Goljan High Yield 36 General EC Flashcards Preview

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Flashcards in Goljan High Yield 36 General EC Deck (227):
1

Physiologic effects of hemorrhage

drop in diastolic blood pressure, activation of RAA system from decreased renal blood flow and catecholamine stimulation, catecholamine release from the high pressure baroreceptors, increased reabsorption of sodium from the kidneys, release of ANP, release of ADH

2

Opportunistic infections in AIDS

Pneumocystis
CMV
Cryptococcus
MAI
TB
Herpes (esophagitis)
Candida (thrush, esophagitis)
Cryptosporidium (acid fast; diarrhea)

3

Decreased uptake of DOPA and NOR

Cocaine

4

Produces thymidine dimers

UVB light
If thymidine dimers not replaced with normal DNA by DNA repair enzymes, may result in cancer

5

ESR increase with age

Probably abnormal and indicates a disease process rather than being an age-related finding

6

Key elements in wound healing

Granulation Tissue and fibronectin

7

MCC of death in 15-25 age bracket

Motor vehicle
Homicide for black male

8

AR disease with absent DNA repair enzymes and increased incidence of UVB related skin cancer

Xeroderma pigmentosum

9

Inhibited by CO and cyanide

Cytochrome oxidase

10

XR disease with absent NADPH oxidase, absent respiratory burst, cannot kill catalase + S. aureus but can kill catalase negative strep

Chonic granulomatous disease

11

Type of necrosis in acute MI

Coagulation necrosis

12

Cause of atrophy in muslce

In a cast

Lack of muscle stimulation

13

Non-disjunction in somatic cells

Mosaicism

14

Mother gives disease to all her kids but son to none of his kids

Mitochondrial inheritance

15

MC vitamin deficiency in alcoholics

folate

16

MC metal deficiency in alcoholics

Magnesium

17

Vitamin associated with pyruvate dehydrogenase

Thiamin (required to make ATP)

18

NADPH oxidase conversion of molecular oxygen into superoxide free radicals. PMNs and monocytes only (no macrophages)

Respiratory burst

19

In Caisson disease, what is decreased when a diver comes up too quickly

pressure of N2 in blood since it forms bubbles in the vessels and moves into tissue

20

DES exposure, vaginal adenosis precursor

Clear cell adenocarcinoma of the vagina

21

What happens to the other kidney if one is damaged

It undergoes hypertrophy

22

Decreases the levels of vit K dependent factors, increased incidence of hemorrhagic strokes, potentiates the action of warfarin

Vit E toxicity

23

Required for carboxylase reaction in the conversion of pyruvate to oxaloacetate

Biotin

24

Involved in transamination reactions involving AST and ALT

Pyridoxine (B6)

25

Functions of ANP

opposite of ang-II
(inhibition of ADH release, inhibits ATII effect on stimulating thirst, inhibits aldosterone secretion, inhibits renal reabsorption of Na, and inhibits renin release

26

Chance of male with CF having a child. What about female?

<5% since the vas deferens never fully develop or are atretic

Females with CF can get pregnant but it is difficult owing to the thick cervical mucus

27

Vitamin supplements in CF

all of the fat soluble vitamins (D,A,E,K)

28

Woman is a pure vegan and is breast feeding her baby and the baby develops anemia

B12 deficiency

29

What does EBV attach to on B cells?

CD21

30

Hypogonadism, mental retardation, and unilateral gynecomastia

Klinefelter syndrome

31

Hypogonadism and color blindness

Kallman syndrome (absent GnRH)

32

Hypogonadism, mental retardation, retinitis pigmentosum

Laurence-Moon-Biedl syndrome

33

Male with hypogonadism, mental retardation, short stature, and webbed neck

Noonan syndrome (similar to Turner's syndrome)

34

Hypogonadism and anosmia

Kallmann syndrome

35

Male pseudohermaphrodite with cryptorchidism

testicular feminization (absent androgen receptors
(sex-linked recessive)

Most common cause of male pseudohermaphroditism

36

Microdeletion syndrome with hypogonadism, mental retardation, short stature, and obesity

Prader-Willi syndrome

(Ch 15 deletion is of paternal origin)

