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USMLE Step I Comprehensive review

This set is a comprehensive review of material covered on the USMLE step I. It can most effectively be used in the familiarization mode or test mode. Use it to create multiple choice tests for yourself

Terms

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Somatomedins
What are the growth factors released from the liver called?
Follicular adenoma
What is the most common one? • Thyroid adenoma
Gastric cancer
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Nitrosamines
Appendix (second is terminal ileum)
What is the most common one? • Site for carcinoid tumors
Topoisomerase I (Relaxase)
What topoisomerase makes ssDNA cuts, requires no ATP, relaxes supercoils, and acts as the swivel in front of the replication fork?
Scrotal cancer, due to the high exposure to polycyclic aromatic hydrocarbons
What cancer is particularly likely to affect English chimney sweeps?
Rectum
What is the most common one? • Site of ulcerative colitis
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
Which three factors cause the release of epinephrine from the adrenal medulla?
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
What are the three epidermal derivatives?
Glucokinase
What glycolytic enzyme has a high Vmax, high Km, and low affinity for glucose?
Humor
Name these mature defense mechanisms: • Easing anxiety with laughter
Stereocilia
What are the long microvilli in the inner ear and male reproductive tract called?
Glutamate
What neurotransmitter inhibits the optic nerve bipolar cell and shuts off in response to light?
Nimodipine
Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?
Positive
Are the following conditions associated with a negative or positive nitrogen balance? • Recovery from injury
Sarcoidosis
A 25-year-old black woman presents with nonproductive cough, shortness of breath, fatigue, and malaise; she has bilateral hilar lymphadenopathy on chest radiography and elevated ACE levels. What do you diagnose?
VIPoma
What pancreatic islet cell tumor is associated with watery diarrhea, hypokalemia, and achlorhydria?
Jejunum (upper)
What area of the GI tract has the highest activity of brush border enzymes?
Cilia
What cell surface modification of ependymal cells and respiratory epithelium has a 9 + 2 microtubular configuration and movement as its function?
If positive, hypotonic urine (osmolarity <300 mOsm/L); if negative, hypertonic urine (osmolarity > 300 mOsm/L)>>
If free water clearance (CH2O) is positive, what type of urine is formed? And if it is negative?
Alveolar macrophages (dust cells)
In the alveoli, what cell type is • part of the mononuclear phagocytic system?
Medial collateral ligament
What structure of the knee is described thus? • Prevents abduction
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
What facultative intracellular fungus is associated with hepatosplenomegaly?
Dyslexia
Name the most common type. • Learning disability
Superego
What Freudian psyche component is described as • The conscience, morals, beliefs (middle of the road)?
Quaternary structure
What structure of a protein describes the interaction among subunits?
Microvillus
What cell membrane structure increases the surface area of a cell and has actin randomly assorted within its structure?
T4; because of the greater affinity for the binding protein, T4 has a significantly (nearly fifty times) longer half-life than T3.
Is there more circulating T3 or T4 in plasma?
Swan-neck deformities
What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
The fasciculus gracilis (Graceful), which lies closest to the midline of the spinal cord.
What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
Filtration is greater than excretion for net reabsorption to occur.
Is filtration greater than or less than excretion for net reabsorption to occur?
Sleep latency
What is the period between going to bed and falling asleep called?
Axis I
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Clinical disorders (e.g., schizophrenia)?
2, 4-Dinitrophenol
What attaches to protons and allows them to enter into the mitochondria without going through the ATP-generating system?
The second pharyngeal pouch and groove
What pharyngeal pouch and groove persist when a pharyngeal fistula is formed?
Ungated potassium channel
Name the ventricular muscle membrane channel: • Always open
Enterococcus faecalis
What is the MCC of the following endocarditis scenarios? • Following biliary infections
Clear cell
What is the most common one? • Renal cell cancer type
Neologisms. Thomas Jefferson noted, "Necessity obliges us to neologize." (Abnormal use of neologisms is known as neolalism.)
What is the term for new made-up words?
Between the renal arteries and at the bifurcation of the abdominal aorta
What is the most common one? • Sites for abdominal aorta aneurysm
L2 to L4 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Obturator nerve
Herpes virus
Name the DNA virus • Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus
Reliability (think of it as "nice grouping" or "precise")
What is the term for the ability of a test to measure something consistently?
Hairy cell leukemia
What B-cell neoplasm is seen in males with massive splenomegaly, produces dry tap on bone marrow aspirations, and stains positive for tartrate-resistant acid phosphatase (TRAP)?
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
In which form of emphysema, panacinar or centriacinar, is the effect worse in the apical segments of the upper lobes?
Postinfectious GN
Name the nephritic disease based on the immunofluorescent staining. • Granular deposits of IgG, IgM, and C3 throughout the glomerulus
Enterokinase
What enzyme is needed to activate the following reactions? • Trypsinogen to trypsin
CLL (B-cell origin)
Which B-cell neoplasm has the following cell surface markers: CD19, CD20, CD5 (T-cell marker), CD23; and are CD10-negative?
True. They absorb nutrients from the host's GI tract.
True or false? Cestodes have no GI tract.
Addition (They are mutually exclusive.)
If one event precludes another event, their probabilities are combined by what method?
The resistance increases 16-fold.
If the radius of a vessel is decreased by half, what happens to the resistance?
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
In the classical conditioning model, when a behavior is learned, what must occur to break the probability that a response will happen?
Ischemia
Name the most common type or cause. • Hypoxia
Vitelline fistula
What is the term for a direct connection between the intestine and the external environment through the umbilicus because the vitelline duct persists?
Epstein-cardiac anomaly of the tricuspid valve
What is the teratogenic effect associated with lithium?
HPV serotypes 6 and 11
Which HPV serotypes are associated with condyloma acuminatum?
Zoophilia
What paraphilia is defined as • Sexual fantasies or practices with animals?
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
What are the three surrogate criteria?
Factor XII for the intrinsic; factor VII for the extrinsic pathway
What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
Listeria monocytogenes
Name the most common type or cause. • Meningitis in renal transplantation patients
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
What cell of the male reproductive system produces testosterone?
Mumps and influenza virus
Which two negative sense RNA viruses have neuraminidase enzymes?
Nigrostriatal pathways (basal ganglia)
Movement disorders are associated with what dopamine pathway (what part of the brain)?
Isoniazid
What antitubercular agent requires vitamin B6 supplementation?
3 ATPs by oxidative phosphorylation
How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?
The resistance will decrease one-sixteenth of the original resistance.
If the radius of a vessel doubles, what happens to resistance?
Both
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Ventral rami?
No, but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Does REM deprivation interfere with performance on simple tasks?
Transcription (C comes before L in the alphabet, and transCription comes before transLation)
What is the term for conversion of a dsDNA molecule to the base sequence of an ssRNA molecule?
Phosphorylation of mannose residues
What signals are used to direct an enzyme to a lysosome?
IVC Remember: 1 at T8, 2 at T10, and 3 at T12
What structure or structures cross the diaphragm at • T8 level?
Somatoform disorder
What disorder is described as having • Unconscious symptoms with unconscious motivation?
Class 1 (1A, 1B, and 1C)
Which class of antiarrhythmics blocks sodium channels?
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. β-Agonists 6. ACh
What are the six substances that promote the secretion of insulin?
Red muscle
What muscle type is characterized by low ATPase activity, aerobic metabolism, myoglobin, association with endurance, and small muscle mass?
Insulin increases total body stores of protein, fat, and CHOs. When you think insulin, you think storage.
What is the effect of insulin on protein storage?
Staphylococcus aureus
Name the most common type or cause. • Pyogenic osteomyelitis
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember, for major articulations, wrist/radius and humerus/ulna = elbow)
Name the bony articulations of the following sites. Be specific. • Wrist
True. Don't forget this list; you will be asked.
True or false? All of the following are risk factors for cervical cancer: multiple pregnancies, early age of intercourse, multiple sexual partners, OCP use, smoking, HIV, and STDs.
Chromosome 5q21
On what chromosome is the adenomatous polyposis coli gene?
1. Sweat glands 2. Arterioles 3. Veins
In what three areas of the body are sympathetics the predominant tone?
Tetralogy of Fallot
Name the most common type or cause. • Cyanotic heart disease
Ischemic
Name the most common type or cause. • Acute tubular necrosis
Gastrinoma
What pancreatic islet cell tumor is associated with MEN I syndrome?
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
What cells of the thyroid gland are stimulated in response to hypercalcemia?
Genomic libraries are made from nuclear DNA, are fragmented, and contain all sequences found in the particular genome copied.
Do genomic or cDNA libraries contain introns, exons, promoters, enhancers, and are they fragmented?
7 to 14 days
What is a plasma cell's life expectancy?
Teratoma (dermoid cyst)
What is the name of the ovarian cyst containing ectodermal, endodermal, and mesodermal elements (i.e., skin, hair, teeth and neural tissue)?
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
Using Laplace's relationship regarding wall tension, why is the wall tension in an aneurysm greater than in the surrounding normal blood vessel's wall?
Kupffer cells
Name the macrophages by location: • Liver
Aldolase B deficiencies are treated by eliminating fructose from the diet.
What fructose metabolism enzyme is deficient in patients with vomiting, apathy, diarrhea, jaundice, proximal renal tubular acidosis, hypoglycemia, and hyperuricemia?
Both
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Spinal nerve?
At least six
How many café-au-lait spots are necessary for the diagnosis of neurofibromatosis type 1?
PTH
What hormone is required for 1, 25-dihydroxy-vitamin D (1, 25-diOH-D) to have bone resorbing effects?
Corticospinal tract
What tract is responsible for voluntary refined movements of distal extremities?
No enzymes are needed. When the stop codon reaches the A site, it results in termination.
What eukaryotic translation enzyme is associated with the following: • Termination
True. Fractures and trauma, however, are the most common causes.
True or false? Sickle cell anemia, Caisson disease, chronic steroid use, and Gaucher disease are causes of avascular necrosis of bone.
Secondary hypoparathyroidism (vitamin D toxicity)
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH decreased, Ca2+ increased, Pi increased
Plasma cell (mature B lymphocyte)
What is the name of the B cell that secretes Ig?
Zero correlation
What type of correlation is defined as • Two variables with no linear relation to one another?
False. Thyroid size is a measure of TSH levels (which are goitrogenic).
True or false? Thyroid size is a measure of its function.
Hypotonia (rag doll appearance)
What is the term to describe the soft, flabby feel and diminished reflexes seen in patients with acute cerebellar injury to the deep cerebellar nuclei?
Middle meningeal artery
Name the cerebral vessel associated with the following vascular pathologies. • Epidural hemorrhage
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
What are the five penicillinase-resistant penicillins?
Motor aspect
What component of the corneal reflex is lost in a CN VII deficit?
True. Remember, the second X chromosome is inactivated, and so is the Barr body. Turner syndrome has only one X chromosome.
True or false? Patients with Turner syndrome have no Barr bodies.
Stage 2, which accounts for approximately 45% of total sleep time, with REM occupying 20%.
Most sleep time is spent in what stage of sleep?
C-peptide levels
What serves as a marker of endogenous insulin secretion?
Autoimmune thrombocytopenia purpura
What type II hypersensitivity disorder is defined as • Autoantibodies directed against platelet integrin?
False. Direct tests detect Ags; indirect tests detect Abs.
True or false? Direct fluorescent Ab test is used to detect Abs in a patient?
Nystagmus is named by the fast component, which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Is nystagmus defined by the fast or slow component?
Affinity (one of each)
What is the term for the strength of the association between Ag and an Ab?
The notochord
What embryonic structure, around day 19, tells the ectoderm above it to differentiate into neural tissue?
Outside the cell
Where is tropocollagen aggregated to form a collagen fibril?
Succinyl CoA synthetase
What enzyme of the TCA cycle catalyzes the production of the following: • GTP
They are in the grey matter of the CNS.
Where are the preganglionic neuron cell bodies, the CNS or the PNS?
LTB4
Which leukotriene—LTA4, LTB4, LTC4, or LTD4—is not associated with anaphylaxis and bronchoconstriction?
Cholera toxin irreversibly activates the cAMP-dependent chloride pumps of the small and large intestine, producing a large volume of chloride-rich diarrhea.
What is the site of action of cholera toxin?
S phase
What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Thioguanine
Serocystadenoma
What is the most common one? • Benign tumor of the ovary
Lesch-Nyhan syndrome
What X-linked recessive disease involves mental retardation, self-mutilation, choreoathetosis, spasticity, a decrease in HGPRT, and an increase in uricemia?
Mean
What is the term to describe the average?
2 to 4 hours
How long is the transit time through the small intestine?
HMG CoA synthase
What is the rate-limiting step of the following? • Ketogenolysis
MEN II and III syndromes
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • et
Rheumatoid arthritis and type 1 diabetes (with HLA-DR3)
What diseases are associated with HLA-DR4
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.
With what thoracic vertebra or vertebrae does rib 7 articulate?
d-Tubocurarine
Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
Schizotypal
Name these cluster A personality disorders: • Odd, strange; has magical thinking; socially isolated, paranoid, lacks close friends; has incongruous affect
True. So are rubeola, smallpox, yellow fever, and the Sabin polio vaccine.
True or false? All of the following are live attenuated vaccines available in the United States: measles, mumps, varicella zoster, and Francisella tularensis.
Chlamydia; gonorrhea is second (Remember, it is mandatory to report STDs to the CDC.)
What is the most common disease or infection reported to the CDC?
Repression
Unconsciously forgetting(forgetting that you forgot something!)
Squamous cell carcinoma
What is the most common one? • Cancer of the vulva
Wiskott-Aldrich syndrome
What X-linked recessive immune disorder is characterized by recurrent infections, severe thrombocytopenia, and eczema?
False. Increased LAP is seen in stress reactions and helps differentiate benign conditions from CML, which has low LAP levels.
True or false? Increased leukocyte alkaline phosphatase (LAP) is associated with CML.
Borderline
Name the cluster B personality disorder: • In a constant state of crisis, promiscuous, unable to tolerate anxiety-causing situations, afraid of being alone, and having intense but brief relationships
Pulmonary shunt (i.e., pulmonary embolism)
What does failure of PaO2 to increase with supplemental O2 indicate?
Low interstitial free Ca2+ concentrations
What is the only important physiological signal regulating the release of PTH?
Hypocalcemia and hypophosphatemia
1-α-Hydroxylase activity is increased in response to what two physiologic states? (hint: think of vitamin D activity)
Cytochrome a/a3
What component of the ETC is inhibited by the following? • Cyanide
Indirect or unconjugated
What type of bilirubin is found in neonatal jaundice?
HTLV-1
What retrovirus is associated with adult T-cell leukemia?
Rigors, leukopenia, decrease in blood pressure, and increase in temperature
What is the tetrad of Jarisch-Herxheimer reaction?
Kidney
What is the most common organ involved in amyloidosis?
Streptococcus agalactiae
Describe the organism based on the following information: • Beta-Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate
DNA polymerase-δ
Name the eukaryotic DNA polymerase based on the following information: • Synthesizes the leading strand during replication
Increase the concentration of enzymes
What is the only way to increase the Vmax of a reaction?
Recall bias. These problems arise in retrospective studies.
Failure to accurately recall the past leads to what form of bias?
It forms a germinal tube at 37°C.
What does Candida albicans do that distinguishes it from other fungi?
Uracil
What pyrimidine base is found • Only in RNA?
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
What hormone, produced by the granulose cell, stimulates the endometrium to enter the proliferative phase?
Streptococcus pneumoniae
What is the MCC of the following meningitides? • In adults
Avoidant
Name the cluster C personality disorder: • Sensitive to criticism, shy, anxious; socially isolated but yearns to be in the crowd
Motor
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Ventral root?
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
What is the term to describe a man who has • Used to be able to achieve an erection but now cannot?
Oncotic pressure increases because of the removal of water.
What happens to capillary oncotic pressure with dehydration?
4.5 years old (Alphabetic order except with a diamond last: circle, cross, rectangle, square, triangle)
By what age should children be able to draw the following figures? • Rectangle
Public speaking (Remember: stage fright)
Name the most common type. • Specific phobia
G-C rich sequences, because they have 3 hydrogen bonds, where A-T has 2 hydrogen bonds, resulting in higher melting points.
Would a G-C or an A-T rich dsDNA sequence have a higher melting point? Why?
16S subunit
What part of the 30S ribosome binds to the Shine-Dalgarno sequence?
Ileum
What area of the small intestine is characterized by Peyer's patches?
The left gastric, splenic, and common hepatic arteries
What are the three branches of the celiac trunk?
5 years old
By what age should children be able to draw the following figures? • Square
TRUE
True or false? Dopamine antagonists at the D2A receptor have the capacity to induce pseudoparkinsonism.
Yersinia pestis
What small coagulase-positive, gram-negative rod with bipolar staining is a facultative intracellular parasite resulting in buboes?
Selective erectile disorder
What is the term to describe a man who has • The ability to have an erection sometimes and other times not?
IgA
Which immunoglobulin is secreted by the plasma cells in the gastrointestinal tract?
Fever, night sweats, and hemoptysis
What is the classic triad of TB?
Graves disease
What disease has IgG autoantibodies, occurs in women more than men, and includes exophthalmos, pretibial myxedema, nervousness, heart palpitations, and fatigue?
Acetyl CoA carboxylase
What enzyme catalyzes the rate-limiting step in fatty acid synthesis?
School phobia
To what does failure to resolve separation anxiety lead?
CD40
Name the B-cell CD marker: • Required for class switching signals from T cells
Anopheles mosquito
What mosquito is responsible for the transmission of malaria?
Type I pneumocytes
In the alveoli, what cell type is • for gas exchange?
Primary follicle of the cortex
What is the name of the B cell-rich area in the lymph node?
RSV
Name the most common type or cause. • Viral pneumonia leading to death
Nominal scale (categorical, e.g., male or female)
What scale separates things into groups without defining the relationship between them?
>3.5 g/day of protein, along with generalized edema, hypoalbuminemia, and hyperlipidemia
How many grams of protein must be excreted in 24 hours to produce the diagnosis of nephrotic syndrome?
Nondominant parietal lobe
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Denial of illness, hemineglect, construction apraxia (can't arrange matchsticks)
ACE inhibitors (the-pril agents)
Which class of antihypertensives produces angioedema, hyperkalemia, and a dry cough?
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g., long bone fracture)
What is the triad of fat embolism?
Shortens
What happens to the following during skeletal muscle contraction? • Sarcomere
Sjogren's syndrome, active hepatitis, systemic lupus erythematosus (with HLA-DR2) and type 1 diabetes (with HLA-DR4)
What diseases are associated with the HLA-DR3 allele
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Left common carotid artery
Howell-Jolly bodies
What is the term for RBC remnants of nuclear chromatin in asplenic patients?
1. Cytosine 2. Uracil (only in RNA) 3. Thymidine
What three bases are pyrimidines?
Alanine and glutamine
As what AAs do muscles send nitrogen to the liver?
Hepatoma and nonseminomatous testicular germ cell tumors
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • alpha-Fetoprotein
C5-C8 deficiency
What complement factor deficiency leads to • Recurrent gonococcal infections?
Loss of isotonic fluid (diarrhea, vomiting, hemorrhage)
Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, decrease; ICF, no change; body, no change
Phase 3
Name the phase of the ventricular muscle action potential based on the following information: • Slow channels close, voltage-gated potassium channels reopen with a large influx of potassium, and the cell quickly repolarizes
Amyl nitrate, sodium nitrate, or sodium thiosulfate
Name the antidote. • Cyanide
Proportionate mortality rate
What type of mortality rate is defined as the number of deaths • From a specific cause per all deaths?
Spasms of the uterus, bladder, and the biliary tree occur with all of the opioids except meperidine.
A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose?
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
When does the hydrostatic pressure in Bowman's capsule play a role in opposing filtration?
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Cervical vertebrae?
Thyroarytenoid muscles
Name the laryngeal muscle described by the following: • Pulls the arytenoids cartilages closer to the thyroid, relaxing the vocal ligaments and thereby decreasing the pitch
Calcitriol
What hormone is characterized by the following renal effects? • Calcium excretion, phosphate excretion
1. Concentration (greater concentration gradient, greater diffusion rate) 2. Surface area (greater surface area, greater diffusion rate) 3. Solubility (greater solubility, greater diffusion rate) 4. Membrane thickness (thicker the membrane, slower the diffusion rate) Molecular weight is clinically unimportant
What four factors affect diffusion rate?
Type II hypersensitivity (cytotoxic)
Name the type of hypersensitivity reaction based on the following properties. • IgG or IgM Abs against a specific target cell or tissue; complement-dependent or ADCC.
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Lateral ventricles
Both
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal rami?
Legionella
What bacterium is diagnosed using the Dieterle silver stain?
Gaucher disease
What disorder is due to a deficiency in the enzyme glucocerebrosidase?
Bronchioloalveolar carcinoma
What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
Ostium secundum defects
What is the most common one? • Type of ASD
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
How many ATPs are generated per acetyl coenzyme A (CoA)?
Alcoholics Anonymous
What is the name of the 12-step program believed to be the most successful for the treatment of alcohol abuse?
The β-subunit; remember, the α-subunit is nonspecific.
What subunit of hCG is used to detect whether a patient is pregnant?
Left heart failure
Name the most common type or cause. • Right heart failure
Paget disease of the breast
What breast pathology involves malignant cells with halos invading the epidermis of the skin?
Borrelia recurrentis
Which organism causes multiple infections by antigen switching?
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
What tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum, helping monitor and modulate muscle movements?
First-pass effect
When a drug is administered orally and enters into portal circulation, it undergoes hepatic metabolism. What is the name of this effect?
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
What test is done to diagnose CGD?
Neuroblastoma
What is the most common one? • Solid tumor in children
Hepatitis B and hepatitis C
What are the two hepatitis viruses that can be chronic and can lead eventually to hepatocellular carcinoma?
Dantrolene
Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
Triazolam
Which benzodiazepine has the shortest half-life?
Umbilical vein and ductus venosus (80%)
What two vessels in fetal circulation have the highest PO2 levels?
Infiltrating ductal carcinoma
What is the most common one? • Histologic variant of breast cancer
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse, hyperreflexia, spastic paralysis, increased muscle tone, and weakness are commonly seen in UMN lesions.
What reflex, seen in lesions of the corticospinal tract, is an extension of the great toe with fanning the of remaining toes?
GABA, quantitatively
What is the most common one? • Neurotransmitter in the brain
Nephrotoxicity
What toxicities are caused by the following agents? • Methoxyflurane
Dominant parietal lobe (Gerstmann's syndrome)
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Agraphia, acalculia, finger agnosia, right-left disorientation
1. Sartorius 2. Gracilis 3. Semitendinous
What three muscles constitute the pes anserinus?
Propofol
Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
Ventricular contraction Atrial, Contraction, Venous
On the venous pressure curve, what do the following waves represent? • C wave?
Arsenic
Name the most common type or cause. • Acute metal poisoning in the United States
P = .05; P < .05 rejects the null hypothesis
What P value defines whether the hull hypothesis should or should not be rejected?
Squamous cell carcinoma
What is the most common one? • Malignant tumor of the esophagus
H 1
Are the following responses associated with histamines H1 or H2 receptor activation? • Edema
Curling ulcers (think curling iron = burn)
What is the term for gastric ulcers associated with severely burned or traumatic patients?
Emphysematous bleb
Name the most common type or cause. • Spontaneous pneumothorax
Osteosarcoma
Codman triangle on radiograph
Conidia
What type of spore is asexual and formed of hyphae?
Hemophilia B
What form of hemophilia is X-linked recessive and is due to a deficiency in factor IX?
>15 mm
What is the size of a positive PPD test for the following? (Reactive) • Healthy suburban male without any medical illnesses
Cirrhosis and hemolytic anemia, which are risk factors for pigmented gallstones.
Which of the following is not a risk factor for cholesterol gallstones: pregnancy, OCP use, female gender, hemolytic anemia, cirrhosis, and obesity? (May be more than one answer.)
Dilation of efferent arteriole
What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↓, RPF ↑, FF ↓, capillary pressure ↓
Thoracic splanchnic fibers
What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Good Samaritan Law. (Physicians are not required to stop and help.)
What law was adopted to shield physicians from liability when helping at the scene of an accident?
Shine-Dalgarno sequence
In prokaryotes, what is the name of the RNA sequence that ribosomes bind to so translation can occur?
50%. The uncles and older siblings are the most likely perpetrators, although stepfathers also have a high rate.
What percent of sexual abuse cases are committed by family members?
Meningocele All except occulta cause elevated-fetoprotein levels.
Name the form of spina bifida. • Meninges project through a vertebral defect
Alendronate
What is the drug of choice for steroid-induced osteoporosis?
Sympathetic chain ganglion
What ganglion receives preganglionic sympathetic fibers from T1 to L1-2 and innervates smooth muscle, cardiac muscle, glands, head, thoracic viscera, and blood vessels of the body wall and limbs?
The inner membrane of the mitochondria (cristae)
Where are the enzymes for the ETC and oxidative phosphorylation found?
Riedel thyroiditis
What rare disorder presents as a large, hard, irregular thyroid gland due to fibrous proliferation of connective tissue in the thyroid gland and extends to adjacent structures?
Direct pathway; a good example is Parkinson's disease.
In what pathway of the basal ganglia do lesions result in an underactive cortex with hypokinetic, slow, or absent spontaneous movement?
Silent
Name the type of mutation: • New codon specifies for the same AA
Adenine and guanine
Name the two purine bases found in both DNA and RNA.
Splenic flexure
What is the most common one? • Site of ischemia in the GI tract
Medial nuclear group (limbic system)
Name the thalamic nucleus based on its input and output. • Input from the amygdala, prefrontal cortex, and temporal lobe; output to the prefrontal lobe and the cingulated gyrus
Euchromatin, the dark stuff in the nucleus on an electron microscope image.
What type of chromatin is transcriptionally active?
RNA polymerase III
Name the eukaryotic RNA polymerase based on the following: • Synthesizes tRNA, snRNA, and the 5S rRNA
Mean corpuscular hemoglobin (MCH)
What is the name for the following RBC indices? • Average mass of the Hgb molecule/RBC
MHC class II Ags. This is accomplished via CD4 T cells.
What MHC class acts to remove foreign Ags from the body?
Decreasing potassium conductance, which results in increased excitability
What triggers phase 4 of the action potential in a ventricular pacemaker cell?
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
What three substrates control the enzyme PEPCK for the conversion of oxaloacetate (OAA) to pyruvate in the cytoplasm?
Necator americanus is treated with mebendazole and iron therapy.
What nematode is known as hookworms? What is the treatment?
CHF
What is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs?
Water-soluble hormones are considered fast-acting hormones.
What form of hormone is described as having membrane-bound receptors that are stored in vesicles, using second messengers, and having its activity determined by free hormone levels.
Pearson correlation
What type of correlation compares two interval variables?
Breast cancer
What do the risk factors late menopause, early menarche, obesity, nulliparity, excessive estrogen, genetic factor p53, and brc-abl characterize?
Acetaldehyde dehydrogenase. When this enzyme is blocked, acetaldehyde builds up, and its presence in excess results in nausea and hypotension.
What enzyme is inhibited by disulfiram?
Priapism
What are the pharmacologic effects seen sexually with • Trazodone?
Duodenal atresia
What is the name for failed recanalization of the duodenum resulting in polyhydramnios, bile-containing vomitus, and a distended stomach?
Vitamin D3
What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate reabsorption
Water
What is absorbed in the gallbladder to concentrate bile?
Limbic system
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Apathy, aggression, inability to learn new material, and memory problems
CD4+T cells
Development of what T cell line follows low affinity for self-MHC class II Ags in the thymus?
Constipation and miosis
What are the two side effects of opioids to which the user will not develop tolerance?
1. 7-methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
What are the three posttranscriptional modifications?
Squamous cell carcinoma
What bronchogenic carcinoma is associated with an elevated level of Ca2+, involves keratin pearls, occurs in men more than women, is associated with smoking, occurs in the major bronchi, and is seen in the central areas of the lung?
Rhinoviruses for summer and fall; coronaviruses for winter and spring
Which virus is the MCC of a cold in the summer and fall? Winter and spring?
The fastigial nucleus
What deep cerebellar nuclei receive Purkinje cell projections in • The vermis?
Superego
According to Freud, what facet of the psyche represents the internalized ideals and values of one's parents?
Prostatic carcinoma
What adenocarcinoma presents with elevated levels of acid phosphatase, dihydrotestosterone, PSA, and bone pain?
Hepadnavirus
What is the only DNA virus that has the reverse transcriptase enzyme?
Aldehyde dehydrogenase
What enzyme is blocked by disulfiram?
Ependymoma
What is the most common one? • Intraspinal tumor
The DCML system. (Remember, everything but pain and temperature.)
What ascending sensory system carries joint position, vibratory and pressure sensation, and discriminative touch from the trunk and limbs?
Lateral part of the hemispheres
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Is involved in motor planning?
The entire tubule barring the thick ascending limb
What is the site of action of the following? • Osmotic diuretics
Tay-Sachs disease
What condition results from a deficiency in the enzyme hexosaminidase A?
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
What is the only laryngeal muscle innervated by the external laryngeal nerve?
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
What thyroid abnormality has the following? • TRH increased, TSH decreased, T4 decreased
In the PNS, myelin is produced by Schwann cells, in the CNS by oligodendrocytes.
Myelin is produced by which cells in the PNS? In the CNS?
Osteoporosis
What is the most common one? • Bone disorder in the United States
Left anterior descending artery
What artery travels with the following veins? • Great cardiac vein
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
What percentage of cardiac output flows through the pulmonary circuit?
Asparagine
What AA undergoes N-glycosylation?
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
What three structures increase the surface area of the GI tract?
Myasthenia gravis
A 20-year-old woman goes to the ER with ptosis, diplopia, weakness in her jaw muscles when chewing, and muscle weakness with repeated use. What is your diagnosis?
Introjection (a sports fan is a good example)
Name these immature defense mechanisms: • Taking others' beliefs, thoughts, and external stimuli and making them part of the self. (Hint: if it's done consciously, it is called imitation.)
Necrophilia
What paraphilia is defined as • Having sex with cadavers?
1:1. Remember, the flow through the pulmonary circuit and the systemic circuit are equal.
What is the ratio of pulmonary to systemic blood flow?
Sigma factor
What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA?
M:F 4:1 committing, but M:F ratio of attempts is 1:3 (males commit more but females try it more)
What is the male-to-female ratio for committing suicide?
Niacin (B3)
What water-soluble vitamin deficiency results in pellagra?
Transtentorial (uncal)
Which type of cerebral herniation is associated with CN III palsy?
Thick skin
What skin type on the palms and soles is characterized by the absence of hair follicles and presence of stratum lucidum?
It causes a buildup of dATP, which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate, a precursor of DNA, resulting in overall bone marrow suppression.
How can a deficiency in adenosine deaminase be a bone marrow suppressor?
Dilator pupillae muscle
Which muscle of the eye is under sympathetic control?
Left posterolateral side of the diaphragm, usually resulting in pulmonary hypoplasia.
What is the most common one? Site of congenital diaphragmatic hernias
Juxtaglomerular (JG) cell
What cell of the nephron is responsible for renin production and secretion?
Mentally disabled
What is the label given to an individual whose IQ is • Below 69
Acute glomerulonephritis
RBC casts in the urine
Anterior compartment of the thigh, femoral nerve
Name the compartment of the lower extremity and the nerve based on its movements. • Flex the hip and extend the knee
Diabetes mellitus
Name the most common cause. • Blindness in the United States
Impotence
What are the pharmacologic effects seen sexually with • β-Blockers?
Isocitrate dehydrogenase, α-ketoglutarate dehydrogenase, and malate dehydrogenase
What enzyme of the TCA cycle catalyzes the production of the following: • NADH (hint: 3 enzymes)
Dihydrofolate reductase
What enzyme is inhibited by trimethoprim?
Neomycin
Which aminoglycoside is used only topically because it is too toxic for systemic use?
Frontal eye field (Brodmann area 8)
What area of the brain acts as the center for contralateral horizontal gaze?
cDNA, when it is made from mRNA
What form of continuous DNA, used in cloning, has no introns or regulatory elements?
Indirect pathway (Tourette syndrome for example)
In what pathway of the basal ganglia do lesions result in hyperactive cortex with hyperkinetic, chorea, athetosis, tics, and dystonia?
Right-sided
Is jugular venous distention a presentation of isolated left or right heart failure?
alpha-Motor neurons innervate extrafusal muscle fibers (a motor unit), whereas gamma-motor neurons innervate intrafusal muscle fibers.
Do alpha-or gamma-motor neurons innervate extrafusal muscle fibers?
Masochism
What paraphilia is defined as • Deriving sexual pleasure from being abused or in pain?
ACL
What structure of the knee is described thus? • Prevents anterior displacement and has lateral-to-medial attachment on the tibia
Succinyl CoA synthetase
What enzyme of the TCA cycle catalyzes the substrate level phosphorylation?
Prevalence rate
What is the term for the number of individuals who have an attribute or disease at a particular point in time?
Acute tubular necrosis
Name the most common type or cause. • Acute renal failure in the United States
PGE (along with low oxygen tension)
What prostaglandin is associated with maintaining patency of the ductus arteriosus?
Keloid
What is the term for an abnormal amount of collagen type III that produces a large bulging scar, seen primarily in blacks?
GM2 ganglioside Caused by a deficiency of β-hexosaminidase A
What substrate builds up in Tay-Sachs disease?
Massive influx of calcium
Influx of what ion is associated with irreversible cell injury?
L2 to L4 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Femoral nerve
Cholesterolosis
What condition results in a strawberry gallbladder?
Amiloride
Which sodium channel blocker is used to treat lithium-induced diabetes insipidus?
Flutamide
What androgen receptor blocker is used in the treatment of prostatic cancer?
Renin
What substance do the JG cells of the kidney secrete in response to low blood pressure?
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Nitrosoureas
Brushfield spots
What is the term for the speckled appearance of the iris in patients with Down syndrome?
Leucine and lysine
What are the two ketogenic AAs?
Sheehan syndrome
Name the most common type or cause. • Panhypopituitarism
Loose association
What is the term to describe jumping from one topic to the next without any connection?
True. Without ADH hypotonic urine would be formed.
True or false? Without ADH the collecting duct would be impermeable to water.
A loss of afferent activity indicates a decrease in BP, and an increase in afferent activity indicates an increase in BP.
What does a loss of afferent activity from the carotid sinus onto the medulla signal?
Succinate dehydrogenase
What enzyme of the TCA cycle catalyzes the production of the following: • FADH2
HBcAb and HBeAb. You see the antibodies c and e.
In the window phase of a hepatitis B infection, which Abs do you see?
CD28
Name the T-cell CD marker: Is a costimulatory molecule in T cell activation
Trapezius and sternocleidomastoid
What two muscles do you test to see whether CN XI is intact?
Increased CO2, H+, temperature, and 2, 3-BPG levels all shift the curve to the right, thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.
What four factors shift the Hgb-O2 dissociation curve to the right? What is the consequence of this shift?
Procainamide
What class 1A antiarrhythmic agent has SLE-like syndrome side effect in slow acetylators?
MGN
Name the most common type or cause. • Nephritic syndrome in adults
Major
Are the following major or minor Jones criteria of rheumatic fever? • Erythema marginatum
Streptococcus agalactiae and Escherichia coli
What is the MCC of the following meningitides? • In neonates to 3 months of age
Vitamin D
What causes an increase in bone mineralization and Ca2+ along with PO4- absorption from the GI tract and kidney tubules?
Small cell cancer of the lung
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • L-myc
Autograft
Name the type of graft described by these transplants: • From one site to another on the same person
Osteoblasts, which in turn stimulate osteoclasts to break down bone, releasing Ca2+ into the interstitium. (Remember, blasts make, clasts take.)
What cell type of the bone has PTH receptors?
Functional residual capacity (FRC)
Name the lung measurement based on the following descriptions: • Volume in the lungs at the end of passive expiration
Adult tapeworms develop in the definitive host, whereas cysticerci or larvae develop in the intermediate host.
Where do adult tapeworms develop, in the intermediate or definitive host?
Osteoclasts
Name the macrophage based on its location: • Bone macrophages
90% of benign myxomas arise within the left atrium near the fossa ovalis.
What is the most common cardiac tumor? In what chamber does it most commonly arise?
CD4+ T cells (helper)
What subset of T cells recognizes the MHC class II Ags?
PRPP aminotransferase
What enzyme of purine synthesis is inhibited by allopurinol and 6-mercaptopurine?
Phentolamine and phenoxybenzamine
What mixed α-antagonists are used for patients with pheochromocytoma?
The lateral vestibular nucleus
What deep cerebellar nuclei receive Purkinje cell projections in • The flocculonodular lobe?
Mumps
Name the most common cause. • Infectious pancreatitis
IgA
What Ig is associated with mucosal surfaces and external secretions?
Pseudohyphae
What is the term for hyphae with constrictions at each septum that are commonly seen in Candida albicans?
Copper deficiency
What mineral deficiency involves blood vessel fragility?
Eosinophil chemotactic factor A
What mast cell mediator is a chemotactic agent?
Homocysteine methyl transferase and methylmalonyl CoA transferase
What two enzymes are vitamin B12-dependent
False. Interferons are produced by virally infected cells to inhibit viral replication via RNA endonucleases. They do not act directly on the virus, nor are they virus specific.
True or false? Interferons are eukaryotic proteins that inhibit viral replication by being virus specific.
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Which class of diuretics is used to treat metabolic acidosis, acute mountain sicknesses, and glaucoma and to aid in the elimination of acidic drug overdoses?
True. They are also necessary for normal brain maturation.
True or false? Thyroid hormones are necessary for normal menstrual cycles.
Carcinoid tumor
What neuroendocrine tumor produces excess serotonin; is associated with diarrhea, flushing, bronchospasms, wheezing; and is diagnosed by findings of elevated urinary 5-HIAA levels?
DM, hypercholesterolemia, smoking, and HTN are major risk factors. Being male, obesity, sedentary lifestyle, homocysteine elevation, oral contraceptive pills, and genetics are minor risk factors for atherosclerosis.
Name four major risk factors for atherosclerosis.
They are in ganglia in the PNS.
Where are the postganglionic neuron cell bodies, the CNS or the PNS?
Adrenal medulla
What is the only organ in the body supplied by preganglionic sympathetic fibers?
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
What is pumped from the lumen of the ascending loop of Henle to decrease the osmolarity?
Excision endonuclease, which removes thiamine dimers from DNA
What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
Penicillamine, EDTA (calcium disodium edetate), or dimercaprol
Name the antidote. • Lead
Chromosome 15
Name the associated chromosome. • Marfan disease
The rate of β-oxidation
What regulates the rate of ketone body formation?
Aminoacyl-tRNA synthetase, which uses 2 ATPs for this reaction.
What enzyme catalyzes the covalent bonding of the AA's carboxyl group to the 3' end of tRNA?
