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Random Facts Flashcards

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USMLE® Step 1 flashcards
1
Q

Clubbing of Fingernails may indicate

A

cyanotic congenital heart disease, cystic fibrosis, chronic inflammatory bowel disease; any disease that decreases the blood flow to the periphery, often caused by intrathoracic dysfunctions (Cardiac or Respiratory Pathology)

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2
Q

BPH treatment

A

Tamsulosin, α1-antagonist, selective for alpha-1A,D found on the prostate

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3
Q

Alpha-1B receptors are found on

A

vascular system

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4
Q

Erectile dysfunction treatment

A

Sildenafil, Vardenafil

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5
Q

Sildenafil, Vardenafil mechanism of action

A

selective inhibition of PDE-5, causing increased cGMP, SM relaxation and vasodilation of the corpus callosum

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6
Q

Sildenafil, Vardenafil are used to treat

A

Erectile dysfunction & pHTN

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7
Q

Sildenafil, Vardenafil Side Effects

A

HA, flushing, dyspepsia, hypotension

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8
Q

Treatment for Crohn Disease

A

5-ASA, steroids, and immunosuppressants

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9
Q

Failed initial treatment for Crohn Disease, pt may try using this TNF-alpha target

A

Infliximab, Adalimumab

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10
Q

Infliximab, Adalimumab are used to treat

A

IBD, RA, ankylosing spondylitis, psoriasis

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11
Q

Infliximab, Adalimumab

A

blocks TNF-alpha

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12
Q

Spironolactone, Eplerenone MOA

A

competitive Aldosterone receptor antagonists in the cortical collecting tubule

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13
Q

Triamterene, Amiloride MOA

A

block Na+ channels in the cortical collecting tubule

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14
Q

Treatment for Hyperaldosteronism

A

Spironolactone, Eplerenone & Triamterene, Amiloride

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15
Q

Side effects of Spironolactone, Eplerenone & Triamterene, Amiloride

A

hyperkalemia, arrhythmias

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16
Q

Side effects of Spironolactone specifically

A

endocrine effects -> gynecomastia, antiandrogen effects

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17
Q

Name the major S/S in DiGeorge Syndrome

A

Cleft palate, abnormal facies (low-set ears, hypertelorism), Thymic aplasia (T-cell deficiency), Cardiac defects (Truncus arteriosus, ToF), Parathyroid aplasia (hypocalcemia), muscle spasms d/t hypocalcemia

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18
Q

DiGeorge Syndrome genetics

A

22q11 deletion syndromes - microdeletion

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19
Q

DiGeorge Syndrome pathology

A

aberrant development of 3rd and 4th

branchial pouches

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20
Q

First Branchial pouch

A

endoderm lined structures of the ear: auditory tube, middle ear, mastoid antrum, and inner layer of the tympanic membrane.

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21
Q

2nd Branchial pouch

A

epithelial lining of palatine tonsils

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22
Q

3rd Branchial pouch

A

3 structures, ventral wings - thymus, dorsal wings- left and right inferior parathyroids

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23
Q

4th Branchial pouch

A

dorsal wings - superior parathyroids

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24
Q

Branchial pouches—derived from

A

endoderm

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25
Q

Branchial arches—derived from

A

mesoderm & neural crest

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26
Q

Branchial clefts—derived from

A

ectoderm

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27
Q

Enzyme deficiency that may cause precocious puberty

A

21-hydroxylase deficiency

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28
Q

21-hydroxylase deficiency is the most common cause of

A

Congenital Adrenal Hyperplasia

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29
Q

Days 1-4 of the menstrual cycle occurs d/t what change in what hormone?

A

DECREASE in PROGESTERONE in the absence of fertilization –> menses

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30
Q

The follicular phase of the menstrual cycle begins with what hormone?

A

GnRH (hypothalamus)

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31
Q

Effects of GnRH (hypothalamus)?

A

GnRH (hypothalamus) ->

Inc FSH & LH (pituitary)

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32
Q

Effects of FSH (pituitary)?

A

FSH (pituitary) -> maturation of follicular Granulosa cells -> Aromatase production -> conversion of Androstenedione to Estradiol (E2)

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33
Q

Effects of Estradiol (granulosa cells)?

A

Estradiol -> endometrial proliferation

Estradiol -I FSH & LH (pituitary) d/t Neg Feedback

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34
Q

Effects of LH (pituitary)?

A

LH (pituitary) -> androgen secretion (theca interna cells) d/t Desmolase production -> conversion of Cholesterol to Androstenedione

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35
Q

Oligo- prefix

A

scanty or too little/few

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36
Q

Oligomenorrhea

A

> 35d cycles

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37
Q

Polymenorrhea

A

<21-d cycles

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38
Q

Metrorrhagia

A

frequent, irregular menses

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39
Q

Menorrhagia

A

heavy menses (>80mL or >7d)

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40
Q

Menometrorrhagia

A

heavy irregular menses

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41
Q

Desmolase (produced by ?, catalyzes ?)

