ANSWERS (Quiz bank with all the correct answers)
(usmle step 1) Medical examination
62 year old woman - osteoporosis - a bisphosphonate is prescribed. The expected
beneficial effect of the drug is due to which of the following? -Answer- Decreased
Osteoclast Activity
Cohot Study of elderly women - relative risk ratio for hip fractures among those who
exercise regularly is 1.2 (95% confidence interval of 1.1 to 1.8). Which of the following is
the conclusion about the effect of exercise on the risk of hip fracture? -Answer-
Statistically Significant Overall Increase Risk
52 year old man goes to ER with chest pain radiating to his jaw while shoveling snow.
Pulse is 80/min and blood pressure is 130/70. The most immediate treatment
mechanism of action? -Answer- Increased nitric oxide concentration
24 year old woman - spilled hot grease on her left leg while working at a fast-food
restaurant. Exam of leg shows 7cm pink, soft, granular, edematous wound. The
formation of this tissue was most likely caused by increased activity of which? -Answer-
a. Vascular Endothelial Growth Factor
VEGF - stimulates angiogenesiss.
TYPE III Collagen = Blood Vessels - early wound repair
27 year old man- MVC - skull x-ray shows a linear, nondepressed basal skull fracture -
increased serum osm and decreased urin osm. Following desmopressin urine osm
This is Just
increases. A Preview:
Desmopressin's effect is due to the activation of which of the following? -
Answer- a. Adenylyl Cyclase
Adenylate Cyclase - ATP - CAMP -- PROTEKINASE A -- Ca
v2
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A 10 month old boy - 4 day history of fever and cough. He attends day care center.
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Chest exam shows intercostal retractions along with bilateral, diffuse wheezes and
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expiratory rhonchi. The infectious agent most likely has which of the following
Earn properties?
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A 17 year old girl in ED - 15 minutes after being stung by a bee. Mild light headedness
but no difficulty swallowing- Bilateral wheezing - Which is most appropriate
pharmacotherapy for this patient? -Answer- B2- Agonist
14 year old boy - 2 day history of sore throat and fever that peaks in late afternoon. 1
week of fatigue. He recentaly had sex with one partner. Physical exam show cervical
lymphadenopathy and pharyngeal erythema with a creamy exudate. DX? -Answer-
Infectious Mononucleosis
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, 57 year old man - radiation therapy for squamous cell carcinoma of the lung. Despite
therapy, tumor increases in size and he dies 6 months later. The progressive tumor
growth is due to a defect in cell cycle arrest in which of the following phases of cell
cycle? -Answer- G1
28 year old - lived in sub-Saharan Africa - until he came to the US. Temp of 100.4 -
imaging shows bilateral hydroureter and hydronephrosis. Biopsy shows marked fibrosis
and scattered granulomas. DX? -Answer- Schistosomiasis
A couple with a family history of a-thalassemia. Woman has one gene deletion and man
has two gene deletion. If the two gene is trans - what percentage of offspring will have a
two gene deletion? -Answer- 50%
previously healthy 40 year brought to emergency department by her husband - 2 day
history of fever, lethargy, confusion. PE shows scattered petechiae and ecchymoses
over the lower extremities - 3+ polychromasia and 3+ schistocytes and Low platelets
Dx? -Answer- Thrombotic Thrombocytopenia Purpura
16 year old boy - is admitted to the ER because of a knife wound to the left side of his
chest. An X-ray of the chest shows an air-fluid level in the left side of the chest, partial
collapse of the left lung, and the elevation of the stomach bubble. The mediastinum is
midline. DX? -Answer- Hemopneumpothorax under tension
49 year old woman - coronary artery disease - BP 140/90 - High Cholesterol, High LDL
(190), High triglycerides (350) - TX with atorvastatin and losartan. What are the effects
on HDL and Triglycerides? -Answer- HDL increased
Triglycerides Decreased
This is Just
73 yeare A Preview:
old - diffuse weakness and tingling of her arms and legs. Sensation and
vibration and position is decreased in all extremities. What vitamin deficiency? -Answer-
Vitamin B12 - (cyanocobalamin)
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Tea and Toast (With
- low B12 All Pages) HERE:
in diet
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15 year old girl - 3 month history of acne - which is the underlying cause of the patients
acne? -Answer- Stimulation of Sebaceous Glands by androgens
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b. ACNE = Propionibacterium ACNE
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4 year old from Brazil - PE shows single 12x10cm lesion in the right side of jaw with
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diffuse regular edges. Photomicrographs of an incisional biopsy (looks like Burkitts
Lymphoma/ Starry night) - which of the processes most likely to occur in the region
indicated by the arrow? -Answer- Apoptosis
b. Endemic Burkitt lymphoma can happen in Brazil as well as Africa (jaw lesion, puffy
face).
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