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NATIONAL PODIATRIC
BOARD EXAMINATION I
MOCK
This timed examination has been recreated from specifications of the national test part one for
podiatrists. The questions are taken from various board review books. The content is not random
and distributed in the following parts:
Lower Extremity Anatomy 22%
Pharmacology 16%
Microbiology and Immunology 15%
Pathology 15%
Physiology 12%
Biochemistry 10%
General Anatomy 10%
1
1. Which of the following fibrous sheets or bands would most likely cover the body under the
skin and invest the muscles?
Tendon='CT'con$nua$on'of'muscle'that'aeaches'muscle'to'bone'
Tendon'sheath='double'layer'of'CT'around'a'tendon'with'a'small'amount'of'fluid'between'the'
(A) Tendon layers;'allows'tendon'to'glide'freely'when'the'muscle'contracts'or'relaxes'and'prevents'fric$on
(B) Fascia or'damage'to'the'tendon''
(C) Synovial tendon sheath Deep'fascia='layer'of'fibrous'CT'that'can'surround'individual'muscles,'and'also'divide'groups
of'muscles'into'compartments
(D) Aponeurosis Superficial'fascia='immediately'beneath'the'skin'over'the'en$re'surface'of'the'body'
Aponeurosis='flat'CT'sheet'that'aeaches'muscle'to'muscle,'muscle'to'bone'or'muscle'to'skin'
2. If parasympathetic nerves are damaged, which of the following muscles would most likely be
affected? PNS+effects=+cholinergic+muscarinic+receptor+mediated
Eyes=+pupillary+constricLon
(A) Muscles in the hair follicles bundle'of'smooth'm.'fibers'innervated'by'SNS Bronchioles=+bronchoconstricLon
Heart=+bradycardia,+decrease+contracLlity+and+AV+
(B) Muscles in blood vessels dilates'in'Sk'm.'and'constricts'in'GI;'SNS nodal+conducLon
(C) Muscles enclosed by epimysium skeletal'muscle'is'under'SNS'control' GI+Tract=+increased+moLlity,+relaxaLon+of+sphincters
(D) Muscles in the gastrointestinal (GI) tract Male+sex+organs=+erecLon+(point;+SNS=+shoot)+
Text Bladder+and+ureters=+contracLon+of+detrusor,+
relaxaLon+of+sphincter+and+trigone+
3. Which blood vessel or group of vessels carries richly oxygenated blood to the heart?
4. Axons of neurons
5. Which of the following structures shunts blood from the pulmonary trunk to the aorta,
partially bypassing the lungs?
3+Important+Shunts:+
(A) Placenta 1.+Deoxygenated+blood+entering+the+RA+from+the+SVC+goes:+RA+to+RV+to+main+PA+and+then+either+to+
(B) Umbilical artery either+lung+or+through+DUCTUS+ARTERIOSUS;+from+DA+goes+to+aorta+then+to+the+placenta+via+umbilical+
(C) Ductus arteriosis arteries;+(skips+lungs)+
(D) Foramen ovale 2.+Blood+entering+the+fetus+through+the+umbilical+vein+is+conducted+via+the+DUCTUS+VENOSUS+into+the+
IVC+to+bypass+the+hepaLc+circulaLon;+(skips+hepaLc+circulaLon)+
3.+Most+highly+oxygenated+blood+reaching+the+heart+via+the+IVC+is+diverted+through+the+FORAMEN+OVALE
and+pumped+out+the+aorta+to+the+head+and+body+(skips+pulmonary+trunk)+
2
6. Which of the following structures contains cell bodies of unipolar or pseudounipolar neurons?
Pseudounipolar'neurons'have'one'axon'with'2'branches:'central'and'peripheral'(not'to'be'
confused'with'dendrites);'the'cell'body'(soma)'of'each'neuron'is'located'in'a'dorsal'root'
(A) Ventral horn of the spinal cord ganglion;'the'axon'leaves'the'cell'body'out'of'the'ganglion'and'into'the'dorsal'root'where'it'
(B) Lateral horn of the spinal cord branches;'the'central'branch'goes'to'the'posterior'(dorsal)'horn'of'the'spinal'cord,'where'it'forms'
synapses'with'other'neurons;'the'peripheral'branch'travels'through'the'distal'dorsal'root'into'the'
(C) Dorsal horn of the spinal cord spinal'nerve'all'the'way'un$l'skin,'joint'and'muscle;'these'neurons'have'sensory'receptors'at'
(D) Dorsal root ganglion their'peripheral'sites;'signals'conduct'through'the'peripheral'branch'to'the'dorsal'root'ganglions'
cell'body'then'through'the'central'branch'and'ending'at'the'sensory'nuclei'in'the'posterior'horn'
Synapses are most likely absent in or on which of the following structures?
8. Which of the following structures uld most likely be absent in the spinal cord at the L4
spinal cord level?
Lateral'horn'is'present'at'14'levels'of'the'spinal'cord,'
(A) Dorsal horn specifically'through'levels'T1:L2
(B) Lateral horn
(C) Ventral horn
(D) Gray matter
9. The pivot (troehoid) joint is found in which of the following joints? Only'2'types'of'movement:'rota$on'and'gliding
ie'C1:2'Atlas'to'Axis'ar$cula$on;'NONE'in'LE'
10. A patient presents with a loss of sensation to the skin over the shoulder. Injury to which of the
following nerve cells would most likely affect the conduction of sensory information to the
central nervous system (CNS)?
3
11. The genitofemoral nerve (L1,'2)'comes'off'the'lumbar'plexus,'piercing'the'psoas'major'and'
passing'distal'along'the'muscle'belly,'it'divides'into'2'branches:
1.'Genital'Branch='supplies'skin'of'genital'organs
(A) runs in front of the quadratus lumborum 2.'Femoral'Branch'(Lumbo:inguinal'nerve)='passes'deep'to'the'inguinal
(B) is a branch of the femoral nerve ligament'and'through'the'femoral'sheath,'lateral'to'the'Femoral'Artery,'
(C) supplies the testis piercing'the'deep'fascia'and'supplying'the'superficial'skin'of'the'proximal'
(D) passes through the deep inguinal ring femoral'triangle''
12. If a stab wound injures structures that leave the pelvis above the piriformis muscle, which of
the following structures is most likely to be damaged?
13. Tearing of the pelvic diaphragm during childbirth leads to paralysis of which of the following
muscles?
Ques$on'came'from'BRS,'answer'explana$on='
(A) Piriformis Pelvic'diaphragm'is'formed'by'the'levator'ani'and'coccygeus,'whereas'the'urogenital'
diaphragm'consists'of'the'sphincter'urethrae'and'deep'transverse'perinei'muscles;'the'
(B) Sphincter urethrae
piriformis'passes'through'the'greater'scia$c'notch'and'inserts'on'the'greater'trochanter;'the'
(C) Obturator internus
obturator'internus'forms'the'lateral'wall'of'the'ischiorectal'fossa;'
(D) Levator ani
14. A large tumor confined to the posterior mediastinum may compress which of the following
structures? Posterior'medias$num'is'bounded'superiorly'by'the'plane'through'the'sternal'angle'and'T4/5,'
inferiorly'by'the'diaphragm,'anteriorly'by'the'middle'medias$num,'and'posteriorly'by'the'spinal'cord;'
(A) Ascending aorta this'area'contains'the'descending'thoracic'aorta,'the'azygos'system,'the'esophagus,'the'thoracic'duct,'
and'the'lymph'nodes';'
(B) Trachea Contents'of'other'medias$num:'
(C) Descending aorta Superior='thymus,'trachea,'esophagus,'arch'of'aorta,'thoracic'duct,'brachiocephalic'a.,'LCC'a.,'lymph'nodes'
(D) Arch of the aorta Middle='ascending'aorta,'bifurca$on'of'trachea'and'the'2'bronchi,'pulmonary'artery,'
SVC'and'azygous'system,'lympha$cs'
Anterior='thymus,'loose'areolar'$ssue,'lymph'vessels,'lymph'nodes,'branches'of'internal'thoracic'a.'
15. A patient has a torn rotator cuff of the shoulder joint as the result of an automobile accident.
Which of the following muscle tendons is intact and has normal function?
Rotator'Cuff'Muscles'“SItS'(small't'for'Teres'Minor)”'(are'innervated'primarily'by'C5:6)
(A) Supraspinatus Supraspinatus'(suprascapular'nerve):'abducts'arm'ini$ally'(before'ac$on'of'deltoid);'#1'rotator'cuff'injury
(B) Subscapularis Infraspinatus'(suprascapular'nerve):'laterally'rotates'arm;'pitching'nerve'injury
(C) Teres major Teres'Minor'(axillary'nerve):'adducts'and'laterally'rotates'arm
Subscapularis'(subscapularis'nerve):'medially'rotates'and'adducts'arm
(D) Teres minor
4
16. If there is loss of the skin sensation and paralysis of the muscles on the plantar aspect of the
medial side of the foot, which of the following nerves is damaged?
Tibial&N.&(L4,S3):&Semimembranosus,&semitendinosus,&LH&of&BF,&all&posterior&leg&muscles;÷s&into
(A) Common peroneal medial&and&lateral&plantar&nerves&and&supplies&plantar&intrinsics;&
(B) Tibial Common&Peroneal&N.&(L4,S2):&SH&BF;÷s&into&deep&and&superficial&branches&to&supply&anterior
(C) Deep peroneal and&lateral&leg&muscles&as&well&as&dorsal&intrinsics
(D) Sural Deep&Peroneal&(L4,5):&EDL,&EHL,&TA,&Pt,&EHB,&EDB;&1st&webspace&
Sural&N.&(S1,2):&cutaneous&innervaPon&to&lateral&side&of&foot;&made&of&fibers&from&both&the&Pbial&(medial
sural&cutaneous&n.)&and&common&peroneal&(lateral&sural&cutaneous)&nerves&
17. A patient walks with a waddling gait that is characterized by the pelvis falling toward one
side at each step. Which of the following nerves is damaged?
PosiPve&Trendelenburg&Test=&pelvis&Plts&to&opposite&side&and&cannot&be&recovered&
(A) Obturator nerve to&a&straight&posiPon;&due&to¶lysis&of&gluteus&medius&and&minimus,&dislocaPon&of
(B) Nerve to the obturator internus the&hip&joint&or&an&abnormal&angle&of&femoral&inclinaPon;&the&sagging&pelvis&to&the&
(C) Superior gluteal nerve opposite&side&is&caused&by&the&inability&of&the&ipsilateral&hip&abductors&to&counteract
(D) Inferior gluteal nerve gravity;&the&trunk&is&inclined&towards&the¶lyzed&side;¶lysis&of&gluteus&medius
and&causing&characterisPc&waddling&or&lurching&gait
*Gluteus&medius&and&minimus&innervated&by&superior&gluteal&nerve&&&
18. A patient is unable to prevent anterior displacement of the femur on the tibia when the knee is
flexed. Which of the following ligaments is most likely damaged? PosiLve+posterior+draw+sigh
19. Lesion of the femoral nerve results in which of the following conditions?
b+Psoas+Major=+N.+to+Psoas+Major+via+DDVR+L2,3,4
(A) Paralysis of the psoas major muscle
(B) Loss of skin sensation on the lateral side of the foot b+Femoral+Nerve+(DDVR+L2,3,4)+Supplies:+Quads,+Iliacus,+
(C) Loss of skin sensation over the greater trochanter ArLcularis+Genu,+PecLneus,+Sartorius++
(D) Paralysis of the vastus lateralis muscle
b+Supply+to+skin+over:
anterolateral+thigh+(greater+trochanter)=+LFCN+(L2,3)
20. A patient is unable to invert the foot, indicating lesions of which of the following nerves?
5
21. A 22-year-old patient is unable to "unlock" the knee joint to permit flexion of the leg. Which of
the following muscles is most likely damaged?
Prime+medial+rotator+of+the+Lbia,+also+a+lateral+rotator+of+the+femur+when+the+Lbia+is+fixed;+
(A) Rectus femoris it+pulls+the+lateral+meniscus++backward+at+the+beginning+of+flexion;+it+flexes+the+leg+and+
(B) Semimembranosus unscrews+the+Lbia+when+standing+up+“unlocking”+the+knee+joint
(C) Popliteus
Vastus+medialis+does+opposite:+extends+thigh,+thigh+rotates+medially+and+knee+joint+unlocks
(D) Gastrocnemius
22. A patient presentswith sensory loss on the adjacent sides of the great and second toes and
impaired dorsiflexion of the foot. These signs probably indicate damage to which of the
following nerves?
23. When the superficial peroneal nerve is severed near its origin by a deep gash as a result of a
fall from a motorcycle, which of the following muscles is paralyzed?
SecLon+of+SP+N.+results+in:
(A) Peroneus longus 1.+SensaLon+impairment+or+loss+on+the+dorsum+of+the+foot+and+lateral+aspect+of+
(B) Extensor hallucis longus lower+leg+
(C) Extensor digitorum longus 2.+Eversion+of+the+foot+is+lost;+foot+is+inverted+during+dorsiflexion;+equinovarus+posiLon
(D) Peroneus tertius may+develop+
*+there+is+no+foot+drop+with+this+lesion+
24. To avoid damaging the sciatic nerve during an intramuscular injection in the right gluteal
region, the needle should be inserted in which of the following areas?
*+SciaLc+nerve+can+be+blocked+a+few+cm+below
(A) Over the sacrospinous ligament the+midpoint+of+a+line+from+the+upper+boarder
(B) Midway between the ischial tuberosity and the lesser trochanter of+the+greater+trochanter+to+the+PSIS;+ie+upper+
(C) Midpoint of the gemelli muscles lateral+quadrant+of+gluteal+region
(D) Upper right quadrant of the gluteal region
25. Which of the following muscles is damaged if a patient cannot flex and medially rotate the
thigh during running and climbing?
6
26. A motorcycle accident results in the destruction of the groove in the lower surface of the
cuboid bone. Which of the following muscle tendons is most likely damaged?
27. A construction worker sustains a fracture of the groove on the undersurface of the
sustentaculum tali of the calcaneus as a result of falling feet first from a roof, Which of the
following muscle tendons is most likely torn?
FDLb+passes+along+the+medial+(flahened)+edge+of+the+sustentaculum+tali
(A) Flexor digitorum brevis FHLb+passes+along+the+inferior+surface+of+the+sustantaculum+tali+
(B) Flexor digitorum longus FHBb+o:+from+tendon+of+TP,+cuboid+and+lateral+cuneiform
(C) Flexor hallucis brevis FDBb+o:+plantar+aponeurosis+and+medial+calcaneal+tubercle
(D) Flexor hallucis longus
29. The inability to extend the leg at the knee joint indicates paralysis of which of the following
muscles?
30. Which of the following muscles is damaged if a patient experiences weakness in dorsiflexing
and inverting the foot?
Dorsiflexion=+TA,+EDL,+EHL,+Pt
(A) Peroneus longus Plantarflexion=+Gastroc,+Soleus,+Plantaris;+assisted+by+TP,+FDL,+FHL,+PB,+PL
(B) Peroneus tertius Inversion=+TA,+TP;+Gastroc+and+soleus+assist+(Singh),+FHL+assists+(Ohio),+
(C) Tibialis anterior EHL+assists+(southerland)+
(D) Extensor digitorum longus Eversion=+PL,+PB;+Pt+and+EDL+assist+
A=+Eversion,+assists+with+plantarflexion
B=+Dorsiflexion,+assists+with+eversion
C=+Dorsiflexion,+assists+with+eversion+
7
31. A 62-year-old woman slips and falls on the bathroom floor, which results in a posterior
dislocation of the hip joint and a fracture of the neck of the femur. The woman undergoes hip
surgery. If all of the arteries that are part in the cruciate anastomosis of the upper thigh are
ligated, which of the following arteries maintains the blood flow?
32. Which of the following conditions most likely occurs as a result of occlusion of the dorsalis
pedis artery at its origin? DP+is+conLnuaLon+of+the+TA+artery+at+the+level+of+the+ankle;+branches=+
Artery+to+tarsal+sinus,+lateral+and+medial+tarsal,+muscular+branches+(EDB/
EHB)+and+ends+as+trifurcaLonb+1st+DMA,+Arcuate+and+Deep+Plantar+Artery+
(A) Ischemia in the peroneus longus muscle Medial+Tarsalb+anastomosis+w/+medial+malleolar+arterial+plexus+
(B) Reduction of blood flow in the medial tarsal artery Arcuateb+anastomoses+w/+plantar+arch+via+perforaLng+branches+to+DMAs+
(C) Aneurysm in the plantar arterial arch Deep+Plantar+Arteryb+is+conLnuous+with+the+deep+plantar+arch;+represents+
(D) High blood pressure in the arcuate artery primary+point+of+connecLon+with+the+plantar+circulaLon++with+the+dorsal+
circulaLon,+forming+a+loop+circuit++
33. A patient experiences paralysis of the muscle that originates from the femur and contributes
directly to the stability of the knee joint. Which of the following muscles is involved?
34. Which of the following structures remains intact if the structures that pass deep to the inferior or
superior extensor retinaculum of the ankle are damaged?
35. A knife wound penetrates the superficial vein that terminates in the popliteal vein. Bleeding
occurs from which of the following vessels?
8
36. A 10-year-old boy falls from a tree house, causing heavy compression of the sole of his foot
against the ground with fracture of the head of the talus. Which of the following structures is
unable to function normally? Medial+longitudinal+arch=+calcaneus,+talus,+navicular,+cuneiforms+and+medial+3+mets;+flat+foot+(pes
planus)+is+a+depression+of+this+arch
(A) Transverse arch
Lateral+longitudinal+arch=+calcaneus,+cuboid+and+lateral+2+mets;+high+arch+(pes+cavus)+is+when+this
(B) Medial longitudinal arch arch+is+excessively+or+abnormally+high+
(C) Lateral longitudinal arch +
(D) Tendon of the peroneus longus Transverse+arch=+navicular,+cuneiforms,+cuboid+and+5+mets;+each+foot+contributes+1/2+of+arch;+
met+heads+to+not+make+contact+with+the+ground+and+do+not+contribute+to+the+arch;+
cross+inserLons+of+TP+and+PL+largely+create+the+transverse+arch;+
37. A 24-year-old woman complains of weakness associated with extending her thigh and
rotating it laterally. Which of the following muscles is paralyzed?
Extension=+Gluteus+maximus+and+the+hamstrings
(A) Semitendinosus Lateral+rotators=+Gluteus+maximus,+sartorius,+6+deep+gluteal+muscles+(Piriformis+Go+Go+Quad)
(B) Gluteus maximus
(C) Tensor fasciae latae
(D) Sartorius +
38. A radiograph reveals a blood clot in the popliteal artery at its distal end. Blood may reach the
foot by way of which of the following arteries?
Clot+would+occlude+popliteal+artery+branchesb+Anterior+Tibial,+Posterior+Tibial+and+Peroneal+(usually
(A) Anterior tibial a+branch+of+PT);+however+blood+would+sLll+reach+these+arteries+via+the+genicular+anastomosis+of+knee;
(B) Posterior tibial Femoral+A+gives+off+descending+genicular+which+communicates+with+anastomosis+via+arLcular+a.+and
saphenous+a.+before+becoming+the+popliteal+a+which+gives+superior+and+inferior+lateral+and+medial
(C) Peroneal geniculars+and+the+middle+genicular+artery+(does+not+parLcipate+in+anastomoses);++lateral+femoral+
(D) Lateral circumflex femoral circumflex+contributes+via+descending+LFCA+which+anastomoses+with+the+superior+lateral+genicular+and+
would+be+the+sole+supply+if+popliteal+were+occluded;+AT+contributes+to+anastomoses+via+AT+recurrent+a.+
and+PT+via+PT+recurrent++and+circumflex+fibular+artery;+
39. Pus in the adductor canal damages the enclosed structures. Which of the following structures
remains intact?
Contents+of+Adductor/Subsartorial/Hunters+Canal:
(A) Femoral artery Femoral+artery+and+vein
(B) Femoral vein Saphenous+nerveb+end+nerve+of+femoral+nerve
(C) Saphenous nerve Nerve+to+Vastus+Medialis
LymphaLcs+
(D) Great saphenous vein
40. Hypertrophy of the extensor muscles of the leg may cause ischemia due to compression of
which of the following arteries?
(A) Popliteal
Leg+extensors=+Quadriceps+muscles+which+are+in+the+anterior+compartment+of+the+thigh+so+the+only+
(B) Deep femoral opLon+that+makes+sense+would+be+deep+femoral+(profunda+femoris);+descending+branch+of++PF+passes
(C) Anterior tibial inferiorly+in+the+anterior+compartment+of+the+thigh,+intermediate+to+RF+and+vastus+intermedius+at+
(D) Posterior tibial their+lateral+edges,+near+the+vastus+lateralis+muscle;++
9
41. Which of the following muscles functions normally even if the greater trochanter of the
femur is fractured?
(A) Piriformis
(B) Obturator intemus
(C) Gluteus medius
(D) Gluteus maximus
42. Which of the following muscles is able to dorsiflex and invert the foot?
43. The obturator and sciatic (tibial portion) nerves both innervate which of the following
muscles?
Obturator+N.+(posterior)+branch+supplies+all+except+hamstring+part;+Lbial+part+of+
(A) Semitendinosus sciaLc+nerve+supplies+hamstring+part+
(B) Adductor magnus
(C) Adductor longus *PecLneus+may+have+dual+nerve+supply;+main+supply+via+femoral+n.+but+when+accessory+obturator
nerve+is+present,+it+will+communicate+with+the+obturator+nerve+and+give+branches+to+pecLneus+
(D) Pectineus
44. A lesion of which of the following muscles most likely causes weakness in flexing the hip
joint and extending the knee?
RF+plus+iliopsoas+are+called+the+“Kicking+Muscles”;+quads+are+especially+important+in+climbing,+running,
(A) Sartorius jumping,+rising+from+a+seated+posiLon+and+walking+up+and+down+stairs;+RF+is+the+only+one+that+flexes+
(B) Gracilis thigh+and+extends+leg+because+it+crosses+2+joints;+
(C) Rectus femoris
(D) Vastus medialis
45. The obturator is the sole source of innervation for which of the following muscles?
PecLneus=+Femoral+[and/or+accessory+obturator]
Adductor+Magnus=+obturator+++Lbial+
(A) Pectineus BF=+Lbial+++common+peroneal+
(B) Adductor magnus
(C) Adductor longus Obturator+only=+Gracilis,+Adductor+Brevis,+Adductor+Longus,+Obturator+Externus
(D) Biceps femoris
1.0
46. Which of the following bones forms the keystone for the lateral longitudinal arch of the foot?
(A) Calcaneus
(B) Cuboid bone
(C) Head of the talus
(D) Sustentaculum tali
47. While playing football, a 19-year-old college student receives a twisting injury to his knee
when being tackled from the lateral side. Which of the following conditions most likely has
occurred? A+clipping+injury+to+the+lateral+side+of+the+knee+can+cause+
damage+to+3+“C’s”,+and+swelling+of+the+knee
(A) Tear of the medial meniscus 1.+Collateral+ligamentsb+mainly+medial+collateral
2.+Medial+Meniscus+“C”+shapedb+medial+collateral+ahached
(B) Ruptured fibular collateral ligament and+so+both+can+be+injured
(C) Tenderness on pressure along the fibular collateral ligament 3.+anterior+and+posterior+cruciate+ligaments
(D) Ruptured posterior cruciate ligament
*fibular+collateral+is+very+strong,+may+tear+from+
medial+trauma+to+the+knee++
48. Before knee surgery, a surgeon ligates arteries participating in the anastomosis around the
knee joint. Which of the following arteries is most likely spared?
All+of+these+arteries+parLcipate+in+genicular+anastomoses
Lateral+superior+and+medial+inferior+both+from+popliteal
(A) Lateral superior genicular artery;+Descending+branch+of+LFCA+anastomoses+with+the+lateral
(B) Medial inferior genicular genicular+artery+and+is+major+collateral+circulatory+alternaLve
(C) Descending branch of the lateral femoral circumflex in+the+event+the+femoral+artery+is+compromised+in+proximal
(D) Saphenous branch of the descending genicular popliteal+fossa;+Saphenous+branch+of+descending+genicular+
anastomoses+with+the+inferior+medial+genicular+and+gives+off+an+
(E) Middle genicular= only genicular not participating
arLcular+artery+that+anastomoses+with+the+superior+medial+genicular+
in anastomoses
49. The pKa' of acetic acid is 4.76. What is the pH of a 0.1 M solution of acetic acid?
(A) 5.76
(B) 2.88 pH= pKa-log([AH]/[A-])
(C) 2.43 pH=4.76-log(0.1)
(D) 1.88 pH=4.76-(-1)
pH=5.76
50. Which of the following amino acids is an imino acid?
(A) Leucine
Proline is only AA that is an imino acid which is a structure with the
(B) Lysine amino group bonded to the alkyl side chain forming a ring
(C) y-Carboxyglutamate
(D) Proline
1.1
51. Which of the following does not change length during muscle contraction?
(A) The A band Contraction results in shortening of H and I bands between the Z lines
(B) The I band (“HIZ shrinkage”), but the A band remains the same length (“A band is Always
(C) The H zone the same length”)
Sarcomere= measured from 1 z-line to 1 z-line
(D) The sarcomere
52. Which one of the following characteristics best applies to an allosteric effector? It
Drugs that bind to the same receptor
molecule but do not prevent binding
(A) competes with substrate for the catalytic site of the agonist are said to act allosterically
(B) binds to a site on the enzyme molecule distinct from the catalytic site and may enhance or inhibit the action of
(C) changes the nature of the product formed the agonist molecule
(D) changes the substrate specificity of the enzyme
54. If the cytosine content of a double-helical DNA is 20% of the total bases, the adenine content
would be
(A) 10%
(B) 20%
(C) 30%
(D) 40%
55. Which of the following pairs of lipids and related compounds exhibits opposite biological
activities?
12
56. Which mutation of the sequence GATCCT is a transition?
57. The factor required only for accurate initiation of transcription in prokaryotes is
Sigma factor is a bacterial protein that can associate with and become a
(A) alpha (a) subunit of bacterial RNA polymerase; it confers specificity of initiation on
the core enzyme; in the presence of sigma factor RNA polymerase chooses
(B) beta 03) the correct strand of duplex DNA for transcription and initiates transcription
(C) transcription factor IID (TFIID) at the appropriate promoter region
(D) sigma (a)
TFIID binds to TATA box and is the first event that occurs in mRNA synthesis
in eukaryotes
58. The "wobble" hypothesis refers to the less stringent base-pairing specificity of the
tRNA wobble= accurate base pairing is required for only the 1st 2 nucleotide
(A) 5'-end base of the codon positions of an mRNA codon, so codons differing in the 3rd “wobble” position
(B) 3'-end base of the antocodon may code for the same tRNA/AA (as a result of degeneracy of genetic code)
tRNA carries anticodon covalently bound to its 3’end; therefore the
(C) middle base of the codon
3’-end base anticodon would be the 1st nucleotide base;
(D) 5'-end base of the anticodon the 3 nucleotide codon sequence is added to the 3’-end of the mRNA during
elongation; therefore, the 5’-end of the codon would be the 1st nucleotide
base
59. Which primers should be paired to amplify, by the polymerase chain reaction (PCR), the
DNA between the two indicated sequences? 5'-GGAATTCGT---//---AATGCTACC-3'
13
61. If a reaction is at equilibrium, which one of the following statements is correct?
62. Which of the following must be modified to serve as a cofactor for enzymes?
63. Hydrophilic hormones are best described by which of the following statements? They
65. Which of the following decreases the glomerular filtration rate (GFR) and renal blood flow
below normal levels? Constriction of efferent would decrease RPF and increase GFR
Constriction of afferent would cause decrease in both
(A) Glomerulotubular balance Epi and NE both cause vasoconstriction in the kidneys, because,
(B) A small increase in efferent arteriolar resistance alpha receptors greatly outnumber beta; moderate increase in
catecholamines would decrease RBF with little change in GFR
(C) A high plasma catecholamine level but large increases in them could stop GFR completely
(D) A decrease in afferent arteriolar resistance
14
Aldosterone comes from adrenal cortex and is under tonic control by ACTH but is separately regulated by the renin-angiotensin
system (increased by Ang II) and by potassium (increased by hyperkalemia); aldosterone increases renal Na+ reabsorption via
increasing Na+ channels and Na/K+ pump insertion in principle cells (it acts in the collecting tubule at mineralocorticoid receptors
[intracellular receptors] causing insertion of Na+ channels on the luminal side); also increases K and H secretion by up-regulating
principle cell K+ channels and intercalated cell H+ ATPases
66. Which of the following statements applies to aldosterone?
67. Extracellular bicarbonate (HCO3-) is not an effective buffer for which of the following?
(A) extrcellular fluid (ECF) T3/T4 are produced in the follicular cells and stored in thyroglobulin
(B) follicular cells
(C) interstitial fluid (ISF)
(D) parafollicular cells
70. Which of the following statements correctly describes a healthy 30-year-old woman with a
menstrual cycle of 26 days?
15
71. In contrast to motor units that fire later during a movement, motor units that fire at the
beginning of a movement Motor unit= 1 motoneuron and muscle fibers it innervates
Small motoneurons innervate a few muscle fibers (type I),
have the lowest thresholds and therefore fire first; have
(A) can be tetanized at a lower frequency of stimulation greater mitochondria content; generate the smallest force
(B) generate a greater amount of force but are highly resistant to fatigue; tetanized at lower freq.
(C) have a greater amount of glycogen stored within them Large motoreurons innervate many muscle fibers (type II),
have highest thresholds and therefore fire last; generate
(D) fatigue more rapidily the greatest force and either fatigue rapidly (IIb) or are
fatigue resistant (IIa); require higher freq to summate
tetany
72. A 45-year-old man is studied and found to have a respiratory rate of 15 breaths/min, a tidal
volume of 0.5 L and a dead space of 200 ml. The patient is asked to increase his respiratory rate to
30 breaths/min and his tidal volume is measured at 350 ml. Assuming no change in dead space,
which of the following is true regarding alveolar CO2 tension?
(A) The alveolar CO2 tension will increase because of the decreased ventilation.
(B) The alveolar CO2 tension will increase because of the increased ventilation.
(C) The alveolar CO2 tension will not change because it is not affected by respiration.
(D) The alveolar CO2 tension will not change because alveolar ventilation remains
constant.
73. A decrease in the osmolality of arterial blood would lead to an increase in urine volume by
74. Stimuli for aldosterone secretion include all the following EXCEPT
(A) angiotensin II
(E) hyperkalemia
(C) hypovolemia
(D) atrial natriuretic peptide (ANP)
75. Alteration in the amount of Ca2+ released from the sarcoplasmic reticulum (SR) alters the
force of contractions in which of the following muscle type or types?
16
76. Recruitment of additional muscle fibers alters the force of contractions in which of the
following muscle type or types?
77. Amplification of sound stimuli is the function of which component of the auditory system?
17
81. Extracellular bicarbonate ions do not serve as an effective buffer for
83. During a pre-employment evaluation for an executive position, a 35-year-old man is found to
have a serum calcium level of 12.4 mg/100 ml (normal 9-11), a serum phosphorus (phosphate) of
2.0 mg/100 ml (normal 3.0-4.5), a serum alkaline phosphatase of 150 U/L (normal 20-70) and a
serum parathyroid hormone of 800 pg/ml (normal 225-650). If untreated, the likely lesion
responsible for these findings will result in consequences mediated by which of the following
mechanisms? (pg. 421 1st Aid 2014)
High Ca2+, ALP and PTH with Low phosphate= describes primary hyperparathyroidsim
(A) Liquefactive necrosis “Brown tumors” due to fibrous replacement of bone, subperiosteal thinning; is either
idiopathic or via parathyroid hyperplasia, adenoma, carcinoma;
(B) Apoptosis (pg. 223) Metastatic Calcification= widespread deposition of calcium in normal tissue
(C) Metastatic calcification secondary to hypercalcemia (ie primary hyperparathyroidism, sarcoidosis,
(D) Oxygen toxicity hypervitaminosis D) or high calcium-phosphate product (eg CRF + secondary
hyperparathyroidsim); calcium deposits predominantly in interstitial tissue of kidneys,
lungs and gastric mucosa
84. Following a football injury, a 16-year-old boy survives a ruptured spleen, hemorrhagic shock and
profound hypotension. However, a period of severe oliguria follows. Which one of the following
renal tubular changes revealed by kidney biopsy represents irreversible cellular injury?
Irreversible
(A) Fatty change Nuclear pyknosis (shrinkage),
Reversible with O2
(B) Formation of cell blebs ATP depletion
karyorrhexis (fragmentation), karyolysis
Cellular/mitochondrial swelling
(C) Formation of myelin figures Plasma membrane damage
Nuclear chromatin clumping
Lysosomal rupture
(D) Nuclear pyknosis Decreased glycogen
Mitochondrial permeability/vacuolization;
Fatty change
phospholipid-containing amorphous
Ribosomal/polysomal detachment
densities within mitochondria (swelling
Membrane blebbing
alone is reversible)
18
85. A 65-year-old woman fell and sustained a pelvic fracture. The woman died after a short period
of rapidly progressive mental confusion and respiratory insufficiency. Numerous conjunctival
petechiae were noted. These abnormalities were most likely due to which one of the following
conditions? (pg. 603) Pulmonary emboli types: Fat, Air, Thrombus, Bacteria, Amniotic fluid, Tumor (FAT BAT)
Fat- associated with long bone fracture and liposuction, classic triad of hypoxemia,
(A) Epidural hernatoma neurologic abnormalities and petechial rash
(B) Aspiration pneumonia Amniotic- can lead to DIC, especially postpartum
Gas- nitrogen bubbles precipitate in ascending divers; treat with hyperbaric oxygen
(C) Fat embolism
(D) Saddle embolus occluding bifurcation of pulmonary arteries
86. All the following clinical disorders are appropriately matched with effector substances or
cells EXCEPT
(A) a 2-month-old girl with SCID (severe combined immunodeficiency) syndrome who
develops lesions in the skin, gastrointestinal tract and liver following a whole blood
transfusion-mast cells describing TA-GVH, girls immune system cannot defend against donor t-lymphocytes
(B) a severely jaundiced and anemic neonate with a positive direct Coombs (antiglobulin)
test-membrane attack complex (MAC, C5b-9, C5-9) Rh Abs are IgG which cross placenta and fix compliment
(C) a woman with a diffuse goiter, exopthalmos, rapid pulse and warm moist
skin--antireceptor antibody Graves= anti-TSH receptor Ab
(D) a boy with a blistering skin eruption following exposure to poison ivy-CD4+ T cells
Type I Hypersensitivity= anaphylactic/ atopic- free antigen cross links IgE on presensitized mast cells and basophils triggering immediate release of
vasoactive amines (histamines) that act at postcapillary venules; reaction develops rapidly b/c of preformed Ab; type IV involves t cells
87. A 17-year-old girl develops an acute syndrome characterized by low grade fever, lassitude,
pharyngitis, generalized lymphandenopathy and a palpable liver and spleen. A peripheral blood
smear reveals the presence of "atypical lymphocytes." A heterophil test for antibodies reacting
with sheep erythrocytes is negative. Infection with which one of the following viruses is most
likely?
