Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USMLE Step 1 Facts > USMLE Step 1 > Flashcards

USMLE Step 1 Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

Most common causes of Meningitis in Older Pts

A 
S. pneumoniae
N. meningitis 
H. influenzae type b
S. agalactiae (group B)
L. monocytogenes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Metronidazole adverse reaction

A

disulfiram-like reaction (pt should avoid alcohol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

bacterial vaginosis

A

organism: G. vaginalis
clinical findings: gray watery discharge, vaginal pH > 4.5, positive KOH whiff test
Microscopic findings: clue cells
treatment: metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Trichomoniasis

A

clinical findings: green-yellow discharge, strawberry cervix, dyspareunia
Vaginal pH: > 4.5
microscopy: motile trichomonads
treatment: metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

vulvovaginal candidiasis

A

clinical findings: thick white discharge
vaginal pH: <4.5
microscopy: pseudohyphae
treatment: fluconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Vitamin C is a cofactor for what reaction?

A

It is a cofactor the propyl hydroxylase. It catalyzes the formation of hydroxyproline and hydroxylysine from proline and lysine. This relates to the development of symptoms seen in scurvy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ALK

A

adenocarcinoma of the lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

BRAF

A

melanoma, non Hodgkin lymphoma, papillary thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

c-MYC

A

Burkitt lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HER2/neu

A

breast and gastric carcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

JAK2

A

chronic myeloproliferative disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

KRAS

A

colon cancer, lung cancer, pancreatic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

RET

A 
MEN 2A (pheochromocytoma, medullary thyroid, parathyroid)
MEN 2B (pheochromocytoma, medullary thyroid, mucosal neuromas), papillary thyroid cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

APC

A

colorectal cancer (associated with FAP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

BRCA1 and BRCA2

A

breast and ovarian cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MEN1

A

MEN1 (pituitary, parathyroid, pancreatic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

NF1

A

NF1 (cafe au leit spots, leisch nodules, fibrodysplasia of bone, pernicious puberty)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

NF2

A

NF2 (meningeoms, schwannomas, ependymomas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Rb

A

retinoblastoma and osteosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

TP53

A

Li-Fraumeni syndrome; associated with most cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

VHL

A

von Hippel-Lindau disease (renal cell carcinoma, cardiac rhabdomyosarcoma, liver cysts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What drug class is used for cervical ripening?

A

Prostaglandin analogs (-prost)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment for Lyme disease

A 
doxycycline
amoxicillin (pregnant women and children younger than 8 years old)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Penicillin MOA

A

block transpeptidase cross-linking of peptidoglycan in the cell wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Doxycycline (tetracycline) MOA

A

blocks attachment of aminoacyl-tRNA at the 30S ribosomal subunit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Clindamycin MOA

A

blocks translocation at the 50S ribosomal subunit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Vancomycin MOA

A

inhibits cell wall peptidoglycan formation by binding the D-Ala-D-Ala portion of the cell wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What class of diuretics can lead to hypercalcemia?

A

Thiazide diuretics (eg chlorthalidone). Decreased intracellular Na activates the Na/Ca antiporter. Leads to decreased intracellular Ca which causes enhanced calcium reabsorption within the convoluted tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Osteoprotegerin MOA

A

Acts as a physiologic decoy receptor that decreases binding of RANK-L to RANK. Inhibition of this reduces differentiation and survival of osteoclasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

A-I

A

HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

B-48

A

chylomicrons, chylomicron remnants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

B-100

A

IDL, LDL, VLDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

C-II

A

HDL, IDL, VLDL, chylomicrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Apolipoprotein E

A

HDL, IDL, VLDL, Chylomicrons, chylomicron remnants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Acute Intermittent Porphyria

A

Affected enzyme: porphobilinogen deaminase

accumulated substrate: porphobilinogen and aminolevulinic acid (ALA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Clinical presentation of acute intermittent porphyria

A

abdominal pain
polyneuropathy
port wine colored urine
psych disturbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Exacerbation of acute intermittent porphyria

A

alcohol, tobacco, P-450 inducers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Porphyria cutanea tarda

A

affected enzyme: uroporphyrinogen decarboxylase
risk factor: Hep C
accumulated substrate: uroporphyrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Clinical presentation of porphyria cutanea tarda

A

blistering cutaneous photosensitivity
hyperpigmentation
tea-colored urine
symptoms exacerbated by alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Switch to what drug following HIT?

A

alternative non-heparin, non-warfarin anticoagulants. This can include direct thrombin inhibitors and indirect factor Xa inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Mirtazapine MOA

A

alpha2 antagonist, 5-HT2 and 5-HT3 antagonist, H1 antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

acetaminophen

A

N-acetylcysteine (NAC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

anticholinergic toxicity

A

physostigmine (AChE inhibitor, crosses BBB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Benzodiazepines

A

flumazenil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

beta blockers

A

atropine

glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

carbon monoxide

A

100% O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

cyanide

A

nitrite + thiosulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

digoxin

A

anti-digoxin antibody fragments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

heparin

A

protamine sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

lead

A

dimercaprol
EDTA
succimer (for children)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Methanol and ethylene glycol

A

fomepizole
ethanol
dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

methemoglobin

A

methylene blue

vitamin C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

opioids

A

naloxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

salicylates

A

sodium bicarbonate

dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

serotonin syndrome

A

dantrolene (also for malignant hyperthermia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

TCAs

A

sodium bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

warfarin

A

vitamin K

fresh frozen plasma (if rapid reversal is needed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Urea cycle produces what amino acid

A

arginine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Albendazole MOA

A

inhibition of microtubule synthesis by inhibiting tubulin polymerization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Treatment for latent TB

A

9 month course of isoniazid monotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

treatment for active TB

A

9 month course of rifampin, isoniazid, pyrazinamide, and ethambutol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Treatment for hypertensive emergency and MOA

A

Nitroprusside: increases cGMP via direct release of NO
Fenoldopam: dopamine D1 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

diagnosis of A. lumbricoides

A

visualization of characteristic eggs in concentrated stool samples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Function and associations of Apolipoprotein E

A
  • Clearance of lipoprotein and chylomicron remnants from circulation
  • IDL,HDL,VLDL, chylomicrons and chylomicron remnants
  • associated with late-onset Alzheimer disease
  • type 3 familial dyslipidemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

function of apolipoprotein A-I

A
  • structural protein for HDL

* activation of LCAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Apolipoprotein B-48

A

required for the assembly and secretion of chylomicrons

*chylomicrons and chylomicron remnants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Apolipoprotein B-100

A
  • LDL, IDL, VLDL
  • assembly and secretion of VLDL
  • type 2 familial dyslipidemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

apolipoprotein C-II

A
  • cofactor for lipoprotein lipase

* dysfunction leads to type 1 familial dyslipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Functions of Vitamin C

A

antioxidant
collagen synthesis
conversion of dopamine to norepinephrine
facilitates iron absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Treatment for MDD

A

first line: cognitive behavioral therapy, SSRI

second line: bupropion (contraindicated in a pt with hx of seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Differentiate between failed regression of allantois and vitelline duct.

A

allantois: urinary leakage through the umbilicus

vitelline duct: purulent or feculent umbilical drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Marfan syndrome

A

pathology: AD, FBN1 gene, chromosome 15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Marfan syndrome clinical presentation

A

major criteria: ectopia lentis (up and out), dilation of aortic root, aortic dissection
mitral valve prolapse in majority of pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Adverse effect of Mannitol

A

Pulmonary edema
heart failure
dehydration
electrolyte imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What drug/drug class would enhance the effects of levodopa/carbidopa?

A

Selegiline (MAO-B inhibitor) slows metabolism of levodopa. Avoid use if pt is on an SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Signs of decreased synthetic function of the liver

A
  • decreased albumin
  • increased PTT
  • increased unconjugated bilirubin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Which inflammatory cytokines cause an increase in levels of acute phase reactants?

A

IL-6, IL-1, and TNF-alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

IL-1

A

secreted by: macrophage

USMLE association: causes inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

IL-6

A

secreted by: macrophage

USMLE association: increase ESR and CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

TNF-alpha

A

secreted by: macrophage

USMLE association: cachexia in malignancy, maintain granulomas in Tb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

IL-8

A

secreted by: macrophage

USMLE: association: recruits neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

IL-12

A

secreted by: macrophage

USMLE association: activated NK cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

IL-2

A

secreted by: all T cells

USMLE association: stimulate T cell and NK cell proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

IL-3

A

secreted by: all T cells

USMLE association: growth and differentiation of bone marrow stem cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Interferon-gamma

A

secreted by: Th1 cells

USMLE association: stimulates macrophages, stimulates granuloma formation, activate NK cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

IL-4

A 
secreted by: Th2 cells
USMLE association: T cell differentiate into Th2 cells, class switching of antibodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

