Usmle 1 First Aid Miscellaneous

Front 1

What UTI causing bacterium is associated with struvite stones?

Back 1

proteus mirabilis

Front 2

Chlamydial infections (PID) can have these 2 syndromes as a complication

Back 2

Reiter's
Fitz-Hugh-Curtis syndrome- infection of the liver capsule and violin string adhesions of parietal peritoneum to liver

Front 3

Name the syndrome and etiology: infection of the liver capsule and violin string adhesions of parietal peritoneum to liver

Back 3

Fitz-Hugh-Curtis

Front 4

What is the sign name when checking for cervical motion tenderness?

Back 4

Chandelier sign

Front 5

Nosocomial infection associated with hyperalimentation?

Back 5

Candida albicans

Front 6

Name 2 bacteria responsible for nosocomial urinary cath infections?

Back 6

E.coli
Proteus Mirabilis

Front 7

PCP in Aids starts at what count?

Back 7

<200 CD4

Front 8

Osteomyelitis in most people is caused by S. aureus, but in pts with sickle cell anemia it is often what bacterium?

Back 8

Salmonella

Front 9

Triad of toxo gondii in infants

Back 9

choreoretinitis, hydrocephalus, intracranial calcifications

Front 10

Branching rods in oral infection?

Back 10

Actinomyces Israelii

Front 11

What test is positive during Lymphogranuloma venereum

Back 11

Frei test

Chlamydia trachomatis (LK)

Front 12

When superantigens bind to MHCII outside the antigen pocket and stimulate polyclonal T cells, what 2 major cytokines are mass released?

Back 12

Gamma-interferon
Il-2

Front 13

Scarlet fever is caused by?

Back 13

Strep Pyogenes
Group B

Front 14

Urease positive bugs

Back 14

Klebsiella
H. Pylori
Ureaplasma
Proteus (struvite stones Hello?!)

Front 15

Obligate anaerobes

Back 15

Clostridium
Actinomyces
Bacterioides

ABC mnemonic

Front 16

Obligate Aerobes

Back 16

Nagging pests must breathe
Nocardia
Pseudomonas
Mycobacterium tb
Bacillus

Front 17

Group A Strep

Back 17

beta hemolytic
strep pyogenes

Front 18

Clostridium has which exotoxin?

Back 18

exotoxin a, which is a lecithinase, breaks down tissues

Front 19

Gram positive rods that are filamentous, branched?

Back 19

Nocardia- sulfa- soil
Actinomyces-anaerobe, sulfur granules, penicilin drugs

SNAP mnemonic for tx

Front 20

a test performed to confirm a diagnosis of lymphogranuloma venereum. Killed antigen, originally derived from infected patients, is injected intradermally in one forearm, and a control material is injected into the other arm. If a red, thickened papule develops at the site of injection of antigen, the test result is positive. See also Chlamydia./ Lymphogranuloma venereum

Back 20

Frei test

Front 21

Frei Test

Back 21

a test performed to confirm a diagnosis of lymphogranuloma venereum. Killed antigen, originally derived from infected patients, is injected intradermally in one forearm, and a control material is injected into the other arm. If a red, thickened papule develops at the site of injection of antigen, the test result is positive. See also Chlamydia./ LGV

Front 22

What ricketsia will not give a positive Weil-Felix test?

Back 22

Coxiella Burnetii

Front 23

Discriminate between endemic and epidemic typhus and what are the causative organisms, as well as where does the rash start

Back 23

endemic, fleas, R. typhi
epidemic, louse, R. prowazeckii
Rash starts on the trunk in Typhus, but in the rest of rickettsia it starts on soles and palms, except Q fever, which has no rash

Front 24

Which Rickettsia does not cause rash?

Back 24

Q fever
spores
C. burnetii
animal placentas, soil, inhaled aerosoles, pulmonary symptoms

Front 25

Rickettsial test Weil-Felix may cross react with Ag of what bacterium?

