1. Meckel Diverticulum normally presents with?

a. Spontaneous painless melena

b. Pretechnetate study detects ectopic gastric mucosa
2. Thin actin filaments are bound to structural proteins at what site?
a. Z lines
3. Effect modification is present when?
a. The effect of the main exposure on the outcome is modified by the presence of another
variable
4. Nontypeable strains of H. Influenzae are?
a. Unencapsulated (#2 mcc for otitis media)
5. Biotin an essential co-factor for?
a. Pyruvate carboxylase (pyruvate --> oxaloacetate)
b. Acetyl-CoA carboxylase (acetyl-CoA --> malonyl-CoA
c. Propionyl-CoA carboxylase (propionyl-CoA --> methylmalonyl-CoA)
6. Pulsatile administration of GnRH stimulates LH and FSH release and is useful in the tx of?
a. Infertility
7. Potter sequence(syndrome) is caused by?
a. Renal anomaly (Bilateral renal agenesis, ARPKD, obstructive uropathy)
8. Meningoencephalitis in HIV patients
a. Cryptococcus Neoformans(narrow budding yeast, india ink, latex agglutination positive)
9. Acute hemolytic transfusion reaction is mediated by?
a. Antibody and compliment --> MAC(compliment mediated cell lysis)
10. Patient with drug seeking behavior or prescription drug misuse physicians can request?
a. Patients prescription history
11. Leading cause of chronic bronchitis?
a. Smoking
12. Nucleolus functions as a primary site for?
a. Ribosome synthesis and assembly 60S, 40S
13. Androgenic alopecia (male pattern baldness) is inherited by
a. Polygenic inheritance with variable expressivity
14. Tetanus vaccine prevents tetanus by?
a. Production of antitoxin antibodies to neutralize the exotoxin
15. RT-PCR used to diagnose CML by detecting?
a. mRNA transcript containing both BCL and ABL exons in affected cells.
16. What part of the ear does the Vagus provide sensation?
a. Posterior external auditory canal?
17. Intestinal malrotation is when?
a. Midgut undergoes incomplete counterclockwise rotation
18. Centriacinar emphysema is associated with chronic smoking that involves the release of?
a. Elastase from neutrophils and macrophages
19. Two growth factors that Heamophilus Influenzae require for growth?
a. Factor V(NAD+) and Factor X(Hematin)
b. Can be grown with S. Aureus(provides factor V)
20. Antidepressant monotherapy in susceptible patients can induce?
 a. Mania
21. Isolated systolic hypertension is due to?
a. Age related stiffness and decrease in compliance of the aorta and major peripheral
arteries
22. Influenza vaccines induce neutralizing antibodies against hemagglutinin antigen preventing?
a. Viral entry
23. Frontal lobe lesions can be divided into left or right with predominant characteristics of?
a. Left --> apathy and depression
b. Right --> disinhibition behavior
24. Case fatality rate is?
a. # of fatal cases of a disease / total # of people with that disease
25. Ability to take up exogenous DNA fragments and express the encoded proteins is called?
a. Transformation --> S. Pneumoniae, H. Influenzae and Neiseria
26. Weakness on dorsiflexion "foot drop", eversion, toe extension and sensory loss on dorsum of
foot is caused by?
a. Lesion to common peroneal nerve (L4-S2)
27. G6PD is rate limiting enzyme in?
a. Pentose phosphate pathway (PPP)...can lead to G6PD deficiency(hemolytic anemia)
28. Fine dust particles in respiratory bronchioles and alveoli are removed by?
a. Alveoli macrophages...seen in coal workers pneumoconiosis (black lung disease)
29. Activated macrophages in the lungs can form...?
a. Langhans giant cells (multiple nuclei organized along the periphery in a horse shoe
pattern) seen in granulomatous conditions
30. Mallory-Weiss tear from excessive vomiting can lead to a
a. Metabolic alkalosis
31. Abdominal pain, psychological disturbances and port wine colored urine is a sign of?
a. Heme synthesis, Porphyrias...Acute intermittent Porphyria --> deficiency in
Prophobilinogen deaminase (PBG)
32. Ionizing radiation causes cancer cell death by two mechanisms?
a. DNA-double strand breakage
b. Free radical formation
33. Mechanism developing greenish pigment in bruises several days after?
a. Heme oxygenase converts heme into biliverdin causing the greenish color
34. Cardiac pacemaker action potential phase 0 is due to?
a. Opening of voltage gated Ca+2 channels
35. Px with no upper vagina, variable uterine development, with normal secondary sexual
characteristics, has lack of?
a. Mullerian duct aplasia
36. Cross-over study is?
a. Subjects randomly allocated to a sequence of 2 or more treatments given
consecutively...with a washout period in between treatments.
