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 disease causes a lack of intracellular killing? lack of killing viruses and fungi?
Recurrent larygneal
LT (LTD4 - E4 - C4) - and Ach
CGD; t cell dysfxn (diGeorge)
10-14 days; coagulation and marginal contraction band necrosis; collagen formation; coagulation necrosis and neutrophilic infiltrate; nothing to see; 4-12 hours

2. What is suggestive of complete central DI?
When it invades the bm; carcinoma in situ
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)
Single adenomatous ones
Increase by 50% in urine osmolality

3. What is the mcc of elevated AFP leves in pregnancy>
Underestimation of gestational age
Ether and other organic solvents
P53 mutation; DCC is also required for adenoma to carcinoma
RER; copper

4. which cells produce surfactant? which ones mediate gas exchange?
Amiloride - spironolactone - triamterene
II; I (I more abundant)
P53 mutation; DCC is also required for adenoma to carcinoma
Lower extremity spasticity due to stretching of periventricular pyrimadal tracts - visual disturbances and learning disabilities

5. What is the sole neurologic manifestation of acute rheumatic fever?
Dry skin - papilledema - intracranial pressure - alopecia - hyperlipidemia - hepatoxicity - hepatosplenomegaly -
Trauma to stereociliated hair cells of the organ of corti
gram positive organisms
Sydenham chorea

6. what dissolves the lipid bilayer of a viral envelope?
Not lined by epithelium
Ether and other organic solvents
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
II; I (I more abundant)

7. What three factors effect total oxygen content of blood?
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
Intussusception
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
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)

8. What causes alpha helical proteins in alzheimers to become insoluble and prone to aggregating?
Susceptible; soluble (unable to be cultured in bile)
Brief psychotic disorder; schizophreniform; schizophrenia
Become beta pleated and then form neurofibrillary tangle!
High potassium conductance and some sodium conductance

9. What is the Na/Ca exchange used for?
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR
To pump calcium out in cardiac myocytes so that relaxation occurs
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
women

10. why should you not use ACE inhibitors with someone who had hereditary angioedema?
Because ACE blocks breakdown of bradykinin and hereditary angioedema patients have high levels of bradykinin; high levels of bradykinin - C3a - and C5a mediate edema by increasing vascular permeability and vasodilation
Ketone body production by preventing fatty acids into the mitochondria
NF- KB; responsible for cytokine production
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)

11. integrin mediated adhesion of cells to ECM (and BM) involves integrin binding to what?
Hyperkalemia; potassium sparing diuretics - potassium supplements
Superior larygeal; cricothyroid; recurrent laryngeal
II; I (I more abundant)
Fibronectin - laminin - collagen

12. Where is conduction in heart fastest? slowest?
MAO inhibitors; wine and cheese
Purkinje system; AV node
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity
Radial nerve and deep brachial artery

13. What is it called if psychotic symptoms last less than one month? one to six months? more than six months?
Brief psychotic disorder; schizophreniform; schizophrenia
In the extracellular space
transcription activation/suppression
RER; copper

14. what enzyme converts procarcinogens into carcinogens?
Inactivates kallikrein which activates kininogen into bradykinin
P450 mitochondrial monooxygenase
low in serum
E6 and E7 of HPV knock off p53 and Rb suppressor genes

15. why does hypothyroidism cause increased CPK levels?
Hypothyroid myopathy (thyroid is required for maintaining a lot!)
21 hydroxylase deficiency; progesterone to 11 deoxycorticosterone; ambiguous genitalia in females and salt wasting
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)
Pulmonic and systemic!

