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Rapid Review USMLE Step 1 > Rapid Review > Flashcards

Rapid Review Flashcards

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USMLE® Step 1 flashcards
1
Q

Lipid soluble hormones

A

thyroid hormone, steroid hormones (estrogen, aldosterone, cortisol, testosterone, etc,) fat soluble vitamin receptors.

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2
Q

Proopiomelanocortin (POMC) is a precursor to what

A

produces beta-endorphin(endogenous opioids); ACTH and MSH (bronze)

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3
Q

Somatotropin hormones

A

GH, prolactin

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4
Q

Ecthyma gangrenosum

A

pseudomonas; perivascular bacterial invasion of arteries and veins in the dermis with subsequent release of EXOTOXIN causing necrosis and ulcerations (Dalmatian in sketchy)

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5
Q

Alpha and Beta interferons (secretion, production, moa?)

A

Are secreted in response to virally infected cells. These interferons generate enzymes capable of halting protein synthesis in virally infected cells. Enzymes become active upon detection of dsRNA, which is only present in virally infected cells.

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6
Q

Treatment of hepatic encephalopathy

A

lactulose: bacteria convert lactulose into acetic acid and lactic acid promoting ammonia excretion; Ramifixan is an antibiotic that disrupts GI flora and prevents the formation of ammonia.

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7
Q

Duodenal ulcer

A

Pain better with food, can be caused by H Pylori, very low risk to become malignant; Zollinger Ellison association

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8
Q

refractory peptic ulcers with high gastrin secretion (gastrinoma of the duodenum or pancreas), associated with MEN 1, causes GERD, and diarrhea

A

Zollinger Ellison

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9
Q

pheochromocytoma vs neuroblastoma

A

neuroblastoma is what its called in children; pheo- is in adults

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10
Q

Annular Pancreas

A

abnormal rotation of ventral pancreas–> forms ring encircling part of the duodenum –> narrowing–> obstruction

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11
Q

Pancreatic Divisum

A

ventral and dorsal parts fail to fuse at 8 weeks. benign but can cause pancreatitis or abdominal pain

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12
Q

Obstructive jaundice with palpable, non-tender gallbladder

A

Courvoisier sign; associated with pancreatic adenocarcinoma

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13
Q

Migratory thrombophlebitis- redness, tenderness on palpation fo extremities (migrating DVTs and vasculitis)

A

Trousseau syndrome- associated with pancreatic adenocarcinoma OR adenocarcinoma of the lung

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14
Q

Reynolds pentad

A

Jaundice, RUQ pain, fever– all charcot’s triad + altered mental status and shock (hypotension) associated with Ascending cholangitis

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15
Q

Charcot triad

A

jaundice, fever, RUQ pain- Ascending cholangitis

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16
Q

S Bovis

A

Colon Cancer

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17
Q

Crescendo-decrescendo systolic ejection murmur and soft S2 (ejection click may be present)

A

Aortic Stenosis- Systolic Murmur; Pulsus parvus et tarsus- pulses are weak and delayed; radiates to carotids

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18
Q

Holosystolic, high pitching “blowing” murmur

A

Mitral (loudest at apex; radiates toward axilla) or tricuspid (loudest at tricuspid area; RV dilation); rheumatic fever infective endocarditis- systolic murmur

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19
Q

Late systolic crescendo murmur w/ mid systolic click

A

Mitral Valve prolapse; Marfans, AD-PCKD, fragile-X Syndrome; Ehlers-Danlos- systolic murmur; Chordae rupture, rheumatic fever

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20
Q

Holosystolic harsh sounding murmur

A

ventricular septal defect- systolic murmur

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21
Q

High pitched Blowing in early diastolic decrescendo murmur

A

Aortic regurgitation; wide pulse pressure, bobbing head, headaches
Etiology: aortic root dilation, bicuspid aortic valve, endocarditis, rheumatic fever

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22
Q

Follows opening snap; delayed rumbling mid-to-late diastolic murmur.

