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 does nitroprusside do to afterload? preload?
Decreases both
Hypothyroidism
Medullary
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis

2. What type of gene is bcl 2 ? On what chromosome is it? what chromosome is IgG heavy chain on?
Aortic root dilation or bicuspid aortic valve; diastolic murmur (right sternal border(
4 - 4 - 9
Anti - apoptotic (prevents going into apoptosis)- 18; 14
Syncope - angina - dyspnea (SAD)

3. Acyl coA synthetase is not...
S3 gallop; S2 to opening snap interval
liver specific
25; 25
When it invades the bm; carcinoma in situ

4. What is it called if psychotic symptoms last less than one month? one to six months? more than six months?
25; 25
Brief psychotic disorder; schizophreniform; schizophrenia
Pan colitis and right sided colitis (more than left sided and proctitis)
glycerol kinase

5. why does neutrophila occur with corticosteroids?
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
Inhibits it
Demargination of neutrophils from the vessel walls
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids

6. What is pickwickian syndrome? What are the lab findings?
Drink plenty of fluids
Obesity prevents expansion of wall and lungs for breathing; chronically elevated (all the time not just sleep) PaCO2 and decreased PaO2
GI tract; mood!
E6 and E7 of HPV knock off p53 and Rb suppressor genes

7. What can worse neurologic dysfunction in cobalamic def?
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!
Kallmans
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics

8. which congenital adrenal hyperplasia presents with ambiguous genitalia in females and salt retention?
Pain and discomfort from dilation and stretching of the renal capsule from all the cysts!; hypertension - hematuria
Bile salt accumulation in urine
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)
11beta hydroxylase deficiency (11 deoxycortisol to cortisol)

9. What is somatomedin C?
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
Terminal bronchioles; small bronchi
Insulin like growth factor 1 (just another name)

10. what dictates the resting membrane potential of most cells?
RBC mass; epo levels (secondary has high)
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)
Acute gastric mucosal defects (superficial or full thickness)
High potassium conductance and some sodium conductance

11. how long is substance P? What does it do?
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC
11 aa polypeptide; pain NT in CNS and PNS
Drug induced interstitial nephritis
As a CO2 carrier with the carboxylase enzyme

12. Which is slower AV node or ventricular muscle?
AV node slowest - to allow time for diastole
Hyperkalemia; potassium sparing diuretics - potassium supplements
S. saprophyticus - and s. epidermidis; novobiocin
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness

13. What agonists reduce the gradient across the LV outflow tract?
Selective alpha 1 (increases SVR)
Increases
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
Skin flushing and warmth; prostaglandins; give with aspirin

14. other than parvo B19 - what else is associated with red cell aplasia?
Hypothyroidism
transcription activation/suppression
Thymic tumor
Class I

15. What are ulcers arising in the proximal duodenum in association with severe trauma or burns called?
Increases bronchial and vascular smooth muscle reactivity to catecholamines
Curlings ulcers
Lower extremity spasticity due to stretching of periventricular pyrimadal tracts - visual disturbances and learning disabilities
Radial nerve and deep brachial artery

16. Where does terminal peptide cleavage of collagen fibrils take place?
Syringomelia
In the extracellular space
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
II; I (I more abundant)

17. on which chromosome is wilms tumor found?
Squatting - sitting - lying supine - passive leg raising
46 - 4N; 23 2N
RBF= PAH clearance/(1- hematocrit)
11

18. which staphylococci can do mannitol fermaentation?
Hexokinase
Tzanck smear
Joints d/t increased purine production and thus uric acid production
S. aureus

19. What is the most common cause of pyelonephritis in both adults and childre?
Measles and M3 AML`
Abnormal closing of the urethral folds
MAC complex (C5b - C9 complement deficiency)
E. coli

20. What is a limiting factor when initiating ACE inhibitors? hwo do you prevent a really bad reaction?
manifestations - congenital (stretching of periventricular pyrimadal fibers)
First dose hypotension (severe hyponatremia and hypovolemia); by checking for other diuretics
Purkinje system; AV node
Aromatase deficiency in child

21. SIADH patients have normal blood volume but...
hyponatremia (aldosterone activation equilibrates body volume)
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
Proteasome inhibitor; treatment for MM and waldenstroms
Syringomelia

22. what happens to PaO2 - % sat - and O2 content in: Anemia - polycythemia - CO poisoning?
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
SSRI; erectile dysfunction
Lateral; RV; RA; LV
Vomitting - NG suctioning - diuretic use - hyperaldosteronism; urinary chloride concentration

23. What are diastolic (lowest) pressures in aorta? LV?
Right before diastole (filling begins)
TCAs and prazosin
Around 70 (normal measured diastolic pressures); 9--
Neutrophilia (Up) - eosinopenia - lymphocytopenia (All The REST DOWN- monocytopenia - basophilopenia)

24. Metronidizaole does not cover...
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
SVC and IVC; right below the aortic knob
gram positive organisms
Parallel play; reproduce simple shapes; tricycle riding - stair climbing; simple sentences

25. What can long term leg cast wearing cause?
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
Coronary vasospasm (cocaine) - coronary arteritis - hypercoaguability with acute thrombosis
Pulmonary hypertension
Anti - apoptotic (prevents going into apoptosis)- 18; 14

26. What is a malignant pustule? What is it usually caused by? What type of capsule does it have?
No; yes
Painless ulcer with black eschar and local edema; b. anthracis; D glutamate
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis

27. What is a keloid?
Excessive collagen formation during tissue repair in susceptible individuals
Hypothalamus and pituitary; dopaminergic tonic inhibition of prolactin
SSRI; erectile dysfunction
HSV and VZV

28. What are the skin presentation in sarcoid?
Varying; erythema nodosum is common
Pan colitis and right sided colitis (more than left sided and proctitis)
Vertical diplopia
25; 25

