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0 - USMLE Step 1 > Kaplan Q bank > Flashcards

Kaplan Q bank Flashcards

(69 cards)

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1
Q

Lead poisoning leads to the inhibition of what enzymes?

A
  • Aminolevulinate (ALA) dehydratase in heme biosynthesis pathway
  • Ferrochelatase —> ↑ free erythrocyte protoporphyrin
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2
Q

Which organisms would be on the differential for a neonate born with petechial rash, deafness, jaundice, thrombocytic purpura and periventricular CNS calcifications?

A
  • CMV = most common in U.S.
  • T. gondii
  • Rubella
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3
Q

What will be seen histologically with adult-onset myotonic dystrophy (DM1)?

A

Ring fibers w/ central nuclei

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4
Q

Olfactory bulb neurons send axons where?

A

Piriform cortex aka primary olfactory cortex that overlies uncus of the temporal lobe

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5
Q

Which type of ovarian tumor should be suspected in a girl exhibiting precocious sexual development?

A

Granulosa cell tumor –> estrogen-secreting

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6
Q

Which type of encephalitis is characterized by hemorrhagic necrosis in the temporal lobes and base of the frontal lobe?

A

Herpes simplex

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7
Q

A neonate presenting at 24-48 hrs after birth with lethargy, poor feeding, vomiting, hyperventilation, seizures, and cerebral edema should make you suspect what?

A
  • OTC deficiency
  • Will have hyperammonnemia w/ ↓ BUN
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8
Q

A child with dyspnea, difficulty feeding, poor weight gain and a strong radial pulse w/ weak femoral pulse most likely has what?

A

Coarctation of the aorta

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9
Q

Which ovarian tumor exhibits follicle-like structures (Call-Exner bodies) and stain positive for inhibin?

A

Granulosa cell tumor

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10
Q

What are the clinical manifestations of “dry” vs. “wet” beribri as a result of Thiamine deficiency?

A
  • Dry = progressive polyneuropathy w/ myelin degeneration –> wrist and foot drop
  • Wet = high-output cardiac failures –> dilated cardiomyopathy
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11
Q

Dynein is a molecular motor protein important for what 3 functions?

A
  • Ciliary beating: respiratory tract
  • Flagellar beating: sperm
  • Intracellular vesicle transport
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12
Q

What is the major outlet for the esophageal venous plexus and is the major accessory pathway for venous return in patients with end-stage liver disease and critical portal HTN?

A

Azygos V.

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13
Q

What occurs to the majority of severe cervical dysplasia (CIN 3) aka high-grade squamous intraepithelial lesion (HSIL) after 2 years?

A

60% of lesions persist at the same level

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14
Q

Which landmark is used for injection of pudendal nerve block?

A

Ischial spine

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15
Q

The oculomotor n. (CN III) emerges from the interpeduncular fossa of the midbrain and the passes between which 2 arteries?

A

Superior Cerebellar a. and the PCA

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16
Q

In wound healing what is the dominant cell type found at 2 days, 3-5 days, and one week following the injury?

A
  • 2 days = neutrophils
  • 3-5 days = macrophages
  • 1 week = fibroblasts
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17
Q

What is the initial type and later type of collagen that is layed down by fibroblasts during wound healing?

A

Initially deposit type III collagen (granulation tissue), which later is replaced by stronger type I collagen (fibrosis)

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18
Q

Tetralogy of Fallot is more commonly associated with what congenital syndrome?

A

DiGeorge syndrome

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19
Q

Which congenital heart defect is most commonly seen in Down Syndrome?

A

Ostium primum ASD, often w/ malformations of AV valves due to endocardial cushion defect

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20
Q

Which virus is associated with focal necrotizing arteritis with fibrinoid necrosis of small- and medium-sized arteries known as Polyarteritis Nodosa (PAN)?

A

Hepatitis B

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21
Q

Which portion of the smooth muscle in the bladder is innervated by the sympathetic NS vs. parasympathetic NS?

A
  • Internal urethral sphincter at bladder neck = sympathetic
  • Remaining smooth m. of bladder = parasympathetic
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22
Q

Which structure is resected during a TURP procedure resulting in retrograde ejaculation?

A

Internal urethral sphincter

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23
Q

Differentiate primary, seconday, and tertiary prevention.

