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. which RPGN is also called pauci immune GN? why?
E. coli; staphylococcus saprophyticus
ANCA because of lack of Ig and C3 deposits on IF
Ketone body production by preventing fatty acids into the mitochondria
...

2. What is Tzanck smear used to detect?
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
HSV and VZV
Congenital hypothyroidism - downs - amyloidosis - acromegaly
Excessive collagen formation during tissue repair in susceptible individuals

3. What can nitrates lead to that is bad for angina therapy? How do you counter this?
Valproate
Relfex tachycardia; giving beta blockers
Ulcers in esophagus - stomach - or duodenum and high ICP can cause perforation or ulcers in duodenum d/t acute physiologic stress
Pain and discomfort from dilation and stretching of the renal capsule from all the cysts!; hypertension - hematuria

4. Metronidizaole does not cover...
gram positive organisms
Biphosphonate
Prostate tumor and increased osteoclast activity
Mucor - rhizopus infection (Mucormycosis); mucosal biopsy; black necrotic eschar in nasal cavity

5. what happens with LDL receptor density in statin therapy?
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy
Vagus nerve stimulation
Increases
PDA open

6. at three years of age What are social - fine motor - gross motor and language developments?
Fibrosis; macrophages
Parallel play; reproduce simple shapes; tricycle riding - stair climbing; simple sentences
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)
Prepatellar

7. which trisomy is associated with endocardial cushion defects? What does thsi mean>
Susceptible; soluble (unable to be cultured in bile)
Downs; regurgitant AV valves - ASDs
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Phencyclidine (PCP)

8. What is omalizumab and What is it used for?
Anterior and to the right (on the ECG!) of the pulmonary artery; right to left shunt
only up to bronchi
Syncope - angina - dyspnea (SAD)
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids

9. what phase do adenosine and acetylcholine act on? doing what?
Coagulation factors are made in the liver
RBF= PAH clearance/(1- hematocrit)
Phase 4 (sodium current); reducing the rate of spontaneous depolarization
Think Hb deformation diseases

10. Where does 90% of serotonin lie? What is this NT responsible?
Squatting - sitting - lying supine - passive leg raising
Vagus nerve stimulation
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
GI tract; mood!

11. niacin used for hyperlipidemia - What are its side effects? why do they occur? how can you prevent them?
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Boiling - bleach - formalin - UV irradiation
Skin flushing and warmth; prostaglandins; give with aspirin
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

12. What is suggestive of complete central DI?
Vertical diplopia
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
Pulmonary hypertension
Increase by 50% in urine osmolality

13. what would be a sign of absence of cardiogenic pulm edem?
Chorda tympani branch
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)
Fibrosis; macrophages
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!

14. What is the cause of fixed splitting of S2? why?
Near the medial epicondyle or in Guyon's canal near the hook of the hamate and pisiform bone in the wrist
Episodes of painless - well circumscribed pitting edema; face - lips - neck - and tongue - tracheobronchial tree can cause respiration obstruction
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
ASD - causes increased pulmonary vascular blood flow which causes pulmonic vessel stenosis and damage

15. Which branch of the facial nerve provides taste from ant 2/3 of tongue?
Parallel play; reproduce simple shapes; tricycle riding - stair climbing; simple sentences
Chorda tympani branch
Varying; erythema nodosum is common
Coagulation factors are made in the liver

16. What are pancreatic pseudocysts called pseudo rather than true cysts?
21 hydroxylase deficiency; progesterone to 11 deoxycorticosterone; ambiguous genitalia in females and salt wasting
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness
Not lined by epithelium
Paranoid personality disorder is a distrust that pervades all parts of the patients life as opposed to delusional disorder Which is one fixed delusion

17. In what form are mitochondrial DNA? What do they transcribe?
Circular - outside nucleus; transport proteins - rRNA - tRNA
Ceftriaxone; azithromycin
Sydenham chorea
T test; chi squared

