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. carnitine deficiency impairs production of What and how?
Amiadarone
Superior larygeal; cricothyroid; recurrent laryngeal
Ketone body production by preventing fatty acids into the mitochondria
No (unlike adenomyosis); yes

2. What does the tuberoinfundibular pathway connect? What is it responsible for?
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin
Serum FFA and serum triglyceride levels
E6 and E7 of HPV knock off p53 and Rb suppressor genes
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)

3. What is the most important prognostic indicator in patients with malignant melanoma?
Rose spots on abdomen - hepatosplenomegaly - hemorrhagic enteritis (with possible perforation)
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
Measure of depth invasion (vertical!)
Highly lethal fulminant hepatits; acute viral hepatitis (cant be distinguished clinically); significantly elevated ALT and AST an prolonged prothrombin time - and eosinophilia

4. What is the mc manifestation of CMV in HIV patient? immunocompetent?
Retinitis; mononucleosis
Downs; regurgitant AV valves - ASDs
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity
Chlorpheniramine and diphenhydramine

5. why is crohns disease associated with oxaloacetate kidney stones?
Single adenomatous ones
Lack of calcium to bind oxaloacetate; crohns prevents fat absorption from lack of bile reabsorption in the terminal illeum which leads to fats pulling calcium and lack of calcium reabsorption
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
MAO inhibitors; wine and cheese

6. What are diastolic (lowest) pressures in aorta? LV?
Diabetic microangiopathy
Highly negative resting potential
Close but purkinje system to ensure contraction in a bottom up fashion
Around 70 (normal measured diastolic pressures); 9--

7. What is the precursor protein to beta amyloid and On what chromosome is it found?
Ulcers in esophagus - stomach - or duodenum and high ICP can cause perforation or ulcers in duodenum d/t acute physiologic stress
APP on chrom 21 (this is why downs more susceptible)
Downs; regurgitant AV valves - ASDs
Because left renal vein passes between aorta and SMA and hardening of SMA can cause renal vein compression

8. 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?
Not lined by epithelium
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
Radial nerve damage
Raphe

9. What does anti phospholipid syndrome in SLE patients predispose them to?
Demargination of neutrophils from the vessel walls
glycerol kinase
low in serum
Multiple miscarriages d/t hypercoaguability

10. is strep pneumo optochin resistant or susceptible? bile soluble or insoluble?
11 aa polypeptide; pain NT in CNS and PNS
In the extracellular space
Susceptible; soluble (unable to be cultured in bile)
Right heart failure

11. what indicates the severity of a mitral regurg ? mitral stenosis?
Parallel play; reproduce simple shapes; tricycle riding - stair climbing; simple sentences
Muscarinic antagonist; pralidoxime because atropine doesnt work at nicotinc receptors and organophospates act at all cholinergic (muscle paralysis not solved with only atropine)
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity
S3 gallop; S2 to opening snap interval

12. which nucleus releases serotonin?
Purkinje system; AV node
Raphe
Barium enema
Recurrent larygneal

13. on What part of the clavicle does the SCM attach?
Underestimation of gestational age
Medial part
Acute interstitial nephritis
Right before diastole (filling begins)

14. in the LV and aorta - What are the pressures?
Octreotide
Normally close to systolic
Increase in permeability of two ions with equal and opposite equilibrium potentials
Gluteus maximus; difficulty getting up from seated position and climbing chair

15. What are the common causes of metabolic alkalosis? How do you differentiate between them?
Vomitting - NG suctioning - diuretic use - hyperaldosteronism; urinary chloride concentration
Near the hinge point; site for attachment to phagocytic cells is at the very end (Fc receptor)
GI tract; mood!
Vascular endothelium; protease

16. What are some side effects seen in TCAs?
Cardiac arrhthymias (quinidine like long QT) - orthostatic hypotension (antagonism of alpha adrenergic receptors) - urinary retention (d/t anticholinergic effects) - seizures
Demargination of neutrophils from the vessel walls
Relfex tachycardia; giving beta blockers
Progressive dysphagia - chest pain - food regurg - and aspiration; birds beak deformity of the LES

17. within the right atrium - What is the maximum pressure? left atrium?
Serum FFA and serum triglyceride levels
SVT; increases vagal tone; rectus abdominis
8; 12
Valproate

18. Where is the base of the heart? apex?
Adductor
8 (myc protein) with 2 - 14 - 22 (iG chains)
Coagulation factors are made in the liver
Closer to head; closer to diaphragm

19. What is low levels of C1 esterase inhibitor diagnostic of? how can this be acquired?
Anterior and to the right (on the ECG!) of the pulmonary artery; right to left shunt
CGD; t cell dysfxn (diGeorge)
Hereditary angioedema; ACE inhibitors
Ketone body production by preventing fatty acids into the mitochondria

20. How do you calculate RPF from urine PAH?
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus
(urine PAH x urine flow rate)/plasma PAH
Regular insulin (Not fast acting - regular better)
Lateral; RV; RA; LV

21. What does hypocapnia cause in teh brain? What is hypocapnia?
Right heart failure
S. saprophyticus - and s. epidermidis; novobiocin
Diabetic microangiopathy
Cerebral vasoconstriction and thus decreased blood flow; decreaed pCO2

