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What gland is found in the muscular triangle of the neck?
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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?
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USMLE questions
| Question | Answer |
|---|---|
| What gland is found in the muscular triangle of the neck? | Thyroid gland |
| 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 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 |
| 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 |
| Name the laryngeal muscle described by the following: • Tenses the vocal ligaments, increasing the distance between the cartilages, thereby increasing the pitch | Cricothyroid muscles |
| Name the laryngeal muscle described by the following: • Adducts the vocal ligaments, closes the air passageway during swallowing, and allows phonation | Lateral cricoarytenoid muscles |
| Name the laryngeal muscle described by the following: • Only muscle to abduct the vocal cords | Posterior cricoarytenoid muscles |
| Where does the parotid (Stensen's) duct enter the oral cavity? | Opposite the second upper molar tooth |
| 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 |
| From what aortic arch are the following structures derived? • Degenerates | Fifth MS CARD is my mnemonic for the aortic arch derivatives |
| From what aortic arch are the following structures derived? • Stapes artery | Second MS CARD is my mnemonic for the aortic arch 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 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 |
| 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 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 |
| 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 |
| 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. • 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 |
| 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 |
| 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 |
| 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 |
| Name the correct artery. • The right recurrent laryngeal nerve passes around it. | Right brachiocephalic artery |
| Name the correct artery. • The left recurrent laryngeal nerve passes around it. | Arch of the aorta |
| The inferior mesenteric artery drains into it. | The splenic vein |
| 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. |
| What bones make up the acetabulum? | Pubis, ilium, and ischium |
| 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!) |
| What vessel is lacerated in an epidural hematoma? | Middle meningeal artery |
| True or false? Below the arcuate line, all the aponeurotic fibers run anterior to the rectus abdominis. | TRUE |
| What ocular muscle • Adducts the eyeball and is involved in horizontal conjugate gaze? | Medial rectus (CN III) (LR6 SO4)3 |
| What ocular muscle • Elevates and adducts the eyeball? | Superior rectus (CN III) (LR6 SO4)3 |
| What ocular muscle • Depresses and abducts the eyeball? | Superior Oblique (CN IV) (LR6 SO4)3 |
| What ocular muscle • Elevates and abducts the eyeball? | Inferior Oblique (CN III) (LR6 SO4)3 |
| What ocular muscle • Abducts the eyeball and is involved in horizontal conjugate gaze? | Lateral rectus (CN VI) (LR6 SO4)3 |
| What ocular muscle • Depresses and adducts the eyeball? | Inferior rectus (CN III) (LR6 SO4)3 |
| Which muscles of the eye are under parasympathetic control? | Constrictor pupillae and ciliary muscles |
| 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.) |
| 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. |
| Which CNs are found in the midline of the brainstem? | CN I, II, III, VI, and XII Add 1 + 1 |
| What muscles insert in or on the intertubercular groove of the humerus? | "Lady between two Majors": latissimus dorsi, pectoralis major, and teres major |
| What nerve supplies taste sensation to the anterior two-thirds of the tongue? | Chorda tympani of CN VII |
| What part of the heart forms • The right border? | Right atrium |
| What part of the heart forms • Left border? | Left ventricle and auricle of left atrium |
| What part of the heart forms • Apex? | Tip of the left ventricle |
| What part of the heart forms • Base? | Left atrium and tip of the right atrium |
| What part of the heart forms • Superior border? | Conus arteriosus of the right ventricle and right and left auricles |
| What part of the heart forms • Anterior wall? | Right ventricle |
| What part of the heart forms • Posterior wall? | Left atrium |
| What part of the heart forms • Diaphragmatic wall? | Left ventricle and tip of right ventricle |
| 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 muscle keeps the stapes taut against the oval window? | Stapedius muscle |
| Name the components of the femoral canal, working laterally to medially. | NAVEL: Femoral Nerve, Artery, Vein, Empty space, and Lymphatics/Lacunar ligament |
| What muscle is most superior in the orbit? | Levator palpebrae superioris |
| What portion of the pericardium adheres to the tunica adventitia of the great vessels? | Fibrous pericardium |
| 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 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. |
| 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 • Suprasp | 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 liga |
| 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 |
| What is the name for the most prominent spinous process? | Vertebra prominens (C7 in 70% of cases, C6 in 20%, T1 in 10%) |
| What muscles make up the rotator cuff? | SITS—Subscapularis, Infraspinatus, Teres minor, Supraspinatus |
| What is the function of white rami communicantes? | They are preganglionic sympathetic axons. They are white because they are myelinated. |
| What muscle or muscles are innervated by the following nerves? • Suprascapular nerve | Supraspinatus and infraspinatus |
| What muscle or muscles are innervated by the following nerves? • Upper subscapularis nerve | Subscapularis |
| What muscle or muscles are innervated by the following nerves? • Thoracodorsal nerve | Latissimus dorsi |
| What muscle or muscles are innervated by the following nerves? • Long thoracic nerve | Serratus anterior |
| 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 associated with the following functions? • Flex the shoulder, flex the elbow, and supinate the elbow | Musculocutaneous nerve |
| 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 |
| What nerve is associated with the following functions? • Supinate the wrist, extend the wrist and digits, extend the shoulder and elbow | Radial nerve |
| What abdominal muscle runs horizontally, contributes to the posterior rectus sheath, and contributes to form the conjoint tendon? | Transverse abdominis |
| 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. |
| Which kidney is lower? Why? | The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies. |
| What two regions of the vertebral column are considered primary curvatures? | Thoracic and sacral |
| What vein drains the lower third of the thoracic wall? | Hemiazygous vein |
| At what point does the axillary artery become the brachial artery? | When it crosses the teres major |
| 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). |
| At what vertebral level does the common carotid artery bifurcate? | C4 (the upper border of the thyroid cartilage) |
| 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). |
| In what compartment of the thigh is the profundus femoris artery found? | Anterior compartment (it's the blood supply to the posterior compartment) |
| 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. |
| 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. |
| What is the largest muscle in the body? | Gluteus maximus |
| At what vertebral levels does the aortic arch begin and end? | It both begins and ends at T4 (sternal angle [of Louis]). |
| What artery travels with the following veins? • Great cardiac vein | Left anterior descending artery |
| What artery travels with the following veins? • Middle cardiac vein | Posterior interventricular artery |
| What artery travels with the following veins? • Small cardiac vein | Right coronary artery |
| The ophthalmic artery is a branch of what vessel? | Internal carotid artery |
| What structure or structures cross the diaphragm at • T8 level? | IVC Remember: 1 at T8, 2 at T10, and 3 at T12 |
| 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 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 |
| 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 nerve or nerves supply general sensation and taste to the posterior third of the tongue? | CN XI and X |
| Which muscle of the eye is under sympathetic control? | Dilator pupillae muscle |
| 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. |
| 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 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. |
| Name the bony articulations of the following sites. Be specific. • Shoulder | Clavicle, acromion, and glenoid fossa of the scapula and the humerus |
| Name the bony articulations of the following sites. Be specific. • Elbow | Humerus with ulna (major) and radius (minor) |
| 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 |
| 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. |
| What seven structures are found in more than one mediastinum? | Esophagus, SVC, vagus nerve, azygos vein, thoracic duct, thymus, and phrenic nerve |
| How many bronchopulmonary segments are on the right lung? Left lung? | There are 10 bronchopulmonary segments on the right and 8 on the left. |
| The duodenal-jejunal flexure is suspended from the posterior abdominal wall by what? | Ligament of Treitz |
| 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 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 cor | Internal abdominal oblique |
| What are the five branches of the superior mesenteric artery? | Inferior pancreaticoduodenal, middle colic, right colic, ileocolic, and 10 to 15 intestinal arteries |
| 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 connects the third and the fourth ventricles? | Cerebral aqueduct |
| What nerve and artery could be affected in a humeral neck fracture? | Axillary nerve and posterior humeral artery |
| 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 two vessels come together to form the external jugular vein? | 1. Posterior auricular vein 2. Posterior division of the retromandibular vein |
| 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 are the three branches of the celiac trunk? | The left gastric, splenic, and common hepatic arteries |
| What region of the pharynx does the eustachian tube enter? | Nasopharynx |
| 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. |
| How many pairs of spinal nerves exit from the spinal cord? | 31 pairs |
| What artery turns into the dorsalis pedis when it crosses the extensor retinaculum? | Anterior tibial artery |
| 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 connects the lateral ventricles to the third ventricle? | Foramen of Monro |
| What nerve supplies general sensation to the anterior two-thirds of the tongue? | Lingual nerve of CN V3 |
| What type of pleura is adherent to the surface of the organ? | Visceral pleura |
| What artery supplies the left ventricle, left atrium, and interventricular septum? | Left coronary artery |
| Where are the tonsillar tissues? | Waldeyer's ring |
| 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 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 area of the posterior aspect of the eye has no photoreceptors? | The optic disk is the blind spot. |
| At the level of rib 6, the internal thoracic artery divides into what two arteries? | Musculophrenic and superior epigastric arteries |
| What is the name of inflammation of the prepatellar bursa? | Housemaid's knee |
| What nerve roots constitute the cervical plexus? | C1 through C4 |
| 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: • Descending aorta | Posterior |
| 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 |
| 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: • Trachea | Superior |
| 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: • Thoracic duct | Superior and posterior |
| Name the compartment of the mediastinum associated with the following thoracic structures: • Azygos vein | Superior and posterior |
| 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: • Splanchnic nerves | Posterior |
| 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: • IVC | Middle |
| Name the compartment of the mediastinum associated with the following thoracic structures: • Vagus nerve | Posterior |
| 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: • Pulmonary artery and veins | Middle |
| 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 |
| What is the only organ in the body supplied by preganglionic sympathetic fibers? | Adrenal medulla |
| 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 are the four muscles of mastication? | 1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid |
| 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 are the three branches of the inferior mesenteric artery? | Left colic, superior rectal, and sigmoidal arteries |
| What is the only valve in the heart with two cusps? | Mitral (bicuspid) valve |
| What are five clinical signs of portal HTN? | Caput medusa, internal hemorrhoids, esophageal varices, retroperitoneal varices, and splenomegaly |
| What three muscles constitute the erector spinae? | 1. Iliocostalis 2. Longissimus 3. Spinalis ("I Love Science" muscles) |
| What nerve is compromised in carpal tunnel syndrome? | Median nerve |
| 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 nerve and artery could be affected in a midshaft humeral fracture? | Radial nerve and the profunda brachii artery |
| 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 |
| Ventral rami of what cervical nerves constitute the phrenic nerve? | C3, C4, and C5 keep the diaphragm alive! |
| What is the region of the fallopian tube where fertilization most commonly occurs? | Ampulla |
| What foramen must be traversed for entry into the lesser peritoneal sac? | Foramen of Winslow |
| 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: • Foramen spinosum | Middle meningeal artery |
| 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 |
| Name the structure that enters or exits the following foramina: • Jugular foramen | CN IX, X, and XI; sigmoid sinus |
| Name the structure that enters or exits the following foramina: • Carotid canal | Internal carotid artery and sympathetic plexus |
| Name the structure that enters or exits the following foramina: • Stylomastoid foramen | CN VII |
| Name the structure that enters or exits the following foramina: • Hypoglossal canal | CN XII |
| Name the structure that enters or exits the following foramina: • Internal auditory meatus | CN VII and VIII |
| Name the structure that enters or exits the following foramina: • Optic canal | CN II and ophthalmic artery |
| Name the structure that enters or exits the following foramina: • Cribriform plate | CN I |
| What vessel can be found atop the scalene anterior? | Subclavian vein |
| What component of the corneal reflex is lost in a CN VII deficit? | Motor aspect |
| 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. |
| 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 two ligaments of the uterus are remnants of the gubernaculum? | Round and ovarian ligaments |
| What segments of the lumbosacral plexus form the following nerves? • Tibial nerve | L4 to S3 (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? • Femoral nerve | L2 to L4 (L2 to L4, thigh; L4 to S3, leg) |
| What segments of the lumbosacral plexus form the following nerves? • Obturator nerve | L2 to L4 (L2 to L4, thigh; L4 to S3, leg) |
| 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 three muscles constitute the pes anserinus? | 1. Sartorius 2. Gracilis 3. Semitendinous |
| 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 vessels carry deoxygenated blood into the lungs from the right ventricle? | The right and left pulmonary arteries, the only arteries that carry deoxygenated blood |
| Fracture of the fibular neck, resulting in foot drop, is an injury of what nerve? | Common peroneal nerve |
| What vein is formed by the union of the right and left brachiocephalic veins? | Superior vena cava |
| 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 muscle laterally rotates the femur to unlock the knee? | Popliteus |
| What chamber of the eye lies between the iris and the lens? | Posterior chamber |
| What artery supplies the right atrium, right ventricle, sinoatrial and atrioventricular nodes? | Right coronary artery |
| 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 vertebral level is marked by the xiphoid process? | T9 |
| 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 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 lower extremity nerve is described by the following motor loss? • Loss of knee extension, weakened hip flexion | Femoral nerve |
| 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 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 lower extremity nerve is described by the following motor loss? • Loss of adduction of the thigh | Obturator nerve |
| What nerve lesion presents with ape or simian hand as its sign? | Median nerve lesion |
| What muscle acts in all ranges of motion of the arm? | Deltoid |
| What is the first branch of the abdominal artery? | Inferior phrenic artery |
| 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. |
| What two muscles do you test to see whether CN XI is intact? | Trapezius and sternocleidomastoid |
| What two CNs are responsible for the carotid body and sinus reflexes? | CN IX and X |
| At what vertebral level does the trachea bifurcate? | T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis). |
| What is the function of the arachnoid granulations? | Resorb CSF into the blood |
| 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. |
| What portion of the intervertebral disk is a remnant of the notochord? | Nucleus pulposus |
| What component of the pelvic diaphragm forms the rectal sling (muscle of continence)? | Puborectalis |
| 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 |
| What bone houses the ulnar groove? | Humerus (between the medial epicondyle and the trochlea) |
| What CN is associated with the sensory innervation of • Nasopharynx? | Maxillary division of CN V and glossopharyngeal nerves |
| What CN is associated with the sensory innervation of • Oropharynx? | Glossopharyngeal nerve |
| What CN is associated with the sensory innervation of • Laryngopharynx? | Vagus nerve |
| What protective covering adheres to the spinal cord and CNS tissue? | Pia mater |
| What is the name of the urinary bladder where the ureters enter and the urethra exits? | Urinary trigone |
| What is the term when the brachial artery is compressed, resulting in ischemic contracture of the hand? | Volkmann's contracture |
| What attaches the cusps of the valves to the papillary muscles in the heart? | Chordae tendineae |
| What is the lymphatic drainage of the pelvic organs? | Internal iliac nodes |
| What bursa is inflamed in clergyman's knee? | Infrapatellar bursa |
| What muscle is the chief flexor of the hip? | Psoas major |
| 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 muscles in the hand adduct the fingers? | The Palmar interosseus ADducts, whereas the Dorsal interosseus ABducts (PAD and DAB) |
| What type of cerebral bleed is due to a rupture of a berry aneurysm in the circle of Willis? | Subarachnoid hematoma |
| 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 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 structure of the knee is described thus? • Prevents posterior displacement and has medial-to-lateral attachment on the tibia | Posterior cruciate ligament |
| What structure of the knee is described thus? • Prevents adduction | Lateral collateral ligament |
| What structure of the knee is described thus? • Prevents anterior displacement and has lateral-to-medial attachment on the tibia | ACL |
| What structure of the knee is described thus? • Prevents abduction | Medial collateral ligament |
| 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. |
| 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. |
| From what pharyngeal groove is the external auditory meatus derived? | First pharyngeal groove; all others degenerate. |
| 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 adult male structure? • Scrotum | Labioscrotal swelling |
| What embryonic structure forms the adult male structure? • Urinary bladder, urethra, prostate gland, bulbourethral gland | Urogenital sinus |
| What embryonic structure forms the adult male structure? • Testes, seminiferous tubules, and rete testes | Gonads |
| What embryonic structure forms the adult male structure? • Ventral part of the penis | Urogenital folds |
| What embryonic structure forms the adult male structure? • Gubernaculum testes | Gubernaculum |
| What embryonic structure forms the adult male structure? • Epididymis, ductus deferens, seminal vesicle, and ejaculatory duct | Mesonephric duct |
| 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. |
| When does the primitive gut herniate out of the embryo? When does it go back into the embryo? | 6 weeks 10 weeks |
| What results when the palatine prominences fail to fuse with the other side? | Cleft palate |
| 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 |
| Where do the primordial germ cells arise? | From the wall of the yolk sac |
| 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. |
| Does the zygote divide mitotically or meiotically? | The zygote divides mitotically; only germ cells divide meiotically. |
| During what embryonic week does the intraembryonic coelom form? | Third week |
| 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). • Midbrain | Mesencephalon |
| 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). • Diencephalon | Proencephalon |
| 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). • 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). • Eye | Proencephalon* *diencephalon derivative |
| Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Pons | 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). • Pineal gland | Proencephalon* *diencephalon derivative |
| 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). • Neurohypophysis | Proencephalon* *diencephalon derivative |
| 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). • Hypothalamus | Proencephalon* *diencephalon derivative |
| Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Lateral ventricles | Proencephalon |
| 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) |
| What syndrome is due to a deficiency of surfactant? | Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant. |
| How many oogonia are present at birth? | None; they are not formed until a girl reaches puberty. |
| 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 the adult remnants of the following structures? • Left umbilical vein | Ligament teres |
| What are the adult remnants of the following structures? • Foramen ovale | Fossa ovale |
| What are the adult remnants of the following structures? • Right and left umbilical arteries | Medial umbilical ligaments |
| 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 |
| Mandibular hypoplasia, down-slanted palpebral fissures, colobomas, malformed ears, and zygomatic hypoplasia are commonly seen in what pharyngeal arch 1 abnormality? | Treacher Collins syndrome |
| What is the tetrad of tetralogy of Fallot? | SHIP: Shifting of the aorta, Hypertrophy of the right ventricle, Interventricular septal defect, Pulmonary stenosis |
| What is the term for the external urethra opening onto the ventral surface of the penis? | Hypospadia |
| What CN is associated with the • First pharyngeal arch? | CN V |
| What CN is associated with the • Second pharyngeal arch? | CN VII |
| What CN is associated with the • Third pharyngeal arch? | CN IX |
| What CN is associated with the • Fourth pharyngeal arch? | CN X |
| What CN is associated with the • Fifth pharyngeal arch? | None; it degenerates. |
| What CN is associated with the • Sixth pharyngeal arch? | CN X |
| 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 immunologic syndrome is due to a pharyngeal pouch 3 and 4 failure? | DiGeorge's syndrome |
| What embryonic structure, around day 19, tells the ectoderm above it to differentiate into neural tissue? | The notochord |
| 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. |
| 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. |
| What pharyngeal pouch and groove persist when a pharyngeal fistula is formed? | The second pharyngeal pouch and groove |
| 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. |
| From what pharyngeal pouch is the following structure derived? • Middle ear | First M PITS for pharyngeal pouch derivatives |
| 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 pharyngeal pouch is the following structure derived? • Inferior parathyroid gland and thymus | Third M PITS for pharyngeal pouch derivatives |
| From what pharyngeal pouch is the following structure derived? • Palatine tonsil | Second M PITS for pharyngeal pouch derivatives |
| What is the term for the external urethra opening onto the dorsal surface of the penis? | Epispadia |
| True or false? In females, meiosis II is incomplete unless fertilization takes place. | True. The elimination of the unfertilized egg is menses. |
| What adult structures are derived from preotic somites? | Muscles of the internal eye |
| What disorder is associated with jaundice, white stools, and dark urine due to biliary duct occlusion secondary to incomplete recanalization? | Extrahepatic biliary atresia |
| What hormone, produced by the syncytiotrophoblast, stimulates the production of progesterone by the corpus luteum? | hCG |
| How many mature sperm are produced by one type B spermatogonium? | Four |
| All primary oocytes in females are formed by what age? | They are all formed by the fifth month of fetal life. |
| From what embryonic structure are the following structures derived? • The ascending aorta and the pulmonary trunk | Truncus arteriosus |
| 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 embryonic structure are the following structures derived? • The right and left ventricles | Primitive ventricle |
| From what embryonic structure are the following structures derived? • The aortic vestibule and the conus arteriosus | Bulbus cordis |
| From what embryonic structure are the following structures derived? • The right and left atria | Primitive atrium |
| After a longstanding left-to-right shunt reverses, causing cyanosis, and becomes a right-to-left shunt, what is it termed? | Eisenmenger's syndrome |
| 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. |
| 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? • Urinary bladder and urethra | Urogenital sinus |
| What embryonic structure forms the following adult structures? • External genitalia | Phallus, urogenital folds, and labioscrotal swellings |
| What embryonic structure forms the following adult structures? • Nephrons, kidney | Metanephros |
| What embryonic structure forms the following adult structures? • Median umbilical ligament | Urachus |
| True or false? The epithelial lining of the urinary bladder and the urethra are embryologic hindgut derivatives. | TRUE |
| 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. |
| 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 |
| 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. |
| Blood and its vessels form during what embryonic week? | Third week; they are derived from the wall of the yolk sac. |
| What embryonic structure forms the adult female structures? • Glans clitoris, corpus cavernosus, and spongiosum | Phallus |
| What embryonic structure forms the adult female structures? • Gartner's duct | Mesonephric duct |
| What embryonic structure forms the adult female structures? • Ovary, follicles, rete ovarii | Gonads |
| What embryonic structure forms the adult female structures? • Uterine tube, uterus, cervix, and upper third of the vagina | Paramesonephric ducts |
| What embryonic structure forms the adult female structures? • Labia majora | Labioscrotal swelling |
| What embryonic structure forms the adult female structures? • Labia minora | Urogenital folds |
| What embryonic structure forms the adult female structures? • Ovarian and round ligaments | Gubernaculum |
| What embryonic structure forms the adult female structures? • Urinary bladder, urethra, greater vestibular glands, vagina | Urogenital sinus |
| What direction does the primitive gut rotate? What is its axis of rotation? | The gut rotates clockwise around the superior mesenteric artery. |
| What syndrome occurs when a 46XY fetus develops testes and female external genitalia? | Testicular feminization syndrome (Dude looks like a lady!) |
| Preeclampsia in the first trimester, hCG levels above 100, 00 mIU/mL, and an enlarged bleeding uterus are clinical signs of what? | Hydatidiform mole |
| 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. |
| At ovulation, in what stage of meiosis II is the secondary oocyte arrested? | Metaphase II |
| What is the name for failed recanalization of the duodenum resulting in polyhydramnios, bile-containing vomitus, and a distended stomach? | Duodenal atresia |
| What remains patent in a hydrocele of the testis, allowing peritoneal fluid to form into a cyst? | A patent processus vaginalis |
| 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. -------------------------------------------------------------------------------- |
| What is the name for failure of the allantois to close, resulting in a urachal fistula or sinus? | Patent urachus |
| What structure is derived from the prochordal plate? | The mouth |
| What is the only organ supplied by the foregut artery that is of mesodermal origin? | Spleen |
| What tumor is derived from primitive streak remnants and often contains bone, hair, or other tissue types? | Sacrococcygeal teratoma |
| What two pathologic conditions occur when the gut does not return to the embryo? | Omphalocele and gastroschisis |
| 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! |
| What results when the maxillary prominence fails to fuse with the medial nasal prominence? | Cleft lip |
| What is the direction of growth for the primitive streak, caudal to rostral or rostral to caudal? | The primitive streak grows caudal to rostral. |
| During what embryonic week do somites begin to form? | Third week |
| 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. |
| What embryonic week sees the formation of the notochord and the neural tube? | Third week |
| What right-to-left shunt occurs when only one vessel receives blood from both the right and left ventricles? | Persistent truncus arteriosus |
| What three embryonic cell layers form the chorion? | 1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm |
| Where are the preganglionic neuron cell bodies, the CNS or the PNS? | They are in the grey matter of the CNS. |
| 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 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 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 syndrome is associated with the following brainstem lesions? • Slow-growing acoustic neuroma producing CN VII deficiencies | Pontocerebellar angle syndrome |
| 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 | Lateral medullary (Wallenberg's) syndrome |
| 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, i | Lateral pontine syndrome |
| 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 |
| What CNs are affected if there is a lesion in • The midbrain? | CN III and IV |
| What CNs are affected if there is a lesion in • The upper medulla? | CN IX, X, and XII |
| What CNs are affected if there is a lesion in • Pontomedullary junction? | CN VI, VII, and VIII |
| What CNs are affected if there is a lesion in • The upper pons? | CN V |
| What is the only CN nucleus found in the cervical spinal cord? | Accessory nucleus |
| What component of the trigeminal nuclei • Supplies the muscles of mastication? | Motor nucleus of CN V |
| 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 |
| What component of the trigeminal nuclei • Forms the sensory component of the jaw jerk reflex? | Mesencephalic nucleus |
| What deep cerebellar nuclei receive Purkinje cell projections in • The flocculonodular lobe? | The lateral vestibular nucleus |
| What deep cerebellar nuclei receive Purkinje cell projections in • The vermis? | The fastigial nucleus |
| What deep cerebellar nuclei receive Purkinje cell projections in • The lateral cerebellar hemispheres? | The interposed nucleus |
| What deep cerebellar nuclei receive Purkinje cell projections in • The intermediate hemispheres? | The dentate nucleus |
| 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 three CNs are associated with conjugate eye movements? | CN III, IV, and VI |
| 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 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.) |
| 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. |
| 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 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 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 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 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 |
| 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 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 |
| Which thalamic nucleus receives auditory input from the inferior colliculus? | MGB |
| Where are the postganglionic neuron cell bodies, the CNS or the PNS? | They are in ganglia in the PNS. |
| What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion? | Syringomyelia |
| What nucleus of the hypothalamus receives visual input from the retina and helps set the circadian rhythm? | Suprachiasmatic nucleus |
| Are white rami preganglionic or postganglionic fibers? | White rami are preganglionic fibers, whereas grey rami are postganglionic fibers. |
| 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 CN transmits sensory information from the cornea? | CN V1, the occulomotor division of the trigeminal nerve, is the sensory component of the corneal reflex. |
| What preganglionic sympathetic fibers are responsible for innervating the smooth muscle and glands of the pelvis and the hindgut? | Lumbar splanchnics |
| 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 |
| What term describes the reflex that increases the curvature of the lens, allowing near vision? | Accommodation |
| 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 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 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. |
| What four CN carry preganglionic parasympathetic fibers? | CN III, VII, IX, and X |
| Name the form of spina bifida. • Meninges and spinal cord project through a vertebral defect | Meningomyelocele All except occulta cause elevated-fetoprotein levels. |
| Name the form of spina bifida. • Meninges project through a vertebral defect | Meningocele All except occulta cause elevated-fetoprotein levels. |
| 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. |
| Name the form of spina bifida. • Defect in the vertebral arch | Occulta All except occulta cause elevated-fetoprotein levels. |
| 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) |
| 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 |
| 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 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 the amygdala, prefrontal cortex, and temporal lobe; output to the prefrontal lobe and the cingulated gyrus | Medial nuclear group (limbic system) |
| Name the thalamic nucleus based on its input and output. • Input from inferior colliculus; output to primary auditory cortex | MGB (think EARS) |
| 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 is the name of a thin brown ring around the outer edge of the cornea, seen in Wilson's disease? | Kayser-Fleischer ring |
| What do UMNs innervate? | They innervate LMNs. |
| 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.) |
| 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. |
| 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 contral |
| 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. |
| How many pairs of spinal nerves are associated with • Cervical vertebrae? | Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves. |
| How many pairs of spinal nerves are associated with • Thoracic vertebrae? | Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves. |
| 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. |
| 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 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 CNs arise from • The midbrain? | CN III and IV |
| What CNs arise from • The pons? | CN V, VI, VII, and VIII |
| What CNs arise from • The medulla? | CN IX, X, and XII CN XI arises from the cervical spinal cord. |
| 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. |
| 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. |
| 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 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 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 |
| 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 d |
| 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 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 branch off the vertebral artery supplies • The cerebellum and the dorsolateral part of the medulla? | PICA |
| 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) |
| 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. |
| What cells lining the ventricles have cilia on their luminal surface to move CSF? | Ependymal cells |
| 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 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 name of violent projectile movements of a limb resulting from a lesion in the subthalamic nuclei of the basal ganglia? | Hemiballismus |
| 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. |
| 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. |
| What Brodmann area is associated with • Broca's area? | Areas 44 and 45 |
| What Brodmann area is associated with • Primary auditory cortex? | Areas 41 and 42 |
| What Brodmann area is associated with • Primary somatosensory cortex? | Areas 1, 2, and 3 |
| What Brodmann area is associated with • Somatosensory association cortex? | Areas 5 and 7 |
| 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 • Visual association cortex? | Areas 18 and 19 |
| What Brodmann area is associated with • Frontal eye fields? | Area 8 |
| 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 is the fluid of the posterior compartment of the eye? | Vitreous humor |
| 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 |
| In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls the axial and proximal musculature of the limbs? | The vermis |
| In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Is involved in motor planning? | Lateral part of the hemispheres |
| 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!) |
| In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls distal musculature? | Intermediate part of the hemispheres |
| 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 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 artery supplies most of the lateral surfaces of the cerebral hemispheres? | Middle cerebral artery |
| What hypothalamic nucleus is responsible for the production of ADH? | Supraoptic nuclei; lesions here result in diabetes insipidus. |
| 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. |
| What nucleus of the hypothalamus is the satiety center, regulating food intake? | Ventromedial nucleus; lesions here result in obesity. |
| What cells of the retina sees in color and needs bright light to be activated? | Cones (C for color and cones) |
| What cell's axons are the only ones that leave the cerebellar cortex? | The Purkinje cell |
| What splanchnic carries preganglionic parasympathetic fibers that innervate the hindgut and the pelvic viscera? | Pelvic splanchnics (They all begin with P.) |
| 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. |
| Name the ocular lesion; be specific. • Left optic nerve lesion | Left eye anopsia (left nasal and temporal hemianopsia) |
| Name the ocular lesion; be specific. • Right calcarine cortex lesion | Left homonymous hemianopsia |
| Name the ocular lesion; be specific. • A right LGB lesion (in the thalamus) | Left homonymous hemianopsia |
| Name the ocular lesion; be specific. • Optic chiasm lesion | Bitemporal heteronymous hemianopsia |
| 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 |
| Name the ocular lesion; be specific. • Left Meyer's loop lesion of the optic radiations. | Left homonymous hemianopsia |
| 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 is the name for inability to stop a movement at the intended target? | Dysmetria; this is seen in a finger-to-nose test. |
| 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 sulcus divides the occipital lobe horizontally into a superior cuneus and inferior lingual gyrus? | Calcarine sulcus |
| 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. |
| 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 |
| 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 ganglion supplies the postganglionic parasympathetic fibers to the ciliary muscles of the eye? | Ciliary ganglion |
| 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 CN nucleus receives auditory information from both ears via the cochlear nuclei? | Superior olivary nucleus |
| 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 |
| 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 do LMNs innervate? | They innervate skeletal muscle. |
| 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. |
| 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+. |
| What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal root? | Sensory |
| 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) • Ventral rami? | Both |
| What type of fiber or fibers are carried in (answer motor, sensory, or both) • Ventral root? | Motor |
| 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) • Spinal nerve? | Both |
| 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 |
| 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) • Spinothalamic tract? | Contralateral loss below and bilateral loss at the level of the lesion |
| What area of the brain acts as the center for ipsilateral horizontal gaze? | PPRF |
| 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 is the function of the basal ganglia? | Initiate and manage gross skeletal muscle movement control |
| What artery is formed by the union of the two vertebral arteries? | The basilar artery is formed at the pontomedullary junction. |
| 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. |
| Which dopamine receptor excites the direct pathway of the basal ganglia? | D1 receptor; inhibition of the direct pathway occurs through the D2 receptors. |
| 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. |
| 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 brain acts as the center for contralateral horizontal gaze? | Frontal eye field (Brodmann area 8) |
| 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. |
| 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 area of the limbic system is responsible for attaching emotional significance to a stimulus? | Amygdala; it helps imprint an emotional response in memory. |
| 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. |
| 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 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 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 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? • Right eye can't look left, left eye nystagmus, and convergence is intact | Right medial longitudinal fasciculus |
| 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 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.) |
| 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) |
| 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! |
| 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 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. |
| What area of the retina consists of only cones and has the greatest visual acuity? | Fovea |
| What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord? | The fasciculus cuneatus |
| What CNS demyelinating disease is characterized by diplopia, ataxia, paresthesias, monocular blindness and weakness, or spastic paresis? | Multiple sclerosis |
| What part of the ANS (i.e., PNS or CNS) controls the constriction of the pupil in response to light? | Parasympathetic |
| With which CN are preganglionic parasympathetic axons arising from the Edinger- Westphal nucleus associated? | CN III |
| Ophthalmic artery is a branch of what artery? | Internal carotid artery |
| What thalamic relay nucleus do the mammillary bodies project to? | The anterior nucleus of the thalamus |
| What cells contribute to the blood-brain barrier and proliferate in response to CNS injury? | Astrocytes |
| What causes slow writhing movements (athetosis)? | Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy) |
| What area of the brain is responsible for emotion, feeding, mating, attention, and memory? | The limbic system |
| 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.) |
| 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 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 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 neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1-L2) | Preganglionic sympathetic neurons |
| 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. |
| What tract is responsible for voluntary refined movements of distal extremities? | Corticospinal tract |
| Craniopharyngiomas are remnants of what? | Rathke's pouch; they can result in compression of the optic chiasm. |
| 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. |
| 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 is the only CN to arise from the dorsal surface of the midbrain? | CN IV |
| 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. |
| 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 nucleus, found in the intermediate zone of the spinal cord, sends unconscious proprioception to the cerebellum? | Clarke's nucleus |
| The vertebral artery is a branch of what artery? | The subclavian artery |
| What muscle of the middle ear is innervated by the mandibular division of CN V? | Tensor tympani |
| 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 muscle of the middle ear is innervated by CN VII? | The stapedius muscle |
| What part of the inner ear contains the gravity receptors for changes in the position of the head? | Saccule and utricle |
| What nucleus supplies the preganglionic parasympathetic fibers to the ciliary ganglion? | Edinger-Westphal nucleus (via CN III) |
| What reticular nuclei synthesize serotonin from L-tryptophan and plays a role in mood, aggression, and inducing sleep? | The raphe nuclei |
| 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. |
| 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. |
| True or false? Neurons in the dorsal horn participate in reflexes. | True. They are the sensory component of a spinal reflex. |
| 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 |
| What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut? | Thoracic splanchnic fibers |
| Does light or darkness regulate the pineal gland? | Light regulates the activity of the pineal gland via the retinal-suprachiasmatic- pineal pathway. |
| Name the three hormones produced by pinealocytes. | Melatonin, serotonin, and CCK |
| Is the pH of CSF acidotic, alkalotic, or neutral? | The pH of CSF is 7.33, acidotic. |
| 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 reflex enables the eyes to remain focused on a target while the head is turning? | The vestibulo-ocular reflex |
| What cells of the retina see in black and white and are used for night vision? | Rods |
| 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 |
| 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 intermedia | Cardiac muscle |
| 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 segment of the small intestine is associated with Brunner's glands? | Duodenum |
| Who is responsible for passing on mitochondrial DNA genetic disorders? | Mitochondria-linked disorders are always inherited from the mother. |
| What part of a neuron receives information? | Dendrites receive information, whereas axons send information. |
| What type of collagen is associated with the basement membrane? | Type IV collagen |
| 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 cell of the nephron is responsible for renin production and secretion? | Juxtaglomerular (JG) cell |
| What cell surface modification of ependymal cells and respiratory epithelium has a 9 + 2 microtubular configuration and movement as its function? | Cilia |
| 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!) |
| What substance found in eosinophils is toxic to parasitic worms? | Major basic protein |
| After fertilization, what cells of the corpus luteum • Secrete progesterone? | Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells. |
| After fertilization, what cells of the corpus luteum • Secrete estrogen? | Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna. |
| What is the largest organ in the body? | Integument (skin and its derivatives) |
| On what layer of the epidermis does all mitosis occur? | Malpighian layer (made up of the stratum basale and stratum spinosum) |
| What ribosomal subunit binds first to the mRNA strand? | The small subunit (40S) binds first. |
| What is the T-cell area of the spleen? | PALS |
| What element is needed for the proper alignment of tropocollagen molecules? | Copper (Cu+) |
| 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 organelle is responsible for ribosomal RNA synthesis? | Nucleolus. Ribosomal assembly also takes place in the nucleolus. |
| 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 papillae send their senses via chorda tympani of CN VII? | Fungiform papillae |
| 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.) |
| 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): • 46/4n | Primary spermatocyte |
