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USMLE Step 1 > Week 1 > Flashcards

Week 1 Flashcards

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USMLE® Step 1 flashcards
1
Q

What infections are associated with reactive arthritis?

A

Campylobacter, shigella, salmonella, yersinia, bordetella, chlamydia

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2
Q

What kind of study assesses for odds ratio? How is it calculated?

A

Case-control; ad/bc

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3
Q

At what sites in the CNS can an UMN lesion occur?

A

Internal capsule, precentral gyrus, midbrain, pons, medulla, cerebrospinal tracts

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4
Q

What is cladibrine?

A

It is a purine analog that is resistant to adenosine deaminase. It used for the treatment of hairy cell leukemia.

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5
Q

What infectious agents typically cause septic arthritis (3)? What is the drug of choice?

A

S. aureus, streptococcus, N. gonorrhoeae. Ceftriaxone

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6
Q

What is the first-line treatment for partial seizures?

A

Carbamazepine

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7
Q

What is the treatment for tonic-clonic seizures?

A

Phenytoin, carbamazepine, valproate

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8
Q

What is the first-line treatment for myoclonic seizures?

A

Valproate

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9
Q

What is the treatment for absent seizures?

A

Ethosuxamide followed by valproate

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10
Q

What microbe contains lecithinase? What does it cause?

A

Clostridium perfringes. It causes cell lysis (hemolysis), edema, and necrosis (gas gangrene)

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11
Q

What is the MOA of the diphtheria toxin? What does it cause? What other toxin is similar to diphtheria toxin?

A

It inhibits EF-2, preventing protein synthesis. It causes pseudomembrane pharyngitis, cervical LA, and severe myocarditis. P. aeruginosa’s exotoxin A is very similar.

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12
Q

What is unique about the murmurs of mitral valve prolapse and hypertrophic cardiomyopathy?

A

They do not increase with maneuvers that return blood to the heart and they do not diminish with maneuvers that decrease blood flow to the heart.

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13
Q

What is unique about the murmurs of VSD? What other murmurs share this feature?

A

It increases with the handgrip maneuver. This also occurs with the murmurs of aortic regurg and mitral regurg.

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14
Q

What is the MOA of daptomycin? What is its clinical use? For what infections is it ineffective?

A

It disrupts bacterial membranes by inserting channels in their membranes. It used for skin infections and bacteremia caused by MRSA. It is ineffective against gram (-) bugs.

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15
Q

What drugs induce P450?

A

Rifampin, phenobarbital, phenytoin

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16
Q

What drugs inhibit warfarin metabolism?

A

Amiodarone (inhibits P450), cimetidine, TMP/SMX, erythromycin

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17
Q

What drug slows AV node conduction by stimulating the vagus nerve?

A

Digoxin

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18
Q

What is a dangerous side effect of nitroprusside? What are the signs of this side effect? How can it be countered?

A

Nitroprusside can be metabolized to CN-, which presents w/ lactic acidosis and altered mental status. Countered with sodium thiosulfate

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19
Q

What are patients with Paget’s disease at risk of developing?

A

Osteosarcoma

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20
Q

Procainamide: what class?

A

Class Ia

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21
Q

Disopyramide: what class?

A

Class Ia

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22
Q

What class of antiarrhythmics are useful for ventricular arrhythmia and digoxin-induced arrhythmias?

A

Class Ib Na channel blockers

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23
Q

What antiarrhythmics significantly prolong the AV node refractory period making them contraindicated s/p MI?

A

Class Ic Na channel blockers

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24
Q

Flecainide: what class?

A

Class Ic Na channel blocker

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25
Q

Propafenone: what class?

A

Class Ic Na channel blocker

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26
Q

What drugs are useful for SVT that progress to ventricular fibrillation?

A

Class Ic Na channel blocker

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27
Q

Sotalol: what class?

A

Class III K channel blocker

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28
Q

Bretylium: what class?

A

Class III K channel blocker

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29
Q

What antiarrhythmics are useful for v-tach, v-flutter, and slowing ventricular rate in a fib and a flutter?

A

Class II β blockers

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30
Q

What drugs are useful for preventing nodal arrhythmias?

A

Class IV Ca channel blockers

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31
Q

What drug is useful for quickly abolishing SVT? How does it work?

A

Adenosine. It is a fast-acting drug that increases K efflux, hyperpolarizing the cell and decreasing Ca current

32
Q

Name the intoxication: clammy skin, lethargy, constricted pupils, nausea, euphoria

A

Heroin

33
Q

Name the intoxication: tachycardia, HTN, anxiety, tremor, hallucination, sweating, dry mouth

A

Amphetamine

34
Q

Name the intoxication: tachycardia, HTN, tremors, twitching chest pain, irritability, delusion

A

Cocaine

35
Q

Name the intoxication: detachment, vertigal nystagmus, ataxia, paranoia

A

Phencyclidine

36
Q

Name the intoxication: bradycardia, decreased BP, confusion, sedation, mild amnesia, slurred speech

A

Benzodiazepine

37
Q

Name the intoxication: tachycardia, dilated pupils, confusion, hallucination, disorientation, tremor

A

LSD

38
Q

How is chronic granulomatous dz diagnosed?

A

Neutrophils are unable to reduce nitroblue tetrazolium

39
Q

Where is the most common site of osteomyelitis? Why?

A

Metaphysis of long bone because of the rich vascular supply

40
Q

Describe the effect of fibrates (Gemfibrozil).

A

Upregulates lipoprotein lipase, which increases triglyceride clearance

41
Q

What drugs increase risk of myopathy when taken with statins and increase the risk of gallstone when taken with acid-binding resins?

A

Fibrates (Gemfibrozil)

42
Q

How is theophylline intoxication treated?

A

Gastric lavage, activated charcoal, β blockers for arrhythmia, and benzos/barbs for seizures

43
Q

What are the normal gas partial pressures for inspired air, tracheal air, alveolar air, and venous blood?

A

Inspired air: PO2 = 160
Tracheal air: PO2 = 150
Alveolar air: PO2 = 104; PCO2 = 40
Venous blood: PO2 = 40, PCO2 = 45

44
Q

When the content of alveolar air matches the content of tracheal air, what does it represent?

A

Perfusion deficit

45
Q

When the content of alveolar air matches the content of venous blood, what does it represent?

A

Ventilation deficit

46
Q

What drugs can cause pancreatitis?

A

Sulfasalazine, azathioprine, furosemide, valproate

47
Q

What infections can cause pancreatitis?

A

Mumps, EBV, VZV, coxsackie, TB, mycoplasma

48
Q

PAH clearance is used to estimate what?

A

Renal plasma flow

49
Q

Inulin clearance is used to estimate what?

A

GFR

50
Q

What is a normal filtration fraction?

A

About 20 percent

51
Q

What is the quad screen for trisomy 18?

A

Decreased αFP, decreased βHCG, decreased estriol, normal inhibin A

52
Q

What is the quad screen for trisomy 13?

A

Normal αFP, βHCG, estriol, and inhibin A

53
Q

This drug is a 5HT1α agonist used for anxiety that requires 2-3 weeks to be effective. What are its advantages?

A

Buspirone. It is not associated with addiction, sedation, or tolerance.

54
Q

What is the standard treatment for urethritis?

A

Ceftriaxone to cover gonorrhea; azithromycine or doxycycline to cover chlamydia

55
Q

What are the S/S of serotonin syndrome?

A

Neuromuscular: rigidity, myoclonus, hyperreflexia
Autonomic: diaphoresis, flushing, tachycardia, hyperthermia
CNS: confusion and agitation

56
Q

What drugs can cause serotonin syndrome (8)?

A

SSRIs, SNRIs, TCAs, MAOIs, tramadol, ondansetron, linezolid, triptans

57
Q

What are the actions of thiamine?

A

Cofactor for pyruvate DH, αKG-DH, transketolase, branched-chain AA DH

58
Q

What is the purpose of pyridoxine?

A

Decarboxylation reactions, transamination, glycogen phosphorylase and synthesis of cystathionine, histamine, GABA, heme, and niacin

59
Q

Describe the presentation of rubella.

A

Fever, LA (postauricular and occipital), mild flu-like illness followed by rash that spreads from forehead to face to torso to extremities (lasts 3 days)

60
Q

Name the class: tranylcypromine

A

MAOI

61
Q

Name the class: isocarboxazid

A

MAOI

62
Q

Name the class: phenelzine

A

MAOI

63
Q

What drugs are antiandrogenic? What are their MOAs?

A

Finasteride (5α reductase inhibitor), flutamide (steroid receptor antagonist), ketoconazole (inhibits desmolase), spironolactone (blocks steroid binding)

64
Q

What is the quad screen results for a fetus with Down syndrome?

A

Decreased αFP, increased βHCG, decreased estriol, increased inhibin A

65
Q

A lacunar infarct of the VPL or VPM causes what?

A

Pure sensory loss

66
Q

A lacunar infarct of the base of the pons causes what?

A

ataxia-hemiplegia syndrome or dysarthria-clumsy hand syndrome

67
Q

A lacunar infarct of the posterior limb of the internal capsule causes what?

A

Hemiparesis

68
Q

A lacunar infarct of the of the internal capsule causes what?

A

Dysarthria-clumsy hand syndrome.

69
Q

What grows on Thayer-Martin VCN agar?

A

N. gonorrhoeae

70
Q

What is the function of DNA polymerase I?

A

Prokaryotic. Degrades RNA primer (5’ to 3’ exonuclease) and fills in the gap with DNA. Proofreads w/ 3’ to 5’ exonuclease.

71
Q

What is the function of DNA polymerase III?

A

Prokaryotic. Elongates 5’ to 3’. Proofreads each added nucleotide with 3’ to 5’ exonuclease.

72
Q

What is the function of DNA polymerase α?

A

It synthesizes the RNA primer.

73
Q

What is the function of DNA polymerase δ?

A

Catalyzes DNA elongation, and proofreads 5’ to 3’.

74
Q

What is the function of DNA polymerase ε?

A

It fills in the gaps on lagging strand and proofreads 5’ to 3’.

75
Q

What are the distinguishing features of pseudomonas aeruginosa?

A

Motile, aerobic, gram (-) rod, oxidase (+), lactose non-fermenter, produces procyanin, produces endotoxin and exotoxin A

76
Q

What antibiotics are effective against pseudomonas (6)?

A

Aminoglycosides, antipseudomonal penicillins, 3rd gen cephs, imipenem, aztreonam, quinolones

77
Q

What can be used to treat Alzheimer’s?

A

ACh agonists (donepezil), NMDA antagonists (memantine), neuroprotective antioxidants (vit. E)

USMLE Step 1 (3 decks)

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