USMLE Step 1 200 Concepts | Complete Practice Questions & Verified Answers
Tdap vaccine for pregnancy 27th - 36th week
RSV vaccine for pregnancy 32nd - 36th weeks
Hereditary angioedema C1 inhibitor deficiency -> inc. bradykinin
- Recurrent spidoes fo swelling without urticaria or pruritus
- Affects skin and GI mucosa
- Triggered by stress or trauma
Cyclosporine use and side effects Use: transplant rejection prophylaxis
SE: hypertension, ginigival hyperplasia and hirsutism
Tacrolimus side effects Hypertension
Hyperglycemia
Nephrotoxicity
Initial step for treatment and prevention of anaphlyaxis Allergen identification
What is the only vaccine that depends on the child's birth HepB vaccine: <2 kg should recieve at 1 month of age or hospital discharge
weight?
Which vaccines should be administered at 12 months? Fourth Hib dose
Fourth PCV13 dose
First MMR
First varicella
Acute GVHD - Within 100 days
- Type IV HS
- Maculopapular rash, diarrhea, abdominal pain, jaundcie and cholestatic liver
dysfunction
PTLD - Post-transplant lymphoproliferative disorder
- EBV reactivation
- Weight loss, fever, lymphoadenomapy
- Abdominal pain and liver dysfunction
X-linked agammaglobulinemia - Recurrent pyogenic infections (pneumonia and otitis media) with encapsulated
bacteria
- Hypoplastic lymph tissue
- Low immunoglobulin
- Low B-cells
- Develop at 3-6 months
CVID - Recurrent pyogenic infections
- Hypogammaglobulinemia
- Common in 20-40 years old
- Normal B and T cells
Selective IgA def. predisposes to what infection Giardia lamblia
Selective IgA def. symptoms - Sinopulmonary infections
- Inc. risk of autoimmune disease -> immune thrombocytopeina
- Anaphylaxis following transfusion with blood products
, USMLE Step 1 200 Concepts | Complete Practice Questions & Verified Answers
Flow cytometry is used to diagnose Bruton agammaglobulinemia
Mild fever, diffuse pain in legs and arms, history of down Acute lymphoblastic leukemia
syndrome, fever, enlarged lymph nodes, > 50,000 -> diagnose with bone marrow biopsy
leukocyte count
Next step in management for a child with ITP Observation
If bleeding: give IVIG or corticosteroids
Next step for patient with fatigue, mild anemia, low MCV, Beta-thalassemia minor: reassurance
target cells, normal RDW
Impaired G6PD -> Impaired production of NADPH -> imparied regenration of glutathione which is an
antioxidant
Symptoms of G6PD deficiency Diffuse abdominal pain, fever, chills and jaundice
UMP synthase deficiency - Orotic aciduria
- Anemia
- Splenomegaly
- Megaloblastic anemia
- Recurrent infection
- Failure to thrive
- Facial dysmorphism
Treatment for AML All-trans retinoic acid
(also cytarabine)
Older man, lower back pain, hypercalcemia, anemia, lytic Multiple myeloma: serum protein electrophoresis
lesions in skull
- bone biopsy is only confirmatory
Most common non-hodgkin lymphoma in adults Diffuse large B-cell lymphoma
Symptoms of diffuse large B-cell lymphoma - B symptoms
- Lymphadenopathy
- Inc. LDH
- Extensive lymph node involvement
Way to rule out follicular lymphoma It does not cause acute-onset symptoms because it is indolent and low-grade
Way to rule out Burkitt lymphoma It happens in children, only in adults with HIV
Marginal zone lymphoma is associated with Chronic inflammation: MALT lymphoma with chronic gastritis
How to differentiate hemophilia A from Von Willbrand Bleeding time is normal in hemophilia A (it does not affect platelets)
diseae
, USMLE Step 1 200 Concepts | Complete Practice Questions & Verified Answers
Treatment for vWD Desmopressin
Recurrent episodes of diffuse, symmetrical pain and Dactylitis -> vasooculusive episodes of sickle cell disease -> microhematuria
swelling of hands and feet
When is LMWH first line for DVT - Pregnant patients
- Active cancer
- Liver impairment
- Increased INR
First-line treatment for long-term prophylaxis of DVT Direct oral anticoagulants: rivaroxaban
When is warfarin the long-term anticogulant therapy Severe renal impaitment
- Second line for DVT and normal renal function
When to do echocardiography for kawaski At diagnosis
2 weeks after
6-8 weeks after
IDA lab values - Dec. ferritin
- Dec. TIBC
- Dec. transferrin saturation
- Dec. reticulocyte count
- Inc. transferrin
- Inc. RDW
Most common symptoms of agranulocytosis Oral ulceration
Fever
Sore throat
Malaise
Inc. susceptibility to infections
Development age: kicking a ball 2 years, gross motor skill
Development age: fasten buttons 5 year, fine motor skill
Development age: feed themselves with a spoon 2 years, fine motor skill
Development age: hops on one foot 5 years: gross motor skill
Development age: pencil grasping 4 years: fine motor skill
Development age: copies a circle drawn 3 years: cognitive skill
Development age: playing with more than one toy at a 2 years: cognitive skill
time
Tdap vaccine for pregnancy 27th - 36th week
RSV vaccine for pregnancy 32nd - 36th weeks
Hereditary angioedema C1 inhibitor deficiency -> inc. bradykinin
- Recurrent spidoes fo swelling without urticaria or pruritus
- Affects skin and GI mucosa
- Triggered by stress or trauma
Cyclosporine use and side effects Use: transplant rejection prophylaxis
SE: hypertension, ginigival hyperplasia and hirsutism
Tacrolimus side effects Hypertension
Hyperglycemia
Nephrotoxicity
Initial step for treatment and prevention of anaphlyaxis Allergen identification
What is the only vaccine that depends on the child's birth HepB vaccine: <2 kg should recieve at 1 month of age or hospital discharge
weight?
Which vaccines should be administered at 12 months? Fourth Hib dose
Fourth PCV13 dose
First MMR
First varicella
Acute GVHD - Within 100 days
- Type IV HS
- Maculopapular rash, diarrhea, abdominal pain, jaundcie and cholestatic liver
dysfunction
PTLD - Post-transplant lymphoproliferative disorder
- EBV reactivation
- Weight loss, fever, lymphoadenomapy
- Abdominal pain and liver dysfunction
X-linked agammaglobulinemia - Recurrent pyogenic infections (pneumonia and otitis media) with encapsulated
bacteria
- Hypoplastic lymph tissue
- Low immunoglobulin
- Low B-cells
- Develop at 3-6 months
CVID - Recurrent pyogenic infections
- Hypogammaglobulinemia
- Common in 20-40 years old
- Normal B and T cells
Selective IgA def. predisposes to what infection Giardia lamblia
Selective IgA def. symptoms - Sinopulmonary infections
- Inc. risk of autoimmune disease -> immune thrombocytopeina
- Anaphylaxis following transfusion with blood products
, USMLE Step 1 200 Concepts | Complete Practice Questions & Verified Answers
Flow cytometry is used to diagnose Bruton agammaglobulinemia
Mild fever, diffuse pain in legs and arms, history of down Acute lymphoblastic leukemia
syndrome, fever, enlarged lymph nodes, > 50,000 -> diagnose with bone marrow biopsy
leukocyte count
Next step in management for a child with ITP Observation
If bleeding: give IVIG or corticosteroids
Next step for patient with fatigue, mild anemia, low MCV, Beta-thalassemia minor: reassurance
target cells, normal RDW
Impaired G6PD -> Impaired production of NADPH -> imparied regenration of glutathione which is an
antioxidant
Symptoms of G6PD deficiency Diffuse abdominal pain, fever, chills and jaundice
UMP synthase deficiency - Orotic aciduria
- Anemia
- Splenomegaly
- Megaloblastic anemia
- Recurrent infection
- Failure to thrive
- Facial dysmorphism
Treatment for AML All-trans retinoic acid
(also cytarabine)
Older man, lower back pain, hypercalcemia, anemia, lytic Multiple myeloma: serum protein electrophoresis
lesions in skull
- bone biopsy is only confirmatory
Most common non-hodgkin lymphoma in adults Diffuse large B-cell lymphoma
Symptoms of diffuse large B-cell lymphoma - B symptoms
- Lymphadenopathy
- Inc. LDH
- Extensive lymph node involvement
Way to rule out follicular lymphoma It does not cause acute-onset symptoms because it is indolent and low-grade
Way to rule out Burkitt lymphoma It happens in children, only in adults with HIV
Marginal zone lymphoma is associated with Chronic inflammation: MALT lymphoma with chronic gastritis
How to differentiate hemophilia A from Von Willbrand Bleeding time is normal in hemophilia A (it does not affect platelets)
diseae
, USMLE Step 1 200 Concepts | Complete Practice Questions & Verified Answers
Treatment for vWD Desmopressin
Recurrent episodes of diffuse, symmetrical pain and Dactylitis -> vasooculusive episodes of sickle cell disease -> microhematuria
swelling of hands and feet
When is LMWH first line for DVT - Pregnant patients
- Active cancer
- Liver impairment
- Increased INR
First-line treatment for long-term prophylaxis of DVT Direct oral anticoagulants: rivaroxaban
When is warfarin the long-term anticogulant therapy Severe renal impaitment
- Second line for DVT and normal renal function
When to do echocardiography for kawaski At diagnosis
2 weeks after
6-8 weeks after
IDA lab values - Dec. ferritin
- Dec. TIBC
- Dec. transferrin saturation
- Dec. reticulocyte count
- Inc. transferrin
- Inc. RDW
Most common symptoms of agranulocytosis Oral ulceration
Fever
Sore throat
Malaise
Inc. susceptibility to infections
Development age: kicking a ball 2 years, gross motor skill
Development age: fasten buttons 5 year, fine motor skill
Development age: feed themselves with a spoon 2 years, fine motor skill
Development age: hops on one foot 5 years: gross motor skill
Development age: pencil grasping 4 years: fine motor skill
Development age: copies a circle drawn 3 years: cognitive skill
Development age: playing with more than one toy at a 2 years: cognitive skill
time
