USMLE Rx: Week of 07/04/16 Flashcards
What value, tested in the amniotic fluid, is the best indicator of risk for neonatal respiratory distress syndrome?
The lecithin:sphingomyelin ratio; if it is greater than 2, then the risk of NRDS is significantly decreased
What reaction does NADPH oxidase catalyze?
It converts oxygen to superoxide
Minimal change disease, and nephrotic syndrome in general leads to a decreased _____________ pressure in the glomerulus.
oncotic (because of the loss of albumin)
Thrombophlebitis is indicated by a ____________ on physical examination.
warm, nodular cord
What ankle ligament is most commonly injured?
The anterior talofibular (part of the lateral ligament)
Review the four rotator cuff muscles and the motions they facilitate.
Supraspinatus: abduction and lateral rotation
Infraspinatus: lateral rotation
teres minor: lateral rotation and adduction
Subscapularis: internal rotation and adduction
What type of vaccine can induce both a humoral and cell-mediated response?
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
Gliadins are a component of ___________.
gluten
Gout crystals are ____________ birefringent.
negatively (Pseudogout is Positively)
Remember that vitamin K is necessary for the ___________ of clotting factors.
gamma-carboxylation
Most studies have shown that ___________ does not decrease breast cancer mortality.
monthly self-examination
Which chemotherapy is associated with increased risk of pulmonary fibrosis?
bleomycin
Of the TB drugs, which is an inhibitor and which is an inducer of CYP-450?
Rifampin = inducer Isoniazid = inhibitor
List the mnemonics for inhibitors and inducers of CYP-450.
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
Recall that thiazides can cause __________ due to volume depletion and electrolyte loss.
metabolic alkalosis
What is the mnemonic for target cells?
"HALT" said the hunter to his target Hemoglobin C Asplenia Liver disease Thalassemia
List the mnemonic for antimicrobials to avoid in pregnant women.
SAFe Children Take Really Good Care Sulfonamides Aminoglycosides Fluoroquinolones Clarithromycin Tetracycline Ribavirin Griseofulvin Chloramphenicol
What virus leads to increased risk of PDA?
Rubella (maculopapular rash spreading from face to body)
In response to exsanguination, acute tubular necrosis can result due to __________.
ischemia
“Muddy brown casts” indicate ____________.
acute tubular necrosis
ITP will often present with antibodies to __________.
GPIIb/IIIa
The only tongue muscle innervated by the vagus nerve is _____________.
the palatoglossus
Recall that the I in MUDPILES can be either _________.
isoniazid or iron
Aschoff bodies have _____________ cells.
multinucleated giant
What does DIC do to platelet count and bleeding time?
Platelets go down (due to consumption) and bleeding time increases
Foreign bodies mostly lodge in the __________ lobe.
lower right
The brachioradialis is innervated by the _________.
radial
What rash often presents in those with sarcoidosis?
Erythema nodosum (red, nodular bumps on the shins)
What chemotherapy cocktail is given to those with Hodgkin’s?
ABVD Adriamycin Bleomycin Vinblastine Dacarbazine
Staphylococcus aureus is associated with what virulence factor?
Protein A
What is the first-line treatment for sarcoidosis?
Steroids
Neonatal respiratory distress syndrome is most similar to what other kind of pulmonary disorder?
Atelectasis, because the lungs haven’t opened up
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
What is the most worrisome adverse effect of occupational exposure to nitroglycerine?
Cardiac arrest due to compensatory vasoconstriction following NO withdrawal
Massive blood transfusions can cause low levels of what electrolyte?
Calcium
Hypocalcemia can manifest with what symptoms?
Perioral paresthesias, muscle cramping, and muscle contraction upon tapping
A positive heterophile test indicates ___________.
EBV mono
What cancer drug works by generating free radicals that cleave DNA?
Bleomycin
Why are ACE inhibitors contraindicated in pregnancy?
They can lead to renal agenesis.
What should be given to those with aspirin overdose?
Bicarbonate to alkalinize the urine and plasma
Recall that most diuretics contain a _______ moiety.
sulfa
Sudden death a few hours after an MI is most often due to _______________.
arrhythmia; later (3-7 days) ventricular rupture is more common
Angiotensin II stimulates the ________ antiporter.
sodium-proton (in the proximal tubule)
Which kind of antibiotic requires oxygen to be taken into bacteria?
Aminoglycosides
Aminoglycosides bind to the __________.
30S subunit
