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amboss incorrects Flashcards

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USMLE® Step 1 flashcards
1
Q

false incorrets of vdrl

A

h viral infections, rheumatic fever, lupus, or leprosy.

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2
Q

white lump curd ike discharge in vagina

A

vulvovaginitis

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3
Q

an old woman has high inhibin b what could the diagnosis be

A

granulosa cell tumor

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4
Q

contraindications of ocps

A

OCPs are contraindicated in women who have migraines with aura, smoke cigarettes above the age of 35 years, or have a history of stroke, thromboembolism, breast cancer, or liver disease.

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5
Q

histology of an oocyte

A

surrounded by flat granulosa cells, stroma surrounds granulosa

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6
Q

when does meiosis complete in an ococyte

A

Primary oocyte arrest occurs in prophase I of meiosis I (think PROphase = PRior to Ovulation).
Secondary oocyte arrest occurs in metaphase II of meiosis II (think METaphase = before egg MET sperm).

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7
Q

female embryonic deriative of gubarnaculum

A

Ovarian ligament

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8
Q

what is the purpose of giving ocps in pcos

A

increases SHBG binds to testosterone decreases androgens

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9
Q

how does progesterone act

A

it arrests endometrium at certain stage

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10
Q

raloxifene contraindications

A

previous throm

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11
Q

does endometriois increase risk of malignancy

A

yes

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12
Q

what is round ligament responsible for

A

anteverson antiflexion of uterus

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13
Q

what is artery of sampson

A

anatomosis in uterine and ovarian artery

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14
Q

what is a dermoid cyst

A

A mature cystic teratoma that can occur on the head, the neck, spine, cranium, and in the abdomen (most common ovarian tumor in females). Cysts typically become symptomatic as they grow in size. They are treated with complete surgical excision.

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15
Q

how tod istinguish uterine prolapse from cytocele

A

urinary symotoms same, but cystocele has vaginal protusion uterine prolapse has decent of utrus

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16
Q

gestial sac visualistion and dilated cervix is

A

Visualization of the gestational sac and dilatation of the cervix in a woman at only 31 weeks’ gestation would be concerning for preterm labor. A

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17
Q

causes of congenital torticollis

A

., secondary to clavicular fracture, cervical fracture, or dislocation of C1/C2 with spastic contracture of the sternocleidomastoid muscle

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18
Q

defective intraellular transport of meanosomes to keratinocyes

A

post inflammatory hypopigmenation

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19
Q

a pregnant with prexisitng heart disease

A

systolic benign diastolic path

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20
Q

vaterl association leads o

A

polyhydraminos

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21
Q

best drug for treating postpartum hemorrhage

A

oxytocin

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22
Q

small pelvis shallow intragleutal cleft maternal diabeties

A

caudal regression syndrme

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23
Q

which rrna trasncript is transcribed outside the nucleous

A

rrna transcrpit 5s rna poly 3

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24
Q

i give a person azothoprine and he has xanthine oxidase deficiency

A

no secretion of thiouric acid azothoprine completely blocks HGPRT, since it blocks HGPRT no salvage= increased toxicity

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25
Q

uti by klebseilla causes what colour change of agar

A

greent o purple

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26
Q

pyrdazimide tb drug

A

requires acidic ph to be activated so its only functional within lysosomes not exxtracellular

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27
Q

pyrdazimide tb drug

A

requires acidic ph to be activated so its only functional within lysosomes not exxtracellular

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28
Q

which is the only trna that does not bind to A site

A

Methonine

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29
Q

what is the function of N fromylmethonine

A

it codes for chemotaxis of neutrophils

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30
Q

where does n and o glycosylation occur

A

n occurs in rer o occurs in golgi in n aspargine is involved in o serine and theorine

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31
Q

which aminoacid is excised due to post transitaional modification

A

The first methionine is subsequently removed by an N-terminal peptidase as a part of the cotranslational or posttranslational modification, while all other sulfur-containing amino acids are not excised

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32
Q

which is inovled in methylatiuon

A

SAm

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33
Q

how does the process of N acetylation work

A

its simple aminoacid methionine is removed by aminoacid peptidase, then replaced by acetyl group by acetyl coa via acetyl transferase this always happens

aceylation also occurs in lysine residudes of histones

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34
Q

what is the moa of ampicillin gentamicin synergestic effect

A

it makes bacterial cell wall more permeable

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35
Q

difference between elastin and collagen synthesis

A

elastin doesnt undergo glyscosylation no hydroxylastion and lysine is crosslinked due to lysl oxidase what is solar elastossis? what is transglutaminase and lysloxidase

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36
Q

errors in ubiquintation

A

parkinson monoubq vs polyubq mom is for trafficking poly is for degradation

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37
Q

glucose 6 p to glucose

A

in ser

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38
Q

how do glucorticoids cause osteoporosis

A

apoptosis of osteocytes, inhibits differenction of mesenchymal cells to osteoblasts
high glucorticoid support RANKL synthesis by preosteoblasts
inhibits androgens and estrogens

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39
Q

osgood schatler disease

A

Overuse (especially sports involving sprinting and jumping) during the ossification period (adolescence) → excessive strain and repeated avulsion of the patellar ligament on the tibial tuberosity → inflammation → traction apophysiti

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40
Q

chronic inflammation of patella

A

secondary ossification of the tibial tuberosity → detachment of the apophysis → subsequent callous formation during the healing process → pronounced tibial tubercle [1]

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41
Q

chronic inflammation of patella

A

secondary ossification of the tibial tuberosity → detachment of the apophysis → subsequent callous formation during the healing process → pronounced tibial tubercle [1]

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42
Q

myophosphrylase deficiency lab findings and explain the why

A

flat venous lactate curve with exaggerated elevations in blood ammonia during exer
because glucose not produced to overwhelm the krebs cycle to form pyruvate which causes lactate to form

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43
Q

histopath of ewings

A 
A t(11;22) chromosomal translocation, resulting in expression of fusion protein EWS-FLI 1,
several layers of new bine around lytic bone
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44
Q

conversion of prostglandin H2 to txa2

A

thrombonxane synthase inhibtied by anti thrombitc drugs

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45
Q

which drugs inhibti DHF

A

pyrmethimee, trimethoprim and methotrexate

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46
Q

what is codmans triangle

A

basically when osteosarcomas bcome malignant they grow into the periosteum leading to periosteal reactions (these periosteal reaction are know as bony spicules giving it a suburst appearnence)

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47
Q

where do chrondromsarcomas commonly occur

A

chondrosarcomas commonly present with osteolytic lesions involving the pelvis, spine, or shoulder girdle and mainly occur in patients over the age of 50 years.

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48
Q

giant cell osteomas

A

they arise promixal to the knee and is associated with age 20 however osteosarcoma age 15

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49
Q

what is ragged muscle fibres

A

compensatory proliferation of mitochondria in gomori stain

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50
Q

polymyositis vs dermatomysositis

A

poly is endomysial inflammation, whereas dermato is perimysial
poly is cd8 t whereas dermato is cd4

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51
Q

cutaneus manifestaion of dem

A

mechanis hand, externsor papules symmetrically distributed,, helitrope rash

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52
Q

pagets vs osteopetoris

A

“bowing of the legs” is a buzzword for Paget’s disease, and it also tends to be more localized (whereas Osteopetrosis is diffuse). The warmth over the shins is also a clue towards Paget’s because of the increased vascularity (remember how it’s associated with AV shunts/high output

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53
Q

high pth what is changed

A

subperiosteal changes with cysts

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54
Q

osteoporosis what is changed

A

trabeculae

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55
Q

when is woven bone formed

A

Formed during embryonic development, after fractures (secondary bone healing), and in Paget disease

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56
Q

trabecular bone vs cortical bone

A

it is the ends of the bone which resists tensile strength

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57
Q

what are the muscle fibre changes in hypothyroid myopathy and what is elevated

A

Hypothyroid myopathy is characterized by noninflammatory type II muscle fiber atrophy with relative type I muscle fiber hypertrophy. This condition may also manifest with proximal muscle weakness and elevated creatine kinase,

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58
Q

why osteomyletits is common in children and why only in the metaphysis

A

blood is slow in metaphysis creates a sharp lopp whichcauses stasis of blood

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59
Q

why we have involvurum what is it and what is sequestrem

A

Inflammation in the marrow causes increased intramedullary pressure, which forces the exudate into the cortex, where it can rupture through the periosteum. More than 80% of cases of hematogenous osteomyelitis occur in the long bones, the femur and tibia being the most common, and cases usually originate in the metaphyses.

