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Finals 3rd year > Final 2015 > Flashcards

Final 2015 Flashcards

1
Q

Which of the following is affected in asthmatic attack?

a. Trachea
b. Primary bronchi
c. Secondary bronchi
d. Bronchiole

A

d. Bronchiole

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2
Q

The graph below shows the relationship between the intensity of exercise and relative contribution of carbohydrates/lipids to ATP production. What exercise intensity range would you suggest to an overweight individual to efficiently burn fat?

A

a. A (first part)

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3
Q

What would be the response of a patient with type 2 DM after taking glucose?

Number 1

Number 2

Number 3

Number 1 in the morning, and number 2 at night

Number 2 in the morning, and number 3 atnight

A

Number 1

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4
Q

What hormone does this graph represent?

1- Glucose

2- GH

3- Cortisol

4- FSH

5- LH

A

Cortisol

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5
Q

What is the underlying problem in the ECG?

Right atrial enlargement

LVH

Left atrial enlargement

A

Left atrial enlargement

couldn’t find a similar ECG to the one in the test but you get the gist

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6
Q

What is the diagnosis from theECG?

A

Hyper-acute anterolateral infarction

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7
Q

Which nerve is affected if the patient tilts his left gluteal area when walking on his right leg?

a. Right superior gluteal nerve
b. Left superior gluteal nerve
c. Left inferior gluteal nerve
d. Right inferior gluteal nerve
e. Left obturator nerve

A

a. Right superior gluteal nerve

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8
Q

A 17-year-old school boy was diagnosed with pulmonary TB. He is a member of music school team who travelled a 2-week concert trip to Malaysia 1 month earlier. What preventive medicine action would the physician take??

a. isolate whole team in the infectious disease hospital.
b. vaccinate whole team.
c. Give isoniazid for whole team
d. carry on tracing and screening the team
e. carry on chest X-ray for symptomatic individuals.

A

c. Give isoniazid for whole team

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9
Q

If the left coronary artery was blocked, what would be affected?

a. 1/3 of the anterior interatrial septum
b. 2/3 of the anterior interventricular septum
c. 1/3 of the posterior interatrial septum
d. 1/3 of the posterior interventricular septum

A

b. 2/3 of the anterior interventricular septum

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10
Q

an ex-smoker has cyanosis and lower limb edema. He showed vesicular breathing with scattered rhonchi and dyspnea, pulmonary function tests were as follows:

FEV1 (45% predicted) 
FVC (46% predicted )
FEV1/FVC = 65%
TLC 2.9 ( 85% predicted ) 
DLCO (70% predicted )
What is the probable diagnosis?

a. restrictive pulmonary disorder
b. obstructive pulmonary disorder

A

a. restrictive pulmonary disorder
b. obstructive pulmonary disorder
(Dr. Zoran counted both as correct)

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11
Q

If there’s a displacement of the olecranon process, what movement would likely be lost?

a. extension of the elbow
b. extension of the wrist and ulnar deviation
c. extension of the wrist and radial deviation

A

a. extension of the elbow

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12
Q

If the superior parathyroid gland was affected with a tumor, what structure would likely be least affected initially?

a. trachea
b. esophagus
c. recurrent laryngeal nerve
d. external laryngeal nerve

A

d. external laryngeal nerve

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13
Q

Which vit-D Dependent Ca absorption protein is used for intracellular Ca transport in enterocytes?

a. Calbindin
b. Calcitriol

A

a. Calbindin

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14
Q

38 year old female, missed period for three months, weight gain, depression, [fatigue(?) ]. With the obvious amenorrhea, what would you find in her blood tests?

a. Raised prolactin
b. Raised cortisol

A

a. Raised prolactin
b. Raised cortisol
(both are possible answers)

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15
Q 
What is a characteristic of stanzolol?
has more virilization affects than testosterone
delays premature closure of epiphyses
useful in hyperprolactinemia
Used in hypoproteinemia states
contraindicated in endometriosis
A

Used in hypoproteinemia states

According to Dr. bitar, stanzolol has more of an anabolic effect than virilizing

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16
Q

Which component of the conducting system of the heart is located in the membranous part of the intraventricular septum?

a. Bundle of his
b. Right bundle of his
c. Left bundle of his
d. AV node
e. SA node

A

a. Bundle of his

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17
Q

A 15-year-old boy presented with supracondylar fracture of the humerus, which nerve will most likely be affected?

a. Ulnar
b. Median
c. Radial
d. Axillary
e. Musculocutaneous

A

b. Median

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18
Q

What is a characteristic of IGF-1 receptor?

a. have intrinsic tyrosine kinase activity
b. Hetrodimeriztion with GH receptor
c. Coupled to Gi protien
d. Coupled to Ras protien

A

a. have intrinsic tyrosine kinase activity

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19
Q

The mutation F508 in Cystic fibrosis causes the deletion of which AA?

a. Phenylalanine
b. Glycine
c. Lysine

A

a. Phenylalanine

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20
Q

Which one of these steroids bind to albumin in circulation for transport?

