Madi Egan
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Quiz on W5 Questions, created by Madi Egan on 12/10/2018.

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Madi Egan
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Question 1 of 34

1

Protein degradation
What degrades damaged mitochondria?

Select one of the following:

  • Macroautophagy

  • Caspases

  • Chaperon-mediated autophagy

  • 26S proteasomes

Explanation

Question 2 of 34

1

Protein degradation (Wojcik)
What is the difference between lysosomes and proteasomes?

Select one of the following:

  • In contrast to proteasomes, lysosomal enzymes operate at alkaline pH.

  • In contrast to lysosomes, proteasomes are not surrounded by a membrane.

  • In contrast to proteasomes, lysosomes do not degrade cytoplasmic proteins.

  • In contrast to lysosomal enzymes, proteasomes have only one catalytic activity.

Explanation

Question 3 of 34

1

Protein degradation (Wojcik)
Proteasome inhibitors are currently used for the treatment of which of the following conditions?

Select one of the following:

  • Malaria

  • Asthma

  • Multiple myeloma

  • Ulcerative colitis

Explanation

Question 4 of 34

1

Anatomy (Nelsen)
A 28-year-old man presents with chest pain and breathlessness resulting from formation and rupture of a lung bleb (a weakening in
the alveolar wall resulting in an out-pocketing and eventual rupture into the pleural space). In addition to the breakdown of the epithelial wall of the alveoli, what is the final membrane that must be breached in order to allow air to escape from the lung into the pleural cavity?

Select one of the following:

  • Endothoracic fascia

  • Parietal pleura

  • Visceral pleura

  • Pulmonary ligament

Explanation

Question 5 of 34

1

Nelson-Anatomy: cardiovascular
A 45-year-old woman is admitted to the hospital with edema of the lower extremities. Ultrasound imaging reveals an incompetent bicuspid valve. Into which area will regurgitation (i.e., backwards flow) of blood occur in this patient?

Select one of the following:

  • Ascending aorta

  • Left atrium

  • Pulmonary trunk

  • Right ventricle

Explanation

Question 6 of 34

1

Histology (Wojcik)
Volkmann's (aka perforating) canals allow direct connections between what structures?

Select one of the following:

  • Two osteocytes

  • Blood vessels in adjacent osteons

  • Blood vessels outside a bone and inside an osteon

  • Blood vessels outside a bone and inside the marrow cavity

Explanation

Question 7 of 34

1

Histology (Wojcik)
By what route do nutrients and oxygen reach chondrocytes in hyaline cartilage?

Select one of the following:

  • Diffusion from endochondral capillaries

  • Diffusion from the perichondrium

  • Passage through canaliculi

  • Passage through gap junctions

Explanation

Question 8 of 34

1

Johnstone-Extracellular Matrix
What is the importance of the non-covalent aggregation of aggrecan (The major proteoglycan of articular cartilage) along hyalurononan chains?

Select one of the following:

  • Aggregates provide tensile strength to connective tissues.

  • Aggregation causes the hyaluronan to unfold and form microfibrils.

  • It allows outside-in signaling to occur at the cell surface.

  • It holds aggrecan in tissues, providing a high net negative charge.

Explanation

Question 9 of 34

1

Johnstone-Extracellular Matrix
Collagen type I is the major collagen of the human body. Which of the following is a collagen type I rich tissue?

Select one of the following:

  • Articular cartilage

  • Basal lamina

  • Skin

  • Zona apparatus of the eye

Explanation

Question 10 of 34

1

Epi Diagnostic (Gorman)
In clinical skills lab you learn to rate the loudness of heart murmurs according to a standard scale as follows: This data represents which type of variable?

Select one of the following:

  • Continuous

  • Nominal

  • Ordinal

  • Interval

Explanation

Question 11 of 34

1

Epi Diagnostic (Gorman)
A patient you are seeing in clinic has blood pressures recorded by her doctor at each of the last 6 visits. During the same period, the patient had her blood pressure checked by firefighters at the neighborhood fire station. Blood pressure values are shown in the table: You note an overall difference between the blood pressure values taken at the doctor's office to those obtained at the fire station, and attribute the difference to which of the following?:

Select one of the following:

  • Measurement bias

  • Selection bias

  • Reliability

  • Chance

Explanation

Question 12 of 34

1

Gene Expression (Spellman)
Histones alter gene expression by which of the following processes?

Select one of the following:

  • Condensing DNA and methylating DNA

  • Condensing DNA

  • Methylating DNA

  • Interacting with transcription factors that contain bromodomains and chromodomains

Explanation

Question 13 of 34

1

Gene Expression (Spellman)
Mammalian mRNAs are primarily transcribed by which of the following?

