Communication: Discussion Board: Final Study Questions
  1. A 40-year old man had retro-sternal pain that was most pronounced when lying down after meals. This was associated with regurgitation of gastric acid into his mouth. What is the most likely cause of this condition?

  2. A 60-year old man with a history of heavy smoking and alcohol consumption could not swallow meat. What could account for dysphagia in this patient?

  3. A 40-year old man complained of epigastric pain 3 to 4 hours after meals. He could pinpoint the most painful site on the anterior abdominal wall. What is the most likely diagnosis?

  4. A 20-year old woman complained of frequent bowel movements and bloody stools. Biopsy of the colon revealed ulceration of the superficial bowel mucosa. What is the most likely diagnosis?

  5. A 60-year old man reported having thinned stools that were tinged with blood. What is a likely diagnosis?
Liver and Biliary System
  1. A 20-year old woman became jaundiced 3 weeks after vacationing in Mexico. She had no other symptoms. Could a viral infection be responsible her condition?

  2. A chronic alcoholic developed high fever, nausea, and vomiting accompanied by jaundice after a 3-day drinking binge. What is the likely cause of acute hepatitis in this patient?

  3. An obese, 45-year old woman developed spasmodic pain in the upper right quadrant of the abdomen 1-hour after ingesting a fat-laden meal. What is the most likely diagnosis?

  4. Sudden enlargement of the liver was noted in a 50-year old man who was infected with hepatitis B virus during puberty and who developed signs of cirrhosis at the age of 40 years. The differential diagnosis included liver cancer (hepatocellular carcinoma). Which test should be ordered to substantiate the diagnosis of liver cancer?
Pancreas
  1. Following two-days of heavy drinking, a 40-year old man developed upper abdominal pain. You suspect acute pancreatitis. Which blood tests should you order?

  2. A chronic alcoholic had indigestion and bulky, foul-smelling fatty stools (steatorrhea). Radiographic examination of the abdomen revealed dystrophic calcification of the pancreas. What was the most likely cause of this condition?
Kidney and Bladder
  1. The mother of a 3-month old child palpated a mass on the left side of the child's abdomen. What is the most likely diagnosis for this mass? What would the diagnosis be if this mass were a neoplasm?

  2. A 40-year old man has end-stage kidney failure and bilaterally enlarged kidneys. What is the most likely diagnosis?

  3. A 4-year old child developed puffiness around the eyes and became chronically sleepily 2 weeks after an episode of "strep-throat". The mother noted that the child's urine was dark brown and was being excreted in small amounts. What is the probably diagnosis?

  4. A 40-year old man noticed generalized swelling, most prominently in his face and lower extremities. His physician discovered proteinuria and hypoalbuminemia. What is the most likely cause of edema in this case?

  5. A 46-year old man noticed brown-red urine and, over a period of 6 days, stopped urinating all together. What is the probable diagnosis?

  6. A 50-year old man who underwent a routine medical check-up was found to have blood in his urine. X-ray studies revealed a renal mass on the left side. What is the probable cause of this hematuria?

  7. A 20-year old woman complained of pain during urination. She also noticed blood in her urine. What is the most likely diagnosis?
Testis
  1. A 3-month old boy had a testis that was not palpable. What is the most likely diagnosis?

  2. In the same patient described above, the testis is still in the inguinal canal at 1 year of age. Why should an orchiopexy (surgical correction) be performed?

  3. A 60-year old man complained of urgency and dribbling on urination. What is the most likely diagnosis?

  4. A testicular nodule was noticed by a 30-year old man on self-examination. What is the appropriate work-up for this painless nodule?

  5. Elevated serum levels of prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) were detected in a 60-year old man. What is the significance of these findings?