| 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 mitotically) | Spermatogonia (type B) |
| 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 are the four functions of SER? | Steroid synthesis, drug detoxification, triglyceride resynthesis, and Ca2+handling |
| Which immunoglobulin is secreted by the plasma cells in the gastrointestinal tract? | IgA |
| 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. |
| What type of chromatin is transcriptionally inactive? | Heterochromatin, the light stuff in the nucleus on an electron microscope image. |
| 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 is the only neuroglial cell of mesodermal origin? | Microglia. All others are neuroectodermal derivatives. |
| Where is tropocollagen aggregated to form a collagen fibril? | Outside the cell |
| 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 is the epithelial cell lining the nasopharynx? | Stratified squamous nonkeratinized epithelium, which has cilia that beat toward the oropharynx. |
| What are the three epidermal derivatives? | 1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous) |
| What are the long microvilli in the inner ear and male reproductive tract called? | Stereocilia |
| 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. |
| What cell of the male reproductive system produces testosterone? | Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.) |
| 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. |
| What cell type of the epidermis functions as antigen-presenting cells? | Langerhans cells (found in the stratum spinosum) |
| 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 area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen? | The vagina |
| 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 cell transports IgA, is secreted by plasma cells, and is in Peyer's patches to the gastrointestinal lumen? | M-cells |
| What are the cells of the parathyroid gland that produce PTH? | Chief cells |
| 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 name of hydrophilic pores that allow the direct passage of ions and particles between two adjacent cells? | Gap junctions |
| 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) |
| What cell membrane structure increases the surface area of a cell and has actin randomly assorted within its structure? | Microvillus |
| What are the four components of the basement membrane? | 1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen |
| 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 cell type of the body or fundus of the stomach secretes IF? | Parietal cells (Remember, they secrete HCl, too.) |
| What cell type of the body or fundus of the stomach secretes pepsinogen? | Chief cells |
| 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 cells of the nephron function as sodium concentration sensors of the tubular fluid? | Macula densa |
| What type of chromatin is transcriptionally active? | Euchromatin, the dark stuff in the nucleus on an electron microscope image. |
| What cells of the thyroid gland secrete calcitonin? | Parafollicular C cells |
| 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. |
| How many days after the LH surge is ovulation? | One day after the LH surge and 2 days after the estrogen peak. |
| In what layer of the epidermis is melanin transferred from melanocytes to keratinocytes? | Stratum spinosum |
| What cells of the epidermis, derived from the neural crest, act as mechanoreceptors? | Merkel cells (Merkel's tactile cells) |
| What substance do the JG cells of the kidney secrete in response to low blood pressure? | Renin |
| 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 papillae are responsible for sweet taste? | Circumvallate papillae |
| What area of the lymph node contains germinal centers? | The outer cortex contains most of the germinal centers and therefore also most B cells. |
| 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? Depolarization of the postsynaptic membrane excites the neuron. | True. Hyperpolarization inhibits the postsynaptic membrane. |
| In the alveoli, what cell type is • for gas exchange? | Type I pneumocytes |
| In the alveoli, what cell type is • responsible for producing surfactant? | Type II pneumocytes |
| In the alveoli, what cell type is • part of the mononuclear phagocytic system? | Alveolar macrophages (dust cells) |
| Which trophoblast layer of the placenta remains until the end of pregnancy? | Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.) |
| What is the first epidermal layer without organelles and nuclei | Stratum lucidum |
| What area of the small intestine is characterized by Peyer's patches? | Ileum |
| What lymphoid organ has the following characteristics: outer and inner cortical areas, encapsulation, germinal centers, and high endothelial venules? | Lymph nodes |
| What area of the nephron is sensitive to the effects of ADH? | Collecting ducts, which make them readily permeable to water reabsorption. |
| 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 hormone causes milk letdown? | Oxytocin |
| 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 cell type of the epidermis originates from the neural crest? | Melanocytes |
| If no fertilization occurs, how many days after ovulation does the corpus luteum begin to degenerate? | 12 days after ovulation |
| What area of the spleen consists of splenic cords of Billroth and phagocytoses RBCs? | Red pulp (Remember, Red pulp and RBCs begin with R.) |
| What is the name of the protein coat that surrounds the nuclear envelope? | Vimentin |
| What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)? | Filiform papillae |
| What is the most superficial layer of the epidermis? | Stratum corneum (keratinized) |
| 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 are the functions of the zonula occludens and the zonula adherens | To provide attachment between contiguous cells and to maintain a semipermeable barrier |
| What is the name of the SER of striated muscle? | Sarcoplasmic reticulum |
| Where do sperm go for maturation? | Ductus epididymis, which is lined by pseudostratified epithelium with stereocilia. |
| 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 longest and most convoluted segment of the nephron? | PCT |
| What cells of the epidermis carry the pigment melanin? | Keratinocytes, the most numerous cells in the epidermis, carry melanin and produce keratin. |
| 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. |
| 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. |
| 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. |
| Where are the enzymes for the ETC and oxidative phosphorylation found? | The inner membrane of the mitochondria (cristae) |
| What lymphoid organ is characterized by germinal centers, plasma cells that secrete IgA, and no encapsulation? | Peyer's patch |
| What generate anterograde transport of information in a neuron? | Kinesins. Dynein generates retrograde transportation of information. |
| What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan? | Hyaluronic acid (all sulfates bind to the core protein) |
| What cell in bone is a part of the mononuclear phagocytic system? | Osteoclasts |
| What three factors do Sertoli cells produce for normal male development? | Inhibin, müllerian-inhibiting factor, and androgen binding protein |
| What epidermal layer's function is to release lipids to act as a sealant? | Stratum granulosum |
| What does the tunica intima of arteries have that veins do not? | An internal elastic lamina |
| 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. |
| What cell of the duodenum contains high concentrations of lysozymes and has phagocytic activity? | Paneth cells |
| What maintains the osmotic gradient that is critical to the concentrating ability of the kidney? | The venae recta maintain the gradient via countercurrent flow. |
| Are the JG cells of the nephron a part of the afferent or efferent arteriole? | Afferent arteriole |
| What cell of the duodenum secretes CCK? | Enteroendocrine (EE) cells; they also secrete secretin. |
| What are the proteoglycans of cartilage and bone? | Chondroitin sulfate and keratan sulfate |
| 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 second arrested stage of development in the female reproductive cycle? | Metaphase of meiosis II (in the oocyte of the graafian follicle) |
| 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. |
| What term describes how an action potential is propagated along an axon? | Saltatory conduction |
| 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 |
| A single mRNA strand translated by a ribosome is termed what? | Polysome. Ribosomes read from the 5' to the 3' end of the mRNA. |
| 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 |
| What histone binds two nucleosomes together? | H1 histones |
| What is the major inorganic component of bone? | Hydroxyapatite |
| What cells of the adrenal gland are neural crest derivatives? | Chromaffin cells (adrenal medulla) |
| 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 organelles make ATP, have their own dsDNA, and can synthesize protein? | Mitochondria |
| 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 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. |
| What is the legal age to be deemed competent to make decisions? | 18 years old (except if emancipated) |
| 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. |
| When more than one explanation can account for the end result, what form of bias occurs? | Confounding bias |
| Increased levels of what neurotransmitter, in the hippocampus, decrease the likelihood of learned helplessness? | Increased GABA levels decrease the likelihood of learned helplessness. |
| How does ceasation of barbiturate use affect sleep? | By causing rebound insomnia and decrease in REM sleep |
| What type of correlation compares two ordinal variables? | Spearman correlation |
| What syndrome is characterized by bilateral medial temporal lobe lesion, placidity, hyperorality, hypersexuality, hyperreactivity to visual stimuli, and visual agnosia? | Klüver-Bucy syndrome |
| What is the term for having fantasies or dressing in female clothes for sexual arousal by heterosexual men? | Transvestite fetishism |
| What disorder is described as having • Unconscious symptoms with unconscious motivation? | Somatoform disorder |
| What disorder is described as having • Conscious symptoms with conscious motivation? | Malingering |
| What disorder is described as having • Conscious symptoms with unconscious motivation? | Factitious disorder |
| What is the term for the ability of a test to measure something consistently? | Reliability (think of it as "nice grouping" or "precise") |
| What cerebral vessel size is affected in patients with vascular dementia? | Small to medium-sized cerebral vessels |
| What is the name of the program that deals with codependency and enabling behaviors for family members of alcohol abusers? | Al-Anon |
| What level of mental retardation is characterized by • Needing a highly structured environment with constant supervision? | Profound (I.Q. range < 20) |
| 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 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) |
| What level of mental retardation is characterized by • Can work in sheltered workshops and learn simple tasks but need supervision? | Moderate (35-49) |
| 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) |
| Name these immature defense mechanisms: • Returning to an earlier stage of development (e.g., enuresis) | Regression |
| Name these immature defense mechanisms: • Inability to remember a known fact (aware of forgetting) | Blocking |
| Name these immature defense mechanisms: • Psychic feelings converted to physical symptoms | Somatization |
| 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 • See death as irreversible? | Concrete operations (6-12 years) |
| At what stage of cognitive development (according to Piaget) do children • Have abstract thinking? | Formal operations (> 12 years) |
| At what stage of cognitive development (according to Piaget) do children • Lack law of conservation and be egocentric? | Preoperational (2-6 years) |
| Is it acceptable to lie, even if it protects a colleague from malpractice? | No, it is never acceptable to lie. |
| What happens to prevalence as duration increases? | Prevalence increases. (Note: Incidence does not change.) |
| With what stage of sleep are nightmares associated? | REM sleep. Nightmares are frightening dreams that we recall. |
| 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) |
| 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 happens to dopamine levels when we awaken? | Dopamine levels rise with waking; dopamine is associated with wakefulness. |
| What is the primary risk factor for suicide? | Previous suicide attempt |
| What is defined as a general estimate of the functional capacities of a human? | IQ |
| 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. |
| What is the term for a deficiency or absence of sexual fantasies or desires? | Hypoactive sexual desire disorder |
| What phobia is described as the fear of open spaces? | Agoraphobia. It also means having a sense of humiliation or hopelessness. |
| 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.) |
| 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 ethnic group has the highest adolescent suicide rate? | Native Americans |
| What are the three microscopic pathologic changes seen in Alzheimer's disease? | Senile plaques, neurofibrillary tangles, and granulovascular changes in neurons |
| 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. |
| What is the name of the benzodiazepine antagonist used in the treatment of an overdose? | Flumazenil |
| 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 is the biochemical trigger for REM sleep? | Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.) |
| What neuropsychologic test shows nine designs to the patient, then asks for recall of as many as possible? | Bender Visual Motor Gestalt Test |
| What are the three characteristics of ADHD? | 1. Short attention span 2. Impulsivity 3. Hyperactivity |
| Is suicidal ideation a component of normal grief? | It is rare with normal grief; however, it is relatively common in depression |
| In what stage of sleep is it easiest to arouse a sleeping individual? | During REM sleep |
| What scale separates things into groups without defining the relationship between them? | Nominal scale (categorical, e.g., male or female) |
| 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. |
| 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 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 percentage of children born to HIV-positive mothers will test positive for HIV at birth? | 100%, with about 20% remaining positive after 1 year |
| 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 |
| Which drug is used to treat opioid withdrawal, ADHD, and sometimes Tourette's syndrome? | Clonidine |
| What chromosome is autism linked to? | Chromosome 15 |
| What type of correlation is defined as • Two variables that go together in the same direction? | Positive correlation |
| What type of correlation is defined as • Two variables with no linear relation to one another? | Zero correlation |
| What type of correlation is defined as • One variable that diminishes in the presence of the other? | Negative correlation |
| 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) |
| What hypothesis states that the findings of a test are a result of chance? | Null hypothesis (what you hope to disprove) |
| What is the term to describe the inability to feel any pleasant emotions? | Anhedonia |
| 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 is the term for the same results achieved again on testing a subject a second or third time? | Test-retest reliability |
| At what age does a child develop • Endogenous smile? | At birth (reflex) |
| At what age does a child develop • Exogenous smile? | 8 weeks (response to a face) |
| At what age does a child develop • Preferential smile? | 12 to 16 weeks (in response to mother's face) |
| Per Freud, with what part of the unconscious are sex and aggression (instincts) associated? | Id |
| 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. |
| 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. |
| 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) |
| 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. |
| At what stage of psychosexual development (according to Freud) do children fear castration? | Phallic stage (4-6 years) |
| What is the label given to an individual whose IQ is • 130 | Very superior (<2.5% of the population) |
| What is the label given to an individual whose IQ is • 110 to 119 | High average |
| What is the label given to an individual whose IQ is • 80 to 89 | Low average |
| What is the label given to an individual whose IQ is 70 to 79 | Borderline |
| What is the label given to an individual whose IQ is • 90 to 109 | Average |
| What is the label given to an individual whose IQ is • Below 69 | Mentally disabled |
| What is the label given to an individual whose IQ is • 120 to 129 | Superior |
| At what stage of sleep is GH output elevated? | Stage 4 |
| 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. |
| Can incidence, prevalence, and cause and effect be assessed in • Cross-sectional studies? | Cross-sectional studies determine prevalence, not incidence or cause and effect. |
| Can incidence, prevalence, and cause and effect be assessed in • Cohort studies? | Cohort studies determine incidence and causality, not prevalence. |
| 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). |
| 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 tr |
| 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 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 Freudian psyche component is described as • The urges, sex aggression, and "primitive" processes? | Id (pleasure principle) |
| What Freudian psyche component is described as • The conscience, morals, beliefs (middle of the road)? | Superego |
| What Freudian psyche component is described as • Reality, rationality, language basis? | Ego |
| 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) |
| 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 rate removes any difference between two populations, based on a variable, to makes groups equal? | Standardized rate |
| 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. |
| What is the term for any stimulus that increases the probability of a response happening? | Reinforcement |
| 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!) |
| Name the cluster C personality disorder: • Gets others to assume responsibility, is subordinate, and is fearful of being alone and caring for self | Dependent |
| 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 |
| Name the cluster C personality disorder: • Sensitive to criticism, shy, anxious; socially isolated but yearns to be in the crowd | Avoidant |
| What is the term for a complete aversion to all sexual contact? | Sexual aversion disorder |
| 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 symptoms in schizophrenia are associated with • Muscarinic receptors (ACh)? | Type II symptoms (negative); otherwise healthy persons have them, but schizophrenics do not. |
| 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 |
| 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. |
| What is the key issue surrounding teenagers' maturation? | Formation of an identity through issues of independence and rebellion; they define who they are. |
| What is the relationship between chance of error and • Standard deviation? | As the standard deviation increases, the greater the chance of error. |
| What is the relationship between chance of error and • Sample size? | As sample size increases, the lower the chance of error. |
| Name the cluster B personality disorder: • Colorful, dramatic, extroverted, seductive, and unable to hold long-term relationships | Histrionic |
| 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 |
| Name the cluster B personality disorder: • Criminal behavior; lacking friends, reckless, and unable to conform to social norms | Antisocial |
| Name the cluster B personality disorder: • Grandiose sense of self-importance; demands constant attention; fragile self-esteem; can be charismatic | Narcissistic |
| 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 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. |
| If the P value is less than or equal to .05, what do you do to the null hypothesis? | Reject it |
| 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 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 has proved to be the best way to extinguish enuresis? | Bell pad |
| 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 associated with prolonged lithium use? | Hypothyroidism. (TSH levels must be monitored.) |
| What scale has a true zero point, graded into equal increments, and also orders them? | Ratio scale |
| By what age should children be able to draw the following figures? • Triangle | 6 years old |
| 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? • Diamond | 7 years old |
| By what age should children be able to draw the following figures? • Square | 5 years old |
| By what age should children be able to draw the following figures? • Circle | 3 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) |
| What personality disorder affects 75% of the prison population? | Antisocial personality |
| 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 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. |
| 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 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 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 |
| What are the top three causes of infant mortality? | Birth defects, low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS), and SIDS |
| Do newborns have a preference for still or moving objects? | Moving objects, along with large bright objects with curves and complex designs. |
| What is the name of the 12-step program believed to be the most successful for the treatment of alcohol abuse? | Alcoholics Anonymous |
| 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 serotonin reuptake inhibitor's major sexual side effect is priapism? | Trazodone |
| 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 part of the ANS is affected in the biofeedback model of operant conditioning? | The biofeedback model is based on the parasympathetic nervous system. |
| The proportion of truly diseased persons in the screened population who are identified as diseased refers to? | Sensitivity (it deals with the sick) |
| How far below ideal body weight are patients with anorexia nervosa? | At least 15% |
| 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. |
| What is the term for an inhibited female orgasm? | Anorgasmia. (The overall prevalence is 30%.) |
| 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 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 type of bias is it when the sample population is not a true representative of the population? | Selection bias |
| 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 period between falling asleep and REM sleep called? | REM latency; normally it is about 90 minutes. |
| 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 drug is used to prevent alcohol consumption by blocking aldehyde dehydrogenase? | Disulfiram |
| According to Freud, what facet of the psyche represents the internalized ideals and values of one's parents? | Superego |
| 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 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 somatoform disorder is described as • La belle indifférence, suggestive of true physical ailment because of alteration of function? | Conversion disorder |
| What somatoform disorder is described as • Unrealistic negative opinion of personal appearance, seeing self as ugly? | Body dysmorphic disorder |
| 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 somatoform disorder is described as • Severe, prolonged pain that persists with no cause being found, disrupts activities of daily living? | Somatoform pain disorder |
| What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable? | One-way ANOVA |
| 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. |
| In Parkinson's disease, what area of the basal ganglia has a decreased amount of dopamine? | Substantia nigra |
| What naturally occurring substances mimic the effects of opioids? | Enkephalins |
| 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 |
| 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. |
| 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) |
| To what does failure to resolve separation anxiety lead? | School phobia |
| What is the term to describe the average? | Mean |
| How does L-tryptophan affect sleep? | It increases REM and total sleep time. |
| 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. |
| 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. |
| What is the name of the hypothesis you are trying to prove? | Alternative hypothesis (what is left after the null has been defined) |
| What percent of unwed mothers are teenagers? | 50%, with 50% of them having the child |
| 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 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.) |
| 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.) |
| What is the term to describe jumping from one topic to the next without any connection? | Loose association |
| What is the leading cause of school dropout? | Pregnancy |
| 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 happens to cortisol levels in sleep-deprived individuals? | Cortisol levels increase. Lymphocyte levels decrease in sleep-deprived individuals. |
| What is the period between going to bed and falling asleep called? | Sleep latency |
| 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 form of conditioning is defined as a new response to an old stimulus resulting in a consequence? | Operant conditioning (reinforcement is after a response) |
| What pituitary hormone is inhibited during sleep? | TSH. 5-HT and prolactin increase during sleep, and dopamine levels decrease during sleep. |
| Based on operant conditioning, what type of reinforcement is described when • Adding a stimulus stops a behavior? | Punishment |
| Based on operant conditioning, what type of reinforcement is described when • Removing a stimulus stops a behavior? | Extinction |
| Based on operant conditioning, what type of reinforcement is described when • Adding a stimulus reinforces a behavior? | Positive reinforcement |
| Based on operant conditioning, what type of reinforcement is described when • Removing a stimulus reinforces a behavior? | Negative reinforcement |
| What is the formula to calculate IQ? | (MA/CA) x 100 |
| What happens to NE levels in • Major depression? | Decrease (5-HT and dopamine levels do the same) |
| What happens to NE levels in • Bipolar disorder? | Increase (5-HT and dopamine levels do the same) |
| 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 is the term for the number of new events occurring in a population divided by the population at risk? | Incidence rate |
| 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 classical conditioning therapy or modification is described as • Pairing noxious stimuli to an inappropriate behavior? | Aversive conditioning |
| 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 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 |
| Failure to accurately recall the past leads to what form of bias? | Recall bias. These problems arise in retrospective studies. |
| 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 potentially lethal side effect of clozapine should be monitored with frequent blood drawing? | Agranulocytosis; approximately 2% develop this side effect. |
| 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. |
| What is the term for the rate measured for a subgroup of a population? | Specific rate (e.g., men aged 55-60) |
| In what stage of psychosexual development, according to Freud, do children resolve the Oedipus complex? | Latency stage (6-12 years) |
| Where is lithium metabolized and excreted? | 95% in the kidneys; that's why adequate Na+ and fluid intake is essential. |
| 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. |
| 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 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 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 subtype of schizophrenia is characterized by • Stuporous mute echopraxia and automatic obedience, waxy flexibility with rigidity of posture? | Catatonic schizophrenia |
| What subtype of schizophrenia is characterized by • Delusions of persecution and/or grandeur, auditory hallucinations, late onset, and the best prognosis? | Paranoid schizophrenia |
| 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. |
| Does alcoholism increase the rate of suicide? | Yes. It increases the rate of suicide to nearly 50 times that of the general population. |
| 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 is the term for the difference between the highest and the lowest score in a population? | Range |
| How is sleep affected in a person with alcohol intoxication? | Decreased REM sleep and REM rebound during withdrawal |
| 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.) |
| 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. |
| 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. |
| 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. |
| Can advance directives be oral? | Yes |
| 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) |
| Is marital satisfaction higher for couples with or without children? | Without children (but don't think about this one for too long) |
| At what age does IQ stabilize? | From age 5 onward IQ stabilizes. |
| Name the aphasia based on these characteristics: • Nonfluent speech, telegraphic and ungrammatical; lesion in Brodmann's area 44; unimpaired comprehension | Broca's aphasia |
| Name the aphasia based on these characteristics: • Lesion in the prefrontal cortex; inability to speak spontaneously; unimpaired ability to repeat | Transcortical aphasia |
| 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 | Conduction aphasia |
| 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 |
| 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 rare form of dementia is associated with personality changes and affects the frontal and temporal lobes? | Pick's disease |
| Which drug is used to treat respiratory depression associated with an overdose of opioids? | Naloxone or naltrexone |
| What rate is indicated by 1-specificity? | False-positive rate |
| 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. |
| 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: • Delta waves | Stage 3 and 4 |
| Name the stages of sleep with these EEG patterns: • Sawtooth waves, random low voltage pattern | REM |
| Name the stages of sleep with these EEG patterns: • Alpha waves | Being awake |
| Name the stages of sleep with these EEG patterns: • Sleep spindles, K-complexes | Stage 2 |
| What is the drug of choice for treating ADHD? | Methylphenidate (Ritalin) |
| True or false? Prolactin levels can serve as a rough indicator of overall dopamine activity. | True. PIF is dopamine in the tuberoinfundibular system. |
| What is the term for failure to give up infantile patterns of behavior for mature ones? | Fixation (arrested development) |
| Is masturbation considered an abnormal sexual practice? | No. It is abnormal only if it interferes with normal sexual or occupational function. |
| Which benzodiazepine has the longest half-life? | Flurazepam |
| 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 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. |
| Name these anxiety defense mechanisms: • Separating oneself from the experience. The facts are accepted but the form is changed for protection. | Dissociation |
| Name these anxiety defense mechanisms: • Use of explanations to justify unacceptable behaviors. | Rationalization |
| Outburst to cover up true feelings (emotion is covered, not redirected). | Acting out |
| Use of an outlet for emotions (stuff flows downhill). | Displacement |
| Fact without feeling (la belle indifférence) | Isolation of affect |
| Replacing normal affect with "brain power" | Intellectualization |
| Unconsciously forgetting(forgetting that you forgot something!) | Repression |
| Fixing impulses by acting out the opposite of an unacceptable behavior | Undoing |
| Setting up to be let down (it is unconscious; if conscious, you're just rude) | Passive-aggressive |
| 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 |
| Name these cluster A personality disorders: • Odd, strange; has magical thinking; socially isolated, paranoid, lacks close friends; has incongruous affect | Schizotypal |
| Name these cluster A personality disorders: • Socially withdrawn, seen as eccentric but happy to be alone | Schizoid |
| 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 statistical method do you use when analyzing • Cross-sectional studies? | Chi-square. |
| What statistical method do you use when analyzing • Cohort studies? | Relative risk and/or attributable risk. (Cohort studies deal with incidence.) |
| What statistical method do you use when analyzing • Case control studies? | Odds ratio. (Case control studies deal with prevalence.) |
| 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. |
| 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. |
| 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.) |
| 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.) |
| What is the primary method of nonverbal communication of emotional states? | Facial expression (the second is vocal intonation) |
| What type of mortality rate is defined as the number of deaths • In the population? | Crude mortality rate |
| What type of mortality rate is defined as the number of deaths • From a specific cause per population? | Cause-specific mortality rate |
| What type of mortality rate is defined as the number of deaths • From a specific cause per all deaths? | Proportionate mortality rate |
| 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 |
| 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. |
| 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. |
| 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.) |
| The probability that a person with a positive test result is truly positive refers to what value? | Positive predictive value |
| 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). |
| 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.) |
| 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 type of scale is graded into equal increments, showing not only any difference but how much? | Interval scale (a ruler, for example) |
| With what stage of sleep are bruxisms associated? | Teeth grinding is associated with stage 2 sleep. |
| What rate is indicated by 1- sensitivity? | False-negative rate |
| 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 is the name of depression and mania alternating within a 48-to 72-hour period? | Rapid cycling bipolar disorder |
| 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. |
| What is the teratogenic effect associated with lithium? | Epstein-cardiac anomaly of the tricuspid valve |
| What is the triad of NPH? | Dementia Urinary incontinence Gait apraxia (NPH wet, wacky, wobbly) |
| True or false? Only men have refractory sexual periods. | Sad but true. Some women can have multiple successive orgasms. |
| 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) |
| Name these mature defense mechanisms: • Preparing for an upcoming event | Anticipation |
| Name these mature defense mechanisms: • Helping others without expecting any return | Altruism |
| 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 |
| Name these mature defense mechanisms: • Forgetting on purpose (so you can actually remember it) | Suppression |
| Name these mature defense mechanisms: • Easing anxiety with laughter | Humor |
| 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-orde | Frontal lobe |
| Name the area of the cerebral cortex with the function described: • Language, memory, and emotion (Hint: herpesvirus infects here commonly) | Temporal lobe |
| 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 |
| Name the area of the cerebral cortex with the function described: • Initiation and control of movements | Basal ganglia |
| Name the area of the cerebral cortex with the function described: • Skill-based memory, verbal recall, balance, refined voluntary movements | Cerebellum |
| Name the area of the cerebral cortex with the function described: • Important for REM sleep; origin of NE pathway | Pons |
| Name the area of the cerebral cortex with the function described: • Motivation, memory, emotions, violent behaviors, sociosexual behaviors, conditioned responses | Limbic system |
| Name the area of the cerebral cortex with the function described: • Recall of objects, distances, and scenes; visual input processed here | Occipital lobe |
| What is the degree to which two measures are related? Does it imply causation? | Correlation. No, correlation does not imply causation. |
| 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.) |
| What is the only drug that does not have an intoxication? | Nicotine (but it sure has a nasty withdrawal!) |
| What is the term to describe homosexuals who • Are comfortable with their own person and agree with their sense of self? | Ego syntonic |
| What is the term to describe homosexuals who • Are uncomfortable with their own person and disagree with their sense of self? | Ego dystonic |
| Which benzodiazepine has the shortest half-life? | Triazolam |
| 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 are the two ways to leave the prevalence pot? | Recovery and death |
| What aspects of sleep are affected during benzodiazepine use? | REM and stage 4 sleep; they decrease. |
| What is the term to describe a man who has • Never been able to achieve an erection? | Primary erectile disorder |
| 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 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 stage of sleep is associated with somnambulism? | Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep. |
| 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? |
| 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! |
| Can a patient refuse life-saving treatment for religious reasons? | Yes. (Remember, Jehovah's witnesses refuse blood transfusions.) |
| 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 type of hallucination occurs during awakening? | Hypnopompic hallucinations occur during awakening, whereas hypnagogic hallucinations occur while one is falling asleep. |
| 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. |
| 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. |
| 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? Serious psychiatric illness is more common after abortion than childbirth. | False. Childbirth carries five times as much risk of serious psychiatric illness as abortion. |
| 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.) |
| 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%. |
| 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. |
| 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 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. |
| 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 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 form of depression is due to abnormal metabolism of melatonin? | Seasonal affective disorder (treat with bright light therapy) |
| 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 tho |
| What operant conditioning therapy or modification is described as • Reinforcing successive attempts that lead to the desired goal (gradual improvement)? | Shaping (successive approximation) |
| What operant conditioning therapy or modification is described as • Having a stimulus take over the control of the behavior (unintentionally)? | Stimulus control |
| 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 operant conditioning therapy or modification is described as • Removing a reinforcement (without the patient knowing) gradually over time to stop a condition? | Fading |
| What operant conditioning therapy or modification is described as • Stopping the reinforcement that is leading to an undesired behavior? | Extinction |
| 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 • 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 • 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 • Global assessment of function? | Axis V |
| 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 |
| 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. |
| In regard to motor development during infancy, choose the motor response that happens first. • Release or grasp | Grasp proceeds release |
| In regard to motor development during infancy, choose the motor response that happens first. • Proximal or distal progression | Proximal to distal progression |
| In regard to motor development during infancy, choose the motor response that happens first. • Radial or ulnar progression | Ulnar to radial progression |
| 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 are the strongest determinants of gender identity? | Parental assignment and culture (not biology) |
| With what stage of sleep are night terrors associated? | NREM sleep. Night terrors are dreams that we are unable to recall. |
| What type of bias is it when the information is distorted because of the way it is gathered? | Measurement bias |
| What term describes senseless repetition of words or phrases? | Verbigeration |
| Who decides competency and sanity? | The courts. These are legal, not medical terms. |
| Name these narcissistic defense mechanisms: • Everything in the world is perceived as either good or bad . No middle ground; it is all extremes. | Splitting |
| Name these narcissistic defense mechanisms: • Not allowing reality to penetrate because afraid of becoming aware of painful aspect of reality. | Denial |
| 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 |
| 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 condit |
| 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. |
| 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 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 h | Dorsal prefrontal cortex |
| 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 |
| 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. • Withdrawn, fearful, explosive moods, violent outbursts, and loss of inhibitions | Orbitomedial frontal lobe |
| 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. • Denies being blind, cortical blindness | Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions) |
| 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 |
| 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. |
| 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) |
| 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 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. |
| If one event precludes another event, their probabilities are combined by what method? | Addition (They are mutually exclusive.) |
| 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. |
| 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 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. |
| What renal side effect is commonly seen in patients taking lithium? | Nearly 25% of patients taking lithium develop polyuria and polydipsia. |
| 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 is the term for repetitive actions blocking recurring bad thoughts? | Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts. |
| 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? 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. |
| In what study, for ethical reasons, is no group left out of intervention? | Crossover study |
| Shuffling gait, cogwheel rigidity, masklike facies, pill-rolling tremor, and bradykinesia describe what form of dementia? | Parkinson's disease |
| 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 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. |
| The most frequent number occurring in a population is what? | Mode |
| Movement disorders are associated with what dopamine pathway (what part of the brain)? | Nigrostriatal pathways (basal ganglia) |
| What neurotransmitter is associated with sedation and weight gain? | Histamine |
| The probability that a person with a negative test result is truly disease free refers to what value? | Negative predictive value |
| 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. |
| What P value defines whether the hull hypothesis should or should not be rejected? | P |
| What hormone level increases in the first 3 hours of sleep? | Prolactin |
| What is the most widely used class of antidepressants? | SSRIs |
| 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 primary predisposing factor for vascular dementia? | Hypertension |
| What paraphilia is defined as • Sexual urges toward children? | Pedophilia |
| What paraphilia is defined as • Deriving sexual pleasure from watching others having sex, grooming, or undressing? | Voyeurism |
| What paraphilia is defined as • Having a recurrent desire to expose the genitals to strangers? | Exhibitionism |
| What paraphilia is defined as • Deriving sexual pleasure from other peoples' pain? | Sadism |
| What paraphilia is defined as • Deriving sexual pleasure from being abused or in pain? | Masochism |
| What paraphilia is defined as • Having sex with cadavers? | Necrophilia |
| What paraphilia is defined as • Sexual fantasies or practices with animals? | Zoophilia |
| What paraphilia is defined as • Combining sex with defecation? | Coprophilia |
| What paraphilia is defined as • Combining sex with urination? | Urophilia |
| What paraphilia is defined as • A male rubbing his genitals on a fully clothed female to achieve orgasm? | Frotteurism |
| Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body. | ACh; think about the ANS. |
| What are the pharmacologic effects seen sexually with • α1-Blockers? | Impaired ejaculation |
| What are the pharmacologic effects seen sexually with • Serotonin? | Inhibited orgasm |
| What are the pharmacologic effects seen sexually with • β-Blockers? | Impotence |
| What are the pharmacologic effects seen sexually with • Trazodone? | Priapism |
| What are the pharmacologic effects seen sexually with • Dopamine agonists? | Increased erection and libido |
| What are the pharmacologic effects seen sexually with • Neuroleptics? | Erectile dysfunction |
| 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) |
| True or false? Pregnancy ensures emancipation. | FALSE |
| 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. |
| What happens to prevalence as incidence increases? | Prevalence increases. |
| What type of correlation compares two interval variables? | Pearson correlation |
| 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 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 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 |
| 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 |
| 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 type of random controlled test is least subjective to bias? | Double-blind study. It is the most scientifically rigorous study known. |
| 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 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 AA is the major carrier of nitrogen byproducts from most tissues in the body? | Glutamine |
| What two AAs have a pKa of 4? | Aspartic acid and glutamic acid |
| 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 topoisomerase makes ssDNA cuts, requires no ATP, relaxes supercoils, and acts as the swivel in front of the replication fork? | Topoisomerase I (Relaxase) |
| In prokaryotes, what is the name of the RNA sequence that ribosomes bind to so translation can occur? | Shine-Dalgarno sequence |
| 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 | Autosomal recessive |
| What factors are needed for translation in prokaryotes? | Elongation factor-G and GTP |
| What three AAs must patients with maple syrup urine disease not eat? | Isoleucine, leucine, and valine |
| How many high-energy bonds are used to activate an AA? | 2 ATPs, via the amino acyl tRNA synthase enzyme |
| What water-soluble vitamin deficiency results in pellagra? | Niacin (B3) |
| What glycolytic enzyme has a high Vmax, high Km, and low affinity for glucose? | Glucokinase |
| How many ATPs are generated per acetyl coenzyme A (CoA)? | 12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle) |
| What cytoplasmic pathway produces NADPH and is a source of ribose 5-phosphate? | HMP shunt |
| What is the main inhibitor of pyruvate dehydrogenase? | Acetyl CoA (pyruvate to acetyl CoA) |
| 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 DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum? | Excision endonuclease, which removes thiamine dimers from DNA |
| What form of bilirubin is carried on albumin? | Unconjugated (indirect) |
| What are the two ketogenic AAs? | Leucine and lysine |
| Which organisms have polycistronic mRNA? | Prokaryotes. Polycistronic and prokaryotes both start with P. |
| As what compound do the carbons for fatty acid synthesis leave the mitochondria? | Citrate, via the citrate shuttle |
| What four substances increase the rate of gluconeogenesis? | 1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP |
| 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 |
| What test uses very small amounts of DNA that can be amplified and analyzed without the use of Southern blotting or cloning? | PCR |
| What apoprotein is required for the release of chylomicrons from the epithelial cells into the lymphatics? | apo B-48 |
| 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 must be supplemented in patients with medium-chain acyl CoA dehydrogenase (MCAD) deficiency? | Short-chain fatty acids |
| What form of AA is found only in collagen? | Hydroxyproline |
| In a diabetic patient, to what does aldose reductase convert glucose? | Sorbitol (resulting in cataracts) |
| What enzyme catalyzes the rate-limiting step in cholesterol metabolism? | HMG-CoA reductase |
| What is the term for the pH at which the structure carries no charge? | pI (isoelectric point) |
