The attached figure shows data obtained by measuring the uptake of L-alanine into a mammalian cell from an isotonic salt solution made without (“Without Na+”) versus with (“With Na+”) sodium. Sodium was replaced on a mole-per-mole basis with choline in the “Without Na+” isotonic saline solution. Which of the following statements about L-alanine uptake into this cell is most correct?

Increasing the extracellular isotonic saline solution K+ concentration will decrease the Na+-dependent component of L-alanine uptake into the cell

L-alanine moves into the cell via an antiporter for Na+

In the absence of Na+, L-alanine moves into the cell via a uniporter with a Km for L-alanine of 50 microM

At 500 microM L-alanine in the extracellular solution, the majority of L-alanine uptake is through a Na+-dependent process

ATP depletion would not affect the rate of L-alanine uptake into the cell

You are examining the uptake into cells of a proposed peptide growth factor, Gribel. You show there are no membrane transporters that mediate the movement of Gribel across the plasma membrane. You measure the internalization of Gribel into neuronal cells after you add Gribel to the extracellular solution. You also measure the uptake of a fluid phase marker, a soluble compound that quantitates the rate of fluid uptake, in the absence and presence of Gribel. The data are attached. Based on the presented data, which of the following statements about Gribel is most correct?

Gribel is not internalized by receptor-mediated endocytosis

Gribel is internalized in vesicles that are greater than 250 nm in size

Gribel is not internalized in coated pits

Gribel internalization is not energy-dependent

Gribel is internalized via a mechanism other than endocytosis

Ninety-five percent of the mutations in tumors are:

Frameshift mutations comprise 1.7% of mutations

A man with porphyria starts a cult which soon increases in number. Many of his descendants were found to have porphyria. A smallpox epidemic soon occurs in the cult. Which one of the following terms best describes this situation?

Carriers of porphyria have a higher immunity to smallpox

Which of the following antigens is the most immunogenic?

The protein toxoid from tetanus

The lipids isolated from the milk of a cow with an udder infection

The term redundancy of cytokines means that:

More than one cytokine can have the same function

One cytokine can have many effects

One cytokine can act synergistically with another

One cytokine produced by one cell can effect another cell

One cytokine is antagonistic to another

When a cell is infected and presents the antigen of the infection, in which molecule does it present the antigen and which type of cell responds?

Toll-like receptors; macrophages

Compared to a secondary response, a primary response is:

Slower and lower in amount of IgG

Faster and higher in amount of IgG

Slower but higher in amount of IgG

Slower and lower in amount of IgM

Faster, more specific but lower in amount of IgG

The designated purpose of the “A” (bacitracin)-disc is to distinguish:

Streptococcus pyogenes from other beta hemolytic streptococcus

Alpha-hemolytic bacteria from beta-hemolytic bacteria

Staphylococcus aureus from other staphylococcal bacteria

Staphylococcus aureus from streptococcus pyogenes

Streptococcus pneumoniae from other alpha-hemolytic streptococcus

What type of epithelial tissue is normally keratinized?

Stratified squamous epithelium of skin

Simple cuboidal epithelium of the kidney tubules

Transitional epithelium of the ureter

Simple squamous epithelium of a blood vessel

Mesothelial lining of the lungs

A pathologist is examining tissue under the microscope and sees an area where the cells are necrotic and the nuclei of the cells are pyknotic and have undergone karyorrhexis and karyolysis. The enzymes responsible for these changes were activated by a molecule which enters the cell because of:

Decrease in anaerobic glycolysis

A 37-year-old woman has a Pap smear which is abnormal. A subsequent colposcopy shows a 1 cm flat red area on her cervix which is excised, and is diagnosed as carcinoma-in-situ. This lesion:

Will most likely not recur once completely excised

Is commonly associated with metastatic disease

Derives from mesenchyme and is invasive

Occurred because of previous cervical hyperplasia

Is genetically transmitted and is not influenced by environmental factors

An 8-year-old boy falls on his elbow while running on a sidewalk. He does not sustain an open skin wound but the area first becomes red and then swells up. Pain develops and his mother decides to bring him to the emergency department for an X-ray. Which of the following contributes to the initial redness of the injury?

Release of histamine from trauma injury

Constriction of vascular smooth muscle

Formation of the membrane attack complex

Increased intravascular oncotic pressure

Expression of integrins on endothelium

Beta 2 adrenergic receptor has a Kd of 10-10 M for epinephrine and 10-8 for norepinephrine. This means that:

The affinity for epinephrine is greater

Epinephine will produce a greater end effect in the target cell at saturation

The receptor will bind epinephrine faster

The receptor will bind norepinephrine faster

The receptor will cycle norepinephrine on/off more slowly

Which of the following statements is true regarding Cholera toxin and Pertussis toxin?

Both increase adenylyl cyclase activity

Both inhibit adenylyl cyclase activity

Both inhibit G protein alpha subunit

Both activate G protein alpha subunit

Which of the following statements is true regarding the second messenger cAMP?

cAMP modifies existing proteins as well as affecting gene expression resulting in new protein synthesis

cAMP is generated downstream of an activated Gq subunit

the enzyme adenylyl cyclase converts AMP to cAMP

cAMP activates protein kinase C

The enzyme cAMP phosphodiesterase helps terminate a cAMP-mediated response by converting cAMP to ATP

Which of the following statements is true regarding PIP2 (Phosphatidylinositol 4,5-bisphosphate) and PIP3 (Phosphatidylinositol 3,4,5-trisphosphate)?

PIP2 and PIP3 are membrane-bound inositol phospholipids

PIP3 is broken apart by phospholipase C to produce Inositol trisphosphate (IP3) and Diacylglycerol (DAG)

PIP2 recruits Akt to plasma membrane where Akt is activated

PIP2 is made from PIP3 by the action of phosphatidylinositide 3-kinase (PI-3-kinase)

PIP3 is a second messenger that carries the message directly from Gαq

Quiz

Science Questions

jochamplin 243 questions

Take the quiz

Questions in this quiz (243)

1Attached are the solute concentrations for a normal mammalian cell under resting conditions. Which value will be closest to the resting membrane potential of this cell?
1. A100 mV
2. B4 mV
3. C-80 mV
4. D-183 mV
5. E-22 mV
2The attached figure shows data obtained by measuring the uptake of L-alanine into a mammalian cell from an isotonic salt solution made without (“Without Na+”) versus with (“With Na+”) sodium. Sodium was replaced on a mole-per-mole basis with choline in the “Without Na+” isotonic saline solution. Which of the following statements about L-alanine uptake into this cell is most correct?
1. AL-alanine moves into the cell via an antiporter for Na+
2. BIn the absence of Na+, L-alanine moves into the cell via a uniporter with a Km for L-alanine of 50  microM
3. CAt 500 microM L-alanine in the extracellular solution, the majority of L-alanine uptake is through a  Na+-dependent process
4. DATP depletion would not affect the rate of L-alanine uptake into the cell
5. EIncreasing the extracellular isotonic saline solution K+ concentration will decrease the Na+-dependent component of L-alanine uptake into the cell
3You are examining the uptake into cells of a proposed peptide growth factor, Gribel. You show there are no membrane transporters that mediate the movement of Gribel across the plasma membrane. You measure the internalization of Gribel into neuronal cells after you add Gribel to the extracellular solution. You also measure the uptake of a fluid phase marker, a soluble compound that quantitates the rate of fluid uptake, in the absence and presence of Gribel. The data are attached. Based on the presented data, which of the following statements about Gribel is most correct?
1. AGribel is internalized in vesicles that are greater than 250 nm in size
2. BGribel is not internalized in coated pits 
3. CGribel internalization is not energy-dependent 
4. DGribel is internalized via a mechanism other than endocytosis
5. EGribel is not internalized by receptor-mediated endocytosis
4Spectrin is an integral part in which of the following intracellular structure(s)?
1. AIntermediate filaments
2. BCentrosome
3. CBasal body
4. DDesmosome
5. ECell cortex
5Which protein is necessary to create the forces that result in the bending movements of cilia and flagella?
1. AMyosin
2. BDynein
3. CActin
4. DKinesin
5. EKeratin
6Which intracellular process would be primarily disrupted by inhibition of Arp2/3 complexes?
1. AMicrotubule nucleation
2. BDynamic instability
3. CMicrofilament nucleation
4. DTreadmilling
5. EIntracilliary transport
7Which type of the anchoring contact is used by the migrating (crawling) fibroblasts?
1. ADesmosome
2. BAdherence junction
3. CHemidesmosome
4. DTight junctions
5. EFocal adhesion
8What is the primary function of tissue fibronectin?
1. AIt binds to laminin
2. BIt binds to collagen
3. CIt binds to desmosomes
4. DIt binds to cadherins
5. EIt binds to actin filaments
9Which of the following extracellular matrix components assembles proteoglycans into the gigantic complexes called proteoglycan aggregates?
1. ACollagen type I
2. BHyalumnan
3. CHeparan sulfate
4. DFibronectin
5. ELaminin
10Which type of gene mutations confer a selective growth advantage in cancers?
1. APassenger mutations
2. BFrameshift mutations
3. CDriver mutations
4. DDeletions
5. EInsertions

