USMLE Practice Exam Question and Answer

Cause of ARDS on a histological level? - Injury and inflam of alveolar pneumoncytes and pulmonary endothelium from neutrophils Glomerular biopsy shows mesangial expansion, glomerular BM thickening, glomerular sclerosis. If sclerosis is nodular and large it is a Kimmelstiel-Wilson lesion(hyaline deposits)? - Long standing Diabetes Right hip radiograph shows mixed lysis and sclerosis with focal periosteal elevation and reactive new bone formation? - Osteosarcoma Right hip radiograph shows crescent sign and subchondral collapse? - Avascular necrosis of hip Right hip radiograph shows generalized osteosclerosis and evidence of fractures? - Osteopetrosis What is globus sensation(globus hystericus, globus pharyngeus)? - Abnormal sensation of a foreign body, tightness, or fullness in the throat. Worse with swallowing saliva. A functional disorder Pt presents with feeling like something is stuck in her throat. She has more difficulty swallowing saliva. Upper GI shows no abnormality. No neck abnormality? - Globus sensation Functional disorder What is Pseudobulbar palsy? - Neurological condition caused by MS which results in dysarthria, dysphagia, dysphonia, and impaired movement of the tongue and facial muscles What vitamin can be teratogenic in pregnancy? - Vitamin A(fetal microcephaly, cardiac anomalies, early epiphysial closure, growth retardation, or spontaneous abortion) DNA electrophoresis reveals fragmentation in multiples of 180 bases what does this indicate? - Laddering of DNA and is fairly specific from apoptosis from endonucleases that cleave DNA at internucleosomal linker regions Atropine muscarinic effects? - Muscarinic antagonist Pt begins acting bizarre after chewing plant seeds. Says bugs are crawling on him, talking to people who arent there, has trouble seeing, continues to ask for drinking water? What drug overdose? - Jimson weed or Atropine(Anticholinergic excess - hot as a hare, dry as a bone, red as a beet, blind as a bat, and mad as a hatter) Family has two children with osteogenesis imperfecta but no family history of disease? what should be suspected? - Germline mosaism. Chance of next child will be determined by ratio of wild type to germline mutated gametes How often should foot inspections and pinprick sensation testing be done on diabetes? - Foot: Daily and Pinprick: Yearly t(12:21)? - Childhood B cell acute lymphocytic leukemia What IL is produced exclusively by lymphocytes? - IL-2 What cell cell adhesion molecules are calcium dependent and join cell together rather than too the BM? - Cadherins What two intercellular adhesions utilize cadherins? - Desmosomes and adherens junctions What artery can be damaged by posterior dislocation of the tibia relative to the femur? - Popliteal artery because it is held in place rigidly by the adductor magnus and soleus muscle Pt recently gave birth and uterus is found to be tender and there is a foul smelling discharge? What organism?` - Endometritis from Bacteroides species that normally colonize the uterus