USMLEWorld Flashcards by W W

The best drug for gestational diabetes is ___.

Insulin

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Meiosis I separates _____ chromosomes.

Homologous

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Meiosis II separates ___ chromosomes.

Sister

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Cells expressing CD16/CD56

NK cells

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Ventral pancreatic bud gives rise to. . .

Uncinate process, main pancreatic duct of Wirsung, part of head

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Angular stomatitis, cheilitis, glossitis, seborrheic dermatitis, eye changes, anemia

Riboflavin (B2) deficiency

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Succinate DHGN (succinate–>fumarate) requires what cofactor?

FAD (B2, riboflavin)

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___ is a nuclear transcription factor that directly binds DNA via a leucine zipper motif

c-Jun

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S-100

Neural crest marker and homodimeric calcium binding protein

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Stimulation of V1R causes. . .

Vasoconstriction and prostaglandin release

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Stimulation of V2R causes. . .

Increased medullary collecting duct reabsorption of urea; increased cortical collecting duct reabsorption of water

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Mechanism of anastrozole

Aromatase inhibitor

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Ketoconazole (mechanism in breast cancer)

Decreased androgen synthesis

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Pathogenesis of cryptorchidism

Seminiferous tubules become atrophic and hyalinized; NO functional impairment of Leydig cells

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Factors promoting osteoclasts

M-CSF and RANK-L

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TGFB effect on bone

Osteoclast apoptosis; osteoblast differentiation

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First line drug for myoclonic seizures

Valproic acid

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Mechanism of Lithium

Inhibition of IP3

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Mechanism of Ethosuximide

Inhibition of T-type Ca++ channels

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Prevention of DVT in in-patient setting

Heparin (binds antithrombin III)

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Management of heparin-induced thrombocytopenia

Direct thrombin inhibitors (lepirudin and argatroban)

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Percutaneous coronary intervention: anti-coag

Ticlopidine and clopidogrel (block ADP-mediated plt aggregation)

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Most common benign liver tumor

Cavernous hemangioma

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Enzymes requiring B1 as co-factor

Transketolase, pyruvate DHGN, aketoglutarate DHGN

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Massive liver necrosis post-op, elevated LFTs

Halothanes

IL-4 promotes. . .

Class switching to IgE

IL-5 promotes. . .

Eosinophils and IgA synthesis

Immune cells vs. Candida?

1) T cells (localized) and (2) PMNs for hematogenous spread

Bohr effect?

Increased O2 release in periphery with low pH due to protons binding histadine residues on Hb and decreasing affinity

Haldane effect?

Increased O2 in lungs causes release of H+, CO2 from Hb

HCO3- shifts ___ erythrocytes in the lungs (in/out) in exchange for Cl-

HCO3- shifts ___ erythocytes in periphery (in/out) in exchange for Cl-

out

Pathogenesis of easy bruising in Cushing's

Decreased collagen and matrix GAG synthesis

Crystalloid bodies containing eosinophil membrane protein

Charcot-Leyden crystals

Eggshell calcification of apices and birefringent crystals surrounded by fibrosis

Silicosis

Noncaseating epitheliod granulomas

Sarcoidosis or Berylliosis

Hypertriglyceridemia causes acute pancreatitis by ___

Direct tissue toxicity to acinar cells

Elastin is composed primarily of. . .

Glycine, alanine, valine (non-polar)

Elastin interacts with. . .

Fibrillin

Extensive desmosine crosslinking

Elastic fibers

Rx for Trigeminal neuralgia (tic douloureux)

Carbamazepine

Mech of dantrolene

Prevents further release of Ca++ in to muscular fiber cytoplasm (direct interaction with ryanodine receptor)

Ureteric bud gives rise to. . .

Ureters, collecting tubules and ductules, calyces, renal pelvis

Metanephric blastema gives rise to. . .

Glomeruli, Bowman's space, PCT, LoH, DCT

+ Trendelenburg sign

Injury of superior gluteal nerve

Difficulty rising from seated position or climbing stairs

Injury of inferior gluteal nerve (gluteus maximus)

Pathogenesis of overactive Vit D in sarcoidosis

Alpha-1 hydroxylase activity in macrophages

Protein phosphatase-1

Activated by insulin

Echinocandins: mechanism?

Block 1,3-beta-D-glucan synthesis

Mechanism of terbinafine

Accumulates in skin, nails; inhibits squalene-2,3,epoxidase

Golgi tendon organ

In series, limit over-contraction (cause relaxation)

Intrafusal spindle fibers

In parallel, limit stretch (cause contraction)

Anti-Yo antibodies

ovary & breast cancer

Anti-P/Q, anti-Hu antibodies

Lung cancer

Extensive cerebellar Purkinje cell degeneration

Lung, ovary, and breast cancer (paraneoplastic)

GH increases ___ growth of long bones via IGF-1

Linear

___ are the most effective preventative medicine in preventing cellular reaction in asthma

Inhaled glucocorticoids (fluticasone)

Schizophreniform disorder looks like schizophrenia but is present for ___

<6 months

Brief psychotic disorders are present for ___

<1 month

Adjustment disorders last between ___ and ____ months

3 and 6

Superficial infiltrate of mononuclear cells and eos around dermal venules; collagen bundles parted by dermal edema

Urticaria (hives)

_____ prevents lactation pre-birth

Progesterone

___ nerve arises at the middle cerebellar peduncle in the lateral aspect of the mid-pons

CN V

Contralateral hemiparesis and Babinski, contralateral lower facial palsy and dysarthria, contralateral dysmetria and dysdiadochokinesia

Anterior pons (basis pontis) infarct

___ nerve arises from dorsolateral aspect of caudal pons at pontomedullary junction (below MCP)

CN VII

___ nerve is the only cranial nerve to decussate before innervating its target

CN IV (trochlear)

Blood supply to posterior duodenal bulb

Gastroduodenal a.

Amino acids safe to give in pyruvate DHGN deficiency

Ketogenic-only amino acids (lysine, leucine)

Cure for serotonin syndrome

Cyproheptadine

Preferred rx for drug-induced Parkinsonism

Trihexyphenidyl, benztropine (anti-musc)

Rx for drug-induced akathisia

Propanolol

Pronounced atrophy of frontal and temporal lobes

Pick's disease

Cytoplasmic inclusions of microtubule-associated protein tau

Pick's disease

Behavioral abnormalities, speech and language decline, urinary incontinence

Pick's disease

R/L confusion, dysgraphia, dyslexia, dyscalculia

Gerstmann's syndrome (destruction of inferior parietal lobule of dominant hemisphere)

Apraxia and CL hemineglect

Damage of inferior P lobe on non-dominant side

Nests of polygonal cells with Congo red-+ deposits

Medullary thyroid cancer

Problem: osteoid matrix accumulation around trabeculae

Vitamin D deficiency

Beading along anterior chest, lateral bowing of legs

Vitamin D deficiency

Genu varus, rachitic rosary, Harrison's sulci, craniotabes, hypocalcemia, hypophosphatemia, hypertonia, growth retardation

Rickets

Genu varus, rachitic rosary, Harrison's sulci, craniotabes, hypocalcemia, hypophosphatemia, hypertonia, growth retardation

Rickets

Subperiosteal resorption with cystic degeneration

Hyperparathyroidism

Spongiosa filling medullary canal with no mature trabeculae

Paget's dz of bone

MCC of acute orchitis in young people

Chlamydia and Gonorrhea

MCC of acute orchitis in old people

E. coli

___ most influences the prognosis of poststreptococcal glomerulonephritis

Age

What do fibrates suppress?

7a hydroxylase (reduced conversion of chol --> bile acids)

Deconjugates hemoglobin

Beta-glucoronidase

Decreased C3 level, neutrophil infiltration in arteries/small arterioles, fibrinoid necrosis, pruritic skin rash, joint pain

Serum sickness

Substrate for HMG-CoA synthase

Acetoacetyl CoA

Decreased C3 level

Serum sickness

Block cortisol synthesis by inhibiting 11-beta-hydroxylase and stimulate pituitary secretion of ACTH

Metyrapone testing

Metyrapone testing with increase in 11-deoxycortisol in serum and 17-hydroxy-corticosteroids in urine

Normal HPA axis

Carrier proteins for ADH and oxytocin

Neurophysins

Reducing sugar

Fructose

___ induces decreased adenylate cyclase activity which causes poor binding of catabolite activator protein (CAP) in lac operon

Glucose

Red flat-topped papules on bony prominences

Grotton papules

Heavy menses, easy bruising, prolonged bleeding with minor trauma

vWF deficiency

Platelets aggregate poorly with ADP; increased BT

GPIIb/IIIa receptor deficiency (Glanzmann thombosthenia)

Platelets aggregate poorly with ristocetin; increased BT

vWF deficiency

Right-sided face and right arm swelling with malignancy

R brachiocephalic vein obstruction