BECOM-1 Exam 2 (2019)

Welcome to your BECOM-1 Exam 2 (2019)

Once a vessel is damaged, platelets start to cling to the injured site and release chemicals that attract more platelets. The platelets continue to pile up and release chemicals until a clot is formed. Blood clotting is an example of:Once a vessel is damaged, platelets start to cling to the injured site and release chemicals that attract more platelets. The platelets continue to pile up and release chemicals until a clot is formed. Blood clotting is an example of which of the following?
In the cold northern winters, you many times will see people out at bars not wearing jackets who claim that they are not cold, is this problematic? Why or Why not?
Which of the following would be a long-term effect of hemolytic anemia?

Which of the following is an example of a positive feedback mechanism?

Gene was recently diagnosed with hypertension and put on enalapril, an ACE inhibitor. He wants to know how it works, so you tell him, in layman's terms:
Jenna fell off her bike scraping her knee. This started a cascade of cellular processes: her knee started bleeding, turned red and was painful.  Her broken endothelial cells release cytokines which signal thrombocytes to release more cytokines thus activating additional thrombocytes to clot and stop the bleeding. This is an example of:
Which of the following combinations of membrane potential (Vm) and equilibrium potential (Eion) for either a cation or anion would result in an overall decrease in membrane potential if: The channel for the specific anion or cation was open and uninhibited. Concentration differences between the cytosol and EC anion/cation are negligible.
Potassium channels allow for potassium to leave the cell. What prevents sodium from using this channel?
Lethal injections contain potassium chloride which works to stop the heart. Why is this an effective method of euthinasia?
Patent ductus arteriosus is a heart defect in the pulmonary artery that carries oxygen-poor blood to the lungs and the artery that carries oxygen-rich blood to the rest of your body. How would this condition affect the rest of the body in terms of membrane potential?
Cystic Fibrosis is a disease caused by a mutation in which of the following types of channels?

The ion with the biggest effect on the resting membrane potential is the ion with which of the following?

A patient presents at a clinic you are rotating at during your OMS III year with acute hyperkalemia. Which of the following is a true statement regarding the physiology of this condition?

Which of the following locations has voltage gated calcium channels?

An unknown bacteria has the following equilibrium potentials for sodium and potassium (picture above). Membrane potential of this bacteria is -60. Given the values below, what is the driving force of potassium and would it flow in or out?
  • K+: -84
  • Na+: +68

Which of the following is true regarding the Sodium Potassium ATPase?

Adrenoleukodystrophy is a rare hereditary metabolic disorder in which fats accumulate in the brain causing demyelination of nerves. Which of the following symptoms would you expect to see in a patient suffering from adrenoleukodystrophy?

In reference to the diagram below, which segment is dominated by the opening of ligand gated sodium channels?

You are completing your residency as a family practitioner and one of your colleagues asks for a refresher on coding for stimulus intensity. You explain that the intensity of the stimulus is impacted through which of the following?

Which of the following descriptive factors can be used to describe an action potential?

While rotating in the ED your preceptor notices a patient come in with a superficial laceration to their forearm and instructs you to suture the wound. Before you begin suturing you inform your patient you are going to inject Lidocaine (a local anesthetic) into the area around the laceration to numb the area. If you want to really be a know-it-all you can explain that the lidocaine will inhibit which of the following from working?

Tristan drinks Diet Coke at all hours of the day averaging about a twelve pack daily. Lately he has been having headaches and drinking more because he believes they are caffeine related headaches. What problem is he truly having?

What is the correct order of the sequence of events of action potential propagation that are listed below?
  1. Neurotransmitters bind to postsynaptic receptor
  2. Voltage gated Ca2+ channels open,
  3. Neurotransmitters diffuse into synaptic cleft
  4. Na+ channels open in postsynaptic neuron,
  5. Threshold is reached initiating a new action potential
  6. Neurotransmitter is degraded by enzymes in the synaptic cleft,
  7. Ca2+ influx
  8. Synaptic vesicles fuse with membrane,
  9. Action potential reaches the presynaptic terminal

Sinemet (Carbidopa-levodopa) is a medication used to treat the symptoms of parkinson’s disease. How does this medication work?

The synapse responsible for a sodium channel causes a graded potential could be described as which of the following?

You recently discover that one of your grandparents has been diagnosed with Alzheimer’s Disease. Knowing that Glutamate excitotoxicity has been found to be correlated with this disease, what else may also be dysfunctional?

Why are blood vessels able to contract strongly and not contract in a ripple?

When we are hot, our body sends a signal to our sweat glands to release their contents which then evaporates on our skin to help cool us down. Which of the following explains how the sweat gland functions?

