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Epidemiology
The videoconferencing of a rural primary care physician and an OHSU specialist is best described as:
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Epidemiology
HIPAA allows for limited use of patient information for treatment, payment, and operations (TPO) without explicit consent. In which of the following situations is sharing of patient data NOT permitted?
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Consulting with another physician involved in patient care
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Clinical research approved by an institutional review board (IRB) protocol and patient consent
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Use of diagnosis codes for billing Medicare
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Using patient diagnosis to market supplies to patients with diabetes
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Anatomy
A 36-year-old man is brought to the emergency department because of a deep knife wound on the medial side of his distal forearm.
He is unable to hold a piece of paper between his fingers and has sensory loss on the medial side of his hand and little finger. Which nerve is most likely injured?
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Median
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Musculocutaneous
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Radial
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Ulnar
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Embryology
A recent case study reported on twins experiencing congenital chest pains. Echocardiographic imaging reveals that the infants each had a defect that permitted the herniation (abnormal passage) of the left auricle of the heart into the left pleural cavity. Which of the following defects might allow a portion of the heart to move abnormally into the space normally occupied by the lungs?
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Failure of the dorsal mesocardium to break down
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Failure of the epicardium to cover the heart
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Failure of one of the pleuroperitoneal membranes to form
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Failure of one of the pleuropericardial membranes to form
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Embryology (Copenhaver)
Once the lesser omentum has formed, it will extend between which two structures?
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The gut and the dorsal body wall
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The gut and the ventral body wall
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The gut and the liver
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The diaphragm and the pleuroperitoneal membranes
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Histology Blood
Leukocytes are characterized by their nuclear morphology. Monocytes have variable nuclear shapes and are classified as which of the following?
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Formation of body cavities
Which component of the embryonic lung will be formed by the somatic mesoderm from the lateral plate region?
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The parietal linings of the pleural cavities
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The visceral linings of the pleural cavities
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The muscle and connective tissue of the lungs
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The mediastinum
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Anatomy: limbs
17-year-old football player presents to the emergency department with extreme pain in his leg after a particularly brutal tackle during a game. The attending physician determines that he is suffering from compartment syndrome compression of the muscles and neurovascular structures due to bleeding and swelling in the leg. The patient is transferred immediately to the OR. To preserve the integrity of the muscles and neurovascular structures, which of the following structures should be cut to release the pressure?
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Histology: Blood, connective tissue, adipose
Major Basic Protein is associated with killing of helminthic (parasitic) worms. What type of cell produces and secretes Major Basic Protein?
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Basophil
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Eosinophil
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Neutrophil
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Plasma cell
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Histology: Blood, connective tissue, adipose
During congestive heart failure, the liver may not get sufficient oxygenated blood to meet its metabolic needs. A pathologist can detect this problem by inspection of a liver biopsy and noting the pattern of dying hepatocytes. Based on your knowledge of normal histology, where would you expect the pathologist to see the most pathologic changes in these cells?
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Close to the central vein
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Close to the portal tract
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Halfway between the portal tract and the central vein
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Uniformly along the sinusoids
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Histology: Blood, connective tissue, adipose
The primary function of multilocular adipocytes is which of the following?
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Thermal insulation
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Heat production
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Cushioning
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Glucose regulation
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Limbs (Nelsen)
A 42-year-old painter visits the orthopedics clinic complaining of weakness of her upper limb. Physical examination suggests
involvement of the posterior cord of the brachial plexus. Which action would be affected?
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Wrist flexion
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Finger flexion
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Elbow extension
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Pronation
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CAD (Wojcik)
To detect subclinical coronary artery disease, which of the following methods is commonly used?
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CAD (Wojcik)
Regardless of intervention used, a decrease in LDL-C levels by 1 mmol/L (38.7 mg/dL) can reduce the relative risk of a major
cardiovascular event by which of the following percentages?
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GWAS (Spellman)
Imagine that 10,000 generations ago a new mutation was generated that can cause tall stature and green skin. The mutation has passed through the population but is very rare and not fully penetrant. You are interested in identifying this mutation and seek to use the property of linkage disequilibrium to find it. The most effective strategy to find this variant would be which of the following?
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Use a GWAS
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Collect families with stall stature and green skin to sequence their genomes looking for mutations.
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Take a candidate gene approach sequencing the genes involved in pigmentation and stature.
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Look for SNPs that are associated with one another because that is the principle of linkage disequilibrium.
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GWAS (Spellman)
In a condition such as colon cancer, the risk will be least for which of the following relatives of an affected individual?
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Sister
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Cousin
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Aunt
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Grandmother
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Intercellular Junctions (Musil)
Which of the following substances is excluded from all gap junction channels?
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Intercellular Junctions (Musil)
If the lateral plasma membranes of a confluent monolayer of epithelial cells were completely fused to each other, what would
happen to the transepithelial resistance (TER)?
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Intercellular Junctions (Musil)
The adhesive function of the classical cadherin E-cadherin is directly regulated by which of the following?
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Lipoproteins (Wojcik)
Which lipoprotein fraction is called atherogenic cholesterol?
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Lipoproteins (Wojcik)
Henry is a 56 year-old male with well-controlled hypertension who comes to the office for an annual visit. His physical exam is completely normal. As part of the routine labs, you obtain a fasting lipid panel. The results are reported as follows: Total
Cholesterol - 174 Triglycerides 97 HDL-cholesterol 60 LDL-cholesterol -95 In this case, which one of the values is calculated rather than measured directly?
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Total cholesterol
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Triglycerides
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HDL cholesterol
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LDL cholesterol
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Mevalonate (Duell)
Which of the following genes is most frequently mutated in familial hypercholesterolemia?
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ApoB
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LDL-R
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LDL-RAP1
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PCSK9
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Mevalonate (Duell)
Cholesterol is a substrate for which of the following?
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Mevalonate (Duell)
Sterol regulatory element binding protein-2 (SREBP-2) is involved in which of the following functions?
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ATP generation in muscle
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Cholesterol sensing in the liver
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Energy production in the liver
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Fatty acid oxidation in muscle
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Mevalonate (Duell)
The rate limiting enzyme for cholesterol synthesis is which of the following?
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Sorting (Mayinger)
Using genetic engineering techniques, you have created a protein that contains two conflicting sorting sequences that specify different compartments: A cleavable N-terminal signal sequence for mitochondrial targeting and a C-terminal KDEL peptide that mediates retrieval to the ER via KDEL receptor and COP-I vesicular traffic. Where would this protein most likely end up?
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In the lumen of the endoplasmic reticulum
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Secreted outside of the cell
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In the cytosol
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In the mitochondrial matrix
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Sorting (Mayinger)
What is the role of the nuclear localization sequence in a nuclear protein?
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It is a hydrophobic sequence that enables the protein to diffuse across the nuclear membranes.
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It aids protein unfolding in order for the protein to thread through nuclear pores.
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It binds to cytoplasmic import receptors that direct the nuclear protein to the nuclear pore.
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It prevents the protein diffusing out of the nucleus via nuclear pores.
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Nutrition (Stadler)
Preconception folic acid supplementation is recommended to decreases the risk in offspring of which of the following conditions?
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Vitamins (Stadler)
Vitamin C is an essential water soluble vitamin required for:
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Muscle synthesis and antioxidant defense preventing lipid peroxidation
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Collagen synthesis and maintaining blood Ca++ homeostasis
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Collagen synthesis and antioxidant defense mechanisms
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Muscle synthesis and as a cofactor for the normal clotting cascade
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Sorting (Mayinger)
After isolating the rough endoplasmic reticulum (ER) from the rest of the cytoplasm, you purify the mRNAs attached to ER-bound ribosomes. Which of the following would be among the proteins these mRNAs encode?
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Cytosolic enzymes
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Transcription factors
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Mitochondrial proteins
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Lysosomal hydrolases