USMLE7

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rere_girl4ever
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293578
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USMLE7
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2015-02-01 23:59:03
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USMLE17
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  1. This microtubule associated motor protein which carries synpatic vesicles down axons to nerve terminals.
    Kinesin
  2. What are the findings of Sarcoidosis?
    • Noncaseating granuloma
    • ↑Serum Angiotensin-converting enzyme
    • Hypercalcemia
    • Bilateral hiliar/mediastinal adenopathy
    • Pulmonary reticular infiltrates
    • Negative PPD
  3. What is idiopathic pulmonary fibrosis?
    Repeated cycles of lung injury and wound healing with ↑collagen deposition.

    ↑Neutrophils
  4. In this type of bias, there is a loss to follow-up between exposed and unexposed groups.
    Attrition bias, a form of selection bias.
  5. What is Attrition bias?
    A type of selection bias that occurs due to loss of participants in a study.
  6. What is the Bohr effect?
    In peripheral tissues, high concentrations of CO2 and H+ facilitate oxygen unloading from hemoglobin.
  7. What is Haldane effect?
    In the lungs the binding of oxygen from hemoglobin drives the release of H+ and CO2 from hemoglobin.
  8. What is the most common cause of fetal hydronephrosis?
    • Inadequate recanalization of the ureteropelvic junction 
  9. Acute nausea and vomiting following administration from chemotherapy results from?
    Stimulation of the chemoreceptor trigger zone in the area postrema of the dorsal medulla near the 4th ventricle
  10. Which of the following brain sites is responsible for nausea and vomiting following chemotherapy?
    D- Chemoreceptor trigger zone in Area postrema
  11. Early onset of familial Alzheimer disease is associated with which gene mutations?
    • Amyloid precursor protein (APP) on chromosome 21
    • Presenilin-1 
    • Presenilin-2
  12. Late onset of familial Alzheimer disease is associated with which gene mutation?
    ε4 allele of Apolipoprotein E (Apo-E4)
  13. Gene mutation of ε2 allele of Apolipoprotein E (Apo-E2) is associated with?
    ↓risk of familial Alzheimers disease
  14. Gene mutation of ε4 allele of Apolipoprotein E (ApoE4) is associated with?
    Late onset of familial Alzheimers disease(↑risk)
  15. Gene mutation of amyloid precursor protein is associated with?
    Early onset of familial Alzheimer disease
  16. Gene mutation of Presenilin-1 and 2 is associated with?
    Early onset of familial Alzheimer disease
  17. This familial dyslipidemia is characterized by an absent or defective low-density lipoprotein receptor.
    • Type IIa
    • Familial hypercholesterolemia
    • Decreased hepatic LDL uptake and severe elevation in total cholesterol and LDL levels.
  18. Describe the pathology in Familial hypercholesterolemia.
    • Defective low-density lipoprotein receptor.
    • This defect causes decreased hepatic LDL uptake and severe elevation in total cholesterol and LDL levels.
  19. β-myosin heavy chain mutation is characteristic of which disease?
    Hypertrophic cardiomyopathy
  20. What type of mutation is seen in Hypertrophic cardiomyopathy?
    β-myosin heavy chain mutation
  21. How do we calculate blood flow through a vessel?
    Q= P1-P2/ R
  22. When does implantation occur?
    6 days after ovulation
  23. When does β-hGC secretion occur?
    8 days after ovulation
  24. How do we calculate attributable risk with respect to relative risk?
