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 ulcers arising in the proximal duodenum in association with severe trauma or burns called?
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness
Curlings ulcers
Inhaled animal dander allergens
Spongiosis

2. How can renal blood flow be calculated from RPF?
The first is involved in fatty acid synthesis; the other is involved in beta oxidation of fatty acids to make ketones (ketone synthesis)
Hexokinase
RBF= PAH clearance/(1- hematocrit)
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin

3. what protein is increased in Crohns disease? What does it do?
NF- KB; responsible for cytokine production
manifestations - congenital (stretching of periventricular pyrimadal fibers)
Parallel play; reproduce simple shapes; tricycle riding - stair climbing; simple sentences
No (unlike adenomyosis); yes

4. in a positively skewed distribution is the mean greater than or equal to the median or the mode?
SVT; increases vagal tone; rectus abdominis
OCPs - multiparity - breast feeding
Mean greater than median greater than mode
Ether and other organic solvents

5. why does liver dysfunction cause coagulation disorders?
Ceftriaxone; azithromycin
Coagulation factors are made in the liver
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC
Aromatase deficiency in child

6. What is somatomedin C?
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
Insulin like growth factor 1 (just another name)
Parallel play; reproduce simple shapes; tricycle riding - stair climbing; simple sentences
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17

7. What are the potassium sparing diuretics?
Amiloride - spironolactone - triamterene
HSV and VZV
Tissue redistribution (out of plasma) rather than metabolism
ZDV or AZT

8. What type of calcium channels dictate the plateau in cardiac myocyte?
Little effect on cell and no change
Brief psychotic disorder; schizophreniform; schizophrenia
Dihydropyridine sensitive Ca channels (L type)
Become beta pleated and then form neurofibrillary tangle!

9. other than in pyelonephritis - where else are WBC casts seen?
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)
Bile soluble which means they are bile sensitive
Varying; erythema nodosum is common
Acute interstitial nephritis

10. What are the acute effects of corticosteroids on the CBC?
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)
Echinococcus granulosus; anaphylaxis
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC
Prostate tumor and increased osteoclast activity

11. at one year of age - What are the social - fine motor - gross motor and language developments?
P53 mutation; DCC is also required for adenoma to carcinoma
hyponatremia (aldosterone activation equilibrates body volume)
Mood stabilizer (lithium - valproate - carbamazepime) plus an atypical antipsychotic
Initiation - pointing; pincer grasp; walking; mama/dada

12. What is a cord factor and Which bugs have it? How do they appear on culture?
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Mycoside (made of two mycolic acids) and is responsible for inactivating neutrophils - mit damage - and induced release of TNF; mycobacteria virulence; serpentine cords
S. saprophyticus - and s. epidermidis; novobiocin

13. What is the best indicator for the severity of mitral stenosis?
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia
The time interval between S2 and OS- the shorter the interval - the more intense
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
Duration and extent of disease

14. What type of mutation does aflatoxin cause? what cancer does this increase for?
Abnormal closing of the urethral folds
G to T in p53; HCC
No
Rose spots on abdomen - hepatosplenomegaly - hemorrhagic enteritis (with possible perforation)

15. where are neurons lost in huntingtons disease? What are two mc presenting symptoms?
hyponatremia (aldosterone activation equilibrates body volume)
Chlorpheniramine and diphenhydramine
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)
Myasthenia gravis

16. What does the tuberoinfundibular pathway connect? What is it responsible for?
Terminal bronchioles; small bronchi
AV node slowest - to allow time for diastole
Prevents hepatic VLDL production
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin

17. What test would be best to determine if a gene is being transcribed? translated?
GI tract; mood!
Southern - western
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)
Anti - apoptotic (prevents going into apoptosis)- 18; 14

18. What is dobutamine? What is it used for?how it is it most helpful? What is bad about it?
Prevent phagocytosis
Apocrine; eccrine
Anterior nares
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

19. What can chronic vit A toxicity cause?
Tissue redistribution (out of plasma) rather than metabolism
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
Dry skin - papilledema - intracranial pressure - alopecia - hyperlipidemia - hepatoxicity - hepatosplenomegaly -
Adeno

20. 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?
Lateral; RV; RA; LV
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
SSRI
Purkinje system; AV node

21. why should you not use ACE inhibitors with someone who had hereditary angioedema?
Bile soluble which means they are bile sensitive
Pulmonic and systemic!
Clindamycin; covers anaerobic oral flora and aerobic bacteria
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

22. What is the most common location of colonization of all s. aureus types?
TCAs and prazosin
Anterior nares
Medial circumflex artery; avascular necrosis
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

23. What type of gene is bcl 2 ? On what chromosome is it? what chromosome is IgG heavy chain on?
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)
Anti - apoptotic (prevents going into apoptosis)- 18; 14
11
Faulty positioning of the genital tubercle

24. a patient fearing all white coats is a phenomenon of what?
Minimal change disease
Drug induced interstitial nephritis
Classical conditioning
Varying; erythema nodosum is common

25. Which nerve lies in close proximity to the inferior thyroid artery?
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)
Recurrent larygneal
RER; RER
Medial circumflex artery; avascular necrosis

26. metabolism of 1 gram of protein produces How many calories? carb? fat?
Medial part
4 - 4 - 9
LT (LTD4 - E4 - C4) - and Ach
FGF and VEGF

