25 cardsUSMLE Step 1
USMLE Step 1: High-Yield Medical Mnemonics & Clinical Pathology
25 flashcards to revise the key facts for the USMLE Step 1. Study material written for practice, not the official exam.
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Beck's Triad of Cardiac Tamponade
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Terms in this deck (25)
1
Beck's Triad of Cardiac Tamponade
1. Hypotension
2. Distended neck veins (elevated JVP)
3. Muffled heart sounds
(Plus pulsus paradoxus: drop in systolic BP > 10 mmHg on inspiration).
2. Distended neck veins (elevated JVP)
3. Muffled heart sounds
(Plus pulsus paradoxus: drop in systolic BP > 10 mmHg on inspiration).
2
Virchow's Triad of Venous Thrombosis
1. Endothelial injury (e.g. trauma, hypertension)
2. Stasis or abnormal blood flow (e.g. immobilization, atrial fibrillation)
3. Hypercoagulability (e.g. Factor V Leiden, protein C/S deficiency).
2. Stasis or abnormal blood flow (e.g. immobilization, atrial fibrillation)
3. Hypercoagulability (e.g. Factor V Leiden, protein C/S deficiency).
3
Charcot's Triad vs Reynolds' Pentad (Acute Cholangitis)
Charcot's Triad: (1) Fever, (2) Jaundice, (3) Right Upper Quadrant pain. Reynolds' Pentad adds: (4) Hypotension/shock, (5) Altered mental status.
4
Cushing's Triad of Increased Intracranial Pressure
1. Hypertension (widening pulse pressure)
2. Bradycardia
3. Irregular respirations (Cheyne-Stokes or respiratory depression). Indicative of impending brainstem herniation.
2. Bradycardia
3. Irregular respirations (Cheyne-Stokes or respiratory depression). Indicative of impending brainstem herniation.
5
Nephritic vs Nephrotic Syndrome Classic Features
Nephritic: Hematuria (RBC casts), hypertension, oliguria, mild proteinuria (< 3.5 g/day). Nephrotic: Massive proteinuria (> 3.5 g/day), hypoalbuminemia, generalized edema, hyperlipidemia, fatty casts.
6
Reiter Syndrome (Reactive Arthritis) Triad
'Can't see, can't pee, can't climb a tree':
1. Conjunctivitis / Uveitis
2. Urethritis
3. Arthritis (oligoarticular, asymmetric). Associated with HLA-B27 following GI or Chlamydia infection.
1. Conjunctivitis / Uveitis
2. Urethritis
3. Arthritis (oligoarticular, asymmetric). Associated with HLA-B27 following GI or Chlamydia infection.
7
Crest Syndrome (Limited Systemic Sclerosis)
C - Calcinosis cutis
R - Raynaud phenomenon
E - Esophageal dysmotility
S - Sclerodactyly
T - Telangiectasia
(Associated with anti-centromere antibodies).
R - Raynaud phenomenon
E - Esophageal dysmotility
S - Sclerodactyly
T - Telangiectasia
(Associated with anti-centromere antibodies).
8
Whipple's Disease: Tropheryma whipplei
'Foamy Whipped Cream in a CAN':
Cardiac symptoms, Arthralgias, Neurologic symptoms + diarrhea/malabsorption. Biopsy: PAS-positive, diastase-resistant foamy macrophages in lamina propria.
Cardiac symptoms, Arthralgias, Neurologic symptoms + diarrhea/malabsorption. Biopsy: PAS-positive, diastase-resistant foamy macrophages in lamina propria.
9
DiGeorge Syndrome (22q11.2 Microdeletion): CATCH-22
C - Cardiac abnormalities (Tetralogy of Fallot, truncus arteriosus)
A - Abnormal facies
T - Thymic hypoplasia (T-cell deficiency)
C - Cleft palate
H - Hypocalcemia (parathyroid aplasia leading to tetany).
A - Abnormal facies
T - Thymic hypoplasia (T-cell deficiency)
C - Cleft palate
H - Hypocalcemia (parathyroid aplasia leading to tetany).
10
Wiskott-Aldrich Syndrome Triad: WATER
W - Wiskott-Aldrich
A - Thrombocytopenia (microthrombocytes, petechiae)
E - Eczema
R - Recurrent pyogenic infections.
X-linked recessive mutation in WAS gene, impaired actin cytoskeleton.
A - Thrombocytopenia (microthrombocytes, petechiae)
E - Eczema
R - Recurrent pyogenic infections.
X-linked recessive mutation in WAS gene, impaired actin cytoskeleton.
11
Multiple Myeloma Clinical Features: CRAB
C - Hypercalcemia
R - Renal insufficiency (myeloma kidney, light chain casts)
A - Anemia
B - Bone lytic lesions (punched-out lesions, pathological fractures).
Serum protein electrophoresis shows M-spike (monoclonal IgG/IgA).
R - Renal insufficiency (myeloma kidney, light chain casts)
A - Anemia
B - Bone lytic lesions (punched-out lesions, pathological fractures).
Serum protein electrophoresis shows M-spike (monoclonal IgG/IgA).
12
Atropine / Anticholinergic Toxicity Mnemonic
'Hot as a hare (hyperthermia), Blind as a bat (mydriasis, cycloplegia), Dry as a bone (anhidrosis), Red as a beet (cutaneous flushing), Mad as a hatter (delirium), Full as a flask (urinary retention)'.
13
Zero-Order vs First-Order Pharmacokinetics
First-Order: Rate of elimination is proportional to drug concentration (constant fraction/half-life eliminated per unit time). Zero-Order: Rate of elimination is constant, independent of concentration (constant amount eliminated; e.g., PEA: Phenytoin, Ethanol, Aspirin).
14
Volume of Distribution () Clinical Meaning
. Low (3-5 L) = confined to vascular space (large, polar, protein-bound). High (> 42 L) = extensive tissue binding and lipid accumulation.
15
Cytochrome P450 Inducers vs Inhibitors
Inducers: Rifampin, Phenytoin, Carbamazepine, St. John's Wort, Chronic alcohol, Barbiturates. Inhibitors: Cimetidine, Ciprofloxacin, Ketoconazole, Macrolides (Erythromycin), Isoniazid, Grapefruit juice.
16
Encapsulated Bacteria (Splenectomy Risk): SHiNE SKiS
Streptococcus pneumoniae, Haemophilus influenzae type B, Neisseria meningitidis, Escherichia coli, Salmonella, Klebsiella pneumoniae, Group B Strep. Asplenic patients require vaccination against S. pneumoniae, H. influenzae, N. meningitidis.
17
Gram-Positive Endospore-Forming Rods
Bacillus (aerobic: Bacillus anthracis, Bacillus cereus) and Clostridium (anaerobic: Clostridium tetani, Clostridium botulinum, Clostridium perfringens, Clostridioides difficile). Spores contain dipicolinic acid.
18
Kawasaki Disease Diagnostic Criteria: CRASH and Burn
Burn = Fever days + 4 of:
C - Conjunctivitis (bilateral, non-purulent)
R - Rash (polymorphous)
A - Adenopathy (cervical, usually unilateral)
S - Strawberry tongue (oral mucosal changes)
H - Hands and feet edema/erythema.
Risk: Coronary artery aneurysms (treat with IVIG + Aspirin).
C - Conjunctivitis (bilateral, non-purulent)
R - Rash (polymorphous)
A - Adenopathy (cervical, usually unilateral)
S - Strawberry tongue (oral mucosal changes)
H - Hands and feet edema/erythema.
Risk: Coronary artery aneurysms (treat with IVIG + Aspirin).
19
Types of Hypersensitivity Reactions: ACID
Type I: Anaphylactic / Atopic (IgE mediated, mast cell degranulation)
Type II: Cytotoxic (antibody-mediated: IgG/IgM against cell surfaces; e.g. Goodpasture, Rh hemolytic disease)
Type III: Immune Complex (antigen-antibody deposition; e.g. SLE, serum sickness)
Type IV: Delayed-type (T-cell mediated; e.g. PPD test, contact dermatitis).
Type II: Cytotoxic (antibody-mediated: IgG/IgM against cell surfaces; e.g. Goodpasture, Rh hemolytic disease)
Type III: Immune Complex (antigen-antibody deposition; e.g. SLE, serum sickness)
Type IV: Delayed-type (T-cell mediated; e.g. PPD test, contact dermatitis).
20
Horner Syndrome Triad & Anatomical Defect
Triad: Ptosis (mild drooping of upper lid), Miosis (pupillary constriction), Anhidrosis (loss of hemifacial sweating). Caused by disruption of oculosympathetic pathway (e.g., Pancoast tumor of lung apex).
21
Pheochromocytoma 5 P's
Pressure (paroxysmal hypertension)
Pain (headache)
Perspiration (profuse sweating)
Palpitations (tachycardia)
Pallor.
Diagnosis: elevated 24-hr urinary metanephrines and catecholamines.
Pain (headache)
Perspiration (profuse sweating)
Palpitations (tachycardia)
Pallor.
Diagnosis: elevated 24-hr urinary metanephrines and catecholamines.
22
Causes of Normal Anion Gap Metabolic Acidosis: HARDASS
H - Hyperalimentation (TPN)
A - Acetazolamide / Addison disease
R - Renal Tubular Acidosis (RTA Types 1, 2, 4)
D - Diarrhea
A - Aldosterone inhibitors (Spironolactone)
S - Saline infusion (hyperchloremic acidosis)
S - Solitary kidney / fistula.
A - Acetazolamide / Addison disease
R - Renal Tubular Acidosis (RTA Types 1, 2, 4)
D - Diarrhea
A - Aldosterone inhibitors (Spironolactone)
S - Saline infusion (hyperchloremic acidosis)
S - Solitary kidney / fistula.
23
Causes of High Anion Gap Metabolic Acidosis: MUDPILES
M - Methanol
U - Uremia
D - Diabetic ketoacidosis
P - Propylene glycol
I - Iron / Isoniazid
L - Lactic acidosis
E - Ethylene glycol
S - Salicylates (aspirin). Anion Gap .
U - Uremia
D - Diabetic ketoacidosis
P - Propylene glycol
I - Iron / Isoniazid
L - Lactic acidosis
E - Ethylene glycol
S - Salicylates (aspirin). Anion Gap .
24
Tumor Suppressor Genes: Rb and p53 Mechanisms
p53: 'Guardian of the genome'; activates p21 (inhibits CDKs) in response to DNA damage to arrest at G1/S, or triggers Bax (apoptosis). Rb: In hypophosphorylated state, binds and inhibits E2F transcription factor; phosphorylation by CDK4/6 releases E2F to allow S-phase entry.
25
Warfarin vs Heparin Mechanism & Monitoring
Warfarin: Inhibits Vitamin K epoxide reductase (VKOR), impairing synthesis of clotting factors II, VII, IX, X, Protein C & S; monitored with PT/INR; reversed with Vitamin K & FFP/PCC. Heparin: Potentiates antithrombin III, inactivating thrombin (IIa) and Xa; monitored with PTT; reversed with Protamine sulfate.
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