IVMS Cell Biology and Pathology Flash Facts I

Cell Biology and Pathology Flash Facts
Q0001:Three cell types with regard to cell cycle
Permanent; Stable; Labile
Q0002:Rough Endoplasmic Reticulum rich cells
-Mucus-secreting goblet cells of small intestine;-Antibodysecreting plasma cells;(ie lost of secretory protein)
Q0003:Cell cycle: Permanent cells
Remain in G0. If they regenerate; they regenerate from stem cells.
Q0004:Cell cycle: Stable cells
Enter G1 from G0 when stimulated
Q0005:Cell cycle: Labile cells
Never go to G0; divide rapidly with a short G1
10
Q0006:Smooth Endoplasmic Reticulum: Functions
11
-Steroid synthesis;-Detoxification of drugs and poisons
12
Q0007:Permanent cells: cell types
13
-Neurons;-Skeletal and cardiac muscle;-RBCs (regenerate from stem cells)
14
Q0008:Stable cells: cell types
15
-Hepatocytes;-Lymphocytes
16
Q0009:Smooth Endoplasmic Reticulum rich cells
17
-Liver hepatocytes;-Steroid hormone-producing cells of the adrenal cortex
18
Q0010:Labile cells: cell types
19
-Bone marrow;-Gut epithelium;-Skin;-Hair follicles;(think about chemotherapy side effects)
20
Q0011:Rough Endoplasmic Reticulum: Functions
21
-Synthesis of secretory (exported) proteins;-N-linked oligosaccharide addition to many proteins
22
Q0012:Neurons: name of Rough Endoplasmic Reticulum and its function
23
Nissl bodies sytnhesize enzymes (eg ChAT) and peptide neurotransmitters.
24
Q0013:6 functions of Golgi apparatus
25
1. Distribution center;--Input: Proteins and lipids from endoplasmic reticulum;--Output: Plasma membrane; lysosomes; secretory vesicles;2. Modifies N-oligosaccharides on asparagine;3. Adds O-oligosaccharides to serine and threonine residues (on protein);4. Addition of mannose-6phosphate to proteins designated for lysosome;5. Proteoglycan assembly from core proteins;6. Sulfation of sugars in proteoglycans and of selected tyrosine on proteins
26
Q0014:I-cell disease: Presentation
27
-coarse facial features;-clouded corneas;-restricted joint movement;-high plasma levels of lysosomal enzymes;-fatal in childhood
28
Q0015:3 types of vesicular trafficking proteins
29
COPI; COPII; and Clathrin
30
Q0016:COPI: Function
31
Retrograde Intracellular transport: cis-Golgi to RER
32
Q0017:COPII: Function
33
Anterograde Intracellular transport: RER to cis-Golgi
34
Q0018:Clathrin: Function
35
Extracellular/lysosomal transport;-lysosome: trans-Golgi to lysosome ;-trans-Golgi to plasma membrane to endosomes (for receptor mediated endocytosis)
36
Q0019:Microtubules: Diameter
37
24 nm
38
Q0020:Microtubules: Structure
39
13 dimers of alpha/beta tubulin per circumference (each dimer bound to GTP); repeated in helical configuration
40
Q0021:Microtubules: Found in ?
41
-Flagella;-Cilia;-Mitotic spindles;-Slow neuronal axoplasmic transport
42
Q0022:Microtubules: Speed of growth and collapse
43
Grows slowly and collapses quickly
44
Q0023:Microtubules: Affected by which drugs?
45
-Mebendazole/thiabendazole (antihelminthic);-Taxol (antibreast cancer);-Griseofulvin (anti-fungal);Vincristine/Vinblastine (anti-cancer);-Colchicine (anti-gout)
46
Q0024:Microtubule polymerization defects: Found in what syndrome
47
Chediak-Higashi syndrome
48
Q0025:Chediak-Higashi syndrome
49
Microtubule polymerization defect resulting in decreased phagocytosis
50
Q0026:Cilia: Structure
51
-9+2 arrangement of microtubule doublets;-The 9 peripheral doublets are linked by dynein atpase
52
Q0027:Cilia: Mechanism
53
The 9 peripheral doublets are linked by dynein atpase; which causes bending of cilium by differential sliding of doublets
54
Q0028:Molecular motors and direction of transport in cell
55
Dynein: retrograde (DIES back towards nucleus);Kinesin: anterograde (MOVES kinetically forward)
56
Q0029:Kartagener's syndrome: Defect
57
Dynein arm defect causing immotile cilia
58
Q0030:What is phosphatidylcholine also known as?
59
lecithin
60
Q0031:Kartagener's syndrome: Presentation
61
-Male infertility (immotile sperm);-Female infertility (immotile fallopian cilia);-Bronchiectasis and recurrent sinusitis (bacteria and particles not pushed out);-Situs inversus
62
Q0032:What syndrome is situs inversus associated with?
63
Kartagener's
64
Q0033:Plasma membrane: composition
65
-Cholesterol (~50%);-Phospholipids (~50%);-Sphingolipids;Glycolipids;-Proteins
66
Q0034:What is lecithin also known as?
67
phosphatidylcholine
68
Q0035:Plasma membrane: melting temperature association
69
High cholesterol or long saturated fatty acid content means increased melting temperature
70
Q0036:Where is phosphatidylcholine found?
71
Major component of;1. RBC membranes;2. myelin;3. bile;4. surfactant (DPPC- dipalmitoyl phosphatidylcholine)
72
Q0037:Drugs that inhibit the sodium-potassium pump
73
-Ouabain;-Cardiac glycosides (digoxin; digitoxin)
74
Q0038:Ouabain: Mechanism
75
Inhibits Na-K atpase by binding to K site.
76
Q0039:What process uses phosphatidylcholine?
77
Esterification of cholesterol with LCAT (lecithin-cholesterol acyltransferase)
78
Q0040:Cardiac glycosides: Mechanism
79
Inhibits Na-K atpase; increasing cardiac contractility
80
Q0041:True or False: Collagen is not the most abundant protein in the body?
81
False; it is. (25% of all protein in the human body is collagen)
82
Q0042:True or False: Collagen is the most abundant protein in the body?
83
True. (25% of all protein in the human body is collagen)
84
Q0043:Collagen types and their primary locations
85
Be (So Totally) Cool; Read Books;1. (90% of all collagen) Bone; Skin; Tendon (bONE);2. Cartilage (carTWOlage);3. (Reticulin)-blood vessels;4. Basement membrane
86
Q0044:Collagen Type I locations
87
Be (So Totally) cool; read books;-Bone (bONE);-Skin;Tendon;-dentin;-fascia;-cornea;-late wound repair
88
Q0045:Collagen Type II locations
89
be (so totally) COOL; read books;-Cartilage (carTWOlage);vitreous body;-nucleus pulposus
90
Q0046:Collagen Type III locations
91
be (so totally) cool; READ books;(Reticulin);-blood vessels;skin;-uterus;-fetal tissue;-granulation tissue
92
Q0047:Collagen Type IV locations
93
be (so totally) cool; read BOOKS;-basement membrane or basal lamina;(four under the floor)
94
Q0048:Collagen synthesis: list of events and locations
95
Intracellular;1. Synthesis (Rough Endoplasmic Reticulum);2. Hydroxylation (Endoplasmic Reticulum);3. Glycosylation (Golgi);4. Exocytosis;Extracellular;5. Proteolytic processing;6. Cross-linking
96
Q0049:Collagen production step 1: Synthesis
97
-In rough endoplasmic reticulum;-translation of collagen alpha chains (aka preprocollagen)
98
Q0050:Composition and other name of collagen alpha-chains
99
-Gly-X-Y (where X and Y are proline; hydroxyproline; or hydroxylysine);-aka preprocollagen
100
Q0051:Composition and other name of preprocollagen
101
-Gly-X-Y (where X and Y are proline; hydroxyproline; or hydroxylysine);-aka collagen alpha-chains
102
Q0052:Collagen production step 2: Hydroxylation
103
-In endoplasmic reticulum;-Hydroxylation of specific proline and lysine residues (using vitamin C)
104
Q0053:Collagen production step for which vitamin C is required
105
Hydroxylation of Gly-X-Y chains to form hydroxyproline or hydroxylysine
106
Q0054:Collagen production step 3: Glycosylation
107
-In Golgi apparatus;-Glycosylation of preprocollagen lysine residues and formation of procollagen (triple helix of three collagen alpha chains)
108
Q0055:Composition of procollagen
109
Triple helix of three collagen alpha chains (aka three preprocollagen chains)
110
Q0056:Osteogenesis Imperfecta: Pathophysiology
111
Cannot take glycosylated alpha-chains and form procollagen (triple helix)
112
Q0057:Collagen production step 4: Exocytosis
113
Exocytosis of procollagen
114
Q0058:Collagen production step 5: Proteolytic processing
115
Cleavage of terminal regions of procollagen; transforming it into insoluble tropocollagen
116
Q0059:Composition of tropocollagen
117
Procollagen (triple-helix) with terminal regions cleaved
118
Q0060:Collagen production step 6: Cross-linking
119
Reinforcement of many staggered tropocollagen molecules by covalent lysine-hydroxylysine cross-linkage to make collagen fibrils
120
Q0061:Enzyme which performs collagen cross-linking (final step)
121
Lysyl oxidase
122
Q0062:Ehlers-Danlos syndrome: Pathophysiology
123
Nonfunctioning lysyl oxidase resulting in lack of collagen fibrils (linked tropocollagen molecules)
124
Q0063:Ehlers-Danlos syndrome: Presentation
125
-Hyperextensible skin;-Tendency to bleed/easy bruising;Hypermobile joints
126
Q0064:Ehlers-Danlos syndrome: # of types
127
10
128
Q0065:Ehlers-Danlos syndrome: Inheritance
129
Varies
130
Q0066:Ehlers-Danlos syndrome: Most frequently affected collagen type and result
131
Type III collagen resulting in blood vessel instability
132
Q0067:Osteogenesis Imperfecta: Types
133
-Abnormal collagen type I (bONE);--Most common;-Autosomal-dominant;-Type II;--Fatal in utero or neonatal period
134
Q0068:Osteogenesis Imperfecta: Presentation
135
1. Brittle bone disease: Multiple fractures with minimal trauma (often during birth);2. Blue sclearae (due to translucency of connective tissue over the choroid);3. Hearing loss (abnormal middle ear bones);4. Dental imperfections due to lack of dentition
136
Q0069:Multiple fractures in a child: Differential Diagnosis
137
-Child abuse;-Osteogenesis Imperfecta
138
Q0070:Osteogenesis Imperfecta: Incidence
139
1:10;000
140
Q0071:Immunohistochemical stain for: Connective tissue
141
Vimentin
142
Q0072:Immunohistochemical stain for: Muscle
143
Desmin
144
Q0073:Immunohistochemical stain for: Epithelial cells
145
Cytokeratin
146
Q0074:Immunohistochemical stain for: Neuroglia
147
GFAP (Glial fibrillary acid proteins)
148
