Usmle Step 1 Flash Cards Caitlin Cohen

Front 1

What is the difference between classic and operant conditioning?

Back 1

In classic an OLD response (salivating) happening to a new stimulus (bell). Operant is an NEW response to an old stimulus (Food producing an aversion). Requires reinforcement.

Front 2

What is extinction

Back 2

discontinuing reinforcement that maintains an undesired behavior (eg a time out)

Front 3

What are the three steps of systematic desensitization?

Back 3

1) hierarchy, 2) muscle relaxation 3) relax in each level of the heirarchy

Front 4

What does APGAR stand for?

Back 4

Activity (tone), Pulse, Grimace (reflexes), Appearance (color), Resp

Front 5

What happens to HGH, prolactin, dopamine, serotonin, cortisol, TSH during sleep?

Back 5

up, up, down, up, up, down.

Front 6

What stage of sleep is sleepwalking?

Back 6

4

Front 7

What stage of sleep is enuresis?

Back 7

Delta (3 and 4)

Front 8

What is bruxism?

Back 8

teeth grinding

Front 9

What is narcolepsy? What do you use to tx?

Back 9

quick REM latency. Modafinil (non-amphetamine stimulant)

Front 10

What stage of sleep do night terrors happen versus nightmares?

Back 10

delta vs REM

Front 11

what do you use to tx delerium tremens

Back 11

thiamine. sedative hypnotics, anit-adrenergics to fix the hyperadrenergic state (clonipin and propanolol), lorazepam for seizires.

Front 12

what does cocaine do to neurotransmitters?

Back 12

blocks DA NE 5ht reuptake

Front 13

what do amphetamines do to neurotransmitters?

Back 13

release da ne 5ht and weak maoi

Front 14

how do you tx cocaine and amphetamine overdose?

Back 14

BZs

Front 15

Which channel to BZs and Barbs work on?

Back 15

BZs increase frequency of gaba A opening, barbs increase duration of opening.

Front 16

How do you treat BZ overdose?

Back 16

flumazenil

Front 17

what receptors do opioids stimulate

Back 17

mu kappa delta. mu is most important.

Front 18

what do you give for opioid overdose

Back 18

naloxone (short t1/2) or naltrexone

Front 19

What receptors does thc bind?

Back 19

CB1 and 2

Front 20

What drug mimics thc and is used as antiemetic

Back 20

dronabinol

Front 21

what receptor do hallucinogens bind

Back 21

5ht

Front 22

what drug is similar to PCP

Back 22

ketamine

Front 23

what treats tourettes

Back 23

molindone

Front 24

what are the three DA pathways in brain

Back 24

nigrostriatal, mesolimbic/mesocortical, tuberoinfundibular

Front 25

two common ADEs of antipsychotics

Back 25

extrapyramidal effects, hyperprolactinemia

Front 26

Neuroleptic malignant syndrome and rx

Back 26

really severe rxn to antipsychotic meds... mm rigidity, hyperthermia, autonomic instability. rx dantroline or DA agonists.

Front 27

akasthesia

Back 27

restlessness and twitching

Front 28

tardive dyskinesia

Back 28

involuntary repetitive motions of lips, face, tongue, limbs.

Front 29

Major clozipine ADE

Back 29

agranulocytosis

Front 30

sleep changes in depression

Back 30

increased REM, early AM wakening, less stage 4 sleep

Front 31

bipolar 2 v bipolar 1

Back 31

1 is more manic, 2 is more depressive and hypomanic

Front 32

rx for bipolar

Back 32

lithium, olanzapine, arirprazole, fluphenazine, valproate

Front 33

which three benzos are not metabolized in liver

Back 33

Out The Liver: Oxazepam, Temazepam, Lorazepam

Front 34

what meds can reduce vaginal lubrication?

Back 34

antihistamines, anticholinergics

Front 35

Sensitivity

Back 35

TP/(TP+FN) true positives/everyone with the disease

Front 36

Specificity

Back 36

TN/ (TN+FP) true negatives/ everyone without the disease

Front 37

PPV

Back 37

TP/ All positives

Front 38

NPV

Back 38

TP/All negatives

Front 39

accuracy

Back 39

TP plus TN/ total group

Front 40

do you use odds ratio or rr for a case-control study?

