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Question 1

What muscles and nerves are derived from the first brachial arch?

Answer 1

[The Ms and Ts] Muscles (muscles of mastication, mylohyoid muscle, Tensor tympani, Tensor veli palatini). Nerves (Maxillary and mandibular division of the trigeminal nerve).

Question 2

Which amino acids are found in large concentrations in elastin?

Answer 2

Glycine and proline.

Question 3

What is the mechanism of action of adenosine as an antiarrhythmic?

Answer 3

Increases the outward K+ current, hypolarizing the cell, and decreases intracellular Ca2+.

Question 4

What muscles and nerves are derived from the second brachial arch?

Answer 4

[The S’s] Nerve: CN Seven (muscles of facial expression). Muscle: Stapedius, Stylohyoid.

Question 5

What is the antidote for opioids?

Answer 5

Naloxone or naltrexone.

Question 6

What is the antidote for Benzodiazepines?

Answer 6

Flumazenil.

Question 7

What is the antidote for Tricyclic antidepressants?

Answer 7

Alkalinize the urine w/ sodium bicarb.

Question 8

What is the antidote for Heparin?

Answer 8

Protamine.

Question 9

What is the antidote for Warfarin?

Answer 9

Vitamin K. Immediate antidote is fresh frozen plasma.

Question 10

What is the antidote for Theophylline?

Answer 10

Beta blockers.

Question 11

How does hyperkalemia affect the shape of T waves?

Answer 11

Tall, peaked T waves. (T waves mirror the K+ levels).

Question 12

What muscles and nerves are derived from the third brachial arch?

Answer 12

Muscle: Stylopharyngeus muscle. Nerve: Glossopharyngeal nerve (CN IX).

Question 13

What drug category is often used in the treatment of myasthenia gravis?

Answer 13

Acetylcholinesterase inhibitors (Ex: pyridostigmine, physostigmine).

Question 14

To which class of antiarrhythmics does Sotalol belong?

Answer 14

Technically a Beta blocker but strongest action is on K+ channels which would make it Class III.

Question 15

To which class of antiarrhythmics does Propranolol belong?

Answer 15

Beta blockers are Class II.

Question 16

To which class of antiarrhythmics does Bretylium belong?

Answer 16

Class III.

Question 17

To which class of antiarrhythmics does Quinidine belong?

Answer 17

Class I.

Question 18

What muscle and nerves are derived from the fourth and sixth brachial arch?

Answer 18

Muscles: Cricothyroid, Levator veli palatini, and all of the muscles of the larynx. Nerves: Recurrent laryngeal, superior laryngeal.

Question 19

What defect is associated with the following type of murmur: Pansystolic (holosystic) murmur best heard at the apex, often radiates to the left axila.

Answer 19

Mitral regurgitation.

Question 20

What defect is associated with the following type of murmur: Crescendo/decrescendo systolic murmur heard best in the 2nd-3rd right interspace close to the sternum.

Answer 20

Aortic stenosis.

Question 21

What defect is associated with the following type of murmur: Late systolic murmur usually preceded by a mid-systolic click.

Answer 21

Mitral prolapse.

Question 22

What defect is associated with the following type of murmur: Early diastolic decrescendo murmur heard best along the left side of the sternum.

Answer 22

Pulmonic regurgitation.

Question 23

What defect is associated with the following type of murmur: late diastolic decresendo murmur heard best along the left side of the sternum.

Answer 23

Tricuspid stenosis.

Question 24

What heart defect is associated w/ Chromosome 22q11 deletion?

Answer 24

Truncus arteriosus and tetralogy of Fallor.

Question 25

What heart defect is associated w/ Congenital rubella?

Answer 25

PDA or pulmonary artery stenosis.

Question 26

What heart defect is associated w/ Turner syndrome?

Answer 26

Coarctation of the aorta and bicuspid aortic valve.

Question 27

What heart defect is associated w/ Marfan syndrome?

Answer 27

Aortic insufficiency.

Question 28

Which organism's exotoxin works via the following mechanism: Inactivates EF-2.

Answer 28

Corynbacterium diphtheriae. Pseudomonas (exotoxin A).

Question 29

Which organism's exotoxin works via the following mechanism: Activates Gs.

Answer 29

Vibrio cholerae. E.coli (ETEC heat-labile toxin).

Question 30

Which organism's exotoxin works via the following mechanism: Disables Gi?

Answer 30

Pertussis toxin.

Question 31

Which organism's exotoxin works via the following mechanism: Bacterial adenylate cyclase (no G protein involved).

Answer 31

Bacillus anthracis.

Question 32

Which organism's exotoxin works via the following mechanism: Blocks GABA and glycine.

Answer 32

Clostridium tetani.

Question 33

What drug is used to help make the diagnosis of myasthenia gravis?

Answer 33

Edrophonium ("Tensilon test").

Question 34

What heart sound is associated w/ dilated congestive heart failure? With chronic hypertension and a stiffened left ventricle?

Answer 34

For Dilated CHF: S3 heart sound. Chronic HTN + Stiffed LV: S4 heart sound.

Question 35

What gives rise to the jugular venous a, c, and v waves?

Answer 35

A wave: atrial contraction. C wave: ventricular contraction. V wave: Atrial filling against closed tricuspid valve.

Question 36

Which heart murmur is associated w/ weak pulses?

Answer 36

Aortic stenosis.

Question 37

What findings are associated w/ Ehlers-Danlos syndrome?

Answer 37

Easy bleeding or bruising. Hyperextensible skin. Joint hypermobility. Dislocated joints. Aneurysms.

Question 38

What heart sounds are considered benign when there is no evidence of disease?

Answer 38

Split S1. Split S2 on inspiration. S3 heart sound in patient less than 40. Early, quiet systolic murmur.

Question 39

Which organisms do not take Gram stain?

Answer 39

Treponema (too thin). Rickettsia, Chlamydia, Legionella (they are intracellular). Mycoplasma (no cell wall). Mycobacteria (too much lipid in their cell wall).

Question 40

What is the Cause of Duchenne's muscular dystrophy?

Answer 40

Deletion of gene for dystrophin. Degeneration of individual muscle fibers.

Question 41

A pregnant patient comes to the clinic complaining of new dark pigmentation on her face. What is the likely diagnosis?

Answer 41

Melasma (mask of pregnancy).

Question 42

A woman that is breastfeeding develops redness and swelling of her right breast over a period of 24 hours. Examination reveals a warm, fluctuant mass. What is the diagnosis?

Answer 42

Mastitis.

Question 43

A 55-y.o man who is a smoker and heavy drinker presents w/ a new cough and flu-like symptoms. Gram Stain shows now organisms; silver stain of sputum shows gram-negative rods. What is the diagnosis?

Answer 43

Legionella pneumophila (Legionnaire's disease).

Question 44

What defect is associated with the following type of murmur: Rumbling late diastolic murmur w/ an opening snap.

Answer 44

Mitral stenosis.

Question 45

What defect is associated with the following type of murmur: pansystolic (or holosystolic) murmur best heard along the left lower sternal border, generally radiates to the right lower sternal border.

Answer 45

Tricuspid regurgitation. Ventricular septal defect.

Question 46

What defect is associated with the following type of murmur: high-pitched diastolic murmur associated w/ a widened pulse pressure.

Answer 46

Aortic regurgitation.

Question 47

What defect is associated with the following type of murmur: Cresscendo/decrescendo systolic murmur heard best at the 2nd-3rd left interspace close to the sternum.

Answer 47

Pulmonic stenosis.

Question 48

What defect is associated with the following type of murmur: continuous machine-like murmur occuring both in systole and diastole?

Answer 48

Patent ductus arteriosus.

Question 49

Which antiarrhythmic has the SE of cinchonism?

Answer 49

Quinidine.

Question 50

What stain is required to see Cryptococcus?

Answer 50

India ink.

Question 51

What stain is required to see PCP?

Answer 51

Silver stain.

Question 52

What stain is required to see Chlamydia?

Answer 52

Giemsa stain.