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USMLE Step 1 > UWorld_4.4 > Flashcards

Flashcards in UWorld_4.4 Deck (26)
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1

reverse T3 (rT3)

inactive form derived from peripheral conversion of T4

2

Antidote for TCA-related cardiac abnormalities

  • TCA ==> quinidine-like effect =+> QRS prolong + ventricular tachy
  • Tx = NaHCO3

3

HCTZ vs. Furosemide effect on Ca

  • HCTZ ==> increased Ca reabsorb
  • Fur ==> decreased Ca reabsorb

4

Ketone bodies

  • acetoacetate
  • acetone
  • beta-hydroxybutyric acid

5

Restless leg syndrome tx

  • avoid triggers
  • supportive
  • dopamine agonsits (e.g. pramipexole, ropinirole)

6

myxomatous changes @ media of vessels ==>

aoritc aneurysms/dissection (e.g. @ Maran's)

7

Antiviral drugs for HSV-1/2/VZV vs. EBV/CMV

  • acyclovir = guanisine analog 
    • activated by thimidine kinase that is present @ HSV1/2/VZV
    • TK is different @ CMV/EBV, thus less effective
  • gangciclovir ==> CMV/EBV

8

Vitamin tx for measles

Vit A

9

T3 receptor = 

nuclear receptor

10

Blasts of smear + severe infection + 8yo boy ==> Dx?

most likely T-ALL

11

Medullary vs. Papillary thyroid cancer

  • Medullary
    • parafollicular c-cells
    • polygonal to spindle shaped granular cells that stain for calcitonin
    • adjacent amyloid deposits
    • assoc. MEN 2A/@B
  • Papillary
    • large cells with nuclei with widely dispersed chromatin
    • ground-glass appearance (orphan annie eyes)

12

Major syndromes caused by lacunar infarcts

  1. motor only = post. limb of internal capsule
  2. sensory only = VPL or VPM or thalamus
  3. ataxia-hemipalegia = base of pons
  4. dysarthria-clumsy hand syndrome = base of pons or genu of internal capsule

13

aminoglycoside resistance by enterococci

cytoplasmic membrane proteins that transfer chemical groups to aminoglycosides (e.g. acetyl, adenyl or phosphate)

14

Lab value to check if alk-phos is moderately elevated

  • gamma-glutamyl transpeptidase ==> present in several tissues, esp. @ hepatocytes, and biliary epithelial, but not @ bone
    • helps differentiate alk phos elevation source as bone vs. liver

15

claudication usually due to...

atherosclerosis

16

Characteristics of subacute cerebellar degen paraneoplastic syndrome

  • occurs with:
    • SC LC
    • breast, ovarian, and uterine
  • mediators:
    • anti-yo
    • anti-P/Q
    • anti-Hu

17

Tuberculoid vs. Lepromatous Leprosy

  • Tuberculoid
    • positive skin test
    • TH1 response +  IL-2 & INF-gamma & IL-12 present 
    • lower bacterial load
  • Lepromatous
    • negative skin test (low TH1 response)
    • disseminated disease/high bacterial load
    • TH2 (humoral) response predominates
      • IL-4, IL-5, IL-10
    • acummulation of acid-fast bacteria w/in lesions

18

acute onset, mid-chest pleuritic pain, improves w/sitting up/leaning forward ==> dx?

pericarditis

19

Integrin-mediated adhesion of cells depends on ...

bidning to collagen, fibronectin, and laminin

20

Mechanism of increased ESR

  • local injury/inflammation ==> mac release of TNF-alpha, IL-1, and IL-6
  • IL-6 ==> APR release: fibrinogen, ferritin, CRP, serum amyloid A/P, complement)
    • fibrinogen ==> rouleux formation of RBCs ==> faster sedimentation

21

Haptoglobin

serum protien that binds free Hb

decreased in hemolytic anemias

22

Characteristics of Digoxin

  • common 2nd line tx for Afib
  • MOA: slows conduction through AV node via stimulation of vagus n.
    • acts @ Na/K ATP-ase pump
  • **difficult to dose
  • Toxicity ==>
    • fatigue, blurry vision, changes in color perception
    • N/V, diarrhea, abdominal pain
    • headache, dizziness, confusion, delerium
    • AV nodal block ==> bradycardia + jxnl escape beats <== most common cause of mortality

23

Small bluish neoplasm under nail bed ==> Ddx?

  • melanoma vs. glomangioma
  • glomangioma = tumor of modified smooth m. cells
    • responsible for shunting blood away from skin surfaces to prevent heat loss

24

Drug-induced SLE

  • hydralizine
  • procainamide
  • isoniazid
  • minocycline
  • quinidine

25

Gram - rods classification

  • Lactose-fermenting
    • E. Coli
  • Non-lactose
    • oxidase + = pseudomonas
    • oxidase (-)
      • No H2S production
        • Shigella
      • H2S production
        • Salmonella
        • Proteus

26

Immediate possible adverse effect of opiods

  • ==> smooth m. contraction ==> contraction/spasm of sphincter of Oddi ==> increased common bile duct pressure & biliary colic
  • ==> RUQ abdominal pain
  • discontinue meds, manage sx and pain

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