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usmle rx qbank > multisys > Flashcards

multisys Flashcards

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USMLE® Step 1 flashcards
1
Q

worsening arthritis of the left knee.
apt 50 sec
BT normal
Pt normal

A

hemophilia A … factor VIII…. XLR ….

remember factor VII is extrinsic …. PT is more extr

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2
Q

bleeding … normat apt … increased PT

A

factor VII

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3
Q

Presence of antiphospholipid antibody levels

A

lupus

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4
Q

vWF disease findings

A

BT would increase … vWF is used for platelet adhesion

apt increased …. vwf is carrier of factor VIII

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5
Q

prophylaxis for hep b infection is ?

A

hepb antibodies … which is passive immunization

just like igG from the mother to fetus

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6
Q

passive immunization is used for

A 
To Be Healed Very Rapidly 
Tetanus
Botulism
HepB
Varicella
Rabies
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7
Q

noncoding repetitive neucleotide sequences at the end of the chromosome

A

telomreres…. maintain chromosomal integrity

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8
Q

AT rich sequences, TATA and CAAT boxes

A

recognized by RNA polymerase II or other transcription factors leading to transcription
PROMOTERS

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9
Q

gold standard for HCV treatment

A

ribavirin

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10
Q

side effects of ribavirin

A

hemolyitic anemia … remember ‘R’ … increased reticulocyte count

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11
Q

what are the signs of hemolytic anemia in blood

A

when rbc damage… inc LDH…. low haptoglobin levels as the free hb binds to the haptoglobin

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12
Q

immunized hep b pt shows

A

antiHbs

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13
Q

window hepb

A

antiHbe and anti HBc IgM

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14
Q

when can minors consent on their own ? <18

A

sex(birth control, STI, pregnancy)
drugs(substance abuse)
rock n roll ( emerg trauma)

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15
Q

antibiotic that induces DNA damage in anaerobes

A

metrondazole

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16
Q

antibiotic that inhibits 30s .. food borne illness

A

shigella

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17
Q

consuming undercooked chicken could lead to infection with

A

salmonella … but symptms take 12-72 hrs

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18
Q

homocystinuria can be caused by?

A

cystathione synthase def
vit b6 def
methionine synth def

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19
Q

researcher’s beliefs, in this case in the efficacy of a treatment, changes the outcome of a study.

A

observer bias

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20
Q

conclusion might be drawn about a population of people who chew gum in order to quit smoking and an increased incidence of lung cancer,
what could be the error?

A

confounding …. the real cause of cancer would be the smoking

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21
Q

Drugs that inhibit IMP dehydrogenase negatively affect guanine synthesis

A

hep c drugs like

ribavirin

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22
Q

Guanosine analogues that inhibit viral DNA polymerase

A

acyclovir

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23
Q

HIV drugs that cause hyperglycemia and lipodystrophy

A

protease inhibitors … navirs

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24
Q

nucleic acid fragment is added to a tube along with a polymerase, a primer, and deoxyribonucleotides. The tube also contains the four bases as fluorescently labeled dideoxynucleotides. The products in the tube are then run through a capillary, and a laser detects the fluorescence of the products that come out of the capillary

A

process is called sequencing

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25
Q

tumor suppressor gene on the short arm of chromosome 3

A 
VHL... AD
Hemangioblastoma (retina,brainstem,cerebellum,spine)
Angiomatosis
Renal cell carcinoma
Pheo
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26
Q

patient presents with a slowly spreading rash, decreased energy, anorexia, fever, and hepatomegaly.
puppy,child, rash, no allergies

A

toxocara canis

visceral larva migrans …. increased eosinophils

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27
Q

upregulation of eosinophils in this process is mediated by interleukin

A

IL 5

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28
Q

JW parents deny blood transfusions for a dying child what do u do

A

GIVE BLOOD …. parents do not have the authority to deny life saving treatment for their child

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29
Q

A root cause analysis (RCA

A

identify the causal factors that underlie the failure and identify methods to prevent recurrence

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30
Q

Drug utilization reviews (DURs)

A

URs serve as a means of improving the quality of patient care, enhancing therapeutic outcomes, and reducing inappropriate pharmaceutical expenditures.

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31
Q

Failure mode and effect analysis (FMEA)

A

process applied before process implementation to prevent the occurrence of failure

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32
Q

defect in protein tagging in the Golgi complex

A

I cell disease

no tags means cant be sent to lysosomes so instead they get excerted extracellularly

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33
Q

defects in the breakdown of glycosaminoglycans.

