Usmle Boardbuster Set 1

Front 1

cardiac intercalated discks made of?

Back 1

fascia adherens and desmosomes (macula adherens)

Front 2

action potential pattern for cardiac pacemaker?

Back 2

ph 0--slow upstroke, calcium channel opening; ph3--gradual repolarization from closed Ca channels, open K+ channels; ph4--slow leak of Na until enough of depolarization--> ph0

Front 3

first choice antiHTN drug for preggers?

Back 3

methyldopa (decreases sympathetic outflow)

Front 4

alternatives to aspirin for stroke prophylaxis

Back 4

ADP inhibitors: ticlopidine, clopidogrel

Front 5

when does developing fetus start making its blood in bone marrow?

Back 5

~wk 28 (wk3--yolk sac; wks 7~30 liver; wks9-28 spleen)

Front 6

cardiovascular structures and blood derived from?

Back 6

mesoderm

Front 7

how close PDA medically?

Back 7

indomethacin (PG E can keep it open--would want in transposition of great vessels)

Front 8

pheochromocytoma treatment?

Back 8

alpha antags (phenoxybenzamine)

Front 9

most common cardiac malformation in Downs

Back 9

septum primum (ASD defect due to endocardial cushion abnl)

Front 10

single umbilical artery assoc'd with?

Back 10

(should be 2); congenital and chromosoma abnl

Front 11

when should pregnant woman's BP be lowest?

Back 11

~wk 24. slowly rises after that but should never exceeed pre-preggers level

Front 12

highest PO2 in fetus is where?

Back 12

umbilical vein (brings oxygenated blood from mom)

Front 13

female infant with swelling at nape of neck at birth--?

Back 13

think Turner's (and coarctation of aorta)

Front 14

S3 in adults >40y/o?

Back 14

usually indicative of congestive heart failure

Front 15

4 classic signs of heart failure in kids, infants?

Back 15

tachypnea, tachycardia, hepatomegaly, cardiomegaly (NOT peripheral edema--would see in adults)

Front 16

when do PDAs usually close?

Back 16

4-8 wks after birth

Front 17

Job's syndrome characterized by?

Back 17

increased IgE, repeated staph abscesses, eczema

Front 18

which leukemia assoc'd with decreased AP?

Back 18

CML

Front 19

t(11;18)

Back 19

marginal zone lymphoma

Front 20

t(14;21)

Back 20

robertsonian translocation in Downs

Front 21

which coagulative factor changes the most in preggers?

Back 21

fibrinogen

Front 22

hemolytic uremic syndrome--a)classic triad; b) lab values

Back 22

a) renal failure, anemia, thrombocytopenia; b) dec'd platelets, schistocytes, nl coagulation (PT, PTT)

Front 23

which form of AML assoc'd with DIC?

Back 23

M3 (APL)

Front 24

which form of AML assoc'd with myelofibrosis?

Back 24

M1-CML

Front 25

which form of AML assoc'd with chronic myelomonocytic leukemia?

Back 25

M4

Front 26

M5 AML-?

Back 26

chronic monocytic leukemia

Front 27

yellowish tinge to skin + PMNs indicative of what kind of anemia?

Back 27

megaloblastic

Front 28

warm Ab autoimmune hemolytic anemia often secondary to what dzs?

Back 28

SLE, Hodgkin lymphoma, non Hodgkin lymphoma

Front 29

orotic acidemia caused by

Back 29

AR, mut in pyrimidine synthesis; def: orotidylic pyrophosphorylase orotidylic decarboxylase

Front 30

infant with severe megaloblastic anemia not reversible by vit B12, folate?

Back 30

orotic acidemia; will have crystals of orotic acid

Front 31

aspirated material goes where if a) standing b) supine

Back 31

a) RLL, lower portion; b) RLL, upper portion

Front 32

most common cause of fever or pneumonia in <1y/o?

Back 32

RSV

Front 33

which IL activates eosinophils?

Back 33

IL-5

Front 34

major complication of silicosis?

