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USMLE > export_uworld qbank > Flashcards

export_uworld qbank Flashcards

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USMLE® Step 1 flashcards
1
Q

VIP GAL Valine Isoleucine Proline Glycine Alanine Leucine

A

Non-Polar Aliphathic Hydrophobic Amino Acids

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2
Q

Try Trippin with Pheynyoin Tyrosine Tryptophan Phenilalanine

A

Aromatic Hydrophobic Amino Acids

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3
Q

halothane (inhaled anesthetic) hepatotoxicity

A
  • fulminant hepatitis - rapid atrophy and centrolobular hepatcyte necrosis - inflammation of the portal tracts and parenchyma - S/S: fever, anorexia, nausea, myalgias, arthralgias, rash, tender hepatomegaly, jaundice - labs: increased ALT, AST, PT. Leukocytosis and eosinophila. normal albumin (makrer of chronic liver failure) - very high mortality rate
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4
Q

Type 3 Hypersensitivity

A

Neutrophils and complement activation. * Fibrinoid Necrosis * Neutrophil Infiltration * Hypocomplementemia

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5
Q

Leuprolide Use in “leu” of GnRH

A

* Use: fertility (pulsatile release) and cancer chemotherapy (continuous) * pulsatile release stimulates sustained release of FSH and LH and results in ovulation * continuous desensitizes GnRH receptors on anterior pituitary leading to suppression of FSH and LH release “medical castration”

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6
Q

beta-glucuronidase

A

* This enzyme contributes to the hydrolysis of bilirubin glucuronides and increases the amount of unconjugated bilirubin in bile * infx in biliary tract –> release of by injured hepatocytes and bacteria * **seen in pigment bile stones (mostly asia/africa)

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7
Q

Phentolamine

A

nonselective alpha antagonist Blocks vasoconstriction at alpha 1 and feedback inhibition of NE release at alpha 2 which causes increased HR and contractility (Beta 1 not blocked) prevention/control of HTN pheocromocytoma (adrenal tumor)

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8
Q

Zidovudine Zombie Dove

A

Deoxythymidine analogue Used in HAART for HIV treatment Nucleoside reverse transcriptase inhibitor Neutropenia

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9
Q

cromolyn

A

prevent release of mediators from mast cell. Prophylaxis against asthma. Not affective during acute attacks.

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10
Q

adenocarcinoma

A

most common form of lung cancer in women and in people under 45 Form glandular configurations Peripheral portion of lung with a scar like area. Common among non smokers

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11
Q

Subacute granulomatous thyroiditis

A

* 3-5x in female, 30-50y/o * Seasonal incidence, peaking in summer, most common cause of thyroid pain * Pathogen: viral infection or post inflamm response: ( Coxsackie, mumps, measles, adeno, others ) * Viral induced tissue damage, release of ‘antigen’, tim of cytotoxic T cells limited

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12
Q

Dobutamine Dough Buddha

A

* Mech: Predominant Beta1 agonist. CV effect: Increases Contractility(pure inotrope)–> increase CO, decrease SVR and increase HR moderately, * Indication: Heart failure, MI. * Pharm: t1/2 = 2 min. * Chronic continuous infusion can lead to desensitization; inhibited by beta-blockers

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13
Q

Zollinger-Ellison syndrome

A

A gastrinoma (often in pancreas and associated with MEN 1, a tumor of pancreas, pituitary, and parathyroid, 3 P’s) causes gastrin hypersecretion which increases gastric HCl, which leads to severe peptic ulceration. * Uncommon, but a possible cause of PUD, GERD, and fatty diarrhea(bc not alkalinized enough to activate pancreatic enzymess

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14
Q

Erythrocyte Sedimentation Rate.

A

*This lab value* should be determined if temporal arteritis is suspected. It will be increased.

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15
Q

HOT T-bone stEAk

A

IL1 - fever and osteoclast activating factorIL2 - T cells IL3 - like GM-CSF IL4 - class switching to IgE and IgG IL5 - IgA and eosinophils IL-6 - acute phase reactants

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16
Q

Clomipramine

A

TCA that treats OCD

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17
Q

flurazepam

A

long-acting BZD

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18
Q

TOM Triazolam Oxazepam Alprazolam

A

Short acting benzodiazepines

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19
Q

NF-κB

A

Transcription factor * induces production of TNF-α and other inflammatory cytokines Inhibited by corticosteroids

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20
Q

Nevirapine

A

Non-Nucleoside Inhibitor of Reverse Transcriptase Skin Rash Lactic Acidosis

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21
Q

Ritonavir

A

Anti-HIV (protease inhibitor)

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22
Q

ramipril

A

* class: ACE inhibitor * use: hypertension, CHF, MI * MOA: blocks conversion of angiotensin I to angiotensin II (a vasoconstrictor) and suppresses aldosterone, limiting sodium re-uptake in the kidney * ADE: hypotension, HA, cough, bradykinin accumulation, dizziness, vision changes

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23
Q

Hashimoto’s thyroiditis

A

* Gross: pale, firm, rubbery, tan or white. * Micro: lymphocyte and plasma cell infiltration w/ germinal centers and fibrosis. variable amount of parenchymal atrophy: small follicles, w/ scant colloid and pink, plump, granular oxyphil epithelial cells (aka Askanazy or Hurthle cells), and desquamated epi cells in follicular lumens. Slightly increased risk of thyroid lymphoma and papillary thyroid carcinoma.

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24
Q

Granulosa Cells

A

Androgens released from theca interna cells migrate to *these cells* which contain aromatase to convert androgens to estradiol

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25
Q

pseudomonas aeurginosa

A

* opportunistic G- rod * strict aerobe * non-fermenter * oxidase + * pigment producing * Hot Tub folliculitis

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26
Q

Agranulocytosis

A

Major side effect of thionamides such as propylthiouracil and methimazole

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27
Q

Lidocaine

A

Class IB- Na blocker Use: Ventricular fibrillation; IV Short-acting, emergency act mostly on inactivated ischemic tissues

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28
Q

Medial femoral circumflex artery

A

Vessel that is vulnerable to damage from femoral head fractures

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29
Q

Dofetilide

A

Class III antiarrhythmic Potassium channel blocker Used for Atrial Flutter

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30
Q

Gemfibrozil

A

Best treatment for acute pancreatitis due to severe hypertriglyceridemia

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31
Q

Seborrheic keratosis

A

Thickened areas of pigmentation that look dark and greasy; develop in unexposed and sun exposed areas

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32
Q

-pril

A

ending used for angiotensin converting enzyme (ACE) inhibitor, antihypertensive (causes vasodilaiton)

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33
Q

Renal papillary necrosis

A

*This Conditon* can be caused by chronic analgesic abuse, diabetes mellitus, sickle cell trait or disease, severe acute pyelonephritis

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34
Q

Nonmalignant hypertension Diabetes

A

2 conditons that can cause Homogenous deposition of eosinophilic hyaline material in intima and media of small arteries and arterioles

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35
Q

Henoch-Schonlein Purpura

A

* Small-vessel vasculitis * MC childhood systemic vasculitis * URI, then triad of palpable purpura, arthralgia, and GI (abd pain, melena, lesions same age) * Path: IgA complex deposition, vasculitis * Assoc: IgA nephropathy

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36
Q

Rotavirus

A

-sudden onset w short incubation, ab pain/fever, lasts 3-8 days -fecal oral, winter peak, dehydration in kids -death(6-24 mths) -segs of dsDNA capable of reassortment- infects & kills enterocytes- loss of microvilli- replaced by immature cells cannot absorb nutrients and water -vaccine: 5 live strains

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37
Q

Parvovirus B19

A

* 5th disease * Slapped cheek disease (erythema infectosium) in children

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38
Q

Ondansetron

A

5HT3 antagonist Antiemetic

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39
Q

cidofovir

A

* synthetic acyclic purine nucleotide * treats: CMV retinitis in AIDS patients * mode of action: cidofovir diphosphate inhibits viral DNA synthesis * Doesn’t need virally encoded kinase

40
Q

Budd-Chiari syndrome

A

* Liver infarction secondary to hepatic vein obstruction * Present with painful hepatomegaly and ascites

41
Q

CML

A

Increased white blood cell count Many immature cells, few blasts Low leukocyte alkaline phosphatase

42
Q

HMP shunt

A

This metabolic process provides a source of NADPH and ribose for nucleotide synthesis (from glucose-6-P via glucose-6-P dehydrogenase)

43
Q

Transketolase Transaldolase

A

two enzymes which are part of reversible phase of HMP shunt

44
Q

Burkitt’s lymphoma

A

This type of lymphoma demonstrates translocation of c-myc oncogene

45
Q

C-MYC and N-MYC

A
  • nuclear transcription factor oncogene - translocation (of C-MYC)= Burkitt’s lymphoma - amplification (of N-MYC)= neuroblastoma - most common nuclear transcription factor mutation in human tumors
46
Q

MRP2

A

A ATP-dependent, uni-directional transporter - transports Conjugated Bilirubin against its concentration gradient RLS

47
Q

Peptic Ulcer Disease

A

Selective Cox2 inhibition using drugs such as celecoxib is useful for pain management with people with which condition?