Aortic stenosis
Name the valve abnormality based on the following criteria: • Systolic murmur, increased preload and afterload, decreased aortic pulse pressure and coronary blood flow
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
What hormone controls relaxation of the lower esophageal sphincter during swallowing?
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
After traveling in a plane across the Atlantic Ocean, an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
True. Restriction endonucleases cut only unmethylated DNA.
True or false? Methylation of bacterial DNA prevents restriction endonuclease from cutting its own chromosomes.
Catalase-negative bacteria secrete H2O2 as a byproduct (remember, catalase breaks down H2O2), allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase-positive bacterial infections.
Why are patients with Chronic Granulomatous Disease not prone to develop infections from catalase-negative bacteria?
The limbic system
What area of the brain is responsible for emotion, feeding, mating, attention, and memory?
The inner cortex (paracortex) contains the T cells, so it is considered the thymic-dependent area.
What area of the lymph node is considered the thymic-dependent area?
Phenylalanine hydroxylase
What enzyme is deficient in patients with PKU?
Acanthosis nigricans
What is the term for thickened, hyperpigmented skin in the axillae, groin, and skin folds associated with malignancies, obesity, and DM?
Severe combined immunodeficiency disease
What disease involves a lack of both T cell-mediated and humoral immune responses that can be either X-linked or AR?
LVEDV and LVEDP (left ventricular end-diastolic volume and end-diastolic pressure, respectively)
What are the two best indices of left ventricular preload?
Rationalization
Name these anxiety defense mechanisms: • Use of explanations to justify unacceptable behaviors.
Remember the mnemonic PAM SMIDT P, (hyper) Parathyroid/ Paget disease A, Addison's disease M, Milk-alkali syndrome/metastatic cancer S, Sarcoidosis M, Multiple myeloma I, Immobilization/idiopathic D, Vitamin D intoxication T, Tumors
Name at least three causes of metastatic calcification.
Filovirus
What family do the following viruses belong to? • Ebola
Pompe's disease
What glycogen storage disease is due to the following enzyme deficiencies? • Lysosomal glucosidase (acid maltase)
Metaphase of meiosis II (in the oocyte of the graafian follicle)
What is the second arrested stage of development in the female reproductive cycle?
Labetalol
What β-blocker is also an α-blocker?
Incidence rate
What is the term for the number of new events occurring in a population divided by the population at risk?
>10 mm
What is the size of a positive PPD test for the following? (Reactive) • Recent immigrant from India
Myelofibrosis with myeloid metaplasia
What myeloid disorder is characterized by dry bone marrow aspirations, splenomegaly, leukoerythroblastosis, teardrop RBCs, and hyperuricemia due to increased cell turnover?
Posterior chamber
What chamber of the eye lies between the iris and the lens?
During stage 3 and 4 (remember, it is called deep sleep.)
In what stage of sleep is it hardest to arouse a sleeping individual?
Intrinsic factor (IF)
What substance is secreted by parietal glands and is required for life?
Hematoxylin
Do the following structures pick up stain from hematoxylin or eosin? • Nuclei
First pharyngeal groove; all others degenerate.
From what pharyngeal groove is the external auditory meatus derived?
Tetany
What is the term for the summation of mechanical stimuli due to the skeletal muscle contractile unit becoming saturated with calcium?
Variable interval
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • Varying in time?
Alternative hypothesis (what is left after the null has been defined)
What is the name of the hypothesis you are trying to prove?
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
If you order a V/Q scan for suspected pulmonary emboli, is the filling defect seen on the ventilation or perfusion side?
Type II pneumocytes
In the alveoli, what cell type is • responsible for producing surfactant?
Chlamydia
Name the most common reported STD. • In females
In the dorsal horn of the spinal cord on the primary afferent neurons
Where in the spinal cord are the presynaptic opioid receptors?
HPVs 16 and 18
What viruses are associated with cervical carcinoma?
NO!! Remember, only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Can a physician commit a patient?
Vitamin C
What water-soluble-vitamin deficiency is associated with poor wound healing, easy bruising, bleeding gums, anemia, and painful glossitis?
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions, and only cells with bound Ag undergo clonal expansion
What are the three rules of clonal selection?
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
What are the three branches of the lateral cord of the brachial plexus?
Ticlopidine or clopidogrel
Name one of the ADP receptor antagonists used in patients who are post-MI, have had TIAs, have unstable angina, and are allergic to ASA?
Pyruvate, acetyl CoA, and propionyl CoA carboxylase
What are the three carboxylase enzymes that require biotin?
Repaglinide
What oral hypoglycemic agent stimulates pancreatic β-cell release of insulin and is given just prior to meals because of its short half-life?
Pituitary adenoma
Name the most common type or cause. • Cushing syndrome
Temporal arteritis
What is the most common one? • Form of vasculitis
S phase
What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Mercaptopurine
snRNA
Name the RNA subtype based on the following: • Found only in the nucleus of eukaryotes and functions to remove introns from mRNA
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)
What area of the brain serves as the major sensory relay center for visual, auditory, gustatory, and tactile information destined for the cerebral cortex, cerebellum, or basal ganglia?
GH, especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
What hormone has the following effects: chondrogenic in the epiphyseal end plates of bones; increases AA transport for protein synthesis; increases hydroxyproline (collagen); and increases chondroitin sulfate synthesis?
Primitive neuroectodermal tumors (i.e., medulloblastomas and retinoblastomas)
What highly undifferentiated aggressive CNS tumor of primordial neuroglial origin develops in children and is associated with pseudorosettes?
NH4+(ammonium)
What acid form of H+ in the urine cannot be titrated?
Metabolic rate and alveolar ventilation (main factor)
What are the two factors that affect alveolar PCO2 levels?
ACh, histamine, and gastrin
What three substances stimulate parietal cells?
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
What two vessels come together to form the external jugular vein?
Insulin
What hormone is secreted into the plasma in response to a meal rich in protein or CHO?
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage, removing the causative agent, and giving cyproheptadine.
What syndrome is characterized by sweating, insomnia, nausea, diarrhea, cramps, delirium, and general restlessness secondary to MAOI and SSRI in combination?
Coxiella burnetii
What organism causes Q fever?
Ependymoma
What is the most common one? • Intramedullary spinal cord tumor in adults
Somatization
Name these immature defense mechanisms: • Psychic feelings converted to physical symptoms
Adult polycystic kidney disease
What AD renal disorder is associated with mutations of the PKD 1 gene on chromosome 16 and berry aneurysms in the circle of Willis and presents in the fifth decade with abdominal masses, flank pain, hematuria, HTN, and renal insufficiency?
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Why are eukaryotes unable to perform transcription and translation at the same time like prokaryotes?
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see, can't wee, can't kick with your knee
What is the triad of Reiter syndrome?
Atropine and 2-PAM (pralidoxime)
What is the antidote for organophosphate ingestion?
>5 mm
What is the size of a positive PPD test for the following? (Reactive) • Posttransplantation patient taking immunosuppressive agents
Total and NREM sleep decrease considerably as we age, but REM sleep remains relatively constant (20%) up to age 80, then begins to decline.
In the elderly, what happens to total sleep time, percentage of REM sleep, and percentage of NREM sleep?
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
True. IQ correlates well with education and academic achievement but is not a predictor of success.
True or false? There is a strong positive correlation between IQ and academic achievement.
Type III hypersensitivity (immune complex)
Name the type of hypersensitivity reaction based on the following properties. • Circulating Ab-Ag immune complexes deposited in the tissue result in neutrophil attraction and the release of lysosomal enzymes.
A high-resistance system is formed when resistors are added in a series.
What type of resistance system, high or low, is formed when resistors are added in a series?
Thymine
What pyrimidine base is found • Only in DNA?
Primary erectile disorder
What is the term to describe a man who has • Never been able to achieve an erection?
Asbestosis
What pneumoconiosis is associated with exposure to the following occupations or materials? • Shipyards, brake linings, insulation, and old building construction
3 years old
By what age should children be able to draw the following figures? • Circle
LTC4 and LTD4
Which leukotrienes are associated with the late-phase inflammatory response?
Yolk sac tumor
What is the most common one? • Testicular tumor in infants and children
Helicase (requires ATP for energy)
What DNA replication enzyme breaks the hydrogen bond of base pairing, forming two replication forks?
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
What Ig is associated with mast cell and basophil binding?
Resistance decreases as resistors are added in parallel.
In a parallel circuit, what happens to resistance when a resistor is added in parallel
Apneustic center (deep breathing place)
What respiratory center in the caudal pons is the center for rhythm promoting prolonged inspirations?
Waldenström's macroglobulinemia
What lymphoma is associated with bleeding and cryoglobulin precipitation at low temperatures, headache and confusion due to hyperviscosity, IgM M-protein spike on serum electrophoresis, and Russell bodies?
Chromomycosis
What fungus is seen as colored cauliflower lesions?
Residual volume
What is the term for the amount of blood in the ventricle after maximal contraction?
First-order elimination
What type of drug elimination is characterized by the following? • Elimination directly proportional to plasma level; constant fraction eliminated per unit time; fixed half-life
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:-ili-in ciliary ganglion looks like the III of CN III.)
What is the name of the postganglionic parasympathetic ganglion that innervates • The papillary sphincter and ciliary muscle of the eye?
Infliximab
What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis?
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
Porcelain gallbladder
What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
True. Increased renin and AT II levels occur as a result of the decreased production of aldosterone.
True or false? Renin secretion is increased in 21-β-hydroxylase deficiency.
A wave
What wave is the cause of the following venous pulse deflections? • The contraction of the right atrium
PICA
What branch off the vertebral artery supplies • The cerebellum and the dorsolateral part of the medulla?
Severe (range 20-34)
What level of mental retardation is characterized by • Having the ability to communicate and learn basic habits but training is usually not helpful?
Rickets
What childhood pathology involves anterior bowing of the tibia, epiphyseal enlargements, and costochondral widening, with the endochondral bones being affected?
Specificity (it deals with the healthy)
What is the statistical term for the proportion of truly nondiseased persons in the screened population who are identified as nondiseased?
Areas 18 and 19
What Brodmann area is associated with • Visual association cortex?
ACh receptor
To what host cell receptor does the rabies virus attach?
True. Don't forget this in your differential diagnosis of an asthmatic.
True or false? GERD is a cause of asthma.
Surface tension; in the alveoli, it is a force that acts to collapse the lung.
What is the greatest component of lung recoil?
Atrial contraction Atrial, Contraction, Venous
On the venous pressure curve, what do the following waves represent? • A wave?
Clavicle, acromion, and glenoid fossa of the scapula and the humerus
Name the bony articulations of the following sites. Be specific. • Shoulder
Lactose must be present and glucose must be absent
What two requirements must be met for the Lac operon to be activated?
LTB4
Name the product or products of arachidonic acid: • Chemotactic for neutrophils
Variola (smallpox)
With which DNA virus are Guarnieri bodies associated?
Marijuana
What drug causes a sixfold increase in schizophrenia, can impair motor activity, and can cause lung problems?
Tyramine
What agent, in combination with a MAOI inhibitor, can cause hypertensive crisis?
The mouth
What structure is derived from the prochordal plate?
They are all formed by the fifth month of fetal life.
All primary oocytes in females are formed by what age?
Serum 25-hydroxy-vitamin D (25-OH-D)
What is the best measure of total body vitamin D if you suspect a deficiency?
Clearance
What term describes the volume of plasma from which a substance is removed over time?
Chemotaxis
What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation?
Staphylococcus aureus
What are the most common causes of osteomyelitis • Overall?
Spironolactone (binds to aldosterone receptors)
What is the only diuretic that works on the blood side of the nephron?
Streptococcus viridans
What is the MCC of the following endocarditis scenarios? • Post dental work
Gap junctions
What is the name of hydrophilic pores that allow the direct passage of ions and particles between two adjacent cells?
Total ventilation (minute ventilation or minute volume)
What is the term for the total volume of air moved in and out of the respiratory system per minute?
Decreases
With a decrease in arterial diastolic pressure, what happens to • Stroke volume?
Aspartame
What artificial sweetener must patients with PKU avoid?
Abs to HBsAg
Abs to what hepatitis B Ag provide immunity?
Negative reinforcement
Based on operant conditioning, what type of reinforcement is described when • Removing a stimulus reinforces a behavior?
Lateral compartment of the leg, superficial peroneal nerve
Name the compartment of the lower extremity and the nerve based on its movements. • Plantar flex the foot and evert the foot
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells, virus-infected cells—anything the body recognizes as nonself via CD8+ T cells.
What MHC class functions as a target for elimination of abnormal host cells?
Enterococcus (Streptococcus faecalis)
Which streptococcal species is characterized by being catalase negative, turning bile esculin agar black, producing a positive PYR test, and resulting in biliary and urinary tract infections?
Pregnancy
What is the leading cause of school dropout?
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive-compulsive disorder and learning disabilities.
What disease is described by the following characteristics: multiple motor and vocal tics, average age of onset 7, a M:F ratio of 3:1, and association with increased levels of dopamine?
Burkitt lymphoma
Starry sky appearance of macrophages is pathognomonic of what lymphoma?
Gonads
What embryonic structure forms the adult male structure? • Testes, seminiferous tubules, and rete testes
False. Separation, divorce, being widowed, and unemployment increase your risk, but being single does not.
True or false? Being single increases your risk of suicide.
1. Large sample size 2. Large effect size 3. Type I error is greater
In biostatistics, what are the three criteria required to increase power?
None; it degenerates.
What CN is associated with the • Fifth pharyngeal arch?
Androgen-binding protein
What hormone, produced by the Sertoli cells, is responsible for keeping testosterone levels in the seminiferous tubules nearly 50 times that of the serum?
Mebendazole
What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm?
Aedes (the same for yellow fever)
What mosquito is the vector for dengue fever?
Anterior hypothalamic zone; lesions here result in hyperthermia.
What area of the hypothalamus is responsible for recognizing an increase in body temperature and mediates the response to dissipate heat?
Al-Anon
What is the name of the program that deals with codependency and enabling behaviors for family members of alcohol abusers?
Ampulla
What is the region of the fallopian tube where fertilization most commonly occurs?
Quinolones
Name the antimicrobial agent whose major side effect is listed. • Cartilage abnormalities
Diverticulosis
Name the most common type or cause. • Rectal bleeding
Valence
What is the term for the number of Ag-binding sites on an Ig?
The optic disk is the blind spot.
What area of the posterior aspect of the eye has no photoreceptors?
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
What type of error is made if you reject the null hypothesis when it is true?
IgA
What is the major Ig of the secondary immune response in the mucosal barriers?
Chief cells
What cell type of the body or fundus of the stomach secretes pepsinogen?
Phase 1
Name the phase of the ventricular muscle action potential based on the following information: • Slight repolarization secondary to potassium and closure of the sodium channels
Hematoxylin
Do the following structures pick up stain from hematoxylin or eosin? • Bacteria
Cystic fibrosis
What is the most common lethal AR disorder affecting white Americans?
Cystadenocarcinoma
What ovarian carcinoma is characterized by psammoma bodies?
Sympathetic nervous system
What component of the ANS is responsible for movement of semen from the epididymis to the ejaculatory ducts?
Chemotaxis
What is the name of the process in which cells migrate toward an attractant along a concentration gradient?
Aminophylline
What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?
Simple diffusion; it does not use protein-mediated transport
What is the main mechanism for exchange of nutrients and gases across a capillary membrane?
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical, psychological, and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
What is the most common form of elderly abuse?
True. High-frequency sound waves stimulate the hair cells at the base of the cochlea, whereas low-frequency sound waves stimulate hair cells at the apex of the cochlea.
True or false? High-frequency sound waves stimulate hair cells at the base of the cochlea.
Area 4
What Brodmann area is associated with • Primary motor cortex?
The fasciculus cuneatus
What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
Vancomycin
What bactericidal agent is the DOC for MRSA, enterococci, and Clostridium difficile?
Paramyxovirus
What family do the following viruses belong to? • Measles
Negative
Are the following conditions associated with a negative or positive nitrogen balance? • Uncontrolled DM
Collecting ducts, which make them readily permeable to water reabsorption.
What area of the nephron is sensitive to the effects of ADH?
No, unsaturated fatty acids have double bonds.
Does a saturated fatty acid have double bonds?
Streptococcus pyogenes
Describe the organism based on the following information: • Beta-hemolytic Streptococcus sensitive to bacitracin
Low molecular weight heparin (LMWH)
What class of heparin is active against factor Xa and has no effect on PT or PTT?
Membranoproliferative glomerulonephritis (MGN)
Name the most common type or cause. • Nephrotic syndrome
Phallus
What embryonic structure forms the adult male structure? • Corpus cavernosus, corpus spongiosum, and glans and body of the penis
True. (Remember, blood flows from the portal tracts to the central vein, so it is the first area to receive blood and therefore oxygen.)
True or false? The portal tract of the liver lobule is the first area to be oxygenated in the liver.
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
What disconnect syndrome results from a lesion in the corpus callosum secondary to an infarct in the anterior cerebral artery, so that the person can comprehend the command but not execute it?
Enterohemorhagic Escherichia coli
What organism is associated with the following types of diarrhea? Bloody diarrhea associated with hamburger ingestion
rRNA
Name the RNA subtype based on the following: • The most abundant form of RNA in the cell
Compliance (think of it as distensibility)
What is the term to describe how easily a vessel stretches?
Listeria monocytogenes
What is the MCC of the following meningitides? • In renal transplant patients
Prodrugs
What class of pharmaceuticals are inactive until they are metabolized to their active products?
14 L, 33% of body weight
What is the amount in liters and percent body weight for the following compartments? • ECF
The AR form is malignant and AD is benign.
Is the AD or AR form of osteopetrosis malignant?
Fanconi-like syndrome
What syndrome is characterized by the triad of renal tubular acidosis, nephrosis, and amino aciduria?
Leukotriene B4 (LTB4)
What is the name of the major chemotactic agent released from • Neutrophils?
Guillain-Barré syndrome
What syndrome has loss of deep tendon reflexes, muscle weakness, and ascending paralysis preceded by a viral illness?
Metastatic calcification
What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?
Intraductal papilloma
What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
Decreases
With a decrease in arterial diastolic pressure, what happens to • TPR?
DNA ligase
What protein catalyzes the formation of the last PDE bond between the Okazaki fragments to produce a continuous strand?
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
What cells of the parathyroid gland are simulated in response to hypocalcemia?
ELISA is used as a screening test because it is very sensitive; Western blot is used as a confirmatory test because it detects antibodies (protein) to the HIV virus.
What is the primary screening test used to detect HIV-infected individuals? Confirmatory test?
Uroporphyrinogen I synthetase
What enzyme is deficient in acute intermittent porphyria?
Inferior pancreaticoduodenal, middle colic, right colic, ileocolic, and 10 to 15 intestinal arteries
What are the five branches of the superior mesenteric artery?
Vitamin K
Name the antidote. • Warfarin
Bulla
What is the term for a raised fluid-filled cavity greater than 0.5 cm that lies between the layers of the skin?
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
What is the ratio of T4:T3 secretion from the thyroid gland?
Oddly enough, it is true. Cryptorchidism, Klinefelter syndrome, testicular feminization, and family history of testicular cancer are all risk factors.
True or false? Being a white male increases your risk factor for testicular cancer.
Primary spermatocyte
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 46/4n
Streptococcus agalactiae
What are the most common causes of osteomyelitis • In neonates?
Nephrotoxic oxylate stones
What type of damage to the kidneys is caused by drinking ethylene glycol (antifreeze)?
Adulthood
What stage of male development is characterized by the following LH and testosterone levels? • LH secretion drives testosterone production, with both levels paralleling each other.
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance, taking longer to reach threshold and slowing the rate of firing.
In a ventricular pacemaker cell, what phase of the action potential is affected by ACh?
Acarbose
What oral hypoglycemic agent inhibits α-glucosidase in the brush border of the small intestine?
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
In reference to membrane potential (Em) and equilibrium potential (Ex), which way do ions diffuse?
Infant Doe. Generally, parents cannot forego lifesaving treatment, but this case states that there are exceptions to the rule.
What case is known as "let nature take its course"?
Eosin
Do the following structures pick up stain from hematoxylin or eosin? • Fibrin
C5a
What is the name of the major chemotactic agent released from • The blood serum? (Hint: it is a complement factor.)
Ewing sarcoma
Pseudorosettes
The coding strand is identical to mRNA, and the template strand is complementary and antiparallel.
Is the coding or the template strand of DNA identical to mRNA (excluding the T/U difference)?
Metastatic carcinomas
What is the most common one? • Neoplastic tumor in the lungs
Peutz-Jeghers syndrome
What AD syndrome produces hamartomatous polyps in the small intestine and pigmentation of the lips and oral mucosa?
Broca's aphasia
Name the aphasia based on these characteristics: • Nonfluent speech, telegraphic and ungrammatical; lesion in Brodmann's area 44; unimpaired comprehension
LTC4, LTD4, and LTE4
Name the product or products of arachidonic acid: • Vasodilation, bronchospasm, and increased vascular permeability
Rubor (red), dolor (pain), calor (heat), tumor (swelling); also sometimes there is loss of function
What are the four signs of acute inflammation?
Posterior compartment of the leg, tibial nerve
Name the compartment of the lower extremity and the nerve based on its movements. • Plantar flex the foot, flex the toes, and invert the foot
MHC class I antigens; they are also found on the surface of platelets.
What MHC class of antigens do all nucleated cells carry on their surface membranes?
Upper third skeletal muscle, middle third both skeletal and smooth muscle, and lower third smooth muscle
What is the rule of one-third regarding muscle type of the esophagus?
Hypoglycemia for secretion and hyperglycemia for inhibition
What is the most potent stimulus for glucagon secretion? Inhibition?
CD8+ T cells
What T cell line arises from low affinity for self-MHC class I Ags in the thymus?
Early distal tubule
What is the site of action of the following? • Thiazide diuretics
Parasympathetics (parasympathetics point, sympathetics shoot)
What component of the ANS is responsible for dilation of the blood vessels in the erectile tissue of the penis, resulting in an erection?
Propranolol
What β-blocker is also a membrane stabilizer?
Female pseudohermaphrodite
What condition results from a 46XX karyotype and female internal organs with virilized external genitalia?
Nasopharynx
What region of the pharynx does the eustachian tube enter?
Parietal cells (Remember, they secrete HCl, too.)
What cell type of the body or fundus of the stomach secretes IF?
Reverse transcriptase
What is the term for RNA-dependent DNA polymerase?
Gangrenous necrosis
Name the type of necrosis. • Seen as dead tissue with coagulative necrosis
Initiate and manage gross skeletal muscle movement control
What is the function of the basal ganglia?
Ovarian cancer
What is the most common one? • Female genital tract malignancy resulting in death
The bifurcation of the abdominal aorta
What is the most common one? • Site for atherosclerotic plaques in the abdominal aorta
Rhabdovirus
What is the name of the bullet-shaped virus?
C3 deficiency
What complement factor deficiency leads to • Increased susceptibility to pyogenic infections?
At the end of the PCT 25% of the original volume is left
What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Percentage of original filtered volume left in the lumen
Hepatocellular carcinoma is associated with hepatitis B and C infections, not with EBV.
Which carcinoma—Burkitt's lymphoma, nasopharyngeal carcinoma, hepatocellular carcinoma, or thymic carcinoma—is not associated with EBV?
Acetyl CoA, FADH2, and NADH
At the end of each round of β-oxidation, what is released?
P1 protein
What protein allows Mycoplasma to attach to the respiratory epithelium?
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
On a graphical representation of filtration, reabsorption, and excretion, when does glucose first appear in the urine?
Pseudomonas sp.
Name the MCC. • Pneumonia in a neutropenic burn patient
Macrophages
What cell in chronic inflammation is derived from blood monocytes?
Hemochromatosis
What is the term for increased iron deposition resulting in micronodular cirrhosis, CHF, diabetes, and bronzing of the skin?
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Coccygeal vertebrae?
Fluconazole
What is the DOC for coccidioidomycosis?
Anticipation
Name these mature defense mechanisms: • Preparing for an upcoming event
1. Big 2. Bilateral 3. Berry aneurysm
What are the three Bs of adult polycystic kidneys?
42 L, 67% of body weight
What is the amount in liters and percent body weight for the following compartments? • Total body water
HBc Ab
What Ab is an indication of recurrent disease for hepatitis?
ELISA screens and Western blot confirms the diagnosis.
Does ELISA or Western blot confirm whether a patient is HIV-positive?
Tinea favosa (favus)
What is the most serious form of tinea capitis, which results in permanent hair loss and is highly contagious?
Krukenberg tumor
What is the name of the tumor when gastric carcinoma spreads to the ovaries?
TRUE
True or false? All spore formers are gram positive.
Diphenhydramine
What agent is used IM to treat acute dystonias?
Parental assignment and culture (not biology)
What are the strongest determinants of gender identity?
Down syndrome (it is slightly more common than fragile X syndrome.)
What is the most common genetic cause of mental retardation?
Endometrial cancer
What is the most common one? • Malignancy of the female genital tract
Relative refractory period
What period is described when a larger-than-normal stimulus is needed to produce an action potential?
Four high energy bonds, two from ATP in AA activation and two from GTP
How many high-energy bonds does the cycle of elongation cost?
Area 22 and occasionally 39 and 40
What Brodmann area is associated with • Wernicke's area?
Metaraminol (α1, β1 )
What α1-agonist is used to treat paroxysmal atrial tachycardia with hypotension?
Rhabdovirus
What family do the following viruses belong to? • Rabies
Supraspinatus and infraspinatus
What muscle or muscles are innervated by the following nerves? • Suprascapular nerve
Voltage-gated channel
What type of membrane channel opens in response to depolarization?
Sexual aversion disorder
What is the term for a complete aversion to all sexual contact?
Glycogen synthase
What is the rate-limiting enzyme of glycogen synthesis?
Aorta, azygos vein, and thoracic duct Remember: 1 at T8, 2 at T10, and 3 at T12
What structure or structures cross the diaphragm at • T12 level?
Chromosome 6
Which chromosome is associated with MHC genes?
Variola virus (Smallpox)
What virus is associated with Guarnieri bodies?
Arsenic, thorotrast, and vinyl chloride
What three chemical agents are associated with angiosarcomas of the liver?
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8, 2 at T10, and 3 at T12
What structure or structures cross the diaphragm at • T10 level?
HHV 6
What DNA virus is associated with exanthem subitum (roseola)?
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
How can a genetic deficiency of carbamoyl phosphate synthetase be differentiated from an ornithine transcarbamoylase deficiency?
Copper
What mineral is a component of cytochrome a/a3?
Hypotonic, because NaCl is reabsorbed in the salivary ducts
Are salivary secretions hypertonic, hypotonic, or isotonic?
Osteogenesis imperfecta
Blue sclera
Astrocytoma
What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
Large intestine. Water is passively removed from the lumen.
What segment of the gastrointestinal tract lacks villi, has crypts, and actively transports sodium out of its lumen?
Type IV hypersensitivity (cell-mediated)
Name the type of hypersensitivity reaction based on the following properties. • Reaction-mediated by sensitized T-cells
External abdominal oblique
What abdominal muscle contributes to the anterior layer of the rectus sheath, forms the inguinal ligament, and in men gives rise to the external spermatic fascia of the spermatic cord?
Displacement
Use of an outlet for emotions (stuff flows downhill).
Cytosine
What pyrimidine base is found • In both DNA and RNA?
Strongyloides stercoralis is treated with thiabendazole.
What nematode is known as threadworms? What is the treatment?
White muscle; short term too
What type of muscle is characterized by no myoglobin, anaerobic glycolysis, high ATPase activity, and large muscle mass?
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Metencephalon
Streptococcus agalactiae (Group B Streptococcus, or GBS)
Name the most common type or cause. • Neonatal septicemia and meningitis
The right gonadal vein drains into the inferior vena cava directly, and the left gonadal vein drains into the left renal vein.
What vessel does the right gonadal vein drain into?
Meningomyelocele All except occulta cause elevated-fetoprotein levels.
Name the form of spina bifida. • Meninges and spinal cord project through a vertebral defect
Yes
Can advance directives be oral?
Prevalence increases. (Remember, prevalence can decrease in only two ways, recovery and death.)
What happens to prevalence as the number of long-term survivors increases?
Glucosyl cerebroside
What substrate gets built up in Gaucher's disease?
Ipsilateral loss at and below the level of the lesion
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • Dorsal column tract?
Central. Remember, there is a deficiency in ADH production in the central form.
To differentiate central from nephrogenic diabetes insipidus, after an injection of ADH, which will show a decreased urine flow?
Escherichia coli and Pseudomonas sp.
What are the two MCC of acute epididymitis in males? • More than 35 years old
Allograft
Name the type of graft described by these transplants: • From one person to the next (the same species)
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
What are the five branches of the posterior cord of the brachial plexus?
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
What three substances stimulate glycogenolysis?
Lysine and arginine
What are the two most common AAs found in histones?
Tip of the left ventricle
What part of the heart forms • Apex?
Klüver-Bucy syndrome
What syndrome is described as bilateral lesions of the amygdala and the hippocampus resulting in placidity, anterograde amnesia, oral exploratory behavior, hypersexuality, and psychic blindness?
Systemic lupus erythematosus
What disease is associated with the HLA-DR2 and HLA-DR3 alleles
CSF H+ levels, with acidosis being the main central drive, resulting in hyperventilation (the opposite being true with alkalosis)
What is the central chemoreceptor's main drive for ventilation?
Listeria monocytogenes
What small gram-positive, non-spore-forming rod is a facultative intracellular parasite that grows in the cold and is associated with unpasteurized milk products?
Zileuton
Which agent used in the treatment of asthma is a selective inhibitor of the lipoxygenase pathway?
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Thalamus
Nystagmus and ataxia
What are the first signs of phenobarbital overdose?
False. It is reversible because the Ags and Abs are not linked covalently.
True or false? Ag-Ab binding is irreversible
Turcot syndrome
What syndrome has multiple adenomatous colonic polyps and CNS gliomas?
FALSE
True or false? Bile pigments and bile salts are reabsorbed in the gallbladder.
Gerstmann's syndrome; spoken language is usually understood.
What syndrome is described by a lesion in the angular gyrus (area 39) resulting in alexia, agraphia, acalculia, finger agnosia, and right-left disorientation?
Avidity (more than one binding site)
What is the term for the strength of association between multiple Abbinding sites and multiple antigenic determinants?
Inferior rectus (CN III) (LR6 SO4)3
What ocular muscle • Depresses and adducts the eyeball?
Moving objects, along with large bright objects with curves and complex designs.
Do newborns have a preference for still or moving objects?
Kidney
What is the most common one? • Organ involved in amyloidosis
HBeAb
What Ab is an indication of low transmissibility for hepatitis?
Fibrillary protein, amyloid protein, and glycosaminoglycans (heparin sulfate mainly)
What are the three main components of amyloid?
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
What limb of the internal capsule is not supplied by the middle cerebral artery?
The reduviid bug
What is the vector for Chagas disease?
Accessory nucleus
What is the only CN nucleus found in the cervical spinal cord?
Primary hypogonadism (postmenopausal women)
What hormone disorder is characterized by the following abnormalities in sex steroids↓, LH↑, and FSH↑? • Sex steroids , LH , FSH ?
Acetoacetate, acetone, and β-hydroxybutyrate
Name the three ketone bodies.
C5-C9
What complement factor or factors are associated with • Membrane attack complex (MAC)?
Ventral anterior nucleus
Name the thalamic nucleus based on its input and output. • Input from globus pallidus and substantia nigra; output to primary motor cortex
Inspiratory capacity
Name the lung measurement based on the following descriptions: • The maximal volume inspired from FRC
Aspartate transcarbamylase
What enzyme catalyzes the rate-limiting step in pyrimidine synthesis?
CMV; remember, EBV is associated with heterophile-positive mononucleosis.
What DNA virus is associated with heterophile-negative mononucleosis?
Your duty is to tell the patient, not the family. The patient decides who gets to know and who doesn't, not you.
Should information flow from the patient to the family or vice versa?
Amphotericin B
What is the DOC for severe infections with Sporothrix, Mucor, Histoplasma, Cryptococcus, Candida, and Aspergillus?
Misoprostol
What medication is a PGE1 analog that results in increased secretions of mucus and HCO3-in the GI tract?
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
What right-to-left shunt occurs when the aorta opens into the right ventricle and the pulmonary trunk opens into the left ventricle?
Teeth grinding is associated with stage 2 sleep.
With what stage of sleep are bruxisms associated?
von Hippel-Lindau syndrome
In what syndrome does the patient have angiomatosis; renal cell carcinomas; pheochromocytomas; retinal, cerebellar, medulla, or spinal cord hemangioblastomas; and epidermal cysts?
True. Adipose depends on glucose uptake for dihydroxyacetone phosphate (DHAP) production for triglyceride synthesis.
True or false? Adipose tissue lacks glycerol kinase.
Mitosis
What phase of the cell cycle are the following antineoplastic agents specific for? • Vincristine
Increased secretion of GH postpuberty leading to acromegaly.
What hormone excess brings about abnormal glucose tolerance testing, impaired cardiac function, decreased body fat, increased body protein, prognathism, coarse facial features, and enlargements of the hands and feet?
Ankylosing spondylitis
What seronegative spondyloarthropathy is seen in HLA-B27-positive young men, involves the sacroiliac joints, has no subcutaneous nodules, and has a bamboo spine appearance on radiograph?
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
What organelle is responsible for ribosomal RNA synthesis?
Paget disease (osteitis deformans)
What disorder of bone remodeling results in thick, weak bones and is associated with high-output cardiac failure?
Pyridoxine (B6)
What vitamin is needed for the production of heme?
DiGeorge's syndrome
What immunologic syndrome is due to a pharyngeal pouch 3 and 4 failure?
In the first and second bronchi
Where is most of the airway resistance in the respiratory system?
Subscapularis
What muscle or muscles are innervated by the following nerves? • Upper subscapularis nerve
G-6-PD deficiency
Heinz bodies
Pergolide
What is the DOC for hyperprolactinemia?
A-T are linked by 2 hydrogen bonds, C-G by 3 hydrogen bonds.
How many hydrogen bonds link A-T? C-G?
Taenia saginata
Which cestode in raw or rare beef containing cysticerci results in intestinal tapeworms?
Calcium oxylate
What is the most common one? • Renal calculus type
Gametocytes
What form of the Plasmodium species is ingested by mosquitoes?
Semicircular canal
What component of the inner ear • Contains perilymph and responds to angular acceleration and deceleration of the head?
Palms-up before palms-down maneuvers
In regard to motor development during infancy, choose the motor response that happens first. • Palms up or down
T cells, B cells, and macrophages
What three major cell lines participate in the acquired immune system?
Ampulla of the fallopian tube
Where is the most frequent site of ectopic pregnancy?
Seminoma
What is the most common one? • Germ cell tumor in men
Obsessive-compulsive
Name the cluster C personality disorder: • Orderly, inflexible, perfectionist; makes rules, lists, order; doesn't like change, has a poor sense of humor, and needs to keep a routine
Vital capacity (VC)
Name the lung measurement based on the following descriptions: • Maximal volume that can be expired after maximal inspiration
C3a, C4a, and C5a
What three complement fragments are also anaphylatoxins?
Glossopharyngeal nerve
What CN is associated with the sensory innervation of • Oropharynx?
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
What happens to flow and pressure in capillaries with arteriolar dilation? Arteriolar constriction?
Hypoxia
Name the most common type or cause. • Cellular injury
True. B cell antigen receptors are Abs.
True or false? B-cell Ag receptors can be secreted.
Permanent
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Cardiac muscle
Postductal coarctation of the aorta (adult)
What vascular pathology is associated with HTN in the upper extremities, hypotension in the lower extremities, and a radial-femoral delay?
TRUE
True or false? Monocytosis is seen in TB.
Sadism
What paraphilia is defined as • Deriving sexual pleasure from other peoples' pain?
Osteomalacia. Osteoporosis has normal levels of calcium, phosphorus, and alkaline phosphatase.
Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
Class II
Which class of antiarrhythmics are β-blockers?
After the latent period
Regarding the viral growth curve, is the external virus present before or after the latent period?
The venae recta maintain the gradient via countercurrent flow.
What maintains the osmotic gradient that is critical to the concentrating ability of the kidney?
Thiogalactoside transacetylase
Regarding the Lac operon, for what do the following genes code? • A gene
gamma and delta chains
What are the two chains of the TCR that are mainly found on the skin and mucosal surfaces?
Ionized drugs are water soluble, and since only lipid-soluble drugs can cross biomembranes, an ionized drug cannot cross them without the help of a carrier.
If a drug is ionized, is it water or lipid soluble? Can it cross a biomembrane?
β-Galactosidase
Regarding the Lac operon, for what do the following genes code? • Z gene
False. Bacteriocidals kill; bacteriostatics slow growth.
True or false? Antimicrobial agents that slow bacterial growth are bactericidal.
Plasmodium malariae
What type of Plasmodium affects • Only mature RBCs?
Affinity decreases; they are inversely proportional.
What happens to affinity if you increase Km?
Transferrin
What transports iron in the blood?
Dopamine is converted into NE in the vesicle via the enzyme dopamine-Beta-hydroxylase.
In an adrenergic nerve terminal, where is dopamine converted to NE? By what enzyme?
CN III, VII, IX, and X
What four CN carry preganglionic parasympathetic fibers?
Purine nucleoside phosphorylase
What enzyme of the purine salvage pathway is deficient in the following? • Selective T-cell immunodeficiency
Round and ovarian ligaments
What two ligaments of the uterus are remnants of the gubernaculum?
Henoch-Schönlein purpura
With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
Achalasia
What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus?
Preganglionic sympathetic neurons
What neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1-L2)
False. The disease has no associated pathology; the phenomenon is arterial insufficiency due to an underlying disease.
True or false? Raynaud's phenomenon has no underlying pathology.
Case fatality rate
What type of mortality rate is defined as the number of deaths • From a specific cause per number of persons with the disease?
Streptomycin
Which aminoglycoside is the DOC for tularemia and the bubonic plague?
Isocitrate dehydrogenase
What enzyme catalyzes the rate-limiting step in the TCA cycle?
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result), these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease, when obstructive symptoms begin to occur.
A 70-year-old man complains of urinary urgency, nocturia, hesitancy, postvoid dribbling, urinary retention, and a PSA result of 6.5 ng/mL. What is your diagnosis?
Graves disease
What type II hypersensitivity disorder is defined as • Autoantibodies directed against the TSH receptor?
Plummer-Vinson syndrome
What syndrome is seen in iron-deficient middle-aged women with esophageal webs?
Secretin stimulates the pancreas to secrete a HCO3--rich solution to neutralize the acidity of the chyme entering the duodenum.
What is secretin's pancreatic action?
Fixed interval
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • On a set time schedule?
Fourth MS CARD is my mnemonic for the aortic arch derivatives
From what aortic arch are the following structures derived? • Arch of the aorta and right subclavian artery
Nocardia asteroides
What aerobic branching rod that is gram positive and partially acid-fast is associated with cavitary bronchopulmonary disease in immunosuppressed patients?
