USMLE Step 1 questions
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.
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
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.
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.)
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
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 somatoform disorder is described as • Unrealistic negative opinion of personal appearance, seeing self as ugly?
Body dysmorphic disorder
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 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)
Which three organisms cause heterophilic negative mononucleosis?
CMV, Toxoplasma gondii, and Listeria
What viral infection is known to cause intracerebral calcifications?
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
What DNA virus is associated with heterophile-negative mononucleosis?
CMV; remember, EBV is associated with heterophile-positive mononucleosis.
Name the structure that enters or exits the following foramina: • Cribriform plate
CN I
Which CNs are found in the midline of the brainstem?
CN I, II, III, VI, and XII Add 1 + 1 = 2, 1 + 2 = 3, 1 + 2 + 3 = 6, 1 + 2 + 3 + 6 = 12
Name the structure that enters or exits the following foramina: • Optic canal
CN II and ophthalmic artery
What CNs are responsible for the sensor and motor components of the light reflex?
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
With which CN are preganglionic parasympathetic axons arising from the Edinger- Westphal nucleus associated?
CN III
What CNs are affected if there is a lesion in • The midbrain?
CN III and IV
What CNs arise from • The midbrain?
CN III and IV
What three CNs are associated with conjugate eye movements?
CN III, IV, and VI
What four CN carry preganglionic parasympathetic fibers?
CN III, VII, IX, and X
What is the only CN to arise from the dorsal surface of the midbrain?
CN IV
What CN is associated with the • Third pharyngeal arch?
CN IX
What two CNs are responsible for the carotid body and sinus reflexes?
CN IX and X
Name the structure that enters or exits the following foramina: • Jugular foramen
CN IX, X, and XI; sigmoid sinus
What CNs are affected if there is a lesion in • The upper medulla?
CN IX, X, and XII
What CNs arise from • The medulla?
CN IX, X, and XII CN XI arises from the cervical spinal cord.
What CN is associated with the • First pharyngeal arch?
CN V
What CNs are affected if there is a lesion in • The upper pons?
CN V
What CNs arise from • The pons?
CN V, VI, VII, and VIII
What nerves carry the sensory and motor components of the blink reflex?
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
What CN transmits sensory information from the cornea?
CN V1, the occulomotor division of the trigeminal nerve, is the sensory component of the corneal reflex.
Name the structure that enters or exits the following foramina: • Foramen rotundum
CN V2
Name the structure that enters or exits the following foramina: • Foramen ovale
CN V3 and the lesser petrosal nerve
What CNs are affected if there is a lesion in • Pontomedullary junction?
CN VI, VII, and VIII
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
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
What sulcus divides the occipital lobe horizontally into a superior cuneus and inferior lingual gyrus?
Calcarine sulcus
What virus is associated with the Norwalk agent?
Calicivirus
What is the name of the superficial subcutaneous fascia of the abdomen containing fat?
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
What microaerophile is a motile gram-negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
Campylobacter jejuni
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
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.
What subtype of schizophrenia is characterized by • Stuporous mute echopraxia and automatic obedience, waxy flexibility with rigidity of posture?
Catatonic schizophrenia
What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina?
Cauda equina
What type of mortality rate is defined as the number of deaths • From a specific cause per population?
Cause-specific mortality rate
What fissure of the cerebral cortex runs perpendicular to the lateral fissure and separates the frontal and the parietal lobes?
Central sulcus (sulcus of Rolando)
What is the precursor of all sphingolipids?
Ceramide
Name the area of the cerebral cortex with the function described: • Skill-based memory, verbal recall, balance, refined voluntary movements
Cerebellum
What connects the third and the fourth ventricles?
Cerebral aqueduct
What cell surface modification of ependymal cells and respiratory epithelium has a 9 + 2 microtubular configuration and movement as its function?
Cilia
What ganglion supplies the postganglionic parasympathetic fibers to the ciliary muscles of the eye?
Ciliary ganglion
What ocular ganglion is affected if the pupil on the affected side sluggishly responds to light with normal accommodation?
Ciliary ganglion producing a tonic pupil
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
Which dimorphic fungus is found as Arthroconidia in desert sand of the southwestern United States (e.g., San Joaquin Valley)?
Coccidioides immitis
Can incidence, prevalence, and cause and effect be assessed in • Cohort studies?
Cohort studies determine incidence and causality, not prevalence.
What area of the nephron is sensitive to the effects of ADH?
Collecting ducts, which make them readily permeable to water reabsorption.
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
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 for repetitive actions blocking recurring bad thoughts?
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
At what stage of cognitive development (according to Piaget) do children • See death as irreversible?
Concrete operations (6-12 years)
Name the aphasia based on these characteristics: • Lesion is in the parietal lobe or arcuate fibers because the connection between Broca's and Wernicke's area is severed; word comprehension preserved; inability to write or speak the statement (can't tell you what you said)
Conduction aphasia
What cells of the retina sees in color and needs bright light to be activated?
Cones (C for color and cones)
What nucleus supplies the preganglionic parasympathetic fibers to the ciliary ganglion?
Edinger-Westphal nucleus (via CN III)
What is the term for making up stories regarding past experiences because of an inability to retrieve them?
Confabulation; it is commonly seen in Korsakoff's syndrome.
What paraphilia is defined as • Having a recurrent desire to expose the genitals to strangers?
Exhibitionism
True or false? Streptococci have catalase.
False. Staphylococci have catalase; streptococci do not.
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? 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.
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? The increased oxygen consumption after phagocytosis is for ATP production.
False; it is for the production of toxic metabolites.
What AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas?
Familial hypercholesterolemia
What intermediate of cholesterol synthesis anchors proteins in the membranes and forms CoA?
Farnesyl pyrophosphate (FPP)
During a prolonged fast, why is the brain unable to use fatty acids?
Fatty acids cannot cross the blood-brain barrier; therefore, they cannot be used as an energy source.
What lower extremity nerve is described by the following motor loss? • Loss of knee extension, weakened hip flexion
Femoral nerve
What enzyme is deficient in hereditary protoporphyria?
Ferrochelatase
What portion of the pericardium adheres to the tunica adventitia of the great vessels?
Fibrous pericardium
From what aortic arch are the following structures derived? • Degenerates
Fifth MS CARD is my mnemonic for the aortic arch derivatives
What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
Filiform papillae
What family do the following viruses belong to? • Ebola
Filovirus
What specifies how accurately the sample values and the true values of the population lie within a given range?
Confidence interval. It is a way of admitting estimation for the population.
When more than one explanation can account for the end result, what form of bias occurs?
Confounding bias
What type of spore is asexual and formed of hyphae?
Conidia
What type of jaundice is seen in Rotor's syndrome?
Conjugated (direct) hyperbilirubinemia
What type of jaundice is seen in Dubin-Johnson syndrome?
Conjugated (direct) hyperbilirubinemia, a transport defect
Do the duct or the acini cells of the pancreas secrete HCO3-?
Duct cells secrete HCO3-, electrolytes, and water. The acini secrete the enzymes necessary for carbohydrate, nucleic acid, protein cleavage, and emulsification of fats.
Where do sperm go for maturation?
Ductus epididymis, which is lined by pseudostratified epithelium with stereocilia.
What happens to dopamine levels when we awaken?
Dopamine levels rise with waking; dopamine is associated with wakefulness.
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 name for failed recanalization of the duodenum resulting in polyhydramnios, bile-containing vomitus, and a distended stomach?
Duodenal atresia
What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
Duodenal ulcer
What segment of the small intestine is associated with Brunner's glands?
Duodenum
In what stage of sleep is it easiest to arouse a sleeping individual?
During REM sleep
What three vitamin deficiencies are associated with homocystinemia?
Folate, vitamin B12, and vitamin B6
What water-soluble-vitamin deficiency is associated with neural tube defects in the fetus?
Folic acid
What type of foods should patients taking MAOIs avoid? Why?
Foods rich in tyramine (e.g., cheese, dried fish, sauerkraut, chocolate, avocados, and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
With what virus are Downey type II cells associated?
EBV
What factors are needed for elongation in eukaryotes?
EF-1 and GTP
What factors are needed for translocation in eukaryotes?
EF-2 and GTP
What prokaryotic positioning enzyme in translation is blocked by the following? • Erythromycin
EF-G of the 50S subunit
What prokaryotic positioning enzyme in translation is blocked by the following? • Tetracycline
EF-Tu and EF-Ts of the 30S ribosomal subunit
What factors are needed for elongation in prokaryotes?
EF-Tu or EF-ts and GTP
What is the primary screening test used to detect HIV-infected individuals? Confirmatory test?
ELISA is used as a screening test because it is very sensitive; Western blot is used as a confirmatory test because it detects antibodies (protein) to the HIV virus.
What test is used to screen for HIV?
ELISA. It detects anti-p24 IgG.
What is the only factor of enzyme kinetics that the enzyme affects?
Ea (activation energy)
What is the key issue surrounding teenagers' maturation?
Formation of an identity through issues of independence and rebellion; they define who they are.
What are the adult remnants of the following structures? • Foramen ovale
Fossa ovale
What group of eukaryotic regulatory proteins has a major factor in controlling the gene expression embryonically?
Homeodomain proteins
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 is the major inorganic component of bone?
Hydroxyapatite
What form of AA is found only in collagen?
Hydroxyproline
What purine base is contained in inosine monophosphate?
Hypoxanthine (remember, IMP is a precursor for AMP and GMP)
Is the Lac operon activated or inactivated in the presence of both glucose and lactose?
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
What is the term for the number of new events occurring in a population divided by the population at risk?
Incidence rate
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 are the three polymorphonuclear leukocytes? Be specific.
Neutrophils, eosinophils, and basophils
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 term to describe the average?
Mean
What negative sense RNA virus is associated with cough, coryza, and conjunctivitis with photophobia?
Measles (rubeola)
What type of bias is it when the information is distorted because of the way it is gathered?
Measurement bias
What structure of the knee is described thus? • Prevents abduction
Medial collateral ligament
Name the compartment of the lower extremity and the nerve based on its movements. • Adduct the thigh and flex the hip
Medial compartment of the thigh, obturator nerve
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 is the only drug that does not have an intoxication?
Nicotine (but it sure has a nasty withdrawal!)
Movement disorders are associated with what dopamine pathway (what part of the brain)?
Nigrostriatal pathways (basal ganglia)
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 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 two AAs do not have more than one codon?
Methionine (start) and tryptophan are the only two AAs with only one codon.
What is the drug of choice for treating ADHD?
Methylphenidate (Ritalin)
What assay is used to identify MHC class I molecules?
Microcytotoxic assay
What glial cell is derived from mesoderm and acts as a scavenger, cleaning up cellular debris after injury?
Microglia (Microglia and mesoderm both begin with M)
What is the only neuroglial cell of mesodermal origin?
Microglia. All others are neuroectodermal derivatives.
Name the macrophages by location: • CNS
Microglial cells
Which genus of dermatophytes is associated with the following sites of infection? • Hair and skin only
Microsporum
What cell membrane structure increases the surface area of a cell and has actin randomly assorted within its structure?
Microvillus
Name the compartment of the mediastinum associated with the following thoracic structures: • Ascending aorta
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Heart and pericardium
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • IVC
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Pulmonary artery and veins
Middle
What artery supplies most of the lateral surfaces of the cerebral hemispheres?
Middle cerebral artery
Name the structure that enters or exits the following foramina: • Foramen spinosum
Middle meningeal artery
What vessel is lacerated in an epidural hematoma?
Middle meningeal artery
What renal side effect is commonly seen in patients taking lithium?
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
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
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 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.
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.
Name the cluster C personality disorder: • Orderly, inflexible, perfectionist; makes rules, lists, order; doesn't like change, has a poor sense of humor, and needs to keep a routine
Obsessive-compulsive
What lower extremity nerve is described by the following motor loss? • Loss of adduction of the thigh
Obturator nerve
Name the area of the cerebral cortex with the function described: • Recall of objects, distances, and scenes; visual input processed here
Occipital lobe
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Denies being blind, cortical blindness
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
Name the form of spina bifida. • Defect in the vertebral arch
Occulta All except occulta cause elevated-fetoprotein levels.
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)
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls distal musculature?
Intermediate part of the hemispheres
What bonds are broken by endonucleases?
Internal 3', 5' PDE bonds
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
What are the five AAs that are both ketogenic and glucogenic?
Isoleucine, threonine, tryptophan, tyrosine, and phenylalanine
What is the most common cause of vitamin B6 deficiency?
Isoniazid treatment
What is the term for different classes and subclasses of the same gene products?
Isotypes
At what vertebral levels does the aortic arch begin and end?
It both begins and ends at T4 (sternal angle [of Louis]).
What does Candida albicans do that distinguishes it from other fungi?
It forms a germinal tube at 37°C.
What are the two actions of calcitonin?
It increases Ca2+ excretion from the kidney and increases bone mineralization.
How does L-tryptophan affect sleep?
It increases REM and total sleep time.
What segments of the lumbosacral plexus form the following nerves? • Obturator nerve
L2 to L4 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Common peroneal nerve
L4 to S3 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Tibial nerve
L4 to S3 (L2 to L4, thigh; L4 to S3, leg)
What is the anatomic positioning of the right and left gastric nerve plexus of the esophagus as they pass through the diaphragm?
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
Name the lipoprotein based on the following characteristics. • apo B-100
LDL
What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle?
LDL
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)
Which leukotriene is chemotactic for neutrophils?
LTB4
Which leukotrienes are associated with the late-phase inflammatory response?
LTC4 and LTD4
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 are the two ketogenic AAs?
Leucine and lysine
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.
When is the first arrested stage of development in the female reproductive cycle?
Prophase of meiosis I (between 12th and 22nd week in utero)
What is the only fatty acid that is gluconeogenic?
Propionic acid
What type of mortality rate is defined as the number of deaths • From a specific cause per all deaths?
Proportionate mortality rate
Name three products of HIV's pol gene.
Protease, integrase, and reverse transcriptase
What Staphylococcus aureus protein inhibits phagocytosis?
Protein A
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
Name the bony articulations of the following sites. Be specific. • Wrist
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember, for major articulations, wrist/radius and humerus/ulna = elbow)
What is the term for the difference between the highest and the lowest score in a population?
Range
What childhood pathology involves anterior bowing of the tibia, epiphyseal enlargements, and costochondral widening, with the endochondral bones being affected?
Rickets
What is the term for vitamin D deficiency prior to epiphyseal fusion?
Rickets prior to fusion, osteomalacia if the deficiency occurs after epiphyseal fusion.
What rare disorder presents as a large, hard, irregular thyroid gland due to fibrous proliferation of connective tissue in the thyroid gland and extends to adjacent structures?
Riedel thyroiditis
What part of the heart forms • The right border?
Right atrium
Name the correct artery. • The right recurrent laryngeal nerve passes around it.
