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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 249 -

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

Page 249 -
33 Picmonics to Learn | 1 hr 2 mins
Clozapine (Clozaril)
Mechanism
Atypical Antipsychotic
Indications
Schizophrenia
Levodopa-Induced Psychosis
Side Effects
Weight Gain
Hypersalivation (Sialorrhea)
Myocarditis
Agranulocytosis
Sedation
Orthostatic Hypotension
Constipation (Risk of Bowel Ileus)
Considerations
Weekly Lab Tests
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2 mins
Carbamazepine
Indications
First-line Seizure Medication
First Line for Trigeminal Neuralgia
Mechanism of Action
Stabilizes Inactive State of Na+ Channels
Side Effects
Stevens-Johnson Syndrome
Induce Cytochrome P450
Teratogen
Hepatotoxicity
Blood Dyscrasias
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2 mins
Propylthiouracil (PTU) and Methimazole (MMI)
Indications
Hyperthyroidism
Mechanism
Inhibits Thyroid Peroxidase
PTU Blocks Peripheral Conversion of T4 to T3
Side Effects
Agranulocytosis
Skin Rash
Hepatotoxicity (PTU)
Teratogen (MMI)
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1 min
Ticlopidine (Ticlid)
Mechanism
ADP Receptor Antagonist
Irreversibly Inhibits Platelet Aggregation
Indications
Thrombotic Event Prevention
Side Effects
Neutropenia
Thrombotic Thrombocytopenic Purpura (TTP)
GI Distress
Rash
Considerations
Withhold Before Surgery
Monitor Blood Count
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2 mins
Ganciclovir
Indications
Cytomegalovirus (CMV)
Immunocompromised
Mechanism
Guanosine Analog
Disrupts DNA Synthesis
Inhibits Viral DNA Polymerase
Side Effects
Hematologic Effects
Nephrotoxicity
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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
Chloramphenicol
Mechanism
Bacteriostatic
Inhibits 50S Peptidyltransferase Activity
Indications
Meningitis
Rocky Mountain Spotted Fever in Pregnant Women
Side Effects
Anemia
Aplastic Anemia
Gray Baby Syndrome due to Decreased UDP-Glucuronyl Transferase
Resistance Caused by Plasmid Encoded Acetyltransferase
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2 mins
Normocytic Hemolytic Anemia Causes
Intrinsic Hemolytic
Hereditary Spherocytosis
RBC Enzyme Deficiency
Hemoglobin C Defect
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Sickle Cell Anemia
Extrinsic Hemolytic
Autoimmune
Microangiopathic
Mechanical Destruction
Prosthetic Cardiac Valves
Infection
Snake Venom
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2 mins
Penicillin
Gram Positive
Spirochetes
Bind PBPs
Block Transpeptidase Cross-linking of Cell Wall
Activate Autolytic Enzymes
Bactericidal
Hypersensitivity Reactions
Hemolytic Anemia
Beta-lactamase Sensitive
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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
Phenytoin
Indications
Status Epilepticus
Tonic-Clonic Seizures
Mechanism of Action
Blocks Na+ Channel Activation
Inhibition of Glutamate Release
Class IB Antiarrhythmic
Side Effects
Teratogenic
Macrocytic Megaloblastic Anemia
Induce Cytochrome P450
Drug-induced Lupus
Neuropathy
Hirsutism
Gingival Hyperplasia
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1 min
Vancomycin Side Effects & Toxicity
Side Effects
Thrombophlebitis
Nephrotoxicity
Ototoxicity
Diffuse Flushing Called Red Man Syndrome
Prevent with Antihistamine
Prevent with Slow Infusion
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2 mins
G6PD Deficiency
X-linked Recessive
Hemolytic Anemia
Inflammatory Response
Fava Beans
Sulfonamides
Primaquine
Anti TB Drugs
Heinz Bodies
Bite Cells
Prevalent Among African Americans due to Increased Malarial Resistance
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2 mins
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
Sulfonamides Side Effects
Side Effects
Hypersensitivity
Nephrotoxicity
Photosensitivity
Kernicterus in Infants
Displaces Warfarin from Albumin
Considerations
Hemolysis with G6PD Deficiency
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3 mins
Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
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2 mins
