Review UWorld Self Assessment 1 with these practice questions and answers. This guide helps predict your NCLEX readiness and identify areas for improvement.
Q: Acute onset lung dysfunction, pulmonary edema, normal LA pressure, damage to endothelial cells lining pulmonary capillaries
Answer: ARDS
Q: Kimmelstiel-Wilson lesion
Answer: Diabetic Nephropathy
Q: Cardiac tissue conduction velocity
Answer: Purkinje system > Atrial muscle > Ventricular muscle > AV node
Q: Pagets disease association
Answer: Osteosarcoma
Q: Sensation of lump in throat without any physical findings
Answer: Globus hystericus
Q: Needle shaped crystals in synovial fluid
Answer: Crystal arthropathy (Gout)
Q: 3 causes of endometriosis
Answer: Retrograde menstruationLymph/vascular spreadCoelomic DysplasiaChocolate cyst
Q: Teratogenic Vitamin
Answer: Vitamin A
Q: Sialic acid analogue that inhibits nueraminidases of Influenza A and B
Answer: Oseltamivir
Q: Gel electrophoresis showing 1 large protein being broken down to smaller ones over 25 mins
Answer: Precursor protein subsequently modified via cleavage
Q: DNA fragments of 180 bp’s
Answer: DNA laddering (cleavage at internuucleosomal linker regions)Sign of apoptosis
Q: Physostigmine
Answer: ACh-esterase
Q: Atropine
Answer: Opposite action of physostigmineDecreases muscle contraction
Q: SE of benzos
Answer: Confusion, anterograde amnesia, psychomotor retardation, paradoxical agitationElderly eliminate slower -> prolonged half life -> increased side effects
Q: Hot as a hare, dry as a bone, red as a beet, blind as a bat and mad as a hatter
Answer: Anticholinergic drugs (Atropine) ODJimson weed
Q: Genetic mutation in offspring but not the parents
Answer: Germline mosaicismPresence of multiple, genetically different gamete cells
Q: Most important counseling for people w DM
Answer: Tell them to inspect their feet daily
Q: t(15;17)
Answer: APL (Auer rods – needle shaped cytoplasmic inclusions)
Q: Cytokine only released by T cells
Answer: IL-2Stimulates growth and differentiation of T/B/NK cells and macrophages
Q: Cadherins are part of
Answer: DesmosomesBind epithelial cells together
Q: Dome shaped, flesh colored, umbilicated papules
Answer: Molluscum contagiosumCaused by poxvirusEosinophilic cytoplasmic inclusions -> molluscum bodies
Q: Triggers bicarb rich fluid accumulation in the duodenum
Answer: Low pH of duodenal contentDuodenal acidity triggers the release of bile and bicarbonate rich pancreatic fluid
Q: Structure most likely to be torn in anterior or posterior dislocations of the knee
Answer: Popliteal artery
Q: Infection of uterus following delivery
Answer: Endometritis (Bacteroides organisms)Fever, leukocytosis, tender abdomen and foul smelling dischargeC-section is the most important risk factor for postpartum endometriosis due to the introduction of microbial organisms and foreign bodies into the incised uterus
Q: Eruption of vesicles with surrounding erythema isolated to a single dermatome accompanied by severe neuropathic pain
Answer: Herpes zoster
Q: Converting unacceptable feelings into more socially acceptable ones
Answer: Sublimation
Q: Transferring feelings to a less threatening object/person
Answer: Displacement
Q: Binding of a ligand to what kind of receptor causes transient dimerization of the intracellular portion of that receptor?
Answer: Tyrosine kinase (Insulin, EGF, PDGF, VEGF)
Q: Physician repeats what has just been told
Answer: Reflection
Q: Chronic nasal discharge, atrophic nasal mucosa, thinning of the nasal septum, oropharyngeal ulcers, osteolytic sinusitis
Answer: Cocaine abuser
Q: GFR % post-heminephrectomy
Answer: Surgery: 50%6 Weeks: 80%Compensatory hyper-filtration and hypertrophy of the nephrons in the remaining kidney
Q: Sildinalfil acts where
Answer: Corpus cavernosa of the penis
Q: Calcified tumor causing bitemporal hemianopsia
Answer: CraniopharyngeomaSuprasellar tumor that compresses the central portion of the optic chiasmLoss of vision on temporal sides of both eyes
Q: No abduction > 90% and winging of the scapula
Answer: Long thoracic nerve injury (serratus anterior)
Q: Equal level of Cl dec as HCO3 inc, steady stake of Na and KWhat tissue?
Answer: PancreasFlow of pancreatic secretions increases in response to secretinHigh flow – bicarb increases while Cl drops and vice versa for low flow
Q: PTSD symptoms for < 4 weeks
Answer: Acute stress disorder(3 days – 1 month)
Q: Times of schizophrenia disorders
Answer: Brief psychotic disorder: < 1 monthSchizophreniform disorder: 1-6 monthsSchizophrenia: > 6 months
Q: (1 – specificity)
Answer: False positive rateIndependent of disease prevalence
Q: Risk in exposed subjects / risk in unexposed subjects
Answer: Relative risk
Q: 1 / ARR
Answer: NNTLower is more beneficial
Q: Temporal lobe encephalitis
Answer: HSV encephalopathyFever, headache, seizures, altered level of consciousness, temporal lobe dysfunction (olfactory hallucinations, personality changes, psychosis)
Q: Confusion, abd pain, dark urine after abx
Answer: Acute intermittent porphyriaPBG deaminase deficiencyNeuro manifestations, no photosensitivityUrine will darken when exposed to sunlight
Q: Long term alcohol abuse will cause a deficiency in
Answer: Cobalamin/B12Megaloblastic anemia, neuro dysfunctionSubacute combined degeneration of the dorsal column -> diminished vibration sensation and gait ataxia
Q: Difficulty chewing, double vision, mild ptosis of right eye
Answer: Myasthenia grasvis -> thymic hyperplasia
Q: Osteosarcoma and retinoblastoma
Answer: Loss of heterozygosity2 hit hypothesis
Q: Most common causes of infectious arthritis
Answer: S. Aureus (old people)N. gonorrhea (sexually active)HFlu (kids)Salmonella (sickle cell)Numerous polymorphonuclear leukocytes and bacteria in joint space
Q: Failed development of the 3rd and 4th pharyngeal pouches
Answer: DiGeorge SyndromeCleft palate, low CD3, normal CD20
Q: Metabolic acidosis, hyperkalemia, hyponatremia, ketonemia, hyperammonemia, hyperglycemia
Answer: DKA
Q: Child w cerebellar tonsil herniation through foramen magnum and into upper cervical canal
Answer: Arnold Chiari malformationOccipital headache and symptoms of cerebellar dysfunction that may worsen with valsalva
Q: Testosterone and LH inc; FSH dec; blind pouch vagina
Answer: Androgen insensitivity
Q: Tx for pheochromocytoma and length of effect
Answer: Phenoxybenzamine- 3 daysPhentolamine- <1 hour
Q: Bleeding from where causes intraventricular hemorrage in neonates?
Answer: Germinal matrixBulging fontanelle, intermittent apnea, and decerebrate posturingBilateral thrombi in lateral ventricles
Q: Ototoxic chemotherapeutic drug
Answer: CisplatinDamages hair cells in the cochlear membranous labyrinth
Q: Drug that causes a delayed onset pneumonitis
Answer: Amiodarone
Q: PGE1 analog that helps combat effects of NSAIDs on gastric mucosa
Answer: MisoprostolDecreases parietal cell acid formation
Q: Mediators of aspirin-induced asthma
Answer: Leukotrienes (bronchoconstriction)
Q: Most cancers in head and neck are what type?
Answer: SCCPresenting sx is cervical lymphadenopathyNests of sheets of squamous cells with intercellular bridging and keratin pearls
Q: Distinct genotype has varying phenotypic manifestations
Answer: Variable expressivityMay present with a wide range of clinical sx throughout people affected
Q: Some individuals express a genotype but not the corresponding phenotype
Answer: Incomplete penetrance
Q: Anti-anginal drug that causes inc HR and dec end-systolic LV volume
Answer: NitroglycerinDecreases LV volume and wall stressDecreases oxygen demand despite a reflexive increase in HR
Q: CFTR mediated flow of Cl in lungs vs sweat glands (normal)
Answer: Lungs- Cl secreted into bronchial mucusSweat glands- Cl reabsorbedCF- High Cl in sweat, low in bronchial secretionElectrolyte abnormalities develop due to tissue specific variation in the functioning of the CFTR gene
Q: End organ resistance to PTH, TSH, LH, FSH (Gs mediated pathways)
Answer: Albright hereditary osteodystrophyPseudohypothyroidism associated with short stature and short metacarpal and metatarsal bones
Q: DNA-mRNA hybrids with several DNA loops
Answer: RNA splicing
Q: Different mutations in the same genetic locus cause similar phenotypes
Answer: Allelic heteregeneity (think Duchennes and Beckers)Some mutations cause complete loss of protein function while others cause only partial loss
Q: Asthma attack management
Answer: Cysteinyl leukotriene receptorMontelukast – cysteinyl leukotriene receptor antagonist
Q: Skin hyperpigmentation from hemosiderin deposition in the dermis
Answer: Hemochromatosis
Q: Splenomegaly in a homeless person. Cause?
Answer: Portal HTN from cirrhosisSplenic vein hypertension and splenomegaly
Q: Indirect ELISA
Answer: Known Ag is fixed to surface and pt serum is addedAdd anti-human Ig Ab’s, each coupled to an enzymeThese secondary Ab’s will bind the Ag-bound Ig from the pt’s serum
Q: 2 main causes of impetigo
Answer: S. aureus and Group B StrepHoney colored crust
Q: Common cause of multi drug resistance
Answer: Enhanced antibiotic export by the bacterial efflux pumps
Q: AD activating mutation of FGFR-3
Answer: AchondroplasiaProximal limb shortening with resultant short stature, midface hypoplasia and frontal bossing
Q: Defect in gene that codes for cytoplasmic tyrosine kinase activated in CD19+ cells by antigen exposure leading to cell maturation
Answer: Brutons x-Linked agammaglobulinemiaIntracellular messaging abnormality that results in recurrent infections
Q: Change in karyotype after bone marrow graft due to
Answer: Donor karyotypeDonor stem cells engraft in the bone marrow and produce all of the hemopoietic cell lines for the recipientPeripheral blood cells will be genetically different from the rest of the body’s cells
Q: Large deletion in mRNA signal sequence with hydrophobic core near N-terminal = accumulation of protein where?
Answer: CytosolProteins destined for the rER posses these sequences so when removed, accumulate in the cytosol
Q: Defect in branched chain alpha ketoacid dehyrdogenase
Answer: Maple Syrup Urine disease (BAD!: leucine, isoleucine, valine)
Q: Thiamine needed as cofactor
Answer: TransketolaseBranched chain alpha ketoacid dehydrogenaseEx. maple syrup urine disease
Q: Alpha thalassemia minor blood smear
Answer: Microcytic
Q: Low concentration of testosterone in seminiferous tubules and epididymis
Answer: Sertoli cells not making ABP
Q: Glucagon acts on what type of receptor?
Answer: Gs –> stimulates adenylate cyclase –> inc cAMP
Q: Destruction of what is used to tx axillary hyperhydrosis?
Answer: T2 sympathetic ganglion
Q: Free floating tissue fragments in the joint space
Answer: OADegradation of cartilage type II collagens and proteoglycans
Q: Vestige of gubernaculum in females that goes through the inguinal canal and into the labia majora
Answer: Round ligament
Q: Most likely to be elevated in a patient with pheochromocytoma
Answer: Urinary metanephrines
Q: PE complications
Answer: Hypoxemia and hyperventilation leading to hypocapnia with respiratory alkalosis (dec PaCO2, dec PaO2, inc pH, hyperventilation)
Q: Right ventricular heave on chest palpitation and bilateral pitting edema of the ankles
Answer: PAHResults from pulmonary arterial endothelial dysfunction
Q: Heavy menses and pelvic heaviness
Answer: Leiomyoma
Q: Ischemic colitis
Answer: Mucosal hemorrhage and patchy areas of necrosisBowel wall thickens and becomes edematous -> transmural infarctionAssociated with CV disease (weak pulses)
Q: Type of collagen messed up in OI
Answer: Type 1Blue sclera
Q: Hypoglycemia and low ketone bodies after 24 hour fast
Answer: Acyl CoA dehydrogenase deficiencyImpaired beta oxidationThis is the most common genetic defect in beta oxidation
Q: Oncoprotein involved with signal transmission from PM to nucleus in MAP kinase system
Answer: RasGTP binding, signal transducing oncoprotein
Q: Effect of adding more enzyme on a lineweaver-burke plot
Answer: Y intercept goes down (1/Vmax), X stays the same (-1/Km)
Q: Most powerful risk factor for osteoarthritis
Answer: Age
Q: Carcinoid tumors
Answer: Polygonal, eosinophilic cells that stain positive for chromogranin and synaptophysinArise in GIT or bronchus and release serotonin
Q: Gram negative bacterium with a haploid genome and a peptidoglycan cell wall between an inner and outer membrane
Answer: E. coli
Q: Alternative method of translation for proteins necessary for apoptosis
Answer: Internal ribosome entry siteA distinct nucleotide sequence allows translation to begin in the middle of mRNA
Q: Medication that induces differentiation of preadipocytes into adipocytes and increases GLUT4
Answer: PioglitazonePPARy activator that decreases insulin resistance
Q: Perineal abscess plus mouth ulcers
Answer: Crohns (affects ileum the most)
Q: Effect of antifungaluse with Warfarin
