1
STEP 1 USMLE |
UPDATE|COMPREHENSIVE FREQUENT
MOST-TESTED QUESTIONS AND
VERIFIED ANSWERS/SOLUTIONS
Heterophile ab NEGATIVE Mono-like syndromes - (ANSWER)*CMV
HHV-6
HIV
Toxoplasmosis
Wernicke's Aphasia - (ANSWER)-word salad: well-articulated, nonsensical speech
paired with lack of lang comprehension
-aud association cortex: post part of sup temporal gyrus
- supplied by MCA
Congenital Deficiency of Propionyl CoA Carboxylase - (ANSWER)-prevents
conversion of propionyl CoA to methylmalonyl CoA
-propionyl CoA derived from= val, ile, met, thr, odd # FA, cholesterol side chains
-Propionic Acidemia: poor feeding, vomiting, hypotonia, lethargy, dehydration,
anion gap acidosis
Down Synd Comorbidities - (ANSWER)Neuro: MR, early onset Alzheimer's
Cardio: complete AV septal defect, VSD, ASD
,2
GI: duodenal atresia, hirschprung disease
Endo: hypothyroid, DM1, obesity
Heme: ALL (> 5 yo) and AML (<5 yo)
Rheumatology: atlantoaxial stability
MCC of Hypoglycemia in EtOH-ics - (ANSWER)Thiamine def= suppression of GNG
(pyruvate DH) and TCA cyle (alpha-KG DH)
MCC of Hypoglycemia in advanced renal insuff - (ANSWER)impaired clearance of
insulin
Avoid Nitrates in Hypertrophic Cardiomyopathy bc... - (ANSWER)Nitrates
decrease preload, which will increase the LV outflow tract... BUT since the
ventricle is abnormally shaped, there is an outflow obstruction
Mets through BM - (ANSWER)Clonal proliferation of cells can invade/
metastasize*
1. malignant cells to lose their cell-to-cell adhesion molecules (cadherins)
2. cell receptors to attach to laminin (a glycoprotein) in the basement membrane
and to release metalloproteinases (e.g., collagenases, stromelysins, gelatinases)
to degrade the basement membrane and other enzymes to degrade the
interstitial connective tissue- tissue inhibitors of metalloproteinases neutralize
these tumor-produced enzymes and limit the degree of invasion
3. cell receptors to attach to bronectin and other proteins in the extracellular
matrix (ECM) and to break it down
,3
4. malignant cells to produce cytokines that stimulate locomotion, so that they
can move through basement membranes and the intracellular and extracellular
matrices
Bicuspid Aortic Valve - (ANSWER)Commonly presents in young, asymptomatic
patient with soft systolic ejection at right 2nd ICS
-can cause aortic regurg
MCC of Vaginal Candidiasis - (ANSWER)1. Abx use= reduces lactobacilli pop
2. High estrogen levels- preg
3. System corticosteroid therapy
4. Uncontrolled DM
5. Immunosuppression, including HIV
Drug causes of SIADH - (ANSWER)-Carbamazepine
-Cyclophosphamide
-SSRI
MC Ankle Sprain due to inversion of plantar-flexed foot - (ANSWER)-Ant
Talofibular Lig dmg
-ecchymosis at the ant-lat aspect of the ankle
, 4
Upper Brachial Plexus Injury - (ANSWER)- Musculocutaneous and Suprascapular
N.
- dystocia mc in neonates; severe trauma mc in adults
- should adduction, elbow extension, and forearm pronation
Patent foramen ovale - (ANSWER)-failure of septum primum and septum
secundum to fuse after birth
-can lead to paradoxical emboli
Ventricular Septal Defect - (ANSWER)-MC occurs in membranous septum
-Acyanotic at birth bc of L to R shunt
Coronary Blood Flow Peak - (ANSWER)-at Early Diastole
-coronary perfusion driven by diastolic pressure
-tachycardia will decrease coronary perfusion
Right Dom Heart - (ANSWER)majority of people
-PDA comes off RCA
-SA and AV nodes supplied by RCA
Left Dom Heart - (ANSWER)-PDA comes off of LCX
- SA and AV node supplied by LCX
STEP 1 USMLE |
UPDATE|COMPREHENSIVE FREQUENT
MOST-TESTED QUESTIONS AND
VERIFIED ANSWERS/SOLUTIONS
Heterophile ab NEGATIVE Mono-like syndromes - (ANSWER)*CMV
HHV-6
HIV
Toxoplasmosis
Wernicke's Aphasia - (ANSWER)-word salad: well-articulated, nonsensical speech
paired with lack of lang comprehension
-aud association cortex: post part of sup temporal gyrus
- supplied by MCA
Congenital Deficiency of Propionyl CoA Carboxylase - (ANSWER)-prevents
conversion of propionyl CoA to methylmalonyl CoA
-propionyl CoA derived from= val, ile, met, thr, odd # FA, cholesterol side chains
-Propionic Acidemia: poor feeding, vomiting, hypotonia, lethargy, dehydration,
anion gap acidosis
Down Synd Comorbidities - (ANSWER)Neuro: MR, early onset Alzheimer's
Cardio: complete AV septal defect, VSD, ASD
,2
GI: duodenal atresia, hirschprung disease
Endo: hypothyroid, DM1, obesity
Heme: ALL (> 5 yo) and AML (<5 yo)
Rheumatology: atlantoaxial stability
MCC of Hypoglycemia in EtOH-ics - (ANSWER)Thiamine def= suppression of GNG
(pyruvate DH) and TCA cyle (alpha-KG DH)
MCC of Hypoglycemia in advanced renal insuff - (ANSWER)impaired clearance of
insulin
Avoid Nitrates in Hypertrophic Cardiomyopathy bc... - (ANSWER)Nitrates
decrease preload, which will increase the LV outflow tract... BUT since the
ventricle is abnormally shaped, there is an outflow obstruction
Mets through BM - (ANSWER)Clonal proliferation of cells can invade/
metastasize*
1. malignant cells to lose their cell-to-cell adhesion molecules (cadherins)
2. cell receptors to attach to laminin (a glycoprotein) in the basement membrane
and to release metalloproteinases (e.g., collagenases, stromelysins, gelatinases)
to degrade the basement membrane and other enzymes to degrade the
interstitial connective tissue- tissue inhibitors of metalloproteinases neutralize
these tumor-produced enzymes and limit the degree of invasion
3. cell receptors to attach to bronectin and other proteins in the extracellular
matrix (ECM) and to break it down
,3
4. malignant cells to produce cytokines that stimulate locomotion, so that they
can move through basement membranes and the intracellular and extracellular
matrices
Bicuspid Aortic Valve - (ANSWER)Commonly presents in young, asymptomatic
patient with soft systolic ejection at right 2nd ICS
-can cause aortic regurg
MCC of Vaginal Candidiasis - (ANSWER)1. Abx use= reduces lactobacilli pop
2. High estrogen levels- preg
3. System corticosteroid therapy
4. Uncontrolled DM
5. Immunosuppression, including HIV
Drug causes of SIADH - (ANSWER)-Carbamazepine
-Cyclophosphamide
-SSRI
MC Ankle Sprain due to inversion of plantar-flexed foot - (ANSWER)-Ant
Talofibular Lig dmg
-ecchymosis at the ant-lat aspect of the ankle
, 4
Upper Brachial Plexus Injury - (ANSWER)- Musculocutaneous and Suprascapular
N.
- dystocia mc in neonates; severe trauma mc in adults
- should adduction, elbow extension, and forearm pronation
Patent foramen ovale - (ANSWER)-failure of septum primum and septum
secundum to fuse after birth
-can lead to paradoxical emboli
Ventricular Septal Defect - (ANSWER)-MC occurs in membranous septum
-Acyanotic at birth bc of L to R shunt
Coronary Blood Flow Peak - (ANSWER)-at Early Diastole
-coronary perfusion driven by diastolic pressure
-tachycardia will decrease coronary perfusion
Right Dom Heart - (ANSWER)majority of people
-PDA comes off RCA
-SA and AV nodes supplied by RCA
Left Dom Heart - (ANSWER)-PDA comes off of LCX
- SA and AV node supplied by LCX
