USMLE Step 1

USMLE Step 1 QUESTION of the DAY!

A 48 year-old smoker complains of a “new cough.” During her history, she also notes that she has a lost 36 pounds in the last 2 years. A chest x-ray is obtained and shows a central mass. Her labs show that she also has hypercalcemia. What is most likely responsible for her hypercalcemia?

A) Small cell carcinoma
B) Parathyroid Hormone
C) Adenocarcinoma
D) PTH-like peptide
E) ACTH

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Answer: D) PTH-like peptide. This case presents squamous cell carcinoma. There is an increased risk for smokers. It is also secretes PTH-like peptide (not PTH itself) which causes hypercalcemia. Don’t be surprised to see this trick question on your boards.



USMLE Step 1 D.O.C. of the DAY!

Drug of choice for

Candida causing vaginal candidiasis

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Miconazole



FACT of the DAY!

The Larynx
Muscles: ‘P’osterior cricoarytenoid= o’p’ens glottis
‘L’ateral cricoarytenoid= c’l’oses glottis
Thyroarytenoid= relaxes vocal cords
Cricothyroid= tightens vocal cords, innervated by sup. Laryngeal nerve
All 3 “arytenoids” are innervated by the recurrent laryngeal nerve
Sensory innervation:
‘Above’ glottis- ‘superior’ laryngeal nerve
Below glottis- Recurrent laryngeal nerve