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USMLE Step 1: Part 1 COPY > USMLE Rx: Week of 08/19/16 > Flashcards

USMLE Rx: Week of 08/19/16 Flashcards

1
Q

What is the first thing you should do when you suspect that a child has minimal change disease?

A

Administer steroids. Although definitive diagnosis requires renal biopsy, that test should only be considered for children with nephrotic syndrome that does not respond to steroids.

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2
Q

What cell types are often found in the alveoli of those with chronic bronchitis?

A

Macrophages and CD8+ T cells

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3
Q

Other than cigarette smoking, what is a known cause of Goodpasture syndrome?

A

Exposure to hydrocarbon solvents (such as those used in dry cleaning)

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4
Q

In terms of PT, PTT, and platelets, how can you differentiate DIC from TTP?

A

TTP will have low platelets but normal PT and PTT times, whereas DIC will have low platelets and elevated PT and PTT.

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5
Q

What type of drug is beclamethasone?

A

It is a corticosteroid.

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6
Q

Once again, what mnemonic lists the drugs that can cause SLE?

A 
SHIPP-E
Sulfa drugs
hydralazine
Isoniazid
Phenytoin
Procainamide
Etanercept
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7
Q

The only rotator cuff muscle that medially rotates the arm is the ____________.

A

subscapularis

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8
Q

What is hematochezia?

A

Pooping out fresh, red blood

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9
Q

Although not as striking as the surface lesions, Kaposi’s sarcoma can appear anywhere – including the __________.

A

lungs, biliary tract, or gastrointestinal tract (which can present as hematochezia or melena)

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10
Q

What type of cancer often shows T-cell mediated tumor shrinkage? Consequently, what medication is given to amplify this effect?

A

Renal cell clear cell carcinoma; IL-2 (called aldesleukin)

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11
Q

What factor (produced by tumors) may contribute to migratory thrombophlebitis?

A

Tissue factor

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12
Q

Ranibizumab, which targets __________, has been approved for the treatment of which type of cancer?

A

Vascular endothelial growth factor; colon cancer

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13
Q

Describe the life cycle of heme and bilirubin.

A

Macrophages engulf RBCs and process the hemoglobin into heme and protein. Heme is converted to biliverdin by heme oxygenase and then to indirect (aka unconjugated) bilirubin. Bilirubin is passed into the bloodstream to then be carried by albumin to the liver, where it will be conjugated to bilirubin glucuronide (aka direct bilirubin). Conjugated bilirubin is sent to the colon, where bacteria degrade it to urobilinogen. Some urobilinogen gets reabsorbed and excreted in the urine (hence the name)

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14
Q

What three organs are most affected by graft-versus-host disease?

A

Skin (itchiness, erythema, and hives)
Liver (elevated ALT/AST)
Gut (diarrhea)

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15
Q

Recall that sulfa-containing drugs can cause interstitial nephritis. Which diuretics contain those?

A

Most loop and thiazide diuretics

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16
Q

Recall that radiolucent stones include __________.

A

uric and cysteine stones

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17
Q

Why do those with hyperparathyroid syndrome urinate excessively?

A

Because calcium inhibits ADH

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18
Q

Hepatitis B often precedes which vasculitis?

A

Polyarteritis nodosa (Plan B = “PAN B”)

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19
Q

How is polyarteritis nodosa treated?

A

Cyclophosphamide

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20
Q

What fracture is common in child abuse?

A

Spiral fracture (such as from an adult twisting a child’s arm)

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21
Q

What is rheumatoid factor?

A

Anti-IgG IgM

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22
Q

What molecule does etoposide inhibit?

A

Topoisomerase II – thus, etoposide leads to the breaking of DNA during attempted unwinding

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23
Q

Carcinoid syndrome is a disorder in which GI tumors secrete vasoactive amines. What are the symptoms?

A

Facial flushing, wheezing, and episodic diarrhea

24
Q

What is sepsis defined as?

A 
At least two of the four SIRS criteria: 
HR > 90
WBC > 12,000 or  10%
Fever or hypothermia
RR > 20
25
Q

Review the structures derived from the branchial arches.

A

1: mastication, CN V, masseter and mandible
2: facial expression, CN VII
3: CN IX, stylopharyngeus
4 and 6: CN X, vocal cords, swallowing

26
Q

What joint disorder sometimes (15% of the cases) occurs with giant cell arteritis?

A

Polymyalgia rheumatica

27
Q

What renal disorder is often a side effect of lithium therapy?

