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First Aid for the USMLE Step 1 (2021)
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First Aid for the USMLE Step 1 (2021) | Physician Assistant (PA) School Study Aid

Page 229 -
16 Picmonics to Learn | 39 mins
Polymyositis / Dermatomyositis Disease
Pathophysiology
Idiopathic Inflammatory Myopathy
More Common in Women
Endomysial Inflammation with CD8+ Cells (Polymyositis)
Perimysial Inflammation with CD4+ Cells (Dermatomyositis)
Signs and Symptoms (Both)
Symmetric Proximal Muscle Weakness
Dysphagia
Lung and Cardiac Involvement
Signs and Symptoms (Dermatomyositis)
Malar Rash
Shawl-like Shoulder Rash
Gottron Papules on Knuckles
Heliotrope Rash
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3 mins
Acanthosis Nigricans
Associations
Endocrine Disorders
Diabetes Mellitus
Obesity
Malignancy
Presentation
Velvety Plaques
Dark, Thickened Flexural Areas
Diagnosis
Hyperkeratosis with Melanocytes
Treatment
Treat Underlying Disorder
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2 mins
Stomach Cancer
Adenocarcinoma
Intestinal Type
Intestinal Type
Smoked Foods Containing Nitrosamines
Achlorhydria
Type A Blood
Helicobacter pylori
Diffuse Type
Diffuse Type
Signet Ring Cells
Linitis Plastica (Leather Bottle Stomach)
Assessment
Acanthosis Nigricans
Left Supraclavicular Lymph Node
Virchow's Node
Subcutaneous Periumbilical Mets
Sister Mary Joseph's Nodule
Complications
Bilateral mets to ovaries
Krukenberg's tumor
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3 mins
Adenocarcinoma of the Lung
Characteristics
Most Common Lung Cancer
Most Common in Nonsmokers
Peripheral Location
KRAS, EGFR, and ALK Mutations
Diagnosis
Glandular Pattern
Often Stains with Mucin
Clinical Features
Presents with Hemoptysis
Clubbing
Treatment
Surgical Resection
Chemotherapy and Radiation
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2 mins
Hypercalcemia
Assessment
> 10.5 mg/dL Ca2+
Pathologic Fractures
Lethargy
Hypercoagulation
Constipation
ECG Changes
QT Shortening
Interventions
No Calcium Intake
Chelating Drugs
Calcitonin
Bisphosphonates
Loop Diuretics instead of Thiazide Diuretics
Considerations
Increased Risk for Renal Calculi
Increase Fluids
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3 mins
Hypercalcemia Causes
Two CHIMPANZEES Acronym
Thyroid Disorders
Calcium Supplements
Hyperparathyroidism
Iatrogenic (Drugs, immobility)
Milk-Alkali Syndrome
Paget's Disease of Bone
Acromegaly or Addison's Disease
Neoplasms
Zollinger-Ellison Syndrome
Excessive Vitamin A
Excessive Vitamin D
Sarcoidosis
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2 mins
Cushing's Syndrome Characteristics
More Common in Women
Exogenous Etiologies
Glucocorticoids
Endogenous Etiologies
Decreased ACTH
Primary Adrenal Disease
Increased ACTH
Pituitary Adenoma (Cushing's Disease)
Paraneoplastic: Small Cell Carcinoma
CRF-releasing Tumors
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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
Polycythemia Vera Disease
Pathophysiology
JAK2 Mutation leading to increased red blood cells
Tyrosine Kinase
Symptoms
Erythromelalgia
Pruritus
Often After Hot Shower
Headache
Treatment
Phlebotomy
Aspirin
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1 min
Pancreatic Adenocarcinoma Symptoms and Risk Factors
Common Signs and Symptoms
Abdominal Pain
Anorexia and Weight Loss
Migratory Superficial Thrombophlebitis
New-Onset Diabetes
Signs/Symptoms Specific to Tumors in the Pancreatic Head
Jaundice
Steatorrhea
White Stool
Palpable but Non-tender Gall Bladder
Risk Factors
Elderly
Chronic Pancreatitis
Smoking
Alcoholism
Diabetes
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5 mins
Teratoma
Germ-cell Tumor
Dermoid Cyst (Benign and Mature Teratoma)
Immature Teratoma (Malignant)
Struma Ovarii
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2 mins
Neuroblastoma Characteristics and Presentation
Characteristics
Malignant Neuroendocrine Tumor
Neural Crest Cells Origin
Sympathetic Ganglia
Adrenal Glands
Amplification of N-myc Oncogene
Most Common Cancer In Infancy
Clinical Presentation
Abdominal Mass That Can Cross Midline
Gastrointestinal Distress
Metastasis
Raccoon Eyes
Opsoclonus-Myoclonus Syndrome
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4 mins
Neuroblastoma Diagnosis and Management
Diagnosis
24-hour Urine Test
Increased Catecholamines
Increased Homovanillic and Vanillylmandelic Acid
Ultrasound
Magnetic Resonance Imaging (MRI)
Biopsy
Pathology
Small Round Blue Cells
Homer-Wright Rosettes
Bombesin Positive
Neuron Specific Enolase Positive
Interventions
Local Excision
Chemotherapy
Radiation
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3 mins
Small Cell (Oat Cell) Carcinoma
Characteristics
Aggressively Malignant
Strong Correlation with Smoking
Central Location
Amplification of Myc Oncogenes
Signs and Symptoms
Narrowing of Bronchial Airways
Cushing's Syndrome
Ectopic ACTH
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Lambert-Eaton Syndrome
Diagnosis
Kulchitsky Cells
Neuron-Specific Enolase Positive
Chromogranin A Positive
Treatment
Chemotherapy and Radiation
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3 mins
Lambert-Eaton Syndrome
Mechanism
Autoantibody to the Presynaptic Calcium Channel on Motor Neurons
Inhibits Acetylcholine (ACh) Release at Neuromuscular Junction
Paraneoplastic Syndrome
Small Cell Lung Cancer
Symptoms
Proximal Muscle Weakness
Improves with Muscle Use
Autonomic Symptoms
Extraocular Muscle Sparing
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2 mins
Myasthenia Gravis
Mechanism
Antibodies to Acetylcholine Receptor
Symptoms
Ptosis
Diplopia
Weakness with Muscle Use
Respiratory Death
Thymus Associated
Treatment
Acetylcholinesterase Inhibitors
Plasmapheresis
Thymectomy
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1 min

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