Q0075:Immunohistochemical stain for: Neurons
149
Neurofilaments
150
Q0076:Vimentin stains for:
151
Connective tissue
152
Q0077:Desmin stains for:
153
Muscle
154
Q0078:Cytokeratin stains for:
155
Epithelial cells
156
Q0079:GFAP (Glial fibrillary acid proteins) stains for:
157
Neuroglia
158
Q0080:Neurofilaments stain for:
159
Neurons
160
Q0081:Elastin: Description and Location
161
Stretchy protein within lungs; large arteries; elastic ligaments
162
Q0082:Elastin and Collagen: Peptide composition difference
163
Both: Proline and lysine rich;Collagen: Hydroxylated forms;Elastin: Non-hydroxylated forms
164
Q0083:Elastin: Structure
165
Tropoelastin with fibrillin scaffolding (fibrillin defect in Marfan's syndrome)
166
Q0084:Elastin: Conformations
167
Relaxed and stretched
168
Q0085:Elastase: function
169
Break down elastin
170
Q0086:Elastase inhibitor
171
alpha-1-antitrypsin
172
Q0087:Elastase excess: Found where
173
Found in emphysema
174
Q0088:Association of emphysema with elastase
175
Excess elastase activity can cause emphysema
176
Q0089:Apoptosis: Characteristics
177
1. Cell shrinkage;2. Chromatin condensation;3. Membrane blebbing;4. Formation of apoptotic bodies which are then phagocytosed
178
Q0090:Apoptosis: Events which initiate it
179
-Embryogenesis;-Hormone induction (menstruation);-Immune cell-mediated death;-Injurious stimuli (eg radiation; hypoxia);Atrophy
180
Q0091:Necrosis: Definition
181
Enzymatic degradation of a cell resulting from exogenous injury
182
Q0092:Necrosis: Characteristics
183
1. Enzymatic digestion;2. Protein denaturation;3. Release of intracellular components;4. Inflammatory process.
184
Q0093:Necrosis: Types and where they are found
185
1. Coagulative (heart; liver; kidney);2. Liquefactive (brain);3. Caseous (Tuberculosis);4. Fat (Pancreas);5. Fibrinoid (blood vessels);6. Gangrenous (limbs; GI tract)
186
Q0094:Reversible or irreversible cell injury: Cellular swelling
187
Reversible
188
Q0095:Reversible or irreversible cell injury: Nuclear chromatin clumping
189
Reversible
190
Q0096:Reversible or irreversible cell injury: Decreased ATP synthesis
191
Reversible
192
Q0097:Reversible or irreversible cell injury: Ribosomal detachment
193
Reversible
194
Q0098:Reversible or irreversible cell injury: Glycogen depletion
195
Reversible
196
Q0099:Reversible or irreversible cell injury: Plasma membrane damage
197
Irreversible
198
Q0100:Reversible or irreversible cell injury: Lysosomal rupture
199
Irreversible
200
Q0101:Reversible or irreversible cell injury: Calcium influx leading to oxidative phosphorylation
201
Irreversible
202
Q0102:Reversible or irreversible cell injury: Nuclear pyknosis
203
Irreversible
204
Q0103:Reversible or irreversible cell injury: Karyolysis
205
Irreversible
206
Q0104:Reversible or irreversible cell injury: Karyorrhexis
207
Irreversible
208
Q0105:Reversible or irreversible cell injury: Mitochondrial permeability
209
Irreversible
210
Q0106:Inflammation: Classic signs
211
-Rubor (redness);-Dolor (pain);-Calor (heat);-Tumor (Swelling);-Functio lassa (Loss of function)
212
Q0107:Characteristics of Inflammation: Fluid exudation
213
1. Increased vascular permeability;2. Vasodilation;3. Endothelial injury
214
Q0108:Characteristics of Inflammation: Leukocyte activation
215
1. Emigration;2. Chemotaxis;3. Phagocytosis and killing
216
Q0109:Characteristics of Inflammation: Fibrosis
217
1. Fibroblast emigration and proliferation;2. Deposition of extracellular material
218
Q0110:Characteristics of Acute Inflammation
219
Mediated by;1. Neutrophils;2. Eosinophils;3. Antibodies
220
Q0111:Characteristics of Chronic Inflammation
221
Mediated by mononuclear cells;-Characterized by persistant destruction and repair;-Granulomas: nodular collections of macrophages and giant cells
222
Q0112:Characteristics of Inflammation: Resolution
223
1. Restoration of normal structure;2. Granulation tissue;3. Abscess;4. Fistula;5. Scarring
224
Q0113:Granulation tissue: histologic characteristics
225
-highly vascularized;-fibrotic
226
Q0114:Abscess: histologic characteristics
227
fibrosis surrounding pus
228
Q0115:Fistula: characteristics
229
abnormal communication
230
Q0116:Scarring: histologic characteristics
231
Collagen deposition resulting in altered structure and function
232
Q0117:Steps in leukocyte emigration
233
1. Rolling;2. Tight binding;3. Diapedisis;4. Migration
234
Q0118:Leukocyte emigration step characteristics: Rolling
235
Binding between;-E-selectin on vascular endothelium;-SialylLewisX on the leukocyte
236
Q0119:Leukocyte emigration step characteristics: Tight binding
237
binding between;-ICAM-1 on vascular endothelium ;-LFA-1 on leukocyte
238
Q0120:Leukocyte emigration step characteristics: Diapedesis
239
leukocyte travels between endothelial cells and exits blood vessel
240
Q0121:Leukocyte emigration step characteristics: Migration
241
Leukocyte travels through interstitium to the site of injury or infection guided by chemotactic signals
242
Q0122:Chemotactic signals
243
1. Bacterial products;2. Complement;3. Chemokines
244
Q0123:Free radical injury: Initiated by what?
245
1. Radiation exposure;2. Metabolism of drugs (phase I);3. Redox reactions;4. Nitric oxide;5. Transition metals;6. Leukocyte oxidative burst
246
Q0124:Free radical injury: Mechanism
247
-Membrane lipid peroxidation;-Protein modification;-DNA breakage
248
Q0125:Free radical injury: Stopped by what?
249
-Spontaneous decay;-Antioxidants;--Vitamin E;--Vitamin A;Enzymes;--Catalase;--Superoxide dismutase;--Glutathione peroxidase
250
Q0126:Major cause of injury after thrombolytic therapy
251
Free-radical production induced by reperfusion after anoxia
252
Q0127:Hyperplasia: definition
253
reversible increase in number of cells
254
Q0128:Metaplasia: definition
255
Reversible substitution of one cell type for another.
256
Q0129:Metaplasia: When found?
257
Often secondary to irritation and/or environmental exposure (eg squamous metaplasia in trachea and bronchi of smokers)
258
Q0130:Dysplasia: definition
259
Reversible abnormal growth with loss of cellular orientation; shape and size in comparison to normal tissue maturation
260
Q0131:Dysplasia: When found?
261
In paraneoplastic syndromes
262
Q0132:Anaplasia: definition
263
abnormal cells lacking differentiation; like primitive cells of same tissue.
264
Q0133:Anaplasia: When found?
265
Undifferentiated malignancies
266
Q0134:Neoplasia: Definition
267
A clonal proliferation of cells that is uncontrolled and excessive
268
Q0135:Difference between hyperplasia and dysplasia
269
Can occur together;1. hyperplasia - increase in number;2. dysplasia - abnormal proliferation of cells with loss of size; shape; and orientation
270
Q0136:Appearance of cancerous cells
271
-High nuclear/cytoplasmic ratio;-Clumped chromatin
272
Q0137:How does carcinoma invade a basement membrane?
273
-Collagenases;-Hydrolases
274
Q0138:Seed and soil theory of metastasis
275
Seed: Tumor embolus;Soil: Target organ
276
Q0139:Tumor grade: definition
277
Degree of cellular differentiation based on histologic appearance of tumor
278
Q0140:Tumor stage: definition
279
Degree of localization/spread based on site and size of primary lesion; spread to regional lymph nodes; and presence of metastases
280
Q0141:Tumor grade vs stage: Quick characterization
281
grade: character of tumor itself;stage: spread of tumor in a specific patient (Stage=Spread)
282
Q0142:Tumor grade vs stage: Which has more prognostic value?
283
Stage
284
Q0143:TNM staging system
285
Tumor size;Node involvement;Metastases
286
Q0144:Benign tumors of cell type: Blood cells
287
Does not exist. The malignant blood cells are automatically metastasizing.
288
Q0145:Benign tumors of cell type: Blood vessels
289
Hemangioma
290
Q0146:Benign tumors of cell type: Smooth muscle
291
Leiomyoma
292
Q0147:Benign tumors of cell type: Skeletal muscle
293
Rhabdomyoma
294
Q0148:Benign tumors of cell type: Bone
295
Osteoma
296
Q0149:Benign tumors of cell type: Fat
297
Lipoma
298
Q0150:Benign tumors of cell type: >1 cell type
299
Mature teratoma (women)
300
Q0151:Benign tumors of cell type: Epithelium
301
-Adenoma;-Papilloma
302
Q0152:Malignant tumor of cell type: Epithelium
303
-Adenocarcinoma;-Papillary carcinoma
304
Q0153:Malignant tumor of cell type: Blood cells
305
-Leukemia;-Lymphoma
306
Q0154:Malignant tumor of cell type: Blood vessels
307
Angiosarcoma
308
Q0155:Malignant tumor of cell type: Smooth muscle
309
Leiomyosarcoma
310
Q0156:Malignant tumor of cell type: Skeletal muscle
311
Rhabdomyosarcoma
312
Q0157:Malignant tumor of cell type: Bone
313
Osteosarcoma
314
Q0158:Malignant tumor of cell type: Fat
315
Liposarcoma
316
Q0159:Malignant tumor of cell type: >1 cell type
317
Immature teratoma; Mature teratoma (men only)
318
Q0160:Name the cell type: Adenoma
319
Epithelium
320
Q0161:Name the cell type: Papilloma
321
Epithelium
322
Q0162:Name the cell type: Adenocarcinoma
323
Epithelium
324
Q0163:Name the cell type: Papillary carcinoma
325
Epithelium
326
Q0164:Name the cell type: Leukemia
327
Blood cells
328
Q0165:Name the cell type: Lymphoma
329
Blood cells
330
Q0166:Name the cell type: Hemangioma
331
Blood vessels
332
Q0167:Name the cell type: Angiosarcoma
333
Blood vessels
334
Q0168:Name the cell type: Leiomyoma
335
Smooth muscle
336
Q0169:Name the cell type: Leiomyosarcoma
337
Smooth muscle
338
Q0170:Name the cell type: Rhabdomyoma
339
Skeletal muscle
340
Q0171:Name the cell type: Rhabdomyosarcoma
341
Skeletal muscle
342
Q0172:Name the cell type: Osteoma
343
Bone
344
Q0173:Name the cell type: Osteosarcoma
345
Bone
346
Q0174:Name the cell type: Lipoma
347
Fat
348
Q0175:Name the cell type: Liposarcoma
349
Fat
350
Q0176:Name the cell type: Teratoma
351
>1 cell type
352
Q0177:Neoplasm associated with: Down syndrome
353
ALL (we ALL fall Down); AML
354
Q0178:Neoplasm associated with: Xeroderma pigmentosum
355
Melanoma and basal/squamous cell carcinomas of the skin
356
Q0179:Neoplasm associated with: albinism
357
Melanoma and basal/squamous cell carcinomas of the skin
358
Q0180:Neoplasm associated with: Chronic atrophic gastritis
359
Gastric adenocarcinoma
360
Q0181:Neoplasm associated with: Pernicious anemia
361
362
Q0182:Neoplasm associated with: Post surgical gastric remnants
363
364
Q0183:Neoplasm associated with: Tuberous sclerosis (facial angiofibroma; seizures; mental retardation)
365
Astrocytoma and cardiac rhabdomyoma
366
Q0184:Neoplasm associated with: Actinic Keratosis
367
Squamous Cell Carcinoma of skin
368
Q0185:Neoplasm associated with: Barrett's esophagus
369
Esophageal adenocarcinoma
370
Q0186:Neoplasm associated with: Plummer-Vinson syndrome (atrophic glossitis; esophageal webs; anemia; all due to iron deficiency)
371
Squamous Cell carcinoma of the esophagus
372
Q0187:Neoplasm associated with: Cirrhosis (alcoholic; hepatitis B and C)
373
Hepatocellular carcinoma
374
Q0188:Neoplasm associated with: Ulcerative colitis
375
Colonic adenocarcinoma
376
Q0189:Neoplasm associated with: Paget's disease of bone
377
Secondary osteosarcoma and fibrosarcoma
378
Q0190:Neoplasm associated with: Immunodeficiency states
379
Malignant lymphomas
380
Q0191:Neoplasm associated with: AIDS
381
Aggressive malignant lymphomas (non-Hodgkin's) and Kaposi's sarcoma
382
Q0192:Neoplasm associated with: Autoimmune diseases
383
Benign/malignant thymomas
384
Q0193:Neoplasm associated with: Acanthosis nigricans (hyperpigmentation and epidermal thickening)
385
Visceral malignancy (stomach; lung; breast; uterus)
386
Q0194:Neoplasm associated with: Dysplastic nevus
387
Malignant melanoma
388
Q0195:Condition associated with: ALL
389
Down syndrome (we ALL fall Down)
390
Q0196:Condition associated with: AML
391
Down syndrome
392
Q0197:Condition associated with: Melanoma
393
Xeroderma pigmentosum and albinism;If malignant; dysplastic nevus
394
Q0198:Condition associated with: Basal cell carcinoma of skin
395
Xeroderma pigmentosum and albinism
396
Q0199:Condition associated with: Squamous cell carcinoma of skin
397
Actinic keratosis; Xeroderma pigmentosum and albinism
398
Q0200:Condition associated with: Gastric adenocarcinoma
399
1. Chronic atrophic gastritis;2. Pernicious anemia;3. Postsurgical gastric remnants
400
Q0201:Condition associated with: Astrocytoma
401
Tuberous sclerosis (facial angiofibroma; seizures; mental retardation)
402
Q0202:Condition associated with: Cardiac rhabdomyoma
403
Tuberous sclerosis (facial angiofibroma; seizures; mental retardation)
404
Q0203:Condition associated with: Esophageal adenocarcinoma
405
Barrett's esophagus
406
Q0204:Condition associated with: Squamous cell carcinoma of esophagus
407
Plummer-Vinson syndrome
408
Q0205:Plummer-Vinson syndrome: Presentation
409
-Atrophic glossitis;-Esophageal webs;-Anemia
410
Q0206:Plummer-Vinson syndrome: Cause
411
Iron deficiency
412
Q0207:Condition associated with: Hepatocellular carcinoma
413
Cirrhosis due to;1) alcohol;2) hepatitis B or C
414
Q0208:Condition associated with: Colonic adenocarcinoma
415
Ulcerative colitis
416
Q0209:Condition associated with: Secondary osteosarcoma
417
Paget's disease of bone
418
Q0210:Condition associated with: Fibrosarcoma
419
Paget's disease of bone
420
Q0211:Condition associated with: Malignant lymphomas
421
Immunodeficiency states
422
Q0212:Condition associated with: aggressive malignant nonHodgkin's lymphoma
423
AIDS
424
Q0213:Condition associated with: Kaposi's sarcoma
425
AIDS
426
Q0214:Condition associated with: Benign thymoma
427
Autoimmune diseases (eg Hashimoto's thyroiditis; myasthenia gravis)
428
Q0215:Condition associated with: Malignant thymoma
429
Autoimmune diseases (eg Hashimoto's thyroiditis; myasthenia gravis)
430
Q0216:Condition associated with: Visceral malignancy
431
Acanthosis nigricans
432
Q0217:Acanthosis nigricans: Presentation
433
-Hyperpigmentation;-Epidermal thickening
434
Q0218:Tumor associated with this gene: abl
435
CML
436
Q0219:Tumor associated with this gene: c-myc
437
Burkitt's lymphoma
438
Q0220:Tumor associated with this gene: bcl-2
439
Follicular and undifferentiated lymphomas (inhibits apoptosis)
440
Q0221:Tumor associated with this gene: erb-B2
441
Breast; ovarian; and gastric carcinomas
442
Q0222:Tumor associated with this gene: ras
443
Colon carcinoma
444
Q0223:Tumor associated with this gene: L-myc
445
Lung tumor (L for Lung)
446
Q0224:Tumor associated with this gene: N-myc
447
Neuroblastoma (N for Neuroblastoma)
448
Q0225:Tumor associated with this gene: ret
449
Multiple endocrine neoplasia types II and III
450
Q0226:Gene associated with this tumor: CML
451
oncogene abl (philadelphia chromosome)
452
Q0227:Gene associated with this tumor: Burkitt's lymphoma
453
oncogene c-myc
454
Q0228:Gene associated with this tumor: Follicular lymphoma
455
oncogene bcl-2 (inhibits apoptosis)
456
Q0229:Gene associated with this tumor: Undifferentiated lymphoma
457
oncogene bcl-2 (inhibits apoptosis)
458
Q0230:Gene associated with this tumor: Breast carcinoma
459
oncogene erb-B2
460
Q0231:Gene associated with this tumor: Ovarian carcinoma
461
oncogene erb-B2
462
Q0232:Gene associated with this tumor: Gastric carcinoma
463
oncogene erb-B2
464
Q0233:Gene associated with this tumor: Colon carcinoma
465
oncogene ras
466
Q0234:Gene associated with this tumor: Lung tumor
467
oncogene L-myc (L for Lung)
468
Q0235:Gene associated with this tumor: Neuroblastoma
469
oncogene N-myc (N for neuroblastoma)
470
Q0236:Gene associated with this tumor: Multiple Endocrine Neoplasia type I
471
oncogene MEN1 encoding menin on chromosome 11q
472
Q0237:Gene associated with this tumor: Multiple Endocrine Neoplasia type II
473
oncogene ret
474
Q0238:Gene associated with this tumor: Multiple Endocrine Neoplasia type III
475
oncogene ret
476
Q0239:Chromosome and tumor associated with this gene (what type of gene): Rb
477
Tumor suppressor gene on 13q: Retinoblastoma; osteosarcoma
478
Q0240:Chromosome and tumor associated with this gene (what type of gene): BRCA1
479
Tumor suppressor gene on 17q: Breast and ovarian cancer
480
Q0241:Chromosome and tumor associated with this gene (what type of gene): BRCA2
481
Tumor suppressor gene on 13q: Breast and ovarian cancer
482
Q0242:Chromosome and tumor associated with this gene (what type of gene): p53
483
Tumor suppressor gene on 17p: Most human cancers and LiFraumeni Syndrome
484
Q0243:Chromosome and tumor associated with this gene (what type of gene): p16
485
Tumor suppressor gene on 9p: Melanoma
486
Q0244:Chromosome and tumor associated with this gene (what type of gene): APC
487
Tumor suppressor gene on 5q: Colorectal cancer
488
Q0245:Chromosome and tumor associated with this gene (what type of gene): WT1
489
Tumor suppressor gene on 11q: Wilm's tumor
490
Q0246:Chromosome and tumor associated with this gene (what type of gene): NF1
491
Tumor suppressor gene on 17q: Neurofibromatosis type 1
492
Q0247:Chromosome and tumor associated with this gene (what type of gene): NF2
493
Tumor suppressor gene on 22q: Neurofibromatosis type 2
494
Q0248:Chromosome and tumor associated with this gene (what type of gene): DPC
495
Tumor suppressor gene on 18q: Pancreatic cancer
496
Q0249:Chromosome and tumor associated with this gene (what type of gene): DCC
497
Tumor suppressor gene on 18q: Colon cancer
498
Q0250:Gene and associated tumor on chromosome: 5q
499
Tumor suppressor gene APC: Colorectal cancer
500
Q0251:Gene and associated tumor on chromosome: 9p
501
Tumor suppressor gene p16: melanoma
502
503
Tumor suppressor gene WT1: Wilm's tumor
504
505
Tumor suppressor genes Rb (Retinoblastoma; Osteosarcoma) and BRCA2 (Breast and Ovarian cancer)
506
Q0254:Gene and associated tumor on chromosome: 17p
507
Tumor suppressor gene p53: Most human cancers and LiFraumeni syndrome
508
509
Tumor suppressor genes BRCA1 (Breast and ovarian cancer) and NF1 (Neurofibromatosis type 1)
510
511
Tumor suppressor genes DPC (Pancreatic cancer) and DCC (Colon cancer)
512
513
Tumor suppressor gene NF2: Neurofibromatosis type 2
514
Q0258:Gene and matching chromosome associated with: Retinoblastoma
515
Tumor suppressor gene Rb on chromosome 13q
516
Q0259:Gene and matching chromosome associated with: Osteosarcoma
517
Tumor suppressor gene Rb on chromosome 13q
518
Q0260:Gene and matching chromosome associated with: Breast cancer
519
Tumor suppressor genes BRCA1 (17q) and BRCA2 (13q)
520
