NBME 17 Review Deck Flashcards by alina bischin

Which viruses acquire an envelope similar to the phospholipid concentration of the nuclear phospholipid membrane.

Herpesviruses; all other enveloped viruses acquire a phospholipid membrane by busting through the plasma membrane of the host cell

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External ear infection in a diabetic 80 year old patient

Pseudomonas Aeruginosa

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Polyarteritis Nodosa typically spares what arteries

Pulmonary Arteries and Bronchial arteries

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Rupture of what part of the aorta is most common in a decelerating injury/ trauma in a motor vehicle accident where the driver/ passenger is wearing a seatbelt

Damage to the aortic isthmus– Distal to the left Subclavian Artery

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Cardiac tumor with abundant ground substance and gelatinous matrix mucopolysaccharide storm, abundant blood vessels with hemorrhaging. Mesenchymal origin

Cardiac Myxoma

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Benign heart hamartoma in children and its associations

Rhabdomyosarcoma; associated with Tuberous sclerosis

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infant in the first few days of life presenting with maple syrup urine/ Burnt sugar urine smell, dry mucus membranes and hypertonia

Branched chain alpha-ketoacid dehydrogenase deficiency

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Infant with fair complexion, eczema, MUSTY body odor, seizures

PKU either due to phenylalanine hydroxylase, BH4 cofactor deficiency, or dihydropteridine reductase deficiency (Conversion of Tryptophan to serotonin)

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Recurrent cysteine sones in an infant

Cystinuria; defect in PCD and intestinal amino acid transporter that prevents resorption of Cysterine, ornithine, and lysine

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Deficiency in homogentisate oxidase

Alkaptouria; black cartilage, etc

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diet restriction for infants with Branched Chained alpha-ketoacid Dehydrogenase deficiency

Decreased Leucine, valine, and isoleucine intake

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Niesseria is grown on what time of agar, and which are the components?

Chocolate agar (heated blood)= Thayer martin agar also called VPN (Vancomycin, Polymixin (also called collistatin), nystatin (inhibits growth of candida) and trimethoprim

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Cancers that cause sclerotic bone lesions

Prostate, Small Cell Lung Cancer, Hodgkin Lymphoma

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Patient with a long-standing history of RA that gets intubated develops areflexia and whole body paralysis; what complication of RA is to be expected?

Cervical sublaxation; typically occurs 2nd to endotracheal intubation in patients with a long-standing history of RA

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Grabbing a tree branch while falling that leads to loss of fine movements of the affected hand

Klumpke palsy/ Damage to the lower trunk of the brachial plexus

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Abduction (arm hanging by side), lateral rotation (arm medially rotated) while also being flexed and supinated

erb Palsy (C5-C6) trauma to the upper trunk

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Benign, painful, red-blue discoloration under the finger nails arising from the smooth muscle cells of the thermoregulatory glomus body.

Glomus Tumor

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four causes of Hydrops fetalis

Parvo B19 infection, Alpha Thalassema (–/–), Rh Hemolytic disease of the newborn, syphilis

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Causes of carpal tunnel

DM, chronic hemodialysis (deposition of amyloid B2-microglobulin), hypothyroidism, pregnancy, and RA

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Tumors that stain GFAP +

astrocytomas, glioblastomas, ependymomas, and nerve sheath tumors

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Synaptophysin + tumors

Small cell lung cancer, Carcinoid (neuroendocrine cells)

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acute pancreatitis, lipidemia retinitis, eruptive skin xanthomas, and hepatosplenomegaly

Familial Chylomicron syndrome

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Protein defect in familial chylomicron syndrome and elevated lipoprotein

Lipoprotein lipase, ApoC-II; Chylomicron

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Premature coronary artery disease, corneal arcus, tendon xanthomas, xanthelasmas

Familial Hypercholesterolemia

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Protein defect in Familial Hypercholesterolemia and elevated lipoprotein

ApoB-100, LDL-R; LDL is elevated

Premature coronary artery disease, peripheral vascular disease, tuboeruptive palmar Xanthomas

Familial Dysbetalipoproteinemia

Protein defect associated with dysbetalipopproteinemia and elevated lipoprotein

ApoE; elevated chylomicron and VLDL elements

inherited lipoproteinemia that Increases pancreatitis risk; associated with obesity and insulin resistance

Familial Hypertriglyceridemia

Protein defect in familial hypertriglyceridemia and elevated lipoprotein

ApoA-V; elevated VLDL

cystic dilation of the fourth ventricle with posterior fossa enlargement

dandy-walker syndrome

Displacement of the cerebellar vermis and tonsils below the foramen magnum

Arnold Chiari- Chiari II malformation

Displacement of the cerebellar tonsil through the foramen magnum; associated with syringomyelia

