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 omalizumab and What is it used for?
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids
Cleaves bases leaving apyrimidine and apurine sites; cleaves 5' end of DNA; cleaves 3' end of DNA; base excision repair; DNA polymerase - and ligase
The LES is supposed to relax when food comes its way (from above) and in achalasia - a motor dysfunction - LES doesnt relax and seen as elevated pressure on the esophageal mannometry
Aromatase deficiency in child

2. nucleotide deletions do not cause missense mutations - they cause...
Aortic root dilation or bicuspid aortic valve; diastolic murmur (right sternal border(
frameshift mutations (missense is substitution)
Increases
Valproate

3. why are pregnant predisposed to cholelithiasis?
Lecithin (same as phosphatidylcholine)/sphingomyelin; by 35 weeks should be 2/1 or higher
2 -3 BPG; glycolysis - instead of ATP; erythrocytes because want to right shift the oxygen dissociation curve so that oxygen is released from RBCs into tissue
Raphe
Estrogen induced cholesterol hypersecretion (increase HMG CoA reductase activity) and progesterone induced gallbladder hypomotility (decreases bile acid secretion)-- both these conditions predispose cholesterole to insolubilize out

4. What is an abortive viral infection?
Medial part
Bile salt accumulation in urine
Little effect on cell and no change
Anterior circumflex (and axillary nerve)

5. What causes vertical diplopia? horizontal?
Trochlear nerve (IV); abducens nerve (VI)
Transported to liver - glycerol kinase converts it to glycerol 3 phosphate Which is then converted to DHAP which can either join glycolysis for ATP or be used to make glucose
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
Reiter syndrome; B27

6. is strep pneumo optochin resistant or susceptible? bile soluble or insoluble?
Faulty positioning of the genital tubercle
AV node slowest - to allow time for diastole
Susceptible; soluble (unable to be cultured in bile)
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids

7. lipid filled plaques in which arteries does thigh claudication suggest? difficulty sustaining an erection?
Intussusception
The time interval between S2 and OS- the shorter the interval - the more intense
Primary
External illiac - superficial femora - or common femoral or profunda femoris (ipsilateral); pudendal branches of internal illiac

8. what receptors do first generation anti histamines block?
Trauma to stereociliated hair cells of the organ of corti
C3 decreased after 5-10 days; sulfonamides
Diabetic microangiopathy
Anti Histaminic 1; anti cholinergic; antiseritoninergic;anti alpha adrenergic

9. why should you not use ACE inhibitors with someone who had hereditary angioedema?
Hypothyroidism
Amiloride - spironolactone - triamterene
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
Folic acid treatment!

10. Which branch of the facial nerve provides taste from ant 2/3 of tongue?
Fibronectin - laminin - collagen
Near the medial epicondyle or in Guyon's canal near the hook of the hamate and pisiform bone in the wrist
No only for prophylaxis (even for treating staphylococcal endocarditis its as multi drug); this is to prevent drug resistance from spontaneous mutations by DNA dependent RNA polymerase
Chorda tympani branch

11. What can cause virilization of a mother during pregnancy?
Ceftriaxone; azithromycin
Because of vasodiation to skeletal muscles
Aromatase deficiency in child
Epinephrine; adrenal medulla; phenylethanolamine N methyltransferase; cortisol

12. What does Rb protein do? what chrom is it on?
Protamine sulfate
Become beta pleated and then form neurofibrillary tangle!
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
No

13. What is suggestive of complete central DI?
Normally close to systolic
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)
Increase by 50% in urine osmolality
RBC mass; epo levels (secondary has high)

14. What is contraindicated in toxic mega colon?
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Think Hb deformation diseases
Barium studies and colonoscopy can cause perforation just use plain abdominal xray
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia

15. What is diagnostic (and possible therapeutic for intussusception)?
ZDV or AZT
Barium enema
P450 mitochondrial monooxygenase
46 - 4N; 23 2N

16. What is Bortezomib and What is it used for?
Near the hinge point; site for attachment to phagocytic cells is at the very end (Fc receptor)
Proteasome inhibitor; treatment for MM and waldenstroms
Abnormal closing of the urethral folds
Superior larygeal; cricothyroid; recurrent laryngeal

17. What is cataplexy and When is it seen?
Sudden loss of muscle tone without loss of consciousness; narcolepsy
Thymic tumor
P53 mutation; AD
Octreotide

18. What are the two mcc of focal brain lesions in HIV positive patients?
Covalent (between two cysteines)- allows protein to withstand denaturation
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
FGF and VEGF
transcription activation/suppression

19. What is the mcc of extrinsic allergic asthma?
Inhaled animal dander allergens
Ceftriaxone; azithromycin
MAC complex (C5b - C9 complement deficiency)
No; yes

20. How do you explain the selective proteinuria of loss to albumin only in MCD?
Leukotriene precursor and does neutrophil chemotaxis
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
Diabetic microangiopathy

21. ___________ is liver specific
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
glycerol kinase
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
Increases the systemic vascular resistance and thus reduces the gradient across the LV outflow tract

22. What is extraocular muscle weakness a common symptom of?
Chromosome 3- von hippel lindau gene (the disease itself is rare - but mutations of the gene are common)
Vancomycin
Think Hb deformation diseases
Myasthenia gravis

23. 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

24. which anti epileptic is preferred in patients with both absence and tonic clonic seizures?
Epinephrine; adrenal medulla; phenylethanolamine N methyltransferase; cortisol
NF- KB; responsible for cytokine production
Valproate
HSV and VZV