37

Patient with neurofibromatosis has severe diastolic hypertension

Pheochromocytoma

38

Complications of cyclophosphamide

hemorrhagic cystitis and transitional carcinoma of the bladder

39

Decline in deaths due to SIDS

Having baby sleep supine
(babies rebreathe their own CO2, those with immature central chemoreceptors do not respond to the respiratory acidosis by moving their heads and die)

40

Most important risk factor for increased morbidity/mortality in a single 25 year old black male

Unprotected sex
(AIDS #1 killer in this age bracket; also applies to women regardless of age, but not white men, where MVAs are #1 killer)

41

Several employees that work in a car assembly plant present with headache, nausea, vomiting, muscle weakness, and abdominal cramps

Lead poisoning from incineration of batteries; may change history to people making moonshine in an old car radiator

42

Newborn female presents with edema of the hands and feet and a cystic mass in the neck

Turner's syndrome with a 45 XO karyotype

43

Compare to mature breast milk, cow's milk has . . .

More vit K, B12, & Casein
Less ascorbic acid

(breast milk has low iron but it is better absorbed; casein is the key protein in cow's milk, while whey is the primary protein in breast milk)

44

Vitamin that is absent in colostrum

Vit D

45

Anemia in an infant that develops when switched from cow's milk to goat's milk

Goat's milk is low in folate, B6, iron

High in K, Cl, arachidonic acids, and linoleic acids

(when compared to cows milk)

46

Type of UV light with the greatest potential for producing a corneal burn

UVB

B is Bad

47

Retinal hemorrhages in young children

Possible child abuse (shaking syndrome)

48

Patient is stung by a bee and begins to have respiratory difficulty, flushing, and abdominal cramping. Treatment?

Aqueous epinephrine

49

Multiple wheals that later develop into vesicles and pustules

Fire ant bites

50

Painful bite (carrying some logs from outside, moving boxes in basement) followed by crampy pain in the thighs and abdomen

Black widow bite

Treat with muscle relaxant [Ca gluconate], tetanus prophylaxis, antivenin if available in severe case

51

In southwest, painful sting followed by local itching, paresthesias, N/V, and hypertesion

Scorpion bite

52

Painless bite beginning with a slightly tender red papular lesion on the arm that latter forms a hemorrhagic blister surrounded by purpura

Brown recluse spider bite

53

Extremely pruritic discrete, bright red papules on legs around the waist

Chigger bites

54

Child who ingested 30 adults aspirins will most likely develop

increased anion gap metabolic acidosis
(children unlike adults do not commonly develop mixed metabolic acidosis and respiratory alkalosis)

Treatment is to perform gastric lavage and add activated charcoal and to produce an alkaline urine for the increase excretion of the acid

55

What disease is more likely to infect the fetus after the first trimester

Syphilis

56

Engineer driving a train involved in a crash with an oncoming train was found to have THC metabolites in his urine- why did this occur

Delayed reaction time
(it also impairs the ability to judge speed and distances)

57

Angiosarcoma of the liver-causes?

Vinyl chloride
Arsenic
Thorotrast

58

Cardiovascular age dependent changes

loss of elasticity of aorta

59

Respiratory age dependent changes

obstructive findings

60

Musculoskeletal age dependent changes

Osteoarthritis

61

CNS age dependent changes

cataracts,
presbycusis (inner ear degeneration)
otosclerosis (conductive hearing loss)
decreased smell and taste
arcus senilis

62

Immune system age dependent changes

Increased CD4
Decreased CD8
Increased autoantibodies
Decreased cellular immunity

63

Integument age dependent changes

Loss of elasticity
Increased collagen cross bridges
Increased body fat
Ecchymoses from vessel instability
Decreased skin turgor

64

Reproductive age dependent changes

Breast and vulvovaginal atrophy
decreased serum estrogens and increased gonadotropins

Testicular atrophy with decreased testosterone levels, prostate hyperplasia

65

Renal age dependent changes

Decrease GFR (40%)
Decreased creatinine clearance (important in dosing drugs to avoid toxicity)

66

Endocrine age dependent changes

Increased carbohydrate intolerance (less insulin receptors from increased adipose)

67

Target organs for acetaminophen injury

liver and kidneys (renal medulla)
Free radical injury

68

Low AFP

Down syndrome

69

Block phospholipase A2 hence decreasing prostaglandin and leukotriene production
Decrease leukocyte adhesion (increase PMNs, decrease lymphocytes and eosinophils)

Corticosteroids

70

Tumor marker that is a gene product (oncofetal antigen). Hepatocellular carcinoma, germ cell tumors, )yolk sac or endodermal sinus tumors of testicle or ovary). Testicular/ovarian cancer.

