Orbit's Q.Bank

[Anonymous]

Hi!. I collected the most of orbit q's that were posted since november-december. Unfortunately, I didn't save them form the very beginning, but have all from 318 till end. So, I think they will be helpful to review. Let's call it ORBIT QBANK

PArt 1
318. what¡¯s the second messenger of secretin?
cAMP opposite to CCK, that is why they potentiate each other
319. what¡¯s the second messenger of CCK?
IP3&increased intracellular Ca++
320. which condition associated with no change in Hct level?
a)diarrhea
b)SIADH
c)adrenal insufficiency
d)isotonic NaCl infusion
b.SIADH- hypoosmotic expansion. so ECF increases ,and RBS conc should decreses, but RBS swell, so no changes in the conc.
321. which effect is not seen with thiazide diuretics?
a)increased K+ excretion
b)decreased Ca++ excretion
c)decreased ability to dilute urine
d)decreased ability to concentrate urine
d.No effect on ability to concentrate


322. which statement about gastrin is incorrect?
a)gastrin stimulates growth of mucosa of the small intestine and colon
b)the most potent releasers of gastrin are phenylalanine and tryptophan
c)atropine blocks vagus-mediated gastrin release
d)stomach distention stimulates gastrin secretion
c.Atropine does not block,since the mediator is GRP not Ach

323. high grade malignant Bcell lymphoma that most often develops in the setting of abnormal immune states(e.g SLE,Sjogren syndrome.......)
a)follicular lymphoma
b)small lymphocytic lymphoma
c)lymphoblastic lymphoma
d)large cell immunoblastic lymphoma
d)large cell immunoblastic lymphoma

324. which one is not a stimulus for release of CCK?
a)small peptides
b)amino acids
c)fatty acids
d)triglycerides
d,triglycerids:bcoz they can¨ˆt cross the intestinal mucosal membrane,but monoglycerides can cross& stimulate CCK secretion

325. which one causes hypokalemia?
a)insulin deficiency
b)hyposmolarity
c)digoxin
d)triamterene
e)beta-adrenergic antagonists
b:hyposmolarity
coz H2O flows into the cells,K+ diffuses in with H2O leads to hypokalemia
all other choices with hyperkalemia, remember that digoxin inhibits Na+/K+ pump causes hyperkalemia
AND hypokalemia predisposes to digoxin toxicity!

326. autosomal recessive childhood cyctic disease that's bilateral and associated with polyuria,growth retardation,the presence of corticomedullary cysts and cortical atrophy of tubules:
a)medullary sponge kidney
b)medullary cystic disease
c)childhood polycystic kidney disease
d)cystic renal dysplasia
this is a case of medullary cystic disease

327. virulance factor of mycobacterium TB that inhibit phagosome-lysosome fusion?
Sulfolipids
M . tb survives in a phagosome in the cell & produces a protein called "exported repetitive protein" which prevents phagosome & lysosome from fusing

328. it determines the percent saturation of Hgb?
a)PaO2
b)PaCO2
c)Hgb concenteration
d)both a&c
the answer is PaO2

329. after 6mo of drug therapy,a patient develops HTN&creatinuria without proteinuria.A biopsy shows ischemic damage to glumeroli and some tubular damage:
a)penicillinG
b)gentamicin
c)cyclosporine
d)naproxen
e)cyclophosphamide
cyclosporine. it causes nephrotoxicity & hypertension.....
pen g- causes acute hypersensitive interstitial nephritis..., gentamicin causes toxic ATN but that would be acute too & it would involve the tubule mainly...
naproxen may cause chronic analgesic nephropathy.. but that would first manifest as papillary necrosis..& cyclophosphamide causes cystitis....

330. this condition makes no change in filtration fraction:
a)constriction of afferent arteriole
b)constriction of efferent arteriole
c)increased plasma protein
d)ureteral stone
a. in uretheral stone and increased plasma protein- RPF- is unchanged, but GFR- changed, so FF is also changed. in efferent artetiole, they change in opposite, so FF also changed., only in afferent artetiole GFR
and RPF change in the same direction - so FF is unchanged.


331. after several days of treatment the patient develops significant proteinuria,renal biopsy shows myeloid bodies in proximal tubule cells,what's the drug responsible?
a)penicillinG
b)gentamicin
c)cyclosporine
d)naproxen
e)cyclophosphamide
myeloid bodies in proximal tubule characteristic for gentamicin


332. which one is not a marker for ECF volume measurement?
a)sulfate
b)evans blue
c)inulin
d)mannitol
the answer is B:evans blue is a marker to measure plasma volume
sulfate,inulin,mannitol to measure ECF volume


333. which effect is not seen in diarrhea?
a)decreased ECF volume
b)increased ECF osmolarity
c)increased Hct
d)no change in ICF volume
b. in diarrhea lost both water and electrolytes, so ecf volume decreases, but no change in ecf and icf osmolarity. the result of decreased volume- increased Hematocrit, but RBS neither shrink nor swell.


334. diarrhea is an example of:
a)isosmotic volume expansion
b)isosmotic volume contraction
c)hyperosmotic volume expansion
d)hyperosmotic volume contraction
e)hyposmotic volume expansion
f)hyposmotic volume contraction
b)isosmotic volume contraction


335. this hormone inhibits the effect of gastrin on growth of gastric cells:
a)secretin
b)CCK
c)GIP
d)somatostatin
secretin


336. cisapride increases GI motility by activating these serotonin receptors:
a)5HT1D
b)5H2
c)5H3
d)5H4
5HT-4


337. this disease transmitted by the same tick that transmits lyme disease?
a)Babesiosis
b)Relapsing fever
c)Rocky Mountain spotted fever
d)Ehrlichiosis
e)Colorado tick bite fever
babesiosis transmitted by ixodes tick

338. retrograde ejaculation is a side effect of:
a)clonidine
b)propranolol
c)prazosin
d)minoxidil
e)guanethidine
f)captopril

guanethidine
it¨ˆs an adrenergic blocker that inhibits sympa activity responsible for ejaculation


339. this drug acts by blocking guanosine monophosphate formation:
a)ribavirin
b)acyclovir
c)gancyclovir
d)amantadine
e)ziduvidine
ribavirin


340. what¡¯s the effect of hyperventilation on serum Ca level?
hyperventilation leads to respiratory alkalosis,elevated PH increases negative ions on albumin that bind more to ionized Ca++,so ionized Ca++ decreases that leads to tetany but the amount of total serum Ca unchanged
341.


