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USMLE 2019 > Patho > Flashcards

Patho Flashcards

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1
Q

Rule of 10s of pheochromocytoma

A 
10% malignant
10% bilateral
10% extra-adrenal
10% calcify
10% kids
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2
Q

Hurthle cells

A

Hashimoto’s thyroiditis

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3
Q

thyroid disease assoc with increased risk of non-Hodgkin lymphoma

A

Hashimoto thyroiditis

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4
Q

most common cause of death in gigantism

A

cardiac failure

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5
Q

treatment of nephrogenic DI

A

Hydrochlorothiazide
Amiloride
Indomethacin

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6
Q

Aggressive correction of hyponatremia leads to

A

Central pontine myelinolysis

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7
Q

Paraneoplastic syndromes associated with small cell lung CA

A

ADH and ACTH

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8
Q

Treatment of SIADH

A

Vasopressin antagonists:
Tolvaptan
Conivaptan

Demeclocycline

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9
Q

most common cause of death among diabetics

A

myocardial infarction

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10
Q

rule of 1/3 of carcinoid syndrome

A

1/3 metastasize
1/3 present with second malignancy
1/3 are multiple

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11
Q

gastrin-secreting tumor of pancreas or duodenum

A

Zollinger-Ellison syndrome

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12
Q

recurrent diarrhea
cutaneous flushing
asthmatic wheezing
R-sided valvular disease

niacin deficiency
high urinary 5-HIAA

A

Carcinoid syndrome

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13
Q

MEN 1

Wermer syndrome

A

Pit Pan Para
Pituitary
Pancreas
Parathyroid

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14
Q

MEN 2A

Sipple syndrome

A

Pheochromocytoma
Parathyroid hyperplasia
Medullary thyroid carcinoma

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15
Q

MEN 2B

A

Oral / mucosal neuroma
Medullary thyroid carcinoma
Pheochromocytoma

*Marfinoid habitus

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16
Q

clinical syndrome of VIPoma (pancreatic tumor)

A

WDHA syndrome:
Watery Diarrhea
Hypokalemia
Achlorhydria

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17
Q

benign cystic tumor with germinal centers; second most common salivary gland tumor

A

Warthin tumor

papillary cystadenoma lymphomatosum

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18
Q

Triad of Plummer-Vinson syndrome

A

“Plummers DIG”
Dysphagia (esophageal webs)
IDA
Glossitis

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19
Q

CREST Syndrome of limited cutaneous systemic scleroderma

A 
Calcinosis cutis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasia
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20
Q

Risk factors for esophageal cancer

A 
AABCDEFFGH
Achalasia
Alcohol
Barrett
Cigarette
Diverticula
Esophageal web
Familial
Fat
GERD
Hot liquids
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21
Q

most common site of intestinal gastric adenoca

A

lesser curvature of stomach

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22
Q

Common symptoms of whipple disease

A

Foamy Whipped cream in a CAN
Cardiac
Arthralgia
Neurologic

foamy macrophages
PAS +
Tropheryma whipplei (gram +)

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23
Q

Diagnosis of celiac sprue

A

serum level of tissue transglutaminase antibodies

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24
Q

malabsorption syndrome assoc with dermatitis herpetiformis

A

celiac sprue

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25
treatment of Crohn’s disease
``` Corticosteroids Azathioprine Methotrexate Infliximab Adalimumab ```
26
treatment of ulcerative colitis
Sulfasalazine 6-mercaptopurine Infliximab Colectomy
27
most common congenital anomaly of the GIT
Meckel diverticulum
28
Five 2s of Meckel
``` 2% of population 2 inches long 2 feet from ileocecal valve 2 years old 2 types of epithelia (gastric/pancreatic) ```
29
Diagnosis of Meckel
Pertechnetate study | uptake by ectopic gastric mucosa
30
diagnosis of Hirschsprung
rectal suction biopsy
31
most common cause of small bowel obstruction
adhesions
32
causes of ileus
post op abdominal surgery opiates hypokalemia sepsis
33
common location of ischemic colitis
splenic flexure | distal colon
34
most common non neoplastic polyp in the colon
hyperplastic
35
Failure of GnRH-secreting neurons to migrate from olfactory lobes to the hypothalamus
Kallmann’s syndrome
36
FAP + osseous and soft tissue tumors congenital hypertrophy of RPE
Gardner syndrome
37
FAP + malignant CNS tumor
Turcot syndrome
38
molecular pathogenesis of colorectal carcinoma
loss of APC gene K-RAS mutation loss of tumor suppressor gene (p53)
39
serum marker that decreases in Wilson disease
ceruloplasmin
40
fatal childhood hepatoencephalopathy ``` mitochondrial abn fatty liver hypoglycemia vomiting hepatomegaly coma ```
Reye syndrome
41
hobnail appearance of the liver
alcoholic cirrhosis
42
intracytoplasmic eosinophilic inclusions (Mallory bodies) are seen in
alcoholic hepatitis
43
aflatoxin: HCC | arsenic, vinyl chloride:
angiosarcoma
44
associated conditions with Budd-Chiari syndrome
hypercoagulable states polycythemia vera pregnancy HCC
45
conjugated hyperbilirubinemia due to defective liver excretion; presents with grossly black liver
Dubin-Johnson syndrome
46
absent UDPGT leading to unconjugated hyperbilirubinemia; fatal within a few years
Crigler - Najjar syndrome type I
47
treatment of Wilson disease
penicillamine
48
Kayser - Fleischer rings
Wilson disease | hepatolenticular degeneration
49
symptoms of Wilson disease
Copper is Hella BAD ``` Ceruloplasmin low, Cirrhosis, Corneal deposits, Carcinoma hepatocellular Hemolytic anemia Basal ganglia degeneration Asterixis Dementia, Dyskinesia, Dysarthria ```
50
symptoms of hemochromatosis
“Can Cause Deposits” Cirrhosis CHF Diabetes mellitus
51
autoimmune conditions associated with primary biliary cirrhosis
CREST Sjogren Rheumatoid arthritis Celiac disease
52
unknown cause of concentric “onion skin” bile duct fibrosis presents with alternating strictures and dilatation with beading of intra and extrahepatic bile ducts
Primary sclerosing cholangitis
53
migratory thrombophlebitis (Trousseau syndrome) seen in
pancreatic adenocarcinoma
54
obstructive jaundice with palpable, nontender gallbladder
Courvoisier sign in pancreatic adenocarcinoma
55
cause of isolated basophilia
myeloproliferative disease | CML
56
conditions decreasing ESR
``` polycythemia sickle cell disease microcytosis hypofibrinogenemia CHF ```
57
Conditions assoc with basophilic stippling
BASically, ACiD Alcohol is LeThal Anemia of chronic disease Alcohol Lead poisoning Thalassemias
58
Conditions assoc with target cell
HALT Hemoglobin C disease Asplenia Liver disease Thalassemia
59
Conditions assoc with basophilic stippling
BASically, ACiD Alcohol is LeThal Anemia of chronic disease Alcohol Lead poisoning Thalassemias
60
Conditions assoc with target cell
HALT Hemoglobin C disease Asplenia Liver disease Thalassemia
61
treatment of sideroblastic anemia
pyridoxine | cofactor of ALA synthase
62
causes of sideroblastic anemia
``` alcohol lead isoniazid vit B6 def copper def ```
63
anemia with elevated homocysteine and methylmalonic acid
Vit B12 deficiency | versus folate deficiency - normal methylmalonic acid
64
Nonmegaloblastic macrocytic anemias
liver disease alcoholism reticulocytosis drugs (5-FU, zidovudine, hydroxyurea)
65
Heinz bodies | Bite cells
G6PD deficiency
66
Triad of PNH
Pancytopenia veNous thrombosis Hemolytic anemia
67
``` Salmonella osteomyelitis Dactylitis Acute chest syndrome Avascular necrosis Stroke Renal papillary necrosis ``` are complications of
Sickle cell disease
68
AIHA seen in Mycoplasma infections and infectious Mononucleosis
Cold agglutinin (IgM)
69
AIHA seen in Mycoplasma infections and infectious Mononucleosis
Cold agglutinin (IgM)
70
Schistocytes (helmet cells) are seen in
Macro and microangiopathic hemolytic anemias, thalassemias
71
Conditions causing eosinopenia
Cushing syndrome | Corticosteroids
72
Conditions causing lymphopenia
HIV DiGeorge syndrome Corticosteroids SCID
73
Enzymes inhibited in lead poisoning
Ferrochelatase | ALA dehydratase
74
most common porphyria
porphyria cutanea tarda
75
5 Ps of Acute intermittent porphyria
``` Painful abdomen Port wine-colored urine Polyneuropathy Psychological disturbances Precipitated by drugs, alcohol and starvation ```
76
Treatment of acute intermittent porphyria
Glucose Heme (to decrease activity of ALA synthase)
77
platelet disorder characterized by anti GpIIb/IIIa antibodies may be triggered by viral illness
immune thrombocytopenia
78
platelet disorder characterized by deficiency of ADAMTS 13 (vWF metalloproteinase)
TTP
79
pentad of TTP
``` FAT RN Fever Anemia (microangiopathic hemolytic) Thrombocytopenia Renal (Uremia) Neurologic sx ```
80
most common inherited bleeding disorder
von Willebrand disease
81
Ristocetin cofactor assay is used in the diagnosis of
vWD (decreased agglutination)
82
Causes of DIC
``` STOP Making New Thrombi Sepsis (gram neg) Trauma OB complications Pancreatitis Malignancy Nephrotic syndrome Transfusion ```
83
decreased ability to inactivate factors V and VIII leading to thrombotic skin necrosis may present with hemorrhage following administration of warfarin
protein C or S deficiency
84
Contents of cryoprecipitate
``` Fibrinogen vWF Fibronectin Factor 8 Factor 13 ```
85
Blood transfusion risks (electrolyte imbalance)
Hypocalcemia | Hyperkalemia
86
S/Sx of Parkinson Disease
``` SMART Shuffling gait Mask-like facies Akinesia/bradykinesia Rigidity Tremors (resting) ```
87
disease characterized by bone pain, deformity and hearing loss increased abnormal osteoclasts - multinucleated cells (100 nuclei)
Paget’s disease of the bone
88
most common cause of male hypogonadism
Klinefelter syndrome
89
``` primary hypogonadism long lower extremities small, firm testes azoospermia intellectual disability gynecomastia sparse body hair ```
Klinefelter syndrome | 47 XXY
90
Arm span > height Long fingers Joint laxity
Marfanoid habitus
91
gross: | well-defined yellowish tumors of adrenal cortex
adrenocortical adenomas
92
electrolyte imbalance in Conn’s syndrome
hypokalemia, metab alka
93
T cell NHL
Adult T cell lymphoma | Mycosis fungoides / Sezary syndrome
94
lymphoma caused by HTLV-1
Adult T cell lymphoma (NHL)
95
high serum level of 17-hydroxyprogesterone is diagnostic of
21-hydroxylase deficiency | congenital adrenal hyperplasia
96
``` rapid linear growth weight gain excessive sweating oily skin prognathism (protrusion of jaw) thickened calvarium large hands and feet ```
Gigantism | Acromegaly
97
type of urethral injury presenting with high-riding prostate
posterior urethral injury | membranous urethra
98
impaired tail mobility of the sperm (ciliary dyskinesia) leading to infertility
Kartagener syndrome
99
Streak ovary Short stature Shield chest (bicuspid aortic valve, preductal CoA - notched ribs) Lymphatic defects (webbed neck, cystic hygroma, lymphedema) Horseshoe kidney
Turner syndrome | 45 XO
100
most common form of male pseudohermaphroditism
androgen insensitivity syndrome (testicular feminization)
101
condition resulting to female pseudohermaphroditism
CAH
102
autosomal recessive dso of sexual devt leading to ambiguous genitalia until puberty
5a reductase deficiency
103
referred pain in the shoulder due to peritoneal irritation, most likely splenic laceration
Kehr’s sign
104
gallstone ileus (stones >2.5cm) typically lodges in
ileum (narrowest portion of intestine)
105
most common intra abdominal organ injured during blunt trauma
spleen
106
conditions causing polyhydramnios
``` esophageal / duodenal atresia anencephaly maternal DM fetal anemia multiple gestation ```
107
most common ovarian tumor in the young (10-30 y/o)
Mature cystic teratoma | (dermoid cyst)
108
ovarian neoplasm with uniform “fried egg” cells appearance on histology
Dysgerminoma | GCT
109
large cells in the breast epidermis with clear halo suggesting an underlying DCIS
Paget cells
110
Peau d’orange is usually seen in this type of breast malignancy
Inflammatory breast CA
111
most common cause of scrotal enlargement in adult males
varicocele
112
most common testicular tumor
seminoma
113
most common testicular tumor in young boys (<3 y/o)
endodermal sinus tumor / yolk sac tumor
114
most common testicular tumor in older men
testicular lymphoma
115
tunica vaginalis lesion presenting as a testicular mass due to dilated epididymal duct
spermatocele
116
premalignant lesion presenting as leukoplakia in penile shaft
Bowen disease
117
most common extragonadal GCT in infants and young children
sacrococcygeal teratoma
118
pancreatic tumor presenting with diarrhea, cholelithiasis and DM
somatostatin-producing tumor
119
in lactase deficiency, stool pH is decreased (<6) because lactose is fermented by bacteria into:
short chain fatty acids: acetate butyrate propionate
120
constitutive activation of fibroblast growth factor receptor 3
achondroplasia | inhibition of chondrocyte proliferation
121
most common site of osteonecrosis
femoral head | insufficiency of medial circumflex femoral artery
122
primary bone tumor: | soap bubble appearance on xray
giant cell tumor
123
primary bone tumor: | onion skin appearance in bone
Ewing sarcoma
124
conditions presenting with overproduction of uric acid
Lesch-Nyhan syndrome Tumor lysis syndrome von Gierke disease
125
conditions strongly assoc with HLA-B27
PAIR Psoriatic arthritis Ankylosing spondylitis IBD Reactive arthritis
126
Dactylitis | pencil-in-cup deformity on xray
psoriatic arthritis
127
serum marker sensitive for drug-induced lupus
antihistone antibodies
128
``` enlarged lymph node restrictive lung disease bilateral hilar adenopathy increased serum ACE Schaumann and asteroid bodies ```
Sarcoidosis
129
most common cause of death in scleroderma
pulmonary sclerosis
130
acantholysis and nikolsky sign can be seen in
pemphigus vulgaris
131
acanthosis with parakeratotic scaling | more spinosum, less granulosum
psoriasis
132
sudden appearance of multiple seborrheic keratoses indicating an underlying malignancy
Leser - Trélat sign | GI, lymphoid malignancy
133
skin layer affected in: - SSSS - TEN
- Stratum Granulosum | - Epidermal-dermal junction
134
Infections assoc with Erythema Multiforme
Mycoplasma pneumoniae | HSV
135
Diseases assoc with erythema nodosum
sarcoidosis crohn’s disease leprosy TB strep infx histoplasmosis coccidioidomycosis
136
wickham striae seen in
lichen planus
137
most frequent feature of lateral medullary infarct
vertigo
138
most common location of syringomyelia (vertebral level)
C8-T1
139
assoc with lewy bodies (a synuclein)
Parkinson disease
140
atrophy of caudate nuclei on imaging
Huntington disease
141
choreiform movements aggression depression dementia CAG repeats AD
Huntington disease
142
regions in the brain that are highly vulnerable to ischemia
3 Ps Pyramidal neurons of HIPPOCAMPUS (temporal lobe) Pyramidal neurons of cortex (layers 3, 5, 6) Purkinje layer of cerebellum
143
Early microscopic finding in liquefactive necrosis of the brain
Red neurons | 12 hrs after infarction
144
most frequent location of a berry aneurysm
Anterior communicating artery
145
s/sx of Lesch - Nyhan syndrome
``` HGPRT Hyperuricemia Gout Pissed off (aggression) Retardation dysTonia ```
146
assoc with cystic degeneration of the putamen
Wilson’s disease
147
most common site of ICH
basal ganglia
148
cavernous sinus thrombosis affects which cranial nerves
3, 4, 5-1, 5-2, 6
149
clinical triad of urinary incontinence, ataxia and cognitive dysfunction
Normal pressure hydrocephalus ``` 3 Ws (wet, wobbly and wacky) -d/t disrupted corona radiata ```
150
s/sx of multiple sclerosis
SIN Scanning speech Intention tremors Nystagmus (random and asymmetrical tracts)
151
spinal cord lesion assoc with charcot joints and argyll robertson pupils
tabes dorsalis
152
peak incidence of sexual abuse
9 - 12 years old
153
most common form of child maltreatment
child neglect
154
most common subtype of depression
atypical depression
155
postpartum blues usually resolve within
10 days
156
dorsal hand calluses from induced vomiting
Russell sign of bulimia nervosa
157
caused by decreased orexin production in the lateral hypothalamus
narcolepsy
158
sensitive indicator of alcohol use
serum gamma glutamyl transferase
159
intoxication with this hallucinogen leads to perceptual distortions, depersonalization and possible flashbacks
LSD
160
most common lethal genetic disease in caucasian population
cystic fibrosis
161
peak of delirium tremens
2 to 5 days after last alcohol drink
162
tx of acute intermittent porphyria
glucose, heme | to inhibit ALA synthase
163
conditions characterized by wide splitting of S2
RBBB Pulmonic stenosis (delayed RV emptying)
164
conditions characterized by paradoxical splitting of S2
LBBB Aortic stenosis (delayed LV emptying)
165
most frequent valvular lesion
mitral valve prolapse
166
most common cause of coronary sinus dilatation
Pulmonary arterial hypertension (due to increased R-sided pressure)
167
most common cause of death during acute phase of rheumatic fever
myocarditis
168
complications of aortic stenosis
syncope and angina during exercise microangiopathic hemolytic anemia concentric LVH
169
endocarditis with Strep bovis, check for underlying..?
colorectal carcinoma
170
endocarditis with negative blood cultures
HACEK ``` Hemophilus Actinobacillus Cardiobacterium Eikenella Kingella ```
171
Rhabdomyoma of the heart is assoc with
tuberous sclerosis
172
most common primary cardiac tumor in adults
myxoma
173
causes of dilated cardiomyopathy
ABCCCD ``` Alcohol abuse Beri beri Cocaine (chronic) Chagas Coxsackie B Doxorubicin ```
174
most common childhood systemic vasculitis
HSP
175
small vessel vasculitis that are p-ANCA +
Microscopic polyangiitis | Churg Strauss
176
HAMARTOMAS of tuberous sclerosis
``` Hamartomas (CNS, skin) Angiofibromas Mitral regurg Ash-leaf spots Rhabdomyoma (cardiac) Tuberous sclerosis dOminant autosomal Mental retardation Angiomyolipoma (renal) Shagreen patches, seizures ```
177
congenital dse assoc with devt of berry aneurysms
Ehlers Danlos (type IV affecting type 3 collagen)
178
dses assoc with ADPKD
hepatic cysts berry aneurysms MVP
179
pathognomonic dermatologic feature of lightning strike
Lichtenberg figures
180
most common cause of mitral stenosis
prior rheumatic carditis
181
most common genetic cause of homocystinemia
MTHFR deficiency
182
ESRD on dialysis is at increased risk for which malignancy
renal cell carcinoma
183
most common cause of ARF (intrarenal azotemia)
acute tubular necrosis
184
nephrotic syndrome can present with hypercoagulable state due to loss of
antithrombin III
185
minimal change disease may be assoc with
Hodgkin lymphoma
186
most common nephrotic syndrome in SLE
membranous nephropathy
187
difference of Churg Strauss from microscopic polyangiitis
chAGE strauss Asthma Granulomatous inflam Eosinophilia
188
most common nephropathy worldwide
IgA nephropathy | Berger disease
189
WBC casts may be seen in
acute pyelonephritis
190
waxy casts may be seen in
chronic pyelonephritis
191
thyroidization of kidney occurs in
chronic pyelonephritis
192
most common type of nephrolithiasis
calcium oxalate stones
193
most common cause of bilateral fetal hydronephrosis in boys
posterior urethral valves
194
tuberous sclerosis is assoc with increased frequency of
angiomyolipoma
195
PAraneoplastic syndromes assoc with REnal cell ca
PA RE PTHrp ACTH Renin EPO
196
most common malignant renal tumor in children
Wilm tumor
197
syndromes assoc with Wilm’s tumor
WAGR | Beckwith - Wiedemann
198
benign counterpart of renal cell carcinoma
renal oncocytoma
199
conditions assoc with fibrinoid necrosis
PAN malignant HTN hyperacute transplant rejection
200
Goodpasture syndrome is assoc with what type of nephropathy
RPGN
201
GBM splitting can be seen in (2)
``` MPGN (tram-track) Alport syndrome (lamellated GBM) ```
202
Type I MPGN is assoc with
Hep B and C
203
2 associations of nasal polyps
cystic fibrosis | aspirin-intolerant asthma
204
eosinophil-derived crystals in sputum of asthma patients
Charcot-Leyden crystals
205
spiral-shaped mucus plugs seen in asthma
Curschmann spirals
206
interstitial lung disease increased serum ACE asteroid bodies
sarcoidosis
207
only pneumoconioses with increased risk for TB
silicosis
208
RA + coal workers’ pneumoconiosis
caplan syndrome
209
psammoma bodies can be seen in this type of lung malignancy
mesothelioma
210
preductal CoA bicuspid aortic valve horse shoe kidney assoc with?
Turner syndrome
211
paraneoplastic syndromes assoc with renal cell carcinoma
PTHrP ACTH ectopic EPO
212
most common sources of metastatic tumors to the brain (3)
breast lung kidney
213
most common location of metastatic tumors in the brain
gray-white junction
214
most common cause of sporadic enceph in the US
tempor lobe encephalitis
215
s/sx of cholinesterase inhibitor poisoning / organophosphate poisoning
DUMBBELSS ``` Diarrhea Urination Meiosis Bradycardia Bronchospasm Excitation of CNS and skeletal muscle Lacrimation Sweating Salivation ```
216
permanent tissues (3)
skeletal muscle cardiac muscle nerve
217
substances that attract and activate neutrophils (4)
LTB4 C5a IL-8 bacterial products
218
``` bone marrow/liver transplant maculopapular rash diarrhea jaundice hepatomegaly ```
GVHD
219
malignancies with propensity for bone mets
“PB KTL” lead kettle ``` Prostate Breast Kidney Thyroid Lung ```
220
most common cause of death in adults with sickle cell disease
acute chest syndrome
221
perivascular pseudorosettes are characteristic finding on biopsy
ependymoma
222
rosenthal fibers GFAP + cystic lesion with mural nodule
pilocytic astrocytoma
223
most common vitamin deficiency in the US
folic acid | B9
224
types of susceptible infection with decreased immunoglobulins (3)
bacteria enterovirus giardia
225
hypersensitivity type in Sjogren
type IV
226
sjogren syndrome increases the risk of | unilateral enlargement of parotid gland
B cell / marginal zone lymphoma
227
target protein of antibodies in Sjogren
ribonucleoproteins
228
target protein of antibodies in scleroderma
DNA topoisomerase I
229
autoimmune disease with antibodies against U1 ribonucleoprotein
MCTD
230
complication of nephrotic syndrome char by sudden onset flank pain, hematuria and varicocele
renal vein thrombosis
231
primary organ of osteoblastic bone mets
small cell lung CA Hodgkin lymphoma prostate CA

USMLE 2019 (10 decks)

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