USMLE world Flashcards

Standardized Tests
Terms Definitions
what virus can imitate RA?
parvovirus
Trousseau's syndrome is
migratory superficial thrombophlebitis
What vascular tumor, immunohistochemically test positive for CD 31 cell marker and the pt has been exposed to arsenic, thorotrast, or polyvinyl chloride
liver angiosarcoma
what apo is responsible for lipoprotein lipase activation?
ApoC-II
what presents with maternal virilization and newborn ambiguous genitilia?
aromatase def
Onion-like concentric thickening of the walls of arterioles is seen in
hyperplastic arteriolosclerosis
what is used to rx arsenic poisoning?
dimercaprol
what is suggested by urethritis, conjunctivitis and arthritis?
Reiter syndrome
what must be monitored before starting amiodarone therapy?
TSH
What are atheromas
lipid-filled intimal plaques tha tbulge into the arterial lumen
Takayasu arteritis occurs predominantly in what pt.
females less than 40
What lesions histologically appear as sharply circumscribed areas of congested capillaries and post-capillary venules in the papillary dermis in adults?
Cherry hemangiomas
Venous states ulcers very commonly occur over
medial malleolus
giant cell arteritis tends to develop in pt. over the age of
50
what does low C1 esterase inhibitor levels lead to?
increased bradykinin
what apo is responsible for LDL uptake by by extrahematic cells?
apob100
What dz. begins /w vasa vasorum endarteritis and obliteration, resulting in inflammation , ischemia and weakening of the adventitia.
Tertiary syphilis
Hyperplstic arteriolosclerosis most commonly affects arterioles in what tissue
kidneys, retinas, and intestinal arterioles
Which disorder is has acute and chronic inflammation of the arterial walls, often /w thrombosis of the lumen, which cna undergo organization ant recanalizaiton.
Thromboangiitis obliterans
Medial band-like calcification are characteristic of
Monckeberg's medial calcific sclerosis
what reaction is vit B2 important for?
succinate to fumarate
what is suggested by joint pain and pruritic skin rash with fibrinoid necrosis and neutrophil infiltration in arteries and small arterioles?
serum sickness
what is suggested by floppy baby with poor feeding, gaunsice, mecroglossia and umbilical hernia?
congenital hypothyroidism
CD 31 is what?
A PECAM1 (platelet endothelial cell adhesion molecule)a marker for vascular endothelial cells
What dz. is characterized by segmental fibrinoid necrosis of the small vessels (arterioles, cap, venules)
Leukocytoclastic vasculitis (microscopic polyangiitis, microscopic polyarteritis, hypersensitivity vasculitis)
What are pyogenic granulomas
a rapidly growing, exophytic red nodules attached by a stalk to the gingival or oral mucosa or skin. They bleed easily and may be ulcerated.
What lesion is a polypoid form of capillary hemangioma
pyogenic granulomas
Severe, complicated intimal atheromas can destroy and weaken the underlying media, resulting in aortic aneurysms. The most common site of these lesions; however, is
abdominal aorta- specifically, below the origin of the renal arteries.
What lesion consist of a bright red central papule surrounded by several outwardly radiating vessels. They occur due to dilation of a central arteriole and its superficial cap. network and are estrogen-dependent
Spider angiomas
When there is cutaneous involvement in langerhans cell histiocytosis, Pt. present /w
erythematous papules
nodules
scaling plaques
A tumor of antigen-processing cells would be either a?
histiocytosis or a lymphoma
What causes hyperplastic arteriolosclerosis
laminated smooth muscle cells and reduplicated basement membranes. It can result from malignant hypertension (diastolic pressures >120-130 mm Hg)
Medial degeneration is characterized by
fragmentation of elastic tissue + separation of the elastic and fibromuscular components of the tunica media by small, cleft-like spaces. Medial degeneration is the most frequent histopaht abnormality (other than an intimal tear = aortic dissections
Takayasu arteritis typically affects what vessels?
Aortic arch, though there is involvement of the remainder of the aorta and its branches (including coronary and renal arteries) in 1/3 pt.
Which disorder is commonly seen among heavy cigarette smokers, which an onset prior to the age of 35
Thromboangiitis obliterans (Buerger's disease)
Takayasu arteritis and temporal arteritis involve arterial vessels of different sizes and locations how/where?
(aorta and proximal aortic arterial branch involvement versus more distal carotid artery branch involvement, respectively
what is synthesized in the nucleolus and by what
rRNA by RNA pol I
What is Phlegmasia alba dolens
Painful white leg, "milk leg" a consequence of iliofemoral venous thrombosis occurring in peripartum women
what is suggested by mosaic bone pattern?
Paget's disease of bone (osteitis deformans)
Why are medial band-like calcifications palpable on physical exam but asymptomatic
/b they do not narrow the vessel lumen
What is the main mechanism by which LDL is cleared from the circulation
Receptor-medicated uptake by the liver
What is used to prevent pulmonary emboli after surgery
low-dose heparin an anticoagulant that acts by binding to antithrombin III
what causes phlegmasia alba dolens
venous stasis due to the pressure of the gravid uterus on deep pelvic veins and the hypercoagulable state inherently present during pregnancy can result in deep venous thrombosis
Test
Answer
Clavulanate
B-lactamase inhibitors
CONTRACTILITY
catecholamines (sympthathetics), digitalis increase heart...
Cyproheptadine
Serotonin syndrome treatment.
Treatment for bradycardia
Atropine
low neck dermatome
C4
portal hypertension (parasite)
Schistosoma mansoni
Painful tibial tuberosity
Osgood schlatter
Nicardipine
Dihydropyridine calcium channel blocker for hypertension and angina. SMC contraction depends (dipines!) on calcium
Mesna
Fights drug-induced hemorrhagic cystitis.
Marker for drug-induced lupus
Anti-histone
postherpetic neuralgia tx
TCA (amitriptyline)
S4
contraction against stiff ventricule (ventircular hypertrophy); late in diastole
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies
ZAFIRLUKAST/MONTELUKAST/ZILUETON
competitive inhibitor of leukotriene inhibitor; lipoxygenase inhibitor which prevents leukotriene production; used for maintenance tx of asthma
Metalloproteinases
Secreted by macrophages
Dissolve clots by degrading collagen
1st line treatment for GBS
Plasmaphoresis
-flurane
General anesthesia, unknown mechanism of potentiating GABA. Maintenance.
Allopurinol
Xanthine oxidase inhibitor. Iinhibits catabolism of purines into uric acid to reduce uric acid levels in gout. Only for prophylaxis. May cuase rash,
Eprostanol
Prostaglandin I. Pulmonary artery hypotension that relaxes SMC.
Edrophonium
AchE inhibitor used for treatment/diagnosis of myasthenia gravis, emergence from NMJ blocks (competitive only). Causes muscarinic effects that should be treated with atropine
CD marker for macrophages?
CD 14
What HIV drug causes pancreatitis
didanosine
Function of lateral hypothalamic nucleus
Hunger
Hemidesmosome
connects cells to underlying extracellular matrix
AORTIC REGURG
immediate high pitched diastolic murmur (blowing); wide pulse pressure
Pancreatic, pituitary, parathyroid tumors
MEN 1 (Wermer's)
What is treatment for apthous ulcers
Prednisone
Buerger's Disease
present w/ intermittent claudication, superficial nodular phlebitis, cold sensitivity, severe pain, gangrene
Most important risk factor for osteoporosis
Age
Neuroblastoma is associated with what gene translocation
N-myc
Citalopram
SSRI. Used for depression, OCD, anorexia nervosa, bulimia, fibromyalgia, panic attacks, PMDD, phobia. May cause sexual dysfunction.
Phenoxybenzamine
Alpha blocker. Hypertension caused by pheochromocytoma. Causes postural hypotension. Phen=pheochromocytoma
Gabapentin
Potentiates GABA. Used for partial seizures, chronic pain, migraine prophylaxis.
Naproxen
NSAID. Used for moderate pain, antipyretic, and inflammation. Bleeding risk
Bumetanide
Blocks Na/2Cl/K transporter in TAL. Good for relief of CHF symptoms, edema, hypercalcemia (blocks paracellular calcium reabsorption), hypertension. Can cause hypocalemia, metabolic alkalosis (increase distal K load, which increases H excretion), hypocalcemia.
Propofol
GABA potentiation. IV anesthesia with very rapid onset. Can cause bradycardia and hypotension.
Findings in infectious myringitis
Vesicles on TM
Treatment of IHSS
B blockers or CaCB
Does the Gestational DM screen requiring fasting?
No
Test of choice for Transverse Myelitis
MRI
Alkaptonuria has deficiency of what?
homogentisic oxidase
Lithium level > 4. How tx?
dialysis!
Most common location of coronary artery occlusion
LAD
Male homologue of vestibular bulbs
corpus spongiosum
RRP
action potential can be initiated, but requires more current than NL
MURMUR
ejection into a dilated chamber will result in a
Situs inversus, chronic sinusitis, bronchiectasis, infertility
Kartagener's syndrome (dynein)
aortic dissection
presetn w/ tearing chest pain radiating to the back , widened mediastinum on CXR, can result in rupture and death
MCC of Catheter Assoc Infections
Coag Neg Staph
What injury causes foot drop
Peroneal nerve injury
Treatment of nephrogenic DI
Hydrochlorthiazide or indomethacin. Increases water reabsorption at proximal tubule
Gag Reflex.
Afferent (sensory)?
Efferent (motor)?
Afferent (sensory): Glossopharyngeal (IX)
Efferent (motor): Vagus (X)
Misoprostol
Prostaglandin E. Makes you ALL man. Used for ED and maintaining PDA. Prostaglandin E used in GERD.
Exudative effusions with high lipid content, most commonly related to trauma and malignancy?
chylous effusions
What is MC complication of scaphoid fracture
Non-union
Treatment for borderline personality d/o
Dialectical Behavior Therapy
What drug is protective in colon cancer
NSAIDs
What does a DW-1 MRI show
Dying tissue
Cardiac drugs causing increased K
ACE-I, ARBs, Spironalactone
Which drugs are associated with tendon rupture and arthropathy in children?
Fluoroquinolones
Infant has bronchilitis, atypical pneumonia, wheezing...?
Respiratory Syncytial Virus
anticholinergic overdose
hyperventilate to increase pH, since this
Lower border of spinal cord in adults
L1-L2
Umbilical artery contents
de-oxygenated blood from iliac vessels
Desquamated epithelium casts in sputum
Curschmann's spirals (bronchial asthma, can result in whorled mucous plugs)
Hereditary nephritis, sensorineural hearing loss, cataracts
Alport's syndrome (type IV collagen)
Treatment for neurosyphilis
PCN G IV for 2 weeks
HLA-B27
1) Conjuctivitis & Uveitis
2) Urethritis
3) Asymmertric Acute Arthritis
4) Sacroiliitis
Pathology of Reiter's Syndrome
Name 2 SE of Ginseng
Stevens Johnson and psychosis
What is irradiated blood
Prevents GVHD by killing lymphocytes
MC presenting symptoms of PML
Speech difficulties, hemiparesis, vision probs and ataxia
Anterior spinal artery (medial medullary syndrome) symptoms?
Contralateral lower hemiparesis, decreased contralateral propioception, and tongue deviates to side of lesion (because of CN XII lesion)
B-thallasemia major (homozygote) is when the b-chain is absent. this requires blood tranfusions...what is the risk?
hemochromatosis from blood transfusions because of the iron overload.
-iron deposition in the heart can lead to CHF. look for breathing problems and edema
What drug should you never use in acute gout attacks
Allopurinol
What is used for prevention of cluster headaches
Verapamil
How does dopamine affect prolactin production
It suppresses it
What family is RSV from? Characteristics?
Paramyxovirus
Negative sense ssRNA
Type III collagen
reticulin - skin, blood vessels, uterus, fetal tissue, granulation tissue
Brachial plexus injury leading to wrist drop
Posterior cord (C7)
Unilateral facial drooping involving forehead
Bell's palsy (LMN CN VII)
4th aortic arch
on lwdt, aortic arch, on right proximal part of right subclavian artery, superior laryngeal nerve
3 Causes of Hypercalcemia
Malignancy (very high levels), Vitamin D induced, Primary hyperPTH
Markers for chronic Hep B infection
HBsAg, anti-Hbe, IgG Anti-HBc
Treatment of Torsades
MgSO4 or defib or temporary overriding pacemaker
DIC is associated with which type of shock?
Septic Shock
Valproic Acid
Fatty acid that increases GABA and Na inhibitor. May cause hepatotoxicity. Seizures (absence AND tonic-clonic!), migraine prevention, mood stabilizer.
