USMLE Step 1 questions

What is the drug of choice for steroid-induced osteoporosis?

Alendronate

What enzyme is associated with osteoblastic activity?

Alkaline phosphatase

Which of the following Enterobacteriaceae family members—Yersinia, Klebsiella, Enterobacter, Escherichia, Proteus, and Citrobacter— do not ferment lactose?

All are lactose fermenters except Yersinia and Proteus.

What enzyme catalyzes the covalent bonding of the AA's carboxyl group to the 3' end of tRNA?

Aminoacyl-tRNA synthetase, which uses 2 ATPs for this reaction.

Name the antimicrobial agent whose major side effect is listed. • CN VIII damage (vestibulotoxic)

Aminoglycosides

Which drugs bind to the 30S ribosomal subunit and interfere with the initiation complex, causing a misreading of mRNA?

Aminoglycosides

What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?

Aminophylline

What term describes the inability to recall personal information, commonly associated with trauma?

Amnesia. (The person is aware of the memory loss.)

What is the DOC for severe infections with Sporothrix, Mucor, Histoplasma, Cryptococcus, Candida, and Aspergillus?

Amphotericin B

What are the two broad-spectrum penicillins?

Ampicillin and amoxicillin

What is the region of the fallopian tube where fertilization most commonly occurs?

Ampulla

Where is the most frequent site of ectopic pregnancy?

Ampulla of the fallopian tube

What area of the limbic system is responsible for attaching emotional significance to a stimulus?

Amygdala; it helps imprint an emotional response in memory.

Name the antidote. • Cyanide

Amyl nitrate, sodium nitrate, or sodium thiosulfate

What linkage of complex CHOs does pancreatic amylase hydrolyze? What three complexes are formed?

Amylase hydrolyzes alpha-1, 4-glucoside linkages, forming alpha-limit dextrins, maltotriose, and maltose.

Name the most common type or cause. • Restrictive cardiomyopathy

Amyloidosis

In what compartment of the thigh is the profundus femoris artery found?

Anterior compartment (it's the blood supply to the posterior compartment)

Name the compartment of the lower extremity and the nerve based on its movements. • Dorsiflex the foot, extend the toes, and invert the foot

Anterior compartment of the leg, deep peroneal nerve

Name the compartment of the lower extremity and the nerve based on its movements. • Flex the hip and extend the knee

Anterior compartment of the thigh, femoral nerve

What area of the hypothalamus is responsible for recognizing an increase in body temperature and mediates the response to dissipate heat?

Anterior hypothalamic zone; lesions here result in hyperthermia.

What limb of the internal capsule is not supplied by the middle cerebral artery?

Anterior limb of the internal capsule is supplied by the anterior cerebral artery.

Name the thalamic nucleus based on its input and output. • Input from the mammillary bodies via the mammillothalamic tract and the cingulated gyrus; output to the cingulated gyrus via the anterior limb of the internal capsule

Anterior nuclear group (Papez circuit of the limbic system)

What branch off the vertebral artery supplies • The ventrolateral two-thirds of the cervical spinal cord and the ventrolateral part of the medulla?

Anterior spinal artery

What artery turns into the dorsalis pedis when it crosses the extensor retinaculum?

Anterior tibial artery

What is the most common one? • Location of a duodenal ulcer

Anterior wall of the first part of the duodenum

Name the correct artery. • The left recurrent laryngeal nerve passes around it.

Arch of the aorta

What Brodmann area is associated with • Primary visual cortex?

Area 17

What Brodmann area is associated with • Wernicke's area?

Area 22 and occasionally 39 and 40

What Brodmann area is associated with • Primary motor cortex?

Area 4

What Brodmann area is associated with • Premotor cortex?

Area 6

What Brodmann area is associated with • Frontal eye fields?

Area 8

What Brodmann area is associated with • Primary somatosensory cortex?

Areas 1, 2, and 3

What Brodmann area is associated with • Visual association cortex?

Areas 18 and 19

What Brodmann area is associated with • Primary auditory cortex?

Areas 41 and 42

What Brodmann area is associated with • Broca's area?

Areas 44 and 45

What Brodmann area is associated with • Somatosensory association cortex?

Areas 5 and 7

What AA has a pKa of 13?

Arginine

What AA is a precursor of the following substances? • N2O

Arginine

What AA is broken down into N2O, causing an increase in cyclic guanosine monophosphate (cGMP) of smooth muscle, hence vasodilation?

Arginine

What is the term for pupils that react normally to accommodation but have bilateral loss of constriction in response to light?

Argyll Robertson pupils

What is the term for the type of pupil seen in neurosyphilis, and what ocular reflexes are lost?

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 CNS developmental abnormality is associated with 90% of syringomyelia?

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?

Arnold-Chiari malformation type 2

What enzyme converts androgens to estrogens?

Aromatase

Name the most common type or cause. • Acute metal poisoning in the United States

Arsenic

What three chemical agents are associated with angiosarcomas of the liver?

Arsenic, thorotrast, and vinyl chloride

Under resting conditions, what is the main determinant of cerebral blood flow?

Arterial PCO2 levels are proportional to cerebral blood flow.

What component of the vascular system is most sensitive to the effects of calcium channel blockers?

Arterioles

In the systemic circulation, what blood vessels have the largest pressure drop? Smallest pressure drop?

Arterioles have the largest drop, whereas the vena cava has the smallest pressure drop in systemic circulation.

A suspected dermatophyte infection is stained with KOH. What spore type do you expect to see?

Arthroconidia with hyphae

How are flow through the loop of Henle and concentration of urine related?

As flow increases, the urine becomes more dilute because of decreased time for H2O reabsorption.

What is the relationship between chance of error and • Sample size?

As sample size increases, the lower the chance of error.

What happens to the Ab specificity when class switching occurs in mature B cells?

As the isotype is switched, the Ab specificity does not change because it does not affect the variable chains.

What happens to intraventricular pressure and volume during isovolumetric contraction?

As the name indicates, there is no change in volume but there is an increase in pressure.

What is the relationship between chance of error and • Standard deviation?

As the standard deviation increases, the greater the chance of error.

Name the most common type or cause. • Nonorganic pneumoconiosis

Asbestosis

What pneumoconiosis is associated with exposure to the following occupations or materials? • Shipyards, brake linings, insulation, and old building construction

Asbestosis

With what two pathologies is a honeycomb lung associated?

Asbestosis and silicosis

What is the most common one? • Helminthic parasite worldwide

Ascaris lumbricoides

What is the site of action of the following? • Loop diuretics

Ascending limb

What foci of fibrinoid necrosis are surrounded by lymphocytes and macrophages throughout all the layers of the heart?

Aschoff bodies of rheumatic fever

What vitamin deficiency is evidenced by poor wound healing, loose teeth, bleeding gums, petechiae, and ecchymosis?

Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)

What AA undergoes N-glycosylation?

Asparagine

What artificial sweetener must patients with PKU avoid?

Aspartame

What are the two ways that nitrogen can enter into the urea cycle?

Aspartate and carbomoyl PO4-

What enzyme catalyzes the rate-limiting step in pyrimidine synthesis?

Aspartate transcarbamylase

What two AAs have a pKa of 4?

Aspartic acid and glutamic acid

Name the most common type or cause. • Lung abscess

Aspiration

What is the most common one? • Complication of nasogastric tube feeding

Aspiration pneumonia

What is the term for squamous to columnar metaplasia of the distal esophagus secondary to chronic inflammation?

Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.

What is the most common one? • Skin tumor in the United States

Basal cell carcinoma

What is the most common one? • Tumor on sun-exposed sites

Basal cell carcinoma

Name the area of the cerebral cortex with the function described: • Initiation and control of movements

Basal ganglia

At the apex of the lung, what is the baseline intrapleural pressure, and what force does it exert on the alveoli?

Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.

What is the term for cytoplasmic remnants of RNA in RBCs, seen in lead poisoning?

Basophilic stippling

What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?

Bcl-2

Why is there an increase in FF if the GFR is decreased under sympathetic stimulation?

Because RPF is markedly decreased, while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).

Why is the clearance of creatinine always slightly greater than the clearance of inulin and GFR?

Because creatinine is filtered and a small amount is secreted

Why isn't the incidence of a disease decreased when a new treatment is initiated?

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 will turbulence first appear in the aorta in patients with anemia?

Because it is the largest vessel and has the highest velocity in systemic circulation

Why is there an increase in prolactin if the hypothalamic-pituitary axis was severed?

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 a minimal change in BP during exercise if there is a large drop in TPR?

Because the large drop in TPR is accompanied by a large increase in cardiac output, resulting in a minimal change in BP.

Regarding the venous system, what happens to blood volume if there is a small change in pressure?

Because the venous system is more compliant than the arterial vessels, small changes in pressure result in large changes in blood volume.

Why are clozapine and olanzapine unlikely to result in EPS effects?

Because they do not block D2A receptors, they are antagonists of 5HT2 receptors.

What type of spore is defined as an asexual budding daughter yeast cell?

Blastoconidia

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?

Blastomyces dermatitidis

Name these immature defense mechanisms: • Inability to remember a known fact (aware of forgetting)

Blocking

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?

Biofeedback

What water-soluble-vitamin deficiency may result from eating raw eggs?

Biotin (only if eaten in large quantities)

In the mitochondria, what complex is needed for pyruvate carboxylase to catalyze the reaction from pyruvate to OAA?

Biotin, ATP, and CO2

What complex is needed for propionyl CoA carboxylase?

Biotin, ATP, and CO2

Avidin decreases the absorption of what vitamin?

Biotin. Avidin is found in raw egg whites.

Increased self-esteem, flight of ideas, decreased sleep, increased libido, weight loss, and erratic behavior are all symptoms of what disorder?

Bipolar disorder (manic-depressive disorder)

What is the reservoir for the togavirus?

Birds

What are the top three causes of infant mortality?

Birth defects, low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS), and SIDS

What class of drugs is used in the treatment of demineralization of the bone?

Bisphosphonates

Name the ocular lesion; be specific. • Optic chiasm lesion

Bitemporal heteronymous hemianopsia

Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Naphthylamine

Bladder cancer

RBCs in the urine

Bladder carcinoma

What body fluid preferentially breaks down esters?

Blood

What somatoform disorder is described as • Unrealistic negative opinion of personal appearance, seeing self as ugly?

Body dysmorphic disorder

Is bone deposition or resorption due to increased interstitial Ca2+concentrations?

Bone deposition increases with increased Ca2+ or PO 4- concentrations, whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.

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

Borderline

What is the label given to an individual whose IQ is 70 to 79

Borderline

What small gram-negative aerobic rod requires Regan-Lowe or Bordet- Gengou medium for growth?

Bordetella pertussis

What spirochete is responsible for Lyme disease?

Borrelia burgdorferi

Which organism causes multiple infections by antigen switching?

Borrelia recurrentis

What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal rami?

Both

What type of fiber or fibers are carried in (answer motor, sensory, or both) • Spinal nerve?

Both

What type of fiber or fibers are carried in (answer motor, sensory, or both) • Ventral rami?

Both

What are the two exceptions to the rule "all cocci are gram positive"?

Both Neisseria and Moraxella are gram-negative cocci.

Is Dubin-Johnson or Rotor syndrome associated with black pigmentation of the liver?

Both are AR with conjugated hyperbilirubinemia, but Dubin-Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.

What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints?

Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.

What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?

Boutonnière deformities

What condition results in the following CSF results? • Opening pressure 450 mm H2O; 5 WBCs (90% lymphocytes); normal glucose and protein levels

Brain abscess

What are the three most common sites for left-sided heart embolisms to metastasize?

Brain, spleen, and kidney

Name the cancer associated with the following oncogenes. (Some may have more than one answer) • c-myc

Burkitt lymphoma

Starry sky appearance of macrophages is pathognomonic of what lymphoma?

Burkitt lymphoma

Starry sky pattern

Burkitt lymphoma

What is the term for RBCs with smooth undulations on the surface of their membrane, commonly seen in uremia?

Burr cells (echinocytes)

How does ceasation of barbiturate use affect sleep?

By causing rebound insomnia and decrease in REM sleep

What wave is the cause of the following venous pulse deflections? • The bulging of the tricuspid valve into the right atrium

C wave

What serves as a marker of endogenous insulin secretion?

C-peptide levels

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?

C1 esterase inhibitor (C1INH)

What complement factor deficiency leads to • Hereditary angioedema?

C1 inhibitor (C1-INH)

What nerve roots constitute the cervical plexus?

C1 through C4

What complement factor deficiency leads to • Leukocyte adhesion deficiency with poor opsonization?

C1, C2, or C4 deficiency

What is the most common complement deficiency?

C2 deficiency

What complement factor deficiency leads to • Increased susceptibility to pyogenic infections?

C3 deficiency

Ventral rami of what cervical nerves constitute the phrenic nerve?

C3, C4, and C5 keep the diaphragm alive!

What complement factor or factors are associated with • Anaphylaxis?

C3a, C4a, C5a

What three complement fragments are also anaphylatoxins?

C3a, C4a, and C5a

What complement factor or factors are associated with • Opsonization?

C3b

At what vertebral level does the common carotid artery bifurcate?

C4 (the upper border of the thyroid cartilage)

What complement factor deficiency leads to • Recurrent gonococcal infections?

C5-C8 deficiency

What complement factor or factors are associated with • Membrane attack complex (MAC)?

C5-C9

What complement factor or factors are associated with • Chemotaxis?

C5a

What is the name of the major chemotactic agent released from • The blood serum? (Hint: it is a complement factor.)

C5a

What components of the complement cascade form the MAC?

C5b-C9

What is the pancreatic action of CCK?

CCK stimulates the pancreas to release amylase, lipase, and proteases for digestion.

What endotoxin receptor is the best marker for macrophages?

CD14

What two CD cell surface markers do Reed- Sternberg cells stain positive for?

CD15 and CD30

What receptors are the best markers for NK cells?

CD16 and CD56

Name the B-cell CD marker: • Used clinically to count B cells in blood

CD19

What cell surface marker is found on blood B cells?

CD19

Name the B-cell CD marker: • Receptor for EBV

CD21; it is a complement receptor for cleaved C3

Name the T-cell CD marker: Is a costimulatory molecule in T cell activation

CD28

Name the T-cell CD marker: • Expressed on all T cells and is needed as a signal transducer for the T cell receptor

CD3

What cell surface marker do all T cells have?

CD3

What molecule that is needed to trigger T cell activation is noncovalently linked to TCR?

CD3 molecule. It transmits signals to the inside of the T cell to trigger activation

Name the T-cell CD marker: • Interacts with MHC class II molecules

CD4

What subset of T cells recognizes the MHC class II Ags?

CD4+ T cells (helper)

Development of what T cell line follows low affinity for self-MHC class II Ags in the thymus?

CD4+T cells

Name the B-cell CD marker: • Required for class switching signals from T cells

CD40

What cell surface marker is found on activated helper T cells?

CD40

Name the T-cell CD marker: • Essential for Ab isotype switching (for B cell binding)

CD40 ligand

Name the T-cell CD marker: • Interacts with MHC class I molecules

CD8

What T cell line arises from low affinity for self-MHC class I Ags in the thymus?

CD8+ T cells

What subset of T cells recognizes the MHC class I Ags?

CD8+ T cells (cytotoxic) Remember, 8×1=8 (CD×8×MHC class I=8); 4×2=8 (CD×4 MHC class II 8)

Why are patients with Chronic Granulomatous Disease not prone to develop infections from catalase-negative bacteria?

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.

Which three CNs send sensory information to the solitary nucleus?

CN VII, IX, and X; taste and general sensation for the tongue is sent to the solitary nucleus.

What CN is associated with the • Fourth pharyngeal arch?

CN X

What CN is associated with the • Sixth pharyngeal arch?

CN X

What CN carries preganglionic parasympathetic fibers that innervate the viscera of the neck, thorax, foregut, and midgut?

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 nerve or nerves supply general sensation and taste to the posterior third of the tongue?

CN XI and X

Name the structure that enters or exits the following foramina: • Foramen magnum

CN XI, vertebral arteries

Name the structure that enters or exits the following foramina: • Hypoglossal canal

CN XII

Can incidence, prevalence, and cause and effect be assessed in • Case control studies?

Case control studies cannot assess incidence or prevalence, but they can determine causal relationships.

What type of mortality rate is defined as the number of deaths • From a specific cause per number of persons with the disease?

Case fatality rate

Name the type of necrosis. • Soft, friable, cottage-cheese appearing; characteristically seen in TB

Caseous necrosis

What subtype of schizophrenia is characterized by • Stuporous mute echopraxia and automatic obedience, waxy flexibility with rigidity of posture?

Catatonic schizophrenia

What stage of male development is characterized by the following LH and testosterone levels? • Both LH and testosterone levels drop and remain low.

Childhood

Name the most common reported STD. • In females

Chlamydia

Name the MCC. • Pneumonia in a patient with atypical bird exposure and hepatitis

Chlamydia psittaci

Name the most common cause. • Blindness worldwide

Chlamydia trachomatis

What is the most common disease or infection reported to the CDC?

Chlamydia; gonorrhea is second (Remember, it is mandatory to report STDs to the CDC.)

Which sedative-hypnotic is contraindicated for patients taking warfarin?

Chloral hydrate

Name the antimicrobial agent whose major side effect is listed. • Grey baby syndrome

Chloramphenicol

What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?

Chloramphenicol

What tetracycline is associated with hepatotoxicity?

Chlortetracycline

What toxin ADP-ribosylates via Gs protein to increase cAMP?

Cholera toxin

What is the site of action of cholera toxin?

Cholera toxin irreversibly activates the cAMP-dependent chloride pumps of the small and large intestine, producing a large volume of chloride-rich diarrhea.

What pathway uses HMG CoA synthetase in the cytoplasm?

Cholesterol biosynthesis

What condition results in a strawberry gallbladder?

Cholesterolosis

What are the proteoglycans of cartilage and bone?

Chondroitin sulfate and keratan sulfate

What nerve supplies taste sensation to the anterior two-thirds of the tongue?

Chorda tympani of CN VII

What attaches the cusps of the valves to the papillary muscles in the heart?

Chordae tendineae

What is the most common one? • Malignant germ cell tumor in women

Choriocarcinoma

Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Beta-hCG

Choriocarcinomas and trophoblastic tumors

What cells of the adrenal gland are neural crest derivatives?

Chromaffin cells (adrenal medulla)

What mineral is associated with impaired glucose tolerance?

Chromium (Cr)

What fungus is seen as colored cauliflower lesions?

Chromomycosis

What is the most common one? • Pituitary tumor

Chromophobe adenoma

Name the associated chromosome. • Gaucher disease

Chromosome 1

Name the associated chromosomal translocation. • Ewing sarcoma

Chromosome 11, 22

Name the associated chromosome. • Albinism

Chromosome 11p

Name the associated chromosome. • Niemann-Pick disease

Chromosome 11p

Name the associated chromosome. • Chronic lymphocytic leukemia (CLL)

Chromosome 12

Name the associated chromosome. • Patau syndrome

Chromosome 13

Name the associated chromosomal translocation. • Follicular lymphoma

Chromosome 14, 18

Name the associated chromosome. • Marfan disease

Chromosome 15

What chromosome is autism linked to?

Chromosome 15

Name the associated chromosomal translocation. • Acute promyelocytic leukemia (M3)

Chromosome 15, 17

Name the associated chromosomal translocation. • M3 AML

Chromosome 15, 17

Name the associated chromosome. • Tay-Sachs disease

Chromosome 15q

Name the associated chromosome. • Neurofibromatosis type 1

Chromosome 17

Name the associated chromosome. • Edward syndrome

Chromosome 18

Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?

Chromosome 19

Name the associated chromosome. • Familial hypercholesterolemia

Chromosome 19

What chromosome is associated with the AR form of SCID?

Chromosome 20q (deficiency in adenosine deaminase)

Name the associated chromosome. • Down syndrome

Chromosome 21

Name the associated chromosome. • Neurofibromatosis type 2

Chromosome 22q

Name the associated chromosome. • VON Hippel-Lindau disease

Chromosome 3p

Name the associated chromosome. • Huntington disease

Chromosome 4p

Cri-du-chat syndrome results in a terminal deletion of the short arm of what chromosome?

Chromosome 5

Name the associated chromosomal translocation. • Adult familial polyposis

Chromosome 5, 21

Name the associated chromosome. • Cri-du-chat

Chromosome 5p

On what chromosome is the adenomatous polyposis coli gene?

Chromosome 5q21

Which chromosome is associated with MHC genes?

Chromosome 6

Name the associated chromosome. • Cystic fibrosis

Chromosome 7

Name the associated chromosomal translocation. • Burkitt lymphoma

Chromosome 8, 14

Name the associated chromosomal translocation. • CML

Chromosome 9, 22 (Philadelphia chromosome)

Mallory bodies

Chronic alcoholic

Waxy casts

Chronic end-stage renal disease

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

Chronic rejection

What excitatory fibers arise from the inferior olivary nuclei on the contralateral side of the body?

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 area of the nephron is sensitive to the effects of ADH?

Collecting ducts, which make them readily permeable to water reabsorption.

What are the three C's of a TCAD overdose?

Coma, convulsions, and cardiotoxicity

If the pH is low with increased CO2 levels and decreased HCO3- levels, what is the acid-base disturbance?

Combined metabolic and respiratory acidosis

Fracture of the fibular neck, resulting in foot drop, is an injury of what nerve?

Common peroneal nerve

What lower extremity nerve is described by the following motor loss? • Loss of eversion; inversion, dorsiflexion, and plantarflexion of the foot

Common peroneal nerve

Is the following description characteristic of competitive or noncompetitive antagonists: parallel shift to the right on a dose-response curve, complete reversibility with increase of the dose of the agonist drug, and capacity to decrease the potency of the agonist drug?

Competitive antagonist

What complex of the ETC contains Cu2+?

Complex 4

What component of the ETC is inhibited by the following? • Barbiturates

Complex I

What component of the ETC is inhibited by the following? • Rotenone

Complex I

What is the term to describe how easily a vessel stretches?

Compliance (think of it as distensibility)

What term is an index of the effort needed to expand the lungs (i.e., overcomes recoil)?

Compliance; the more compliant a lung is, the easier it is to inflate.

What are the three branches of the lateral cord of the brachial plexus?

1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus

What sided muscle weakness is seen in an UMN corticospinal tract injury above the pyramidal decussation?

Contralateral muscle weakness when above the decussation, whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.

Will a unilateral lesion in the spinothalamic tract result in a contralateral or ipsilateral loss of pain and temperature?

Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn, crosses over, and ascends contralateral in the spinal cord, brainstem, thalamus, and postcentral gyrus.

What part of the heart forms • Superior border?

Conus arteriosus of the right ventricle and right and left auricles

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?

Convergence

What somatoform disorder is described as • La belle indifférence, suggestive of true physical ailment because of alteration of function?

Conversion disorder

What test is used to detect anti-RBC Abs seen in hemolytic anemia?

Coombs test

Leukopenia, neutropenia, and mental deterioration are signs of what mineral deficiency?

Copper

What mineral is a component of cytochrome a/a3?

Copper

What element is needed for the proper alignment of tropocollagen molecules?

Copper (Cu+)

What mineral deficiency involves blood vessel fragility?

Copper deficiency

What paraphilia is defined as • Combining sex with defecation?

Coprophilia

What cycle is responsible for converting to glucose in the liver the lactate produced in the RBCs?

Cori cycle

Where are the lowest resting PO2 levels in a resting individual?

Coronary circulation

Name the most common cause. • A cold in the winter and summer

Coronavirus

What is the degree to which two measures are related? Does it imply causation?