A

Mitral Stenosis; often late sequels of rheumatic fever
Complication: leads to LA dilation–> compression of recurrent laryngeal nerve–> dysphagia/ hoarseness via compression of esophagus/ left RcLn. Diastolic

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23
Q

Continous machine like murmur

A

PDA; continuous murmur; Loudest at S2

Congenital Rubella or prematurity

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24
Q

Acute erosive gastropathy

A

erosion extends into the muscularis mucosa but not beyond it

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25
Q

Agraphia, acalculia (unable to carry out simple math), finger agnosia, left-right disorientation

A

Dominant parietal cortex/ angular gyrus; Gerstmann Syndrome;

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26
Q

Agnosia of the contralateral side of the world

A

hemispatial neglect; non dominant parietal cortex lesion

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27
Q

Contralateral hemiballismus

A

contorting an continuous movements that are asymmetric–> subthalamic nucleus lesion

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28
Q

Anterograde amnesia (cant make new memories)

A

Bilateral hippocampus lesion

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29
Q

Vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus

A

Parinaud Syndrome; Stroke, hydrocephalus, pinealoma

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30
Q

Palpable purpura, abdominal pain, arthralgias, acute glomerulonephritis

A

Henoch-Schonlein Purpura

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31
Q

Microthrombi, thrombocytopenia, microangiopathic hemolytic anemia

A

Hemolytic Uremic Syndrome causes by E Coli O157:H7 or caused by shigella

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32
Q

Presence of iron deficiency anemia, dysphagia, esophageal webs

A

Plummer Vinson Syndrome; treatment with Fe typically helps resolve symptoms

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33
Q

insertion or deletion of any number of nucleotides that are not multiples of 3

A

Frameshift mutation

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34
Q

Single base substitution that results in the incorrect placement of an amino acid in the protein sequence. Occur in coding region of a gene, do not alter coding length

A

missense mutation

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35
Q

Replacement of one amino acid with another of the same characteristics.

A

conservative mutation

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36
Q

Single base change within a codon that does not change the amino acid

A

silent mutation

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37
Q

Mutation that results in a truncated protein

A

nonsense mutation

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38
Q

nutmeg liver; hepatic vein thrombus/ obstruction

A

Budd Chiari Syndrome

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39
Q 
Pulmonary hypoplasia, oligohydroamnios, twisted face, twisted skin, Extremity defects (clubbed feet) 
Renal failure (in utero)
A

Potter sequence

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40
Q

Hamartomas of the CNS and skin, Angiofibroma, mitral regurgitation, ash-leaf spots, cardiac rhabdomyoma, autosomal dominant, mental retardation, renal angiomyolipoma, seizures, shagreen patches, increased incidence of giant cell astrocytomas and unfurl fibromas

A

tuberous sclerosis; TSC1 Chr 9; TSC2 on Christmas 16

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41
Q

Mutation associated with Hirschsprung Disease

A

RET mutation; failure of the Aurebach and Meissner plexus

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42
Q

Nucleotide Excision Repair

A

Xeroderma pigments

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43
Q

Mismatch Repair

A

Lynch syndrome (HNPCC)

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44
Q

Polymorphism of Apolipoprotein E

A

Alzheimers

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45
Q

Prion disease (PrPsc)

A

Creutzfeldt Jakob; mad cow disease- bovine; kuru-canabilism

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46
Q

recurrent infection with Neisseria species

A

MAC complex deficiency/ terminal complement deficiency

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47
Q

Increased risk of SLE; severe, recurrent pyogenic infections

A

C1-4 defiinecy

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48
Q

hereditary angioedema; increased levels of bradykinin

A

C1 esterase deficiency (increased C5a and C3a- uncontrolled)

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49
Q

low testosterone; high FSH, high LH, decreased inhibin

A

Klinefelter: Dysgenesis of the seminiferous tubules leading to testicular atrophy (both sertoli and leydig cell dysfunction); decreased Testosterone–> no feedback increased LH, decreased inhibin B–> Increased FSH; mosaic patients have low sperm count; somatic–> azoospermia

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50
Q

Low voltage EKG with diminished QRS amplitude

A

Restrictive Cardiomyopathy

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51
Q

Low Voltage QRS with electrical alternans; pulsus paradoxus

A

Cardiac tamponade; fall >10mmHg in systolic pressure on insipiration

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52
Q

Complication of MI within 24 hrs

A

ventricular Arrythmia causing sudden death

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53
Q

Complication of MI within 1-3 days

A

Post-infarction fibrinous pericarditis

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54
Q

Complication of MI within 2-7 days

A

Papillary muscle rupture

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55
Q

complication of MI within 3-5 days

A

Interventricular Septal rupture

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56
Q

Complication of MI within 3-14 days

A

Ventricular Pseudoaneurysm

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57
Q

Complication of MI within 5-14 days

A

Ventricular Free Wall rupture

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58
Q

Occurs 2 weeks after MI

A

True ventricular aneurysm

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59
Q

Complication of MI several Weeks later

A

Dressler Syndrome: autoimmune attack resulting in fibrinous pericarditis

60
Q

This vitamin deficiency results in cheilosis (inflammation of the lips, scaling and fissures at the corners of the mouth) corneal vascularization

A

Riboflavin; produces FAD and FMN;

61
Q

required vitamin for succinate dehydrogenase

A

riboflavin–> FAD and FMN (For ETC)

62
Q

Pyruvate dehydrogenase (glycolysis to TCA), alph-ketoglutarate dehydrogenase, branched chain ketoacid dehydrogenase and transketolase require which vitamin?

