Review Game Flashcards
(196 cards)
1
Q
What are the names of the spots on the iris for children with down syndrome?
A
Brushfield spots
2
Q
A 26 year old pregnant female presents to ER with a myocardial infarction. She does not have a history of heart disease. What is the most likely cause?
A
Cocaine
3
Q
Which diagnostic test may be the first indicator of hemochromatosis?
A
- Elevated LFT
- iron levels
4
Q
Which spinal disorder in a tall youth should make you consider marfans?
A
scoliosis
5
Q
Identify types of cancer that are related to BRCA 1 and 2
A
- prostate
- pancreatic
- breast
- ovarian
6
Q
Patient presents with brown macules on lips, what condition may they have?
A
Peutz-jeghers
7
Q
Which bacteria results from cat scratch?
A
bordetella henselae
8
Q
Which infections are prevented by DTP vaccine series?
A
- diphtheria
- tetanus
- pertussis
9
Q
Which atypical pneumonia causing bacteria caused walking pneumonia in adolescents and teenagers?
A
mycoplasma pneumonia
10
Q
Which medication is the most common cause of hypokalemia?
A
diuretics
11
Q
What type of process is in place when there is direct hyperbilirubinemia?
A
blockage
12
Q
What type of injury will cause hyperkalemia?
A
crush injury
13
Q
What is the normal rate for erythrocyte sedimentation rate?
A
under 20
14
Q
Identify three symptoms of HYPERthyroidism?
A
- irritability
- fast metabolism, hunger
- heat intolerant
15
Q
What is the name of the fatty eyelid deposit found in familial hypercholesterolemia?
A
xanthelasma
16
Q
What are the three cardinal symptoms of acute chest syndrome in sickle cell anemia?
A
- chest pain
- dyspnea
- fever
17
Q
Which gram-negative bacillus is responsible for an infected hand wound after a bar fight?
A
eikenella corrodens
18
Q
Which bacteria that causes pneumonia can be caused by sitting in a hot tub or working with water?
A
legionella pneumoniae
19
Q
Which gram negative bacteria not typically found in the US is responsible for rice water stools?
A
cholera
20
Q
Which gram negative bacteria which causes pneumonia is typically given person to person especially in hospital, displays currant jelly sputum?
A
klebsiella pneumonia
21
Q
Which pathogenic organism responsible for diarrhea is obtained from eating undercooked pigs?
A
yersinia enterocolitica
22
Q
Which of red blood cell indices classify macro micro normocytic?
A
MCV
23
Q
Patient with low hemoglobin, low hematocrit, low iron, but ferritin is normal/ high. What type of anemia?
If there is low H&H, low iron and low ferritin, what type of anemia is this?
A
- anemia of chronic disease
- iron deficiency anemia
24
Q
Why would ferritin be normal to high in anemia of chronic disease?
A
acute phase reactant
25
Which organ should we blame in the case of indirect hyperbilirubinemia?
liver
26
Identify two hormones that regulate calcium levels in the body?
- parathyroid hormone
- calcitonin
27
Which gram positive bacteria that grows in chains is most common cause of bacterial pneumonia?
streptococcus pneumonia
28
What is the normal value for a total WBC?
4.5-11
29
If you have a patient and they have an ESR above 100, what is the most likely occurrence you think is happening with this patient ?
- overwhelming bacterial infection
- cancer
30
What animal does the typical hallmark rash of lupus resemble?
butterfly
31
Which bacteria causes infections often in hospitals and immunocompromised patients and has a grape odor and causes a blue green pus?
pseudomonas aeruginosa
32
What is the name of the gram positive bacteria that causes white exudates, sore throat, and anterior cervical lymphadenopathy?
streptococcus pyogenes
33
Bacteria that causes us to have positive reactions at 10 millimeters because of our job?
mycobacterium tuberculosis
34
What is wrong specifically with a hypochromic erythrocyte?
- pale because it lacks hemoglobin
35
When your patient has a high alkaline phosphatase level what two organs are indicated?
- liver
- bones
36
At what percentage of the hemoglobin A1C do we tell the patient they have diabetes?
6.5%
37
Pt has been diabetic for 10 years, what is their goal A1C?
7.0
38
What 2 positively charged substances when released cause RBC (Rouleaux) stacking?
