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USMLE Step 1 > High Yield > Flashcards

High Yield Flashcards

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USMLE® Step 1 flashcards
1
Q

Physiological effects of hemorrhage

A

drop in BP, activates RAAS, catecholamine stimulation from baroreceptors= increase cardiac contraction, increased peripheral resistance, stimulation of JG apparatus

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2
Q

Does ESR increase with age?

A

Yes, but slightly, not a large amount

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3
Q

Key elements in wound healing

A

granulation tissue and fibronectin

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4
Q

In Caisson disease, what is decreased when diver comes up from a depth?

A

PN2 in blood, forms bubbles and moves into tissue

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5
Q

What happens to other kidney if one undergoes damage

A

Hypertrophy!

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6
Q

Vitamin E toxicity

A

decrease levels of Vitamin K dep factors= increase hemorrhagic strokes, Increase Warfarin action= more bleeding

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7
Q

Chance of male with cystic fibrosis having a child

A

<5%, since vas deferens dont fully develop/atresia. Female with CF can get pregnant, but difficult with thickened mucus for sperm to penetrate

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8
Q

Woman is pure vegan and breastfeeding, baby gets anemia

A

Vit B12

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9
Q

Hypogonadism, Mental Retardation, Retinitis Pigmentosum

A

Laurence-Moon-Biedl

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10
Q

Male with hypogonadism, mental retardation, short stature, webbed neck

A

Noonan syndrome (similar to Turners)

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11
Q

Patient with NF has high diastolic HTN

A

pheochromocytoma

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12
Q

Complications of cyclophosphamide

A

hemorrhagic cystitis, transitional renal cell cancer

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13
Q

decline in SIDS attributed to

A

having baby sleep supine (if sleep facing down then rebreathe own CO2 and with immature central chemoreceptors- do not respond to respiratory acidosis and die)

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14
Q

Employees from car assembly plant with headache, nausea, vomiting, abdominal pain

A

Lead poisoning

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15
Q

Breast Milk Vs Cows Milk. What is missing in colostrum? Goat milk switch causes anemia in baby?

A

Colustrum lacks Vitamin D. Cows milk also has more vitamin K and more B12, more casein.
Goat Milk- low in folate, B6, iron

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16
Q

Crampy pain in thighs after a painful bite when moving some logs from outside.

A

Black widow bite

Rx; muscle relaxant (calcium gluconate), tetanus prophylaxis

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17
Q

painless bite with red papular lesion, that forms a HEMORRHAGIC blister

A

Brown recluse spider

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18
Q

very itchy discrete red papules on leg and waist

A

Chigger bite

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19
Q

Child vs adult with aspirin OD

A

child develops anion gap metabolic acidosis, not a mixed picture like in adults.
Tx: gastric lavage, activated CHARCOAL, alkalnize urine

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20
Q

disease that can infect fetus AFTER first trimester

A

syphilis

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21
Q

CAH deficiency= male pseudohermaphrodite

A

17-OH def (cant push to the androgen synthesis)

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22
Q

CAH deficiency= female pseudohermaphrodite

A

21OH and 11 OH, both make more androgens

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23
Q

Age related changes in lung

A

resemble obstructive lung disease= overinflation, decreased elasticity, decreased FEV-1

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24
Q

Immune changes with age

A

increased CD4, decrease CD8, more autoantibodies

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25
Q

Increased cross bridging of collagen

A

can be seen with increased age

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26
Q

Gynecomastia, hyperthyrodism in a patient with a trophoblastic tumor

A

BHCG can act as LH and TSH!

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27
Q

Bombesin and Neuron Specific enolase marker of

A

Small cell carcinoma of lung, neuroblastoma

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28
Q

LDH may be a marker of

A

Hodgkins Disease

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29
Q

EM zebra bodies in lysosomes

A

Niemann Pick

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30
Q

How can primary hypothyroidism cause yellowing of eyes?