A

Nephrogenic diabetes insipidus (think of LMNOP: Lithium can cause Movement disorders (tremor), Nephrogenic diabetes insipids, hypOthyroidism, and Pregnancy problems)

28
Q

What drug is known to trigger asthma attacks, particularly in those with nasal polyps?

A

Aspirin

29
Q

Mannitol should not be given to patients with what condition?

A

Congestive heart failure – think, mannitol helps pull fluid from the brain and leads to eventual increase in diuresis, but it has a temporary effect of increasing fluid retention with potential to cause pulmonary edema. Thus, patients with volume overload should not be given mannitol.

30
Q

What is the overall effect of acetazolamide on the nephron?

A

Increases bicarb excretion; decreases proton excretion (A deCEitful LAMb riding a BIke out of the tubule with two ACEs)

31
Q

The fibrate drugs have what three effects?

A

Increase HDL
Decrease LDL
Decrease triglycerides

32
Q

Cholesterol gallstones are a side effect of a drug that lowers ___________.

A

Triglycerides (specifically, the fibrates)

33
Q

Major basic protein is a component of which cell type?

A

Eosinophils (“Many Blobs of Pink” because eosinophilic means pink-loving)

34
Q

What is the basic idea behind Paget’s disease? What is the unique lab profile?

A

Paget disease is abnormal construction and destruction of the bone; it presents with a normal Ca, normal Phos, but an elevated Alk Phos.

35
Q

In terms of biomechanics, what does purse-lip breathing do?

A

It increases pressure in the smaller airways, which need that because their increased compliance causes them to shut.

36
Q

What is the standard therapy for prophylactic PCP treatment in an AIDS patient?

A

Bactrim

37
Q

What kind of pneumonia do fungi cause?

A

Diffuse interstitial

38
Q

What is the best alternative to bactrim to treat PCP in an AIDS patient (for a person with a sulfa allergy)?

A

Aerosolized pentamidine

39
Q

___________ is administered with methotrexate to treat its unpleasant side effects.

A

Leucovorin (aka folinic acid)

40
Q

Isoniazid reduces the body’s store of what necessary molecule?

A

B6 (so TB patients often need B6)

41
Q

What disorder leads to increased production of IgM? What disorder leads to increased production of IgG?

A 
IgM = Waldenström macroglobulinemia (think of the IgM basketball in Waldenbooks) 
IgG = multiple myeloma (think of a CRAB – hypercalcemia, renal problems, anemia, and lytic bone lesions –wearing Gangster attire)
42
Q

Histologically, how can you differentiate mast cells and eosinophils?

A

Mast cells are bluish/purple; eosinophils are pink

43
Q

___________ blocks the conversion of plasminogen to plasmin and can be used to treat negative reactions to ____________.

A

Aminocaproic acid; tPA

44
Q

What cell lineage do SLL/CLL cancers most resemble?

A

B cells (expressing CD19 and CD20)

45
Q

Describe the presentation of Langerhans cell histiocytosis.

A

Fever
Lytic lesions
Rash
Birbeck granules on EM

46
Q

What positive titer has a strong correlation with polyarteritis nodosa?

A

Hepatitis B

47
Q

What is the pathologic appearance of polyarteritis nodosa?

A

Transmural, fibrinoid necrosis (different – “POLY” – stages may coexist)

48
Q

____________ is a syndrome in which there is general failure of the proximal convoluted tubule, resulting in increased excretion of bicarb, amino acids, and phosphate.

A

Fanconi syndrome

49
Q

What genetic disorder leads to a defect in the channel targeted by furosemide?

A

Bartter (think of BART Simpson skateboarding up the ascending loop of Henle)

50
Q

Gitelman syndrome is a disorder of the channel targeted by __________.

A

hydrochlorothiazide

51
Q

What is the classic description of basal cell carcinoma?

A

Pearly borders with telangiectasias

52
Q

Contact dermatitis is an example of a type _____ immune reaction.

A

IV

53
Q

Immediate transfusion reactions are a type ___________ hypersensitivity reaction.

A

II (because IgM immediately targets RBCs –so it is organ-specific)

54
Q

EBV targets which cells?

A

B lymphocytes –think of what cancers are caused by EBV: Burkitt’s lymphoma, DLBCL

55
Q

What will the basement membranes of those with mesangial-proliferative nephritic disease demonstrate?

A

“Thickening and splitting” (think MPGN = mesangial proliferation with splitting because they’re Gripping the edges of the Nephron filter)

56
Q

What drug (strangely) blocks the effects of ACTH (and can thus be used to treat disorders in which ACTH is overexpressed)?

A

Ketoconazole (think of the KEy that unlocks the moon [facies])

USMLE Step 1: Part 1 COPY (243 decks)

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