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 contraindicated in toxic mega colon?
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities
11
Barium studies and colonoscopy can cause perforation just use plain abdominal xray
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin

2. where exactly is ACE expressed in the lungs? What type of enzyme is it?
Vascular endothelium; protease
Inhaled animal dander allergens
No
transcription activation/suppression

3. What causes congenital QT prolongation syndrome? What is death caused by? in one of the syndromes - What is a common other symptom?
SSRI
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness
Susceptible; soluble (unable to be cultured in bile)

4. 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

5. what marker should be followed in a patient with cirrhosis?
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia
Classical conditioning
GI malignancies and Insulin resistance (acromegal for ex)
AFP (HCC marker - produced in fetal liver and yolk sac!)- more specific than sensitive unfortunately

6. within the right atrium - What is the maximum pressure? left atrium?
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia
Measles and M3 AML`
8; 12
Barium studies and colonoscopy can cause perforation just use plain abdominal xray

7. What is the mainstay treatment for acute mania?
Enterococci (e. faecalis)- found on genitalia area
Decreases both
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
Shock symptoms (blood loss); amennorhea history; decidualized stroma (hormone changes are exactly the same) but no chorionic villi

8. What are the skin presentation in sarcoid?
Adductor
Not lined by epithelium
Varying; erythema nodosum is common
AV node slowest - to allow time for diastole

9. What does anti phospholipid syndrome in SLE patients predispose them to?
S3 gallop; S2 to opening snap interval
Multiple miscarriages d/t hypercoaguability
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)

10. how does achalasia present? What does barium swallow show on dilated esophagus?
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
Progressive dysphagia - chest pain - food regurg - and aspiration; birds beak deformity of the LES
Chlorpheniramine and diphenhydramine
Fibrosis; macrophages

11. How can renal blood flow be calculated from RPF?
Because of vasodiation to skeletal muscles
Hyperkalemia; potassium sparing diuretics - potassium supplements
Thymic tumor
RBF= PAH clearance/(1- hematocrit)

12. What is difference between Arnold Chiari type I and II?
Syncope - angina - dyspnea (SAD)
Classical conditioning
I is more benign and can present later in adulthood
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness

13. what locations of UC increase the risk of Colon cancer?
Headaches and facial flushing; vasodilation in meninges and skin
In the extracellular space
Pan colitis and right sided colitis (more than left sided and proctitis)
Epinephrine; adrenal medulla; phenylethanolamine N methyltransferase; cortisol

14. What is epleronone?
Aromatase deficiency in child
Mean greater than median greater than mode
E. coli
Another type of aldosterone antagonist (like spironolactone)

15. is strep pneumo optochin resistant or susceptible? bile soluble or insoluble?
Susceptible; soluble (unable to be cultured in bile)
No and yes
Rabies encephalitis from cave bats; rabies killed vaccines
P53 mutation; DCC is also required for adenoma to carcinoma

16. What is capacitance inversely proportional to?
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Inhibits it
differentiate
Elastance

17. which anti epileptic is preferred in patients with both absence and tonic clonic seizures?
OCPs - multiparity - breast feeding
only up to bronchi
Anti centromere; anti DNA topoisomerase
Valproate

18. which has better side effect profile - SSRI or TCA?
SSRI
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
Sydenham chorea
Congenital hypothyroidism - downs - amyloidosis - acromegaly

19. What can cause virilization of a mother during pregnancy?
Duration and extent of disease
HSV and VZV
Proteasome inhibitor; treatment for MM and waldenstroms
Aromatase deficiency in child

20. What is somatomedin C?
Little effect on cell and no change
Reiter syndrome; B27
Vancomycin
Insulin like growth factor 1 (just another name)

21. What is the mcc of asymmetric inflammatory arthiritis of the lower extremities in young men? what HLA association?
Prepatellar
Reiter syndrome; B27
Nuclei pushed to periphery and nissl susbstance widely dispersed (increased protein repair); axonal reaction; Wallerian degeneration
Inactivates kallikrein which activates kininogen into bradykinin

22. eukaryotes are often polycistronic (multiple genes per mRNA) so ____________ is linked
Squatting - sitting - lying supine - passive leg raising
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
Well
transcription activation/suppression

23. What is the mcc of nephrotic syndrome in children and can occur in adults as wel?
Minimal change disease
CGD; t cell dysfxn (diGeorge)
Because gamma chains replace beta chains and then gamma chain formation wanes
Dihydropyridine sensitive Ca channels (L type)

24. 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?
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Spongiosis
Cluster
Elevated GGT and macrocytosis

25. Increase in lung cancer incidence and mortality has been observed in _____ over last four decades
In the extracellular space for collagen cross linking; zinc
women
Cluster
Amiloride - spironolactone - triamterene

26. what has the greatest effect on prognosis when treating c. diptheriae?
Echinococcus granulosus; anaphylaxis
Adductor
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)
Turbulence

27. what immune deficiency causes recurrent neisseria infections?
MAC complex (C5b - C9 complement deficiency)
Clindamycin; covers anaerobic oral flora and aerobic bacteria
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)
External illiac - superficial femora - or common femoral or profunda femoris (ipsilateral); pudendal branches of internal illiac