| What enzyme catalyzes the rate-limiting step in gluconeogenesis? | Fructose-1, 6-bisphosphatase |
| What is the drug of choice in treating a patient with hyperuricemia due to underexcretion of uric acid? | Probenecid, a uricosuric agent |
| What enzyme deficiency results in darkening of the urine when exposed to air? | Homogentisate oxidase deficiency is seen in patients with alcaptonuria. |
| In eukaryotes, what transcription factor binds to the TATA box before RNA polymerase II can bind? | Transcription factor IID |
| 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 |
| What enzyme catalyzes the rate-limiting step in fatty acid synthesis? | Acetyl CoA carboxylase |
| 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 lagging strand during replication | DNA polymerase-α |
| Name the eukaryotic DNA polymerase based on the following information: • Synthesizes the leading strand during replication | DNA polymerase-δ |
| 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 |
| 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 enzyme of pyrimidine synthesis is inhibited by the following? • 5-FU | Thymidylate synthase |
| What enzyme of pyrimidine synthesis is inhibited by the following? • Methotrexate | Dihydrofolate reductase |
| What enzyme of pyrimidine synthesis is inhibited by the following? • Hydroxyurea | Ribonucleotide reductase |
| 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 gluconeogenic mitochondrial enzyme requires biotin? | Pyruvate carboxylase |
| What factors are needed for translocation in eukaryotes? | EF-2 and GTP |
| DNA replication occurs during what phase of the cell cycle? | S phase |
| What is the end product of purine catabolism? | Uric acid |
| What causes transcription to stop in eukaryotes? | The poly(A) site on the DNA |
| What enzyme of the TCA cycle catalyzes the production of the following: • FADH2 | Succinate dehydrogenase |
| What enzyme of the TCA cycle catalyzes the production of the following: • GTP | Succinyl CoA synthetase |
| What enzyme of the TCA cycle catalyzes the production of the following: • NADH (hint: 3 enzymes) | Isocitrate dehydrogenase, α-ketoglutarate dehydrogenase, and malate dehydrogenase |
| What form of alcohol causes blindness? | Methanol (wood alcohol) |
| 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. |
| What are the two essential fatty acids? | Linoleic acid and linolenic acid |
| 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 type of jaundice is seen in Rotor's syndrome? | Conjugated (direct) hyperbilirubinemia |
| If a sample of DNA has 30% T, what is the percent of C? | Solved as 30% T + 30% A |
| From where is the energy for gluconeogenesis derived? | β-Oxidation of fatty acids |
| Name the type of mutation: • The deletion or addition of a base | Frameshift |
| Name the type of mutation: New codon specifies a different AA | Missense |
| Name the type of mutation: • Unequal crossover in meiosis with loss of protein function | Large segment deletions |
| Name the type of mutation: • New codon specifies for the same AA | Silent |
| Name the type of mutation: • New codon specifies for a stop codon | Nonsense |
| What form of bilirubin can cross the blood-brain barrier? | Unconjugated free bilirubin |
| What AA is broken down into N2O, causing an increase in cyclic guanosine monophosphate (cGMP) of smooth muscle, hence vasodilation? | Arginine |
| What three things are needed to produce a double bond in a fatty acid chain in the endoplasmic reticulum? | NADPH, O2, and cytochrome b5 |
| What are the vitamin K-dependent coagulation factors? | Factors II, VII, IX, X, and proteins C and S |
| 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. |
| 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 the enzyme for the oxidative reaction in glycolysis? | Glyceraldehyde dehydrogenase |
| What substrate builds up in Tay-Sachs disease? | GM2 ganglioside Caused by a deficiency of β-hexosaminidase A |
| 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 rate-limiting enzyme of glycogen synthesis? | Glycogen synthase |
| What sphingolipid is formed by the union of serine and palmitoyl CoA? | Sphingosine |
| What causes an increase in bone mineralization and Ca2+ along with PO4- absorption from the GI tract and kidney tubules? | Vitamin D |
| What two sugars can be used to produce cerebrosides? | Glucose and galactose |
| What group of eukaryotic regulatory proteins has a major factor in controlling the gene expression embryonically? | Homeodomain proteins |
| 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. |
| All AAs have titration plateaus at what pH values? | pH of 2 and 9 |
| What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA? | SER |
| What is the binding site for RNA polymerase? | The promoter indicates where transcription will begin. |
| What vitamin is necessary for epithelial health? | Vitamin A is responsible for vision and epithelial health. |
| What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle? | LDL |
| What structure of a protein describes the interaction among subunits? | Quaternary structure |
| What is the only factor of enzyme kinetics that the enzyme affects? | Ea (activation energy) |
| 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. |
| At the end of each round of β-oxidation, what is released? | Acetyl CoA, FADH2, and NADH |
| What is the rate-limiting enzyme on glycolysis? | Phosphofructokinase-1 and costs 1 ATP |
| What enzyme of heme synthesis is deficient in the autosomal dominant disorder acute intermittent porphyria? | Uroporphyrinogen-I synthase |
| What enzyme is blocked by disulfiram? | Aldehyde dehydrogenase |
| Deficiencies in what enzyme result in insoluble glycogen synthesis formation? | α-1, 6 transferase |
| What eukaryotic translation enzyme is associated with the following: • Initiation | eIF-2 in the P site |
| What eukaryotic translation enzyme is associated with the following: • Elongation | eEF-1 |
| 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. |
| What AA undergoes N-glycosylation? | Asparagine |
| What is the pyrimidine intermediate that joins PRPP (5-Phosphoribosyl-1-Pyrophosphate)? | Orotic acid (purine metabolism) |
| What intermediate of cholesterol synthesis anchors proteins in the membranes and forms CoA? | Farnesyl pyrophosphate (FPP) |
| What AA is a phenol? | Tyrosine |
| What hormone is activated in adipose tissue when blood glucose levels decrease? | Hormone-sensitive lipase |
| How many NADPHs are used per addition of acetyl CoA into a fatty acid chain? | 2 NADPHs per acetyl CoA |
| What factors are needed for elongation in eukaryotes? | EF-1 and GTP |
| What purine base is contained in inosine monophosphate? | Hypoxanthine (remember, IMP is a precursor for AMP and GMP) |
| What are the two ways that nitrogen can enter into the urea cycle? | Aspartate and carbomoyl PO4- |
| What two requirements must be met for the Lac operon to be activated? | Lactose must be present and glucose must be absent |
| Name the phase of the eukaryotic cell cycle: • Period of cellular growth (translation and transcription) before DNA synthesis | G1 phase (gap 1) |
| Name the phase of the eukaryotic cell cycle: • Period of cellular growth (translation and transcription) after DNA synthesis | G2 phase (gap 2) |
| Name the phase of the eukaryotic cell cycle: • Period of DNA replication (preparing for mitosis) | S phase |
| Name the phase of the eukaryotic cell cycle: • Cells cease replicating (i.e., nerve cell) | G0 phase |
| 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. |
| What enzyme of the TCA cycle catalyzes the substrate level phosphorylation? | Succinyl CoA synthetase |
| What apoprotein on HDL activates lecithin-cholesterol acyltransferase (LCAT)? | apo A-1 |
| What three AAs are used to synthesize the purine ring? | 1. Glycine 2. Aspartate 3. Glutamine |
| How many ATPs are produced from cytoplasmic NADH oxidation using the glycerol phosphate shuttle? | 2 ATPs by oxidative phosphorylation |
| What enzyme is deficient in patients with PKU? | Phenylalanine hydroxylase |
| What three steps of the TCA cycle generate NADH? | 1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. α-Ketoglutarate dehydrogenase |
| What two enzymes of heme synthesis are inhibited by lead? | ALA dehydrogenase and ferrochelatase |
| What enzyme, induced by insulin and activated by apo C-II, is required for chylomicron and VLDL metabolism? | Lipoprotein lipase |
| What is the most common genetic deficiency resulting in hemolytic anemia? | G-6-PD deficiency; pyruvate kinase deficiency is second. |
| 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? • 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? • Uncontrolled DM | 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? • Infection | Negative |
| Are the following conditions associated with a negative or positive nitrogen balance? • Recovery from injury | Positive |
| Are the following conditions associated with a negative or positive nitrogen balance? • Kwashiorkor | Negative |
| Why is the liver unable to metabolize ketone bodies? | Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase). |
| What toxin ADP-ribosylates via Gs protein to increase cAMP? | Cholera toxin |
| What two vitamins are inactivated when they come in contact with acetaldehyde? | Thiamine and folate |
| Name the end product or products: • Fatty acid synthesis | Palmitate |
| Name the end product or products: • Fatty acid oxidation | Acetyl CoA and propionyl CoA (in odd chain fatty acids) |
| What is the term for production of a DNA copy from an RNA molecule? | Reverse transcription |
| What two monosaccharides are produced when lactose is hydrolyzed? | Galactose and glucose |
| What mineral is required for cross-linking of collagen molecules into fibrils? | The enzyme lysyl oxidase requires Cu2+and O2 to function properly. |
| What blotting technique uses the following for analysis? • DNA | Southern blot |
| What blotting technique uses the following for analysis? • Protein | Western blot |
| What blotting technique uses the following for analysis? • RNA | Northern blot |
| 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 |
| What enzyme of purine synthesis is inhibited by allopurinol and 6-mercaptopurine? | PRPP aminotransferase |
| 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. |
| What is the only fatty acid that is gluconeogenic? | Propionic acid |
| What enzyme has a 5' to 3' synthesis of the Okazaki fragments, 3' exonuclease activity, and 5' exonuclease activity? | DNA polymerase I |
| In what organelle does the TCA cycle occur? | Mitochondria |
| 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 enzyme is deficient in selective T cell immunodeficiency? | Purine nucleoside phosphorylase |
| True or false? Adipose tissue lacks glycerol kinase. | True. Adipose depends on glucose uptake for dihydroxyacetone phosphate (DHAP) production for triglyceride synthesis. |
| In what form is excess folate stored in the body? | N-5-methyl THF |
| What is the term for taking an mRNA molecule and arranging the AA sequence forming a protein? | Translation |
| What enzyme is blocked by hydroxyurea? | Ribonucleotide reductase |
| What protein carries free fatty acids to the liver? | Albumin |
| What substrate is built up in Niemann-Pick disease? | Sphingomyelin |
| True or false? Methylation of bacterial DNA prevents restriction endonuclease from cutting its own chromosomes. | True. Restriction endonucleases cut only unmethylated DNA. |
| What two AAs have a pKa of 10? | Lysine and tyrosine |
| What is the only enzyme in the body that uses N-5-methyl folate? | Homocysteine methyl transferase |
| 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 unit of DNA that encodes a particular protein or RNA molecule? | A gene (a rather simple definition but accurate) |
| 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. |
| What enzyme is deficient in acute intermittent porphyria? | Uroporphyrinogen I synthetase |
| 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 pattern of genetic transmission affects only M and has no M-to-M transmission, and mother is usually an unaffected carrier? | X-linked recessive |
| To what does aldose reductase convert galactose? | Galactitol |
| Name three purine bases that are not found in nucleic acids. | Xanthine, hypoxanthine, theophylline, theobromine, caffeine, and uric acid are all purines. |
| What water-soluble-vitamin deficiency is associated with cheilosis and magenta tongue? | Riboflavin (B2) |
| What is the precursor of all sphingolipids? | Ceramide |
| What three substances stimulate glycogenolysis? | 1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon |
| 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 factors are needed for elongation in prokaryotes? | EF-Tu or EF-ts and GTP |
| What restriction endonuclease site is destroyed in sickle β-globin allele? | MstII; changing codon 6 (from A to T) destroys the restriction site. |
| What complex is needed for propionyl CoA carboxylase? | Biotin, ATP, and CO2 |
| What enzyme catalyzes the reversible oxidative deamination of glutamate and produces the TCA cycle intermediate α-ketoglutarate? | Glutamate dehydrogenase |
| What enzyme is deficient in congenital erythropoietic porphyria? | Uroporphyrinogen III cosynthase |
| What is the drug of choice for treating a patient with hyperuricemia due to overproduction of uric acid? | Allopurinol |
| What is the maximum rate possible with a given amount of enzyme? | Vmax |
| From what do catalase, superoxide dismutase, and glutathione peroxidase defend the cell? | Production of oxygen free radicals |
| What signals are used to direct an enzyme to a lysosome? | Phosphorylation of mannose residues |
| What enzyme catalyzes the rate-limiting step of the urea cycle? | Carbamoyl phosphate synthetase I |
| What liver enzyme, for triglyceride synthesis, converts glycerol to glycerol-3-phosphate? | Glycerol kinase |
| 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 |
| What pattern of inheritance does G-6-PD deficiency follow? | X-linked recessive |
| 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) |
| Via what cell surface receptor does HDL cholesterol from the periphery enter hepatoceles? | Scavenger receptor (SR-B1) |
| Which shuttle is used to bring fatty acyl CoA from the cytoplasm for ketogenesis? | Carnitine acyl CoA transferase II |
| What enzyme is blocked by 5-FU? | Thymidylate synthetase |
| What disease has a genetically low level of UDPglucuronate transferase, resulting in elevated free unconjugated bilirubin? | Gilbert's syndrome |
| What AA has a pKa of 13? | Arginine |
| What X-linked recessive disorder is characterized by hyperuricemia, spastic cerebral palsy, mental retardation, and self-mutilation? | Lesch-Nyhan syndrome |
| How many ATPs per glucose are generated from glycolysis in RBCs? | 2 ATPs, because RBCs use only anaerobic metabolism. |
| What enzyme catalyzes the rate-limiting step in glycogenolysis? | Glycogen phosphorylase |
| 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. |
| As what AAs do muscles send nitrogen to the liver? | Alanine and glutamine |
| What sphingolipid cannot be produced without sialic acid and amino sugars? | Ganglioside |
| What happens to affinity if you increase Km? | Affinity decreases; they are inversely proportional. |
| What type of bilirubin is found in neonatal jaundice? | Indirect or unconjugated |
| What two AAs do not have more than one codon? | Methionine (start) and tryptophan are the only two AAs with only one codon. |
| What bonds are broken by exonucleases? | External 3', 5' PDE bonds |
| 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. |
| Name the lipoprotein based on the following characteristics. • apo E | IDL |
| Name the lipoprotein based on the following characteristics. • apo B-100 | LDL |
| Name the lipoprotein based on the following characteristics. • apo E, apo B-100, apo C-II | VLDL |
| Name the lipoprotein based on the following characteristics. • apo A-1, apo E, apo C-II | HDL |
| Name the lipoprotein based on the following characteristics. • apo E, apo C-II, apoB-48 | Chylomicrons |
| 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. |
| What are the three tissues where triacylglycerols are produced? | 1. Liver 2. Muscle 3. Adipose tissue |
| What toxin ADP-ribosylates via Gi to increase cAMP? | Pertussis toxin |
| What enzyme catalyzes the rate-limiting step in heme synthesis? | δ-ALA synthase |
| What cycle is responsible for converting to glucose in the liver the lactate produced in the RBCs? | Cori cycle |
| What enzyme is used to remove the hairpin loop during production of cDNA from mRNA? | S1 nuclease |
| Does a saturated fatty acid have double bonds? | No, unsaturated fatty acids have double bonds. |
| What pyrimidine base is found • Only in RNA? | Uracil |
| What pyrimidine base is found • Only in DNA? | Thymine |
| What pyrimidine base is found • In both DNA and RNA? | Cytosine |
| What two AAs require vitamin C for hydroxylation? | Proline and lysine |
| What is the only organ in the body that can produce ketone bodies? | The liver (in the mitochondria) |
| What determines the rate of reaction? | The energy of activation |
| 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 enzyme is blocked by methotrexate/ trimethoprim? | Dihydrofolate reductase |
| 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. |
| What enzyme catalyzes the rate-limiting step in purine synthesis? | PRPP aminotransferase |
| What water-soluble-vitamin deficiency is associated with poor wound healing, easy bruising, bleeding gums, anemia, and painful glossitis? | Vitamin C |
| 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 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. |
| What two glycolytic enzymes catalyze the substrate-level phosphorylations? | 3-Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs) |
| What pathway uses HMG CoA synthetase in the cytoplasm? | Cholesterol biosynthesis |
| Where in the body is heme converted to bilirubin? | RES(Reticular endothelial system) |
| What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA? | Sigma factor |
| What enzyme catalyzes the rate-limiting step in pyrimidine synthesis? | Aspartate transcarbamylase |
| What are the two actions of calcitonin? | It increases Ca2+ excretion from the kidney and increases bone mineralization. |
| What enzyme of the purine salvage pathway is deficient in the following? • Selective T-cell immunodeficiency | Purine nucleoside phosphorylase |
| What enzyme of the purine salvage pathway is deficient in the following? • SCID | Adenosine deaminase |
| What enzyme of the purine salvage pathway is deficient in the following? • Lesch-Nyhan syndrome | HGPRT |
| 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 is the primary end product of pyrimidine synthesis? | UMP |
| What pyrimidine base is produced by deaminating cytosine? | Uracil |
| 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. |
| What enzyme is deficient in hereditary protoporphyria? | Ferrochelatase |
| What elongation factor is inactivated by ADP ribosylation, preventing translation? | eEF-2 is the site where Pseudomonas and Diphtheria toxins work. |
| Is linolenic acid an omega-3 or omega-6 fatty acid? | Omega-3; linoleic is omega-6 |
| 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] |
| Name the three ketone bodies. | Acetoacetate, acetone, and β-hydroxybutyrate |
| What three bases are pyrimidines? | 1. Cytosine 2. Uracil (only in RNA) 3. Thymidine |
| 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: • Only type of RNA that is translated | mRNA |
| Name the RNA subtype based on the following: • Carries AA to the ribosome for protein synthesis | tRNA |
| Name the RNA subtype based on the following: • RNA molecules with enzymatic activity | Ribozymes |
| Name the RNA subtype based on the following: • Found only in the nucleus of eukaryotic cells and are precursors of mRNA | hnRNA |
| What enzyme is deficient in the following glycogen storage disease? • von Gierke's disease | Glucose-6-phosphatase |
| What enzyme is deficient in the following glycogen storage disease? • Pompe's disease | Lysosomal α-1, 4-glucosidase |
| What enzyme is deficient in the following glycogen storage disease? • McArdle's disease | Muscle glycogen phosphorylase |
| What enzyme is deficient in the following glycogen storage disease? • Hers' disease | Hepatic glycogen phosphorylase |
| 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 |
| What are the two most common AAs found in histones? | Lysine and arginine |
| 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 complex of the ETC contains Cu2+? | Complex 4 |
| 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) |
| What is the size of the prokaryotic ribosome? | 70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes |
| What type of fatty acid is associated with a decrease in serum triglycerides and cardiovascular disease? | Omega-3 fatty acids |
| What disease is produced by a deficiency in the enzyme tyrosinase? | Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase. |
| In what form are triglycerides sent to adipose tissue from the liver? | VLDLs |
| What determines the rate of a reaction? | The energy of activation (Ea) |
| What is the rate-limiting enzyme of the HMP shunt? | G-6-PD |
| 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 is the only sphingolipid that contains choline and PO4? | Sphingomyelin (lecithin also, but it is not a sphingolipid) |
| What protein catalyzes the formation of the last PDE bond between the Okazaki fragments to produce a continuous strand? | DNA ligase |
| What type of damage to the kidneys is caused by drinking ethylene glycol (antifreeze)? | Nephrotoxic oxylate stones |
| What water-soluble-vitamin deficiency may result from eating raw eggs? | Biotin (only if eaten in large quantities) |
| Regarding the Lac operon, for what do the following genes code? • Z gene | β-Galactosidase |
| Regarding the Lac operon, for what do the following genes code? • Y gene | Galactoside permease |
| Regarding the Lac operon, for what do the following genes code? • I gene | Lac repressor protein |
| Regarding the Lac operon, for what do the following genes code? • A gene | Thiogalactoside transacetylase |
| What attaches to protons and allows them to enter into the mitochondria without going through the ATP-generating system? | 2, 4-Dinitrophenol |
| 1-α-Hydroxylase activity is increased in response to what two physiologic states? (hint: think of vitamin D activity) | Hypocalcemia and hypophosphatemia |
| What is the major ketone body produced during alcoholic ketoacidosis? | β-Hydroxybutyrate |
| What enzyme catalyzes the rate-limiting step in the TCA cycle? | Isocitrate dehydrogenase |
| 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 |
| What bonds are broken by endonucleases? | Internal 3', 5' PDE bonds |
| 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 skeletal muscle and adipose tissues | GLUT 4 |
| Name the GLUT transporter based on the following: • Found in most tissues, including brain and RBCs | GLUT 3 and 4 |
| What enzyme catalyzes the rate-limiting step in fatty acid oxidation? | Carnitine acyltransferase-I |
| What enzyme of the TCA cycle also acts as complex II of the ETC? | Succinate dehydrogenase |
| 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) |
| In the mitochondria, what complex is needed for pyruvate carboxylase to catalyze the reaction from pyruvate to OAA? | Biotin, ATP, and CO2 |
| How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle? | 3 ATPs by oxidative phosphorylation |
| What is the rate-limiting step of the following? • Fatty acid synthesis | Acetyl CoA carboxylase |
| What is the rate-limiting step of the following? • β-Oxidation | Carnitine acyltransferase I |
| What is the rate-limiting step of the following? • Ketogenolysis | HMG CoA synthase |
| What is the rate-limiting step of the following? • Cholesterol synthesis | HMG CoA reductase |
| What direction does RNA polymerase move along the template strand of DNA during transcription? | 3'-5' direction, synthesizing RNA in the 5'-3' direction |
| True or false? Histidine activates the histidine operon. | False. Histidine operon is activated when there are low intracellular levels of histidine. |
| 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 is the only way to increase maximum velocity (Vmax)? | Increase enzyme concentrations |
| Name the two purine bases found in both DNA and RNA. | Adenine and guanine |
| What prokaryotic positioning enzyme in translation is blocked by the following? • Tetracycline | EF-Tu and EF-Ts of the 30S ribosomal subunit |
| 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? • Streptomycin | IF-2 of the 30S subunit |
| True or false? DNA polymerases can correct mistakes, whereas RNA polymerases lack this ability. | True. DNA polymerases have 3'-5' exonuclease activity for proofreading. |
| What are the two precursors of heme? | Glycine and succinyl-CoA |
| What two factors cause PTH to be secreted? | A decrease in Ca2+ and an increase in PO4- |
| 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 are the five AAs that are both ketogenic and glucogenic? | Isoleucine, threonine, tryptophan, tyrosine, and phenylalanine |
| What artificial sweetener must patients with PKU avoid? | Aspartame |
| Cri-du-chat syndrome results in a terminal deletion of the short arm of what chromosome? | Chromosome 5 |
| What substrate gets built up in Gaucher's disease? | Glucosyl cerebroside |
| What protein prevents ssDNA from reannealing during DNA replication? | Single-strand DNA binding protein |
| What type of jaundice is seen in Dubin-Johnson syndrome? | Conjugated (direct) hyperbilirubinemia, a transport defect |
| 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 is the most common cause of vitamin B6 deficiency? | Isoniazid treatment |
| What lysosomal enzyme is deficient in • Gaucher's disease? | Glucocerebrosidase |
| What lysosomal enzyme is deficient in • Niemann-Pick disease? | Sphingomyelinase |
| What lysosomal enzyme is deficient in • Tay-Sachs disease? | Hexosaminidase A |
| 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 |
| 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 |
| What is the only way to increase the Vmax of a reaction? | Increase the concentration of enzymes |
| From which two substances are phospholipids made? | Diacylglycerols and phosphatidic acid |
| What intermediate enables propionyl CoA to enter into the TCA cycle? | Succinyl CoA |
| What vitamin is an important component of rhodopsin? | Vitamin A |
| What is the term to describe the 5'-3' sequence of one strand being the same as the opposite 5'-3' strand? | Palindrome |
| What gluconeogenic enzyme is absent in muscle, accounting for its inability to use glycogen as a source for blood glucose? | Glucose-6-phosphatase |
| What is the term for vitamin D deficiency prior to epiphyseal fusion? | Rickets prior to fusion, osteomalacia if the deficiency occurs after epiphyseal fusion. |
| In what disease is there a genetic absence of UDP-glucuronate transferase, resulting in an increase in free unconjugated bilirubin? | Crigler-Najjar syndrome |
| What enzyme requires molybdenum as a cofactor? | Xanthine oxidase |
| At what three sites can the HMP shunt enter into glycolysis? | 1. Fructose-6-phosphate 2. Glucose-6-phosphate 3. Glyceraldehyde-3-phosphate |
| 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) |
| What regulates the rate of ketone body formation? | The rate of β-oxidation |
| 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 |
| 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 is needed to initiate translation? | IF and GTP (eIF for eukaryotes) |
| What part of the 30S ribosome binds to the Shine-Dalgarno sequence? | 16S subunit |
| What component of the ETC is inhibited by the following? • Barbiturates | Complex I |
| What component of the ETC is inhibited by the following? • Antimycin A | Cytochrome b/c1 |
| What component of the ETC is inhibited by the following? • Cyanide | Cytochrome a/a3 |
| What component of the ETC is inhibited by the following? • Oligomycin | Fo/F1 complex |
| What component of the ETC is inhibited by the following? • Atractyloside | ATP/ADP Translocase |
| What component of the ETC is inhibited by the following? • CO | Cytochrome a/a3 |
| What component of the ETC is inhibited by the following? • Rotenone | Complex I |
| What component of the ETC is inhibited by the following? • Azide | Cytochrome a/a3 |
| What AA is a precursor of the following substances? • Serotonin | Tryptophan |
| What AA is a precursor of the following substances? • GABA | Glutamate |
| What AA is a precursor of the following substances? • Histamine | Histidine |
| What AA is a precursor of the following substances? • Creatine | Glycine/arginine |
| What AA is a precursor of the following substances? • NAD | Tryptophan |
| What AA is a precursor of the following substances? • N2O | Arginine |
| What two enzymes are vitamin B12-dependent | Homocysteine methyl transferase and methylmalonyl CoA transferase |
| What two post-transcriptional enzymes in collagen synthesis require ascorbic acid to function properly? | Prolyl and lysyl hydroxylases |
| What three organs participate in production of vitamin D? | 1. Skin 2. Liver 3. Kidney |
| What water-soluble-vitamin deficiency is associated with neural tube defects in the fetus? | Folic acid |
| What phase of Interphase is haploid (N)? | G1 phase; G2 and S phase are diploid (2N). |
| What neurotransmitter inhibits the optic nerve bipolar cell and shuts off in response to light? | Glutamate |
| 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. |
| 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 | X-linked dominant |
| What fat-soluble vitamin is connected to selenium metabolism? | Vitamin E |
| 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 is determined by the secondary structure of an AA? | The folding of an AA chain |
| What three vitamin deficiencies are associated with homocystinemia? | Folate, vitamin B12, and vitamin B6 |
| 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. |
| What form of continuous DNA, used in cloning, has no introns or regulatory elements? | cDNA, when it is made from mRNA |
| 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. |
| What parasite found in raw fish can produce vitamin B12 deficiency? | Diphyllobothrium latum |
| Methylating uracil produces what pyrimidine base? | Thymine |
| Name the eukaryotic RNA polymerase based on the following: • Synthesizes tRNA, snRNA, and the 5S rRNA | RNA polymerase III |
| 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 28S, 18S and 5.8S rRNAs | RNA polymerase I |
| 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. |
| 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. |
| How many hydrogen bonds link A-T? C-G? | A-T are linked by 2 hydrogen bonds, C-G by 3 hydrogen bonds. |
| What DNA replication enzyme breaks the hydrogen bond of base pairing, forming two replication forks? | Helicase (requires ATP for energy) |
| 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 is the valence of an Ig molecule equal to? | The number of Ags that the Ab can bind |
| 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. |
| What is the major Ab of the primary immune response? | IgM |
| What form of immunity is responsible for removal of intracellular infections? | Cell-mediated immunity |
| True or false? Direct fluorescent Ab test is used to detect Abs in a patient? | False. Direct tests detect Ags; indirect tests detect Abs. |
| What is the triad of Wiskott-Aldrich syndrome? | Thrombocytopenia, eczema, and immunodeficiency is the triad of this X-linked recessive disorder. |
| What complement factor deficiency leads to • Increased susceptibility to pyogenic infections? | C3 deficiency |
| What complement factor deficiency leads to • Recurrent gonococcal infections? | C5-C8 deficiency |
| What complement factor deficiency leads to • Leukocyte adhesion deficiency with poor opsonization? | C1, C2, or C4 deficiency |
| What complement factor deficiency leads to • Hereditary angioedema? | C1 inhibitor (C1-INH) |
| Which IgG cannot activate complement? | IgG4 |
| 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 |
| Name the T-cell CD marker: • Expressed on all T cells and is needed as a signal transducer for the T cell receptor | CD3 |
| Name the T-cell CD marker: • Interacts with MHC class II molecules | CD4 |
| Name the T-cell CD marker: Is a costimulatory molecule in T cell activation | CD28 |
| What three cells are essential for T-cell differentiation in the thymus? | Dendritic cells, macrophages, and thymic epithelial cells |
| What is the only specific Ag-presenting cell? | B cells; macrophages and dendritic cells are nonspecific. |
| What is the tetrad of Jarisch-Herxheimer reaction? | Rigors, leukopenia, decrease in blood pressure, and increase in temperature |
| What is the name of the B cell that secretes Ig? | Plasma cell (mature B lymphocyte) |
| What would be the result if an Ab were cleaved with papain? | There would be two Fab and Fc regions. |
| What is the bone marrow maturation time for a phagocytic cell? | 14 days |
| Which leukotrienes are associated with the late-phase inflammatory response? | LTC4 and LTD4 |
| What is the term for the strength of the association between Ag and an Ab? | Affinity (one of each) |
| 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. |
| What is the term for the strength of association between multiple Abbinding sites and multiple antigenic determinants? | Avidity (more than one binding site) |
| What Ig mediates ADCC via K cells, opsonizes, and is the Ig of the secondary immune response? | IgG |
| What test is used to detect anti-RBC Abs seen in hemolytic anemia? | Coombs test |
| What subset of T cells recognizes the MHC class I Ags? | CD8+ T cells (cytotoxic) Remember, 8×1 |
| What cell surface marker is found on activated helper T cells? | CD40 |
| What are the five Ig isotypes? | IgA, IgD, IgE, IgG, and IgM |
| Which integrin mediates the adhesion to endothelial cells for migration in and out of the blood during an immune response? | Beta2-integrins |
| What type of hypersensitivity is an Ab-mediated response against our own cells, receptors, or membranes via IgG or IgM? | Type II hypersensitivity reaction |
| What is the term to describe the limited portion of an Ag that is recognized by an Ab? | Antigenic determinant (epitope) |
| What cytokine do Th1 cells secrete to inhibit Th2 cell function? | INF-gamma |
| What three cells are essential for T-cell maturation? | Thymic epithelial cells, dendritic cells, and macrophages |
| What is the term for a single isolated antigenic determinant? | Hapten (not immunogenic) |
| What are the two opsonizing factors? | The Fc region of IgG and C3b |
| What is the most common Ig deficiency? | IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances. |
| What is the name of the B cell-rich area of the spleen? | Primary follicle (in the white pulp) |
| 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 Ig prevents bacterial adherence to mucosal surfaces? | IgA |
| 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 is a plasma cell's life expectancy? | 7 to 14 days |
| What are defined by Ag-binding specificity? | Idiotypes |
| What type of binding occurs with one Fab or one idiotype of IgG? | Affinity |
| 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 |
| What is the term for Ags that activate B cells without T-cell signaling? | Thymus-independent Ags |
| 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 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) |
| Name the macrophages by location: • Liver | Kupffer cells |
| Name the macrophages by location: • Lungs | Alveolar macrophages |
| Name the macrophages by location: • CNS | Microglial cells |
| Name the macrophages by location: • Kidney | Mesangial macrophages |
| What is the first human disease successfully treated with gene therapy? | Adenosine deaminase (ADA) deficiency |
| What receptors are the best markers for NK cells? | CD16 and CD56 |
| True or false? Ag-Ab binding is irreversible | False. It is reversible because the Ags and Abs are not linked covalently. |
| What three major cell lines participate in the acquired immune system? | T cells, B cells, and macrophages |
| What test is used to screen for HIV? | ELISA. It detects anti-p24 IgG. |
| During what stage of B-cell development is IgM first seen on the surface? | Immature B cells |
| 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 |
| True or false? B-cell Ag receptors can be secreted. | True. B cell antigen receptors are Abs. |
| 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). |
| By which process do Abs make microorganisms more easily ingested via phagocytosis? | Opsonization |
| What MHC class acts to remove foreign Ags from the body? | MHC class II Ags. This is accomplished via CD4 T cells. |
| What disorder is characterized by autoantibodies to IF? | Pernicious anemia |
| What cytokines do Th2 cells secrete to inhibit Th1 cell function? | IL-4, IL-10, and IL-13 |
| What is the term for the number of Ag-binding sites on an Ig? | Valence |
| Which major cell type is found in the red pulp of the spleen? | RBCs. That is why it is called red pulp. |
| What is the name of the pathway that produces leukotrienes? | Lipoxygenase pathway, from arachidonic acid |
| What is the term to describe basophils that have left the bloodstream and entered a tissue? | Mast cells |
| 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 IL is important in myeloid cell development? | IL-3 (3 face down is an M) |
| What is the term for different classes and subclasses of the same gene products? | Isotypes |
| What is the first Ab a baby makes? | IgM |
| 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 T cell-rich area of the spleen? | PALS (Parietolateral lymphocytic sheath) |
| What three complement fragments are also anaphylatoxins? | C3a, C4a, and C5a |
| Name the B-cell CD marker: • Required for class switching signals from T cells | CD40 |
| Name the B-cell CD marker: • Receptor for EBV | CD21; it is a complement receptor for cleaved C3 |
| Name the B-cell CD marker: • Used clinically to count B cells in blood | CD19 |
| What immunologic test checks for a reaction between Abs and a particular Ag? (hint: ABO typing) | Agglutination test |
| Which leukotriene is chemotactic for neutrophils? | LTB4 |
| What Ig is associated with mucosal surfaces and external secretions? | IgA |
| What are the genetic variants of a molecule within members of the same species? | Allotypes |
| 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 |
| Which protein prevents internal binding of self proteins within an MHC class II cell? | Invariant chain |
| 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. |
| 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 are the two chains of the TCR that are mainly found on the skin and mucosal surfaces? | gamma and delta chains |
| Which IL is associated with increases of IgG and IgE? | IL-4 |
| 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. |
| 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. |
| 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 |
| 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 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 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 is the first membrane-bound Ig on B cell membranes? | IgM; IgD follows shortly thereafter. |
| What region of the Ig does not change with class switching? | Hypervariable region |
| 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) |
| What chromosome codes for HLA gene products? | The short arm of chromosome 6 |
| What cells are atypical on a peripheral blood smear in heterophil-positive mononucleosis? | T cells, not B cells |
| What is the major Ig of the secondary immune response in the mucosal barriers? | IgA |
| 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 are the four chemotactic agents? | 1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides |
| What subset of CD4 helper T cells stimulate B-cell division and differentiation? | Th2 |
| Which region of the variable domain comprises the Ag-binding site of the Ab? | Hypervariable region (three per light chain; three per heavy chain) |
| True or false? The increased oxygen consumption after phagocytosis is for ATP production. | False; it is for the production of toxic metabolites. |
| 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.) |
| What complement factor or factors are associated with • Chemotaxis? | C5a |
| What complement factor or factors are associated with • Membrane attack complex (MAC)? | C5-C9 |
| What complement factor or factors are associated with • Opsonization? | C3b |
| What complement factor or factors are associated with • Anaphylaxis? | C3a, C4a, C5a |
| 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 IL down-regulates cell mediated immunity? | IL-10 |
| Name the type of graft described by these transplants: • From one site to another on the same person | Autograft |
| Name the type of graft described by these transplants: Between genetically identical individuals | Isograft |
| Name the type of graft described by these transplants: • From one person to the next (the same species) | Allograft |
| Name the type of graft described by these transplants: • From one species to another | Xenograft |
| What is the name of the process in which cells migrate toward an attractant along a concentration gradient? | Chemotaxis |
| 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 is the name of the T cell-rich area of the lymph node? | Paracortex |
| What cell surface marker do all T cells have? | CD3 |
| 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. |
| What is the Ig associated with the primary immune response? | IgM |
| 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 Ig is responsible for activation of complement, opsonization, and ADCC and is actively transported across the placenta? | IgG |
| What type of Ag do T cells recognize? | Processed antigenic peptides bound in the groove of the MHC molecule |
| What Ig is the major protective factor in colostrum? | IgA |
| 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 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 five main oxidizing reactions are used to kill ingested organisms? | 1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid |
| What Ig is associated with ADCC for parasites? | IgE |
| 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. |
| 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 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. |
| Development of what T cell line follows low affinity for self-MHC class II Ags in the thymus? | CD4+T cells |
| 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 subset of CD4 T cells is responsible for mast cell and eosinophil precursor proliferation? | Th2 cells |
| 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 endotoxin receptor is the best marker for macrophages? | CD14 |
| 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 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 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 subtype of IgG does not bind to staphylococcal A protein? | IgG3 |
| What mast cell mediator is a chemotactic agent? | Eosinophil chemotactic factor A |
| What is the major Ig of the secondary immune response? | IgG |
| What T-cell surface projection recognizes and reacts to foreign Ags (presented by APCs)? | TCR |
| What is the confirmatory test for HIV? | Western blot |
| What is the name of the major chemotactic agent released from • Neutrophils? | Leukotriene B4 (LTB4) |
| What is the name of the major chemotactic agent released from • Macrophages? | IL-8 (IL-1 and TNF-gamma also) |
| What is the name of the major chemotactic agent released from • The blood serum? (Hint: it is a complement factor.) | C5a |
| What is the name of the major chemotactic agent released from • Bacteria? | F-Met-Peptides |
| What cell surface marker is found on blood B cells? | CD19 |
| What is the name of the B cell-rich area in the lymph node? | Primary follicle of the cortex |
| 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 is the only Ig that crosses the placenta? | IgG |
| 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. |
| What IL is essential for lymphoid cell development? | IL-7 (A 7 upside down is an L; L is for Lymphoid) |
| What type of cell can never leave the lymph node? | Plasma cell |
| Via what pathway is glycolysis increased after phagocytosis? | HMP shunt |
| 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 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 is the term for the strength of the association between Ags and Abs? | Avidity. There is a positive correlation between valence numbers and avidity. |
| What type of Ag do B cells recognize? | Free, unprocessed Ag |
| What Ig is associated with Ag recognition receptor on the surface of mature B cells? | IgD; IgM is also correct. |
| Which chromosome is associated with MHC genes? | Chromosome 6 |
| 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 most common precipitin test used in clinical medicine? | Radial Immuno Diffusion (RID) for Ig levels. |
| What Ig activates the complement cascade most efficiently? | IgM |
| What assay is used to identify MHC class I molecules? | Microcytotoxic assay |
| Which IL increases IgA synthesis? | IL-5. It also stimulates eosinophil proliferation. |
| 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. |
| What type II hypersensitivity disorder is defined as • Autoantibodies directed against ACh receptors? | Myasthenia gravis |
| What type II hypersensitivity disorder is defined as • Autoantibodies directed against platelet integrin? | Autoimmune thrombocytopenia purpura |
| 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 |
| What type II hypersensitivity disorder is defined as • Autoantibodies directed against the TSH receptor? | Graves disease |
| What type II hypersensitivity disorder is defined as • Autoantibodies directed against RBC Ag I? | Autoimmune hemolytic anemia |
| What Ig activates the alternate pathway, neutralizes bacterial endotoxins and viruses, and prevents bacterial adherence? | IgA |
| What enzyme is deficient in patients with CGD? | NADPH oxidase is deficient, resulting in an inability to produce toxic metabolites. |
| What subtype of IgG does not activate complement cascade? | IgG4 |
| 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 subset of T cells recognizes the MHC class II Ags? | CD4+ T cells (helper) |
| What T cell line arises from low affinity for self-MHC class I Ags in the thymus? | CD8+ T cells |
| 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 are the three polymorphonuclear leukocytes? Be specific. | Neutrophils, eosinophils, and basophils |
| What disease is associated with the HLA-A3 allele | Primary Hemochromatosis |
| What diseases are associated with the HLA-B27 allele | Psoriasis, ankylosing spondylitis, inflammatory bowel disease, and Reiter's syndrome |
| What disease is associated with the HLA-DR2 and HLA-DR3 alleles | Systemic lupus erythematosus |
| 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) |
| What diseases are associated with HLA-DR4 | Rheumatoid arthritis and type 1 diabetes (with HLA-DR3) |
| What does Candida albicans do that distinguishes it from other fungi? | It forms a germinal tube at 37°C. |
| 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 is the most likely causative organism for a patient with folliculitis after spending time in a hot tub? | Pseudomonas aeruginosa |
| What two viruses get their envelope not from budding but from coding? | HIV and poxvirus |
| Which type of hepatitis can cause hepatocellular carcinoma? | Hepatitis B |
| Gas gangrene is associated with which Clostridium species? | Clostridium perfrigens |
| 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 |
| Which parasitic organism, when it crosses the placenta, results in intracerebral calcifications, chorioretinitis, microcephaly, hydrocephaly, and convulsions? | Toxoplasma gondii |
| What staphylococcal species is positive for Beta-hemolysis and coagulase? | Staphylococcus aureus |
| What vector is associated with malaria? | Anopheles mosquito |
| What is the term for hyphae with constrictions at each septum that are commonly seen in Candida albicans? | Pseudohyphae |
| Which cestode infection results in alveolar hydatid cyst disease? | Echinococcus multilocularis |
| Which hepatitis virus is in the Flaviviridae family? | Hepatitis C |
| 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 |
| What is the only Rickettsia that is stable in the environment? | Coxiella burnetii |
| Regarding the viral growth curve, is the internal virus present before or after the eclipse period? | After the eclipse period |
| What Ab is an indication of recurrent disease for hepatitis? | HBc Ab |
| 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 is the only DNA virus that is not icosahedral? | Poxvirus |
| Which organism causes trench mouth? | Fusobacterium |
| 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. |
| 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 |
| 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 |
| 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 |
| True or false? A positive PPD skin test indicates the patient has active pulmonary disease. | False. The PPD tests exposure to TB. |
| What viral infection is known to cause intracerebral calcifications? | CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite. |
| What viruses are associated with cervical carcinoma? | HPVs 16 and 18 |
| 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 glycoprotein in the HIV virus is used for fusion? | GP41 |
| What Ag is needed to diagnose an infectious patient with hepatitis B? | HBeAg |
| Which organism causes multiple infections by antigen switching? | Borrelia recurrentis |
| What is the first Ag seen in an individual with hepatitis? | HBsAg (incubation period) |
| With which DNA virus are Guarnieri bodies associated? | Variola (smallpox) |
| What nematode is known as pinworms? What is the treatment? | Enterobius vermicularis; the treatment is albendazole. |
| What protein allows Mycoplasma to attach to the respiratory epithelium? | P1 protein |
| What organism is associated with the following types of diarrhea? Day care-associated diarrhea in infants | Rotavirus |
