USMLE Step Flashcards

Terms Definitions
"Dermatan Sulfate: Use/Mechanism"
Prokaryotic genome: single/multiple origins of replication
"I-Cell disease: Presentation"
"Skeletal abnormalities, restricted joint movement, coarse facial features, severe psychomotor impairment, death by 8 years"
What toxin inhibits lipoic acid?
Name the purines.
Adenine and Guanine
"Anode: What does it contain?"
What molecule contributed this atom?
"Anode: What does it attract?"
Ubiquitin or Ubiquinone: Proteosomal degradation
Where does NADPH come from?
HMP shunt
"Cyanogen bromide cleaves peptides at which side of what residues?"
"C-terminal of methionine"
What is rotenone?
An electron transport inhibitor.
Zinc deficiency: Presentation
"Delayed wound healing, hypogonadism, and decreased adult hair (axillary, facial, pubic)"
Is the following amino acid essential or inessential, and is it glucogenic, ketogenic, or both?: Lysine
"Chondroitin Sulfate: Where found?/Distinguishing characteristic from other GAGs"
"Cartilage, tendons, ligaments, aorta. Most abundant GAG in body."
In aerobic metabolism of glucose, which pathway produces 36 ATP?
G3P shuttle
What is this molecule an activated carrier of?: NADPH
What enzyme converts galactose to galactitol?
Aldose reductase
Enzyme function: DNA polymerase III
Elongates the chain
"~ average pKa of carboxyl group on AA"
"I-Cell disease: Pathophysiology"
"Inability of cell to phosphorylate mannose residues on glycoproteins indicating that they are lysosome bound."
"Refsum Disease: Pathophysiology"
"Inability to degrade phytanic acid, resulting in accumulation in plasma and tissues"
"~ pKa of side chain of Tyrosine"
What disease state is glycolytic enzyme deficiency generally associated with?
Hemolytic anemia
"Uses of Succinyl CoA"
"TCA intermediate, and biosynthesis of heme"
mRNA initiation codons
1. AUG (inAUGurates protein synthesis)
2. GUG (rarely)
Cysteine or Cystine: Two copies of the amino acid joined by a disulfide bond
Name the irreversible enzymes in glycolysis.
1. Hexokinase
2. Phosphofructokinase-1
3. Pyruvate kinase
4. Pyruvate dehydrogenase
Name that mutation: Same amino acid, often with a base change in 3rd position of codon
Silent mutation
A patient presents with confusion, ataxia, diplopia and memory loss. Another presents with muslce wasting and polyneuritis. A third patient presents with edema and high output cardiac failure. All three admit to either alcoholism or malnutrition)
B1 (thiamine) deficiency.
Converted to thiamine pyrophosphate (TPP) a cofactor for:
- pyruvate dehydrogenase (glycolysis)
- alpha-ketoglutarate dehydrogenase (Kreb's)
- transketolase (HMP shunt)
- branched chain AA dehydrogenase
Presents as three syndromes:
- Wernicke-Korsakoff
- Dry beriberi
- Wet beriberi
How much ATP is used in the pentose phosphate shunt?
"How does glucagon stimulate gluconeogenesis?"
"Regulation of F2,6-BP and inactivation of Pyruvate Kinase via elevation of cAMP-dependent protein kinase A."
Which amino acids are necessary for purine synthesis?
"Glycine, Aspartate, Glutamine"
This enzyme phosphorylates glucose with low affinity.
Glucokinase (as opposed to hexokinase)
Heterochromatin or Euchromatin: Which is more condensed?
Heterochromatin. Euchromatin is less condensed.
What is on the 5' end of a nucleotide
How does lactose intolerance present?
1. Bloating
2. Cramps
3. Osmotic diarrhea
What does Uridyl transferase do?
1. converts UDP-glucose to UDP-galactose
2. converts Galactose-1-Phosphate to Glucose-1-Phosphate
Base excision repair: Mechanism
1. Specific glycosylases recognize and remove damaged bases
2. AP endonuclease cuts DNA at apyrimidinic site
3. Empty sugar is removed
4. Gap is refilled and resealed
"Which major metabolic reactions require Thiamine as a cofactor?"
"TCA: Pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase, HMP shunt: Transketolase"
"Hyaluronic Acid: Where found?/Distinguishing characteristic from other GAGs"
"Found in synovial fluid of joints, vitreous humor f eye, umbilical cord, and loose connective tissue. Unlike other GAGs: Unsulfated, not covalently attached to protein, and only GAG not limited to animal tissue, but also found in bacteria."
"Why is fructose metabolism faster than glucose metabolism?"
"Bypasses PFK, major regulatory step of glycolysis."
Pyruvate dehydrogenase: What does it do, and what stimulates and inhibits it?
Pyruvate dehydrogenase converts pyruvate to acetyl-coA, and produces NADH and CO2.

Stimulated by: excess pyruvate?
Inhibited by:
1. NADH (Listen, seriously, we don't need anymore of me.)
2. NADH (You produce NADH, soon there'll be more of me.)
3. Acetyl-CoA (Enough of me, save your pyrvuate.)
Lipoamide or lipoate: Which is a cofactor for pyruvate dehydrogenase?
Lipoate (Lipoic acid)
"Dermatan Sulfate: Where found?/Distinguishing characteristic from other GAGs"
"Found in skin, blood vessels, and heart valves"
Patient presents with an inflammed tongue. On examination, he also has fissuring at the corners of his mouth. On fundoscopic exam, there is corneal vascularization.
B2 (riboflavin) deficiency
Made into FAD ad FMN, cofactors for redox reactions. The reduced for of each cofactor can donate an electron to the ETC to make 2 ATP.
Which groups are more likely to be lactose intolerant?
1. Blacks
2. Asians
Draw a diagram showing the relationship between:
1. glucose
2. fructose-6-P
3. insulin
4. glucagon
5. PFK-1
6. PFK-2
7. F-1,6-BPAse
8. F-2,6-BPAse
9. Fructose-1,6-Bisphosphate
10. Fructose-2,6-Bisphosphate
from Rumors Were True blog
Nonhomologous end joining: Mechanism
Brings together two ends of DNA fragments (no requirement for homology)
Which RNA polymerase makes rRNA?
eukaryotic RNA polymerase I and prokaryotic RNA polymerase
What is on the 3' end of a nucleotide
Hydroxyl group
This enzyme phosphorylates glucose and is not feedback inhibited.
Glucokinase (as opposed to hexokinase)
What does the mRNA initiation codon code for?
Methionine in eukaryotes. formyl-methionine in prokaryotes.
"Chromatin structure: In the beads on a string analogy, what are the beads?"
"Start with a nucleosome core made up of an 8 histone cube (two each of positively-charged histones H2A, H2B, H3, and H4). Negatively charged DNA loops twice around nucleosome core."
Role of ATP in protein synthesis
ATP does tRNA Activation (charging)
Aminoacyl tRNA synthetase: Mechanism
1. Scrutinizes amino acid before it binds to tRNA
2. Binds AMP-amino group to 3' end of tRNA
3. Scrutinizes amino acid again. If incorrect, bond is hydrolyzed.
"What disease process is due to a missing respiratory burst?"
"Chronic granulomatous disease"
What is the mechanism of uncoupling agents?
"Uncouples" ATP synthesis from gradient production

1. Increase permeability of membrane
2. Proton gradient decreases, but oxygen consumption increases, as the gradient is not being maintained.
3. ATP synthesis stops, but electron transport continues.
Where do the various pyruvate transformation reactions happen?
1. ALT (Alanine to/from pyruvate)
2. LDH (Lactate to/from pyruvate)

1. Pyruvate carboxylase (pyruvate to oxaloacetate)
2. Pyruvate dehydrogenase (pyruvate to acetyl-coa)
DNA Topoisomerase II: Mechanism
cuts both strands, and passes an unbroken double strand through it then reanneals the cut strand
Enzyme function: Primase
Makes an RNA primer on which DNA polymerase III can initiate replication
"Amino acids that disrupt alpha-helix"
"proline, many charged aas, bulky side chains"
What are the net reactants and products in the reaction that Pyruvate Dehydrogenase catalyzes?
1. Pyruvate
2. CoA
3. NAD

1. Acetyl CoA
2. CO2
Which is more serious, essential fructosuria or fructose intolerance?
Fructose intolerance, because it depletes the cells of phosphate.
Pyruvate dehydrogenase deficiency: Mechanism
Backup of pyruvate and alanine leads to lactic acidosis.
Eukaryotic genome: Trigger for replication
Consensus sequence of AT-rich base pairs
Define promoter of gene expression.
Site where RNA polymerase and multiple other transcription factors bind to DNA upstream from gene locus
Energy malnutrition leads to what disease?
Marasmus (as opposed to Kwashiorkor from protein malnutrition)
In what condition is nucleotide excision repair mutated?
Xeroderma pigmentosa (dry skin with melanoma and other cancers)
"Where is the mutation for G6PD?"
"Point mutation in coding region of the G6PD gene (X-linked)"
What is the difference in presentation between von Gierke's disease and fructose intolerance?
Both have hypoglycemia, jaundice, cirrhosis and vomiting.

von Gierke's disease also has lactic acidosis whereas fructose intolerance does not.
Role of P site in protein synthesis
P site accomodates growing Peptide.
Amino acid binding to tRNA: Where (on the tRNA) and how?
Where: 3' end
How: Covalently
What enzymes and cofactors are used in conversion of pyruvate to alanine?
Enzyme: Alanine Transaminase (ALT)

Cofactors: None
What is the mechanism of ATPase inhibitors?
1. Directly inhibit mitochondrial ATPase causing:
2. Increased protein gradient and increased oxygen consumption, but no ATP is produced because electron transport stops.
Protein malnutrition leads to what disease?
Kwashiorkor (as opposed to Marasmus from energy malnutrition)
Define enhancer of gene expression.
Stretch of DNA that alters gene expression by binding transcription factors. May be located close to, far from, or even within the gene whose expression it regulates.
A woman comes in for preconception counseling. A peripheral blood smear results in macrocytic, megaloblastic anemia. She admits to not eating green leafy vegetables so the doctor prescribes a vitamin supplement to reduce the chances of neural tube defects
Folic acid deficiency (more common becuase the liver has only small stores).
Converted to THF, a coenzyme for 1-carbon (methyl) group transfers, nucleotide synthesis for RNA, DNA synthesis.
- lack of foliage in the diet
- iatrogenic: phenytoin, sulfonamides, methotrexate
What characterizes a promoter of gene expression?
AT-rich upstream sequence with TATA and CAAT boxes
"Where in glycolysis and TCA does CO2 come off?"
"3 places: Pyruvate to Acetyl CoA, Isocitrate to alpha-ketoglutarate, and alpha-ketoglutarate to Succinyl CoA"
What is the sequence of mRNA splicing?
1. Primary transcript combines with snRNP ("snerp") to form spliceosome
2. Lariat-shaped intermediate is generated
3. Lariat is released to remove intron precisely and join two exons
Ethanol metabolism: All steps with enzymes and cofactors
"Step 1: Ethanol is oxidized by NAD (forming NADH) to acetaldehyde using alcohol dehydrogenase. Step 2: Acetaldehyde is oxidized by NAD (forming NADH) to acetate using acetaldehyde dehydrogenase."
What are the conditionally essential amino acids, and why are they conditionally essential?
The condition is age. They are necessary early in life during growth.

Mnemonic: Babies CRY for Help

1. Cysteine
2. aRginine
3. tYrosine
4. Histidine
Types of RNA and their important qualities
Massive, Rampant, Tiny

mRNA is the largest type
rRNA is the most abundant type
tRNA is the smallest type
What kind of mutation is called: nonsense
Change resulting in early stop codon

(Mnemonic: Stop the nonsense!)
What is the enzyme involved in processing tRNA
Aminoacyl tRNA synthetase (uses 1 ATP)
What are the two most common glycolytic enzyme deficiencies?
Pyruvate kinase (95% of cases) followed by glucose phosphate isomerase (4% of cases)
What is the presentation of arsenic toxicity?
1. Vomiting
2. Rice water stools
3. Garlic breath
Role of A site in protein synthesis
A site holds incoming Aminoacyl tRNA.
A young woman is brought to ER by her friend after having a seizure. Blood smear shows nucleated RBCs with iron-laden mitochodria around the nucleus. She began using OCPs recently.
B6 (pyridoxine) deifiency
Is converted to pyridoxal phosphate, a cofactor for the following reactions:
- transamination (AST, ALT)
- decarboxylation (GABA synthesis)
- glycogenolysis (glycogen phosphorylase)
- cystatione synthesis
- heme synthesis (ALA synthase- rate limiting step)
- niacin synthesis from tryptophan
Etiologies of deficiency: isoniazid or OCP use
Hexokinase: Where is it found and why does it do what it does?
Found in every cell's cytoplasm. Phosphorylates glucose to proceed with glycolysis.
What is the treatment for fructose intolerance?
Decreased intake of both fructose and sucrose.
Where in the electron transport chain is ADP converted to ATP?
Complex V aka ATP synthase aka mitochondrial ATPase
What is the mechanism of thermogenin?
Uncoupling protein OR UCP which is an uncoupling agent
What is the result of promoter mutation?
Dramatic decrease in amount of gene transcribed
Where in the cell does the following occur: Protein Synthesis
Rough endoplasmic reticulum in the cytoplasm
A doctor on a navy ship sees a sailor who has easy bruising, swollen gums and wounds that are taking a long time to heal. The doctor recommends he eat more fruit.
Vitamin C (ascorbic acid) deficiency
What does it mean for genetic code to be universal?
Genetic code is conserved throughout evolution
What are the steps in processing hnRNA to make mRNA? (Note: This is more than splicing.)
1. Capping on 5' end with 7-methyl-G
2. Polyadenylation on 3' end (approximately 200 As)
3. Splicing out of introns
What sequence does every tRNA share at the 3' end?
CCA along with a high percentage of chemically modified bases
Which steps in the citric acid cycle produce CO2?
The steps where carbons are lost, the two structures after isocitrate each have one less carbon than the last.

1. Isocitrate to alpha-ketoglutarate
2. alpha-ketoglutarate to succinyl coA
What is the mechanism of hemolytic anemia in someone with glycolytic enzyme deficiency?
1. Lack of glycolysis leads to lack of ATP in RBCs
2. Lack of ATP leads to inactivity of Na, K-ATPase pump.
3. Lack of the pump leads to sodium influx.
4. Water follows sodium into the cell.
5. The cell swells and bursts.
What is the order of the citric acid cycle beginning at citrate?
CAn I Keep Selling Sex For Money, Officer?

1. Citrate
2. cis-Aconitate
3. Isocitrate
4. alpha-Ketoglutarate
5. Succinyl CoA
6. Succinate
7. Fumarate
8. Malate
9. Oxaloacetate
Thalassemia major
Rheumatic fever
Aschoff bodies
antibasement memb Ab
Goodpasture $
heterophil Ab
infectious mononucleosis (EBV)
primary cardiac tumor ( kids)MC
What drug causes retrograde ejaculation
What term describes senseless repetition of words or phrases?
Which centrally acting α2-adrenergic agonist is safe for use in renal dysfunction and in HTN during pregnancy?
pseudopalisade tumor cell arrangement
Glioblastoma multiforme
what causes sideroblastic anemia?
decreased b6
Cushing ulcers
GU produced by increased ICP
MC presenting symptom of HIV encephalopathy
secondary hyperparathyroidism
hypocalcemia of chronic kidney disease
What β-blocker is also an α-blocker?
Name these mature defense mechanisms: • Easing anxiety with laughter
Francisella tularensis
What small gram-negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite?
Parkinson's disease
Shuffling gait, cogwheel rigidity, masklike facies, pill-rolling tremor, and bradykinesia describe what form of dementia?
Name the antimicrobial agent whose major side effect is listed. • Grey baby syndrome
Treacher Collins syndrome
Mandibular hypoplasia, down-slanted palpebral fissures, colobomas, malformed ears, and zygomatic hypoplasia are commonly seen in what pharyngeal arch 1 abnormality?
morbid state.... something which is not physiological
When is bronchoalveolar lavage useful?
what causes malabsorbative diarrhea?
celiac sprue
post gastro
MOA: indoleacetic acid used for anti-inflammatory, analgesic & antipyretic props, also for osteoarthritis and pain
What has a pos valgus test
MCL injury
Prophylaxis for N. Meningitis
Rifampin 4 doses q12h
What type of metal poisoning causes mental retardation, somnolence, convulsions, and encephalopathy?
Which antimicrobial agent is used with pyrimethamine to treat toxoplasmosis?
What β-blocker is also a membrane stabilizer?
What is the treatment for nephrogenic diabetes insipidus induced by lithium?
What glycoprotein allows platelets to adhere to von Willebrand factor?
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • sis
H 2
Are the following responses associated with histamines H1 or H2 receptor activation? • SA nodal activity
Suprachiasmatic nucleus
What nucleus of the hypothalamus receives visual input from the retina and helps set the circadian rhythm?
Bact meningitis (kids)
Strep pneumoniae or N meningitidis
what vitamin deficiency can prolonged antibiotic use cause?
vit K
what is the Rx for epidural hematoma?
what is cor pulmonale?
right ventricular enlargement, hypertrophy, and failure 2/2 lung disease. COPD, PE
MOA: prevents NE & dopamine from getting packaged into vesicles, then degraded by MAO & thus no extra-cellular effect, used for HPTN
Arnorld Chiari formation
cong herniation of cerebellar tonsils and vermis through Foramen magnum , may compress medulla or cervical cord
What drug can be given during an upright tilt table test
What is the name of the bullet-shaped virus?
What CD4 T-cell receptor does the HIV virus bind to?
Vitamin D3
What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate reabsorption
What is the most common one? • Pancreatic islet cell tumor
Middle meningeal artery
Name the cerebral vessel associated with the following vascular pathologies. • Epidural hemorrhage
Myasthenia gravis
What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities, red cell aplasia, and muscle weakness?
What herpes virus is associated with Kaposi sarcoma?
Xanthine oxidase
What enzyme requires molybdenum as a cofactor?
Filiform papillae
What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
Transcortical aphasia
Name the aphasia based on these characteristics: • Lesion in the prefrontal cortex; inability to speak spontaneously; unimpaired ability to repeat
The vagina
What area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen?
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal rami?
holosystolic murmur,most freq cause
VSD, tricuspid regurgitation, mitral regurgitation
what causes type III hypersensitivity?
immune complex from antigen-antibody
serum sickness
lupus, RA, polyarteritis nodosa, cryoglobulinemia glomerulonephritis
what psych disorder in kids is expressionlessness in social situations?
selective mutism
what is concernting about lochia that may make you think of endometritis
foul smell
what is malignant hyperthermia?
general anesthesia; succs or halothate
treat with dantrolene
MOA: ACEI for all pts, anti-HPTN of choice for DM, reserved 4 pts 4 whom diuretics or beta-blockers r unsuccessful, more potent, long T1/2; ADRs: dry cough, rash, fever, altered taste, hypoTN, hyperkalemia, angioedema & 1st dose syncope, not 4 pregnancy
How does HRT affect dementia
Doubles the risk of dementia
What is better, mastectomy or breast conserving surgery + radiation
They are equal
Left homonymous hemianopsia
Name the ocular lesion; be specific. • Right calcarine cortex lesion
Tensor tympani
What muscle of the middle ear is innervated by the mandibular division of CN V?
Nigrostriatal pathways (basal ganglia)
Movement disorders are associated with what dopamine pathway (what part of the brain)?
Staphylococcus saprophyticus
Name the most common type or cause. • Urethritis in a young, newly sexually active individual
Being awake
Name the stages of sleep with these EEG patterns: • Alpha waves
What AD disorder due to a mutation in fibroblast growth factor receptor 3 results in normal-size vertebral column and skull and short, thick extremities?
Paget disease of the breast
What breast pathology involves malignant cells with halos invading the epidermis of the skin?
cold water in the ear goes towards or opposite?
when do you suspect wilm's tumor?
flank mass
palpable kidneys
MOA: unknown, used to reduce RF & when gold has failed or is too toxic, chelate heavy metals & tx heavy metal poisoning; ADRs: dermatitis, nephritis, aplastic anemia (bone marrow suppression)
If patient suspected to have STD chlamydia fails Azithro, what other bug should you consider
Metronidazole to cover Trichomonas
Liver, kidney, and GI epithelium
What are the three glycogenic organs?
Ventral lateral nucleus
Name the thalamic nucleus based on its input and output. • Input from globus pallidus and the cerebellum; output to the primary motor cortex
Levator palpebrae superioris
What muscle is most superior in the orbit?
Down syndrome (trisomy 21)
Name the most common one. • Chromosomal disorder
Transient ischemic attack
What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
alpha-Cells; glucagon has stimulatory effects on -cells and inhibitory effects on -cells.
What pancreatic islet cell secretes glucagons?
Increase in erythropoietin and increase in 2, 3-BPG, also called 2, 3-diphosphoglycerate (2, 3-P2Gri) (increase in glycolysis)
What two compensatory mechanisms occur to reverse hypoxia at high altitudes?
Berger d/s
Ig A nephropathy , MC form of Primary GN
how do you diagnose ZE?
gastrin serum
secretin if gastrin not indicative
what are basal epithelial cells in vaginal discharge a symbol of?
atrophy of the vagina
how do you treat viral rhinitis?
rhinovirus, influ, paraflu, coxsacki, adeno, RSV, etc. Treat symps
What is a hand elevation test
In carpal tunnel syndrome, the symptoms are worse when patient lifts hands over head
Lateral part of the hemispheres
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Is involved in motor planning?
Succinylcholine and halothane (Treatment is with dantrolene.)
What two drugs, when mixed, can lead to malignant hyperthermia?
Helicase (requires ATP for energy)
What DNA replication enzyme breaks the hydrogen bond of base pairing, forming two replication forks?
2 ATPs by oxidative phosphorylation
How many ATPs are produced from cytoplasmic NADH oxidation using the glycerol phosphate shuttle?
Ostium secundum defects
What is the most common one? • Type of ASD
Formal operations (> 12 years)
At what stage of cognitive development (according to Piaget) do children • Have abstract thinking?
2 to 4 hours
How long is the transit time through the small intestine?
False. The gallbladder does not produce bile, but it concentrates bile via active sodium transport; water follows the sodium.
True or false? The gallbladder functions to produce bile.
Dendrites receive information, whereas axons send information.
What part of a neuron receives information?
What is the difference between Physostigmine and Pyridostigmine?
Physostigmine is used to treat glaucoma, and it crosses the BBB. Pyridostigmine is used in the treatment of myasthenia gravis.
what causes EMG to show fascics or fibs at rest?
lower motor neuron lesion
what are the characteristics of a thyroglossal duct cysts?
midline, elevate with tongue protrusion
What is next test if patient has unilateral nipple discharge
Mammogram, especially if guaic positive
gamma and delta chains
What are the two chains of the TCR that are mainly found on the skin and mucosal surfaces?
Papillary carcinoma of the thyroid
What is the most common one? • Malignant thyroid tumor
Increased androgen secretion at puberty drives the increased GH secretion.
During puberty, what is the main drive for the increased GH secretion?
IL-8 (IL-1 and TNF-gamma also)
What is the name of the major chemotactic agent released from • Macrophages?
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
What type of hypersensitivity is a T cell-mediated response to Ags that are not activated by Ab or complement?
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
What are the four functions of saliva?
Planning and fine-tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember, the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
What is the function of the cerebellum?
what is the classic definition of scabies?
tunnels into skin, leaves visible burrows on the skin, finger web spaces and flexor surface of the wrists
what are the signs of TE fistula?
resp compromise with feedings, asp pneumonia inability to pass NG tube
How do you know syncope is vasovagal
N, dizziness, pale, sweaty prior to episode
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
Calcium influx secondary to slow channel opening
What triggers phase 0 of the action potential in a ventricular pacemaker cell?
Meningocele All except occulta cause elevated-fetoprotein levels.
Name the form of spina bifida. • Meninges project through a vertebral defect
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
What happens to flow and pressure in capillaries with arteriolar dilation? Arteriolar constriction?
CD8+ T cells (cytotoxic) Remember, 8×1=8 (CD×8×MHC class I=8); 4×2=8 (CD×4 MHC class II 8)
What subset of T cells recognizes the MHC class I Ags?
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
What are two causes of diffusion impairment in the lungs?
It increases Ca2+ excretion from the kidney and increases bone mineralization.
What are the two actions of calcitonin?
Alcohol and its related problems cost the country approximately $100 billion a year.
What is the costliest health care problem in the United States?
what is the interaction between dig and serum K?
dig pts are very sensitive to K.
None; they are the storage sites for ADH and oxytocin.
What hormones are produced in the median eminence region of the hypothalamus and the posterior pituitary gland?
Osteoblasts, which in turn stimulate osteoclasts to break down bone, releasing Ca2+ into the interstitium. (Remember, blasts make, clasts take.)
What cell type of the bone has PTH receptors?
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used, cutting the rate from 20% to 10%.
What drug is being given to HIV-positive mothers during labor and to the children after birth to decrease the risk of mother-to-child HIV transmission?
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
ADH is secreted in response to what two stimuli?
if acute pyelo does not resolve, what is needed?
US to look for abscess or stone
How do bisphosphonates lower Ca levels
By keeping it in the bone, but this is minimal
False. It is a passive process due to decreased sex hormones.
True or false? Menstruation is an active process due to increased gonadal sex hormones?
When do you follow thyroid nodules with ultrasound on a yearly basis
If nodule less than 1 cm. If it is greater than 1 cm, do FNA now
(MA/CA) x 100 = IQ score, where MA = mental age and CA = chronological age
What is the formula to calculate IQ?
Hemophelia A causes what lab test to be different?
prolonged PTT, low levels of 8, nl PT, bleeding time
The sensory limb is via CN IX, and the motor limb is from CN X.
Which CNs act as the sensory and motor components of the gag reflex?
continuous machinery murmur
breast tumor (benign)
MC Treatment for Chlamydia
Nephrotic $ MC
memb GN
Treatment of opioid withdrawal symptoms
Methylating uracil produces what pyrimidine base?
What T-cell surface projection recognizes and reacts to foreign Ags (presented by APCs)?
Yersinia pestis
What small coagulase-positive, gram-negative rod with bipolar staining is a facultative intracellular parasite resulting in buboes?
what are hallenhorst bodies?
cholesterol particles
MOA: non-selective alpha-blocker used in HPTN crisis & dx of pheochromocytoma; ADRs: orthohypoTN, reflex tachy, vertigo & decreased ejaculation
tram track appearance on LM
membranoproliferative GN
First test of blunt cardiac injuries
What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA?
Clostridium botulinum
Which gram-positive bacteria infection of infancy is associated with ingestion of honey?
Dimercaprol, D-penicillamine
Name the antidote. • Arsenic
True or false? Acetaminophen has analgesic and antipyretic activities but lacks anti-inflammatory effects.
Protein A
What Staphylococcus aureus protein inhibits phagocytosis?
Wiskott-Aldrich syndrome
What X-linked recessive immune disorder is characterized by recurrent infections, severe thrombocytopenia, and eczema?
What Ig prevents bacterial adherence to mucosal surfaces?
Lead poisoning
What metal poisoning produces microcytic anemia with basophilic stippling?
What disorder is associated with spider angiomas, palmar erythema, gynecomastia, testicular atrophy, encephalopathy, abnormalities in clotting factors, and portal HTN?
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Window period
Niemann Pick d/s
potentially fatal sphingomyelinase deficiency causing sphingomyelin deposition in brain and other organs , cherry red macula spot and neurological problems
when do you think of DVT?
inherited condistions
MOA: anti-tumor necrosis factor agents used only for severe inflammatory conditions like leprosy, HIV-assoc skin lesions & multiple myeloma; ADRs: tetratogenic thus women need to have - preggers test or take PO contraceptives prior to taking mediation
crenitism , most freq cause
I2 deficiency, hypothyroidism
What is Turcot's Syndrome
FAP + Brain tumor
- corticosteroid therapy
- excess ACTH secretion by pituitary
Cushing's syndrome
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Liver
What slow-growing CNS tumor in 30-to 50-year-old patients with a long history of seizures has fried egg cellular appearance in a network of chicken wire?
Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?
Graves disease
What disorder leads to IgG autoantibodies to the TSH receptor?
Copper deficiency
What mineral deficiency involves blood vessel fragility?
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Lateral ventricles
Goodpasture syndrome
What type II hypersensitivity disorder is defined as • Autoantibodies against the type IV collagen in the basement membrane of the kidneys and lungs?
Variable interval
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • Varying in time?
palpable purpura on legs and buttocks
Henoch-Scholein purpura
who should get Ca channels?
raynaud, atrial tachys
What manifests as decreased reflexes, fascics, atrophy?
LMN disease
Uses:antiemetic b/c - D2 receptors in medulla,tranquilizers;ADRs:antimuscarinic cause blurred vision,xerostomia,sedation,confusion,constipation & urinary retention,also cause orthostatic hypoTN,poikilothermia,increased prolactin release,some tolerance
What is spondyliosthiasis
Anterior slippage of the vertebral body
may sometimes be associated with ALL/AML
Philadelphia chromosome
t(9;22) (bcr-abl)
Gastric carcinoma
A Japanese man has weight loss, anorexia, early satiety, epigastric abdominal pain, and a palpable left supraclavicular lymph node. On endoscopy you find a large, irregular ulcer with elevated margins on the lesser curvature of the stomach. What is your diagnosis?
Phase 1
Name the phase of the ventricular muscle action potential based on the following information: • Slight repolarization secondary to potassium and closure of the sodium channels
What is the most common one? • Malignant germ cell tumor in women
Gaucher disease
What is the most common lysosomal storage disorder?
Name the most common type or cause. • Nephritic syndrome in adults
Are the following major or minor Jones criteria of rheumatic fever? • Pericarditis
Are the following major or minor Jones criteria of rheumatic fever? • Fever
Vitamin D
What causes an increase in bone mineralization and Ca2+ along with PO4- absorption from the GI tract and kidney tubules?
Common peroneal nerve
What lower extremity nerve is described by the following motor loss? • Loss of eversion; inversion, dorsiflexion, and plantarflexion of the foot
Substantia nigra
In Parkinson's disease, what area of the basal ganglia has a decreased amount of dopamine?
Clostridium perfrigens
Gas gangrene is associated with which Clostridium species?
What Ig is associated with ADCC for parasites?
patient with AML MC age group
adults > 60
What is Job syndrome?
recurrent bacterial infections, high IgE, skin infections
What changes HDL
increased by moderate alc, exercise, egens
lowered by smoking, androgens, progesterone, hyperTG
Criggler Najjar $
mild (type 2) to life threatening (type 1) ; cong unconjugated hyperbilirubinemia
If a pt alleges another sexually harrassed her, who do you tell
The medical board
Left abducens nerve
Where is the lesion that produces these symptoms when a patient is asked to look to the left? • Left eye can't look to the left
PR interval
What component of an ECG is associated with the following? • Conduction delay in the AV node
Medial medullary syndrome
What syndrome is associated with the following brainstem lesions? • Vertebral artery or anterior spinal artery occlusion, resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
Thiogalactoside transacetylase
Regarding the Lac operon, for what do the following genes code? • A gene
Inspiratory capacity
Name the lung measurement based on the following descriptions: • The maximal volume inspired from FRC
The reduviid bug
What is the vector for Chagas disease?
pneumonia in CF , burn infection most freq cause
Pseudomonas aeruginosa
what is the best choice for head trauma?
non-contrast CT
how does pH affect Ca?
alk-> hypoCa (shifts Ca intracellularly)
hyperventilation, anxiety
MOA: 1st line drug for HPTN, block Na in the DCT used for CHF & chronic renal failure; ADRs: dont use in DM & hyperlipidemia, causes hypokalemia, hypercalcemia & hyperuricemia
How can you differentiate aspiration pneumonia from aspiration pneumonitis
Aspiration pneumitis patients usually present after recurrent vomiting and they are obtunded. Don't treat with abx
Alveolar dead space
What is the term for ventilation of unperfused alveoli?
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
What disconnect syndrome results from a lesion in the corpus callosum secondary to an infarct in the anterior cerebral artery, so that the person can comprehend the command but not execute it?
Renal cell carcinoma
Name the most common type or cause. • Painless hematuria
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Cisplatin
Metaraminol (α1, β1 )
What α1-agonist is used to treat paroxysmal atrial tachycardia with hypotension?
Tidal volume (VT)
Name the lung measurement based on the following descriptions: • The amount of air that enters or leaves the lung system in a single breath
What kind of paralysis is associated with C. botulinum? What kind of paralysis is associated with C. tetani? What kind of a paralysis is associated with Guillan-Barre Syndrome?
Botulism=flaccid decending paralysis due to ACh release blockage. Tetanus=rigid paralysis due to inhibition of GABA release. Guillan-Barre=ascending flaccid paralysis.
what are teh signs of LBO?
gradually increasing ab pain, abdominal distention, cramping, feculant vomiting (late)
what bug when stuck with a thorn?
schenckii- K or ketoconazole
What two amino acids are used in making urea?
arginine and aspartate
What is htn urgency
SBP greater than 180 and/or DBP more than 120 with no end organ damage
They prevent mast cell degranulation.
What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?
Antithyroglobulin and antimicrosomal Abs
What two Abs are used to diagnose Hashimoto's thyroiditis?
Rheumatoid arthritis and type 1 diabetes (with HLA-DR3)
What diseases are associated with HLA-DR4
Opposite the second upper molar tooth
Where does the parotid (Stensen's) duct enter the oral cavity?
Type II pneumocytes
In the alveoli, what cell type is • responsible for producing surfactant?
Adenocarcinoma (30% to 35%)
What is the most common one? • Primary malignant tumor of the lungs
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
What happens to extracellular volume with a net gain in body fluid?
Atrial contraction Atrial, Contraction, Venous
On the venous pressure curve, what do the following waves represent? • A wave?
OCPs and breast, cervical cancer
breast is increased in long term users, cervical neoplasia may be increased.
wheat meds aren't given to pts with nasal polyps?
aspirin-> severe asthma attack
Name some symptoms of hemolytic transfusion reaction
Back pain, oozing of blood after transfusion, fever, hypotension
Hypoglycemia for secretion and hyperglycemia for inhibition
What is the most potent stimulus for glucagon secretion? Inhibition?
Free hormone levels remain constant, and the bound hormone level changes with a decrease in binding hormones.
What happens to free hormone levels when the liver decreases production and release of binding proteins?
Resistance and vessel length are proportionally related. The greater the length of the vessel, the greater the resistance is on the vessel.
How are resistance and length related regarding flow?
Hypoactive sexual desire disorder
What is the term for a deficiency or absence of sexual fantasies or desires?
True. They inhibit DNA gyrase (topo II).
True or false? Fluoroquinolones are bactericidal.
How do you tell Staph from Strep?
Catalse test (Staph are positive, Strep are negative)
what elements would steer you away from MI?
<40, unless mad risks.
no risk factors
reproducible by pain, not sharp or well locallized. not related to foods
when is lumbar puncture contraindicated?
if acute head trauma or igns of ICH.
What is treatment for syphilis with duration of less than 1 year
B PCN G IM x 1 dose
True. They are also necessary for normal brain maturation.
True or false? Thyroid hormones are necessary for normal menstrual cycles.
Compliance (think of it as distensibility)
What is the term to describe how easily a vessel stretches?
Odds ratio. (Case control studies deal with prevalence.)
What statistical method do you use when analyzing • Case control studies?
False. Risk of breast and endometrial cancer but not ovarian cancer increases with the use of estrogen.
True or false? Estrogen use increases the risk of developing ovarian cancer.
. Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUPS DAKRI is the mnemonic, everything else is covered with peritoneum
Name the 10 retroperitoneal organs.
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed, thereby increasing the secretion of prolactin.
Why is there an increase in prolactin if the hypothalamic-pituitary axis was severed?
28 L, 40% of body weight
What is the amount in liters and percent body weight for the following compartments? • ICF
what are teh signs of strangulation in SBO?
tenderness, guarding, no bowel sounds, SIRS, met acid
What are criteria for DKA resolution
Glc less than 200, gap less than 12, HCO higher than 18, patient taking PO
True. Remember, all nucleated cells (and platelets) have MHC class I Ags, and RBCs are not nucleated.
True or false? RBCs do not have MHC class I Ags on their surface.
what are common causes of htn in young peeps?
alcohol in men
ocps or fibromuscular dysplasia in women
Decreased REM sleep and REM rebound during withdrawal
How is sleep affected in a person with alcohol intoxication?
G1 phase; G2 and S phase are diploid (2N).
What phase of Interphase is haploid (N)?
cDNA libraries are derived from mRNA, are continuous, and contain no introns or regulatory elements.
What type of DNA library is made from the mRNA from a tissue expressing a particular gene?
14 days in most women (Remember, the luteal phase is always constant.)
How many days before the first day of menstrual bleeding is ovulation?
61 codons code for AAs and 3 codons (UAA, UGA, UAG) code for the termination of translation.
How many codons code for AAs? How many for termination of translation?
post-flu PNA
Vit A helps
Varicella zoster
Dermatomal distribution.
dysthymic disorder duration
>2 years
odd/eccentric behavior, magical thinking
esophageal cancer
Barrett's/smoking- adenocarcinoma. Smoking/alcohol- squamous cell carcinoma
confusion, somnolence, seizures, coma
CO poisoning
carboxyhemoglobinemia. Polycythemia, nausea, dizziness, HA
hyperglycemia, necrolytic migratory erythema, diarrhea/weight loss. Usually malignant. Dx- elevated fasting glucose and glucagon, pancreatic mass on CT. Tx- surgery, not responsive to chemotx
tinea corporis tx
topical terbinafine
fungal keratitis
multiple stromal abscesses
Stasis, hypercoagulability, endothelial damage
Virchow's triad.
Treatment for opioid overdose.
autosomal recessive. bronze DM, hepatomegaly, arthropathy, restrictive heart failure, cardiac conduction problems, hypogonadism, HCC. Dx- iron studies, liver bx to confirm
gastrinoma (often in pancreas). Multiple duodenal ulcers, jejunal ulcer, prominent gastric folds, inactivation of pancreatic enzymes, malabsorption. Dx- fasting serum gastrin, secretin stimulation test if uncertain (increases gastrin in Z-E)
wernicke's encephalopathy
thiamine deficiency. Triad- encephalopathy, oculomotor problems, ataxia
presynaptic membrane damage (voltage gated Ca channels), hyporeflexia, strength increases with repetition. Associated with small cell carcinoma of lung
lithium SE
nephrotoxic (DI), hypothyroid, teratogen (Ebstein's anomaly - right heart defect)
triad- flushing, diarrhea, wheezing. Serotonin. Tx- surgery, octreotide
primary adrenal failure. Potential causes- TB, granulomatous diseases. Nonspecific Sx- anorexia, fatigue, GI, weight loss, hyperpigmentation, hypotension, vitiligo. Low Na, high K, high Cl, acidosis, eosinophilia. Dx- cosyntropin (ACTH analogue) stimulation test. Tx- hydrocortisone
conductive hearing loss. Stapes footplate fixed to oval window.
anticholinergic sometimes used for Parkinson's in younger patients with tremor as primary symptom.
Combined UMN and LMN disorder.
AML subtype associated with DIC.
chronic pancreatits
chronic abdominal pain, pancreatic insufficiency, chronic diarrhea, possibly DM. dx- stool elastase
dumping syndrome
common postgastrectomy syndrome. Rapid emptying of hypertonic gastric contents leads to fluid shift from intravascular into small intestine. Postprandial abdominal cramps, weakness, dizzy, diaphoresis. Tx- small frequent meals without simple carbs, maybe octreotide.
3 P's - precocious puberty, pigmentation (café-au-lait), polyostotic fibrous dysplasia. Associated with other endocrine d/o's - hyperthyroid, prolactinoma, growth hormone, cushing's
cocaine vasospasm
tx- Ca-channel blocker or alpha-blocker phentolamine, NOT beta blocker. Myocardial ischemia tx- BZDs, nitrates, aspirin.
nicotinic acid
lowers trigs and raises HDL
membranous nephropathy
nephrotic, HBV, HCV, malaria, syphilis
postpartum endometritis
polymicrobial, treat with clindamycin + gentamicin
target BP in DM
<130/80. tx- ACEi
rapid rewarming with warm water immersion
weakness, fatigue, muscle cramps. Flat T waves, U waves, PVCs. Severe- flaccid paralysis, hyporeflexia, arrythmias.
flank pain, hematuria, palpable mass, non-emptying varicocele, polycythemia (from high epo). Dx- CT abdomen
X-linked recessive, factor 8/9. high PTT, normal PT, normal bleeding time, normal fibrinogen, low factor 8/9. tx- replace factor, desmopressin (causes F8 release). Hematomas, hemarthroses.
estrogen antagonist in breast, agonist in uterus/bone. Helps osteoporosis, increases endometrial cancer, uterine sarcoma, venous thrombosis
risk of cerebral vasospasm. Tx- Ca-channel blockers
S. aureus
Identify key organisms causing diarrhea: ■ Church picnics/mayonnaise
An antidiabetic agent associated with lactic acidosis.
IV benzodiazepine
First-line medication for status epilepticus.
Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs
Treatment for TTP.
Name the organism: ■ Osteomyelitis in a sickle cell patient.
Red plaques with silvery-white scales and sharp margins.
invasive in IMCD. CXR - cavitary lesions. CT - pulm nodules, halo sign, air crescent
Sudden death during MI
v-fib, a reentrant rhythm
primary dysmenorrhea
caused by high prostaglandins. Tx- NSAIDs, OCPs
Usually due to chronic infections with poor mucus clearance or IMCD. obstructive signs/symptoms, chronic productive cough, hemoptysis- sometimes massive to the point of requiring bronchial artery embolization. Dx- CT
syncopal arrythmia
Prolonged PR (sick sinus syndrome, conduction system problem) or QRS (bundle branch block): bradyarrythmia. Prolonged QT: torsades (can be caused by low Mg), tachyarrythmia.
systemic sclerosis
CREST. Pulmonary disease - most commonly interstitial fibrosis. ANA, anti-topoisomerase-I Ab.