22. What is dobutamine? What is it used for?how it is it most helpful? What is bad about it?
Well
Biphosphonate
Kallmans
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

23. Where does terminal peptide cleavage of collagen fibrils take place?
Ketone body production by preventing fatty acids into the mitochondria
S. aureus
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR
In the extracellular space

24. what has the greatest effect on prognosis when treating c. diptheriae?
Vagus (auricular branch); vasovagal syncope!
Elevated GGT and macrocytosis
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)

25. 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

26. What is a keloid?
Prepatellar
Medullary
Excessive collagen formation during tissue repair in susceptible individuals
Duration and extent of disease

27. how does increased ICP result in curlings ulcers?
T test; chi squared
Vagus nerve stimulation
Increased reticulocytes
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)

28. in the fluid running along the PT - what happens to PAH - inulin - urea - creatinine? how about glucose - aa - bicarb?
Right heart failure
Increase; decreased
Anti Histaminic 1; anti cholinergic; antiseritoninergic;anti alpha adrenergic
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)

29. What is usually teh last gene mutation in development of a carcinoma (from an adenoma for example)?
P53 mutation; DCC is also required for adenoma to carcinoma
Dry skin - papilledema - intracranial pressure - alopecia - hyperlipidemia - hepatoxicity - hepatosplenomegaly -
Anti centromere; anti DNA topoisomerase
differentiate

30. what Cardiac condition does the valsalva maneuver abolish? how? what muscle is most important?
SVT; increases vagal tone; rectus abdominis
Because gamma chains replace beta chains and then gamma chain formation wanes
Reiter syndrome; B27
only up to bronchi

31. does congenital renal hypoplasia cause secondary hypertension? how about unilateral renal artery stenosis?
Medullary
No and yes
ANCA because of lack of Ig and C3 deposits on IF
Right before diastole (filling begins)

32. What is extraocular muscle weakness a common symptom of?
Medial circumflex artery; avascular necrosis
Tzanck smear
Joints d/t increased purine production and thus uric acid production
Myasthenia gravis

33. what should you think of with coarctation of aorta - bicuspid valves and horseshoe kidney?
Turners`
MAC complex (C5b - C9 complement deficiency)
Ceftriaxone; azithromycin
Ig A deficiency

34. What is a common complication of acute pancreatitis? What is it?
Vagus (auricular branch); vasovagal syncope!
C3 decreased after 5-10 days; sulfonamides
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis
Curlings ulcers

35. What type of vision is myopia? In What type of patients does it improve?
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
Abnormal closing of the urethral folds
The term used to describe decreased drug responsiveness with repeated administration
gram positive organisms

36. what chromosome is c - myc found on?
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)
Because gamma chains replace beta chains and then gamma chain formation wanes
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
Chrom 8

37. What is subacute sclerosisng encephalitis caused by?
Sarcoid
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics
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

38. What three factors effect total oxygen content of blood?
Inactivates kallikrein which activates kininogen into bradykinin
transcription activation/suppression
Pan colitis and right sided colitis (more than left sided and proctitis)
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2

39. What type of mutation does aflatoxin cause? what cancer does this increase for?
Nonsense; mRNA processing
Hypothyroidism
G to T in p53; HCC
hyponatremia (aldosterone activation equilibrates body volume)

40. what disease causes a lack of intracellular killing? lack of killing viruses and fungi?
TCAs and prazosin
CGD; t cell dysfxn (diGeorge)
Syncope - angina - dyspnea (SAD)
Barium enema

41. what happens to sperm count and semineferous tubules in patient with cryptoorchidism? hormonal function? why do they need to be surgically descended?
On cardiac tissue and renal juxtaglomerular cells
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
Bronchial dilation (bronchiectasis)
Around 70 (normal measured diastolic pressures); 9--

42. what diseases can vit A be used to treat?
Increases
Measles and M3 AML`
Radial nerve damage
Localized dermatologic pain that persists for more than one month after zoster eruption

43. neisseria are...
LT (LTD4 - E4 - C4) - and Ach
Close but purkinje system to ensure contraction in a bottom up fashion
25; 25
facultative intracellular

44. do Class IC agents prolong the QT interval?
Increases cytokine production
Phencyclidine (PCP)
Boiling - bleach - formalin - UV irradiation
No

45. What are biphosphanate drugs structurally similar to? What are they used in the treatment of?
Increases bronchial and vascular smooth muscle reactivity to catecholamines
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness

46. What causes alpha helical proteins in alzheimers to become insoluble and prone to aggregating?
Become beta pleated and then form neurofibrillary tangle!
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!
Nocardia
SS +rNA

47. What is an abortive viral infection?
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
Amiloride - spironolactone - triamterene
4 - 4 - 9
Little effect on cell and no change

48. When is an S4 sound normal?
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
Purkinje system; AV node
SVC and IVC; right below the aortic knob
Well trained athletes and children

49. what protein is increased in Crohns disease? What does it do?
women
Hypertension - edema - and proteinuria
NF- KB; responsible for cytokine production
frameshift mutations (missense is substitution)

50. which two virus families have hemagluttinin on their surface?
G to T in p53; HCC
Paramyxo and influenza
Lateral; RV; RA; LV
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD