1.

A healthy 26-year-old woman comes to the physician for a health

maintenance examination. She says that her moods change easily
and that she has seen numerous
psychiatristsa nd therapistsf or "emotionalp roblems."P hysicale
xaminations hows multipleh ealing,s elf-inflictedw ounds.A t the
end of the examination,s he thankst he
physicianf or "being the most skilled, compassionate,a nd
understandingp hysicianI have ever known."W hich of the
followingi s the most likely diagnosis?
e, A) Bipolar disorder
@ B) Borderline personality disorder
e, C) Dysthymic disorder
ei D) Histrionic personality disorder
e, E) Major depressive disorder
2. A 52-year-oldm an has cavitaryp ulmonaryle sions. Examinationo
f tissue obtained on biopsy of the lung shows granulomatousin
flammationw ith caseous necrosis.T
lymphocytese xtractedf rom this tissue are most likelyt o have an
increasedc oncentrationo f which of the following?
O A) Bradykinin
o B) Histamine
@ C) lnterferon-v
o D) lnterleukin-8( IL-8)
O E) Myeloperoxidase

3. Multiple members of an extended family are diagnosed with a

specific autoimmune disease. In an attempt to identify a marker to
assess the risk for this disease in other
family members, the expression of which of the following should be
identified in each fami ty member?
O A) B-lymphocyteim munoglobulin
o B) ~ lntegrins on leukocytes
2

o C) CD4+ molecules on T lymphocytes

O D) CDS+ molecules on T lymphocytes
@ E) Histocompatibilitya ntigens

4. A 70-year-old man is being treated with a new antifungal drug for

fungal sepsis. The drug is actively secreted by the kidney and has a
volume of distribution of 35 Land a
clearance of 690 mUmin. The half-life of the drug (in min) is closest
to which of the following?
@ A) 15
OB) 35
O C) 65
0 D) 105
0 E) 205

5. An 18-year-oldm an has an appendectomyT. wo weeks later,t he

abdominali ncision has healedw ell and has a pink, shiny,g ranulara
ppearance.W hich of the following
findings is most likely on examination of tissue obtained from the
healing area?
@ A) Angiogenesis

o B) Epithelioid cells
O C) Fibrinoid necrosis
e, D) Granulomatousin flammation
o E) lschemi c injury
6. The condensation reaction between succinyl-CoA and glycine is
the rate-limiting reaction in the biosynthesis of which of the
following compounds?
ei A) Cholesterol
@ B) Heme
ei C) Urea
e, D) Vitamin D

7. An investigator has designed a drug that is transported into the

cell through a membrane channel and remains isolated in the
cytoplasm. This drug will most likely directly
influence which of the following cellular processes?
o A) DNA transcription
o B) Electron transport
o C) Glycolysis
@ D) Protein folding
o E) Transcription factor binding
8. Duringa meal,t he vagus nerves timulatess ecretiono f
acetylcholinew, hich stimulatest he stomacht o secrete HCI in a
second-messengepr athwayd erived directlyf rom
membrane phospholipids. Which of the following second
messengers is involved?
O A) cAMP
OB) cGMP
0 C) Choline
o D) G protein
@ E) Inositol 1, 4 ,5-tri phosphate

9. A 45-year-old man with a history of type 1 diabetes mellitus is

brought to the emergency department because of chest pain
radiating to the jaw for the past 10 hours. He dies
shortly after admission. A photograph of a kidney as seen at autopsy
is shown. Which of the following types of necrosis is the most likely
cause of these findings?
ei A) Caseation
@ B) Coagulation
e, C) Fat
tO D) Gangrenous
ei E) Liquefaction

10. A specimen from a patient's surgical wound is streaked for

isolation on an agar plate. After overnight culture at 37°C, the plate
has bacterial growth as shown in the
diagram. Which of the following labeled arrows points to a colony
that is most likely to be a laboratory contaminant?

E
B~
'. @

C
'

D
@ A) e, B) e, C) e, D) O E)

11. A 28-year-old woman who is at 12 weeks' gestation and her

husband request genetic evaluation because they have a son with
cystic fibrosis. Genetic linkage analysis is
performed. Results of genotyping to detect alleles at 5 polymorphic
loci linked to the cystic fibrosis transmembrane regulatory gene
(CFTR) are shown. The risk of
recombination between each of the loci and CFTR is known to be
less than 1°/o.
Genetic Marker Father Mother Son With CF Fetus
I 1,2 2,2 1,2 1,2
II 4,4 4,4 4,4 4,4
Ill 3,9 3,3 3,3 3,3
IV 1,1 1,8 1,8 1,1
V 4,8 5,5 5,8 5,8
Which of the following best represents the alleles present on the
father's chromosome that has a CFTR mutation?
e, A) 12,1 141,1 1I9V,1 , V4
O B) 11,1 141,1 1I9V,1 , V4
@ C) 11,1 141,1 1I3V,1 , V8
O D) 12,1 141,1 1I3V,1 , V4
e, E) 12,1 141,1 1I9V,1 , V8

12. Sixty-three cases of smallpox are confirmed within a 15-mile

radius of a town with a population of 200,000. The outbreak is
believed to be the result of a bioterrorism attack
10 days ago. Initiationo f which of the followingi s the best methodf
or controllingt he spread of this disease?
O A) Acyclovir therapy
o B) Amantadine therapy
o C) lnterleukin-2( IL-2)t herapy
e, D) Intravenousim muneg lobulint herapy
O E) Ribavirin therapy
@ F) Vaccinia immunization

13. A married 78-year-old man is brought to the emergency

department after ingesting ten 15-mg temazepam tablets. After he is
stabilized medically, he undergoes psychiatric
evaluation. Which of the following is most important in assessing
his risk for suicide?
o A) Early morning awakening with decreased appetite
o B) Family history of suicide
O C) Male gender
e, D) Marital status
@ E) Patient's belief that temazepam would ki II him

14. A 25-year-old man develops fever, muscle pain, and headache 1

week after being bitten by several ticks while camping near the
Grand Canyon. The fever remits and he
feels better in 7 days. Two to four days later, his symptomsr ecur.A
Giemsa stain of a peripheralb lood smear showst he bacteriumi
llustrated.W hich of the followingi s the
most likely explanationf or the recurrenceo f the symptoms?
O A) Expressiono f endotoxin-likes tructureso n the surfaceo f the
organism
@ 8) Migration of the organism from a tissue site to the blood stream

o C) Production of a toxin that had become suppressed during the

infection
e, D) Secondary infection by a different organism of the same
species
O E) Variation of a major surface protein antigen of the organism

15. A 3-year-old girl is broughtt o the emergencyd epartmentu

nconsciousa fter ingestinga n unknownq uantityo f ethanol.H er
serum glucosec oncentrationis 30 mg/dl.
Throughw hicho f the followingm echanismsa re the productso f
alcoholm etabolismc ontributingt o the hypoglycemia?
o A) Increasing the conversion of pyruvate to oxaloacetate
e, B) Increasing the formation of pyruvate from acetyl CoA
@ C) Increasing the reduction of pyruvate to lactate

o D) Inhibiting pyruvate dehydrogenase

o E) lnhi biting the formation of pyruvate from alanine
16. While traveling by ship from India to Mexico, a 52-year-old
man develops malaise, chills, and spiking temperatures to 39.4°C
(103°F). Over the next several days, he
develops progressive hypotension and multio rganf ailure. He is
taken to a hospital;a completeb lood cell counts hows a
hemoglobinc oncentrationo f 4.0 g/dl. A Wrightstained
peripheral blood smear is shown. Which of the following is the most
likely diagnosis?
e, A) Lei shmani asi s
@ B) Malaria
e, C) Meningococcemia
ei D) Schistosomiasis
e, E) Trichinosis
17. A 4-year-oldb oy is broughtt o the physicianb y his parentsb
ecause of global developmentadl elays and odd behaviorss uch as
handf lapping. His motherh as a learning
disability,a nd his maternalu ncleh as mentalr etardation.P hysicale
xaminations hows macrocephalyl,a rge ears, and a prominentc hin.
He has a 3-wordv ocabulary.A
diagnosis of fragile X syndrome is made. After the parents are
informed of the results, they ask if their healthy 12-year-old
daughter, who has met all developmental
milestones, should be tested to determine her carrier status. Which
of the following responses by the physician is most appropriate?
<!:) A) "I recommend testing her now so that she can be prepared for
what may lie ahead if she has children."
<!:) B) "I recommend waiting until she is older and mature enough to
decide for herself if she would like to be tested."
<!:) C) "It would be better if she were at least 16 years of age, closer
to her childbearing years, before testing was initiated."
@ D) "Let's discuss the situation with her, review the pros and cons
of testing, and then ask her if she would like to be tested now."
<!:) E) "Let's hold off on that and discuss the options with her when
she is planning to marry and have children."

18. An HIV virus has been isolated that is not inhibited by soluble
CD4. Mutations are most likely to have occurred in the viral gene
encoding which of the following?
e> A) Core
@ B) Glycoprotein
e> C) lntegrase
e> D) Matrix
e> E) Reverse transcri ptase
19. Embryonicc hondrogenesisr equirest he formationo f
mesenchymacl ondensationsa t the sites of futurec artilage. Duringt
his developmentasl tep, cAMP concentrationsin
the cells comprisingt he condensationi ncrease significantlyT.
reatmentw ith a membrane-permeablefo rm of cAMP (eg, dibutyrylc
AMP) allows individualm esenchymal
cells to differentiatei nto chondrocytesw ithoutf irst formingt hese
condensations.I nhibitiono f which of the followinge nzymesw ould
most directlyi nhibit dibutyrylc AMPmediated
inductiono f chondrogenesisfr om mesenchyme?
<!:) A) Guanylycl yclase
<!:) B) Phosphodiesterase
<!:) C) Proteasome
@ D) Protein kinase A
<!:) E) Tyrosine kinase

20. Two children in a family have a disease characterized by mental

retardation and mild dysmorphic features. The family was evaluated
by standard karyotype and then by
DNA microsatellite polymorphism studies for two autosomal
markers. A pedigree is shown. Which of the following is the most
likely cause of the congenital disorder?
<!:) A) Anticipation
<!:) B) Autosomal recessive inheritance
@ C) Genomic imprinting
<!:) D) Mitochondrial inheritance

21. A 20-year-old woman comes to the emergency department

because of difficulty breathing for 2 hours. Audible wheezing is
heard. Physical examination shows
overdistentiono f the chest and marked restrictiono f expansion.L
aboratoryt ests show an increasedb lood eosinophilc ounta nd
eosinophilsi n the sputum.W hich of the
followingi s the most likely sequenceo f eventsf or initial
sensitizationt o the allergenc ausingt hese findings?
ro A) Cytokiner elease ➔ lgE production ➔ T-lymphocytein duction
ro B) lgE production ➔ B-lymphocytea ctivation ➔ T-lymphocytein
duction
@ C) lgE production ➔ T-lymphocytei nduction ➔ cytokiner elease
ro D) T-lymphocytei nduction ➔ cytokiner elease ➔ lgE production
22. A 2-year-old girl is admitted to the hospital for the second time
since birth because of pneumonia and respiratory distress for 1
week. She appears poorly developed and
thin. Her respirationsa re 42/min.P hysicale xaminations hows mild
respiratoryd istress.A n x-rayo f the chest shows hyperinflationw ith
infiltratesi n the right middle and right
lower lobes of the lung. Duringh ospitalizationt,h e patient has
greasy bowel movementsw ith a pungento dor. A sweat chloridet est
confirmst he diagnosis,a nd the patient is
started on a special formulaw ith oral supplementationo f fat-
solublev itamins.I f the incidenceo f this genetic disease is 1/2500
amongw hites,w hich of the followingi s the
approximate carrier frequency of this mendelian trait in this
population?
e> A) 1/12
e> B) 1/25
e> C) 1/50
e> D) 1/125
@ E) 1/625

23. A 15-year-old girl is brought to the physician's office by her

mother because of a 3-day history of constant dull suprapubic pain.
The mother leaves the room before the
examination, and the patient says, "My mother has no idea that I am
having sex, and she would kill me if she found out. Please don't tell
her." Examination shows marked
tenderness on cervical motion and a copious yellow discharge from
the cervical os. Cultures of the discharge grow Neisseria
gonorrhoeae and Chlamydia trachomatis.
Which of the following is the most appropriate next step in patient
care?
o A) Refuse to treat the patient unless she promises to abstain from
sexual activity until she is older
O B) Refuse to treat the patient unless she tells her mother
@ C) Treat the patient and do not tell the mother but urge the patient
to do so
o D) Treat the patient and tell the mother in front of the patient
o E) Treat the patient and tell the mother privately
24. An 82-year-old man has had bleeding gums, several loose teeth,
and bruises on his legs over the past 3 weeks. His lower extremities
are shown. He has prepared his own
meals since his wife died 4 months ago. Which of the following is
most likely to be abnormal in this patient?
<!:) A) Bone mineralization
@ 8) Collagen synthesis
<!:) C) DNA metabolism
<!:) D) Gamma carboxylation
<!:) E) Thiamine phosphorylation

