DNA segment exchange, not single nucleotide changes described.
Option c is incorrect because the abnormality involves chromosome fusion creating new gene, not deletion of existing genes.
Option d is incorrect because gene amplification increases copy number; Philadelphia chromosome involves translocation creating fusion gene.

Correct Answer: Pulmonary edema

Left heart failure causes pulmonary edema with fluid entering alveoli, creating pink frothy sputum from blood-tinged fluid.
Option a is incorrect because pneumonia produces purulent sputum from infection, not the pink frothy fluid described here.
Option c is incorrect because pulmonary embolism may cause hemoptysis but not the characteristic pink frothy sputum pattern.
Option d is incorrect because pneumothorax involves air in pleural space, not fluid in alveoli causing sputum.

Correct Answer: Proliferation

Keratinocyte hyperproliferation in psoriasis causes rapid turnover creating thick silvery plaques as cells accumulate faster than shedding.
Option a is incorrect because apoptosis is decreased in psoriasis; hyperproliferation causes the plaque buildup described here.
Option c is incorrect because differentiation is abnormal but hyperproliferation is the primary driver of plaque formation.
Option d is incorrect because while immune cells migrate, keratinocyte proliferation causes the characteristic skin changes described.

Correct Answer: Ammonia

Failed hepatic ammonia detoxification allows accumulation affecting brain function, causing confusion progressing to coma potentially.
Option a is incorrect because bilirubin causes jaundice but ammonia specifically causes the neurological symptoms described here.
Option c is incorrect because urea elevation indicates kidney problems; ammonia causes hepatic encephalopathy symptoms described.
Option d is incorrect because creatinine reflects kidney function; ammonia accumulation causes the brain dysfunction described.

Correct Answer: Vessel connection

AVMs involve abnormal direct connections between arteries and veins without intervening capillaries, risking hemorrhage or ischemia.
Option a is incorrect because AVMs involve abnormal connections, not obstructions blocking flow through vessels described.
Option c is incorrect because the problem is inappropriate connections, not vessel narrowing or stenosis patterns.
Option d is incorrect because while vessels may dilate, the primary abnormality is direct arteriovenous connections described.

Correct Answer: Continuous versus skip

Crohn disease shows skip lesions with normal areas between affected segments while ulcerative colitis spreads continuously.
Option b is incorrect because while Crohn is transmural, the skip pattern versus continuous spread distinguishes them primarily.
Option c is incorrect because both can affect various locations; the patchy versus continuous pattern distinguishes them.
Option d is incorrect because both are chronic conditions; the distribution pattern of lesions distinguishes them clearly.

Correct Answer: Cytokines

Inflammatory cytokines from burn injury increase vascular permeability causing fluid shifts despite replacement, requiring careful monitoring continuously.
Option a is incorrect because epinephrine is stress response but cytokines specifically increase the permeability causing fluid loss.
Option c is incorrect because insulin regulates glucose; cytokines cause the vascular permeability changes in burn injury.
Option d is incorrect because glucagon affects glucose metabolism; inflammatory cytokines cause capillary leak syndrome described.

Correct Answer: Wernicke area

Wernicke area damage causes receptive aphasia with fluent speech lacking meaning and comprehension deficits characteristically present.
Option a is incorrect because Broca area damage causes expressive aphasia with comprehension preserved but speech production impaired.
Option c is incorrect because motor cortex damage causes weakness or paralysis, not the language deficits described here.
Option d is incorrect because sensory cortex processes sensation; Wernicke area specifically processes language comprehension described.

Correct Answer: Venous hypertension

Valve incompetence causes venous hypertension leading to edema, skin changes, and ulceration typically near medial malleolus.
Option a is incorrect because arterial insufficiency causes different ulcer patterns; venous hypertension causes stasis ulcers described.
Option c is incorrect because lymphatic problems cause lymphedema; venous hypertension specifically causes stasis ulceration patterns.
Option d is incorrect because capillaries remain but venous hypertension causes the tissue damage and ulceration described.

Correct Answer: Total versus protein

Marasmus involves total calorie deficiency causing wasting while kwashiorkor involves protein deficiency with edema despite adequate calories.
Option a is incorrect because both involve macronutrient deficiencies, not primarily vitamin or mineral deficiencies described.
Option c is incorrect because both can be chronic; the distinction is total calorie versus protein deficiency specifically.
Option d is incorrect because both primarily affect children; the nutritional deficit type distinguishes these conditions clearly.