a. Cortisol
b. Estradiol
c. Testosterone
d. Progesterone
e. Aldosterone

A

e. Aldosterone

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21
Q

In females, which tanner stage reflects the enlargement of breast and areola as a single mound?

a. stage 1
b. stage 2
c. stage 3
d. stage 4
e. stage 5

A

c. stage 3

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22
Q

A patient presents with chest pain and the ECG is suggestive of STEMI. Which of the following is true?

a. thrombolytic therapy superior to percutaneous coronary intervention
b. thrombolytic therapy is indicated if onset of symptoms is less than 12 hours
c. thrombolytic therapy is not indicated if troponin was normal
d. check for ischemia before obtaining the thrombolytic therapy

A

b. thrombolytic therapy is indicated if onset of symptoms is less than 12 hours

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23
Q

A 44-year-old victim of a car accident was bleeding & her blood pressure was reduced to 90/60 mmHg. What is the most likely mechanism for the maintaining of her coronary blood flow?

a. autoregulation
b. reactive hyperemia
c. parasympathetic stimulation

A

a. autoregulation

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24
Q

What hormone acts to lower calcium concentration?

A

Calcitonin

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25
Q

Where is tubular myelin found?

a. extracellular alveolar fluid
b. at air water interface

A

a. extracellular alveolar fluid

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26
Q

Injury to which nerve causes an effect on the antero-medial side of leg? a. L2

b. L3
c. L4
d. L5
e. S2

A

c. L4

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27
Q

What causes cough in patient with high bradykinin levels?

A

a. Ace inhibitor

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28
Q

Which of the following ligands bind to ABCG1?

a. lipid poor A-1
b. lipid free A-2
c. small HDL
d. large HDL

A

c. small HDL

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29
Q

A 60-year-old woman with low bone mass density was given alendronate by an oral route. Which would be an effect of the drug?

a. Diarrhea
b. Constipation
c. erosive esophagitis
d. pernicious anemia

A

c. erosive esophagitis

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30
Q

During the development of IE, which bacterial component mediates binding to the endothelial cells of the endocardium?

a. Dextran
b. Flagella
c. Peptidoglycan
d. Lipoteichoic acid

A

a. Dextran

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31
Q

What is the type of metabolism used in a failing heart?

A

a. Glycolysis

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32
Q

What is the key feature of local action of prostaglandins?

a. Reduced 1/2 life after production
b. Released from albumin
c. Produced by protease
d. Released from granules

A

a. Reduced 1/2 life after production

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33
Q

What is the cytological feature of hypothyroidism?

a. active follicular
b. Active Para follicular
c. Flat follicular cells
d. Poorly stained

A

c. Flat follicular cells

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34
Q

The fact the CF (cystic fibrosis) is more common in monozygotic twins than dizygotic twins. What’s the reason?

a. environmental modifiers
b. genetic modifiers
c. solid genetic heterogeneity
d. partial allele differences

A

(We had this question and the choices didn’t make sense to us. We tried to get the correct answer but couldn’t. SORRY)

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35
Q

A mother brought her 14 years old daughter in concern of bleeding problem. What, from history, suggests a platelet problem rather than coagulation problem?

a. A joint swelling
b. The fact that she received fresh frozen plasma in the past
c. The mother has a brother with similar condition
d. The daughter experiences heavy menstrual bleeding

A

d. The daughter experiences heavy menstrual bleeding

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36
Q

A 53-year-old female with a mass on the right side of her neck on examination with tc-99 revealed hyper activity (hot) nodule and no other parts are visualized, the patient is clinically euthyroid. Which lab result would correlate to her findings?

a. Low TSH regardless of Free T4 level
b. Low TSH with high freeT4 and freeT3
c. High TSH with low freeT4

A

a. Low TSH regardless of Free T4 level

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37
Q

The range of the painful arc in impingement syndrome.

A

a. 60-120 degrees

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38
Q

Which of the following stimulate the synthesis of fat from carbohydrates?

a. insulin
b. epinephrine
c. glucagon
d. thyroid hormones

A

a. insulin

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39
Q

What is indicated to monitor levels of toxicity of Adriamycin (doxyrubicin) on the heart?

a. Myocardial perfusion imaging
b. Gated blood pool imaging
c. ECG

A

b. Gated blood pool imaging

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40
Q

A 19-year-old boy presented with cardiac failure following infection. There were indications of necrosis upon histology and lymphocytosis. What is the most likely pathogen implicated w/ Myocarditis?

a. Adenovirus
b. Coxsackie virus
c. Parvovirus

A

b. Coxsackie virus

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41
Q

What are the consequences of mitochondrial genomic mutation?

a. Defect in Translation
b. Defect in ATP production
c. Defect in Replication
d. Defect in Transcription

A

b. Defect in ATP production

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42
Q

What is the nerve that carries sensory stimuli from the larynx to above the vocal folds?

a. External laryngeal
b. Internal laryngeal
c. Inferior laryngeal
d. Glossopharyngeal

A

b. Internal laryngeal

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43
Q

What hormone act as inhibitor of long loop negative feedback?