Back 34

TB

Front 35

what happens in PDA?

Back 35

(L->R shunt) blood from aorta goes to pulmonary trunk (to lungs), exposing low P low R pulmonary circulation to increased P/vol. No hypoxemia. increased pulmonary blood flow and pulm arterial P, PO2

Front 36

lab findings in sarcoidosis

Back 36

hypercalcemia/calciuria, hypergammaglobulinemia, inc'd ACE activity

Front 37

stages of lung development

Back 37

1. glandular (wks5-17); 2. canalicular (wks13-25); 3. terminal sac (wks24-birth); 4. alveolar (birth-8yr)

Front 38

in what week of gestation do type II pneumocytes start to secrete surfactant?

Back 38

wk 35

Front 39

TB cultured best on?

Back 39

Lowenstein-Jenson agar

Front 40

H. influenzae cultured on?

Back 40

chocolate agar with factors V (NAD) and X (hematin)

Hint 40

None

Front 41

fungi cultured on?

Back 41

Sabouraud's agar

Front 42

Berylliosis--presentation and assoc'ns

Back 42

hilar adenopathy on CXR; exposure to nuclear weapons, ceramincs, fluorescent lights

Front 43

Name the organism: catalase(-), alpha hemolysis, resistant to optochin

Back 43

strep mutans (Viridans strep. strep pneumo also cat(-) and alpha hemolyis but optochin sensitive)

Hint 43

None

Front 44

Hirschsprung's also assoc'd with what congenital dz?

Back 44

Down syndrome; 10% of hirschsprungs have Down syndrome

Front 45

HLA-DQw2 assoc'd with?

Back 45

celiac sprue

Front 46

HLA-DR2 assoc'd with

Back 46

hay fever, MS

Front 47

HLA-DR4 assoc'd with?

Back 47

RA

Front 48

HLA-DR3 assoc'd with?

Back 48

DM

Front 49

diarrhea, polyarthralgias, PAS+ macrophages--?

Back 49

Whipple dz

Front 50

Plummer-Vinson syndrome

Back 50

1. cervical esophageal web; 2. mucosal lesions of mouth and pharynx; 3. Fe deficiency anemia

Front 51

sequelae of Plummer-Vinson syndrome

Back 51

carcinoma of oropharynx and upper esophagus (e.g. poscricoid carcinoma)

Front 52

S. American with progressive dysphagia--think?

Back 52

Chagas dz. paraste can infect neurons--> megacolon, megaesophagus

Front 53

syndromes assoc'd with pyloric stenosis

Back 53

Turner's (also coarctation of aorta); Edwards (trisomy 18)

Front 54

Name the bug: polar flagella, rice water poo

Back 54

Virio cholerae (>20L/day! grows on TCBS agar)

Front 55

Name the bug: polar flagella, raw oysters or boating accident

Back 55

Vibrio vulnificus

Front 56

Peutz-Jeghers mutation?

Back 56

(hamartomatous polyps in intestine and buccal pigmentation) SKT-100, a serine threonine kinase

Front 57

incomplete fusion of lateral body folds-->

Back 57

protrusion of abdominal viscera in neonate

Front 58

failure of peritoneal fusion-->

Back 58

omphalocele

Front 59

failure of yolk sac degeneration--> ?

Back 59

Meckel's diverticulum

Front 60

which hep virus has high mortality in preggers?

Back 60

Hep E

Front 61

Name the bug: microabscesses in distal ileum & colon, postinfectious autoimmune arthritis & erythema nodosum

Back 61

Yersinia enterocolitica

Hint 61

None

Front 62

Name the dz: 70y/o man w/acute LLQ pain and passage of bright red blood after pain begins (w/in hours?)

Back 62

acute colonic ischemia (pain not relieved by passage of blood)

Hint 62

None

Front 63

nephroptosis assoc'd with?

Back 63

truck drivers, motorcyclists, horseback riders. caused by loss of supporting fat (due to all the jarring/vibration?) around kidney

Front 64

horizontally riding testicle--think?

