1.

Esophageal peristalsis and lower esophageal sphincter

tone in scleroderma: both decreased
2. Tx of hepatic encephalopathy: lactulose
3. Ursodiol: reduces cholesterol absorption and can dissolve
cholesterol gallstones
4. Lactulose: decreases NH3 production by bacteria and acts as a
laxative for hepatic encephalopathy
5. Bisacodyl: stimulant laxative
6. 12 hours after birth baby begins sucking frantically and
crying inconsolably, also overreacts to stimuli around
him and has a marked startle response, symptoms
resolve in 2-3 weeks, what was the mother using: heroin
7. cause of hypercalcemia in multiple myeloma: IL-1, TNF
8. structure that attaches to the cervical region and extends
posteriorly: uterosacral ligament
9. a mutation in 50% of material mitochondrial DNA
present in 100% of her children is explained by:
heteroplasmy
10. painless blood-tingued uring and hx of smoking in 55
YO: bladder cancer
11. problem in brothers who die of mycobacterial infection:
IFN-gamma receptor deficiency
12. Cardiac tumor with scattered mesenchymal cells in an
abundant extracellular matrix: myxoma
13. Molecular problem if trismus and opisthotonos: blockade
of inhibitory NT release
14. Micafungin targets: fungal cell wall
15. Megaloblastic anemia, increased methylmalonic acid
and total homocysteine suggest a deficiency in: B12
16. Histological sign of diffuse alveolar damage: alveolar
hyaline membrane
17. Virulence factor of E. coli causing pyelonephritis:
adhesins
18. Major risk with too much metformin consumption:
lactic acidosis
19. We can administer bevacizumab even though it is a
foreign protein because: it is a humanized antibody
20. Cancer type and tumor antigen with high antibody titer:
cervical cancer and HPV 16, E6 protein
21. Osteoporosis is associated with an increase in what
cytokine: IL-1
22. Tyrosine kinases do what: phosphorylate targets by taking a
phosphate from ATP
23. Defective protein if glucagon does not correct
hypoglycemia in a strain of mice but epinephrine does:
glucagon receptor
24. Erythromycin mechanism: interferes with amino-acyl
translocation
25. Metabolic process impaired if rapid red fibers: oxidative
phosphorylation
26. Best diet for obese person wanting to avoid diabetes: low
calorie
27. Staghorn caliculus think: Proteus mirabilis
28. AATAAA at 3' end encodes: cleavage and polyadenation
29. Muddy brown cast of ATN is a type of: granular cast
30. Two weeks after granular cast seen and none since then,
we expect to see: regenerating tubular epithelium
31. Greatest risk for death a few weeks after strep infection
and PE that reveals pericardial friction rub and quiet
heart sounds, but not pathogens: myocarditis
32. Seminal vesicles secrete: fructose, glandins all the other stuff
33. Cause of hyperglycemia in a type I diabetic: activation of
hepatic adenylyl cyclase
34. ANP function: opposite of aldosterone (inhibits renin)
35. Where do the adductors of the hip attach: femur and
ischium
36. Cough suppressant treatment that does not cause
constipation and has a low potential for substance
abuse: dextromethorphan
37. Aspirin induced asthma is due to: leukotrienes
38. Watery diarrhea, hypokalemia, achlorhydria: VIPoma
39. Tx of fetal pulmonary hypertension: nitric oxide (monitor
for methemoglobinemia)
40. Receptor causing uterine relaxation: B2
41. Receptor causing increased myocardial contractility: B1
42. Receptor causing internal urethral sphincter
contraction: A1
43. Receptor causing lipolysis: B1, B2
44. Receptor causing pilomotor contraction: A
45. Receptor causing pupillary dilation: A1
46. Hypochondriasis requires: disproportionate fear of serious
illness
47. Laryngeal neoplasm in a smoker: squamous cell
48. Decreased MCV, red, swollen, tender tongue, angular
stomatitis, spoon-shaped nails: iron deficiency