Increased androgen secretion at puberty drives the increased GH secretion.
During puberty, what is the main drive for the increased GH secretion?
Lipoxygenase pathway, from arachidonic acid
What is the name of the pathway that produces leukotrienes?
Leukemias
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Benzenes
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Cerebral hemispheres
8 to 25 hours
How long after ovulation does fertilization occur?
Dimorphic
What is the term for fungi that can convert from hyphal to yeast forms?
T4, as long as T4 levels remain constant, TSH will be minimally effected by T3.
Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland?
Biofeedback
What operant conditioning therapy or modification is described as • Providing the person with information regarding his or her internal responses to stimuli with methods of controlling them?
Lead
Name the most common type or cause. • Chronic metal poisoning
MI
Name the MCC of death. • In diabetic individuals
CN IX, X, and XII CN XI arises from the cervical spinal cord.
What CNs arise from • The medulla?
D-Penicillamine
Name the antidote. • Copper
NADPH, O2, and cytochrome b5
What three things are needed to produce a double bond in a fatty acid chain in the endoplasmic reticulum?
Münchhausen's syndrome (factitious disorder)
In which syndrome does a person present with intentionally produced physical ailments with the intent to assume the sick role?
Gonorrhea
Name the most common reported STD. • In males
Duodenum
In what area of the GI tract does iron get absorbed?
hCG
What hormone, produced by the syncytiotrophoblast, stimulates the production of progesterone by the corpus luteum?
Myasthenia gravis
What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
Separation anxiety
Name the reaction that appears in babies who are temporarily deprived of their usual caretaker. (This reaction usually begins around 6 months of age, peaks around 8 months, and decreases at 12 months.)
Schistocytes
What is the term for RBC fragments?
Type I symptoms (positive); schizophrenics have them, but otherwise healthy persons do not.
What type of symptoms in schizophrenia are associated with • Dopamine receptors?
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
What causes slow writhing movements (athetosis)?
This is the triad of renal cell carcinoma
What carcinoma produces hematuria, flank pain, and a palpable mass?
Levator palpebrae superioris
What muscle is most superior in the orbit?
Wegener granulomatosis
What rare vasculitis has the following characteristics: males aged 40 to 60; affecting small arteries and veins; involving nose, sinuses, lungs, and kidneys; C-ANCA and autoantibodies against proteinase 3?
Proximal to distal progression
In regard to motor development during infancy, choose the motor response that happens first. • Proximal or distal progression
Diffuse proliferative GN
What is the most common one? • Renal pathology in patients with SLE
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels
What are the four ways to increase TPR?
Stages 3 and 4 (NREM)
In what stage of sleep is GH secreted?
Haemophilus influenzae type B
What is the MCC of the following meningitides? • In those 12 months to 6 years of age
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney?
Estrogens are 18-carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
How many carbons do estrogens have?
1. Maltose 2. Maltotetrose 3. α-Limit dextrans (α-1, 6 binding)
What are the three end products of amylase digestion?
delta-Cells; somatostatin has an inhibitory effect on alpha- and Beta-islet cells.
What pancreatic islet cell secretes somatostatin?
IL-8 (IL-1 and TNF-gamma also)
What is the name of the major chemotactic agent released from • Macrophages?
Posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Splanchnic nerves
True. (They are quite a busy bunch of cells!)
True or false? The following are functions of hepatocytes: protein production, bile secretion, detoxification, conjugation, and lipid storage.
On the superior body of the posterior wall of the uterus
What is the most common site for implantation of the blastocyst?
Acetazolamide
What is the only class of diuretics to retain Cl- used in the short-term treatment of glaucoma and of acute mountain sickness?
Left coronary artery
What artery supplies the left ventricle, left atrium, and interventricular septum?
UMP
What is the primary end product of pyrimidine synthesis?
CN IX
What CN is associated with the • Third pharyngeal arch?
Calcarine sulcus
What sulcus divides the occipital lobe horizontally into a superior cuneus and inferior lingual gyrus?
Herpes I
What virus lies dormant in the • Trigeminal ganglia?
True. A thrombus has platelets, but clots do not.
True or false? Blood clots lack platelets.
Birth defects, low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS), and SIDS
What are the top three causes of infant mortality?
In men it is prostate cancer, and in women it is breast cancer.
What is the most common cancer diagnosed in men? In women?
Chronic rejection
Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Months to years after transplantation; gradual onset of HTN, oliguria, and azotemia; seen as intimal fibrosis of the blood vessels and interstitial lymphocytes
Lateral collateral ligament
What structure of the knee is described thus? • Prevents adduction
HBcAb IgM, HBV-DNA, HBeAg, HBsAg
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Acute infection
Seven-eighths of nephrons are cortical, with the remainder juxtamedullary.
What percentage of nephrons is cortical?
Erythema nodosum
What type of erythema do you see in • Ulcerative colitis?
Log-kill hypothesis (follows first order kinetics)
What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells, not a fixed number?
CN VI, VII, and VIII
What CNs are affected if there is a lesion in • Pontomedullary junction?
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
What are the three functions of surfactant?
Hashimoto thyroiditis
Name the most common type or cause. • Noniatrogenic hypothyroidism in the United States
Prostatic carcinoma
What cancer of the male genitourinary system is associated with osteoblastic bony metastasis?
Primary hyperparathyroidism
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH increased, Ca2+ increased, Pi decreased
The number of cross-bridges cycling during contraction: the greater the number, the greater the force of contraction.
What determines the overall force generated by the ventricular muscle during systole?
Positive
Are the following conditions associated with a negative or positive nitrogen balance? • Growth
Bernard-Soulier syndrome
What AR syndrome is due to a deficiency of glycoprotein Ib, resulting in a defect in platelet adhesion?
Aspiration pneumonia
What is the most common one? • Complication of nasogastric tube feeding
False. It does increase uterine synthesis of prostaglandins, which increase uterine contractions.
True or false? Oxytocin initiates rhythmic contractions associated with labor.
Primitive atrium
From what embryonic structure are the following structures derived? • The right and left atria
One day after the LH surge and 2 days after the estrogen peak.
How many days after the LH surge is ovulation?
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
What are the three sites where CSF can leave the ventricles and enter the subarachnoid space? (Name the lateral and the medial foramina.)
Malpighian layer (made up of the stratum basale and stratum spinosum)
On what layer of the epidermis does all mitosis occur?
Stratified squamous nonkeratinized epithelium, which has cilia that beat toward the oropharynx.
What is the epithelial cell lining the nasopharynx?
Middle cerebral artery
What artery supplies most of the lateral surfaces of the cerebral hemispheres?
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Where does most circulating plasma epinephrine originate?
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
What enzyme found in a cholinergic synapse breaks down ACh? What are the byproducts?
Axon hillock
Where is the action potential generated on a neuron?
Cortisol, a 21-carbon steroid, has a -OH group at position 17.
What is the only 17-hydroxysteroid with hormonal activity?
Right medial longitudinal fasciculus
Where is the lesion that produces these symptoms when a patient is asked to look to the left? • Right eye can't look left, left eye nystagmus, and convergence is intact
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
What five factors promote turbulent flow?
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Heart and pericardium
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
What are the three major functions of secretory IgA?
Enteroendocrine (EE) cells; they also secrete secretin.
What cell of the duodenum secretes CCK?
Probenecid, a uricosuric agent
What is the drug of choice in treating a patient with hyperuricemia due to underexcretion of uric acid?
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
Which dopamine receptor excites the direct pathway of the basal ganglia?
Meningioma
What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies?
Prefrontal cortex; it is in front of the premotor area.
What frontal lobe cortex is associated with organizing and planning the intellectual and emotional aspect of behavior?
Chromosome 1
Name the associated chromosome. • Gaucher disease
ALA dehydrogenase and ferrochelatase
What two enzymes of heme synthesis are inhibited by lead?
False. Right-sided valves are the first to open and last to close.
True or false? Right-sided valves close before the valves on the left side of the heart.
Trichuris trichiura is treated with albendazole.
What nematode is known as whipworms? What is the treatment?
Breast cancer
What is the most common diagnosis made (or missed!) resulting in a malpractice suit?
RNA polymerase II
Name the eukaryotic RNA polymerase based on the following: • Synthesizes hnRNA, mRNA, and snRNA
Western blot
What blotting technique uses the following for analysis? • Protein
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
A 20-year-old woman who was recently diagnosed with a sexually transmitted disease goes to the ER with a tender, painful, swollen, and erythematous knee (monoarticular). What organism is the likely culprit?
Fixed ratio (rewards set behaviors)
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • After a set number of responses?
Dystrophic calcification
What is the term for precipitation of calcium phosphate in dying or necrotic tissue?
Myasthenia gravis
What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities, red cell aplasia, and muscle weakness?
Iron (Fe)
What mineral, via excessive depositions in the liver, causes hemochromatosis?
Small to medium-sized cerebral vessels
What cerebral vessel size is affected in patients with vascular dementia?
Bronchial asthma (whorled mucous plugs)
Curschmann spirals
Deficiency in surfactant
What protein deficiency results in respiratory distress syndrome of newborns?
Corynebacterium diphtheriae
What non-spore-forming gram-positive aerobic rod produces bull neck, sore throat with pseudomembranes, myocarditis, and sometimes respiratory obstructions?
Chromosome 19
Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?
Hemiazygous vein
What vein drains the lower third of the thoracic wall?
Hodgkin lymphoma
Reed-Sternberg cells
Disulfiram
What drug is used to prevent alcohol consumption by blocking aldehyde dehydrogenase?
Reinforcement
What is the term for any stimulus that increases the probability of a response happening?
Acute cystitis
WBCs in the urine
Major basic protein
What substance found in eosinophils is toxic to parasitic worms?
Medial medullary syndrome
What syndrome is associated with the following brainstem lesions? • Vertebral artery or anterior spinal artery occlusion, resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
Parasites
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Eukaryotic cell, 15 to 25 microns, 80S ribosomes, no cell walls, replicates via cytokinesis with mitosis and meiosis
Glycerol kinase
What liver enzyme, for triglyceride synthesis, converts glycerol to glycerol-3-phosphate?
Squamous cell carcinoma
What is the most common one? • Cancer of the esophagus in the world
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
What vitamin deficiency produces homocystinuria and methylmalonic aciduria?
Accuracy (think of it as all the trues, because they are the ones correctly identified)
What is the term for the total percentage of correct answers selected on a screening test?
Id (pleasure principle)
What Freudian psyche component is described as • The urges, sex aggression, and "primitive" processes?
True. They block the dopamine receptors in the chemoreceptor trigger zone.
True or false? Dopamine antagonists are antiemetic.
Compliance; the more compliant a lung is, the easier it is to inflate.
What term is an index of the effort needed to expand the lungs (i.e., overcomes recoil)?
It increases Ca2+ excretion from the kidney and increases bone mineralization.
What are the two actions of calcitonin?
A low-resistance system is formed by resistors added in parallel.
What type of resistance system (i.e., high or low) is formed when resistors are added in parallel?
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
What nerves provide sensory innervation above the vocal cords? Below the vocal cords?
C4 (the upper border of the thyroid cartilage)
At what vertebral level does the common carotid artery bifurcate?
Thiamine
What vitamin deficiency can result in high-output cardiac failure?
Hepatitis D
Which hepatitis strain is a defective virus that can replicate only inside HBV-infected cells?
Being awake
Name the stages of sleep with these EEG patterns: • Alpha waves
Middle meningeal artery
What vessel is lacerated in an epidural hematoma?
DNA polymerase-γ
Name the eukaryotic DNA polymerase based on the following information: • Replicates mitochondrial DNA
True. Common variable hypogammaglobinemia first appears by the time patients reach their 20s and is associated with a gradual decrease in Ig levels over time.
True or false? Patients with common variable hypogammaglobinemia have B cells in the peripheral blood.
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Where is lithium metabolized and excreted?
Ataxia-telangiectasia
What AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections, uncoordinated muscle movements, and dilation of the blood vessels?
Middle cerebral artery
What is the most common one? • Site of a cerebral infarct
Ulcerative colitis
Is ulcerative colitis or Crohn disease more commonly associated with primary sclerosing cholangitis?
Finasteride
What agent used in the treatment of BPH and baldness is a 5-α-reductase inhibitor?
Blastomyces dermatitidis
Which dimorphic fungus is found as hyphae with nondescript conidia in rotting wood in the Upper Great Lakes, Ohio, Mississippi, eastern seaboard of the United States, and southern Canada?
M3 (promyelocytic leukemia)
Which subtype of AML is most commonly associated with Auer rods?
Goodpasture disease
Name the nephritic disease based on the immunofluorescent staining. • Smooth and linear pattern of IgG and C3 in the GBM
Kayser-Fleischer rings
What is the term for the copper corneal deposits found in Wilson's disease?
Epidermophyton
Which genus of dermatophytes is associated with the following sites of infection? • Nails and skin only
Encapsulated bacteria
Patients with sickle cell anemia are at increased risk for infection from what type of organisms?
Clonidine
Which centrally acting α2-adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Craniopharyngioma
What CNS tumor arises from Rathke's pouch?
Chlamydia trachomatis
Name the most common cause. • Blindness worldwide
Coprophilia
What paraphilia is defined as • Combining sex with defecation?
Aged adult
What stage of male development is characterized by the following LH and testosterone levels? • Decreased testosterone production is accompanied by an increase in LH production.
Factors II, VII, IX, X, and proteins C and S
What are the vitamin K-dependent coagulation factors?
Sucralfate
Which medication requires an acidic gastric pH for activation to form a protective gel-like coating over ulcers and GI epithelium?
1. Glycine 2. Aspartate 3. Glutamine
What three AAs are used to synthesize the purine ring?
Naloxone or naltrexone
Which drug is used to treat respiratory depression associated with an overdose of opioids?
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
What are the three Beta-lactamase inhibitors?
2 ATPs, via the amino acyl tRNA synthase enzyme
How many high-energy bonds are used to activate an AA?
Dilation of afferent arteriole
What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↑, RPF ↑, FF normal, capillary pressure ↑
Osteocyte
What type of cell is surrounded by mineralized bone?
<2
What is the lecithin:sphingomyelin ratio in respiratory distress syndrome of newborns?
Acute pyelonephritis
WBC casts in the urine
Hirschsprung's disease (colonic gangliosus)
What disease results in a failure of neural crest cells to migrate to the myenteric plexus of the sigmoid colon and rectum?
Skeletal muscles
Name the muscle type based on these descriptions: • Discontinuous voluntary contraction, multinuclear striated unbranched fibers, actin and myosin overlapping for banding pattern, triadic T tubules, troponin and desmin as Z disc intermediate filament.
Duchenne muscular dystrophy
What disease is seen in children younger than 5 years of age and is characterized by X-linked recessive cardiac myopathies, calf pseudohypertrophy, lordosis, protuberant belly, an increase then a decrease in CPK, and death commonly in the second decade of life?
Ego
What Freudian psyche component is described as • Reality, rationality, language basis?
Third week
During what embryonic week does the intraembryonic coelom form?
Secondary spermatocyte
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 23/2n
Galactoside permease
Regarding the Lac operon, for what do the following genes code? • Y gene
Systematic desensitization
What classical conditioning therapy or modification is described as • Triage of a hierarchy of fears (from least to most), then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
Why isn't the incidence of a disease decreased when a new treatment is initiated?
Succinyl CoA
What intermediate enables propionyl CoA to enter into the TCA cycle?
Fatty acids cannot cross the blood-brain barrier; therefore, they cannot be used as an energy source.
During a prolonged fast, why is the brain unable to use fatty acids?
Wilson disease
Kayser-Fleischer rings
Stage 2
Name the stages of sleep with these EEG patterns: • Sleep spindles, K-complexes
False. Elevated calcitonin levels are seen in medullary carcinoma of the thyroid. Psammoma bodies are seen in papillary carcinoma of the thyroid and ovaries, as well as meningiomas.
True or false? Psammoma bodies are seen in medullary carcinoma of the thyroid.
IQ
What is defined as a general estimate of the functional capacities of a human?
Bactericidal
What form of antimicrobial therapy is best for an immunocompromised patient?
Ulnar to radial progression
In regard to motor development during infancy, choose the motor response that happens first. • Radial or ulnar progression
Lisch nodules
What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?
The one start codon, AUG, in eukaryotes codes for methionine and in prokaryotes formylmethionine.
What is the start codon, and what does it code for in eukaryotes? Prokaryotes?
Median nerve
What nerve is compromised in carpal tunnel syndrome?
Prader-Willi syndrome and Angelman syndrome, respectively
What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
Zafirlukast
Which prophylactic asthmatic agent is an antagonist of LTD4?
Superior
What is the label given to an individual whose IQ is • 120 to 129
Intermediate part of the hemispheres
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls distal musculature?
Hirschsprung disease
Name the most common type or cause. • Neonatal bowel obstruction
Protamine sulfate
What agent antagonizes the effects of heparin?
Proto-oncogenes
What is the term for normal cellular genes associated with growth and differentiation?
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma
What are the three signs of morphine overdose?
Histiocytes
Name the macrophage based on its location: • Connective tissue macrophages
IDL
Name the lipoprotein based on the following characteristics. • apo E
Ulnar nerve
What nerve is associated with the following functions? • Innervation of the flexor carpi ulnaris, flexor digiti profundus (pinky and ring fingers), and the intrinsic muscles of the hand
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Both submandibular and sublingual glands are innervated by CN VII (facial) and produce mucous and serous secretions. Which one mainly produces serous secretions?
Molybdenum (Mb)
What mineral is an important component of the enzyme xanthine oxidase?
Integrase
What enzyme does HIV use to integrate the proviral dsDNA into the host?
By causing rebound insomnia and decrease in REM sleep
How does ceasation of barbiturate use affect sleep?
When a patient closes the eyes while standing with feet together, the visual and cerebellar components of proprioception are removed, so you are testing the dorsal columns. Swaying with eyes closed is a positive Romberg's sign indicating a lesion in the dorsal columns. The cold water caloric test mimics a brainstem lesion by inhibiting the normal reflex response. (COWS: Cold Opposite Warm Same)
By asking a patient to close the eyes while standing with feet together, what two pathways are you eliminating from proprioception?
5' deiodinase
What enzyme is inhibited by propylthiouracil (PTU)?
Raloxifene
What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
Liquids, CHO, protein, fat
Place in order from fastest to slowest the rate of gastric emptying for CHO, fat, liquids, and proteins.
Internal carotid artery
The ophthalmic artery is a branch of what vessel?
Bronchiectasis
What is the term for chronic necrotizing pulmonary infections resulting in permanent airway dilation and associated with Kartagener syndrome?
Adenovirus
What is the MCC of viral conjunctivitis?
Mantle cell lymphoma
What lymphoma is characterized by CD19, CD20, CD5; CD23-negative; and chromosome 11;14 translocations?
Chromophobe adenoma
What is the most common one? • Pituitary tumor
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Which hemoflagellate species causes kala azar?
Stratum granulosum
What epidermal layer's function is to release lipids to act as a sealant?
Primary hypocortisolism (Addison's disease)
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol decreased, ACTH increased
Primary intention
What type of healing occurs in a clean surgical incision?
Melanosis coli
What is the term for black pigmentation of the colon associated with laxative abuse?
Gastric carcinoma
A Japanese man has weight loss, anorexia, early satiety, epigastric abdominal pain, and a palpable left supraclavicular lymph node. On endoscopy you find a large, irregular ulcer with elevated margins on the lesser curvature of the stomach. What is your diagnosis?
GP Ib
What glycoprotein allows platelets to adhere to von Willebrand factor?
Parkinson's disease
Shuffling gait, cogwheel rigidity, masklike facies, pill-rolling tremor, and bradykinesia describe what form of dementia?
A decrease in Ca2+ and an increase in PO4-
What two factors cause PTH to be secreted?
Anemia of chronic disease
Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, TIBC, and percent saturation; increased ferritin
Chromosome 11p
Name the associated chromosome. • Albinism
Thyroid gland
What gland is found in the muscular triangle of the neck?
45XO
What is the karyotype in Turner syndrome?
False-positive rate
What rate is indicated by 1-specificity?
Squamous cell carcinoma of the lung
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • erb-1
Pseudomembranous exudates
Name the type of exudate, given the following examples. • Diphtheria infection
Metanephros
What embryonic structure forms the following adult structures? • Nephrons, kidney
Waterhouse-Friderichsen syndrome
What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?
Frotteurism
What paraphilia is defined as • A male rubbing his genitals on a fully clothed female to achieve orgasm?
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity
Name five causes for zero-order metabolism.
Maxillary division of CN V and glossopharyngeal nerves
What CN is associated with the sensory innervation of • Nasopharynx?
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
Which trophoblast layer of the placenta remains until the end of pregnancy?
Ipratropium
What is the DOC for β-blocker-induced bronchospasms?
Limbic system
Name the area of the cerebral cortex with the function described: • Motivation, memory, emotions, violent behaviors, sociosexual behaviors, conditioned responses
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Damage to what nerve will give you winged scapula?
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin, ACh, and catecholamines promote closure of the ductus arteriosus.
Which PG is associated with maintaining a PDA?
Mycoplasma
What genus is known as the smallest free living bacteria? (hint: has no cell wall and has sterols in the membrane)
Insulinoma
What is the most common one? • Pancreatic islet cell tumor
Primase
What enzyme produces an RNA primer in the 5'-3' direction and is essential to DNA replication because DNA polymerases are unable to synthesize DNA without an RNA primer?
Bacteria
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Small prokaryotic cells; no histones; 70S ribosomes; no sterols in cell membrane; peptidoglycans in cell wall; replicate by binary fission
Need 3 panic attacks over 3 weeks (remember, they come out of the blue.)
How many attacks are needed over how much time before panic disorder is diagnosed?
Hydroxyproline
What form of AA is found only in collagen?
Escherichia coli
What is the most common one? • Organism that causes pyelonephritis
Zinc (Zn) deficiency
What mineral deficiency in children is associated with poor growth and impaired sexual development?
CN V
What CNs are affected if there is a lesion in • The upper pons?
Metastatic
What is the most common one? • Brain tumor
Coagulative necrosis
Name the type of necrosis. • The most common form of necrosis; denatured and coagulated proteins in the cytoplasm
Follicular phase is estrogen-dependent with increased FSH levels, while the luteal phase is progesterone-dependent.
What phase of the menstrual cycle is dominated by estrogen? Progesterone?
Capillaries
What vessels have the largest total cross-sectional area in systemic circulation?
Pseudomembranous colitis
What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile, ischemia, Staphylococcus, Shigella, or Candida infection?
Intellectualization
Replacing normal affect with "brain power"
Hepatitis D
Name the hepatitis virus based on the following information. • Small circular RNA virus with defective envelope
CD8+ T cells (cytotoxic) Remember, 8×1=8 (CD×8×MHC class I=8); 4×2=8 (CD×4 MHC class II 8)
What subset of T cells recognizes the MHC class I Ags?
Depression
Name the most common cause. • Insomnia
Viral meningitis
What condition results in the following CSF results? • Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
True. Because of intrapulmonary shunting, there is a slight decrease in PO2 and increase in PCO2 between the pulmonary end capillary blood and the systemic arterial blood.
True or false? The alveolar PO2 and PCO2 levels match the pulmonary end capillary blood levels.
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle, and you would risk injury if you went below the rib.
If inserting a needle to perform a pleural tap or insertion of a chest tube, do you use the inferior or the superior border of a rib as your landmark? Why?
These are the gross pathologic changes associated with Alzheimer's disease.
What dementia is associated with dilated ventricles with diffuse cortical atrophy, decreased parietal lobe blood flow, and a decrease in choline acetyl transferase activity?
Multiple myeloma
Bence-Jones proteinuria
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
What is the effect of insulin on intracellular K+ stores?
They are directly related; the greater the preload, the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
What is the relationship between preload and the passive tension in a muscle?
Succinate dehydrogenase
What enzyme of the TCA cycle also acts as complex II of the ETC?
Retinoblastoma
What is the most common one? • Eye tumor in children
6 weeks 10 weeks
When does the primitive gut herniate out of the embryo? When does it go back into the embryo?
Plasmodium malariae; the others are tertian.
What is the only Plasmodium that is quartan?
Efficacy
What is the term for how well a drug produces its desired response?
TRUE
True or false? All Proteus species are urease positive.
There are no valves and no smooth muscle in the walls of the veins in the face.
What is the major difference between the veins in the face and the veins in the rest of the body?
Pneumocystis carinii
What is the most common infectious agent in HIV?
Hyperacute rejection
Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Immediately after transplantation; seen as a neutrophilic vasculitis with thrombosis
Femoral nerve
What lower extremity nerve is described by the following motor loss? • Loss of knee extension, weakened hip flexion
Hypothyroidism. (TSH levels must be monitored.)
What is associated with prolonged lithium use?
Huntington disease
What AD disorder is characterized by degeneration of GABA neurons in the caudate nucleus resulting in atrophy, chorea, dementia, and personality changes?
False. It is a passive process due to decreased sex hormones.
True or false? Menstruation is an active process due to increased gonadal sex hormones?
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
Which of the colliculi help direct the movement of both eyes in a gaze?
Sjögren's syndrome; SS-A (Ro) and SS-B (La)
What autoimmune syndrome is characterized by keratoconjunctivitis, corneal ulcers, xerostomia, and an increased risk of high-grade B-cell lymphomas? What two Ab tests are used in making the diagnosis?
Filtered and secreted: Cx > Cin (i.e., PAH). Filtered and reabsorbed: Cx < Cin (i.e., glucose), where Cx = clearance of a substance and Cin = clearance of inulin.
Is the clearance for a substance greater than or less than for inulin if it is freely filtered and secreted? If it is freely filtered and reabsorbed?
True. HPV serotypes 16 and 18 are risk factors for squamous cell carcinoma.
True or false? HPV infection increases the risk of developing squamous cell carcinoma of the penis.
Superior and middle
Name the compartment of the mediastinum associated with the following thoracic structures: • SVC
Lispro insulin
Name the insulin preparation based on the peak effect and duration of action. • Peak, 0.3 to 2 hours; duration, 3 to 4 hours
Type II symptoms (negative); otherwise healthy persons have them, but schizophrenics do not.
What type of symptoms in schizophrenia are associated with • Muscarinic receptors (ACh)?
Doxycycline
Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
After fertilization, what cells of the corpus luteum • Secrete progesterone?
Friedreich ataxia
What AR CNS disorder presents early in childhood with gait ataxia, loss of deep tendon reflexes, impaired vibratory sensation, hand clumsiness, and loss of position sense?
Waldeyer's ring
Where are the tonsillar tissues?
True. Remember, it degenerates 4 to 5 days post fertilization, and implantation occurs 7 days post fertilization!
True or false? For implantation to occur the zona pellucida must degenerate.
Alzheimer disease
Senile plaques
Mild (50-70)
What level of mental retardation is characterized by • Being self-supportive with minimal guidance and able to be gainfully employed (includes 85% of the mentally retarded)?
Because creatinine is filtered and a small amount is secreted
Why is the clearance of creatinine always slightly greater than the clearance of inulin and GFR?
Purkinje cell is the fastest, and the AV node is the slowest.
What is the fastest-conducting fiber of the heart? Slowest conduction fiber in the heart?
CD14
What endotoxin receptor is the best marker for macrophages?
Entamoeba histolytica
What is the most common one? • Organism associated with liver abscesses
First M PITS for pharyngeal pouch derivatives
From what pharyngeal pouch is the following structure derived? • Middle ear
Infrapatellar bursa
What bursa is inflamed in clergyman's knee?
Prevalence increases.
What happens to prevalence as incidence increases?
RSV
Which virus is treated with the monoclonal antibody palivizumab?
In the tuberoinfundibular pathway, dopamine release will decrease prolactin release, which is why dopamine agonists are used in the treaatment of hyperprolactinemic states.
What hormone can be affected by dopamine release in the tuberoinfundibular pathway?
Gabapentin
Which anticonvulsant is used in the treatment of bipolar disorder and neuropathic pain?
21-β-Hydroxylase deficiency leads to hypotension, hyponatremia, and virilization.
What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency, glucocorticoid deficiency, and an excess of adrenal androgens?
True. Muscle spindles are modified skeletal muscle fibers. They are the sensory component of the stretch reflexes.
True or false? Intrafusal fibers form muscle spindles.
MEN I (or Wermer syndrome)
Which subset of MEN syndrome is associated with the following? • Parathyroid, pancreatic, and pituitary gland tumors and Zollinger-Ellison syndrome
SER
What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA?
Psoas major
What muscle is the chief flexor of the hip?
Superior vena cava
What vein is formed by the union of the right and left brachiocephalic veins?
Membranous glomerulonephritis
What renal pathology involves uniform thickening of the glomerular capillary wall, granular appearance under the microscope, and effacement of foot processes?
Nucleus pulposus
What portion of the intervertebral disk is a remnant of the notochord?
Adenosine (it is an excellent agent to use in emergencies because its half-life is 30 seconds)
What antiarrhythmic agent is the DOC for treating and diagnosing paroxysmal supraventricular tachycardia (PSVT) and AV nodal arrhythmias?
Zero-order elimination
What type of drug elimination is characterized by the following? • Elimination independent of plasma concentration; constant amount eliminated per unit time; no fixed half-life
Leuprolide
What GnRH analog is used as a repository form of treatment in prostatic cancer?
Vibrio cholera
What organism is associated with the following types of diarrhea? Rice water stools
Aortic insufficiency
Name the valve abnormality based on the following criteria: • Diastolic murmur; increased preload, stroke volume, and aortic pulse pressure; decreased coronary blood flow; no incisura; and peripheral vasodilation
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
What are the four segmented RNA viruses?
Folate deficiency (very common in the elderly)
The "tea-and-toast" diet is classically associated with what cause of megaloblastic anemia?
False. It is an enzyme secreted by the lining of the small intestine.
True or false? Enterokinase is a brush border enzyme.
ACh
What are the primary neurotransmitters at the following sites? • Autonomic preganglionic neurons
Giant cell tumor of the bone
Soap bubble appearance on radiograph
Roth spots
Name the following descriptions associated with bacterial endocarditis: • Retinal emboli
Rochalimaea quintana (now called Bartonella quintana)
Which organism causes trench fever?
Head of the pancreas
What is the most common one? • Site of pancreatic cancer
True hermaphrodism
What condition is defined by both testicular and ovarian tissues in one individual?
80S ribosomes (because they are eukaryotic)
What size ribosomes do fungi have?
True. Pancreatic enzymes begin the breakdown of vitamin B12-R complex in the duodenum.
True or false? Pancreatic insufficiency results in vitamin B12 malabsorption.
Vanillylmandelic acid (VMA)
What urinary metabolite is elevated in pheochromocytoma?
Neisseria gonorrhoeae
A urethral swab of a patient shows gram-negative diplococci in PMNs; what organism do you diagnose?
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Is a subdural hematoma an arterial or venous bleed?
Cryptococcus neoformans
Which encapsulated fungus is found in soil enriched with pigeon droppings?
Neisseria meningitides
What is the MCC of the following meningitides? • In military recruits
Pyridoxine
Name the antidote. • Isoniazid
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Why should opioid analgesics be avoided for patients with head trauma?
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
Are the quadrate and caudate lobes of the liver functionally part of the left or right lobe?
Palindrome
What is the term to describe the 5'-3' sequence of one strand being the same as the opposite 5'-3' strand?
Hyperventilation, which decreases CO2, shifting the reaction to the left and decreasing H+
What is the respiratory compensation mechanism for metabolic acidosis?
Seasonal affective disorder (treat with bright light therapy)
What form of depression is due to abnormal metabolism of melatonin?
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
What syndrome is due to a deficiency of surfactant?
Prokaryotes. Polycistronic and prokaryotes both start with P.
Which organisms have polycistronic mRNA?
Hypercortisolism (Cushing syndrome)
Thin extremities, fat collection on the upper back and abdomen, hypertension, hypokalemic alkalosis, acne, hirsutism, wide purple striae, osteoporosis, hyperlipidemia, hyperglycemia with insulin resistance, and protein depletion are all characteristics of what disorder?
Asbestosis
Name the most common type or cause. • Nonorganic pneumoconiosis
False. All except multiparity are risk factors for breast cancer. Nulliparity, increasing age, and family history in first-degree relative are also risk factors. Memorize this list!
True or false? All of the following are risk factors for breast cancer: early menses, late menopause, history of breast cancer, obesity, and multiparity.
They prevent mast cell degranulation.
What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?
Cerebellum
Name the area of the cerebral cortex with the function described: • Skill-based memory, verbal recall, balance, refined voluntary movements
Thioridazine
What neuroleptic agent causes retinal deposits, hypotension, and torsades de pointes?
Splitting
Name these narcissistic defense mechanisms: • Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
HPV serotypes 16, 18, 31, and 33
What HPV serotypes are associated with increased risk of cervical cancer?
Coxsackie B
What is the most common one? • Viral cause of myocarditis
CHF, cirrhosis, and nephrosis
What are the three causes of transudate?
Vitreous humor
What is the fluid of the posterior compartment of the eye?
TXA2
Name the product or products of arachidonic acid: • Vasoconstriction and platelet aggregation produced by platelets
Bacillus anthracis
What bacterium is characterized by large boxcar-shaped gram-positive rods and is spore-forming, aerobic, and associated with cutaneous infections and woolsorter's disease?
With arteriolar constriction both the flow and pressure downstream decrease.
What happens to blood flow and pressure downstream with local arteriolar constriction?
Aminoglycosides
Which drugs bind to the 30S ribosomal subunit and interfere with the initiation complex, causing a misreading of mRNA?
Streptococcus viridans
Describe the organism based on the following information: • Alpha-hemolytic Streptococcus; not lysed by bile; not sensitive to Optochin
Ketoconazole
What antifungal agent is used in the treatment of androgen receptor-positive cancers?
RU 486
What drug, if given during pregnancy, would cause the uterus to exhibit signs of progesterone withdrawal and induce an abortion?
Major
Are the following major or minor Jones criteria of rheumatic fever? • Subcutaneous nodules
Posterior hypothalamic zones; lesions here result in poikilothermy (environmental control of one's body temperature).
What area of the hypothalamus is responsible for recognizing a decrease in body temperature and mediates the response to conserve heat?
Duodenum
In what area of the GI tract are water-soluble vitamins absorbed?
Rapid cycling bipolar disorder
What is the name of depression and mania alternating within a 48-to 72-hour period?
Reserpine
What drug blocks intragranular uptake of NE?
PGE2 and PGF2α
What two PGs are used to induce labor?
I-cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
What genetic defect is characterized by coarse facial features, gingival hyperplasia, macroglossia, psychomotor and growth retardation, club foot, claw hand, cardiorespiratory failure, and death in the first decade of life?
For males, HTN; for females, pregnancy.
What is the most common primary diagnosis resulting in an office visit for males? For females?
Pedophilia
What paraphilia is defined as • Sexual urges toward children?
Preoptic area of the hypothalamus; if the lesion occurs after puberty, amenorrhea or impotence will be seen.
If a lesion occurs before the onset of puberty and arrests sexual development, what area of the hypothalamus is affected?
1. α-Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl-coenzyme A, providing entry of oxidizable substrate into the Krebs cycle for the generation of energy
With what three enzymes is thiamin pyrophosphate (TPP) associated?
Mixed (both cholesterol and calcium)
What is the most common one? • Stone type associated with cholecystitis
Actually, yes. You should encourage your patient to try other forms of medicine as long as they are not contraindicated with the patient's preexisting illness. You must be able to accept the health beliefs of your patients, even if you don't agree.
Should you refer a patient to a form of folk medicine even if you don't believe in it?
Chromosome 11, 22
Name the associated chromosomal translocation. • Ewing sarcoma
No, you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
If a patient cannot pay, can you refuse services?
Ventromedial nucleus; lesions here result in obesity.
What nucleus of the hypothalamus is the satiety center, regulating food intake?
Menses. (Ovulation occurs 14 days before the beginning of menses.)
What is the term for the first 3 to 5 days of the female reproductive cycle?
Mast cells
What is the term to describe basophils that have left the bloodstream and entered a tissue?
Placental alkaline phosphatase
What tumor marker is associated with seminomas?
Bender Visual Motor Gestalt Test
What neuropsychologic test shows nine designs to the patient, then asks for recall of as many as possible?
G-6-PD
What is the rate-limiting enzyme of the HMP shunt?
True; it requires both a concentration gradient and ATP to work.
True or false? Active protein transport requires a concentration gradient.
TXA2
What potent platelet aggregator and vasoconstrictor is synthesized by platelets?
The vermis
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls the axial and proximal musculature of the limbs?
Odds ratio. (Case control studies deal with prevalence.)
What statistical method do you use when analyzing • Case control studies?
Varicella virus and influenza virus
What two viruses are associated with Reye's syndrome?
Dimercaprol
Name the antidote. • Gold
Native Americans
What ethnic group has the highest adolescent suicide rate?
ASA (salicylate)
What commonly encountered overdose produces headache, tinnitus, respiratory alkalosis, metabolic acidosis, confusion, vomiting, and tachypnea?
Angiosarcoma of the liver
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Vinyl chloride
Stimulus control
What operant conditioning therapy or modification is described as • Having a stimulus take over the control of the behavior (unintentionally)?
Negative
Are the following conditions associated with a negative or positive nitrogen balance? • Kwashiorkor
Hepatic glycogen phosphorylase
What enzyme is deficient in the following glycogen storage disease? • Hers' disease
Arginine
What AA is broken down into N2O, causing an increase in cyclic guanosine monophosphate (cGMP) of smooth muscle, hence vasodilation?
Hepatitis A
Which hepatitis virus is in the Picornaviridae family?
Acetaldehyde dehydrogenase
What enzyme is inhibited by disulfiram?
Cyanide
What form of poisoning is associated with bitter almond-scented breath?
One, and it provides the energy for mechanical contraction.
How many ATPs are hydrolyzed every time a skeletal muscle cross-bridge completes a single cycle?
Cori cycle
What cycle is responsible for converting to glucose in the liver the lactate produced in the RBCs?
False. Dopamine is an inhibitory neurotransmitter in the CNS.
True or false? Dopamine is an excitatory neurotransmitter in the CNS.
In the medulla; all the other structures are cortical.
Where in the kidney are the long loops of Henle and the terminal regions of the collecting ducts?
Hemorrhagic exudates
Name the type of exudate, given the following examples. • Rickettsial infection
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
What are the four components of the basement membrane?
Male pseudo-intersexuality (hermaphrodite); these individuals are 46XY.
What disorder is due to a 5--reductase deficiency, resulting in testicular tissue and stunted male external genitalia?
Elongation factor-G and GTP
What factors are needed for translation in prokaryotes?
S2, S3, S4—keeps the pee-pee off the floor!
What spinal nerves contribute to the pelvic splanchnic (parasympathetic) nerves that innervate the detrusor muscle of the urinary bladder?
Anorgasmia. (The overall prevalence is 30%.)
What is the term for an inhibited female orgasm?
Cauda equina
What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina?