Back 64

testicular torsion (medical emergency!)

Front 65

management of testicular torsion

Back 65

doppler scan to check blood flow. then must detorsion

Front 66

prostate--female counterpart and embryonic origin?

Back 66

gls of skene; from embryonic genital cords

Front 67

bartholin glands--male counterpart and embryonic origin?

Back 67

Cowper's gls; from embryonic genital cords

Front 68

Muller's tubercle gives rise to?

Back 68

male: veromontanum; female: hymen

Front 69

which nerve runs atop spermatic cord?

Back 69

ilioinguinal (easily injured in inguinal hernia repair)

Front 70

fibrillary pattern within mesangium and subendothelium--characteristic of what renal path?

Back 70

amyloidosis

Front 71

injury to what part of CNS leads to loss of urge to void & overflow incontinence

Back 71

lateral spinothalamic tract (contains ascending fibers from pudendal, pelvic, and hypograstric nerves)

Front 72

Sipple's syndrome

Back 72

MEN IIA--pheochromocytoma, medullary thyroid carcinoma, hyperparathyroidism

Front 73

phimosis

Back 73

acquired or congenital; can't pull foreskin back behind glans penis

Front 74

cremasteric mm of spermatic cord extension of what layer of ab wall?

Back 74

internal oblique fascia (gives rise to middle spermatic fascia, conjoint tendon, cremasteric mm)

Front 75

boundaries of Hesselbach triangle

Back 75

inguinal ligament, inferior epigastric artery, lateral border of rectus abdominus

Front 76

what calcium channel blocker may cause gingival hyperplasia?

Back 76

nifedipine

Front 77

what diuretic might precipitate gouty attack?

Back 77

furosemide (in addition to inhibiting Na-K-Cl in ascending limb, also increases uric acid reabsorp. in PCT)

Front 78

what other features assoc'd with exstrophy of bladder

Back 78

epispadias, widened pubic symphysis

Front 79

lymph drainage of vagina--a)lower 25% b)upper 75%

Back 79

a)superficial inguinal nodes; b) internal iliac nodes

Front 80

embryologic origin of vagina?

Back 80

dual! upper portion (including fornix)--paramesonephric ducts; lower portion--sinovaginal bulbs

Front 81

ovarian vessels run though what ligament?

Back 81

suspensory ligament of ovary

Front 82

uterine vessels run through what ligament?

Back 82

transverse cervical ligament; also broad ligament

Front 83

broad ligament contains what important structures?

Back 83

uterine vessels, uterine tubules, round ligaments of uterus and ovaries

Front 84

what important anatomic structures contained w/i round ligament of uterus?

Back 84

none. but lymphatics run with it (uterus to subQ tissue of labia majora)

Front 85

umbilical arteries in what ligaments?

Back 85

median umbilical ligaments

Front 86

multiple reddish-brown papules on penis of sexually active not old adult?

Back 86

Bowenoid papulosis

Front 87

most common presenting complaint of endometriosis?

Back 87

cyclic abdominal pain

Front 88

what increases risk of Peyronie's dz?

Back 88

(=dorsal subQ fibrosis of penis); men with ED who continue to have intercouse at half mast

Front 89

how would a carcinoma of uterus spread directly to labia majora?

Back 89

via lymphatics that follow round ligament of uterus

Front 90

treatment for metastasized prostate cancer?

Back 90

pharmacologic orchiectomy

Front 91

how soon do syphilitic chancres usually heal?

Back 91

2-6 weeks

Front 92

gestational choriocarcinoma

Back 92

aggressive malignant neoplasm with inc'd hcG, early hematogenous spread to lungs. (50% preceded by hydatidiform mole)

Front 93

tubular ducts lined by 1-2layers of nonciliated columnar cells with flattened layer of myoepithelial cells beneath epithelium

Back 93

papillary hidroadenoma (sharply circumscribed, on/around labia majora, may ulcerate)

Front 94

anencephaly--what lab findings?

