USMLE Rx: Week of 07/04/16 Flashcards

1
Q

What value, tested in the amniotic fluid, is the best indicator of risk for neonatal respiratory distress syndrome?

A

The lecithin:sphingomyelin ratio; if it is greater than 2, then the risk of NRDS is significantly decreased

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2
Q

What reaction does NADPH oxidase catalyze?

A

It converts oxygen to superoxide

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3
Q

Minimal change disease, and nephrotic syndrome in general leads to a decreased _____________ pressure in the glomerulus.

A

oncotic (because of the loss of albumin)

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4
Q

Thrombophlebitis is indicated by a ____________ on physical examination.

A

warm, nodular cord

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5
Q

What ankle ligament is most commonly injured?

A

The anterior talofibular (part of the lateral ligament)

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6
Q

Review the four rotator cuff muscles and the motions they facilitate.

A

Supraspinatus: abduction and lateral rotation
Infraspinatus: lateral rotation
teres minor: lateral rotation and adduction
Subscapularis: internal rotation and adduction

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7
Q

What type of vaccine can induce both a humoral and cell-mediated response?

A

First off, only viral vaccines can induce cell-mediated immunity, so bacterial vaccines will not produce a T cell response (except intracellular bacteria); second, only live, attenuated vaccines can induce a cell-mediated response, because they need to be activated inside a cell and express proteins in MHC I receptors to activate CTLs; inactivated vaccines (such as intramuscular influenza vaccines) only induce humoral responses

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8
Q

Gliadins are a component of ___________.

A

gluten

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9
Q

Gout crystals are ____________ birefringent.

A

negatively (Pseudogout is Positively)

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10
Q

Remember that vitamin K is necessary for the ___________ of clotting factors.

A

gamma-carboxylation

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11
Q

Most studies have shown that ___________ does not decrease breast cancer mortality.

A

monthly self-examination

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12
Q

Which chemotherapy is associated with increased risk of pulmonary fibrosis?

A

bleomycin

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13
Q

Of the TB drugs, which is an inhibitor and which is an inducer of CYP-450?

A
Rifampin = inducer
Isoniazid = inhibitor
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14
Q

List the mnemonics for inhibitors and inducers of CYP-450.

A
Inducers: "chronic alcoholics steal phen-phen and never refuse greasy carbs"
Chronic alcoholism 
St. John's wort 
Phenytoin 
Phenobarbital 
Nevirapine 
Rifampin 
Griseofulvin 
Carbamazepine
Inhibitors: "SICKFACES.COM"
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Amiodarone
Ciprofloxacin
Erythromycin and clarithromycin
Sulfonadmides
Chloramphenicol
Omeprazole
Metronidazole
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15
Q

Recall that thiazides can cause __________ due to volume depletion and electrolyte loss.

A

metabolic alkalosis

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16
Q

What is the mnemonic for target cells?

A
"HALT" said the hunter to his target
Hemoglobin C 
Asplenia 
Liver disease
Thalassemia
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17
Q

List the mnemonic for antimicrobials to avoid in pregnant women.

A
SAFe Children Take Really Good Care
Sulfonamides
Aminoglycosides
Fluoroquinolones
Clarithromycin
Tetracycline
Ribavirin
Griseofulvin
Chloramphenicol
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18
Q

What virus leads to increased risk of PDA?

A

Rubella (maculopapular rash spreading from face to body)

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19
Q

In response to exsanguination, acute tubular necrosis can result due to __________.

20
Q

“Muddy brown casts” indicate ____________.

A

acute tubular necrosis

21
Q

ITP will often present with antibodies to __________.

A

GPIIb/IIIa

22
Q

The only tongue muscle innervated by the vagus nerve is _____________.

A

the palatoglossus

23
Q

Recall that the I in MUDPILES can be either _________.

A

isoniazid or iron

24
Q

Aschoff bodies have _____________ cells.

A

multinucleated giant

25
What does DIC do to platelet count and bleeding time?
Platelets go down (due to consumption) and bleeding time increases
26
Foreign bodies mostly lodge in the __________ lobe.
lower right
27
The brachioradialis is innervated by the _________.
radial
28
What rash often presents in those with sarcoidosis?
Erythema nodosum (red, nodular bumps on the shins)
29
What chemotherapy cocktail is given to those with Hodgkin's?
``` ABVD Adriamycin Bleomycin Vinblastine Dacarbazine ```
30
Staphylococcus aureus is associated with what virulence factor?
Protein A
31
What is the first-line treatment for sarcoidosis?
Steroids
32
Neonatal respiratory distress syndrome is most similar to what other kind of pulmonary disorder?
Atelectasis, because the lungs haven't opened up
33
Describe the pathophysiology of hemophagocytic lymphohistiocytosis.
An autoimmune disorder in which lymphohistiocytes get abnormally activated and attack bone marrow cells; cytokines are overactive; histo-slides show macrophages engulfing RBCs; treated with steroids
34
What is the most worrisome adverse effect of occupational exposure to nitroglycerine?
Cardiac arrest due to compensatory vasoconstriction following NO withdrawal
35
Massive blood transfusions can cause low levels of what electrolyte?
Calcium
36
Hypocalcemia can manifest with what symptoms?
Perioral paresthesias, muscle cramping, and muscle contraction upon tapping
37
A positive heterophile test indicates ___________.
EBV mono
38
What cancer drug works by generating free radicals that cleave DNA?
Bleomycin
39
Why are ACE inhibitors contraindicated in pregnancy?
They can lead to renal agenesis.
40
What should be given to those with aspirin overdose?
Bicarbonate to alkalinize the urine and plasma
41
Recall that most diuretics contain a _______ moiety.
sulfa
42
Sudden death a few hours after an MI is most often due to _______________.
arrhythmia; later (3-7 days) ventricular rupture is more common
43
Angiotensin II stimulates the ________ antiporter.
sodium-proton (in the proximal tubule)
44
Which kind of antibiotic requires oxygen to be taken into bacteria?
Aminoglycosides
45
Aminoglycosides bind to the __________.
30S subunit