1. The sphincter doesn’t remain closed and the pressure in the stomach pushes the stomach contents into the esophagus. 2. The mucosa takes on a “cobblestone” appearance. 3. A defect in the diaphragm permits a portion of the stomach to pass through the esophageal hiatus into the chest cavity. 4. Helicobacter pylori bacteria release a toxin that de- stroys the stomach’s mucous lining. 70. Which laboratory test helps distinguish esophagitis from car- diac disorders? 1. Esophageal manometry 2. Barium swallow 3. Acid-perfusion test 4. Upper GI series 71. Which disorder occurs more commonly in children than adults? 1. Osteoarthritis 2. Osteomyelitis 3. Osteomalacia 4. Osteoporosis 72. What’s the most common causative organism in os- teomyelitis? 1. Staphylococcus aureus 2. Streptococcus pyogenes 3. Pseudomonas aeruginosa 4. Proteus vulgaris 479 PRACTICE MAKES PERFECT
73. Pulmonary embolism generally results from an obstruction of the pulmonary arterial bed caused by: 1. sickle cell disease. 2. foreign substance. 3. heart valve growth. 4. dislodged thrombi originating in the leg veins or pelvis. 74. Which signs and symptoms are associated with severe acute respiratory syndrome (SARS)? Select all that apply. 1. High fever 2. Chills 3. Sudden onset of chest pain 4. Dry cough 5. Shortness of breath 6. Neck stiffness 75. A 72-year-old patient is admitted to the emergency depart- ment with a stroke. The patient was believed to be lying on the floor for more than 24 hours. Rhabdomyolysis is also suspected. When rhabdomyolysis occurs, which substances are released from necrotic muscle fibers into the circulation? Select all that ap- ply. 1. Myoglobin 2. Potassium 3. Creatine kinase (CK) 4. Urate 5. Sodium 6. Calcium 76. Which test findings help to confirm the diagnosis of rhab- domyolysis? Select all that apply. 1. Elevated cardiac troponin level 2. Severely elevated creatine kinase (CK) level 3. Hypercalcemia (in early stages) 4. Elevated serum creatinine level 5. Elevated intracompartmental venous pressure 6. Urine myoglobin level greater than 0.5 mg/dl 480 PRACTICE MAKES PERFECT
77. Rank in order the pathological progression of rhabdomyoly- sis. Use all of the options. 78. In gastroesophageal reflux disease, the lower esophageal sphincter (LES) doesn’t remain closed because of deficient lower esophageal pressure. Place an “X” over the LES. 481 PRACTICE MAKES PERFECT 1. Local edema increases compartment pressure and tamponade. 2. Pressure from severe swelling causes blood vessels to collapse. 3. Substances are released from the necrotic muscle fibers into the circulation. 4. Muscle trauma compresses tissue. 5. Tissue ischemia and necrosis occur.
79. A patient is hospitalized for observation after a head injury. He’s now having tonic-clonic seizures and has been ordered an im- mediate injection of 15 mg/kg phenytoin I.V. The patient’s weight on admission was 176 lb. In grams, what total dose of phenytoin should be administered by slow I.V. infusion? Record your answer using one decimal place.
- Fall '15