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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. which cells produce surfactant? which ones mediate gas exchange?
II; I (I more abundant)
ZDV or AZT
Rabies encephalitis from cave bats; rabies killed vaccines
Right heart failure

2. what enzymes is lipoic acid a cofactor for? What does a mutation in it result in?
Muscarinic antagonist; pralidoxime because atropine doesnt work at nicotinc receptors and organophospates act at all cholinergic (muscle paralysis not solved with only atropine)
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Multiple miscarriages d/t hypercoaguability
SSRI; erectile dysfunction

3. What is medullary sponge kidney disease and how does it present? What does it lead to?
Purkinje system; AV node
Pain and discomfort from dilation and stretching of the renal capsule from all the cysts!; hypertension - hematuria
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)
Hypo or hyper pigmentations; after tanning

4. Would alpha 1 agonists cause flushing? muscarinic antagonist?
Primary
No; yes
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Mean greater than median greater than mode

5. What agonists reduce the gradient across the LV outflow tract?
Standing suddenly from supine position; valsalva maneuver
Selective alpha 1 (increases SVR)
Octreotide
Elevates ASO titers; elevated anti DNAase B titers; decreased C3 and total complement levels and presence of cryoglobulins (C4 normal)

6. What are the three presentations of ataxia telangectasia? What does the mutation cause? What is the mode of inheritance?
Coronary vasospasm (cocaine) - coronary arteritis - hypercoaguability with acute thrombosis
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR
Radial nerve and deep brachial artery
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)

7. What is extraocular muscle weakness a common symptom of?
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Paramyxo and influenza
Myasthenia gravis
Ether and other organic solvents

8. What is the mc manifestation of CMV in HIV patient? immunocompetent?
Prepatellar
Proteasome inhibitor; treatment for MM and waldenstroms
Ceftriaxone; azithromycin
Retinitis; mononucleosis

9. what stimulates bicarb secretion from the pancreas? Where is this hormone produced?
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)
Anti Histaminic 1; anti cholinergic; antiseritoninergic;anti alpha adrenergic
Abnormal closing of the urethral folds
Coronary vasospasm (cocaine) - coronary arteritis - hypercoaguability with acute thrombosis

10. What type of drug is atropine? what else is needed in addition to atropine when treating organophosphate poison?
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Varying; erythema nodosum is common
Little effect on cell and no change
Muscarinic antagonist; pralidoxime because atropine doesnt work at nicotinc receptors and organophospates act at all cholinergic (muscle paralysis not solved with only atropine)

11. Acyl coA synthetase is not...
Primary
ZDV or AZT
liver specific
Progressive dysphagia - chest pain - food regurg - and aspiration; birds beak deformity of the LES

12. what should you think of in 'smear of an oral ulcer base'?
RER; copper
To pump calcium out in cardiac myocytes so that relaxation occurs
Tzanck smear
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus

13. What is the only cranial nerve that comes out dorsally? What does this mean clinically?
Strength of cell mediated immune response
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)
low in serum
Phase 4 (sodium current); reducing the rate of spontaneous depolarization

14. What can chronic vit A toxicity cause?
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness
Dry skin - papilledema - intracranial pressure - alopecia - hyperlipidemia - hepatoxicity - hepatosplenomegaly -
No; MRI
Vascular endothelium; protease

15. What causes curlings ulcers?
Vancomycin
TSh (in testicular tumors can cause hyperthyroidism)
Acute gastric mucosal defects (superficial or full thickness)
Ulcers in esophagus - stomach - or duodenum and high ICP can cause perforation or ulcers in duodenum d/t acute physiologic stress

16. What is epispadias caused by?
Faulty positioning of the genital tubercle
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
Relfex tachycardia; giving beta blockers
Well trained athletes and children

17. where exactly is ACE expressed in the lungs? What type of enzyme is it?
Hypertension - edema - and proteinuria
Proteasome inhibitor; treatment for MM and waldenstroms
Measure of depth invasion (vertical!)
Vascular endothelium; protease

18. Which branch of the facial nerve provides taste from ant 2/3 of tongue?
Chorda tympani branch
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)
Trauma to stereociliated hair cells of the organ of corti
Gluteus medius and minimus; positive trendelenberg

19. What are the first line agents used in acute gouty arthritis? why not use colchicine? when would you use glucocorticoids?
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
Because increases intracellular cAMP independent of adrenergic receptors (does it via G proteins)
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)

20. What do you treat s. epidermidis with?
Vancomycin
Fibrosis; macrophages
Reticulocytes
No; yes

21. What are the three predominant symptoms of VHL? What is its mode of inheritance?
Valproate
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
No; MRI
Anti - apoptotic (prevents going into apoptosis)- 18; 14

22. why does liver dysfunction cause coagulation disorders?
Adductor
Coagulation factors are made in the liver
Because of vasodiation to skeletal muscles
Classical conditioning

23. What does protein M do in Group A strep<
Prevent phagocytosis
Rose spots on abdomen - hepatosplenomegaly - hemorrhagic enteritis (with possible perforation)
Dissolved in plasma and attached to Hgb
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)

24. why is there only minor blood pressure increase during exercise if sympathetic activity is high (to increase CO and HR)?
The first is involved in fatty acid synthesis; the other is involved in beta oxidation of fatty acids to make ketones (ketone synthesis)
Adductor
Because of vasodiation to skeletal muscles
ZDV or AZT

