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Rapid Review USMLE Step 1 > Week 2 Review Deck > Flashcards

Week 2 Review Deck Flashcards

1
Q

hematuria, periorybital edema, cola-colored urine, HTN; Anti-DNase and Anti-streptolysin O titers, with decreased C3 concentration and normal C4

A

poster-strep glomerular nephritis

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2
Q

Name the 6 types of nephritis

A

PSGN, RPGN, Alport Syndrome, MPGN, IgA nephropathy, Diffuse Proliferative Glomerulonephritis (SLE)

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3
Q

Name the 5 types of Nephrotic syndrome

A

minimal change disease, FSGS, membranous nephropathy, Amyloidosis, Diabetic glomerulonephropathy

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4
Q

Hematuria with hemoptysis

A

Goodpasture Syndrome (Anti-GBM antibodies with linear IF due to Antibodies on GBM)

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5
Q

Common statistical test that checks the differences between means of 2 groups

A

T-Test

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6
Q

Common statistical test that checks difference between means of 3 or more groups

A

ANoVA/ Analysis of Variance

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7
Q

Common statistical test between two or more percentages OR proportions of categorical outcome (i.e. Comparing the percentages of members of 3 different ethnic groups who have essential HTN.

A

Chi Squared Test

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8
Q

What branch of the facial nerve supplies taste to the anterior 2/3 of the tongue

A

Chorda Tympani N

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9
Q

What nerve provides sensation to the anterior 2/3 of the tongue

A

Mandibular branch (V3) of the Trigeminal N.

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10
Q

What nerve supplies taste and sensation to the posterior 1/3 of the tongue?

A

Glossopharyngeal nerve (IX)

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11
Q

Two bacterial species that cleave IgA

A

S pneumo (IgA dimer shield) and N Gonorrhea cleave IgA protease (Ace Card)

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12
Q

Function of Protein A in Staph Aureus

A

Cleaves the Fc portion of IgG preventing complement activation, opsonization, and phagocytosis

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13
Q

refractory ulcers in the distal duodenum, abdominal pain, diarrhea and positive secretin stimulation test; associated with MEN1

A

ZES

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14
Q

Water diarrhea, achlorhydria, hypokalemia; Associated with MEN1

A

VIPoma

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15
Q

Hunger center in the hypothalamus

A

Lateral Nucleus

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16
Q

Satiety center of the hypothalamus

A

ventromedial nucleus

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17
Q

Cooling center of the hypothalamus; loss of function leads to hyperthermia

A

anterior nucleus

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18
Q

heating center of the hypothalamus; loss of function leads to hypothermia and poikilotherm (snake) skin

A

posterior nucleus

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19
Q

Nucleus in the hypothalamus responsible for production and release of ADH Oxytocin, CRH and TRH release

A

paraventricular nucleus (neurohypophysis)

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20
Q

Nucleus in the hypothalamus responsible for ADH and Oxytocin production and release.

A

Superoptic nucleus

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21
Q

Nucleus in the hypothalamus responsible for circadian rhythm

A

Suprachiasmatic

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22
Q

When should a 5HT3 Blocker be administered as an antiemetic

A

Ondansetron should be used in cases of diarrhea with nausea and vomiting caused by chemo, recent infection that lead to GI inflammation, or obstruction

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23
Q

When should D2 Receptor blockers be used as an anti-emetic

A

Metoclopramide and prochlorperazine should be used in the causes of nausea associated with migraine

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24
Q

When should H1 histamine blockers and mAChR blockers be used in the treatment of nausea and vomiting?

A

Should be used in cases of vestibular nausea (motion sickness) Diphenhydramine, meclizine; scopolamine; Promethazine can also be used

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25
Q

When should an NK-1 Receptor blocker be used in the treatment of Nausea and vomiting?

