Random Topics Flashcards by Hayley Young

Which MD presents with sx age 2-3, proximal muscle weakness, Gower sign, calf pseudohypertrophy, dilated cardiomyopathy, elevated CK, and treated with glucocorticoids?

Duchenne Muscular Dystrophy (absent dystrophin)

XLR inheritance

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Which MD presents with milder weakness than Duchenne, cardiomyopathy, and presents age 5-15?

Becker Muscular Dystrophy

XLR inheritance

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Which MD presents age 12-30, facial weakness, grip myotonia, dysphagia, arrhythmias, cataracts, excessive daytime sleepiness, and testicular atrophy?

Classic Myotonic Dystrophy

AD inheritance
Trinucleotide repeat in DMPK gene

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What dx presents with parathyroid adenomas, pituitary adenomas, and pancreatic/GI tumors?

MEN1

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What dx presents with medullary thyroid cancer and pheochromocytoma?

MEN2

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How do you differentiate MEN2A from MEN2B?

MEN2A has parathyroid hyperplasia and MEN2B has mucosal neuromas and marfanoid habitus

Neuromas kind of look like B shape, and marfanoid habitus is a B-male

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What dx presents with massive amounts of watery diarrhea, hypokalemia, episodic flushing, mass in the pancreatic tail, and can sometimes correspond with MEN1?

VIPoma

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What dx presents with multiple ulcers in the stomach, duodenum, and small intestine, severe diarrhea, and thickened gastric folds on endoscopy?

Gastrinoma

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Which dx causes bone pain and deformity, osteolytic or mixed lytic/sclerotic bone lesions, can cause hearing loss and radiculopathy, giant cell tumor or osteosarcoma, has elevated alk phos but normal calcium and phosphate, is a dysfunction of osteoclasts, and is treated with bisphosphonates?

Paget disease

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Which dx causes bone pain and presents with elevated alk phos, elevated PTH, normal/decreased calcium, decreased phospate, and decreased Vit D?

Osteomalacia/Rickets

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What’s the most common cause of unilateral nipple bleeding?

Intraductal papilloma

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What tumor marker is elevated in hepatocellular carcinoma?

AFP

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What 3 fetal conditions cause elevated maternal serum AFP?

Open neural tube defects
Ventral wall defects
Multiple gestations

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What 2 fetal conditions cause decreased maternal serum AFP?

Trisomy 18

2. Trisomy 21

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How do you differentiate between Trisomy 18 and Trisomy 21 on second-trimester quad screen?

Both:

Decreased AFP
Decreased estriol

Trisomy 18:

Decreased B-hCG
Normal Inhibin A

Trisomy 21:

Increased B-hCG
Increased Inhibin A

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What tumor marker is elevated in non-seminomatous germ cell testicular tumors?

AFP

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What 2 tumor markers are elevated in malignant biliary obstruction?

2. Alk phos

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What might a low level of PAPPA at 8-14 weeks gestation mean?

Increased risk of IUGR, premature delivery, preeclampsia, and stillbirth

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Do seminomas have elevated AFP?

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Do mixed germ cell tumors have elevated AFP?

Yes

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Can mixed germ cell tumors metastasize to the anterior mediastinum?

Yes

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Which testicular tumor has elevated hCG and LDH?

Seminoma

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Which testicular tumor has elevated AFP and hCG?

Mixed germ cell tumor

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Which testicular tumor can cause increased estradiol in a man?

Leydig

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Which tumor can cause increased testosterone production in a female?

Sertoli-Leydig

Which ovarian tumor has elevated hCG and LDH?

Dysgerminoma

Which ovarian tumor in females grows quickly, often presenting with pelvic pain, and secretes AFP?

Yolk sac

Which ovarian tumor has elevated AFP and LDH?

Endodermal sinus tumor

Which ovarian tumor has elevated AFP only?

Immature teratoma

Which ovarian tumor has elevated AFP and hCG?

Embryonal carcinoma

Which ovarian tumor has elevated hCG only?

Choriocarcinoma

Which testicular tumor has elevated hCG and LDH?

Seminoma

Which testicular tumor has elevated AFP, hCG, and LDH?

Yolk sac

Which testicular tumor has VERY elevated hCG and elevated LDH?

Choriocarcinoma | Follows a pregnancy

Which testicular tumor has elevated AFP, hCG, and LDH?

Embryonal carcinoma

Which testicular tumor has just elevated AFP but doesn't have to?

Teratoma

Which 2 ovarian tumors can cause increased estrogen in a female?

Granulosa (malignant) & thecoma (benign)

Polymyositis vs. Polymyalgia Rheumatica?

Polymyositis: proximal muscle weakness, elevated ANA & CK Polymyalgia Rheumatica: Pain in shoulders, hip girdle, elevated ESR & CRP

What are the conditions that require an x-ray of the ankle?

Pain at the malleolar zone and 1 of the following: - Tender at posterior margin/tip of medial malleolus - Tender at posterior margin/tip of lateral malleolus - Unable to take 2 steps on each foot

What are the conditions that require an x-ray of the foot?

Pain at the midfoot zone and 1 of the following: - Tender at the navicular - Tender at the base of the 5th metatarsal - Unable to take 2 steps on each foot

What category of dx presents with oliguria, hematuria, HTN, RBC casts, and edema?

Nephritic syndrome

What dx presents with cola colored urine, edema, HTN, and occurs after GAS infex?

Post-infectious glomerulonephritis

What dx presents with episodic gross hematuria after URI or GI infex, often seen in young males?

IgA nephropathy (Berger's disease)

What dx presents with fever, WL, hematuria, respiratory, and sinus sx, and hemoptysis?

Wegener's granulomatosis

What dx presents with hematuria, hemoptysis, dyspnea, respiratory failure in males in their mid-20s?

Goodpasture's syndrome

What dx presents with hematuria, deafness, and eye disorders?

Alport's syndrome

What are the 5 nephritic syndromes?

"Nephritic WIG AP" Wegener's IgA Goodpasture's Alport Post-infectious

What category of dx presents with edema, HLD, proteinuria, and hypoalbuminemia?

Nephrotic syndrome

What dx presents with sudden onset of edema in kids?

Minimal change disease

What dx presents with edema, HLD, proteinuria, in a young African American male with uncontrolled HTN?

FSGS

What dx presents with edema, HLD, proteinuria, and is associated with HBV, syphilis, malaria, and gold?

Membranous nephropathy

What dx presents in a diabetic patient with edema, HLD, and proteinuria?

Diabetic nephropathy

What dx presents with proteinuria, edema, in a patient with lupus?

Lupus nephritis

What dx presents with proteinuria, edema, in a patient with multiple myeloma or RA?

Renal amyloidosis

What dx presents with proteinuria, edema, and may be associated with HCV, cryoglobulinemia, and subacute bacterial endocarditis?

Membranoproliferative nephropathy

What are the 7 types of nephrotic syndrome?

"MMM FRLD" Membranoprolif Membranous Minimal change FSGS Renal Amyloid Lupus Nephritis (weird yes) Diabetic

Which type of kidney stone is associated with calciuria and alkaline urine?

Calcium

Which type of kidney stone is associated with staghorn calculi and urease-producing organisms?

Struvite

Which type of kidney stone is associated with gout and acidic urine?

Uric acid

Which type of kidney stone is associated with a genetic disorder of transport of COLA aa's?

Cystine

What's the first step in suspected Cushing syndrome?

Low dose dexamethasone suppression test

After the low dose dex, what are the 2 options?

If ACTH is suppressed, this means it's an ectopic source If ACTH is elevated, then do either a high-dose dex test OR a CRH test

What does the following result mean?: Low dose dex: ACTH elevated High dose dex: ACTH suppressed

Cushing disease (pituitary)

What does the following result mean?: Low dose dex: ACTH elevated High dose dex: ACTH not suppressed

Ectopic ACTH secretion

What does the following result mean?: Low dose dex: ACTH elevated CRH stimulation test: ACTH and cortisol elevated

Cushing disease (pituitary)

What does the following result mean?: Low dose dex: ACTH elevated CRH stimulation test: ACTH and cortisol not elevated

Ectopic

What does the following result mean?: | Low dose dex: ACTH suppressed

Exogenous glucocorticoids or adrenal tumor

What are the 3 options for initial steps to diagnose Cushing syndrome?

1. Low dose dex 2. Late night salivary cortisol 3. 24-hour urinary cortisol

What is a normal anion gap?

8-12

What is an elevated anion gap?

Above 12

CO2 is an ____?

Acid

Bicarb is a ____?

Base

What does the mnemonic "MUDPILES" stand for in elevated anion gap metabolic acidosis?

Methanol Uremia DKA ``` Propylene glycol Iron tablets Lactic acidosis Ethylene glycol Salicylates ```

What does the mnemonic "HARDASS" stand for in normal anion gap metabolic acidosis?

Hyperalimentation Addison disease RTA Diarrhea Acetazolamide Spironolactone Saline infusion

What is the equation for anion gap?

Na - (Cl+HCO3)

What are the 4 causes of metabolic alkalosis?

1. Loop diuretics 2. Vomiting 3. Antacid use 4. Hyperaldosteronism

What's the BUN:Creatinine ratio in prerenal azotemia?

>20:1

What's the BUN:Creatinine ratio in ATN?

<20:1

What's the FENa in prerenal azotemia?

<1%

What's the FENa in ATN?

>1%

What's the urine sodium in prerenal azotemia?

<20

What's the urine sodium in ATN?

>20

What's the urine osmolality in prerenal azotemia?

>500

What's the urine osmolality in ATN?

<300

What knee injury results from a noncontact twisting mechanism, forced hyperextension, or impact to an extended knee?

ACL

What knee injury has a positive valgus stress test?

MCL

What knee injury has a positive varus stress test?

LCL

What knee injury results from directed force to the front of the flexed knee?

PCL

What knee injury has a positive McMurray test and may have clicking or locking?

Meniscal

The OS is ___?

Which condition is fixed splitting heard in?

ASD

What causes pulsus alternans?

Cardiac tamponade

What causes pulsus parvus et tardus?

Aortic stenosis

What's the FEV1/FVC ratio in asthma?

Low

What's the FEV1/FVC ratio in COPD?

Low

What are the 5 causes of low MCV anemia?

1. Iron deficiency 2. Thalassemia 3. Sideroblastic 4. Anemia of chronic dz 5. Spherocytosis

What are the 4 causes of normocytic anemia?

1. Blood loss 2. Hemolysis 3. Anemia of chronic dz 4. Aplasia

What are the 6 causes of macrocytic anemia?

1. Vit B12 & folate deficiency 2. Alcoholism 3. Liver disease 4. Drugs 5. Mydelodysplastic syndrome 6. Sideroblastic

If reticulocytes are high, what type of anemia is it (only 2 options)?

Hemolytic or chronic blood loss (both normocytic)

How do you calculate NNT?

NNT = 1/ARR

How do you calculate ARR?

Percent 1 - percent 2 | in decimal forms

How do you calculate ARP?

ARP = (RR-1)/RR

What is this question asking:? "What percent of colorectal carcinoma in women with high fat consumption could be attributable to diet?"

ARP

What is the following asking:? "How many patients with diabetes undergoing PCI need to be treated with efrenzia to prevent 1 additional event, as compared with clopidogrel?"

NNT

What is the definition of Hazard Ratio?

If it's <1, the treatment group had a lower event rate If it's >1, the treatment group had a higher event rate

Sensitivity =

Sensitivity = A/(A+C)

Specificity =

Specificity = D(B+D)

What does a cross-sectional study measure?

Disease prevalence

What does a case-control study measure?

Odds ratio

What does a cohort study measure?

Relative risk

What does a cohort study measure?

Relative risk

What are the percents for the bell curve for the first, second, and third SD's?

68% 95% 99.7%

Which test checks for differences between means of 2 groups?

t-test

Which test checks for differences between means of 3+ groups?

ANOVA

Which test checks for differences between 2 or more percentages of categorical outcomes? Eg: comparing the percentage of members of 3 diff ethnic groups who have HTN?

Chi-square