Review Topics Flashcards
Tay-Sachs disease is due to a deficiency of _________, leading to accumulation of __________
Hexosaminidase A; GM2 ganglioside
In the case of gas gangrene caused an organism that when cultured on blood agar shows a double zone of hemolysis, the causative organism is most likely ____________, which possesses ______ as a virulence factor responsible for erythema, necrosis, warmth, crepitus, and strong odor associated with the wound
Clostridium perfringens; alpha toxin
[MOA of alpha toxin is lysis of phospholipids]
What amino acid is essential in the diet of a patient with phenylketonuria?
Tyrosine
[treatment of PKU includes elimination of phenylalanine from the diet and supplementation of tyrosine because pts are no longer able to synthesize tyrosine]
A mutation in the DNA mismatch repair system leads to increased risk of __________
Colon cancer
[Hereditary nonpolyposis colorectal cancer (HNCC)]
Karyotype of a partial mole vs. complete mole
Partial mole = 69,XXY or 69, XXX
Complete mole = 46, XX or 46 XY
Vitamin that is an essential component of coenzyme A
Pantothenate (Vit B5)
______ = bacteriophage mediated transfer of genetic material between 2 prokaryotes
Transduction
Morphology of HPV
Non-enveloped double-stranded circular DNA virus
Increased intracranial pressure, dry skin, alopecia, sore throat, and hepatomegaly are symptoms of vitamin _____ excess
Vitamin A (retinol)
Vitamin B12 deficiency can cause a macrocytic anemia. Lab results show increased _____ and _____
Homocysteine; methylmalonyl coA
Actinomyces israelii causes extensive fibrosis and eventually a lumpy jaw with a wooden consistency during its chronic phase. Describe the growth of this organism during the chronic phase
Forms communicating sinus tracts that release sulfur granules
Teratogenic antiseizure drug that interferes with folate absorption in the GI tract leading to potential neural tube defects
Valproic acid
Oral medication for MRSA and its MOA
Linezolid
Binds 23s RNA and interacts with the bacterial initiation complex
MOA of mirtazapine
Alpha-2 antagonist
Acute colonic pseudo-obstruction with signs, symptoms, and radiographic appearance of a large bowel obstruction, but with no mechanical cause of obstruction; commonly seen in elderly males after major surgery
Ogilvie’s syndrome
[management = correction of underlying condition, anticholinesterases, and colonic decompression]
IV medication used to decrease intracranial pressure in the setting of diffuse intracerebral hemorrhage; works through inhibition of the sodium channels and water reabsorption at the proximal tubule as well as both parts of the loop of henle
IV mannitol
[pulls water via osmosis from tissues such as cerebral parenchyma into the blood and then into the urine where it can be eliminated, resulting in a decreased intracerebral pressure]
Erb-Duchenne palsy clinical features and etiology
Etiology = damage to C5 and C6 nerve roots
Clinical features = paralysis of abductors, lateral rotators, and biceps brachii —> arm is pronated and medially rotated
Mechanism of resistance to methicillin in MRSA
Methicillin resistance in S.aureus is encoded by the mecA gene, which encodes the enzyme PBP2a, an ALTERED PENICILLIN BINDING PROTEIN that has reduced affinity for beta-lactam antibiotics
A popliteal artery aneurysm may cause symptoms due to a mass effect on other structures that lie in the popliteal fossa, such as the popliteal vein and the tibial nerve. If the tibial nerve is damaged, what 2 motor and 2 sensory areas would be affected?
Plantar flexion
Foot inversion
Sensation along posterior calf and sole of the foot
4 classical clinical features of minimal change disease (most common cause of childhood nephrotic syndrome)
- Nephrotic range proteinuria (>50mg/kg/day or 4+)
- Hypoalbuminemia (<30g/L)
- Edema
- Hyperlipidemia
Biochemical process affected by G6PD deficiency
Fatty acid synthesis
MOA of bacillus anthracis toxin
Anthrax edema toxin is an adenylate cyclase that increases intracellular cAMP
Anthrax edema toxin is an adenylate cyclase that increases intracellular cAMP. What 2 other bacteria have a toxin that is most similar?
Bordetella pertussis
Vibrio cholerae
[MOA of their toxin is to activate adenylate cyclase]
MOA of toxin associated with Corynebacterium diphtheria and Pseudomonas aeruginosa
ADP-ribosylation of EF-2
MOA of toxin associated with C.botulinum
Inhibits release of ACh at synaptic vesicles
MOA of toxin associated with C.tetani
Inhibits release of GABA and glycine
What 2 bacteria have a toxin that inhibits protein synthesis by degrading ribosome subunit 60S?
Shigella dysenteriae
E.coli O157:H7
MOA of the 2 toxins associated with S.aureus
Alpha toxin forms holes in membrane
Beta toxin degrades sphingomyelin
________ is administered with chemotherapeutic agent Doxorubicin to prevent the worrisome side effect of _________
Dexrazoxane; cardiotoxicity
[can cause CHF, dilated cardiomyopathy, and death in dose-dependent manner]
In the setting of carcinoid syndrome, patients are at risk of what vitamin deficiency?
Vitamin B3 (niacin)
[this is because tryptophan (precursor to both niacin and serotonin) is shunted to serotonin synthesis, thus leading to a niacin deficiency]
Tapeworm that causes cysts in organs, especially the liver (hydatid disease)
Echinococcus granulosus
Dopamine agonists, such as __________ and ________, inhibit prolactin secretion and cause shrinkage of prolactin-producing adenomas
Cabergoline; bromocriptine
The presence of _______ and _______ in the urine are indicative of lead poisoning
Coproporphyrin; d-aminolevulinic acid
[this is because ingested lead interferes with heme synthesis by blocking both ferrochelatase and aminolevulinic acid dehydratase]
_______ is a MAO-B inhibitor utilized in parkinsons that slows the metabolism of levodopa, enhancing its effect, but can increase side effects caused by levodopa
Selegiline
Irinotecan has been used either as monotherapy or in conjunction with 5-FU with or without leucovorin for treatment of advanced colorectal cancer. What is the MOA of irinotecan?
Inhibition of topoisomerase I
A primary lesion in left temporal lobe would cause what pattern of visual loss?
