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USMLE Step 1 > General Principles > Flashcards

General Principles Flashcards

1
Q

What are the histological characteristics of apoptosis?

A

Cell with hyperchromatic, fragmented nuclei and small, discrete blebs containing cytoplasm and nuclear fragments

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2
Q

What is amyloidosis?

A

Liver produces serum amyloid-assoc protein in response to systemic inflammation (like in RA)

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3
Q

How does amyloidosis appear on histology?

A

Stains red w Congo red and exhibits apple-green birefringence upon polarization

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4
Q

What are histological characteristics of psammoma bodies? And what are they associated with?

A

laminated, concentric, calcific spherules

Papillary carcinoma of thyroid
Serous papillary cystadenocarcinoma of ovary
a
Meningioma
Malignant Mesothelioma
o
m
a
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5
Q

What is the clinical triad for hypertrophic osteoarthropathy (HOA)?

A

clubbing of the digits,
periostitis of the long (tubular) bones,
arthritis

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6
Q

What imaging can be used to help diagnose hypertrophic osteoarthropathy (HOA)?

A

CHEST X-RAY bc HOA is assoc w thoracic malignancy: bronchogenic carcinoma, lung cancer, mesothelioma, etc.

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7
Q

What is Sturge-Weber syndrome?

A 
port-wine Stain
Tram-track calcifications
Unilateral
Retardation
Glaucoma/Gnaq gene
Epilepsy
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8
Q

Which mycs are assoc w which diseases?

A 
N-myc = neuroblastoma
L-myc = small cell carcinoma of the lung
C-myc = Burkitt Lymphoma
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9
Q

Under which conditions would Central inappropriate ADH secretion occur?

A

head trauma or intracranial neoplasm

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10
Q

Which cell is responsible for wound contracture?

A

myofibroblasts

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11
Q

Which diseases are assoc with the following amyloid types:

AA, AF, AL, ACal, AB

A 
AA = acute phase rxn (inflamm)
AF = familial + old Fogies
AL = light chains + lymphoma
ACal = Calcitonin
AB = Alzheimers
ATTR = cardiac + old Fogies
Beta-2 = long term hemodialysis
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12
Q

What are symptom is likely to present with cardiac amyloidosis?

A

proteinuria

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13
Q

What disease should be suspected in woman 15-45 who presents with non-specific arthralgias, fatigue, and malaise?

A

Systemic lupus erythematosus

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14
Q

What type of genetic abnormality causes Tay-Sachs?

A

Frameshift mutation

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15
Q

What stain is used for hemochromatosis?

A

Prussian blue

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16
Q

What is desmoplasia?

A

Excessive fibrous tissue formation in stroma surrounding a tumor

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17
Q

What is the predisposition to Lynch Syndrome (hereditary nonpolyposis colorectal cancer (HNPCC))?

A

mutation in DNA mismatch repair

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18
Q

What are the hallmarks of Lynch Syndrome ( hereditary nonpolyposis colorectal cancer (HNPCC))?

A

3-2-1 rule: 3 relatives with Lynch syndrome– associated cancers across 2 generations, 1 of whom must be diagnosed before age 50 years.

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19
Q

What are the hallmarks of salicylate poisoning?

A

Early resp alkalosis (high pH, low pCO2, norm bicarb) –> mixed metabolic acidosis-resp alkalosis

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20
Q

What are the hallmarks of acetaminophen poisoning?

A

irreversible liver fail; metabolic acidosis (not resp alk)

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21
Q

What are the hallmarks of hydrochlorothiazide poisoning?

A

metabolic alkalosis (w resp comp) + hyper GLUC

  • Glycemia
  • Lipidemia
  • Uricemia
  • Calcemia
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22
Q

Familial breast cancer and ovarian cancer abnormality in tumor suppressor gene is on which chromosome?

A

17q

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23
Q

What are the causes of metabolic acidosis w normal anion gap?

A 
HARD-ASS:
Hyperalimentation
Addison disease
Renal tubular acidosis 
Diarrhea 
-
Acetazolamide 
Spironolactone 
Saline infusion
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24
Q

What are the causes of metabolic acidosis w increased anion gap?

A 
MUDPILES:
Methanol (formic acid) 
Uremia
Diabetic ketoacidosis 
Propylene glycol
Iron tablets or Isoniazid 
Lactic acidosis
Ethylene glycol (oxalic acid) 
Salicylates (late)
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25
When does one calculcate anion gap?
To find cause of metabolic acidosis?
26
What is the most common cause of metabolic acidosis w normal anion gap?
loss of bicarb thru diarrhea
27
What is contraction alkalosis?
Loss of ECF vol from brisk diuresis leads to increased conc of bicarb -loop diuretics cause salt and water to be lost but bicarb retained
28
What immunological factors mediate septic shock?
TNF from macros
29
Hyperventilation and feeling of faintness indicates a decrease in what?
Cerebral blood flow
30
Which substance is affected as a consequence of iodine def (cretinism)?
growth hormone
31
Describe the effect ECF osmolarity has on ICF vol.
Decrease ECF osm = expansion of ICF | Increase ECF osm = decrease ICF vol
32
How does one calculate interstitial fluid vol?
= ECF vol (inulin) - plasma vol (RIS Albumin)
33
Which factors cause a RIGHT shift in O2-Hb dissoc curve?
``` Right shift—ACE BATs right handed: Acid CO2 Exercise 2,3-BPG Altitude Temperature ``` Right shift = decreased affinity of Hb for O2
34
Which anti-histamine has minimal sedative effects and low anti-cholinergic effects?
Fexofenadine
35
Which drug is used to treat CML (bcr-abl[9;22]) and has side effects of fluid retention and edema?
Imatinib
36
Which immunosuppressant inhibits purine synthesis and interacts w allopurinol?
Azathioprine
37
What drug is associated with "gray baby" syndrome?
Chloramphenicol
38
What drug(s) is associated with fetal teeth issues?
tetracyclines
39
What drug is associated with fetal kernicterus?
TMP-SMX
40
What drug(s) is associated with fetal MSK issues?
fluoroquinolones
41
What drug(s) is associated with fetal ototoxicity?
Kanamycin, streptomycin
42
What drug is associated with fetal cleft palate?
clarithromycin
43
What drug is used for tinea corporis?
clotrimazole
44
What side effect of Metformin leads to increased anion gap?
Lactic acidosis
45
What is efficacy of a drug?
the ability of a drug to produce the desired effect
46
What is the MOA and indication for mycophenolate mofetil?
Inhibits purine synthesis (G) to prevent organ rejection
47
Which drug is used to treat AML by inhibiting DNA polymerase and causes leukopenia and anemia?
Cytarabine
48
Which antibiotic combos can be used to treat acute cholecystitis?
Cefo/metro piper/tazo amp/sulfba meropenem
49
What equation can be used to determine half life?
t/2 = (0.7 x Vd)/CL
50
What is the earliest symptoms for salicylate intox?
tinnitus
51
Which drugs are P450 inducers?
Chronic alcoholics Steal Phen-Phen and Never Refuse Greasy Carbs ``` Chronic alcohol use St. John’s wort Phenytoin Phenobarbital Nevirapine Rifampin Griseofulvin Carbamazepine ```
52
Which drugs are P450 substrates?
Always Think Wet Octopussy Anti-epileptics Theophylline Warfarin OCPs
53
Which drugs are P450 inhibitors?
AAA RACKS IN GQ Magazine ``` Acute alcohol abuse Ritonavir Amiodarone Cimetidine Ketoconazole Sulfonamides Isoniazid (INH) Grapefruit juice Quinidine Macrolides (except azithromycin) ```
54
Which drugs prevents organ rejection by preventing IL-2 via Calcineurin/cyclophilin w side effect of nephrotox?
cyclosporine
55
Whats the key difference between OD on stimulants v anti-cholinergics?
``` Stimulants = diaphoresis (sweating) anti-cholingergics = dry ```
56
What are the effects of anti-cholinergic toxicity?
``` “red as a beet, dry as a bone, mad as a hatter, blind as a bat and hot as a hare” ```
57
What kind of receptors or glutamate receptors?
ligand-gated and voltage-gated cation channel
58
What is the general guideline for steady-state plasma conc of a drug?
50% in 1 half-life 75% in 2 half-lives 87.5% in 3 half-lives
59
Which drug attacks guanine to cause DNA crosslinking, thereby causing hemorrhagic cystitis?
cyclophosphamide
60
Which anti-depressant can cause priapism?
Trazodone
61
Daclizumab is used for renal transplants via what MOA?
Monoclonal antibodies that block IL-2R.
62
What is serum sickness and its hallmarks?
Type III hypersensitivity in which antibodies to foreign proteins are produced Keys: Fever, urticaria, arthralgia, proteinuria, lymphadenopathy occur 5–10 days
63
Tx for serum sickness?
antihistamine + corticosteroids
64
Which second messenger do ANP receptors stimulate?
Guanylyl cyclase (cGMP)
65
Where should primers be positioned for PCR?
3' end on both strands of the DNA sequence of interest
66
Thiamine (B1) is a cofactor for which 4 enzymes?
BAT-P! Branched-chain ketoacid dehydrogenase Alpha-ketoglutarate dehydrogenase Transketolase Pyruvate dehydrogenase

USMLE Step 1 (13 decks)

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