Right brachiocephalic artery
What artery supplies the right atrium, right ventricle, sinoatrial and atrioventricular nodes?
Right coronary artery
What artery travels with the following veins? • Small cardiac vein
Right coronary artery
Where is the lesion that produces these symptoms when a patient is asked to look to the left? • Right eye can't look left, left eye nystagmus, and convergence is intact
Right medial longitudinal fasciculus
Name the ocular lesion; be specific. • A right lateral compression of the optic chiasm (as in aneurysms in the internal carotid artery)
Right nasal hemianopsia
What part of the heart forms • Anterior wall?
Right ventricle
What is the tetrad of Jarisch-Herxheimer reaction?
Rigors, leukopenia, decrease in blood pressure, and increase in temperature
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 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 term describes how an action potential is propagated along an axon?
Saltatory conduction
What level of mental retardation is characterized by • Having the ability to communicate and learn basic habits but training is usually not helpful?
Severe (range 20-34)
What is the term for a complete aversion to all sexual contact?
Sexual aversion disorder
What operant conditioning therapy or modification is described as • Reinforcing successive attempts that lead to the desired goal (gradual improvement)?
Shaping (successive approximation)
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)
What nematode is known as threadworms? What is the treatment?
Strongyloides stercoralis is treated with thiabendazole.
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 these mature defense mechanisms: • Forgetting on purpose (so you can actually remember it)
Suppression
What nucleus of the hypothalamus receives visual input from the retina and helps set the circadian rhythm?
Suprachiasmatic nucleus
What hypothalamic nucleus is responsible for the production of ADH?
Supraoptic nuclei; lesions here result in diabetes insipidus.
What muscle or muscles are innervated by the following nerves? • Suprascapular nerve
Supraspinatus and infraspinatus
What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
Swan-neck deformities
What ganglion receives preganglionic sympathetic fibers from T1 to L1-2 and innervates smooth muscle, cardiac muscle, glands, head, thoracic viscera, and blood vessels of the body wall and limbs?
Sympathetic chain ganglion
Which trophoblast layer of the placenta remains until the end of pregnancy?
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
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 condition results from a deficiency in the enzyme hexosaminidase A?
Tay-Sachs disease
With what stage of sleep are bruxisms associated?
Teeth grinding is associated with stage 2 sleep.
Name the area of the cerebral cortex with the function described: • Language, memory, and emotion (Hint: herpesvirus infects here commonly)
Temporal lobe
What part of the ANS is affected in the biofeedback model of operant conditioning?
The biofeedback model is based on the parasympathetic nervous system.
Which is the conditioned response, the conditioned stimulus, the unconditioned response, the unconditioned stimulus in this case? A patient has blood withdrawn and faints. The next time she goes to have blood taken, she faints at the sight of the needle.
The blood withdrawn is the unconditioned stimulus, inducing the unconditioned response (fainting). The needle is part of the blood-drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in the conditioned response (fainting at the sight of the needle).
Is the carotid sinus sensitive to pressure or oxygen?
The carotid sinus is a pressure-sensitive (low) receptor, while the carotid body is an oxygen-sensitive (low) receptor. (Remember "Sinus Pressure").
What is the essential reservoir host for Toxoplasma gondii?
The cat
What structure is derived from the prochordal plate?
The mouth
What basic reflex regulates muscle tone by contracting muscles in response to stretch of that muscle?
The myotatic reflex is responsible for the tension present in all resting muscle.
Regarding the Lac operon, for what do the following genes code? • A gene
Thiogalactoside transacetylase
What is the binding site for RNA polymerase?
The promoter indicates where transcription will begin.
What is the only vein in the body with a high O2 content?
The pulmonary vein, which carries oxygenated blood from the lung to the left atrium.
What reticular nuclei synthesize serotonin from L-tryptophan and plays a role in mood, aggression, and inducing sleep?
The raphe nuclei
What regulates the rate of ketone body formation?
The rate of β-oxidation
What is the vector for Chagas disease?
The reduviid bug
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 two regions of the vertebral column are considered primary curvatures?
Thoracic and sacral
What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Thoracic splanchnic fibers
What are the functions of the zonula occludens and the zonula adherens
To provide attachment between contiguous cells and to maintain a semipermeable barrier
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
Which benzodiazepine has the shortest half-life?
Triazolam
Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining?
Trichomonas vaginalis (treat with metronidazole)
Which genus of dermatophytes is associated with the following sites of infection? • Skin, hair, and nails
Trichophyton
What nematode is known as whipworms? What is the treatment?
Trichuris trichiura is treated with albendazole.
What type of symptoms in schizophrenia are associated with • Dopamine receptors?
Type I symptoms (positive); schizophrenics have them, but otherwise healthy persons do not.
What type of error is made if you accept the null hypothesis when it is false?
Type II error (beta error). (Remember it as saying something doesn't work when it does.)
What type of hypersensitivity is an Ab-mediated response against our own cells, receptors, or membranes via IgG or IgM?
Type II hypersensitivity reaction
In the alveoli, what cell type is • responsible for producing surfactant?
Type II pneumocytes
What type of symptoms in schizophrenia are associated with • Muscarinic receptors (ACh)?
Type II symptoms (negative); otherwise healthy persons have them, but schizophrenics do not.
What type of hypersensitivity is a result of high circulating levels of soluble immune complexes made up of IgG or IgM Abs?
Type III hypersensitivity reaction
What type of collagen is associated with the basement membrane?
Type IV collagen
What type of hypersensitivity is a T cell-mediated response to Ags that are not activated by Ab or complement?
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
What AA is a phenol?
Tyrosine
What is the primary end product of pyrimidine synthesis?
UMP
What two arteries join to form the superficial and deep palmar arches of the hand?
Ulnar and radial arteries (ulnar is the main supplier)
What nerve is associated with the following functions? • Innervation of the flexor carpi ulnaris, flexor digiti profundus (pinky and ring fingers), and the intrinsic muscles of the hand
Ulnar nerve
In regard to motor development during infancy, choose the motor response that happens first. • Radial or ulnar progression
Ulnar to radial progression
What form of sunlight is the most carcinogenic?
Ultraviolet B (UVB) sunlight
What form of bilirubin is carried on albumin?
Unconjugated (indirect)
What form of bilirubin can cross the blood-brain barrier?
Unconjugated free bilirubin
What two viruses are associated with Reye's syndrome?
Varicella virus and influenza virus
With which DNA virus are Guarnieri bodies associated?
Variola (smallpox)
What virus is associated with Guarnieri bodies?
Variola virus (Smallpox)
What is the term for the dementia characterized by decremental or patchy deterioration in cognitive function due to a cerebrovascular accident?
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
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.)
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
What nucleus of the hypothalamus is the satiety center, regulating food intake?
Ventromedial nucleus; lesions here result in obesity.
What term describes senseless repetition of words or phrases?
Verbigeration
What is the name for the most prominent spinous process?
Vertebra prominens (C7 in 70% of cases, C6 in 20%, T1 in 10%)
What is the maximum rate possible with a given amount of enzyme?
Vmax
What is the term when the brachial artery is compressed, resulting in ischemic contracture of the hand?
Volkmann's contracture
What paraphilia is defined as • Deriving sexual pleasure from watching others having sex, grooming, or undressing?
Voyeurism
Where are the tonsillar tissues?
Waldeyer's ring
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.
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
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
What blotting technique uses the following for analysis? • Protein
Western blot
What is the confirmatory test for HIV?
Western blot
By asking a patient to close the eyes while standing with feet together, what two pathways are you eliminating from proprioception?
When a patient closes the eyes while standing with feet together, the visual and cerebellar components of proprioception are removed, so you are testing the dorsal columns. Swaying with eyes closed is a positive Romberg's sign indicating a lesion in the dorsal columns. The cold water caloric test mimics a brainstem lesion by inhibiting the normal reflex response. (COWS: Cold Opposite Warm Same)
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 form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
Operant conditioning (reinforcement is after a response)
Which PG is associated with maintaining a PDA?
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin, ACh, and catecholamines promote closure of the ductus arteriosus.
What branch off the vertebral artery supplies • The cerebellum and the dorsolateral part of the medulla?
PICA
What area of the brain acts as the center for ipsilateral horizontal gaze?
PPRF
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
What direct-pathway basal ganglia disease is described by masklike facies, stooped posture, cogwheel rigidity, pill-rolling tremor at rest, and a gait characterized by shuffling and chasing the center of gravity?
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
What form of anemia is diagnosed with sucrose lysis test and Ham test?
Paroxysmal nocturnal hemoglobinuria
Name the DNA virus: • ssDNA; naked; icosahedral; replicates in the nucleus
Parvovirus
What ssDNA virus must make dsDNA before it makes mRNA?
Parvovirus (it is the only ssDNA virus)
What DNA viral disease is associated with aplastic crisis in patients with sickle cell anemia?
Parvovirus B-19
Setting up to be let down (it is unconscious; if conscious, you're just rude)
Passive-aggressive
What organism is commonly associated with a cellulitis from an animal bite?
Pasteurella multocida
Which four bacteria require cysteine for growth?
Pasteurella, Brucella, Legionella, and Francisella (all of the-ellas)
What is the name for failure of the allantois to close, resulting in a urachal fistula or sinus?
Patent urachus
Will a patient with a unilateral lesion in the cerebellum fall toward or away from the affected side?
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
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 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
Shuffling gait, cogwheel rigidity, masklike facies, pill-rolling tremor, and bradykinesia describe what form of dementia?
Parkinson's disease
What type of correlation compares two interval variables?
Pearson correlation
What paraphilia is defined as • Sexual urges toward children?
Pedophilia
What splanchnic carries preganglionic parasympathetic fibers that innervate the hindgut and the pelvic viscera?
Pelvic splanchnics (They all begin with P.)
What structure of the knee is described thus? • Prevents posterior displacement and has medial-to-lateral attachment on the tibia
Posterior cruciate ligament
What area of the hypothalamus is responsible for recognizing a decrease in body temperature and mediates the response to conserve heat?
Posterior hypothalamic zones; lesions here result in poikilothermy (environmental control of one's body temperature).
What artery travels with the following veins? • Middle cardiac vein
Posterior interventricular artery
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Hypothalamus
Proencephalon* *diencephalon derivative
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Neurohypophysis
Proencephalon* *diencephalon derivative
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Pineal gland
Proencephalon* *diencephalon derivative
What level of mental retardation is characterized by • Needing a highly structured environment with constant supervision?
Profound (I.Q. range < 20)
Name these narcissistic defense mechanisms: • Person takes his or her own feelings, beliefs, wishes, and so on and thinks they are someone else's. (e.g., a cheating man thinks his wife is unfaithful)
Projection
What type of test asks a patient to draw a scene, attempting to find out the individual's unconscious perceptions in his or her life?
Projective drawing. The artistic form is irrelevant, but the size, placement, erasures, and distortions are relevant.
What type of personality test is the Rorschach inkblot test, objective or projective?
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Which organisms have polycistronic mRNA?
Prokaryotes. Polycistronic and prokaryotes both start with P.
What hormone level increases in the first 3 hours of sleep?
Prolactin
What two AAs require vitamin C for hydroxylation?
Proline and lysine
What two post-transcriptional enzymes in collagen synthesis require ascorbic acid to function properly?
Prolyl and lysyl hydroxylases
Deficiencies in what enzyme result in insoluble glycogen synthesis formation?
α-1, 6 transferase
Regarding the Lac operon, for what do the following genes code? • Z gene
β-Galactosidase
What is the major ketone body produced during alcoholic ketoacidosis?
β-Hydroxybutyrate
From where is the energy for gluconeogenesis derived?
β-Oxidation of fatty acids
What enzyme catalyzes the rate-limiting step in heme synthesis?
δ-ALA synthase
What cestode causes cysticercosis?
Taenia solium
What is the only CN nucleus found in the cervical spinal cord?
Accessory nucleus
What endotoxin receptor is the best marker for macrophages?
CD14
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
Use of an outlet for emotions (stuff flows downhill).
Displacement
What virus lies dormant in the • Trigeminal ganglia?
Herpes I
What virus lies dormant in the • Sensory ganglia of S2 and S3?
Herpes II
What term describes the reflex that increases the curvature of the lens, allowing near vision?
Accommodation
What is the term to describe the inability to feel any pleasant emotions?
Anhedonia
Name the ocular lesion; be specific. • Optic chiasm lesion
Bitemporal heteronymous hemianopsia
What five main oxidizing reactions are used to kill ingested organisms?
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
What type of spore is defined as an asexual budding daughter yeast cell?
Blastoconidia
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 four substances increase the rate of gluconeogenesis?
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
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
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
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
What three AAs are used to synthesize the purine ring?
1. Glycine 2. Aspartate 3. Glutamine
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 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 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 three substances stimulate glycogenolysis?
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
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
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 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
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 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 four components of the basement membrane?
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
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 three branches of the lateral cord of the brachial plexus?
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
What are the three tissues where triacylglycerols are produced?
1. Liver 2. Muscle 3. Adipose tissue
What three steps of the TCA cycle generate NADH?
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. α-Ketoglutarate dehydrogenase
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 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 two vessels come together to form the external jugular vein?
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
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 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 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 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
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 bone marrow maturation time for a phagocytic cell?
14 days
What part of the 30S ribosome binds to the Shine-Dalgarno sequence?
16S subunit
What is the legal age to be deemed competent to make decisions?
18 years old (except if emancipated)
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
What attaches to protons and allows them to enter into the mitochondria without going through the ATP-generating system?
2, 4-Dinitrophenol
How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?
3 ATPs by oxidative phosphorylation
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' or the 5' 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)
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)
By what age should children be able to draw the following figures? • Square
5 years old
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.
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 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
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
Where is lithium metabolized and excreted?
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
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
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 two factors cause PTH to be secreted?
A decrease in Ca2+ and an increase in PO4-
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)
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 remains patent in a hydrocele of the testis, allowing peritoneal fluid to form into a cyst?
A patent processus vaginalis
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.
How many hydrogen bonds link A-T? C-G?
A-T are linked by 2 hydrogen bonds, C-G by 3 hydrogen bonds.
What hematological malignancy is particularly likely to affect patients with Down syndrome?
ALL (nearly 15-20 times the normal risk)
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 structure of the knee is described thus? • Prevents anterior displacement and has lateral-to-medial attachment on the tibia
ACL
To what host cell receptor does the rabies virus attach?
ACh receptor
Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body.
ACh; think about the ANS.
What two enzymes of heme synthesis are inhibited by lead?
ALA dehydrogenase and ferrochelatase
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 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
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.
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)
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
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.
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 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 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 potentially lethal side effect of clozapine should be monitored with frequent blood drawing?
Agranulocytosis; approximately 2% develop this side effect.
What is the only organ in the body supplied by preganglionic sympathetic fibers?
Adrenal medulla
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 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
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 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 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 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 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 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
What is the name of the 12-step program believed to be the most successful for the treatment of alcohol abuse?
