Heme synthesis cycle- know the rate limiting step
Cholesterol synthesis - know the rate limiting step
Enzyme kinetic graph with increased Vmax. Likely cause? Overexpression of of Kinase gene
Vitamin.A deficiency (skin problems and dry eyes and blurred vision at night)
Thiamine deficiency in HMP shunt (causes reduction in RBC transketolase activity)
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1. Biochemsitry: not many, but know ALL the enzyme-related dz, DNA/ RNA stx and enz. working mechanism, enzyme-kinetics.
7.
1
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, one q on HOX genes--had no idea,
3-4 questions on identification of inheritance patterns-one was mitochondrial pattern
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o16.PKU, Maple syrup disease ( what enzyme), vegan mother .kid with presentation. ( sorry can™t recall the detail).urine shows methamalonic acidvoilaB12 deficiency, Alcoholic with thiamine deficiency, Few questions on different biochemical pathwaywith glucagon and Insulin effect.18.Glucose-6 phosphatse deficiency, Carnitine deficiency, MCAD deficiency
19.Lesch_Nyhan syndromewhat enzyme, Tay-Sachs disease
20.I had atleast 3-4 questions on different dyslipidemias
21.How Hydroxyurea is used to make HbFto help in sickle cell disease.2
Biochemistry/genetics:
1: HGPRT deficiency with typical case scenario
2: HGPRT defieicency, which substance accumulated .. GMP
3: Glucose to gluose 6 phophate, reaction requiring .. ATP to ADP
4: Diabetic mother, child born with Hypoglycemia, which pathway affected .. confusing answers, i checked Hepatic gluconeogenesis ?
5: Child born with biliary atresia n severe jaundice, which vitamin deficeint after 1 month .. all were water soluble vit in answers, no fat soluble mentioned .. folic acid, vit B6, Vit B12, vit C .. i checked folic acid ??
6: Vit C deficiency
7: Ch lead poisoning with histo slide, asked which diagnostic test confirmatory .. raised delta aminolevulenic acid
8: Glucose 6 phosphatase deficiency with confusing scenario mixing with Galactose metablism disorder ?
9: Vit D deficiency linked to chronic renal failure
10: Few questions ab chances of homozygous/ heterozygous with diease identificaiton in stem
11: Rickets presentation
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* Pic ofDNA replication, where is helicase? A.. at the fork unwinding. * Few cases of modes of inheritance.
*.
* Case of pt taking anti-depressive eats cheese and wine having headacheA.. MOA inhibitors + tyramineA.. hypertensive crisis.
* Case of G6PD deficiency A.. decrease in NADPH leading to hemolytic anema. * Case ofMcArdled£TMs dis. What is deficient? Glycolosis or Gluconeogenisis?
.
A~ Case of PKU
A ~ Case of Alkaptonuria ..dark urine.
A~ Case of Lesch-Nyhan syndrome ..hyperurisemia, def. In HGPRT. ~
A ~r.
A ~ Case ofDown Synd.A.. meiotic DISJUNCTION ofHOMOLOGOUS chromosomes. A ~ Case of DuchennedTMs Ms
Dystorphy A ..defect in dystrophin gene which results in hypertrophy in calf muscle, replaces with fat. Dx with biopsy. A ~
* ~ choice. -,
* Mech. Of action of AllopurinolA.. inhibits xanthine oxidase. * Side effect ofPTUA.. agranulocytosis.
* One half life problem. J * Pt has anemia after taking anti malarial drug, what dei Does pt have?A.. G6PD dei
* One case with cardiac cycle.
* Case of new born with bleedingA..def. Vit K.
* Case of child with Necator americanus infection and anemia why? A.. dei of iron.
* Case ofD. latum infection and anemia why?A.. BI2 dei that leads to megalogblastic anemia.
14.
19. vitamin b12 def 20. thiamine def in alcoholics 21.
Biochem
frameshift mutation
topoisomerase (what is their function)
promoter sequesnces
intron vs, exon
3' polyadenylation
tRNA charging
Northern Blot
several pedigrees
several Hardy Weinberg questions
Pompe's Disease
Hunter's syndrome
Ehlers-Danlos syndrome
Osteogenesis Imperfecta (picture of kid with blue sclerae)
carnitine shuttle for fatty acids
many, many questions on G-protein linked 2nd messengers (make sure you know all the ANS receptor types and what type of 2nd messenger it is linked to---it was SO MONEY to know that)
many insulin/glucagon questions
several questions on arachidonic acid pathway
kwashiokor vs. marasmus
enzyme kinetics
CO2 transport in blood (which way does the Hb curve shift)
which vitamins are fat soluble
vitamin A deficiency (can cause alopecia)
>g
>>47. Where is mRNA made in the cell?
>48.>?
>>69. Know steps involved in doing a PCR.
>
>1
>1
>16. mitochondrial inheritance -2 q's
>17. >18. pku
>19>
.
Hardy Weinberg population genetics calculations
Glucose-6-phosphate dehydrogenase deficiency and reaction to sulfa drugs
Which a.a. become essential in a patient with PKU with phenylalanine restricted diet:
Answer: tyrosine
PPatient presents with muscle weakness and hypertrophy of calf muscles, which chromosome is defective?
Answer: X chromosome (DMD)
Uncoupling agents and on which part of mitochondria they work?
Anwer: dissipate proton gradient across the inner mitochondrial membrane
Urea cycle
Arachidonic Acid products (very heavily tested, at least 5 questions)
Collogen Synthesis and structure
Vitamins (heavily tested):
B1 (alcoholics)
B2 (cofactor in oxidation and reduction-FADH2)
B6 (given along with isonizid to prevent peripheral neuropathy)
Vitamin C (hydroxylation of proline and lysine in collogen)
Vitamin D (which organ hydroxylates 25 hydroxy D3 at alpha1 position: kidney)
2 questions on Huntington Disease:
trinuclear repeat pattern
point to Caudate Nuclei on MRI
BIOCHEM
-DNA mutations
-where in cell introns are removed
-tRNA attachemnt to ribosomes
-modes of inheritence (I actually had one ask me the chance of a MAN passing an X-linked recessive gene to a son, read CAREFULLY)
-urea cycle
-carnitine
-glucokinase vs. hexokinase kinetics
-enzyme kinetics
-prednisone
biochem...my weak area was thankfully easy. mostly rate limiting enzymes , insulin- glucagon world, enzyme defeciencies.
molecular biology ws the toughest part for me. there were qs i had no clue. i cant even remember the qs properly now. some were ok too like anticipation, hardy weinberg calculation, and simple punnet square calculations.
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knock out mouse with defect in ubiqutin gene...result-->
knock out mouse with defect in special integrin gene, what causes in lymphocyte action--->
yup, ubiquitin ar sevral classes of protein like e3 ligase. it causes polyuiquitination. proteasome will come and degrade the protein that are ubiquitinated. most imp example is nf-kb. this is th most imp transcription factor in immunity.in the absence of ubiquitin, u cant activate nf -kb as there will not be any degradation of ikb associated with nf-kb, which are inhibitory to nf-kb. so u mus remember that apart from decreased protein turnover, loss of ubiquitin will affect inflammatory response in cells as ubiquitin is must for nf-kb activation.
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.
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was one question on HOX on asso of HOX with uterine anomalies, s.. MCAD deficiency, McArdles, Achondroplasia and Huntingtons and Neurofibromatosis were all there
Biochemistry: a lot of qs about transcription, say what kind o mutations, a lot related with alcohol, tehy were ones really odds, vitamins,
Genetics:a lot of qs with q2, what is the amount of carriers in a population.
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¢
BIOCHEM N GENETICS
1.AS GOLJAN UNCLE SAYS ALL PATHWAY REGULATING ENZYMES WTH THEIR RESPECTIVE DEF DISEASES--V IMP
2.GLYCOGEN STORAGE DISEASES
3.AMINO ACIDS N FATS RELATED TO VARIOUS DISEASES
4.JUST TRY TO TAKE "THE BIG PICTURE"FRST N THEN U WILL BE ABLE TO INTEGRATE
5.GENETICS BE SURE ABT THE GENETIC DIAGNOSIS
METHODS N THEIR PARTICULAR DIFFERENCES
bichemistry
nieman picks
carnitine deificiency
pyruvate kinse def
g6pd def -- 4/5 q--caused by drugs -- primaquine, sulfonamides
vit b12-- 4/5 q
thiamine-- alcoholic
folate-- pregnancy 3q
mol bio
a-t c-g bonds
dna gyrase
tata box
7 methyl guanosine cap
restriction endonuclease-- 4q
2 transgenic mice exp -- answerable
unhybridised loops on mRNA
dna recombinant technology
@BEH.SCI.:
*phobia case-in patient with artificial pacemaker.
*factitious disorder-path.lab worker with hematuria.
*one girl stopped going to school after an vehicular accident.
*Informed concent-mentally retarded patient for hernia repair.
*old patient-came with 2 daufgters-how will you startetc.
*Teen comes with STD,asks not to tell her parents
*female worker with nuchal rigidity-onlt at work,no pain at weekends-what will you suggest?stetching exercise/ask more about her posture/work depression.
*MCAD deficiency-dicarboxylic aciduria
*Maple syrup urine disease-valine was in choices.
*Ac.porphyria-with alcohol
*patient with malabsorption-fat soluble vit.supplementation is needed.
*MOA of brown fat in newborn-uncoupling agent
*pilot on 3days fasting-action of glucagon
*arginino succinate in urea cycle
*patient on pure veg.diet-what deficiency?..CHO/protein/fat/minerals
*deficiency of tyrosine-effect on which neurotransmitter?Ach/NE/GABA/dopamine
@MOL.BIO.&GENETICS:
*2 pedigree qs
*photo of a girl with blue eyes-defect in?..precollagen-1
*why some diseases are common in A.jews?-vague options.
* DNA synthesis in nucleus &RNA synthesis in cytoplasm-how is it possible?
Nucleus/nuclear pores/chromatin.
*2qs on southern blot,northern blot &other immunoassays.
*mutation at TATA box
*given numbers to codons-asked how many codons are translated?you have to identify stop codons and answer accordingly.
*some one liner qs on transcription/translation
*mutation in glucuronyl transferase enz.in a case of Gilbert`s syndrome.
*adopted kid-wilson`s disease-keyser fleisher ring
*I-cell disease
*anticipation
*no Hardy-wienberg!!!!!!!!
¢ Aldose reductase: converts galactose to galactitol. What is harmful effect of this?
¢ Ans: Galactitol can cause cataracts.
¢ Pt's description classic for diarrhea, dementia, dermatitis - I think the answer is Hartnup's which can cause the pellagra
¢ Adenosine deaminase defic (ADA defic) can cause what? Ans: SCID
Some bacteria make Vit. K, thus if you give an ABX, would expect to see Vit. K levels to decrease. DZZ'A-r rich DNA has low .tpeWng~polnt than_ rich DNA due to different numbers of hydrogen bonds formed between the bases~~
KNOW WELL: Potymerase chain reaction- why you do It, how you do it, materials needed, etc.(4 questions at least)
Know electrophoresis- what it is, why you do it. how to read a drawing of one (3 questions)
Know restriction endonudeases -what they are, why you use them, palindrome sequences are usually cut (be able to recognize a palindrome)
Transition, transverslon, deletion, frame-shift mutation, nonsense mutation, missense mutation, silent mutation, Introns, exons, cap and tall on mRNA (what are they and when are they put on)
Remeber thymine in DNA, uradi in RNA
Understand the E.cdi In opernn (operon, promoter. repressor, co-repressor, Inducer, etc.) Understand transcription and translation VERY WELL (primers, sigma factor. 3as and 50s
ribosomes, translocation, DNA and RNA polymerises, elongation, TATA box) both in eukaryotes and prokaryotes
WA light damages DNA by indudng formation of thymine dimers (dinical--xemderma pigmentosa)
Upid storage disease/mucopolysaccharidoseslgiycagen storage diseases- thXKNOW WELL¢ Receptor signal transdudion. In other words, second messengers for each receptor subtype (CAMP, IP3&DAG, ion gated channels, etc.)
)
Biochemistry:
1) Alkaptonuria, ?parents asked u about long term prognosis: ?arthritis*, ?renal calculi
2) Pathogenesis of CGD of childhood
3) Menkes disease, MOA
4) In which part of the cell removal of the introns from mRNA take place?: _nu_c_le_i*?, RER? Golgi? Etc
5) CF, MOA receptor, CF transmembrane conductance regulator gene ---+ defect in CI-channels* (CF is HY, many qs)
6) SCD (but not in q stem), they said disease caused by substitution val for glu, question about which type of bond of bond is affected ....
7) Mother Hx of myelomeningocoele, son with MMC, which vitamin decreases risk for this abnormality? Folate*
8) Hypercholesterolemia, ?pathogenesis: ans description of LDL receptor (Receptors and second messengers r extremely HYI)
9) tRNA wobble diagram, asked to show site of different functions (2 qs .. similar q in
retired or self test)
10) Fetal alcohol sy: 2 qs
11) Tx child with hyperammonemia, etc
12) ?Reason some pts get lactic acidosis post alcohol ingestion .... know everything u can
about OH
13) McArdle's described, ? enzyme: muscle phosphorilase
14) Von Gierke's*, description disease
15) Drawing IG, where does the Ag bind?
16) Multiple skin ca (xeroderma pigmentosum), ?what's wrong; DNA repair defect*
17) Mother has 2 y old son wi MPS wi decr iduronidase and wiN chromosomes, now she is pregnant again, amniocentesis is done, demonstrated decr iduronidase, what else is necessary to be done: ?check for MPS in amniotic fluid*, ?chromosomal analysis, ?fetal biopsy of the liver, ?mothers liver biopsy
18) Prader Willi sy, paternal imprinting, microdeletion 15q*
-WHICH ANTINEOPLASTIC DRUG REACTS WITH DNA DIRECTLY A)MTX B)CYCLOSPORINE
3-5-FU D)VINCA ALKALOIDS
4-. USE OF GABAPENTIN
5-an anti tb drug hepatotoxic,hyperurecemia acting against only intracellular bact..pyrazinamide
6- Lots of MOA, few side efeects
7-HIV pt on drug present w/anemia, what cause it
8-How Hydroxyurea is used to make HbFto help in sickle cell disease
9-Rat poisoing what to give ptonly vit K wasn™t an optionbut there was fresh frozen plasma,
10-What to give in CMV infection if resistant to ganciclovir.foscarnet, One question on HIV medsHAART regiminforgot what it was.
11- Legionella what drug to use, Staph Aureus what drug to use, N Gonnorhea what drug to use,
12- Drug for helminth, S/E of malaria drug
13-.Question on CVS, ANS drugswith graphsI made my best guessnot sure if I did right or wrong, Renal drugs, M/O of phenytoin and carbimazapine, Haloperdol, M/O buripion ( FA says still unknownI had to guess), S/E of TCA, Some CTY P450 related questions, 2-3 picture asking where the drug works
14-Aspirinblockinglowers what, TXA2
15-??), Neurotransmitter decrease in Huntington ..only they didn™t mentio in was Huntingtonyou have to figure that outI choose GABA, SuccinylCholinsaying aneasthetic drug causing flaccid paralysis..what drug?
16-Pt taking already two drug for hypertension and saying you add 3rd drug to control pressure but causes hyperkalamia.what drug..ACE inhibitor
17-Sidenfil and nitroprissidewhat happens, Birth control pill associated break through bleeding in contex of CTY P450 drugs.
18-pharma.... easy.mostly MOA and resistance. antiviral and chemotherapy drugr tested heavily
19-know minoxidil also give a B-blocker with it
Zero order elimination question
bethanachol question
physostigmine question
2 alpha-1 blocker questions
what drug pheochromocytoma
Erythromyocin cyp inhibitor
20-Na channel blocker that increases QT
2 warfarin questions
Thrombolytic question
Methotrexate and leucovorin
Bleomycin question
Vincristine and neurotoxicity
21-.they love to ask MOA of warfarin-Rx for AF,bleeding diathesis c cimitidine(gyn.mastia) monitor PT,preg CI(*) 2,7,9,10/anti vitK.heparin-safe in preg/antithrombin3/???INR, stk/tpr plasmin-plasminogen etc etc.BPH/ca.prost.......
22-pharmacology
1 doxorubicin : intercalatred dna or break strand DNA?
2 mech of colchicine :inhibit microtubule
3 rupture appendicites : atb cefotaxime+genta or pipercilin/tazobactam?
4 s/e of dramamine : urinary tention
5 old people need to use digoxin need to check liver or renal function or both
6 orlistat SE steatorrhea
23-A father brings his child to the ER, he was fixing the sink that is usually locked cozz they keep different poisons there but he got careless and his kid drank one of the poisons. they have fumigators, sprays and rat poisons there, what is the teatment for this pt. I forgot the patient is bleeding from the gums.
a) deferoxamide
b) Atropine
c) fresh frozen plasma
d) EDTA
e) Naloxone
24-what is the mech of action of Sparfloxacin???
a) inhibit protein synthesis
b) inhibit cell wall synthesis
c) inhibit DNA polimerase V
d) inhibit DNA Gyrase
e) Competes with para-aminobenzoic acid
25-PHARMAC : Many many Q from this ...but they were easy and simple..need to memorise all tiny tiny side effects for some Q.Had 2 graphs from pharmaco dynamics regarding potency and efficacy and also from ANS with drug X and norepinephrine etc
26-For example, how does tetracycline work? Ans: by inhibiting attachment of tRNA to the ribosome. Something like that. Study also the AIDS drugs. As usual, what action of drug at the molecular level.
27-Drug for methotrexate
1. What drug is usually given as pre-treatment for leukemia chemotherapy?
- allopurinol
2. Drawing of nephron. Where does this diuretic act?
3. Which of the following anti-diuretics works by inhibiting the Na/K/2Cl transporter?
- furosemide
28-1. 25 y.o male who went hiking in the woods 2 wks ago. He was treated with a penicillin drug for throat infection. PE shows linear erythematous rashes over arms, legs, hands. What is the cause?
- photosensitivity
- Varicella-Zoster
- Hypersensitivity
(I answered photosensitivity
29- Px with greenish ear discharge, with a fruity smell. What is the antibiotic of choice?
30-focus on antimicrobials with emphasis on pneumonias,some complicated drug interactions,MOA of neoplastic{favourite was doxorubicin and vincristine
31-on acyclovir- they want you to know that for it to function it needs à thymidine kinase (phosphorylates DNA polymerase
32-Q on how NSAIDS affect the kidney in general à INHIBITS prostaglandins. What does that mean? Prostaglandins œDilate the afferent arteriole and if inhibited GFR will dec- watch if for patients with renal failure.
33-NE release from adrenal gland medulla is mediated by? Ã Ach
34-Q on site of action of drugs tricyclic antidepressantsà inhibits reuptake of NE
35-Q describes Reye™s syndrome and ask what is the mech of action of the drug that causes it à Irreversibly inhibits cyclooxygenase(COX-I and COX-2) that is Aspirin
36-Q on what is the advantage of COX-II inhibitors à It only plays a role in inflammation ONLY and does not give any GI side effects (GI lining which is protected by COX-I inhibited by Aspirin
37-Q on which drug to add in a patient on NSAIDs and GI upset à add misoprostol (Note that misoprostol should NOT be given to pregnant women because it is abortifacient
38-Q you must know the Mech of action of streptokinaseà conversion of plasminogen to plasmin to aid in thrombolysis.
39-Q about the efficacy and potency curves for drugsknow the diagrams in FA p299 p300. This is ALWAYS in the exam.
40-Q about the most common side effect of Calcium channel blockersà Flushing
41-Q about the substitute to ACEI in case of its coughing side effect à LOSARTAN (AgII receptor antagonist)
Q about the drug (s) that cause SLE like symptoms à Procainamide
Q about the P450 inhibitorsà Cimetidine is almost always in the answer choices
Q about a drug that blocks gastric acid secretions even in the presence of Ach à omeprazole
Q on accidental injection of NE into tissues what to give to prevent necrosis à Alpha blocker
Q on patient who has mania and seizures whch drug to give to treat both à valproate
Q case decribes hemorrhagic cystitis what drug causes it à cyclophasphamide
Q on what is used to treat the hemorrhagic cystitis of cyclophasphamide à mesna¢
42-Q on a pt. is using 3 or 4 different drugs names listed) and present w/ some symptoms. Which drug can be substituted to prevent the cough? Losartan
43-Q shows a pic where drug X is stimulating muscular contractions while Drug Y is inhibiting muscular contractions. ID? Ã Most of the time they have Atropine and Succinylcholine as X and Y.
44-
Q on the MOA of Ketoconazole? Ã Inhibit ergosterol synthesis
Q on the MOA of tetracyclines? Ã Prevents the attachment of amino-acyl tRNA to the ribosome
Q on a Pt. who has Herpes, what™s the tx? Ã Acyclovir
Q on Parathion (organophosphate) poisoning along w/ it™s symptoms how ou treat it? Ã Atropine
Q on a Pt w/ Wilson™s disease. Tx? Ã Penicillamine
Q describes a Pt who has a prolactin secreting tumor.Tx? Ã us Dopanine Agonist
Q asks about aecond messenger of Nitroglycerin? Ã CGMP (FA 324)
Q describes a Mother who is pregnant, what anticoagulant should be used? Ã Heparin
Q on the MOA of 5-FU? Ã Bioactivation of FdUMP which leads to decrease dTMP
Q Tell you about hemorrhagic cystitis caused by cyclophosphamide and asked the MOA? Ã Alkylating agent which covalently cross link DNA at guanine N-7.
Q asks why penicillin not effective against Mycoplasma. Has cholesterol in its bacterial membraneNOTE - œno cell wall might not be an answer choice.
45-Q ask about 5-fu mode of action à inhibit thymidylate synthase.
Q to trt Teenager with acne à tx is tetracycline
Q on which hormone has affect on renal vasculature à dopamine
Q where you must know the mech of action of Sertralineà inhibit the neuronal reuptake of serotonin
Q on how you treat influnza A Ã neuranunidase..
46-on a patient taking an antiarhythmic has pulmonary fibrosis. Ã amiodarone.
47-Q on a guy who just turned positive for a TB testà Give INH with Vit. B6.
48-Q on Allopurinol MOA....diagram will be given. Locate where it acts à xanthine oxidase inhibitor
49-Q on colchicines MOA Ã inhibit microtublules
50- about a kid who has asthma, what should be given during an acute episodeà albuterol
51-on a women who was put on warfarin- what allergy medicine should be avoidedà cimetidine
52- describes a woman who has an oral candidiasis... what drug should be used. Ã nystatin
53-describes a patient on ahypertensive medication and now he is allergic to sulfa- what to give? Ã Ethacrynic acid
54-Q on which Beta-blocker not to give an asthmatic à propranolol
55-Questions Prophylaxis for accidental healthcare worker exposure to TB (Rif for a month)
56-on which antibiotic would you not prescribe an eight year old. Ã Tetracycline
57- activators of the P450 system and one question on inhibition of P450. FA 336 DRUG reaction table is a MUST KNOW.
58-Qss always asked in the exam arediuretics “ know the MOA and Site of action of Acetozolamide, MOA and site of action of Furosamide
59-Q on Which diuretic will you prescribe to a diabetic with a GFR of
Q on a schizophrenic patient who has diabetes develops facial and tongue movements, what is the mechanism of action of the medication that you will prescribe next? Ã ID clozapine MOA
60- Describes of galactosema, cataract, reason for It à osmotic damage by formation galactilol
61- on antiCA -Bloomycin- it causes à interstitial pulmonary fibrosis
Q ask If tumor produced in rats, what is deleted à tumor superssor gene, p53 etc.
62-Drug induced interstitial nephritis- methicillin
63-breast tumor Esgn Rc positive, how to treat- tamoxifen
64-Hyperprolactinemia assoc. with Dpamine
65-absence seizure “ Rx ethosuccamide
erection problem in pt, how to Rx
66-Benzo antagonism”flumazenil
67-Pt after operation not recovering from relaxation, gave neostygmine, condition didn™t improve, which was relaxant- succinylycholine
Antipsychotic causes EPS; how to treat it- antimuscarinic- Benztropine
S/S mania -what drug to treat”lithium
M/A of TCA drugs
gingival hypertrophy”phenytoin
What other drug act on beta- lactamases
Pencicilin elimination blocked where by probeneied- renal tubular secretion,
toxoplasma- treatment trimethoprim”sulfo
M/R to INH”by change in catalase
Rx of herpes zoster-acyclovir
Pulmonary fibrosis as an ADR-bleomycin
Pt on Rx hodkin™s dz, ADR, describing CHF, drug was doxorubicin
Breast Ca, Rc +ve,-- Rx with tamioxifen
Drug acting on IL-2 , INF, blocking their synthesis
68-Drug given in peptic ulcer, coates mucosa”sucralfate
M/A of omeprazol- inhibit H+/K+ ATPhase
Hx of bipolar, which is the DOC? Lithium
69-A man with an absence seizure, what drug you use?
70-Penicillin hypersensitivity
Tetracycline mechanism
Patient given Clindamycin, what is likely to results = overgrowth of bacteria in his gut
TB patient with red-orange body fluid, what drug? (: Rifampin)
Amphotericin B mechanism
Hs of HSV, what does it required? Thymidine kinase
Picture: Where does Cocaine acts on NE pathway FA page311
Picture: Where alpha-2 acts on NE pathway FA page311
Patient with diarrhea, who is salivating and sweating. which drug reversesthese symptoms = Atropine
A farmer who sprayed and inhaled parathion, what treat = Atropine
Treat for asthma = beta-2 agonists
Which drug causes metabolic acidosis = Acetazolamide
71-
Amiloride acts on the collecting ducts
Which drug decreases QT interval?
Which drug reduces cholesterol = HMG-CoA reductase
Which drug lowers VLDL = gemfibrizol
What do you monitor with Bleomycin LFTs
What is the disadvantage of giving streptokinase
A man with schizophrenia has been given antipsychitcs and present with Parkinson symptoms, which drug you instead that wouldn™t have similar effects? atypicals
Sildenifil (Viagra): 2nd messenger = cGMP
Isosorbide given with Viagra (Selenfield) = cause hypotension
Antagonizing TXA2 cause what
Colcbicine mechanism
Diabetic drug something to do with glipizidine
Diabetes: Contraindication for Metformin?
cyclosporins
A pituitary tumor patient has been given bromocriptine, which hormone is inhibited = Prolactin
72-Most commonly used glucocorticoid used in chemotherapy? (prednisone
73-Warfarin poisoning
74-know everything about digoxin
75-moa of vancomycin
moa of neostigmine
76-Treatment for person with Wilson™s
77-What antipsychotic is absolutely contraindicated for a person with a heart condition
78-Patient on griseofulvin is now sterile. Problem with sperm is that...(motility)
79-Teratogenic effect of tetracycline.
Experiment where basically ask the order of receptor affinity with Dobutamine.
Drug of choice for DM complaining of neuralgia of one leg.
Mech of action of opiods in cough suppression.
Woman walks into ER with swelling of upper lip, dyspnea with cyanosis. (angioedema) What is her antihypertensive med? (Captopril)
Woman with vasospastic angina by history. Most appropriate med?
80-Phospholipase A2, AA, PG. and Leukotriene cascade, COX I and II, drugs that work here
82-Aldosterone acts via which receptors? Intracellular receptors
Angiotension II acts via which system? 1P3 2nd messenger system
83-Patient was on azithromycin develops resistance over the course of several days, what is the mechanism? Methylation of ribosomal RNA (via methyl-transferases)
Patient has been on a drug for few weeks develop interstitial nephritis and other mild symptoms; what drug was he likely taken? Methicillin
Patient with chlamydia infection was given ceftriaxone, which agent should also be given?
Mechanism of Cilastatin? Inhibits renal dihydropeptidases
Mechanism of Trimethoprim?
Mechanism of Ciprofloxacin? lnhbits DNA gyrase
Mechanism of Mebendazole?
Patient develops hemolytic anemia after taking an X drug, what is the mechanism? G6PD deficiency (Recall: INH causes bemolysis in G6PD deficient people)
A patient is taking Fluconazole for esophageal condiasis, what is the drug™s mechanism? Inhibits synthesis of fungal ergosterol
a diagram of a nucleus and asked where does Ribavarin acts?
An AIDS patient on AZT and Lamivudine, which agent is complementary for the patient regimen? Ritonavir (lndinavir was not a choice) --- must know triple therapy
A diagram of a skeletal muscle and a synaptic vesicle, asked for transmitter? Ach
Therapy for Atropine overdose? Physiostigmine
Malignant hyperthermia and Dantrolene was given, what is D mechanism? Blocks the release of Ca ions and prevents muscle contraction
ID Therapy of pheochromocytoma and ID mechanism?
Dobutamine --- order of receptor™ Beta 1 > Beta 2 and no alpha effect
Mechanism of Nortriptyline?
84-Carbmazapin for a patient with partial seizure, what is C mechanism? Decrease Na~ influx and prevents axonal conduction
Bradykinin role in AceI and cough
Patient on Furosemide develops hypakalemia, which agent can be used to correct the problem? Amiloride --- K-sparing
Hypertensive patient on a diuretic X develops Hypercalcemia, ID X and the likely mechanism of this finding?
Odonserton mechanism? Antagonist of 5-HT
Anti-lipid agents, ID most likely drug for mechanism? Cloflbrate (Gemflbrozil) --- stimulates lipoprotein lipase and chylomicrons
Most common complication with Methotrexate? Bone morrow suppression
Drug used to open and maintain a patent ductus arteriosus (PDA)? A prostaglandin
Asked about Heparin mechanism on treatment of Deep Vein Thrombosis (DVT)?
a structural diagram of arachidonic acid pathway synthesis, know it all.
Gout therapy
A Diabetic treated with Troglitazone- adverse effect? Hepatotoxicity
Leuprolide --- (GnRH agonist)- know it they always ask
Lady has been taking Iodine during pregnancy, likely fetal abnormality?
85-Before a colon surgery what antibiotic should give? Neomycin
86-A patient who was taking Codeine for pain and was complaining of constipation, why was his medicine causing the constipation?
A college girl who had overdosed on something and had pinpoint pupils- what should she be given? naloxone
87-A patient that had hypocalcaemia - what diuretic would be good for her? Furosemide
88-Man taking drug for acne and has sun burn over his sun exposed areas, what drug is he taking? Tetracycline
binds to 30S and prevents attachment or aminoacyl-tRNA.- Tetracycline
89-What should be given as prophylaxis to contacts of someone with meningitis? Rifampin
90-
What receptor Sumatriptan works on? 5-HT 1D agonist
Pt. with positive ANA. Procainamide.
Gemfibrozil what is the side effect? Myositis
Methotrexate works. -- Inhibits dihydrofolate reductase.
What do you have to check in patient on Warfarin? PT
How streptokinase (specifically) works.
91-
1. few were like what is the MOA of HAART (HIV) drugs and lots of antimicrobial drug's MOA...also rifampin and isoniazide
2 they told me pt had gray baby synd and gave cyclophosphamide....what would u give for toxicity...MESNA...
2. then lots of graphs and Drug x and Drug Y and what is the interaction or what is the name of drug X
92-.Pregnant patients with DVTfamily history of DVTwhat to giveheparin
93-What to give in CMV infection if resistant to ganciclovir.foscarnet, One question on HIV medsHAART regiminforgot what it was
94-Question on CVS, ANS drugswith graphsI made my best guessnot sure if I did right or wrong, Renal drugs, M/O of phenytoin and carbimazapine, Haloperdol, M/O buripion ( FA says still unknownI had to guess), S/E of TCA, Some CTY P450 related questions, 2-3 picture asking where the drug works
95-M/O of Diabetic drug.
96-what to give if patient is allergic to aspirinclopidogrel
97- Birth control pill associated break through bleeding in contex of CTY P450 drugs.
98-1: Volume of distribution can be increased by .. HTN ?? or obesity
2: Drug respose graph of adding drug noncompetetive antagonist
3: 3 Questions with long stem having 2 or more drugs additon and affecting different aspects of CVS, all were time consuming, n i did all wrong
4: Antiphychtic drug poisoning
5: Dextroamphetamine poisoning
6: NO source .. arginine
7: Sildenafil mech of action .. phosdiesteaarse inhibitor raising cGMP
8: Benzodiazipine acting on which receptor with diagram
9: Amphotericin B main side affect .. its nephrotixic .. damn main ne theek kr ke wapis ja ke change kr dya
itna gusa aya baad main
10: Pt allergic to penicillin .. which drug to give for UTI .. 5 options, 2 penicillin, 1 cepaholosprin, clindamycin, gentamicin .. i checked gentamicin
11: Cyclophosphamide, hemorragic cystitis .. mesna
12: Pic showing cell in different phases of cell divison n spindle formation, which dug affective .. Vincristine
13: AIDS pt taking Indinavir, which other drug can replace it .. ritinavir
14: Affect of asparte inhibitor on cellular function in virus .. inhibiton of proteins for virus core
15: Women wants to have prophylaxis for malaria, which drug .. Mefloquiine
16: Pt with diarrhea, stool has entameba and giardia, drug of choice .. Metronidazole
17: Drug covering ulcer surface .. sucralfate
99-Pt presented w/hepatosplenomegaly, mild retardation, jaundice and cataract, asking what is the MOA of cataract? Galactitol
100-. A young girl had unprotected sex, and present w/cervical motion tenderness (key word) and ask for MOA of Rx? Easy on I hope
101-Questions asking what is the mechanism of resistance of Cipro
102-What is the mechanism of sulfonureas causing hyperglycemia? Straight forward
103-Pt was brought in to the ER in COMA, history of diabetes, how do you RX?
104-Parents notice there is some kind of brownish substance in the baby diaper (something like that, Can™t recall exactly) and asking for Rx MOA
105-Graph of chemical synapse. Included receptors alpha and beta
106-Dopamine, Acelyacholine, Norepi and Epinephrine. What drug would activate beta I receptor? -
107-Case of pt having psychotic symptoms, weight loss, agitation, dilated pupils, what drug abused? Amphetamine
108-What neurotransmitter does cocaine effect?
109- What does haloperidol act on? A ..dopamine receptors
110-Case of pt taking anti-depressive eats cheese and wine having headacheA.. MOA inhibitors + tyramineA.. hypertensive
111-What can give most lasting treatment for ulcerA.. antimicrobials.
112- Case of girl getting sick after drinking alcohol, what drug is she
(on?A.. metronidozole, disalfuram like effect.
* Griseofulvin.A.. interferes with microtubual function, distrupts mitosis.
Mechanism of action of Acyclovir ,
* DOC for CMV A ..ganciclovir, F oscarnet is gancyclovir fails.
* Case of pt taking nasal decongestant, what receptor is activated? A .. alpha 1.
* Side effects ofLithiumA.. hypothyroidism and nephrogenic Dl. ,
* ACE inhibitors will INCREASE renin due to reflex inhibition.
* Man with high lipids and hypertension having muscle pains and
myalgias, which drugs are causing symptoms? A.. lovastatin and loop diuretic. * Acetazlamide will causeA.. metabolic acidosis.
* Pt on warfarin has infarct, what other drug is he taking? A .. ehenobarbitol, induces P450 systep.
* Case of gout what drugs to useA.. colchicine not answer, probenecid was
~ choice. -,
* Mech. Of action of AllopurinolA.. inhibits xanthine oxidase. * Side effect ofPTUA.. agranulocytosis.
* One half life problem. J * Pt has anemia after taking anti malarial drug, what dei Does pt have?A.. G6PD dei
113- Pt taking pills develops acute hepatic reaction based on enzyme levels, AST>AL T, what did she take? A.. acetaminophen
114-Case of hypertensive having orthostatic hypotension, what drug? A .. Prazosin.A.. alpha I antogonist.
* Where does anti-cancer effect of Vincristine and Vinblastine work? DNA or RNA ?
* Case of hypertensive develops Lupus-Like symptoms, what drug is she taking?A.. Hydralazine. Other drugs include: procainamided£:. *
115- cimetidine effect on p450 and drug metabolism
116-benzodiazepines- 3-4 ques on mechanism of action/metabolism/changes in dosage for elderly 35. PCO- history given- had to
117-at least 5 kinetics questions
clavulanic acid
tetracycline as used for acne
gentamicin assoc. with nephrotoxicity
trimethoprim for PCP
flouroquinolones contraindicated in kids
anti TB drugs
fluconazole--inhibits steroid hormone synthesis
HIV therapy
mebendazole
ANS was big!
bethanechol, cocaine, antimuscarinics, clonidine, B blockers, succinylcholine, phenylyephrine (rebound nasal congestion), epi, norepi, prazosin, glaucoma drugs...just know ANS real well
several antipsychotic drugs
opioid analgesics
carbamazepine--causes aplastic anemia
nitrous oxide as anesthetic
ACE inhibitors
acid/base balance with diuretic use
hydrochorothiazide causes hyperglycemia
K+ sparing diuretics--spirinolactone can cause gynecomastia
quinidine
several questions on lipid-lowering agents
anti-cancer drugs were big too: 5 fluorouracil, doxorubicin, prednisone, raloxifene (make sure you know all their side effects)
Magnesium antacid abuse
heparin/warfarin
many NSAID questions
glucocorticoids
propylthiouracil
118-
1. MOA of rifampin (darn question showed up 2 times)
>2. MOA of erythromycin
>3. MOA of cephlosporins
>4. What do u give first to unconcious alcholic who comes in to ER?
>IV thiame first
119-Side effects of combo drugs of person being treated with
>Hodgkins
120-25. If person has megaloblastic anemia with folate and neuro
>problems and after Rx u only have neuro problems what did u give
>patient?
121- MOA of erythromycin?
122- ACE inhibitors cause renal damage.
123--SE of person taking aminoglycosides
124-. Person with H.Pylori given medication that covers ulcer, what
>is MOA of that drug?
125-SE of person taking H2 blockers
126- Give heparin to person but no change in PT or PTT what is
>deficient?
127-Best treatment of person who is Black suffering from CHF
128-. know the cyto p450 inducers and inhibitors - 6 q's
129-. moa of omeprazole
>52. moa of vancomycin
>53. moa of neostigmine
130-Very long intimidating question about drug given to young versus old. Young person™s VD and CL are twice that of the old™s. T1/2 for young person is 24 hours. What™s the T1/2 for the old person? (Without computing, I just answered 24 hours; should it have been higher or lower? I mean, the VD and CL are half of the young person™s and the formula is 0.7 Vd/Cl anyway?)
6.Glyceraldehyde 6 P ßà DHAP, reaction in favor of DHAP. What™s the G of this reaction? (I didn™t cover this in my review so I forgot about choices.)
131-Cyclosporine™s MOA
132-Mechanism of Tetracycline
Nephrotoxicity associated with Aminoglycosides and also ototoxicity.
Isoniazid and B6 which can prevent neurotoxicity
HIV triple therapy (two nucleotide reverse transcriptase inhibitors with a protease inhibitor.
Mechanism of Dantrolene
Isoprotrenol effect and reflex tachycardia associated with it
Mechanisms of action of sympathetic receptors, Dopamine receptors (eg. cAMP, IP3, etc.)
Antipsychotics and Tardive dyskinesia
Lithium and it™s effect on thyroid (may cause hypothyroidism)
Sumatriptan and it™s mechanism of action
ACE inhibitors and it™s effect on blood pressure and it™s mechanism of action
Cardiac glycosides and it™s effect on intracellular and extracellular Na and K
Busulfan associated with pulmonary fibrosis
Cisplastin associated with Nephrotoxicity
Lead poisoning and it™s features (eg. lead lines) and treatment
H2 Blockers and their mode of action and their effects on gastrin and stomach acid
Arachidonic acid products and their effects on vascular tone and platelet action
Leuprolide and it™s indications (also mechanism of action).
133--maintanence dose
-first order elim.
-effect of antagonist in general
-tetracycline mechanism (MORE than knowing 30S)
-aminoglycosides=ototoxicity
-INH mechanism
-cocaine additction mech.
-PAM
-Dantrolene mech. (Ca2+ from SR) (yes, got it right Kelly)
-Beta blockers
-Alcohol and Benzodiazipenes
-Sumatriptan mech
-Diuretics X5-6
-Quinidein efx X3
-Bleomycin side efx (cancer bear will be your friend)
-warfarin mech
-misoprostol (w/NSAIDs)
-H2 blockers
-Arachidonic acid pathway X3
-diabetic drugs (increasing insulin receptor sens)
-prednisone
VEINS DRAINING CAVERNOUS SINUS......
2-HIGHEST NERVE IN POSTERIOR TRIANGLE
5-abt 2 brainstem crosssectns,1 spinal cord...easy ones..1 mri showing sup sagittal thrombosis(curved line in sagittal section)
. pt present with knee injury w/posterior posterior sign, ask for defect & MRI ,X-RAY
8-.about 5-6 CT/MRI, one angiogram pointing to Posterior cerebral artery giving a small senerio asking what other associated symptom the patient will have.
. Bicornuate uterus what problemincomplete fusion of paramesonephric ducts, few
10-4 fracture questions what nerve involved, brachial plexus..identify radial nerve, rotator cuff.one tendon tornXray pointing asking what muscleI thought it was supraspinatus as it was on the top,
11-Buccinator pushes cheek up against your molars
12-allantois is median umbilical ligament
13-DAMN question- CN 7 via solitary nucleus (how do I forget that)
14-Double cervix caused by Double Uterus caused by
15-Testes are paraaortic
16-what artery does testes get blood supply from
17-picture of a compression fracture
18-section of the spine labeled, and they asked a lesion where would be equivalent to the SX of Horner's????
19-picture of a subarachnoid hemorrhage, question what is the etiology??
a) rupture of the bridging veins
b) coup
c) contercoup
d) sacular aneurism
e) HTA
20-gross anat.was mostly on upperlimb nerve injuries ,had 3CTSCAN total of neuroanat.and few Q from neuroanat
21-. origin of mandible/external auditory meatus
22-. Man burn his tongue when he sipped coffee, what CN?
23- 1 year old with weakness, vomiting and abd distention- revealed volvulus- what is the developmental anomaly that lead to these? (it was meckels diverticuum that lead to volvulus but the answer that they want is viteline duct.
24- child with bladder extrophy- associated with epispadia
25- Bicornuate uterus “cause
26- ANomalies of a singe umbilical artery
27- ANomalies of a singe umbilical artery
28-surgical repair of hiatal hernia - most likely to be injured by the surgeon ?
13. Most posterior part of the heart
14. 58 yr old man with abd hernia -landmark to dtermine the tpe of hernia
15. vessels to connect to bypass portosystemic shunt “
29-. Px with inattention, loss of drive. Point to the lesion. (Drawing of brain)
2. Px with injury to the knee. Point to the structure in the MRI that prevents excessive sliding of the tibia anteriorly.
3. Hypothenar atrophy and impaired adduction of fingers. What nerve is affected?
4. Px with difficulty doing push ups, doing wrist flexion, extension of fingers. What nerve is affected?
30-4-5 Cts on lower limb lesions-knee joint hit posteriorly,ankle sprains and abdomen{which i think i messed up thoroughly--i knew the answers but couldn't place them on the CT
32-
Q CT of the pelvis of a man with BPH describe à ID prostate (picture#16)
Q CT of the pelvis ID which muscle helps in valsalva à rectus abdominis (picture#16)
34-about the base of bladder “ what is the structure closely associated with it? Ã vas deferens
35- will mention cancer from descending colon spreads to which lymph nodesà inferior mesenteric identify on x-ray--- maxillary sinus (picture#19)
36-describe homer™s syndrome (ptosis, meiosis and anhidrosis) -where is lesion? Ã cervical sympathetic plexus
37- patient has a tachycardia; carotid massage stops it, mechanism? à Pressure on carotid sinus à CN IX send the signal to the brainstemà CN X (vagus) returns the signal to slow down the heart. (this is my explanation in plain English picture#20) Easy ha..
38-mentions that lateral and third ventricles enlarged, 4th is normal where is the obstruction? Ã Aqueduct of sylvius
39- describes subacute combined degeneration of cord, which vitamin deficient? Ã Vit. B12
40-
Q description of UMN corticospinal tracts- ID lesion in cordà (picture#21)- try to memorize the big ones from High Yield Neuroanatomy by Fix (very good source for neuro for step 1)
41-of a patient that has unilateral hearing loss- vertigo diagnosis? Ã meniere™s disease
42-Qsss about visual field defects STRIGHT from First Aid page 111- KNOW ALL of them. Most famous question on this topic will be Bitemporal Hemianopsia- whats causes it? Ã Optic chiasm compression by a pituitary adenoma.
43- describes internal capsule infarct, which artery? Ã lenticulostriate branches of middle cerebral artery.
44-in a picture (Picture#25) must diagnoseà intussuuception
45-on Pt who has a severe headache. Subarachnoid hemorrhage was noticed on the CT. What are the other findings? - Ã Out pouching at the junction of the Ant. Communicating Artery and Ant. Cerebral Art. Ã Berry Aneurysm
46-shows a picture (picture#28) of an arteriogram of the cerebral arteries and Ant. Cerebral A. will be labeled and asked what functions will be lost if you severe this artery? Pt. can climb the stairs
47-shows a picture (picture#28) of an arteriogram of the cerebral arteries and Ant. Cerebral A. will be labeled and asked what functions will be lost if you severe this artery? Pt. can climb the stairs
48- will show a pic (picture#34) of supratentarial herniation occurs, what CN will be affected mostly?
49-of a young male gets a stab wound in his neck right above the clavicle and lateral to the manubrium sternum. What structures most likely damaged? Ã Pleurae
50- describes a child who has absence of both kidneys but the ureters are present. What™s was the defect?
51- describes a pt. has Adenexal mass is going through a surgery, which ligament would you ligate to prevent the bleeding? Ã Suspensory Ligament (has ovarian vessels)
52- shows a Head CT (picture#38) w/ an arrow in the temporal lobe lesion (around the Meyer™s Loop) and asked the visual field defect?- Ã Left upper quadrantic anopsia (œpie in the sky)
53-on an athlete who fell on his knee- injury describes the tibia moving interiorly to the femur what is the injury? Ã Anterior cruciate ligament injury
54- on women fallen on an outstretched hand what™s signs? Ã Media n. compression or damage.
55- on a women off of a ladder down and bit her bead on the table..but she is ok, 2 or 3 days after she falls unconscious... Ã subdural hematoma.
56- on a guy who has a stroke and has aphasia and paresis what structure is involved? Ã anterior capsule
57-on papillary light reflex....what is involvedà pretectal area
58- on diaphragmatic hernia (xray shown)(picture#46)- dignosis
59- on peroneal nerve injury... Ã loss of dorsiflexion
60-on a young boy with stridor and fuzzy X-Ray- thumb sign (picture#47) must ID Ã H. influenza
61- on TB delineates the difference of the Ghon complex from the Ghon focus.
62- about a boy who uses Gowers sign to stand who has adipocytes in his calf muscle biopsy à X-linked inheritance
63- which foramen the maxillary (V3) branch of the trigeminal pass through. Ã foramen ovale
64- on CATs-- subdural hematomas (picture#50) vs. Epidural hematoma (picture#51). Ã Make sure you know that the subdural is crecent shaped and epidural is bi- convex shaped- knowing this fact always helped me pick it up.
65-on a fish bone was stuck in a kid™s œPeriformis fossa, the nerve Damaged will delay what function? Ã gag reflex
Q on an infant dies suddenly due to pulmonary hypoplesia
66-on a child has to go thru Tracheaectomy, which structure does it passes thru? Ã Skin and cricothyroid membrane most likely the answer will be.
67- on Loss of pain and temperature on one side of the face, what is the nerve lesion? Ã CN V
68- on a child who was extremely HOT, which structure is damaged? Ã Anterior hypothalamus
69-on what controls the Autononuic nervous system? Ã Hypothalamus
70-on an alcoholic who is losing memory, what structure is damaged? Ã mammary bodies
71-on child with craniopharyngima, what visual field is defect à heteronymous hemianopsia
72-on a child with temporal lobe lesion, what visual field is defect? Ã Left Upper qudrantic anopia (pie in the sky) “ Know the picture of Visual defects page 111- here there are alwaysss questions.
Q on a patient with paralysis of the upper arm, which structure is lesioned? Ã MCA
Q shows a c-section (picture#52) of the cord in a lady who losses pressure and touch on her legs, which lesion? Ã Gracillis nucleus area (1. Nucleus gracilis )
Q on a Man with subararachnid bleeding, which area is most likely source? Ã circle of Willis (berry aneurism)
73- mentions an Occlusion of the Superior Mesenteric Artery, what does it affect? Ã Ascending colon most likely to be in the answer choices
74-brachial plexus
75-Which structure must be preserved during hysterectomy, after the uterine artery was ligated. (Ureter?) Also which nerve must be preserved during repair of a hernia
76-Kid who choked on a peanut with signs of SVC syndrome
77-Cervical rib, ID nerve by cutaneous innervation.
78-Broca™s vs. Wernicke™s aphasias and their locations
79-Carotid angiographies, Identify (ID) ACA & MCA and their related deficits
80-ID damaged structures in a) Parkinson™s disease = ID substantia Niagara b) Huntington™s disease = ID caudate nucleusc) Alzheimer™s ID hippocampusd) Kluver Bucy syndrome = ID amygdale) Wernicke Korsakoffs encephalopathy ID mamillary bodies
81-ID fiisciculus cuneate vs fasciculus gracilis and related deficits
82-structures in Circle of Willis and related deficits
83-MRI of eye muscles, ID muscles and related structures
84-Derivation of Mylohyoid muscle? 1st brachial arch
85-Pt presents with RIGHT side hoarseness, which structure is related to which structure?
86-A tumor located in Ascending colon, most likely route of spread? Superior mesentery artery
MRI of eye muscles, damage to which muscle (ID) causes the eye to deviate inward and down?
History of pt with acromegaly and giant bone formation, likely association? Bitemporal hemonopsia
Loss of sensation and movement in lower limps, ID damaged structure in carotid angiography? ACA
Description of pt with Huntington™s disease (jerky movements, etc), ID damaged structure? (picture#78)
Loss of vibration & touch in lower extremities, ID structure in Spinal cord section? Gracilis nucleus
CTs ID GI and Pelvis structures
87-A view of the intervertebral discs and pointed to the nucleus pulposis and, what was it derived from? Notochord
88-Bicornuate uterus, what caused this? Incomplete fusion of the paramesonephric ducts.
A very athletic woman who was having pain in her leg when she ran, her x-ray
89-Athlete with positive anterior drawer test, asked what was torn? AC
90-showed a faint line on one of her tibia? Stress fracture
91-Embryo of heart--sinus venosus,omphalocele vs gastrochisis-very well worded..again hard to choose between 2 options
92-GT CT FOR EPIDURAL HEMRRHAGE WTH TYPICAL TALK N DIE PRESENTATION
93-GT BRAIN SECTION HAD TO IDENTIFY SUBSATNTIA NIGRA
GT MIDBRAIN SPECIMEN WTH PARKINSONS RESTING TREMOR GVEN HAD TO IDENTIFY
SUBSTANTIA NIGRA AGAIN
GT A BRAIN SPECIMEB ,HAD TO IDENTIFY PREMOTOR AREA
HAD TO IDENTIFY MEDIAL LONGITUDINAL FASICULUS WTH SYMPTOMS GVEN OF ITS
LESION
WAS A MRI OF THIGH HAD TO IDENTIFY AN ANTEROLATERAL MUSCLE WTH LIPOMA,WAT
WAS THAT
RECTIS FEMORIS,SARTORIUS,VASTES LATERALIS
MRI OF HIP JOINT WTH OSTEOATHRITIS I GUESS BUT WAS VERY POORLY PRESENTED
94-GT A2 QS REGARDING FIELD OF VISION
1 WAS BINASAL HEMIANOPIA
1 WAS LEFT HOMONYMOUS HEMOANOPIA
95-FRACTURE OF HUMERUS WCH NERVE AFFECTED?
HAD TO IDENTIFY AXILLARY NERVE ON A BRACHIAL PLEXUS DRAWING
GT A BRANCHIAL FISTULA QS
96-about 5-6 CT/MRI, one angiogram pointing to Posterior cerebral artery giving a small senerio asking what other associated symptom the patient will have.
97-.One Brachial arch questionwhere do mandible derive fromArch1. Tip of the tongue burned when drinking hot coffee.pain transmitted byV nerve., Bicornuate uterus what problemincomplete fusion of paramesonephric ducts, few questions on developmental anomalies
98-3-4 fracture questions what nerve involved, brachial plexus..identify radial nerve, rotator cuff.one tendon tornXray pointing asking what muscleI thought it was supraspinatus as it was on the top,
99-1: Membranes of heart which contain pericarial fluid .. visceral n parietal layer of pericardium
2: Portal hypertension, stent passed to releieve from which structures .. portal vein to right hepatic vein
3: Injection in gluteal region which nerve damaged .. Schiatic N
4: Fracture of upper part of shaft of femur with Xray, which artery damaged .. Profunda femori??
4: Baby with cessation of breathing on right side also brachial plexus injury, cause of cessation .. Phrenic N damage
5: Young man having pain in temoromandibular joint, touching which muscle illicit pain .. Masseter??
6: Sucide attempt by cutting wrist, Radial N damage, which function affected .. oppostion of thumb
Neuroscience/anatomy:
1: CT scan showing arrow head to lateral rectus muscle, which funtion affected and on which side ..
2: Angiogram of cerebral artries, arrow head on some artery, n asked which fucntion affected after its blockage .. Middle cerebral artery ??causing spastic paresis of upper limbs
3: CT scan showing tumor obsructing 4th ventricle, cause .. obstructive hydrocephalus
4: Pt in vegetative state, not responding to painful stimuli, site of damage .. brainstem or internal capsule ?? right answer is brainstem, i checked internal capsule
5: Convergence of eyes intact with accomodation, but when light is shown eyes do not respond, also pt has severe myopia .. Optic N damage ( hina knows better
)
6: also few questions with syptom described in stem and then shown 4-5 sections of spinal cord with labels to localise whr is the damage .. simple but time consuming
7: Section of lower part of medulla with damaged anterior part, lesion .. Hypoglosal N, tongue deviation
8: Suprachiasmatic N damage, abnormality .. melatonin secretion
100-Question described some kind of mass remnant from the tongue below cricothyroid muscle ? thyroglossal duct
101-cleft palate: ."failure of fusion of LATERAL PALENTINE, NASAL SEPTUM
* Cleft lip: Failure of fusion of MAXILLARY, MEDIAL NASAL.
101-Ct point to the body of the pancreas and asking what structure like retroperoeal? Celiac (I hope)
102-Case of g!rl who has loss of eversion and lifting whole leg to walk: what nerve? A.. common peroneal
103- Loss of sensation of lateral digitsA ..median n.
* Tumor compressing renal vein, what is result? A.. edema in lower leg, varicocele, esophageal varicies were the choices.
Blood supply to descending colon ..Inferior mesenteric artery.
104- Visual field defect of homonymous hemianopsia, where is the lesion? A .. East the optic chiasm.
* Knee jerk reflex arc.
* Where do the cerebral veins drain into : ..find on angiogram.
105- Gross photo ofbrainstem, where is : cranial nerve 5?
*
106- Case of loss of sensation of face, what nerve is affected? A ..Maxillary branch ofCN V.
107- CT of abdomen-at the level of pancreas
108-Rathke's pouch
neurohypophysis derived from ectoderm
what causes increased left atrial pressure and decreased right atrial pressure after birth
several branchial apparatus questions
question about remnant of thyroglossal duct
Meckel's Diverticulum
mesonephric vs. paramesonephric ducts
Bartholin's glands
function of sertoli cells
Potter's sequence
common peroneal nerve lesion
PCL injury
Congenital megacolon
109-.Cross section diagram of superior part of chest. What pointed structure is responsible for mydriasis, eye opening, sweating/what structure if lesioned will produce Horner™s? (I chose this bilateral structure very near and just lateral to the vertebral bodies, other choices were several nerve like sections albeit unilateral just posterior & lateral to esophagus, and the trachea) I know I™m supposed to look for the superior cervical ganglion but I haven™t encountered this diagram before.
110-.Cross section diagram of superior part of chest. What pointed structure is responsible for mydriasis, eye opening, sweating/what structure if lesioned will produce Horner™s? (I chose this bilateral structure very near and just lateral to the vertebral bodies, other choices were several nerve like sections albeit unilateral just posterior & lateral to esophagus, and the trachea) I know I™m supposed to look for the superior cervical ganglion but I haven™t encountered this diagram before.
111-.Nerve deficits, and two q about severe combined degeneration
112-Which of the abdominal aorta branches supply the foregut Answer: Celiac trunk
113-Patient presents with inflammation and necrosis of small intestine, ascending colon and proximal 2/3 of transverse colon, which blood vessel is involved:
Answer: superior mesenteric A.
114-Which branchial arch makes up Mandible and Mylohyoid, etc.
Answer: first arch
115-Picture of endochondral bone formation (similar to picture in first aid) and asks which of the following bones are formed by the shown process. Choices were clavicle, skull, femor, etc.
Answer: Femur (long bones)
Picture of a child being able to bring her shoulders together, which bone is she missing:
Answer: clavicle
116-Patient presents with deviation of uvula and shoulder droop, where is the lesion?
Answer: jugular foramen
117-Point to the muscle that depresses the eye from the adducted position
Answer: Superior Oblique muscle (same diagram as in page 108 first aid, 2001 edition).
Marcus Gunn Pupil
Lesion in which blood vessel causes left homonymous hemianopsia (angiography similar to circle of willis pictures in High Yield Neuro)
Answer: right post. Cerebral
Brown Sequard lesion
Dorsal Column pathway and lesions of Gracilis fibers and Cuneatus fibers and how they affect sensation on upper and lower limbs.
Radial nerve injury
Cervical rib and what it affects
Answer: inf. Trunk of brachial plexus
118-Patient presenting with upper and lower motor neuron problems
Answer: ALS
119- brachial plexus- I had ulnar nerve b/c interossei
120- lat rectus on mri
121- know your fractures- what muscles pull them
122- know your lesions in the CNS- whats ipsi whats
> contra
123--mesonephric ducts=male spermatochord
-inguinal fascia and saddle injury (kids starts to pee, where will urine go inside body cavity, NOT down thigh)
-diaphragmatic hernia
-GI blood supply (celiac trunk=forgeut)
-ureters and obstructions
-macula adherens
-ciliar dynein (Kartagener's syn)
-picture of lesion in Broca's area
-spianl cord lesions
-braichial plexus (of course, mine was axillary n.)
125- Q .Anatomical common injuries are super duper HY.
A football player comes in with an injury in the shaft of his humerus. What nerve is crushed (choices: radial, median, ulnar, axillary) and what prob. does he have?
Radial nerve is damaged. He is lose his triceps, brachioradialis, and have wrist drop.
This is a must know...
The aforementioned athlete breaks his supracondyle of humerus. What nerve is crushed?
(Radial, median, ulnar, or axillary)
(All of you will get a variation of the upper arm injuries)
A. MEDIAN nerve is blown. He loses his finger flexing ability and some thumb movements and some loss of sensation over lateral palm and thumb and radial 2.5 digits
Q. Everyone I hear is asked about brachial plexis injuries. But they are not easy direct questions. E.g.
A supermodel in a car crash looks at you with a "claw hand". What two cord segments contribute to the nerve which is damaged?
A. Cord segments are C8 and T1! See, not so easy, right?
126- The suprachiasmatic nucleus of the hypothalamus!
Peace to Everyone on Earth!
Yoda says rather asks you:
127- Pt, older gentleman with visual field defects from a Circle of Willis (they'll give a pic) hemorrhage. Point to the artery in Webpath. for now, though, what is the name of this most famous artery?
A This is a case of anterior communicating artery stroke, the most common circle of Willis aneurysm! Got it? Got Milk?
128- Case: Visual field defect of homonymous hemianopsia, there will be a series of diagrams of the eye nerves (you guys know with pic I am talking about right?) with arrows everywhere. Where exactly is the lesion?
A There are at least two dozen questions that can be asked from this crucial concept with those visual field defects. Master them all.
an arrow point to the nerves behind the optic chiasm contralateral.
129-some brain slides with lesions...
one brain angiogram
2-3 x-rays
2 CT head ( sinusitis + hematoma)
one girl with cleft plate
130-2. CT of the chest and ask to identify the structure directly behind the panreas
3. pt present with knee injury w/posterior posterior sign, ask for defect
5. pt L eye deviate toward midline when looking straight, R eye is normal, what nerve defect
6. Rx of SVT
140-Compartment sundrome ( Median nerve compression)
Hemiballimus : contralateral subtlalamic nuclei
141-5% Anatomy/NA-again disappointed, also my strong points. ihave alot of trauma cases (IC hematoma), leg and arm fractures, easy ones, know ur spinal cord lesions and tracts very well.
142-in anat there was an angiogram(which i'm poor at)
2 sections of spinal cord and where is the lesion...
leg injury what is damaged...some xrays.
143-Q on what make up the Blood-Brain barrierà Remember the CIA (choroids, intracerebral capillary endothilum and arachnoid
144-describes Alzheimer™s patient where™s lesion à hippocampus (picture#14)
145-Damage to base of penis- urethral rupture is fluid is lost in which perineal layer
146-Where does seminoma drain?
147-
Fracture to it. L 9th rib- spleen
cavernous sinus thrombosis-
myasthenia gravis
dermatomes
paradoxical emboli- know what it means
brca met. via axillary nodes
neuro syphlis- arguile robinson pupil
Little girl is bowlegged and has pain. Likely maternal infection? syphilitic saber shins
148-
Diapliragmatic hernia (by history), most likely complications? Pulmonary hypoplesia
A tumor located in Ascending colon, most likely route of spread? Superior mesentery artery
MRI of eye muscles, damage to which muscle (ID) causes the eye to deviate inward and down?
History of pt with acromegaly and giant bone formation, likely association? Bitemporal hemonopsia
Loss of sensation and movement in lower limps, ID damaged structure in carotid angiography? ACA
Description of pt with Huntington™s disease (jerky movements, etc), ID damaged structure? (picture#78)
Loss of vibration & touch in lower extremities, ID structure in Spinal cord section? Gracilis nucleus
CTs ID GI and Pelvis structures
Sperm development in EM
149-A man who was stabbed in the back and paralyzed from diaphragm down, asked how can he get an erection?
150-Case of alcoholic..thiamine def, destruction of mamillary bodies. *
151-17. CT of brain of person involved in car accident, what kind of
>hematoma? Subdural, epidural or subrachnoid?
152-18. Enlargement of lateral ventricles with blood in them, where is
>the problem?
>19. Brachial plexus d
I recommend to focus and try to stay motivated whole exam , ˜cause after few blocks you™ll really feel like œlet me go home owing to weariness and bore. I began to speed up , just to push another block forward. I think that reasonably planned breaks are important to prevent that kind of concentration problems and derealization. 