29. When is an S4 sound normal?
Aromatase deficiency in child
Hypothyroid myopathy (thyroid is required for maintaining a lot!)
Well trained athletes and children
SVC and IVC; right below the aortic knob

30. what murmur is enhanced by decreased blood flow to the heart?
Ketone body production by preventing fatty acids into the mitochondria
TSh (in testicular tumors can cause hyperthyroidism)
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)
Integration of viral DNA into genome of host hepatocytes

31. why does liver dysfunction cause coagulation disorders?
Prevents hepatic VLDL production
Coagulation factors are made in the liver
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
Drink plenty of fluids

32. What three things can reduce the risk of non hereditary ovarian and endometrial cancer?
Enterococci (e. faecalis)- found on genitalia area
Vagus (auricular branch); vasovagal syncope!
Because of the low output from heart failure - they will have increased aldosterone levels
OCPs - multiparity - breast feeding

33. 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

34. How do you explain the selective proteinuria of loss to albumin only in MCD?
Normal; low
Integration of viral DNA into genome of host hepatocytes
Loss of negatively charged components in the GBM so that the loss of those particles destroys the negative - negative repulsion between GBM and albumin
By vascular permeability and vasodilation

35. When is acid phosphatase elevated (Name two times)?
Prostate tumor and increased osteoclast activity
Aromatase deficiency in child
Close but purkinje system to ensure contraction in a bottom up fashion
Bronchogenic carcinoma

36. niacin used for hyperlipidemia - What are its side effects? why do they occur? how can you prevent them?
Skin flushing and warmth; prostaglandins; give with aspirin
Ulcers in esophagus - stomach - or duodenum and high ICP can cause perforation or ulcers in duodenum d/t acute physiologic stress
Echinococcus granulosus; anaphylaxis
Prostate tumor and increased osteoclast activity

37. what increases turbulence and thus causes bruits? (specifically in terms of viscosity and velocity)
Anti centromere; anti DNA topoisomerase
Hgb concentration - PaO2 (pp of O2 dissolved in blood) - and SaO2
Decreased viscosity (anemia) - increased velocity (narrowing of vessel)
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)

38. What would a deflection of the membrane potential to near zero indicate?
facultative intracellular
Serum creatine kinase; reperfusion injury causes necrosis
Increase in permeability of two ions with equal and opposite equilibrium potentials
Indirect inguinal hernia (persistent connection between peritoneum and tunica vaginalis)

39. What translocations can cause c - myc overexpression?
8 (myc protein) with 2 - 14 - 22 (iG chains)
Joints d/t increased purine production and thus uric acid production
Ig A deficiency
Hypothyroidism

40. Axillary lymph node dissection is a risk factor for the development of chronic lymphedema of the ipsilateral arm. What does chronic lymphedema predispose to?
Octreotide
Folic acid treatment!
Mycoside (made of two mycolic acids) and is responsible for inactivating neutrophils - mit damage - and induced release of TNF; mycobacteria virulence; serpentine cords
Angiosarcoma (infiltration of dermis with slit like abnormal vascular spaces)

41. Where does complement bind on the Fc region of Ig chains?
Near the hinge point; site for attachment to phagocytic cells is at the very end (Fc receptor)
Insulin like growth factor 1 (just another name)
Near sightedness; in elderly with lens sclerosis and loss of elasticity- leads to inability of lens to focus on near objects
Mycoside (made of two mycolic acids) and is responsible for inactivating neutrophils - mit damage - and induced release of TNF; mycobacteria virulence; serpentine cords

42. What is used to prevent vertical transmission of HIV?
Anterior nares
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
ZDV or AZT
Episodes of painless - well circumscribed pitting edema; face - lips - neck - and tongue - tracheobronchial tree can cause respiration obstruction

43. What is the general compensatory mechanism to prevent edema is situations with increased central venous pressure?
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
TCAs and prazosin
Multiple infections with bugs like neisseria becuase they block igM and IgG from binding and activating MAC
Increase lymphatic drainage!

44. What are the three top bacterial causes of acute otitis media - sinusitis - and conjuctivitis?
Elevated GGT and macrocytosis
Coagulation factors are made in the liver
Apocrine; eccrine
1. s. pneumo 2. non typable h. influenzae and 3. moraxella cattarhalis

45. why is glucagon used in beta blocker toxicitiy?
Serum creatine kinase; reperfusion injury causes necrosis
Because increases intracellular cAMP independent of adrenergic receptors (does it via G proteins)
SSRI
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)

46. What is gardeners mydriasis? How is it treated?
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Close but purkinje system to ensure contraction in a bottom up fashion
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
Acute gastric mucosal defects (superficial or full thickness)

47. What is the fibrinogen level in patient with TTP- HUS? DIC?
Clindamycin; covers anaerobic oral flora and aerobic bacteria
The first is involved in fatty acid synthesis; the other is involved in beta oxidation of fatty acids to make ketones (ketone synthesis)
Normal; low
The term used to describe decreased drug responsiveness with repeated administration

48. What is the difference between paranoid personality disorder and delusional disorder?
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia
E. coli
Paranoid personality disorder is a distrust that pervades all parts of the patients life as opposed to delusional disorder Which is one fixed delusion
Ig A deficiency

49. What does sustained hand grip do to the C/V system?
When it invades the bm; carcinoma in situ
Purkinje system; AV node
Increases the systemic vascular resistance and thus reduces the gradient across the LV outflow tract
HSV and VZV

50. What is a primary HSV 1 infection like?
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
MAB to igE antibodies; sever allergic asthma - effectivein reducing dependency on both oral and inhaled steroids
Cerebellar hemangioblastomas - pheochromocytomas - renal cell carcinomas; AD
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine