[2a] A ⼀ Step 2 OD USLME > Biochem/Rx/Optho > Flashcards

Biochem/Rx/Optho Flashcards

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1
Q

What is Von Gierkes’ Disease

A

[Type 1 Glycogen Storage - Glucose6Phosphatase deficiency] in Liver/Kidney/Intestine

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2
Q

Von Gierkes’ Disease CP - 4

A
  1. Seizures 2/2 hypOglycemia
  2. Lactic Acidosis
  3. Doll-Like Fat cheeks
  4. Protuberant Abd (Hepatomegaly)
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3
Q

[McArdle Glycogen Storage Dz 5] etx

A

Myophosphorylase Deficiency–> DEC Muscle Glycogenolysis

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4
Q

[McArdle GSD5 Muscle Phosphorylase deficiency] CP

A

Myoglobinuria with Exercise

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5
Q

[Cori GSD3 Debranching deficiency] CP (3)

________________

GSD = Glycogen Storage Disease

A
  1. SHORT STATURE
  2. hypOglycemia
  3. Muscle weakness & hypOtonia
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6
Q

[Cori GSD3 Debranching deficiency] etx

A

Debranching enzyme deficiency –> accumulation of glycogen with abnormal short outer chains (inability to degrade at alpha1-6 branch points)

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7
Q

What is Pompe Disease

________________

CP-2

A

[Type 2 Glycogen Storage - Acid Maltase deficiency] –>

________________

Floppy baby & HF

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8
Q

What is AmyLoPectinosis?

________________

CP?

A

[Type 4 GSD Glycogen Branching deficiency]

________________

Progressive Cirrhosis

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9
Q

How do pts with Liver phosphorylase deficiency present - 2

A

Hepatomegaly and growth retardation early in childhood

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10
Q

Slit Lamp Exam indication

A

Evalutes for abnormalities of ANT eye (conjunctiva, cornea, ANT chamber, iris)

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11
Q

[Niemann Pick] MOD

A

Sphingomyelinase Deficiency –> accumulation of Sphingomyelin

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12
Q

[Niemann Pick] Clinical Presentation (3)

A
  1. Cherry Red Macular Spot
  2. Neuro Regression
  3. Hepatosplenomegaly (differentiates from Tay-Sachs)
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13
Q

Tay-Sachs Clinical Presentation (2)

A
  1. Cherry Red Macular Spot
  2. Neuro Regression
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14
Q

Tay-Sachs MOD

A

[B-Hexosaminidase A Deficiency] –> GM2 accumulation in neurons

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15
Q

Hurler Syndrome etx

A

lysosomal Hydrolase deficiency

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16
Q

Hurler Syndrome CP-5

A
  1. Coarse face
  2. Corneal Clouding
  3. Claw Hand
  4. HepatoSplenomegaly
  5. Hernias (umbilical vs inguinal)

________________

lysosomal Hydrolase deficiency

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17
Q

Gaucher Dz etx

A

auto recessive Glucocerebrosidase deficiency –> accumulates in macrophages –> crumbled newspaper appearance

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18
Q

Gaucher Dz CP-3

A
  1. anemia
  2. thrombocytopenia
  3. Hepatosplenomegaly

________________

auto recessive Glucocerebrosidase deficiency –> accumulates in macrophages –> crumbled newspaper appearance

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19
Q

Krabbe Disease etx

________________

CP-3

A

[auto recessive GalactoCerebrosidase deficiency]

________________

  1. Retard
  2. hypOreflexia
  3. hypOtonia
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20
Q

CP for Retinal Detachment - 3

A
  1. Floaters
  2. Visual Curtain descending from periphery
  3. Photopsia Flashes of Light
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21
Q

Identify

A

Central Retinal VEIN Thrombosis

  • Blood & Thunder appearance 2/2 scattered hemorrhage
  • Cotton Wool Spots
  • Disk Swelling
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22
Q

diagnosis?

________________

What’s the most common cause?