A

produced by Theca cells, catalyzes the conversion of Cholesterol to Androstenedione

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42
Q

Aromatase (produced by ?, catalyzes ?)

A

produced by Granulosa cells, catalyzes the conversion of Androstenedione to 17b-Estradiol (E2)

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43
Q

What causes the LH surge?

A

High levels of estradiol produced by the follicle, neg. feedback switches to POSITIVE feedback when Estrogen peaks

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44
Q

Estradiol peaks

A

Day 1 of Ovulation

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45
Q

Until ovulation, oogenesis is arrested at what phase?

A

Prophase I of Meiosis I (Primary Oocyte)

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46
Q

Until fertilization, oogenesis is arrested at what phase?

A

Metaphase II of Meiosis II (Secondary Oocyte)

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47
Q

DNA content of a Primary Oocyte?

A

2N, 4C (46 sister chromatids)

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48
Q

DNA content of a Secondary Oocyte?

A

1N, 2C (23 sister chromatids)

49
Q

DNA content of an Ovum?

A

1N, 1C (23 single chromatids)

50
Q

What secretes Progesterone during the menstrual cycle?

A

Corpus Luteum

51
Q

If fertilization occurs, which hormone supports the corpus luteum and Progesterone production?

A

hCG

52
Q

Progesterone causes?

A
  • > endometrium maturation (spiral aa. dev. & glandular secretions)
  • I FSH & LH (Neg Feedback to Pituitary)
53
Q

Mittelschmerz

A

mid-cycle ovulatory pain d/t peritoneal irritation

54
Q

Fertilization occurs _________ & w/in __ days of ovulation

A

ampulla & w/in ONE day of ovulation

55
Q

hCG is produced by

A

Syncytiotrophoblasts of the placenta (outer layer of the blastocyst, formed by replicating trophoblasts)

56
Q

hCG is detectable in blood

A

1 week after conception

57
Q

Pregnancy tests detect

A

beta-subunit of hCG

58
Q

HIGH levels of hCG may indicate

A

multiple gestations or pathology (hydatidiform mole, choriocarcinoma)

59
Q

Lactation following delivery occurs d/t

A

decreased Progesterone and Estrogen levels + suckling/nerve stimulation
-> disinhibition of Prolactin & Oxytocin

60
Q

Prolactin Lactation Effects

A

induces & maintains milk production & decrease reproductive function

61
Q

Oxytocin Lactation Effects

A

assists in milk letdown & promotes uterine contractions

62
Q

Breast milk contains what immune components

A

maternal Ig (mostly IgA; passive immunity) + macrophages + lymphocytes

63
Q

Main form of estrogen following Menopause

A

Estrone (peripheral conversion of androgens)

64
Q

What hormone is greatly elevated following Menopauses & why?

A

FSH, absence of NEG feedback by estrogen

65
Q

Hormonal changes following Menopause

A

HIGH FSH, high LH & GnRH, LOW Estrogen

66
Q

Menopause S/S

A

Hot flashes, Atrophy of Vagina, Osteoporosis, CAD, Sleep disturbances (HAVOCS)

67
Q

Menopause before 40 can indicate

A

Premature Ovarian Failure

68
Q

Hormone imbalance in Diabetes Insipidus

A

Insufficient Vasopressin (inability to concentrate urine)

69
Q

Hormone imbalance in SIADH

A

Excess Vasopressin (aka ADH)

70
Q

Hormone imbalance in MEN Syndrome

A

Excess PTH

71
Q

Hormone imbalance in DiGeorge’s Syndrome

A

Hypoparathyroidism - Insufficient PTH

72
Q

Kartagener Syndrome

A

ciliary dyskinesia -> impaired sperm tail mobility -> infertility

73
Q

5alpha-reductase action

A

conversion of Testosterone –> DHT

74
Q

Which drug inhibits 5alpha-reductase?

A

Finasteride

75
Q

Kallman Syndrome

A

defective migration of GnRH cells -> low GnRH production -> low FSH/LH -> amenorrhea

76
Q

Factors that decrease GnRH production

A

stress, anorexia, severe weight loss, extreme exercise, HYPERprolactinemia

77
Q

Sheehan Syndrome

A

pituitary infarct (often d/t hypotension & hemorrhaging during delivery) -> low FSH/LH -> amenorrhea

78
Q

Premature Ovarian Failure

A

Menopause before age 40 (amenorrhea)

79
Q

Premature Ovarian Failure Pathophysiology

A

Follicle Depletion (Turner’s, Fragile X, Toxins) or Follicle Dysfunction (Autoimmune)