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60
Q

osteogensis imperfecta pathophys

A

cola1 mutation this codes for alpha chains in collagen

61
Q

what are wormian bones

A

excessiove bones around crainal suture=OI

62
Q

spinal stensosi associated with what genetic disease

A

achondroplasia

63
Q

intestinal rupture which disease complication

A

ED vasuclar type type 3 collagen fucked

64
Q

hyperextension of finger can lead to which tendone to rupture

A

digitoirum to profundus

65
Q

if a ball hits the distal finger what could happen

A

hyperextension also known as baseball injury

66
Q

what is a trigger finger

A

An inflammation of the flexor tendon sheath leading to a stenosing tenosynovitis. Patients experience a locking or catching sensation during active flexion-extension activity and often have a palpable nodule along the axis of the flexor tendon. The cause is unknown

67
Q

mechanism of boutinere deformity in RA

A

Finger deformity caused by hyperextension of the distal interphalangeal joint with flexion of the proximal interphalangeal joint due to slipping or disruption of the central band of the extensor digitorum (ED) tendon. Can be caused by sharp or blunt trauma (e.g., jamming a finger in a door) or by rheumatoid arthritis (inflammation of the joint space pushes the central band of the ED out of its normal anatomical position).

68
Q

epidural abscess presents as

A

An inflammatory reaction in the epidural space might be caused by an epidural abscess or bone metastases. Both could present with acute back pain and signs of spinal cord compression. However, the patient has no evidence of cancer. Furthermore, an epidural abscess would demonstrate point tenderness and constitutional symptoms (fever, chills) and is usually associated with risk factors such as IV drug use, diabetes, or immunosuppression. Additionally, the acute onset of symptoms makes both diagnoses unlikely.

69
Q

a person comes with macroglossia and osa what could be etiologies

A

gh,hypothyroidism,glycogen storage disease(pompe)

70
Q

DMPk deficiency

A

insulin resistance/arrhtymias

71
Q

premature hair loss in men should hint u towards

A

myotonic dystrophy

72
Q

how to assess supraspinotous injury px

A

empty can test, and subacromial tnederness

73
Q

how to asses subscapularis muscle injury

A

liftoff test lift posteriorly

74
Q

explain pathophys of malignant hyperthermia

A

A mutation in the ryanodine receptor gene of striated muscle cells results in a ryanodine receptor that can be activated by certain substances, such as inhalation narcotics (e.g., isoflurane). This activation leads to an uncontrolled release of Ca2+ from the SR, which results in a continuous contraction that increases the energy and oxygen consumption of the muscle cell enormously. Affected individuals present with lactic acidosis due to increased anaerobic glycolysis and hyperthermia due to increased muscle metabolism. This life-threatening condition is called malignant hyperthermia.

75
Q

how to diagnose fibromyalgia vs polymalgia rheumatica(symmetrical pain)

A

flu like symotoms with tender points associated with other diseases such ad ibs or incontinence
neck, back, shoulders, and medial aspect of the knees

76
Q

denosumab moa

A

nfkb inhibtor mimics osteoprogets=rin

77
Q

how is osteoclast activated

A

Receptor activator of nuclear factor kappa B ligand; ligand of the osteoclast receptors

78
Q

what are the common causes of becker muscular dystrophy

A

inframe mutations=reading fram intact

or point mutation which causes deletion

79
Q

splice site mutations are caused in

A

cancers, dementia, epilepsy, and some types of β-thalassemia.

80
Q

what can damage ulnar nerve

A

guyon cnaal fucked hamate fucked and pisirofrm fucked

81
Q

posterior interossous nerve

A

A motor branch of the radial nerve that arises near the lateral epicondyle and innervates all muscles of the posterior compartment of the forearm except for the long head of the extensor carpi radialis (which is directly innervated by the radial nerve).
extensor carpi radials muscle preserved causes unapposed wrist deviation

82
Q

radiological finding of gout vs chondrocalcinosis

A

chondrocalcinois doesnt have punctate radiological findings

83
Q

radiological finding of gout vs chondrocalcinosis

A

chondrocalcinois doesnt have punctate radiological findings

84
Q

where does calcification occur in pseudogout

A

Fibrocartilage (meniscus, annulus fibrosus of intervertebral disk)

85
Q

supracondylar fracture various displavcements

A

anterior=brachial artery
anteriolateral=radial nerve
medial =median nerve

86
Q

if you have a flexion type of supracondylar fracture

A

then you have ulnar nerve injury

87
Q

obtruator artery destroyed in which fracture

A

acetabulum fracture

88
Q

what is the branch of femoral profundus artery

A

middle femoral circumflex artery

89
Q

lateral femoral circumflex artery

A

intertrochanteric artery

90
Q

which muscle inserts in lateral 3rd of clavicle

A

trapexius muscle displaces posteriorly

91
Q

what inserts in the lateral clavicle

A

deltoid

92
Q

a person comes with muscle injury if i give him succinyl choline what will happen