Right upper quadrantic anopia
Gaucher’s disease is due to a deficiency of ____________, leading to an accumulation of __________. Pts can have hepatosplenomegaly, anemia, thrombocytopenia, osteopenia, and avascular necrosis. Gaucher’s cells are macrophages with lipid accumulation that give appearance of wrinkled paper
Beta-glucocerebrosidase; glucocerebroside
Krabbe’s disease is caused by a deficiency of ______, leading to elevated levels of ________. Pts present with peripheral neuropathy, atrophy of the optic nerve, and developmental delay
Galactocerebrosidase; galactocerebroside
The long thoracic n. innervates the serratus anterior m. and may be injured during a mastectomy. PE findings generally include “winging” of the scapula and difficulty with what action?
Abduction of the arm past 90 degrees
First line treatment for Giardia infection
Metronidazole
[can cause disulfuram reaction with alcohol; other drugs that do this include griseofulvin (antifungal), some of the cephalosporins, and sulfonylureas]
Side effect most commonly seen with medication used to treat mucormycosis (caused by Mucor, Rhizopus, or Absidia)
Nephrotoxicity
[caused by Amphotericin B; other adverse effects include infusion reaction (fever, chills, and myalgias)]
Pain and inability to rotate the shoulder medially indicate injury to what rotator cuff muscle?
Subscapularis
[subscapularis also does adduction]
Nephritic syndrome that presents as hematuria (gross or microscopic) discovered within 1-3 days of an upper respiratory or gastrointestinal infection
IgA nephropathy (aka Berger’s disease)
[Note: key difference with acute poststreptococcal glomerulonephritis (another nephritic syndrome associated with hematuria following a URI) is TIMING. While Berger’s disease has hematuria within 1-3 days of URI, acute PSGN has hematuria 1-3 weeks after URI. Acute PSGN also appears as “lumpy bumpy” on light microscopy with low C3 levels]
_______ is an autosomal recessive genetic disorder that leads to hexagonal-shaped crystals in the urine, often causing bilateral renal stones at an early age. Treatment includes ______, which alkalizes the urine, thereby preventing precipitation of these crystals
Cystinuria; acetazolamide
Most likely location for aspirated foreign bodies while pt is upright/seated vs. supine
Seated = posterobasal segment of right lower lobe
Supine = superior segment of right lower lobe
What cells release CCK?
I cells
____ cells release somatostatin hormone, responsible for decreasing gastric acid and pepsinogen secretion, pancreatic and small intestine fluid secretion, gallbladder contraction, and insulin and glucagon release
D
_____ cells are located in the antrum of the stomach and release gastrin, which is responsible for increasing ______ secretion, growth of gastric mucosa, and gastric motility
G; gastric H+
S cells are responsible for releasing ______ in response to increased levels of acid in the lumen of the duodenum; other functions include increasing bicarbonate and bile secretion, as well as decreasing gastric acid secretion
Secretin
How is renal reabsorption rate of a substance calculated?
Reabsorption rate = (Filtered Load) - (Excretion)
Filtered load = GFR x plasma concentration
Excretion = urine flow rate x urine concentration
What autonomic receptors are considered Gs-linked?
Beta 1 Beta 2 D1 H2 V2
[alpha 1, M1, and M3 are Gq-linked. D2 and M2 are Gi-linked]
What are 3 options for prophylactic treatment for mycobacterium infections?
Isoniazid
Azithromycin
Clarithromycin
_______ is used for moderate-to-severe persistent asthma in pts who react to perennial allergens wherein symptoms are not controlled by inhaled corticosteroids
Omalizumab
Most common helminthic infection worldwide; usually asymptomatic, but some patients present with pulmonary and GI complaints. Stool microscopy shows characteristic thick shelled parasitic eggs.
Ascaris lumbricoides
[nematode/roundworm]
Cold agglutinin disease is an autoimmune disease characterized by the presence of high concentrations of circulating _____ antibodies directed against RBCs. Patients will have low levels of circulating _____ due to consumption of that protein
IgM; C3b
[Note: IgG is associated with warm agglutinins]
______ poisoning inhibits the ETC in the mitochondria, inhibiting ATP production via oxidative phosphorylation. Exposure can lead to altered mental status, new onset seizures, hepatic failure, and rhabdomyolysis leading to renal failure. Early in the course, pts have flushed skin with tachycardia, tachypnea, and HTN. Later, pts may have cyanosis, bradycardia, bradypnea, and hypotension. Treatment involvees IV administration of either a mixture of sodium nitrite and sodium thiosulfate, or hydroxocobalamin
Cyanide
Parasitic infection with clinical manifestations including periorbital swelling, myalgia, and myositis involving facial and neck muscles, conjuntival hemorrhage, and splinter hemorrhages. Muscle biopsy will show encysted larvae.
Trichinella spiralis
Interferon-alfa combined with ribavirin and a NS3/4A protease inhibitor is occasionally used to treat chronic hepatitis C if other drugs are not available. What are the 3 major side effects of this treatment?
Flu-like symptoms
Neutropenia
Depression
Where is the right mainstem bronchus in relation to the right pulmonary artery?
Posterior
[mnemonic RALS to remember positions of pulmonary arteries in relation to their respective bronchi: Right pulmonary a. is Anterior, Left pulmonary a. is Superior]
How is renal potassium metabolism altered in the case of respiratory acidosis?
Potassium secretion in the distal tubules is decreased
[explanation: High concentrations of H+ in the ECF cause H+ to enter cells in exchange for K+. This reduces the intracellular K+ concentration, resulting in hyperkalemia. Secretion in the distal tubules is reduced by any factor that reduces the intracellular K+ concentration]
T/F: anabolic steroid use may lead to prostatic hyperplasia
True
[the prostate is a testosterone dependent gland and may increase in size due to steroid’s androgenic effects]
Four basic factors that cause a right-shift of oxygen-hemoglobin dissociation curve
Decrease in pH
Increase in 2,3-BPG
Increase in PCO2
Increase in temperature
Parkinsonian features, visual hallucinations, and waxing/waning mental status are characteristic of what type of dementia?
Lewy body dementia
Hematuria, mild proteinuria, fever, eosinophilia, nausea, vomiting, and rash are all features of __________________, which can occur within a few days of administration of an offending agent such as penicillin.
Acute interstitial nephritis
[Note: difference in acute tubular necrosis is that there are muddy brown casts in the urine and eosinophilia is not a feature]
______________ is a paraneoplastic syndrome characterized by development of antibodies to presynaptic voltage gated calcium channels, leading to decreased release of ACh at the NMJ. Pts present with symmetric muscle weakness, most prominently in the proximal muscles of the lower extremities. It is associated with __________ cancer, so a ________ should be included in the workup
Lambert-Eaton Syndrome; Small cell lung cancer; CXR
___________ media is the culture media of choice for growth of Neisseria gonorrhea.
It contains _____ to inhibit gram-positive bacterial growth, _______ to inhibit gram-negatives other than Neisseria, and ______ to inhibit fungal growth
Thayer-Martin
Vancomycin; Polymyxin; Nystatin
[Thayer-Martin = VPN media]
Vitamin B1 is essential for the synthesis of thiamine pyrophosphate (TPP), which is an active carrier of aldehydes and enzymes use it to transfer aldehydes to another molecule during the reaction. The enzyme ______ is involved in the hexose monophosphate shunt and uses TPP as its sole cofactor
Transketolase
During which phase of bacterial growth does spore formation begin — lag phase, log phase, stationary phase, or death phase?
Stationary phase
[Lag phase = metabolic activity w/o division; log phase = rapid cell division; death phase = period of prolonged nutrient depletion and buildup of metabolic waste products leading to death]
Breakdown products of disaccharides lactose, sucrose, and maltose
Lactose = Glucose + Galactose
Sucrose = Glucose + Fructose
Maltose = Glucose + Glucose
Head lice is typically treated with topical _______. However, resistance to topical medications has grown. When resistance occurs, systemic treatment may be initiated, and ______ is the best option
Permethrin; ivermectin
N.meningitidis is a gram-negative diplococci that has a _______ capsule and ferments ______ and ______
Polysaccharide; glucose; maltose
3 features of irreversible cell injury
Severe membrane damage
Calcium influx
Release of intracellular enzymes (i.e., lysosomal rupture)
3 treatment options for heparin-induced thrombocytopenia (HIT) upon discontinuation of heparin
Lepirudin
Argatroban
Fondaparinux
[Lepirudin and Argatroban are direct thrombin inhibitors, and Fondaparinux catalyzes the pt’s endogenous antithrombin to inhibit factor X (indirect factor X inhibitor)]
How do functional residual capacity (FRC), vital capacity, and total lung capacity (TLC) change in interstitial lung disease?
All decrease
Are acetyl-CoA carboxylase, arginase I, and PEP carboxykinase enzymes found in the mitochondria or the cytosol?
Cytosol
Are citrate synthase, carbamoyl phosphate synthetase I, and pyruvate carboxylase found in the mitochondria or the cytosol?
Mitochondria
When treating a patient with pheochromocytoma for hypertension, phenoxybenzamine may be used. What is the MOA?
Irreversible alpha adrenergic antagonist
Biliary complication associated with ulcerative colitis
Primary Sclerosing Cholangitis
[Causes inflammation, fibrosis, and stricturing of medium and large-sized ducts in the intrahepatic and extrahepatic biliary tree. Clinically presents with fatigue and pruritis. Histology shows fibrous obliteration of epithelium and CT replacement in an onion-skin pattern]
Tumor marker for pancreatic cancer
CA 19-9
Tumor marker for colon cancer
CEA
Nontender testicular mass, elevated serum placental alkaline phosphatase, sheets of relatively uniform tumor cells with prominent nucleoli and clear cytoplasm — What type of tumor?
Seminoma
Wilson disease can affect the kidneys leading to what complication and subsequent electrolyte abnormality?
Renal tubular acidosis type II
Results in hypokalemic, hyperchloremic nonanion gap metabolic acidosis
Diabetic cataracts are an end-organ consequence of uncontrolled DM. Glucose can enter cells via facilitated glucose transporters of GLUT family. Once in the cell it can be phosphorylated to glucose-6-phosphate by either glucokinase or hexokinase. Glucose-6-phosphate cannot leave the cell and can enter glycolysis. In the lens, nerve, and kidney cells glucose can also be converted to _________, a reaction accomplished by the enzyme _______ ______ using cofactor NADPH.
Sorbitol; aldose reductase
2 primary treatment options for bacterial vaginosis due to Gardnerella vaginalis infection
Metronidazole
Clindamycin
Acid-base disturbance caused by hyperventilation
Respiratory alkalosis
T/F: the membrane potential of the postsynaptic membrane does not change as a result of rocuronium for anesthesia induction
True — Rocuronium is a non-depolarizing muscle relaxant that acts as a competitive antagonist at the NMJ causing muscle paralysis without membrane depolarization
MOA of Metformin
Decreases hepatic glucose production by inhibition of liver gluconeogenesis
[can also decrease intestinal glucose absorption and increase insulin sensitivity]
Where is intrinsic factor produced?
Parietal cells within the gastric mucosa
CML is most commonly associated with a _______ translocation, usually resulting in the ______ fusion gene, which leads to constitutional activation of ________ _______ activity
t(9;22); BCR-ABL; Tyrosine kinase
Treatment agent of choice for CML
Imatinib (tyrosine kinase inhibitor)
[this is because BCR-ABL fusion gene leads to constitutive activity of a tyrosine kinase!!]
Self-limited hypothyroidism that is typically seen following a viral, flu-like illness. Initially presents as transient hyperthyroidism as well as tender, enlarged thyroid gland with referred jaw pain
de Quervain thyroiditis
Spinal cord somatosensory pathway that conveys light touch, vibration, and proprioception
Posterior column
Spinal cord somatosensory pathway that conveys pain, temperature, and crude touch
Spinothalamic tract
The de novo synthesis of pyrimidines relies on the enzymatic conversion of orotic acid to _______ ________
Uridine monophosphate
In ________ palsy, pts have paralysis of the ipsilateral hand and Horner’s syndrome on the ipsilateral face. This is due to damage to _____ and _____ nerve roots
Klumpke; C8, T1
Cori’s disease is an inherited glycogen storage disease caused by a deficiency of __________, an enzyme responsible for debranching of glycogen during glycogenolysis.
While not the most severe glycogen storage disease, pts still experience fasting hypoglycemia due to inability to use stored glycogen. As a result, gluconeogenesis is upregulated. The regulation of gluconeogenesis occurs at several key steps, but only ________ serves as an allosteric activator.
This allosteric activation occurs with the reaction catalyzed by pyruvate carboxylase, which converts pyruvate to OAA. This reaction also requires ______ as a source of energy, and _____ as a cofactor, but these are not allosteric regulators of the enzyme.
Alpha 1,6-glucosidase
Acetyl-CoA
ATP; Biotin
Croup may present on X ray with narrowing of the trachea d/t inflammation, called “steeple sign”. What is the most common cause of croup?