IL-5

A

secreted by: Th2 cells

USMLE association: growth and differentiation of eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

IL-10

A

secreted by: Th2 cells

USMLE association: IL-10 and TGF-beta are the main anti-inflammatory cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Topoisomerase inhibitors: drug name and target

A

etoposide: II
teniposide: II
irinotecan: I
topotecan: I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Muscle activity involved in micturition

A

Relaxation of the levator ani muscles and contraction of detrusor muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Hunter syndrome

A

inheritance: x-linked recessive
pathophysiology: deficiency of iduronate-2-sulfatase
accumulated substance: heparan sulfate and dermatan sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Why can’t newborns synthesize vitamin K?

A

Lack intestinal flora that are seen in adults. Will have bleeding issues and require IM vitamin K injections after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Clinical features of Digeorge syndrome

A

CATCH-22

  • cardiac defects
  • abnormal facies
  • thymic dysplasia
  • cleft palate
  • hypocalcemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Folate deficiency clinical features

A
  • megaloblastic anemia without neurologic symptoms (differentiate from B12)
  • in pregnancy, neural tube defects
  • hyper segmented neutrophils
  • increased homocysteine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Niacin (B3) deficiency clinical features

A

diarrhea, dermatitis, dementia

glossitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Vitamin A deficiency clinical features

A

Nyctalopia (night blindness)
xeropthalmia
keratomalacia
complete blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Wet beriberi clinical features

A 
B1 deficiency
cardiovascular symptoms
leg swelling
dyspnea
jugular vein distention
high output heart failure
98
Q

Dry beriberi clinical features

A 
B1 deficiency
peripheral nervous system symptoms
ataxia
weakness
loss of DTRs
paralysis
99
Q

Wernicke Encephalopathy clinical features

A 
B1 deficiency
Seen in alcoholics
Paralysis of eye movements
Abnormal gait
Deranged mental functioning
Korsakoff syndrome; confabulation
100
Q

Pyridoxine (B6) deficiency clinical features

A 
Seborrheic dermatitis
Atrophic glossitis
Angular cheilitis 
Conjunctivitis 
intertrigo
neurologic symptoms: somnolence, confusion, peripheral neuropathy
101
Q

Cobalamin (B12) deficiency clinical features

A

Megaloblastic anemia with neurologic symptoms
Fatigue
Ataxia
Cognitive deficits
hyper segmented neutrophils
increased homocysteine and methylmalonic acid

102
Q

Vitamin C deficiency clinical features

A

easy bruising

bleeding from gums

103
Q

Vitamin E deficiency clinical features

A 
Peripheral neuropathy
Ataxia
Myopathy
Retinopathy
Poor immune response
Hemolytic anemia
104
Q

Vitamin K deficiency clinical features

A

Bleeding
Prolonged PT and PTT
affects factors 2, 7, 9, 10

105
Q

What genetic mutation predisposes pt to adenocarcinoma of the lungs

A

ALK gene overexpression

106
Q

MOA of amoxicillin

A

block transpeptidase cross-linking of peptidoglycan in the cell wall
used to treat Lyme disease in pregnant women and children younger than 8 years old

107
Q

Which class of medication can lead to hypercalcemia?

A

thiazide diuretics (HCTZ and chlorthalidone)

108
Q

Apo A-I

A

HDL

109
Q

Apo B-48

A

Chylomicron, chylomicron remnants

110
Q

Apo B-100

A

IDL, LDL, VLDL

111
Q

Apo C-II

A

HDL, IDL, VLDL, chylomicrons

112
Q

Apo E

A

HDL, IDL, VLDL, Chylomicrons, Chylomicron remnants

113
Q

Treatment Acute Intermittent Porphyria

A

Dextrose

Hemin

114
Q

If pt presents with muscle pain and weakness in the setting of hypokalemia what drug most likely caused this?

A

Thiazide diuretics
other lab abnormalities include hyperuricemia, hyperglycemia, hypercalcemia, and dyslipidemia
Need to replace with a potassium sparing diuretic

115
Q

3 diagnostic markers of UTI

A
  1. positive leukocyte esterase
  2. positive nitrite test (indicates reduction of urinary nitrates by gram-negative bacteria)
  3. urine white blood cells
116
Q

urine pH >8.5 is indicative of?

A

infection caused by urease-producing organism such as Proteus, S. saprophyticus, or Klebsiella

117
Q

Increased LAP score is associated with?

A

leukemoid reactions

leukemias typically have a low LAP score

118
Q

How does procalcitonin help determine what is causing the infection?

A

levels are typically normal in the setting of a viral infection

levels rise to detectable levels with bacterial infections

119
Q

Adverse effects of Amphotericin B

A 
Nephrotoxicity
Renal Tubular Acidosis 
Arrhythmias 
Anemia
Hypotension
Fever, chills, vomiting
120
Q

Krabbe Disease: etiology, clinical features, histo

A

etiology: accumulation of galactocerebroside
clinical features: developmental delay, feeding difficulty, seizures, peripheral neuropathy, optic atrophy
Histo: multinucleated globoid cells

121
Q

Heparin primarily affects what test?

A

PTT (12, 11, 9, 8, 10, 5)

122
Q

Warfarin primarily affects what test?

A

PT (7, 10, 5)

123
Q

Antibiotic treatment for acne

A

first line: doxycycline

use minocycline instead if pt requires being outside for extended periods of time

124
Q

which element is found only in gram-negative bacterial cell membranes?

A

lipopolysaccharide

this is what keeps the stain out making it gram negative

125
Q

Which bacteria acquires its toxin by specialized transduction by a lysogenic bacteriophage?

A

Cholera

126
Q

Which vitamin is predominantly stored in the liver?

A

vitamin B12 (cobalamin)

127
Q

Individuals who have a long history of using insecticides have been exposed to what which has caused what disease?

A

Rotenone

Parkinson disease

128
Q

How to differentiate between the two groups of local anesthetics

A

amide: i before -caine
ester: no i before -caine

129
Q

Enzyme and reactions involved in Lesch-Nyhan syndrome

A

enzyme: HGPRT
Reactions:
guanine –> GMP
hypoxanthine –> IMP

130
Q

Name the drugs that cause gynecomastia

A 
DISCO
Digitalis
Isoniazid
Spironolactone
Cimetidine, ketoconazole
Oestrogen/anti-testosterone
131
Q

Treatment for organophosphate poisoning

A

Atropine: inhibition of muscarinic receptors
Pralidoxime: reactivation of AChE
Supportive care

132
Q

Use subluxation of lens to determine disease

A

Up and out: Marfan syndrome

Down and in: Homocysteinuria

133
Q

Linezolid is contraindicated on pts taking what medication?

A

SSRIs due to linezolid having weak activity as a MAO-I and could lead to serotonin syndrome

134
Q

Classification and treatment of intermittent asthma

A
  1. daytime symptoms < 2 times per week
  2. < 2 nocturnal awakenings per month
  3. ability to carry out normal activities without interference by asthma symptoms

SABA (beta 2): causes bronchial smooth muscle relaxation

135
Q

Cyclosporine: MOA, what is it used to treat, and adverse effects

A

MOA: calcineurin inhibitor
Tx: steroid-resistant nephrotic syndrome
Adverse: nephrotoxicity, headache, and GI upset

136
Q

First line treatment for focal and focal tonic-clonic seizures

A

Prolonging inactivation of Na channels in rapidly firing nerves

  1. Carbamazepine (agranulocytosis)
  2. Phenytoin (gingival hyperplasia)
137
Q

Clinical features of hereditary fructose intolerance

A

AR
deficient in fructose 1-phosphate aldolase (aldolase B)
Pt needs to avoid fructose and sucrose in their diets

138
Q

Clinical features of Vitamin A toxicity

A

dry scaly skin, nausea, vomiting, and blurry vision

Can be a side affect of a pt on isotretinoin

139
Q

Pathophysiology of toxic shock syndrome caused by S. aureus

A

Cytokine storm secondary to unregulated activation of T-cells.

TSST-1 binds to MHC class II and TCRs

140
Q

WHO guidelines for treatment of P. falciparum

A

Artemisinin-based combination therapy (ACT). Most common is dihydroartemisinin and piperaquine

141
Q

Treatment and MOA of malignant hyperthermia

A

dantrolene: inhibition of calcium release from the sarcoplasmic reticulum

142
Q

Adverse effects of TCAs

A

dry mouth and other symptoms consistent with anti-cholinergic properties

143
Q

Clinical presentation of Measles

A

3 C’s: cough, conjunctivitis, and coryza
Koplik’s spots: clustered white lesions on the buccal mucosa
Maculopapular, erythematous rash covering the whole body

Give live attenuated vaccine

144
Q

What drugs can precipitate digoxin toxicity?