37. Chronic Granulomatous disease is a defect in?
a. NADPH oxidase (oxygen dependent killing)
38. Hallucinations in children of recently deceased relatives are considered?
 a. Normal grief reaction
39. General sensation of the anterior 2/3 of tongue is by?
a. Trigeminal V3(mandibular)
40. ANOVA (Analysis of variance) compares differences between?
a. 3 or more groups
41. Mitochondrial myopathies mode of inheritance is?
a. Only through the mother.
42. Wolff-Parkinson-White is an accessory conduction pathway between atrial and ventricular
(bundle ok Kent) characterized by?
a. Delta wave
b. Widened QRS
c. Shorter PR
43. Polyhydramnios due to impaired swallowing is due to?
a. GI obstruction (Duodenal, esophageal or intestinal atresia)
b. Anencephaly
44. Lead poisoning (most common in children in old houses)...two enzymes affected are?
a. Ferrochetalase (Protoporphyrin --> heme)
b. Delta-ALA dehydratase (Delta-aminolevulinic acid --> prophobilinogen)
45. Lymphatic drainage of the rectum proximal to the anal dentate line occurs via?
a. Inferior mesenteric and internal iliac lymph nodes
46. Hyperacute transplant rejection is mediated by?
a. Pre-existing recipient antibodies(IgG) react to donor antigen (type II hypersensitivity).
47. Hyperammonemia results in an excess of ___ in astrocytes, due to the increase in ammonia?
a. Glutamine (excess glutamine in astrocytes impairs its release).
48. Treatment for Gonorrhea?
a. 3rd gen cephalosporin(ceftriaxone) + MAC(Azithromycin)
49. What nerve is in the anterior compartment of the leg?
a. Deep peroneal nerve.
50. Most common complication 5-14 days after MI
a. Ventricular free wall rupture --> cardiac tamponade
51. Henoch-Schonlein Purpura is caused by?
a. Circulating IgA immune complexes --> type III hypersensitivity reaction
52. Probability of a female sibling of a male affected with a X-linked disorder will have an affected
child?
a. 1/8th chance
53. Causes of a left shift to the oxygen hemoglobin dissociation curve?
a. Decrease in all factors including (H+) --> increase in pH
54. Displacement (Immature defense)
a. Transferring feelings to another object or person
55. Piriformis Syndrome
a. Piriformis muscle (occupying most of the greater sciatic foramen) injury or hypertrophy
compresses sciatic nerve producing sciatica like symptoms.
56. Brown pigmentes gallstones are produces by?
a. Beta-glucuronidases released by injured hepatocytes and bacteria
 b. Due to E. Coli o C. senesis
57. Treacher Collins Syndrome is a disruption of the development of the 1st and 2nd pharyngeal
arches, derivatives of the 2nd arch are?
a. Stapes, Styloid, lesser horn of hyoid and stylohyoid ligament
58. Peripheral blood smear of infectious mononucleosis EBV infection will present with?
a. Atypical lymphocytes (CD8+ T-lymphocytes)
59. TCA's overdose cause of death is cardiac arrhythmias due to?
a. Inhibition of fast sodium channels in myocytes
60. Cite of conversion from androgens to estrogen
a. Granulosa cells
61. Penicillin's, cephalosporins and vancomycin have no effect on Mycoplasma genus?
a. Mycoplasma have no cell wall
62. Longterm use of exogenous corticosteroids results in?
a. Decrease ACTH --> bilateral adrenal atrophy (Cushing Syndrome)
63. Hypercoagulability sates(OCP) accompanied by which heart defect can lead to paradoxical
emboli?
a. Patent foramen ovale --> venous thromboemboli entering the systemic arterial
circulation.
64. Confounding bias
a. When a factor is related to both the exposure and outcome.
65. PKU findings are M.R., growth retardation, seizures, fair skin, eczema, musty body odder and
hypopigmentation of?
a. Catecholanergic brain nuclei (accumulation of phenylalanine)
b. Deficiency in phenylalanine hydroxylase
66. Parts of the duodenum and their associations
a. 1st --> L1 vertebra, not retroperitoneal, gastroduodenal artery and common bile duct
b. 2nd --> L1-L3 vertebra, head of the pancreas, ampulla of vater.
c. 3rd --> L3 vertebra, abdominal aorta, inferior vena cava, unicate pancreas, SMA and SMV
67. Autism spectrum disorder characteristics are?
a. Poor social interactions, social communication deficits, repetitive/ritualized behavior,
restricted interests, early childhood, intellectual disability and more common in boys.
