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+--- Thread: good for those whos exam is near - rizowana (/showthread.php?tid=340380)
0 - ArchivalUser - 09-21-2008
barti - 08/14/08 10:11
Here are some things I remember,
1) cervical hemivertebrae - a question about a newborn who cries when his head is turned to right side so he keeps his head only to the left
2) are changes in lungs in people with POChP irreverssible and ifthey are after how many years?
3)difference between acute stress disorder and depersonalization disorder...very complicated questions, know that in ASD there can be feeling of reduced sense of surroundings
4)what thing is most protective against infections during input of central line catheter, i did it wrong i think cause i put gloves and scrubs but i think it's hand washing
5)diagnosis of motor neuron disease/difference between spastic and flaccid, very confusing
6)fat boy eating all the tine with almond ashape lips and fish mouth - Prader Willi
7)drug that protects from uric stones forming - confused between allopurinol and probenecid
8)Nadir after chemotherapy - we give antibiotics or not when fever appears but no other symptoms? I have no idea;(
9)prophylaxis for newborn of mother with HIV infection, 4 weeks of 2 drugs
10)know how to count negative predictive value
11)very tricky question about difference between multiple myeloma and polymyalgia rheumatica-symptoms very similar, calcium not mentionned
12)Scarlet fever and Kawassaki - know the difference
about 4 ECG's, two of them was really confusing so, but the other was atrial fibrillationa and torsades de pointes..., 2 audio questions, very easy - patent ductus arteriosus (what we should give - indomethacin) and aortic stenosis sounds...
0 - ArchivalUser - 09-21-2008
Bump Bump Bump Bump Bump Bump Bump Bump Bump Bump
God Bless U
God Bless U
God Bless U
God Bless U
God Bless U
God Bless U
God Bless U
God Bless U
God Bless U
God Bless U
0 - ArchivalUser - 09-21-2008
GOD AND ALLAH BLESS U FR BEING SO SELFLESS . GOOD LUCK DEAR AND U WILL SHARE URE EXPERIENCE WITH US AM SURE .THANKS AGAIN RIZZU
0 - ArchivalUser - 09-21-2008
Posted by MORE question TOPICS from IP 74.77.162.8 on June 17, 2008 at 12:45:47:
In Reply to: IMPORTANT QUESTION LIST follow up to my step 1 experience posted by laptopdoc on June 17, 2008 at 12:17:30:
some more topics from which i got mulitple questions were
transmitters involved in different stages of action potential of muscle vs conducting tissue ex sa node
nerve supply of tongue anterior or posterior
4-5 questions on what is the most appropriate answer by the phsyician to a patient who is upset. or putting him in a ethical delimma.
identifing features on physical examination of person with overdose of narcotics vs drugs of abuse like cocaine mariuana and pcp.
mean median mode and standard deviation
sleep cycle stages
polymerases and enzymes involved in dna synthesis
malarial drugs
diarrheas espeically giardia vs salmonella vs ecoli
ldl vldl hdl metabolism
iron metabolism and levels of different forms of iron
co vs cn poisioning
diuretics causing hypercalcemia and which cause metabolic acidosis vs alkalosis
menstrual vs harmonal cycle and
male reproductive hormonal control
testes venous and lymphatic drainage
t3 t4 synthesis and feedback.
0 - ArchivalUser - 09-21-2008
#256143
2confused2bdoctor - 12/29/07 22:57
Hi everyone, I have put together some chrom. abnormality together and some pnumonics which i have to thank others for it too..hope this helps..
Chromosome related:
Chrm. 3- VPL
Chrm. 4- Huntington™s disease
Chrm. 5- Cri-du-chat, FAP
Chrm. 6- Hemochromatosis
Chrm. 7- CF
Chrm. 11- Wilm™s tumor, Sickle cell disease
Chrm. 13- Patau™s syndrome, Retinoblastoma, osteosarcoma
Chrm. 15- Prader-willi and Angelman syndrome
Chrm. 16- ADPK, Spontaneous abortion in trisomy
Chrm. 17- NF1
Chrm. 18- Edward™s syndrome
Chrm. 19- Myotonic dystrophy
Chrm. 21- Down syndrome
Chrm. 22-Digeorge syndrome, NF2
ANGINA :
1. Stable ... mnemonic SS (strain, subendocardial ischemia)
2. PrinzmeTal ... P (periodic /episodic pain at rest ), Transmural ischemia
ex: pt wakes up with chest pain
3.USA ... Uncontrollable pain at rest (i.e. recurrent pain), related to plaque rupture/ulceration/hemorrhage
RADIOLOGY LINKS
irfanmir - 08/08/08 20:38
i hope this helps
http://anatomy.uams.edu/anatomyhtml/xrays/rad_atlas.html
http://www.med.wayne.edu/diagRadiology/Anatomy_Modules/Page1.html
http://sprojects.mmi.mcgill.ca/radpath/molson3/default2.htm
another good one
http://www.gentili.net/fracturemain1.asp#
0 - ArchivalUser - 09-21-2008
IF U DONT HAVE TIME TO REVISE UW QUESTIONS CAN CHECK OUT THIS
md83 - 07/25/08 20:34
Hello everyone...here are all the USMLE world qbank highyields...I highly recommend USMLEWORLD qbank...I think it trains your mind to think and integrate a lot...but if you want to just read the high yield concepts here they are.
USMLE World: Step 1 High-Yields
Subendothelial Deposits are seen in SLE patients
Subepithelial Humps are seen in Acute Poststreptococcal Glomeruloneprhitis
Linear Subendothelial are seen in Goodpasture™s (Type II)
Mesangial Deposits are seen in IgA Nephropathy
Spike and Dome are seen in Membranous
Subendothelial Humps are seen in Membranoproliferative
Azithromycin “ administered to HIV + patients can prevent Mycobacterium Avium
Ethambutol “ inhibits arabinosyl transferase which polymerizes arabinose into arabinan etc. Side Effects ïƒ Optic Neuritis
Rifampin “ inhibits bacterial DNA dependent RNA polymerase and thus prevents transcription of DNA into mRNA.
Isoniazid “ inhibits mycolic acid synthesis.
FF = GFR/RPF GFR = Creatinine Clearance/Inulin
RPF = PAH
Fibroadenoma “ cellular myxoid stroma, sometimes there are compressed cystic spaces.
Spongiosis - epidermal accumulation of edematous fluid in the intercellular spaces.
Diphenoxylate “ opiate anti-diarrheal structurally related to Meperidine.
Octreotide “ good for secretory diarrhea, which is a Somatostatin Analog
Urease “ converts urea to carbon dioxide and ammonia and thus increases pH
Radiation Therapy - causes 1) DNA double strand breakage 2) formation of free radical
Methadone “ has a long half life
In Fetal Lungs - after 30 weeks there is an increase in Lecithin
After 36 weeks there is a rise in Phosphatydylglycerol
Males with 5 α reductase deficiency - feminized external genitalia, small phallus and Hypospadias are common.
Repair Damage “ Glycosylase ïƒ Endonuclease ïƒ Lyase ïƒ DNA Polymerase ïƒ Ligase
H. Pylori “ most common cause of duodenal ulcers
CMV in immunocompromised “ Mononucleosis
Retinitis in CMV “ HIV+ Patients
Primary CNS Lymphoma “ most commonly associated with AIDS
Squamous Cell Lung Cancer “ produces Parathyroid Hormone Related Peptide, which in turn will decrease PTH
Campylobacter “ can be transmitted from domestic animals
Shigella - is transmitted via fecal oral in day care centers
Keratin - marker of epithelial cell origin.
Secretin - produced by S endocrine cells in the duodenum, that increases bicarbonate secretion from exocrine pancreas into the small bowel.
Alprazolam “ benzodiazepine with the shortest half life, which is used in Acute Anxiety.
Diazepam, Chlordiazepoxide and Clonazepam “ longest half life, used in prophylaxis.
Sheets of Primitive Cells with Many Mitotic Figures “ Medulloblastoma
Most Common Tumors in Children:
Pilocytic Astrocytoma - Rosenthal Fibers
Medulloblastoma - sheets of small blue cells, many mitotic figures
Ependyoma “ can cause Hydrocephalus and form Rosettes
Orthostatic Hypotension “ side effects of α adrenergic blockers.
AML - has associations with t(15,17), t(8,21) and Auer Rods are stained with Myeloperoxidase.
CLL “ deletion on Chromosome 13
Mantle Cell B Lymphoma “ t(11,14)
Dobutamine “ causes increase in cardiac contractility and increase in Heart Rate
Tumors of Schwann Cells “ are derived from neural Crest Cells.
Patients with CGD “ susceptible to 1) Staph Aureus 2) Pseudomonas 3) Serratia
Nocardia 5) Aspergillus
Rosenthal Fibers “ with granular eosinophilic bodies are seen in Pilocytic Astrocytoma. They are well differentiated comprised of spindle cells with hair like glial projections
Atropine “ reverses muscarinic effects but does not prevent the development of nicotinic effects such as muscle paralysis
Pralidoxime “ reverses both muscarinic and nicotinic effects of organophosphates by œrestoring cholinesterase.
Calcium “ binds to Troponin C and then uncovers tropomyosin sites, thus allowing actin to bind to myosin.
S 3 Heart Sound “ can be heard if the patient lies down in Left Lateral Decubitus Position or Exhales Completely
RBF = Renal Plasma Flow/ (1-Hematocrit)
In Metabolic Alkalosis “ measure patient™s Urinary Chloride
Germinoma - tumors of Pineal Gland, formed in children and adolescents.
Will present with 1) Precocious Puberty due to β-HCG Production (similar in testicular seminoma) 2) Obstructive Hydrocephalus 3) Parinaud Syndrome “ paralysis of upward gaze.
Ultraviolet Specific Endonuclease “ initiates repair by nicking the strand at Thymine Dimer. This enzyme is missing in Xeroderma Pigmentosum
SER “ functions in synthesis of Lipids, Carbohydrate Metabolism and Detoxification of Harmful Substances
Uretero Pelvic Junction “ most common site of obstruction
Increased Intraocular Pressure “ most common side effect of treatment of Bradycardia with Atropine.
Mutation in Glycoprotein “ will cause changes in the host and they mediate attachment to target host cell.
cAMP pathway - α2, β1 and β2
Inositol Pathway “ α1 adrenergic, muscarinic, cholinergic
Ion Channel “ Nicotinic, Cholinergic.
Ampicillin “ must be added to treat infants with Meningitis. Ceftriaxone covers all organisms, but Listeria Monocytogenis is killed by Ampicillin.
B 19 Fifth™s Disease “ causes aplastic crises (bone marrow)
Eaton Lambers Syndrome - associated with Lung Cancer, similar to Myasthenia Gravis. Antibodies are against pre-synaptic Calcium Channels.
Myotonic Dystrophy “ triplicate repeat, movement frontal baldness, cataracts are seen. Cannot Loosen Hand Grip.
Cholinomimetics “ indicated in Urinary Retention Paralytic Ileus and Glaucoma
HUS “ after E. Coli “ Microangiopathic Hemolytic Anemia
Segmental Viruses (Rotavirus and Orthomyxovirus) - capable of Genetic Shift.
Paget™s Disease - increase in Osteoclasts, then increase in Osteoblasts, which will increase Alkaline Phosphatase.
Arginase - enzyme in Urea Cycle produces Urea and Ornithine from Arginine.
Minute Ventilation - product of Tidal Volume and RR and includes Dead Space.
Neurophysis “ carriers for Oxytocin and ADH in Posterior Pituitary.
