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 are pancreatic pseudocysts called pseudo rather than true cysts?
Sickle cell; G6PD
Nuclei pushed to periphery and nissl susbstance widely dispersed (increased protein repair); axonal reaction; Wallerian degeneration
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
Not lined by epithelium

2. at 2 years of age - What are the social - fine motor - gross motor and language developments?
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)
Hypertension - edema - and proteinuria
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
Imitation of household tasks; page turning; jumping - standing on one foot; 2 word phrases

3. Metronidizaole does not cover...
P53 mutation; AD
gram positive organisms
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!
Acute gastric mucosal defects (superficial or full thickness)

4. What type of drug is atropine? what else is needed in addition to atropine when treating organophosphate poison?
I is more benign and can present later in adulthood
Highly lethal fulminant hepatits; acute viral hepatitis (cant be distinguished clinically); significantly elevated ALT and AST an prolonged prothrombin time - and eosinophilia
8 (myc protein) with 2 - 14 - 22 (iG chains)
Muscarinic antagonist; pralidoxime because atropine doesnt work at nicotinc receptors and organophospates act at all cholinergic (muscle paralysis not solved with only atropine)

5. What three factors effect total oxygen content of blood?
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
No (unlike adenomyosis); yes
Pulmonic and systemic!
Bronchogenic carcinoma

6. neisseria are...
Inhaled animal dander allergens
Large stroke volumes with ventricular contraction; aortic regurg
facultative intracellular
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)

7. why does variocele occur more in left side?
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
Anterior nares
Because left renal vein passes between aorta and SMA and hardening of SMA can cause renal vein compression
Acute necrotizing pancreatitis; alveolar hyaline membranes; leaky capillary alveolar membrane (proteins deposit)

8. where are Beta 1 receptors found?
ATP binding (resets the myosin head to contract again for next binding)
In the extracellular space for collagen cross linking; zinc
On cardiac tissue and renal juxtaglomerular cells
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)

9. What are two common side effects of both acute and long acting nitrates? What causes them?
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)
Headaches and facial flushing; vasodilation in meninges and skin
INTRApartum Abs (ampicillin/penicillin)
Prevents hepatic VLDL production

10. What is subacute sclerosisng encephalitis caused by?
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
Acute gastric mucosal defects (superficial or full thickness)
Drink plenty of fluids
Trochlear nerve (IV); abducens nerve (VI)

11. niacin used for hyperlipidemia - What are its side effects? why do they occur? how can you prevent them?
Because of vasodiation to skeletal muscles
High potassium conductance and some sodium conductance
Hypothyroidism
Skin flushing and warmth; prostaglandins; give with aspirin

12. what should you think of with coarctation of aorta - bicuspid valves and horseshoe kidney?
Turners`
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
TCAs and prazosin
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)

13. which congenital hyperbilirubinemia actually presents with serious symptoms? which are less serious/
In the extracellular space for collagen cross linking; zinc
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)
Medullary
INTRApartum Abs (ampicillin/penicillin)

14. what happens to sperm count and semineferous tubules in patient with cryptoorchidism? hormonal function? why do they need to be surgically descended?
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
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
Minimal change disease; lmw proteins: albumin and transferrin; IgG or alpha 2 microglobulin
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy

15. which congenital adrenal hyperplasia presents with ambiguous genitalia in females and salt retention?
11beta hydroxylase deficiency (11 deoxycortisol to cortisol)
Because of vasodiation to skeletal muscles
Decreased viscosity (anemia) - increased velocity (narrowing of vessel)
In the extracellular space for collagen cross linking; zinc

16. what would be a sign of absence of cardiogenic pulm edem?
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)
Terminal bronchioles; small bronchi
Fibrosis; macrophages
Syringomelia

17. What are examples of action that decrease venous return to the heart?
E. coli
Acute necrotizing pancreatitis; alveolar hyaline membranes; leaky capillary alveolar membrane (proteins deposit)
Standing suddenly from supine position; valsalva maneuver
Congenital hypothyroidism - downs - amyloidosis - acromegaly

18. how does increased ICP result in curlings ulcers?
Close but purkinje system to ensure contraction in a bottom up fashion
Vagus nerve stimulation
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
Because left renal vein passes between aorta and SMA and hardening of SMA can cause renal vein compression

19. metabolism of 1 gram of protein produces How many calories? carb? fat?
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis
4 - 4 - 9
HSV and VZV
Adductor

20. what enzymes is lipoic acid a cofactor for? What does a mutation in it result in?
Fat - fertile - forty - female
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Anti Histaminic 1; anti cholinergic; antiseritoninergic;anti alpha adrenergic
21 hydroxylase deficiency; progesterone to 11 deoxycorticosterone; ambiguous genitalia in females and salt wasting

21. what defines hypoxemia?
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
21 hydroxylase deficiency; progesterone to 11 deoxycorticosterone; ambiguous genitalia in females and salt wasting
Octreotide
SaO2 <92%

22. what induces bronchial squamous metaplasia?
Bronchogenic carcinoma
Lecithin (same as phosphatidylcholine)/sphingomyelin; by 35 weeks should be 2/1 or higher
Dissolved in plasma and attached to Hgb
Smoking

23. What is the mc location for avascular necrosis? What is it associated with?
SVC and IVC; right below the aortic knob
Smoking
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
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy

24. at four years of age - What are the social - fine motor - gross motor - and language developments?
Because of the low output from heart failure - they will have increased aldosterone levels
The term used to describe decreased drug responsiveness with repeated administration
glycerol kinase
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use

25. What is a side effect of ACE inhibitor that is more worrisome in patients with renal failure?who else is it worrisome in?
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
Hyperkalemia; potassium sparing diuretics - potassium supplements
Headaches and facial flushing; vasodilation in meninges and skin
Barium studies and colonoscopy can cause perforation just use plain abdominal xray

26. what vessel would a fracture to the neck of the of the humerus damage?
HSV and VZV
The term used to describe decreased drug responsiveness with repeated administration
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
Anterior circumflex (and axillary nerve)

27. there are mucus secreting cells in the bronchioles...
only up to bronchi
Increase lymphatic drainage!
Octreotide
Lecithin (same as phosphatidylcholine)/sphingomyelin; by 35 weeks should be 2/1 or higher

28. What is the mc outcome of a patient acutely infected with Hep C? 2nd mc?
SSRI; erectile dysfunction
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
No; MRI
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17

29. What is the general compensatory mechanism to prevent edema is situations with increased central venous pressure?
Increase lymphatic drainage!
Relfex tachycardia; giving beta blockers
Bile soluble which means they are bile sensitive
Increase in permeability of two ions with equal and opposite equilibrium potentials

30. What is the presentation of sever aortic stenosis?
Southern - western
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)
Syncope - angina - dyspnea (SAD)
Excessive collagen formation during tissue repair in susceptible individuals

31. within the right atrium - What is the maximum pressure? left atrium?
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
S. saprophyticus - and s. epidermidis; novobiocin
Bile salt accumulation in urine
8; 12

32. why are pregnant predisposed to cholelithiasis?
HSV and VZV
Vascular endothelium; protease
Estrogen induced cholesterol hypersecretion (increase HMG CoA reductase activity) and progesterone induced gallbladder hypomotility (decreases bile acid secretion)-- both these conditions predispose cholesterole to insolubilize out
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2

33. What is an abortive viral infection?
Classical conditioning
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
Little effect on cell and no change
Kallmans

34. What does nitroprusside do to afterload? preload?
Decreases both
Enterococci (e. faecalis)- found on genitalia area
Leukotriene precursor and does neutrophil chemotaxis
Normally close to systolic

35. What triggers the neoplastic changes that are associated with HBV infecton?
Downs; regurgitant AV valves - ASDs
Prostate tumor and increased osteoclast activity
Syncope - angina - dyspnea (SAD)
Integration of viral DNA into genome of host hepatocytes

36. What is the Na/Ca exchange used for?
To pump calcium out in cardiac myocytes so that relaxation occurs
G to T in p53; HCC
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)
Smoking

37. What type of bond is a disulfide bond?
RBC mass; epo levels (secondary has high)
Skin flushing and warmth; prostaglandins; give with aspirin
Radial nerve damage
Covalent (between two cysteines)- allows protein to withstand denaturation

38. what enzyme converts procarcinogens into carcinogens?
E. coli
E6 and E7 of HPV knock off p53 and Rb suppressor genes
Because increases intracellular cAMP independent of adrenergic receptors (does it via G proteins)
P450 mitochondrial monooxygenase

39. what indicates the severity of a mitral regurg ? mitral stenosis?
Smoking
S3 gallop; S2 to opening snap interval
11 aa polypeptide; pain NT in CNS and PNS
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)

40. in essential fructosuria - what enzyme do patients use to metabolize fructose?
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)
Hexokinase
No (unlike adenomyosis); yes
Bronchogenic carcinoma

41. how long is substance P? What does it do?
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus
Both sides
11 aa polypeptide; pain NT in CNS and PNS
Anterior nares

42. What is the most common cause of hydatid cysts in humans? What does spilling of cysts cause?
Rabies encephalitis from cave bats; rabies killed vaccines
APP on chrom 21 (this is why downs more susceptible)
Echinococcus granulosus; anaphylaxis
low in serum

43. If a patient has higher levels of HbF - What does this mean?
No; MRI
Think Hb deformation diseases
Anti centromere; anti DNA topoisomerase
Octreotide

44. What is Bortezomib and What is it used for?
Single adenomatous ones
SSRI; erectile dysfunction
Faulty positioning of the genital tubercle
Proteasome inhibitor; treatment for MM and waldenstroms

45. What is the diagnosis in delayed puberty plus anosmia?
Barium enema
Kallmans
Pulmonary hypertension
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

46. other than proteinuria - What can cause foamy froathy urine?
Protamine sulfate
Bile salt accumulation in urine
Initiation - pointing; pincer grasp; walking; mama/dada
Susceptible; soluble (unable to be cultured in bile)

47. What is the most important prognostic indicator in patients with malignant melanoma?
Ig A deficiency
Circular - outside nucleus; transport proteins - rRNA - tRNA
Trauma to stereociliated hair cells of the organ of corti
Measure of depth invasion (vertical!)

48. What is gardeners mydriasis? How is it treated?
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
In ER of bile canaliculi
P53 mutation; AD
RBC mass; epo levels (secondary has high)

49. What are the two pharmacologic antagonists that offer clear benefit in allergic asthma?
Drink plenty of fluids
LT (LTD4 - E4 - C4) - and Ach
In the extracellular space for collagen cross linking; zinc
SSRI

50. How do bradykinin - C3a and C5a cause edema?
By vascular permeability and vasodilation
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
facultative intracellular