1. Fabry disease is due to a deficiency in α-galactosidase A resulting is an accumulation in?

a. Ceramidetrihexosade (globotriaosylceramide)-Gb3
2. Treatment for Bipolar disorder is?
a. Lithium & Valproic acid
3. Injury to the posterior urethra is most common in pelvic fractures affecting?
a. The bulbomembranous junction between the posterior and anterior urethra
4. Transplant patient w/ pneumonia and owl eye inclusions caused by
a. CMV-dsDNA enveloped virus
5. Anti-phospholipid syndrome Primary or secondary to SLE, presents with?
a. Thrombosis, spontaneous abortions
b. Labs: Lupus anticoagulant, anticardiolipin, anti-β2-glycoprotien antibodies
c. False positive VDRL/RPR and prolonged PTT
6. Most common congenital heart defect in Turner syndrome?
a. Bicuspid aortic valve (early systolic high frequency click)
7. Competitive inhibitors
a. Compete with substrate for active binding sites
b. Vmax is un changed
c. Km is increased
8. Most commonly delayed milestone in kids?
a. Language --> may catch up in pre-school and may need help or further evaluation
9. Gerstmann syndrome is characterized by?
a. Agraphia, acalculia, finger agnosia, left to right disorientation
b. Dominant parietal cortex (left side) angular gyrus
10. Minimal change disease (MCD) nephrotic syndrome with edema caused by?
a. Loss of proteins leads to decrease in plasma oncotic pressure --> edema
11. Risk of wrong site surgery can be reduced by?
a. Dual Identifiers (nurse and physician) independently confirm correct patient, site and
procedure.
12. Sebaceous glands(acne) are what type of exocrine glands?
a. Holocrine
13. Disseminated (systemic) candidiasis in HIV patients is mediated by?
a. Decreased neutrophils (Neutropenia)
14. HbS(sickle cell anemia) promotes...?
a. Hydrophilic interaction --> polymerization of HbS --> erythrocytes sickling
15. FSH negative feedback is done by
a. Inhibin B (Sertoly cells)
16. Stahp. Epidermidis causes foreign body infections due to?
a. Ability to make adherent biofilms
17. Characteristics of Congenital Hypothyroidism?
a. Deficiency of T4 --> constipation, lethargy, hypotonia, macroglossia, umbilical hernia
and large anterior fontanelle. If un treated leads to mental retardation.
18. Hypersensitivity type I is mediated by?
a. Interaction of allergen with preexisting IgE bound to basophils and mast cells -->
crosslinking --> degranulation (release of chemical mediators).
19. The rubber like properties of elastin is due to?
a. Extensive cross liking between elastin monomers (facilitated by lysil oxidase)
b. Α1-antitrypsin (prevents the brake down of elastin by elastase) deficiency --> early onset
emphysema.
20. To prevent falls in the elderly optimal management of the fallowing should be done.
a. Medication review and discontinue medication with risk of falls
21. Characteristics of a murmur due to a VSD
a. Holosystolic, harsh-sounding, loudest at the left sternal border.
22. Enterococcus
a. Gram +, non-hemolytic, grown in pairs or chains (UTI nosocomial)
23. What substance promotes B-cells to class switching to IgE and IgG?
a. IL-4 from the Th2 cells
24. Etiology for cholesterol stones in pregnancy?
a. Estrogen --> cholesterol hypersecretion
b. Progesterone --> gallbladder hypomotility
25. Meningococcal lipooligosaccharide (LOS) effects are responsible for?
a. Toxic effects in meningococcemia and meningitis
26. SIADH characterized by?
a. Oliguria(excessive free water retention)
b. Euvolemic Hyponatremia
c. Urine osmolarity > serum osmolality
d. Secondary to small cell lung cancer
27. Alkaptonuria (ochronosis, urine turn black to air exposure) is result from defect in what
metabolic pathway?
a. Tyrosine --> Fumarate (deficiency in homogentisate oxidase)
28. Rett Syndrome(X-linked mutation in MECP2 gene) symptoms include?
a. Loss of development
b. Loss of verbal skills
c. Intellectual disability
d. Hand wringing
e. Deceleration of head growth
29. Bacillus anthracis Edema toxin mechanism?
a. Mimic the adenylate cyclase enzyme --> increase in cAMP
30. Interferon α and β produced by most human cells in response to viral infection do?
a. Help suppress viral replication by halting protein synthesis and promoting cell apoptosis.
31. McArdles (glycogen storage disease type V) is a deficiency in?
a. Skeletal muscle Glycogen phosphorylase (Myophosphorylase)
32. 4 major causes of hypoxemia are?
a. Hypoventilation (normal A-a gradient)
b. V/Q mismatch
c. Diffusion impairment
d. Right to left shunting
33. Deep cerebral hemorrhages are typically caused by
 a. Hypertensive vasculopathy involving the penetrating branches of the cerebral
arteries(Lenticulostriate-MCA)
34. Walking Pneumonia (X-ray looks worse than patient) military recruits caused by?
a. Mycoplasma pneumoniae
35. Loss of atrial contraction due to atrial fib can lead to?
a. Decreased LV preload and cardiac output --> hypotension
b. Backup of blood --> pulmonary edema
36. Positive and negative predicting values can change depending on?
a. Disease prevalence (pretest probability)
b. PPV is directly related to prevalence
c. NPV is inversely related to prevalence
37. Down Syndrome is due to?
a. 95% meiotic nondisjunction (miosis 1)
b. 4% Robertsonian translocation (chromosomes 14-21)
c. 1% Mosaicism
38. Primary route of copper elimination?
a. Hepatic excretion into the bile and excreted in stool
39. Diabetic autonomic neuropathy(DM2) can cause?
a. Overflow incontinence (in ability to sense full bladder)
b. Incomplete emptying --> Postvoid residual volume increase.
40. Surgical landmark for appendicitis?
a. Teniae Coli
41. S3 heart sound is due to?
a. Increased LV end-systolic volume (LV systolic failure)
b. Mitral regurgitation / HF
42. Co-factor in the synthesis of Phosphoenolpyruvate from oxaloacetate?
a. GTP --> from the conversion of Succinyl-CoA --> Succinate (TCA cycle)
43. Criteria for major depression?
a. ≥2 weeks with 5 or more of the fallowing
b. Depressed mode, loss of interest, sleep disturbance, appetite disturbance, loss of
energy, psychomotor agitation, impaired concentration, guilt and suicidal thoughts
44. Serum markers for HBV recovery?
a. Anti-HBs, Anti-HBe, Anti-HBc(IgG)
45. Highest urine osmolarity is in the?
a. Bottom of the loop of Henle
46. Prophylaxis to prevent Group B Strep(GBS) in Neonates?
a. Screen pregnant women at 35-37weeks, if + administer intrapartum penicillin
prophylaxis.
47. Cohort Study is?
a. Compares a group w/ given exposure or risk to a group w/out such exposure
b. Typically, prospective (Who will develop disease?)
48. Polysaccharide vs conjugate pneumococcal vaccine
a. Polysaccharide protective against 23 strains(weekly immunogenic)
 b. Conjugate protective against 13strains(strongly immunogenic due to B/T cell
recruitment) used in children and immunocompromised
49. AV shunt or exercise produces what changes to a cardiac and vascular function curves?
a. Decrease in TPR --> right shift of the venous return curve, left shift of cardiac output
curve.
50. Antipsychotics adverse effect is drug induced parkinsonism...treat with?
a. Benztropine – antimuscarinic --> improves tremor and rigidity.
51. Classic signs of Graves disease?
a. Pretibial myxedima, exophthalmos (caused by an excess stimulation of the TSH
receptors --> accumulation of glycosaminoglycans in the selected tissue.
52. Klinefelter Syndrome characteristics
a. Tall, testicular atrophy(azoospermia), gynecomastia, barr body (extra X)
b. Developmental delay and eunuchoid body shape
53. Why is the H. influenza vaccine conjugates w/ diphtheria toxoid?
a. It causes a t-cell mediated immune response leading to long-term immunity due to
memory B-lymphocytes
54. Watery --> bloody diarrhea, spots on chest/abdomen (rose spots), fever, abdominal pain is?
a. Salmonella typhi...developing countries.
55. Failure of the golgi to phosphorylate mannose residues on glycoproteins leads to?
a. Extracellular secretion of proteins rather than delivered to the lysosomes.
56. Attack rate is?
a. Number of people who contracted an illness divided by the number of people who were
at risk.
57. Occlusion of the MCA leads to?
a. Contralateral paralysis and sensory loss of face and upper limb
b. Aphasia if in dominant hemisphere
c. Hemineglect if in nondominant hemisphere
58. Discussions regarding patients should be...
a. In a privet setting to protect patient information
59. N. Gonococci and C. Trachomatis --> Mucopurulent cervicitis, left untreated can cause
a. PID --> infertility, ectopic pregnancies
60. Wide fixed S2 splitting...
a. Heard in an ASD, can lead to long-term increase in pulmonary vascular resistance.
61. The last codon to be translated on a mRNA is?
a. The codon prior to the stop codon
b. Stop codons do not encode an amino acid.
62. Mitochondrial myopathies are inherited by means of?
a. Mitochondrial inheritance
63. What happens to proinsulin
a. It is cleaved in the pancreatic beta cell secretory granules into insulin and C peptide -->
stored in granules until secreted,
64. Surface markers for macrophages?
a. CD14
65. Hemoglobin S aggregates in what sate?
 a. Deoxygenated sate (oxygen unloading)
66. Triad of aspirin intoxication?
a. Fever, tinnitus and tachypnea
b. Initially results in respiratory alkalosis < 12hrs
c. Late results in mixed metabolic acidosis/respiratory alkalosis >12hrs
67. Case-control study characteristics
a. Compares a group of people with disease to a group of people without disease...looking
for prior exposure or risk factor.