Parainfluenza virus
Which of the following is not found in the outpouching of tissue associated with a Zenker’s diverticulum?
A. Lamina propria B. Muscularis mucosa C. Muscularis propria D. Submucosa E. This is a true diverticulum and contains all of the above layers
C. Muscularis propria
[Zenker’s diverticulum is a pseudodiverticulum, so it does not contain all mucosal tissue layers. It has mucosal and submucosal tissue, but not the muscularis propria]
Mitochondrial disorder that causes painless progressive loss of central vision. Other clinical manifestations include dystonia, pseudobulbar palsy, intellectual deterioration, and muscle weakness. Many patients also have Wolff-Parkinson-White syndrome.
Leber hereditary optic neuropathy
[Caused by mtDNA mutations that encode subunits of ETC complex I. Biopsy shows loss of retinal ganglion cells and degeneration of papillomacular bundle]
Dobutamine may be used to enhance contractile ability of the heart in pts with CHF exacerbation. It exerts its effect primarily on _____ receptors, which are GPCRs of the ______ subtype.
Beta-1; Gs
__________ presents in infancy with symptoms of lethargy, vomiting, jaundice, hepatomegaly, and bilateral cataracts while taking breast milk
Galactosemia
[deficiency in galactose-1-phosphate uridyltransferase]
Disease and enzyme deficiency associated with the following clinical presentation:
11 year old girl of Ashkenazi Jewish descent presenting with hepatosplenomegaly, anemia, thrombocytopenia, osteopenia, and avascular necrosis
Gaucher’s diease
Deficiency of beta-glucocerebrosidase
[note: diagnostic histologic finding = lipid-filled macrophages with wrinkled-paper appearance]
What effect do competitive inhibitors have on Km and Vmax?
Km increases
Vmax stays the same
Which of the following inhibits microtubule depolymerization?
A. 6-mercaptopurine B. Vincristine C. Cyclophosphamide D. Cisplatin E. Paclitaxel
E. Paclitaxel
[note: vincristine inhibits microtubule POLYMERIZATION while paclitaxel inhibits microtubule DEPOLYMERIZATION]
The urea cycle is the pathway responsible for synthesis of what amino acid?
Arginine
Vertebral levels at which the celiac trunk, SMA, and gonadal artery arise from the abdominal aorta
Celiac trunk = T12
SMA = L1
Gonadal = L2
The inferior mesenteric artery arises from the abdominal aorta at vertebral level _______. The bifurcation of the aorta occurs at vertebral level ______.
L3; L4
Embryonic origin of prostate gland
Urogenital sinus
Brugada syndrome is a condition associated with a high risk of _____ _______ _____ in young adults
Sudden cardiac death
______ ______ presents on ECG as persistent ST elevations in leads V1-V3 with RBBB +/- terminal S waves in lateral leads (associated with typical RBBB); may also see prolongation of PR interval
Brugada syndrome
[Note: Pts with Brugada syndrome may present with normal ECGs, with abnormalities appearing when pt has a fever, takes a Na-channel blocker, takes a TCA, or uses cocaine. Adrenergic stimulating decreases the ST elevation, while vagal stimulation worsens it]
__________ testicular tumors present in early childhood and secrete alpha-fetoprotein, but not hCG. They have a number of morphologic variants, but ___________ are diagnostic for these tumors, resembling primitive glomeruli
Yolk sac; Schiller-Duvall
What is the only apolipoprotein associated with LDL, binding LDL receptor on the liver?
Apolipoprotein B-100
Most abundant amino acid in collagen
Glycine
_______ ______ occurs due to deficiency of acid maltase. Thus, glycogen accumulates in lysosomes and cytoplasm, leading to cardiomyopathy, hypotonia, and hepatomegaly. Pts may present in the first few months of life or later in adulthood. When presenting in infancy, children commonly have respiratory distress, difficulty with feeds, and cardiomegaly
Pompe’s disease
Nitroprusside is a potent arterio- and venodilator indicated when rapid reduction of blood pressure is desired, as in the case of malignant hypertension. However, nitroprusside is converted to ______ in the bloodstream, and thus has the potential to cause toxicity, particularly in the setting of prolonged exposure.
Cyanide
3 serious adverse reactions that need to be monitored for in patients taking methimazole (antithyroid medication)
Agranulocytosis
Aplastic anemia
Hepatotoxicity
Benztropine is an _______ medication that is used to decrease the resting tremor and rigidity associated with Parkinson’s disease. It does not have any impact on bradykinesia.
Anticholinergic
Most common site of renal stone obstruction in children
Ureteropelvic junction
Abciximab functions by inhibiting a platelet integrin called ___________.
This is the same molecule is defective in _______ _________ (disease)
GP IIb/IIIa
Glanzmann Thrombasthenia
How does emphysema affect compliance and FRC?
Both are increased
What is Conn Syndrome?
Primary aldosteronism caused by hyperaldosteronism originating in the adrenal gland
Characterized by HTN secondary to sodium retention, hypokalemia, and decreased renin secretion due to negative feedback of increased BP on renin secretion
Congenital condition affecting capillaries leading to port-wine stain, leptomeningeal angioma, seizures, glaucoma, and mental retardation
Sturge-Weber syndrome
The ganglionic destruction in achalasia begins with irreversible of the esophageal myenteric neruons, ultimately leading to fibrosis and scarring of Auerbach’s plexus. In particular, the neurons destroyed are important in secretion of ______ ______, thus secretion of this substance is decreased in achalasia
Nitric oxide
Which class of anti-asthma drugs exhibits hepatotoxicity?
Antileukotrienes (e.g., Zileuton)
A lesion in the ______ ______ will lead to a right or left upper quadrantic anopia
Temporal lobe
Anticoagulant treatment for atrial fibrillation that does not require monitoring through routine blood draws
Dabigatran (direct thrombin inhibitor)
Inheritance of Marfan syndrome
Autosomal dominant
Is the IVC intraperitoneal or retroperitoneal?
Retroperitoneal
Is the pancreas intraperitoneal or retroperitoneal?
