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1

disseminated Histoplasmosis

HSM (with calcifications) and tongue lesions (often)
Lung nodules similar to TB

2

complement fixation, immunodiffusion

serological tests to measure Abs

3

young (otherwise healthy)
fatigue, progressive dyspnea, atypical chest pain, unexplained syncope.
leads to hypertrophy and/or dilation of right ventricle (cor pulmonale)
Look for thickened RV

PAH

4

Birth defect study: women who had a baby with a birth defect are more likely to remember exposures than mothers who had a normal baby

Recall Bias

5

Peyronie disease

excess collagen formation within tunica albuginea = pain and hook dick

6

JAK2 Inhibitor approved for tx of primary myelofibrosis

Ruxolitinib

7

Drugs that cause hypersensitivity myocarditis

diuretics (furosemide, HCTZ) and antibiotics (ampicillin, azithromycin)

8

Alcohol fixed neutrophils...

think ANCA

9

CD16 and CD56+
Do not require thymus for maturation and are present in athymic patients
Activated by INF-gamma and IL-12

NK cells

10

SMA and IMA anastomosis

marginal artery (of Drummond)> mesenteric meandering artery (arc of Riolan)

11

Vinyl chloride, arsenic or thorotrast exposure

hepatic angiosarcoma

12

Results from failure of vitelline (or omphalomesenteric duct) to obliterate. Toddlers may have GI bleeding due to ectopic gastric mucosa

meckel diverticulum

13

Well tolerated antirheumatic drug used in RA and SLE. ADR= irreversible retinopathy. Patients must have regular eye exams!

Hydroxychloroquine

14

Tetracycline antibiotic with weak antirheumatic activity. ADR: photosensitivity

Minocycline

15

Medical therapy Conn's Syndrome

Aldosterone antagonist such as spironolactone or eplerenone

16

SAH vasospasm

Autoregulation impairred. Do a Transcranial color doppler to see

17

Most feared comp. of SAH

rebleed

18

Proteasomes

degrade nuclear and cytoplasmic proteins

19

Lysosomes

degrade cellular organelles and Extracellular proteins

20

RNA interference (base pairing with complementary strands)

Posttranscriptional gene siliencing
Translation repressed (imperfect)
mRNA cleavage (perfect)
miRNA (mutations can cause cancers) and Si RNA (c-MYC therapy)

21

Normal epithelium to early adenoma

APC mutation

22

Early Adenoma-->Late (increase in size)

K-Ras Mutation (proto-onco) - uncontrolled cell proliferation

23

Malignant transformation of adenoma in carcinoma

mutation of two genes required: DCC and p53 (anti-oncogene mutation)

24

BRCA (anti-oncogene)

supresses cell cycle

25

WT-1 (tumor suppressor/anti-onco)

Wilms tumor

26

N-myc oncogene

Increased number of copies of gene (amplification) Neuroblastoma

27

Colon cancer (diet that leads too)

high in cholesterol and carbs
low in fiber

28

Protects fatty acids from oxidation

Vit. E

29

Corneal softening

keratomalacia

30

Abdominal pain diarrhea and nausea = acute
Chronic= calcium oxalate kidney stones

Vit. C overuse

31

Acetylation (slow) of INH can have have toxic effects ---reduce dose

also actylate
Dapson, Hydralazine and procainamide

32

Azathiprine and 6-MP biotransformation

methylation (fast and slow)

33

Note:

Patients who take opioids on the reg...develop tolerance to respiratory depression very quickly
Tolerance also developed to itching and N/V and i guess drowsiness

34

When is aortic regurg heard best?

After closure of aortic valve (A2) along the left sternal boarder at the third and fourth intercostal spaces while the patient is sitting up and leaning forward with the breath held in end expiration

35

Left shift in oxy-Hb curve

Lower P50 (partial pressure of O2 in blood at which Hb is 50% saturated)...Higher affinity saturates to 50% quicker thus lower P50
think left shift = lower P50

36

Very severe anemia, strenous workout would shift

curve to right

37

DRESS SYNDROME DRUGS: fever, GAD, facial edema and diffuse morbilliform skin rash--> confluent erythema with follicular accentuation
Labs: eosinophillia, atypical lymphocytes and elevated ALT

phenytoin and carbamazepine
allopurinol
Sulfonamides (sulfasalazine)
Minocycline and vancomycin

38

Essential for GBM diagnosis

Necrosis

Common is prominent microvascular proliferation

39

Neuritic process called a neuropil

Pathognomonic for neuroblastoma

40

MYCN (N-MYC)

Chromosome 2 neuroblastoma

NSE, chromogranin, synaptophysin and S-100 positive
Elevated VMA and/or HVA

41

Pulsion

pathogenesis of false diverticula (increased pressure)

ex: in colon (strained bowel movements due to chronic constipation