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Misc > USMLE-RX > Flashcards

USMLE-RX Flashcards

1
Q

Failure to synth MHCII antigens

A

SCID

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2
Q

Leukocyte adhesion deficiency (type 1)

A

LFA1 integrin on phagocytes is defective and can’t bind ICAM1 –> PMNs can’t migrate, so wound healing is reduced, no pus formation, lots of infxns

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3
Q

Chedak-Higashi syndrome

A

Microtubule dysfxn in phag-lysosome fusion –> partial albinism, recurrent infxns, peripheral neuropathy

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4
Q

Wiskott-Aldrich syndrome

A

defective cytoskel organization in T cells –> decreasing lymphocytes over time

Truncal TTP, eczema, recurrent infxns, X-linked

Elevated IgA, IgE; low IgM (vs. hyper IgM: B cells can’t class switch, so get low IgA, E and G)

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5
Q

Nystatin

A

Used to treat thrush (oral candida)

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6
Q

Haloperidol mech

A

Blocks D2 receptors, can –> acute dystonia (most likely with haloperidol of all typical antipsychotics [“-azine”])

Treat dystonia by blocking ACh receptors (eg benztropine)

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7
Q

Typical vs. atypical antipsychotic mech

A

Typical - inhibit D2

Atypical - inhibit D2 and serotonin receptors

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8
Q

Effect of antipsychotics on prolactin

A

Tonic inhibition of prolactin by DP, so when inhibit DA –> increased PRL –> inhib of GnRH –> decreased LH and FSH –> no ovulation

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9
Q

Brenner tumor

A

Ovarian tumor, usually benign, cells look like bladder transitional epith in nests with coffee bean-shaped nuclei among fibrous stroma

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10
Q

Classic triad of fibroma, ascites, and hydrothorax

A

Meigs syndrome - ovarian fibromas (lots of fibroblasts)

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11
Q

Intraperitoneal mucus

A

Pseudomyxoma peritonei (presentation of ovarian mucinous cystadenomas or mucinous cystadenocarcinomas)

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12
Q

Estrogen-secreting ovarian tumor?

A

Granulosa cell tumors -> precocious puberty, endometrial hyperplasia, endometrial carcinomas

Histo: ovarian follicles with eo material (Call-Exner bodies)

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13
Q

Schiller-Duval bodies

A

Look like glomeruli, seen in yolk sac/endodermal sinus ovarian tumors

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14
Q

Krukenberg tumor

A

GI malig –> mets in ovaries (mucin-secreting signet cell adenoca)

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15
Q

Benzodiazepine mech

A

Increase GABA receptor action by increasing Cl channel opening in the receptor

Reverse with Flumazenil (competitive antag at benzo binding site on GABA receptor)

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16
Q

Classic triad of MS

A

Scanning speech
Intention tremor/Incontinence/Internuclear ophthalmoplegia
Nystagmus

“SIN”

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17
Q

MS findings

A

Increased IgG in CSF (oligoclonal bands)

MRI: periventricular plaques, WM lesions = separated in time and space

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18
Q

Symmetric ascending weakeness

A

Guillan Barre

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19
Q

IL2 treats…

A

RCCA and metastatic melanoma

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20
Q

CMV encephalitis MRI findings

A

Enhancing periventricular WM lesions in cortical and subependymal regions

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21
Q

CMV encephalitis histo findings

A

Giant cells with eosinophilic inclusions in cyt and nucleus

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22
Q

FAP mutation

A

Deletions/mut of APC gene on chrom 5 (tumor suppressor gene, mut = aut dom and second hit –> polyps –> adenoca of colon in 100% untreated pts (treat with colon resection))

vs. Hereditary nonpolyposis CRC = assoc with mutations in DNA repair genes (MSH2, MLH1)

23
Q

Hereditary retinoblastoma increases risk of…

A

soft tissue sarcomas, osteosarcomas, melanomas, brain cancer

24
Q

Medullary thyroid carcinoma associated with…

A

MEN 2A and 2B (Ret gene)

25
Q

RCC associated with which genetic syndrome?

A

VHL

26
Q

Painless hematuria - think of…

A

Transitional cell carcinoma

assoc with phenacetin, smoking, aniline dyes, cyclophosphamide

27
Q

4 sx of Gerstmann aphasia

A

Dyscalculia, agraphia, left/right disorientation, finger nagnosia

Lesion in left parietal lobe

28
Q

Ethacrynic acid

A

Loop diuretic that inhibits NKCC in LoH - K wasting diuretic, can –> hyperuricemia

Spironolactone (antag of aldo receptor) and triamterene (inhibits ENac) = K sparing

29
Q

Birefringence of gout vs. pseudogout crystals

A

Gout: needle-shaped, negative birefringent (yellow when parallel to axis of polarization and blue when perpendicular)

Pseudogout: rhomboid-shaped (blue when parallel, yellow when perpendicular)

30
Q

Acute treatment of gout

A

NSAIDs (indomethacin), steroids, colchicine

31
Q

HTLV1 cancer assoc

A

T-lymphocyte leukemia/lymphoma (skin lesions, hyperCa, adenopathy, hepatosplenomegaly)

32
Q

Job Syndrome

A

Hyper IgE - helper T cells don’t make IFN-gamma, so neutrophils can’t get where they need to go –> blunted inflamm response and frequent infxn (esp eczematous skin infx and pulm infxn + course facies and bone fractures)

33
Q

Finasteride

A

Treats BPH

estradiol levels increase with age and sensitize prostate to DHT; finasteride blocks 5-alpha reductase, decreasing conversion of test to DHT

Side effect: promote hair growth

34
Q

Gynecomastia is a common side effect of ____

A
  • Flutamide (treats prostatic carcinoma)

Spironolactone, ketoconazole

35
Q

Loss of blue-green color vision is a common side effect of _____

A

Sildenafil, vardenafil (treat ED by inhibiting cGMP phosphodiesterase –> increased cGMP)

36
Q

Common triad of sx with pericarditis

A

Distant heart sounds, distended jugular vv, hypotension

May –> tamponade, friction rub

37
Q

Drugs that have survival benefit in decompensated HF

A

Beta blockers and ACE-i (“-pril”)

Don’t start beta blockers acutely!!

38
Q

Classic triad of Wernicke-Korsakoff syndrome

A

Wernicke: Confusion, ataxia, nystagmus

Korsakoff: memory problems and confabulations (irrev)

Seen with thiamine deficiency, esp in alcoholism

39
Q

First aortic arch –> _____

Second aortic arch –>

Third –>

Fourth –>

Fifth –>

A

First: Maxillary artery (to deep structures of face)

Second: Stapedial and hyoid aa (usually regress, only important to fetus)

Third: common carotids and proximal internal carotid

Fourth: ascending arch of aorta on L and subclavian on R

Fifth: regresses

Sixth: proximal pulmonary arteries and ductus arteriosus arteries

40
Q

Diethylstilbestrol exposure assoc with increased risk of _____

A

vaginal clear cell adenocarcinoma

Used to treat metastatic prostate cancer (used to be used to treat preg-related things)

41
Q

Scurvy pathophysio

A

Vit C deficiency –> proline and lysine aren’t hydroxylated in ER during collagen production –> ecchymoses, petechiae, corkscrew hairs

42
Q

Associations of primary vs. secondary amyloidosis

A

Primary - multiple myeloma (Ig light chains); that increased serum protein –> rouleaux formation of RBCs

Secondary - chronic dz (TB, RA), serum amyloid-associated protein

Dialysis-associated amyloidosis (accum of MHCI proteins)

43
Q

Small lymphocytic lymphoma can transform into ___ and they share ___ as a cell marker

A

DLBCL, CD5 (usually a T cell marker)

vs. Follicular lymphoma (can transform into DLBCL, but doesn’t have CD5)
vs. Mantle cell lymphoma (has CD5 but can’t transform into DLBCL)

44
Q

LN with cells with open chromatin, prominent nucleoli, moderate amount of cytoplasm - think ___

A

DLBCL

45
Q

Most common cause of B12 deficiency

A

Pernicious anemia

46
Q

IFN-alpha is used for ____

A

its leukocytic effects

tx: hep, Kaposi sarcoma, melanoma, leukemia

47
Q

Lab findings that distinguish thal from Fe-deficiency anemia

A

Thalassemia: normal serum iron, increased retics

Fe-def anemia: decreased serum iron, so can’t have increased retics b/c have insufficient iron for RBC synth

48
Q

What is phenobarbital used for, and why is phenobarbital not used outpt?

A

Anti-seizure drug, works on GABA receptors to increase Cl channel opening

Highly sedating, so only used inpt

49
Q

Anticonvulsants used for tonic-clonic vs. absence and myoclonic seizures

A

Tonic-clonic: Gabapentin, Lamotrigine (most likely to cause SJS)

Absence and myoclonic: Clonazepam (benzo)

50
Q

Down syndrome increases likelihood of this cancer by 20x

A

ALL

“We ALL fall DOWN”

51
Q

Presenting sx of ALL

A

Bone marrow infiltration –> anemia, easy bruising (thrombocytopenia), fatigue etc

52
Q

Childhood illness that can –> trendelenberg gait, and nerve involved

A

Superior gluteal nerve damage from polio

Superior gluteal n. innervates gluteus medius and minimus, which do hip abduction and medial rotation of thigh, keeping pelvis level during gait

53
Q

Pralidoxine

A

regenerates AChE, so reverses AChE inhibitor in case of ACh poisoning

Misc (6 decks)

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