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USMLEWORLD buzzwords - step 1
Notes from USMLEWORLD step 1 qbank
Terms in this set (184)
Subcutaneous nodules (xanthomas), family history
Familial hypercholesterolemia; decreased LDL receptors
Mid-abdominal pain, waking up during the night, relieved by eating a light meal
Peptic ulcer; urea breath test for urease produced by Helicobacter pylori
Low-pitched, mid-diastolic murmur at the cardiac apex
Mitral stenosis (MS), most commonly caused by Rheumatic fever
Mild abdominal discomfort (GI hamartomatous polyps), pigmented mucocutaneous macules
Peutz-Jeghers syndrome, autosomal dominant
Tender mass, cytoplasmic vacuoles (cytoplasmic lipid), scalloping of the nuclear membrane
In autoimmune blistering disease (Pemphigus vulgaris), the autoantibodies react with an antigen at which location?
An infant dies from shortness of breath and low lung compliance (Neonatal respiratory distress syndrome, NRDS). Which cells are dysfunctional?
Type 2 pneumocytes
Apical bronchogenic carcinoma that invades the brachial plexus (Pancoast tumor) results in eye asymmetry and anisocoria (Horner syndrome)
Sympathetic trunk (superior cervical ganglion) invovled
Method to achieve fertility in a patient with Turner's syndrome
In vitro fertilization (IVF)
Depressive patient complaints excessive thirst and dry mouth after hospitalization, urine remains dilute following water depreviation
Renal tubular dysfunction caused by lithium; nephrogenic diabetes insipidus (DI)
Infant, bright bleeding per rectum, microscopic evaluation of discharge reveal gastric mucosal cells
Gastric mucosa (Meckel diverticulum)
Chest pain, sudden death of an African American in young age
Hypertrophic cardiomyopathy (HCM); Normal coronary arteries, hypertrophy of the LV myocardium, LV outlet obstruction
Second heart sound (S2)
Closure of the aortic (A2) and pulmonic valves (P2); left ventricular pressure has fallen just below aortic pressure at the onset of isovolumetric left ventricular relaxation.
Best blood donor for a patient with IgA deficiency
A patient with IgA deficiency; due to anti-IgA antibodies in their blood
Replicating DNA strands contains multiple discontinuous fragments of DNA with intervening RNA fragments (RNA primer).
DNA polymerase I inhibited
Most accurate ROC curve in diagnosing a disease
The curve has the largest area under the curve
Elderly female, adnexal mass, abdominal discomfort
Ovarian caner; increased CA 125
Solid organ transplant patient, decling renal function
Vomiting, Parkinson history, which medication should be avoided?
Metroclopramide; can exacerbate Parkinsonian syndrome
Urine turns dark on standing, homogentisic acid in urine, what is the most prominent long-term consequence?
Debilitating arthritis; due to alkaptonuria, homogentisate 1,2-dioxygenase (HGO) deficiency
Rigidity, tremor that disappears with motion
Parkinsonism, damage to substantia nigra, located in the midbrain
A patient with atrial fibrillation experience foot pain (acute ischemia), which is most likely increased in the extracellular space of the affected region?
Potassium, via reduced functionality of membrane Na-K-ATPase
Darkly stained (protein accumulation) cells adjacent to the renal glomerulus
Juxtaglomerular cells, secrete renin
Amniotic fluid is added to a test well containing ethanol, shaken, stable ring of foam
Test for surfactant
Female athlete, vertebral fracture (osteoporosis), disordered eating, amenorrhea
Estrogen deficiency, due to decreased LH and GnRH
Vision prolem (ectopia lentis), mental retardation, cystathionine synthase deficiency
Homocystinuria; Methionine and Homocysteine accumulate
A round fluid-filled space within pancreas on CT (Pancreatic pseudocyst)
Complementary DNA sequences run in an antiparallel direction
From 3' end to 5' end
Heparin is a safer choice in pregnant woman compared to warfarin because of?
High water solubility; warfarin is a lipophilic molecule that can easily cross the placenta
Urinary infection caused by Gram-negative cocci
Neisseria gonorrhoeae; pili is responsible for infection
Treatment of Eye infection in AIDS (CMV retinitis)
Ganciclovir, blocks DNA chain elongation
Benefits of smoking cessation
Decreases the risk of lung cancer, myocardial infarction, and cerebrovascular accident
Outbreak transmitted from poultry to human (bird flu, avian flu)
antigenic shift, genetic reassortment
Early adulthood, muscle pain on exertion, exercise tolerance
McArdle disease (glycogen storage disease type IV), impaired glycogenolysis
Peaked T-waves on EKG
Bulging eyes, weight loss, palpitation
Graves disease; glycosaminoglycan synthesis by fibroblasts results in the eye symptoms
Palpitations, dyspnea on exertion, an irregular heartbeat and absence of p-waves on EKG
Atrial fibrillation (AF); loss of the a-wave from the jugular venous pressure (JVP) tracing.
A child squats during cyanotic episodes in order to improve oxygenation
Tetralogy of Fallot, most common cyanotic congenital heart defect
A tumor on the dorsal midbrain (pineal tumor)
Upward gaze palsy, absent pupillary light reflex, failure of convergence and a wide-based gait
Where do gastrointestinal stem cells reside?
Crypts of Lieberkuhn
Chronic alcoholic, frequent falls, tremor
Damage of cerebellum
An agent that increases peripheral vascular resistance, increases systolic blood pressure, decreases pulse pressure, and decreases heart rate
Phenylephrine, a selective α1-adrenergic receptor agonist
TATA and CAAT boxes
Hypermobile joints, hyperextensible skin, brusies easily, family history
Ehlers-Danlos syndrome (EDS), an autosomal recessive defect in lysyl hydroxylase; bruising tendency is similar to Vitamin C deficiency
In radioimmunoassay (RIA), if substance Y and substance X had the same epitoes, then
The plot of radioactivity against increasing concentraiton of substance Y would show a proportionate decrease in radioactivity.
A defense mechanism where inappropirate actions are explained using logical reasoning that was not part of the thought process leading to the original action
Liver biopsy shows spherical nodules within the confines of fibrous septae.
Cirrhosis; the regenerative nodules are composed of proliferating hepatocytes.
Increased resistance to passive movement about a joint (cogwheel regidity)
Young female evaluated for infertility, normal height and normal progesterone level
Previous pelvic inflammatory disease
Antibiotics that bind to a pocket within the 23S rRNA moiety of the prokaryotic 50S ribosomal subunit, block translocation of the ribosome along mRNA.
Macrolide (e.g., Erythromycin) and clindamycin
A painless, compressible mass above the left clavicle that transilluminate
Cystic hygroma; associated with chromosomal aneuploidy (i.e., Turner syndrome, trisomies)
The neuronal action potential will increase with
Increase in extracellular sodium concentrations or decreases in intracellular sodium concentrations
A linear, erythematous rash that develops shortly after a hiking trip
Plant-induced allergic contact dermatitis (e.g., poison ivy); type IV hypersensitivity (delayed-type hypersensitivity)
Sickle cell patient, sepsis due to encapsulated Gram-positive cocci
Lactose intolerance getting worse with age
Expression of lactase gene declines with age
External radiation therapy to the head and neck during childhood
Increased riks of developing thyroid cancer
Inappropriate sexual behavior, constant food seeking (oral fixation), hyperphagia
Kluver-Bucy syndrome (KBS); damage to amygdala (temporal lobe)
In the urea cycle, which step releases urea
Arginine to ornithine
Mechnical ventilation, blood pH > 7.4, PaCO2 < 40 mmHg
Respiratory alkalosis due to hyperventilation; kidney compensation results in increased urine pH
Mechanism of action for clyclosporine
Inhibiting IL-2 transcription
Lip smaking and tongue protruding (Involuntary movements), psychiatric history
Tardive dyskinesia, upregulation of dopamine receptors, decrease in cholinergic tone in the striatum
Deficiency of dopamine hydroxylase
Orthostatic hypotension (defect in sympathetic nervous system)
P wave in EKG
Exertional dyspnea, poor exercise tolerance, smoking history
COPD, increased residual volume and total lung capacity
When normal cells are cultured in a Petri dish, they reproduce until the medium is covered with a single layer of cells.
Contact inhibition. Malignant cells do not show contact inhibition and will pile up into small mounds.
Advantage of the inactivated polio vaccine over the oral form
Does not revert to a virulent form
Face and neck edema, neck vein engorgement
Superior vena cava (SVC) syndrome. In axial sections, the SVC can be seen in the region of the right heart, just lateral to the ascending aorta.
Improper use of crutches;
Midshaft fractures of the humerus
Radial nerve injury; weakness of elbow extension.
