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0 - USMLE Step 1 > Kaplan Q bank > Flashcards

Kaplan Q bank Flashcards

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USMLE® Step 1 flashcards
1
Q

Lead poisoning leads to the inhibition of what enzymes?

A
  • Aminolevulinate (ALA) dehydratase in heme biosynthesis pathway
  • Ferrochelatase —> ↑ free erythrocyte protoporphyrin
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2
Q

Which organisms would be on the differential for a neonate born with petechial rash, deafness, jaundice, thrombocytic purpura and periventricular CNS calcifications?

A
  • CMV = most common in U.S.
  • T. gondii
  • Rubella
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3
Q

What will be seen histologically with adult-onset myotonic dystrophy (DM1)?

A

Ring fibers w/ central nuclei

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4
Q

Olfactory bulb neurons send axons where?

A

Piriform cortex aka primary olfactory cortex that overlies uncus of the temporal lobe

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5
Q

Which type of ovarian tumor should be suspected in a girl exhibiting precocious sexual development?

A

Granulosa cell tumor –> estrogen-secreting

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6
Q

Which type of encephalitis is characterized by hemorrhagic necrosis in the temporal lobes and base of the frontal lobe?

A

Herpes simplex

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7
Q

A neonate presenting at 24-48 hrs after birth with lethargy, poor feeding, vomiting, hyperventilation, seizures, and cerebral edema should make you suspect what?

A
  • OTC deficiency
  • Will have hyperammonnemia w/ ↓ BUN
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8
Q

A child with dyspnea, difficulty feeding, poor weight gain and a strong radial pulse w/ weak femoral pulse most likely has what?

A

Coarctation of the aorta

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9
Q

Which ovarian tumor exhibits follicle-like structures (Call-Exner bodies) and stain positive for inhibin?

A

Granulosa cell tumor

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10
Q

What are the clinical manifestations of “dry” vs. “wet” beribri as a result of Thiamine deficiency?

A
  • Dry = progressive polyneuropathy w/ myelin degeneration –> wrist and foot drop
  • Wet = high-output cardiac failures –> dilated cardiomyopathy
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11
Q

Dynein is a molecular motor protein important for what 3 functions?

A
  • Ciliary beating: respiratory tract
  • Flagellar beating: sperm
  • Intracellular vesicle transport
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12
Q

What is the major outlet for the esophageal venous plexus and is the major accessory pathway for venous return in patients with end-stage liver disease and critical portal HTN?

A

Azygos V.

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13
Q

What occurs to the majority of severe cervical dysplasia (CIN 3) aka high-grade squamous intraepithelial lesion (HSIL) after 2 years?

A

60% of lesions persist at the same level

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14
Q

Which landmark is used for injection of pudendal nerve block?

A

Ischial spine

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15
Q

The oculomotor n. (CN III) emerges from the interpeduncular fossa of the midbrain and the passes between which 2 arteries?

A

Superior Cerebellar a. and the PCA

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16
Q

In wound healing what is the dominant cell type found at 2 days, 3-5 days, and one week following the injury?

A
  • 2 days = neutrophils
  • 3-5 days = macrophages
  • 1 week = fibroblasts
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17
Q

What is the initial type and later type of collagen that is layed down by fibroblasts during wound healing?

A

Initially deposit type III collagen (granulation tissue), which later is replaced by stronger type I collagen (fibrosis)

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18
Q

Tetralogy of Fallot is more commonly associated with what congenital syndrome?

A

DiGeorge syndrome

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19
Q

Which congenital heart defect is most commonly seen in Down Syndrome?

A

Ostium primum ASD, often w/ malformations of AV valves due to endocardial cushion defect

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20
Q

Which virus is associated with focal necrotizing arteritis with fibrinoid necrosis of small- and medium-sized arteries known as Polyarteritis Nodosa (PAN)?

A

Hepatitis B

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21
Q

Which portion of the smooth muscle in the bladder is innervated by the sympathetic NS vs. parasympathetic NS?

A
  • Internal urethral sphincter at bladder neck = sympathetic
  • Remaining smooth m. of bladder = parasympathetic
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22
Q

Which structure is resected during a TURP procedure resulting in retrograde ejaculation?

A

Internal urethral sphincter

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23
Q

Differentiate primary, seconday, and tertiary prevention.

