USMLE Rx: Week of 11/29/16 Flashcards
What syndrome presents with thrombocytopenia, eczema, and recurrent pyogenic infections?
Wiskott-Aldrich syndrome (think WATER: Wiskott-Aldrich = Thrombocytopenia, Eczema, and Recurrent pyogenic infections)
This is an X-linked disorder in which boys can’t mount an IgM response to bacteria. IgA and IgE will be elevated.
The internal jugular vein is ___________ to the common carotid artery.
lateral
The disorder that presents with hypogonadism, short stature, obesity, and intellectual disability results from methylation of chromosome ____.
15
True or false: a living will does not override durable power of attorney.
True. Durable power of
Those with ____________ deficiency are at increased risk of GI infections.
selective IgA
A patient who has an absent patellar reflex might also have numbness where?
The back of the thigh, back of the calf, and lateral side of the foot
Disc herniation will present with pain when _____________.
the leg is bent
In addition to affected mastication muscles, impairment in V3 will also present with _____________.
jaw deviation, because V3 also innervates the pterygoid muscles
The palms and soles of the feet have what additional layer of skin?
Stratum lucidum
Urine sodium greater than 20 mEq/L indicates what type of renal injury?
Intrinsic (renal)
Urine osmolality will be _____________ in both prerenal and postrenal azotemia.
less than 350 mOsm/kg
What is the confirmatory test for HIV?
Immunoassay
Cervical LAD with buccal and pharyngeal thrush should raise suspicion for _____________.
AIDS
Drugs that inhibit ______________ can help prevent male-pattern baldness.
5-alpha reductase (which converts testosterone to dihydrotestosterone)
There are two sets of veins that can produce hemorrhoids. Differentiate them.
Hemorrhoids from the superior rectal veins are internal (i.e., cannot be seen from outside) and are not innervated by pain-sensing neurons. Hemorrhoids from the inferior rectal vein can be seen from outside and are painful.
What genetic syndrome is strongly associated with Hirschprung’s?
Down syndrome
The leading cause of small bowel obstruction is ____________.
abdominal surgery
Bilateral lesions of the amygdala (from a stroke, for instance), result in what syndrome?
Klüver-Bucy syndrome: hypersexuality, hyperorality, anterograde amnesia, and disinhibition
(Without your amygdala, you’re not afraid to put your mouth on stuff. Also, think Busy Luver.)
What disorder might you think of if a father and son both had violent shaking movements of the legs?
Hereditary spastic paraplegia (caused by disturbances in the corticospinal tract that result in spasm rather than paralysis)
Most trisomies are caused by a problem in which step of mitosis/meiosis?
Anaphase I of meiosis (because this is when the chromosomes must separate)
True or false: the femoral sheath contains the femoral nerve, artery, and vein.
False. The sheath only contains the blood vessels.
What virus presents with the POM-Pom symptoms?
Mumps! Parotitis Orchitis (can lead to infertility) Meningitis Pancreatitis
The ductal cells of the salivary gland secrete ____________ into the saliva. As flow rate increases, this substance will decrease in concentration.
potassium
There are three main therapeutics for ulcerative colitis. Describe the order in which you’d prescribe them.
First sulfasalazine, which gets metabolized to 5-aminosalicylic acid that decreases inflammation locally.
If that fails to work, switch to steroids.
If steroids fail to work, give infliximab.
The drug that is in Neosporin is not used systemically because it can cause nephrotoxicity. What is its name and mechanism?
Bacitracin; works by inhibiting the transport of mucopeptides to the outside of the cell, thereby disrupting peptidoglycan synthesis
What antiviral is contraindicated in severely depressed or suicidal patients?
Interferon, because it leads to a flu-like response characterized by fever, chills, and depression
Recall that drugs like sodium nitroprusside decrease ____________.
afterload
True or false: Dubin-Johnson syndrome presents with jaundice in infancy.
False. It is often asymptomatic in infants. Obstructive jaundice in infants suggests biliary atresia.
Without surgical intervention, biliary atresia leads to what outcome?
Cirrhosis in infancy
What genetic causes lead to Gilbert and Crigler-Najar?
Gilbert = defect in promoter region Crigler-Najar = defect in enzyme
What is one key feature that distinguishes antimuscarinic toxicity from cocaine toxicity?
Sweating is decreased in anticholinergic overdose and increased in cocaine overdose.
What is the mechanism of the recreational drug that causes nystagmus?
Blocks NMDA receptors
Infusion rate should equal ______________.
steady state concentration x clearance
Steady state concentration equals ________________.
infusion rate / clearance rate
A “down and out” eye with a non-responsive pupil indicates _________________.
oculomotor nerve damage
True or false: resistance to cephalosporins is most often by beta-lactams.
False. It’s by altering penicillin-binding proteins.
Type I hypersensitivity reactions are initiated by what cell type?
Mast cells!
Which antibiotic binds to the 23S subunit of the 50S subunit?
Macrolides
Think: “My ChROmosomes have 23 pairs.”
Resistance to macrolides occurs by the _________________.
methylation of the 23S subunit
“Walking pneumonia” implies ______________.
Mycoplasma infection (treat with macrolides)
Pneumonia with Gram-negative rods in a teen with CF is generally ________________. Treat with _____________.
Pseudomonas aeruginosa; piperacillin/tazobactam and an aminoglycoside
The antibiotic that causes tendonitis has what mechanism?
inhibits DNA gyrase (this being the fluoroquinolones)
Guillain-Barré syndrome results from ________________.
inflammatory demyelination
Make a card for metachromatic leukodystrophy.
Ok!
Make a card for Hartnup.
Ok!