Q0261:Gene and matching chromosome associated with: Ovarian cancer
521
Tumor suppressor genes BRCA1 (17q) and BRCA2 (13q)
522
Q0262:Gene and matching chromosome associated with: Most human cancers
523
Tumor suppressor gene p53 on chromosome 17p
524
Q0263:Gene and matching chromosome associated with: LiFraumeni syndrome
525
526
Q0264:Gene and matching chromosome associated with: Melanoma
527
528
Q0265:Gene and matching chromosome associated with: Colorectal cancer
529
Tumor suppressor gene APC on chromosome 5q
530
Q0266:Gene and matching chromosome associated with: Wilms' tumor
531
Tumor suppressor gene WT1 on chromosome 11q
532
Q0267:Gene and matching chromosome associated with: Neurofibromatosis type 1
533
Tumor suppressor gene NF1 on chromosome 17q
534
Q0268:Gene and matching chromosome associated with: Neurofibromatosis type 2
535
Tumor suppressor gene NF2 on chromosome 22q
536
Q0269:Gene and matching chromosome associated with: Pancreatic cancer
537
Tumor suppressor gene DPC on chromosome 18q
538
Q0270:Gene and matching chromosome associated with: Colon cancer
539
Tumor suppressor gene DCC on chromosome 18q
540
Q0271:Oncogenes: gain or loss of function QUICK
541
onco: gain
542
Q0272:tumor suppressor genes: gain or loss of function QUICK
543
tumor suppressor: loss
544
Q0273:Oncogenes: one or two alleles need to be damaged QUICK
545
One (gain of function)
546
Q0274:Tumor suppressor genes: one or two alleles need to be damaged QUICK
547
Two (loss of function)
548
Q0275:Association for tumor marker: PSA
549
Screening for Prostatic Carcinoma
550
Q0276:Association for tumor marker: CEA
551
-Carcinoembryonic antigen;-In ~70% of colorrectal and pancreatic cancers;-Also produced by gastric and breast carcinomas;-Very nonspecific
552
Q0277:Association for tumor marker: alpha-fetoprotein
553
-Hepatocellular carcinomas;-Nonseminomatous germ cell tumors of the testis (eg yolk sac tumor)
554
Q0278:Association for tumor marker: beta-hCG
555
-Hydatidiform moles;-Choriocarcinomas;-Gestational trophoblastic tumors
556
Q0279:Association for tumor marker: CA-125
557
Ovarian malignant epithelial tumors
558
Q0280:Association for tumor marker: S-100
559
-Melanoma;-Neural tumors;-Astrocytomas
560
Q0281:Association for tumor marker: Alkaline phosphatase
561
-Metastases to bone;-Obstructive biliary disease;-Paget's disease of bone
562
Q0282:Association for tumor marker: Bombesin
563
-Neuroblastoma;-Lung cancer;-Gastric cancer
564
Q0283:Association for tumor marker: TRAP
565
-Tartrate-resistance acid phosphatase;-Found in hairy cell leukemia
566
Q0284:What type of cell is found in hairy cell leukemia?
567
B-cells
568
Q0285:Association for tumor marker: CA-19-9
569
Pancreatic adenocarcinoma
570
Q0286:Tumor marker for: Prostatic carcinoma
571
-PSA;-Prostatic acid phosphatase
572
Q0287:Tumor marker for: Colorectal cancer
573
CEA - Carcinoembryonic antigen;-Produced by 70% of colorectal cancers
574
Q0288:Tumor marker for: Pancreatic cancer
575
CEA - Carcinoembryonic antigen;-Produced by 70% of pancreatic cancers;CA-19-9;-Produced in pancreatic adenocarcinoma
576
Q0289:Tumor marker for: Gastric carcinoma
577
-CEA - Carcinoembryonic antigen;-Bombesin
578
Q0290:Tumor marker for: Breast carcinoma
579
CEA - Carcinoembryonic antigen
580
Q0291:Tumor marker for: Hepatocellular carcinoma
581
alpha-fetoprotein
582
Q0292:Tumor marker for: Nonseminomatous germ cell tumors of the testis
583
alpha-fetoprotein
584
Q0293:Tumor marker for: Hydatidiform moles
585
beta-hCG
586
Q0294:Tumor marker for: Choriocarcinoma
587
beta-hCG
588
Q0295:Tumor marker for: Gestational Trophoblastic tumors
589
beta-hCG
590
Q0296:Tumor marker for: Malignant ovarian epithelial tumors
591
CA-125
592
Q0297:Tumor marker for: Melanoma
593
S-100
594
Q0298:Tumor marker for: Neural tumors
595
General: S-100;Neuroblastoma: Bombesin
596
Q0299:Tumor marker for: Astrocytomas
597
S-100
598
Q0300:Tumor marker for: Metastases to bone
599
Alkaline phosphatase
600
Q0301:Tumor marker for: Obstructive biliary disease
601
602
Q0302:Tumor marker for: Paget's disease of bone
603
604
Q0303:Tumor marker for: Neuroblastoma
605
Bombesin
606
Q0304:Tumor marker for: Lung cancer
607
Bombesin
608
Q0305:Tumor marker for: Hairy cell leukemia
609
TRAP (Tartrate-resistant acid phosphatase)
610
Q0306:Tumor marker for: Pancreatic adenocarcinoma
611
CA-19-9
612
Q0307:Cancer associated with: HTLV-1
613
HTLV=Human T-Lymphotropic Virus;Adult T-cell leukemia
