Step 1 First Aid Rapid Review With Complete Solution 2023/2024

Thalidomide as a teratogen {Ans: Limb defects (flipper limbs)}Blink reflex {Ans: V1 sensory (long and short ciliary nerve), Facial nerve closes the orbicularis oculi}Nicotine/CO as a teratogen {Ans: Low birth weight, preterm labor, placental problems, IUGR, and ADHD Nicotine is vasoconstriction, CO impairs O2 delivery}Optochin response {Ans: Sensitive: S. pneumoniae; resistant: viridans streptococci (S. mutans, S. sanguis)}PCP vs. LSD {Ans: PCP: nystagmus, dissociation, violence LSD: visual hallucinations, tachycardia}Primary bone tumor (adults) {Ans: Multiple myeloma Calcium Renal failure Anemia Bone lesion Bence Jones bodies in urine from IgG light chains, rouleaux formation, lytic bone lesions, M spike (IgG or IgA) Differential: HTLV lymphoma with rash}Chronic atrophic gastritis (autoimmune) {Ans: Predisposition to gastric carcinoma (can also cause pernicious anemia)}Specificity {Ans: Specificity = TN / (TN + FP)}Right heart failure due to a pulmonary cause {Ans: Cor pulmonale}Increased uric acid levels {Ans: Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics}Heart valve in bacterial endocarditis {Ans: Mitral Regurgitation that can become mitral stenosis and fusion of commissures > Aortic (rheumatic fever) Tricuspid (IV drug abuse)}Phenytoin as a teratogen {Ans: Fetal Hydantoin syndrome: cleft palate, cardiac defects, nail/finger hypoplasia Neural tube