Back 94

increased alphaFP (NTD); polyhydramnios (b/c fetus can't swallow and reduce amount of uterine fluid)

Front 95

cerebellum and pons derived from?

Back 95

metencephalon

Front 96

metencephalon-->

Back 96

pons and cerebellum

Front 97

mesencephalon-->

Back 97

midbrain

Front 98

myelencephalon-->

Back 98

medulla

Front 99

which toxin acts on Renshaw cells in spinal cord?

Back 99

tetanus toxin

Front 100

MOA of black widow venom?

Back 100

acts on presynaptic side at NMJ to cause massive release of NTs, esp ACh

Front 101

what toxin binds irreversibly to nicotinic R?

Back 101

strychnine

Front 102

hypopigmented "ash leaf spots" on skin--

Back 102

tuberous sclerosis (also: facial lesions--adenoma sebaceum, cortical and retinal hamartomas, seizures mental 'tardation, etc)

Front 103

test for fxn of flexor digitorum superficialis

Back 103

fix other digits and have pt flex middle finger at MCP joint

Front 104

what nerve root controls a)heel walking b)toe walking c) knee flexion

Back 104

a)L5; b)S1 c) S2

Hint 104

None

Front 105

inability to squat suggests what neuro deficit?

Back 105

L4

Front 106

Koplik spots

Back 106

measles! (rubeola)

Front 107

coryza, conjunctivitis, cough, Koplik spots--

Back 107

measles (rubeola)

Front 108

most common route of spread to CNS?

Back 108

hematogenous

Front 109

which comes first--wernicke or korsakoff?

Back 109

Wernicke (ophthalmoplegia, ataxia, confusion); if untreated--Korsakoff (irreversible confabulation)

Front 110

new onset HA, "graying out of vision", papilledema in overweight 20-50 y/o woman--think?

Back 110

pseudotumor cerebri--benign intracranial neoplasm; (inc'd ICP, HA, papilledema w/o demonstrable lesion)

Front 111

Binswanger dz

Back 111

vascular dementia (due to strokes); usually no "cognitive features" (anomia, apraxia, etc)

Front 112

methylsergide

Back 112

serotonin antag--can be used for treatment of carcinoid symptoms

Front 113

why might a hydatidiform mole cause hyperthyroidism?

Back 113

lots of hcG and at high enough levels, hcG can stimulate TSH R

Front 114

major side effect of metformin

Back 114

lactic acidosis (also: GI side effects and should not be given to renal pts)

Front 115

what Abs seen often in type 1 diabetes?

Back 115

glutamic decarboxylase (GAD), pancreatic beta cells

Front 116

increase in what can cause dry cough in pts on ACE inhibitors?

Back 116

bradykinin

Front 117

what test to confirm Addison's?

Back 117

cosyntropin stim test

Front 118

Duchenne muscular dystrophy also assoc'd with what congenital syndrome?

Back 118

congential adrenal hyPOplasia (DAX1 gene); both on X chromosome

Front 119

"hungry bones" syndrome

Back 119

transient hypocalcemia after removal of parathyroid adenoma--due to rapid movement of Ca and phosphate back into bones b/c of sudden decrease in PTH

Front 120

Somogyi effect

Back 120

phenom of reactive hyperglycemia following period of relative hypoglycemia--get release of hyperglycemia elements (Ne, EPI, etc); (ex: when diabetic given too much insulin in evening)

Front 121

dawn phenomenon

Back 121

early morning hyperglycemia due to increased cortisol

Front 122

why might choriocarcinoma cause gynecomastia?

Back 122

high hcG can activate aromatase gene--> inc'd conversion of androgen to estrogen (Leydig cell tumor could also cuase gynecomastia but there wouldn't be high hcG)

Front 123

umbilical hernia + macroglossia + enlarged fontanelles + coarse facial features in neonate--think?

Back 123

congenital hyPOthyroidism (cretin!) T4 is best test

Front 124

which anterior pituitary hormones are polypeptide dimers?

Back 124

TSH, FSH/LH