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USMLE Step 1 Random Facts > Final review > Flashcards

Final review Flashcards

1
Q

histones rich in what AA

A

lysine and arginine

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2
Q

uracil formed by

A

deamination of cytosine

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3
Q

AAs coded by only 1 codon

A

methionine (AUG)

tryptophan (UGG)

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4
Q

genetic code is NOT conserved in?

A

mitochondria

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5
Q

telomerase is what kind of enzyme

A

reverse transcriptase enzyme (RNA-dependent DNA polymerase)

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6
Q

eukaryotic DNA Polymerase alpha function

A

makes own primer

replicates lagging strand

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7
Q

eukaryotic DNA Polymerase beta function

A

replic leading strand

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8
Q

eukaryotic DNA Polymerase delta function

A

DNA repair

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9
Q

eukaryotic DNA Polymerase gamma function

A

replic mitochondrial DNA

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10
Q

NER vs BER

A

NER - endonuclease first

BER - glycosylase first

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11
Q

what does amanitin (mushroom poison) do

A

inhib RNA polymerase II

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12
Q

where does mRNA processing take place

A

nucleus

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13
Q

antibodies to spliceosomal snRNPs seen in what pts

A

Lupus

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14
Q

noncoding RNAs are

A

carry out out functions w/o first being translated
snRNA
rRNA
tRNA

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15
Q

tRNAs contain what anticodon @ 3’ end

A

CCA

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16
Q

tRNA charged via? and using?

A

aminoacyl-tRNA synthetase

using ATP

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17
Q

where does start codon first attach on ribosome

A

P site

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18
Q

aminoglycosides MOA

A

bind 30S + inhib formation of initiation complex causing mRNA misreading

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19
Q

tetracyclines MOA

A

bind 30S + block aminoacyl-tRNA for entering A site

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20
Q

chloramphenicol MOA

A

binds 50S + inhibit peptidyl transferase (23S rRNA)

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21
Q

macrolides MOA

A

binds 50S + prevent release of uncharged tRNA after it donates its AA (prevents TRANSLOCATION)

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22
Q

clindamycin + lincomycin MOA

A

bind 50S + block translocation

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23
Q

nissl bodies are

A

RER in neurons (seen in DENDRITES)

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24
Q

free ribosome function

A

synth of cytosolic + organellar proteins

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25
RER rich areas =
mucus-secreting goblet cells of SI | AB-secreting plasma cells
26
SER rich areas =
liver hepatocytes | steroid-hormone producing cells in adrenal cortex
27
COPI vesicle trafficking
Golgi-->ER | retrograde Golgi transport
28
COPII vesicle trafficking
ER--->Golgi (cis) | anterograde Golgi transport
29
Clathrin vesicle trafficking
trans-Golgi --> lysosomes | plasma membrane --> endosomes (receptor-mediated endocytosis)
30
def in peroxisome function leads to
accum of VLCFA
31
protein translation initiation/termination depends on a
GTPase
32
dynein moves
retrograde (from +-->-) | towards nucleus
33
kinesin moves
anterograde (from - --> +) | towards axon/nerve terminal
34
axonemal dynein is an?
ATPase (causes bending of cilium)
35
ouabain binds to what
K+ site on Na/K ATPase
36
ligamentum flava connects
vertebrae
37
elastin is rich in what AAs
proline + glycine (NONhydroxylated)
38
indirect ELISA
use test antigen to find Ab
39
direct ELISA
use Ab to find antigen
40
Southern blot =
DNA sample and DNA probe
41
Nouthern blot =
RNA sample w/ DNA probe | useful for mRNA studies!
42
Western blot =
protein sample w/ Ab probe
43
Southwestern blot =
DNA-binding protein (TF) w/ oligonucleotide probe
44
fluorescence preferred to visualize
microdeletions! (things at a MOLECULAR level)
45
cDNA only contains
CODING portion of gene (exons)
46
AD diseases usually are
defects in structural genes
47
AR diseases are usually
enzyme deficiencies
48
folate and B12 stored in
liver
49
B1 required for enzymes:
alpha-ketoglutarate transketolase Pyruvate DH branched-chain amino acid DH
50
B7 cofactor for enzymes:
in carboxylation! pyruvate carboxylase (pyruvate --> OA) acetyl-CoA carboxylase (acetyl-CoA --> malonyl CoA) propionyl-CoA carboxylase (propionyl CoA --> methylmalonyl CoA)
51
B12 cofactor for enzymes:
``` homocysteine methyltransferase (homocysteine --> methionine); indirectly affects SAM (bc needs methionine) methylmalonyl-CoA mutase (methylmalonyl-CoA --> succinyl CoA) ```
52
4 functions of vit C
1) antioxidant 2) keeps Fe in reduced state (so increases absorption) 3) hydroxylation of proline and lysine for collagen 4) in dopamine beta-hydroxylase --> convert dopamine to NE
53
ethanol metab shunts which 2 processes
pyruvate --> lactate OAA --> malate to regen NAD+! inhibs gluconeogenesis + stim FA synth
54
mitochondria is site of
FA oxidation (beta-oxidation) acetyl-CoA prod TCA cycle oxidative phosphorylation
55
cytoplasm is site of
``` glycolysis FA synthesis HMP shunt protein synth (RER) steroid synth (SER) cholesterol synth ```
56
mitochondria AND cytoplasm are sites for
Heme synth Urea cycle Gluconeogenesis
57
phosphorylase
adds inorganic phosphate W/O using ATP!!
58
shuttle producing 32 ATP
malate-aspartate (in heart/liver)
59
shuttle producing 30 ATP
glycerol-3-phosphate (muscle)
60
hexokinase properties
LOW Km and Vmax | UNINDUCED by insulin
61
glucokinase properties
HIGH Km and Vmax | INDUCED by insulin
62
fasting state changes seen in glycolysis/gluconeogenesis
increased FBPase-2, cAMP decreased PFK-1, PFK-2, fructose-2,6-bisphosphate glucagon!!
63
increased fructose-2,6-bisphosphate is sign of what state
fed
64
fed state changes seen in glycolysis/gluconeogenesis
decreased FBPase-2, cAMP increased PFK-1, PFK-2, fructose-2,6-bisphosphate insulin!!
65
carboxylase function
adds CO2 group w/ help of biotin!
66
when you see F-2,6-Bisphosphate think:
there's enough glucose, we need more energy!
67
arsenic poisoning key feature
garlic breath
68
similar to pyruvate DH complex
alpha-ketoglutarate DH complex
69
pyruvate DH complex deficiency features
buildup of pyruvate and alanine --> lactic acidosis X-linked gene mut of E1-alpha subunit neuro deficits in infancy!
70
pyruvate DH complex deficiency tx
increase ketogenic nutrients: high fat content increase LEUCINE or LYSINE intake
71
Cori disease vs. von Gierke disease
Cori - NORMAL blood lactate levels | von Gierke - elevated lactate + hepatic steatosis
72
Niemann-Pick vs. Tay-Sachs
Tay-Sachs has NO hepatosplenomegaly
73
Hurler's synd vs. Hunter's synd
Hunter's synd: NO corneal clouding! aggressive behavior X-linked!
74
4 fates of pyruvate
alanine OAA acetyl-CoA lactate
75
pyruvate --> alanine
alanine aminotransferase (w/ B6) - amino group from liver to muscle (from glutamate)
76
pyruvate --> OAA
pyruvate carboxylase (w/ biotin) - OAA can replenish TCA cycle or go to GNG
77
pyruvate --> acetyl-CoA
pyruvate DH complex (B1, B2, B3, B5, lipoic acid) - glycolysis to TCA cycle
78
pyruvate --> lactate
LDH (w/ B3) - anaerobic glycolysis (RBCs, kidney medulla, lens, testes, cornea)
79
citrate synthase rxn
acetyl-CoA --> citrate
80
isocitrate DH rxn
isocitrate --> alpha-ketoglutarate
81
alpha-ketoglutarate DH rxn
alpha-KG --> succinyl-CoA
82
succinate DH is part of?
complex II in ETC and uses FADH2 | converts succinate --> fumarate
83
blocks complex I of ETC
amytal rotenone MPP
84
blocks complex III of ETC
antimycin A
85
blocks complex IV of ETC
H2S CO sodium azide (N3-) CN-
86
blocks ATPase of ETC
oligomycin A
87
uncoupling agents do what in ETC
produce heat by allowing H+ to leak down their concentration gradient
88
examples of uncoupling agents
2,4-DNP thermogenin (in brown fat) aspirin
89
sites for HMP shunt (pentose phosphate pathway)
lactating mammary glands liver adrenal cortex RBCs
90
AA required during periods of growth
Arg | His
91
what donates NH4 group to citrulline to make argininosuccinate
aspartate | catalyzed by arginosuccinate synthetase
92
ornithine transcarbamoylase rxn
ornithine --> citrulline
93
in urea cycle, argininosuccinate to arginine step creates what?
fumarate
94
which step creates urea
arginine to ornithine via arginase
95
what 2 AA can be used in urea cycle to remove NH4
alanine | glutamate (w/ NH4 --> becomes glutamine which is directly transported to liver from muscles)
96
tx for hyperammonia
reduce protein intake benzoate, phenylbutyrate (bind AA --> facilitate excretion) lactulose - acidify GI tract + trap NH4
97
homocystinuria vs. Marfan
lens subluxation in: - Marfan = upward - homocystinuria = downward and inward
98
accum of what AA in maple syrup urine dz
Ile Val Leu (especially this)
99
FA synth begins w/
citrate (in mitochondria) --> transport to cytoplasm + become acetyl-CoA by ATP citrate lyase
100
FA degrad inhib by
malonyl-CoA
101
urine tests detect which ketone
acetoacetate only
102
function of pancreatic lipase
degrad of TG in SI
103
function of LPL
degrad of TG in chylomicrons and VLDLs
104
function of hepatic lipase
degrad of TG in IDLs
105
function of hormone-sensitive lipase
degrad of TG in adipocytes
106
function of LCAT (lecithin-cholesterol acyltransferase)
esterification of cholesterol
107
function of CETP (cholesterol ester transfer protein)
transfer of cholesterol esters to other lipoprotein particles
108
chylomicron function
``` TG --> peripheral tissues chylomicron remnants (depleted of TG): cholesterol --> liver secreted by intestinal epith cells ```
109
VLDL function
hepatic TG --> periph tissues | secreted by liver
110
IDL function
TG + cholesterol --> liver | formed in degrad of VLDL
111
LDL function
hepatic cholesterol --> periph tissues taken up via recept-med endocytosis formed by hepatic lipase modif of IDL in periph tissue
112
HDL function
cholesterol from periphery --> liver repository of apoC and apoE secreted from liver and intestine
113
hyperchylomicronemia vs. familial hypercholesterolemia
no increased risk of atherosclerosis in hyperchylomicronemia (but pancreatitis!)
114
thalamus a relay for everything except?
olfaction!
115
increase preload by
increased BV (overhydration, transfusion, preg) exercise (slight) increased sympathetic activity
116
wide splitting seen in conditions that
delay RV emptying like pulm stenosis, RBBB | exaggeration of normal inspiration split, but ALSO split in expiration (but by less)
117
fixed splitting seen in
ASD; pulmonic closure delayed regardless of breath by SAME amount
118
paradoxical splitting seen in
delayed LV emptying (like aortic stenosis, LBBB) | P2 occurs BEFORE A2, and paradoxically, on inspiration gets closer to A2 thereby eliminating the split
119
only virus w/ 2 identical ssRNA molecules
retrovirus
120
only DNA virus that replicates in cytoplasm
poxvirus | others replic in nucleus
121
only 2 RNA viruses that replicate in nucleus
influenza, retrovirus | others replic in cytoplasm
122
virus that acquires its envelope from nuclear membrane
herpesvirus family
123
ONLY ssDNA virus
parvovirus
124
all DNA viruses are linear except:
papilloma, polyoma (circular, supercoiled) | hepadna (circular, incomplete)
125
all DNA viruses are icosahedral except:
poxvirus (complex)
126
3 poxviruses:
variola (smallpox) vaccinia (cowpox - provides immunity to smallpox) Molluscum contagiosum
127
EBV latent in
B-cells
128
CMV latent in
mononuclear cells (lymphocytes, monocytes)
129
Roseola features:
high fevers that can cause seizures, followed by macular rash
130
Tzank test to check for
HSV-1, 2 | VZV
131
Deformed cell seen in EBV infection
atypical lymphocytes (CD8+ reactive T-cells) aka Downey cells (w/ foamy appearing basophilic cytoplasm)
132
drug that forms a maculopapular rash that covers trunk + extremities when given to EBV mono pt
amoxicillin
133
all picornaviruses are _________ except __________
enteroviruses (fecal-oral spread) | rhinovirus is not
134
rhinovirus is unique from other picornaviruses in that
it is destroyed by stomach acid and therefore does not cause GI dz
135
#1 cause of fatal diarrhea in children + its MOA
rotavirus - decrease reabsorp of Na and loss of K (due to villous destruction)
136
paramyxoviruses contain what protein
F (fusion) protein --> resp eptih cells to fuse + form multinucleated cells
137
tx for RSV pneumonia in pre-mature infants
palivizumab (Mab against F protein) | also, ribavirin
138
measles vs. rubella rash
both are descending maculopapular rashes, BUT: measles - involves hands/feet rubella - truncal
139
complications of measles
SSPE (subacute sclerosing panencephalitis) encephalitis giant cell pneumo (rare)
140
rabies infection found in what part of brain
Purkinje cells of cerebellum (Negri bodies seen in neurons)
141
vaccines available for which hepatitis viruses
HAV, HBV (and HDV by extension)
142
env gene in HIV forms
envelope proteins gp120 and gp41 (from cleavage of gp160)
143
gp120 function in HIV
attachment to host CD4+ T-cell
144
gp41 function in HIV
fusion and entry
145
gag gene in HIV is also known as? and forms what?
p24 | capsid protein
146
pol gene in HIV forms
reverse transcriptase aspartate protease integrase
147
nef gene in HIV does what?
decreases expression MHC class I proteins on surface of infected cells
148
false negative ELISA/Western blot seen in which HIV population
those w/ acute infection (bc low Ab)
149
false positive ELISA/Western blot seen in which HIV population
babies born to infected mothers bc gp120 crosses placenta
150
latent HIV phase, virus replicates in where in body
LN
151
oral candidiasis in HIV pts when CD4 < ?
400
152
esophageal candidiasis in HIV pts when CD4 < ?
100
153
histo difference in B.henselae vs Kaposi sarcoma in HIV
``` B.hens = NEUTROPHILIC infiltrate Kaposi = LYMPHOCYTIC infiltrate ```
154
opportunistic infections seen with CD4 < 400
oral candidiasis
155
opportunistic infections seen with CD4 < 200
cryptosporidium - diarrhea JC virus (reactivation) - PML PCP
156
opportunistic infections seen with CD4 < 100
esophageal candida Histoplasmosis dissem dz (HSM, fever, cough, etc) Toxoplasmosis (MANY ring-enhancing lesions)
157
opportunistic infections seen with CD4 < 50
C.neoformans CMV retinitis (cotton-wool spots) MAC
158
T.gondii vs. primary CNS lymphoma in HIV pts (histo)
T.gondii - MANY ring-enhancing lesions | CNS lymphoma - usually FOCAL lesion
159
bugs mimicking appendicitis
Y.pestis (mesenteric adenitis) Salmonella C.jejuni
160
tx for atypical pneumo
macrolide
161
tx for neonatal pneumo
ampicillin + gentamicin
162
empiric tx for meningitis
ceftriaxone + vancomycin add ampicillin if Listeria suspected! also maybe give dexamethasone
163
Neisseria meningitidis presents first w/
purpura on skin before meningitis
164
+ leukocyte esterase test seen in
BACTERIAL UTI
165
+ nitrate test seen in
GRAM NEG bacterial UTI (presence of Enterobactericeae)
166
measles vs. rubella
postauricular LAD in rubella!
167
Fitz-Hugh-Curtis synd features
from PID infects liver capsule see "violin-string" adhesions of parietal peritoneum to liver
168
avoid what when taking tetracyclines
anything w/ divalent cations bc inhibs absorption
169
aminoglycoside resistance is by
transferase enzymes that acetylate, phosphorylate or adenylate drug to inactivate it
170
macrolide resistance is by
methylation of 23S rRNA
171
anaerobic infection tx
clindamycin (above diaphragm) | metronidazole (below diaphragm)
172
SE of sulfonamides
``` HST hemolysis in G6PD def pts nephrotox (tubulointerstitial nephritis) photosensitivity kernicterus in infants displace other drugs from albumin (like warfarin) ```
173
prophylaxis for meningococcal infection
ciprofloxacin | rifampin (for children)
174
prophylaxis for H.flu meningitis
rifampin
175
prophylaxis for recurrent UTIs
TMP-SMX
176
prophylaxis for endocarditis w/ surgical or dental procedures
penicillins
177
prophylaxis for preg women w/ GBS
ampicillin DURING labor
178
prophylaxis of strep pharyngitis in child w/ prior rheumatic fever
oral penicillin
179
prophylaxis for prevention of post surgical infection due to S.aureus
cefazolin
180
prophylaxis for prevention of gonoccocal or chlamydial conjunctivitis in newborn
erythromycin ointment
181
prophylaxis for MAC if CD4 <50
azithromycin
182
toxoplasmosis, antimalarial tx
pyrimethamine
183
T.cruzi tx
nifurtimox
184
leshmaniasis tx
Na stibogluconate
185
ribavirin MOA/SE
competitively inhib IMP dehydrogenase + inhib synth of guanine nucleotides SE = hemolytic anemia, teratogen
186
foscarnet binds to
pyrophosphate-binding site of enzyme
187
enfuvirtide binds to
gp41
188
tenofovir unique in that it is a
nucleoTIDE analog (does not have to be phosphorylated to be active)
189
HIV prophylaxis during preg
zidovudine
190
tx for chronic granulomatous disease
IFN-gamma
191
maraviroc MOA
CCR5 anatagonist; inhib gp120 conformational change
192
murmur ass. w/ coarctation of aorta
aortic regurg
193
heart disorder ass w/ 22q11 synd
ToF | truncus arteriosus
194
heart disorder ass w/ congenital rubella
PDA | pulmonary artery stenosis
195
heart disorder ass w/ Turner's synd
Coarctation of aorta (preductal) | bicuspid aortic valves
196
heart disorder ass w/ infant of diabetic mother
transposition of great vessels
197
monckeberg lesion seen in what part of artery
media
198
atherosclerosis deposits seen in what part of artery
intima
199
AAA ass w/?
Atherosclerosis
200
thoracic aortic aneurysm ass w/ + can cause what?
HTN | also, can cause AR
201
ST depression
stable/unstable angina
202
ST elevation
prinzmetal's angina
203
tx for prinzmetal's angina
dihydropyridine CCB
204
MI ECG changes seen
ST depression --> ST elevation
205
most useful marker in detecting MI reinfarction
CK-MB
206
MI changes seen in 0-4 hrs
NO gross/microscopic changes risk of arrhythmia, shock
207
MI changes seen in 4-12 hrs
``` dark mottling (pale w/ tetrazolium stain) early coag necrosis, edema ``` risk of arrhythmia
208
MI changes seen in 12-24 hrs
still dark mottling contraction bands from reperfusion injury (via fibrinolytic therapy) release of necrotic cell content into blood risk of arrhythmia
209
MI changes seen in 1-3 days
hyperemic tissue extensive coag necrosis; acute inflamm; NEUTROPHILS! risk of fibrinous pericarditis (in transmural infarcts esp)
210
MI changes seen in 3-14 days
yellow-brown central softening! MACROPHAGES, granulation tissue @ margins risk of: free wall rupture (can cause cardiac tamponade), papillary muscle rupture (can cause MR), IV septum rupture (can cause VSD), ventricular aneurysm [all from macrophage weakening]
211
MI changes seen in 2 wks to several months
gray-white tissue! scar seen risk of Dressler's synd
212
MI changes reversible w/in
20-40 mins
213
causes a systolic dysfunction
dilated cardiomyopathy
214
causes a diastolic dysfunction
hypertrophic cardiomyopathy | restrictive cardiomyopathy
215
marker used to dx CHF
BNP
216
common cause of cor pulmonale
pulm HTN (from obliteration of pulm vasculature by COPD)
217
bacterial endocarditis signs
``` Fever Roth spots Osler's nodes Murmur Janeway lesions Anemia Nail-bed hemorrhages (splinter hemorrhages) Emboli ```
218
Rheumatic fever signs
``` Fever Erythema marginatum Valvular lesions (fibrosis and vegetations) ESR elevated Red-hot joints (migratory polyarthritis) Subcut. nodules Syndenham's chorea ```
219
2 things seen on histo w/ rheumatic fever
``` Aschoff bodies (granuloma w/ giant cells) Anitschkow's cells (activated histiocytes that look like "caterpillar cells" bc of condensed chromatin, abund cytoplasm) ```
220
ECG changes in pericarditis
widespread ST elevations and/or PR depression
221
pericardial knock heard when
``` early diastole (shortly after S2) brief, high-freq sound ```
222
cause of Raynaud's phenom
arteriolar vasospasm
223
tx for Raynaud's
``` dihydropyridine CCB (vasodil) aspirin (to prevent clots) ```
224
vasculitis w/ increased p-ANCA + differences b/w them
microscopic polyangiitis - no granulomas; segmental fibrinoid necrosis churg-strauss synd - granulomatous, necrotizing vasculitis w/ eosinophilia
225
vasculitis w/ increased c-ANCA
Wegener's granulomatosis
226
strawberry hemangioma
infancy | grows rapidly, regresses spontaneously (around 5-8y.o)
227
cherry hemangioma
elderly no regression; freq increases w/ age thin-walled BV
228
pyogenic granuloma
raised capillary hemangioma | ass w/ trauma + pregnancy
229
cystic hygroma
cavernous lymphangioma often on posterior neck/lateral chest wall ass w/ Turner synd
230
glomus tumor
painful! (but benign) red-blue tumor UNDER FINGERNAILS glomus cell (mod SM cells) tumor - controls thermoregulation
231
bacillary angiomatosis
B.hensalae in AIDS pts necrotizing granulomatous adenitis (inflamm of LN) w/ stellate microabscesses
232
angiosarcoma
BV malignancy head, neck, breast areas ass w/ pts receiving radiation therapy (esp breast cancer, Hodgkin's lymphoma) metastasis to brain/bone
233
lymphangiosarcoma
persistant lymphedema | ass. w/ post-radical mastectomy
234
spider angiomas
red central papule w/ outwardly radiating vessels that BLANCH on pressure estrogen dependent! ass w/ preg, liver dz, pts taking OCPs and estrogen
235
cavernous hemangioma
dilated vascular spaces w/ thin-walled endoth cells | soft blue compressible masses
236
Sturge-Weber disease
congenital - affects capillary-sized vessels findings: port-wine stain on face (nevus flammeus) ipsilateral leptomeningeal angiomatosis (intracerebral AVM) seizures early-onset glaucoma skull opacities ("tram-track" calcifications)
237
drug class protective against diabetic nephropathy
ACE inhib
238
arteriolar vasodilator
hydralazine
239
vasodilation OR venodilation (but not both together) can ALWAYS lead to a (SE)
compensatory tachycardia
240
malig HTN 1st line drug
nitroprusside (balanced arterial/venous vasodil)
241
fenoldapam MOA
dopamine D1 recept agonist
242
malig HTN w/ renal failure: use what drug?
fenoldopam
243
fenoldopam causes what effects
coronary, periph, renal, splanchnic vasodil | decreases BP and increases natriuresis
244
beta-blockers CI w/ what other drug
non-dihydropyridine CCBs
245
beta-blockers CI in angina
pindolol acebutolol bc partial Beta agonists
246
precapillary sphincters respond to
histamine, decreased O2, increased pCO2, decreased pH - causes dilation of capillaries
247
HMG-CoA reductase inhibitors inhib conversion of HMG-CoA to?
mevalonate
248
3 SE of niacin
hyperuricemia (--> gout) hyperglycemia (--> acanthosis nigracans) red flushing of face
249
SE of fibrates
myositis hepatotox chol gallstones CI w/ statins
250
MOA of fibrates
upregulate LPL --> increased TG clearance | activates PPAR-alpha
251
fibrates increases conc of what lipoprotein
IDL
252
digoxin indicated for
``` chronic CHF (bc increases contractility) Afib (bc decreases AV node conduction and depresses SA node) ```
253
poor prognostic indicator of digoxin tox
hyperkalemia
254
factors predisp to digoxin tox
hypokalemia quinidine, verapamil (displaces digoxin binding from tissue binding sites --> decreased excretion) renal failure (decreases excretion)
255
increased markers in NTD
AFP | AChE (confirmatory)
256
ass w/ Chiari I malformation
syringomyelia
257
ass w/ Chiari II malformation
hydrocephalus aqueductal stenosis thoracolumbar myelomeningocele common herniation!!
258
ass w/ Dandy Walker malformation
hydrocephalus spina bifida agenesis!!
259
causes of glossitis
``` B12 def riboflavin (B2) def Fe def niacin def (B3) ```
260
NE changes/synth in
increased in anxiety decreased in depression Locus ceruleus
261
dopamine changes/synth in
increased in schizophrenia decreased in depression, Parkinson's ventral tegmentum and SNc (midbrain)
262
serotonin (5-HT) changes/synth in
decreased in anxiety, depression Raphe nucleus (pons)
263
ACh changes/synth in
decreased in Alzheimer's, Huntington's increased in REM sleep, Parksinson's Basal nucleus of Meynert
264
GABA changes/synth in
decreased in anxiety, Huntington's Nucleus accumbens
265
BBB composed of
astrocyte foot process tight junctions BM
266
areas of brain w/o BBB
area postrema neurohypophysis OVLT (senses changes in osmolarity)
267
melatonin can inhibit the prod of
LH and FSH from ant pituitary
268
globus pallidus internus does what to movement
inhibits
269
globus pallidus externus does what to movement
facilitates
270
subthalamic nucleus does what to movement
inhibits
271
substantia nigra pars compacta does what to movement
facilitates
272
SNr does what to movement
inhibits
273
how does MPP cause Parkinson's
destroys dopaminergic cells in substantia nigra by inhib ETC @ complex 1
274
how does MPTP become MPP
MAO metabolism
275
cause of neuronal death in Huntington's
NMDA-recept binding and glutamate toxicity
276
drug that is metab to active phenobarbitol-like metabolite
primidone
277
intention tremor = dysfun in what area
cerebellar damage
278
hemiballismus = lesion where
contralateral STN
279
myoclonus = lesion where and is common in what conditions
nucleus ambiguus of medulla | w/ metabolic abnorm (like liver or renal failure)
280
lesion of hippocampus =
inability to make NEW memories (anterograde amnesia)
281
lesion of superior colliculus -->
parinaud's synd (paralysis of upward gaze)
282
conduction aphasia = damage to
arcuate fasciculus
283
ass w/ CN III palsy
PComm artery aneurysm
284
common causes of intraparenchymal hemorrhage
systemic HTN! amyloid angiopathy vasculitis neoplasm
285
genetic cause of ALS
defect in superoxide dismutase 1
286
tx for ALS/it's MOA
riluzole - decreases presynaptic glutamate release (can moderately increase survival)
287
nonbenzo hypnotics?
zolpidem zaleplon eszopiclone
288
CN III and vascular damage -->
motor dysfunct --> ptosis, down and out pupil
289
CN III compressive damage --->
parasymp dysfunct --> blown pupil (absent pupillary light reflex)
290
pie in the sky lesion
``` temporal lesion (MCA) aka Meyer's loop ```
291
pie on the floor lesion
``` parietal lesion (MCA) aka dorsal optic radiation ```
292
right homonymous hemianopia
left optic TRACT lesion | **switch for left
293
left anopia
right optic NERVE lesion | **switch for right
294
butorphanol MOA/uses
MOA - mu-partial agonist; kappa full agonist | uses - severe pain
295
tramadol MOA/uses
weak opioid agonist; inhib serotonin + 5-HT reuptake | use - chronic pain
296
tolerance does not develop to which opioid SE
constipation | miosis
297
1st line prophylaxis of status epilepticus
phenytoin
298
1st line for simple, complex, tonic-clonic seizures
carbamazepine
299
1st line for trigeminal neuralgia
carbamazepine
300
DOC for partial seizures
lamotrigine
301
1st line for seizures in children
phenobarbitol
302
valproic acid MOA
blocks NMDA receptors | increases GABA conc by inhib breakdown + increasing synth
303
1st line for acute status epilepticus + eclampsia seizures
diazepam, lorazepam
304
1st line for eclampsia seizures
MgSO4
305
phenytoin blood SE
megaloblastic anemia by decreasing folate absorption (bc of inhib of intestinal conjugase)
306
CI for barbiturate use
acute intermittant porphyria
307
osteoclasts stain positive for what + req what 2 signals
TRAP positive | M-CSF + RANK-L signals
308
substance that can cause morphine tolerance + what can block it?
glutamate (NMDA activation) | ketamine can block
309
complex regional pain syndrome type I vs. II
type I - NO evidence of nerve damage; severe, burning pain, muscle spasm, joint stiffness, restricted mobility, vasospasm, increased hair growth type II - evidence of nerve damage
310
early detection of diabetic nephropathy =
check for microalbuminemia
311
oral ulcers can be seen in what dz?
pemphigus vulgaris paraneoplastic pemphigus Behcet dz Crohn's dz
312
examples of flat bones
skull sternum bones of pelvis
313
most common location of hematogenous osteomyelitis in adults
vertebral body **also same location for Pott's dz
314
classic findings in multiple myeloma
- easy fatiguability (from anemia) - constipation (from hypercalcemia) - bone pain in back and ribs usually (from production of osteoclast activating factor by myeloma cells and subseq bone lysis) - renal failure
315
dz found in metaphysis of long bone
osteochondroma osteosarcoma osteomyelitis in children
316
dz found in epiphysis of long bone
giant cell tumor (osteoclastoma)
317
dz found in diaphysis of long bone
Ewing sarcoma | chondrosarcoma (w/in medullary cavity)
318
DI dx w/ urine specific gravity <
1.006
319
systolic dysfunction
DCM
320
diastolic dysfunction
HCM (due to LV rigidity) | RCM
321
GI drug CI in pts w/ Parkinson or SI obstruction
metoclopramide
322
estrogen deficiency can lead to:
- atrophied vagina - infertility - breast atrophy - osteopenia
323
types of substances that CAN'T cross placenta
water-solube (like conjugated bilirubin, heparin)
324
types of substances that can cross placenta
lipophilic substances (like unconj bilirubin, warfarin)
325
smoking cessation ass w/ what effects?
- prolong life expectancy - decreases risk of MI, cerebrovascular injury, lung cancer - slows rate of pulm function loss
326
EDS = problem w/ what enzyme
lysyl oxidase (contains Copper)
327
macrolide resistance
methylation of 23S rRNA binding site
328
aminoglycoside resistance
transferase enzymes that inactivate drug by acetylation, phosphorylation, or adenylation
329
chloramphenicol resistance
plasmid-encoded acetyltransferase that inactivates drug
330
step in urea cycle that forms urea
hydrolyzation of L-arginine by arginase to ornithine and urea; ornithine transported back to mitochondria to restart
331
Bloom synd defect?
mut in DNA helicase
332
hyperestrogenemia causes?
``` spider angiomas (telangiectasias) palmar erythema gynecomastia testicular atrophy decreased body hair Dupuytren's contractures ```
333
Kayser-Fleisher rings located in what part of eye?
cornea
334
Lisch nodules of NF1 located in what part of eye?
iris
335
retinal lesions caused by what diseases?
DM HTN pseudoxanthoma elasticum Tay-Sachs disease
336
osteogenesis imperfecta involves what part of eye?
sclerae
337
different retinoid meds
``` isotretinoin acetretin tretinoin adapalene tazarotene ```
338
"sputum eosinophils" think:
asthma
339
most common cause of death w/ HCM
Vfib
340
most common cause of death w/ RCM
CHF
341
AA w/ 3 titratable protons
``` His Arg Lys Asp Glu Cys Tyr ```
342
tx for hemorrhagic cystitis (if already occurring)
N-acetylcysteine
343
magenta-colored tongue =
vit B2 deficiency
344
burnt almonds smell?
cyanide poisoning
345
dimorphic fungi
``` Sporothrix schenkii Blastomyces Paracoccidioides Coccidioides Histoplasma ``` molds @ 25-30C yeast @ 35-37C
346
DOC for toxoplasmosis
pyrimethamine and sulfadiazine
347
Reactive arthritis seen after infection w/ what 6 bugs?
``` Campylobacter Shigella Salmonella Yersinia Chlamydia Bartonella ```
348
tx for acute mania
mood stabilizer (lithium, carbamazepine, valproate) + atypical antipsych (olanzapine usually)
349
findings highly ass w/ ankylosing spondylitis
- enthesopathies (inflamm @ site of insertion of tendons into bone) - pain can limit chest wall expansion --> causes hypoventilation (monitor chest wall!!) - ascending aortitis --> dilation of aortic ring and aortic insuff - anterior uveitis in 20-30%
350
source of N in urea cycle?
aspartate
351
function of prokaryotic 16S rRNA
contains seq complimentary to Shine Dalgarno seq on mRNA --> necessary for initiation of protein synth
352
3'-->5' DNA exonuclease activity
proofreading + removal of mismatched nucleotides
353
K-ATP channel regulatory substance in pancreatic beta-cells
ATP
354
mRNA translation regulation/degradation depends on?
cytoplasmic P bodies
355
essential activator of CPS1 + substrates formed from?
N-acetylglutamate | precursors = acetyl-CoA + glutamate
356
babies exclusively breast-fed req supplementation of what vit?
vit K and D
357
BH4 = cofactor in?
dopamine serotonin tyrosine NO
358
SSPE caused by measles virus due to lack of Ab to what?
M-component of virus
359
common cause of death in PCP toxicity?
trauma
360
most common non-nuclear DNA found in eukaryotic cells?
mtDNA
361
common cause of death in diphtheria infection?
cardiomyopathy
362
1st thing to do in acute diphtheria infection?
admin passive immunization (diphtheria antitoxin)
363
1st line tx for acute gout
NSAIDS | 2nd line = colchicine; then GC
364
increased # of trinucleotide repeats in Fragile X synd leads to?
hypermethylation of FMR1 gene --> inactivation
365
inhaled anesthetic solubility correlates to?
blood/gas partition coefficient
366
inhaled anesthetic potency correlates to?
MAC
367
clearance of inhaled anesthetic usually by
exhalation through lungs
368
parvovirus B19 replicates in?
bone marrow
369
MOA of pentazocine
opioid narcotic w/ partial agonist activity and weak antag activity @ mu receptors
370
pentazocine SE
withdrawal symptoms in pts dependent on or tolerant to opioids
371
gastric ulcers form because of?
lack/destruction of mucosal layer
372
duodenal ulcers form bc of?
increased acid production
373
UMN lesion sites =
- CS tract - medulla, pons, midbrain - internal capsule - precentral gyrus (primary motor cortex)
374
alpha-receptors _______ insulin secretion?
inhibit
375
beta-receptors _______ insulin secretion?
stimulates
376
NADPH used in?
- anabolic processes (steroid + FA synth) - resp burst - P-450 - glutathione reductase
377
what inhibits glucokinase activity
F-6-P
378
what inhibits hexokinase activity
G-6-P
379
stim/inhib of pyruvate kinase?
stim by: F-1,6-BP | inhib by: ATP, alanine
380
LDH pathway impt in?
``` RBC leukocytes kidney medulla lens testes cornea ```
381
Chlamydia cell wall lacks _________? It also uses an EXTERNAL __________ bc ________?
lacks peptidoglycan; | uses external ATP source bc they're obligate intracellular organisms
382
OTC deficiency unique in that it's inheritance is?
X-linked recessive (vs. most other urea cycle enzyme defects which are AR)
383
OTC stimulated by what vitamin?
biotin
384
tyrosine can form what 2 substances?
Dopa | thyroxine
385
tyrosinase activity on Dopa produces?
melanin
386
Tay-Sachs histo?
lysosomes w/ onion skin
387
Niemann-Pick histo?
foam cells
388
Gaucher disease histo + unique feature?
Gaucher's cells (macrophages w/ cytoplasmic fibrils) - look like crumpled tissue paper unique - bone crises
389
Krabbe disease histo + unique feature?
globoid cells | unique - optic atrophy
390
FA synth starting substrate?
citrate
391
FA synth req what vitamin?
biotin (for acetyl-CoA --> malonyl-CoA)
392
what inhibits acyl-CoA translocation from cytoplasm to mitochondrial matrix?
malonyl-CoA
393
injections in superomedial part of buttock injure what?
gluteal nerves
394
injections in inferomedial part of buttock injure what?
sciatic nerve
395
serotonin-releasing neurons
raphe nucleus (in brainstem)
396
NE-secreting neurons
nucleus ceruleus (in dorsal pons)

USMLE Step 1 Random Facts (35 decks)

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