AFP

71

Tumor marker that is an enzyme. Hepatocellular carcinoma, yolk sac or endodermal sinus tumors of testicle or ovary

AAT

72

Tumor marker that is a hormone. Trophoblastic tumor in germ cell tumors of ovary/testis and placenta (benign=hyatidiform mole) (malignant=choriocarcinoma)

b-HCG

73

Tumor marker that is a protein. Small cell carcinoma of the lung, neuroblastoma

Bombesin

74

Tumor marker that is a protein. Multiple myeloma (excellent prognostic factor). Light chains in urine (Bence Jones protein)

B2-microglobulin

75

Tumor marker that is a glycoprotein (cancer antigen) in breast cancer

CA 15-3

76

Tumor marker that is a glycoprotein (cancer antigen) in pancreatic cancer (excellent marker)

CA 19-9

77

Tumor marker that is a glycoprotein (cancer antigen) in surface derived ovarian cancer

CA 125

78

Tumor marker that is a gene product (oncofetal antigen) in colorectal, pancreatic, breast, and SCC of the lung.

CEA

Bad prognostic sign if elevated preoperatively (greater incidence of undetected metastases)

79

Tumor marker that is an enzyme in Hodgkin's disease (non-specific tumor marker in general)

LDH

80

Tumor marker that is an enzyme in SCC of the lung, and neuroblastoma

NSE (neuron specific enolase)

81

Tumor marker that is a glycoprotein in prostate adenocarcinoma.

PSA

Excellent sensitivity but poor specificity (increased in prostate hyperplasia)

Excellent indicator of tumor burden.

Not increased after rectal exam

82

Virus associated with adults T cell leukemia/lymphoma

HTLV-1 (RNA)

83

Virus associated with hairy cell leukemia

HTLV-2 (RNA)

84

RNA virus associated with CNS malignant lymphoma

HIV

85

RNA virus associated with hepatocellular carcinoma

HCV

86

Virus associated with hepatocellular carcinoma

HBV

(aflatoxin B a cocarcinogen)

87

DNA virus associated with Burkitt's lymphoma, nasopharyngeal carcinoma, and polyclonal malignant lymphoma

EBV

88

DNA virus associated with SCC of the cervix, vagina, vulva, and anus in homosexuals. Laryngeal papillomas (may progress to cancer)

HPV (16&18)

89

DNA virus associated with Kaposi's sarcoma

HSV-8

90

EM of zebra bodies in lysosomes in Niemann Pick disease

look like lamellar bodies in type II pneumocytes

91

Enamel injury in young woman

bulimia
Metabolic alkalosis from vomiting
Boerhaave's syndrome

92

Secondary amenorrhea

Anorexia nervosa

Decreased GnRH and gonadotropins

93

Decreased protein intake but normal total caloric intake (all carbs).

Kwashiorkor

Fatty liver from decreased apolipoproteins, pitting edema, flaky paint dermatitis, "flag sign" in hair

94

Decreased total caloric intake. Loss of muscle mass

Marasmus

95

Squamous metaplasia in eyes, broncus, nyctalopia

Vit A deficiency

96

Increased intracranial pressure, hypercalcemia

Vit A deficiency

97

Yellow but sclera white

beta-carotenemia

*can be primary hypothyroidism from decreased conversion of B-carotenes into retinoic acid in the intestine (thyroxine is a cofactor)

98

Rickets vs osteomalacia

Craniotabes and rachitic rosary in rickets (not osteomalacia)

Both have increased unmineralized osteoid

99

Cerebellar dysfunction; hemolytic anemia

Vit E deficiency

100

Vit E toxicity

interferes with vit. K dependent factors leading to hemorrhagic diathesis (synergistic w/ warfarin)

101

Gums bleed when brushing teeth, glossitis, perifollicular hemorrhages, "tea and toast diet"