28. who bleed more DIC or TTP- HUS patients?
DIC; TTP- HUS dont bleed that much
Multiple miscarriages d/t hypercoaguability
Mycoside (made of two mycolic acids) and is responsible for inactivating neutrophils - mit damage - and induced release of TNF; mycobacteria virulence; serpentine cords
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)

29. what happens to the cell body of a neuron after the axon has been severed? What is this called? What is it second to?
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
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
Nuclei pushed to periphery and nissl susbstance widely dispersed (increased protein repair); axonal reaction; Wallerian degeneration
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

30. When does opening snap begin?
Right before diastole (filling begins)
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
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
Apocrine; eccrine

31. What is a limiting factor when initiating ACE inhibitors? hwo do you prevent a really bad reaction?
Reticulocytes
Vomitting - NG suctioning - diuretic use - hyperaldosteronism; urinary chloride concentration
Diabetic microangiopathy
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics

32. what happens to sperm count and semineferous tubules in patient with cryptoorchidism? hormonal function? why do they need to be surgically descended?
MAO inhibitors; wine and cheese
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
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
gram positive organisms

33. What actions increase venous return?
Squatting - sitting - lying supine - passive leg raising
T test; chi squared
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
External illiac - superficial femora - or common femoral or profunda femoris (ipsilateral); pudendal branches of internal illiac

34. What is a cardiac cause of head pounding with exertion and nocturnal palpitations? What can cause this?
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics
SaO2 <92%
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
Large stroke volumes with ventricular contraction; aortic regurg

35. What are the two coagulase negative staphylococci? How do you distinguish them?
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
S. saprophyticus - and s. epidermidis; novobiocin
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
Aromatase deficiency in child

36. prostaglandin synthesis keeps...
Phase 4 (sodium current); reducing the rate of spontaneous depolarization
Anterior circumflex (and axillary nerve)
Primary
PDA open

37. What is the most common cause of hydatid cysts in humans? What does spilling of cysts cause?
Mycoside (made of two mycolic acids) and is responsible for inactivating neutrophils - mit damage - and induced release of TNF; mycobacteria virulence; serpentine cords
Echinococcus granulosus; anaphylaxis
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis
Fibrosis; macrophages

38. why does neutrophila occur with corticosteroids?
Chlorpheniramine and diphenhydramine
RR-1/RR
Demargination of neutrophils from the vessel walls
Medial circumflex artery; avascular necrosis

39. What is the key lab finding seen in type III serum sickness? What are some drugs that can induce it?
Serum creatine kinase; reperfusion injury causes necrosis
C3 decreased after 5-10 days; sulfonamides
P53 mutation; DCC is also required for adenoma to carcinoma
Bronchial dilation (bronchiectasis)

40. What causes the blurry vision side effects in first generation anti histamines?
Coagulation factors are made in the liver
No (unlike adenomyosis); yes
Anti cholinergic effects of pupil dilation and lack of accomodation
Right heart failure

41. Where is conduction in heart fastest? slowest?
Purkinje system; AV node
Common peroneal; bony fractures and compression; sciatic
Drug induced interstitial nephritis
indomethacin

42. Where does lysyl oxidase act? What is the cofactor for that?
Increase by 50% in urine osmolality
In the extracellular space for collagen cross linking; zinc
Rabies encephalitis from cave bats; rabies killed vaccines
RBF= PAH clearance/(1- hematocrit)

43. What is a major risk factor for progression ARDS? What is the pathology seen in ARDS- d/t what?
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17
Medial circumflex artery; avascular necrosis
Cleaves bases leaving apyrimidine and apurine sites; cleaves 5' end of DNA; cleaves 3' end of DNA; base excision repair; DNA polymerase - and ligase
Acute necrotizing pancreatitis; alveolar hyaline membranes; leaky capillary alveolar membrane (proteins deposit)

44. Is the uterus enlarged in endometriosis? does it cause dyspareunia?
No (unlike adenomyosis); yes
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
HSV and VZV
46 - 4N; 23 2N

45. metabolism of 1 gram of protein produces How many calories? carb? fat?
Folic acid treatment!
4 - 4 - 9
facultative intracellular
MAC complex (C5b - C9 complement deficiency)

46. How do you explain the selective proteinuria of loss to albumin only in MCD?
Elastance
Cerebral vasoconstriction and thus decreased blood flow; decreaed pCO2
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
only up to bronchi

47. are there signs of inflammation in avascular necrosis? then How do you diagnose?
Another type of aldosterone antagonist (like spironolactone)
S. aureus
No; MRI
Cerebral vasoconstriction and thus decreased blood flow; decreaed pCO2

48. What is a malignant pustule? What is it usually caused by? What type of capsule does it have?
only up to bronchi
Curlings ulcers
Prepatellar
Painless ulcer with black eschar and local edema; b. anthracis; D glutamate

49. why should you not use ACE inhibitors with someone who had hereditary angioedema?
glycerol kinase
Elevated GGT and macrocytosis
Sydenham chorea
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

50. What are some of the permissive effects of cortisol?
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
...
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
Increases bronchial and vascular smooth muscle reactivity to catecholamines