The head, neck, and body are retroperitoneal
The tail is intraperitoneal (located in splenorenal ligament)
Of the 4-drug regimen used to treat mycobacterium tuberculosis infection, _________ frequently produces visual problems due to retrobulbar neuritis, including laack of acuity and color blindness. The mechanism of action of this medication is to inhibit _______ _______, interfering with the mycobacterial cell wall
Ethambutol; arabinosyl transferase
3 types of antibody associated with antiphospholipid antibody syndrome
Lupus anticoagulant
Anti-cardiolipin
Anti-beta2-glycoprotein
Lesions within the ______ ______ cause contralateral hemiballismus
Subthalamic nucleus
MOA of heparin
Potentiates pt’s endogenous antithrombin
[thus inactivating thrombin and factor Xa]
What causes impaired vision in the case of giant cell arteritis?
Occlusion of the ophthalmic artery
Triad associated with Plummer Vinson syndrome
Esophageal webs
Glossitis
Iron deficiency anemia
Pyruvate kinase is responsible for conversion of phosphoenolpyruvate to pyruvate, a reaction that produces 2 ATP molecules. Without functioning enzymes (e.g., Pyruvate Kinase Deficiency), phosphoenolpyruvate builds up and is shunted to an alternative pathway, generating ________________ which results in increased tendency for hemoglobin to release oxygen
2,3-bisphosphoglycerate (2,3-BPG)
________ is a chemotherapeutic that may cause myelosuppression due to inhibition of thymidylate synthase. The rescue for this myelosuppression is _______
5-FU; thymidine
The head of the pancreas is supplied by the __________ artery, which is a primary branch of the _______ ______ artery
Pancreaticoduodenal; superior mesenteric
Nerve roots associated with radial nerve
C5, C6, C7, C8, T1
Apolipoprotein B-48 is found in ______ and helps facilitate their secretion
Chylomicrons
Hydralazine may increase the risk of drug-induced lupus, which presents with myalgias, arthralgias, and red scaly rash. What genetic abnormality may predispose pts to drug-induced lupus with lipid soluble drugs?
Polymorphisms in the genes for phase II reactions of lipid-soluble drugs — like glucuronidation, sulfurization, or acetylation
Hereditary or acquired defect in the PCT that occurs almost exclusively in caucasian males which results in losses of glucose, sodium, phosphate, protein, and other solutes in the urine
Fanconi syndrome
What complication of hyperparathyroidism is characterized by “brown tumors” that form in bone leading to increased risk of fracture; the lesions are cysts filled with blood, fibrous tissue, and osteoclasts
Osteitis fibrosa cystica
The ______ ______ contains the primary motor cortex and so damage to this region would cause major motor deficits such as hemiparesis
Precentral gyrus
Side effect most likely to limit patient’s ability to tolerate a fibrate for hyperlipidemia
Myalgia
[Fibrates activate PPARs and can cause muscle damage, especially when combined with statins]
The scleroderma variant associated with CREST syndrome has a positive ____________ antibody
Anti-centromere
Depletion of ________ is responsible for the reduction of glycolysis in the setting of lactate dehydrogenase deficiency
NAD+
[if skeletal muscle lacks lactate dehydrogenase, NADH can not be oxidized to NAD+ and the cori cycle cannot provide the glucose input. Thus ATP production via anaerobic fermentation is reduced, ATP production drops, and muscle activity decreases]
Yellow fever virus is a type of _________ found in the saliva of the Aedes aeqypti mosquito typically found in South America and sub-Saharan Africa. These viruses are enveloped, single-stranded, positive-sense, linear RNA viruses.
Flavivirus
______ is a recognized tumor-suppressor gene and has been shown to be down-regulated in extranodal NK/T cell lymphoma. When expressed, it inhibits cell growth through activation of apoptosis as well as arrest of the cell cycle. When it is down-regulated, there is decreased apoptosis of the malignant cells
FOXO3
Acute severe lead intoxication can be treated by _______ or CaNa2EDTA
Dimercaprol
Drug of choice for absence seizures
Ethosuximide
[blocks T-type Ca++ channels in the thalamus]
Major side effects of the chemotherapeutic _________ include myelosuppression, GI upset, and hepatotoxicity. Allopurinol inhibits xanthine oxidase, the enzyme that metabolizes this drug, so concurrent allopurinol therapy increases the risk of side effects.
6-mercaptopurine
________ _______ can mimic acute coronary syndrome, including ST elevation in precordial leads (V1-V4) and ballooning of the heart’s apex and midventricular hypokinesis on echocardiography, and often follows a severe physical or psychosocial stressor
Takotsubo cardiomyopathy
_______, _______, and _______ all stimulate parietal cells within the stomach to produce acid to decrease the stomach’s pH
Histamine, Acetylcholine, and Gastrin
What organelle are the CYP450 enzymes found in?
Smooth ER
Most patients with anticholinergic toxicity can be treated with supportive care only until the effects of the drug wear off; however, ________ is indicated when one of the following is present: (1) tachydysrrhythmias with hemodynamic compromise, (2) intractable seizures, or (3) severe agitation or psychosis
Physostigmine
What organ is affected most in mercury exposure?
Kidneys
[Mercury exposure can cause membranous glomerulonephritis, leading to NEPHROTIC syndrome]
Heme, which is synthesized from porphyrin, is dependent upon sufficient quantities of amino acid _______ for its synthesis. Deficiency would result in a non-iron deficiency anemia
Glycine
To avoid chronic lactic acidosis in pyruvate dehydrogenase complex deficiency, a diet rich in what 2 amino acids is recommended?
Lysine
Leucine
[these are the 2 purely ketogenic amino acids]
______________ artery aneurysms can lead to visual disturbances due to compression of the optic nerve
Anterior communicating artery
The inability to rotate the shoulder medially indicates injury to what rotator cuff muscle?
Subscapularis
[Infraspinatus does lateral rotation, Teres minor adducts and laterally rotates, supraspinatus helps deltoid abduct]
What type of heart murmur would you expect in a pt with longstanding ankylosing spondylitis?
Aortic regurgitation (soft, high-pitched early diastolic murmur)
Autosomal recessive enzyme deficiency in which diagnosis is established by identifying lab abnormalities, including anion gap metabolic acidosis, hypoketotic hypoglycemia, and the presence of dicarboxylic acids in the urine
Acyl-CoA dehydrogenase deficiency
4 most common primary tumor sites that metastasize to the lungs
Colon
Breast
Prostate
Bladder
Typical antipsychotics primarily block the _____ receptor. Atypical antipsychotics offer a more favorable side effect profile than typical antipsychotics due to additional antagonism at the _____ receptor
D2; 5-HT2
Blood supply to the proximal 1/3, middle, and distal 1/3 of the ureter
Proximal 1/3 = Renal a.