- fibrinogens
- immunoglobulins
39
What autoimmune disease leads to joint pain, muscle pain, and hardening of the skin of the hands and mouth?
scleroderma
40
What autoimmune disease manifests with dry membranes, dry eyes, vaginal dryness, and increased risk of lymphoma?
sjogrens syndrome
41
What test should be ordered when you suspect that Group A strep(strep pyogenes) is the cause of their rash, suspect they have rheumatic fever, or kidney damage?
ASO titer
42
Identify the letters of the 4 bacteria that are considered pathogenic on a stool culture, that is not E. coli?
SSYC:
- Shigella
- Salmonella
- Yersinia
- Campylobacter
43
What is the name of the primary dermatologic manifestation in early syphilis?
chancres
44
Which genotype is represented in klinefelter's syndrome?
XXY
45
What is the appearance of the chest with a patient with turner's syndrome?
wide chest/wide nipples
46
Which medication which we use to treat blood clots causes nasal hypoplasia as a teratogen?
warfarin
47
What type of palmar defect is present in fetal alcohol syndrome?
hockey stick crease
48
How is early onset alzheimer's transmitted?
autosomal dominant
49
3 genes associated with early onset alzheimer's?
- APP
- presenilin 1
- presenilin 2
50
What is the medical term for spider fingers in Marfan’s syndrome?
arachnodactyly
51
What are the two pectus malformations with Marfan's syndrome?
- pectus excavatum
- pectus carinatum
52
What is the name of the hereditary colorectal syndrome when the mutation occurs at the end of the FAP gene?
attenuated FAP
53
What gram negative diplococcus named after disease it causes purpura fulminans races, headache and stiff neck?
neisseria meningitidis
54
What bacteria causes trismus (lockjaw) and lives in soil?
clostridium tetani
55
Which pathogen results from eating spoiled food leads to bilateral eyelid drooping (ptosis), double vision, difficulty swallowing, and generalized muscle weakness?
clostridium botulinum
56
Which diarrhea pathogen is acquired from soft cheese and deli meat which is why these are contraindicated in pregnancy?
listeria monocytogenes
57
What is the most common reason for lymphocytosis?
viral infection
58
Which teratogen can cause intrauterine passage of meconium and can cause the baby to be born addicted so they have to be weaned off with morphine?
opioids
59
Which teratogen can cause placental previa, PPROM, and increases the chances of SIDS, and can also cause anal atresia?
tobacco use
60
Which teratogen can cause cyanosis and hypotonia in a newborn?
benzodiazepines
61
Which teratogen is the most dangerous SSRI for the fetus and can cause gastroschisis, oomphalocele, alone with craniosynostosis and anencephaly?
paroxetine (paxil)
62
Which medication used to treat blood pressure can cause oligohydramnios?
ACEs/ARBs
63
Providers wanting to prescribe accutane have to submit what type of registration?
iPLEDGE
64
DES daughters have an increased risk for what cancers?
- cervical
- vaginal (early onset)
65
Which medication when taken during pregnancy can cause amelia, meromelia, or phocomelia?
thalidomide
66
Which drug can cause neurotoxicity, cardiac toxicity, and hepatotoxicity on the fetus if taken during pregnancy?
methamphetamine
67
What is the name of the crease on the palm of an individual with DS?
simian crease
68
An individual with DS can have extra space between which toes?
1 and 2
69
Why do individuals with DS have an increased risk of Alzheimer's?
APP gene found on chromosome 21
70
What is the genotype of turner syndrome?
XO
71
What are some characteristics of an individual with turners syndrome?
- short stature
- primary amenorrhea
- increased risk of cardiac issues
72
In which syndrome is the paternal copy inactivated so only the maternal copy is active?
angelman syndrome
73
In which syndrome is the maternal copy inactivated, so only the paternal copy is active?
prader-willi syndrome
74
- Which APOE gene reduces risk of alzheimer's?
- Which one means an individual has no risk and is most common?
- Which one means an individual is at an increased risk?
- APOE epsilon 2
- APOE epsilon 3
- APOE epsilon 4
75
How many CAG repeats to say that the patient and kids will develop Huntington's disease?
over 40
76
Which NF is more common?
NF 1
77
Which NF is associated with cafe-au-lait macules, cutaneous neurofibromas, plexiform neurofibromas, optic gliomas, and tibia bowing?
NF 1
78
- What does NF1 mutation suppress?
- What about NF2?
- neurofibromin
- merlin
79
Which NF presents with bilateral vestibular schwannomas, subtle cutaneous tumors, and tumors of the spine an meninges?
