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USMLE Step 1: Part 2 COPY > Q Banks: Week of 03/27/17 # 2 > Flashcards

Q Banks: Week of 03/27/17 # 2 Flashcards

1
Q

If a man can get an erection but not maintain it, then he likely has ________________ erectile dysfunction.

A

psychogenic

Don’t be tricked into picking physiologic if they give you red herrings like diabetes or stroke.

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2
Q

How does AMP affect glycogen phosphorylase?

A

It is an allosteric activator.

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3
Q

What are catabolite activators?

A

Transcription factors that activate genes in response to metabolic activity

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4
Q

What is tactile fremitus and how is it used?

A

Tactile fremitus is vibration felt on the chest wall while the person is speaking.

It is decreased in pleural effusion, pneumothorax, and COPD.

It is increased in pneumonia.

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5
Q

Hyperresonace occurs in which lung disorders?

A

Emphysema and pneumothorax

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6
Q

Which lung disorders present with decreased breath sounds?

A
  • COPD
  • Pneumothorax
  • Pleural effusion
  • Bronchial occlusion
  • Atelectasis
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7
Q

True or false: dullness to percussion can be found in atelectasis.

A

True!

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8
Q

Describe the role that each of the following nerves plays in micturition:
•Hypogastric
•Pelvic
• Pudendal

A
  • Hypogastric: sympathetic to detrusor and internal urethral sphincter (“You need a lot of GAS if you’re in flight or fight.”)
  • Pelvic: parasympathetic to detrusor and internal urethral sphincter (“The PElvic makes you PEe.”)
  • Pudendal: volUNtary to external urethral sphincter
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9
Q

High levels of ________________ in the nephron prevent formation of kidney stones.

A

citrate

Citrate binds to calcium and does not form stones, so it helps shuttle excess calcium out of the kidney. In fact, potassium citrate can be given to help treat recurrent kidney stones.

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10
Q

BK virus causes ________________.

A

hemorrhagic cystitis and nephropathy in immunocompromised individuals (fountain peeing in the Sketchy scene)

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11
Q

EBV can cause what cancers in those with AIDS?

A

CNS lymphoma and Burkitt lymphoma

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12
Q

True or false: head bobbing is seen in those with aortic stenosis.

A

False. It is seen in those with aortic regurgitation.

Other signs of AR include bounding femoral pulses and a blowing diastolic murmur best heard at the lower-left sternal border.

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13
Q

Why does CCl4 damage the liver?

A

It gets oxidized by CYP450 and causes free radical damage.

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14
Q

Fever, anorexia, and dark urine are signs of what viral infection?

A

HAV

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15
Q

Describe the histologic signs of HAV.

A

“Spotty” –i.e., not widespread –ballooning degeneration of hepatocytes with inflammatory infiltrate

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16
Q

LDH will be elevated in those with what histologic sign of ovarian cancer?

A

Dysgerminoma with “fried egg” cells

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17
Q

True or false: all ovarian cancers secrete CA-125.

A

False. Only epithelial.

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18
Q

Other than VEGF, _________ is an important stimulator of endothelial cell formation.

A

FGF

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19
Q

Why does oxygen supplementation cause damage to the retinas of newborns?

A

For some reason, hyperoxia causes neovascularization in the retina which increases likelihood of retinal detachment.

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20
Q

What wrist sign is typical of rheumatoid arthritis?

A

Ulnar deviation

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21
Q

Healed areas of necrosis in the brain are lined with _______________.

A

astrocytes

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22
Q

How does aflatoxin cause HCC?

A

Aflatoxin B1 causes mutations in p53.

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23
Q

Non-bacterial endocarditis – characterized by sterile, platelet-rich thrombi –can be found in advanced ____________.

A

malignancy

It’s thought that adenocarcinomas secrete mucin into the bloodstream which damages endothelium and leads to widespread coagulation.

