HY USMLE Review – Part I Flashcards

High-yield vocabulary and diagnostic flashcards for USMLE Step 1 and Step 2 CK preparation based on Part I review notes.

Traveler diarrhea (ETEC)

Self-limiting watery or brown/green diarrhea associated with travel, caused by HL or HS toxins.

Campylobacter jejuni / Salmonella spp.

Pathogens causing bloody diarrhea typically associated with poultry consumption.

C. difficile stool AB toxin test

The official diagnostic test for C. difficile infection rather than a stool culture.

Toxic megacolon in C. diff

Complication presenting with fever of $104^{\circ}F$ and abdominal distension, requiring laparotomy.

Tx of C. diff

As of February 2018 guidelines, vancomycin is the preferred treatment over metronidazole.

Entamoeba histolytica

Parasite causing bloody diarrhea in travelers; treated with metronidazole plus iodoquinol (or paromomycin).

Norwalk virus

Cause of watery diarrhea often associated with close quarters, military barracks, or cruise ships.

Yersinia enterocolitica

Causes bloody diarrhea and pseudoappendicitis-like pain in children, and reactive arthritis in adults.

Albuminocytologic dissociation

CSF finding in Guillain-Barre syndrome (Campylobacter association) characterized by high protein and normal cell counts.

ECG stress test

First-line evaluation for suspected cardiac ischemia.

Pericarditis

Condition showing diffuse ST-segment elevations on ECG; pain is worse when supine and better when leaning forward.

Pulsus paradoxus

A drop in systolic BP $>10\,mm\,Hg$ with inspiration; associated with cardiac tamponade or severe asthma.

Beck triad

Hypotension, muffled heart sounds, and JVD; indicates pericardial tamponade.

Mycoplasma (CPP)

Most common cause of community-acquired pneumonia (CPP) with bilateral CXR infiltrates or an interstitial description.

Pneumonia in Cystic Fibrosis (CF)

S. aureus is the leading cause in patients under $10$ years; Pseudomonas is more common in those over $10$ years.

Coxiella (Q fever)

Pneumonia associated with exposure to cattle.

Pulmonary embolism (PE) acid-base disturbance

Respiratory alkalosis (low $CO_{2}$, high $pH$, low $O_{2}$, normal bicarb).

Aspirin toxicity (after 20 mins)

Mixed metabolic acidosis-respiratory alkalosis (low $CO_{2}$, low $pH$, normal $O_{2}$, low bicarb).

Hypercalcemia (10.2-12 mEq/L)

Treated with normal saline ($0.9\%\,NaCl$).

Hypercalcemia ($14+\,mEq/L$)

Emergency treated with normal saline ($0.9\%\,NaCl$) plus bisphosphonates (e.g., pamidronate).

Wernicke encephalopathy

B1 deficiency causing ataxia, confusion, and ophthalmoplegia; affects mammillary bodies.

Stress incontinence

Incontinence due to downward movement of the vesicourethral junction; treated with Kegel exercises or a mid-urethral sling.

Urge incontinence (Detrusor instability)

Sudden need to run to the bathroom; treated with oxybutynin (muscarinic antagonist) or mirabegron (beta-3 agonist).

Overflow incontinence (Diabetes)

Incontinence with high post-void volume ($300-400\,mL$); treated with bethanacol (muscarinic agonist).

Vascular dementia

Dementia characterized by step-wise decline and history of hypertension or motor/sensory disturbances.

Lewy body dementia

Triad of visual hallucinations, Parkinsonism, and dementia.

Pick disease (Frontotemporal dementia)

Dementia presenting with apathy, disinhibition, and personality changes.

Normal-pressure hydrocephalus (NPH)

Condition characterized by urinary incontinence, ataxia, and CNS dysfunction ('wet, wobbly, wacky').

Erb-Duchenne palsy

Upper brachial plexus injury ($C5/6$) resulting in the 'waiter tip' arm position.

Klumpke palsy

Lower brachial plexus injury ($C8/T1$) resulting in 'claw hand'.

Radial nerve injury

Injury resulting in a pronated arm and wrist-drop; often caused by midshaft humerus fractures.

Ankylosing spondylitis (AS)

Morning back pain in young males that improves with exercise, associated with 'bamboo spine' and sacroiliac x-ray findings.

Polycythemia vera

Condition with high hemoglobin, low EPO, and pruritis after showering (basophilia).

Labrynthitis

Neurosensory hearing loss, tinnitus, and vertigo following a viral infection.

Atrial septal defect (ASD)

Congenital heart defect characterized by a fixed splitting of $S2$.

HOCM (Crescendo-decrescendo murmur)

Mid-systolic murmur that becomes louder with the Valsalva maneuver.

BUN/Cr > 20

Indicates prerenal azotemia, often caused by hypovolemia or heart failure.

Achalasia

Neurogenic dysphagia to both solids and liquids simultaneously; Dx confirmed by manometry showing 'bird's beak'.

Diabetic gastroparesis

Diabetic presenting with new-onset GERD; treated with metoclopramide.

Anorexia electrolyte abnormality

Hypokalemia, which is the most common cause of death due to arrhythmia.

Sarcoidosis (Labs)

Noncaseating granulomas lead to hypercalcemia, low PTH, and high vitamin $D3$ via $1\text{-alpha hydroxylase}$.

Goodpasture syndrome

Anti-GBM antibodies (anti-collagen IV) causing hematuria and hemoptysis; biopsy shows linear immunofluorescence.

Granulomatosis with polyangiitis (Wegener)

Hematuria, hemoptysis, and 'head-itis' (sinusitis, ear issues); positive for $c-ANCA$ (anti-PR3).

Primary biliary cirrhosis (PBC)

Autoimmune bile duct destruction with high ALP, high direct bilirubin, pruritis, and anti-mitochondrial antibodies.

Hyper IgM syndrome

Deficiency of $CD40$ ligand on T cells, preventing isotype class switching.

Lesch-Nyhan syndrome

$X$-linked deficiency of HGPRT causing self-mutilation and orange crystals in the diaper.

Rheumatoid arthritis (RA) specifics

Symmetrical involvement of PIPs and MCPs (not DIPs); positive for anti-CCP (cyclic citrullinated peptide).

Methotrexate side-effects

Pulmonary fibrosis, hepatotoxicity, and mouth ulcers (neutropenia).

Diffuse proliferative glomerulonephritis (DPGN)

The most specific renal manifestation of SLE (lupus nephritis), showing wire looping on histology.

ITP mechanism

Antibodies against $GpIIb/IIIa$ on platelets; results in low platelet count and increased bleeding time.

von Willebrand Disease (vWD)

$AD$ inheritance; increased bleeding time and increased $aPTT$ (50% of cases) due to lack of Factor $VIII$ stabilization.

agranulocytosis drugs

Clozapine, ganciclovir, PTU, methimazole, methotrexate, and ticlopidine.