Vit. C deficiency

102

Thiamin deficiency

alcohol abuse MCC
Important biochemical reactions (need to make ATP): pyruvate dehydrogenase, transketolase, ketoglutarate, dehydrogenase

Ring hemorrhages in mamillary bodies and periventricular area

High output cardiac failure, congestive cardiomyopathy, peripheral neuropathy

103

Confusion, ataxia, nystagmus

Wernicke (thiamin deficiency)

104

Antegrade and retrograde memory deficits

Korsakoff (thiamin deficiency)

105

Niacin deficiency

Important biochemical reactions: NAD/NADH, NADP/NADPH

Pellagra

Tryptophan can be used to synthesize niacin (tryptophan decreased in Hartnup's, carcinoid syndrome [converted to serotonin])

106

Riboflavin deficiency

Important biochemical reactions: FMN and FAD

Synthesis of glutathione

Magenta tongue, neovascularization of cornea, angular stomatits

107

Pyridoxine deficiency

INH MCC

Transaminase (heme synthesis)

Sideroblastic anemia w/ ringed sideroblasts, neurotransmitter synthesis

absent in goats milk

108

Important in fatty acid synthase complex (co-enzyme reactions)

Pantothenic acid

109

Biotin deficiency

Required for carboxylation reactions (ie gluconeogenesis)

avidin in raw eggs binds

causes alopecia

110

Chromium (functions and disorders)

part of the glucose tolerance factor which potentiates insulin activity

Deficiency associated with glucose intolerance and peripheral neuropathy

111

Copper Functions

Cofactor in many enzymes involved in oxidation-reduction reactions Lysyl oxidase-collagen cross links
Superoxide dismutase-
Ferroxidase- converts Fe2+ to Fe3+ so it can bind transferrin
Tyrosinase-conversion of tyrosine to DOPA

112

Copper deficiency clinical disorders

Deficiency associated with
Microcytic hypochromic anemia (cannot bind transferrin)
Skeletal abnormalities (defective collagen)
Osteoporosis
Skin depigmentation (problem with tyrosinase)
Dissecting aortic aneurysms (defective collagen and elastic tissue)
Mencke's kinky hair syndrome (impaired utilization of copper)

113

Copper toxicity

Wilson's disease

AR w/ defect in excretion of copper into bile. It leads to liver damage and eventual deposition of free copper into the eye (Kayer-Fleischer ring) and lenticular nuclei in the brain. Total copper levels are decreased owing to a decrease in ceruloplasmin synthesis by the damaged liver, but free copper levels are increased

114

Selenium functions

Functions in the metalloenzyme GLUTATHIONE PEROXIDASE which is an anti-oxidant that destroys peroxides in the cytosol. It neutralizes peroxides in the cytosol, while vitamin E prevents peroxide formation in the membranes of cells. It inhibits DNA synthesis and stimulates the immune system.

It is also an enzyme
cofactor in the peripheral conversion of T4 into T3

115

Selenium deficiency

Muscle pain
Weakness
Cardiomyopathy

116

Zinc function

Cofactor in
Superoxide dismutase
Carbonic anhydrase
Alkaline phosphatase
Collagenases
Polymerases
Thymidine kinase
Alcohol dehydrogenase

117

Zinc deficiency

Growth retardation
Hypogonadism and infertility
Dysgeusia (decreased taste)
Rash around eyes and mouth
Impaired wound healing
Impaired cellular immunity
Deficiency is common in diabetics, alcoholics, and cirrhosis

118

Acrodermatitis enteropathica

Recessive disease characterized by decreased intestinal absorption of zinc

119

Goat's milk

vit B6 (pyridoxine) and folate deficiency

120

Functions of Vit. C

Reduce dietary iron from ferric to ferrous for reabsorption
Hydroxylation of proline and lysine (binding site for cross-bridges)
Prevents nitrosamination
Reduces metHb

121

Cyanosis not relieved by oxygen in a patient coming home from a camping trip

methemoglobinemia (water has nitrites that oxidized iron to ferric condition)

SaO2 not PaO2 is decreased

Methylene blue treatment of choice (ascorbic acid ancillary role)

122

HbF

left shifts Hb ODC, protects newborns with sickle cell disease and severe beta-thalassemia, increased with hydroxyurea, resistant to alkali/acid denaturation

123

Raising the upper limit of normal of a test

Increases specificity and positive predictive value (decreases sensitivity and predictive value of a negative test result)

124

Prevalence

Number of people with disease in the population studied

=Incidence * duration of disease

125

What part of adrenal cortex is atrophies in a patient on corticosteroids?