Mononucleosis= characterized by lymphadenopathy, hepatosplenomegaly, fever
(A) Cytomegalovirus CMV= Characteristic “owl-eye” inclusions in mononuclear cells; heterophile -
(B) Epstein-Barr virus (EBV) mononucleosis;
EBV= heterophile + mono
(C) Measles virus
(D) Papillomavirus
88. A 70-year-old man is found to have a papillomatous neoplasm of the bladder. Even though
the lesion is extremely well-differentiated, the pathologist makes a diagnosis of transitional cell
carcinoma grade I (urothelial neoplasm of low malignant potential). The distinction of
"malignant" from "benign" in this instance was most likely based on which of the following
known general characteristics of this type of lesion?
pg. 541
Transitional cell carcinoma= most common tumor of urinary tract (can occur
(A) Appearance of oncofetal antigens in renal calyces, renal pelvis, ureters and bladder); painless hematuria (no
(B) Chromosomal aneuploidy casts) suggests bladder cancer; a/w problems in your Pee SAC: phenacetin,
smoking, aniline dyes, cyclophosphamide; histology: papillary growth lined
(C) Loss of contact inhibition in tissue culture by transitional epithelium with mild nuclear atypia and pleomorphism
(D) Clinical behavior
Grade= determined by degree of cellular differentiation and mitotic activity on histology; 1= low grade, well differentiated
Stage= degree of localization/spread on site and size of primary lesion, spread to regional LNs, presence of metastases;
Benign= usually well differentiated, low mitotic activity, well demarcated, no metastasis, no necrosis
Malignant= may be poorly differentiated, erratic growth, locally invasive/diffuse, may metastasize, decreased apoptosis 19
89. A 24-year-old nonsmoker who does not consume alcohol is found to have both pulmonary
emphysema and cirrhosis of the liver. A sister and several close relatives also have had similar
findings. This history suggests that this patients illness may be caused by a deficiency of
a1-antitrypsin deficiency= misfolded gene product protein aggregates in hepatocellular ER leading to cirrhosis
(A) al-antitrypsin (PAS + globules in liver); in lungs decreased a1-antitrypsin leads to uninhibited elastase in alveoli causing
decreased elastic tissue and panacinar emphysema; Codominant trait
(B) galactokinase B= hereditary (AR) deficiency, mild condition, galactose in blood and urine,
(C) glucose-6-phosphatase infantile cataracts; may initially present as failure to track objects or to develop a social smile
(D) phenylalanine hydroxylase C= Von Geirke disease, type I glycogen storage disease; AR deficiency, causes severe
hypoglycemia, hepatomegaly, increased blood lactate, increased glycogen in liver
D= PKU, AR deficiency, tyrosine is essential, increased pheylketones in urine, intellectual
disability, growth retardation, seizures, fair skin, eczema, musty body odor
90. Upper and lower gastrointestinal endoscopic examinations are performed on a 45-year-old
man. A lesion is found and the patient is told that the lesion has NO malignant potential. Of the
following choices, which is the lesion that was most likely found?
A=Adenomatous polyps are precancerous for colorectal cancer (CRC); the more villous
(A) Colorectal villous adenoma the higher cancer risk, also increases with increased size and epithelial hyperplasia;
(B) Crohn disease B=Chron disease carries relative risk of 5.6% for developing colon cancer
(C) Duodenal peptic ulcer C=Duodenal peptic ulcers are generally benign (vs gastric ulcers=increased risk of carcinoma)
D=100% progress to CRC; AD mutation in APC gene, pancolonic, always involves rectum
(D) Familal multiple polyposis
91. A 60-year-old man was seen because of progressive bone deformity and pain, progressive
hearing loss and increasing skull size. Workup revealed generalized increasing bone density with
cortical thickening , normal serum calcium and phosphorus, and markedly elevated serum alkaline
phosphatase. Biopsy revealed a characteristic "mosaic' pattern. Which one of the following tumors
is a known complication of the disorder suggested by this scenario?
20
93. A 21-year-old basketball player died suddenly during a game. Autopsy revealed hypertrophy of
the left ventricular wall, especially of the ventricular septum. Histologically, the myocardial fibers
were arranged in a disorganized pattern. Which of the following best characterizes this disorder?
Hypertrophic cardiomyopathy is cause of sudden death in
(A) Can be a manifestation of primary amyloidosis young athletes due to ventricular arrhythmia; 60-70% of cases
are familial, AD (commonly a beta-myosin heavy chain mutation;
(B) Can be a result of mycarditis Finding: S4 systolic murmur; rarely can be a/w Friedreich ataxia;
(C) Often demonstrates autosomal dominant inheritance diastolic dysfunction ensues, myofibrillar disarray and fibrosis,
(D) Is often associated with coronary artery disease ventricular hypertrophy often with septal predominance; (pg. 290)
Restrictive/infiltrative cardiomyopathy a/w amyloidosis; diastolic dysfunction, can have low-voltage ECG despite thick myocardium (esp. w/ amyloid)
Dilated cardiomyopathy a/w Coxsackie B virus myocarditis; systolic dysfunction, eccentric hypertrophy (sarcomeres in series)
94. Which finding would be LEAST expected in disseminated intravascular coagulation (DIC)?
DIC a/w increased BT, PT, PTT, decreased PC
(A) Increased fibrin degradation products Mechanism= widespread activation of clotting leads to
deficiency in clotting factors, which creates a BT
(B) Prolonged activated partial thromboplastin time Causes= STOP Making New Thrombi- Sepsis, Trauma,
(C) Prolonged prothrombin time Obstetric complications, Pancreatitis (acute), Malignancy,
(D) Thrornbocytosis (or Thrombocythemia)= increased platelets Transfusion;
Labs= schistocytes, increased fibrin split products (d-dimers),
Note in von Willebrand disease would see increased BT but decreased fibrinogen and factors V and VIII
normal or increased PTT; PC and PT unaffected
95. Which of the following findings is most likely in the cerebrospinal fluid (CSF) of a 10-dayold
infant with a high fever and nuchal rigidity? CSF Findings in Meningitis
(Opening Pressure) OP Cell type Protein Sugar
Fever + Nuchal Rigidity= Meningitis!
Bacterial up PMNs up down
(A) Decreased protein, decreased glucose Fungal/TB up Lymphos up down
(B) Decreased protein, increased glucose Viral norm/up Lymphos norm/up norm
(C) Increased protein, decreased glucose Causes of Meningitis
Newborns (0-6M)= Group B strep, E coli, Listeria
(D) Increased protein, increased glucose Kids (6M-6Y)= S. pneumoniae, N. meningitidis, H. influ (B), Enteroviruses
6-60y= S. pneumoniae, N. meningitidis (#1 teens), Enteroviruses, HSV
60+= S. pneumoniae, Gram-neg rods, Listeria
96. In an experimental model, an autopsy study of a rat exposed to toxic doses of carbon
tetrachloride (CC14) revealed fatty change and necrosis of hepatocytes. The mechanism of cell
injury exemplified here is
(pg. 224) Free radicals damage cell via membrane lipid peroxidation, protein modification
(A) activation of apoptosis and DNA breakage; can be eliminated by enzymes (glutathione peroxidase, catalase,
superoxide dismutase), spontaneous decay, antioxidants (vitamins A, C, E);
(B) acute phase reaction
(C) arrest of cell cycle Pathologies include: retinopathy of prematurity, bronchopulmonary dysplasia, reperfusion
injury (esp. after thrombolytic therapy), iron overload (hemochromatosis), Acetaminophen OD
(D) free radical injury (fulminant hepatitis, renal papillary necrosis), CCl4 leading to liver necrosis (fatty change)
97. Mutations of the ras oncogene result in a protein product that has
RAS a/w colon, lung, pancreatic cancer; gene product= GTPase
(A) decreased GTPase activity Oncogenes cause gain of function= increased
(B) decreased reverse transcriptase activity cancer risk; only 1 allele need be damaged for
(C) increased protein phosphatase activity expression of disease
Tumor Suppressor Genes cause loss of function=
(D) increased responsiveness to growth factors increased risk of cancer; both alleles must be lost
for expression of disease
21
98. A 68-year-old woman presents with fever, chills and cough productive of blood-tinged
sputum. Fluid aspirated from the right pleural space would most likely
S. pneumoniae #1 cause pneumonia in adults and elderly
(A) be clear and straw colored in appearance.
(B) contain large numbers of neutrophils.
(C) have a glucose content somewhat higher than the serum glucose .
(D) have a protein content of less than 1g/cll.
99. Prior to the birth of a still-born infant, decreased amniotic fluid (oligohydramnios) for
gestational age was demonstrated on ultrasound examination. Which of the following autopsy
findings of the stillborn is most consistent with this maternal-fetal abnormality?
(A) Infection with Toxoplasrna gondii along with microcephaly, hydrocephaly, chorioretinitis
and micropthalmia
(B) Infection with rubella virus along with microcephaly and heart malformations
(C) Infection with cytomegalovirus along with microcephaly, hepatitis and intracranial
calcifications p.522- Potter Sequence (syndrome)= oligohydraminos via
(D) Bilateral renal agenesis and hypoplasia of one lung ARPKD, posterior urethral valves, or bilateral renal agenesis;
a/w pulmonary hypoplasia, twisted face and skin, extremity
defects, renal failure (in utero)
100. An adult patient is evaluated for splenomegaly. Which of the following sets of associated
findings would be LEAST likely?
101. All the following are associated with carcinoma of the urinary bladder EXCEPT
Transitional Cell Carcinoma of Bladder= a/w aniline dyes
Squamous Cell Carcinoma of Bladder= chronic irritation of bladder leads
(A) early hematogenous metastasis. to squamous metaplasia they dysplasia and carcinoma; risk factors incl.
(B) hematuria. Schistosoma haematobium (middle east), chronic cystitis, smoking,
chronic nephrolithiasis;
(C) high recurrence rate. Both= painless hematuria
(D) increased incidence in analine dye workers.
Carcinomas typically spread lymphatically and sarcomas hematogenously; exceptions to carcinomas= renal cell, hepatocellular,
follicular carcinoma of thyroid and choriocarcinoma, which all spread hematogenously
102. Which of the following parathyroid disorders is characterized by renal end-organ
unresponsiveness?
22
103. A 56-year-old woman presents with bone pain, diffuse demineralization of bone,
hypercalcemia, anemia, hypergammaglobulinemia, proteinuria and normal serum alkaline
phosphatase. This set of findings is most suggestive of
Signs of Multiple Myeloma: clasma cell cancer, primary bone tumor in
(A) Ewing sarcoma. adults, is a hyperproteinimic state
Bone pain- increased clasts= lytic lesions, hypercalcemia
(B) hyperparathyroidism. Anemia
(C) multiple myeloma. Renal Failure
(D) osteomalacia. Infection
Neurologic symptoms
Monoclonal antibody spike- usually IgG or IgA (hypergammaglobulinemia)
(A) Heterotrophs
(B) Aerobes
(C) Obligate anaerobes Lack catalase and/or superoxide dismutase and are thus susceptible to oxidative damage
(D) Facultative anaerobes
23
108. The expression of the lac operon Allolactose is an inducer that binds to the
repressor protein changing its confirmation
so that it cannot recognize the operator
(A) must be initiated by the binding of an inducer protein. and expression of the lac operon takes place
(B) involves the release of allolactose from a repressor protein.
(C) does not involve the expression of structural genes.
(D) necessitates the finding of RNA polymerase followed by transcription.
(A) Transformation
(D) Conjugation
(C) Transduction
(D) Transcription
112. Which of the following organisms causes relapsing fever and is transmitted by lice or ticks?
(A) Vibrio cholerae Shigella invade cells lining the colon, they replicate within in the host cell
(B) Vibrio parahaemolyticus cytoplasm (unlike salmonella, which do so in a vacuole) and thy spread
(C) Salmonella typhi by cell to cell transmission, evading host immune response (salmonella
spread hematogenously); shigella causes infiltration of PMNs in turn destabilizing
(D) Shigella sonnei the integrity of the intestinal cell wall and giving them access to deeper epithelial cells
24
114. Which of the following is the most frequent cause of blood transfusion-associated hepatitis?
Virus Transmission
(A) Hepatitis A virus HAV Fecal-oral
(B) Hepatitis B virus HBV parenteral, sexual, maternal-fetal
HCV primarily blood (IVDU, post-transfusion)
(C) Hepatitis C virus HDV parenteral, sexual, maternal-fetal
(D) Hepatitis D virus HEV fecal-oral, especially with waterborne epidemics
(A) caliciviruses
(B) flaviviruses
(C) papovaviruses smallest virus, only SS DNA virus
(D) parvoviruses
116. Which of the following is an RNA virus that has a nuclear phase to its replication process?
117. A 15-year old dirt biker visiting southern California has pneumonia caused by an organism
whose environmental form consists of hyphae that break up into arthroconidia, which become
airborne. What is the agent?