25. PDAs are often asymptomatic. How do you treat?
Transported to liver - glycerol kinase converts it to glycerol 3 phosphate Which is then converted to DHAP which can either join glycolysis for ATP or be used to make glucose
indomethacin
Fibronectin - laminin - collagen
Biphosphonate

26. What is the sole neurologic manifestation of acute rheumatic fever?
10-14 days; coagulation and marginal contraction band necrosis; collagen formation; coagulation necrosis and neutrophilic infiltrate; nothing to see; 4-12 hours
Sydenham chorea
S. aureus
Proteasome inhibitor; treatment for MM and waldenstroms

27. does congenital renal hypoplasia cause secondary hypertension? how about unilateral renal artery stenosis?
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
RER; copper
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis
No and yes

28. What is the precursor protein to beta amyloid and On what chromosome is it found?
APP on chrom 21 (this is why downs more susceptible)
Hexokinase
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
Superior larygeal; cricothyroid; recurrent laryngeal

29. What is a common complication of acute pancreatitis? What is it?
Boiling - bleach - formalin - UV irradiation
Anti centromere; anti DNA topoisomerase
Sodium escape due to ANP activation results in no edema; edema is the precipitating factor
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis

30. What is pickwickian syndrome? What are the lab findings?
Elevated GGT and macrocytosis
S3 gallop; S2 to opening snap interval
P450 mitochondrial monooxygenase
Obesity prevents expansion of wall and lungs for breathing; chronically elevated (all the time not just sleep) PaCO2 and decreased PaO2

31. What is the fibrinogen level in patient with TTP- HUS? DIC?
Class I
Turners`
Normal; low
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)

32. which virus inactivates both Rb and p53?
E. coli; staphylococcus saprophyticus
Vagus nerve stimulation
HSV ( also in utero: chlymadia - neisseria - group B strep)
E6 and E7 of HPV knock off p53 and Rb suppressor genes

33. which congenital adrenal hyperplasia presents with all genotypes as phenotypically female and with salt retention and hypertension?
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Decreases both
Anterior nares
(urine PAH x urine flow rate)/plasma PAH

34. what chromosome is c - myc found on?
As a CO2 carrier with the carboxylase enzyme
Chrom 8
Enterococci (e. faecalis)- found on genitalia area
Vomitting - NG suctioning - diuretic use - hyperaldosteronism; urinary chloride concentration

35. is Rifampin ever used as monotherapY? why either way?
No only for prophylaxis (even for treating staphylococcal endocarditis its as multi drug); this is to prevent drug resistance from spontaneous mutations by DNA dependent RNA polymerase
APP on chrom 21 (this is why downs more susceptible)
Dissolved in plasma and attached to Hgb
GI malignancies and Insulin resistance (acromegal for ex)

36. name three pathological states that present with large tongues.
Become beta pleated and then form neurofibrillary tangle!
Elastance
Congenital hypothyroidism - downs - amyloidosis - acromegaly
Boiling - bleach - formalin - UV irradiation

37. What is Tzanck smear used to detect?
Adductor
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
Medullary
HSV and VZV

38. what immune deficiency causes recurrent neisseria infections?
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Tryptophan; pellagra (diarrhea - dementia - dermatitis)
Strength of cell mediated immune response
MAC complex (C5b - C9 complement deficiency)

39. who bleed more DIC or TTP- HUS patients?
By IgE activation (IgE binds to them as they are in the blood and then bind to Fc receptor on eos)- ADCC
MAC complex (C5b - C9 complement deficiency)
DIC; TTP- HUS dont bleed that much
...

40. if there are keratin swirls does that mean well or poorly differentiated?
P53 mutation; AD
Chrom 8
frameshift mutations (missense is substitution)
Well

41. which two drug types can cause orthostatic hypotension (think depression and BPH)?
Anterior nares
Chorda tympani branch
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
TCAs and prazosin

42. What is the stabilizing force for the secondary structure of proteins?
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)
Hydrogen bonds dictate alpha or beta structure
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Syringomelia

43. What are the acute effects of corticosteroids on the CBC?
No
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
Dissolved in plasma and attached to Hgb

44. In What type of nephritis would you see high serum eos count?
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
Drug induced interstitial nephritis
Smoking
SaO2 <92%

45. how will ectopic pregnancy rupture present? What is key history question for diagnosis? what would a uterine biopsy show?
Shock symptoms (blood loss); amennorhea history; decidualized stroma (hormone changes are exactly the same) but no chorionic villi
The time interval between S2 and OS- the shorter the interval - the more intense
Elevated GGT and macrocytosis
SSRI

46. what virus causes pharyngoconjuctival fever?
Diabetic microangiopathy
Sickle cell; G6PD
Adeno
CGD; t cell dysfxn (diGeorge)

47. What is the mc malignancy in asbestosis?
Duration and extent of disease
Right before diastole (filling begins)
Bronchogenic carcinoma
Little effect on cell and no change

48. What are the skin presentation in sarcoid?
Coagulation factors are made in the liver
Varying; erythema nodosum is common
Nuclei pushed to periphery and nissl susbstance widely dispersed (increased protein repair); axonal reaction; Wallerian degeneration
Terminal bronchioles; small bronchi

49. what should you think of in 'smear of an oral ulcer base'?
Anti cholinergic effects of pupil dilation and lack of accomodation
Hydrogen bonds dictate alpha or beta structure
Tzanck smear
Tibial

50. What type of gene is bcl 2 ? On what chromosome is it? what chromosome is IgG heavy chain on?
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
Little effect on cell and no change
OCPs - multiparity - breast feeding
Anti - apoptotic (prevents going into apoptosis)- 18; 14