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[2a] A ⼀ Step 2 OD USLME > Biochem/Rx/Optho > Flashcards

Biochem/Rx/Optho Flashcards

1
Q

What is Von Gierkes’ Disease

A

[Type 1 Glycogen Storage - Glucose6Phosphatase deficiency] in Liver/Kidney/Intestine

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2
Q

Von Gierkes’ Disease CP - 4

A
  1. Seizures 2/2 hypOglycemia
  2. Lactic Acidosis
  3. Doll-Like Fat cheeks
  4. Protuberant Abd (Hepatomegaly)
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3
Q

[McArdle Glycogen Storage Dz 5] etx

A

Myophosphorylase Deficiency–> DEC Muscle Glycogenolysis

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4
Q

[McArdle GSD5 Muscle Phosphorylase deficiency] CP

A

Myoglobinuria with Exercise

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5
Q

[Cori GSD3 Debranching deficiency] CP (3)

________________

GSD = Glycogen Storage Disease

A
  1. SHORT STATURE
  2. hypOglycemia
  3. Muscle weakness & hypOtonia
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6
Q

[Cori GSD3 Debranching deficiency] etx

A

Debranching enzyme deficiency –> accumulation of glycogen with abnormal short outer chains (inability to degrade at alpha1-6 branch points)

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7
Q

What is Pompe Disease

________________

CP-2

A

[Type 2 Glycogen Storage - Acid Maltase deficiency] –>

________________

Floppy baby & HF

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8
Q

What is AmyLoPectinosis?

________________

CP?

A

[Type 4 GSD Glycogen Branching deficiency]

________________

Progressive Cirrhosis

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9
Q

How do pts with Liver phosphorylase deficiency present - 2

A

Hepatomegaly and growth retardation early in childhood

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10
Q

Slit Lamp Exam indication

A

Evalutes for abnormalities of ANT eye (conjunctiva, cornea, ANT chamber, iris)

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11
Q

[Niemann Pick] MOD

A

Sphingomyelinase Deficiency –> accumulation of Sphingomyelin

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12
Q

[Niemann Pick] Clinical Presentation (3)

A
  1. Cherry Red Macular Spot
  2. Neuro Regression
  3. Hepatosplenomegaly (differentiates from Tay-Sachs)
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13
Q

Tay-Sachs Clinical Presentation (2)

A
  1. Cherry Red Macular Spot
  2. Neuro Regression
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14
Q

Tay-Sachs MOD

A

[B-Hexosaminidase A Deficiency] –> GM2 accumulation in neurons

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15
Q

Hurler Syndrome etx

A

lysosomal Hydrolase deficiency

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16
Q

Hurler Syndrome CP-5

A
  1. Coarse face
  2. Corneal Clouding
  3. Claw Hand
  4. HepatoSplenomegaly
  5. Hernias (umbilical vs inguinal)

________________

lysosomal Hydrolase deficiency

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17
Q

Gaucher Dz etx

A

auto recessive Glucocerebrosidase deficiency –> accumulates in macrophages –> crumbled newspaper appearance

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18
Q

Gaucher Dz CP-3

A
  1. anemia
  2. thrombocytopenia
  3. Hepatosplenomegaly

________________

auto recessive Glucocerebrosidase deficiency –> accumulates in macrophages –> crumbled newspaper appearance

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19
Q

Krabbe Disease etx

________________

CP-3

A

[auto recessive GalactoCerebrosidase deficiency]

________________

  1. Retard
  2. hypOreflexia
  3. hypOtonia
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20
Q

CP for Retinal Detachment - 3

A
  1. Floaters
  2. Visual Curtain descending from periphery
  3. Photopsia Flashes of Light
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21
Q

Identify

A

Central Retinal VEIN Thrombosis

  • Blood & Thunder appearance 2/2 scattered hemorrhage
  • Cotton Wool Spots
  • Disk Swelling
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22
Q

diagnosis?

________________

What’s the most common cause?

A

Vitreous Hemorrhage

________________

DM

Fundoscopy = Dark Red Glow with Loss of Fundus details

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23
Q

Causes of Corneal Abrasion - 3

________________

How do you diagnose Corneal Abrasion?

A
  1. Trauma
  2. Foreign Body under eyelid
  3. Contact lens –> Corneal epithelial defect

________________

Fluorescein exam revealing corneal staining defect

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24
Q

Pralidoxime MOA

________________

Indication

A

ReActivates AChenesterase

________________

Organophosphate poisoning (along with giving Atropine)

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25
Q

How do Benzodiazepines affect Blood Pressure

A

⬇︎ BP

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26
Q

Glaucoma etx

A

⬆︎ intraocular pressure from [⬆︎ production vs. ⬇︎ outflow of Aqueous humor]

Topical Prostaglandins = latanoprost (open angle glaucoma)

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27
Q

Tx approaches for Glaucoma (3)

________________

how specifically does B-blockers work?

A

B-Blockers –> ⬇︎ Ciliary Epithelium Aqueous humor secretion!

Topical Prostaglandins = latanoprost (open angle glaucoma)

28
Q

What target organ does the M3 Receptor work in (6)

A

“[M1s need Brain], [M2s need Heart], [M3s BEGs for Private Lounges”

“An M3 BEGS for Private Lounges”

Bladder(contraction) / Eyes / GI / Skin / [Peripheral Vasculature] / Lungs

29
Q
A

Glaucoma

30
Q

What are the causes of [Acute Closed Angle Glaucoma]? -3

A

Anticholinergics / Sympathomimetics / Dim light

31
Q

What are the 2 options for reversing Warfarin

A
  1. [VitK IV + PCC]
  2. FFP (Fresh Frozen Plasma)

  • ________________*
  • Give [VitK IV + PCC] since [VitK IV] has 12-24 hr onset*
  • PCC = Prothrombin Complex Concentrate*
32
Q

Tranexamic Acid MOA

________________

Indication-2

A

Prevents Fibrin Lysis

________________

Menorrhagia and [Hemorrhage px]

33
Q

What is the major complaint pts with Glaucoma have?

A

Gradual Tunnel Vision

34
Q

Gabapentin MOA

A

a2-delta Ca+ channel ligand

Structurally similar to GABA

35
Q

Acetazolamide contraindications - 2

A
  1. Pregnancy
  2. Sulfa Allergy

SE = NV

36
Q

Clinical Manifestation of DRESS Syndrome (6)

A

Dysfunctional Internal organs

Really Hot (Fever)

Eosinophilia w/LAD

Skin Rash

Swollen Face

37
Q

Vomiting is a reflex regulated by which receptors? (5)

A

5 Days of Having Nauseating Moomoo :-(

  1. 5HT3 (ondansetron tx) ****
  2. D2
  3. H1 Histamine
  4. [NK1 Neurokinin 1] ***
  5. M1 muscarinic
38
Q

low tone hearing loss = ⬜ hearing loss

A

conductive

39
Q

High Tone hearing loss = ⬜ hearing loss

A

Sensorineural

40
Q

Which is more efficient at transmitting sound between Bone and Air?

________________

Why?

A

AIR!

________________

Air interacts with ossicles FIRST, which Amplifies the sound conduction to cochlea

41
Q

Major SE of Atorvastatin - 3

A
  1. Myalgia
  2. Rhabdomyolysis–>myoglobinuria–>Acute Kidney Injury
  3. Liver Dysfunction
42
Q

Major SE of Metoprolol - 3

A
  1. Bradycardia
  2. hypotension
  3. heart block
43
Q

Major SE of HCTZ - 5

A
  1. Dehydration
  2. hyponatremia
  3. hypokalemia
  4. renal dysfunction
  5. gout attack 2/2 ⬆︎serum uric acid
44
Q

Major SE of [Lisinopril ACE inhibitors] - 4

A
  1. Angioedema
  2. Cough
  3. HyperKalemia
  4. Renal dysfunction
45
Q

Which Anti-HTN drugs can cause infertility secondary to hyperprolactinemia? - 3

A
  1. Verapamil
  2. Methyldopa
  3. Reserpine
46
Q

From MOST effective to least effective, list non-Rx options for controlling BP -5

A

We Don’t Exercise At All!