Posterior cricoarytenoid muscles
Name the laryngeal muscle described by the following: • Only muscle to abduct the vocal cords
Granulosa/thecal cell tumor of the ovary
Call-Exner bodies
Pertussis toxin
What toxin ADP-ribosylates via Gi to increase cAMP?
Lac repressor protein
Regarding the Lac operon, for what do the following genes code? • I gene
GH and prolactin are produced by acidophils; all others are by basophils.
What two pituitary hormones are produced by acidophils?
Ascaris lumbricoides
What is the most common one? • Helminthic parasite worldwide
Formation of an identity through issues of independence and rebellion; they define who they are.
What is the key issue surrounding teenagers' maturation?
Phase I
What phase of Food and Drug Administration approval tests • The safety in healthy volunteers?
Basal cell carcinoma
What is the most common one? • Skin tumor in the United States
HBsAg (incubation period)
What is the first Ag seen in an individual with hepatitis?
Lactulose
Which laxative is used in the treatment of hepatic encephalopathy ?
Paramesonephric ducts
What embryonic structure forms the adult female structures? • Uterine tube, uterus, cervix, and upper third of the vagina
Sickle cell disease
Name the most common type or cause. • Hematologic cause of papillary necrosis
Taenia solium
What cestode causes cysticercosis?
Right brachiocephalic artery
Name the correct artery. • The right recurrent laryngeal nerve passes around it.
Albendazole
What drug blocks glucose uptake, leading to decreased formation of ATP and resulting in immobilization of the parasite?
GP120
What glycoprotein in the HIV virus attaches to CD4?
Posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Vagus nerve
As sample size increases, the lower the chance of error.
What is the relationship between chance of error and • Sample size?
PKU
What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
Secondary hypercortisolism (pituitary)
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol increased, ACTH increased
Type II error (beta error). (Remember it as saying something doesn't work when it does.)
What type of error is made if you accept the null hypothesis when it is false?
Entamoeba histolytica (treat with metronidazole)
What protozoal parasite results in dysentery with blood and pus in the stool, is transmitted via fecal-oral route, is diagnosed by cysts or trophozoites in the stool, and forms liver abscesses and inverted flask-shaped lesions in the large intestine?
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
When does most REM sleep occur, in the first or second half of sleep?
AT II
What hormone constricts afferent and efferent arterioles (efferent more so) in an effort to preserve glomerular capillary pressure as the renal blood flow decreases?
Splenomegaly and anemia (with a high index of suspicion)
What are the two most important features in the diagnosis of malaria?
Follicular lymphoma
What is the most common form of non-Hodgkin lymphoma in the United States?
Resorb CSF into the blood
What is the function of the arachnoid granulations?
Climbing fibers;, they are monosynaptic input on Purkinje cells. Mossy fibers, also excitatory, are axons of all other sources and synapse on granule cells.
What excitatory fibers arise from the inferior olivary nuclei on the contralateral side of the body?
Rapid efflux of potassium
What triggers phase 3 of the action potential in a ventricular pacemaker cell?
Fibrocystic change of the breast
Blue-domed cysts
TRUE
True or false? The epithelial lining of the urinary bladder and the urethra are embryologic hindgut derivatives.
Fungiform papillae
What papillae send their senses via chorda tympani of CN VII?
Conduction aphasia
Name the aphasia based on these characteristics: • Lesion is in the parietal lobe or arcuate fibers because the connection between Broca's and Wernicke's area is severed; word comprehension preserved; inability to write or speak the statement (can't tell you what you said)
Temporal lobes
What cerebral lobes are most commonly affected in herpes encephalitis?
Truncus arteriosus
From what embryonic structure are the following structures derived? • The ascending aorta and the pulmonary trunk
Phase III. It is considered the definitive test.
What phase of Food and Drug Administration approval tests • The efficacy and occurrence of side effects in large group of patient volunteers?
White rami are preganglionic fibers, whereas grey rami are postganglionic fibers.
Are white rami preganglionic or postganglionic fibers?
The alveoli at the apex are almost completely inflated prior to inflation, and although they are large, they receive low levels of alveolar ventilation.
Why is the apex of the lung hypoventilated when a person is standing upright?
Superior and posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Azygos vein
Squamous cell carcinoma (skin, lung) and angiosarcoma of the liver
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Arsenic
IL-8. It not only is chemotactic, it also acts as an adhesive for neutrophils.
What IL, produced by macrophages, is chemotactic for neutrophils?
Paget disease of the breast
What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting, fissuring, and oozing?
CN V
What CN is associated with the • First pharyngeal arch?
Absolutely not. Diabetics who are given a β-blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Is DM a contraindication to use of a β-blocker in a patient who is having an MI?
They are inversely related. If ventilation increases, there will be a decrease in PCO2 levels and vice versa.
What is the relationship between ventilation and PCO2 levels?
Bone deposition increases with increased Ca2+ or PO 4- concentrations, whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
Is bone deposition or resorption due to increased interstitial Ca2+concentrations?
Ureaplasma urealyticum
Which mycoplasma species is associated with urethritis, prostatitis, and renal calculi?
Macule (e.g., a freckle)
What is flat, circumscribed nonpalpable pigmented change up to 1 cm?
Mannitol
What IV-only agent inhibits water reabsorption in the PCTs and is used to treat increased intracranial pressure, increased intraocular pressure, and acute renal failure?
Metabolic acidosis (summary: low pH, high H+, and low HCO3-)
What primary acid-base disturbance is caused by a gain in fixed acid forcing the reaction to shift to the left, decreasing HCO3- and slightly increasing CO2?
Vaginismus; it is the female counterpart of premature ejaculation.
What is the term for involuntary constriction of the outer third of the vagina to prevent penile penetration?
Glucuronidation
What enzyme system is the most common form of phase II biotransformation?
Histamine
What neurotransmitter is associated with sedation and weight gain?
Schistosoma have separate males and females.
What is the only trematode that is not hermaphroditic?
Urogenital sinus
What embryonic structure forms the following adult structures? • Urinary bladder and urethra
Primary follicle (in the white pulp)
What is the name of the B cell-rich area of the spleen?
The lung will expand; also the opposite is true.
What happens to the lung if the intrapleural pressure exceeds lung recoil?
Lesser curvature of the antrum of the stomach
What is the most common one? • Location of a gastric ulcer
The left is a branch of the aortic arch, while the right is a branch of the brachiocephalic trunk.
The left subclavian artery is a branch of what artery?
Right nasal hemianopsia
Name the ocular lesion; be specific. • A right lateral compression of the optic chiasm (as in aneurysms in the internal carotid artery)
Free ionized Ca2+
What is the physiologically active form of Ca2+?
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
What infection is associated with ring-enhancing lesions seen on computed tomography (CT) of the brain in an HIV-positive individual?
Vesicle (e.g., poison ivy)
What is an elevated, fluid-filled cavity between skin layers up to 0.5 cm?
Left atrial myxoma
What is the most common one? • Cardiac tumor
Down syndrome
What is the most common chromosomal disorder?
Arnold-Chiari malformation type 2
What CNS developmental abnormality is associated with downward displacement of the cerebellar vermis and medulla compressing the fourth ventricle and leading to obstructive hydrocephalus?
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
What is the term for the dementia characterized by decremental or patchy deterioration in cognitive function due to a cerebrovascular accident?
Hemolytic uremic syndrome
What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
Bacillus cereus
What organism would you suspect in a patient with diarrhea after eating rice?
Glanzmann syndrome
What AR disorder is due to a deficiency in glycoprotein IIb-IIIa, resulting in a defect in platelet aggregation?
Mallory-Weiss syndrome
What is the term for severe and protracted vomiting resulting in linear lacerations at the gastroesophageal junction?
Erectile dysfunction
What are the pharmacologic effects seen sexually with • Neuroleptics?
Coccidioides immitis
Which dimorphic fungus is found as Arthroconidia in desert sand of the southwestern United States (e.g., San Joaquin Valley)?
The conversion of tyrosine to dopamine in the cytoplasm
What is the rate-limiting step in the synthetic pathway of NE at the adrenergic nerve terminal?
Glyceraldehyde dehydrogenase
What is the enzyme for the oxidative reaction in glycolysis?
Galactose and glucose
What two monosaccharides are produced when lactose is hydrolyzed?
Gardner syndrome
What AD GI neoplasia produces multiple adenomatous polyps, osteomas, fibromas, and epidural inclusion cysts?
Fitz-Hugh-Curtis syndrome
What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
14 days in most women (Remember, the luteal phase is always constant.)
How many days before the first day of menstrual bleeding is ovulation?
Fibrocystic change of the breast
What is the most common one? • Benign lesion that affects the breast
Anatomical dead space, which ends at the level of the terminal bronchioles.
What is the term for any region of the respiratory system that is incapable of gas exchange?
Unconjugated free bilirubin
What form of bilirubin can cross the blood-brain barrier?
Thiamine and folate
What two vitamins are inactivated when they come in contact with acetaldehyde?
Opsonization
By which process do Abs make microorganisms more easily ingested via phagocytosis?
Cysticerci
What is the term for cestode-encysted larvae found in intermediate hosts?
Frontal lobe
Name the area of the cerebral cortex with the function described: • Speech; critical for personality, concentration, initiating and stopping tasks (do one thing and begin a new without completion of the first), abstract thought, and memory and higher-order mental functions
RES(Reticular endothelial system)
Where in the body is heme converted to bilirubin?
Coronary circulation
Where are the lowest resting PO2 levels in a resting individual?
Hydrolysis
What form of oxidation takes place with the addition of a water molecule and breakage of bonds?
The T-test (used when comparing two groups)
What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
SLE; ANA, anti-dsDNA and anti-Sm (anti-Smith)
A 20-year-old black woman goes to you with nonspecific joint pain, fever, and a malar rash over the bridge of her nose and on her cheeks. This is a classic example of what autoimmune disease? What are three autoantibody tests you could order to make the diagnosis?
Arterioles
What component of the vascular system is most sensitive to the effects of calcium channel blockers?
Temporal arteritis
What is the most common one? • Vasculitis
Because they do not block D2A receptors, they are antagonists of 5HT2 receptors.
Why are clozapine and olanzapine unlikely to result in EPS effects?
Isotonic contraction
What type of muscle contraction occurs when the muscle shortens and lifts the load placed on it?
Medullary carcinoma of the thyroid
What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?
Metronidazole
What is the DOC for the following protozoal infections? • Trichomoniasis
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
What organ of the body has the smallest AV oxygen difference?
BPH
What is the most common one? • Proliferative abnormality of an internal organ
Pyelonephritis
In what condition do you see dimpling on the kidney's surface?
Renal circulation
Where is the greatest venous PO2 in resting tissue?
MGB (think EARS)
Name the thalamic nucleus based on its input and output. • Input from inferior colliculus; output to primary auditory cortex
Guanethidine and bretylium
What two drugs inhibit the release of neurotransmitters from storage granules?
Granulosa cell
What cell converts androgens to estrogens?
After the eclipse period
Regarding the viral growth curve, is the internal virus present before or after the eclipse period?
Ethyl alcohol
Name the antidote. • Ethylene glycol
Subthreshold potential
What type of potential is characterized as graded, decremental, and exhibiting summation?
Glutamine and aspartate
What two AAs act as excitatory transmitters in the CNS, generating EPSPs?
Osteoclasts
What cell in bone is a part of the mononuclear phagocytic system?
Yes, it decreases fat and muscle uptake of glucose, thereby increasing blood glucose levels.
Is GH considered a gluconeogenic hormone?
Aedes mosquito
What is the vector for yellow fever?
Metaplasia (usually to a more protective cell type)
What is the term for a reversible change in one cell type to another?
Posterior compartment of the thigh, tibial nerve
Name the compartment of the lower extremity and the nerve based on its movements. • Extend the hip and flex the knee
Prolyl and lysyl hydroxylases
What two post-transcriptional enzymes in collagen synthesis require ascorbic acid to function properly?
Marrow failure, cancer, and leukemia
What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti-Ab
What are the four ways to down-regulate the immune system?
X-linked recessive
What pattern of genetic transmission affects only M and has no M-to-M transmission, and mother is usually an unaffected carrier?
MEN III (or IIb)
Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and mucocutaneous neuromas
Chromosome 13
Name the associated chromosome. • Patau syndrome
Flea-bitten kidney (can also be seen in pyelonephritis)
What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)?
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
To what is the diffusion rate indirectly proportional?
Nitrofurantoin
Name the antimicrobial agent whose major side effect is listed. • Hemolytic anemia
Bordetella pertussis
What small gram-negative aerobic rod requires Regan-Lowe or Bordet- Gengou medium for growth?
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Telencephalon
True. Increased alkaline phosphatase levels also are associated with increased bone formation.
True or false? An elevated serum osteocalcin level is a marker for increased bone formation.
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
What CNs are responsible for the sensor and motor components of the light reflex?
LC4, LD4, and LE 4
What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
PDA
What is the most common one? • Cardiac anomaly in children
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Can committed mentally ill patients refuse medical treatment?
Squamous cell carcinoma
What type of skin carcinoma occurring on sun-exposed sites has a low level of metastasis?
Dysmetria; this is seen in a finger-to-nose test.
What is the name for inability to stop a movement at the intended target?
Sensitivity (it deals with the sick)
The proportion of truly diseased persons in the screened population who are identified as diseased refers to?
Early collecting duct
What is the site of action of the following? • K+-sparing diuretics
True. They are useful in the early-phase response to an asthmatic attack.
True or false? Beta2-Adrenergic agents are used in the management of an acute asthmatic attack.
REM
Name the stages of sleep with these EEG patterns: • Sawtooth waves, random low voltage pattern
100%, with about 20% remaining positive after 1 year
What percentage of children born to HIV-positive mothers will test positive for HIV at birth?
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
A single mRNA strand translated by a ribosome is termed what?
Decreased REM sleep and REM rebound during withdrawal
How is sleep affected in a person with alcohol intoxication?
EF-G of the 50S subunit
What prokaryotic positioning enzyme in translation is blocked by the following? • Erythromycin
The granule cell is the only excitatory neuron in the cerebellar cortex, and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons, and they use GABA as their neurotransmitter.
What is the only excitatory neuron in the cerebellar cortex, and what is its neurotransmitter?
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
What are the five F's associated with gallstones?
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
The closure of what valve indicates the beginning of the isovolumetric relaxation phase of the cardiac cycle?
Arboviruses (bunyavirus, flavivirus, and togavirus)
What is the term given to arthropod-borne viruses?
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Which of the following—DNA methylating enzymes, scaffolding proteins, histone acetylases, or deacetylases—is a regulator of eukaryotic gene expression?
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
When does most of the NREM sleep (stage 3 and 4) occur, in the first or second half of sleep?
Klinefelter syndrome
Name the most common one. • Chromosomal disorder involving sex chromosomes
The folding of an AA chain
What is determined by the secondary structure of an AA?
Inhaled anesthetics with low lipid solubility have low potency (directly related), so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
True. They are the sensory component of a spinal reflex.
True or false? Neurons in the dorsal horn participate in reflexes.
pK (think of it as where half is base and half is acid)
What is the term for the pH range where the dissociation of H+ occurs?
When the pH is more acidic than the pI, it has a net positive charge, and when the pH is more basic than the pI, it has a net negative charge.
If the pH is more acidic than the pI, does the protein carry a net positive or net negative charge?
50%, with 50% of them having the child
What percent of unwed mothers are teenagers?
Skin, liver, and kidneys
What three organs are necessary for the production of vitamin D3(cholecalciferol)?
Sulfonamides
What class of antimicrobial agents should be avoided in patients with a history of GPDH deficiency?
Lente or NPH insulin (neutral protamine Hagedorn insulin)
Name the insulin preparation based on the peak effect and duration of action. • Peak, 8 to 12 hours; duration, 18 to 24 hours
Mycosis fungoides (cutaneous T-cell lymphoma)
What skin carcinoma is a superficial dermal infiltrate of T lymphocytes seen in males more than 40 years old and presents as scaly red patches or plaques?
Third week
What embryonic week sees the formation of the notochord and the neural tube?
Congenital heart disease
Name the most common type or cause. • Childhood heart disease in the United States
Increases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. --------------------------------------------------------------------------------
When a person goes from supine to standing, what happens to the following? • Dependent venous pressure
Receptive aphasia is due to a lesion in Brodmann areas 22, 39, and 40; generally the patient is unaware of the deficit.
What aphasia is seen as an inability to comprehend spoken language and speaking in a word salad?
Atrophy. Disuse can also be due to immobilization, ischemia, aging, and a host of other causes.
What is the term to describe a decrease in the cell size and function usually associated with disuse?
Anterior spinal artery
What branch off the vertebral artery supplies • The ventrolateral two-thirds of the cervical spinal cord and the ventrolateral part of the medulla?
Hepatitis E (enteric)
Which type of hepatitis is a calicivirus?
Mitosis
What phase of the cell cycle are the following antineoplastic agents specific for? • Paclitaxel
C1 esterase inhibitor (C1INH)
Hereditary angioneurotic edema (AD) produces local edema in organs (e.g., GI, skin, respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides?
Melatonin. It is a light-sensitive hormone that is associated with sleepiness.
What pineal hormone's release is inhibited by daylight and increased dramatically during sleep?
PCR
What test uses very small amounts of DNA that can be amplified and analyzed without the use of Southern blotting or cloning?
INF-gamma
What cytokine do Th1 cells secrete to inhibit Th2 cell function?
2 ATPs, because RBCs use only anaerobic metabolism.
How many ATPs per glucose are generated from glycolysis in RBCs?
Ipsilateral flaccid paralysis
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • LMN?
Two major or one major and two minor
How many major and/or minor Jones criteria are required for the diagnosis of rheumatic fever?
Both are AR with conjugated hyperbilirubinemia, but Dubin-Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Is Dubin-Johnson or Rotor syndrome associated with black pigmentation of the liver?
Vertebra prominens (C7 in 70% of cases, C6 in 20%, T1 in 10%)
What is the name for the most prominent spinous process?
Heterochromatin, the light stuff in the nucleus on an electron microscope image.
What type of chromatin is transcriptionally inactive?
Confounding bias
When more than one explanation can account for the end result, what form of bias occurs?
Frameshift
Name the type of mutation: • The deletion or addition of a base
Arginine
What AA has a pKa of 13?
Heart disease
What is the MCC of death in the United States?
Proton pump inhibitors
What class of drugs are the DOCs for peptic ulcer disease, Zollinger-Ellison syndrome, and gastroesophageal reflux disease?
Scrofula
What is the term for TB with the cervical lymph node involved?
Chromosome 18
Name the associated chromosome. • Edward syndrome
Down syndrome (trisomy 21)
Name the most common one. • Chromosomal disorder
Toxoplasma gondii
Which parasitic organism, when it crosses the placenta, results in intracerebral calcifications, chorioretinitis, microcephaly, hydrocephaly, and convulsions?
The hallmarks of LMN lesion injury are absent or decreased reflexes, muscle fasciculations, decreased muscle tone, and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget, LMN lesions are ipsilateral at the level of the lesion!
What happens to muscle tone and stretch reflexes when there is a LMN lesion?
Familial hypercholesterolemia
What AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas?
Squamous cell carcinoma
What is the most common one? • Esophageal carcinoma
Acute toxic or viral nephrosis
Renal epithelial casts in the urine
REM sleep. Remember, awake brain in a sleeping body.
Aroused EEG pattern (fast low voltage and desynchronization), saccadic eye movements, ability to dream, and sexual arousal are all associated with what general pattern of sleep?
Anterior wall of the first part of the duodenum
What is the most common one? • Location of a duodenal ulcer
Salmonella typhi
What Vi-encapsulated gram-negative motile anaerobic rod that produces H2S is associated with enteric fever, gastroenteritis, and septicemia?
Decreases
With an increase in arterial systolic pressure, what happens to • Heart rate?
Pseudogout
What form of arthritis is associated with calcium pyrophosphate crystals?
Right atrium
What part of the heart forms • The right border?
Osteosarcoma
What is the most common primary malignant tumor in bone?
AML-M3
Auer rods
False. Metformin does not have weight gain as a potential side effect (unlike sulfonylureas).
True or false? Metformin is contraindicated in obese patients because of weight gain as its side effect.
Neisseria meningitidis
Which organism releases endotoxins prior to cell death?
Postinfectious GN
What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex-mediated; and is seen as lumpy-bumpy subepithelial deposits?
12 to 16 weeks (in response to mother's face)
At what age does a child develop • Preferential smile?
CD4
Name the T-cell CD marker: • Interacts with MHC class II molecules
The time it takes ACh to diffuse to the postjunctional membrane
What is the rate-limiting step in a conduction of a NMJ?
Increased REM sleep, decreased REM latency, and decreased stage 4 sleep, leading to early morning awakening
What happens to REM, REM latency, and stage 4 sleep during major depression?
Patent urachus
What is the name for failure of the allantois to close, resulting in a urachal fistula or sinus?
Clarke's nucleus
What nucleus, found in the intermediate zone of the spinal cord, sends unconscious proprioception to the cerebellum?
Aromatase
What enzyme converts androgens to estrogens?
Oxytocin
What hormone causes milk letdown?
Serocystadenocarcinoma
What is the most common one? • Primary malignant tumor of the ovary
Histiocytosis X
What malignant tumor of the skin is associated with Birbeck granules?
False. Atelectasis is a reversible collapse of a lung.
True or false? Atelectasis is an irreversible collapse of a lung.
CN V, VI, VII, and VIII
What CNs arise from • The pons?
Hyperpolarization (i.e., K+ influx)
What is the term for the negative resting membrane potential becoming more negative?
Carbamazepine
Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
True; the greater the fat, the less the total body water.
True or false? There is an inverse relationship between fat content and total body water.
ACTH
What hormone excess produces adrenal hyperplasia?
Common peroneal nerve
Fracture of the fibular neck, resulting in foot drop, is an injury of what nerve?
True. No loss of drug and no absorption if a drug is given IV.
True or false? There is no absorption of an IV-administered drug.
Proencephalon* *diencephalon derivative
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Pineal gland
They innervate skeletal muscle.
What do LMNs innervate?
Yes, by three to four times. Having multiple sexual partners, being overweight, and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.
Are sexually abused females more likely to have learning disabilities than the general population?
Aspiration
Name the most common type or cause. • Lung abscess
Ribonucleotide reductase
What enzyme of pyrimidine synthesis is inhibited by the following? • Hydroxyurea
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
What disorder is defined by inability of the lower esophageal sphincter to relax with swallowing and a bird beak barium swallow result?
Folate, vitamin B12, and vitamin B6
What three vitamin deficiencies are associated with homocystinemia?
Minocycline
What tetracycline is associated with vestibular toxicity?
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Which anticonvulsant causes gingival hyperplasia?
Undoing
Fixing impulses by acting out the opposite of an unacceptable behavior
Repolarization is from base to apex and from epicardium to endocardium.
How does ventricular repolarization take place, base to apex or vice versa?
Carbamazepine
What antiepileptic agent has SIADH as a side effect?
Interval scale (a ruler, for example)
What type of scale is graded into equal increments, showing not only any difference but how much?
Wernicke's aphasia
Name the aphasia based on these characteristics: • Lesion in Brodmann area 22; impaired comprehension; incoherent rapid, fluent speech; verbal paraphrasias; trouble repeating statements
Isoniazid treatment
What is the most common cause of vitamin B6 deficiency?
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Diencephalon
Stage 1
Name the stages of sleep with these EEG patterns: • Disappearance of alpha waves, appearance of theta waves
The surface of the medulla
What region of the brain houses the central chemoreceptors responsible for control of ventilation?
Muscle glycogen phosphorylase
What enzyme is deficient in the following glycogen storage disease? • McArdle's disease
Enterobius vermicularis
What is the most common one? • Helminth parasitic infection in the United States
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Denies being blind, cortical blindness
Melanocytes
What cell type of the epidermis originates from the neural crest?
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes, but the accommodation-convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
What is the term for the type of pupil seen in neurosyphilis, and what ocular reflexes are lost?
Celiac sprue (gluten-sensitive enteropathy)
What malabsorption syndrome produces abdominal distention, bloating, flatulence, diarrhea, steatorrhea, and weight loss shortly after eating bread products?
No. It is abnormal only if it interferes with normal sexual or occupational function.
Is masturbation considered an abnormal sexual practice?
Yes. It is also a cause of cancers of the lung, esophagus, ureter, and kidney, just to name a few.
Is cigarette smoking associated with transitional cell carcinoma of the bladder?
REM latency; normally it is about 90 minutes.
What is the period between falling asleep and REM sleep called?
CN V1, the occulomotor division of the trigeminal nerve, is the sensory component of the corneal reflex.
What CN transmits sensory information from the cornea?
SHIP: Shifting of the aorta, Hypertrophy of the right ventricle, Interventricular septal defect, Pulmonary stenosis
What is the tetrad of tetralogy of Fallot?
Increase in urinary excretion of HCO3-, shifting the reaction to the right and increasing H+
What is the renal compensation mechanism for alkalosis?
1. Short attention span 2. Impulsivity 3. Hyperactivity
What are the three characteristics of ADHD?
Puborectalis
What component of the pelvic diaphragm forms the rectal sling (muscle of continence)?
Plasmodium malariae
Name the Plasmodium species based on the following information:No persistent liver stage or relapse; blood smear shows rosette schizonts; 72-hour fever spike pattern
Cytokine. If a cytokine affects another class of leukocytes, it is called an interleukin.
What is the term for a substance secreted by a leukocyte in response to a stimulus?
Unstable (crescendo) angina
What form of angina is characterized by • Coronary artery nonocclusive thrombus; symptom occurrence with increasing frequency, duration, intensity, and decreasing activity, frequently at rest?
As the isotype is switched, the Ab specificity does not change because it does not affect the variable chains.
What happens to the Ab specificity when class switching occurs in mature B cells?
Medial meniscus
What structure of the knee is described thus? • C-shaped shock absorber; aids in attachment of the tibia to the femur via the medial collateral ligament
False. It closes just after birth because the change in pulmonary circulation causes increased left atrial pressure.
True or false? The foramen ovale closes just prior to birth.
IL-10
What IL down-regulates cell mediated immunity?
Neutropenia, splenomegaly, and rheumatoid arthritis
What is the triad of Felty syndrome?
Absolute refractory period is due to voltage inactivation of sodium channels.
Name the period described by the following statement: no matter how strong a stimulus is, no further action potentials can be stimulated.
>5 mm
What is the size of a positive PPD test for the following? (Reactive) • Patient with AIDS
Dynorphin
What is the neurotransmitter at the K-receptor?
Carnitine acyl CoA transferase II
Which shuttle is used to bring fatty acyl CoA from the cytoplasm for ketogenesis?
Disseminated intravascular coagulation (DIC)
What disorder is associated with decreased platelet count, prolonged PT and PTT, decreased fibrinogen, and increased fibrin split products (D-dimers)?
hCS and serum estriol, which are produced by the fetal liver and placenta, respectively, are used as estimates of fetal well-being.
What hormones, secreted in proportion to the size of the placenta, are an index of fetal well-being?
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa, resulting in a narrowed pyloric outlet
Projectile nonbilious vomiting and a small knot at the right costal margin (olive sign) are hallmarks of what embryonic disorder?
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints?
Teratoma
What tumor constitutes 40% of testicular tumors in children?
Duodenum
What segment of the small intestine is associated with Brunner's glands?
Hapten (not immunogenic)
What is the term for a single isolated antigenic determinant?
Thoracic and sacral
What two regions of the vertebral column are considered primary curvatures?
Hydroxyapatite
What is the major inorganic component of bone?
Pseudomonas aeruginosa
Which bacteria are associated with the following pigment production? • Pyocyanin (blue-green)
Large segment deletions
Name the type of mutation: • Unequal crossover in meiosis with loss of protein function
Protamine sulfate
Name the antidote. • Heparin
PCT
What is the longest and most convoluted segment of the nephron?
Klüver-Bucy syndrome
What syndrome is characterized by bilateral medial temporal lobe lesion, placidity, hyperorality, hypersexuality, hyperreactivity to visual stimuli, and visual agnosia?
McArdle's syndrome
What glycogen storage disease is due to the following enzyme deficiencies? • Muscle phosphorylase
Erythema multiforme
What type of erythema do you see in • Stevens-Johnson syndrome?
Hydroxyproline (breakdown product of collagen)
Excess bone demineralization and remodeling can be detected by checking urine levels of what substance?
Nystagmus and ataxia
What are the first signs of overdose from phenobarbitals?
HHV 8
What herpes virus is associated with Kaposi sarcoma?
Albumin
What protein carries free fatty acids to the liver?
Paroxysmal nocturnal hemoglobinuria
What form of anemia is diagnosed with sucrose lysis test and Ham test?
Pyelonephritis
What is the term for ascending bacterial infection of the renal pelvis, tubules, and interstitium causing costovertebral angle tenderness, fever, chills, dysuria, frequency, and urgency?
Anxiety disorders; for men it is substance abuse.
Name the most common type. • Psychiatric disorder in women of all ages
Secondary hypocortisolism (pituitary)
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol decreased, ACTH decreased
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
What medication is used to help alcoholics avoid relapse by decreasing glutamate receptor activity?
Basal ganglia
Name the area of the cerebral cortex with the function described: • Initiation and control of movements
Isovolumetric contraction
What is the most energy-demanding phase of the cardiac cycle?
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Lumbar vertebrae?
Gastric ulcer
What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
Fibroadenoma
What is the most common one? • Benign breast tumor in females less than 35 years old
Thyroid hormones are necessary for conversion of carotene to vitamin A.
Why is hypothyroidism associated with night blindness?
Epispadia
What is the term for the external urethra opening onto the dorsal surface of the penis?
Tetracycline
Name the antimicrobial agent whose major side effect is listed. • Dental staining in children
Libman-Sacks endocarditis
What form of endocarditis do patients with SLE commonly encounter?
Listeria
What gram-positive rod is distinguished by its tumbling motility?
False. Females are more likely to develop femoral hernias then males (remember Female's Femoral).
True or false? Males are more likely to develop femoral hernias than females.
The outer cortex contains most of the germinal centers and therefore also most B cells.
What area of the lymph node contains germinal centers?
Site 3
Name the Hgb-O2 binding site based on the following information: • Requires a PO2 level of 40 mm Hg to remain attached
Metaproterenol and albuterol
What two β2-agonists are used to produce bronchodilation?
G-6-PD deficiency
In what X-linked recessive disease is there a decrease in the HMP shunt, along with Heinz body formation?
Subacute combined degeneration, which is bilateral below the level of the lesion.
What is the name of demyelination of the corticospinal tract and the dorsal column in the spinal cord due most commonly to a vitamin B12 deficiency?
DNA polymerase I
What enzyme has a 5' to 3' synthesis of the Okazaki fragments, 3' exonuclease activity, and 5' exonuclease activity?
Albinism
What disorder is due to a deficiency in tyrosinase?
Negative correlation
What type of correlation is defined as • One variable that diminishes in the presence of the other?
Axis IV
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Psychosocial and environmental problems (stressors)?
Steroid synthesis, drug detoxification, triglyceride resynthesis, and Ca2+handling
What are the four functions of SER?
Vagus nerve
What CN is associated with the sensory innervation of • Laryngopharynx?
Stable angina
What form of angina is characterized by • Coronary artery luminal narrowing, symptom occurrence during exertion, ST segment depression on ECG?
CN IV
What is the only CN to arise from the dorsal surface of the midbrain?
Physostigmine
Name the antidote. • Anticholinergics
ASA
What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?
False. Meningococcus is encapsulated; Gonococcus is not.
True or false? Gonococcus is encapsulated.
Schistosoma haematobium
Which trematode is associated with bladder carcinoma in Egypt and Africa?
18 years old (except if emancipated)
What is the legal age to be deemed competent to make decisions?
K1 capsule
What capsular serotype is associated with Escherichia coli- induced meningitis?
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
IL-7 (A 7 upside down is an L; L is for Lymphoid)
What IL is essential for lymphoid cell development?
CN III, IV, and VI
What three CNs are associated with conjugate eye movements?
Vibrio parahaemolyticus
What organism is associated with the following types of diarrhea? Diarrhea associated with raw or undercooked shellfish
Sideroblastic anemia
Name the hypochromic microcytic anemia based on the following laboratory values. • Increased iron, decreased TIBC, increased percent saturation, increased ferritin
Grasp proceeds release
In regard to motor development during infancy, choose the motor response that happens first. • Release or grasp
Caisson disease
What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur, humerus, and tibia?
α-1, 6 transferase
Deficiencies in what enzyme result in insoluble glycogen synthesis formation?
Eosin
Do the following structures pick up stain from hematoxylin or eosin? • Thyroid colloid
von Gierke's disease
What glycogen storage disease is due to the following enzyme deficiencies? • Glucose-6-phosphatase
Look for broken blood vessels in the baby's eyes.
In what organ system would you attempt to localize a sign for shaken baby syndrome"? What do you look for?
Pick's disease
What rare form of dementia is associated with personality changes and affects the frontal and temporal lobes?
Magnesium
What is the DOC for treating torsade de pointes?
NADPH oxidase is deficient, resulting in an inability to produce toxic metabolites.
What enzyme is deficient in patients with CGD?
Hypoparathyroidism
What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate?
Alkaline phosphatase
What enzyme is associated with osteoblastic activity?
Riboflavin (B2) deficiency
What vitamin deficiency produces angular stomatitis, glossitis, and cheilosis?
Sjögren disease
For what disease are SS-A(Ro), SS-B(La), and R-ANA diagnostic markers?
Neuroblastoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • N-myc
True. The energy status of the cell dictates if the cycle is running or relaxing.
True or false? There is no hormonal control to the TCA cycle.
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
ADH is secreted in response to what two stimuli?
Red blood cell distribution width index (RDW)
What is the name for the following RBC indices? • The coefficient of variation of the RBC volume
Rheumatoid arthritis
What is the most common one? • Inflammatory arthritis
B lymphocyte
What cell type involves humoral immunity?
1. Iliocostalis 2. Longissimus 3. Spinalis ("I Love Science" muscles)
What three muscles constitute the erector spinae?
IgA nephropathy (Berger disease)
Name the nephritic disease based on the immunofluorescent staining. • Mesangial deposits of IgA and C3
CN III and IV
What CNs are affected if there is a lesion in • The midbrain?
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 decreased
Pro-opiomelanocortin (POMC) is cleaved into ACTH and β-lipotropin.
Corticotropin-releasing hormone promotes the synthesis and release of what prohormone?
Bell pad
What has proved to be the best way to extinguish enuresis?
Parvovirus
Name the DNA virus: • ssDNA; naked; icosahedral; replicates in the nucleus
Resistance and vessel length are proportionally related. The greater the length of the vessel, the greater the resistance is on the vessel.
How are resistance and length related regarding flow?
L4 to S3 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Tibial nerve
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
What happens to the intrapleural pressure when the diaphragm relaxes?
Diazoxide
Which direct-acting vasodilator is used clinically to treat hypertensive emergencies, insulinomas, and as a uterine smooth muscle relaxant?
Volkmann's contracture
What is the term when the brachial artery is compressed, resulting in ischemic contracture of the hand?
Clostridium perfringens
What is the only nonmotile pathogenic Clostridium species?
Dementia Urinary incontinence Gait apraxia (NPH wet, wacky, wobbly)
What is the triad of NPH?
Azathioprine
What immunosuppressive agent is converted to 6-mercaptopurine?
Sphingosine
What sphingolipid is formed by the union of serine and palmitoyl CoA?
CD3
Name the T-cell CD marker: • Expressed on all T cells and is needed as a signal transducer for the T cell receptor
Contralateral loss below and bilateral loss at the level of the lesion
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • Spinothalamic tract?
Gubernaculum
What embryonic structure forms the adult female structures? • Ovarian and round ligaments
Campylobacter jejuni
What microaerophile is a motile gram-negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
If a peripheral blood smear shows schistocytes, reticulocytes, and thrombocytopenia, is it more commonly seen in patients with ITP or TTP?
Graves disease
What disorder leads to IgG autoantibodies to the TSH receptor?
Meckel diverticulum
What congenital small bowel outpouching is a remnant of the vitelline duct?
Osteosarcoma
What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
Serous exudates
Name the type of exudate, given the following examples. • Sunburn
Isolation of affect
Fact without feeling (la belle indifférence)
Tropomyosin
What is the name of the regulatory protein that covers the attachment site on actin in resting skeletal muscle?
Thrombocytopenia, eczema, and immunodeficiency is the triad of this X-linked recessive disorder.
What is the triad of Wiskott-Aldrich syndrome?
Medial midbrain (Weber's) syndrome
What syndrome is associated with the following brainstem lesions? • Posterior cerebral artery occlusion resulting in a contralateral corticospinal tract signs, contralateral corticobulbar signs to the lower face, and ipsilateral CN III palsy
Temporal arteritis (giant cell arteritis)
An 80-year-old woman presents to you with right-sided temporal headache, facial pain and blurred vision on the affected side, and an elevated ESR. Your diagnosis?
Transcortical aphasia
Name the aphasia based on these characteristics: • Lesion in the prefrontal cortex; inability to speak spontaneously; unimpaired ability to repeat
Proline and lysine
What two AAs require vitamin C for hydroxylation?
Pinpoint pupils, decreased respiratory rate, and coma
What are the three signs of morphine overdose?
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?
The lack of glutathione peroxidase activity results in a decrease in NADPH production, leaving glutathione in the reduced state.
What causes the lysis of RBCs by oxidizing agents in a G-6-PD deficiency?
Sphingomyelin (lecithin also, but it is not a sphingolipid)
What is the only sphingolipid that contains choline and PO4?
IgM
What is the Ig associated with the primary immune response?
Pterygopalatine ganglion (I remember this as the only ganglion left.)
What is the name of the postganglionic parasympathetic ganglion that innervates • The lacrimal gland and oral and nasal mucosa?
Ferritin
What is the physiologic storage form of iron?
Cystadenoma
What is the most common one? • Benign ovarian tumor
True. Yohimbine, sodium lactate, and epinephrine can also induce panic attacks; they are considered panicogens.
True or false? Panic attacks can be induced by hyperventilation or carbon dioxide.
Dorsal motor nucleus of CN X
What parasympathetic nucleus is found on the floor of the fourth ventricle and supplies preganglionic fibers innervating the terminal ganglias of the thorax, foregut, and midgut?
Ovulation
What is the term for the day after the LH surge in the female cycle?
Pygmalion effect (experimenter expectancy). This can be eliminated with double-blind studies.
What form of bias occurs when the experimenter's expectation inadvertently is expressed to the subjects, producing the desired effects? How can it be eliminated?
Duodenal ulcer
What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
Dendrites receive information, whereas axons send information.
What part of a neuron receives information?
Stage 3 and 4
Name the stages of sleep with these EEG patterns: • Delta waves
The sandfly
What is the vector for Leishmania infections?
Major
Are the following major or minor Jones criteria of rheumatic fever? • Pericarditis
Ordinal scale (e.g., faster/slower, taller/shorter)
What scale assesses a rank order classification but does not tell the difference between the two groups?
IgG3
What subtype of IgG does not bind to staphylococcal A protein?
