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USMLE Step 1 Quick Notes > Do Not Confuse > Flashcards

Do Not Confuse Flashcards

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USMLE® Step 1 flashcards
1
Q

Mitral Regurg with CNS disease

A

Tuberous Scerlosis

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2
Q

Angiofibromas

A

Tuberous Sclerosis

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3
Q

Ash leaf spots

A

Tuberous Sclerosis

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4
Q

Cardiac rhabdomyoma

A

Tuberous Sclerosis

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5
Q

Renal angiomyolipoma

A

Tuberous Sclerosis

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6
Q

Shagreen patches

A

Tuberous Sclerosis

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7
Q

Subependymal astrocytoma

A

Tuberous Sclerosis

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8
Q

Cafe au lait

A

NF1

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9
Q

Lisch nodules

A

NF2

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10
Q

Pheochromocytoma

A

MEN, NF1, VHL

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11
Q

Cavernous hemangiomas

A

VHL

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12
Q

Renal cell carcinoma

A

VHL

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13
Q

Hemangioblastoma

A

VHL

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14
Q

Retinal angiomas

A

VHL

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15
Q

What substances are neither secreted nor reabsorbed in the kidney?

A

Inulin and Creatinine

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16
Q

Doe Hep b cause chronic infection?

A

In adult it is less likely but VERY high chance in neonates that get it from a mom with HbeAg! Neonates will not show very elevated LFTs

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17
Q

What is bethanechol?

A

Cholinergic agent that activates bowel and bladder.

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18
Q

What is bethamethasone?

A

Prenatal to improve surfactant production

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19
Q

What is beclamethasone?

A

Chronic asthma

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20
Q

What presents with myoclonus, nonrhythmic conjugate eye movement, and abdominal mass in a kid?

A

Neuroblastoma

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21
Q

How does CFTR work in the lungs and sweat in cystic fibrosis?

A

Lungs: doesn’t secrete Cl and doesn’t inhibit Enac so Na is reabsorbed

Sweat: causes Na and Cl secretion

Pancreas is same as lung

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22
Q

What is nucleus accumbens vs ambiguus?

A

Accumbens: where GABA is made

Amibguus: where the nuclei for 9,10,11 are

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23
Q

What does histology for type 1 DM look like?

A

Islet leukocyte infiltration

Destruction in T1DM primarily through cell mediated immunity

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24
Q

What does histology for type 2 DM look like?

A

Islet amyloid deposition

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25
Q

What has microabscesses at tips of papillae?

A

Dermatitis herpetiformis

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26
Q

What is the mutation in the inherited form of pulm. HTN?

A

Inactivating mutation in BMPR2 (normally inhibits vascular smooth muscle proliferation)

Two hit hypothesis (first insult is mutation, second is infection, drugs etc)

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27
Q

What cells have high telomerase activity?

A

Cancer cells and stem cells (like in the epidermis and BM)

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28
Q

How does maternal diabetes affect the baby?

A

Too much glucose from mom crosses to the baby and it causes fetal beta cell hyperplasia. The glucose gets absorbed and deposited (responsible for macrosomia and big baby). After detachment from mother, the hyperinsulinemia in baby continues transiently causing baby to be hypoglycemic

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29
Q

What causes tissue damage and resultant abscess formation?

A

Lysosomal enzyme release from neutrophils and macrophages

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30
Q

What is galacatosyl beta 1,4 glucose?

A

Lactose!

Broken down into galactose and glucose

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31
Q

What causes eggshell calcifications of hilar nodes and birefringent particles surrounded by fibrous tissue?

A

Silicosis

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32
Q

What causes calcified pleural plaques and ferruginous bodies?

A

Asbestosis

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33
Q

What disease does the pathogenesis of nonbacterial thrombotic endocarditis (NBTE) resemble?

A

Trousseau

NBTE often involves hypercoagule state. When hypercoagulable state from procoagulant effects of circulating cancer products then vegetations on valve may be called marantic. Migratory thrombophlebitis (trosseau) is also from release of procoagulants of cancer.

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34
Q

Why do you see urinary incontinence with normal pressure hydrocephalus?

A

Because the enlarged ventricles mess up the corona radiata (cortical afferent/efferent fibers) so the cortex cannot inhibit the sacral micturition reflex (s2-s4 stimualte bladder wall)

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35
Q

How long does it take to lose myocardial contractility after ischemia?

A

60 seconds! After 30 minutes it is irreversible.

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36
Q

What is likely the cause of SCD if soon after an MI or CAD event?

A

VENTRICULAR FIBRILLATION!