Weight control = BEST

DASH diet

Exercise

sAlt

Alcohol

47
Q

Macular degeneration affects [⬜ central | peripheral] vision, while Glaucoma affects [⬜ central | peripheral] vision

A

MaCular –> CENTRAL vision loss

with straight lines appearing curvy (wet/exudative-neovascular= aggressive and uL while dry/atrophic=gradual and BL)

________________

Glaucoma –> peripheral vision loss (gradual tunnel vision)

48
Q

Ophthalmoscopy findings include cupping of the optic disc

Diagnosis?

A

Glaucoma

________________

Glaucoma affects peripheral vision –> tunnel vision! OAG is more common in Blacks

49
Q

etx of Cataracts

________________

What are the most common presenting sx of Cataracts? -2

A

[⬆︎ lens opacity] –>

  1. [gradual BL NIGHT VISION ⬇︎]
  2. halos around lights

________________

Fundoscopy eventually shows lost of red reflex and retinal details

50
Q

How can you differentiate conjunctivitis from Adenovirus and conjunctivitis from IgE mediated allergy response? - 2

A
  1. Adenovirus does NOT cause pruritus. Allergies does
  2. Adenovirus is preceded by viral prodrome
51
Q

Dacryocystitis etx

________________

which organisms cause this?-2

A

infection of lacrimal sac in medial canthal region

________________

  1. Staph A
  2. GASP
52
Q

What is the treatment for Emergent [Acute Closed angle Glaucoma] - 4

A

“PMAT his glouck’d eye!”

Pilocarpine

Mannitol

Acetazolamide

Timolol

53
Q
A

Retinoblastoma leukocoria

54
Q

cp for Acute Closed angle Glaucoma - 3

A
  1. Red Painful eye uL
  2. Fixed Dilated pupil
  3. Cloudy Cornea
55
Q

Prognosis for [Acute Closed angle Glaucoma]

A

Permanent Vision Loss within 2-5 hrs of onset!

56
Q

Dx for [Acute Closed angle Glaucoma] -2

A

Gonioscopy vs Ocular Tonometry

57
Q

cp for Uveitis - 3

A
  1. Blurred painful vision
  2. conjunctival injection
  3. miosis
58
Q

Identify finding

A

Dendriform Corneal Ulcer

________________

dx = Zoster Ophthalmicus

59
Q
A

Zoster Ophthalmicus

________________

finding = Dendriform Corneal Ulcer

60
Q

Tx for Central Retinal Artery occlusion - 2

Painless loss of monocular vision

A
  1. HiFlo O2
  2. Ocular massage
61
Q

What type of immunity do polysaccharide vaccines (like the pneumococcal vaccine) produce?

A

B cell response that is independent of T cells

62
Q

MOD for Trachoma

_________________

cp for Trachoma-2

A

Repeated infections with Chlamydia Trachomatis A,B,C –> Inversion of Eyelashes = Trachoma (PALE FOLLICLES with Conjunctival injection) –> Blindness from lash ulceration

63
Q

Subconjunctival Hemorrhage is self limited to how long?

A

2 days

64
Q

How does this abnormality clinically present? - 2

A

[Sudden uL Vision Loss] + Floaters

________________

  • dx = Vitreous Hemorrhage*
  • Fundoscopy = Dark Red Glow with Loss of Fundus details*
65
Q

When can you hospitalize a mentally competent pt against their will?

A

when their ailment poses a serious threat to public health

66
Q

When can you mandate parents against their will to accept treatment for a [non emergent ailment] for their child?

A

when the [non-emergent ailment] is a fatal medical condition (i.e. Cancer), M.D. can obtain a court order to give tx

________________

PARENTS ARE NOT ALLOWED TO REFUSE LIFE SAVING TREATMENT FOR THEIR CHILD (EVEN IF BASIS IS RELIGIOUS)

67
Q

Describe ophthalmoscopy findings for Diabetic Retinopathy-3

A
  1. microaneurysms = simple type
  2. retinal edema = simple type
  3. newly formed vessels if malignant type

[2a] A ⼀ Step 2 OD USLME (21 decks)

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