Tia's Deck USMLE Flashcards
1
Q
difficulty sleeping
A
problem with LEFT heart
2
Q
pain after delivery
A
most likely ovarian thrombus drains into right or left ivc. Uterin vein frained into internal iliac
3
Q
new house after painting - child with constipation
A
lead posion - constipation , anemia and neurological symptoms
4
Q
chronic hemolytic anemia
A
hemoglobin c- glutamate to lysin - dehydration of rbc
5
Q
bacterial infection
A
gluco < 45 , protein > 250
6
Q
gout pt
A
cox2 inhibitors can reduce il1 at the site of inflammation
7
Q
reid index
A
mucous \ lamina propia + submucosa
8
Q
adenocarcinoma
A
smoking , age over 65 , chrnoic panceratitis , men , herditary pancreatitis, pautz jagher
9
Q
ani smith
A
against snRNP together with Mrna is the splicesosome
10
Q
BRAFF
A
valin to glutamic
11
Q
mutation
A
BRACA 1 BRACA 2
12
Q
crackels
A
fine - pulmonary fibrosis. Due to opening of small aw
13
Q
methylation
A
azathioprin
14
Q
integrins
A
integrins bind fibronectin that bind collagen . Intacelular domain of fibronectin binds actin
15
Q
keratin sulfate
A
keratin sulfate in ecm organized type 1 collagen in cornea
16
Q
virulence
A
transformation - uptake dna , transduction - phage , conjugation - f factor
17
Q
acne
A
anabolic steroids eg methyltestestoron can cause acne
18
Q
area postreme
A
indirectly by ht3 via afferent vegal nerves or directly via dubstance p nk1
19
Q
aortic dissection
A
htn marfan sy , severe pain , >20 hg variation in bp
20
Q
ddx vsd and regurgitation mitral
A
radiation to axilla
21
Q
myxedema degeneration
A
valves are formed from gag and thus can be degenrated by mafan or eheler danlor
22
Q
performance anxiety
A
b blockers
23
Q
qt prolangation
A
romano - no deafness and jurval
24
Q
burgasa sy
A
rbbb and st elevation v1 v3 - can cause ventricular tachyarrythmias
25
theophillin over dose
tachycardia and seizures - treated with bb
26
ami smooth muscle cell ab
autoimmune hepatitis
27
speach
broca - not fluent vs wernice - fluent . In conduction (arcuate fasiculus) - very poor repetition.
28
sarcoidosis
increase ectopic ACE producation and increase ca - non caseating mainly african american
29
monckeberg calcification
effect only media , no itima . Asymptomamtic . Do not acclude vessel
30
onion conceric hyperthrophy
only above 180 bp usually and effects arterioles mainly kidney retina intestine .
31
leriche syndrome
aortoilliac occlusion
32
hpv
can cause squmous cell carcinoma in hiv pt in anal region
33
sevalamer
phosphate binder
34
cri du chat
cat cry hypotonoa , low ears broad nasal bridge
35
digeorge syndrome
trancus arteriolus , clrft plate , low ears
36
patau
cleft and polydactly
37
edowars
prominent occipital and overlapping fingers clench
38
big hematoma
ecchymosis. <5 mm is petachia and smaller is porpura
39
scotoma
any visueal defect sorrounded by unimpaired field of vision
40
trigeminal neuralgia
pain in one side of the face - treatment is carbamazepine.
41
sputum
green color is indicative of neutrophil myeloperoxodase activity
42
ependymoma
histo perivascular rossete.
43
blood supply
lad- supplies anterior aspect of left ventrical - v1-v4. distal will spare the v1v2
44
dilated coronory sinus
pulmonary htn \ presistent left superior vena cava
45
hypersensativity reaction hiv drugs
abacavir - hla b 57 : 01
46
emtrictiban
nrti - palmar rush
47
pulmonic stenosis
soft s2 pluse wide spleating
48
systemic scelrosis
pulmonery htn many times is cause of death
49
heptitic c
no proofreading of exonuclease 3 to 5 prime
50
eosinophilic inclusion
negri bodies - rabies virus
51
delusional
more than 1 month of delusional and no other psychotic symptoms!!
52
bullemia nervosa
hypokalemia , metabolic alkalosis , enlargment of parotid glnd bilateraly
53
alcohol withdrowal
erly sighn : anxiety , tremor , palpitation , gi
54
negative symptoms
lack of facial expression monotome voice poor eye contact
55
nacrolepsy
dx by low hypocretin -1 in csf
56
adhd dx
hyperactivity interfering with functioning in more than 2 setting ( school \ home ) . Dx before age 12 with more than 6 events over 2 months
57
opioids
incresed pain sensetivity in long term use due to - upregulation of nmda receptors .
58
opioids
mu receptor g coupled
59
phencyclidine
presistent nystagmus , psychosis and violent behavioral
60
seratonin precursor
tryptophan - fun syndrome
61
adjusment disorder
if pt meets the critria of mdd than it rules out adjusment
62
pharma - benzos
avoided in pt with substance use history
63
panic
acute - benz , chronic - ssri
64
mao inhibitors
good for atypical antodepressents and anxiety and seleglin for parkinson
65
nacrolepsy
treatment : modafenil , sodium oxybate
66
low calcium
increase ph increses the bound calcium to albumin , less free clacium . Low albomin - less total calcium but same free ionized
67
oculomotor nerve
in diabitic neuropathy the peropheral part is intact ( ehre parasympathetic is ) but the xentral part is smaged thus down and put and ptosis. In aneurysmal - compreesion of periphery too , parasympatetic - loss of accomodation to light
68
young pt sudden caraic death
hyperthropic cardiomyopathy
69
encephalitis causes
hsv , rabies , tick born virus, enteroviruses . Temporal lobe encephalitis- hsv1
70
secretin test
gastrinoma
71
pseupalsisatinf with central necrosis
glioblastoma with new vessel formation , age 40 70 year od age
72
diabitis
fetus develops hyperinsulinemia due to high glucxose for mom , thus in delivery where will be transient hypoglycemia
73
wide splitting
pulmonic stenosis
74
sle
can cause serositis- pericarditis , pleuritis and peritonitis
75
hemartoma
hemartomas are common in lung , cartilage in biopsy
76
testicular cancer
does not transilluminate . Ususlally in young age , not painfull
77
dilated cardiomyopathy
sudden cardiac death at around age 30 40 , fatgue people
78
bph
can predispose to urinary tract infection
79
mutation
in apc we must have polyp while in the other no
80
atheroembolic event
vascular procedures can dislodge a plaque into small arteries. Symp: blue tue , bowek ischemia , acute tubualar necrosis , livedo reticularis
81
aortic stenosis
fibroblast differentiat onto osteoblast like cells thay causes progeressive valvular clacification
82
deposition of sterile platelet thrombi eg limban sacks
leads to regurgiatation rather than stenosis
83
mxomatous
mitral valve prolapse ( mardan eheler danlor )
84
ckd
low clalcium high pth
85
osler weber rendu syndrome
hereditary hemorrhagic telangiectasia , epistaxis
86
abdominal annurism
below renal above bifurcation , can radiate to the back , different pulses
87
irreversible damage
red neurons - eosinophilic cytoplasm and basophilic nuclei
88
kaposi
spindle cells sorrounding blood vessels
89
entamoeba histolytica
trophozoite ingested rbc
90
rapiddly progressive demantia with myclonous and spongiform changes
creutzfeldt jakob disease .
91
diabtis
can cause hylalinization of nerve arterioles leading to ischemic damage.
92
lab value
after alp cheack ggtp to see if its liver damage
93
absence and tonic clonic
valproic acid is the first line treatment for the combination
94
atheroscelrosis suseptabilty
abdominal aorta and coronory
95
diabetis
lengh depended axonopathy - amall fiber- prodominance of positive symptoms while large fiber involvment predominance of negative symptoms
96
zolinger elison
distal duadenal ulcer
97
ttp
normal pt and ptt
98
drug induced toxisity
takes time and is not acute
99
systemic mastocytosis
clonal cell proliferation in bone marrow assocated with mutation in kit receptor tyrosin kinase
100
neuropenic patient
oppurnotist mycosis .
101
tenofovir
can cause fanconi syndrome and on histo - eosinophilic sytoplasmic inclusions
102
negative endocardidtis
coxiella and batonella
103
s3
best heard in lateral decubitis and in expiration
104
etaercept
decoy protein
105
brachicephlic vs svc syndrome
in svc syndrome both sides will be affected
106
gullian barre
albuminocytologic dissociation 0 increase protein and low wbc
107
pneumonia
staph aureus - productive cough
108
parvovirus
begins as flu and than rush spreading from face to trunk .
109
gastroenteritis
no mucous no bloody if its viral
110
prostatectomy
damnge cavernous nerves - eractile dysfunction
111
nucleus arcute hypoth
dopamin
112
hcg
mimcs lh in alpha subunit thus can mimic lh surge- used in pcos
113
syphilid
raised ulcer clean base - syphilis
114
syphilis - dx
nontreponemal - humoral response takes time thus its not sensative in the first 4 weeks
115
alcohol absitenence
natrexon and then disulfiram
116
gestational diabetes
glucokianse mutation - less insulin release
117
strep viridans
adherence to fibron and platlets
118
increase icp treatment
increase cerebral vascular resistance via decreasing co2
119
purulent pericarditis
staph aurous ...
120
head traume leading to lost of taste
avulsion of olfactory outlets
121
hypertansion
can can hemorrhage of retina via fibrinoid necroiss. Htn can be seen as cotton wool spots too
122
tarrry stool and fatigue
associated with alkylating agents - causing death of repidly devideing cell in upper gi -- > blood in atool ( tarry - melane)
123
bacterial meningitis
dexamethason is given broew treatment to reduce inflammtory responce and increase mortality
124
acute memory loss
suspect depression
125
irregular enlargment of uterus
leiomoma
126
levodopa + carbidopa
less vomit , tachyarrythmias but more anxity agitation .
127
seratonin syndrome
accours in combination with other seratogenic agent
128
aging
increase residual volume decrease forced vital capacity , unchanges tlc due to decrease chest wall compliance but increased compliance of lung
129
PE
hypotension , persistent hypoxemia , hypocapnia , respiratory alkalosis --> v\q mismatch - can be pneumoni or more probable to luhypotension to be PE
130
LHF
pulmonary edema severe dyspnea
131
pulmonary htn
rhf - no pulmonary edema ( at least unril lhf occurs too )
132
fat embolism syndrome
petachie , dyspnea , neurological abnor
133
malposition of gential tubrcle
epispadis
134
descent of testis
4 months
135
dwarfism
achrondroplesia \ laron syndrome - achondroplasia- not propotional - prominent forhead saddle nose normal genitelia .
136
swarfism
small genitellia ( laron not doing sex) small head , propotional
137
meckel diverticulum
kjelly bloody urine - can cause intessuspetion
138
bronchopulmonary shunting
decrease only in 4 mmhg between alveolar and vein pressure of oxygen
139
hepatic adenoma
can regress after discontnuetion of OCP ( unlike hemagioma)
140
alaptonuria
AR -black urine , blue black pigmentaation in ear nose cheeks .
141
acute rejection
less than 6 months - lymphocytic infiltrate
142
spleen
9 10 11 rib , liver 8- 11 rib , viceral pleura - dan 4 - 6 rib
143
reye syndrome
liver - microvesicular steatosis ( apaptosis seen in viral infection )
144
pyruvate dh deficeincy
XL
145
cleft lip
defect in fusion of maxillary and intermaxillary segments
146
malate aspartate shuttle
heart and liver
147
preterm labor
terbutulin , nifedipin , indimethacin
148
perineal nerve
deep -anterior compartment of leg - > muscles of dorsiflexio and sensation toes. Lateral comp - sip perineal - sense doral leg
149
anabolic steroid use
concentric lv hypethrophy , reduce diastolic function and reduce coronary vascularization
150
negative tuberculin test
low cellular immunity
151
inspiration
increases right ventricular blood return - thus tricuspid regurgitation can be heart the most . Left side is heard less- like valsava on the left.
152
narrow spectrum anticunvolsion
eg arbamzapin and phentoyn can excerbate myclonic and absence seizure . Only broad spectrum can treat myclonic seiuzures.
153
staning pas
demonstats - glycoproteins and polysacharides - can be seen in hyalin atherosclerosis
154
aortic regurgitaion
hpistol shot , wide pulse pressure ,
155
amino acids
arginine and hitadine are the ones needed drung fast growth .
156
ddx oroti aciduria and ornithin tranca def
only orotic aciduria has megaloblastic anemia and has no elvated ammonia and decrease bun
157
albinism
tyrsinase enzyme deficiency
158
homocystinuria
subluxation of eye is inward and downword unlike in marfin where its upwards
159
mucous in stool
secretory diarrha can be seen in polyps as villous or tubullar
160
fibromascular dysplasia
young woman , involve the medial layer , anneurysms of vessels , common in renal and carotid , renal artery stenosis
161
fetus defect analysis
elvated AFP AND AChE
162
RA
has vascular phenomena and immunological - janway - vascular and osler and roth - immunological
163
gi metastasis
via pertitoneum space - krukenberg and gastric tumor
164
bmpr2 mutation
enlraged artery on imaging ( smooth muscle proliferation )
165
rebound rhinorrhea
after using decongestions more than 3 days develops tachypalxis and rebound vasodilation woithout couphig
166
honycombing on lung
suspect idiopathic pulmonary fibrosis
167
lehf
patient can have pulmonary edema thus decreasing the lung compliance having restrictive like symptoms .
168
cell awelling
increases ca in cell will drow water into the cell
169
dysmorphic rbc
seen in glumerolar damge , isomorphic seen in non glomerular source as urinary tract malg
170
high dofe folic
antagonise phenytoin can cause seiuzers
171
cephalic phase
secretion of acid before meal
172
basal phase
here is always mild acid secretion bw meals
173
all
tdt is a marker of pre b cells or t cells
174
entral chemoreceptorss
esponce to hypercapnia rather to o2 ( unlike carotid body )
175
carotid sinus
baroreceptors
176
CANCER
LIPID PEROXIDATION - YELLOW BROWN - due to raddiation in cancer
177
right cornory artery blockage
supply the sa and av thus can cause bradycardia in case of blockage .
178
surfectant
transferred by lamellar bodies
179
informed consent
by someone who does the procedure - its adialoge!!
180
incapacitated pt
protect privacy by telling the relative if he is stable but no other info
181
saddle nose
can be part of weagner triad
182
steady state
reaches in 4 5 hf
183
hear remodeling recovery
after reperfusion it will take months for remodeling eg ventricular to be healed
184
low EF in ischemic heart
hibernation of myocardium " - decrease contractility and metabolism to adjust to lack of oxygen state
185
renal cell carcinoma
orginated from proximal renal tubules
186
to increase compliance of pt - eldery
if present and close - doughter . If not check list .
187
mother refusing to treat child
obtain court injunction
188
hospital ethics committee
only in ethically dificult situation
189
management of somatic symptomes
regular visitis with same providor
190
prognosis of breast canceer
worse in TN and in HER +
191
falcifarom ligament
contains the round ligament - fetal umblical vein . Used to be anterior mesentery in fetal development
192
exudate teansudate
pleural fluid ldh >2 upper limint of the serum =light criteria. If it meets it that might indicate exudate. Glucose is high in transudate due to lack of inflammatory cells eating it
193
adenocarcinoma
kras mutataion is seen in smokers while alk gene and egfr in non smokers
194
adenocarcinoma
paraneoplastic syn: hyperthropic osteoathropayh
195
atheroscelrotic plague
stemi- rapture and thrombus formation - fully ocllusion
196
hemosiderin laded macrophages
present in chronic lung congestion but not in acute
197
red blood cell cast
glumerolar disease . Red cells are in disruption of urethral epithelium
198
congenital torticollis
sternocleidomastoid fibrosis due to malposition of head in fetus
199
reassortment
genetic shift heppans only in those who are segmented
200
minute ventila
tidal volume * resp rate
201
mechanical ventilation weaning
weak respiratory muscles - increase respiratory rate but low tisal volume . Rsvi - low indicated high tidal volume--> cant be discontinoued of ventilation
202
nitrates
have moderate effect on arteries too
203
antiarrythmics
class c - rate depended manner can increase the qrs and the qt a little.
204
sedative drugs
high gas blood partition --> low onset
205
femoral hernia
far more common in woman , can cause icarceration due to small area. Lateraly is the femoral vein
206
melanoma
s100 + hmb 45
207
midical history taking
open ended quations
208
matched ventilation and perfusion defect
-obstruction atalctasis and airway inflammation - poor ventilation and hypoxic vasoconstriction
209
dilitiazam
constipation is a major se
210
aspirin
protective in barret esophagus , protective in colorectal cancer
211
salt wasting
due to excessive salrt wasting via sweat ( also cl )
212
hyperchloremia
can develop to exsseve sweating
213
systemic infection candida
imunodeficiency in granulocytes number while in t deficienct is more local
214
differentiation of trigeminal neuralgia and cluster
duration . Cluster ( 15 min to hours ) while trigeminal neuralgia seconeds
215
restless leg syndrome
iron defeciency , ckd -
216
prion disease jacob
periodic sharp wave EEG
217
ALZHAIMER
PRESENILIN 1 and 2 --> earlier onset
218
whare the partial sezures orginiate ?
midial temporal lobe
219
what do you rule out before dx dementia ?
depression
220
drug damage substansia nigra
mptp
221
huntington neural death
nmda toxisity - glutamate
222
sevirity of alzhimer
corrolets with neurofibrillary tangles
223
sabouraud agar
growing fungi - "fun guy - sab +
224
e coli
gores green in eosin methilin blue culture
225
infants
the minarales they really need is vitamin k and vitamin d
226
duadenal atresia
down syndrome
227
normal aa gradient hypoxemia
high altitude or obesity hypoventilation syndrome
228
complete mole
more common to have xx than x y
229
up to 2 weeks after mi
ventricu;ar free wall rapture = can lead to severe hypotention
230
increased dlco
asthma - intact alveolar arterial membrane and icrease flow to the area
231
osmolarity urine > 100
indicative to sidh
232
seep deprevation
can effect cognitive behavioral , can cause mistakes at handeling patients
233
temporary local hypoxia in retina
up regulated vegf
234
treatment of congenital syphilis
1 trisemester - penicillin
235
neisseria ganneria prevention
erythoromycin ointment for infants
236
dx of neisseria
gonococi- nat , maningo- pcr + culture
237
leprosy dx
tissue biopsy or pcr
238
salmonella - why do we need flagella?
hematogenous spread
239
shigela vs salmonela typhi
bloody diarreha- salmonela --> constpation before
240
salmonela typhi
monocyte response unlike the others pmn
241
h influenza culture
needs factor five and ten. Five is given by hemolysis by staph aerous
242
osteomylitis after oancture wound
pseudomona
243
spirocetes
light microscopy - borrelia is the only spirochete big enough to visualize
244
e coli
can be trasmited from row leaf veg too
245
etec
enterotoxins!
246
helicobacter
oxidate catalase urease +
247
only e coli that invaded intestinal nucosa
enteroinvasive
248
klebsiella normal flora
intestine
249
sudan staining
dx of steatorea - kind of screening test non specific . For specific - checking oca parasites
250
t cell all
presents ad mediastinal mass can cause dysphagia
251
wilson
treament : zinc \ chelators
252
cavernous hemangioma
can heppan in brain and liveer
253
glioblastoma
necrosis pseudopalsiating
254
ependymoma
perivascular pseudorossetes
255
glucorticoids
chronic use of glucorticoids can cause hypotention in surgery due to not suffcient increase in cortisol level due to stress
256
tensor tympani
dampening the noices produced by chewing by streching it. Inerveted by trigeminal nerve
257
crohn
less absorbtion of bile due to inflammation , more wasting , increase odds of developing stones
258
nrti
inhibit phosphodiester bond formation
259
pure motor symptoms , nocortical
lacunar infract
260
neuropenic patient
endogenous bacterial flora , neutropenia causes fever to be only side of infection
261
vasculitis
first of all anyursm than inflammation and fibrosis . Beads on a string.
262
vasculitis
fibrinoid necrosis : polyarthritis nodosa , weagner , chraug , microscopic polyangitis
263
tau alzhaimer
microtubule associated protein
264
alzhimer
early onset - presinilin 1 and 2 , down syndrome
265
alzhimer
if app undergo beta cleavage instead of alpha --> ab amyloid is formed
266
pick
early change in language and behavioral , personality , rem disturbacnes hallucination
267
lewy disease
dimentia and parkinson within 1 year . ( in parkinson dementia is after years )
268
what is common cause of death in hantgton
suicide
269
prpcs
congo red , resistente,spongiform encephalopathy - intracellular vacuols. Ataxia,periodic sharp waves,dmentia , death 1 year.
270
creutzfeldt
rarely can transmited via cotact with prion infected tissue eg retinal transplant
271
fetal familiar insomnia
inherited spongiform encephalopathy
272
arachnoid post maningtis
can cause arachnoid granulation scarring and eventtually lack of absorbtin
273
ddx bw norml pressure and ex vaco
wet, webby , wacky
274
adjesment disorder
markej dysfunction !!! Functional impirment
275
hbsag
vaccination --> impir virion entry to hepatocyte !!
276
sle
anti nuclear r sensative but ani smith and ani dsdna is spesific
277
delirium
indicates some medical problem . If a patient is in delirium in hospital suspect ilness
278
h pylori
can cause hyperplasia of submucosal galnds such as brenner .
279
kit cd117
systemic matocytosis - clonal mast cell proliferation .. More histamin more gastric secretion
280
ebv
reactive ly,phocytes - accumolation of proferins
281
heptatitis
where cooporation isnt good idea. Coinfection of d and b is longer!
282
hepatitic c
lack of 3 5 exonuclease activity lead to antigenic varietion of the envelope proteins
283
circadian rythem disorder
sleep in day , wakt ar night
284
infraction in mca
homonymois hemianopia- due to damaging the radiations to both temporal and prietal
285
anion gap
calculated as : na - (chloride + bicarbonate ) . Normal 10 -14
286
ethynyl glycol
can cause calcium oxalate stones , acute kidney injury + non anion gap !
287
preload
increase preload increases the overlapping bw actin and myosin. Too much preload will decrease contractility evetually
288
velocity of ocntraction
depended on after load
289
decresing extracelular ca
reduced contractility cause more ca will leave the cell
290
sam
conversion of norepinephrin to epinephrin , controled by cortsiol , in adrenal medulla
291
varicoceles
when patient lies than the blood returns and is wont be seen
292
celliac
dermatitis hepatiformis is on the extensors
293
eactive arthritis
the joint aspiration is aterile
294
prokaryotes
have no nucleus
295
aphtous ulcers and perianl inflammtion
indicative of crohn
296
osteomalacia
decrease mineralization of osteoid
297
iron deficiency
burning sansation in the mouth
298
arthritis
children - h influenza athritis . Adult- staph aureus
299
nitrates
reflex tachycardia!!!!
300
polygenic
defect in numerus unrelated genes eg in diabetis
301
histamin 1
does not praticipate in pathogenesis of asthma. Histamin 4 does
302
isotretinoin
ear anomalities microcephalyu hydrocephalot microganthia ..
303
vagotomy
peptic ulcer disease treatmnet
304
globus sensation
functional abnormality usually due to stress emotional problems
305
diabetis
achilis tendon inspection is one a year while foot inspection is every month
306
fde5 inhibitors
eaffect corpus cavernosa via c gmp
307
acute hymokytic transfusion
antibody mediated type 2 hs
308
sudden vision loss and pain
vasculitis ! Fibromylga rehumatica- pain!!
309
urine test vs serum
urine test is postive for pregnancy after 14 days( level = 20 u\l) while serum is after 8 days
310
cauda equina
disruption of pelvic slechnic nervs provide parasympatethis inervation . No urniation .
311
inguinal hernia
inguinal canal contains illiogunal nerve round ligament and spermatic cord
