A 51-year-old man comes to the physician for a follow-up appointment. He has a 1-year history of increasing frequency of episodes in which he wakes up catching his breath in the middle of the night. Polysomnography performed last week showed 72 nocturnal awakenings within an 8-hour period. Blood pressure is 150/90. Which of the following is most likely to be seen in this patient?

A) Carotid chemoreceptor potassium channel closure
B) Decreased afferent glossopharyngeal firing
C) Decreased interomediolateral tract activation
D) Decreased rostral ventrolateral nucleus activation
E) Pulmonary vascular potassium channel opening

A 24-year-old man partakes in a research study in which his hormonal secretions are plotted in relation to macronutrient consumption. The following graph shows the secretion of Hormone X as a function of duodenal acid exposure. The Y-axis is Hormone X secretion; the X-axis is duodenal acid exposure.

Which of the following is most likely to be seen in this patient as Hormone X levels increase?

A) Increased gallbladder contraction
B) Increased gastric acid secretion
C) Increased pancreatic bicarbonate secretion
D) Increased vasoactive intestinal peptide secretion
E) Increased water and electrolyte production by acinar cells

A 61-year-old man comes to the physician for a health maintenance check. After consultation, the physician commences him on labetalol. Which of the following combinations of findings is most likely to be seen in this patient as a result of initiation of this pharmacoagent?

A) ↑ Cardiac output (CO); ↑ Left-ventricular end-diastolic volume (LVEDV); ↑ Systemic vascular resistance (SVR)
B) ↑ CO; ↑ LVEDV; ↓ SVR
C) ↑ CO; ↓ LVEDV; ↑ SVR
D) ↑ CO; ↓ LVEDV; ↓ SVR
E) ↓ CO; ↑ LVEDV; ↑ SVR
F) ↓ CO; ↑ LVEDV; ↓ SVR
G) ↓ CO; ↓ LVEDV; ↑ SVR
H) ↓ CO; ↓ LVEDV; ↓ SVR

A 17-year-old girl is brought to the physician by her mother for a 5-month history of loss of her menses. She is an avid runner and frequently competes cross country for her school. BMI is 17. Which of the following is the most likely explanation for this patient’s presentation?

A) Decreased serum leptin
B) Increased serum FSH
C) Increased serum GnRH
D) Increased serum LH
E) Primary hypogonadism

A 49-year-old man comes to the physician for a follow-up appointment. His blood pressure 2 months ago was 150/90. He attempted lifestyle modification with limited success. His blood pressure today is 145/92. He is commenced on hydrochlorothiazide. Which of the following is most likely to be seen in this patient as a result of this pharmacotherapy?

A) Calciuresis
B) Inhibition of early-DCT antiporter
C) Inhibition of late-DCT symporter
D) Reduction in cortical collecting duct ENaC activity
E) Secretion of potassium via ROMK

A 59-year-old man comes to the physician for a 5-month history of progressively worsening shortness of breath. Physical examination shows diffuse dry inspiratory crackles. Blood pressure is 120/80.

Which of the following is most likely to be predominant in this patient’s pathology?

A) Aleveolar dead space
B) Anatomic dead space
C) Physiologic dead space
D) Shunt
E) V/Q elevation

Which of the following is most likely to be seen in this patient?

A) Decreased alveolar-arteriolar oxygen gradient
B) Decreased intravascular oncotic pressure
C) Loud pulmonic component of S2
D) Normal pulmonary capillary wedge pressure
E) Reduced splenic size

A 31-year-old woman comes to the physician for a 12-month history of inability to conceive with her partner. Her BMI is 30. Her menses occur every 2-3 months. Mild acne is visible on her upper back and cheeks. Which of the following is most likely to be seen in this patient?

A) Decreased ovarian aromatase activity
B) Decreased stimulation of theca interna cells
C) Increased FSH/LH ratio
D) Increased risk of breast neoplasia
E) Increased risk of ovarian neoplasia

A 34-year-old woman comes to the physician for a follow-up appointment. She is receiving triiodothyronine supplementation. Which of the following combinations of findings is most likely to be seen in this patient?

A) ↑ TSH; ↑ T3; ↑ T4
B) ↑ TSH; ↑ T3; ↓ T4
C) ↑ TSH; ↓ T3; ↑ T4
D) ↑ TSH; ↓ T3; ↓ T4
E) ↓ TSH; ↑ T3; ↑ T4
F) ↓ TSH; ↑ T3; ↓ T4
G) ↓ TSH; ↓ T3; ↑ T4
H) ↓ TSH; ↓ T3; ↓ T4

A 30-year-old man comes is evaluated in hospital. His father has a history of cirrhosis. His arterial bloods are shown:

pH                                             7.39
HCO3^–                                    24 mEq/L
O2 content                          Reduced
pO2                                         90 mmHg
pCO2                                      38 mmHg

Which of the following is the most likely explanation for this patient’s findings?

A) Alpha-1 antitrypsin deficiency
B) Anemia
C) Polycythemia vera
D) Salicylate poisoning
E) Ventilation/perfusion mismatch