(A) Aspergillus fumigatus Cocci immitis is a dimorph; has barrel-shaped arthroconidia formed in hyphae
at room temperature; forms endospore filled “spherules” in tissues; causes Valley
(B) Blastomyces dermatitides Fever endemic to southern California
(C) Coceidioides immitis
(D) Histoplasma capsulatum
(A) Coenocyte
(B) Hypha
(C) Mycelium
(D) Septum
25
119. What characteristically sets fungal cells apart from human cells?
120. A patient whose major source of protein is smoked and cooked fish develops what appears to
be pernicious anemia. What parasite is noted for causing a look-alike vitamin B 12 anemia in
certain genetically predisposed infected individuals?
122. Which of the following is the tapeworm acquired from eating undercooked pork?
(A) Trichinella spiralis Trichinosis via ingestion of undercooked pork that contains encysted larvae
(B) Taenia soliwn Taenia solium= pork tapeworm
(C) Taenia saginata Taenia saginata= beef tapeworm
(D) Echinococcus granulosus associated with sheep farmers, humans are accidental host, eggs ingested, larva hatch
and penetrate the intestinal wall, enter circulation and are carried to various tissues,
primarily liver and lungs but brain and bone also common
(A) IgD
(B) IgA
(C) IgM
(D) IgE
26
124. What type of hypersensitivity reaction is responsible for myasthenia gravis?
126. Which of the following immunoglobulins (Ig) is at its highest level in a normal adult?
IgG= main antibody in delayed response; most abundant in serum; fixes complement, crosses placenta,
opsonizes bacteria
(A) IgA IgA= prevents bacteria and virus attachment to mucous membranes; does not fix complement; released in
secretions; most abundant produced overall
(B) IgG IgM= produced in immediate response to antigen; fixes complement; doesn’t cross placenta; monomer on
(C) IgM B cells; pentamer when secreted
IgE= binds mast cells and basophils; mediates type I hypersensitivity through release of histamine (etc.);
(D) IgE mediates immunity to worms by activating eosinophils; lowest concentration in serum
IgD= function unclear
127. Which of the following is the antidote for the toxin Benzodiazepines?
(A) Flumazenil
(B) Methylene blue
(C) Deferoxamine
(D) Alkalinize urine
128. Which of the following is the antidote for the toxin Lead? EDTA, dimercaprol, succimer, penicillamine
27
129. Which of the following is the primary site of activity for the drug Warfarin?
(A) Kidney
(B) Liver
(C) Blood Heparin
(D) Heart
130. Which of the following drugs is associated with the reaction of Cinchonism?
131. Which of the following drugs is associated with the reaction of Stevens-Johnson syndrome?
Anti-epileptic drugs (ethosuxamide, carbamazepine, lamotrigine, phenytoin, phenobarbital)
(A) Valproic acid Allopurinol
Sulfa drugs
(B) Quinidine Penicillin
(C) Isoniazid
(D) Ethosuximide
132. Which of the following drugs is associated with the reaction of Tendon dysfunction?
Flurooquinolones= Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin (the -oxacins), and
nalidixic acid; inhibit DNA gyrase (topisomerase II) and topoisomerase IV; cannot take
(A) Digitalis with antacids; tx gram negative rods of urinary and GI tracts (including pseudomonas),
(B) Niacin Neisseria and some gram positives
(C) Tetracycline
Most common SE= GI upset, superinfections, skin rashes, headache, dizziness; less
(D) Fluoroquinolones commonly cause tendonitis, tendon rupture (pts >60Y and in those taking prednisone),
leg cramps and myalgias
134. Which of the following drugs is associated with the reaction of extreme photosensitivity?
Photosensitivity= STAT For Photo
Sulfonamides, Amiodarone, Tetracyclines, 5-Fu
(A) Digitalis Gynecomastia
(B) Niacin Facial flushing via prostaglandin not histamine, hyperglycemia, hyperuricemia
(C) Tetracycline
(D) Fluoroquinolones
28
135. Which of the following is not related to a drug toxicity of Prednisone?
SE: weight gain, central obesity, muscle breakdown, cataracts, acne, osteoporosis,
(A) Cataracts hypertension, peptic ulcers, hyperglycemia, psychosis
(B) Hypotension Iatrogenic Cushing Syndrome= buffalo hump, moon facies, truncal obesity, muscle
(C) Psychosis wasting, thin skin, easy bruisability, osteoporosis, adrenocortical atrophy, peptic ulcers,
diabetes (if chronic)
(D) Acne Adrenal insufficiency when drug stopped abruptly after chronic use
137. Which of the following is not considered a class IA Sodium Channel blocker?
IA= “The Queen Proclaims Diso’s pyrmaid”
Quinidine, Procainaimide, Disopyramide
(A) Mexiletine IB (Amiodarone can be classified under every class)
(B) Amiodarone
(C) Quinidine
(D) Procainamide
138. Which of the following is not directly related to a drug toxicity of Ibuprofen?
139. Which of the following is not a side effect of the Ace Inhibitor (Captopril)?
Captopril’s CATCHH: (1st Aid)
Cough (dry), Angioedema (contraindicated in Cl esterase inhibitor deficiency),
(A) Rash Teratogen (fetal renal malformations), increased Creatinine (decreased GFR),
Hyperkalemia and Hypotension;
(B) Angioedema
(C) Cough (wikipedia) CAPTOPRIL= Cough, Angioedema, Proteinuria, Taste change, hypOtension,
(D) Congestion Pregnancy problems, Rash, Increased renin, Lower pressure (lack of vasoconstriction)
140. Which of the following is not a side effect of the Vasodilator (Nifedipine)?
SE of CCBS: Cardiac depression, AV block, peripheral edema, flushing, dizziness,
hyperprolactinemia, constipation; Verapamil and Nifedipine also causes
(A) Nausea gingival hyperplasia
(B) Flush appearance
-dipines= Dihdyropyridine CCBs
(C) Vertigo Diltiazem, verapamil= Non-dihydropyridine CCBs
(D) Sexual dysfunction
Beta blockers and H2 blockers cause
impotence; SSRIs cause decreased
libido and anorgasmia
29
141. Which of the following is not a side effect of the Sympathoplegics (Clonidine)?
145. Which of the following are not treated with opioid analgesics like (dextramethorophan and
methadone)?
30
146. Which of the following is not treated with Hydrochiorothiazide?
150. Which of the following is the antidote for the toxin Heparin?
(A) Protamine
(B) Methylene blue Methemoglobin
(C) N-acetyleysteine Acetominophen
(D) Glucagon Beta Blockers
31