A

Thiamine pyrophosphate (TPP) derived from thiamine B1

63
Q

Confusion, opthalmoplegia, ataxia, confabulation, personality change, memory loss, damage to medial dorsal nucleus of the thalamus, mammillary bodies

A

Wernicke Korsakoff Syndrome

64
Q

Polyneuropathy, symmetrical muscle wasting

A

Dry beri beri- thiamine deficiency

65
Q

light output cardiac failure, edema; Alcoholics

A

Wet Beri Beri (B-1 deficiency)

66
Q

Toxin penetration through the blood- nerve barrier causing peripheral neuropathy

A

Diphtheria toxin

67
Q

Symmetric proximal muscle weakness involving the shoulder characterized by endomysial inflammation with CD8+ T cells ;

A

Polymyositis

68
Q

Night blindness, severe eye dryness and corneal laceration, hyperkeratosis, growth retardation

A

Vitamin A deficiency (diet, pancreatic insufficiency, Cholestatic/ biliary disease, intestinal malabsorption)

69
Q

Contraindicated in pregnancy due to its teratogenic nature causes cleft palate

A

vitamin A (retinol) and valproate

70
Q

Alopecia, dry skin, hepatic toxicity, hepatomegaly arthralgia, pseudo tumor cerebri

A

Vitamin A (retinol) Excess

71
Q

Calcinosis, raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia

A

CREST Syndrome

72
Q

involved in segmental organization of the embryo and is the code for transcription factors

A

Homeobox Gene (Hox)

73
Q

produced at apical ectodermal ridge; + mitosis of underlying mesoderm providing for lengthening of limbs in utero

A

Fibroblas growth factor gene

74
Q

Produced at apical ectodermal ridge, necessary for proper dorsal ventral axis organization; arms can get put on the wrong way

A

Wnt-7 Gene

75
Q

Produced at the base of the limb in zone of polarizing activity; involved in patterning along anteroposterior axis and CNS development; holoproscencephaly

A

Sonic Hedgehog gene

76
Q

ATP Dependent Efflux Pump seen in adrenocortical carcinoma; pumps out toxin including chemotherapeutic agents

A

Multidrug Resistance protein 1 (MDR1)

77
Q

Antibodies against antigens in Purkinje Cells; associated with Small Cell Lung Cancer (anti-HU), gynecologic and breast cancers (Anti-Yo), and Hodgkin Lymphoma (Anti-Tr)

A

Paraneoplastic Cerebellar degeneration

78
Q

Kulchitsky Cell

A

Small cell carcinoma of the lung

79
Q

Chromagranin A +

A

Pheo, Small Cell Carcinoma of the lung, Bronchial Carcinoid Tumor of the lung

80
Q

Proximal extremity weakness that improves with muscle use; associated with small cell lung cancer

A

Lambert Eaton Syndrome; similar to MG but auto-antibodies are directed against Pre-synaptic Ca2+ channels.

81
Q

Flexion of the upper extremities and extension of the lower extremities (decorticate posturing)

A

Associated with lesions about the red nucleus

82
Q

Extension of the upper and lower extremities (decerebrate posturing)

A

associated with lesions at or below the red nucleus

83
Q

Diseases associated with the RET mutation

A

Hirschsprungs disease, MEN2A, MEN2B (medullary carcinoma)

84
Q

Marfan Habitus

A

Homocysteineuria, MEN2B

85
Q

persistent peptic ulcer disease with parietal hyperplasia

A

Zollinger-Ellison

86
Q

Membrane proteins that maintain the integrity of the basolateral membrane by binding to collagen, fibronectin, and laminin

A

Integrins

87
Q

Spherules containing endospores

A

Cocciodiodes immitis

88
Q

Small oval yeast forms within macrophages

A

histoplasma capsulatum

89
Q

Painful genital ulcer with exudate and inguinal lymphadenopathy

A

Chancroid caused by H ducreyi

90
Q

Painless ulcer

A

Primary syphilis

91
Q

Painless, beefy red ulcer that bleeds readily on contact

A

Granuloma inguinal caused by klebsiella granulomatis (cytoplasmic donovan bodies)

