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. how long is substance P? What does it do?
INTRApartum Abs (ampicillin/penicillin)
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)
11 aa polypeptide; pain NT in CNS and PNS
Clindamycin; covers anaerobic oral flora and aerobic bacteria

2. What is a common complication of acute pancreatitis? What is it?
Lecithin (same as phosphatidylcholine)/sphingomyelin; by 35 weeks should be 2/1 or higher
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis
Prostate tumor and increased osteoclast activity

3. What causes congenital QT prolongation syndrome? What is death caused by? in one of the syndromes - What is a common other symptom?
Highly negative resting potential
Sudden loss of muscle tone without loss of consciousness; narcolepsy
Superior larygeal; cricothyroid; recurrent laryngeal
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness

4. on which chromosome - and which gene - are people with sporadic and hereditary renal cell carcinomas found to have mutations?
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
Chromosome 3- von hippel lindau gene (the disease itself is rare - but mutations of the gene are common)
Medullary
Vertical diplopia

5. other than proteinuria - What can cause foamy froathy urine?
Bile salt accumulation in urine
E. coli; staphylococcus saprophyticus
Both sides
11 aa polypeptide; pain NT in CNS and PNS

6. What is the mcc of nephrotic syndrome in children and can occur in adults as wel?
Congenital hypothyroidism - downs - amyloidosis - acromegaly
Normally close to systolic
TCAs and prazosin
Minimal change disease

7. What is the mc manifestation of CMV in HIV patient? immunocompetent?
ZDV or AZT
Octreotide
Retinitis; mononucleosis
Paranoid personality disorder is a distrust that pervades all parts of the patients life as opposed to delusional disorder Which is one fixed delusion

8. nucleotide deletions do not cause missense mutations - they cause...
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)
frameshift mutations (missense is substitution)
Covalent (between two cysteines)- allows protein to withstand denaturation
Relfex tachycardia; giving beta blockers

9. What translocations can cause c - myc overexpression?
8 (myc protein) with 2 - 14 - 22 (iG chains)
Well trained athletes and children
4 - 4 - 9
Anti - apoptotic (prevents going into apoptosis)- 18; 14

10. what increases turbulence and thus causes bruits? (specifically in terms of viscosity and velocity)
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Pulmonary hypertension
Gluteus maximus; difficulty getting up from seated position and climbing chair
Decreased viscosity (anemia) - increased velocity (narrowing of vessel)

11. biotin is used By what in tissues responsible for gluconeogenesis
Dry skin - papilledema - intracranial pressure - alopecia - hyperlipidemia - hepatoxicity - hepatosplenomegaly -
RBF= PAH clearance/(1- hematocrit)
Recurrent larygneal
As a CO2 carrier with the carboxylase enzyme

12. What does VIP do to gastric acid secretion?
Inhibits it
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Vascular endothelium; protease
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)

13. What is best to prevent GBS infection in a baby?
INTRApartum Abs (ampicillin/penicillin)
By IgE activation (IgE binds to them as they are in the blood and then bind to Fc receptor on eos)- ADCC
Highly negative resting potential
Congenital hypothyroidism - downs - amyloidosis - acromegaly

14. What are the long term consequences of hydrocephalus?
P53 mutation; AD
Radial nerve and deep brachial artery
Lower extremity spasticity due to stretching of periventricular pyrimadal tracts - visual disturbances and learning disabilities
Radial nerve damage

15. What is 5- HETE and What does it do?
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
Leukotriene precursor and does neutrophil chemotaxis
Vascular endothelium; protease
Gluteus medius and minimus; positive trendelenberg

16. What is a primary HSV 1 infection like?
Think Hb deformation diseases
Anti - apoptotic (prevents going into apoptosis)- 18; 14
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)

17. 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

18. why does neutrophila occur with corticosteroids?
RR-1/RR
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus
Demargination of neutrophils from the vessel walls
Because left renal vein passes between aorta and SMA and hardening of SMA can cause renal vein compression

19. Where does vit C act in the hydroxylation of lysine residues for collagen? What is the cofactor required?
AV node slowest - to allow time for diastole
RER; copper
Kallmans
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics

20. Which is faster atrial muscle or ventricular muscle?
Folic acid treatment!
Serum FFA and serum triglyceride levels
Atrial
Enterococci (e. faecalis)- found on genitalia area

21. What is the only catecholamine that is made in only one place? where? By what enzyme? controlled by what?
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
No (unlike adenomyosis); yes
ATP binding (resets the myosin head to contract again for next binding)
Epinephrine; adrenal medulla; phenylethanolamine N methyltransferase; cortisol

22. What is hypospadias caused by?
Bile soluble which means they are bile sensitive
Octreotide
Abnormal closing of the urethral folds
Anti centromere; anti DNA topoisomerase

23. What is Bortezomib and What is it used for?
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
SSRI; erectile dysfunction
Proteasome inhibitor; treatment for MM and waldenstroms
HSV ( also in utero: chlymadia - neisseria - group B strep)

24. What can worse neurologic dysfunction in cobalamic def?
Acute interstitial nephritis
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
Folic acid treatment!
Vagus nerve stimulation

25. What is the cause of fixed splitting of S2? why?
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)
Dihydropyridine sensitive Ca channels (L type)
ASD - causes increased pulmonary vascular blood flow which causes pulmonic vessel stenosis and damage
SSRI

26. why does hypothyroidism cause increased CPK levels?
Around 70 (normal measured diastolic pressures); 9--
Increase lymphatic drainage!
Hypothyroid myopathy (thyroid is required for maintaining a lot!)
Imitation of household tasks; page turning; jumping - standing on one foot; 2 word phrases

