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USMLE Step 1 > UWorld_4.5 > Flashcards

Flashcards in UWorld_4.5 Deck (38)
1

Cardiac consequences of chronic arteriovenous fistula 

  • acutely: decreased TPR ==> increased CO and increased venous return
  • over time ==> increased sympathetic nervous system ==> increased cardiac contractility, vascular tone, and circulating blood volume

2

Characteristics of Paget Disease of the Bone

  • problem w/overactive osteoclasts
  • osteoclasts originate from hematopoietic progenitor cells
  • RANK-L and M-CSF play an important role in osteoclast differention

3

Presentation of HepB

  • "serum-like sickness"
  • malaise, fever, skin rash, pruritis, lymphadenopathy and joint pain
  • anorexia, nausea, jaundice and RUQ pain may ensue
  • ALT > AST + bilirubin, alk phos
  • vs. Hep C = mild, usually asymptomatic

4

Phenoxybenzamine: MOA

  • irreversible alpha 1 & 2 antagonist

5

Listeria characteristics + immune defense

  • gram + rods
  • tumbling motility @ 22C, can be cultured @ as low as 4C
  • narrow zone of beta-hemolysis
  • intact cell-mediated immunity is essential for elimination

6

Cells of origin of SCC

  • neuroendocrine origin
  • markers
    • neuron-specific enolase
    • chromogranin
    • synaptophysin
    • neurofilaments

7

Neurblast tumor in children

  • non-rhythmic conjugate eye movements + myoclonus
  • arises from adrenal medulla
  • increased n-myc copies

8

Characteristics of medullary carcinoma of thyroid

  • extracellular deposits of amyloid <== formed by calcitonin secreted by parafollicular c-cells
    • amyloid stains with congo red
    • nests of uniform/spindle or polygonal cells

9

Migratory thrombophlebitis association

cancer (hypercoag is common paraneoplastic)

10

Extended consumption of appetite suppressants ==> 

pulmonary HTN, cor pulmonale, RVH

11

Nitroprusside toxicity + antidote

  • nitroprusside ==> cyanide ==> thiocyanate by liver rhodanase
  • sodium thiosulfate = antidote for cyanide toxicity
    • donates sulfar to help liver rhodanase

12

Drug that can induce prinzmetal angina

  • Ergonovine ==> vasoconstriction via alpha-adrenergic and serotonergic mechanisms
  • can be used to dx prinzmetal

13

Important tx guideline for hospital tx of alcoholics

No glucose without thiamine in thiamine-deficient patients

14

Characteristics of syndenham's chorea

  • possible sequelae from rheumatic fever
  • restless and purposeless jerking movement a few months after sore throat

15

Cause of increased risk for gallstones in Crohn's patient

  • decreased bile reabsorption ==> increased loss in feces
  • ==> increased lithogenicity of bile 

16

Most common elbow injury in children

  • radial head subluxation ==> annular ligament injury
  • commonly in younger children (<5)
  • little distress unless moving elbow
  • hold arm close, extended with pronation

17

MG antibodies =

MS antibodies = 

  • MG = anti-ACh receptor
  • MS = anti-presynp Ca channel
    • assoc. with Lambert-Eaton paraneoplastic syndrome

18

Gastric ulcer vs. erosion

  • ulcer extends through muscularis mucosa and erosion does not

19

Myoclonus vs. Dystonia

  • myoclonus = sudden, brief shock-like contraction
  • dystonia = prolonged muscle contraction

20

facial pain + H/A + black necrotic eschar @ pt. w/diabetic ketoacidosis ==> dx?

  • mucormycosis
    • rhizopus
    • mucor
    • absidia
  • dx via biopsy
    • broad, nonseptate hyphae w/right angle branching

21

Median n. course

between humeral and ulnar head of pronator teres ==> between flexor digitorum superficial and flexor digitorum profundus =+> carparl tunnel

22

Bell's palsy = 

  • CN VII palsy
  • facial m. paralysis
  • decreased lacrimation
  • decreased taste from ant. 2/3

23

Increasing/decreased LVO obstruction murmur intensity

  • decreased preload ==> decreased EDV ==> increased intesity
  • increased preload/afterload ==> increased EDV ==> decreased intensity

24

Type I vs. Type II Famililal hypercholsterol

  • Type I = chylomicrons
    • LP lipase is low 
    • elevated TGs
    • increased risk for acute pancreatitis
    • skin lesions
  • Type II = LDL receptor/apoB100
    • tendon xanthomas
    • xanesthesas (e/g/ on eyelids)
    • early CAD

25

Possible CSF complication in meningeal disease

destruction of arachnoid granulations ==> communicating hydrocephalus

26

viruses with segmented genomes

orthomyxoviruses

influenza

rota virus

27

Possible neuro consequences of measles

  • encephalitis (days)
  • acute dissemenated enchephalomyelitis (weeks)
  • subacute sclerosing panencephalitis (years)

28

Lipoic acid is a cofactor for...

  • pyruvate DH (deficiency ==> lactic acidosis)
  • alpha-ketoglutarate DH
  • branched-chain ketoacid DH (deficiency ==> MSUD)

29

Valvular defect association w/inherited HCM

mitral valve has systolic anterior motion ==> comes close to IV septum

30

most common location of anal fissure

posterior midline distal to dentate line

31

menigococcal vaccine composition

capsular protiens 

32

glycogen accumulation in lysosomal vacuoles ==> dx?

alpha-glucosidase deficiency

33

Hemophilia A labs

prolonged PTT, normal bleeding time

34

Precursor of Nitric Oxide

arginine

35

Most common lung cancer in gen pop

adenocarcinoma (common @ women, nonsmokers)

36

thiamine is a cofactor for...

alpha-ketoglutarate DH

37

Molecules that use JAK/STAT pathways

  • colony-stimulating factors
  • prolactin
  • growth hormone
  • IL-2/cytokines

38

Histo findings in contact dermatitis

spongiosis

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