NF 2
80
What are the genes associated with PKD?
- polycystin 1 (PKD 1: more common, worse severity)
- polycystin 2 (PKD 2: less common, less severe)
81
What is the biggest worry with PKD?
intracranial aneurysm
82
Hereditary hemochromatosis is more common in what individuals? What are some manifestations? What is it potentiated by?
- males (onset after 40)
- hepatomegaly, elevated liver enzymes, bronze skin
- alcoholism and hepatitis
83
- Hemophilia A is a deficiency in what factor?
- What about Hemophilia B? What is another name for this?
- What about Hemophilia C?
- Factor 8
- Factor 9; Christmas disease
- Factor 11
84
What factor does VWD affect?
Factor 8
85
What is the inheritance of VWD type 1, 2, and 3?
- What is their severity?
- type 1: AD; mild
- type 2: AD or AR; moderate to severe
- type 3: AR; severe
86
What can you use to aid in marfan syndrome diagnosis?
ghent criteria
87
If a young person comes passes away from aortic dissection, what condition could they have had?
marfans
88
What are the 4 Ps of aneurysms?
- palor
- pulseless
- paralysis
- paresthesia
89
In which condition does the left ventricle become thickened and is inherited in an AD manner and is associated with dyspnea upon exertion?
hypertrophic cardiomyopathy
90
In which condition does the right ventricle become replaced with scar tissue and is inherited in an AD manner and is associated with arrythmias?
arrhythmogenic cardiomyopathy
91
What should you suspect in individuals who have Ashkenazi Jewish ancestry that come to see you and have breast cancer?
HBOC
92
What is the 2nd most common gynecological cancer?
ovarian
93
Which colorectal cancer (FAP) has mutations in the middle of the gene?
classic FAP
94
Which colorectal cancer is associated with uterine cancer and an individual will have less than 100 polyps?
lynch syndrome
95
What are gram-positive bacteria that we should know the names of?
"super silly baddies make cute clinicians"
- Staph
- Strep
- Bacillus
- Mycobacterium
- Clostridium
- Corynebacterium
96
What are some examples of atypical bacteria?
- mycoplasma
- chlamydia
- legionella
97
Which bacteria are true pathogens?
- Strep pneumoniae
- Staph aureus
- E. coli
- Pseudomonas aeruginosa
- Candida albicans
- Klebsiella pneumoniae
98
If an individual comes in with a systemic fungal infection (fungal pneumonia), what might be going on?
- HIV
- Immunocompromised
- Cancer
99
Which fungi need keratin to grow and what are some different types?
dermatophytes:
- tinea pedis (athletes foot)
- tinea corporis (ringworm)
- tinea capitis (scalp ringworm)
100
What are some diarrhea risk factors?
- drinking untreated water
- swimming in poorly treated pools
- working with animals or on farm
- daycare
- handling soil
101
What are different testing options to diagnose parasitic infections?
- blood smears
- stool cultures
- stool for ova and parasites
- CBC (elevated eosinphils)
- antigen testing
102
What type of amenia is the most common form and may be from poor diet, pregnancy, gastric by-pass?
iron deficiency anemia
103
What type of anemia results for lower levels of B12 or folate?
vitamin deficiency anemia?
104
What type of anemia results from destroying RBCs and can be from a snake bite?
hemolytic anemia
105
What type of anemia occurs in the presence of multiple chronic conditions?
anemia of chronic disease
106
What are the types of WBCs?
- monocytes
- lymphocytes
- granulocytes (eosinophils, basophils, neutrophils-most abundant)
107
If you observe a left shift with neutrophils (higher presence of immature neutrophils), what can you rule out?
steroids
108
What results from radiation or chemo, measles or influenza, aplastic anemia, alcohol abuse, and poor nutrition or gastric bypass?
leukopenia
109
What condition is associated with viral infections vs bacterial infections? (CMV, Mono, MMR)
lymphocytosis
110
What can lead to lymphopenia?
- compromised states
- malignancy
- sepsis from bacterial or fungal infections
- corticosteroids
111
What causes monocytosis?
- bacterial infections
- viral infections
- parasitic infections
- chronic inflammatory diseases
112
What causes eosinophilia?
- parasites
- allergic reaction disorders
113
What causes eosinopenia?
bacterial infections
114
What causes thrombocytosis?
