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201-400 Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the antidote for an overdose with: Acetaminophen?

A

N-Acetylcysteine

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2
Q

What is the antidote for an overdose with: Nitrates?

A

Methylene blue

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3
Q

What is the antidote for an overdose with: Lead?

A

EDTA (calcium disodium edetate), dimercaprol, succimer

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4
Q

What structure is derived from the prochordal plate?

A

The mouth

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5
Q

What is the only organ supplied by the foregut artery that is of mesodermal origin?

A

Spleen

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6
Q

In which direction and how far does the gut rotate?

A

Counterclockwise 270 degrees

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7
Q

What structure connects the primitive gut to the yolk sac?

A

The yolk stalk (vitelline duct)

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8
Q

What is the artery of the embryonic foregut?

A

The celiac artery

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9
Q

When does the primitive gut herniate out of the embryo?

A

6 weeks

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10
Q

When does it return back into the embryo?

A

10 weeks

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11
Q

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

A

Omphalocele and gastroschisis

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12
Q

Around what structure does the midgut rotate?

A

Superior mesenteric artery

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13
Q

What three things cause the indifferent gonad to become a testis?

A

1.Testis-determining factor (TDF) from the short arm of the Y chromosome 2.Miillerian inhibiting factor (MIF) from Sertoli cells 3.Testosterone from Leydig cells

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14
Q

Where does the embryologic foregutend?

A

At the first part of the duodenum

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15
Q

What is the artery of the embryonic hindgut?

A

The inferior mesenteric artery

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16
Q

What three embryonic cell layers form the chorion?

A
  1. Cytotrophoblast 2. Symcytiotrophoblast 3. Extraembrvonic mesoderm
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17
Q

Which neuropore closes last?

A

Caudal-and it is the first to open, too.

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18
Q

What is the artery of the embryonic midgut?

A

The superior mesenteric artery

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19
Q

From where are nephrons derived embryonically?

A

Metanephros

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20
Q

What are the five derivatives of the ventral mesentery?

A
  1. Falciform ligament 2. Hepatoduodenal ligament 3. Hepatogastric ligament 4 and 5. Coronary and triangular ligaments of the liver. All else is derived from the dorsal mesentery.
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21
Q

When do the septum primum and the septum secundum of the heart fuse?

A

After birth

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22
Q

The cerebral cortex is a derivative of what?

A

The telencephalon

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23
Q

What is the adult structure found in the embryo as the: Umbilical vein?

A

Ligamentum teres

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24
Q

What is the adult structure found in the embryo as the: Ductus venosus?

A

Ligamentum venosum

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25
Q

What is the adult structure found in the embryo as the: Foramen ovule?

A

Fossa ovule

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26
Q

What is the adult structure found in the embryo as the: Ductus arteriosus?

A

Ligamentum arteriosum

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27
Q

What is the adult structure found in the embryo as the: Umbilical artery?

A

Medial umbilical ligament

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28
Q

Where does the hindgut end?

A

At the superior portion of the anal canal

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29
Q

Where does the midgut end?

A

At the right two thirds of the transverse colon

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30
Q

From where is the tongue musculature derived?

A

Occipital somites

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31
Q

What two branchial arches contribute to the formation of the anterior two thirds of the tongue?

A

First and some of the second

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32
Q

What are the two fourth pharyngeal pouch derivatives?

A

Superior parathyroid glands and the ultimobranchial body

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33
Q

What two structures are derived from the fourth aortic arch?

A

Arch of the aorta and the right subclavian artery

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34
Q

What adult structures are derived from preotic somites?

A

Muscles of the internal eye

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35
Q

What structure is derived from the first pharyngeal pouch?

A

The middle ear

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36
Q

What two branchial arches contribute to the posterior two thirds of the tongue?

A

Third and part of the fourth

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37
Q

What are the two third pharyngeal pouch derivatives?

A

Inferior parathyroid glands and the thymus

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38
Q

What structure is derived from the first aortic arch?

A

Maxillary artery

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39
Q

From what are the urinary bladder and the urethra derived?

A

Urogenital sinus

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40
Q

From what are the pulmonary trunk and the ascending aorta derived?

A

Truncus arteriosum

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41
Q

What disorder will result when there is a failure of the urachus to close, causing a leakage of urine out of the umbilicus?

A

Urachal fistula

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42
Q

The common carotid and the internal carotid arteries are derivatives of what embryonic structure?

A

Third aortic arch

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43
Q

The palatine tonsils are derived from what embryonic structure?

A

Second pharyngeal pouch

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44
Q

What are the sixth aortic arch derivatives?

A

Right and left pulmonary arteries and the ductus arteriosus

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45
Q

The stapedial artery is derived from what?

A

Second aortic arch

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46
Q

The mesonephric ducts contribute to what renal structures?

A

The collecting ducts, calyx, renal pelvis, and ureters

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47
Q

Of what embryonic structureis the coronary sinus a derivative?

A

The left horn of the sinus venosus

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48
Q

What cranial nerve (CN) is associated with the: First pharyngeal arch?

A

CN V

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49
Q

What cranial nerve (CN) is associated with the: Second pharyngeal arch?

A

CN VII

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50
Q

What cranial nerve (CN) is associated with the: Third pharyngeal arch?

A

CN IX

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51
Q

What cranial nerve (CN) is associated with the: Fourth pharyngeal arch?

A

CN X

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52
Q

What cranial nerve (CN) is associated with the: Fifth pharyngeal arch?

A

None-it degenerates

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53
Q

What cranial nerve (CN) is associated with the: Sixth pharyngeal arch?

A

CN X

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54
Q

From where is the external auditory meatus derived?

A

First pharyngeal groove

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55
Q

From where is the smooth portion of the right atrium derived?

A

Right horn of the sinus venosus

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56
Q

Meckel’s diverticulum is a remnant of what embryonic structure?

A

Vitelline duct (yolk stalk)

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57
Q

The pons and cerebellum are derived from what portion of the embryonic neural tissue?

A

Metencephalon

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58
Q

The medulla is a derivative of what portion of the embryonic neural tissue?

A

Myelencephalon

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59
Q

What structure “tells” the overlying cells to begin neurulation?

A

The notochord

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60
Q

What structure splits the cloacal membrane, resulting in the formation of the perineum?

A

Urorectal septum

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61
Q

In the adult, the thoracic veins are derived from what structure?

A

The cardinal veins

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62
Q

The gastrointestinal tract and abdominal veins are derived from what structure?

A

Vitelline veins

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63
Q

From what is the thyroid gland derived?

A

The floor of the endoderm (the posterior aspect of the tongue)

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64
Q

The thalamus and its related structures are derivatives of what?

A

The diencephalon

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65
Q

Transcriptionally active DNA is known as what?

A

Euchromatin

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66
Q

Transcriptionally inactive DNA is called?

A

Heterochromatin

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67
Q

What is the only histone not found inside the nucleosomes?

A

H1 histone-Its function is to bind nucleosomes together.

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68
Q

What coating protects proteins from intracellular degradation?

A

Clathrin coating

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69
Q

A nucleosome is made up of what two components?

A

Histories and DNA

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70
Q

What are the four functions of smooth endoplasmic reticulum (SER)?

A
  1. Steroid synthesis 2. Drug detoxification 3. Ca2+ handling 4. TAG resynthesis
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71
Q

What are the long microvilli found in the inner ear and the male reproductive tract called?

A

Stereocilia

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72
Q

What cell junction type allows for communication between two adjacent cells?

A

Gap junctions (nexus)

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73
Q

Where are the enzymes for ATP production and the ETC located?

A

Inner fold of the mitochondria membrane

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74
Q

What cell membrane structure increases the surface area of a cell and has actin randomly assorted within its structure?

A

Microvillus

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75
Q

What is the function of desmosomes?

A

To hold adjacent cells together (i.e., adhesion)

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76
Q

What is the microtubule configuration of a basal body?

A

9 + 0 microtubule arrangement

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77
Q

What are the four components of the basement membrane?

A
  1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
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78
Q

The proteins that are to stay within the cell are produced by what organelle?

A

Free polysome (polyribosome)

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79
Q

What is the lysosomal post- translational modification of proteins?

A

Phosphorylation of mannose residues

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80
Q

What cell surface modification of ependymal cells and respiratory epithelium has a 9 + 2 microtubular configur- ation and movement as its function?

A

Cilia

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81
Q

What protein binds hemidesmosomes to the basal lamina?

A

Integrin

82
Q

What intermediate filament is found in the zona adherens?

A

Actin

83
Q

The proteins to be exported or incorporated into the lysosome are produced by what organelle?

A

Bound polysome (polyribosome), attached to rough endoplasmic reticulum (RER)

84
Q

What is the function of the zonula occludens and the zonula adherens?

A

To provide attachment between contiguous cells and to maintain a semipermeable barrier

85
Q

The following intermediate filaments are associated with what cell types: Desmin?

A

Muscle cells

86
Q

The following intermediate filaments are associated with what cell types: Cytokeratins?

A

Epithelial cells

87
Q

The following intermediate filaments are associated with what cell types: Vimentin?

A

Mesenchymal cells

88
Q

The following intermediate filaments are associated with what cell types: Neurofilaments?

A

Neurons

89
Q

The following intermediate filaments are associated with what cell types: Glial filaments?

A

Astrocytes

90
Q

The basal lamina + the reticular lamina

A

what?

91
Q

What is the name of the organelle where collagen is made?

A

Rough endoplasmic reticulum (RER)

92
Q

What vitamin is needed for the hydroxylation of proline and lysine in collagen synthesis?

A

Vitamin C - Survy

93
Q

What are the two amino acids that cross-link elastin molecules?

A

Desmosine and isodesmosine

94
Q

What is the major inorganic component of bone?

A

Hydroxyapatite

95
Q

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

A

Osteoclasts

96
Q

What are the two types of cells located in the perichondrium of cartilage?

A

Fibroblasts and chondroblasts

97
Q

What cell in the CNS is part of the mononuclear phagocytic system?

A

Microglia

98
Q

What substance, found in eosinophils, is toxic to parasitic worms?

A

Major basic protein

99
Q

Where is tropocollagen aggregated to form a collagen fibril?

A

Extracellularly

100
Q

What cell surface extension allows osteocytes in the lacunaeto “talk” to each other?

A

Canaliculi

101
Q

What cell type produces myelin in the CNS?

A

Oligodendrocytes

102
Q

In which ventricles is/are choroid plexus found?

A

All four ventricles

103
Q

What muscle type has calmodulin?

A

Smooth muscle

104
Q

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

A

Copper (Cu+)

105
Q

What is added to the procollagen molecules to prevent intracellular precipitation?

A

Registration peptides

106
Q

In what tissue can you find intercalated disks?

A

Cardiac muscle

107
Q

What are intercalated disks?

A

Dense bands containing intercellular junctions that link adjacent cells mechanically and electrically

108
Q

Of what are intercalated disks composed?

A

Fascia adherens (mainly) Desmosomes Gap junctions

109
Q

What are the proteoglycans of cartilage and bone?

A

Chondroitin sulfate and keratan sulfate

110
Q

What is the only glycosamino- glycan (GAG) that binds to the linker portion of the proteoglycan?

A

Hyaluronic acid (all sulfates bind to the core portion)

111
Q

What is the portion of an axon that lacks myelin and is rich in Na+/K+ pumps?

A

Node of Ranvier

112
Q

What type of CNS cells have cilia, line the ventricles, and contribute to the blood-brain barrier?

A

Ependymal cells

113
Q

What are the largest glial cells in the CNS (Hint: They contribute to the blood- brain barrier.)?

A

Astrocytes

114
Q

Myelin is produced by what type of PNS cells?

A

Schwann cells

115
Q

What is the dominant cell type in the lacunae of cartilage?

A

Chondrocytes

116
Q

What structure runs perpendicular to the Haversian canals in the bone?

A

Volkmann’s canal

117
Q

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

A
  1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
118
Q

What types of muscle have troponin?

A

Skeletal and cardiac

119
Q

What type of muscle is uninuclear and nonstriated?

A

Smooth muscle - it lacks T tubules and has gap junctions

120
Q

On what area of the spleen are the APCs located?

A

Marginal zone

121
Q

What is the dominant cell type in the red pulp of the spleen?

A

Red blood cells

122
Q

On what area of the lymph node can you locate plasma cells?

