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Flashcards in Do NOT Confuse Deck (57):
1

Amiloride vs Amlodipine vs Amiodarone

Amiloride: diuretic K+ sparing
Amlodipine: Ca++ channel inhibitor
Amiodarone: K+ channel inhibitor --> prolongs QT but no Torsades

2

Menetrier vs Menieres

Menetrier: thickened rugae in stomach, mucus, protein loss
Meniere: short duration vertigo w/ hearing loss due to decreased endolymph absorption

3

Menke vs Meckle

Menke: too much copper, kinky hair, lysyl oxidase mutation
Meckle: true diverticulum, rule of 2's, pertechnatate scan

4

PDE vs PGE

Phosphodiesterase: if inhibited --> vasodilates (used for erectile dysfunction to inhibit cGMP degradation by PDE5 --> NO)
--> Nitric oxide also called EDRF (endothelium derived relaxation factor)
Prostaglandin: vasodilates (eg. afferent arteriole), synthesis inhibited by NSAIDs

5

HUS vs Henoch Schonlein Purpura

HUS: microangiopathic hemolytic anemia, thrombocytopenia, and acute renal injury (diarrhea associated [EHEC shiga toxin])
Henoch Schonlein: systemic vasculitis caused by IgA deposition (in skin and GI tract), aw/ arthralgias and acute glomerulonephritis

6

IgA Nephrophathy vs Post-streptococcal Glomerulonephritis

IgA Nephropathy: few days after URI or GI infection, mesangial IgA deposits, aw/ Henoch Schonlein Purpura
PSGN: weeks after URI or skin infection (GAS), low C3, granular/starry sky appearance, better prognosis in children

7

Rheumatic Fever vs Rheumatic Heart Disease vs Polymyalgia Rheumatica

Rheumatic Fever: mitral regurgitation, JONES criteria, few weeks after pharyngitis
Rheumatic Heart Disease: mitral stenosis, and sometimes infectious endocarditis
Polymyalgia Rheumatica: aw/ temporal (giant cell) arteritis, muscle aches and jaw claudication, blindness

8

Rheumatic Fever vs Scarlet Fever

Both: GAS pharyngitis
Rheumatic Fever: JONES criteria
Scarlet Fever: strawberry tongue, sandpaper rash, can progress to RF if untreated

9

Bacterial Endocarditis vs Rheumatic Fever/Heart Disease

Endocarditis: fever, new murmur, Roth spots, osler nodes, janeway lesions, splinter hemorrhages (vegetations made of fibrin and platelets --> thrombi to different parts of body)
Caused by dental procedures or IV drug use
[May also be non-bacterial due to malignancy, hypercoagulable state or SLE]
RF/RHD: Do not have all of these, only have murmur and fever

10

Cryptococcus vs Coccidiodes

Cryptococcus: meningitis, round/oval budding year w/ thick polysaccharide capsule (latex agglut. test)
Coccidioides: Valley fever, respiratory pneumonia, spherule w/ endospores

11

Leukemoid Reaction vs CML

Both: elevated WBC ( low blasts, many band cells, metamyelocytes, and myelocytes)
Leukemoid Reaction: high alk phos
CML: low alk phos

12

Bethanechol vs Bethamethasone vs Beclamethasone

Bethanechol: cholinergic agent to activate bowel and bladder
Bethamethasone: prenatal to improve surfactant production
Beclamethasone: chronic asthma tx

13

Trichomonas vs Treponema pallidum vs Trachomatis

Trichomonas vaginalis: vaginitis
Treponema: syphilis
Trachomatis: chlamydia

14

Vit B12 vs Vit E Deficiency

B12: megaloblastic anemia, methylmalonic acid, paresthesia, degeneration of dorsal column, lateral corticospinal tract, and spinocerebellar tracts
E: hemolytic anemia, muscle weakness, posterior column and spinocerebellar tract demyelination

15

Dietary B12 Deficiency vs Pernicious Anemia vs Malabsorption of B12

Dietary deficiency: radiolabeled oral cobalamin excreted in urine
Pernicious Anemia: oral labeled cobalamin with IF excreted in normal amount in urine
Malabsorption: oral labeled cobalamin with IF will be lower in amount in urine