- post surgery
- malignancy
- acute blood loss
- iron deficiency anemia
115
If an individual is living at high altitudes or hiking at high altitudes or has COPD, what condition might they have (labs)?
erythrocytosis
116
What can lead to erythrocytopenia?
- bleeding
- bone marrow failure
- poor nutrition
- pregnancy
117
- Small, low RBC volumes is (...)
- Larger than normal RBC volumes is (...)
- microcytic
- macrocytic
118
What value describes RBC color as normochromic, hyperchromic (red), and hypochromic (pale)?
MCHC
119
Hypochromic RBC are associated with what condition?
iron deficiency anemia
120
What describes the variation in RBC volume and size and a high value can be associated with immature RBC being sent out?
RDW
121
Normocytic anemia (low H&H, normal MCV) is associated with what?
ACD (75%), hemolytic anemia
122
Microcytic anemia (low H&H, low MCV) is associated with what?
- IDA
- ACD (25%)
123
Macrocytic anemia (low H&H, high MCV) is associated with what?
- alcoholism
- liver disease
- B12 or folate deficiency
124
Why would reticulocytes be elevated?
- hemolytic anemia
- blood loss
- bone marrow disorder
125
Why would reticulocytes be decreased?
- IDA
- vitamin deficiency anemia
- decreased EPO
- bone marrow failure
126
What can hemoglobin electrophoresis help diagnose?
sickle cell anemia
127
What is beta thalassemia more common in?
- asians
- african descent
- mediterranean
128
What are proteins that serve as chemical messengers that promote interactions and communication between cells and can increase inflammation or reduce it?
cytokines
129
Individuals with gastric bypass or low iron levels could have what ordered?
serum iron
130
What increases serum iron?
- alcoholic cirrhosis
- viral hepatitis
- high iron intake
- hereditary hemochromatosis
131
What decreases serum iron?
- colon cancer
- renal disease
- inadequate absorption (gastric bypass)
- increased demand (pregnancy)
- decreased intake (poor diet)
132
What is the gold standard for identifying states of anemia?
serum ferritin
133
What is the storage unit for iron?
ferritin
134
What are indications for testing ferritin?
- helps identify all causes of anemia
- differentiate b/w IDA and ACD/IDA
- monitor pts on iron therapy
135
- What serum ferritin value is associated with IDA?
- What about ACD?
- < 10
- > 10
136
What is responsible for iron transport in the body? What is this synthesized by?
transferrin; liver
137
Transferrin is decreased during (...) infections
bacterial
138
What does an increased total iron binding capacity (TIBC) mean? What condition is this associated with?
- empty seats available; less transferrin binding
- IDA, pregnancy
139
What does decreased TIBC mean? What conditions are associated with this?
- seats are full; more transferrin binding
- ACD, hemochromatosis
140
If an individual comes in younger than 40 with COPD symptoms and they do not smoke, what might they have?
alpha-1-antitrypsin deficiency
141
What alleles are associated with alpha-1-antitrypsin? What is its inheritance?
- M, Z, S
- autosomal codominant
142
What is synthesized mainly in the liver and is composed of amino acids which are gained through proper diet intake and transports protein for thyroxine and vitamin A?
prealbumin
143
Prealbumin may have increased levels during when?
- pregnancy
- long term renal disease
- steroid/alcohol use
144
Prealbumin may be decreased when?
- liver disease
- eating disorder
- malnutrition
145
Where is haptoglobin produced? This is also a what? What does it bind to?
- liver
- APR
- binds free hemoglobin when RBC are destroyed
146
What transports hemoglobin back to the liver where the heme is converted to bilirubin?
haptoglobin
147
What is very useful when looking for signs of hemolytic anemia due to there being a depletion of this due to excessive need?
haptoglobin
148
When can haptoglobin increase?
inflammation and infection
149
What causes haptoglobin to decrease?
- hemolytic anemia of any cause
- transfusion reaction
150
What are C3 and C4 considered? This means they will increase in states of what?
- APR
- inflammatory, infection, cancer
151
What test can you use to test specific complement factors or the entire complement system?
CH50 test
152
- What needs to be present for a normal CH50?
- What does a decreased MC50 mean?
- What does an MC50 of zero mean?
- all 9 proteins
- decreased complement activity
- one of pathway components completely absent
153
If a patient has an undetectable CH50, what can you order next?
C3 and C4
154
What leads to decreased C3 and C4?
