1. An elderly woman die. Then her daughter came and ask if she die in peace.

The answer
of the physician is what core ethical principle?

Justice?

2. A guy has gonorrhea. What the physicial should do?

-Give him treatment and inform health care system

3. A guy like to smoke and he thinks is okay. He was send to the prision for eight months.
He saids “I think smoking is good but going to prision was a real bummer” What stage
is that?
-Precomtemplation?

4. Nonnormal distributions a positive skew

-The mean is greater than the median

5. An experiment that allow unlimited replication what will be the enzyme?

- Telomerase

6. A pts has hypopigmentation, freckes, absent of the thumb and anemia. What is the dx?
- Fanconi Anemia

7. If there is an anomaly is the Rb the cell will stick in which phase?

- G1

8. Pts has ocular disturbance. Has two uncles that has hematuria and hearing loss. What
collagen is affected?
-Type 4

9. They give u a flow cytometry diagram and is CD4+ and CD8+. Which organ it is?
Thymus

10. Calculate the carrier frequency when the disease (AR) is 1/100.000

11. Pts has alopaceia, dry skin

Vitamin A toxicity

12. Pts eat a lot of liver from animals

Vitamin A toxicity

13. Pts has severe acne with is the next step for treatment?
Isotretinoin

14. Ps with cystic fibrosis. Has decrease vibration sensation.

Vitamin E def

15. If u have a problem with ornithinetranscarbalylase u will have a defect in

Urea cycle
 16. Pts has a defect in arylsulfatase A what will be increase?
Cerebroside

17. Pts has cancer in the testes. Where will be the lymphatic drainage?
Para aortic

18. MHC class 1 has ….B2 microglobulin

19. Young man with stiff in this back …. is B27

20. Natural killers induce apoptosis via… granzymes

21. Ps has neumonia what will attract the cells involve? C5a

22. Pts has recurrent Neisseria infections… terminal complement def

23. Pts wakes up and has hematuria – complement regulatory protein def

24. Pts has paroxysmal nocturnal hemoglobinuria- what else he got? … decrease in
haptoglobin

25. Pts is vaccinated for Hepatitis B. lab? HbsAg

26. Pts has been scratch for her cat. Develop a rash in couple of hours? What type of
hypersensitivy is? Type 4

27. Pts bas an acute hemolytic transfusion reaction. What type of hypersensity is ?
Complement mediated cell lysis

28. Pts with Bruton disease? Has LOW CD19 and normal T cell

29. Pts has a transplant 6 weeks later he develops vasculitis of the graft with dense
interstitial lymphocyte? Acute transplant rejection

30. Pts has rheumatoid arthritis they give rituximab the drug target is? CD20

31. Experiment with shiga toxin.. Transduction

32. Vibrio cholera is increase adenyalate cyclase

33. The machrophage activation is via Toll like receptor 4

34. A pts has a cathether infection the organism is catalase + and coagulase negative. What
is the mechanism of virulence? Capsule polysaccharide

35. Pts has a pulmonary hemorrghage. CXR widened mediastinum and has contact with
animals. What is the capsule? Poly D- glutamante
36. Pts has a sx similar of TB, branching filaments and is acid fast what is the organism?
Nocardia

37. They give u a picture of clue cells. Cause? Decrease in lactobacillus

38. Macrophage filled with an organism? Histoplasmosis

39. Pts has a pet and now develop a rash what is the organism? Microsporum canis

40. Pneumocytis jiroveci same picture A and C as first aid.

41. Pts has HIV CD4 less than 150 profilaxis for what organism? Jiroveci

42. Pts travels and develop plasmodium.. Treatment? Chloroquine

43. Pts taking mefloquine star developing hallucitations cause? Drug side effect

44. Pregnant woman has hepatitis high mortality with? HEV

45. Doctor prescribe oral vanco but pts doesn’t want cause last time he receive IV vanco he
developed renal problem. Why this time will not be that side effect? First drug pass

46. Pts receive a drugs that acts in RNA polymerase.? Rifampin

47. Mechanism of resistance of a drug that u give for cytomegalovirus? Viral kinase

48. Experiment that talk about mitochondrial membrane impermeable? Bcl2

49. Experiment talk about what is release in the mitochondrial membrane? Cytochrome C

50. GlyCAM-1 in leukocyte extravasation? Margination

51. Fibroblast? Stain… Vimentin

52. A pts with rhabdiomyosarcoma? Stain… Desmin

53. A pts taking warfarin and also St john wort? Why the alteration in inr? Cause st john is
an inducer

54. The SA node is supply by… RCA

55. Pts has an infart in the ADA they are gonna be collateral branches from? PDA

56. Aortic stenosis heart sound

57. Mitral regurgitation heart sound.. they said increase with handgrip
58. Young pts gets tired when he does exercise ekg delta wave? Atrioventricular
conduction tract bypassing the AV node (answer choice looks really similar)

59. Cardiogenic shock? CO decrease, preload decreae, increase in central venous

60. Pregnant woman why has anemia? Plasma expansion

61. Pts develop a thyroidectomy they damage a nerve? What is the only mucle is okay?
Crycrothyroid

62. Pts has increase growth hormone and increase in IGF-1 but there is not growth?
IGF-1 resistance

63. Experiment of giving insulin to a rat. What happen with gnrh? Increase

64. Pts with neumonia develop decrease in T3? Euthyroid sick syndrome

65. Mechanism of actions of euthyrodi sick syndrome? Altered deiodinase enzyme

66. Pts inject insulin to hearself? Facticious disorder

67. Picture of germinal centers dx? Hashimoto

68. Pts with psammoma bodies? Papillary carcinoma of thyroid

69. Pts with kidney stones, constipations how is the labs? Primay hyperparathyroidism
(arrows qxs)
PTH increase
ALP increae
increase unirnay cAMP

70. Pts taking lithium now wants to drink lot of water ADH is increase. Dx?
Nephrogenic diabetes

71. Young that run get tired but normal lactic acidosis? What enzyme is affected?
Myophosphorilase

72. Sitagliptin mechanism of action? Inhibit glp-1

73. Which drug cause cholesterol gallstone? Fenofibrate

74. Pts has GI symptoms, he is thin and there is a structure that compreess the third
portion of duodenum? Superior mesenteric artery

75. Patient has a cirrhosis and now vomit what is the shunt?
Left gastric – azygos
76. Pts has a hemorrhoid above the pectine line. What is the structure?
Superior rectal vein

77. They give u a pts with the picture of diaphragmatic hernia. What is the cause?
Defect of the pleuroperitoneal membrane

78. They give u the picture of barret esophagus similar to first aid? Intestinal metaplasia

79. Pts with quadrant pain and fever? Cholangitis

80. What drug is used for constipation? Bysacodyl

81. Pts AB+ receive Rh – and develop hemolytic syndrome? Anti kell

82. DIC thrombin increase, fibrinololysis increae and plasmin generation increase

83. Little boy has abdominal paint and the dad said he is like distracted? Lead poison

84. A pts has increase in 2,3 biphosphoglycerate? Decrease in an enzyme pyruvate

kinase

85. A picture of reed stembeg cells? Cd 15- Cd 30

86. Cells with atypical Cd4 with cerebriform and pautriel microabscess? Sezary syndrome

87. Multiple myeloma? Serum and urine PTH CA and 1,25 Vitamin D

88. They give u a picture of aur rods with a weird description? AML

89. Plaxitaxel- microtubules

90. Vincristine- tubules

91. Absent of cremateric reflex? Genitofemoral

92. Patients cant not do dorsiflexion? Peroneal nerve

93. Pts has a sunburst parttern of the tibia on X ray? Osteosarcoma

 94. What layer is the one the one that has more changing rate? Epidermis

95. Pts has an peptid ulcer u give him a drug for pain?
Celecoxib
96. Acetaminophen toxicity is for? N-acetyl-p-benzoquinone imine

97. The picture of primary auditory cortex? Medial geniculate

98. Pts has hemihabillis where is the lesion? Subthalamic nucleus

99. Pts was in a car collision he was okay and then fainted. Dx? Epidural hematoma

100. Young Woman with headache, nausea photophobia. Dx? Migraine

101. Man with dementia with a protein that is increase in 14-3-3 and then he dies?
Creutzfeld jakob disease

102. Pts with vertical palzy. Their cells are from? The Dx is Pinealoma so the
answer Germ cells or astrocytes (I choose the wrong one so don’t recall)

103. Pts has some flaccid muscle, some spastic muscle, no sensory symptoms? ALS

104. Drug for glaucoma?

105. Pts has horner syndrome lesion? Sympathethic thoracic

106. Pts has Alzheimer what is the mechanism of action for the drugs? AChE
inhibitor

107. What is the drug that dilate pulmonary artery but not the rest of the body?
Enflurane? List choice where anesthetics

108. Child is giving ethosuximide this drug act in the? Thalamus

109. Pts said he prefers to be alone? Schizoid

110. Pts is taking ectasy in a party then he develops serotonin syndrome? Ectasy
side effect

111. Pts is alcoholic he said he want to change has been one day withouth taking
alchocol and now has withdrawal. What drug we should give him right away?
Benzodiazepines

112. Experiment of mild constrition of efferent arteriore? GFR increase and FF

increaase

113. A child has a kidney disease that has well response with corticosteroid?
Minimal change disease

114. Acute postestreptococcal glomerulonephritis has? Rbc cast

115. 50 years old man smoker has hematuria flank pain they give u the picture of
clear cells dx? Renal cell carcinoma

116. Young child with palpable mas hematuria aniridia gen? WT1 gen

117. Pts got a radiocontrast they give u a granular cast picture. Dx? Acute tubular
necrosis

118. Mechanism of action of amiloride? Block Na in collecting duct

119. Pts has short extremities what is the alteration on embryogenesis?

Fibroblast growth factor

120. Woman has amenorrhea u do vaginal palpation and feel something that separate
the canal. What else the pts has? Didelphys

121. Pts has a pelvis fracture where is the lesion? Membranous urethra

122. Pts with polycystic ovarian risk for? Endometrial hyperplasia

123. What is the last part of the lung in development? Alveolar

124. Guy wakes up at night doesn’t feel rested, labs are normal is not fat? Dx?
Obstructive sleep apnea

125. Pts has decrease breath sounds decrease fremitus no tracheal deviation? Simple
pneumothorax