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USMLE Prep 2

Instructions:

Answer 50 questions in 15 minutes.
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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 is the mcc of cystitis and and acute pyelonephritis? mcc of UTI in sexually active women?
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
E. coli; staphylococcus saprophyticus
Neisseria induced small cell vasculitis (including hands and soles)
Relfex tachycardia; giving beta blockers

2. What almost exclusively causes Epliglottitis?What type of capsule does it have? What are the symptoms?

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3. hypertensive crises on food intake is typical of What antidepressant? what kind of food?
Prevent phagocytosis
Large stroke volumes with ventricular contraction; aortic regurg
Elastance
MAO inhibitors; wine and cheese

4. Where is the base of the heart? apex?
Acute necrotizing pancreatitis; alveolar hyaline membranes; leaky capillary alveolar membrane (proteins deposit)
Closer to head; closer to diaphragm
Syringomelia
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone

5. What is hyaline arteriosclerosis usually a sign of ?
Diabetic microangiopathy
Joints d/t increased purine production and thus uric acid production
women
Additive is equal to the sum of the two actions (lets say agonists at a receptor) and synergistic is when the sum is greater than just their two effects together

6. What does 'oxygen' content in blood refer to?
Dry skin - papilledema - intracranial pressure - alopecia - hyperlipidemia - hepatoxicity - hepatosplenomegaly -
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Highly negative resting potential
Dissolved in plasma and attached to Hgb

7. What is a clara cell?
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
Non ciliary secretory constituents of the terminal respiratory epithelium; play a role in detoxification of inhaled toxins with a p450 system
Tibial
glycerol kinase

8. at one year of age - What are the social - fine motor - gross motor and language developments?
Excessive collagen formation during tissue repair in susceptible individuals
Increased reticulocytes
Normal - normal - decreased; normal - normal - increased; normal - decreased - decreased
Initiation - pointing; pincer grasp; walking; mama/dada

9. What is a primary HSV 1 infection like?
Anterior circumflex (and axillary nerve)
Acute interstitial nephritis
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
only up to bronchi

10. What is a cell surface marker seen in liver angiosarcoma?
Belladonna alkaloids from weeds causes atropine poisoning; physostigmine
Proteasome inhibitor; treatment for MM and waldenstroms
E. coli
CD31 (endothelial cell marker)- a PECAM for leukocyte migration actually!

11. What does Rb protein do? what chrom is it on?
Rb suppressor protein prevents cells going from G1 to S phase - when phosphorylated by cdk it is inactivated - p53 prevents this phosphorylation; chrom 13
Painless ulcer with black eschar and local edema; b. anthracis; D glutamate
NSAIDs; nausea and diarrhea; when you have renal failure (cant have either NSAIDs or colchicine)
Sarcoid

12. What is diagnostic (and possible therapeutic for intussusception)?
Increases
RBC mass; epo levels (secondary has high)
Diabetic microangiopathy
Barium enema

13. what chromosome is c - myc found on?
Vancomycin; histamine mediated
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia
P53 mutation; AD
Chrom 8

14. 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)
Around 70 (normal measured diastolic pressures); 9--
Normal; low
No

15. What would a deflection of the membrane potential to near zero indicate?
Anti - apoptotic (prevents going into apoptosis)- 18; 14
Increase in permeability of two ions with equal and opposite equilibrium potentials
Drug induced interstitial nephritis
Muscarinic antagonist; pralidoxime because atropine doesnt work at nicotinc receptors and organophospates act at all cholinergic (muscle paralysis not solved with only atropine)

16. What can inhaled anesthetics (like halothane) cause post operatively? what virus does it immitate? What are the presenting symptoms?
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
Highly lethal fulminant hepatits; acute viral hepatitis (cant be distinguished clinically); significantly elevated ALT and AST an prolonged prothrombin time - and eosinophilia
RER; copper
Pulmonic and systemic!

17. what disease causes a lack of intracellular killing? lack of killing viruses and fungi?
CGD; t cell dysfxn (diGeorge)
differentiate
Filtration rate - tubular reabsorption rate; GFR x plasma concentration (of that substance); inulin
Vomitting - NG suctioning - diuretic use - hyperaldosteronism; urinary chloride concentration

18. what commonly happens in GI in response to acute physiologic stress?
manifestations - congenital (stretching of periventricular pyrimadal fibers)
Ceftriaxone; azithromycin
Pan colitis and right sided colitis (more than left sided and proctitis)
Acute gastric mucosal defects (superficial or full thickness)

19. what makes bruits?
RR-1/RR
RER; copper
GI tract; mood!
Turbulence

20. other than in pyelonephritis - where else are WBC casts seen?
Octreotide
liver specific
Mutations in membrane K+ ion channels; torsade de pointes; neurosensory deafness
Acute interstitial nephritis

21. What is it called when you see double vision when walking down stairs or looking at nose or reading newspaper?
Vertical diplopia
Boiling - bleach - formalin - UV irradiation
Strength of cell mediated immune response
Cluster

22. What is used to prevent vertical transmission of HIV?
ZDV or AZT
Measles and M3 AML`
Susceptible; soluble (unable to be cultured in bile)
Intracranial berry aneurysms and when rupture can cause subarachnoid hemorrhage

23. which staphylococci can do mannitol fermaentation?
(urine PAH x urine flow rate)/plasma PAH
S. aureus
Nocardia
CN 4- superior oblique muscle; hydrocephauls and pineal germinomas and defects in that area cause vertical gaze issues (parinaud syndrome etc)

24. hypertonicity and hyperreflexity are ________________ of hydrocephalus
Mesolimbic - mesocortical (behavior); nigrostriatal (coordination of voluntary movements); tuberoinfundibular (inhibition of prolactin); resp: schizophrenia - parkinsonism - hyperprolactinemia
SSRI
manifestations - congenital (stretching of periventricular pyrimadal fibers)
SSRI; erectile dysfunction

25. What three things can reduce the risk of non hereditary ovarian and endometrial cancer?
Pulmonic and systemic!
Shock symptoms (blood loss); amennorhea history; decidualized stroma (hormone changes are exactly the same) but no chorionic villi
Classical conditioning
OCPs - multiparity - breast feeding

26. what presents congenitally as macroglossia - generalized hypotonia - and an umbilical hernia?
RR-1/RR
Aromatase deficiency in child
Hypothyroidism
Purkinje system; AV node

27. What aa is NAD+ coenyzme synthesized endogenously from? What does def cause?
No (unlike adenomyosis); yes
Epinephrine; adrenal medulla; phenylethanolamine N methyltransferase; cortisol
Tryptophan; pellagra (diarrhea - dementia - dermatitis)
Cluster

28. carnitine deficiency impairs production of What and how?
More systemic with cervical lymphadenopathy and fever (in comparison to reactivation)
Bile salt accumulation in urine
Ketone body production by preventing fatty acids into the mitochondria
Lower extremity spasticity due to stretching of periventricular pyrimadal tracts - visual disturbances and learning disabilities

29. what enzyme converts procarcinogens into carcinogens?
AV node slowest - to allow time for diastole
P450 mitochondrial monooxygenase
INTRApartum Abs (ampicillin/penicillin)
P53 suppressor gene phosphorylates cyclin dependent kinase so that it does not phosphorylate Rb protein; chrom 17

30. When does opening snap begin?
PDH - alpha ketoglutarate DH - branched chain DH; lactic acidosis and maple syrup urine disease
Right before diastole (filling begins)
Biphosphonate
G to T in p53; HCC

31. What does hypocapnia cause in teh brain? What is hypocapnia?
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
INTRApartum Abs (ampicillin/penicillin)
The first is involved in fatty acid synthesis; the other is involved in beta oxidation of fatty acids to make ketones (ketone synthesis)
Cerebral vasoconstriction and thus decreased blood flow; decreaed pCO2

32. What is tachyphylaxis?
The term used to describe decreased drug responsiveness with repeated administration
Gluteus maximus; difficulty getting up from seated position and climbing chair
Circular - outside nucleus; transport proteins - rRNA - tRNA
Radial nerve and deep brachial artery

33. a patient fearing all white coats is a phenomenon of what?
External illiac - superficial femora - or common femoral or profunda femoris (ipsilateral); pudendal branches of internal illiac
Anterior circumflex (and axillary nerve)
Headaches and facial flushing; vasodilation in meninges and skin
Classical conditioning

34. What does extended consumption of appetite suppressants lead to?
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)
Anterior and to the right (on the ECG!) of the pulmonary artery; right to left shunt
Right before diastole (filling begins)
Pulmonary hypertension

35. why does neutrophila occur with corticosteroids?
Adeno
Ig A deficiency
Extrinsic def; instrinsic def; platelet def
Demargination of neutrophils from the vessel walls

36. In what form are mitochondrial DNA? What do they transcribe?
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
ANCA because of lack of Ig and C3 deposits on IF
By vascular permeability and vasodilation
Circular - outside nucleus; transport proteins - rRNA - tRNA

37. how does neisseria cause a petechial rash?
Ulcers in esophagus - stomach - or duodenum and high ICP can cause perforation or ulcers in duodenum d/t acute physiologic stress
Barium enema
Neisseria induced small cell vasculitis (including hands and soles)
P53 mutation; AD

38. non ceruloplasmin deposition - ceruloplasmin is...
S. saprophyticus - and s. epidermidis; novobiocin
low in serum
Prostate tumor and increased osteoclast activity
Ketone body production by preventing fatty acids into the mitochondria

39. What is the mcc of nephrotic syndrome in children and can occur in adults as wel?
Covalent (between two cysteines)- allows protein to withstand denaturation
(urine PAH x urine flow rate)/plasma PAH
Minimal change disease
Cooperative play - toilet use; dresses self with help; running without difficulty; complex sentences with pronoun and plural use

40. in the fluid running along the PT - what happens to PAH - inulin - urea - creatinine? how about glucose - aa - bicarb?
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
C3 decreased after 5-10 days; sulfonamides
Chrom 8
Increase; decreased

41. What are some of the permissive effects of cortisol?
Increase; decreased
17 hydroxylase deficiency; pregnelone to 17 hydroxypregnelone
Tibial
Increases bronchial and vascular smooth muscle reactivity to catecholamines

42. what murmur is enhanced by decreased blood flow to the heart?
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)
Increases the systemic vascular resistance and thus reduces the gradient across the LV outflow tract
Single adenomatous ones
ATP binding (resets the myosin head to contract again for next binding)

43. What are the three presentations of ataxia telangectasia? What does the mutation cause? What is the mode of inheritance?
Cerebellar ataxia - telangactasias (in sun exposed areas) - respiratory infections; DNA break repair is damaged; AR
Systolic ejection murmur caused by hypertrophic cardiomyopathy (decreases in LVEDV causes an increase in obstruction)
Insulin like growth factor 1 (just another name)
Because of the low output from heart failure - they will have increased aldosterone levels

44. What type of drug is alendronate?
Biphosphonate
8; 12
RER; RER
Reiter syndrome; B27

45. What type of endocarditis is cytoscopy induced?
OCPs - multiparity - breast feeding
Enterococci (e. faecalis)- found on genitalia area
Boiling - bleach - formalin - UV irradiation
Increases bronchial and vascular smooth muscle reactivity to catecholamines

46. When does neovascularization granulation tissue begin to form after severe ischemia and MI? what happens in 12-24 hours? 2 weeks to 2 months? 1-5 days? 0-4 hours? when do you see edema - hemorrhage - wavy fibers?
indomethacin
10-14 days; coagulation and marginal contraction band necrosis; collagen formation; coagulation necrosis and neutrophilic infiltrate; nothing to see; 4-12 hours
By IgE activation (IgE binds to them as they are in the blood and then bind to Fc receptor on eos)- ADCC
Class I

47. what defines hypoxemia?
SaO2 <92%
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
Cerebral vasoconstriction and thus decreased blood flow; decreaed pCO2
Ketone body production by preventing fatty acids into the mitochondria

48. What is the mc outcome of a patient acutely infected with Hep C? 2nd mc?
Chorda tympani branch
Sarcoid
Stable chronic hepatitis; chronic hepatitis leading to cirrhosis
Curlings ulcers

49. What is the Na/Ca exchange used for?
To pump calcium out in cardiac myocytes so that relaxation occurs
Chrom 8
Dry skin - papilledema - intracranial pressure - alopecia - hyperlipidemia - hepatoxicity - hepatosplenomegaly -
ANCA because of lack of Ig and C3 deposits on IF

50. which RPGN is also called pauci immune GN? why?
RR-1/RR
ANCA because of lack of Ig and C3 deposits on IF
P53 mutation; AD
Common peroneal; bony fractures and compression; sciatic