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 a malignant pustule? What is it usually caused by? What type of capsule does it have?
Adeno
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
Painless ulcer with black eschar and local edema; b. anthracis; D glutamate
Spongiosis

2. What is the preferred treatment for DKA?
Syncope - angina - dyspnea (SAD)
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)
MAC complex (C5b - C9 complement deficiency)
Regular insulin (Not fast acting - regular better)

3. What can cause virilization of a mother during pregnancy?
Varying; erythema nodosum is common
Aromatase deficiency in child
Pulmonary hypertension
Biphosphonate

4. What is the inherited defect in LiFraumeni syndrome? What is the mode of inheritance?
P53 mutation; AD
hyponatremia (aldosterone activation equilibrates body volume)
Appetite suppressants
Susceptible; soluble (unable to be cultured in bile)

5. What are the potassium sparing diuretics?
Vascular endothelium; protease
Amiloride - spironolactone - triamterene
Near the medial epicondyle or in Guyon's canal near the hook of the hamate and pisiform bone in the wrist
Echinococcus granulosus; anaphylaxis

6. Which is faster purkinje system or atrial muscle?
Close but purkinje system to ensure contraction in a bottom up fashion
Mycoside (made of two mycolic acids) and is responsible for inactivating neutrophils - mit damage - and induced release of TNF; mycobacteria virulence; serpentine cords
Rabies encephalitis from cave bats; rabies killed vaccines
Aortic root dilation or bicuspid aortic valve; diastolic murmur (right sternal border(

7. What is best to prevent GBS infection in a baby?
Curlings ulcers
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
INTRApartum Abs (ampicillin/penicillin)
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin

8. What causes alpha helical proteins in alzheimers to become insoluble and prone to aggregating?
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
(urine PAH x urine flow rate)/plasma PAH
Become beta pleated and then form neurofibrillary tangle!
S. saprophyticus - and s. epidermidis; novobiocin

9. facial pain and headache in a patient with diabetic ketoacidosis is highly suggestive of what? How do you diagnose? What is a char finding?
S. saprophyticus - and s. epidermidis; novobiocin
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids

10. What does Rb protein do? what chrom is it on?
Sarcoid
Pain and discomfort from dilation and stretching of the renal capsule from all the cysts!; hypertension - hematuria
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Ether and other organic solvents

11. What are the first generation anti histamines?
Single adenomatous ones
Parallel play; reproduce simple shapes; tricycle riding - stair climbing; simple sentences
Chlorpheniramine and diphenhydramine
Mean greater than median greater than mode

12. why is crohns disease associated with oxaloacetate kidney stones?
gram positive organisms
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
Centrally located - strong smoking association - neuroendocrine markers: enolase - chromogranin - synaptophysin
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

13. do patients with cor pulmonale have increased or decreased levels of aldosterone?
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
Right before diastole (filling begins)
Appetite suppressants
Because of the low output from heart failure - they will have increased aldosterone levels

14. Which is faster atrial muscle or ventricular muscle?
Atrial
Drug induced interstitial nephritis
Dihydropyridine sensitive Ca channels (L type)
Regular insulin (Not fast acting - regular better)

15. What are some side effects seen in TCAs?
Anti Histaminic 1; anti cholinergic; antiseritoninergic;anti alpha adrenergic
Normally close to systolic
OCPs - multiparity - breast feeding
Cardiac arrhthymias (quinidine like long QT) - orthostatic hypotension (antagonism of alpha adrenergic receptors) - urinary retention (d/t anticholinergic effects) - seizures

16. hypertonicity and hyperreflexity are ________________ of hydrocephalus
HSV and VZV
Obesity prevents expansion of wall and lungs for breathing; chronically elevated (all the time not just sleep) PaCO2 and decreased PaO2
By IgE activation (IgE binds to them as they are in the blood and then bind to Fc receptor on eos)- ADCC
manifestations - congenital (stretching of periventricular pyrimadal fibers)

17. how does eos release MBP to kill protozoa etc?
Downs; regurgitant AV valves - ASDs
Localized dermatologic pain that persists for more than one month after zoster eruption
By IgE activation (IgE binds to them as they are in the blood and then bind to Fc receptor on eos)- ADCC
To pump calcium out in cardiac myocytes so that relaxation occurs

18. nucleotide deletions do not cause missense mutations - they cause...
Prevents hepatic VLDL production
frameshift mutations (missense is substitution)
Atrial
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis

19. What is the Na/Ca exchange used for?
Turbulence
The term used to describe decreased drug responsiveness with repeated administration
To pump calcium out in cardiac myocytes so that relaxation occurs
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD

20. which nerve is at risk when ligating the superior thyroid artery? Which is the only muscle this nerve innervates? what nerve innervates all the other laryngeal muscles?
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Superior larygeal; cricothyroid; recurrent laryngeal
Echinococcus granulosus; anaphylaxis
Anti Histaminic 1; anti cholinergic; antiseritoninergic;anti alpha adrenergic

21. if there are keratin swirls does that mean well or poorly differentiated?
Well
Highly negative resting potential
OCPs - multiparity - breast feeding
Appetite suppressants

22. which RPGN is also called pauci immune GN? why?
Near the hinge point; site for attachment to phagocytic cells is at the very end (Fc receptor)
ANCA because of lack of Ig and C3 deposits on IF
Pain reliever - reduces pain by locking substance P in the PNS
Recurrent larygneal

23. What would a deflection of the membrane potential to near zero indicate?
Increase in permeability of two ions with equal and opposite equilibrium potentials
Tibial
Little effect on cell and no change
SSRI

24. What is a limiting factor when initiating ACE inhibitors? hwo do you prevent a really bad reaction?
Single adenomatous ones
No (unlike adenomyosis); yes
Excessive collagen formation during tissue repair in susceptible individuals
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics

25. What is the mutation type in thalassemias? what process is defective because of this?
Nonsense; mRNA processing
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)
Smoking
Chrom 8

26. What is capsaicin? Where does it work?
Env genes (for getting into target cells)
Susceptible; soluble (unable to be cultured in bile)
Prepatellar
Pain reliever - reduces pain by locking substance P in the PNS

27. How do you calculate atributable risk percent?
Anti cholinergic effects of pupil dilation and lack of accomodation
frameshift mutations (missense is substitution)
RR-1/RR
Radial nerve and deep brachial artery

28. at four years of age - What are the social - fine motor - gross motor - and language developments?
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
Well
Another type of aldosterone antagonist (like spironolactone)
In ER of bile canaliculi

29. In what view of CXR is anterior part of heart best seen? anterior part of heart is formed by?right border of heart is formed by? left border?
The time interval between S2 and OS- the shorter the interval - the more intense
Lateral; RV; RA; LV
Inhibits it
Mycoside (made of two mycolic acids) and is responsible for inactivating neutrophils - mit damage - and induced release of TNF; mycobacteria virulence; serpentine cords

30. What are examples of action that decrease venous return to the heart?
Parallel play; reproduce simple shapes; tricycle riding - stair climbing; simple sentences
Another type of aldosterone antagonist (like spironolactone)
Echinococcus granulosus; anaphylaxis
Standing suddenly from supine position; valsalva maneuver

31. What are the two mcc of focal brain lesions in HIV positive patients?
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
gram positive organisms
Faulty positioning of the genital tubercle
I is more benign and can present later in adulthood

32. What is dobutamine? What is it used for?how it is it most helpful? What is bad about it?
H. influenzae type B; polyribosyl phosphate (PRP); cherry red uvula - dysphagia - stridor (sometimes) - difficulty breathing - fever - drooling - positive 'thumbs up sign' on lateral xray of cervical region d/t swollen epiglottis
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
Leukotriene precursor and does neutrophil chemotaxis
liver specific