Thromboemboli and mural thrombosis are not till later!

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37
Q

What is acute acalculous cholecystitis?

A

Acute inflammation of GB in absence of gallstones. MC in hospitalized and severely ill

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38
Q

What causes fibrotic and shrunken GB?

A

Chronic cholecystitis

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39
Q

Hippocampal atrophy on MRI is highly suggestive of what disease?

A

Alzheimers!

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40
Q

What GF stimulate angiogenesis?

A

VEGF and FGF

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41
Q

What does EGF do?

A

Promote mitosis in epithelial, hepatocytes, and fibroblast cells

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42
Q

Amino acid charges based on pH and pKa?

A

pH > pKa: protons dissociate

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43
Q

How do you treat neuroleptic malignant syndrome?

A

Dantrolene or Bromocriptine

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44
Q

How do you treat antipsychotic related EPS symptoms?

A

Benztropine or diphenhydramine

45
Q

What happens to TLC and RV in obstructive lung disease?

A

RV/TLC increases!

46
Q

Where do you see inflammatory inflammation in Guillan Barre?

A

Endoneural!!

Endomysial was polymyositis and is muslce!

47
Q

What will be normal after pancreaticectomy?

A

D-xylose absorption

used to test for malabsorption vs pancreatic dysfunction

48
Q

If someone presents with vit A deficiency what is a possible cause?

A

Biliary obstruction! (fat soluble malabsorption)

49
Q

What is aspirated in aspiration pneumonia?

A

Oropharyngeal contents

Anaerobic bacteria in oral cavity or S. aureus causes the lung abscess

50
Q

What happens if maxillary prominences fail to properly fuse with intermaxillary segment?

A

Cleft lip

51
Q

What happens if palatine shelves of maxillary prominence don’t fuse with one another?

A

Cleft palate

52
Q

What cells line the walls of a cyst in the brain after months/years after ischemic event?

A

Astrocytes! They are what make up the glial scar

53
Q

What do you use for diagnosing toxic megacolon from UC?

A

X-ray

54
Q

Is PBC of PSC a complication of UC?

A

PSC

55
Q

What is heliotrope?

A

Erythematous periorbital rash

Aw/ dermatomyositis

56
Q

What has precipitated hemoglobin?

A

Heinz

57
Q

What has precipitated nuclear fragments?

A

Howell Jolly

58
Q

What presents with non rhythmic conjugate eye movements, myoclonus, hypotonia?

A

Neuroblastoma

59
Q

What is a cell with bilobed nucleus and a lot o granules?

A

Eosinophil

Neutro have multilobed nuclei but no granules

60
Q

What can induce mania in susceptible patients (like those with unrecognized bipolar)?

A

Antidepressants

61
Q

What has cavernous blood filled vascular spaces lined by single epithelial layer?

A

Cavernous hemangioma

MC benign liver tumor

62
Q

What is the cosyntropin stimulation test used for?

A

Adrenocortical insufficiency

63
Q

What is the high dose dexamethasone suppression test used for?

A

To determine if it is a pituitary adenoma (will suppress) or ectopic ACTH (like small cell)

Can also do a CRH stimulation test (inc ACTH if pituitary adenoma but no inc if ectopic)

64
Q

What is low dose dexamethasone suppression test for?

A

To determine if its a adrenal tumor (dec ACTH) or a pituitary adenoma/ectopic ACTH (inc ACTH)

65
Q

What does PBC resemble?

A

GVHD because they both have granulomatous bile duct destruction and lymphocyte infiltrate

66
Q

What has florid duct lesions?

A

PBC

67
Q

What causes autosplenectomy in sickle cell patients?

A

Vaso occlusive crises causes repetitive infarcts of the spleen leading to it become shrunken and fibrotic over time.

68
Q

Diagnosis: bleeding from venupuncture sites, immature myeloid cells with giant cytoplasmic granules, and bruising?

A

APL

Granules = auer rods
Infection and coagulopathy causing hemorrhagic signs (remember they get DIC)

69
Q

What do you think if multiple cysts in liver with only mildly elevated liver enzymes?

A

Metastaes to liver (won’t really mess up enzymes until later, tends to multiple, and MC than hepatocellular carcinoma)

70
Q

What happens to aldosterone levels with ARB?

A

They DECREASE!

ARB inhibits Angiotensin II receptors so ang II can’t stimulate aldosterone release from the adrenal glands

71
Q

Which way does PCL go?

A

When looking at the knee from the front, it is from bottom left to top right

Attaches to anterior part of lateral surface of medial epicondyle of femur

72
Q

What do you use for arsenic posioning?