Mike is college basketball player. He goes in for a checkup and finds that his heart rate is resting at about 45 beats per minute. He had just learned that 60-100 beats per minute is normal and is concerned about his low rate. You tell him that...

Which of the following is true in regards to the sympathetic nervous system?

While doing your family medicine rotation 3rd year you notice a patient with who has been diagnosed with both high blood pressure and asthma. It looks like your preceptor may not have noticed he was diagnosed with both because when you look at his chart he has been prescribed which of the following medications?

A patient recently had to have both his adrenal glands removed due to adrenal cell carcinoma. Which of the following activities would it be most difficult for him to achieve now?

Which of the following is true regarding the autonomic tone of blood vessels?

Assume for the point of this question that the heart follows the concept of the Denervation in the same principle as blood vessels. After the heart has been completely denervated the heart rate will increase to that of the sinoatrial node which is 80-100. After one week a patient is given an epinephrine injection due to an allergic reaction What will the effect on the patient’s heart rate be?

Which of the following below correctly matches the receptor with its G protein/mechanism of action?

Which of the following below correctly matches the reflex with its stimulus and response?

The preganglionic axons that synapse with collateral ganglia of the abdominopelvic cavity are most specifically

You are rotating in your OMS III year with a neurologist that asks you about your knowledge of preganglionic axons. You tell him that they all communicate with the neurotransmitter:

Raynaud’s Phenomenon is a condition where cold activates the sympathetic nervous system and results in a scenario of excessive vasoconstriction. This is most commonly seen in the hands, feet, ears, nose, and other extremities. What would be the most effective medication to use to treat such a condition?

Alpha 2 receptors differ from the other receptors in the adrenergic class in which it belongs. Because of this variation, they prevent excessive stimulation so that you do not have a heart attack each time you are scared. They can perform this life saving response because when Alpha 2 receptors bind norepinephrine

When doing a biopsy of your diabetic patient’s pancreas, you discover that your patient has cancer in their β-cells. You then get a measurement of her C-peptide and your preceptor asks why that is a logical next step. You tell him that:

Your friend Tiffany was only half listening about leptin and is confused as to why it couldn’t be used independently to treat obesity in humans. Which of the following explains why this would not be an effective obesity treatment for humans?

After running a routine physical and blood tests on a patient, they begin to freak out because their blood glucose level is 135! They are very healthy, non obiese 35 year old male, and have no history of diabetes in their family. What is the most likely cause of the high blood glucose levels?

Martha tells you that she has been doing the keto diet where she eats fewer than 20 grams of carbohydrates a day. While on this diet, what does her red blood cells use for fuel?

Epinephrine is a more powerful regulator of glycogen synthesis/breakdown than glucagon, which is why it needs two different receptors on the liver. When epinephrine bings to a Beta 2 receptor on the liver, which G protein will it be?

The conversion of Fructose-6-Phosphate to Fructose-1,6-Bisphosphate is a highly regulated part of glycolysis. Which of the following is an agonist of this step?

Which of the following pairs would show a similar Lineweaver-Burke graph?

Which step in glycolysis is unable to proceed if there is a shortage of NAD+?

Veronica suffers from anorexia nervosa causing her to have low vitamin B1 levels. Which of the following coenzymes related to the pyruvate dehydrogenase complex would she have trouble synthesizing?

Which of the following regulators when present will decrease or inhibit the formation of Acetyl CoA from Pyruvate by activating PDC Kinase?

Fumaric aciduria is a rare autosomal recessive metabolic disorder characterized by a deficiency of the enzyme fumarate hydratase (fumarase), which causes a deficiency of malate. What effect would this have on the production of ATP?

Fumaric aciduria is a rare autosomal recessive metabolic disorder characterized by a deficiency of the enzyme fumarate hydratase (fumarase), which causes a deficiency of malate. What effect would this have on the production of ATP?

Isocitrate dehydrogenase is the TCA enzyme responsible for the oxidative decarboxylation of Isocitrate to α-ketoglutarate. In IDH mutations, mutant isocitrate dehydrogenase additionally reduces α-ketoglutarate to D-2-hydroxyglutarate (2-DHG). How does this mutant TCA oncometabolite compromise cellular integrity that potentially leads to cancer?

The legend of vampires is believed to have stemmed from individuals who had the disease porphyria which can often include symptoms such as sensitivity to sunlight which can be treated with exogenous blood ingestion. Deficiency in which TCA cycle intermediate can lead to porphyria?

Which of the following enzymes reduce a vitamin B2 derivative through their enzymatic activity in the TCA cycle?

Which of the following below contains the three enzymes that produce NADH during the TCA Cycle?

In the early 1960’s the benefits of Vitamin E were discovered and doctors started prescribing it as a pill to virtually everyone. Which of the following explains why this was not effective in preventing many of the diseases that natural vitamin E had been seen to prevent?

Molly’s pediatrician told her that she could give acetaminophen to her 6 month old for fevers. She didn’t have any acetaminophen so she gave her baby baby aspirin which she thought would be okay because it had the word baby in the name. Which of the following explains what would happen?

In most infections (especially bacterial), neutrophils are characterized as the first responders as they often the first leukocyte to be elevated and attempt to resolve the infection. Neutrophils are also characterized as phagocytes which means they ingest their targets and then fuse them with lysosome to degrade them. Phagocytes also implement reactive oxygen species is order to damage and destroy their ingested targets. Which NADPH oxidase (NOX) enzyme is found in these types of cells?

Nitric oxide is created in endothelial cells of blood vessels when acetylcholine binds to its G protein coupled receptor. What enzyme will the G alpha subunit activate after acetylcholine has bound?

Kevin wanted to look cool when he went to his first rave festival, so he took amphetamines that he got from the sketchy looking man in the bathroom line. Unfortunately they were laced with MPP+ and Kevin woke up confused in the hospital with tremors in his hand, stiff muscles, and feeling very fatigued. Which of the following explains his symptoms?

Which of the following is required to produce additional NADPH in order to fuel Glutathione Reductase to reduce glutathione?

People suffering from Crohn Disease are frequently deficient in many vitamins including Selenium due to their inability to absorb vitamins despite their consumption. Which of the following would be affected by a selenium deficiency?

People with hemolytic anemia have problems reducing glutathione. Hemolytic anemia results in the rupture of red blood cells. Which of the following would NOT be a problem for people with this disease? 

Which of the following would be an example of a Hormetic response to stressors?

In the very young and the elderly, it is common to be deficient in the various B vitamins. If one of these individuals is deficient in both cobalamin and pyroxidine, they will get a toxic buildup of which product?

All of the following Gluconeogenic mechanisms are stimulated by increased levels of Glucagon, except for:

Skipping her normal balanced breakfast, Tammy was beginning to feel the burn one hour in to her midmorning marathon in downtown Chicago. Which of the following occurs during Glycogenolysis to maintain Tammy’s blood glucose levels and fuel exercising skeletal muscle during this event?

A point mutation in glycogenin causes a stop codon to form where a tyrosine residue should be. Which of the following would you expect to see in a patient with this mutation?

A mutation in PFKFB genes 1-4 on chromosome X leads to non-functional PFK-2/FBP-2 enzyme. What effect does this have on metabolism?

Which of the following is most characteristic of Glycolysis?

In order to test the efficacy of a novel drug therapy on diseased cardiomyocytes, you first want to determine if any unwanted side-effects occur in otherwise healthy cardiac cells. Fibroblasts donated to your research clinic from a healthy 30 year old male could be reprogrammed into iPS cells using which of the following combinations of transcription factors?

A patient comes in complaining of pain in their lower abdomen. Blood tests are ordered and show an increase in white blood cells. A CT scan reveals a tumor in their small intestine. Which of the following enzymes involved in the WNT pathway would you expect to see a mutation in?

Which of the following is a difference between necrosis and apoptosis?

Following an MI there is an increase in neutrophils that can be seen in tissue samples of myocardial tissue, which of the following explain this?

After a routine follow-up visit, your patient presents you with information regarding a new stem cell therapy for DM Type I that they saw on Doctor Oz using earlobe cartilage as a stem cell precursor. As a DM Type I patient, they intrigued and clearly fixated on this new therapy as a way to cure their life-long disease. As an osteopathic physician trained in bioethical practices and well-versed in current stem cell literature, you politely inform your patient that:

A tissue sample from an unknown skin lesion is analyzed microscopically and enzymatically to determine whether or not necrosis has taken place. Which of the following scenarios is indicative of necrosis and not apoptosis?

Your patient, a seasoned automotive mechanic, presents to your clinic with an abnormal growth on his forearm that occasionally bleeds and has persisted for the past 6 months. During the intake, he reveals to you that he has never felt the need to wear protective gloves while doing oil changes for the past 30 years. You biopsy the lesion and send it to pathology to rule out basal vs. squamous cell carcinoma. What abnormality in the internal cell death program would indicate that apoptosis has been compromised in this lesion?

A recent discovery by John B Gourdon and Shinya Yamanaka showed that mature cells can be reprogrammed to become pluripotent using a specific set of transcription factors that are able to upregulate and downregulate thousands of genes depending on their concentrations. Which of the following transcription factors is unable to reprogram cells by regulating epigenetics?

Mesenchymal cells of the mesoderm are considered to be which of the following?

The inner cell mass is considered to be pluripotent because it can become almost everything necessary to a developing embryo and future human. What is one structure that it can NOT become?

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