Back 25

with Proteus Ag

Front 26

Facial flushing, diarrhea, 3cuspid regurgitation. DX?

Back 26

carcinoid syndrome
commonly arises in appendix, but does not metastasize to liver
if arises in terminal ileum, then metastasizes to the liver

Front 27

What primary cancer commonly metastasizes to the left supraclavicular lymph nodes and the ovaries?

Back 27

Stomach cancer

(Virchow lymph nodes)

Front 28

A boy with a complain of pain in the knee, blood in the urine and palpable lesions/rash like/purplish on his legs and buttocks. DX?

Back 28

Classical Henoch-Schonlein purpura

IgA anti IgA immune complexes deposition in small vessels and in nephrons, joints

Front 29

Schilling test?

Back 29

Reabsorption of B12 after orally administering intrinsic factor

(speaking of pernicious anemia)

Front 30

anti=endomysial
anti-reticulin
anti-gliadin antibodies
dermatitis herpetiformis

Back 30

celiac disease

Front 31

Hemochromatosis test and presentation?

Back 31

DMI, bronzed skin, liver cirrhosis, history of diarrhea
do a ferritin test, should be increased
it's autosomal recessive

Front 32

Oligoclonal bands?

Back 32

MS
gamma globulin bands indicative of demyelination
lesions in th white matter

Front 33

generalized pruritus, increased ggt and alkaline phosphatase,
non-tender hepatomegaly

Back 33

autoimmune billiary cirrhosis
look for antimitochondrial antibodies
COOL: pruritus is due to the deposition of bile salts under the skin

Front 34

If you give an elderly with type A a type AB transfusion by mistake and he does not hemagglutinate, nor does his blood do so in vitro, what's going on?

Back 34

Elderly often lose the isohemagglutinins such as IgM anti B in this case
normal aging

Front 35

Name two enzyme deficiencies responsible for hemolytic anemia, in other words, directly affecting health and life of RBCs

Back 35

Glucose 6 phosphate dehydrogenase (for the shunt)
and deficiency in pyruvate kinase, so glycolysis is not possible in the RBC, which does not have mitochondria and does not do TCA

Front 36

Pyruvate kinase deficiency

Back 36

restricted to RBC
mild to severe chronic hemolytic anemia, which req. blood transfusions

Front 37

Pyruvate to lactate is the final pathway in which organs/ tissues

Back 37

RBCs, lens of the eye, medulla of the kidney, testes, leukocytes, cornea

Front 38

Fate of lactate in myocardium

Back 38

myocardium exclusively oxidizes lactate to CO2 an H2O via the citric acid cycle.

Front 39

B1 thiamine f

Back 39

Component of thiamine pyrophosphate, cofactor in:
Pyruvate dehydrogenase (glycolysis)
α-ketoglutarate dehydrogenase (TCA cycle)
Transketolase (HMP shunt)
Branched chain amino acid dehydrogenase

Front 40

List 2 treatments for hyperammonemia

Back 40

benzoate
phenylbutyrate

Front 41

A 6 mo old child that presents with mental retardation/deterioration and cherry red spot on the macular, but no hepatospenomegaly

vs a child that presents with the above but with the hepatosplenogmegaly

Back 41

cherry red spot in the macula can be seen in Tay-Sachs (Hexoaminidase A def) and Nieman Pick's (sphyngomyelinase def.) but the latter one Neimann Pick's also presents with hepatosplenomegaly

Front 42

Differentiate between Hurler's and Hunter's disease

Back 42

Hunter's has no corneal opacities
but it is also x-linked recessive
a mucopolysaccharidosis
iduronate sulfatase deficiency
hepatosplenomegaly, kyphosis,short stature, valvular and ischemic heart disease, CHF, flexion contractures

Front 43

How do you differentiate hemolytic anemia due to pyruvate kinase deficiency versus G6P dehydrogenase deficiency, which is more common

Back 43

Pyruvate kinase def. caused anemia will not have Heinz bodies
it is also autosomal recessive

Front 44

HOwell Jollie bodies

Back 44

sickle cell autosplenectomy
in rbc dots

Front 45

Pale infarcts in which organs?