A
  • Primary: reducing # of new cases of disease (incidence) thru eliminating risk factors or immunization
  • Secondary: identifying disease in a pre-clinical state, ↑ likelihood of tx or curing disease i.e., cervical cancer screening
  • Tertiary: reducing likelihood of disease recurrence or exacerbation in pt who has already been diagnosed w/ disease
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24
Q

Atrophy of which spinal cord structures is associated with tertiary syphilis?

A

Bilateral degeneration of the dorsal roots and 2’ degeneration of the dorsal columns

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25
Which enzyme catalyzes the rate-limiting step in fatty acid biosynthesis?
**Acetyl-CoA carboxylase**
26
Abdominal pain + cervical motion tenderness or adnexal tenderness is characteristic of which infectious organisms?
***Chlamydia***
27
Mitigating the use of antibiotics in children with viral illness is an example of what type of prevention?
**Quaternary prevention**
28
Sparse, completely hyalinized seminiferous tubules with complete absence of spermatogonia (germ cells) and rare Sertoli cells is seen with what condition?
**Klinefelter syndrome** (**47,XXY**)
29
Cell shrinkage, hyperchromatic pyknotic nuclei, and apoptotic bodies composed of cytoplasm and nuclear fragments describes what?
**Apoptosis**
30
Intacytoplasmic eosinophilic inclusions containing _alpha-synuclein_ or _ubiquitin_ describes what?
**Lewy bodies**
31
What are the 4 exceptions to the informed consent rule?
- **Emergency** - **Waiver by the patient** - **Patient is incompetent** - **Therapeutic privilege**: pt is unconscious, confused, or the physician deprives pt of autonomy in interest of health
32
What is the effect of low intrathoracic pressure during inspiration on th pulmonary vasculature and left-side of heart?
↓ pulm. vasculature pressure --\> ↑ intravascular volume --\> ↓ LA filling --\> ↓ LV preload --\> **↓ LV EDV** --\> ↓ LV stroke volume --\> **↓ systolic BP**
33
Senile cardiac amyloidosis results from the deposition of what type of amyloid and leads to what?
**ATTR-type amyloid** ---\> **_restrictive_** **cardiomyopathy**
34
Loss of sensation to the medial 1.5 digits, atrophy of intrinsic hand muscles and radial deviation of the hand upon wrist flexion are all sx's of what?
**Cubital tunnel syndrome**: Ulnar n. entrapment
35
What is a prominent histologic feature of Neuroblastomas?
**Homer-Wright pseudorosettes**
36
Which mutation is seen in many cases of Neuroblastoma and confers a _worse_ prognosis?
**Amplification** of ***MYCN*** oncogene --\> **n-myc**
37
Which fungus is found in the body as a small (2-5 um) intracellular yeast (within macrophages) and has _no_ true capsule?
***Histoplasma capsulatum***
38
What are the manifestations of carcinoid heart disease?
Fibrotic **endocardial** thickening of the **right heart** + **tricuspid stenosis** and insufficiency
39
High titers of anti-U1 ribonucleoprotein, RF, and anti-nuclear antibody are suggestive of what?
**Mixed Connective Tissue Disease**
40
Anti-centromere antibody is the distinctive marker for what?
- **CREST syndrome** - **C**alcinosis + **R**aynaud's + **E**sophageal dysmotility + **S**clerodactyly + **T**elangiectasia
41
High-titers of anti-histone antibody without other autoantibodies is a distinctive marker for what?
**_Drug_**-induced **lupus**
42
Primary oocytes found in the ovary stay arrested in which phase until ovulation; what about secondary oocytes prior to ovulation?
- **1' oocyte** = **diploid**; arrested in **_prophase I_** of the **1st meiotic division** - **2' oocyte** = **haploid;** arrested in **_metaphase_** of the **2nd meiotic division**
43
Familial transthyretin (TTR) amyloidosis is an autosomal dominant condition characterized by what findings?
- **Sensorimotor** and **autonomic neuropathy** - **Cardiomyopathy** - **AF amyloid** protein
44
Why is *Histoplasma capsulatum* non-communicable?
**Intracellular yeast** inside of **macrophages**
45
The mechanism by which a temperate phage can accidentally transfer bacterial DNA from cell to cell if there is an error of excision is known as what?