18. What is the general compensatory mechanism to prevent edema is situations with increased central venous pressure?
Nucleus caudatus and putamen; random movement of extremities and personality abnormalities (getting angry!)
Increase lymphatic drainage!
Anti centromere; anti DNA topoisomerase
Trochlear nerve (IV); abducens nerve (VI)

19. What is it called if psychotic symptoms last less than one month? one to six months? more than six months?
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness
Leukotriene precursor and does neutrophil chemotaxis
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
Brief psychotic disorder; schizophreniform; schizophrenia

20. How do left sided colon adenocarcinomas present? right sided?
P53 mutation; DCC is also required for adenoma to carcinoma
<1% - 55% - concentration dependent
Toxoplasmosis and primary CNS lymphoma (EBV B cell induced)
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

21. what has the greatest effect on prognosis when treating c. diptheriae?
Classical conditioning
V fib; v. failure
Circular - outside nucleus; transport proteins - rRNA - tRNA
Giving antitoxin (also give antibiotics and passive immunization but antitoxin has greatest effect on prognosis)

22. what disease causes a lack of intracellular killing? lack of killing viruses and fungi?
Nuclei pushed to periphery and nissl susbstance widely dispersed (increased protein repair); axonal reaction; Wallerian degeneration
CGD; t cell dysfxn (diGeorge)
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
Thymic tumor

23. 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

24. What are the skin presentation in sarcoid?
Varying; erythema nodosum is common
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
Lateral; RV; RA; LV
TSh (in testicular tumors can cause hyperthyroidism)

25. What does anti phospholipid syndrome in SLE patients predispose them to?
Multiple miscarriages d/t hypercoaguability
Raphe
Skin flushing and warmth; prostaglandins; give with aspirin
Normal pulmonary capillary wedge pressure (used for LA pressure measurement)

26. What is epispadias caused by?
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
Varying; erythema nodosum is common
Become beta pleated and then form neurofibrillary tangle!
Faulty positioning of the genital tubercle

27. What are some side effects seen in TCAs?
11beta hydroxylase deficiency (11 deoxycortisol to cortisol)
Increase by 50% in urine osmolality
RER; RER
Cardiac arrhthymias (quinidine like long QT) - orthostatic hypotension (antagonism of alpha adrenergic receptors) - urinary retention (d/t anticholinergic effects) - seizures

28. what happens to sperm count and semineferous tubules in patient with cryptoorchidism? hormonal function? why do they need to be surgically descended?
Vancomycin; histamine mediated
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
T test; chi squared
APP on chrom 21 (this is why downs more susceptible)

29. what bursa is affected when on knees like a maid/gardner?
Sudden loss of muscle tone without loss of consciousness; narcolepsy
Prepatellar
S. aureus
Ig A deficiency

30. What is the most common location of colonization of all s. aureus types?
Radial nerve damage
Anterior nares
Excessive collagen formation during tissue repair in susceptible individuals
Intussusception

31. What is the most common neurologic complication of VZV reactivation?
Hypothyroid myopathy (thyroid is required for maintaining a lot!)
SaO2 <92%
Enterococci (e. faecalis)- found on genitalia area
Localized dermatologic pain that persists for more than one month after zoster eruption

32. What is the mc manifestation of CMV in HIV patient? immunocompetent?
Drug induced interstitial nephritis
Retinitis; mononucleosis
Bronchogenic carcinoma
Smoking

33. What is the Na/Ca exchange used for?
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)
To pump calcium out in cardiac myocytes so that relaxation occurs
High potassium conductance and some sodium conductance
OCPs - multiparity - breast feeding

34. what hormone is structurally similar to hCG?
Bile soluble which means they are bile sensitive
Acute interstitial nephritis
8; 12
TSh (in testicular tumors can cause hyperthyroidism)

35. who bleed more DIC or TTP- HUS patients?
Epinephrine; adrenal medulla; phenylethanolamine N methyltransferase; cortisol
Bile salt accumulation in urine
DIC; TTP- HUS dont bleed that much
Faulty positioning of the genital tubercle