Alcoholics Anonymous
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.
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.
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
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)
What T cell line arises from low affinity for self-MHC class I Ags in the thymus?
CD8+ T cells
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
What is the name of the hypothesis you are trying to prove?
Alternative hypothesis (what is left after the null has been defined)
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.
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 region of the fallopian tube where fertilization most commonly occurs?
Ampulla
What area of the limbic system is responsible for attaching emotional significance to a stimulus?
Amygdala; it helps imprint an emotional response in memory.
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 does the tunica intima of arteries have that veins do not?
An internal elastic lamina
What vector is associated with malaria?
Anopheles mosquito
What is the term for an inhibited female orgasm?
Anorgasmia. (The overall prevalence is 30%.)
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
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.
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 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
What is the term given to arthropod-borne viruses?
Arboviruses (bunyavirus, flavivirus, and togavirus)
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.
A suspected dermatophyte infection is stained with KOH. What spore type do you expect to see?
Arthroconidia with hyphae
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 is the relationship between chance of error and • Standard deviation?
As the standard deviation increases, the greater the chance of error.
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
What cells contribute to the blood-brain barrier and proliferate in response to CNS injury?
Astrocytes
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 AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections, uncoordinated muscle movements, and dilation of the blood vessels?
Ataxia-telangiectasia
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 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
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 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
Name the area of the cerebral cortex with the function described: • Initiation and control of movements
Basal ganglia
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
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).
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
Which integrin mediates the adhesion to endothelial cells for migration in and out of the blood during an immune response?
Beta2-integrins
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.
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
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
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
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.
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
What case is best known for use of the "best interest standard"?
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent, so no one knew what the patient would have wanted. Therefore, the decision was based on what a "reasonable" person would have wanted.
What small, facultative gram-negative intracellular rod's transmission is associated with unpasteurized dairy products and undulant fever?
Brucella
What two bacteria are associated with drinking unpasteurized milk?
Brucella and Listeria (has tumbling motility)
What B cell disorder is characterized by pre-B cells in the bone marrow, no circulating B cells in plasma, normal cell-mediated immunity, low Igs, and appearance by 6 months of age?
Bruton X-linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
What is the term for the syndrome consisting of hepatomegaly, ascites, and abdominal pain due to hepatic vein thrombosis?
Budd-Chiari syndrome
What is the term for chemicals that keep the pH constant despite the formation of acids and bases during metabolism?
Buffers (remember that buffers are best when they are used in a pH range near its pK)
From what embryonic structure are the following structures derived? • The aortic vestibule and the conus arteriosus
Bulbus cordis
What family do the following viruses belong to? • California encephalitis
Bunyavirus
What family do the following viruses belong to? • Hantavirus
Bunyavirus
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 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 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 fungus causes endocarditis in IV drug users?
Candida albicans
What are five clinical signs of portal HTN?
Caput medusa, internal hemorrhoids, esophageal varices, retroperitoneal varices, and splenomegaly
What enzyme catalyzes the rate-limiting step of the urea cycle?
Carbamoyl phosphate synthetase I
What neuroendocrine tumor produces excess serotonin; is associated with diarrhea, flushing, bronchospasms, wheezing; and is diagnosed by findings of elevated urinary 5-HIAA levels?
Carcinoid tumor
Name the muscle type based on these descriptions: • Continuous involuntary contraction, uninuclear striated branched fibers, actin and myosin overlapping for banding pattern, dyadic T tubules, intercalated discs, troponin and desmin as a Z disc intermediate filament.
Cardiac muscle
Which shuttle is used to bring fatty acyl CoA from the cytoplasm for ketogenesis?
Carnitine acyl CoA transferase II
What is the rate-limiting step of the following? • β-Oxidation
Carnitine acyltransferase I
What enzyme catalyzes the rate-limiting step in fatty acid oxidation?
Carnitine acyltransferase-I
Name the three postganglionic sympathetic ganglia that receive input from thoracic splanchnics.
Celiac, aorticorenal, and superior mesenteric ganglias. (Remember all " Splanchnics" are Sympathetic except for the Pelvic splanchnics, which are Preganglionic Parasympathetic fibers.)
What form of immunity is responsible for removal of intracellular infections?
Cell-mediated immunity
What is the name of the process in which cells migrate toward an attractant along a concentration gradient?
Chemotaxis
What statistical test, using nominal data only, checks whether two variables are independent events?
Chi-square (when you are in doubt and have nominal data, use chi-square)
What statistical method do you use when analyzing • Cross-sectional studies?
Chi-square.
What are the cells of the parathyroid gland that produce PTH?
Chief cells
What cell type of the body or fundus of the stomach secretes pepsinogen?
Chief cells
What toxin ADP-ribosylates via Gs protein to increase cAMP?
Cholera toxin
What pathway uses HMG CoA synthetase in the cytoplasm?
Cholesterol biosynthesis
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
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 fungus is seen as colored cauliflower lesions?
Chromomycosis
What chromosome is autism linked to?
Chromosome 15
Cri-du-chat syndrome results in a terminal deletion of the short arm of what chromosome?
Chromosome 5
Which chromosome is associated with MHC genes?
Chromosome 6
Name the lipoprotein based on the following characteristics. • apo E, apo C-II, apoB-48
Chylomicrons
In what rare AR disorder do you see neutropenia, defective degranulation, and delayed microbial killing due to a problem in chemotaxis and migration?
Chédiak-Higashi syndrome
What is the name of the postganglionic parasympathetic ganglion that innervates • The papillary sphincter and ciliary muscle of the eye?
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:-ili-in ciliary ganglion looks like the III of CN III.)
Which cerebral herniation results in compression of the anterior cerebral artery?
Cingulate gyrus herniation (subfalcine)
What papillae are responsible for sweet taste?
Circumvallate papillae
As what compound do the carbons for fatty acid synthesis leave the mitochondria?
Citrate, via the citrate shuttle
What nucleus, found in the intermediate zone of the spinal cord, sends unconscious proprioception to the cerebellum?
Clarke's nucleus
Name the bony articulations of the following sites. Be specific. • Shoulder
Clavicle, acromion, and glenoid fossa of the scapula and the humerus
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 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.
Which drug is used to treat opioid withdrawal, ADHD, and sometimes Tourette's syndrome?
Clonidine
What bacterium found in poorly preserved canned food causes flaccid paralysis?
Clostridium botulinum
What gram-positive spore-forming anaerobic rod blocks the release of ACh at the NMJ, resulting in reversible flaccid paralysis?
Clostridium botulinum
Which gram-positive bacteria infection of infancy is associated with ingestion of honey?
Clostridium botulinum
Gas gangrene is associated with which Clostridium species?
Clostridium perfrigens
What is the only nonmotile pathogenic Clostridium species?
Clostridium perfringens
What organism is associated with the following types of diarrhea? Watery diarrhea from beef, poultry, or gravies
Clostridium perfringens
What large, spore-forming, gram-positive anaerobic rod is associated with infections due to puncture wounds and trauma?
Clostridium tetani
Which muscles of the eye are under parasympathetic control?
Constrictor pupillae and ciliary muscles
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • Spinothalamic tract?
Contralateral loss below and bilateral loss at the level of the lesion
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
What element is needed for the proper alignment of tropocollagen molecules?
Copper (Cu+)
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
Name these anxiety defense mechanisms: • Separating oneself from the experience. The facts are accepted but the form is changed for protection.
Dissociation
What is the term to describe inability to recall the past and possible assumption of a completely new identity?
Dissociative fugue. (Patients are unaware of memory loss.)
What is the term for fungi that can convert from hyphal to yeast forms?
Dimorphic
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 happens to cortisol levels in sleep-deprived individuals?
Cortisol levels increase. Lymphocyte levels decrease in sleep-deprived individuals.
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 is the only Rickettsia that is stable in the environment?
Coxiella burnetii
What organism causes Q fever?
Coxiella burnetii
What picornavirus is associated with hand-foot-and-mouth disease?
Coxsackie A
What form of dementia is characterized by onset at age 40 to 50, rapid progression, infection by a prion, and death within 2 years?
Creutzfeldt-Jakob's disease. Patients first develop vague somatic complaints and anxiety, rapidly followed by dysarthria, myoclonus, ataxia, and choreoathetosis.
What is the only laryngeal muscle innervated by the external laryngeal nerve?
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Name the laryngeal muscle described by the following: • Tenses the vocal ligaments, increasing the distance between the cartilages, thereby increasing the pitch
Cricothyroid muscles
In what disease is there a genetic absence of UDP-glucuronate transferase, resulting in an increase in free unconjugated bilirubin?
Crigler-Najjar syndrome
Objective tests that base the result of the examination on a preset standard use what form of reference?
Criterion-referenced tests. You need a certain number correct to pass (e.g., the USMLE).
Can incidence, prevalence, and cause and effect be assessed in • Cross-sectional studies?
Cross-sectional studies determine prevalence, not incidence or cause and effect.
In what study, for ethical reasons, is no group left out of intervention?
Crossover study
What type of mortality rate is defined as the number of deaths • In the population?
Crude mortality rate
What fungus is urease positive?
Cryptococcus
What is the only encapsulated fungal pathogen?
Cryptococcus
What fungus is characterized by India ink staining of the CSF that produces colorless cells with a halo on a black background?
Cryptococcus neoformans
Which encapsulated fungus is found in soil enriched with pigeon droppings?
Cryptococcus neoformans
What is the term for failure of the testes to descend into the scrotum?
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
What protein catalyzes the formation of the last PDE bond between the Okazaki fragments to produce a continuous strand?
DNA ligase
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 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 is the term for cestode-encysted larvae found in intermediate hosts?
Cysticerci
What component of the ETC is inhibited by the following? • Azide
Cytochrome a/a3
What component of the ETC is inhibited by the following? • CO
Cytochrome a/a3
What component of the ETC is inhibited by the following? • Cyanide
Cytochrome a/a3
What component of the ETC is inhibited by the following? • Antimycin A
Cytochrome b/c1
What is the term for a substance secreted by a leukocyte in response to a stimulus?
Cytokine. If a cytokine affects another class of leukocytes, it is called an interleukin.
What pyrimidine base is found • In both DNA and RNA?
Cytosine
What enzyme has a 5' to 3' synthesis of the Okazaki fragments, 3' exonuclease activity, and 5' exonuclease activity?
DNA polymerase I
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 organism is associated with megaloblastic anemia?
Diphyllobothrium latum
What parasite found in raw fish can produce vitamin B12 deficiency?
Diphyllobothrium latum
Which dopamine receptor excites the direct pathway of the basal ganglia?
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
What happens to NE levels in • Major depression?
Decrease (5-HT and dopamine levels do the same)
How is sleep affected in a person with alcohol intoxication?
Decreased REM sleep and REM rebound during withdrawal
What muscle acts in all ranges of motion of the arm?
Deltoid
What is the triad of NPH?
Dementia Urinary incontinence Gait apraxia (NPH wet, wacky, wobbly)
What part of a neuron receives information?
Dendrites receive information, whereas axons send information.
What three cells are essential for T-cell differentiation in the thymus?
Dendritic cells, macrophages, and thymic epithelial cells
Name these narcissistic defense mechanisms: • Not allowing reality to penetrate because afraid of becoming aware of painful aspect of reality.
Denial
What are the five Kübler-Ross stages of death and dying? Must they be completed in order?
Denial Anger Bargaining Depression Acceptance No, they can be skipped, repeated, and completed out of sequence.
Name the cluster C personality disorder: • Gets others to assume responsibility, is subordinate, and is fearful of being alone and caring for self
Dependent
In what pathway of the basal ganglia do lesions result in an underactive cortex with hypokinetic, slow, or absent spontaneous movement?
Direct pathway; a good example is Parkinson's disease.
What subtype of schizophrenia is characterized by • Childlike behaviors, unorganized speech and behaviors, poor grooming, incongruous smiling and laughter, and the worst prognosis?
Disorganized schizophrenia
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
From which two substances are phospholipids made?
Diacylglycerols and phosphatidic acid
What enzyme is blocked by methotrexate/ trimethoprim?
Dihydrofolate reductase
What enzyme of pyrimidine synthesis is inhibited by the following? • Methotrexate
Dihydrofolate reductase
Which muscle of the eye is under sympathetic control?
Dilator pupillae muscle
What drug is used to prevent alcohol consumption by blocking aldehyde dehydrogenase?
Disulfiram
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
Arrange the following layers in the correct sequence through which a needle must pass in a lumbar puncture. • Skin • Subarachnoid space • Interspinous ligament • Dura mater • Deep fascia • Epidural space • Superficial fascia • Interlaminar space • Supraspinous ligament • Arachnoid mater
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3-L4, with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspinous ligament 5. Interspinous ligament 6. Interlaminar space 7. Epidural space 8. Dura mater 9. Arachnoid mater 10. Subarachnoid space. (They ask this in some variation every year, so know it.)
In what stage of sleep is it hardest to arouse a sleeping individual?
During stage 3 and 4 (remember, it is called deep sleep.)
What is the name for inability to stop a movement at the intended target?
Dysmetria; this is seen in a finger-to-nose test.
What is the term for recurrent and persistent pain before, after, or during sexual intercourse?
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
What is the term for nonneoplastic abnormal proliferation of cell size, shape, and cellular organization?
Dysplasia
What disorder is characterized by a depressed mood and a loss of interest or pleasure for more than 2 years?
Dysthymia, which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
What Freudian psyche component is described as • Reality, rationality, language basis?
Ego
What is the term to describe homosexuals who • Are uncomfortable with their own person and disagree with their sense of self?
Ego dystonic
What is the term to describe homosexuals who • Are comfortable with their own person and agree with their sense of self?
Ego syntonic
How many pairs of spinal nerves are associated with • Cervical vertebrae?
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
After a longstanding left-to-right shunt reverses, causing cyanosis, and becomes a right-to-left shunt, what is it termed?
Eisenmenger's syndrome
What factors are needed for translation in prokaryotes?
Elongation factor-G and GTP
What naturally occurring substances mimic the effects of opioids?
Enkephalins
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 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 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
What mast cell mediator is a chemotactic agent?
Eosinophil chemotactic factor A
What cells lining the ventricles have cilia on their luminal surface to move CSF?
Ependymal cells
Which genus of dermatophytes is associated with the following sites of infection? • Nails and skin only
Epidermophyton
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
What facultative gram-negative anaerobic rod is motile, ferments lactose, and is the MCC of UTIs?
Escherichia coli
What structure or structures cross the diaphragm at • T10 level?
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8, 2 at T10, and 3 at T12
What seven structures are found in more than one mediastinum?
Esophagus, SVC, vagus nerve, azygos vein, thoracic duct, thymus, and phrenic nerve
What hormone, produced by the granulose cell, stimulates the endometrium to enter the proliferative phase?
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
What type of chromatin is transcriptionally active?
Euchromatin, the dark stuff in the nucleus on an electron microscope image.
What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
Excision endonuclease, which removes thiamine dimers from DNA
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 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
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 disorder is associated with jaundice, white stools, and dark urine due to biliary duct occlusion secondary to incomplete recanalization?
Extrahepatic biliary atresia
What is the name of the major chemotactic agent released from • Bacteria?
F-Met-Peptides
True or false? Gonococcus is encapsulated.
False. Meningococcus is encapsulated; Gonococcus is not.
True or false? Being single increases your risk of suicide.
False. Separation, divorce, being widowed, and unemployment increase your risk, but being single does not.
True or false? Pregnancy ensures emancipation.
FALSE
What is the primary method of nonverbal communication of emotional states?
Facial expression (the second is vocal intonation)
What disorder is described as having • Conscious symptoms with unconscious motivation?
Factitious disorder
What are the vitamin K-dependent coagulation factors?
Factors II, VII, IX, X, and proteins C and S
What operant conditioning therapy or modification is described as • Removing a reinforcement (without the patient knowing) gradually over time to stop a condition?
Fading
What rate is indicated by 1- sensitivity?
False-negative rate
What rate is indicated by 1-specificity?
False-positive rate
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? T cells can recognize, bind, and internalize unprocessed Ags.
False. B cells recognize unprocessed Ags, but T cells can recognize only processed Ags.
True or false? CSF is a clear, hypertonic solution with higher concentrations of K + and HCO3-, than the serum.
False. CSF is a clear isotonic solution with lower concentrations of K+ and HCO3-. It does have higher concentrations of Cl- and Mg2+.
True or false? Serious psychiatric illness is more common after abortion than childbirth.
False. Childbirth carries five times as much risk of serious psychiatric illness as abortion.
True or false? Direct fluorescent Ab test is used to detect Abs in a patient?
False. Direct tests detect Ags; indirect tests detect Abs.
True or false? Males are more likely to develop femoral hernias than females.
False. Females are more likely to develop femoral hernias then males (remember Female's Femoral).
True or false? More Ag is needed to produce a secondary immune response than a first immune response.
False. Fewer Ags are needed to trigger a secondary response.
True or false? Histidine activates the histidine operon.
False. Histidine operon is activated when there are low intracellular levels of histidine.
True or false? Interferons are eukaryotic proteins that inhibit viral replication by being virus specific.
False. Interferons are produced by virally infected cells to inhibit viral replication via RNA endonucleases. They do not act directly on the virus, nor are they virus specific.
True or false? The foramen ovale closes just prior to birth.
False. It closes just after birth because the change in pulmonary circulation causes increased left atrial pressure.
True or false? Ag-Ab binding is irreversible
False. It is reversible because the Ags and Abs are not linked covalently.
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.
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)
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls balance and eye movements?
Flocculonodular lobe (one of my favorite words in all of medicine!)
What test, by using specific Abs to different receptors, allows for rapid analysis of cell types in a blood sample?
Flow cytometric analysis
What is the name of the benzodiazepine antagonist used in the treatment of an overdose?
Flumazenil
Which benzodiazepine has the longest half-life?
Flurazepam
What component of the ETC is inhibited by the following? • Oligomycin
Fo/F1 complex
If the family member of a patient asked you to withhold information, would you?
For the USMLE Step 1 the answer is no, but if the information would do more harm than good, withhold. This is very rare but it does occur.
What connects the lateral ventricles to the third ventricle?
Foramen of Monro
What foramen must be traversed for entry into the lesser peritoneal sac?
Foramen of Winslow
At what stage of cognitive development (according to Piaget) do children • Have abstract thinking?
Formal operations (> 12 years)
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
From what pharyngeal pouch is the following structure derived? • Superior parathyroid gland and ultimobranchial body of the thyroid
Fourth M PITS for pharyngeal pouch derivatives
From what aortic arch are the following structures derived? • Arch of the aorta and right subclavian artery
Fourth MS CARD is my mnemonic for the aortic arch derivatives
What area of the retina consists of only cones and has the greatest visual acuity?
Fovea
Name the type of mutation: • The deletion or addition of a base
Frameshift
What small gram-negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite?
Francisella tularensis
What organelle synthesizes proteins that are intended to stay within the cell?
Free polysomes. Membrane-associated polysomes are the site of protein synthesis destined to leave the cell.
What type of Ag do B cells recognize?
Free, unprocessed Ag
At what age does IQ stabilize?
From age 5 onward IQ stabilizes.
Where do the primordial germ cells arise?
From the wall of the yolk sac
What area of the brain acts as the center for contralateral horizontal gaze?
Frontal eye field (Brodmann area 8)
Name the area of the cerebral cortex with the function described: • Speech; critical for personality, concentration, initiating and stopping tasks (do one thing and begin a new without completion of the first), abstract thought, and memory and higher-order mental functions
Frontal lobe
What syndrome causes inability to concentrate, easy distractibility, apathy, and regression to an infantile suckling or grasping reflex?
Frontal lobe syndrome (lesion in the prefrontal cortex)
What paraphilia is defined as • A male rubbing his genitals on a fully clothed female to achieve orgasm?
Frotteurism
What enzyme catalyzes the rate-limiting step in gluconeogenesis?
Fructose-1, 6-bisphosphatase
Are the quadrate and caudate lobes of the liver functionally part of the left or right lobe?
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Eukaryotic cell; 3 to 10 microns; 80S ribosomes; chitinous cell wall; ergosterol in cell membrane; replicate via cytokinesis with mitosis and meiosis
Fungi
What papillae send their senses via chorda tympani of CN VII?
Fungiform papillae
Which organism causes trench mouth?
Fusobacterium
What is the rate-limiting enzyme of the HMP shunt?
G-6-PD
What is the most common genetic deficiency resulting in hemolytic anemia?
G-6-PD deficiency; pyruvate kinase deficiency is second.
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
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).
Name the phase of the eukaryotic cell cycle: • Period of cellular growth (translation and transcription) after DNA synthesis
G2 phase (gap 2)
What hormone's release is strongly associated with stage 4 sleep?
GH. The largest output of GH in a 24-hour period is during stage 4 sleep.
Name the GLUT transporter based on the following: • Found in liver and pancreatic β-cells
GLUT 2
Name the GLUT transporter based on the following: • Found in most tissues, including brain and RBCs
GLUT 3 and 4
Name the GLUT transporter based on the following: • Found in skeletal muscle and adipose tissues
GLUT 4
What substrate builds up in Tay-Sachs disease?
GM2 ganglioside Caused by a deficiency of β-hexosaminidase A
What glycoprotein in the HIV virus attaches to CD4?
GP120
What glycoprotein in the HIV virus is used for fusion?
GP41
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 sphingolipid cannot be produced without sialic acid and amino sugars?
Ganglioside
What is the name of hydrophilic pores that allow the direct passage of ions and particles between two adjacent cells?
Gap junctions
Clue cells are associated with which organism that causes vaginal discharge?
Gardnerella vaginalis
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
What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
Gastric ulcer
What pancreatic islet cell tumor is associated with MEN I syndrome?
Gastrinoma
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 disease has a genetically low level of UDPglucuronate transferase, resulting in elevated free unconjugated bilirubin?
Gilbert's syndrome
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)
Which serotypes of HPV are associated with plantar warts?
HPV serotypes 1 and 4
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 CN is associated with the sensory innervation of • Oropharynx?
Glossopharyngeal nerve
What lysosomal enzyme is deficient in • Gaucher's disease?
Glucocerebrosidase
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 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 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 viruses are associated with cervical carcinoma?
HPVs 16 and 18
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
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.)
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
After fertilization, what cells of the corpus luteum • Secrete progesterone?
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
In regard to motor development during infancy, choose the motor response that happens first. • Release or grasp
Grasp proceeds release
What disorder leads to IgG autoantibodies to the TSH receptor?
Graves disease
What type II hypersensitivity disorder is defined as • Autoantibodies directed against the TSH receptor?
Graves disease
Rheumatic fever most commonly follows pharyngeal infections with what bacteria?
Group A β-hemolytic streptococci
What embryonic structure forms the adult female structures? • Ovarian and round ligaments
Gubernaculum
What embryonic structure forms the adult male structure? • Gubernaculum testes
Gubernaculum
What histone binds two nucleosomes together?
H1 histones
What Ab is an indication of recurrent disease for hepatitis?
HBc Ab
In the window phase of a hepatitis B infection, which Abs do you see?
HBcAb and HBeAb. You see the antibodies c and e.
What Ab is an indication of low transmissibility for hepatitis?
HBeAb
What Ag is needed to diagnose an infectious patient with hepatitis B?
HBeAg
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 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 enzyme of the purine salvage pathway is deficient in the following? • Lesch-Nyhan syndrome
HGPRT
What DNA virus is associated with exanthem subitum (roseola)?
HHV 6
What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
HIV
What two viruses get their envelope not from budding but from coding?
HIV and poxvirus
What is the rate-limiting step of the following? • Cholesterol synthesis
HMG CoA reductase
What is the rate-limiting step of the following? • Ketogenolysis
HMG CoA synthase
What enzyme catalyzes the rate-limiting step in cholesterol metabolism?
HMG-CoA reductase
Via what pathway is glycolysis increased after phagocytosis?
HMP shunt
What cytoplasmic pathway produces NADPH and is a source of ribose 5-phosphate?
HMP shunt
What virus produces koilocytic cells on a Papanicolaou (Pap) smear?
HPV
How do delusions, illusions, and hallucinations differ?
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
What is the term for a single isolated antigenic determinant?
Hapten (not immunogenic)
What is the term for an immunogenic agent that is too small to elicit an immune response?
Hapten; if it is coupled with a carrier, it may become immunogenic.
Which carcinoma—Burkitt's lymphoma, nasopharyngeal carcinoma, hepatocellular carcinoma, or thymic carcinoma—is not associated with EBV?
Hepatocellular carcinoma is associated with hepatitis B and C infections, not with EBV.
Why is the liver unable to metabolize ketone bodies?
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
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 three organs can be affected by Trypanosoma cruzi?
Heart, esophagus, and colon. Remember, you get megas: cardiomegaly, megaesophagus, and megacolon.
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 vein drains the lower third of the thoracic wall?
Hemiazygous vein
What is the name of violent projectile movements of a limb resulting from a lesion in the subthalamic nuclei of the basal ganglia?
Hemiballismus
Name the DNA virus: • Partially dsDNA circular; enveloped; virion-associated polymerases; has RNA intermediate; replicates in the nucleus
Hepadnavirus
What is the only DNA virus that has the reverse transcriptase enzyme?
Hepadnavirus
What enzyme is deficient in the following glycogen storage disease? • Hers' disease
Hepatic glycogen phosphorylase
Which hepatitis virus is in the Picornaviridae family?
Hepatitis A
Which type of hepatitis is a picornavirus?
Hepatitis A (infectious)
Which type of hepatitis can cause hepatocellular carcinoma?
Hepatitis B
What are the two hepatitis viruses that can be chronic and can lead eventually to hepatocellular carcinoma?
Hepatitis B and hepatitis C
Which hepatitis virus is in the Flaviviridae family?
Hepatitis C
What type of hepatitis has the highest mortality rate among pregnant women?
Hepatitis E
Which type of hepatitis is a calicivirus?
Hepatitis E (enteric)
Name the DNA virus • Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus
Herpes virus
What viruses are associated with Cowdry type A intranuclear inclusions?
Herpes virus I and II
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 is the label given to an individual whose IQ is • 110 to 119
High average
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)
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.
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
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 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 bone houses the ulnar groove?
Humerus (between the medial epicondyle and the trochlea)
Name the bony articulations of the following sites. Be specific. • Elbow
Humerus with ulna (major) and radius (minor)
Name these mature defense mechanisms: • Easing anxiety with laughter
Humor
What AD dementia has a defect in chromosome 4, onset between the ages of 30 and 40, choreoathetosis, and progressive deterioration to an infantile state?
Huntington's chorea. (Death in 15-20 years, often via suicide.)
What chromosome 4, AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia?
Huntington's chorea; patients have chorea, athetoid movements, progressive dementia, and behavioral problems.
What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan?
Hyaluronic acid (all sulfates bind to the core protein)
Preeclampsia in the first trimester, hCG levels above 100, 00 mIU/mL, and an enlarged bleeding uterus are clinical signs of what?
Hydatidiform mole
What causes slow writhing movements (athetosis)?
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
What is the primary predisposing factor for vascular dementia?
Hypertension
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 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 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 term for the external urethra opening onto the ventral surface of the penis?
Hypospadia
What is associated with prolonged lithium use?
Hypothyroidism. (TSH levels must be monitored.)
What is the term to describe the soft, flabby feel and diminished reflexes seen in patients with acute cerebellar injury to the deep cerebellar nuclei?
Hypotonia (rag doll appearance)
What genetic defect is characterized by coarse facial features, gingival hyperplasia, macroglossia, psychomotor and growth retardation, club foot, claw hand, cardiorespiratory failure, and death in the first decade of life?
I-cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Name the lipoprotein based on the following characteristics. • apo E
IDL
What is needed to initiate translation?
IF and GTP (eIF for eukaryotes)
What prokaryotic positioning enzyme in translation is blocked by the following? • Streptomycin
IF-2 of the 30S subunit
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
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)
Myelin is produced by which cells in the PNS? In the CNS?
In the PNS, myelin is produced by Schwann cells, in the CNS by oligodendrocytes.
Where does Beta-oxidation of very long chain fatty acids begin?
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
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.
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.
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 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
During what stage of B-cell development is IgM first seen on the surface?
Immature B cells
Where are the LMN cell bodies of the corticospinal tract?
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
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
Why are eukaryotes unable to perform transcription and translation at the same time like prokaryotes?
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
What happens to NE levels in • Bipolar disorder?
Increase (5-HT and dopamine levels do the same)
What is the only way to increase maximum velocity (Vmax)?
Increase enzyme concentrations
What is the only way to increase the Vmax of a reaction?
Increase the concentration of enzymes
What is the biochemical trigger for REM sleep?
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Increased levels of what neurotransmitter, in the hippocampus, decrease the likelihood of learned helplessness?
Increased GABA levels decrease the likelihood of learned helplessness.
What happens to REM, REM latency, and stage 4 sleep during major depression?
Increased REM sleep, decreased REM latency, and decreased stage 4 sleep, leading to early morning awakening
What are the pharmacologic effects seen sexually with • Dopamine agonists?
Increased erection and libido
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.
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 bursa is inflamed in clergyman's knee?
Infrapatellar bursa
What three factors do Sertoli cells produce for normal male development?
Inhibin, müllerian-inhibiting factor, and androgen binding protein
What are the pharmacologic effects seen sexually with • Serotonin?
Inhibited orgasm
What is the function of the basal ganglia?
Initiate and manage gross skeletal muscle movement control
What enzyme does HIV use to integrate the proviral dsDNA into the host?