364. the indication of use of Ames test?
to identify potential carcinogens by assessing their ability to cause mutations

365. gr+ protozoan associated with gay bowel syndrome and drug of choice for treatment?
Microsporidium,albendazole

366. treatment of cough due to captopril?
u can prescribe aspirin, nifedipine, chromolyn sodium to treat cough
change to losartan another option(an angiotensin II receptor antagonist. It is not an ACE inhibitor and does not cause caugh)


367. For which of the following patients niacin can be a good choice to contol hyperlipidemia?
a)a 47yr old male with history of gout
b)a 56yr old female with history of NIIDM
c)a 50 yr old male with history of angina pectoris
d)a 38yr old male with history of duodenal ulcer
e)none of above
it's C
niacin side effects:hyperglycemia,hyperuricemia,increased PUD(peptic ulcer)

368. which type of hypolipidemia can be associated with retinitis pigmentosa?
abetalipoproteinemia that associated with retinitis pigmentosa

369. U can¡¯t prescribe ketoconazole and amphotericinB together?why?
Absorption of which one of these drugs depends on gastric PH?
ketoconazole absorption depends on gastric PH&inhibited by H2 blockers and antacids
u can't prescribe these 2drugs together as one drug inhibits membrane ergosterol synthesis(ketoconazole):fungicidal,so no fungus available for the action of ampho B that act by increasing the permeability of fungal membranes:static effect

370. 2 drugs that increase warfarin effect by displacing it from albumin?
sulphonamides....also furosemide, chloral hydrate

371. which one is a risk factor for osteoporosis?smoking?alcohol?caffeine?
smoking a RF for osteoporosis
caffeine not approved that be a RF
and low to moderate use of alcohol a protective effect on osteoporosis development

372. what¨ˆs the mode of inheritance of retinitis pigmentosa?
AR-40%, AD-20%, X-linked-5%
no herad of mitochondrial inheritence, could u tell me ur ref?
or mitochondrial

373. a 50yr old male always arrives 15minute late for his appointment,which personality disorder he has?
a)schizoid
b)borderline
c)histrionic
d)passive-aggressive
e)obcessive-compulsive
I think it's D because it's a possibility
that the patient wants to show his unhappiness
via coming late all the time instead of
confronting. Again, it could be E as well only
if there was an explanation in the question
that the patient comes late to appointment
because he was preoccupied to lock his house
door many times.

374. amiodarone belongs to which class of antiarthmytic drugs?AND what's 3 important drug interactions of this drug?
both class IA, III(K+ CHANNEL BLOCKER)
increased level of phenytoin,warfarin,digoxin, increase theophylline and quinine levels
It causes pulmonary fibrosis, corneal deposits, hepatotoxicity, both hypo&hyperthyroidism,blue skin discoloration due to iodine deposition as a side effect

375. which one is not a side effect of heparin overdose?
a)hyperkalemia
b)hypoglycemia
c)hyperlipidemia
d)thrombocytopenia
the answer is b
hyperkalemia,hyperlipidemia,thrombocytopenia,osteo porosis side effects of heparin

376. anti-TB drug that can cause tubulointerestitial nephritis?
Rifampin

377. diuretic associated with tubulointerestitial nephritis as a side effect?
as per goljan both thiazides n furosimide causes tubulointerstitial nephritis

378. active toxic metabolite of cyclophosphamide that¨ˆs responsible for hemorrhagic cyctitis?
Acrolein

379. active toxic metabolite of cyclophosphamide that¨ˆs responsible for hemorrhagic cyctitis?
Acrolein

380. drug of choice for treatment of pinworm infection?
mebendazole or pyrantel pamoate
381. which one is not a side effect of interferon therapy?
a)pancytopenia
b)confusion
c)thyroiditis
d)upper GI irritation and ulceration
e)fever,chills
d)upper GI irritation and ulceration
interferon therapy side effects:fever,chills,myalgia,fatigue,pancytopenia, somnolence,confusion,thyroiditis


382. which one is not a side effect of cyclosporine?(may be more than one answer)
a)hyperkalemia
b)tremor
c)seizure
d)gingival hyperplasia
e)hypertension
f)hirsutism
g)pancreatitis
h)glucose intolerance
i)hepatic dysfunction
all are side effects of cyclosporine except gancreatitis

383. the mechanism of action of sibutramine?
appetite suppression,blocking central serotonin,norepinephrine reupatake
Sibutramine is a new agent used to treat obesity. It interferes with the reuptake of serotonin and NE into the presynaptic nerve terminal, thereby increasing their levels in the brain.


384. a child can use toothbrush and has imaginary friend
at what age?
4 yrs

385. deQurvein thyroiditis associated HLA?
HLA-B35

386. chronic use of this drug to treat dermatitis herpetiform may lead to metheoglobinemia?
Dapsone
387. the most common cause of vision loss in African-American population?
open-angle glaucoma
They are five times more likely to develop it than whites, due to inherited risk factors. African-Americans over 40 and people in other ethnic groups over 60 are at greatest risk for developing glaucoma
Trachoma is found in poor rural areas of most African countries and a few other areas today.
Q is about African Americans.
Cataract is the number 1 world wide cause of blindness.
African Americans suffer 5x more from Glaucoma than other counterparts.
Age-related macular degeneration (ARMD) is the number 1 cause of blindness after 60. So here it is age related question.
What Orbit says, waiting. He might have more Qs about eye and ORBIT.
388. drug of choice for treatment of sleep apnea?
Protryptilline

389. what¡¯s the second messenger for muscarinic receptors?(M1?M2?M3?)

M1,M3:IP3
M2:decreased cAMP


390. the indication of use of oseltamivir?the most common side effect?
neuroaminidase inhibitors,block release of progeny virus from cells
treatment of influenzaA,B,vomiting in 1-2days that occurs with first dose and disappears with continuing of treatment,other side effects:conjunctivitis,epistaxis,abdominal pain


391. the mechanism of action of zanamivir?indication of use?
neuroaminidase inhibitors,block release of progeny virus from cells,treatment of influenzaA,B,vomiting in 1-2days that occurs with first dose and disappears with continuing of treatment,other side effects:conjunctivitis,epistaxis,abdominal pain
exacerbate pulmonary symptoms in COPD

392. what's the second messenger for histamine receptors?
H1:IP3,H2:cAMP
393. what's the second messenger for dopamine receptors?
D1, 4 and 5 - cAMP, D2 and 3 -cAMP inhibition

394. what's the second messenger for alpha(alpha-1,alpha-2) receptors?
alpha 1 IP3
alpha 2 cAMP inhibition

395. the origin of gastrinoma in Zollinger-Ellison syndrome?
a)alpha cells
b)beta cells
c)delta cells
the answer is delta cells

396. the effects of Epinephrine and Norepinephrine on TPR(Total Peripheral Resistance)?
NE:INCREASED TPR: act through alpha receptors
EPECREASED TPR: act through beta receptors


397. enzyme defect in porphyria cutanea tarda?
partial loss of activity of hepatic uroporphyrinogen decarboxylase
398. enzyme defect in acute intermittent porphyria?
defeciency in porphobilinogen deaminase(another name: uroporphyrinogen I synthase)

399. which part of thalamus considered a part of limbic system?
ant thalamus
mamillary bodies..........> ant.thalamaus.........>cingula


400. which one is not a derivative of middle trunk brachial plexus?
a)median nerve
b)ulnar nerve
c)radial nerve
d)axillary nerve
upper trunk:musculocutaneus nerve
middle trunk:median,radial,axillary nerves
lower trunk:ulnar nerve


401. the origin of C cells of thyroid?
a)first pouch
b)second pouch
c)third pouch
d)4th pouch
e)5th pouch
5th pouch(Dr Carl¡¯s book)
high yield & kaplan say 4th pouch... which forms the ultimobranchial body... (the actual origin is migration of neural crest cells).

402. a patient with aluminium toxicity presents with dyspnea.why?(the cause of dyspnea?)
Al toxicity leads to impaired absorption of P in GI tract,decreased available P leads to decreased level of 2,3DPG,abnormal tissue oxygenation causes malaise,dyspnea,muscle weakness

403. the most common clinical presentation of chronic arsenic poisoning?
neurologic symptoms predominate:burning sensation(glove-stock distribution),bilateral arm,leg weakness(pigmentation another symptom but not the most common)

404. risk factors for developing tardive dyskinesia?
Chronic use of Neuroleptis medications,CO poisoning,female sex etc also DM,old age,smoking


405. mechanism of action of nevirapine and common side effects?
anti retro viral.... nonnucleoside reverse transcriptase inhibitor...which doenot require metabolic activation..
side effect is rash ... steven johnsons syndrome

406. mechanism of action of nelfinavir and common side effects?
anti retro viral.. protease inhibitor...
side effect diarrhea... central adiposity...inslin resistance
increased levels of TG,cholestrol,lipodystrophy

407. to treat tricyclic antidepressant overdose which treatment is not effective and WHY?
a)gastric lavage
b)use of activated charcol
c)physostigmine
d)dialysis
d:dialysis
coz TCAs have a wide Vd(volume of distribution),so dialysis not effective


408. what's the difference betwen clinical presentation of NMS and serotonin syndrome?
both of them present with hyperthermia, myoclonus,rigidity, CVinstability
in addition
NMS=altered consciousness is seen
SErotonin syndrome=diaphoresis n seizures are seen


409. which of the following statistical tests is most appropriately used to evaluate the difference in the percentage of women who lose weight on a protein-sparing diet versus the percentage who lose weight on a high-protein diet?
a)paired t-test
b)ANOVA
c)chi-square test
d)correlation
e)independent t-test
chi square used to determine between frequencies in a sample


410. which of the following statistical tests is most appropriately used to evaluate the difference between initial body weight and final body weight for each woman on a protein-sparing diet?
a)paired t-test
b)ANOVA
c)chi-square test
d)correlation
e)independent t-test
A,t-test used to examine differences between means of 2 samples,this is paired t-test coz the same women are examined on 2 diff occasions
e)independent t-test:2groups of subjects are sampled on one occasion


411. an IQ test has high interrater reliability,what does it mean?
it means that the results are very similar when the test is administered by a different examiner


412. these cells contain a peripheral hyalomere and central granulomere?
a)lymphocytes
b)monocytes
c)basophils
d)neutrophils
e)eosinophils
f)platelets

platelets!


413. in a kidney donor,what changes are seen in:
1)creatinine excretion?
2)GFR?
3)plasma Cr concentration?

Cr excretion=GFR x plasma Cr concentration
GFR decreased,plasma Cr increased,Cr excretion unchanged


414. which enzyme responsible for secretion of pancreatic enzymes?CCK or secretin?
CCK responsible for pancreatic enzyme secretion
secretin for HCO3- secretion

415. Sabin-Feldman dye test used to identify this organism?
Gold standard serologic test for toxoplasmosis

416. where¨ˆs the location of folic acid and iron absorption?
yes,duodenum, according to kaplan most of folic acid and iron absorption occurs in duodenum
417. defeciency of this factor associated with thrombosis rather than hemorrhage?
a)factor V
b)factor VII
c)factor XII
d)factor XIII

factor XII

418. intramembranous deposits are seen in which type of glomerulonephritis?

