USMLE PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS GRADED A+
◍ 2nd generation cephalosporins.
Answer: -Cefoxitin, cefaclor, cefuroxime-Use: gram-positive cocci,
Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus
mirabilis, E. coli, Klebsiella pneumoniae, Serratia marcescens.
◍ -terol.
Answer: β2-agonist
◍ Neostigmine.
Answer: -Anticholinesterse - increases ACh-Used in postoperative and
neurogenic ileus and urinary retention, myasthenia gravis, and postoperative
reversal of neuromuscular junction blockade
◍ Norepinephrine.
Answer: -α1 > α2 > β1 direct agonist-Hypotension (butrenal perfusion).
Significantly weaker effect at β2-receptor than epinephrine.
◍ Bismuth, sucralfate mechanism.
Answer: Bind to ulcer base, providing physical protection and allowing
HCO3- secretion to reestablish pH gradient in the mucus layer
◍ Doxorubicin, daunorubicin (mechanism, use, toxicity).
Answer: -Mechanism: generate free radicals. Intercalate in DNA causing
breaks in DNA decreasing replication.-Use: solid tumors, leukemias,
lymphomas.-Toxicity: cardiotoxicity (dilated cardiomyopathy),
myelosuppression, alopecia. Toxic to tissues following extravasation.
Dexrazoxane (iron chelating agent), used to prevent cardiotoxicity.
◍ Diuretics that increase blood pH (alkalemia).
Answer: Loop diuretics and thiazides cause alkalemia through several
, mechanisms: -Volume contraction increase AT II increasing Na+/H+
exchange in PCT increasing HCO3− reabsorption ("contraction
alkalosis")-K+ loss leads to K+ exiting all cells (via H+/K+ exchanger) in
exchange for H+ entering cells -In low K+ state, H+ (rather than K+) is
exchanged for Na+ in cortical collecting tubule causing alkalosis and
"paradoxical aciduria"
◍ Guaifenesin.
Answer: Expectorant—thins respiratory secretions; does not suppress cough
reflex.
◍ Acanthocytes on blood smear (looks like spur cell but with more rounded
spurs).
Answer: liver disease, hypothyroidism, alcoholism
◍ Urine NaCl changes with diuretic therapy.
Answer: Increase with all diuretics except acetazolamide. Serum NaCl may
decrease as a result
◍ Interferons MoA.
Answer: Glycoproteins normally synthesized by virus-infected cells,
exhibiting a wide range of antiviral and antitumoral properties.
◍ Bile acid resin mechanism.
Answer: Prevents intestinal absorption of bile acids; liver must use
cholesterol to make more
◍ Drugs that cause hot flashes.
Answer: Tamoxifen, clomiphene
◍ Cytochrome P-450 substrates.
Answer: Anti-epileptics, Theophylline, Warfarin OCPs
◍ Vasculitis associated with chronic Hep B.
Answer: polyarteritis nodosa
◍ tPA, streptokinase, urokinase toxicity antidote.
Answer: Aminocaproic acid
,◍ PCP withdrawal.
Answer: Depression, anxiety, irritability, restlessness, anergia, disturbances
of thought and sleep.
◍ Nonspecific depressant intoxication.
Answer: Mood elevation, anxiety, sedation, behavioral disinhibition,
respiratory depression.
◍ Opioids (e.g., morphine, heroin, methadone) withdrawal.
Answer: Sweating, dilated pupils, piloerection ("cold turkey"), fever,
rhinorrhea, yawning, nausea, stomach cramps, diarrhea ("flu-like"
symptoms). Treatment: long-term support, methadone, buprenorphine.
◍ What does a high RBC count mean?.
Answer: thalassemia (also expect to see VERY low MCV and normal
RDW)
◍ Kallman's syndrome.
Answer: -anosmia-hypogonadotropic hypogonadism-sometimes midline
facial defects
◍ Pilocarpine.
Answer: -Direct cholinergic agonist-Contracts ciliary muscle of eye (open
angle glaucoma), contracts pupillary sphincter (closed angle
glaucoma)-Potent stimulator of sweat, tears and saliva-AChE resistant
◍ Vasculitis associated with chronic Hep C.
Answer: cryoglobulinemia
◍ Doxazosin.