Epinephrine “ increases Systolic BP (α1 Effect)
Increase Heart Rate (β1 Effect)
Decreases Diastolic (β2 Effect)
Pretreatment with Propranolol ïƒ eliminates β Effects and Leaves α Effects Only.
Protein C Defficiency in Warfarin Therapy “ will exaggerate the response and cause Hypercoagulable State with Skin Necrosis
Neonates with Hypothyroidism - weak, pale, dry. Macroglossia and Umbilical Hernia
Acyclovir - incorporates into newly replicated Viral DNA
Hemorrhagic Cystitis in Children “ Adenovirus (especially in Males)
Uric Acid precipitates - collecting ducts due to Low Urine pH.
Insulin - drug of choice for Gestational Diabetes.
AML - formation of PML/RAR α fusion gene, unable to signal for proper differentiaton
Auer Rods “ stained with myeloperoxidase
Donepezil “ Tx for Alzheimer™s Disease, is a Cholinesterase Inhibitor and also you would add Vitamin E.
NMDA Receptor in CNS overstimulation by Glutamate “ thought to increase AD Symptoms. Tx with Memantine (antagonist)
Barbiturates “ increase duration of Chloride Channel Opening
Benzodiazepines “ increase frequency of Chloride Channels.
Serum Fibrinogen “ must be monitored in DIC.
Narcolepsy “ deficiency or Low Levels of Neurotransmitter Orexin ( Hypocretin)
Hawthorne Effect - tendency of a study population to affect an outcome due to what is studied.
Mullerian Inhibitory Factor “ secreted by Sertoli Cells
Primary infection with HSV “ more spread out, but Reactivation is more Localized to 1 side.
S-100 Positive “ Schwannoma and Melanoma. Both are from Neural Crest Cells.
T- Lymphocytes “ Paracortical Zone
B-Lymphocytes - Germinal Centers of Lymph Node
Turner Syndrome - heavily methylated DNA due to Low Transcription Activity (Heterochromatin is not transcriptionally active, it™s too condensed)
Adenovirus “ low grade fever, throat pain, pharyngoconjunctivitis, can be transmitted in Summer Camps.
Fragile X - gene methylation, and this is inactive, because it™s condensed.
Burr Cells, Helmet Cells - Mechanical Red Cell Destruction. Pt™s with Prosthetic Valves.
When Vaccinated - Virus Entry into cells is impaired.
Sotalol “ β Blocker with Class III (Potassium Channel Blocker) Properties will cause Bradycardia and QT Prolongation.
Pre B-ALL ïƒ TdT + CD 10 and CD 19
Pre T-ALL ïƒ CD2, CD3, CD4, CD5, CD7, CD8, CD1a, TdT
Leukocyte Alkaline Phosphatase “ decreased in CML, increased or normal in Leukemoid Reaction which is 50,000 WBC.
Homocystinuria (similar to Marfan™s) “ deficiency of Cystathione Synthase. Tx with Pyridoxine Supplements (B6)
Ring Enhanced Lesions “ Toxoplasmosis, Seizures
Dihydrobiopterin Reductase “ Cofactor for Both Phenylalanine Hydroxylase and Tyrosine Hydroxylase.
Osteoblasts convert to Osteocytes “ osteocytes are connected by Gap Junctions.
Lecithinase “ alpha toxin, produced by C. Perfringes and has an ability to degrade Lecithin, main component of Phospholipid Membrane
Terminal Bronchioles “ lined by ciliated simple cuboidal epithelium.
Nipple Retraction “ in Breast Cancer is usually due to infiltration of Cooper™s Ligament by Cancer.
Prepatellar Bursa “ commonly seen in roofers, carpenters, people who are kneeling all the time.
Acute Myelogenous Leukemia “ is associated with t(15,17), where gene for Retinoic Acid is transferred from Ch. 17 to Ch. 15
Sarcoidosis “ presents with increased number of CD4 + T cells.
Calcitonin “ released from Parafollicular cells of Thyroid, in response to increasing levels of calcium. It promotes calcium absorption by the bone and reducing calcium absorption by the intestines and thus decreasing the levels of circulating calcium
NSAIDS - are the primary cause of papillary necrosis and chronic interstitial nephritis
Increased levels of Calcium, Phosphate and Oxalate “ promote salt formation and thus stones
Increased levels of Citrate and High Fluid Intake “ prevent salt formation
Cell Mediated Immune Response “ stimulates production of Interferon Gamma, Tumor Necrosis Factor Beta and IL 12 which in turn induces cytotoxic T cell response and eliminated intracellular organism such as Listeria
Listeria Monocytogenes “ Gram Positive Rod which produces Very Narrow Beta Hemolysis Zone on Sheep Blood Agar and exhibits Tumbling Motility and the only Gram Positive Organism that produces LPS endotoxin (which is normally found in Gram -)
Succinylcholine “ depolarizing NMJ blocker and usually elicits a fast response within 60 seconds and lasts for 10 minutes.
Bethanechol “ muscarinic agonist that improves bladder motility in post operative patients
Oxybutinin “ antimuscarinic agonist that is used in patients with urinary incontinence
Motor Innervation of the Tongue “ provided by Hypoglossal Nerve (12), except for palatoglossus which is innervated by Vagus Nerve (10)
Sensation of the Tongue “ Anterior 2/3 is Mandibular Branch of Trigeminal Nerve, Posterior 1/3 is by Glossopharyngeal Nerve (9).
Gustatory Innervation of the Tongue “ Anterior 2/3 is Chorda Tympani by Facial Nerve, Posterior 1/3 is by Glossopharyngeal Nerve.
Hypercalcemia in Sarcoidosis “ is by macrophages activated Vitamin D, which is extrarenally produced, it will in turn suppress PTH.
1st Pharyngeal Pouch “ external auditory meatus, primary tympanic cavity and auditory tube
2nd Pharyngeal Pouch “ Palatine Tonsils
3rd Pharyngeal Pouch “ Thymus, Inferior Parathyroid Gland
4th Pharyngeal Pouch “ Superior Parathyroid Gland.