MPGN typeII
MPGN typeI:with subendothelial deposits

419. coagulation factors inhibited by proteinC?
factor V,VIII

420. which phase of cell cycle affected by tamoxifen?
G1

421. In chemotherapy,what¡¯ the only antibiotic that¡¯s cell-cycle specific?and which phase of cycle affected by this drug?
bleomycin--G2 phase

422. the indication of use of cyclobenzaprine?
centrally acting muscle relaxant

423. the indication of use of tetrahydrozoline:
conjunctival congestion?? in allergies, it's alpha-agonist

424. the first heart sound corresponds to which of the following points on an atrial pressure tracing?
a)a wave
b)c wave
c)v wave
d)x descent
e)y descent
c wave

425. the second heart sound corresponds to which of the following points on an atrial pressure tracing?
a)a wave
b)c wave
c)v wave
d)x descent
e)y descent
v wave


426. S4 corresponds to which of the following points on an atrial pressure tracing?
a)a wave
b)c wave
c)v wave
d)x descent
e)y descent
a wave


427. match markers for each measurement:
1)evans blue
2)antipyrine
3)inulin
4)tritium
a)measurement of total body water
b)measurement of plasma compartment
c) measurement of extracellular fluid compartment
a)measurement of total body water: antipyrine, tritium
b)measurement of plasma compartment: evans blue
c) measurement of extracellular fluid compartment:inulin
428. mutation in apoprotein CII is seen in which type of hyperlipidemia?
type1:associated with LPL dificiency or mutation in apoCII


429. Most comonly uesd calcium channel blocker in CHF?
a)nifedipine
b)amlodipine
c)isradipine
d)diltiazem
e)verapamil
amlodipine&felodipine

430. rate limiting step of pyrimidine synthesis?
aspartate transcarbamylase

431. rate-limiting enzyme of cathecholamine synthesis?
tyrosine hydroxylase

432. side effects of carmustine?
Pulmonary toxicity.
And delayed myelosuppresion
Pul.Toxicity by Bleomycin, Busulfan,MTX, Carmustine
(BBC...MaTriX (Methotrexate)
nausea, vomiting
temp. reduction in bone marrow function (anemia)

433. what¡¯s the final product of glycolysis?
pyruate aerobic,lactate anaerobic

434. rate-limiting enzyme in glycogenolysis?
glycogen phosphorylase


435. rate-limiting enzyme in gluconeogenesis?
Fructose 1-6Bisphosphatase.
Stimulated by , ATP,Glucagon, inhibited by Insulin,AMP,Fructose 2-6 Bisphosphate.
pyruate carboxylase
PEPCK

436. what enzyme difficiency is seen in heredity fructose intolerance?
Aldolase B(Fructose 1P Aldolase),
Hereditary F intolerance.
Aldolase B found in Liver and Kidney.
not evident till babay is on mother's milk.
After Fructose ingestion, Sever Hypoglycemia ( lethargic baby, diaphoresis) and Sevr Lactic Acidosis.
Fructose 1 phosphate accumulate in Liver(hepatomegaly,hyperbili,liver damage,hypoglycemia) and Proximal Tubular Acidosis (Fanconi) in Kidney.
Negative Finding...Cataract is not present, sunce fructose is not a subtrate for aldose redutace) of len.
Tx:Eliminate fructose.

437. the skeletal muscle relaxant that release histamine?
Tubocurarine

438. rate-limiting enzyme in fatty acid synthesis?
acetyl-coA carboxylase
Acetyl CoA carboxylase, needing Biotin, ATP
Activated by Insulin,Citrate, High Carb Dieat, Low fat Diet.
Inhibited by Glucagon,Free Fatty acids in Blood, High fat diet.

439. rate-limiting enzyme in HMP shunt?
G6PD
G6PD.
The great enzyme, only rate limiting step in HMP.
HMP.
Also yeilds 2 NADPH. help in Fatty acid synthesis, Keep Glutathione reduced and Oxidative killing of bacteriain PMN.
BTW, there are other ways to get Ribose 5 Phosphate with out using G6PD, is Tranketolases, and Glycolytic intermediates, F6P,Gleceraldehyde3P are used as intermediate....But they need Thiamine . Transketolases are found in RBC for your info.
Other thing to remebr is we can differentiate G6PD deficiency from Pyruvate Kinase deficiency(which give hemolytic anemia too) is that G6PD has heinz bodies , the latter does not.
heinz bodies.
In mediteranean it is fava beans.


In america it is drug induced , infections and African Americans too
440. the phase of cell cycle affected by cytarabine?
Sphase


441. enzyme difficiency in Tangier¨ˆs disease?
Familial alpha-Lipoprotein deficiency, absence of apoA
Low sr. Chol, and HDL.
High TAG,VLDL ,Chylomicron.
lArge orAnge Tonsils,
HepAtomegaly,
Neurological deficits.......
442. enzyme difficiency in Fabry disease?
alpha galactosidase
Xlinked, accumulation of cermide trihexoside, Renal failure.
443. enzyme difficiency in Hunter &Hurler diseases?
Hunter: Aim for X, Xlinked, iduronase sulfatase, NO corneal clouding and mild MR
Hurler:Alpha - L iduronase. Corneal clouding and MR.
Drawifsm. Not diagnosed in infancy.
444. drug of choice for cysticercosis?and mechanism of action?
praziquantal- increases Ca membrane permeability causing loss of calcium.
albendazole alternative treatment
445. SIADH a side effect of which drug?
a)gancyclovir
b)foscarnet
c)amantadine
d)vidarabine
vidarabine
446. the only fatty acid that¨ˆs gluconeogenic?
propionic acid
447. mechanism of action of foscarnet?
inhibits viral replication by blocking the pyrophosphate binding site of viral DNA polymerase
448. drug of choice for blastomycosis?
itraconazole choice
amphoB for severe cases
449. which chemotherapeutic drug considered a cell-cycle nonspecific drug?
a)hydroxyurea
b)etoposide
c)metothroxate
d)busulfan
busulfan:alkylating agents cell-cycle nonspecific
450. drug of choice for African sleeping sickness:CNS stage?hemolymphatic stage?
Melarsaprol,pentamidine

[Anonymous]

Sorry but what is this Orbitz Q-bank?