Deficiency of carbonic anhydrase in bone cells
Impaired bone modeling (bone demineralization)
dsDNA replication (e.g., adenovirus)
DNA-dependent DNA polymerase
Painful pharyngeal contractures, eosinophilic cytoplasmic inclusions in hippocampal neurons (Negri bodies)
Rabies infection; animal contact
Which will be increased in renal artery stenosis?
Filtration fraction, due to decreased renal blood flow.
Understimulation of which receptor is responsible for orthostatic hypotension?
Which medication to treat psoriasis has strong teratogenic potential?
Mechanisms of bacterial resistance to aminoglycosides (e.g., gentamicin)
Poor drug penetration through the bacterial membrane
Weight loss agent FDA-approved for the treatment of obesity
Orlistat; inhibiting intestinal lipase to inhibit fat absorption in the gut
Curve produced by Cooperative kinetics
Sigmoid shape. Michaelis-Menten kinetics produces a hyperbolic curve.
Venous drainge from the rectum to liver
Superior rectal vein -> inferior mesenteric vein -> splenic vein -> portal vein
Dry skin (xerosis)
Skin moisturization after bathing
Exercise-induced muscle pain, colored urine (myoglobinuria)
McArdle disease (glycogen storage disease V), glycogen accumulation, myophosphorylase deficiency
Effect of insulin on phosphofructoinase (PFK-2)
Increased fructose-6-phosphate -> promoting PFK-2 activity -> increased fructose-2,6-bisphosphate (glycolysis)
Membrane-associated proteins (hydrophobic)
Glycine, alanine, valine, leucine, isoleucine, phenylalanine, tryptophan, methionine, and proline.
Spread of infection from the orbit, nose and paranasal sinuses will result in thrombosis of which dural sinus?
Cyanosis that worsens with feeding, crying or exercise; squat to improve pulmonary blood flow
Tetralogy of Fallot
Bilateral parotid swelling, a swollen and tender scrotum, does not "fell like having sex"
Mumps-induced orchitis; Leydig cell atrophy, decreased testosterone
Abdominal pain, bloody diarrhea, homosexual, trophozoites with phagocytosed blood cells in stool
Entamoeba histolytica; transmitted through oral-anal contact
Excessive contracture of the hip flexors, weakness of the hip extensors.
Proteinuria, spike-like deposition, adult
Membranous glomerulonephritis; associated with chronic infection, autoimmune disease, or an underlying carcinoma
GI hormones stimulate insulin release following oral consumption of glucose
Incretin, glucagon-like peptide (GLP-1), gastric inhibitory peptide (glucose-dependent insulinotropic peptide, GIP)
An infant born to a hypertensive women, renal failure
ACE inhibitor fetopathy (AIF); impaired angiotensinogen metabolism
Mechanism of action of Statins
Increased LDL receptor-mediated endocytosis in hepatocytes, decreased circulating LDL levels
ApoB-48, a truncated form of ApoB-100, is produced by
Intestinal enterocytes; ApoB-100 is produced by hepatocytes.
Testis, Gram stain shows neutrophils but no organisms
Chlamydia trachomatis; treat with bacterial protein synthesis inhibitor (e.g., azithromycin).
Penicillin and probenecid
Imipenem and cilastatin; combinations of an antibiotic with a drug that inhibits renal tubular secretion of the antibiotic.
Tetracycline side effects
Tooth discoloration, retarded bone formation.
Hypertension, hypokalemia, deficiencies of cortisol and sex steroids
17α-hydroxylase deficiency (congenital adrenal hyperplasia)
Decreased venous return to the heart
DNA from skin cells accumulates covalently bound adjacent pyrimidines
Xeroderma pigmentosum; defects in DNA repair process
t(14; 18), Bcl-2
Flesh-colored skin nodules (cafe-au-lait), axillary freckling, pigmented iris hamartomas (Lisch nodules)
Neurofibromatosis type 1, Schwann cells proliferations in the skin nodules
Normal distribution, 68/95/99 rule
68% within 1 SD, 95% within 2 SDs, 99.7% within 3 SDs of the mean.
Drug raising HDL level
Niacin; use Aspirin to diminishe the side effects
Abdominal cramping, loose and blood stools, neutrophils accumulate in the crypt mucosa
Ovarian follicular atresia
Agglutination inhibition test
Presence of agglutination is considered a negative result
Urinary retention due to taking antidepressant drug
Tricyclic antidepressant (e.g., amitriptyline)
Restriction fragment length polymorphism (RFLP)
Single nucleotide polymorphisms (SNPs) are the most common cause of RFLP.
Paclitaxel coating in coronary artery stents
Inhibiting intimal hyperplasia
Fever, chills, sore throat, a single-strand RNA virus that replicates in the nucleus
Effect of insulin on the GLUT4 protein in adipose cells
Translocates the protein to the cell membrane
Muscle that pulls the distal clavicular fragment inferolaterally
Deltoid; Trapezius draws superomedially
Numbness of the anterolateral leg and dorsal foot
Injury of common peroneal nerve
Seven transmembrane α-helical domains
High blood ammonium, increased urinary orotic acid (accumulation of carbamoyl phosphate)
Ornithine transcarbamoylase deficiency
Defective proline hydroxylation
Failure of triple-helix formation and stabilization by pro-alpha chains during collagen synthesis
Bacterial host DNA is packages into a bacteriophage (viron instead of viral genome)
Transduction, no new virus synthesized. Virion is able to infect cells, but not able to produce progeny.
Temporal lobe herniated through tentorium
Uncal herniation; oculomotor nerve affected
Multiple physical complaints including four pain symptoms, two GI symptoms, one sexual symptom and one pseudoneurological symptom before age 30
The number of CAG (polyglutamine) repeats increases
Huntington disease; anticipation
Postmenopausal female, vertebral fracture following minor trauma
Osteoporosis; ovarian hypofunction, estrogen deficiency
Memory impairment in an alcoholic patient
17-alpha-hydroxylase deficiency, insufficient sex hormones and cortisol and overproduce aldosterone
LH and ACTH increased, renin decreased
Heterozygote of MCAD deficiency
Have half the normal level of MCAD activity while remaining phenotypically normal
Biochemical pathway that uses glycine and succinyl-CoA as substrates in liver
Fatigue, muscle cramps and weakness
Tuberculosis of the lumbar vertebrae
Psoas major muscle involved, abcess in the groin
Young patient preseting with herpes zoster (grouped or solitary vesicles on an erythematous base in a dermatomal distribution)
Antihypertensive drug that causes increased renin level and decreased angiotensin II and aldosterone levels
ACE inhibitor (e.g., captopril)
Virus antigen that gains acces to the cell by non-normal way(injection) treated as extrinsic protein
MHC II are expressed by macrophages and B cells, recognized by CD4 helper T cells
Elderly female, pain and stiffness in fingers after knitting
Osteoarthritis; repeated mechanical trauma
Mechnical ventilation, respiratory acidosis, hypoxemia
Increased physiologic dead space and/or physiologic right-to-left shunt
Hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome)
Female, dyspareunia, red/blue punctate lesions on the bladder mucosa
HIV, abdominal pain, diarrhea, colonoscopy shows erythema, ulcerations and nodular lesions.
CMV (herpesvirus) colitis
Antiretroviral medication derived from gp41 on HIV
Enfuvirtide; prevent HIV viral fusion and entry into host cells
Severe lower extremity in the absence of an explanation for such edema (e.g., right heart failure, hepatic cirrhosis or nephrotic syndrome)
Inferior vena cava (IVC) obstruction
Flank pain, flank mass, hematuria, increased hemoglobin
Excessive erythropoietin produced by renal cell carcinoma
A single point mutation in the viral protease region of the HIV pol gene
Resistance to all protease inhibitors, with the suffix "-navir". (e.g., indinavir, ritonavir)
Cerebellar and retinal hemangioblastomas
von Hippel-Lindau syndrome; renal cell carcinoma, pheochromocytoma
Increased oxygen affinity of normal hemoglobin; dissociation curve resembles that of fetal hemoglobin (HbF).
Copper deposits in the cornea (Kayser-Fleischer ring)
Phagocytosis of bacterials by neutrophils
NADPH oxidase; Neutrophil oxidative (respiratory) burst
Point mutation resulting in the substitution of one amino acid for another
A firm, mobile breast nodule in young woman, increasing in size during pregnancy, lactation or menstrual cycle
Mutation of chromosome 9p21
Dysplastic nevus syndrome; family history of melanoma
Widening of the mediastinum and an abnormal aortic contour on chest x-ray, chronic uncontrolled hypertension, normal EKG
Drugs that increase choloride conductance produced by GABA
Benzodiazepines and barbiturates; Flumazenil competitively inhibits benzodiazepines.
