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Question 1 of 8
1. Question
A 32-year-old woman is brought to the emergency department after being stuck in a malfunctioning elevator for 45 minutes. The patient says she felt extremely anxious in the closed space of the elevator and experienced dizziness, shortness of breath, generalized weakness, and blurred vision. She has no other medical conditions and takes no medications. She does not use tobacco, alcohol, or illicit drugs. Which of the following is the most likely cause of this patient’s symptoms?
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Question 2 of 8
2. Question
A 75-year-old man is brought to the emergency department after he was found unresponsive at home. The patient has a history of poorly controlled hypertension. Blood pressure is 240/120 mm Hg and pulse is 104 /min. He has extensor posturing and pinpoint pupils. CT scan of the head without contrast reveals an acute pontine hemorrhage with associated mass effect. The patient dies several hours later. Autopsy reveals disruption of all pigmented neurons in the posterior rostral pons at the lateral floor of the fourth ventricle. These neurons normally produce which of the following?
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Question 3 of 8
3. Question
A 29-year-old woman comes to the office for treatment of anxiety that has worsened over the past year. She finds herself worrying all the time and fears that she may not complete her graduate studies in time to meet requirements for her degree. The patient is also worried about her son’s health and anxiously obsesses about him all the time. She says, “My anxiety just comes out of the blue; one way or another, I’m anxious all the time.” The patient has no history of medical problems. Physical examination is unremarkable; complete blood count, chemistry panel, and TSH and B12 levels are normal. An anxiety disorder is diagnosed and fluoxetine is prescribed. The patient’s anxiety begins to improve over the next 4-6 weeks. The physician explains that the medication inhibits the reuptake of a neurotransmitter released by a specific set of neurons. These neurons are most likely part of which of the following structures?
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Question 4 of 8
4. Question
A 34-year-old man begins treatment with combination chemotherapy for Hodgkin lymphoma. Shortly thereafter, he experiences severe vomiting and requires intravenous fluid supplementation. Which of the following sites in the brain is most likely responsible for his symptoms?
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Question 5 of 8
5. Question
A 19-year-old man is brought to the emergency department after sustaining a traumatic brain injury during a motor vehicle collision. On arrival, the patient is comatose and has a Glasgow Coma Scale score of 3. His blood pressure is 110/70 mm Hg, and pulse is 114/min. Pupils are miotic, equal, and reactive to light. Ecchymosis is present behind the ear, but the remainder of the trauma survey is unremarkable. Rapid-sequence intubation is performed, and the patient is mechanically ventilated. A noncontrast head CT scan demonstrates bifrontal contusions and a basilar skull fracture. One day later, a repeat head CT scan reveals diffuse cerebral edema. The ventilator respiratory rate is adjusted to achieve a PaCO2 level of 26-30 mm Hg. Which of the following is the most likely effect of this intervention?
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Question 6 of 8
6. Question
A 65-year-old man comes to the emergency department with right upper and lower extremity weakness and slurred speech. The patient went to bed in his usual state of health and woke up with these symptoms. His medical problems include type 2 diabetes mellitus, hypertension, and hyperlipidemia. He takes atorvastatin, metformin, lisinopril, and low-dose aspirin. The patient has smoked a pack of cigarettes daily for the past 40 years. His temperature is 36.7 C (98 F), blood pressure is 160/90 mm Hg, and pulse is 118/min. He is mildly dysarthric with a right lower facial droop and right-sided hemiparesis. A noncontrast head CT is normal. Brain MRI reveals an acute subcortical infarct in the left internal capsule. Six months later, which of the following findings is most likely to be observed in the affected pyramidal tracts of this patient?
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Question 7 of 8
7. Question
Anterior horn cells of the spinal cord of an experimental animal demonstrate cell body rounding, peripheral displacement of the nuclei and dispersion of Nissl substance to the periphery of the cells. The findings described most likely indicate:
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Question 8 of 8
8. Question
Researchers find that repeated stimulation of hippocampal neurons involved in memory and learning leads to potentiation of synaptic transmission. Patch-clamp recordings of stimulated neurons are shown below (dotted line: baseline; solid line: after repeated stimulation [potentiated]).
Which of the following neurotransmitter receptors on the postsynaptic membrane is most likely involved in this process?
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