A

Aprepitant should be used basically for chemo and radiation only (inhibits Substance P binding to the NK-1 R)

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26
Q

Side effects and MOA of Daptomycin

A

Depolarizes cellular membrane by creating transmembrane channels (Taser); rhabdomyolysis and myopathy, elevated CPK

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27
Q

rhino sinusitis, peripheral eosinophilia, asthma, skin nodules or purpura; Can affect the GI, heart and kidneys; cause p-ANCA glomerulonephritis

A

Churg Strauss/ Eosinophilic Granulomatosis with Polyangitis (small vessel vasculitides)

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28
Q

5 bacterial toxins coded in a lysogenic phage

A

1) A strep erythrogenic toxin 2) Botulinum Toxin 3) Cholera Toxin 4) Diphtheria exotoxin 5) Shiga Toxins (ABCD’S)

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29
Q

DNA repair mechanism affected in xeroderma pigmentosa

A

DNA single stranded, nucleotide excision repair

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30
Q

DNA repair mechanism associated with HNPCC/ Lynch

A

DNA mismatch Repair

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31
Q

DNA repair mechanism defective in ataxia telangiectasia and Fanconi Syndrome

A

Nonhomolygous end joining (DS breaks)

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32
Q

DNA repair mechanism defective in breast/ ovarian cancer

A

BRCA1/2 causes defective homologous recombination

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33
Q

Experiencing the self as either all bad or as all good

A

splitting

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34
Q

Channeling an unacceptable impulse into an appropriate behavior (Wanting to fight someone but signing up for boxing instead)

A

sublimation

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35
Q

Common infection seen in diabetic patients causing a sinus infection that rapidly spreads to involve the orbit and brain

A

Rhizopus causing mucormycosis

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36
Q

Fungal infection that causes fever, hemoptysis, chest pain and dyspnea, also growing mold.

A

Invasive Pulmonary Aspergillosis seen in immunocompromised.

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37
Q

Causes of pill-induced esophagitis

A

NSAIDs, bisphosphonates, tetracyclines, potassium chloride, ferrous sulfate.

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38
Q

Endoscopy with histology showing elongation of the lamina propria, basal zone hyperplasia, and scattered eosinophils and neutrophils

A

GERD

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39
Q

Bronchoscopy shows fibrosis, egg shell calcifications and bifringent particles

A

Silica

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40
Q

pt with SOB and co-workers who share similar sx; Bronchoscopy shows non-caseating granulomas with no associated particulate

A

berylliosis

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41
Q

Variety of bodily complaints lasting for months to years, associated with persistent thoughts and anxiety about symptoms. May co-occur with an illness- Tx with recurrent office visits

A

Somatic Symptom Disorder

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42
Q

Histology of liver shows microvesicular steatosis(small fat vacuoles in cytoplasm); Nausea, vomiting, abnormal LFTs, increased PT and PTT; Hyperammonia leading to encephalopathy

A

Reyes Syndrome

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43
Q

de novo mutation MCEP2 of the x-chromosome; causes regression of cognitive, motor, and verbal ability in girls between the ages of 1-4. Also include growth failure, ringed hand movements, seizures and Ataxia

A

Rett Syndrome

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44
Q

Coarse facial features, gingival hyperplasia, clouded corneas, restricted joint movement, claw hand deformity, kyphoscoliosis, increased plasma levels of lysosomal enzymes; typically a fatal disease

A

I cell Disease

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45
Q

Deficient Enzyme in lysosomal storage disease and MOA

A

N_acetylglucosaminyl-1-phosphotransferase; deficiency results in failure of the golgi apparatus to phosphorylate mannose residues leads to proteins getting secreted extracellularly instead of being transported to the lysosome.

