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Most common cause of neural tube defects

Folate deficiency

* MC nutritional deficit in US

1

MCC of congenital malformation in US

Ethanol use during pregnancy

3

MCC of congenital intellectual disability in US?

Fetal alcohol syndrome

4

3 amino acids modfied in the golgi appartus

1. asparagine
2. serine
3. threonine

5

hyperflexible joints, arachnodactyly, aortic dissection, lens dislocation

Marfan syndrome

(defective fibrillin, which holds together trophoelastin subunits)

6

Heriditary nephritis, cataracts, sensorineural hearing loss

Alport syndrome

(defective Type IV collagen, found in basement membrane of eye, ear, kindey); cant see, cant pee, cant hear high C

7

Unilateral facial drooping involving the forehead

Bell's palsy

*if forehead unaffected, think stroke

8

Ptosis, miosis and anhydrosis

Horner's syndrome

*lesion of spinal cord above T1

9

Worst HA of life

Subarachnoid hemorrhage

10

lucid interval

epidural hematoma

11

Bloody CSF

subarachnoid hemorrhage

12

MCC of subdural hematoma (anatomically)

torn bridging veins
(hitting head of old person/ alcoholic; shaking baby syndrome)

13

MCC of epidural hematoma

Rupture of middle meningeal artery(banch of maxillary)--> frequently secondary to fracture of temporal bone

14

Urinary incontinence, ataxia, cognitive dysfunction

Normal pressure hydrocephalus (wet, wacky, wild)

*sx due to expansion of ventricles compressing corona radiata

15

Amyloid deposits in gray matter of brain

senile plaques (Alzheimers)

16

Drooling, sweating, agitated farmer

Organophosphate poisoning

17

Medical treatment for pheochromocytoma

Alpha antagonist--> usually phenoxybenzamine (binds irreversibly)

18

selective A1 antagonist used to treat BPH

Tamsulosin--> is specific for alpha 1A, Alpha 1D receptors found in the prostate; little effects on the alpha 1b receptors found in vasculature

19

continuous machine like heart murmur

patent ductus arteriosus (PDA)

* is a non-cyanotic shunt (L to R)

20

"boot-shaped heart"

Tetralogy of Fallot

* is a sign of right ventricular hypertrophy; can be indicative of pulmonary HTN in adult

21

rib notching, or pulsating pulses on ribs

coarctation of aorta

22

MCC congenital cardiac anomaly

VSD (ventricular septal defect)

23

MCC congenital cause of early cyanosis

Tetralogy of Fallot

* review the 4 issues
*transposition of the great vessels may be a close 2nd, causes profound cyanosis

24

bounding pulses, head-bobbing, diastolic murmur

aortic regutgitation

* bounding pulses due to the wide pulse pressures (normal systolic, but diastolic much lower due to loss of blood through incompetent aortic valve

25

bone enlargement, bone pain, arthritis

Paget's disease of bone

26

vertebral compression fractures

osteoporosis

27

positive anterior drawer sign

torn ACL

28

swollen, hard, painful finger joints (which hand joints involved)

osteoarthritis

(DIP and PIP)

29

swollen, boggy, painful finger joints (which joints involved)

rheumatoid arthritis

(PIP and MIP--> spares the DIPs)

30

swollen, red, acutely painful great toe joint

gout

31

positively birefringent crystals

pseudogout

*blue when perpendicular!!--> rhomboid shaped classicaly, but can be needle shaped
* big joints, like Knee!

32

negatively birefringent crystals

gout

*yellow when parallel--> classically needle shaped

33

HLA-DR4

Rheumatoid arthritis

34

HLA-B27

seronegative spondyloarthropathies , esp with men

("PAIR" = psoriatic arthritis, Ankylosing spondylitis, IBS, Reactive arthritis (aka Reiter's syndrome))

35

bamboo spine on x-ray

ankylosing spondylitis

36

painless oral ulcers plus raised erythematous lesions and photosensitivity

SLE--> painless oral ulcers is a buzzword

37

Anti-smith and anti-ds DNA Abs

SLE

*anti-dsDNA Abs is specific for renal manifestations of lupus

38

anti-histone Abs

drug induced SLE

39

anti-centromere Abs

CREST scleroderma

40

anti-topoisomerase I Abs (and what is other name for these)

Systemic scleroderma

*scl-70

41

Anti-Ro Abs or anti La Abs

Sjogren's syndrome

*Ro = SS-A
*La = SS-B

42

facial rash and raynaud phenomenon in young woman

SLE

43

arthritis, dry mouth, dry eyes

Sjogrens syndrome

44

most common cause of death in SLE

Lupus nephritis/ nephropathy

45

keratin pearls on skin biopsy

Squamous cell carcinoma

46

MC malignant skin tumor

Basal cell carcinoma

*basal cell > squamous > melanoma

47

MC cancer in men

Prostatic adenocarcinoma

48

MCC of urinary obstruction in men

BPH

49

MC treatment for ED in men

sildafenil or vardafenil

50

Dysplastic cervical cells with enlarged, dark nuclei

Koilocytes--> HPV infection

51

DES exposure

Clear cell adenocarcinoma of vagina

52

MC tumor in women

Leiomyoma

53

MC gynecologic malignancy in the U.S.

endometrial carcinoma

54

MC gynecologic malignancy worldwide

Cervical CA

55

chocolate cyst of ovary

endometriosis

56

MC benign ovarian tumor

Serous cystadenoma

57

MC malignant ovarian tumor

serous cystadenocarcinoma

58

disarrayed granulosa cells in eosinophilic fluid

Call-exner bodies--> Granulosa cell tumor

59

MC genetic cause of intellectual disability

Down's syndrome (trisomy 21)

60

2nd MC genetic cause of intellectual disability

Fragile X syndrome

61

horseshoe kidney, congenital heart defects, streak ovaries, cystic hygroma

Turner's syndrome

62

rocker bottom feet, clenched hands, microcephaly with prominent occiput and small jaw

Edwards syndrome (trisomy 18)

63

MC cancer in women in US

Breast CA

64

MC benign breast tumor

Fibroadenoma (esp in women under 35)

65

MC malignant breast tumor

Invasive ductal carcinoma

66

blue dome cyst in breast

Fibrocystic change

67

Treatment for ER (+) breast CA

Tamoxifen

68

Red, itchy, swollen rash on nipple and areola

Paget's disease of breast

*commonly indicates an underlying breast carcinoma, usually ductal carcinoma in situ (DCIS)

69

branching, filamentous Gram (+) rods with sulphur granules

Actinomyces israelii

70

food poisoning due to exotoxin (2)

1. S. aureus (vomiting within 2-3 hours, think mayo)
2. B. cereus (reheated rice)

71

osteomylelitis in Sickle cell

Salmonella

72

MC medication used for UTI prophylaxis

TMP-SMX

73

MC bacterial infection in a pt. w/ struvite (rams horn) kidney stone

Proteus mirabilis

(sometimes S. aureus)

74

standard tx for T. palladium

Penicillin

75

cellulitis form dog or cat bite

Pasteurella multocida

76

non-painful, indurated ulcerous lesion

Syphilis chancre--> primary syphilis

77

moist, smooth, flat, white genital lesion

condylomata lati--> secondary syphilis

78

Large bulls eye rash

erythema migrans--> Lyme disease

79

calcified granuloma in lung, plus hilar lymphadenopathy

Ghon Complex--> primary TB

80

Back pain, fever, night sweats and weight loss

Pott's disease (extrapulmonary reactivated TB, secondary TB)

81

standard treatment regimen for TB

1. Rifampin
2. Isoniazid
3. Pyrazinamide
4. Ethambutol

82

eczema, recurrent cold abscesses, high serum IgE

Hyperimmunoglobilin E syndrome (Job syndrome)

83

large lysosomal vesicles in phagocyte

Chediak-Higashi Syndrome

84

Toe extension upon stimulating sole of foot with blunt instrument

positive Babinski

85

Hyperreflexia, increased muscle tone, positive Babinski

Upper Motor neuron lesion

86

Hyporeflexia, decreased muscle tone, muscle atrophy, fasciculations

Lower motor neuron lesion

87

Depigmentation of substantia nigra

Parkinson's disease

88

Chorea, dementia, atrophy of caudate and putamen

Huntington's disease

89

Eosinophilic inclusions in the cytoplasm of neurons

Lewy bodies (alpha-synulcein deposits)

90

conjugate lateral gaze palsy, with nystagmus and diplopia during lateral gaze

Internuclear opthalmoplegia

91

degenerating dz of dorsal columns

Tabes dorsalis

92

demyelinating dz in a young woman

Multiple Sclerosis

93

Mixed upper and lower motor neuron disease

AML

94

newborn with arm paralysis following labor

Upper trunk (C5-C6) lesion--> Erb-duchenne palsy

95

MCC of dementia

Alzheimers

96

2nd MCC cause of dementia

Vascular (multi-infarct) dementia

97

Extracellular amyloid deposits in grey matter

Amyloid plaques of Alzheimers

98

Intracellular deposits of hyperphosphorylated tau protein

Neurofibrillary tangles (alzheimers)

99

intracellular spherical aggrgates of tau protein seen on silver stain

Pick bodies (frontotemporal dementia)

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