Calcium levels
high in immobilization (tx with bisphosphanates), low in ARF due to rhabdo, low in low albumin (asymptomatic because ionized calcium normal). Alkalosis --> more calcium binds to albumin --> low ionized calcium --> hypocalcemia symptoms
lithium DI
damages renal tubules. Tx- amiloride (prevents further lithium accumulation), IVF NS if hypotensive, hypotonic fluids if normotensive
Pneumocystis PNA
dx- sputum induction with hypertonic saline (low sensitivity), BAL if sputum non-diagnostic (high sensitivity). Tx- IV bactrim, +steroids if PaO2<70
esophageal varices
screening endoscopy in any newly diagnosed cirrhosis. Prophylactic tx- beta blockers
parvovirus b19
kids - slapped cheeks, erythema infectiosum, fifth disease. Adults - viral arthritis, 2 months sx, MCP/PIP/wrists/ankles joints, normal ESR, dx- Anti-B19 IgM
central US (most in Wisconsin). Often asymptomatic or flu-like Sx. Systemic disease- lytic bone lesions, pulmonary infection, skin lesions. Dx- broad-based budding yeast. Tx- itraconazole, amphotericin B
Cirrhosis, CHF, nephritic syndrome
Differential of hypervolemic hyponatremia.
Calcium oxalate
The most common type of nephrolithiasis.
Panic disorder
A 35-year-old male has recurrent episodes of palpitations, diaphoresis, and fear of going crazy.
Term for heavy bleeding during and between menstrual periods.
RUQ pain, jaundice, and fever/chills in the setting of ascending cholangitis
Charcot's triad.
INH, penicillamine, hydralazine, procainamide
Causes of drug-induced SLE.
The most common cause of female infertility.
Diphenhydramine or epinephrine 1:1000
Treatment of anaphylactic shock.
How to diagnose and follow a leiomyoma.
most common thyroid cancer
papillary. Also best prognosis. Psammoma bodies.
women > 65yo. > 60yo if high risk
spinal cord injury
tx with high dose steroids ASAP
BV dx
3 out of 4: thin/gray/white vaginal discharge, vaginal pH>4.5, positive whiff test with KOH, clue cells
primary syphilis dx
serologic tests often false negative. Dx with spirochetes on darkfield microscopy
sickle cell trait
can cause painless gross hematuria that resolves spontaneously. Hyposthenuria/nocturia
Cold water is flushed into a patient's ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Perinatal mortality?
Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin
Treatment for acute coronary syndrome.
Streptococcus pneumoniae
Name the organism: ■ Meningitis in elderly.
Rate control, rhythm conversion, and anticoagulation
Treatment of AF.
Medication to avoid in patients with a history of alcohol withdrawal seizures.
Stasis, endothelial injury and hypercoagulability (Virchow's triad)
Risk factors for DVT.
SAH in children
usually due to AVM rupture- supported by hx of seizures and migraine-like HA
epo use
use if Hb<10. Also assess Fe stores. SE: HTN, HA, flu Sx, red cell aplasia
ascites SAAG
serum albumin -- ascites albumin > 1.1 = transudate = portal HTN
schizo positive/negative symptom tx
typicals better for positive Sx, atypicals better for negative Sx.
type 4 renal tubular acidosis
diabetic patient, non-gap metabolic acidosis, hyperkalemia, renal insufficiency. Caused by aldosterone deficiency/insensitivity.
microcytic anemia in kids
iron deficiency- RDW > 20%. Thalassemia/chronic disease - normal RDW
Factitious disorder (Munchausen syndrome)
A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
Monoclonal gammopathy, Bence Jones proteinuria, "punched-out" lesions on x-ray of the skull and long bones
A 60-year-old African-American male presents with bone pain. Workup for multiple myeloma might reveal?
Identify cause; fluid and blood repletion
Treatment of hypovolemic shock.
False. Withdrawing and withholding life are the same from an ethical standpoint
True or false: Withdrawing life-sustaining care is ethically distinct from withholding sustaining care.
Hypertrophic cardiomyopathy
A young patient with a family history of sudden death collapses and dies while exercising.
↓ protein intake, lactulose, neomycin
Medical treatment for hepatic encephalopathy.
Consider Fitz-Hugh–Curtis syndrome
A patient presents with recent PID with RUQ pain.
IV penicillin or ampicillin
Typical antibiotics for group B streptococcus (GBS) prophylaxis.
adjustment disorder
within 3 months of event, lasts < 6 months post-event. Tx- cognitive/psychodynamic psychotherapy
contraindications to breast feeding
active illicit drug abuse, active TB, HIV, HSV on breast
IV hydration and loop diuretics (furosemide)
First-line treatment for moderate hypercalcemia.
Free air under the diaphragm, extravasation of contrast, severe bowl distention, space-occupying lesion (CT), mesenteric occlusion (angiography)
Radiographic indications for surgery in patients with acute abdomen.
Pharmacologic stress test (e.g., dobutamine echo)
Appropriate diagnostic test? ■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.
transient hypogammaglobulinemia of infancy
after 6 months old, usually normal by 11 months. Low IgG, normal IgA, variable IgM
Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms)
A 21-year-old male has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking.
von Willebrand's disease; treat with desmopressin, FFP, or cryoprecipitate
A 14-year-old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or ↑ PTT, and ↑ bleeding time. Diagnosis? Treatment?
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
An elderly male with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?
Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia
The 6 P's of ischemia due to peripheral vascular disease.
1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia)
A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis.
Murphy's sign, seen in acute cholecystitis
Inspiratory arrest during palpation of the RUQ.
Widened mediastinum (> 8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus
Radiographic evidence of aortic disruption or dissection.
Treat existing heart failure and replace the tricuspid valve
IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction
A first-born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
What are the 3 avians of the human body?
thoracic duct, azagous vein, hemi azagous vein
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