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USMLE PRACTICE STUDY QUESTIONS AND ANSWERS

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USMLE PRACTICE STUDY QUESTIONS AND ANSWERS What are the two major microtubular motor proteins? Which does anterograde axonal transport, which does retrograde axonal transport? - CORRECT ANSWER-Kinesin, Dynein Kinesin: Anterograde Dynein: Retrograde` What do you think, immunologically speaking, when you see someone with recurrent Neisseria infections? - CORRECT ANSWER-Inability to form the membrane attack (MAC) complex this is a common complement deficiency What is the defect in Chronic Granulomatous disease? What is the pathophysiology? - CORRECT ANSWER-NADPH Oxidase deficiency leads to the inability to kill intracellular organisms Characteristic triad of ataxia telangiectasia? - CORRECT ANSWER-cerebellar ataxia, telangiectasias, increased risk of sinopulmonary infections What is the major immune deficiency of ataxia telangiectasia? - CORRECT ANSWER-IgA deficiency, which predisposes to infections of the upper and lower airways (and other mucous membranes) There's a useful mnemonic for Ataxia Telangiectasia and the gene that's mutated. What is it? - CORRECT ANSWER-ATM Ataxia Telangiectasia Mutated ATM gene is responsible for DNA break repair What is one reason that lead intoxication causes hypochromic anemia? - CORRECT ANSWER-Mitochondrial iron transport is important for Heme synthesis! It's inhibited by lead. So you don't make heme in your mitochondria and you get hypochromic anemia. What is the biochemical problem in Lesch-Nyhan syndrome? (And, only if you got that right, what are the really cool symptoms of it?) - CORRECT ANSWER-Defective purine catabolism, so buildup of purines. It's an X-linked recessive disorder with mutated HGPRT gene (hypoxanthine-guanine phosphoribosyltransferase, if you want to impress people). Now, if you got HGPRT and purine catabolism right, you can say: self-mutilating behavior on top of mental retardation, choreoathetoid (think Chorea) movements and spasticity. What is the defect in Niemann-Pick disease? What causes that? What is the common macular finding? - CORRECT ANSWERSphingolipid degradation is defective Caused by an autosomal recessive defect in sphingomyelinase Cherry Spot on the macula? Niemann Pick's or Tay Sach's. If a baby gets exposed to an unclean knife (...) and subsequently develops rigid paralysis, what is the diagnosis, where do we think this might happen, and how do we prevent it? - CORRECT ANSWER-Neonatal Tetanus Developing Countries Maternal immunization with tetanus toxoid is the best way to prevent it an adeuately immunized mom will transfer IgG's across the placenta to the neonate Which microtubule associated protein aids in anterograde transport of intracellular vesicles and organelles? Which end of the microtubule do they go towards? - CORRECT ANSWERKinesin. Towards the (+) rapidly growing end. What is an early BRAIN finding of Ataxia-Telangiectasia and how does it manifest itself? - CORRECT ANSWER-Cerebellar atrophy manifests as ataxia in the first years of life. High yield path association for Alzheimer's disease? - CORRECT ANSWER-Neurofibrillary tangles in the neocortex High yield path association for Parkinson's disease? - CORRECT ANSWER-Loss of neurons in the substantia nigra High yield path association for Huntington disease? - CORRECT ANSWER-Atrophy of caudate nucleus What are the major manifestations of Ataxia-telangiectasia? - CORRECT ANSWER-cerebellar ataxia, oculocutaneous tenlangiectasias, repeated sinopulmonary infections, and an increased incidence of malignancy If you heard: amenorrhea, bitemporal hemianopsia, and enlargement of the pituitary gland on brain imaging, what would you be thinking? - CORRECT ANSWER-Prolactinoma, the most common pituitary adenoma. What embryological layer is the anterior pituitary derived from? - CORRECT ANSWER-Surface ectoderm What is the most common congenital abnormality associated with the use of Sodium Valproate during pregnancy? - CORRECT ANSWER-neural tube defects, e.g., meningocele because valproate inhibits intestinal folic acid absorption resulting in teratogenicity What is the characteristic histology of a craniopharyngioma? - CORRECT ANSWER-On light microscopy, cysts are lined by stratified squamous epithelium, possibly with Keratin perals. Cysts are usually filled iwth a yellow, viscous fluid that's rich in cholesterol crystals. Where do craniopharyngyomas arise from? - CORRECT ANSWER-Craniopharyngiomas are calcified cystic tumors that arise from remnants of Rathke's pouch (embryonic precuros of the anterior pituitary) Failure of what process leads due neural tube defects? What can be seen in the amniotic fluid due to leakage of fetal cebebrospinal fluid? - CORRECT ANSWER-Failure of fusion of the neuropores. Alpha-fetoprotein and Acetylcholinesterase may appear in the amniotic fluid