[Cadusma]

User beware ... some of the answers are not correct.

[mjl1717]

Good heads up Cadusma!

[mjl1717]

Good heads up Cadusma!

[Anonymous]

Hi,
where were these questions posted originally?which website?
Please answer

Thanks.

[Cadusma]

OrbitWebs = http://p196.ezboard.com/bpinoyimgforum

Note: This link can also be found in the "USMLE Step 1 Preparation Resource Center" ... http://www.valuemd.com/viewtopic.php?t=11810

[rbaig]

Hi Cadusma.

Thanks for replying.

[Anonymous]

actually thats "obitsweb" which is like network54. thats different than orbit's qbank which is a compilation of questions put together by 'orbit', a generous user who posted lots of helpful questions. he is the tommy of the past. hope this helps.


here is part 2 of his questions. enjoy!


PART 2 of orbit review
451. drug of choice for American sleeping sickness? Nifurtimox
452. drug of choice for Wulchereria bancrofti? Diethylcarbamazine
453. enzyme blocked by hydroxyurea?ribonucleotide reductase
454. this apoprotein required for the uptake of LDL in peripheral tissues? apoB100
455. drug that prevents renal toxicity of cisplatin? Amifastine
456. drug that prevents neutropenia of paclitaxel?Filgrastim
457. drug that protects against cardiotoxicity of adriamycin?dexrazone
458. this antiepileptic drug blocks sustained repetitive firing by blocking voltage-dependent Na+channels:
a)ethosuximide
b)tiagabine
c)lamotrigine
d)topiramate
e)vigabatrin
lamotrigine
also remember that its side effect is rash,e*******-johnson syndrome
459. this antiepileptic drug is a chemical relative of fructose?
a)ethosuximide
b)tiagabine
c)lamotrigine
d)topiramate
e)vigabatrin
topiramate
460. This antiepileptic drug decreases the efficacy of OC?
a)ethosuximide
b)tiagabine
c)lamotrigine
d)topiramate
e)vigabatrin
TOPIRAMATE
461. detachment of epithelial cells from glomerular BM hallmark for this GN? FSGS, FOCAL SEGMENTAL GLOMERULOSCLROSIS
462. HCV serology should be obtained with diagnosis of this GN?FSGS:Focal Segmental GN
463. GN associated with atopic history?minimal change disease
464. subendothelial deposits in which type of GN?MPGN typeI and SLE:typeIV:diffuse proliferative form
465. estrogen decrease release of this IL from osteoblasts? yes,IL-1,osteoclast activating factor, also i read from UCV that estrogen inhibits IL-6
466. a sharply demarcated,red velvety lesion of vulve,microscopic examination:large cells with vaculated cytoplasm containing mucin.
What’s the diagnosis? Paget disease of the vulva, mucin+ cells
467. a 45yr old man with epididymitis, most common organism responsible? >35yr old: E.coli, pseudomonas, less than 35-chlamydia
468. RFs for vulvar SCC? HPV16,18, DM,HTN,obesity, smoking, immunosupression,
469. the most common immature element found in immature ovarian teratoma? Neuroepithelium
470. OC protects against which organism? gonorrhea or Chlamydia? it's protectice against gonorrhea not chlamydia
Oc thinkens cervical mucus, rending it difficult for Gonorrhea to invade the cells.
It decrease PID incidence by same mechanism I guess.
471. which malignancy with hobnail cells?
hobnail cells associated with clear cell carcinoma: including: renal cell carcinoma, ductal cell carcinam (clear cells),clear cell adenocarcinoma of ovary (not related to DEB),clear cell adenocarcinoma of vagina
if u want to see hobnail cells,go to:
http://radiology.uchc.edu/eAtlas/GYN/1940.htm
472. cells with Orphan Annie nuclei associated with this cancer? papillary carcinoma of thyroid to see these cells go to :
http://pathophysiology.uams.edu/Spri...013/sld013.htm
473. how u detect ferruginous bodies and related disorder?, it's associated with asbestosis(more involved lower lobes!)
these bodies:yellow-brown rod bodies stain with prossian blue
to see ferruginous bodies,go to
1) http://www.med.uiuc.edu/PathAtlasf/W...ges/V4111.html
2) http://www.med.uiuc.edu/PathAtlasf/W...ges/V4363.html
most common presntation pleural plaques usually calsifies-bilateral calcified plaques in x-ray
main diagnosis is y x-ray in the form of irregular linear opacities mainly in lower lobe.
can also use hrct...but history of exposure and duration when combined with radiological features help in diagnosis
474. what’s the cofactor for the enzyme that’s deficient in maple-syrup urine disease? the enzyme defecient:Branched chain alpha keto acid dehydrogenase
cofactor:vitB1:thiamine
475. DNA repair syndrome with defect in DNA ligase? Bloom syndrome
476. renin changes with these drugs?(increase or decrease?captopril, clonidine, propranolol, minoxidil
in capto,minoxidil increase, in propranolol,clonidine decrease,captopril inhibits ACE,decrease in AngII levels,feedback increase in renin level
minoxidil a vasodilator,vasodilators increase plasma renin concentration leads to sodium and water retention
clonidine:alpha-2 agonist that decreases central adrenergic outflow,leads to decrease in vascular peripheral resistance,sodium and water retention,secondary decrease of renin level(that's why clonidine a good choice for treatment of HTN in patients with renal disease coz it does not reduce renal blood flow,and that's why we usually prescribe clonidine with diuretic!)
propranolol:decrease BP leads to Na,water retention,secondary decrease of renin level
477. a serum sample from a 28yr old female bird-handler suspecting of having psittacosis is evaluated by a complement fixation test.Lysis of erythrocytes happens, what’s ur diagnosis?
answer: the patient is not affected!
as no Ab present,fixation of complement does not occur and complement lysis the RBCs
if this patient had psittacosis,Abs in her serum made a complex with Ags(in test environment)Ag-Ab complex fixed complement so no complement was available to lysis RBCs
478. which one cause both bradycardia and vasodialation?why?
a)parasympathetic nerve stimulation
b)injection of Ach
c)both
d)none of them
injection of Ach
muscarinic receptors in vascular smooth muscle cells are not inervated,so parasympathetic innervation only lowers heart rate,but injection of Ach stimulates muscarinic receptors and both events happen
479. this IL transforms macrophages to epitheliod and giant cells?that's IL-4 are u sure about IL-2?
480. IL that’s responsible for conversion of Bcells to plasma cells?, IL-5
481. the only enzyme of TCA cycle that use FAD as a cofactor? succinate dehydrogenase
482. fanconi anemia at risk for which type of leukemia? AML, Acute myeloblastic leukemia
483. a 65yr old man who recently moved to Phoenix,Arizona,presents with fever,flu-like symptoms,nonproductive cough and painful red nodules on ant aspect of his lower left leg.a solitary coin lesion with an egg shell-like cavity is noted in the upper portion of his left lower lobe on Cxray.what’s the diagnosis?
coccidiodomycosis
Phoenix,Arizona:SW deserts
484. the effect of clonidine on?
1:cardiac output
2eripheral resistance
3:rennin activity
all decrease
clonidine:alpha-2 agonist that decreases central adrenergic outflow,leads to decrease CO,decrease in vascular peripheral resistance,sodium and water retention,secondary decrease of renin level(that's why clonidine a good choice for treatment of HTN in patients with renal disease coz it does not reduce renal blood flow,and that's why we usually prescribe clonidine with diuretic!)
485. the effect of hydralazine on?
1:cardiac output
2eripheral resistance
3:rennin activity
PR decrease,CO increase,renin increase
hydralazine is a vasodilator,vasodilators increase plasma renin concentration leads to sodium and water retention
as a vasodilator decrease peripheral resistance,also reflex stimulation of the heart that increases heart contractility and heart rate leads to increase in cardiac output
486. enzyme deficiency in essential fructosoria and fructosemia? in essentiel fructosuria :fructokinase
aldolase B : fructosemia?
it 's fructosemia seen in both that is leading to fructosuria due to overload on kidney reabsorption ....
487. defenitive diagnosis of fructosemia in a symptomatic infant? liver biopsy to detect aldolase B activity
488. involvement of which tract responsible for ataxia seen in lateral medullary syndrome? Spinocerebellar
489. by which mechanism vitB12 defeciency causes functional folic acid deficiency?
In the absence of vitB12 methylTHF can’t transfer its methyl group to homocysteine to form methionine- homocysteine methy transferase enzyme
490. the main side effect of didanosine,zalcitabine?
the main side effect of didanosine is pancreatitis,also dose-limiting toxicity of drug causes painful peripheral sensorimotor toxicity
the main side effect of zalcitabine is painful peripheral sensorimotor neuropathy,it also can cause pancreatitis
491. autoregulation of blood flow occurs in the circulation of which organs?
heart(coronary c.)
brain(cerebral c.)
kidney(renal c.)
492. a motile gr- rod that ferments lactose and forms indole from tryptophan:
a)E.coli
b)proteus
c)pseudomonas
d)klebsiella
e)enterobacter
E.coli
493. this vitamin used to treat methemoglobinemia?vitC,bcoz it reduces ferric to ferrous iron in the heme molecule
494. this vitamin is primarily involved in amino acid metabolism?vitB6
495. vitamin that acts as a cofactor for conversion of propionyl coA to succinyl coA?
yes,2reactions,first biotin for propionyl coA carboxylase(remember that's a cofactor for carboxylation reactions)that converts it to methylmalonyl coA,and then vitB12 cofactor for methylmalonyl coA mutase that converts methylmalonyl coA to succinyl coA
496. which cells contain Weibel-palade bodies? endothelial cells
497. enzyme inhibited by etoposide? topoisomerase2
498. the location of ketone body synthesis:mitochondria or cytoplasm? Mitochondria
499. measurement the activity of this enzyme in RBCs used as a clinical marker in vitB1 defeciency? Transketolase
500. vitamin acts as a cofactor for the reaction that converts phosphatidylserine to phosphatidylethanolamine?
the enzyme Phosphotidylserine decarboxylase,i concluded that B1(thiamine)can be a cofactor as it's cofactor for decarboxylation reaction.am i right?
501. Guthrie test for newborn screening of what disease? PKU
502. amino acids that essential only in infants and children? arginine,histidine
503. HMP shunt activity changes in overnight fast?decreased
504. the change in lung compliance in asthma?compliance increases, elasticity decreases, according to BSS CD,it's unchanged!
505. reduplication of meiotic chromosomes a characteristic of which disorder?
a)dermoid cyst
b)struma ovarii
c)choriocarcinoma
d)fibroma
the answer is a:actually reduplication of maternal meiotic chromosomes:all benign ovarian teratomas or dermoid cysts are of 46,XX karyotype,these tumors r abberent fetuses solely of maternal origin arising after the first meiotic division
506. testosterone decreased in old persons, so u expect less DHT produced, but why BPH correlates with old age?
with old age, estrogen increased, estrogen promotes expression of receptors for residual DHT, leads to prostate growth, even though testosterone decreased
507. the effect of lovostatin on anticoagulant effect of warfarin? increased effect
508. metabolic disease with accumulation of galactocerebroside? krabbe's disease
509. Metabolic disease with deficiency of glucocerebrosidase? gaucher disease
510. Metabolic disease with deficiency of alpha-galactocerebrosidase A? fabry
512. the rennin main function in neonates?
reNNin like pepsin,it secreted as prorennin and activated by gastric HCl to make rennin,but it’s activated in higher levels of PH than pepsin,that’s important in neonates that their gastric juice is not as acidic as adults and its main function is initiation of digestion of milk proteins
don't mixed it with renin from kidney!
513. a medical Dr who spends most of his day sitting in front of the computer doing Qbank for step I,is developing increased girth around his waistline. He wasn’t an overweight as a child or during his adolescence, his obesity most likely caused by:
a)hyperplasia
b)metaplasia
c)hypertrophy
d)anaplasia
hypertrophy,&
in child fat cell increases by hypertrophy&hyperplasia
in adult " " " " only hypertrophy
514. hypertrophy,&
in child fat cell increases by hypertrophy&hyperplasia
in adult " " " " only hypertrophy
it often presents with pain or metastasis
515. when u see physiologic goiter?
puberty and pregnancy
516. which one is not a characteristic of muscle fibers type II?
a)dominant fibers in biceps muscle
b)react to training with hypertrophy
c)pale even with ATPase staining at an alkaline PH
d)rich in glycogen,poor in mitochondria
C:dark not pale
muscle fibers typeII:
fast-twitch muscle in white muscles:like biceps(typeI:slow-twitch in red muscles like postural muscles)
poor mitochondria,rich in glycogen(opposite seen in typeI)
react to traning with hypertrophy(size of typeI unchanged)
faster,shorter,more powerful contraction than typeI
more enzymes for anaerobic glycolysis than typeI
dark ATPase staining at an alkaline PH(typeIale)
517. malakoplakia is most common seen in which organ?
malakoplakia:degeneration process in macrophages,most common site:bladder:raised,yellow plaques in bladder mucosa:foamy macrophages that PAS+ and contain Michaelis-Gutmann bodies which r composed of Ca&iron
518. what’s the difference between pathogenesis of these 2 diseases?
Common variable immunodeficiency
Bruton agammaglobulinemia
difference in pathogenesis:
Common variable immunodeficiency:Mature Bcells can’t differentiate to plasma cells,so we have Bcells
Bruton agammaglobulinemiareBcells can’t differentiate to Bcells:lack of Bcells
519. IL important for mast cell synthesis?IL-3, il-4
520. citrulline accumulates in deficiency of which enzyme of urea cycle?
a)carbamoyl-P synthetase
b)Ornithine transcarbamoylase
c)Argininosuccinate synthetase
d)Argininosuccinate lyase
e)Arginase
c)Argininosuccinate synthetase
521. which product of urea cycle forms in mitochondria?
a)citrulline
b)ornithine
c)arginosuccinate
d)arginine
a)citrulline
522. which one is associated with secondary adrenal insufficiency?
a)K+increased,glucose increased,pigmentation unchanged
b)K+increased,glucose unchanged,pigmentation unchanged
c)K+increased,glucose decreased,pigmentation increased
d)K+unchanged,glucose decreased,pigmentation decreased
e)K+increased,glucose decreased,pigmentation decreased
the answer is D:
K+unchanged,glucose decreased,pigmentation decreased
in adrenal insufficiency :lack of ACTH:so pigmentation decreased,as ACTH has a main control on cortisol,it decreased and results to hypoglycemia,but aldosterone unaffected and K+unchanged
523. which tumor also called zebra tumor?
where u can see zebra bodies?
zebra tumor:aucostic neuroma
zebra bodies:Nieman Pick
524. what is Pautrier’s microabscess?and associated disease?
malignant CD4+T cells in epidermis,MF
525. what’s Munro’s microabces?and associated disease?
collection of neutrophils in epidermis,psoriasis
526. which Ab acts by misreading of mRNA?
a)erythromycin
b)tetracycline
c)streptomycin
d)chloramphenicol
it's streptomycin:aminoglycosides actually
527. this Ab blocks translocation of the peptide chain from the aminoacyl site to peptidyl site?
a)erythromycin
b)tetracycline
c)streptomycin
d)chloramphenicol
a)erythromycin
528. in a patient with hypomagnesemia:
a)total Ca decreased,ionized Ca unchanged
b)total Ca unchanged,ionized Ca decreased
c)both decreased
d)both increased
yes,both decreased
Mg is a cofactor for adenylate cyclase,so in hypomagnesemia PTH can’t activate adenylate cyclase and both total and ionized Ca decreased
529. the location of synthesis of erythropoietin in kidney?
endothelial cells of peritubular capillaries in renal cortex
530. removed during processing of eukaryocytic mRNA?
a)CAAT
b)CCA
c)GAATTC
d)GU…….AG
e)TATA
f)UAG
G)polyA
h)polyadenylation sequence
good!d:GU…….AG
interons are spliced out during posttranscriptional processing of eukaryocytic mRNA,these interons begin at their 5’end with GU and end at their 3’ end with sequence:AG
531. during posttranscriptional processing of tRNA which one added at the end of tRNA?
a)CAAT
b)CCA
c)GAATTC
d)GU…….AG
e)TATA
f)UAG
G)polyA
h)polyadenylation sequence
b)the base sequence:CCA
532. indication of use of domperidone?
nausea after radiation therapy
also thiethylperazine another choice to control it
533. indication of use of domperidone?
nausea after radiation therapy
also thiethylperazine another choice to control it
also for increasin prolactin secretion for breast feeding purposes
