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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. other than parvo B19 - what else is associated with red cell aplasia?
Thymic tumor
Initiation - pointing; pincer grasp; walking; mama/dada
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
Trochlear nerve (IV); abducens nerve (VI)

2. How do bradykinin - C3a and C5a cause edema?
Permissive - sensitizes vasoconstrictive response from catecholamines - doesnt actually act on them but increases transcription of some genes that creates permissive effect (not additive or synergistic becuase cortisol alone doesnt have any effect on
By vascular permeability and vasodilation
liver specific
RR-1/RR

3. What are ulcers arising in the proximal duodenum in association with severe trauma or burns called?
Measles and M3 AML`
RBF= PAH clearance/(1- hematocrit)
Underestimation of gestational age
Curlings ulcers

4. Where is aromatase used?
Ovaries - testes - placental and other peripheral tissue (ie dont just think fat!)
Appetite suppressants
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
By vascular permeability and vasodilation

5. what hormone is structurally similar to hCG?
Aromatase deficiency in child
Permissive - sensitizes vasoconstrictive response from catecholamines - doesnt actually act on them but increases transcription of some genes that creates permissive effect (not additive or synergistic becuase cortisol alone doesnt have any effect on
Increases
TSh (in testicular tumors can cause hyperthyroidism)

6. What are the three causes of acute MI in context of normal coronary arteries ?
Measure of depth invasion (vertical!)
MAC complex (C5b - C9 complement deficiency)
Opiate anti diarrheal that binds to mu opiate receptors in GI tract and slows motility; meperidine; low doses - but therapeutic doses combined with atropine (under marked brand name lomotil)
Coronary vasospasm (cocaine) - coronary arteritis - hypercoaguability with acute thrombosis

7. what enzyme converts procarcinogens into carcinogens?
TCAs and prazosin
Increases the systemic vascular resistance and thus reduces the gradient across the LV outflow tract
G to T in p53; HCC
P450 mitochondrial monooxygenase

8. where are neurons lost in huntingtons disease? What are two mc presenting symptoms?
P53 mutation; AD
Because gamma chains replace beta chains and then gamma chain formation wanes
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)
Amiloride - spironolactone - triamterene

9. What are the two mcc of focal brain lesions in HIV positive patients?
Nonsense; mRNA processing
Skin flushing and warmth; prostaglandins; give with aspirin
Gluteus maximus; difficulty getting up from seated position and climbing chair
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)

10. What does the superior gluteal nerve innervate? how does damage to this nerve manifest?
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
Gluteus medius and minimus; positive trendelenberg
HSV and VZV
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)

11. What are the acute effects of corticosteroids on the CBC?
Well trained athletes and children
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
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)

12. what happens with LDL receptor density in statin therapy?
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
Increases
Anti centromere; anti DNA topoisomerase
Permissive - sensitizes vasoconstrictive response from catecholamines - doesnt actually act on them but increases transcription of some genes that creates permissive effect (not additive or synergistic becuase cortisol alone doesnt have any effect on

13. What does L/S stand for in fetal lung maturity? When does maturity occur?
Hydrogen bonds dictate alpha or beta structure
Lecithin (same as phosphatidylcholine)/sphingomyelin; by 35 weeks should be 2/1 or higher
II; I (I more abundant)
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia

14. What are the three presentations of ataxia telangectasia? What does the mutation cause? What is the mode of inheritance?
Chlorpheniramine and diphenhydramine
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR
Syringomelia
chronic urticaria and allergic symptoms

15. In what population does cholelithiasis occur?
Fat - fertile - forty - female
CGD; t cell dysfxn (diGeorge)
Chorda tympani branch
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects

16. in overweight individuals What is thought to contribute to insulin resistance?
When it invades the bm; carcinoma in situ
The term used to describe decreased drug responsiveness with repeated administration
Increases
Serum FFA and serum triglyceride levels

17. when do ghon complexes form - primary or secondary TB?
Primary
Proteasome inhibitor; treatment for MM and waldenstroms
Tissue redistribution (out of plasma) rather than metabolism
Vancomycin; histamine mediated

18. What aa is NAD+ coenyzme synthesized endogenously from? What does def cause?
10-14 days; coagulation and marginal contraction band necrosis; collagen formation; coagulation necrosis and neutrophilic infiltrate; nothing to see; 4-12 hours
Faulty positioning of the genital tubercle
Localized dermatologic pain that persists for more than one month after zoster eruption
Tryptophan; pellagra (diarrhea - dementia - dermatitis)

19. What are examples of action that decrease venous return to the heart?
Aromatase deficiency in child
Bile soluble which means they are bile sensitive
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
Standing suddenly from supine position; valsalva maneuver

20. Is there edema in primary Conns? secondary hyperaldosteronism? why?
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
Sodium escape due to ANP activation results in no edema; edema is the precipitating factor
11 aa polypeptide; pain NT in CNS and PNS
Octreotide

21. in a positively skewed distribution is the mean greater than or equal to the median or the mode?
Mean greater than median greater than mode
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Echinococcus granulosus; anaphylaxis
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)

22. What are fenfluramine - phentermine?
Appetite suppressants
Tzanck smear
No; yes
Selective alpha 1 (increases SVR)

23. What does TGF beta do? What produces it?
Retinitis; mononucleosis
Fibrosis; macrophages
The term used to describe decreased drug responsiveness with repeated administration
Cardiac arrhthymias (quinidine like long QT) - orthostatic hypotension (antagonism of alpha adrenergic receptors) - urinary retention (d/t anticholinergic effects) - seizures

24. What is the mcc of extrinsic allergic asthma?
Inhaled animal dander allergens
Proteasome inhibitor; treatment for MM and waldenstroms
8; 12
Highly lethal fulminant hepatits; acute viral hepatitis (cant be distinguished clinically); significantly elevated ALT and AST an prolonged prothrombin time - and eosinophilia

25. What is congestive hepatomegaly specific for?
Right heart failure
Pulmonary hypertension
Sodium escape due to ANP activation results in no edema; edema is the precipitating factor
Strength of cell mediated immune response

26. What is the general compensatory mechanism to prevent edema is situations with increased central venous pressure?
Thymic tumor
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)
Increase lymphatic drainage!
Increase by 50% in urine osmolality

27. why does hypothyroidism cause increased CPK levels?
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
Hypothyroid myopathy (thyroid is required for maintaining a lot!)
No (unlike adenomyosis); yes
Downs; regurgitant AV valves - ASDs

28. What is a clara cell?
Non ciliary secretory constituents of the terminal respiratory epithelium; play a role in detoxification of inhaled toxins with a p450 system
8 (myc protein) with 2 - 14 - 22 (iG chains)
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Downs; regurgitant AV valves - ASDs

29. What is extraocular muscle weakness a common symptom of?
Myasthenia gravis
Increases bronchial and vascular smooth muscle reactivity to catecholamines
V fib; v. failure
S. saprophyticus - and s. epidermidis; novobiocin

30. What is normal fibrinogen levels?
200-500
Cerebral vasoconstriction and thus decreased blood flow; decreaed pCO2
Adeno
Atrial

31. how long is substance P? What does it do?
Biphosphonate
Echinococcus granulosus; anaphylaxis
Env genes (for getting into target cells)
11 aa polypeptide; pain NT in CNS and PNS

32. What type of disease has selective proteinuria? What is found in urine? What is not?
Minimal change disease; lmw proteins: albumin and transferrin; IgG or alpha 2 microglobulin
Think Hb deformation diseases
4 - 4 - 9
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)

33. what diseases can vit A be used to treat?
Serum FFA and serum triglyceride levels
Measles and M3 AML`
Increase; decreased
Coronary vasospasm (cocaine) - coronary arteritis - hypercoaguability with acute thrombosis

34. What is the stabilizing force for the secondary structure of proteins?
Hydrogen bonds dictate alpha or beta structure
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis
Elastance
Insulin like growth factor 1 (just another name)

35. What are three symptoms in s.typhi?
Myasthenia gravis
Skin flushing and warmth; prostaglandins; give with aspirin
Rose spots on abdomen - hepatosplenomegaly - hemorrhagic enteritis (with possible perforation)
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects

36. What do you treat s. epidermidis with?
Parallel play; reproduce simple shapes; tricycle riding - stair climbing; simple sentences
Abnormal closing of the urethral folds
Extrinsic def; instrinsic def; platelet def
Vancomycin

37. What are pancreatic pseudocysts called pseudo rather than true cysts?
As a CO2 carrier with the carboxylase enzyme
Strength of cell mediated immune response
Not lined by epithelium
25; 25

38. do patients with cor pulmonale have increased or decreased levels of aldosterone?
Clindamycin; covers anaerobic oral flora and aerobic bacteria
Because of the low output from heart failure - they will have increased aldosterone levels
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
Not lined by epithelium

39. other than mycobacterim wha other bacteria is acid fast?
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
Nocardia
Abnormal closing of the urethral folds
Anterior and to the right (on the ECG!) of the pulmonary artery; right to left shunt

40. name three pathological states that present with large tongues.
Intussusception
Faulty positioning of the genital tubercle
Proteasome inhibitor; treatment for MM and waldenstroms
Congenital hypothyroidism - downs - amyloidosis - acromegaly

41. What can cause aortic regurg? What is the heart sound you hear?
Aortic root dilation or bicuspid aortic valve; diastolic murmur (right sternal border(
women
Anti cholinergic effects of pupil dilation and lack of accomodation
No and yes

42. What does the tuberoinfundibular pathway connect? What is it responsible for?
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)
Gluteus maximus; difficulty getting up from seated position and climbing chair
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin
Prevent phagocytosis

43. What antibiotic is best to treat alcoholic pulm infections? why?
DIC; TTP- HUS dont bleed that much
Curlings ulcers
11
Clindamycin; covers anaerobic oral flora and aerobic bacteria

44. When does opening snap begin?
No
Right before diastole (filling begins)
Inactivates kallikrein which activates kininogen into bradykinin
Sarcoid

45. What is subacute sclerosisng encephalitis caused by?
Drug induced interstitial nephritis
Single adenomatous ones
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
Elastance

46. What are the two pharmacologic antagonists that offer clear benefit in allergic asthma?
Adeno
liver specific
8 (myc protein) with 2 - 14 - 22 (iG chains)
LT (LTD4 - E4 - C4) - and Ach

47. What test would be best to determine if a gene is being transcribed? translated?
Southern - western
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!

48. What causes curlings ulcers?
Appetite suppressants
Apocrine; eccrine
Dissolved in plasma and attached to Hgb
Ulcers in esophagus - stomach - or duodenum and high ICP can cause perforation or ulcers in duodenum d/t acute physiologic stress

49. within the right ventricle - What are maximum pressures? the pulm arter?
Gluteus medius and minimus; positive trendelenberg
Boiling - bleach - formalin - UV irradiation
25; 25
Classical conditioning

50. What almost exclusively causes Epliglottitis?What type of capsule does it have? What are the symptoms?

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