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USMLE Step 1 > UWorld_3.31 > Flashcards

Flashcards in UWorld_3.31 Deck (28)
1

Reason for methodone use

  • used to help patients recover from heroin addiction
  • very long half-life opioid agonist w/good oral bioavailablity
  • prevents withdrawal sx while weaning off heroin

2

Gastroenteritis that can transfer between domestic animals and humans

  • campylobacter
  • acquired from domestic animals (cattle, chicken, dogs) or contaminated food
  • ==> inflammatory diarrhea + ab pain + tenesmus

3

hidgut derivatives + blood supply

  • transverse colon
  • descending colon
  • sigmoid colon
  • rectum
  • bs = inferior mesenteric artery

4

Major complication in subarachanoid hemorrhage + tx

  • vasospasm can occur 4-12 days after ==> new onset sx
  • Nimodipine = selective ca channel blocker usually prescribed to prevent

5

Shizoaffective disorder

  • multiple psychotic episodes with concurrent major depressive/manic sx
  • >2 weeks of psychosis (delusions, hallucinations) w/out mood sx
  • mood sx present over majority of illness

6

Characteristics of Jervell and Lange-Nielson syndrome

  • AR
  • QT prolongation
  • congenital neurosensory deafness

7

Consequence of Afib in LVH/aortic stenosis pt.

  • afib ==> ineffective atrial contraction
    • atrial contraction is important in ventricular filling of a noncompliant chamber
  • innefective atrial contraction ==> sig. decreased preload ==> decreased CO

8

Common causes of myopathy with elevated CK

  • inflammatory myopathy
    • skin rash and inflammatory arthritis may also be present
  • statin-induced
  • hypothyroidism
    • hypothyroid sx present
    • myoedema = mounding of m. after percussion <== slow reabsorption of Ca from sarc. reticulum

9

Characteristics of germinomas

  • most common tumor of pineal gland ==>
  • B-hCG ==> prec. puberty in males
  • obstructive hydrocephalus
  • parinaud syndrome = paralysis of upward gaze

10

Common complication of bronchial asthma

  • aspergillosis ==> transient recurrent pulm infiltrates ==> proximal bronchiectasis

11

PrP definition & consequences

  • PrP = prion protein = alpha helix ==> beta pleated sheet = resistant to proteases ==> accumulation ==> spongiform transformation of gray matter

12

Ipratropium: MOA, use

  • Muscarinic antagonist @ bronchial smooth m.
    • less effective than B2 agonists
    • enhance B2 agonists
  • use in asthma

13

Theophylline: MOA, use

  • MOA: inhibit phosphodiesterase ==> increased cAMP ==> bronchial sm. m. dilation
  • use: asthma

14

Presentation of age-related macular degeneration (AMD) + Tx

  • progressive ==> acute vision loss (usually)
  • dry = subretinal drusden deposit or pigment changes
  • wet = abnormal vessels, gray subretina, neovascularization
  • dry ==> wet
  • dry tx = antioxidant vitamins + zinc
  • wet = anti-VEGF, laser therapy, phototherapy

15

Nicotinic receptors

  • ligand-gated ion channels
  • ACh binding ==> immediate influx of Ca2+ and Na+ and efflux of K+

16

Progressive dementia + cortical atropy ==> dx + tx

  • dx = Alzheimer's
  • Tx
    • Donepezil = cholinesterase inhibitor
    • Vitamin E (antioxidant)
    • Memantine = NMDA antagonist

17

Characteristics of cachexia

  • lung mass that releases TNF-alpha ==> cachexia syndrome
  • weight loss
  • anemia
  • anorexia
  • wasting

18

H. pylori location?

prepyloric area of gastric antrum = greatest concentrations

19

Glucokinase fxn + deficiency consequences

  • glucokinase = glucose sensor in pancreatic B-cells
  • inactivation of glucokinase ==> mild hyperglycemia exacerbated by pregnancy

20

Acitinic keratosis presentation

  • erythematous papules + white central scale
  • rough, sandpaper like texture

21

Granulosa-theca cell tumors secrete...

estrogen

22

Biotin role in metabolism

  • CO2 carrier on carboxylase enzymes
    • pyruvate carboxylase
    • ACoA carboyxlase
    • propionyl carboxylase
    • beta-methylacrotonyl carboxylase
    • **all involved in carb and lipid metabolism
  • in tissues that perform gluconeo gen, PC: pyruvate ==> OAA
    • no gluconeogen ==> pyruvate ==> LA ==> metabolic acidosis

23

Clozapine: MOA, use, SE

  • MOA: blocks D4 receptors
  • use: refractory psychosis/schizophrenia
  • SE
    • agranulocytosis <== must monitor WBC count
    • seizures

24

Total flow (w/in tube) = 

Flow = cross sectional area x velocity = constant

25

Insulin types

  • Basal/long-acting
    • Glargine; Determir = once daily
    • NPH = twice daily
  • Short-acting/post-prandial
    • Regular = best for IV
    • Lispro, Aspart, Glulisine = peak @ 45 min - hour
      • best for post-prand hyperglycemia 

26

Common disinfectant mechanisms:

alcohols

chlorhexadine

hydrogen peroxide

iodine

  • alcohols
    • disruption of cell membranes
    • denaturation of proteins
  • chlorhexadine
    • disruption of cell membranes
    • coagulation of cytoplasm
  • hydrogen peroxide
    • free radicals
    • sporocidal
  • iodine
    • halogenation of proteins & nucleic acids
    • sporocidal

27

Consequences of placental aromatase deficiency

  • inability to produce estrogens in placenta ==> excess androgens
  • XX w/ambigous genitalia
  • virilization of mother during preg.

28

Common sites of injury of ulnar nerve

  • medial epicondyle of humerus
  • near hook of hamate and pisiform bones of wrist

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