At the end of the PCT 25% of Na+, Cl-, K+ is left
What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Percentage of Na+, Cl-, K+ left in the lumen
True if she is Rho-negative; false if she is Rho-positive
True or false? If a mother delivers a Rho-positive baby, she should receive Rho-immunoglobulin.
Inferior phrenic artery
What is the first branch of the abdominal artery?
env structural protein
What HIV structural gene produces GP120 and GP41?
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
What are the four effects of suckling on the mother?
Substantia nigra
In Parkinson's disease, what area of the basal ganglia has a decreased amount of dopamine?
CCK stimulates the pancreas to release amylase, lipase, and proteases for digestion.
What is the pancreatic action of CCK?
Third week; they are derived from the wall of the yolk sac.
Blood and its vessels form during what embryonic week?
Substance P. (Opioids relieve pain in part by blocking substance P.)
What 11-amino acid peptide is the neurotransmitter of sensory neurons that conveys pain from the periphery to the spinal cord?
Agglutination test
What immunologic test checks for a reaction between Abs and a particular Ag? (hint: ABO typing)
Stercobilin
What bile pigment is formed by the metabolism of bilirubin by intestinal bacteria, giving stool its brown color?
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
How is the eye affected by use of opioids?
Kartagener's syndrome (also known as immotile cilia syndrome) --------------------------------------------------------------------------------
What syndrome is characterized by dynein arm abnormality resulting in chronic sinusitis, recurrent pulmonary infections, and infertility?
Reverse transcription
What is the term for production of a DNA copy from an RNA molecule?
LDL
Name the lipoprotein based on the following characteristics. • apo B-100
Primary Hemochromatosis
What disease is associated with the HLA-A3 allele
The granule cell. Its neurotransmitter is glutamic acid, which is also the principal neurotransmitter of the visual pathways.
What is the most abundant neuron in the cerebellum?
Processed antigenic peptides bound in the groove of the MHC molecule
What type of Ag do T cells recognize?
Translation
What is the term for taking an mRNA molecule and arranging the AA sequence forming a protein?
Testicular tumors
What is the most common one? • Tumor in men aged 15 to 35
Aminoglycosides
Name the antimicrobial agent whose major side effect is listed. • CN VIII damage (vestibulotoxic)
Methicillin
Which penicillin can cause interstitial nephritis?
Th2 cells
What subset of CD4 T cells is responsible for mast cell and eosinophil precursor proliferation?
Phase I
Are hydrolysis, oxidation, and reduction phase I or II biotransformations?
Production of oxygen free radicals
From what do catalase, superoxide dismutase, and glutathione peroxidase defend the cell?
Progestin
Is hirsutism a side effect of estrogen or progestin therapy?
Aschoff bodies of rheumatic fever
What foci of fibrinoid necrosis are surrounded by lymphocytes and macrophages throughout all the layers of the heart?
Voltage-gated calcium channel
Name the ventricular muscle membrane channel: • Closed at rest; depolarization causes channels to open slowly
Yolk sac tumor
What is the most common one? • Germ cell tumor in boys
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • IVC
True; cortisol inhibits glucose uptake in most tissue, making it available for neural tissue use.
True or false? Cortisol inhibits glucose uptake in skeletal muscle.
CD19
Name the B-cell CD marker: • Used clinically to count B cells in blood
Merkel cells (Merkel's tactile cells)
What cells of the epidermis, derived from the neural crest, act as mechanoreceptors?
Type III hypersensitivity reaction
What type of hypersensitivity is a result of high circulating levels of soluble immune complexes made up of IgG or IgM Abs?
Orotic acid (purine metabolism)
What is the pyrimidine intermediate that joins PRPP (5-Phosphoribosyl-1-Pyrophosphate)?
Smoking
What is the leading cause of preventable premature death and illness in the United States?
Microglia. All others are neuroectodermal derivatives.
What is the only neuroglial cell of mesodermal origin?
Heart rate determines the diastolic interval, and contractility determines the systolic interval.
Does the heart rate determine the diastolic or systolic interval?
Thymic epithelial cells, dendritic cells, and macrophages
What three cells are essential for T-cell maturation?
Celecoxib
What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
Class IV
Which class of antiarrhythmics are calcium channel blockers?
AT II
What component of the renin-angiotensin-aldosterone axis increases sodium reabsorption in the proximal convoluted tubules and increases thirst drive?
9.3 L, 15% of body weight
What is the amount in liters and percent body weight for the following compartments? • Interstitial fluid
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
What are the three effects of insulin on protein metabolism?
Combined metabolic and respiratory acidosis
If the pH is low with increased CO2 levels and decreased HCO3- levels, what is the acid-base disturbance?
Pedophilia
What is the most common sexual assault?
Pulmonary alveolar macrophages
Name the macrophage based on its location: • Lung macrophages
Subarachnoid hematoma
What type of cerebral bleed is due to a rupture of a berry aneurysm in the circle of Willis?
Hyaluronic acid (all sulfates bind to the core protein)
What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan?
HBeAg
What Ag is needed to diagnose an infectious patient with hepatitis B?
HBsAb IgG
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Immunization
Varicella
What virus lies dormant in the • Dorsal root ganglia?
Increase in erythropoietin and increase in 2, 3-BPG, also called 2, 3-diphosphoglycerate (2, 3-P2Gri) (increase in glycolysis)
What two compensatory mechanisms occur to reverse hypoxia at high altitudes?
D2 and 5HT3 receptors
What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
The aorta
What large-diameter vessel has the smallest cross-sectional area in systemic circulation?
Renal failure
Name the MCC of death. • In SLE
H 2
Are the following responses associated with histamines H1 or H2 receptor activation? • Gastric acid secretion
Viscosity and resistance are proportionally related. The greater the viscosity, the greater the resistance is on the vessel.
How are resistance and viscosity related regarding flow?
Follicular phase
What phase of the female cycle occurs during days 1 to 15?
Case control studies cannot assess incidence or prevalence, but they can determine causal relationships.
Can incidence, prevalence, and cause and effect be assessed in • Case control studies?
Cross-sectional studies determine prevalence, not incidence or cause and effect.
Can incidence, prevalence, and cause and effect be assessed in • Cross-sectional studies?
Mature B cell; the memory B cell can have IgG, IgA, or IgE on its surface.
At what stage of B-cell development can IgM or IgD be expressed on the cell surface?
Helicobacter pylori, which is also associated with an increased risk of gastric carcinoma
What urease-producing gram-negative curved rod is associated with PUD and chronic gastritis?
Selenium (Se)
What mineral is an important component of glutathione peroxidase?
Tryptophan
What AA is a precursor of the following substances? • Serotonin
Glucose-6-phosphatase
What gluconeogenic enzyme is absent in muscle, accounting for its inability to use glycogen as a source for blood glucose?
Ptosis (eyelid drooping), miosis (pupillary constriction), and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1-to T4 are obstructed.
What is the triad of Horner's syndrome?
None; they are not formed until a girl reaches puberty.
How many oogonia are present at birth?
The sensory limb is via CN IX, and the motor limb is from CN X.
Which CNs act as the sensory and motor components of the gag reflex?
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
What disease is produced by a deficiency in the enzyme tyrosinase?
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
What are the four posttranslational modifications done by the Golgi apparatus?
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Does the oncotic pressure of plasma promote filtration or reabsorption?
Internal iliac nodes
What is the lymphatic drainage of the pelvic organs?
Selegiline
What MAOI does not cause a hypertensive crisis?
Minoxidil (orally and topically, respectively!)
Which α-blocking agent is used to treat refractory hypertension and baldness?
α-Methyldopa (Guanabenz or clonidine is also used.)
What is the drug of choice for hypertensive patients with a decreased renal function?
Atrial filling (venous filling) Atrial, Contraction, Venous
On the venous pressure curve, what do the following waves represent? • V wave?
PALS (Parietolateral lymphocytic sheath)
What is the name of the T cell-rich area of the spleen?
Haloperidol and fluphenazine (but use of any high-potency phenothiazine runs the risk of EPS)
Which two antipsychotic drugs create a high risk for developing extrapyramidal syndrome (EPS) side effects?
Seminoma
What germ cell tumor is seen in the 15-to 35-year-old age group, peaks when the person is 35 years of age, and is a bulky mass that spreads via the lymphatic system?
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
Microglia (Microglia and mesoderm both begin with M)
What glial cell is derived from mesoderm and acts as a scavenger, cleaning up cellular debris after injury?
Carbamoyl phosphate synthetase I
What enzyme catalyzes the rate-limiting step of the urea cycle?
Premature ejaculation
What is the term for ejaculation before or immediately after vaginal penetration on a regular basis?
Acute rejection
Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Weeks to months after transplantation; abrupt onset of oliguria and azotemia; seen as neutrophilic vasculitis and interstitial lymphocytes
Gain of hypotonic fluid (water intoxication or hypotonic saline)
Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, increase; ICF, increase; body, decrease
HPV serotypes 1 and 4
Which serotypes of HPV are associated with plantar warts?
Adenosine deaminase (ADA) deficiency
What is the first human disease successfully treated with gene therapy?
Rickets prior to fusion, osteomalacia if the deficiency occurs after epiphyseal fusion.
What is the term for vitamin D deficiency prior to epiphyseal fusion?
Ketamine
What is the only anesthetic that causes cardiovascular stimulation?
Diphyllobothrium latum
What parasite found in raw fish can produce vitamin B12 deficiency?
Tryptophan
What AA is a precursor of the following substances? • NAD
Decreased pulmonary arterial pressure (low perfusion) and less-distensible vessels (high resistance) result in decreased blood flow at the apex.
What two factors result in the apex of the lung being hypoperfused?
Hypnozoite
What form of Plasmodium species affects the liver?
Areas 41 and 42
What Brodmann area is associated with • Primary auditory cortex?
Somatoform pain disorder
What somatoform disorder is described as • Severe, prolonged pain that persists with no cause being found, disrupts activities of daily living?
Mesangial macrophages
Name the macrophages by location: • Kidney
Calcium oxalate
What is the most common one? • Kidney stone type
1. Streptomycin 2. Gentamicin 3. Tobramycin
Which three aminoglycosides have vestibular toxicity?
Osteoarthritis
What is the most common one? • Form of arthritis
Bronchogenic carcinoma
What is the most common one? • Tumor in individuals exposed to asbestos
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
What is the term for headaches, inability to concentrate, sleep disturbances; avoidance of associated stimuli; reliving events as dreams or flashbacks following a psychologically stressful event beyond the normal range of expectation?
Labioscrotal swelling
What embryonic structure forms the adult male structure? • Scrotum
Chloramphenicol
What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
In a negatively skewed curve is the mean greater than the mode?
Oxytocin
Near the end of pregnancy, what hormone's receptors increase in the myometrium because of elevated plasma estrogen levels?
Gaucher disease
What is the most common lysosomal storage disorder?
Hydatidiform mole
Preeclampsia in the first trimester, hCG levels above 100, 00 mIU/mL, and an enlarged bleeding uterus are clinical signs of what?
If the polyuria begins before the collecting ducts, the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts, the patient is dehydrated with normal electrolytes.
What is the origin of the polyuria if a patient is dehydrated and electrolyte depleted?
True. The laryngotracheal (respiratory) diverticulum is divided from the foregut by the tracheoesophageal septum. --------------------------------------------------------------------------------
True or false? The respiratory system is derived from the ventral wall of the foregut.
Erythromycin
Which macrolide is used in the treatment of gastroparesis?
Nodular sclerosis
What is the most common one? • Subtype of Hodgkin lymphoma
Polycystic ovary disease (Stein-Leventhal syndrome)
What female genital tract disorder is characterized by obesity, hirsutism, infertility, amenorrhea, elevated LH and testosterone levels, and low FSH levels?
Oxygen
Name the antidote. • Carbon monoxide (CO)
Increase enzyme concentrations
What is the only way to increase maximum velocity (Vmax)?
Global aphasia
Name the aphasia based on these characteristics: • Both Broca's and Wernicke's areas damaged by lesion in the presylvian speech area; trouble repeating statements; poor comprehension with telegraphic speech
Melatonin, serotonin, and CCK
Name the three hormones produced by pinealocytes.
The energy of activation
What determines the rate of reaction?
Afferent arteriole
Are the JG cells of the nephron a part of the afferent or efferent arteriole?
Thymidylate synthase
What enzyme of pyrimidine synthesis is inhibited by the following? • 5-FU
α-Blockers (-zosins)
Which class of antihypertensives is used in the treatment of BPH?
It decreases insulin secretion.
How does the sympathetic nervous system affect insulin secretion?
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
What type of membrane is characterized as being permeable to water only?
Although both pathways are associated with disinhibition, the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Does the direct or indirect basal ganglia pathway result in a decreased level of cortical excitation?
Malassezia furfur (treat with selenium sulfide)
What fungus is characterized by hypopigmented spots on the thorax, spaghetti-and-meatball KOH staining, and pityriasis or tinea versicolor?
Chromosome 5p
Name the associated chromosome. • Cri-du-chat
Venlafaxine. (It also has a mild dopaminergic effect.)
What antidepressant, which recently was approved for general anxiety disorder, inhibits the reuptake of NE and 5-HT?
Pirenzepine
What drug is an M1-specific antispasmodic?
MEN IIa (or Sipple syndrome)
Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and parathyroid adenomas (or hyperplasia)
14 days
What is the bone marrow maturation time for a phagocytic cell?
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days, whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
Based on the onset of the symptoms, how are bacterial conjunctivitis from Neisseria and Chlamydia differentiated?
Cytochrome c
What is released from the mitochondria to trigger apoptosis?
Pseudomonas
What are the most common causes of osteomyelitis • In drug addicts?
Trichomonas vaginalis (treat with metronidazole)
Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining?
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working, you will see an increased reticulocyte count on the peripheral smear in about 5 days.
A chronic alcohol abuser goes to the ER with weakness, a sore, beefy red tongue, loss of vibration and position sense, arm and leg dystaxia, elevated levels of methylmalonic acid in the urine, and anemia with an MCV above 105 fL. What is your diagnosis, and how will you monitor his response to treatment?
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
What chromosome is mutant in patients with cystic fibrosis?
Decreases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
When a person goes from supine to standing, what happens to the following? • Cardiac output
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
What are the five tissues in which glucose uptake is insulin independent?
Preductal (infantile)
What form of coarctation of the aorta is associated with Turner syndrome?
Boutonnière deformities
What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
Propionic acid
What is the only fatty acid that is gluconeogenic?
Leiomyoma
What is the most common one? • Benign GI tumor
Autosomal dominant
Name the pattern of genetic transmission characterized thus: both M and F are affected; M may transmit to M; each generation has at least one affected parent; and one mutant allele may produce the disease.
Foramen of Winslow
What foramen must be traversed for entry into the lesser peritoneal sac?
GnRH constant infusion
What hormone disorder is characterized by the following abnormalities in sex steroids↑, LH↓, and FSH↓? • Sex steroids , LH , FSH ?
Phase 4
Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency
What are the four exceptions to requirements for informed consent?
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Name the end product or products: • Fatty acid oxidation
Previous suicide attempt
What is the primary risk factor for suicide?
Valproic acid
Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches?
Tamoxifen
What competitive estrogen receptor antagonist is used in the treatment of breast cancer?
Cones (C for color and cones)
What cells of the retina sees in color and needs bright light to be activated?
Takayasu arteritis (medium-size to large vessels)
What vasculitis affects a 30-year-old Asian female having visual field deficits, dizziness, decreased blood pressure, and weakened pulses in the upper extremities?
Leiomyoma (fibroids)
What is the most common one? • Tumor of the female genital tract
Anemia
What toxicities are caused by the following agents? • Occupational nitrous oxide exposure
Four Ms and a U 1. Median 2. Medial antebrachial 3. Medial pectoral 4. Medial brachial cutaneus 5. Ulnar
What are the five branches of the median cord of the brachial plexus?
In children, the fourth ventricle; in adults, the lateral ventricle or spinal cord
What is the most common one? • Location of ependymomas in children
Liver, kidneys, and pituitary gland via 5' deiodinase enzyme
What three organs are responsible for peripheral conversion of T4 to T3?
The vagina
What area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen?
Emphysema
What pulmonary disease, most commonly associated with smoking, results in enlarged, overinflated lungs owing to the destruction of the alveolar walls with diminished elastic recoil?
Methionine (start) and tryptophan are the only two AAs with only one codon.
What two AAs do not have more than one codon?
5HT1D
Of what serotonin receptor is sumatriptan an agonist?
PRPP aminotransferase
What enzyme catalyzes the rate-limiting step in purine synthesis?
Parietal lobe
Name the area of the cerebral cortex with the function described: • Intellectual processing of sensory information, with the left (dominant) processing verbal information, the right processing visual-spatial orientation
Ciliary ganglion
What ganglion supplies the postganglionic parasympathetic fibers to the ciliary muscles of the eye?
Cryptococcus
What is the only encapsulated fungal pathogen?
Avidity. There is a positive correlation between valence numbers and avidity.
What is the term for the strength of the association between Ags and Abs?
Substituted judgment. It is made by the person who best knows the patient, not the closest relative.
What judgment states that the decision, by rights of autonomy and privacy, belongs to the patient, but if the patient is incompetent to decide, the medical decision is based on subjective wishes?
Arterioles have the largest drop, whereas the vena cava has the smallest pressure drop in systemic circulation.
In the systemic circulation, what blood vessels have the largest pressure drop? Smallest pressure drop?
Vmax
What is the maximum rate possible with a given amount of enzyme?
Ag-Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
What is the stimulus for the classical pathway activation?
Edrophonium
What drug is used to differentiate a cholinergic crisis from myasthenia gravis?
Osteosarcoma
What malignant bone tumor is associated with familial retinoblastoma?
The carotid sinus reflex
What reflex increases TPR in an attempt to maintain BP during a hemorrhage?
The conus medullaris terminates at the level of the second lumbar vertebra.
In an adult, where does the spinal cord terminate and what is it called?
Mural infarct
What is the term for hypoperfusion of an area involving only the inner layers?
Ventral lateral nucleus
Name the thalamic nucleus based on its input and output. • Input from globus pallidus and the cerebellum; output to the primary motor cortex
Positive correlation
What type of correlation is defined as • Two variables that go together in the same direction?
Type 2
What type of neurofibromatosis is associated with bilateral acoustic schwannomas?
TRUE
True or false? All of the hormones in the hypothalamus and anterior pituitary gland are water soluble.
Eclipse period
What is the term of the viral growth period when no viruses can be found intracellularly?
Estriol
What form of estrogen is of placental origin?
Measurement bias
What type of bias is it when the information is distorted because of the way it is gathered?
CO
Cherry red intoxication is associated with what form of poisoning?
The JG cells
What modified smooth muscle cells of the kidney monitor BP in the afferent arteriole?
Trazodone
What serotonin reuptake inhibitor's major sexual side effect is priapism?
Escherichia coli
What facultative gram-negative anaerobic rod is motile, ferments lactose, and is the MCC of UTIs?
Decreases
With a decrease in arterial diastolic pressure, what happens to • Heart rate?
Leydig cell tumor
What stromal tumor in males is characterized histologically with crystalloids of Reinke?
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high-step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
What sensory system is affected in the late spinal cord manifestation of syphilis?
Superior rectus (CN III) (LR6 SO4)3
What ocular muscle • Elevates and adducts the eyeball?
ALL
What is the most common one? • Malignancy in children
True. Delta-Cell tumors produce excess somatostatin, which inhibits CCK, gastrin (hypochlorhydria), and insulin secretion (diabetes).
True or false? Pancreatic delta-cell tumors inhibit CCK secretion, leading to gallstones and steatorrhea.
CD40 ligand
Name the T-cell CD marker: • Essential for Ab isotype switching (for B cell binding)
The kidneys excrete the excess nitrogen from the body as urea in the urine.
What organ is responsible for the elimination of excess nitrogen from the body?
Confidence interval. It is a way of admitting estimation for the population.
What specifies how accurately the sample values and the true values of the population lie within a given range?
False. The PPD tests exposure to TB.
True or false? A positive PPD skin test indicates the patient has active pulmonary disease.
Chédiak-Higashi syndrome
In what rare AR disorder do you see neutropenia, defective degranulation, and delayed microbial killing due to a problem in chemotaxis and migration?
Candida
What is the most common fungal infection in HIV?
Crossover study
In what study, for ethical reasons, is no group left out of intervention?
VLDLs
In what form are triglycerides sent to adipose tissue from the liver?
Sublimation
Name these mature defense mechanisms: • Converting an unacceptable impulse to a socially acceptable form (Hint: it is the most mature of all defense mechanisms)
Atracurium
Which nicotinic receptor antagonist is inactivated to laudanosine?
Expressive aphasia
What aphasia produces a nonfluent pattern of speech with the abilty to understand written and spoken language seen in lesions in the dominant hemisphere?
Day 14
What day of the menstrual cycle does ovulation take place?
S phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Hydroxyurea
Reovirus
What is the only dsRNA virus?
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
What mineral is required for cross-linking of collagen molecules into fibrils?
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
What is the name of the postganglionic parasympathetic ganglion that innervates • The submandibular and sublingual glands?
Yes
Is the Salk polio vaccine inactivated?
Transcription factor IID
In eukaryotes, what transcription factor binds to the TATA box before RNA polymerase II can bind?
Insulin
Name the hormone—glucagon, insulin, or epinephrine: • Glycogenic, gluconeogenic, lipogenic, proteogenic, glycolytic, and stimulated by hyperglycemia, AAs, fatty acids, ketosis, ACh, GH, and Beta-agonist
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands, it compresses the fibers from the upper temporal fields of the optic chiasm, producing bitemporal inferior quadrantanopia
What is the most common site for an aneurysm in cerebral circulation?
IL-4, IL-10, and IL-13
What cytokines do Th2 cells secrete to inhibit Th1 cell function?
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
What are the CAGE questions?
IgA nephropathy
What form of nephritic syndrome is associated with celiac sprue and Henoch- Schönlein purpura?
Copper (Cu+)
What element is needed for the proper alignment of tropocollagen molecules?
An increase in serum glucose levels
What is the most important stimulus for the secretion of insulin?
Urogenital folds
What embryonic structure forms the adult female structures? • Labia minora
Because the large drop in TPR is accompanied by a large increase in cardiac output, resulting in a minimal change in BP.
Why is there a minimal change in BP during exercise if there is a large drop in TPR?
Excretion is greater than filtration for net secretion to occur.
Is excretion greater than or less than filtration for net secretion to occur?
There would be a Fab' region; thus, it would still be able to participate in precipitation and agglutination.
What would be the result if an Ab were cleaved with pepsin?
The splenic vein
The inferior mesenteric artery drains into it.
True. They all have helical nucleocapsids and virion-associated polymerases too.
True or false? All negative sense RNA viruses are enveloped.
Goodpasture syndrome
What syndrome is due to anti-GBM Abs directed against the lung and kidneys?
LTB4
Which leukotriene is chemotactic for neutrophils?
CD19
What cell surface marker is found on blood B cells?
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember, it may be negative in the first week of the illness, so retest if you have a high index of suspicion.)
A 20-year-old college student has fever, grey-white membranes over the tonsils, posterior auricular lymphadenitis, and hepatosplenomegaly. What is your diagnosis? What test do you order to confirm your diagnosis?
Plasma concentration and excretion rate
What two factors determine the clearance of a substance?
Borderline
What is the label given to an individual whose IQ is 70 to 79
Salpingitis
What is the term for pelvic inflammatory disease of the fallopian tubes?
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
How many kilocalories per gram are produced from the degradation of fat? CHO? Protein?
Amantadine
What antiviral agent blocks the attachment and penetration of influenza A virus?
Transitional cell carcinoma
What is the most common one? • Bladder tumor
False. The faster the rate of absorption, the smaller the Tmax and larger the Cmax (bioinequivalence). The slower the rate of absorption, the larger the Tmax and smaller the Cmax.
True or false? The faster the rate of absorption, the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
CN VII
What CN is associated with the • Second pharyngeal arch?
ACE inhibitors (-pril)
Which antihypertensive class is used to help stop the progression of microalbuminuria?
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Pulmonary artery and veins
The affinity of the drug for its receptor
What is the most important determinant of drug potency?
Parvovirus B-19
What DNA viral disease is associated with aplastic crisis in patients with sickle cell anemia?
Lung recoil, being a force to collapse the lung, increases as the lung enlarges during inspiration.
What is the name of the force that develops in the wall of the lungs as they expand?
Fc portion of IgG, C3b, and mannose-binding proteins
Name three opsonins.
Anti-HAV IgG Abs are associated with immunization or a prior infection. Anti-HAV IgM is associated with acute or recent infection.
Is an anti-HAV IgG Ab associated with immunization or recent infection?
IgM
What Ig activates the complement cascade most efficiently?
Eisenmenger syndrome, which can also occur with any left-to-right shunt
What is the term for a large VSD that leads to pulmonary HTN, RVH, and cyanosis due to right-to-left reversal of the shunt?
Fifth MS CARD is my mnemonic for the aortic arch derivatives
From what aortic arch are the following structures derived? • Degenerates
Latissimus dorsi
What muscle or muscles are innervated by the following nerves? • Thoracodorsal nerve
VLDL
Name the lipoprotein based on the following characteristics. • apo E, apo B-100, apo C-II
Coma, convulsions, and cardiotoxicity
What are the three C's of a TCAD overdose?
NADPH oxidase
What enzyme is deficient in chronic granulomatous disease of childhood?
Asbestosis and silicosis
With what two pathologies is a honeycomb lung associated?
The pulsatile release of GnRH
What prevents the down-regulation of the receptors on the gonadotrophs of the anterior pituitary gland?
Mitosis
What phase of the cell cycle are the following antineoplastic agents specific for? • Vinblastine
p-53
What gene stimulates apoptosis when DNA repair is unable to be done?
Syphilitic
What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased β-1-sympathetic stimulation of the JG cells
What are the three stimuli that result in the reninangiotensin-aldosterone secretion?
Palmitate
Name the end product or products: • Fatty acid synthesis
Rapidly progressive glomerulonephritis (RPGN)
What form of GN is characteristically associated with crescent formation?
Flucytosine
What antifungal agent is activated by fungal cytosine deaminase to form 5-FU?
CN III
With which CN are preganglionic parasympathetic axons arising from the Edinger- Westphal nucleus associated?
False-negative rate
What rate is indicated by 1- sensitivity?
Alcohol consumption
Name the most common type or cause. • Cirrhosis in the United States
Site 4
Name the Hgb-O2 binding site based on the following information: • Least affinity for O2; requires the highest PO 2 levels for attachment (approx. 100 mm Hg)
Acetyl CoA carboxylase
What is the rate-limiting step of the following? • Fatty acid synthesis
False. CSF is a clear isotonic solution with lower concentrations of K+ and HCO3-. It does have higher concentrations of Cl- and Mg2+.
True or false? CSF is a clear, hypertonic solution with higher concentrations of K + and HCO3-, than the serum.
REM and stage 4 sleep; they decrease.
What aspects of sleep are affected during benzodiazepine use?
Cardiac muscle
Name the muscle type based on these descriptions: • Continuous involuntary contraction, uninuclear striated branched fibers, actin and myosin overlapping for banding pattern, dyadic T tubules, intercalated discs, troponin and desmin as a Z disc intermediate filament.
Lewy bodies
What is the term for the round intracytoplasmic eosinophilic inclusions containing ɑ-synuclein found in the dopaminergic neurons of the substantia nigra?
Area 6
What Brodmann area is associated with • Premotor cortex?
False. Risk of breast and endometrial cancer but not ovarian cancer increases with the use of estrogen.
True or false? Estrogen use increases the risk of developing ovarian cancer.
Pontocerebellar angle syndrome
What syndrome is associated with the following brainstem lesions? • Slow-growing acoustic neuroma producing CN VII deficiencies
Streptolysin O
Which Streptococcus pyogenes toxin is immunogenic?
alpha-Cells; glucagon has stimulatory effects on -cells and inhibitory effects on -cells.
What pancreatic islet cell secretes glucagons?
Criterion-referenced tests. You need a certain number correct to pass (e.g., the USMLE).
Objective tests that base the result of the examination on a preset standard use what form of reference?
Coronavirus
Name the most common cause. • A cold in the winter and summer
Id
Per Freud, with what part of the unconscious are sex and aggression (instincts) associated?
The alveoli at the base are small and very compliant, so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
Why is the base of the lung hyperventilated when a person is standing upright?
Western blot
What is the confirmatory test for HIV?
First-pass metabolism and acid lability
What two factors influence low oral bioavailability?
Bunyavirus
What family do the following viruses belong to? • Hantavirus
Vitamin E
What fat-soluble vitamin is connected to selenium metabolism?
Adult T-cell leukemia
What leukemia is associated with four-leaf-clover lymphocytes on peripheral blood smear?
The number of Ags that the Ab can bind
What is the valence of an Ig molecule equal to?
Hurler syndrome and Hunter syndrome, respectively
What syndrome results if the enzyme ɑ-1-iduronidase is deficient? L-iduronate sulfatase deficiency?
They are preganglionic sympathetic axons. They are white because they are myelinated.
What is the function of white rami communicantes?
Ixodes (also the vector for Lyme disease)
What tick is the vector for babesiosis?
Alcohol abuse
Name the most common cause. • Chronic pancreatitis
Malignant mesothelioma
In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
Huntington's chorea. (Death in 15-20 years, often via suicide.)
What AD dementia has a defect in chromosome 4, onset between the ages of 30 and 40, choreoathetosis, and progressive deterioration to an infantile state?
Erythema marginatum
What type of erythema do you see in • Rheumatic fever?
The aorta has the greatest velocity and the capillaries have the slowest velocity.
What vessels in the systemic circulation have the greatest and slowest velocity?
Corynebacterium diphtheriae
Which bacteria are associated with the following pigment production? • Black-gray pigmentation
Pseudomonas aeruginosa
What is the most likely causative organism for a patient with folliculitis after spending time in a hot tub?
IgM; IgD follows shortly thereafter.
What is the first membrane-bound Ig on B cell membranes?
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
What type of hypersensitivity is a T cell-mediated response to Ags that are not activated by Ab or complement?
Allotypes
What are the genetic variants of a molecule within members of the same species?
Ligamentum arteriosum
What are the adult remnants of the following structures? • Ductus arteriosus
1. Sleep paralysis 2. Hypnagogic hallucinations (while falling asleep) 3. Sleep attacks with excessive daytime sleepiness 4. Cataplexy (pathognomonic) Narcolepsy is a disorder of REM sleep, with REM occurring within 10 minutes of sleep.
Name the four components of the narcoleptic tetrad.
HPV
What is the most common STD?
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.
What ribosomal subunit sizes do eukaryotic cells have?
Heart, esophagus, and colon. Remember, you get megas: cardiomegaly, megaesophagus, and megacolon.
What three organs can be affected by Trypanosoma cruzi?
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Name the four right-to-left congenital cardiac shunts.
Ipratropium
What antimuscarinic is used as an inhalant for asthma?
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm
What three embryonic cell layers form the chorion?
Succinylcholine and halothane (Treatment is with dantrolene.)
What two drugs, when mixed, can lead to malignant hyperthermia?
Transference. When it is from the physician to the patient it is called countertransference.
What term is defined as a patient unconsciously placing his or her thoughts and feelings on the physician in a caregiver or parent role?
EBV
With what virus are Downey type II cells associated?
Mitochondria
What organelles make ATP, have their own dsDNA, and can synthesize protein?
Alveolar macrophages
Name the macrophages by location: • Lungs
NE
What are the primary neurotransmitters at the following sites? • Postganglionic sympathetic neurons
No CHO, AA, ketones, or peptides are left in the tubular lumen.
What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Concentration of CHO, AA, ketones, peptides
Aspartate and carbomoyl PO4-
What are the two ways that nitrogen can enter into the urea cycle?
Amygdala; it helps imprint an emotional response in memory.
What area of the limbic system is responsible for attaching emotional significance to a stimulus?
MIF
What hormone, produced by Sertoli cells, if absent would result in the formation of internal female structures?
Mesothelioma and bronchogenic carcinoma
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Asbestos
Primary sclerosing cholangitis
What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
There is a difference; it takes about 7 to 8 half-lives to reach mathematical steady state and 4 to 5 half-lives to reach clinical steady state.
Is there a difference between mathematical and clinical steady states? If so, what are their values (half-lives)?
Serocystadenocarcinoma
What ovarian disease involves psammoma bodies?
1. Fructose-6-phosphate 2. Glucose-6-phosphate 3. Glyceraldehyde-3-phosphate
At what three sites can the HMP shunt enter into glycolysis?
Regression
Name these immature defense mechanisms: • Returning to an earlier stage of development (e.g., enuresis)
Dapsone
Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis?
Coombs test
What test is used to detect anti-RBC Abs seen in hemolytic anemia?
Eosin
Do the following structures pick up stain from hematoxylin or eosin? • Cytoplasm
Poxvirus
Name the DNA virus • Linear dsDNA; enveloped; virion-associated polymerases; replicates in the cytoplasm :
Major
Are the following major or minor Jones criteria of rheumatic fever? • Migratory polyarthritis
True. Aminoglycosides use O 2-dependent uptake and therefore are ineffective for treatment of anaerobic infections.
True or false? Anaerobes are resistant to the effects of aminoglycosides.
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get in trouble.)
What are the five pieces of information considered necessary for fully informed consent?
Flumazenil
Name the antidote. • Benzodiazepines
Eosinophilic exudates
Name the type of exudate, given the following examples. • Parasitic infection
Internal carotid artery and sympathetic plexus
Name the structure that enters or exits the following foramina: • Carotid canal
Hepatitis A
Name the hepatitis virus based on the following information. • Naked capsid RNA picornavirus
GnRH pulsatile infusion
What is it called when levels of sex steroids increase, LH increases, and FSH increases?
Toxoplasmosis
What is the most common opportunistic infection of the CNS in HIV?
The basilar artery is formed at the pontomedullary junction.
What artery is formed by the union of the two vertebral arteries?
Fibrinoid necrosis
Name the type of necrosis. • Histologically resembles fibrin
Tibial nerve
What lower extremity nerve is described by the following motor loss? • Loss of flexion of the knees and toes, plantarflexion, and weakened inversion
Mycoplasma pneumoniae
What atypical pneumonia can be diagnosed with elevated cold agglutinin titers?
Cleft lip
What results when the maxillary prominence fails to fuse with the medial nasal prominence?
Neuroleptic malignant syndrome is a potentially life-threatening condition which is treated with symptomatic support, bromocriptine, and dantrolene.
A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity, a temperature of 104° F, altered mental status, and hypotension. What is your diagnosis and what is the treatment?
Shifts it to the right
Which way will the O2 dissociation curve shift with the addition of 2, 3-bisphosphoglycerate (2, 3-BPG) to adult hemoglobin (Hgb)?
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?
Zona fasciculata and zona reticularis
What region or regions of the adrenal cortex are stimulated by ACTH?
Ménétrier's disease
What protein-losing enteropathy has grossly enlarged rugal fold in the body and fundus of the stomach in middle-aged males, resulting in decreased acid production and an increased risk of gastric cancer?
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
Name the most common type or cause. • Infantile bacterial diarrhea
IgG
What Ig mediates ADCC via K cells, opsonizes, and is the Ig of the secondary immune response?
Trypsin
What enzyme is needed to activate the following reactions? • Procarboxypeptidase to carboxypeptidase
False. Fewer Ags are needed to trigger a secondary response.
True or false? More Ag is needed to produce a secondary immune response than a first immune response.
Norm reference (i.e., 75% of the students in the class will pass)
When the results of a test are compared to findings for a normative group, what form of reference does the objective test use?
CN XI, vertebral arteries
Name the structure that enters or exits the following foramina: • Foramen magnum
In early-morning sleep, usually between the sixth and eighth hours
When does cortisol secretion peak?
Excess estradiol in the blood
What is a sign of a Sertoli cell tumor in a man?
Normal values
What condition results in the following CSF results? • Opening pressure 70 to 180 mm H2O; 0-10 WBCs (monocytes); glucose 45 to 85, protein 15 to 45
Primary hypercortisolism
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol increased, ACTH decreased
Radial nerve and the profunda brachii artery
What nerve and artery could be affected in a midshaft humeral fracture?
Paranoid
Name these cluster A personality disorders: • Baseline mistrust; carries grudges; afraid to open up; uses projection as defense mechanism; lacks hallucinations or delusions
Macula densa
What cells of the kidney are extravascular chemoreceptors for decreased Na+, Cl-, and NaCl?
The conversion of CHO to pregnenolone via the enzyme desmolase
What is the rate-limiting step in the production of steroids?
Cirrhosis
What disorder is associated with spider angiomas, palmar erythema, gynecomastia, testicular atrophy, encephalopathy, abnormalities in clotting factors, and portal HTN?
gp120
What CD4 T-cell receptor does the HIV virus bind to?
Copper
Leukopenia, neutropenia, and mental deterioration are signs of what mineral deficiency?
Pasteurella multocida
What organism is commonly associated with a cellulitis from an animal bite?
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.
Where on the codon and anticodon does the wobble hypothesis take place?
The V/Q ratio increases, since the area is ventilated but hypoperfused as a result of the occlusion.
What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
TRUE
True or false? Acetaminophen has analgesic and antipyretic activities but lacks anti-inflammatory effects.
Bioavailability
What is the term for the proportion of a drug that reaches systemic circulation?
EF-1 and GTP
What factors are needed for elongation in eukaryotes?
Chromium (Cr)
What mineral is associated with impaired glucose tolerance?
Chromosome 21
Name the associated chromosome. • Down syndrome
Axis V
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Global assessment of function?
Prolactinoma
What is the most common one? • Pituitary adenoma
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
Is a membranous septal defect more commonly interventricular or interatrial?
IGF-1
What is the major stimulus for cell division in chondroblasts?
False. These beliefs are characteristic of people with an external locus of control.
True or false? According to social learning theory, people who believe that luck, chance, or the actions of others control their fate have an internal locus of control.
Plasmodium falciparum
Name the Plasmodium species based on the following information: No persistent liver stage or relapse; blood smear shows multiple ring forms and crescent-shaped gametes; irregular febrile pattern; associated with cerebral malaria
Reaction formation
A complete opposite expression of your inward feeling (e.g., arguing all the time with someone you are attracted to when your feelings are not known)
Tyrosine
What AA is a phenol?
Median nerve lesion
What nerve lesion presents with ape or simian hand as its sign?
Riboflavin (B2)
What water-soluble-vitamin deficiency is associated with cheilosis and magenta tongue?
Viruses
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Acellular; some are enveloped; replicate within the host cell; no cell walls
Parvovirus B 19
What viral infection in patients with sickle cell anemia results in aplastic crisis?
Hirschsprung disease (aganglionic megacolon)
What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon?
Pyloric stenosis
A mother takes her 2-week-old infant to the ER because the baby regurgitates and vomits after eating and has peristaltic waves visible on the abdomen and a palpable mass in the right upper quadrant. What is your diagnosis?
Free hormone levels remain constant, and the bound hormone level changes with a decrease in binding hormones.