Middle = Small branches from common iliac a.
Distal 1/3 = Superior vesical a.
In a patient with a history of transplant over 100 days ago, typical findings of _____________ include erythema, hyper/hypopigmentation, induration, atrophy, and skin thickening. Patients also complain of ocular involvement, including aqueous tear deficiency, cataracts, conjunctival hyperemia, and corneal epithelial staining. Hair and nail dystrophy can also occur. The liver is affected in about half of patients, most commonly manifesting as liver function test abnormalities
Chronic graft-versus-host disease
The most commonly used prophylactic agent in the prevention of chronic graft-vs-host disease is _________. This is a potent immunosuppressive that can lead to severe renal insufficiency and hyperbilirubinemia. In patients with significant side effects, ________ can be given as a rescue regimen
Methotrexate; leucovorin
[leucovorin is a reduced form of folic acid]
_________ are tumors that are most commonly found within the cerebellum, arising from the vasculature. Patients may present with symptoms of cerebellar ataxia (i.e., wide based gait). Most are sporadic, but they can be seen in association with __________ syndrome, in which case there may be multiple throughout the CNS. Surgical resection is warranted because bleeding from these tumors can be fatal
Hemangioblastomas; VHL
Treatment for Tourette’s syndrome
Atypical and typical neuroleptics, like haloperidol
_______ _______ _______ is characterized by repetitive seizures consisting of brief, often symmetric, muscular contractions with loss of body tone causing the patient to fall or slump forward. Seizures usually occur in the morning and are precipitated by stress and sleep deprivation. ________ ______ is often used to treat these seizures
Juvenile myoclonic epilepsy; Valproic acid
What characteristic of HCV leads to its high genetic heterogeneity?
HCV lacks RNA polymerase proofreading exonuclease
When used in the treatment of HIV, maraviroc antagonizes the ______ receptor on white blood cells, preventing its interaction with the ______ protein of HIV.
CCR5; gp120
________ ________ is due to a deficiency in galactocerebrosidase, leading to accumulation of galactocerebroside. Clinical features include peripheral neuropathy, optic atrophy, and developmental delay in infancy. ______ cells can be seen in the white matter of the CNS; these cells are macrophages clustered near blood vessels that have numerous nuclei and enlarged cytoplasm
Krabbe’s disease; Globoid
[Krabbe’s disease = Globoid cell leukodystrophy]
Chronic carriers of HBV infection have increased chances of malignant transformation to hepatocellular carcinoma. This develops independently of the progression to cirrhosis, so what is the mechanism of carcinogenesis?
HBV viral incorporation into the hepatocellular genome, leading to genomic instability
Parasitic roundworm found in tropical climates (such as Southeast Asia) that can present with vague GI complaints as well as pulmonary and dermatologic problems. With chronic infection, dermal migration of larvae becomes apparent as serpiginous eruptions in the skin
Strongyloides stercoralis
Inheritance of Hemophilia A and B
X-linked recessive
Local anesthetics include the ester family (benzocaine, cocaine, procaine, and tetracaine) and the amide family (bupivacaine, lidocaine, mepivacaine, prilocaine).
The local anesthetics in the _______ family are more allergenic because they are metabolized by the plasma pseudocholinesterases while _______ drugs are metabolized by the CYP450 system
Ester; amide
Symptoms of chronic infection with ________ _________ (parasitic infection) are typically isolated to the heart and GI systems. In the heart, the disease can cause arrhythmias and 3rd degree BBB. Symptoms include syncope, lightheadedness, and palpitations. It can also cause CHF and stroke. In the GI tract, it typically causes achalasia and megacolon.
Trypanosoma cruzi (Chagas disease)
Etiology of Rocky Mountain Spotted Fever and how this organism causes the rash
Rickettsia rickettsii
R.rickettsii is an obligate intracellular organism that causes rash by invading vascular endothelial cells, resulting in increased vascular permeability, hypovolemia, and hypotension
_______ cells have Reinke crystalloids (hexagonal prisms by EM) and produce testosterone in response to LH.
________ cells have Charcot-Bottcher crystalloids (bundles of microfilament) and form the blood-testis barrier
Leydig
Sertoli
________ are a class of drugs that increase insulin release from beta cells of the pancreas. Hypoglycemia is a prominent side effect due to possibility of overstimulation of insulin release
Sulfonylureas
Amantadine was originally developed to treat ________, but recently has been used to treat Parkinson’s disease
Influenza
Proteus mirabilis is a gram-negative bacterium that produces urease, which alkalinizes the urine. This can lead to what complication specific to UTI caused by this organism?
Alkalinization causes precipitation of magnesium ammonium phosphate crystals, which can lead to formation of struvite kidney stones
Broca’s aphasia is typically due to a lesion located where?
Dominant frontal lobe, affecting the inferior frontal gyrus
Ito cells are lipid-containing stellate cells in the liver which store ________ in the quiescent state and secrete _______ in the activated state
Vitamin A; collagen
Patients with ____________ typically have circulating antinuclear and anti-smooth muscle antibodies, jaundice, hepatosplenomegaly, and elevated transaminases
Autoimmune hepatitis
_______ _____ tumors lead to blockage of the aqueduct, leading to damage to CN III, CN IV, and Edinger-Westphal nucleus. As a result, pts have impaired pupillary response to light but intact accommodation. Mass effect on the superior colliculi can lead to impaired conjugate vertical gaze as well as deviation of the eyes downward. This is also known as _______ syndrome
Pineal gland; Parinaud’s
The abducens nerve begins at the junction of the pons and medulla. From there, it moves anteriorly through the skull, going through the ________________ with the oculomotor nerve, trochlear nerve, opthalmic and maxillary branches of the trigeminal nerves, and the internal carotid artery. It then passes through the ____________ before innervating the lateral rectus m.
Cavernous sinus; superior orbital fissure
By what mechanism do beta blockers reduce blood pressure?
Beta blockers inhibit release of renin from renal JG cells through antagonism of beta-1 receptors on these cells
Niacin can be obtained through dietary intake or synthesized endogenously from _______
Tryptophan
Cystic fibrosis is most commonly due to a 3-base pair deletion in the CFTR gene at amino acid position F508. How does this mutation affect CFTR?
