USMLE secrets

Question 1

digitalis moa, tox, treatment?

Answer 1

tox: diarrhea, vomiting, increased PR interval, arrythmias, blurry yellow vision (cholinergic effects); stop dig, give potassium/mg/Fab fragments; lidocaine for arrhythmia

Question 2

things causing eosinophilia?

Answer 2

helminths, asthma, allergic disorders, AIN, hodgkins lymphoma

Question 3

drugs ass with AIN?

Answer 3

penicillins, cephalosporins, sulfonamides, NSAIDs, PPIs

Question 4

ADPKD vs ARPKD

Answer 4

ARPKD presents in infancy and is always associated with liver abnormalities: hepatic cysts, congenital hepatic fibrosis/organ dysfunction

Question 5

VHL Presents with:

Answer 5

bilateral kidney cysts, AD, mutiple types of neoplasms and hamartomas; hemangioblastomas of CNS and retina, pheos, pancreatic tumors, renal cysts predispose to RCC

Question 6

tuberous sclerosis

Answer 6

AD, multiple cysts and tumors in kidney with CNS tuber formation + skin lesions, subungual/periungual fibromas, astrocytoms, renal angiolipomas, retinal hamartomas, cardiac rhabdomyomas

Question 7

drugs that case oto and nephrotoxicity

Answer 7

loop diuretics, vancomycin, cisplatin, aminoglycosides

Question 8

struvite vs uric vs cystine stones ppt at high/low pH?

Answer 8

struvite ppt at High pH; uric ppt at low PH; cystine at low pH

Question 9

which stones can be seen on xray?

Answer 9

calcium stones; cystine/uric acid stones are organic and cannot be seen on x-ray

Question 10

stones in Crohn’s

Answer 10

gall stones and kidney stones–calcium oxalate

Question 11

CYP450 inhibitors

Answer 11

cimetidine, macrolides, azoles, isoniazid, sulfonamides, grapefruit juice, protease inhibitors, ciprofloxacin

Question 12

CYP450 inducers

Answer 12

barbiturates, quinidine, rifampin, phenytoin, griseofulvin, carbamazepine, st john’s wort, chronic alcohol use

Question 13

treatment for Gilbert or Crigler najjar Type 2?

Answer 13

phenobarbital–increases UDP glucoronyltransferase activity

Question 14

treatment for Dubin johnsons?

Answer 14

avoid estrogens

Question 15

treatment for crigler najjar type 1?

Answer 15

phototherapy bridge to liver transplant

Question 16

treatment for rotor syndrome?

Answer 16

no treatment

Question 17

diseases that hepB makes you susceptible to?

Answer 17

liver disease/HCC; glomerulonephritis (Ab-Ag deposition in glomerulus); polyarteritis nodosa; HepD infection

Question 18

HCC mets to where?

Answer 18

lungs, adrenals, regional lymph nodes

Question 19

HCC paraneoplastic syndromes?

Answer 19

IGF-1–>constitutional hypoglycemia; EPO; PTHrP

Question 20

substances that signal through cAMP

Answer 20

FLAT P + HCG: FSH, LH, ACTH, TSH, PTH, hCG, CRH, glucagon

Question 21

substances that signal through cGMP

Answer 21

NO, ANP (vasodilators)

Question 22

substances that signal through IP3 (Gq)

Answer 22

GnRH, GHRH, oxytocin, TRH

Question 23

substances that signal through steroid receptors

Answer 23

Estrogen, testosterone, glucocorticoids, vitD, aldosteron, progesterone, T3/T4

Question 24

substances that signal through tyrosine kinases

Answer 24

insulin, growth factors, GH, prolactin

Question 25

tuberoinfundibular stalk disruption by head trauma?

Answer 25

all anterior pituitary hormones decreased because lose hypothalamic stimulus, except prolactin which increases because dopamine (via hypothalamus) is no longer inhibiting prolactin

Question 26

licorice inhibits…and can cause?

Answer 26

inhibits 11B-HSD, enzyme converts cortisol–cortisone–>hypertension and pseudohyperaldosteronism–>metabolic alkalosis

Question 27

POMC cleavage gives…which hormones?

Answer 27

ACTH and MSH in the anterior pituitary

Question 28

neisseria meningitis–>adrenal?

Answer 28

Waterhouse Freidrichson: adrenal hemorrhage, septicemia, DIC, petechial rash

Question 29

neural crest derived cells:

Answer 29

chromaffin cells, parafollicular thyroid cells, Schwann cells, ANS, dorsal root and celiac ganglia, melanocytes, cranial nerves, pia/arachnoid, odontoblasts, skull bones, aorticopulmonary system

Question 30

neural crest derived tumors?

Answer 30

pheo and neuroblastoma, medullary thyroid (parafollicular)

Question 31

methimazole vs PTU

Answer 31

both inhibit thyroperoxidase (organification) centrally, only PTU inhibits T4 to T3 conversion peripherally via inhibtion of 5-hydroiodoinase (something like that)

Question 32

meds that can cause hypothyroidism

Answer 32

amiodarone and lithium

Question 33

drugs that induce uterine contractions

Answer 33

alkaloids (ergonovine), triptans, synthetic prostaglandins

Question 34

X-linked immunodeficiencies?

Answer 34

Missing WBCS: hyper IgM syndrome, Wiscott-Aldrich syndrome, Bruton’s aggama..; chronic granulamatous disease, SCID;