Integrase
What is the largest organ in the body?
Integument (skin and its derivatives)
Replacing normal affect with "brain power"
Intellectualization
What is the name of the tremor that occurs during movements and is absent while the person is at rest?
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e., pill rolling) is seen in basal ganglia lesions.
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
What type of scale is graded into equal increments, showing not only any difference but how much?
Interval scale (a ruler, for example)
Name these immature defense mechanisms: • Taking others' beliefs, thoughts, and external stimuli and making them part of the self. (Hint: if it's done consciously, it is called imitation.)
Introjection (a sports fan is a good example)
Which protein prevents internal binding of self proteins within an MHC class II cell?
Invariant chain
In MHC class II molecules, what chain blocks access to the peptide-binding groove during transportation within the cell, ensuring that the MHC class II-peptide complex is transported to the surface?
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
Regarding neuroleptics, what is the relationship between potency and anticholinergic side effects?
Inversely proportional: the higher the potency, the lower the anticholinergic side effects.
What intrauterine deficiency leads to failure to thrive, mental retardation, motor incoordination, and stunted growth?
Iodine, resulting in congenital hypothyroidism
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • LMN?
Ipsilateral flaccid paralysis
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • Dorsal column tract?
Ipsilateral loss at and below the level of the lesion
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 enzyme catalyzes the rate-limiting step in the TCA cycle?
Isocitrate dehydrogenase
What enzyme of the TCA cycle catalyzes the production of the following: • NADH (hint: 3 enzymes)
Isocitrate dehydrogenase, α-ketoglutarate dehydrogenase, and malate dehydrogenase
Name the type of graft described by these transplants: Between genetically identical individuals
Isograft
Fact without feeling (la belle indifférence)
Isolation of affect
What three AAs must patients with maple syrup urine disease not eat?
Isoleucine, leucine, and valine
What type of questions should you begin with when a patient seeks your medical opinion?
It is best to begin with open-ended questions, allowing patients to describe in their own words what troubles them. You can then move to closed-ended questions when narrowing the diagnosis.
Is suicidal ideation a component of normal grief?
It is rare with normal grief; however, it is relatively common in depression
What tick is the vector for babesiosis?
Ixodes (also the vector for Lyme disease)
What virus is associated with progressive multifocal leukoencephalopathy?
JC virus
What cell of the nephron is responsible for renin production and secretion?
Juxtaglomerular (JG) cell
What capsular serotype is associated with Escherichia coli- induced meningitis?
K1 capsule
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 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 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 renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
Kimmelstiel-Wilson disease
What generate anterograde transport of information in a neuron?
Kinesins. Dynein generates retrograde transportation of information.
What encapsulated gram-negative, lactose-fermenting rod is associated with pneumonia in patients with alcoholism, diabetes, and chronic lung disease?
Klebsiella pneumoniae
What syndrome is characterized by bilateral medial temporal lobe lesion, placidity, hyperorality, hypersexuality, hyperreactivity to visual stimuli, and visual agnosia?
Klüver-Bucy syndrome
What syndrome is described as bilateral lesions of the amygdala and the hippocampus resulting in placidity, anterograde amnesia, oral exploratory behavior, hypersexuality, and psychic blindness?
Klüver-Bucy syndrome
What is the name of the tumor when gastric carcinoma spreads to the ovaries?
Krukenberg tumor
Name the macrophages by location: • Liver
Kupffer cells
What segments of the lumbosacral plexus form the following nerves? • Femoral nerve
L2 to L4 (L2 to L4, thigh; L4 to S3, leg)
What two requirements must be met for the Lac operon to be activated?
Lactose must be present and glucose must be absent
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.)
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
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Is involved in motor planning?
Lateral part of the hemispheres
What syndrome is associated with the following brainstem lesions? • AICA or superior cerebellar artery occlusion, resulting in ipsilateral limb ataxia, ipsilateral facial pain and temperature loss, contralateral loss of pain and temperature to the body, ipsilateral Horner's syndrome, ipsilateral facial paralysis, and hearing loss
Lateral pontine syndrome
What ocular muscle • Abducts the eyeball and is involved in horizontal conjugate gaze?
Lateral rectus (CN VI) (LR6 SO4)3
What muscle or muscles are innervated by the following nerves? • Thoracodorsal nerve
Latissimus dorsi
What form of bias is due to false estimates of survival rates?
Lead-time bias (remember, patients don't live longer with the disease; they are diagnosed sooner.)
What direction would the tongue protrude in a left CN XII lesion?
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
Where is the lesion that produces these symptoms when a patient is asked to look to the left? • Left eye can't look to the left
Left abducens nerve
Where is the lesion that produces these symptoms when a patient is asked to look to the left? Neither eye can look left with a slow drift to the right
Left abducens nucleus or right cerebral cortex
What artery travels with the following veins? • Great cardiac vein
Left anterior descending artery
What part of the heart forms • Posterior wall?
Left atrium
What part of the heart forms • Base?
Left atrium and tip of the right atrium
What are the three branches of the inferior mesenteric artery?
Left colic, superior rectal, and sigmoidal arteries
What artery supplies the left ventricle, left atrium, and interventricular septum?
Left coronary artery
Name the ocular lesion; be specific. • Left optic nerve lesion
Left eye anopsia (left nasal and temporal hemianopsia)
Name the ocular lesion; be specific. • A right LGB lesion (in the thalamus)
Left homonymous hemianopsia
Name the ocular lesion; be specific. • Left Meyer's loop lesion of the optic radiations.
Left homonymous hemianopsia
Name the ocular lesion; be specific. • Right calcarine cortex lesion
Left homonymous hemianopsia
What part of the heart forms • Left border?
Left ventricle and auricle of left atrium
What part of the heart forms • Diaphragmatic wall?
Left ventricle and tip of right ventricle
What three structures are in contact with the left colic flexure? With the right colic flexure?
Left: stomach, spleen, and left kidney; right: liver, duodenum, and right kidney
What bacterium is diagnosed using the Dieterle silver stain?
Legionella
What water-associated organism is a weakly stained gram-negative rod that requires cysteine and iron for growth?
Legionella (think air conditioners)
Which hemoflagellate species causes kala azar?
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Which organism causes Weil's disease?
Leptospira
What X-linked recessive disorder is characterized by hyperuricemia, spastic cerebral palsy, mental retardation, and self-mutilation?
Lesch-Nyhan syndrome
What is the name of the major chemotactic agent released from • Neutrophils?
Leukotriene B4 (LTB4)
What muscle is most superior in the orbit?
Levator palpebrae superioris
What cell of the male reproductive system produces testosterone?
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
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 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
What gram-positive rod is distinguished by its tumbling motility?
Listeria
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 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
In what organ system would you attempt to localize a sign for shaken baby syndrome"? What do you look for?
Look for broken blood vessels in the baby's eyes.
What is the term to describe jumping from one topic to the next without any connection?
Loose association
What is the label given to an individual whose IQ is • 80 to 89
Low average
What tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum, helping monitor and modulate muscle movements?
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
What preganglionic sympathetic fibers are responsible for innervating the smooth muscle and glands of the pelvis and the hindgut?
Lumbar splanchnics
What lymphoid organ has the following characteristics: outer and inner cortical areas, encapsulation, germinal centers, and high endothelial venules?
Lymph nodes
What substance found in eosinophils is toxic to parasitic worms?
Major basic protein
What are the two most common AAs found in histones?
Lysine and arginine
What two AAs have a pKa of 10?
Lysine and tyrosine
What enzyme is deficient in the following glycogen storage disease? • Pompe's disease
Lysosomal α-1, 4-glucosidase
What cell transports IgA, is secreted by plasma cells, and is in Peyer's patches to the gastrointestinal lumen?
M-cells
Which M-protein strain of Streptococcus pyogenes is associated with acute glomerulonephritis?
M12 strains
What is the male-to-female ratio for committing suicide?
M:F 4:1 committing, but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Which thalamic nucleus receives auditory input from the inferior colliculus?
MGB
Name the thalamic nucleus based on its input and output. • Input from inferior colliculus; output to primary auditory cortex
MGB (think EARS)
What MHC class functions as a target for elimination of abnormal host cells?
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells, virus-infected cells—anything the body recognizes as nonself via CD8+ T cells.
What MHC class of antigens do all nucleated cells carry on their surface membranes?
MHC class I antigens; they are also found on the surface of platelets.
What MHC class acts to remove foreign Ags from the body?
MHC class II Ags. This is accomplished via CD4 T cells.
What cell in chronic inflammation is derived from blood monocytes?
Macrophages
What family do the following viruses belong to? • RSV
Paramyxovirus
What cells of the nephron function as sodium concentration sensors of the tubular fluid?
Macula densa
What CN is associated with the sensory innervation of • Nasopharynx?
Maxillary division of CN V and glossopharyngeal nerves
What fungus is characterized by hypopigmented spots on the thorax, spaghetti-and-meatball KOH staining, and pityriasis or tinea versicolor?
Malassezia furfur (treat with selenium sulfide)
What disorder is due to a 5--reductase deficiency, resulting in testicular tissue and stunted male external genitalia?
Male pseudo-intersexuality (hermaphrodite); these individuals are 46XY.
What disorder is described as having • Conscious symptoms with conscious motivation?
Malingering
On what layer of the epidermis does all mitosis occur?
Malpighian layer (made up of the stratum basale and stratum spinosum)
What drug causes a sixfold increase in schizophrenia, can impair motor activity, and can cause lung problems?
Marijuana
What paraphilia is defined as • Deriving sexual pleasure from being abused or in pain?
Masochism
What is the term to describe basophils that have left the bloodstream and entered a tissue?
Mast cells
At what stage of B-cell development can IgM or IgD be expressed on the cell surface?
Mature B cell; the memory B cell can have IgG, IgA, or IgE on its surface.
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 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
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 cell type of the epidermis originates from the neural crest?
Melanocytes
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 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.
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 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 cells of the epidermis, derived from the neural crest, act as mechanoreceptors?
Merkel cells (Merkel's tactile cells)
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
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)
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 form of alcohol causes blindness?
Methanol (wood alcohol)
What level of mental retardation is characterized by • Being self-supportive with minimal guidance and able to be gainfully employed (includes 85% of the mentally retarded)?
Mild (50-70)
Name the type of mutation: New codon specifies a different AA
Missense
In what organelle does the TCA cycle occur?
Mitochondria
What organelles make ATP, have their own dsDNA, and can synthesize protein?
Mitochondria
Who is responsible for passing on mitochondrial DNA genetic disorders?
Mitochondria-linked disorders are always inherited from the mother.
What pattern of genetic transmission is characterized by no transmission from M, maternal inheritance, and the potential for the disease to affect both sons and daughters of affected F?
Mitochondrial inheritance
What is the only valve in the heart with two cusps?
Mitral (bicuspid) valve
The most frequent number occurring in a population is what?
Mode
What level of mental retardation is characterized by • Can work in sheltered workshops and learn simple tasks but need supervision?
Moderate (35-49)
What virus causes small pink benign wartlike tumors and is associated with HIV-positive patients?
Molluscum contagiosum
Are more Abs produced in a primary or a secondary immune response?
More Ab is produced in less time in a secondary immune response (shorter lag period).
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Ventral root?
Motor
What component of the corneal reflex is lost in a CN VII deficit?
Motor aspect
What component of the trigeminal nuclei • Supplies the muscles of mastication?
Motor nucleus of CN V
Do newborns have a preference for still or moving objects?
Moving objects, along with large bright objects with curves and complex designs.
What restriction endonuclease site is destroyed in sickle β-globin allele?
MstII; changing codon 6 (from A to T) destroys the restriction site.
What CNS demyelinating disease is characterized by diplopia, ataxia, paresthesias, monocular blindness and weakness, or spastic paresis?
Multiple sclerosis
What negative sense RNA virus is associated with parotitis, pancreatitis, and orchitis?
Mumps
Which two negative sense RNA viruses have neuraminidase enzymes?
Mumps and influenza virus
Name the cluster B personality disorder: • Grandiose sense of self-importance; demands constant attention; fragile self-esteem; can be charismatic
Narcissistic
What enzyme is deficient in the following glycogen storage disease? • McArdle's disease
Muscle glycogen phosphorylase
What adult structures are derived from preotic somites?
Muscles of the internal eye
What nerve is associated with the following functions? • Flex the shoulder, flex the elbow, and supinate the elbow
Musculocutaneous nerve
At the level of rib 6, the internal thoracic artery divides into what two arteries?
Musculophrenic and superior epigastric arteries
A 20-year-old woman goes to the ER with ptosis, diplopia, weakness in her jaw muscles when chewing, and muscle weakness with repeated use. What is your diagnosis?
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
What genus is known as the smallest free living bacteria? (hint: has no cell wall and has sterols in the membrane)
Mycoplasma
What region of the pharynx does the eustachian tube enter?
Nasopharynx
What ethnic group has the highest adolescent suicide rate?
Native Americans
What enzyme of pyrimidine synthesis is inhibited by the following? • Hydroxyurea
Ribonucleotide reductase
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.
In which syndrome does a person present with intentionally produced physical ailments with the intent to assume the sick role?
Münchhausen's syndrome (factitious disorder)
In what form is excess folate stored in the body?
N-5-methyl THF
What enzyme is deficient in chronic granulomatous disease of childhood?
NADPH oxidase
What enzyme is deficient in patients with CGD?
NADPH oxidase is deficient, resulting in an inability to produce toxic metabolites.
What three things are needed to produce a double bond in a fatty acid chain in the endoplasmic reticulum?
NADPH, O2, and cytochrome b5
Name the components of the femoral canal, working laterally to medially.
NAVEL: Femoral Nerve, Artery, Vein, Empty space, and Lymphatics/Lacunar ligament
Can a physician commit a patient?
NO!! Remember, only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
With what stage of sleep are night terrors associated?
NREM sleep. Night terrors are dreams that we are unable to recall.
What general pattern of sleep is described by slowing of EEG rhythms (high voltage and slower synchronization), muscle contractions, and lack of eye movement or mental activity?
NREM sleep. Remember awake body, sleeping brain
Which drug is used to treat respiratory depression associated with an overdose of opioids?
Naloxone or naltrexone
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
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.)
What type of damage to the kidneys is caused by drinking ethylene glycol (antifreeze)?
Nephrotoxic oxylate stones
What disease arises from the adrenal medulla, displaces and crosses the midline, metastasizes early, is the most common solid tumor, and is seen in the 2-to 4-year-old age group?
Neuroblastoma
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.
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 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.
What aerobic branching rod that is gram positive and partially acid-fast is associated with cavitary bronchopulmonary disease in immunosuppressed patients?
Nocardia asteroides
What scale separates things into groups without defining the relationship between them?
Nominal scale (categorical, e.g., male or female)
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.
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)
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 blotting technique uses the following for analysis? • RNA
Northern blot
Is nystagmus defined by the fast or slow component?
