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STEP COPY > NBME 17 > Flashcards

NBME 17 Flashcards

1
Q

what innervates uvula

A

vagus. deviates away

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2
Q

painless menometrahia

A

endometrial hyperplasia

nuclear atypia. post menopause vaginal bleeding.

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3
Q

pt with rhabdo, what actually causes nephrotic syndrome

A

myoglobin (not CK, just a marker of rhabdo)

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4
Q

anticoag used in PE that causes thrombocytopenia

A

heparin

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5
Q

What type of stone causes staghorn caliculi

A

Struvite. caused by infection of urease + bugs (proteus, staph saphophyticus, klebsiella)

made up of ammonium, magnesium, phosphate

radiopaque

look like coffin lid

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6
Q

which hemroids are painful

A

external

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7
Q

what nerve causes rectum motility (and internal urethral function and erections)

A

pelvic splanchnic

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8
Q

string of beads appearance of artery (renal)?

A

fibromuscular dysplasia seen in polyarteritis nodosa

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9
Q

what could cause abd structures in the thorax in a newborn?

A

failure of pleuroperitoneal membrane

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10
Q

why does leprocy (myobacterium leprae) prefer extremities?

A

cooler temperatures

gives glove and stocking loss of sensation

tx: dapsone, rifampin, clofazimine

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11
Q

TNF-alpha

A

cause fever and hypotension (vascular leak) secreted by macrophages in response to Lipid A of endotoxin

ALSO causes cachexia in malignancy

ALSO causes WBC recruitment

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12
Q

Breath sounds dull to percussion with decreased tactile fremitus, decreased breath sounds

A

Pleural effusion, excess fluid between the pleural layers

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13
Q

LH stimulates (male)

FSH stimulates

A

–> Leydig cells –> testosterone

–> Sertoli cells –> androgen binding protein, mullerian inhibiting factor

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14
Q
A
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15
Q

Pincer grasps by how many months?

A

by 10 months

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16
Q

Pull to stand at how many months

A

10 months

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17
Q

synthesis of compounds in the skin that are subject to excitation by light. What pathway is defective

A

Porphyria cutanea tarda (defective heme synthesis, see photosensitivity, common porphyria)

18
Q

where does gluconeogenesis occur?

A

primarily in the liver but also in the kidney and intestinal epithelium

19
Q

Loratadine

A

2nd gen h1 antagonist that does not enter CNS

20
Q

Neural tube defect if neuropores fail to close by?

A

4th week

increased AFP, AChE increased in CSF

21
Q

osteogenesis imperfect

A

PROBLEM FORMING TRIPLE helix of collagen. decreased production of otherwise normal collagen

22
Q

Molluscum contagiosum— flesh-colored papule with

central umbilication

A

Poxvirus, DS linear enveloped. Also cause of smallpox and cowpox. often seen in kids sharing towel (fomite)

23
Q

ibutilide

A

class III antiarrhythmic

prolong phase 3, K channels of AP

predispose to long QT –> torsades

Tx for AFIB

24
Q

1-3 days post MI

A

fibrinous pericarditis with pericardial rub

extensive coagulative necrosis with neutrophils present

25
Q

3-14 days post MI

A

free wall rupture, causing tamponade. Due to macrophages coming in and eating up dead debris and make wall weakest point.

Also can get papillary muscle rupture getting mitral regurgitation

26
Q

cyclophosphamide

A

crosslink DNA at guanine N-7

An alkalating agent that inhibits DNA replication

Can cause hemorrhagic cystitis (need to give mesna

27
Q

cyclosporine

A

calcineurin inhibitor, blocks T-cell activation

prevent IL-2 transcription

NEPHROTOXICITY

used for transplant rejection, PAIR

28
Q

rosacea

A

In inflammatory facial skin disorder characterized by erythematous papules and pustules but no comedones.

May be associated with facial flushing in response to external stimuli (eg, alcohol, heat).

Phymatous rosacea can cause rhinophyma (bulbous deformation of nose).

29
Q

Pityriasis rosea

A

“Herald patch” followed days later by other scaly erythematous plaques, often in a “Christmas tree” distribution on trunk J . Multiple plaques with collarette scale. Self-resolving in 6–8 weeks

30
Q

Peutz-Jeghers syndrome

A

Autosomal dominant syndrome featuring numerous hamartomas throughout GI tract, along with hyperpigmented mouth, lips, hands, genitalia. Associated with risk of breast and GI cancers (eg, colorectal, stomach, small bowel, pancreatic).

31
Q

upper motor neuron lesion cause what to reflexes?

A

hyperreflexia

32
Q

MLF lesions are contra/ipsilateral?

A

ipsilateral.

Right affects Right

inability to tract pass midline in affected eye

33
Q

schizotypal

A

eccentric appearance, odd beliefs or magical thinking. Interpersonal awkward

= magical thinking

34
Q

antisocial

A

sociopath

35
Q

sulfasalizine

A

A combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-in ammatory). Activated by colonic bacteria.

Ulcerative colitis, Crohn disease (colitis component).

36
Q

IL-2

A

activate T-lymphocytes (blocked by cyclosporine–> calcineurin inhibitor)

IL-2 activate mTOR pathway

37
Q

adalimumab, infliximab

A

IBD treatment. (PAIR)

TNF-Alpha monoclonal antibody

38
Q

tx ADHD

A

methylphenidate (increase DA and NE)

can cause wt loss, insomnia

39
Q

Sarcoidosis

A

Characterized by immune-mediated, widespread noncaseating granulomas A , elevated serum ACE levels, and elevated CD4+/CD8+ ratio in bronchoalveolar lavage uid. More common in African-American females. Often asymptomatic except for enlarged lymph nodes. Findings on CXR of bilateral adenopathy and coarse reticular opacities B ; CT of the chest better demonstrates the extensive hilar and mediastinal adenopathy.

Associated with restrictive lung disease (interstitial brosis), erythema nodosum, lupus pernio (skin lesions on face resembling lupus), Bell palsy, epithelioid granulomas containing microscopic Schaumann and asteroid bodies, uveitis, hypercalcemia (due to 1α-hydroxylase–mediated vitamin D activation in macrophages).

40
Q

caause of menopause

A

decreased estrogen release from ovaries (failure of ovaries to secrete 17b estradiol)

41
Q

ezetimibe

A

stops cholesterol absorption from brush border

can make statin myopathy worse

42
Q
A

STEP COPY (36 decks)

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