Back 40

OR

Front 41

Type 2 Beta error

Back 41

saying there is NOT a difference when there is

Front 42

type 1 alpha error

Back 42

saying there is a difference when there is not

Front 43

power of a study

Back 43

capacity to detect if there is a difference (1-beta)

Front 44

do you use RR or OR for a cohort study?

Back 44

RR

Front 45

late look bias

Back 45

info gathered at an innappropriate time

Front 46

standard error of the mean

Back 46

standard deviation over the square root of N

Front 47

psychological stress effects

Back 47

induces FFA production, 17OK corticoids (immunosuppression), chol/lipids, catecolamines, gastrocolic reflex/mucosal irritation

Front 48

Sleep eeg waveforms for awake, drowsy, 1, 2, 3-4, REM in that order

Back 48

BATS Drink Blood
Beta (high freq low amp)
Alpha
Theta
Sleep spindles and K
Delta (low frequency high aplitude)
Beta again

Front 49

what part of brain controls circadian rhythm and what does it control (X4)?

Back 49

suprachiasmatic nucleus in hypothal. Acth, prolactin, melatonin, NE at night

SCN senses light, releases NE, goes to pineal gland, produces melatonin.

Front 50

how do you calculate IQ?

Back 50

stanford binet or wechsler adult intel. scale

Front 51

rx for adhd

Back 51

methylphenedrate and dexedrine (amphetamine)

Front 52

tourettes

Back 52

motor and vocal tics, associated with OCD, begins in chidhood, rx with antipsychotics

Front 53

rett's disorder

Back 53

Xlinked, seen in girls (boys die in utero), loss of devt, verbal, ataxia, MR

Front 54

childhood degenerative disorder

Back 54

regressed functioning after 2 years of normal det. (loss of language, bladder control, etc around age 3 or 4)

Front 55

neurotransmitters and anxiety

Back 55

ne up, gaba down, se down

Front 56

neurotransmitters and deoression

Back 56

ne down, se down, da down

Front 57

neurotransmitters and altzheimers

Back 57

ach down

Front 58

neurotransmitters and huntingtons

Back 58

gaba down ach down

Front 59

neurotransmitters and schizophrenia

Back 59

DA up

Front 60

neurotransmitters and parkinsons

Back 60

DA down, ach up

Front 61

korsakoffs

Back 61

anteretrograde amnesia secondary to thiamine deficiency. associated with confabulation. destruction of mamillary bodies. often in etohics

Front 62

dissociative identity disorder

Back 62

like multiple personality disorder (new name). Rz w antipsychotics

Front 63

what is early morning awakening a sign of?

Back 63

MDD

Front 64

conversion disorder

Back 64

motor or sensory symptopms (like blindness) following an acute stressor (la belle indifference)

Front 65

which psych med is contraindicated in anorexia because of seizures

Back 65

bupropion

Front 66

What is a sensitive serum marker for etoh use

Back 66

gama glutamyl transferase (ggt)

Front 67

does cocaine dilate or constrict pupils? opioids?

Back 67

dilate (and constrict for opioids)

Front 68

what is characteristic of pcp intoxication

Back 68

beligerance. may reoccur as the drug moves to alkaline duodenum after acidic stomach

Front 69

wernickes

Back 69

thiamine deficiency.. confusion, opthalmoplegia, ataxia. may progress to korsikoff psychosis. tx B1 (thiamine)

Front 70

mallory-weiss syndrome

Back 70

longitudinal lacerations on GE jxn caused by vomiting. seen in bulemia and etoh etc. PAIN (unlike esoph varicies)

Front 71

three "mood stabilizers"

Back 71

lithium
valproic acid
carbamazipine

Front 72

which antidepressant/GAD tx causes an increase in BP

Back 72

venlafaxine for GAD

Front 73

What is trazadone used for?

Back 73

insomnia

Front 74

What is unique about mirtazapine as an antidepressant

Back 74

alpha 2 antagonist as well as 5ht. use for depression w insomnia

Front 75

what combination of medications can cause serotonin storm

Back 75

ssri plus MAOI

Front 76

what are the major SEs of TCAs

Back 76

convulsion, coma, cardiotox. and anticholinergic (tachy, urinary retention)

Front 77

what do you use to treat toxicity from tcas?

Back 77

naHCO3 for cv toxicity

Front 78

major difference between MDD and dysthymia?

Back 78

remittance and recurrance in MDD

Front 79

difference between schizoid and avoidant?

Back 79

schizoids like being withdrawn

Front 80

characteristics of disorganized schisophrenia

Back 80

disorganized speech, child-like behavior

Front 81

Is clozipine an atypical or typical? what is the major SE? what does this cause?

Back 81

atypical. agranulocytosis. sore throat and fever.

Front 82

which psych med causes diabetes insipidus

Back 82

lithium

Front 83

what do you use to treat acute dystonia in antipsychotic use (4 hrs). How about tardive dyskinesia (4 mo).

Back 83

anticholinergic to treat acute dystonia. Dopamine agonists to treat tardive dyskinesia and EPS. will not work on short-term dystonia. switch patient to an atypical antipsychotic, too.

Front 84

What are the four stages of EPSyx in response to antipsychotic meds

Back 84

acute dystonia 4h, akinesia 4d, akasthesia 4 wks, tardive dyskinesia 4 mo

Front 85

epistaxis, hypopigmented skin lesions on extremities and buttocks, loss of eyebrows, childhood history of asthma and atopic dermatitis.

What local cytokine would you use to treat it?

Back 85

mycobacterium leprae. Intracellular, infects macrophages. severe lepromatous disease happens when cd4 type 1 differentiate into type 2

ifn gamma is secreted by th1 cells and activates macrophages, helps kill the disease

Front 86

where is rocky mountain spotty fever most common?

Back 86

southeastern USA

Front 87

how do you define direct v indirect hernia. Which has less of a chance of strangulation?

Back 87

through the abdominal wall vs through the internal ring (patent procesus vaginalis, more common). both can exit the external ring. Direct strangulates less.

Front 88

what is the peak incidence for osteosarcoma? how can you differentiate from mets?

Back 88

teenage males. No nodular lesions in osteosarcoma. also sytemic syx.

Front 89

red tender subq nodules on lower leg, panniculitis, accompanied by fever and malaise. And five things it is associated with.

Back 89

inflamation of sub q fat called erythema nodosum. associated with IBD, sarcoid, OCPs/sulfas, some infections and malignancies.

Front 90

is osteoarthritis more common in weight bearing joints or small joints?

Back 90

weight bearing

Front 91

what innervates the adductor policis? and what else in the hand does this innervate? what hand do you get when this doesn't work?

Back 91

ulnar. also other hypothenar mms and some lumbricals and most interosseii. get an ulnar claw= popes blessing on extension.

Front 92

do lateral pterygoids open or close jaw?

Back 92

medial munch, lateral lower

Front 93

drug induced lupus: what kind of antibodies are present?

Back 93

antihistone abs.

Front 94

bowing v buckle v greenstick v spiral fracture

Back 94

deformed b/c pediatric bone has greater compiance, budging or buckling of periosteum from compression, perioisteum on convex part is torn due to accidents. spiral fracture caused by twisting= abuse?

Front 95

sicca v sjogrens?

Back 95

sjogrens happens with arthritis, skin stuff, other ct or autoimmune disorder. sicca is just dry eyes and mouth

Front 96

what does crest stand for?

Back 96

calcinosis, raynauds, esoph dysfxn, sclerodactyle, telangectasias. some skin involvement compared with diffuse scleroderma, but less.

Front 97

rachitic rosary

Back 97

vit d deficiency.

Front 98

is alk phos up or down in vit d deficiency?

Back 98

up. trying to make bone but cant.

Front 99

what kind of Ig is RF?

Back 99

IgG. Though both IgG and IgM are elevated.

Front 100

what kind of hypersensitivity is RA?

Back 100

type 3 immune complex.