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46
Q

SAEs of Cephalosporins

A

Autoimmune, Hypersensitivity reaction, hemolytic anemia, disulfiram like reaction, Vitamin K deficiency, Increase nephrotoxicity of aminoglycosides

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47
Q

Causes of spherocytosis

A

Hereditary spherocytosis (ankyrin, spectrin, band 3 protein, etc), drug and infection induced hemolytic anemia

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48
Q

triggers of vasospastic angina

A

dihydroergotamine (migraine drug that causes vasoconstriction) via stimulation of alpha-adrenergic and serotonin receptors; cigarette smoke, cocaine, amphetamines, triptans (migraines)

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49
Q

Initiating event of acute appendicitis

A

obstruction first (fecalith) infection later.

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50
Q

+ Cyanide-nitroprusside test and aminoaciduria on urinalysis

A

Cystinuria

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51
Q

Autosomal recessive defect in Sodium independent amino acid transporters on the apical membrane of intestinal and PCT cells preventing absorption of dibasic Amino acids (cysteine, ornithine, lysine, Arginine (COLA))

A

Cystinuria

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52
Q

myxomatous changes with pooling of proteoglycans in the media layer of large arteries predispose you to what conditions

A

aortic aneurysms, and aortic dissection

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53
Q

Hyperplastic arteriolosclerosis is associated with proliferation of what that produces onion skinning

A

intimal smooth muscle hyperplasia

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54
Q

inheritance pattern of G6PD Deficiency

A

X-linked Recessive

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55
Q

Patient receives medication and develops jaudince, dark urine, hemolytic anemia on labs, decreased haptoglobin and blood cells show dark inclusion bodies; there is also a history of these type of events

A

G6PD deficiency

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56
Q

older patient (in 70s), post-prandial epigastric pain that is not relieved with antacids, weight loss, food aversion along with a significant medical history of CABG, etc

A

colonic mesenteric ischemia

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57
Q

+ niklosky sign (sloughing of skin on manual light touch) characterized by fever and sloughing of the skin that heals completely

A

Scaled Skin syndrome caused by staph aureus

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58
Q

cell-mediated hypersensitivity is what kind of hypersensitivity reaction

A

Type IV Hypersensitivity Reaction mediated by Th1 cells

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59
Q

Lactase deficiency presents with what manifestations

A

In addition to indigestion and steatorrhea, you get decreased stool pH because bacteria convert lactulose to FA–> acidification of the stool, increase stool osmolality due to excess water in stool, and increased hydrogen gas on a breath test because it a byproduct of bacterial fermentation of lactulose.

60
Q

skin manifestation associated with celiac disease

A

dermatitis herpetaformis

61
Q

Biggest complication of psoriasis

A

psoriatic arthritis; seronegative spondyloathropathy

62
Q

Severe headache, pan-hypopituitarism (decreased libido,etc), bitemporal hemianopsia, ophthalmoplegia

A

Pituitary apoplexia/ hemorrhage

63
Q

S-100 + malignancies

A

melanoma, Schwannoma, Langherhans Histiocytosis (presents as a lytic bone lesion in children- Langherhans cells are functionally immature and don’t stimulate T cells)

64
Q

Hypospadias

A

below the penis; failure of the urethral fold to fuse

65
Q

Epispadias

A

Hole on top; Failure of the genital tubercle to position itself properly

66
Q

Manifestrations of Chlamydia with strains L1-L3

A

Lymphogranuloma venerum

67
Q

Manifestations of Chlamydia with strains A-C

A

Chronic infection, cause blindness due to follicular conjunctivitis

68
Q

Severe, acute pain testicular pain with absence of cremasteric muscle reflex and high riding testicles

A

Testicular torsion

69
Q

causes of Congenital Hydrocele

A

caused by incomplete obliteration of the process vaginalis

70
Q

Schiller duvall bodies, elevated AFP, tumor seen in children

A

Yolk sac tumor

71
Q

GnRH Analog used to treat prostate cancer

A

Leuprolide

72
Q

Androgen Receptor Inhibitor used to treat prostate cancer

A

Flutamide

73
Q

Alpha-1 Antagonist with anti-hypertensive properties used to treat BPH

A

Terazosin

74
Q

Alpha-1 Antagonist used to treat BPH in normotensive patients

A

Tamsulosin

75
Q

PDE inhibitor used to treat BPH and erectile dysfunction

A

Sildenafil

76
Q

Class IA Anti-arrythmic’s

A

Disopyramide, Quinadine, procainamide (Curtain pulled and tilted mic) (prolong phase 0 upstroke, and the refractory period– increased duration of AP)

77
Q

Class IB Anti Arrhythmic’s

A

Mexlitine, Phenytoin, lidocaine (Decrease AP duration; prolong phase 0 upstroke)

78
Q

Class IC Anti Arrhythmic’s

A

Flecanide, Propafone (No change in AP duration, prolong phase 0)

79
Q

Supplementation for Breast fed infants

A

Vitamin D and Fe

80
Q

Port wine stains, painful abdomen, polyneuropathy, psychological disturbances, precipitated by drugs (alcohol or starvation)

A

Porphobilinogen deaminase deficiency- Acute intermittent porphyria

81
Q

Blistering cutaneous photosensitivity predominately affecting the hands; exacerbated by alcohol and associated with Hep C

A

Uroporphyrinogen Deaminase (most common)- Porphyria cutanea tarda

82
Q

microcytic anemia, basophilic stippling of RBCs, ringed sideroblasts, GI and Kidney disease; presents with mental deterioration in children; in adults it presents with headache, memory loss, demyelination

A

Lead poisoning (inhibits ferroketolase and ALA Deaminase)

83
Q

Treatment of Acute Intermittent prophyria

A

Heme and glucose inhibit Ala Synthase

84
Q

Ringed siderblasts; Anemia can be inherited (X-linked), acquired (myelodysplastic syndrome), and reversible (Vitamin B6 deficiency, Cu deficiency, lead, isoniazid, chloramphenicol)

A

Sideroblastic Anemia (deficient ALA Synthase)

85
Q

Features of hypomania

A

last greater than 4 days, patients are a lot more productive, they need less sleep; No psychotic features marked enough impairment to merit hospitalization

86
Q

Features of Mania

A

> /= 1 week; distractibility, impulsivity, indiscretion– seeks pleasure without regard to consequence, grandiosity (inflated self-esteem), flight of ideas (racing thoughts), increased goal directed activity/ psychomotor agitation, decreased need for sleep and talkativeness/ pressured speech

87
Q

POMC

A

ACTH, beta endorphin MSH

88
Q

Obstructive hydrocephalus (nausea, vomiting, papilledema) due to aqueduct stenosis; vertical gaze palsy, pupillary light-near dissociation (pupils that react to accommodation but not to light), lid-retraction (collier sign), and convergence-retraction nystagmus

A

Parinaud Syndrome caused by pineal gland tumor

89
Q

Bradycardia, diarrhea, muscle weakness, seizures, coma

A

Organophosphate poisoning

90
Q

Treatment for organophosphate poisoning

A

Atropine (mAChR antagonist)

91
Q

1st neuron lesions that cause horner syndrome

A

1) syringomyelia 2) Bernard- Sequard 3) pontine hemorrhage 4) Spinal cord lesion about T1

92
Q

2nd neuron lesions that causes horner syndrome

A

Pancoast tumor

93
Q

3 rd neuron lesion that causes horner syndrome

A

carotid dissection, carotid endardectomy

94
Q

Anti-mitochondrial Antibody

A

Primary Biliary Cirrhosis/ Sclerosis

95
Q

Anti-dsDNA, Anti-sm, anti-phospholipid antibodies

A

SLE

96
Q

HPV 6 and 11 has a predilection for what part of the respiratory tract?

A

true vocal cords because these have stratified squamous epithelium which it can infect (also found in the vagina, anal canal, and cervix)

97
Q

Key difference between Anorexia and bulimia

A

bulimics tend to maintain their weight at or above normal level; anorexics tend to binge and purge or restrict until there is significant physiological changes including hairless, osteoporosis, decreased heart size, etc.

98
Q

K+ sparing diuretics

A

Epleronone (apple) spironolactone (apple)

99
Q

weird SAEs of corticosteroids

A

Sleep disturbances, hypomania, psychosis, neutrophilia (inhibit demmargination) peptic ulcer disease, GI bleeding (decrease PG), proximal muscle weakness, and hypogonadism

100
Q

Fracture of the femoral head or neck can create insufficiency in which branch of the femoral artery leading to avascular necrosis

A

medial femoral circumflex artery

101
Q

Saline microscopy

A

Wet mouth; Trichamonis and Gardnerella

102
Q

Passive immunity/ available antitoxins- short span antibodies that have rapid onset

A

tetanus toxin, botulinum toxin, HBV, Varicella, Rabies Virus, diphtheria,

103
Q

Streptolysin O function in strep

A

lysis RBCs and leukocytes (beta-hemolysis); responsible for the Anti-ASO titers that occur after strep infection

104
Q

DNase function in Strep

A

DNase is an enzyme that catalyzes plasminogen to plasmin allowing spread through infected tissues (this is why its used as an anti-thrombotic agent)

105
Q

Function of M proteins in Strep

A

antigen; anti-phagocytic virulence factor and prevents activation of compliment

106
Q

Consequences of malrotation of the gut

A

Malrotation is typically asymptomatic but can cause volvulus later in life; this cause ischemic necrosis of the bowel; sigmoid volvulus in elderly, midgut in children

107
Q

heparin induced thrombocytopenia treatment

A

protamine sulfate

108
Q

Inherited mutation associated with ALS

A

Superoxide Dismutase I;

109
Q

Gene mutated in Spinal Muscular Atrophy (Werdnig-Hoffmann Disease); how does it present

A

SMN1: Anterior horn–> therefore LMN in infant

110
Q

Presentation of ALS

A

SPARES SENSORY AND BLADDER/BOWEL; dysarthria, dysphagia asymmetric limb weakness, atrophy, fasciculations; pseudo bulbar palsy, spastic gait, clonus ;

111
Q

Mutation and chromosomal association of Friedriech Ataxia

A

AR on Chromosome 9; GAA repeat in the Frataxin Gene which is an iron binding protein in mitochondria

112
Q

Child with a staggering gait, kyphoscoliosis, nystagmus, dysarthria, pes cavus, hammer toes, diabetes mellitus, and hypertrophic cardiomyopathy which is often the cause of death

A

Friedriech Ataxia

113
Q

Rapid correction of hypernatremia

A

Cerebral edema/ herniation

114
Q

Rapid correction of hyponatremia

A

Cerebral pontine Myelinosis (osmotic demyelination); dysphagia, dysarthria, diplopia, loss of consciousness (locked-in syndrome)

115
Q

lower extremity weakness and sensory deficits with foot deformities (pes cavus, hammer toe)

A

Charcot-Marie-Tooth Disease

116
Q

Mutations associated with Charcot marie tooth disease

A

Autosomal Dominant- CMT1A and PMP22

117
Q

post wine stain (nevus falmmeus; CNV1/V2 distribution), ipsilateral leptomeningeal angioma which causes epilepsy/ seizures, intellectual disability, and episcleral hemangioma which causes increased introcular pressure leading to early onset glaucoma

A

Sturge Weber Syndrome

118
Q

Mutation associated with Sturge Weber

A

congenital, non inherited (sporadic) developmental anomaly of neural crest derivatives due to somatic mosaicism –> an activating mutation in GNAQ gene affecting small arteries

119
Q

hemangioblastomas in the retina, brain stem, cerebellum, spring; angiomatosis (cavernous hemangioma in the skin, mucosa, organs), bilateral RCC, pheochromocytoma.

A

VHL Disease

120
Q

Mutation associated with VHL

A

Deletion of VHL gene on chromosome 3p; AD; pVHL ubiquitinates hypoxia inducible factor 1a (HIF)

121
Q

stool sample of strongy will show what findings?

A

Larva

122
Q

Child undergoes fasting >24hrs, becomes lethargic and develops a seizure. Labs show 0 ketones, elevated LFTs, and low glucose. Enzyme deficient?

A

Acetyl-CoA Dehydrogenase; This is not a glycogen storage issue (glycogen is depleted in 6-8 hours), hypoketonia indicates fatty acid oxidation issue.

123
Q

People that carry MRSA are most likely to be infected where?

A

The Anterior nares

124
Q

peripheral Blood smear showing enlarged red blood cells that stain blue with Wright Giemsa Stain

A

rRNA in reticulocytes

125
Q

What segment of the colon is always involved in Hirschsprung’s Disease?

A

The rectum, sigmoid colon is involved only 75% of the time

126
Q

Antibody Dependent Cell Mediated Toxicity

A

Parasitic infections (parasite is bound by IgE and IgG–> binds Fc portion on Eosinophil–> degranulation–> released of major basic protein and O2 species for destruction) similar to NK cell killing in TII HS Rxn

127
Q

Pt w/ a hx of gastrectomy presents with positive romberg, loss of vibration and sense, atrophic gastritis (smooth tongue) and symmetrical loss of strength in the proximal extremities

A

Vit B12 deficiency

128
Q

Unilateral facial pain that worsens with chewing, hearing loss, headache and eye discomfort

A

Temporomandibular disorder that arise from motor dysfunction of the Mandibular nerve (V3 or Trigeminal) More specifically, TMJ damage can affect the tensor tympani (muscle in ear) because its innervated by V3 motor fibers

129
Q

Cytokines involved in the systemic inflammatory response

A

TNF-alpha, IL-1, IL-6

130
Q

Neutrophilic chemotactic factors

A

LTB4, C5a, C3a,

131
Q

Charcot Bouchard Micro-aneurysm (HTN)

A

Intracerebal hemorrhage

132
Q

Sudden HA, Xanthochromia on LP, bleed on bottom of the brain, Berry/ Saccular Aneurysm

A

Subarachnoid Hemorrhage

133
Q

Defect in a berry/ Saccular aneurysm (why do they burst)

A

They lack a media layer

134
Q

Duret hemorrhages or posterior cerebral artery compression (visual defects)

A

Transtentorial herniation

135
Q

Down and out eye with mitosis

A

CNIII- Uncal herniation

136
Q

Herniation resulting in cardio-pulmonary arrest

A

cerebellar tonsil herniation

137
Q

Anterior cerebral artery compression herniation

A

Cingulate gyrus under the faux cerebri

138
Q

Dgx of tumor if Histo shows: pleomorphic tumor cells bordering areas of central necrosis, hemorrhage and/ or microvascular proliferation.

A

GBM

139
Q

CNS tumor: abundance of whorled cells with hypervascularity (Adults) and psammoma bodies

A

meningioma

140
Q

CNS Tumor: spindle cells alternating with hypo cellular, myxoid areas

A

Schwannoma

141
Q

CNS Tumor: round cells with blue nuclei and a rim of clear cytoplasm(adults)

A

Oligodendroglioma

142
Q

CNS Tumor: Astrocytes with thick eosinophilic processes also called rosenthal fibers (child)

A

Pilocytic astrocytoma

143
Q

CNS Tumor: small, round cells with homer wright rosettes (child)

A

Medulloblastoma

144
Q

CNS tumor: Perivascular rosettes (child)

A

Ependymoma

145
Q

CNS tumor: bitemporal hemianopsia in a child

A

Craniopharyngioma (Rathke’s pouch remnant)

Rapid Review USMLE Step 1 (8 decks)

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