Correlation. No, correlation does not imply causation.

What tract is responsible for voluntary refined movements of distal extremities?

Corticospinal tract

What is the DOC for the treatment of the late phase response in an asthmatic attack?

Corticosteroid

What is the major hormone produced in the following areas of the adrenal cortex? • Zona fasciculata

Cortisol Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.

What happens to cortisol levels in sleep-deprived individuals?

Cortisol levels increase. Lymphocyte levels decrease in sleep-deprived individuals.

What is the only 17-hydroxysteroid with hormonal activity?

Cortisol, a 21-carbon steroid, has a -OH group at position 17.

What non-spore-forming gram-positive aerobic rod produces bull neck, sore throat with pseudomembranes, myocarditis, and sometimes respiratory obstructions?

Corynebacterium diphtheriae

Which bacteria are associated with the following pigment production? • Black-gray pigmentation

Corynebacterium diphtheriae

What law states that an enlarged, palpable gallbladder is more likely due to cancer than stone obstruction?

Courvoisier's law

What is the only Rickettsia that is stable in the environment?

Coxiella burnetii

What organism causes Q fever?

Coxiella burnetii

What are the CAGE questions?

Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)

What form of poisoning is associated with bitter almond-scented breath?

Cyanide

What vitamin requires IF for absorption?

Cyanocobalamin (B12)

What vitamin deficiency produces homocystinuria and methylmalonic aciduria?

Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)

What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?

Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.

What antihistamine is used in the treatment of serotonergic crisis?

Cyproheptadine

What is the most common one? • Malignant carcinoma of the ovaries

Cystadenocarcinoma

What ovarian carcinoma is characterized by psammoma bodies?

Cystadenocarcinoma

What is the most common one? • Benign ovarian tumor

Cystadenoma

What is the most common lethal AR disorder affecting white Americans?

Cystic fibrosis

Name five causes for zero-order metabolism.

1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity

In what three areas of the body are sympathetics the predominant tone?

1. Sweat glands 2. Arterioles 3. Veins

What five cofactors and coenzymes are required by pyruvate dehydrogenase?

1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)

What are the five terminal branches of the facial nerve?

1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)

What three circumstances allow a child to be committed to institutional care?

1. The child poses an imminent danger to self or others. 2. The child is unable to self-care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety even though they refuse hospitalization.

Name the four ventral mesentery derivatives.

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.

What are the three reasons for the effectiveness of the blood-brain barrier?

1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries

What are the three anatomic characteristics that differentiate the large bowel from the small bowel and the rectum?

1. Tinea coli 2. Haustra 3. Epiploic appendages

What are the three left-to-right shunts?

1. VSD 2. ASD 3. PDA

What are the three surrogate criteria?

1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?

With what three enzymes is thiamin pyrophosphate (TPP) associated?

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

What are the rules of 10 regarding pheochromocytoma?

10% are bilateral, 10% malignant, and 10% familial, 10% in children, and 10% outside the adrenal gland

What percentage of children born to HIV-positive mothers will test positive for HIV at birth?

100%, with about 20% remaining positive after 1 year

What percentage of cardiac output flows through the pulmonary circuit?

100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.

What adrenal enzyme deficiency results in hypertension, hypernatremia, and virilization?

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.

How many ATPs are generated per acetyl coenzyme A (CoA)?

12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)

If no fertilization occurs, how many days after ovulation does the corpus luteum begin to degenerate?

12 days after ovulation

At what age does a child develop • Preferential smile?

12 to 16 weeks (in response to mother's face)

What is the amount in liters and percent body weight for the following compartments? • ECF

14 L, 33% of body weight

What is the bone marrow maturation time for a phagocytic cell?

14 days

How many days before the first day of menstrual bleeding is ovulation?

14 days in most women (Remember, the luteal phase is always constant.)

How much dietary iodine is necessary to maintain normal thyroid hormone secretion?

150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.

What part of the 30S ribosome binds to the Shine-Dalgarno sequence?

16S subunit

What adrenal enzyme deficiency results in hypertension, hypernatremia, increased ECF volume, and decreased adrenal androgen production?

17-alpha-Hydroxylase deficiency

What is the legal age to be deemed competent to make decisions?

18 years old (except if emancipated)

What is the ratio of pulmonary to systemic blood flow?

1:1. Remember, the flow through the pulmonary circuit and the systemic circuit are equal.

How many ATPs are produced from cytoplasmic NADH oxidation using the glycerol phosphate shuttle?

2 ATPs by oxidative phosphorylation

How many ATPs per glucose are generated from glycolysis in RBCs?

2 ATPs, because RBCs use only anaerobic metabolism.

How many high-energy bonds are used to activate an AA?

2 ATPs, via the amino acyl tRNA synthase enzyme

How many NADPHs are used per addition of acetyl CoA into a fatty acid chain?

2 NADPHs per acetyl CoA

How many acetyl CoAs per glucose enter into the TCA cycle?

2 acetyl CoA per glucose, producing 12 ATPs per acetyl CoA, resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle

How many days prior to ovulation does estradiol peak in the menstrual cycle?

2 days prior to ovulation

How long is the transit time through the small intestine?

2 to 4 hours

What are the rules of 2 for Meckel diverticulum?

2% of population, 2 cm long, 2 feet from ileocecal valve, 2 years old, and 2% of carcinoid tumors

What attaches to protons and allows them to enter into the mitochondria without going through the ATP-generating system?

2, 4-Dinitrophenol

What lecithin: sphingomyelin ratio indicates lung maturity?

2.0 or greater

What is the ratio of T4:T3 secretion from the thyroid gland?

20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.

What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency, glucocorticoid deficiency, and an excess of adrenal androgens?

21-β-Hydroxylase deficiency leads to hypotension, hyponatremia, and virilization.

Outburst to cover up true feelings (emotion is covered, not redirected).

Acting out

What gram-positive anaerobic rod with branching filaments is a component of the normal flora of the mouth and female genital tract and is responsible for draining abscesses with sulfur granules in the exudates?

Actinomyces israelii

What type of potential is characterized as being an all-or-none response, propagated and not summated?

Action potential

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?

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.

What is the name of the 12-step program believed to be the most successful for the treatment of alcohol abuse?

Alcoholics Anonymous

Name the most common type or cause. • Mallory-Weiss syndrome

Alcoholism

What enzyme is blocked by disulfiram?

Aldehyde dehydrogenase

What fructose metabolism enzyme is deficient in patients with vomiting, apathy, diarrhea, jaundice, proximal renal tubular acidosis, hypoglycemia, and hyperuricemia?

Aldolase B deficiencies are treated by eliminating fructose from the diet.

What is the major hormone produced in the following areas of the adrenal cortex? • Zona glomerulosa

Aldosterone Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.

Where do adult tapeworms develop, in the intermediate or definitive host?

Adult tapeworms develop in the definitive host, whereas cysticerci or larvae develop in the intermediate host.

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.

Adulthood

What mosquito is the vector for dengue fever?

Aedes (the same for yellow fever)

What is the vector for yellow fever?

Aedes mosquito

Are the JG cells of the nephron a part of the afferent or efferent arteriole?

Afferent arteriole

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?

Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)

A urethral swab of a patient shows gram-negative diplococci in PMNs; what organism do you diagnose?

Neisseria gonorrhoeae

What are the two MCC of acute epididymitis in males? • Less than 35 years old

Neisseria gonorrhoeae and Chlamydia trachomatis

What is the MCC of the following meningitides? • In military recruits

Neisseria meningitides

Which organism releases endotoxins prior to cell death?

Neisseria meningitidis

What is the term for new made-up words?

Neologisms. Thomas Jefferson noted, "Necessity obliges us to neologize." (Abnormal use of neologisms is known as neolalism.)

Which aminoglycoside is used only topically because it is too toxic for systemic use?

Neomycin

Name the MCC of death. • In neonates

Neonatal respiratory distress syndrome (NRDS)

What is the most common one? • Solid tumor in the body

Nephroblastoma

What drug is being given to HIV-positive mothers during labor and to the children after birth to decrease the risk of mother-to-child HIV transmission?

Nevirapine; it cuts the rate from 20% to 10%. AZT is also used, cutting the rate from 20% to 10%.

What water-soluble vitamin deficiency results in pellagra?

Niacin (B3)

What is the drug of choice, which inhibits oxidative phosphorylation in cestodes, for taeniasis?

Niclosamide

What is the only drug that does not have an intoxication?

Nicotine (but it sure has a nasty withdrawal!)

Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?

Nicotinic acid, because its side effects include hyperuricemia and exacerbation of ulcers.

What two lysosomal storage diseases have cherry-red spots on the retina?

Niemann-Pick and Tay-Sachs diseases

What AR disease involves a decreased amount of sphingomyelinase, massive organomegaly, zebra bodies, and foamy histiocytes and is associated with chromosome 11p?

Niemann-Pick disease

Movement disorders are associated with what dopamine pathway (what part of the brain)?

Nigrostriatal pathways (basal ganglia)

Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?

Nimodipine

What is the name of RER in neurons?

Nissl substances; there is a great deal of RER in neuron cell bodies, indicating high protein synthesis.

What class of antianginal activates the NO pathway to produce endothelial vasodilation?

Nitrates

What test is done to diagnose CGD?

Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.

Name the antimicrobial agent whose major side effect is listed. • Hemolytic anemia

Nitrofurantoin

What antihypertensive agent produces cyanide and thiocyanate as byproducts?

Nitroprusside

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

No CHO, AA, ketones, or peptides are left in the tubular lumen.

What happens to the following during skeletal muscle contraction? • A band

No change in length

What happens to the following during skeletal muscle contraction? • Actin and myosin lengths

No change in length

What eukaryotic translation enzyme is associated with the following: • Termination

No enzymes are needed. When the stop codon reaches the A site, it results in termination.

Does REM deprivation interfere with performance on simple tasks?

No, but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)

Is it acceptable to lie, even if it protects a colleague from malpractice?

No, it is never acceptable to lie.

Is spousal abuse a mandatory reportable offense?

No, it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.

Is allopurinol used in the acute treatment of gout?

No, it is used in chronic treatment of gout to decrease the uric acid pools in the body.

Can you tell which drug is more toxic based on therapeutic indices alone?

No, therapeutic indices can tell which drug is safer, not more toxic.

Does a saturated fatty acid have double bonds?

No, unsaturated fatty acids have double bonds.

If a patient cannot pay, can you refuse services?

No, you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.

Is heparin contraindicated in pregnancy?

No. Heparin is safe in pregnancy, but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.

Is masturbation considered an abnormal sexual practice?

No. It is abnormal only if it interferes with normal sexual or occupational function.

Are antibiotics helpful in treating a disease caused by a prion?

No. Prions are infectious proteins, so antibiotics are useless.

Can an acute MI be diagnosed only by looking at an ECG?

No. Remember, tests do not diagnose, they confirm or refute your diagnosis. Also, diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI, elevated cardiac enzymes consistent with MI, and ST segment elevation of 2 mm or more in at least two contiguous leads.

What aerobic branching rod that is gram positive and partially acid-fast is associated with cavitary bronchopulmonary disease in immunosuppressed patients?

Nocardia asteroides

What is the region of an axon where no myelin is found?

Nodes of Ranvier

Which form of melanoma carries the worst prognosis?

Nodular melanoma

What is the most common one? • Subtype of Hodgkin lymphoma

Nodular sclerosis

What is the only subtype of Hodgkin's lymphoma that is most commonly seen in females?

Nodular sclerosis

What scale separates things into groups without defining the relationship between them?

Nominal scale (categorical, e.g., male or female)

What hematologic malignancy is treated with the monoclonal antibody rituximab?

Non-Hodgkin lymphoma

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)

Nondominant parietal 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

Nondominant temporal lobe

How many covalent bonds per purine-pyrimidine base pairing are broken during denaturation of dsDNA?

None. Denaturation of dsDNA breaks hydrogen bonds, not covalent bonds.

What CN is associated with the • Fifth pharyngeal arch?

None; it degenerates.

How many oogonia are present at birth?

None; they are not formed until a girl reaches puberty.

What hormones are produced in the median eminence region of the hypothalamus and the posterior pituitary gland?

None; they are the storage sites for ADH and oxytocin.

Name the type of mutation: • New codon specifies for a stop codon

Nonsense

When the results of a test are compared to findings for a normative group, what form of reference does the objective test use?

Norm reference (i.e., 75% of the students in the class will pass)

What hormone is necessary for normal GH secretion?

Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.

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

Normal values

How do the corticobulbar fibres of CN VII differ from the rest of the CNs?

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. --------------------------------------------------------------------------------

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?

Oligodendroglioma

What type of fatty acid is associated with a decrease in serum triglycerides and cardiovascular disease?

Omega-3 fatty acids

Is linolenic acid an omega-3 or omega-6 fatty acid?

Omega-3; linoleic is omega-6

What two pathologic conditions occur when the gut does not return to the embryo?

Omphalocele and gastroschisis

What is the most common site for implantation of the blastocyst?

On the superior body of the posterior wall of the uterus

What happens to capillary oncotic pressure with dehydration?

Oncotic pressure increases because of the removal of water.

How many days after the LH surge is ovulation?

One day after the LH surge and 2 days after the estrogen peak.

How many pairs of spinal nerves are associated with • Coccygeal vertebrae?

One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.

How many ATPs are hydrolyzed every time a skeletal muscle cross-bridge completes a single cycle?

One, and it provides the energy for mechanical contraction.

What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable?

One-way ANOVA

What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?

Onion skinning

What event signifies the first day of the menstrual cycle?

Onset of bleeding

The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?

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 termination of isovolumetric relaxation phase of the cardiac cycle?

Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.

What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?

Operant conditioning (reinforcement is after a response)

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?

Operon

Why should opioid analgesics be avoided for patients with head trauma?

Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.

Where does the parotid (Stensen's) duct enter the oral cavity?

Opposite the second upper molar tooth

By which process do Abs make microorganisms more easily ingested via phagocytosis?

Opsonization

Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Withdrawn, fearful, explosive moods, violent outbursts, and loss of inhibitions

Orbitomedial frontal lobe

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?

Order of attachment is site 1, 2, 3, 4, and for release is 4, 3, 2, 1.

What scale assesses a rank order classification but does not tell the difference between the two groups?

Ordinal scale (e.g., faster/slower, taller/shorter)

What is the pyrimidine intermediate that joins PRPP (5-Phosphoribosyl-1-Pyrophosphate)?

Orotic acid (purine metabolism)

Name the following descriptions associated with bacterial endocarditis: • Painful subcutaneous nodules on fingers and toes

Osler nodes

What is the term for diffusion of water across a semipermeable or selectively permeable membrane?

Osmosis; water will diffuse from higher to lower water concentrations.

What bone disorder is characterized by brown tumors, bone pain, deformities, and fractures due to excessive PTH?

Osteitis fibrosa cystica (von Recklinghausen disease)

What disorder causes joint stiffness that worsens with repetitive motion, crepitus, effusions, and swelling and commonly affects the knees, hips, and spine?

Osteoarthritis

What is the most common one? • Form of arthritis

Osteoarthritis

What cell type in the bone is responsible for bone deposition?

Osteoblast (Remember, blasts make, clasts take)

What bone cell has receptors for PTH?

Osteoblasts (Remember, they modulate the function of osteoclasts.)

What cell type of the bone has PTH receptors?

Osteoblasts, which in turn stimulate osteoclasts to break down bone, releasing Ca2+ into the interstitium. (Remember, blasts make, clasts take.)

Name the macrophage based on its location: • Bone macrophages

Osteoclasts

What cell in bone is a part of the mononuclear phagocytic system?

Osteoclasts

What type of cell is surrounded by mineralized bone?

Osteocyte

Blue sclera

Osteogenesis imperfecta

Blue sclera is seen in what hereditary bone disorder?

Osteogenesis imperfecta

What benign bone tumor is associated with Gardner syndrome?

Osteoma

Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?

Osteomalacia. Osteoporosis has normal levels of calcium, phosphorus, and alkaline phosphatase.

What hereditary bone disorder is due to decreased osteoclast function, resulting in thick, sclerotic bones that fracture easily?

Osteopetrosis (Albers-Schönberg disease)

What is the most common one? • Bone disorder in the United States

Osteoporosis

Codman triangle on radiograph

Osteosarcoma

What is the most common one? • Malignant tumor in the bone of teenagers

Osteosarcoma

What is the most common primary malignant tumor in bone?

Osteosarcoma

What malignant bone tumor is associated with familial retinoblastoma?

Osteosarcoma

What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?

Osteosarcoma

What is the most common one? • Type of ASD

Ostium secundum defects

Where is tropocollagen aggregated to form a collagen fibril?

Outside the cell

Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-125

Ovarian cancer

What is the most common one? • Female genital tract malignancy resulting in death

Ovarian cancer

What is the most common one? • Stromal tumor of the ovary

Ovarian fibroma

What area of the brain acts as the center for ipsilateral horizontal gaze?

PPRF

Name the product or products of arachidonic acid: • Pain and fever

PGE2

What two PGs are used to induce labor?

PGE2 and PGF2α

Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?

PGI 2

Name the product or products of arachidonic acid: • Vasodilation and inhibition of platelet aggregation produced by vascular endothelium

PGI2

What branch off the vertebral artery supplies • The cerebellum and the dorsolateral part of the medulla?

PICA

What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?

PKU

What component of an ECG is associated with the following? • Conduction delay in the AV node

PR interval

What enzyme catalyzes the rate-limiting step in purine synthesis?

PRPP aminotransferase

What enzyme of purine synthesis is inhibited by allopurinol and 6-mercaptopurine?

PRPP aminotransferase

Does PT or PTT test the extrinsic coagulation pathway?

PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT, which means warfarin, extrinsic, PT; heparin, intrinsic, PTT)

What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate excretion

PTH

What hormone is required for 1, 25-dihydroxy-vitamin D (1, 25-diOH-D) to have bone resorbing effects?

PTH

What are effects of PTH in the kidney?

PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.

What disorder of bone remodeling results in thick, weak bones and is associated with high-output cardiac failure?

Paget disease (osteitis deformans)

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?

Paget disease of the breast

What breast pathology involves malignant cells with halos invading the epidermis of the skin?

Paget disease of the breast

What is the only tongue muscle innervated by CN X?

Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.

What is the term to describe the 5'-3' sequence of one strand being the same as the opposite 5'-3' strand?

Palindrome

Name the end product or products: • Fatty acid synthesis

Palmitate

What two areas of the skin do not contain sebaceous glands?

Palms and soles of the feet. Sebaceous glands are associated with hair follicles, which are lacking on the palms and soles of the feet.

In regard to motor development during infancy, choose the motor response that happens first. • Palms up or down

Palms-up before palms-down maneuvers

Which form of emphysema is associated with an alpha1-antitrypsin deficiency?

Panacinar

Name the cancer associated with the following oncogenes. (Some may have more than one answer) • Ki-ras

Pancreas and colon

Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-19.9 and CEA

Pancreatic cancer

What cell of the duodenum contains high concentrations of lysozymes and has phagocytic activity?

Paneth cells

What vitamin is a component of the enzymes fatty acid synthase and acyl CoA?

Pantothenic acid

What is the most common one? • Thyroid cancer

Papillary carcinoma

Orphan Annie cells

Papillary carcinoma of the ovary

What is the most common one? • Malignant thyroid tumor

Papillary carcinoma of the thyroid

What thyroid carcinoma is associated with radiation exposure, psammoma bodies, and Orphan Annie eye nuclei?

Papillary carcinoma of the thyroid

Name the DNA virus: • Circular dsDNA; naked; icosahedral; replicates in the nucleus

Papovavirus

What is a palpable, elevated solid mass up to 0.5 cm?

Papule

The clearance of what substance is the gold standard of renal plasma flow?

Para-aminohippurate (PAH)

What is the name of the T cell-rich area of the lymph node?

Paracortex

What is the term for a venous embolus in the arterial system?

Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.

What cells of the thyroid gland secrete calcitonin?

Parafollicular C cells

Name the most common cause. • Croup

Parainfluenza virus

In what type of circuit is the total resistance always less than that of the individual resistors?

Parallel circuit

What embryonic structure forms the adult female structures? • Uterine tube, uterus, cervix, and upper third of the vagina

Paramesonephric ducts

What family do the following viruses belong to? • Measles

Paramyxovirus

What family do the following viruses belong to? • RSV

Paramyxovirus

Name these cluster A personality disorders: • Baseline mistrust; carries grudges; afraid to open up; uses projection as defense mechanism; lacks hallucinations or delusions

Paranoid

What subtype of schizophrenia is characterized by • Delusions of persecution and/or grandeur, auditory hallucinations, late onset, and the best prognosis?

Paranoid schizophrenia

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

Parasites

What part of the ANS (i.e., PNS or CNS) controls the constriction of the pupil in response to light?

Parasympathetic

What component of the ANS, when stimulated, results in bronchoconstriction?

Parasympathetic stimulation, via the vagus nerve, results in bronchoconstriction, whereas sympathetic stimulation results in bronchodilation.

What component of the ANS is responsible for dilation of the blood vessels in the erectile tissue of the penis, resulting in an erection?

Parasympathetics (parasympathetics point, sympathetics shoot)

What are the strongest determinants of gender identity?

Parental assignment and culture (not biology)

What cell type of the body or fundus of the stomach secretes IF?

Parietal cells (Remember, they secrete HCl, too.)

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

Parietal lobe

Lewy bodies

Parkinson disease

What form of penicillin is used in the treatment of life-threatening illnesses?

Penicillin G (benzylpenicillin)

What form of penicillin is stable in acid environments?

Penicillin V

What hematologic agent is used in the treatment of intermittent claudication because it decreases blood viscosity and increases RBC membrane flexibility and stability?

Pentoxifylline

What is the DOC for hyperprolactinemia?

Pergolide

What is the most common one? • Lymph node affected in non-Hodgkin lymphoma

Periaortic lymph nodes

Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • CNS neurons

Permanent

Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Cardiac muscle

Permanent

Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Skeletal muscle

Permanent

What disorder is characterized by autoantibodies to IF?

Pernicious anemia

What type of anemia is the result of a deficiency in intrinsic factor?

Pernicious anemia (secondary to a lack of vitamin B12 absorption)

What thyroid enzyme is needed for oxidation of I- to I&#039;?

Peroxidase, which is also needed for iodination and coupling inside the follicular cell

What right-to-left shunt occurs when only one vessel receives blood from both the right and left ventricles?

Persistent truncus arteriosus

What toxin ADP-ribosylates via Gi to increase cAMP?

Pertussis toxin

What AD syndrome produces hamartomatous polyps in the small intestine and pigmentation of the lips and oral mucosa?

Peutz-Jeghers syndrome

What lymphoid organ is characterized by germinal centers, plasma cells that secrete IgA, and no encapsulation?

Peyer's patch

At what stage of psychosexual development (according to Freud) do children fear castration?

Phallic stage (4-6 years)

What embryonic structure forms the adult female structures? • Glans clitoris, corpus cavernosus, and spongiosum

Phallus

What embryonic structure forms the adult male structure? • Corpus cavernosus, corpus spongiosum, and glans and body of the penis

Phallus

What embryonic structure forms the following adult structures? • External genitalia

Phallus, urogenital folds, and labioscrotal swellings

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

Phase 0

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

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?

Phase 1

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

Phase 2

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

Phase 3

Which phase of clinical drug testing includes postmarket reporting of adverse reactions?

Phase 4

In a ventricular pacemaker cell, what phase of the action potential is affected by ACh?

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 NE?

