Misc - Usmle Step 1

Front 1

Intoxication of alcohol

Back 1

-emotional lability, slurred speech, ataxia, coma, blackouts

Front 2

Sensitive indicator of alcohol use?

Back 2

serum gamma-glutamyltransferase (GGT)

Front 3

Treatment for alcohol intoxication?

Back 3

naltrexone, disulfram

Front 4

Withdrawal from alcohol?

Back 4

-tremor, tachycardia, hypertension, malaise, nausea, seizures, delirium tremens (DTs), tremulousness, agitation, hallucinations (including tactile)

Front 5

treatment for delirium tremens?

Back 5

benzodiazepines

Front 6

opoid toxicity? (morphine, heroin, methadone)

Back 6

CNS depression, N/V constipation, pupillary constriction, seizures (overdose is life-threatening)

Front 7

treatment of opoid toxicity?

Back 7

naloxone, naltrexone

Front 8

Withrdawal symptoms of opoids?

Back 8

Anxiety, insomnia, anorexia, sweating, DILATED pupils, piloerection ("cold turkey"), fever, rhinorrhea, nausea, stomach cramps, diarrhea ("flulike"), yawning

Front 9

tx of withdrawal from opoids?

Back 9

symptomatic, naloxone + buprenorphrine (suboxone), methadone

"buprenorphrine helps you when you get BUsted from using opoids"

Front 10

Intoxication from Barbituates?

Back 10

-Low safety margin
-respiratory depression

Front 11

tx for intoxication of barbituates?

Back 11

symptom management (assist respiration)

Front 12

symptoms of withdrawal from barbituates?

Back 12

Anxiety, seizures, delirium, life-threatening cardiovascular collapse

"The barbie died from cardiovascular collapse"

Front 13

Intoxication with Benzos?

Back 13

-greater safety margin
-amnesia, ataxia, somnolence, minor respiratory depression.

Front 14

tx for Intoxication with Benzos?

Back 14

flumazenil

Front 15

withdrawal symproms of Benzos?

Back 15

-rebound anxiety
-seizures
-tremor
-insomnia

Front 16

Intoxication with amphetamines?

Back 16

-psychomotor agitation, impaired judgment, pupillary DILATION, hypertension, tachycardia, euphoria, prolonged wakefulness and attention, cardiac arrhythmias, delusions, hallucinations fevers
(can cause placental abruption if a women uses while pregnant)

Front 17

Withdrawal from amphetamines?

Back 17

post-use "crash", including depression, lethargy, headache, stomach cramps, hunger, hypersomnolence

Front 18

Cocaine intoxication?

Back 18

Euphoria, psychomotor agitation, impaired judgement, tachycardia, pupillary DILLATION, hyptertension, hallucinations (including tactile), paranoid ideations, angina, sudden cardiac death

Front 19

Treatment of Cocaine intoxication?

Back 19

Benzos

Front 20

Withdrawal sumptoms of cocaine?

Back 20

post-use crash, including sever depression and suicidality, hypersomnolence, fatigue, malaise, severe psychological craving

Front 21

symptoms of Caffeine intoxication?

Back 21

Restlessness, insomnia, increase diuresis, muscle twitching, cardiac arrythmias

Front 22

symptoms of caffeine withdrawal?

Back 22

headache, lethargy depression, weight gain

Front 23

symptoms of nicotine intoxication?

Back 23

Restlessness, insomnia, anxietym arrhythmias

Front 24

withdrawal of nicotine?

Back 24

irritability, headache, anxiety, weight gain, craving,

Front 25

tx for withdrawal of nicotine?

Back 25

bupropion/varenicline

Front 26

PCP intoxication?

Back 26

-Belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homicidality, psychosis, delirium

Front 27

PCP withdrawal?

Back 27

Depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep

Front 28

LSD toxicity

Back 28

Marked anxiety or depression, delusions, visual hallucinations, flashbacks, pupillary DILATION

Front 29

Marijuana toxicity?

Back 29

Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social withdrawal, increased appetite, dry mouth, hallucinations

Front 30

Marijuana withdrawal?

Back 30

-irritability, depression, insomnia, nausea, anorexia.
-Most symptoms peak in 48 hrs and last for 5-7 days.
-Can be detected in urine up to 1 month after last use

Front 31

Heroin users are at risk for what?

Back 31

hepatitis, abcesses, overdoes, hemorrhoids, AIDS and right-sided endocarditis

Front 32

Delirium tremens

Back 32

-Life-threatening alcohol withdrawal
-peaks 2-5 days after last drink
-symptoms in order of apperance: autonomic system hyperactivity (tachycardia, tremors, anxiety, seizures), psychotic symptoms (hallucinations, delusions), confusion

Front 33

Arsenic

Back 33

Inhibits enzymes that require lipoic acid as a cofactor (e.g.. pyruvale dehydrogenase) causing increased conversion of pyruvate tolactate.
Severe headaches, abdominal pain, diarrhea, delirium, convulsions.
transverse bands in nails (Mees lines), death. Squamous cell carcinoma of skin, liver angiosarcoma, lung cancer

Front 34

Benzene

Back 34

Acute leukemia, aplastic anemia

Front 35

Carbon monoxide

Back 35

Headache (first sign), cherry-red skin, coma
4 O, saturation, normal PaOj; lactic acidosis (due to hypoxia)
rrBOtment: O, via nonbreathcr mask or endotracheal tube (100% O,)

Front 36

Cyanide

Back 36

-House fires
-Odor of bitter almonds; coma, seizures, heart dysfunction, melabolic
acidosis (serum lactate >io mmol/L), due to inhibition of
cytochrome oxidase in ETC and subsequent shift to anaerobic
glycolysis as only ATP source
Treatment: amyl nitrite (produces metHb which

Front 37

treatment of arsenic

Back 37

chelating agents: succimer (z,3-dimercaptosuccinic acid)
or dimercaprol (BAL)

Front 38

treatment of carbon monoxide

Back 38

O, via nonbreathcr mask or endotracheal tube (100% O,)

Front 39

treatment of cyanide

Back 39

amyl nitrite (produces metHb which combines with CN
to form cyanmetHb) followed by thiosulfate (CN converted to
thiocyanate)

Front 40

Ethylene glycol

Back 40

-Antifreeze
Increased anion gap metabolic acidosis
Acute renal failure

Front 41

Isopropyl alcohol

Back 41

-Rubbing alcohol
End-product: acetone
Fruity odor lo breath (acetone); can progress into deep coma
Does not produce increased anion gap like ethanol, methanol,
ethylene glycol but does increase osmolal gap

Front 42

treatment of ethylene glycol

Back 42

Treatment: IV infusion of ethanol

Front 43

treatment of isoprpyl alcohol

Back 43

hemodialysis

Front 44

Mercury

Back 44

Diarrhea, constricted visual fields, nephrotoxicity in proximal tubule, tachycardia, hyperhidrosis (T sweating), peripheral neuropathy,
hypertension

Front 45

treatment for mercury?

Back 45

Treatment: chelating agents; succimer, penicillamine, or dimercaprol

Front 46

homocystinuria causes

Back 46

1) Cystathionine synthase deficiency (increase b12 and folate in diet
2) decrease affinitity of cystathionine synthase for pyridoxal phosphate (give pyridoxine!! (B6))
3) homocysteine methyltransferase deficiency

Front 47

Findings in homocystinuria?

Back 47

-Long limbs
-increased homocysteine in urine
-mental retardation
-osteoporosis, tall stature, kyphosis
-lens subluxation
-atherosclerosis
-arachnodactyly
-increased risk for deep vein thrombosis

Front 48

function of vitamin A

Back 48

antioxidant; constituent of visual pigments (retinal); essential for normal differentiation of epithelal cells into specialized tissue (pancreatic cells, mucus-secreting cells)

Front 49

deficency of vitamin A

Back 49

night blindness, dry skin

Front 50

excess vitamin A

Back 50

Arthralgias, fatigue, headaches, skin changes, sore throat, alopecia
Tertogenic (cleft palate, cardiac abnormalities)

Adam was always fatigued and complained about a headache and sorethroat. He was afraid of the dark (deficiency) and also complained of dry skin (deficiency). He was bald and hated babies

Front 51

deficiency of Vitamine B1 (Thiamine)

Back 51

-Wernicke-Korsakoff
-Dry beriberi (polyneuritis, symmetrical muscle wasting)
-Wet BeriBeri- high output cardiac failure (dilated cardiomyopathy), edema

Think of a homeless person who crazy, thinks he paralyzed and has muscle wasting and edema bc he is malneurished. Most homeless ppl mean well, they have a big heart

Front 52

Vitmain B2 (riboflavin) deficiency

Back 52

Cheilosis (inflammation of the lips, scaling and fissures at all corners of the mouth), Corneal vascularization

Flava Flav has big lips and crazy eyes

Front 53

Vitamin B3 deficiency (niacin)

Back 53

Glossitis, pellagra (Diarrhea, Dermatitis, Dementia)

Front 54

Excess vitamin B3

Back 54

Facial flushing (due to pharmacologic doeses for treatment of hyperlipidemia

Front 55

Vitamin B5 (pantothenate) deficiency

Back 55

Dermatitis, enteritis, alopecia, adrenal insufficency

Front 56

Vitamin B6 deficiency (pyridoxine)

Back 56

-Convulsions, hyperirritability, peripheral neuropathy,sideroblastic anemias