Answer: -Selective α1-blocker -Uses: urinary symptoms of
BPH;-Hypertension -Toxicity: 1st-dose orthostatic hypotension, dizziness,
headache
◍ Glitazones/ thiazolidinediones mechanism.
Answer: Increase sensitivity in peripheral tissue. Binds to PPAR-γ nuclear
transcription regulator.
, ◍ Granuloma inguinale.
Answer: -rare, beefy red genital lesion that ulcerates-get a bx or "touch
prep"-treat with doxy or bactrim
◍ Common chemotoxicities (chemo-tox man).
Answer: -Cisplatin/Carboplatin acoustic nerve damage (and
nephrotoxicity)-Vincristine peripheral neuropathy -Bleomycin, Busulfan:
pulmonary fibrosis -Doxorubicin: cardiotoxicity -Trastuzumab
cardiotoxicity -Cisplatin/Carboplatin: nephrotoxic (andacoustic nerve
damage)-CYclophosphamide: hemorrhagic cystitis-5-FU: myelosuppression
-6-M: myelosuppression-Methotrexate: myelosuppression
◍ Early HIV associated PNA.
Answer: S. pneumo, H. flu, M. tuberculosis
◍ What are the major functions of the M2 receptor?.
Answer: Decrease heart rate and contractility of atria
◍ Disease associated with hypothyroidism.
Answer: hyperlipidemia (usually just elevated LDL, but sometimes also
elevated triglycerides)
◍ Glucocorticoids MoA.
Answer: Inhibit NF-κB. Suppress both B- and T-cell function by
transcription of many cytokines.
◍ Hypoproliferative normocytic anemias (7).
Answer: TRAM MAP1. thyroid disease (can also be macrocytic)2. renal
failure3. aplastic anemia4. multiple myeloma5. myelofibrosis6. anemia of
chronic disease7. pure red cell aplasia
◍ Most common cause of hypophosphatemia in hospitalized patients.
Answer: continuous glucose infusion
◍ Antidepressants schematic.
Answer:
◍ Parkinson disease drugs schematic.
QUESTIONS WITH ANSWERS GRADED A+
◍ 2nd generation cephalosporins.
Answer: -Cefoxitin, cefaclor, cefuroxime-Use: gram-positive cocci,
Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus
mirabilis, E. coli, Klebsiella pneumoniae, Serratia marcescens.
◍ -terol.
Answer: β2-agonist
◍ Neostigmine.
Answer: -Anticholinesterse - increases ACh-Used in postoperative and
neurogenic ileus and urinary retention, myasthenia gravis, and postoperative
reversal of neuromuscular junction blockade
◍ Norepinephrine.
Answer: -α1 > α2 > β1 direct agonist-Hypotension (butrenal perfusion).
Significantly weaker effect at β2-receptor than epinephrine.
◍ Bismuth, sucralfate mechanism.
Answer: Bind to ulcer base, providing physical protection and allowing
HCO3- secretion to reestablish pH gradient in the mucus layer
◍ Doxorubicin, daunorubicin (mechanism, use, toxicity).
Answer: -Mechanism: generate free radicals. Intercalate in DNA causing
breaks in DNA decreasing replication.-Use: solid tumors, leukemias,
lymphomas.-Toxicity: cardiotoxicity (dilated cardiomyopathy),
myelosuppression, alopecia. Toxic to tissues following extravasation.
Dexrazoxane (iron chelating agent), used to prevent cardiotoxicity.
◍ Diuretics that increase blood pH (alkalemia).
Answer: Loop diuretics and thiazides cause alkalemia through several
, mechanisms: -Volume contraction increase AT II increasing Na+/H+
exchange in PCT increasing HCO3− reabsorption ("contraction
alkalosis")-K+ loss leads to K+ exiting all cells (via H+/K+ exchanger) in
exchange for H+ entering cells -In low K+ state, H+ (rather than K+) is
exchanged for Na+ in cortical collecting tubule causing alkalosis and
"paradoxical aciduria"
◍ Guaifenesin.
Answer: Expectorant—thins respiratory secretions; does not suppress cough
reflex.
◍ Acanthocytes on blood smear (looks like spur cell but with more rounded
spurs).
