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USMLE Prep 2
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Subjects
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health-sciences
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usmle
Instructions:
Answer 50 questions in 15 minutes.
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study here
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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 diseases can vit A be used to treat?
II; I (I more abundant)
Dissolved in plasma and attached to Hgb
Congenital hypothyroidism - downs - amyloidosis - acromegaly
Measles and M3 AML`
2. hypertensive crises on food intake is typical of What antidepressant? what kind of food?
Varying; erythema nodosum is common
Vancomycin
Tissue redistribution (out of plasma) rather than metabolism
MAO inhibitors; wine and cheese
3. What agonists reduce the gradient across the LV outflow tract?
Anterior and to the right (on the ECG!) of the pulmonary artery; right to left shunt
Selective alpha 1 (increases SVR)
Pulmonary hypertension
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
4. What is the cause of rapid plasma decay of thiopental?
Susceptible; soluble (unable to be cultured in bile)
Criggler Najjar (UGT enzyme in bilirubin glucoronidation) ; Dubin Johnson (transport protein lacking - Black liver) and Rotor syndrome - defects in hepatic uptake and excretion of bile (numerous defect)
Tissue redistribution (out of plasma) rather than metabolism
Think Hb deformation diseases
5. what would be a sign of absence of cardiogenic pulm edem?
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)
Strength of cell mediated immune response
11 aa polypeptide; pain NT in CNS and PNS
Cleaves bases leaving apyrimidine and apurine sites; cleaves 5' end of DNA; cleaves 3' end of DNA; base excision repair; DNA polymerase - and ligase
6. within the right ventricle - What are maximum pressures? the pulm arter?
OCPs - multiparity - breast feeding
25; 25
Ceftriaxone; azithromycin
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
7. what enzyme converts procarcinogens into carcinogens?
No
P450 mitochondrial monooxygenase
Because of vasodiation to skeletal muscles
Bile soluble which means they are bile sensitive
8. Is there edema in primary Conns? secondary hyperaldosteronism? why?
Pan colitis and right sided colitis (more than left sided and proctitis)
Sodium escape due to ANP activation results in no edema; edema is the precipitating factor
Right before diastole (filling begins)
Around 70 (normal measured diastolic pressures); 9--
9. What are the three dopaminergic systems and What are they responsible for? disease?
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
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia
Syringomelia
10. up to what level are ciliated cells present in the pulmonary system? mucus producing cells?
Terminal bronchioles; small bronchi
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
Vagus nerve stimulation
Raphe
11. What is the precursor protein to beta amyloid and On what chromosome is it found?
Lecithin (same as phosphatidylcholine)/sphingomyelin; by 35 weeks should be 2/1 or higher
APP on chrom 21 (this is why downs more susceptible)
Centrally located - strong smoking association - neuroendocrine markers: enolase - chromogranin - synaptophysin
Rose spots on abdomen - hepatosplenomegaly - hemorrhagic enteritis (with possible perforation)
12. What is intussusception? how does ischemia and necrosis occur?
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
Paramyxo and influenza
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
13. What is the most important prognostic indicator in patients with malignant melanoma?
Minimal change disease; lmw proteins: albumin and transferrin; IgG or alpha 2 microglobulin
Measure of depth invasion (vertical!)
By IgE activation (IgE binds to them as they are in the blood and then bind to Fc receptor on eos)- ADCC
Diabetic microangiopathy
14. which staphylococci can do mannitol fermaentation?
46 - 4N; 23 2N
S. aureus
glycerol kinase
Superior larygeal; cricothyroid; recurrent laryngeal
15. hypertonicity and hyperreflexity are ________________ of hydrocephalus
manifestations - congenital (stretching of periventricular pyrimadal fibers)
Covalent (between two cysteines)- allows protein to withstand denaturation
Ketone body production by preventing fatty acids into the mitochondria
Primary
16. What are the skin presentation in sarcoid?
AFP (HCC marker - produced in fetal liver and yolk sac!)- more specific than sensitive unfortunately
Varying; erythema nodosum is common
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)
17. Which is slower AV node or ventricular muscle?
Around 70 (normal measured diastolic pressures); 9--
Because of the low output from heart failure - they will have increased aldosterone levels
RER; copper
AV node slowest - to allow time for diastole
18. what happens to the cell body of a neuron after the axon has been severed? What is this called? What is it second to?
Nuclei pushed to periphery and nissl susbstance widely dispersed (increased protein repair); axonal reaction; Wallerian degeneration
P53 mutation; DCC is also required for adenoma to carcinoma
Susceptible; soluble (unable to be cultured in bile)
Increased reticulocytes
19. What is somatomedin C?
The time interval between S2 and OS- the shorter the interval - the more intense
Insulin like growth factor 1 (just another name)
ZDV or AZT
Paramyxo and influenza
20. What is the most common neurologic complication of VZV reactivation?
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
Localized dermatologic pain that persists for more than one month after zoster eruption
Faulty positioning of the genital tubercle
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)
21. In What type of nephritis would you see high serum eos count?
Fibronectin - laminin - collagen
Anti - apoptotic (prevents going into apoptosis)- 18; 14
Drug induced interstitial nephritis
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
22. which nerve provides innervation for plantar flexion and inversion?
II; I (I more abundant)
No and yes
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
Tibial
23. What are the first generation anti histamines?
Chlorpheniramine and diphenhydramine
T test; chi squared
transcription activation/suppression
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
24. What are two indicators of chronic alcohol consumption?
Hypothyroidism
G to T in p53; HCC
Elevated GGT and macrocytosis
Because gamma chains replace beta chains and then gamma chain formation wanes
25. what pathology is found around the illeo cecal valve and presents in 2 year old children with colicky abdominal pain and currant jelly stools?
Intussusception
Painless ulcer with black eschar and local edema; b. anthracis; D glutamate
Raphe
Anti centromere; anti DNA topoisomerase
26. What does TGF beta do? What produces it?
Pulmonic and systemic!
Fibrosis; macrophages
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
Become beta pleated and then form neurofibrillary tangle!
27. which two drug types can cause orthostatic hypotension (think depression and BPH)?
Trauma to stereociliated hair cells of the organ of corti
No; yes
C3 decreased after 5-10 days; sulfonamides
TCAs and prazosin
28. what protects the resting heart from arrhythmias?
Class I
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia
Hypertension - edema - and proteinuria
Highly negative resting potential
29. What are some of the permissive effects of cortisol?
Pain reliever - reduces pain by locking substance P in the PNS
Increases bronchial and vascular smooth muscle reactivity to catecholamines
Insulin like growth factor 1 (just another name)
Duration and extent of disease
30. When does dysplasia become a carcinoma - in other words When does it nonreversible? What is high grade dysplasia synonymous with?
When it invades the bm; carcinoma in situ
Vascular endothelium; protease
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Increase in permeability of two ions with equal and opposite equilibrium potentials
31. What does extended consumption of appetite suppressants lead to?
Sudden loss of muscle tone without loss of consciousness; narcolepsy
Criggler Najjar (UGT enzyme in bilirubin glucoronidation) ; Dubin Johnson (transport protein lacking - Black liver) and Rotor syndrome - defects in hepatic uptake and excretion of bile (numerous defect)
Pulmonary hypertension
Purkinje system; AV node
32. are there signs of inflammation in avascular necrosis? then How do you diagnose?
Sudden loss of muscle tone without loss of consciousness; narcolepsy
No; MRI
Anterior circumflex (and axillary nerve)
H. influenzae type B; polyribosyl phosphate (PRP); cherry red uvula - dysphagia - stridor (sometimes) - difficulty breathing - fever - drooling - positive 'thumbs up sign' on lateral xray of cervical region d/t swollen epiglottis
33. What is gardeners mydriasis? How is it treated?
Enterococci (e. faecalis)- found on genitalia area
low in serum
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
Relatively selective B1 adrenergic agonist; acute heart failure with decreased myocardial contractility (cardiogenic shock); increases myocardial contractility; can induce arrhythmias because increases cardiac conduction velocity
34. What type of bond is a disulfide bond?
CGD; t cell dysfxn (diGeorge)
Drink plenty of fluids
Covalent (between two cysteines)- allows protein to withstand denaturation
On cardiac tissue and renal juxtaglomerular cells
35. What is congestive hepatomegaly specific for?
Think Hb deformation diseases
Medullary
Gluteus medius and minimus; positive trendelenberg
Right heart failure
36. What are the first line agents used in acute gouty arthritis? why not use colchicine? when would you use glucocorticoids?
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
SSRI
Anti - apoptotic (prevents going into apoptosis)- 18; 14
37. other than parvo B19 - what else is associated with red cell aplasia?
Diabetic microangiopathy
Ether and other organic solvents
Thymic tumor
11
38. what clinical findings help distinguish small cell carcinoma?
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
As a CO2 carrier with the carboxylase enzyme
Centrally located - strong smoking association - neuroendocrine markers: enolase - chromogranin - synaptophysin
Demargination of neutrophils from the vessel walls
39. What are the two mcc of focal brain lesions in HIV positive patients?
Standing suddenly from supine position; valsalva maneuver
Dihydropyridine sensitive Ca channels (L type)
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
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
40. facial pain and headache in a patient with diabetic ketoacidosis is highly suggestive of what? How do you diagnose? What is a char finding?
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity
Dry skin - papilledema - intracranial pressure - alopecia - hyperlipidemia - hepatoxicity - hepatosplenomegaly -
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus
41. How do you explain the selective proteinuria of loss to albumin only in MCD?
Bronchial dilation (bronchiectasis)
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
Clindamycin; covers anaerobic oral flora and aerobic bacteria
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis
42. what locations of UC increase the risk of Colon cancer?
Atrial
SaO2 <92%
SVT; increases vagal tone; rectus abdominis
Pan colitis and right sided colitis (more than left sided and proctitis)
43. What is extraocular muscle weakness a common symptom of?
Near the medial epicondyle or in Guyon's canal near the hook of the hamate and pisiform bone in the wrist
Barium enema
Cleaves bases leaving apyrimidine and apurine sites; cleaves 5' end of DNA; cleaves 3' end of DNA; base excision repair; DNA polymerase - and ligase
Myasthenia gravis
44. name three pathological states that present with large tongues.
Ulcers in esophagus - stomach - or duodenum and high ICP can cause perforation or ulcers in duodenum d/t acute physiologic stress
Congenital hypothyroidism - downs - amyloidosis - acromegaly
Because gamma chains replace beta chains and then gamma chain formation wanes
Appetite suppressants
45. what disease causes a lack of intracellular killing? lack of killing viruses and fungi?
Circular - outside nucleus; transport proteins - rRNA - tRNA
OCPs - multiparity - breast feeding
In ER of bile canaliculi
CGD; t cell dysfxn (diGeorge)
46. in the fluid running along the PT - what happens to PAH - inulin - urea - creatinine? how about glucose - aa - bicarb?
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
ZDV or AZT
Increase; decreased
Reticulocytes
47. What is hyaline arteriosclerosis usually a sign of ?
Inhaled animal dander allergens
Diabetic microangiopathy
11 aa polypeptide; pain NT in CNS and PNS
Increases bronchial and vascular smooth muscle reactivity to catecholamines
48. what chromosome is c - myc found on?
The term used to describe decreased drug responsiveness with repeated administration
Excessive collagen formation during tissue repair in susceptible individuals
Chrom 8
Adductor
49. What is difference between Arnold Chiari type I and II?
I is more benign and can present later in adulthood
Acute gastric mucosal defects (superficial or full thickness)
AFP (HCC marker - produced in fetal liver and yolk sac!)- more specific than sensitive unfortunately
Bronchial dilation (bronchiectasis)
50. What is low levels of C1 esterase inhibitor diagnostic of? how can this be acquired?
Kallmans
Standing suddenly from supine position; valsalva maneuver
Hereditary angioedema; ACE inhibitors
transcription activation/suppression
Sorry!:) No result found.
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