Key Associations Flashcards
(494 cards)
1
Q
Acute gastric ulcer assoc. w/ CNS injury
A
Cushing ulcer
increased ICP stimulates vagal gastric H+ secretion
2
Q
Acute gastric ulcer assoc. w/ severe burns
A
Curling ulcer
-Greatly reduce plasma volume results in sloughing of gastric mucosa
3
Q
Alternating areas of transmural inflammation and normal colon
A
Skip lesions
-Crohn’s disease
4
Q
Aortic aneurysm, abdominal
A
Atherosclerosis
5
Q
Aortic aneurysm, ascending arch
A
Tertiary syphilis
-Occurs due to obliteration of the vasa vasorum
6
Q
Aortic aneurysm, thoracic
A
Marfan syndrome
-Assoc. w/ cystic medial degeneration
7
Q
Atrophy of the mammillary bodies
A
Wernick encephalopathy (thiamine deficiency causing ataxia, opthalmoplegia, confusion, and confabulation)
8
Q
Autosplenectomy (fibrosis and shrinkage)
A
SCD
9
Q
Bacteri assoc. w/ gastritis, PUD, and stomach cancer
A
H. pylori
10
Q
Bacterial meningitis (adults and elderly)
A
S. pneumoniae
11
Q
Bacterial meningitis (newborns and kids)
A
S. agalactiae, E. coli
N. meningitidis in teens
12
Q
Bilateral ovarian metastases from gastric carcinoma
A
Krukenberg tumor
-Mucin-secreting signet ring cells
13
Q
Bleeding disorder w/ GpIB deficiency
A
Bernard-Soulier syndrome
-Defect in platelet adhesion to vWF; will see giant platelets
14
Q
Brain tumor (Adults)
A
Supratentorial: Glioblastoma multiforme (MCC), meningioma, schwannoma
15
Q
Brain tumor (kids)
A
Infratentorial: Medulloblastoma (MCC)
Supratentorial: Craniopharyngioma
16
Q
Breast Cancer
A
Invasive ductal carcinoma
17
Q
Breast Mass
A
Think Fibrocystic change
or
Carcinoma in postmenopausal women
18
Q
Cardiac primary tumor (in kids)
A
Rhabdomyoma (seen in tuberous sclerosis)
19
Q
Cardiac manifestation of lupus
A
Marantic/thrombotic endocarditis on both sides of valve
“Liberman-Sachs endocarditis”
20
Q
Cardiac tumor (adults)
A
Metastasis
or
Myxoma (“ball and valve” in LA)
21
Q
Cerebellar tonsillar herniation
A
Chiari II malformation
22
Q
Chronic arrhythmia
A
A-fib
-high risk of cardiac emboli
23
Q
Chronic atrophic gastritis (AI)
A
Predisposition to gastric carcinoma
-Can also cause pernicious anemia
24
Q
Clear cell adenocarcinoma of the vagina
A
DES exposure in utero
25
Congenital adrenal hyperplasia, hypotension
21-hydroxylase deficiency
26
Congenital cardiac anomaly
VSD (MCC)
27
Congenital conjugated hyperbilirubinemia (black liver)
Dubin-Johnson syndrome (inability of hepatocytes to excrete conjugated bilirubin into bile)
28
Constrictive pericarditis
TB (developing world)
Viral illness (developed world)
29
Coronary artery involved in thrombosis
LAD > RCA > L. circumflex
30
Cretinism
Iodine deficient/congenital hypothyroidism
31
Cushing syndrome
Iatrogenic (corticosteroid therapy)
Adrenocortical adenoma
ACTH-secreting pituitary adenoma
Paraneoplastic (ACTH secretion by tumors like SCC of lung)
32
Cyanosis (early; less common)
TOR, transposition of the great vessels truncus arteriosus
33
Cyanosis (late; more common)
VSD, ASD, PDA
34
Death in CML
Blast crisis
35
Death in SLE
Lupus nephropathy
36
Dementia
Alzheimer's disease
Vascular dementia (multiple infarcts)
37
Demyelinating disease in young women
MS
38
DIC
Severe sepsis
Obstetric complications
Cancer
Burns
Trauma
Major surgery
39
Dietary deficit
Iron
40
Diverticulum in pharynx
Zenker diverticulum
-diagnosed by barium swallow
41
Ejection click
Aortic stenosis
42
Esophageal cancer
SCC
Adenocarcinoma in murica
43
Food poisoning (via exotoxins)
S. aureus
B. cereus
44
Glomerulonephritis (adults)
Berger disease (IgA nephropathy)
45
Gynecologic malignancy
Endometrial carcinoma (MCC in US)
Cervical carcinoma (worldwide)
46
Congenital heart murmur
Mitral valve prolapse
47
Heart valve in bacterial endocarditis
Mitral>Aortic (RF)
Tricuspid (IV drugs)
48
Helminth infection in the US
Enterobius vermicularis
Ascaris lumbricoides
49
Epidural hematoma
Rupture of MMA from trauma
-"Lentiform shaped"
50
Subdural hematoma
Rupture of bridging veins in old person w/ cortical atrophy
-"Crescent shaped"
51
Hemochromatosis
Multiple blood transfusions or HFE mutation
| =>> can result in HF, yellow diabetes, and increased risk of hepatocellular carcinoma)
52
Hepatocellular carcinoma
Cirrhotic liver
-assoc. w/ HBV, HCV, alcoholism)
53
Hereditary bleeding disorder
von Willebrand disease
54
Hereditary harmless jaundice
Gilbert syndrome
-benign congenital unconjugated hyperbilirubinemia)
55
HLA-B27
Psoriatic arthritis
Ankylosing spondylitis
IBD (UC)
Reactive arthritis
56
HLA-DR3
DM Type I
SLE
Grave's disease
Hashimoto's thyroiditis
57
HLA-DR4
DM Type I
RA
58
Holosystolic murmur
VSD
Tricuspid regurgitation
Mitral regurgitation
59
Hypercoagulability, endothelial damage, blood stasis
Virchow triad
*increased risk of thrombosis
60
Secondary HTN
Renal artery stenosis
61
Hypoparathyroidism
Accidental excision during thyroidectomy
62
Hypopituitarism
Pituitary adenoma (usually a benign tumor)
63
Infection due to blood transfusion
HCV
64
Infections in CGD
S. aureus
E. coli
Aspergillus
***Catalase (+)
65
Intellectual disability
Down's Syndrome
Fragile-X Syndrome
66
Actinic kertosis
Precursor to SCC
67
Kidney stones (different types)
Calcium= radioopaque
Struvite (ammonium)= radioopaque (formed by urease pos organisms such as Klebsiella, Proteus, and Staph. saprophyticus)
Uric acid= radiolucent
68
Late cyanotic shunt (uncorrected left-right becomes right-left)
Eisenmeger syndrome; caused by chronic ASD, VSD, PDA
=>>pulmonary hypertension/polycythemia
69
Liver disease
Alcoholic cirrhosis
70
Lysosomal storage disease
Gaucher's disease
71
Male cancer
Prostatic carcinoma
72
Malignancy assoc. w/ noninfectious fever
Hodgkin's lymphoma
73
Malignancy (kids)
ALL, medulloblastoma (cerebellum)
74
Metastases to bone
Prostate, breast > lung > thyroid
"BLT and a Kosher Pickle"
75
Metastases to brain
Lung > Breast > Genitourinary > Melanoma > GI
76
Metastases to liver
Colon >> Stomach, pancreas
77
Mitochondrial inheritance
Disease occurs in both males and females, inherited thru females only
78
Mitral valve stenosis
Rheumatic heart disease
79
Mixed (UMN and LMN) motor neuron disease
ALS
80
Myocarditis
Coxsackie B virus
81
Nephortic syndrome
Focal segmental glomerulosclerosis
82
Nephrotic syndrome (kids)
Minimal change disease
83
Neuron migration failure
Kallman Syndrome
-hypogonadotropic hypogonadism and anosmia
84
Nosocomial pneumonia
Staph. aureus
Pseudomonas
Enteric GNRs
85
Obstruction of male urinary tract
BPH
86