11Ninety-five percent of the mutations in tumors are:
1. ADeletions
2. BInsertions
3. CTranslocations
4. DFrameshift mutations comprise 1.7% of mutations
5. ESingle base substitutions
12A man and his wife are carriers of a gene for sickle cell disease (autosomal recessive inheritance). What is the probability that this couple may have a phenotypically normal child?
1. A100%
2. B25%
3. C50%
4. D67%
5. E75%
13A man with porphyria starts a cult which soon increases in number. Many of his descendants were found to have porphyria. A smallpox epidemic soon occurs in the cult. Which one of the following terms best describes this situation?
1. AGenetic isolation
2. BFounder effect
3. CHeterozygote advantage
4. DPopulation bottleneck
5. ECarriers of porphyria have a higher immunity to smallpox
14A female alcoholic presents to the emergency department with confusion and memory loss. She also exhibits rolling of her eyeballs. Her diet consists mainly of canned soup. Lack of which vitamin is most likely to be responsible for her symptoms?
1. AVitamin C
2. BFolic acid
3. CThiamine
4. DVitamin B6 (pyridoxine)
5. EVitamin B12
15Which vitamin is involved in collagen synthesis?
1. AFolic acid
2. BNiacin
3. CVitamin B12
4. DVitamin C
5. EVitamin D
16The attached image depicts a histological image of the human mammary gland stained with H&E. What type of connective tissue is most abundant immediately around the glands (arrows)?
1. ADense irregular
2. BDense regular
3. CEmbryonic
4. DLoose connective
5. EWharton's jelly
17As a pathologist you would like to make sure that the magenta colored staining result of a cancerous liver specimen with Periodic acid-Schiff (PAS) reaction is real. Which enzyme would you use to confirm your positive staining result?
1. AAmylase
2. BDNase
3. CLipase
4. DProteinase
5. ERNase
18Which of the following antigens is the most immunogenic?
1. AStreptococcal polysaccharide
2. BDNA from a hepatitis B virus
3. CRNA from HIV
4. DThe protein toxoid from tetanus
5. EThe lipids isolated from the milk of a cow with an udder infection
19Which multilobed lymphatic organ serves as the place for T cell maturation?
1. ASpleen
2. BTrachea
3. CThymus
4. DBone marrow
5. ESalivary gland
20The term redundancy of cytokines means that:
1. AOne cytokine can have many effects
2. BOne cytokine can act synergistically with another
3. COne cytokine produced by one cell can effect another cell
4. DOne cytokine is antagonistic to another
5. EMore than one cytokine can have the same function
21When a cell is infected and presents the antigen of the infection, in which molecule does it present the antigen and which type of cell responds?
1. AClass II molecule; CD4+ T cell
2. BClass II molecule; CD8+ T cell
3. CClass I molecule; CD8+ T cell
4. DClass I molecule; CD4+ T cell
5. EToll-like receptors; macrophages
22Compared to a secondary response, a primary response is:
1. AFaster and higher in amount of IgG
2. BSlower and lower in amount of IgG
3. CSlower but higher in amount of IgG
4. DSlower and lower in amount of IgM
5. EFaster, more specific but lower in amount of IgG
23Which is the most accurate description of the type of organism that a laboratory would try to isolate on MacConkey agar?
1. AGram-positive coccus
2. BGram-negative enteric bacillus
3. CGram-positive bacillus
4. DYeast-like fungus
5. ESpirochetal bacteria
24The designated purpose of the “A” (bacitracin)-disc is to distinguish:
1. AAlpha-hemolytic bacteria from beta-hemolytic bacteria 
2. BStaphylococcus aureus from other staphylococcal bacteria
3. CStaphylococcus aureus from streptococcus pyogenes
4. DStreptococcus pyogenes from other beta hemolytic streptococcus 
5. EStreptococcus pneumoniae from other alpha-hemolytic streptococcus
25You suspect that your patient may have an infection. You send a patient sample to the clinical microbiology lab for analysis. The lab cultures an organism on blood agar which is catalase positive. A coagulase test is done next and the result is clumping of the test plasma. The likely cause of this patient’s infection is:
1. AStreptococcus pyogenes
2. BStreptococcus pneumoniae
3. CStaphylococcal aureus
4. DStaphylococcal epidermidis
5. EStaphylococcal saprophyticus
26What type of epithelial tissue is normally keratinized?
1. ASimple cuboidal epithelium of the kidney tubules
2. BTransitional epithelium of the ureter
3. CSimple squamous epithelium of a blood vessel
4. DStratified squamous epithelium of skin
5. EMesothelial lining of the lungs
27The inner lining of this blood vessel allows for passive diffusion and filtration. It is best classified as what type of epithelium? (Please see attachment)
1. APseudostratified
2. BSimple squamous
3. CCuboidal
4. DSimple columnar
5. ETransitional
28Which of the tissues/organs listed below is most likely to be lined by transitional epithelium?
1. ABladder
2. BLarge intestine
3. CSkin
4. DEsophagus
5. EUterus
29Which of the following features does cardiac muscle have in common with skeletal muscle?
1. APeripheral, multiple nuclei
2. BVoluntary control
3. CStriations
4. DLocation
5. EIntercalated discs
30A 66-year-old woman has multiple bladder stones and undergoes a cystoscopy. Irregular areas of her bladder mucosa are biopsied and reveal that the normal transitional epithelium has been replaced in areas by mature normal appearing squamous epithelium. What is this process known as?
1. APathological hyperplasia
2. BMetaplasia
3. CAtrophy
4. DPhysiological hypertrophy
5. EDysplasia
31The accompanying photo represents a microscopic section of an unidentified organ with an area of necrosis which shows preserved cellular architecture with loss of nuclei, resulting from loss of blood supply. What does this most likely represent? (Please see attachment)
1. AA kidney infarct
2. BAcute pancreatitis
3. CPulmonary tuberculosis
4. DBrain abscess
5. EVascuilitis
32A pathologist is examining tissue under the microscope and sees an area where the cells are necrotic and the nuclei of the cells are pyknotic and have undergone karyorrhexis and karyolysis. The enzymes responsible for these changes were activated by a molecule which enters the cell because of:
1. ALoss of intracellular Na+
2. BIncreased pH
3. CIncreased ATP production
4. DFailure of the Ca+2 pump
5. EDecrease in anaerobic glycolysis
33A 4-year-old girl has recurrent acute bacterial infections. During the most recent bout of acute bacterial cellulitis of her arm, caused by Staphylococcus aureus, she has an elevated white blood cell count with an increased percentage of neutrophils in her peripheral blood. A biopsy taken from an area of soft tissue necrosis shows many bacteria but very few neutrophils. An analysis of neutrophil function shows a defect in rolling. Which of the following is most likely to be dysfunctional?
1. AComplement C3b
2. BSelectins
3. CIntegrins
4. DNADPH oxidase
5. ELeukotrienes
34A 20-year-old woman has two days of low grade fever with malaise, cough, and nasal congestion. Physical examination reveals clear breath sounds. A white blood cell count shows mild to moderate elevation in lymphocytes. The most likely etiology for this woman’s condition is:
1. AAcute, bacterial infection
2. BParasitic infection
3. CAllergic reaction
4. DViral infection
5. EAnaphylaxis
35A 33-year-old morbidly obese man undergoes a colectomy with a large incision because of difficulties during the surgery. During recovery after the surgery, he experiences severe nausea and has an episode of vomiting without fever. Which of the following complications is most likely to be a deterrent in his surgical wound healing?
1. AInfection
2. BMalnutrition
3. CForeign body
4. DDehiscence
5. EContracture
36A 33-year-old woman undergoes successful surgery for a ruptured appendix. Approximately five to seven days post-operatively, the healing skin suture site predominantly contains:
1. ANeutrophils
2. BCollagen
3. CGranulomas
4. DKeloid
5. EGranulation tissue
37A 37-year-old woman has a Pap smear which is abnormal. A subsequent colposcopy shows a 1 cm flat red area on her cervix which is excised, and is diagnosed as carcinoma-in-situ. This lesion:
1. AIs commonly associated with metastatic disease
2. BWill most likely not recur once completely excised
3. CDerives from mesenchyme and is invasive
4. DOccurred because of previous cervical hyperplasia
5. EIs genetically transmitted and is not influenced by environmental factors
38A large, bulky retroperitoneal mass is removed from a 58-year-old woman. Microscopic examination reveals no distinct glands, keratin, or other structures and the cells are extremely disorganized. There is marked anaplasia and pleomorphism with increased mitoses, including bizarre mitotic figures. Special stains are needed to make a final diagnosis. This tumor is most likely:
1. ABenign
2. BWell-differentiated
3. CSlow-growing
4. DHigh grade
5. EWell-circumscribed
39A 69-year-old man has guaiac positive stools and weight loss. He undergoes a colonoscopy and a large ulcerating mass is discovered in his sigmoid colon. A biopsy of the mass reveals invasive, irregular, crowded glands with pleomorphic nuclei. There is invasion into blood vessels and lymphatics. What is the tumor best classified as?
1. ALeiomyosarcoma
2. BMelanoma
3. CFibroadenoma
4. DPapiloma
5. EAdenocarcinoma
40An 8-year-old boy falls on his elbow while running on a sidewalk. He does not sustain an open skin wound but the area first becomes red and then swells up. Pain develops and his mother decides to bring him to the emergency department for an X-ray. Which of the following contributes to the initial redness of the injury?
1. AConstriction of vascular smooth muscle
2. BFormation of the membrane attack complex
3. CIncreased intravascular oncotic pressure
4. DExpression of integrins on endothelium
5. ERelease of histamine from trauma injury
41Which of the following is a signal that mammalian cells use to communicate between themselves?
1. ALight
2. BSound
3. CSmell
4. DHeat
5. EGas
42Beta 2 adrenergic receptor has a Kd of 10-10 M for epinephrine and 10-8 for norepinephrine. This means that:
1. AEpinephine will produce a greater end effect in the target cell at saturation
2. BThe affinity for epinephrine is greater
3. CThe receptor will bind epinephrine faster
4. DThe receptor will bind norepinephrine faster
5. EThe receptor will cycle norepinephrine on/off more slowly
43Which of the following statements is true regarding Cholera toxin and Pertussis toxin?
1. ABoth inhibit adenylyl cyclase activity
