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Clues usmle
| Question | Answer |
|---|---|
| Gait abnormality | Ataxia Telengiectasia |
| Ataxic gait (wide based unsteady gait) heel to toe walking difficulty | Cerebellar dysfunction (stroke, alcohol intoxication, multiple sclerosis) |
| Parkinsonian (hypokinetic, Shuffling gait) | Lesion in Basal ganglia (substantia nigra, dopamine depletion) |
| Steppage (high stepping gait), foot drop. Exaggerated hip /knee extension | Lesion peripheral nerves (L5 radiculopathy, peroneal nerve palsy) |
| Waddling (myopathic, trendelenburg gait)bilateral pelvic drop (duchene muscular dystrophy) | Lesion in gluteus medius/minimus weakness (superior gluteal nerve lesion) |
| Magnetic (shuffling apraxia gait) Normal pressure hydrocephalus | Gait disturbance, urinary incontinence, dementia, enlarged ventricles |
| Nystagmus and increase sensitivity to light | Chediak Higashi syndrome, oculocutaneous albinism, platelet dysfunction |
| Absence of the thymic shadow on CXR | SCID, low levels of Ig |
| Bruising | Wisckott Aldrich syndrome, dermatitis, thrombocytopenia, low IgM, normal IgG, up IgA, IgD, IgE |
| Double stranded linear DNA | EBV associated with Hodgkin lymphoma |
| Single stranded positive linear RNA | Hepviruses, caliciviruses, flaviviruses, coronaviruses, retroviruses |
| Single stranded negative linear RNA | Orthomyxoviruses, paramyxoviruses, rhabdoviruses, filoviruses |
| Single stranded circular RNA | Arenaviruses, bunyaviruses, delta viruses |
| Nystagmus, ataxia, dysarthria | Cerebellar lesion |
| Nystagmus, vertigo, hearing loss | Vestibular dysfuction |
| Nystagmus, increase sensitivity to light/touch (hyperesthesia) | Brainstem or thalamic lesion |
| Internuclear opthalmoplegia (INO), fatigue, sensory disturbances | MS |
| Ipsilateral facial pain,temp loss, contralateral body pain/temp loss | Lateral medullary syndrome |
| Contralateral burning pain, hypersensitivity | Thalamic stroke |
| Nystagmus, hyperacusia, facial nerve involvement | Bell’s palsy (CN VII), Ramsey hunt syndrome (zooster oticus) |
| Young women, optic neuritis, INO, fatigue, sensory symptoms | MS |
| Recent viral infection, sudden vertigo, nystagmus | Vestibular neuritis/labyrinthitis |
| Alcoholism or malnutrition, ataxia, ophthalmplegia, confusion | WERNICKE encephalopathy |
| Contralateral burning pain, allodynia, hemisensory loss | Thalamic stroke |
| MUDPILES low ph low HCO3 compensatory low PCO2 | Metabolic acidosis |
| Vision loss, anion gap, high osmolar gap | Methanol |
| Chronic kidney disease, high BUN/Cr | Uremia |
| Fruity breath, kussmaul respirations | Diabetic ketoacidosis |
| Found in antifreeze, seizures | Isoniazid/iron overdose |
| Sepsis, hypoxia, metformin toxicity | Lactic acidosis |
| Calcium oxalate crystals in urine, renal failure | Ethylene glycol |
| Early respiratory alkalosis, later metabolic acidosis | Salicylates |
| Normal anion Gap metabolic acidosis mnemonic | HARDASS |
| IV nutrition | Hyperalimentation (causes acidosis) |
| low aldosterone produce Na loss H retention | Addison disease (acidosis) |
| Type I distal, urine ph <5.5, type IV hypoaldosteronism | Renal tubular acidosis (RTA) (metab acidosis) |
| Loss of bicarbonate, hypokalemia | Diarrhea (metab acidosis) |
| Carbonic anhydrase inhibitor causes HCO3 loss (OUT) | Acetazolamide (metabolic acidosi) |