Select one of the following:

  • RNA Polymerase III and then spliced by the spliceosome and capped

  • RNA Polymerase II, which recruits splicing and capping enzymes

  • RNA Polymerase I and then translated by the ribosome

  • RNA Polymerase's CTD

Explanation

Question 14 of 34

1

Gene Expression (Spellman)
Epigenetic regulation allows information to be passed from which of the following?:

Select one of the following:

  • Cells to their daughters

  • One cell to nearby cells

  • Viruses to cells that they infect

  • Many nearby cells to a target cell

Explanation

Question 15 of 34

1

Gene Expression (Spellman)
The Central Dogma of Molecular Biology is which of the following?

Select one of the following:

  • DNA encodes genes that make protein

  • RNA is translated into protein

  • DNA is used to make RNA, which is used to make protein

  • DNA encodes genes, RNA encodes proteins

Explanation

Question 16 of 34

1

Marfan (Sakai)
In the absence of a family history of Marfan syndrome, diagnosis of Marfan syndrome (according to the new Ghent criteria) requires an enlarged aortic root and which of the following?

Select one of the following:

  • FBN1 mutation known to cause Marfan syndrome

  • Systemic score less than 7 points

  • Scoliosis and facial features

  • Wrist and thumb sign

Explanation

Question 17 of 34

1

Marfan (Sakai)
Marfan Syndrome is a good example of a pleiotropic disease: multiple clinical manifestations are caused by a single defect in a single gene. Which of the following clinical manifestations are characteristic of Marfan syndrome?

Select one of the following:

  • Joint contractures, arachnodactyly, and short stature

  • Ectopia lentis, short stature and stiff joints

  • Aortic aneurysm, hypertelorism, and bifid uvula

  • Aortic aneurysm, ectopia lentis, scoliosis, joint hypermobility and tall stature

Explanation

Question 18 of 34

1

Metabolism (Wirz)
Children with kawashiorkor usually have a fatty liver, due to which of the following?

Select one of the following:

  • The high fat content of their diet

  • The high carbohydrate content of their diet

  • The lack of substrates for gluconeogenesis in the liver

  • The lack of substrates for protein synthesis in the liver

Explanation

Question 19 of 34

1

Nitrogen metabolism (Wirz)
Pyridoxal Phosphate is required for which of the following reactions?

Select one of the following:

  • Glucose -> glycogen

  • Phenylalanine -> tyrosine

  • Propionyl-CoA -> succinyl-CoA

  • Pyruvate -> Alanine

Explanation

Question 20 of 34

1

Nitrogen Workshop (Hansen)
An individual with a deficiency in the conversion of trypsinogen to trypsin would be expected to experience a more detrimental effect on protein digestion than an individual who was defective in other digestive proteases. Why would that be?

Select one of the following:

  • Trypsin activates other zymogens that are secreted by the pancreas.

  • Trypsin has a greater and wider range of substrates.

  • Trypsin activates pepsinogen, which allows digestion to begin in the stomach.

  • Trypsin inhibits intestinal motility, allowing substrates more time to be exposed to the proteolytic enzymes.

Explanation

Question 21 of 34

1

Nitrogen Workshop (Hansen)
Elevated plasma phenylalanine levels are indicative of which disorder?

Select one of the following:

  • Tyrosinemia

  • Argininosuccinic aciduria

  • Maple syrup urine disease

  • Phenylketonuria

Explanation

Question 22 of 34

1

Nitrogen Workshop (Hansen)
Tetrahydrobiopterin is required for which of the following reaction pathways?

Select one of the following:

  • Methionine -> cysteine + alpha-ketobutyrate

  • Propionyl-CoA -> succinyl-CoA

  • Phenylalanine -> tyrosine

  • Pyruvate -> acetyl-CoA

Explanation

Question 23 of 34

1

Pathology (Graf)
A 71 year old woman survives a myocardial infarction (MI). Thirty years later, she has an unfortunate sky-diving accident and dies. At autopsy, a microscopic slide is taken in the area of the old MI and shows which of the following?

Select one of the following:

  • Necrotic myocytes

  • Clusters of neutrophils

  • Aggregates of macrophages

  • Fibrosis

Explanation

Question 24 of 34

1

Pathology (Graf)
After partial resection of the liver, hepatocytes proliferate to re-build the liver. This is an example of which of the following?