Opening snap
Mitral stenosis
87
Opportunistic infxn in AIDS
PCP
88
Osteomyelitis
Staph. aureus (MCC overall)
89
Osteomyelitis in SCD
Salmonella paratyphi
90
Osteomyelitis w/ IV drug abuse
Pseudomonas
Candida
Staph. aureus
91
Ovarian tumor (benign, bilateral)
Serous cystadenoma
92
Ovarian tumor (malignant)
Serous cystadenocarcinoma
93
Pancreatitis (acute)
Gallstones, alcohol
94
Pancreatitis (chronic)
Alcohol (adults)
CF (kids)
95
Pt. w/ ALL/CLL/AML/CML
ALL = child
CLL= Adult > 60
AML = Adult
CML= Adult >50
96
Pelvic inflammatory disease
C. trachomatis or N. gonorrhoeae
97
Philadelphia Chromosome
t(9;22) (BCR-ABL)
CML; occasionally AML
98
Pituitary tumor
Prolactinoma, somatotropic adenoma
99
Primary amenorrhea
Turner Syndrome; 45, XO
100
Primary bone tumor (adults)
MM
101
Primary hyperaldosteronism
Conn's syndrome
-Adenoma of adrenal cortex
102
Primary hyperthyroidism
Adenomas, hyperplasia, carcinoma, PTHrP assoc. w/ SCC of lung
103
Primary liver cancer
Hepatocelllular carcinoma
-could be assoc. w/ chronic hepatitis, cirrhosis, Wilson's disease, hemochromatosis, a1-antitrypsin deficiency
104
Pulmonary HTN
COPD
105
Recurrent inflammation/thrombosis of small/medium vessels in extremities
Buerger disease (strong assoc. w/ tobacco use)
106
Renal tumor
Renal cell carcinoma; assoc. w/ von-Hippel Lindau and cigarette smoking
-Paraneoplastic syndromes could increase EPO, renin, PTHrP, ACTH and cause as well
107
Right heart failure due to a pulmonary cause
Cor pulmonale
108
s3 heart sound
Increased ventricular filling pressure
-Common in dilated ventricles, mitral regurgitation, HF
109
s4 heart sound
Stiff/hypertrophic ventricle
-Aortic stenosis, restrictive cardiomyopathy
110
Secondary hyperparathyroidism
Hypocalcemia of chronic kidney disease
111
STD
Chlamydia trachomatis, usually coinfxn w/ N. gonnorhoeae
112
SIADH
Small cell carcinoma of the lung
113
Site of diverticula
Sigmoid colon
114
Sites of atherosclerosis
Abdominal aorta > Coronary artery > Popliteal artery > Carotid artery > Circle of Willis
115
Stomach cancer
Adenocarcinoma
116
Stomach ulcerations and high gastrin levels
Zollinger-Ellison syndrome (gastrinoma of the duodenum or pancreas)
117
t (14;18)
Follicular lymphoma
*BCL-2 activation causing mitochondrial membrane stability and acts as an anti-apoptotic oncogene
118
t(8;14)
Burkitt's Lymphoma
-c-myc fusion is a transcription factor oncogene
119
Temporal arteritis
Risk of ipsilateral blindness due to occlusion of ophthalmic artery
-assoc. w/ polymyalgia rheumatica
120
Testicular cancer
Seminoma (malignant, radiosensitive)
121
Thyroid cancer
Papillary carcinoma
122
Tumor in women
Leiomyoma
-estrogen dependent; not precancerous tho
123
Tumor of adrenal medulla (adults)
Pheochromocytoma (usually benign)
124
Tumor of infancy
Strawberry hemangioma
-grows at first then spontaneously regresses)
125
Tumor of the adrenal medulla (kids)
Neuroblastoma (malignant)
126
Type of Hodgkin lymphoma
Nodular sclerosis = MCC
Lymphocyte depletion = Poorest prognosis
127
UTI
E. coli
Staph. saprophyticus (young women)
128
Vertebral compression fracture
Osteoporosis (Type 1: postmenopausal woman; Type II: elderly man or woman)
129
Viral encephalitis affecting the temporal lobe
HSV-1
130
Vitamin deficiency (U.S.)
Folate
-pregnant women are at high risk; body stores only 3-4 months supply; supplementation required to prevent neural tube defects
131
Increased homocysteine
Damages the endothelium producing thrombosis
- Can be caused by decreased B12 or Folate
* Methyl group path: Folate =>> B12 =>> Homocysteine (converts it to methionine)
132
Cystathionine Beta Synthase deficiency
Homocystinuria; decreased conversion of homocysteine to cystathionine
Clinical: Thrombosis, MR, lens dislocation, long, slender fingers
-And crystals in urine
133
CRC
Rc x Hct/45
CRC > 3% = good response to anemia
134
VSD baby
Fetal alcohol syndrome
135
ASD
Assoc. w/ Down syndrome
136
PDA
Assoc. w/ congenital rubella
137
Transposition of the great vessels
Assoc. w/ maternal diabetes (although usually doesn't happen)
-Maintain PDA until surgery is possible
138
Coarction of the Aorta
congenital assoc. w/ Turner Syndrome
Adult form occurs AFTER the ligamentum arteriosum BUT leads to notched ribs due to development of collateral vessels
*Also assoc. w/ bicuspid aortic valve
139
Wilm's tumor (3 syndromes)
```
WAGR syndrome (Wilm's, aniridia, genital abnormalities, motor Retardation)
-WT1 deletion
```
Denyrs-drash syndrome (Wilm's, male ️Pseudohermaphroditism)
-WT1 mutation
```
Beckwith Wiedemann (Wilm's, muscular hemihypertrophy, organomegaly (tongue)
-WT2 mutation
```
140
Maternal alcohol
MCC of mental retardation in newborn
Facial abnormalities and microcephaly
VSD
Fetal alcohol syndrome
141
Maternal cocaine use effects
Intrauterine growth retardation
Placental Abruption
142
Isotretinoin effects on baby
Spontaneous abortion
Hearing and visual defects
143
Phenytoin effects on newborn
Digit hypoplasia
Cleft lip/palate
144
Mononuclear germinal centers in the thyroid gland
Hashimoto's thyroiditis
145
anti-TPO
Hashimoto's thyroiditis
146
Schizophreniform disorder
Psychotic episode that lasts 1-6 months
147
Cyclothymic disorder
Dysthymia and hypomania lasting at least 2 years
Basically like a mild bipolar type II
148
Dysthymia
Persistent Depressive Disorder= depression lasting at least 2 years
149
Hypomanic episode
Similar to a manic episode but does not cause serious impairment in social or occupational fnxn
-Lasts about a week
```
Distracted
Irresponsible
Grandiose
Flight of Ideas
Activity (increased)
Sleep (decreased)
Talkative
```
150
Schizoid Personality (Type A)
Voluntary social withdrawal
Limited emotional expression
Content with social isolation
-Lack of any psychosis differentiates from true schizophrenia
151
Shizotypal Personality Disorder (Type A)
Eccentric appearance
Odd beliefs
Magical thinking
Interpersonal awkwardness
-Lack of any true psychosis differentiates from schizophrenia
152
Histrionic Personality Disorder (Type B)
Excessive emotionality and excitability
Attention seeking
Sexually provocative
Overly concerned w/ appearance
153
Obsessive-Compulsive Personality Disorder (Type C)
Preoccupation w/ order, perfectionism, and control
-Behavior is consistent w/ ones own beliefs and attitudes which differentiates it from tru OCD
154
Burnt sugar diapers
Maple syrup urine disease; defective a-keto acid dehydrogenase causes defective breakdown of leucine, isoleucine, and valine
