Hyguru

Question 1

Myasthenia Gravis is a type ___ hypersensitivity sd just as Good Pasture sd

Answer 1

II

Question 2

Bulbar sts (swallonging probs, ptosis, CN sts) + weakness worse at the end of the day + thymoma. Think of

Answer 2

Myasthenia Gravis

Question 3

Proximal limb weakness, absent Reflexes but incremental increase with activity. Paraneoplastic sd (small cell lung Ca, SIADH, Cushing). Think of

Answer 3

Lambart Eaton sd

Question 4

Weakness that improves with -stigmines (pyridostigmine) (AchE inh) Think of

Answer 4

Myasthenia Gravis

Question 5

NMJ damage are caused by

Answer 5

Myasthenia G
Lambart E
Organophosphates poisoning
Botulism

Question 6

UMN damage manifests as___
Can be caused by ___

Answer 6

-Hyperreflexia, babinsky [+], clonus, spasticity
-ALS, Vit B12 deficiency

Question 7

LMN damage manifests as___
Can be caused by ___

Answer 7

-Flaccidity, hypo or areflexia, fasciculations, severe musc atrophy
-Spinal musc atrophy, ALS (both UMN and LMN), Polio

Question 8

Schwann cells affected in Guillain Barre are derived from___

Answer 8

Neural Crest cells

Question 9

Organophosphates inhibit __ which causes __ to accumulate

Answer 9

AChE
ACh

Question 10

Child with Hypotonia and or constipation after eating honey, think of

Answer 10

Botulism (less ACh is released)

Question 11

Bulbous pemphigoid features

Answer 11

• Ab to Hemi-desmosome → basal layer
• Tense blisters = Nikolski (-)
• Pruritic
• No Oral involvement
• Linear IgG & C3 along
Dermal-epidermal junction (inmunofluorescence)

Question 12

Pemphigoid Vulgaris

Answer 12

• Ab to desmosome → intercellular connections
• Flaccid Blisters = Nikolski (+)
• Oral involvement (say vulgar things from mouth)
• Acantholysis (loss of intercellular connections)
• Reticular (net-like) pattern on IF

Question 13

Hemoptisis + hematuria + high DLCO and collagen type IV def. Think of __. Key fractures

Answer 13

Good Pasture’s sd
Type ll Hypersensitivity
Anti-GBM antibodies

Question 14

Hematuria (high Crea and CRP) + hemoptysis (bloody caugh). Possible causes

Answer 14

Good Pasteur’s (Type ll Hypersensitivity Anti-GBM antibodies )
Microscopic polyangitis (p-ANCA [+], precipitated by drugs/infection)
Granulomatous with polyangitis (Wegners) (c-ANCA [+], chronic sinositus

Question 15

Microscopic poliangitis vs Churg Strauss (both are p-ANCA [+])

Answer 15

Churg hast asthma + eosinophilia + granuloma
* Eosinophilic Granulomatosis with Polyangiitis (new name)

Question 16

Vesicular rash in a particular distribution. Think of

Answer 16

Herpes

Question 17

Vesicular rash on extensor surface + GI sts. Think of __ and on biopsy__
Tto__

Answer 17

-Dermatitis herpetiformis + celiac diasease
-Intra-intestinal epithelial lymphocytes
-diet modification

Question 18

Pathophysiology of Celiac diasease

Answer 18

• Gluten → Tissue transflutaminase → modifies gliadin → T-cells are activated by modified gliadin → crypt hyperplasia and villous atrophy

Question 19

Celiac disease Dg is made with

Answer 19

Anti-endomysial and Anti-IgA TTG

Question 20

IgA deficiency features

Answer 20

Synopulm diseases
Anaphylaxis to blood transfusion

Question 21

Type ll hyperactivity mec __ and examples

Answer 21

Antibodies attack own IgM and IgG
AIHA, Celiac disease

Question 22

Cold AIHA vs warm AIHA

Answer 22

Cold: antibodies to IgM
Warm: antibodies to igG

Question 23

Type lll hypersensitivity mec __
Examples__

Answer 23

Antigen-antibody complex deposition, C3 is consume/reduced
Serum sickness, PSGN, SLE nephritis

Question 24

Pt with recent exposure to medication (penicillins) presents with joint pain and low complement. Think of

Answer 24

Serum sickness

Question 25

Type IV hypersensitivity mec

Answer 25

Cell mediated * T cell response is delayed

Question 26

Type IV hypersensitivity mec

Answer 26

Cell mediated * T cell response is delayed

Question 27

Actinic keratoses (flaky, scaly rash) is a precursor to __

Answer 27

Squamous cell carcinoma of the skin

Question 28

Mec of 5- furiluracil and MTX on squamous cell carcinoma

Answer 28

Inhibition from dUMP to dTMP

Question 29

Squamous cell carcinoma affects upper or lower lip ?