A

Medulla

123
Q

What is the name of the area in the thymus where T cells are produced?

A

Hassall’s corpuscle

124
Q

What type of muscle is striated and multinuclear?

A

Skeletal muscle- it of T tubules and SR at the A-I junction

125
Q

In what region of the spleen are the germinal centers located?

A

White pulp-where B cell differentiation takes place

126
Q

What layer of the skin is missing in thin skin?

A

Stratum lucidum

127
Q

What are the phagocytic cells of the GI tract called?

A

Paneth cells (Paneth’s granular cells)

128
Q

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

A

IgA

129
Q

In what area of the spleen are the T cells located?

A

Periarterial lymphatic sheath (PALS)

130
Q

In what area of the lymph node are the T cells and the APCs located?

A

Paracortical (thymic-dependent) area

131
Q

What type of muscle is striated, branched, and uninuclear?

A

Cardiac muscle-dyadic T tubules with SR at the Z line

132
Q

What does the tunica intima of arteries have that veins do not?

A

An internal elastic lamina

133
Q

What two layers of skin makeup the malphighian layer?

A

Stratum basalis and spinosus (mitotic area)

134
Q

What type of skin cells have the mature melanin granules?

A

Keratinocytes. Melanocytes inject melanosomes into the keratinocytes and mature there.

135
Q

What type of skin cells are part of the mononuclear phagocytic system?

A

Langerhans’ cells

136
Q

What cells of the epidermis, derived from the neural crest, act as mechano- receptors?

A

Merkel’s cells (Merkel’s tactile cells)

137
Q

What layer of the epidermis acts as a sealant to protect against desiccation?

A

Stratum granulosum

138
Q

What layer of the skin is composed of non-nucleated cells full of keratin?

A

Stratum corneum

139
Q

What are the antigen- presenting cells in the Peyer’s patches of the GI known as?

A

M cells

140
Q

What are the three “tunica” layers of a blood vessel wall?

A
  1. Tunica intima 2. Tunica media 3. Tunica adventitia
141
Q

Within what layer of the heart are the nerves and conducting fibers located?

A

Subendocardial space

142
Q

Which organs have fenestrated capillaries with diaphragms?

A

Kidney, Intestines, Endocrine organs

143
Q

What secondary lymphoid tissue is encapsulated and has germinal centers?

A

Peyer’s patches

144
Q

What organs have sinusoid capillaries (leakiest type)?

A

Liver, Bone marrow, Spleen

145
Q

What type of vessel has a thick tunica media?

A

Arteries. Veins have a thick tunica adventitia.

146
Q

Is the spleen a capsulated organ with trabeculae?

A

Yes-although it does not have cortical or medullary regions

147
Q

What secondary lymphoid organ is found just below the stratified squamous epithel- ium and is partially capsulated?

A

Tonsils

148
Q

What type of capillary lacks fenestrations and has pinocytotic vesicles?

A

Continuous capillary

149
Q

What region of the body has fenestrated capillaries without diaphragms?

A

Kidney glomeruli

150
Q

Does the thymus have germinal centers?

A

No. Germinal centers are associated with B cells.

151
Q

What cell of the liver is part of the mononuclear phagocytic system?

A

Kupffer cells

152
Q

What papillae are respons- ible for sweet taste?

A

Circumvalate papillae

153
Q

What are the three epi- dermal derivatives?

A
  1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
154
Q

What papillae send their senses via chorda tympani of CN VII?

A

Fungiform papillae

155
Q

What is the area of mitotic activity in the GI tract?

A

The crypts of Lieberkuhn

156
Q

What cells of the GI tract secrete HCl and intrinsic factor?

A

Parietal cells of the stomach

157
Q

What type of sweat gland is under cholinergic stimulation?

A

Eccrine gland

158
Q

What gland produces a serous secretion that is approximately 20% of the total saliva produced?

A

Parotid gland

159
Q

What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?

A

Filiform papillae

160
Q

Secretin and CCK are produced in what portion of the GI tract?

A

Small intestine

161
Q

What cells of the stomach secrete pepsinogen?

A

Chief cells

162
Q

What cell type produces dentin of the teeth?

A

Odontoblasts (neural crest)

163
Q

What cell type produces enamel of the teeth?

A

Ameloblasts (ectoderm)

164
Q

What gland produces 70% of the total salivary secretions and is a mixture of serous (predominantly) and mucous alveoli and secretory units?

A

Submandibular gland

165
Q

What type of cells of the respiratory system secrete surfactant?

A

Type II pneumocytes

166
Q

What zone of the liver is the first to be affected in times of hypoxia?

A

Central region (around the central vein)

167
Q

In what region of the respiratory system do you first see Clara cells?

A

Terminal bronchioles

168
Q

What substance does the juxtaglomerular cells of the kidney secrete in response to low blood pressure?

A

Renin

169
Q

In what region of the liver is fat stored?

A

Space of Disse -Ito cells and Vit A also

170
Q

In what region of the GI tract does exfoliation take place?

A

At the tip of the villi

171
Q

What are the mucus secreting cells in the respiratory tract above the level of the terminal bronchioles?

A

Goblet cells

172
Q

What cells of the distal convoluted tubule are sensitive to the low ion content of the urine?

A

Macula densa

173
Q

What cells comprise 95% of the alveolar surface and are responsible for gas exchange?

A

Type I pneumocytes

174
Q

What are the two hormones secreted by the posterior pituitary gland via the para- ventricular supranuclei?

A

ADH and oxytocin

175
Q

What area of the nephron is impermeable to water?

A

Ascending limb of the loop of Henle

176
Q

What region of the kidney is affected by ADH?

A

Collecting duct for water reabsorption- but the DCT is also affected by ADH

177
Q

What portion of the kidney actively pumps Cl- out of the tubule?

A

Thick ascending limb of the loop of Henle

178
Q

What region of the kidney has a countercurrent multi- plier producing a gradient of hypertonicity in the tubule lumen?

A

Loop of Henle

179
Q

What region of the liver is first affected in toxic doses of drugs?

A

Peripheral zone (because extraction of substances occurs there first)

180
Q

What are the two acidophilic hormones secreted by the adenohypophysis?

A

GH and prolactin “(,Pp;~

181
Q

In what region of the kidney does the greatest extraction of nutrients occur?

A

Proximal convoluted tubule (-66% of nutrient extraction occurs here)

182
Q

What cells of the thyroid gland secrete calcitonin?

A

Parafollicular C cells (new4 ash,

183
Q

What cells of the adrenal gland are neural crest derivatives?

A

Chromaffin cells (adrenal medulla)

184
Q

What cells secrete glucagon?

A

Alpha cells of the islet of Langerhans

185
Q

What hormone inhibits glucagon release and pancreatic exocrine secretions?

A

Somatostatin

186
Q

What hormone causes milk letdown?

A

Oxytocin

187
Q

Low levels of what hormone stimulates the uterus to go into its proliferative stage?

A

Estrogen

188
Q

What cells of the genito- urinary system secrete testosterone?

A

Leydig cells (stimulated by LH)

189
Q

What is the mucus-secreting gland in the male reproductive system?

A

Bulbourethral glands (Cowper’s glands)

190
Q

Elevated levels of what hormone cause the endometrium to enter the secretory phase of the female cycle?

A

Progesterone

191
Q

What are the cells of the parathyroid gland that produce parathyroid hormone (PTH)?

A

Chief cells

192
Q

What hormone produced during the night causes a decrease in gonadal function?

A

Melatonin

193
Q

Where is melatonin produced?

A

Pineal gland

194
Q

What are the four basophilic hormones released from the adenohypophysis?

A
  1. Adrenocorticotrophic hormone (ACTH) 2. Thyroid-stimulating hormone (TSH) 3. Luteinizing hormone (LH) 4. Follicle-stimulating hormone (FSH)
195
Q

What cells form the blood-testis barrier?

A

Sertoli’s cells

196
Q

What is the chromosome number of-G1?

A

46 (2n)

197
Q

What is the chromosome number of-S phase?

A

46 (4n)

198
Q

What is the chromosome number of-G2?

A

46 (4n)

199
Q

What is the chromosome number of-Mitosis?

A

46 (4n) to 46 (2n)

200
Q

What is the chromosome number of a primary spermatocyte?

A

46 (4n)

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