Big clue to carotid artery disseciton
Horner's syndrome + Syncope
How do you diagnose bone metastases in prostate cancer
Bone scan
2 ECG findings for pericarditis
PR depression, diffuse ST elevation
What is worst lab test finding in patients with PE
Increased troponin
Dz has Increase LH, Decreased FSH, Increased Testosterone, and cystic follicles in ovary
Polycystic Ovarian Disease
Pheochromocytoma1. triad of sx2. how tx
1. headache, palpitations, diaphoresis. Elevated bp during these episodes of course. 2. adrenalectomy, but first give alpha-blocker (phenoxybenzamine) to prevent hypertensive crisis in surgery.
Left horn of sinus venosus gives rise to
coronary sinus
Periosteum raised from bone, creating triangular area
Codman's triangle on X-ray (osteosarcoma, Ewing's, pyogenic osteomyelitis)
What has migratory necrotizing skin erythema
Glucagonoma (Hyperglycemia will also be present)
Type IIa muscle fibers
Use aerobic metabolism and mix between I and II
A known complication of bacterial endocarditis?
brain abscesses. seen as ring-enhancing lesions on CT.
What is best way to predict severity of pancreatitis
APACHE II score
How do you diagnose Lyme Disease arthritis
ELIZA of synovial fluid
If patient suspected to have STD chlamydia fails Azithro, what other bug should you consider
Metronidazole to cover Trichomonas
Mechanism of Phentolamine?
antagonist at both alpha 1, alpha 2 blockers.
correction of Na for hyperglycemia
1.6 for every 100 above 100
venous drainage below pectinate line
inferior rectal vein --> internal pudendal vein --> internal iliac vein --> IVC
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer Wright rosettes (adrenal neuroblastoma, medulloblastoma, Ewing's sarcoma)
What is htn emergency
DBP more than 120 with end organ damage
Name 2 diseases that can cause bone marrow expansion because of trying to compensate for ineffective erythropoesis
-Sickle-Cell and Thalassemia major.
'crew cut' on x-ray is bone deformities of bone marrow expansion.
How long is HIV prophylaxis after a sexual encounter
4 weeks (2 drugs)
What is treatment for aortic regurg
Afterload reduction (ACE I or vasodilators)
Describe symptoms of medial medullary syndrome
Spastic paralysis + vibratory and sensory loss on same side + tongue deviates to opposite side
Where does Celiac Dz cause villous atrophy?
Small intestine (duodenum and jejenum)
uncal herniation on right side, what eye exam look like?
fixed and constricted on left
High level of D dimers
DVT, PE, DIC, Budd-Chiari (D dimer is fibrin breakdown products)
What arrhythmia is adenosine good for and why?
SVT because it increases vagal tone
Drug that binds to IgE? It's Mechanism?
Omalizumad: binds to human IgE inhibiting the binding of IgE with fc receptors of mast cells.
Used as prophylaxis in asthma.
How do you treat folate deficiency from methotrexate
FolINIC acid, not simply folate acid
What is treatment of cocaine induced MI
IV lorazepam and phentolamine with angiography
Where is the earliest and severely affected areas of Alzheimers?
Hippocampus. Involved in learning and memory.
Vasculitis types by vessel size
large - giant cell arteritismedium - Polyarteritis nodosa - kawasakiSmall vessel- Churg Strauss (pANCA eosinophilia, asthma, nephritic syndrome)- Wegener's (cANCA, resp. mainly, eye, skin, nerve, upper resp. tract, kidneys)- HSP
When do you treat a person with subclinical hypothyroidism
1. antithyroid antibodies, 2. abnormal lipids, 3. Symptoms of hypothyroidism, 4. menstrual dysfunction
Atypical cells you will see in EPV?
Downey Cells Type II.
(these are atypical CD8+ cytotoxic cells)
What should you think of if HIV pos patient has focal neurologic signs? What test do you run?
PML and diagnose with MRI
What are some symptoms of renal cell cancer
Mass, polycythemia, flank pain, h/o smoking
What is risk of giving person packed RBCs who is hypovolemic or hypothermic
Hypocalcemia, so give them calicum if they start seizing
Clue for lumbar stenosis and how do you diagnose
Pain with spine extension. First test is MRI
When do you test for cure of H Pylori
4-6 weeks after treatment completion with a urea breath test
What blood type are most at risk for ABO incompatibiity
O type (both a and b antibodies)
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
length of time for fluoxetine to achieve steady-state
at least 5 weeks, up to 6-8 weeks in many people
If the TB is resistant to TB, then what is the next drug you use for treatment of latent TB
Rifampin for 6 mos in kids, 4 mos in adults
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