1.Antiphospholipid antibody syndrome is characterized by a prolonged PTT that is not corrected by mixing 1:1 with fresh-frozen plasma.
PTTは延長。FFP混ぜても改善しないのが抗リン脂質抗体症候群の特徴。
2.To adapt to high altitude, RBCs increase production of 2,3-bisphosphoglycerate, which shifts the oxygen-hemoglobin dissociation curve to the right and releases more oxygen to the tissues.
高山病について。登山で高度になれるため赤血球は2,3-BPG産生→酸素ヘモグロビン曲線は右へシフト。酸素をより組織に届ける。
3.Radiation therapy歴のある甲状腺疾患はpapillary thyroid carcinoma. psammoma bodies are commonly present
砂粒体！
4.AVNRTとAVRTがPSVTの90%
Atrioventricular nodal reentry tachycardia occurs secondary to a reentry circuit at the atrioventricular node and presents on ECG as a heart rate of >120 beats per minute and a narrow QRS complex, usually without P waves.
AVNRT(房室結節リエントリー性頻拍)は心拍120以上でP派消失、QRS幅狭い。
The baseline (nontachycardic) ECG will show a delta wave (slurred R upstroke), a wide QRS interval, and a short PR interval.
AVRT(房室リエントリー性頻拍)は心拍150-250。PR間隔短い。頻脈ではないときにΔ波。
5.Finasteride inhibits 5α-reductase to decrease the synthesis of DHT and can be used for the treatment of benign prostatic hyperplasia.
フィナステリドは5α還元酵素阻害剤
6.AIPはdeficiency of porphobilinogen deaminase→urine porphobilinogen増加
7.Lead poisonigはdeficiency of δ-aminolevulinic dehydratase→δ-aminolevulinic増加
8.bunyavirus (hantavirus, arenavirus, Crimean-Congo hemorrhagic fever)
Transmission of hantavirus occurs through contact with rodents.
ブ二ヤウイルスのハンタウイルスはねずみ(げっ歯類)
ダニ→ライム
コウモリ→狂犬病
蚊→マラリア
9.回旋枝梗塞→Infarction of the lateral wall would lead to ST-segment elevations in leads I, aVL, V5, and V6 on the ECG.
10.Endocardial cushion defects are congenital heart defects common in patients with Down syndrome.
心内膜症欠損症はDown症の合併症。
11.Hearing loss is prominent in children infected with CMV or rubella in utero.
難聴はサイトメガロと風疹の子宮内感染
12.Reversible competitive inhibitors increase the Km of the enzyme without affecting Vmax.
可逆的競合拮抗薬はKm上昇、Vmaxは変わらない。
MTXとか。
13.Hypertrophic cardiomyopathy causes asymmetric septal hypertrophy and sometimes leads to outflow obstruction, causing dyspnea, dizziness, or syncope.
拡張型心筋症は流出路狭窄。
Venous return上昇させ心室サイズを増大させるスクワットで心雑音低下させる。
ジゴキシンなどでは心室サイズが減少するため雑音は大きくなる。
14.Hypophosphatemia may be seen in primary hyperparathyroidism, malnutrition, or diabetic ketoacidosis
低リンは副甲状腺機能亢進症、栄養不良、DKAで見られる。
15.Advanced CKD commonly causes hypocalcemia due to low calcitriol and hyperphosphatemia.
低Ca・高PはCKDで見られる。
腎でcalcitriol(1,25 vitamin D)産生が減るため。→secondary hyperparathyroidism
16.N gonorrhoeae has antigenically variable pili that mediate its virulence in the human host.
淋菌。
Neisseria meningitidis has a polysaccharide capsule.
髄膜炎菌。
17.Replicative infectious forms describe the elementary and reticulate bodies of Chlamydia trachomatis, which is not visible on Gram stain.
クラミジア。Gram染色では見られない。
18.chronic watery diarrhea, hypokalemia (causing muscle weakness), increased gastric pH (achlorhydria), and pancreatic mass are consistent with a rare vasoactive intestinal polypeptide (VIP)-secreting neuroendocrine tumor called a VIPoma.
慢性下痢と低K、胃pH上昇→VIPoma
19.乳癌進展の機序。
Metalloproteinases allow degradation of the basement membrane, thus allowing progression from carcinoma in situ to invasive carcinoma.
20.Bcl-2 is an antiapoptotic factor that prevents cytochrome C from being released, thus preventing activation of caspases. Upregulation would increase this antiapoptotic factor, so downregulation might help prevent cancer.
