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USMLE_World_Notes

USMLE World Not es - Import ant Point s
**Credit s t o Duncan

Subendot helial Deposit s are seen in SLE pat ient s

Subepit helial Humps are seen in Acut e Post st rept ococcalGlomeruloneprhit is

Linear Subendot helial are seen in Goodpast ures (Type II)

Mesangial Deposit s are seen in IgA Nephropat hy

Spike and Dome are seen in Membranous

Subendot helial Humps are seen in Membranoprolif erat ive

Azit hromycin administ ered t o HIV + pat ient s can prevent Mycobact erium Avium

Et hambut ol inhibit s arabinosyl t ransf erase which polymerizesarabinose int o arabinan et c. Side Ef f ect s
Opt ic Neurit is

Rif ampin inhibit s bact erial DNA dependent RNA polymerase and t hus prevent s t ranscript ion of DNA
int o mRNA.

Isoniazid inhibit s mycolic acid synt hesis.

FF = GFR/RPF GFR = Creat inine Clearance/Inulin

RPF = PAH

Fibroadenoma cellular myxoid st roma, somet imes t here arecompressed cyst ic spaces.

Spongiosis - epidermal accumulat ion of edemat ous f luid in t heint ercellular spaces.

Diphenoxylat e opiat e ant i-diarrheal st ruct urally relat ed t oMeperidine.

Oct reot ide good f or secret ory diarrhea, which is a Somat ost at inAnalog

Urease convert s urea t o carbon dioxide and ammonia and t husincreases pH

Radiat ion Therapy - causes 1) DNA double st rand breakage 2)f ormat ion of f ree radical

Met hadone has a long half lif e

In Fet al Lungs - af t er 30 weeks t here is an increase in Lecit hin

Af t er 36 weeks t here is a rise in Phosphat ydylglycerol

Males wit h 5 reduct ase def iciency - f eminized ext ernal genit alia,small phallus and Hypospadias are
common.

Repair Damage Glycosylase Endonuclease Lyase DNAPolymerase Ligase

H. Pylori most common cause of duodenal ulcers

CMV in immunocompromised Mononucleosis

Ret init is in CMV HIV+ Pat ient s

Primary CNS Lymphoma most commonly associat ed wit h AIDS

Squamous Cell Lung Cancer produces Parat hyroid HormoneRelat ed Pept ide, which in t urn will
decrease PTH

Campylobact er can be t ransmit t ed f rom domest ic animals

Shigella - is t ransmit t ed via f ecal oral in day care cent ers

Kerat in - marker of epit helial cell origin.

Secret in - produced by S endocrine cells in t he duodenum, t hat increases bicarbonat e secret ion f rom
exocrine pancreas int o t hesmall bowel.

Alprazolam benzodiazepine wit h t he short est half lif e, which isused in Acut e Anxiet y.

Diazepam, Chlordiazepoxide and Clonazepam longest half lif e,used in prophylaxis.

Sheet s of Primit ive Cells wit h Many Mit ot ic Figures Medulloblast oma

Most Common Tumors in Children:

Pilocyt ic Ast rocyt oma - Rosent hal Fibers

Medulloblast oma - sheet s of small blue cells, many mit ot ic f igures

Ependyoma can cause Hydrocephalus and f orm Roset t es

Ort host at ic Hypot ension side ef f ect s of adrenergic blockers.

AML - has associat ions wit h t (15,17), t (8,21) and Auer Rods are st ained wit h Myeloperoxidase.

CLL delet ion on Chromosome 13

Mant le Cell B Lymphoma t (11,14)

Dobut amine causes increase in cardiac cont ract ilit y and increasein Heart Rat e

Tumors of Schwann Cells are derived f rom neural Crest Cells.