| What organism is associated with the following types of diarrhea? Watery diarrhea from beef, poultry, or gravies | Clostridium perfringens |
| 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 organism is associated with the following types of diarrhea? Bloody diarrhea associated with hamburger ingestion | Enterohemorhagic Escherichia coli |
| Which fungus is found worldwide on plants, is a cigar-shaped yeast in tissue form, and results in rose gardener's disease? | Sporothrix schenckii |
| Which type of hepatitis is a picornavirus? | Hepatitis A (infectious) |
| What gram-positive rod is distinguished by its tumbling motility? | Listeria |
| What is the vector for Leishmania infections? | The sandfly |
| What is the term of the viral growth period when no viruses can be found intracellularly? | Eclipse period |
| What organism causes Q fever? | Coxiella burnetii |
| What are the three naked RNA viruses? | 1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR) |
| HIV's capsid, core nucleocapsid, and matrix proteins are products of what structural gene? | gag gene |
| What facultative intracellular fungus is associated with hepatosplenomegaly? | Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly. |
| What type of hepatitis has the highest mortality rate among pregnant women? | Hepatitis E |
| Which gram-negative diplococcus ferments maltose? | Meningococcus (Gonococcus does not) |
| Are antibiotics helpful in treating a disease caused by a prion? | No. Prions are infectious proteins, so antibiotics are useless. |
| What bacterium is responsible for woolsorter's disease? | Bacillus anthracis |
| What picornavirus is associated with hand-foot-and-mouth disease? | Coxsackie A |
| What is the only trematode that is not hermaphroditic? | Schistosoma have separate males and females. |
| What water-associated organism is a weakly stained gram-negative rod that requires cysteine and iron for growth? | Legionella (think air conditioners) |
| With what virus are Downey type II cells associated? | EBV |
| 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. |
| What is the vector for yellow fever? | Aedes mosquito |
| What small, facultative gram-negative intracellular rod's transmission is associated with unpasteurized dairy products and undulant fever? | Brucella |
| True or false? All Proteus species are urease positive. | TRUE |
| Which genus of dermatophytes is associated with the following sites of infection? • Nails and skin only | Epidermophyton |
| Which genus of dermatophytes is associated with the following sites of infection? • Hair and skin only | Microsporum |
| Which genus of dermatophytes is associated with the following sites of infection? • Skin, hair, and nails | Trichophyton |
| What protein of the HIV virus does ELISA detect to determine whether a patient is HIV positive? | P24 |
| What genus of bacteria is described by catalase-positive, gram-positive cocci in clusters? | Staphylococcus |
| True or false? Vibrio parahaemolyticus require NaCl in its growth medium. | True. Staphylococcus aureus and group D enterococci also grow in high-salt media. |
| What virus causes small pink benign wartlike tumors and is associated with HIV-positive patients? | Molluscum contagiosum |
| What two bacteria are associated with drinking unpasteurized milk? | Brucella and Listeria (has tumbling motility) |
| What cestode causes cysticercosis? | Taenia solium |
| What DNA virus is associated with exanthem subitum (roseola)? | HHV 6 |
| Which acid-fast rod is an obligate intracellular parasite? | Mycobacterium leprae |
| What form of the Plasmodium species is ingested by mosquitoes? | Gametocytes |
| What small gram-negative aerobic rod requires Regan-Lowe or Bordet- Gengou medium for growth? | Bordetella pertussis |
| True or false? Streptococci have catalase. | False. Staphylococci have catalase; streptococci do not. |
| What three bacteria are positive to quellung reactive test? | 1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae |
| 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 |
| True or false? All spore formers are gram positive. | TRUE |
| What is the only DNA virus that has the reverse transcriptase enzyme? | Hepadnavirus |
| What enzyme does HIV use to integrate the proviral dsDNA into the host? | Integrase |
| What are the two hepatitis viruses that can be chronic and can lead eventually to hepatocellular carcinoma? | Hepatitis B and hepatitis C |
| What gram-positive spore-forming anaerobic rod blocks the release of ACh at the NMJ, resulting in reversible flaccid paralysis? | Clostridium botulinum |
| Name three products of HIV's pol gene. | Protease, integrase, and reverse transcriptase |
| What form of Plasmodium species affects the liver? | Hypnozoite |
| What small coagulase-positive, gram-negative rod with bipolar staining is a facultative intracellular parasite resulting in buboes? | Yersinia pestis |
| What hemoflagellate species is the cause of Chagas disease? | Trypanosoma cruzi |
| To what host cell receptor does the rabies virus attach? | ACh receptor |
| Which hepatitis virus is in the Picornaviridae family? | Hepatitis A |
| Abs to what hepatitis B Ag provide immunity? | Abs to HBsAg |
| What type of spore is defined as an asexual budding daughter yeast cell? | Blastoconidia |
| 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 |
| 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 |
| 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 |
| 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 mosquito is the vector for dengue fever? | Aedes (the same for yellow fever) |
| True or false? Gonococcus is encapsulated. | False. Meningococcus is encapsulated; Gonococcus is not. |
| What virus is associated with Guarnieri bodies? | Variola virus (Smallpox) |
| Regarding the viral growth curve, is the external virus present before or after the latent period? | After the latent period |
| What aerobic branching rod that is gram positive and partially acid-fast is associated with cavitary bronchopulmonary disease in immunosuppressed patients? | Nocardia asteroides |
| What obligate extracellular fungus is silver stain-positive and is associated with pneumonia in patients with AIDS? | Pneumocystis carinii |
| What Vi-encapsulated gram-negative motile anaerobic rod that produces H2S is associated with enteric fever, gastroenteritis, and septicemia? | Salmonella typhi |
| What is the most likely organism causing cellulitis in a patient who was cut by an oyster shell? | Vibrio vulnificus |
| What virus is associated with the Norwalk agent? | Calicivirus |
| Describe the organism based on the following information: • Beta-Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate | Streptococcus agalactiae |
| Describe the organism based on the following information: • Alpha-Hemolytic Streptococcus; lysed by bile; sensitive to Optochin | Pneumococcus (Streptococcus pneumoniae) |
| Describe the organism based on the following information: • Alpha-hemolytic Streptococcus; not lysed by bile; not sensitive to Optochin | Streptococcus viridans |
| Describe the organism based on the following information: • Beta-hemolytic Streptococcus sensitive to bacitracin | Streptococcus pyogenes |
| What is the only nonmotile pathogenic Clostridium species? | Clostridium perfringens |
| 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. |
| 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. |
| 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 three carcinomas are associated with EBV? | 1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma |
| Which organism causes trench fever? | Rochalimaea quintana (now called Bartonella quintana) |
| 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 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) |
| 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. |
| What family do the following viruses belong to? • Ebola | Filovirus |
| What family do the following viruses belong to? • California encephalitis | Bunyavirus |
| What family do the following viruses belong to? • Hantavirus | Bunyavirus |
| What family do the following viruses belong to? • Rabies | Rhabdovirus |
| What family do the following viruses belong to? • RSV | Paramyxovirus |
| What family do the following viruses belong to? • Measles | Paramyxovirus |
| What microaerophile is a motile gram-negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)? | Campylobacter jejuni |
| What bacterium is diagnosed using the Dieterle silver stain? | Legionella |
| How many strains of Pneumococcus capsular polysaccharides are present in the vaccine? | The vaccine contains 23 capsular polysaccharides. |
| What nematode is known as whipworms? What is the treatment? | Trichuris trichiura is treated with albendazole. |
| Which Streptococcus pyogenes toxin is immunogenic? | Streptolysin O |
| A urethral swab of a patient shows gram-negative diplococci in PMNs; what organism do you diagnose? | Neisseria gonorrhoeae |
| A suspected dermatophyte infection is stained with KOH. What spore type do you expect to see? | Arthroconidia with hyphae |
| What negative sense RNA virus is associated with cough, coryza, and conjunctivitis with photophobia? | Measles (rubeola) |
| Which M-protein strain of Streptococcus pyogenes is associated with acute glomerulonephritis? | M12 strains |
| What are the three C's of measles? | 1. Cough 2. Coryza 3. Conjunctivitis |
| What is the term given to arthropod-borne viruses? | Arboviruses (bunyavirus, flavivirus, and togavirus) |
| Which organism causes Weil's disease? | Leptospira |
| What form of the Plasmodium species are injected into humans by mosquitoes? | Sporozoites |
| What ssDNA virus must make dsDNA before it makes mRNA? | Parvovirus (it is the only ssDNA virus) |
| What is the vector of African sleeping sickness? | The tsetse fly |
| What HIV enzyme produces a dsDNA provirus? | Reverse transcriptase |
| What non-spore-forming gram-positive aerobic rod produces bull neck, sore throat with pseudomembranes, myocarditis, and sometimes respiratory obstructions? | Corynebacterium diphtheriae |
| What organism is associated with megaloblastic anemia? | Diphyllobothrium latum |
| What is the most serious form of tinea capitis, which results in permanent hair loss and is highly contagious? | Tinea favosa (favus) |
| What are the first intermediate hosts for trematodes? | Snails |
| What are the four capsular polysaccharides used in the Neisseria meningitides vaccine? | Y, W-135, and C and A capsular polysaccharides |
| What is the only encapsulated fungal pathogen? | Cryptococcus |
| What type of spore is asexual and formed of hyphae? | Conidia |
| What is the only Plasmodium that is quartan? | Plasmodium malariae; the others are tertian. |
| Which bacteria are associated with the following pigment production? • Red pigmentation | Serratia |
| Which bacteria are associated with the following pigment production? • Black-gray pigmentation | Corynebacterium diphtheriae |
| Which bacteria are associated with the following pigment production? • Pyocyanin (blue-green) | Pseudomonas aeruginosa |
| Which bacteria are associated with the following pigment production? • Yellow pigmentation | Staphylococcus aureus |
| 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. |
| What capsular serotype is associated with Escherichia coli- induced meningitis? | K1 capsule |
| What two Ags must be positive for a patient to have chronic active hepatitis? | HBsAg and HBeAg |
| In the window phase of a hepatitis B infection, which Abs do you see? | HBcAb and HBeAb. You see the antibodies c and e. |
| True or false? All streptococci are catalase-negative | TRUE |
| In what trimester is the fetus most vulnerable to congenital rubella syndrome? | The first trimester |
| What virus causes hoof-and-mouth disease? | Vesicular stomatitis virus |
| Which gram-negative diplococcus grows on chocolate agar? Thayer- Martin medium? | Meningococcus grows on chocolate agar, and Gonococcus grows on Thayer-Martin medium. |
| Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining? | Trichomonas vaginalis (treat with metronidazole) |
| Name the DNA virus • Linear dsDNA; enveloped; virion-associated polymerases; replicates in the cytoplasm : | Poxvirus |
| Name the DNA virus • Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus | Herpes virus |
| Name the DNA virus: • Linear dsDNA; naked; replicates in the nucleus | Adenovirus |
| Name the DNA virus: • ssDNA; naked; icosahedral; replicates in the nucleus | Parvovirus |
| Name the DNA virus: • Partially dsDNA circular; enveloped; virion-associated polymerases; has RNA intermediate; replicates in the nucleus | Hepadnavirus |
| Name the DNA virus: • Circular dsDNA; naked; icosahedral; replicates in the nucleus | Papovavirus |
| What fungus is urease positive? | Cryptococcus |
| 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 |
| Is the Salk polio vaccine inactivated? | Yes |
| True or false? All negative sense RNA viruses are enveloped. | True. They all have helical nucleocapsids and virion-associated polymerases too. |
| What urease-positive non-lactose-fermenting gram-negative rod with swarming-type motility is associated with staghorn renal calculi? | Proteus |
| What two viruses are associated with Reye's syndrome? | Varicella virus and influenza virus |
| Which organism releases endotoxins prior to cell death? | Neisseria meningitidis |
| Clue cells are associated with which organism that causes vaginal discharge? | Gardnerella vaginalis |
| What is the name of the bullet-shaped virus? | Rhabdovirus |
| What fungus is characterized by India ink staining of the CSF that produces colorless cells with a halo on a black background? | Cryptococcus neoformans |
| What does hepatitis D virus need from hepatitis B virus to be infective? | HBsAg as its envelope |
| Which type of hepatitis is a calicivirus? | Hepatitis E (enteric) |
| What genus is known as the smallest free living bacteria? (hint: has no cell wall and has sterols in the membrane) | Mycoplasma |
| What three organs can be affected by Trypanosoma cruzi? | Heart, esophagus, and colon. Remember, you get megas: cardiomegaly, megaesophagus, and megacolon. |
| Which serotypes of HPV are associated with plantar warts? | HPV serotypes 1 and 4 |
| What facultative gram-negative anaerobic rod is motile, ferments lactose, and is the MCC of UTIs? | Escherichia coli |
| What is the only dsRNA virus? | Reovirus |
| What are the four segmented RNA viruses? | 1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR |
| What type of Plasmodium affects • Only mature RBCs? | Plasmodium malariae |
| What type of Plasmodium affects • Only reticulocytes? | Plasmodium vivax |
| What type of Plasmodium affects • RBCs of all ages? | Plasmodium falciparum |
| What is the major cell membrane sterol found in fungi? | Ergosterol |
| What Ab is an indication of low transmissibility for hepatitis? | HBeAb |
| What is the term for RNA-dependent DNA polymerase? | Reverse transcriptase |
| Which gram-positive bacteria infection of infancy is associated with ingestion of honey? | Clostridium botulinum |
| Which trematode is associated with bladder carcinoma in Egypt and Africa? | Schistosoma haematobium |
| Which encapsulated fungus is found in soil enriched with pigeon droppings? | Cryptococcus neoformans |
| What virus lies dormant in the • Trigeminal ganglia? | Herpes I |
| What virus lies dormant in the • Dorsal root ganglia? | Varicella |
| What virus lies dormant in the • Sensory ganglia of S2 and S3? | Herpes II |
| 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 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 color do fungi stain with PAS? Silver stain? | Hot pink with PAS and grey to black with silver stain |
| A tropical fish enthusiast has granulomatous lesions and cellulitis; what is the most likely offending organism? | Mycobacterium marinum |
| Which dimorphic fungus is found as Arthroconidia in desert sand of the southwestern United States (e.g., San Joaquin Valley)? | Coccidioides immitis |
| Which mycoplasma species is associated with urethritis, prostatitis, and renal calculi? | Ureaplasma urealyticum |
| What tick is the vector for babesiosis? | Ixodes (also the vector for Lyme disease) |
| 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 organism would you suspect in a patient with diarrhea after eating rice? | Bacillus cereus |
| What small gram-negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite? | Francisella tularensis |
| True or false? Cestodes have no GI tract. | True. They absorb nutrients from the host's GI tract. |
| What negative sense RNA virus is associated with parotitis, pancreatitis, and orchitis? | Mumps |
| 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) • Patient with AIDS | >5 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) • Posttransplantation patient taking immunosuppressive agents | >5 mm |
| What are the only two picornaviruses that do not lead to aseptic meningitis? | Rhinovirus and hepatitis A virus |
| Which cestode in raw or rare beef containing cysticerci results in intestinal tapeworms? | Taenia saginata |
| What DNA viral disease is associated with aplastic crisis in patients with sickle cell anemia? | Parvovirus B-19 |
| What glycoprotein in the HIV virus attaches to CD4? | GP120 |
| What Enterobacteriaceae are prone to produce osteomyelitis in sickle cell patients? | Salmonella |
| What organism is commonly associated with a cellulitis from an animal bite? | Pasteurella multocida |
| What fungus is seen as colored cauliflower lesions? | Chromomycosis |
| What is the reservoir for the togavirus? | Birds |
| What are the two exceptions to the rule "all cocci are gram positive"? | Both Neisseria and Moraxella are gram-negative cocci. |
| What nematode is known as hookworms? What is the treatment? | Necator americanus is treated with mebendazole and iron therapy. |
| What HIV structural gene produces GP120 and GP41? | env structural protein |
| Which hemoflagellate species causes kala azar? | Leishmania donovani (kala azar is also known as visceral leishmaniasis) |
| What DNA virus is associated with heterophile-negative mononucleosis? | CMV; remember, EBV is associated with heterophile-positive mononucleosis. |
| What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies? | Rabies |
| What large, spore-forming, gram-positive anaerobic rod is associated with infections due to puncture wounds and trauma? | Clostridium tetani |
| What is the vector for Chagas disease? | The reduviid bug |
| 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 viral infection is associated with black vomit? | Yellow fever (flavivirus) |
| What encapsulated gram-negative, lactose-fermenting rod is associated with pneumonia in patients with alcoholism, diabetes, and chronic lung disease? | Klebsiella pneumoniae |
| What is the essential reservoir host for Toxoplasma gondii? | The cat |
| 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 |
| What is the term for Candida infection of the oral mucosa? | Thrush |
| What is the term for fungi that can convert from hyphal to yeast forms? | Dimorphic |
| To what viral family does the polio virus belong? | Picornaviridae |
| 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 |
| True or false? There are no persistent infections with naked viruses? | True. They lyse the host cell |
| What virus is associated with progressive multifocal leukoencephalopathy? | JC virus |
| What bacterium is a gram-negative, oxidase-positive aerobic rod that produces a grapelike odor and pyocyanin pigmentation? | Pseudomonas aeruginosa |
| Which three organisms cause heterophilic negative mononucleosis? | CMV, Toxoplasma gondii, and Listeria |
| What bacterium found in poorly preserved canned food causes flaccid paralysis? | Clostridium botulinum |
| Which two negative sense RNA viruses have neuraminidase enzymes? | Mumps and influenza virus |
| What Staphylococcus aureus protein inhibits phagocytosis? | Protein A |
| Which four bacteria require cysteine for growth? | Pasteurella, Brucella, Legionella, and Francisella (all of the-ellas) |
| What fungus causes endocarditis in IV drug users? | Candida albicans |
| What viruses are associated with Cowdry type A intranuclear inclusions? | Herpes virus I and II |
| Which streptococcal species is associated with dental caries and infective endocarditis in patients with poor oral hygiene? | Streptococcus viridans |
| What is the term for cestode-encysted larvae found in intermediate hosts? | Cysticerci |
| 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 nematode is known as threadworms? What is the treatment? | Strongyloides stercoralis is treated with thiabendazole. |
| What are known as jumping genes? | Transposons |
| What virus produces koilocytic cells on a Papanicolaou (Pap) smear? | HPV |
| 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 |
| 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. |
| What two HIV regulatory genes down-regulate MHC class I expression in the host? | nef and tat genes |
| What size ribosomes do fungi have? | 80S ribosomes (because they are eukaryotic) |
| What is the term for an abnormal amount of collagen type III that produces a large bulging scar, seen primarily in blacks? | Keloid |
| True or false? Klinefelter syndrome cannot be diagnosed until puberty. | TRUE |
| What form of sunlight is the most carcinogenic? | Ultraviolet B (UVB) sunlight |
| What renal pathology involves uniform thickening of the glomerular capillary wall, granular appearance under the microscope, and effacement of foot processes? | Membranous glomerulonephritis |
| What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase? | HIV |
| What enzyme is deficient in chronic granulomatous disease of childhood? | NADPH oxidase |
| 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 |
| Rheumatic fever most commonly follows pharyngeal infections with what bacteria? | Group A β-hemolytic streptococci |
| What benign cardiac tumor is associated with tuberous sclerosis? | Rhabdomyoma |
| 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 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) |
| 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 |
| What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma? | Tylosis |
| 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) |
| 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 malignant bone tumor is associated with familial retinoblastoma? | Osteosarcoma |
| 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 |
| 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 |
| What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis? | Swan-neck deformities |
| 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. |
| 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 triad consists of endothelial injury, changes in laminar flow, and hypercoagulation? | Virchow triad, associated with the formation of a thrombus. |
| What bone cell has receptors for PTH? | Osteoblasts (Remember, they modulate the function of osteoclasts.) |
| What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating? | Gastric ulcer |
| What is the term for normal cellular genes associated with growth and differentiation? | Proto-oncogenes |
| Blue sclera is seen in what hereditary bone disorder? | Osteogenesis imperfecta |
| What form of anemia is diagnosed with sucrose lysis test and Ham test? | Paroxysmal nocturnal hemoglobinuria |
| 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 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.) |
| 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. |
| What transports iron in the blood? | Transferrin |
| What hematological malignancy is particularly likely to affect patients with Down syndrome? | ALL (nearly 15-20 times the normal risk) |
| What childhood pathology involves anterior bowing of the tibia, epiphyseal enlargements, and costochondral widening, with the endochondral bones being affected? | Rickets |
| 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 d | Gastric carcinoma |
| What drug causes a sixfold increase in schizophrenia, can impair motor activity, and can cause lung problems? | Marijuana |
| 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 name of the tumor when gastric carcinoma spreads to the ovaries? | Krukenberg tumor |
| What condition results from a deficiency in the enzyme hexosaminidase A? | Tay-Sachs disease |
| Which cerebral herniation results in compression of the anterior cerebral artery? | Cingulate gyrus herniation (subfalcine) |
| 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 is the term for the syndrome consisting of hepatomegaly, ascites, and abdominal pain due to hepatic vein thrombosis? | Budd-Chiari syndrome |
| 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 form of angina is characterized by • Coronary artery luminal narrowing, symptom occurrence during exertion, ST segment depression on ECG? | Stable angina |
| 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 skin condition is a localized proliferation of melanocytes presenting as small, oval, light brown macules? | Benign lentigo |
| What is the term for nonneoplastic abnormal proliferation of cell size, shape, and cellular organization? | Dysplasia |
| 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 renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules? | Kimmelstiel-Wilson disease |
| 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 cell in chronic inflammation is derived from blood monocytes? | Macrophages |
| True or false? Pancreatic insufficiency results in vitamin B12 malabsorption. | True. Pancreatic enzymes begin the breakdown of vitamin B12-R complex in the duodenum. |
| 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 |
| What tumor constitutes 40% of testicular tumors in children? | Teratoma |
| What urinary metabolite is elevated in pheochromocytoma? | Vanillylmandelic acid (VMA) |
| 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 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 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 thyroiditis presents as a tender, enlarged, firm thyroid gland, usually preceded by an upper respiratory viral illness? | de Quervain thyroiditis |
| What disorder leads to IgG autoantibodies to the TSH receptor? | Graves disease |
| What intrauterine deficiency leads to failure to thrive, mental retardation, motor incoordination, and stunted growth? | Iodine, resulting in congenital hypothyroidism |
| What pancreatic islet cell tumor is associated with MEN I syndrome? | Gastrinoma |
| 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 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 |
| What AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas? | Familial hypercholesterolemia |
| 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 is the term for RBCs with smooth undulations on the surface of their membrane, commonly seen in uremia? | Burr cells (echinocytes) |
| Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Beta-hCG | Choriocarcinomas and trophoblastic tumors |
| Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-125 | Ovarian cancer |
| Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-19.9 and CEA | Pancreatic cancer |
| Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • alpha-Fetoprotein | Hepatoma and nonseminomatous testicular germ cell tumors |
| Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Calcitonin | Medullary carcinoma of the thyroid |
| Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • PSA and prostatic acid phosphatase | Prostate cancer |
| Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Placental alkaline phosphatase | Seminoma |
| Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CEA | Cancer of the lung, stomach, colon, and breast |
| What seronegative spondyloarthropathy is seen in HLA-B27-positive young men, involves the sacroiliac joints, has no subcutaneous nodules, and has a bamboo spine appearance on radiograph? | Ankylosing spondylitis |
| What disorder is associated with decreased platelet count, prolonged PT and PTT, decreased fibrinogen, and increased fibrin split products (D-dimers)? | Disseminated intravascular coagulation (DIC) |
| What spirochete is responsible for Lyme disease? | Borrelia burgdorferi |
| What very aggressive lung cancer metastasizes early and is associated with smoking and paraneoplastic syndromes? | Small cell carcinoma (oat cell) |
| What bone disorder is characterized by brown tumors, bone pain, deformities, and fractures due to excessive PTH? | Osteitis fibrosa cystica (von Recklinghausen disease) |
| What glycogen storage disease is due to the following enzyme deficiencies? • Lysosomal glucosidase (acid maltase) | Pompe's disease |
| What glycogen storage disease is due to the following enzyme deficiencies? • Muscle phosphorylase | McArdle's syndrome |
| What glycogen storage disease is due to the following enzyme deficiencies? • Glucose-6-phosphatase | von Gierke's disease |
| What ovarian disease involves psammoma bodies? | Serocystadenocarcinoma |
| What cystic swelling of the chorionic villi is the most common precursor of choriocarcinoma? | Hydatidiform mole |
| In what condition do you see dimpling on the kidney's surface? | Pyelonephritis |
| What are the most common causes of osteomyelitis • Overall? | Staphylococcus aureus |
| What are the most common causes of osteomyelitis • In neonates? | Streptococcus agalactiae |
| What are the most common causes of osteomyelitis • In patients with sickle cell disease? | Staphylococcus aureus (but they are more prone to salmonella infections) |
| What are the most common causes of osteomyelitis • In drug addicts? | Pseudomonas |
| What malignant neoplasm of the bone is associated with Homer-Wright pseudorosettes; onion skinning of the periosteum on radiographs of the femur, pelvis, and tibia; and chromosome 11;22 translocation? | Ewing's sarcoma |
| What lymphoma is characterized by CD19, CD20, CD5; CD23-negative; and chromosome 11;14 translocations? | Mantle cell lymphoma |
| What components of the complement cascade form the MAC? | C5b-C9 |
| True or false? HPV infection increases the risk of developing squamous cell carcinoma of the penis. | True. HPV serotypes 16 and 18 are risk factors for squamous cell carcinoma. |
| What form of coarctation of the aorta is associated with Turner syndrome? | Preductal (infantile) |
| True or false? An elevated serum osteocalcin level is a marker for increased bone formation. | True. Increased alkaline phosphatase levels also are associated with increased bone formation. |
| What is the most common opportunistic infection of the CNS in HIV? | Toxoplasmosis |
| What hereditary bone disorder is due to decreased osteoclast function, resulting in thick, sclerotic bones that fracture easily? | Osteopetrosis (Albers-Schönberg disease) |
| True or false? Pancreatic delta-cell tumors inhibit CCK secretion, leading to gallstones and steatorrhea. | True. Delta-Cell tumors produce excess somatostatin, which inhibits CCK, gastrin (hypochlorhydria), and insulin secretion (diabetes). |
| What is the term for the speckled appearance of the iris in patients with Down syndrome? | Brushfield spots |
| What is the term for the collapse of the vertebral body due to TB? | Pott disease |
| What organ must metastasize for carcinoid heart disease to occur? | Liver |
| Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and mucocutaneous neuromas | MEN III (or IIb) |
| Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and parathyroid adenomas (or hyperplasia) | MEN IIa (or Sipple syndrome) |
| Which subset of MEN syndrome is associated with the following? • Parathyroid, pancreatic, and pituitary gland tumors and Zollinger-Ellison syndrome | MEN I (or Wermer syndrome) |
| What X-linked recessive disease involves mental retardation, self-mutilation, choreoathetosis, spasticity, a decrease in HGPRT, and an increase in uricemia? | Lesch-Nyhan syndrome |
| What disorder is associated with spider angiomas, palmar erythema, gynecomastia, testicular atrophy, encephalopathy, abnormalities in clotting factors, and portal HTN? | Cirrhosis |
| What is your diagnosis of a young, thin asymptomatic female with a midsystolic click on cardiac auscultation? | Mitral valve prolapse |
| What infection is associated with ring-enhancing lesions seen on computed tomography (CT) of the brain in an HIV-positive individual? | Toxoplasmosis (although you should rule out cerebral abscess due to other organisms) |
| What is the term for a reversible change in one cell type to another? | Metaplasia (usually to a more protective cell type) |
| What liver tumor is associated with oral contraceptive pill use? | Hepatic adenomas |
| What CNS developmental abnormality is associated with downward displacement of the cerebellar vermis and medulla compressing the fourth ventricle and leading to obstructive hydrocephalus? | Arnold-Chiari malformation type 2 |
| What disease involves a lack of both T cell-mediated and humoral immune responses that can be either X-linked or AR? | Severe combined immunodeficiency disease |
| What condition results in the following CSF results? • Opening pressure 70 to 180 mm H2O; 0-10 WBCs (monocytes); glucose 45 to 85, protein 15 to 45 | Normal values |
| What condition results in the following CSF results? • Opening pressure 450 mm H2O; 5 WBCs (90% lymphocytes); normal glucose and protein levels | Brain abscess |
| What condition results in the following CSF results? • Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17 | Viral meningitis |
| What condition results in the following CSF results? • Opening pressure 250 mm H2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100 | TB meningitis |
| What condition results in the following CSF results? • Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120 | Bacterial meningitis |
| True or false? Removal of the ileum results in vitamin B12 deficiencies. | True. The ileum is the site where vitamin B12 is absorbed. |
| What is the term for edema that has LDH below 200, protein level 2.5, and a specific gravity below 1.020? | Transudative; exudative has the opposite values and has an elevated cellular content. |
| What is the term for thickened, hyperpigmented skin in the axillae, groin, and skin folds associated with malignancies, obesity, and DM? | Acanthosis nigricans |
| How many grams of protein must be excreted in 24 hours to produce the diagnosis of nephrotic syndrome? | >3.5 g/day of protein, along with generalized edema, hypoalbuminemia, and hyperlipidemia |
| What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney? | Heroin |
| What catecholamine-hypersecreting tumor, a secondary cause of HTN, results in headache, diaphoresis, anxiety, tachycardia, and palpitations? | Pheochromocytoma |
| What is the term for flattened nose, low-set ears, and recessed chin seen in patients with bilateral renal agenesis? | Potter facies |
| What type of healing occurs in a clean surgical incision? | Primary intention |
| What are the two most common viral infections in HIV? | CMV retinitis and HSV-2 |
| What disorder is defined by inability of the lower esophageal sphincter to relax with swallowing and a bird beak barium swallow result? | Achalasia. (Think Chagas disease if it presents in a person from Central or South America.) |
| Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone? | Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone, whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone. |
| What CD4 T-cell receptor does the HIV virus bind to? | gp120 |
| What is the term for RBC fragments? | Schistocytes |
| What disorder is due to a deficiency in tyrosinase? | Albinism |
| What two Abs are used to diagnose Hashimoto's thyroiditis? | Antithyroglobulin and antimicrosomal Abs |
| What urease-producing gram-negative curved rod is associated with PUD and chronic gastritis? | Helicobacter pylori, which is also associated with an increased risk of gastric carcinoma |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Alkylating agents | Leukemias and lymphomas |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Aromatic amines and azo dyes | Hepatocellular carcinoma |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Arsenic | Squamous cell carcinoma (skin, lung) and angiosarcoma of the liver |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Asbestos | Mesothelioma and bronchogenic carcinoma |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Naphthylamine | Bladder cancer |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Benzenes | Leukemias |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Vinyl chloride | Angiosarcoma of the liver |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Chromium and nickel | Bronchogenic carcinoma |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Polycyclic aromatic hydrocarbons | Bronchogenic carcinoma |
| Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Nitrosamines | Gastric cancer |
| What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count? | 1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia |
| What pancreatic islet cell tumor is associated with hypoglycemia, sweating, hunger, confusion, and increased C-peptide levels? | Insulinoma |
| What substance is used to test platelets' response in patients with von Willebrand disease? | Ristocetin |
| What X-linked recessive disorder that is due to an abnormality in the dystrophin gene, has onset by age 5 with progressive proximal muscle weakness, calf pseudohypertrophy, and elevated CPK levels? | Duchenne muscular dystrophy (Remember, Becker's is slower in progress, less severe, later in onset, and lacks cardiac involvement.) |
| What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls? | Bronchioloalveolar carcinoma |
| What estrogen-producing tumor of the female genital tract is characterized by Call-Exner bodies? | Granulosa cell tumor of the ovary |
| What AD syndrome involves 1000 or more edematous polyps, most commonly affects the colorectal area, and is associated with chromosome 5q21? | Familial polyposis coli |
| What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints? | Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints. |
| What prostaglandin is associated with maintaining patency of the ductus arteriosus? | PGE (along with low oxygen tension) |
| What is the term for dilated veins within the spermatic cord? | Varicocele |
| What type of hemostasis in an intravascular space consists of fibrin, platelets, RBCs, and WBCs? | Thrombus |
| What is the most common primary malignant tumor in bone? | Osteosarcoma |
| What is the most common infectious agent in HIV? | Pneumocystis carinii |
| What myeloid disorder is characterized by dry bone marrow aspirations, splenomegaly, leukoerythroblastosis, teardrop RBCs, and hyperuricemia due to increased cell turnover? | Myelofibrosis with myeloid metaplasia |
| What disease that involves mental retardation, flat face, muscle hypotonia, and a double-bubble sign on radiograph poses an increased risk of Alzheimer's disease and ALL? | Down syndrome (trisomy 21) |
| What form of anemia is associated with IgG Abs against Rh antigens, positive direct Coombs test, and splenomegaly? | Autoimmune hemolytic anemia |
| What urinary metabolite is increased in patients with carcinoid syndrome? | 5-hydroxyindoleacetic acid (5-HIAA) |
| What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram? | Primary sclerosing cholangitis |
| What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction? | LC4, LD4, and LE 4 |
| What are the three Bs of adult polycystic kidneys? | 1. Big 2. Bilateral 3. Berry aneurysm |
| What AR disease involves a defect in AA 508 on chromosome 7, causing a defect in Cl- transportation that leads to recurrent pulmonary infections and an increase in viscid mucoid secretions along with pancreatic insufficiencies? | Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.) |
| What law states that an enlarged, palpable gallbladder is more likely due to cancer than stone obstruction? | Courvoisier's law |
| What is the term for air in the pleural space? | Pneumothorax |
| What disorder of bone remodeling results in thick, weak bones and is associated with high-output cardiac failure? | Paget disease (osteitis deformans) |
| What is the term to describe the increase in organ size due to the increase in cell size and function? | Hypertrophy |
| What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies? | Meningioma |
| True or false? Ethyl alcohol induces the cytochrome P-450 enzymes. | TRUE |
| What are the five components of portal HTN? | 1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids |
| What syndrome results when there is a deletion to paternal chromosome 15? Maternal? | Prader-Willi syndrome and Angelman syndrome, respectively |
| What CNS tumor arises from Rathke's pouch? | Craniopharyngioma |
| What is the triad of Reiter syndrome? | 1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see, can't wee, can't kick with your knee |
| Which of the following is not a risk factor for cholesterol gallstones: pregnancy, OCP use, female gender, hemolytic anemia, cirrhosis, and obesity? (May be more than one answer.) | Cirrhosis and hemolytic anemia, which are risk factors for pigmented gallstones. |
| Name the nephritic disease based on the immunofluorescent staining. • Mesangial deposits of IgA and C3 | IgA nephropathy (Berger disease) |
| Name the nephritic disease based on the immunofluorescent staining. • Smooth and linear pattern of IgG and C3 in the GBM | Goodpasture disease |
| Name the nephritic disease based on the immunofluorescent staining. • Granular deposits of IgG, IgM, and C3 throughout the glomerulus | Postinfectious GN |
| What glycoprotein allows platelets to adhere to each other through the use of fibrinogen? | GP IIb/IIIa, which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes |
| What virus is associated with body cavity large B-cell lymphomas? | HHV-8 |
| What germ cell tumor is seen in the 15-to 35-year-old age group, peaks when the person is 35 years of age, and is a bulky mass that spreads via the lymphatic system? | Seminoma |
| What transmural inflammatory bowel disease can be found from the mouth to anus, has noncaseating granulomas, is discontinuous (skip lesions), and has a cobblestone appearance, thickening of the bowel wall, linear fissures, and aphthous ulcers with normal | Crohn disease |
| Does ELISA or Western blot confirm whether a patient is HIV-positive? | ELISA screens and Western blot confirms the diagnosis. |
| What GN is highly associated with hepatitis B and C infections? | Membranoproliferative glomerulonephritis (MPGN) |
| What is the term for squamous to columnar metaplasia of the distal esophagus secondary to chronic inflammation? | Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus. |
| What is the term for excessive amounts of granulation tissue that can block re-epithelialization and wound healing? | Proud flesh |
| What is released from the mitochondria to trigger apoptosis? | Cytochrome c |
| How much of a vessel must be stenosed to cause sudden cardiac death? | More than 75% of the vessel |
| Oxidation of Hgb forms what bodies in patients with G-6-PD deficiency? | Heinz bodies |
| What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN, hypokalemia, and low rennin levels? | Conn syndrome (primary hyperaldosteronism) |
| What virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma? | EBV |
| What normochromic, normocytic AD anemia has splenomegaly and increased osmotic fragility? | Hereditary spherocytosis |
| What does prepubertal hypersecretion of growth hormone lead to? | Gigantism |
| What enzyme is deficient in alkaptonuria? | Homogentisic oxidase |
| What sex cell tumor causes precocious puberty, masculinization, gynecomastia in adults, and crystalloids of Reinke? | Leydig cell tumor |
| Name four major risk factors for atherosclerosis. | DM, hypercholesterolemia, smoking, and HTN are major risk factors. Being male, obesity, sedentary lifestyle, homocysteine elevation, oral contraceptive pills, and genetics are minor risk factors for atherosclerosis. |
| Name the AD disease associated with chromosome 15 in which the patient has long extremities, lax joints, pigeon chest, and posterior mitral leaflet prolapse and is prone to developing dissecting aortic aneurysm. | Marfan syndrome |
| What is the term for a large VSD that leads to pulmonary HTN, RVH, and cyanosis due to right-to-left reversal of the shunt? | Eisenmenger syndrome, which can also occur with any left-to-right shunt |
| Eating fava beans can produce the Mediterranean type of what deficiency? | G-6-PD deficiency |
| What form of hemophilia is X-linked recessive and due to a deficiency in factor VIII? | Hemophilia A |
| What leukemia affects a 4-year-old child with 3 months of fever, fatigue, generalized lymphadenopathy, CNS involvement, hepatosplenomegaly, bleeding, and platelet count below 100, 000? | ALL |
| What protein deficiency results in respiratory distress syndrome of newborns? | Deficiency in surfactant |
| What are the three components of amyloid? | 1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans |
| What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ? | Myasthenia gravis |
| What are the three left-to-right shunts? | 1. VSD 2. ASD 3. PDA |
| What protein causes fibrinolysis? | Plasmin |
| What pancreatic islet cell tumor is associated with watery diarrhea, hypokalemia, and achlorhydria? | VIPoma |
| True or false? Obesity, DM, HTN, multiparity, early menarche, and late menopause are all risk factors for endometrial carcinoma. | False. They are all risk factors for endometrial carcinoma except multiparity. Nulliparity, estrogen-producing tumors, and estrogen replacement therapy are also risk factors for endometrial carcinoma. |
| What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1? | Lisch nodules |
| What GI pathology is associated with a positive string sign, an increase in the number of bloody stools, RLQ pain, skip lesions, terminal ileum most commonly affected, occurrence in women more than men, and an increased thickness of the bowel? | Crohn disease |
| What is the most common fungal infection in HIV? | Candida |
| True or false? GERD is a cause of asthma. | True. Don't forget this in your differential diagnosis of an asthmatic. |
| Name the product or products of arachidonic acid: • Vasodilation and inhibition of platelet aggregation produced by vascular endothelium | PGI2 |
| Name the product or products of arachidonic acid: • Vasodilation | PGD2, PGE2, and PGF 2 |
| Name the product or products of arachidonic acid: • Pain and fever | PGE2 |
| Name the product or products of arachidonic acid: • Vasoconstriction and platelet aggregation produced by platelets | TXA2 |
| Name the product or products of arachidonic acid: • Chemotactic for neutrophils | LTB4 |
| Name the product or products of arachidonic acid: • Vasodilation, bronchospasm, and increased vascular permeability | LTC4, LTD4, and LTE4 |
| Which hepatitis B Ab indicates low transmissibility? | HBeAb |
| What pneumoconiosis is associated with exposure to the following occupations or materials? • Miners, metal grinders, and sandblasters | Silicosis Note: Coal worker's pneumoconiosis is synonymous with black lung disease, an upper lobe occupational disorder |
| What pneumoconiosis is associated with exposure to the following occupations or materials? • Aerospace industry, nuclear reactors | Berylliosis |
| What pneumoconiosis is associated with exposure to the following occupations or materials? • Shipyards, brake linings, insulation, and old building construction | Asbestosis |
| What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder? | Porcelain gallbladder |
| What is the term to describe a decrease in the cell size and function usually associated with disuse? | Atrophy. Disuse can also be due to immobilization, ischemia, aging, and a host of other causes. |
| Which B-cell neoplasm has the following cell surface markers: CD19, CD20, CD5 (T-cell marker), CD23; and are CD10-negative? | CLL (B-cell origin) |
| What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur, humerus, and tibia? | Caisson disease |
| What are the four DNA oncogenic viruses? | 1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma |
| Is the AD or AR form of osteopetrosis malignant? | The AR form is malignant and AD is benign. |
| What carcinoma produces hematuria, flank pain, and a palpable mass? | This is the triad of renal cell carcinoma |
| Name at least three causes of metastatic calcification. | Remember the mnemonic PAM SMIDT P, (hyper) Parathyroid/ Paget disease A, Addison's disease M, Milk-alkali syndrome/metastatic cancer S, Sarcoidosis M, Multiple myeloma I, Immobilization/idiopathic D, Vitamin D intoxication T, Tumors |
| What is the only subtype of Hodgkin's lymphoma that is most commonly seen in females? | Nodular sclerosis |
| What is the leading cause of preventable premature death and illness in the United States? | Smoking |
| What prion-associated CNS pathology produces rapidly progressive dementia with myoclonus, involuntary movements, and death within 6 to 12 months? | Creutzfeldt-Jakob disease |
| What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting, fissuring, and oozing? | Paget disease of the breast |
| What breast pathology involves malignant cells with halos invading the epidermis of the skin? | Paget disease of the breast |
| Macro-ovalocytes in the peripheral blood smear are formed from what cell in the bone marrow? | Megaloblasts |
| Name the type of exudate, given the following examples. • Sunburn | Serous exudates |
| Name the type of exudate, given the following examples. • Uremic pericarditis | Fibrinous exudates |
| Name the type of exudate, given the following examples. • Parasitic infection | Eosinophilic exudates |
| Name the type of exudate, given the following examples. • Diphtheria infection | Pseudomembranous exudates |
| Name the type of exudate, given the following examples. • Meningococcal infection | Purulent exudates |
| Name the type of exudate, given the following examples. • Rickettsial infection | Hemorrhagic exudates |
| What parasite is associated with squamous cell carcinoma of the urinary bladder? | Schistosoma haematobium |
| What malabsorption syndrome produces abdominal distention, bloating, flatulence, diarrhea, steatorrhea, and weight loss shortly after eating bread products? | Celiac sprue (gluten-sensitive enteropathy) |
| What herpes virus is associated with Kaposi sarcoma? | HHV 8 |