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24
Q

Hypoplasia of the cerebellar vermis and cystic dilation of the fourth ventricle is called ______________.

A

Dandy-Walker malformation

The other disorder you’re likely to mistake for this is Chiari II malformations (also called Arnold-Chiari malformations), but DW will definitely be symptomatic early on, whereas Chiari II presents later.

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25
Q

How can you distinguish parietal cells on H&E staining?

A

They are highly eosinophilic.

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26
Q

Ras is normally only active when binding _______.

A

GTP

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27
Q

Unilateral swelling from the TMJ to the mandible in an intubated patient likely indicates ____________.

A

parotitis

Parotitis is an infection of the parotid glands. Risk factors include anticholinergic medications (because of xerostomia), intubation, and dehydration. It presents with fever and swelling over the parotid gland. Definitive diagnosis can be made with CT or elevated serum amylase in the absence of pancreatitis.

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28
Q

If a section of spinal cord has a lateral horn, then it must be from what area?

A

T1 - L2

The lateral horn is the sympathetic nervous system which is only found in these levels.

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29
Q

What is transthyretin deposition?

A

Transthyretin is a protein produced by the liver that binds to thyroxine. It can accumulate in the heart and produce restrictive cardiomyopathy.

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30
Q

How will reduced compliance appear on an LV pressure-volume curve?

A

Increased pressure at the same volume as a normal curve

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31
Q

Temporal lobe lesions produce what visual defects?

A

Meyer’s loop passes through the temporal lobe, so disruptions here – such as from a tumor –usually produce the contralateral “pie in the sky” defect.

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32
Q

In developed countries, the most common pathology that leads to subacute bacterial endocarditis is __________________.

A

mitral valve prolapse

In third-world countries, it is rheumatic heart fever. If a stem says a patient has “no significant medical history,” then mitral valve prolapse is a better answer than rheumatic heart disease.

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33
Q

True or false: mitral annular calcification can cause infective endocarditis.

A

False. Mitral annular calcification is a valve defect that presents in older adults with calcification around the valve. It is not a nidus for IE.

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34
Q

How does the hot tub folliculitis from P. aeruginosa present?

A

As multiple, small papulopustular lesions

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35
Q

How can mania be differentiated from substance-abuse-induced psychosis?

A

Mania does not usually cause disturbances in vital signs, so if a patient presents with signs of mania but has diaphoresis, mydriasis, hypertension, or tachycardia, then consider substance abuse as a cause.

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36
Q

NPH insulin is an intermediate between which two other types of insulin (in terms of duration)?

A

Regular insulin (8 hours) and detemir (20 hours)

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37
Q

Which part of the urinary tract is most likely to become obstructed in a male with a pelvic fracture?

A

The bulbomembranous junction (just inferior to the prostate)

This area is least supported by adjacent tissues and is thus most likely to be blocked.

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38
Q

What x-ray sign is typical of necrotizing enterocolitis in an infant?

A

Curvilinear lucency lines around the bowel

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39
Q

Histologically, what are nevus cells?

A

Melanocytes without dendrites

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40
Q

Histologically, melanoma cells have what feature that nevus cells don’t?

A

Prominent nucleoli

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41
Q

True or false: any nevus cells that are below the basement membrane are malignant.

A

False. Compound nevi and intradermal nevi are both in the dermis but are benign.

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42
Q

Without using a microscope, how can you tell compound nevi and interdermal nevi apart?

A

Intradermal nevi have lost their melanin and typically appear as skin-colored.

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43
Q

The “air crescent” in lung cavitary lesions is indicative of _______________.

A

Aspergilloma

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44
Q

Varicella zoster virus (VZV) is also called _______________.

A

human herpesvirus 8

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45
Q

Which Gram-negative rod is triple positive?

A

H. pylori: catalase-, oxidase-, and urease-positive

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46
Q

What is the Sister Mary Joseph nodule?

A

Gastric adenocarcinoma that has metastasized to the periumbilical region

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47
Q

A positive quellung test indicates _______________.

A

S. pneumoniae

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48
Q

Risk of ovarian cancer ___________ with use of OCPs.

A

decreases

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49
Q

Back pain, jaundice, hematemesis, and fever are indicative of what virus?

A

Yellow fever

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50
Q

List two things that progesterone does at the hypothalamus.

A
  • Negative feedback for both LH and FSH

* Increases basal body temperature (gotta warm the oven to cook a bun)

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51
Q

How do the testes stop producing sperm in response to increased temperature?

A

The Sertoli cells are heat-sensitive and down-regulate sperm production when the body gets too hot.

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52
Q

Which cytokines does the body make in response to LPS?

A

TNF-alpha, IL-1, and IL-6

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53
Q

HSV temporal lobe encephalitis is especially common in ________________.

A

the immunocompromised

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54
Q

True or false: Candida infections can make the vaginal pH as low as 1.0.

A

False. No vaginal pathology has a pH that low.

The normal pH is 3.8 to 4.5, and Candida does not alter the normal pH.

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55
Q

Describe the usual presentation of subacute sclerosing panencephalitis.

A

This neurodegenerative disorder most often presents 6-8 years after the primary measles infection! It is caused by demyelination and leads to progressive visual, motor, and behavioral disturbances. It presents with multifocal enhancing lesions on MRI and neurons with intracytoplasmic inclusions.

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56
Q

Which drug causes nystagmus at therapeutic levels?

A

Phenytoin

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57
Q

You know that phenytoin can cause cleft palate in fetuses, but what else can it cause?

A
  • Hirsutism
  • Microcephaly
  • Low nasal bridge
  • Cardiac defects
  • Phalange hypoplasia
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58
Q

Why does the clitoris enlarge during puberty in girls with 5-alpha reductase deficiency (and XY chromosomes)?

A

Because there is still testosterone present, but not DHT. At puberty, the amount of testosterone vastly increases and leads to clitoromegaly.

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59
Q

What happens if an XY baby has defective AMH?

A

He will develop male external genitalia with both male and female internal genitalia.

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60
Q

Which type of estrogen rises the most in pregnancy?

A

Estriol (“esTRIol in your TRImesters”)

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61
Q

Diphtheria toxin leads to impaired _______________.

A

translocation –remember that it is elongation factor, not initiation factor, that diphtheria toxin binds to

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62
Q

Centrolobular hemorrhagic necrosis in the liver is caused by ________________.

A

ischemic injury (occlusion of the hepatic artery)

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63
Q

Which bacteria can undergo phage transformation?

A
  • group A streptococcus
  • Botulinum
  • Cholera
  • Diphtheriae
  • shigElla
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64
Q

What does AIDS stand for?

A

Acquired Immune Deficiency Syndrome

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65
Q

What is found in the CSF of those with PML?

A

Nothing

MRI is the best diagnostic for PML.

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66
Q

Which antiviral is used to prevent vertical transmission of HIV?

A

Zidovudine

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67
Q

If a woman has pelvic pain and there are large red chunks in her cells, then she likely has _____________-.

A

C. trochomatis

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68
Q

What is the “classic sign” of yellow fever?

A

Bradycardia with fever

Think of the slow, languid water buffalo in the Sketchy scene – his heart was definitely slow.

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69
Q

How can you differentiate between late proliferative and early secretory endometrium?

A

Early secretory endometrium will have vacuoles starting in the glands –little cleared out areas of the glandular cells near the basement membrane.

Also, the secretory endometrium will start to have tortuous glands.

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70
Q

HEV used to be classified as a ____________ virus.

A

Calici

This is useful in remembering HEV’s features.

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71
Q

Scalded skin syndrome disrupts which intercellular connections?

A

Desmosomes (hence the easily ruptured blisters)

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72
Q

The biggest difference between IgA nephropathy and PSGN is ____________.