**Specialized transduction**
46
Which type of gene transfer occurs from one bacterial cell to another via cell-to-cell contact using a plasmid (fertility factor)?
**Conjugation**
47
The aorticopulmonary septum and endocardial cushions are derived from what embryologically?
**Neural Crest Cells**
48
Multiple brick-red dots, Schüffner dots, seen in a pt's erythrocytes are indicative of which organism?
***Plasmodium vivax*** _or_ ***ovale***
49
Which 2 serological markers are specific, but not sensitive for SLE?
- **anti-dsDNA** - **anti-Smith** \***anti-nuclear Ab** is _sensitive_, but _not_ specific
50
Renal manifestations such as proteinuria and hematuria should raise suspicion of which disase process in 15-45 y/o woman with chronic, poorly defined sx's?
**SLE**
51
Where is ipoprotein lipase is the enzyme required for metabolism of chylomicrons and VLDL located; what does it require for activation?
Luminal surface of **vascular endothelium (capillaries)** of adipose tissue; requires **Apo C2** for _activation_
52
Which hormonal levels will be increased during menopause?
↓ estrogen --\> **↑ GnRH, ↑ FSH, and ↑ LH**
53
Dystonia is an extrapyramidal side effect characterized by what; what are some examples?
- Repeated, **sustained** involuntary muscle contractions, as well as abnormal postures of the trunk, face and/or extremities - **Torticollis**, **oculogyric crisis**, and **opisthotonic crisis**
54
Deficiency of what causes a defect in the development of CD4+ cells in the thymus?
**MHC class II** proteins
55
Increases in which 2 parameters are seen with obstructive lung diseases such as emphysema, chronic bronchitis, and asthma?
- **Total lung capacity** - **Pulmonary compliance** = Δ**V/**Δ**P**
56
Beck's triad: ↓ arterial pressure, ↑ systemic venous pressure, and a small, quiet heart (distant heart sounds) are classic signs of what?
**Cardiac Tamponade**
57
Which nerve innervates the posterior compartment muscles of th arm and forearm including the triceps, extensors and the supinator muscle?
**Radial n.**
58
Marfarn syndrome is an autosomal dominant disorder due to defects in what?
***FBN1 gene --\>*** **fibrillin-1** an **extracellular matrix** protein
59
Which organism causes a high fever for ~3 days that abrupty goes away prior to development of morbilliform rash in 9-12 month olds?
**Roseola** - **HHV-6**
60
Combination of hypotension with normal or ↑ pulse pressure and a HR of 30-45/min should suggest the diagnosis of what?
**Complete heart block**
61
Progesterone levels are sustained during the 1st trimester of pregnancy as a response to what?
**hCG**
62
Which tumor can cause dysfunction of the vertical gaze center in the dorsal midbrain?
**Pinealoma**
63
The most important clnical presentation of pineal germinomas is Parinaud syndrome which is characterized by what 3 major findings?
- **Palsy** of **upward gaze** - Dissociation of light and accomodation (**light-near dissociation**) - **Failure of convergence**
64
In anemia there is a ↓ O2 carrying capacity of blood leading to low tissue PO2 which causes what adaptive responses?
- **Reflex _vasodilation_** of resistance vessels --\> ↓ **PVR** and ↑ flow through capillary beds - **CO** and **venous return** _both_ ↑↑↑
65
Anastomoses of which vein with the splenic vein would allow for blood to bypass the liver and relieve portal HTN?
**Splenic V**. --\> **Left Renal V.** (drains _directly_ in **IVC**)
66
Which type of blot is used to identify DNA-binding protein interactions?
**Southwestern blot**
67
Which tumors would desmin vs. vimentin be found in?
- **Desmin**: rhabdomyosarcoma; tumors of **skeletal m.** - **Vimentin**: non-skeletal, soft tissue sarcomas and mesenchymal tumors
68
Case-control studies are analyzed using what ratio and what is the formula?
**Odds ratio**: (a/c) / (b/d) _or_ (a\*d) / (b\*c)
69
Pt's with Plummer-Vinson Syndrome are at an increased risk for developing which malignancy?
**SCC** of the **upper esophagus**

0 - USMLE Step 1 (22 decks)

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