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USMLE-RX Flashcards

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1
Q

Failure to synth MHCII antigens

A

SCID

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2
Q

Leukocyte adhesion deficiency (type 1)

A

LFA1 integrin on phagocytes is defective and can’t bind ICAM1 –> PMNs can’t migrate, so wound healing is reduced, no pus formation, lots of infxns

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3
Q

Chedak-Higashi syndrome

A

Microtubule dysfxn in phag-lysosome fusion –> partial albinism, recurrent infxns, peripheral neuropathy

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4
Q

Wiskott-Aldrich syndrome

A

defective cytoskel organization in T cells –> decreasing lymphocytes over time

Truncal TTP, eczema, recurrent infxns, X-linked

Elevated IgA, IgE; low IgM (vs. hyper IgM: B cells can’t class switch, so get low IgA, E and G)

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5
Q

Nystatin

A

Used to treat thrush (oral candida)

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6
Q

Haloperidol mech

A

Blocks D2 receptors, can –> acute dystonia (most likely with haloperidol of all typical antipsychotics [“-azine”])

Treat dystonia by blocking ACh receptors (eg benztropine)

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7
Q

Typical vs. atypical antipsychotic mech

A

Typical - inhibit D2

Atypical - inhibit D2 and serotonin receptors

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8
Q

Effect of antipsychotics on prolactin

A

Tonic inhibition of prolactin by DP, so when inhibit DA –> increased PRL –> inhib of GnRH –> decreased LH and FSH –> no ovulation

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9
Q

Brenner tumor

A

Ovarian tumor, usually benign, cells look like bladder transitional epith in nests with coffee bean-shaped nuclei among fibrous stroma

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10
Q

Classic triad of fibroma, ascites, and hydrothorax

A

Meigs syndrome - ovarian fibromas (lots of fibroblasts)

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11
Q

Intraperitoneal mucus

A

Pseudomyxoma peritonei (presentation of ovarian mucinous cystadenomas or mucinous cystadenocarcinomas)

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12
Q

Estrogen-secreting ovarian tumor?

A

Granulosa cell tumors -> precocious puberty, endometrial hyperplasia, endometrial carcinomas

Histo: ovarian follicles with eo material (Call-Exner bodies)

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13
Q

Schiller-Duval bodies

A

Look like glomeruli, seen in yolk sac/endodermal sinus ovarian tumors

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14
Q

Krukenberg tumor

A

GI malig –> mets in ovaries (mucin-secreting signet cell adenoca)

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15
Q

Benzodiazepine mech

A

Increase GABA receptor action by increasing Cl channel opening in the receptor

Reverse with Flumazenil (competitive antag at benzo binding site on GABA receptor)

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16
Q

Classic triad of MS

A

Scanning speech
Intention tremor/Incontinence/Internuclear ophthalmoplegia
Nystagmus

“SIN”

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17
Q

MS findings

A

Increased IgG in CSF (oligoclonal bands)

MRI: periventricular plaques, WM lesions = separated in time and space

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18
Q

Symmetric ascending weakeness

A

Guillan Barre

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19
Q

IL2 treats…

A

RCCA and metastatic melanoma

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20
Q

CMV encephalitis MRI findings

A

Enhancing periventricular WM lesions in cortical and subependymal regions

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21
Q

CMV encephalitis histo findings

A

Giant cells with eosinophilic inclusions in cyt and nucleus

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22
Q

FAP mutation

Study These Flashcards
A

Deletions/mut of APC gene on chrom 5 (tumor suppressor gene, mut = aut dom and second hit –> polyps –> adenoca of colon in 100% untreated pts (treat with colon resection))

vs. Hereditary nonpolyposis CRC = assoc with mutations in DNA repair genes (MSH2, MLH1)

23
Q

Hereditary retinoblastoma increases risk of…

Study These Flashcards
A

soft tissue sarcomas, osteosarcomas, melanomas, brain cancer

24
Q

Medullary thyroid carcinoma associated with…

Study These Flashcards
A

MEN 2A and 2B (Ret gene)

25
RCC associated with which genetic syndrome?
VHL
26
Painless hematuria - think of...
Transitional cell carcinoma assoc with phenacetin, smoking, aniline dyes, cyclophosphamide
27
4 sx of Gerstmann aphasia
Dyscalculia, agraphia, left/right disorientation, finger nagnosia Lesion in left parietal lobe
28
Ethacrynic acid
Loop diuretic that inhibits NKCC in LoH - K wasting diuretic, can --> hyperuricemia Spironolactone (antag of aldo receptor) and triamterene (inhibits ENac) = K sparing
29
Birefringence of gout vs. pseudogout crystals
Gout: needle-shaped, negative birefringent (yellow when parallel to axis of polarization and blue when perpendicular) Pseudogout: rhomboid-shaped (blue when parallel, yellow when perpendicular)
30
Acute treatment of gout
NSAIDs (indomethacin), steroids, colchicine
31
HTLV1 cancer assoc
T-lymphocyte leukemia/lymphoma (skin lesions, hyperCa, adenopathy, hepatosplenomegaly)
32
Job Syndrome
Hyper IgE - helper T cells don't make IFN-gamma, so neutrophils can't get where they need to go --> blunted inflamm response and frequent infxn (esp eczematous skin infx and pulm infxn + course facies and bone fractures)
33
Finasteride
Treats BPH estradiol levels increase with age and sensitize prostate to DHT; finasteride blocks 5-alpha reductase, decreasing conversion of test to DHT Side effect: promote hair growth
34
Gynecomastia is a common side effect of ____
- Flutamide (treats prostatic carcinoma) Spironolactone, ketoconazole
35
Loss of blue-green color vision is a common side effect of _____
Sildenafil, vardenafil (treat ED by inhibiting cGMP phosphodiesterase --> increased cGMP)
36
Common triad of sx with pericarditis
Distant heart sounds, distended jugular vv, hypotension May --> tamponade, friction rub
37
Drugs that have survival benefit in decompensated HF
Beta blockers and ACE-i ("-pril") Don't start beta blockers acutely!!
38
Classic triad of Wernicke-Korsakoff syndrome
Wernicke: Confusion, ataxia, nystagmus Korsakoff: memory problems and confabulations (irrev) Seen with thiamine deficiency, esp in alcoholism
39
First aortic arch --> _____ Second aortic arch --> Third --> Fourth --> Fifth -->
First: Maxillary artery (to deep structures of face) Second: Stapedial and hyoid aa (usually regress, only important to fetus) Third: common carotids and proximal internal carotid Fourth: ascending arch of aorta on L and subclavian on R Fifth: regresses Sixth: proximal pulmonary arteries and ductus arteriosus arteries
40
Diethylstilbestrol exposure assoc with increased risk of _____
vaginal clear cell adenocarcinoma Used to treat metastatic prostate cancer (used to be used to treat preg-related things)
41
Scurvy pathophysio
Vit C deficiency --> proline and lysine aren't hydroxylated in ER during collagen production --> ecchymoses, petechiae, corkscrew hairs
42
Associations of primary vs. secondary amyloidosis
Primary - multiple myeloma (Ig light chains); that increased serum protein --> rouleaux formation of RBCs Secondary - chronic dz (TB, RA), serum amyloid-associated protein Dialysis-associated amyloidosis (accum of MHCI proteins)
43
Small lymphocytic lymphoma can transform into ___ and they share ___ as a cell marker
DLBCL, CD5 (usually a T cell marker) vs. Follicular lymphoma (can transform into DLBCL, but doesn't have CD5) vs. Mantle cell lymphoma (has CD5 but can't transform into DLBCL)
44
LN with cells with open chromatin, prominent nucleoli, moderate amount of cytoplasm - think ___
DLBCL
45
Most common cause of B12 deficiency
Pernicious anemia
46
IFN-alpha is used for ____
its leukocytic effects tx: hep, Kaposi sarcoma, melanoma, leukemia
47
Lab findings that distinguish thal from Fe-deficiency anemia
Thalassemia: normal serum iron, increased retics Fe-def anemia: decreased serum iron, so can't have increased retics b/c have insufficient iron for RBC synth
48
What is phenobarbital used for, and why is phenobarbital not used outpt?
Anti-seizure drug, works on GABA receptors to increase Cl channel opening Highly sedating, so only used inpt
49
Anticonvulsants used for tonic-clonic vs. absence and myoclonic seizures
Tonic-clonic: Gabapentin, Lamotrigine (most likely to cause SJS) Absence and myoclonic: Clonazepam (benzo)
50
Down syndrome increases likelihood of this cancer by 20x
ALL "We ALL fall DOWN"
51
Presenting sx of ALL
Bone marrow infiltration --> anemia, easy bruising (thrombocytopenia), fatigue etc
52
Childhood illness that can --> trendelenberg gait, and nerve involved
Superior gluteal nerve damage from polio Superior gluteal n. innervates gluteus medius and minimus, which do hip abduction and medial rotation of thigh, keeping pelvis level during gait
53
Pralidoxine
regenerates AChE, so reverses AChE inhibitor in case of ACh poisoning

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