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1 USMLE-rx > March 22 > Flashcards

March 22 Flashcards

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USMLE® Step 1 flashcards
1
Q

Disease that presents with diffuse muscle atrophy, hypotonia, fasciculations and decreased DTR–is due to destruction of the anterior horn cells of the spinal cord..

A

Werdnig-Hoffmann disease

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2
Q

What enzyme catalyzes the formation of a phosphodiester bond within a strand of dsDNA–Joins Okazaki fragments?

A

DNA ligase

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3
Q

What ocular muscle is innervated by CN VI?

A

Lateral Rectus

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4
Q

What ocular muscle is innervated by CN IV?

A

Superior Oblique

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5
Q

What ocular muscles are innervated by CN III?

A

Superior rectus
Medial rectus
Inferior rectus
Inferior oblique

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6
Q

What enzyme is deficient in Maple syrup urine disease?

A

a-ketoacid dehydrogenase–causes increase in a-ketoacids in the blood

  • Isoleucine
  • Leucine
  • Valine
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7
Q

What NT is responsible for REM sleep?

A

Acetylcholine

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8
Q

Why is hypoglycemia seen with maple syrup urine disease?

A

Occurs secondary due to impaired gluconeogenesis

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9
Q

Congenital defect causing abdominal contents to enter the thorax is caused by failure of what to completely form?

A

Failure of Pleuroperitoneal folds/membrane to form

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10
Q

Urachal cyst or sinus if remnant of _____ and forms the ______ ligament?

A

AllaNtosis

MediaN umbilical ligament

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11
Q

What is used to confirm dx of Acromegaly?

A

Glucose tolerance test–give glucose and if GH is not suppressed–indicated excess GH that is unresponsive to negative feedback

Also–will have increased IGF-1 and may have pituitary mass on MRI

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12
Q

What NT is elevated with schizophrenia?

A

DA–in mesolimbic frontal system

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13
Q

What is the classic murmur for mitral stenosis?

A

Opening snap followed by a late diastolic rumble

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14
Q

What heart defect can cause hoarseness due to compression of the left laryngeal nerve?

A

Mitral valve stenosis –leading to LA hypertrophy—compression of left laryngeal nerve as it hooks around the aorta at the ligamentum arteriosum –Ortner syndrome

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15
Q

Positive skew distribution =

A

Asymmetry with longer tail on right–Mean > Median > mode

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16
Q

Negative skew distribution=

A

Asymmetry with longer tail on left–mean

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17
Q

Put these in order from fastest to slowest conduction velocity – atria, ventricles, AV node, purkinje

A

Purkinje > atria > ventricles > AV node

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18
Q

What type of Nephritic syndrome is present with SLE?

A

Diffuse proliferative GN –wire looping (Lupus)

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19
Q

What can prolong the infection time of nontypoidal Salmonella spp infection?

A

Tx with abx–but do tx typoid with abx

20
Q

What nerve is effected causing wrist drop and what are the 2 clinical situations in which this can occur?

A

Radial nerve (C5-T1)–Midshaft fracture of the humerus and compression of the axilla

21
Q

N-acethlcysteine is used in CF pts in order to…

A

Helps break up mucus plugs

22
Q

A mutation in what causes the classical type of Ehlers-Danlos syndrome?

A

Type V collagen–joint and skin symptoms

23
Q

A mutation in what causes the vascular type of Ehlers-Danlos syndrome?

A

Deficient type III collagen–vascular and organ rupture

24
Q

What is 1st line therapy for HepB infection?

A

Tenofovir

25
Q

What is a severe complication of Juvenile idiopathic arthritis?

A

Blindness due to uveitis

26
Q

Intraperitoneal accumulation of mutinous material from ovarian or appendices tumor?

A

Pseudomyxoma peritonei–mucinous cysadenocarcinoma rupture

27
Q

What 2 complement factors circulate in the blood and cause anaphylaxis?

A

C5a and C3a

28
Q

A risk factor for the development of transposition of the great vessels is?

A

maternal DM

29
Q

What is Delirium tremens and how is it treated?

A

Life-threatening ETOH withdrawal syndrome that peaks 2-4 days after last drink
–autonomic hyperactivity

Tx: Benzodiazepines

30
Q

What branchial arch does the recurrent laryngeal branch originate from?

A

6th Branchial arch

31
Q

What muscles originate from the 4th branchial arch?

A

Pharyngeal constrictors, cricothyroid, and levator veli palatini–muscles for swallowing

Superior laryngeal branch of CN X supplies these muscles

32
Q

Hyperpigmented neutrophils are seen with what deficiency?

A

Vit B12–megaloblastic anemia

Also–folate deficiency

33
Q

What is the pathophys of sarcoidosis?

A

Dysregulation of CD4+ T-helper (Th) cells –stimulates the production of multiple granuloma promoting cytokines

34
Q

What type of fracture would raise suspicions of child abuse?

A

Spiral fracture of long bone

35
Q

Iodine deficiency includes what symptoms?

A

MR
Growth delay
Bone age will appear less than the child’s actual age

36
Q

Where the macular fibers housed within the brain?

A

Posterior occipital lobe–occipital pole–so when you get macular sparing this is NOT affected –no lose of central vision

37
Q

What is deficient in neonate with respiratory distress syndrome?

A

Dipalmitoylphosphatidylcholine –Lecithin component

38
Q

Factors that increase the amount of _____ increase risk of breast cancer?

A

Estrogen–early menarche or late menopause

39
Q

What is the building block for fatty acid synthesis?

A

Malonyl-coenzyme A

40
Q

The risk of the development of what after a S. pyogenes infection is reduced with the use of Abx within timely fashion of primary infection?

A

Rheumatic fever

41
Q

Why is PTT increased with vWF deficiency?

A

vWF acts as a carrier of factor VIII

42
Q

What type of receptor does insulin work through?

A

Tyrosine kinase receptor

43
Q

If there is complete occlusion of the anterior spinal artery, what senses are still present?

A

Proprioception and vibration–because these run through the dorsal column which is fed by the posterior spinal arteries

44
Q

What disease has a + TRAP (tartrate-resistant acid phosphatase and what sighs and symptoms are seen with this disease?

A

Hairy cell leukemia–B-cell lymphocyte neoplasms

-Fatigue and easy bruising due to anemia and thrombocytopenia

45
Q

Patients with DiGeorge syndrome are more susceptible to ____ and ____ due to a _____ deficiency?

A

Fungal and viral infections

T-cell

46
Q

What presentation is seen with T-ALL compared to B-ALL?

A

T-ALL usually presents with thymic mass, which may result in widen mediastinum on CXR.

47
Q

Shows M spike = Igm –hyperviscosity syndrome with blurred vision and Raynaud phenomenon and has NO CRAB findings, which are seen with multiple myeloma…

A

Waldenstrom macroglobulinemia

1 USMLE-rx (16 decks)

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