USMLE 13

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rere_girl4ever
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295339
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USMLE 13
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2015-02-11 08:18:36
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USMLE 13
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  1. What are the findings of congenital toxoplasmosis?
    • Chorioretinitis- yellow/white scars on retina
    • Hydrocephalus - ↑ head circumference
    • Intracranial calcifications
  2. How is toxoplasma gondii transmitted?
    • Cysts in meat
    • Oocysts in cat faeces
  3. What does intrapartum mean?
    During childbirth
  4. What is the significance of R protein (haptocorrin)?
    • R protein (haptocorrin) is secreted by the salivary glands in response to the ingestion of food.
    • The protein binds to B12 and protects it from denaturation by gastric acid.
  5. Where is B12 absorbed?
    Distal ileum
  6. A high mortality rate is observed in pregnant women infected with this hepatitis virus.
    Hepatitis E
  7. This hepatitis virus have been suggested to have oncogenic properties.
    Hepatitis B and C
  8. This hepatitis virus is dependent on HBsAg for infection and multiplication.
    Hepatitis D
  9. What is the most common mutation in Duchenne muscular dystrophy?
    • Deletions of the dystrophin gene that encodes the dystrophin protein on X chromosome 21.
    • Deletions that are not a multiple of 3 change the reading frame, causing a frameshift mutation.
  10. What is the function of dystrophin?
    It links a component of the cystoskeleton (actin) to transmembrane proteins (α- and β-dystroglycan) that are connected to the extracellular matrix.
  11. Loss of dystrophin results in?
    Myonecrosis
  12. What is the Gower sign?
    • Patient uses upper extremeties to help them stand up
    • Duchenne muscular dystrophy
  13. This disease involves the use of one's hands to rise from a squat or from a chair to compensate for proximal muscle weakness.
    Gower sign- Duchenne muscular dystrophy
  14. Describe the clinical findings of Duchenne muscular dystrophy.
    • Patients use upper extremeties to help them stand up (Gower sign)
    • Pseudohypertrophy of calf muscles due to replacement of muscle by fat and connective tissue.
  15. What is Hereditary motor and sensory neuropathy? What causes it? Clinical findings?
    • Charcot-Marie-Tooth disease
    • Caused by mutation in the genes responsible for myelin synthesis.
    • Abnormal myelin synthesis leads to decreased nerve conduction velocity.
    • Common presentation- weakness in foot dorsiflexion (foot drop) due to involvement of the common peroneal nerve
  16. What is Charcot-Marie-Tooth disease? What causes it? Clinical findings?
    • Hereditary motor and sensory neuropathy
    • Caused by mutation in the genes responsible for myelin synthesis
    • .Abnormal myelin synthesis leads to decreased nerve conduction velocity.
    • Common presentation- weakness in foot dorsiflexion (foot drop) due to involvement of the common peroneal nerve
  17. Which receptors use the receptor associated tyrosine kinase pathway? How does this pathway work?
    • Janus kinase phosphorylates signal transducers and activators of transcription (STAT).
    • Prolactin
    • Immunomodulators- cytokines, IL
    • Growth hormone
    • Granulocyte colony stimulating factor
    • L
    • Erythropoietin
    • Thrombopoietin
  18. What is the JAK/STAT signal transduction system and which receptors use this pathway?
    • Janus kinase phosphorylates signal transducers and activators of transcription (STAT).
    • Prolactin
    • Immunomodulators- cytokines, IL
    • Growth hormone
    • Granulocyte colony stimulating factor
    • L
    • Erythropoietin
    • Thrombopoietin
  19. Which receptors use the MAP kinase pathway?
    • Insulin
    • Growth factors- IGF-1, FGF, PDGF, EGF
    • Intrinsic tyrosine kinase
  20. Which enzymes does thiamine act as a cofactor for?
    • 1. Pyruvate dehydrogenase
    • 2. α-ketoglutarate dehydrogenase
    • 3. Transketolase
    • 4. Branched-chain ketoacid dehydrogenase
  21. Stimulation of the vagus nerve branches that supply the lung would cause?
    • M3
    • Bronchoconstriction
    • ↑bronchial mucus production
  22. Which receptors cause bronchoconstriction/ bronchodilation?
    • β2- Bronchodilation
    • M3- bronchoconstriction (Ach-vagus)
  23. What are the effects of acetylcholine on the lungs?
    M3- bronchoconstriction
  24. What is the injury and where is the lesion?
    • Monocular/ Central scotoma.
  25. Resistance in each of the four vessels shown is 2mmHg/mL/min. What is the total peripheral resistance of the circuit shown on the slide?
    • 1/TR= 1/R1 + 1/R2 + 1/R3 + 1/R4
    • 1/TR= 1/2 + 1/2 + 1/2 + 1/2
    • 1/TR= 2
    • TR=0.5
  26. What are some quick clinical tests to assess concentration and attention?
    • 1. Counting down from 100 by intervals of 3 or more.
    • 2. Reciting the months of the year in reverse order.
    • 3. Spelling "world" backwards
  27. What does the dorsal pancreatic bud form?
    Pancreatic tail, body, most of the head, and the small accessory pancreatic duct
  28. What does the ventral pancreatic bud form?
    Uncinate process, a portion of the pancreatic head and the main pancreatic duct
  29. What forms the pancreatic tail?
    Dorsal pancreatic bud
  30. What forms the pancreatic body?
    Dorsal pancreatic bud
  31. The head of the pancreas is formed by?
    • Ventral bud- inferior/ posterior head
    • Dorsal bud- superior head
  32. The small accessory pancreatic duct is formed by?
    Dorsal pancreatic bud
  33. Label the following diagram
  34. The unicate process of the pancreas is formed by?
    Ventral bud
  35. What forms the main pancreatic duct?
    Ventral bud
  36. What is the MOA and use of Zolpidem?
    • Nonbenzodiazepine hypnotic
    • Acts via the BZI subtype of the GABA receptor.
    • Short term treatment of Insomnia
  37. What is the main difference between Zolpidem and Benzodiazepines?
    • Zolpidem has a much lower risk for tolerance/ addiction
    • No anticonvulsant properties
    • No muscle relaxant effects and not used for anesthesia
  38. What are the short acting benzodiazepines?
    • Alprazolam
    • Triazolam
    • Oxazepam
    • Midazolam
  39. What is the pathology seen below?
    • Histoplasma capsulatum
    • Macrophages filled with histoplasma
  40. What is the pathology seen below?
    • Histoplasma capsulatum
    • Macrophages filled with histoplasma
  41. What is the pathology seen below?
    • Aspergillus fungimatus
    • Conidiophore with radiating chains of spores
  42. What is the pathology seen below?
    • Aspergillus fungimatus
    • 45 degree angle
  43. What is the pathology seen below?
    • Aspergillus fungimatus
    • 45 degree angle
  44. What is the pathology seen below?
    • Candida albicans
    • Pseudohyphae and budding yeasts at 20 degrees
  45. What is the pathology seen below?
    • Candida albicans
    • Germ tubes at 37 degrees
  46. What is the pathology seen below?
    • Cryptococcus neoformans
    • Yeasts with wide capsular halos and unequal budding in India ink stain
  47. What is the pathology seen below?
    • Blastomycosis
    • Broad -base budding
  48. What is the pathology seen below?
    • Blastomycosis
    • Broad base budding
  49. What is the pathology seen below?
    Cryptococcus neoformans
  50. What is the pathology seen below?
    • Coccidiodes immitis
    • Spherules filled with endospores
  51. What is the pathology seen below?
    • Coccidioides immitis
    • Spherules filled with endospores
  52. Which route does the tetanuus toxin take?
    • Wound → Motor neuron axons → Spinal cord & Medulla
    • RETROGRADE TRANSPORT
  53. Describe the palpation of the prostate in benign prostatic hyperplasia
    • Smooth, firm, nodular enlargement.
    • Rubbery consistency
  54. Which parts of the prostate are enlarged in benign prostatic hyperplasia?
    • Periuretheral- Lateral and middle lobes 
  55. Describe the presentation of benign prostatic hyperplasia?
    ↑Frequency of urination, nocturia, hesitancy, weak urinary stream, difficulty starting and stopping urine stream, dysuria
  56. Patient presents with increased frequency of urination, nocturia, weak urinary steam as well as oliguria alternating with polyuria. What is the most likely pathology?
    Benign prostatic hyperplasia
  57. What is the half life  (t1/2)of a drug?
    The time required for the plasma concentration of a drug to decrease by 50%
  58. The time required for the plasma concentration of a drug to decrease by 50% is known as?
    The half life of a drug t1/2
  59. How do we calculate specificity?
    • =TN/ (TN+FP)
    • = 180/ (180+20)
  60. How do we calculate Sensitivity?
    • = TP / (TP+FN)
    • = 60/ (60+140)
  61. How do we calculate the positive predictive value?
    • = TP / (TP+FP)
    • = 60 / (60+20)

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