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. sporadic colon cancer tend to arise From what type of polyps?
Bile soluble which means they are bile sensitive
Single adenomatous ones
Relfex tachycardia; giving beta blockers
TCAs and prazosin

2. Where does conjugation of bilirubin take place?
Reticulocytes
INTRApartum Abs (ampicillin/penicillin)
No
In ER of bile canaliculi

3. What does glycosylase do to DNA? endonuclease? lyase? What does the order here of enzymes represent? what other enzymes are needed?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

4. What is capsaicin? Where does it work?
No (unlike adenomyosis); yes
Pain reliever - reduces pain by locking substance P in the PNS
AV node slowest - to allow time for diastole
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis

5. What three pathogens cause infectious esophagitis in HIV positive patients?
CGD; t cell dysfxn (diGeorge)
LT (LTD4 - E4 - C4) - and Ach
Smoking
CMV - HSV 1 - Candida

6. why should you not use ACE inhibitors with someone who had hereditary angioedema?
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)
Pulmonic and systemic!
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
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17

7. What antibodies are present in CREST? What is the most specific?
Anti centromere; anti DNA topoisomerase
INTRApartum Abs (ampicillin/penicillin)
Selective alpha 1 (increases SVR)
Permissive - sensitizes vasoconstrictive response from catecholamines - doesnt actually act on them but increases transcription of some genes that creates permissive effect (not additive or synergistic becuase cortisol alone doesnt have any effect on

8. which artery provides the majority of the blood supply to the head and neck of the femur? what happens in fracture of neck?
Shock symptoms (blood loss); amennorhea history; decidualized stroma (hormone changes are exactly the same) but no chorionic villi
In the extracellular space
FGF and VEGF
Medial circumflex artery; avascular necrosis

9. What is best to prevent GBS infection in a baby?
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
MAC complex (C5b - C9 complement deficiency)
INTRApartum Abs (ampicillin/penicillin)
HSV and VZV

10. What is a side effect of ACE inhibitor that is more worrisome in patients with renal failure?who else is it worrisome in?
Hyperkalemia; potassium sparing diuretics - potassium supplements
Congenital hypothyroidism - downs - amyloidosis - acromegaly
Close but purkinje system to ensure contraction in a bottom up fashion
Medial circumflex artery; avascular necrosis

11. what dictates the resting membrane potential of most cells?
High potassium conductance and some sodium conductance
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics
Selective alpha 1 (increases SVR)
women

12. Which is faster purkinje system or atrial muscle?
Close but purkinje system to ensure contraction in a bottom up fashion
Acute necrotizing pancreatitis; alveolar hyaline membranes; leaky capillary alveolar membrane (proteins deposit)
Insulin like growth factor 1 (just another name)
Brief psychotic disorder; schizophreniform; schizophrenia

13. why does hypothyroidism cause increased CPK levels?
Hypothyroid myopathy (thyroid is required for maintaining a lot!)
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics
gram positive organisms
The term used to describe decreased drug responsiveness with repeated administration

14. What is medullary sponge kidney disease and how does it present? What does it lead to?
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Common and benign congenital disorder characterized by cystic dilation of the medullary collecting ducts (cortex is spared); painless hematuria or asymptomatic; mc is development of kidney stones (benign disease)
ANCA because of lack of Ig and C3 deposits on IF
Turners`

15. What can cause virilization of a mother during pregnancy?
Intussusception
SSRI; erectile dysfunction
Aromatase deficiency in child
Excessive collagen formation during tissue repair in susceptible individuals

16. are strep pneumo bile sensitive or bile resistant? bile soluble or insoluble?
gram positive organisms
Bile soluble which means they are bile sensitive
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!
IgE

17. What does 'oxygen' content in blood refer to?
Pan colitis and right sided colitis (more than left sided and proctitis)
Dissolved in plasma and attached to Hgb
Tibial
OCPs - multiparity - breast feeding

18. What is intussusception? how does ischemia and necrosis occur?
Class I
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
Clindamycin; covers anaerobic oral flora and aerobic bacteria
11beta hydroxylase deficiency (11 deoxycortisol to cortisol)

19. What are examples of action that decrease venous return to the heart?
Appetite suppressants
Around 70 (normal measured diastolic pressures); 9--
External illiac - superficial femora - or common femoral or profunda femoris (ipsilateral); pudendal branches of internal illiac
Standing suddenly from supine position; valsalva maneuver

20. What is suggestive of complete central DI?
At cochlear base near round and oval window; near apex of cochlea - helioctrema; high frequency sound
ATP binding (resets the myosin head to contract again for next binding)
Increase by 50% in urine osmolality
Close but purkinje system to ensure contraction in a bottom up fashion

21. How do you explain the selective proteinuria of loss to albumin only in MCD?
Multiple miscarriages d/t hypercoaguability
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
Hypothyroidism
Anterior circumflex (and axillary nerve)

22. When is an S4 sound normal?
Well trained athletes and children
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
On cardiac tissue and renal juxtaglomerular cells
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)

23. What causes vertical diplopia? horizontal?
The time interval between S2 and OS- the shorter the interval - the more intense
I is more benign and can present later in adulthood
Trochlear nerve (IV); abducens nerve (VI)
S. saprophyticus - and s. epidermidis; novobiocin

24. What is the neurologic manifestation of ADPKD?
Insulin like growth factor 1 (just another name)
C3 decreased after 5-10 days; sulfonamides
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Secretin stimulates the exocrine pancrease; S enteroendocrine cells in duodenal mucosa in response to acid secrete secretin (HCL is most potent stimulus for secretin release)

