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USMLE > Goljan High Yield > Flashcards

Goljan High Yield Flashcards

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USMLE® Step 1 flashcards
1
Q

Physiologic effects of hemorrhage

A

Drop in BP, activation in RAA, DEC renal blood flow, catecholamine stimulation, catecholamine release from high pressure baroreceptors, tachycardia, stimulation of JG apparatus (venoconstriction), INC ADH

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2
Q

Opportunistic infections of AIDS 8

A

PCP, CMV, Cryptococcus, MAI, TB, Herpes (esophagitis), Candida, (Thrush, esophagitis, vulvogaginitis - T cell candida are superficial, not systemic (N!), Cryptosporidium (acid fast; diarrhea)

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3
Q

Cocaine

A

CNS Stimulant, DEC uptake of DOPA, NOR

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4
Q

Serum protein electrophoresis - polyclonal vs monoclonal

A

Polyclonal - chronic inflam. Monoclonal - one clone of plasma cell, MGUS is most common cause

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5
Q

Abscence of Y chromosomes

A

germinal ridge moves in direction of ovarian differentiation, presence of Y chromosome -> testes differentiation

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6
Q

UVB light. Action and causes

A

Thymidine dimers. If not replaced by normal DNAw/ repair enzymes -> CA (Basal, squam, melanom)

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7
Q

ESR related to age?

A

INC w/ age. Probably abnormal (indicates disease process rather than just age related)

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8
Q

Key elements in wound healing

A

granulation tissue, fibronectin

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9
Q

Cause of death in 15-25 age bracket

A

MVA. Black males - homicide

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10
Q

Xeroderma pigmentosum

A

AR disease w/ absent DNA repair enzymes and INC indidence of UVB related skin CA

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11
Q

Cytochrome oxidase - Inhibited by?

A

Last enzyme in electron transport chain - inhibited by CO and cyanide

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12
Q

Chronic granulomatous disease of childhood

A

SXR diseae, absent NADPH oxidase, absent respiratory burst, cant kill catalase positive S. aureus but can kill catalse negative sterptococci

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13
Q

Cause of atrophyi n muscle in a cast?

A

Lack of muscle stimulation

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14
Q

Mosaicism

A

Non-disjunction in somatic cells

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15
Q

How to calculate the reference interval of a test when given mean of test and 1 SD

A

Double SD - since 2 SD covering 95% of population is used

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16
Q

Mitochondria inheritance patterns

A

Mom give disease to all kids. Her son gives none to his kids

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17
Q

Vitamin deficiency in acloholics

A

Folate

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18
Q

Metal deficiency in alcoholics

A

magnesium

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19
Q

Viatamin assoc w/ pyruvate dehydrogenase

A

thiamine

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20
Q

Ambiguous genitalia - what to do?

A

Always determine genetic sex of a child

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21
Q

Respiratory burst. Found where?

A

NADPH oxidase conversion of O2 to superoxide free radicals. Found in N! and monocytes only

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22
Q

Caisson disease- blood gas?

A

Pressure N2 DEC in blood, as it moves from vessels into tissue

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23
Q

Clear Cell AdenoCA of vagina risk

A

DES exposure. Vaginal adenosis is precursor (persistence of upper 1/3 of vagina (columnar) - did not differentiate into squamous

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24
Q

What happens to other kidney if one is damaged?

A

Undergoes hypertrophy

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25
Q

Vit E toxicity

A

DEC Vit K dependent factors and thus INC risk of hemorrhagic strokes - potentiates action of Warfarin

26
Q

Biotin reaction (B7)

A

carboxylase reaction in conversion of pyruvate to oxaloacetate

27
Q

Cherry red macula

A

Tay sach disease

28
Q

Pyridoxine (B6)

A

Transamination rx involving AST/ALT. Also needed for Heme creation (ALAS, ALAD)

29
Q

Functions of ANP

A

inhibits ADH release, AT2 affects on thirst stimulation, inhibits aldosterone secretion, inhibits renal reabs of Na

30
Q

Chance of a male w/ CF having a kid

A

Less tahn 5%. Vas deferens never fully develop or are atretic. Females w/ CF can be pregnant but it is difficult due to thick cervical mucus

31
Q

Vitamin supplements for CF?

A

All fat soluble vitamins

32
Q

Woman is pure vegan and is breats feeding baby and baby develops anemia. Why?

A

B12 deficiency

33
Q

EBV attaches to waht moleecule on B cell?

A

B21

34
Q

Hypogonadism, MR, and unilateral gynecomastia

A

Klinefelter syndrome (XYY) - males

35
Q

Hypogonadism and color blindness

A

Kallman syndrome (absent GnRH

36
Q

Hypogonadism, MR, Retinitis pigmentosum

A

Laurence-Moon-Biedl Syndrome

37
Q

Male w/ hypogonadism, MR, short stature, webbed neck

A

Noonan syndrome - AD - can be in males of females. (similar to male version of Turner-45x),

38
Q

Male pseudohermaphrodite w/ cryptorchidism

A

Testicular feminization (absent androgen receptors, SXR (sex reversal XX -> male), most common cause of male pseudohermaphroditism

39
Q

Microdeletion syndrome w/ hypogonadism, MR, short stature, obesity

A

Prader Willi syndrome (Chr15 deletion of paternal origin - can occur in females and males). Angelman syndrome is deletion is of maternal origin

40
Q

Pt. w/ neurofibromatosis w/ severe diastolic HTN

A

Probably Pheo. MEN3

41
Q

Use and Complications of cyclophosphamide

A

Alkylating drug for chemo. Hemorrhagic cystitis and transitional CA of bladder

42
Q

Decline in deaths due to SIDS attributed to

A

Having baby sleep supine. SIDS often due to immature central chemoreceptors which do not respond to reespiratory acidosis by moving their heads and die

43
Q

Most important risk factors for INC morbidity/mortality of single 25 black male

A

Unprotected sex (AIDS is number 1 killer) , white males - MVA

44
Q

Car assembly plant present w/ headache nausea vomiting, muscle weakness, ab cramps

A

Lead poisoning from incineration of battery. Or People making moonshine in an old car radiator.

45
Q

Newborn female presents w/ edema of hands and feet and cystic mass in neck

A

Turners Syndrome w/ 45XO karyotype

46
Q

Compare breast milk to cows milk

A

Cows milk has more vitamin K, B12, more casein, less ascorbic acid. Breast milk has low iron but it is better absorbed. Whey is primary protein in breast milk, wherears casein is in cows

47
Q

UV light most likely to produce corneal burn

A

UVB - snow skiing. UVB also related to CA (UV-Bad)

48
Q

Retinal hemorrhage in young children

A

Possible child abuse - shaking syndrome

49
Q

Pt stung by bee and has respiratory difficulty, flushing, ab cramping - Tx?

A

Aqueous Epinephrine 1:1000 sc.

50
Q

Fire ant bites

A

multiple wheals that later devo into vesicles, and pustules

51
Q

Black widow bite (carrying logs outside, moving boxes in basement

A

painful bite that is followed by crampy pain in thighs and ab. Rx w/ muscle relaxant (Calcium gluconate), tetanus prophylaxis, antivenin in severe cases.

52
Q

Poisonous scorption sting in Southwest presentation

A

pain sting followed by local itching, paresthesia, nausea, vomiting, HTN

53
Q

Brown Reculuse spider bite

A

PAINLESS BITE begins w/ slightly tender red papule on arm that laters forms hemorrhagic blister surrounded by purpura

54
Q

Chigger bites

A

extremely pruritic, discrete bright red papules on legs and around waist

55
Q

Child who ingests 30 adult aspirins most likely to devo

A

INC anion gap metabolic acidosis (kids unlike adults, do not devo mixed metabolic acidosis and respiratory alkalosis. Rx - gastric lavage and activated charcol to alkalinize urine for INC excretion of the acid

56
Q

Disease to more likely infect fetus AFTER first trimester?

A

syphilis

57
Q

Engineer driving train involved w/ crash has THC metabolites in urine - why?

A

Delayed reaction time, impaired ability to judge speed/distance

58
Q

Angiosarcoma of liver - causes?

A

Vinyl chloride, arsenic, thorotrast (radiocontrast used in the 40s)

59
Q

Acetaminophen tox - worry about where?

A

Liver and kidney (renal medulla), free radical injury. Tx Liver w/ n-acetylcysteine

60
Q

Low AFP - be concerned for?

A

Downs syndrome

USMLE (16 decks)

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