Phase 4; NE increases the slope of the prepotential, allowing threshold to be reached sooner, and increases the rate of firing.

Are hydrolysis, oxidation, and reduction phase I or II biotransformations?

Phase I

What phase of Food and Drug Administration approval tests • The safety in healthy volunteers?

Phase I

What phase of Food and Drug Administration approval tests • The protocol and dose levels in a small group of patient volunteers?

Phase II

What phase of Food and Drug Administration approval tests • The efficacy and occurrence of side effects in large group of patient volunteers?

Phase III. It is considered the definitive test.

What mixed α-antagonists are used for patients with pheochromocytoma?

Phentolamine and phenoxybenzamine

What enzyme is deficient in patients with PKU?

Phenylalanine hydroxylase

What α1-agonist, not inactivated by catechol-O-methyl transferase (COMT), is used as a decongestant and for treatment of paroxysmal atrial tachycardia?

Phenylephrine

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?

Phenytoin

Which anticonvulsant causes gingival hyperplasia?

Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)

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?

Polycythemia vera (Remember, polycythemia vera is a risk factor for acute leukemias.)

A single mRNA strand translated by a ribosome is termed what?

Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.

What glycogen storage disease is due to the following enzyme deficiencies? • Lysosomal glucosidase (acid maltase)

Pompe's disease

Name the area of the cerebral cortex with the function described: • Important for REM sleep; origin of NE pathway

Pons

What syndrome is associated with the following brainstem lesions? • Slow-growing acoustic neuroma producing CN VII deficiencies

Pontocerebellar angle syndrome

What muscle laterally rotates the femur to unlock the knee?

Popliteus

What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?

Porcelain gallbladder

Are the following conditions associated with a negative or positive nitrogen balance? • Growth

Positive

Are the following conditions associated with a negative or positive nitrogen balance? • Pregnancy

Positive

Are the following conditions associated with a negative or positive nitrogen balance? • Recovery from injury

Positive

What type of correlation is defined as • Two variables that go together in the same direction?

Positive correlation

Name the DNA virus • Linear dsDNA; enveloped; virion-associated polymerases; replicates in the cytoplasm :

Poxvirus

What is the only DNA virus that is not icosahedral?

Poxvirus

What is the only DNA virus that does not replicate its DNA in the nucleus of the host cell?

Poxvirus replicates its DNA in the cytoplasm.

What syndrome results when there is a deletion to paternal chromosome 15? Maternal?

Prader-Willi syndrome and Angelman syndrome, respectively

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)

Reaction formation

What form of coarctation of the aorta is associated with Turner syndrome?

Preductal (infantile)

What frontal lobe cortex is associated with organizing and planning the intellectual and emotional aspect of behavior?

Prefrontal cortex; it is in front of the premotor area.

Failure to accurately recall the past leads to what form of bias?

Recall bias. These problems arise in retrospective studies.

What highly undifferentiated aggressive CNS tumor of primordial neuroglial origin develops in children and is associated with pseudorosettes?

Primitive neuroectodermal tumors (i.e., medulloblastomas and retinoblastomas)

From what embryonic structure are the following structures derived? • The right and left ventricles

Primitive ventricle

What form of angina is characterized by • Coronary artery vasospasm, symptom occurrence at rest, ST segment elevation (during episode), and no signs on ECG?

Prinzmetal variant angina

What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?

Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels

What is the term for excessive amounts of granulation tissue that can block re-epithelialization and wound healing?

Proud flesh

In regard to motor development during infancy, choose the motor response that happens first. • Proximal or distal progression

Proximal to distal progression

What is the site of action for carbonic anhydrase inhibitors?

Proximal tubule

What form of arthritis is associated with calcium pyrophosphate crystals?

Pseudogout

What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?

Pseudogout

What is the term for hyphae with constrictions at each septum that are commonly seen in Candida albicans?

Pseudohyphae

What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile, ischemia, Staphylococcus, Shigella, or Candida infection?

Pseudomembranous colitis

Name the type of exudate, given the following examples. • Diphtheria infection

Pseudomembranous exudates

What are the most common causes of osteomyelitis • In drug addicts?

Pseudomonas

Name the most common type or cause. • Infection in a patient on a ventilator

Pseudomonas aeruginosa

What bacterium is a gram-negative, oxidase-positive aerobic rod that produces a grapelike odor and pyocyanin pigmentation?

Pseudomonas aeruginosa

What is the most likely causative organism for a patient with folliculitis after spending time in a hot tub?

Pseudomonas aeruginosa

Which bacteria are associated with the following pigment production? • Pyocyanin (blue-green)

Pseudomonas aeruginosa

Name the MCC. • Pneumonia in a neutropenic burn patient

Pseudomonas sp.

What muscle is the chief flexor of the hip?

Psoas major

What diagnosis ensues from finding well-demarcated erythematous plaques with silvery scales on the knees, elbows, and scalp along with nail bed pitting and discoloration?

Psoriasis

What diseases are associated with the HLA-B27 allele

Psoriasis, ankylosing spondylitis, inflammatory bowel disease, and Reiter's syndrome

What is the name of the postganglionic parasympathetic ganglion that innervates • The lacrimal gland and oral and nasal mucosa?

Pterygopalatine ganglion (I remember this as the only ganglion left.)

What is the triad of Horner's syndrome?

Ptosis (eyelid drooping), miosis (pupillary constriction), and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1-to T4 are obstructed.

What stage of male development is characterized by the following LH and testosterone levels? • LH pulsatile amplitude and levels increase, with increased testosterone production.

Puberty

What bones make up the acetabulum?

Pubis, ilium, and ischium

Name the most common type. • Specific phobia

Public speaking (Remember: stage fright)

What component of the pelvic diaphragm forms the rectal sling (muscle of continence)?

Puborectalis

Name the macrophage based on its location: • Lung macrophages

Pulmonary alveolar macrophages

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?

Pulmonary embolism due to a DVT; this is not absolute but a classic description.

Name the MCC of death. • In patients with cystic fibrosis

Pulmonary infections

What does failure of PaO2 to increase with supplemental O2 indicate?

Pulmonary shunt (i.e., pulmonary embolism)

What is the term for the difference between systolic and diastolic pressures?

Pulse pressure

Based on operant conditioning, what type of reinforcement is described when • Adding a stimulus stops a behavior?

Punishment

What enzyme is deficient in selective T cell immunodeficiency?

Purine nucleoside phosphorylase

What enzyme of the purine salvage pathway is deficient in the following? • Selective T-cell immunodeficiency

Purine nucleoside phosphorylase

What is the fastest-conducting fiber of the heart? Slowest conduction fiber in the heart?

Purkinje cell is the fastest, and the AV node is the slowest.

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?

Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)

What is the term for cestode-encysted larvae found in intermediate hosts?

Cysticerci

Name the eukaryotic DNA polymerase based on the following information: • Synthesizes the lagging strand during replication

DNA polymerase-α

Name the eukaryotic DNA polymerase based on the following information: • Replicates mitochondrial DNA

DNA polymerase-γ

Name the eukaryotic DNA polymerase based on the following information: • Synthesizes the leading strand during replication

DNA polymerase-δ

What aspects of sleep are affected during benzodiazepine use?

REM and stage 4 sleep; they decrease.

What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia, tetany, and T-cell deficiency?

DiGeorge syndrome

What T cell deficiency syndrome is associated with facial anomalies, hypoparathyroidism, thymic hypoplasia, and recurrent viral and fungal infections?

DiGeorge syndrome, which is due to a failure of the third and fourth pharyngeal pouch development. Remember, B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections

What immunologic syndrome is due to a pharyngeal pouch 3 and 4 failure?

DiGeorge's syndrome

Name the most common cause. • Blindness in the United States

Diabetes mellitus

From which two substances are phospholipids made?

Diacylglycerols and phosphatidic acid

What is the period between falling asleep and REM sleep called?

REM latency; normally it is about 90 minutes.

What aphasia is seen as an inability to comprehend spoken language and speaking in a word salad?

Receptive aphasia is due to a lesion in Brodmann areas 22, 39, and 40; generally the patient is unaware of the deficit.

What scale has a true zero point, graded into equal increments, and also orders them?

Ratio scale

Name these anxiety defense mechanisms: • Use of explanations to justify unacceptable behaviors.

Rationalization

Is most of the coronary artery blood flow during systole or diastole?

Diastole. During systole the left ventricle contracts, resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.

What are the longest-acting and shortest-acting benzodiazepines?

Diazepam is longest acting and midazolam is shortest acting.

Which direct-acting vasodilator is used clinically to treat hypertensive emergencies, insulinomas, and as a uterine smooth muscle relaxant?

Diazoxide

What is the drug of choice for filariasis and onchocerciasis?

Diethylcarbamazine

Based on operant conditioning, what type of reinforcement is described when • Removing a stimulus stops a behavior?

Extinction

What operant conditioning therapy or modification is described as • Stopping the reinforcement that is leading to an undesired behavior?

Extinction

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?

Dorsal motor nucleus of CN X

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)

Dorsal prefrontal cortex

Clarke's nucleus is the second ascending sensory neuron of which spinocerebellar tract?

Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.

What type of random controlled test is least subjective to bias?

Double-blind study. It is the most scientifically rigorous study known.

What is the MCC of inherited mental retardation?

Down syndrome

What is the most common chromosomal disorder?

Down syndrome

What is the most common genetic cause of mental retardation?

Down syndrome (it is slightly more common than fragile X syndrome.)

Name the most common one. • Chromosomal disorder

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?

Down syndrome (trisomy 21)

What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?

Excision endonuclease, which removes thiamine dimers from DNA

Is excretion greater than or less than filtration for net secretion to occur?

Excretion is greater than filtration for net secretion to occur.

What paraphilia is defined as • Having a recurrent desire to expose the genitals to strangers?

Exhibitionism

Why is spermatogenesis decreased with anabolic steroid therapy?

Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone, produced by Leydig cells, is needed for spermatogenesis.

Name the lung measurement based on the following descriptions: • Additional volume that can be expired after normal expiration

Expiratory reserve volume (ERV)

What classical conditioning therapy or modification is described as • Forcing patients to confront their fears by being exposed to them until they are extinguished?

Exposure

What aphasia produces a nonfluent pattern of speech with the abilty to understand written and spoken language seen in lesions in the dominant hemisphere?

Expressive aphasia

What bonds are broken by exonucleases?

External 3', 5' PDE bonds

What disorder is associated with jaundice, white stools, and dark urine due to biliary duct occlusion secondary to incomplete recanalization?

Extrahepatic biliary atresia

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?

External abdominal oblique

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?

Reiter syndrome

If the P value is less than or equal to .05, what do you do to the null hypothesis?

Reject it

What period is described when a larger-than-normal stimulus is needed to produce an action potential?

Relative refractory period

What statistical method do you use when analyzing • Cohort studies?

Relative risk and/or attributable risk. (Cohort studies deal with incidence.)

What happens to the intrapleural pressure when the diaphragm relaxes?

Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).

What is the term for the ability of a test to measure something consistently?

Reliability (think of it as "nice grouping" or "precise")

What chronic systemic inflammatory disease commonly seen in women aged 20 to 50 is a progressive, symmetric arthritis affecting the hands, wrists, knees, and ankles that improves with increased activity?

Rheumatoid arthritis

What is the most common one? • Inflammatory arthritis

Rheumatoid arthritis

What diseases are associated with HLA-DR4

Rheumatoid arthritis and type 1 diabetes (with HLA-DR3)

Name the most common cause. • A cold in the spring and fall

Rhinovirus

What are the only two picornaviruses that do not lead to aseptic meningitis?

Rhinovirus and hepatitis A virus

Which virus is the MCC of a cold in the summer and fall? Winter and spring?

Rhinoviruses for summer and fall; coronaviruses for winter and spring

True or false? All of the following are inactivated vaccines available in the United States: influenza, Vibrio cholera, hepatitis A, rabies, and adenovirus.

False. Adenovirus vaccine is a live pathogenic virus in an enteric coated capsule. All of the others are inactivated vaccines.

True or false? A positive PPD skin test indicates the patient has active pulmonary disease.

False. The PPD tests exposure to TB.

True or false? Raynaud's phenomenon has no underlying pathology.

False. The disease has no associated pathology; the phenomenon is arterial insufficiency due to an underlying disease.

True or false? The faster the rate of absorption, the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).

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 gallbladder functions to produce bile.

False. The gallbladder does not produce bile, but it concentrates bile via active sodium transport; water follows the sodium.

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.

False. These beliefs are characteristic of people with an external locus of control.

What is given to pregnant women within 24 hours after birth to eliminate Rh+ fetal blood cells from their circulation?

Rho (D) immune globulin (RhoGAM), an anti-RhD IgG antibody, prevents generation of RhD-specific memory B cells in the mother.

What substance is used to test platelets' response in patients with von Willebrand disease?

Ristocetin

What two β2-agonists cause myometrial relaxation?

Ritodrine and terbutaline

Which organism causes trench fever?

Rochalimaea quintana (now called Bartonella quintana)

What cells of the retina see in black and white and are used for night vision?

Rods

Name the most common type or cause. • Diarrhea in children

Rotavirus

Name the most common type or cause. • Infantile diarrhea

Rotavirus

What organism is associated with the following types of diarrhea? Day care-associated diarrhea in infants

Rotavirus

Name the following descriptions associated with bacterial endocarditis: • Retinal emboli

Roth spots

What is the best measure of total body vitamin D if you suspect a deficiency?

Serum 25-hydroxy-vitamin D (25-OH-D)

What is the term for white retinal spots surrounded by hemorrhage? In what condition are they seen?

Roth spots, and they are seen in bacterial endocarditis.

What two ligaments of the uterus are remnants of the gubernaculum?

Round and ovarian ligaments

What are the four signs of acute inflammation?

Rubor (red), dolor (pain), calor (heat), tumor (swelling); also sometimes there is loss of function

What is the main mechanism for exchange of nutrients and gases across a capillary membrane?

Simple diffusion; it does not use protein-mediated transport

DNA replication occurs during what phase of the cell cycle?

S phase

Name the phase of the eukaryotic cell cycle: • Period of DNA replication (preparing for mitosis)

S phase

What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Mercaptopurine

S phase

What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Thioguanine

S phase

What phase of the cell cycle are the following antineoplastic agents specific for? • Cytarabine

S phase

What phase of the cell cycle are the following antineoplastic agents specific for? • Hydroxyurea

S phase

What enzyme is used to remove the hairpin loop during production of cDNA from mRNA?

S1 nuclease

What spinal nerves contribute to the pelvic splanchnic (parasympathetic) nerves that innervate the detrusor muscle of the urinary bladder?

S2, S3, S4—keeps the pee-pee off the floor!

What cell in the heart has the highest rate of automaticity?

SA node; it is the reason it is the primary pacemaker of the heart.

True or false? Obesity, DM, HTN, multiparity, early menarche, and late menopause are all risk factors for endometrial carcinoma.

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? Tetracyclines are bactericidal.

False. They are bacteriostatic.

True or false? Thyroid size is a measure of its function.

False. Thyroid size is a measure of TSH levels (which are goitrogenic).

True or false? Glucose readily diffuses across the blood-brain barrier.

False. Water readily diffuses across the blood-brain barrier, but glucose requires carrier-mediated transport.

True or false? A patient has to prove his or her competency.

False. You need clear evidence the patient is not competent; if you are unsure, assume the patient is competent.

True or false? Hyperkalemia increases the effect of digoxin.

False. hyperkalemia decreases digoxin's activity, while hypokalemia, hypomagnesemia, and hypercalcemia all increase digoxin toxicity.

True or false? The increased oxygen consumption after phagocytosis is for ATP production.

False; it is for the production of toxic metabolites.

Is filtration greater than or less than excretion for net reabsorption to occur?

Filtration is greater than excretion for net reabsorption to occur.

If capillary hydrostatic pressure is greater than oncotic pressure, is filtration or reabsorption promoted?

Filtration; if hydrostatic pressure is less than oncotic pressure, reabsorption is promoted.

What agent used in the treatment of BPH and baldness is a 5-α-reductase inhibitor?

Finasteride

From what pharyngeal pouch is the following structure derived? • Middle ear

First M PITS for pharyngeal pouch derivatives

From what aortic arch are the following structures derived? • Maxillary artery

First MS CARD is my mnemonic for the aortic arch derivatives

From what pharyngeal groove is the external auditory meatus derived?

First pharyngeal groove; all others degenerate.

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

First-order elimination

When a drug is administered orally and enters into portal circulation, it undergoes hepatic metabolism. What is the name of this effect?

First-pass effect

What two factors influence low oral bioavailability?

First-pass metabolism and acid lability

What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?

Fitz-Hugh-Curtis syndrome

How many pairs of spinal nerves are associated with • Lumbar vertebrae?

Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.

How many pairs of spinal nerves are associated with • Sacral vertebrae?

Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.

What is the term for failure to give up infantile patterns of behavior for mature ones?

Fixation (arrested development)

What type of scheduled reinforcement states that after a desired response, the reinforcement is given • On a set time schedule?

Fixed interval

What type of scheduled reinforcement states that after a desired response, the reinforcement is given • After a set number of responses?

Fixed ratio (rewards set behaviors)

What antiviral agent for ganciclovir-resistant infections has limited utility because of its nephrotoxic side effect?

Foscarnet

What are the adult remnants of the following structures? • Foramen ovale

Fossa ovale

How many mature sperm are produced by one type B spermatogonium?

Four

What are the five branches of the median cord of the brachial plexus?

Four Ms and a U 1. Median 2. Medial antebrachial 3. Medial pectoral 4. Medial brachial cutaneus 5. Ulnar

How many high-energy bonds does the cycle of elongation cost?

Four high energy bonds, two from ATP in AA activation and two from GTP

What sphingolipid cannot be produced without sialic acid and amino sugars?

Ganglioside

Name the type of necrosis. • Seen as dead tissue with coagulative necrosis

Gangrenous necrosis

What is the name of hydrophilic pores that allow the direct passage of ions and particles between two adjacent cells?

Gap junctions

In what X-linked recessive disease is there a decrease in the HMP shunt, along with Heinz body formation?

G-6-PD deficiency

What is the most common genetic deficiency resulting in hemolytic anemia?

G-6-PD deficiency; pyruvate kinase deficiency is second.

What AD GI neoplasia produces multiple adenomatous polyps, osteomas, fibromas, and epidural inclusion cysts?

Gardner syndrome

Clue cells are associated with which organism that causes vaginal discharge?

Gardnerella vaginalis

Would a G-C or an A-T rich dsDNA sequence have a higher melting point? Why?

G-C rich sequences, because they have 3 hydrogen bonds, where A-T has 2 hydrogen bonds, resulting in higher melting points.

Name the phase of the eukaryotic cell cycle: • Cells cease replicating (i.e., nerve cell)

G0 phase

What phase of the cell cycle are the following antineoplastic agents specific for? • Alkylating agents

G0 phase

What phase of the cell cycle are the following antineoplastic agents specific for? • Cisplatin

G0 phase

What phase of the cell cycle are the following antineoplastic agents specific for? • Dacarbazine

G0 phase

What phase of the cell cycle are the following antineoplastic agents specific for? • Nitrosoureas

G0 phase

Name the phase of the eukaryotic cell cycle: • Period of cellular growth (translation and transcription) before DNA synthesis

G1 phase (gap 1)

What phase of Interphase is haploid (N)?

G1 phase; G2 and S phase are diploid (2N).

What phase of the cell cycle are the following antineoplastic agents specific for? • Bleomycin

G2 phase

Name the phase of the eukaryotic cell cycle: • Period of cellular growth (translation and transcription) after DNA synthesis

G2 phase (gap 2)

Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Nitrosamines

Gastric cancer

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: no change; body: no change

Gain of isotonic fluid (isotonic saline)

To what does aldose reductase convert galactose?

Galactitol

What two monosaccharides are produced when lactose is hydrolyzed?

Galactose and glucose

Regarding the Lac operon, for what do the following genes code? • Y gene

Galactoside permease

What form of the Plasmodium species is ingested by mosquitoes?

Gametocytes

What is the DOC for CMV retinitis?

Ganciclovir

What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA?

SER

What is the tetrad of tetralogy of Fallot?

SHIP: Shifting of the aorta, Hypertrophy of the right ventricle, Interventricular septal defect, Pulmonary stenosis

What muscles make up the rotator cuff?

SITS—Subscapularis, Infraspinatus, Teres minor, Supraspinatus

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?

SLE; ANA, anti-dsDNA and anti-Sm (anti-Smith)

What is the most widely used class of antidepressants?

SSRIs

What are the five branches of the posterior cord of the brachial plexus?

STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis

What part of the inner ear contains the gravity receptors for changes in the position of the head?

Saccule and utricle

What tumor is derived from primitive streak remnants and often contains bone, hair, or other tissue types?

Sacrococcygeal teratoma

True or false? Only men have refractory sexual periods.

Sad but true. Some women can have multiple successive orgasms.

What paraphilia is defined as • Deriving sexual pleasure from other peoples' pain?

Sadism

What β2-agonist is used as a prophylactic agent in the treatment of asthma?

Salmeterol

What Enterobacteriaceae are prone to produce osteomyelitis in sickle cell patients?

Salmonella

What Vi-encapsulated gram-negative motile anaerobic rod that produces H2S is associated with enteric fever, gastroenteritis, and septicemia?

Salmonella typhi

What is the term for pelvic inflammatory disease of the fallopian tubes?

Salpingitis

What term describes how an action potential is propagated along an axon?

Saltatory conduction

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?

Sarcoidosis

What is the name of the SER of striated muscle?

Sarcoplasmic reticulum

Via what cell surface receptor does HDL cholesterol from the periphery enter hepatoceles?

Scavenger receptor (SR-B1)

What ring is a weblike narrowing of the gastroesophageal junction?

Schatzki ring

Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?

Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent

What is the term for RBC fragments?

Schistocytes

What parasite is associated with squamous cell carcinoma of the urinary bladder?

Schistosoma haematobium

Which trematode is associated with bladder carcinoma in Egypt and Africa?

Schistosoma haematobium

What is the only trematode that is not hermaphroditic?

Schistosoma have separate males and females.

Name these cluster A personality disorders: • Socially withdrawn, seen as eccentric but happy to be alone

Schizoid

Name these cluster A personality disorders: • Odd, strange; has magical thinking; socially isolated, paranoid, lacks close friends; has incongruous affect

Schizotypal

To what does failure to resolve separation anxiety lead?

School phobia

What CNS tumor commonly produces tinnitus and hearing loss?

Schwannoma

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

Sciatic nerve

What disease is diagnosed by findings of ANAs and anti-SCL-70 antibodies?

Scleroderma

What pathology involves excessive fibrosis throughout the body via increased fibroblast activity, occurs in women more than men, and is most commonly seen in the third to the fifth decade?

Scleroderma

What syndrome is characterized by sweating, insomnia, nausea, diarrhea, cramps, delirium, and general restlessness secondary to MAOI and SSRI in combination?

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.

Name the type of exudate, given the following examples. • Sunburn

Serous exudates

Which bacteria are associated with the following pigment production? • Red pigmentation

Serratia

What muscle or muscles are innervated by the following nerves? • Long thoracic nerve

Serratus anterior

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?

Gastric carcinoma

Signet ring cells

Gastric carcinoma

What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?

Gastric ulcer

What parasympathetic neurotransmitter of the GI tract stimulates the release of gastrin?

Gastrin-releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)

What pancreatic islet cell tumor is associated with MEN I syndrome?

Gastrinoma

What disorder is due to a deficiency in the enzyme glucocerebrosidase?

Gaucher disease

What is the most common lysosomal storage disorder?