Correct Answer: Cardiac output

Increased cardiac output compensates for reduced oxygen-carrying capacity by delivering blood more frequently to tissues needing oxygen.
Option a is incorrect because while breathing may increase, cardiac output increase is the primary compensation for anemia.
Option c is incorrect because blood viscosity decreases in anemia; increased cardiac output provides compensation described here.
Option d is incorrect because while vasodilation occurs, increased cardiac output is the main compensatory mechanism described.

Correct Answer: Catecholamines

Pheochromocytomas secrete epinephrine and norepinephrine causing paroxysmal hypertension, palpitations, and sweating episodes characteristically occurring.
Option a is incorrect because cortisol excess causes Cushing syndrome; pheochromocytomas specifically secrete catecholamines causing symptoms.
Option c is incorrect because aldosterone excess causes different hypertension pattern; catecholamines cause episodic symptoms described.
Option d is incorrect because androgen-secreting tumors cause virilization; catecholamines cause the cardiovascular symptoms described here.

Correct Answer: Golgi apparatus

Golgi apparatus modifies proteins with glycosylation and packages them into vesicles for cellular export or membrane insertion.
Option a is incorrect because rough ER synthesizes proteins but Golgi performs final modifications and packaging described.
Option c is incorrect because smooth ER synthesizes lipids and detoxifies substances, not protein packaging described here.
Option d is incorrect because nucleolus produces ribosomal RNA, not the protein modification and packaging functions described.

Correct Answer: Platelet deficiency

Low platelet counts prevent adequate primary hemostasis allowing blood to leak from capillaries forming small purpuric spots.
Option a is incorrect because vessel inflammation causes different patterns; platelet deficiency specifically causes petechiae formation described.
Option c is incorrect because clotting factors affect secondary hemostasis; platelets prevent the capillary leaking causing petechiae.
Option d is incorrect because collagen defects cause different bleeding patterns; platelet deficiency causes petechial hemorrhages described.

Correct Answer: Glucuronyl transferase

Reduced UDP-glucuronyl transferase activity impairs bilirubin conjugation causing mild unconjugated hyperbilirubinemia during stress or fasting.
Option b is incorrect because alkaline phosphatase elevation indicates bile duct problems, not the conjugation defect described.
Option c is incorrect because transaminases indicate hepatocyte damage; Gilbert syndrome involves conjugation enzyme deficiency specifically.
Option d is incorrect because dehydrogenases have various functions; glucuronyl transferase specifically conjugates bilirubin described here.

Correct Answer: Glycolytic switch

Cancer cells shift to glycolysis for energy even with oxygen present, allowing survival in hypoxic tumor environments.
Option a is incorrect because cancer cells actually reduce oxidative respiration, relying on glycolysis described instead.
Option c is incorrect because while lipid metabolism occurs, the glycolytic shift enables hypoxic survival specifically described.
Option d is incorrect because protein breakdown occurs but glycolytic metabolism specifically allows low oxygen survival.

Correct Answer: Epithelioid macrophages

Activated macrophages transform into epithelioid cells forming granuloma centers surrounded by lymphocytes in sarcoidosis and similar conditions.
Option a is incorrect because neutrophils cause acute inflammation; epithelioid macrophages form chronic granulomas described here.
Option c is incorrect because plasma cells produce antibodies; epithelioid macrophages are the central granuloma cells described.
Option d is incorrect because mast cells mediate allergic responses; macrophages form the granuloma structure described here.

Correct Answer: Difficulty versus pain

Dysphagia involves difficulty swallowing while odynophagia specifically means painful swallowing regardless of mechanical difficulty present.
Option a is incorrect because both can affect any level; the distinction is difficulty versus pain with swallowing.
Option c is incorrect because both can affect solid or liquid swallowing; pain versus difficulty distinguishes them.
Option d is incorrect because both can be acute or chronic; the symptom quality of pain versus difficulty distinguishes them.

Correct Answer: Transferrin

Transferrin binds iron for safe transport to bone marrow and storage sites, preventing oxidative damage from free iron.
Option a is incorrect because ferritin stores iron intracellularly; transferrin specifically transports iron in blood circulation.
Option c is incorrect because hemosiderin is storage form in tissues; transferrin provides the transport function described.
Option d is incorrect because haptoglobin binds free hemoglobin; transferrin specifically transports iron in plasma described.