100% tevredenheidsgarantie Direct beschikbaar na je betaling Lees online óf als PDF Geen vaste maandelijkse kosten
logo-home
USMLE UWORLD STEP 1| LATEST QUIZBANK WITH QUESTIONS AND ANSWERS | LATEST 2024 $18.49
In winkelwagen

Tentamen (uitwerkingen)

USMLE UWORLD STEP 1| LATEST QUIZBANK WITH QUESTIONS AND ANSWERS | LATEST 2024

 0 keer verkocht
  • Vak
  • USMLE
  • Instelling
  • USMLE

USMLE UWORLD STEP 1| LATEST QUIZBANK WITH QUESTIONS AND ANSWERS | LATEST 2024 Nitroglycerin (nitrates) - symptomatic relief in chronic stable angina - MOA? Adverse effects? - Predominantly a *venodilator*, also some arterial vasodilation - decreases both preload & afterload (stroke ...

[Meer zien]

Voorbeeld 4 van de 68  pagina's

  • 16 augustus 2024
  • 68
  • 2024/2025
  • Tentamen (uitwerkingen)
  • Vragen en antwoorden
  • USMLE
  • USMLE
avatar-seller
Mboffin
USMLE UWORLD STEP 1| LATEST QUIZBANK WITH
QUESTIONS AND ANSWERS | LATEST 2024




Nitroglycerin (nitrates) - symptomatic relief in chronic stable angina - MOA? Adverse
effects? - Predominantly a *venodilator*, also some arterial vasodilation - decreases
both preload & afterload (stroke volume maintained) -- NO ^cGMP, decreasing
intracellular Ca, dephosphorylating myosin light-chain, relaxing vascular smooth muscle
-- headaches, flushing, lightheadedness, hypotension, reflex tachycardia ---
nitroprusside can cause cyanide toxicity

First line treatment for essential tremor - Propranolol

RAS signaling protein is active when bound to - GTP (ex: constitutively activated KRAS
implicated in colon cancer)

Mullerian Aplasia - No upper (therefore short) vagina, variable uterine development.
46,XX females with normal ovaries and 2ndary sexual characteristics

Physician's priority in domestic violence case - safety (emergency plan? safe place to
go?) - don't confront denial or pressure patient to disclose abuse or leave

Stroke in what brain area would cause complete contralateral SENSORY loss -
Thalamus

Cause of lacunar infarcts - small vessel occlusion due to lipohyalinosis and
microatheroma formation -> lenticulostriate arteries <- uncontrolled HTN & DM

Cocaine MOA - inhibits presynaptic reuptake of NE,D,S (increased sympathetic
activity); vasoconstrictor (cause MI, sudden death)

Mutations associated with thyroid cancer: medullary vs follicular vs anaplastic -
Medullary (RET), Follicular (RAS), Anaplastic (p53)

Dynein vs Kinesin - molecular motor proteins
(nerve axonal transport direction) - Dynein (periphery->center, + to -, retrograde)
Kinesin (center->periphery, - to +, anterograde)
Negative end Near Nucleus
Positive end Points to Periphery

,Treatment of choice for behavioral symptoms of delirium - low dose antipsychotic
(haloperidol)

Adenosine & Dypyridamole - selective vasodilators of all coronary vessels, can cause
coronary steal syndrome (hypoperfusion & worsening of existing myocardial ischemia)

Treatment of choice for status epilepticus? (single seizure lasting >5 minutes or multiple
discrete seizures with incomplete recovery between episodes) - IV benzodiazepine (like
lorazepam) ...to stop the seizure, then concurrently begin phenytoin to prevent
recurrence

Pellagra - *Vitamin B3 (Niacin) deficiency - diarrhea, dermatitis, dementia* - precursor
for NAD & NADP (cofactors for many dehydrogenase and reductase enzymes) - seen in
those with poor nutrition (alcoholics) or corn-heavy diets - Niacin can be synthesized
endogenously from *tryptophan*

Stimulation of what nerve will move bulky tongue out of the way in obstructive sleep
apnea? - Hypoglossal