Phenytoin “ causes increased expression of Platelet Derived Growth Factor (PDGF), they stimulate growth of gingival cells.
Propranolol “ used in Thyrotoxicosis and will decrease the heart rate and Decreases Peripheral Conversion of T4 to T3
MEN 1 “ Parathyroid Tumor (Hypercalcemia), Pancreatic Tumor (Gastrin), Pituitary Adenoma (Prolactin, ACTH)
MEN 2a “ Medullary Carcinoma of the Thyroid (Calcitonin), Pheochromocytoma and Parathyroid Tumor
MEN 2b “ Medullary Carcinoma of Thyroid, Pheochromocytoma, Marfanoid Features/Mucosal Neuromas
Myocardial Infarction “ is the most common cause of Death in Diabetic Patients.
Carbamazepine “ blocks Voltage Gated Na Channels in Cortical Neurons, and is used in Trigeminal Neuralgia. Causes Bone Marrow Suppression and increase in ADH will cause SIADH.
Ethosuximide “ blocks T-type Calcium Channels and decreases Calcium current in Thalamic Neurons, used for Absence Seizures.
Type 2 Diabetes “ Amyloid Deposition in the Pancreatic Beta Cells.
Type 1 Diabetes “ beta cells are destroyed by T Lymphocytes, look for Infection
Von Hippel Lindau - autosomal dominant disorder characterized by cerebellar hemangioblastomas, clear cell carcinomas and pheochromocytomas. All patients have a deletion of VHL gene on Chromosome 3b.
Acyclovir “ can cause crystalline nephropathy if hydration is not provided.
In CO poisoning “ PO2 is normal, % Saturation of Oxygen is decreased, because CO competes with O for Heme Sites, Oxygen Content is decreased.
In Anemia - PO2 is normal, % Saturation of Oxygen is Normal, Oxygen Content is decreased
In Polycythemia “ PO2 is normal, % Saturation of Oxygen is Normal, Oxygen content in the blood is Increased.
Foscarnet “ is a pyrophosphate analog and can chelate Calcium, it will also cause Magnesium excretion and thus the side effects are Hypocalcemia and Hypomagnesemia and thus there will be Seizures in patients taking Foscarnet.
In Restrictive Lung Diseases “ high expiratory flow rates occur despite Low Lung Volumes, and that is due to Increased Elastic Recoil Pressure and Increased Radial Traction on the airways.
Henoch Schonlein Purpura “ leukocytoclastic vasculitis due to deposition of IgA immune complexes and presents with low extremity purpura, abdominal pain, arthralgia and renal involvement.
Lymphogranuloma Venerium “ is caused by Chlamydia Trachomatis, and will present with painful vesicular lesions.
Acute Salicylate Overdose “ at first there is a Respiratory Alkalosis, because salicylates stimulate medullar respiratory center and cause hyperventilation. Metabolic Acidosis occurs due to accumulation of acids, and thus it™s a mixture of Respiratory Alkalosis (low PCO2) and Metabolic Acidosis (low plasma HCO3)
Prevention of Reinfection with Influenza “ anti-hemagglutinin IgG antibodies in the blood and anti-IgA antibodies in the mucus and nasopharynx.
Estrogen “ will increase TBG levels, by reducing its destruction and thus will increase T4 levels. So expect patients on Hormone Therapy to have increased T4 levels.
Acanthosis Nigricans “ Benign Form is associated with Insulin Dependent Diabetes and Malignant Form is usually due to underlying GI Adenocarcinoma.
Nucleoside Analogs “ Acyclovir, Gancyclovir, Valacyclovir are nucleotide analogs that need to be converted into a Monophosphate Form by Herpes Viral Kinases “ Thymidine Kinases.
Cidofovir “ is already a Nucleoside Monophosphate and thus doesn™t need to be converted to monophosphate and only needs to be converted into an active Triphosphate Form.
Neuraminidase Inhibitors “ prevent Virion Release from infected cells with Hemophilis Influenza.
Amantadine “ inhibits uncoating and disassembly of Influenza A Toxin after it has entered the cell.
Ribosomal RNA “ is synthesized in Nucleolus. It™s the proteins that are synthesized in RER.
+ Trandelenburg Test “ checks for damage to Superior Gluteal Nerve that innervates Gluteus Medius and Minimus.
Newborn born to Diabetic Mothers “ will present with Hypoglycemia and most of the times they present with Macrosomia, Transposition of Great Vessels, Renal Agenesis, Rectal Atresia. Hypogycemia is due to Beta Cell Hyperplasia, and not because Insulin has crossed the Placenta, because it doesn™t. Thus when glucose crosses placenta into fetal blood, the response of the fetus will be Beta Cell Hyperplasia.
In Cyanide poisoning “ Amyl Nitrite is the antidote, because Nitrites increase formation of Methemoglobin, and Methemoglobin has an increased affinity for Cyanide. Sodium Thiosulfate also is used in Cyanide Poisoning which will form Thyocyanite which is less toxic.
Recall Bias “ when patients are selected who suffered an adverse effect and they are more likely to recall previous risk factors.
Selection Bias “ is when patients are selected by providers based on their severity of the disease. For Example: severely ill patients are more likely to enroll in cancer trials.
P. Aeruginosa “ non-lactose fermenting (gram “) Rod and is the cause of UTI in patients with Indwelling Urinary Catheters as well as patients on Respirators.
Injections into gluteal region “ must be targeted into Superior Gluteal Region, to avoid injury to sciatic or gluteal nerves.
Foscarnet “ is a pyrophosphate analog and does not need to be converted intracellularly to monophosphate form by viral Thymidine Kinase. Its side effects include Hypocalcemia, Hypmagnesemia and thus Seizures!!!!
Cushing™s Syndrome “ is usually caused by exogenous administration of Glucocorticoids. Thus the Adrenal Cortex will appear shrunken and Atrophied.