What happens to free hormone levels when the liver decreases production and release of binding proteins?
CD3
What cell surface marker do all T cells have?
Mitral valve stenosis
What is the most common one? • Valve abnormality associated with rheumatic fever
Lentigo maligna melanoma
Which form of melanoma carries the best prognosis?
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2, reducing the carrying capacity and shifting the curve to the left, making it difficult to remove the CO molecule from Hgb.
Which way does the Hgb-O2 dissociation curve shift in patients with CO poisoning?
The tsetse fly
What is the vector of African sleeping sickness?
Rabies
What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies?
True. At high doses ASA decreases uric acid reabsorption in the renal tubules, resulting in uricosuric actions. At low doses ASA decreases tubular secretion of uric acid, leading to hyperuricemia.
True or false? At high doses aspirin has uricosuric properties.
Coxsackie A
What picornavirus is associated with hand-foot-and-mouth disease?
Galactitol
To what does aldose reductase convert galactose?
Clearance
What is the term for drug removal per unit of time in a given volume of blood?
The larger the volume of distribution, the lower the plasma concentration of a drug.
What happens to plasma concentration of a drug if there is a large volume of distribution?
Osteoarthritis
What disorder causes joint stiffness that worsens with repetitive motion, crepitus, effusions, and swelling and commonly affects the knees, hips, and spine?
Glycogen phosphorylase
What enzyme catalyzes the rate-limiting step in glycogenolysis?
Carbamazepine
What is the DOC for trigeminal neuralgia?
Four
How many mature sperm are produced by one type B spermatogonium?
Complex I
What component of the ETC is inhibited by the following? • Rotenone
NREM sleep. Night terrors are dreams that we are unable to recall.
With what stage of sleep are night terrors associated?
Polycystic kidney disease of childhood
What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?
Schistosoma haematobium
What parasite is associated with squamous cell carcinoma of the urinary bladder?
Carnitine acyltransferase I
What is the rate-limiting step of the following? • β-Oxidation
T lymphocyte
What is the main type of cell involved in cellular immunity?
Methyldopa
Which centrally acting α2-adrenergic agonist is safe for use in renal dysfunction and in HTN during pregnancy?
CN X
What CN is associated with the • Sixth pharyngeal arch?
Pneumotaxic center (short, fast breaths)
What respiratory center in the rostral pons has an inhibitory affect on the apneustic center?
Denial
Name these narcissistic defense mechanisms: • Not allowing reality to penetrate because afraid of becoming aware of painful aspect of reality.
False. B cells recognize unprocessed Ags, but T cells can recognize only processed Ags.
True or false? T cells can recognize, bind, and internalize unprocessed Ags.
Patau syndrome (trisomy 13)
What disease involves microcephaly, mental retardation, cleft lip or palate, and dextrocardia?
Moderate (35-49)
What level of mental retardation is characterized by • Can work in sheltered workshops and learn simple tasks but need supervision?
PGE2
Name the product or products of arachidonic acid: • Pain and fever
As the standard deviation increases, the greater the chance of error.
What is the relationship between chance of error and • Standard deviation?
Papillary carcinoma of the thyroid
What is the most common one? • Malignant thyroid tumor
2 ATPs by oxidative phosphorylation
How many ATPs are produced from cytoplasmic NADH oxidation using the glycerol phosphate shuttle?
True. The odontoid process of C2 acts as the vertebral body of C1 allowing lateral rotation of the head.
True or false? The first cervical vertebra has no vertebral body.
Cervical neoplasia
What is the most common one? • Primary malignant tumor of the female genital tract in the world
Red pulp (Remember, Red pulp and RBCs begin with R.)
What area of the spleen consists of splenic cords of Billroth and phagocytoses RBCs?
Histiocytosis X
Birbeck granules
Suprachiasmatic nucleus
What nucleus of the hypothalamus receives visual input from the retina and helps set the circadian rhythm?
Transverse abdominis
What abdominal muscle runs horizontally, contributes to the posterior rectus sheath, and contributes to form the conjoint tendon?
Factitious disorder
What disorder is described as having • Conscious symptoms with unconscious motivation?
Thymine (B1)
What vitamin is a component of the coenzyme thiamine pyrophosphate (TPP)?
False. ASO titers are elevated, but serum complement levels are decreased.
True or false? Elevated ASO titers and serum complement levels are associated with poststreptococcal GN.
Pancreas and colon
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • Ki-ras
EF-Tu and EF-Ts of the 30S ribosomal subunit
What prokaryotic positioning enzyme in translation is blocked by the following? • Tetracycline
Altruism
Name these mature defense mechanisms: • Helping others without expecting any return
Saccule and utricle
What part of the inner ear contains the gravity receptors for changes in the position of the head?
Subclavian vein
What vessel can be found atop the scalene anterior?
Solved as 30% T + 30% A = 60%; therefore, C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
If a sample of DNA has 30% T, what is the percent of C?
Magnesium ammonium phosphate (struvite)
What renal calculus is associated with urea-splitting bacteria?
Inspiratory reserve volume (IRV)
Name the lung measurement based on the following descriptions: • Additional air that can be taken in after normal inspiration
Homogentisic oxidase
What enzyme is deficient in alkaptonuria?
Chromosome 15, 17
Name the associated chromosomal translocation. • Acute promyelocytic leukemia (M3)
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Brachiocephalic vein
Panacinar
Which form of emphysema is associated with an alpha1-antitrypsin deficiency?
Penicillin V
What form of penicillin is stable in acid environments?
Pneumocystis carinii
Name the MCC. • Pneumonia in an HIV-positive patient with CD4 less than 200
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+, K+, and Cl-.
What acid-base disturbance is produced from vomiting?
Thrush
What is the term for Candida infection of the oral mucosa?
From age 5 onward IQ stabilizes.
At what age does IQ stabilize?
The muscle's ATPase activity
What determines the Vmax of skeletal muscle?
ACh; think about the ANS.
Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body.
Eosinophils
What chronic inflammatory WBC is associated with IgE-mediated allergic reactions and parasitic infections?
N-5-methyl THF
In what form is excess folate stored in the body?
True. In the distal colon, sweat glands, and salivary ducts, aldosterone has sodium-conserving effects.
True or false? Aldosterone has a sodium-conserving action in the distal colon.
When it crosses the teres major
At what point does the axillary artery become the brachial artery?
Naloxone, naltrexone
Name the antidote. • Opioids
Myeloperoxidase
What oxygen-dependent killing enzyme requires hydrogen peroxide and halide (Cl-) to produce hypochlorous acid?
Area 17
What Brodmann area is associated with • Primary visual cortex?
Free polysomes. Membrane-associated polysomes are the site of protein synthesis destined to leave the cell.
What organelle synthesizes proteins that are intended to stay within the cell?
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
What area of the hypothalamus is the feeding center?
3-Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
What two glycolytic enzymes catalyze the substrate-level phosphorylations?
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
What three cephalosporins have good penetration against Bacteroides fragilis?
Leydig cell tumor
What sex cell tumor causes precocious puberty, masculinization, gynecomastia in adults, and crystalloids of Reinke?
Omega-3 fatty acids
What type of fatty acid is associated with a decrease in serum triglycerides and cardiovascular disease?
Ego syntonic
What is the term to describe homosexuals who • Are comfortable with their own person and agree with their sense of self?
Two-way ANOVA. It allows the test to check several variables at the same time.
What statistical test compares the means of groups generated by two nominal variables by using an interval variable?
CML and ALL
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • abl
Secondary lysosome (think of the primary as inactive and secondary as active)
What type of lysosome is formed when lysosome fuses with a substrate for breakdown?
C2 deficiency
What is the most common complement deficiency?
Clozapine
What is the only neuroleptic agent that does not cause hyperprolactinemia?
Mesencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Midbrain
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
How do delusions, illusions, and hallucinations differ?
Pia mater
What protective covering adheres to the spinal cord and CNS tissue?
Autism. Head-banging, rocking, and self-injurious behaviors are also common in autism.
What axis I disorder is characterized by pronoun reversal, preference for inanimate objects, obliviousness to the external environment, lack of separation anxiety, and abnormalities in language development?
C1 inhibitor (C1-INH)
What complement factor deficiency leads to • Hereditary angioedema?
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
A migrating myoelectric complex is a propulsive movement of undigested material of undigested material from the stomach to the small intestine to the colon. During a fast, what is the time interval of its repeats?
Agents that decrease ACh function reduce tremors and rigidity, not bradykinesias.
Do agents used in the treatment of Parkinson's disease that decrease ACh function have little effect on reducing tremors and rigidity?
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
What are effects of PTH in the kidney?
Lumbar splanchnics
What preganglionic sympathetic fibers are responsible for innervating the smooth muscle and glands of the pelvis and the hindgut?
Squamous cell carcinoma
Keratin pearls
Purulent exudates
Name the type of exudate, given the following examples. • Meningococcal infection
7 years old
By what age should children be able to draw the following figures? • Diamond
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available, but the renal collecting ducts are impermeable to its actions.
What form of diabetes insipidus is due to an insufficient amount of ADH for the renal collecting ducts?
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma
What three carcinomas are associated with EBV?
Coagulative
What is the most common one? • Form of necrosis
Chronic alcoholic
Mallory bodies
Estrone
What type of estrogen is produced in peripheral tissues from androgens?
They are inversely proportional to each other; as pulse pressure increases, compliance decreases.
How are pulse pressure and compliance related?
Extravascular hemolysis if it occurs in the spleen; if in the liver, it results in hepatomegaly.
Is splenomegaly more commonly associated with intravascular or extravascular hemolysis?
Bcl-2
What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?
Polycythemia vera (Remember, polycythemia vera is a risk factor for acute leukemias.)
What myeloid disorder is characterized by increased hematocrit, blood viscosity, basophils, and eosinophils; intense pruritus; and gastric ulcers due to histamine release from basophils, increased LAP, and plethora?
True. Aluminum reacts with PO4, resulting in AlPO4, an insoluble compound that cannot be absorbed.
True or false? All aluminum-containing antacids can cause hypophosphatemia.
Acute CO poisoning
With what is cherry red intoxication associated?
At least 15%
How far below ideal body weight are patients with anorexia nervosa?
CN I, II, III, VI, and XII Add 1 + 1 = 2, 1 + 2 = 3, 1 + 2 + 3 = 6, 1 + 2 + 3 + 6 = 12
Which CNs are found in the midline of the brainstem?
Stage fright (discrete performance anxiety)
Name the most common type. • Phobia
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Where is most of the body's Ca2+ stored?
Giant cell bone tumor (osteoclastoma)
What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
Alzheimer disease
Name the most common cause. • Dementia in persons aged 60 to 90 years
Pelvic splanchnics (They all begin with P.)
What splanchnic carries preganglionic parasympathetic fibers that innervate the hindgut and the pelvic viscera?
True; also, stressful marriage, early sexual experiences in the back of a car, and sex with a prostitute all increase the risk of premature ejaculation.
True or false? Being college educated increases a man's risk of having premature ejaculation.
FALSE
True or false? Pregnancy ensures emancipation.
GH-producing adenoma
With which pituitary adenoma is an elevated somatomedin C level associated?
Plasmodium falciparum
What type of Plasmodium affects • RBCs of all ages?
Right coronary artery
What artery supplies the right atrium, right ventricle, sinoatrial and atrioventricular nodes?
BPH
Name the most common type or cause. • Urinary tract obstruction
EF-2 and GTP
What factors are needed for translocation in eukaryotes?
G1 phase (gap 1)
Name the phase of the eukaryotic cell cycle: • Period of cellular growth (translation and transcription) before DNA synthesis
There are 10 bronchopulmonary segments on the right and 8 on the left.
How many bronchopulmonary segments are on the right lung? Left lung?
In the RBC; remember, you need carbonic anhydrase for the conversion, and plasma does not have this enzyme.
Where does the conversion of CO2 into HCO3- take place?
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.
What vitamin is necessary for the transfer of one amino group from a carbon skeleton to another?
REM sleep. Nightmares are frightening dreams that we recall.
With what stage of sleep are nightmares associated?
Basal cell carcinoma
What is the most common one? • Tumor on sun-exposed sites
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
What is the size of the prokaryotic ribosome?
The courts. These are legal, not medical terms.
Who decides competency and sanity?
CN X (Remember, the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)
What CN carries preganglionic parasympathetic fibers that innervate the viscera of the neck, thorax, foregut, and midgut?
For the USMLE Step 1 the answer is no, but if the information would do more harm than good, withhold. This is very rare but it does occur.
If the family member of a patient asked you to withhold information, would you?
Ciliary ganglion producing a tonic pupil
What ocular ganglion is affected if the pupil on the affected side sluggishly responds to light with normal accommodation?
True. The elimination of the unfertilized egg is menses.
True or false? In females, meiosis II is incomplete unless fertilization takes place.
Enkephalin
What is the neurotransmitter at the δ-receptor?
Cholesterol biosynthesis
What pathway uses HMG CoA synthetase in the cytoplasm?
2 NADPHs per acetyl CoA
How many NADPHs are used per addition of acetyl CoA into a fatty acid chain?
Buerger disease (thromboangiitis obliterans)
What small- to medium- sized vasculitis is seen in a 35-year-old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities?
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Pancreas
Increase (5-HT and dopamine levels do the same)
What happens to NE levels in • Bipolar disorder?
The enzyme phenyl ethanolamine N-methyltransferase (PNMT), used in the conversion of epinephrine, is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Why is there a decrease in the production in epinephrine when the anterior pituitary gland is removed?
Spleen
What is the only organ supplied by the foregut artery that is of mesodermal origin?
Choriocarcinoma
What is the most common one? • Malignant germ cell tumor in women
Respiratory acidosis (summary: high CO2, high H+, slightly high HCO3-)
What primary acid-base disturbance is cause by a decrease in alveolar ventilation (increasing CO2 levels) resulting in the reaction shifting to the right and increasing H+ and HCO3- levels?
Pantothenic acid
What vitamin is a component of the enzymes fatty acid synthase and acyl CoA?
Correlation. No, correlation does not imply causation.
What is the degree to which two measures are related? Does it imply causation?
Loss of hypotonic fluid (alcohol, diabetes insipidus, dehydration)
Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, decrease; ICF, decrease; body: increase
Clindamycin
Which antimicrobial agent is used with pyrimethamine to treat toxoplasmosis?
Melanoma, cancer of the stomach and bladder
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1 and int-2
Superoxide dismutase, glutathione peroxidase, catalase
Name the three enzymes that protect the cell from oxygen-derived free radicals.
TCR
What T-cell surface projection recognizes and reacts to foreign Ags (presented by APCs)?
GH deficiency
Insulin-induced hypoglycemia is the most reliable (by far not the safest) test for what hormone deficiency?
1. Lowers surface tension, so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
What are the three main functions of surfactant?
Tip of the loop of Henle (1200 mOsm/L)
What region of the nephron has the highest osmolarity?
Mitochondria-linked disorders are always inherited from the mother.
Who is responsible for passing on mitochondrial DNA genetic disorders?
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Name the four ventral mesentery derivatives.
True. It is considered medical treatment, so it can be withdrawn or refused. (Remember the Cruzan case.)
True or false? A patient can refuse a feeding tube.
Afterload
What is the term for the force the ventricular muscle must generate to expel the blood into the aorta?
1. Covalent bonding between the hapten and carrier 2. B-cell exposure to hapten twice 3. T-cell exposure to carrier twice
What are the three rules governing a secondary immune response?
TRUE
True or false? NSAIDs have analgesic, antipyretic, anti-inflammatory, and antiplatelet activities.
ACh
What are the primary neurotransmitters at the following sites? • All motor neurons, postganglionic parasympathetic neurons
True. β-Blockers are a component of CHF regimen for stable patients, not those who are decompensated. (This means you discharge a patient from the hospital with a prescription for a -blocker; you don't start -blockers when the patient is admitted.)
True or false? β-Blockers are contraindicated in patients who present to the hospital with CHF.
Labile
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Hematopoietic cells
Constrictor pupillae and ciliary muscles
Which muscles of the eye are under parasympathetic control?
Herpes virus I and II
What viruses are associated with Cowdry type A intranuclear inclusions?
TLC, FRC, and RV have to be calculated. (Remember, any volume that has RV as a component has be calculated.)
What three lung measurements must be calculated because they cannot be measured by simple spirometry?
Operant conditioning (reinforcement is after a response)
What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
CN XI and X
What nerve or nerves supply general sensation and taste to the posterior third of the tongue?
Motor nucleus of CN V
What component of the trigeminal nuclei • Supplies the muscles of mastication?
Cryptococcus
What is the MCC of the following meningitides? • In patients who have AIDS or are immunocompromised
Auspitz sign
What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
What two veins form the portal vein?
Imipenem and meropenem
What bactericidal agents are resistant to β-lactamases and are used to treat in-hospital life-threatening infections?
True. They are evaginations of the surface membranes and therefore extracellular.
True or false? In a skeletal muscle fiber, the interior of the T-tubule is extracellular.
The short arm of chromosome 6
What chromosome codes for HLA gene products?
X-linked dominant
Name the pattern of genetic transmission characterized thus: both M and F affected; no M-to-M transmission; affected M passes trait to all daughters, every generation; affected F passes trait to both sons and daughters; a single mutant allele can produce the disease.
LGB (think EYES)
Name the thalamic nucleus based on its input and output. • Input from the optic tract; output projects to the primary visual cortex of the occipital lobe
Somatotrophins are stimulated by IGF-1, and they inhibit GH secretion. GHRH stimulates GH secretion.
How do elevated blood glucose levels decrease GH secretion? (Hint: what inhibitory hypothalamic hormone is stimulated by IGF-1?)
When the intra-alveolar pressure equals zero, there is no airflow.
Which direction is air flowing when the intra-alveolar pressure is zero?
Intercellular adhesion molecule (ICAM) 1
Which integrin mediates adhesion by binding to lymphocyte function- associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
False. Glutamic acid is excitatory, but GABA is inhibitory.
True or false? Both GABA and glutamic acid are excitatory neurotransmitters in the CNS.
Under resting conditions expiration is considered a passive process; therefore, no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
What is the major muscle used in the relaxed state of expiration?
Isoleucine, threonine, tryptophan, tyrosine, and phenylalanine
What are the five AAs that are both ketogenic and glucogenic?
Pasteurella, Brucella, Legionella, and Francisella (all of the-ellas)
Which four bacteria require cysteine for growth?
Facial expression (the second is vocal intonation)
What is the primary method of nonverbal communication of emotional states?
Plasmin
What protein causes fibrinolysis?
The Beta-2-microglobin. It is the separately encoded Beta-chain for class I Ags.
What molecule differentiates the MHC class I from II Ag? (Hint: it's in the light chain.)
Plasmodium ovale
Name the Plasmodium species based on the following information:Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites with oval, jagged infected RBCs; 48-hour fever spike pattern
Duchenne muscular dystrophy (Remember, Becker's is slower in progress, less severe, later in onset, and lacks cardiac involvement.)
What X-linked recessive disorder that is due to an abnormality in the dystrophin gene, has onset by age 5 with progressive proximal muscle weakness, calf pseudohypertrophy, and elevated CPK levels?
Leukemias and lymphomas
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Alkylating agents
The CD4 T cell; the APC is the first cell in the immune response.
What is the second cell involved in the immune response?
Ferrochelatase
What enzyme is deficient in hereditary protoporphyria?
Ristocetin
What substance is used to test platelets' response in patients with von Willebrand disease?
Extinction
What operant conditioning therapy or modification is described as • Stopping the reinforcement that is leading to an undesired behavior?
Afterload
What is the term for the load a muscle is trying to move during stimulation?
Langerhans cells (found in the stratum spinosum)
What cell type of the epidermis functions as antigen-presenting cells?
Serratus anterior
What muscle or muscles are innervated by the following nerves? • Long thoracic nerve
More Ab is produced in less time in a secondary immune response (shorter lag period).
Are more Abs produced in a primary or a secondary immune response?
True. The thyroid gland, the lungs, and the pharyngeal pouches are foregut derivatives that are not a component of the gastrointestinal system.
True or false? The thyroid gland is an embryologic foregut derivative.
Thymus-independent Ags
What is the term for Ags that activate B cells without T-cell signaling?
More than 75% of the vessel
How much of a vessel must be stenosed to cause sudden cardiac death?
Osmosis; water will diffuse from higher to lower water concentrations.
What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
Proencephalon* *diencephalon derivative
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Hypothalamus
Papillary carcinoma of the thyroid
What thyroid carcinoma is associated with radiation exposure, psammoma bodies, and Orphan Annie eye nuclei?
Cyanocobalamin (B12)
What vitamin requires IF for absorption?
CN IX, X, and XI; sigmoid sinus
Name the structure that enters or exits the following foramina: • Jugular foramen
O2 affinity increases with a decrease in the p50, making O2 more difficult to remove from the Hgb molecule.
What happens to O2 affinity with a decrease in p50?
Estrogen
Circulating levels of what hormone cause the cervical mucus to be thin and watery, allowing sperm an easier entry into the uterus?
T and B-cells belong to the adaptive branch, whereas PMNs, NK cells, eosinophils, macrophages, and monocytes belong to the innate branch.
What two cell lines of the immune system do not belong to the innate branch?
Chloramphenicol
Name the antimicrobial agent whose major side effect is listed. • Grey baby syndrome
In the JG cells of the kidney
Where is renin produced?
Negative selection. This helps to prevent autoimmune diseases.
What is the term for thymic induction of T cells with high-affinity Ag receptors for self that are programmed to undergo apoptosis?
Left homonymous hemianopsia
Name the ocular lesion; be specific. • Left Meyer's loop lesion of the optic radiations.
Primary hypoaldosteronism (Addison's disease)
What disorder of aldosterone secretion is characterized by • Decreased total body sodium, ECF volume, plasma volume, BP, and pH; increased potassium, renin, and AT II activity; no edema?
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
What are two causes of diffusion impairment in the lungs?
Neurofibromatosis
Café-au-lait spot on the skin
Average
What is the label given to an individual whose IQ is • 90 to 109
Fixation (arrested development)
What is the term for failure to give up infantile patterns of behavior for mature ones?
Varicocele
What is the term for dilated veins within the spermatic cord?
Epinephrine
What are the primary neurotransmitters at the following sites? • Chromaffin cells of the adrenal medulla
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first, not worry about legal responsibility.
If you report a suspected case of child abuse and are wrong, are you protected from legal liability?
External 3', 5' PDE bonds
What bonds are broken by exonucleases?
X-linked recessive
What pattern of inheritance does G-6-PD deficiency follow?
A Ghon focus is a TB tubercle, whereas a Ghon complex is a focus with hilar lymph node involvement.
What is the difference between a Ghon focus and a Ghon complex?
Keratinocytes, the most numerous cells in the epidermis, carry melanin and produce keratin.
What cells of the epidermis carry the pigment melanin?
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
By removing Na+ from the renal tubule and pumping it back into the ECF compartment, what does aldosterone do to the body's acid-base stores?
Expiratory reserve volume (ERV)
Name the lung measurement based on the following descriptions: • Additional volume that can be expired after normal expiration
Crohn disease
What transmural inflammatory bowel disease can be found from the mouth to anus, has noncaseating granulomas, is discontinuous (skip lesions), and has a cobblestone appearance, thickening of the bowel wall, linear fissures, and aphthous ulcers with normal mucosa between?
G0 phase
Name the phase of the eukaryotic cell cycle: • Cells cease replicating (i.e., nerve cell)
Antisocial
Name the cluster B personality disorder: • Criminal behavior; lacking friends, reckless, and unable to conform to social norms
Inhibin, müllerian-inhibiting factor, and androgen binding protein
What three factors do Sertoli cells produce for normal male development?
The liver (in the mitochondria)
What is the only organ in the body that can produce ketone bodies?
Seminoma
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Placental alkaline phosphatase
CN V3 and the lesser petrosal nerve
Name the structure that enters or exits the following foramina: • Foramen ovale
Chromosome 5, 21
Name the associated chromosomal translocation. • Adult familial polyposis
Flurazepam
Which benzodiazepine has the longest half-life?
Hepatitis B
Name the hepatitis virus based on the following information. • Enveloped DNA hepadnavirus
C3, C4, and C5 keep the diaphragm alive!
Ventral rami of what cervical nerves constitute the phrenic nerve?
Isograft
Name the type of graft described by these transplants: Between genetically identical individuals
C wave
What wave is the cause of the following venous pulse deflections? • The bulging of the tricuspid valve into the right atrium
Depolarization is from apex to base and from endocardium to epicardium.
How does ventricular depolarization take place, base to apex or vice versa?
Ewing's sarcoma
What malignant neoplasm of the bone is associated with Homer-Wright pseudorosettes; onion skinning of the periosteum on radiographs of the femur, pelvis, and tibia; and chromosome 11;22 translocation?
O2 has a higher driving force but is only one-twenty-fourth as soluble as CO2. CO 2 has a very small partial pressure difference across the alveolar membrane (47-40 = 7 mmHg), but it is extremely soluble and therefore diffuses readily across the membrane.
Does O2 or CO2 have a higher driving force across the alveolar membrane?
Sporozoites
What form of the Plasmodium species are injected into humans by mosquitoes?
Zollinger-Ellison syndrome
What syndrome is associated with gastrin-producing islet cell tumor resulting in multiple intractable peptic ulcers?
Target cell
What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb-containing area?
Plasma cell
What type of cell can never leave the lymph node?
Somatization disorder
What somatoform disorder is described as • Having a F:M ratio of 20:1, onset before age 30, and having 4 pains (2 gastrointestinal, 1 sexual, 1 neurologic)?
Rods
What cells of the retina see in black and white and are used for night vision?
Positive reinforcement
Based on operant conditioning, what type of reinforcement is described when • Adding a stimulus reinforces a behavior?
Phallic stage (4-6 years)
At what stage of psychosexual development (according to Freud) do children fear castration?
False. Flumazenil is unable to block the effects of barbiturates.
True or false? Flumazenil is used in the treatment of barbiturate overdose.
True. Transcription (conversion of DNA to RNA), as well as replication, occurs in the nucleus.
True or false? The nucleus is the site of transcription.
The vaccine contains 23 capsular polysaccharides.
How many strains of Pneumococcus capsular polysaccharides are present in the vaccine?
Bronchial asthma (eosinophil membranes)
Charcot-Leyden crystals
β-Oxidation of fatty acids
From where is the energy for gluconeogenesis derived?
Histamine
What are the primary neurotransmitters at the following sites? • The hypothalamus
L4 to S3 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Common peroneal nerve
ICF volume decreases when there is an increase in osmolarity and vice versa.
What happens to intracellular volume when there is an increase in osmolarity?
Malingering
What disorder is described as having • Conscious symptoms with conscious motivation?
Pimozide
What is the drug of choice for treating Tourette syndrome?
Sensory
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal root?
Histrionic
Name the cluster B personality disorder: • Colorful, dramatic, extroverted, seductive, and unable to hold long-term relationships
Anopheles mosquito
What vector is associated with malaria?
Tetracycline
Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children?
Staphylococcus aureus
What is the most common one? • Organism associated with mastitis
Escherichia coli
Name the most common type or cause. • Cystitis
Dihydrofolate reductase
What enzyme is blocked by methotrexate/ trimethoprim?
Dysthymia, which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
What disorder is characterized by a depressed mood and a loss of interest or pleasure for more than 2 years?
IgG
What is the major Ig of the secondary immune response?
DLCO, an index of lung surface area and membrane thickness, is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is an increase in surface area due to capillary recruitment.
Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise?
The primitive streak grows caudal to rostral.
What is the direction of growth for the primitive streak, caudal to rostral or rostral to caudal?
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
What is the primer for the synthesis of the second strand in production of cDNA from mRNA?
Ea (activation energy)
What is the only factor of enzyme kinetics that the enzyme affects?
Osteosarcoma
What is the most common one? • Malignant tumor in the bone of teenagers
Fibroadenoma
What is the most common one? • Benign tumor of the breast
Neuroblastoma
Homer-Wright rosettes
Sigmoid colon
What is the most common one? • Site for colonic diverticula
Glioblastoma multiforme
What is the most common one? • Primary CNS tumor in adults
Farnesyl pyrophosphate (FPP)
What intermediate of cholesterol synthesis anchors proteins in the membranes and forms CoA?
Stratum spinosum
In what layer of the epidermis is melanin transferred from melanocytes to keratinocytes?
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid
What are the four muscles of mastication?
Calcium influx secondary to slow channel opening
What triggers phase 0 of the action potential in a ventricular pacemaker cell?
Osteogenesis imperfecta
Blue sclera is seen in what hereditary bone disorder?
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
Is digoxin or digitoxin renally eliminated?
Convergence
Contracting both medial rectus muscles simultaneously makes the images of near objects remain on the same part of the retina. What term describes this process?
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Cerebellum
Body dysmorphic disorder
What somatoform disorder is described as • Unrealistic negative opinion of personal appearance, seeing self as ugly?
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)
Kaiser-Fleischer rings, abnormal copper metabolism, and ceruloplasmin deficiency characterize what disease, which may include symptoms of dementia when severe?
Fungi
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Eukaryotic cell; 3 to 10 microns; 80S ribosomes; chitinous cell wall; ergosterol in cell membrane; replicate via cytokinesis with mitosis and meiosis
Hemosiderin
What Hgb-derived endogenous pigment is found in areas of hemorrhage or bruises?
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion, patients sway with eyes closed. (Don't forget this one.)
What bedside test is used to differentiate a dorsal column lesion from a lesion in the vermis of the cerebral cortex?
Phenylephrine
What α1-agonist, not inactivated by catechol-O-methyl transferase (COMT), is used as a decongestant and for treatment of paroxysmal atrial tachycardia?
B cells; macrophages and dendritic cells are nonspecific.
What is the only specific Ag-presenting cell?
Lithium
What is the DOC for bipolar disorder?
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream, and the -35 promoter site is self-explanatory.
How many base pairs upstream is the prokaryotic TATA box promoter?
Pneumococcus
Name the most common type or cause. • Meningitis in adults
apo A-1
What apoprotein on HDL activates lecithin-cholesterol acyltransferase (LCAT)?
Treacher Collins syndrome
Mandibular hypoplasia, down-slanted palpebral fissures, colobomas, malformed ears, and zygomatic hypoplasia are commonly seen in what pharyngeal arch 1 abnormality?
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
Antigenic determinant (epitope)
What is the term to describe the limited portion of an Ag that is recognized by an Ab?
ELISA test
What test uses p24 protein when diagnosing HIV?
Onion skinning
What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
Cyproheptadine
What antihistamine is used in the treatment of serotonergic crisis?
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
What type of anemia is the result of a deficiency in intrinsic factor?
Cortisol levels increase. Lymphocyte levels decrease in sleep-deprived individuals.
What happens to cortisol levels in sleep-deprived individuals?
Doxacurium
What is the most potent NMJ blocker and also has no cardiovascular side effects?
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
What is the name of the superficial subcutaneous fascia of the abdomen containing fat?
Stanford-Binet Scale, developed in 1905, is useful in the very bright, the impaired, and children less than 6 years old.
What is the first formal IQ test used today for children aged 2 to 18?
Left abducens nerve
Where is the lesion that produces these symptoms when a patient is asked to look to the left? • Left eye can't look to the left
Hemangioma (benign)
What is the most common one? • Primary tumor of the liver
Type II
Which phenotype of osteogenesis imperfecta is incompatible with life?
Flumazenil
What is the name of the benzodiazepine antagonist used in the treatment of an overdose?
Wernicke's encephalopathy
What encephalopathy causes ocular palsies, confusion, and gait abnormalities related to a lesion in the mammillary bodies and/or the dorsomedial nuclei of the thalamus?
LH
For what hormone do Leydig cells have receptors?
Metaphase II
At ovulation, in what stage of meiosis II is the secondary oocyte arrested?
Beryllium
What chemical can be dangerous if you work in the aerospace industry or in nuclear plants?
Acting out
Outburst to cover up true feelings (emotion is covered, not redirected).
Mycobacterium marinum
A tropical fish enthusiast has granulomatous lesions and cellulitis; what is the most likely offending organism?
Middle meningeal artery
Name the structure that enters or exits the following foramina: • Foramen spinosum
cDNA libraries are derived from mRNA, are continuous, and contain no introns or regulatory elements.
What type of DNA library is made from the mRNA from a tissue expressing a particular gene?
Conn syndrome (primary hyperaldosteronism)
What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN, hypokalemia, and low rennin levels?
Staphylococcus aureus
What is the MCC of the following endocarditis scenarios? • Non-IV drug user
IL-4
Which IL is associated with increases of IgG and IgE?
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
Liver, kidney, and GI epithelium
What are the three glycogenic organs?
Cortisol Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.
What is the major hormone produced in the following areas of the adrenal cortex? • Zona fasciculata
T3
What is the bioactive form of thyroid hormone?
Alcohol. Nearly 10% of adults have a problem with alcohol.
What is the most abused drug across all age groups?
Chromosome 14, 18
Name the associated chromosomal translocation. • Follicular lymphoma
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
What two factors are required for effective exocytosis?
Dimercaprol, D-penicillamine
Name the antidote. • Arsenic
Medial pontine syndrome
What syndrome is associated with the following brainstem lesions? • Contralateral corticospinal and medial lemniscus tract deficits and an ipsilatera medial strabismus secondary to a lesion in CN VI
Parasympathetic
What part of the ANS (i.e., PNS or CNS) controls the constriction of the pupil in response to light?
Ethacrynic acid
Irreversible ototoxicity is associated with which loop diuretic?
RSV
Name the most common cause. • Hospitalization in children younger than 1 year of age
Lethal dose for 50% of drug takers (median lethal dose)
What do the following values indicate? • LD50
H 1
Are the following responses associated with histamines H1 or H2 receptor activation? • Pain and pruritus
HBsAg and HBeAg
What two Ags must be positive for a patient to have chronic active hepatitis?
Hypertension
What is the primary predisposing factor for vascular dementia?
11-Beta-Hydroxylase deficiency results in excess production of 11-deoxycorticosterone, a weak mineralocorticoid. It increases BP, Na+, and ECF volume along with production of adrenal androgens.
What adrenal enzyme deficiency results in hypertension, hypernatremia, and virilization?
Thiabendazole
What is the drug of choice for threadworm, trichinosis, and larva migrans?
Homeodomain proteins
What group of eukaryotic regulatory proteins has a major factor in controlling the gene expression embryonically?
Astrocytoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • sis
Oxazepam, temazepam, and lorazepam ( OTL, Outside The Liver)
Name the three benzodiazepines that are not metabolized by the cytochrome P450 enzyme system.
Physiologic antagonism
Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?
Proencephalon* *diencephalon derivative
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Neurohypophysis
Mercury
What type of acute metal poisoning involves stomach and colon erosion and acute tubular necrosis?
Edinger-Westphal nucleus (via CN III)
What nucleus supplies the preganglionic parasympathetic fibers to the ciliary ganglion?
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
What is the term for recurrent and persistent pain before, after, or during sexual intercourse?
Resistance increases as resistors are added to the circuit.
When referring to a series circuit, what happens to resistance when a resistor is added?
Hereditary spherocytosis
What normochromic, normocytic AD anemia has splenomegaly and increased osmotic fragility?
Bacterial meningitis
What condition results in the following CSF results? • Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
Primary hyperparathyroidism
What pathology is associated with elevated levels of Ca2+, cardiac arrhythmias, bone resorption, kidney stones, and metastatic calcifications?
ELISA. It detects anti-p24 IgG.
What test is used to screen for HIV?
Sertoli cell
What cell is under control of FSH and testosterone; secretes inhibin, MIF, and androgen-binding protein; and phagocytizes the excess cytoplasm of the spermatid?
. Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUPS DAKRI is the mnemonic, everything else is covered with peritoneum
Name the 10 retroperitoneal organs.
Medial compartment of the thigh, obturator nerve
Name the compartment of the lower extremity and the nerve based on its movements. • Adduct the thigh and flex the hip
PGI 2
Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
S phase
DNA replication occurs during what phase of the cell cycle?
Hypervariable region
What region of the Ig does not change with class switching?
Scavenger receptor (SR-B1)
Via what cell surface receptor does HDL cholesterol from the periphery enter hepatoceles?
Non-Hodgkin lymphoma
What hematologic malignancy is treated with the monoclonal antibody rituximab?
Since CO2 is 24 times as soluble as O2, the rate at which CO2 is brought to the membrane determines its rate of exchange, making it perfusion-limited a gas. For O2 the more time it is in contact with the membrane, the more likely it will diffuse, making it diffusion-limited.
Is CO2 a perfusion-or diffusion-limited O2 gas?
Hapten; if it is coupled with a carrier, it may become immunogenic.
What is the term for an immunogenic agent that is too small to elicit an immune response?
Minimal change disease
What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition?
True. PIF is dopamine in the tuberoinfundibular system.
True or false? Prolactin levels can serve as a rough indicator of overall dopamine activity.
Stranger anxiety
What form of anxiety, appearing at 6 months, peaking at 8 months, and disappearing by 1 year of age, is seen in the presence of unfamiliar people?
The placenta
From the fourth month of fetal life to term, what secretes the progesterone and estrogen to maintains the uterus?
Stratum corneum (keratinized)
What is the most superficial layer of the epidermis?
Residual volume (RV)
Name the lung measurement based on the following descriptions: • Amount of air in the lungs after maximal expiration
28 L, 40% of body weight
What is the amount in liters and percent body weight for the following compartments? • ICF
Minor
Are the following major or minor Jones criteria of rheumatic fever? • Fever
Lysosomal α-1, 4-glucosidase
What enzyme is deficient in the following glycogen storage disease? • Pompe's disease
Urophilia
What paraphilia is defined as • Combining sex with urination?
Permanent
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Skeletal muscle
Extinction
Based on operant conditioning, what type of reinforcement is described when • Removing a stimulus stops a behavior?
Para-aminohippurate (PAH)
The clearance of what substance is the gold standard of renal plasma flow?
Dihydrofolate reductase
What enzyme of pyrimidine synthesis is inhibited by the following? • Methotrexate
Microglial cells
Name the macrophages by location: • CNS
Squamous cell carcinoma
What malignant neoplasm of the skin is associated with keratin pearls?
Ganglioside
What sphingolipid cannot be produced without sialic acid and amino sugars?
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
Is there a shift in p50 values with anemia? Polycythemia?
EBV
What virus is associated with the endemic form of Burkitt lymphoma?
Type III
What type of collagen is associated with keloid formation?
Pyrantel pamoate
What drug of choice for ascaris causes neuromuscular blockade of the worm?
Hepatitis E
What type of hepatitis has the highest mortality rate among pregnant women?
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
In MHC class II molecules, what chain blocks access to the peptide-binding groove during transportation within the cell, ensuring that the MHC class II-peptide complex is transported to the surface?
Toxic dose for 50% of drug takers (median toxic dose)
What do the following values indicate? • TD50
True. The lack of dopamine leads to an excess of ACh, hence extrapyramidal dysfunction.
