NBME17 Flashcards
what are the 2nd generation antihitamines
Loratadine
Fexofenadine
Desloratadine
Cetirizine
“a fox, cert, and lonely rat”
usually end in -adine
which immunoglobulins are the warm and col
Warm: IgG
“warm weather is Great”
Cold: IgM and complement
“Cold weather is Miserable”
small tender blisters on genitals a few days after sex. what are they
Herpes simplex virus 2
what is Rosacea?
erythematous papule and pustules, no comedones
may be associated with facial flushing in response to external stimuli (alcohol, heat)
Phymatous rosacea can cause rhinopehyma (nose deformity)
what does Malaria vs Leishmania look like on stain
Malaria:
tiny little horseshoes with knobs on the end inside of RBCs
Leishmania:
macrophages containing amastigotes- which looks like a polka-dot cell
distinguish between visceral and cutaneous Leishmaniasis
Visceral: Kala-azar
AKA black fever
spiking fevers, HSM, pancytopenia
Cutaneous:
skin ulcers
brazilyensis- “flesh eating”
what is Cholera’s MOA
works w/ a Gs mechanism- so it activates adenylyl cyclase and cAMP
“GaS can” in “cAMP Cholera”
where would a tumor be if it gave you ataxia, but muscle strength, DTR, sensation, and proprioception are all normal
cerebellum
what might a newborn’s serum show if they have congenital CMV
IgG and IgM
the mom’s IgG crosses the placenta
the baby makes IgM
when does neural tube develop
neural tube forms in week 3 and closes by week 4
where does the femoral nerve come from
L2-L4
what are the stages of change
pre-contemplation: no acknowledgment of problem
contemplation: acknowledging there’s a problem, but not willing to do anything
preparation/determination: getting ready to change
action/willpower: changing behaviors
maintenance: maintaining the changes
relapse: returning to old behaviors and abandoning new ones
what is the reaction to poison ivy
type 4, cell-mediated with T LYMPHOCYTES
(linear vesicles)
antigenic activation of T lymphocytes and macrophages leads to the production of lymphokines, which produce the tissue injury.
this rxn does not require formation of antibodies.
what do the labioscrotal swellings make
Scrotum or labia majora
what do the urogenital folds make
ventral shaft of penis (penile urethra) or labia minora
what does the urogenital sinus make x 2?
1- prostate gland or
urethral and paraurethral glands (of Skene) in female
2- Bulbourehtral glands (of Cowper) or
greater vestibular glands (of Bartholin)
what makes the urinary bladder
urogenital sinus + mesonephric ducts
what do the genital tubercles make x 2?
glans penis or
glans clitoris
corpus cavernosum and spongiosum or
vestibular bulbs
what would happen if you were in cold water for 20 min
peripheral vessels would constrict, so
central blood volume would increase
ADH will be decreased, because
your body thinks it has enough volume right now with it all shifting centrally
ANP would be increased, because
it thinks you’re in a hypervolemic state (the atria is seeing more fluid)
delayed separation of umbilical cord is buzzword for what
Leukocyte adhesion deficiency :)
when someone asks about why they’re overweight
you can attribute it both to genes and environment
confused, diarrhea, not taking care of himself, stomatitis, and diffuse rash on sun exposed areas… what does he have
Pellagra
probably from Niacin deficiency
what does a highly sensitive test or specific
sensitivity: rules out the HEALTHY ONES, if this is high and you get a negative test result, then it’s safe to say they don’t have it.
specificity: rules in the disease
so if this isn’t super high, you still need to do additional testing to confirm dx. just because a test is positive, doesn’t mean they definitely have this
what causes beta thalassemia
point mutations in splice sites of introns, causing a retained intron
how could you identify HIV-2
less common, less pathogenic, really only in Africa
p24 (capsid) will be positive in HIV-1 and HIV-2
NAT for viral RNA is more specific, so the primers will bind to HIV-1 not HIV-2, so it can differentiate
what are the 2 possible cancers after complete molar pregnancies
gestational trophoblastic neoplasia GTN:
vaginal bleeding, enlarged uterus, super high beta-hCG
material within endometrial cavity w/ no intrauterine pregnancy
CT shows necrotic intrauterine mass and metastatic nodules
Choriocarcinoma:
can develop in mother or baby
malignancy of trophoblastic tissue
NO CHORIONIC VILLI PRESENT
it looks like these might be the same…
describe Basal cell carcinoma
locally invasive, but rarely metastasizes
Pink, pearly nodules, commonly w/ telangiectasis, rolled borders, central crusting, or ulceration
non healing ulcers with infiltrating growth
scaling plaque!
“palisading” nuclei on histo
describe squamous cell carcinoma
locally invasive, may spread to lymph nodes, but rarely metastasizes
ulcerative red lesions with frequent scale
associated with chronic draining sinuses
keratin pearls on histology
keratoacanthoma is a variant that grows rapidly then may regress
what is actinic keratosis
scaly plaque
precursor to squamous cell carcinoma
usually from people exposed to UVB
what 2 organs release glucose into the blood
liver and KIDNEY
what do type 2 pneumocytes look like
little bear claws
type 1 pneumocytes are really thin stretches of cells
a capillary lumen will have RBCs in it
where whats the buzzwords for suprasellar mass
craniopharyngioma
Rathke pouch remnants
diverticulum of the roof of the embryonic oral cavity ectoderm
ORAL ECTODERM
which factor recruits PMNs to inflammatory sites by epithelial cells
IL-8
what will give you infertility and PID
gonorrhea
pt has progressive thirst, drinking lots of water, and urinary frequency over last 3 days.
Specific gravity <1.006
most likely dysfunction
posterior pituitary- ADH
dilute urine is ADH because it purely affects water/volume
Aldosterone retains Na/water, and dumps K/H+
if they give you a painful blue thrombus in anus, what is it
inferior rectal vein
below pectinate = painful
blue = vein
6 week old infant w/ vomiting small amount of milk 2-3x/day. normal growth. what’s wrong
immature LE sphincter
what is buzzword for pyloric stenosis
olive mass palpable
non bilious projective vomiting 2-6 weeks old
what should you think with polyhydramnios
esophageal atresia- the baby can’t swallow
pure TEF = H type (esophagus and trachea are connected)
EA with distal TEF = most common (blind ending esophagus; gasless abdomen)
widened aortic arch is buzzword for what
dissecting aneurysm
diminished pulses somewhere in L upper extremity
what’s your next step if you suspect a defect in fatty acid oxidation
measure serum acylcarnitine concentration
carnitine is what breaks down fatty acids eventually to acetyl CoA to either go to ketone bodies or TCA cycle
“carnage” of fatty acids
what is 1st degree heart block
prolonged PR interval
benign, asymptomatic
what is 2nd degree heart block
Mobitz type 1 and 2
1: progressive PR lengthening that eventually drops a P wave
variable RR interval
2: randomly dropped P waves
often treated with pacemaker
what is 3rd degree heart block
atria and ventricles functioning independently of each other
atria rate > ventricular rate
treat with transvenous pacemaker
can be caused by Lyme disease
how does toluene toxicity present
glue sniffing in a teenager
daily headaches, bilateral temple aches confused, forgetful ataxia, frequent falls broad-based ataxic gait slow to answer questions
