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USMLE General Principles Question Bank

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The General Principles section of the USMLE covers these topics:
Biochemistry
Genetics
Microbiology
Pathology
Pharmacology

USMLE General Principles Question Bank

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25 Questions

1. Which molecule is involved with desensitization therapy in regards to allergies? 2. How does desensitization work?

1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Bind to D-ala-Dala terminus of cell wall precursors. 2. Genes change D-ala-Dala terminus to D-ala-Dlac which binds less to vancomycin.1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin

2. A 58 year old man is brought to ED with fever, shaking chills, productive cough with reddish brown colored sputum. Temp is 40 C and respirations are 33/min. CXR shows lobar consolidation of the left lower lobe. 1. What is likely diagnosis and why? 2. What is the main protective immunologic mechanism against this organism?

1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Bind to D-ala-Dala terminus of cell wall precursors. 2. Genes change D-ala-Dala terminus to D-ala-Dlac which binds less to vancomycin.

3. 2 year old boy brought to doctor on background of frequent URTI and GIT infections. Was delivered at 39 weeks gestation without any complications in delivery or pregnancy. Up to date with immunizations. Has had three hospitilizations in past year for pneumonia. 1. What is likely diagnosis and why? 2. What is he most likely deficient in?

1. Bind to D-ala-Dala terminus of cell wall precursors. 2. Genes change D-ala-Dala terminus to D-ala-Dlac which binds less to vancomycin.1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin

4. How does vancomycin work? 2. How do vancomycin resistance genes work?

5. MOA of: 1. Phentolamine? 2. Propranolol? 3. Epinephrine? 4. Isoproterenol? 5. Norepinephrine?

1. alpha 1 and alpha 2 antagonist 2. Beta 1 and beta 2 antagonist. 3. Alpha 1, alpha 2, beta 1, beta 2 agonist 4. Beta 1 and beta 2 agonist 5. Alpha 1, alpha 2, beta 1 agonist1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin

6. What sort of contraction or expansion is caused by diuressis of a man with heart failure who is fluid overloaded and given diuretics?

1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Isotonic fluid contraction with fluid only lost from ECF.1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.

7. What is the virulence factor that causes the symptoms seen in septic patients who are positive for gram negative organisms?

Gram negative septic shock is caused by the endotoxin in the outer membrane of gram negative organisms. It is called: Lipid A, a component of the lipopolysaccharide.1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin

8. What is defense mechanism of sublimation?

Diversion of unacceptable impulses into acceptable outlets. Example: Aggressive violent person channeling this into MMA.1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin

9. What virulence factor allows for bacterial survival within phagolysosomes of neutrophils in exudate?

Catalase: It destroys hydrogen peroxide the substrate for myeloperoxidase.1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization

10. What does it mean of the 95 % confidence interval for relative risk does not contain the value of 1.0 in it?

1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.It means that there is no statistically significant effect of whatever the confidence interval is measuring.

11. A 12 yo boy brought to GP due to skin abscess. Mother states patient has had several abscesses and aspergillus infections in childhood. Area around abscess is indurated. Wound cultures are obtained duri ngincision and draining. Culture grows staphylococcus aureus. 1. What is your diagnosis? 2. What is cause of this?

1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Chronic granulomatous disease 2. Defective NADPH oxidase1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization

12. A 33 year old man has X-linked dominant disease. Wife his homozygous for normal at locus. Disease genotype has 60 % penetrance. 1. What is probability that first child will be affected with this disorder? Show your work?

1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulinSo only daughters will be affected since boys get Y sex chromosome from dad but daughters get fucked up X chromosome. Soo right off bat 50 % chance. But since it has 60 % penetrance this means that first someone with the allele there is a 60 % chance it will present. So probability would be 50 % chance of girl X 60 % chance of penetrance = 30 % chance of first child being affected by the disorder.

13. A 23 yo man is brought to ED with sudden high fever, severe dyspnea and malaise. He has history of IV drug use. One hour later he develops progressive respiratory distress and supplemental oxygen is provided. His CD4 cell count is 73. Chest x ray shows bilateral diffuse fine granula appearing interstitial opacification. 1. What test is most appropriate for confirming identity of most likely causal agent and why?

