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USMLE Step 1 > Week 3 > Flashcards

Week 3 Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the manifestations of Chediak-Higashi syndrome?

A

Giant lysosomal inclusions, ablinism, neuro defects, susceptibility to staph and strep.

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2
Q

What are the treatment options for gout?

A

1st line for acute: NSAIDs; 2nd line for acute: colchicine; Prophylaxis: uricosurics (for under-excretors) or xanthine oxidase inhibitors.

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3
Q

What is 7α hydroxylase?

A

It converts cholesterol to bile acids. Inhibition (by fibrates) reduces the conversion, resulting in excess cholesterol in the bile.

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4
Q

What are S/S of opiate withdrawal (4)?

A

Piloerection, dilated pupils, diaphoresis, fever.

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5
Q

What is the host defense against giardia?

A

Secretory IgA prevents adherence to duodenal and jejunal mucosa.

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6
Q

Describe the morphologic features of silicosis

A

Eggshell calcification of hilar nodes and birefringent particles surrounded by collagen.

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7
Q

Describe the morphologic features of beryllosis

A

Noncaseating epithelioid granulomas.

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8
Q

What is malignant hyperthermia? How does it present (5)?

A

It occurs due to hypersensitivity of skeletal muscles to inhaled anesthetics. Its due to an AD defect in the ryanodine receptors. Hyperthermia, tachycardia, rigidity, hyperkalemia, myoglobinuria.

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9
Q

How is malignant hyperthermia treated? What is its MOA?

A

Dantrolene (a muscle relaxant) It prevents Ca release from SR of skeletal muscle.

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10
Q

What is the HAART regimen? When is it initiated?

A

2 NRTIs + 1 NNRTI or 1 PI or 1 integrase inhibitor. Initiated w/ AIDS defining illness, CD4 <350, or high viral load.

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11
Q

Describe the inflammation of polyarteritis nodosa. What artery is always spared?

A

Segmental, transmural, necrotizing inflammation to small and medium-sized arteries. Fibrinoid necrosis is apparent. Pulmonary arteries are spared.

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12
Q

Subdural hematoma (blood vessel involved, location, clinical manifestation, CT)

A

Bridging cortical veins, between dura and arachnoid mater, gradual onset of HA and confusion, crescent-shaped hematoma.

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13
Q

What is lymphangiosarcoma? What condition is it associated with?

A

Malignancy of the endothelial lining of lymphatic channels. Assoc’d w/ prolonged lymphedema.

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14
Q

Name the serum marker: pancreatic cancer

A

CEA and CA19-9

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15
Q

Name the serum marker: ovarian cancer

A

CA-125

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16
Q

Name the serum marker: malignant epithelial tumor

A

CA-125

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17
Q

Name the serum marker: malignant melanoma

A

S-100

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18
Q

Name the serum marker: neural tumor

A

S-100

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19
Q

Name the serum marker: astrocytoma

A

S-100

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20
Q

Name the serum marker: metastasis to bone

A

Alk phos

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21
Q

Name the serum marker: neuroblastoma

A

Bombesin

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22
Q

Name the serum marker: lung cancer

A

Bombesin

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23
Q

Name the serum marker: gastric cancer

A

Bombesin

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24
Q

What are gene enhancers?

A

Stretches of DNA that alter transcription by binding transcription factors. They can be located anywhere upstream, downstream, or even within a gene.

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25
Q

Describe the flow of CSF.

A

Lateral ventricles (foramen of Monroe), 3rd ventricle (cerebral aqueduct), 4th ventricles (foramen of Luschka and foramen of Magendie) subarachnoid space.

26
Q

What bugs can cause aspiration pneumonia? What ABx covers them?

A

Anaerobes (bacteroides, prevotella, fusobacterium, peptostreptococcus) Covered by clindamycin.

27
Q

What is ergonovine? What is its clinical significance?

A

It stimulates α adrenergic and serotonergic receptors to cause vasoconstriction. It is used to induce angina for the Dx of Prinzmetal’s angina.

28
Q

What is phentolamine? What is its clinical significance?

A

It is a reversible α1 and α2 antagonist. It is given to patients on MAOIs that eat tyramine-containing foods.

29
Q

What is the prodromal presentation of hepatitis B infection? What are the acute lab findings?

A

Serum sickness-like: Malaise, fever, LA, headache, rash, pruritus, arthralgia. Acute labs: elevated ALT, AST, bilirubin, alk phos

30
Q

What are 4 signs of a villous polyp?

A
  1. Occult blood; 2. partial obstruction; 3. mucus secretion; 4. progression to adenoca.
31
Q

What 3 bugs are common causes of pneumonia 2ndary to influenza A infection?

A

Staph aureus, s. pneumo, h flu

32
Q

What is the MOA of opioids?

A

Open K channels, close Ca channels

33
Q

What is the MOA of streptokinase?

A

Forms a complex w/ plasminogen to cleave and activate plasmin. Plasmin cleaves fibrin. The complex also destroys fibrinogen, CF V and VII.

34
Q

What are the side fx of inhaled anesthetics? What drug is associated with each?

A

Hepatotoxicity (halothane); nephrotoxicity (methoxyflurane); convulsions (enflurane); expansion of trapped gas (nitrous oxide); malignant hyperthermia (all)

35
Q

What is the treatment for Lyme’s disease?

A

Doxycycline and ceftriaxone

36
Q

How is Lyme’s disease diagnosed?

A

AB detection (ELISA or Western blot) or culture by Wright-Giemsa stain.

37
Q

What are the clinical features of lead poisoning (6)?

A

Abdominal colic, constipation, headache, blue pigmentation at tooth-gum line, microcytic microchromic anemia w/ basophilic stippling, peripheral neuropathy.

38
Q

What are the s/s of adrenal crisis (3)?

A

Hypoglycemia, tachycardia, hypotension

39
Q

What information does the VPL relay?

A

It relays information from the dorsal and spinothalamic tracts to the primary somatosensory cortex.

40
Q

What are the s/s of chronic adrenal insufficiency (4)?

A

Vomiting, weight loss, abdominal pain, hyperpigmentation.

41
Q

How do arterial vasodilators cause increased sympathetic activity? What drugs are arterial vasodilators?

A

The decrease in arterial pressure induces baroreceptor-mediated sympathetic firing causing increased contractility, heart rate, and renal activity. Hydralazine and minoxidil.

42
Q

Describe the negative feedback mechanisms of the GnRH axis

A

FSH stimulates granulosa cells and sertoli cells to secrete inhibin A, which inhibits FSH. LH stimulates theca cells and leydig cells to secrete testosterone, which inhibits GnRH and LH.

43
Q

What are the common causes of meningitis in neonates (0-6mos)?

A

GBS, E. coli, Listeria

44
Q

What are the common causes of meningitis in kids 6mos - 6yrs

A

S. pneumo, H. flu B, N. meningitidis, enterovirus

45
Q

What are the common causes of meningitis in people 6yrs-60yrs?

A

S. pneumo, N. meningitidis, enteroviruses, HSV

46
Q

What are the common causes of meningitis in people over 60 years?

A

S. pneumo, gram (-) rods, listeria

47
Q

What are the common causes of pneumonia in neonates 0-4wks?

A

Group B strep, E. coli

48
Q

What are the common causes of pneumonia in kids 4wks-18yrs?

A

RSV, mycoplasma, C. trachomatis, S. pneumo

49
Q

What are the common causes of pneumonia in adults 18 yrs-40yrs?

A

Mycoplasma, C. pneumophilia, s. pneumo

50
Q

What are the common causes of pneumonia in adults 40-65 yrs?

A

S. pneumo, H. flu, anaerobes, viruses, mycoplasma

51
Q

What are the common causes pneumonia in elderly older than 65?

A

S. pneumo, H. flu, influenza, anaerobes, gram (-) rods.

52
Q

List the steps of B cell differentiation.

A

1) Precursors mature and prolif in the bone marrow
2) Mature B cells migrate into lymphoid organs
3) Exposure of Ag induces activation of a clone of B cells (differentiation into plasma cells secrete IgM, a majority migrate to the lymphoid follicle)
4. The germinal ctr is the site of B cell prolif.
5. The germinal ctr is the site of isotype switching via CD40-CD40L interactions

53
Q

What medications are used to induce abortion within the first 49 days of pregnancy?

A

Mifepristone: a competitive progesterone antagonist
Misoprostol: a PGE1 analog that causes uterine contraction and cervical dilation

54
Q

What is the morphology of Buerger’s disease? What arteries are most commonly affected?

A

AKA thromboangiitis obliterans. Acute and chronic inflammation w/ thrombosis of the lumen extending into contiguous veins and nerves. Tibial and radial aa. are most commonly affected.

55
Q

How does carboxyhemoglobin alter O2-carrying capacity?

A

Decreased O2 binding and a left shift in the O2-dissociation curve.

56
Q

What is pure red cell aplasia? With what conditions is it associated?

A

It is destruction of erythropoieitic precursors by IgG autoABs and CTLs. It is associated with thymomas and lymphocytic leukemia.

57
Q

What are the naked viruses?

A

Calicivirus (norwalk virus), picornavirus (polio, echo, rhino, coxsackie, HAV), reovirus (rotavirus); parvovirus, adenovirus, papillomavirus, polyoma virus (JC and BK)

58
Q

What is the presentation of ornithine transcarbamoylase deficiency?

A

Elevated NH4+, neuro disorders, increased excretion of orotic acid. Carbamoyl PO4 is converted to orotic acid for use in the pyrimidine synthesis pathway.

59
Q

What is pentazocine?

A

It is an opioid narcotic w/ partial agonist activity and weak antagonistic activity at µ receptors. It decreases analgesic effects and induces withdrawal symptoms in people dependent on morphine.

60
Q

What are the features of intravascular hemolytic anemia? What are some examples of intravascular hemolysis?

A

Elevated LDH, decreased haptoglobin, hemoglobinuria. Paroxysmal nocturnal hemoglobinuria and prosthetic valves.

61
Q

What are the features of extravascular hemolytic anemia? What are some examples of extravascular hemolysis?

A

Macs clear RBCs in the spleen. Elevated LDH, elevated UCB, jaundice. G6PDH deficiency, sickle cell, spherocytosis.

62
Q

In what conditions are Cheyne-Stokes respirations seen?

A

CHF, stroke, brain tumor, traumatic brain injury.

USMLE Step 1 (3 decks)

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