16. What does Rb protein do? what chrom is it on?
Close but purkinje system to ensure contraction in a bottom up fashion
10-14 days; coagulation and marginal contraction band necrosis; collagen formation; coagulation necrosis and neutrophilic infiltrate; nothing to see; 4-12 hours
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Undesirable effects that cause myocardial ischemia (increased HR and increased O2 consumption) are less (still there tho)

17. What are examples of action that decrease venous return to the heart?
facultative intracellular
8 (myc protein) with 2 - 14 - 22 (iG chains)
Standing suddenly from supine position; valsalva maneuver
Cleaves bases leaving apyrimidine and apurine sites; cleaves 5' end of DNA; cleaves 3' end of DNA; base excision repair; DNA polymerase - and ligase

18. which congenital adrenal hyperplasia presents with ambiguous genitalia in females and salt retention?
Apocrine; eccrine
Proteasome inhibitor; treatment for MM and waldenstroms
11beta hydroxylase deficiency (11 deoxycortisol to cortisol)
Increases

19. what color pigmentations are caused by malassezia furfur? when do they become more visible?
Underestimation of gestational age
Hypo or hyper pigmentations; after tanning
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus
Vagus nerve stimulation

20. What can long term leg cast wearing cause?
The term used to describe decreased drug responsiveness with repeated administration
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
Barium enema
Nuclei pushed to periphery and nissl susbstance widely dispersed (increased protein repair); axonal reaction; Wallerian degeneration

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
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)
Ether and other organic solvents
Painless ulcer with black eschar and local edema; b. anthracis; D glutamate

22. What is 5- HETE and What does it do?
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Elevated GGT and macrocytosis
Localized dermatologic pain that persists for more than one month after zoster eruption
Leukotriene precursor and does neutrophil chemotaxis

23. Is the uterus enlarged in endometriosis? does it cause dyspareunia?
No (unlike adenomyosis); yes
Decreased viscosity (anemia) - increased velocity (narrowing of vessel)
10-14 days; coagulation and marginal contraction band necrosis; collagen formation; coagulation necrosis and neutrophilic infiltrate; nothing to see; 4-12 hours
Pain and discomfort from dilation and stretching of the renal capsule from all the cysts!; hypertension - hematuria

24. what clinical findings help distinguish small cell carcinoma?
only up to bronchi
Centrally located - strong smoking association - neuroendocrine markers: enolase - chromogranin - synaptophysin
ZDV or AZT
Vancomycin; histamine mediated

25. Where does lysyl oxidase act? What is the cofactor for that?
11beta hydroxylase deficiency (11 deoxycortisol to cortisol)
In the extracellular space for collagen cross linking; zinc
No; yes
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use

26. What is low levels of C1 esterase inhibitor diagnostic of? how can this be acquired?
Hereditary angioedema; ACE inhibitors
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness
Southern - western
Barium enema

27. What is the mainstay treatment for acute mania?
Demargination of neutrophils from the vessel walls
8; 12
Inhibits it
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic

28. which trisomy is associated with endocardial cushion defects? What does thsi mean>
Closer to head; closer to diaphragm
Lecithin (same as phosphatidylcholine)/sphingomyelin; by 35 weeks should be 2/1 or higher
Syncope - angina - dyspnea (SAD)
Downs; regurgitant AV valves - ASDs

29. What is the general compensatory mechanism to prevent edema is situations with increased central venous pressure?
Selective alpha 1 (increases SVR)
Increase lymphatic drainage!
Medial circumflex artery; avascular necrosis
Fibronectin - laminin - collagen

30. why is glucagon used in beta blocker toxicitiy?
Paramyxo and influenza
<1% - 55% - concentration dependent
Because increases intracellular cAMP independent of adrenergic receptors (does it via G proteins)
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone

31. What antibiotic is best to treat alcoholic pulm infections? why?
Because of vasodiation to skeletal muscles
Fibrosis; macrophages
indomethacin
Clindamycin; covers anaerobic oral flora and aerobic bacteria

32. PDAs are often asymptomatic. How do you treat?
Leukotriene precursor and does neutrophil chemotaxis
indomethacin
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
Transported to liver - glycerol kinase converts it to glycerol 3 phosphate Which is then converted to DHAP which can either join glycolysis for ATP or be used to make glucose