1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Direct fluorescent antibody test: Can be used to identify pathogen antigens, likely has pneumocystis jirovecii from AIDS based on low CD4 count. Samples stained with methenamine silver stain1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin

14. What is associated with highest percentage of hospital acquired infections?

1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.Surgical site wound care1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin

15. What is galactosemia? 2. What are features of it?

1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. Autosomal recessive disease cause by lack of enzyme to break down galactose. 2. Vomiting, hyperbilirubinemia, jaundice, hepatomegally, cataracts1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.

16. Which stage of sleep has K complexes and sleep spindles in it?

1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonizationStage 2 sleep

17. A 28 year old man comes to doctor after experience 5 days of intense, vivid dreams and nightmares. He states that he used to sleep erratically for the past several years and just wrote it off as anxiety from his job. Upon further questioning, he states that he was drinkin three shots of whiskey to help him fall asleep for past two years but stopped this practice a week ago after frequent urgings from his wife. What could also preciptate the sleep symptoms present in this patient?

1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonizationParoxetine cessation: SSRIs suppress rapid eye movement sleep. When SSRI is discontinued an individual may experience REM rebound characterized by an increase in vivid dreaming

18. What does first order kinetics mean in regards to a chemotherapuetic drug? What does zero order mean in this case?

Means that the proportion of tumor cells eradicated per unit of time remains constant over time. zero ordre = constant number1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin

19. What is the MOA Mycophenolate mofetil?

1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.Inhibits purine synthesis and decreases B and T cell proliferation.

20. According to the WHO what is the most common cause for bloodstream infections in hospital?

1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. Central line contamination.1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.

21. A 2 week old newborn with a cleft palate and abnormal facies is brought to the physican by his parents because of frequent crying spells and spasms of the hands and feet. Lab serume shows calcium of 6.8, CXR shows and absence of tissue in the area posterior to the manubrium of the sternum. 1. What condition does this child likely have and why?

1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. DiGeorge syndrome = abnormal neural crest cell migration due to microdelation on chromosome 22. Occurs when pharyngeal pouches 3 and 4 fail to differentiate into: -parathyroid gland -thymus -cardiac and facial structures. Common features are: -Immunologic problems : Thymus issues -Hypocalcemia -Cardiovascular defects -Abnromal ears -Micrognathia1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.

22. A 50 yo man comes to doctor because of a chronic cough. He has smoked 1 pack of cigarettes daily for 30 years. Crackles and wheezes are heard on auscultation of the chest. A chest x ray shows no abnormalities. Gram stain of the sputum shows gram negative coccobacilli. 1. What is the most likely causative organism? Why do you think this?

1. Haemophilus influenzae: - Gram negative -Coccobacillus1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.

23. What is moa of leuprolide? 2. What is it used for?

1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. Gonadotropin releasing hormone analog 2. Advanced prostate cancer, estrogen dependent breast cancer.1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.

24. What sort of contraction occurs if you give a marathon runner distilled water to rehydrate with such that he only drinks as much water as he has lost? 2. What happens in it?

1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.1. Hypotonic contraction 2. Osmolality of ECF and ICF drop but volume of ICF increases while volume of ECF decreases.1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin

25. What is MOA of methotrexate?

1. Streptococcus pneumonia: -Shakes -High fever -lobar consolidation -Blood tinged, rust color sputum. **it is optochin sensitive. ** polysaccharide capsule is major virulence factor 2. IgG-mediated opsonization1. Selective IgA deficiency. Usually occurs at around two year old mark. IgA from mom and IgG usually help child. Child recieves theses through placenta in utero and then in breast milk. 2. Child lacks dimeric immunoglobulin1. IgG. 2. Insert small amount of allergen subcut over period of time. Causes increase in Treg cells that decrease TH2 cells and increase IgG that decreases IgE allergen cross linking.Inhibits DNA synthesis as an antimetabolit.

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25 Questions

❤ If you liked Fatskills, consider supporting us by checking out The Life Manuals You Never Got.

About | Explore | User Guide | Topics | Subjects | Doubt Solver | Career Aptitude Test | Answers | Free Tools | What Should We Know? Privacy | Terms |

Without work one finishes nothing. - Ralph Waldo Emerson© 2026 Fatskills.com

All trademarks, logos and brand names are the property of their respective owners. All company, product and service names used in this website are for identification purposes only. Use of these names, trademarks and brands does not imply endorsement.

About | Explore | User Guide | Topics | Subjects | Doubt Solver | Career Aptitude Test | Answers | Free Tools | What Should We Know?
Privacy | Terms |

Without work one finishes nothing. - Ralph Waldo Emerson
© 2026 Fatskills.com