  6. A 70-year old man with sclerosis of the lumbar vertebrae had a rock-hard prostate on palpation. Which serum enzyme tests should be expected to yield positive results?
Female Reproductive System
  1. A 35-year old woman received a report from her gynecologist indicating that she had a human papillomavirus (HPV) infection. This is important, because HPV is a risk factor for cancer of the:

  2. A 35-year old woman complained of heaviness in the abdomen and frequent urge to urinate. Gynecologic examination revealed an enlarged, bulky uterus. What is the probable diagnosis?

  3. A 28-year old woman had vague lower abdominal pain that intensified at the time of menstruation. What is the possible cause of this pain?

  4. A postmenopausal 52-year old woman who had cessation of menstruation suddenly noted a bloody vaginal discharge. Pap smear was normal, but endometrial biopsy revealed a malignancy. The most appropriate histological diagnoses is:

  5. A 70-year old woman noted abdominal swelling. The doctor diagnosed ascites and requested a gynecologic consultation. What findings might be expected on gynecologic examination?

  6. A 30-year old woman stopped menstruating and developed chest hair. Such virilization could be caused by:

  7. A pregnant woman presented to the emergency room 5 months after her last menstrual period complaining of spotting. An enlarged uterus, corresponding to a 7-month pregnancy was noted. No fetal movement was evident. What is the most likely diagnosis?
Breast
  1. A 3-cm breast mass was found in a 20-year old woman. What is the most likely diagnosis?

  2. Painful, small nodules in both breasts were noted in a 40-year old woman. What is the most likely diagnosis?

  3. A 3-cm mass was palpated in the breast of a 45-year old woman. What is the most likely diagnosis?
Endocrine
  1. A 30-year old woman who is not pregnant has not menstruated for 4 months and is now producing milk from her breasts. What is the diagnosis?

  2. A 40-year old man noticed enlargement of his feet (suddenly ill-fitting shoes) and hands. He had prominent lower jaw and noticed that his teeth were becoming separated from one another. What is the name for this endocrine disorder? What could have caused these symptoms?

  3. A 45-year old woman presented with complaints of sweating a lot, feeling hot and being constantly tired. She had a fast pulse rate and reported feeling constantly hungry. On examination, she was found to have bulging eyes and an enlarged thyroid. What is the diagnosis? What is the pathogenesis of her disease?

  4. A 30 year old woman noted a "swelling" on the anterior side of her lower neck. She had no other symptoms. What is the most likely diagnosis?

  5. A 50-year old man became extremely obese, with fat accumulating most markedly on his trunk. He had a red rounded face and almost translucent skin that was prone to bruising. What is the first question that should be posed to this man?

  6. A 40-year old man reported having sudden attacks of dizziness, blurred vision, and excruciating headaches. During these attacks his blood pressure was 180/120 mm Hg. What could cause these paroxysms of hypertension?

  7. A 20-year old woman presented with a history of weight loss and urinary frequency (polyuria). She reportedly ate a lot and was always thirsty? What is the most likely diagnosis?

  8. The development of diabetic complications (e.g. atherosclerosis, renal failure and blindness) relates largely to the severity and chronicity of:
Nervous System
  1. A baby born with a small skin defect on her lower back could not move her legs. What is the most likely cause of her congenital paralysis? What is the blood test that is used for prenatal diagnosis of this disease?

  2. A 60-year old man with hypertension suddenly developed an excruciating headache, collapsed, and became unconscious. What is the cause of this man's collapse?

  3. A 20-year old woman had a car accident. When she was removed from the car, she could not move her legs. Is she paralyzed for life?

  4. A 30-year old woman had a bout of flu accompanied by fever and nasal congestion. On the third day of her disease, she experienced sever headache, blurry vision and neck rigidity. What is the cause of these symptoms?

  5. The family of a 70-year old man noticed that he had become very forgetful. He could not remember anything and was dismissed from his office job. What is the most likely diagnosis?

  6. Spongiform encephalopathies are a group of neurodegenerative diseases characterized by slowly progressive ataxia and dementia. The infectious agents of these diseases (prions) are best defined as: