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USMLE Step 1 > Pathology (all categories) > Flashcards

Pathology (all categories) Flashcards

(49 cards)

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1
Q

Type 1 Renal Tubular Acidosis (defect and findings)

A

Distal. pH > 5.5
Defect in ability of alpha intercalated cells to secrete H+. (new HCO3- is not generated).
Associated with hypokalemia. Inc risk for calcium phosphate kidney stones (due to inc urine pH and inc bone turnover)

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2
Q

Type 2 Renal Tubular Acidosis (defect and findings)

A

Proximal. pH < 5.5
Defect in proximal tubule HCO3- reabsorption results in inc excretion of HCO3- in urine. Metabolic acidosis. Urine is acidified by alpha intercalated cells in collecting tubule.
Hypokalemia. Inc risk for hypophosphatemic rickets (impaired bicarb reabsorption)

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3
Q

Type 1 Renal Tubular Acidosis (causes)

A

Causes: amphotericin B toxicity, multiple myeloma

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4
Q

Type 2 Renal Tubular Acidosis (causes)

A

Fanconi syndrome; chemicals (lead; aminoglycosides), carbonic anhydrase inhibitors

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5
Q

Type 4 Renal Tubular Acidosis (cause and findings)

A

*Hyperkalemia
pH < 5.5
Hypoaldosteronism, aldosterone resistance or K+ sparing diuretics. Impairs ammoniagenesis in the proximal tubule.

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6
Q

Renal Tubular Defects (mnemonic)

A 
The kidneys put out FABulous Glittering Liquid:
FAnconi syndrome (PCT)
Bartter syndrome (thick ascending loop of Henle)
Gitelman syndrome (DCT)
Liddle syndrome (collecting tubule)
all are "reabsorptive defects"
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7
Q

Fanconi Syndrome

A

Reabsorptive defect PCT
inc excretion of amino acids, glycose, bicarb, and phosphate
–> metabolic acidosis (only one)
causes: hereditary defects (wilson disease), ischemia

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8
Q

Bartter Syndrome

A

Reabsorptive defect TAL
Affects Na/K/2Cl transporter
–> hypokalemia and metabolic alkalosis WITH hypercalciuria (chloride build up = loss of driving force for reabsorption)

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9
Q

Gitelman Syndrome

A

Reabsorptive defect of NaCl in DCT

Hypokalemia and metabolic alkalosis WITHOUT hypercalciuria. b/c here Ca2+ depends on Vit D channels

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10
Q

Liddle Syndrome

A

INCREASED Na+ reabsorption in distal and collecting tubules.
Result: hypertension, hypokalemia, metabolic alkalosis.
Dec aldosterone.
Treatment: Amiloride (block Na+ channels)

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11
Q

Treacher Collins Syndrome

A

Failure of 1st-arch neural crest to migrate. Mandibular hypoplasia and facial abnormalities

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12
Q

Congenital Pharyngo-cutaneous Fistula

A

Persistence of cleft AND pouch –> fistula between tonsillar area and lateral neck

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13
Q

Branchial cleft cyst

A

Persistent cervical sinus: clefts 2-4 should have obliterated by proliferation of 2nd arch mesenchyme
Does NOT move with swallowing (unlike a thyroglossal duct cyst)

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14
Q

4th Branchial Arch (nerve, muscle, cartilage, and blood)

A

Nerve: CN X: Superior Laryngeal Branch
Muscle: pharyngeal constrictors. Cricothyroid
Cartilage: Thyroid and Cricocoid
Blood: Aortic Arch and Right Subclavian

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15
Q

6th Branchial Arch (nerve, muscle and blood)

A

Nerve: CN X: Recurrent laryngeal branch
Muscle: intrinsic muscles of larynx EXCEPT cricothyroid
Blood: Pulm Artery and Ductus Arteriosus

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16
Q

3rd Pouch

A

Dorsal wings: Inferior Parathyroid

Ventral wings: Thymus (ThImus)

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17
Q

4th Pouch

A

Superior parathyroid

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18
Q

Surface Ectoderm

A

Adenohypophysis; lens of eye; oral cavity; epidermis; anal canal below pectinate line; parotid, sweat and mammary glands

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19
Q

Neuroectoderm

A

CNS: Brain, retina, and optic nerve; spinal cord

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20
Q

Neural Crest

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A

PSN: cranial nerves; dorsal roota ganglia; melanocytes; parafollicular C cells of thyroid; bones of skull

21
Q

Mesoderm

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A

Muscle, bone, connective tissue; most organs

Heart and lymphatics. blood; kidneys;

22
Q

Notochord

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A

Induces ectoderm to form neuroectoderm (neural plate)

Only becomes nucleus pulposus of the intervertebral disc

23
Q

Endoderm

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A

Gut tube epithelium. luminal epithelial derivatives (lung, liver, gallbladder, pancreas, thymus, parathyroid)
GI, GU, Resp

24
Q

Gestational HTN vs Preeclampsia vs Eclampsia

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A

Gestational: + HTN - proteinuria - seizure
Preeclampsia: + HTN + proteinuria - seizure
Eclampsia: + HTN + proteinuria + seizure

25
Wolff-Chaikoff effect
excess iodine temporarily inhibits thyroid peroxidase --> dec iodine organification --> dec H3/T4 production
26
Conn Syndrome
Primary Hyperaldosteronism aldosterone-secreting adrenal adenoma -- HTN, hypokalemia, metabolic alkalosis (tetany), and LOW plasma renin Treatment: remove the tumor; use spironolactone
27
Secondary Hyperaldosteronism
Kidneys think low intravascular volume --> overactive RAAS cause: renal artery stenosis, CHF, cirrhosis, or nephrotic syndrome HIGH renin levels
28
Addison Disease
chronic primary adrenal insufficiency due to adrenal atrophy or destruction by disease deficiency of aldosterone and cortisol --> hypotension, hyperkalemia, acidosis and skin and mucosal hyperpigmentation (ACTH --> MSH) ALL 3 cortical levels (spares medulla)
29
Fixed, hard and painless neck mass
Riedel thyroiditis
30
Very tender thyroid
de Quervian (subacute thyroiditis)
31
Moderately enlarged, nontender thyroid
Hashimoto thyroiditis
32
Subacute thyroiditis (de Quervain)
self limited hypothryoidism following a flu-like illness (post viral infection; ex coxsackie or mumps) granulomatous inflammation (multinucleated giant cells) jaw pain and very tender thyroid
33
Hasimoto thyroiditis
hypothyroidsm: autoimmune disorder markers: anti-thyroid peroxidase and antithryroglobulin Ab inc risk of non-Hodgkins lymphoma Hurthle cells, lymphoid aggregate with germinal centers nontender thyroid
34
Riedel thyroiditis
Thyroid replaced by fibrous tissue (hypothyroid) | Similar to anaplastic carcinoma but this is younger patient and cancer is older patient
35
Jod-Basedow phenomenon
thyrotoxicosis if a patietn with iodine deficiency goiter is given iodine too fast (wgt loss but high appetite, tremor of hands, heat intolerance, anxiety, oligomenorrhea)
36
Graves Disease
Hyperthyroidism IgG autoantibodies stimulate TSH receptors; retro-orbital fibroblasts secrete glycosaminoglycans and cause swelling behind eyes = proptosis); dermal fibroblasts (pretibial myxedema) Need beta-blocker as A Fib is common
37
Toxic multinodular goiter
Focal patches of hyperfunctioning follicular cells working independently of TSH. inc release of T3 and T4
38
Thyroid Storm
stress-induced catecholamine surge: serious complication of Graves disease Agitation, delirium, fever, diarrhea, coma and tachyarrhythmia (cause of death) treat: beta-blocker, propylthiouracil, and corticosteroids
39
Pseudohypoparathyroidism
PTH receptor mutation normal PTH levels (or high) but can not stimulate receptor Hypocalcemia, short 4th/5th digit, short stature
40
Insulinoma
Tumor of beta cells --> hypoglycemia Whipple Triad of CNS symptoms: lethargy, syncope, and diplopia dec blood glucose and inc C-peptide can be part of MEN1
41
Glucagonoma
Tumor of alpha cells --> hyperglycemia ** leg rash: necrolytic migratory erythema Treatment: octreotide
42
Somatostatinoma
Tumor of delta cells: increased somatostatin | cholelithiasis + steatorrhea, diabetes mellitus, dec gastrin; dec cholecystokinin
43
Cortisol
BIG FIB inc: BP, Insulin resistance, Gluconeogenesis (proteolysis) dec: Fibroblast activation, Inflammation/Immune, Bone formation
44
Long Acting Insulin
Glargine and Detemir | GD: Good Day (only have to take once a day)
45
Regular Insulin
Short acting
46
Rapid Acting Insulin
Lispro, Aspart, Glulisine
47
Intermediate Acting Insulin
NPH
48
Carnitine Deficiency
inability to transport LCFAs into the mitochondria -- toxic accumulation causes: weakness, hypotonia, and hypoketotic hypoglycemia CARnitine = CARnage of fatty acids
49
Acyl-CoA dehydrogenase deficiency
decreased glucose AND ketones with fast

USMLE Step 1 (8 decks)

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