92
Q

Painless gental ulcers with painful lymphadenopathy

A

C trachomatis (L1-L3

93
Q

Macrophages loaded with PAS + granules; steatorrhea, arthropathy, polyarthritis, psychiatric and cardiac abnormalities

A

T whipplei- tx with abx

94
Q

painful abdomen, red tinged urine, polyneuropathy, psychological disturbances, precipitated by drugs (Alcohol, tobacco, CYP450 inducers)

A

Acute Intermittent Porphyria- Porphobilinogen deaminase deficiency

95
Q

Anti-Cyclic Citrullinated Antibodies

A

RA

96
Q

Anti-Nuclear Antibodies

A

Sjorgens

97
Q

Anti-mitochondrial Antibodies

A

Primary Biliary Cirrhosis

98
Q

Regression in motor, verbal, and cognitive abilities; ataxia, seizures, growth failure and stereotyped hand wringing- associated with the MECP2 mutation on Chromosome X

A

Rett Syndrome- Mostly girls, boys die in utero

99
Q

Self-mutilating behaviors, gout, mental retardation, repetitive involuntary movements, poor muscle control

A

Lesch-Nyhan syndrome; Deficiency in HGPRT

100
Q

arthralgia, photosensitivity, glomerulonephritis, elevated PTT, and + VDRL/ RPR for treponema palladium.

A

Anti-phospholipid Antibody syndrome: Anti-cardiolipin antibodies yield false positive VDRL tests; prolonged PTT–> clots (lupus anticoagulant)

101
Q

patient with urinary incontinence, gait apraxia, cognitive dysfunction and enlarged ventricles

A

normal pressure hydrocephalus that is compressing the corona radiata damaging descending cortical fibers running in the paraventricular area

102
Q

Decreased tear production, decreased saliva production, lymphocytic infiltrate of exocrine glands, parotid enlargement; Anti-nuclear antibodies, anti-ribonucleoprotein antibodies (Anti-SSA and/or Anti-SSB)

A

Sjorgens Syndrome

103
Q

Anti-Histadyl tRNA Synthetase Antibodies

A

Polymyositis

104
Q

progressive gait ataxia due to spinocerebellar tract degeneration, skeletal abnormalities (kyphscoliosis, per cavus, etc), impaired joint and vibration sense, hypertrophic cardiomyopathy, and DM.

A

Friedreich Ataxia

105
Q

Autosomal Recessive Trinucleotide repeat GAAn on Chromosome 9

A

Friedreich Ataxia

106
Q

severe hypoplasia of marrow erythroid elements only

A

Thymoma, parvo B-19, and lymphocytic leukemias

107
Q

Inhibition of calcineurin preventing IL-2 transcription

A

Tacrolimus or cyclosporin (nephrotoxicity)

108
Q

Inhibition of IL-2 gene transcription

A

glucocorticoids

109
Q

Inhibition of IL-2 R (immunosuppression Rx)

A

Daclizumab, Basiliximab

110
Q

Inhibition of proliferation by blocking IL-2 signal transduction

A

Sirolimus

111
Q

Inhibition of IMP dehydrogenase (immunosuppression

A

Myecophenolate

112
Q

Inhibition of PRPP amidotransferase

A

Azathioprine

113
Q

Anti-bodies against the Alpha 3 chain of the type IV collagen that damage the glomerular basement membrane along with alveoli in the lungs; leads to alveolar hemorrhage and RPGN

A

Goodpasture Syndrome

114
Q

Progressive ataxia, impaired proprioception and vibratory sensation, and hemolytic anemia

A

Vitamin E Deficiency

115
Q

Thiazide diuretics SAEs

A

Hypokalemia (banana peele), contraction metabolic alkalosis (squeeze bleach bottle), hyponatremia (NaCl spilled in pool), hyperglycemia (candy jar), hyperlipidemia (elevated butter stick), hyperuricemia (knitting needles), hypercalcemia (elevated calci-yum ice cream)

116
Q

Loop Diuretic SAEs

A

ototoxicity (Gong), Hypocalcemia (falling calci-yum ice cream/ rare), hypokalemia (banana peele), hypomagnesia (falling magnets), allergy (sulfa eggs), contraction metabolic alkalosis (squeeze bottle), acute interstitial nephritis (blue ticket kidney jar), and gout (knitting needles)