Answer: Gradual increase in PT over several says (P450 inhibitors)
Q: Tx for hepatic encephalopathy
Answer: Lactulose (acidifies contents of intestines = NH3 to NH4+ and gets rid of hyperammonemia)
Q: Macrolide effect on P450
Answer: Inhibit P450, inhibiting hepatic drug metabolism
Q: Albuterol (beta 2 agonist) receptor in the lungs
Answer: GsIncrease cAMP to relax bronchiole smooth muscle cells
Q: Deposition of excessive unmineralized osteoid matrix in bone
Answer: Osteomalacia (vitamin D deficiency)Resultant hypophosphatemia
Q: DM with cramping calf pain, skin atrophy, foot ulcer
Answer: Peripheral artery disease -> arterial atherosclerosis (femoral artery atherosclerosis)
Q: Mutated gene in Li-Fraumeni
Answer: p53Inactivating mutation affecting 1 alleleDeletion of both copies of a tumor suppressor gene -> malignant cells (second hit)
Q: Hoarseness after cheering loudly at a sporting event, CT reveals dilation of aortic arch
Answer: Posterior cricoarytenoid muscle dysfunction
Q: Virus family that affects epithelial cells and uses host enzymes in the nucleus to replicate
Answer: Papollomavirus
Q: Hemoptysis, fever, cough, thin walled lung cavitation, Mexico
Answer: Coccidiodes immitis
Q: Hypothyroidism with lymphocytic infiltration in the thyroid gland
Answer: Hashimoto’s thyroiditis
Q: Widely split and fixed S2
Answer: ASDYoung patient with poor exercise toleranceNormally, PO2 levels are lowest in the deoxygenated blood of the SVC, RA, and RV
Q: Mother with child with DMD wants to know chance of her unborn child suffering from this disease?
Answer: 50%X-linked recessive, all sons to carrier mothers have a 50% chance of being affected
Q: Excessive thinking in order to avoid painful emotions or fears
Answer: IntellectualizationActing as if he is discussing someone else’s illness
Q: Putting unwanted feelings aside to cope with reality
Answer: Suppression
Q: Esophageal aperistalsis and birds beak sign
Answer: Achalasia -> inflammation and degeneration of neurons in the esophageal wall
Q: Immigrant from Greece with scleral icterus, mild splenomegaly, and anemia after taking antibiotic
Answer: G6PD deficiency -> oxidant stress hemolysis
Q: Stroke in Broca’s area
Answer: Agrammatic speechInferior frontal gyrusIntact comprehension and poor repetition
Q: MAP/TPR
Answer: RPF
Q: Increase in GFR and decrease in RPF
Answer: Constriction in efferent arteriole
Q: Unmyelinated nerve fibers
Answer: Slow pain, heat, olfaction, postganglionic autonomic neurons
Q: Fixed delusions, no other pysch problems, functioning intact
Answer: Delusional disorder
Q: To decrease the standard error, …
Answer: Increase the sample size
Q: Common cause of viral meningitis
Answer: Enteroviruses from the picornavirus family (+ssRNA)
Q: Which component of MHC II is digested by macrophages during antigen processing?
Answer: Invariant chainRemoved and replaced by an EC peptide
Q: Reduction of taste sensation, a burning sensation in her mouth, lip dryness, and anemia
Answer: Iron deficiency
Q: Spike in insulin > spike in blood glucose after glucose injection
Answer: Increased peripheral insulin resistance
Q: Periorbital edema and rust colored urine, honey crusted layer over face
Answer: Post strep GNDue to group A strep (pyogenes) -> gram positive, bacitracin sensitive, beta hemolytic
Q: Oligoarthritis, conjunctivitis, urethritis
Answer: Reactive arthritis
Q: Prader Willi
Answer: Both chromosome 15s are from the mother
Q: Atrophy of the intestinal wall
Answer: Intestinal biopsy of celiac diseaseDermatitis herpetiformis association
Q: High rate of myosin mRNA synthesis
Answer: Changes in cardiac muscle cells responsible for hypertrophy
Q: Callus formation affects this skin layer
Answer: Stratum corneum
Q: Hormone associated with PCOS
Answer: Increased testosteroneFSH is low
Q: Mutations of different genes cause similar phenotypes
Answer: Genetic heterogeneity
Q: Self mutilating behavior, MR, involuntary movements, nephrolithiasis, gout, XLR, HGPRT defect
Answer: Lesch-Nyhan Syndrome
Q: Inhibit protein synthesis at 30S
Answer: Tetracyclines (doxycycline) and aminoglycosides
Q: Inhibit protein synthesis at 50S
Answer: Erythromycin and chloramphenicol
Q: What is responsible for cellular differentiation?
Answer: Transcription factorsGrowth factors stimulate growth, proliferation, and differentiation
Q: What drug could cause pupillary constriction in a denervated eye?
Answer: Pilocarpine (direct cholinergic agonist)Phenylephrine would cause dilation (A1 > A2 agonist)
Q: What is increased in pernicious anemia induced atrophic glossitis?
Answer: Gastrin(intrinsic factor, gastric acid and secretin are DEC)
Q: Scrotal mass that regresses when lying down
Answer: Varicocele
Q: Sudden skin changes in the presence of GI or lung malignancy
Answer: Acanthosis nigricans
Q: Vitamin K antagonist
Answer: WarfarinGiven for long-term anticoagulation in those with mechanical heart valves
Q: Continuous administration of this drug decreases GnRH, LH, FSH and Testosterone
Answer: LeuprolideDecreases testosterone synthesis to slow progression of prostate cancer
Q: Cells that migrate in embryonic development
Answer: Melanocytes and germ cells
Q: Thymic aplasia, parathyroid aplasia and truncus arteriosis
Answer: DiGeorge Syndrome
Q: What types of Ig can we make without class switching?
Answer: IgM and IgD
Q: Hyper IgM syndrome has low levels of what Ig?
Answer: IgA and IgGNo CD40L
Q: Methylated DNA
Answer: SilencedLow transcriptional activity
Q: Bone pain and macrophages that look like wrinkled tissue paper
Answer: Gaucher sisease (beta glucocerebrosidase Def)Marked osteopenia with cortical collapse
Q: Second messager system for alpha1 receptors
Answer: Gq (phospholipase C, IP3, DAG, Ca)
Q: Anti TNF-alpha agents
Answer: Infliximab (monoclonal anitbody)Enterecept (recombinant TNF receptor fusion protein)
Q: Aspirin – COX1 vs COX2 effects
Answer: COX1- platelet thingsCOX2- inflammatory things
Q: Umbilical vein –> Liver –> ??? –> IVC
Answer: Ductus Venosus
Q: Broomlike structure on silver stain
Answer: AspergillusThose with a history of Tb are prone to develop aspergillomas
Q: Bacteria take up naked DNA from environment and incorporate it into their genome
Answer: Transformation
Q: Bacteriophage mediated transfer of genetic information
Answer: Transduction
Q: Collapsing glomerulopathy and microcysts in the setting of HIV
Answer: FSGS
Q: Pneumothorax tx
Answer: Chest tube
Q: Hand-Foot-Genital Disease; short thumb/great toe, small feet, urinary tract probs, hypospadias, GU duplications in women
Answer: HoxA-13 mutation
Q: Increased ADH with an increase in urine output
Answer: Nephrogenic DIHigh serum osmolalityLow urine osmolalityHigh serum ADHHigh serum sodium
Q: Malabsorption caused by celiac disease -> vitamin D deficiency
Answer: Dec bone resorptionInc intestinal calcium absorptionInc renal phosphate reabsorptionDec PTH secretion
Q: High anion gap metabolic acidosis
Answer: Methanol, Uremia, DKA, Propylene glycol, Isoniazid, Iron, LA, Ethylene glycol, Salicylates (MUDPILES)
Q: High anion gap, flank pain, hematuria, oliguria, oxalate crystals in urine
Answer: Ethylene glycol poisoning
Q: PCR thermal cycling
Answer: Heat- DNA denaturationCool- RNA primers attach to ssDNAHeat-primer extension and DNA synthesis
Q: MCA infarct effect on vision
Answer: Homonymous hemianopsia
Q: Supraclavicular
Answer: Virchow’s nodeMay signify an occult abdominal malignancy
Q: Decreased what = increase contraction velocity
Answer: Afterload
Q: Semilunar hiatus in middle nasal meatus
Answer: Path of drainage of the maxillary sinuses
Q: I band
Answer: Part of the sarcomere that lengthens during muscle relaxation and shortens during contractionContains Z line and thin (actin) filaments that do not overlap with thick (myosin) filaments
Q: Consistent delay in the time of sleep onset
Answer: Circadian rhythm disorder