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Medicine (MD/DO)
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First Aid
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First Aid for the USMLE Step 1 (2023)
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Page 248 -

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First Aid for the USMLE Step 1 (2023) | Medicine (MD/DO) School Study Aid

Page 248 -
29 Picmonics to Learn | 56 mins
Addison's Disease
Mechanism
Chronic 1° Adrenal Insufficiency
Atrophy
Destruction
Symptoms
Deficiency In Cortisol And Aldosterone
Skin Hyperpigmentation
Increased POMC
Hypotension
Hyperkalemia
Acidosis
Addisonian Crisis
Diagnosis
ACTH (Cosyntropin) Stimulation Test
Treatment
Exogenous Cortisol
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2 mins
Addisonian Crisis
Assessment
Severe Symptoms
Shock
Interventions
High-Dose Hydrocortisone
Large Volumes of IV Fluid
Insulin with Dextrose
Kayexalate
Loop or Thiazide Diuretics
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2 mins
Diabetes Insipidus Assessment
Polyuria
Nocturia
Low Specific Gravity (USG)
Polydipsia
Dehydration
Hypotension
Tachycardia
Confusion
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2 mins
Tamoxifen
Mechanism of Action
Selective Estrogen Receptor Modulator (SERM)
Antagonist on Breast Tissue
Indications
ER-positive Breast Cancer
Side Effects
Decreased Risk of Osteoporosis
Increased Risk of Endometrial Cancer
Increased Risk of Venous Thromboembolism (VTE)
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1 min
Tacrolimus (Prograf) Side Effects
Nephrotoxicity
Neurotoxicity
GI Distress
Infection
Hypertension
Hyperkalemia
Hyperglycemia
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1 min
Antipsychotics Overview
Generations
Typical
Atypical
Mechanism
Blocks D2 Receptor
2nd Generation Blocks the 5-HT 2 Receptor
Indications
Psychosis
Delirium
Bipolar Disorder
Tourette’s Syndrome
Side Effects
Hyperprolactinemia
Extrapyramidal Symptoms
Tardive Dyskinesia
Neuroleptic Malignant Syndrome
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4 mins
Haloperidol (Haldol)
Mechanism
High Potency Antipsychotic
Indications
Migraine
Schizophrenia
Side Effects
Extrapyramidal Symptoms
Weight Gain
QT Prolongation
Restlessness
Considerations
Caution in Seizure Patients
Neuroleptic Malignant Syndrome
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2 mins
Atypical Antipsychotics
Indications
Schizophrenia
Mechanism of Action
Unknown Mechanism
Side Effects
Seizures
Prolonged QT Interval
Agranulocytosis
Weight Gain
Fewer Extrapyramidal Side Effects
Fewer Anticholinergic Side Effects
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2 mins
Risperidone (Risperdal)
Mechanism
Atypical Antipsychotic
Indications
Schizophrenia
Bipolar Mania
Autism-Associated Irritability
Side Effects
Extrapyramidal Symptoms
Hyperprolactinemia
Gynecomastia
Galactorrhea
Amenorrhea
Prolonged QT
Considerations
Intramuscular Long Acting (Depot) Form
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2 mins
Metoclopramide
Indications
Antiemetic
Promotility Agent
Mechanism
Increased Resting Tone
Antagonist at D2 Receptor
Side Effects
Parkinsonian Symptoms
Galactorrhea
Contraindication
Small Bowel Obstruction
Parkinson's Disease
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2 mins
Hyperthyroidism Assessment
Assessment
Heat Intolerance
Exophthalmos
Warm, Moist Skin and Silky Hair
Tremors
Goiter
Diarrhea
Weight Loss
Tachycardia
Hypertension
Amenorrhea
Diagnosis
Decreased TSH with Elevated Free T4
Radioactive Iodine Uptake (RAIU)
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2 mins
Amiodarone
Mechanisms
Class III Antiarrhythmic (K+ Channel Blocker)
Decreases SA and AV Node Conduction
Inhibits Cytochrome P450
Indications
Supraventricular Tachycardia with Heart Failure
Ventricular Tachycardia
Side Effects
Hepatotoxicity
Pulmonary Fibrosis
Bradycardia
Heart Block
Thyroid Disorders
Blue/Gray Skin Deposits
Corneal Deposits
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3 mins
Lithium
Indications
Bipolar Disorder
Mechanism of Action
Mood Stabilizer
Unknown Mechanism
Side Effects
Nephrogenic Diabetes Insipidus
Hypothyroidism
Movement (Tremor)
Heart Block