This mutation IMPAIRS POST-TRANSLATIONAL PROCESSING of CFTR, resulting in shunting of CFTR toward the proteasome, with complete absence of the protein on the cell surface
Meningeal signs, confusion, and trophozoites in the CSF raise strong suspicion for primary amebic meningoencephalitis, which is caused by ______ ______, a free-living, motile protozoan parasite that lives in warm water and soil worldwide. Exposure primarily occurs when humans inadvertently inhale the organism during recreational water activities. Most individuals do not become ill, but a minority develop fatal meningoencephalitis after the organism penetrates the olfactory mucosa, crosses the cribriform plate, and invades the olfactory bulb
Naegleria fowleri
For the embryologic development of the kidney, the _____ _____ ultimately gives rise to the collecting system - including the collecting tubules and ducts, major and minor calyces, renal pelvis, and the ureters. The ______ ______ gives rise to the glomeruli, Bowman’s space, proximal tubules, loop of henle, and distal convoluted tubules
Ureteric bud; metanephric mesoderm (blastema)
Heme synthesis occurs partly in the _________ and partly in the cytoplasm of erythrocytes
Mitochondria
Excess ________ secretion due to a pancreatic islet cell tumor can result in watery diarrhea, hypokalemia, and achlorhydria (WDHA syndrome aka pancreatic cholera)
VIP
[this is a VIPoma]
A positive tuberculin skin test is characterized by significant skin induration around the injection site at 48 hours. What 2 immune effector cells are most important for control of the tuberculosis?
CD4 T cells
Macrophages
T/F: failed gallbladder visualization on radionuclide biliary scan is specific to acute cholecystitis
True — acute cholecystitis is most often caused by gallstones obstructing the cystic duct. In acute or chronic cholecystitis, the radiotracer will be taken up by the liver with progressive excretion into the common bile duct and proximal small bowel, but the gallbladder will NOT be visualized due to the obstruction
Viruses with segmented genomes are capable of genetic shifts through reassortment. What 4 viral classes have segmented genomes?
Bunyavirus
Orthomyxovirus
Arenavirus
Reovirus
________ is a potent immunosuppressive agent that works via inhibition of calcineurin activation, resulting in decreased IL-2 production; often used in transplant pts. Serum levels should be monitored closely, and patients should be routinely checked for _____ toxicity
Cyclosporin; renal
AR or X-linked disorder affecting several genes that alter a multi-protein complex required for DNA repair; Typically presents in early childhood with signs of pancytopenia in addition to congenital malformations. Short stature, cafe-au-lait spots or hypopigmentation, dysplastic thumbs, microcephaly, and hypogonadism may be seen
Fanconi anemia
Malignant ovarian tumors with “fried egg” appearance, normal serum AFP, but beta-hCG and LDH are commonly elevated; frequently seen on streak gonads, which can occur in Turner’s syndrome
Dysgerminomas
_________ is a zoonotic illness that is transmitted directly to humans through contact with infected animals (like veteranarians or farmers) or via ingestion of unpasteurized milk or cheese products. Symptoms include persistent, undulating fever and joint pain
Brucellosis
_______ is a chemotherapeutic primarily used in NHL, breast, and ovarian cancers that carries the risk of hemorrhagic cystitis due to irritation of the bladder by its metabolite acrolein. MOA is alkylation of nitrogenous bases in nucleic acids.
A few medications have been used with efficacy for preventing this damage, and each of these bind to acrolein. The most frequently used is _______, because it does not decrease the efficacy of the chemotherapeutic. Other agents used include N-acetylcysteine, amifostine, and pentosan polysulfate
Cyclophosphamide
Mesna (2-mercaptoethanesulfonate sodium)
A pt presenting with hypertension, hematuria, proteinuria, and edema likely has a _________ syndrome. One potential cause is ____________, an immune-complex mediated disease that occurs 2-4 weeks after exposure to group A beta hemolytic streptococcus.
Nephritic
PSGN
The most highly oxygenated blood in the fetus is carried by the ___________, which flows directly into the __________ via the ___________
Umbilical vein; IVC; ductus venosus
The strain phase of valsalva, abrupt standing, and nitroglycerin administration will _________ the intensity of the murmur associated with hypertrophic cardiomyopathy.
Sustained hand grip, squatting, and passive leg raise will ________ the intensity of the murmur associated with hypertrophic cardiomyopathy
Increase
Decrease
Most common cause of viral gastroenteritis
Norovirus
Neurophysins are carrier proteins for _______ and _________. Thus, point mutations in neurophysin II underlie most cases of hereditary hypothalamic __________ __________
Oxytocin; ADH; diabetes insipidus
Sitagliptin, an oral antidiabetic agent, functions by inhibiting the enzyme ______, which is responsible for the inactivation of incretins. This results in increased active incretin levels, leading to increased secretion of insulin and decreased secretion of glucagon
Dipeptidyl peptidase IV (DDP-IV)
______ is an inhaled anesthetic associated with mild hepatotoxicity and more fulminant hepatitis
Halothane
Cyanide is an inhibitor of what enzyme affecting oxidative phosphorylation?
Cyanide is an inhibitor of cytochrome c oxidase (part of 4th complex of ETC)
It increases venous O2 saturation by preventing the body from using O2
A deficiency in vitamin C would most affect the synthesis of which of the following neurotransmitters?
A. ACh B. Dopamine C. Glutamate D. Histamine E. Norepinephrine
E. Norepinephrine
[Vitamin C is required for the conversion of dopamine to NE by the enzyme dopamine-beta-hydroxylase]
Autosomal recessive disorder that affects the metabolism of methionine; manifests clinically with mental retardation, osteoporosis, tall stature, kyphosis, and atherosclerosis leading to stroke and MI at a young age
Homocysteinuria
Diffuse esophageal spasm can cause retrosternal chest pain that is typically precipitated by cold or hot food; the pain can be intermittent and is not situation-dependent. It can show ______ pattern on barium swallow (but barium swallow can also be negative). This can ultimately lead to functional obstruction due to increased esophageal wall stress.
What is first line treatment for diffuse esophageal spasm?
Corkscrew
First line is CCBs like nifedipine, which act on L-type calcium channels of both cardiac and smooth muscle
Transthyretin is a protein responsible for transporting vitamin A and thyroxine. Transthyretin ______ is an autosomal dominant condition, and an important subtype affects the heart, causing a restrictive cardiomyopathy
Amyloidosis
Adenocarcinoma of the lung (NSCLC) is associated with mutation on the _____gene
K-ras
Metachromatic leukodystrophy is due to a deficiency of __________, leading to accumulation of __________, which causes demyelination. Patients present with cognitive impairment, ataxia, and optic atrophy
Arylsulfatase A; cerebroside sulfate
In essential fructosuria, _______ is able to phosphorylate fructose to fructose-6-phosphate, shunting it to glycolysis
Hexokinase
Long-term uncontrolled diabetes can lead to diabetic hyporeninism, which causes RTA type ____, which presents with hyperkalemia.