A

Verapamil and diltiazem (CCB)

145
Q

Where in the cell does gluconeogenesis occur?

A

cytoplasm and mitochondria

146
Q

What medications are contraindicated in the treatment of Mono?

A

Amoxicillin or ampicillin

147
Q

Virulence factor of Neisseria species

A

Antigenic variation of pili

148
Q

How does Hep B facilitate infection by Hep D virus?

A

Production of proteins that coat HDV viral particles. Hep D cannot complete virion assembly and secretion independently

149
Q

Pt presents with diffuse abdominal pain, urine that is red in color, and urine shows elevated levels of porphobilinogen. What is the diagnosis?

A

Acute intermittent porphyria

150
Q

What accumulates in urine in a pt with lead poisoning? What enzymes are blocked?

A

ALA and coproporphyrin

ferrochelatase and ALA dehydratase

151
Q

MOA and adverse effects of Ethambutol

A

MOA: inhibit arabinosyl transferase, interfering with the mycobacterial cell wall
Adverse: visual problems including lack of acuity and color blindness

152
Q

Adverse effects seen with Myco Tb drugs (RIPE ON GO)

A

Rifampin: orange sweat, urine, and tears
Isoniazid: neuropathy, B6 deficiency, Drug induced SLE, hemolysis in G6PD deficiency pyrazinamide: gout, hepatotoxicity
Ethambutol: optic neuritis, visual problems, lack of acuity, and color blindness

153
Q

Production of what is decreased in carnitine deficiency?

A

Acetyl-CoA and Ketone bodies

154
Q

What drug is used to prevent side effects seen with using Doxorubicin?

A

dexrazoxane is an FDA approved cardioprotective agents used to prevent some of the side effects of anthracyclines

155
Q

MOA of dobutamine

A

enhance contractile ability of the heart by acting as a beta 1 agonist
Beta 1 = Gs = increased cAMP

156
Q

Clinical presentation of infective endocarditis

A

-fever
-clubbing of the distal fingers
-Roth spots (on retina)
-Osler nodes
Janeway lesions (palms and soles)
-Petechiae
-Splinter hemorrhages

157
Q

Clinical Presentation of McArdle’s disease

A
  • muscle cramping

- myoglobinuria with strenuous exercise

158
Q

How does MRSA become resistant to methicillin

A

Altered penicillin binding protein

159
Q

Adverse effects of Sildenafil (used to treat ED)

A
  • “blue vision”

- blurred vision

160
Q

What enzyme is deficient and what accumulates in pts with Tay-Sachs disease?

A

Enzyme: hexosaminidase A
Accumulation: GM2 ganglioside

161
Q

What is the most feared complication of a chronic infection with Onchocerca volvulus?

A

Blindness

162
Q

Enzyme deficient in McArdle’s disease

A

skeletal muscle glycogen phosphorylase

163
Q

Clinical presentation of Porphyria cutanea tarda

A
  • deficiency of uroporphyrinogen decarboxylase leading to accumulation of uroporphyrin in the urine
  • cutaneous blisters
  • liver involvement
164
Q

Shape of crystals seen in a pt with Cystinuria

A

hexagonal crystals “6tinuria”

165
Q

Enzyme deficient in PKU

A

phenylalanine hydroxylase leading to an accumulation of phenylalanine and phenylpyruvate

166
Q

Clinical presentation of PKU

A
  • fair skin
  • eczema
  • musty body odor or diaper
167
Q

Caplan’s syndrome is seen only in patients with these two diseases at the same time

A

rheumatoid arthritis and pneumoconiosis related to coal, asbestos, and silica exposure

168
Q

Clinical presentation of lactose intolerance

A

abdominal pain, bloating, diarrhea, and a decreased stool pH

169
Q

Diagnostic findings of Lactose Intolerance

A
  1. Positive hydrogen breath test
  2. Decreased stool pH: <5.5 normal ~6.0
  3. Increased stool osmolarity
  4. Intestinal biopsy will show that the pt has normal-appearing villi
170
Q

Clinical features of chronic mesenteric ischemia

A
  • postprandial abdominal pain

- food aversion which leads to weight loss

171
Q

Defect seem with Xeroderma Pigmentosum

A

AR defect in nucleotide excision repair. UV light exposure damages DNA and leads to the presence of pyrimidine dimer; patients with xeroderma pigmentosum are unable to repair DNA pyrimidine dimers

172
Q

Pathology and associated conditions of Chiari I malformation

A

Pathology: displacement of the cerebellar tonsils through the foramen magnum
Associated: spinal cavitation such as syringomyelia

173
Q

Pathology and associated conditions of Chiari II malformation

A

Pathology: herniation of cerebellar vermis and tonsils through the foramen magnum
Associated: Lumbosacral myelomeningocele

174
Q

Pathology and associated conditions of Dandy-Walker malformation

A

Pathology: agenesis of cerebellar vermis
Associated: agenesis of the corpus callosum and occipital encephalocele

175
Q

Empiric treatment of meningitis in newborns (0-6 months)

A

ceftriaxone and ampicillin

176
Q

Empiric treatment of meningitis in pts 6-60 years old

A

Vancomycin + third gen cephalosporin (ceftriaxone or cefotaxime)

177
Q

Empiric treatment of meningitis in pts >60 years old

A

Vancomycin + third gen cephalosporin (ceftriaxone or cefotaxime) + ampicillin

178
Q

Name tumors associated with all 3 MEN syndromes

A

1: pituitary adenoma, parathyroid hyperplasia, pancreatic tumors
2A: Parathyroid hyperplasia, pheochromocytoma, medullary thyroid carcinoma
2B: pheochromocytoma, medullary thyroid carcinoma, mucosal neuromas

179
Q

Common Peroneal Nerve Injury: vertebrae level, MOI, and Symptoms

A

Nerve: L4-S2
MOI: -fibular neck fracture
-trauma or compression of the lateral leg
Symptoms: -loss of dorsiflexion
-loss of ankle eversion
-decreased sensation on the dorsum of the foot

180
Q

Femoral nerve injury: vertebrae level, MOI, and symptoms

A

nerve: L2-L4
MOI: pelvic fracture
Symptoms: - decreased leg extension, patellar reflex, and sensation on the anterior and lateral thigh

181
Q

Inferior Gluteal nerve injury: vertebrae level, MOI, and symptoms

A

Nerve: L5-S2
MOI: posterior hip dislocation
Symptoms: -weakness climbing stairs or rising from a seated position
-decreased hip extension

182
Q

Obturator nerve injury: vertebrae level, MOI, and symptoms

A

Nerve: L2-L4 (just like femoral)
MOI: Pelvic surgery (not pelvic fracture as seen with femoral)
Symptoms: decreased thigh adduction and sensation on the medial thigh

183
Q

Pudendal nerve injury: vertebrae level, MOI, symptoms

A

Nerve: S2-S4
MOI: stretch injury during childbirth
symptoms: -decreased sensation in the perineum and genital area
-fecal and/or urinary incontinence

184
Q

Sciatic nerve injury: vertebrae level, MOI, symptoms

A

Nerve: L4-S3
MOI: -herniated disc
-posterior hip location (same as inferior gluteal)
symptoms: -pain and paresthesia along the posterior leg
-decreased motor and sensory function in the ankle and foot

185
Q

Tibial nerve injury: vertebrae level, MOI, symptoms

A 
Nerve: L4-S3
MOI: -Baker cyst
-knee trauma 
-tarsal tunnel syndrome
symptoms: -decreased plantar flexion
-inability to curl the toes
-loss of ankle inversion (opposite of common peroneal nerve)
-decreased sensation on the sole of the foot
186
Q

What is the most common pituitary tumor in adults?

A

Prolactinoma

187
Q

Name the 4 tumors associated with psammoma bodies

A
  • concentric spherules with dystrophic calcifications
  • meningiomas
  • papillary thyroid carcinoma
  • serous epithelial ovarian carcinoma
  • mesothelioma
188
Q

Foster Kennedy Syndrome: most common cause and symptoms

A

Cause: meningiomas arising from the olfactory groove
Symptoms: -anosmia
-ipsilateral anopia
-contralateral papilledema

189
Q

Describe subclavian steal syndrome and the vessels involved

A

blood flow through the subclavian artery to the ipsilateral upper limb is diminished: perfusion to the affected extremity is maintained through the ipsilateral vertebral artery. This occurs through the basilar artery

190
Q

Brugada syndrome: What is it, who does it affect, and what will you see on EKG?

A
  • AD mutation that affects sodium channels within the heart. This pts are at risk of developing ventricular tachyarrhythmias that can result in cardiogenic syncope and sudden cardiac death
  • most commonly affects Asian males
  • pseudo-right bundle branch block and ST-segment elevations in leads V1-V3
191
Q

What medical condition is a contraindication for using mannitol?

A

Congestive Heart Failure. The drug causes water to move into the extracellular space leading to pulmonary edema. A pt with CHF is already experiencing this and could not handle the exacerbation

192
Q

Name 4 hormones that have nuclear receptors that contain DNA-binding domains

A
  • aldosterone
  • cortisol
  • estradiol
  • thyroxine
193
Q

Does prolactin have a plasma membrane or nuclear receptor?

A

plasma membrane receptor

194
Q

Pathology behind why older people can’t see up close

A

age-related hardening of the lens and loss of accommodative ability (aka presbyopia). It can no longer relax and curve to see object up close. Corrected with positive power lenses

195
Q

What is the role of IkB in the NF-kB signal transduction pathway from IL-1 binding to IL-6 induction?

A

Releases NF-kB after undergoing phosphorylation

196
Q

Adverse effects of Metformin

A

nausea, abdominal discomfort, diarrhea, and lactic acidosis

197
Q

Remodeling of a scar is primarily mediated by what enzyme?

A

matrix metalloproteinases

198
Q

How to distinguish parietal cells on histo

A

parietal cells can be identified by their large size, central, round, nucleus, and intensely acidophilic cytoplasm

199
Q

What is the vector for Yersinia pestis?

A

Most often transmitted by infected fleas, and the direct handling of animals infected with those fleas

200
Q

What is self-selection sampling technique?

What type of bias is seen with this?

A

Self-selection occurs when individuals select for themselves to participate in a study.
Self-selection bias

201
Q

What diseases will show an M-protein spike (M-spike)?

A

B cell malignancies including Waldenstrom macroglobulinemia, plasma cell leukemia, smoldering myeloma, amyloidosis, or plasmacytoma

202
Q

How is multiple myeloma diagnosed?

A

Confirmed by bone marrow biopsy where there are at least 10% clonal plasma cells. Disease is only suspected when an M-spike is seen

203
Q

Lack of input from which neural pathway would lead to priapism?

A

sympathetic fibers from the prostatic plexus.

Cavernous and pudendal nerves carry sympathetic fibers that release NE to stop erection

Parasympathetic=Erection
Sympathetic=no erection

204
Q

Vitamin E deficiency can have a similar presentation to deficiency of what other vitamin?

A

Vitamin B12. Pts will not have megaloblastic anemia, hyper segmented neutrophils, or increased serum methylmalonic acid concentrations

205
Q

Tissue biopsy of a pt with Kaposi sarcoma (HHV-8) will show what?

A

Proliferating spindle cells forming slit-like spaces filled with blood

206
Q

If a new drug prevents polymerization of actin filaments, what leukocyte function will most likely be inhibited?

A

Phagocytosis
actin provides a mechanical superstructure for the phagocyte to maintain shape, shuttles enzymes and their substrates together to augment signaling, aids in the endocytosis of large particles

207
Q

What age related change causes older people to not be able to concentrate urine as well as a younger pt?

A

Decreased renal tubule responsiveness to ADH (vasopressin)

208
Q

If the MCA ruptures on the dominant side of the brain what symptoms will be seen?

A

Global aphasia as a result of the involvement of Broca and Wernicke areas, along with the arcuate fasciculus

Also presents with paralysis and sensory loss of the contralateral face and arm

209
Q

What is Pierre Robin syndrome and what pharyngeal arch is altered?

A

Pierre Robin: small lower jaw, downward displacement or retraction of the tongue, and cleft palate

First pharyngeal arch: maxilla, mandible, masseter, pterygoids, and mylohyoid, CN V2 and V3

210
Q

What is a critical component of Extracellular matrix found in human renal mesangial cells?

A

Fibronectin

211
Q

What is the location of the lymph nodes which first drain the ovaries on their way to the para-aortic lymph nodes?

A

along the ovarian vessels.

Most lymph vessels follow the arterial supply

212
Q

What PE findings are suggestive of a pleural effusion?

A

unilateral decreased breath sounds, dullness to percussion, and decreased tactile fremitus are most suggestive of a pleural effusion

213
Q

How is Cryptosporidium parvum characterized?

A

Fever, watery diarrhea, and cramping abdominal pain. Light microscopy shows intraluminal oocysts on acid-fast stain

214
Q

What component of Myco Tb can be directly cytotoxic to macrophages?

A

cord factor: prevents fusion of the vesicles containing MTB with the lysosome

The acid-fast guy is using his whip in the sketchy video. That is what is used to show Cord Factor

215
Q

How will S. Aureus and S. pyogenes appear on culture?