Back 45

In the ones with single supply

heart kidney spleen

Front 46

Differentiate between gangrenous necrosis: wet and dry

Back 46

wet (with bacteria)
dry (coagulative ischemic)

Front 47

Desmoplasia

Back 47

fibrous tissue formation in response to neoplasia

Front 48

Plummer-Vinson Syndrome

Back 48

atrophic glossitis
dysphagia
iron def. anemia

all due to iron deficiency
premalignant syndrome

high risk for esophageal squamous carcinoma

Front 49

Tumors associated with tuberous sclerosis

Back 49

astrocytoma
angiomyolipoma
cardiac rhabdomyosarcoma

Front 50

BCL-2

Back 50

follicular and undiff. lymphomas

Front 51

c-myc

Back 51

Burkitt's

Front 52

ABL

Back 52

CML

Front 53

L-myc

Back 53

lung cancer

Front 54

n-myc

Back 54

neuroblastoma

Front 55

BCL-2

Back 55

follicular and undiff. lymphomas

Front 56

erb-B2

Back 56

breast
ovary
gastic carcinomas

Front 57

ras

Back 57

colon carcinoma

Front 58

CEA

Back 58

Carcioembryonic antigen
produced by 70 percent of pancreatic and colon cancer
also by gastric and breast carcinomas

Front 59

Lambert=Eaton Syndrome

Back 59

neuromuscular weakness due to the antibodies against pre-synaptic Ca channels
these antibodies are produced by thymomas and small cell lung cancers

Front 60

ventricular preexcitation syndrome is also known as what?

Back 60

Wolfe-Parkinson-white syndrome
look for delta wave at the onset of qrs
Bundle of Kent=accessory pathway between atria and ventricles bypassing AV node
can lead to SV tach

Front 61

Congenital syndrome of long QT with sensorineural deafness is knows as what?

Back 61

Jervell
Lange-Nielsen

Front 62

Cushing's triad

Back 62

hypertension, bradycardia, respiratory depression

Front 63

Turner's syndrome is associated with what congenital cardiac abnormality?

Back 63

coarctation of aorta

Front 64

Infant of a diabetic mother has a high risk of what heart abnormality?

Back 64

transposition of great vessels

RtoL cyanotic shunt

Front 65

Friction rub post MI after 3-5 days?

Back 65

postinfarction fibrinous pericarditis

Front 66

Dressler's syndrome

Back 66

autoimmune phenomenon resulting in fibirinous pericarditis several WEEKS after MI,

NOT DAYS

Front 67

Several weeks after an MI, autoimmune fibrinous pericarditis is called what?

Back 67

Dressler syndrome

Front 68

Roth Spots

Back 68

diagnostic of bacterial endocarditis
are white spots on the retina surrounded by hemorrhage

Front 69

Janeway Lesions

Back 69

can be seen in bac. endocarditis
small erythematous lesions on palm or sole

Front 70

Osler's nodes

Back 70

can be seen in bact. endocarditis
tender raised lesions on finger or toe pads

Front 71

what is marantic thrombotic endocarditis?

Back 71

secondary to hypercoagulable state

Front 72

Loffler syndrome

Back 72

endomyocardial fibrosis with a prominent eosinnophilic infiltrate

Front 73

Libman-Sacks endocarditis

Back 73

the most common manifestation of cardiac SLE
verrucous sterile vegetations on mitral valve, may cause regurg, or stenosis uncomonly

SLE causes LSE

Front 74

Hashimoto's

Back 74

autoimmune
type 4 hypersensitivity
antimicrosomal, antithyroglobulin antibodies
HLA DR5
Hurthle cells

Front 75

In Hyperparathyroidism (primary), hypercalcemia predisposes to?

Back 75

peptic ulcer!

Front 76

Albright's Hereditary Osteodystrophy

Back 76

autosomal dominant kidney unresponsiveness to PTH
Hypocalcemia, shortened 4th/5th digits, short stature

Front 77

Kimmelstiel-Wilson nodules

Back 77

This is nodular glomerulosclerosis (the Kimmelstiel-Wilson lesion) of diabetes mellitus. Nodules of pink hyaline material form in regions of glomerular capillary loops in the glomerulus. This is due to a marked increase in mesangial matrix from damage as a result of non-enzymatic glycosylation of proteins

Front 78

alfa 2 agonist such as clonidine would have what effect on insulin release?

Back 78

inhibition of insulin release
b2 agonism stimulates the release

Front 79

IN DKA, hydroxybutyrate: acetoacetate ratio is

Back 79

usually hydroxybutyrate and acetoacetate are produced 1:1
but in pathologic cases
such as alcoholism or DM
you get more b hydroxybutyrate than acetoacetate

Front 80

in good pastures, describe renal findings

Back 80

linear immune complex deposits
plus
NEPHRITIC syndrome (minor amounts of protein)

Front 81

Discuss Ghrelin

Back 81

D1/P cells in stomach
lost with gastric bypass surgery
regulates appetite
increases growth hormone, prolactin, ACTH, cortisol
Ghrelin is increased when fasting
Ghrelin is decreased after a meal
Loss of Ghrelin is associated with hyperphagia in Prader-Willi syndrome

Front 82

What hormone is responsible for churning and turning sounds in the intestines when one is hungry?

Back 82

motilin, secreted by small intestine
produces migrating motor complexes

Front 83

What hormone's loss is associated with achalasia?

Back 83

NO

Front 84

Copious diarrhea would be seen with what tumor?

Back 84

VIPoma
increases intestinal water and electrolyte secretion
relaxation of intestinal smooth muscle and sphincters

Front 85

Somatostatin is used to treat what tumors?

Back 85

VIPoma and carcinoid tumors

Front 86

In cholelithiasis, pain worsens after fatty meals. why?

Back 86

secretion of CCK which increases contractions of the gall bladder
(but decreases gastric emptying)

Front 87

Warthin's tumor

Back 87

benign salivary tissue trapped in the lymph node , heterotropic

Front 88

Peutz-Jeghers

Back 88

autosomal-dominant
multiple nonmalignant hamartomas throughut the GI, along with hyperpigmented mouth, lips, genitalisa, hands. Associated with increasedd risk of CRC and other visceral malignancies

Front 89

Differentiate Boerhaave's syndrome versus Mallory Weiss

Back 89

In Boerhaave's: rupture of distal esophagus (mostly 75 percent due to endoscopy, complication is pneumomediastinum and Hamman's crunch on PE)

Mallory-Weiss syndrome: mucosal tear of distal esophagus

Front 90

VATER syndrome

Back 90

vertebral abnormalities
Anal atresia
TE tracheoesophageal fistula
Renal disorder plus absent radius

Front 91

Riley-Day Syndrome

Back 91

Familial dysautonomia
autosomal recessive
mostly in Jewish children
unstable blood pressure, difficulty feeding, abnormal sweating, orthostatic hypotension, progressive sensory loss
results from loss of neurons in the autonomic and sensory ganglia

Front 92

Shy-Drager syndrome

Back 92

preganglionic sympathetic neurons form the intermediolateral cell column
it is characterized by orthostatic hypotension, anhidrosis, impostence, and bladder atonicity

Front 93

Migratin thrombophebitis

Back 93

carcinoma

pancreatic
or lung

Front 94

Heyde's Syndrome

Back 94

syndrome of aortic valve stenosis associated with gastrointestinal bleeding from colonic angiodysplasia. It is named after Dr. Edward C. Heyde, who first described the association in 1958.[1] It is due to the induction of von Willebrand disease type IIA by the valvular stenosis.[2]

Front 95

When aortic stenosis is associated with lower GI bleeding (colonic angiodysplasia) what is the syndrome's name?