117
Q

Anti-dsDNA Antibodies, Anti-Sm Antibodies, and Antiphospholipid antibodies

A

SLE

118
Q

Benign liver tumor characterized by blood filled capillary

A

Cavernous Hemangioma

119
Q

Benign tumor of the liver that regresses with discontinuation of oral contraceptives or anabolic steroids and histologically characterized by disorganized hepatocytes that do not form the normal lobular architecture

A

hepatic adenoma

120
Q

Mutation associated with Burkitt Lymphoma

A

t(8;14) C-Myc and Ig Heavy Chain

121
Q

Mutation associated with Marginal Cell Lymphoma

A

t(11;18) Bcl-2 and Cyclin D1

122
Q

Mutation association with Mantel Cell Lymphoma

A

t(11;14) Cyclin D1 with Ig Heavy Chain

123
Q

Mutation associated with Follicular Lymphoma

A

t(14; 18) BCl-2 with Ig Heavy Chain

124
Q

Rash/ Cutaneous lesions, lytic bone lesions with hypercalemia, HTLV1 Infection

A

Adult T Cell Lymphoma

125
Q

CD4+ T cell neoplasm that invades the skin causing paltrier micro abscesses

A

Mycosis fungioides/ Sezary Syndrome

126
Q

Translocation associated with ALL

A

t(12;21)

127
Q

Flow Cytometry of B Cell ALL

A

tdt+, Cd20+

128
Q

Flow cytometry of T cell ALL

A

tdt+, CD2-CD8 +

129
Q

TRAP stain positive neoplasm (tartrate resistant acid phosphatase) causing bone marrow fibrosis

A

Hairy Cell Leukemia

130
Q

Flow cytometry of CLL/SmallLL

A

Cd20+, CD23+, CD5+

131
Q

Notable finding of AML bone marrow

A

auer rods (crystallized MPO); AML is MPO+

132
Q

translocation associated with APL

A

t(15;17); mutation of the Retinoic receptor

133
Q

Treatment for APL

A

Trans-retinoinc acid (Vitamin A); promotes maturation of promyelocyte

134
Q

What is the biggest complication of APL

A

DIC: accumulation of promyelocytes–> increased MPO crystals–> coag cascade–> DIC

135
Q

Flow Cytometry for Hodgkins Lymphoma

A

CD15+, CD30+

136
Q

M spike (IgA or IgG) with no CRAb features

A

MGUS

137
Q

M Spike with IgM and symptoms can include raynaud phenomenon, blurred vision, retinal hemorrhage, stroke

A

Waldenstrom Macroglobulinemia (IgM makes blood hyper viscous)

138
Q

Lytic bone lesions and skin rash or recurrent otitis media with a mass involving the mastoid bone; S-100 and CD1a positive; Tennis rackets/ birbeck granules

A

Langherhans Cell Histiocytosis; APCs are immature and do not stimulate T cells via antigen presentation

139
Q

Abdominal mass that on biopsy shows polygonal cells with abundant clear cytoplasm; Where do they originate from?

A

Renal Cell Carcinoma originating from the PCT

140
Q

tumor occurring in the 4th ventricle; perivascular pseudo rosettes

A

Ependymoma

141
Q

calcified well circumscribed masses in the frontal lobe; adults; round nuclei with clear cytoplasm surrounded by anastomosing capillaries in a chicken wire patterning

A

oligodendrogliomas

142
Q

tumors that arise in the cerebellum showing glial fibrillary acidic protein positive (GFAP+) hairlike processes and eosinophilic intracytoplasmic inclusions

A

Pilocytic Astrocytoma

143
Q

Associated with MEN2A and MEN2B; sheets of polygonal cells or spindle-shaped cells with extracellular amyloid deposits derived from calcitonin secreted by neoplastic C cells (parafollicular cells); stain with congo red

A

Medullary thyroid Carcinoma

144
Q

Adverse effect of secondhand smoke in children

A

low birth weight, middle ear disease, and sudden infant death syndrome

145
Q

Patient with glomerulonephritis and nasal ulcers has anti bodies against what?

A

Cytoplasmic Anti-Neutrophilic Antibodies; Wegners

146
Q

Diarrhea, achlorhydria, and hypokalemia that persists with fasting

A

VIPoma; does not involve ulcers

147
Q

cafe au last spots, neurofibromas, optic gliomas, pheochromocytoma, lisch nodules (pigmented iris hamartomas)

A

NF1

Rapid Review USMLE Step 1 (8 decks)

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