25. In What type of nephritis would you see high serum eos count?
Drug induced interstitial nephritis
Amiadarone
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17
HSV ( also in utero: chlymadia - neisseria - group B strep)

26. What is Bortezomib and What is it used for?
Syringomelia
Proteasome inhibitor; treatment for MM and waldenstroms
Normal; low
Radial nerve and deep brachial artery

27. How do bradykinin - C3a and C5a cause edema?
Hypothyroidism
By vascular permeability and vasodilation
On cardiac tissue and renal juxtaglomerular cells
Vagus nerve stimulation

28. What is the Na/Ca exchange used for?
Close but purkinje system to ensure contraction in a bottom up fashion
Reticulocytes
To pump calcium out in cardiac myocytes so that relaxation occurs
chronic urticaria and allergic symptoms

29. what should you think of with coarctation of aorta - bicuspid valves and horseshoe kidney?
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)
Raphe
Turners`

30. What does the tuberoinfundibular pathway connect? What is it responsible for?
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin
Decreases both
Rose spots on abdomen - hepatosplenomegaly - hemorrhagic enteritis (with possible perforation)
Ether and other organic solvents

31. what increases turbulence and thus causes bruits? (specifically in terms of viscosity and velocity)
Fibrosis; macrophages
Cluster
Decreased viscosity (anemia) - increased velocity (narrowing of vessel)
NF- KB; responsible for cytokine production

32. in B12 deficiency - what levels in blood rise very quickly and then drop?
Ceftriaxone; azithromycin
Reticulocytes
Class I
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities

33. what dissolves the lipid bilayer of a viral envelope?
Retinitis; mononucleosis
Dihydropyridine sensitive Ca channels (L type)
Tzanck smear
Ether and other organic solvents

34. What is contraindicated in toxic mega colon?
Increase in permeability of two ions with equal and opposite equilibrium potentials
NF- KB; responsible for cytokine production
Barium studies and colonoscopy can cause perforation just use plain abdominal xray
Increases

35. What causes vertical diplopia? horizontal?
SSRI
As a CO2 carrier with the carboxylase enzyme
Acute gastric mucosal defects (superficial or full thickness)
Trochlear nerve (IV); abducens nerve (VI)

36. What are the three top bacterial causes of acute otitis media - sinusitis - and conjuctivitis?
Gluteus medius and minimus; positive trendelenberg
Become beta pleated and then form neurofibrillary tangle!
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis
S3 gallop; S2 to opening snap interval

37. How do you calculate RPF from urine PAH?
In the extracellular space for collagen cross linking; zinc
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia
(urine PAH x urine flow rate)/plasma PAH
Purkinje system; AV node

38. neisseria are...
Gluteus maximus; difficulty getting up from seated position and climbing chair
facultative intracellular
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
P450 mitochondrial monooxygenase

39. What is the triad seen in pre eclampsia?
(urine PAH x urine flow rate)/plasma PAH
GI tract; mood!
CMV - HSV 1 - Candida
Hypertension - edema - and proteinuria

40. What does 'oxygen' content in blood refer to?
Dissolved in plasma and attached to Hgb
Diabetic microangiopathy
TSh (in testicular tumors can cause hyperthyroidism)
liver specific

41. what diseases can vit A be used to treat?
I is more benign and can present later in adulthood
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin
Measles and M3 AML`

42. which anti epileptic is preferred in patients with both absence and tonic clonic seizures?
Because of the low output from heart failure - they will have increased aldosterone levels
Valproate
Painless ulcer with black eschar and local edema; b. anthracis; D glutamate
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities

43. what Cardiac condition does the valsalva maneuver abolish? how? what muscle is most important?
Turbulence
Little effect on cell and no change
SVT; increases vagal tone; rectus abdominis
In the extracellular space for collagen cross linking; zinc

44. What type of vision is myopia? In What type of patients does it improve?
Serum creatine kinase; reperfusion injury causes necrosis
Inhibits it
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
Adductor

45. do patients with cor pulmonale have increased or decreased levels of aldosterone?
Vertical diplopia
No and yes
Tzanck smear
Because of the low output from heart failure - they will have increased aldosterone levels

46. do Class IC agents prolong the QT interval?
Because increases intracellular cAMP independent of adrenergic receptors (does it via G proteins)
Adductor
No
Become beta pleated and then form neurofibrillary tangle!

47. are strep pneumo bile sensitive or bile resistant? bile soluble or insoluble?
Chromosome 3- von hippel lindau gene (the disease itself is rare - but mutations of the gene are common)
Intussusception
Bile soluble which means they are bile sensitive
Joints d/t increased purine production and thus uric acid production

48. What is a primary HSV 1 infection like?
25; 25
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
Strength of cell mediated immune response
Anterior nares

49. What is the mcc of cystitis and and acute pyelonephritis? mcc of UTI in sexually active women?
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity
Reticulocytes
E. coli; staphylococcus saprophyticus
Boiling - bleach - formalin - UV irradiation

50. What is the key lab finding seen in type III serum sickness? What are some drugs that can induce it?
C3 decreased after 5-10 days; sulfonamides
No; yes
Curlings ulcers
Syringomelia