    AR= (RR-1)/ RR
  25. What gene is mutated in Friedreich ataxia?
    Trinucleotide repeat disorder (GAA) on chromosome 9 in gene that encodes frataxin (iron binding protein)
  26. This disease has a gene mutation on chromosome 9
    Friedreich ataxia
  27. This disease is characteristic of a gene mutation that encodes frataxin.
    • Friedreich ataxia
    • Trinucleotide repeat disorder (GAA) on chromosome 9 in gene that encodes frataxin (iron binding protein)
  28. What are the causes of death in Friedreich ataxia?
    • 1. Hypertrophic cardiomyopathy
    • 2. Bulbar dysfunction (unable to protect airway)
  29. This disease presents in childhood with Kyphoscoliosis.
    Friedreich ataxia
  30. What is the pathology seen below and in which disease is it usually found?
    Pes cavus- Freidreich ataxia, Charcot-marie tooth disease
  31. What is the pathology seen below and in which disease is it usually found?
    Hammer toes- Friedreich ataxia
  32. Which diseases are ppts with Friedreich's ataxia at high risk of developing?
    • Diabetes mellitus
    • Hypertrophic cardiomyopathy
  33. Describe the presentation of Friedreich ataxia.
    • Presents in childhood with kyphoscoliosis.
    • Gait ataxia -progressively slow and clumsy walking
    • Staggering gait, frequent falling
    • Wide based gait with difficulty maintaining balance is characteristic.
    • Loss of position and vibration sensation (degeneration of dorsal columns and spinocerebellar tracts)
    • Pes cavus
    • Hammer toes
    • Diabetes mellitus
    • Hypertrophic cardiomyopathy
  34. Describe the presentation and findings of Severe combined immunodeficiency.
    • Presentation: Presents in infancy as failure to thrive, chronic diarrhea, thrush. Recurrent viral, bacterial, fungal and protozoal infections.
    • Findings: Absent thymic shadow, absent germinal centers and absent T cells, hypogammaglobulinemia↓T cell receptor excision circles
  35. What causes Severe combined immunodeficiency disorder?
    • Defective IL-2R gamma chain
    • Adenosine deaminase deficiency
  36. Describe the effects of the Metyrapone stimulation test.
    • 1. Metyrapone blocks cortisol synthesis by inhibiting 11-β hydroxylase, which converts 11-deoxycortisol to cortisol
    • 2. ↓Cortisol causes ↑ACTH which leads to ↑production of 11-deoxycortsiol, which is further metabolized to the liver to 17-hydroxycorticosteroids that accumulate in the urine.
  37. What does the Falciform ligament connect?
    • Liver to anterior abdominal wall
  38. This ligament connects the liver to the anterior abdominal wall.
    Falciform ligament
  39. Which structures are contained in the Falciform ligament?
    Ligamentum teres hepatis (derivative of fetal umbilical vein)
  40. This ligament contains the ligamentum teres hepatis.
    Falciform ligament
  41. This structure is a derivative of the fetal umbilical vein. In which ligament is it contained?
    • Ligamentum teres hepatis 
    • Contained in the Falciform ligament which connects the liver to the anterior abdominal wall.
  42. Where is the Falciform ligament derived from?
    Ventral mesentery
  43. What does the hepatoduodenal ligament connect?
    • Liver to duodenum
  44. This ligament connects the liver to duodenum.
    Hepatoduodenal ligament (derivative of lesser omentum)
  45. Which structures are contained in the Hepatoduodenal ligament?
    • Proper hepatic artery
    • Portal vein
    • Common bile duct
  46. What does the Gastrohepatic ligament connect?
    • Liver to lesser curvature of the stomach

