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USMLE Flashcards

1
Q

MHC class 2 deficiency

A

defect: failure of MHC class 2 expression, defects in transcription factors

T cells present and responsive to nonspecific mitogens, no GVHD, deficient in CD4+ T cells, hypogammaglobulinemia.

clinically observed as a severe combined immunodeficiency

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2
Q

halothane- important post-surgical complication

A

hepatitis

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3
Q

tabes dorsalis

A

degeneration of dorsal columns and dorsal roots. Loss of pain sensation and peripheral reflexes, impairment of vibration and position senses, progressive ataxia

goes with tertiary syphilis

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4
Q

mycosis fungoides

A

cutaneous T-cell lymphoma

malignant T cells densely infiltrate the superficial dermis and epidermis –> plaques and nodules.

can look like fungal infection

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5
Q

swiss cheese model

A

major catastrophic systems failures often reveal multiple, smaller failures –> the hazard

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6
Q

Klinefelter syndrome

A

47 XXY
sparse body hair, feminine body habitus, gynecomastia, small testes, reduced fertility

halinized seminiferous tubules without sperm

decreased inhibin and testosterone, increased LH, FSH, estrogen

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7
Q

what gallstones in hemolytic disorders?

A

calcium bilirubinate (black pigmented)

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8
Q

Chagas disease

A

brazil

cardiomyopathy/ failure and megaesophatus/ megacolon

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9
Q

bacillus anthracis shape/ stain

A

boxcar-shaped
gram positive
aerobic
spore-forming

treat with cipro or doxy

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10
Q

urachus obliterates and becomes what?

A

median umbilical ligament

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11
Q

Dressler syndrome

A

utoimmune post-MI phenoenon –> fibrinous pericarditis

prefer to sit upright and lean forward
friction rub
4-6 weeks after MI
ECG changes with diffuse ST elevations in many limb leads

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12
Q

In electron micrographs of cilia we see

A

9 doublets + 2

microtubules

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13
Q

hypokalemia and metabolic alkalosis suggests

A

use of a loop diuretic such as furosemide

increases acid excretion

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14
Q

Hyper IgM syndrome

A

high levels of IgM, depressed IgA, IgG and IgE

can’t do isotype switching, most commonly because of hte absence of CD40L on TH2 cells

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15
Q

treatment of Mycoplasma pneuminiae and mechanism

A

Macrolies (azithromycin)

inhibit the translocation of peptidyl tRNA from the acceptor site to the donor site of the 50S subunit

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16
Q

digoxin and loop diuretic

A

digoxin toxicity increased with hypokalemia/ hypomagnesemia brought on by furosemid, torsemide, or ethacrynic acid

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17
Q

first manifestation of cystic fibrosis

A

meconium ileus- obstruction

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18
Q

gastric adenocarcinomas/ infiltrating lobular carcinoma of the breast mutation

A

E-cadherin (CDH1)

impacts adherens junctions

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19
Q

disfiguring skin lesions, multinucleated giant cells, anesthesias. What? Cell marker?

A

lebrosy

CD14 (modified macrophages)

20
Q

post-strep glomerulonephritis. Looks like on biopsy?

A

subepithelial humps

can follow pharynx OR skin infection

21
Q

toxoplasmosis shape

A

necrotic, focally hemorrhagic lesions containing both large, round encysted bradyzoites and free, crescent-shaped tachyzoites toward the edge of the lesion

treat with pyrimethamine and sulfadiazine

22
Q

blood supply to the head of the femur arises from

A

medial circumflex femoral artery

23
Q

lines of Zahn

A

pre-mortem thrombus

24
Q

tri-cyclic anti-depressants

A

block NE and 5-HT reuptake

side effects: anticholinergic, sedation, lower seizure threshold

examples: amitriptyline, imipramine, nortriptyline, desipramine

25
Q

hormone secreted during severe hypoglycemia

A

epinephrine

26
Q

most common CNS tumor

A

metastatic

27
Q

what’s happening in Type 4 hypersensitivity?

A

TH1 cells sensitized to haptenated cells make cytokines that activate cytotoxic T lymphocytes and macrophages –> tissue damage

28
Q

rhomboid crystals seen on polarization

A

pseudogout: calcium pyrophosphate.

Gout is needle-shaped, negatively birefringent (yellow) cristals

29
Q

seborrheic keratoses - microscopic

A

keratin-filled cysts, aka pseudo-horn cysts

30
Q

anterior pituitary hormones

A

TSH, ACTH, LH, FSH, GH, prolactin

31
Q

blood flow is slowest where?

A

capillaries

32
Q

decreased sesation over right face and body - all sensory modalities- implies lesion where?

A

left ventral posterior thalamus

33
Q

long thoracic nerve innervates what?

A

serratus anterior

34
Q

gonorrhoeae growth medium, characteristics?

A

chocolate agar (thayer martin)
gram-eg
oxidase positive diplococcus
has over 1 million variants of pili –> no immunity

35
Q

LCAD deficiency

A

–> fasting hypoglycemia and hypoketosis

muscle weakness and cardiomyopathy

36
Q

encapsulated organisms to vaccinate against in sickle cell

A

strep pneumo
salmonella
haemophilus (younger kids, commonly given)

37
Q

metformin side effect

A

lactic acidosis, esp. w/ renal insufficiency

38
Q

metaclopromide

A

prokinetic agent that stimulates the intestinal tract

do not give with bowel obstruction

39
Q

cytokine that stimulates macrophages

A

IFN-gamma

40
Q

APL translocation

A

t(15;17) with Auer rods

41
Q

skin scrapings of HSV have

A

intranuclear inclusion bodies

42
Q

drugs that decrease aldosterone

A

ACE inhibitors (like enalapril)

43
Q

Paget disease of the breast goes with

A

adenocarcinoma

44
Q

how do we make dx of pyloric stenosis?

A

abdominal ultrasound

45
Q

bartonella henselae

A

gram negative
papule/ pustule, regional lymphadeonopathy
stellate granulomas

treat with quinolones, doxycycline or azithromycin (preggos)

46
Q

Paternity testing– what kind?

A

microsatellite testing

47
Q

biggest predisposing risk factor for TB?

A

AIDS

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