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USMLE - Random

USMLE - questions I got wrong

QuestionAnswer
first set of lymph nodes that drain testes para-aortic
first set of lymph nodes that will show metastases for colon/rectal cancer if the cancer is below the pectineal line inguinal - palpable
first set of lymph nodes that will show metastases for colon/rectal cancer if the cancer is above the pectineal line iliac - inside the pelvis and not palpable
what does + leukocyte esterase test mean in urinalysis? neutrophils in urine --> bacterial infection
What does Enterobacter do with nitrate? nitrate ---> nitrite
reactivity for nitrite enterobacter (includes klebsiella), eColi, P aeruginosa. Trite: Enter the eCommon Place Kleb.
UTI with no nitrite reactivity enterococci (faecalis)
acute interstitial nephritis can be a hypersensitivity reaction to what drugs NSAIDs and antibiotics
how does a patient with acute interstitial nephritis present? acute renal failure, fever, maculopapular rash, periorbital edema and eosinophilia. Remember: 2 types of sxs: 1. renal failure --> periorbital edema because losing albumin, 2. systemic sx's (fever, rash, eosinophilia)
sphenopalatine artery arises from which artery? maxillary
Duchenne Muscular dystrophy lethal x-linked recessive disease, lacking the dystrophin protein in cardiac and skeletal muscle. Douchebag -- Douche = woman = X-linked. Bag = big calves, big heart.
1/3 of Duchene Muscular Dystrophy arises from what genetic mechanism? the gene has many series of aa's that are similar but not identical repeats --> misalignment of homologous chromosomes at meiotic synapsis --> frameshift mutations --> untranslatable mRNA
what drug maintains a patent ductus arteriosus? prostaglandin, i.e. PGE1 analog - alprostadil
what do ibuprofen and indomethacin have in common? inhibit formation of prostaglandins
patients on Li for bipolar disorder should get frequently tested for what? TSH - Li causes decrease in thyroid hormones. Li sits on TSH.
how to treat hypothyroidism? levothyroxine
phosphofructokinase-1. When is it elevated? rate-limiting enzyme of glycolysis. would increase in anaerobic metabolism because glycolysis would be the only way to make ATP
phosphoenolpyruvate carboxykinase gluconeogenesis regulating enzyme
name three enzymes that induce gluconeogenesis cortisol, glucagon, epinephrine -- the stress enzymes
what does pyruvate dehydrogenase do? turns pyruvate (from glycolysis) into Acetyl CoA (TCA cycle)
what are the 5 coenzymes of pyruvate dehydrogenase? NAD, FAD, B1 (thiamine), lipoic acid, coenzyme A. What we're seeing in the codependent (cofactor) PD (pedi) visits: it's a FAD to put CoAn's (CoEnzyme A) LIPs (lipoic acid) between his thighs (thiamine) on his goNAD.
succinate dehydrogenase makes FADH2 in the TCA cycle. Sucking him until he's dry (succinate dehydrogenase) is such a FAD.
transketolase hexose monophosphate shunt, feeds GP3 and F6P into glycolysis
what is transketolase a marker of? thiamin deficiency (it requires thiamin as a co-factor) and is markedly decreased in Wernicke Korsakoff Syndrome
what does the coombs test identify? maternal anti-Rh antibodies bound to fetal RBC's or fetal autoimmune hemolytic anemia
what is the direct coombs test? Baby's Rh+ cells already coated with maternal antibodies
what is the indirect coombs test? mom's serum that has now developed the anti-Rh antibodies that would be bad for the fetus to get exposed to
how do babies with autoimmune hemolytic anemia present? mild anemia, high post-natal hyperbilirubinemia
what are microspherocytes? RBCs that have had antibody-coated portions clipped off by the spleen
what are reticulocytes? immature RBCs
when do B thalassemia and sickle cell anemia present in babies? why? 6 mos because that is when fetal Hb production ceases
what is congenital spherocytosis? genetic defect in the cell membranes of RBC's --> smaller surface area and breaks open easily --> jaundice, enlarged spleen, shorter life span per RBC (RBC lifespan returns to nl after splenectomy)
heparin monitored by APTT time
warfarin monitored by PT time
child with massive painless rectal bleeding think of peptic ulcer created by acid-secreting gastric mucosa next to Meckel's diverticulum in the ileum
UTI in renal pelvis magnesium ammonium phosphate stone (most likely proteus infection)
when do you see calcium-containing kidney stones? hypercalcinuria without hyperCa2+
what are gall stones made of? cholesterol
in whom do you see uric acid stones? gout, leukemia, acidic urine
ameboid motility Entamoeba, Naegleria, Acanthamoeba
corkscrew motility trichomonas vaginalis
falling leaf motility giardia lamblia
tumbling motility listeria monocytogenes
swarming motility proteus mirabilis
shaking in R hand, trouble starting movements, resting tremor which decreases with active movement, expressionless face, soft voice, soft shuffling gait Parkinson's
selegiline Parkinson's drug; inhibits MAO-B, which breaks down dopamine -- makes the levodopa last longer
MAO-A, MAO-B MAO-A preferentially metabolizes NE and serotonin; MAO-B preferentially metabolizes dopamine
benztropine antimuscarinic, improves Parkinson's tremor and rigidity
bromocriptine dopamine receptor agonist; Parkinson's drug
levodopa dopamine precursor -- increases circulating levels of dopamine; best drug for Parkinson's
pergolide dopamine receptor agonist; Parkinson's drug
Kartagener Syndrome autosomal recessive, abnormal dynein --> abnormal sperm motility, ciliary clearance, retrograde axonal transport
what proteins are responsible for anterograde and retrodrage axonal transport? kinesin for anterograde, dynein for retrograde
what drug for schizoaffective disorder should you not give to patients with thrombocytopenia valproic acid because it is already associated with thrombocytopenia
metformin is associated with which side effect? lactic acidosis; more likely in renal-impaired pts or in pts taking nephrotoxic medication aminoglycosides or radio contrast dyes.
what is metformin used for? non-insulin-dependent diabetes
aminoglycosides binds to 30S ribosomal unit
glyburide sulfonylurea antidiabetic agent used in adjunct to diet to lower blood glucose levels in non-insulin dependent diabetes
5yo boy, awkward walking, frequent falls, hypertrophic calves (atrophy of myofibers and fibrofatty replacement of the interstitium), dilated cardiomyopathy Duchenne muscular dystrophy
how to diagnose Duchenne Muscular Dystrophy? immunohistochemistry showing absence of dystrophin in skeletal muscle biopsy
what is genetic anticipation? phenomenon whereby a disease presents at an earlier age (with deeper penetrance) as it's passed down through generations; happens with trinucleotide repeat diseases
name three trinucleotide repeat diseases Huntington's, Duchenne muscular dystrophy, fragile X
Created by: christinapham