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 the mcc of asymmetric inflammatory arthiritis of the lower extremities in young men? what HLA association?
P53 mutation; DCC is also required for adenoma to carcinoma
Relfex tachycardia; giving beta blockers
Chlorpheniramine and diphenhydramine
Reiter syndrome; B27

2. which anti epileptic is preferred in patients with both absence and tonic clonic seizures?
As a CO2 carrier with the carboxylase enzyme
chronic urticaria and allergic symptoms
TSh (in testicular tumors can cause hyperthyroidism)
Valproate

3. What does phosphoglycerate mutase produce? In what process - instead of what? what cells used this and why?
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
Leukotriene precursor and does neutrophil chemotaxis
Underestimation of gestational age
Tryptophan; pellagra (diarrhea - dementia - dermatitis)

4. What is the mcc of extrinsic allergic asthma?
PDA open
Inhaled animal dander allergens
Aromatase deficiency in child
The term used to describe decreased drug responsiveness with repeated administration

5. What does protein M do in Group A strep<
Prevent phagocytosis
Bile soluble which means they are bile sensitive
Skin flushing and warmth; prostaglandins; give with aspirin
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)

6. What is achalasia and how would this correlate on the esophageal mannometry?
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
Decreased viscosity (anemia) - increased velocity (narrowing of vessel)
Relfex tachycardia; giving beta blockers
Purkinje system; AV node

7. when do ghon complexes form - primary or secondary TB?
Nocardia
Anterior nares
Primary
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)

8. why are beta thal major patients asymptomatic at birth?
Imitation of household tasks; page turning; jumping - standing on one foot; 2 word phrases
RER; copper
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
Because gamma chains replace beta chains and then gamma chain formation wanes

9. What is used to compare means? categorical outcomes?
Paranoid personality disorder is a distrust that pervades all parts of the patients life as opposed to delusional disorder Which is one fixed delusion
T test; chi squared
Pan colitis and right sided colitis (more than left sided and proctitis)
On cardiac tissue and renal juxtaglomerular cells

10. prostaglandin synthesis keeps...
Obstruction because they infiltrate the intestinal wall and encircle causing decrease in size of lumen - constipation - abdominal distension - abdominal pain - changes in stool caliber; right sided are often exophytic masses iron def anemia and syste
chronic urticaria and allergic symptoms
PDA open
Barium enema

11. What would a deflection of the membrane potential to near zero indicate?
Non ciliary secretory constituents of the terminal respiratory epithelium; play a role in detoxification of inhaled toxins with a p450 system
Adeno
Increase in permeability of two ions with equal and opposite equilibrium potentials
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)

12. why does liver dysfunction cause coagulation disorders?
Sudden loss of muscle tone without loss of consciousness; narcolepsy
Imitation of household tasks; page turning; jumping - standing on one foot; 2 word phrases
Coagulation factors are made in the liver
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin

13. where are neurons lost in huntingtons disease? What are two mc presenting symptoms?
Ig A deficiency
Not lined by epithelium
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)
Extrinsic def; instrinsic def; platelet def

14. What agonists reduce the gradient across the LV outflow tract?
Ether and other organic solvents
Selective alpha 1 (increases SVR)
Another type of aldosterone antagonist (like spironolactone)
hyponatremia (aldosterone activation equilibrates body volume)

15. What does prolonged PT indicated? aPTT? bleeding time?
Extrinsic def; instrinsic def; platelet def
Env genes (for getting into target cells)
Hereditary angioedema; ACE inhibitors
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics

16. what color pigmentations are caused by malassezia furfur? when do they become more visible?
Barium studies and colonoscopy can cause perforation just use plain abdominal xray
Sickle cell; G6PD
Hypo or hyper pigmentations; after tanning
Prevent phagocytosis

17. When does opening snap begin?
Serum creatine kinase; reperfusion injury causes necrosis
Right before diastole (filling begins)
PDA open
transcription activation/suppression

18. What is Bortezomib and What is it used for?
Proteasome inhibitor; treatment for MM and waldenstroms
DIC; TTP- HUS dont bleed that much
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
Multiple miscarriages d/t hypercoaguability

19. What is easiest way to treat nephrolithiasis?
Clindamycin; covers anaerobic oral flora and aerobic bacteria
Congenital hypothyroidism - downs - amyloidosis - acromegaly
Painless ulcer with black eschar and local edema; b. anthracis; D glutamate
Drink plenty of fluids

20. What is acanthosis nigricans associated with?
Nuclei pushed to periphery and nissl susbstance widely dispersed (increased protein repair); axonal reaction; Wallerian degeneration
Barium enema
Increase in permeability of two ions with equal and opposite equilibrium potentials
GI malignancies and Insulin resistance (acromegal for ex)

21. What does extended consumption of appetite suppressants lead to?
Pulmonary hypertension
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
MAC complex (C5b - C9 complement deficiency)
Biphosphonate

22. what should you think of in 'smear of an oral ulcer base'?
Tzanck smear
As a CO2 carrier with the carboxylase enzyme
frameshift mutations (missense is substitution)
The term used to describe decreased drug responsiveness with repeated administration

23. SIADH patients have normal blood volume but...
Shock symptoms (blood loss); amennorhea history; decidualized stroma (hormone changes are exactly the same) but no chorionic villi
Measure of depth invasion (vertical!)
Think Hb deformation diseases
hyponatremia (aldosterone activation equilibrates body volume)

24. Which is faster purkinje system or atrial muscle?
No (unlike adenomyosis); yes
Barium studies and colonoscopy can cause perforation just use plain abdominal xray
Close but purkinje system to ensure contraction in a bottom up fashion
Acute interstitial nephritis