Contraindication
Pregnancy (Ebstein's Anomaly)
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1 min
Hypothyroidism Assessment
Assessment
Weight Gain - Edema
Lethargy
Cold Intolerance
Bradycardia
Hypertension
Brittle Nails and Dry Skin
Constipation
Goiter
Prolonged Menses
Slowed Thinking
Diagnostic Tests
Decreased Free T4
Increased TSH
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2 mins
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Pathophysiology
Hypersecretion of ADH
Increased Sensitivity to ADH
Signs & Symptoms
Serum Hypoosmolality
Coma and Seizure
Dilutional Hyponatremia
Cramps and Tremors
Euvolemia
Change in LOC
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2 mins
Jaundice
General
Due To Elevated Conjugated Or Unconjugated Bilirubin
Unconjugated
Hemolysis
Crigler-Najjar Or Gilbert's Syndrome
Physiologic Jaundice Of Newborn
Conjugated
Biliary Obstruction From Stone Or Mass
Cholangitis
Dubin-Johnson And Rotor Syndrome
Mixed
Cirrhosis
Hepatitis
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5 mins
Macrolides Side Effects
Side Effects
Diarrhea
Prolonged QT Interval
P450 Inhibitor
Cholestatic Hepatitis
Skin Rash
Eosinophilia
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3 mins
Valproic Acid (Valproate) Side Effects
V-A-L-P-R-O-A-T-E
Vomiting
Alopecia
Liver Toxicity
Pancreatitis/Pancytopenia
Retain Fat (Weight Gain)
Oedema (Edema)
Appetite Increase
Tremor
Enzyme Inhibitor (P450)
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2 mins
Hepatitis B Virus Disease
Can turn chronic
< 10% of adults become chronic carriers
90% of newborns become chronic carriers
Cirrhosis
Hepatocellular carcinoma
Membranous Glomerulonephritis
Polyarteritis nodosa
Serum sickness like syndrome
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2 mins
Rifampin
Tuberculosis (TB)
Blocks RNA Polymerization
Haemophilus influenzae Type B
Leprosy
Meningitis
P450 inducer
Red-orange urine
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55 secs
Isoniazid
Indications
Tuberculosis (TB)
Mechanism of Action
Requires Catalase Peroxidase
Decreases Mycolic Acid Synthesis
Fast vs Slow Acetylators
Side Effects
B6 Deficiency
Neurotoxicity
Hepatotoxicity
Drug-induced Lupus
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1 min
Acute Pancreatitis Causes
"GET SMASHHED" Mnemonic
Gallstones
(Ethanol) Alcohol
Trauma
Steroids
Mumps
Autoimmune
Scorpion Sting
Hypercalcemia
Hypertriglyceridemia > 1000
ERCP
Drugs
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1 min
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Tetracycline Toxicities
Inhibition of Bone Growth in Children
Teratogen
Discoloration of Teeth
Photosensitivity
GI Distress
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2 mins
Ampicillin and Amoxicillin
Mechanism
Aminopenicillin
Broad Spectrum Penicillin
Indications
Gram-Positive and Some Gram-Negative Infections
Side Effects
Rash
Diarrhea
Considerations
No Effect Against Staph Aureus
Often combined with Beta Lactamase Inhibitor
Allergic Reaction
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2 mins
Cephalosporins Overview
Mechanism of Action
Beta lactam drug
Inhibits cell wall synthesis
Bactericidal
Side Effects
Hypersensitivity reactions
Vitamin K Deficiency
Disulfiram like reaction with Alcohol
Increased Nephrotoxicity of Aminoglycosides
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1 min
Clindamycin
Mechanism of Action
Bacteriostatic
Binds 50S Ribosomal Subunit
Blocks Translocation
Indications
Anaerobic Infections above the Diaphragm
Aspiration Pneumonia
Lung Abscess
Side Effects
Can Cause Pseudomembranous Colitis
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1 min
Fluoroquinolones Toxicities
Diarrhea
Skin Rash
Headache
Tendon Rupture in Adults
Myalgias in Kids
Damage to Cartilage
Teratogen
QT Prolongation
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1 min
Beers Criteria
Use
Elderly
Avoiding Harmful Polypharmacy
Drug Classes
Anticholinergics
Benzodiazepines
Proton Pump Inhibitors (PPIs)
Antihistamines
Antidepressants
NSAIDs
Antispasmodics
Opioids
Alpha Blockers
Antiparkinson Agents
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2 mins

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