2. BBoth inhibit G protein alpha subunit
3. CBoth activate G protein alpha subunit
4. DBoth increase adenylyl cyclase activity
5. EBoth decrease cAMP production
44Which of the following statements is true regarding the second messenger cAMP?
1. AcAMP is generated downstream of an activated Gq subunit
2. Bthe enzyme adenylyl cyclase converts AMP to cAMP
3. CcAMP activates protein kinase C
4. DcAMP modifies existing proteins as well as affecting gene expression resulting in new protein synthesis
5. EThe enzyme cAMP phosphodiesterase helps terminate a cAMP-mediated response by converting cAMP to ATP
45Which of the following statements is true regarding PIP2 (Phosphatidylinositol 4,5-bisphosphate) and PIP3 (Phosphatidylinositol 3,4,5-trisphosphate)?
1. APIP2 and PIP3 are membrane-bound inositol phospholipids
2. BPIP3 is broken apart by phospholipase C to produce Inositol trisphosphate (IP3) and Diacylglycerol  (DAG)
3. CPIP2 recruits Akt to plasma membrane where Akt is activated
4. DPIP2 is made from PIP3 by the action of phosphatidylinositide 3-kinase (PI-3-kinase)
5. EPIP3 is a second messenger that carries the message directly from Gαq
46If a healthy adult carries a Robertsonian 21:21 translocation, what is the approximate chance that any of their live-born biological offspring will have Down syndrome?
1. A0%
2. B100%
3. C50%
4. D25%
5. E5%
47Which of the following genetic disorders is caused by a chromosomal abnormality usually not detectable on routine karyotype but usually detectable using a specific FISH (Fluorescent In-Situ Hybridization) probe?
1. ADown syndrome
2. BEdwards syndrome
3. CDiGeorge syndrome
4. DPatau syndrome
5. ETurner syndrome
48A patient taking a particular antiepileptic medication is given an antimicrobial agent that is metabolized by CYP3A4. Because of drug interaction involving CYP3A4, the dose of the antimicrobial is increased, according to the manufacturer’s recommendations. The CYP3A4 inducer is most likely:
1. ACarbamazepine
2. BErythromycin
3. CItraconazole
4. DProbenecid
5. ERitonavir
49An adult with a history of prescription drug abuse presents to the emergency department with signs and symptoms consistent with morphine overdose. The drug’s therapeutic and toxic effects are both related to its activity on specific G protein-coupled receptors. The seriousness of the drug’s toxic effects is proportionately related to the drug concentration. This is an example of:
1. ADose dependent toxicity
2. BGentoxicity
3. CIdiosyncratic toxicity
4. DSupra-additive toxcitiy
5. EUnpredictable toxicity
50A cancer patient is given an antineoplastic drug that causes damage to the cancer cells’ DNA which ultimately activates intracellular signaling leading to programmed cell death. This phenomenon is termed:
1. AApoptosis
2. BFibrosis
3. CMutagenesis
4. DNecrosis
5. ETeratogenesis
51A patient presenting with a morphine overdose is given a rapid-acting antidote that acts at the same receptors and reverses the effects of the morphine. (Morphine is a mu receptor agonist.) The mechanism of this antidote-agonist drug action is:
1. AAllosteric antagonism
2. BChemical antagonism
3. CPartial antagonism
4. DPhysiologic antagonism
5. EReceptor antagonism
52A patient’s sputum sample is sent to the microbiology laboratory for culture and susceptibility testing. The pathogen is found to have intermediate resistance to the first-line antibiotic. As a result of this resistance, the drug exhibits reduced:
1. AEfficacy
2. BHalf-life
3. CPotency
4. DSelectivity
5. ESpectrum
53A pharmaceutical company investigating an experimental antibiotic finds that the drug produces a faster kill rate and more extensive degree of killing as the drug concentrations increase. Additionally, the drug produces prolonged, persistent antibacterial effects. This activity profile is best described by which one of the following?
1. AEC50 right shift
2. BEmax decrease
3. CPeak/MIC
4. DT>MIC
5. E24h-AUC/MIC
54Which of the following provide glutamatergic input to granule cells?
1. AStellate cells
2. BPurkinje cells
3. CClimbing fibers
4. DMossy fibers
5. EParallel fibers
55Cerebellar efferents destined for the right red nucleus exit through which peduncle?
1. ALeft inferior peduncle
2. BLeft middle peduncle
3. CLeft superior peduncle
4. DRight inferior peduncle
5. ERight superior peduncle
56Striatal neurons possessing D1 receptors:
1. AExhibit decreased excitability with dopamine
2. BExcite the globus pallidus external
3. CInhibit the globus pallidus external
4. DInhibit the substantia nigra pars reticulata
5. EInhibit the subthalamic nucleus
57This basal ganglia disorder has a strong genetic component:
1. AHemiballismus
2. BDementia pugilistica
3. CIdiopathic Parkinson's disease
4. DMPTP
5. EWilson's disease
58Which of the following basal ganglia nuclei receive direct input from the cerebral cortex?
1. AGlobus pallidus external
2. BGlobus pallidus internal
3. CSubstantia nigra pars compacta
4. DSubstantia nigra pars reticulata
5. ESubthalamic nucleus
59The presence of these neuron-embedded protein aggregations are a hallmark of Parkinson’s disease:
1. AAmyloid plaques
2. BLewy bodies
3. CMelanin
4. DMPTP
5. ENeurofibrillary tangles
60The cell bodies of which neurons are found in the middle layer of the cerebellar cortex?
1. AClimbing fibers
2. BDeep cerebellar nuclei
3. CGranule cells
4. DInhibitory interneurons
5. EPurkinje cells
61Primary somatosensory cortex receives direct input from which nuclei?
1. AGracile and cuneate nuclei
2. BMedial dorsal nuclei (MD)
3. CMesencephalic trigeminal nucleus
4. DReticular formation
5. EVentral posterior lateral nuclei (VPL)
62A lesion to this neural substrate would blunt the sensation of light touch along the left forehead:
1. ALeft spinal trigeminal nucleus
2. BLeft pontine trigeminal nucleus
3. CLeft mesencephalic trigeminal nucleus
4. DLeft ventral posterior medial nucleus
5. ERight ventral posterior lateral nucleus
63Which sensation would be least affected by blocking the activity of myelinated afferent fibers?
1. ALimb position
2. BMuscle force
3. CSharp pain
4. DVibration
5. EWarmth
64Accurate two-point discrimination is dependent on which sensory organ?
1. AJoint receptors
2. BMerkel disks
3. CMuscle spindles
4. DPacinian corpuscles
5. ERuffini corpuscles
65Neurons of the corticobulbar tract:
1. AAre "lower motor neurons"
2. BArise from the medial portion of the primary motor cortex
3. CMostly terminate bilaterally in the brainstem
4. DMostly terminate contralaterally in the brainstem
5. EMostly terminate ipsilaterally in the brainstem
66What percentage of pyramidal tract fibers form the ventral corticospinal tract?
1. A5%
2. B15%
3. C50%
4. D85%
5. E95%
67Which of the following is characteristic of a lower motor neuron lesion?
1. AAtrophy of the muscle
2. BMuscle spasms leading to altered limb posture
3. CExtension of hallux evoked by stroking the foot sole
4. DSustained limb oscillations to a tendon tap
5. ETremor present during passive rest
68What is the lateral-medial representation within primary motor cortex?
1. AFace-arm-hand-trunk-leg
2. BFace-hand-arm-trunk-leg
3. CHand-face-arm-trunk-leg
4. DLeg-trunk-arm-face-arm
5. ELeg-trunk-arm-hand-face
69A carotid angiogram demonstrates occlusion of the left middle cerebral artery. Based on the location of this occlusion, you expect to see which of the following deficits?
1. AParalysis and sensory deficits in the right leg and perineuim, weakness of the right face, tongue and upper limb, and anosmia
2. BParalysis of the lower right side of the face and right arm and bilateral hemianopsia of the contralateral visual fields of both eyes
3. CParalysis of the right-side of the body, right-sided hemianopsia, and left-sided blindness
4. DParalysis of the lower left side of the face and left arm, bilateral hemianopsia of the contralateral  visual fields of both eyes, and global aphasia
5. EParalysis and sensory deficits in the left leg and perineuim, weakness of the left face, tongue and  upper limb, and anosmia
70An 8-year-old male is brought in by ambulance to the emergency department after being hit in the head by a fast moving foul ball at a baseball game. He is currently awake and alert, and responds to questions and commands. However, a CT scan of the head shows a collection of blood that does not cross suture lines. The most likely source of this blood is a(n):
1. ARupture of the bridging veins
2. BTear of the middle meningeal artery
3. CRupture of a berry aneurysm
4. DEmbolus to the left posterior cerebral artery
5. ERupture of a Charcot-Bouchard microaneurysm
71A 55-year-old Caucasian male presents to the emergency department with left-sided loss of pain and temperature sensation to the upper and lower limb. While conducting a neurological exam, you also note that his right eye is exhibiting ptosis and miosis. After conducting an MRI, it is verified that the patient has a lesion to the right caudal pons. Which of the following symptoms might this patient also have presented with based on the location of the lesion?
1. ALeft facial paralysis
2. BLeft facial paralysis with sparing of the forehead
3. CDecreased gag reflex
4. DRight facial paralysis
5. ERight facial paralysis with sparing of the forehead
72An 80-year-old African American female is brought into the emergency department via ambulance from her nursing home facility. The paramedics activated the advanced care life support protocol for a code stroke based on the patient’s signs and symptoms. Once you begin examining her, you note that she has left-sided hemiparesis, right-sided total facial paralysis, and right-sided conjugate gaze paralysis. Before sending your patient for an MRI you suspect she is suffering from which of the following syndromes?
1. ARaymond's syndrome
2. BWallenberg's syndrome
3. CMillard-Guebler syndrome
4. DWeber's syndrome
5. EFoville's syndrome
73A patient with receptive aphasia presents to the emergency department. Neuroimaging reveals no injury to Wernicke’s area. What other neural structure might exhibit injury/lesion to produce this clinical presentation?
1. AOccipital lobe
2. BMiddle cerebellar peduncle
3. CArcuate fasciculus
4. DCerebral peduncle
5. EPrecentral gyrus
74An unconscious patient presents to the emergency department with left-side parietal lobe injury evident in neuroimaging. Which of the following might a clinician suspect will be present in this patient upon return of consciousness?
1. AVoluntary motor control deficits
2. BAuditory deficits
3. CHemi-neglect
4. DExpressive aphasia
