Usmle First Aid 15

Front 1

What are some of the complicatons a/w lung cancer?

Back 1

SPHERE of complications:
SVC syndrome
Pancoast tumor
Horner Syn
Endocrine (paraneoplastic)
Recurrent laryngeal sym (hoarseness)
Effusion (pleural or pericardial)

Front 2

What type of lymphoma has the hisotological appearance of starry sky pattern? What virus is a/w it?

Back 2

starry sky: sheets of lymphocytes with interspersed macrophages; Burkitt's lymphoma

assoc with EBV

Front 3

What are the various clinical application of atropine?

Back 3

mydriasis and cycloplegia. Muscarinic antag for cholinesterase inhib poisoning

Front 4

What is the classical triad of symptoms in hemochromatosis? What lab tests are used to dx it and the tx?

Back 4

dz caused by iron deposition (hemosiderosis is the deposition of hemosiderin (iron))
triad: microdnodular Cirrhosis, DM and skin pigmentation (bronze diabetes)
labs: up ferritin, iron, down TIBC --> up transferrin sat

Front 5

What are the typical signs and symptoms of hyper and hypothyroidism?

Back 5

hyper: heat intolerance, hyperactivity, wt loss, chest pain/palpitations, arrhythmisa, diarrhea, up reflexes, warm, moist skin and fine hair

Hypo: cold intolerance, hypoactivity, wt gain, fatigue, lethargy, down appetite, constipation, weakness, down reflexs,myxedema (facial/periorbital), dry, cool skin and coarse, brittle hair

Front 6

breast pathology:

*MC breat tumor in women <25
*MC breast mass in postmenopausal women
*MC breast mass in premenopausal women
*MC form of breast cancer

Back 6

tumor <25:fibroadenoma
postmenopausal: invasive ductal
premenopausal: fibrocystic dz
common form: invasive ductal

Front 7

Describe how the properties and clinical use of leuprolide can change depending on how it is administered

Back 7

Leuprolide is a GnRH analog with agaonist prop when used in pulsatile fashion and antagonist when used in continuous fashion.

use for infertility (pulse), prostate cancer (continuous use with flutamid) and uterine fibroids

Front 8

For what reasons are tetracyclines and fluoroquinolones not given to children

Back 8

tetracyclilnes: dicoloration of teeth and inhibition of bone growth in children

fluoroquinolones: damage cartilage in children, leg cramps and myalgias

Front 9

What is the difference between a desmosome and a hemidesmosome?

Back 9

desmosome: (macula adherens) are small discrete sites of attachment; cadherins connect to intermediate filaments:

Hemi: connects cells to underlying e.c matrix

Front 10

What agent can be given as an inhaled drug to loosen mucus polugs, can be given orally to tx acetaminophen od and can be given orally as prophylaxis against IV contrast-induced nephropathy in those with preexisting renal dz?

Back 10

N-acetylcysteine. An antidote for acetaminophen OD and can loosen mucous plugs in CF pts

Front 11

What sexually transmitted organisma can cause osteomyelitis?

Back 11

N. gonorrhea

Front 12

What would you expect to see on a small bowel follow through of a pt with Crohn's dz?

Back 12

transmural inflammation: Cobblestone mucosa, creeping fat, bowel wall thinckening (sting sign) on barium swallow xray), linear ulcers , fissures, fistulas

Front 13

What is the m.o.a and clinical indication for the drug sucralfate? misoprostol?

Back 13

sucralfate: bind to ulcer base, providing physical protection and allow HCO3 secretion to reestablish ph gradient in the mucous layer. use for increasing healing ulcer and travele'rs diarrhea

misoprostol: A PGE1 analog, increases production and secretion of gastric mucous barier, decreasing acid prod. Use for prevention of NSAID induced peptic ulcer; maintenance of a PDA and induces labor

Front 14

What role do PG and AII play on renal arterioles?

Back 14

PG dilate afferent arterioles (up RPF, up GFR, so FF remains constant)

AII preferentially constrict efferent arteriole (down RPR, up GFR so FF increases)

Front 15

Antibiotic causing side effect.

*teet discoloration
*tendonitis
*red man syndrome
*gray baby syndrome
c*artilage damage in children
*nephrotox (esp with cephalosporins), ototox (esp with loops)
*pseudomembranous colitis

Back 15

teeth discoloration : tetracyclines
tendonitis: fluoroquinolones
red man syn: vancomycin
gray baby syn: chloramphenicol
cartilage damage in kids: fluoroquinolones
nephrotox with cephalosporins: aminoglycosides
ototox with loops: aminoglycosides
pseudomembranous colitis: clindamycin and aminopenicillins

Front 16

Which conditions are a/w oligohydramnios? polyhydramnios? What is Potter's syn?

Back 16

oligohydramnios: <0.5L amniotic fluid assoc with bilat renal agenesis or post urethral valves--> inability to excrete urine.

polyhydramnios: >1.5-2L of amniotic fluid assoc with esophageal/duodenal atresia--> inability to swallow fluid, anencephaly.

Potter's: bilat renal agenesis -->oligohydramnios --> limb deformities, facial deformities, pulm hypoplasia. Caused by malformation of ureteric bud

Front 17

What lab abnormalities would you see in a pt with hyperaldosteronism? why?

Back 17

hypokalemia, metab alkalosis and low plasma renin in primary due to aldosterone secreting tumor

in secondary high plasma renin due to renal art stenosis, chornic renal failure, CHF, cirrhosis or nephrotic syndrome. There is ano overactive RAAS

Front 18

What are the causes of aplastic anemia? Tx?

Back 18

radiation, benzene, chloramphenicol, alkylating agents, antimetabolites, viral agents (parvo B19, EBV, HIV), Fanconi's anemia (inherited defect in DNA repair) may follow acute hep

tx: w/d of offending agetn, immunosuppressive regimens (antithymocyte globulin, cyclosporine), allogenic bone marrow transplantation, RBC and platelet transfusion, G-CSF or GM-CSF

Front 19

During what stage of sleep do night terros, sleepwalking and enuresis occur? what med shorten this stage and thus helpful?

Back 19

stage 3-4.

BZD shorte stage 4 sleep
Imiparmine for enuresis.

Front 20

What exactly is DIC

Back 20

Activation of coag cascade leading to microthrombi and global consumption of platelets, fibrin, and coag factors.