Rx_Random Set #1 Flashcards Preview

USMLE Step 1 > Rx_Random Set #1 > Flashcards

Flashcards in Rx_Random Set #1 Deck (28)
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2

What structure causes pathogenicty of gram - bacteria?

  • structures @ outer membrane
    • endotoxin
      • activate compliment, coag cascade, macrophages
    • LPS capsule

3

Name structures & fxns

  • Gram negative bacteria structure
  • A = outer membrane
    • endotoxin ==> pathogenecity
    • LPS
  • B = periplasmic space 
  • C = inner cytoplasmic membrane 
    • contains penicilin-beingin proteins
  • D = porins ==> endocytosis ==> inflammation
  • E = peptidoglycan (target of penicillins & cephalosporins)

4

Major pathologic findings in Parkinson's

  • neurons w/round, haloed, eosinophillic inclusion bodies in the cytoplasm = "lewy bodies"
    • made of alpha-synuclein
  • depigmentation & degeneration of substantia nigra

5

Open angle vs. closed angle glaucoma

6

Epinephrine use in glaucoma

  • agonist @ alpha1 receptor ==> mydriasis (pupilarry dilation)
  • no effect on ciliary muscles
  • decreases aqueous humor production ==>
  • used to tx open-angle
  • NOT used in closed-angle

7

Diffuse breast pain, multiple bilateral masses @ upper outer quadrants of breast ==> Dx?

  • fibrocystic disease

8

Histologic changes in fibrocystic disease

  • fibrosis
  • cysts
  • sclerosis
  • epithelial hyperplasia

9

TGF-beta role in inflammation

  • dampens inflammatory response

10

Interferon-gamma source/fxn

  • source = T lymphocytes
  • fxn = stimulate macrophages

11

Complications of inguinal surgery

  • male infertility in the future
  • inguinal repair ==> accidental ligation of vas deferens or obstruction via scar tissue ==> impaired sperm transport

12

MLF lesion consequences

  • Paralysis of the SAME side medial rectus muscle during OPPOSITE side gaze
  • e.g. R MLF lesion ==> paralysis of R medial rectus during leftward gaze (+ left nystagmus)

13

Amiodarone toxicity sx

  • hyperthyroidism
    • weight loss
    • hyperreflexia
    • chest palpitiations

14

Common causes of disseminated intravascular coagulation

  • gram-negative sepsis
  • malignancy
  • acute pancreatitis
  • transfusion rxns
  • obstetric complications

15

Mechanism of disseminated intravascular coagulation

  • massive activation of coagulation cascade ==>
  • thrombus formartion throughout vasculature ==>
  • rapid consumption of platelets and coag factors ==> easy bleeding and bruising

16

Tx for carcinoid tumor

octreotide = somatostatin analog

17

5-HIAA in urine ==> Dx?

  • carcinoid tumor
  • 5-HIAA = metabolic product of serotonin

18

Complications of carcinoid tumors

  • R-sided heart disease
    • tricuspid regurgitation
    • pulmonic stenosis
  • wheezing
  • recurrent diarrhea
  • flushing

19

Tricuspid regurgitation murmur

  • holosystolic
  • high-pitched
  • radiate to right sternal border

20

child/teen w/ recurrent pneumonia + bronchiectasis + low weight + intermittent diarrhea ==> Dx?

Cystic fibrosis

21

Common cause of pneumonia in CF + tx

  • pseudomonas
  • tx = gentamicin

22

Conversion disorder = 

  • mimics dysfxn of voluntary motor or sensory system
  • presentation:
    • pseudo-seizure
    • blindness
    • deafness
    • paresthesias
    • paralyses

23

Dxn of Vit K

  • cofactor for gamme-carboxylation of glutamic acid residues on clotting factors

24

Vit K-dependent clotting factors

  • II
  • VII
  • IX
  • X
  • Protein C & Protein S

25

Congenital adrenal hyperplasia ==> glucocorticoid & sex hormone deficits + HTN + hypokalemia

  • 17a-hydroxylase deficiency
  • deficient glucocorticoid & sex steroids + elevated mineralcorticoids (aldosterone)
  • ==> lack of sexual development/ambigious genitalia

26

Layers of adrenal cortex & products

  • Salt, Sugar, Sex
  • Salt = outer zona glomerulosa
    • product = aldosterone ==> sodium retention
  • Sugar = zona fasciculata 
    • product = cortisol ==> many fxns + insulin resist + gluconeogenic
  • Sex = zona reticularis
    • product = androgens

27

Dx? Child presenting with recurrent respiratory infections...

  • Cystic Fibrosis
  • Chromosome 7 defect ==> defective chloride channel

28

Drug for treating underlying cause of respiratory infections in CF?

  • N-acetylcysteine ==> loosens mucus plugs

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