Bcl-2(B cell Leukemia gene-2)はアポトーシス制御。Downregulationで抗腫瘍。
21.DVTの閉塞起点clotがある部位で上昇している物質はTxA2。血小板凝集と血管収縮作用あり。
22.誤嚥性肺炎の原因菌は嫌気性菌。
Peptostreptococcus and other anaerobic organisms are a common cause of aspiration pneumonia.
Obligate aerobes, such as Pseudomonas, are typically seen in hospitalized patients who often have an underlying risk factor such as immunocompromised status, recent antibiotic use, cystic fibrosis, or recurrent exacerbations of chronic obstructive pulmonary disease.
緑膿菌感染症は基本は入院中でリスクのある人などなど。
23.The Babinski sign (an upward-moving great toe with fanning of the other toes when the bottom of the foot is stroked) disappears after 12 months of age.
Babinski反射は1歳で消失。→立てるようになる。
・By the age of 4 months, an infant will be able to lift the head while prone.
・At around age 6 months, an infant can roll and sit but not crawl.
・A child around 20 months of age can feed himself or herself with fork and spoon.
・A child around 2 years of age can stack 6 cubes.
・A child of around 3 years of age can ride a tricycle.
なんとなくの月齢はわかりますが...
24.Sinus bradycardia can be normal in well-conditioned athletes and may be seen in elderly patients in the absence of heart disease. It can also be caused by drugs or SA node disease.
The heart rate is determined by the cyclic nucleotide-gated “funny” cation channels.
運動選手、高齢の方の徐脈の機序。
25.心膜炎を来たすウイルスの特徴は？
coxsackie B virus→picornavirus→the smallest of the RNA viruses.→single-stranded, naked, icosahedral RNA viruses.
26.Subacute thyroiditis亜急性甲状腺炎→Inflammatory infiltrate with multinucleated giant cells
27.Major risk factors for ectopic pregnancy include salpingitis (pelvic inflammatory disease).
卵管炎の既往が異所性妊娠のリスク。
28.Chloramphenicol binds to the bacterial 50S ribosomal subunit and inhibits peptidyl transferase.
抗菌薬使用後に汎血球減少→Chloramphenicol
29.Nonrenal water losses cause hypernatremia with urine osmolarity >300 mOsm/L and low urine sodium.
脱水で高Na血症。尿浸透圧は300以上で尿中Na低値。
Both central diabetes insipidus and nephrogenic diabetes insipidus would cause large volumes of dilute urine, not concentrated urine.
尿崩症は希釈尿。
Drug-induced elevation of serum vasopressin would cause hyponatremia, not hypernatremia.
薬剤誘発のバソプレッシンは低Na。
Hyperglycemic osmotic diuresis is associated with poorly controlled diabetes mellitus and would have an elevated serum glucose.
高血糖性の浸透圧利尿はDMコントロール不良による。
30.Müllerian agenesis is characterized by primary amenorrhea, absent or underdeveloped uterus, and a blind vaginal pouch.
Müllerian agenesis is caused by the absence of the paramesonephric (Müllerian) duct in utero.
原発性無月経、盲端→Müller管無発生
31.High frequency sounds travel through the auditory system and activate hair cells at the base of the cochlea. Low frequency sounds activate hair cells at the apex.
高音は蝸牛の底の有毛細胞活性
32. only calcitonin can lower serum Ca2+
カルシトニンはカルシウムイオン下げる。
33. Dopamine receptor antagonists, such as typical antipsychotic agents, can cause hyperprolactinemia by disinhibiting the tuberoinfundibular pathway, which manifests with amenorrhea and galactorrhea.
ドーパミン阻害でプロラクチン高値→無月経、乳汁漏出
34.バイアス
・Recall bias is when the knowledge of a disorder alters recall by subjects.
・Detection bias, certain observations are more likely to be detected by the researcher, which confounds the results.
・Measurement bias occurs when measurement or data-gathering methods differ between groups and is often due to poor methodology or training of personnel leading to variability in gathering data.
・In response bias, subjects may vary in how completely or accurately they respond to questions.
リコールバイアスは知識があることで過去の考えを変えるバイアス。
検出バイアスは特定の物事に注目してしまう。測定バイアスは測定時、データ収集時に起こる。
反応バイアス・想起バイアスは正確性、完全性の違いから生じるバイアス。
バイアスは面白いですね。厄介ですが。
35.Acnes vulgaris is a multifactorial disorder of the pilosebaceous unit associated with the growth of C acnes.