A

Pencillamine or dimercaprol

73
Q

What do you use EDTA for?

A

Lead poisoning

74
Q

What happens in Sheehan syndrome?

A

Pituitary enlarges due to inc estrogen in pregnancy. If significant ischemia (ie if as during postpartum hemorrhage), pituitary can undergo ischemic necrosis –> deficiency of pituitary hormones

75
Q

What is the hemodynamic response to volume overload by aortic regurg to maintain CO?

A

Increase LVEDV (ie preload). Also do eccentric left ventricular hypertrophy (causing dilation and “in series” sarcomeres)

Remember concentric is hypertrophic

76
Q

What does the vascular reaction to intimal injury?

A

Smooth muscle cells (they cause intimal hyperplasia, fibrosis, ECM deposition) lading to fibrou atheroma formation

77
Q

What type of fluid loss do you get with hemorrhaging?

A

Isotonic ECF loss (no effect on ICF)

78
Q

What type of fluid loss do you get with adrenal insufficiency?

A

Hypoosmotic volume contraction

Loss of NaCl in the urine so serum is hypoosmotic but euvolemic. Since hypoosmotic, ECF fluid moves into ICF>

79
Q

What type of fluid loss do you get with diabetes inspidius?

A

Hyperosmotic volume contraction

80
Q

Why do you see the on off phenomena with levodopa?

A

Due to progressive nigrostriatal neurodegeneration leading to decreased therapeutic window for levodopa. Leads to unpredictable drug response

81
Q

What intensifies the S4 sound?

A

Expiration because blood flows from lungs to left atrium

82
Q

What is the MCC of aortic dissection?

A

HTN!!

or cystic medial degeneration

83
Q

What causes thoracic aorta aneurysms?

A

Cystic medial degeneration from HTN (older) or marfan (younger) and obliteration of vaso vasorum

84
Q

What tests attention and concentration on MMSE?

A

Counting down from 100, reciting months in reverse order, and spelling words backword

85
Q

What tests comprehension on MMSE?

A

Following multistep commands

86
Q

What is myc?

A

A transcription factor

87
Q

What are the anaerobes?

A

Clostridium, Actinomyces, and Bacteroides

88
Q

What is released because of rhabdomyolysis?

A

Myoglobin! It can damage kidneys

Increased exertion usually cause myoglobin release
CK when there is muscle damage

89
Q

Why do people with interstitial lung fibrosis have greater than normal expiratory flow volumes?

A

Increased radial traction

They have increased elastic recoil which causes increased radial traction (outward pulling) due to fibrotic lung tissue pulling

90
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer wright rosettes

91
Q

What is yellowish CSF?

A

Xanthochromia seen with subarachnoid hemorrhage

92
Q

What is the MCC of death in duchenne?

A

Dilated CM

93
Q

What do you treat hyperammonemia with?

A

Lactulose, benzoate, phenylbutyrate

94
Q

Why does leprosy only infect skin and superficial nerves?

A

Because it likes cool temperatures

95
Q

Which one has flagella? Salmonella or Shigella?

A

Salmonella

96
Q

Which one has an animal reservoir? Salmonella or Shigella?

A

Salmonella

97
Q

Which one does not have hematogenous spread: salmonella or shigella?

A

Shigella

98
Q

What is Jarisch Herxheimer reaction?

A

Flu like syndrome after antibiotics started due to bacteria releasing pyrogens

99
Q

What causes VDRL false positives?

A

Viruses
Drugs
Rheumatic fever
Lupus and leprosy

100
Q

What do the ABC serotypes for chlamydia do?

A

Blindness from follicular conjunctivitis in Africa

ABC = Africa, blindness, chronic infection

101
Q

How do you treat mycoplasma?

A

Macrolide, doxycycline, fluoroquinolone

102
Q

What does T. brucei present with?

A

Lymphadenopathy, recurring fever (ferom antigenic variation), somnolence, coma

103
Q

What does babesia present with?

A

fever and hemolytic anemia in NE US

Same tick as lyme (ixodes)

104
Q

What are the flavivirus?

A

HCV, yellow fever, dengue, west nile

105
Q

What is test for the diagnosis for HIV?

A

ELISA: sensitive

Western blot: specific

106
Q

What is the toxicity for carbapenem?

A

CNS toxicity at high doses, skin rash, GI distress

107
Q

What is the antibiotic with NMJ blockade as a toxicity?

A

Aminoglycoside

108
Q

What are aminoglycosides for?

A

Gram negative rods

USMLE Step 1 Quick Notes (17 decks)

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