49. Neutropenia, giant granules in neutrophils, white hair,
pale skin, blue irises, red pupils: Chediak Higashi (defect
on phagolysosome fusion)
50. Neuraminidase inhibitor mechanism of action: prevents
release of virus from infected epithelial cells
51. Baby gets GBS from a vaccinated mother, means mother
only made one ab isotype: IgM
52. Parasitic drug that increases the permeability of the cell
membranes to calcium causing paralysis, dislodgement,
and death: praziquantel
53. Why are patients with CF chronically infected with
pseudomonas: biofilm formation in the lower respiratory tract
54. Cuboidal lung epithelial cells with dense lamellar bodies
1-2 u in diam: surfactant
NBME 13
Study online at quizlet.com/_eiyp2
55. Erectile dysfunction is caused by decreased: testosterone
56. Everything has been normal for a woman but she cannot
conceive, what should we give her next: clomiphene
57. Trisomy 21 associated with increased risk of which
cancers?: ALL and AML
58. Hydronephrosis causes?: Increased tubular hydrostatic
pressure from blockage
59. Chronic HTN, heavy heart?: Hypertrophy of heart
60. Valproic Acid MOA: inhibits HISTONE ACETYLASE -
Histones were in DNA - transcription error
61. Chloroquine, primaquine MOA: Chloroquie kills malaria/
Primaquine kills hypnozoites
62. Pain with thumbs down, shoulders up: Arm up Thumbs
down sign... supraspinatus...
63. Left Axillary line holosytolic murmur: Mitral Regurg - Left
Axillary line holosystolic murmur
64. Oculomotor palsy from aneurysm?: Posterior
Communicating Artery Anuerysm
65. Dental procedure, bug?: Strep Mitis - alpha hemolytic
66. HDL with age in woman?: HDL of a 25 year old vs. 55 year
old, high in 25, low in 55 (estrogen)
67. Organophosphate poisoning- first antidote: Atropine
first/Pralidoxime second
68. Partial vs complete mole: Partial 1 egg two sperm 69XXY vs
paternal complete 46XX 2 sperm no egg
69. EPO doping = ?: EPO will increase RBC's erythroid precursors
70. Ammonia source in ammonioagenesis: Aspartate &
GLUTAMINE donate NH4 ( amonia ) in renal ammoniaagenesis
71. long-chain-fatty-acids?: LCFA - peroxisomes
72. Salmonella post antibiotic?: prolonged fecal excretement
post antibiotic
73. Hypokinesis of Posterior Left Ventricle?: Stenosis of the
right coronary artery
74. Pain upper abdomen, refered to shoulder: Diaphram
ulceration phrenic nerve
75. Oligomenorrhea: increased estrogen in adipose tissue
76. metabolic alkalosis with volume contraction: loop diuretic
77. drug overdose?: respiratory acidosis
78. suprasellar mass, hormone excess?: prolactin
79. RNA splice error: skipping of exons
80. metastaic colon cancer spread MOA: Hematogenous
spread of Liver Tumor from Colon via Portal Venous System
81. Diabetic neuropathy pain?: burning pain
82. pinpoint pupils, unconscious: heroin OD
83. Why deoxyHB can carry CO2 better than OxyHB?:
DeoxyHB = better buffer
84. Recurrent severe mycobacterial diseases: INF-gamma
receptor defect
85. Insulin increases?: glucokinase activity
86. Stain Drug effects: Upregulates LDL receptors
87. Lithium induced Nephrogenic DI, where?: Collecting
tubule
88. MOA IKB: lkb --> NF-KB post phosphorylation for IL-1/IL-6
fever induction
89. Zanamavir MOA: Zanamivir MOA - inhibit virion release
90. CML treatment: Imatinib. BCR-ABL 9:22
91. Low blood solubility = slow or fast induction?: 141) low
blood solubility --> rapid induction, low potency
92. Screening for CD markers?: Immunohistochemistry
93. acute ischemic injury = kidney findings?: Acute Tubular
Necrosis - Muddy Brown Casts with epithelial cells
94. cyt a/a3 blocked by: CO poisoning (requires oxygen)
95. capillary hemangioma embryological origin: endothelial
96. Lambert-Eaton MG: Autoantibodies to presynaptic Ca2+
channel = proximal muscle weakness, improves with use
97. Highest immunogenic tumor cell response: cervical cancer
