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 hormone is structurally similar to hCG?
Congenital hypothyroidism - downs - amyloidosis - acromegaly
TSh (in testicular tumors can cause hyperthyroidism)
Hypo or hyper pigmentations; after tanning
By IgE activation (IgE binds to them as they are in the blood and then bind to Fc receptor on eos)- ADCC

2. What is low levels of C1 esterase inhibitor diagnostic of? how can this be acquired?
Hereditary angioedema; ACE inhibitors
Hypo or hyper pigmentations; after tanning
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17
(urine PAH x urine flow rate)/plasma PAH

3. Axillary lymph node dissection is a risk factor for the development of chronic lymphedema of the ipsilateral arm. What does chronic lymphedema predispose to?
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)
Reiter syndrome; B27
Hydrogen bonds dictate alpha or beta structure
RER; copper

4. What does anti phospholipid syndrome in SLE patients predispose them to?
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
Around 70 (normal measured diastolic pressures); 9--
ANCA because of lack of Ig and C3 deposits on IF
Multiple miscarriages d/t hypercoaguability

5. which nerve in the lower leg is easily injured and causes foot drop ? What are common causes? From what nerve does it branch off or?
Varying; erythema nodosum is common
RER; copper
Common peroneal; bony fractures and compression; sciatic
Curlings ulcers

6. What is medullary sponge kidney disease and how does it present? What does it lead to?
II; I (I more abundant)
Chromosome 3- von hippel lindau gene (the disease itself is rare - but mutations of the gene are common)
TCAs and prazosin
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)

7. What is hyaline arteriosclerosis usually a sign of ?
Underestimation of gestational age
Downs; regurgitant AV valves - ASDs
Serum FFA and serum triglyceride levels
Diabetic microangiopathy

8. What three pathogens cause infectious esophagitis in HIV positive patients?
CMV - HSV 1 - Candida
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
Classical conditioning
Appetite suppressants

9. What is a limiting factor when initiating ACE inhibitors? hwo do you prevent a really bad reaction?
Anti centromere; anti DNA topoisomerase
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics
Acute interstitial nephritis
Excessive collagen formation during tissue repair in susceptible individuals

10. which cells produce surfactant? which ones mediate gas exchange?
II; I (I more abundant)
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
Octreotide
Localized dermatologic pain that persists for more than one month after zoster eruption

11. what commonly happens in GI in response to acute physiologic stress?
Acute gastric mucosal defects (superficial or full thickness)
liver specific
Chorda tympani branch
Bile soluble which means they are bile sensitive

12. What is the general compensatory mechanism to prevent edema is situations with increased central venous pressure?
Faulty positioning of the genital tubercle
Increase lymphatic drainage!
AV node slowest - to allow time for diastole
Prevents hepatic VLDL production

13. 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

14. What is damaged in early syringomelia? later?
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities
Tzanck smear
RBF= PAH clearance/(1- hematocrit)
21 hydroxylase deficiency; progesterone to 11 deoxycorticosterone; ambiguous genitalia in females and salt wasting

15. What is the most common cause of pyelonephritis in both adults and childre?
Because of vasodiation to skeletal muscles
E. coli
Adductor
Prevents hepatic VLDL production

16. What are the acute effects of corticosteroids on the CBC?
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17
chronic urticaria and allergic symptoms
Myasthenia gravis

17. What is the inherited defect in LiFraumeni syndrome? What is the mode of inheritance?
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17
P53 mutation; AD
Leukotriene precursor and does neutrophil chemotaxis

18. What does the superior gluteal nerve innervate? how does damage to this nerve manifest?
Clindamycin; covers anaerobic oral flora and aerobic bacteria
Chrom 8
Gluteus medius and minimus; positive trendelenberg
Minimal change disease; lmw proteins: albumin and transferrin; IgG or alpha 2 microglobulin

19. what diseases can vit A be used to treat?
SVC and IVC; right below the aortic knob
Measles and M3 AML`
Primary
When it invades the bm; carcinoma in situ

20. What is omalizumab and What is it used for?
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids
Increases cytokine production
Increase lymphatic drainage!
Sarcoid

21. What does VIP do to gastric acid secretion?
P53 mutation; AD
Ventral commisure (decussating spinothalamic tracts) and anterior horns causing upper extremity hyporeflexia and numbness to heat; lateral corticospinal tracts causing hyperreflexia in lower extremities
Inhibits it
Duration and extent of disease

22. hypertensive crises on food intake is typical of What antidepressant? what kind of food?
Shock symptoms (blood loss); amennorhea history; decidualized stroma (hormone changes are exactly the same) but no chorionic villi
Demargination of neutrophils from the vessel walls
MAO inhibitors; wine and cheese
DIC; TTP- HUS dont bleed that much

23. What is the difference between Acyl CoA carboxylase and Acyl CoA dehydrogenase?
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
No; yes
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17
The first is involved in fatty acid synthesis; the other is involved in beta oxidation of fatty acids to make ketones (ketone synthesis)

24. What is suggestive of complete central DI?
200-500
Increase by 50% in urine osmolality
Ovaries - testes - placental and other peripheral tissue (ie dont just think fat!)
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia

25. What is a keloid?
Trochlear nerve (IV); abducens nerve (VI)
RBC mass; epo levels (secondary has high)
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Excessive collagen formation during tissue repair in susceptible individuals

26. what dictates the resting membrane potential of most cells?
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis
Single adenomatous ones
Squatting - sitting - lying supine - passive leg raising
High potassium conductance and some sodium conductance