A
  • Primary: reducing # of new cases of disease (incidence) thru eliminating risk factors or immunization
  • Secondary: identifying disease in a pre-clinical state, ↑ likelihood of tx or curing disease i.e., cervical cancer screening
  • Tertiary: reducing likelihood of disease recurrence or exacerbation in pt who has already been diagnosed w/ disease
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24
Q

Atrophy of which spinal cord structures is associated with tertiary syphilis?

A

Bilateral degeneration of the dorsal roots and 2’ degeneration of the dorsal columns

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25
Q

Which enzyme catalyzes the rate-limiting step in fatty acid biosynthesis?

A

Acetyl-CoA carboxylase

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26
Q

Abdominal pain + cervical motion tenderness or adnexal tenderness is characteristic of which infectious organisms?

A

Chlamydia

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27
Q

Mitigating the use of antibiotics in children with viral illness is an example of what type of prevention?

A

Quaternary prevention

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28
Q

Sparse, completely hyalinized seminiferous tubules with complete absence of spermatogonia (germ cells) and rare Sertoli cells is seen with what condition?

A

Klinefelter syndrome (47,XXY)

29
Q

Cell shrinkage, hyperchromatic pyknotic nuclei, and apoptotic bodies composed of cytoplasm and nuclear fragments describes what?

A

Apoptosis

30
Q

Intacytoplasmic eosinophilic inclusions containing alpha-synuclein or ubiquitin describes what?

A

Lewy bodies

31
Q

What are the 4 exceptions to the informed consent rule?

A
  • Emergency
  • Waiver by the patient
  • Patient is incompetent
  • Therapeutic privilege: pt is unconscious, confused, or the physician deprives pt of autonomy in interest of health
32
Q

What is the effect of low intrathoracic pressure during inspiration on th pulmonary vasculature and left-side of heart?

A

↓ pulm. vasculature pressure –> ↑ intravascular volume –> ↓ LA filling –> ↓ LV preload –> ↓ LV EDV –> ↓ LV stroke volume –> ↓ systolic BP

33
Q

Senile cardiac amyloidosis results from the deposition of what type of amyloid and leads to what?

A

ATTR-type amyloid —> restrictive cardiomyopathy

34
Q

Loss of sensation to the medial 1.5 digits, atrophy of intrinsic hand muscles and radial deviation of the hand upon wrist flexion are all sx’s of what?

A

Cubital tunnel syndrome: Ulnar n. entrapment

35
Q

What is a prominent histologic feature of Neuroblastomas?

A

Homer-Wright pseudorosettes

36
Q

Which mutation is seen in many cases of Neuroblastoma and confers a worse prognosis?

A

Amplification of MYCN oncogene –> n-myc

37
Q

Which fungus is found in the body as a small (2-5 um) intracellular yeast (within macrophages) and has no true capsule?

A

Histoplasma capsulatum

38
Q

What are the manifestations of carcinoid heart disease?

A

Fibrotic endocardial thickening of the right heart + tricuspid stenosis and insufficiency

39
Q

High titers of anti-U1 ribonucleoprotein, RF, and anti-nuclear antibody are suggestive of what?

A

Mixed Connective Tissue Disease

40
Q

Anti-centromere antibody is the distinctive marker for what?

A
  • CREST syndrome
  • Calcinosis + Raynaud’s + Esophageal dysmotility + Sclerodactyly + Telangiectasia
41
Q

High-titers of anti-histone antibody without other autoantibodies is a distinctive marker for what?

A

Drug-induced lupus

42
Q

Primary oocytes found in the ovary stay arrested in which phase until ovulation; what about secondary oocytes prior to ovulation?

A
  • 1’ oocyte = diploid; arrested in prophase I of the 1st meiotic division
  • 2’ oocyte = haploid; arrested in metaphase of the 2nd meiotic division
43
Q

Familial transthyretin (TTR) amyloidosis is an autosomal dominant condition characterized by what findings?

A
  • Sensorimotor and autonomic neuropathy
  • Cardiomyopathy
  • AF amyloid protein
44
Q

Why is Histoplasma capsulatum non-communicable?

A

Intracellular yeast inside of macrophages

45
Q

The mechanism by which a temperate phage can accidentally transfer bacterial DNA from cell to cell if there is an error of excision is known as what?

