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USMLE-rx > Feb 19th Kaplan > Flashcards

Feb 19th Kaplan Flashcards

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USMLE® Step 1 flashcards
1
Q

What is ferritin?

A

Binds iron with in the cells

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2
Q

What is transferrin?

A

Transfers iron in the serum

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3
Q

Where is transferrin made and what causes it to increase in synthesis?

A

In the liver and its synthesis is increased when ferritin is low

Thus high ferritin leads to decrease in the production of transferrin

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4
Q

What is Total biding capacity and what does it show?

A

How much transferrin is in the serum to bind iron

- thus synonymous with transferrin levels

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5
Q

what is Percent transferrin saturation?

A

Amount of iron bound to transferrin

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6
Q

Where are common places for excess iron to accumulate?

A 
Pancreas 
Spleen 
Skin
Liver
Heart 
pituitary 
Joints
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7
Q

What tumor results in loss of vertical eye movements?

A

Pinealoma

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8
Q

What is central pontine myelinosis?

A

Demyelination primarily of the pons due to prolonged hyponatremia followed by rapid correction

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9
Q

Are steroids hormones produced on demand or stored in vesicles?

A

Produced on demand

- they are lipophilic thus can move quickly across membrane so no need to make them before

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10
Q

What sort of hormones are produced and stored in vesicles?

A

Protein hormones which are lipiphopic which means they need more time to get signal across cell membrane

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11
Q

Celiac has antibodies produced against which protein?

A

Gliadin

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12
Q

Which HLA typing is Celiac disease associated with?

A

HLA- DQ2 and DQ8

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13
Q

What are the common findings in celiac disease?

A
  1. IgA anti tissue transglutaminase
  2. Anti-endomysial
  3. Anti-deamindated gliadin peptides
  4. Reticulin IgA
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14
Q

Does a pt with celiac disease present with bone pain? why?

A

They can

- Auto-ab’s against osteoprotegerin which causes in activation of osteoclasts via RANK-ligand

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15
Q

What is another name for osteoprotegerin?

A

Osteoclastogenesis inhibitory factor

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16
Q

What is dermatitis herpetiformis?

A

Itchy red vesicular rash found predominantly on the extensors

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17
Q

What is the pathogenesis of dermatitis herpetiformis?

A

subepidermal deposition of IgA and Anti-transflutaminases

- May also find neutrophils

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18
Q

What is the mnemonic for sensitivity ruling out?

A

Dogs have SENSITIVE SNouts

  • SN- Sensitivity
  • Rules out
  • Like a D-dimer
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19
Q

What does the mnemonic SPPIN stand for?

A

Specificity rules IN

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20
Q

Who commonly presents with s. aureus scalded skin syndrome?

A

Infants–> especially around umbilicus
children
Adults with renal insufficiency

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21
Q

What is seen on physical exam in SSSS?

A

Positive Nikolsky sign of blisters
Sloughing of upper layers of epidermis
Erythema

22
Q

What is the cause and what is targeted in SSSS?

A

Exotoxin from S. Aureus

- Targets desmosomes at the layer between the granulosum and corneum.

23
Q

Where do SJS and TEN target on the skin layer?

A

Epidermal and dermal junction

24
Q

What does hypercapnia cause in terms of vessels?

A

Vasodilation

  • increase systemic and pulmonary resistance
  • thus increased afterload
25
Q

Pt presents with increased anion gap metabolic acidosis? She is on metformin. What is the cause of the acidosis?

A

Lactic acid

- especially in renal insufficient patients

26
Q

What is cyclobenzaprine?

A

Centrally acting Skeletal muscle relaxant

- spasmolytic

27
Q

What are the AE’s of Cyclobenzaprine?

A

Anticholinergic affects

28
Q

What muscle controls contraction if the bladder?

A

Detrusor

29
Q

What are oxybutin and tolterodine used for?

A

M3 antagonists which are used for urge incontinence

- leads to smooth muscle relaxation of bladder and ureters

30
Q

What is Menetrier disease?

A

Gastric hyperplasia of mucosa–> leads to hypertrophied regae
- increased proliferation of mucous producing cells

31
Q

pt presents with Menetrier disease, what is lost in fecal matter?

A

protein

  • increased mucous cells causes parietal cell atrophy and decreased H+ which leads to decreased breakdown of proteins
  • malaborption downstream
32
Q

What cytokine is overproduced in Menetriers disease

A

TGF-a

33
Q

What is first line treatment for schizophrenia?

A

Atypical antipsychotics

- Risperidone

34
Q

What else can be used to treat schizophrenia?

A

Antipsychotics (neuroleptics)

  • high potency
  • low potency
35
Q

What is Torticollis?

A

involuntary twisting of the neck with neck pain and abnormal head posture

36
Q

What drugs are commonly associated with Toricollis?

A

High potency antipsychotics

  • Haloperidol
  • Fluphenazine
  • Trifluoperazine
37
Q

What is the mnemonics for high potency antipsychotics?

A

Try to fly high

  • Trifluoperazine
  • Haloperidol
  • Fluphenazine
38
Q

What are some other common side affects of high potency antipsychotics?

A

More EPS symptoms and less non-neurological symptoms

39
Q

How about low potency antipsychotics what are their sxs compared to high potency?

A

We need more of them to act

  • thus more non-neuro sxs
  • less EPS sxs
40
Q

What is the mnemonic for low potency antipsychotics?

A

Cheating Thieves are low

  • Chlorpromazine
  • Thioridazine
41
Q

What are EPS symptoms?

A

Extra-pyramidal sxs

  1. acute dystonia
  2. Akathisias
  3. Parkinsonian syndromes
  4. Tarditive dyskinesias (irreversible)
42
Q

what can one give to treat the reversible EPS sxs?

A

Benztropine
Diphenhydramine
Benzos

43
Q

What are the non-neuro sxs associated with taking typical antipsychotics?

A

Muscarinic
Alpha1
Histamine

44
Q

How many pts with mumps present with bilateral parotitis? Orchitis

A

90% and 40 respectively

45
Q

Where are some common locations for tophus?

A

External ear
Olecranon bursa
Achilles

46
Q

how do you treat acute gouty arthirtis?

A

NSAID’s
Indomethacin
Steroids
Colchicine

47
Q

Increased AFP (amniotic and maternal) and Ache (amniotic) lead to what type of defect and when?

A

Day 27

  • Meningocele or Meningomyelocele
  • NOT bifida
48
Q

What is normal range of ejection fraction?

A

55-75%

49
Q

What is the systemic response to hypoxia in terms of vessels?

A

vasodilation

  • allows for increase return of venous blood to heart
  • Constrictions small vessels and arterioles
50
Q

Does gastrin weaken or strengthen the stomach lining?

A

Strengthen

- causes increase in cell division in the proliferation zone

USMLE-rx (9 decks)

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