Pat ient s wit h CGD suscept ible t o 1) St aph Aureus 2)Pseudomonas 3) Serrat ia

Nocardia 5) Aspergillus

Rosent hal Fibers wit h granular eosinophilic bodies are seen inPilocyt ic Ast rocyt oma. They are well
dif f erent iat ed comprised of spindle cells wit h hair like glial project ions

At ropine reverses muscarinic ef f ect s but does not prevent t hedevelopment of nicot inic ef f ect s such
as muscle paralysis

Pralidoxime reverses bot h muscarinic and nicot inic ef f ect s of organophosphat es by rest oring
cholinest erase.

Calcium binds t o Troponin C and t hen uncovers t ropomyosinsit es, t hus allowing act in t o bind t o
myosin.

S 3 Heart Sound can be heard if t he pat ient lies down in Lef t Lat eral Decubit us Posit ion or Exhales
Complet ely

RBF = Renal Plasma Flow/ (1-Hemat ocrit )

In Met abolic Alkalosis measure pat ient s Urinary Chloride

Germinoma - t umors of Pineal Gland, f ormed in children andadolescent s.

Will present wit h 1) Precocious Pubert y due t o -HCG Product ion(similar in t est icular seminoma) 2)
Obst ruct ive Hydrocephalus 3)Parinaud Syndrome paralysis of upward gaze.

Ult raviolet Specif ic Endonuclease init iat es repair by nicking t hest rand at Thymine Dimer. This enzyme
is missing in XerodermaPigment osum

SER f unct ions in synt hesis of Lipids, Carbohydrat e Met abolismand Det oxif icat ion of Harmf ul
Subst ances

Uret ero Pelvic Junct ion most common sit e of obst ruct ion

Increased Int raocular Pressure most common side ef f ect of t reat ment of Bradycardia wit h At ropine.

Mut at ion in Glycoprot ein will cause changes in t he host and t heymediat e at t achment t o t arget host
cell.

cAMP pat hway - 2, 1 and 2

Inosit ol Pat hway 1 adrenergic, muscarinic, cholinergic

Ion Channel Nicot inic, Cholinergic.

Ampicillin must be added t o t reat inf ant s wit h Meningit is.Cef t riaxone covers all organisms, but List eria
Monocyt ogenis iskilled by Ampicillin.

B 19 Fif t hs Disease causes aplast ic crises (bone marrow)

Eat on Lambers Syndrome - associat ed wit h Lung Cancer, similart o Myast henia Gravis. Ant ibodies are
against pre-synapt ic CalciumChannels.

Myot onic Dyst rophy t riplicat e repeat , movement f ront albaldness, cat aract s are seen. Cannot Loosen
Hand Grip.

Cholinomimet ics indicat ed in Urinary Ret ent ion Paralyt ic Ileusand Glaucoma

HUS af t er E. Coli Microangiopat hic Hemolyt ic Anemia

Segment al Viruses (Rot avirus and Ort homyxovirus) - capable of Genet ic Shif t .

Paget s Disease - increase in Ost eoclast s, t hen increase inOst eoblast s, which will increase Alkaline
Phosphat ase.

Arginase - enzyme in Urea Cycle produces Urea and Ornit hinef rom Arginine.

Minut e Vent ilat ion - product of Tidal Volume and RR and includesDead Space.

Neurophysis carriers f or Oxyt ocin and ADH in Post erior Pit uit ary.

Epinephrine increases Syst olic BP (1 Ef f ect )

Increase Heart Rat e (1 Ef f ect )

Decreases Diast olic (2 Ef f ect )

Pret reat ment wit h Propranolol eliminat es Ef f ect s and Leaves Ef f ect s Only.

Prot ein C Def f iciency in Warf arin Therapy will exaggerat e t heresponse and cause Hypercoagulable
St at e wit h Skin Necrosis

Neonat es wit h Hypot hyroidism - weak, pale, dry. Macroglossiaand Umbilical Hernia

Acyclovir - incorporat es int o newly replicat ed Viral DNA

Hemorrhagic Cyst it is in Children Adenovirus (especially inMales)

Uric Acid precipit at es - collect ing duct s due t o Low Urine pH.

Insulin - drug of choice f or Gest at ional Diabet es.

AML - f ormat ion of PML/RAR f usion gene, unable t o signal f orproper dif f erent iat on

Auer Rods st ained wit h myeloperoxidase

Donepezil Tx f or Alzheimers Disease, is a Cholinest eraseInhibit or and also you would add Vit amin E.

NMDA Recept or in CNS overst imulat ion by Glut amat e t hought t oincrease AD Sympt oms. Tx wit h
Memant ine (ant agonist )

Barbit urat es increase durat ion of Chloride Channel Opening

Benzodiazepines increase f requency of Chloride Channels.

Serum Fibrinogen must be monit ored in DIC.

Narcolepsy def iciency or Low Levels of Neurot ransmit t er Orexin( Hypocret in)

Hawt horne Ef f ect - t endency of a st udy populat ion t o af f ect anout come due t o what is st udied.

Mullerian Inhibit ory Fact or secret ed by Sert oli Cells

Primary inf ect ion wit h HSV more spread out , but React ivat ion ismore Localized t o 1 side.

S-100 Posit ive Schwannoma and Melanoma. Bot h are f romNeural Crest Cells.

T- Lymphocyt es Paracort ical Zone

B-Lymphocyt es - Germinal Cent ers of Lymph Node

Turner Syndrome - heavily met hylat ed DNA due t o LowTranscript ion Act ivit y (Het erochromat in is not
t ranscript ionallyact ive, it s t oo condensed)

Adenovirus low grade f ever, t hroat pain, pharyngoconjunct ivit is,can be t ransmit t ed in Summer Camps.

Fragile X - gene met hylat ion, and t his is inact ive, because it scondensed.
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Burr Cells, Helmet Cells - Mechanical Red Cell Dest ruct ion. Pt swit h Prost het ic Valves.

When Vaccinat ed - Virus Ent ry int o cells is impaired.

Sot alol Blocker wit h Class III (Pot assium Channel Blocker)Propert ies will cause Bradycardia and QT
Prolongat ion.

Pre B-ALL TdT + CD 10 and CD 19

Pre T-ALL CD2, CD3, CD4, CD5, CD7, CD8, CD1a, TdT

Leukocyt e Alkaline Phosphat ase decreased in CML, increased ornormal in Leukemoid React ion which
is 50,000 WBC.

Homocyst inuria (similar t o Marf ans) def iciency of Cyst at hioneSynt hase. Tx wit h Pyridoxine
Supplement s (B6)

Ring Enhanced Lesions Toxoplasmosis, Seizures

Dihydrobiopt erin Reduct ase Cof act or f or Bot h PhenylalanineHydroxylase and Tyrosine Hydroxylase.

Ost eoblast s convert t o Ost eocyt es ost eocyt es are connect ed byGap Junct ions.

Lecit hinase alpha t oxin, produced by C. Perf ringes and has anabilit y t o degrade Lecit hin, main
component of PhospholipidMembrane

Terminal Bronchioles lined by ciliat ed simple cuboidalepit helium.

Nipple Ret ract ion in Breast Cancer is usually due t o inf ilt rat ionof Coopers Ligament by Cancer.

Prepat ellar Bursa commonly seen in roof ers, carpent ers, peoplewho are kneeling all t he t ime.

Acut e Myelogenous Leukemia is associat ed wit h t (15,17), wheregene f or Ret inoic Acid is t ransf erred
f rom Ch. 17 t o Ch. 15

Sarcoidosis present s wit h increased number of CD4 + T cells.

Calcit onin released f rom Paraf ollicular cells of Thyroid, inresponse t o increasing levels of calcium. It
promot es calciumabsorpt ion by t he bone and reducing calcium absorpt ion by t heint est ines and t hus
decreasing t he levels of circulat ing calcium

NSAIDS - are t he primary cause of papillary necrosis and chronicint erst it ial nephrit is
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