Gaucher disease

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?

Generalized anxiety disorder

Do genomic or cDNA libraries contain introns, exons, promoters, enhancers, and are they fragmented?

Genomic libraries are made from nuclear DNA, are fragmented, and contain all sequences found in the particular genome copied.

What syndrome is described by a lesion in the angular gyrus (area 39) resulting in alexia, agraphia, acalculia, finger agnosia, and right-left disorientation?

Gerstmann's syndrome; spoken language is usually understood.

What malignant tumor of the trophoblast causes high levels of hCG and may occur after a hydatidiform mole, abortion, or normal pregnancy?

Gestational trophoblastic neoplasia (GTN or choriocarcinoma)

What malignant neoplasm of the bone has a soap bubble appearance on radiograph?

Giant cell bone tumor (osteoclastoma)

Soap bubble appearance on radiograph

Giant cell tumor of the bone

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?

Giardia lamblia (treat with metronidazole)

What does prepubertal hypersecretion of growth hormone lead to?

Gigantism

What disease has a genetically low level of UDPglucuronate transferase, resulting in elevated free unconjugated bilirubin?

Gilbert's syndrome

What AR disorder is due to a deficiency in glycoprotein IIb-IIIa, resulting in a defect in platelet aggregation?

Glanzmann syndrome

Pseudopalisades

Glioblastoma multiforme

What is the most common one? • Primary CNS tumor

Glioblastoma multiforme

What is the most common one? • Primary CNS tumor in adults

Glioblastoma multiforme

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

Global aphasia

What is the main factor determining GFR?

Glomerular capillary pressure (increased glomerular capillary pressure, increased GFR and vice versa)

What CN is associated with the sensory innervation of • Oropharynx?

Glossopharyngeal nerve

Name the hormone—glucagon, insulin, or epinephrine: • Glycogenolytic, gluconeogenic, lipolytic, glycolytic, proteolytic, and stimulated by hypoglycemia and AAs

Glucagon

What two stress hormones are under the permissive action of cortisol?

Glucagon and epinephrine

What lysosomal enzyme is deficient in • Gaucher's disease?

Glucocerebrosidase

What two classes of drugs can cause schizoid behavior?

Glucocorticoids and amphetamines

What glycolytic enzyme has a high Vmax, high Km, and low affinity for glucose?

Glucokinase

What two sugars can be used to produce cerebrosides?

Glucose and galactose

What enzyme is deficient in the following glycogen storage disease? • von Gierke's disease

Glucose-6-phosphatase

What gluconeogenic enzyme is absent in muscle, accounting for its inability to use glycogen as a source for blood glucose?

Glucose-6-phosphatase

What substrate gets built up in Gaucher's disease?

Glucosyl cerebroside

What enzyme system is the most common form of phase II biotransformation?

Glucuronidation

What AA is a precursor of the following substances? • GABA

Glutamate

What neurotransmitter inhibits the optic nerve bipolar cell and shuts off in response to light?

Glutamate

What enzyme catalyzes the reversible oxidative deamination of glutamate and produces the TCA cycle intermediate α-ketoglutarate?

Glutamate dehydrogenase

What AA is the major carrier of nitrogen byproducts from most tissues in the body?

Glutamine

What two AAs act as excitatory transmitters in the CNS, generating EPSPs?

Glutamine and aspartate

What is the largest muscle in the body?

Gluteus maximus

What is the enzyme for the oxidative reaction in glycolysis?

Glyceraldehyde dehydrogenase

What liver enzyme, for triglyceride synthesis, converts glycerol to glycerol-3-phosphate?

Glycerol kinase

What are the two precursors of heme?

Glycine and succinyl-CoA

What AA is a precursor of the following substances? • Creatine

Glycine/arginine

What enzyme catalyzes the rate-limiting step in glycogenolysis?

Glycogen phosphorylase

What is the rate-limiting enzyme of glycogen synthesis?

Glycogen synthase

What hypothalamic hormone is synthesized in the preoptic nucleus?

GnRH

What hormone disorder is characterized by the following abnormalities in sex steroids↑, LH↓, and FSH↓? • Sex steroids , LH , FSH ?

GnRH constant infusion

What is it called when levels of sex steroids increase, LH increases, and FSH increases?

GnRH pulsatile infusion

What encapsulated group of nerve endings seen at the muscle-tendon junction responds to an increase in tension generated in that muscle? (This is dropping a box that is too heavy to carry.)

Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.

What embryonic structure forms the adult female structures? • Ovary, follicles, rete ovarii

Gonads

What embryonic structure forms the adult male structure? • Testes, seminiferous tubules, and rete testes

Gonads

Name the most common reported STD. • In males

Gonorrhea

What law was adopted to shield physicians from liability when helping at the scene of an accident?

Good Samaritan Law. (Physicians are not required to stop and help.)

Name the nephritic disease based on the immunofluorescent staining. • Smooth and linear pattern of IgG and C3 in the GBM

Goodpasture disease

What syndrome is due to anti-GBM Abs directed against the lung and kidneys?

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?

Goodpasture syndrome

Upon seeing negatively birefringent needle-shaped crystals from a joint aspiration of the great toe, what form of arthritis do you diagnose?

Gout

What pathology is associated with podagra, tophi in the ear, and PMNs with monosodium urate crystals?

Gout

Oxidation of Hgb forms what bodies in patients with G-6-PD deficiency?

Heinz bodies

What DNA replication enzyme breaks the hydrogen bond of base pairing, forming two replication forks?

Helicase (requires ATP for energy)

What motile, gram-negative spiral bacillus with flagella is oxidase positive, urease positive, and associated with gastritis, peptic ulcer disease, and stomach cancer?

Helicobacter pylori

What two viruses get their envelope not from budding but from coding?

HIV and poxvirus

What urease-producing gram-negative curved rod is associated with PUD and chronic gastritis?

Helicobacter pylori, which is also associated with an increased risk of gastric carcinoma

What is characterized by an intense inflammatory reaction, an increase in the amounts of granulation tissue and wound contraction by myofibroblasts?

Healing by secondary intention

What is the MCC of death in the United States?

Heart disease

Does the heart rate determine the diastolic or systolic interval?

Heart rate determines the diastolic interval, and contractility determines the systolic interval.

What three organs can be affected by Trypanosoma cruzi?

Heart, esophagus, and colon. Remember, you get megas: cardiomegaly, megaesophagus, and megacolon.

What vascular tumor associated with von Hippel-Lindau syndrome involves the cerebellum, brainstem, spinal cord, and retina?

Hemangioblastoma

What is the most common one? • Primary tumor of the liver

Hemangioma (benign)

What is the most common one? • Route for infectious arthritis

Hematogenous

What is the most common one? • Route of spread in pyogenic osteomyelitis

Hematogenous

Do the following structures pick up stain from hematoxylin or eosin? • Bacteria

Hematoxylin

Do the following structures pick up stain from hematoxylin or eosin? • Calcium

Hematoxylin

Do the following structures pick up stain from hematoxylin or eosin? • Nuclei

Hematoxylin

Do the following structures pick up stain from hematoxylin or eosin? • Nucleoli

Hematoxylin

What cell is under control of FSH and testosterone; secretes inhibin, MIF, and androgen-binding protein; and phagocytizes the excess cytoplasm of the spermatid?

Sertoli cell

What type of chromatin is transcriptionally inactive?

Heterochromatin, the light stuff in the nucleus on an electron microscope image.

What lysosomal enzyme is deficient in • Tay-Sachs disease?

Hexosaminidase A

What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?

Hgb F

What is the label given to an individual whose IQ is • 110 to 119

High average

What type of saliva is produced under parasympathetic stimulation?

High volume, watery solution; sympathetic stimulation results in thick, mucoid saliva.

Name the most common type or cause. • Neonatal bowel obstruction

Hirschsprung disease

What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon?

Hirschsprung disease (aganglionic megacolon)

What disease results in a failure of neural crest cells to migrate to the myenteric plexus of the sigmoid colon and rectum?

Hirschsprung's disease (colonic gangliosus)

IgE-mediated mast cell release, C3a and C5a, and IL-1 all trigger the release of what vasoactive amine?

Histamine

What are the primary neurotransmitters at the following sites? • The hypothalamus

Histamine

What neurotransmitter is associated with sedation and weight gain?

Histamine

What AA is a precursor of the following substances? • Histamine

Histidine

What AA is classified as basic even though its pK is 6.5 to 7?

Histidine, because of the imidazole ring found in the R group, is basic.

Name the macrophage based on its location: • Connective tissue macrophages

Histiocytes

Birbeck granules

Histiocytosis X

What malignant tumor of the skin is associated with Birbeck granules?

Histiocytosis X

Which of the following—DNA methylating enzymes, scaffolding proteins, histone acetylases, or deacetylases—is a regulator of eukaryotic gene expression?

Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.

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?

Histoplasma capsulatum

What facultative intracellular fungus is associated with hepatosplenomegaly?

Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.

Name the cluster B personality disorder: • Colorful, dramatic, extroverted, seductive, and unable to hold long-term relationships

Histrionic

Reed-Sternberg cells

Hodgkin lymphoma

What group of eukaryotic regulatory proteins has a major factor in controlling the gene expression embryonically?

Homeodomain proteins

What is the MCC of death in black males aged 15 to 24?

Homicide. It is also the leading cause of death in black females aged 15 to 24.

What is the only enzyme in the body that uses N-5-methyl folate?

Homocysteine methyl transferase

What two enzymes are vitamin B12-dependent

Homocysteine methyl transferase and methylmalonyl CoA transferase

What enzyme deficiency results in darkening of the urine when exposed to air?

Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

What enzyme is deficient in alkaptonuria?

Homogentisic oxidase

What are the two functions of the thymus in T-cell differentiation?

Hormone secretion for T-cell differentiation and T-cell education to recognize self from nonself

What hormone is activated in adipose tissue when blood glucose levels decrease?

Hormone-sensitive lipase

What hormone, stimulated by epinephrine, results in an increase in lipolysis?

Hormone-sensitive lipase, which breaks down triglyceride into glycerol and free fatty acid

What color do fungi stain with PAS? Silver stain?

Hot pink with PAS and grey to black with silver stain

What is the name of inflammation of the prepatellar bursa?

Housemaid's knee

What is the term for RBC remnants of nuclear chromatin in asplenic patients?

Howell-Jolly bodies

What is the term for an increase in the number of cells in a tissue?

Hyperplasia

What is the term for the negative resting membrane potential becoming more negative?

Hyperpolarization (i.e., K+ influx)

What is the first sign of megaloblastic anemia on a peripheral blood smear?

Hypersegmented neutrophils

What is the primary predisposing factor for vascular dementia?

Hypertension

What cardiomyopathy is due to a ventricular outflow obstruction as a result of septal hypertrophy and leads to sudden cardiac death in young athletes?

Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis, or IHSS)

Projectile nonbilious vomiting and a small knot at the right costal margin (olive sign) are hallmarks of what embryonic disorder?

Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa, resulting in a narrowed pyloric outlet

What is the term for excessive production of collagen that flattens out and does not extend beyond the site of the injury?

Hypertrophic scar

What is the term to describe the increase in organ size due to the increase in cell size and function?

Hypertrophy

What region of the Ig does not change with class switching?

Hypervariable region

Which region of the variable domain comprises the Ag-binding site of the Ab?

Hypervariable region (three per light chain; three per heavy chain)

What is the respiratory compensation mechanism for metabolic acidosis?

Hyperventilation, which decreases CO2, shifting the reaction to the left and decreasing H+

What type of hallucination occurs during awakening?

Hypnopompic hallucinations occur during awakening, whereas hypnagogic hallucinations occur while one is falling asleep.

What form of Plasmodium species affects the liver?

Hypnozoite

What is the term for a deficiency or absence of sexual fantasies or desires?

Hypoactive sexual desire disorder

1-α-Hydroxylase activity is increased in response to what two physiologic states? (hint: think of vitamin D activity)

Hypocalcemia and hypophosphatemia

What somatoform disorder is described as • Preoccupied with illness or death, persisting despite reassurance, lasting longer than 6 months?

Hypochondriasis (they will begin with "I think I have...")

What is the most potent stimulus for glucagon secretion? Inhibition?

Hypoglycemia for secretion and hyperglycemia for inhibition

What acid-base disturbance occurs in colonic diarrhea

Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.

What acid-base disturbance is produced from vomiting?

Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+, K+, and Cl-.

What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate?

Hypoparathyroidism

What is the term for the external urethra opening onto the ventral surface of the penis?

Hypospadia

What catecholamine-hypersecreting tumor, a secondary cause of HTN, results in headache, diaphoresis, anxiety, tachycardia, and palpitations?

Pheochromocytoma

What is the rate-limiting enzyme on glycolysis?

Phosphofructokinase-1 and costs 1 ATP

What signals are used to direct an enzyme to a lysosome?

Phosphorylation of mannose residues

What is the treatment for physiologic jaundice of newborns?

Phototherapy

Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?

Physiologic antagonism

Anatomical and alveolar dead spaces together constitute what space?

Physiologic dead space is the total dead space of the respiratory system.

Name the antidote. • Anticholinergics

Physostigmine

Name the antidote. • Atropine

Physostigmine

What protective covering adheres to the spinal cord and CNS tissue?

Pia mater

What rare form of dementia is associated with personality changes and affects the frontal and temporal lobes?

Pick's disease

To what viral family does the polio virus belong?

Picornaviridae

What is the drug of choice for treating Tourette syndrome?

Pimozide

What are the three signs of morphine overdose?

Pinpoint pupils, decreased respiratory rate, and coma

What drug is an M1-specific antispasmodic?

Pirenzepine

Name the most common type or cause. • Cushing syndrome

Pituitary adenoma

What IL down-regulates cell mediated immunity?

IL-10

What IL do T cells secrete to induce T-and B-cell division?

IL-2. T cells express IL-2 receptors on their surface to induce self-expression.

What IL is important in myeloid cell development?

IL-3 (3 face down is an M)

Which IL is associated with increases of IgG and IgE?

IL-4

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?

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 cytokines do Th2 cells secrete to inhibit Th1 cell function?

IL-4, IL-10, and IL-13

Which IL increases IgA synthesis?

IL-5. It also stimulates eosinophil proliferation.

What IL is essential for lymphoid cell development?

IL-7 (A 7 upside down is an L; L is for Lymphoid)

What is the name of the major chemotactic agent released from • Macrophages?

IL-8 (IL-1 and TNF-gamma also)

What IL, produced by macrophages, is chemotactic for neutrophils?

IL-8. It not only is chemotactic, it also acts as an adhesive for neutrophils.

What cytokine do Th1 cells secrete to inhibit Th2 cell function?

INF-gamma

What is defined as a general estimate of the functional capacities of a human?

IQ

What structure or structures cross the diaphragm at • T8 level?

IVC Remember: 1 at T8, 2 at T10, and 3 at T12

What hormone disorder is characterized by the following abnormalities in sex steroids↓, LH↓, and FSH↓? • Sex steroids , LH , FSH

Pituitary hypogonadism

What tumor marker is associated with seminomas?

Placental alkaline phosphatase

What is the function of the cerebellum?

Planning and fine-tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember, the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.

What type of cell can never leave the lymph node?

Plasma cell

What is the name of the B cell that secretes Ig?

Plasma cell (mature B lymphocyte)

What two factors determine the clearance of a substance?

Plasma concentration and excretion rate

What protein causes fibrinolysis?

Plasmin

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

Plasmodium falciparum

What type of Plasmodium affects • RBCs of all ages?

Plasmodium falciparum

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

Plasmodium malariae

What type of Plasmodium affects • Only mature RBCs?

Plasmodium malariae

What is the only Plasmodium that is quartan?

Plasmodium malariae; the others are tertian.

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

Plasmodium ovale

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

Plasmodium vivax

What type of Plasmodium affects • Only reticulocytes?

Plasmodium vivax

What syndrome is seen in iron-deficient middle-aged women with esophageal webs?

Plummer-Vinson syndrome

Name the most common type or cause. • Meningitis in adults

Pneumococcus

Name the most common type or cause. • Sinusitis and otitis media in children

Pneumococcus

Describe the organism based on the following information: • Alpha-Hemolytic Streptococcus; lysed by bile; sensitive to Optochin

Pneumococcus (Streptococcus pneumoniae)

Name the MCC. • Pneumonia in an HIV-positive patient with CD4 less than 200

Pneumocystis carinii

What is the most common infectious agent in HIV?

Pneumocystis carinii

What obligate extracellular fungus is silver stain-positive and is associated with pneumonia in patients with AIDS?

Pneumocystis carinii

What respiratory center in the rostral pons has an inhibitory affect on the apneustic center?

Pneumotaxic center (short, fast breaths)

What is the term for air in the pleural space?

Pneumothorax

What is the name of bilateral flaccid paralysis, hyporeflexia, and hypotonia due to a viral infection of the ventral horn of the spinal cord?

Poliomyelitis; it is a bilateral LMN lesion.

Name the most common type or cause. • Hypothyroidism in the United States

Iatrogenesis

Per Freud, with what part of the unconscious are sex and aggression (instincts) associated?

Id

What Freudian psyche component is described as • The urges, sex aggression, and "primitive" processes?

Id (pleasure principle)

What are defined by Ag-binding specificity?

Idiotypes

What is found in the R group if the AA is acidic? Basic?

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.

If free water clearance (CH2O) is positive, what type of urine is formed? And if it is negative?

If positive, hypotonic urine (osmolarity <300 mOsm/L); if negative, hypertonic urine (osmolarity > 300 mOsm/L)>>

What is the origin of the polyuria if a patient is dehydrated and electrolyte depleted?

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.

If the ratio of a substance's filtrate and plasma concentrations are equal, what is that substance's affect on the kidney?

If the ratio of the filtrate to plasma concentration of a substance is equal, the substance is freely filtered by the kidney.

What Ig activates the alternate pathway, neutralizes bacterial endotoxins and viruses, and prevents bacterial adherence?

IgA

What Ig is associated with mucosal surfaces and external secretions?

IgA

What Ig is the major protective factor in colostrum?

IgA

What Ig prevents bacterial adherence to mucosal surfaces?

IgA

What is the major Ig of the secondary immune response in the mucosal barriers?

IgA

Which immunoglobulin is secreted by the plasma cells in the gastrointestinal tract?

IgA

What is the most common Ig deficiency?

IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.

Name the most common type or cause. • GN in the world

IgA nephropathy

What form of nephritic syndrome is associated with celiac sprue and Henoch- Schönlein purpura?

IgA nephropathy

Name the nephritic disease based on the immunofluorescent staining. • Mesangial deposits of IgA and C3

IgA nephropathy (Berger disease)

What are the five Ig isotypes?

IgA, IgD, IgE, IgG, and IgM

What Ig is associated with Ag recognition receptor on the surface of mature B cells?

IgD; IgM is also correct.

What Ig is associated with ADCC for parasites?

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?

IgE

What Ig is associated with mast cell and basophil binding?

IgE. It attaches via receptor for the Fc region of the heavy epsilon chain

What Ig is responsible for activation of complement, opsonization, and ADCC and is actively transported across the placenta?

IgG

What Ig mediates ADCC via K cells, opsonizes, and is the Ig of the secondary immune response?

IgG

What is the major Ig of the secondary immune response?

IgG

What is the most common circulation Ig in the plasma?

IgG

What is the only Ig that crosses the placenta?

IgG

What subtype of IgG does not bind to staphylococcal A protein?

IgG3

What subtype of IgG does not activate complement cascade?

IgG4

Which IgG cannot activate complement?

IgG4

What Ig activates the complement cascade most efficiently?

IgM

What is the Ig associated with the primary immune response?

IgM

What is the first Ab a baby makes?

IgM

What is the major Ab of the primary immune response?

IgM

What is the first membrane-bound Ig on B cell membranes?

IgM; IgD follows shortly thereafter.

What area of the small intestine is characterized by Peyer's patches?

Ileum

What bactericidal agents are resistant to β-lactamases and are used to treat in-hospital life-threatening infections?

Imipenem and meropenem

During what stage of B-cell development is IgM first seen on the surface?

Immature B cells

What is the term for the inherent ability to induce a specific immune response?

Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.

What are the pharmacologic effects seen sexually with • α1-Blockers?

Impaired ejaculation

What are the pharmacologic effects seen sexually with • β-Blockers?

Impotence

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?

Polyarteritis nodosa

What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?

Polycystic kidney disease of childhood

Name the most common type or cause. • Anovulation

Polycystic ovaries

What female genital tract disorder is characterized by obesity, hirsutism, infertility, amenorrhea, elevated LH and testosterone levels, and low FSH levels?

Polycystic ovary disease (Stein-Leventhal syndrome)

When a person goes from supine to standing, what happens to the following? • Dependent venous blood volume

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

Increases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. --------------------------------------------------------------------------------

What is the only way to increase O2 delivery in the coronary circulation?

Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.

What type of hernia is described as passing through the deep lateral ring of the inguinal canal?

Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.

What type of bilirubin is found in neonatal jaundice?

Indirect or unconjugated

In what pathway of the basal ganglia do lesions result in hyperactive cortex with hyperkinetic, chorea, athetosis, tics, and dystonia?

Indirect pathway (Tourette syndrome for example)

What case is known as "let nature take its course"?

Infant Doe. Generally, parents cannot forego lifesaving treatment, but this case states that there are exceptions to the rule.

Name the most common type or cause. • Hematuria

Infection

What ocular muscle • Elevates and abducts the eyeball?

Inferior Oblique (CN III) (LR6 SO4)3

What are the five branches of the superior mesenteric artery?

Inferior pancreaticoduodenal, middle colic, right colic, ileocolic, and 10 to 15 intestinal arteries

What is the first branch of the abdominal artery?

Inferior phrenic artery

What ocular muscle • Depresses and adducts the eyeball?

Inferior rectus (CN III) (LR6 SO4)3

What is the most common one? • Histologic variant of breast cancer

Infiltrating ductal carcinoma

What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis?

Infliximab

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?

Internal abdominal oblique

Ophthalmic artery is a branch of what artery?

Internal carotid artery

The ophthalmic artery is a branch of what vessel?

Internal carotid artery

Name the structure that enters or exits the following foramina: • Carotid canal

Internal carotid artery and sympathetic plexus

What is the lymphatic drainage of the pelvic organs?

Internal iliac nodes

Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • Corticospinal tract?

Ipsilateral loss below the level of the lesion

What mineral, via excessive depositions in the liver, causes hemochromatosis?

Iron (Fe)

Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, percent saturation, and ferritin; increased TIBC

Iron deficiency anemia

What syndrome is characterized by dynein arm abnormality resulting in chronic sinusitis, recurrent pulmonary infections, and infertility?

Kartagener's syndrome (also known as immotile cilia syndrome) --------------------------------------------------------------------------------

What coronary artery vasculitis is seen in Japanese infants and children less than 4 years old with acute febrile illness, conjunctivitis, maculopapular rash, and lymphadenopathy?

Kawasaki disease

What is the name of a thin brown ring around the outer edge of the cornea, seen in Wilson's disease?

Kayser-Fleischer ring

What is the term for the copper corneal deposits found in Wilson's disease?

Kayser-Fleischer rings

What is the term for an abnormal amount of collagen type III that produces a large bulging scar, seen primarily in blacks?

Keloid

What cells of the epidermis carry the pigment melanin?

Keratinocytes, the most numerous cells in the epidermis, carry melanin and produce keratin.

What is the only anesthetic that causes cardiovascular stimulation?

