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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. who bleed more DIC or TTP- HUS patients?
Hypothyroidism
Undesirable effects that cause myocardial ischemia (increased HR and increased O2 consumption) are less (still there tho)
TCAs and prazosin
DIC; TTP- HUS dont bleed that much

2. What type of bond is a disulfide bond?
Trauma to stereociliated hair cells of the organ of corti
Covalent (between two cysteines)- allows protein to withstand denaturation
Both sides
Trochlear nerve (IV); abducens nerve (VI)

3. how does increased ICP result in curlings ulcers?
High potassium conductance and some sodium conductance
Vagus nerve stimulation
Tryptophan; pellagra (diarrhea - dementia - dermatitis)
By IgE activation (IgE binds to them as they are in the blood and then bind to Fc receptor on eos)- ADCC

4. Where does glycolsylation occur of alpha procollagen chains occur? disulfide bond formation at the C terminus?
Anti - apoptotic (prevents going into apoptosis)- 18; 14
RER; RER
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)
Minimal change disease

5. what hormone is structurally similar to hCG?
TSh (in testicular tumors can cause hyperthyroidism)
ATP binding (resets the myosin head to contract again for next binding)
LT (LTD4 - E4 - C4) - and Ach
Acute necrotizing pancreatitis; alveolar hyaline membranes; leaky capillary alveolar membrane (proteins deposit)

6. What type of endocarditis is cytoscopy induced?
Enterococci (e. faecalis)- found on genitalia area
Hypothyroid myopathy (thyroid is required for maintaining a lot!)
ZDV or AZT
Inhaled animal dander allergens

7. What is suggestive of complete central DI?
Increase by 50% in urine osmolality
Turners`
Initiation - pointing; pincer grasp; walking; mama/dada
RER; RER

8. within the right atrium - What is the maximum pressure? left atrium?
8; 12
Folic acid treatment!
GI malignancies and Insulin resistance (acromegal for ex)
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis

9. 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
No and yes
Vertical diplopia
Biphosphonate

10. what diseases can vit A be used to treat?
Fat - fertile - forty - female
Measles and M3 AML`
(urine PAH x urine flow rate)/plasma PAH
Medullary

11. What does NF- KB do?
Increases cytokine production
Think Hb deformation diseases
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
Well trained athletes and children

12. What is omalizumab and What is it used for?
Pain and discomfort from dilation and stretching of the renal capsule from all the cysts!; hypertension - hematuria
I is more benign and can present later in adulthood
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids
Recurrent larygneal

13. how can HAV be inactivated?
11 aa polypeptide; pain NT in CNS and PNS
Boiling - bleach - formalin - UV irradiation
Pulmonic and systemic!
Increase; decreased

14. what increases turbulence and thus causes bruits? (specifically in terms of viscosity and velocity)
Not lined by epithelium
Retinitis; mononucleosis
Decreased viscosity (anemia) - increased velocity (narrowing of vessel)
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!

15. What three things can reduce the risk of non hereditary ovarian and endometrial cancer?
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
SVT; increases vagal tone; rectus abdominis
Skin flushing and warmth; prostaglandins; give with aspirin
OCPs - multiparity - breast feeding

16. what indicates the severity of a mitral regurg ? mitral stenosis?
INTRApartum Abs (ampicillin/penicillin)
Rabies encephalitis from cave bats; rabies killed vaccines
OCPs - multiparity - breast feeding
S3 gallop; S2 to opening snap interval

17. What is gardeners mydriasis? How is it treated?
T test; chi squared
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
GI malignancies and Insulin resistance (acromegal for ex)
Biphosphonate

18. What is the best indicator for the severity of mitral stenosis?
transcription activation/suppression
The time interval between S2 and OS- the shorter the interval - the more intense
Increase in permeability of two ions with equal and opposite equilibrium potentials
Regular insulin (Not fast acting - regular better)

19. What test would be best to determine if a gene is being transcribed? translated?
Southern - western
Kallmans
TCAs and prazosin
Ovaries - testes - placental and other peripheral tissue (ie dont just think fat!)

20. Acyl coA synthetase is not...
No; yes
liver specific
Bile salt accumulation in urine
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

21. what drug causes aggression - nystagmus - ataxia - slurred speech - exaggerated gait and involuntary movements?
Hypothyroid myopathy (thyroid is required for maintaining a lot!)
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)
Clindamycin; covers anaerobic oral flora and aerobic bacteria
Phencyclidine (PCP)

22. What causes congenital QT prolongation syndrome? What is death caused by? in one of the syndromes - What is a common other symptom?
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
Reiter syndrome; B27
No; yes

23. 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
Another type of aldosterone antagonist (like spironolactone)
Selective alpha 1 (increases SVR)
Increase; decreased

24. 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?
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
Enterococci (e. faecalis)- found on genitalia area
Fat - fertile - forty - female
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