A

S. aureus: clusters

S. pyogenes: chains

216
Q

What is the immune reaction seen with an Acute allograft rejection?

A

Host CD8+ T lymphocytes recognize class 1 MHC molecules on renal allograft cells

Type 4 hypersensitivity

217
Q

What PE finding would there be with an occlusion of the posterior cerebral artery (PCA)?

A

Infarction of the ipsilateral occipital lobe and a contralateral homonymous hemianopsia with macular sparing

218
Q

Why are premature neonates with hyaline membrane disease given O2 at a saturation between 92% and 95%?

A

Prevent retinopathy of prematurity by maintaining the chemical gradient of VEGF. High O2 saturation would eliminate this and blood vessel growth which isn’t complete would stop, leading to ROP

219
Q

MOA of topical erythromycin used on newborns. What is it used to prevent?

A

MOA: inhibits bacterial protein synthesis by binding to bacterial ribosomal 50s subunits

220
Q

If pt presents with abdominal pain, vomiting, and presence of large white worms in the stool what is the most likely organism?

A

Ascaris lumbricoides

221
Q

Which enzyme is needed to convert trypsinogen to trypsin?

A

Enteropeptidase

Results in the inability to convert numerous digestive proenzymes into their active forms

222
Q

Clinical presentation of scabies

A

intensely pruritic erythematous papules of the sides or webs of the fingers, wrist, axillae, areolae, or genitalia, and burrows may be visible

223
Q

When embolizing a leiomyomata what is the route of the catheter when entering through the femoral artery?

A

external iliac –> internal iliac artery –> uterine artery

224
Q

What type of lung tumor will lead to the production of PTHrP?

A

squamous cell carcinoma

225
Q

What are the primary inflammatory mediators that promote vasodilation in the initial innate immune response?

A

Histamine, Prostaglandin-E2, and bradykinin

Prostaglandin-E2 and bradykinin also sensitize nociceptive nerve endings

226
Q

Which nerves located near the posterior aspect of the prostate , when damaged, could lead to erectile dysfunction?

A

Pelvic splanchnic

Parasympathetic= erection
sympathetic= no erection
227
Q

Which two organs participate in gluconeogenesis?

A

liver and kidney

228
Q

What causes roseola and clinical presentation of the disease?

A

HHV-6
several days of high fevers followed by a macular eruption that starts on the neck and trunk which then spreads outward to the face and extremities

229
Q

Which tumor causes precocious puberty or virilization?

A

Ovarian sertoli-leydig cell tumor

230
Q

Side effects of Beta 2 adrenergic agonists

A

tremor, hypokalemia, hyperglycemia, tachycardia, hypertension, and headache

231
Q

Which spinal tract is responsible for temperature and pain?

A

lateral spinothalamic tract. Crosses the body two levels up so contralateral side is affected

232
Q

What is the dysfunction in Leukocyte Adhesion Deficiency (LAD) and what would this cause to be wrong in the leukocyte?

A

LFA-1 (CD18) which would inhibit migration of the cell

233
Q

Describe esophageal peristalsis and lower esophageal sphincter tone in a pt with CREST syndrome

A

esophageal peristalsis: decreased

lower esophageal sphincter tone: decreased

234
Q

What does CREST syndrome stand for?

A 
calcinosis cutis
Raynaud phenomenon
esophageal dysmotility 
sclerosis
telangiectasias
235
Q

Function of cytochrome c

A

released from mitochondria as the intrinsic and extrinsic apoptotic pathways converge. Cytochrome c then activates caspases that potentiate apoptosis. This leads to cell shrinkage, nuclear, pyknosis, karyorrhexis, and blebbing of the cellular membrane

236
Q

MOA of fluroquinolones

A

Inhibit DNA gyrase, which disrupts DNA synthesis

237
Q

Glipizide: Class and MOA

A

second-generation sulfonylurea

inhibits potassium pump, depolarizing the insulin cells, leading to calcium induced exocytosis of insulin into the blood

238
Q

Best way to decrease the number of sudden cardiac deaths

A

placement of external automatic defibrillators in public spaces

239
Q

Which cells contain high-affinity glutamate transporters?

A

astrocytes

240
Q

Relationship between mean and median according to the skew of a chart

A

right skew: mean > median

left skew: mean < median

241
Q

Lab findings seen with von Willebrand disease

A

increased bleeding time
decreased factor VIII activity
suppressed ristocetin cofactor activity

USMLE Step 1 Facts (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions