Rx_Random Set #7 Flashcards Preview

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Flashcards in Rx_Random Set #7 Deck (26)
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1

Placenta previa presentation and sx

  • placenta previa = placenta overlies internal cervical os
    • subtypes: complete, partial, marginal, low-lying
  • major sx:
    • significant vaginal bleeding after 20 weeks
    • absence of pain

2

Abruptio placentae definition, sx, risk factors

  • abruptio placentae = premature separation of placenta from uterus
  • presentation:
    • vaginal bleeding after 20 weeks
    • uterine contraction 
    • pain
  • risk factors
    • HTN
    • cocaine use
    • short umblical cord
    • trauma
    • smoking
    • uterine fibroids
    • advanced age
    • prior abruption/premature membrane rupture
    • sudden uterine decompression
    • bleed diathesis

3

Tx of neonatal respiratory distress syndrome

  • administration of exogenous surfactant 
  • surfactant = mixture of lipids (dipalmitoulphosphatidylcholine) & proteins

4

Drug of choice for TB prophylaxis (+MOA)

  • Isoniazid (or INH)
  • MOA = inhibition of mycolic acid synthesis

5

Common drugs in combination tx for TB (+MOA)

  • Rifampin = inhibits DNA-dependent RNA polymerase
  • Ethambutol = inhibition of arabinogalactan syntehsis ==> inhibition of cell wall synthesis

6

Macrolides: MOA + e.g.

  • used in tx of bacterial infection
  • e.g. erythromycin
  • MOA = methylation of rRNA ==> prevents ribosomal binding

7

Vancomycin: MOA + common use

  • MOA = binds to D-ala-D-ala portion of cell wall precursors ==> inhibition of cell wall peptidoglycan formation
  • common use = 
    • gram-positive infections
    • methicillin-resistant Staph. aureus

8

Presentation and cause of waterhouse-friderichsen syndrome

  • cause = N. meningitidis ==> menigitis and sepsis & W-F syndrome
  • presentation
    • disseminated intravascular coagulation (purpura)
    • shock (hypotension)
    • adrenal failure

9

Mass effects of neoplasm at pyloric zone

  • obstruction of hepatoduodenal ligament = common bile duct, hepatic artery, hepatic portal vein ==> jaundice

10

Pathologic consequences of giardia infections

  • ==> inflammation and villous atrophy in the gut
  • ==> malabsorption

11

Characteristics of Reed-sternberg cells

  • binucleate cells w/inclusion-like nucleoli
  • B-cell origin
  • CD15 and CD30 positive
  • present in Hodgkin's lymphoma

12

Pathologic characteristics of Lymphocyte-rich Hodgkin lymphoma

  • few Reed-Sternberg cells (more present in mixed cellularity Hodgkin's)
    • binucleate cells w/inclusion-like nucleoli
  • numerous lymphocytes
    • high lymphocyte count
    • dark-staining nuclei and little cytoplasm
  • lack areas of collagen banding or lacunar cells (found in nodular sclerosis Hodgkins lymph)

13

Presentation/pathologic characteristics of Kartagener's syndrome

  • presentation
    • recurrent sinusitis
    • infertility in males due to immotile sperm
    • situs inversus (=major visceral organs reversed or mirrored from normal positions)
    • bronchiectasis
  • pathology
    • lack of dynein arms in micrtobules in cilia and flagella ==> immotile

14

Presentation of Immune Thrombocytopenic Purpura

  • low platelet count
  • antiplatelet antibodies
  • enlared platelets

15

Common chemotherapeutic agents associated with cardiotoxicity (+MOA)

  • doxorubicin/daunorubicin
  • fluorouracil
  • busulfan
  • cisplatin
  • mitoxantrone
  • paclitaxel

16

Doxorubicin: MOA

MOA = intercalating DNA

17

Tx of bulimia

  • psychotherapy and antidepressants
  • usually SSRI ==> fluoxetine

18

Presentation of bulimia

  • calluses/scars on dorsum of hand
    • due to abrasian from teeth during gagging
  • parotid enlargement
  • erosion of tooth surfaces 

19

Hydralazine: MOA/use/SE

  • MOA = potent arteriole vasodilator ==> reduced BP
  • use = first-line for HTN in pregnancy
  • SE
    • ==> reflex tachycardia
      • administer w/B-blocker (e.g. labetalol)

20

Treatment for refractory Parkinson's (not responsive to medication)

  • ablative surgery pf globus pallidus 

21

Lab results in metabolic alkalosis

  • increased pH (> 7.4)
  • increased plasma bicarb
  • increased CO2 (due to respiratory compensation)

22

Common causes of metabolic alkalosis

  • general: loss of hydrogen ions or increase in bicarb concentation
  • vomiting ==> loss of H+ in gastric acid
  • antacid use
  • diuretic use
  • hyperaldosteronism

23

Presentation of interruption of posterior inferior cerebellar artery

  • ==> "lateral medullary syndrome"
  • ispilateral Horner's syndrome
    • ptsois, miosis, anhidrosis
  • absent pain & temp on ispilateral face and contralateral body
    • damage to spinal trigeminal and spinothalamic tract
  • ataxia
    • damage to inferior cerebellar peduncle
  • nystagmus
    • vestibular nucleus
  • hoarsness
    • nucleus ambiguus of the vagus

24

Low alpha-fetoprotein (AFP) on prenatal triple triple screen ==> dx?

  • fetus may have Down's syndrome
    • "AFP goes down in Down's"

25

Congenital anomalies in Down's

  • VSD
  • endocardial cusion defects 
  • omphalocele

26

Microscopic polyangitis presentation/mechanism

  • white individuals
  • sx
    • fatigue
    • muscle pain
    • weight loss
    • dark brown stools
    • febrile
    • palable purpra
    • cough w/reddish-looking sputum
  • MOA
    • activation of neutrophils and monocytes by perinuclear antineutrophil cytoplasmic antibodies

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