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Level 1/Step 1 > NBME 30 > Flashcards

NBME 30 Flashcards

1
Q

Deformation vs Disruption

A

Deformation = teratogen
changes to structures AFTER embryonic period. Extrinsic forces limiting normal organ development (Potter sequence)

Disruption = normal development occurs but something causes an abnormality (bands + compress + encircle)

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2
Q

Renal papillary necrosis

A

Severe ischemic injury

Sickle cell
Obstructive nephropathy
NSAIDs
DM
Severe pyelonephritis

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3
Q

Osteopetrosis

A

Excessive mineralization of bone

OSTEOCLAST = remodeling and arises from monocyte-macrophage lineage

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4
Q

Porphyria cutanea tarda

A

Severe cutaneous photosensitivity = blistering + hyperpigmentation

Urine color change

Decrease uroporphyringogen decarboxylase (Heme synthesis)

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5
Q

Bortezomib

A

Proteasome inhibitor

prevents Ag processing on MHC1 = not CD8 T cell activation

Tx of MM

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6
Q

Melanosome

A

specialized organelle w/n melanocytes that produce melanin

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7
Q

Gap junctions

A

connexin = communication between cells

think cardiac myocytes

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8
Q

Tight junctions

A

Claudins (Ca++ dependent) & occludins

inflammation = increases permeability

Crohn
Pleural effusion
Pneumonia

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9
Q

Catalyzing the formation of plasmin

A

MOA of fibrinolytic drugs used when percutaneous coronary intervention/CABG not an option

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10
Q

Plasmin

A

serine protease that cleaves fibrin clots

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11
Q

AML

A

Adults w/ pancytopenia
blast cells

mouth ulcers or gingival hypertrophy = neutropenia

ALL = doesnt include platelet

15;17

Vit. A

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12
Q

Multiple Myeloma

A

Clonal proliferation of plasma cells in bone marrow

Plasma cells = clock-face

recurrent bacteria infections

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13
Q

Animal RBC agglutinates when

A

heterophile Ab is present which is seen in EBV

EBV associated with Burkitt lymphoma + nasopharyngeal carincoma

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14
Q

Primary myelofibrosis

A

clonal expansion of Megakaryocytes = increase TGFb

Cytopenias

Extramedullary hematopoiesis = splenomegaly

Dacrocytes

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15
Q

Councilman bodies

A

Hepatocytes = apoptosis + necrosis

Eosinophilic cytoplasm

Acute + Chronic hepatitis

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16
Q

Posterior medial aspect of the kidney

Abscess

A

Psoas fascia

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17
Q

Increase ALP
dense thickening of bony cortex

A

Osteitis deformans (Paget)

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18
Q

Hypermetabolic states

A

Burns

Sepsis

Post-surgery

Traumatic injury

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19
Q

Majority of TH exists in which form

A

T4-globulin

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20
Q

ETC
Complex 1 or 2

A

1 = NADH

2 = FADH2

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21
Q

Leber Hereditary Optic Neuropathy

A

Mit.-inherited

Degeneration of optic nerve & retina in C/L

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22
Q

NRDS

A

Inadequate production of Surfactant by type 2

Atelectasis = alveolar collapse

Proteinsceous debris

23
Q

Calcium oxalate stone Tx

A

Thiazide = inhibits NCC channel

Low sodium diet

Potassium citrate

24
Q

Lies posterior & inferior to aortic valve

A

Mitral

25
Q

Ehrlichiosis

A

Intracellular pathogen = E. chaffeensis

Tx: doxycycline = 30s

Fever + headache + myalgia + rash

Thrombocytopenia + leukopenia + increase transaminase

26
Q

Estrogen initial site binding receptor

A

Cytosol

TH goes to the nucleus

27
Q

Degeneracy

A

Different codons encode for the same AA

Multiple tRNA exists exist for most amino acids

28
Q

Glucokinase

A

Liver, β cells of pancreas

29
Q

Carcinoid tumors

A

Neuroendocrine

GI tract = SI

5-HIAA

30
Q

Actinic purpura

A

Dorsal hands + Forearm

Dermal collagen atrophy + chronic sun exposure = blood vessel fragility

31
Q

Increase
1. Central venous pressure = decrease preload
2. Pulmonary capillary wedge pressure = decrease preload

Reduce TPR

A

Decreases Contractility

32
Q

DM neuropathy

A

Formation of advanced glycation in vascular endothelium = ischemic nerve

Persistent activation Na+ nociceptor

Tx: TCA + carbamazepine

33
Q

↑ LV EDV = ↑SV
↓Pulse

A

Stimulation of Baroreceptors

Arterial stretch

34
Q

Decrease SA and AV nodal activity by ↓cAMP

AV node particularly sensitive— ↑ PR interval

Short acting

A

Esmolol

35
Q

Cystic hygroma = lymphangioma + cystically dilated space filled w/ lymph fluid

A

Turner 45, XO

36
Q

Supplies
1. Flexors
2. Sensory fibers to the lateral forearm
3. Supinate

A

Musculocutaneous

37
Q

Anterior interosseous

A

Pure motor

38
Q

Occult blood = melena

Nocturnal diarrhea

Worsening ab pain

Wt loss

Colon cancer

Family history

A

IBD

39
Q

Soft
Fleshy
Skin- colored papules

A

HPV

40
Q

Dilated Submucosa veins in the anal canal

A

Hemorrhoids

41
Q

↓ K+

Excessive dieting

A

Laxative = ↓pH

Diuretics (low Cl- –> high bicarb) + Vomiting= ↑pH

42
Q

Atazanavir
Darunavir
Lopinavir
Ritonavir

A

Protease inhibitors

43
Q

McArdle enzyme

A

Glycogen phosphorylase

44
Q

 ↑ glycogen in muscle = painful muscle cramps

myoglobinuria (red urine) w/ strenuous exercise

Arrhythmia from electrolyte abnormalities

Second-wind phenomenon noted during exercise due tomuscular blood flow

PAS+

A

McArdle disease (type V)

45
Q

Reflux nephropathy

A

2° vesicoureteral reflux = retrograde flow of urine from bladder into ureter + renal calyces

Abnormal ureteric valve

Chronically → renal parenchyma atrophy + chronic renal failure

46
Q

Uterine atony

A

Postpartum hemorrhage

Boggy uterus

Want uterus to contract & stop vessel dilation

Tx: uterine massage + oxytocin (Gq) = ↑Ca++

47
Q

Which vessels lie posterior to the liver

A

Hepatic veins → drain into IVC

48
Q

Avulusion of celiac trunk /aorta

A

Retroperitoneal hemorrhage

49
Q

Kappa:Lambda should be

A

Equal; when the ratio is↑ (skewed) = CLL

Cancer of mature B cells = large blue cells + scant cytoplasm

Cytopenia + lymphadenopathy

Tx: ilbruti-NIB

50
Q

Pt w/ EBV, the atypical lymphocytes on smear area

A

Cytotoxic CD8+ T cells

51
Q

Migration at developing thyroid gland

A

Along the thyroglossal duct

Base of neck = superior mediastinum
Base of tongue = thyroglossal duct

52
Q

Muscarinic vs Nicotinic receptors

A

CNS = muscarinic

ONLY PNS = nicotinic

53
Q

Cyclosporine

A

Calcinamin inhibitor = no T cell (IL-2) proliferation

Can cause stones

Level 1/Step 1 (15 decks)

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