68. Prolonged untreated OSA(obstructive sleep apnea) can lead to?
a. Pulmonary hypertension and right heart failure.
69. Sickle cell anemia is autosomal recessive, in order for an offspring to receive the disease?
a. Both parents must be carriers
70. Etiology of Altitude sickness?
a. Decrease in atmospheric oxygen pressure --> decrease in PaO2 --> increase in
ventilation(hyperventilation) --> decrease in PaCO2 --> respiratory alkalosis.
71. External rotation of the shoulder is done by
a. Infraspinatus
72. Tetrahydrobiopterin is a cofactor used in the synthesis of serotonin, dopamine, tyrosine and
phenylalanine and a deficiency can result in?
a. PKU (malignant)
73. Serum sickness is a type III hypersensitivity reaction leading to
 a. Decreased C3, C4 serum levels.
74. A screening test should have a high?
a. Sensitivity (ability to correctly identify those with a disease)
75. Inhaled anesthetics (Halothane) common adverse effect is?
a. Hepatotoxicity --> highly lethal fulminant hepatitis
76. Transport of Glucose across a cell membrane is done by?
a. Facilitated diffusion (GLUT2 and GLUT4)
77. All patients with major depression should be screened for?
a. A past history of manic episodes to distinguish between major depression o bipolar.
78. Acetyl-CoA can stimulate gluconeogenesis by?
a. Increasing the activity of pyruvate carboxylase when Acetyl-CoA is abundant
79. M.O.A. of Sirolimus an immunosuppressant used in kidney transplant rejection prophylaxis.
a. Binds to the immunophilin FK-506 binding protein(FKBP) forming a complex that
inhibits mTOR --> interruption of IL-2 signaling transduction
80. Dubin-Johnson syndrome is caused by?
a. Defective excretion of bilirubin glucuronides across the canalicular membrane
81. Communicating hydrocele results when serous fluid accumulates with in the?
a. Tunica vaginalis
82. CO poisoning oxygen content?
a. %O2 sat. Of Hb decreased
b. %CO2 sat. Of Hb increased(higher affinity for CO2)
c. PaO2 normal
d. Total O2 content decreased
83. Uterine anomalies are produced by?
a. Incomplete resorption of septate
b. Failure or incomplete fusion of Mullerian ducts(paramesonephric)
84. Lymph drainage from the testes is to...?
a. Para-aortic lymph nodes
b. Lymph from the scrotum drains to the superficial inguinal nodes
85. Down syndrome with karyotype 46XX t(14:21)?
a. Robertsonian translocation
86. Calcium binding receptors(CaSR) are what type of receptors?
a. G-coupled receptors that regulate the secretion of PTH
87. To calculate the probability of independent events you must
a. Multiply the probability
88. Chrons disease affecting terminal ileum leading to a decrease in bile acid reabsorption causing?
a. Cholesterol gallstones
89. Offspring's of carrier parents(sickle cells anemia A.R.) have...?
a. 25% chance of being affected
b. 50% of being heterozygous carriers
c. Total of 75% of inheriting an affected allele
st
90. 1 line treatment for general anxiety disorder?
a. SSRI(Fluoxetine, paroxetine, sertraline and citalopram)
91. Hormones with incretin effects (stimulating insulin release after a meal) are?
 a. Glucagon-like-peptide-1(GLP-1)
b. Glucose dependent insulinotropic peptide (GIP)
92. Viral Meningitis CFS findings are
a. Opening pressure --> normal
b. Cell types --> predominant lymphocytes
c. Proteins --> normal or slightly elevated
d. Sugar --> normal
93. Schizotypal presents with
a. Eccentric appearance, odd beliefs, magical thinking, interpersonal awkwardness
94. Leukocyte adhesion deficiency type 1 is caused by?
a. Defect in the LFA-1 integrin (CD18) protein.
b. Recurrent bacterial skin/mucosal infections w/ no purulence (no puss formation)
c. Increased leukocytosis
95. Thiamine (B1) deficiency causes?
a. Wernicke-Korsakoff syndrome (central nervous system involvement)
b. Dry Beri-Beri (peripheral neuropathy)
c. Wet Beri-Beri (High cardiac output failure, edema)
96. Digeorge/velocardiofacial sundrome result from...?
a. Microdeletion at chromosome 22q11
97. Most common source for rabies
a. Bat
b. Rabies vaccine is inactivated
98. Murmur of an aortic stenosis is a...?
a. Systolic ejection-type
b. Crecendo-decrecendo
99. Chi-square test is used for?
a. Evaluate the association between 2 or more percentages or proportions of categorical
variables
100.