True or false? The lack of dopamine production in the substantia nigra leads to the extrapyramidal dysfunction, characteristically seen in patients with Parkinson's disease.
Temporal lobe
Name the area of the cerebral cortex with the function described: • Language, memory, and emotion (Hint: herpesvirus infects here commonly)
Anticipation, associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.
What is the term for the number of trinucleotide repeats increasing with successive generations and correlating with increased severity of disease?
Lead
What type of metal poisoning causes mental retardation, somnolence, convulsions, and encephalopathy?
True. Remember, RBCs do not contain mitochondria, so they cannot metabolize aerobically.
True or false? RBCs anaerobically use glucose in both the well-fed and fasting states.
H 2
Are the following responses associated with histamines H1 or H2 receptor activation? • SA nodal activity
Enkephalins
What naturally occurring substances mimic the effects of opioids?
Chlortetracycline
What tetracycline is associated with hepatotoxicity?
Short-chain fatty acids
What forms of fatty acids are absorbed from the small intestine mucosa by simple diffusion?
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
Will a patient with a unilateral lesion in the cerebellum fall toward or away from the affected side?
Urogenital sinus
What embryonic structure forms the adult female structures? • Urinary bladder, urethra, greater vestibular glands, vagina
Multiple myeloma
What is the most common one? • Tumor arising within the bone
Alzheimer disease
Neurofibrillary tangles
Polyarteritis nodosa
What vasculitis is characterized by systemic vasculitis in small to medium- size vessels (except the lung); affecting young males; 30% HBsAg-positive; P-ANCA and autoantibodies against myeloperoxidase?
P wave
What component of an ECG is associated with the following? • Atrial depolarization
Catatonic schizophrenia
What subtype of schizophrenia is characterized by • Stuporous mute echopraxia and automatic obedience, waxy flexibility with rigidity of posture?
Autoimmune hemolytic anemia
What type II hypersensitivity disorder is defined as • Autoantibodies directed against RBC Ag I?
Pseudomonas aeruginosa
Name the most common type or cause. • Infection in a patient on a ventilator
Phototherapy
What is the treatment for physiologic jaundice of newborns?
Haemophilus ducreyi
Name the most common type or cause. • Chancre
Metronidazole
What is the DOC for the following protozoal infections? • Amebiasis
The greater the cell diameter, the greater the conduction velocity.
How does cell diameter affect the conduction velocity of an action potential?
Superior and posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Esophagus
Diazepam is longest acting and midazolam is shortest acting.
What are the longest-acting and shortest-acting benzodiazepines?
Surface tension, the force to collapse the lung, is greatest at the end of inspiration.
When is the surface tension the greatest in the respiratory cycle?
Ethambutol
What antitubercular agent causes loss of red-green visual discrimination?
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
What three actions should take place when one person threatens the life of another? (Hint: think of the Tarasoff decision.)
Y, W-135, and C and A capsular polysaccharides
What are the four capsular polysaccharides used in the Neisseria meningitides vaccine?
The negative charge inhibits the filtration of protein anions.
What is the role of the negative charge on the filtering membrane of the glomerular capillaries?
0.21; it is a fancy way of saying 21% of the air is O2.
What is the FiO2 of room air?
Persistent truncus arteriosus
What right-to-left shunt occurs when only one vessel receives blood from both the right and left ventricles?
1. Cefamandole 2. Cefoperazone 3. Moxalactam
What three cephalosporins can produce disulfiram-like reactions?
Autosomal recessive
Name the pattern of genetic transmission: both M and F are affected; M-to-M transmission may be present; both parents must be carriers; the trait skips generations; two mutant alleles are needed for disease; and affected children may be born of unaffected adults?
False. Staphylococci have catalase; streptococci do not.
True or false? Streptococci have catalase.
FSH
What hormone acts on Granulosa cells?
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Aortic arch
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Smooth muscle
Creutzfeldt-Jakob's disease. Patients first develop vague somatic complaints and anxiety, rapidly followed by dysarthria, myoclonus, ataxia, and choreoathetosis.
What form of dementia is characterized by onset at age 40 to 50, rapid progression, infection by a prion, and death within 2 years?
Verbigeration
What term describes senseless repetition of words or phrases?
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
What is the only muscle of the soft palate that is innervated by CN V3?
Androgens are 19-carbon steroids.
How many carbons do androgens have?
False. Histidine operon is activated when there are low intracellular levels of histidine.
True or false? Histidine activates the histidine operon.
Fading
What operant conditioning therapy or modification is described as • Removing a reinforcement (without the patient knowing) gradually over time to stop a condition?
Selection bias
What type of bias is it when the sample population is not a true representative of the population?
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Kidney
pI (isoelectric point)
What is the term for the pH at which the structure carries no charge?
Eaton-Lambert syndrome
What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?
Cocaine
What is the only local anesthetic to produce vasoconstriction?
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
Which kidney is lower? Why?
Because it is the largest vessel and has the highest velocity in systemic circulation
Why will turbulence first appear in the aorta in patients with anemia?
Amyloidosis
Name the most common type or cause. • Restrictive cardiomyopathy
Schizoid
Name these cluster A personality disorders: • Socially withdrawn, seen as eccentric but happy to be alone
Giardia lamblia (treat with metronidazole)
What protozoal parasite forms flasked-shaped lesions in the duodenum, is transmitted via fecal-oral route, and is commonly seen in campers who drank stream water?
Foramen of Monro
What connects the lateral ventricles to the third ventricle?
Both Neisseria and Moraxella are gram-negative cocci.
What are the two exceptions to the rule "all cocci are gram positive"?
HGPRT
What enzyme of the purine salvage pathway is deficient in the following? • Lesch-Nyhan syndrome
CN II and ophthalmic artery
Name the structure that enters or exits the following foramina: • Optic canal
Luteal phase
What is the term for days 15 to 28 in the female cycle?
H 1
Are the following responses associated with histamines H1 or H2 receptor activation? • Bronchial smooth muscle activity
Langerhans cells
Name the macrophage based on its location: • Epidermal macrophages
FALSE
True or false? Miniature end-plate potentials (MEPPs) generate action potentials.
Type I (makes sense, since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
What type of collagen is abnormal in patients with osteogenesis imperfecta?
Clostridium botulinum
Which gram-positive bacteria infection of infancy is associated with ingestion of honey?
Citrate, via the citrate shuttle
As what compound do the carbons for fatty acid synthesis leave the mitochondria?
δ-ALA synthase
What enzyme catalyzes the rate-limiting step in heme synthesis?
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
What are the three reasons for the effectiveness of the blood-brain barrier?
Parvovirus (it is the only ssDNA virus)
What ssDNA virus must make dsDNA before it makes mRNA?
3' end. Phosphate (PO4) is at the 5' end.
Is the hydroxyl (-OH) end of DNA and RNA at the 3' or the 5' end?
Uroporphyrinogen III cosynthase
What enzyme is deficient in congenital erythropoietic porphyria?
3'-5' direction, synthesizing RNA in the 5'-3' direction
What direction does RNA polymerase move along the template strand of DNA during transcription?
The poly(A) site on the DNA
What causes transcription to stop in eukaryotes?
T cells, not B cells
What cells are atypical on a peripheral blood smear in heterophil-positive mononucleosis?
IGF-1 (somatomedin C)
What somatomedin serves as a 24-hour marker of GH secretion?
Toxic or viral hepatitis
Councilman bodies
Primary hypoparathyroidism
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH decreased, Ca2+ decreased, Pi increased
Shortens
What happens to the following during skeletal muscle contraction? • H zone
Gastrin-releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)
What parasympathetic neurotransmitter of the GI tract stimulates the release of gastrin?
Dihydropteroate synthetase
What enzyme is inhibited by sulfonamides?
Iatrogenesis
Name the most common type or cause. • Hypothyroidism in the United States
Left ventricle and auricle of left atrium
What part of the heart forms • Left border?
Rathke's pouch; they can result in compression of the optic chiasm.
Craniopharyngiomas are remnants of what?
Thiazide diuretics
Which group of antihypertensive agents best decreases left ventricular hypertrophy?
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Notching of the ribs, seen on chest radiograph in patients with postductal coarctation of the aorta, is due to collateralization of what arteries?
0.2
How many milliliters of O2 per milliliter of blood?
HMG-CoA reductase
What enzyme catalyzes the rate-limiting step in cholesterol metabolism?
Narcissistic
Name the cluster B personality disorder: • Grandiose sense of self-importance; demands constant attention; fragile self-esteem; can be charismatic
Occulta All except occulta cause elevated-fetoprotein levels.
Name the form of spina bifida. • Defect in the vertebral arch
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
The opening of what valve indicates the termination of isovolumetric relaxation phase of the cardiac cycle?
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
What is the most common Ig deficiency?
Posterior interventricular artery
What artery travels with the following veins? • Middle cardiac vein
Affinity
What type of binding occurs with one Fab or one idiotype of IgG?
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
What four substances increase the rate of gluconeogenesis?
Reye syndrome
What potentially fatal disease occurs in children who are given aspirin during a viral illness?
The fast component is directed toward the affected side of a cerebellar lesion.
If a patient with a cerebellar lesion has nystagmus, which way is the fast component directed, toward or away from the lesion?
Hydroxyproline
Increased urinary excretion of what substance is used to detect excess bone demineralization?
Fovea
What area of the retina consists of only cones and has the greatest visual acuity?
Alveolar dead space
What is the term for ventilation of unperfused alveoli?
Methanol
Which form of alcohol toxicity results in ocular damage?
Operon
In prokaryotes, what is the term for a set of structural genes that code for a select group of proteins and the regulatory elements required for the expression of such gene?
Gilbert's syndrome
What disease has a genetically low level of UDPglucuronate transferase, resulting in elevated free unconjugated bilirubin?
IgA
What Ig prevents bacterial adherence to mucosal surfaces?
Mesolimbic system
What area of the brain is linked to emotion and movement?
Salmonella
What Enterobacteriaceae are prone to produce osteomyelitis in sickle cell patients?
T9
What vertebral level is marked by the xiphoid process?
SSRIs
What is the most widely used class of antidepressants?
Prolactin
What hormone level increases in the first 3 hours of sleep?
Palms and soles of the feet. Sebaceous glands are associated with hair follicles, which are lacking on the palms and soles of the feet.
What two areas of the skin do not contain sebaceous glands?
The myotatic reflex is responsible for the tension present in all resting muscle.
What basic reflex regulates muscle tone by contracting muscles in response to stretch of that muscle?
Fructose-1, 6-bisphosphatase
What enzyme catalyzes the rate-limiting step in gluconeogenesis?
JC virus
What virus is associated with progressive multifocal leukoencephalopathy?
1. Liver 2. Kidney 3. Pituitary gland (via 5'-deiodinase enzyme)
At which three sites in the body is T4 converted to T3?
No, it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
Is spousal abuse a mandatory reportable offense?
Progressive multifocal leukoencephalopathy
What encephalitis is associated with the JC virus?
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
What five cofactors and coenzymes are required by pyruvate dehydrogenase?
Apoptosis (Remember, there is a lack of inflammatory response.)
What is the term for programmed cell death?
Sciatic nerve
What lower extremity nerve is described by the following motor loss? • Loss of flexion of the knee and all function below the knee, weakened extension of the thigh
Disorganized schizophrenia
What subtype of schizophrenia is characterized by • Childlike behaviors, unorganized speech and behaviors, poor grooming, incongruous smiling and laughter, and the worst prognosis?
Prostate and lung cancer, respectively
What are the two leading causes of cancer-related death in men?
In the mouth with salivary α-amylase (ptyalin)
Where does CHO digestion begin?
The small subunit (40S) binds first.
What ribosomal subunit binds first to the mRNA strand?
Specific rate (e.g., men aged 55-60)
What is the term for the rate measured for a subgroup of a population?
Histoplasma capsulatum
Which dimorphic fungus is endemic in the Ohio, Mississippi, Missouri, and Eastern Great Lakes, is found in soil with bird and bat feces, and is associated with infections in spelunkers and chicken coop cleaners?
Microcytotoxic assay
What assay is used to identify MHC class I molecules?
Projection
Name these narcissistic defense mechanisms: • Person takes his or her own feelings, beliefs, wishes, and so on and thinks they are someone else's. (e.g., a cheating man thinks his wife is unfaithful)
Bronchoconstriction is associated with parasympathetic stimulation (ACh), and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Is ACh associated with bronchoconstriction or bronchodilation?
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 increased
Velocity is inversely related to cross-sectional area.
How is velocity related to the total cross-sectional area of a blood vessel?
Constipation and miosis
What are the two side effects of opioids to which the user will not develop tolerance?
None; they are the storage sites for ADH and oxytocin.
What hormones are produced in the median eminence region of the hypothalamus and the posterior pituitary gland?
Phase 1
Testing of a drug in a small group of volunteers without the disease is a component of which phase of clinical drug testing?
6 ATPs (remember 2 pyruvates per glucose are produced, and 2 NADHs result from production of acetyl CoA, so 6 ATPs)
How many ATPs per glucose are produced by pyruvate dehydrogenase?
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
What nerves carry the sensory and motor components of the blink reflex?
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
With what stage of sleep is enuresis associated?
Clofazimine
What is the drug of choice in the treatment of the lepra reaction?
Hepatitis E
Name the hepatitis virus based on the following information. • Naked capsid RNA calicivirus
Goodpasture syndrome
What type II hypersensitivity disorder is defined as • Autoantibodies against the type IV collagen in the basement membrane of the kidneys and lungs?
Crigler-Najjar syndrome
In what disease is there a genetic absence of UDP-glucuronate transferase, resulting in an increase in free unconjugated bilirubin?
Spectinomycin
What is the drug of choice for penicillin-resistant gonococcal infections?
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR, Appearance, Pulse, Grimace, Activity, Respiration
What five things are checked in the APGAR test?
CMV, Toxoplasma gondii, and Listeria
Which three organisms cause heterophilic negative mononucleosis?
ASD
What is the most common one? • Congenital heart defect in adults
HIV
What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
The stomach
What is the only site in the body that uses M1 receptors?
Amnesia. (The person is aware of the memory loss.)
What term describes the inability to recall personal information, commonly associated with trauma?
False. Ergotamines are used in the treatment of migraines for their vasoconstrictive action in the cerebral circulation.
True or false? Ergotamines, because of their vasodilation action, cause migraines.
12 days after ovulation
If no fertilization occurs, how many days after ovulation does the corpus luteum begin to degenerate?
Xanthine, hypoxanthine, theophylline, theobromine, caffeine, and uric acid are all purines.
Name three purine bases that are not found in nucleic acids.
Pulmonary infections
Name the MCC of death. • In patients with cystic fibrosis
The Purkinje cell
What cell's axons are the only ones that leave the cerebellar cortex?
Multiple myeloma
Russell bodies
Carbonic anhydrase
What enzyme is essential for the conversion of CO2 to HCO3-?
Phase 4; NE increases the slope of the prepotential, allowing threshold to be reached sooner, and increases the rate of firing.
In a ventricular pacemaker cell, what phase of the action potential is affected by NE?
(MA/CA) x 100 = IQ score, where MA = mental age and CA = chronological age
What is the formula to calculate IQ?
IgA
What Ig is the major protective factor in colostrum?
They chronically inhibit ADH secretion; when there is a decrease in the blood volume, the stretch receptors send fewer signals, and ADH is secreted.
What is the venous and arterial stretch receptors' function regarding the secretion of ADH?
hnRNA
Name the RNA subtype based on the following: • Found only in the nucleus of eukaryotic cells and are precursors of mRNA
Antithyroglobulin and antimicrosomal Abs
What two Abs are used to diagnose Hashimoto's thyroiditis?
Yes, as long the illness does not threaten limb or life. If illness is critical or an emergency, treat the child.
Can parents withhold treatment from their children?
Cholera toxin
What toxin ADP-ribosylates via Gs protein to increase cAMP?
Peyer's patch
What lymphoid organ is characterized by germinal centers, plasma cells that secrete IgA, and no encapsulation?
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
What hormone is necessary for normal GH secretion?
Urogenital folds
What embryonic structure forms the adult male structure? • Ventral part of the penis
C5b-C9
What components of the complement cascade form the MAC?
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
What is the term for repetitive actions blocking recurring bad thoughts?
Double-blind study. It is the most scientifically rigorous study known.
What type of random controlled test is least subjective to bias?
Chromaffin cells (adrenal medulla)
What cells of the adrenal gland are neural crest derivatives?
Negative
Are the following conditions associated with a negative or positive nitrogen balance? • Infection
PGI2
Name the product or products of arachidonic acid: • Vasodilation and inhibition of platelet aggregation produced by vascular endothelium
PALS
What is the T-cell area of the spleen?
Superior and posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Thoracic duct
Alveoli; they are part of the respiratory portion.
Which of the following is not part of the conducting portion of the respiratory system: trachea, bronchi, alveoli, or larynx?
HPV
What virus produces koilocytic cells on a Papanicolaou (Pap) smear?
Minor
Are the following major or minor Jones criteria of rheumatic fever? • Arthralgias
Haemophilus influenzae type B
Name the MCC. • Epiglottitis in an unvaccinated child
Bunyavirus
What family do the following viruses belong to? • California encephalitis
Terminal bronchioles. (No gas exchange occurs here.)
Where is the last conducting zone of the lungs?
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors
What are the four types of signaling mechanisms?
True. Although the CSF normally contains 0 to 4 lymphocytes or monocytes, the presence of PMNs is always considered abnormal.
True or false? The presence of PMNs in the CSF is always abnormal.
True. Blood flows from the portal tracts (distal) to the central vein (proximal), so it is the first area affected during hypoxia.
True or false? The central vein of the liver lobule is the first area affected during hypoxia.
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Does alcoholism increase the rate of suicide?
Streptococcus pneumoniae
Name the most common type or cause. • Lobar pneumonia
Type II hypersensitivity reaction
What type of hypersensitivity is an Ab-mediated response against our own cells, receptors, or membranes via IgG or IgM?
Dominant temporal lobe
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Euphoria, delusions, thought disorders, Wernicke's aphasia, auditory hallucinations (Hint: the lesion is in the left hemisphere)
Ribavirin
What antiviral agent is used to treat RSV, influenza A and B, Lassa fever, and hantavirus and as an adjunct to IFN-in hepatitis C?
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
What is the term for the inherent ability to induce a specific immune response?
Stratum lucidum
What is the first epidermal layer without organelles and nuclei
Increased erection and libido
What are the pharmacologic effects seen sexually with • Dopamine agonists?
Mesocortical area
In what area of the brain can an excess of dopamine lead to psychotic symptoms?
Median (think of it as the halfway point)
What is the term for the point on a scale that divides the population into two equal parts?
Adenocarcinoma of the cervix
What is the most common one? • Primary malignant tumor of the female genital tract in the United States
Conversion disorder
What somatoform disorder is described as • La belle indifférence, suggestive of true physical ailment because of alteration of function?
Chi-square.
What statistical method do you use when analyzing • Cross-sectional studies?
Second M PITS for pharyngeal pouch derivatives
From what pharyngeal pouch is the following structure derived? • Palatine tonsil
PTH
What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate excretion
Depolarization (i.e., Na+ influx)
What is the term for the negative resting membrane potential moving toward threshold?
Right ventricle
What part of the heart forms • Anterior wall?
Bladder carcinoma
RBCs in the urine
MstII; changing codon 6 (from A to T) destroys the restriction site.
What restriction endonuclease site is destroyed in sickle β-globin allele?
The systemic veins have the largest blood volume, and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
What component of the cardiovascular system has the largest blood volume? Second largest blood volume?
Hepatocellular carcinoma
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Aromatic amines and azo dyes
Prostate cancer
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • PSA and prostatic acid phosphatase
Snails
What are the first intermediate hosts for trematodes?
Trichophyton
Which genus of dermatophytes is associated with the following sites of infection? • Skin, hair, and nails
CN III and IV
What CNs arise from • The midbrain?
Benign lentigo
What skin condition is a localized proliferation of melanocytes presenting as small, oval, light brown macules?
Eosinophil
What cell type is commonly elevated in asthma?
Test-retest reliability
What is the term for the same results achieved again on testing a subject a second or third time?
Mitral (bicuspid) valve
What is the only valve in the heart with two cusps?
Chi-square (when you are in doubt and have nominal data, use chi-square)
What statistical test, using nominal data only, checks whether two variables are independent events?
Cefuroxime and cefaclor
Which two cephalosporins cross the blood-brain barrier?
Testicular feminization syndrome (Dude looks like a lady!)
What syndrome occurs when a 46XY fetus develops testes and female external genitalia?
Chromosome 19
Name the associated chromosome. • Familial hypercholesterolemia
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
What is the anatomic positioning of the right and left gastric nerve plexus of the esophagus as they pass through the diaphragm?
Hypertrophy
What is the term to describe the increase in organ size due to the increase in cell size and function?
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 increased
Psoriasis, ankylosing spondylitis, inflammatory bowel disease, and Reiter's syndrome
What diseases are associated with the HLA-B27 allele
Inulin
The clearance of what substance is the gold standard of GFR?
Carnitine acyltransferase-I
What enzyme catalyzes the rate-limiting step in fatty acid oxidation?
Exhibitionism
What paraphilia is defined as • Having a recurrent desire to expose the genitals to strangers?
Breast cancer
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1, int-2, erb-2, and erb-3
Third week
During what embryonic week do somites begin to form?
Validity (remember, reliability is necessary but not the only thing needed for validity)
What is the term for the degree to which a test measures what it is intended to measure?
IL-4 is secreted to activate B cells. This begins the second step in the immune response, known as Activation. CD4 T cells secrete INF-alpha to activate macrophages
What cytokine do CD4 T cells secrete to activate B cells when the specific peptide in the groove of the MHC II molecule interacts with the TCR?
Metastatic carcinoma
What is the most common one? • Liver tumor
Filtration; if hydrostatic pressure is less than oncotic pressure, reabsorption is promoted.
If capillary hydrostatic pressure is greater than oncotic pressure, is filtration or reabsorption promoted?
Renal plasma flow (decrease flow, increase FF)
What is the main factor determining FF?
Hypoxanthine (remember, IMP is a precursor for AMP and GMP)
What purine base is contained in inosine monophosphate?
True. Probenecid can precipitate uric acid crystals in the kidney if the patient is an overexcretor of urate.
True or false? You would not prescribe probenecid for a patient with gout who is an overexcretor of uric acid.
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
What two factors result in the base of the lung being hyperperfused?
False. Adenovirus vaccine is a live pathogenic virus in an enteric coated capsule. All of the others are inactivated vaccines.
True or false? All of the following are inactivated vaccines available in the United States: influenza, Vibrio cholera, hepatitis A, rabies, and adenovirus.
VSD
What is the most common one? • Congenital cardiac anomaly
Volvulus
What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
Escherichia coli
Name the most common type or cause. • UTIs
Ligament teres
What are the adult remnants of the following structures? • Left umbilical vein
Yolk sac tumor
What testicular tumor of infancy is characterized by elevated-fetoprotein levels and Schiller-Duval bodies?
IgM
What is the first Ab a baby makes?
Projective test. Most tests with a wide range of possibilities for the answers are projective.
What type of personality test is the Rorschach inkblot test, objective or projective?
NREM sleep. Remember awake body, sleeping brain
What general pattern of sleep is described by slowing of EEG rhythms (high voltage and slower synchronization), muscle contractions, and lack of eye movement or mental activity?
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
At what vertebral level does the trachea bifurcate?
Turner syndrome
Streaky ovaries
Left ventricle and tip of right ventricle
What part of the heart forms • Diaphragmatic wall?
False. That is precisely where COMT is found; it is not found in adrenergic nerve terminals.
True or false? Catechol-O-methyl transferase (COMT) is not found in smooth muscle, liver, and the kidneys.
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
What is the only way to increase O2 delivery in the coronary circulation?
Gout
What pathology is associated with podagra, tophi in the ear, and PMNs with monosodium urate crystals?
Propionibacterium acnes
What is the most common causative organism of acne vulgaris?
Down syndrome (trisomy 21)
What disease that involves mental retardation, flat face, muscle hypotonia, and a double-bubble sign on radiograph poses an increased risk of Alzheimer's disease and ALL?
Myasthenia gravis
What type II hypersensitivity disorder is defined as • Autoantibodies directed against ACh receptors?
Alcoholism
Name the most common type or cause. • Mallory-Weiss syndrome
Arterial PCO2 levels are proportional to cerebral blood flow.
Under resting conditions, what is the main determinant of cerebral blood flow?
Chromosome 11p
Name the associated chromosome. • Niemann-Pick disease
Cingulate gyrus herniation (subfalcine)
Which cerebral herniation results in compression of the anterior cerebral artery?
Yolk sac tumor
Schiller-Duval bodies
The vestibulo-ocular reflex
What reflex enables the eyes to remain focused on a target while the head is turning?
Gain of hypertonic fluid (mannitol or hypertonic saline)
Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, increase; ICF, decrease; body, increase
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
What statistical method do you use when analyzing • Cohort studies?
Antidigoxin Fab fragments
Name the antidote. • Digoxin
True. Scl-70 Abs are used in diagnosing diffuse scleroderma.
True or false? Anticentromere Abs are used in diagnosing CREST syndrome.
Sporothrix schenckii
Which fungus is found worldwide on plants, is a cigar-shaped yeast in tissue form, and results in rose gardener's disease?
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Third ventricle
RBCs. That is why it is called red pulp.
Which major cell type is found in the red pulp of the spleen?
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III), B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.
Is an afferent or efferent pupillary defect described as B/L pupillary constriction when light is shined in the unaffected eye and B/L paradoxical dilation when light is shined in the affected eye?
Voltage-gated potassium channels
Name the ventricular muscle membrane channel: • Open at rest; depolarization is stimulus to close; begin to reopen during the plateau phase and during repolarization
Transketolase and transaldolase. The reactions they catalyze are reversible.
What are the nonoxidative enzymes of the HMP shunt? Are the reactions they catalyze reversible or irreversible?
Hydatidiform mole
What cystic swelling of the chorionic villi is the most common precursor of choriocarcinoma?
Metastatic
What is the most common one? • Bone tumor
Chylomicrons
Name the lipoprotein based on the following characteristics. • apo E, apo C-II, apoB-48
Under normal resting conditions no, but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg, resulting in increased ventilatory drive.
Do the PO2 peripheral chemoreceptors of the carotid body contribute to the normal drive for ventilation?
Preload (the load on the muscle in the relaxed state)
What term is described as the prestretch on the ventricular muscle at the end of diastole?
NE, via its vasoconstrictive action on blood vessels
What neurotransmitter is essential for maintaining a normal BP when an individual is standing?
NE
What neurotransmitter is presynaptically inhibited by reserpine and guanethidine?
Legionella (think air conditioners)
What water-associated organism is a weakly stained gram-negative rod that requires cysteine and iron for growth?
Hepatocellular carcinoma
What is the most common one? • Primary malignant tumor in the liver
Phase 2
Name the phase of the ventricular muscle action potential based on the following information: • Slow channels open, allowing calcium influx; voltage-gated potassium channels closed; potassium efflux through ungated channels; plateau stage
Nondominant temporal lobe
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Dysphoria, irritability, musical and visual abilities decreased
G1 phase; G2 and S phase are diploid (2N).
What phase of Interphase is haploid (N)?
Rotavirus
Name the most common type or cause. • Diarrhea in children
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
What molecule that is needed to trigger T cell activation is noncovalently linked to TCR?
Alteplase
Which thrombolytic agent, activated in the presence of fibrin, is manufactured by recombinant DNA process?
Left homonymous hemianopsia
Name the ocular lesion; be specific. • Right calcarine cortex lesion
mRNA
Name the RNA subtype based on the following: • Only type of RNA that is translated
Direct; in males less than 50 years old indirect hernias are the most common type.
What is the most common one? • Type of hernia seen in males more than 50 years old
Stretch receptors prevent overdistension of the lungs during inspiration.
What receptor is in the smooth muscle cells of the small bronchi, is stimulated during inflation, and inhibits inspiration?
Agranulocytosis; approximately 2% develop this side effect.
What potentially lethal side effect of clozapine should be monitored with frequent blood drawing?
Conjugated (direct) hyperbilirubinemia
What type of jaundice is seen in Rotor's syndrome?
Hematoxylin
Do the following structures pick up stain from hematoxylin or eosin? • Calcium
Vitamin B 6 (pyridoxine)
What vitamin is a cofactor of aromatic amino acid decarboxylase and decreases the efficacy of L-dopa if used concomitantly?
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards, so remember it.
What happens to total and alveolar ventilation with • Increased depth of breathing?
DNA polymerase-α
Name the eukaryotic DNA polymerase based on the following information: • Synthesizes the lagging strand during replication
Glutamate dehydrogenase
What enzyme catalyzes the reversible oxidative deamination of glutamate and produces the TCA cycle intermediate α-ketoglutarate?
Homocysteine methyl transferase
What is the only enzyme in the body that uses N-5-methyl folate?
Male pseudohermaphrodite (dude looks like a lady!)
What condition is characterized by a 46XY karyotype, testes present, and ambiguous or female external genitalia?
Obturator nerve
What lower extremity nerve is described by the following motor loss? • Loss of adduction of the thigh
Childhood
What stage of male development is characterized by the following LH and testosterone levels? • Both LH and testosterone levels drop and remain low.
Extrahepatic biliary atresia
What disorder is associated with jaundice, white stools, and dark urine due to biliary duct occlusion secondary to incomplete recanalization?
Estradiol
What hormone level peaks 1 day before the surge of LH and FSH in the female cycle?
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
What three criteria allow you to differentiate an ulcer from an erosion or carcinoma?
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
Where does Beta-oxidation of very long chain fatty acids begin?
TAT (Thematic apperception test)
What projective test asks the patient to tell a story about what is going on in the pictures, evaluating the conflicts, drives, and emotions of the individual?
Lymphoblastic lymphoma
What rapidly progressive and aggressive T-cell lymphoma affects young males with a mediastinal mass (thymic)?
Site 1
Name the Hgb-O2 binding site based on the following information: • Remains attached under most physiologic conditions
C1, C2, or C4 deficiency
What complement factor deficiency leads to • Leukocyte adhesion deficiency with poor opsonization?
Preoperational (2-6 years)
At what stage of cognitive development (according to Piaget) do children • Lack law of conservation and be egocentric?
Water flows from a low-solute to high-solute concentrations.
In regards to solute concentration, how does water flow?
HTN
What is the most common condition leading to an intracerebral bleed?
Nicotine (but it sure has a nasty withdrawal!)
What is the only drug that does not have an intoxication?
It is rare with normal grief; however, it is relatively common in depression
Is suicidal ideation a component of normal grief?
Bronchogenic carcinoma
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Polycyclic aromatic hydrocarbons
Medial umbilical ligaments
What are the adult remnants of the following structures? • Right and left umbilical arteries
Primary hypothyroidism (Low T4 has a decreased negative feedback loop, resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release, respectively.)
What thyroid abnormality has the following? • TRH increased, TSH increased, T4 decreased
Order of attachment is site 1, 2, 3, 4, and for release is 4, 3, 2, 1.
What is the order of attachment of O2 to Hgb-binding sites in the lung? Order of release from the binding sites in the tissue?
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
What are the three mechanisms of action for atrial natriuretic peptide's diuretic and natriuretic affects?
S phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Cytarabine
True. Remember, all nucleated cells (and platelets) have MHC class I Ags, and RBCs are not nucleated.
True or false? RBCs do not have MHC class I Ags on their surface.
Hgb F
What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?
Erythromycin
Name the antimicrobial agent whose major side effect is listed. • Cholestatic hepatitis
Frontal lobe syndrome (lesion in the prefrontal cortex)
What syndrome causes inability to concentrate, easy distractibility, apathy, and regression to an infantile suckling or grasping reflex?
Voyeurism
What paraphilia is defined as • Deriving sexual pleasure from watching others having sex, grooming, or undressing?
Constriction of efferent arteriole
What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↑, RPF ↓, FF ↑, capillary pressure ↑
None. Denaturation of dsDNA breaks hydrogen bonds, not covalent bonds.
How many covalent bonds per purine-pyrimidine base pairing are broken during denaturation of dsDNA?
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Which direction does the uvula deviate in a left vagus nerve lesion?
Mantle cell lymphoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • cyclin D
Achondroplasia
What is the most common form of inherited dwarfism?
Negative
Are the following conditions associated with a negative or positive nitrogen balance? • AA deficiency
CN XII
Name the structure that enters or exits the following foramina: • Hypoglossal canal
Left homonymous hemianopsia
Name the ocular lesion; be specific. • A right LGB lesion (in the thalamus)
Poststreptococcal GN
Two weeks after her son has a throat infection, a mother takes the boy to the ER because he has fever, malaise, HTN, dark urine, and periorbital edema. What is your diagnosis?
False. Childbirth carries five times as much risk of serious psychiatric illness as abortion.
True or false? Serious psychiatric illness is more common after abortion than childbirth.
Somatomedins (IGF-1)
What growth factors are chondrogenic, working on the epiphyseal end plates of bone?
The zygote divides mitotically; only germ cells divide meiotically.
Does the zygote divide mitotically or meiotically?
Astrocytes
What cells contribute to the blood-brain barrier and proliferate in response to CNS injury?
True. They lyse the host cell
True or false? There are no persistent infections with naked viruses?
Fibrocystic change of the breast
Name the most common type or cause. • Breast lump in females
Mode
The most frequent number occurring in a population is what?
Cricothyroid muscles
Name the laryngeal muscle described by the following: • Tenses the vocal ligaments, increasing the distance between the cartilages, thereby increasing the pitch
Shigella
What nonmotile gram-negative, non-lactose-fermenting facultative anaerobic rod uses the human colon as its only reservoir and is transmitted by fecal-oral spread?
VSD, RVH, overriding aorta, and pulmonary stenosis
What is the tetrad of tetralogy of Fallot?
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
What is the central issue regarding the Roe vs. Wade decision (legalization of abortion)?
Conus arteriosus of the right ventricle and right and left auricles
What part of the heart forms • Superior border?
Dysgerminoma
What is the most common one? • Germ cell tumor of the ovary
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
What three cephalosporins are eliminated via biliary mechanisms?
Superior olivary nucleus
What CN nucleus receives auditory information from both ears via the cochlear nuclei?
Northern blot
What blotting technique uses the following for analysis? • RNA
Aldosterone Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.
What is the major hormone produced in the following areas of the adrenal cortex? • Zona glomerulosa
Hepatitis A (infectious)
Which type of hepatitis is a picornavirus?
Mitochondrial inheritance
What pattern of genetic transmission is characterized by no transmission from M, maternal inheritance, and the potential for the disease to affect both sons and daughters of affected F?
Metronidazole
What is the DOC for the following protozoal infections? • Giardiasis
α-and β-chains are on most T cells.
What are the two most common chains of the TCR?
Rho (D) immune globulin (RhoGAM), an anti-RhD IgG antibody, prevents generation of RhD-specific memory B cells in the mother.
What is given to pregnant women within 24 hours after birth to eliminate Rh+ fetal blood cells from their circulation?
IgG4
What subtype of IgG does not activate complement cascade?
β-Hydroxybutyrate
What is the major ketone body produced during alcoholic ketoacidosis?
Pubis, ilium, and ischium
What bones make up the acetabulum?
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle, delaying the closure of the pulmonic valve.
Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
1 day prior to ovulation
How many days prior to ovulation does LH surge occur in the menstrual cycle?
Areas 1, 2, and 3
What Brodmann area is associated with • Primary somatosensory cortex?
RNA polymerase I
Name the eukaryotic RNA polymerase based on the following: • Synthesizes 28S, 18S and 5.8S rRNAs
Variable ratio If it is based on time, it is an interval, and if it is based on the number of responses, it is a ratio.
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • Varying in the number of responses?
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis, or IHSS)
What cardiomyopathy is due to a ventricular outflow obstruction as a result of septal hypertrophy and leads to sudden cardiac death in young athletes?
CN I
Name the structure that enters or exits the following foramina: • Cribriform plate
True. They have no gates, so by definition they are always open.
True or false? Ungated channels are always open.
Endocardial cushion defect
Name the most common one. • Heart defect in Down syndrome
Yes, they stimulate the growth of mammary tissue but block milk synthesis. At parturition, the decrease in estrogen lifts the block on milk production.
Do high levels of estrogen and progesterone block milk synthesis?
If the ratio of the filtrate to plasma concentration of a substance is equal, the substance is freely filtered by the kidney.
If the ratio of a substance's filtrate and plasma concentrations are equal, what is that substance's affect on the kidney?
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
Regarding skeletal muscle mechanics, what is the relationship between velocity and afterload?
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
What direction would the tongue protrude in a left CN XII lesion?
Measles (rubeola)
What negative sense RNA virus is associated with cough, coryza, and conjunctivitis with photophobia?
Osteoblasts (Remember, they modulate the function of osteoclasts.)
What bone cell has receptors for PTH?
Humerus with ulna (major) and radius (minor)
Name the bony articulations of the following sites. Be specific. • Elbow
Multiple sclerosis
What CNS demyelinating disease is characterized by diplopia, ataxia, paresthesias, monocular blindness and weakness, or spastic paresis?
Pneumothorax
What is the term for air in the pleural space?
Mycoplasma pneumoniae
Name the MCC. • Walking pneumonia, seen in teens and military recruits
ATP/ADP Translocase
What component of the ETC is inhibited by the following? • Atractyloside
Volume of distribution is decreased when a large percentage of drug is protein bound.
What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound?
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
Does T3 or T4 have a greater affinity for its nuclear receptor?
Prevalence increases. (Note: Incidence does not change.)
What happens to prevalence as duration increases?
The carotid body, which monitors arterial blood directly
What peripheral chemoreceptor receives the most blood per gram of weight in the body?
Glycine/arginine
What AA is a precursor of the following substances? • Creatine
Fourth M PITS for pharyngeal pouch derivatives
From what pharyngeal pouch is the following structure derived? • Superior parathyroid gland and ultimobranchial body of the thyroid
The Fc region of IgG and C3b
What are the two opsonizing factors?
Bacillus anthracis
What bacterium is responsible for woolsorter's disease?
Selegiline
What is the drug of choice for early Parkinson's disease?
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Thoracic vertebrae?
Roth spots, and they are seen in bacterial endocarditis.
What is the term for white retinal spots surrounded by hemorrhage? In what condition are they seen?
Ego dystonic
What is the term to describe homosexuals who • Are uncomfortable with their own person and disagree with their sense of self?
Glucose and galactose
What two sugars can be used to produce cerebrosides?
Reiter syndrome
What seronegative spondyloarthropathy is seen in HLA-B27-positive young females and presents with the triad of conjunctivitis, urethritis, and arthritis affecting the knees and ankles?
Pseudomonas aeruginosa
What bacterium is a gram-negative, oxidase-positive aerobic rod that produces a grapelike odor and pyocyanin pigmentation?
Third aortic arch MS CARD is my mnemonic for the aortic arch derivatives
From what aortic arch are the following structures derived? • Common and internal carotid arteries
90% as HCO3-, 5% as carbamino compounds, and 5% as dissolved CO2
What percentage of CO2 is carried in the plasma as HCO3- ?