RTA type IV
[Other causes of RTA type IV include ACE inhibitors, ARBs, NSAIDs, and adrenal insufficiency. RTA types I and II present with hypokalemia. Causes of RTA type I include analgesic nephropathy and amphotericin toxicity in severe fungal infections. Causes of RTA type II include Fanconi syndrome and Acetazolamide]
An intention tremor in the right arm indicates a lesion in which of the following?
A. Cerebellar vermis B. Left cerebellar hemisphere C. Left subthalamic nucleus D. Right cerebellar hemisphere E. Right subthalamic nucleus
D. Right cerebellar hemisphere
[Lesions in cerebellar hemispheres can cause ataxia and intention tremors in ipsilateral limbs. Pts with lesions in the subthalamic nuclei present with contralateral hemiballismus]
WAGR syndrome is due to a chromosomal deletion of the WT1 gene. What are the clinical features?
Wilms tumor
Aniridia
Genitourinary abnormalities
Mental retardation
Most effective class of medications to lower triglycerides
Fibrates
______ ______ = description of anomalies including pulmonary hypoplasia, clubbed feet, and cranial abnormalities due to oligohydramnios
Potter sequence
[classically due to bilateral renal agenesis; other causes include polycystic kidney disease, hydronephrosis, and any other cause of ureter obstruction]
Most common cardiac defect seen in DiGeorge syndrome patients
Tetralogy of Fallot
Disease characterized by rheumatoid nodules surrounded by pigmented cells in the lungs. It is specifically seen in rheumatoid arthritis patients who also have one of the pneumoconiosis
Caplan’s syndrome
Beck’s triad of cardiac tamponade
- Jugular venous distention
- Hypotension (with pulsus paradoxus)
- Diminished heart sounds
Ehlers-Danlos syndrome is a group of CT disorders involving a defect in _____ synthesis
Collagen
Small intestinal bacterial overgrowth (SIBO) is characterized by overproduction of _______ and _______, associated with nausea, bloating, abdominal discomfort, and malabsorption
Vitamin K; Folate
Light microscopy revealing several small, ovoid bodies within a macrophage raise strong suspicion for ______ ________, a dimorphic fungus transmitted by inhalation. Patients with impaired immunity (e.g., advanced AIDS) are at risk for dissemination through the ___________ system; common manifestations include hepatosplenomegaly, lymphadenopathy, pancytopenia, and ulcerated lesions on the tongue
Histoplasma capsulatum; reticuloendothelial
Microtubule-associated, ATP-powered motor protein that facilitates the anterograde transport of neurotransmitter-containing secretory vesicles down axons to synaptic terminals
Kinesin
Which one causes transcriptional repression: acetylation of histones or deacetylation of histones?
Deacetylation of histones
[This is the mechanism behind Huntington disease — abnormal huntingtin gene causes increased histone deacetylation, silencing the genes necessary for neuron survival]
Pulmonary artery catheters are used to diagnose pulmonary HTN and occasionally for management of critically ill pts. The pressure measured at the catheter tip is called the pulmonary artery occlusion pressure (aka pulmonary capillary wedge pressure), and closely reflects the end-diastolic pressure in what heart chamber(s)?
Left atrium
Left ventricle
What triad of changes are seen on ECG with Wolff-Parkinson-White syndrome?
Shortened PR interval (<0.12s)
Early upslope of QRS (delta wave)
Widened QRS complex
Treatment of choice for CMV
IV Ganciclovir
[Works by competitively inhibiting incorporation of dGTP by viral DNA polymerase. Other options to tx CMV include oral valganciclovir, IV foscarnet, or IV cidofovir]
2 most common causes of pulsus paradoxus without pericardial effusion
Asthma
COPD
Farmer’s lung is a hypersensitivity pneumonitis caused by inhalation of thermophylic Actinomyces found in the dust from moldy hay. Initial treatment involves giving _______ to decrease the inflammatory response. Afterwards, avoiding exposure to offending agent and wearing a mask when exposure is possible
Corticosteroids
_______ _______ are calcifications found in several benign or malignant tumors including papillary thyroid carcinoma, serous cystadenocarcinoma of the ovary, meningioma, and mesothelioma
Psammoma bodies
Nerve roots associated with long thoracic n.
C5-7
What is the most common enzyme deficiency associated with congenital adrenal hyperplasia, manifesting with hyponatremia, hyperkalemia, hypotension, and ambiguous external genitalia?
21-beta-hydroxylase deficiency
What ligament prevents posterior translation of the tibia relative to the femur, and when ruptured the tibia rests in a more posterior position than usual?
Posterior cruciate ligament
Which of the following is the treatment for carcinoid syndrome?
A. Hydroxyurea B. Leuprolide C. Octreotide D. Phentolamine E. Somatropin
C. Octreotide
________ herniations result in ptosis, mydriasis, lateral strabismus, and contralateral hemiparesis of the extremities
Uncal
Brown-Sequard syndrome results from a hemisection of the spinal cord. It is characterized by _________ spastic paralysis below the lesion, ________ loss of touch and vibration sensations below the lesion, and _________ loss of pain and temperature sensation below the lesion.
[ipsilateral/contralateral/bilateral]
Ipsilateral; ipsilateral; contralateral
Henoch-Schonlein purpura, a _____ (small/medium/large) vasculitis that occurs in children. It is a type _____ hypersensitivity characterized by ___________ on vessel walls
Small; III; IgA immune complexes
CLL is associated with _______ about 10% of the time, which is an anemia characterized by an elevated reticulocyte count, a reduced haptoglobin level, and a positive Coombs test, as well as the presence of ______ on peripheral smear
Autoimmune hemolytic anemia (AIHA); spherocytes
[Note: the differential diagnosis for spherocytosis includes hereditary spherocytosis and autoimmune hemolytic anemia]
New-onset seizures in adults justify MRI to exclude the possibility of an intracranial neoplasm. __________ are most commonly located in the frontal lobes, and examination will reveal the presence of rounded cells with perinuclear halos giving them “fried egg” appearance. They also have the presence of finely branching capillaries, which looks like “chicken wire”
Oligodendrogliomas
