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Step 1 > NBME 22 > Flashcards

NBME 22 Flashcards

1
Q

explain all the problems that can happen with the posterior cord of the brachial plexus or parts of it

A

axillary –> deltoid paralysis
radial –> saturday night palsy, wrist drop
posterior –> wrist drop

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2
Q

how does the clostridium perfringens alpha toxin work

A

lecithinase –> splits lecithin into phosphorylcholine and diglyceride

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3
Q

what do prostaglandins do to the kidney

A

prostaglandins cause vasodilation of the afferent arteriole

-NSAIDs then cause vasoconstriction

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4
Q

what does angiotensin 2 do to the kindey

A

vasoconstriction of the efferent arteriole

-ACEi cause vasodilation of the efferent arteriole

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5
Q

what are the H2 blockers and how do they work

A

H2 blockers –> cimetidine, ranitidine, famotidine, nizatidine
-work by blocking the H2 receptor which works via Gs and cAMP which then induces the H+/K+ ATPase to work

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6
Q

what type of medication is first line for benign prostatic hyperplasia and what type of receptor does it work on

A

prazosin, terazosin, doxazosin, tamsulosin

-alpha 1 blocker (works on post synaptic cells)

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7
Q

what is the life span of an erythrocyte

A

120 days

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8
Q

how does the small intestine look on x-ray

A

feathery due to the vili and greater mucosal surface area

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9
Q

what enzymes do fluorouracil and methotrexate work on respectively

A

FU (prodrug is capecitabine): thymidylate synthase

MTX: dihydrofolate reductase

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10
Q

patient has had previous chemo for hodgkins…. years later they have numerous blast forms seen in their blood. what do they have?

A

AML (you will see auer rods)

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11
Q

how do the potassium sparing diuretics work

A

work by blocking Na+ channel (ENaC)

-decrease the luminal permeability to Na+ in the cortical collecting duct

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12
Q

first vs second vs third degree burn

A

First –> superficial, through epidermis (common sunburn), painful, erythematous, blanching

Second –> partial-thickness burn through epidermis and dermis, skin is blistered and usually heals without scarring, painful, erythematous, blanching

Third –> full-thickness burn through epidermis, dermis, and hypodermis, skin scars with healing, painless, waxy, leathery appearance, nonblanching

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13
Q

what is osteitis deformans

A

another name for pagets disease of bone

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14
Q

what do laxatives do to the body

A

pt will have an increased anion gap metabolic acidosis and hypokalemia

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15
Q

pt has isolated thrombocytopenia… what do you think of?

A

immune thrombocytopenic purpura

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16
Q

where is the epileptic seizure if a pt smells burning rubber before the event

A

olfactory hallucination –> usually due to aura of TEMPORAL LOBE epilepsy and in brain tumors

17
Q

what type of medication do you give to a pt with nephrogenic diabetes insipidus

A

hydrochlorothiazide

-note that if the nephrogenic DI is due to lithium then use amiloride for the pt

18
Q

explain postpartum thyroiditis

A

self-limited thyroiditis arising up to 1 year after deliver. presents as transient hyperthyroidism, hypothyroidism, or hyper followed by hypothyroidism

  • majority of women are euthyroid following resolution
  • thyroid usually painless and normal in size
  • histology –> lymphocytic infiltrate with occasional germinal center formation
19
Q

what does an increase in dATP do

A

inhibits ribonucleotide reductase used in DNA synthesis

20
Q

what effect does testosterone have on the kidney

A

it stimulates EPO and increases levels of hemoglobin

21
Q

how does parvo cause anemia

A

interruption of erythrocyte precursors

22
Q

how does nicotinic acid (niacin/vitamin B3) work

A 
inhibits lipolysis (hormone sensitive lipase) in adipose tissue 
-reduces hepatic VLDL synthesis
23
Q

In I-cell disease what happens to the stuff that can’t be taken to the lysosomes for degradation

A

it ends up being secreted from the cells into the extracellular space

24
Q

egophony

A

increased resonance of voice sounds heard when auscultating the lungs, often caused by lung consolidation and fibrosis
-It is due to enhanced transmission of high-frequency sound across fluid, such as in abnormal lung tissue, with lower frequencies filtered out

25
Q

normal pressure vs ex vacuo hydrocephalus

A

normal pressure –> affects the elderly and CSF pressure is only elevated episodically, expansion of ventricles distorts the fibers of the corona radiata –> triad of urinary incontinence, gait apraxia, and cognitive dysfunction (WET, WOBBLY, AND WACKY)

ex vacuo –> appearance of increased CSF on imaging but is actually due to decrease in brain tissue and neuronal atrophy. ICP is normal

26
Q

undialyzed renal failure leads to what acid base disorder

A

metabolic acidosis

-as a result bicarb gets depleted as it tries to buffer the accumulation of organic acids

27
Q

pt presents after spontaneous abortion with thrombosis and elevated PT and aPTT

A

antiphospholipid syndrome

  • treat with systemic anticoagulation
  • you can also expect to see anticardiolipin antibodies which can cause false-positive VDRL/RPR
  • lupus anticoagulant can cause prolonged PTT that is not corrected by the addition of normal platelet-free plasma
28
Q

pneumonics for sensitivity and specificity

A

SN-N-OUT –> sensitivity rules out

SP-P-IN –> specificity rules in

29
Q

what equation do you use to determine the infusion rate of a drug (maintenance dose)

A

(CL x Css) / F

30
Q

loading dose equation

A

(Css x Vd) / F

31
Q

lateral corticospinal tracts

A

MOTOR (descending)

-voluntary movement of contralateral limbs

32
Q

what are the ascending tracts in the spinal cord

A

dorsal column
-pressure, vibration, fine touch, proprioception

spinothalamic tract

  • lateral –> pain, temp
  • anterior –> crude touch, pressure
33
Q

how does kaposi sarcoma look on histology

A

slit like vascular spaces with plump spindle shaped stromal cells

34
Q

inheritance patterns of protein structural genes vs enzyme deficiencies

A

protein structural genes –> AD

enzyme deficiencies –> AR

35
Q

when do babies develop a social smile and start cooing

A

2 months

36
Q

when do babies lift their head while prone

A

1 month

37
Q

side effect of nitrates

A

headache

-also hypotension and dizziness

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