A

Specialized transduction

46
Q

Which type of gene transfer occurs from one bacterial cell to another via cell-to-cell contact using a plasmid (fertility factor)?

A

Conjugation

47
Q

The aorticopulmonary septum and endocardial cushions are derived from what embryologically?

A

Neural Crest Cells

48
Q

Multiple brick-red dots, Schüffner dots, seen in a pt’s erythrocytes are indicative of which organism?

A

Plasmodium vivax or ovale

49
Q

Which 2 serological markers are specific, but not sensitive for SLE?

A
  • anti-dsDNA
  • anti-Smith

*anti-nuclear Ab is sensitive, but not specific

50
Q

Renal manifestations such as proteinuria and hematuria should raise suspicion of which disase process in 15-45 y/o woman with chronic, poorly defined sx’s?

A

SLE

51
Q

Where is ipoprotein lipase is the enzyme required for metabolism of chylomicrons and VLDL located; what does it require for activation?

A

Luminal surface of vascular endothelium (capillaries) of adipose tissue; requires Apo C2 for activation

52
Q

Which hormonal levels will be increased during menopause?

A

↓ estrogen –> ↑ GnRH, ↑ FSH, and ↑ LH

53
Q

Dystonia is an extrapyramidal side effect characterized by what; what are some examples?

A
  • Repeated, sustained involuntary muscle contractions, as well as abnormal postures of the trunk, face and/or extremities
  • Torticollis, oculogyric crisis, and opisthotonic crisis
54
Q

Deficiency of what causes a defect in the development of CD4+ cells in the thymus?

A

MHC class II proteins

55
Q

Increases in which 2 parameters are seen with obstructive lung diseases such as emphysema, chronic bronchitis, and asthma?

A
  • Total lung capacity
  • Pulmonary compliance = ΔV/ΔP
56
Q

Beck’s triad: ↓ arterial pressure, ↑ systemic venous pressure, and a small, quiet heart (distant heart sounds) are classic signs of what?

A

Cardiac Tamponade

57
Q

Which nerve innervates the posterior compartment muscles of th arm and forearm including the triceps, extensors and the supinator muscle?

A

Radial n.

58
Q

Marfarn syndrome is an autosomal dominant disorder due to defects in what?

A

FBN1 gene –> fibrillin-1 an extracellular matrix protein

59
Q

Which organism causes a high fever for ~3 days that abrupty goes away prior to development of morbilliform rash in 9-12 month olds?

A

Roseola - HHV-6

60
Q

Combination of hypotension with normal or ↑ pulse pressure and a HR of 30-45/min should suggest the diagnosis of what?

A

Complete heart block

61
Q

Progesterone levels are sustained during the 1st trimester of pregnancy as a response to what?

A

hCG

62
Q

Which tumor can cause dysfunction of the vertical gaze center in the dorsal midbrain?

A

Pinealoma

63
Q

The most important clnical presentation of pineal germinomas is Parinaud syndrome which is characterized by what 3 major findings?

A
  • Palsy of upward gaze
  • Dissociation of light and accomodation (light-near dissociation)
  • Failure of convergence
64
Q

In anemia there is a ↓ O2 carrying capacity of blood leading to low tissue PO2 which causes what adaptive responses?

A
  • Reflex vasodilation of resistance vessels –> ↓ PVR and ↑ flow through capillary beds
  • CO and venous return both ↑↑↑
65
Q

Anastomoses of which vein with the splenic vein would allow for blood to bypass the liver and relieve portal HTN?

A

Splenic V. –> Left Renal V. (drains directly in IVC)

66
Q

Which type of blot is used to identify DNA-binding protein interactions?

A

Southwestern blot

67
Q

Which tumors would desmin vs. vimentin be found in?

A
  • Desmin: rhabdomyosarcoma; tumors of skeletal m.
  • Vimentin: non-skeletal, soft tissue sarcomas and mesenchymal tumors
68
Q

Case-control studies are analyzed using what ratio and what is the formula?

A

Odds ratio: (a/c) / (b/d) or (a*d) / (b*c)

69
Q

Pt’s with Plummer-Vinson Syndrome are at an increased risk for developing which malignancy?

A

SCC of the upper esophagus

0 - USMLE Step 1 (22 decks)

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