25. What type of cancer is keratin swirls indicative of ? What is the prognosis of this cancer in the esophagus? What is it associated with?
Dissolved in plasma and attached to Hgb
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)
Spongiosis

26. if there are keratin swirls does that mean well or poorly differentiated?
Recurrent larygneal
Pan colitis and right sided colitis (more than left sided and proctitis)
No
Well

27. What is the only cranial nerve that comes out dorsally? What does this mean clinically?
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)
Prevents hepatic VLDL production
Vomitting - NG suctioning - diuretic use - hyperaldosteronism; urinary chloride concentration
T test; chi squared

28. neisseria are...
Classical conditioning
Serum creatine kinase; reperfusion injury causes necrosis
Ovaries - testes - placental and other peripheral tissue (ie dont just think fat!)
facultative intracellular

29. In What type of nephritis would you see high serum eos count?
Drug induced interstitial nephritis
Syncope - angina - dyspnea (SAD)
APP on chrom 21 (this is why downs more susceptible)
Octreotide

30. What is it called if psychotic symptoms last less than one month? one to six months? more than six months?
Brief psychotic disorder; schizophreniform; schizophrenia
Both sides
Syringomelia
21 hydroxylase deficiency; progesterone to 11 deoxycorticosterone; ambiguous genitalia in females and salt wasting

31. Which branch of the facial nerve provides taste from ant 2/3 of tongue?
Right heart failure
Acute interstitial nephritis
Chorda tympani branch
Vagus nerve stimulation

32. what should you think of with coarctation of aorta - bicuspid valves and horseshoe kidney?
Atrial
Drug induced interstitial nephritis
Because increases intracellular cAMP independent of adrenergic receptors (does it via G proteins)
Turners`

33. in treating an anemia and erythropoiesis results - what would you expect to see in peripheral blood findings transiently?
Increased reticulocytes
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)
Single adenomatous ones
Selective alpha 1 (increases SVR)

34. What does VIP do to gastric acid secretion?
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
Inhibits it
Cluster
Regular insulin (Not fast acting - regular better)

35. where are the two classical places that the ulnar nerve can be injured?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

36. what dissolves the lipid bilayer of a viral envelope?
Vancomycin; histamine mediated
Common and benign congenital disorder characterized by cystic dilation of the medullary collecting ducts (cortex is spared); painless hematuria or asymptomatic; mc is development of kidney stones (benign disease)
Ether and other organic solvents
Pain reliever - reduces pain by locking substance P in the PNS

37. What is somatomedin C?
HSV ( also in utero: chlymadia - neisseria - group B strep)
Ketone body production by preventing fatty acids into the mitochondria
women
Insulin like growth factor 1 (just another name)

38. What is normal fibrinogen levels?
Extrinsic def; instrinsic def; platelet def
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
200-500
Think Hb deformation diseases

39. what protein is increased in Crohns disease? What does it do?
Skin flushing and warmth; prostaglandins; give with aspirin
liver specific
NF- KB; responsible for cytokine production
200-500

40. What does the superior gluteal nerve innervate? how does damage to this nerve manifest?
Multiple miscarriages d/t hypercoaguability
Because gamma chains replace beta chains and then gamma chain formation wanes
Another type of aldosterone antagonist (like spironolactone)
Gluteus medius and minimus; positive trendelenberg

41. what happens with LDL receptor density in statin therapy?
Tibial
Increases
Highly negative resting potential
Medial circumflex artery; avascular necrosis

42. What is 5- HETE and What does it do?
Leukotriene precursor and does neutrophil chemotaxis
PDA open
Coronary vasospasm (cocaine) - coronary arteritis - hypercoaguability with acute thrombosis
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR

43. what disease causes a lack of intracellular killing? lack of killing viruses and fungi?
Increases cytokine production
Gluteus medius and minimus; positive trendelenberg
200-500
CGD; t cell dysfxn (diGeorge)

44. which congenital adrenal hyperplasia presents with ambiguous genitalia in females and salt retention?
Syringomelia
11beta hydroxylase deficiency (11 deoxycortisol to cortisol)
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC
Standing suddenly from supine position; valsalva maneuver

45. What is gardeners mydriasis? How is it treated?
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
Sydenham chorea
11
Anti - apoptotic (prevents going into apoptosis)- 18; 14

46. How is dobutamine better than dopamine?
Undesirable effects that cause myocardial ischemia (increased HR and increased O2 consumption) are less (still there tho)
manifestations - congenital (stretching of periventricular pyrimadal fibers)
Radial nerve and deep brachial artery
25; 25

47. What are ulcers arising in the proximal duodenum in association with severe trauma or burns called?
Radial nerve and deep brachial artery
Curlings ulcers
46 - 4N; 23 2N
Sarcoid

48. at 2 years of age - What are the social - fine motor - gross motor and language developments?
Gluteus medius and minimus; positive trendelenberg
Imitation of household tasks; page turning; jumping - standing on one foot; 2 word phrases
Hexokinase
To pump calcium out in cardiac myocytes so that relaxation occurs

49. What can too much IgA in serum produces?
Purkinje system; AV node
Decreases both
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC
Raphe

50. What is the primary histologic finding in patients with eczematous dermatitis?
Prostate tumor and increased osteoclast activity
Increases the systemic vascular resistance and thus reduces the gradient across the LV outflow tract
Chlorpheniramine and diphenhydramine
Spongiosis