to HPV 16, E6 protein
98. bevacizumab properties: humanized antibody inhibiting
VEGF
99. metformin overdose: lactic acidosis
100. erythromycin MOA: Bind 50S, prevent release of uncharged
tRNA after it has donated its amino acid (aka translocation)
101. relative risk under/over 1: under one = decreased risk, over
one = increased risk
102. pulmonary vs bronchial circulation: pulmonary
circulation = larger percentage of CO (=CO vs. bronchial circ is
much less of CO)
103. muscle misuse: increased protein degradation not myosin
activity
104. MPO deficiency: decreased production of bleach aka hydroxy-
halide radicals = susceptibility to yeast infections
105. features of apoptosis: cell shrinkage, eosinophilia,
condensed cytoplasm, apoptotic bodies
106. amphetamine intox: pupillary dilation, diaphoresis,
agitation, confusion
107. heroin intox: euphoria, resp, CNS depression, pupillary
constriction, seizures
108. seminal vesicle secretions: fructose (bulbourethral
gland/Cowper = mucous, prostate =acid phosphate and PSA )
109. mitochondrial inheritance expression: heteroplasmy =
variable expression
110. treatment for hepatic encephalopathy: lactulose
111. location of bone that heals fracture: periosteum (includes
osteoblasts)
112. CREST achalsia: dysmotility and decreased LES pressure
113. Hypercalcemia in MM vs Sarcoid: MM = IL1 (osteoclast
activating factor), Sarcoid = elevated 1,25 vit D
114. ab pain, nausea, vomiting after party, normal temp, low
BP: enterotoxin ingestion (S. aureus, usually rapid onset in 1-8
hours)
115. cerebellar vermis damage: truncal ataxia, dysarthria
(vermis is tree like)
116. cerebellar hemisphere: intention tremor, limb ataxia, loss of
balance, fall towards side of lesion
117. hyochondriasis: fear of serious disease
118. aspirin induced asthma mediated by? Treat with?:
leukotrienes (montelukast, zirlukast)
119. Nephrogenic DI (PCT, DCT, CT): PCT = always isotonic,
DCT and CT = hypotonic because ADH acts here and action is
blocked in DI
120. nitric oxide: reduces pulmonary vascular resistance (watch for
metglobinemia)
121. Beta2 agonists: decrease uterine tone
122. bupivicaina MOA: amide local anesthetic = decreased
permeability of Na
123. blood supply of esophagus: branches off aorta
124. cough suppressant without constipation and low
addiction: dextrometorphan
125. suspensory ligament: connects ovaries to lateral pelvic wall,
contains ovarian vessels
126. carcinoid tumors (3 most common sites): appendix,
ileum, rectum (once mets outside GI tract = carcinoid syndrome)
127. Hunter's syndrome accumulation: iduronate sullfatase
deficiency = heparan sulfate, dermatan sulfate (mild
developmental delay, gargoylism, airway obstruction +
aggression)
128. protease inhibitor MOA: inhibits cutting up of long enzyme
chain into smaller pieces = no new viruses, lack mature core
129. Excess IL1 in elderly woman: osteoporosis
130. diabetes lipid levels: low HDL, high TG, high free fatty acids
131. placenta accreta: placenta attahed to myometrium after birth
= massive bleeding
132. increased UC bilirubin: Gilbert syndrome
133. gestational trophoblastic disease: high hCG, nausea,
vomiting, large uterus, associated with complete mole (male,
male, no egg parts, 46 complete, 69 Partial)
134. uterosacral ligament: attaches to cervical region and extends
posteriorly
135. Limited healing in lateral collateral ligament tear:
impaired blood supply
136. thoracentesis location: above the 9th rib, midscapular line
137. micafungin/caspofungin MOA: cell wall inhibitor, blocks
B-glucan synthesis
138. staghorn calciulus bugs: urease-positive (Proteus, Staph,
Klebsiella)
139. praziquantel MOA: increased cell membrane permeability
140. partial beta agonists: pindolol, acebutolol (PAPA)
141. musculocutaneous nerve: sensation on lateral forearm, loss
of elbow flexion