27. Is there edema in primary Conns? secondary hyperaldosteronism? why?
4 - 4 - 9
Trauma to stereociliated hair cells of the organ of corti
hyponatremia (aldosterone activation equilibrates body volume)
Sodium escape due to ANP activation results in no edema; edema is the precipitating factor

28. How do you calculate RPF from urine PAH?
Right heart failure
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
(urine PAH x urine flow rate)/plasma PAH

29. what phase do adenosine and acetylcholine act on? doing what?
Little effect on cell and no change
At cochlear base near round and oval window; near apex of cochlea - helioctrema; high frequency sound
Right before diastole (filling begins)
Phase 4 (sodium current); reducing the rate of spontaneous depolarization

30. Where is high frequency sound best recepted? low frequency sound? Which is lost more in elderly?
P450 mitochondrial monooxygenase
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
At cochlear base near round and oval window; near apex of cochlea - helioctrema; high frequency sound
Bronchial dilation (bronchiectasis)

31. at 2 years of age - What are the social - fine motor - gross motor and language developments?
HSV ( also in utero: chlymadia - neisseria - group B strep)
Imitation of household tasks; page turning; jumping - standing on one foot; 2 word phrases
Increase by 50% in urine osmolality
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy

32. What are three symptoms in s.typhi?
Folic acid treatment!
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Rose spots on abdomen - hepatosplenomegaly - hemorrhagic enteritis (with possible perforation)
Around 70 (normal measured diastolic pressures); 9--

33. in essential fructosuria - what enzyme do patients use to metabolize fructose?
21 hydroxylase deficiency; progesterone to 11 deoxycorticosterone; ambiguous genitalia in females and salt wasting
Vertical diplopia
Hexokinase
External illiac - superficial femora - or common femoral or profunda femoris (ipsilateral); pudendal branches of internal illiac

34. What type of gene is bcl 2 ? On what chromosome is it? what chromosome is IgG heavy chain on?
Little effect on cell and no change
Anti - apoptotic (prevents going into apoptosis)- 18; 14
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness
frameshift mutations (missense is substitution)

35. What are two indicators of chronic alcohol consumption?
I is more benign and can present later in adulthood
Syncope - angina - dyspnea (SAD)
GI malignancies and Insulin resistance (acromegal for ex)
Elevated GGT and macrocytosis

36. what happens to the cell body of a neuron after the axon has been severed? What is this called? What is it second to?
Undesirable effects that cause myocardial ischemia (increased HR and increased O2 consumption) are less (still there tho)
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)
Nuclei pushed to periphery and nissl susbstance widely dispersed (increased protein repair); axonal reaction; Wallerian degeneration
Acute gastric mucosal defects (superficial or full thickness)

37. are there signs of inflammation in avascular necrosis? then How do you diagnose?
No; MRI
Multiple miscarriages d/t hypercoaguability
Obesity prevents expansion of wall and lungs for breathing; chronically elevated (all the time not just sleep) PaCO2 and decreased PaO2
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)

38. What is hypospadias caused by?
hyponatremia (aldosterone activation equilibrates body volume)
Abnormal closing of the urethral folds
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
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)

39. after a thrombus extraction - what serum enzyme shoots up and why?
Circular - outside nucleus; transport proteins - rRNA - tRNA
Susceptible; soluble (unable to be cultured in bile)
No and yes
Serum creatine kinase; reperfusion injury causes necrosis

40. Where does vit C act in the hydroxylation of lysine residues for collagen? What is the cofactor required?
GI tract; mood!
Serum FFA and serum triglyceride levels
E6 and E7 of HPV knock off p53 and Rb suppressor genes
RER; copper

41. other than in pyelonephritis - where else are WBC casts seen?
differentiate
Acute interstitial nephritis
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
Sudden loss of muscle tone without loss of consciousness; narcolepsy

42. When is acid phosphatase elevated (Name two times)?
FGF and VEGF
Prostate tumor and increased osteoclast activity
RBC mass; epo levels (secondary has high)
11

43. What are the three top bacterial causes of acute otitis media - sinusitis - and conjuctivitis?
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis
Brief psychotic disorder; schizophreniform; schizophrenia
Classical conditioning
Paramyxo and influenza

44. Which branch of the facial nerve provides taste from ant 2/3 of tongue?
Vancomycin
Strength of cell mediated immune response
Chorda tympani branch
Serum creatine kinase; reperfusion injury causes necrosis

45. What can worse neurologic dysfunction in cobalamic def?
Increase; decreased
Bronchogenic carcinoma
Pancreatic pseduocyst (d/t proteolytic enzyme release); collection of fluid rich in enzymes and inflammatory debris - with granulation tissue and fibrosis
Folic acid treatment!

46. when do ghon complexes form - primary or secondary TB?
Near the medial epicondyle or in Guyon's canal near the hook of the hamate and pisiform bone in the wrist
Centrally located - strong smoking association - neuroendocrine markers: enolase - chromogranin - synaptophysin
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Primary

47. 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
Ether and other organic solvents
Serum FFA and serum triglyceride levels
gram positive organisms

48. What does TGF beta do? What produces it?
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
Anti centromere; anti DNA topoisomerase
Tibial
Fibrosis; macrophages

49. What effects does cortisol have on catecholamines?
Duration and extent of disease
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
Ulcers in esophagus - stomach - or duodenum and high ICP can cause perforation or ulcers in duodenum d/t acute physiologic stress
Increases cytokine production

50. What does extended consumption of appetite suppressants lead to?
Rabies encephalitis from cave bats; rabies killed vaccines
Pulmonary hypertension
Regular insulin (Not fast acting - regular better)
Paranoid personality disorder is a distrust that pervades all parts of the patients life as opposed to delusional disorder Which is one fixed delusion