25. What is the most common neurologic complication of VZV reactivation?
By vascular permeability and vasodilation
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
Localized dermatologic pain that persists for more than one month after zoster eruption
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC

26. What does the severity of leprosy depend on?
Little effect on cell and no change
IgE
Strength of cell mediated immune response
Both sides

27. do patients with cor pulmonale have increased or decreased levels of aldosterone?
Because of the low output from heart failure - they will have increased aldosterone levels
Superior larygeal; cricothyroid; recurrent laryngeal
Vertical diplopia
Undesirable effects that cause myocardial ischemia (increased HR and increased O2 consumption) are less (still there tho)

28. What is the mc outcome of a patient acutely infected with Hep C? 2nd mc?
Right heart failure
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
No and yes

29. in a positively skewed distribution is the mean greater than or equal to the median or the mode?
Well
Lateral; RV; RA; LV
Mean greater than median greater than mode
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities

30. How do left sided colon adenocarcinomas present? right sided?
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Pulmonic and systemic!
Dissolved in plasma and attached to Hgb
Obstruction because they infiltrate the intestinal wall and encircle causing decrease in size of lumen - constipation - abdominal distension - abdominal pain - changes in stool caliber; right sided are often exophytic masses iron def anemia and syste

31. IL4 is used for isotypye switching to what?
Cleaves bases leaving apyrimidine and apurine sites; cleaves 5' end of DNA; cleaves 3' end of DNA; base excision repair; DNA polymerase - and ligase
IgE
High potassium conductance and some sodium conductance
Increased reticulocytes

32. what happens to sperm count and semineferous tubules in patient with cryptoorchidism? hormonal function? why do they need to be surgically descended?
Adductor
RBF= PAH clearance/(1- hematocrit)
TCAs and prazosin
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

33. What type of cancer is keratin swirls indicative of ? What is the prognosis of this cancer in the esophagus? What is it associated with?
RBC mass; epo levels (secondary has high)
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
Lecithin (same as phosphatidylcholine)/sphingomyelin; by 35 weeks should be 2/1 or higher
CMV - HSV 1 - Candida

34. 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

35. which staphylococci can do mannitol fermaentation?
Not lined by epithelium
S. aureus
Vagus nerve stimulation
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities

36. What do you treat s. epidermidis with?
Vancomycin
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR
Right before diastole (filling begins)
No (unlike adenomyosis); yes

37. in essential fructosuria - what enzyme do patients use to metabolize fructose?
Hexokinase
RER; RER
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
When it invades the bm; carcinoma in situ

38. What is the mainstay treatment for acute mania?
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus
Epinephrine; adrenal medulla; phenylethanolamine N methyltransferase; cortisol
Multiple miscarriages d/t hypercoaguability

39. why does neutrophila occur with corticosteroids?
Demargination of neutrophils from the vessel walls
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
In ER of bile canaliculi
No and yes

40. Where does 90% of serotonin lie? What is this NT responsible?
GI tract; mood!
ZDV or AZT
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17
Progressive dysphagia - chest pain - food regurg - and aspiration; birds beak deformity of the LES

41. niacin used for hyperlipidemia - What are its side effects? why do they occur? how can you prevent them?
Coagulation factors are made in the liver
Skin flushing and warmth; prostaglandins; give with aspirin
Headaches and facial flushing; vasodilation in meninges and skin
Both sides

42. What is low levels of C1 esterase inhibitor diagnostic of? how can this be acquired?
Pain reliever - reduces pain by locking substance P in the PNS
AFP (HCC marker - produced in fetal liver and yolk sac!)- more specific than sensitive unfortunately
Hereditary angioedema; ACE inhibitors
Extrinsic def; instrinsic def; platelet def

43. on What part of the clavicle does the SCM attach?
V fib; v. failure
Ether and other organic solvents
Fibronectin - laminin - collagen
Medial part

44. What are examples of action that decrease venous return to the heart?
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)
Standing suddenly from supine position; valsalva maneuver
Nocardia
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2

45. What is difference between Arnold Chiari type I and II?
Hypertension - edema - and proteinuria
Increase; decreased
The term used to describe decreased drug responsiveness with repeated administration
I is more benign and can present later in adulthood

46. what drug causes aggression - nystagmus - ataxia - slurred speech - exaggerated gait and involuntary movements?
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
NF- KB; responsible for cytokine production
Phencyclidine (PCP)
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia

47. what stimulates bicarb secretion from the pancreas? Where is this hormone produced?
Pain reliever - reduces pain by locking substance P in the PNS
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)
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!

48. What is the diagnosis in delayed puberty plus anosmia?
Nonsense; mRNA processing
Selective alpha 1 (increases SVR)
Prepatellar
Kallmans

49. When does neovascularization granulation tissue begin to form after severe ischemia and MI? what happens in 12-24 hours? 2 weeks to 2 months? 1-5 days? 0-4 hours? when do you see edema - hemorrhage - wavy fibers?
Single adenomatous ones
10-14 days; coagulation and marginal contraction band necrosis; collagen formation; coagulation necrosis and neutrophilic infiltrate; nothing to see; 4-12 hours
hyponatremia (aldosterone activation equilibrates body volume)
Common peroneal; bony fractures and compression; sciatic

50. what vessel would a fracture to the neck of the of the humerus damage?
Anterior circumflex (and axillary nerve)
Cerebral vasoconstriction and thus decreased blood flow; decreaed pCO2
SS +rNA
Right before diastole (filling begins)