A

cardiac arrythmia

93
Q

which muscle relaxant has organ independant elimination

A

atarocium

94
Q

which gender does inclusion body myositis

A

50 male ,assymetic of distal muscle polymositis is generally female

95
Q

myasthenia gravis

A

fluctuating muscle weakness with ocular involvement worsens end of the day

96
Q

what is seen in polymyalgia rheumatica

A

Inflammation of synovial structures (e.g., of the subacromial or subdeltoid bursas, of the glenohumeral joint) on ultrasound may be seen in polymyalgia rheumatica (PMR)

97
Q

which physical exam finding is common in OSA

A

facial plethora

98
Q

a patient develops facial redness on exposure to sunlight what could it be

A

delayed hypersensitivity reactions

99
Q

what is the pathophys of malasezia causing hypo and hyperpigmentation

A

Malassezia spp. infect the stratum corneum → lipid degradation → production of acids that inhibit tyrosinase and damage melanocytes → hypopigmentation
the inflammation causes hyperpigmentation,
it is a well demarcated lesion

100
Q

a person takes demeclocycline to treat his malignancy he later develops rash why

A

photosensitivity

101
Q

if a patient ahs idiopathic rash due to hiv typically greasy could be associated with

A

sebarrhoreic keratosis

102
Q

sle drug induced vs classical rash

A

drug induced is erythematous and scaly vs cassical spares nasolabial fold

103
Q

what sort symtom is seen in plegarra

A

burning

104
Q

ehat is helitroprash

A

An erythematous to violaceous rash on the upper eyelids, sometimes accompanied by edema. Classically associated with dermatomyositis

105
Q

specify rash in dermatomyositis

A

associated with nasolabial

106
Q

radiological finding of gout vs chondrocalcinosis

A

chondrocalcinois doesnt have punctate radiological findings

107
Q

where does calcification occur in pseudogout

A

Fibrocartilage (meniscus, annulus fibrosus of intervertebral disk)

108
Q

supracondylar fracture various displavcements

A

anterior=brachial artery
anteriolateral=radial nerve
medial =median nerve

109
Q

if you have a flexion type of supracondylar fracture

A

then you have ulnar nerve injury

110
Q

obtruator artery destroyed in which fracture

A

acetabulum fracture

111
Q

what is the branch of femoral profundus artery

A

middle femoral circumflex artery

112
Q

what is the most coommon fetal cause of spontaneus abortions

A

chromosomal abnormalities

113
Q

which muscle inserts in lateral 3rd of clavicle

A

trapexius muscle displaces posteriorly

114
Q

what inserts in the lateral clavicle

A

deltoid

115
Q

a person comes with muscle injury if i give him succinyl choline what will happen

A

cardiac arrythmia

116
Q

which muscle relaxant has organ independant elimination

A

atarocium

117
Q

which gender does inclusion body myositis

A

50 male ,assymetic of distal muscle polymositis is generally female

118
Q

myasthenia gravis

A

fluctuating muscle weakness with ocular involvement worsens end of the day

119
Q

what is seen in polymyalgia rheumatica

A

Inflammation of synovial structures (e.g., of the subacromial or subdeltoid bursas, of the glenohumeral joint) on ultrasound may be seen in polymyalgia rheumatica (PMR)

120
Q

which physical exam finding is common in OSA

A

facial plethora

121
Q

a patient develops facial redness on exposure to sunlight what could it be

A

delayed hypersensitivity reactions

122
Q

what is the pathophys of malasezia causing hypo and hyperpigmentation

A

Malassezia spp. infect the stratum corneum → lipid degradation → production of acids that inhibit tyrosinase and damage melanocytes → hypopigmentation
the inflammation causes hyperpigmentation,
it is a well demarcated lesion

123
Q

a person takes demeclocycline to treat his malignancy he later develops rash why

A

photosensitivity

124
Q

if a patient ahs idiopathic rash due to hiv typically greasy could be associated with

A

sebarrhoreic keratosis

125
Q

sle drug induced vs classical rash

A

drug induced is erythematous and scaly vs cassical spares nasolabial fold

126
Q

what sort symtom is seen in plegarra

A

burning

127
Q

ehat is helitroprash

A

An erythematous to violaceous rash on the upper eyelids, sometimes accompanied by edema. Classically associated with dermatomyositis