Ketamine

What syndrome is associated with the following brainstem lesions? • Occlusion of the PICA, resulting in ipsilateral limb ataxia, ipsilateral facial pain and temperature loss, contralateral pain and body temperature loss, ipsilateral Horner's syndrome, and ipsilateral paralysis of the vocal cords, palate droop, dysphagia, nystagmus, vomiting, and vertigo

Lateral medullary (Wallenberg's) syndrome

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

LGB (think EYES)

For what hormone do Leydig cells have receptors?

LH

The surge of what hormone induces ovulation?

LH

What is the effect of LH on the production of adrenal androgens?

LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.

Name the product or products of arachidonic acid: • Chemotactic for neutrophils

LTB4

Which leukotriene is chemotactic for neutrophils?

LTB4

Which leukotriene—LTA4, LTB4, LTC4, or LTD4—is not associated with anaphylaxis and bronchoconstriction?

LTB4

Which leukotrienes are associated with the late-phase inflammatory response?

LTC4 and LTD4

Name the product or products of arachidonic acid: • Vasodilation, bronchospasm, and increased vascular permeability

LTC4, LTD4, and LTE4

What are the two best indices of left ventricular preload?

LVEDV and LVEDP (left ventricular end-diastolic volume and end-diastolic pressure, respectively)

What β-blocker is also an α-blocker?

Labetalol

Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Epidermis

Labile

Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Hematopoietic cells

Labile

Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Mucosal epithelium

Labile

What embryonic structure forms the adult female structures? • Labia majora

Labioscrotal swelling

What embryonic structure forms the adult male structure? • Scrotum

Labioscrotal swelling

Regarding the Lac operon, for what do the following genes code? • I gene

Lac repressor protein

What two requirements must be met for the Lac operon to be activated?

Lactose must be present and glucose must be absent

Which laxative is used in the treatment of hepatic encephalopathy ?

Lactulose

What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor?

Laminin

Name the macrophage based on its location: • Epidermal macrophages

Langerhans cells

What cell type of the epidermis functions as antigen-presenting cells?

Langerhans cells (found in the stratum spinosum)

What segment of the gastrointestinal tract lacks villi, has crypts, and actively transports sodium out of its lumen?

Large intestine. Water is passively removed from the lumen.

Name the type of mutation: • Unequal crossover in meiosis with loss of protein function

Large segment deletions

In what stage of psychosexual development, according to Freud, do children resolve the Oedipus complex?

Latency stage (6-12 years)

What structure of the knee is described thus? • Prevents adduction

Lateral collateral ligament

Name the compartment of the lower extremity and the nerve based on its movements. • Plantar flex the foot and evert the foot

Lateral compartment of the leg, superficial peroneal nerve

Name the laryngeal muscle described by the following: • Adducts the vocal ligaments, closes the air passageway during swallowing, and allows phonation

Lateral cricoarytenoid muscles

What fissure of the cerebral cortex separates the frontal and temporal lobes rostrally and partially separates the parietal and temporal lobes?

Lateral fissure (fissure of Sylvius)

What area of the hypothalamus is the feeding center?

Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)

In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Is involved in motor planning?

Lateral part of the hemispheres

What are the two ketogenic AAs?

Leucine and lysine

Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Benzenes

Leukemias

Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Alkylating agents

Leukemias and lymphomas

What is the name of the major chemotactic agent released from • Neutrophils?

Leukotriene B4 (LTB4)

What GnRH analog is used as a repository form of treatment in prostatic cancer?

Leuprolide

What muscle is most superior in the orbit?

Levator palpebrae superioris

What is the term for the round intracytoplasmic eosinophilic inclusions containing ɑ-synuclein found in the dopaminergic neurons of the substantia nigra?

Lewy bodies

Reinke crystals

Leydig cell tumor

What sex cell tumor causes precocious puberty, masculinization, gynecomastia in adults, and crystalloids of Reinke?

Leydig cell tumor

What stromal tumor in males is characterized histologically with crystalloids of Reinke?

Leydig cell tumor

What cell of the male reproductive system produces testosterone?

Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)

What form of endocarditis do patients with SLE commonly encounter?

Libman-Sacks endocarditis

What is the most common one? • Cardiac pathology in patients with SLE

Libman-Sacks endocarditis

The duodenal-jejunal flexure is suspended from the posterior abdominal wall by what?

Ligament of Treitz

What are the adult remnants of the following structures? • Left umbilical vein

Ligament teres

What are the adult remnants of the following structures? • Ductus arteriosus

Ligamentum arteriosum

What are the adult remnants of the following structures? • Ductus venosus

Ligamentum venosum

Does light or darkness regulate the pineal gland?

Light regulates the activity of the pineal gland via the retinal-suprachiasmatic- pineal pathway.

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

Limbic system

Name the area of the cerebral cortex with the function described: • Motivation, memory, emotions, violent behaviors, sociosexual behaviors, conditioned responses

Limbic system

What nerve supplies general sensation to the anterior two-thirds of the tongue?

Lingual nerve of CN V3

What are the two essential fatty acids?

Linoleic acid and linolenic acid

What type of hormone is described as having intracellular receptors, being synthesized as needed, mostly bound to proteins, and having its activity determined by free hormone levels?

Lipid-soluble hormones are considered slow-acting hormones.

Name the most common type or cause. • Nephrotic syndrome in children

Lipoid nephrosis

What enzyme, induced by insulin and activated by apo C-II, is required for chylomicron and VLDL metabolism?

Lipoprotein lipase

What is the name of the pathway that produces leukotrienes?

Lipoxygenase pathway, from arachidonic acid

Name the type of necrosis. • Seen as dead tissue with liquefactive necrosis?

Liquefaction necrosis

Place in order from fastest to slowest the rate of gastric emptying for CHO, fat, liquids, and proteins.

Liquids, CHO, protein, fat

What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?

Lisch nodules

Name the insulin preparation based on the peak effect and duration of action. • Peak, 0.3 to 2 hours; duration, 3 to 4 hours

Lispro insulin

What gram-positive rod is distinguished by its tumbling motility?

Listeria

Name the most common type or cause. • Meningitis in renal transplantation patients

Listeria monocytogenes

What is the MCC of the following meningitides? • In renal transplant patients

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?

Listeria monocytogenes

What is the DOC for bipolar disorder?

Lithium

Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland?

Lithium

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?

Liver

What organ must metastasize for carcinoid heart disease to occur?

Liver

What is the primary target for the action of glucagon?

Liver (hepatocytes)

What are the three glycogenic organs?

Liver, kidney, and GI epithelium

What three organs are responsible for peripheral conversion of T4 to T3?

Liver, kidneys, and pituitary gland via 5' deiodinase enzyme

What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells, not a fixed number?

Log-kill hypothesis (follows first order kinetics)

Damage to what nerve will give you winged scapula?

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.

How can you differentiate between a medial temporal lobe and a hippocampal lesion based on memory impairment?

Long-term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.

What enzyme is deficient in the following glycogen storage disease? • Pompe's disease

Lysosomal α-1, 4-glucosidase

Which CNS ACh receptor or receptors are excitatory? Inhibitory?

M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.

Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?

M 2

What MHC class acts to remove foreign Ags from the body?

MHC class II Ags. This is accomplished via CD4 T cells.

Name the MCC of death. • In diabetic individuals

MI

What hormone, produced by Sertoli cells, if absent would result in the formation of internal female structures?

MIF

What genus is known as the smallest free living bacteria? (hint: has no cell wall and has sterols in the membrane)

Mycoplasma

On what layer of the epidermis does all mitosis occur?

Malpighian layer (made up of the stratum basale and stratum spinosum)

Which form of alcohol toxicity results in ocular damage?

Methanol

What form of alcohol causes blindness?

Methanol (wood alcohol)

Which penicillin can cause interstitial nephritis?

Methicillin

What two AAs do not have more than one codon?

Methionine (start) and tryptophan are the only two AAs with only one codon.

Name the MCC. • Walking pneumonia, seen in teens and military recruits

Mycoplasma pneumoniae

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

Medial medullary syndrome

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

Medial meniscus

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

Medial midbrain (Weber's) syndrome

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

Medial nuclear group (limbic system)

What atypical pneumonia can be diagnosed with elevated cold agglutinin titers?

Mycoplasma pneumoniae

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?

Mycosis fungoides (cutaneous T-cell lymphoma)

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

Medial pontine syndrome

What ocular muscle • Adducts the eyeball and is involved in horizontal conjugate gaze?

Medial rectus (CN III) (LR6 SO4)3

What are the adult remnants of the following structures? • Right and left umbilical arteries

Medial umbilical ligaments

What is the term for the point on a scale that divides the population into two equal parts?

Median (think of it as the halfway point)

What nerve is associated with the following functions? • Flex the wrist and digits, pronate the wrist and the LOAF (Lumbricales, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis) muscles of the hand

Median nerve

What nerve is compromised in carpal tunnel syndrome?

Median nerve

What nerve lesion presents with ape or simian hand as its sign?

Median nerve lesion

What is the most common one? • Primary CNS tumor in children

Medulla blastoma

Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Calcitonin

Medullary carcinoma of the thyroid

What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?

Medullary carcinoma of the thyroid

What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning?

Mees lines

What blood disorder is a side effect of metformin?

Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)

Macro-ovalocytes in the peripheral blood smear are formed from what cell in the bone marrow?

Megaloblasts

The separation of 46 homologous chromosomes without splitting of the centromeres occurs during what phase of meiosis?

Meiosis I; disjunction with centromere splitting occurs during meiosis II.

What endogenous pigment found in the substantia nigra and melanocytes is formed by the oxidation of tyrosine to dihydroxyphenylalanine?

Melanin

What cell type of the epidermis originates from the neural crest?

Melanocytes

Name the cancer associated with the following oncogenes. (Some may have more than one answer) • CDK4

Melanoma

Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1 and int-2

Melanoma, cancer of the stomach and bladder

What is the term for black pigmentation of the colon associated with laxative abuse?

Melanosis coli

What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?

Melasma

Name the three hormones produced by pinealocytes.

Melatonin, serotonin, and CCK

What pineal hormone's release is inhibited by daylight and increased dramatically during sleep?

Melatonin. It is a light-sensitive hormone that is associated with sleepiness.

What is the term that refers to the number of channels open in a cell membrane?

Membrane conductance (think conductance = channels open)

What is the signal to open the voltage-gated transmembrane sodium channels?

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 potassium channels?

Membrane depolarization is the stimulus to open these slow channels, and if they are prevented from opening, it will slow down the repolarization phase.

Name the most common type or cause. • Nephrotic syndrome

Membranoproliferative glomerulonephritis (MGN)

What GN is highly associated with hepatitis B and C infections?

Membranoproliferative glomerulonephritis (MPGN)

What renal pathology involves uniform thickening of the glomerular capillary wall, granular appearance under the microscope, and effacement of foot processes?

Membranous glomerulonephritis

Is a membranous septal defect more commonly interventricular or interatrial?

Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.

What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies?

Meningioma

Name the form of spina bifida. • Meninges project through a vertebral defect

Meningocele All except occulta cause elevated-fetoprotein levels.

Which gram-negative diplococcus ferments maltose?

Meningococcus (Gonococcus does not)

Which gram-negative diplococcus grows on chocolate agar? Thayer- Martin medium?

Meningococcus grows on chocolate agar, and Gonococcus grows on Thayer-Martin medium.

Name the form of spina bifida. • Meninges and spinal cord project through a vertebral defect

Meningomyelocele All except occulta cause elevated-fetoprotein levels.

What is the term for days 1 to 7 of the female cycle?

Menses

What is the term for the first 3 to 5 days of the female reproductive cycle?

Menses. (Ovulation occurs 14 days before the beginning of menses.)

What is the label given to an individual whose IQ is • Below 69

Mentally disabled

What type of acute metal poisoning involves stomach and colon erosion and acute tubular necrosis?

Mercury

What cells of the epidermis, derived from the neural crest, act as mechanoreceptors?

Merkel cells (Merkel's tactile cells)

Which centrally acting α2-adrenergic agonist is safe for use in renal dysfunction and in HTN during pregnancy?

Methyldopa

Name the antidote. • Nitrates

Methylene blue

What is the drug of choice for treating ADHD?

Methylphenidate (Ritalin)

Name the antimicrobial agent whose major side effect is listed. • Teratogenicity

Metronidazole

What is the DOC for the following protozoal infections? • Amebiasis

Metronidazole

What is the DOC for the following protozoal infections? • Giardiasis

Metronidazole

What is the DOC for the following protozoal infections? • Trichomoniasis

Metronidazole

What is the DOC for treating Entamoeba histolytica, Giardia, Trichomonas, Bacillus fragilis, and Clostridium difficile infections?

Metronidazole

What myeloid disorder is characterized by dry bone marrow aspirations, splenomegaly, leukoerythroblastosis, teardrop RBCs, and hyperuricemia due to increased cell turnover?

Myelofibrosis with myeloid metaplasia

Name the macrophages by location: • Kidney

Mesangial macrophages

What component of the trigeminal nuclei • Forms the sensory component of the jaw jerk reflex?

Mesencephalic nucleus

Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Cerebral aqueduct

Mesencephalon

Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Midbrain

Mesencephalon

In what area of the brain can an excess of dopamine lead to psychotic symptoms?

Mesocortical area

What area of the brain is linked to emotion and movement?

Mesolimbic system

What embryonic structure forms the adult female structures? • Gartner's duct

Mesonephric duct

What embryonic structure forms the adult male structure? • Epididymis, ductus deferens, seminal vesicle, and ejaculatory duct

Mesonephric duct

What embryonic structure forms the following adult structures? • Collecting ducts, calyces, renal pelvis, and ureter

Mesonephric duct (ureteric bud)

Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Asbestos

Mesothelioma and bronchogenic carcinoma

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?

Metabolic acidosis (summary: low pH, high H+, and low HCO3-)

What primary acid-base disturbance is caused by a loss in fixed acid forcing the reaction to shift to the right, thereby increasing HCO3- levels?

Metabolic alkalosis (summary: high pH, low H+ and high HCO3-)

What are the two factors that affect alveolar PCO2 levels?

Metabolic rate and alveolar ventilation (main factor)

What embryonic structure forms the following adult structures? • Nephrons, kidney

Metanephros

At ovulation, in what stage of meiosis II is the secondary oocyte arrested?

Metaphase II

What is the second arrested stage of development in the female reproductive cycle?

Metaphase of meiosis II (in the oocyte of the graafian follicle)

What is the term for a reversible change in one cell type to another?

Metaplasia (usually to a more protective cell type)

What two β2-agonists are used to produce bronchodilation?

Metaproterenol and albuterol

What α1-agonist is used to treat paroxysmal atrial tachycardia with hypotension?

Metaraminol (α1, β1 )

What is the most common one? • Bone tumor

Metastatic

What is the most common one? • Brain tumor

Metastatic

What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?

Metastatic calcification

What is the most common one? • Liver tumor

Metastatic carcinoma

What is the most common one? • Neoplastic tumor in the lungs

Metastatic carcinomas

What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?

Metformin

What restriction endonuclease site is destroyed in sickle β-globin allele?

MstII; changing codon 6 (from A to T) destroys the restriction site.

What oxygen-dependent killing enzyme requires hydrogen peroxide and halide (Cl-) to produce hypochlorous acid?

Myeloperoxidase

Name the form of spina bifida. • An open neural tube lying on the surface of the back

Myeloschisis All except occulta cause elevated-fetoprotein levels.

What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities, red cell aplasia, and muscle weakness?

Myasthenia gravis

What type II hypersensitivity disorder is defined as • Autoantibodies directed against ACh receptors?

Myasthenia gravis

Which acid-fast rod is an obligate intracellular parasite?

Mycobacterium leprae

A tropical fish enthusiast has granulomatous lesions and cellulitis; what is the most likely offending organism?

Mycobacterium marinum

Name the cluster B personality disorder: • Grandiose sense of self-importance; demands constant attention; fragile self-esteem; can be charismatic

Narcissistic

What are the three components to the asthma triad?

Nasal polyps, rhinitis, and aspirin hypersensitivity

What region of the pharynx does the eustachian tube enter?

Nasopharynx

What ethnic group has the highest adolescent suicide rate?

Native Americans

What renal side effect is commonly seen in patients taking lithium?

Nearly 25% of patients taking lithium develop polyuria and polydipsia.

What is the most common form of elderly abuse?

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 nematode is known as hookworms? What is the treatment?

Necator americanus is treated with mebendazole and iron therapy.

What paraphilia is defined as • Having sex with cadavers?

Necrophilia

What is the most common one? • Acquired GI emergency of infancy

Necrotizing enterocolitis

How many attacks are needed over how much time before panic disorder is diagnosed?

Need 3 panic attacks over 3 weeks (remember, they come out of the blue.)

Are the following conditions associated with a negative or positive nitrogen balance? • AA deficiency

Negative

Are the following conditions associated with a negative or positive nitrogen balance? • Infection

Negative

Are the following conditions associated with a negative or positive nitrogen balance? • Kwashiorkor

Negative

Are the following conditions associated with a negative or positive nitrogen balance? • Starvation

Negative

Are the following conditions associated with a negative or positive nitrogen balance? • Uncontrolled DM

Negative

What type of correlation is defined as • One variable that diminishes in the presence of the other?

Negative correlation

The probability that a person with a negative test result is truly disease free refers to what value?

Negative predictive value

Based on operant conditioning, what type of reinforcement is described when • Removing a stimulus reinforces a behavior?

Negative reinforcement

What is the term for thymic induction of T cells with high-affinity Ag receptors for self that are programmed to undergo apoptosis?

Negative selection. This helps to prevent autoimmune diseases.

What wave is the cause of the following venous pulse deflections? • The rise in right atrial pressure secondary to blood filling and terminating when the tricuspid valves opens

V wave

Is CO2 a perfusion-or diffusion-limited O2 gas?

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.

If the occurrence of one event had nothing to do with the occurrence of another event, how do you combine their probabilities?

Since they are independent events, their probabilities would be multiplied.

What protein prevents ssDNA from reannealing during DNA replication?

Single-strand DNA binding protein

From what embryonic structure are the following structures derived? • The sinus venarum, coronary sinus, and the oblique vein of the left atrium

Sinus venosus

Name the Hgb-O2 binding site based on the following information: • Remains attached under most physiologic conditions

Site 1

Name the Hgb-O2 binding site based on the following information: • Greatest affinity of the three remaining sites for attachment; requires PO2 levels of 26 mm Hg to remain attached

Site 2

Name the Hgb-O2 binding site based on the following information: • Requires a PO2 level of 40 mm Hg to remain attached

Site 3

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)

Site 4

From what aortic arch are the following structures derived? • Right and left pulmonary arteries and the ductus arteriosus

Sixth MS CARD is my mnemonic for the aortic arch derivatives

What diseases are associated with the HLA-DR3 allele

Sjogren's syndrome, active hepatitis, systemic lupus erythematosus (with HLA-DR2) and type 1 diabetes (with HLA-DR4)

For what disease are SS-A(Ro), SS-B(La), and R-ANA diagnostic markers?

Sjögren disease

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?

Sjögren's syndrome; SS-A (Ro) and SS-B (La)

Name the muscle type based on the histological features: • Actin and myosin in sarcomeres; striated; multinuclear; lacks gap junctions; troponin:calcium binding; T tubules and SR forming triadic contacts; highest ATPase activity; no calcium channels

Skeletal muscle

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.

Skeletal muscles

What is the term for the rate measured for a subgroup of a population?

Specific rate (e.g., men aged 55-60)

What is the statistical term for the proportion of truly nondiseased persons in the screened population who are identified as nondiseased?

Specificity (it deals with the healthy)

What is the drug of choice for penicillin-resistant gonococcal infections?

Spectinomycin

Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 23/1n

Spermatid

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)

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 mitotically)

Spermatogonia (type B)

What substrate is built up in Niemann-Pick disease?

Sphingomyelin

What is the only sphingolipid that contains choline and PO4?

Sphingomyelin (lecithin also, but it is not a sphingolipid)

What lysosomal enzyme is deficient in • Niemann-Pick disease?

Sphingomyelinase

What sphingolipid is formed by the union of serine and palmitoyl CoA?

Sphingosine

What component of the trigeminal nuclei • Receives sensory input (all but pain and temperature) from the face, scalp, dura, and the oral and nasal cavities?

Spinal trigeminal nucleus

In what tract does pain, temperature, and crude touch sensory information ascend to the postcentral gyrus of the parietal lobe?

Spinothalamic tract (anterolateral system)

Which diuretic is used as an adrenal steroid antagonist?

Spironolactone

Which potassium-sparing drug is an aldosterone receptor antagonist ?

Spironolactone

What is the only diuretic that works on the blood side of the nephron?

Spironolactone (binds to aldosterone receptors)

What is the only organ supplied by the foregut artery that is of mesodermal origin?

Spleen

What is the most common one? • Site of ischemia in the GI tract

Splenic flexure

What are the two most important features in the diagnosis of malaria?

Splenomegaly and anemia (with a high index of suspicion)

Name these narcissistic defense mechanisms: • Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.

Splitting

Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?

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.

Which bacteria are associated with the following pigment production? • Yellow pigmentation

Staphylococcus aureus

What are the most common causes of osteomyelitis • In patients with sickle cell disease?

Staphylococcus aureus (but they are more prone to salmonella infections)

Name the most common type or cause. • Urethritis in a young, newly sexually active individual

Staphylococcus saprophyticus

What bile pigment is formed by the metabolism of bilirubin by intestinal bacteria, giving stool its brown color?

Stercobilin

What are the long microvilli in the inner ear and male reproductive tract called?

Stereocilia

What are the four functions of SER?

Steroid synthesis, drug detoxification, triglyceride resynthesis, and Ca2+handling

What is the DOC for the following protozoal infections? • Leishmaniasis

Stibogluconate

How is velocity related to the total cross-sectional area of a blood vessel?

Velocity is inversely related to cross-sectional area.

What antidepressant, which recently was approved for general anxiety disorder, inhibits the reuptake of NE and 5-HT?

Venlafaxine. (It also has a mild dopaminergic effect.)

Why would a puncture to a vein above the heart have the potential to introduce air into the vascular system?

Venous pressure above the heart is subatmospheric, so a puncture there has the potential to introduce air into the system.

If you order a V/Q scan for suspected pulmonary emboli, is the filling defect seen on the ventilation or perfusion side?

Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.

Name the thalamic nucleus based on its input and output. • Input from globus pallidus and substantia nigra; output to primary motor cortex

Ventral anterior nucleus

Name the thalamic nucleus based on its input and output. • Input from globus pallidus and the cerebellum; output to the primary motor cortex

Ventral lateral nucleus

Name the thalamic nucleus based on its input and output. • Input from medial lemniscus and the spinocerebellar tracts; output to the primary somatosensory cortex

Ventral posterolateral nucleus

Name the thalamic nucleus based on its input and output. • Input from the trigeminal pathways; output to primary somatosensory cortex of the parietal lobe

Ventral posteromedial nucleus

On the venous pressure curve, what do the following waves represent? • C wave?

Ventricular contraction Atrial, Contraction, Venous

Name the most common type or cause. • Sudden cardiac death

Ventricular fibrillation (V fib)

What is the term when the brachial artery is compressed, resulting in ischemic contracture of the hand?

Volkmann's contracture

Name the ventricular muscle membrane channel: • Closed at rest; depolarization causes channels to open slowly

Voltage-gated calcium channel

What type of membrane channel opens in response to depolarization?

Voltage-gated channel

Name the ventricular muscle membrane channel: • Open at rest; depolarization is stimulus to close; begin to reopen during the plateau phase and during repolarization

Voltage-gated potassium channels

Name the ventricular muscle membrane channel: • Closed at rest; depolarization causes channels to open quickly; will not respond to a second stimulus until cell is repolarized.

