Test your basic knowledge |

USMLE Prep 2

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What is used to treat heparin toxicity?
Because of the low output from heart failure - they will have increased aldosterone levels
Radial nerve and deep brachial artery
Fibrosis; macrophages
Protamine sulfate

2. What does prolonged PT indicated? aPTT? bleeding time?
Serum FFA and serum triglyceride levels
Extrinsic def; instrinsic def; platelet def
Ig A deficiency
Anterior and to the right (on the ECG!) of the pulmonary artery; right to left shunt

3. when arrested in prophase of meiosis I - What are primary oocytes chrom number? What about the secondary oocytes that are stuck in metaphase of Meiosis II?
Demargination of neutrophils from the vessel walls
Radial nerve and deep brachial artery
46 - 4N; 23 2N
Enterococci (e. faecalis)- found on genitalia area

4. What is the immune deficinecy seen in ataxia telangactasia?
Ig A deficiency
Increased reticulocytes
Primary
Acute gastric mucosal defects (superficial or full thickness)

5. what bursa is affected when on knees like a maid/gardner?
Well trained athletes and children
Prepatellar
Demargination of neutrophils from the vessel walls
Trauma to stereociliated hair cells of the organ of corti

6. what drug is useful for secretory diarrhea?
Vagus (auricular branch); vasovagal syncope!
No and yes
S3 gallop; S2 to opening snap interval
Octreotide

7. what presents congenitally as macroglossia - generalized hypotonia - and an umbilical hernia?
No and yes
Kallmans
Hypothyroidism
Leukotriene precursor and does neutrophil chemotaxis

8. What does the tuberoinfundibular pathway connect? What is it responsible for?
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)
Chlorpheniramine and diphenhydramine
Serum FFA and serum triglyceride levels

9. h1 receptor anatagonists are not effective in treatment of asthma only for...
manifestations - congenital (stretching of periventricular pyrimadal fibers)
Paramyxo and influenza
Anterior nares
chronic urticaria and allergic symptoms

10. What is normal fibrinogen levels?
Increases
200-500
Turners`
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis

11. What are some of the permissive effects of cortisol?
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
Increases bronchial and vascular smooth muscle reactivity to catecholamines
11
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness

12. What type of bond is a disulfide bond?
Covalent (between two cysteines)- allows protein to withstand denaturation
Elastance
Turners`
CGD; t cell dysfxn (diGeorge)

13. What are the three causes of acute MI in context of normal coronary arteries ?
Coronary vasospasm (cocaine) - coronary arteritis - hypercoaguability with acute thrombosis
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
Duration and extent of disease

14. What can too much IgA in serum produces?
Injury to common peroneal nerve (d/t trauma or sustained pressure to neck of fibula) causing pain and numbness on dorsum of foot and inability to dorsiflex
Increased reticulocytes
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC
Episodes of painless - well circumscribed pitting edema; face - lips - neck - and tongue - tracheobronchial tree can cause respiration obstruction

15. Where does lysyl oxidase act? What is the cofactor for that?
In the extracellular space for collagen cross linking; zinc
Extrinsic def; instrinsic def; platelet def
Acute necrotizing pancreatitis; alveolar hyaline membranes; leaky capillary alveolar membrane (proteins deposit)
P450 mitochondrial monooxygenase

16. What is the most important prognostic indicator in patients with malignant melanoma?
200-500
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
Measure of depth invasion (vertical!)

17. how does noise induced hearing loss occur?
200-500
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus
Trauma to stereociliated hair cells of the organ of corti
Pan colitis and right sided colitis (more than left sided and proctitis)

18. What test would be best to determine if a gene is being transcribed? translated?
No; MRI
Southern - western
ASD - causes increased pulmonary vascular blood flow which causes pulmonic vessel stenosis and damage
Normally close to systolic

19. which nucleus releases serotonin?
Lower extremity spasticity due to stretching of periventricular pyrimadal tracts - visual disturbances and learning disabilities
Raphe
Chromosome 3- von hippel lindau gene (the disease itself is rare - but mutations of the gene are common)
RR-1/RR

