NBME 30 Flashcards by Barbara Beberaggi

Specificity is calculated using which formula

True negative/ true neg + false positives

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Biceps muscle is in charge of __ and __ the arm.
It is innervated by __

Flexing the elbow and supinating the forearm
Musculocutaneous

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ATBs are indicated in food poisoning by Salmonella enterica only if

Severe, immunocompromised or extreme age

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Using ATBs in salmonella infections can cause ___ but that doesn’t mean one must continue further ATB use

Asymptomatic shedding of salmonella in the stool for a short time

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Amyloidosis proteins that can accumulate in the heart

Lambda light chains
Transthyretin (hereditary)

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In statistics a Type I error and alpha mean

Type I error = false positive = rejects H0 = Accepta H1 (there is a difference between groups)
Alpha value = significance = probability of making a type l error

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Power refers to __ in statistics

1 - beta = chance of detecting true difference between groups

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What’s actinic or senile purpura

Atrophy of dermal collagen from age and actinic (sun-related) damage -> dermal vessels become fragile and easily broken. Common on dorsal hands and arms

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S1 and S2 lesion will manifest as

Sensory deficit on lat foot
Weakness in plantarflexion
Achilles tendon hyporeflexia

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Child or teen with persistent rash around nose and mouths (for months) + conjunctival injection + anorexia + unusual breath odor + other possible multi-organ system, consider

Inhalant abuse (glue, spray, shoe polish, etc)

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Which beta blocker is the most rapid-acting and has short half-life

Esmolol

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Increased cryoglobunins (inmunoGb) associates with___ and can manifest as___

-Chronic viral infections, Chronic inflamm conditions, Lymphoproliferative disease
-purpura (leukocytoclastic vasculitis)

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Mixed cryoglobulinemia sts

*Weakness
*Arthralgias
*Palpable purpura
Hepatosplenomegaly
Hematuria
Peripheral neuropathy

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Migraines are treated with ___ which are ___ that help___

Triptans
Serotonin agonists
Inhibiting descending pain pathways and vasoconstricting

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Proteosome inhibitors mec

Impaire the capacity of proteosome to chop up intracell proteins -> load them up on MHC l -> be recognized by CD8 cells

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MHC I vs MHC ll

I: on All nucleated cells, Presents Endogenous antigens (e.g. viruses, tumor proteins) Recognized by CD8+. Allows CD8+ to recognize and kill infected or abnormal cells

II: on APCs (e.g. dendritic cells, macrophages, B cells) Presents Exogenous antigens (e.g. bacteria, extracellular pathogens) Recognized by: CD4+ (release cytokines and help other immune cells)

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Which ACh receptors are found in the NMJ ?

Nicotinic
*affected in Myasthenia Gravis
*Remember Muscarinic ones are in the PSNS

Succinylcholine (neuromusc blocker) is adm for intubation. Prolongation of its paralyzing effects can be due to a genetic abnormality of

Pseudocholinesterase

Heparin exerts its effects by binding to

Anti-thrombin lll

Sulfunureas names

• 1st gen: Chlorpropamide, Tolbutamide
• 2nd gen (more common): Glyburide, Glipizide, Glimepiride

What’s external validity ?

determines whether an experiment can be generalized, and its conclusions applied to other groups

Cryptosporodiosis vs cryptococosis vs coccidioidomycosis sts HIV

Chronic watery diarrhea
2.meningitis
Lung cavities / meningitis

Suppression vs repression vs denial

S: conscious decision to ignore something
R: unconscious response to deny something internal
D: unconscious response to deny something external

Zollinger-Ellison Sd

Pancreatic or duodenal secreting tumor -> recurrent duo/jejunum ulcers, malabsorption,hematochezia, etc

Causes of male infertility

Blood testis barrier damage due to testicular trauma Klinefelter sd Increased testicular temperature GbRH deficiency

Which cell may be compromised in male infertility and why

Sertoli cells -> line seminiferous tubules and create blood testis barrier (immune protection)

Cystocele vs uterine prolapse

C: Bladder protrudes towards *ant vaginal wall* with valsalva (bulge) Wall weakness U: uterus protrudes into vaginal *canal* Ligament weakness

Blistering and hyperpigmentation after exposure to sunlight, think of __ caused by ___

Porphyria cutanea tarda Decreased activity of uroporphyrinogen decarboxylase (heme producer enzyme)

Pt with fever, chest pain and cough from central California (southwest US), mild eosinophilia and patchy bronchoneumonia. Think of

Coccidioidomycosis

Hypertrophic obstructive Cardiomyopathy TTO

Beta blockers or ND Ca+ channel blockers (reduce HR-> more time for ventricular filling (diastole) -> more coronary irrigation)

If after thyroidectomy, radioIodine ablation is done and radioIodine accumulation is found somewhere else, think of

Ectopic thyroid tissue

Which vitamines absorption is affected in CF?

Vit A, D, E, K (fat-soluble)

Which fat soluble Vit deficiency can cause neuro sts?

Vit E *Similar to B12 deficiency but Vit B is not fat soluble

Weber vs Horner

•Weber sd is a *motor* stroke of the ventral midbrain causing ipsilateral oculomotor palsy plus contralateral hemiparesis. •Horner sd is an autonomic block of *sympathetic* fibers to the eye causing ptosis, miosis, and anhidrosis without motor weakness.

Coarse Facial feature +hirsutism + hepatomegaly + skeletal abnormality. Think of

Mucopolysaccharidoses

Hurler vs Hunter sd (Mucopolysaccharidoses)

Hurler = Hereditary (AR). Hunter = X‑linked → think “H” in Hunter = “Hunts” in boys. • Corneal clouding: Present in Hurler, absent in Hunter. • Enzyme names Hurler: α‑L‑idUronidase Hunter: idUrOnate‑2‑sulfatase Hunter has milder sts

Colonic adenocarcinoma mutations

APC -> KRAS -> p53

Tight junctions (zonulae occludentes) are particularly affected by

Inflammatory diseases

Herpes virus infection is treated with __ which are ___. These must be activated by

-ciclovir Guanosine analogs (inhibit viral DNA polymerase) Thymine kinase