25. An infantw ith an inheritedd efect in ornithinet

ranscarbamoylaseis most likelyt o have an increasedp lasma
concentrationo f which of the following?
@ A) Ammonia
ro B) Arginine
ro C) Citrulline
ro D) Putresci ne
ro E) Urea
26. Virulent strains of Neisseria meningitidis, Streptococcus
pneumoniae, and Haemophi/us inf/uenzae each contain which of the
following surface components?
(') A) Bundle-formingp ili
(') B) Endotoxins
(') C) Flagella
(') D) Hemolysins
@ E) Polysaccharidec apsules

27. A 15-year-old girl sustainsa minor burn on the forearm. Within

severalm inutes,a red (hyperemic)a rea developso n the skin
surroundingth e site of injury.W hich of the
following mediators is the most likely cause of the hyperemia?
0 A) C3b
O B) 5-HETE
@ C) Histamine

o D) lnterleukin-1( IL-1)
O E) Leukotriene B o F) ThromboxaneA
4 2

28. In an animal model of myocardial ischemia, morphologic and

biochemical changes in myocardial cells are studied after ligation of
a branch of the coronary artery.
Degradationo f membranel ipid bilayersa nd of cytoskeletalp
roteinso ccursf ollowinga ctivationo f intracellularp hospholipaseA 2
and proteases. An increase in which of the
following is most directly responsible for activation of those
enzymes?
@ A) Calcium ion concentration
<!:) B) Creatine kinase activity
<!:) C) Endonuclease activity
<!:) D) Sodium ion concentration
<!:) E) Water content

29. Which of the followingb est explainsw hy proteinss ynthesizedin

the roughe ndoplasmicr eticuluma nd secretedf rom eukaryoticc ells
have a shorterl engtht hanw ould be
predicted by their respective mRNAs?
@ A) Cleavage of 5' segments of nascent polypeptides being
synthesized on polyribosomes in the endoplasmic reticulum
<!:) B) Covalent binding of nascent polypeptides to specific
membrane proteins during their synthesis
<!:) C) Nonspecific protease activity during passage of these proteins
through the endoplasmic reticulum membrane
<!:) D) Shortening of the carboxyterminus because hydrophobic
amino acids remain within the membrane

30. Which of the followingg enetic phenomenam ost likely

accountsf or the variabilityi n biotransformationo f compoundsb y a
liver hydroxylase?
e> A) Allelic exclusion
e> B) Fragile sites
@ C) Hypervariable DNA
ro D) Multi pie polymorphisms
e> E) Multiple pseudogenes
31. The graph showst he relationshipb etweent he expressiono f
repressorp rotein and the expression( transcriptiona nd translation)o
f a lac z gene, in wild-typeE scherichia
coli. Which of the following mutations in genetic elements of the lac
operon could account for this relationship?
(') A) lac z promoter with no affinity for RNA polymerase
(') B) lac z protein with increased affinity for substrate
(') C) lac z protein with no affinity for substrate
(') D) Repressor with increased affinity for operator
@ E) Repressor with no affinity for operator

32. A 37-year-old man returns to the physician because of persistent

pain in his dominant hand resulting from tenosynovitis of the
abductor pollicis longus. He is upset because
he is no longer able to play tennis and softball,w hich he used to do
regularly.H e has been treated unsuccessfullyo ver the past 7
monthsw ith ice, exercise,i mmobilization,
physical therapy, and 2 corticosteroid injections. He says, "You are
just shuttling me around through all these worthless treatments!"
Which of the following is the most
appropriate response?
<!:) A) "Every step of the way I have prescribed the appropriate
standard treatments."
<!:) B) "I really can't discuss this with you until you calm down."
<!:) C) "If that is how you feel now, perhaps it would be best to just
change doctors."
@ D) "It has really been very frustrating to get so little help from
everything we've tried."
<!:) E) "Perhaps you need to see a counselor to work on your
problems with anger control."
<!:) F) "You are going to have to learn how to play with your left
hand."

