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USMLE Step 1 > General Principles > Flashcards

General Principles Flashcards

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USMLE® Step 1 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
Q

When does one calculcate anion gap?

A

To find cause of metabolic acidosis?

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26
Q

What is the most common cause of metabolic acidosis w normal anion gap?

A

loss of bicarb thru diarrhea

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27
Q

What is contraction alkalosis?

A

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
Q

What immunological factors mediate septic shock?

A

TNF from macros

29
Q

Hyperventilation and feeling of faintness indicates a decrease in what?

A

Cerebral blood flow

30
Q

Which substance is affected as a consequence of iodine def (cretinism)?

A

growth hormone

31
Q

Describe the effect ECF osmolarity has on ICF vol.

A

Decrease ECF osm = expansion of ICF

Increase ECF osm = decrease ICF vol

32
Q

How does one calculate interstitial fluid vol?

A

= ECF vol (inulin) - plasma vol (RIS Albumin)

33
Q

Which factors cause a RIGHT shift in O2-Hb dissoc curve?

A 
Right shift—ACE BATs right handed: 
Acid
CO2 
Exercise 
2,3-BPG 
Altitude 
Temperature

Right shift = decreased affinity of Hb for O2

34
Q

Which anti-histamine has minimal sedative effects and low anti-cholinergic effects?

A

Fexofenadine

35
Q

Which drug is used to treat CML (bcr-abl[9;22]) and has side effects of fluid retention and edema?

A

Imatinib

36
Q

Which immunosuppressant inhibits purine synthesis and interacts w allopurinol?

A

Azathioprine

37
Q

What drug is associated with “gray baby” syndrome?

A

Chloramphenicol

38
Q

What drug(s) is associated with fetal teeth issues?

A

tetracyclines

39
Q

What drug is associated with fetal kernicterus?

A

TMP-SMX

40
Q

What drug(s) is associated with fetal MSK issues?

A

fluoroquinolones

41
Q

What drug(s) is associated with fetal ototoxicity?

A

Kanamycin, streptomycin

42
Q

What drug is associated with fetal cleft palate?

A

clarithromycin

43
Q

What drug is used for tinea corporis?

A

clotrimazole

44
Q

What side effect of Metformin leads to increased anion gap?

A

Lactic acidosis

45
Q

What is efficacy of a drug?

A

the ability of a drug to produce the desired effect

46
Q

What is the MOA and indication for mycophenolate mofetil?

A

Inhibits purine synthesis (G) to prevent organ rejection

47
Q

Which drug is used to treat AML by inhibiting DNA polymerase and causes leukopenia and anemia?

A

Cytarabine

48
Q

Which antibiotic combos can be used to treat acute cholecystitis?

A

Cefo/metro
piper/tazo
amp/sulfba
meropenem

49
Q

What equation can be used to determine half life?

A

t/2 = (0.7 x Vd)/CL

50
Q

What is the earliest symptoms for salicylate intox?

A

tinnitus

51
Q

Which drugs are P450 inducers?

A

Chronic alcoholics Steal Phen-Phen and Never Refuse Greasy Carbs

Chronic alcohol use 
St. John’s wort 
Phenytoin 
Phenobarbital 
Nevirapine 
Rifampin 
Griseofulvin 
Carbamazepine
52
Q

Which drugs are P450 substrates?

A

Always Think Wet Octopussy

Anti-epileptics
Theophylline
Warfarin
OCPs

53
Q

Which drugs are P450 inhibitors?

A

AAA RACKS IN GQ Magazine

Acute alcohol abuse 
Ritonavir 
Amiodarone 
Cimetidine 
Ketoconazole 
Sulfonamides 
Isoniazid (INH) 
Grapefruit juice 
Quinidine 
Macrolides (except azithromycin)
54
Q

Which drugs prevents organ rejection by preventing IL-2 via Calcineurin/cyclophilin w side effect of nephrotox?

A

cyclosporine

55
Q

Whats the key difference between OD on stimulants v anti-cholinergics?

A 
Stimulants = diaphoresis (sweating)
anti-cholingergics = dry
56
Q

What are the effects of anti-cholinergic toxicity?

A 
“red as a beet,
dry as a bone, 
mad as a hatter, 
blind as a bat and 
hot as a hare”
57
Q

What kind of receptors or glutamate receptors?

A

ligand-gated and voltage-gated cation channel

58
Q

What is the general guideline for steady-state plasma conc of a drug?

A

50% in 1 half-life
75% in 2 half-lives
87.5% in 3 half-lives

59
Q

Which drug attacks guanine to cause DNA crosslinking, thereby causing hemorrhagic cystitis?

A

cyclophosphamide

60
Q

Which anti-depressant can cause priapism?

A

Trazodone

61
Q

Daclizumab is used for renal transplants via what MOA?

A

Monoclonal antibodies that block IL-2R.

62
Q

What is serum sickness and its hallmarks?

A

Type III hypersensitivity in which antibodies to foreign proteins are produced

Keys: Fever, urticaria, arthralgia, proteinuria, lymphadenopathy occur 5–10 days

63
Q

Tx for serum sickness?

A

antihistamine + corticosteroids

64
Q

Which second messenger do ANP receptors stimulate?

A

Guanylyl cyclase (cGMP)

65
Q

Where should primers be positioned for PCR?

A

3’ end on both strands of the DNA sequence of interest

66
Q

Thiamine (B1) is a cofactor for which 4 enzymes?

A

BAT-P!

Branched-chain ketoacid dehydrogenase
Alpha-ketoglutarate dehydrogenase
Transketolase
Pyruvate dehydrogenase

USMLE Step 1 (13 decks)

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