A

hurler and hunter
hunter has no corneal clouding (iduronate 2 def) XR
hurler (L iduronidase ) def

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34
Q

stranger anxiety and should be able to roll over, hold a sitting position unassisted, pass toys from hand to hand, and babble.

A

6 months

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35
Q

at 3 months child can

A

hold head up (devp at 1 mont)

cant roll over or sit

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36
Q

kick a ball and should have a vocabulary of 200 words with the ability to form 2-word sentences. A child at this age should also be climbing stairs
feed himherself with spoon/fork

A

24 months

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37
Q

arly-onset joint pain and stiffening, skin hyperpigmentation, limited range of motion of the large joints, and a systolic murmur in the aortic area.

A

alkaptanuria

homogentisate oxidase def …… blocks tyrosine to fumarate pathway

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38
Q

structure(s) is most likely avoided by inserting the needle at the midaxillary line along the upper border of the 10th rib

A

LUNG
void lung injury, the needle must be inserted into the costodiaphragmatic recess between the 8th and 10th ribs at the midaxillary line.

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39
Q

CCA on tRNA

A

can carry amino acids ….. AA is covalently bound here to the 3’ end

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40
Q

deficiency in ß-glucocerebrosidase and is most prevalent in members of the Ashkenazi Jewish population
hepatosplenomegaly, aseptic necrosis of the femur, and bone crises.

A

gaucher

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41
Q

finding in gaucher

A

crumbles macrophages

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42
Q

mental retardation, cherry-red maculae, and “foamy” macrophages hepatosplenomegaly

A

neiman pick

43
Q

n addition to GLUT transporters, utilize SGLT glucose transporters

A

enterocytes and nephrons

44
Q

RSA resists β-lactams by

A

altering PBP … penicillin binding proteins.. transpeptidases

45
Q

trisomy in downsyndrome happens when

A

mostly in anaphase of meiosis I or II

46
Q

heriditary fructose intolerance …

A

diarrhea … watery
aldolase B def
no cataracts
accum of fructose 1 phosphate … that inhibits gluconeogensis

47
Q

anti cardiolipin antibodies are found in syphilis … where is cardiolipin found

A

inner mitochondrial membrane

48
Q

a useful tool to help guide the root cause analysis

A

fishbone diagram

49
Q

opiod toxicity ,,, respiratory acidosis … what is the body’s first reaction to buffer the H+

A

excess H+ enters cells and binds the intracellular proteins

50
Q

which step uses biotin in gluconeogenesis

A

pyruvate to oxaloacetate

51
Q

antifungal that binds tubulin

A

griseofulvin

52
Q

when is RhoGHAM given

A

it is given to the mother who is RH - with Rh + child … it is to prevent sensitization vs the Rh antigen in the blood

53
Q

bright red rash 2 days after having a fever, a headache, and diarrhea. He has not had any change in appetite, cough, shortness of breath, or sore throat.
erythematous reticular extensive rash

A

fifth disease
parvo B19
self limting

54
Q

pleitrophy

A

single mutation has diverse effects on different organs example PKU

55
Q

locus hetrogeneity

A

different mutations present same phenotype

ex; marfan homocystinuria MEN2B

56
Q

mean

A

negative skew

tail of the curve is where the

57
Q

diabetic mother … child has loud S2 … blood from right ventricle seen in systemic circulation

A

failure of aorticopulomnary septum to spiral.. transp of greater vessels

58
Q

defect in septum primum

A

ASD in down syndrome

59
Q

hospice care covered by which medicare

A

A

60
Q

test of antigen-antibody hybridization that is used to detect an antigenic match in a patient’s blood sample to determine if a person’s immune system has encountered a particular antigen.

A

Elisa

61
Q

protein-antibody hybridization to detect protein

A

westernblt

62
Q

most abundant form of rna

A

rrna

63
Q

young healthy girl ,,, main concern is cheaper monthly insurance plan

A

HPO

64
Q

birebeck granules activate which type of immune respnse

A

they are APC in the skin … they present MHC2 —- activate TH4 cells

65
Q

APC that present MHC1

and which cells do they activate

A

MHC 1 is present on all cells except RBC

activate natural killer cells

66
Q

capping

A

occurs at the 5’ end of the mRNA - regardless of the sequence - and acts to stabilize the mRNA for export from the nucleus.

67
Q

transcription

A

is the process of RNA synthesis from a precursor DNA template

68
Q

polyadenylation

A

is the addition of adenosine to the 3’ end of the initial RNA transcript and functions as stability for nuclear export.