36. how does achalasia present? What does barium swallow show on dilated esophagus?
Barium enema
Hexokinase
Progressive dysphagia - chest pain - food regurg - and aspiration; birds beak deformity of the LES
Hypertension - edema - and proteinuria

37. sporadic colon cancer tend to arise From what type of polyps?
<1% - 55% - concentration dependent
TSh (in testicular tumors can cause hyperthyroidism)
Lower extremity spasticity due to stretching of periventricular pyrimadal tracts - visual disturbances and learning disabilities
Single adenomatous ones

38. What is the mc location for avascular necrosis? What is it associated with?
differentiate
No
women
Femoral head; sickle cell - SLE - alcoholism - high steroid therapy

39. What is the neurologic manifestation of ADPKD?
Anti centromere; anti DNA topoisomerase
Increases
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Abnormal closing of the urethral folds

40. what disease causes hypoxia induced hemolysis? oxidant induced hemolysis?
GI malignancies and Insulin resistance (acromegal for ex)
frameshift mutations (missense is substitution)
Sickle cell; G6PD
Relfex tachycardia; giving beta blockers

41. What is usually teh last gene mutation in development of a carcinoma (from an adenoma for example)?
Standing suddenly from supine position; valsalva maneuver
manifestations - congenital (stretching of periventricular pyrimadal fibers)
P53 mutation; DCC is also required for adenoma to carcinoma
Cluster

42. what happens to PaO2 - % sat - and O2 content in: Anemia - polycythemia - CO poisoning?
LT (LTD4 - E4 - C4) - and Ach
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Common peroneal; bony fractures and compression; sciatic
RER; copper

43. What are biphosphanate drugs structurally similar to? What are they used in the treatment of?
Sarcoid
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
Dihydropyridine sensitive Ca channels (L type)
Pyrophosphate (important comp of hydroxyapatite); osteoporosis - Pagets disease of the bone - malignancy induced hypercalcemia

44. Where does vasopressin act - on the medullary or cortical segment of collecting tubule?
Anti cholinergic effects of pupil dilation and lack of accomodation
Inhaled animal dander allergens
Medullary
Bile salt accumulation in urine

45. What is gardeners mydriasis? How is it treated?
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis
Dihydropyridine sensitive Ca channels (L type)
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
Tissue redistribution (out of plasma) rather than metabolism

46. which type of glands produce an initially odorless secretion but can become malodorous secondary to bacterial decompisition on the skin surface? which glands are present throughout the skin except on lips and glans penis?
Trauma to stereociliated hair cells of the organ of corti
Apocrine; eccrine
I is more benign and can present later in adulthood
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC

47. Where is high frequency sound best recepted? low frequency sound? Which is lost more in elderly?
At cochlear base near round and oval window; near apex of cochlea - helioctrema; high frequency sound
LT (LTD4 - E4 - C4) - and Ach
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage
Faulty positioning of the genital tubercle

48. h1 receptor anatagonists are not effective in treatment of asthma only for...
chronic urticaria and allergic symptoms
Inhibits it
only up to bronchi
Trauma to stereociliated hair cells of the organ of corti

49. what makes bruits?
Phase 4 (sodium current); reducing the rate of spontaneous depolarization
Strength of cell mediated immune response
Turbulence
Anterior circumflex (and axillary nerve)

50. nucleotide deletions do not cause missense mutations - they cause...
Decreased viscosity (anemia) - increased velocity (narrowing of vessel)
Elevates ASO titers; elevated anti DNAase B titers; decreased C3 and total complement levels and presence of cryoglobulins (C4 normal)
frameshift mutations (missense is substitution)
Cardiac arrhthymias (quinidine like long QT) - orthostatic hypotension (antagonism of alpha adrenergic receptors) - urinary retention (d/t anticholinergic effects) - seizures