33. What is mcc of death pre hospital phase of MI? in hospital phase?
Ketone body production by preventing fatty acids into the mitochondria
Boiling - bleach - formalin - UV irradiation
(urine PAH x urine flow rate)/plasma PAH
V fib; v. failure

34. Where is high frequency sound best recepted? low frequency sound? Which is lost more in elderly?
glycerol kinase
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
Hydrogen bonds dictate alpha or beta structure
At cochlear base near round and oval window; near apex of cochlea - helioctrema; high frequency sound

35. What is used to prevent vertical transmission of HIV?
Measure of depth invasion (vertical!)
Gluteus medius and minimus; positive trendelenberg
Lower extremity spasticity due to stretching of periventricular pyrimadal tracts - visual disturbances and learning disabilities
ZDV or AZT

36. is strep pneumo optochin resistant or susceptible? bile soluble or insoluble?
Susceptible; soluble (unable to be cultured in bile)
Echinococcus granulosus; anaphylaxis
II; I (I more abundant)
Turbulence

37. where exactly is ACE expressed in the lungs? What type of enzyme is it?
indomethacin
Vascular endothelium; protease
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Radial nerve damage

38. 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?
Cerebral vasoconstriction and thus decreased blood flow; decreaed pCO2
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)
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin

39. in the fluid running along the PT - what happens to PAH - inulin - urea - creatinine? how about glucose - aa - bicarb?
Measure of depth invasion (vertical!)
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
Adductor
Increase; decreased

40. Where does vasopressin act - on the medullary or cortical segment of collecting tubule?
Additive is equal to the sum of the two actions (lets say agonists at a receptor) and synergistic is when the sum is greater than just their two effects together
Medullary
Chorda tympani branch
Cluster

41. What does glycosylase do to DNA? endonuclease? lyase? What does the order here of enzymes represent? what other enzymes are needed?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

42. after a thrombus extraction - what serum enzyme shoots up and why?
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
Serum creatine kinase; reperfusion injury causes necrosis
Pain and discomfort from dilation and stretching of the renal capsule from all the cysts!; hypertension - hematuria
Obesity prevents expansion of wall and lungs for breathing; chronically elevated (all the time not just sleep) PaCO2 and decreased PaO2

43. which two virus families have hemagluttinin on their surface?
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia
Paramyxo and influenza
Spongiosis
HSV ( also in utero: chlymadia - neisseria - group B strep)

44. Where does the aorta lie in relation to the pulmonary artery in transposition of the great arteries (is this right to left or left to right shunt?)?
Anterior and to the right (on the ECG!) of the pulmonary artery; right to left shunt
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)
P53 mutation; AD
Fat - fertile - forty - female

45. What is diagnostic (and possible therapeutic for intussusception)?
Coagulation factors are made in the liver
Boiling - bleach - formalin - UV irradiation
Reticulocytes
Barium enema

46. What type of vision is myopia? In What type of patients does it improve?
Drug induced interstitial nephritis
Prepatellar
Acute necrotizing pancreatitis; alveolar hyaline membranes; leaky capillary alveolar membrane (proteins deposit)
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects

47. what happens to PaO2 - % sat - and O2 content in: Anemia - polycythemia - CO poisoning?
Not lined by epithelium
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
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
Atrial

48. how does noise induced hearing loss occur?
Trauma to stereociliated hair cells of the organ of corti
Recurrent larygneal
SVT; increases vagal tone; rectus abdominis
Lateral; RV; RA; LV

49. at 2 years of age - What are the social - fine motor - gross motor and language developments?
Because of the low output from heart failure - they will have increased aldosterone levels
Imitation of household tasks; page turning; jumping - standing on one foot; 2 word phrases
Aortic root dilation or bicuspid aortic valve; diastolic murmur (right sternal border(
The term used to describe decreased drug responsiveness with repeated administration

50. What is a keloid?
Retinitis; mononucleosis
11 aa polypeptide; pain NT in CNS and PNS
Excessive collagen formation during tissue repair in susceptible individuals
Anterior and to the right (on the ECG!) of the pulmonary artery; right to left shunt