Fasciculata and reticularis

(not glomerulosa)

126

Apoptosis

individual cell necrosis
Normal involution of structures (atrophy, thymus)
Programmed cell death
Loss of Mullerian structures in males and Wolffian in females
Councilman (acidophilic) bodies
Psammoma bodies
Mechanism of atresia in the bowel (no lumen)

127

Hypercalcemia as paraneoplastic syndrome

PTHrP from SCC of lung or renal adenocarcinoma

128

Acanthosis nigricans

Insulin resistance
Stomach cancer (visceral malignancy)

129

Eaton-Lambert syndrome (Myasthenia-like)

Small cell carcinoma

130

Polymyositis paraneoplastic syndrome

Lung cancer

131

Oncogenesis in HPV

gene products E6 inhibits p53and E7 inhibits Rb

132

Metalloenzyme that aids tumor invasion of tissue

Type IV collagenase with Zinc cofactor

133

Smoker with history of peptic ulcer disease . . . advice?

Stop smoking

134

Normal karyotype in a child with Down syndrome

probable translocation w/ chromosome 21 sitting on top of ch 14

or acrocentric Robertsonian translocation of Ch 21

135

Sepsis in an elderly man with BPH

E. coli and can produce endotoxic shock

(warm shock due to activation of complement system and release of anaphylatoxins + release of NO from damaged endothelial cells)

136

DNA repair defects

Fanconi's anemia (cross-linking agents)

137

Effect of barbiturates and other drugs that enhance P450s

decrease heme and increased activity of ALA synthase (rate limiting enzyme in heme synthesis)

Dangerous in precipitating porphyric attacks

138

Genomic imprinting

did chromosome come from mother or father (ie Ch 15 microdeletion syndromes - Prader Willi and Angelman)

139

Normal changes in pregnancy

Greater increase in PV than RBC mass leading to decreased Hb
Increased:
GFR
CCr
Alkaline phosphatase
Decreased BUN, creatinine, and uric acid
Respiratory alkalosis from progesterone effect
Increased T4 and cortisol from increased synthesis of their binding proteins (free hormone normal)

140

Main difference in adult male and female labs

iron studies all lower in females

141

Increased alkaline phosphatase (osteoblasts from bone growth) and phosphate. Slight decrease in Hb

Children

142

Analytes increased with hemolyzed blood sample

LDH
K

143

Lipid most affected by fasting

TG component coming from chylomicrons
CH and HDL not affected

144

Enhance cytochrome system in the SER of the liver

Alcohol
Barbiturates

Increase in serum GGT
Decreased drug levels from increased metabolism

145

inhibit cytochrome system

H2 blockers, proton blockers, danger of drug toxicity

146

First sign of tissue hypoxia

Swelling of cell from inactiva Na/K ATPase

147

Examples of growth alterations

Atrophy
Hypertrophy
Hyperplasia
Metaplasia
Dysplasia

148

Examples of cell accumulations

Melanin
Fe
Ca (dystrophic, metastatic)
Glycogen
Bilirubin products

149

Free radicals

Superoxide
OH'
Peroxide
Acetaminophen
Fe increases formation via Fenton reaction

150

Types of cell necrosis

Coagulation (infarction-exception CNS)
Liquefactive (infections, brain infarct)
Caseous (TB, fungi)
Enzymatic fat necrosis (acute pancreatitis)
Fibrinoid (immunologic injury:small vessel vasculitis, vegetations in RHD and Libman Sacks)
Gummatous (tertiary syphilis)

151

Chemical mediators of inflammation

Histamine
C3a C3b C5a
LTB4
LTC-D-E4
Bradykinin
Prostaglandins

152

Factors increasing and decreasing adhesion molecule synthesis

Increase:
C5a
LTB4
Endotoxins
IL-1
TNF

Decrease:
Catecholamines
Corticosteroids
Lithium

153

Circumscribed red lesion containing multinucleated giant cells

Granuloma

Type IV hypersensitivity

Macrophages when activates become epitheloid cells and fuse into multinucleated giant cells

