USMLE Step 2 Internal Medicine Lecture Review

Comprehensive practice flashcards focusing on high-yield vocabulary and definitions for Internal Medicine and USMLE Step 2 preparation.

CT First

The critical first test in rapid stroke triage used to differentiate between ischemic and hemorrhagic findings before further intervention.

Protamine sulfate

The specific reversal agent for Heparin.

Andexanet alpha

The specific reversal agent for XA Inhibitors.

tPA (Tissue Plasminogen Activator)

The intravenous treatment considered for acute ischemic stroke if symptom onset is within $< 4.5$ hours.

Transient Ischemic Attack (TIA)

A brief, resolving ischemic event with a duration of $< 24$ hours (typically minutes) and no permanent imaging findings.

Epidural Hematoma

Traumatic injury caused by Middle meningeal artery rupture, often presenting with a loss of consciousness followed by a lucid interval.

Subdural Hematoma

Caused by the tearing of bridging veins (associated with cerebral atrophy or alcohol use), presenting as gradual somnolence and confusion.

Subarachnoid Hemorrhage

Presents as a 'thunderclap' headache typically due to aneurysmal rupture; CT is the first step, followed by LP for xanthochromia if inconclusive.

Cushing Reflex

A triad indicating increased intracranial pressure (ICP) characterized by bradycardia, hypertension, and irregular respirations.

Toxoplasmosis

Common in immunocompromised patients, presenting with multiple ring-enhancing lesions on MRI; requires TMP-SMX prophylaxis when $CD4 < 100$.

CNS Lymphoma

Presents as a single, ring-enhancing periventricular lesion on MRI with EBV DNA found in the CSF.

Progressive Multifocal Leukoencephalopathy (PML)

Rapidly progressive demise caused by the JC Virus, showing well-demarcated asymmetric lesions without mass effect.

Neurocysticercosis

Parasitic infection from Taenia solium causing 'Swiss-cheese' cysts in the brain; treated with Albendazole, Praziquantel, and corticosteroids.

Internuclear Ophthalmoplegia

An inability to adduct the ipsilateral eye, often seen as part of the relapsing-remitting neurologic deficits in Multiple Sclerosis.

Neuromyelitis Optica (NMO)

A condition characterized by recurrent bilateral optic neuritis and extensive transverse myelitis associated with AQP4 antibodies.

Bacterial Meningitis CSF Pattern

Characterized by high neutrophils, low glucose, and high protein.

Lambert-Eaton Syndrome

Proximal muscle weakness that improves with exercise; caused by antibodies to pre-synaptic $Ca^{2+}$ channels and associated with Small Cell Lung Cancer (SCLC).

Guillain-Barré Syndrome

Progressive, ascending symmetric flaccid paralysis with paresthesia following a viral illness; CSF shows albuminocytologic dissociation.

Botulism

Triad of ptosis, myosis, and descending paralysis caused by the inhibition of presynaptic ACh release.

Organophosphate Poisoning

Inhibition of AChE leading to a cholinergic crisis (DUMBELS); treated with Atropine and Pralidoxime.

Meniere's Disease

Condition caused by endolymphatic pressure resulting in low-frequency hearing loss, episodic vertigo, and asymmetric tinnitus.

Lemierre Syndrome

Septic thromboemboli from a pharyngeal infection (Fusedobacterium necrophorum) invading the internal jugular vein.

CHA2DS2-VASc Score

A risk assessment for AFib patients; values of $\ge 2$ typically indicate the need for Warfarin.

First-Degree Heart Block

An EKG finding where the R is far from the P, with a prolonged PR interval exceeding $200\,ms$.

Mobitz Type II Block

A block below the AV node showing a normal or long PR interval with dropped QRS complexes at random.

Wolff-Parkinson-White Syndrome

An abnormal conduction pathway characterized by a Delta wave on EKG.

Torsades de Pointes

A polymorphic ventricular tachycardia precipitated by a long QT interval; treated with Magnesium sulfate.

Vasospastic (Prinzmetal) Angina

Coronary artery spasm causing chest pain and ST elevations at rest in young patients; treated with Nitrates or Nifedipine.

Beck's Triad

A diagnostic classic for Cardiac Tamponade consisting of hypotension, JVD, and muffled/distant heart sounds.

Libman-Sacks Endocarditis

Verrucous endocarditis characterized by a new murmur and negative blood cultures in a patient with SLE.

Light's Criteria (Exudate)

Pleural/serum protein $> 0.5$, pleural/serum LDH $> 0.6$, or pleural LDH $> 2/3$ the upper limit of normal serum LDH.

ARDS Berlin Criteria

Abnormal CXR (bilateral opacities), respiratory failure within 1 week of insult, and decreased $PaO_2/FiO_2$ ratio ($< 300\,mmHg$).

Squamous Cell Carcinoma (Lung)

A central lung mass in smokers that may secrete PTHrP, leading to hypercalcemia.

Small Cell Lung Carcinoma

A central mass in smokers associated with paraneoplastic syndromes like SIADH, Cushing syndrome, or Lambert-Eaton.

Silicosis

A restrictive lung pattern with 'eggshell' calcifications in the upper lobes found in foundry or stone quarry workers; increases TB risk.

Achalasia

Failure of the lower esophageal sphincter to relax and loss of peristalsis, appearing as a 'bird’s beak' on barium swallow.

Charcot Triad

A clinical presentation of acute cholangitis consisting of Fever, Jaundice, and RUQ pain.

Wilson Disease

Autosomal recessive mutation in ATP7B causing copper buildup, low ceruloplasmin, and Kayser-Fleischer rings.

Spontaneous Bacterial Peritonitis (SBP)

Infection characterized by $SAAG > 1.1$, abdominal tenderness, and localizing to the ascitic fluid; often seen in cirrhosis.

BUN:Cr Ratio in Pre-renal AKI

A ratio typically greater than $20:1$ due to decreased effective perfusion and RAAS activation.

Minimal Change Disease

The most common causes of Nephrotic syndrome in children; typically responds well to steroids.

Struvite Stones

Also known as infection stones; caused by urease-positive organisms, appearing as staghorn calculi with 'coffin-lid' crystals.

Jarisch-Herxheimer Reaction

A systemic inflammatory response caused by spirochete toxin release following the first dose of Penicillin for Syphilis.

Sign of Leser-Trélat

The sudden onset of multiple seborrheic keratoses, which serves as a red flag for internal malignancy.

Blastomycosis

A fungal infection presenting with pneumonia and verrucous skin lesions; KOH stain show broad-based budding yeast.

Whipple Disease

Bacterial infection causing malabsorption and lymphadenopathy; biopsy shows PAS-positive 'foamy' macrophages.

AUER Rods

Pathognomonic needle-like inclusions seen in myoblasts on a blood smear for Acute Myeloid Leukemia.

Multiple Myeloma (CRAB)

Characterized by Calcium (hypercalcemia), Renal involvement, Anemia, and Bone pain/lytic lesions.

ADAMTS13 Deficiency

Genetic or acquired deficiency in TTP leading to ultra-large vWF multimers and microthrombi.

Lynch Syndrome

The most common inherited colorectal cancer syndrome, also high risk for endometrial and ovarian cancer (CEO).

Antiphospholipid Syndrome

Condition characterized by false-positive syphilis tests (VDRL), recurrent pregnancy loss, and venous/arterial thrombosis.