80
Q

Savage Syndrome

A

Ovarian resistance to FSH/LH

81
Q

Common presentation of Sheehan Syndrome

A

Failure to Lactate, amenorrhea, cold intolerance

82
Q

17alpha-hydroxylase deficiency may cause

A

ambiguous genitalia, amenorrhea, hypocortisolism, hypertension,

83
Q

17alpha-hydroxylase deficiency -> hormone results

A

No sex steroids or cortisol

High mineralcorticoids

84
Q

21alpha-hydroxylase deficiency -> hormone results

A

No cortisol or mineral corticoids

High sex steroids

85
Q

11beta-hydroxylase deficiency -> hormone results

A

No cortisol or Aldosterone

High sex steroids & 11-deoxycorticosterone

86
Q

Obese woman, facial hair, amenorrhea, high LH:FSH ratio (>3:1) –> think

A

PCOS

87
Q

Androgens & Cortisol are produced where in the adrenals?

A

zona fasciculata & zona reticularis of the adrenal cortex

88
Q

Aldosterone is produced where in the adrenals?

A

zona glomerulosa

89
Q

High LH:FSH + Androgen excess

A

Ovary is the source (LH stimulates theca androgen production; low FSH cannot cause the conversion of all the androgens to estrogen)

90
Q

The androgens DHEA & DHEA-S are produced by

A

adrenal gland

91
Q

Cushing Syndrome - hormone imbalance?

A

Hypercortisolism

92
Q

Cushing Syndrome - S/S

A

moon face, buffalo hump, weakness

93
Q

Cushing Disease - hormone imbalance?

A

High ACTH d/t hypersecretion usually from a benign pituitary adenoma

94
Q

Hirsutism & Virilism are associated w/ Cushing Syndrome or Cushing Disease?

A

Cushing Disease! High ACTH -> androgen production

95
Q

Bartholin Cysts are most common in

A

women of reproductive age

96
Q

Bartholin Cysts d/t

A

inflammation & obstruction of gland

97
Q

Vulva epithelium?

A

stratified squamous

98
Q

Condyloma Acuminatum- prevalent HPV strains

A

HPV-6 or -11

99
Q

High-risk strains of HPV

A

HPV-16, -18, -31, -33

100
Q

Hallmark feature of cells infected w/ HPV

A

Koilocytic changes (acentric, hyperchromatic nucleus that is displaced by a large perinuclear vacuole; “crinkled nucleus”)

101
Q

Fabry Disease

A

Sex-linked, Lysosomal Storage Disease

102
Q

Fabry Disease leads to the accumulation of

A

Ceramide Trihexosidase

103
Q

Fabry Disease Sx

A

peripheral neuropathy, ocular abnormalities, multiple diffuse purplish nodules

104
Q

Fabry Disease - deficiency of

A

alpha-galactosidase

105
Q

Fabry Disease Pathology

A

angiokeratoma corporis diffusum (cavernous hemangioma w/ epidermal keratosis), thickened blood vessels (MI risk), progressive renal Fx & HTN

106
Q

Niemann-Pick Disease leads to accumulation of

A

Sphingomyelin d/t a deficiency of sphingomyelinase

107
Q

Lichen Sclerosis S/S, common pt

A

atrophy of vulvar epidermis & fibrosis of dermis -> white patches + paper-thin skin
Seen in Post-menopausal women

108
Q

Lichen Simplex Chronicus S/S, common pt

A

Hyperplasia of the vulvar epithelium -> white patches + thick, leathery skin d/t chronic irritation

109
Q

Tx for Gestational HTN

A

Deliver @ 39wks + alpha-methyldopa, labetalol, hydralazine, or nifedipine

110
Q

Which drugs should NEVER be used to Tx Gestational HTN? Why?

A

ARBs or ACE-I –> risk of fetal renal failure or fetal death

111
Q

HIGH hCG

A

Complete Mole > Partial Mole

112
Q

LOW hCG

A

Ectopic Pregnancy

113
Q

passage of “cluster of grapes” + “snowstorm” pattern w/o fetus on U/S —> think…

A

Molar pregnancy

114
Q

HIGH alpha-fetoprotein (AFP) @ 16wks

A

may indicate neural tube defect

115
Q

LOW alpha-fetoprotein (AFP) @ 16wks

A

may indicate Down Syndrome

116
Q

“chocolate cysts” on ovaries –> think…

A

Endometriosis

117
Q

Chandelier sign —> think…

A

PID (often d/t N. gonorrhoeae, or C. trachomatis)

118
Q

Clue cells —> think…

A

Bacterial Vaginosis (Gardnerella vaginalis) –> cover the outside of vaginal squamous epithelial cells

119
Q

Most common breast tumor in premenopausal women

A

Fibroadenoma

USMLE PREP!!!! (7 decks)

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