5. EVertigo
75Neurons in the neocortex with pyramidal morphology and dendritic spines release which of the following neurotransmitters?
1. AAcetylcholine
2. BGamma amino-butyric acid
3. CGlutamate
4. DNorepinephrine
5. ESerotonin
76Genetic mutations affecting this cellular process have been implicated in microcephaly?
1. ANeurotransmitter release
2. BDendritic growth
3. CCell division
4. DAxonal sprouting
5. ENeuronal excitability
77Which of the following best describes the developmental sequence for neocortical layer IV?
1. ALayer IV neurons are born after layer III 
2. BLayer IV neurons are born before layer III neurons and migrate closer to the pial surface than layer III neurons 
3. CLayer IV neurons are born after layer V neurons and migrate past layer V neurons
4. DLayer IV neurons are born before layer V neurons and migrate past layer V neurons 
5. ELayer IV neurons are born after layer V neurons and migrate further away from the pial surface than layer V neurons
78Which of the following best describes the function of the massa intermedia?
1. AConstitutes the speech-language pathway
2. BConnects the cerebral hemispheres
3. CConnects the thalamic hemispheres
4. DConnects the thalamus and cortex
5. EConnects the mammillary bodies and thalamus
79Which of the following constitutes the axonal pathway connecting the thalamus and neocortex?
1. AArcuate fasciculus
2. BCorpus callosum
3. CInternal capsule
4. DMassa intermedia
5. EMammilothalamic tract
80Neurons in the primary auditory cortex project to which of the following thalamic nuclei?
1. AOnly the medial geniculate
2. BOnly the reticular nucleus
3. CMedial geniculate and reticular nucleus
4. DMedial dorsal and reticular nucleus
5. EMedial geniculate and medial dorsal
81A patient with sudden onset blindness is brought to the emergency department. Imaging of the eye and visual cortex reveals no obvious pathology. The next brain region to examine for possible lesions would include which of the following thalamic nuclei?
1. AVentral posterior medial
2. BVentral posterior lateral
3. CLateral geniculate
4. DMedial dorsal
5. EMedial geniculate
82Which of the following hypothalamic nuclei is the feeding center of the brain?
1. ALateral nucleus
2. BMedial preoptic nucleus
3. CArcuate nucleus
4. DVentromedial nucleus
5. EMammillary nucleus
83Which of the following hormones participates in the short-term control of pre-meal hunger and meal initiation?
1. AAgouti-related peptide
2. BCorticotropin-releasing factor (CRF)
3. CGhrelin
4. DLeptin
5. EGlucagon
84Which of the following hypothalamic nuclei is the satiety center of the brain?
1. ALateral nucleus
2. BSuprachiasmatic nucleus
3. CSupraoptic nucleus
4. DParaventricular nucleus
5. EVentromedial nucleus
85A 7-year-old girl presents to your office with severe obesity (body mass index of >40), hyperphagia and metabolic neuroendocrine and immune dysfunction. Sequencing of the ob gene for both the proband and her parents reveals the child to be homozygous for deletion of a single guanine nucleotide in codon 133 of the ob gene reading frame. Based upon these findings, you would suspect the above mutation to be localized to cells of the:
1. AHypothalamus
2. BBrown adipose tissue
3. CPituitary
4. DDuodenum
5. EProximal small intestine
86Stringing together unrelated or inappropriate facts, as often seen in patients with chronic alcohol consumption, is known as:
1. AConfabulation
2. BDiplopia
3. CVertigo
4. DHyperorality
5. EHyperphagia
87A 42-year-old man is brought to the emergency department from the site of a collapsed building after an earthquake. Suspecting a brain injury, the attending physician orders a CT (computerized tomography) scan. This reveals bilateral damage to rostral aspects of the temporal lobes. After recovering from the initial trauma, this man displays compulsive exploratory behavior around the hospital and repeatedly examines objects by placing them in his mouth. These behavioral aberrations, when correlated with the CT findings, suggest which of the following syndromes?
1. AFoster-Kennedy syndrome
2. BKluver-Bucy syndrome
3. CWernicke-Korsakoff syndrome
4. DWallenberg syndrome
5. ESeptal rage syndrome
88This clinical condition results from a thiamine (vitamin B1) deficiency and is characterized by ocular disturbances and nystagmus, gait ataxia and cognitive deficits. Brain pathology includes lesions to the mammillary nuclei, dorsomedial nucleus of the thalamus, periaqueductal gray and pontine tegmentum. What is the name of this condition?
1. AAmnestic syndrome
2. BFoster-Kennedy syndrome
3. CKorsakoff syndrome
4. DStrachan's syndrome
5. EWernicke's enceophalopathy
89Which of the following nuclei is associated with the neural control of micturition?
1. ASupraoptic nucleus
2. BRaphe nucleus
3. CBarrington's nucleus
4. DEdinger-Westphal nucleus
5. ENucleus of Maynert
90Which of the following conditions is a common side effect of opioid medication?
1. AHemorrhoids
2. BConstipation
3. CAscites
4. DProctorrhea
5. EDiarrhea
91Which of the following brain regions modulates the phenomenon of stimulus-induced analgesia?
1. AVentral tegmental area
2. BSuprachiasmatic nucleus of the hypothalamus
3. CAmygdala
4. DHippocampus
5. EPeriaqueductal gray area
92Which of the following brain waves best represents stage 3-4 of the sleep-wake cycle? (Please see attachment)
1. AA
2. BB
3. CC
4. DD
5. EE
93
A 50-year-old man with a history of severe insomnia presents to the neurology department complaining of bizarre sensations in his legs such as “pulling, searing, crawling and shimmering”. On examination, he is noted to have iron-deficiency anemia. Which of the following diagnoses should you suspect?
1. AObstructive sleep apnea
2. BRestless leg syndrome
3. CNarcolepsy
4. DDelayed-sleep syndrome
5. ECircadian-rhythm disorder
94Which of the following physical exam findings are clinical features of narcolepsy?
1. AConfabulation
2. BRetrograde amnesia
3. CHypnagogic hallucinations
4. DDysphagia
5. EAnorexia
95Which of the following neuropeptides plays an essential role in maintaining wakefulness and regulating transitions between sleep and wake cycles?
1. AOrexins
2. BMelanocortins
3. CIndoleamines
4. DCannabinoids
5. EEndorphins
96At what vertebral level can one most easily introduce a needle into the dural sac without piercing the spinal cord?
1. AC5/6
2. BL3/4
3. CS3/4
4. DT4/5
5. ET8/L1
97Which neural structure is located on the ventral medulla?
1. AGracile tubercle
2. BInferior olive
3. CMammillary bodies
4. DMedial eminence
5. ESuperior colliculus
98What neural structure is immediately inferior to the inferior colliculus?
1. AGracile tubercle
2. BInferior olive
3. CPyramidal decussation
4. DSuperior colliculus
5. ETrochlear nerve
99The tonsils belong to what part of the cerebellum?
1. AAnterior lobe
2. BFloculonodular lobe
3. CInferior vermis
4. DPosterior lobe
5. EUvula
100Impaired temperature and pain sensation from the right leg would result from a lesion to which white matter tract of the spinal cord?
1. ALeft antero-lateral tract
2. BLeft gracile fasciculus
3. CRight antero-lateral tract
4. DRight cuneate fasciculus
5. ERight gracile fasciculus
101Which is the largest descending tract of the spinal cord?
1. ACuneate fasciculus
2. BLateral corticospinal tract
3. CRubrospinal tract
4. DVentral corticospinal tract
5. EVestibulospinal tract
102Which portion of the spinal cord is involved in processing pain information?
1. AOnuf's nucleus
2. BPhrenic nucleus
3. CNucleus dorsalis
4. DSpinal accessory nucleus
5. ESubstantia gelatinosa
103Damage to which of the cerebral lobes is likely responsible for the majority of expressive aphasia cases?
1. ALeft cerebellar lobe/hemisphere
2. BLeft frontal lobe
3. CLeft parietal lobe
4. DRight occipital lobe
5. ERight temporal lobe
104 Which cortical invagination divides the primary motor cortex from the primary sensory cortex?
1. ACentral sulcus
2. BLateral fissure
3. CLongitudinal fissure
4. DPre-occipital notch
5. ESylvian fissure
105Which cerebral lobe controls primary motor movement on the right side of the body?
1. ALeft frontal lobe
2. BLeft parietal lobe
3. CLeft temporal lobe
4. DRight frontal lobe
5. ERight parietal lobe
106Which of the following general statements applies to the human brain?
1. AFemale brains tend to contain more glial cells than male brains
2. BHuman brains consist of more neurons than glial cells
3. CHuman brains do not grow anymore after birth
4. DMale brains are generally heavier than female brains
5. EMale brains generally contain more neurons than female brains
107Which process/event initiates the invagination of neuroectodermal tissue and is thereby responsible for the formation of the neural tube?
1. AAccumulation of folic acid in neuroectoderm
2. BClosure of the rostral neuropore
3. CProduction of bone morphogenetic proteins (BMPs) by neural crest cells
4. DRelease of alpha-fetoprotein (AFP) by neuroectoderm
5. ERelease of the signaling protein sonic hedgehod (SHH) notochord cells
108What defect, most commonly observed in infants, will most likely result from excessive cerebrospinal fluid?
1. AAnencephaly
2. BArnolad-Chiari malformation
3. CHydrocephalus
4. DMeroanencephaly
5. ESpina bifida with meningomyelocele
109How can genetic defects that specifically affect central and peripheral nervous system cells also affect skin pigmentation?
1. ABecause certain pigment forming cells are of neural crest origin
2. BBecause melanocytes are of mesodermal origin
3. CBecause of a direct innervation of pigment forming cells
4. DBecause of the involvement of Schwann cells in skin pigmentation
5. EBecause pigment forming chromaffin cells are of neuroectodermal origin
110What distinguishes microglia from all other major resident cell types found in the central nervous system?
1. AMicroglia are derived from mesoderm
2. BMicroglia are derived from neural crest cell
3. CMicroglia are non-phagocytic
4. DMicroglia form processes that wrap around brain endothelial capillaries
5. EMicroglia have the ability to differentiate into macroglia
111Neural signals mediating touch and proprioception are carried by the:
1. ACorticospinal pathway which decussates in the midbrain
2. BCorticospinal pathway which decussates in the medulla
3. CPyramidal tract which decussates in the midbrain
4. DSpinothalamic tract which is medially located throughout the length of the brainstem
5. EDorsal column-medial lemniscus pathway which decussates in the medulla
112The inferior olivary complex of nuclei:
1. AProject axons across the midline to the red nuclei
2. BControl eye movements
3. CAre anterior to the pyramids in the brainstem
4. DAre located in the midbrain
5. EProject axons across the midline to the cerebellum
113A patient has pain and temperature loss on the right side of the body, but unaffected movement control. A possible location of the lesion in the brainstem is in:
1. AThe left ventral pons
2. BThe left medial pontine tegmentum
3. CThe right medial medulla
4. DThe right ventral midbrain
5. EA lateral part of the tegmentum
114Of the following, you most suspect that a patient with a localized brainstem injury who complains of loud noise would also:
1. ABe able to blink both eyes
2. BHave difficulty sticking out his tongue symmetrically
3. CHave hemiparisis
4. DHave impaired ocular elevation
5. EHave impaired lateral gaze
115The medial rectus muscle:
1. ADepresses the eye
2. BElevates the eye
3. CExtorts the eye
4. DIntorts the eye
5. EParticipates in conjugate eye movements
116A patient has muscle weakness and intact sensation on the left side of the body. To rule out medial medullary syndrome you test:
1. AContralateral facial pain
2. BFacial paralysis
3. CLateral gaze
4. DUpward gaze
5. ETongue movement
117An absent bilateral corneal reflex may be due to unilateral injury of:
1. ACN II
2. BCN III
3. CCN VI
4. DCN VII
5. ECN V
118A lesion in the midbrain will most likely affect:
1. APain and temperature sense on the face
2. BBlink reflex
3. CSwallowing
4. DTouch and proprioception on the face
5. EChewing
119Each CN XI projects to the:
1. ABilateral sternocleidomastoids and the contralateral trapezius
2. BContralateral sternocleidomastoid and the contralateral trapezius
3. CContralateral sternocleidomastoid and the ipsilateral trapezius
4. DIpsilateral sternocleidomastoid and the contralateral trapezius
5. EIpsilateral sternocleidomastoid and the ipsilateral trapezius
120CN IX affects:
1. ASomatosensation, blood pressure feedback, lacrimation, and salivation
2. BTrapezius control, taste, blood pressure feedback, and salivation
3. CSomatosensation, taste, blood pressure feedback, lacrimation, and swallowing
4. DSomatosensation, taste, blood pressure feedback, mastication, and swallowing
5. ESomatosensation, taste, blood pressure feedback, salivation, and swallowing
121Including facial expression, CN VII also affects:
1. ASomatosensation, taste, and blood pressure feedback
2. BSomatosensation, taste, blood pressure feedback, and salivation
3. CSomatosensation, taste, blood pressure feedback, and swallowing
4. DTaste, salivation, and swallowing
5. ESomatosensation, taste, salivation, and hearing
122Cranial nerves involved with muscular control of swallowing include:
1. AV, VII, IX, X
2. BV, X, XII
3. CVII, X, XII
4. DVIII, IX, X
5. EIX, X
123The number of cranial nerves projecting directly to each eye is:
1. A3
2. B4
3. C10
4. D8
5. E5
124Cranial nerve VII is involved with:
1. AThe gag reflex
2. BParotid gland secretion
3. CProprioception from the posterior part of the tongue
4. DTaste from the posterior part of the tongue
5. EControlling the stapedius
125Cranial nerve IX is involved with:
1. AControlling facial expression muscles
2. BProducing tears and saliva
3. CSkin sense from the back of the ear
4. DTaste from the anterior part of the tongue
5. ERegulating blood pressure
126The pyramidal decussation:
1. AAccounts for the cortical activity related to sensation of contralateral proprioception
2. BAccounts for the cortical activity related to sensation of contralateral bodily pain
3. CIs dorsal to the inferior cerebellar peduncles
4. DIs where all corticospinal fibers cross the midline
5. EAccounts for the cortical control of contralateral movement
127Which of the following is responsible for the transition between the action potential undershoot and the return of the membrane potential back to rest:
1. AOpening of voltage-gated K+ channels
2. BActivation of glutamate receptors
3. COpening of voltage-gated Na+ channels
4. DClosing of voltage-gated K+ channels
5. EOpening of voltage-gated Ca+ channels
128Opening of voltage-gated K+ channels during the action potential is responsible for which of the following?
1. AOnly the falling phase
2. BOnly the rising phase
3. COnly the undershoot
4. DThe overshoot and the falling phase
5. EThe falling phase and the undershoot
129Which of the following cell types make contact with the brain vasculature?
1. APurkinje cells
2. BOligodendrocytes
3. CSchwann cells
4. DAstrocytes
5. ESatellite cells
130Which of the following cell types are stained black in the attached photomicrograph? (Please see attachment)
1. ASchwann cells
2. BSatellite cells
3. CPurkinje cells
4. DAstrocytes
5. EMicroglial cells
131Which of the following cell types produce myelin insulating axons of the PNS?
1. AOligodendrocytes
2. BSatellite cells
3. CSchwann cells
4. DChoroid plexus cells
5. EMicroglial cells
132Which of the following values would be the resting membrane potential of a neuron given the ionic conditions, permeability values, and reversal potentials shown in the attached table?
1. A+62 mV
2. B0 mV
3. C-80 mV
4. D+123 mV
5. E-72 mV
133Which of the following is an active mechanism that contributes to a hyperpolarized resting membrane potential in neurons?
1. ALeak K+ channels
2. BGlutamate receptors
3. CNa-K+ pump
4. DVoltage-gated Na+ channels
5. EVoltage-gated K+ channels
134Which of the following clinical conditions is often associated with the breakdown of the blood-brain barrier?
1. AGrave's disease
2. BAutism spectrum disorder (ASD)
3. CMultiple sclerosis (MS)
4. DSerotonin syndrome
5. EMetabolic syndrome (e.g. clinical obesity)
135Which of the following brain sites lacks a blood-brain-barrier?
1. AThe area postrema
2. BThe cerebellum
3. CThe falx cerebri
4. DThe hippocampus
5. EThe Virchow-Robin space
136Significant amounts of serotonin (5-HT)-containing neurons are found in the upper brain stem, particularly in the pons and medulla, areas that are collectively called the:
1. AParaventricular nucleus (PVN) of the hypothalamus
2. BVentral tegmental area (VTA)
3. CMeso-striatal pathways
4. DRaphe nuclei
5. ESupraoptic nucleus
137Which of the following physiological conditions is modulated by the actions of substance P?
1. ANociceptive transmission
2. BCognitive processes
3. CMetabolic signaling cascades
4. DFeeding signals
5. ESpinal reflexes
138Which of the following receptors can modulate the release of neurotransmitters from the same nerve ending?
1. AInositol trisphosphate receptors/channels
2. BAuto-receptors
3. CMetabotropic receptors
4. DIntra-cellular receptors
5. EPost-synaptic receptors
139Which of the following structural brain deficits have been repeatedly reported in patients with schizophrenia?
1. AExpansion of the ventricular system
2. BExpansion of the Virchow-Robin space
3. CSelective atrophy of the hippocampus
4. DDegeneration of the frontal cortex
5. EMalformations of the cerebellum
140An expansion of the ventricles due to tissue loss, as in the case of Alzheimer’s disease, is termed:
1. AHydrocephalus ex vacuo
2. BFocal cerebral ischemia
3. CCytotoxic cerebral edema
4. DTraumatic brain injury
5. EEpidural hematoma
141Which modification of histones is associated with a decrease in transcription?
1. APhosphorylation
2. BMethylation
3. CAcetylation
4. DGlycosylation
5. EAddition of a coenzyme
142In an experimental polymerase chain reaction (PCR), 12 out of 25 total cycles have been completed. During the 13th cycle, immediately after a DNA polymerase synthesizes the target DNA sequence on all available DNA templates, which one of the following will occur next?
1. AThe samples will be cooled down
2. BAdditional reactants will be added
3. CThe flanking primers hybridize to their complementary DNA sequences
4. DThe double -stranded DNA will be denatured by heating
5. ETaq polymerase will catalyze DNA synthesis
143During DNA replication:
1. AAddition of nucleotides occurs at the 5' end of a new strand
2. BThe double helix is unwound by SSB protein
3. CRNA primers are removed by DNA polymerase
4. DMultiple primers are added to the leading strand
5. EOkazaki fragments are joined by DNA ligase
144Antibiotics in the quinolone family:
1. ADisrupt the initiation step of bacterial protein synthesis
2. BBlock the action of bacterial RNA polymerase
3. CAct as inhibitors of bacterial DNA topoisomerases
4. DAre incorporated into new DNA and stop replication of the AIDS virus
5. EDegrade bacterial DNA
145The toxin of the Amanita phalloides mushroom:
1. ABinds to eukaryotic RNA polymerase and blocks transcription
2. BActs to prematurely remove the new mRNA from its DNA template
3. CInhibits the splicing process in eukaryotes
4. DStops the post-transcriptional processing of mRNA
5. EBlocks the action of topoisomerases
146What is the definition of an intron?
1. AIt connects the codon to the anticodon
2. BIt codes for a nonfunctional part of a protein
3. CIt is part of the final protein
4. DIt is a mutation in the DNA
5. EIt is one type of a promoter
147A 32-year-old man with AIDS (CD4 count is 21/mm3) presents with shortness of breath. Despite treatment with piperacillin-tazobactam, he has progressive respiratory failure and is intubated. Chest radiographs show a diffuse interstitial pneumonia. Silver staining of sputum reveals the presence of irregularly shaped 5 micron organisms that do not grow in the laboratory. This disease is most likely caused by which of the following fungi?
1. APneumocystis jirovecii
2. BAspergillus niger
3. CCandida albicans
4. DSporothrix schenckii
5. ECoccidioides immmitis
148Which of the following diseases is orally acquired and spreads to the central nervous system causing flaccid paralysis mostly in children?
1. AInfectious mononucleosis
2. BMeasles
3. CPolio
4. DHerpes simplex virus
5. EChicken pox
149e reverse transcriptase of HIV:
1. ATranscribes viral DNA to cell DNA
2. BTranscribes viral RNA to DNA
3. CTranscribes cellular DNA to viral DNA
4. DIs attached to the viral DNA
5. ETranslate viral RNA to DNA
150Which is the correct sequence (first to last) of events in viral replication?
1. APenetration, uncoating, synthesis, adsorption, assembly, release
2. BUncoating, penetration, synthesis, assembly, absorption, release
3. CAdsorption, penetration, uncoating, synthesis, assembly, release
4. DAssembly, synthesis, uncoating, release, penetration, adsorption
5. ESynthesis, uncoating, release, penetration, adsorption, assembly
151Which is the protein shell around the nucleic acid core of a virus?
