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USMLE: step 1 > Hodge Podge > Flashcards

Hodge Podge Flashcards

1
Q

What type of sensitivity is contact dermatitis from Poison Ivy? What mediates?

A

Type IV: mediated by T cells

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2
Q

What is the ubiquitin protease pathway?

A

Uses ubiquitin ligase to break down proteins in cells so they can be recycled or presented in MHC

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3
Q

Drug of choice in anaphylactic shock?

A

Epinephrine: even if it is a drug mediated allergy

  1. B2 dilation of bronchioles
  2. A1 constriction
  3. B1 increase in contractility
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4
Q

Which are the stop codons?

A
  1. UAA
  2. UGA
  3. UAG
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5
Q

What happens when ribosome hits stop codon?

A

Releasing factor binds ribosome to release protein

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6
Q

Presentation of digeorge?

A 
"CATCH 22Q"
Cardiac: tetralogy, truncus 
Abnormal facies 
Thymic HYPOplasia 
Craniofacial deformities: clefts 
HYPO calcemia / thyroid
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7
Q

Function of nucleosis?

A

Synthesize and assemble r-RNA

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8
Q

Lead poisoning in adult?

A
  1. Mental status change
  2. Constipation
  3. Microcytic
  4. Basophilic stippling
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9
Q

What is head bobbing and wide pulse pressure indicative of?

A

Aortic regurg

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10
Q

What can rapid correction of HYPOnatremia cause?

A

Osmotic demyelination syndrome of pons

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11
Q

When is PVR lowest in lung?

A

FRC: less oxygen compressing vasculature

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12
Q

NT in tetanus and botulism?

A

Tetanus: GABA / GLYCINE
BOTULISM: ACH

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13
Q

Function of GABA and glycine?

A

Inhibitory NTs

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14
Q

Toxin in C. perfringens?

A

Lecithinase which cleaves phospholipids

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15
Q

What does H flu require to grow?

A

Factor V: NAD

Factor X: Hematin

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16
Q

How does CNIII palsy present?

A
  1. Drooping of upper eyelid
  2. Eye stuck down and out
  3. Impaired pupillary constriction
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17
Q

Presentation of common peroneal nerve injury?

A
  1. Loss of sensation on foot dorsum
  2. Foot drop: loss of dorsal flexiion
    - Often injured in lateral blows to knee since nerve wraps around fibula
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18
Q

Dry beriberi?

A

Thiamin deficiency causing:

  1. Symmetric peripheral neuropathy
  2. Cardiac involvement (wet)
  3. CNS issues (wet)
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19
Q

Anesthetic effect on cerebral / renal / liver flow?

A

Cerebral: Increase
Renal: Decreased
Liver: decreased

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20
Q

What does wedge pressure measure?

A

LA pressure

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21
Q

What is tryptophan a precursor of?

A

5HT

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22
Q

Appearance of serotonin syndrome?

A
  1. NM excitation: spasm, clonus, rigidity
  2. Hyperthermia / tachy
  3. Vomit / sweat
  4. Agitation, confusion
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23
Q

What is cyproheptadine?

A

Histamine antagonist with non specific 5HT antagonism properties
- Can be used to treat serotonin syndrome

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24
Q

What is chronic lymphedema risk factor for?

A

Angiosarcoma of skin

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25
Q

What does IL 4 do? 12?

A

4: TH2 differentiation
12: TH1 differentiation
* Released by APCs when interacting with naive TH

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26
Q

What are TH1/2 involved in?

A

TH1: Cell mediated immunity
TH2: Antibody mediated immunity

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27
Q

What does IFN-Gamma do?

A

Released by TH1 cells to activate macs

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28
Q

T3 or 4 more potent?

A

T3

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29
Q

What is reverse T3?

A

Inactive form generated from peripheral use of T4

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30
Q

The production of what corresponds with severity of giant cell arteritis?

A

IL6

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31
Q

Part of heart at left sternal border, fourth intercostal?

A

Right ventricle

32
Q

What composes majority of anterior heart border?

A

Right ventricle

33
Q

Nerve for afferent and efferent pupillary response to light?

A

Afferent: II
Efferent: III

34
Q

What is SMA syndrome?

A

Transverse duodenum being trapped between SMA and aorta = epigastric pain and bilious vomit

35
Q

Earliest change in diabetic nephropathy?

A

GBM thickening: normally has negative hep sulfate to deflect proteins but this is lost = microalbuminuria

36
Q

What to do in early diabetic albuminuria?

37
Q

What is modafinil used to treat?

A

Narcolepsy

38
Q

Treatment for trigeminal neuralgia?

A

Carbamazepine

39
Q

What is holosystolic murmur at apex?

A

Mitral regurg

40
Q

What is an S3 gallop?

A

Increased LV filling rate

41
Q

What is TNF alpha responsible for?

A

Sequestration of TB in granulomas

42
Q

MOA of PTU and methimazole?

A

Both: stop organification and coupling by thyroid peroxidase
PTU: stope peripheral conversion of T4-3

43
Q

When are bilateral acoustic neuromas seen?

44
Q

What is following:

  1. Cafe au lait spots
  2. Multiple neurofibromas
  3. Lisch nodules
45
Q

Area of brain first damaged by ischemia?

A

Hippocampus

46
Q

Baby with large tongue, large anterior fontanelle, umbilical hernia and regression?

A

HYPOthyroid

47
Q

What precedes PSGN and ARF?

A

PSGN: strep impetigo OR pharyngitis
ARF: only ARF

48
Q

Dynamic changes in mitral regurg?

A
  1. Decreased Afterload
  2. Increased Preload
  3. Increased EF
49
Q

Time course of schizo diagnosis?

A

6, schizophrenia: functional decline required

50
Q

What does LVEDP indicate?

51
Q

Signs of open angle glaucoma?

A

Progressive loss of peripheral vision

52
Q

Cause of open angle glaucoma?

A

Increased production or decreased outflow of humor

53
Q

Goal of open angle treatment?

A

Decrease intraocular pressure: BBs do this by decreasing aqueous humor production

54
Q

Why do PPIs cause osteopenia?

A

Ca needs acidic environment to be absorbed

55
Q

How are osteocytes attached to each other?

A

Gap junctions

56
Q

Effects of estrogen on T4?

A
  • E2 increases TBG production transiently dropping T4 levels

- TSH will ramp up to increase T4 again increasing overall pool by having the same free amount

57
Q

What is substance P?

A

Pain transmitter

58
Q

When is slit lamp exam used?

A

Kayser fleischer rings in wilson disease

59
Q

When are anti smooth muscle antibodies seen?

A

Autoimmun hepatitis

60
Q

What is bipolar I?

A

Manic episodes

- Depression common but not required

61
Q

What is bipolar II?

A

Depression:

- Hypomanic episodes

62
Q

What does TGF beta control in healing?

A

Fibroblast migration and proliferation

63
Q

Cells involved in skin test like TB?

A

Mac, CD4, CD8

64
Q

Why isn’t muscle contracting in MG?

A

Can’t reach the end plate potential since the receptors are blocked

65
Q

Which diuretic increases serum Ca?

66
Q

Chediak higashi presentation?

A
  1. Albinism
  2. Immunodeficiency: neut phagolysosome defects
  3. Neuro Defects: nystagmus
67
Q

What is following:

  1. Albinism
  2. Immunodeficiency
  3. Neurologic defects
A

Chediak higashi

68
Q

What type of secretion to sebaceous glands use?

A

Holocrine: cell lysis releasing contents

69
Q

Bone injured in fall on hand?

70
Q

Bone with pain in snuff box?

71
Q

What is BRAF?

A

Involved in signalling in melanocyte proliferation - mutation can = melanoma

72
Q

Mutation seen in melanoma?

73
Q

Cytokines high in Mycobacterial infx?

A

TH1 mediated:

  1. IL2
  2. IL12
  3. IFN gamma
74
Q

First line gout treatment?

75
Q

How to diagnose vertebral osteomyelitis?

A

MRI of spine

76
Q

What is thin granulosum, keratotic corneum and foci of neutrophils?

USMLE: step 1 (15 decks)

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