にきび。
36.Antibodies against GAS may cross-react with antigens in the host, a concept called molecular mimicry.
37.Familial hypercholesterolemia is an autosomal dominant disease that is due to an abnormality in apolipoprotein B-100 or LDL cholesterol receptors.
LDL高値はB-100。
・Deficiency of apolipoprotein C-II ：acute pancreatitis, hepatosplenomegaly, lipemia retinalis, eruptive xanthomas, and milky supernatant.
C−Ⅱは急性膵炎。
・Deficiency of apolipoprotein E：dysbetalipoproteinemia, which is characterized by premature atherosclerosis, tuberoeruptive xanthomas, and xanthoma striatum palmare.
・Lipoprotein lipase deficiency→TG高値.
・Mutations in apolipoprotein A-II→HDLに障害。LDLは関係なし！
38.AVNRT is an SVT that may cause rapid pulse, palpitations, and chest pain.
Esmolol is a very short-acting β1-selective antagonist that acts to slow down conduction.
エスモロールは作用時間が短い。
39.甲状腺腫瘍でRas遺伝子異常→Follicular thyroid cancer
甲状腺腫瘍で2番目に多い。bone and lung metastasesあり。
Medullary thyroid cancerはRET。
40.Ethanol intoxication is associated with a high serum osmolality.
NAD+ is converted to NADH during ethanol metabolism. The resulting increased NADH:NAD+ ratio in the liver leads to inhibition of gluconeogenesis and subsequent hypoglycemia.
41.aldosterone secretion by the zona glomerulosa of the adrenal gland
アルドステロンと球状層から分泌。
GFR；glomerulosa・fasciculata・reticularis
42.Amiodarone is used to treat ventricular arrhythmias and may cause thyroid disease because of its structural similarity to thyroxine.
アミオダロンはサイロキシンと構造が似ている！
Although procainamide and lidocaine could be considered as drugs to treat ventricular tachycardia, they do not cause thyroid abnormalities.
プロカインアミド、リドカインもVTの治療薬。
43.Maple syrup urine disease results in an increase of leucine levels due to deficiency of the branched-chain alpha-ketoacid dehydrogenase complex.
ロイシン上昇。
44.
・Transduction is a form of bacterial genetic transfer that can lead to antibiotic resistance. It involves DNA transfer from infection of a virion packaged with DNA (a so-called lytic phage) from another bacterial cell.
・Translocation (also known as transposition) describes the transfer of DNA from one part of a chromosome to a new position on the same chromosome or to a different chromosome, resulting in the rearrangement of the genes.
45.Bacterial conjugation refers to the direct transfer of DNA, via a bacterial pilus, from one bacterium to another.
抗菌薬感受性ありとなしの大腸菌を同じ環境に置くことで、全て耐性を持つ→この場合のgenetc exchangeをconjugatoin...という...
46.Adverse effects of furosemide include hypokalemia, volume depletion, metabolic alkalosis, hypocalcemia, and hyperuricemia.
フロセミドの副作用で低カルシウム、低マグネシウム、低カリウム。
47.Receptors for vitamin D are in the nucleus and use zinc finger proteins to bind the vitamin D to DNA and activate gene transcription.
ビタミンDの受容体は核内。zinc finger蛋白介在。
Angiotensin II, atrial natriuretic peptide, insulin, and vasopressin signal through cell-surface receptors.
Aldosterone binds its receptor in the cytosol, after which the receptor-hormone complex transits to the nucleus.
48.STI
・Neisseria gonorrhoeae (a gram-negative diplococcus)
・Treponema pallidum (a gram-negative spirochete)痛くない。
・Painless papules or ulcers are characteristic of Chlamydia trachomatis infection (an obligate intracellular bacterium).
痛くない。
・Chancroid is caused by Haemophilus ducreyi, a gram-negative coccobacillus.
49.People who work in shipyards, plumbers, and people who handle or install insulation are at increased risk for asbestosis.
アスベスト。造船、配管工がリスク。
50.
・Subepithelial electron dense deposits are seen in other forms of glomerular disease, such as membranous glomerulonephritis.
・Thickened basement membrane with nodular mesangial expansion is seen in diabetic nephropathy.
USMLEに興味がある方はまずこれから始めてみて下さい。
アマゾンでは2022年度版が予約できます。