16

Alkaptonuria vs Acute Intermittent Porphyria

Both: urine that darkens with exposure to air
Alkaptonuria: black urine, brown sclera, cannot metabolize phenylalanine or tyrosine (to fumarate)
AIP: port wine urine, abdominal pain, no photosensitivity

17

Minimal Change Disease vs Focal Segmental Glomerulosclerosis

Both: foot process effacement
Minimal change: children, response well to steroids, can be aw/ Hodgkin's Lymphoma
FSGS: African American/Hispanic adults, poor response to steroids, HIV, heroin, Sickle cell

18

Membranous Nephropathy vs Membranoproliferative Glomerulonephritis

Both: thick membranes, poor response to steroids
Membranous: Caucasian, HBV/HCV SLE, solid tumors, spike & dome/grainy, IgG4
Membranoproliferative: hypercellularity, tram track, 2 types (subendo HCV/HBV or intramembranous C3 convertase) low C3

19

EHEC vs ETEC

EHEC: O157:H7, shiga-like toxin (inactivates 60s ribosome), does NOT ferment sorbitol
ETEC: traveler's diarrhea, LT cholera-like toxin (cAMP)

20

Tay-Sachs vs Neimann-Pick

Both: cherry red spot, neurodegeneration
Tay-Sachs: hexosaminidase B, GM2 ganglioside
Neimann-Pick: hepatosplenomegaly, sphingomyelinase, sphingomyelin

21

Erythema's

Migrans: Lyme
Marginatum: Rheumatoid fever
Multiforme: Steven Johnson, HSV
Infectiousum: parvovirus (fifth’s disease)
Nodosum: shins, sarcoidosis, TB, strep, leprosy, Crohn’s

22

Erythema Nodosum vs Polyarteritis Nodosa

Erythema Nodosum: on shins (sarcoidosis, TB, strep, leprosy, Crohn's/UC)
Polyarteritis nodosa: vasculitis, usually affects renal arteries and spares the pulmonary arteries

23

Condyloma's

Accuminatum: HPV
Latum: Syphillis (secondary)

24

Lichen Sclerosis vs Lichen Simplex Chronicus

Sclerosis: thinning of vulvar skin, slight increased risk sq. cell carcinoma, non-HPV related cause of VIN
Simplex chronicus: thickened vulvar skin due to irritation, no increased risk

25

Scarlet Fever vs Kawasaki

Both: red tongue
Scarlet fever: may precede rheumatic fever, scarlet splotches/spot sandpaper rash, GAS
Kawasaki: coronary artery disease, Asian children

26

Von Gierke vs Cori vs McArdle

Both: glycogen storage diseases
Von Gierke: hepatomegaly, Glucose 6 phosphatase problem
Cori Disease: milder form of Von Gierke
McArdle: more glycogen in muscle, not in liver, myophosphorylase problem

27

Primary Biliary Cirrhosis vs Primary Sclerosing Cholangitis

PBC: granulomatous, lymphocytes, usually females, pruritis, AMA
PSC: crimping/beading and strictures, UC, p-anca

28

Neuroblastoma vs Wilm's Tumor

Both: abdominal mass in young children
Neuroblastoma: adrenal medulla, myoclonus, non-rhythmic eye movements
Wilms (nephroblastoma): aniridia (no irises), GU malformation, retardation

29

Bacillary Angiomatosis vs Kaposi Sarcoma

Both: reddish purple vascular tumor
Bacillary angiomatosis: Bartonella (also causes cat scratch), benign
Kaposi: malignant, HHV8, skin or GI tract

30

Gardnerella Vaginalis vs Trichomonas Vaginalis

Both: STDs with distinct smell
Gardnerella: bacterial vaginosis, fishy smelling grey-white discharge, clue cells
Trichomonas: vaginitis, foamy, foul smelling yellow green discharge

31

HNPCC vs Xeroderma Pigmentosum

HNPCC: mismatch repair problem, sporadic colon cancer
XP: endonuclease problem (can’t remove thymine dimers, photosensitivity