27. What is the mcc of elevated AFP leves in pregnancy>
Underestimation of gestational age
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus
P53 mutation; AD
Because of the low output from heart failure - they will have increased aldosterone levels

28. What are the three predominant symptoms of VHL? What is its mode of inheritance?
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Vancomycin
Initiation - pointing; pincer grasp; walking; mama/dada

29. which virus inactivates both Rb and p53?
manifestations - congenital (stretching of periventricular pyrimadal fibers)
Vertical diplopia
E6 and E7 of HPV knock off p53 and Rb suppressor genes
Neisseria induced small cell vasculitis (including hands and soles)

30. Where is conduction in heart fastest? slowest?
Purkinje system; AV node
RBF= PAH clearance/(1- hematocrit)
Think Hb deformation diseases
Curlings ulcers

31. What is the diagnosis in delayed puberty plus anosmia?
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia
Kallmans
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease

32. what dissolves the lipid bilayer of a viral envelope?
Ether and other organic solvents
INTRApartum Abs (ampicillin/penicillin)
When it invades the bm; carcinoma in situ
Pineal region; precocious puberty and parinaud syndrome - obstructive hydrocephalus

33. What antibodies are present in CREST? What is the most specific?
Skin flushing and warmth; prostaglandins; give with aspirin
Anti centromere; anti DNA topoisomerase
hyponatremia (aldosterone activation equilibrates body volume)
V fib; v. failure

34. What does the clinical presentation of restlessness - agitation - dysphagia - and progression to coma 30-50 days after cave exploring? hwo do you prevent?
P450 mitochondrial monooxygenase
P53 mutation; DCC is also required for adenoma to carcinoma
Rabies encephalitis from cave bats; rabies killed vaccines
Because left renal vein passes between aorta and SMA and hardening of SMA can cause renal vein compression

35. What are examples of action that decrease venous return to the heart?
Anti centromere; anti DNA topoisomerase
Turners`
II; I (I more abundant)
Standing suddenly from supine position; valsalva maneuver

36. What is acanthosis nigricans associated with?
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
Paranoid personality disorder is a distrust that pervades all parts of the patients life as opposed to delusional disorder Which is one fixed delusion
Circular - outside nucleus; transport proteins - rRNA - tRNA
GI malignancies and Insulin resistance (acromegal for ex)

37. what disease causes hypoxia induced hemolysis? oxidant induced hemolysis?
No and yes
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)
Sickle cell; G6PD
Trauma to stereociliated hair cells of the organ of corti

38. if there are keratin swirls does that mean well or poorly differentiated?
OCPs - multiparity - breast feeding
transcription activation/suppression
Well
Near the medial epicondyle or in Guyon's canal near the hook of the hamate and pisiform bone in the wrist

39. Where does 90% of serotonin lie? What is this NT responsible?
Elastance
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)
V fib; v. failure
GI tract; mood!

40. In what population does cholelithiasis occur?
Fat - fertile - forty - female
Fibrosis; macrophages
Squamous cell carcinoma; poor prognosis; smoking and alcohol (also plummer vinson syndrome - achalasia - and corrosive strictures)
Radial nerve damage

41. Where does vasopressin act - on the medullary or cortical segment of collecting tubule?
Enterococci (e. faecalis)- found on genitalia area
Medullary
Skin flushing and warmth; prostaglandins; give with aspirin
HSV and VZV

42. Where is high frequency sound best recepted? low frequency sound? Which is lost more in elderly?
Leukotriene precursor and does neutrophil chemotaxis
Right heart failure
Hypothyroidism
At cochlear base near round and oval window; near apex of cochlea - helioctrema; high frequency sound

43. 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
Barium studies and colonoscopy can cause perforation just use plain abdominal xray
glycerol kinase
T test; chi squared

44. What is usually teh last gene mutation in development of a carcinoma (from an adenoma for example)?
P53 mutation; DCC is also required for adenoma to carcinoma
Localized dermatologic pain that persists for more than one month after zoster eruption
indomethacin
P53 mutation; AD

45. What are the long term consequences of hydrocephalus?
ATP binding (resets the myosin head to contract again for next binding)
Bronchogenic carcinoma
Lower extremity spasticity due to stretching of periventricular pyrimadal tracts - visual disturbances and learning disabilities
Increase by 50% in urine osmolality

46. What three factors effect total oxygen content of blood?
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
Gluteus medius and minimus; positive trendelenberg
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use
Atrial

47. What is epleronone?
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
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
Another type of aldosterone antagonist (like spironolactone)
LT (LTD4 - E4 - C4) - and Ach

48. What effects does cortisol have on catecholamines?
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
Circular - outside nucleus; transport proteins - rRNA - tRNA
Initiation - pointing; pincer grasp; walking; mama/dada
indomethacin

49. What is it called if psychotic symptoms last less than one month? one to six months? more than six months?
Adeno
Lecithin (same as phosphatidylcholine)/sphingomyelin; by 35 weeks should be 2/1 or higher
Brief psychotic disorder; schizophreniform; schizophrenia
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness

50. What are pancreatic pseudocysts called pseudo rather than true cysts?
Downs; regurgitant AV valves - ASDs
Episodes of painless - well circumscribed pitting edema; face - lips - neck - and tongue - tracheobronchial tree can cause respiration obstruction
I is more benign and can present later in adulthood
Not lined by epithelium