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 primary histologic finding in patients with eczematous dermatitis?
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
As a CO2 carrier with the carboxylase enzyme
Apocrine; eccrine
Spongiosis

2. what marker should be followed in a patient with cirrhosis?
AFP (HCC marker - produced in fetal liver and yolk sac!)- more specific than sensitive unfortunately
Protamine sulfate
In ER of bile canaliculi
Multiple miscarriages d/t hypercoaguability

3. How do you explain the selective proteinuria of loss to albumin only in MCD?
46 - 4N; 23 2N
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
indomethacin
Pan colitis and right sided colitis (more than left sided and proctitis)

4. What does VIP do to gastric acid secretion?
Bronchial dilation (bronchiectasis)
Inhibits it
Covalent (between two cysteines)- allows protein to withstand denaturation
Ether and other organic solvents

5. What does Rb protein do? what chrom is it on?
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Classical conditioning
Ketone body production by preventing fatty acids into the mitochondria
Biphosphonate

6. Metronidizaole does not cover...
Drug induced interstitial nephritis
SaO2 <92%
NF- KB; responsible for cytokine production
gram positive organisms

7. What is the difference between Acyl CoA carboxylase and Acyl CoA dehydrogenase?
Southern - western
Retinitis; mononucleosis
P53 mutation; DCC is also required for adenoma to carcinoma
The first is involved in fatty acid synthesis; the other is involved in beta oxidation of fatty acids to make ketones (ketone synthesis)

8. What is used to compare means? categorical outcomes?
Atrial
Radial nerve damage
T test; chi squared
I is more benign and can present later in adulthood

9. When does opening snap begin?
...
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)
Medial circumflex artery; avascular necrosis
Right before diastole (filling begins)

10. which headaches are seen mostly in men - are severe - unilateral - periorbital - episodic (around same time every day) - temporal pain - with lacrimation - nasal congestion and ptosis?
Varying; erythema nodosum is common
Skin flushing and warmth; prostaglandins; give with aspirin
Cluster
Excessive collagen formation during tissue repair in susceptible individuals

11. what nerve and artery course along the posterior aspect of the humerus?
Radial nerve and deep brachial artery
Episodes of painless - well circumscribed pitting edema; face - lips - neck - and tongue - tracheobronchial tree can cause respiration obstruction
Reiter syndrome; B27
Biphosphonate

12. which congenital adrenal hyperplasia presents with all genotypes as phenotypically female and with salt retention and hypertension?
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Inhibits it
Paramyxo and influenza
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus

13. What is somatomedin C?
Phase 4 (sodium current); reducing the rate of spontaneous depolarization
Reiter syndrome; B27
APP on chrom 21 (this is why downs more susceptible)
Insulin like growth factor 1 (just another name)

14. What is the sole neurologic manifestation of acute rheumatic fever?
Circular - outside nucleus; transport proteins - rRNA - tRNA
Headaches and facial flushing; vasodilation in meninges and skin
Terminal bronchioles; small bronchi
Sydenham chorea

15. which anti epileptic is preferred in patients with both absence and tonic clonic seizures?
Valproate
(urine PAH x urine flow rate)/plasma PAH
Skin flushing and warmth; prostaglandins; give with aspirin
No and yes

16. How do you calculate RPF from urine PAH?
Pulmonary hypertension
Little effect on cell and no change
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
(urine PAH x urine flow rate)/plasma PAH

17. Where does conjugation of bilirubin take place?
In ER of bile canaliculi
As a CO2 carrier with the carboxylase enzyme
Because of the low output from heart failure - they will have increased aldosterone levels
Radial nerve damage

18. What is congestive hepatomegaly specific for?
Hydrogen bonds dictate alpha or beta structure
Hyperkalemia; potassium sparing diuretics - potassium supplements
Right heart failure
Hypothyroidism

19. What is the mcc of nephrotic syndrome in children and can occur in adults as wel?
Minimal change disease
Coagulation factors are made in the liver
Proteasome inhibitor; treatment for MM and waldenstroms
Vascular endothelium; protease

20. in essential fructosuria - what enzyme do patients use to metabolize fructose?
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Because left renal vein passes between aorta and SMA and hardening of SMA can cause renal vein compression
Hexokinase
Curlings ulcers

21. What are examples of action that decrease venous return to the heart?
Smoking
Standing suddenly from supine position; valsalva maneuver
Hexokinase
Fibronectin - laminin - collagen

22. What does TGF beta do? What produces it?
Prostate tumor and increased osteoclast activity
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
differentiate
Fibrosis; macrophages

23. after triglyceride metabolism - What is the fate of the glycerol? what enzyme is involved?
Multiple miscarriages d/t hypercoaguability
Atrial
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)
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

24. metabolism of 1 gram of protein produces How many calories? carb? fat?
4 - 4 - 9
V fib; v. failure
Anterior circumflex (and axillary nerve)
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia

25. Acyl coA synthetase is not...
8 (myc protein) with 2 - 14 - 22 (iG chains)
Anterior circumflex (and axillary nerve)
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR
liver specific

26. What does protein M do in Group A strep<
Pulmonary hypertension
Highly negative resting potential
Chromosome 3- von hippel lindau gene (the disease itself is rare - but mutations of the gene are common)
Prevent phagocytosis

27. is strep pneumo optochin resistant or susceptible? bile soluble or insoluble?
External illiac - superficial femora - or common femoral or profunda femoris (ipsilateral); pudendal branches of internal illiac
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
Susceptible; soluble (unable to be cultured in bile)
Ovaries - testes - placental and other peripheral tissue (ie dont just think fat!)