| Hyperkalemia, normal anion gap metabolic acidosis | Spironolactone |
| Dilutional acidosis | Saline infusion(acidosis) |
| High pH high HCO3 compensatory high PCO2 | Metabolic alkalosis |
| Loss of HCI, hypokalemia, hypochloremia | Vomiting or NG suction (alkalosis) |
| Loss of Na, K, Cl cause H shift into cells | Diuretic use (loop/thiazide) alkalosis |
| High Na retention, K and H loss | Hyperaldosteronism (CONN sx) alkalosis |
| Resemble loop/thiazide diuretic use | Bartter & Gitelman syndrome |
| Excess calcium and anti acid ingestion | Milk alkali syndrome |
| Alkalosis, u waves on ECG | Hypokalemia (alkalosis) |
| Low pH high PCO2 compensatory high HCO3 | Respiratory acidosis |
| COPD, asthma, respiratory depression, opioids, benzodiazepines, OSA, hypoventilation are | Respiratory acidosis |
| High pH low PCO2 low HCO3 | Respiratory alkalosis |
| Jaw deviate toward lesion | CN V trigeminal lesion |
| Uvula deviates away from lesion | CN X lesion |
| Tongue deviates toward lesion | CN XII lesion |
| Sudden thunderclap headache | Subarachnoid hemorrhage |
| Unilateral headache, jaw claudication | Temporal arteritis (check ESR) |
| Loss of pain/temp on one side of face, opposite body | Lateral medullary syndrome Wallenberg |
| Bilateral loss of pain/ temp, cape like distribution | Syringomyelia |
| Confusion, ophthalmoplegia, ataxia | WERNICKE encephalopathy (B1 deficiency) |
| Young athlete, sudden cardiac death, septal hypertrophy | Hypertrophic cardiomyopathy |
| Holosystolic murmur, radiates to axilla | Mitral regurgitation |
| Continuos machine like murmur | PDA |
| Boot shaped heart on X-ray | Tetralogy of fallot |
| ST elevation in all leads | Pericarditis |
| Displaced PMI, S3 heart sound | Dilated cardiomyopathy |
| Hematuria, hearing loss, eye problems | Alport syndrome |
| Child, periorbital edema, frothy urine | Minimal change disease |
| Kidney stone, hexagonal crystals | Cystinuria |
| Urine smells like maple syrup | Maple syrup urine disease |
| Enveloped shaped crystals in urine | Calcium oxalate (ethylene glycol poisoning) |
| Child with abdominal mass, opsoclonus-myoclonus | Neuroblastoma (high HVA/VMA in urine) |
| Kid with severe fasting, hypoglycemia, hepatomegaly | Von Gierke disease (glucose 6 phosphatase deficiency) |
| Cafe au lait spots, polyostotic fibrous dysplasia, precocious puberty | McCune Albright syndrome |
| Hypertension, hypokalemia, metabolic alkalosis | Conn syndrome (hyperaldosteronism) |
| Reed sternberg cells | Hodgkin lymphoma |
| 9-22 BCR ABL fusion | CML (philadelphia ) |
| 8-14 cMYC | Burkitt lymphoma (starry sky) |
| 15-17 APL subtype of AML | Treat with all trans retinoids acid |
| Child with fever, bone pain, BLAST on smear | ALL |
| Elderly with SMUDGE cells | CLL |
| Morning stiffness >1 hr improves with use | RA |
| Uris acid crystals, negatively birefringent | Gout (monosodium urate crystals) |
| Bilateral hilar adenopathy, noncaseating granulomas | Sarcoidosis |
| Snowstorm appearance USG, high hCG | Hydatidiform mole |
| Infant with hypotonia, large tongue, umbilical hernia | Congenital hypothyroidism |
| Severe muscle cramps after exercise, dark urine | McArdle disease (glycogen storage disease type V) |
| Neonatal hypotonia, almond shaped eyes, obesity | Prader Willi syndrome |
| Happy puppet, inappropriate laughter, seizures | Angelman syndrome |
| Unilateral pstosis, miosis, anhidrosis | Horner |
| Headache, jaw claudication, poly myalgia rheumatica | Giant cell arteritis |
| Flaccid paralysis, dry mouth, diplopia | Botulism (clostridial neurotoxin) |
| Ascending paralysis after GI infection | Guillem Barre (campylobacter jejuni) |
| Stiff baby with clenched fists, hyperreflexia | Cerebral palsy |
| Hyperreflexia, babinski, spastic paralysis | UMN lesion |
| Fasciculation, atrophy, flaccid paralysis | LMN lesion |
| Dementia, myoclonus, periodic sharp waves on EEG | Creutzfeldt Jakob disease |
| Diastolic murmur with opening snap | Mitral stenosis |
| Periorbital edema. Proteinuria >3.5 hyperlipidemia | Nephrotic syndrome |
| Renal failure, hemolysis, thrombocytopenia in child after bloody diarrhea | HUS hemolytic uremic syndrome |
| Result in supravalvular aortic stenosis or loose hanging skin seen in cutis laxa | Elastin defect |
| Lead to marfan Sx, ectopia Lentis, arachnodactyly, scoliosis | Fibrillin-1 defect |
| Disorders like osteogenesis imperfecta | Type 1 collagen defect |
| Present in Alport Sx, disturbance in vision, hearing and renal (COL4A5)basement protein | Type IV collagen defect |
| Essential in fibrillar collagen, elasticity, arteries, skin, smooth muscle, liver, spleen, kidney and lung | Type III collagen COL3A1 gene |
| Inferior pancreaticoduodenal arteries are branches of | Superior mesenteric arteries |
| Respecting a portion of duodenum or head of pancreas requires ligation of | Gastroduodenal and superior mesenteric arteries. |
| Neck, body, tail of pancreas major arterial supply from | Splenic artery |
| Deficient in Cori, hypoglycemia, glycogen in liver, hepatomegaly, normal lactate | Alpha-1-6 glucosidase |
| Deficiency leads to absence liver glycogen, fasting hypoglycemia and ketonuria | Glycogen synthase |
| Deficient in Von Gierke. Severe fasting hypoglycemia, glycogen liver, hepatomegaly high blood lactate | Glucose -6 phosphatase |
| Defect in Pompe, respiratory diaphragmatic weakness, cardiomegaly, progressive loss muscle tone | Lysosomal alpha-1,4 glucosidase |
| PYGM gene, leads to exercise energy deficit, muscle injury. Myoglobinuria | Myophosphorylase |
| Used to treat heparin and warfarin overdose | Protamine sulfate and vit K |
| Prothrombin time normal, partial thromboplastin up platelet normal bleeding up | Hemophilia |
| Prothrombin up partial thromboplastin up platelet normal bleeding normal | Vit K deficency |
| Mnemonic for DiGeorge sx | CATCH (cleft, abnormal facies, Thymic aplasia, Cardiac defects, Hypocalcemia) |
| Thymus is derived from | Third pharyngeal pouch |
| Develops in maxillary and mandibular structures (maxillary, mandibular, mastication, masseter | First pharyngeal arch (M letter) |
| Facial structures, stapedius, stylohyoid, platysma, stapes | Second pharyngeal arch (s letter) |
| Associated with thymic aplasia, cleft palate, abnormal facies, cardiac defects, hypocalcemia | DiGeorge Sx |
| Shortness of breath, pulmonary crackles, early systolic murmur days after MI | Papillary muscle rupture 2-7 days after MI |
| Hypotension, distant heart sounds, pulsus paradoxus, low QRS | Cardiac tamponade |
| Persistent chest pain, syncope, distended jugular veins, causes sudden death | Ventricular rupture MI 3-14 days after |
Created by:
Lillithys
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