a. Calcitriol
b. Thyroxine
c. Parathyroid hormone
d. Oxytocin

A

b. Thyroxine

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44
Q

A patient presented with chest pain and ECG demonstrates a 3 mm ST- segment depression in chest lead v3 to v5. What treatment would you administer to this patient?

a. immediate mechanical revascularization in catheterization laboratory
b. immediate administration of fibrinolytic therapy
c. anticoagulation in the form of warfarin
d. dual antiplatelet therapy and heparin

A

d. dual antiplatelet therapy and heparin

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45
Q

Which of the following is involved in increased killing of internalized material due to respiratory burst?

a. Reactive Oxygen Intermediates (ROS)
b. Phagocytosis
c. Complement
d. Apoptotic Cytokines
e. Antibody dependent cellular cytotoxicity

A

a. Reactive Oxygen Intermediates (ROS)

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46
Q

A 15-year-old girl complains of prolonged bleeding from small cuts and wounds, heavy menses (menorrhagia) she has prolonged APTT and bleeding time. What be found during lab investigation?

A

a. Low ristociten factor activity (Von-willebrand disease)

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47
Q

What determines unequal ventilation in different parts of the lungs in healthy people, especially in deep breathing?

a. Differences in the resistance of the airways
b. Differences of the residual volumes between apical and basal parts
c. Higher lung compliance in basal parts than apical parts

A

c. Higher lung compliance in basal parts than apical parts

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48
Q

In which of the following cases helium dilution is better than body plethysmography? 1. abdominal bloating

  1. lung bleb
  2. emphysema
  3. lung fibrosis
A
  1. abdominal bloating
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49
Q

how does AAT-1 helps in the lungs?

A

It inhibits the activity of the enzyme elastase

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50
Q

Which of the following is common when B adrenergic blocker and thiazide diuretic is chronically used to treat HTN?

a. Persistent decrease in cardiac output
b. Persistent decrease in peripheral vascular resistance
c. renin inhibition
d. inhibition of tubular reabsorption of Na+ in kidney
e. Inhibit activation of Chloride and K+ channels

A

b. Persistent decrease in peripheral vascular resistance

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51
Q

What activated sugar is important for the salvage pathway of purine synthesis?

A

a. 5-phosphoribosyl-1phosphatase

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52
Q

A patient did a test and was found to have a pituitary tumor. If that tumor enlarged and grew laterally, what nerve will be affected first?

a. Trochlear
b. abducent

A

b. abducent

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53
Q

Which statement is true regarding nuclear imaging of the adrenal gland?

a. NP-59 is an analogue for cholesterol
b. l-131 MIB6 used only for neuroblastoma and other neuroendocrine tumors
c. FDG PE7 has high specificity for neuroendocrine tumor
d. MI BG when injected is excreted majorly by the kidneys

A

a. NP-59 is an analogue for cholesterol

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54
Q

Which condition can cause apparent high DLCO?

a. lung fibrosis
b. lung hemorrhage

A

b. lung hemorrhage

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55
Q

Which lipid is the major lipid on lung surfactant?

A

Glycerosphingolipid

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56
Q

Normal AaDO2 but dyspneic?

A

Hypoperfusion

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57
Q

What causes hypoxic vasoconstriction?

a. PA02
b. Pa02 (not this because this means SYSTEMIC arterial o2, not pulmonary

A

a. PA02 (not Pa02 because this means SYSTEMIC arterial o2, not pulmonary arterial po2) (both were considered correct in our exam, but the correct answer is PAO2 according to Dr. Zoran)

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58
Q

A patient came in weak, after coughing with greenish sputum a couple of days ago (lung infection). Plasma osmolality was 260 mosm, 115 sodium, in urine osmolality was 150 mosm, 145 sodium. What is the cause of hyponatremia?

a. Addison’s
b. SIADH
c. pseudoaldoestronism
d. aldosterone

A

b. SIADH

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59
Q

Female patient with hypertension, angina pectoris, diabetes type 1 comes agitated and confused. She presents with pallor, diaphoresis, hunger, dizziness, headache and her daughter took her to the hospital. Stat glucose is 3.1, acute hypoglycemic reaction. Patientwastreated,whatisthe nextstepafterrecovery?

a. 2-5 grams of simple carb
b. 10-15 grams of simple carb
c. 150 mL full fat milk
d. 250 mL orange juice
e. Increase dose of insulin at the next meal

A

b. 10-15 grams of simple carb

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60
Q

Patient lost 18% body volume after RTA, how do you manage him?

a. Crystalloids
b. Crystalloids and RBCs
c. Colloids
d. FFP

A

a. Crystalloids

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61
Q

Patient with polyuria, depression, anorexia, and bone pain stopping him from leaving the house, what is the cause?

  1. DI
  2. DM2
  3. Hyperparathyroidism
  4. Hyperthyroidism
  5. Hypothyroidism
A
  1. Hyperparathyroidism
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62
Q

What passes in the aortic hiatus with the aorta?

a. Azygous vein
b. Sympathetic chain

A

a. Azygous vein

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63
Q

Drug used for osteoporosis with tachyphylaxis as a characteristic?