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
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2 mins
Hydroxyurea
Mechanism
Inhibits Ribonucleotide Reductase
Decreased DNA Synthesis
S-phase Specific
Indications
Melanoma
Chronic Myelogenous Leukemia (CML)
Sickle Cell Disease
Through Increased HbF (Fetal Hemoglobin)
Side Effects
Myelosuppression
GI Distress
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2 mins
Heparin Induced Thrombocytopenia (HIT)
Pathophysiology
5-10 Days After Heparin Exposure
Heparin-Platelet Factor 4 Complex
Autoantibodies Form Against Complex
Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
Platelet Aggregation
Procoagulant Release
Symptoms
Thrombocytopenia
Diagnosis
Serotonin Release Assay (SRA)
Treatment
Stop Heparin, Start Direct Thrombin Inhibitor
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2 mins
Systemic Lupus Erythematosus (SLE) Mechanism, Treatment and Complications
Mechanism and Characteristics
Systemic Autoimmune Disease
9:1 female to male ratio
Treatment
Glucocorticoids
NSAIDS
Hydroxychloroquine
Cyclophosphamide
Complications
Lupus nephritis
Libman-Sacks Endocarditis
Secondary Antiphospholipid Antibody Syndrome
Other
Drug-induced lupus
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2 mins
Protease Inhibitors
End in "-navir"
Indications
HIV/AIDS
Hepatitis C
Mechanism
Inhibit Protease
Unable to Cleave Proteins
Inhibits Maturation of New Virus
Side Effects
GI Distress
Nephropathy
Lipodystrophy
Hyperglycemia
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3 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins
Cyclosporine (Sandimmune) Overview
Mechanism
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Prevent Transplant Rejection
Psoriasis
Rheumatoid Arthritis
Considerations
Monitor Plasma Levels
Avoid Grapefruit Juice
Increased Risk of Lymphoma
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2 mins
Cyclosporine (Sandimmune) Side Effects
Side Effects
Nephrotoxicity
Hepatotoxicity
Infection
Hypertension
Hirsutism
Tremor
Hyperkalemia
Hypomagnesemia
Gingival Hyperplasia
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1 min
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Arrhythmias
Essential Hypertension
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
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2 mins
Gout Disease
Acute Inflammatory Monoarthritis
Epidemiology
Primarily in Males
Pathophysiology
Precipitation of Monosodium Urate Crystals
Underexcretion of Uric Acid
Overproduction of Uric Acid
Negatively Birefringent, Needle-Shaped
Symptoms
Swollen, Red, Painful Joint
Asymmetric Joint Distribution
Podagra
Tophus
After Large Meal or Alcohol
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2 mins
Loop Diuretics
Mechanism of Action
Thick Ascending Limb of Loop of Henle
Inhibits Na+-K+-2Cl- Symporter
Sulfa Drug
Drug Names
Furosemide
Lasix
Side Effects
Gout
Ototoxicity
Hypocalcemia
Hypokalemia
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4 mins
Statins
Rhabdomyolysis
Hepatotoxicity
HMG-CoA reductase inhibitors
Decrease LDL
Decrease Triglycerides
Increase HDL
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2 mins
Osteoporosis Assessment
Highest Risk
Postmenopausal Women
Long Term Corticosteroids
Assessment
Kyphosis
Dowager's Hump
Loss of Height
Back Pain
Pathologic Fractures
Spinal Compression Fracture
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1 min
Stevens-Johnson Syndrome
Etiologies
Drugs
Symptoms
< 10% of Body Surface Area (BSA) Involved
10-30% BSA Overlaps with Toxic Epidermal Necrolysis (TEN)
Fever
Affects Skin and Mucous Membranes
Bullae Formation
Necrosis
Sloughing of Skin
High Mortality Rate
Treatment
Supportive Care
IVIG (Intravenous Immunoglobulin)
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3 mins
Lamotrigine
Indications
Seizure Treatment
Bipolar Disorder
Mechanism of Action
Blocks Voltage-Gated Na+ Channels
Side Effect
Stevens-Johnson Syndrome
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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
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

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