*CMV
Heterophile ab
HHV-6
NEGATIVE Mono-like
HIV
syndromes
Toxoplasmosis
-word salad: well-articulated, nonsensical speech
paired with lack of lang comprehension
Wernicke's Aphasia -aud association cortex: post part of sup temporal
gyrus
- supplied by MCA
-prevents conversion of propionyl CoA to
methylmalonyl CoA
Congenital Deficiency of
-propionyl CoA derived from= val, ile, met, thr, odd
Propionyl CoA
# FA, cholesterol side chains
Carboxylase
-Propionic Acidemia: poor feeding, vomiting,
hypotonia, lethargy, dehydration, anion gap acidosis
Neuro: MR, early onset Alzheimer's
Cardio: complete AV septal defect, VSD, ASD
Down Synd GI: duodenal atresia, hirschprung disease
Comorbidities Endo: hypothyroid, DM1, obesity
Heme: ALL (> 5 yo) and AML (<5 yo)
Rheumatology: atlantoaxial stability
MCC of Hypoglycemia in Thiamine def= suppression of GNG (pyruvate DH)
EtOH-ics and TCA cyle (alpha-KG DH)
,10/27/24, 5:51 AM STEP 1 USMLE |2024-2025 UPDATE|COMPREHENSIVE FREQUENT MOST-TESTED QUESTIONS AND VERIFIED ANSW…
MCC of Hypoglycemia in impaired clearance of insulin
advanced renal insuff
Avoid Nitrates in Nitrates decrease preload, which will increase the
Hypertrophic LV outflow tract... BUT since the ventricle is
Cardiomyopathy bc... abnormally shaped, there is an outflow obstruction
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
Mets through BM 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
4. malignant cells to produce cytokines that
stimulate locomotion, so that they can move
through basement membranes and the intracellular
and extracellular matrices
Commonly presents in young, asymptomatic patient
Bicuspid Aortic Valve with soft systolic ejection at right 2nd ICS
-can cause aortic regurg
1. Abx use= reduces lactobacilli pop
2. High estrogen levels- preg
MCC of Vaginal
3. System corticosteroid therapy
Candidiasis
4. Uncontrolled DM
5. Immunosuppression, including HIV
-Carbamazepine
Drug causes of SIADH -Cyclophosphamide
-SSRI
, 10/27/24, 5:51 AM STEP 1 USMLE |2024-2025 UPDATE|COMPREHENSIVE FREQUENT MOST-TESTED QUESTIONS AND VERIFIED ANSW…
MC Ankle Sprain due to -Ant Talofibular Lig dmg
inversion of plantar- -ecchymosis at the ant-lat aspect of the ankle
flexed foot
- Musculocutaneous and Suprascapular N.
- dystocia mc in neonates; severe trauma mc in
Upper Brachial Plexus
adults
Injury
- should adduction, elbow extension, and forearm
pronation
-failure of septum primum and septum secundum to
Patent foramen ovale fuse after birth
-can lead to paradoxical emboli
-MC occurs in membranous septum
Ventricular Septal Defect
-Acyanotic at birth bc of L to R shunt
-at Early Diastole
Coronary Blood Flow
-coronary perfusion driven by diastolic pressure
Peak
-tachycardia will decrease coronary perfusion
majority of people
Right Dom Heart -PDA comes off RCA
-SA and AV nodes supplied by RCA
-PDA comes off of LCX
Left Dom Heart
- SA and AV node supplied by LCX
Hypokalemia, Hypermagnesemia, or prolonged QT
Causes of Spontaneous
interval
Depol causing
= all cause spontaneous depol of ventricles in phase
Tachyarrhythmias
3 or 4 and it will cause an extra AP in heart
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