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USMLE Step 1 > UWorld_4.4 > Flashcards

UWorld_4.4 Flashcards

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USMLE® Step 1 flashcards
1
Q

reverse T3 (rT3)

A

inactive form derived from peripheral conversion of T4

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2
Q

Antidote for TCA-related cardiac abnormalities

A
  • TCA ==> quinidine-like effect =+> QRS prolong + ventricular tachy
  • Tx = NaHCO3
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3
Q

HCTZ vs. Furosemide effect on Ca

A
  • HCTZ ==> increased Ca reabsorb
  • Fur ==> decreased Ca reabsorb
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4
Q

Ketone bodies

A
  • acetoacetate
  • acetone
  • beta-hydroxybutyric acid
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5
Q

Restless leg syndrome tx

A
  • avoid triggers
  • supportive
  • dopamine agonsits (e.g. pramipexole, ropinirole)
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6
Q

myxomatous changes @ media of vessels ==>

A

aoritc aneurysms/dissection (e.g. @ Maran’s)

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7
Q

Antiviral drugs for HSV-1/2/VZV vs. EBV/CMV

A
  • acyclovir = guanisine analog
    • activated by thimidine kinase that is present @ HSV1/2/VZV
    • TK is different @ CMV/EBV, thus less effective
  • gangciclovir ==> CMV/EBV
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8
Q

Vitamin tx for measles

A

Vit A

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9
Q

T3 receptor =

A

nuclear receptor

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10
Q

Blasts of smear + severe infection + 8yo boy ==> Dx?

A

most likely T-ALL

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11
Q

Medullary vs. Papillary thyroid cancer

A
  • Medullary
    • parafollicular c-cells
    • polygonal to spindle shaped granular cells that stain for calcitonin
    • adjacent amyloid deposits
    • assoc. MEN 2A/@B
  • Papillary
    • large cells with nuclei with widely dispersed chromatin
    • ground-glass appearance (orphan annie eyes)
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12
Q

Major syndromes caused by lacunar infarcts

A
  1. motor only = post. limb of internal capsule
  2. sensory only = VPL or VPM or thalamus
  3. ataxia-hemipalegia = base of pons
  4. dysarthria-clumsy hand syndrome = base of pons or genu of internal capsule
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13
Q

aminoglycoside resistance by enterococci

A

cytoplasmic membrane proteins that transfer chemical groups to aminoglycosides (e.g. acetyl, adenyl or phosphate)

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14
Q

Lab value to check if alk-phos is moderately elevated

A
  • gamma-glutamyl transpeptidase ==> present in several tissues, esp. @ hepatocytes, and biliary epithelial, but not @ bone
    • helps differentiate alk phos elevation source as bone vs. liver
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15
Q

claudication usually due to…

A

atherosclerosis

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16
Q

Characteristics of subacute cerebellar degen paraneoplastic syndrome

A
  • occurs with:
    • SC LC
    • breast, ovarian, and uterine
  • mediators:
    • anti-yo
    • anti-P/Q
    • anti-Hu
17
Q

Tuberculoid vs. Lepromatous Leprosy

A
  • Tuberculoid
    • positive skin test
    • TH1 response + IL-2 & INF-gamma & IL-12 present
    • lower bacterial load
  • Lepromatous
    • negative skin test (low TH1 response)
    • disseminated disease/high bacterial load
    • TH2 (humoral) response predominates
      • IL-4, IL-5, IL-10
    • acummulation of acid-fast bacteria w/in lesions
18
Q

acute onset, mid-chest pleuritic pain, improves w/sitting up/leaning forward ==> dx?

A

pericarditis

19
Q

Integrin-mediated adhesion of cells depends on …

A

bidning to collagen, fibronectin, and laminin

20
Q

Mechanism of increased ESR

A
  • local injury/inflammation ==> mac release of TNF-alpha, IL-1, and IL-6
  • IL-6 ==> APR release: fibrinogen, ferritin, CRP, serum amyloid A/P, complement)
    • fibrinogen ==> rouleux formation of RBCs ==> faster sedimentation
21
Q

Haptoglobin

A

serum protien that binds free Hb

decreased in hemolytic anemias

22
Q

Characteristics of Digoxin

A
  • common 2nd line tx for Afib
  • MOA: slows conduction through AV node via stimulation of vagus n.
    • acts @ Na/K ATP-ase pump
  • **difficult to dose
  • Toxicity ==>
    • fatigue, blurry vision, changes in color perception
    • N/V, diarrhea, abdominal pain
    • headache, dizziness, confusion, delerium
    • AV nodal block ==> bradycardia + jxnl escape beats <== most common cause of mortality
23
Q

Small bluish neoplasm under nail bed ==> Ddx?

A
  • melanoma vs. glomangioma
  • glomangioma = tumor of modified smooth m. cells
    • responsible for shunting blood away from skin surfaces to prevent heat loss
24
Q

Drug-induced SLE

A
  • hydralizine
  • procainamide
  • isoniazid
  • minocycline
  • quinidine
25
Q

Gram - rods classification

A
  • Lactose-fermenting
    • E. Coli
  • Non-lactose
    • oxidase + = pseudomonas
    • oxidase (-)
      • No H2S production
        • Shigella
      • H2S production
        • Salmonella
        • Proteus
26
Q

Immediate possible adverse effect of opiods

A
  • ==> smooth m. contraction ==> contraction/spasm of sphincter of Oddi ==> increased common bile duct pressure & biliary colic
  • ==> RUQ abdominal pain
  • discontinue meds, manage sx and pain

USMLE Step 1 (97 decks)

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