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Associations 5 Flashcards

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1
Q

Cause basophilic stippling

A

Lead poisoining
Thalassemia
Alcohol use

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2
Q

Anemia + neurological symptoms

A 
Lead poisoning (microcytic)
B12 deficiency (macrocytic)
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3
Q

Sickle cell + aplastic anemia crisis

A

Parvovirus B19

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4
Q

Pancytopenia with hypocellularity and fatty infiltrates on BM biopsy

A

Aplastic anemia

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5
Q

Thalassemia more prevalent in which races

A

Alpha - African and Asian

Beta - Mediterannean

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6
Q

“Hair on end” skull x-ray

A

BM hyperplasia in sickle cell disease

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7
Q

Salmonella osteomyelitis

A

Assoc w/ sickle cell disease

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8
Q

Encapsulated organisms

A 
Strep pneumo
H. influenzae
N. meningitidis
Klebsiella
Salmonella
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9
Q

Complication of 10% sideroblastic anemia

A

Acute leukemia

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10
Q

Causes of eosinophilia

A 
DNAAACP
Drugs
Neoplasms
Allergies/asthma (Churg Strauss)
AIN
Adrenal insufficiency (Addisons)
CVD
Parasites
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11
Q

Type I hypersensitivity rxn

A

IgE / mast cell degranulation
Hives, pruritis, allergic rhinitis
Asthma, bronchospasm, angioedema
Anaphylaxis

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12
Q

Type II hypersensitivity rxn

A 
Cell-mediated / Complement cascade / IgM and IgG react w/ cellular antigens
Drug-induced or immune hemolytic anemia
Hemolytic disease of the newborn
Graves
Myasthenia gravis
ITP
Acute rheumatic fever
Goodpasture's
Bullous pemphigoid
Pemphigous vulgaris
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13
Q

Type III hypersensitiviy rxn

A

Immune complexes deposit in tissue and activate complement/ IgM and IgG bind soluble antigens
Arthus rxn
(serum sickness)
Glomerulonephritis

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14
Q

Type IV hypersensitivity rxn

A

Delayed / T-cell mediated
Transplant rejection
Contact dermatitis
PPD

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15
Q

von Willebrand disease

A

AD
vWF and sometimes factor VIII deficiency
+PTT and +BT (NORMAL platelet number)

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16
Q

Hemophilia

A

X-linked recessive
Factor VIII (A) or IX (B) deficiency
+PTT, normal PT/BT/platelet number

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17
Q

+Fibrin split products, +D-dimer

A

DIC

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18
Q

Common causes DIC

A 
STOP Making Thrombi
Sepsis
Trauma (including surgery)
Ob complications
Pancreatitis
Malignancy
Transfusions
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19
Q

MC inherited hypercoagulability disorder

A

Factor V Leiden mutation (40-50%)

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20
Q

SIRS criteria

A

2/4 for diagnosis
Temp >38.3 or 90
RR >20 or PaCO2 12K or 10% bands

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21
Q

Sepsis

A

SIRS = 2/4 criteria
Sepsis = SIRS + infection
Septic shock = Sepsis + hypotension

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22
Q

MCC malaria

A

Plasmodium falciparum

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23
Q

Common areas for malaria

A

Sub-Saharan Africa
SW/SE Asia (India)
Tropical S. America

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24
Q

India ink stain

A

Stain of CSF = cryptococcal meningitis

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25
HIV + purple subcutaneous nodules or hemoptysis
Kaposi sarcoma (HHV-8) skin or lung lesions
26
HIV + diarrhea
Isospora, strongyloides | Cryptosporidium
27
HIV + Cough, fever, dyspnea
CD4 <200, non-productive cough: PCP | Acid-fast bacilli: TB
28
HIV + ataxia, apathy, tremor, intellectual decline
AIDS dementia, CD4 <100
29
HIV + odynophagia
Candida esophagitis | CD4 <200, gram stain on lesion scrapings
30
HIV + fever, weight loss, fatigue, abdominal pain, GI bleeding, skin lesions, dyspnea, meningitis or adrenal insufficiency
Histoplasmosis CD4 <150 Bilateral infiltrates on CXR, positive serum/urine antigen
31
HIV + focal neurologic symptoms, HA, AMS
CD4 <50: Cryptococcal meningitis
32
HIV + vision loss, esophagitis, cellulitis, ulcers
CMV | CD4 <50, yellow infiltrates + hemorrhage on fundoscopy, viral titer to confirm
33
HIV + fatigue, weight loss, fever, diarrhea, abdominal pain, hepatosplenomegaly
MAC | CD4 <50, blood cultures
34
Thrombosis + erythromelalgia + pruritis (esp after warm bath)
Polycythemia vera (also facial plethora, hepatosplenomegaly, visual disturbances, tinnitus)
35
``` CRAB symptoms hyperCalcemia Renal insufficiency Anemia Back pain ```
Multiple myeloma
36
Bence Jones proteins
Multiple myeloma (UPEP)
37
M spike on SPEP
Multiple myeloma
38
Painless cervical lymphadenopathy
Hodgkin lymphoma
39
MC type Hodgkin lymphoma
Nodular sclerosis (men = women)
40
MC lymphoma in US
Diffuse large B cell (NHL)
41
EBV related lymphoma (Africa)
Burkitt (NHL)
42
Reed-Sternberg cells on LN biopsy
Hodgkin lymphoma
43
"Starry sky" pattern
Burkitt lymphoma (NHL)
44
T cell lymphoma
Peripheral (NHL)
45
14:18 translocation
Follicular small cell lymphoma (NHL)
46
8:14 translocation
Burkitt lymphoma (NHL)
47
B symptoms in lymphomas
Fever, night sweats, weight loss
48
Cleaved cells in LN biopsy
Follicular small cell lymphoma (NHL)
49
MC cancer in children
ALL
50
Pancytopenia in Down syndrome patient
ALL
51
Aeur rods + notched nuclei
AML
52
Smudge cells
CLL
53
BM biopsy w/ abundant blasts, +PAS, +tdt
ALL
54
Leukemia + bone pain
ALL
55
BM biopsy w/ abundant blasts, -PAS, +myeloperoxidase
AML
56
WBC > 50-100K
CML or CLL
57
Leukemia and lymphoma that are same disease
CLL and small lymphocytic lymphoma
58
Progresses to fatal blast crisis
CML
59
Leukemia in adults >65
CLL
60
Leukemia in adults 50-60
AML, CML
61
Numerous lymphocytes with irregular cytoplasmic projections
Hairy cell leukemia
62
t 9:22
Philadelphia chromosome (BCR-ABL) CML 15% adult ALL (5% ALL overall), rare in AML
63
Short stature + abnormal skin pigmentation + horseshoe kidney + thumb abnormalities + fatigue + infections + pancytopenia on labs
Fanconi anemia (autosomal recessive)
64
Fatigue + dyspnea + craniofacial and thumb abnormalities + heart murmur + MR + hypogonadism + decreased Hgb/Hct but normal WBC/plt
Diamond-Blackfan anemia (congenital)
65
HTN + abdominal pain + diarrhea with no hematuria in kid: next step?
Neuroblastoma (check VMA and homovanillic acid in 24 hr urine; then CT)
66
Mass in soft tissue/muscle in child: next step?
Rhabdomyosarcoma (MC soft tissue sarcoma in children) (CT/MRI to see extent, biopsy afterwards is diagnostic)
67
Fall on outstretched hand
Colles fx
68
Fall on flexed wrist
Smith fx
69
Fall on outstretched hand, snuffbox tenderness
Scaphoid fx
70
Pain in hand after punching hard surface
Boxer fx (5th metacarpal)
71
Radial head dislocation w/ ulnar fx
Monteggia fx
72
Ulnar dislocation (DRUJ) w/ radial fx
Galeazzi fx
73
Complication of scaphoid fx
AVN
74
Complication of anterior shoulder dislocation
Axillary nerve injury
75
Complication of boxer fx
Infection, tendon laceration
76
Complication of humerus fx
Radial nerve injury
77
Complication of hip fx
AVN
78
Complication of femur fx
Fat embolism, blood loss
79
Complication of tibial fx
Compartment syndrome
80
Complication of pelvic fx
Hypovolemic shock (massive blood loss)
81
6Ps of compartment syndrome
Pain, Pallor, Poikilothermia, Pulselessness, Paresthesia, Paralysis
82
Unhappy triad
ACL + MCL + lateral meniscus
83
Hat doesn't fit anymore
Paget's disease of bone (much more common; bone scan) | Osteopetrosis (anemia; X-ray)
84
Blue sclerae
Osteogenesis imperfecta
85
Sudden severe pain and swelling in one joint (first MTP, ankle, foot, knee MC)
Gout
86
Sudden severe pain and swelling in one joint (ankle, wrist MC)
Pseudogout
87
Needle-shaped negatively birefringent crystals (yellow)
Gout
88
Rhomboid-shaped positively birefringent crystals (blue)
Pseudogout
89
MCC septic arthritis
S. aureus | N. gonorrhea in young, sexually active
90
Joint aspirate w/ <2000 WBC
Osteoarthritis | Trauma
91
Joint aspirate w/ 5-50,000 WBC
Inflammatory (RA, gout, pseudogout, etc)
92
Joint aspirate w/ >50,000 WBC
Septic joint
93
MCC osteomyelitis
S. aureus Consider Salmonella in sickle cell Consider Pseudomonas in IVDU, old tennis shoe/nail
94
Radiology for osteomyelitis
MRI most useful
95
Erythema chronicum migrans
Lyme disease
96
B/L Bell's palsy
Think Lyme disease
97
Heberden nodes
Osteoarthritis, DIP joints
98
Bouchard nodes
Osteoarthritis, PIP joints
99
MC adult bone tumor
Metastases | Lung = lytic, Prostate = blastic, Breast = both; Thyroid, Lymphoma, RCC
100
MC primary malignant bone tumor
Osteosarcoma
101
MC benign bone tumor
Osteochondroma
102
Sunburst bone lesion +/- Codman's triangle
Osteosarcoma (more common in adolescents) | Codman = new periosteal bone formation at diaphyseal end of lesion
103
Onion skin lesion +/- Codman's triangle
``` Ewing sarcoma (5-15 yo) (Codman = new periosteal bone formation at diaphyseal end of lesion) ```
104
Complications of scleroderma
Pulmonary fibrosis Heart failure ARF from renal hypertension
105
Complications of polymyositis and dermatomyositis
Interstitial lung disease | Increased risk of several malignancies
106
Associated w/ polymyalgia rheumatica
Temporal arteritis
107
Positive Barlow or Ortalani maneuver
Developmental hip dysplasia
108
Positive Galeazzi sign
Developmental hip dysplasia (knees at unequal heights when hips and knees are flexed)
109
Radiology to dx developmental hip dysplasia
Ultrasound (X-ray not useful until >4 months)
110
JIA w/ <4 joints and uveitis or iridocyclintis
Pauciarticular
111
JIA w/ >4 joints, symmetric, and hand deformities
Polyarticular
112
JIA w/ systemic symptoms usu before joint pain
Systemic (Still's disease)
113
MC fracture in children
Clavicular
114
Difficulty walking + Gower maneuver + calf pseudohypertrophy
Duchenne muscular dystrophy (x-linked)
115
MCC cellulitis
S. aureus, GAS (pyrogenes)
116
Apocrine gland inflammation (axilla, groin, perineum)
Hirdradenitis suppurativa
117
S/Sx necrotizing fasciitis
Extreme pain w/o cellulitis or outside borders Erythema + bulla or blisters Crepitus DM w/ foot ulcer w/ systemic symptoms Perineal cellulitis w/ abrupt onset and rapid spread (Fournier's gangrene)
118
Dry gangrene cause, s/sx
Gradual skin necrosis from vascular insufficiency | Ache/cold/pallor -> bluish/black/hard/dry
119
Wet gangrene cause, s/sx
Necrosis from infection or acute vascular obstruction | Bruised, swollen, blistering, +pus
120
Gas gangrene cause, s/sx
C. perfringens | Pale/swelling around injury -> dark purplish-red, tense, tender, +crepitus w/ systemic symptoms
121
Yellow crusted lesion around mucocutaneous surfaces
Impetigo
122
Causes of impetigo
S. aureus, GAS (pyrogenes)
123
Cause of necrotizing fasciitis
GAS (pyrogenes) or multiple pathogens
124
Herpes simplex virus types
HSV 1 - oral ulcers HSV 1 - genital ulcers (herpes zoster) - VZV
125
Tzanck smear
Finds multi-nucleated giant cells on sample of lesion in HSV or VZV
126
Teardrop vesicles
Chicken pox (VZV)
127
Grouped vesicles
Shingles (VZV) or HSV
128
Temporal lobe encephalitis
Herpes (esp newborn)
129
Complications of VZV
Adult PNA, encephalitis | Newborn varicella
130
Myalgia, malaise, HA, fever proceeding to lesions in
Chicken pox (VZV)
131
HPV types
1-4 - skin warts 6, 11 - genital warts 16, 18, 31, 33 - cervical cancer
132
Painless, small, shiny/pearly, flesh colored papules w/ central umbilication
Molluscum contagiosum
133
Macules that do not tan w/ "spaghetti and meatballs" on KOH prep (short hyphae + spores)
Tinea versicolor / Pityriasis versicolor | Malassezia furfur
134
Irritant rash vs intertrigo (candida albicans)
Intertrigo MC in skin creases, irritant usu avoids Intertrigo can have 'satellite' lesions away from rash Intertrigo KOH prep has pseudohyphae
135
Infectious causes of EM/SJS/TEN
HSV and Mycoplasma pneumonia
136
Drug causes of EM/SJS/TEN
Penicillins, sulfonamides NSAIDs OCPs Anticonvulsant medications
137
EM vs SJS vs TEN
``` EM = mild disease, macules, plaques, vesicles, target lesions, esp palms/soles SJS = EM involving mucous membranes, skin sloughing 30% surface area ```
138
Pruritic, erythematous plaques w/ yellow, greasy scales most commonly on face or scalp
Seborrheic dermatitis (or cradle cap in babies)
139
Dry skin patches w/ papules most commonly on flexor surfaces, face/scalp in infants
Atopic dermatitis (eczema)
140
Well-defined red plaques w/ silvery scales on extensor surfaces that bleed easily w/ scale removal (Auspitz sign)
Psoriasis
141
Herald patch + pruritic papules covered with white scale in "christmas tree" pattern
Pityriasis rosea
142
Subcutaneous fat inflammation -> painful, erythematous nodules esp on anterior tibias
Erythema nodosum
143
Conditions associated w/ erythema nodosum
``` SPUD BITS Strep infections Pregnancy Unknown/idiopathic Drugs Behcet's IBD TB Sarcoidosis ```
144
Pruritic, purple, polygonal papules and plaques that are shiny and flat, most commonly on flexor surfaces of extremities, possibly on mucus membranes/genitals
Lichen Planus
145
Infections associated w/ lichen planus
``` HIV (younger patients) Hep C (older patients) ```
146
Decubitus ulcer stages
I - color/consistency/temp change of skin II - superficial skin abrasion, shallow crater III - full thickness skin loss + SQ damage, deep crater IV - muscle, bone or supporting structure damage
147
Eczematous dermatitis w/ inflammatory papules, scaly and crusted erosions, increased pigmentation, stippling w/ recent and old hemorrhages, possible ulceration
Stasis dermatitis
148
Flaccid, easily ruptured bullae (+Nikolsky sign) w/ oral lesions
Pemphigus vulgaris (anti-desmosome Abs)
149
Tense, hard, difficult to rupture bullae w/o oral lesions
Bullous pemphigoid (anti-hemidesmosome Ab)
150
Chronic blistering lesions on sun-exposed skin
Porphyria cutanea tarda
151
Porphyria cutanea tarda associations
Hep C, alcoholism | Iron overload, estrogen use, smoking
152
Pigmented plaques that appear to be stuck onto skin
Seborrheic keratosis
153
Black velvety plaques on flexor surfaces, body folds
Acanthosis nigricans
154
Acanthosis nigricans associated with what
Obesity DM Malignancies
155
Rough lesions on sun-exposed skin that are easier to feel than see
Actinic keratosis
156
Circular rash w/ central clearing on trunk/arms
Tinea corporis
157
Sharply demarcated patches of hypopigmentation
Vitiligo
158
Hyperpigmentation in pregnancy
Melasma
159
Vitiligo associated comorbidities
``` Thyroid disease (30%) - Graves, AI Pernicious anemia, DM I, primary adrenal insufficiency, hypopituitarism, alopecia areata, AI hepatitis ```
160
Asymptomatic, inflammatory, non-scarring areas of complete hair loss
Alopecia areata
161
Stress-related diffuse hair loss
Telogen effluvium
162
Male-pattern baldness (men or women)
Androgenic alopecia

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