128
Q

specify rash in dermatomyositis

A

associated with nasolabial

129
Q

how do antiphospholipid antibodies work

A

These antibodies inactivate anticoagulant proteins (e.g., protein C and protein S, antithrombin III) and activate platelets and vascular endothelium,

130
Q

necrotising autoimmune myopathy

A

necrotic muscle fibers infiltrated by noninflammatory macrophages beside normal muscle fibers without immune cell infiltration. Occurs in association with other rheumatic diseases (e.g., scleroderma or mixed connective tissue disease) or statin use, but does not improve with discontinuation of statins.

131
Q

atrophic muscle fibres interspaced with hypertrophy

A

Atrophic muscle fibers interspersed among hypertrophic muscle fibers would be found in spinal muscular atrophy. While spinal muscular atrophy can manifest with progressive muscle weakne

132
Q

which two diseases has gowers sign

A

SMA/becker, differentiation is spinal muscular atrophy has fasiculations, whereas and bulbar symotoms

133
Q

which virus causes gullian barre syndrome, intial symtoms

A

zika virus back and limb pain

134
Q

what is the most coommon fetal cause of spontaneus abortions

A

chromosomal abnormalities

135
Q

decreased grip strenth with fall on outstretched hand

A

Decreased grip strength with pain in the anatomical snuffbox suggests a scaphoid fracture, which is typically caused by falling onto an outstretched hand.

136
Q

colles fx vs scaphoid

A

colles dorsiflexed wrist abnormal wrist and radial angulation

137
Q

pathophys of dupteryn contracture

A 
Dupuytren contracture (palmar fibromatosis) is a fibroproliferative disorder of the palmar fascia  [9]
Injury (trauma/ischemia) to the palmar fascia triggers myofibroblasts → fibroblast proliferation and collagen (type III) deposition  → thickening of the palmar fascia → formation of nodules in the palmar fascia
The nodules are adherent to the overlying dermis → characteristic puckering of palmar skin [4]
Nodules progress to form cords in the palmar fascia → flexion contractures  of the palmar fas
138
Q

osteochondritis disseca s presents with

A

diffusie joint pain withactivity
focal, aseptic necrosis of subchondral bone (most often the knee, elbow, or ankle) caused by mechanical stress and/or repetitive trauma. Results in the detachment of bone-cartilage fragments that become displaced within in the joint space and causes pain and progressive joint stiffness.§

139
Q

radiograph xray of gout

A

Punched-out lytic bone lesions with spiky periosteal appositions can be detected in individuals with gout

140
Q

trichenaliis

A

ransmitted via ingestion of encysted larvae in undercooked meat (especially pork). Infection can be subclinical or manifest with abdominal pain, nausea, vomiting, and diarrhea. In severe infections, larvae disseminate into the skeletal muscle and cause fever, pain, weakness, periorbital edema, and eosinoph

141
Q

do skelektal myocytes have gap junctions

A

no bectherefore each cell must be stimulated via its endmotor plate

142
Q

what is spigelian hernia

A

A rare type of hernia that arises in the ventral abdominal wall along the semilunar line, typically below the level of the umbilicus. Has a high risk of complications (e.g., incarceration, strangulation).

143
Q

spinal accesory nerve

A

The spinal accessory nerve exits the skull through the jugular foramen and sends a branch to the sternocleidomastoid muscle 3 cm below the mastoid process before entering the posterior triangle of the neck to innervate the trapezius muscle. Spinal accessory nerve injury resulting in trapezius (and sternocleidomastoid) paralysis would be expected if there were an injury to the upper aspect of the posterior triangle of the neck.

144
Q

where does azygous vein drain

A

svc at t4

145
Q

what vessl extends to left supraclavicular space

A

thoracic duct

146
Q

chondrocalcinosis affects which compartment and Oa affects which compartment

A

patellofemoral joint and the lateral knee compartment,

oa is medial kneww compartment

147
Q

marginal erosion perarticular tissue opacificaiton=

A

gout

148
Q

describe soap bubble appearence

A

loculated epiphyseal cyst

149
Q

celidocranial dysplasia

A

n autosomal dominant condition characterized by delayed closure of the cranial sutures, craniofacial dysmorphism (e.g., frontal bossing, prominent chin, maxillary hypoplasia), dental abnormalities, and hypoplastic clavicles.

usmle (38 decks)

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