32

Toxins

Diphtheria and Pseudomonas (Exotoxin A): Ribosylate EF-2 inhibiting protein synthesis
Pertussis: ADP ribosylates Gi to increase cAMP
Cholera: increases cAMP and Cl- secretion
EHEC (shiga-like) and Shiga: Inactivate 60S by removing an adenine
ETEC: LT (cholera-like): increases cAMP and ST: increases cGMP

33

Isoniazid vs Isocarboxazid

Isoniazid: mycolic acid synthesis inhibitor for TB, similar to B6 (pyridoxine)
Isocarboxazid: MAOi for atypical depression or refractory depression, hypertensive crisis w/ tyramine containing foods

34

Liver Damage Appearance

PBC: granulomatous inflammation, florid duct lesions
PSC: onion skinning and crimping of ducts
Alcoholic hepatitis: hepatocyte swelling and necrosis, Mallory bodies
Acetaminophen toxicity: centrilobular necrosis
Reyes: microvesicular steatosis
Hemochromatosis: hemosiderin deposition
Budd Chiari: reddish purple, necrotic, centrilobular congestion

35

Neuroleptic Malignant Syndrome vs Serotonin Syndrome vs Malignant Hyperthermia

NMS: rigidity (no myoclonus), high fever, autonomic instability, myoglobinuria
Serotonin Syndrome: myoclonus, high fever, flushing, diarrhea, seizures
Malignant Hyperthermia: hereditary condition, fever + severe muscle contraction with use of inhaled anesthetics

36

Severe Combined Immunodeficiency vs X-Linked Agammaglobulinemia

SCID: adenosine deaminase, defective T cells --> not making B cells either, pneumocystis jerovecii in infants
XLA: bruton tyrosine kinase defect (BTK), not making antibodies

37

Mast Cells vs Basophils vs Eosinophils

Mast cells: main allergic response cell (type 1 hypersensitivity); histamine, heparin, tryptase, and eosinophil chemotactic factors
Basophils: also for allergic reactions, heparin, histamine, leukotrienes
Eosinophils: helminths mainly; histamine and arylsulfatase

38

Hexokinase vs Glucokinase

Hexokinase: most tissues (NOT liver and beta cells in pancreas)
- High affinity, not insulin induced, works at low glucose concentration, feedback inhibited by glucose-6-P
Glucokinase: Liver and Pancreatic Beta cells
- Low affinity, insulin induced, works at high glucose concentration, not feedback inhibited by glucose-6-P, aw/ MODY

39

Ornithine Transcarbamylase Deficiency vs Orotic Aciduria

Both: Orotic Acid in urine
- Ornithine Transcarb. Deficiency: (problem with urea cycle), orotic acid in blood and urine (because excess carbamoyl phosphate is converted to it), hyperammonemia
- Orotic Aciduria: UMP Synthase deficiency (part pyrimidine synthesis), NO hyperammonemia (because urea cycle is fine), Megaloblastic anemia

40

Homocystinuria vs Marfan's

Both: tall, kyphosis, long limbs, lens subluxation
Homocystinuria: mental retardation and increased risk thrombosis & atherosclerosis, and high levels of homocysteine, can treat with PLP (B6)
Marfan's: similar presentation, without extra things

41

Hamartoma

Tuberous Sclerosis

42

Angiofibromas

Tuberous Sclerosis

43

Ash-leaf spots

Tuberous Sclerosis

44

Cardiac Rhabdomyoma

Tuberous Sclerosis

45

Renal Angiomyolipoma

Tuberous Sclerosis

46

Shagreen Patches

Tuberous Sclerosis

47

Subependymal Astrocytoma

Tuberous Sclerosis

48

Cavernous Hemangioma

VHL

49

Renal Cell Carcinoma

VHL

50

Hemangioblastoma (Retina and Cerebellum)

VHL

51

Mitral Regurgitation

Tuberous Sclerosis

52

Seizure

Tuberous Sclerosis

53

Lisch Nodules

NFT 1

54

Cafe au Lait

NFT 1

55

Pheochromocytoma

MEN, VHL, NFT1

56

TTP vs HUS

Both: microangiopathic hemolytic anemia; PENTAD
TTP: adults and primarily neuro problems
HUS: children and primarily renal involvement

57

Patau (13) vs Edwards (18)

Patau: Cleft palate, polydactyly, and omphalocele
Edwards: Clenched hands