Voltage-gated sodium channel

What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound?

Volume of distribution is decreased when a large percentage of drug is protein bound.

What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?

Volvulus

What paraphilia is defined as • Deriving sexual pleasure from watching others having sex, grooming, or undressing?

Voyeurism

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?

Waldenström's macroglobulinemia

Where are the tonsillar tissues?

Waldeyer's ring

What is absorbed in the gallbladder to concentrate bile?

Water

In regards to solute concentration, how does water flow?

Water flows from a low-solute to high-solute concentrations.

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.

Water-soluble hormones are considered fast-acting hormones.

What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?

Waterhouse-Friderichsen syndrome

What is the only pharyngeal muscle not innervated by CN X?

Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.

What is the most common one? • Complication of PDA

Subacute bacterial endocarditis

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?

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.

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?

Subacute combined degeneration, which is bilateral below the level of the lesion.

What type of cerebral bleed is due to a rupture of a berry aneurysm in the circle of Willis?

Subarachnoid hematoma

Bloody tap on lumbar puncture

Subarachnoid hemorrhage

Does subatmospheric pressure act to expand or collapse the lung?

Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.

What vessel can be found atop the scalene anterior?

Subclavian vein

Is a subdural hematoma an arterial or venous bleed?

Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.

Name these mature defense mechanisms: • Converting an unacceptable impulse to a socially acceptable form (Hint: it is the most mature of all defense mechanisms)

Sublimation

Both submandibular and sublingual glands are innervated by CN VII (facial) and produce mucous and serous secretions. Which one mainly produces serous secretions?

Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.

Name the compartment of the mediastinum associated with the following thoracic structures: • SVC

Superior and middle

Name the compartment of the mediastinum associated with the following thoracic structures: • Azygos vein

Superior and posterior

Name the compartment of the mediastinum associated with the following thoracic structures: • Esophagus

Superior and posterior

Name the compartment of the mediastinum associated with the following thoracic structures: • Thoracic duct

Superior and posterior

Which one of the cerebellar peduncles is mainly responsible for outgoing (efferent) information?

Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.

Which of the colliculi help direct the movement of both eyes in a gaze?

Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.

What lower extremity nerve is described by the following motor loss? • Loss of abduction of the hip resulting in Trendelenburg gait

Superior gluteal nerve

What CN nucleus receives auditory information from both ears via the cochlear nuclei?

Superior olivary nucleus

What ocular muscle • Elevates and adducts the eyeball?

Superior rectus (CN III) (LR6 SO4)3

What vein is formed by the union of the right and left brachiocephalic veins?

Superior vena cava

Name the three enzymes that protect the cell from oxygen-derived free radicals.

Superoxide dismutase, glutathione peroxidase, catalase

Which trophoblast layer of the placenta remains until the end of pregnancy?

Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)

What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?

Syphilitic

What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?

Syringomyelia

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?

Systematic desensitization

What disease is associated with the HLA-DR2 and HLA-DR3 alleles

Systemic lupus erythematosus

True or false? All of the hormones in the hypothalamus and anterior pituitary gland are water soluble.

TRUE

True or false? All spore formers are gram positive.

TRUE

True or false? All streptococci are catalase-negative

TRUE

True or false? Below the arcuate line, all the aponeurotic fibers run anterior to the rectus abdominis.

TRUE

True or false? Dopamine antagonists at the D2A receptor have the capacity to induce pseudoparkinsonism.

TRUE

True or false? Ethyl alcohol induces the cytochrome P-450 enzymes.

TRUE

True or false? Klinefelter syndrome cannot be diagnosed until puberty.

TRUE

True or false? Live vaccines are contraindicated in patients with SCID.

TRUE

True or false? Monocytosis is seen in TB.

TRUE

True or false? NSAIDs have analgesic, antipyretic, anti-inflammatory, and antiplatelet activities.

TRUE

True or false? Progestins are used in combination with estrogens to decrease the risk of endometrial cancer.

TRUE

True or false? Somatic motor neurons innervate the striated muscle of the bulbospongiosus and ischiocavernous muscles and result in ejaculation of semen.

TRUE

True or false? Succinylcholine is a nicotinic receptor agonist.

TRUE

True or false? The epithelial lining of the urinary bladder and the urethra are embryologic hindgut derivatives.

TRUE

True or false? The parasympathetic nervous system has very little effect on arteriolar dilation or constriction.

TRUE

True or false? There are no central O2 receptors.

TRUE

What pituitary hormone is inhibited during sleep?

TSH. 5-HT and prolactin increase during sleep, and dopamine levels decrease during sleep.

If a peripheral blood smear shows schistocytes, reticulocytes, and thrombocytopenia, is it more commonly seen in patients with ITP or TTP?

TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.

Name the product or products of arachidonic acid: • Vasoconstriction and platelet aggregation produced by platelets

TXA2

What potent platelet aggregator and vasoconstrictor is synthesized by platelets?

TXA2

Which cestode in raw or rare beef containing cysticerci results in intestinal tapeworms?

Taenia saginata

What cestode causes cysticercosis?

Taenia solium

What vasculitis affects a 30-year-old Asian female having visual field deficits, dizziness, decreased blood pressure, and weakened pulses in the upper extremities?

Takayasu arteritis (medium-size to large vessels)

What competitive estrogen receptor antagonist is used in the treatment of breast cancer?

Tamoxifen

What major side effect of neuroleptics is characterized by pill rolling, shuffling gait, and tremors that abate during sleep?

Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.

What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb-containing area?

Target cell

What is the term for the summation of mechanical stimuli due to the skeletal muscle contractile unit becoming saturated with calcium?

Tetany

Name the antimicrobial agent whose major side effect is listed. • Dental staining in children

Tetracycline

Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children?

Tetracycline

Name the most common type or cause. • Cyanotic heart disease

Tetralogy of Fallot

What bedside test is used to differentiate a dorsal column lesion from a lesion in the vermis of the cerebral cortex?

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 statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?

The T-test (used when comparing two groups)

What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?

The V/Q ratio increases, since the area is ventilated but hypoperfused as a result of the occlusion.

How many strains of Pneumococcus capsular polysaccharides are present in the vaccine?

The vaccine contains 23 capsular polysaccharides.

What area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen?

The vagina

What maintains the osmotic gradient that is critical to the concentrating ability of the kidney?

The venae recta maintain the gradient via countercurrent flow.

In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls the axial and proximal musculature of the limbs?

The vermis

What is the largest nucleus in the midbrain?

The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.

What reflex enables the eyes to remain focused on a target while the head is turning?

The vestibulo-ocular reflex

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?

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.

What two veins form the portal vein?

The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.

What region of the brain houses the central chemoreceptors responsible for control of ventilation?

The surface of the medulla

What component of the cardiovascular system has the largest blood volume? Second largest blood volume?

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 is the only muscle of the soft palate that is innervated by CN V3?

The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.

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?

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 is the rate-limiting step in a conduction of a NMJ?

The time it takes ACh to diffuse to the postjunctional membrane

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?

The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.

Does the zygote divide mitotically or meiotically?

The zygote divides mitotically; only germ cells divide meiotically.

What subunit of hCG is used to detect whether a patient is pregnant?

The β-subunit; remember, the α-subunit is nonspecific.

What female follicular cell is under LH stimulation and produces androgens from cholesterol?

Theca cell

After fertilization, what cells of the corpus luteum • Secrete estrogen?

Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.

How many bronchopulmonary segments are on the right lung? Left lung?

There are 10 bronchopulmonary segments on the right and 8 on the left.

What is the major difference between the veins in the face and the veins in the rest of the body?

There are no valves and no smooth muscle in the walls of the veins in the face.

How many base pairs upstream is the prokaryotic TATA box promoter?

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 bases upstream is the eukaryotic TATA box promoter?

There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.

Is there a difference between mathematical and clinical steady states? If so, what are their values (half-lives)?

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.

What would be the result if an Ab were cleaved with pepsin?

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 papain?

There would be two Fab and Fc regions.

What dementia is associated with dilated ventricles with diffuse cortical atrophy, decreased parietal lobe blood flow, and a decrease in choline acetyl transferase activity?

These are the gross pathologic changes associated with Alzheimer's disease.

All primary oocytes in females are formed by what age?

They are all formed by the fifth month of fetal life.

What is the relationship between preload and the passive tension in a muscle?

They are directly related; the greater the preload, the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.

Where are the postganglionic neuron cell bodies, the CNS or the PNS?

They are in ganglia in the PNS.

Where are the preganglionic neuron cell bodies, the CNS or the PNS?

They are in the grey matter of the CNS.

How are pulse pressure and compliance related?

They are inversely proportional to each other; as pulse pressure increases, compliance decreases.

What is the relationship between ventilation and PCO2 levels?

They are inversely related. If ventilation increases, there will be a decrease in PCO2 levels and vice versa.

What is the function of white rami communicantes?

They are preganglionic sympathetic axons. They are white because they are myelinated.

What is the physiologic basis for the actions of birth control pills?

They block the midcycle surge of LH.

What is the venous and arterial stretch receptors' function regarding the secretion of ADH?

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 do UMNs innervate?

They innervate LMNs.

What do LMNs innervate?

They innervate skeletal muscle.

What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?

They prevent mast cell degranulation.

What is the drug of choice for threadworm, trichinosis, and larva migrans?

Thiabendazole

What vitamin deficiency can result in high-output cardiac failure?

Thiamine

What two vitamins are inactivated when they come in contact with acetaldehyde?

Thiamine and folate

Which group of antihypertensive agents best decreases left ventricular hypertrophy?

Thiazide diuretics

What skin type on the palms and soles is characterized by the absence of hair follicles and presence of stratum lucidum?

Thick skin

A known IV drug abuser goes to the ER with respiratory depression and pinpoint pupils and in a semicomatose state. What overdose do you suspect, and what agent will you give to reverse its effects?

The triad of respiratory depression, pinpoint pupils, and coma in an IV drug abuser suggests opioid overdose (e.g., heroin), and you should give naloxone.

What is the vector of African sleeping sickness?

The tsetse fly

What happens to the tonicity of the urine with increased ADH secretion?

The urine becomes hypertonic because of water reabsorption in the collecting duct.

Regarding the Lac operon, for what do the following genes code? • A gene

Thiogalactoside transacetylase

What neuroleptic agent causes retinal deposits, hypotension, and torsades de pointes?

Thioridazine

From what pharyngeal pouch is the following structure derived? • Inferior parathyroid gland and thymus

Third M PITS for pharyngeal pouch derivatives

From what aortic arch are the following structures derived? • Common and internal carotid arteries

Third aortic arch MS CARD is my mnemonic for the aortic arch derivatives

During what embryonic week do somites begin to form?

Third week

During what embryonic week does the intraembryonic coelom form?

Third week

What embryonic week sees the formation of the notochord and the neural tube?

Third week

Blood and its vessels form during what embryonic week?

Third week; they are derived from the wall of the yolk sac.

What carcinoma produces hematuria, flank pain, and a palpable mass?

This is the triad of renal cell carcinoma

What are the functions of the zonula occludens and the zonula adherens

To provide attachment between contiguous cells and to maintain a semipermeable barrier

Inhibition of peripheral COMT, allowing increased CNS availability of L-dopa, is accomplished by what two agents?

Tolcapone and entacapone

What is the term for edema that has LDH below 200, protein level 2.5, and a specific gravity below 1.020?

Transudative; exudative has the opposite values and has an elevated cellular content.

What abdominal muscle runs horizontally, contributes to the posterior rectus sheath, and contributes to form the conjoint tendon?

Transverse abdominis

What is the term for having fantasies or dressing in female clothes for sexual arousal by heterosexual men?

Transvestite fetishism

What two muscles do you test to see whether CN XI is intact?

Trapezius and sternocleidomastoid

What serotonin reuptake inhibitor's major sexual side effect is priapism?

Trazodone

Mandibular hypoplasia, down-slanted palpebral fissures, colobomas, malformed ears, and zygomatic hypoplasia are commonly seen in what pharyngeal arch 1 abnormality?

Treacher Collins syndrome

True or false? The portal tract of the liver lobule is the first area to be oxygenated in the liver.

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 following are functions of hepatocytes: protein production, bile secretion, detoxification, conjugation, and lipid storage.

True. (They are quite a busy bunch of cells!)

True or false? Blood clots lack platelets.

True. A thrombus has platelets, but clots do not.

True or false? Adipose tissue lacks glycerol kinase.

True. Adipose depends on glucose uptake for dihydroxyacetone phosphate (DHAP) production for triglyceride synthesis.

True or false? The presence of PMNs in the CSF is always abnormal.

True. Although the CSF normally contains 0 to 4 lymphocytes or monocytes, the presence of PMNs is always considered abnormal.

True or false? All aluminum-containing antacids can cause hypophosphatemia.

True. Aluminum reacts with PO4, resulting in AlPO4, an insoluble compound that cannot be absorbed.

True or false? Anaerobes are resistant to the effects of aminoglycosides.

True. Aminoglycosides use O 2-dependent uptake and therefore are ineffective for treatment of anaerobic infections.

True or false? At high doses aspirin has uricosuric properties.

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? B-cell Ag receptors can be secreted.

True. B cell antigen receptors are Abs.

True or false? The alveolar PO2 and PCO2 levels match the pulmonary end capillary blood levels.

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? Paranoid and catatonic schizophrenia are good prognostic predictors.

True. Being female, having positive symptoms, quick onset, and family history of mood disorders are all good prognostic predictors of schizophrenia.

True or false? The central vein of the liver lobule is the first area affected during hypoxia.

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? Gynecomastia is a side effect of cimetidine.

True. Cimetidine can decrease androgen production and lead to gynecomastia.

True or false? Patients with common variable hypogammaglobinemia have B cells in the peripheral blood.

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? DNA polymerases can correct mistakes, whereas RNA polymerases lack this ability.

True. DNA polymerases have 3'-5' exonuclease activity for proofreading.

True or false? Pancreatic delta-cell tumors inhibit CCK secretion, leading to gallstones and steatorrhea.

True. Delta-Cell tumors produce excess somatostatin, which inhibits CCK, gastrin (hypochlorhydria), and insulin secretion (diabetes).

True or false? GERD is a cause of asthma.

True. Don't forget this in your differential diagnosis of an asthmatic.

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.

True. Don't forget this list; you will be asked.

True or false? Progesterone has thermogenic activities.

True. Elevated plasma levels of progesterone can raise the body temperature 0.5° to 1.0°F.

True or false? Sickle cell anemia, Caisson disease, chronic steroid use, and Gaucher disease are causes of avascular necrosis of bone.

True. Fractures and trauma, however, are the most common causes.

True or false? HPV infection increases the risk of developing squamous cell carcinoma of the penis.

True. HPV serotypes 16 and 18 are risk factors for squamous cell carcinoma.

True or false? High-frequency sound waves stimulate hair cells at the base of the cochlea.

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? Depolarization of the postsynaptic membrane excites the neuron.

True. Hyperpolarization inhibits the postsynaptic membrane.

True or false? There is a strong positive correlation between IQ and academic achievement.

True. IQ correlates well with education and academic achievement but is not a predictor of success.

True or false? In a positively skewed curve the mean is greater than the mode.

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? Aldosterone has a sodium-conserving action in the distal colon.

True. In the distal colon, sweat glands, and salivary ducts, aldosterone has sodium-conserving effects.

True or false? An elevated serum osteocalcin level is a marker for increased bone formation.

True. Increased alkaline phosphatase levels also are associated with increased bone formation.

True or false? Renin secretion is increased in 21-β-hydroxylase deficiency.

True. Increased renin and AT II levels occur as a result of the decreased production of aldosterone.

True or false? Excess lead deposits in the oral cavity.

True. It deposits at the gingivodental line, known as the lead line.

True or false? A patient can refuse a feeding tube.

True. It is considered medical treatment, so it can be withdrawn or refused. (Remember the Cruzan case.)

True or false? Intrafusal fibers form muscle spindles.

True. Muscle spindles are modified skeletal muscle fibers. They are the sensory component of the stretch reflexes.

True or false? There is no absorption of an IV-administered drug.

True. No loss of drug and no absorption if a drug is given IV.

True or false? Prolactin levels can serve as a rough indicator of overall dopamine activity.

True. PIF is dopamine in the tuberoinfundibular system.

True or false? Pancreatic insufficiency results in vitamin B12 malabsorption.

True. Pancreatic enzymes begin the breakdown of vitamin B12-R complex in the duodenum.

In men, at what embryonic week do the primordial germ cells migrate to the indifferent gonad?

Week four, and they remain dormant there until puberty.

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?

Wegener granulomatosis

Name the aphasia based on these characteristics: • Lesion in Brodmann area 22; impaired comprehension; incoherent rapid, fluent speech; verbal paraphrasias; trouble repeating statements

Wernicke's aphasia

True or false? You would not prescribe probenecid for a patient with gout who is an overexcretor of uric acid.

True. Probenecid can precipitate uric acid crystals in the kidney if the patient is an overexcretor of urate.

True or false? RBCs anaerobically use glucose in both the well-fed and fasting states.

True. Remember, RBCs do not contain mitochondria, so they cannot metabolize aerobically.

True or false? RBCs do not have MHC class I Ags on their surface.

True. Remember, all nucleated cells (and platelets) have MHC class I Ags, and RBCs are not nucleated.

True or false? The urea cycle takes place in both the cytoplasm and the mitochondria.

True. Remember, carbamoyl phosphate synthetase and ornithine transcarbamoylase are mitochondrial enzymes.

True or false? For implantation to occur the zona pellucida must degenerate.

True. Remember, it degenerates 4 to 5 days post fertilization, and implantation occurs 7 days post fertilization!

True or false? Patients with Turner syndrome have no Barr bodies.

True. Remember, the second X chromosome is inactivated, and so is the Barr body. Turner syndrome has only one X chromosome.

True or false? Methylation of bacterial DNA prevents restriction endonuclease from cutting its own chromosomes.

True. Restriction endonucleases cut only unmethylated DNA.

True or false? In skeletal muscle relaxation is an active event.

True. Sarcoplasmic calcium-dependent ATPase supplies the energy to terminate contraction, and therefore it is an active process.

True or false? Anticentromere Abs are used in diagnosing CREST syndrome.

True. Scl-70 Abs are used in diagnosing diffuse scleroderma.

True or false? All of the following are live attenuated vaccines available in the United States: measles, mumps, varicella zoster, and Francisella tularensis.

True. So are rubeola, smallpox, yellow fever, and the Sabin polio vaccine.

True or false? Vibrio parahaemolyticus require NaCl in its growth medium.

True. Staphylococcus aureus and group D enterococci also grow in high-salt media.

True or false? In females, meiosis II is incomplete unless fertilization takes place.

True. The elimination of the unfertilized egg is menses.

True or false? There is no hormonal control to the TCA cycle.

True. The energy status of the cell dictates if the cycle is running or relaxing.

True or false? Removal of the ileum results in vitamin B12 deficiencies.

True. The ileum is the site where vitamin B12 is absorbed.

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.

True. The lack of dopamine leads to an excess of ACh, hence extrapyramidal dysfunction.

True or false? The respiratory system is derived from the ventral wall of the foregut.

True. The laryngotracheal (respiratory) diverticulum is divided from the foregut by the tracheoesophageal septum. --------------------------------------------------------------------------------

True or false? The first cervical vertebra has no vertebral body.

True. The odontoid process of C2 acts as the vertebral body of C1 allowing lateral rotation of the head.

True or false? The thyroid gland is an embryologic foregut derivative.

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? Cestodes have no GI tract.

True. They absorb nutrients from the host's GI tract.

True or false? All negative sense RNA viruses are enveloped.

True. They all have helical nucleocapsids and virion-associated polymerases too.

True or false? Thyroid hormones are necessary for normal menstrual cycles.

True. They are also necessary for normal brain maturation.

True or false? In a skeletal muscle fiber, the interior of the T-tubule is extracellular.

True. They are evaginations of the surface membranes and therefore extracellular.

True or false? Neurons in the dorsal horn participate in reflexes.

True. They are the sensory component of a spinal reflex.

True or false? Beta2-Adrenergic agents are used in the management of an acute asthmatic attack.

True. They are useful in the early-phase response to an asthmatic attack.

True or false? Dopamine antagonists are antiemetic.

True. They block the dopamine receptors in the chemoreceptor trigger zone.

True or false? Ungated channels are always open.

True. They have no gates, so by definition they are always open.

True or false? Fluoroquinolones are bactericidal.

True. They inhibit DNA gyrase (topo II).

True or false? There are no persistent infections with naked viruses?

True. They lyse the host cell

True or false? The nucleus is the site of transcription.

True. Transcription (conversion of DNA to RNA), as well as replication, occurs in the nucleus.

True or false? Without ADH the collecting duct would be impermeable to water.

True. Without ADH hypotonic urine would be formed.

True or false? Panic attacks can be induced by hyperventilation or carbon dioxide.

True. Yohimbine, sodium lactate, and epinephrine can also induce panic attacks; they are considered panicogens.

True or false? both the left and right lungs have an oblique fissure?

True. on the right lung the oblique fissure divides the middle from the inferior lobe and the horizontal fissure further divides the middle from the upper lobe. On the left the oblique divides the superior from the inferior lobe.

True or false? Cocaine-induced coronary ischemia should not be treated with β-blockers.

True. β-Blockade would result in unopposed-adrenergic stimulation and worsen the patient's symptoms. Calcium channel blockers are the way to go.

True or false? β-Blockers are contraindicated in patients who present to the hospital with CHF.

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? Four-fifths of those who attempt suicide first give a warning.

True; 80% have visited a doctor in the previous 6 months. And 50% within the last month!

True or false? Being college educated increases a man's risk of having premature ejaculation.

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? Cortisol inhibits glucose uptake in skeletal muscle.

True; cortisol inhibits glucose uptake in most tissue, making it available for neural tissue use.

True or false? Active protein transport requires a concentration gradient.

True; it requires both a concentration gradient and ATP to work.

True or false? Marriage emancipates a child less than 17 years old.

True; military service and independent self-care by a child over 13 years old also emancipate.

True or false? There is an inverse relationship between fat content and total body water.

True; the greater the fat, the less the total body water.

Name the four right-to-left congenital cardiac shunts.

Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T

From what embryonic structure are the following structures derived? • The ascending aorta and the pulmonary trunk

Truncus arteriosus

What hemoflagellate species is the cause of Chagas disease?

Trypanosoma cruzi

What enzyme is needed to activate the following reactions? • Chymotrypsinogen to chymotrypsin

Trypsin

What enzyme is needed to activate the following reactions? • Procarboxypeptidase to carboxypeptidase

Trypsin

What AA is a precursor of the following substances? • NAD

Tryptophan

What AA is a precursor of the following substances? • Serotonin

Tryptophan

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?

Wernicke's encephalopathy

Are white rami preganglionic or postganglionic fibers?

White rami are preganglionic fibers, whereas grey rami are postganglionic fibers.

What tumor is seen in the 2-to 4-year-old age group; does not cross the midline; has immature glomeruli, tubules, and stroma; and metastasizes late to the lungs?

Wilms tumor

Kayser-Fleischer rings

Wilson disease

What AR disorder of copper metabolism can be characterized by Kayser- Fleischer rings, decreased ceruloplasmin levels, and increased urinary copper excretion and tissue copper levels?

Wilson disease. (Remember, patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)

Kaiser-Fleischer rings, abnormal copper metabolism, and ceruloplasmin deficiency characterize what disease, which may include symptoms of dementia when severe?

Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)

What X-linked recessive immune disorder is characterized by recurrent infections, severe thrombocytopenia, and eczema?

Wiskott-Aldrich syndrome

What agent, in combination with a MAOI inhibitor, can cause hypertensive crisis?

Tyramine

What AA is a phenol?

Tyrosine

What is the name of the urinary bladder where the ureters enter and the urethra exits?

Urinary trigone

What embryonic structure forms the adult female structures? • Labia minora

Urogenital folds

What embryonic structure forms the adult male structure? • Ventral part of the penis

Urogenital folds

What embryonic structure forms the adult female structures? • Urinary bladder, urethra, greater vestibular glands, vagina

Urogenital sinus

What embryonic structure forms the adult male structure? • Urinary bladder, urethra, prostate gland, bulbourethral gland

Urogenital sinus

What embryonic structure forms the following adult structures? • Urinary bladder and urethra

Urogenital sinus

What paraphilia is defined as • Combining sex with urination?

Urophilia

What enzyme is deficient in acute intermittent porphyria?

Uroporphyrinogen I synthetase

What enzyme is deficient in congenital erythropoietic porphyria?

Uroporphyrinogen III cosynthase

What enzyme of heme synthesis is deficient in the autosomal dominant disorder acute intermittent porphyria?

Uroporphyrinogen-I synthase

What component of the inner ear • Contains endolymph and gravity receptors monitoring linear acceleration and deceleration of the head, noting changes in head position?

Utricle and saccule

What disease is X-linked recessive, is associated with eczema thrombocytopenia and an increased chance of developing recurrent infections, involves a decrease in serum IgM and in the T cell-dependent paracortical areas of the lymph nodes, and means that the patient is likely to develop malignant lymphoma?

Wiskott-Aldrich syndrome

What happens to total and alveolar ventilation with • Increased depth of breathing?

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 rate of breathing?

With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid, shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).

What happens to blood flow and pressure downstream with local arteriolar constriction?

With arteriolar constriction both the flow and pressure downstream decrease.

How is the eye affected by use of opioids?

With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.

Is marital satisfaction higher for couples with or without children?

Without children (but don't think about this one for too long)

Name three purine bases that are not found in nucleic acids.

Xanthine, hypoxanthine, theophylline, theobromine, caffeine, and uric acid are all purines.

Name the type of graft described by these transplants: • From one species to another

Xenograft

What are the four capsular polysaccharides used in the Neisseria meningitides vaccine?

Y, W-135, and C and A capsular polysaccharides

What viral infection is associated with black vomit?

Yellow fever (flavivirus)

What small coagulase-positive, gram-negative rod with bipolar staining is a facultative intracellular parasite resulting in buboes?

Yersinia pestis

Can advance directives be oral?

Yes

Is the Salk polio vaccine inactivated?

Yes

Can parents withhold treatment from their children?

Yes, as long the illness does not threaten limb or life. If illness is critical or an emergency, treat the child.

Could an overdose with either zolpidem or zaleplon be reversed with flumazenil?

Yes, because they both activate the BZ1-receptors, which can be reversed by flumazenil.

Are sexually abused females more likely to have learning disabilities than the general population?

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.

Is GH considered a gluconeogenic hormone?

Yes, it decreases fat and muscle uptake of glucose, thereby increasing blood glucose levels.

Do high levels of estrogen and progesterone block milk synthesis?

Yes, they stimulate the growth of mammary tissue but block milk synthesis. At parturition, the decrease in estrogen lifts the block on milk production.

Can a patient refuse life-saving treatment for religious reasons?

Yes. (Remember, Jehovah's witnesses refuse blood transfusions.)

In a negatively skewed curve is the mean greater than the mode?

Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.

Does alcoholism increase the rate of suicide?

Yes. It increases the rate of suicide to nearly 50 times that of the general population.

Is cigarette smoking associated with transitional cell carcinoma of the bladder?

Yes. It is also a cause of cancers of the lung, esophagus, ureter, and kidney, just to name a few.

Can committed mentally ill patients refuse medical treatment?

Yes. The only civil liberty they lose is the freedom to come and go as they please.

If you report a suspected case of child abuse and are wrong, are you protected from legal liability?

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.

What α2-antagonist is used to treat impotence and postural hypotension?

Yohimbine

Schiller-Duval bodies

Yolk sac tumor

What is the most common one? • Germ cell tumor in boys

Yolk sac tumor

What is the most common one? • Testicular tumor in infants and children

Yolk sac tumor

What testicular tumor of infancy is characterized by elevated-fetoprotein levels and Schiller-Duval bodies?

Yolk sac tumor

Should information flow from the patient to the family or vice versa?

Your duty is to tell the patient, not the family. The patient decides who gets to know and who doesn't, not you.

Which prophylactic asthmatic agent is an antagonist of LTD4?

Zafirlukast

What antiviral agents inhibit neuraminidases of influenza A and B?

Zanamivir and oseltamivir

What type of correlation is defined as • Two variables with no linear relation to one another?

Zero correlation

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

Zero-order elimination

Which agent used in the treatment of asthma is a selective inhibitor of the lipoxygenase pathway?

Zileuton

What mineral deficiency in children is associated with poor growth and impaired sexual development?

Zinc (Zn) deficiency

What syndrome is associated with gastrin-producing islet cell tumor resulting in multiple intractable peptic ulcers?

Zollinger-Ellison syndrome

What region or regions of the adrenal cortex are stimulated by ACTH?

Zona fasciculata and zona reticularis

What type of cell surface projection lies on the lateral surface of cells closest to the apex and acts to seal off the outside environment from the rest of the body?

Zonula occludens (tight junctions)

What paraphilia is defined as • Sexual fantasies or practices with animals?

Zoophilia

Name the most common type or cause. • Rectal bleeding

Diverticulosis

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

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. • Euphoria, delusions, thought disorders, Wernicke's aphasia, auditory hallucinations (Hint: the lesion is in the left hemisphere)

Dominant temporal lobe

In an adrenergic nerve terminal, where is dopamine converted to NE? By what enzyme?

Dopamine is converted into NE in the vesicle via the enzyme dopamine-Beta-hydroxylase.

What happens to dopamine levels when we awaken?

Dopamine levels rise with waking; dopamine is associated with wakefulness.

What is the site of action of the following? • Thiazide diuretics

Early distal tubule

What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?

Eaton-Lambert syndrome

Which cestode infection results in alveolar hydatid cyst disease?

Echinococcus multilocularis

What is the term of the viral growth period when no viruses can be found intracellularly?

Eclipse period

What naturally occurring substances mimic the effects of opioids?

Enkephalins

What is the most common one? • Organism associated with liver abscesses

Entamoeba histolytica

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?

Entamoeba histolytica (treat with metronidazole)

What is the most common one? • Helminth parasitic infection in the United States

Enterobius vermicularis

What nematode is known as pinworms? What is the treatment?

Enterobius vermicularis; the treatment is albendazole.

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?

Enterococcus (Streptococcus faecalis)

What is the MCC of the following endocarditis scenarios? • Following biliary infections

Enterococcus faecalis

What cell of the duodenum secretes CCK?

Enteroendocrine (EE) cells; they also secrete secretin.

What organism is associated with the following types of diarrhea? Bloody diarrhea associated with hamburger ingestion

Enterohemorhagic Escherichia coli

How are drugs that are excreted via the biliary system resorbed by the GI tract?

Enterohepatic cycling

What enzyme is needed to activate the following reactions? • Trypsinogen to trypsin

Enterokinase

Name the most common type or cause. • Infantile bacterial diarrhea

Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)

Do the following structures pick up stain from hematoxylin or eosin? • Collagen

Eosin

Do the following structures pick up stain from hematoxylin or eosin? • Cytoplasm

Eosin

Do the following structures pick up stain from hematoxylin or eosin? • Fibrin

Eosin

Do the following structures pick up stain from hematoxylin or eosin? • RBCs

Eosin

Do the following structures pick up stain from hematoxylin or eosin? • Thyroid colloid

Eosin

What cell type is commonly elevated in asthma?

Eosinophil

What mast cell mediator is a chemotactic agent?

Eosinophil chemotactic factor A

Name the type of exudate, given the following examples. • Parasitic infection

Eosinophilic exudates

What chronic inflammatory WBC is associated with IgE-mediated allergic reactions and parasitic infections?

Eosinophils

What cells lining the ventricles have cilia on their luminal surface to move CSF?

Ependymal cells

What is the most common one? • Intramedullary spinal cord tumor in adults

Ependymoma

What is the most common one? • Intraspinal tumor

Ependymoma

What drug that penetrates the blood-brain barrier is found in asthma preparations and used as a nasal decongestant?

Ephedrine

Which genus of dermatophytes is associated with the following sites of infection? • Nails and skin only

Epidermophyton

Lucid interval

Epidural hematoma

Name the hormone—glucagon, insulin, or epinephrine: • Glycogenolytic, gluconeogenic, lipolytic, glycolytic, and stimulated by hypoglycemia

Epinephrine

What are the primary neurotransmitters at the following sites? • Chromaffin cells of the adrenal medulla

Epinephrine

What is the term for the external urethra opening onto the dorsal surface of the penis?

Epispadia

What is the teratogenic effect associated with lithium?

Epstein-cardiac anomaly of the tricuspid valve

What are the pharmacologic effects seen sexually with • Neuroleptics?

Erectile dysfunction

What is the major cell membrane sterol found in fungi?

Ergosterol

Which organism causes trench mouth?

Fusobacterium

What is the rate-limiting enzyme of the HMP shunt?

G-6-PD

Eating fava beans can produce the Mediterranean type of what deficiency?

G-6-PD deficiency

Heinz bodies

G-6-PD deficiency

Which hepatitis B Ab indicates low transmissibility?

HBeAb

What Ag is needed to diagnose an infectious patient with hepatitis B?

HBeAg

Which hepatitis B Ag correlates with infectivity and viral proliferation?

HBeAg

Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Immunization

HBsAb IgG

What is the first Ag seen in an individual with hepatitis?

HBsAg (incubation period)

What two Ags must be positive for a patient to have chronic active hepatitis?

HBsAg and HBeAg

What neuroleptic agent is also considered to be an antihistamine?

Risperidone

What is the term for granuloma at the lung apex in TB?

Simon focus

Name the most common type or cause. • Liver transplantation in adults

Alcoholic cirrhosis

What mosquito is responsible for the transmission of malaria?

Anopheles mosquito

What vector is associated with malaria?

Anopheles mosquito

What is the term for an inhibited female orgasm?

Anorgasmia. (The overall prevalence is 30%.)

What is the term given to arthropod-borne viruses?

Arboviruses (bunyavirus, flavivirus, and togavirus)

What is the term for the proportion of a drug that reaches systemic circulation?

Bioavailability

Name the structure that enters or exits the following foramina: • Stylomastoid foramen

CN VII

What CN is associated with the • Second pharyngeal arch?

CN VII

Name the structure that enters or exits the following foramina: • Internal auditory meatus

CN VII and VIII

What is the term for drug removal per unit of time in a given volume of blood?

Clearance

What term describes the volume of plasma from which a substance is removed over time?

Clearance

What results when the maxillary prominence fails to fuse with the medial nasal prominence?

Cleft lip

What results when the palatine prominences fail to fuse with the other side?

Cleft palate

What does hepatitis D virus need from hepatitis B virus to be infective?

HBsAg as its envelope

Name the lipoprotein based on the following characteristics. • apo A-1, apo E, apo C-II

HDL

What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?

HIV

What muscles insert in or on the intertubercular groove of the humerus?

"Lady between two Majors": latissimus dorsi, pectoralis major, and teres major

What is the formula to calculate IQ?

(MA/CA) x 100 = IQ score, where MA = mental age and CA = chronological age

What are the five penicillinase-resistant penicillins?

1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)

Name the most common type or cause. • Noniatrogenic hypothyroidism in the United States

Hashimoto thyroiditis

What is the most common one? • Site of pancreatic cancer

Head of the pancreas

Name the DNA virus • Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus

Herpes virus

What are the four effects of suckling on the mother?

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 five factors promote turbulent flow?

1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice

In biostatistics, what are the three criteria required to increase power?

1. Large sample size 2. Large effect size 3. Type I error is greater

What are the five hormones produced by Sertoli cells?

1. Inhibin 2. Estradiol (E2) 3. Androgen-binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antimüullerian hormone

What are the four types of signaling mechanisms?

1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors

Which three aminoglycosides have vestibular toxicity?

1. Streptomycin 2. Gentamicin 3. Tobramycin

What viruses are associated with Cowdry type A intranuclear inclusions?

Herpes virus I and II

What are the four components of the basement membrane?

1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen

Name the 10 retroperitoneal organs.

. 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

How many milliliters of O2 per milliliter of blood?

0.2

What is the FiO2 of room air?

0.21; it is a fancy way of saying 21% of the air is O2.

What is the most common serotype of enterohemorrhagic Escherichia coli?

0157:H7

How many days prior to ovulation does LH surge occur in the menstrual cycle?

1 day prior to ovulation

Cowdry type A bodies

Herpesvirus

What are the four characteristics of all protein-mediated transportation?

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 three cephalosporins can produce disulfiram-like reactions?

1. Cefamandole 2. Cefoperazone 3. Moxalactam

What three cephalosporins have good penetration against Bacteroides fragilis?

1. Cefotetan 2. Cefoxitin 3. Ceftizoxime

What are the three Beta-lactamase inhibitors?

1. Clavulanic acid 2. Sulbactam 3. Tazobactam

What are the three posttranscriptional modifications?

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 platelet aggregating factors?

1. ADP 2. PG 3. TXA2

What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?

1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia

What are the five pieces of information considered necessary for fully informed consent?

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 three Bs of adult polycystic kidneys?

1. Big 2. Bilateral 3. Berry aneurysm

What are the four segmented RNA viruses?

1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR

What three carcinomas are associated with EBV?

1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma

What are the four chemotactic agents?

1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides

What four conditions result in secondary hyperaldosteronism?

1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis

What are the five tissues in which glucose uptake is insulin independent?

1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa

What three substances stimulate glycogenolysis?

1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon

What are the five components of portal HTN?

1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids

What three cephalosporins are eliminated via biliary mechanisms?

1. Cefamandole 2. Cefoperazone 3. Ceftriaxone

What four factors affect diffusion rate?

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 is the triad of Reiter syndrome?

1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see, can't wee, can't kick with your knee

What three substrates control the enzyme PEPCK for the conversion of oxaloacetate (OAA) to pyruvate in the cytoplasm?

1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP

What are the three C's of measles?

1. Cough 2. Coryza 3. Conjunctivitis

What are the three rules governing a secondary immune response?

1. Covalent bonding between the hapten and carrier 2. B-cell exposure to hapten twice 3. T-cell exposure to carrier twice

What three bases are pyrimidines?

1. Cytosine 2. Uracil (only in RNA) 3. Thymidine

What three embryonic cell layers form the chorion?

1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm

Name the three methods of vasodilation via the sympathetic nervous system.

1. Decrease alpha-1 activity 2. Increase Beta-2 activity 3. Increase ACh levels

What are the four ways to down-regulate the immune system?

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 increase TPR?

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 Ds of niacin deficiency?

1. Diarrhea 2. Dermatitis 3. Dementia 4. Death

What are the three mechanisms of action for atrial natriuretic peptide's diuretic and natriuretic affects?

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 four branches of the brachial plexus arise prior to the first rib?

1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius

What five pathways use SAM (S-adenosylmethionine) as the methyl donor?

1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N-methyl cap of mRNA

Which three factors cause the release of epinephrine from the adrenal medulla?

1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)

What are the five F's associated with gallstones?

1. Fat 2. Forty 3. Female 4. Familial 5. Fertile

What are the three components of amyloid?

1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans

What are the three characteristics of autoregulation?

1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes

What are the eight liver-specific enzymes?

1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose-1, 6-bisphosphatase 8. Glucose-6-phosphatase

At what three sites can the HMP shunt enter into glycolysis?

1. Fructose-6-phosphate 2. Glucose-6-phosphate 3. Glyceraldehyde-3-phosphate

What four substances increase the rate of gluconeogenesis?

1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP

What are the six substances that promote the secretion of insulin?

1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. β-Agonists 6. ACh

What is the order of fuel use in a prolonged fast?

1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat

What three AAs are used to synthesize the purine ring?

1. Glycine 2. Aspartate 3. Glutamine

What five main oxidizing reactions are used to kill ingested organisms?

1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid

What are the four DNA oncogenic viruses?

1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma

What are the three major functions of secretory IgA?

1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases

What three muscles constitute the erector spinae?

1. Iliocostalis 2. Longissimus 3. Spinalis ("I Love Science" muscles)

What are the four exceptions to requirements for informed consent?

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 three functions of surfactant?

1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation

What are the three effects of insulin on protein metabolism?

1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis

What are the five effects of insulin on fat metabolism?

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 three factors increase simple diffusion?

1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane

What three criteria allow you to differentiate an ulcer from an erosion or carcinoma?

1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa

At which three sites in the body is T4 converted to T3?

1. Liver 2. Kidney 3. Pituitary gland (via 5'-deiodinase enzyme)

What are the three tissues where triacylglycerols are produced?

1. Liver 2. Muscle 3. Adipose tissue

What are the three stimuli that result in the reninangiotensin-aldosterone secretion?

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 main functions of surfactant?

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 three steps of the TCA cycle generate NADH?

1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. α-Ketoglutarate dehydrogenase

What are the three end products of amylase digestion?

1. Maltose 2. Maltotetrose 3. α-Limit dextrans (α-1, 6 binding)

What are the four muscles of mastication?

1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid

What are the three epidermal derivatives?

1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)

What three bacteria are positive to quellung reactive test?

1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae

What three actions should take place when one person threatens the life of another? (Hint: think of the Tarasoff decision.)

1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.

What are the three rules of clonal selection?

1. One cell type 2. One Ab type 3. Random selection of hypervariable regions, and only cells with bound Ag undergo clonal expansion

What is the triad of fat embolism?

1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g., long bone fracture)

What are the four posttranslational modifications done by the Golgi apparatus?

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 three naked RNA viruses?

1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)

What are the three signs of morphine overdose?

1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma

What three structures increase the surface area of the GI tract?

1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)

What two vessels come together to form the external jugular vein?

1. Posterior auricular vein 2. Posterior division of the retromandibular vein

What three β-blockers are used in the treatment of glaucoma?

1. Propranolol 2. Timolol 3. Carteolol

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?

1. Protest 2. Despair 3. Detachment

What are the four functions of saliva?

1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion

What are the four major functions of the acquired immune system?

1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material

What three muscles constitute the pes anserinus?

1. Sartorius 2. Gracilis 3. Semitendinous

What are the three characteristics of ADHD?

1. Short attention span 2. Impulsivity 3. Hyperactivity

What are the four reasons for hypochromic microcytic anemia with a low MCV?

1. Sideroblastic anemias (i.e., porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning

What three organs participate in production of vitamin D?

1. Skin 2. Liver 3. Kidney

What five things are checked in the APGAR test?

1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR, Appearance, Pulse, Grimace, Activity, Respiration

Name the four components of the narcoleptic tetrad.

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.

What are the four most common causes of femoral head necrosis?

1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia

What is the amount in liters and percent body weight for the following compartments? • ICF

28 L, 40% of body weight

How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?

3 ATPs by oxidative phosphorylation

How many months in how many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?

3 months of symptoms in 2 consecutive years

How long is the transit time through the large intestine?

3 to 4 days

By what age should children be able to draw the following figures? • Circle

3 years old

Is the hydroxyl (-OH) end of DNA and RNA at the 3&#039; or the 5&#039; end?

3' end. Phosphate (PO4) is at the 5' end.

What direction does RNA polymerase move along the template strand of DNA during transcription?

3'-5' direction, synthesizing RNA in the 5'-3' direction

Where on the codon and anticodon does the wobble hypothesis take place?

3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.

What two glycolytic enzymes catalyze the substrate-level phosphorylations?

3-Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)

What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Osmolarity

300 mOsm/L

How many pairs of spinal nerves exit from the spinal cord?

31 pairs

How many ATPs per glucose are generated in glycolysis?

38 ATPs if aerobic, 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)

By what age should children be able to draw the following figures? • Cross

4 years old

By what age should children be able to draw the following figures? • Rectangle

4.5 years old (Alphabetic order except with a diamond last: circle, cross, rectangle, square, triangle)

What is the amount in liters and percent body weight for the following compartments? • Vascular fluid

4.7 L, 5% of body weight

What is the amount in liters and percent body weight for the following compartments? • Total body water

42 L, 67% of body weight

What is the karyotype in Turner syndrome?

45XO

By what age should children be able to draw the following figures? • Square

5 years old

What enzyme is inhibited by propylthiouracil (PTU)?

5' deiodinase

What urinary metabolite is increased in patients with carcinoid syndrome?

5-hydroxyindoleacetic acid (5-HIAA)

What percent of unwed mothers are teenagers?

50%, with 50% of them having the child

What percent of sexual abuse cases are committed by family members?

50%. The uncles and older siblings are the most likely perpetrators, although stepfathers also have a high rate.

Of what serotonin receptor is sumatriptan an agonist?

5HT1D

How many ATPs per glucose are produced by pyruvate dehydrogenase?

6 ATPs (remember 2 pyruvates per glucose are produced, and 2 NADHs result from production of acetyl CoA, so 6 ATPs)

When does the primitive gut herniate out of the embryo? When does it go back into the embryo?

6 weeks 10 weeks

By what age should children be able to draw the following figures? • Triangle

6 years old

What is the PO2 of aortic blood in fetal circulation?

60%

What ribosomal subunit sizes do eukaryotic cells have?

60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.

How many codons code for AAs? How many for termination of translation?

61 codons code for AAs and 3 codons (UAA, UGA, UAG) code for the termination of translation.

What is a plasma cell's life expectancy?

7 to 14 days

By what age should children be able to draw the following figures? • Diamond

7 years old

What is the size of the prokaryotic ribosome?

70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes

How long after ovulation does fertilization occur?

8 to 25 hours

At what age does a child develop • Exogenous smile?

8 weeks (response to a face)

What size ribosomes do fungi have?

80S ribosomes (because they are eukaryotic)

How many kilocalories per gram are produced from the degradation of fat? CHO? Protein?

9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism

What is the amount in liters and percent body weight for the following compartments? • Interstitial fluid

9.3 L, 15% of body weight

What percentage of CO2 is carried in the plasma as HCO3- ?

90% as HCO3-, 5% as carbamino compounds, and 5% as dissolved CO2

What is the most common cardiac tumor? In what chamber does it most commonly arise?

90% of benign myxomas arise within the left atrium near the fossa ovalis.

Where is lithium metabolized and excreted?

95% in the kidneys; that's why adequate Na+ and fluid intake is essential.

What is the lecithin:sphingomyelin ratio in respiratory distress syndrome of newborns?

<2

What is the size of a positive PPD test for the following? (Reactive) • IV drug abuser

>10 mm

What is the size of a positive PPD test for the following? (Reactive) • Recent immigrant from India

>10 mm

What is the size of a positive PPD test for the following? (Reactive) • Healthy suburban male without any medical illnesses

>15 mm

How many grams of protein must be excreted in 24 hours to produce the diagnosis of nephrotic syndrome?

>3.5 g/day of protein, along with generalized edema, hypoalbuminemia, and hyperlipidemia

What is the size of a positive PPD test for the following? (Reactive) • Patient with AIDS

>5 mm

What is the size of a positive PPD test for the following? (Reactive) • Posttransplantation patient taking immunosuppressive agents

>5 mm

What is the difference between a Ghon focus and a Ghon complex?