27. what protects the resting heart from arrhythmias?
Close but purkinje system to ensure contraction in a bottom up fashion
Leukotriene precursor and does neutrophil chemotaxis
Highly negative resting potential
FGF and VEGF

28. What is the difference between Acyl CoA carboxylase and Acyl CoA dehydrogenase?
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
Valproate
The first is involved in fatty acid synthesis; the other is involved in beta oxidation of fatty acids to make ketones (ketone synthesis)

29. What type of cancer is keratin swirls indicative of ? What is the prognosis of this cancer in the esophagus? What is it associated with?
Chlorpheniramine and diphenhydramine
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
Strength of cell mediated immune response
Bronchogenic carcinoma

30. What is diphenoxylate and What is it used for? what drug is it structurally similar to? What allows for potent anti diarrheal effect without signigicant opiate effects?
Single adenomatous ones
P450 mitochondrial monooxygenase
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)
SSRI

31. How do you calculate RPF from urine PAH?
(urine PAH x urine flow rate)/plasma PAH
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)
Hyperkalemia; potassium sparing diuretics - potassium supplements
Ovaries - testes - placental and other peripheral tissue (ie dont just think fat!)

32. What are the two coagulase negative staphylococci? How do you distinguish them?
The time interval between S2 and OS- the shorter the interval - the more intense
S. saprophyticus - and s. epidermidis; novobiocin
Chromosome 3- von hippel lindau gene (the disease itself is rare - but mutations of the gene are common)
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)

33. What are some side effects seen in TCAs?
Acute interstitial nephritis
E. coli; staphylococcus saprophyticus
By IgE activation (IgE binds to them as they are in the blood and then bind to Fc receptor on eos)- ADCC
Cardiac arrhthymias (quinidine like long QT) - orthostatic hypotension (antagonism of alpha adrenergic receptors) - urinary retention (d/t anticholinergic effects) - seizures

34. What is the preferred treatment for DKA?
Anti cholinergic effects of pupil dilation and lack of accomodation
46 - 4N; 23 2N
Regular insulin (Not fast acting - regular better)
Tissue redistribution (out of plasma) rather than metabolism

35. What does phosphoglycerate mutase produce? In what process - instead of what? what cells used this and why?
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity
Standing suddenly from supine position; valsalva maneuver
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
Hexokinase

36. 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?
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
Cluster
only up to bronchi
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC

37. In what form are mitochondrial DNA? What do they transcribe?
The first is involved in fatty acid synthesis; the other is involved in beta oxidation of fatty acids to make ketones (ketone synthesis)
External illiac - superficial femora - or common femoral or profunda femoris (ipsilateral); pudendal branches of internal illiac
Episodes of painless - well circumscribed pitting edema; face - lips - neck - and tongue - tracheobronchial tree can cause respiration obstruction
Circular - outside nucleus; transport proteins - rRNA - tRNA

38. 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

39. in the LV and aorta - What are the pressures?
Right before diastole (filling begins)
At cochlear base near round and oval window; near apex of cochlea - helioctrema; high frequency sound
Normally close to systolic
Cardiac arrhthymias (quinidine like long QT) - orthostatic hypotension (antagonism of alpha adrenergic receptors) - urinary retention (d/t anticholinergic effects) - seizures

40. what kind of drug is sertraline? What is a common side effect?
Radial nerve and deep brachial artery
E. coli
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities
SSRI; erectile dysfunction

41. what drug is useful for secretory diarrhea?
Extrinsic def; instrinsic def; platelet def
SVT; increases vagal tone; rectus abdominis
Octreotide
Localized dermatologic pain that persists for more than one month after zoster eruption

42. is Rifampin ever used as monotherapY? why either way?
Neisseria induced small cell vasculitis (including hands and soles)
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
Hydrogen bonds dictate alpha or beta structure
facultative intracellular

43. What is the most common cause of hydatid cysts in humans? What does spilling of cysts cause?
Echinococcus granulosus; anaphylaxis
facultative intracellular
Intussusception
Ether and other organic solvents

44. 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?
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)
Superior larygeal; cricothyroid; recurrent laryngeal
Elevates ASO titers; elevated anti DNAase B titers; decreased C3 and total complement levels and presence of cryoglobulins (C4 normal)
I is more benign and can present later in adulthood

45. What are pancreatic pseudocysts called pseudo rather than true cysts?
Prevents hepatic VLDL production
Not lined by epithelium
Because left renal vein passes between aorta and SMA and hardening of SMA can cause renal vein compression
GI tract; mood!

46. What does Rb protein do? what chrom is it on?
Brief psychotic disorder; schizophreniform; schizophrenia
Both sides
Episodes of painless - well circumscribed pitting edema; face - lips - neck - and tongue - tracheobronchial tree can cause respiration obstruction
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13

47. which staphylococci can do mannitol fermaentation?
Integration of viral DNA into genome of host hepatocytes
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
S. aureus
Strength of cell mediated immune response

48. What is the mainstay treatment for acute mania?
When it invades the bm; carcinoma in situ
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
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
ASD - causes increased pulmonary vascular blood flow which causes pulmonic vessel stenosis and damage

49. 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?
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)
Shock symptoms (blood loss); amennorhea history; decidualized stroma (hormone changes are exactly the same) but no chorionic villi
10-14 days; coagulation and marginal contraction band necrosis; collagen formation; coagulation necrosis and neutrophilic infiltrate; nothing to see; 4-12 hours
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)

50. What is an abortive viral infection?
Little effect on cell and no change
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Anterior nares
In the extracellular space