A

Vitreous Hemorrhage

________________

DM

Fundoscopy = Dark Red Glow with Loss of Fundus details

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23
Q

Causes of Corneal Abrasion - 3

________________

How do you diagnose Corneal Abrasion?

A
  1. Trauma
  2. Foreign Body under eyelid
  3. Contact lens –> Corneal epithelial defect

________________

Fluorescein exam revealing corneal staining defect

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24
Q

Pralidoxime MOA

________________

Indication

A

ReActivates AChenesterase

________________

Organophosphate poisoning (along with giving Atropine)

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25
How do Benzodiazepines affect Blood Pressure
⬇︎ BP
26
Glaucoma etx
⬆︎ intraocular pressure from [⬆︎ production vs. ⬇︎ outflow of Aqueous humor] ## Footnote *Topical Prostaglandins = latanoprost (open angle glaucoma)*
27
Tx approaches for Glaucoma (3) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ how specifically does B-blockers work?
B-Blockers --\> ⬇︎ Ciliary **Epithelium** Aqueous humor secretion! *Topical Prostaglandins = latanoprost (open angle glaucoma)*
28
What target organ does the M3 Receptor work in (6)
"[M1s need Brain], [M2s need Heart], [M3s BEGs for Private Lounges" "An M3 **BEGS** for **P**rivate **L**ounges" **B**ladder(contraction) / **E**yes / **G**I / **S**kin / [**P**eripheral Vasculature] / **L**ungs
29
Glaucoma
30
What are the causes of [Acute Closed Angle Glaucoma]? -3
Anticholinergics / Sympathomimetics / Dim light
31
What are the 2 options for reversing Warfarin
1. [VitK IV **+ PCC**] 2. FFP (Fresh Frozen Plasma) ## Footnote * \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_* * Give [VitK IV + PCC] since [VitK IV] has 12-24 hr onset* * PCC = Prothrombin Complex Concentrate*
32
Tranexamic Acid MOA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Indication-2
Prevents Fibrin Lysis \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Menorrhagia and [Hemorrhage px]
33
What is the major complaint pts with Glaucoma have?
**Gradual Tunnel Vision**
34
Gabapentin MOA
a2-delta Ca+ channel ligand ## Footnote *Structurally similar to GABA*
35
Acetazolamide contraindications - 2
1. Pregnancy 2. Sulfa Allergy ## Footnote *SE = NV*
36
Clinical Manifestation of DRESS Syndrome (6)
**D**ysfunctional Internal organs **R**eally Hot (Fever) **E**osinophilia w/LAD **S**kin Rash **S**wollen Face
37
Vomiting is a reflex regulated by which receptors? (5)
**5** **D**ays of **H**aving **N**auseating **M**oomoo :-( 1. **5**HT3 (ondansetron tx) \*\*\*\* 2. **D**2 3. **H**1 Histamine 4. [**N**K1 Neurokinin 1] \*\*\* 5. **M**1 muscarinic
38
low tone hearing loss = ⬜ hearing loss
conductive
39
High Tone hearing loss = ⬜ hearing loss
Sensorineural
40
Which is more efficient at transmitting sound between Bone and Air? \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Why?
**AIR!** ## Footnote \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Air interacts with ossicles FIRST, which **A**mplifies the sound conduction to cochlea
41
Major SE of Atorvastatin - 3
1. Myalgia 2. Rhabdomyolysis--\>myoglobinuria--\>Acute Kidney Injury 3. Liver Dysfunction
42
Major SE of Metoprolol - 3
1. Bradycardia 2. hypotension 3. heart block
43
Major SE of HCTZ - 5
1. Dehydration 2. hyponatremia 3. hypokalemia 4. renal dysfunction 5. gout attack 2/2 ⬆︎serum uric acid
44
Major SE of [Lisinopril ACE inhibitors] - 4
1. Angioedema 2. Cough 3. HyperKalemia 4. Renal dysfunction
45
Which Anti-HTN drugs can cause infertility secondary to hyperprolactinemia? - 3
1. Verapamil 2. Methyldopa 3. Reserpine
46
From MOST effective to least effective, list non-Rx options for controlling BP -5
**W**e **D**on't **E**xercise **A**t **A**ll! ## Footnote **W**eight control = BEST **D**ASH diet **E**xercise s**A**lt **A**lcohol
47
Macular degeneration affects [⬜ central | peripheral] vision, while Glaucoma affects [⬜ central | peripheral] vision
Ma**C**ular --\> **C**ENTRAL vision loss ## Footnote *with straight lines appearing curvy (wet/exudative-neovascular= aggressive and uL while dry/atrophic=gradual and BL)* \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Glaucoma --\> peripheral vision loss (gradual tunnel vision)
48
Ophthalmoscopy findings include cupping of the optic disc Diagnosis?
Glaucoma \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ *Glaucoma affects peripheral vision --\> tunnel vision! OAG is more common in Blacks*
49
etx of Cataracts \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ What are the most common presenting sx of Cataracts? -2
[⬆︎ lens **opacity**] --\> 1. [gradual BL NIGHT VISION ⬇︎] 2. halos around lights \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ *Fundoscopy eventually shows lost of red reflex and retinal details*
50
How can you differentiate conjunctivitis from Adenovirus and conjunctivitis from IgE mediated allergy response? - 2
1. Adenovirus does NOT cause pruritus. Allergies does 2. Adenovirus is preceded by viral prodrome
51
Dacryocystitis etx \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ which organisms cause this?-2
infection of lacrimal sac in medial canthal region \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 1. Staph A 2. GASP
52
What is the treatment for Emergent [Acute Closed angle Glaucoma] - 4
"**PMAT** his *glouck'd* eye!" **P**ilocarpine **M**annitol **A**cetazolamide **T**imolol
53
Retinoblastoma leukocoria
54
cp for Acute Closed angle Glaucoma - 3
1. Red Painful eye uL 2. Fixed Dilated pupil 3. Cloudy Cornea
55
Prognosis for [Acute Closed angle Glaucoma]
Permanent Vision Loss within 2-5 hrs of onset!
56
Dx for [Acute Closed angle Glaucoma] -2
**Gonioscopy** vs Ocular Tonometry
57
cp for Uveitis - 3
1. Blurred painful vision 2. conjunctival injection 3. miosis
58
Identify finding
Dendriform Corneal Ulcer \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ *dx = Zoster Ophthalmicus*
59
Zoster Ophthalmicus \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ *finding = Dendriform Corneal Ulcer*
60
Tx for Central Retinal Artery occlusion - 2 ## Footnote *Painless loss of monocular vision*
1. HiFlo O2 2. Ocular massage
61
What type of immunity do polysaccharide vaccines (like the pneumococcal vaccine) produce?
B cell response that is **independent of T cells**
62
MOD for Trachoma \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ cp for Trachoma-2
Repeated infections with Chlamydia Trachomatis A,B,C --\> **Inversion of Eyelashes** = Trachoma (**PALE FOLLICLES** with Conjunctival injection) --\> Blindness from lash ulceration
63
Subconjunctival Hemorrhage is self limited to how long?
2 days
64
How does this abnormality clinically present? - 2
[Sudden uL Vision Loss] + Floaters \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ * dx = Vitreous Hemorrhage* * Fundoscopy = Dark Red Glow with Loss of Fundus details*
65
When can you hospitalize a mentally competent pt against their will?
when their ailment **poses a serious threat to public health**
66
When can you mandate parents against their will to accept treatment for a [non emergent ailment] for their child?
when the [non-emergent ailment] is a **fatal medical condition** (i.e. Cancer), M.D. can obtain a court order to give tx \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ PARENTS ARE **NOT** ALLOWED TO REFUSE LIFE SAVING TREATMENT FOR THEIR CHILD (EVEN IF BASIS IS RELIGIOUS)
67
Describe ophthalmoscopy findings for Diabetic Retinopathy-3
1. microaneurysms = simple type 2. retinal edema = simple type 3. newly formed vessels if malignant type
[2a] A ⼀ Step 2 OD USLME
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