A Ghon focus is a TB tubercle, whereas a Ghon complex is a focus with hilar lymph node involvement.

What two factors cause PTH to be secreted?

A decrease in Ca2+ and an increase in PO4-

How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated, and how?)

A decrease in cutaneous blood flow results from constriction of the arterioles, and decreased cutaneous blood volume results from constriction of the venous plexus.

What is the term for a unit of DNA that encodes a particular protein or RNA molecule?

A gene (a rather simple definition but accurate)

What type of resistance system, high or low, is formed when resistors are added in a series?

A high-resistance system is formed when resistors are added in a series.

Which direction does the uvula deviate in a left vagus nerve lesion?

A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)

What does a loss of afferent activity from the carotid sinus onto the medulla signal?

A loss of afferent activity indicates a decrease in BP, and an increase in afferent activity indicates an increase in BP.

What type of resistance system (i.e., high or low) is formed when resistors are added in parallel?

A low-resistance system is formed by resistors added in parallel.

What remains patent in a hydrocele of the testis, allowing peritoneal fluid to form into a cyst?

A patent processus vaginalis

If the AV difference is positive, is the substance extracted or produced by the organ?

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.

A motor lesion to the right CN V results in deviation of the jaw to which side?

A right CN V lesion results in weakened muscles of mastication, and the jaw deviates to the right.

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.

A transport maximum (Tm) system

What wave is the cause of the following venous pulse deflections? • The contraction of the right atrium

A wave

How many hydrogen bonds link A-T? C-G?

A-T are linked by 2 hydrogen bonds, C-G by 3 hydrogen bonds.

Which antihypertensive class is used to help stop the progression of microalbuminuria?

ACE inhibitors (-pril)

Which class of antihypertensives produces angioedema, hyperkalemia, and a dry cough?

ACE inhibitors (the-pril agents)

What structure of the knee is described thus? • Prevents anterior displacement and has lateral-to-medial attachment on the tibia

ACL

What hormone excess produces adrenal hyperplasia?

ACTH

What are the primary neurotransmitters at the following sites? • All motor neurons, postganglionic parasympathetic neurons

ACh

What are the primary neurotransmitters at the following sites? • Autonomic preganglionic neurons

ACh

To what host cell receptor does the rabies virus attach?

ACh receptor

What three substances stimulate parietal cells?

ACh, histamine, and gastrin

Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body.

ACh; think about the ANS.

What is the most common one? • Melanoma in dark-skinned persons

Acral-lentiginous melanoma

ADH is secreted in response to what two stimuli?

ADH is secreted in response to increased plasma osmolarity and decreased blood volume.

What two enzymes of heme synthesis are inhibited by lead?

ALA dehydrogenase and ferrochelatase

What is the most common one? • Malignancy in children

ALL

What leukemia affects a 4-year-old child with 3 months of fever, fatigue, generalized lymphadenopathy, CNS involvement, hepatosplenomegaly, bleeding, and platelet count below 100, 000?

ALL

What hematological malignancy is particularly likely to affect patients with Down syndrome?

ALL (nearly 15-20 times the normal risk)

Auer rods

AML-M3

What sweat gland type is associated with odor production and hair follicles and is found in the axilla?

APocrinE glands (APES is my memory aid) Axilla, Areola, and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production), and if confronted by an APE, your Adrenergic nervous system would be firing (innervation).

What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?

ASA

What commonly encountered overdose produces headache, tinnitus, respiratory alkalosis, metabolic acidosis, confusion, vomiting, and tachypnea?

ASA (salicylate)

What is the most common one? • Congenital heart defect in adults

ASD

What component of the renin-angiotensin-aldosterone axis increases sodium reabsorption in the proximal convoluted tubules and increases thirst drive?

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?

AT II

What component of the ETC is inhibited by the following? • Atractyloside

ATP/ADP Translocase

When attempting to make up sleep, what stage of sleep is recovered?

About 80% of stage 4 sleep is recovered, approximately half of REM is recovered, and only one-third of total sleep is ever made up.

Abs to what hepatitis B Ag provide immunity?

Abs to HBsAg

Name the period described by the following statement: no matter how strong a stimulus is, no further action potentials can be stimulated.

Absolute refractory period is due to voltage inactivation of sodium channels.

If a patient asks you a question and you do not know the answer, do you tell a white lie or simply not respond?

Absolutely not! Answer any question you are asked.

Is DM a contraindication to use of a β-blocker in a patient who is having an MI?

Absolutely not. Diabetics who are given a β-blocker for an acute chest syndrome have significantly better outcomes than those who do not.

What medication is used to help alcoholics avoid relapse by decreasing glutamate receptor activity?

Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)

What is the term for thickened, hyperpigmented skin in the axillae, groin, and skin folds associated with malignancies, obesity, and DM?

Acanthosis nigricans

What oral hypoglycemic agent inhibits α-glucosidase in the brush border of the small intestine?

Acarbose

What is the only CN nucleus found in the cervical spinal cord?

Accessory nucleus

What is the MCC of death in children aged 1 to 14 in the United States?

Accidents

What term describes the reflex that increases the curvature of the lens, allowing near vision?

Accommodation

What is the term for the total percentage of correct answers selected on a screening test?

Accuracy (think of it as all the trues, because they are the ones correctly identified)

What two β-blockers decrease serum lipids?

Acebutolol and Pindolol

What enzyme is inhibited by disulfiram?

Acetaldehyde dehydrogenase

What enzyme is inhibited by disulfiram?

Acetaldehyde dehydrogenase. When this enzyme is blocked, acetaldehyde builds up, and its presence in excess results in nausea and hypotension.

What is the only class of diuretics to retain Cl- used in the short-term treatment of glaucoma and of acute mountain sickness?

Acetazolamide

Name the three ketone bodies.

Acetoacetate, acetone, and β-hydroxybutyrate

What is the main inhibitor of pyruvate dehydrogenase?

Acetyl CoA (pyruvate to acetyl CoA)

Name the end product or products: • Fatty acid oxidation

Acetyl CoA and propionyl CoA (in odd chain fatty acids)

What enzyme catalyzes the rate-limiting step in fatty acid synthesis?

Acetyl CoA carboxylase

What is the rate-limiting step of the following? • Fatty acid synthesis

Acetyl CoA carboxylase

At the end of each round of β-oxidation, what is released?

Acetyl CoA, FADH2, and NADH

What enzyme found in a cholinergic synapse breaks down ACh? What are the byproducts?

Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).

What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus?

Achalasia

What disorder is defined by inability of the lower esophageal sphincter to relax with swallowing and a bird beak barium swallow result?

Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)

What AD disorder due to a mutation in fibroblast growth factor receptor 3 results in normal-size vertebral column and skull and short, thick extremities?

Achondroplasia

What is the most common form of inherited dwarfism?

Achondroplasia

What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?

Acid is needed for the activation of pepsin and therefore needed for protein digestion.

Should you refer a patient to a form of folk medicine even if you don't believe in it?

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.

With what is cherry red intoxication associated?

Acute CO poisoning

WBCs in the urine

Acute cystitis

RBC casts in the urine

Acute glomerulonephritis

WBC casts in the urine

Acute pyelonephritis

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

Acute rejection

Renal epithelial casts in the urine

Acute toxic or viral nephrosis

Name the most common type or cause. • Acute renal failure in the United States

Acute tubular necrosis

What branch of the immune system is acquired in response to an Ag?

Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.

If one event precludes another event, their probabilities are combined by what method?

Addition (They are mutually exclusive.)

Name the two purine bases found in both DNA and RNA.

Adenine and guanine

What is the most common one? • Primary lung cancer

Adenocarcinoma

What is the most common one? • Primary malignant tumor of the lungs

Adenocarcinoma (30% to 35%)

What is the most common one? Esophageal cancer in the United States

Adenocarcinoma (because of Barrett esophagus)

What is the most common one? • Primary malignant tumor of the female genital tract in the United States

Adenocarcinoma of the cervix

What antiarrhythmic agent is the DOC for treating and diagnosing paroxysmal supraventricular tachycardia (PSVT) and AV nodal arrhythmias?

Adenosine (it is an excellent agent to use in emergencies because its half-life is 30 seconds)

What enzyme of the purine salvage pathway is deficient in the following? • SCID

Adenosine deaminase

What is the first human disease successfully treated with gene therapy?

Adenosine deaminase (ADA) deficiency

Name the DNA virus: • Linear dsDNA; naked; replicates in the nucleus

Adenovirus

What is the MCC of viral conjunctivitis?

Adenovirus

Name the most common type or cause. • Intestinal obstructions in adults

Adhesions and hernias

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?

Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).

What is the only organ in the body supplied by preganglionic sympathetic fibers?

Adrenal medulla

What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?

Adrenarche

What leukemia is associated with four-leaf-clover lymphocytes on peripheral blood smear?

Adult T-cell leukemia

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?

Adult polycystic kidney disease

What type of binding occurs with one Fab or one idiotype of IgG?

Affinity

What is the term for the strength of the association between Ag and an Ab?

Affinity (one of each)

What happens to affinity if you increase Km?

Affinity decreases; they are inversely proportional.

Regarding the viral growth curve, is the internal virus present before or after the eclipse period?

After the eclipse period

Regarding the viral growth curve, is the external virus present before or after the latent period?

After the latent period

What equals the total tension on a muscle minus the preload?

Afterload

What is the term for the force the ventricular muscle must generate to expel the blood into the aorta?

Afterload

What is the term for the load a muscle is trying to move during stimulation?

Afterload

What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?

Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.

What is the stimulus for the classical pathway activation?

Ag-Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.

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.

Aged adult

Do agents used in the treatment of Parkinson's disease that decrease ACh function have little effect on reducing tremors and rigidity?

Agents that decrease ACh function reduce tremors and rigidity, not bradykinesias.

What immunologic test checks for a reaction between Abs and a particular Ag? (hint: ABO typing)

Agglutination test

What phobia is described as the fear of open spaces?

Agoraphobia. It also means having a sense of humiliation or hopelessness.

What potentially lethal side effect of clozapine should be monitored with frequent blood drawing?

Agranulocytosis; approximately 2% develop this side effect.

What result occurs because of the negative alveolar pressure generated during inspiration?

Air flows into the respiratory system.

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?

Akathisia

What is the name of the program that deals with codependency and enabling behaviors for family members of alcohol abusers?

Al-Anon

As what AAs do muscles send nitrogen to the liver?

Alanine and glutamine

In what cycle does glucose go to the muscle, where it is converted to pyruvate and then into alanine before being taken back to the liver?

Alanine cycle

What drug blocks glucose uptake, leading to decreased formation of ATP and resulting in immobilization of the parasite?

Albendazole

What disorder is due to a deficiency in tyrosinase?

Albinism

What disease is produced by a deficiency in the enzyme tyrosinase?

Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.

What protein carries free fatty acids to the liver?

Albumin

Name the most common cause. • Chronic pancreatitis

Alcohol abuse

Name the most common type or cause. • Reversible HTN in the United States

Alcohol abuse

What is the costliest health care problem in the United States?

Alcohol and its related problems cost the country approximately $100 billion a year.

Name the most common type or cause. • Cirrhosis in the United States

Alcohol consumption

What is the most abused drug across all age groups?

Alcohol. Nearly 10% of adults have a problem with alcohol.

What is the name of the process that ensures that each B cell produces only one heavy-chain variable domain and one light chain?

Allelic exclusion. It is to ensure that one B cell produces only one Ab.

Name the type of graft described by these transplants: • From one person to the next (the same species)

Allograft

What is the drug of choice for treating a patient with hyperuricemia due to overproduction of uric acid?

Allopurinol

What are the genetic variants of a molecule within members of the same species?

Allotypes

Which thrombolytic agent, activated in the presence of fibrin, is manufactured by recombinant DNA process?

Alteplase

What is the name of the hypothesis you are trying to prove?

Alternative hypothesis (what is left after the null has been defined)

Does the direct or indirect basal ganglia pathway result in a decreased level of cortical excitation?

Although both pathways are associated with disinhibition, the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.

Name these mature defense mechanisms: • Helping others without expecting any return

Altruism

What is the term for ventilation of unperfused alveoli?

Alveolar dead space

Name the macrophages by location: • Lungs

Alveolar macrophages

In the alveoli, what cell type is • part of the mononuclear phagocytic system?

Alveolar macrophages (dust cells)

Which of the following is not part of the conducting portion of the respiratory system: trachea, bronchi, alveoli, or larynx?

Alveoli; they are part of the respiratory portion.

Name the most common cause. • Dementia in persons aged 60 to 90 years

Alzheimer disease

Neurofibrillary tangles

Alzheimer disease

Senile plaques

Alzheimer disease

What is the most common form of dementia?

Alzheimer's (dementia of Alzheimer's type, DAT). (Remember, Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)

What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?

Amanita phalloides

What antiviral agent blocks the attachment and penetration of influenza A virus?

Amantadine

What antiviral agent is used in the treatment of drug-induced Parkinson's disease?

Amantadine

What is the treatment for nephrogenic diabetes insipidus induced by lithium?

Amiloride

Which sodium channel blocker is used to treat lithium-induced diabetes insipidus?

Amiloride

What disease is described by bilateral flaccid weakness of the upper limbs (LMN) and bilateral spastic weakness of the lower limbs (UMN) beginning at the cervical level of the spinal cord and progressing up or down the cord?

Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a LMN lesion at the level of the lesion and UMN lesion below the level of the lesion.

What is the most important stimulus for the secretion of insulin?

An increase in serum glucose levels

Regarding skeletal muscle mechanics, what is the relationship between velocity and afterload?

An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)

What does the tunica intima of arteries have that veins do not?

An internal elastic lamina

What is the term for any region of the respiratory system that is incapable of gas exchange?

Anatomical dead space, which ends at the level of the terminal bronchioles.

What hormone, produced by the Sertoli cells, is responsible for keeping testosterone levels in the seminiferous tubules nearly 50 times that of the serum?

Androgen-binding protein

How many carbons do androgens have?

Androgens are 19-carbon steroids.

What toxicities are caused by the following agents? • Occupational nitrous oxide exposure

Anemia

Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, TIBC, and percent saturation; increased ferritin

Anemia of chronic disease

Why is O2 content depressed in anemic patients?

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.

Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Vinyl chloride

Angiosarcoma of the liver

What is the term to describe the inability to feel any pleasant emotions?

Anhedonia

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?

Ankylosing spondylitis

Is an anti-HAV IgG Ab associated with immunization or recent infection?

Anti-HAV IgG Abs are associated with immunization or a prior infection. Anti-HAV IgM is associated with acute or recent infection.

Name these mature defense mechanisms: • Preparing for an upcoming event

Anticipation

What is the term for the number of trinucleotide repeats increasing with successive generations and correlating with increased severity of disease?

Anticipation, associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.

Name the antidote. • Digoxin

Antidigoxin Fab fragments

What is the term to describe the limited portion of an Ag that is recognized by an Ab?

Antigenic determinant (epitope)

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?

Antigenic determinant (epitope). (Idiotypes bind to epitopes.)

Name the cluster B personality disorder: • Criminal behavior; lacking friends, reckless, and unable to conform to social norms

Antisocial

What personality disorder affects 75% of the prison population?

Antisocial personality

What two Abs are used to diagnose Hashimoto's thyroiditis?

Antithyroglobulin and antimicrosomal Abs

Name the most common type. • Psychiatric disorder in women of all ages

Anxiety disorders; for men it is substance abuse.

What structure or structures cross the diaphragm at • T12 level?

Aorta, azygos vein, and thoracic duct Remember: 1 at T8, 2 at T10, and 3 at T12

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

Aortic insufficiency

Name the valve abnormality based on the following criteria: • Systolic murmur, increased preload and afterload, decreased aortic pulse pressure and coronary blood flow

Aortic stenosis

What respiratory center in the caudal pons is the center for rhythm promoting prolonged inspirations?

Apneustic center (deep breathing place)

What is the term for programmed cell death?

Apoptosis (Remember, there is a lack of inflammatory response.)

What is the most common one? • Site for carcinoid tumors

Appendix (second is terminal ileum)

What cells contribute to the blood-brain barrier and proliferate in response to CNS injury?

Astrocytes

Name the cancer associated with the following oncogenes. (Some may have more than one answer) • sis

Astrocytoma

What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?

Astrocytoma

At what age do children begin to understand the irreversibility of death?

At 8 to 9 years of age. Prior to this age they view death as a form of punishment.

At what age does a child develop • Endogenous smile?

At birth (reflex)

How far below ideal body weight are patients with anorexia nervosa?

At least 15%

What percentage of the bone marrow must be composed of blast for leukemia to be considered?

At least 30% blast in the bone marrow

How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?

At least 5 lobes

How many café-au-lait spots are necessary for the diagnosis of neurofibromatosis type 1?

At least six

On a graphical representation of filtration, reabsorption, and excretion, when does glucose first appear in the urine?

At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.

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

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 original filtered volume left in the lumen

At the end of the PCT 25% of the original volume is left

What AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections, uncoordinated muscle movements, and dilation of the blood vessels?

Ataxia-telangiectasia

Which nicotinic receptor antagonist is inactivated to laudanosine?

Atracurium

On the venous pressure curve, what do the following waves represent? • A wave?

Atrial contraction Atrial, Contraction, Venous

On the venous pressure curve, what do the following waves represent? • V wave?

Atrial filling (venous filling) Atrial, Contraction, Venous

What is the term to describe a decrease in the cell size and function usually associated with disuse?

Atrophy. Disuse can also be due to immobilization, ischemia, aging, and a host of other causes.

What is the antidote for organophosphate ingestion?

Atropine and 2-PAM (pralidoxime)

Name the antidote. • AChE inhibitors

Atropine with pralidoxime

Name the antidote. • Organophosphates

Atropine, 2-PAM (pralidoxime)

What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?

Auspitz sign

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?

Autism. Head-banging, rocking, and self-injurious behaviors are also common in autism.

Name the type of graft described by these transplants: • From one site to another on the same person

Autograft

What are the three exceptions to the rule of codominant gene expression?

Barr bodies in females, T-cell receptor loci, and immunoglobulin light and heavy chain loci

What form of anemia is associated with IgG Abs against Rh antigens, positive direct Coombs test, and splenomegaly?

Autoimmune hemolytic anemia

What type II hypersensitivity disorder is defined as • Autoantibodies directed against RBC Ag I?

Autoimmune hemolytic anemia

What type II hypersensitivity disorder is defined as • Autoantibodies directed against platelet integrin?

Autoimmune thrombocytopenia purpura

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.

Autosomal dominant

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?

Autosomal recessive

What is the label given to an individual whose IQ is • 90 to 109

Average

What classical conditioning therapy or modification is described as • Pairing noxious stimuli to an inappropriate behavior?

Aversive conditioning

What is the term for the strength of association between multiple Abbinding sites and multiple antigenic determinants?

Avidity (more than one binding site)

What is the term for the strength of the association between Ags and Abs?

Avidity. There is a positive correlation between valence numbers and avidity.

Name the cluster C personality disorder: • Sensitive to criticism, shy, anxious; socially isolated but yearns to be in the crowd

Avoidant

What nerve and artery could be affected in a humeral neck fracture?

Axillary nerve and posterior humeral artery

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)?

Axis I

The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Personality and mental disorders?

Axis II

The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Medical or physical ailments?

Axis III

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)?

Axis IV

The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Global assessment of function?

Axis V

Where is the action potential generated on a neuron?

Axon hillock

What immunosuppressive agent is converted to 6-mercaptopurine?

Azathioprine

Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium intracellulare complex?

Azithromycin

What cell type is found in the peripheral white pulp of the spleen?

B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.

What is the only specific Ag-presenting cell?

B cells; macrophages and dendritic cells are nonspecific.

What cell type involves humoral immunity?

B lymphocyte

Name the most common type or cause. • Urinary tract obstruction

BPH

What is the most common one? • Proliferative abnormality of an internal organ

BPH

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?

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.

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?

Bacillus anthracis

What bacterium is responsible for woolsorter's disease?

Bacillus anthracis

What organism would you suspect in a patient with diarrhea after eating rice?

Bacillus cereus

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

Bacteria

What condition results in the following CSF results? • Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120

Bacterial meningitis

What form of antimicrobial therapy is best for an immunocompromised patient?

Bactericidal

What cardiac reflex is characterized by stretch receptors in the right atrium, afferent and efferent limbs via the vagus nerve, and increased stretch leading to an increase in heart rate via inhibition of parasympathetic stimulation?

Bainbridge reflex

Which overdose carries a higher mortality rate, that of benzodiazepines or barbiturates?

Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.

Does being a female physician increase or decrease the risk of suicide?

Being a female physician increases the risk of suicide nearly four times the general population.

Name the stages of sleep with these EEG patterns: • Alpha waves

Being awake

What has proved to be the best way to extinguish enuresis?

Bell pad

What neuropsychologic test shows nine designs to the patient, then asks for recall of as many as possible?

Bender Visual Motor Gestalt Test

What skin condition is a localized proliferation of melanocytes presenting as small, oval, light brown macules?

Benign lentigo

What is the term for a benign melanocytic tumor associated with sun exposure that presents as tan-to-brown colored and has sharply defined well-circumscribed borders?

Benign nevus (mole)

What type of GN, associated with celiac disease and dermatitis herpetiformis, has mesangial deposits of IgA, C3, properdin, IgG, and IgM?

Berger disease (IgA nephropathy)

What AR syndrome is due to a deficiency of glycoprotein Ib, resulting in a defect in platelet adhesion?

Bernard-Soulier syndrome

What aneurysm of the circle of Willis is associated with polycystic kidney disease?

Berry aneurysm

Name the cerebral vessel associated with the following vascular pathologies. • Subarachnoid hemorrhage

Berry aneurysm in the circle of Willis

What pneumoconiosis is associated with exposure to the following occupations or materials? • Aerospace industry, nuclear reactors

Berylliosis

What chemical can be dangerous if you work in the aerospace industry or in nuclear plants?

Beryllium

Which integrin mediates the adhesion to endothelial cells for migration in and out of the blood during an immune response?

Beta2-integrins

What is the most common one? • Sites for abdominal aorta aneurysm

Between the renal arteries and at the bifurcation of the abdominal aorta

What sensory system is affected in the late spinal cord manifestation of syphilis?

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.

Which class of antihyperlipidemics would you avoid for a patient with elevated triglyceride levels?

Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore, they are not used if a patient has hypertriglyceridemia.

Where in the GI tract does the reabsorption of bile salts take place?

Bile salts are actively reabsorbed in the distal ileum.

What is the most common one? • Malignant tumor in women

Breast

What is the most common one? • Primary tumor metastasis to the bone

Breast

What are the two leading causes of cancer-related death in women?

Breast and lung cancer, respectively.

Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1, int-2, erb-2, and erb-3

Breast cancer

What do the risk factors late menopause, early menarche, obesity, nulliparity, excessive estrogen, genetic factor p53, and brc-abl characterize?

Breast cancer

What is the most common diagnosis made (or missed!) resulting in a malpractice suit?

Breast cancer

What two factors lead to the development of the bends (caisson disease)?

Breathing high-pressure nitrogen over a long time and sudden decompression result in the bends.

Name the cerebral vessel associated with the following vascular pathologies. • Subdural hemorrhage

Bridging veins draining into the sagittal sinus

What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?

Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)

Name the aphasia based on these characteristics: • Nonfluent speech, telegraphic and ungrammatical; lesion in Brodmann's area 44; unimpaired comprehension

Broca's aphasia

Charcot-Leyden crystals