1. ACapsid
2. BSpike
3. CEnvelope
4. DMonolayer
5. ECanon
152A 53-year-old man with a renal transplant develops shortness of breath and fevers. His chest radiograph reveals a dense left upper lobe infiltrate. A bronchoscopy with biopsy is performed. The pathologist calls to inform you that encapsulated yeast cells ~5 micrometer (μm) in diameter are present in the biopsy specimen. Which of the following is the cause of this patient’s disease?
1. AHistoplasma capsulatum
2. BAspergillus fumigatus 
3. CCryptococcus neoformans
4. DBlastomyces dermatitidis
5. ECandida albicans
153Outbreaks of systemic mycoses have been associated with:
1. AUrban areas
2. BSummer season
3. CCold weather
4. DRegions over sea level
5. EDisturbances of the environment in endemic regions
154Which of the following combination of characteristics apply only to fungi?
1. AEukaryotic, autotrophic, rigid cell wall
2. BEukaryotic, heterotrophic, rigid cell wall
3. CEukaryotic, heterotrophic, no cell wall
4. DEukaryotic, autotrophic, no cell wall
5. EProkaryotic, heterotrophic, rigid cell wall
155Viruses are distinguishable from both bacteria and protozoan parasites because viruses have:
1. AFlagella
2. BDNA or RNA genomes and not both
3. CChromosomal DNA
4. DIntracellular organelles
5. ERibosomes that assist in RNA synthesis
156The Rickettsia microbe is a good example of a type of pathogen that:
1. AIs a frequent cause of gastroenteritis
2. BCauses a condition known as oral thrush
3. CGrows and divides inside various host cells
4. DProduces spores under harsh conditions
5. EHas a cell similar to yeast-like fungi
157Which of the following is an accurate description for the pathogen that can cause encephalitis in immunocompromised patients and congenital abnormalities, and can be acquired from contact with infected cat feces?
1. AProtozoan parasite
2. BAcid-fast bacillus
3. CGram negative bacillus
4. DGram positive coccus
5. EDimorphic fungus
158A widespread infection or disease with high attack rates that includes either high morbidity or mortality rates and occurs worldwide or in a particular region is known as a/an:
1. AEndemic situation
2. BEpidemic situation
3. CPandemic situation
4. DIncubation period
5. EProlonged carrier state
159Your patient is a 54-year-old man who presents with a fever, cough and chest pain. A sputum sample reveals numerous neutrophils and extracellular gram-positive diplococci. The likely etiologic agent is
1. AChlamydophila pneumoniae
2. BHaemophilus influenzae 
3. CMycoplasma pneumoniae
4. DStreptococcus pneumoniae
5. EKlebsiella pneumoniae
160A 3-year-old girl presents to the emergency department in severe respiratory distress. She has a fever and difficulty breathing. A gram-negative pathogen is isolated from a respiratory sample which is only culturable on chocolate agar. This clinical scenario could have been prevented if the patient had been immunized with:
1. AThe BCG vaccine
2. BPneumovax
3. CLipopolysaccharide
4. DSerotype b vaccine
5. EAcelluar pertussis vaccine
161Your patient is a 9-year-old boy who presents with a fever and a severe sore throat. A rapid test for Group A streptococcal antigen is done using a throat swab and it comes back positive. Which of the following tests would confirm the likely diagnosis?
1. AGiemsa stain of a patient sample
2. BGrowth on MacConkey agar
3. CPresence of a peptidoglycan capsule
4. DAlpha hemolysis on a blood agar plate
5. EInhibition of a growth by bacitracin
162A 64-year-old homeless man presents to the emergency department complaining of fever, chills and night sweats. He also has a productive cough and a sputum sample reveals acid-fast bacilli. A PPD skin test is done and 48 hours later the area of induration measures 10 mm. The likely diagnosis is:
1. APsittacosis
2. BTuberculosis
3. CPneumococcal pneumonia
4. DInfluenza
5. ELegionnaires disease
163An experimental drug is found to produce its maximum effect at concentrations in which all of its targeted receptors are bound by the drug. This example describes the relationship between drug dose, receptor occupancy, and:
1. AMagnitude of effect
2. BPhysiochemical properties
3. CPhysiologic response
4. DTherapeutic window
5. EVariability in drug serum levels
164Fluconazole has an oral bioavailability factor of 1. What percentage of an oral dose reaches the systemic circulation?
1. A0.01%
2. B0.1%
3. C1%
4. D10%
5. E100%
165A hospitalized hypotensive patient is started on a continuous intravenous infusion of a drug that raises blood pressure. The serum concentration of the drug reaches steady state when the dosing rate equals the clearance multiplied by:
1. AConcentration of drug in plasma (Cp) 
2. BHalf-life (t1⁄2) 
3. CHepatic blood flow (Qhepatic) 
4. DMaximum rate of drug metabolism (Vmax)
5. EVolume of distribution (Vd)
166A hospitalized patient stabilized on an intravenous medication is being switched to the oral form of the same drug. Which of the following equations is used to calculate the maintenance dose?
1. A1- (CL / Q)
2. B(CL X Css) / F
3. CDose / AUC 
4. D(t1⁄2 x CL) / 0.693
5. E(Vd xCss)/F
167A particular receptor agonist is given to a patient for pain management. The patient is directed to take the medicine once daily at the same time of day. After a couple of weeks, the patient notices that the drug is not controlling the pain as well as it did when she first started taking it, even though she is taking it exactly as directed. She does not smoke or take any other drugs or alcohol. Which one of the following best describes the receptor-related mechanism for the reduced efficacy of this drug?
1. AConstitutive activity
2. BDesensitization
3. CReduced affinity
4. DSaturation
5. EUpregulation
168A series of increasing doses of an experimental drug in preclinical development is administered to a group of experimental animals. The therapeutic index of this drug in this population is found to be large. This parameter is indicative of:
1. ACompetitive antagonism
2. BHepatic blood flow
3. CFirst-order elimination kinetics
4. DTime to steady state
5. EVariation of effect between subjects
169The ability of a drug bound to its receptor to activate downstream effector mechanisms defines the drug’s:
1. AAffinity
2. BBioavailability
3. CDose-response relationship
4. DIntrinsic activity
5. ESpecificity
170A particular drug undergoes significant first-pass effect by diffusing into the lipid bilayer of the endoplasmic reticulum in hepatocytes where it undergoes an oxidation reaction. The enzymes involved in the metabolism of this drug are most likely:
1. ACytochrome P450 enzymes
2. BIsomerases
3. CGlucuronosyltransferases 
4. DMetalloproteinases
5. EOxidoreductases
171A pharmacologic hormone undergoes hepatic glucuronidation and biliary secretion. Intestinal bacterial flora cleave the glucuronic acid from the therapeutic molecule, which is then reabsorbed. Which one of the following best fits this description?
1. AClearance
2. BEnterohepatic circulation
3. CFirst-pass metabolism
4. DPhase 1 metabolism
5. EZero-order process
172A pharmaceutical company develops a second-generation version of an antihistamine that prevents seasonal allergy symptoms (sneezing, itchy, runny nose and watery eyes). The advantage of the new version is that, unlike the first-generation drug, it does not cause central nervous system side effects, such as sedation and dizziness. Both drugs are taken orally. Compared to the older antihistamine, the second-generation agent has a low degree of:
1. AAbsorption
2. BCYP metabolism
3. CEffectiveness
4. DIonization
5. ELipid solubility
173A woman experiencing menopausal symptoms is given a prescription for estrogen in a drug delivery system that allows for gradual diffusion of the hormone across the skin and dermal layers and into the venous circulation. Which one of the following is a disadvantage of this route of administration?
1. AFrequent administration
2. BFirst-pass metabolism
3. CGastric hyperacidity
4. DPain on injection
5. ESkin irritation
174A weak acid, HA, has a pK of 5.75. A solution is made by dissolving HA in water to a final concentration of 10 mM. The pH of this solution is adjusted to 7.75. Which of the following statements about this solution is true?
1. AThe concentration of the conjugate base (A-) in the solution is less than 5 mM
2. BThe solution strongly resists changes to its pH 
3. CAll HA is dissociated into H+ and A-
4. DThe concentration of A- is greater than the concentration of HA
5. EThe pH of the solution was adjusted to 7.75 by adding HCl
175Which of the following will be the most effective buffer pair for a solution that is adjusted to pH 6.80?
1. AH3AH+ +H2A,pK=2.32
2. BH2A- H+ + HA-2, pK = 5.45
3. CH2B H+ + HB-, pK = 6.70
4. DHB- H+ +B-2,pK=9.1
5. EHA-2 H+ + A-3, pK = 7.20
176A test subject hyperventilates (breathes deeply and much faster than usual) for 3 minutes. Which of the following statements will be true of this test subject at the end of this 3 minute period?
1. AThe test subject’s [HCO3-]plasma will be decreased
2. BThe test subject’s [HCO3-]plasma will be increased
3. CThe test subject’s pHplasma will be below 7.20
4. DThe test subject’s pHplasma will be above 7.40
5. EThe test subject’s [CO2]plasma will be increased
177Living cells are placed in a solution of 300 mM sucrose. The intracellular environment contains 140 mM NaCl and 5 mM KCl. These compounds have the following reflection coefficients: σsucrose =1,σNa =0.8,σK =1,σCl =1. Which of the following statements about this experiment is true?
1. AThe cells will swell
2. BSucrose will move into the cells
3. CK+ will move out of the cells
4. DThe cells will shrink
5. ECl- will move into the cells
178In early July, a 28-year-old woman is brought to the emergency department complaining of profuse diarrhea, weight loss, weakness, and dizziness for the past three days. She says she weighed 55 kg the morning her diarrhea began. Her weight upon admission is 50 kg. Lab tests of the diarrheal fluid indicate it has an osmolarity of 147 mOsm. Which Darrow-Yannet diagram reflects what has occurred in this patient during her diarrhea period?
1. ADiagram A
2. BDiagram B
3. CDiagram C
4. DDiagram D
5. EDiagram E
179A patient has lost a significant amount (1-2 L) of blood through hemorrhage. In the emergency department, a new resident administers 2 L of hypertonic saline solution by IV. Which diagram shows what would be the correct treatment for this patient to restore their blood volume? (Please see attachment)
1. ADiagram A
2. BDiagram B