Cardiovascular response to exercise: increased heart rate and LV end-diastolic volume, decreased LV end-systolic volume, unchanged LV end-diastolic pressure
Normal response to exercise
Chronic alcohol consumption
Cerebellar degeneration; derivative of the rhombencephalon
A short α-helix protein fragment with leucine residues at every seventh position
Leucine zipper dimerization domain; nucleic acid-binding domain
Painless lymphadenopathy, fever, night sweats, weight loss, owl's eyes cell (Reed-Sternberg)
G protein-coupled receptor stimulates hydrolysis of membrane-bound phospholipids
Phospholipase C -> IP3 -> DAG -> Ca2+ efflux -> Protein Kinase-c
The first reaction in the synthesis of pyrimidines using CO2 occurs in
Pain due to flex the hip against resistance
Psoas muscle inflammation
Chronic alcoholic, foot edema, exertional dyspnea
What structure of mycobacterial cell membranes is responsible for Carbolfuchsin stain (acid-fast staining)
Mycolic acid; inhibited by isoniazid.
Crescentic proliferations of the epithelial cells lining Bowman's space on histologic examination
Anti-GBM disease (Rapidly progressive glomerulonephritis, RPGN); IgG deposits.
Irregular vaginal bleeding and high β-hCG within weeks after childbirth
An enlarged parathyroid gland and three small atrophic parathyroid glands
Negative feedback inhibition; parathyroid adenoma
Acne drugs binding nuclear receptors
Retinoid (isotretinoin, acitretin, tretinoin, adapalene, and tazarotene)
Major risk factors for coronary artery disease
Smoking, dyslipidemia, hypertension, diabetes, prior ischemic heart disease
Which structures pass through the diaphragm alongside the esophagus?
Mechanism of action of amlodipine (calcium channel blocker)
Decreases afterload and cardiac work by causing arteriolar vasodilatation
Young adult, pancreatic islet cells have a high set point for insulin secretion
Glucokinase deficiency; maturity onset diabetes of the yourng (MODY)
Severe hypoglycemia, hepatomegaly, administration of fructose causes lactic acidosis
von Gierke disease (glycogen storage disease type I), glucose-6-phosphatase deficiency
Hypertrophic cardiomyopathy, hypotonia in infant, PAS-positive intracellular granules (glycogen accumulation within lysosomes)
Pompe disease (glycogen storage disease type II), lysosomal enzyme deficiency (acid maltase, acid alpha-glucosidase)
Male, infertility, gynecomastia, small firm testes, low testosterone, increased LH and estradiol
Klinefelter syndrome (47XXY); karyotype analysis for diagnosis
Typical lab findings of DIC
Low fibrinogen and pletelets, prolongation of PT and PTT, increased fibrin degradation products
Subtherapeutic INR (low INR, warfarin is metabolized faster)
P450 inducer (e.g., phenobarbital antiepileptic therapy)
Blue-black discoloration of the skin, nails, cartilage and sclerae
Ochronosis; tyrosine degradation impairment, alkaptonuria
Sickle cell anemia, bone pain
Osteomyelitis, Gram-negative rod (Selmonella)
Pinpoint pupils, loss of horizontal gaze, quadriparesis, decerebrate posturing, and rapidly evolving coma culminating in death within hours
Brain tumor, increased intracranial pressure
Reactive arthritis, conjunctivitis, urethritis
Reiter syndrome; urogenital infection with Chlamydia trachomatis
Which structure within the female genital tract has two types of epithelium
Cervix; columnar epthelium and stratified squamous epithelium
Tetanus; exotoxin-induced muscle spasm
Anti-HAV IgM positive
Acute hepatitis A
Menigitis in AIDS, yeast in CSF
Cryptococcus neoformans infection; treat with amphotericin B (binds ergosterol, creating pores in fungal cell membranes).
Reddish-purple skin patches in AIDS
Kaposi sarcoma; associated human herpes virus-8 (HHV-8)
Fail to concentrate urine with dehydration, increased vasopressin
Nephrogenic diabetes insipidus (DI); renal tubular dysfunction
Renal tubular dysfunction due to lung nodule
Hypercalcemia of malignancy
Platelet inhibition drugs that are analogs of the carboxyl terminal of the delta chain of fibrinogen
Glycoprotein IIb/IIIa antagonist (abciximab, eptifibatide, and tirofiban); competitive inhibitor of integrin
Clopidogrel coadministrated with omeprazole increases the risk of thrombosis
Clopidogrel must be activated by P450, a P450 inhibitor (omeprazole) would decrease the efficacy of clopidogrel.
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