Interesting Important Facts Flashcards
(83 cards)
1
Q
Where are PSAMMoma bodies found?
A
Papillary thyroid
Serous ovary
Meningioma
Mesothelioma
1
Q
Free nerve endings Meissner corpuscles Pacinian corpuscles Merkel discs Ruffini corpuscles
A
Pain, temperature
Dynamic, fine/light touch, position sense
Vibration, pressure
Pressure, deep static touch, position sense
Pressure, slippage of objects along surface of skin, joint angle change
2
Q
Causes of eosinophilia
A
Neoplasm Asthma Allergy Collagen vascular disease Parasites
3
Q
Mother is Rh- and has multiple Rh+ babies
A
Hemolytic disease of the newborn, erythroblastosis fetalis.
Attacks blood so extramedullary hematopoiesis
4
Q
Anti nuclear antibody
Anti-dsDNA, anti-smith
Anti-histone antibody
A
SLE nonspecific
SLE
Drug induced SLE
5
Q
Rheumatoid factor
Anti-CCP cytidine cyclic phosphate
A
Rheumatoid Arthritis
6
Q
Anti-centromere
Anti-Scl-70 (anti-DNA topoisomerase 1)
A
Scleroderma CREST syndrome
Scleroderma diffuse
7
Q
Anti mitochondrial
A
Primary biliary cirrhosis
8
Q
IgA antiendomysial
IgA anti-tissue transglutaminase
A
Celiac disease
9
Q
Anti basement membrane
A
Goodpasture’s syndrome
10
Q
Anti-desmoglein
A
Pemphigus vulgaris
11
Q
Antimicrosomal, antithyroglobulin
A
Hashimoto’s thyroiditis
12
Q
Anti Jo 1
Anti SRP
Anti Mi 2
A
Polymyositis, dermatomyositis
13
Q
Anti-SSA (anti-Ro)
Anti-SSB (anti-La)
A
Sjögren’s syndrome
14
Q
Anti-U1 RNP (ribonucleoprotein)
A
Mixed connective tissue disease
15
Q
Anti smooth muscle
A
Autoimmune hepatitis
16
Q
Anti-glutamate decarboxylase
A
Type 1 diabetes mellitus
17
Q
C-ANCA (PR3-ANCA)
A
Granulomatosis with polyangiitis (Wegener’s)
18
Q
P-ANCA (MPO-ANCA)
A
Microscopic polyangiitis, Churg-Strauss syndrome
19
Q
Surfactant producing cells
A
Type 2 pneumocytes
Clara cells, aka Club cells. These are also site for cytochrome p450 dependent mixed-function oxidase activity
20
Q
Schilling test
A
Determines cause of B12 deficiency
If low go to next stage.
Stage 1: give radio labeled b12 and normal b12 and collect urine for 24 hrs. High= dietary deficiency
Stage 2: give R b12 and oral IF. High=pernicious anemia
Stage 3: give R b12 and antibiotics. high=pernicious anemia
Stage 4: give R b12 and pancreatic enzyme. High=pancreatic insufficiency
Low=other causes like ileal resection
21
Q
Mallory bodies
A
Intracytoplasmic hyaline inclusions derived from cyto keratin intermediate filaments
Commonly seen in primary biliary cirrhosis, Wilson’s disease, chronic cholestatic syndromes, and hepatocellular tumors
22
Q
Pyknosis, karyolysis, karyorrhexis
A
Pyk: nuclear condensation
Karyorrhexis: fragmentation
Karyolysis: dissolution
23
Q
How much is 1U of blood?
A
About 3% increase of hematocrit
24
SIRS criteria
Sepsis needs 2 or more
- Wbc count: 12000 or band>10%
- Heart rate>100
- RR>20 or PCO238 (100.4)
25
Menopause causes what and what causes menopause
```
Menopause causes: HAVOC
-hot flashes
-atrophy of the vagina
-osteoporosis
-coronary artery disease
Causes of meno:
Cessation of estrogen production because of a loss of ovarian sensativity to gonadotropin stimulation caused by decreased ovarian follicles and ovarian dysfunction
```
26
Sources of estrogen and potency
Ovary-estradiol
Placenta-estriol
Adipose-estrone
Estradiol>estrone>estriol
27
Anion gap equation
Na-(Cl+HCO3)
Normal anion gap 8-12 mEq/L
29
Cancer markers and association
```
AFP in Hepatocellular carcinoma
CA 27.29 in Breast cancer
CA 19.9 in pancreatic cancer
CEA in colon cancer
PSA in prostate cancer
```
30
Tumor Lysis Syndrome
Sxs: Acute renal failure, HYPERphosphotemia, HYPOcalcemia, Metabolic acidosis. Prevented with the use of allopurinol (axanthine oxidase inhibitor)
31
In Metabolic acidosis with respiratory compensation you need to look at the Anoin gap
Normal: HARD ASS
Increased: MUDPILES
32
HARDASS
```
Hyperalimentation
Addison's Disease
Renal Tubular Acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline
```
33
MUDPILES
```
Methanol (formic Acid)
Uremia
Diabetic Ketoacidosis
Propylene Glycol
Iron tablets or Isoniazid
Lactic Acidosis
Ethylen glycol (oxalic acid)
Salicylates (late)
```
34
From birth to ovulation, in what phase remains the oocyte
Prophase 1
35
Beta hCG is similar to what other hormones
TSH, FSH and LH
All share the same alpha subunit. It's their beta subunit that confirms specific functionality
36
VIPoma
Rare, commonly in tail of pancreas.
Causes relaxation of intestinal muscles, increased secretion of water and electrolytes: diarrhea, hypokalemia, hypochlorhydria (achlorhydria)
37
Mittelschmerz
Woman suddenly develops abdominal pain in middle of menstraul cycle but everything points away from pregnancy.
- this is unilateral pain, due to bleeding from rupture of mature follicle
38
Serum osmolality
=2xNa +BUN/3+glucose/20
Rough estimate mOsm/kg
39
Causes for kidney stone formation
Increased urinary calcium- increased pth, immobilization, absorptive or renal hypercalciuria
Increased urinary oxalate-inflammatory bowel disease, small bowel resection
Increased uric acid excretion-hyperuricemia, gout
Abnormal urine pH
Urinary tract infection- urea splitters
40
Causes of pancytopenia
Decreased production: aphasia, dysplasia (b12/folate), infiltration (leukemia, lymphoma, myeloma, fibrosis or metastasis)
Sequestration (hypersplenism)
Increased destruction: immune or nonimmune
41
Drugs that cause aplastic anemia
```
Chloramphenicol
Phenylbutazone
Gold salts
Sulfonamides
Phenytoin
Carbamazepine
Quinacrine
Tolbutamide
```
42
Dry tap for bone marrow biopsy
Hairy cell leukemia
Aplastic anemia
Myelofibrosis
43
What is myelodysplasia?
Group of disorders broadly characterized by cytopenias(anemia, thrombocytopenia, neutropenia) associated with a dysmorphism or abnormal appearing and usually cellular bone marrow
"Old fart disease"
Epigenetic modifacation, chemo, genetics
44
Renal clearance equation
Urine concentration x urine flow rate
-------—--------------------------------- ml/min
Plasma concentration
45
Filtered load equation
GFR x plasma concentration. mg/min
46
Renal plasma flow equation
Urine concentration x urine flow rate/ renal arterial concentration
47
Filtered fraction equation
GFR/RPF
48
Diabetes Mellitus Presentation
Polydipsia, Polyphagia, Lethargy, Stupor
Blurred vision, acetone breath, weight loss, Kussmal breathing (hyperventilation), Nausea, vomiting, Abdominal pain
Polyuria, Glycosuria
49
Risk factors for suicide (require hospitalization)
```
Male
Age(teens and elderly)
Depression
Previous attempts
Alcohol and drugs
Sickness
Organized plans
No spouse (single, widow, divorce)
Social support lacking
```
50
Type 1 error
False positive error.
Rejecting null hypothesis incorrectly
*you saw a difference that did not exist
51
Type 2 error
False negative error
Null hypothesis is not rejected when it should be
*blind to the truth
Increase the sample size to decrease this error
52
Test results for prediabetes
* higher values=Diabetes
* lower vales=Normal
A1C: 5.7-6.4
Fasting Plasma Glucose: 100-125
Oral Glucose Tolerance Test: 140-199
53
GFR Calculations
*Can assume Creatinine Clearance is equivalent
**the real equation is:
GFR=((140-AGE)(Kg))/(SCr x 72)
54
Pre-Renal vs Renal vs Post renal
Prerenal: volume contraction due to blood or ECF fluid loss
Renal: Ischemic renal injury due to trauma or toxic renal injury due to anesthesia
Postrenal: retroperitoneal hemorrhage, clots in the bladder causing outlet obstruction
55
Narcolepsy has a deficiency of what...
Hallucination before sleeping is called...
Hallucination after sleeping is called...
Orexin produced in lateral hypothalamus
Hypnagogic
Hypnopompic
56
Deficiencies of these hormones cause what?
Acetylcholine
Dopamine
Epinephrine/norepinephrine
Alzheimer's
Parkinson's
Depression
57
Transference vs countertransference
T: patient projects feelings about someone else on to the doctor
CT: doctor projects feelings about someone else on to the patient
58
Clinical reflexes
S1-2 Achilles reflex
L3-4 patellar reflex
C5-6 biceps reflex
C7-8 triceps reflex
L1-2 cremaster reflex
S3-4 anal wink reflex
59
Seminoma
Malignant, painless homogenous testicular enlargement. most common testicular tumor, most common in third decade,
Large cells in lobules with watery cytoplasm and fried egg appearance. Increased AFP. Excellent prognosis.
60
Yolk sac tumor
Yellow, mucinous, aggressive malignancy, Schiller Duvall bodies resemble primitive glomeruli
Increased AFP.
Most common in 3 yr olds
61
Choriocarcinoma
Malignant, disordered syncytiotrophoblastic and cytotrophoblastc elements. Hematogenous metastasis to brain and lungs. (May present with hemorrhagic stroke due to bleeding into metastasis)
Gynecomastia, sxs of hyperthyroidism ( hCG similar to TSH, LH, FSH)
Increased hCG
62
Embryonal carcinoma
Malignant, hemorrhagic mass with necrosis, painful, worse prognosis than Seminoma. Often glandular or papillary morphology, Pure embryonal carcinoma is rare. most commonly mixed with other tumor types
May have increased hCG, and normal AFP when pure. Increased AFP levels When mixed
63
Cremaster muscle derived from what abdominal muscle
Internal oblique
64
```
Mutations in these proteins cause what?
Alpha synuclein
Dystrophin
Huntingtin
Presenilin
Tau
```
```
Parkinson's
Duchene muscular dystrophy
Huntingtons
Alzheimers
Frontotemporal dementia with Parkinsonism (AD, picks, palsy)
```
65
Rheumatic Fever
comes from pharyngeal infection with Group A Beta hemolytic strept.
- Affects Mitral>aortic>>>tricuspid
- Associated with Aschoff Bodies (granuloma with giant cells), Anitschkow cells (enlarged macrophages with ovoid, wavy, rod-like nucleus)
- Immune mediated Type 2 HS, Ab to M protein cross react with self antigens
* *Joint (migratory ppolyarthritis)
* *Carditis
* *Nodules in skin (subcutaneous)
* *Erythema marginatum
* *Sydenham Chorea
66
Anti Hemidesmosomes
Bullous Pemphigoid
| *Nikolsky sign in Negative (separation of epidermis upon manual stroking of skin doesnt happen)
67
Anti Desmoglein
Pemphigus Vulgaris
*Nikolsky sign is positive
(Desmosomes attacked)
68
Dermatitis herpetiformis
IgA deposits at tips of dermal papillae. Associated with celiac disease. Pruritis papules, vescicles, and bullae (usually at elblows)
69
I Cell Disease
Inherited Lysosomal storage disorder. Defect in N acetylglucosaminyl-1-phosphotranferase. Mannose residues not phosphorylated by Golgi apparatus. this causes it to be exocytosed instead of broken down.
*course facial features, clouded corneas, restricted joint ovement, high plasma levels of lysosomal enzymes. Often fatal
70
Chvostek's Signs
facial twitch due to hypocalcemia
71
cluster headaches
Unilateral
last 15min-3 hours, repetative
*Excruciating periorbital pain with lacrimation and rhinorrhea. May induce horner syndrome (ptosis), more common in males
Treat with O2 therapy. Sumatriptan
72
Tension Headaches
Bilateral
>30min, constant, 4-6hrs
*Steady pain, no photophobia or phonophobia or auras
Tx: Analgesics, NSAIDS, Acetaminophen. Amitrptyline for chronic pain
73
Migraine
Unilateral
4-72 hrs
*pulsating pain with nausea, photophobia, phonophobia, aura.
**Due to irritation of CN 5, meninges, Blood vessels, p Calcitonin gene
Tx: Abortive therapies: Sumatriptan, NSAIDS, Prophylaxis: Propranolol, topiramide, Ca channel blockers, amitriptyline
74
Migraine
Unilateral
4-72 hrs
*pulsating pain with nausea, photophobia, phonophobia, aura.
**Due to irritation of CN 5, meninges, Blood vessels, p Calcitonin gene
Tx: Abortive therapies: Sumatriptan, NSAIDS, Prophylaxis: Propranolol, topiramide, Ca channel blockers, amitriptyline
75
Myasthenia Gravis
Most common NMJ disorder.
Ab to postsynaptic AChR
*Ptosis, diplopia, weakness, worsens with use
*Associated with Thymoma, Thymic hyperplasia
Tx: Give AChR inhibitor to reverse Sxs
76
Lamber Eaton Myasthenic Syndrome
Ab against Ca Channles on Presynaptic terminal= Decreased ACh release
* Proximal muscle weakness, autonomic SXS(dry mouth, impotence)
* Associated with Small Cell Lung Cancer
77
SLE
| RASH OR PAIN
```
Rash (malar or discoid)
Arthritis
Soft tissue/Serositis
Hematologic disorders (cytopenias)
Oral/nasopharyngeal ulcers
Renal Disease, Raynaud Phen.
Photosensativity, +VDRL/RPR
ANA
Immunosuppresants
Neurologic Disorders (Seizures, psychosis)
```
78
SLE Presentation
Rash, joint pain, fever, most commonly fertile female, african descent.
* Libman Sacks endocarditis- nonbacterial, wartlike vegetations on both sides of valve
* *Nephritic: Diffuse proliferative glomerulonephritis
* *Nephrotic: Membranous Glomerulonephritis
79
Antimicrosomal Antibody
Hashimoto Thyroiditis
80
Trisomy 13
Patau's syndrome
| Cleft lip, microphthalmia, mental retardation, polydactyly, Congential Heart disease, renal defects
81
Trisomy 18
Edward's syndrome
Severe mental retardation, micrognathia, low set ears, congenital heart defects, limited hip abduction and rocker bottom feet
82
Deletion of 11p13
Wilm's tumor and aniridia and Genital anomalies and mental retardation
*Wilms=most common childhood renal tumor and 4th most common pediatriac malignancy in US
83
Deletion of 5p
Cri-Du-Chat syndrome
| cry sounds like meowing kitten, microcephaly, mental retardation, epicanthal folds, and cardiac defects