69
Q

a 5’ GU — AG 3’ sequence serves as a site for?

A

splicing

70
Q

which blood disorder is affected by splicing

A

B thalassemia

71
Q

marathon runner sweats .. what glands and thru stimulation of?

A

eccrine … thermoregulatory glands… sympathetic stim

72
Q

influenza vaccine response

A

humoral response against hemaglutinin

hem helps virus bind cells

73
Q

how to block an anaphylaxis shock

A

target immunoglobulin surface receptor

disrupt the cross linking

74
Q

topical antibiotic form commonly used OTC but not used systemically coz of toxicity

A

bacitracin

inhibiting translocation of the D-ala-D-ala peptide from inside to outside the bacterial cell.

75
Q

involves DNA transfer from infection of a virion, which is packaged with DNA from another bacterial cell.

A

transduction

76
Q

is a process through which naked purified DNA (DNA outside any cell exposed in the environment) is taken up by bacteria and incorporated into the chromosome.

A

transformation

77
Q

muscle biopsy showing deficiency or absence of the enzyme myophosphorylase.

A

type V mcARDLE

78
Q

Liver biopsy revealing deficiency of phosphorylas

A

Hers disease type VI

hepatomegaly and growth retardation

79
Q

Muscle biopsy showing a deficiency of debranching enzyme

A

IIIa Cori disease
solely outside skeletal myocytes, including the liver and heart, leading to early symptoms, including hepatomegaly, growth retardation, muscle weakness, hypoglycemia, hyperlipidemia, and elevated liver transaminase levels.

80
Q

Muscle biopsy revealing a deficiency of lysosomal α-glucosidase

A

Pompe

glycogen buildup in cardiomyocytes

81
Q

Muscle biopsy revealing deficiency of phosphoglycerate kinase

A

muscle weakness, neurological symptosm, anemia

due to decreased pyruvate

82
Q

enveloped -ssRNA linear virus

child has a rash runny nose cough

A

rubeola measles

83
Q

enveloped +ssRNA lineaer virus

A

Rubella

fever occurs 1-5 days before the rash

84
Q

gram-negative coccobacillus

A

bordtella pertusis

ADP ribosylation of Gi

85
Q

the palmar skin has an additional layer which is it

A

lucidum

86
Q

Mutation in the penicillin-binding protein

A

mechanism of resistance for VANCO

87
Q

cyclic fever headaches and general weakness.. hepatosplenomegaly after travel
MRI shows cerebral edema and pt has seizures

A

malaria

p.falciparum has cerebral involvmnt

88
Q

what is different in inf with p.malaria

A

more regular 72 hour cycles

89
Q

the sand fly and may cause spiking fevers and hepatosplenomegaly

A

leishmania donovani

90
Q

meeting with all healthcare professionals involved in surgeries to discuss ways to minimize potential errors that would result in harm to the patient.

A

swiss cheese model

think “S” … system safetyyyy

91
Q

onvulsions, hyperirritability, peripheral neuropathy and sideroblastic anemia
vitamin def

A

B6 pyridoxine

92
Q

adrenal insufficiency along with enteritis and dermatitis

vitamin

A

B5 Pantothenic acid

93
Q

cheilosis, corneal vascularisation, and seborrheic dermatitis.

A

B2 riboflavin

94
Q

Lipid and membrane biosynthesis

A

smooth ER

95
Q

Degradation of cellular material

A

lysosomes

96
Q

β-Oxidation of long-chain fatty acids

A

peroxisome

97
Q

golgi apparatus

A

protein modification

98
Q

defect in the CD40 ligand on CD4 T-helper cells.

A

hyper IgM syndrome

99
Q

efect in nicotinamide adenine dinucleotide phosphate oxidase

A

CGD

increase risk of infc with staph nocardia pseudo listeria

100
Q

non motile gram negative bacterium

A

shigella

101
Q

mechanism of shigella infection

A

infects M cells in peyers patches

102
Q

facial features have developed abnormally. hyperactive and aggressive. Physical examination reveals a prominent forehead; an enlarged tongue; hepatosplenomegaly; and several pearly, papular skin lesions over the scapulae, lateral upper arms, and thighs.

A

Hunter
iduronate sulfatase

rmmber hunters are aggressive***

103
Q

peripheral neuropathy, angiokeratomas, and hypohidrosis

A

fabry

alpha galactosidase

104
Q

oagulase-negative Staphylococcus species, such as S. saprophyticus and S. epidermidis, are associated with infection.

A

foley catheter

usmle rx qbank (29 decks)

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