20. is strep pneumo optochin resistant or susceptible? bile soluble or insoluble?
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
hyponatremia (aldosterone activation equilibrates body volume)
Susceptible; soluble (unable to be cultured in bile)
Nocardia

21. hemaglobin and hematocrit levels cannot __________ between relative and absolute erythrocytosis
Vomitting - NG suctioning - diuretic use - hyperaldosteronism; urinary chloride concentration
differentiate
Reiter syndrome; B27
Apocrine; eccrine

22. What does TGF beta do? What produces it?
To pump calcium out in cardiac myocytes so that relaxation occurs
Fibrosis; macrophages
transcription activation/suppression
ZDV or AZT

23. what pathology is found around the illeo cecal valve and presents in 2 year old children with colicky abdominal pain and currant jelly stools?
No; yes
Intussusception
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)
Vascular endothelium; protease

24. What is diagnostic (and possible therapeutic for intussusception)?
women
Hypo or hyper pigmentations; after tanning
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities
Barium enema

25. Metronidizaole does not cover...
gram positive organisms
HSV and VZV
G to T in p53; HCC
Atrial

26. What is the stabilizing force for the secondary structure of proteins?
Single adenomatous ones
Hydrogen bonds dictate alpha or beta structure
women
Drug induced interstitial nephritis

27. What is a cell surface marker seen in liver angiosarcoma?
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!
11 aa polypeptide; pain NT in CNS and PNS
SVT; increases vagal tone; rectus abdominis
FGF and VEGF

28. which type of glands produce an initially odorless secretion but can become malodorous secondary to bacterial decompisition on the skin surface? which glands are present throughout the skin except on lips and glans penis?
Additive is equal to the sum of the two actions (lets say agonists at a receptor) and synergistic is when the sum is greater than just their two effects together
Episodes of painless - well circumscribed pitting edema; face - lips - neck - and tongue - tracheobronchial tree can cause respiration obstruction
Apocrine; eccrine
Anti Histaminic 1; anti cholinergic; antiseritoninergic;anti alpha adrenergic

29. which anti epileptic is preferred in patients with both absence and tonic clonic seizures?
46 - 4N; 23 2N
Valproate
Brief psychotic disorder; schizophreniform; schizophrenia
Anti Histaminic 1; anti cholinergic; antiseritoninergic;anti alpha adrenergic

30. What are ulcers arising in the proximal duodenum in association with severe trauma or burns called?
11beta hydroxylase deficiency (11 deoxycortisol to cortisol)
Chrom 8
Protamine sulfate
Curlings ulcers

31. What are the potassium sparing diuretics?
Chlorpheniramine and diphenhydramine
Amiloride - spironolactone - triamterene
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
Mycoside (made of two mycolic acids) and is responsible for inactivating neutrophils - mit damage - and induced release of TNF; mycobacteria virulence; serpentine cords

32. which are the only glycosylated proteins in HIV virus?
200-500
Sickle cell; G6PD
Env genes (for getting into target cells)
As a CO2 carrier with the carboxylase enzyme

33. What is the most common cause of pyelonephritis in both adults and childre?
Underestimation of gestational age
E. coli
TSh (in testicular tumors can cause hyperthyroidism)
Covalent (between two cysteines)- allows protein to withstand denaturation

34. in the LV and aorta - What are the pressures?
Close but purkinje system to ensure contraction in a bottom up fashion
Normally close to systolic
Folic acid treatment!
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)

35. What is subacute sclerosisng encephalitis caused by?
facultative intracellular
Right heart failure
Rare complication of measles (years later)- thought to be d/t certain type that doesnt have surface M protein antigen so goes unseen into CNS
Demargination of neutrophils from the vessel walls

36. What are the three dopaminergic systems and What are they responsible for? disease?
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
Muscarinic antagonist; pralidoxime because atropine doesnt work at nicotinc receptors and organophospates act at all cholinergic (muscle paralysis not solved with only atropine)
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia

37. How do left sided colon adenocarcinomas present? right sided?
Obstruction because they infiltrate the intestinal wall and encircle causing decrease in size of lumen - constipation - abdominal distension - abdominal pain - changes in stool caliber; right sided are often exophytic masses iron def anemia and syste
Fat - fertile - forty - female
P53 mutation; AD
Protamine sulfate

38. What can cause aortic regurg? What is the heart sound you hear?
Aortic root dilation or bicuspid aortic valve; diastolic murmur (right sternal border(
Fibronectin - laminin - collagen
Demargination of neutrophils from the vessel walls
Progressive dysphagia - chest pain - food regurg - and aspiration; birds beak deformity of the LES

39. which headaches are seen mostly in men - are severe - unilateral - periorbital - episodic (around same time every day) - temporal pain - with lacrimation - nasal congestion and ptosis?
8 (myc protein) with 2 - 14 - 22 (iG chains)
Close but purkinje system to ensure contraction in a bottom up fashion
Cluster
ST become atrophic and hyalinized (temp induced damage) and depressed sperm count becuase of that; hormonal function not impaired (test and LH levels normal) because Leydig cells not as temp sensitive so secondary sexual characteristics and sexual pe

40. What is the only cranial nerve that comes out dorsally? What does this mean clinically?
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Amiloride - spironolactone - triamterene
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)
Echinococcus granulosus; anaphylaxis

41. How do you calculate excretion rate of a substance? How do you calculate the filtration rate of a substance? clearance of what substance estimates the GFR?
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
No; MRI
Pain reliever - reduces pain by locking substance P in the PNS
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)

42. What is the Na/Ca exchange used for?
S3 gallop; S2 to opening snap interval
To pump calcium out in cardiac myocytes so that relaxation occurs
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
An invagination of portion of intestine into the lumen of the adjacent intestinal segment; can lead to impaired venous return from the invaginated segment of the bowel which can cause ischemia and subsequent necrosis

43. what induces bronchial squamous metaplasia?
Smoking
Acute interstitial nephritis
Inhaled animal dander allergens
As a CO2 carrier with the carboxylase enzyme

44. how does neisseria cause a petechial rash?
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia
Neisseria induced small cell vasculitis (including hands and soles)
Because ACE blocks breakdown of bradykinin and hereditary angioedema patients have high levels of bradykinin; high levels of bradykinin - C3a - and C5a mediate edema by increasing vascular permeability and vasodilation
Sodium escape due to ANP activation results in no edema; edema is the precipitating factor

45. What are diastolic (lowest) pressures in aorta? LV?
Around 70 (normal measured diastolic pressures); 9--
Close but purkinje system to ensure contraction in a bottom up fashion
Little effect on cell and no change
Biphosphonate

46. What is capsaicin? Where does it work?
Cluster
Sarcoid
Pain reliever - reduces pain by locking substance P in the PNS
Prevents hepatic VLDL production

47. What are the two coagulase negative staphylococci? How do you distinguish them?
S. saprophyticus - and s. epidermidis; novobiocin
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Progressive dysphagia - chest pain - food regurg - and aspiration; birds beak deformity of the LES
Highly negative resting potential

48. What can long term leg cast wearing cause?
The term used to describe decreased drug responsiveness with repeated administration
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities
Injury to common peroneal nerve (d/t trauma or sustained pressure to neck of fibula) causing pain and numbness on dorsum of foot and inability to dorsiflex
hyponatremia (aldosterone activation equilibrates body volume)

49. What type of disease has selective proteinuria? What is found in urine? What is not?
Initiation - pointing; pincer grasp; walking; mama/dada
Minimal change disease; lmw proteins: albumin and transferrin; IgG or alpha 2 microglobulin
Strength of cell mediated immune response
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin

50. What is the difference between paranoid personality disorder and delusional disorder?
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin
Because ACE blocks breakdown of bradykinin and hereditary angioedema patients have high levels of bradykinin; high levels of bradykinin - C3a - and C5a mediate edema by increasing vascular permeability and vasodilation
Pain reliever - reduces pain by locking substance P in the PNS
Paranoid personality disorder is a distrust that pervades all parts of the patients life as opposed to delusional disorder Which is one fixed delusion