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USMLE Step 1 practice exam flashcards > UWorld I > Flashcards

UWorld I Flashcards

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USMLE® Step 1 flashcards
1
Q

Acute respiratory distress syndrome

A

Hypoxemia and bilateral pulmonary infiltrates lead to injury to alveolar pneumocystis and endothelial damage - hyaline membranes form, diminished surfactant production (alveolar collapse), and increased capillary permeability

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2
Q

Cardiac tissue conduction velocity

A

Fast - Purkinje –> Atrial muscle –> Ventricular muscle –> AV node - Slow. Park at venture avenue

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3
Q

Osteosarcoma

A

A/w pager’s disease of bone

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4
Q

Vitamin A (retinol)

A

Teratogenic - microcephaly, cardiac anomalies, growth retardation, and spontaneous abortion.

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5
Q

Ribavirin

A

Inhibits viral RNA polymerase - chronic Hep C or RSV

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6
Q

DNA laddering

A

DNA fragments of 180 BP = apoptosis. Endonuclease cleave DNA during karryhorexhis. Absence of BCL-2 = inhibited apoptosis. No DNA laddering suggests malignancy.

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7
Q

M3 receptors

A

Stimulates Gq in bronchial smooth muscle –> IP3 –> increased intracellular Ca2+ –> Bronchoconstriction

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8
Q

Atropine

A

Cholinergic antagonist - Over dose –> Hot as a hare, mad as a hatter, blind as a bat, red as a beet, dry as a bone

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9
Q

Cholinergic toxicity

A

DUMBELLS - Diarrhea, urination, mitosis, bradycardia, emesis, lacrimation, lethargy, salivation

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10
Q

Acute promyelocytic leukemia

A

Auer rods
(15:17) translocation
15 = promyelocytic leukemia gene.
17 = retinoic acid receptor.

Sx: Pancytopenia (weakness, fatigue, infections, gingival bleeding) and DIC

Tx: All trans-retinoid acid

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11
Q

(8:14)

A

Burkitt lymphoma - Starry sky + EBV
8 = c-myc
14 = Ig Heavy chain

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12
Q

(12:21)

A

Childhood B cell acute lymphocytic leukemia

Anemia, thrombocytopenia, lymphoblasts

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13
Q

(14:18)

A

Follicular lymphoma
14 = Ig heavy chain
18 = BCL-2 (inhibits apoptosis)

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14
Q

IL-2

A

Produced only by T cells

Stimulates growth and differentiation of B cells, T cells, macrophages, and NK cells.

Can promote FAS mediated apoptosis

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15
Q

TNF-alpha

A

Systemic inflammatory response - e.g. septic shock and cachexia

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16
Q

Interferon-alpha

A

antiviral

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17
Q

Cadherins

A

Bind epithelial cells together, calcium dependent - loss of calcium –> loss of cell-cell adhesion

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18
Q

Molluscum contagiosum

A

Caused by Poxvirus

Eosinpohillic cytoplasmic inclusion bodies

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19
Q

Anterior/posterior knee dislocation

A

Injury to popliteal artery

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20
Q

Postpartum endometritis

A

A/w C-section

fever, leukocytosis, uterine tenderness, foul-smelling discharge.

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21
Q

NNT

A

NNT=1/ARR

ARR = control group event rate - experimental group event rate

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22
Q

DKA

A

Metabolic acidosis, ketonemia, hyperglycemia, hyperkalemia, hyponatremia.

Everything high EXCEPT sodium - being peed out

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23
Q

Dandy walker formation

A

Absence of cerebellar vermis - 4th ventricle enlargement

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24
Q

Phenoxybenzamine

A

Prior to pheochromocytoma removal

Long active alpha-blocker

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25
Q

Isoproteronol

A

Non-selective beta-agonist (increases beta-1 effects on heart –> increase HR) used for bradycardia and heart block

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26
Q

Phenylephrine

A

Alpha agonist - decongestant and vasopressor in severe hypotension

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27
Q

Germinal matrix hemmorrhage

A

Intraventricular hemorrhage - premature infants less than 32 weeks at greatest risk

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28
Q

Cisplatin

A

Ototoxic

29
Q

Amiodarone

A

Interstitial pneumonitis

slowly progressive dyspnea and productive cough

30
Q

Aspirin sensitivity

A

Cox blockade –> increased leukotrienes and bronchoconstriction. Leukotrienes are pro-inflammatory

31
Q

Allelic heterogeneity

A

different mutations in the same locus cause similar phenotypes

32
Q

Leukotriene D4

A

Bronchial asthma pathogenesis - induces bronchospasm and increases bronchial mucus secretion.

Monteleukast is a D4 antagonist

33
Q

FGFR3 gain of function

A

achondroplasia

34
Q

Bruton tyrosine kinase

A

x-linked agammaglobulinemia - on X-chromosome

B cells can’t leave marrow, no Ab’s produced.

Recurrent respiratory tract bacterial infections in infants.

Normal T cells, absent B cells (less that 1% CD19 or CD20)

35
Q

Chromosome 7

A

CF, ehlers-danlos, osteogenesis imperfecta

36
Q

Chromosome 16

A

polycystic kidney disease, tuberous sclerosis

37
Q

Chromosome 20

A

Maturity onset diabetes of the young

38
Q

Chromosome 22

A

DiGeorge

39
Q

N-terminal peptide sequence

A

signals protein for Rough ER

Deficiency results in cytosolic protein accumulation

40
Q

MSUD

A

Defect in branched chain alpha keto acid dehydrogenase

Branched chain amino acids (leucine, isoleucine, and valine) accumulate in urine and blood –> CNS toxicity and maple syrup smelling urine.

Sx: Poor feeding and vomitting

Tx: restrict branched chain amino acids in diet (leucine, isoleucine, valine). Supplement diet w/ thiamine (B1)

41
Q

Biotin

A

Cofactor for carboxylation enzymes - e.g. acetyl coA decarboxylase and pyruvate carboxylase.

42
Q

Androgen binding protein

A

Keeps testosterone level high in seminiferous tubules. secreted by sertoli cells in response to elevated FSH.

Normal plasma levels of testosterone indicate that Lydia cells are working, low testosterone ONLY in seminiferous tubules indicates sertoli cell (ABP) dysfunction.

43
Q

phentolamine

A

alpha-1 blocker

44
Q

PAS positive granules

A

Whipple’s disease

45
Q

Crypt abscesses + pseudopolyps

A

Ulcerative colitis

46
Q

Cobblestone mucosa + transmural inflammation

A

Crohn’s

47
Q

Ischemic colitis

A

Evidence of CAD or PAS (e.g. decreased peripheral pulses or h/o angina)

Mucosal hemorrhage and patchy necrosis

48
Q

Early onset OA + thin sclerae

A

Osteogenesis imperfecta

Defect in Type I collagen

49
Q

Protooncogenes

A

RAS - GTP binding protein - cholangiocarcinom and pancreatic adenocarcinoma

MYC - Transcription factor - Burkitt lymphoma (8:14)

ERB/EGFR - Receptor tyrosine kinase - lung adenocarcinoma

ERBB2/HER2 - Receptor tyrosine kinase - breast

ABL - non receptor tyrosine kinase - CML (9:22 BCR;ABL)

BRAF - Ras signal transduction - Hairy cell, melanoma

50
Q

Tumor suppressor genes

A

BRCA - DNA repair

APC - WNT signaling - FAP/colon cancer

TP53 - Genome stability - most cancer, li-fraumeni

RB - G1–>S inhibitor - retinoblastoma, osteosarcoma

WT1 - urogenital differentiation - wilms tumor

VHL - Ubiquitin ligase component - RCC, VHL syndrome

51
Q

Ocreotide

A

Treatment of carcinoid syndrome. A somatostatin analog that reduces the secretion of bioactive peptides.

52
Q

Wide split fixed S2

A

ASD

53
Q

Achalasia

A

Absence of esophageal peristalsis in distal esophagus and hypertensive LES that can’t relax. Results in dilated esophagus with distal narrowing

54
Q

Picornaviridae

A

(+) ssRNA

Enteroviruses - most common cause of viral meningitis

55
Q

Paramyxoviruses

A

(-) ssRNA

Measles, mumps, RSV

56
Q

Coronavirus

A

(+) ssRNA

Common cold

57
Q

Calcivirus

A

(+) ssRNA

Norovirus - gastroenteritis

58
Q

Arenavirus

A

(-) ssRNA

Lassa virus - hemmorrhagic fever virus from rodent urine inhalation

59
Q

Prader-will/angelman

A

Prader will - maternal uniparental disomy OR loss of parental gene. LOSS of paternal

Angelman - Paternal uniparentla disomy OR maternal loss of gene. LOSS of maternal

60
Q

Callous

A

Thickening of stratum corneum - outermost layer

61
Q

Fabry

A

X-linked recessive

Deficient: alpha-galactosidase

Clinical presentation: angiokeratomas, peripheral neuropathy, glomerulopathy

62
Q

Tay-sachs

A

AR

Deficient in beta-hexosaminidase A

Macular cherry red spot, progressive neurodegeneration

63
Q

Gaucher

A

AR - Most common lysosomal storage disorder

beta-glucocerebrosidase

Hepatosplenomegaly, pancytopenia, bon pain/osteopenia

64
Q

Niemann-pick

A

AR

Sphingomyelinase deficient

Macular cherry red spot, progressive neurodegeneration, heptaosplenomegaly (differentiates neumann pick from tay-sakcs, hexosaminidase deficiency w/o HSM)

65
Q

Krabbe

A

AR

galactocerebrosidase deficient

Progressive neurodegeneration, peripheral neuropathy, optic atrophy

66
Q

Metachromatic leukodystrophy

A

AR

Arylsulfatase A

Progressive neurodegeneration, peripheral neuropathy

67
Q

FSGS

A

Nephrotic syndrome, most common. Often caused by HIV

68
Q

Vitamin D supplementation

A

Increases intestinal absorption of phosphate and calcium, the rise in serum calcium inhibits PTH

USMLE Step 1 practice exam flashcards (16 decks)

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