USMLE Rx: Week of 06/27/16 Flashcards by Peter Klauck

What is the mechanism by which NO alleviates angina?

NO, at low doses, only dilates the veins; thus, it decreases preload and then decreases myocardial oxygen demand

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Most types of kidney stones are radio-________. Cysteine is the main exception.

opaque

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What kind of malignancy causes Horner syndrome?

Pancoast tumor

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What antibody is found in those with myositis?

Anti-Jo-1

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Another term for Heinz bodies is __________.

inclusion bodies

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What is the most important prognostic factor for children with tetralogy of Fallot?

The degree of pulmonic stenosis

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What drug leads to down-regulation of GnRH and thence down-regulation of FSH/LH?

Leuprolide

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_________ inhibits 5-lipoxygenase.

Zileuton

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What is the only antihypertensive agent that can be delivered transdermally?

Clonidine

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What receptor does clonidine target?

Alpha-2

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What drug is administered with methotrexate to avoid myelosuppression?

Folinic acid (a derivative of THF)

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Of ACE, ARB, and loop diuretics, which are safe in pregnancy?

Only loop diuretics

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Glossitis in a smoker can indicate _____________.

superior vena cava syndrome

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Meningiomas will histologically demonstrate ___________.

psammomma bodies

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ATP binding to myosin causes _____________.

myosin to detach from actin

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What kind of lung disease does Goodpasture’s cause?

Restrictive

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Fibromuscular dysplasia is the main cause of secondary hypertension in ___________.

children and young adults

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What is the mnemonic for types of cancers that lead to psammoma bodies?

2PM
Papillary thyroid cancer
Papillary serous cystadenoca ovary
Meningioma
Mesothelioma

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The ____________ is the most commonly fractured carpal bone.

scaphoid

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Fracture of the _________ is usually not noticeable immediately after the injury, but becomes apparent with avascular necrosis later on.

scaphoid

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Again, what kind of lung cancer leads to cavitation?

Squamous cell carcinoma

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Leiomyosarcoma leads to what kind of cells on histologic examination?

Spindle-shaped smooth muscle cells

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What bleeding disorder can affect infants born at home?

Vitamin K deficiency (because vitamin K is given to all hospital-born infants); thus, PT and PTT are extended, and bleeding time and platelets are normal

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Describe the histologic presentation of Ewing’s sarcoma?

Large nuclei, scant cytoplasm, rosette formation around fibrous centers

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What two things can cause renal tubular acidosis?

Failure to reabsorb bicarb (such as by acetazolamide use) or failure to secrete hydrogen ions

Acetazolamide leads to what pH disorder?

Metabolic acidosis; inhibiting carbonic anhydrase in the proximal tubule leads to increased bicarb excretion

Congenital diaphragmatic hernia is associated with ______-hydramnios.

poly

Adults with warm autoimmune hemolytic anemia (WAHA) are treated with ________, while children respond better to ____________.

IVIG; corticosteroids

Both ACEi and ________ can prevent diabetic nephropathy.

angiotensin-receptor blockers

Recall that direct Coombs tests use patient _________, while indirect tests use patient _________ and donor __________. Both use anti-IgG antibody.

RBCs; serum; RBCs

Prostate cancer commonly causes _________ in the bones.

osteoblastic deposition

What is Courvoisier's sign and what does it indicate?

Enlarged gall bladder; pancreatic process

Trousseau's sign is ________ and indicates ________.

migratory thrombophlebitis; pancreatic adenocarcinoma

The dorsal root carries the _________ neurons.

sensory ("Feel my dorsal Fin")

Family adenomatous polyposis results from __________.

inherited mutation of the APC tumor suppressor gene on chromosome 5 ("five letters in polyp")

Those with FAP are at increased risk of ____________ tumors.

medulloblastomas (called Turcot syndrome)

"How well a test rules out..." = __________.

sensitivity (TP / (TP + FN))

Stratified squamous epithelium in the lung indicates _________.

squamous cell carcinoma; there should only be simple squamous in the lung (in the alveoli, to be specific)

Which nerve is affected in Horner's syndrome?

Preganglionic sympathetic

"One-carbon transfers" = ____________.

methylation reactions

"In-frame deletions" = ______________.

non-frameshift deletions

Genetically differentiate Duchenne's and Becker's.

Duchenne's is a frameshift (out-of-frame deletion) and Becker is a non-frameshift (in-frame) deletion.

Because alpha-one-antitrypsin deficiency affects the liver, patients can also have __________.

coagulation disorders

Describe the features of acute intermittent porphyria.

Genetic deficiency of porphobilinogen deaminase, an enzyme needed in the heme-synthesis pathway; as a result, heme synthesis products accumulate in the blood. When the enzyme ALA is overactive (such as occurs when people take inducers like phenobarbital or have a hypoglycemic event), the blood is flooded with heme synthesis products. ``` Symptoms: PPPP Pain in the abdomen Port-wine urine Polyneuropathy Psychiatric distress ```

Which antiviral drug can cause hemolytic anemia?

Ribavirin

Post-strep syndrome causes what type of kidney disorder?

Nephritic

What is the best treatment for polymyalgia rheumatica?

Steroids

Prednisone is a glucocorticoid _________.

agonist

With positive-pressure ventilation, _______ will be reduced in zone 1.

blood flow (because the increased alveolar pressure presses on the arterioles)

"Necrotizing vasculitis" = _____________.

microscopic polyangiitis

Those with ASDs can have ______________.

embolizing strokes

What is known to increase risk of DLBCL?

Immunosuppression

What two risk factors are most associated with laryngeal carcinoma?

Smoking (the highest risk) and alcohol use

What two labs are elevated in those with sarcoidosis?

ACE levels and calcium

In areas of higher prevalence, PPV ________ and NPV ____________.

increases; decreases

Describe the layout of diaphysis, metaphysis, and epiphysis.

Diaphysis is closest to the middle of the bone; epiphysis is closest to the end of the bone; and metaphysis is in between.

Name the most common tumors of the diaphysis, metaphysis, and epiphysis.

Diaphysis: Ewing's Metaphysis: osteosarcoma Epiphysis: giant cell

Increasing the amount of 2,3-BPG __________ the oxygen curve.

right-shifts (decreasing it left-shifts)

Sensitivity = _______________.

TP / (TP + FN)

__________ accumulates as brown atrophy in cells as a result of wear and tear.

Lipofuscin

Alkaline phosphatase is a marker of ___________.

bone formation

Hepatitis can cause ______________ renal failure.

prerenal (because of dilated splanchic vein and subsequent increase in RAAS

What will lymph node biopsy demonstrate in a patient with SLL/CLL?

Cells with very little cytoplasm and purple, round nuclei