| What is the term for the copper corneal deposits found in Wilson's disease? | Kayser-Fleischer rings |
| Name the six vitamin K-dependent coagulation factors. | Factors II, VII, IX, and X and proteins C and S. |
| What ovarian carcinoma is characterized by psammoma bodies? | Cystadenocarcinoma |
| A marfanoid patient presents with tearing retrosternal chest pain radiating to her back. What is your first diagnosis? | Dissecting aortic aneurysm. MI is also high on the list, but these are buzzwords to look for dissection. |
| What malignant neoplasm of the skin is associated with keratin pearls? | Squamous cell carcinoma |
| Name four chemotactic factors for neutrophils. | N-formyl-methionine LTB4 C5a IL-8 |
| What is the term for granuloma at the lung apex in TB? | Simon focus |
| What are the three platelet aggregating factors? | 1. ADP 2. PG 3. TXA2 |
| What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands? | Waterhouse-Friderichsen syndrome |
| What foci of fibrinoid necrosis are surrounded by lymphocytes and macrophages throughout all the layers of the heart? | Aschoff bodies of rheumatic fever |
| What is the leading cause of primary hyperparathyroidism? | Chief cell adenoma (80%) |
| In what X-linked recessive disease is there a decrease in the HMP shunt, along with Heinz body formation? | G-6-PD deficiency |
| What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb-containing area? | Target cell |
| True or false? Raynaud's phenomenon has no underlying pathology. | False. The disease has no associated pathology; the phenomenon is arterial insufficiency due to an underlying disease. |
| What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge? | Intraductal papilloma |
| What form of hemophilia is X-linked recessive and is due to a deficiency in factor IX? | Hemophilia B |
| What are the two reasons for megaloblastic anemia with elevated MCV? | Vitamin B12 deficiency and folate deficiency |
| Is cigarette smoking associated with transitional cell carcinoma of the bladder? | Yes. It is also a cause of cancers of the lung, esophagus, ureter, and kidney, just to name a few. |
| What disease has multiple schwannomas, café-au-lait spots on the skin, and Lisch nodules and is associated with chromosome 17q? | Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules) |
| What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use? | Eaton-Lambert syndrome |
| In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos? | Malignant mesothelioma |
| What is the term for cytoplasmic remnants of RNA in RBCs, seen in lead poisoning? | Basophilic stippling |
| What is the triad of fat embolism? | 1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g., long bone fracture) |
| Upon seeing negatively birefringent needle-shaped crystals from a joint aspiration of the great toe, what form of arthritis do you diagnose? | Gout |
| What condition is manifested by bilateral sarcoidosis of the parotid glands, submaxillary gland, and submandibular gland with posterior uveal tract involvement? | Mikulicz syndrome |
| What female genital tract disorder is characterized by obesity, hirsutism, infertility, amenorrhea, elevated LH and testosterone levels, and low FSH levels? | Polycystic ovary disease (Stein-Leventhal syndrome) |
| What bronchogenic carcinoma is associated with an elevated level of Ca2+, involves keratin pearls, occurs in men more than women, is associated with smoking, occurs in the major bronchi, and is seen in the central areas of the lung? | Squamous cell carcinoma |
| What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase? | PKU |
| True or false? Being a white male increases your risk factor for testicular cancer. | Oddly enough, it is true. Cryptorchidism, Klinefelter syndrome, testicular feminization, and family history of testicular cancer are all risk factors. |
| Can an acute MI be diagnosed only by looking at an ECG? | No. Remember, tests do not diagnose, they confirm or refute your diagnosis. Also, diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI, elevated cardiac enzymes consistent with MI, and ST segment elevation of 2 mm |
| What autoimmune syndrome is characterized by keratoconjunctivitis, corneal ulcers, xerostomia, and an increased risk of high-grade B-cell lymphomas? What two Ab tests are used in making the diagnosis? | Sjögren's syndrome; SS-A (Ro) and SS-B (La) |
| True or false? Sickle cell anemia, Caisson disease, chronic steroid use, and Gaucher disease are causes of avascular necrosis of bone. | True. Fractures and trauma, however, are the most common causes. |
| What gene stimulates apoptosis when DNA repair is unable to be done? | p-53 |
| Is ulcerative colitis or Crohn disease more commonly associated with primary sclerosing cholangitis? | Ulcerative colitis |
| What test uses p24 protein when diagnosing HIV? | ELISA test |
| How many café-au-lait spots are necessary for the diagnosis of neurofibromatosis type 1? | At least six |
| What is the term for severe and protracted vomiting resulting in linear lacerations at the gastroesophageal junction? | Mallory-Weiss syndrome |
| What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue? | Metastatic calcification |
| What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction? | Volvulus |
| What form of poisoning is associated with bitter almond-scented breath? | Cyanide |
| Name the type of hypersensitivity reaction based on the following properties. • Circulating Ab-Ag immune complexes deposited in the tissue result in neutrophil attraction and the release of lysosomal enzymes. | Type III hypersensitivity (immune complex) |
| Name the type of hypersensitivity reaction based on the following properties. • IgE-mediated release of chemical mediators from basophils and mast cells; need prior exposure to Ag in the past; eosinophils amplify and continue reaction; can be system or lo | Type I hypersensitivity (anaphylactic) |
| Name the type of hypersensitivity reaction based on the following properties. • IgG or IgM Abs against a specific target cell or tissue; complement-dependent or ADCC. | Type II hypersensitivity (cytotoxic) |
| Name the type of hypersensitivity reaction based on the following properties. • Reaction-mediated by sensitized T-cells | Type IV hypersensitivity (cell-mediated) |
| What highly undifferentiated aggressive CNS tumor of primordial neuroglial origin develops in children and is associated with pseudorosettes? | Primitive neuroectodermal tumors (i.e., medulloblastomas and retinoblastomas) |
| What syndrome is due to anti-GBM Abs directed against the lung and kidneys? | Goodpasture syndrome |
| What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces? | Intrinsic. The extrinsic pathway is activated by the release of tissue factors. |
| What tumor is seen in the 2-to 4-year-old age group; does not cross the midline; has immature glomeruli, tubules, and stroma; and metastasizes late to the lungs? | Wilms tumor |
| What CNS tumor commonly produces tinnitus and hearing loss? | Schwannoma |
| True or false? Anticentromere Abs are used in diagnosing CREST syndrome. | True. Scl-70 Abs are used in diagnosing diffuse scleroderma. |
| What AR CNS disorder presents early in childhood with gait ataxia, loss of deep tendon reflexes, impaired vibratory sensation, hand clumsiness, and loss of position sense? | Friedreich ataxia |
| What potent platelet aggregator and vasoconstrictor is synthesized by platelets? | TXA2 |
| Which type of cerebral herniation is associated with CN III palsy? | Transtentorial (uncal) |
| What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum? | Syphilitic |
| What is the main type of cell involved in cellular immunity? | T lymphocyte |
| What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy? | Melasma |
| What is the classic triad of TB? | Fever, night sweats, and hemoptysis |
| True or false? Blood clots lack platelets. | True. A thrombus has platelets, but clots do not. |
| What malignant tumor of the skin is associated with Birbeck granules? | Histiocytosis X |
| What type of anemia is the result of a deficiency in intrinsic factor? | Pernicious anemia (secondary to a lack of vitamin B12 absorption) |
| What cancer is particularly likely to affect English chimney sweeps? | Scrotal cancer, due to the high exposure to polycyclic aromatic hydrocarbons |
| What is the term for a raised fluid-filled cavity greater than 0.5 cm that lies between the layers of the skin? | Bulla |
| What virus is associated with the endemic form of Burkitt lymphoma? | EBV |
| With which pituitary adenoma is an elevated somatomedin C level associated? | GH-producing adenoma |
| What three criteria allow you to differentiate an ulcer from an erosion or carcinoma? | 1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa |
| Name the four right-to-left congenital cardiac shunts. | Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T |
| What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate? | Hypoparathyroidism |
| Does PT or PTT test the extrinsic coagulation pathway? | PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT, which means warfarin, extrinsic, PT; heparin, intrinsic, PTT) |
| What leukemia is associated with four-leaf-clover lymphocytes on peripheral blood smear? | Adult T-cell leukemia |
| What ring is a weblike narrowing of the gastroesophageal junction? | Schatzki ring |
| With what disease do you see IgA deposits in small vessels of the skin and the kidneys? | Henoch-Schönlein purpura |
| What rapidly progressive and aggressive T-cell lymphoma affects young males with a mediastinal mass (thymic)? | Lymphoblastic lymphoma |
| What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)? | Flea-bitten kidney (can also be seen in pyelonephritis) |
| True or false? Psammoma bodies are seen in medullary carcinoma of the thyroid. | False. Elevated calcitonin levels are seen in medullary carcinoma of the thyroid. Psammoma bodies are seen in papillary carcinoma of the thyroid and ovaries, as well as meningiomas. |
| What is the lecithin:sphingomyelin ratio in respiratory distress syndrome of newborns? | <2 |
| What syndrome has loss of deep tendon reflexes, muscle weakness, and ascending paralysis preceded by a viral illness? | Guillain-Barré syndrome |
| What form of endocarditis do patients with SLE commonly encounter? | Libman-Sacks endocarditis |
| What is the term for black pigmentation of the colon associated with laxative abuse? | Melanosis coli |
| Are the following major or minor Jones criteria of rheumatic fever? • Fever | Minor |
| Are the following major or minor Jones criteria of rheumatic fever? • Migratory polyarthritis | Major |
| Are the following major or minor Jones criteria of rheumatic fever? • Subcutaneous nodules | Major |
| Are the following major or minor Jones criteria of rheumatic fever? • Elevated acute phase reactants (e.g., ESR) | Minor |
| Are the following major or minor Jones criteria of rheumatic fever? • Arthralgias | Minor |
| Are the following major or minor Jones criteria of rheumatic fever? • Pericarditis | Major |
| Are the following major or minor Jones criteria of rheumatic fever? • Erythema marginatum | Major |
| Are the following major or minor Jones criteria of rheumatic fever? • Sydenham chorea | Major |
| What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria? | Bcl-2 |
| Which hepatitis strain is a defective virus that can replicate only inside HBV-infected cells? | Hepatitis D |
| What are the three main components of amyloid? | Fibrillary protein, amyloid protein, and glycosaminoglycans (heparin sulfate mainly) |
| What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100, 00); decreased LAP levels; and nonspecific symptoms of fatigue, malaise, weight loss, and anorexia? | CML |
| What is the difference between a Ghon focus and a Ghon complex? | A Ghon focus is a TB tubercle, whereas a Ghon complex is a focus with hilar lymph node involvement. |
| In what disease do you see horseshoe kidneys, rockerbottom feet, low-set ears, micrognathia, and mental retardation? | Edward syndrome (trisomy 18) |
| What parasitic infection is associated with cholangiocarcinoma? | Clonorchis sinensis |
| What disorder is associated with loss of polarity, anaplasia, pleomorphism, discohesiveness, increase in the nuclear:cytoplasmic ratio, hyperchromasia, and increase in the rate of mitosis? | Malignancy |
| What is the term for telescoping of the proximal bowel into the distal segment presenting as abdominal pain, currant jelly stools, and intestinal obstruction? | Intussusception |
| What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis? | Amanita phalloides |
| What type of erythema do you see in • Ulcerative colitis? | Erythema nodosum |
| What type of erythema do you see in • Rheumatic fever? | Erythema marginatum |
| What type of erythema do you see in • Stevens-Johnson syndrome? | Erythema multiforme |
| What benign bone tumor is associated with Gardner syndrome? | Osteoma |
| What renal calculus is associated with urea-splitting bacteria? | Magnesium ammonium phosphate (struvite) |
| What lymphoma is associated with bleeding and cryoglobulin precipitation at low temperatures, headache and confusion due to hyperviscosity, IgM M-protein spike on serum electrophoresis, and Russell bodies? | Waldenström's macroglobulinemia |
| What type of acute metal poisoning involves stomach and colon erosion and acute tubular necrosis? | Mercury |
| What slow-growing CNS tumor in 30-to 50-year-old patients with a long history of seizures has fried egg cellular appearance in a network of chicken wire? | Oligodendroglioma |
| Goodpasture Ag is a component of what type of collagen? | Type IV collagen |
| If a peripheral blood smear shows schistocytes, reticulocytes, and thrombocytopenia, is it more commonly seen in patients with ITP or TTP? | TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP. |
| After traveling in a plane across the Atlantic Ocean, an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose? | Pulmonary embolism due to a DVT; this is not absolute but a classic description. |
| What cell type involves humoral immunity? | B lymphocyte |
| What is the first sign of megaloblastic anemia on a peripheral blood smear? | Hypersegmented neutrophils |
| What is the term for gastric ulcers associated with severely burned or traumatic patients? | Curling ulcers (think curling iron |
| What syndrome arises from mutation in the fibrillin gene (FBN1) on chromosome 15q21? | Marfan syndrome |
| What AD disorder is characterized by degeneration of GABA neurons in the caudate nucleus resulting in atrophy, chorea, dementia, and personality changes? | Huntington disease |
| What atypical pneumonia can be diagnosed with elevated cold agglutinin titers? | Mycoplasma pneumoniae |
| What is the triad of Felty syndrome? | Neutropenia, splenomegaly, and rheumatoid arthritis |
| What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation? | Chemotaxis |
| What is the term for a benign melanocytic tumor associated with sun exposure that presents as tan-to-brown colored and has sharply defined well-circumscribed borders? | Benign nevus (mole) |
| What small- to medium- sized vasculitis is seen in a 35-year-old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities? | Buerger disease (thromboangiitis obliterans) |
| What is the term for pelvic inflammatory disease of the fallopian tubes? | Salpingitis |
| What disease with familial mental retardation produces large, everted ears and macro-orchidism? | Fragile X syndrome |
| What type of skin carcinoma occurring on sun-exposed sites has a low level of metastasis? | Squamous cell carcinoma |
| What is the tetrad of tetralogy of Fallot? | VSD, RVH, overriding aorta, and pulmonary stenosis |
| What is the term for chronic necrotizing pulmonary infections resulting in permanent airway dilation and associated with Kartagener syndrome? | Bronchiectasis |
| What is an elevated, fluid-filled cavity between skin layers up to 0.5 cm? | Vesicle (e.g., poison ivy) |
| What is the term for panhypopituitarism secondary to ischemic necrosis and hypotension postpartum? | Sheehan syndrome |
| What disease is diagnosed by findings of ANAs and anti-SCL-70 antibodies? | Scleroderma |
| What is the name of the ovarian cyst containing ectodermal, endodermal, and mesodermal elements (i.e., skin, hair, teeth and neural tissue)? | Teratoma (dermoid cyst) |
| What syndrome is seen in iron-deficient middle-aged women with esophageal webs? | Plummer-Vinson syndrome |
| What are the three causes of transudate? | CHF, cirrhosis, and nephrosis |
| A chronic alcohol abuser goes to the ER with weakness, a sore, beefy red tongue, loss of vibration and position sense, arm and leg dystaxia, elevated levels of methylmalonic acid in the urine, and anemia with an MCV above 105 fL. What is your diagnosis, a | Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working, you will see an increased reticulocyte count on the peripheral smear in about 5 days. |
| What form of GN is characteristically associated with crescent formation? | Rapidly progressive glomerulonephritis (RPGN) |
| What vitamin deficiency may result in sideroblastic anemia? | Vitamin B6 |
| What is the term for TB with the cervical lymph node involved? | Scrofula |
| Influx of what ion is associated with irreversible cell injury? | Massive influx of calcium |
| What pathology is associated with elevated levels of Ca2+, cardiac arrhythmias, bone resorption, kidney stones, and metastatic calcifications? | Primary hyperparathyroidism |
| What type of metal poisoning causes mental retardation, somnolence, convulsions, and encephalopathy? | Lead |
| What syndrome is rheumatoid arthritis with pneumoconiosis? | Caplan syndrome |
| True or false? All of the following are risk factors for cervical cancer: multiple pregnancies, early age of intercourse, multiple sexual partners, OCP use, smoking, HIV, and STDs. | True. Don't forget this list; you will be asked. |
| What is the term for precipitation of calcium phosphate in dying or necrotic tissue? | Dystrophic calcification |
| What congenital small bowel outpouching is a remnant of the vitelline duct? | Meckel diverticulum |
| What type of crystals are associated with gout? | Monosodium urate crystals |
| What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning? | Mees lines |
| What is the tumor at the bifurcation of the right and left hepatic ducts? | Klatskin tumor |
| IgE-mediated mast cell release, C3a and C5a, and IL-1 all trigger the release of what vasoactive amine? | Histamine |
| What disease is seen in the 20-to 40-year-old age group, is more prevalent in women than men, involves diarrhea with or without bloody stools, starts in the rectum and ascends without skipping areas, includes pseudopolyps, and has a thickness of the bowel | Ulcerative colitis |
| What disorder causes joint stiffness that worsens with repetitive motion, crepitus, effusions, and swelling and commonly affects the knees, hips, and spine? | Osteoarthritis |
| What condition is characterized by a 46XY karyotype, testes present, and ambiguous or female external genitalia? | Male pseudohermaphrodite (dude looks like a lady!) |
| What is the term for RBC remnants of nuclear chromatin in asplenic patients? | Howell-Jolly bodies |
| What is the term for gastric ulcers associated with increased intracranial pressure? | Cushing's ulcers |
| What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea? | Hemolytic uremic syndrome |
| Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia? | Osteomalacia. Osteoporosis has normal levels of calcium, phosphorus, and alkaline phosphatase. |
| What vascular tumor associated with von Hippel-Lindau syndrome involves the cerebellum, brainstem, spinal cord, and retina? | Hemangioblastoma |
| How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented? | At least 5 lobes |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Epidermis | Labile |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Skeletal muscle | Permanent |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Pancreas | Stable |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • CNS neurons | Permanent |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Fibroblasts | Stable |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Hematopoietic cells | Labile |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Liver | Stable |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Smooth muscle | Stable |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Cardiac muscle | Permanent |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Mucosal epithelium | Labile |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Kidney | Stable |
| Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Osteoblasts | Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states, do not proliferate.) |
| What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)? | Astrocytoma |
| True or false? Elevated ASO titers and serum complement levels are associated with poststreptococcal GN. | False. ASO titers are elevated, but serum complement levels are decreased. |
| What glycoprotein allows platelets to adhere to von Willebrand factor? | GP Ib |
| What encephalitis is associated with the JC virus? | Progressive multifocal leukoencephalopathy |
| Hereditary angioneurotic edema (AD) produces local edema in organs (e.g., GI, skin, respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides? | C1 esterase inhibitor (C1INH) |
| Is an anti-HAV IgG Ab associated with immunization or recent infection? | Anti-HAV IgG Abs are associated with immunization or a prior infection. Anti-HAV IgM is associated with acute or recent infection. |
| Which integrin mediates adhesion by binding to lymphocyte function- associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors? | Intercellular adhesion molecule (ICAM) 1 |
| Name the cerebral vessel associated with the following vascular pathologies. • Subarachnoid hemorrhage | Berry aneurysm in the circle of Willis |
| Name the cerebral vessel associated with the following vascular pathologies. • Subdural hemorrhage | Bridging veins draining into the sagittal sinus |
| Name the cerebral vessel associated with the following vascular pathologies. • Epidural hemorrhage | Middle meningeal artery |
| True or false? Live vaccines are contraindicated in patients with SCID. | TRUE |
| What is the term for the round intracytoplasmic eosinophilic inclusions containing ɑ-synuclein found in the dopaminergic neurons of the substantia nigra? | Lewy bodies |
| In which form of emphysema, panacinar or centriacinar, is the effect worse in the apical segments of the upper lobes? | Centriacinar worse in upper lobes; panacinar worse in base of lower lobes |
| What syndrome results if the enzyme ɑ-1-iduronidase is deficient? L-iduronate sulfatase deficiency? | Hurler syndrome and Hunter syndrome, respectively |
| What percentage of the bone marrow must be composed of blast for leukemia to be considered? | At least 30% blast in the bone marrow |
| What is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs? | CHF |
| What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions? | Fitz-Hugh-Curtis syndrome |
| True or false? Patients with Turner syndrome have no Barr bodies. | True. Remember, the second X chromosome is inactivated, and so is the Barr body. Turner syndrome has only one X chromosome. |
| What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs? | Auspitz sign |
| What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea? | Hgb F |
| What vasculitis affects a 30-year-old Asian female having visual field deficits, dizziness, decreased blood pressure, and weakened pulses in the upper extremities? | Takayasu arteritis (medium-size to large vessels) |
| A 20-year-old college student has fever, grey-white membranes over the tonsils, posterior auricular lymphadenitis, and hepatosplenomegaly. What is your diagnosis? What test do you order to confirm your diagnosis? | EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember, it may be negative in the first week of the illness, so retest if you have a high index of suspicion.) |
| What cell type is commonly elevated in asthma? | Eosinophil |
| What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years? | Pseudogout |
| What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells? | Medullary carcinoma of the thyroid |
| What illegal drug can cause rhabdomyolysis, MI, cerebral infarct, and lethal cardiac arrhythmias? | Cocaine |
| What AA is substituted for glutamic acid at position 6 on the Beta-chain in patients with sickle cell anemia? | Valine |
| What endogenous pigment found in the substantia nigra and melanocytes is formed by the oxidation of tyrosine to dihydroxyphenylalanine? | Melanin |
| What tumor marker is associated with seminomas? | Placental alkaline phosphatase |
| What type of GN, associated with celiac disease and dermatitis herpetiformis, has mesangial deposits of IgA, C3, properdin, IgG, and IgM? | Berger disease (IgA nephropathy) |
| What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus, dilatation of the lateral and third ventricles, and signs of extrapyramidal lesions? | Huntington disease |
| What pattern of inheritance is G-6-PD deficiency? | X-linked recessive |
| What adenocarcinoma presents with elevated levels of acid phosphatase, dihydrotestosterone, PSA, and bone pain? | Prostatic carcinoma |
| Is Dubin-Johnson or Rotor syndrome associated with black pigmentation of the liver? | Both are AR with conjugated hyperbilirubinemia, but Dubin-Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver. |
| What oxygen-dependent killing enzyme requires hydrogen peroxide and halide (Cl-) to produce hypochlorous acid? | Myeloperoxidase |
| What condition results in a strawberry gallbladder? | Cholesterolosis |
| What three chemical agents are associated with angiosarcomas of the liver? | Arsenic, thorotrast, and vinyl chloride |
| What is the term for programmed cell death? | Apoptosis (Remember, there is a lack of inflammatory response.) |
| What potentially fatal disease occurs in children who are given aspirin during a viral illness? | Reye syndrome |
| What metal poisoning produces microcytic anemia with basophilic stippling? | Lead poisoning |
| What inflammatory bowel disorder is continuous, with extensive ulcerations and pseudopolyps, and is associated with HLA-B27? | Ulcerative colitis |
| What is the pentad of TTP? | Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern, my senior resident asked me this question more times than I would like to remember.) |
| Which hepatitis B Ag correlates with infectivity and viral proliferation? | HBeAg |
| What disease involves cold skin abscesses due to a defect in neutrophil chemotaxis and a serum IgE level higher than 2000? | Job syndrome |
| What female pathology is associated with endometrial glands and stroma outside the uterus commonly affecting the ovaries as chocolate cysts? | Endometriosis |
| What is the karyotype in Turner syndrome? | 45XO |
| What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon? | Hirschsprung disease (aganglionic megacolon) |
| What syndrome is associated with gastrin-producing islet cell tumor resulting in multiple intractable peptic ulcers? | Zollinger-Ellison syndrome |
| What type of collagen is associated with keloid formation? | Type III |
| The "tea-and-toast" diet is classically associated with what cause of megaloblastic anemia? | Folate deficiency (very common in the elderly) |
| What is the term for ascending bacterial infection of the renal pelvis, tubules, and interstitium causing costovertebral angle tenderness, fever, chills, dysuria, frequency, and urgency? | Pyelonephritis |
| How can a deficiency in adenosine deaminase be a bone marrow suppressor? | It causes a buildup of dATP, which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate, a precursor of DNA, resulting in overall bone marrow suppression. |
| Which phenotype of osteogenesis imperfecta is incompatible with life? | Type II |
| With what is cherry red intoxication associated? | Acute CO poisoning |
| What are the four most common causes of femoral head necrosis? | 1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia |
| What are the four signs of acute inflammation? | Rubor (red), dolor (pain), calor (heat), tumor (swelling); also sometimes there is loss of function |
| Name the hypochromic microcytic anemia based on the following laboratory values. • Increased iron, decreased TIBC, increased percent saturation, increased ferritin | Sideroblastic anemia |
| Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, TIBC, and percent saturation; increased ferritin | Anemia of chronic disease |
| Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, percent saturation, and ferritin; increased TIBC | Iron deficiency anemia |
| Name the hypochromic microcytic anemia based on the following laboratory values. • Normal iron, TIBC, percent saturation, and ferritin | Thalassemia minor |
| Which form of emphysema is associated with an alpha1-antitrypsin deficiency? | Panacinar |
| An 80-year-old woman presents to you with right-sided temporal headache, facial pain and blurred vision on the affected side, and an elevated ESR. Your diagnosis? | Temporal arteritis (giant cell arteritis) |
| What type of neurofibromatosis is associated with bilateral acoustic schwannomas? | Type 2 |
| What disorder is due to a deficiency in the enzyme glucocerebrosidase? | Gaucher disease |
| What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis? | Boutonnière deformities |
| True or false? Atelectasis is an irreversible collapse of a lung. | False. Atelectasis is a reversible collapse of a lung. |
| What viral infection in patients with sickle cell anemia results in aplastic crisis? | Parvovirus B 19 |
| What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype? | Klinefelter syndrome |
| What CNS developmental abnormality is associated with 90% of syringomyelia? | Arnold-Chiari malformation type 2 |
| What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension? | Onion skinning |
| A 30-year-old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis? | Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer, which is commonly unilateral, single nodule, no variation with pregnancy. |
| What disease is X-linked recessive, is associated with eczema thrombocytopenia and an increased chance of developing recurrent infections, involves a decrease in serum IgM and in the T cell-dependent paracortical areas of the lymph nodes, and means that t | Wiskott-Aldrich syndrome |
| Which form of melanoma carries the worst prognosis? | Nodular melanoma |
| Patients with sickle cell anemia are at increased risk for infection from what type of organisms? | Encapsulated bacteria |
| How many major and/or minor Jones criteria are required for the diagnosis of rheumatic fever? | Two major or one major and two minor |
| What skin carcinoma is a superficial dermal infiltrate of T lymphocytes seen in males more than 40 years old and presents as scaly red patches or plaques? | Mycosis fungoides (cutaneous T-cell lymphoma) |
| What Hgb-derived endogenous pigment is found in areas of hemorrhage or bruises? | Hemosiderin |
| What is a palpable, elevated solid mass up to 0.5 cm? | Papule |
| True or false? Monocytosis is seen in TB. | TRUE |
| What pathology is associated with podagra, tophi in the ear, and PMNs with monosodium urate crystals? | Gout |
| What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile, ischemia, Staphylococcus, Shigella, or Candida infection? | Pseudomembranous colitis |
| What do the risk factors late menopause, early menarche, obesity, nulliparity, excessive estrogen, genetic factor p53, and brc-abl characterize? | Breast cancer |
| What thyroid carcinoma is associated with radiation exposure, psammoma bodies, and Orphan Annie eye nuclei? | Papillary carcinoma of the thyroid |
| Name three opsonins. | Fc portion of IgG, C3b, and mannose-binding proteins |
| What chemical can be dangerous if you work in the aerospace industry or in nuclear plants? | Beryllium |
| Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Window period | HBcAb IgM |
| Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Immunization | HBsAb IgG |
| Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Prior infection | HBcAb IgG and HBsAb IgG |
| Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Acute infection | HBcAb IgM, HBV-DNA, HBeAg, HBsAg |
| Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Chronic infection | HBcAb IgG, HBV-DNA, HBeAg, HBsAg |
| Name the type of necrosis. • The most common form of necrosis; denatured and coagulated proteins in the cytoplasm | Coagulative necrosis |
| Name the type of necrosis. • Seen as dead tissue with coagulative necrosis | Gangrenous necrosis |
| Name the type of necrosis. • Seen as dead tissue with liquefactive necrosis? | Liquefaction necrosis |
| Name the type of necrosis. • Due to lipase activity and has a chalky white appearance | Fat necrosis |
| Name the type of necrosis. • Soft, friable, cottage-cheese appearing; characteristically seen in TB | Caseous necrosis |
| Name the type of necrosis. • Histologically resembles fibrin | Fibrinoid necrosis |
| Name the three enzymes that protect the cell from oxygen-derived free radicals. | Superoxide dismutase, glutathione peroxidase, catalase |
| What are the rules of 2 for Meckel diverticulum? | 2% of population, 2 cm long, 2 feet from ileocecal valve, 2 years old, and 2% of carcinoid tumors |
| What aneurysm of the circle of Willis is associated with polycystic kidney disease? | Berry aneurysm |
| A 20-year-old black woman goes to you with nonspecific joint pain, fever, and a malar rash over the bridge of her nose and on her cheeks. This is a classic example of what autoimmune disease? What are three autoantibody tests you could order to make the d | SLE; ANA, anti-dsDNA and anti-Sm (anti-Smith) |
| True or false? Excess lead deposits in the oral cavity. | True. It deposits at the gingivodental line, known as the lead line. |
| What is the term for increased iron deposition resulting in micronodular cirrhosis, CHF, diabetes, and bronzing of the skin? | Hemochromatosis |
| What AR disorder is due to a deficiency in glycoprotein IIb-IIIa, resulting in a defect in platelet aggregation? | Glanzmann syndrome |
| What protein-losing enteropathy has grossly enlarged rugal fold in the body and fundus of the stomach in middle-aged males, resulting in decreased acid production and an increased risk of gastric cancer? | Ménétrier's disease |
| What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities, red cell aplasia, and muscle weakness? | Myasthenia gravis |
| Which subtype of AML is most commonly associated with Auer rods? | M3 (promyelocytic leukemia) |
| What condition results from a 46XX karyotype and female internal organs with virilized external genitalia? | Female pseudohermaphrodite |
| Two weeks after her son has a throat infection, a mother takes the boy to the ER because he has fever, malaise, HTN, dark urine, and periorbital edema. What is your diagnosis? | Poststreptococcal GN |
| What X-linked recessive immune disorder is characterized by recurrent infections, severe thrombocytopenia, and eczema? | Wiskott-Aldrich syndrome |
| What form of arthritis is associated with calcium pyrophosphate crystals? | Pseudogout |
| What is the term for excessive production of collagen that flattens out and does not extend beyond the site of the injury? | Hypertrophic scar |
| What is the term for inflamed, thickened skin on the breast with dimpling associated with cancer? | Peau d'orange |
| What rare vasculitis has the following characteristics: males aged 40 to 60; affecting small arteries and veins; involving nose, sinuses, lungs, and kidneys; C-ANCA and autoantibodies against proteinase 3? | Wegener granulomatosis |
| What retrovirus is associated with adult T-cell leukemia? | HTLV-1 |
| What disease is seen in children younger than 5 years of age and is characterized by X-linked recessive cardiac myopathies, calf pseudohypertrophy, lordosis, protuberant belly, an increase then a decrease in CPK, and death commonly in the second decade of | Duchenne muscular dystrophy |
| What malignant neoplasm of the bone has a soap bubble appearance on radiograph? | Giant cell bone tumor (osteoclastoma) |
| What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition? | Minimal change disease |
| What is the term for tissue-based basophils? | Mast cells |
| What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph? | Osteosarcoma |
| Is splenomegaly more commonly associated with intravascular or extravascular hemolysis? | Extravascular hemolysis if it occurs in the spleen; if in the liver, it results in hepatomegaly. |
| What cancer of the male genitourinary system is associated with osteoblastic bony metastasis? | Prostatic carcinoma |
| What stromal tumor in males is characterized histologically with crystalloids of Reinke? | Leydig cell tumor |
| What pulmonary disease, most commonly associated with smoking, results in enlarged, overinflated lungs owing to the destruction of the alveolar walls with diminished elastic recoil? | Emphysema |
| What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway? | Factor XII for the intrinsic; factor VII for the extrinsic pathway |
| What chronic systemic inflammatory disease commonly seen in women aged 20 to 50 is a progressive, symmetric arthritis affecting the hands, wrists, knees, and ankles that improves with increased activity? | Rheumatoid arthritis |
| Name the following descriptions associated with bacterial endocarditis: • Retinal emboli | Roth spots |
| Name the following descriptions associated with bacterial endocarditis: • Painful subcutaneous nodules on fingers and toes | Osler nodes |
| Name the following descriptions associated with bacterial endocarditis: • Painless hyperemic lesions on the palms and soles | Janeway lesions |
| What two CD cell surface markers do Reed- Sternberg cells stain positive for? | CD15 and CD30 |
| What two lysosomal storage diseases have cherry-red spots on the retina? | Niemann-Pick and Tay-Sachs diseases |
| True or false? Increased leukocyte alkaline phosphatase (LAP) is associated with CML. | False. Increased LAP is seen in stress reactions and helps differentiate benign conditions from CML, which has low LAP levels. |
| What syndrome has multiple adenomatous colonic polyps and CNS gliomas? | Turcot syndrome |
| What is the term for a venous embolus in the arterial system? | Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart. |
| Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions? | Embolic |
| What is the name for the following RBC indices? • The coefficient of variation of the RBC volume | Red blood cell distribution width index (RDW) |
| What is the name for the following RBC indices? • Average mass of the Hgb molecule/RBC | Mean corpuscular hemoglobin (MCH) |
| What is the name for the following RBC indices? • Average volume of a RBC | Mean corpuscular volume (MCV) |
| What is the name for the following RBC indices? • Average Hgb concentration/given volume of packed RBCs | Mean corpuscular hemoglobin concentration (MCHC) |
| What cardiomyopathy is due to a ventricular outflow obstruction as a result of septal hypertrophy and leads to sudden cardiac death in young athletes? | Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis, or IHSS) |
| Which HPV serotypes are associated with condyloma acuminatum? | HPV serotypes 6 and 11 |
| Which form of melanoma carries the best prognosis? | Lentigo maligna melanoma |
| What is the term for an increase in the number of cells in a tissue? | Hyperplasia |
| A 60-year-old man has back pain (compression spinal fracture), hypercalcemia, increased serum protein, Bence- Jones proteinuria, and monoclonal M-spike on serum electrophoresis. What is your diagnosis? | Multiple myeloma |
| What is the term for pus in the pleural space? | Empyema |
| What is flat, circumscribed nonpalpable pigmented change up to 1 cm? | Macule (e.g., a freckle) |
| Name the macrophage based on its location: • Liver macrophages | Kupffer cells |
| Name the macrophage based on its location: • Bone macrophages | Osteoclasts |
| Name the macrophage based on its location: • Brain macrophages | Microglia |
| Name the macrophage based on its location: • Lung macrophages | Pulmonary alveolar macrophages |
| Name the macrophage based on its location: • Connective tissue macrophages | Histiocytes |
| Name the macrophage based on its location: • Epidermal macrophages | Langerhans cells |
| What is the term for a large, immature RBC that is spherical, blue, and without a nucleus? | Reticulocyte |
| What testicular tumor of infancy is characterized by elevated-fetoprotein levels and Schiller-Duval bodies? | Yolk sac tumor |
| Starry sky appearance of macrophages is pathognomonic of what lymphoma? | Burkitt lymphoma |
| In which region of the lung are 75% of the pulmonary infarcts seen? | Lower lobe |
| For what disease are SS-A(Ro), SS-B(La), and R-ANA diagnostic markers? | Sjögren disease |
| What HPV serotypes are associated with increased risk of cervical cancer? | HPV serotypes 16, 18, 31, and 33 |
| Do the following structures pick up stain from hematoxylin or eosin? • Nuclei | Hematoxylin |
| Do the following structures pick up stain from hematoxylin or eosin? • Nucleoli | Hematoxylin |
| Do the following structures pick up stain from hematoxylin or eosin? • Cytoplasm | Eosin |
| Do the following structures pick up stain from hematoxylin or eosin? • Collagen | Eosin |
| Do the following structures pick up stain from hematoxylin or eosin? • RBCs | Eosin |
| Do the following structures pick up stain from hematoxylin or eosin? • Calcium | Hematoxylin |
| Do the following structures pick up stain from hematoxylin or eosin? • Bacteria | Hematoxylin |
| Do the following structures pick up stain from hematoxylin or eosin? • Fibrin | Eosin |
| Do the following structures pick up stain from hematoxylin or eosin? • Thyroid colloid | Eosin |
| What commonly encountered overdose produces headache, tinnitus, respiratory alkalosis, metabolic acidosis, confusion, vomiting, and tachypnea? | ASA (salicylate) |
| What AR syndrome is due to a deficiency of glycoprotein Ib, resulting in a defect in platelet adhesion? | Bernard-Soulier syndrome |
| What AD renal disorder is associated with mutations of the PKD 1 gene on chromosome 16 and berry aneurysms in the circle of Willis and presents in the fifth decade with abdominal masses, flank pain, hematuria, HTN, and renal insufficiency? | Adult polycystic kidney disease |
| Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Months to years after transplantation; gradual onset of HTN, oliguria, and azotemia; seen as intimal fibrosis of the blood vessels and interstitial | Chronic rejection |
| Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Immediately after transplantation; seen as a neutrophilic vasculitis with thrombosis | Hyperacute rejection |
| Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Weeks to months after transplantation; abrupt onset of oliguria and azotemia; seen as neutrophilic vasculitis and interstitial lymphocytes | Acute rejection |
| What type of collagen is abnormal in patients with osteogenesis imperfecta? | Type I (makes sense, since they have a predisposition for fractures and type I collagen is associated with bones and tendons) |
| What coronary artery vasculitis is seen in Japanese infants and children less than 4 years old with acute febrile illness, conjunctivitis, maculopapular rash, and lymphadenopathy? | Kawasaki disease |
| What disease has IgG autoantibodies, occurs in women more than men, and includes exophthalmos, pretibial myxedema, nervousness, heart palpitations, and fatigue? | Graves disease |
| What condition is defined by both testicular and ovarian tissues in one individual? | True hermaphrodism |
| A mother takes her 2-week-old infant to the ER because the baby regurgitates and vomits after eating and has peristaltic waves visible on the abdomen and a palpable mass in the right upper quadrant. What is your diagnosis? | Pyloric stenosis |
| What variant of polyarteritis nodosa is associated with bronchial asthma, granulomas, and eosinophilia? | Churg-Strauss syndrome |
| What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor? | Laminin |
| What B-cell neoplasm is seen in males with massive splenomegaly, produces dry tap on bone marrow aspirations, and stains positive for tartrate-resistant acid phosphatase (TRAP)? | Hairy cell leukemia |
| What form of nephritic syndrome is associated with celiac sprue and Henoch- Schönlein purpura? | IgA nephropathy |
| What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia, tetany, and T-cell deficiency? | DiGeorge syndrome |
| What is the treatment for physiologic jaundice of newborns? | Phototherapy |
| How many months in how many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made? | 3 months of symptoms in 2 consecutive years |
| What chronic inflammatory WBC is associated with IgE-mediated allergic reactions and parasitic infections? | Eosinophils |
| What AD syndrome produces hamartomatous polyps in the small intestine and pigmentation of the lips and oral mucosa? | Peutz-Jeghers syndrome |
| What is the term for formation of a stable fibrin-platelet plug to stop bleeding? | Hemostasis |
| True or false? All of the following are risk factors for breast cancer: early menses, late menopause, history of breast cancer, obesity, and multiparity. | False. All except multiparity are risk factors for breast cancer. Nulliparity, increasing age, and family history in first-degree relative are also risk factors. Memorize this list! |
| Is jugular venous distention a presentation of isolated left or right heart failure? | Right-sided |
| Name the hepatitis virus based on the following information. • Small circular RNA virus with defective envelope | Hepatitis D |
| Name the hepatitis virus based on the following information. • Enveloped RNA flavivirus | Hepatitis C |
| Name the hepatitis virus based on the following information. • Naked capsid RNA calicivirus | Hepatitis E |
| Name the hepatitis virus based on the following information. • Enveloped DNA hepadnavirus | Hepatitis B |
| Name the hepatitis virus based on the following information. • Naked capsid RNA picornavirus | Hepatitis A |
| What AR disease involves a decreased amount of sphingomyelinase, massive organomegaly, zebra bodies, and foamy histiocytes and is associated with chromosome 11p? | Niemann-Pick disease |
| What is the term for hypoperfusion of an area involving only the inner layers? | Mural infarct |
| What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count? | Marrow failure, cancer, and leukemia |
| Notching of the ribs, seen on chest radiograph in patients with postductal coarctation of the aorta, is due to collateralization of what arteries? | Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching. |
| What is the physiologic storage form of iron? | Ferritin |
| What is the term for occlusion of a blood vessel due to an intravascular mass that has been carried downstream? | Embolism |
| What AR disorder of copper metabolism can be characterized by Kayser- Fleischer rings, decreased ceruloplasmin levels, and increased urinary copper excretion and tissue copper levels? | Wilson disease. (Remember, patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.) |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • c-myc | Burkitt lymphoma |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • L-myc | Small cell cancer of the lung |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1 and int-2 | Melanoma, cancer of the stomach and bladder |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • et | MEN II and III syndromes |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • Ki-ras | Pancreas and colon |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • cyclin D | Mantle cell lymphoma |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • N-myc | Neuroblastoma |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • CDK4 | Melanoma |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • abl | CML and ALL |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1, int-2, erb-2, and erb-3 | Breast cancer |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • sis | Astrocytoma |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • Ki-ras and erb-2 | Lung cancer |
| Name the cancer associated with the following oncogenes. (Some may have more than one answer) • erb-1 | Squamous cell carcinoma of the lung |
| What AD GI neoplasia produces multiple adenomatous polyps, osteomas, fibromas, and epidural inclusion cysts? | Gardner syndrome |
| What disease involves microcephaly, mental retardation, cleft lip or palate, and dextrocardia? | Patau syndrome (trisomy 13) |
| What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex-mediated; and is seen as lumpy-bumpy subepithelial deposits? | Postinfectious GN |
| What are the three most common sites for left-sided heart embolisms to metastasize? | Brain, spleen, and kidney |
| With what two pathologies is a honeycomb lung associated? | Asbestosis and silicosis |
| What AD disorder due to a mutation in fibroblast growth factor receptor 3 results in normal-size vertebral column and skull and short, thick extremities? | Achondroplasia |
| True or false? Hyperkalemia increases the effect of digoxin. | False. hyperkalemia decreases digoxin's activity, while hypokalemia, hypomagnesemia, and hypercalcemia all increase digoxin toxicity. |
| Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia? | Dantrolene |
| Which overdose carries a higher mortality rate, that of benzodiazepines or barbiturates? | Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates. |
| What antiviral agent is used in the treatment of drug-induced Parkinson's disease? | Amantadine |
| Are the following responses associated with histamines H1 or H2 receptor activation? • Edema | H 1 |
| Are the following responses associated with histamines H1 or H2 receptor activation? • Gastric acid secretion | H 2 |
| Are the following responses associated with histamines H1 or H2 receptor activation? • SA nodal activity | H 2 |
| Are the following responses associated with histamines H1 or H2 receptor activation? • Pain and pruritus | H 1 |
| Are the following responses associated with histamines H1 or H2 receptor activation? • Bronchial smooth muscle activity | H 1 |
| Are the following responses associated with histamines H1 or H2 receptor activation? • Inotropic action and automaticity | H 2 |
| True or false? The lack of dopamine production in the substantia nigra leads to the extrapyramidal dysfunction, characteristically seen in patients with Parkinson's disease. | True. The lack of dopamine leads to an excess of ACh, hence extrapyramidal dysfunction. |
| Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN? | PGI 2 |
| Which CNS ACh receptor or receptors are excitatory? Inhibitory? | M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory. |
| True or false? Beta2-Adrenergic agents are used in the management of an acute asthmatic attack. | True. They are useful in the early-phase response to an asthmatic attack. |
| Do local anesthetics bind to the activated or inactivated sodium channels? | Inactivated |
| What is the drug of choice for treating Tourette syndrome? | Pimozide |
| What mosquito is responsible for the transmission of malaria? | Anopheles mosquito |
| What enzyme is inhibited by disulfiram? | Acetaldehyde dehydrogenase |
| Which diuretic is used as an adrenal steroid antagonist? | Spironolactone |
| What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV? | Fentanyl |
| What is the drug of choice for penicillin-resistant gonococcal infections? | Spectinomycin |
| What is the DOC for treating torsade de pointes? | Magnesium |
| Is heparin contraindicated in pregnancy? | No. Heparin is safe in pregnancy, but warfarin is contraindicated in pregnancy because of its ability to cross the placenta. |
| What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin? | Griseofulvin |
| Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida? | Carbamazepine |
| What are the three Beta-lactamase inhibitors? | 1. Clavulanic acid 2. Sulbactam 3. Tazobactam |
| Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium? | Carbamazepine |
| Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent? | Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent |
| Which class of diuretics is used to treat metabolic acidosis, acute mountain sicknesses, and glaucoma and to aid in the elimination of acidic drug overdoses? | Carbonic anhydrase inhibitors (acetazolamide and dorzolamide) |
| What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis? | Raloxifene |
| Which tetracycline is used in the treatment of SIADH? | Demeclocycline |
| How is the eye affected by use of opioids? | With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity. |
| Name the antimicrobial agent whose major side effect is listed. • Grey baby syndrome | Chloramphenicol |
| Name the antimicrobial agent whose major side effect is listed. • CN VIII damage (vestibulotoxic) | Aminoglycosides |
| Name the antimicrobial agent whose major side effect is listed. • Teratogenicity | Metronidazole |
| Name the antimicrobial agent whose major side effect is listed. • Cholestatic hepatitis | Erythromycin |
| Name the antimicrobial agent whose major side effect is listed. • Hemolytic anemia | Nitrofurantoin |
| Name the antimicrobial agent whose major side effect is listed. • Dental staining in children | Tetracycline |
| Name the antimicrobial agent whose major side effect is listed. • Altered folate metabolism | Trimethoprim |
| Name the antimicrobial agent whose major side effect is listed. • Auditory toxicity | Vancomycin |
| Name the antimicrobial agent whose major side effect is listed. • Cartilage abnormalities | Quinolones |
| What are the two side effects of opioids to which the user will not develop tolerance? | Constipation and miosis |
| Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches? | Valproic acid |
| What antitubercular agent causes loss of red-green visual discrimination? | Ethambutol |
| Name the insulin preparation based on the peak effect and duration of action. • Peak, 8 to 16 hours; duration, 24 to 36 hours | Ultralente |
| Name the insulin preparation based on the peak effect and duration of action. • Peak, 0.5 to 3 hours; duration, 5 to 7 hours | Regular insulin |
| Name the insulin preparation based on the peak effect and duration of action. • Peak, 8 to 12 hours; duration, 18 to 24 hours | Lente or NPH insulin (neutral protamine Hagedorn insulin) |
| Name the insulin preparation based on the peak effect and duration of action. • Peak, 0.3 to 2 hours; duration, 3 to 4 hours | Lispro insulin |
| Is digoxin or digitoxin renally eliminated? | Digoxin is renally eliminated; digitoxin is hepatically eliminated. |
| What is the drug of choice for steroid-induced osteoporosis? | Alendronate |
| What are the first signs of overdose from phenobarbitals? | Nystagmus and ataxia |
| How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery? | Inhaled anesthetics with low lipid solubility have low potency (directly related), so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility. |
| What α1-agonist, not inactivated by catechol-O-methyl transferase (COMT), is used as a decongestant and for treatment of paroxysmal atrial tachycardia? | Phenylephrine |
| Which laxative is used in the treatment of hepatic encephalopathy ? | Lactulose |
| Are hydrolysis, oxidation, and reduction phase I or II biotransformations? | Phase I |
| What β-blocker is also an α-blocker? | Labetalol |
| What agent is used IM to treat acute dystonias? | Diphenhydramine |
| True or false? Anaerobes are resistant to the effects of aminoglycosides. | True. Aminoglycosides use O 2-dependent uptake and therefore are ineffective for treatment of anaerobic infections. |
| What two β-blockers decrease serum lipids? | Acebutolol and Pindolol |
| If a drug is ionized, is it water or lipid soluble? Can it cross a biomembrane? | Ionized drugs are water soluble, and since only lipid-soluble drugs can cross biomembranes, an ionized drug cannot cross them without the help of a carrier. |
| What are the longest-acting and shortest-acting benzodiazepines? | Diazepam is longest acting and midazolam is shortest acting. |
| What is the DOC for severe infections with Sporothrix, Mucor, Histoplasma, Cryptococcus, Candida, and Aspergillus? | Amphotericin B |
| What neurotransmitter is presynaptically inhibited by reserpine and guanethidine? | NE |
| Which two cephalosporins cross the blood-brain barrier? | Cefuroxime and cefaclor |
| What agent, in combination with a MAOI inhibitor, can cause hypertensive crisis? | Tyramine |
| True or false? Cocaine-induced coronary ischemia should not be treated with β-blockers. | True. β-Blockade would result in unopposed-adrenergic stimulation and worsen the patient's symptoms. Calcium channel blockers are the way to go. |
| What antimuscarinic is used as an inhalant for asthma? | Ipratropium |
| What two forms of insulin, if mixed together, precipitate zinc? | Lente insulin and either NPH or protamine zinc insulin (PZI) |
| What androgen receptor blocker is used in the treatment of prostatic cancer? | Flutamide |
| What are the first signs of phenobarbital overdose? | Nystagmus and ataxia |
| Which virus is treated with the monoclonal antibody palivizumab? | RSV |
| Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland? | Lithium |
| Which class of antiarrhythmics are potassium channel blockers? | Class III |
| Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger? | M 2 |
| What antiepileptic agent has SIADH as a side effect? | Carbamazepine |
| What is the only anesthetic that causes cardiovascular stimulation? | Ketamine |
| Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis? | Dapsone |
| What form of antimicrobial therapy is best for an immunocompromised patient? | Bactericidal |
| Which direct-acting vasodilator is associated with SLE-like syndrome in slow acetylators? | Hydralazine |
| What class of heparin is active against factor Xa and has no effect on PT or PTT? | Low molecular weight heparin (LMWH) |
| What is the DOC for coccidioidomycosis? | Fluconazole |
| What three cephalosporins have good penetration against Bacteroides fragilis? | 1. Cefotetan 2. Cefoxitin 3. Ceftizoxime |
| Which form of alcohol toxicity results in ocular damage? | Methanol |
| What immunosuppressive agent is converted to 6-mercaptopurine? | Azathioprine |
| Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade? | Nerve fibers with small diameter and high firing rates are most sensitive to local blockade |
| What enzyme is inhibited by trimethoprim? | Dihydrofolate reductase |
| What are the two absolute requirements for the cytochrome P450 enzyme system? | NADPH and molecular O 2 |
| What three PGs are potent platelet aggregators? | PGE 1, PGI 2 (most potent), and TXA 2 |
| A depressive patient who is taking paroxetine goes to the ER with pain and is given meperidine. Shortly afterward she develops diaphoresis, myoclonus, muscle rigidity, hyperthermia, and seizures. What is your diagnosis? | Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs, TCADs, dextromethorphan, and meperidine. Treat it with cyproheptadine. |
| What class of drugs is used in the treatment of demineralization of the bone? | Bisphosphonates |
| What is the only class of diuretics to retain Cl- used in the short-term treatment of glaucoma and of acute mountain sickness? | Acetazolamide |
| True or false? All aluminum-containing antacids can cause hypophosphatemia. | True. Aluminum reacts with PO4, resulting in AlPO4, an insoluble compound that cannot be absorbed. |
| What TCAD causes sudden cardiac death in children? | Desipramine |
| What two β2-agonists are used to produce bronchodilation? | Metaproterenol and albuterol |
| What IV-only agent inhibits water reabsorption in the PCTs and is used to treat increased intracranial pressure, increased intraocular pressure, and acute renal failure? | Mannitol |
| What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade? | They prevent mast cell degranulation. |
| What two β2-agonists cause myometrial relaxation? | Ritodrine and terbutaline |
| Where in the spinal cord are the presynaptic opioid receptors? | In the dorsal horn of the spinal cord on the primary afferent neurons |
| What thrombolytic agent is derived from β-hemolytic streptococci, is antigenic, and produces depletion of circulating fibrinogen, plasminogen, and factors V and VII? | Streptokinase |
| What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase? | Terbinafine |
| Which class of antihypertensives produces angioedema, hyperkalemia, and a dry cough? | ACE inhibitors (the-pril agents) |
| Which medication requires an acidic gastric pH for activation to form a protective gel-like coating over ulcers and GI epithelium? | Sucralfate |
| Of what serotonin receptor is sumatriptan an agonist? | 5HT1D |
| A patient with a history of epilepsy goes to the ER with sedation, gait ataxia, diplopia, and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms? | Phenytoin |
| What are the five penicillinase-resistant penicillins? | 1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM) |
| Which aminoglycoside is the DOC for tularemia and the bubonic plague? | Streptomycin |
| Is the following description characteristic of competitive or noncompetitive antagonists: parallel shift to the right on a dose-response curve, complete reversibility with increase of the dose of the agonist drug, and capacity to decrease the potency of t | Competitive antagonist |
| True or false? Progestins are used in combination with estrogens to decrease the risk of endometrial cancer. | TRUE |
| What neuroleptic agent causes agranulocytosis but does not induce tardive dyskinesia? | Clozapine |
| What two factors influence low oral bioavailability? | First-pass metabolism and acid lability |
| What is the only site in the body that uses M1 receptors? | The stomach |
| What vitamin is a cofactor of aromatic amino acid decarboxylase and decreases the efficacy of L-dopa if used concomitantly? | Vitamin B 6 (pyridoxine) |
| True or false? Acetaminophen has analgesic and antipyretic activities but lacks anti-inflammatory effects. | TRUE |
| What happens to plasma concentration of a drug if there is a large volume of distribution? | The larger the volume of distribution, the lower the plasma concentration of a drug. |
| Why should opioid analgesics be avoided for patients with head trauma? | Opioids cause cerebral vasodilation and can result in increased intracerebral pressure. |
| What is the drug of choice in the treatment of the lepra reaction? | Clofazimine |
| What two drugs, when mixed, can lead to malignant hyperthermia? | Succinylcholine and halothane (Treatment is with dantrolene.) |
| What three β-blockers are used in the treatment of glaucoma? | 1. Propranolol 2. Timolol 3. Carteolol |
| What is the neurotransmitter at the K-receptor? | Dynorphin |
| True or false? Succinylcholine is a nicotinic receptor agonist. | TRUE |
| What is the drug of choice for hypertensive patients with a decreased renal function? | α-Methyldopa (Guanabenz or clonidine is also used.) |
| What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound? | Volume of distribution is decreased when a large percentage of drug is protein bound. |
| What antihistamine is used in the treatment of serotonergic crisis? | Cyproheptadine |
| What is the drug of choice for early Parkinson's disease? | Selegiline |
| What is the site of action of the following? • Osmotic diuretics | The entire tubule barring the thick ascending limb |
| What is the site of action of the following? • Loop diuretics | Ascending limb |
| What is the site of action of the following? • Thiazide diuretics | Early distal tubule |
| What is the site of action of the following? • K+-sparing diuretics | Early collecting duct |
| What is the site of action of the following? • Aldosterone antagonists | Distal convoluted tubules |
| What hematologic malignancy is treated with the monoclonal antibody rituximab? | Non-Hodgkin lymphoma |
| Which sodium channel blocker is used to treat lithium-induced diabetes insipidus? | Amiloride |
| Which two antipsychotic drugs create a high risk for developing extrapyramidal syndrome (EPS) side effects? | Haloperidol and fluphenazine (but use of any high-potency phenothiazine runs the risk of EPS) |
| Could an overdose with either zolpidem or zaleplon be reversed with flumazenil? | Yes, because they both activate the BZ1-receptors, which can be reversed by flumazenil. |
| What drug blocks intragranular uptake of NE? | Reserpine |
| True or false? Antimicrobial agents that slow bacterial growth are bactericidal. | False. Bacteriocidals kill; bacteriostatics slow growth. |
| Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD? | Nicotinic acid, because its side effects include hyperuricemia and exacerbation of ulcers. |
| What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm? | Mebendazole |
| What antiviral agents inhibit neuraminidases of influenza A and B? | Zanamivir and oseltamivir |
| What three cephalosporins inhibit vitamin K-dependent factors? | Cefamandole, cefoperazone, and moxalactam |
| Which direct-acting vasodilator is used clinically to treat hypertensive emergencies, insulinomas, and as a uterine smooth muscle relaxant? | Diazoxide |
| Which leukotriene—LTA4, LTB4, LTC4, or LTD4—is not associated with anaphylaxis and bronchoconstriction? | LTB4 |
| What neuroleptic agent causes retinal deposits, hypotension, and torsades de pointes? | Thioridazine |
| What oral hypoglycemic agent inhibits α-glucosidase in the brush border of the small intestine? | Acarbose |
| What enzyme is inhibited by sulfonamides? | Dihydropteroate synthetase |
| What is the most important determinant of drug potency? | The affinity of the drug for its receptor |
| True or false? Estrogen use increases the risk of developing ovarian cancer. | False. Risk of breast and endometrial cancer but not ovarian cancer increases with the use of estrogen. |
| Which sedative-hypnotic is contraindicated for patients taking warfarin? | Chloral hydrate |
| What mixed α-antagonists are used for patients with pheochromocytoma? | Phentolamine and phenoxybenzamine |
| What are the four types of signaling mechanisms? | 1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors |
| The dose of which second-generation sulfonylurea agent must be decreased for patients with hepatic dysfunction? | The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction. |
| Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia? | d-Tubocurarine |
| What transient deficiency may result in a hypercoagulable state if warfarin is given alone? | Transient protein C deficiency, because of its relatively short half-life, may result if warfarin is instituted alone. |
| What component of the vascular system is most sensitive to the effects of calcium channel blockers? | Arterioles |
| What drug blocks glucose uptake, leading to decreased formation of ATP and resulting in immobilization of the parasite? | Albendazole |
| What is the site of action for carbonic anhydrase inhibitors? | Proximal tubule |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Bleomycin | G2 phase |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Cytarabine | S phase |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Vinblastine | Mitosis |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Alkylating agents | G0 phase |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Paclitaxel | Mitosis |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Vincristine | Mitosis |
| What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Thioguanine | S phase |
| What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Mercaptopurine | S phase |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Dacarbazine | G0 phase |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Hydroxyurea | S phase |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Cisplatin | G0 phase |
| What phase of the cell cycle are the following antineoplastic agents specific for? • Nitrosoureas | G0 phase |
| Inhibition of peripheral COMT, allowing increased CNS availability of L-dopa, is accomplished by what two agents? | Tolcapone and entacapone |
| What medication is a PGE1 analog that results in increased secretions of mucus and HCO3-in the GI tract? | Misoprostol |
| Is there a difference between mathematical and clinical steady states? If so, what are their values (half-lives)? | There is a difference; it takes about 7 to 8 half-lives to reach mathematical steady state and 4 to 5 half-lives to reach clinical steady state. |
| True or false? At high doses aspirin has uricosuric properties. | True. At high doses ASA decreases uric acid reabsorption in the renal tubules, resulting in uricosuric actions. At low doses ASA decreases tubular secretion of uric acid, leading to hyperuricemia. |
| What antiviral agent is used to treat RSV, influenza A and B, Lassa fever, and hantavirus and as an adjunct to IFN-in hepatitis C? | Ribavirin |
| Which aminoglycoside is used only topically because it is too toxic for systemic use? | Neomycin |
| Which class of antiarrhythmics blocks sodium channels? | Class 1 (1A, 1B, and 1C) |
| What form of penicillin is used in the treatment of life-threatening illnesses? | Penicillin G (benzylpenicillin) |
| What is the DOC for esophageal candidiasis? | Fluconazole |
| True or false? Flumazenil is used in the treatment of barbiturate overdose. | False. Flumazenil is unable to block the effects of barbiturates. |
| Which three aminoglycosides have vestibular toxicity? | 1. Streptomycin 2. Gentamicin 3. Tobramycin |
| What is the term for the amount of a drug that is needed to produce the desired effect? | Potency |
| What agent used in the treatment of BPH and baldness is a 5-α-reductase inhibitor? | Finasteride |
| What β-blocker is also a membrane stabilizer? | Propranolol |
| Name one of the ADP receptor antagonists used in patients who are post-MI, have had TIAs, have unstable angina, and are allergic to ASA? | Ticlopidine or clopidogrel |
| What is the treatment for nephrogenic diabetes insipidus induced by lithium? | Amiloride |
| Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms? | Nimodipine |
| What two drugs inhibit the release of neurotransmitters from storage granules? | Guanethidine and bretylium |
| What is the DOC for hyperprolactinemia? | Pergolide |
| True or false? The faster the rate of absorption, the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax). | False. The faster the rate of absorption, the smaller the Tmax and larger the Cmax (bioinequivalence). The slower the rate of absorption, the larger the Tmax and smaller the Cmax. |
| What tetracycline is associated with hepatotoxicity? | Chlortetracycline |
| What is the term for how well a drug produces its desired response? | Efficacy |
| What drug, if given during pregnancy, would cause the uterus to exhibit signs of progesterone withdrawal and induce an abortion? | RU 486 |
| Is allopurinol used in the acute treatment of gout? | No, it is used in chronic treatment of gout to decrease the uric acid pools in the body. |
| What three cephalosporins can produce disulfiram-like reactions? | 1. Cefamandole 2. Cefoperazone 3. Moxalactam |
| What is the physiologic basis for the actions of birth control pills? | They block the midcycle surge of LH. |
| When a drug is administered orally and enters into portal circulation, it undergoes hepatic metabolism. What is the name of this effect? | First-pass effect |
| Which thrombolytic agent, activated in the presence of fibrin, is manufactured by recombinant DNA process? | Alteplase |
| Which benzodiazepine is most commonly used IV in conscious sedation protocols? | Midazolam |
| What is the drug of choice for threadworm, trichinosis, and larva migrans? | Thiabendazole |
| Can you tell which drug is more toxic based on therapeutic indices alone? | No, therapeutic indices can tell which drug is safer, not more toxic. |
| What blood disorder is a side effect of metformin? | Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid) |
| A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity, a temperature of 104° F, altered mental status, and hypotension. What is your diagnosis and what is the treatment? | Neuroleptic malignant syndrome is a potentially life-threatening condition which is treated with symptomatic support, bromocriptine, and dantrolene. |
| Which α-blocking agent is used to treat refractory hypertension and baldness? | Minoxidil (orally and topically, respectively!) |
| What components of the coagulation cascade are affected by estrogen? | Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II, VII, IX, and X. |
| What class of antimicrobial agents should be avoided in patients with a history of GPDH deficiency? | Sulfonamides |
| What enzyme of cholesterol synthesis is inhibited by the statins? | HMG-CoA reductase |
| What bactericidal agents are resistant to β-lactamases and are used to treat in-hospital life-threatening infections? | Imipenem and meropenem |
| What adrenergic receptors use inositol triphosphate (IP3) and diacylglycerol (DAG) for their second messenger system? | α1-Receptors |
| True or false? Dopamine antagonists at the D2A receptor have the capacity to induce pseudoparkinsonism. | TRUE |
| What two PGs are used to induce labor? | PGE2 and PGF2α |
| How are drugs that are excreted via the biliary system resorbed by the GI tract? | Enterohepatic cycling |
| Which drugs bind to the 30S ribosomal subunit and interfere with the initiation complex, causing a misreading of mRNA? | Aminoglycosides |
| What antiviral agent blocks the attachment and penetration of influenza A virus? | Amantadine |
| What is the antidote for organophosphate ingestion? | Atropine and 2-PAM (pralidoxime) |
| Which antihypertensive class is used to help stop the progression of microalbuminuria? | ACE inhibitors (-pril) |
| What class of drugs are the DOCs for peptic ulcer disease, Zollinger-Ellison syndrome, and gastroesophageal reflux disease? | Proton pump inhibitors |
| What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia? | Chloramphenicol |
| Inhibition of peripheral aromatic amino acid decarboxylase and increased CNS availability of L-dopa are results of what drug used in the treatment of Parkinson's disease? | Carbidopa and benserazide |
| What type of drug elimination is characterized by the following? • Elimination independent of plasma concentration; constant amount eliminated per unit time; no fixed half-life | Zero-order elimination |
| What type of drug elimination is characterized by the following? • Elimination directly proportional to plasma level; constant fraction eliminated per unit time; fixed half-life | First-order elimination |
| True or false? NSAIDs have analgesic, antipyretic, anti-inflammatory, and antiplatelet activities. | TRUE |
| True or false? Tetracyclines are bactericidal. | False. They are bacteriostatic. |
| What class 1A antiarrhythmic agent has SLE-like syndrome side effect in slow acetylators? | Procainamide |
| What is the major pulmonary side effect of µ-activators? | Respiratory depression |
| What neuroleptic agent is also considered to be an antihistamine? | Risperidone |
| What form of penicillin is stable in acid environments? | Penicillin V |
| What is the term for the proportion of a drug that reaches systemic circulation? | Bioavailability |
| What two drugs block dopa-decarboxylase in the periphery to decrease the conversion of L-dopa to dopamine? | Carbidopa and benserazide |
| What is the DOC for bipolar disorder? | Lithium |
| True or false? If a mother delivers a Rho-positive baby, she should receive Rho-immunoglobulin. | True if she is Rho-negative; false if she is Rho-positive |
| True or false? Both GABA and glutamic acid are excitatory neurotransmitters in the CNS. | False. Glutamic acid is excitatory, but GABA is inhibitory. |
| What is the drug of choice for asymptomatic meningitis carriers? | Rifampin |
| What drug is used to differentiate a cholinergic crisis from myasthenia gravis? | Edrophonium |
| What class of antianginal activates the NO pathway to produce endothelial vasodilation? | Nitrates |
| What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy? | Celecoxib |
| What is the DOC for blastomycoses and sporotrichoses? | Itraconazole |
| What are the two most important features in the diagnosis of malaria? | Splenomegaly and anemia (with a high index of suspicion) |
| Name the three benzodiazepines that are not metabolized by the cytochrome P450 enzyme system. | Oxazepam, temazepam, and lorazepam ( OTL, Outside The Liver) |
| What drug is an M1-specific antispasmodic? | Pirenzepine |
| Which centrally acting α2-adrenergic agonist is safe for use in renal dysfunction and in HTN during pregnancy? | Methyldopa |
| What is the monoamine oxidase B (MAOB) inhibitor? | Selegiline |
| What antitubercular agent causes a red-orange tinge to tears and urine? | Rifampin |
| What two classes of drugs can cause schizoid behavior? | Glucocorticoids and amphetamines |
| What tetracycline is associated with vestibular toxicity? | Minocycline |
| What is the most potent NMJ blocker and also has no cardiovascular side effects? | Doxacurium |
| What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated? | D2 and 5HT3 receptors |
| Which group of antihypertensive agents best decreases left ventricular hypertrophy? | Thiazide diuretics |
| What area of the brain is linked to emotion and movement? | Mesolimbic system |
| Why are clozapine and olanzapine unlikely to result in EPS effects? | Because they do not block D2A receptors, they are antagonists of 5HT2 receptors. |
| What class of pharmaceuticals are inactive until they are metabolized to their active products? | Prodrugs |
| True or false? You would not prescribe probenecid for a patient with gout who is an overexcretor of uric acid. | True. Probenecid can precipitate uric acid crystals in the kidney if the patient is an overexcretor of urate. |
| True or false? Dopamine antagonists are antiemetic. | True. They block the dopamine receptors in the chemoreceptor trigger zone. |
| What bactericidal agent is the DOC for MRSA, enterococci, and Clostridium difficile? | Vancomycin |
| True or false? β-Blockers are contraindicated in patients who present to the hospital with CHF. | True. β-Blockers are a component of CHF regimen for stable patients, not those who are decompensated. (This means you discharge a patient from the hospital with a prescription for a -blocker; you don't start -blockers when the patient is admitted.) |
| True or false? Fluoroquinolones are bactericidal. | True. They inhibit DNA gyrase (topo II). |
| What antiviral agent for ganciclovir-resistant infections has limited utility because of its nephrotoxic side effect? | Foscarnet |
| What oral hypoglycemic agent stimulates pancreatic β-cell release of insulin and is given just prior to meals because of its short half-life? | Repaglinide |
| True or false? There is no absorption of an IV-administered drug. | True. No loss of drug and no absorption if a drug is given IV. |
| What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells, not a fixed number? | Log-kill hypothesis (follows first order kinetics) |
| What is the only local anesthetic to produce vasoconstriction? | Cocaine |
| Which agent used in the treatment of asthma is a selective inhibitor of the lipoxygenase pathway? | Zileuton |
| What is the only diuretic that works on the blood side of the nephron? | Spironolactone (binds to aldosterone receptors) |
| Do you monitor heparin's therapeutic levels by PT or PTT? | Heparin, intrinsic pathway, PTT; warfarin, extrinsic pathway, PT (mnemonic: hPeT, wPiTT) |
| What is the only neuroleptic that does not cause an increase in weight or appetite? | Molindone |
| What α1-agonist is used to treat paroxysmal atrial tachycardia with hypotension? | Metaraminol (α1, β1 ) |
| What antiarrhythmic agent is the DOC for treating and diagnosing paroxysmal supraventricular tachycardia (PSVT) and AV nodal arrhythmias? | Adenosine (it is an excellent agent to use in emergencies because its half-life is 30 seconds) |
| What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ? | Aminophylline |
| Which nicotinic receptor antagonist is inactivated to laudanosine? | Atracurium |
| What α2-antagonist is used to treat impotence and postural hypotension? | Yohimbine |
| What drug of choice for ascaris causes neuromuscular blockade of the worm? | Pyrantel pamoate |
| Testing of a drug in a small group of volunteers without the disease is a component of which phase of clinical drug testing? | Phase 1 |
| Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children? | Tetracycline |
| What antifungal agent is used in the treatment of androgen receptor-positive cancers? | Ketoconazole |
| What MAOI does not cause a hypertensive crisis? | Selegiline |
| Which penicillin can cause interstitial nephritis? | Methicillin |
| Is hirsutism a side effect of estrogen or progestin therapy? | Progestin |
| Which potassium-sparing drug is an aldosterone receptor antagonist ? | Spironolactone |
| What are the three signs of morphine overdose? | 1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma |
| Which anticonvulsant is used in the treatment of bipolar disorder and neuropathic pain? | Gabapentin |
| True or false? Metformin is contraindicated in obese patients because of weight gain as its side effect. | False. Metformin does not have weight gain as a potential side effect (unlike sulfonylureas). |
| What is the DOC for the treatment of the late phase response in an asthmatic attack? | Corticosteroid |
| If you double the infusion rate of a drug, how long will it take to reach steady state? | Regardless of the rate of infusion, it takes 4 to 5 half-lives to reach steady state. |
| What is the neurotransmitter at the µ-receptor? | β-Endorphin |
| What is the DOC for the following protozoal infections? • Amebiasis | Metronidazole |
| What is the DOC for the following protozoal infections? • Leishmaniasis | Stibogluconate |
| What is the DOC for the following protozoal infections? • Pneumocystis carinii pneumonia | Trimethoprim/sulfamethoxazole (TMP-SMX) |
| What is the DOC for the following protozoal infections? • Giardiasis | Metronidazole |
| What is the DOC for the following protozoal infections? • Trichomoniasis | Metronidazole |
| What hematologic agent is used in the treatment of intermittent claudication because it decreases blood viscosity and increases RBC membrane flexibility and stability? | Pentoxifylline |
| What enzyme system is the most common form of phase II biotransformation? | Glucuronidation |
| In what three areas of the body are sympathetics the predominant tone? | 1. Sweat glands 2. Arterioles 3. Veins |
| What is the only antifungal agent to penetrate CSF? | Fluconazole |
| Which class of antiarrhythmics are β-blockers? | Class II |
| What three cephalosporins are eliminated via biliary mechanisms? | 1. Cefamandole 2. Cefoperazone 3. Ceftriaxone |
| Which centrally acting α2-adrenergic agonist is used in the treatment protocol of opioid withdrawal? | Clonidine |
| What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis? | Infliximab |
| Which macrolide is used in the treatment of gastroparesis? | Erythromycin |
| What syndrome is characterized by the triad of renal tubular acidosis, nephrosis, and amino aciduria? | Fanconi-like syndrome |
| In what area of the brain can an excess of dopamine lead to psychotic symptoms? | Mesocortical area |
| Name five causes for zero-order metabolism. | 1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity |
| What antitubercular agent requires vitamin B6 supplementation? | Isoniazid |
| Which antihistamine is one of the DOCs for treatment of vertigo? | Meclizine |
| What is the DOC for treating Entamoeba histolytica, Giardia, Trichomonas, Bacillus fragilis, and Clostridium difficile infections? | Metronidazole |
| Which class of antihypertensives is used in the treatment of BPH? | α-Blockers (-zosins) |
| Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium intracellulare complex? | Azithromycin |
| What is the drug of choice, which inhibits oxidative phosphorylation in cestodes, for taeniasis? | Niclosamide |
| Which class of antihyperlipidemics would you avoid for a patient with elevated triglyceride levels? | Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore, they are not used if a patient has hypertriglyceridemia. |
| True or false? Ergotamines, because of their vasodilation action, cause migraines. | False. Ergotamines are used in the treatment of migraines for their vasoconstrictive action in the cerebral circulation. |
| Is DM a contraindication to use of a β-blocker in a patient who is having an MI? | Absolutely not. Diabetics who are given a β-blocker for an acute chest syndrome have significantly better outcomes than those who do not. |
| What β2-agonist is used as a prophylactic agent in the treatment of asthma? | Salmeterol |
| What hormone can be affected by dopamine release in the tuberoinfundibular pathway? | In the tuberoinfundibular pathway, dopamine release will decrease prolactin release, which is why dopamine agonists are used in the treaatment of hyperprolactinemic states. |
| What determines the plasma level at steady state? | The rate of infusion |
| What enzyme is inhibited by propylthiouracil (PTU)? | 5' deiodinase |
| What is the DOC for CMV retinitis? | Ganciclovir |
| What agent antagonizes the effects of heparin? | Protamine sulfate |
| What antihypertensive agent produces cyanide and thiocyanate as byproducts? | Nitroprusside |
| What is the DOC for β-blocker-induced bronchospasms? | Ipratropium |
| What is the only neuroleptic agent that does not cause hyperprolactinemia? | Clozapine |
| True or false? Gynecomastia is a side effect of cimetidine. | True. Cimetidine can decrease androgen production and lead to gynecomastia. |
| What three drugs are associated with SLE-like syndrome in slow acetylators? | Hydralazine, isoniazid, and procainamide (HIP) |
| What is the drug of choice for filariasis and onchocerciasis? | Diethylcarbamazine |
| What aminoglycoside causes disruption of CN I? | Streptomycin |
| Which anticonvulsant causes gingival hyperplasia? | Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia) |
| What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway? | ASA |
| What antifungal agent is activated by fungal cytosine deaminase to form 5-FU? | Flucytosine |
| Irreversible ototoxicity is associated with which loop diuretic? | Ethacrynic acid |
| What competitive estrogen receptor antagonist is used in the treatment of breast cancer? | Tamoxifen |
| Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid? | Doxycycline |
| True or false? Dopamine is an excitatory neurotransmitter in the CNS. | False. Dopamine is an inhibitory neurotransmitter in the CNS. |
| What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis? | Metformin |
| Which phase of clinical drug testing includes postmarket reporting of adverse reactions? | Phase 4 |
| Which prophylactic asthmatic agent is an antagonist of LTD4? | Zafirlukast |
| What are the three C's of a TCAD overdose? | Coma, convulsions, and cardiotoxicity |
| What is the neurotransmitter at the δ-receptor? | Enkephalin |
| What body fluid preferentially breaks down esters? | Blood |
| What are the two broad-spectrum penicillins? | Ampicillin and amoxicillin |
| What are the three components to the asthma triad? | Nasal polyps, rhinitis, and aspirin hypersensitivity |
| Which class of antiarrhythmics are calcium channel blockers? | Class IV |
| What are the glycoprotein receptors that platelets and fibrinogen cross-link to when forming a thrombus? | GP IIb and IIIa receptors |
| Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery? | Propofol |
| Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism? | Physiologic antagonism |
| What GnRH analog is used as a repository form of treatment in prostatic cancer? | Leuprolide |
| Which antimicrobial agent is used with pyrimethamine to treat toxoplasmosis? | Clindamycin |
| What is the DOC for trigeminal neuralgia? | Carbamazepine |
| What drug that penetrates the blood-brain barrier is found in asthma preparations and used as a nasal decongestant? | Ephedrine |
| What is the term for drug removal per unit of time in a given volume of blood? | Clearance |
| Which two tetracyclines have the highest plasma binding? | Doxycycline and minocycline |
| What do the following values indicate? • ED50 | Effective dose for 50% of drug takers (median effective dose) |
| What do the following values indicate? • TD50 | Toxic dose for 50% of drug takers (median toxic dose) |
| What do the following values indicate? • LD50 | Lethal dose for 50% of drug takers (median lethal dose) |
| Do agents used in the treatment of Parkinson's disease that decrease ACh function have little effect on reducing tremors and rigidity? | Agents that decrease ACh function reduce tremors and rigidity, not bradykinesias. |
| A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose? | Spasms of the uterus, bladder, and the biliary tree occur with all of the opioids except meperidine. |
| What form of oxidation takes place with the addition of a water molecule and breakage of bonds? | Hydrolysis |
| In a ventricular pacemaker cell, what phase of the action potential is affected by NE? | Phase 4; NE increases the slope of the prepotential, allowing threshold to be reached sooner, and increases the rate of firing. |
| Anatomical and alveolar dead spaces together constitute what space? | Physiologic dead space is the total dead space of the respiratory system. |
| What three organs are necessary for the production of vitamin D3(cholecalciferol)? | Skin, liver, and kidneys |
| What is the effect of LH on the production of adrenal androgens? | LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production. |
| What four conditions result in secondary hyperaldosteronism? | 1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis |
| What are the five hormones produced by Sertoli cells? | 1. Inhibin 2. Estradiol (E2) 3. Androgen-binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antimüullerian hormone |
| What is the term for the negative resting membrane potential moving toward threshold? | Depolarization (i.e., Na+ influx) |
| Does the left or right vagus nerve innervate the SA node? | Right vagus innervates the SA node and the left vagus innervates the AV node |
| How does ventricular repolarization take place, base to apex or vice versa? | Repolarization is from base to apex and from epicardium to endocardium. |
| What is the term for any region of the respiratory system that is incapable of gas exchange? | Anatomical dead space, which ends at the level of the terminal bronchioles. |
| What four factors shift the Hgb-O2 dissociation curve to the right? What is the consequence of this shift? | Increased CO2, H+, temperature, and 2, 3-BPG levels all shift the curve to the right, thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule. |
| What two factors result in the apex of the lung being hypoperfused? | Decreased pulmonary arterial pressure (low perfusion) and less-distensible vessels (high resistance) result in decreased blood flow at the apex. |
| What is the ratio of pulmonary to systemic blood flow? | 1:1. Remember, the flow through the pulmonary circuit and the systemic circuit are equal. |
| To differentiate central from nephrogenic diabetes insipidus, after an injection of ADH, which will show a decreased urine flow? | Central. Remember, there is a deficiency in ADH production in the central form. |
| In what area of the GI tract are water-soluble vitamins absorbed? | Duodenum |
| What wave is the cause of the following venous pulse deflections? • The rise in right atrial pressure secondary to blood filling and terminating when the tricuspid valves opens | V wave |
| What wave is the cause of the following venous pulse deflections? • The bulging of the tricuspid valve into the right atrium | C wave |
| What wave is the cause of the following venous pulse deflections? • The contraction of the right atrium | A wave |
| What are the four functions of saliva? | 1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion |
| When a person goes from supine to standing, what happens to the following? • Dependent venous pressure | Increases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------- |
| When a person goes from supine to standing, what happens to the following? • Dependent venous blood volume | Increases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------- |
| When a person goes from supine to standing, what happens to the following? • Cardiac output | Decreases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. |
| When a person goes from supine to standing, what happens to the following? • BP | Decreases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------- |
| When does the hydrostatic pressure in Bowman's capsule play a role in opposing filtration? | It normally does not play a role in filtration but becomes important when there is an obstruction downstream. |
| What happens to intrapleural pressure when the diaphragm is ontracted during inspiration? | Intrapleural pressure decreases (becomes more negative). |
| What is used as an index of cortisol secretion? | Urinary 17-OH steroids |
| If the pH is low with increased CO2 levels and decreased HCO3- levels, what is the acid-base disturbance? | Combined metabolic and respiratory acidosis |
| What is the term that refers to the number of channels open in a cell membrane? | Membrane conductance (think conductance |
| What are the five tissues in which glucose uptake is insulin independent? | 1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa |
| Place in order from fastest to slowest the rate of gastric emptying for CHO, fat, liquids, and proteins. | Liquids, CHO, protein, fat |
| Is most of the coronary artery blood flow during systole or diastole? | Diastole. During systole the left ventricle contracts, resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation. |
| What modified smooth muscle cells of the kidney monitor BP in the afferent arteriole? | The JG cells |
| What are the three functions of surfactant? | 1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation |
| Name the hormone—glucagon, insulin, or epinephrine: • Glycogenolytic, gluconeogenic, lipolytic, glycolytic, and stimulated by hypoglycemia | Epinephrine |
| Name the hormone—glucagon, insulin, or epinephrine: • Glycogenolytic, gluconeogenic, lipolytic, glycolytic, proteolytic, and stimulated by hypoglycemia and AAs | Glucagon |
| Name the hormone—glucagon, insulin, or epinephrine: • Glycogenic, gluconeogenic, lipogenic, proteogenic, glycolytic, and stimulated by hyperglycemia, AAs, fatty acids, ketosis, ACh, GH, and Beta-agonist | Insulin |
| Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment? | Hydrophobic (water-insoluble) end faces the aqueous environment and the hydrophilic (water-soluble) end faces the interior of the cell. |
| What type of muscle is characterized by no myoglobin, anaerobic glycolysis, high ATPase activity, and large muscle mass? | White muscle; short term too |
| What percentage of CO2 is carried in the plasma as HCO3- ? | 90% as HCO3-, 5% as carbamino compounds, and 5% as dissolved CO2 |
| What is the most potent male sex hormone? | Dihydrotestosterone |
| With a decrease in arterial diastolic pressure, what happens to • Stroke volume? | Decreases |
| With a decrease in arterial diastolic pressure, what happens to • TPR? | Decreases |
| With a decrease in arterial diastolic pressure, what happens to • Heart rate? | Decreases |
| What linkage of complex CHOs does pancreatic amylase hydrolyze? What three complexes are formed? | Amylase hydrolyzes alpha-1, 4-glucoside linkages, forming alpha-limit dextrins, maltotriose, and maltose. |
| Does the heart rate determine the diastolic or systolic interval? | Heart rate determines the diastolic interval, and contractility determines the systolic interval. |
| On a graphical representation of filtration, reabsorption, and excretion, when does glucose first appear in the urine? | At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine. |
| What is the relationship between preload and the passive tension in a muscle? | They are directly related; the greater the preload, the greater the passive tension in the muscle and the greater the prestretch of a sarcomere. |
| What is the rate-limiting step in the synthetic pathway of NE at the adrenergic nerve terminal? | The conversion of tyrosine to dopamine in the cytoplasm |
| How many days prior to ovulation does LH surge occur in the menstrual cycle? | 1 day prior to ovulation |
| How are flow through the loop of Henle and concentration of urine related? | As flow increases, the urine becomes more dilute because of decreased time for H2O reabsorption. |
| What is the PO2 of aortic blood in fetal circulation? | 60% |
| How do elevated blood glucose levels decrease GH secretion? (Hint: what inhibitory hypothalamic hormone is stimulated by IGF-1?) | Somatotrophins are stimulated by IGF-1, and they inhibit GH secretion. GHRH stimulates GH secretion. |
| What segment of the nephron has the highest concentration of inulin? Lowest concentration of inulin? | Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin. |
| What type of resistance system, high or low, is formed when resistors are added in a series? | A high-resistance system is formed when resistors are added in a series. |
| What hormones, secreted in proportion to the size of the placenta, are an index of fetal well-being? | hCS and serum estriol, which are produced by the fetal liver and placenta, respectively, are used as estimates of fetal well-being. |
| What primary acid-base disturbance is caused by an increase in alveolar ventilation (decreasing CO2 levels) resulting in the reaction shifting to the left and decreasing both H+ and HCO3- levels? | Respiratory alkalosis (summary: low CO2, low H+, slightly low HCO3-) |
| What respiratory center in the caudal pons is the center for rhythm promoting prolonged inspirations? | Apneustic center (deep breathing place) |
| What area of the GI tract has the highest activity of brush border enzymes? | Jejunum (upper) |
| What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty? | Adrenarche |
| What period is described when a larger-than-normal stimulus is needed to produce an action potential? | Relative refractory period |
| Does T3 or T4 have a greater affinity for its nuclear receptor? | T3 has a greater affinity for the nuclear receptor and therefore is considered the active form. |
| What are the three main functions of surfactant? | 1. Lowers surface tension, so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension |
| What is the only important physiological signal regulating the release of PTH? | Low interstitial free Ca2+ concentrations |
| What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH decreased, Ca2+ increased, Pi increased | Secondary hypoparathyroidism (vitamin D toxicity) |
| What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH increased, Ca2+ decreased, Pi decreased | Secondary hyperparathyroidism (vitamin D deficiency, renal disease) |
| What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH decreased, Ca2+ decreased, Pi increased | Primary hypoparathyroidism |
| What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH increased, Ca2+ increased, Pi decreased | Primary hyperparathyroidism |
| What is the amount in liters and percent body weight for the following compartments? • ECF | 14 L, 33% of body weight |
| What is the amount in liters and percent body weight for the following compartments? • Interstitial fluid | 9.3 L, 15% of body weight |
| What is the amount in liters and percent body weight for the following compartments? • ICF | 28 L, 40% of body weight |
| What is the amount in liters and percent body weight for the following compartments? • Vascular fluid | 4.7 L, 5% of body weight |
| What is the amount in liters and percent body weight for the following compartments? • Total body water | 42 L, 67% of body weight |
| What hormone is secreted by the placenta late in pregnancy, stimulates mammary growth during pregnancy, mobilizes energy stores from the mother so that the fetus can use them, and has an amino acid sequence like GH? | Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL) |
| What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 increased | Graves disease (Increased T4 decreases TRH and TSH through negative feedback.) |
| What thyroid abnormality has the following? • TRH increased, TSH decreased, T4 decreased | Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.) |
| What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 decreased | Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.) |
| What thyroid abnormality has the following? • TRH increased, TSH increased, T4 decreased | Primary hypothyroidism (Low T4 has a decreased negative feedback loop, resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release, respectively.) |
| What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 increased | Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.) |
| What two stress hormones are under the permissive action of cortisol? | Glucagon and epinephrine |
| If the radius of a vessel doubles, what happens to resistance? | The resistance will decrease one-sixteenth of the original resistance. |
| What prevents the down-regulation of the receptors on the gonadotrophs of the anterior pituitary gland? | The pulsatile release of GnRH |
| True or false? Epinephrine has proteolytic metabolic effects. | False. It has glycogenolytic and lipolytic actions but not proteolytic. |
| What is the only 17-hydroxysteroid with hormonal activity? | Cortisol, a 21-carbon steroid, has a -OH group at position 17. |
| Does the oncotic pressure of plasma promote filtration or reabsorption? | The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction. |
| Why is the base of the lung hyperventilated when a person is standing upright? | The alveoli at the base are small and very compliant, so there is a large change in their size and volume and therefore a high level of alveolar ventilation. |
| By removing Na+ from the renal tubule and pumping it back into the ECF compartment, what does aldosterone do to the body's acid-base stores? | The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis. |
| What hormone causes contractions of smooth muscle, regulates interdigestive motility, and prepares the intestine for the next meal? | Motilin |
| What two vessels in fetal circulation have the highest PO2 levels? | Umbilical vein and ductus venosus (80%) |
| How many days prior to ovulation does estradiol peak in the menstrual cycle? | 2 days prior to ovulation |
| What serves as a marker of endogenous insulin secretion? | C-peptide levels |
| What is the term for the total volume of air moved in and out of the respiratory system per minute? | Total ventilation (minute ventilation or minute volume) |
| What is the renal compensation mechanism for alkalosis? | Increase in urinary excretion of HCO3-, shifting the reaction to the right and increasing H+ |
| What is a sign of a Sertoli cell tumor in a man? | Excess estradiol in the blood |
| In the systemic circulation, what blood vessels have the largest pressure drop? Smallest pressure drop? | Arterioles have the largest drop, whereas the vena cava has the smallest pressure drop in systemic circulation. |
| What is the major stimulus for cell division in chondroblasts? | IGF-1 |
| What are two causes of diffusion impairment in the lungs? | Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2) |
| What are the four effects of suckling on the mother? | 1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion |
| A migrating myoelectric complex is a propulsive movement of undigested material of undigested material from the stomach to the small intestine to the colon. During a fast, what is the time interval of its repeats? | It repeats every 90 to 120 minutes and correlates with elevated levels of motilin. |
| With an increase in arterial systolic pressure, what happens to • Stroke volume? | Increases |
| With an increase in arterial systolic pressure, what happens to • Vessel compliance? | Decreases |
| With an increase in arterial systolic pressure, what happens to • Heart rate? | Decreases |
| What enzyme is needed to activate the following reactions? • Trypsinogen to trypsin | Enterokinase |
| What enzyme is needed to activate the following reactions? • Chymotrypsinogen to chymotrypsin | Trypsin |
| What enzyme is needed to activate the following reactions? • Procarboxypeptidase to carboxypeptidase | Trypsin |
| In a ventricular pacemaker cell, what phase of the action potential is affected by ACh? | Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance, taking longer to reach threshold and slowing the rate of firing. |
| What is the most potent stimulus for glucagon secretion? Inhibition? | Hypoglycemia for secretion and hyperglycemia for inhibition |
| What is the term for the summation of mechanical stimuli due to the skeletal muscle contractile unit becoming saturated with calcium? | Tetany |
| What form of renal tubular reabsorption is characterized by low back leaks, high affinity of a substance, and easy saturation? It is surmised that the entire filtered load is reabsorbed until the carriers are saturated, and then the rest is excreted. | A transport maximum (Tm) system |
| In an adrenergic nerve terminal, where is dopamine converted to NE? By what enzyme? | Dopamine is converted into NE in the vesicle via the enzyme dopamine-Beta-hydroxylase. |
| Is the clearance for a substance greater than or less than for inulin if it is freely filtered and secreted? If it is freely filtered and reabsorbed? | Filtered and secreted: Cx > Cin (i.e., PAH). Filtered and reabsorbed: Cx < Cin (i.e., glucose), where Cx |
| What is the term for the load on a muscle in the relaxed state? | Preload. It is the load on a muscle Prior to contraction. |
| The surge of what hormone induces ovulation? | LH |
| What are the two best indices of left ventricular preload? | LVEDV and LVEDP (left ventricular end-diastolic volume and end-diastolic pressure, respectively) |
| What stage of male development is characterized by the following LH and testosterone levels? • LH pulsatile amplitude and levels increase, with increased testosterone production. | Puberty |
| What stage of male development is characterized by the following LH and testosterone levels? • Both LH and testosterone levels drop and remain low. | Childhood |
| What stage of male development is characterized by the following LH and testosterone levels? • LH secretion drives testosterone production, with both levels paralleling each other. | Adulthood |
| What stage of male development is characterized by the following LH and testosterone levels? • Decreased testosterone production is accompanied by an increase in LH production. | Aged adult |
| What primary acid-base disturbance is caused by a loss in fixed acid forcing the reaction to shift to the right, thereby increasing HCO3- levels? | Metabolic alkalosis (summary: high pH, low H+ and high HCO3-) |
| When referring to a series circuit, what happens to resistance when a resistor is added? | Resistance increases as resistors are added to the circuit. |
| Why is there an increase in prolactin if the hypothalamic-pituitary axis was severed? | Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed, thereby increasing the secretion of prolactin. |
| Why is the clearance of creatinine always slightly greater than the clearance of inulin and GFR? | Because creatinine is filtered and a small amount is secreted |
| What acid form of H+ in the urine cannot be titrated? | NH4+(ammonium) |
| Regarding the venous system, what happens to blood volume if there is a small change in pressure? | Because the venous system is more compliant than the arterial vessels, small changes in pressure result in large changes in blood volume. |
| In what stage of sleep is GH secreted? | Stages 3 and 4 (NREM) |
| Where does the conversion of CO2 into HCO3- take place? | In the RBC; remember, you need carbonic anhydrase for the conversion, and plasma does not have this enzyme. |
| From the fourth month of fetal life to term, what secretes the progesterone and estrogen to maintains the uterus? | The placenta |
| What two factors are required for effective exocytosis? | Calcium and ATP are required for packaged macromolecules to be extruded from the cell. |
| What is the best measure of total body vitamin D if you suspect a deficiency? | Serum 25-hydroxy-vitamin D (25-OH-D) |
| What hormone is required for 1, 25-dihydroxy-vitamin D (1, 25-diOH-D) to have bone resorbing effects? | PTH |
| Is bone deposition or resorption due to increased interstitial Ca2+concentrations? | Bone deposition increases with increased Ca2+ or PO 4- concentrations, whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-. |
| The opening of what valve indicates the termination of isovolumetric relaxation phase of the cardiac cycle? | Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase. |
| Why is there a decrease in the production in epinephrine when the anterior pituitary gland is removed? | The enzyme phenyl ethanolamine N-methyltransferase (PNMT), used in the conversion of epinephrine, is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol. |
| Name the period described by the following statement: no matter how strong a stimulus is, no further action potentials can be stimulated. | Absolute refractory period is due to voltage inactivation of sodium channels. |
| How many carbons do estrogens have? | Estrogens are 18-carbon steroids. (Removal of one carbon from an androgen produces an estrogen.) |
| True or false? The alveolar PO2 and PCO2 levels match the pulmonary end capillary blood levels. | True. Because of intrapulmonary shunting, there is a slight decrease in PO2 and increase in PCO2 between the pulmonary end capillary blood and the systemic arterial blood. |
| In high altitudes, what is the main drive for ventilation? | The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels. |
| Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, decrease; ICF, no change; body, no change | Loss of isotonic fluid (diarrhea, vomiting, hemorrhage) |
| Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, increase; ICF, increase; body, decrease | Gain of hypotonic fluid (water intoxication or hypotonic saline) |
| Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, decrease; ICF, decrease; body: increase | Loss of hypotonic fluid (alcohol, diabetes insipidus, dehydration) |
| Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF: increase; ICF: no change; body: no change | Gain of isotonic fluid (isotonic saline) |
| Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, increase; ICF, decrease; body, increase | Gain of hypertonic fluid (mannitol or hypertonic saline) |
| What hormone excess produces adrenal hyperplasia? | ACTH |
| Is there more circulating T3 or T4 in plasma? | T4; because of the greater affinity for the binding protein, T4 has a significantly (nearly fifty times) longer half-life than T3. |
| Why is the cell's resting membrane potential negative? | The resting membrane potential of the cell is -90 mV because of the intracellular proteins. |
| True or false? Thyroid size is a measure of its function. | False. Thyroid size is a measure of TSH levels (which are goitrogenic). |
| If the radius of a vessel is decreased by half, what happens to the resistance? | The resistance increases 16-fold. |
| What neurotransmitter is essential for maintaining a normal BP when an individual is standing? | NE, via its vasoconstrictive action on blood vessels |
| What form of diabetes insipidus is due to an insufficient amount of ADH for the renal collecting ducts? | Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available, but the renal collecting ducts are impermeable to its actions. |
| Name the three methods of vasodilation via the sympathetic nervous system. | 1. Decrease alpha-1 activity 2. Increase Beta-2 activity 3. Increase ACh levels |
| What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate excretion | PTH |
| What hormone is characterized by the following renal effects? • Calcium excretion, phosphate excretion | Calcitriol |
| What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate reabsorption | Vitamin D3 |
| True or false? Progesterone has thermogenic activities. | True. Elevated plasma levels of progesterone can raise the body temperature 0.5° to 1.0°F. |
| How long is the transit time through the small intestine? | 2 to 4 hours |
| Where is the last conducting zone of the lungs? | Terminal bronchioles. (No gas exchange occurs here.) |
| True or false? Cortisol inhibits glucose uptake in skeletal muscle. | True; cortisol inhibits glucose uptake in most tissue, making it available for neural tissue use. |
| What percentage of cardiac output flows through the pulmonary circuit? | 100%; the percentage of blood flow through the pulmonary and systemic circulations are equal. |
| Name the Hgb-O2 binding site based on the following information: • Least affinity for O2; requires the highest PO 2 levels for attachment (approx. 100 mm Hg) | Site 4 |
| Name the Hgb-O2 binding site based on the following information: • Greatest affinity of the three remaining sites for attachment; requires PO2 levels of 26 mm Hg to remain attached | Site 2 |
| Name the Hgb-O2 binding site based on the following information: • Remains attached under most physiologic conditions | Site 1 |
| Name the Hgb-O2 binding site based on the following information: • Requires a PO2 level of 40 mm Hg to remain attached | Site 3 |
| Which three factors cause the release of epinephrine from the adrenal medulla? | 1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es) |
| How many ATPs are hydrolyzed every time a skeletal muscle cross-bridge completes a single cycle? | One, and it provides the energy for mechanical contraction. |
| Why would a puncture to a vein above the heart have the potential to introduce air into the vascular system? | Venous pressure above the heart is subatmospheric, so a puncture there has the potential to introduce air into the system. |
| What type of saliva is produced under parasympathetic stimulation? | High volume, watery solution; sympathetic stimulation results in thick, mucoid saliva. |
| In what area of the GI tract does iron get absorbed? | Duodenum |
| Why is the apex of the lung hypoventilated when a person is standing upright? | The alveoli at the apex are almost completely inflated prior to inflation, and although they are large, they receive low levels of alveolar ventilation. |
| What pancreatic islet cell secretes glucagons? | alpha-Cells; glucagon has stimulatory effects on -cells and inhibitory effects on -cells. |
| What are the four characteristics of all protein-mediated transportation? | 1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero-order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than if by si |
| What is secretin's pancreatic action? | Secretin stimulates the pancreas to secrete a HCO3--rich solution to neutralize the acidity of the chyme entering the duodenum. |
| Why is there an increase in FF if the GFR is decreased under sympathetic stimulation? | Because RPF is markedly decreased, while GFR is only minimally diminished; this results in an increase in FF (remember FF |
| What triggers phase 3 of the action potential in a ventricular pacemaker cell? | Rapid efflux of potassium |
| What is the primary target for the action of glucagon? | Liver (hepatocytes) |
| What is the renal compensation mechanism for acidosis? | Production of HCO3-, shifting the reaction to the left and thereby decreasing H+ |
| What enzyme found in a cholinergic synapse breaks down ACh? What are the byproducts? | Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal). |
| What hormone, produced by Sertoli cells, if absent would result in the formation of internal female structures? | MIF |
| What happens to the lung if the intrapleural pressure exceeds lung recoil? | The lung will expand; also the opposite is true. |
| What two factors determine the clearance of a substance? | Plasma concentration and excretion rate |
| What type of muscle contraction occurs when the muscle shortens and lifts the load placed on it? | Isotonic contraction |
| What type of potential is characterized as being an all-or-none response, propagated and not summated? | Action potential |
| What primary acid-base disturbance is caused by a gain in fixed acid forcing the reaction to shift to the left, decreasing HCO3- and slightly increasing CO2? | Metabolic acidosis (summary: low pH, high H+, and low HCO3-) |
| What two pituitary hormones are produced by acidophils? | GH and prolactin are produced by acidophils; all others are by basophils. |
| What organ of the body has the smallest AV oxygen difference? | The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration. |
| What is the titratable acid form of H+ in the urine? | H2PO4- (dihydrogen phosphate) |
| What hypothalamic hormone is synthesized in the preoptic nucleus? | GnRH |
| What five factors promote turbulent flow? | 1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice |
| What is the major hormone produced in the following areas of the adrenal cortex? • Zona glomerulosa | Aldosterone Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper. |
| What is the major hormone produced in the following areas of the adrenal cortex? • Zona fasciculata | Cortisol Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper. |
| What is the major hormone produced in the following areas of the adrenal cortex? • Zona reticularis | DHEA (androgens) Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper. |
| Where is most of the body's Ca2+ stored? | In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite. |
| What is the relationship between ventilation and PCO2 levels? | They are inversely related. If ventilation increases, there will be a decrease in PCO2 levels and vice versa. |
| Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland? | T4, as long as T4 levels remain constant, TSH will be minimally effected by T3. |
| What is the signal to open the voltage-gated transmembrane potassium channels? | Membrane depolarization is the stimulus to open these slow channels, and if they are prevented from opening, it will slow down the repolarization phase. |
| Increased urinary excretion of what substance is used to detect excess bone demineralization? | Hydroxyproline |
| What is the term to describe how easily a vessel stretches? | Compliance (think of it as distensibility) |
| What is the ratio of T4:T3 secretion from the thyroid gland? | 20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient. |
| Do the PO2 peripheral chemoreceptors of the carotid body contribute to the normal drive for ventilation? | Under normal resting conditions no, but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg, resulting in increased ventilatory drive. |
| What determines the overall force generated by the ventricular muscle during systole? | The number of cross-bridges cycling during contraction: the greater the number, the greater the force of contraction. |
| Where does most circulating plasma epinephrine originate? | From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons. |
| What causes a skeletal muscle contraction to terminate? | When calcium is removed from troponin and pumped back into the SR, skeletal muscle contraction stops. |
| What happens to intracellular volume when there is an increase in osmolarity? | ICF volume decreases when there is an increase in osmolarity and vice versa. |
| Which CHO is independently absorbed from the small intestine? | Fructose; both glucose and galactose are actively absorbed via secondary active transport. |
| When is the surface tension the greatest in the respiratory cycle? | Surface tension, the force to collapse the lung, is greatest at the end of inspiration. |
| What adrenal enzyme deficiency results in hypertension, hypernatremia, increased ECF volume, and decreased adrenal androgen production? | 17-alpha-Hydroxylase deficiency |
| In reference to membrane potential (Em) and equilibrium potential (Ex), which way do ions diffuse? | Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential. |
| Under normal conditions, what is the main factor that determines GFR? | Hydrostatic pressure of the glomerular capillaries (promotes filtration) |
| The closure of what valve indicates the beginning of the isovolumetric relaxation phase of the cardiac cycle? | Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle. |
| What vessels in the systemic circulation have the greatest and slowest velocity? | The aorta has the greatest velocity and the capillaries have the slowest velocity. |
| Thin extremities, fat collection on the upper back and abdomen, hypertension, hypokalemic alkalosis, acne, hirsutism, wide purple striae, osteoporosis, hyperlipidemia, hyperglycemia with insulin resistance, and protein depletion are all characteristics of | Hypercortisolism (Cushing syndrome) |
| What enzyme is essential for the conversion of CO2 to HCO3-? | Carbonic anhydrase |
| True or false? The parasympathetic nervous system has very little effect on arteriolar dilation or constriction. | TRUE |
| What three lung measurements must be calculated because they cannot be measured by simple spirometry? | TLC, FRC, and RV have to be calculated. (Remember, any volume that has RV as a component has be calculated.) |
| What is the venous and arterial stretch receptors' function regarding the secretion of ADH? | They chronically inhibit ADH secretion; when there is a decrease in the blood volume, the stretch receptors send fewer signals, and ADH is secreted. |
| What cell converts androgens to estrogens? | Granulosa cell |
| What hormone acts on Granulosa cells? | FSH |
| How long is the transit time through the large intestine? | 3 to 4 days |
| Does subatmospheric pressure act to expand or collapse the lung? | Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung. |
| What hormone constricts afferent and efferent arterioles (efferent more so) in an effort to preserve glomerular capillary pressure as the renal blood flow decreases? | AT II |
| Why is there a minimal change in BP during exercise if there is a large drop in TPR? | Because the large drop in TPR is accompanied by a large increase in cardiac output, resulting in a minimal change in BP. |
| What is the effect of insulin on protein storage? | Insulin increases total body stores of protein, fat, and CHOs. When you think insulin, you think storage. |
| What is the term for an inhibitory interneuron? | Renshaw neuron |
| What triggers phase 0 of the action potential in a ventricular pacemaker cell? | Calcium influx secondary to slow channel opening |
| What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Percentage of original filtered volume left in the lumen | At the end of the PCT 25% of the original volume is left |
| What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Percentage of Na+, Cl-, K+ left in the lumen | At the end of the PCT 25% of Na+, Cl-, K+ is left |
| What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Osmolarity | 300 mOsm/L |
| What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Concentration of CHO, AA, ketones, peptides | No CHO, AA, ketones, or peptides are left in the tubular lumen. |
| True or false? Enterokinase is a brush border enzyme. | False. It is an enzyme secreted by the lining of the small intestine. |
| Where does the synthesis of ACh occur? | In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase. |
| What pancreatic islet cell secretes somatostatin? | delta-Cells; somatostatin has an inhibitory effect on alpha- and Beta-islet cells. |
| Why is O2 content depressed in anemic patients? | Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients, their O2 content is increased because of the excess Hgb concentrations. |
| What term describes the volume of plasma from which a substance is removed over time? | Clearance |
| If capillary hydrostatic pressure is greater than oncotic pressure, is filtration or reabsorption promoted? | Filtration; if hydrostatic pressure is less than oncotic pressure, reabsorption is promoted. |
| What cells of the parathyroid gland are simulated in response to hypocalcemia? | The chief cells of the parathyroid gland release PTH in response to hypocalcemia. |
| At the base of the lung, what is the baseline intrapleural pressure, and what force does it exert on the alveoli? | Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean), resulting in a force to collapse the alveoli. |
| What hormone is necessary for normal GH secretion? | Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions. |
| What is the signal to open the voltage-gated transmembrane sodium channels? | Membrane depolarization is the stimulus to open these channels, which are closed in resting conditions. |
| What hormones are produced in the median eminence region of the hypothalamus and the posterior pituitary gland? | None; they are the storage sites for ADH and oxytocin. |
| What is the most energy-demanding phase of the cardiac cycle? | Isovolumetric contraction |
| What presynaptic receptor does NE use to terminate further neurotransmitter release? | alpha2-Receptors |
| Are salivary secretions hypertonic, hypotonic, or isotonic? | Hypotonic, because NaCl is reabsorbed in the salivary ducts |
| What is the effect of T3 on heart rate and cardiac output? | T3 increases both heart rate and cardiac output by increasing the number of Beta-receptors and their sensitivity to catecholamines. |
| Why will turbulence first appear in the aorta in patients with anemia? | Because it is the largest vessel and has the highest velocity in systemic circulation |
| What is the origin of the polyuria if a patient is dehydrated and electrolyte depleted? | If the polyuria begins before the collecting ducts, the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts, the patient is dehydrated with normal electrolytes. |
| What is the physiologically active form of Ca2+? | Free ionized Ca2+ |
| What are the two factors that affect alveolar PCO2 levels? | Metabolic rate and alveolar ventilation (main factor) |
| Why is spermatogenesis decreased with anabolic steroid therapy? | Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone, produced by Leydig cells, is needed for spermatogenesis. |
| What type of membrane is characterized as being permeable to water only? | Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane. |
| What thyroid enzyme is needed for oxidation of I- to I'? | Peroxidase, which is also needed for iodination and coupling inside the follicular cell |
| What is the most important stimulus for the secretion of insulin? | An increase in serum glucose levels |
| What term is described as the prestretch on the ventricular muscle at the end of diastole? | Preload (the load on the muscle in the relaxed state) |
| What peripheral chemoreceptor receives the most blood per gram of weight in the body? | The carotid body, which monitors arterial blood directly |
| What adrenal enzyme deficiency results in hypertension, hypernatremia, and virilization? | 11-Beta-Hydroxylase deficiency results in excess production of 11-deoxycorticosterone, a weak mineralocorticoid. It increases BP, Na+, and ECF volume along with production of adrenal androgens. |
| What is the term for diffusion of water across a semipermeable or selectively permeable membrane? | Osmosis; water will diffuse from higher to lower water concentrations. |
| When do hCG concentrations peak in pregnancy? | In the first 3 months |
| How many milliliters of O2 per milliliter of blood? | 0.2 |
| What type of cell is surrounded by mineralized bone? | Osteocyte |
| What two forces affect movement of ions across a membrane? | Concentration force and electrical force |
| What happens to the resistance of the system when a resistor is added in a series? | Resistance of the system increases. (Remember, when resistors are connected in a series, the total of the resistance is the sum of the individual resistances.) |
| What is the greatest component of lung recoil? | Surface tension; in the alveoli, it is a force that acts to collapse the lung. |
| Where is ADH synthesized? | In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland. |
| How is velocity related to the total cross-sectional area of a blood vessel? | Velocity is inversely related to cross-sectional area. |
| True or false? Aldosterone has a sodium-conserving action in the distal colon. | True. In the distal colon, sweat glands, and salivary ducts, aldosterone has sodium-conserving effects. |
| What form of hormone is described as having membrane-bound receptors that are stored in vesicles, using second messengers, and having its activity determined by free hormone levels. | Water-soluble hormones are considered fast-acting hormones. |
| What forms of fatty acids are absorbed from the small intestine mucosa by simple diffusion? | Short-chain fatty acids |
| What is the term for the day after the LH surge in the female cycle? | Ovulation |
| The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle? | Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle. |
| What is the region of an axon where no myelin is found? | Nodes of Ranvier |
| What disorder of aldosterone secretion is characterized by • Increased total body sodium, ECF volume, plasma volume, BP, and pH; decreased potassium, renin and AT II activity; no edema? | Primary hyperaldosteronism (Conn syndrome) |
| What disorder of aldosterone secretion is characterized by • Decreased total body sodium, ECF volume, plasma volume, BP, and pH; increased potassium, renin, and AT II activity; no edema? | Primary hypoaldosteronism (Addison's disease) |
| What four factors affect diffusion rate? | 1. Concentration (greater concentration gradient, greater diffusion rate) 2. Surface area (greater surface area, greater diffusion rate) 3. Solubility (greater solubility, greater diffusion rate) 4. Membrane thickness (thicker the membrane, slower the dif |
| How long after ovulation does fertilization occur? | 8 to 25 hours |
| What is the name of the force that develops in the wall of the lungs as they expand? | Lung recoil, being a force to collapse the lung, increases as the lung enlarges during inspiration. |
| What day of the menstrual cycle does ovulation take place? | Day 14 |
| How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated, and how?) | A decrease in cutaneous blood flow results from constriction of the arterioles, and decreased cutaneous blood volume results from constriction of the venous plexus. |
| What two compensatory mechanisms occur to reverse hypoxia at high altitudes? | Increase in erythropoietin and increase in 2, 3-BPG, also called 2, 3-diphosphoglycerate (2, 3-P2Gri) (increase in glycolysis) |
| What female follicular cell is under LH stimulation and produces androgens from cholesterol? | Theca cell |
| What is the main factor determining FF? | Renal plasma flow (decrease flow, increase FF) |
| Where is the action potential generated on a neuron? | Axon hillock |
| If free water clearance (CH2O) is positive, what type of urine is formed? And if it is negative? | If positive, hypotonic urine (osmolarity <300 mOsm/L); if negative, hypertonic urine (osmolarity > 300 mOsm/L)>> |
| What cell in the heart has the highest rate of automaticity? | SA node; it is the reason it is the primary pacemaker of the heart. |
| What is pumped from the lumen of the ascending loop of Henle to decrease the osmolarity? | NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle. |
| True or false? In skeletal muscle relaxation is an active event. | True. Sarcoplasmic calcium-dependent ATPase supplies the energy to terminate contraction, and therefore it is an active process. |
| What three factors increase simple diffusion? | 1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane |
| What is the pancreatic action of CCK? | CCK stimulates the pancreas to release amylase, lipase, and proteases for digestion. |
| What is the rate-limiting step in a conduction of a NMJ? | The time it takes ACh to diffuse to the postjunctional membrane |
| Is excretion greater than or less than filtration for net secretion to occur? | Excretion is greater than filtration for net secretion to occur. |
| What acid-base disturbance is produced from vomiting? | Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+, K+, and Cl-. |
| What phase of the menstrual cycle is dominated by estrogen? Progesterone? | Follicular phase is estrogen-dependent with increased FSH levels, while the luteal phase is progesterone-dependent. |
| Name the lung measurement based on the following descriptions: • The amount of air that enters or leaves the lung system in a single breath | Tidal volume (VT) |
| Name the lung measurement based on the following descriptions: • The maximal volume inspired from FRC | Inspiratory capacity |
| Name the lung measurement based on the following descriptions: • Additional volume that can be expired after normal expiration | Expiratory reserve volume (ERV) |
| Name the lung measurement based on the following descriptions: • Maximal volume that can be expired after maximal inspiration | Vital capacity (VC) |
| Name the lung measurement based on the following descriptions: • Volume in the lungs at the end of passive expiration | Functional residual capacity (FRC) |
| Name the lung measurement based on the following descriptions: • Additional air that can be taken in after normal inspiration | Inspiratory reserve volume (IRV) |
| Name the lung measurement based on the following descriptions: • Amount of air in the lungs after maximal expiration | Residual volume (RV) |
| Name the lung measurement based on the following descriptions: • Amount of air in the lungs after maximal inspiration | Total lung capacity (TLC) |
| What growth factors are chondrogenic, working on the epiphyseal end plates of bone? | Somatomedins (IGF-1) |
| What determines the Vmax of skeletal muscle? | The muscle's ATPase activity |
| True or false? All of the hormones in the hypothalamus and anterior pituitary gland are water soluble. | TRUE |
| What is the effect of T3 on the glucose absorption in the small intestine? | Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine. |
| Is the bound form or free form of a lipid-soluble hormone responsible for the negative feedback activity? | Free form determines hormone activity and is responsible for the negative feedback loop. |
| What region or regions of the adrenal cortex are stimulated by ACTH? | Zona fasciculata and zona reticularis |
| Are the following parameters associated with an obstructive or restrictive lung disorder: decreased FEV1, FVC, peak flow, and FEV1/FVC; increased TLC, FRC, and RV? | Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern. |
| What is the respiratory compensation mechanism for metabolic alkalosis? | Hypoventilation, which increases CO2, shifting the reaction to the right and increasing H+ |
| During puberty, what is the main drive for the increased GH secretion? | Increased androgen secretion at puberty drives the increased GH secretion. |
| What type of potential is characterized as graded, decremental, and exhibiting summation? | Subthreshold potential |
| What three organs are responsible for peripheral conversion of T4 to T3? | Liver, kidneys, and pituitary gland via 5' deiodinase enzyme |
| The closure of what valve indicates the beginning of isovolumetric contraction? | Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction. |
| How many carbons do androgens have? | Androgens are 19-carbon steroids. |
| At the apex of the lung, what is the baseline intrapleural pressure, and what force does it exert on the alveoli? | Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli. |
| True or false? Renin secretion is increased in 21-β-hydroxylase deficiency. | True. Increased renin and AT II levels occur as a result of the decreased production of aldosterone. |
| What are the four ways to increase TPR? | 1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels |
| What form of estrogen is of placental origin? | Estriol |
| What term is an index of the effort needed to expand the lungs (i.e., overcomes recoil)? | Compliance; the more compliant a lung is, the easier it is to inflate. |
| At which three sites in the body is T4 converted to T3? | 1. Liver 2. Kidney 3. Pituitary gland (via 5'-deiodinase enzyme) |
| Using Laplace's relationship regarding wall tension, why is the wall tension in an aneurysm greater than in the surrounding normal blood vessel's wall? | The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel. |
| What percentage of nephrons is cortical? | Seven-eighths of nephrons are cortical, with the remainder juxtamedullary. |
| To what is the diffusion rate indirectly proportional? | Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area. |
| ADH is secreted in response to what two stimuli? | ADH is secreted in response to increased plasma osmolarity and decreased blood volume. |
| What vessels have the largest total cross-sectional area in systemic circulation? | Capillaries |
| How many days before the first day of menstrual bleeding is ovulation? | 14 days in most women (Remember, the luteal phase is always constant.) |
| What is the major muscle used in the relaxed state of expiration? | Under resting conditions expiration is considered a passive process; therefore, no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration. |
| What subunit of hCG is used to detect whether a patient is pregnant? | The β-subunit; remember, the α-subunit is nonspecific. |
| What happens to capillary oncotic pressure with dehydration? | Oncotic pressure increases because of the removal of water. |
| What cells of the kidney are extravascular chemoreceptors for decreased Na+, Cl-, and NaCl? | Macula densa |
| What is the effect of insulin on intracellular K+ stores? | Insulin increases intracellular K+ stores while decreasing serum K+ levels. |
| What triggers phase 4 of the action potential in a ventricular pacemaker cell? | Decreasing potassium conductance, which results in increased excitability |
| What is it called when levels of sex steroids increase, LH increases, and FSH increases? | GnRH pulsatile infusion |
| What parasympathetic neurotransmitter of the GI tract stimulates the release of gastrin? | Gastrin-releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's) |
| What reflex increases TPR in an attempt to maintain BP during a hemorrhage? | The carotid sinus reflex |
| What is the name of the regulatory protein that covers the attachment site on actin in resting skeletal muscle? | Tropomyosin |
| Which way does the Hgb-O2 dissociation curve shift in patients with CO poisoning? | The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2, reducing the carrying capacity and shifting the curve to the left, making it difficult to remove the CO molecule from Hgb. |
| What is the main factor determining GFR? | Glomerular capillary pressure (increased glomerular capillary pressure, increased GFR and vice versa) |
| What is the effect of hypoventilation on cerebral blood flow? | Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow. |
| What cells of the thyroid gland are stimulated in response to hypercalcemia? | The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia. |
| What is the term for the amount of blood in the ventricle after maximal contraction? | Residual volume |
| What does failure of PaO2 to increase with supplemental O2 indicate? | Pulmonary shunt (i.e., pulmonary embolism) |
| What two substances stimulate Sertoli cells? | FSH and testosterone |
| The clearance of what substance is the gold standard of renal plasma flow? | Para-aminohippurate (PAH) |
| What bile pigment is formed by the metabolism of bilirubin by intestinal bacteria, giving stool its brown color? | Stercobilin |
| Is ACh associated with bronchoconstriction or bronchodilation? | Bronchoconstriction is associated with parasympathetic stimulation (ACh), and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.) |
| What are the growth factors released from the liver called? | Somatomedins |
| Regarding skeletal muscle mechanics, what is the relationship between velocity and afterload? | An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.) |
| What happens to extracellular volume with a net gain in body fluid? | The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment. |
| What are the six substances that promote the secretion of insulin? | 1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. β-Agonists 6. ACh |
| Does O2 or CO2 have a higher driving force across the alveolar membrane? | O2 has a higher driving force but is only one-twenty-fourth as soluble as CO2. CO 2 has a very small partial pressure difference across the alveolar membrane (47-40 |
| What is used as an index for both adrenal and testicular androgens? | Urinary 17-ketosteroids |
| How are resistance and length related regarding flow? | Resistance and vessel length are proportionally related. The greater the length of the vessel, the greater the resistance is on the vessel. |
| Is filtration greater than or less than excretion for net reabsorption to occur? | Filtration is greater than excretion for net reabsorption to occur. |
| What hormone, stimulated by epinephrine, results in an increase in lipolysis? | Hormone-sensitive lipase, which breaks down triglyceride into glycerol and free fatty acid |
| True or false? Miniature end-plate potentials (MEPPs) generate action potentials. | FALSE |
| Is GH considered a gluconeogenic hormone? | Yes, it decreases fat and muscle uptake of glucose, thereby increasing blood glucose levels. |
| True or false? Somatic motor neurons innervate the striated muscle of the bulbospongiosus and ischiocavernous muscles and result in ejaculation of semen. | TRUE |
| What happens to intraventricular pressure and volume during isovolumetric contraction? | As the name indicates, there is no change in volume but there is an increase in pressure. |
| Do high levels of estrogen and progesterone block milk synthesis? | Yes, they stimulate the growth of mammary tissue but block milk synthesis. At parturition, the decrease in estrogen lifts the block on milk production. |
| What two factors lead to the development of the bends (caisson disease)? | Breathing high-pressure nitrogen over a long time and sudden decompression result in the bends. |
| In what type of circuit is the total resistance always less than that of the individual resistors? | Parallel circuit |
| What is the term for days 15 to 28 in the female cycle? | Luteal phase |
| What happens to total and alveolar ventilation with • Increased rate of breathing? | With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid, shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation). |
| What happens to total and alveolar ventilation with • Increased depth of breathing? | With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards, so remember it. |
| What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol decreased, ACTH increased | Primary hypocortisolism (Addison's disease) |
| What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol increased, ACTH increased | Secondary hypercortisolism (pituitary) |
| What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol increased, ACTH decreased | Primary hypercortisolism |
| What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol decreased, ACTH decreased | Secondary hypocortisolism (pituitary) |
| What happens to flow and pressure in capillaries with arteriolar dilation? Arteriolar constriction? | Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction. |
| What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↑, RPF ↑, FF normal, capillary pressure ↑ | Dilation of afferent arteriole |
| What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↑, RPF ↓, FF ↑, capillary pressure ↑ | Constriction of efferent arteriole |
| What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↓, RPF ↑, FF ↓, capillary pressure ↓ | Dilation of efferent arteriole |
| What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↓, RPF ↓, FF normal, capillary pressure ↓ | Constriction of afferent arteriole |
| Which direction is air flowing when the intra-alveolar pressure is zero? | When the intra-alveolar pressure equals zero, there is no airflow. |
| What phase of the female cycle occurs during days 1 to 15? | Follicular phase |
| What determines the effective osmolarity of the ICF and the ECF compartments? | The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins. |
| What region of the brain houses the central chemoreceptors responsible for control of ventilation? | The surface of the medulla |
| What is the site of action of cholera toxin? | Cholera toxin irreversibly activates the cAMP-dependent chloride pumps of the small and large intestine, producing a large volume of chloride-rich diarrhea. |
| Name the phase of the ventricular muscle action potential based on the following information: • Slow channels open, allowing calcium influx; voltage-gated potassium channels closed; potassium efflux through ungated channels; plateau stage | Phase 2 |
| Name the phase of the ventricular muscle action potential based on the following information: • Slight repolarization secondary to potassium and closure of the sodium channels | Phase 1 |
| Name the phase of the ventricular muscle action potential based on the following information: • Fast channels open, then quickly close, and sodium influx results in depolarization | Phase 0 |
| Name the phase of the ventricular muscle action potential based on the following information: • Slow channels close, voltage-gated potassium channels reopen with a large influx of potassium, and the cell quickly repolarizes | Phase 3 |
| Where in the kidney are the long loops of Henle and the terminal regions of the collecting ducts? | In the medulla; all the other structures are cortical. |
| What is absorbed in the gallbladder to concentrate bile? | Water |
| What type of hormone is described as having intracellular receptors, being synthesized as needed, mostly bound to proteins, and having its activity determined by free hormone levels? | Lipid-soluble hormones are considered slow-acting hormones. |
| What are the three stimuli that result in the reninangiotensin-aldosterone secretion? | 1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased β-1-sympathetic stimulation of the JG cells |
| Is there a shift in p50 values with anemia? Polycythemia? | The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood. |
| What hormone level peaks 1 day before the surge of LH and FSH in the female cycle? | Estradiol |
| True or false? Active protein transport requires a concentration gradient. | True; it requires both a concentration gradient and ATP to work. |
| Up to how many hours post ejaculation do sperm retain their ability to fertilize the ovum? | Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release. |
| What type of membrane channel opens in response to depolarization? | Voltage-gated channel |
| What are the five effects of insulin on fat metabolism? | 1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation |
| True or false? In a skeletal muscle fiber, the interior of the T-tubule is extracellular. | True. They are evaginations of the surface membranes and therefore extracellular. |
| Under resting conditions, what is the main determinant of cerebral blood flow? | Arterial PCO2 levels are proportional to cerebral blood flow. |
| On the venous pressure curve, what do the following waves represent? • A wave? | Atrial contraction Atrial, Contraction, Venous |
| On the venous pressure curve, what do the following waves represent? • C wave? | Ventricular contraction Atrial, Contraction, Venous |
| On the venous pressure curve, what do the following waves represent? • V wave? | Atrial filling (venous filling) Atrial, Contraction, Venous |
| What cell type in the bone is responsible for bone deposition? | Osteoblast (Remember, blasts make, clasts take) |
| True or false? The blood stored in the systemic veins and the pulmonary circuit are considered part of the cardiac output. | False. Cardiac output refers to circulating blood volume. The blood in the systemic veins and the pulmonary circuits are storage reserves and therefore are not considered in cardiac output. |
| What hormone disorder is characterized by the following abnormalities in sex steroids↓, LH↓, and FSH↓? • Sex steroids , LH , FSH | Pituitary hypogonadism |
| What hormone disorder is characterized by the following abnormalities in sex steroids↑, LH↓, and FSH↓? • Sex steroids , LH , FSH ? | GnRH constant infusion |
| What hormone disorder is characterized by the following abnormalities in sex steroids↓, LH↑, and FSH↑? • Sex steroids , LH , FSH ? | Primary hypogonadism (postmenopausal women) |
| What are the three characteristics of autoregulation? | 1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes |
| What is the fastest-conducting fiber of the heart? Slowest conduction fiber in the heart? | Purkinje cell is the fastest, and the AV node is the slowest. |
| What equals the total tension on a muscle minus the preload? | Afterload |
| What follicular cell possesses FSH receptors and converts androgens into estradiol? | Granulosa cells |
| What are the primary neurotransmitters at the following sites? • Postganglionic sympathetic neurons | NE |
| What are the primary neurotransmitters at the following sites? • Chromaffin cells of the adrenal medulla | Epinephrine |
| What are the primary neurotransmitters at the following sites? • Brainstem cells | Serotonin |
| What are the primary neurotransmitters at the following sites? • The hypothalamus | Histamine |
| What are the primary neurotransmitters at the following sites? • All motor neurons, postganglionic parasympathetic neurons | ACh |
| What are the primary neurotransmitters at the following sites? • Autonomic preganglionic neurons | ACh |
| What region of the nephron has the highest osmolarity? | Tip of the loop of Henle (1200 mOsm/L) |
| What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion? | Acid is needed for the activation of pepsin and therefore needed for protein digestion. |
| What is the term for the amount of blood expelled from the ventricle per beat? | Stroke volume |
| True or false? Oxytocin initiates rhythmic contractions associated with labor. | False. It does increase uterine synthesis of prostaglandins, which increase uterine contractions. |
| Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise? | DLCO, an index of lung surface area and membrane thickness, is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is an in |
| What enzyme converts androgens to estrogens? | Aromatase |
| The clearance of what substance is the gold standard of GFR? | Inulin |
| How does myelination affect conduction velocity of an action potential? | The greater the myelination, the greater the conduction velocity. |
| What are the three end products of amylase digestion? | 1. Maltose 2. Maltotetrose 3. α-Limit dextrans (α-1, 6 binding) |