Nystagmus is named by the fast component, which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
What organelle is responsible for ribosomal RNA synthesis?
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
A unilateral lesion in what nucleus will produce ipsilateral paralysis of the soft palate?
Nucleus ambiguus, resulting in the uvula deviating away from the side of the lesion.
What portion of the intervertebral disk is a remnant of the notochord?
Nucleus pulposus
What hypothesis states that the findings of a test are a result of chance?
Null hypothesis (what you hope to disprove)
What statistical method do you use when analyzing • Case control studies?
Odds ratio. (Case control studies deal with prevalence.)
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
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.
What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable?
One-way ANOVA
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
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 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)
What bone cell has receptors for PTH?
Osteoblasts (Remember, they modulate the function of osteoclasts.)
What cell in bone is a part of the mononuclear phagocytic system?
Osteoclasts
Blue sclera is seen in what hereditary bone disorder?
Osteogenesis imperfecta
What malignant bone tumor is associated with familial retinoblastoma?
Osteosarcoma
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 are the three benzodiazepines that do not undergo microsomal oxidation?
Oxazepam, temazepam, and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation, not via the cytochrome p450 system.
What hormone causes milk letdown?
Oxytocin
What P value defines whether the hull hypothesis should or should not be rejected?
P = .05; P < .05 rejects the null hypothesis
What protein allows Mycoplasma to attach to the respiratory epithelium?
P1 protein
What protein of the HIV virus does ELISA detect to determine whether a patient is HIV positive?
P24
What is the T-cell area of the spleen?
PALS
What is the name of the T cell-rich area of the spleen?
PALS (Parietolateral lymphocytic sheath)
What test uses very small amounts of DNA that can be amplified and analyzed without the use of Southern blotting or cloning?
PCR
What is the longest and most convoluted segment of the nephron?
PCT
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
What cell of the duodenum contains high concentrations of lysozymes and has phagocytic activity?
Paneth cells
Name the DNA virus: • Circular dsDNA; naked; icosahedral; replicates in the nucleus
Papovavirus
What is the name of the T cell-rich area of the lymph node?
Paracortex
What cells of the thyroid gland secrete calcitonin?
Parafollicular C cells
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 disorder is characterized by autoantibodies to IF?
Pernicious anemia
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 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
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 enzyme is deficient in patients with PKU?
Phenylalanine hydroxylase
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 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
Name the laryngeal muscle described by the following: • Only muscle to abduct the vocal cords
Posterior cricoarytenoid muscles
Name the RNA subtype based on the following: • RNA molecules with enzymatic activity
Ribozymes
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)
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
Describe the organism based on the following information: • Alpha-Hemolytic Streptococcus; lysed by bile; sensitive to Optochin
Pneumococcus (Streptococcus pneumoniae)
What obligate extracellular fungus is silver stain-positive and is associated with pneumonia in patients with AIDS?
Pneumocystis carinii
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.
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
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.
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 nerve and artery could be affected in a midshaft humeral fracture?
Radial nerve and the profunda brachii artery
What muscle laterally rotates the femur to unlock the knee?
Popliteus
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
The probability that a person with a positive test result is truly positive refers to what value?
Positive predictive value
Based on operant conditioning, what type of reinforcement is described when • Adding a stimulus reinforces a behavior?
Positive reinforcement
If a virus has positive sense RNA, can it be used as mRNA or is a template needed?
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA-dependent RNA polymerases.
What is the polarity (i.e., 5'-3' or 3'-5') of a positive sense RNA?
Positive sense RNA means it can serve as mRNA and therefore has 5'-3' polarity
What vascular pathology is associated with HTN in the upper extremities, hypotension in the lower extremities, and a radial-femoral delay?
Postductal coarctation of the aorta (adult)
Name the compartment of the mediastinum associated with the following thoracic structures: • Descending aorta
Posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Splanchnic nerves
Posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Vagus nerve
Posterior
What chamber of the eye lies between the iris and the lens?
Posterior chamber
Name the compartment of the lower extremity and the nerve based on its movements. • Plantar flex the foot, flex the toes, and invert the foot
Posterior compartment of the leg, tibial nerve
Name the compartment of the lower extremity and the nerve based on its movements. • Extend the hip and flex the knee
Posterior compartment of the thigh, tibial nerve
Which bacteria are associated with the following pigment production? • Red pigmentation
Serratia
What is the term for headaches, inability to concentrate, sleep disturbances; avoidance of associated stimuli; reliving events as dreams or flashbacks following a psychologically stressful event beyond the normal range of expectation?
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
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 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.
What neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1-L2)
Preganglionic sympathetic neurons
What is the leading cause of school dropout?
Pregnancy
What is the term for ejaculation before or immediately after vaginal penetration on a regular basis?
Premature ejaculation
At what stage of cognitive development (according to Piaget) do children • Lack law of conservation and be egocentric?
Preoperational (2-6 years)
If a lesion occurs before the onset of puberty and arrests sexual development, what area of the hypothalamus is affected?
Preoptic area of the hypothalamus; if the lesion occurs after puberty, amenorrhea or impotence will be seen.
What happens to prevalence as incidence increases?
Prevalence increases.
What happens to prevalence as duration increases?
Prevalence increases. (Note: Incidence does not change.)
What happens to prevalence as the number of long-term survivors increases?
Prevalence increases. (Remember, prevalence can decrease in only two ways, recovery and death.)
What is the term for the number of individuals who have an attribute or disease at a particular point in time?
Prevalence rate
What is the primary risk factor for suicide?
Previous suicide attempt
What are the pharmacologic effects seen sexually with • Trazodone?
Priapism
What disease is associated with the HLA-A3 allele
Primary Hemochromatosis
What autoimmune liver disease is characterized by affecting a middle-aged woman with jaundice, pruritus, fatigue, xanthomas, increased direct bilirubin levels, and antimitochondrial Abs?
Primary biliary cirrhosis
What is the term to describe a man who has • Never been able to achieve an erection?
Primary erectile disorder
What is the name of the B cell-rich area of the spleen?
Primary follicle (in the white pulp)
What is the name of the B cell-rich area in the lymph node?
Primary follicle of the cortex
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 46/4n
Primary spermatocyte
What enzyme produces an RNA primer in the 5'-3' direction and is essential to DNA replication because DNA polymerases are unable to synthesize DNA without an RNA primer?
Primase
From what embryonic structure are the following structures derived? • The right and left atria
Primitive atrium
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 is the drug of choice in treating a patient with hyperuricemia due to underexcretion of uric acid?
Probenecid, a uricosuric agent
What type of Ag do T cells recognize?
Processed antigenic peptides bound in the groove of the MHC molecule
From what do catalase, superoxide dismutase, and glutathione peroxidase defend the cell?
Production of oxygen free radicals
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Cerebral hemispheres
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Diencephalon
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Lateral ventricles
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Telencephalon
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Thalamus
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Third ventricle
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Eye
Proencephalon* *diencephalon derivative
What urease-positive non-lactose-fermenting gram-negative rod with swarming-type motility is associated with staghorn renal calculi?
Proteus
What is the term for normal cellular genes associated with growth and differentiation?
Proto-oncogenes
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 term for hyphae with constrictions at each septum that are commonly seen in Candida albicans?
Pseudohyphae
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
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 bones make up the acetabulum?
Pubis, ilium, and ischium
What component of the pelvic diaphragm forms the rectal sling (muscle of continence)?
Puborectalis
What form of bias occurs when the experimenter's expectation inadvertently is expressed to the subjects, producing the desired effects? How can it be eliminated?
Pygmalion effect (experimenter expectancy). This can be eliminated with double-blind studies.
What vitamin is necessary for the transfer of one amino group from a carbon skeleton to another?
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.
What gluconeogenic mitochondrial enzyme requires biotin?
Pyruvate carboxylase
What structure of a protein describes the interaction among subunits?
Quaternary structure
Which major cell type is found in the red pulp of the spleen?
RBCs. That is why it is called red pulp.
Name the stages of sleep with these EEG patterns: • Sawtooth waves, random low voltage pattern
REM
What aspects of sleep are affected during benzodiazepine use?
REM and stage 4 sleep; they decrease.
What is the period between falling asleep and REM sleep called?
REM latency; normally it is about 90 minutes.
When does most REM sleep occur, in the first or second half of sleep?
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
With what stage of sleep are nightmares associated?
REM sleep. Nightmares are frightening dreams that we recall.
Aroused EEG pattern (fast low voltage and desynchronization), saccadic eye movements, ability to dream, and sexual arousal are all associated with what general pattern of sleep?
REM sleep. Remember, awake brain in a sleeping body.
Where in the body is heme converted to bilirubin?
RES(Reticular endothelial system)
Name the eukaryotic RNA polymerase based on the following: • Synthesizes 28S, 18S and 5.8S rRNAs
RNA polymerase I
Name the eukaryotic RNA polymerase based on the following: • Synthesizes hnRNA, mRNA, and snRNA
RNA polymerase II
Name the eukaryotic RNA polymerase based on the following: • Synthesizes tRNA, snRNA, and the 5S rRNA
RNA polymerase III
What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies?
Rabies
What is the most common precipitin test used in clinical medicine?
Radial Immuno Diffusion (RID) for Ig levels.
What nerve is associated with the following functions? • Supinate the wrist, extend the wrist and digits, extend the shoulder and elbow
Radial nerve
What is the name of depression and mania alternating within a 48-to 72-hour period?
Rapid cycling bipolar disorder
Craniopharyngiomas are remnants of what?
Rathke's pouch; they can result in compression of the optic chiasm.
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
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
Failure to accurately recall the past leads to what form of bias?
Recall bias. These problems arise in retrospective studies.
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 are the two ways to leave the prevalence pot?
Recovery and death
What area of the spleen consists of splenic cords of Billroth and phagocytoses RBCs?
Red pulp (Remember, Red pulp and RBCs begin with R.)
Name these immature defense mechanisms: • Returning to an earlier stage of development (e.g., enuresis)
Regression
What is the term for the ability of a test to measure something consistently?
Reliability (think of it as "nice grouping" or "precise")
What is the term for any stimulus that increases the probability of a response happening?
Reinforcement
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 statistical method do you use when analyzing • Cohort studies?
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
What substance do the JG cells of the kidney secrete in response to low blood pressure?
Renin
What is the only dsRNA virus?
Reovirus
Unconsciously forgetting(forgetting that you forgot something!)
Repression
What is the function of the arachnoid granulations?
Resorb CSF into the blood
What syndrome is due to a deficiency of surfactant?
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
What HIV enzyme produces a dsDNA provirus?
Reverse transcriptase
What is the term for RNA-dependent DNA polymerase?
Reverse transcriptase
What is the term for production of a DNA copy from an RNA molecule?
Reverse transcription
What benign cardiac tumor is associated with tuberous sclerosis?
Rhabdomyoma
What family do the following viruses belong to? • Rabies
Rhabdovirus
What is the name of the bullet-shaped virus?
Rhabdovirus
What diseases are associated with HLA-DR4
Rheumatoid arthritis and type 1 diabetes (with HLA-DR3)
What are the only two picornaviruses that do not lead to aseptic meningitis?
Rhinovirus and hepatitis A virus
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.
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Cerebellum
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Medulla
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Metencephalon
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Myelencephalon
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Pons
Rhombencephalon
With what thoracic vertebra or vertebrae does rib 7 articulate?
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.
What water-soluble-vitamin deficiency is associated with cheilosis and magenta tongue?
Riboflavin (B2)
What enzyme is blocked by hydroxyurea?
Ribonucleotide reductase
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
What organism is associated with the following types of diarrhea? Day care-associated diarrhea in infants
Rotavirus
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
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 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 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
What is the most widely used class of antidepressants?
SSRIs
What muscle or muscles are innervated by the following nerves? • Long thoracic nerve
Serratus anterior
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)
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 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 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 form of depression is due to abnormal metabolism of melatonin?
Seasonal affective disorder (treat with bright light therapy)
From what pharyngeal pouch is the following structure derived? • Palatine tonsil
Second M PITS for pharyngeal pouch derivatives
From what aortic arch are the following structures derived? • Stapes artery
Second MS CARD is my mnemonic for the aortic arch derivatives
What is the term to describe a man who has • Used to be able to achieve an erection but now cannot?
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
What type of lysosome is formed when lysosome fuses with a substrate for breakdown?
Secondary lysosome (think of the primary as inactive and secondary as active)
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 23/2n
Secondary spermatocyte
What type of bias is it when the sample population is not a true representative of the population?
Selection bias
What is the term to describe a man who has • The ability to have an erection sometimes and other times not?
Selective erectile disorder
What component of the inner ear • Contains perilymph and responds to angular acceleration and deceleration of the head?
Semicircular canal
What component of the inner ear • Contains endolymph and responds to head turning and movement?
Semicircular duct
What are the three microscopic pathologic changes seen in Alzheimer's disease?
Senile plaques, neurofibrillary tangles, and granulovascular changes in neurons
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
The proportion of truly diseased persons in the screened population who are identified as diseased refers to?
Sensitivity (it deals with the sick)
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal root ganglion?
Sensory
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal root?
Sensory
Name the reaction that appears in babies who are temporarily deprived of their usual caretaker. (This reaction usually begins around 6 months of age, peaks around 8 months, and decreases at 12 months.)
Separation anxiety
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.
Which way will the O2 dissociation curve shift with the addition of 2, 3-bisphosphoglycerate (2, 3-BPG) to adult hemoglobin (Hgb)?
Shifts it to the right
What is the name of the exotoxin Shigella dysenteriae produces, which interferes with the 60S ribosomal subunit and results in eukaryotic protein synthesis inhibition?
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin, which is quite similar to shiga toxin)
What nonmotile gram-negative, non-lactose-fermenting facultative anaerobic rod uses the human colon as its only reservoir and is transmitted by fecal-oral spread?
Shigella
In prokaryotes, what is the name of the RNA sequence that ribosomes bind to so translation can occur?
Shine-Dalgarno sequence
What must be supplemented in patients with medium-chain acyl CoA dehydrogenase (MCAD) deficiency?
Short-chain fatty acids
What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA?
Sigma factor
Name the type of mutation: • New codon specifies for the same AA
Silent
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
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)
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 period between going to bed and falling asleep called?
Sleep latency
What stage of sleep is associated with somnambulism?
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
What cerebral vessel size is affected in patients with vascular dementia?
Small to medium-sized cerebral vessels
Name the muscle type based on these descriptions: • Involuntary contraction, uninuclear nonstriated fibers, actin and myosin not forming banding pattern; lack of T tubules, gap junctions, and calmodulin.
Smooth muscle
What are the first intermediate hosts for trematodes?
Snails
If a sample of DNA has 30% T, what is the percent of C?
Solved as 30% T + 30% A = 60%; therefore, C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
Name these immature defense mechanisms: • Psychic feelings converted to physical symptoms
Somatization
What somatoform disorder is described as • Having a F:M ratio of 20:1, onset before age 30, and having 4 pains (2 gastrointestinal, 1 sexual, 1 neurologic)?