A

Thyroxine is a cofactor for conversion of B carotenes into retinoic acid in intestine

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31
Q

cerebellar dysfunction, hemolytic anemia, hemorrhagic

A

Vitamin E deficiency (remember toxicity decreased Vit K coag factors)

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32
Q

avidin binds vitamin…deficiency of

A

biotin

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33
Q

neovascularization of cornea, magenta tongue, angular stomatitis

A

riboflavin deficiency (cant synthesize glutathione)

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34
Q

element deficiency which is associated with glucose intolerance and peripheral neuropathy

A

Chromium- part of glucose tolerance factor which increases insulin activity

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35
Q

microcytic anemia, skeletal abnormalities, skin depigmentation, aortic aneurysms

A

copper feficiency- cannot bind to transferrin (copper needed to get iron to 3+ to bind transferrin), defective collagen, defective tyrosinase, defective elastic tissue

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36
Q

growth retardation, poor wound healing, impaired cellular immunity. disease= acrodermatitis enteropathica

A

zinc (cofactor of superoxide dismutase, carbonic anhydrase, collageneases, RNA and DNA pol)

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37
Q

responsible for Fe3+ to Fe 2+/ met Hb to reduced Hb

A

Vitamin C

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38
Q

cyanosis not relieved by oxygen in a patient who came back from a camping trip

A

water has nitrites- oxidized iron to ferric= methemoglobinemia. Saturation of oxygen decreased, PaO2 would be normal.

Tx: methylene blue + vit C

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39
Q

raising the upper limit of a test

A

increase specificity, and PPV (think about it, if increase specificty, TN is better, so FP is lesser which is in the denominator of PPV)

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40
Q

mechanism of atresia in the bowel

A

apoptosis

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41
Q

HPV E6 and E7 products

A

E6 inhibits p53, E7 inhibits Rb

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42
Q

Normal karyotype in a child with Down Syndrome

A

Robertsonian translocation

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43
Q

Inducers of p450 and porphyrias

A

increase ALA synthase

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44
Q

Lipid most affected by fasting

A

Triglycerides, come from dietary chylomicrons

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45
Q

first sign of tissue ischemia

A

cell swelling due to inactive Na/K

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46
Q

Rejection within 3 months, Type 14, CD8 cells, parenchymal damage

A

Acute transplant rejection

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47
Q

RTA which is characterized by dysfunction aldosterone action. Also cannot regenererate bicarb= ph>5.5

A

Type 1= distal (normal anion gap metabolic acidosis)

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48
Q

Chromium and Nickel assoc with which cancers

A

Lung cancer mainly, nasal cavity cancer also

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49
Q

Benzene associated with which cancer

A

acute leukemia

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50
Q

Decreased ESR in which diseases

A

Sickle cell, polycythemia

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51
Q

How can CO poisoning look like Parkinsons

A

necrosis of the globus pallidus

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52
Q

O2 content equation

A

1.34(15=Hb)(Saturation) + PaO2

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53
Q

Dystrophic calcification

A

normal serum levels, but deposits= atherosclerosis, enzymatic fat necrosis (pancreas), periventricular calicifacations in CMV

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54
Q

Vessels in esophageal varices

A

Left gastric (systemic) and azygous veins

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55
Q

Cryptococcus- foci of infection and how spread

A

infection located in lung, hematogenous spread

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56
Q

unilateral gynecomastia in a pubertal boy

A

NORMAL!

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57
Q

3Hz spike wave acitvity on EEG

A

absence seizure

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58
Q

Right and Left Recurrent Laryngeal

A

Right- under right subclavian, left- under aortic arch

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59
Q

Effect of meryrapone

A

Blocks 11-hydroxylase, decreased cortisol as a result, increased ACTH

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60
Q

When is wall rupture most likely after Acute MI

A

3-7 days (MACROPHAGES)

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61
Q

key prognostic factor in Tet of Fallot

A

degree of pulmonary stenosis

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62
Q

Hepatocyte EM with black granules which disappear after 6 hours

A

Black granules= glycogen (fed state), broken down in fasting state

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63
Q

Why is urine purple colored in AIP?

A

Prophobilinogen accumulated, when oxidized by light= porphobilin

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64
Q

Hypertrichosis, decreased activity of uroporphyrinogen decarboxylase= increased excretion of uroprophyrin 1

A

Porphyria cutanea tarda

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65
Q

mechanism of acute pyelonephritis in females

A

vesicouretral reflex

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66
Q

Renal Artery stenosis- increase in which measure

A

Increased FF (GFR not affected until glomerular injury occurs, RBF decreased)

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67
Q

Black ulcers, related to ulcerative colitis

A

pyoderma gangrenosum= pseudomonas

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68
Q

More associated: crypt abscess with neutrophils, HLA B27, PSC, Colorectal Cancer , Pyoderma gangrenosum, LEAD PIPE appearance

A

Ulcerative Colitis

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69
Q

calcium oxalate stones in Crohns

A

absorption problem, excess calcium can precipitate

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70
Q

myxomatous connective tissue in valve due to increase in mucopolysaccharides

A

MVP (earliest valve lesion in Marfans)

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71
Q

treatment for recurrent ulcers

A

vagotomy

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72
Q

IV Drug user in prison, hepatitis type

A

Hep B

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73
Q

AIDS pt with acute cholecystitis

A

Cryptosporidium and CMV

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74
Q

TE fistula associated what problem

A

polyhydramnios

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75
Q

left radial pulse absent, unequal pulses in upper limmbs

A

aortic dissection

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76
Q

Wegeners vs Goodpastures

A

Both lead to RPGN, but Goodpastures- hemoptysis/hematuria, Wegeners- cANCA + upper airway/nasal involvement

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77
Q

Polyhydramnios associated with which conditions

A

TE fistula, anencephaly, Duodenal atresia

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78
Q

URI followed by epistaxis and petechiae

A

ITP (type 2 hypersensitivity- IgG against platelet Gp2b/3a

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79
Q

why do you bleed after rat poison ingestion

A

contains warfarin, need to give vitamin K

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80
Q

Negative charge of GBM due to

A

heparan sulfate

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81
Q

Child with rash and skin infiltrate, with CD1 positive cells

A

Histiocytosis (also S100)

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82
Q

Tx to prevent osteoporosis 1

1) previous total hystrectomy and bilateral sallpingo-oophorectomy
2) 35 yo with still menstruating
3) Post menopausal with ERA positive Bca

A

1) can give estrogen with or without progesterone
2) dont need to give estrogen
3) estrogen is contraindicated (give raloxifene!)

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83
Q

most common adult benign tumor

A

meningioma

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84
Q

crunching sound in neck and anterior chest in pt involved with a head on collision

A

esophagus rupture- air dissecting into tissue

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85
Q

most common location of osteomyelitis in bone due to vascularity

A

metaphyses

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86
Q

axillary freckling in a patient with HTN

A

neurofibramatosis (cafe au lait, pheo)

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87
Q

irregular paches of balding in child

A

trichotillomania (pull out hair)

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88
Q

patient with hyperpigmented spots on skin , when scratched become very itchy and red

A

urticaria pigmentosa- mast cells in lesion

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89
Q

Graves vs Factitious thyrotoxicosis

A

factitious wont have increased radio-iodine uptake

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90
Q

Tx of condyloma venereum

A

Podophyllin derivative

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91
Q

Tx of partner vs not with metronidazole

A

tx partner if Trichomoniasis, not if just bacterial vaginosis

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92
Q

Legionella treatment

A

erythromycin

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93
Q

short QT

A

hypercalcemia

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94
Q

U wave EKG

A

hypokalemia

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95
Q

most common cause of jaundice in first 24h of birth

A

ABO incompatibility (O mother with an A or B baby)= IgG Anti a and B

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96
Q

blocked endocervical glands with mucus

A

Nabothian cyst

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97
Q

glomerular spike on silver stain, HBV association, subepithelial deposits

A

Membranous nephropathy

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98
Q

Type 1 vs 2 MPGN

A

Type 1: subendothelial deposits, tram tracking, HCV relationship,

2- very low C3 due to C3 nephritic factor , with deposits in the GBM

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99
Q

Orbital cellulitis vs cavernous sinus thrombosis

A

cavernous sinus would also show papilledema, other CN (like CN V signs)

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100
Q

weight lifter with weakness in hand, numbness, absent pulse

A

thoracic outlet syndrome (compression of subclavian artery and brachial plexus)

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101
Q

sterile pyuria, and negative culture

A

renal TB!, also chlamydia

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102
Q

Neonatal pneumonia, afebrile, eosiniphilia, wheezing

A

C. trachomatis

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103
Q

what part of JG vein curve correlates with 1st heart sound

A

c wave (ventricular contraction starting with closure of tricuspid valve)

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104
Q

major site of water reabsorption in GI tract

A

Jejunum>Ileum>colon

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105
Q

What factors of opioids does tolerance not develop to

A

Miosis and constipation

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106
Q

HTN in young woman

A

birth control pills can increase synthesis of angiotensinogen from liver

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107
Q

What to use for arsenic poisoning?

A

Dimercaprol

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108
Q

multinucleated microglial cells

A

AIDS dementia

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109
Q

AV fistulas in bone, high output failure, serum will show only high ALP, risk of osteosarcom

A

Pagets

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110
Q

HLA DR 3 and 4

A

DM 1, Rheumatoid arthritis

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111
Q

type of Hodgkins where f>m

A

nodular sclerosing

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112
Q

PAS stain leukemia

A

ALL

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113
Q

suppression with higher dose dexamethasone

A

Pituitary cushings

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114
Q

xray with step ladder appearance and air/fluid levels

A

Small bowel obstruction

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115
Q

xray of baby with loops of bowel in pleural area

A

diaphragmatic hernia

116
Q

calcium oxalate stones (square with a X on it)

A

crohns disease, ethylene glycol, vit c toxicity

117
Q

hexagonal stone

A

cystinuria

118
Q

Etiology of

1) Achilles tendon xanthoma
2) Xanthalesma
3) Eruptive xanthoma

A

1) absent LDL receptor
2) absent LDL receptor/high LDL
3) increased TG/not assoc with atherosclerosis

119
Q

Pheo associations

A

NF, VHL, MEN 2a and 2b

120
Q

Homer Wright pseudorosettes

A

In children: neuroblastoma and medulloblastoma

121
Q

perivascular rosettes

A

Ependymoma

122
Q

increased gastrin with IV secretin

A

ZE syndrome

123
Q

tx of pericardial effusion

A

needle and suck it out

124
Q

Silo Fillers lung

A

nitrogen dioxide

125
Q

farmers lung

A

thermophilic actinomyecetes

126
Q

most common cause of fever 24h after a surgery, with elevated diaphragm

A

atelectasis

127
Q

baby breaks away from breast, cyanosis relieved by crying

A

choanal atresia (fetal blockage of nasal air pathway)

128
Q

pt with headache develops asthma

A

nasal polyps secondary to aspirin use

129
Q

leukoplakic lesions in mouth or genital region

A

biopsy to rule out squamous cell cancer

130
Q

chewing tobacco associated with

A

verrucoid squamous cancer of mouth

131
Q

squamous vs basal cell cancer location in mouth

A

lateral border of tongue and LOWER lip= squamous

Upper lip= basal

132
Q

bowel obstruction causes

A

likely due to adhesions from prev surgery

133
Q

Right vs Left colon cancer

A

Left= obstructing (anatomy= decreased lumen as go toward rectum), Right= bleed (largest diameter)

134
Q

PAS positive globules in hepatocytes, pan-acinar emphysema

A

Alpha antitrypsin def

135
Q

IUD associated with what gram + branching bacteria

A

actinomyces

136
Q

methylodopa toxicity

A

direct coombs positive hemolytic anemia and hepatitis

137
Q

CCL3, acetaminophen, and Amanita poisoning in liver

A

all in zone 3 (oxygen free radical injury mostly)

138
Q

most common renal stone

A

calcium oxalate

139
Q

intrahepatic cholestasis due to non-inflammatory cause

A

oral contraceptives= estrogen interferes with intrahepatic bile excretion
also anabolic steroids

140
Q

Renal papillary necrosis -4 causes

A

phenacetein, sickle cell, pyelonephritis, diabetes

141
Q

schiller duval bodies

A

yolk sac tumors

142
Q

At cervical os, post-coital bleeding, non neoplastic

A

cervical polyp

143
Q

death due to renal failure from extension into retroperitoneum and blockage of ureters

A

cervical cancer

144
Q

location where iprimary ovarian cancer can seed to , or blood can collect in ruptured ectopic pregnany, pus can drain from inferction

A

Pouch of Douglas (in front of rectum, behind uterus)

145
Q

ovarian tumor associated with pseudomyxoma peritonei

A

mucinous cystadenocarcinoma

146
Q

ovarian tumor with turner syndrome relation

A

dysgerminoma

147
Q

ovarian Fibroma, ascites, pleural effusion,

A

Meigs

148
Q

1) crystals of reinke

2) call exner bodies

A

1) Leydig cell tumor

2) Granulosa cell tumor

149
Q

methotrexate treatment for which repro cancer

A

choriocarcinoma (heavily mets to lung otherwise)

150
Q

low level of urine estriol in pregnancy

A

can indicate fetal, placental or maternal (liver) prob

151
Q

anti-insulinic hormone in pregnancy

A

human placental lactogen (may account for maternal diabetes)

152
Q

most cases of primary amenorrhea

A

constitutional delay- girl has secondary sex characteristics and and withdrawal bleeding with progesterone challenge vs Turners- who dont have good sex characteristics and high FSH/LH

if have good secondary characteristics, but no bleeding= check for imperfoate hymen/absent vagina

153
Q

Asherman syndrome

A

secondary amenorrhea due to stratum basalis removed with repeated D&C

154
Q

PAP smear findings

A

estrogen effect–> superficial squmous cell; progestrone–> intermediate squamous cells, and lack of both hormones: parabasal cells; SO: in pregnancy: intermediate squamous dominates and in non-pregnancy non-menopause: superficial squamous predominates. After menopause: 100% parabasal

155
Q

indicates good pap smear sampling

A

presence of endocervical cells

156
Q

Lewis abdy

A

no clinical significance

157
Q

Duffy antigen

A

receptor for P. vivax= protection from malaria~

158
Q

anti-I

A

IgM cold agglutin can be seen with M. pneumoniae and EBV

159
Q

abdys present in O blood

A

anti-A IgM, anti-B IgM AND anti-A and B IgG (igG can cross placenta- cause jaundice of newborn)

160
Q

viral risks post transfusion

A

HCV (1:3300)>HBV>HIV

161
Q

cryoprecipitate

A

has factor 8 (for hemophilia), fibrinogen (DIC)

162
Q

Febrile Transfusion reaction

A

patient has anti-HLA, so will lyse donor leukocytes which releases pyrogens, Type 2 hypersens

163
Q

most common cause of abnormal bleeding time

A

patient on aspirin- no TXA2 for platelet aggregation

164
Q

PT is a good test for liver synthetic function

A

Yes

165
Q

Femoral Heat aseptic necrosis

A

Legg-Perthe in child, elderly, corticosteroids, HbSS

166
Q

Osgood Schlatters

A

Inflammation of proximal tibial apophysis at insertion of patellar tendon

167
Q

Necrolytic migratory erythema

A

Glucagonoma

168
Q

Achlorhydria, Cholelithiasis, Diabetes Mellitus, Steatorrhea

A

Somatostatin (inhibiting gastin, CCK, secretin, GIP)

169
Q

acholrhydria, secretory diarrhea, hypokalemia, normal gap metabolic acidosis

A

VIPoma

170
Q

AD, triplet repeat, cannot release hand grip, cataracts, heart disease

A

Myotonic dystrophy

171
Q

CSF in guillain barre and MS

A

increased protein with no increase in cells (May see some increased lymphocytes in MS)

172
Q

benign positional vertigo

A

dislocation of otoliths, no nystagmus hearing loss- most common cause of recurring vertigo

173
Q

Secondary Hyper PTH (malabsorption vs renal failure)

A

In renal failure: hypocalcemia, hyperphosphate vs malabsorption where both are low

174
Q

cause of bilateral base crackles and dyspnea in pt with recent MI and S3 sound

A

increased backflow of blood= decreased lung compliance

175
Q

intrapleural vs atm pressure at FRC

A

Airway pressure is 0 with exact opposition of chest wall and lung, but intrapleural pressure is slightly negative at -5 about, allowing net air flow in for inspiration without using active energy

176
Q

tryptase increased in what situation

A

can be high in mast cell degranulation= anaphylaxis

177
Q

why is oxygen slightly lower in LA than in alveolar capillaries

A

account for venous admixture from bronchial circulation

178
Q

ABG difference between heroin overdose and COPD

A

in both, have hypoventilation, with respiratory acidosis. but in COPD, renal compensation would be apparent, ex: with a HCO3 of 35, in heroid OD acutely, bicarb still normal

179
Q

permanent vs transient central DI

A

permanent- hypothalamic, long term

180
Q

why would LV diastolic pressure would not be consistent with isolated mitral stenosis

A

in this case, blood isnt flowing to LV, so high PCWP doesnt equal LV diastolic pressure

181
Q

lab values in osteoporosis (primary)

A

normal PTH, calcium, phosphorus

182
Q

increased creatine kinase level in pt with fatigue and weight gain

A

hypothyroid myopathy

183
Q

what pathological processes can cause ANP/BNP release from ventricles

A

ventricle hypertrophy and volume overload

184
Q

what runs along the radial artery

A

median nerve

185
Q

proliferating cells in wallerian degeneration

A

schwann cells proliferate laying framework for regeneration by axon sprouts from proximal lesion site

186
Q

hip flexion- muscle, nerve

A

iliopsoas, FEMORAL nerve

187
Q

Knee flexion

A

Hamstrings= semitendinosus, semimembranosus, biceps femoris, Sciatic nerve

188
Q

Knee extension

A

quadriceps femoris= femoral nerve

189
Q

cant flex elbow or supinate

A

musculocutaneous nerve

190
Q

nerve injuresd in midshaft of humerus

A

radial nerve

191
Q

patient with BILATERAL lateral rectus palsy

A

likely increased intracranial pressure and papilledema

192
Q

paralysis of upward gaze in infant

A

secondary to stenosis of aqueduct = affects superior colliculus= Parinaud’s syndrome

193
Q

etiology of calcium oxalate stones in crohns

A

fat malabsorption due to poor bile acid absorption in terminal ileum. extra lipids bind calcium, so now oxalate is free and can cause stones

194
Q

common cause of multiple lobar hemorrhages in elderly

A

amyloid angiopathy (age, not Alzheimers assoc)

195
Q

patient has paralysis of oculomotor nerve after a heady injury

A

uncal herniation

196
Q

site of lipid digestion, absorption

A

digestion- duodenum, absorption- jejunum

197
Q

supracondylar fracture

A

injury to brachial artery and median nerve

198
Q

last airway structure with cilia

A

respiratory bronchiole

199
Q

CNIII palsy and UMN signs on opposite side

A

Weber (middle midbrain lesion)

200
Q

abnormal opening in diaphragm in infant, visceral content extend into chest cavity causing distress

A

Bochdalek Hernia

201
Q

why is cyclosporine needed for an identical twin transplant

A

still some diff in MHC sites due to crossover of chromosomes in meiosis

202
Q

cause of diarrhea in children

A

rotavirus

203
Q

acid labile picornavirus

A

rhinovirus (coxsackie, polio, enterovirus are acid stable)

204
Q

CD on both B and T cells

A

CD45

205
Q

viral RNA in lung, carried in rodents, ARDS, hemorrhage, renal failure

A

Hanta virus

206
Q

Larva in stool, not eggs

A

Strongyloides

207
Q

gram +, beta hemolysis, tumbling motility, placental transfer, UNPAST. CHEESE

A

liseria

208
Q

cold sx in spring and summer

A

adenovirus

209
Q

which live vaccine is given in AIDS

A

MMR

210
Q

Killed vaccines

A

RIP= rabies, injected influenza, salk polio

211
Q

egg allergy vaccine caution

A

mainly influenza, some risk with MMR

212
Q

HLA system coded on

A

chromosome 6

213
Q 
HLA A3
HLA B8
HLA B8 and DR3
HLA DR2
HLA DR4
A 
Hemachromatosis
Myasthenia gravis
Celiac
MS
RA
214
Q

number of glucose to build palmitic acid

A

16C needed, and each acetyl coa has 2 C. each glucose= 2 acetyl coa. so need 4 glucose

215
Q

dietary alteration in pt with pheo

A

decrease phe and tyrosine

216
Q

only in liver and pancreatic islet, High Km, High vmax, not inhibited by G6P

A

glucokinase

217
Q

why cant liver use ketone

A

liver cannot activate acetoacetate in mitochondria, requires succinyl coa

218
Q

change to which amino acid would affect movement on SPEP

  • remain at cathode
  • move to anode
A

= remain at cathode (+)- most acidic= glutamic acid

-go to anode (-)= arginine

219
Q

energy source for protein synthesis

A

GTP

220
Q

most common antibiotic used to prevent endocarditis in pts with valvular disease

A

amoxicillin

221
Q

chlorpromazine and arsenic color on skin

A

blue-gray color

222
Q

drug causing hair loss in woman

A

OCP- estrogen causes hair to remain at same stage of devpt

223
Q

elderly man on thiazides at risk of developing

A

gout

224
Q

antipsychotic drug requiring visual exam

A

thioridazine (reTinal), chlorpromazine (Corneal)= both are low potency

225
Q

drug for seizures causes nephrogenic DI

A

lithium

226
Q

congenital defect that is a variant of normal

A

PFO

227
Q

allosteric activator of gluconeogenesis

A

acetyl coA activates pyruvate carboxylase

228
Q

antibiotic implicated with serotonin syndrome

A

linezolid

229
Q

Class 1A
1B
1C
effect on phase 0, length of action potential

A

1A- intermediate effect, prolonged
1B- weak, shortened
1C- strong, no effect

230
Q

the 5 inhibitory effect of TCAs? which block likely to cause death?

A

block reuptake of serotonin and norepi= seizures, tremors
anti alpha1= hypotension
anti HI= sedation
anti- cholinergic- dryness, hot
anti -fast Na channel= arryhtmias, cardiac conduction problems. most likely cause of death

231
Q

test of comprehension vs test of concentration

A

comprehension- follow multistep commands

concentration- recite months backwards

232
Q

waiting 2 weeks between phenelzine and sertraline therapy

A

to decrease risk of serotonin syndrome, waiting for MAO to regenerate (from phenelzine) before starting the SSRI

233
Q

which drug when used without an antipsychotic in the depressed phase of bipolar can precipitate mania

A

TCA

234
Q

paraeneoplastic cerebellar deneration

A

considered paraneoplastic autoimmune trigger (can be from LUNG, breast, ovary cancer)

235
Q

RUQ pain after administration of an analgesic

A

biliary colic- morphine/opioid analgesics cause contraction of sphincter of Oddi

236
Q

poor wound healing, decreased hair, rash around mouth, eyes and anus

A

acrodermatitis enteropathica

Zinc deficiency

237
Q

acrodynia

A

peeling of fingertips- seen in Kawasaki disease and mercury poisoning

238
Q

cadmium poisoning

A

lung cancer, alveolar damage

  • renal tubular damage
  • osteoporosis and osteomalacia
239
Q

CD13/33+, PAS neg

A

AML

240
Q

lymphoma associated with MALT, Sjogren, Hashimotos, and H.pylori

A

Marginal Cell (NHL)

241
Q

vitamin associated with increased risk of lung cancer in smokers

A

vitamin A

242
Q

bile acids which form micelles with dietary fats

A

conjugated (glycine and taurine)

243
Q

convusions, peripheral neuropathy, blindness, globoid cells

A

krabbe

244
Q

angiokeratoma, kidney/heart failure

A

Fabry (alpha galactosidase)

245
Q

allosteric inhibitor of B oxidation

A

malonyl coA

246
Q

Human Polymerases

1) Delta
2) Alpha
3) Beta, Epsilon
4) Gamma

spells out DABEY

A

major DNA pol in humans

1) Leading strand + helicase, no proofreading or exonuclease
2) Lagging Strand + Primase
3) DNA repair
4) Y= mitochondrial

247
Q

Boy with increased facial hair and impaired vertical gaze

A

Pinealoma, likely germinoma secreting b-hcg and causing parinaud syndrome

248
Q

patient with difficulty balancing and speaking with increased liver transaminases

A

Wilsons disease, do Slit lamp for Kayser Fleischer,

note that MRI showing atrophy is not specific for the disease

249
Q

most common cause of death with lightening

A

cardiac arrhythmia

250
Q

patient with hematemisis and liver failure signs is confused

A

hepatic encephalopathy is caused by failure to generate urea. Hematemisis= losing blood,and acid also would precipitate increased load of nitrogenous substances absorbed in the gut

251
Q

most common cardiac anomaly predisposing to native valve bacterial endocarditis

A

mitral valve prolapse

252
Q

viruses that produces a polyprotein product from single mRNA

A

echovirus (picornavirus family)

usually single stranded, positive sense

253
Q

what urinary value correlates with metabolic alkalosis?

A

urine cl
-if have increased loss of acid, decreased serum Cl, and thus a decrease in urine cl
however metabolic alkalosis could also be for example with diuretic use which decreases Na reabsorption/and cl and thus increases HCo3- to maintain electoneutrality

254
Q

cold water vs hot water nystagmus

A

COWS

  • cold- opposite side nystagmus
  • warm- same side
255
Q

what will erythrocytes produce when there is tissue ischemia

A

2,3 BPG- to release more O2

256
Q

Phage infection of a single E. coli, phages released. One of these particles contain fragment of E.coli. Will this phage be able to inject DNA and how many particles produced?

A

Phage will be able to inject DNA, but progeny wont be produced

257
Q

successive cleavage vs successive phosphorylations for activation

A

cleavage: coag pathway
phosph: G protein

258
Q

the two molecules that must interact with superantigen infection

A

Class 2 MHC and TCR

259
Q

how does a single gene able to code for multiple proteins with different functions

A

splicing of primary gene transcripts

260
Q

which lab test used for monitoring response to tx in anemia

A

reticulocyte count

261
Q

ABG with 3-day profuse diarrhea

A

metabolic ACIDOSIS (loss of bicarb)

262
Q

topo 1 action in DNA replication

A

cut a single strand of double helix, and allowing other strand to pass through, and then allow ligate. decrease supercoiling

263
Q

occurrence of some combinations of alleles or genetic markers in a population more often or less often than would be expected from a random formation of haplotypes from alleles based on their frequencies.(doesnt go with Hardy Weinberg)

A

Linkage disequlibrium

264
Q

cold water vs hot water nystagmus

A

COWS

  • cold- opposite side nystagmus
  • warm- same side
265
Q

what will erythrocytes produce when there is tissue ischemia

A

2,3 BPG- to release more O2

266
Q

Phage infection of a single E. coli, phages released. One of these particles contain fragment of E.coli. Will this phage be able to inject DNA and how many particles produced?

A

Phage will be able to inject DNA, but progeny wont be produced

267
Q

successive cleavage vs successive phosphorylations for activation

A

cleavage: coag pathway
phosph: G protein

268
Q

the two molecules that must interact with superantigen infection

A

Class 2 MHC and TCR

269
Q

how does a single gene able to code for multiple proteins with different functions

A

splicing of primary gene transcripts

270
Q

which lab test used for monitoring response to tx in anemia

A

reticulocyte count

271
Q

ABG with 3-day profuse diarrhea

A

metabolic ACIDOSIS (loss of bicarb)

272
Q

topo 1 action in DNA replication

A

cut a single strand of double helix, and allowing other strand to pass through, and then allow ligate. decrease supercoiling

273
Q

occurrence of some combinations of alleles or genetic markers in a population more often or less often than would be expected from a random formation of haplotypes from alleles based on their frequencies.(doesnt go with Hardy Weinberg)

A

Linkage disequlibrium

274
Q

adaptin and dynamin

A

clathrin vesicles- adaptin allows interaction, dynamin pinches off membrane

275
Q

organelle for breakdown of very long chain FA

A

peroxisome

276
Q

AA products- both decrease vascular tone, while one increased uterine tone other doesnt

A

PGI2- decrease both

Prostaglandin- abortificant- increases uterine tone

277
Q

alpha and beta subunits of Tyrosine kinase receptor for insulin and IGF

A

alpha- bind ligand

beta- with kinase activity—-autophosph

278
Q

elevation of what acute phase reactant strong predicto of MI, stroke, PAD, sudden cardiac death

A

C-reactive protein– made by hepatocytes

279
Q

3B hydroxysteroid dehydrogenase def

A

early death- cant make androgens, cortisol, aldosterone

280
Q

cortisol action in increasing BP

A

not direct, increased a1 receptors in arterioles

281
Q

synthesis and breakdown induced by cortisol

A

lipolysis, proteolysis, gluconeogenesis, glycogenlysis

282
Q

abrupt withdrawal of CS tx

A

tertiary adrenal insufficiency, have inhibited CRH

283
Q

hyperthyroidism in a patient presenting after recent use of IV contrast

A

Jod-Basedow (excessive iodine given quickly in hypothyroid pt)

284
Q

Thyroid diseases:
HLA DR3
HLA DR5

A

3= graves, 5= hashimotos

285
Q

thyroid cancer assoc with RAS or PPAR-gamma mutation

A

follicular

286
Q

BRAF mutation

A

melanoma, papillary thyroid cancer

287
Q

sorbitol dehydrogenase lacking

A

retina, schwann cells, lens, retina (cant take sorbitol to fructose)

USMLE Step 1 (2 decks)

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