Answer 29

Lower

Question 30

Ulceration (burn or chronic draining sinus) on lower lip, painless and non-healing. Biopsy shows keratin pearls and intercellular bridges. Think of

Answer 30

Actinic keratoses -> Squamous cell carcinoma

Question 31

Most common malign tumor is __ which usually affects __

Answer 31

Basal cell carcinoma Upper lip, sun exposed areas and inner canthus of eye

Question 32

Sunburn-like rash that waxes and wanes, fam history + skin atrophy on PE. Rapid enlarging nevi. Think of ___ due to

Answer 32

Pseroderma pigmentosum Failure in nucleotide excision repair

Question 33

Skin rash + dysplastic nevi with irregular border (ABCD) and on nailbed. BRAF mutation. Think of

Answer 33

Melanoma

Question 34

Melanoma can metastasize in

Answer 34

Brain Liver Lung

Question 35

Melanocytes are derived from

Answer 35

Neural crest

Question 36

Woman with weight loss + weakness + dizziness + more tan skin on certain areas. Think of ___ in which ___ is high and increasing__

Answer 36

Addison’s disease POMC ACTH, MSH, endorphins

Question 37

Precursor to melanin is __ and its precursor is

Answer 37

Tyrosine Phenylalanine

Question 38

Phenylalanine pathway conversion

Answer 38

Phenylalanine-> thyrosine->Dopa ->Dopamine-> NE -> epinephrine

Question 39

Musty body odor, think of

Answer 39

Phenylketonuria

Question 40

HLA-DR4 [+] think of

Answer 40

Rheumatoid arthritis

Question 41

Pathological mec of Rheumatoid arthritis

Answer 41

Synovium lined by infiltrating lymphocytesis -> CD4 -> TNF-a -> B cells -> RF -> binds IgG -> complement activation -> C5a > Pannus -> cytokines -> joint destruction

Question 42

___ causes ulnar deviation in RA which contains

Answer 42

Granulation tissue Blood vessels, fibroblasts and myofibroblasts

Question 44

RA systemic problems

Answer 44

-Rheumatoid nodules -Alopecia -Scleritis/episcleritis -Atlanto-axial instability -Pericarditis -Lung interstitial fibrosis

Question 45

RA + growth on back of knee. Think of

Answer 45

Baker’s cyst

Question 46

RA + Apple green BRF. Think of

Answer 46

AA amyloid

Question 47

Ankylosing spondylitis is class __ HLA positive

Answer 47

1

Question 48

Pencil-in -cup deformity + scaly rash bleeds, think of

Answer 48

Psoriatic arthritis

Question 49

Ankylosing spondylitis associations

Answer 49

Ant uveitis Restrictive lung disease Bamboo spine

Question 50

Prior infection + red eye + disurea + asymmetrical arthralgias, think of

Answer 50

Reactive Arthritis *”can’t see, can’t pee, can’t climb a tree”

Question 51

Rash on palms an soles are seen in

Answer 51

Meningococcus Kawasaki Coxackievirus A Rocky mountain spotted fever Secondary syphilis

Question 52

Mucositis + blood lines being affected, think of

Answer 52

Lupus

Question 53

Lupus renal disease and how what’s to be expected

Answer 53

• Membranous Glomerulonephropathy ("spike and dome") • Diffuse Proliferative Glomerulonephritis ("capillary wire loops") • Hypocomplementemia.

Question 54

C-ANCA [+], think of

Answer 54

Anti-Proteinase-3 Granulomatosis with polyangitis

Question 55

P-ANCA (+), think of

Answer 55

MPO EO-GPA, MPA, UC & PSC (onion-skinning, beading, associate with UC)

Question 56

Anti basement mb [+], think of

Answer 56

Good Pasteur’s sd

Question 57

Anti- B2 glycoprot [+], think of

Answer 57

Anti-phospholipid sd

Question 58

Anti-centromere (+), think of

Answer 58

CREST

Question 59

Anti-desmosome (+), think of

Answer 59

Pemphigus vulgaris

Question 60

Anti-endomysial [+], think of

Answer 60

Celiac disease

Question 61

Anti-Jo1 (+), think of

Answer 61

Polymyositis dermatomyositis

Question 62

Anti-topoisomerase (+), think of

Answer 62

Systemic scleroderma *(Scl-70)

Question 63

Anti-smooth muscle or Anti-LKM (+), think of

Answer 63

Autoimmune hepatitis

Question 64

Anti-VG Ca channels [+], think of

Answer 64

Lambert Eaton sd

Question 65

Anti-U1-RNP (+), think of

Answer 65

MCTD