- lupus
- cirrhosis
- hepatitis
155
Immunoglobulin usually found in secretions and along the mucosal epithelium
IgA
156
Found to activate basophils and mast cells (immunoglobin) that increased with chronic infections (leprosy, TB, malaria)
IgD
157
Allergic reactions and parasitic infections (immunoglobulin)
IgE
158
MAJOR antibody produced when an antigen is encountered; most prevalent antibody and has the longest half-life?
IgG
159
Initial antibody secreted after an immune challenge; indicated recent infection?
IgM
160
Neoplastic disorder which causes proliferation of a monoclonal immunoglobulin, usually IgG and IgA
multiple myeloma
161
The big spike in the gamma portion on serum electrophoresis is (...)
m spike/m protein
162
What can the CMP measure?
- kidney function
- liver function
- electrolytes
- proteins
- glucose monitoring
163
- What decreases sodium loss in kidneys?
- What increases sodium loss in the kidneys?
- aldosterone
- natriuretic hormone
164
How does ADH regulate sodium?
- decreased ADH increases urination
- increased ADH decreases urination
165
What causes hyponatremia?
- GI losses
- Renal disease
- medications (treatment for hypertension)
- Dietary sodium intake
166
If an elderly patient falls and can't reach water or is not given free access to water, what condition may they develop?
hypernatremia
167
What medication is associated with hyperkalemia?
ACE inhibitors
168
What can lead to hypoglycemia?
- insulin/oral anti-diabetic medication overdose
- starvation
- insulin-secreting tumors
169
What can lead to hyperglycemia?
- diabetes (most common)
- stress
- pancreatitis
- oral corticosteroids
170
What increases BUN?
- high protein diet
- GI bleeding
- dehydration
- renal failure
171
What decreases BUN?
- low protein diet
- liver failure
- overhydration
172
What should you expect if you see an individual with decreased BUN but they look healthy?
overhydration
173
What is the main reason for increased creatinine?
diabetic renal disease
- others: medication, dehydration, sepsis, urinary tract obstruction
174
What is the main reason for decreased creatinine?
decreased muscle mass
- others: debilitation
175
- What is pre-renal BUN/Creatinine ratio associated with?
- What is the ratio value?
- abnormalities that decrease BF to kidney
- > 20:1
176
- What is intra-renal BUN/creatinine ratio associated with?
- What is the ratio value?
- structural kidney abnormalities
- < 10:1
177
What is post-renal BUN/creatine ratio associated with?
What is the ratio value?
- obstruction of collecting system
- > 20:1; early looks like pre-renal, late will look like intra
178
What is the most common cause of hypercalcemia?
hyperparathyroidism
179
What is the most common cause of hypocalcemia?
hypoparathyroidism (hypoalbuminemia; vitamin D deficiency)
180
What is the normal percent of indirect bilirubin? direct?
- 70-85%
- 15-30%
181
What causes indirect hyperbilirubinemia?
liver issues - any disease that increases RBC destruction
182
What is the most abundant serum protein?
albumin
183
What causes hypoproteinemia?
- hepatic failure/disease
- malnutrition
- renal disease
184
What causes hyperproteinemia?
- dehydration
- malignancy
- infections
185
- Regulator of osmotic balance between intravascular and interstitial spaces
Pulls water into the circulatory system
- Transporter for drugs, bilirubin, calcium and thyroid hormones and other hormone enzymes
- Relatively long half life of 12-18 so bad indicator of chronic liver disease
albumin
186
What are the 3 enzymes in LFTs?
- ALP
- AST
- ALT
187
Cancer metastasizing to bone or primary cancer of the bone can lead to elevation in which LFT?
ALP
188
What tissues can AST be found in?
- heart
- liver
- skeletal mm
189
Where can you find ALT?
liver
190
Which LFT is specific to the liver?
ALT
191
What causes major increase if ALT?
hepatitis
192
- What should you think if AST:ALT >1?
- What about <1?
- alcohol cirrhosis (frequently >2); tumor of liver
- viral hepatitis
193
If ALP is elevated, what can you use to differentiate between bone or liver?
GGT
194
What can increase GGT?
liver disease (hepatitis, cirrhosis, alcoholic liver disease, liver cancer)
195
What can you order when you want to know renal and hydration status of pt but not concerned with liver?
BMP
196
What are some indications for LFT?
- jaundice
- dark urine
- hepatitis, hemochromatosis screening
- medication monitoring
- known liver disease
- alcohol abuse