154

Key factors in wound healing

Fibronectin and granulation tissue

155

MCC of delayed wound healing

Infection

156

Suppurative inflammation

abscess (s. aureus)

157

Cellulitis inflammation

strep pyogenes

158

Granulomatous inflammation cause

TB/systemic fungi

159

Pseudomembranous inflammation causes

diphtheria
C. dif

160

Fibrinous inflammation example

pericarditis

161

Serous inflammation example

blister

162

p53 tumor suppressor gene (cancer and chromosome)

Most cancers
chromosome 17

163

APC tumor suppressor gene (cancer and chromosome)

Familial polyposis
Chromosome 5

164

BRCA-1 tumor suppressor gene (cancer and chromosome)

Breast/ovarian cancer
Chromosome 17

165

BRCA-2 tumor suppressor gene (cancer and chromosome)

Breast cancer
Chromosome 13

166

Rb tumor suppressor gene (cancer and chromosome)

Retinoblastoma
Osteosarcoma
Chromosome 13

167

Fragile X syndrome

SXR disease
MC genetic cause of mental retardation in males (Down's most common overall)
Triplet repeat
Macroorchidism at puberty

168

Cri-du-chat

Deletion of short arm of Chr5
Mental retardation
Cry like a cat
Relation with VSD

169

Marfan's syndrome

AD
Fibrillin defect in elastic tissue
Mitral valve prolapse w/ sudden death
Aortic dissection MCC of death
Dislocated lens

170

Brain tumors, meningioma, acoustic neuroma,
Also pheochromocytoma, cafe au lait spots, Lisch nodules (hamartomas on iris)

Neurofibromatosis (AD)

171

Cerebellar hemangioblastomas
Pheochromocytoma
Renal adenocarcinoma

Von Hippel Lindau (AD)

172

Most common teratogen

Alcohol

173

Oncogene relationship erb-B2/HER2

codes for a growth factor receptor

Breast cancer
Ovarian cancer
Colon cancer

174

Oncogene relationship ras

codes for membrane associated G proteins that transduce signals received from growth factor receptors to the phosphatidyl inostitol second messenger system.

30% of all cancer

175

Oncogene relationship abl

produces non-receptor proteins located on the inner cell membrane surface

176

Oncogene relationship t(9:22)

leads to CML

177

Oncogene relationship c-myc

located in the nucleus and produce protein products that activate nuclear transcription

178

Oncogene relationship t(8:14)

translocation leading to Burkitt's lymphoma

179

Oncogene relationship N-myc

Neuroblastoma

180

Oncogene relationship ret

MEN IIa/IIIb

181

Oncogene relationship bcl-2

t(14:18)
leads to inactivation of apoptosis gene on B cells leading to immortal cell and follicular B cell lymphoma

182

Grade of cancer

Well differentiated if you can tell what its origin is

Poorly differentiated if you cannot tell tissue of origin

183

Stage of caner

T=Tumor size
N=Nodal involvement
M=Metastasis

more important than grade

184

Squamous, adeno, or transitional tumor nomenclature

carcinoma

185

mesenchymal tumor nomenclature

sarcoma

186

Hamartoma

non-neoplastic proliferation of cells where they belong
(bronchial hamartoma, PJ polyp, hyperplastic polyp)

187

Choristoma

non-neoplastic normal tissue where it normally isn't (ie pancreatic tissue in stomach)

188

Mixed tumor

2 tissues from same cell layer (ie parotid salivary gland tumor)

189

Teratoma

Tissues from all cell layers

190

Increased AG metabolic acidosis

AG=Na-(Cl+HCO3)
(12 is normal)
adding an acid and the anion of the acid replaces the bicarb used to buffer the H+ (ie lactate, acetoacetate, B-hydroxybutyrate, phosphate/sulfate [renal failure], salicylate, formate [methanol poisoning], oxalate [ethylene glycol poisoning], acetate)

191

Normal AG metabolic acidosis

Losing bicarb and bicarb is replaced by an equal number of Cl anions

192

Acute transplant rejection

within 3 months
predominantly cellular immune reaction (type IV CD8)

193

Carcinogens causing transitional cell carcinoma of bladder, ureters, and renal pelvis

Aniline dyes
Benzidine
Cyclophosphamide
Phenacetin

194

Carcinogen causing angiosarcoma of the liver

Vinyl chloride

195

Carcinogen causing small cell carcinoma of the lung, squamous cancers of the oral cavity, esophagus, larynx, lung, and cervix. And Transitional carcinoma of bladder and adenocarcinoma of pancreas

Polycyclic hydrocarbons
(tobacco smoke)

Alcohol is a cocarcinogen for oral, esophageal and laryngeal cancers

196

Carcinogens causing lung cancerq

Chromium
Uranium (radon gas)

197

Carcinogen causing lung and nasal cavity cancer

Nickel

198

Carcinogen causing nasal cavity cancer

Woodworking

199

Carcinogen causing angiosarcoma of liver, and hepatocellular carcinoma

Thorotrast

200

Carcinogen causing angiosarcoma of liver, squamous carcinoma of skin, and lung cancer

Arsenic

201

Carcinogen causing liver cell adenomas, hepatocellular carcinoma

Oral contraceptives

202

Carcinogen causing hepatocellular carcinoma

Aflatoxins
(Aspergillus : cocarcinogen with HBV)

203

Carcinogen causing prostate cancer and lung cancer

Cadmium

204

Carcinogen causing verrucous carcinoma in mouth

Chewing tobacco

205

Carcinogen causing acute leukemia and malignant lymphoma

Alkylating agents

206

Carcinogen causing acute leukemia

Benzene

207

Carcinogen causing clear cell adenocarcinoma of cervix and vagina

DES exposure in utero

208

Carcinogen causing Esophageal and gastric cancers

Nitrosamines
(inhibited by ascorbic acid and refrigeration)

209

Carcinogen causing squamous carcinoma of the skin (scrotum in chimney sweeps)

Tars, soots, oils

210

Increased in acute/chronic inflammation and monoclonal gammopathies. Best initial screen for temporal arteritis, zero in HbSS disease and polycythemias

ESR

211

Lymph node most common metastasis and primary tumor

MC metastasis from breast

MC primary NHL

212

Lung most common metastasis and primary tumor

MC metastasis from breast

MC primary adenocarcinoma

213

Bone most common metastasis and primary tumor

MC metastasis from breast

MC primary Multiple myeloma

214

Liver most common metastasis and primary tumor

MC metastasis from lung

MC primary hepatocellular carcinoma

215

Adrenal most common metastasis and primary tumor

MC metastasis from lung

MC primary adenocarcinoma

216

Brain most common metastasis and primary tumor

MC metastasis from lung

MC primary glioblastoma multiforme

217

Have synergistic effect on producing cancers of the oral cavity, esophagus, and larynx

Smoking + alcohol

218

Birth control pills protect against

Gonorrhea

(not chlamydia or ovarian cancer)

219

CO poisoning

necrosis of the globus pallidus
Parkinson's; SaO2 decreased, PaO2 normal
L shift ODC
inhibit cytochrome oxidase

220

Respiratory acidosis

increase PaCO2, decrease PaO2 and SaO2

221

Normal PaO2 and SaO2 but decreased Hb

Anemia

222

Normal serum calcium/phosphate but deposits of calcium into damaged tissue, atherosclerotic plaques enzymatic fat necrosis, perivascular calcification in CMV

Dystrophic calcification

223

Increased serum calcium and/or phosphate with deposition of Ca in normal tissue.

Metastatic calcification

(nephrocalcinosis in primary hyperparathyroidism, calcification of basal ganglia in primary hypoparathyroidism)

224

Contain stem cells. Examples are bone marrow stem cells, stratum basalis of skin, and base of intestinal glands

Labile cells

225

Cells in Go phase and must be stimulated to go into G1 phase

Stable cells

Most parenchymal cells in organs, smooth muscle, and neuroglial cells

226

Cannot enter the cell cycle.

Permanent cells

Skeletal muscle, cardiac muscle, and neurons

227

Most common bone metastasized to

Vertebra

Due to Batson vertebral plexus which communicates with the vena cava

Decks in Evan's Step 1 Prep Material Class (72):