NBME 20 Flashcards
Pes Anserinus from anterior to posterior
Say Grace before Tea
Sartorius (most anterior), gracillis, then semitendinosus
Mechanism of the Echinocandins i.e. “fungin”
Adverse side effect
Inhibit synthesis of B-glucan, which inhibits cell wall synthesis and is used for invasive aspergillosis and systemic candida
Histamine flushing
How does thereapeutic hyperventilation work?
Causes decreased PCO2, which causes vasoconstriction, which decreases cerebral blood flow, thereby decreasing intracranial pressure
Hyperchylomicronemia is a deficiency in what? What will the serum look like?
Type I familial dyslipidemia=hyperchylomicronemia
Milky appearing serum due to triglycerides super high
Lipoprotein lipase or APO-CII are affected
Pancreatitis***, eruptive xanthomas, but NO increased risk for atherosclerosis
b-HCG, LH, FSH, TSH all share?
The same alpha subunit
Emphysema will cause what kind of tactile fremitus and percussion findings?
decreased fremitus because air filled doesnt travel as well as would through liquid filled, hyperressonant
Arachnoid and pia mater are from what origin? What about dura?
Arachnoid and pia are from neural crest, whereas dura is from mesoderm
What happens when you fuck the deep branch of the ulnar nerve by busting hook of hamate?
Froments sign (flexion at IP joint at thumb when grabbing paper) Loose inneration to the hypothenar muscles, medial two lumbricals, adductor pollicis, palmar/dorsal interoccei of hand, and palmaris breis
What type of aphasia would you get if you had an inferior frontal gyrus of frontal lobe lesion?
Broca’s expressive aphasia. Broca=broken boca
What would happen if you had a lesion in superior temporal gyrus of the temporal lobe?
Wernicke’s RECEPTIVE aphasia. Can speak fluently but can’t comprehend
What are infliximab and adalimumab?
Monoclonal anti-tnf-alpha drugs used in tx of IBD. Test for latent TB as TNF-a is important for granuloma formation/stabilization.
Keloids are a big increase in which types of collagen?
Types I and III
When might you see someone with Hypertrophic Osteoarthropathy? (Abnormal proliferation of skin and bone at distal extremities with clubbing, arthralgia, joint effusions, periostosis)
Paraneoplastic syndrome associated with adenocarcinoma of the LUNG, AKA bronchogenic carcinoma
What is the difference between patient presentation of severe vitamin E deficiency than that with B12 deficiency?
In B12 you have megaloblastic anemia, hypersegmented neutrophils, increased serum methylmalonic acid levels
What are the findings in the distributive shock subtype known as Septic Shock?
Decreased SVR, decreased preload, decreased PCWP, but *increased CO
Hereditary spherocytosis genetics
Autosomal Dominant
How does pulmonary edema happen when someone is in cardiogenic shock?
LV fails, blood baks up into pulm circuit, extra blood increases capillary hydrostatic pressure, driving fluid into the interstitial space. Now the interstitial space has more hydrostatic pressure and less oncotic pressure than fluid in the alveoli, so it leaks in
Stating that there is not an effect/difference when one ACTUALLY does EXIST
Type II error
How do you increase statistical power?
Increase sample size, increase expected effect size, increase precision of measurement
Some kid has coarce facial features, gingival hyperplasia, clouded corneas, restricted joints, and high plasma levels of lysosomal enzymes… what is this
I-Cell disease: defect in N-acetylglucosaminyl-1-phosphotransferase. Failure of golgi to phosphorylate mannose residues on glycoproteins
What are the atypical lymphocytes seen in EBV?
EBV infects Bcells via CD21
But the atypical lymphocytes are actually reactive cytotoxic T cells
Amoxicillin in mononucleosis patients
Rash
Visible peristaltic waves, nonbilious projectile vomiting
Pyloric stenosis
Heparin induced thrombocytopenia
IgG abs against heparin bound platelet factor 4 (PF4). The highest risk is w/ unfractionated heparin
What are the five 5’s of interstitial nephritis?
What is “special” about the pyuria?
Pee, Pain-free, Penicillins, PPIs, rifamPin, sulfa
See pyuria that is classically eosinophls!
How do C-fibers work?
Slow, burning, long lasting pain via substance P/glutamate in the dorsal horn. Unmyelinated fibers .5-2.0 m/s
Actinic purpura
Old people skin due to age related alteration of collagen (sundamage) making skin very sensitive to trauma
MOA of Cilostazol, dipyridamole?
Antiplatelet phosphodiesterase 3 inhibitors: increase cAMP in platelets, resulting in inhibition of platelet aggregation. Used for intermittent claudication, and dipyradamole is used for cardiac stress testing
Felty syndrome triad
RA, splenomegaly, neutropenia
Why do you get hard poops from dextromethorphan
Its an opium alkaloid derivative
The difference in risk attributable to the intervention as compared to a control
Absolute risk
What percent chance do you have at inheriting same HLA marker as siblings?
25% chance
Why is PTH an indirect way to stimulate osteoclast maturation?
PTH binds to osteoBlasts, which stimulates them to increase their expression of RANK-L and inhibits their secretion of OPG. Binding of RANK-L to RANK is facilitated by the decreased amount of OPG avaiable for binding the excess RANK-L, this stimulates osteoclast precursors to fuse, forming new osteoclasts
CBFA1
Craniocleidodysplasia. No collar bones, too many teeeth, frontal bossing. Osteoblast function is fucked up.
Lymphomas can cause an increase in what (paraneoplastic syndrome)
Calcitriol (1,25-OH2 Vitamin D3)
If the 95% confidence interval contains the number 1, then?
Data is INsignificant
When would you expect to see a papillary muscle rupture post MI?
2-5 days
What is GOAT HAG?
GnRH, Oxytocin, ADH (v1), TRH, Histamine (h1), Angiotensin II, Gastrin
-all use the IP3 signaling pathway.
What is FLAT ChAMP?
FSH, LH, ACTH, TSH, CRH, hCG, ADH (v2), MSH, PTH, calcitonin, GHRH, glucagon, histamine (h2)
-all use cAMP second messenger
What is BAD GraMPa?
BNP, ANP, EDRF
all use cGMP
What does the sun change into Cholecalciferol?
7-Dehydrocholesterol
When would you see cannon ball A waves?
complete AV block, as right ventricle and atria contract independently