A

time!

IgA nephropathy presents in two or three days, while PSGN presents in two weeks.

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73
Q

Persistent activation of stellate cells is found in ______________.

A

micronodular cirrhosis; the stellate cells are what lay down the collagen

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74
Q

Which type of testicular cancer has an alveolar/papillary pattern?

A

Embryonal carcinoma

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75
Q

What is the histologic appearance of seminomas?

A

Large cells with watery cytoplasm (the fried-egg look)

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76
Q

Which testicular mass is most common in boys younger than 3?

A

Yolk sac

“Yolk sac for the Young.”

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77
Q

Which obstetric complication leads to dark blood from the vagina?

A

Abruptio placentae

It is darker because the fetal blood leaks from the intravillous spaces.

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78
Q

True or false: the macula densa secretes renin.

A

False. The macula densa senses flow and communicates with the juxtaglomerular cells of the afferent arteriole to induce renin release.

79
Q

Which CCBs can be used in a hypertensive emergency?

A

Nicardipine and clevidipine (nice card with clover?)

The other agents, like amlodipine, take too long to become effective.

80
Q

Discuss the risks of aniline, cigarettes, and helminths on bladder cancer.

A
  • Aniline: only raises risk of transitional cell carcinoma (like how dyes cause your fabric to transition)
  • Cigarettes: raise risk of both transitional and squamous carcinomas, but mainly transitional
  • Schistosoma haematobium: squamous only (SCC from S. haem.)
81
Q

The main difference between Chlamydia and Mycoplasma pneumonia (histologically) is _________________.

A

inclusion bodies; Chlamydia produces inclusion bodies while Mycoplasma does not

82
Q

Painless genital ulcers with lymphadenopathy indicates ______________.

A

lymphogranuloma venereum (i.e., Chlamydia)

83
Q

b-hCG has a homologous domain with what other hormones?

A
  • TSH (not TRH!!!!!!)
  • LH
  • FSH

The alpha is the same. The beta confers specificity.

84
Q

CT of someone with PCP will show _____________.

A

diffuse covering of the airways and alveoli that can look like cavitations

85
Q

What is the “pathognomonic” toxin produced by P. aeruginosa?

A

Exotoxin A –this is the ribosylating molecule that is similar to C. diphtheriae’s

86
Q

What STD makes subcutaneous granulomas?

A

Syphilis

87
Q

What kind of channel is the CFTR?

A

ATP-gated

88
Q

Patients with _____________ often note visual improvement with age.

A

myopia

This is because the presbyopia (farsightedness) that comes with age counteracts the myopia (nearsightedness).

89
Q

True or false: those with deficiencies in tetrahydrobiopterin synthesis cannot make phenylalanine.

A

False!

They have excess phenylalanine because they can’t make tyrosine from phenylalanine. They will be deficient in serotonin and tyrosine, however.

90
Q

What are symptoms of West Nile virus?

A
  • Morbilliform rash
  • Flaccid paralysis
  • Encephalitis
  • Fever
91
Q

Endocardial thickening and noncompliant ventricles are suggestive of _______________.

A

restrictive cardiomyopathy

92
Q

Where are the two watershed areas in the large intestine?

A
  • Splenic flexure (between SMA and IMA)

* Rectosigmoid junction (between IMA and rectal artery from internal iliac)

93
Q

What is uremic coagulopathy?

A

Patients on hemodialysis can accumulate uremic toxins that inhibit platelet function. All of their coagulation labs will be normal except bleeding time. Removal of the toxins can cure this.

94
Q

Chronic lung transplant rejection leads to destruction of which part of the airways?

A

The small airways

95
Q

On an MRI, how can you differentiate pilocytic astrocytomas from medulloblastomas?

A

Pilocytic astrocytomas have a cystic, fluid-filled component, whereas medulloblastomas are solid.

96
Q

What are dominant negative mutations?

A

When mutation of one allele is sufficient to negatively affect the wild-type allele, such as in osteogenesis imperfecta when the bad collagen disrupts the good collagen.

97
Q

Which two cultures can grow Bordetella?

A
  • Bordet-Genou (made from potato)

* Regan-Lowe

98
Q

What does the cAMP-raising toxin of Bordetella ultimately do?

A

Inhibits phagocytosis

99
Q

PBC presents with what skin findings?

A
  • Jaundice

* Xanthomas (because the bile cannot get into the bile duct with cholesterol and cholesterol builds up)

100
Q

Guillain-Barre usually presents with elevated ____________ in the serum.

A

gamma-globulin

101
Q

What is the only male pelvic organ that does not arise from the mesonephros?

A

The prostate

In men, the mesonephric (Wolffian) duct develops into the bladder (trigone only), epididymis, ejaculatory ducts, ductus deferens, and seminal vesicles (BEEDS).

102
Q

How do statins affect triglycerides?

A

They decrease VLDL and thus decrease triglycerides. (Imagine one of the steam punks stabbing the hot air balloon with a sword.)

103
Q

Pneumonia with intracellular inclusions in a person who owns a pet shop suggests ____________.

A

C. psittaci

104
Q

Low levels of all three maternal amniotic levels suggests which trisomy?

A

18 (like how the voter turnout at Elections is so low)

Note: trisomy 13 presents with low b-hCG but normal estriol and alpha-fetoprotein.

105
Q

What is it called when one bacterium exchanges plasmids with another bacterium through a pilus?

A

Conjugation

106
Q

What is the genetic process of translocation?

A

When a bacterium moves a gene around within its genome to create new forms/expressions of the gene.

107
Q

What’s a good mnemonic for the circular RNA viruses?

A

“Dhey Are Balls”
Deltavirus
Arenavirus
Bunyavirus

108
Q

The most common meningitis between the ages of 3 and 10 is ______________.

A

S. pneumoniae

109
Q

What is mittelschmerz?

A

Bleeding from an ovulated follicle

The key signs of this are as follows:

1) Unilateral lower abdominal pain
2) Menstrual period ~ 2 weeks ago
3) Pregnancy test negative
4) Normal ovaries and uterus on ultrasound
5) No fevers

(“I’m in the MITTLE of my cycle and something hERZ.”)

110
Q

True or false: S. pyogenes impetigo is more likely to lead to PSGN than valvular heart disease.

A

True.

Remember that impetigo does not lead to rheumatic fever –only pharyngitis can do that.

111
Q

Ruptured ovarian cysts can look like what other disorder?

A

Ectopic pregnancies

Test the b-hCG!

112
Q

Describe fibrocystic disease.

A
  • Other multifocal
  • Changes with menstrual cycle
  • Proliferation of acini and intralobular stroma
113
Q

Although Coxsackie B was the most common etiology for viral myocarditis until the 1990s, _____________ have become the most common recently.

A

Parvovirus and HHV6

114
Q

What is Loffler syndrome?

A

Restrictive cardiomyopathy due to endocardial fibrosis with eosinophilic infiltrate (think of a laughing little kid in the restrictive CM scene)

115
Q

The most common cause of impetigo is _______________.

A

S. aureus

116
Q

Acid-fast stains are also called _____________.

A

Ziehl-Neelsen

117
Q

What treatment is indicated for B. cereus food poisoning?

A

Just supportive therapy

It is a toxin-mediated illness, so antibiotics won’t help.

118
Q

Haemophilus ducreyi is what kind of bacteria?

A

Just like H. influenzae, it is a Gram-negative diplococcus

119
Q

What chromosomes have the BRCA genes?

A

13 and 17

Think: if you have BRCA, you’re likely to get cancer before age 30… which is equal to 13 and 17.

120
Q

Individuals with Pott disease may or may not _________________.

A

have pulmonary symptoms

121
Q

What two facial features are common in those with Prader-Willi?

A
  • Narrow forehead

* Downward sloping mouth

122
Q

If Addison’s disease results in all three adrenal layers failing, why don’t men get loss of libido?

A

In men, the androgens are mainly made in the testes.

123
Q

Busulfan and cyclophosphamide are specific to which phase?

A

Trick question. They’re not cell-cycle dependent.

124
Q

What does the CCA sequence in tRNA do?

A

It serves as the recognition site and acceptor stem for AAs. It is the 3’ end.

(It “Can Catch Acids” and it “Can Clarify Arrivals”.)

125
Q

If it has been more than _________ hours since an ischemic stroke, give aspiring instead of alteplase.

A

4.5 (like how the school painting went from 3:00 - 4:30 in the Sketchy scene)

126
Q

What is different between the spread of Shigella and Salmonella?

A

Shigella only spreads cell-to-cell, while Salmonella can spread hematogenously.

127
Q

What are the two most common pneumonias in those with CF?

A
  • Younger than 20: S. aureus

* Older than 20: P. aeruginosa

128
Q

Urethral disruption in males is common with saddle injuries. How can you tell if the disruption is above or below the urogenital membrane?

A

Below the membrane will leak urine into the scrotum.

129
Q

Describe Meigs syndrome.

A
  • Ovarian fibroma
  • Ascites
  • Hydrothorax

(Think of the -igs as standing for “I Go Swimming” to remember the fluid accumulation with ovarian neoplasm.)

130
Q

What is the difference between Mallory bodies and Councilman bodies?

A

Both are eosinophilic inclusions in hepatocytes in response to injury, but Councilman bodies are diffuse while Mallory bodies are rope-like. Also, Mallory bodies are most characteristic of alcoholic injury.

(Think of the climber George Mallory to remember rope-like, and imagine him drunkenly climbing Everest to think of alcohol injury.)

131
Q

Sperm acquire mobility in the ___________.

A

epididymis

132
Q

What epithelium lines the epididymis?

A

Pseudostratified columnar epithelium with stereocilia

133
Q

True or false: acetyl-CoA gets pumped out of the mitochondria to be synthesized into fatty acids.

A

False. Citrate gets pumped out and then citrate is converted to acetyl-CoA by ATP citrate lyase.

134
Q

What two stages do oocytes get stuck in?

A

• Gametogenesis to ovulation: prophase I
(“I PROmise I’ll ovulate some day!”)

•Ovulation to fertilization: metaphase II
(“When the egg MET the sperm.”)

135
Q

Ketoconazole for tinea cruris can cause atrophy in which cells?

A

Leydig cells

Ketoconazole inhibits testosterone synthesis. When applied to the groin it can lead to atrophy of the testicles from inhibited testosterone synthesis in Leydig cells.

136
Q

List the order of spots most likely to have ectopic pregnancy.

A

1) Ampulla
2) Isthmus
3) Fimbriae
4) Uterine interstitium

137
Q

In addition to prospective cohort studies, ______________ can also determine relative risk.

A

retrospective cohort studies

138
Q

What x-ray signs are suggestive of transposition of the great vessels?

A
  • Narrowed mediastinum
  • Egg-shaped heart

Taken together, these make up the “egg on a string” appearance of the heart in those with TGV (which Sketchy symbolized by the Pokeball yoyo!).

139
Q

True or false: uterine fibroids are estrogen-sensitive.

A

True! They often vary in size and symptom presentation with the menstrual cycle or increase in size with pregnancy and decrease in size with menopause.

140
Q

Obesity ______________ the risk of endometrial cancer.

A

increases

141
Q

Radiation raises the risk of ____________ thyroid cancer.

A

papillary

142
Q

What is true hermaphrodism?

A

Presence of both ovaries and testes

143
Q

True or false: hereditary spherocytosis can go undiagnosed for years.

A

True. It often takes infection with Parvovirus to unmask symptoms.

144
Q

Amphotericin is indicated in ______________ fungal infections, regardless of immune status.

A

systemic

For instance, if a person presents with disseminated Blastomycosis they’ll need amphotericin even if they aren’t immunosuppressed.

145
Q

The most common cause of HCC worldwide is _____________.

A

HBV

146
Q

What drug treats Echinococcus?

A

Albendazole (like how the dog is just above the strong man BENDing the pipe)

147
Q

A major complication of preeclampsia is ________.

A

DIC

148
Q

On histologic exam, how can you diagnose CMV vs. EBV?

A

CMV causes basophilic intranuclear inclusions. Although EBV increases risk of Hodgkin’s lymphoma –which also presents with owl-eye inclusions –regular EBV infections do not cause this.

149
Q

Once again (you’ve missed this a lot), differentiate lymphogranuloma venereum and syphilis.

A

•Syphilis:

  • painless ulcer
  • painless lymph nodes

•LGV:

  • painless ulcer
  • PAINFUL lymph nodes
150
Q

Don’t forget that Brucella can also be acquired from contact with ___________________.

A

dairy

151
Q

How can the bleeding from ectopic pregnancies and placenta previa be differentiated?

A

Ectopic pregnancies will be painful, while placenta previa is painless.

152
Q

The right recurrent laryngeal nerve courses around _________________.

A

the right subclavian (think of this if the patient can’t move their right vocal cords after a thyroidectomy).

153
Q

How can you differentiate cholecystitis from cholangitis?

A

Cholangitis usually presents with marked fever and leukocytosis.

154
Q

What is the name of the area of the brain that can lead to the pie-in-the-sky defect?

A

Fusiform gyrus

Think of mike MEYER as a FUSsy baby.

155
Q

What drugs are commonly used for post-transplant organ immunosuppression?

A
  • IL-2 inhibitors: sirolimus, tacrolimus, basiliximab, daclizumab, and cyclosporine
  • Azathioprine
  • Steroids
  • Mycophenolate mofetil
156
Q

What does the SRY gene do?

A

It transcribes the testis-determining factor (TDF) that stimulates the development of testes from primordial gonads. This leads to the development of Leydig cells –which make the testosterone needed for development of the Wolffian duct and external genitals –and Sertoli cells –which make MIH.

157
Q

Give the FENa for prerenal, renal, and postrenal azotemia.

A
  • Prerenal: less than 1%
  • Postrenal: 1% - 2%
  • Renal: greater than 2%
158
Q

Damage to the levator ani during labor leads to ____________________________.

A

urinary incontinence

Fecal incontinence results from damage to the anal sphincter.

159
Q

Other than Neisseria and S. pneumoniae, ____________ also secretes IgA protease.

A

Haemophilus

160
Q

What dermatomes cover the back of the arm?

A

C8 (medial)
C7 (intermediate)
C6 (lateral)

161
Q

Remember that antibiotics can worsen a certain kind of inflammatory diarrhea: _________________.

A

Salmonlla from non-typhi strains like tyrphimurium and enteriditis

Only give antibiotics to those with S. typhi!

162
Q

What two agents stimulate platelet formation?

A
  • Eltrombopag

* Oprelvekin

163
Q

True or false: a swelling in the inguinal region is likely a femoral hernia.

A

False. Swelling in the inguinal region is most likely an indirect inguinal hernia. The patent processus vaginalis can pulse and lead to fluid accumulation in the inguinal canal.

164
Q

Which recombinant agent stimulates both granulocytes and monocytes?

A

Sargramostim (notice the G and M)

165
Q

The uterine artery runs through the _______________ ligament.

A

cardinal

Imagine a retinue of papal CARDINALs riding a carriage over the ureter creek.

166
Q

Give a rundown on Ehrlichiosis.

A
  • Obligate intracellular Gram-negative bacteria
  • Related to Rickettsia
  • Causes fever and maculopapular rash
  • Treatable with doxycycline
  • Creates “berry-like” monocytic inclusions
167
Q

Because they’re so similar, what’s a good way to remember the difference between Ehrlichiosis and anaplasmosis?

A

Ehrlichiosis is inclusions in monocytes and anaplasmosis is inclusion in granulocytes.

(MEGA berry: Monocytes = Ehrlichiosis; Granulocyte = Anaplasmossi)

168
Q

Dissection of the cardinal ligament can sometimes snag pieces of the ________________.

A

ureter

169
Q

Meigs tumors are fibromas that typically present with what under histologic examination?

A

Calcification

170
Q

What cells will be present in pseudomyxoma peritonei?

A

PP is a variant of variant cystadenocarcinoma that presents with glandular columnar epithelium.

171
Q

Which ovarian neoplasm is associated with arrhythmias?

A

Struma ovarii (look for thyroid tissue)

172
Q

Which ovarian tumor presents with transitional epithelium and how might it look under the microscope?

A

Brenner tumors (remember: “Brenner Bladder”)

This usually is benign (“Benign Brenner Bladder”) and show nests of transitional epithelium.

173
Q

What drug is commonly used to treat endometriosis?

A

Leuprolide (watch out for osteoporosis)

Danazol, a partial androgen agonist, is also used but less commonly so.

174
Q

Describe globozoospermia.

A

A disorder in which the Golgi body fails to form the acrosome and sperm have round (globe-shaped) heads

175
Q

Enterococcus UTI should be treated with _____________________.

A

Ampicillin (like the rockers in amino’s cantina)

176
Q

What amount of vaginal discharge is normal?

A

About one teaspoon of thick white discharge daily (don’t be tempted to jump for Candida!)

177
Q

The majority of the fluid in semen comes from ____________, but the prostate ___________________.

A

the seminal vesicles; produces the alkaline component

178
Q

The pseudohyphae of Candida are also called _______________.

A

germ tubes

179
Q

How do tinea look under the microscope?

A

The dermatophytes have branching, septate hyphae.

180
Q

_________ automatically makes a minor emancipated.

A

Marriage

181
Q

True or false: clindamycin is not effective against Enterococcus.

A

True. Ampicillin is first-line.

182
Q

What process is inhibited in fetal alcohol syndrome?

A

Cell migration

183
Q

How does pyruvate kinase deficiency often present?

A

With hemolytic anemia in the newborn

184
Q

Where are self-antigens packaged into MHC I?

A

In the endoplasmic reticulum

MHC II loading occurs in acidified endosomes.

185
Q

Homozygous mutations in ___________ have been shown to make people immune to HIV.

A

CCR5

186
Q

What is encoded on gag and pol?

A
  • gag: p17 and p24 (matrix and capsid proteins)

* pol: protease and reverse transcriptase

187
Q

Which STDs are reportable?

A

Gonorrhoeae

Chlamydia

188
Q

Briefly describe limb formation.

A

The apical ectodermal ridge leads the protrusion outward.

Wnt and the zone of polarizing activity determines the ventral-dorsal development.

The mesoderm makes the underlying structures.

189
Q

Endometrial carcinoma risk does not increase with __________ hormone replacement therapy.

A

combined (the progestin opposes the estrogen)

190
Q

The medical term for lockjaw is __________.

A

trismus (tenesmus is the urge to defecate)

191
Q

“Significantly decreased volume” of an ejaculate indicates what source of infertility?

A

Obstruction in the vas deferens

192
Q

What did Sketchy neglect to mention about Legionnaire’s disease?

A

It can cause TTP by generating autoantibodies to ADAMSTS13.

193
Q

A guy with an artificial mitral valve gets endocarditis after going to the dentist. The most likely cause of infection is ____________.

A

S. viridans

Even with the artificial valve, the dental visit suggests S. viridans.

USMLE Step 1: Part 2 COPY (142 decks)

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