534. the effect of warfarin on phenytoin level:
increased
535. a person with sickle cell symptoms+splenomegaly+target cells,what’s ur diagnosis?
Hgb SC disease
536. Which coagulating factor used as a marker of tumors?and marker for which tumors?
factor VIII
angiosarcoma,Kaposi sarcoma
537. normal flora of nasopharynx?
Anaerobic bacteriaeptostreptococcus,fusobacterium,bacteroi ds
Viridans group streptococci
Coagulase- staph
Avitrulant H.influ,N.meningitides
538. mechanism of action of nystatin?
act like amphoB
binds to ergosterol...forms pores in fungal memb
539. marker of carcinoid tumor?
5hydroxyindole acetic acid, also S-100
540. Giant cells that form by fusion of lymphocytes are seen in which infectious disease?
Warthin-Finkeldey cells in measles
Most giant cells are composed of histiocytes, but the WF giant cell is
created by fusion of lymphocytes
541. A certain substance, which is both freely filtered and secreted, is being maximally secreted. As the plasma concentration of the substance increases, the renal clearance:
A. decreases and approaches that of inulin
B. increases and approaches that of inulin
C. increases to the renal plasma flow
D. will decrease to zero
E. will remain the same
A correct, Cos if the conc is still increased it cant be secreted and the excess remains in plasma.It cant decrease below inulin cos it is secreted.
542. A 35-year-old man is referred to the renal clinic for evaluation of proteinuria. He has no complaints other than
foamy urine. The following data are obtained from the patient:
Inulin clearance 100 mL/min
Plasma osmolarity 286 mOsm/L
Plasma sodium concentration 140 mEq/L
Urine flow 1.44 L / 24 hour
Urine osmolarity 205 mOsm/L
Urine sodium concentration 100 mEq/L
How much sodium does this patient reabsorb each day?
A. 14 mEq
B. 144 mEq
C. 244 mEq
D. 20,016 mEq
E. 20,160 mEq
absorbed load= filtered -excreted.filtered=GFRxplasma Na.now here is the mystery gfr=100ml/mt.you have to get in 24 hrs in litres.so that will be .1 L/mt or .1 x 60 x 24 in one day ie 144..now therefore filtered load =144x140..exreted load = v x urine sodium conc.=100 x1.44=144.therefore absorbed load=144x140-144=20016.hope u got it.
543. what’s the difference between transvestic fetishism and transsexualism?
Transsexuals might cross dress but they do so due to persistent discomfort with their anatomic sex. Transvestic fetishism involves no such discomfort.
544. folic acid required for synthesis of which nucleotides?
folate involves in the transfer of carbons 2,8 of purine nucleotides(A,G)and 5-methyl group of thymidine
545. trisomy with rocker-bottom feet?
Both 13, and 18
don't forget that it's seen in both trisomy,but polydactyly and midline face defects like cleft palate.........with trisomy13
546. metabolic disorders with corneal clouding?
Hurler, Fabry, I-cell disease
547. the eFfect of propranolol on preload?
increased preload
propranolol inhibits beta2 receptors:inhibit vasodilation,and hypotension caused by drug leads to reflex peripheral vasoconstriction
also hypotention increases Na retention and plasma volume
548. 6 medical students receive test scores of 20,20,40,50,100,30
the distribution of this group of scores is:
a)normal
b)Gaussian
c)skewed to right
d)skewed to left
e)bimodal
mode:20
median:35
mean:43.4
mean>median>mode
so skewed to right
549. indication of use of tizanidine?
it's structurally related to clonidine, produces muscle relaxation and reduces spasticity by increasing the presynaptic and postsynaptic inhibition of motor neurons.
550. this vitamin acts as a component of glutathione reductase?
it's riboflavin
what about vitE?u read about it?i know that acts like antioxidant though
551. organism that can grow at 6.5%NaCl?
Organism that can grow at 8%NaCl
organism grows at 6.5%NaCl?enterococcus
Organism grows at 8%NaCl:vibrio.parahemolyticus,vibrio.vulnificus
552. This drug is NMDA receptor antagonist?
a)LSD
b)PCP
c)cocaine
d)baclofen
e)amphetamine
PCP
553. a 5HT1A receptor agonist ?
a)buspirone
b)sumatriptan
c)cisapride
e)olanzapine
buspirone:5HT1A receptor agonist
554. a 5HT1D receptor agonist ?
a)buspirone
b)sumatriptan
c)cisapride
e)olanzapine
sumatriptan:5HT1D receptor agonist
555. a 5HT4 receptor agonist ?
a)buspirone
b)sumatriptan
c)cisapride
e)olanzapine
cisapride: 5HT4 receptor agonist
556. a 5HT2 receptor antagonist ?
a)buspirone
b)sumatriptan
c)cisapride
e)olanzapine
olanzapine:5HT2 receptor antagonist
557. contents of femoral sheath?
femoral A&V,femoral branch of genitofemoral nerve,femoral canal(contains lymph nodes)femoral nerve outside the femoral sheath
558. contents of adductor canal?
femoral vessels,saphenous nerve,nerve to vastus medialis
559. cross over happens in which phase of meiosis?
prophase meiosisI
560. this element required for DNA polymerization?
Mg
561. defect in which enzyme is seen in Ataxia-Telangectasia?
AP endonucleae
562. the mechanism of action of actinomycinD?
it binds to DNA,inhibits RNA synthesis by blocking movement of RNA polymerase along the template.
563. what’s the cellular location of assembly of 60s,40s?
60S:nucleolus
40s:nucleus
564. which phase of protein synthesis affected by puromycin?
it inhibits elongation in both eukaryocytic,prokaryocytics
565. which phase of protein synthesis affected by sparsomycin?
sparsomycin inhibits formation of initiation complex
566. enzyme inhibited by cyclohexamide in process of protein synthesis in eukaryocytes?
ribosomal peptidyl transferase
567. plasma protein decreased,the effect on filteration fraction(