25. What is the mutation type in thalassemias? what process is defective because of this?
Sarcoid
Nonsense; mRNA processing
Anti cholinergic effects of pupil dilation and lack of accomodation
P53 mutation; DCC is also required for adenoma to carcinoma

26. What is hypospadias caused by?
No; MRI
Abnormal closing of the urethral folds
Hexokinase
low in serum

27. which congenital adrenal hyperplasia presents with all genotypes as phenotypically female and with salt retention and hypertension?
Skin flushing and warmth; prostaglandins; give with aspirin
NF- KB; responsible for cytokine production
ANCA because of lack of Ig and C3 deposits on IF
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone

28. at 2 years of age - What are the social - fine motor - gross motor and language developments?
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia
Imitation of household tasks; page turning; jumping - standing on one foot; 2 word phrases
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)

29. What does the clinical presentation of restlessness - agitation - dysphagia - and progression to coma 30-50 days after cave exploring? hwo do you prevent?
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity
Rabies encephalitis from cave bats; rabies killed vaccines

30. nucleotide deletions do not cause missense mutations - they cause...
frameshift mutations (missense is substitution)
Increased reticulocytes
Chlorpheniramine and diphenhydramine
Dihydropyridine sensitive Ca channels (L type)

31. How is dobutamine better than dopamine?
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
transcription activation/suppression
Undesirable effects that cause myocardial ischemia (increased HR and increased O2 consumption) are less (still there tho)
Sydenham chorea

32. which nerve provides innervation for plantar flexion and inversion?
Vertical diplopia
Tibial
Duration and extent of disease
Primary

33. Where is the base of the heart? apex?
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Bile soluble which means they are bile sensitive
Closer to head; closer to diaphragm

34. What are the acute effects of corticosteroids on the CBC?
women
liver specific
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)
Vancomycin; histamine mediated

35. Which is faster atrial muscle or ventricular muscle?
GI malignancies and Insulin resistance (acromegal for ex)
When it invades the bm; carcinoma in situ
Atrial
Both sides

36. What is the mcc of asymmetric inflammatory arthiritis of the lower extremities in young men? what HLA association?
Reiter syndrome; B27
46 - 4N; 23 2N
Downs; regurgitant AV valves - ASDs
HSV and VZV

37. at one year of age - What are the social - fine motor - gross motor and language developments?
Initiation - pointing; pincer grasp; walking; mama/dada
Pulmonary hypertension
Adductor
Aortic root dilation or bicuspid aortic valve; diastolic murmur (right sternal border(

38. what Cardiac condition does the valsalva maneuver abolish? how? what muscle is most important?
S3 gallop; S2 to opening snap interval
Nonsense; mRNA processing
Southern - western
SVT; increases vagal tone; rectus abdominis

39. Where does 90% of serotonin lie? What is this NT responsible?
HSV and VZV
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
Highly negative resting potential
GI tract; mood!

40. what defines hypoxemia?
RER; copper
SaO2 <92%
Proteasome inhibitor; treatment for MM and waldenstroms
Thymic tumor

41. What are the first generation anti histamines?
11
Duration and extent of disease
II; I (I more abundant)
Chlorpheniramine and diphenhydramine

42. What is the mc location of brain germinomas?What are the classic symptoms?
Chlorpheniramine and diphenhydramine
Regular insulin (Not fast acting - regular better)
Medial part
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus

43. What is medullary sponge kidney disease and how does it present? What does it lead to?
differentiate
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)
manifestations - congenital (stretching of periventricular pyrimadal fibers)
Insulin like growth factor 1 (just another name)

44. What is diagnostic (and possible therapeutic for intussusception)?
Atrial
Fibronectin - laminin - collagen
In the extracellular space
Barium enema

45. What is the precursor protein to beta amyloid and On what chromosome is it found?
APP on chrom 21 (this is why downs more susceptible)
Smoking
Shock symptoms (blood loss); amennorhea history; decidualized stroma (hormone changes are exactly the same) but no chorionic villi
Kallmans

46. what phase do adenosine and acetylcholine act on? doing what?
Amiadarone
Dihydropyridine sensitive Ca channels (L type)
Relfex tachycardia; giving beta blockers
Phase 4 (sodium current); reducing the rate of spontaneous depolarization

47. at four years of age - What are the social - fine motor - gross motor - and language developments?
Tissue redistribution (out of plasma) rather than metabolism
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
Thymic tumor

48. If a patient has higher levels of HbF - What does this mean?
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!
Think Hb deformation diseases
ANCA because of lack of Ig and C3 deposits on IF
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin

49. What type of gene is bcl 2 ? On what chromosome is it? what chromosome is IgG heavy chain on?
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)
Anti - apoptotic (prevents going into apoptosis)- 18; 14
Around 70 (normal measured diastolic pressures); 9--
FGF and VEGF

50. What is the immune deficinecy seen in ataxia telangactasia?
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
CMV - HSV 1 - Candida
Increase; decreased
Ig A deficiency