Back 95

Heyde's syndrome

Front 96

Megadoses of what vitamin are associated with reduced synthesis of K-dependent clotting factors and thus are synergistic with warfarin?

Back 96

vitamin E

Front 97

Excess of what vitamin in the mother can cause hemolytic anemia and jaundice in a newborn?

Back 97

vitamin K

Front 98

Effects of vitamin E deficiency

Back 98

hemolytic anemia
spinocerebellar tract/ dorsal column degeneration and peripheral neuropathy plus ataxia

Front 99

Vitamin B2 deficiency symptoms

Back 99

glossitis
angular stomatitis
cheilosis
corneal neovascularization

Front 100

vitamin deficiency and vision

Back 100

corneal neovascularization in vitamin b2 riboflavin deficiency

corneal squamous metaplasia in vtimain A deficiency plus since it's a componenet of rhodopsin you get night blindness

Front 101

Biotin deficiency symptoms

Back 101

dermatitis alopecia
lactic acidosis

Front 102

SE of niacin supplementation in hypercholesterolemia?

Back 102

flushing
intrahepatic cholestasis

Front 103

Hand-Schuller-Christian
(histiocytosis)

Back 103

exophthalmos
diabetes insipidus
bone lytic lesions

Front 104

dermatomyositis in a middle aged man is associated with what?

Back 104

epithelial cancer
like lung carcinoma
inclusion myositis or polymyositis are not associated with malignancy

Front 105

inclusion body myositis is resistant to what tx?

Back 105

corticosteroids, but really to none

Front 106

eaton lambert syndrome assn

Back 106

ab to ca channel releasing ach
muscle weakness
does not improve with ache inhibitor unlike with myasthenia gravis (which often has a thymoma, which resection is curative)
eaton lambert is associated with small cell lung carcinoma

Front 107

Neimann Pick's

Back 107

progressive neurodegenerative
cherry red spot on macular
hepatosplenomegaly
FOAM CELLS

Autosomal Recessive

Sphingomyelinase deficiency

Front 108

Fabry's disease

Back 108

painful neuropathies
corneal opacities
renal/cardiac problems
angiokeratomas/ diffuse violaceous skin rash

alfa galactosidase A
(ceramide trihexoside accumulates)

X linked recessive the only one

Front 109

Metachromatic leukodystrophy

Back 109

arylsulfatase A

Front 110

Krabbe's disease

Back 110

globoi cells in degenerating white matter
galactocerebrosidase
AR
peripheral neuropathy
developmental dealy

Front 111

what enzymes are defficient in Neiman Pick's vs Krabbe's

Back 111

Neimann Picks sphyngomyelinase
Krabbe's galactocerebrosidase

Mr. Neimann

Front 112

DX: pot-bellied, pale, puffy faced child with protruding umbilicus and protuberant tongue

Back 112

cretinism due to hypothyroidism (endemic goiter/ no iodine in the diet)

Front 113

Jod-Basedow phenomenon

Back 113

thyrotoxicosis if a patient with iodine deficiency goiter is made iodine replete

Front 114

Hypercalcemia is co-present in these 2 disorders

Back 114

zollinger-ellison (co present hyperparathyroidism)

addison's (evidently normal physiological levels of cortisol are necessary to decrease bone resorption and activate vitamin D)

Front 115

Hypercalcemia can be a result of excess of these 2 vitamins

Back 115

Vit D of course

VITAMIN A

Front 116

Albright's hereditary osteodystrophy

Back 116

pseudohypoparathyroidism

autosomal dominant
unresponsiveness to PTH
short stature, shortened 4,5 metatarsals/ digits, hypocalcemia (and I think mental retardation mild often)