-Causes life-threatening neurotoxicity
⭐️Diet should restrict these 3 branches AA's
155
Protein w/ a mannose-6-phosphate tag
Targets the protein for transport to the lysosomes
156
I-cell disease
| inclusion cell disease
Failure of golgi to phosphorylate mannose residues causing excess proteins to be secreted extracellularly
Clinical: Coarse facial features
Clouded cornea
Stiff joints
-fatal in childhood
157
Peroxisome
Catabolism of long chain FAs, branched FAs, and AAs
158
Collagen Types
I: Bone, skin, tendon, scar, cornea
II: Cartilage, nucleus pulposus, vitreous body
III: Skin, blood vessels, granulation tissue
IV: BM, lens
159
Collagen synthesis
1. Collagen translated to Gly-X-Y (proline and lysine)
2. Proline and lysine residues hydroxylated
* **REQUIRES ASCORBIC ACID***
3. Procollagen formed via H2 and S2 bonds (forms the triple helix; problems cause osteogenesis imperfecta)
4. Exoctyosis
5. S2 region cleaved making insoluble tropocollagen
6. Lysyl oxidase cross-links lysine-hydroxylysin
* **REQUIRES CU2+***
- Problems here cause Ehlers-Danlos or Menkes
160
Menkes Disease
X-linked disorder cause by defective copper absorption and transport
Clinical: Brittle hair
Growth retardation
Hypotonia
-Impaired lysyl oxidase fnxn
161
McCune-Albright Syndromme
Cafe-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, endocrine abnormalities
- Due to mutations in G-protein signaling
- Lethal if a germline mutation occurs; survivable if somatic
162
X-linked Dominant Disorder
Hypophosphatemic Rickets
-Increased phosphate wasting; presents just like Rickets
163
Telangectasias, Recurrent epistaxis, skin discolorations, hematuria, GI bleeding, AV-malformations
Osler-Weber-Rendau Syndrome
AD disease
164
Hereditary Spherocytosis tx
Splenectomy
Fun fact: This is an AD disease
165
Cafe-au-lait spots, cutaneous neurofibromas, pheochromoytomas, Lisch nodules (pigmented iris lesions)
NFT 1
AD mutation on Chromosome 17
166
Juvenile cataracts, meningiomas, ependyomas, bilateral acoustic schwannomas
NFT-2
AD mutation on chromosome 22
167
Frontal balding, cataracts, muscle wasting, testicular atrophy
Myotonic dystrophy
AD disorder; CTG repeat
168
Intellectual disability, friendliness w/ strangers, "eflin" facies, hypercalcemia
William's Syndrome
-Microdeletion on chromosome 7
169
Meconium ileus in a newborn
CF
170
a-blocker for PTSD
Prazosin
171
Necrolysis migratory erythema
Glucagonoma, lesions leave a bronze-colored, central Indurated area with peripheral blistering
-also presents as DM, diarrhea, abdominal pain,
172
Sonic hedgehog gene mutations
Holoprosencephaly
173
Hox Gene mutations
Limbs/appendages in wrong locations
"Homebox" genes normally encode for transcription factors
174
Gubernaculum remnants in adults
Male ➡️ anchors testes to the scrotum
Female ➡️ Ovarian ligament and the round ligament of the uterus (travels thru the Inguinal canal)
175
Infundibulopelvic ligament
Suspensory ligament of the ovary
Contains the ovarian vessels
176
SpeA
S. PYOGENES VF that is responsible for toxic-shock like syndrome
177
SpeB
S. Pyogenes VF that is responsible for necrotizing fasciitis
178
Theca-luteum cysts
Assoc. W/ hydatiform moles
179
Eczematous patch on the Breast
Paget's disease
The actual Paget cells are clear cells found in the epidermis
180
Bilateral Breast cancer
Invasive lobular carcinoma
Invade in a single file fashion due to decreased e-cadherins
181
MCC of testicular Cancer in old men
Testicular lymphoma
182
Hemorrhagic testicular tumor
Embryonal carcinoma; may see increased hCG and AFP
183
Increased placental ALP
Seminoma
184
Increased placental ALP
Seminoma
185
Milrinone
PDE-3 inhibitor used to increase cAMP levels causing increased inotropy and systemic Vasodilation
-Can produce severe hypotension
186
Sign of severity of mitral regurgitation
Presence of an S3
187
Sign of aortic stenosis severity
LVP: aortic pressure gradient disparity
- Would increase the crescendo-decreasendo length
188
Location of the SA node
Where the SVC enters the right atrium
| Sinus venarum
189
Location of the AV node
The coronary sinus
-Is also the location where the cardiac veins drain and found near the interatrial septum
190
Location of direct inguinal hernias
Hesselbach's triangle; gut herniated directly thru the Transversalis fascia (floor)
191
First area with loss of fnxn in Alzheimers
Hippocampus
192
First area with loss of fnxn in Alzheimers
Hippocampus
193
Herpes lesion on tip of nose
Hutchinsons sign; important because there's a high likelihood of corneal involvement
-Treat it ya dingus
194
Syringomyelia
Arnold-Chiari II malformations
195
Lateral medullary syndrome
Vomiting, nystagmus, loss of facial pain and temp sensation, dysphagia, loss of gag reflex,
⭐️Occurs due to damage to PICA
⭐️Nucleus ambiguus differentiates this syndrome
196
Middle 1/3 of the crus cerebri
Corticospinal fibers
197
Multinucleated giant cells in the CNS
HIV infxn
198
Microglia embryologic origin
Mesoderm
199
Possible cause of tibial nerve injury
Baker's cyst
-Loss of inversion of foot and toe flexion
200
P-bodies
Partake in decapping mRNA, degrading it, and storing it
201
Trousseau syndrome tumors
Adenocarcinoma of the lung
Pancreatic carcinoma
Colon cancer
202
Age distribution of osteosarcome
Bimodal (10-20 yrs; >65)
Arises in metaphysis, assoc. With PAGET's, retinoblastoma, and Li-fraumeni
203
anti-dsDNA antibodies
Specific for lupus
-Extra bad tho cuz it means you probs have renal disease
204
Pain, stiffness in the shoulders and hips; fever, malaise, weight loss, temporal Arteritis
Polymyalgia rheumatica
Will see increased inflammatory markers
Tx: corticosteroids
205
Widespread musculoskeletal pain in a woman with stiffness, poor sleep, fatigue
Fibromyalgia
Tx: TCAs, SNRIs, exercise
206
Anti-SRP, anti-Mi-2, anti-Jo
Polymyositis (endomysial w/ cd8)
Dermatomyositis (perimysial w/ cd4)
207
Increased stratum spinosum
Psoriasis; also has Acanthosis with Parakeratosis
-Pitting of nails other sign you usually forget
208
Rash with well-defined demarcations; usually on the face
Erisypelas; infxn of upper dermis and superficial Lymphatics by S. Pyogenes
209
Yellow, Crusty rash
Impetigo; infxn only involves the epidermis
S. Aureus or s. Pyogenes
210
Possible causes of Acanthosis nigricans
Insulin resistance (hyperglycemia, increased FFAs)
Visceral malignancy (gastric adenocarcinoma usually)
211
Neonatal conjunctivitis in 2-3 days
Neisseria gonorrhea
212
Neonatal conjunctivitis in 1 week
Chlamydia Trachomatis
Tx: ORAL Azithromycin
213
Leading cause of blindness
Endemic trachoma cause by Chlamydia Trachomatis Serotypes A-C
214
Corrosive esophagitis
Bisphosphonates
-Could also cause osteonecrosis of the jaw
215
Pearson correlation coefficient
Examines the linear relationship between two variables
Ex: Relationship between hba1c and blood glucose
216
Belligerence, vertical nystagmus, disorientation, poor judgment, memory loss
PCP use
⭐️Primarily an NMDA RECEPTOR ANTAGONIST
217
Site of injection for a femoral nerve block
The Inguinal crease
-Remember that this nerve does not actually enter the femoral ring and is not included in the femoral sheath in the thigh
218
Cushing triad
Hypertension, bradycardia, bradypnea
⭐️Sign of Increased ICP
-Possible herniation
219
Prostatic nerve plexus
Gives rise to the cavernous nerves that parasympathetically mediate erection
Damage ➡️ erectile dysnfnxn
-Usually occurs after prostatectomy
220
Indirect inguinal hernias
️Occurs due to a patent Processus vaginalis
-Intestines protrude thru the deep inguinal ring and travel LATERAL to the inferior epigastric vessels
221
Direct inguinal hernia
️Occurs in older men due to a weakness in the transversalis fascia
-Content of intestines protrude thru Hesselbach's triangle and travels MEDIAL to the inferior epigastric vessels
222
Femoral hernia
️Occurs in women due to weakness of the proximal femoral canal
-Intestinal content protrudes then the femoral ring and travels INFERIOR to the inguinal ligament
⭐️prone to incarceration and strangulation due to impaired blood flow
223
Cellular receptor for CMV
Cellular integrins
224
Cellular receptor for rabies
Ach-R
225
Cellular receptor for rhinovirus
ICAM-1 (CD54)
226
Mitochondrial vacuoles action
Irreversible cell damage
227
Expired tetracyclines
Fanconi syndrome ( a type of metabolic tubular acidosis due to decreased excretion of acid)
228
Subpleural blebs
Spontaneous pneumothorax
229
Subpleural blebs
Spontaneous pneumothorax
230
Li-Fraumeni tumors
```
Breast cancer
Leukemia
Adrenal tumors
Bone cancer
Sarcomas
```
231
First dose hypotension
️Occurs in pts. Who start ACEIs and have increased renin activity prior to initiation
-More like in HF or HCTZ pts
232
Methadone
U-opioid agonist with an extremely long half-life; used to Tx. Addiction
-Has decreased central activity
233
Supracondylar fracture with anterolateral displacement of the humerus
Wrist drop (radial nerve damage)
234
Supracondylar fracture with anteromedial displacement
Median nerve damage (weakened wrist Flexion)
235
Permanent DI
Damage to the vasopressornergic neurons of the hypothalamus
-If the DI is transient, most likely a posterior pituitary injury
236
DRESS syndrome
"Drug reaction with eosinophila and systemic symptoms"
-️Occurs a few weeks after starting anticonvulsants, allopurinol, Sulfonamides, and antibiotics
Clinical: Fever, lymphadenopathy, facial edema, diffuse rash
237
Intrapleural pressure at FRC
-5 cm H2O
Decreases to -7.5 on expansion of the chest wall
238
Epithelia of true vocal cords
Stratified squamous
-is the reason why HPV 6 and 11 can infect here
239
Tx of thyroid storm
Propanolol
Propylthiouracil
Prednisone
Potassium iodide
⭐️ the 4 p's
240
Location of HEVs in lymph nodes
The Paracortex
241
HLA-DQ2/DQ8
Celiac disease
242
Cd 16 pos cell
NK cell; kills via ADCC and Ifn-a or B activation
243
Positive and negative T-cell selection locations
Positive =>> Cortex (those that can recognize self survive)
Negative =>> Medulla (those with high affinity for self die)
244
FOXP3
Th17 cells; produce anti-inflammatory cytokines TGF-B and IL-10
245
Most produced antibody overall
IgA (is not the highest in the serum tho)
246
Function of CRP
Opsonin that can fix complement and facilitate phagocytosis
247
DOWNREGULATED ARPs
Albumin (to save AAs) and transferrin
248
C3 deficiency
Increases risk of severe, recurrent pyogenic sinus and respiratory tract infxns
Also increased risk of Type III HSN rxns
249
Hot T-bone stEAK
IL-1 =>> Pyrogen
IL-2 =>> stimulates T-cells
IL-3 =>> stimulates bone marrow
IL-4 =>> stimulates IgE prod.
IL-5 =>> stimulates IgA prod.; also the growth of eosinophils
IL-6 =>> stimulates aKute-phase reactant prod.
250
Relationship b/w Km and Vmax
Km= 1/2Vmax
BUT. They are not actually related to each other; one measures the maximum rate of the enzyme and the other measures its affinity for the substrate
251
Crackles on lung auscultation
Atelectasis, bronchitis
252
Wheezing on lung auscultation
Asthma
253
MCC of TIAs and Stroke (Brain attack)
HTN
254
Proliferative cells during axon repair
Schwann cells
255
Possible sequelae of diverticulosis
Fecalith obstruction; presents w/ bleeding and abdominal pain
-Eat high fiber diet to avoid this
256
Sympathetic response to blood loss
HTN and increased HR; all of this is done to maintain adequate BP
257
What organelle is usually damaged w/ hepatotoxic substances?
Mitochondria
258
Adrenal medulla embryologic origin
Neural crest cells
259
Nerves that help to mediate gastric motility
Pelvic splanchnic nerves
260
First sign of puberty in a female
Breast bud development
261
Why is M. leprae found on the skin?
It likes the colder temperature
262
Uterine arteries origin
The internal illiac; ligate this during a hysterectomy
263
Nerve damaged w/ jaw fracture
Inferior alveolar nerve
264
DOC for diuretics in alcoholic liver disease
Spironolactone
265
Appearance of tubular adenomas
Pedunculated; look like those cat-tail plants that used to be in your gully
266
Heart Appears enlarged on right side of CXR
right atrial enlargemnt
267
Umbilical hernia
Present at birth as protruding intestines covered with skin thru an incompletely closed umbilical ring
268
Fluphenazine
1st gen typical antipsychotic with an extensive Extrapyramidal ADR profile
-Similar to haloperidol
Ex: dystonia, Akathisia, Parkinsonism
269
PCR amplification requirements
Must know the DNA templaTe AND the flanking regions in order to make he necessary RNA primers
270
Inactivated vaccines
Rabies, influenza (Intranasal), polio (Salk), hepatitis A
RIP Always
⭐️Only produce a humoral immunity
271
Febrile non-hemolytic transfusion rxn
Host antibodies against donor HLA antigens and WBCSs
-Fever, chills, headache, flushing
272
Anti-smooth muscle antibodies
Autoimmune hepatitis
273
Tx. Of thiamine deficient
Thiamine AND glucose
⭐️Glucose alone will exacerbate the sx.
274
PDGF and atherosclerosis
Release by activated platelets and promotes the proliferation of SMCs
275
Oxalate crystals in the kidney tubules
Ethylene glycol poisoning
-Will cause acute, toxic tubular necrosis
276
coarse Facies, cold staph Abscesses, retained primary Teeth, increased IgE, Dermatologic problems
Hyper-IgE syndrome
-Deficiency of Th17 cells due to STAT3 mutation
277
Chronic mucocutaneous candidiasis
T-cell dysnfnxn leading to chronic, non-invasicve Candida infxns
278
Severe pyogenic infxns in early life, opportunistic infxns, increased IgM
Hyper-IgM syndrome; usually due to defective CD40L on T-cells
**XLR
279
p-glycoprotein
Protein cancer cells use to pump out chemotherapeutic agents
***Classically seen in adrenal cell carcinoma
-Also called MDR1
280
Cachexia mediators
TNF-a (primary) and also IL-1, IL-6, and IFN-y
281
c-kit mutation
Gastrointestinal stromal tumor
282
p16 TSG
Assoc. w/ Melanoma
283
PTEN TSG mutation
Breast, prostate, and endometrial cancer
"Cowden Syndrome"- affects gender specifics
284
CA 19-9 tumor marker
Pancreatic adenocarcinoma
285
DPC4 tumor suppressor gene
Deleted in Pancreatic Cancer
-Assoc. w/ SMAD4?
286
Cancers w/ Psammoma bodies
Papillary carcinoma of the thyroid
Serous papillary cystadenocarcinoma of the ovary
Meningioma
Mesothelioma
287
a-intercalated cells
Cells in the late distal convoluted tubule and the collecting duct that secrete H+ in response to aldosterone
(It's effects on sodium reabsorption happen on the principal cells)
288
Patient w/ fever, jaw pain, a tender thyroid, and increased ESR
Subacute granulomatous thyroiditis
- Commonly caused by mumps or Coxsackie
- Self-limited
289
Pramlinitide
Amylin analog that slows gastric emptying and suppresses glucagon release
-Helps to regulate post-prandial glucose levels
290
Signs of irreversible cell damage
Nuclear pyknosis, karyorrhexis, karolysis
Membrane damage (not just blebbing)
Lysosomal rupture
Mitochondrial vacuolization
291
Dystrophic Calcification
Ca2+ deposition in damaged, native tissues
-Seen w/ aortic stenosis, TB, fat necrosis, thrombi, Monckeberg arteriolosclerosis, others too
***Pts. are NORMOCALCEMIC
292
Metastatic calcification
Diffuse deposition of Ca2+ in normal tissue secondary to HYPERCALCEMIA
-Predominantly in the interstitial tissues of the kidney, the lung, and the gastric mucosa
293
Where does extravasation of PMNs occur?
Postcapillary venules
294
PDGF
Secreted by platelets and macros
Induces vascular remodeling and smooth muscle cell migration
Stimulates fibroblast growth for collagen synthesis
295
FGF
Stimulates angiogenesis
296
DECREASED ESR
Microcytosis, SCA, polycythemia
-Typically due to altered RBC being more dense and falling fast
297
Transthyretin gene mutation
Inheritable cause of amyloidosis
-Could potentially cause nephrotic syndrome, restrictive cardiomyopathy, peripheral neuropathy, hepatosplenomegaly
298
What is the physiology behind lipofuscin?
Oxidized and polymerized organelle membranes
299
Dialysis-related amyloidosis
Composed of B2-microglobulin; may present as carpal tunnel syndrome?
300
Foramen rotundum
V2
301
Foramen ovale
V3
302
NRTI used in pregnancy to decrease vertical transmission
Zidovudine; can cause aplastic anemia tho
303
Foramen rotundum
V2
304
Foramen ovale
V3
305
NRTI used in pregnancy to decrease vertical transmission
Zidovudine; can cause aplastic anemia tho as well as peripheral neuropathy and the usual lipodystrophy and lactic acidosis
306
Trapezoid body
Body located in the pons that contains decussating cochlear fibers to the CONTRALATERAL superior olivary ️Nucleus
307
COWS
Cold Opposite Warm Same
Cold water irrigation moves the eyes towards the opposite side (BUT THE SAME SIDE OF THE IRRIGATION FUCK I DUNNO WHY)
-If only one eye movers ➡️MLF lesion
No eyes move? ➡️ Brainstem lesion
308
Simepravir
HCV protease inhibitor; can cause Photosensitivity
309
Sofosbuvir
HCV RNA-dependent RNA polymerase inhibitor; can cause flu-like symptoms
310
Ribavirin
️Inhibits inosine monophosphate dehydrogenase in HCV; can cause hemolytic anemia and is a Teratogen in pregnant women
311
Chronic GERD with new odynophagia
Ulceration
312
Mossy fibers
Afferent excitatory fibers of the Spinocerebellar tracts
313
Climbing fibers
Afferent Excitatory fibers of the olivocerebellar tracts
314
Purkinje fibers
Contain inhibitory output of the cerebellar cortex to vestibular nuclei
315
Dentate ️Nucleus
Major effector Nucleus of the cerebellum giving rise to the dent opthalamic tract projecting to the ventral lateral nucleus of the thalamus
316
Spinocerebellar ataxia
Genetic disease charger iced by progressive loss of coordination of gait and hand movement, personality change, and some loss of mental fnxn
-A lot like Alzhemers with more significant cerebellar sx.
317
Sources of input to the Neostriatum
1. Neocortex
2. SN
3. Thalamus
318
Efferents pathways of the striatum
1. GP
| 2. SN
319
Sydenham's chorea
️Occurs after viral illness
320
Random flinging of an extremity
Vascular lesion of the CONTRALATERAL subthalamic ️Nucleus
-Hemiballismus
321
U-wave
Hypokalemia
322
Destruction of the inferior parietal lobe of the nondominant hemisphere
Hemineglect
-Topographical memory loss, anosognosia, construction apraxia, sensory neglect, contralateral hemianopia
323
Raphe nuclei
Serotonin containing nuclei of the Brainstem
324
Ideational apraxia
Inability to demonstrate the use of objects (pt. cant perform multistep task)
-Any apraxia is the inability to perform motor fnxns in the presence of intact motor sensory systems and normal comprehension (represents a defect in association pathways)
325
Non-dominant hemisphere dysprosody
Non-dominant Broca's =>> pts. can't express emotion in speech
Non-dominant Wernicke's =>> pts. can't understand emotion in speech
326
Edinger-Westphal nucleus
Contains nuclei for the sphincter muscle of the iris and the ciliary muscle (parasympathetics)
-Axons ride on CN III
327
Nerves that exit at the cerebellopontine angle
VII and VIII
328
Anosognosia
Denial of illness
329
Slow acetylator
Drug-induced lupus
330
MCC of nosebleed
Bleed in Kiesselbachs plexus in anterior segment of nose
-Less commonly due to Sphenopalatine bleed in posterior segment; can be severe and life-threatening here
331
Wheezing on auscultation
Increased mucus secretions
-Likely bronchitis or asthma assoc.
332
Eggshell calcification
Silicosis
-impaired phagolysosome formation increases TB susceptibility
333
Only pneumoconiosis that affects the lower lungs
Asbestos
334
RFs of NRDS
Prematurity
Maternal diabetes
C-section
335
Increased tactile fremitus
Pulmonary edema, lobar pneumonia
-Indicates decreased distance b/w the chest wall and lung
336
Genetic Reassortment
Host cell is infected w/ 2 segmented viruses that exchange whole genome segments
*Causes antigenic SHIFT
337
Genetic recombination
Exchange of genes b/w two chromosomes of two viruses via crossing over
*Causes antigenic DRIFT
338
Indicator of alveolar ventilation rate
PaCO2
- If this is decreased, there is an INCREASED ventilation rate
- Can be brought on by chronic, decreased PaO2
339
Eruptive xanthomas, hepatosplenomegaly, acute pancreatitis
Familial Hyperchylomicronemia
-Deficiency of LPL; causes a milky white blood
340
Restless Leg Syndrome tx.
