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USMLE COMPREHENSIVE REVIEW > D1001-1200 > Flashcards

D1001-1200 Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the term to describe a man who has • Never been able to achieve an erection?

A

Primary erectile disorder

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2
Q

What is the term to describe a man who has • The ability to have an erection sometimes and other times not?

A

Selective erectile disorder

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3
Q

What is the term to describe a man who has • Used to be able to achieve an erection but now cannot?

A

Secondary erectile disorder (Male erectile disorder is the same as impotence.)

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4
Q

What stage of sleep is associated with somnambulism?

A

Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

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5
Q

What are the three surrogate criteria?

A
  1. What did the patient want? 2. What would the patient say? 3. What is in the patient’s best interests?
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6
Q

True or false? Four-fifths of those who attempt suicide first give a warning.

A

True; 80% have visited a doctor in the previous 6 months. And 50% within the last month!

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7
Q

Can a patient refuse life-saving treatment for religious reasons?

A

Yes. (Remember, Jehovah’s witnesses refuse blood transfusions.)

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8
Q

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?

A

Pygmalion effect (experimenter expectancy). This can be eliminated with double-blind studies.

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9
Q

What type of hallucination occurs during awakening?

A

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

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10
Q

When attempting to make up sleep, what stage of sleep is recovered?

A

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.

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11
Q

What is backward masking, and is there a positive correlation with schizophrenic patients?

A

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.

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12
Q

True or false? Being single increases your risk of suicide.

A

False. Separation, divorce, being widowed, and unemployment increase your risk, but being single does not.

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13
Q

True or false? Serious psychiatric illness is more common after abortion than childbirth.

A

False. Childbirth carries five times as much risk of serious psychiatric illness as abortion.

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14
Q

What type of error is made if you accept the null hypothesis when it is false?

A

Type II error (beta error). (Remember it as saying something doesn’t work when it does.)

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15
Q

Most sleep time is spent in what stage of sleep?

A

Stage 2, which accounts for approximately 45% of total sleep time, with REM occupying 20%.

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16
Q

In a negatively skewed curve is the mean greater than the mode?

A

Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.

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17
Q

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?

A

Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).

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18
Q

What type of personality test is the Rorschach inkblot test, objective or projective?

A

Projective test. Most tests with a wide range of possibilities for the answers are projective.

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19
Q

What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?

A

The T-test (used when comparing two groups)

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20
Q

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?

A

Akathisia

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21
Q

What form of depression is due to abnormal metabolism of melatonin?

A

Seasonal affective disorder (treat with bright light therapy)

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22
Q

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

A
  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.
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23
Q

What operant conditioning therapy or modification is described as • Reinforcing successive attempts that lead to the desired goal (gradual improvement)?

A

Shaping (successive approximation)

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24
Q

What operant conditioning therapy or modification is described as • Having a stimulus take over the control of the behavior (unintentionally)?

A

Stimulus control

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25
Q

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?

A

Biofeedback

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26
Q

What operant conditioning therapy or modification is described as • Removing a reinforcement (without the patient knowing) gradually over time to stop a condition?

A

Fading

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27
Q

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

A

Extinction

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28
Q

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)?

A

Axis IV

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29
Q

The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Medical or physical ailments?

A

Axis III

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30
Q

The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Personality and mental disorders?

A

Axis II

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31
Q

The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Global assessment of function?

A

Axis V

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32
Q

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)?

A

Axis I

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33
Q

Should you refer a patient to a form of folk medicine even if you don’t believe in it?

A

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.

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34
Q

In regard to motor development during infancy, choose the motor response that happens first. • Release or grasp

A

Grasp proceeds release

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35
Q

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

A

Proximal to distal progression

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36
Q

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

A

Ulnar to radial progression

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37
Q

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

A

Palms-up before palms-down maneuvers

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38
Q

What are the strongest determinants of gender identity?

A

Parental assignment and culture (not biology)

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39
Q

With what stage of sleep are night terrors associated?

A

NREM sleep. Night terrors are dreams that we are unable to recall.

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40
Q

What type of bias is it when the information is distorted because of the way it is gathered?

A

Measurement bias

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41
Q

What term describes senseless repetition of words or phrases?

A

Verbigeration

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42
Q

Who decides competency and sanity?

A

The courts. These are legal, not medical terms.

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43
Q

Name these narcissistic defense mechanisms: • Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.

A

Splitting

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44
Q

Name these narcissistic defense mechanisms: • Not allowing reality to penetrate because afraid of becoming aware of painful aspect of reality.

A

Denial

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45
Q

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)

A

Projection

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46
Q

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.

A

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).

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47
Q

What three actions should take place when one person threatens the life of another? (Hint: think of the Tarasoff decision.)

A
  1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
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48
Q

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

A

Limbic system

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49
Q

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)

A

Dorsal prefrontal cortex

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50
Q

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)

A

Dominant temporal lobe

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51
Q

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

A

Dominant parietal lobe (Gerstmann’s syndrome)

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52
Q

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

A

Orbitomedial frontal lobe

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53
Q

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)

A

Nondominant parietal lobe

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54
Q

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

A

Occipital lobe (Anton’s syndrome if it is due to bilateral posterior cerebral artery occlusions)

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55
Q

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

A

Nondominant temporal lobe

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56
Q

What hormone’s release is strongly associated with stage 4 sleep?

A

GH. The largest output of GH in a 24-hour period is during stage 4 sleep.

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57
Q

What is the male-to-female ratio for committing suicide?

A

M:F 4:1 committing, but M:F ratio of attempts is 1:3 (males commit more but females try it more)

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58
Q

What is the term for the total percentage of correct answers selected on a screening test?

A

Accuracy (think of it as all the trues, because they are the ones correctly identified)

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59
Q

What type of error is made if you reject the null hypothesis when it is true?

A

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.

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60
Q

If one event precludes another event, their probabilities are combined by what method?

A

Addition (They are mutually exclusive.)

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61
Q

True or false? Marriage emancipates a child less than 17 years old.

A

True; military service and independent self-care by a child over 13 years old also emancipate.

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62
Q

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

A

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

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63
Q

What is the most stressful event as determined by the Holmes and Rahe scale?

A

The death of a spouse. The higher the score, the greater the risk of developing an illness in the next 6 months.

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64
Q

What renal side effect is commonly seen in patients taking lithium?

A

Nearly 25% of patients taking lithium develop polyuria and polydipsia.

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65
Q

What statistical test, using nominal data only, checks whether two variables are independent events?

A

Chi-square (when you are in doubt and have nominal data, use chi-square)

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66
Q

What is the term for repetitive actions blocking recurring bad thoughts?

A

Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.

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67
Q

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

A

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

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68
Q

True or false? Panic attacks can be induced by hyperventilation or carbon dioxide.

A

True. Yohimbine, sodium lactate, and epinephrine can also induce panic attacks; they are considered panicogens.

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69
Q

In what study, for ethical reasons, is no group left out of intervention?

A

Crossover study

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70
Q

Shuffling gait, cogwheel rigidity, masklike facies, pill-rolling tremor, and bradykinesia describe what form of dementia?

A

Parkinson’s disease

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71
Q

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?

A

Unipolar disorder (major depression)

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72
Q

What form of dementia is characterized by onset at age 40 to 50, rapid progression, infection by a prion, and death within 2 years?

A

Creutzfeldt-Jakob’s disease. Patients first develop vague somatic complaints and anxiety, rapidly followed by dysarthria, myoclonus, ataxia, and choreoathetosis.

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73
Q

The most frequent number occurring in a population is what?

A

Mode

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74
Q

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

A

Nigrostriatal pathways (basal ganglia)

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75
Q

What neurotransmitter is associated with sedation and weight gain?

A

Histamine

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76
Q

The probability that a person with a negative test result is truly disease free refers to what value?

A

Negative predictive value

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77
Q

What are the five Kübler-Ross stages of death and dying? Must they be completed in order?

A

Denial Anger Bargaining Depression Acceptance No, they can be skipped, repeated, and completed out of sequence.

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78
Q

What P value defines whether the hull hypothesis should or should not be rejected?

A

P = .05; P < .05 rejects the null hypothesis

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79
Q

What hormone level increases in the first 3 hours of sleep?

A

Prolactin

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80
Q

What is the most widely used class of antidepressants?

A

SSRIs

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81
Q

What happens to prevalence as the number of long-term survivors increases?

A

Prevalence increases. (Remember, prevalence can decrease in only two ways, recovery and death.)

82
Q

What is the primary predisposing factor for vascular dementia?

A

Hypertension

83
Q

What paraphilia is defined as • Sexual urges toward children?

A

Pedophilia

84
Q

What paraphilia is defined as • Deriving sexual pleasure from watching others having sex, grooming, or undressing?

A

Voyeurism

85
Q

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

A

Exhibitionism

86
Q

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

A

Sadism

87
Q

What paraphilia is defined as • Deriving sexual pleasure from being abused or in pain?

A

Masochism

88
Q

What paraphilia is defined as • Having sex with cadavers?

A

Necrophilia

89
Q

What paraphilia is defined as • Sexual fantasies or practices with animals?

A

Zoophilia

90
Q

What paraphilia is defined as • Combining sex with defecation?

A

Coprophilia

91
Q

What paraphilia is defined as • Combining sex with urination?

A

Urophilia

92
Q

What paraphilia is defined as • A male rubbing his genitals on a fully clothed female to achieve orgasm?

A

Frotteurism

93
Q

Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body.

A

ACh; think about the ANS.

94
Q

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

A

Impaired ejaculation

95
Q

What are the pharmacologic effects seen sexually with • Serotonin?

A

Inhibited orgasm

96
Q

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

A

Impotence

97
Q

What are the pharmacologic effects seen sexually with • Trazodone?

A

Priapism

98
Q

What are the pharmacologic effects seen sexually with • Dopamine agonists?

A

Increased erection and libido

99
Q

What are the pharmacologic effects seen sexually with • Neuroleptics?

A

Erectile dysfunction

100
Q

What is the term for the point on a scale that divides the population into two equal parts?

A

Median (think of it as the halfway point)

101
Q

True or false? Pregnancy ensures emancipation.

A

FALSE

102
Q

True or false? Paranoid and catatonic schizophrenia are good prognostic predictors.

A

True. Being female, having positive symptoms, quick onset, and family history of mood disorders are all good prognostic predictors of schizophrenia.

103
Q

What happens to prevalence as incidence increases?

A

Prevalence increases.

104
Q

What type of correlation compares two interval variables?

A

Pearson correlation

105
Q

What term is defined as a patient unconsciously placing his or her thoughts and feelings on the physician in a caregiver or parent role?

A

Transference. When it is from the physician to the patient it is called countertransference.

106
Q

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

A

Phase III. It is considered the definitive test.

107
Q

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

A

Phase I

108
Q

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

A

Phase II

109
Q

In biostatistics, what are the three criteria required to increase power?

A
  1. Large sample size 2. Large effect size 3. Type I error is greater
110
Q

If the occurrence of one event had nothing to do with the occurrence of another event, how do you combine their probabilities?

A

Since they are independent events, their probabilities would be multiplied.

111
Q

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

A

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

112
Q

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

A

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).

113
Q

What are the three posttranscriptional modifications?

A
  1. 7-methyl guanine cap on the 5’ end 2. Addition of the poly(A) tail to the 3’ end 3. Removal of introns
114
Q

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

A

Glutamine

115
Q

What two AAs have a pKa of 4?

A

Aspartic acid and glutamic acid

116
Q

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

A

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

117
Q

What topoisomerase makes ssDNA cuts, requires no ATP, relaxes supercoils, and acts as the swivel in front of the replication fork?

A

Topoisomerase I (Relaxase)

118
Q

In prokaryotes, what is the name of the RNA sequence that ribosomes bind to so translation can occur?

A

Shine-Dalgarno sequence

119
Q

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?

A

Autosomal recessive

120
Q

What factors are needed for translation in prokaryotes?

A

Elongation factor-G and GTP

121
Q

What three AAs must patients with maple syrup urine disease not eat?

A

Isoleucine, leucine, and valine

122
Q

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

A

2 ATPs, via the amino acyl tRNA synthase enzyme

123
Q

What water-soluble vitamin deficiency results in pellagra?

A

Niacin (B3)

124
Q

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

A

Glucokinase

125
Q

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

A

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

126
Q

What cytoplasmic pathway produces NADPH and is a source of ribose 5-phosphate?

A

HMP shunt

127
Q

What is the main inhibitor of pyruvate dehydrogenase?

A

Acetyl CoA (pyruvate to acetyl CoA)

128
Q

Where on the codon and anticodon does the wobble hypothesis take place?

A

3’end of the codon (third position) on mRNA and 5’ end of the anticodon (first position) on tRNA.

129
Q

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

A

Excision endonuclease, which removes thiamine dimers from DNA

130
Q

What form of bilirubin is carried on albumin?

A

Unconjugated (indirect)

131
Q

What are the two ketogenic AAs?

A

Leucine and lysine

132
Q

Which organisms have polycistronic mRNA?

A

Prokaryotes. Polycistronic and prokaryotes both start with P.

133
Q

As what compound do the carbons for fatty acid synthesis leave the mitochondria?

A

Citrate, via the citrate shuttle

134
Q

What four substances increase the rate of gluconeogenesis?

A
  1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
135
Q

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

A
  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
136
Q

What test uses very small amounts of DNA that can be amplified and analyzed without the use of Southern blotting or cloning?

A

PCR

137
Q

What apoprotein is required for the release of chylomicrons from the epithelial cells into the lymphatics?

A

apo B-48

138
Q

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

A

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

139
Q

What must be supplemented in patients with medium-chain acyl CoA dehydrogenase (MCAD) deficiency?

A

Short-chain fatty acids

140
Q

What form of AA is found only in collagen?

A

Hydroxyproline

141
Q

In a diabetic patient, to what does aldose reductase convert glucose?

A

Sorbitol (resulting in cataracts)

142
Q

What enzyme catalyzes the rate-limiting step in cholesterol metabolism?

A

HMG-CoA reductase

143
Q

What is the term for the pH at which the structure carries no charge?

A

pI (isoelectric point)

144
Q

What enzyme catalyzes the rate-limiting step in gluconeogenesis?

A

Fructose-1, 6-bisphosphatase

145
Q

What is the drug of choice in treating a patient with hyperuricemia due to underexcretion of uric acid?

A

Probenecid, a uricosuric agent

146
Q

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

A

Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

147
Q

In eukaryotes, what transcription factor binds to the TATA box before RNA polymerase II can bind?

A

Transcription factor IID

148
Q

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?

A

Primase

149
Q

What enzyme catalyzes the rate-limiting step in fatty acid synthesis?

A

Acetyl CoA carboxylase

150
Q

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

A

DNA polymerase-γ

151
Q

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

A

DNA polymerase-α

152
Q

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

A

DNA polymerase-δ

153
Q

What is the order of fuel use in a prolonged fast?

A
  1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
154
Q

Which way will the O2 dissociation curve shift with the addition of 2, 3-bisphosphoglycerate (2, 3-BPG) to adult hemoglobin (Hgb)?

A

Shifts it to the right

155
Q

What enzyme of pyrimidine synthesis is inhibited by the following? • 5-FU

A

Thymidylate synthase

156
Q

What enzyme of pyrimidine synthesis is inhibited by the following? • Methotrexate

A

Dihydrofolate reductase

157
Q

What enzyme of pyrimidine synthesis is inhibited by the following? • Hydroxyurea

A

Ribonucleotide reductase

158
Q

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

A

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.

159
Q

What gluconeogenic mitochondrial enzyme requires biotin?

A

Pyruvate carboxylase

160
Q

What factors are needed for translocation in eukaryotes?

A

EF-2 and GTP

161
Q

DNA replication occurs during what phase of the cell cycle?

A

S phase

162
Q

What is the end product of purine catabolism?

A

Uric acid

163
Q

What causes transcription to stop in eukaryotes?

A

The poly(A) site on the DNA

164
Q

What enzyme of the TCA cycle catalyzes the production of the following: • FADH2

A

Succinate dehydrogenase

165
Q

What enzyme of the TCA cycle catalyzes the production of the following: • GTP

A

Succinyl CoA synthetase

166
Q

What enzyme of the TCA cycle catalyzes the production of the following: • NADH (hint: 3 enzymes)

A

Isocitrate dehydrogenase, α-ketoglutarate dehydrogenase, and malate dehydrogenase

167
Q

What form of alcohol causes blindness?

A

Methanol (wood alcohol)

168
Q

How many base pairs upstream is the prokaryotic TATA box promoter?

A

There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream, and the -35 promoter site is self-explanatory.

169
Q

What are the two essential fatty acids?

A

Linoleic acid and linolenic acid

170
Q

During a prolonged fast, why is the brain unable to use fatty acids?

A

Fatty acids cannot cross the blood-brain barrier; therefore, they cannot be used as an energy source.

171
Q

What type of jaundice is seen in Rotor’s syndrome?

A

Conjugated (direct) hyperbilirubinemia

172
Q

If a sample of DNA has 30% T, what is the percent of C?

A

Solved as 30% T + 30% A = 60%; therefore, C + G = 40%; then C = 20% and G = 20% (example of Chargaff’s rule)

173
Q

From where is the energy for gluconeogenesis derived?

A

β-Oxidation of fatty acids

174
Q

Name the type of mutation: • The deletion or addition of a base

A

Frameshift

175
Q

Name the type of mutation: New codon specifies a different AA

A

Missense

176
Q

Name the type of mutation: • Unequal crossover in meiosis with loss of protein function

A

Large segment deletions

177
Q

Name the type of mutation: • New codon specifies for the same AA

A

Silent

178
Q

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

A

Nonsense

179
Q

What form of bilirubin can cross the blood-brain barrier?

A

Unconjugated free bilirubin

180
Q

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

A

Arginine

181
Q

What three things are needed to produce a double bond in a fatty acid chain in the endoplasmic reticulum?

A

NADPH, O2, and cytochrome b5

182
Q

What are the vitamin K-dependent coagulation factors?

A

Factors II, VII, IX, X, and proteins C and S

183
Q

Is the hydroxyl (-OH) end of DNA and RNA at the 3’ or the 5’ end?

A

3’ end. Phosphate (PO4) is at the 5’ end.

184
Q

How many codons code for AAs? How many for termination of translation?

A

61 codons code for AAs and 3 codons (UAA, UGA, UAG) code for the termination of translation.

185
Q

What is the enzyme for the oxidative reaction in glycolysis?

A

Glyceraldehyde dehydrogenase

186
Q

What substrate builds up in Tay-Sachs disease?

A

GM2 ganglioside Caused by a deficiency of β-hexosaminidase A

187
Q

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?

A

Mitochondrial inheritance

188
Q

What is the rate-limiting enzyme of glycogen synthesis?

A

Glycogen synthase

189
Q

What sphingolipid is formed by the union of serine and palmitoyl CoA?

A

Sphingosine

190
Q

What causes an increase in bone mineralization and Ca2+ along with PO4- absorption from the GI tract and kidney tubules?

A

Vitamin D

191
Q

What two sugars can be used to produce cerebrosides?

A

Glucose and galactose

192
Q

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

A

Homeodomain proteins

193
Q

What causes the lysis of RBCs by oxidizing agents in a G-6-PD deficiency?

A

The lack of glutathione peroxidase activity results in a decrease in NADPH production, leaving glutathione in the reduced state.

194
Q

All AAs have titration plateaus at what pH values?

A

pH of 2 and 9

195
Q

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

A

SER

196
Q

What is the binding site for RNA polymerase?

A

The promoter indicates where transcription will begin.

197
Q

What vitamin is necessary for epithelial health?

A

Vitamin A is responsible for vision and epithelial health.

198
Q

What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle?

A

LDL

199
Q

What structure of a protein describes the interaction among subunits?

A

Quaternary structure

200
Q

What is the only factor of enzyme kinetics that the enzyme affects?

A

Ea (activation energy)

USMLE COMPREHENSIVE REVIEW (8 decks)

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