A

a. Calcitonin

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64
Q

What is true about the prevention of myocardial infarction?

A

a. Secondary prevention with statins for all regardless of cholesterol level

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65
Q

What is the mechanism of action of ticlopidine?

a. Inhibits activation of IIb/IIIa receptor
b. Inhibits thromboxane production

A

a. Inhibits activation of IIb/IIIa receptor

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66
Q

What is only found on the internal surface of cells?

A

Phosphatidylserine

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67
Q

What is the mechanism of action of tofacitinib?

A

a. JAK kinase inhibitor

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68
Q

Patient present with clicking and his leg gives away due to injury to ACL, MCL, medial meniscus; whattestswouldbepositive?

a. Varus, McMurry, anterior drawer
b. Valgus and anterior drawer

A

b. Valgus and anterior drawer

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69
Q

Patient with small kidneys and concentric hypertrophy?

A

a. systemic hypertension

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70
Q

What is renal hyaline arteriosclerosis most characteristic of?

a. Systemic hypertension
b. Wegner’s granulomatosis

A

a. Systemic hypertension

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71
Q

What is happening at the end of the absolute refractory period?

A

a. Some Na channels are available for activation

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72
Q

What drug causes leg edema as a side effect?

A

Calcium blocker

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73
Q

Why is paracetamol preferred over of aspirin for a child?

A

Reye’s syndrome is associated with aspirin

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74
Q

What blood pressure is associated with pheochromocytoma?

  1. upper limb 170/90, lower limb 120/85
  2. upper limb 120/85, lower limb 170/90
  3. 120/85 all over
  4. 170/90 all over
A
  1. 170/90 all over
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75
Q

what is a characteristic of XY pure gonadal dysgenesis?

A

Female secondary sexual characteristics

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76
Q

What muscle is responsible for flexion while walking?

A

Iliopsoas

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77
Q

How does somatostatin inhibit GH release?

A

Decrease cAMP

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78
Q

What is the function of 2,3-BPG?

A

a. Stabilizes deoxyhemoglobin to facilitate more O2 release

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79
Q

What is the importance of antibodies in diabetes type 1?

A

Predict disease development

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80
Q

What is given to prevent erythroblastosis fetalis?

A

Anti Rh antibodies to the mother after delivery

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81
Q

What is the function of thyroperoxidase?

  1. Iodinatation of tyrosine residues
  2. Reduction of iodine to iodide
A
  1. Iodinatation of tyrosine residues
82
Q

If a patient is given iodide at high doses, what’s is its mechanism of action?

a. Blocks uptake of Iodine
b. Inhibit iodination

A

b. Inhibit iodination

83
Q

If neural crest cells fail to migrate, what structure of the adrenal gland fails to form?

a. Medulla
b. zona glomerulus
c. zona fasciculate

A

a. Medulla

84
Q

What is used to differentiate between follicular carcinoma and adenoma?

a. FNAC
b. Histology

A

b. Histology

85
Q

Which structure of the humerus is most painful in a young man known to have tennis elbow?

a. Medial epicondyle
b. Lateral supracondylar ridge
c. Medial supracondylar ridge
d. Lateral epicondyle

A

d. Lateral epicondyle

86
Q

What is the mechanism of action of statins?

A

a. Inhibit HMG-CoA reductase

87
Q

Why is the net fluid movement directed inwards in the pulmonary circulation comparedto systemiccirculation?

a. Less hydrostatic pressure of pulmonary circulation
b. Less oncotic pressure in the pulmonary vessels

A

a. Less hydrostatic pressure of pulmonary circulation

88
Q

Which nerve damage is responsible for loss of sensation in the posterior part of arm?

a. Musculocutaneous
b. Medial
c. Radial
d. Axillary

A

c. Radial

89
Q

Which of the following does not indicate normal sinus rhythm?

  1. Narrow QRS complex
  2. P wave preceding every QRS
  3. Irregular RR intervals
A
  1. Irregular RR intervals
90
Q

What does the P wave in ECG represent?

  1. Atrial depolarization
  2. Atrial contraction
A
  1. Atrial depolarization
91
Q

What is a feature of heart failure with preserved ejection fraction?

A

S4 sound

92
Q

Patient with low corrected calcium, low phosphate. What could be the cause?

A

Decreased vitamin D

93
Q

Patient with tracheal shift to the right, reduced sounds on the right, reduced chest expansion on the right lower area, what is true?

A

Right lower lobe collapse

94
Q

Patient experienced cough in her teens but then it resolved. Recently, she has been experiencing dyspnea, cough and she experienced headaches and hypertension. She was given medication to fix her blood pressure. Her blood pressure and headache improved, but her dyspnea got worse. What could be a reason?

a. Low grade lung infection
b. Beta blockers used to treat HTN

A

b. Beta blockers used to treat HTN

95
Q

Patient, known asthmatic, was taking salbutamol and steroids inhalers. She then stopped the medications because she was getting better. She moved from her house to another area closer to her new job. She had been treating her asthma with salbutamol as needed, but her asthma seemed to be getting worse. What could the reason be?

a. Moving to an area with more pollution
b. Losing long term control of her asthma

A

b. Losing long term control of her asthma

96
Q 
weight loss.
Patient with long term cough, sometimes streaked with blood. Her daughter noticed some
a. Lung cancer
b. COPD
c. TB
A

a. Lung cancer

97
Q

What is associated with mitral stenosis?

a. LA hypertrophy
b. Atrial fibrillation

A

b. Atrial fibrillation

98
Q

What causes volume overload?

a. Mitral prolapse
b. Atrial regurgitation

A

a. Mitral prolapse

99
Q

Where are immune complexes destroyed?

a. Liver
b. Kidney

A

a. Liver

100
Q

What causes acute exacerbation of chronic bronchitis?

  1. Streptococcus pyogenes
  2. Hemophilus influenza
  3. Leigonella pneumophila
  4. Pseudomonas aeruginosa
A
  1. Hemophilus influenza
101
Q

What is used in patients with respiratory distress (or epiglottitis)?

A

Cefotaxime

102
Q

What is a non-purine xanthine oxidase?

  1. Febuxostat
  2. Allopurinol
A
  1. Febuxostat
103
Q

What is an essential part for fibrinolysis?

a. Plasmin
b. Fibrinogen

A

a. Plasmin

104
Q

What is true about the fast ejection phase in the cardiac cycle?

a. Increased atrial pressure
b. End of ST wave of ECG
c. decreased ventricle pressure
d. decreased aortic blood flow

A

a. Increased atrial pressure

105
Q

Where is collagen for thrombogenesis found?

A

a. Sub endothelial connective tissue

106
Q

What would cause acute hemolytic reaction?

a. Giving group B to O blood
b. Rh+ve to Rh-ve

A

a. Giving group B to O blood

107
Q

What is true about type 1 hypersensitivity

A

a. Low dose favors TH2 sensitization/reaction

108
Q

Question with intracytoplasmic Auer rods. What is the diagnosis?

A

AML

109
Q

What is the purpose of the endothoracic fascia near the ribcage?

A

Acts as a guide in surgeries

110
Q

Where does the cephalic vein drain into?

A

a. Apical lymph nodes

111
Q

A 41 years old man with unexplained progressive cardiac failure undergoes cardiac transplant. His removed heart shows infiltration of the myocardium with multinucleated cells and fibrous tissue.

a. Chagasdisease
b. viralmyocarditis
c. hypersensitivity myocarditis
d. bacterialmyocarditis
e. Giant cell myocarditis
f. toxoplasma myocarditis
g. Diphtheria myocarditis
h. Rheumatic myocarditis
i. Chagas myocarditis

A

e. Giant cell myocarditis

112
Q

A 37-year-old male with severe upper respiratory tract infection soon develops acute myocardial dysfunction and left ventricular failure. He dies despite therapy. After he died a postpartum section of his cariogenic myocyte show excessive necrosis without any inflammatory reaction.

a. Chagasdisease
b. viralmyocarditis
c. hypersensitivity myocarditis
d. bacterialmyocarditis
e. Giant cell myocarditis
f. toxoplasma myocarditis
g. Diphtheria myocarditis
h. Rheumatic myocarditis
i. Chagas myocarditis

A

h. Rheumatic myocarditis

113
Q

Large vessel granulomatous arteritis affecting branches of aortic arch, sometimes called pulseless disease? (A female presents with no pulse)

a. giant cell arteritis
b. Takayasu arteritis
c. Polyarteritis nodosa
d. Kawasaki disease
e. Wegener granulomatosis
f. Churg strauss syndrome
g. Leukocytoblastic vasculitis
h. Thromboangiitis obliterans

A

b. Takayasu arteritis

114
Q

Child presenting with MI, inflammation of oral mucosa, and enlargement of cervical lymph nodes?

a. giant cell arteritis
b. Takayasu arteritis
c. Polyarteritis nodosa
d. Kawasaki disease
e. Wegener granulomatosis
f. Churg strauss syndrome
g. Leukocytoblastic vasculitis
h. Thromboangiitis obliterans

A

d. Kawasaki disease

115
Q

Deficiency in which of the following is seen in hemophilia A?

A

factor 8

116
Q 
What do these values indicate? 
PaO2 96
PaCO2 35
Hb 162
Hb saturation 98%
CaO2 215
CaCO2 150
DLCO 168%

a) Diffusion limitation
b) High altitude
c) Left to right shunt

A

b) High altitude

117
Q 
What do these values indicate?
PaO2 60
PaCO2 36
Hb 157
Hb saturation 77%
CaO2 163
CaCO2 129
DLCO 31%

a) Diffusion limitation
b) High altitude
c) Left to right shunt

A

a) Diffusion limitation

118
Q

A 15-year-old girl presented with long standing anemia with frequent episodes of
hospital visits. Her PBS showed Howell-Jowell bodies.

A

a. Sickle cell anemia

119
Q

Caused by closure of semilunar valves

a. First heart sound
b. Second heart sound
c. Aortic stenosis
d. Pulmonary stenosis
e. Patent ductus arteriosus
f. Tricuspid regurgitation
g. Aortic regurgitation
h. Mistral stenosis

A

b. Second heart sound

120
Q

Causes early diastolic murmur

a. First heart sound
b. Second heart sound
c. Aortic stenosis
d. Pulmonary stenosis
e. Patent ductus arteriosus
f. Tricuspid regurgitation
g. Aortic regurgitation
h. Mistral stenosis

A

g. Aortic regurgitation

121
Q

nasolacrimal duct opens to?

A

Inferior meatus

122
Q

In most cases of sickle cell disease this amino acid replaces glutamate in position 6.

a. valine
b. Lucien
c. glutamate

A

a. valine

123
Q

A tyrosine kinase inhibitor?

a. cyclophosphamide
b. hydroxyurea
c. 6-mercaptopurine
d. methotrexate
e. imatinib
f. procarbazine
g. 5-fluorouracil
h. mechlorethamine

A

e. imatinib

124
Q

A prodrug that causes hemorrhagic cystitis?

a. cyclophosphamide
b. hydroxyurea
c. 6-mercaptopurine
d. methotrexate
e. imatinib
f. procarbazine
g. 5-fluorouracil
h. mechlorethamine

A

a. cyclophosphamide

125
Q

A 27yrs old female with lower limb DVT, what could she have?

A

a. protein C resistance

126
Q

Reflects blood glucose concentration over a long period.

a. reducing sugar
b. Hb
c. HbA1c
d. HbD
e. unsaturated fatty acid
f. enzymatic glycosylation
g. ketone bodies
h. Hbf

A

c. HbA1c

127
Q

Source of advanced glycation

a. reducing sugar
b. Hb
c. HbA1c
d. HbD
e. unsaturated fatty acid
f. enzymatic glycosylation
g. ketone bodies
h. Hbf

A

a. reducing sugar

128
Q

Maintain corpus luteum at the beginning of pregnancy.

a. GnRH
b. hcG
c. FSH
d. LH
e. progesterone
f. testosterone
g. inhibin
h. estradiol

A

b. hcG

129
Q

Plays role in simulation of sertoli cells.

a. GnRH
b. hcG
c. FSH
d. LH
e. progesterone
f. testosterone
g. inhibin
h. estradiol

A

c. FSH

130
Q

Found at the highest level during secretory phase of uterine cycle.

a. GnRH
b. hcG
c. FSH
d. LH
e. progesterone
f. testosterone
g. inhibin
h. estradiol

A

e. progesterone

131
Q

What forms B homo-tetramers?

a. HBH
b. HB bart
c. Valine
d. lysine

A

a. HBH

132
Q

Acts on osteoclasts and osteoclasts precursors to increase both number and activity of
osteoclasts.

a. Teriparatide
b. The amount of matter per square centimeter of bone
c. Alendronate
d. RANKL

A

d. RANKL

133
Q

Contraindicated in patients with osteosarcoma.

a. Teriparatide
b. The amount of matter per square centimeter of bone
c. Alendronate
d. RANKL

A

a. Teriparatide

134
Q

Patient presents with a leg swelling, high hematocrit, and a JAK2 mutation.

A

a. Polycythemia vera

135
Q

A child presenting with recurrent painful deep joint swellings.

a. FFP
b. pRBCs
c. Factor VIII concentrate
d. Granulocytes
e. G-CSF
f. vasopressin

A

c. Factor VIII concentrate

136
Q

A girl is septic following an infection and has prolonged APTT and PT.

a. FFP
b. pRBCs
c. Factor VIII concentrate
d. Granulocytes
e. G-CSF
f. vasopressin

A

a. FFP

137
Q

A man is receiving chemotherapy for cancer and presents with recurrent infections due
to neutropenia.

a. FFP
b. pRBCs
c. Factor VIII concentrate
d. Granulocytes
e. G-CSF
f. vasopressin

A

e. G-CSF

138
Q

Protein C is inable to bind and inhibit factor V.

a. Protein C deficiency
b. Antithrombin III deficiency
c. Factor V Leiden

A

c. Factor V Leiden

139
Q

A mutation present in 5% of the general population.

a. Protein C deficiency
b. Antithrombin III deficiency
c. Factor V Leiden

A

c. Factor V Leiden

140
Q

A girl with joint pain and renal injury presents with DVT.

a. Pulmonary edema
b. Pulmonary embolism
c. Lupus anticoagulant

A

c. Lupus anticoagulant

141
Q

A man presents with a leg swelling, chest pain, and shortness of breath.

a. Pulmonary edema
b. Pulmonary embolism
c. Lupus anticoagulant

A

b. Pulmonary embolism

142
Q

Forms short filaments in membranous cytoskeleton junctional complexes on RBC?

a. Actin
b. AE1
c. Spectrin
d. GLUT1
e. Ankryn
f. Band 4.1
g. Band 4.2
h. Na/K APTase
i. Cyclocporin C

A

a. Actin

143
Q

Mediates rapid electroneutral chloride-bicarbonate exchange.

a. Actin
b. AE1
c. Spectrin
d. GLUT1
e. Ankryn
f. Band 4.1
g. Band 4.2
h. Na/K APTase
i. Cyclocporin C

A

b. AE1

144
Q

An 18-year-old presents with microcytic anemia and splenomegaly.

a. Thalassemia trait
b. IDA
c. Thalassemia major
d. Sickle cell disease

A

c. Thalassemia major

145
Q

A young girl comes to the ER multiple times and presents with severe bone pain.

a. Thalassemia trait
b. IDA
c. Thalassemia major
d. Sickle cell disease

A

d. Sickle cell disease

146
Q

This Hb is seen in SCD.

a. HbS
b. HbH
c. Hb Barts

A

a. HbS

147
Q

Develops from the free margin of the septum primum.

a. Limbus fossa ovalis
b. Fossa ovalis
c. Cresta terminalis
d. Patent foramen ovale
e. SA node

A

b. Fossa ovalis

148
Q

Indicates the point at which sinus venosus absorbed into the primitive atrium.

a. Limbus fossa ovalis
b. Fossa ovalis
c. Cresta terminalis
d. Patent foramen ovale
e. SA node

A

c. Cresta terminalis

149
Q

When this increases, stroke volume decreases.

a. Afterload
b. Preload
c. EDV
d. Inotropy
e. EDP
f. Coronary BF
g. CO

A

a. Afterload

150
Q

When this decreases, end systolic volume increases.

a. Afterload
b. Preload
c. EDV
d. Inotropy
e. EDP
f. Coronary BF
g. CO

A

g. CO

151
Q

72-year-old Patient presents with collapsing pulse and diastolic decrescendo murmur.
His pulse is 80. What is his blood pressure?

a. 170/130
b. 170/45
c. 120/77
d. 100/88
e. 210/170
f. 99/59

A

b. 170/45

152
Q

Patient presents with papilledema and intracranial hemorrhage. what is his blood
pressure?

a. 170/130
b. 170/45
c. 120/77
d. 100/88
e. 210/170
f. 99/59

A

a. 170/130

153
Q

Nystagamus is an early indicator of toxicity with this drug?

a. Lidocaine
b. Adenosine
c. Verapamil
d. Diltiazem
e. Captopril
f. Nitroglycerin
g. Losartan

A

a. Lidocaine

154
Q

Drug of choice for acute SVT.

a. Lidocaine
b. Adenosine
c. Verapamil
d. Diltiazem
e. Captopril
f. Nitroglycerin
g. Losartan

A

b. Adenosine

155
Q

Finding in COPD.

a. FEV1/FVC ratio <60% after bronchodilators
b. TLC <80%

A

a. FEV1/FVC ratio <60% after bronchodilators

156
Q

Finding in extra pulmonary restrictive disease.

a. FEV1/FVC ratio <60% after bronchodilators
b. TLC <80%

A

b. TLC <80%

157
Q

A child with pharyngitis is allergic to penicillin, what is given instead?

a. Cefotaxime
b. Vancomycin
c. Erythromycin

A

c. Erythromycin

158
Q

What is given to a patient with epiglottitis?

a. Cefotaxime
b. Vancomycin
c. Erythromycin

A

a. Cefotaxime

159
Q

What drug inhibits cell wall synthesis?

a. Cefotaxime
b. Vancomycin
c. Erythromycin

A

b. Vancomycin

160
Q

A man presents with diarrhea and pneumonia; he was in Saudi Arabia recently.

a. MERS coronavirus
b. Influenza

A

a. MERS coronavirus

161
Q

A patient presents with fever and myalgia.

a. MERS coronavirus
b. Influenza

A

b. Influenza

162
Q 
An X-ray shows a basal shadow going up to the apex, and the patient has been
experiencing dyspnea. 
a. Pneumonia
b. Pulmonary edema
c. Foreign object
d. Pulmonary effusion
A

b. Pulmonary edema

163
Q

A thyroid mass shows pale nuclei, nuclear grooves, intracytoplasmic inclusions.

a. Hashimoto’s thyroiditis
b. Grave’s disease
c. Papillary carcinoma

A

c. Papillary carcinoma

164
Q

Atrophic follicles with lymphoid follicles and hurthle cells.

a. Hashimoto’s thyroiditis
b. Grave’s disease
c. Papillary carcinoma

A

a. Hashimoto’s thyroiditis

165
Q

Plant-derived drug that binds to tubulin and acts as a mitotic poison.

a. RANKL
b. Teriparatide
c. Colchine

A

c. Colchine

166
Q

Cells involved in bone resorption.

a. Osteoblast
b. Osteoclast

A

b. Osteoclast

167
Q

Cells involved in woven bone deposition for formation of bony callus.

a. Osteoblast
b. Osteoclast

A

a. Osteoblast

168
Q

The genetic defect in IPEX

a. Receptor editing
b. T-reg defect

A

b. T-reg defect

169
Q

Self-reactive B cells change their Ig light chains during central tolerance

a. Receptor editing
b. T-reg defect

A

a. Receptor editing

170
Q

Caused by H1 receptor antagonists and antidepressants

a. Galactorrhea
b. Macro-prolactinoma
c. Lateral nucleus (lateral hypothalamus)