Pramiprexole
-Dopamine agonist
341
Urinary Urgency
Detrusor overactivity
342
Stress incontinence
External urethral sphincter dysfnxn
-More common in women w/ lots of babies
343
Drugs that decrease HF mortality
BB
-Also ACEIs, ARBs, and eplerenone
344
Furosemide ADRs
```
Ototoxicity
Hypokalemia
Dehydration
Allergy (sulfa)
Nephritis
Gout
```
345
Drug given w/ Niacin to decrease flushing
Aspirin; flushing is due to increased prostaglandins from Niacin
346
a-galactosidase A deficiency
Fabry Disease
-XLR
347
Fanconi Anemia
Aplastic anemia due to defective DNA repair
Clinical: MR
Aplastic anemia (increased bleeding, infxns, anemia)
**Absent thumbs
Hypoplastic kidneys
Cafe-au-lait or hyperpigmentation
348
Horseshoe kidney complications
Difficult surgeries due to multiple anomalous origins of the renal arteries
349
Rotator Cuff Muscles
Supraspinatus: Initial abduction of arm; assessed by empty beer can test
-Innervated by suprascapular n.
Infraspinatus: Laterally rotates arm; common pitching injury
-Suprascapular n.
Teres minor: Adducts and laterally rotates arm
-Suprascapular n.
Subscapularis: Medially rotates and adducts arm
-Subscapular n.
350
Fetal Occult Tests
Specific, but not sensitive
WAA-WAA-WEE-WAA
351
Pseudofolliculitis barbae
Razor burn lol
-Itches and burns ya know; found around facial hair distribution
352
Reyes Syndrome CNS damage
Damage occurs due to cerebral edema; this is induced by the hyperammonemia
353
TNM
Tumor=size
N=lymph node involvement
M= metastases
-Note that BM invasion is not included in this criteria so a low-grade tumor can still be locally invasive
354
Kallikrein activation
Requires a good intrinsic pathway to be activated
355
Charcot-Marie-Tooth Disease
*AD
Defective production of proteins involved in the structure and function of peripheral nerves and the MYELIN SHEATH
Assoc. w/ scoliosis and foot deformities along with peripheral neuropathy
356
mRNA translation
Can be repeatedly translated;
1mRNA does NOT equal one protein lol
357
Chronic morphine administration
Buildup of active metabolites can occur =>> respiratory depression
-Even more serious w/ renal failure
358
First action if a drug seeker is in the office
Obtain a list of their previously prescribed meds
359
Cross-sectional study
Data collected from a group of people to assess the PREVALENCE of a disease at a particular point in time
-Asks, "What is happening?"
360
Case-control study
Compares a group of people without a disease to a group of people with disease; looks for a prior exposure or risk factor
-Asks, "What happened?"
361
Hereditary Spherocytosis
*AD
Defect in proteins interacting w/ RBC membrane (ankyrin, spectrin)
- Small, round RBCs w/ increased MCHC and RDW that are removed by the spleen producing ANEMIA
- Aplastic crises w/ parvovirus B19
362
Site of action of potassium sparing diuretics
Late DCT and the CDSs
363
Intrinsic pacemaker of the heart
SA node
364
Complication of osmotic diuretic therapy
Pulmonary edema; rapid redistribution in ECV can lead to momentary increased hydrostatic pressure
-Drug is normally given to manage ICP
365
Decerebrate posturing
Loss of signaling to upper limb flexors so pt. Will be stiff and extended
-Due to damage below the pons, usually at the red Nucleus
366
Decorticate posturing
Excess activation of the upper limb flexors
-️Occurs due to damage above the pons
367
Ruxolitinib
JAK-kinase inhibitor used to Tx. Primary Myelofibrosis, polycythemia Vera
368
Cholestyramine
Binds to bile acids in the GI tract =>> increased endogenous synthesis and increased LDL uptake
ADRs: Diarrhea
****Hypertriglyceridemia
369
MCC of glomerular nephritis
Berger Disease
Presents as painless hematuria 5-7 days post respiratory or GI infxn
Histo: Mesangial proliferation
IgA deposition
370
Cryoglobulins
Cold, precipitable IgGs sometimes assoc. w/ HCV
371
Sudden, severe headache w/ no other focal neurologic deficits
SAH
-CT shows some diffuse enhancements surrounding the ACA area
372
Cholesteatoma
Pearly mass in the middle ear typically secondary to infxn/trauma
***Composed of squamous cell debris
Clinical: Otorrhea
Conductive Hearing Loss
Loss of taste
373
Ecological Study
Utilizes population data on a given data set/characteristic and a given outcome
374
Obesity-hypoventilation syndrome
Overweight pts. w/ chronic fatigue, decreased mental fnxn, and dyspnea
- Also have increased PaCO2 and decreased PaO2
- Normal A-a gradient tho due to decrease in BOTH PAO2 and PaO2
375
Broad-based budding yeast
Blastomyces dermatidis
376
Pseudohyphae w/ blastoconidia
Candida albicans
377
Primary Biliary Cirrhosis
AI destruction of intrahepatic bile ducts
```
Clinical: Generalized pruritus
Hepatosplenomegaly
Xanthoma
Jaundice (if severe)
***Coexistance of other AI disease
```
Labs: Increased ALP and GGT
anti-mitochondrial abs
378
Old person w/ myopia that gradually improves
Presbyopia can actually fix myopia
379
Microcalcifications on mammography
DCIS
380
HF problems
Decreased CO =>> increased sympathetic output causing...
- Increased fluid retention (B1)
- Vasoconstriction
- Deleterious cardiac remodeling (due to increase stress on heart)
381
V-shaped, septate branches found in IC or Cancer pt.
Invasive aspergillosis
Clinical: Fever
Pleuritic chest pain
Hemoptysis
Hematogenous spread
382
MCCoD in TCA OD
Cardiac arrhythmia
- This is due to inhibition of the fast Na+ channels
- Who the fuck knew?
- Tx w/ NaHCO3
383
Hemosiderin-laden macros
HF cells
-remember, these will stain w/ Prussian blue
384
Global Payment
Insurer pays a single-payment to cover all expenses assoc. w/ a single incident of care
-Done w/ elective surgery (will also cover pre- and post-op care)
385
Capitation
Payment of a fixed, pre-determined fee per month
- Idea behind HMOs
- Motivates both sides to decrease the cost of care
386
Point-of-service plans
Requires a patient to see a PCP to obtain a referral for specialist care
-Pts. can go outside the network but at an increased cost
387
Pulmonary abscess
Produced by lysosome release from PMNs and macros that eventually damages the lung parenchyma making a walled-off infxn
388
Changes in MVP murmur
Increased LV volume =>> decreased murmur sound
*squatting and raising legs
389
Only scenario in which monotherapy for TB is ok
Patient has a (+) PPD BUT HAS NO SYMPTOMS
390
Kallikrein
Converts kininogen =>> bradykinin
-Upregulated by the intrinsic pathway
391
Type II Crigler-Najjar syndrome
Less severe and responds to phenobarbital
392
Murphy sign
Inspiratory arrest on RUQ palpation due to pain
-Classic with cholecystitis
393
Macula densa
Responds to increased blood flow to the kidney with constrictions to the Afferent arteriole
- Located in the DCT
- is a local regulatory response
394
Stepwise decrease in cognitive fnxn and memory over time, focal neurologic signs
Vascular dementia
- Often have chronic hypertension in the history
- Symptoms typically cannot be localized to a single area
395
Corneal transplants
Possible vCJD
- Pts. Present with rapid cognitive deterioration (within a couple months), myoclonus, and involuntary jerking
- May see abnormal EEG pattern
396
Juxtaglomerular cells
Modified smooth muscle cells that secrete renin
-Long term renal artery stenosis ➡️ hyperplasia
397
Woman who has had many pregnancies and now has stress incontinence
Damaged levator ani muscles
-Do pelvic floor exercises (Kegel)
398
DNA hypersensitivity to IONIZING radiation
Ataxia-telangectasia
399
Cerebral Amyloid Angiopathy
B-amyloid deposition in the cerebral small and medium arteries leading to weakened walls and potential RUPTURE
**MCCo LOBAR HEMORRHAGE
***COMMONLY AFFECTS PARIETAL AND OCCIPITAL LOBES producing focal deficits
-CT shows many hemorrhages that are old usually
400
Areas affected by Charcot-Bouchard aneurysms
Deep brain nuclei (thalamus, globus pallidus, putamen)
401
a-ketoacid dehydrogenase deficiency
Maple Syrup Urine Disease
-Pts. present w/ seizure, hypotonia, poor feeding
TX: THIAMINE and avoid branched AAs
402
Peripheral iodothyronine deaminase inhibitors
BBs AND PROPYLTHIOURACIL
403
HF drugs
BBs, ACEIs, ARBs, and Spironolactone
-ALL OF THESE WORK BY DECREASING ALDOSTERONES DELETERIOUS EFFECTS ON THE HEART
404
Vimentin (+) tumor
Sarcoma
405
Right Ventricular MI
Occlusion of the RCA; ST elevation in inferior leads
- Increased CVP, normal PCWP, decreased CO
- Presents w/ JVD, hypotension, and clear breath sounds (opposed to LV failure)
406
A-fib effects on LVEDV
Decreases it; this is especially important in pts. w/ HCM
Can =>> pulmonary edema
407
Watershed areas of colon
Splenic flexure and rectosigmoid jnxn
-Ischemia presents as necrosis w/ bloody diarrhea
408
Abdominal Aortic Aneurysms
Characterized by TRANSMURAL inflammation of the aortic wall
=>>Degradation of collagen and elastin =>> expansion of aortic wall
409
ESRD + Excessive Bleeding = ?
Uremic platelet dysfnxn
-All labs normal except for bleeding time
410
Splenic Red pulp
Contains reticuloendothelial cells that remove damaged RBCs
-Hyperplastic in PK deficiency, hereditary spherocytosis,
411
Histoplasma capsulatum prophylactic drug in HIV pts.
Itraconazole
412
Recurrent laryngeal nerve origin
CN X
-Remember what this CN innervates
413
Tonsil sensory innervation
CN IX
-Also provides sensory to eustachian tube, posterior pharynx, tympanic membrane, carotid body and sinus
414
3 year old development
Talks in 3 word sentences, climbs stairs, rides tricycles, knows gender, and CAN DRAW FUCKING CIRCLES ALL OVER THE GODDAMN PLACE
415
Increased urinary cAMP
Sign of increased PTH fnxn on the kidney
416
Finger Drop
Damage to the radial nerve as it passes thru the supinator canal
- Sensory is intact
- Due to excessive twisting motions of the hand (like using a screwdriver)
417
WATERY diarrhea after being treated w/ antibiotics
C. diff
-Is watery because this bacteria IS NOT INVASIVE
418
Filgastrim
G-CSF
419
Diarrhea in diabetics
Occurs due to motility issues of the GI tract
420
Abscess formation type of inflammation
Liquefactive necrosis
421
Pinealomas
Present w/ a Parinaud Syndrome AND usually some signs of cerebral aqueduct obstruction
-possibly some signs of progressive clumsiness as well
422
AV malformations of vessels to mucosal surfaces; digital clubbing
Hereditary Hemorrhagic Telangectasia
423
Clinical Trials
Pts. given a treatment and examined for RECURRENCE of symptoms
-Also done with surgeries
424
ATRA
Used to tx. APML
Acetylates histones to allow transcription to progress and leukocytes to mature
425
Solar elastosis
"Photo aging"
- Increased cross-linking of existing collagen fibers => contracting of the dermis
- Also decreased production of new fibers
426
Natural misoprostol
PGE1 that is produced in response to damage or inflammation
-With premature rupture of the amniotic membrane, this PGE1 can produce contractions and bleeding
427
Spermatocytes
The adult germ cells that undergo meiosis
-Spermatogonia under mitosis
428
Petrolatum
Petroleum jelly; simply fnxns as a barrier to keep moisture in
429
Ascending paralysis, weakness, loss of proprioception
Guillain-Barre syndrome
-Notice how all the major tracts are affected
430
Km and affinity
INVERSELY RELATED
431
Secondary hyperparathyroidism
Chronic renal failure =>> decreased PO43 secretion
-This PO4 binds to free Ca2+ and stimulates the release of PTH
Labs: Increased PTH
Decreased Ca2+
Increased PO43-
Increased AP
432
Tendon damaged in mallet finger
Flexor digitorum profundus
433
Transient hyperthyroidism, tender to the touch, may be after a viral illness
Subacute Granulomatous Thyroiditis
434
Pt. who has steadily decreasing platelet numbers after being treated for a DVT
HIT
-Antibodies are against platelet factor 4; causes thrombosis and thrombocytopenia
****ALWAYS CONSIDER THIS A FEW DAYS AFTER ADMINISTRATION
-In pts. prone to this, use argatroban
435
Urothelial carcinoma
RFs: Smoking, azo dyes, phenacetin, cyclophosphamide, naphthylamine
- Presents as painless hematuria
- Can be flat (assoc. w/ p53) or papillary (potentially invasive)
- Often multifocal and recur
436
Squamous cell carcinoma of the bladder
Arises in background of metaplasia and is assoc. w/ chronic cystitis, Schistosoma haematobium, and long-standing nephrolithiasis
437
Adenocarcinoma of the bladder
Arises from a urachal remnant (originally connected fetal bladder to the yolk sac), cystitis glandularis (chronic infxns), or exystrophy
438
Hydronephrosis, flank tenderness, colicky pain radiating to the groin, hematuria
Kidney stone signs
439
Prasugrel, Ticlopidine
Clopidogrel like drugs
-️Inhibits ADP induced expression of GPIIb/IIIa
440
Cubital tunnel syndrome
Damage of the ulnar nerve as it crosses from the arm into the forearm posterior to the medial epicondyle
441
Guyons canal syndrome or ulnar tunnel syndrome
Prolonged pressure on the ulnar aspect of the palmar surface of the hand
-Classic in cyclists
442
Baby with flaccid paralysis of the legs, urinary incontinence, and dorsiflexion of the feet
Causal regression syndrome
-Agenesis of the sacrum; assoc. With maternal diabetes
443
Pt. With diarrhea and a decreased stool ph
Lactase deficiency
444
Sideroblastic anemia treatment
Vitamin B6
445
Child with megaloblastic anemia signs, failure to thrive, and developmental delay
Orotic aciduria
-Possibly due to defect in UMP synthase
➡️⬇️ de novo Pyrimidine synthesis
Tx: Uridine
446
RBC macrocytic is without hypersegmented PMNs
Nonmegaloblasric macrocytic anemia
-Caused by alcoholism, liver disease, hypothyroidism
447
Ferroportin
️Enzyme that transports intestinally absorbed iron into the blood
448
Sucrose test
Screens for PNH
-Lysed cells secrete procoagulant factors producing thromboses of small Vasculature
449
Signs of intravascular hemolysis
Back pain, fatigue
Hemoglobinemia
Hemoglobinuria
Hemosiderinuria
Decrease haptoglobin
Increased LDH
450
WARM AIHA
IgG mediated; assoc. With SLE, CLL, penicillin, and cephalosporins
a-methyldopa can cause formation of AI abs to RBCs as well
-Presents with signs of intravascular hemolysis
Tx: Remove drugs, steroids, IVIG, splenectomy
451
PNH Tx.
Eculizumab
-C5 inhibitor
452
Pyruvate kinase deficiencies
Decreased ATP ➡️Decreased RBC membrane stability
-Presents as hemolysis in a newborn
453
Painful abdomen
Polyneuropathy
Psychological disturbances
Port-one urine
Precipitated by drugs (CYP inducers)
Acute intermittent porphyria
Decreased porphobilinogen deaminase
Tx: ️Glucose and heme
454
MCC bleeding disorder
VonWillebrands; because it's AD
455
Non-infectious blood transfusion risks
Hyperkalemia
Hypocalcemia
Iron overload
456
Rat poison
Super Warfarin
-Pt needs plasma
457
MC site of fetal urethral obstruction
Uretopelvic junction
458
Intrinsic tyrosine kinase hormones
Insulin and hormones ending in "GF"
459
Phosphatidylinositol 3-kinase
Increased activity with insulin
May take part in dephosphorylation of glycogen and FA synthase
460
Exemestane, Anastrazole
Aromatase inhibitors used in postmenopausal women w/ E2 (+) breast cancer
461
Raloxifen
Estrogen antagonist at the breast and uterus
-Agonist at the bone so it's sometimes used for osteoporosis
462
COX-2 location
Endothelial cells
-Therefore, celecoxib doesn't have an effect on platelets at all
463
Medical Tx. of Gallstones
Bile acid supplementation
=>> Increased solubility of cholesterol
464
MCC of Ca2+ stones in a health male
Idiopathic hypercalciuria
465
Pt. w/ onset of gross hematuria w/ small blood clots and colicky flank pain
Renal papillary necrosis
Causes: SCD
Analgesics (vasoconstriction of afferent arterioles)
Diabetes
Pyelonephritis
466
Location of Phenylethandmine-N-methyltransferase
Only in the adrenal medullas
- Converts NER =>> ER
* Is upregulated by ACTH and Cortisol
467
Acid a-glucosidase def.
Pompe's
468
Trisomy 13
Patau Syndrome
```
Clinical: Holoprosencephaly
Omphalocele
Micropthalmia
Cleft lip and palate
Polydactyl
Cutis aplasi (skin defect on scalp)
```
469
Trisomy 18
Edward's Syndrome
```
Clinical: Low set ears
Clenched fist
Rocker bottom feet
Micrognathia
Heart defects
Prominent occiput
Renal defects
```
470
Glial Scar
Formed 2 weeks after cortical infarct by astrocytic fibers
471
Preeclampsia
Gestational HTN (>140/>90) and PROTEINURIA
-May also see some end organ damage
Path: Abnormal placental vasculature =>> Release of inflammatory mediators that damage maternal vessels
472
Pt. who is inducing damage to themselves or falsifying lab results w/o any obvious external gain
Factitious disorder
473
Drug used in acyclovir-(R) HSV or IC CMV retinitis
Cidofovir
Foscarnet
474
Male gynecomastia tx.
Tamoxifen
475
Pt. w/ fever, RUQ pain, jaundice, pruritis, dark urine, and pale stools w/ a history of travel to 3rd world
HAV
Histo: Ballooning degeneration of hepatocytes
Councilman bodies
Mononuclear infiltrate
476
Newborn w/ malabsorption signs and histo of lipids in enterocytes
Abetalipoproteinemia; LOF in MTP gene =>> no production of Apo B48 or B100
Clinical: Fat-soluble vitamin deficiencies
Decreased TGLs, Cholesterol, VLDL, Chylomicrons
477
2nd line drug for CAD
Clopidogrel
Usually used if pt. has aspirin-intolerant asthma
478
Vitamin B6 rxns and deficiency
Transamination (ALT and AST)
Decarboxylation
Glycogen phosphorylase
Synthesizes heme, Niacin, ER, NER, GABA
Deficiencies =>> Peripheral neuropathy, convulsions, sideroblastic anemia
479
High fever in a smoker w/ diarrhea, cough, confusion
Legionella
-Often have hyponatremia as well
480
Imperforate hymen
Obstructive lesion caused by incomplete degeneration of tissue in the vagina that collected from maternal secretions during childbirth
=>> Primary amenorrhea
Clinical: Bulging vaginal mass
Normal secondary sex characteristics
481
Tx. of recurrent C. diff infxns
Fidxomicin
Macrocyclic antibiotic that inhibits RNA polymerase
*Minimal effect on normal flora; high sustained cure rate
482
Chronic lymphedema after a radical mastectomy
Propensity to develop lymphandiosarcoma OR Cutaneous angiosarcoma (probs this one)
483
Normal heart aging
Decreased LV chamber size
Sigmoid shape of the IVC =>> impaired outflow
Increased collagen (after muscular atrophy)
Lipofuscin
484
R-CHOP
Treats diffuse large b-cell lymphoma very successfully
MC type of non-Hodgkin's lymphoma in adults
485
Pseudo-Pelger Huet anomaly
PMNs nuclei look like ray bands
-Seem after chemotherapy
486
Ashermann syndrome
Secondary amenorrhea due to loss of basalis and scarring
⭐️Due to over aggressive dilation and curettage
487
Woman with dysmenorrhea, pelvic pain, dyspareunia, and retro verged uterus
Endometriosis
Inflammation around the ectopic tissue can result in adhesions involving the uterosacral ligament pulling the uterus back
⭐️ Remember, it doesn't have to present this way
Rf: Nulliparity, early menarche, prolonged menses
488
Hydrocephalus ex vacuo
Enlargement of the ventricles due to neuronal volume
Occurs with AIDS dementia; CSF pressure remains normal
489
Young, obese woman with headache, Papilledema, and visual abnormalities with no abnormal labs, scans, or illnesses
Pseudotumor cerebri = Idiopathic intracranial HTN
"Pseudohypertension"
490
HIV dementia
Subcortical inflammation involving excess infiltration of the HIV infected macros producing
MICROGLIAL NODULES AND MULTINUCLEATED CELLS
491
Determining metabolic alkalosis cause
Decreased urine [Cl-] ➡️ Vomiting, diuretics
Increased urine [Cl-] ➡️ Hypovolemic = Diuretics, Bartter's, Gitelman's
➡️ Hypervolemic = Hyperaldosteronism, Cushing's
492
Part lacking neurons in Hirschsprung's
The narrow part (usually the rectum) yah dingus
493
Child with increased head size, developmental delay, cerebellar dysfnxn, hydrocephalus
Dandy-Walker
Agenesis of the cerebellar vermis and foramen of Luschka and Magendie
494
Erythema multiforme associations
HSV, Mycoplasma
Sulfonamides
Malignancy
-Due to excess CD8 response