3. CDiagram C
4. DDiagram D
5. EDiagram E
180Which of the following situation would produce a Hill plot with nH<1.0:
1. AThe protein has multiple subunits, each with a single ligand-binding site. Binding of ligand to one site increases the binding affinity of other sites for the ligand
2. BThe protein is a single polypeptide with two ligand binding sites, each having a different affinity for the ligand
3. CThe protein is single polypeptide with a single ligand-binding site. As purified, the protein preparation is heterogeneous, containing some protein molecules that partially denatured and thus have a lower affinity for the ligand
4. DThe protein has two different subunits. Only one subunit has a binding site for the ligand
5. EThe protein has multiple subunits, each with a single ligand-binding site. Binding of ligand to one site decreases the binding affinity of other sites for the ligand
181Which of following is the allosteric regulator of hemoglobin oxygen binding?
1. A1,3-Bisphosphoglyceric
2. BFructose 1,6-bisphosphate
3. C2,3-Bisphosphoglycerate
4. D3-phosphglycerate
5. EGlucose 6-phosphate
182Vitamin C deficiency may cause the following collagen related disease:
1. AOsteogenesis imperfecta
2. BEhlers Danlos syndrome
3. CScurvy
4. DSticker syndrome
5. EMarfan syndrome
183Collagens are the major components of:
1. AMitchondria matrix
2. BEndoplasmic reticulum
3. CNuclear matrix
4. DExtracellular matrix
5. EGolgi
184A patient of yours has elevated levels of Alanine aminotransferase (ALT). The patient most likely has a problem with his:
1. ALiver
2. BEyes
3. CHeart
4. DBones
5. EPancreas
185A patient of yours has been admitted to the cardiac care unit after having a myocardial infarction (heart attack). You are monitoring his recovery by measuring serum enzymes. Over the next two days, you find that his CK-MB levels are decreasing towards normal. On the third day, you see a sudden increase in CK-MB levels. This suggests that the patient:
1. AIs recovering from the myocardial infarction (heart attack) and ready to go home
2. BIs recovering from the myocardial infarction (heart attack) but is having a liver damage
3. CHad another recent myocardial infarction (heart attack)
4. DIs recovering from the myocardial infarction (heart attack) but is having some other muscle damage
5. ENever had a myocardial infarction (heart attack); the diagnosis was wrong
186Rotenone, a chemical derived from some roots, kills fish when added to ponds and is often used to kill non-native invasive species. Rotenone seems to affect the mitochondria by inhibiting complex I enzymes. When mitochondria are inhibited by rotenone, the:
1. ARate of respiration will increase
2. BRate of ATP synthesis will increase
3. CRate of NADH oxidation by the electron transport chain will decrease
4. DRate of succinate oxidation by the electron transport chain will decrease
5. EExtent of reduction of Coenzyme Q in mitochondria will increase
187In the rare Luft disease, patients show some microscopic disorder in mitochondrial structures. Mitochondrial respiratory chain complexes show normal levels of activities. When patients with Luft disease complain of feeling hot, have high rates of oxygen consumption and elevated heart rate, this may indicate:
1. ADefective tricarboxylic acid cycle (TCA cycle) enzymes
2. BInhibition of complex III enzymes
3. CLack of Coenzyme Q
4. DUncoupling of the mitochondria electron transfer chain
5. EDefective electron shuttles into the mitochondria
188The glycerol phosphate dehydrogenase shuttle is not as good as the malate-aspartate shuttle because the glycerol phosphate dehydrogenase shuttle:
1. ABrings electrons in at the NADH level
2. BProduces less ATP than the malate-aspartate shuttle electrons
3. CCan also transport ADP
4. DDoes not depend on the proton gradient
5. EIs unidirectional
189A new drug that you are studying has the unfortunate side effect of inhibiting cytochrome c oxidoreductase (complex III). This suggests that the drug will:
1. ADecrease the reduction levels of complex II but not complex I
2. BDecrease the reduction levels of complex I but not complex II
3. CIncrease the proton gradients
4. DDecrease the reduction level of complex IV
5. EIncrease respiration
190What are the effects of an increase in the plasma glucagon level on the activity of the tandem enzyme and the level of fructose 2,6-bisphosphate?
1. AIncrease in tandem enzyme kinase activity and an increase in the cellular level of fructose 2,6-bisphosphate
2. BDecrease in tandem enzyme kinase activity and an increase in the cellular level of fructose 2,6-bisphosphate
3. CIncrease in tandem enzyme phosphatase activity and a decrease in the cellular level of fructose 2,6-bisphosphate 
4. DDecrease in tandem enzyme phosphatase activity and an increase in the cellular level of fructose 2,6-bisphosphate 
5. ENo effect on tandem enzyme and no change in cellular level of fructose 2,6-bisphosphate
191In red blood cells, the reduction of pyruvate produces:
1. AAcetaldehyde, CO2, and NAD
2. BPropionyl CoA, and FADH2
3. CEthanol and NADH + H+
4. DLactate and NAD 
5. EAcetyl CoA, CO2, and NADH + H+
192The irreversible reaction(s) of glycolysis is(are) catalyzed by:
1. AHexokinase, phosphofructokinase, and pyruvate kinase
2. BGlyceraldehyde 3-phosphate dehydrogenase 
3. CPhosphoglucisomerase, and triose phosphate isomerase
4. DPhosphoglycerate kinase, enolase, and pyruvate kinase
5. EAldolase
193Sulfate groups are most likely to be components of:
1. AMonosaccharides
2. BDisaccharides
3. CHeteropolysaccharides
4. DHomopolysaccharides
5. EOligosaccharides
194The correct feature of glycosylaminoglycans is that they:
1. AContain a phosphate group on every fourth sugar residue
2. BAre composed of repeating disaccharide units
3. CAre a storage form of glucose in invertebrates
4. DContain codes for molecular targeting
5. EAre chains of 50-100 fructosamine residues
195The correct statement about the anomeric carbon of a sugar molecule is that it:
1. AIs formed from an optically active carbon
2. BContains a carboxylic acid group formed in the creation of a hemiacetal
3. CCan be any carbon in a sugar with an OH attached to it
4. DContains an OH group formed from a carbonyl group during the creation of a hemiacetal
5. EIs the terminal carbon in a monosaccharide containing an H2COH group
196In regard to main catabolism, the goal of the citric acid cycle is to form:
1. ACO2 to maintain the normal plasma pCO2 level
2. BWater to aid in water balance
3. CReducing equivalents for use by the electron transport chain
4. DNucleotide triphosphates by substrate level phosphorylation
5. ECO2 by breakdown of acetyl groups (from acetyl-CoA) to regulate cellular levels of metabolites
197Decarboxylation reactions during the TCA cycle are catalyzed by:
1. ACitrate synthetase and glyceraldehye 3-phosphate dehydrogenase
2. BMalate dehydrogenase and fumerase
3. CIsocitrate dehydrogenase and alpha-ketoglutrate dehydrogenase
4. DSuccinate dehydrogenase and pyruvate carboxylase
5. ELactate dehydrogenase and malate dehydrogenase
198During the conversion of pyruvate to acetyl-CoA catalyzed by the pyruvate dehydrogenase complex (PDH), the reaction that utilizes thiamine pyrophosphate (TPP) as the coenzyme is:
1. AOxidative phosphorylation of glyceraldehyde 3-phosphate
2. BShift of a hydroxyl group in the conversion of citrate to isocitrate
3. CDecarboxylation of pyruvate
4. DHydrolysis of succinyl-CoA
5. EPhosphorylation and decarboxylation of oxaloacetate
199The correct statement about ketone bodies is: 
1. AThey are used by liver when plasma glucose is low
2. BAcetone is the major intermediate in ketone body synthesis
3. CExcess acetyl-CoA is the starting material for ketone body synthesis
4. DThey do not contain ionizable H+ ions
5. ETissues that use ketone bodies convert them to pyruvate
200The purpose of transferring a fatty acid to carnitine to form acyl-carnitine is:
1. ACarnitine is the acyl group carrier used in fatty acid synthesis
2. BIn the circulation, carnitine is the carrier of fatty acids destined for breakdown in the liver
3. CCarnitine is the coenzyme required for formation of a carbon-carbon double bond in a fatty acid  chain during synthesis
4. DAcyl-carnitine can be transported across the inner mitochondrial membrane
5. ECarnitine is the acyl group carrier used during lipolysis
201The reaction at the main control point for fatty acid breakdown is:
1. ALipolysis
2. BThiolysis
3. COxidation
4. DHydration
5. EReduction
202The correct sequence of reactions in fatty acid synthesis is:
1. ACondensation -> oxidation -> hydration -> oxidation
2. BOxidation -> hydration -> reduction -> condensation
3. CCondensation -> reduction -> dehydration -> reduction
4. DReduction -> condensation -> carboxylation -> reduction
5. ECondensation -> carboxylation -> dehydration -> reduction
203The main control point for fatty acid synthesis is:
1. ACarboxylation of acetyl-CoA
2. BTransfer of acetyl and malonyl groups to acyl carrier protein
3. CCondensation reaction of fatty acid synthesis
4. DElongation reaction
5. EFormation of triacylglycerol
204The role of the malonyl group in fatty acid metabolism is to:
1. AAid in the transport of acetyl groups across the inner mitochondrial membrane
2. BSupply energy through decarboxylation for reactions in fatty acid synthesis
3. CSupply three carbon groups for synthesis of fatty acids with odd numbers of carbons
4. DReact with acetyl-CoA to form 3-hydroxy-3-methylglutaryl CoA 
5. ESupply reducing equivalents for use in fatty acid synthesis
205If a cell requires both reducing equivalents and five carbon sugars for use in biosynthesis reactions, the products of the pentose phosphate pathway will be:
1. ARibulose 5'-phosphate and FADH2
2. BFructose 6'-phosphate and glyceraldehyde 3-phosphate
3. CRibose 5'-phosphate and NADPH+H+
4. DXyulose 5'-phosphate, erythrose 4-phosphate and NADPH+H+
5. ERibose 5'-phosphate and NADH+H+
206The enzyme that can be used to replenish the levels of citric acid cycle intermediates through its anaplerotic function is:
1. APyruvate carboxylase
2. BAconitase
3. CPyruvate dehydrogenase
4. DCitrate synthetase
5. EPhosphopentose epimerase
207Compounds that can enter gluconeogenesis include:
1. AAcetyl-CoA, succinyl-CoA, and acetoacetate
2. BFatty acids and acetyl-CoA
3. CFatty acids, glycerol, and beta-hydroxybutyrate
4. DLactate and glycerol
5. EHydroxymethylglutaryl-CoA, acetone, and lactate
208The effects of insulin on hepatic glycogen metabolism are:
1. AActivation of glycogen synthesis and inactivation of glycogen breakdown through activation of phosphatase I
2. BActivation of glycogen synthesis and inactivation of glycogen breakdown through phosphorylation and inactivation of cAMP-dependent protein kinase
3. CActivation of glycogen synthesis and inactivation of glycogen breakdown by causing glucagon to dissociate from its receptor
4. DActivation of glycogen breakdown and inactivation of glycogen synthesis through inactivation of phosphodiesterase
5. EActivation of glycogen breakdown and inactivation of glycogen synthesis through activation of adenylate cyclase
209During a period of starvation all glycogen reserves in a patient’s body have been consumed. Following treatment with glucose, synthesis of new glycogen will be initiated by:
1. AGlycogen phosphorylase
2. BUDP-glucose pyrophosphorylase
3. CGlycogen synthase
4. DGlycogenin
5. EPhosphoglucomutase
210Pyridoxal phosphate is used as a prosthetic group by:
1. ADebranching enzyme
2. BGlycogen synthetase
3. CBranching enzyme
4. DGlycogen phosphorylase
5. EUDP-glucose pyrophosphatase
211A McDonald's McCafé Frappé Mocha has 18 grams of fat, 65 grams of sugar and 7 grams of proteins. Approximately how many Kcalories is that?
1. A300
2. B450
3. C840
4. D45
5. E250
212Right after a big and heavy lunch:
1. ABlood glucose is high and fat breakdown is high
2. BBlood glucose is low and fat synthesis is high
3. CBlood glucose is high and insulin is high
4. DFat synthesis is high and glycogen breakdown is high
5. EFat breakdown is high and insulin is high
213When a man has not eaten for 20 hours, it is likely that his blood sugar levels are maintained by:
1. AGlycogen breakdown
2. BGluconeogenesis
3. CFat breakdown
4. DBeta oxidation
5. EGlucose synthesis from acetyl-CoA
214A phosphate group is a component of:
1. ASphingomylein
2. BCeramide
3. CGloboside
4. DSulfatide
5. EGanglioside
215In the CDP-diacylglycerol branch of phosphoglyceride synthesis, CDP-diacylglycerol can react with:
1. ACDP-choline
2. BAcyl-CoA
3. CInositol
4. DPhosphatidate
5. ES-adenosylmethionine
216The starting materials for synthesis of sphingosine are:
1. APhosphatidate and glycine
2. BPalmitoyl-CoA and serine
3. CGlycerol 3-phosphate and acyl-CoA
4. DCerebroside and UDP-glucose
5. EArachidonate and CMP-N-acetylneuraminate
217You have isolated a new enzyme that catalyzes the attached reaction. This enzyme would be classified as a/an: (Please see attachment)
1. AOxidoreductase
2. BTransferase
3. CHydrolase
4. DLyase
5. EIsomerase
218Many drugs are competitive inhibitors of the target enzymes. Such competitive inhibitors will:
1. AIncrease the apparent Km of the target enzymes
2. BDecrease the apparent Km of the target enzymes
3. CDecrease the Vmax of the target enzymes
4. DIncrease the Vmax of the target enzymes
5. ENot affect the Vmax of Km of the target enzymes
219You are developing a new drug to treat a new disease by stabilizing the native form of a protein. You believe that phosphorylation of a particular amino acid in the protein will stabilize the protein. Your target is likely to be a/an:
1. AVal
2. BSer
3. CAsp
4. DLeu
5. EGly
220A new enzyme you have isolated is activated only when a very nonpolar small effector molecule binds to a control site; you have also found that a single mutation at the control site abolishes the binding of the effector molecule to the enzyme. Which of the following mutations is the most likely candidate?
1. AAsp is replaced by Glu
2. BGlu is replaced by Asp
3. CAla is replaced by Val
4. DLeu is replaced by Arg
5. ELeu is replaced by Ile
221A man presents with back pain. He also complains that his urine is sometimes dark-colored. His ear cartilage has a gray appearance. The most likely cause of his symptoms is:
1. AHomocystinuria
2. BMaple syrup urine disease
3. CDeficient enzyme in the degradation of tyrosine
4. DDeficient enzyme in the formation of heme
5. EDeficiency of the branched-chain alpha-keto acid dehydrogenase
222Ammonia is transported in a nontoxic form in the blood primarily as:
1. AGlutamine
2. BGlutamate
3. CUrea
4. DA diglucuronide
5. EAspartate
223A patient with cystinuria cannot properly:
1. ASynthesize cystathionine
2. BForm urea
3. CDegrade cystine
4. DDegrade methionine
5. ETransport arginine and cystine
224Two infants appeared normal at birth but developed hyperammonemia after 24 hours. Their laboratory data is attached. Both infants had above normal levels of blood ammonia. Which one of the following enzymes could be deficient and cause this abnormality in infant II?
1. ACarbamoyl phosphate synthetase I
2. BOrnithine transcarbamoylase
3. CArgininosuccinate synthetase
4. DArgininosuccinate lyase
5. EArginase
225Patients with a defect in the degradation of which amino acid should not consume aspartame?
1. ATyrosine
2. BPhenylalanine
3. CGlutamate
4. DGlutamine
5. EAspartate
226A 23-year-old female is brought to the emergency department because she is having hallucinations and is very confused. She spent the day painting outside in bright sunlight. The patient has undergone two previous laparotomies (exploratory pelvic surgery) for acute abdominal pain, but no pathology was found. What is the most likely reason for her symptoms?
1. AShe has taken barbiturates
2. BShe has eaten a lot of aged cheese
3. CShe has Lesch-Nyhan syndrome
4. DShe has porphyria cutanea tarda
5. EShe has acute intermittent porphyria
227A 52-year-old obese male comes to his family doctor complaining of severe pain in the first metatarsophalangeal joint that began after he ate and drank too much on Thanksgiving Day. He has a history of kidney stones. The patient:
1. AShould be treated with allopurinol to decrease the activity of xanthine oxidase
2. BShould be treated with allopurinol to increase the purine salvage pathway
3. CHas a deficiency of adenosine deaminase
4. DHas a deficiency in PRPP synthetase activity
5. EHas an decrease in the purine salvage pathway
228In what genetic disorder is there a deficiency in a canalicular protein that transports bilirubin glucuronides into bile?
1. ADubin-Johnson syndrome
2. BGilbert syndrome
3. CNewborn jaundice
4. DCrigler-Najjar syndrome type II
5. ERotor syndrome
229Two infants appeared normal at birth but developed hyperammonemia after 24 hours. Their laboratory data is attached. Both infants had above normal levels of blood ammonia. Which one of the following enzymes would likely be abnormal in infant I? (Please see attachment)
1. ACarbamoyl phosphate synthetase I
2. BOrnithine transcarbamoylase
3. CGlutamate dehydrogenase
4. DArgininosuccinate synthetase
5. EArginase
230Which of the following brain areas receive olfactory sensory information prior to thalamic relay and must be considered primary olfactory cortex?
1. AInsular cortex
2. BLocus coeruleus
3. COrbitofrontal cortex
4. DPiriform cortex
5. EVentromedial prefrontal cortex
231What would a patient with a partial bilateral lesion of taste fibers projecting to the geniculate ganglion most likely present with?
1. AA general reduction of taste sensitivity of the anterior 2/3 of the tongue
2. BA general reduction of taste sensitivity on the entire tongue and epiglottis
3. CA general reduction of taste sensitivity on the rear 1/3 of the tongue
4. DA specific reduction of taste for "bitter"
5. EA specific reduction of taste for "salty" and "sweet"
232What is the primary function of sustentacular cells found in the olfactory epithelium?
1. AThey act as inhibitory interneurons in fine pitch and tuning
2. BThey cover axons with a layer of myelin
3. CThey form Bowman's olfactory gland
4. DThey provide structural support and mucous secretions
5. EThey transmit action potentials to the olfactory bulb
233Irrigating the ear of a healthy patient with cold water causes:
1. ANystagmus toward the irrigated ear
2. BNystagmus away from the irrigated ear
3. CTorsional ocular counter-roll
4. DVertical ocular counter-roll
5. EHorizontal ocular counter-roll
234Changing visual fixation to different external places is achieved by:
1. ASmooth pursuit eye movement
2. BSaccadic eye movement
3. COcular counter-roll
4. DFast-phase nystagmus
5. ESlow-phase nystagmus
235The membranous labyrinth of the inner ear is filled with:
1. AEndolymph
2. BPerilymph
3. CCerebrospinal fluid
4. DBlood
5. EBile
236Iridectomy treats:
1. ACataracts
2. BClosed angle glaucoma
3. COpen angle glaucoma
4. DRetinal detachment
5. EMacular degeneration
237Beta-blockers and/or cholinergic medication treats:
1. ACataracts
2. BClosed angle glaucoma
3. COpen angle glaucoma
4. DRetinal detachment
5. EMacular degeneration
238How is pupil size increased?
1. AParasympathetic innervation to the dilator pupillae muscle causing mydriasis
2. BParasympathetic innervation to the sphincter pupillae muscle causing miosis
3. CSympathetic innervation to the ciliary muscle causing miosis
4. DSympathetic innervation to the dilator pupillae muscle causing mydriasis
5. ESympathetic innervation to the sphincter pupillae muscle causing miosis
239Myopic vision is due to the inability to:
1. AStretch the lens enough to accommodate far stimuli
2. BRelax the lens enough to accommodate far stimuli
3. CStretch the lens enough to accommodate near stimuli
4. DRelax the lens enough to accommodate near stimuli
5. ECompensate for anterior-posterior elongation of the eye
240Retinal detachment occurs directly between the: 
1. AAmacrine cell layer and the pigment epithelium
2. BGanglion cell layer and the choroid layer
3. CPhotoreceptor layer and the choroid layer
4. DPhotoreceptor layer and the pigment epithelium
5. EPigment epithelium and the choroid layer
241Which of the following best describes the anatomical organization of the ossicles from the tympanic membrane to the round window?
1. AUncus, malleus, stapes
2. BMalleus, stapes, uncus
3. CMalleus, uncus, stapes
4. DStapes, malleus, uncus
5. EUncus, stapes, malleus
242Which of the following would cause hearing deficits due to middle ear dysfunction?
1. ACerumen impaction
2. BOtitis externa
3. COtitis media
4. DHair cell degeneration
5. ECranial nerve VIII leison
243Which of the following best describes the fluid found in the scala vestibule?
1. AIs high in potassium
2. BIs different from the fluid in the scala tympani
3. CIs low in potassium
4. DContains leukocytes and erythrocytes
5. EContains only leukocytes

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Description: Quiz on Science Questions, created by jochamplin on 10/12/2014.
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