| Where is most of the airway resistance in the respiratory system? | In the first and second bronchi |
| What is the respiratory compensation mechanism for metabolic acidosis? | Hyperventilation, which decreases CO2, shifting the reaction to the left and decreasing H+ |
| How are resistance and viscosity related regarding flow? | Viscosity and resistance are proportionally related. The greater the viscosity, the greater the resistance is on the vessel. |
| T3 increases bone ossification through synergistic effect with what hormone? | GH |
| Name the ventricular muscle membrane channel: • Closed at rest; depolarization causes channels to open slowly | Voltage-gated calcium channel |
| Name the ventricular muscle membrane channel: • Always open | Ungated potassium channel |
| Name the ventricular muscle membrane channel: • Closed at rest; depolarization causes channels to open quickly; will not respond to a second stimulus until cell is repolarized. | Voltage-gated sodium channel |
| Name the ventricular muscle membrane channel: • Open at rest; depolarization is stimulus to close; begin to reopen during the plateau phase and during repolarization | Voltage-gated potassium channels |
| What are the three glycogenic organs? | Liver, kidney, and GI epithelium |
| Is CO2 a perfusion-or diffusion-limited O2 gas? | Since CO2 is 24 times as soluble as O2, the rate at which CO2 is brought to the membrane determines its rate of exchange, making it perfusion-limited a gas. For O2 the more time it is in contact with the membrane, the more likely it will diffuse, making i |
| What is the term for the potential difference across a cell membrane? | Transmembrane potential (an absolute number) |
| What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency, glucocorticoid deficiency, and an excess of adrenal androgens? | 21-β-Hydroxylase deficiency leads to hypotension, hyponatremia, and virilization. |
| When the ECF osmolarity increases, what happens to cell size? | Increase in ECF osmolarity means a in decrease in ICF osmolarity, so cells shrink. |
| When does cortisol secretion peak? | In early-morning sleep, usually between the sixth and eighth hours |
| What is the term for ventilation of unperfused alveoli? | Alveolar dead space |
| What is the bioactive form of thyroid hormone? | T3 |
| What acid-base disturbance occurs in colonic diarrhea | Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen. |
| What two AAs act as excitatory transmitters in the CNS, generating EPSPs? | Glutamine and aspartate |
| What are the three mechanisms of action for atrial natriuretic peptide's diuretic and natriuretic affects? | 1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts |
| In a parallel circuit, what happens to resistance when a resistor is added in parallel | Resistance decreases as resistors are added in parallel. |
| What component of the ANS is responsible for movement of semen from the epididymis to the ejaculatory ducts? | Sympathetic nervous system |
| What happens to O2 affinity with a decrease in p50? | O2 affinity increases with a decrease in the p50, making O2 more difficult to remove from the Hgb molecule. |
| If the ratio of a substance's filtrate and plasma concentrations are equal, what is that substance's affect on the kidney? | If the ratio of the filtrate to plasma concentration of a substance is equal, the substance is freely filtered by the kidney. |
| What does a loss of afferent activity from the carotid sinus onto the medulla signal? | A loss of afferent activity indicates a decrease in BP, and an increase in afferent activity indicates an increase in BP. |
| What are the five F's associated with gallstones? | 1. Fat 2. Forty 3. Female 4. Familial 5. Fertile |
| True or false? Menstruation is an active process due to increased gonadal sex hormones? | False. It is a passive process due to decreased sex hormones. |
| What happens to the intrapleural pressure when the diaphragm relaxes? | Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive). |
| What component of the renin-angiotensin-aldosterone axis increases sodium reabsorption in the proximal convoluted tubules and increases thirst drive? | AT II |
| What large-diameter vessel has the smallest cross-sectional area in systemic circulation? | The aorta |
| Excess bone demineralization and remodeling can be detected by checking urine levels of what substance? | Hydroxyproline (breakdown product of collagen) |
| What happens to the following during skeletal muscle contraction? • A band | No change in length |
| What happens to the following during skeletal muscle contraction? • I band | Shortens |
| What happens to the following during skeletal muscle contraction? • H zone | Shortens |
| What happens to the following during skeletal muscle contraction? • Sarcomere | Shortens |
| What happens to the following during skeletal muscle contraction? • Actin and myosin lengths | No change in length |
| What are the three effects of insulin on protein metabolism? | 1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis |
| What is the main mechanism for exchange of nutrients and gases across a capillary membrane? | Simple diffusion; it does not use protein-mediated transport |
| What event signifies the first day of the menstrual cycle? | Onset of bleeding |
| Name the muscle type based on the histological features: • Actin and myosin in sarcomeres; striated; uninuclear; gap junctions; troponin:calcium binding complex; T tubules and SR forming dyadic contacts; voltage-gated calcium channels | Cardiac muscle |
| Name the muscle type based on the histological features: • Actin and myosin in sarcomeres; striated; multinuclear; lacks gap junctions; troponin:calcium binding; T tubules and SR forming triadic contacts; highest ATPase activity; no calcium channels | Skeletal muscle |
| Name the muscle type based on the histological features: • Actin and myosin not in sarcomeres; nonstriated; uninuclear; gap junctions; calmodulin:calcium binding; lacks T tubules; voltage-gated calcium channels | Smooth muscle |
| Name the valve abnormality based on the following criteria: • Back-filling into the left atrium during systole; increased v-wave, preload, left atrial volume, and left ventricular filling | Mitral insufficiency |
| Name the valve abnormality based on the following criteria: • Systolic murmur, increased preload and afterload, decreased aortic pulse pressure and coronary blood flow | Aortic stenosis |
| Name the valve abnormality based on the following criteria: • Diastolic murmur, increased right ventricular pressure, left atrial pressure, and atrial to ventricular pressure gradient; decreased left ventricular filling pressure | Mitral stenosis |
| Name the valve abnormality based on the following criteria: • Diastolic murmur; increased preload, stroke volume, and aortic pulse pressure; decreased coronary blood flow; no incisura; and peripheral vasodilation | Aortic insufficiency |
| Circulating levels of what hormone cause the cervical mucus to be thin and watery, allowing sperm an easier entry into the uterus? | Estrogen |
| What hormone controls relaxation of the lower esophageal sphincter during swallowing? | VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter. |
| What is the term for the difference between systolic and diastolic pressures? | Pulse pressure |
| What hormone, produced by the Sertoli cells, is responsible for keeping testosterone levels in the seminiferous tubules nearly 50 times that of the serum? | Androgen-binding protein |
| True or false? There are no central O2 receptors. | TRUE |
| What cell type of the bone has PTH receptors? | Osteoblasts, which in turn stimulate osteoclasts to break down bone, releasing Ca2+ into the interstitium. (Remember, blasts make, clasts take.) |
| What substance is secreted by parietal glands and is required for life? | Intrinsic factor (IF) |
| What is the only way to increase O2 delivery in the coronary circulation? | Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions. |
| What is the term for the load a muscle is trying to move during stimulation? | Afterload |
| What is the term for days 1 to 7 of the female cycle? | Menses |
| What is the term for the force the ventricular muscle must generate to expel the blood into the aorta? | Afterload |
| What happens to the tonicity of the urine with increased ADH secretion? | The urine becomes hypertonic because of water reabsorption in the collecting duct. |
| What form of renal tubular reabsorption is characterized by high back leak, low affinity for substance, and absence of saturation and is surmised to be a constant percentage of a reabsorbed filtered substance? | Gradient-time system |
| What type of circuit is described when the total resistance is always greater than the sums of the individual resistors? | Series circuit |
| What hormone excess brings about abnormal glucose tolerance testing, impaired cardiac function, decreased body fat, increased body protein, prognathism, coarse facial features, and enlargements of the hands and feet? | Increased secretion of GH postpuberty leading to acromegaly. |
| What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery? | The V/Q ratio increases, since the area is ventilated but hypoperfused as a result of the occlusion. |
| What hormone has the following effects: chondrogenic in the epiphyseal end plates of bones; increases AA transport for protein synthesis; increases hydroxyproline (collagen); and increases chondroitin sulfate synthesis? | GH, especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis. |
| True or false? Bile pigments and bile salts are reabsorbed in the gallbladder. | FALSE |
| What component of an ECG is associated with the following? • Conduction delay in the AV node | PR interval |
| What component of an ECG is associated with the following? • Ventricular depolarization | QRS complex |
| What component of an ECG is associated with the following? • Atrial depolarization | P wave |
| What component of an ECG is associated with the following? • Ventricular repolarization | T wave |
| Where is the greatest venous PO2 in resting tissue? | Renal circulation |
| Near the end of pregnancy, what hormone's receptors increase in the myometrium because of elevated plasma estrogen levels? | Oxytocin |
| What respiratory center in the rostral pons has an inhibitory affect on the apneustic center? | Pneumotaxic center (short, fast breaths) |
| For what hormone do Leydig cells have receptors? | LH |
| What primary acid-base disturbance is cause by a decrease in alveolar ventilation (increasing CO2 levels) resulting in the reaction shifting to the right and increasing H+ and HCO3- levels? | Respiratory acidosis (summary: high CO2, high H+, slightly high HCO3-) |
| What lecithin: sphingomyelin ratio indicates lung maturity? | 2.0 or greater |
| What is the term for the negative resting membrane potential becoming more negative? | Hyperpolarization (i.e., K+ influx) |
| What type of resistance system (i.e., high or low) is formed when resistors are added in parallel? | A low-resistance system is formed by resistors added in parallel. |
| Why is hypothyroidism associated with night blindness? | Thyroid hormones are necessary for conversion of carotene to vitamin A. |
| What is the FiO2 of room air? | 0.21; it is a fancy way of saying 21% of the air is O2. |
| Where are the lowest resting PO2 levels in a resting individual? | Coronary circulation |
| What is the rate-limiting step in the production of steroids? | The conversion of CHO to pregnenolone via the enzyme desmolase |
| In the water deprivation test, does a patient with reduced urine flow have primary polydipsia or diabetes insipidus? | Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine. |
| True or false? There is an inverse relationship between fat content and total body water. | True; the greater the fat, the less the total body water. |
| What is the role of the negative charge on the filtering membrane of the glomerular capillaries? | The negative charge inhibits the filtration of protein anions. |
| What cardiac reflex is characterized by stretch receptors in the right atrium, afferent and efferent limbs via the vagus nerve, and increased stretch leading to an increase in heart rate via inhibition of parasympathetic stimulation? | Bainbridge reflex |
| Where in the GI tract does the reabsorption of bile salts take place? | Bile salts are actively reabsorbed in the distal ileum. |
| What three structures increase the surface area of the GI tract? | 1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times) |
| Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why? | Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle, delaying the closure of the pulmonic valve. |
| How much dietary iodine is necessary to maintain normal thyroid hormone secretion? | 150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day. |
| What is the central chemoreceptor's main drive for ventilation? | CSF H+ levels, with acidosis being the main central drive, resulting in hyperventilation (the opposite being true with alkalosis) |
| What result occurs because of the negative alveolar pressure generated during inspiration? | Air flows into the respiratory system. |
| Corticotropin-releasing hormone promotes the synthesis and release of what prohormone? | Pro-opiomelanocortin (POMC) is cleaved into ACTH and β-lipotropin. |
| What happens to free hormone levels when the liver decreases production and release of binding proteins? | Free hormone levels remain constant, and the bound hormone level changes with a decrease in binding hormones. |
| What type of estrogen is produced in peripheral tissues from androgens? | Estrone |
| What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels? | Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels |
| Where is renin produced? | In the JG cells of the kidney |
| True or false? Right-sided valves close before the valves on the left side of the heart. | False. Right-sided valves are the first to open and last to close. |
| What enzyme is associated with osteoblastic activity? | Alkaline phosphatase |
| What is the order of attachment of O2 to Hgb-binding sites in the lung? Order of release from the binding sites in the tissue? | Order of attachment is site 1, 2, 3, 4, and for release is 4, 3, 2, 1. |
| What hormone is secreted into the plasma in response to a meal rich in protein or CHO? | Insulin |
| What happens to blood flow and pressure downstream with local arteriolar constriction? | With arteriolar constriction both the flow and pressure downstream decrease. |
| What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus? | Achalasia |
| True or false? Ungated channels are always open. | True. They have no gates, so by definition they are always open. |
| What component of the ANS is responsible for dilation of the blood vessels in the erectile tissue of the penis, resulting in an erection? | Parasympathetics (parasympathetics point, sympathetics shoot) |
| What muscle type is characterized by low ATPase activity, aerobic metabolism, myoglobin, association with endurance, and small muscle mass? | Red muscle |
| What happens to diastolic and systolic intervals with an increase in sympathetic activity? | Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate. |
| Circulating levels of what hormone in men is responsible for the negative feedback loop to the hypothalamus and the anterior pituitary gland regulating the release of LH? | Testosterone |
| How are pulse pressure and compliance related? | They are inversely proportional to each other; as pulse pressure increases, compliance decreases. |
| What three substances stimulate parietal cells? | ACh, histamine, and gastrin |
| What two factors result in the base of the lung being hyperperfused? | Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base. |
| True or false? Without ADH the collecting duct would be impermeable to water. | True. Without ADH hypotonic urine would be formed. |
| How does ventricular depolarization take place, base to apex or vice versa? | Depolarization is from apex to base and from endocardium to epicardium. |
| What are effects of PTH in the kidney? | PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT. |
| Regarding muscle mechanics, how is passive tension produced? | It is produced by the preload on the muscle prior to contraction. |
| Insulin-induced hypoglycemia is the most reliable (by far not the safest) test for what hormone deficiency? | GH deficiency |
| In regards to solute concentration, how does water flow? | Water flows from a low-solute to high-solute concentrations. |
| Which extravascular chemoreceptor detects low NaCl concentrations? | Macula densa |
| If the AV difference is positive, is the substance extracted or produced by the organ? | A positive AV difference indicates that a substance is extracted by the organ, and a negative difference indicates that it is produced by the organ. |
| What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney? | Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers. |
| Why is there a transcellular shift in K+ levels in a diabetic patient who becomes acidotic? | The increased H+ moves intracellularly and is buffered by K+ leaving the cells, resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis, even though the serum levels |
| True or false? Catechol-O-methyl transferase (COMT) is not found in smooth muscle, liver, and the kidneys. | False. That is precisely where COMT is found; it is not found in adrenergic nerve terminals. |
| What somatomedin serves as a 24-hour marker of GH secretion? | IGF-1 (somatomedin C) |
| What receptor is in the smooth muscle cells of the small bronchi, is stimulated during inflation, and inhibits inspiration? | Stretch receptors prevent overdistension of the lungs during inspiration. |
| True or false? Thyroid hormones are necessary for normal menstrual cycles. | True. They are also necessary for normal brain maturation. |
| What component of the cardiovascular system has the largest blood volume? Second largest blood volume? | The systemic veins have the largest blood volume, and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation. |
| Serum concentration of what substance is used as a clinical measure of a patient's GFR? | Creatinine |
| Where does CHO digestion begin? | In the mouth with salivary α-amylase (ptyalin) |
| How does the sympathetic nervous system affect insulin secretion? | It decreases insulin secretion. |
| How does cell diameter affect the conduction velocity of an action potential? | The greater the cell diameter, the greater the conduction velocity. |
| Calf pseudohypertrophy | Duchenne muscular dystrophy |
| Kayser-Fleischer rings | Wilson disease |
| Aschoff bodies | Rheumatic fever |
| Curschmann spirals | Bronchial asthma (whorled mucous plugs) |
| Charcot-Leyden crystals | Bronchial asthma (eosinophil membranes) |
| Keratin pearls | Squamous cell carcinoma |
| Bence-Jones proteinuria | Multiple myeloma |
| Russell bodies | Multiple myeloma |
| WBCs in the urine | Acute cystitis |
| RBCs in the urine | Bladder carcinoma |
| RBC casts in the urine | Acute glomerulonephritis |
| WBC casts in the urine | Acute pyelonephritis |
| Renal epithelial casts in the urine | Acute toxic or viral nephrosis |
| Waxy casts | Chronic end-stage renal disease |
| Signet ring cells | Gastric carcinoma |
| Heinz bodies | G-6-PD deficiency |
| Mallory bodies | Chronic alcoholic |
| Auer rods | AML-M3 |
| Starry sky pattern | Burkitt lymphoma |
| Birbeck granules | Histiocytosis X |
| Reed-Sternberg cells | Hodgkin lymphoma |
| Call-Exner bodies | Granulosa/thecal cell tumor of the ovary |
| Cowdry type A bodies | Herpesvirus |
| Orphan Annie cells | Papillary carcinoma of the ovary |
| Streaky ovaries | Turner syndrome |
| Blue-domed cysts | Fibrocystic change of the breast |
| Reinke crystals | Leydig cell tumor |
| Schiller-Duval bodies | Yolk sac tumor |
| Codman triangle on radiograph | Osteosarcoma |
| Councilman bodies | Toxic or viral hepatitis |
| Blue sclera | Osteogenesis imperfecta |
| Soap bubble appearance on radiograph | Giant cell tumor of the bone |
| Pseudorosettes | Ewing sarcoma |
| Neurofibrillary tangles | Alzheimer disease |
| Homer-Wright rosettes | Neuroblastoma |
| Lewy bodies | Parkinson disease |
| Lucid interval | Epidural hematoma |
| Bloody tap on lumbar puncture | Subarachnoid hemorrhage |
| Pseudopalisades | Glioblastoma multiforme |
| Senile plaques | Alzheimer disease |
| Café-au-lait spot on the skin | Neurofibromatosis |
| Name the most common cause. • Blindness worldwide | Chlamydia trachomatis |
| Name the most common cause. • Blindness in the United States | Diabetes mellitus |
| Name the most common cause. • Dementia in persons aged 60 to 90 years | Alzheimer disease |
| Name the most common type. • Learning disability | Dyslexia |
| Name the most common type. • Mental retardation | Fetal alcohol syndrome |
| Name the most common type. • Phobia | Stage fright (discrete performance anxiety) |
| Name the most common type. • Psychiatric disorder in women of all ages | Anxiety disorders; for men it is substance abuse. |
| Name the most common type. • Specific phobia | Public speaking (Remember: stage fright) |
| Name the most common cause. • Chronic pancreatitis | Alcohol abuse |
| Name the most common cause. • Infectious pancreatitis | Mumps |
| Name the most common cause. • Insomnia | Depression |
| Name the most common cause. • Hospitalization in children younger than 1 year of age | RSV |
| Name the most common cause. • Croup | Parainfluenza virus |
| Name the most common cause. • A cold in the winter and summer | Coronavirus |
| Name the most common cause. • A cold in the spring and fall | Rhinovirus |
| Which virus is the MCC of a cold in the summer and fall? Winter and spring? | Rhinoviruses for summer and fall; coronaviruses for winter and spring |
| Name the most common type or cause. • Restrictive cardiomyopathy | Amyloidosis |
| Name the most common type or cause. • Death in the United States | Ischemic heart disease (MIs) |
| Name the most common type or cause. • Sudden cardiac death | Ventricular fibrillation (V fib) |
| Name the most common type or cause. • Right heart failure | Left heart failure |
| Name the most common type or cause. • Childhood heart disease in the United States | Congenital heart disease |
| Name the most common type or cause. • Cyanotic heart disease | Tetralogy of Fallot |
| Name the most common type or cause. • Subacute bacterial endocarditis | Streptococcus viridans |
| Name the most common type or cause. • Acute bacterial endocarditis | Staphylococcus aureus |
| Name the most common type or cause. • Viral pneumonia leading to death | RSV |
| Name the most common type or cause. • Infection in a patient on a ventilator | Pseudomonas aeruginosa |
| Name the most common type or cause. • Bronchiolitis in children | RSV |
| Name the most common type or cause. • Pulmonary HTN in children | VSD |
| Name the most common type or cause. • Reversible HTN in the United States | Alcohol abuse |
| Name the most common type or cause. • Spontaneous pneumothorax | Emphysematous bleb |
| Name the most common type or cause. • Nonorganic pneumoconiosis | Asbestosis |
| Name the most common type or cause. • Cellular injury | Hypoxia |
| Name the most common type or cause. • Hypoxia | Ischemia |
| Name the most common type or cause. • Lobar pneumonia | Streptococcus pneumoniae |
| Name the most common type or cause. • Lung abscess | Aspiration |
| Name the most common type or cause. • Cirrhosis in the United States | Alcohol consumption |
| Name the most common type or cause. • Nephrotic syndrome | Membranoproliferative glomerulonephritis (MGN) |
| Name the most common type or cause. • Nephrotic syndrome in children | Lipoid nephrosis |
| Name the most common type or cause. • Liver transplantation in adults | Alcoholic cirrhosis |
| Name the most common type or cause. • UTIs | Escherichia coli |
| Name the most common type or cause. • Urinary tract obstruction | BPH |
| Name the most common type or cause. • Painless hematuria | Renal cell carcinoma |
| Name the most common type or cause. • Hematuria | Infection |
| Name the most common type or cause. • GN in the world | IgA nephropathy |
| Name the most common type or cause. • Nephritic syndrome in children | Minimal change disease |
| Name the most common type or cause. • Nephritic syndrome in adults | MGN |
| Name the most common type or cause. • Acute renal failure in the United States | Acute tubular necrosis |
| Name the most common type or cause. • Acute tubular necrosis | Ischemic |
| Name the most common type or cause. • Diarrhea in children | Rotavirus |
| Name the most common type or cause. • Intestinal obstructions in adults | Adhesions and hernias |
| Name the most common type or cause. • Neonatal bowel obstruction | Hirschsprung disease |
| Name the most common type or cause. • Rectal bleeding | Diverticulosis |
| Name the most common type or cause. • Mallory-Weiss syndrome | Alcoholism |
| Name the most common type or cause. • Anovulation | Polycystic ovaries |
| Name the most common type or cause. • Breast lump in females | Fibrocystic change of the breast |
| Name the most common type or cause. • Hematologic cause of papillary necrosis | Sickle cell disease |
| Name the most common type or cause. • Panhypopituitarism | Sheehan syndrome |
| Name the most common type or cause. • Cushing syndrome | Pituitary adenoma |
| Name the most common type or cause. • Noniatrogenic hypothyroidism in the United States | Hashimoto thyroiditis |
| Name the most common type or cause. • Hypothyroidism in the United States | Iatrogenesis |
| Name the most common type or cause. • Pyogenic osteomyelitis | Staphylococcus aureus |
| Name the most common type or cause. • Neonatal septicemia and meningitis | Streptococcus agalactiae (Group B Streptococcus, or GBS) |
| Name the most common type or cause. • Sinusitis and otitis media in children | Pneumococcus |
| Name the most common type or cause. • Meningitis in adults | Pneumococcus |
| Name the most common type or cause. • Meningitis in renal transplantation patients | Listeria monocytogenes |
| Name the most common type or cause. • Infantile bacterial diarrhea | Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.) |
| Name the most common type or cause. • Infantile diarrhea | Rotavirus |
| Name the most common type or cause. • Chancre | Haemophilus ducreyi |
| Name the most common type or cause. • Urethritis in a young, newly sexually active individual | Staphylococcus saprophyticus |
| Name the most common type or cause. • Cystitis | Escherichia coli |
| Name the most common type or cause. • Erysipelas | Streptococcus pyogenes |
| Name the most common type or cause. • Chronic metal poisoning | Lead |
| Name the most common type or cause. • Acute metal poisoning in the United States | Arsenic |
| Name the MCC of death. • In neonates | Neonatal respiratory distress syndrome (NRDS) |
| Name the MCC of death. • In SLE | Renal failure |
| Name the MCC of death. • In diabetic individuals | MI |
| Name the MCC of death. • In patients with cystic fibrosis | Pulmonary infections |
| What is the MCC of death in the United States? | Heart disease |
| What is the second leading cause of death in the United States? | Cancer |
| What is the MCC of death in children aged 1 to 14 in the United States? | Accidents |
| What is the second leading cause of death in children aged 1 to 14 in the United States? | Cancer |
| What is the MCC of cancer mortality in males and females? | Lung cancer |
| What is the second leading cause of cancer deaths in males? In females? | For males it's prostate cancer, and for females it's breast cancer. |
| What is the MCC of death in black males aged 15 to 24? | Homicide. It is also the leading cause of death in black females aged 15 to 24. |
| What are the two MCC of acute epididymitis in males? • Less than 35 years old | Neisseria gonorrhoeae and Chlamydia trachomatis |
| What are the two MCC of acute epididymitis in males? • More than 35 years old | Escherichia coli and Pseudomonas sp. |
| What is the most common causative organism of acne vulgaris? | Propionibacterium acnes |
| What is the MCC of viral conjunctivitis? | Adenovirus |
| What is the MCC of the following endocarditis scenarios? • Post dental work | Streptococcus viridans |
| What is the MCC of the following endocarditis scenarios? • Following biliary infections | Enterococcus faecalis |
| What is the MCC of the following endocarditis scenarios? • Non-IV drug user | Staphylococcus aureus |
| Name the MCC. • Epiglottitis in an unvaccinated child | Haemophilus influenzae type B |
| Name the MCC. • Pneumonia in adults | Streptococcus pneumoniae |
| Name the MCC. • Pneumonia in a neutropenic burn patient | Pseudomonas sp. |
| Name the MCC. • Pneumonia in a patient with atypical bird exposure and hepatitis | Chlamydia psittaci |
| Name the MCC. • Walking pneumonia, seen in teens and military recruits | Mycoplasma pneumoniae |
| Name the MCC. • Aspiration pneumonia in an alcoholic | Klebsiella pneumoniae |
| Name the MCC. • Pneumonia in an HIV-positive patient with CD4 less than 200 | Pneumocystis carinii |
| What is the MCC of the following meningitides? • In patients who have AIDS or are immunocompromised | Cryptococcus |
| What is the MCC of the following meningitides? • In military recruits | Neisseria meningitides |
| What is the MCC of the following meningitides? • In those 12 months to 6 years of age | Haemophilus influenzae type B |
| What is the MCC of the following meningitides? • In neonates to 3 months of age | Streptococcus agalactiae and Escherichia coli |
| What is the MCC of the following meningitides? • In adults | Streptococcus pneumoniae |
| What is the MCC of the following meningitides? • In renal transplant patients | Listeria monocytogenes |
| What is the most common one? • Helminthic parasite worldwide | Ascaris lumbricoides |
| What is the most common one? • Helminth parasitic infection in the United States | Enterobius vermicularis |
| What is the most common one? • Form of necrosis | Coagulative |
| What is the most common one? • Organism that causes pyelonephritis | Escherichia coli |
| What is the most common one? • Congenital cardiac anomaly | VSD |
| What is the most common one? • Cardiac anomaly in children | PDA |
| What is the most common one? • Complication of PDA | Subacute bacterial endocarditis |
| What is the most common one? • Congenital heart defect in adults | ASD |
| What is the most common one? • Type of ASD | Ostium secundum defects |
| What is the most common one? • Vasculitis | Temporal arteritis |
| What is the most common one? • Form of vasculitis | Temporal arteritis |
| What is the most common one? • Cardiac tumor | Left atrial myxoma |
| What is the most common one? • Cardiac tumor of infancy | Rhabdomyoma |
| What is the most common one? • Cardiac pathology in patients with SLE | Libman-Sacks endocarditis |
| What is the most common one? • Cardiac anomaly in Turner syndrome | Coarctation of the aorta |
| What is the most common one? • Valve abnormality associated with rheumatic fever | Mitral valve stenosis |
| What is the most common one? • Viral cause of myocarditis | Coxsackie B |
| What is the most common one? • Primary lung cancer | Adenocarcinoma |
| What is the most common one? • Primary malignant tumor of the lungs | Adenocarcinoma (30% to 35%) |
| What is the most common one? • Neoplastic tumor in the lungs | Metastatic carcinomas |
| What is the most common one? • Bladder tumor | Transitional cell carcinoma |
| What is the most common one? • Renal calculus type | Calcium oxylate |
| What is the most common one? • Kidney stone type | Calcium oxalate |
| What is the most common one? • Solid tumor in children | Neuroblastoma |
| What is the most common one? • Renal pathology in patients with SLE | Diffuse proliferative GN |
| What is the most common one? • Cancer of the esophagus in the world | Squamous cell carcinoma |
| What is the most common one? Esophageal cancer in the United States | Adenocarcinoma (because of Barrett esophagus) |
| What is the most common one? • Malignant tumor of the esophagus | Squamous cell carcinoma |
| What is the most common one? • Benign GI tumor | Leiomyoma |
| What is the most common one? • Site of ischemia in the GI tract | Splenic flexure |
| What is the most common one? • Type of PUD | Duodenal ulcers (4 times as common as gastric) |
| What is the most common one? • Location of a duodenal ulcer | Anterior wall of the first part of the duodenum |
| What is the most common one? • Location of a gastric ulcer | Lesser curvature of the antrum of the stomach |
| What is the most common one? • Site for carcinoid tumors | Appendix (second is terminal ileum) |
| What is the most common one? • Site for colonic diverticula | Sigmoid colon |
| What is the most common one? • Site of Crohn disease | Terminal ileum |
| What is the most common one? • Site of ulcerative colitis | Rectum |
| What is the most common one? • Site of pancreatic cancer | Head of the pancreas |
| What is the most common one? • Pancreatic islet cell tumor | Insulinoma |
| What is the most common one? • Stone type associated with cholecystitis | Mixed (both cholesterol and calcium) |
| What is the most common one? • Liver tumor | Metastatic carcinoma |
| What is the most common one? • Primary malignant tumor in the liver | Hepatocellular carcinoma |
| What is the most common one? • Primary tumor of the liver | Hemangioma (benign) |
| What is the most common one? • Organism associated with liver abscesses | Entamoeba histolytica |
| What is the most common one? • Renal cell cancer type | Clear cell |
| What is the most common one? • Esophageal carcinoma | Squamous cell carcinoma |
| What is the most common one? • Solid tumor in the body | Nephroblastoma |
| What is the most common one? • Malignancy in children | ALL |
| What is the most common one? • Lymph node affected in non-Hodgkin lymphoma | Periaortic lymph nodes |
| What is the most common one? • Subtype of Hodgkin lymphoma | Nodular sclerosis |
| What is the most common one? • Thyroid cancer | Papillary carcinoma |
| What is the most common one? • Thyroid adenoma | Follicular adenoma |
| What is the most common one? • Malignant thyroid tumor | Papillary carcinoma of the thyroid |
| What is the most common one? • Pituitary tumor | Chromophobe adenoma |
| What is the most common one? • Pituitary adenoma | Prolactinoma |
| What is the most common one? • Tumor arising within the bone | Multiple myeloma |
| What is the most common one? • Tumor on sun-exposed sites | Basal cell carcinoma |
| What is the most common one? • Malignant germ cell tumor in women | Choriocarcinoma |
| What is the most common one? • Primary malignant tumor of the ovary | Serocystadenocarcinoma |
| What is the most common one? • Malignant tumor in women | Breast |
| What is the most common one? • Cancer of the vulva | Squamous cell carcinoma |
| What is the most common one? • Primary malignant tumor of the female genital tract in the world | Cervical neoplasia |
| What is the most common one? • Primary malignant tumor of the female genital tract in the United States | Adenocarcinoma of the cervix |
| What is the most common one? • Tumor of the female genitourinary tract | Leiomyoma |
| What is the most common one? • Benign tumor of the ovary | Serocystadenoma |
| What is the most common one? • Benign tumor of the breast | Fibroadenoma |
| What is the most common one? • Benign breast tumor in females less than 35 years old | Fibroadenoma |
| What is the most common one? • Histologic variant of breast cancer | Infiltrating ductal carcinoma |
| What is the most common one? • Benign lesion that affects the breast | Fibrocystic change of the breast |
| What is the most common one? • Malignant tumor of the breast | Invasive ductal carcinoma |
| What is the most common one? • Female genital tract malignancy resulting in death | Ovarian cancer |
| What is the most common one? • Malignancy of the female genital tract | Endometrial cancer |
| What is the most common one? • Tumor of the female genital tract | Leiomyoma (fibroids) |
| What is the most common one? • Benign ovarian tumor | Cystadenoma |
| What is the most common one? • Malignant carcinoma of the ovaries | Cystadenocarcinoma |
| What is the most common one? • Stromal tumor of the ovary | Ovarian fibroma |
| What is the most common one? • Germ cell tumor of the ovary | Dysgerminoma |
| What is the most common one? • Tumor in men aged 15 to 35 | Testicular tumors |
| What is the most common one? • Testicular tumor in men over 50 years old | Testicular lymphoma |
| What is the most common one? • Germ cell tumor in men | Seminoma |
| What is the most common one? • Testicular tumor in infants and children | Yolk sac tumor |
| What is the most common one? • Germ cell tumor in boys | Yolk sac tumor |
| What is the most common one? • Malignant tumor in the bone of teenagers | Osteosarcoma |
| What is the most common one? • Intraspinal tumor | Ependymoma |
| What is the most common one? • Eye tumor in children | Retinoblastoma |
| What is the most common one? • Organ involved in amyloidosis | Kidney |
| What is the most common one? • Complication of nasogastric tube feeding | Aspiration pneumonia |
| What is the most common one? • Acquired GI emergency of infancy | Necrotizing enterocolitis |
| What is the most common one? • Organism associated with mastitis | Staphylococcus aureus |
| What is the most common one? • Tumor in individuals exposed to asbestos | Bronchogenic carcinoma |
| What is the most common one? • Proliferative abnormality of an internal organ | BPH |
| What is the most common one? • Inflammatory arthritis | Rheumatoid arthritis |
| What is the most common one? • Form of muscular dystrophy | Duchenne muscular dystrophy |
| What is the most common one? • Joint affected in pseudogout | Knee |
| What is the most common one? • Route for infectious arthritis | Hematogenous |
| What is the most common one? • Form of arthritis | Osteoarthritis |
| What is the most common one? • Route of spread in pyogenic osteomyelitis | Hematogenous |
| What is the most common one? • Bone disorder in the United States | Osteoporosis |
| What is the most common one? • Primary tumor metastasis to the bone | Breast |
| What is the most common one? • Bone tumor | Metastatic |
| What is the most common one? • Neurotransmitter in the brain | GABA, quantitatively |
| What is the most common one? • Site of a cerebral infarct | Middle cerebral artery |
| What is the most common one? • Primary CNS tumor in adults | Glioblastoma multiforme |
| What is the most common one? • Primary CNS tumor in children | Medulla blastoma |
| What is the most common one? • Brain tumor | Metastatic |
| What is the most common one? • Primary CNS tumor | Glioblastoma multiforme |
| What is the most common one? • Intramedullary spinal cord tumor in adults | Ependymoma |
| What is the most common one? • Location of ependymomas in children | In children, the fourth ventricle; in adults, the lateral ventricle or spinal cord |
| What is the most common one? • Melanoma in dark-skinned persons | Acral-lentiginous melanoma |
| What is the most common one? • Type of melanoma | Superficial spreading melanoma |
| What is the most common one? • Skin tumor in the United States | Basal cell carcinoma |
| What is the most common one? Site of congenital diaphragmatic hernias | Left posterolateral side of the diaphragm, usually resulting in pulmonary hypoplasia. |
| What is the most common one? • Type of hernia seen in males more than 50 years old | Direct; in males less than 50 years old indirect hernias are the most common type. |
| What is the most common one? • Sites for abdominal aorta aneurysm | Between the renal arteries and at the bifurcation of the abdominal aorta |
| What is the most common one? • Site for atherosclerotic plaques in the abdominal aorta | The bifurcation of the abdominal aorta |
| What is the most common one? • Site for an ectopic abdominal pregnancy | The rectouterine pouch (of Douglas) |
| What is the most common site for implantation of the blastocyst? | On the superior body of the posterior wall of the uterus |
| Where is the most frequent site of ectopic pregnancy? | Ampulla of the fallopian tube |
| What is the most common diagnosis made (or missed!) resulting in a malpractice suit? | Breast cancer |
| What is the most common serotype of enterohemorrhagic Escherichia coli? | 0157:H7 |
| What is the most common circulation Ig in the plasma? | IgG |
| What is the most common cancer diagnosed in men? In women? | In men it is prostate cancer, and in women it is breast cancer. |
| What is the second most common cancer diagnosed in both males and females? | Lung and bronchus cancer |
| What are the two leading causes of cancer-related death in men? | Prostate and lung cancer, respectively |
| What are the two leading causes of cancer-related death in women? | Breast and lung cancer, respectively. |
| What is the most common primary diagnosis resulting in an office visit for males? For females? | For males, HTN; for females, pregnancy. |
| What is the most common disease or infection reported to the CDC? | Chlamydia; gonorrhea is second (Remember, it is mandatory to report STDs to the CDC.) |
| What is the most common STD? | HPV |
| Name the most common reported STD. • In females | Chlamydia |
| Name the most common reported STD. • In males | Gonorrhea |
| What is the most common sexual assault? | Pedophilia |
| What is the most common form of elderly abuse? | Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical, psychological, and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%. |
| What is the most common complement deficiency? | C2 deficiency |
| What is the most common organ involved in amyloidosis? | Kidney |
| What is the most common form of non-Hodgkin lymphoma in the United States? | Follicular lymphoma |
| In which quadrant is breast cancer most commonly found? | Upper outer quadrant (left more than right) |
| What is the most common cardiac tumor? In what chamber does it most commonly arise? | 90% of benign myxomas arise within the left atrium near the fossa ovalis. |
| What cerebral lobes are most commonly affected in herpes encephalitis? | Temporal lobes |
| What is the most common condition leading to an intracerebral bleed? | HTN |
| What carpal bone is most commonly fractured? Dislocated? | The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated. |
| What is the costliest health care problem in the United States? | Alcohol and its related problems cost the country approximately $100 billion a year. |
| What is the most abused drug across all age groups? | Alcohol. Nearly 10% of adults have a problem with alcohol. |
| What are the two most common chains of the TCR? | α-and β-chains are on most T cells. |
| What is the most common form of inherited dwarfism? | Achondroplasia |
| What is the most common lethal AR disorder affecting white Americans? | Cystic fibrosis |
| What is the most common genetic cause of mental retardation? | Down syndrome (it is slightly more common than fragile X syndrome.) |
| What is the most common chromosomal abnormality associated with CLL? | Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.) |
| Name the most common one. • Chromosomal disorder | Down syndrome (trisomy 21) |
| Name the most common one. • Heart defect in Down syndrome | Endocardial cushion defect |
| Name the most common one. • Chromosomal disorder involving sex chromosomes | Klinefelter syndrome |
| Name the associated chromosomal translocation. • CML | Chromosome 9, 22 (Philadelphia chromosome) |
| Name the associated chromosomal translocation. • Ewing sarcoma | Chromosome 11, 22 |
| Name the associated chromosomal translocation. • Adult familial polyposis | Chromosome 5, 21 |
| Name the associated chromosomal translocation. • Burkitt lymphoma | Chromosome 8, 14 |
| Name the associated chromosomal translocation. • Acute promyelocytic leukemia (M3) | Chromosome 15, 17 |
| Name the associated chromosomal translocation. • M3 AML | Chromosome 15, 17 |
| Name the associated chromosomal translocation. • Follicular lymphoma | Chromosome 14, 18 |
| Name the associated chromosome. • Cri-du-chat | Chromosome 5p |
| Name the associated chromosome. • Patau syndrome | Chromosome 13 |
| Name the associated chromosome. • Huntington disease | Chromosome 4p |
| Name the associated chromosome. • Familial hypercholesterolemia | Chromosome 19 |
| Name the associated chromosome. • Gaucher disease | Chromosome 1 |
| Name the associated chromosome. • Niemann-Pick disease | Chromosome 11p |
| Name the associated chromosome. • Tay-Sachs disease | Chromosome 15q |
| Name the associated chromosome. • Cystic fibrosis | Chromosome 7 |
| Name the associated chromosome. • Chronic lymphocytic leukemia (CLL) | Chromosome 12 |
| Name the associated chromosome. • Marfan disease | Chromosome 15 |
| Name the associated chromosome. • Neurofibromatosis type 1 | Chromosome 17 |
| Name the associated chromosome. • Neurofibromatosis type 2 | Chromosome 22q |
| Name the associated chromosome. • Down syndrome | Chromosome 21 |
| Name the associated chromosome. • Edward syndrome | Chromosome 18 |
| Name the associated chromosome. • VON Hippel-Lindau disease | Chromosome 3p |
| What is the most common chromosomal disorder? | Down syndrome |
| What is the MCC of inherited mental retardation? | Down syndrome |
| What is the most common lysosomal storage disorder? | Gaucher disease |
| What chromosome is mutant in patients with cystic fibrosis? | Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7. |
| Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it? | Chromosome 19 |
| What chromosome is associated with the AR form of SCID? | Chromosome 20q (deficiency in adenosine deaminase) |
| On what chromosome is the adenomatous polyposis coli gene? | Chromosome 5q21 |
| Name the associated chromosome. • Albinism | Chromosome 11p |
| What mineral is associated with impaired glucose tolerance? | Chromium (Cr) |
| What mineral is associated with hypothyroidism? | Iodine (I) |
| What mineral is an important component of the enzyme xanthine oxidase? | Molybdenum (Mb) |
| What vitamin deficiency produces angular stomatitis, glossitis, and cheilosis? | Riboflavin (B2) deficiency |
| What vitamin is a component of the coenzyme thiamine pyrophosphate (TPP)? | Thymine (B1) |
| Avidin decreases the absorption of what vitamin? | Biotin. Avidin is found in raw egg whites. |
| What are the four Ds of niacin deficiency? | 1. Diarrhea 2. Dermatitis 3. Dementia 4. Death |
| What mineral is an important component of glutathione peroxidase? | Selenium (Se) |
| What mineral deficiency in children is associated with poor growth and impaired sexual development? | Zinc (Zn) deficiency |
| What mineral, via excessive depositions in the liver, causes hemochromatosis? | Iron (Fe) |
| What vitamin is needed for the production of heme? | Pyridoxine (B6) |
| What vitamin is a component of the enzymes fatty acid synthase and acyl CoA? | Pantothenic acid |
| What vitamin deficiency produces homocystinuria and methylmalonic aciduria? | Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.) |
| What vitamin deficiency is evidenced by poor wound healing, loose teeth, bleeding gums, petechiae, and ecchymosis? | Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.) |
| What are the three carboxylase enzymes that require biotin? | Pyruvate, acetyl CoA, and propionyl CoA carboxylase |
| What vitamin requires IF for absorption? | Cyanocobalamin (B12) |
| What mineral is a component of cytochrome a/a3? | Copper |
| Leukopenia, neutropenia, and mental deterioration are signs of what mineral deficiency? | Copper |
| What vitamin deficiency causes a glove-and-stocking neuropathy seen in alcoholics? | Pyridoxine (B6) deficiency |
| What mineral deficiency involves blood vessel fragility? | Copper deficiency |
| Megaloblastic anemia and thrombocytopenia are signs of what vitamin deficiency? | Folic acid deficiency |
| What vitamin deficiency can result in high-output cardiac failure? | Thiamine |
| Name the antidote. • Carbon monoxide (CO) | Oxygen |
| Name the antidote. • Mercury | Dimercaprol, penicillamine |
| Name the antidote. • Isoniazid | Pyridoxine |
| Name the antidote. • Atropine | Physostigmine |
| Name the antidote. • Arsenic | Dimercaprol, D-penicillamine |
| Name the antidote. • Digoxin | Antidigoxin Fab fragments |
| Name the antidote. • Gold | Dimercaprol |
| Name the antidote. • Ethylene glycol | Ethyl alcohol |
| Name the antidote. • Opioids | Naloxone, naltrexone |
| Name the antidote. • Organophosphates | Atropine, 2-PAM (pralidoxime) |
| Name the antidote. • Warfarin | Vitamin K |
| Name the antidote. • Copper | D-Penicillamine |
| Name the antidote. • Heparin | Protamine sulfate |
| Name the antidote. • Iron | Deferoxamine, penicillamine |
| Name the antidote. • Cyanide | Amyl nitrate, sodium nitrate, or sodium thiosulfate |
| Name the antidote. • Methyl alcohol | Ethyl alcohol |
| Name the antidote. • Acetaminophen | N-Acetylcysteine |
| Name the antidote. • Nitrates | Methylene blue |
| Name the antidote. • Lead | Penicillamine, EDTA (calcium disodium edetate), or dimercaprol |
| Name the antidote. • Benzodiazepines | Flumazenil |
| Name the antidote. • AChE inhibitors | Atropine with pralidoxime |
| Name the antidote. • Anticholinergics | Physostigmine |
| A known IV drug abuser goes to the ER with respiratory depression and pinpoint pupils and in a semicomatose state. What overdose do you suspect, and what agent will you give to reverse its effects? | The triad of respiratory depression, pinpoint pupils, and coma in an IV drug abuser suggests opioid overdose (e.g., heroin), and you should give naloxone. |
| Cherry red intoxication is associated with what form of poisoning? | CO |
| What toxicities are caused by the following agents? • Occupational nitrous oxide exposure | Anemia |
| What toxicities are caused by the following agents? • Methoxyflurane | Nephrotoxicity |
| What toxicities are caused by the following agents? • Halothane | Hepatitis, with or without necrosis |
| What are the first signs of overdose from phenobarbitals? | Nystagmus and ataxia |
| What are the three signs of morphine overdose? | Pinpoint pupils, decreased respiratory rate, and coma |
| What is the major pulmonary side effect of µ-activators? | Respiratory depression |
| What are the two side effects of opioids to which the user will not develop tolerance? | Constipation and miosis |
Created by:
ykirti