Answer: liver disease, hypothyroidism, alcoholism
◍ Urine NaCl changes with diuretic therapy.
Answer: Increase with all diuretics except acetazolamide. Serum NaCl may
decrease as a result
◍ Interferons MoA.
Answer: Glycoproteins normally synthesized by virus-infected cells,
exhibiting a wide range of antiviral and antitumoral properties.
◍ Bile acid resin mechanism.
Answer: Prevents intestinal absorption of bile acids; liver must use
cholesterol to make more
◍ Drugs that cause hot flashes.
Answer: Tamoxifen, clomiphene
◍ Cytochrome P-450 substrates.
Answer: Anti-epileptics, Theophylline, Warfarin OCPs
◍ Vasculitis associated with chronic Hep B.
Answer: polyarteritis nodosa
◍ tPA, streptokinase, urokinase toxicity antidote.
Answer: Aminocaproic acid
,◍ PCP withdrawal.
Answer: Depression, anxiety, irritability, restlessness, anergia, disturbances
of thought and sleep.
◍ Nonspecific depressant intoxication.
Answer: Mood elevation, anxiety, sedation, behavioral disinhibition,
respiratory depression.
◍ Opioids (e.g., morphine, heroin, methadone) withdrawal.
Answer: Sweating, dilated pupils, piloerection ("cold turkey"), fever,
rhinorrhea, yawning, nausea, stomach cramps, diarrhea ("flu-like"
symptoms). Treatment: long-term support, methadone, buprenorphine.
◍ What does a high RBC count mean?.
Answer: thalassemia (also expect to see VERY low MCV and normal
RDW)
◍ Kallman's syndrome.
Answer: -anosmia-hypogonadotropic hypogonadism-sometimes midline
facial defects
◍ Pilocarpine.
Answer: -Direct cholinergic agonist-Contracts ciliary muscle of eye (open
angle glaucoma), contracts pupillary sphincter (closed angle
glaucoma)-Potent stimulator of sweat, tears and saliva-AChE resistant
◍ Vasculitis associated with chronic Hep C.
Answer: cryoglobulinemia
◍ Doxazosin.
Answer: -Selective α1-blocker -Uses: urinary symptoms of
BPH;-Hypertension -Toxicity: 1st-dose orthostatic hypotension, dizziness,
headache
◍ Glitazones/ thiazolidinediones mechanism.
Answer: Increase sensitivity in peripheral tissue. Binds to PPAR-γ nuclear
transcription regulator.
, ◍ Granuloma inguinale.
Answer: -rare, beefy red genital lesion that ulcerates-get a bx or "touch
prep"-treat with doxy or bactrim
◍ Common chemotoxicities (chemo-tox man).
Answer: -Cisplatin/Carboplatin acoustic nerve damage (and
nephrotoxicity)-Vincristine peripheral neuropathy -Bleomycin, Busulfan:
pulmonary fibrosis -Doxorubicin: cardiotoxicity -Trastuzumab
cardiotoxicity -Cisplatin/Carboplatin: nephrotoxic (andacoustic nerve
damage)-CYclophosphamide: hemorrhagic cystitis-5-FU: myelosuppression
-6-M: myelosuppression-Methotrexate: myelosuppression
◍ Early HIV associated PNA.
Answer: S. pneumo, H. flu, M. tuberculosis
◍ What are the major functions of the M2 receptor?.
Answer: Decrease heart rate and contractility of atria
◍ Disease associated with hypothyroidism.
Answer: hyperlipidemia (usually just elevated LDL, but sometimes also
elevated triglycerides)
◍ Glucocorticoids MoA.
Answer: Inhibit NF-κB. Suppress both B- and T-cell function by
transcription of many cytokines.
◍ Hypoproliferative normocytic anemias (7).
Answer: TRAM MAP1. thyroid disease (can also be macrocytic)2. renal
failure3. aplastic anemia4. multiple myeloma5. myelofibrosis6. anemia of
chronic disease7. pure red cell aplasia
◍ Most common cause of hypophosphatemia in hospitalized patients.
Answer: continuous glucose infusion
◍ Antidepressants schematic.
Answer:
◍ Parkinson disease drugs schematic.