Femoral nerve block (location) - Inguinal crease at lateral border of femoral artery -
numbs anterior thigh, quads, femur, knee

Pudendal nerve block (anatomic landmark / location) for delivery? Presentation of
stretch injury? - Ischial spine tip - for vaginal deliveries
Decreased sensation in perineum and genital area; can cause fecal/urinary
incontinence (pudendal normally controls external sphincters) - although, most common
cause of anal incontinence after childbirth is sphincter damage

Gigantism - hypersecretion of growth hormone from AP; changes mediated by release
of: - insulin-like growth factor 1 (IGF-1) from liver

Toxic component of LPS - Lipid A ... gram-negative sepsis

ACE-inhibitor induced angioedema & dry cough is due to? -- ACEi also decrease GFR
and increase potassium - bradykinin accumulation (vasodilator, increases vascular
permeability; also increases prostaglandin production, irritating bronchi) - normally
broken down by ACE

Lateral ankle sprain due to inversion of plantar-flexed foot most commonly involves: -
anterior talofibular ligament

Anticholinergic toxicity - Atropine & scopolamine (in jimsonweed) competitively inhibit
muscarinic Ach receptors. Blind as a bat, mad as a hatter, red as a beet, hot as a hare,
dry as a bone, full as a flash, fast as a fiddle. REVERSED by cholinesterase inhibitors
(physostigmine).

,How does timolol help treat glaucoma? - non-selective beta-blocker diminish secretion
of aqueous humor by ciliary epithelium (decrease IOP) [glaucoma = progressive
peripheral vision loss]

Ebstein anomaly - Displacement of tricuspid valve leaflets downward into RV,
decreased RV volume, atrialization of RV -- caused by *lithium* teratogenicity, treats
bipolar disorder -- tricuspid regurg & right heart failure

Zellweger syndrome - infantile defective peroxisomal biogenesis (very long chain fatty
acids and branched chain fatty acids cannot undergo oxidation) - buildup causes
craniofacial abnormalities, hepatomegaly, neurologic defects, death -- adult version: x-
linked adrenoleukodystrophy

Pulsus paradoxus - Exaggerated drop in systolic blood pressure (>10 mmHg) during
inspiration -- most commonly seen in pericardial effusion with cardiac tamponade

Beck's triad = Cardiac Tamponade - Hypotension with pulsus paradoxus, elevated
jugular venous pressure, muffled heart sounds

Acute intermittent porphyria - Autosomal dominant, *porphobilinogen (PBG) deaminase
deficiency* - abdominal pain, neuropsychiatric, reddish-brown urine that darkens. Worse
with alcohol/smoking. Treat with IV glucose or heme to downregulate aminolevulinate
(ALA) synthase --- PBG & ALA accumulate, causing symptoms

Two most common adverse effects of long-term *lithium* therapy (can also cause these
same effects in a fetus) - Hypothyroidism & nephrogenic diabetes insipidus (lithium =
bipolar mood stabilizer)

How to get shit out of the lungs: 3 levels, 3 processes - upper airway -
coughing/sneezing
bronchi->terminal bronchioles - mucociliary transport
respiratory bronchioles->alveoli - phagocytosis by alveolar macrophages

2 specific features of Graves disease (TRAb-mediated hyperthyroidism) -
Ophthalmopathy (proptosis) and pretibial myxedema

Gerstmann Syndrome - damage/stroke to angular gyrus of dominant (left-sided) parietal
association cortex (4 signs) - 1. Agraphia (inability to write)
2. Acalculia (inability to math)
3. Finger agnosia (inability to identify individual fingers on hand)
4. Left-right disorientation
---Nondominant (right-sided) lesions to parietal lobe result in hemi-neglect

First line treatment for Wilson Disease - Copper chelator (*penicillamine*) "copper
penny"
[low ceruloplasmin, Kayser-Fleischer rings, atrophy of basal ganglia]

, First line treatment for iron overdose - Iron chelator (Deferoxamine, Deferasirox,
Deferipone)

Lead poisoning - first line treatment? symptoms? --- blue "lead lines" at junction of teeth
& gums, basophilic stippling of RBCs on peripheral blood smear - children in old houses
eating paint chips or adults exposed to ammunition or batteries - Edetate calcium
disodium (CaNa2 *EDTA*) (increases urinary excretion) -- weakness (microcytic
hypochromic anemia), abdominal pain, constipation, neurotoxicity -- inhibition of
ferrochelatase and d-aminolevulinic acid (ALA) dehydratase in heme synthesis
pathway, instead incorporates zinc into protoporphyrin -- could also use dimercaprol,
succimer, penicillamine

Sarcoptes scabiei (mites & eggs) (Scabies) - presentation - Highly contagious, rapidly
spreading, intensely pruritic rash (usually worse at night) - wrist, fingers, finger webs,
palms

Angiogenesis driven by what 2 factors: - VEGF - vascular endothelial growth factor
FGF - fibroblast growth factor

Leydig vs Sertoli cells - LH -> Leydig -> Testosterone
FSH -> Sertoli -> (Inhibin B)
GnRH

t(15;17) and Auer Rods (stain for myeloperoxidase) - Acute Promyelocytic Leukemia
(APML) - fusion gene results in abnormal retinoic acid receptor, so treat with all-trans
retinoic acid - also associated with DIC

Potter Sequence - caused by renal anomaly (decreased urine output ->
oligohydramnios): newborn with pulmonary hypoplasia, along with facial & lower limb
deformities (compression) --- maternal use of ACEi/ARB can cause this, because
Angiotensin II is required for normal renal development

Carotid sinus massage, valsalva, and cold water immersion are _________ maneuvers.
Can be used to terminate paroxysmal supraventricular tachycardia. - Vagal maneuvers
- leads to increase in parasympathetic tone (bradycardia, hypotension, sometimes
syncope) --- Carotid sinus afferent limb is glossopharyngeal nerve (CN IX), efferent limb
is vagus (CN X).

What nerve is vulnerable to injury in fibular neck fractures? What's the deficit? -
Common peroneal (fibular) nerve -> causes weakness of foot dorsiflexion & eversion,
and loss of sensation over dorsum of foot.

Raphe nuclei in the CNS release what neurotransmitter? - Serotonin (target of SSRIs,
SNRIs, TCAs, etc.)

Dit zijn jouw voordelen als je samenvattingen koopt bij Stuvia:

Bewezen kwaliteit door reviews

Bewezen kwaliteit door reviews

Studenten hebben al meer dan 850.000 samenvattingen beoordeeld. Zo weet jij zeker dat je de beste keuze maakt!

In een paar klikken geregeld

In een paar klikken geregeld

Geen gedoe — betaal gewoon eenmalig met iDeal, creditcard of je Stuvia-tegoed en je bent klaar. Geen abonnement nodig.

Direct to-the-point

Direct to-the-point

Studenten maken samenvattingen voor studenten. Dat betekent: actuele inhoud waar jij écht wat aan hebt. Geen overbodige details!

Veelgestelde vragen

Wat krijg ik als ik dit document koop?

Je krijgt een PDF, die direct beschikbaar is na je aankoop. Het gekochte document is altijd, overal en oneindig toegankelijk via je profiel.

Tevredenheidsgarantie: hoe werkt dat?

Onze tevredenheidsgarantie zorgt ervoor dat je altijd een studiedocument vindt dat goed bij je past. Je vult een formulier in en onze klantenservice regelt de rest.

Van wie koop ik deze samenvatting?

Stuvia is een marktplaats, je koop dit document dus niet van ons, maar van verkoper Mboffin. Stuvia faciliteert de betaling aan de verkoper.

Zit ik meteen vast aan een abonnement?

Nee, je koopt alleen deze samenvatting voor $18.49. Je zit daarna nergens aan vast.

Is Stuvia te vertrouwen?

4,6 sterren op Google & Trustpilot (+1000 reviews)

Afgelopen 30 dagen zijn er 64670 samenvattingen verkocht

Opgericht in 2010, al 15 jaar dé plek om samenvattingen te kopen

Begin nu gratis
$18.49
  • (0)
In winkelwagen
Toegevoegd