Chari I malformation

treatment for narcolepsy

Modafinil (CYP450 inducer) , amphetamines

Causes of respiratory alkalosis (hyperventilation)

Salicylates (early), anxiety, Hypoxemia, tumor, PE

Causes of metabolic acidosis with an increased anion gap

Increased (shit) MUDPILES: methanol/ formic acid, Uremia, DKA, Propylene glycol, Iron tablets or isoniazid, lactic acidosis, Ethylene glycol, salicylate (Late)

Causes of Metabolic acidosis with a normal Anion gap

Normal HARDASS: hyperalimenation, Addisons disease, renal tubular acidosis, diarrhea, acetazolamide, spironolactone, saline infusion

Cramps, pain, paresthesias, carpopedal spasm

hypocalcemia

Asbestosis is visualized using what stain

Prussian Blue stain

Tanner Stage I

No sexual hair, flat appearing chest with raised nipple (pre-pubertal)

Tanner Stage II (age and features)

8-11.5; pubic hair (pubarche), testicular enlargement, Breast bud formation (thelarche)

Tanner Stage III (age and features)

11.5-13 years: Coarsening of pubic hair, increased penis size and length; breast enlarges, mound forms

Tanner Stage IV (age and features)

13-15 years: coarse hair across pubis, sparing the thigh, penis width/ glans increases; breast enlargement, raised areola, mound on mound

Tanner Stage V (age and features)

>15; coarse hair across the pubis and medial thigh, penis and testis enlarge to adult size, adult breast contour, areola flattens.

What is the objective sign of puberty

breast budding in the female and testes enlargement in the male

Presenting sx: pain, uniformly enlarged soft globular uterus, dysmenorrhea, menorrhagia,

Adenomyosis endometrium; hyperplasia of basal layer of endometrium

Burn class: superficial, through epidermis (sun burn); painful, erythematous, blanching

First Degree Burn

Burn class: skin is blistered and usually heals without scarring; partial thickness burn through the epidermis and dermis; painful erythematous, blanching

second degree burn

Burn Class: Skin scars with wound healing; full thickness (Epidermis, dermis, hypodermis); painless, waxy or leathery appearance, non-blanching

Third Degree burn

Inflammatory skin disorder with erythematous papules and pustules but no comedones; facial flushing in response to external stimuli; sensation of burning and dryness; may cause rhinopehyma (deformation of the nose)

Rosacea

erythematous, well-demarcated plaques with greasy yellow scales in areas rich in sebaceous glands like scalp, face and periocular region. Associated with Parkinsons and possibly with Malassezia

Seborrheic Dermatitis; tx with topical fungi and CCS

SAEs of Amioderone

CIIIA: pulmonary fibrosis, blue skin discoloration, gray cornea (hapten deposits), Hyper or Hypothryoidism, hypersensitivity hepatitis, CYP450 inhibitor, heart failure

Name all Class III Anti-arrythmics

Amioderone, Ibutilide, dofetilide, sotalol

autosomal dominate syndrome featuring the growth of numerous hamartomas in the GI tract, along with a hyper pigmented mouth, hands, lips and genitalia; increases risk of breast and GI tumors

Peutz-Jegher's syndrome

Pre-contemplation stage

Patients do not understand that there is a problem and often blame external factors or circumstances out of their control

Contemplation stage

The patient recognizes the problem, but is not yet ready to do anything about it

Preparation stage of the stages of change model

Planning/ preparing a behavior medication

Action stage

Putting a Plan into action (enters treatment reducing alcohol)

Maintenance Stage of the stages of change model

Maintaining absence; requires motivation

Most common infection in lactation mastitis

Staph Aureus

Diarrhea, dementia, dermatitis (broad collar rash), hyperpigmentation of sun exposed limbs

Vitamin B3/ Niacin Deficiency; carcinoid syndrome or prolonged isoniazid

Autosomal recessive defect in neutral amino acid transporters in the PCT and on enterocytes

Hartnup disease--> Decrease Tryptophan --> decreased synthesis of Niacin--> pellagra sx (dementia, dermatitis, diarrhea)

abdominal pain, greasy stools, weight loss, joint pain and PAS+ granules in the lamina propria

Whipple Disease (trophyremia whipplei); PAS is a glycoproteins)

Malar rash, gottron papules, heliotrope (preorbital) rash, darkening and thickening of the fingers; perimysial inflammation with CD4+ T cells resulting proximal limb weakness; increased risk/ associated with malignancy (ovarian, lung, NHL, and colorectal)

dermatomyositis

Progressive symmetric proximal muscle weakness that is anti-1-jo (Anti-histidyl-tRNA synthetase), ANti-SRP and ANTI M2 positive

Polymyositis

Inflammation in polymyositis

endomysial inflammation

Causes of septic abortion after curettage

S Aureus and E Coli