Select one of the following:

  • Hyperplasia

  • Hypertrophy

  • Neoplasia

  • Dysplasia

Explanation

Question 25 of 34

1

Pathology (Graf)
A 54 year-old man with a long history of sinusitis presented with progressively worsening headaches. Imaging showed a lesion in his left frontal lobe consistent with an abscess. On biopsy, the center of the lesion was filled with amorphous necrotic debris and acute inflammatory cells. Which type of necrosis does this represent?

Select one of the following:

  • Coagulative

  • Liquefactive

  • Caseous

  • Fibrinoid

Explanation

Question 26 of 34

1

Pathology (Graf)
The left photograph shows a benign neoplasm and the right photograph shows a malignant neoplasm. Which feature of these images best helps to distinguish benign from malignant on gross examination?

Select one of the following:

  • Circumscribed versus infiltrative border

  • Pale yellow color

  • In the uterine cavity versus within the uterine wall

  • Multiple versus single tumors

Explanation

Question 27 of 34

1

Safety (gorman)
Straight out of residency, your new hospitalist job requires special weekend shifts of 48 hours on call, with sufficient staffing so that each person has several hours of down time in which to take a nap. To achieve more competitive premium rates, the health system cuts back on hospitalist staffing, so that naps are no longer possible during weekend shifts. In passing, several of your colleagues mention that they have caught themselves falling asleep at times, such as when browsing through someone's medical record or doing documentation. This is an example of which of the following?:

Select one of the following:

  • Normal accidents

  • Swiss cheese model

  • Human fallibility

  • Latent error

Explanation

Question 28 of 34

1

Safety (Gorman)
An intern rotating on your service prescribes nitrofurantoin for a UTI, failing to notice the patient's allergy to this medication on the new handoff forms. The allergy also escapes the notice of the computer decision support system, the pharmacist, and the nurse who checks off all med orders. Fortunately, the person who is passing meds notices the allergy on the patient's ID and does not administer the medication. This situation is an example of which of the following?:

Select one of the following:

  • Reason's Swiss cheese model

  • Perrow's Normal accidents model

  • Snook's Practical Drift

  • Page's Complex adaptive system

Explanation

Question 29 of 34

1

Trust (Coleman)
You are a medical student rotating in the Emergency Department. Your preceptor asks you go see Sasha, a 22 year-old woman with a chief concern of abdominal pain, who has just been roomed. You introduce yourself to the patient and her companion, Maricel, whom Sasha introduces as her friend. After a brief conversation, you kindly say to Sasha, "I'm glad you have Maricel here for support. I normally like to talk with patients and examine them alone, so in a minute I'd like to have you, Maricel, wait in the lobby, if that's OK with the two of you. Separating an adult (or older child) from a companion can help support a patient's autonomy. Which other ethical principle does this directly support?

Select one of the following:

  • Fidelity

  • Veracity

  • Stewardship

  • Justice

Explanation

Question 30 of 34

1

Trust (Coleman)
A pillar of biomedical ethics is the concept of fidelity. In the context of medicine, fidelity is best described as which one of the following?

Select one of the following:

  • The exactness or reproducibility of a given doctor-patient communication

  • Loyalty between doctor and patient

  • Truth-telling between doctor and patient

  • The development of trust between a doctor and patient

Explanation

Question 31 of 34

1

Urea (Ralle)
Which step of the urea cycle takes place inside the mitochondria?

Select one of the following:

  • Synthesis of carbamoyl phosphate

  • Synthesis of argininosuccinate

  • Synthesis of arginine

  • The release of urea from arginine

Explanation

Question 32 of 34

1

Urea (Ralle)
Which two enzymes provide the ammonia that enters the urea cycle?

Select one of the following:

  • Ornithine transcarbamoylase and nitric oxide synthase in the liver

  • Glutamate synthetase and glutaminase in the liver

  • Alanine aminotransferase and glutamate dehydrogenase in the muscle

  • Glutaminase and glutamate dehydrogenase in the liver

Explanation

Question 33 of 34

1

Urea (Ralle)
In the urea cycle, the first nitrogen comes from ammonia. Where does the second nitrogen in urea come from?

Select one of the following:

  • Lysine

  • Glycine

  • Alanine

  • Aspartate

Explanation

Question 34 of 34

1

Anatomy
The thoracic cardiac nerves that pass through the cardiac plexus contain which type of nerve fibers?

Select one of the following:

  • Preganglionic sympathetic axons

  • Postganglionic sympathetic axons

  • Preganglionic parasympathetic axons

  • Postganglionic parasympathetic axons

Explanation

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