Sand Paper Like Rash “ Actinic Keratosis, that appears as crusted lesion on Sun Exposed Areas in elderly, it may turn into Cutaneous Horns.
Mycobacteria “ that grows as Serpentine Cords, usually establishes Virulence!!!
Adrenal Crisis “ will present with shock syndromes in combination with Hyponatremia, Hyperkalemia and Hypoglycemia, and presence of nuchal rigidity, fever, rash and vomiting suggests Neisseria Meningitidis Infection caused Waterhouse Friedrichsen Syndrome, where there is an Adrenal Hemorrhage.
Primary Mineralocorticoid Excess “ can be due to tumor of Zona Glomerulosa, which will cause Hypokalemia, Bicarbonate Retention and Sodium Retention. Which will in turn decrease Renin.
Cushing Syndrome “ primary work up will include Dexamethasone Suppression Test. Where Cortisol Levels would not be suppressed due to endogenous Cushing Syndrome causing Pituitary Adenoma.
In Anorrhexia “ levels of fat drop below normal and this will in turn decrease pulsatile release of GnRH.
Acid Fast Stain “ stains mycolic acid and at first its placed into Carbolfuchsin and then will be treated with Hydrochloric Acid and Alcohol
SnRNP (snurps) “ are involved in the process of removing RNA introns during Synthesis and thus are necessary for synthesis of Messenger RNA
Competent Patients “ have the right not to find out about their diagnosis, if they don™t want to.
Beta Lactamase Inhibitors “ Clavulinic Acid, Sulbactam and Tazobactam will inhibit destruction of Beta Lactam Ring of Penicillins.
Abciximab “ inhibits binding of Glycoprotein IIb/IIIa to Fibrinogen.
Glanzmann Thrombasthenia “ is a deficiency of IIb/IIIa glycoprotein on platelet surfaces.
Leukotrienes “ are synthesized by eosinophils, basophils in asthmatics
Histamine “ bronchoconstrictor and is released by mast cells.
Methacholine Challenge “ cholinergic muscarinic agonist used in testing for asthma
Valproic Acid “ if taken during pregnancy, increases the risk of Neural Tube Defects.
Test for Temporal Arteritis “ first thing to look at is Erythrocyte Sedimentation Rate. If it™s elevated (>100) then the positive diagnosis.
PrP “ has an α - helical structure and is usually found in Creutzfeld Jacob Disease, where there is a Spongiform Transformation of Gray Matter. Spongiform is because the abnormal protein accumulates in Vacuoles and will form a Sponge Like surface.
Subacute Sclerosing Encephalitis “ complication of Measles Virus in children and adolescents. Usually found in type of Measles Virus that has an M-antigen missing.
Multiple Sclerosis “ will present with visual changes, painful eye movements and there will be Demyelination of Axons, but Never a Loss of Neurons, Axon Disruption or Astrocyte Degeneration.
Herpes Encephalitis “ usually a complication of HSV 1 virus in children and will involve Temporal Lobe Encephalitis.
Meningitis caused by E.coli “ usually will involve a K-1 Viral Capsule that will be infectious. E.coli will grow Pink Colonies on Maconkey Agar.
Transfused Blood “ will contain citrate, that is used to prevent clotting of the blood, but in patients who are transfused with large amounts of blood, it will cause Hypocalcemia, because it chelates Calcium.
Fanconi Anemia “ patients will present with DNA exonuclease deficiency, and will be similar mechanism to Xeroderma Pigmentosum.
Warfarin Therapy “ Gamma Carboxylate protein C and S (which are Natural Anti Coagulants), and in patients with Protein C deficiency, there will be an extreme risk of Thrombosis.
Clopidogrel and Ticlopidine “ are ADP antagonists and will act by blocking interaction of Ligands with Platelet Receptors. Patients on Ticlopidine, will have Neutropenia and Mouth Ulcers as a side effect!!!!!
Cilostazol and Dypyridamole “ decrease Phosphodiasterase and thus increase cAMP.
RANK Receptor/RANK Ligand “ are essential for formation and differentiation of Osteoclasts. Hypoestrogenic state (Low Estrogen) will increase RANK and thus will cause an increase in Osteoclasts and thus in Increased Bone Resorption.
Vacuoles formed in CJ Prion Disease “ are accumulations of Alpha Helical Protein that became abnormal and these accumulations will form Spongeform Encephalitis and we will see PrP proteins in this disease.
C-peptide “ can be used as a marker for Endogenous secretion of Insulin by β-pancreatic cells. Glyburide which is a SulfonylUrea will increase the rate of Insulin Secretion and Levels of C-peptide in Type II Diabetes.
Patients with MS after Hot Showers “ will experience Extreme Fatigue after taking a Hot Shower, because the Heat will Decrease the Speed of Axonal Transport.
M-CSF and RANK receptors “ are present on Osteoclasts. Macrophage “Colony Stimulating Factor and RANK are present in Osteoclasts.
E.Coli causing UTI “ will express Fimbriae, which are Fimbrial Antigens, which are used for adhesion to Uroepithelial Cells.
Brunner™s Glands in Duodenum “ which are unique to Duodenum, will secrete Alkaline Mucous into the ducts.
Cilostazol and Dipyridamole “ will decrease the activity of Platelet Phosphodiesterase and thus will increase cAMP. Also they will cause Vasodilation of Arterioles. Used in Peripheral Artery Disease “ Intermittent Claudication!!!!!
Ankylosing Spondylitis “ are associated with HLA B-27, which are TYPE I HLA class.
Type II HLA Class are antigens that contain DR, DP and DQ.
Ethosuximide “ blocks T-type Calcium channels that trigger and sustain rhythmical burst discharges in thalamic neurons.
Phenytoin “ blocks Na channels and thus decreases the firing of neurons
Valproic Acid “ blocks NMDA receptors and affects K current.
Benzodiazepines “ can cause daytime drowsiness and increase the risk of Falls in Elderly.
Meckel™s Diverticulum “ remnant of omphalomesenteric duct (vitelling duct) and is a true diverticulum, that consists of all the layers of the intestinal wall (mucosa, submucosa and muscularis)
Power of a study “ 1-percentage where it fails. So if the data fails 20% of the time, then .8 is a power of study.
Acute Rejection - occurs within weeks of transplantation and primarily mediated by host T-lymphocytes that act against donor MHC antigens. To prevent, administer Calcineurin Inhibitor such as Cyclosporine.
Cricopharyngeal Muscle Dysfunction “ caused by diminished relaxation of pharyngeal muscles during swallowing. Usually occurs in elderly, where they present with coughing, choking and recurrent aspiration.
Doxyrubicin “ anthracycline chemotherapeutic agent will form free radicals in myocardium. The side effect is cardiac fibrosis, which will present with Dilated Cardiomyopathy.
Phospholipase C - forms IP3 and DAG from phospholipids. And IP3 causes an increase in intracellular calcium, which then activates Protein Kinase C.
Lactase Deficient Patients - will present with a Normal Intestinal Mucosa.
Polycystic Ovarian Disease Patients “ will benefit from therapy with Clomiphene, which is an estrogen receptor antagonist and will increase the release of GnRH and stimulates ovulation. Because in PCOS the patients™ ovaries will secrete estrogen which will feedback inhibit GnRH, and in treatment with Clomiphene, these receptors will be suppressed and thus GnRH will secrete estrogens and induce ovulation.
Nimodipine “ Calcium Channel Blocker, used in surgery on Subarachnoid Hemorrhage to prevent cerebral vasospasm.
Aspergillosis “ occurs in Old Lung Cavities. It will grow as a Fungus Ball and will present in old cavities caused by TB, Sarcoidosis or Emphysema. Patients with Asthma may have a hypersensitivity reaction to Aspergillus.
Erosions of Gastric Mucosa - are called erosions because they do not penetrate Muscularis Mucosa, when they do, then it™s called Ulcers.
Candida Albicans “ will inoculate into serum at 37 degrees for 3 hours will lead to formation of Hyphae from Yeast.
Mitral Valve Prolapse “ the most common cardiac abnormality that predisposes to native Valve Bacterial Endocarditis.
Majority of Free Water “ will be reabsorbed in the Proximal Tubule, regardless of the patient™s Hydration Status.
Alpha 1 antitrypsin deficiency “ should be suspected in all patients with premature onset (200 CD4 Count “ will have Strep. Pneumonia as a cause of their Lung Infections
Incidence of Squamous Cell Carcinoma “ and Esophageal Adenocarcinoma are now Equal
Smoking “ is the most Important Risk Factor for Pancreatic Cancer. Diabetes, Chronic Pancreatitis and Age >50 are Strong Risk Factors as well
Dating Error “ where the expectance Date was miscalculated, might be the most Important Reason for Increase in Alpha Fetoprotein
Digoxin “ will decrease AV Nodal Conduction, by Increasing Parasympathetic Tone of the Cardiac Muscle
Pancreatic Pseudocyst “ is a most common complication of Acute Pancreatitis, and is composed of Granulation Tissue and Fibrosis
Langerhan Cells “ present in Histiocytosis have a Tennis Racquet Shape Intracytoplasmic Granules and are called Birbect Granules
JAK/STAT Signaling Pathway “ is used by Colony Stimulating Factors, Growth Hormones and Cytokines associated with Tyrosine Kinase Receptors
Cysteine “ becomes an Essential Amino Acid in patients with Homocystinuria, where there is a defect of Cystathione Synthetase and accumulationg of Methionine
Atherosclerotic Plaques with more 75% Occlusion “ are a cause of Stable Angina. Where plaques that occlude less than 75% of the Coronary Vessel will be Asymptomatic.
Ulcerated Plaque “ with partially obstructive thrombosis is associated with Unstable Angina or Subendocardial Infarction.
Ruptured Plaque “ is associated with Transmural Infarction with a Full Obstructive Thrombus
Friedrich™s Ataxia “ is associated with Degeneration of Spinocerebellar Tracts, Kyphoscoliosis, Foot Abnormalities (High Arch), Hypertrophic Cardiomyopathy and Increased Risk of Diabetes Mellitus
Cleft Lip “ is associated with Impaired Fusion of Maxillary Prominence and Medial Nasal Processes
Cleft Palate “ is due to incomplete Fusion of Palatine Shelves of Maxillary Prominences
Spinal Scoliosis “ is usually seen in Marfan™s Syndrome
Coccioidis Immitis “ presents as Flu Like Symptoms, Cough and Erythema Nodosum. Will Have Thick Walled Spherules with Endospores
Histoplasma Capsulatum “ will present with Pulmonary Symptoms similar to TB, and has Oval Yeast Within the Macrophages (found in caves, infested with bats)
Blastomycis “ Large Round Yeast with Broad Based Bud, presents with Pulmonary Pneumonia
Caspofungin “ which are Echinocandins, Inhibit Synthesis of Polysaccharide Glucan and used as Anti Fungal.
Wilson™s Disease “ will affect degeneration of Putamen as well as Damage to Basal Ganglia.
MAP Kinase “ signal pathway includes RAS Protein which is a G Protein
Colon Adenocarcinoma in UC Patients “ will present in 30s and will be Uniformly Spread out. Unlike Sporadic, that arise in patients in 60s and more localized to the Left Side.
Carcinoid Syndrome “ when Localized to Intestine, it™s products will be Metabolized by the Liver and Patients will not have Symptoms. When it™s Metastasized to the Liver, then Secretory Products are Not Degraded and Patients Will Experience Symptoms.
Carcinoid Tumors “ arise from Chromaffin Cells of the Intestine, have Eosinophilic Cytoplasm and Oval Shaped Nuclei
4 Stages of Lobar Pneumonia : 1) Congestion (first 24 hours) “ Vascular Dilatation, Alveolar Exudate Contains Mostly Bacteria 2) Red Hepatization (2-3 Days) Alveolar Exudate “ Erythrocytes, Neutrophils and Fibrin 3) Grey Hepatization (4-6 Days) No RBCs, mostly Neutrophils and Fibrin
Polyarteritis Nodosa “ will present with Fibrinoid Necrosis with Transmural Inflammation of Arterioles, fever, malaise, melena. Associated with Hep. B Infection
Alpha 1 Antitrypsin Defficiency “ presents with red-pink PAS Granules of Unsecreted A1AT in Periportal Hepatocytes
Hepatic Abscess “ will present with Fluid Filled Cavity in the Liver, usually due to Staph Aureus, due to Hematogenous Spread. Where Entamoeba Hystolytica will have Aerobic and Non Aerobic Bacteria containing Abscess
Hemosiderin Laden Macrophages “ are usually due to Elevated Pulmonary Pressure, secondary to Left Sided Heart Failure
Paraneoplastic Cerebellar Degeneration “ is an Autoimmune Process and presents with Limb and Truncal Ataxia, Dysarthria. Occurs in patients with Ovarian, Small Cell Carcinoma of the Lung, Breast and Uterine Cancers.
Space Constant “ how far along an axon signal will travel is Decreased in patients with Multiple Sclerosis
Class Switching for IgE “ is due to IL-4 and IL-13 produced by TH2 cells.
IL-5 “ is responsible for Eosinophilia and Class Switching and Synthesis of IgA
Central Retinal Artery Occlusion “ presents with Painless, Permanent Monocular Blindness and will have Cherry Macula
Patients with Essential Fructosuria “ Metabolism of Fructose by Hexokinase to Fructose 6 Phosphate is primary methode of Metabolizing Dietary Fructose
Carbamoyl Phosphate Synthase and N-Acetylglutamate Synthetase “ have increased levels of Ammonia and Neurological Defects.
Mycoplasma Pneumonia “ will require Cholesterol to grow on Artificial Media, due to Single Layer of Cholesterol Phospholipid Bilayer. They Completely Lack Peptidoglycan Cell Wall, Envelope or Capsule. Usually seen among Military Recruits
Optic Nerve Damage “ will cause neither pupil to react to Light, but when Light is shined into an opposite eye, both eyes will Constrict due to Intact Motor Function
Occlusion of Right Coronary Artery “ will result in Transmural Ischemia of Left Ventricle, producing ST Elevation in Leads II, III and avF
Occlusion of LAD “ will result in Anteroseptal Transmural Ischemia with ST Elevation in V1-V4
Occlusion of Left Circumflex “ will result in Transmural Ischemia of Lateral Wall of Left Ventricle and ST Elevation in V5 and V6
Combination of Statins and Fibrates “ increases the Risk of Myopathy and Hepatotoxicity
Combination of Fibrates and Bile Acid Resins “ will result in Increased Risk of Cholesterol Stones, due to Increased Cholesterol in Bile
Neuron Specific Enolase, Chromogranin “ along with Synapthophysin are Neuroendocrine Markers in Patients with Small Cell Carcinoma, which is located Centrally in Smokers.
Meniere™s Disease “ characterized by Triad of Tinnitus, Vertigo and Sensorineural Hearing Loss. Due to Increased Pressure and Volume of Endolymph in Vestibular Apparatus
α 3 chain of Type IV Collagen “ is targeted by anti-glomerular basement membrane antibodies in Goodpasture™s Syndrome
Drug Induced Nephritis “ due to NSAIDS will predominantly affect Interstitium, leaving Glomeruli Intact.
Beta Endorphin and ACTH “ are derived from the same Origin. Beta Endorphin has Increased Affinity to Delta and Mu Receptors.
Pulsion Diverticulitis “ is usually seen in Older Patients due to Increased Pressure, and will affect primarily Sigmoid Colon.
Li Fraumeni Syndrome “ Autosomal Dominant Syndrome, due to Mutation of p53 Gene and will cause Breast, Brain and Adrenal Cortex Sarcomas and Tumors mainly.
Niacin “ potentiates the effects of Anti Hypertensive Medications and Decrease the Effect of Diabetic Medications.
Eplerenone and Spironolactone “ are Aldosterone Antagonists are a usual Therapy for Conn™s Syndrome
Portal Vein Thrombosis “ will present with Normal Liver, because the Defect is Distal to the Liver, will cause Portal Hypertension without affecting the Liver.
Pick™s Disease “ is pronounced with Frontal Lobe Atrophy, and patients present with Dementia, Mood Disturbance and Speech Difficulties
Estrogen and Progesterone in Pregnancy “ Estrogen will cause Increased Cholesterol Synthesis by Upregulating HMG CoA Reductase and Progesterone will reduce Bile Acid Secretion and Slow Gallbladder Emptying
Muddy Brown Granular Casts “ are seen in Ischemic Tubular Necrosis in hospitalized patients.
Papillary Necrosis “ occurs in patients with Sickle Cell, Diabetes Mellitus, Analgesic Nephropathy and Obstructive Pyelonphritis.
Hypersensitivity to Intradermal Injections of Tobacco “ are seen in Buerger™s Disease, which is Thromboangitis Obliterans among Heavy Smokers.
Opening Snap “ is an abrupt Opening of Stenosed Mitral Valve.
Villous Adenomas “ are more likely to undergo Malignant Transformation, unlike Tubular Adenomas
Amifostine “ thiol based cytoprotective free radical scavenger used in patient on Cisplatin, to prevent nephrotoxicity
0 - ArchivalUser - 09-21-2008
elbamaritza - 08/16/08 12:35
NAME THE ANTIDOTE FOR EACH OF THE FOLLOWIN TOXINS:
a.iron
b. copper-gold-arsenic
c. lead
d. arsenic-mercury
e. car exhaustion intoxication
f. cyanide
. methemoglobin
h. antifreeze
i. tylenol
j. aspirin
k. opioids
l. benzodiazepines
m. organophsphates
n. heparin
o. rat poison
p. grandpa's pills ( digitalis)
#1422925
elbamaritza - 08/16/08 20:05
ANTIDOTS
a. deferoxamine
b. penicillamine
c EDTA succimer, dimercprol, and oral penicillamine
d. dimercaprol
e. 100% o2
f. nitrite, vit b 12 and thiosulfate
g. methylene blue
h. ETOH, fomepizole, and dialysis
i. n acaetylcysteine and....?
j. alkalinize urine
k. naloxone or naltrexone
l. flumazenil
m. atropine and or pralidoxime
n. protamine sulfate
o. vit k, FFP
p.anti Fab fragments after stop the drug and stabiize k and Mg. and lidocaine also.
Source;Deja review for usmle step 1
0 - ArchivalUser - 09-21-2008
ANS TO NBME 2
0 - ArchivalUser - 09-21-2008
md83 - 07/27/08 21:16
Here are all the answers to NBME from someone in our school that scored an 800 on it. Good luck. Each 1-50 coincides with every set of 50 questions...all in order for NBME 2. Good luck
1B
2G
3B
4A
5D
6A
7C
8A
9C
10E
11A
12H
13D
14B
15C
16E
17C
18B
19B
20C
21D
22A
23A
24B
25A
26A
27C
28D
29B
30E
31D
32A
33B
34C
35C
36C
37E
38D
39D
40E
41C
42C
43B
44B
45B
46G
47E
48A
49E
50C
1C
2A
3D
4C
5C
6C
7D
8A
9B
10E
11C
12E
13B
14A
15A
16D
17B
18B
19D
20A
21E
22A
23E
24A
25G
26A
27E
28B
29C
30A
31A
32B
33E
34D
35C
36D
37D
38F
39E
40B
41C
42D
43D
44E
45D
46D
47E
48C
49C
50C
1C
2B
3B
4C
5F
6A
7B
8E
9E
10A
11C
12D
13A
14D
15E
16B
17D
18A
19B
20D
21D
22B
23D
24E
25B
26C
27D
28C
29A
30B
31A
32F
33B
34A
35B
36F
37D
38E
39B
40C
41C
42A
43B
44E
45D
46E
47D
48D
49C
50B
1D
2D
3D
4E
5B
6A
7D
8E
9C
10D
11C
12A
13B
14C
15A
16C
17C
18B
19A
20E
21D
22E
23C
24C
25B
26I
27C
28D
29A
30D
31E
32F
33A
34B
35D
36D
37C
38B
39A
40B
41A
42B
43D
44C
45A
46E
47D
48C
49B
50C
0 - ArchivalUser - 09-21-2008
useful post
#334922
letsallget99 - 09/05/08 11:57
Hello everyone I have compiled up some numbers over the past few months from all of my friends that have taken the Step 1. These numbers hopefully reflect the overall averages in the 2008 testing season. Every year the two digit and three digit score change- so I tried to take this into account. I feel these numbers hold true if you take the last 10 tests (50 random timed) in under a weeks period in any of the question banks. Please feel free to put your input in if you feel the numbers are off. If you have any questions you can email me at dr.keithschmidt .
These the formulas I used:
(Usmleworld avg. x 1.922 ) + 106.4 = 3 digit
(Usmleworld avg. x 2.4) + 84 = 3 digit
USMLERx(%)*2.64 + 47 = USMLE 3-digit score (+/- 20 for the 95% CI)
75-----185------------------------------------------42world
76-----187--380 nbme-------53 RX------54kaplan
76-----188------------------------------------------43world
77-----189 “-----------------54 RX
77-----190------------------------------------------44world
78-----191--390 nbme
78-----193-------------------55 RX------55kaplan--45world
78-----194
79-----195 “400 nbme-------56 RX-----------------46world
79-----196
80-----197-------------------------------57kaplan--47world
80-----198-------------------57 RX
80-----199--410 nbme
81-----200 ------------------------------------------48world
82-----201-------------1 SD-58 RX------58kaplan
82-----202-------------------------------------------49world
82-----203--420 nbme-------59 RX
83-----204-------------------------------------------50world
83-----205-------------------------------60kaplan
84-----206-------------------60 RX
85-----207--430 nbme-------------------------------51world
85-----208
85-----209-------------------61 RX------61kaplan---52world
86-----210--440 nbme
86-----211-------------------62 RX------------------53world
86-----212-------------1/2 SD
86-----213--450 nbme-------------------------------54world
87-----213-------------------63 RX------63kaplan
88-----214-------------------------------------------55world
89-----215
89-----216--460 nbme-------64 RX------------------56world
89-----217-------------------------------64kaplan
90-----218--470 nbme-------65 RX------------------57world
90-----219
90-----220--480 nbme-------------------------------58world
91-----221-------------------66 RX-------65kaplan
91-----222--490 nbme----NATIONAL AVERAGE------59world
91-----223-------------------67 RX
92-----224--500 nbme-------------------------------60world
93---- 225
94-----226--510 nbme--------68 RX------66kaplan--61world
94-----227
95-----228--520 nbme-------------------------------62world
95-----229--530 nbme--------69 RX------67kaplan
95-----230--------------------------------68kaplan---63world
96-----231--540 nbme
97-----232--------------------70 RX------69kaplan
98-----233--550 nbme-1/2 SD-----------------------64world
99-----234--------------------71 RX------70kaplan
99-----235--560 nbme-------------------------------65world
99-----236
99-----237--570 nbme --------72 RX-----71kaplan
99-----238--------------------------------------------66world
99-----239--580 nbme -------------------72kaplan
99-----240---------------------73 RX
99-----241--------------------------------73kaplan---67world
99-----242-------590 nbme
99-----243----------------74 RX-------------74kaplan
99-----244--600 nbme-1 SD--------------------------68world