Infection
Name the most common type or cause. • Hematuria
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II, VII, IX, and X.
What components of the coagulation cascade are affected by estrogen?
Glucose-6-phosphatase
What enzyme is deficient in the following glycogen storage disease? • von Gierke's disease
Ischemic heart disease (MIs)
Name the most common type or cause. • Death in the United States
eEF-1
What eukaryotic translation enzyme is associated with the following: • Elongation
Osler nodes
Name the following descriptions associated with bacterial endocarditis: • Painful subcutaneous nodules on fingers and toes
M-cells
What cell transports IgA, is secreted by plasma cells, and is in Peyer's patches to the gastrointestinal lumen?
Urachus
What embryonic structure forms the following adult structures? • Median umbilical ligament
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
The closure of what valve indicates the beginning of isovolumetric contraction?
Phase 0
Name the phase of the ventricular muscle action potential based on the following information: • Fast channels open, then quickly close, and sodium influx results in depolarization
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
What enzyme deficiency results in darkening of the urine when exposed to air?
Fentanyl
What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
IgG4
Which IgG cannot activate complement?
Circumvallate papillae
What papillae are responsible for sweet taste?
Superior Oblique (CN IV) (LR6 SO4)3
What ocular muscle • Depresses and abducts the eyeball?
Helicobacter pylori
What motile, gram-negative spiral bacillus with flagella is oxidase positive, urease positive, and associated with gastritis, peptic ulcer disease, and stomach cancer?
Urinary 17-ketosteroids
What is used as an index for both adrenal and testicular androgens?
Passive-aggressive
Setting up to be let down (it is unconscious; if conscious, you're just rude)
Metronidazole
What is the DOC for treating Entamoeba histolytica, Giardia, Trichomonas, Bacillus fragilis, and Clostridium difficile infections?
Autoimmune hemolytic anemia
What form of anemia is associated with IgG Abs against Rh antigens, positive direct Coombs test, and splenomegaly?
Flow cytometric analysis
What test, by using specific Abs to different receptors, allows for rapid analysis of cell types in a blood sample?
Mitral stenosis
Name the valve abnormality based on the following criteria: • Diastolic murmur, increased right ventricular pressure, left atrial pressure, and atrial to ventricular pressure gradient; decreased left ventricular filling pressure
Leptospira
Which organism causes Weil's disease?
Potter facies
What is the term for flattened nose, low-set ears, and recessed chin seen in patients with bilateral renal agenesis?
Standardized rate
What rate removes any difference between two populations, based on a variable, to makes groups equal?
Impaired ejaculation
What are the pharmacologic effects seen sexually with • α1-Blockers?
Chronic end-stage renal disease
Waxy casts
Gastric carcinoma
Signet ring cells
Cytochrome b/c1
What component of the ETC is inhibited by the following? • Antimycin A
Methylphenidate (Ritalin)
What is the drug of choice for treating ADHD?
Hypersegmented neutrophils
What is the first sign of megaloblastic anemia on a peripheral blood smear?
Glucagon and epinephrine
What two stress hormones are under the permissive action of cortisol?
To provide attachment between contiguous cells and to maintain a semipermeable barrier
What are the functions of the zonula occludens and the zonula adherens
Left abducens nucleus or right cerebral cortex
Where is the lesion that produces these symptoms when a patient is asked to look to the left? Neither eye can look left with a slow drift to the right
Burkitt lymphoma
Starry sky pattern
Iodine (I)
What mineral is associated with hypothyroidism?
Chondroitin sulfate and keratan sulfate
What are the proteoglycans of cartilage and bone?
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).
What axis I disorder is characterized by a clinically significant syndrome that affects social, occupational, and/or academic achievement; occurs less than 3 months after a stressor; and abates less than 6 months after the stressor is removed?
At least 5 lobes
How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone, whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
What is the limited portion of a large Ag that will actually be recognized and bound to an Ab and that contains approximately five to six amino acids or four to five hexose units?
Mesonephric duct (ureteric bud)
What embryonic structure forms the following adult structures? • Collecting ducts, calyces, renal pelvis, and ureter
Superior and middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Phrenic nerve
Confabulation; it is commonly seen in Korsakoff's syndrome.
What is the term for making up stories regarding past experiences because of an inability to retrieve them?
Klebsiella pneumoniae
Name the MCC. • Aspiration pneumonia in an alcoholic
Menses
What is the term for days 1 to 7 of the female cycle?
Ulcerative colitis
What inflammatory bowel disorder is continuous, with extensive ulcerations and pseudopolyps, and is associated with HLA-B27?
Phallus
What embryonic structure forms the adult female structures? • Glans clitoris, corpus cavernosus, and spongiosum
Macula densa
Which extravascular chemoreceptor detects low NaCl concentrations?
Epidural hematoma
Lucid interval
Meiosis I; disjunction with centromere splitting occurs during meiosis II.
The separation of 46 homologous chromosomes without splitting of the centromeres occurs during what phase of meiosis?
Adenocarcinoma (because of Barrett esophagus)
What is the most common one? Esophageal cancer in the United States
False. They are all risk factors for endometrial carcinoma except multiparity. Nulliparity, estrogen-producing tumors, and estrogen replacement therapy are also risk factors for endometrial carcinoma.
True or false? Obesity, DM, HTN, multiparity, early menarche, and late menopause are all risk factors for endometrial carcinoma.
False. Cardiac output refers to circulating blood volume. The blood in the systemic veins and the pulmonary circuits are storage reserves and therefore are not considered in cardiac output.
True or false? The blood stored in the systemic veins and the pulmonary circuit are considered part of the cardiac output.
Foods rich in tyramine (e.g., cheese, dried fish, sauerkraut, chocolate, avocados, and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
What type of foods should patients taking MAOIs avoid? Why?
Risperidone
What neuroleptic agent is also considered to be an antihistamine?
Latency stage (6-12 years)
In what stage of psychosexual development, according to Freud, do children resolve the Oedipus complex?
Hematogenous
What is the most common one? • Route for infectious arthritis
Hormone-sensitive lipase
What hormone is activated in adipose tissue when blood glucose levels decrease?
Atropine, 2-PAM (pralidoxime)
Name the antidote. • Organophosphates
True. DNA polymerases have 3'-5' exonuclease activity for proofreading.
True or false? DNA polymerases can correct mistakes, whereas RNA polymerases lack this ability.
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
What three factors increase simple diffusion?
Melasma
What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
Sensory
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal root ganglion?
Poliomyelitis; it is a bilateral LMN lesion.
What is the name of bilateral flaccid paralysis, hyporeflexia, and hypotonia due to a viral infection of the ventral horn of the spinal cord?
Yes. (Remember, Jehovah's witnesses refuse blood transfusions.)
Can a patient refuse life-saving treatment for religious reasons?
False. The gallbladder does not produce bile, but it concentrates bile via active sodium transport; water follows the sodium.
True or false? The gallbladder functions to produce bile.
Klinefelter syndrome
What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
>10 mm
What is the size of a positive PPD test for the following? (Reactive) • IV drug abuser
Reject it
If the P value is less than or equal to .05, what do you do to the null hypothesis?
Liver
What organ functions to keep blood glucose levels normal through both well-fed and fasting states and produces ketones in response to increased fatty acid oxidation?
Clostridium botulinum
What bacterium found in poorly preserved canned food causes flaccid paralysis?
Macula densa
What cells of the nephron function as sodium concentration sensors of the tubular fluid?
Integument (skin and its derivatives)
What is the largest organ in the body?
Mycobacterium leprae
Which acid-fast rod is an obligate intracellular parasite?
Lysine and tyrosine
What two AAs have a pKa of 10?
Glucocerebrosidase
What lysosomal enzyme is deficient in • Gaucher's disease?
The secretory phase is progesterone-dependent and 14 days long, whereas the length of the proliferative phase varies
What phase of the female reproductive cycle is 14 days long?
Group A β-hemolytic streptococci
Rheumatic fever most commonly follows pharyngeal infections with what bacteria?
Caseous necrosis
Name the type of necrosis. • Soft, friable, cottage-cheese appearing; characteristically seen in TB
A positive AV difference indicates that a substance is extracted by the organ, and a negative difference indicates that it is produced by the organ.
If the AV difference is positive, is the substance extracted or produced by the organ?
Positive
Are the following conditions associated with a negative or positive nitrogen balance? • Pregnancy
Total lung capacity (TLC)
Name the lung measurement based on the following descriptions: • Amount of air in the lungs after maximal inspiration
Breast
What is the most common one? • Malignant tumor in women
Internal 3', 5' PDE bonds
What bonds are broken by endonucleases?
Mesencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Cerebral aqueduct
No, it is never acceptable to lie.
Is it acceptable to lie, even if it protects a colleague from malpractice?
True. In positively skewed distributions the mode is less than the median is less than the mean.(Remember to name a skewed distribution: the tail points in the direction of its name. positive skew tails point to the positive end of a scale.)
True or false? In a positively skewed curve the mean is greater than the mode.
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Why is the cell's resting membrane potential negative?
Rhinovirus and hepatitis A virus
What are the only two picornaviruses that do not lead to aseptic meningitis?
CN X
What CN is associated with the • Fourth pharyngeal arch?
Phenytoin
A patient with a history of epilepsy goes to the ER with sedation, gait ataxia, diplopia, and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms?
Choriocarcinomas and trophoblastic tumors
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Beta-hCG
True. Cimetidine can decrease androgen production and lead to gynecomastia.
True or false? Gynecomastia is a side effect of cimetidine.
Poxvirus
What is the only DNA virus that is not icosahedral?
Herpesvirus
Cowdry type A bodies
False. It has glycogenolytic and lipolytic actions but not proteolytic.
True or false? Epinephrine has proteolytic metabolic effects.
Hyperplasia
What is the term for an increase in the number of cells in a tissue?
Clozapine
What neuroleptic agent causes agranulocytosis but does not induce tardive dyskinesia?
Melanoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • CDK4
PPRF
What area of the brain acts as the center for ipsilateral horizontal gaze?
Diastole. During systole the left ventricle contracts, resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Is most of the coronary artery blood flow during systole or diastole?
Urinary trigone
What is the name of the urinary bladder where the ureters enter and the urethra exits?
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.
What cell type is found in the peripheral white pulp of the spleen?
Areas 5 and 7
What Brodmann area is associated with • Somatosensory association cortex?
1. ADP 2. PG 3. TXA2
What are the three platelet aggregating factors?
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
What is the name of the process that ensures that each B cell produces only one heavy-chain variable domain and one light chain?
Akathisia
What antipsychotic movement disorder can occur at any time and is characterized by a subjective sense of discomfort that brings on restlessness, pacing, sitting down, and getting up?
Rotavirus
Name the most common type or cause. • Infantile diarrhea
Chief cells
What are the cells of the parathyroid gland that produce PTH?
nef and tat genes
What two HIV regulatory genes down-regulate MHC class I expression in the host?
Lente insulin and either NPH or protamine zinc insulin (PZI)
What two forms of insulin, if mixed together, precipitate zinc?
Malignancy
What disorder is associated with loss of polarity, anaplasia, pleomorphism, discohesiveness, increase in the nuclear:cytoplasmic ratio, hyperchromasia, and increase in the rate of mitosis?
A right CN V lesion results in weakened muscles of mastication, and the jaw deviates to the right.
A motor lesion to the right CN V results in deviation of the jaw to which side?
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Trachea
Rotavirus
What organism is associated with the following types of diarrhea? Day care-associated diarrhea in infants
Thymine
Methylating uracil produces what pyrimidine base?
Linoleic acid and linolenic acid
What are the two essential fatty acids?
Renal cell carcinoma
Name the most common type or cause. • Painless hematuria
TRUE
True or false? All streptococci are catalase-negative
Unipolar disorder (major depression)
Anhedonia, lack of motivation, feelings of worthlessness, decreased sex drive, insomnia, and recurrent thoughts for at least 2 weeks, representing a change from previous level of function, describes what disorder?
Chromosome 17
Name the associated chromosome. • Neurofibromatosis type 1
Transient protein C deficiency, because of its relatively short half-life, may result if warfarin is instituted alone.
What transient deficiency may result in a hypercoagulable state if warfarin is given alone?
Epinephrine
Name the hormone—glucagon, insulin, or epinephrine: • Glycogenolytic, gluconeogenic, lipolytic, glycolytic, and stimulated by hypoglycemia
1. Liver 2. Muscle 3. Adipose tissue
What are the three tissues where triacylglycerols are produced?
Fibrinous exudates
Name the type of exudate, given the following examples. • Uremic pericarditis
hCG can be detected in the blood by day 8 and in the urine by day 10.
How early can a pregnancy be detected by hCG assays in the blood? In urine?
Chromosome 9, 22 (Philadelphia chromosome)
Name the associated chromosomal translocation. • CML
Neisseria gonorrhoeae and Chlamydia trachomatis
What are the two MCC of acute epididymitis in males? • Less than 35 years old
Yellow fever (flavivirus)
What viral infection is associated with black vomit?
Serratia
Which bacteria are associated with the following pigment production? • Red pigmentation
As the name indicates, there is no change in volume but there is an increase in pressure.
What happens to intraventricular pressure and volume during isovolumetric contraction?
C3b
What complement factor or factors are associated with • Opsonization?
True. Hyperpolarization inhibits the postsynaptic membrane.
True or false? Depolarization of the postsynaptic membrane excites the neuron.
Constriction of afferent arteriole
What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↓, RPF ↓, FF normal, capillary pressure ↓
NADPH and molecular O 2
What are the two absolute requirements for the cytochrome P450 enzyme system?
Pyruvate carboxylase
What gluconeogenic mitochondrial enzyme requires biotin?
Tidal volume (VT)
Name the lung measurement based on the following descriptions: • The amount of air that enters or leaves the lung system in a single breath
pH of 2 and 9
All AAs have titration plateaus at what pH values?
Candida albicans
What fungus causes endocarditis in IV drug users?
During REM sleep
In what stage of sleep is it easiest to arouse a sleeping individual?
Subacute bacterial endocarditis
What is the most common one? • Complication of PDA
Adenocarcinoma (30% to 35%)
What is the most common one? • Primary malignant tumor of the lungs
Transudative; exudative has the opposite values and has an elevated cellular content.
What is the term for edema that has LDH below 200, protein level 2.5, and a specific gravity below 1.020?
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
What is the term for squamous to columnar metaplasia of the distal esophagus secondary to chronic inflammation?
Physiologic dead space is the total dead space of the respiratory system.
Anatomical and alveolar dead spaces together constitute what space?
Paracortex
What is the name of the T cell-rich area of the lymph node?
TRUE
True or false? Succinylcholine is a nicotinic receptor agonist.
Peroxidase, which is also needed for iodination and coupling inside the follicular cell
What thyroid enzyme is needed for oxidation of I- to I'?
Berger disease (IgA nephropathy)
What type of GN, associated with celiac disease and dermatitis herpetiformis, has mesangial deposits of IgA, C3, properdin, IgG, and IgM?
HBsAg as its envelope
What does hepatitis D virus need from hepatitis B virus to be infective?
Blocking
Name these immature defense mechanisms: • Inability to remember a known fact (aware of forgetting)
Cancer
What is the second leading cause of death in the United States?
Th1; they are also responsible for delayed-type hypersensitivity (type IV)
What subset of CD4 helper T-cell function is helping the development of CD8 T cells?
RSV
Name the most common type or cause. • Bronchiolitis in children
T wave
What component of an ECG is associated with the following? • Ventricular repolarization
All are lactose fermenters except Yersinia and Proteus.
Which of the following Enterobacteriaceae family members—Yersinia, Klebsiella, Enterobacter, Escherichia, Proteus, and Citrobacter— do not ferment lactose?
Negative predictive value
The probability that a person with a negative test result is truly disease free refers to what value?
DiGeorge syndrome
What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia, tetany, and T-cell deficiency?
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.
Does subatmospheric pressure act to expand or collapse the lung?
TRUE
True or false? Somatic motor neurons innervate the striated muscle of the bulbospongiosus and ischiocavernous muscles and result in ejaculation of semen.
Inferior Oblique (CN III) (LR6 SO4)3
What ocular muscle • Elevates and abducts the eyeball?
Arch of the aorta
Name the correct artery. • The left recurrent laryngeal nerve passes around it.
Glycine and succinyl-CoA
What are the two precursors of heme?
Type IV collagen
Goodpasture Ag is a component of what type of collagen?
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?
ALL (nearly 15-20 times the normal risk)
What hematological malignancy is particularly likely to affect patients with Down syndrome?
Minimal change disease
Name the most common type or cause. • Nephritic syndrome in children
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
What are the four major functions of the acquired immune system?
Clonorchis sinensis
What parasitic infection is associated with cholangiocarcinoma?
Missense
Name the type of mutation: New codon specifies a different AA
Papovavirus
Name the DNA virus: • Circular dsDNA; naked; icosahedral; replicates in the nucleus
Lipoprotein lipase
What enzyme, induced by insulin and activated by apo C-II, is required for chylomicron and VLDL metabolism?
Thrombus
What type of hemostasis in an intravascular space consists of fibrin, platelets, RBCs, and WBCs?
Deltoid
What muscle acts in all ranges of motion of the arm?
Picornaviridae
To what viral family does the polio virus belong?
CD16 and CD56
What receptors are the best markers for NK cells?
Ultralente
Name the insulin preparation based on the peak effect and duration of action. • Peak, 8 to 16 hours; duration, 24 to 36 hours
Hydralazine
Which direct-acting vasodilator is associated with SLE-like syndrome in slow acetylators?
Meningococcus grows on chocolate agar, and Gonococcus grows on Thayer-Martin medium.
Which gram-negative diplococcus grows on chocolate agar? Thayer- Martin medium?
Calicivirus
What virus is associated with the Norwalk agent?
Without children (but don't think about this one for too long)
Is marital satisfaction higher for couples with or without children?
Internal carotid artery
Ophthalmic artery is a branch of what artery?
HBcAb IgG and HBsAb IgG
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Prior infection
Decreases
With an increase in arterial systolic pressure, what happens to • Vessel compliance?
Insulinoma
What pancreatic islet cell tumor is associated with hypoglycemia, sweating, hunger, confusion, and increased C-peptide levels?
Granulosa cell tumor of the ovary
What estrogen-producing tumor of the female genital tract is characterized by Call-Exner bodies?
Cohort studies determine incidence and causality, not prevalence.
Can incidence, prevalence, and cause and effect be assessed in • Cohort studies?
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Left subclavian artery
Chromosome 8, 14
Name the associated chromosomal translocation. • Burkitt lymphoma
Oxazepam, temazepam, and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation, not via the cytochrome p450 system.
What are the three benzodiazepines that do not undergo microsomal oxidation?
Histidine
What AA is a precursor of the following substances? • Histamine
At least 30% blast in the bone marrow
What percentage of the bone marrow must be composed of blast for leukemia to be considered?
A decrease in cutaneous blood flow results from constriction of the arterioles, and decreased cutaneous blood volume results from constriction of the venous plexus.
How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated, and how?)
Brucella and Listeria (has tumbling motility)
What two bacteria are associated with drinking unpasteurized milk?
6 years old
By what age should children be able to draw the following figures? • Triangle
The popliteal artery, the deepest structure in the popliteal fossa, risks injury in a supracondylar fracture of the femur.
What vascular injury may result from a supracondylar fracture of the femur?
GnRH
What hypothalamic hormone is synthesized in the preoptic nucleus?
Bridging veins draining into the sagittal sinus
Name the cerebral vessel associated with the following vascular pathologies. • Subdural hemorrhage
Secondary hyperparathyroidism (vitamin D deficiency, renal disease)
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH increased, Ca2+ decreased, Pi decreased
Very superior (<2.5% of the population)
What is the label given to an individual whose IQ is • 130
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
In high altitudes, what is the main drive for ventilation?
Increase in ECF osmolarity means a in decrease in ICF osmolarity, so cells shrink.
When the ECF osmolarity increases, what happens to cell size?
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Cisplatin
Embolism
What is the term for occlusion of a blood vessel due to an intravascular mass that has been carried downstream?
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
What happens to extracellular volume with a net gain in body fluid?
de Quervain thyroiditis
What thyroiditis presents as a tender, enlarged, firm thyroid gland, usually preceded by an upper respiratory viral illness?
HHV-8
What virus is associated with body cavity large B-cell lymphomas?
High volume, watery solution; sympathetic stimulation results in thick, mucoid saliva.
What type of saliva is produced under parasympathetic stimulation?
Membrane depolarization is the stimulus to open these channels, which are closed in resting conditions.
What is the signal to open the voltage-gated transmembrane sodium channels?
Herpes II
What virus lies dormant in the • Sensory ganglia of S2 and S3?
PGD2, PGE2, and PGF 2
Name the product or products of arachidonic acid: • Vasodilation
Cefamandole, cefoperazone, and moxalactam
What three cephalosporins inhibit vitamin K-dependent factors?
Class III
Which class of antiarrhythmics are potassium channel blockers?
1. Decrease alpha-1 activity 2. Increase Beta-2 activity 3. Increase ACh levels
Name the three methods of vasodilation via the sympathetic nervous system.
The Palmar interosseus ADducts, whereas the Dorsal interosseus ABducts (PAD and DAB)
What muscles in the hand adduct the fingers?
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
What are the four Ds of niacin deficiency?
Urogenital sinus
What embryonic structure forms the adult male structure? • Urinary bladder, urethra, prostate gland, bulbourethral gland
Klatskin tumor
What is the tumor at the bifurcation of the right and left hepatic ducts?
Third M PITS for pharyngeal pouch derivatives
From what pharyngeal pouch is the following structure derived? • Inferior parathyroid gland and thymus
Salmeterol
What β2-agonist is used as a prophylactic agent in the treatment of asthma?
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
What is the order of fuel use in a prolonged fast?
HMP shunt
Via what pathway is glycolysis increased after phagocytosis?
Denial Anger Bargaining Depression Acceptance No, they can be skipped, repeated, and completed out of sequence.
What are the five Kübler-Ross stages of death and dying? Must they be completed in order?
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states, do not proliferate.)
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Osteoblasts
If a carboxyl group is the R group, it is acidic; if an amino group is the R group, it is said to be basic.
What is found in the R group if the AA is acidic? Basic?
Streptococcus pneumoniae
Name the MCC. • Pneumonia in adults
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
Where is ADH synthesized?
There would be two Fab and Fc regions.
What would be the result if an Ab were cleaved with papain?
The first trimester
In what trimester is the fetus most vulnerable to congenital rubella syndrome?
Internal abdominal oblique
What abdominal muscle runs in a posteroinferior direction, splits to contribute to the rectus sheath, contributes to the formation of the conjoint tendon, and in men gives rise to the middle spermatic fascia and the cremasteric muscle of the spermatic cord?
Brain, spleen, and kidney
What are the three most common sites for left-sided heart embolisms to metastasize?
N-Acetylcysteine
Name the antidote. • Acetaminophen
Anterior compartment (it's the blood supply to the posterior compartment)
In what compartment of the thigh is the profundus femoris artery found?
Profound (I.Q. range < 20)
What level of mental retardation is characterized by • Needing a highly structured environment with constant supervision?
Tensor tympani
What muscle of the middle ear is innervated by the mandibular division of CN V?
Phase II
What phase of Food and Drug Administration approval tests • The protocol and dose levels in a small group of patient volunteers?
Generalized anxiety disorder
What disorder, experienced more than half of the time for a 6-month period, is described as being fearful, worrisome, or impatient and having sleep disturbances, poor concentration, hyperactivity, and an overall sense of autonomic hyperactivity?
Theca cell
What female follicular cell is under LH stimulation and produces androgens from cholesterol?
Chromosome 22q
Name the associated chromosome. • Neurofibromatosis type 2
Meclizine
Which antihistamine is one of the DOCs for treatment of vertigo?
Vancomycin
Name the antimicrobial agent whose major side effect is listed. • Auditory toxicity
1. Protest 2. Despair 3. Detachment
What are the three stages that children aged 7 months to 5 years go through when they are separated from a primary caregiver for a long time?
Testicular lymphoma
What is the most common one? • Testicular tumor in men over 50 years old
Huntington disease
What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus, dilatation of the lateral and third ventricles, and signs of extrapyramidal lesions?
Glutamate
What AA is a precursor of the following substances? • GABA
Hypnopompic hallucinations occur during awakening, whereas hypnagogic hallucinations occur while one is falling asleep.
What type of hallucination occurs during awakening?
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
What determines the effective osmolarity of the ICF and the ECF compartments?
3 months of symptoms in 2 consecutive years
How many months in how many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
Lung cancer
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • Ki-ras and erb-2
Duchenne muscular dystrophy
What is the most common one? • Form of muscular dystrophy
Breast and lung cancer, respectively.
What are the two leading causes of cancer-related death in women?
Shaping (successive approximation)
What operant conditioning therapy or modification is described as • Reinforcing successive attempts that lead to the desired goal (gradual improvement)?
Mean corpuscular hemoglobin concentration (MCHC)
What is the name for the following RBC indices? • Average Hgb concentration/given volume of packed RBCs
A transport maximum (Tm) system
What form of renal tubular reabsorption is characterized by low back leaks, high affinity of a substance, and easy saturation? It is surmised that the entire filtered load is reabsorbed until the carriers are saturated, and then the rest is excreted.
Posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Descending aorta
Molluscum contagiosum
What virus causes small pink benign wartlike tumors and is associated with HIV-positive patients?
Invasive ductal carcinoma
What is the most common one? • Malignant tumor of the breast
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex), but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only contralateral input. --------------------------------------------------------------------------------
How do the corticobulbar fibres of CN VII differ from the rest of the CNs?
The first sensory neuron is in the dorsal root ganglia. It carries ascending sensory information in the dorsal root of a spinal nerve, eventually synapsing with second sensory neuron. In the brainstem (DCML) and the spinal cord (spinothalamic) the second neuron cell body sends its axons to synapse in the thalamus. The third sensory neuron cell body is a thalamic nuclei that sends its fibers to the primary somatosensory cortex.
Where are the cell bodies for the DCML and spinothalamic sensory systems?
IgE
What Ig is responsible for Antibody-Dependent Cell-mediated Cytotoxicity of parasites, has a high-affinity Fc receptor on mast cells and basophils, and is responsible for the allergic response?
Ulcerative colitis
What disease is seen in the 20-to 40-year-old age group, is more prevalent in women than men, involves diarrhea with or without bloody stools, starts in the rectum and ascends without skipping areas, includes pseudopolyps, and has a thickness of the bowel that does not change?
Stage 4
At what stage of sleep is GH output elevated?
CML
What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100, 00); decreased LAP levels; and nonspecific symptoms of fatigue, malaise, weight loss, and anorexia?
Heroin
What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
Filiform papillae
What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
Gradient-time system
What form of renal tubular reabsorption is characterized by high back leak, low affinity for substance, and absence of saturation and is surmised to be a constant percentage of a reabsorbed filtered substance?
Type I hypersensitivity (anaphylactic)
Name the type of hypersensitivity reaction based on the following properties. • IgE-mediated release of chemical mediators from basophils and mast cells; need prior exposure to Ag in the past; eosinophils amplify and continue reaction; can be system or localized.
Ephedrine
What drug that penetrates the blood-brain barrier is found in asthma preparations and used as a nasal decongestant?
Enterobius vermicularis; the treatment is albendazole.
What nematode is known as pinworms? What is the treatment?
Immature B cells
During what stage of B-cell development is IgM first seen on the surface?
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Sacral vertebrae?
True. Staphylococcus aureus and group D enterococci also grow in high-salt media.
True or false? Vibrio parahaemolyticus require NaCl in its growth medium.
60%
What is the PO2 of aortic blood in fetal circulation?
Recovery and death
What are the two ways to leave the prevalence pot?
Omphalocele and gastroschisis
What two pathologic conditions occur when the gut does not return to the embryo?
Long-term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
How can you differentiate between a medial temporal lobe and a hippocampal lesion based on memory impairment?
Budd-Chiari syndrome
What is the term for the syndrome consisting of hepatomegaly, ascites, and abdominal pain due to hepatic vein thrombosis?
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Ascending aorta
Dopamine levels rise with waking; dopamine is associated with wakefulness.
What happens to dopamine levels when we awaken?
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
What are the five components of portal HTN?
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Medulla
Preload. It is the load on a muscle Prior to contraction.
What is the term for the load on a muscle in the relaxed state?
Hexosaminidase A
What lysosomal enzyme is deficient in • Tay-Sachs disease?
Spermatogonia (type A)
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 46/2n (divide meiotically)
Clostridium tetani
What large, spore-forming, gram-positive anaerobic rod is associated with infections due to puncture wounds and trauma?
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern, my senior resident asked me this question more times than I would like to remember.)
What is the pentad of TTP?
The carotid sinus is a pressure-sensitive (low) receptor, while the carotid body is an oxygen-sensitive (low) receptor. (Remember "Sinus Pressure").
Is the carotid sinus sensitive to pressure or oxygen?
True. Elevated plasma levels of progesterone can raise the body temperature 0.5° to 1.0°F.
True or false? Progesterone has thermogenic activities.
Chief cell adenoma (80%)
What is the leading cause of primary hyperparathyroidism?
Dorsal prefrontal cortex
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Apathy, poor grooming, poor ability to think abstractly, decreased drive, poor attention span (Hint: if the lesion is in the dominant hemisphere, the patient will develop Broca's aphasia)
Tylosis
What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
Cytochrome a/a3
What component of the ETC is inhibited by the following? • CO
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients, their O2 content is increased because of the excess Hgb concentrations.
Why is O2 content depressed in anemic patients?
Popliteus
What muscle laterally rotates the femur to unlock the knee?
Meningococcus (Gonococcus does not)
Which gram-negative diplococcus ferments maltose?
Oligodendroglioma
What slow-growing CNS tumor in 30-to 50-year-old patients with a long history of seizures has fried egg cellular appearance in a network of chicken wire?
Griseofulvin
What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
The death of a spouse. The higher the score, the greater the risk of developing an illness in the next 6 months.
What is the most stressful event as determined by the Holmes and Rahe scale?
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Liver
False. You need clear evidence the patient is not competent; if you are unsure, assume the patient is competent.
True or false? A patient has to prove his or her competency.
Axis II
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Personality and mental disorders?
The Halsted-Reitan battery. It consists of finger oscillation, speech sound perception, rhythm, tactual, and category testing.
What neuropsychologic test has five basic scales testing for the presence and localization of brain dysfunction?
Nodes of Ranvier
What is the region of an axon where no myelin is found?
Conjugated (direct) hyperbilirubinemia, a transport defect
What type of jaundice is seen in Dubin-Johnson syndrome?
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
What are the five effects of insulin on fat metabolism?
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
The dose of which second-generation sulfonylurea agent must be decreased for patients with hepatic dysfunction?
Kayser-Fleischer ring
What is the name of a thin brown ring around the outer edge of the cornea, seen in Wilson's disease?
Clostridium perfringens
What organism is associated with the following types of diarrhea? Watery diarrhea from beef, poultry, or gravies
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero-order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than if by simple diffusion
What are the four characteristics of all protein-mediated transportation?
Acral-lentiginous melanoma
What is the most common one? • Melanoma in dark-skinned persons
Occipital lobe
Name the area of the cerebral cortex with the function described: • Recall of objects, distances, and scenes; visual input processed here
Action potential
What type of potential is characterized as being an all-or-none response, propagated and not summated?
Intrapleural pressure decreases (becomes more negative).
What happens to intrapleural pressure when the diaphragm is ontracted during inspiration?
Shortens
What happens to the following during skeletal muscle contraction? • I band
Kupffer cells
Name the macrophage based on its location: • Liver macrophages
Distal convoluted tubules
What is the site of action of the following? • Aldosterone antagonists
An internal elastic lamina
What does the tunica intima of arteries have that veins do not?
SITS—Subscapularis, Infraspinatus, Teres minor, Supraspinatus
What muscles make up the rotator cuff?
Niemann-Pick disease
What AR disease involves a decreased amount of sphingomyelinase, massive organomegaly, zebra bodies, and foamy histiocytes and is associated with chromosome 11p?
CD40
What cell surface marker is found on activated helper T cells?
True. Sarcoplasmic calcium-dependent ATPase supplies the energy to terminate contraction, and therefore it is an active process.
True or false? In skeletal muscle relaxation is an active event.
Terbinafine
What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Stibogluconate
What is the DOC for the following protozoal infections? • Leishmaniasis
Musculophrenic and superior epigastric arteries
At the level of rib 6, the internal thoracic artery divides into what two arteries?
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed, thereby increasing the secretion of prolactin.
Why is there an increase in prolactin if the hypothalamic-pituitary axis was severed?
Superior and anterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Thymus
Motilin
What hormone causes contractions of smooth muscle, regulates interdigestive motility, and prepares the intestine for the next meal?
Rifampin
What is the drug of choice for asymptomatic meningitis carriers?
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
What AR disease involves a defect in AA 508 on chromosome 7, causing a defect in Cl- transportation that leads to recurrent pulmonary infections and an increase in viscid mucoid secretions along with pancreatic insufficiencies?
Gout
Upon seeing negatively birefringent needle-shaped crystals from a joint aspiration of the great toe, what form of arthritis do you diagnose?
GLUT 4
Name the GLUT transporter based on the following: • Found in skeletal muscle and adipose tissues
Hematoxylin
Do the following structures pick up stain from hematoxylin or eosin? • Nucleoli
Anhedonia
What is the term to describe the inability to feel any pleasant emotions?
Fossa ovale
What are the adult remnants of the following structures? • Foramen ovale
H2PO4- (dihydrogen phosphate)
What is the titratable acid form of H+ in the urine?
Amylase hydrolyzes alpha-1, 4-glucoside linkages, forming alpha-limit dextrins, maltotriose, and maltose.
What linkage of complex CHOs does pancreatic amylase hydrolyze? What three complexes are formed?
Proteus
What urease-positive non-lactose-fermenting gram-negative rod with swarming-type motility is associated with staghorn renal calculi?
DHEA (androgens) Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.
What is the major hormone produced in the following areas of the adrenal cortex? • Zona reticularis
Decrease (5-HT and dopamine levels do the same)
What happens to NE levels in • Major depression?
Mesonephric duct
What embryonic structure forms the adult male structure? • Epididymis, ductus deferens, seminal vesicle, and ejaculatory duct
Crude mortality rate
What type of mortality rate is defined as the number of deaths • In the population?
Nucleus ambiguus, resulting in the uvula deviating away from the side of the lesion.
A unilateral lesion in what nucleus will produce ipsilateral paralysis of the soft palate?
Chromosome 15, 17
Name the associated chromosomal translocation. • M3 AML
Being a female physician increases the risk of suicide nearly four times the general population.
Does being a female physician increase or decrease the risk of suicide?
True. The ileum is the site where vitamin B12 is absorbed.
True or false? Removal of the ileum results in vitamin B12 deficiencies.
Transposons
What are known as jumping genes?
Parainfluenza virus
Name the most common cause. • Croup
Creatinine
Serum concentration of what substance is used as a clinical measure of a patient's GFR?
Yohimbine
What α2-antagonist is used to treat impotence and postural hypotension?
Hemostasis
What is the term for formation of a stable fibrin-platelet plug to stop bleeding?
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Are the following parameters associated with an obstructive or restrictive lung disorder: decreased FEV1, FVC, peak flow, and FEV1/FVC; increased TLC, FRC, and RV?
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e., pill rolling) is seen in basal ganglia lesions.
What is the name of the tremor that occurs during movements and is absent while the person is at rest?
1. VSD 2. ASD 3. PDA
What are the three left-to-right shunts?
NAVEL: Femoral Nerve, Artery, Vein, Empty space, and Lymphatics/Lacunar ligament
Name the components of the femoral canal, working laterally to medially.
G-6-PD deficiency
Eating fava beans can produce the Mediterranean type of what deficiency?
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Why is the liver unable to metabolize ketone bodies?
Gonads
What embryonic structure forms the adult female structures? • Ovary, follicles, rete ovarii
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
Clarke's nucleus is the second ascending sensory neuron of which spinocerebellar tract?
GLUT 2
Name the GLUT transporter based on the following: • Found in liver and pancreatic β-cells
Pyridoxine (B6) deficiency
What vitamin deficiency causes a glove-and-stocking neuropathy seen in alcoholics?
Spermatogonia (type B)
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 46/2n (divide mitotically)
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Which CHO is independently absorbed from the small intestine?
Invariant chain
Which protein prevents internal binding of self proteins within an MHC class II cell?
Uric acid
What is the end product of purine catabolism?
Plasmodium vivax
Name the Plasmodium species based on the following information: Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites; 48-hour fever spike pattern; the most prevalent form worldwide
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
What is the most common chromosomal abnormality associated with CLL?
SA node; it is the reason it is the primary pacemaker of the heart.
What cell in the heart has the highest rate of automaticity?
Spinothalamic tract (anterolateral system)
In what tract does pain, temperature, and crude touch sensory information ascend to the postcentral gyrus of the parietal lobe?
True; military service and independent self-care by a child over 13 years old also emancipate.
True or false? Marriage emancipates a child less than 17 years old.
Increases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. --------------------------------------------------------------------------------
When a person goes from supine to standing, what happens to the following? • Dependent venous blood volume
Courvoisier's law
What law states that an enlarged, palpable gallbladder is more likely due to cancer than stone obstruction?
Barr bodies in females, T-cell receptor loci, and immunoglobulin light and heavy chain loci
What are the three exceptions to the rule of codominant gene expression?
Endometriosis
What female pathology is associated with endometrial glands and stroma outside the uterus commonly affecting the ovaries as chocolate cysts?
Streptococcus pyogenes
Name the most common type or cause. • Erysipelas
Common peroneal nerve
What lower extremity nerve is described by the following motor loss? • Loss of eversion; inversion, dorsiflexion, and plantarflexion of the foot
Arginine
What AA is a precursor of the following substances? • N2O
Regardless of the rate of infusion, it takes 4 to 5 half-lives to reach steady state.
If you double the infusion rate of a drug, how long will it take to reach steady state?
G-6-PD deficiency; pyruvate kinase deficiency is second.
What is the most common genetic deficiency resulting in hemolytic anemia?
HIV and poxvirus
What two viruses get their envelope not from budding but from coding?
TRUE
True or false? The parasympathetic nervous system has very little effect on arteriolar dilation or constriction.
Burr cells (echinocytes)
What is the term for RBCs with smooth undulations on the surface of their membrane, commonly seen in uremia?
Ductus epididymis, which is lined by pseudostratified epithelium with stereocilia.
Where do sperm go for maturation?
Job syndrome
What disease involves cold skin abscesses due to a defect in neutrophil chemotaxis and a serum IgE level higher than 2000?
IgE
What Ig is associated with ADCC for parasites?
Muscles of the internal eye
What adult structures are derived from preotic somites?
Leiomyoma
What is the most common one? • Tumor of the female genitourinary tract
The promoter indicates where transcription will begin.
What is the binding site for RNA polymerase?
Echinococcus multilocularis