68. Atrial naturetic peptide is secreted from?
a. Atrial cardiomyocytes (atrial stretch)
b. Lowers BP by vasodilation, natriuresis, diuresis.
69. What cytokine attenuates inflammatory response
a. IL-10
70. Eg. of selective media (bacterial growth)
a. Thayer Martin(Neisseria)
71. Phenylephrine effects?
a. α-1 selective --> increase in TPR, increase in BP, reflex bradycardia, no change in pulse
pressure.
72. Innervation of the muscles of mastication
a. Trigeminal nerve (mandibular branch)
73. Two most important factors for osteoclast differentiation are?
a. Macrophage colony stimulating factor (M-CSF)
b. Receptor activator of nuclear factor kapa-B ligand(RANk-L)
74. Function of the snRNA?
a. Removal of intron from RNA transcripts
75. Humoral hypercalcemia of malignancy is caused by?
a. Secretion of parathyroid hormone - related protein (PTHrP)
76. Difference between medial and lateral superficial lymph drainage of the lower extremities?
a. Medial --> drains directly to the superficial inguinal nodes bypassing the popliteal nodes.
b. Lateral --> drain to the popliteal nodes then the superficial inguinal nodes.
77. Treatment for psoriasis that activates nuclear transcription factor?
a. Calcipotriene --> Vit. D analog (nuclear transcription factor) that inhibit keratinocyte
proliferation and stimulate keratinocyte differentiation.
78. Feelings of detachment or estrangement from one's own body (out of body experience)
a. Depersonalization / derealization disorder
79. Number needed to treat(NNT)?
a. NNT=1/ARR
80. Turners with karyotype 45,XO/46,XX most likely caused by?
a. Mosaicism(Somatic)
81. Ions responsible for resting membrane potential (-70mV)
a. Efflux of potassium, influx of sodium
82. Vitamin B6(pyridoxine) is a cofactor for?
a. Amino acid transamination and decarboxylation
83. Attrition bias(selection) is mostly seen in?
 a. Prospective study where a disproportionate loss of follow-up between the exposed and
unexposed groups
84. Southwestern blot identifies?
a. DNA-binding proteins (transcription factors)
85. PECAM-1 in leukocyte extravasation is part of what step?
a. Diapedesis(Transmigration)
86. Re-assortment happens in?
a. Viruses with segmented genomes (eg, influenza, rotavirus, arenaviruses, bunyaviruses)
87. Components of LPS endotoxin found in gram (-) rods and cocci
a. O antigen
b. Core polysaccharide
c. Lipid A – the toxic component
88. Retroperitoneal organs(structures)
a. SAD PUCKER
b. Suprarenal (adrenal) glands
c. Aorta and IVC
d. Duodenum (2nd-4th parts)
e. Pancreas (except tail)
f. Ureter
g. Colon (ascending and descending)
h. Kidneys
i. Esophagus
j. Rectum
89. Volume of Distribution of large/charged(highly) molecules is?
a. Low (plasma protein bound) stays in the blood compartment
90. Hemodynamics of an Acute Mitral regurgitation are?
a. Increase in preload (End-diastolic volume)
b. Decrease in afterload
c. Increase ejection fraction
d. Decrease forward stroke volume
e. Contractility normal
91. Complete vs partial mole?
a. Complete --> Diploid (46,XX[most common] or XY) parental DNA only, 1ege(enucleated)
+ 1 sperm, NO fetal parts, HIGH βhCG, pre-eclamcia 1st trimester, honeycombed uterus,
clusters of grapes, choriocarcinoma risk.
b. Partial --> Triploid (69XXY most common), 2 sperm + 1 egg, fetal parts, slightly elevated
βhCG,
92. Ataxia-telangiectasia triad?
a. Cerebellar defects(ataxia) --> cerebellar atrophy
b. Spider Angiomas(telangiectasia)
c. IgA deficiency
93. M.O.A. in Ivabradine?
a. Inhibits funny current sodium channels (phase 4 in pacemaker action potential)
b. Decreasing heart rate (chronotropic effect)
 c. No effects on contractility (Inotropy effect)
94. Niacin a constituent of NAD+, NADP+ can de synthesized endogenously from?
a. Tryptophan
b. Deficiency results in Pellagra
95. Cardiac catheterization of the femoral artery above the inguinal ligament increases the risk of?
a. Retroperitoneal hemorrhage
96. Patient with HLA-B5701 mutation?
a. Abacavir is contraindicated
97. Unit of analysis of an ecological study is?
a. Population not individuals
98. Strategy to reduce confounding bias?
a. Matching (patients with similar characteristics in both treatment and control groups)
b. Crossover studies
c. Randomization
99. Etiology of splenomegaly in pyruvate kinase deficiency
a. Red pulp hyperplasia (removal of damaged RBCs)
100.