Somatization disorder
What disorder is described as having • Unconscious symptoms with unconscious motivation?
Somatoform disorder
What somatoform disorder is described as • Severe, prolonged pain that persists with no cause being found, disrupts activities of daily living?
Somatoform pain disorder
In a diabetic patient, to what does aldose reductase convert glucose?
Sorbitol (resulting in cataracts)
What blotting technique uses the following for analysis? • DNA
Southern blot
What type of correlation compares two ordinal variables?
Spearman correlation
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 only organ supplied by the foregut artery that is of mesodermal origin?
Spleen
Name these narcissistic defense mechanisms: • Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
Splitting
Which fungus is found worldwide on plants, is a cigar-shaped yeast in tissue form, and results in rose gardener's disease?
Sporothrix schenckii
What form of the Plasmodium species are injected into humans by mosquitoes?
Sporozoites
What form of angina is characterized by • Coronary artery luminal narrowing, symptom occurrence during exertion, ST segment depression on ECG?
Stable angina
Name the stages of sleep with these EEG patterns: • Disappearance of alpha waves, appearance of theta waves
Stage 1
Name the stages of sleep with these EEG patterns: • Sleep spindles, K-complexes
Stage 2
Most sleep time is spent in what stage of sleep?
Stage 2, which accounts for approximately 45% of total sleep time, with REM occupying 20%.
Name the stages of sleep with these EEG patterns: • Delta waves
Stage 3 and 4
With what stage of sleep is enuresis associated?
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
At what stage of sleep is GH output elevated?
Stage 4
What rate removes any difference between two populations, based on a variable, to makes groups equal?
Standardized rate
What is the first formal IQ test used today for children aged 2 to 18?
Stanford-Binet Scale, developed in 1905, is useful in the very bright, the impaired, and children less than 6 years old.
What muscle keeps the stapes taut against the oval window?
Stapedius muscle
What genus of bacteria is described by catalase-positive, gram-positive cocci in clusters?
Staphylococcus
A patient goes to the ER with abdominal cramps, vomiting, diarrhea, and sweating less than 24 hours after eating potato salad at a picnic; what is the most likely responsible organism?
Staphylococcus aureus
What staphylococcal species is positive for Beta-hemolysis and coagulase?
Staphylococcus aureus
Which bacteria are associated with the following pigment production? • Yellow pigmentation
Staphylococcus aureus
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 operant conditioning therapy or modification is described as • Having a stimulus take over the control of the behavior (unintentionally)?
Stimulus control
In the classical conditioning model, when a behavior is learned, what must occur to break the probability that a response will happen?
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
What form of anxiety, appearing at 6 months, peaking at 8 months, and disappearing by 1 year of age, is seen in the presence of unfamiliar people?
Stranger anxiety
What is the epithelial cell lining the nasopharynx?
Stratified squamous nonkeratinized epithelium, which has cilia that beat toward the oropharynx.
What is the most superficial layer of the epidermis?
Stratum corneum (keratinized)
What epidermal layer's function is to release lipids to act as a sealant?
Stratum granulosum
What is the first epidermal layer without organelles and nuclei
Stratum lucidum
In what layer of the epidermis is melanin transferred from melanocytes to keratinocytes?
Stratum spinosum
Describe the organism based on the following information: • Beta-Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate
Streptococcus agalactiae
Name at least three bacteria that use capsules to prevent immediate destruction from the host's defense system.
Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Neisseria meningitidis; also Cryptococcus neoformans, a fungus
Describe the organism based on the following information: • Beta-hemolytic Streptococcus sensitive to bacitracin
Streptococcus pyogenes
Describe the organism based on the following information: • Alpha-hemolytic Streptococcus; not lysed by bile; not sensitive to Optochin
Streptococcus viridans
Which streptococcal species is associated with dental caries and infective endocarditis in patients with poor oral hygiene?
Streptococcus viridans
Which Streptococcus pyogenes toxin is immunogenic?
Streptolysin O
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 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
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.
What muscle or muscles are innervated by the following nerves? • Upper subscapularis nerve
Subscapularis
What 11-amino acid peptide is the neurotransmitter of sensory neurons that conveys pain from the periphery to the spinal cord?
Substance P. (Opioids relieve pain in part by blocking substance P.)
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
In Parkinson's disease, what area of the basal ganglia has a decreased amount of dopamine?
Substantia nigra
What judgment states that the decision, by rights of autonomy and privacy, belongs to the patient, but if the patient is incompetent to decide, the medical decision is based on subjective wishes?
Substituted judgment. It is made by the person who best knows the patient, not the closest relative.
What enzyme of the TCA cycle also acts as complex II of the ETC?
Succinate dehydrogenase
What enzyme of the TCA cycle catalyzes the production of the following: • FADH2
Succinate dehydrogenase
What intermediate enables propionyl CoA to enter into the TCA cycle?
Succinyl CoA
What enzyme of the TCA cycle catalyzes the production of the following: • GTP
Succinyl CoA synthetase
What enzyme of the TCA cycle catalyzes the substrate level phosphorylation?
Succinyl CoA synthetase
According to Freud, what facet of the psyche represents the internalized ideals and values of one's parents?
Superego
What Freudian psyche component is described as • The conscience, morals, beliefs (middle of the road)?
Superego
Name the compartment of the mediastinum associated with the following thoracic structures: • Aortic arch
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Brachiocephalic vein
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Left common carotid artery
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Left subclavian artery
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Trachea
Superior
What is the label given to an individual whose IQ is • 120 to 129
Superior
What ocular muscle • Depresses and abducts the eyeball?
Superior Oblique (CN IV) (LR6 SO4)3
Name the compartment of the mediastinum associated with the following thoracic structures: • Thymus
Superior and anterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Phrenic nerve
Superior and middle
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
What two cell lines of the immune system do not belong to the innate branch?
T and B-cells belong to the adaptive branch, whereas PMNs, NK cells, eosinophils, macrophages, and monocytes belong to the innate branch.
What three major cell lines participate in the acquired immune system?
T cells, B cells, and macrophages
What cells are atypical on a peripheral blood smear in heterophil-positive mononucleosis?
T cells, not B cells
At what vertebral level does the trachea bifurcate?
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
What vertebral level is marked by the xiphoid process?
T9
What projective test asks the patient to tell a story about what is going on in the pictures, evaluating the conflicts, drives, and emotions of the individual?
TAT (Thematic apperception test)
What T-cell surface projection recognizes and reacts to foreign Ags (presented by APCs)?
TCR
True or false? All Proteus species are urease positive.
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? Klinefelter syndrome cannot be diagnosed until puberty.
TRUE
True or false? The epithelial lining of the urinary bladder and the urethra are embryologic hindgut derivatives.
TRUE
What pituitary hormone is inhibited during sleep?
TSH. 5-HT and prolactin increase during sleep, and dopamine levels decrease during sleep.
Which cestode in raw or rare beef containing cysticerci results in intestinal tapeworms?
Taenia saginata
What muscle of the middle ear is innervated by the mandibular division of CN V?
Tensor tympani
What tumor constitutes 40% of testicular tumors in children?
Teratoma
What is the term for the same results achieved again on testing a subject a second or third time?
Test-retest reliability
What syndrome occurs when a 46XY fetus develops testes and female external genitalia?
Testicular feminization syndrome (Dude looks like a lady!)
What toxin, produced by Clostridium tetani, binds to ganglioside receptors and blocks the release of glycine and GABA at the spinal synapse?
Tetanospasmin (also called tetanus toxin)
What subset of CD4 helper T-cell function is helping the development of CD8 T cells?
Th1; they are also responsible for delayed-type hypersensitivity (type IV)
What subset of CD4 helper T cells stimulate B-cell division and differentiation?
Th2
What subset of CD4 T cells is responsible for mast cell and eosinophil precursor proliferation?
Th2 cells
What artery is formed by the union of the two vertebral arteries?
The basilar artery is formed at the pontomedullary junction.
What reflex, seen in lesions of the corticospinal tract, is an extension of the great toe with fanning the of remaining toes?
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse, hyperreflexia, spastic paralysis, increased muscle tone, and weakness are commonly seen in UMN lesions.
What molecule differentiates the MHC class I from II Ag? (Hint: it's in the light chain.)
The Beta-2-microglobin. It is the separately encoded Beta-chain for class I Ags.
What is the second cell involved in the immune response?
The CD4 T cell; the APC is the first cell in the immune response.
What ascending sensory system carries joint position, vibratory and pressure sensation, and discriminative touch from the trunk and limbs?
The DCML system. (Remember, everything but pain and temperature.)
What are the two opsonizing factors?
The Fc region of IgG and C3b
What neuropsychologic test has five basic scales testing for the presence and localization of brain dysfunction?
The Halsted-Reitan battery. It consists of finger oscillation, speech sound perception, rhythm, tactual, and category testing.
What muscles in the hand adduct the fingers?
The Palmar interosseus ADducts, whereas the Dorsal interosseus ABducts (PAD and DAB)
What cell's axons are the only ones that leave the cerebellar cortex?
The Purkinje cell
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 thalamic relay nucleus do the mammillary bodies project to?
The anterior nucleus of the thalamus
Is the coding or the template strand of DNA identical to mRNA (excluding the T/U difference)?
The coding strand is identical to mRNA, and the template strand is complementary and antiparallel.
In an adult, where does the spinal cord terminate and what is it called?
The conus medullaris terminates at the level of the second lumbar vertebra.
Who decides competency and sanity?
The courts. These are legal, not medical terms.
Where is the cupola of the lung in relation to the subclavian artery and vein?
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
What is the most stressful event as determined by the Holmes and Rahe scale?
The death of a spouse. The higher the score, the greater the risk of developing an illness in the next 6 months.
When does most of the NREM sleep (stage 3 and 4) occur, in the first or second half of sleep?
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
What deep cerebellar nuclei receive Purkinje cell projections in • The intermediate hemispheres?
The dentate nucleus
What determines the rate of reaction?
The energy of activation
What determines the rate of a reaction?
The energy of activation (Ea)
What mineral is required for cross-linking of collagen molecules into fibrils?
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
The fasciculus cuneatus
What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
The fasciculus gracilis (Graceful), which lies closest to the midline of the spinal cord.
If a patient with a cerebellar lesion has nystagmus, which way is the fast component directed, toward or away from the lesion?
The fast component is directed toward the affected side of a cerebellar lesion.
What deep cerebellar nuclei receive Purkinje cell projections in • The vermis?
The fastigial nucleus
What happens to muscle tone and stretch reflexes when there is a LMN lesion?
The hallmarks of LMN lesion injury are absent or decreased reflexes, muscle fasciculations, decreased muscle tone, and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget, LMN lesions are ipsilateral at the level of the lesion!
Where are the cell bodies for the DCML and spinothalamic sensory systems?
The first sensory neuron is in the dorsal root ganglia. It carries ascending sensory information in the dorsal root of a spinal nerve, eventually synapsing with second sensory neuron. In the brainstem (DCML) and the spinal cord (spinothalamic) the second neuron cell body sends its axons to synapse in the thalamus. The third sensory neuron cell body is a thalamic nuclei that sends its fibers to the primary somatosensory cortex.
In what trimester is the fetus most vulnerable to congenital rubella syndrome?
The first trimester
What is determined by the secondary structure of an AA?
The folding of an AA chain
What is the only excitatory neuron in the cerebellar cortex, and what is its neurotransmitter?
The granule cell is the only excitatory neuron in the cerebellar cortex, and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons, and they use GABA as their neurotransmitter.
What is the most abundant neuron in the cerebellum?
The granule cell. Its neurotransmitter is glutamic acid, which is also the principal neurotransmitter of the visual pathways.
What direction does the primitive gut rotate? What is its axis of rotation?
The gut rotates clockwise around the superior mesenteric artery.
What is the primer for the synthesis of the second strand in production of cDNA from mRNA?
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
What area of the lymph node is considered the thymic-dependent area?
The inner cortex (paracortex) contains the T cells, so it is considered the thymic-dependent area.
Where are the enzymes for the ETC and oxidative phosphorylation found?
The inner membrane of the mitochondria (cristae)
What nerves provide sensory innervation above the vocal cords? Below the vocal cords?
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
What deep cerebellar nuclei receive Purkinje cell projections in • The lateral cerebellar hemispheres?
The interposed nucleus
What is the most common site for an aneurysm in cerebral circulation?
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands, it compresses the fibers from the upper temporal fields of the optic chiasm, producing bitemporal inferior quadrantanopia
What organ is responsible for the elimination of excess nitrogen from the body?
The kidneys excrete the excess nitrogen from the body as urea in the urine.
What causes the lysis of RBCs by oxidizing agents in a G-6-PD deficiency?
The lack of glutathione peroxidase activity results in a decrease in NADPH production, leaving glutathione in the reduced state.
What deep cerebellar nuclei receive Purkinje cell projections in • The flocculonodular lobe?
The lateral vestibular nucleus
What are the three branches of the celiac trunk?
The left gastric, splenic, and common hepatic arteries
The left subclavian artery is a branch of what artery?
The left is a branch of the aortic arch, while the right is a branch of the brachiocephalic trunk.
What area of the brain is responsible for emotion, feeding, mating, attention, and memory?
The limbic system
What is the only organ in the body that can produce ketone bodies?
The liver (in the mitochondria)
What embryonic structure, around day 19, tells the ectoderm above it to differentiate into neural tissue?
The notochord
What is the valence of an Ig molecule equal to?
The number of Ags that the Ab can bind
What is the start codon, and what does it code for in eukaryotes? Prokaryotes?
The one start codon, AUG, in eukaryotes codes for methionine and in prokaryotes formylmethionine.
Based on the onset of the symptoms, how are bacterial conjunctivitis from Neisseria and Chlamydia differentiated?
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days, whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
What area of the posterior aspect of the eye has no photoreceptors?
The optic disk is the blind spot.
What is the name of the postganglionic parasympathetic ganglion that innervates • The parotid gland?
The otic ganglion. (These fibers are carried in CN IX. Remember it like this: the -oti-is in both otic ganglion and parotid gland.)
What area of the lymph node contains germinal centers?
The outer cortex contains most of the germinal centers and therefore also most B cells.
Is the pH of CSF acidotic, alkalotic, or neutral?
The pH of CSF is 7.33, acidotic.
What is the central issue regarding the Roe vs. Wade decision (legalization of abortion)?
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
What causes transcription to stop in eukaryotes?
The poly(A) site on the DNA
What vascular injury may result from a supracondylar fracture of the femur?
The popliteal artery, the deepest structure in the popliteal fossa, risks injury in a supracondylar fracture of the femur.
What is the direction of growth for the primitive streak, caudal to rostral or rostral to caudal?
The primitive streak grows caudal to rostral.
What vessels carry deoxygenated blood into the lungs from the right ventricle?
The right and left pulmonary arteries, the only arteries that carry deoxygenated blood
What vessel does the right gonadal vein drain into?
The right gonadal vein drains into the inferior vena cava directly, and the left gonadal vein drains into the left renal vein.
Which kidney is lower? Why?
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
What is the vector for Leishmania infections?
The sandfly
What pharyngeal pouch and groove persist when a pharyngeal fistula is formed?
The second pharyngeal pouch and groove
What phase of the female reproductive cycle is 14 days long?
The secretory phase is progesterone-dependent and 14 days long, whereas the length of the proliferative phase varies
What branches of CN X are the sensory and motor components of the cough reflex? Be specific.
The sensory component is through the superior laryngeal nerve, and the motor limb is via the recurrent laryngeal nerve.
Which CNs act as the sensory and motor components of the gag reflex?
The sensory limb is via CN IX, and the motor limb is from CN X.
What chromosome codes for HLA gene products?
The short arm of chromosome 6
What ribosomal subunit binds first to the mRNA strand?
The small subunit (40S) binds first.
The inferior mesenteric artery drains into it.
The splenic vein
What muscle of the middle ear is innervated by CN VII?
The stapedius muscle
The vertebral artery is a branch of what artery?
The subclavian artery
What is the name of the postganglionic parasympathetic ganglion that innervates • The submandibular and sublingual glands?
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
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.
Where are the preganglionic neuron cell bodies, the CNS or the PNS?
They are in the grey matter of the CNS.
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 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 vector of African sleeping sickness?
The tsetse fly
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 reflex enables the eyes to remain focused on a target while the head is turning?
The vestibulo-ocular reflex
Does the zygote divide mitotically or meiotically?
The zygote divides mitotically; only germ cells divide meiotically.
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.
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.
Where are the postganglionic neuron cell bodies, the CNS or the PNS?
They are in ganglia in the PNS.
What is the function of white rami communicantes?
They are preganglionic sympathetic axons. They are white because they are myelinated.
What do UMNs innervate?
They innervate LMNs.
What do LMNs innervate?
They innervate skeletal muscle.
What two vitamins are inactivated when they come in contact with acetaldehyde?
Thiamine and folate
What skin type on the palms and soles is characterized by the absence of hair follicles and presence of stratum lucidum?
Thick skin
What is the triad of Wiskott-Aldrich syndrome?
Thrombocytopenia, eczema, and immunodeficiency is the triad of this X-linked recessive disorder.
What is the term for Candida infection of the oral mucosa?
Thrush
What three cells are essential for T-cell maturation?
Thymic epithelial cells, dendritic cells, and macrophages
What enzyme of pyrimidine synthesis is inhibited by the following? • 5-FU
Thymidylate synthase
What enzyme is blocked by 5-FU?
Thymidylate synthetase
Methylating uracil produces what pyrimidine base?
Thymine
What pyrimidine base is found • Only in DNA?
Thymine
What encapsulated lymphoid organ is characterized by presence of Hassall's corpuscles, and absence of germinal centers and B cells?
Thymus gland. (Thymus gland is essential for T cell maturation.)
What is the term for Ags that activate B cells without T-cell signaling?
Thymus-independent Ags
Name the laryngeal muscle described by the following: • Pulls the arytenoids cartilages closer to the thyroid, relaxing the vocal ligaments and thereby decreasing the pitch
Thyroarytenoid muscles
What gland is found in the muscular triangle of the neck?
Thyroid gland
What lower extremity nerve is described by the following motor loss? • Loss of flexion of the knees and toes, plantarflexion, and weakened inversion
Tibial nerve
What is the most serious form of tinea capitis, which results in permanent hair loss and is highly contagious?
Tinea favosa (favus)
What part of the heart forms • Apex?
Tip of the left ventricle
What topoisomerase makes ssDNA cuts, requires no ATP, relaxes supercoils, and acts as the swivel in front of the replication fork?
Topoisomerase I (Relaxase)
In the elderly, what happens to total sleep time, percentage of REM sleep, and percentage of NREM sleep?
Total and NREM sleep decrease considerably as we age, but REM sleep remains relatively constant (20%) up to age 80, then begins to decline.
What disease is described by the following characteristics: multiple motor and vocal tics, average age of onset 7, a M:F ratio of 3:1, and association with increased levels of dopamine?
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive-compulsive disorder and learning disabilities.
Which parasitic organism, when it crosses the placenta, results in intracerebral calcifications, chorioretinitis, microcephaly, hydrocephaly, and convulsions?
Toxoplasma gondii
Name the aphasia based on these characteristics: • Lesion in the prefrontal cortex; inability to speak spontaneously; unimpaired ability to repeat
Transcortical aphasia
What disconnect syndrome results from a lesion in the corpus callosum secondary to an infarct in the anterior cerebral artery, so that the person can comprehend the command but not execute it?
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
What is the term for conversion of a dsDNA molecule to the base sequence of an ssRNA molecule?
Transcription (C comes before L in the alphabet, and transCription comes before transLation)
In eukaryotes, what transcription factor binds to the TATA box before RNA polymerase II can bind?
Transcription factor IID
What term is defined as a patient unconsciously placing his or her thoughts and feelings on the physician in a caregiver or parent role?
Transference. When it is from the physician to the patient it is called countertransference.
What transports iron in the blood?
Transferrin
What is the term for a delay in the onset of normal IgG synthesis seen in the fifth to sixth month of life?
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
Transient ischemic attack
What is the epithelial lining of the prostatic portion of the urethra?
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.
What are the nonoxidative enzymes of the HMP shunt? Are the reactions they catalyze reversible or irreversible?
Transketolase and transaldolase. The reactions they catalyze are reversible.
What is the term for taking an mRNA molecule and arranging the AA sequence forming a protein?
Translation
What right-to-left shunt occurs when the aorta opens into the right ventricle and the pulmonary trunk opens into the left ventricle?
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
What are known as jumping genes?
Transposons
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
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? 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? B-cell Ag receptors can be secreted.
True. B cell antigen receptors are Abs.
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? 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? 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? 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? 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.
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? Methylation of bacterial DNA prevents restriction endonuclease from cutting its own chromosomes.
True. Restriction endonucleases cut only unmethylated DNA.
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? 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.
In the alveoli, what cell type is • for gas exchange?
Type I pneumocytes
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? Neurons in the dorsal horn participate in reflexes.
True. They are the sensory component of a spinal reflex.
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? 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? 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? 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.
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 AA is a precursor of the following substances? • NAD
Tryptophan
What AA is a precursor of the following substances? • Serotonin
Tryptophan
How many pairs of spinal nerves are associated with • Thoracic vertebrae?
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
What are the three sites where CSF can leave the ventricles and enter the subarachnoid space? (Name the lateral and the medial foramina.)
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
What statistical test compares the means of groups generated by two nominal variables by using an interval variable?
Two-way ANOVA. It allows the test to check several variables at the same time.
What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
Tylosis
What type of error is made if you reject the null hypothesis when it is true?
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
Fixing impulses by acting out the opposite of an unacceptable behavior
Undoing
Anhedonia, lack of motivation, feelings of worthlessness, decreased sex drive, insomnia, and recurrent thoughts for at least 2 weeks, representing a change from previous level of function, describes what disorder?
Unipolar disorder (major depression)
What form of angina is characterized by • Coronary artery nonocclusive thrombus; symptom occurrence with increasing frequency, duration, intensity, and decreasing activity, frequently at rest?
Unstable (crescendo) angina
What is the rule of one-third regarding muscle type of the esophagus?
Upper third skeletal muscle, middle third both skeletal and smooth muscle, and lower third smooth muscle
What embryonic structure forms the following adult structures? • Median umbilical ligament
Urachus
What pyrimidine base is found • Only in RNA?
Uracil
What pyrimidine base is produced by deaminating cytosine?
Uracil
How can a genetic deficiency of carbamoyl phosphate synthetase be differentiated from an ornithine transcarbamoylase deficiency?
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Which mycoplasma species is associated with urethritis, prostatitis, and renal calculi?
Ureaplasma urealyticum
What is the end product of purine catabolism?
Uric acid
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 virus lies dormant in the • Dorsal root ganglia?
Varicella
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
Name the lipoprotein based on the following characteristics. • apo E, apo B-100, apo C-II
VLDL
In what form are triglycerides sent to adipose tissue from the liver?
VLDLs
The fibers of nucleus gracilis and nucleus cuneatus cross at the medullary decussation and ascend contralateral to what thalamic relay nucleus?
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
What is the term for involuntary constriction of the outer third of the vagina to prevent penile penetration?
Vaginismus; it is the female counterpart of premature ejaculation.
What CN is associated with the sensory innervation of • Laryngopharynx?
Vagus nerve
What is the term for the number of Ag-binding sites on an Ig?
Valence
What is the term for the degree to which a test measures what it is intended to measure?
Validity (remember, reliability is necessary but not the only thing needed for validity)
What urinary metabolite is elevated in pheochromocytoma?
Vanillylmandelic acid (VMA)
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • Varying in time?
Variable interval
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • Varying in the number of responses?
Variable ratio If it is based on time, it is an interval, and if it is based on the number of responses, it is a ratio.
What is the label given to an individual whose IQ is • 130
Very superior (<2.5% of the population)
What virus causes hoof-and-mouth disease?
Vesicular stomatitis virus
What organism is associated with the following types of diarrhea? Rice water stools
Vibrio cholera
What organism is associated with the following types of diarrhea? Diarrhea associated with raw or undercooked shellfish
Vibrio parahaemolyticus
What is the most likely organism causing cellulitis in a patient who was cut by an oyster shell?
Vibrio vulnificus
What is the name of the protein coat that surrounds the nuclear envelope?
Vimentin
What triad consists of endothelial injury, changes in laminar flow, and hypercoagulation?
Virchow triad, associated with the formation of a thrombus.
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Acellular; some are enveloped; replicate within the host cell; no cell walls
Viruses
What type of pleura is adherent to the surface of the organ?
Visceral pleura
What vitamin is an important component of rhodopsin?
Vitamin A
What vitamin is necessary for epithelial health?
Vitamin A is responsible for vision and epithelial health.
What water-soluble-vitamin deficiency is associated with poor wound healing, easy bruising, bleeding gums, anemia, and painful glossitis?
Vitamin C
What causes an increase in bone mineralization and Ca2+ along with PO4- absorption from the GI tract and kidney tubules?
Vitamin D
What fat-soluble vitamin is connected to selenium metabolism?
Vitamin E
How can you differentiate vitamin K from vitamin C deficiency by bleeding time and PT levels?
Vitamin K deficiency has normal bleeding time and increased PT, and vitamin C deficiency has increased bleeding time and normal PT.
What is the term for a direct connection between the intestine and the external environment through the umbilicus because the vitelline duct persists?
Vitelline fistula
What is the fluid of the posterior compartment of the eye?
Vitreous humor
At what point does the axillary artery become the brachial artery?
When it crosses the teres major
What is backward masking, and is there a positive correlation with schizophrenic patients?
When showing two pictures in rapid succession, you split the pictures half a second apart, resulting in the second picture masking the first (indicating poor short-term memory). This is seen in nearly 33% of schizophrenic patients.
If the pH is more acidic than the pI, does the protein carry a net positive or net negative charge?
When the pH is more acidic than the pI, it has a net positive charge, and when the pH is more basic than the pI, it has a net negative charge.
Are white rami preganglionic or postganglionic fibers?
White rami are preganglionic fibers, whereas grey rami are postganglionic fibers.
Is marital satisfaction higher for couples with or without children?
Without children (but don't think about this one for too long)
Name the pattern of genetic transmission characterized thus: both M and F affected; no M-to-M transmission; affected M passes trait to all daughters, every generation; affected F passes trait to both sons and daughters; a single mutant allele can produce the disease.
X-linked dominant
What pattern of genetic transmission affects only M and has no M-to-M transmission, and mother is usually an unaffected carrier?
X-linked recessive
What pattern of inheritance does G-6-PD deficiency follow?
X-linked recessive
What enzyme requires molybdenum as a cofactor?
Xanthine oxidase
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.
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.
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.
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.
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.
What type of correlation is defined as • Two variables with no linear relation to one another?
Zero correlation
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
Do alpha-or gamma-motor neurons innervate extrafusal muscle fibers?
alpha-Motor neurons innervate extrafusal muscle fibers (a motor unit), whereas gamma-motor neurons innervate intrafusal muscle fibers.
What apoprotein on HDL activates lecithin-cholesterol acyltransferase (LCAT)?
apo A-1
What apoprotein is required for the release of chylomicrons from the epithelial cells into the lymphatics?
apo B-48
What type of DNA library is made from the mRNA from a tissue expressing a particular gene?
cDNA libraries are derived from mRNA, are continuous, and contain no introns or regulatory elements.
What form of continuous DNA, used in cloning, has no introns or regulatory elements?
cDNA, when it is made from mRNA
What thyroiditis presents as a tender, enlarged, firm thyroid gland, usually preceded by an upper respiratory viral illness?
de Quervain thyroiditis
What eukaryotic translation enzyme is associated with the following: • Elongation
eEF-1
What elongation factor is inactivated by ADP ribosylation, preventing translation?
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
What eukaryotic translation enzyme is associated with the following: • Initiation
eIF-2 in the P site
What HIV structural gene produces GP120 and GP41?
env structural protein
What are the two chains of the TCR that are mainly found on the skin and mucosal surfaces?
gamma and delta chains
HIV's capsid, core nucleocapsid, and matrix proteins are products of what structural gene?
gag gene
What hormone, produced by the syncytiotrophoblast, stimulates the production of progesterone by the corpus luteum?
hCG
How early can a pregnancy be detected by hCG assays in the blood? In urine?
hCG can be detected in the blood by day 8 and in the urine by day 10.
Name the RNA subtype based on the following: • Found only in the nucleus of eukaryotic cells and are precursors of mRNA
hnRNA
Name the RNA subtype based on the following: • Only type of RNA that is translated
mRNA
What two HIV regulatory genes down-regulate MHC class I expression in the host?
nef and tat genes
All AAs have titration plateaus at what pH values?
pH of 2 and 9
What is the term for the pH at which the structure carries no charge?
pI (isoelectric point)
What is the term for the pH range where the dissociation of H+ occurs?
pK (think of it as where half is base and half is acid)
Name the RNA subtype based on the following: • The most abundant form of RNA in the cell
rRNA
Name the RNA subtype based on the following: • Found only in the nucleus of eukaryotes and functions to remove introns from mRNA
snRNA
Name the RNA subtype based on the following: • Carries AA to the ribosome for protein synthesis
tRNA
In what syndrome does the patient have angiomatosis; renal cell carcinomas; pheochromocytomas; retinal, cerebellar, medulla, or spinal cord hemangioblastomas; and epidermal cysts?
von Hippel-Lindau syndrome