  47. This ligament connects the liver to the lesser curvature of the stomach.
    Gastrohepatic ligament
  48. The lesser omentum is divided into two ligaments. What are they?
    • 1. Hepatoduodenal ligament
    • 2. Gastrohepatic ligament
  49. Which structures are contained in the gastrohepatic ligament?
    Gastric arteries
  50. This ligament contains the gastric arteries.
    • Gastrohepatic ligament
    • Conncts the liver to the lesser curvature of the stomach
  51. What does the gastrocolic ligament connect?
    • Greater curvature and transverse colon
  52. This ligament connects the greater curvature of the stomach to the transverse colon.
    • Gastrocolic ligament
  53. This ligament contains the gastroepiploic arteries.
    Gastrocolic ligament
  54. Which structures are contained in the Gastrocolic ligament?
    • Gastroepiploic arteries/ Gastro-omental arteries

  55. What does the gastrosplenic ligament connect?
    • Greater curvature and spleen
  56. This ligament connects the greater curvature and the spleen.
    • Gastrosplenic ligament
  57. Which structures are contained in the gastospenic ligament?
    • Short gastrices
    • Left gastroepiploic vessels
  58. The short gastrics are contained in this ligament.
    Gastrosplenic ligament
  59. The left gastroepiploic vessels are contained in this ligament.
    Gastrosplenic ligament
  60. What does the splenorenal ligament connect?
    Spleen to posterior abdominal wall
  61. This ligament connects the spleen to the posterior abdominal wall.
    Splenorenal ligament
  62. This ligament contains the splenic artery.
    Splenorenal ligament
  63. This ligament contains the splenic vein.
    Splenorenal ligament
  64. This ligament contains the tail of the pancreas.
    Splenorenal ligament
  65. Which structures are contained in the Splenorenal ligament?
    • Splenic artery and vein
    • Tail of pancreas
  66. In females, no fusion of the urogenital folds result in?
    Formation of the labia minora
  67. In males, incomplete fusion of the urogenital/ urethral folds result in?
    Hypospadias- abnormal opening of penile urethra on ventral surface of the penis
  68. What causes Hypospadias?
    Failure of the urethral folds to fuse in males results in an abnormal opening of penile urethra on the ventral surface of the penis.
  69. Where does the labia minora form from?
    Nonfusion of the urethral folds
  70. What does the urethral folds become in males and females respectively?
    • Ventral shaft of the penis (penile urethra) in males.
    • Labia minora in females.
  71. What causes Epispadias?
    Faulty positioning of the genital tubercule causes abnormal positioning of penile urethra on dorsal surface of penis.
  72. What does the genital tubercule develop into?
    • Penis and Clitoris
    • Corpus cavernosum and spongiosum
    • Vestibular bulbs
  73. What causes a bifid scrotum?
    Bifid scrotum (2 separate sacs) results from the malunion of labioscrotal folds
  74. What does the labioscrotal swelling differentiate to in males and females respectively?
    • Scrotum
    • Labia majora
  75. Where does the scrotum differentiate from?
    Labioscrotal swelling
  76. Where does the labia majora develop from?
    Labioscrotal swelling
  77. Deletion of a single nucleotide causes this type of mutation.
    Frameshift mutation
  78. What is a frameshift mutation?
    • Deletion or insertion of any number of nucleotides that are NOT multiples of three.
    • Usually results in a nonfunctional protein
  79. What is a conservative mutation?
    A type of missense mutation in which one amino acid is replaced with another amino acid that has similar biochemical characteristics.
  80. What is a Missense mutation?
    • Nucleotide substitution resulting in changed amino acid.
    • It is called conservative if the new amino acid is similar in chemical structure.
  81. What is a nonsense mutation?
    Nucletide substitution resulting in early stop codon- UAA, UGA, UAG
  82. What toxicity can arise from the use of Halothane?
    Hepatotoxicity- occurs after surgery
  83. Why is it that antibodies do not confer immunity against hepatitis C virus?
    • Because there are variations in the antigenic structure of the virus.
    • Also, there is no proofreading 3'→5' exonuclease activity in the RNA polymerase. As a result, there are many uncorrected mutations.
  84. How do we calculate filtration fraction?
    • FF= GFR/RPF
    • (RPF=Renal plasma flow)
  85. What are the effects of ureteral constriction on filtration fraction and GFR?
    ↓FF and ↓GFR
  86. What causes Classic galactosemia?
    • Absense of galactose-1-phosphate-uridyltransferase
    • Converts Galactose-1-Phosphate → Glucose-1-Phosphate
  87. In this disease, there is a deficiency of galctose-1-phosphate-uridyltransferase.
    • Classic galactosemia
    • Cant convert Galactose-1-Phosphate to Glucose-1-phosphate
  88. Describe the presentation of Classic galactosemia.
    • Presents as failure to thrive soon after breastfeeding is begun
    • Vomiting
    • Jaundice
    • Hepatomegaly
    • Infantile cataracts
    • Intellectual disability
  89. What complication can arise from Classic galactosemia?
    Can lead to E.coli sepsis in neonates
  90. How do we treat classic galactosemia?
    Exclude galactoe and lactose (galactoe + glucose) from diet.
  91. What is Generalized anxiety disorder?
    • Anxiety lasting>6 months
    • Excessive worry over several different issues accompanied by sleep disturbance, fatigue, GI disturbance, difficulty concentrating

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