28. Where does vasopressin act - on the medullary or cortical segment of collecting tubule?
Raphe
Because gamma chains replace beta chains and then gamma chain formation wanes
gram positive organisms
Medullary

29. what indicates the severity of a mitral regurg ? mitral stenosis?
S3 gallop; S2 to opening snap interval
Folic acid treatment!
LT (LTD4 - E4 - C4) - and Ach
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!

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

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

31. 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?
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
10-14 days; coagulation and marginal contraction band necrosis; collagen formation; coagulation necrosis and neutrophilic infiltrate; nothing to see; 4-12 hours
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)
Coronary vasospasm (cocaine) - coronary arteritis - hypercoaguability with acute thrombosis

32. What is the diagnosis in delayed puberty plus anosmia?
Covalent (between two cysteines)- allows protein to withstand denaturation
Dihydropyridine sensitive Ca channels (L type)
Kallmans
Nocardia

33. what presents congenitally as macroglossia - generalized hypotonia - and an umbilical hernia?
GI malignancies and Insulin resistance (acromegal for ex)
Syncope - angina - dyspnea (SAD)
Hypothyroidism
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)

34. Where does complement bind on the Fc region of Ig chains?
FGF and VEGF
Near the hinge point; site for attachment to phagocytic cells is at the very end (Fc receptor)
GI tract; mood!
Inhibits it

35. What does the superior gluteal nerve innervate? how does damage to this nerve manifest?
Gluteus medius and minimus; positive trendelenberg
Skin flushing and warmth; prostaglandins; give with aspirin
TSh (in testicular tumors can cause hyperthyroidism)
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD

36. Where is the base of the heart? apex?
Closer to head; closer to diaphragm
II; I (I more abundant)
No; yes
only up to bronchi

37. are there signs of inflammation in avascular necrosis? then How do you diagnose?
C3 decreased after 5-10 days; sulfonamides
No; MRI
Vagus nerve stimulation
Right before diastole (filling begins)

38. facial pain and headache in a patient with diabetic ketoacidosis is highly suggestive of what? How do you diagnose? What is a char finding?
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)
Common peroneal; bony fractures and compression; sciatic
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity
Drink plenty of fluids

39. What are pancreatic pseudocysts called pseudo rather than true cysts?
RER; copper
Not lined by epithelium
Adductor
facultative intracellular

40. What are some side effects seen in TCAs?
Painless ulcer with black eschar and local edema; b. anthracis; D glutamate
Obesity prevents expansion of wall and lungs for breathing; chronically elevated (all the time not just sleep) PaCO2 and decreased PaO2
Aromatase deficiency in child
Cardiac arrhthymias (quinidine like long QT) - orthostatic hypotension (antagonism of alpha adrenergic receptors) - urinary retention (d/t anticholinergic effects) - seizures

41. What does extended consumption of appetite suppressants lead to?
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis
Demargination of neutrophils from the vessel walls
Pulmonary hypertension
Around 70 (normal measured diastolic pressures); 9--

42. What can long term leg cast wearing cause?
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
RBF= PAH clearance/(1- hematocrit)
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
Intussusception

43. What is the Na/Ca exchange used for?
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
To pump calcium out in cardiac myocytes so that relaxation occurs
The term used to describe decreased drug responsiveness with repeated administration
Susceptible; soluble (unable to be cultured in bile)

44. what enzymes is lipoic acid a cofactor for? What does a mutation in it result in?
SVT; increases vagal tone; rectus abdominis
Medial part
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
SS +rNA

45. What is tachyphylaxis?
only up to bronchi
The term used to describe decreased drug responsiveness with repeated administration
Primary
Tzanck smear

46. What are two indicators of chronic alcohol consumption?
Medial circumflex artery; avascular necrosis
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin
Elevated GGT and macrocytosis
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)

47. What are the three presentations of ataxia telangectasia? What does the mutation cause? What is the mode of inheritance?
Both sides
Bronchogenic carcinoma
Anti - apoptotic (prevents going into apoptosis)- 18; 14
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR

48. What does the clinical presentation of restlessness - agitation - dysphagia - and progression to coma 30-50 days after cave exploring? hwo do you prevent?
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)
46 - 4N; 23 2N
Rabies encephalitis from cave bats; rabies killed vaccines
Varying; erythema nodosum is common

49. what diseases can vit A be used to treat?
Initiation - pointing; pincer grasp; walking; mama/dada
Measles and M3 AML`
Drug induced interstitial nephritis
Right before diastole (filling begins)

50. which virus inactivates both Rb and p53?
E6 and E7 of HPV knock off p53 and Rb suppressor genes
Headaches and facial flushing; vasodilation in meninges and skin
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)
RBF= PAH clearance/(1- hematocrit)