A

a. Galactorrhea

171
Q

Involved in increasing food intake and arousal

a. Galactorrhea
b. Macro-prolactinoma
c. Lateral nucleus (lateral hypothalamus)

A

c. Lateral nucleus (lateral hypothalamus)

172
Q

Hallmark of pathophysiology of osteoarthritis

a. Crepitus
b. Osteophytes
c. Cartilage destruction
d. Subchondral sclerosis
e. Bone cyst

A

c. Cartilage destruction

173
Q

Feature of osteoarthritis during passive knee flexion and extension

a. Crepitus
b. Osteophytes
c. Cartilage destruction
d. Subchondral sclerosis
e. Bone cyst

A

a. Crepitus

174
Q

What is involved in the cori cycle?

a. AMP
b. ADP
c. Lactate

A

c. Lactate

175
Q

What is a substrate for myokinase?

a. AMP
b. ADP
c. Lactate

A

b. ADP

176
Q

Bone scan, multiple foci of increased uptake

a. AVN
b. Osteomyelitis
c. Metastasis

A

c. Metastasis

177
Q

Bone scan, decreased uptake

a. AVN
b. Osteomyelitis
c. Metastasis

A

a. AVN

178
Q

Brachial artery begins at the lower border of this muscle.

A

Teres major

179
Q

What muscle is supplied by the spinal accessory nerve?

A

Trapezius

180
Q

Passes in the adductor canal?

A

Femoral

181
Q

Supplies lateral compartment of leg?

A

Fibular

182
Q

Anteromedial supply to leg?

A

Saphenous nerve

183
Q

Damage results in foot eversion?

A

Tibial nerve

184
Q

Red ragged fibers.

a. Polymyositis
b. Pompes disease
c. Duchenne muscular dystrophy
d. Dermatomyositis
e. Mitochondrial myopathy
f. Spinal muscular atrophy
g. Inclusion body myositis

A

mitochondrial disease

185
Q

Regenerative muscle fiber.

a. Polymyositis
b. Pompes disease
c. Duchenne muscular dystrophy
d. Dermatomyositis
e. Mitochondrial myopathy
f. Spinal muscular atrophy
g. Inclusion body myositis

A

Duchenne muscular dystrophy

186
Q

Which of the following is more potent than thyroxin?

A

a. T3

187
Q

Which of the following at low doses can impair the secretion of uric acid?

A

a. Aspirin

188
Q

Which of the following is an inhibitor of leukotrienes?

a. Zafirlukast
b. Salbutamol
c. Albuterol
d. zilueton

A

a. Zafirlukast

189
Q

Which of the following is a short term B2 agonist?

a. Zafirlukast
b. Salbutamol
c. Albuterol
d. zilueton

A

b. Salbutamol

190
Q

which of the following sinuses is mostly infected?

a. Maxillary
b. Frontal

A

a. Maxillary

191
Q

What is special about the visceral pleura of the lungs?

A

a. It has no pain receptors

192
Q

3 weeks following a mitral valve replacement surgery, a woman developed a valve infection.
What could be the causative agent?

a. S. epidermidis
b. Brucella

A

a. S. epidermidis

193
Q

A farmer came with an infection due to drinking unpasteurized milk. What could be the
causative organism?

a. S. epidermidis
b. Brucella

A

b. Brucella

194
Q

a patient came with cough and fever with high WBC count (neutrophilia) with toxic granulation.

A

a. Reactive neutrophilia

195
Q

A heart transplant unit kept patient record of heart-lung transplants for the last 15 years. They used the data of patient that had pre-transplant pulmonary arterial pressure (exposure). And records of patient who died (outcome) in the last 15 years, time of death. What type of study was done?

a. nested case-control
b. concurrent cohort
c. non-concurrent cohort
d. (something) case-control
e. RCT

A

c. non-concurrent cohort

196
Q

In cohort studies, why do we oversample the high exposure group?

a. to eliminate information bias
b. to eliminate selection bias
c. to eliminate confounding
d. to increase statistical power
e. to increase the sample size

A

d. to increase statistical power

197
Q

In a study of patients with diabetes, we were given a table with n% and rows of age and
gender, what’s this?
a. Descriptive analysis of categorical variables
b. Bivariate analysis of categorical variables
c. Descriptive analysis of continuous variables

A

a. Descriptive analysis of categorical variables

198
Q

Case control study of inactivity and MI, cases from hospital with MI, controls were
from a health spa. Is there bias or not?
a. Unbiased case, biased control, OR increased
b. Biased case, unbiased control, OR increased
c. Unbiased case, unbiased control, OR normal

A

a. Unbiased case, biased control, OR increased

199
Q

What’s the difference between RCT and cohort?

A

a. Exposures are assigned by the person doing the study

200
Q

Study A: wide CI, insignificant. Study B: narrow CI, significant P. What could be the
cause?

A

a. Increased sample size in B

201
Q

A question about p-value that was 0.01. What is the meaning of the P value?

A

a. Probability that this association found by chance is 1% if there really isn’t
a true association

Finals 3rd year (4 decks)

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