48
Q

Candida albicans

A

* Opportunistic fungal infxn * Yeast w/ pseudohyphae in culture at 20°, Germ tubes at 37° * Oral/esophageal thrush in IC (neonates, roids, AIDs, DM), vulvovaginits (high pH, Abx, DM), diaper rash, endocarditis in IV drug users, disseminated candidiasis, cmc * Nystatin for superficial infxn, Amphotericin B for systemic

49
Q

Anaplastic Tumor

A

Type of Tumor that is * Pleomorphism * Hyperchromatic (dark) * Nuclear/Cytoplasmic ratio 1-1 * Giant cells, prominent nucleoli * Atypical (tri or quadri polar) mitosis *not specific for diagnosis

50
Q

Pilocytic Astrocytomas

A

* Grade I tumor * Children, young adults * usu. in cerebellum (& other midline structures) * or spinal cord if adult patient slow-growing tumors that can be cut out

51
Q

Hemosiderin

A

Hemoglobin derived aggregates of partially denatured ferritin within lysosomes. Prussian blue stain is positive. Localized accumulation follows hemorrhage (bruise)

52
Q

Cytochrome P450

A

General name for a large class of enzymes that play a significant role in drug metabolism.

53
Q

Desmopressin

A

Drug that is used to treat mild caes of hemophilia A. Causes temporary increase in plasma factor VIII levels by two to three fold. vWF is also increased

54
Q

Protamine

A

Antidote for heparin overdose

55
Q

Fibronectin

A

A type of large glycoprotein that is found on the surface of cells and mediates cellular adhesion, control of cell shape, and cell migration

56
Q

T-cell ALL

A

Which lineage of Acute Lymphoblastic Leukemia (ALL) is more likely to result in mediastinal mass that can compress trachea?

57
Q

Multiple Myeloma

A

Which type of Plasma cell disorder results in Primary AL amyloidosis?

58
Q

Amifostine Amy Frost. Cold like platinum

A

Prevents nephrotoxicity of platinum-based chemotherapeutic agents

59
Q

erythrocyte

A

red blood cell. there are about 5 million per microliter

60
Q

reticulocyte

A

a young RBC characterized by a network of granules within the cell membrane

61
Q

Foscarnet

A
  • Synthetic pyrophosphate analog - Prevents viral DNA replication - Binds viral DNA polymerase - Drug of choice during acyclovir resistance - HSV, VZV, CMV, HIV-1
62
Q

Foscarnet

A

“Fox cARRR net” If you catch foxes in a net, they won’t reproduce (this drug is a stage 3 inhibitor). ARRR… it inhibits RNA polymerase and Reverse transcriptase to block Reproduction. You’re going to put the foxes into a car that’s made out of bones (this drug binds to bones and decreases Ca2+ and Mg2+). Also, a foxy lady is HOT (this drug will cause a fever) and never wear fox urine to hunt (this is excreted in the kidney and causes renal insufficiency).

63
Q

Valine, Leucine & Isoleucine Muscles LIVe Fast

A
  • branched chain amino acids - bulky non polar R group (hydrophobic so on the interior of proteins)
64
Q

BRAF

A

Q.id: 7707 ONCOGENE : Melanoma (Serine/threonine kinase)

65
Q

valproate

A

generalized tonic-clonic seizures partial seizures generalized seizure absence seizure myoclonic seizure

66
Q

Phenytoin

A

MOA: use dependent Na-channel blocker; prolongs refractory period First like for partial and generalized seizures Tox: nystagmus, ataxia, dyplopia, sedation, gingival hyperplasia , p450 induction

67
Q

CREST syndrome

A

Calcinosis Raynaud’s phenomen Esophageal dysmotility Sclerodactyly (thickening and tightness of skin of fingers and toes) Telangiectasia (small dilated blood vessels near surface of skin and mucosa, usually seen around nose, cheeks and chin)

68
Q

adenocarcinoma in situ

A

tumor that lines glands preserving glandular structure non-invasive but can lead to invasive carcinoma muscin preserved

69
Q

Type I diabetes

A

Q.ID 921 Increased thirst, increased hunger dry mouth, frequent urination unexplained weight loss fatigue blurred vision labored, heavy breathing loss of consciousness

70
Q

permissive

A

Q.id: 551 -need one hormone to have full effect of another hormone e.g Cortisol with Norepinephrine

71
Q

Status Epilepticus

A

Q..ID 353 Treatment of this conditon 1. DOC is Benzodiazepines 2. Phenytoin if no response (beware cardiotoxicity) 3. Phenobarbital is the DOC in pediatric patients

72
Q

Anti-centromere

A

Q.id: 340 Type of antibody found in CREST scleroderma * C - Calcinosis/Centromere * R - Raynauds * E - Esophageal dysmotility * S - Sclerodactyly * T - Telangiectasia

73
Q

Left Anterior Descending

A

Q.ID: 10467 Occlusion of this artery leads to ST elevation in leads V1-V3

74
Q

Helicase

A

Q.ID 1436 This enzyme unwinds DNA at the replication fork.

75
Q

Poly Arteritis Nodosa

A

Necrotizing Med Vessel Vasculitis of Rena, coronary Messenteric Arteries Spares Pulmonary Arteries Asct with HBsAg & Middle aged men Nodosa: Nodes: Focal Vasculitis produces aneurysms RUN Angiogram to Confirm Organ infarctionin Kidneys (renaal failure), heart (acute MI), bowels (bloody diarrhea), skin (ischemic ulcer) testicle (testicular pain)

76
Q

Pilocytic astrocytoma

A

Q.ID 457 * MC in children * 5C’s: C ystic, C hildhood, C ontrast-enhancing, C alcification, C ircumscribed * Biphasic, dense, loose appearance, Rosenthal fibers, eosinophilic granules * 40% cerebellum and 25% optic nerve

77
Q

delusional disorder

A

Q.ID 2046 a condition in which a person has a non bizarre delusion, no other psychotic symptoms, and few changes in overall functioning other than the behaviors immediately surrounding the delusion

78
Q

Schizophreniform disorder

A

Q.ID 2046 a disorder in the schizophrenic spectrum characterized by symptoms of schizophrenia for less than 6 months, less social dysfunction than schizophrenia, and a more likely recovery

79
Q

Tryptophan

A

An amino acid that can be converted to niacin in the body.

80
Q

PSGN

A

Discrete subepithelial humps on electron microscopy consisting of IgG and C3

81
Q

Cilostazol

A

MOA : phosphodiesterase III inhibitor; increases cAMP (usually metabolized by phosphodiesterase) in platelets, thus inhibiting platelet aggregation; vasodilator Use : intermittent claudication, coronary vasodilation, prevention of stroke or TIAs (combined with aspirin), angina prophylaxis; superior to aspirin in peripheral arterial disease Toxicity : nausea, headache, facial flushing, hypotension, abdominal pain

82
Q

CA-125

A

serum marker for ovarian surface epithelial tumors

83
Q

t1/2= (Vd × 0.7) /CL

A

Formular for half life

84
Q

Lambert-Eaton Myasthenic Syndrome

A

Flaccid - Weakness is greatest at the initiation of muscle use or with slow rates of stimulation. Pre-synaptic side of neurotransmission. Mostly in men with small cell lung carcinoma

85
Q

Trousseau Syndrome

A

tumor-associated release of procoagulants cause migratory thrombophlebitis usually associated with pancreatic adenocarcinoma Non-Bacterial thrombotic endocarditis can also be seen.

86
Q

Reye syndrome

A

Microvesicular steatosis of hepatocytes without inflammation.

87
Q

EBV

A

Associated with which virus? Primary CNS lymphoma arising mostly from B-cells. (Diffuse large B-cell lymphoma)

88
Q

Descending Aorta

A

When TEE probe is faced posteriorly in mid esophageal position, what structure will be best imaged in this position?

89
Q

Echinococcus granulosus

A

Q.ID: 61 Rapidly growing mass in liver which has this gross appearance. Due to infection by? Eggshell calcification

90
Q

Propanolol

A

Q.ID: 1364 This medication can counteract effect of epinephrine by blocking both beta 1 and beta 2 receptors

91
Q

Gallstone ileus

A

Q.ID: 88 Hard high cholesterol mass obstructing ileocecal valve and air in biliary tree is most consistent with?

92
Q

CREST scleroderma

A

Q.ID: 825 Calcinosis, raynaud’s, esophageal dysmotility, sclerodactyly, and telangiectasia. Microvascular injury of pulmonary arterioles leads to narrowing of lumen and increased pressure in pulmonary circulation

93
Q

HNPCC (Hereditary Non-polyposis colon cancer)

A

Q.ID: 429 Occurence of colonic adenocarcinoma at

94
Q

axonal reaction

A

Q.ID: 494 Term used to describe following histologic change Cell body has edema, and nucleus displaced to periphery; Nissl substance disperse around the cytoplasm (central chromatolysis)

95
Q

Submocosa Narrow Part

A

Q.id: 331 Barium anema shows narrow rectum and rectosigmoid area, and large proximal dilation close to narrow area. Sampling of which area and layer would be most useful for diagnosis?

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