33. Is the uterus enlarged in endometriosis? does it cause dyspareunia?
Near the medial epicondyle or in Guyon's canal near the hook of the hamate and pisiform bone in the wrist
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
No (unlike adenomyosis); yes
Think Hb deformation diseases

34. which nerve provides innervation for plantar flexion and inversion?
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Tibial
SVT; increases vagal tone; rectus abdominis
E. coli; staphylococcus saprophyticus

35. what nerve and artery course along the posterior aspect of the humerus?
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
Ulcers in esophagus - stomach - or duodenum and high ICP can cause perforation or ulcers in duodenum d/t acute physiologic stress
Vascular endothelium; protease
Radial nerve and deep brachial artery

36. What is diagnostic (and possible therapeutic for intussusception)?
Chrom 8
External illiac - superficial femora - or common femoral or profunda femoris (ipsilateral); pudendal branches of internal illiac
Barium enema
46 - 4N; 23 2N

37. a patient fearing all white coats is a phenomenon of what?
Hydrogen bonds dictate alpha or beta structure
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
Classical conditioning
21 hydroxylase deficiency; progesterone to 11 deoxycorticosterone; ambiguous genitalia in females and salt wasting

38. what defines hypoxemia?
Well
Anterior and to the right (on the ECG!) of the pulmonary artery; right to left shunt
Hereditary angioedema; ACE inhibitors
SaO2 <92%

39. PDAs are often asymptomatic. How do you treat?
indomethacin
No (unlike adenomyosis); yes
Barium enema
Multiple miscarriages d/t hypercoaguability

40. What is epispadias caused by?
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis
SS +rNA
Faulty positioning of the genital tubercle
High potassium conductance and some sodium conductance

41. what would be a sign of absence of cardiogenic pulm edem?
Elevates ASO titers; elevated anti DNAase B titers; decreased C3 and total complement levels and presence of cryoglobulins (C4 normal)
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)
transcription activation/suppression

42. What type of antiarrythmics can protect against both atrial and ventricular arrythmias?
Adductor
Decreases both
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
Class I

43. What are ulcers arising in the proximal duodenum in association with severe trauma or burns called?
ASD - causes increased pulmonary vascular blood flow which causes pulmonic vessel stenosis and damage
Curlings ulcers
Purkinje system; AV node
CGD; t cell dysfxn (diGeorge)

44. how will ectopic pregnancy rupture present? What is key history question for diagnosis? what would a uterine biopsy show?
Shock symptoms (blood loss); amennorhea history; decidualized stroma (hormone changes are exactly the same) but no chorionic villi
Phase 4 (sodium current); reducing the rate of spontaneous depolarization
Proteasome inhibitor; treatment for MM and waldenstroms
Fibrosis; macrophages

45. what chromosome is c - myc found on?
Highly lethal fulminant hepatits; acute viral hepatitis (cant be distinguished clinically); significantly elevated ALT and AST an prolonged prothrombin time - and eosinophilia
Chrom 8
As a CO2 carrier with the carboxylase enzyme
<1% - 55% - concentration dependent

46. in the LV and aorta - What are the pressures?
Elastance
Relfex tachycardia; giving beta blockers
Normally close to systolic
Hypertension - edema - and proteinuria

47. which opponens muscle does ulnar innervate?
Adductor
Hypertension - edema - and proteinuria
Vancomycin; histamine mediated
SVT; increases vagal tone; rectus abdominis

48. What three pathogens cause infectious esophagitis in HIV positive patients?
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)
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)
Biphosphonate
CMV - HSV 1 - Candida

49. What are the lab findings in poststreptococcal GN?
ATP binding (resets the myosin head to contract again for next binding)
Vascular endothelium; protease
Folic acid treatment!
Elevates ASO titers; elevated anti DNAase B titers; decreased C3 and total complement levels and presence of cryoglobulins (C4 normal)

50. What does 'oxygen' content in blood refer to?
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
Dissolved in plasma and attached to Hgb
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
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