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USMLE PRACTICE STUDY QUESTIONS
AND ANSWERS




What are the two major microtubular motor proteins? Which
does anterograde axonal transport, which does retrograde
axonal transport? - CORRECT ANSWER-Kinesin, Dynein

Kinesin: Anterograde
Dynein: Retrograde`

What do you think, immunologically speaking, when you see
someone with recurrent Neisseria infections? - CORRECT
ANSWER-Inability to form the membrane attack (MAC)
complex
this is a common complement deficiency

What is the defect in Chronic Granulomatous disease? What is
the pathophysiology? - CORRECT ANSWER-NADPH Oxidase
deficiency leads to the inability to kill intracellular organisms

Characteristic triad of ataxia telangiectasia? - CORRECT
ANSWER-cerebellar ataxia, telangiectasias, increased risk of
sinopulmonary infections

What is the major immune deficiency of ataxia telangiectasia? -
CORRECT ANSWER-IgA deficiency, which predisposes to

,infections of the upper and lower airways (and other mucous
membranes)

There's a useful mnemonic for Ataxia Telangiectasia and the
gene that's mutated. What is it? - CORRECT ANSWER-ATM

Ataxia
Telangiectasia
Mutated

ATM gene is responsible for DNA break repair

What is one reason that lead intoxication causes hypochromic
anemia? - CORRECT ANSWER-Mitochondrial iron transport is
important for Heme synthesis! It's inhibited by lead. So you
don't make heme in your mitochondria and you get
hypochromic anemia.

What is the biochemical problem in Lesch-Nyhan syndrome?
(And, only if you got that right, what are the really cool
symptoms of it?) - CORRECT ANSWER-Defective purine
catabolism, so buildup of purines. It's an X-linked recessive
disorder with mutated HGPRT gene (hypoxanthine-guanine
phosphoribosyltransferase, if you want to impress people).

Now, if you got HGPRT and purine catabolism right, you can
say: self-mutilating behavior on top of mental retardation,
choreoathetoid (think Chorea) movements and spasticity.

What is the defect in Niemann-Pick disease?
What causes that?
What is the common macular finding? - CORRECT ANSWER-
Sphingolipid degradation is defective
Caused by an autosomal recessive defect in sphingomyelinase
Cherry Spot on the macula? Niemann Pick's or Tay Sach's.

,If a baby gets exposed to an unclean knife (...) and
subsequently develops rigid paralysis, what is the diagnosis,
where do we think this might happen, and how do we prevent
it? - CORRECT ANSWER-Neonatal Tetanus
Developing Countries
Maternal immunization with tetanus toxoid is the best way to
prevent it

an adeuately immunized mom will transfer IgG's across the
placenta to the neonate

Which microtubule associated protein aids in anterograde
transport of intracellular vesicles and organelles? Which end of
the microtubule do they go towards? - CORRECT ANSWER-
Kinesin.

Towards the (+) rapidly growing end.

What is an early BRAIN finding of Ataxia-Telangiectasia and
how does it manifest itself? - CORRECT ANSWER-Cerebellar
atrophy

manifests as ataxia in the first years of life.

High yield path association for Alzheimer's disease? -
CORRECT ANSWER-Neurofibrillary tangles in the neocortex

High yield path association for Parkinson's disease? -
CORRECT ANSWER-Loss of neurons in the substantia nigra

High yield path association for Huntington disease? -
CORRECT ANSWER-Atrophy of caudate nucleus

What are the major manifestations of Ataxia-telangiectasia? -
CORRECT ANSWER-cerebellar ataxia, oculocutaneous
tenlangiectasias, repeated sinopulmonary infections, and an
increased incidence of malignancy

, If you heard: amenorrhea, bitemporal hemianopsia, and
enlargement of the pituitary gland on brain imaging, what would
you be thinking? - CORRECT ANSWER-Prolactinoma, the
most common pituitary adenoma.

What embryological layer is the anterior pituitary derived from?
- CORRECT ANSWER-Surface ectoderm

What is the most common congenital abnormality associated
with the use of Sodium Valproate during pregnancy? -
CORRECT ANSWER-neural tube defects, e.g., meningocele

because valproate inhibits intestinal folic acid absorption
resulting in teratogenicity

What is the characteristic histology of a craniopharyngioma? -
CORRECT ANSWER-On light microscopy, cysts are lined by
stratified squamous epithelium, possibly with Keratin perals.
Cysts are usually filled iwth a yellow, viscous fluid that's rich in
cholesterol crystals.

Where do craniopharyngyomas arise from? - CORRECT
ANSWER-Craniopharyngiomas are calcified cystic tumors that
arise from remnants of Rathke's pouch (embryonic precuros of
the anterior pituitary)

Failure of what process leads due neural tube defects? What
can be seen in the amniotic fluid due to leakage of fetal
cebebrospinal fluid? - CORRECT ANSWER-Failure of fusion of
the neuropores.

Alpha-fetoprotein and Acetylcholinesterase may appear in the
amniotic fluid
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