33. In nucleotides,t he sugars are attachedt o nitrogen-containingb

ases by which of the following?
e> A) Electrostatic interactions
@ B) Hydrogen bonds
e> C) N-glycosidic bonds
e> D) Phosphodiester bonds
e> E) Stacking interactions
34. A 45-year-old woman comes to the physician because of a 6-
month history of mouth ulcers, thickening of the skin, and throbbing
pain in her hands when they are exposed
to the cold. She also has had a 1-month history of severe headaches
and difficulty swallowing. Physical examination shows small red
lesions around the mouth and
generalizedm usclew eakness.L aboratorys tudies show a high titer
of anti-Sci7 0 (anti-topoisomeraseI) antibody.A biopsy specimeno f
the skin showst hinningo f the
epidermis, hyalinizationa nd obliterationo f arterioles,a nd dermalt
hickening.T hese dermatologicc hangesa re caused primarilyb y the
release of chemokinesf rom which of
the followingi nflammatoryc ell types?
@ A) Endothelial cells
ro B) Eosinophils
e> C) Lymphocytes
ro D) Mast cells
e> E) Platelets
ro F) Segmented neutrophils
35. A 37- year-oldw oman developsp ancytopeniaa fter exposuret o
a benzene-containinga gent.T issue obtained on a bone marrowb
iopsy is most likelyt o show replacement
of normalh ematopoei tic cells by which of the followingc ells?
@ A) Adipocytes
<!:) B) Lymphocytes
<!:) C) Monocytes
<!:) D) Osteoblasts
<!:) E) Retic uloendotheali l cells

36. A 2-year-old boy is brought to the physician's office for a

follow-up examination because of recurrent bilateral otitis media.
He is at the 50th percentile for height, weight, and
head circumferenceH. e is almostt oilet trained, pretendst o help care
for his youngers ibling, and can form three to four-words
entences.W hich of the followingb est
describes his development?
Cognitive Social Motor
e) A) Delayed delayed delayed
e, B) Delayed delayed normal
0 C) Delayed normal delayed
e) D) Delayed normal normal
e) E) Normal delayed delayed
e, F) Normal delayed normal
0 G) Normal normal delayed
@ H) Normal normal normal

37. Which of the following steps in collagen synthesis is impaired in

patients with scurvy?
e>A ) Cleavageo f the N and C terminalp eptides from procollageni
n the extracellularm atrix
e> B) Formation of the procollagen triple helix in the endoplasmic
reticulum
e>C ) Glycosylationo f hydroxylysineso n the pro-a collagenc hain
@ D) Hydroxylationo f selected pralinesa nd lysineso n the pro-a
collagenc hain
e> E) Self-assembly of a collagen molecule into a collagen fibril
38. A 68-year-old man is brought to the emergency department
because of a 2-day history of fever, headache, muscle weakness, and
confusion. His temperature is 38.6°C
( 101.5°F).P hysicale xaminations hows generalizedl
ymphadenopathya nd weaknesso f the right lower extremity.L
aboratorys tudies show antibodiest o a virus that is
maintained in wild birds, carried to humans by Cu/ex species
mosquitoes, and has a low fatality rate. Which of the following is
the most likely causal virus?
e, A) Coronavirus
e, B) Dengue virus
e, C) Norovirus
e, D) Poliovirus
@ E) West Nile virus
e, F) Yellow fever virus

39. A 50-year-old man comes to the physician because of a 10-

month history of multiple symptoms including fatigue, shortness of
breath with exertion, ringing in his ears, a
sore tongue, abdominal discomfort, mild peripheral muscle
weakness, burning sensations on his hands, and tingling in his toes.
He appears thin and pale. Laboratory
studies show:
Hemoglobin
Hematocrit
Leukocytes
Reti culocytes
10 g/dL
41%
4000/mm3
2% of red cells
Hemoglobine lectrophoresisi s normal.A peripheralb lood smear
shows ovoid macrocytica nisocytosisa nd some poikilocytosiso f
erythrocytesH. e says that he follows an
adequated iet. His conditioni s most likely caused by a dysfunctiono
f synthetica ctivities in which of the followingc ell types?
@ A) Follicular epithelial cells of the thyroid gland
ro B) Hepatocytes
e> C) Macrophages of bone marrow
ro D) Pari eta I cells of the stomach
e> E) Schwann cells of coronary arteries
40. Many human genes encode more than one polypeptide sequence.
Which of the following mechanisms accounts for the production of
more than one protein by one human
gene in most cases?
<!:) A) Alternative splicing of the transcript
@ B) Production of a polycistronic mRNA
<!:) C) Reading mRNA in both directions
<!:) D) Reading mRNA in more than one reading frame
<!:) E) Transcription of both strands of the gene

41. A 60-year-old man with signs and symptoms of an obstruction

in the large bowel undergoes surgical resection. The presence of a
malignant neoplasm is most strongly
supported by which of the following features seen in the photograph
of the resected segment of the colon?
e> A) Fibrosis of the wall
e> B) Invasion of the submucosa and muscular layer
@ C) Narrowing of the lumen
ro D) Sharp demarcation from the normal mucosa
e> E) Ulceration of the mucosa
42. Which of the followingi ntracellulars ignal moleculesr egulatest
he phosphorylationo f fructose6 -phosphate?
e> A) Calcium
e> B) cAMP
e> C) Ceramide
e> D) Fructose 1,6-bisphosphate
@ E) Fructose 2,6-bisphosphate
e> F) Malonyl CoA

43. A 55-year-old man has a 2-week history of intense burning pain

in his calves when he walks rapidly. The pain is relieved by resting.
He has smoked 2 packs of cigarettes
daily for 40 years. The skin on his lower extremitiesi s dry, scaly,a
nd shinyw ith normalc olor and temperature.F emoralp ulses are
weak. Hemoglobinc oncentrationis 14
g/dl. Which of the following best describes the cellular changes in
the myocytes in his calves during the painful episodes?
@ A) Cytoplasmic swelling
e> B) Formation of large densities in mitochondria
e> C) Karyorrhexis
e> D) Lysis of endoplasmic reticulum
e> E) Rupture of lysosomes
44. A 64-year-old man comes to the physician because of a 3-month
history of bleeding gums and a tendency to bruise easily. He has
chronic pancreatitis and a 40-year
history of alcohol abuse. His prothrombin time is 21 seconds (INR =
3.2). Qualitative analysis of stool shows increased fat. Which of the
following is most likely responsible
for the development of these symptoms in this patient?
ro A) Folic acid deficiency
e> B) Thiamine deficiency
ro C) Thrombocytopenia
e> D) Vitamin 812 (cobalamin) deficiency
@ E) Vitamin K deficiency
45. Which of the following laboratory tests is most useful in
differentiating Staphylococcus aureus from other staphylococci?
(') A) Bacitracin (A disk) susceptibility
(') B) Catalase test
@ C) Coagulase test
(') D) Lactose fermentation
(') E) Optochin (P disk) susceptibility
(') F) Oxidase test
(') G) Urease test

46. A 28-year-old woman has a pelvic neoplasm composed of

mature glandular and chondroid elements and cysts lined by
stratified squamous epithelium. Which of the
following is the most likely diagnosis?
0 A) Adenocarci noma
0 B) Adenoma
0 C) Chondroma
0 D) Chondrosarcoma
@ E) Teratoma

Enzyme 1
ADP
R = Regulated protein
R-OH
0

II R-O-P-oo1-
.- ....P ;
Enzyme2
H20
47. The reactions shown constitute an important regulatory switch
for the activity of a large number of proteins in eukaryotic cells.
Enzyme 1 transfers a phosphate group from
ATP to particular amino acids in regulatory proteins. Enzymes that
perform this reaction are members of which of the following groups
of enzymes?
<!:) A) Adenine phosphorylases
<!:) B) Adenylyl cyclases
<!:) C) Adenylyl transferases
<!:) D) Protein ki nases
@ E) Protein phosphatases

48. Treatmento f respiratorys yncytiavl irus with 70% ethanold

estroysi ts infectivity.T he loss of infectivityi s the resulto f a direct
effect of the treatmento n which of the following
viral functions?
@ A) Entryo f the nucleocapsdi into the nucleus
<!:) B) Fusion of the virion membrane with the target cell membrane
<!:) C) Replication of the virus genome
<!:) D) Transcription of mRNA

49. A 45-year-old woman is admitted to the hospital for treatment of

a perforated ulcer. She refuses to speak to the nurse assigned to her.
She calls the nurse "a terrible
person" and tells the physician that he is the best doctor she has ever
had. This behavior is best described as which of the following?
0 A) Denial
0 B) ldentifci ation
0 C) Projection
0 D) Rationalization
0 E) Reaction formation
0 F) Repression
0 G) Somatization
@ H) Splitting
0 I) Sublimation
e) J) Suppression

50. Transgenic mice are generated that are incapable of expressing

Bruton tyrosine kinase. These mice are at increased risk for severe
infections caused by which of the
following microorganisms?
<!:) A) Aspergil/us fumigatus
<!:) B) Influenzav irus
<!:) C) Loa loa
<!:) D) Scrapie prions
@ E) Streptococcus pneumoniae