614
Q0308:Cancer associated with: HBV
615
616
Q0309:Cancer associated with: HCV
617
618
Q0310:Cancer associated with: EBV
619
-Burkitt's lymphoma;-Nasopharyngeal carcinoma
620
Q0311:Cancer associated with: HPV
621
-Cervical carcinoma (with HPV 16;18);-Penile/anal carcinoma
622
Q0312:Cancer associated with: HHV-8
623
HHV-8 = Kaposi's sarcoma-associated herpes virus;-Kaposi's sarcoma;-body cavity fluid B-cell lymphoma
624
Q0313:Oncogenic virus associated with: Adult T-cell leukemia
625
HTLV-1 (HTLV=Human T-Lymphotropic Virus)
626
Q0314:Oncogenic virus associated with: Hepatocellular carcinoma
627
-HBV ;-HCV
628
Q0315:Oncogenic virus associated with: Burkitt's lymphoma
629
EBV
630
Q0316:Oncogenic virus associated with: Nasopharyngeal carcinoma
631
EBV
632
Q0317:Oncogenic virus associated with: Cervical carcinoma
633
HPV 16 and 18
634
Q0318:Oncogenic virus associated with: Penile carcinoma
635
HPV
636
Q0319:Oncogenic virus associated with: Anal carcinoma
637
HPV
638
Q0320:Oncogenic virus associated with: Kaposi's sarcoma
639
HHV-8 (aka Kaposi's sarcoma-associated herpesvirus)
640
Q0321:Oncogenic virus associated with: body cavity fluid Bcell lymphoma
641
HHV-8 (Human Herpesvirus 8)
642
Q0322:Organ affected by: Aflatoxins
643
Liver (hepatocellular carcinoma)
644
Q0323:Organ affected by: Vinyl chloride
645
Liver (angiosarcoma)
646
Q0324:Organ affected by and effects of: CCl4
647
Liver;-centrilobular necrosis;-fatty change
648
Q0325:Organ affected by: Nitrosamines
649
-Esophagus;-Stomach
650
Q0326:Organ affected by: Cigarette smoke
651
-Larynx;-Lung
652
Q0327:Organ affected by: Asbestos
653
Lung;-Mesothelioma;-Bronchogenic carcinoma
654
Q0328:Organ affected by: Arsenic
655
Skin (squamous cell carcinoma)
656
Q0329:Organ affected by: Naphthalene (aniline) dyes
657
Bladder (transitional cell carcinoma)
658
Q0330:Organ affected by: Alkylating agents
659
Blood (leukemia)
660
Q0331:Carcinogen associated with: Hepatocellular carcinoma
661
Aflatoxins
662
Q0332:Carcinogen associated with: Angiosarcoma
663
Vinyl chloride
664
Q0333:Carcinogen associated with: Centrilobular necrosis of liver
665
CCl4
666
Q0334:Carcinogen associated with: Fatty change of liver
667
CCl4
668
Q0335:Carcinogen associated with: Liver
669
-Aflatoxins;-Vinyl chloride;-CCl4
670
Q0336:Carcinogen associated with: Esophagus
671
Nitrosamines
672
Q0337:Carcinogen associated with: Stomach
673
Nitrosamines
674
Q0338:Carcinogen associated with: Larynx
675
Cigarette smoke
676
Q0339:Carcinogen associated with: Lung
677
-Cigarette smoke;-Asbestos
678
Q0340:Carcinogen associated with: Mesothelioma of lung
679
Asbestos
680
Q0341:Carcinogen associated with: Bronchogenic carcinoma of lung
681
Asbestos
682
Q0342:Carcinogen associated with: Skin
683
Arsenic (squamous cell carcinoma)
684
Q0343:Carcinogen associated with: Bladder
685
Naphthalene dyes (transitional cell carcinoma)
686
Q0344:Carcinogen associated with: Blood
687
Alkylating agents (leukemia)
688
Q0345:Paraneoplastic effects: definition
689
Symptoms not directly related to tumor or hormones of tumor tissue
690
Q0346:Name/effect and cause of paraneoplastic syndrome associated with: Small cell lung carcinoma
691
(with intracranial neoplasms);-Cause: ADH;-Effect: SIADH;(without intracranial neoplasms);Cause:ACTH/ACTH-like peptide;-Effect: Cushing's;Cause:Antibodies against presynaptic Ca2+ channels at neuromuscular junction;-Effect: Lambert-Eaton Syndrome (muscle weakness)
692
Q0347:Name/effect and cause of paraneoplastic syndrome associated with: Squamous cell lung carcinoma
693
Causes;-PTH-related peptide;-TGF-beta;-TNF-alpha;-IL1;Effect: Hypercalcemia
694
Q0348:Name/effect and cause of paraneoplastic syndrome associated with: Renal cell carcinoma
695
Cause: Erythropoietin;Effect: Polycythemia;Causes;-PTHrelated peptide;-TGF-beta;-TNF-alpha;-IL-1;Effect: Hypercalcemia
696
Q0349:Name/effect and cause of paraneoplastic syndrome associated with: Breast carcinoma
697
698
Q0350:Name/effect and cause of paraneoplastic syndrome associated with: Multiple myeloma
699
700
Q0351:Name/effect and cause of paraneoplastic syndrome associated with: Bone metastasis (lysed bone)
701
(Though technically not a paraneoplastic syndrome);Causes;PTH-related peptide;-TGF-beta;-TNF-alpha;-IL-1;Effect: Hypercalcemia
702
Q0352:Name/effect and cause of paraneoplastic syndrome associated with: Hemangioblastoma
703
Cause: Erythropoietin;Effect: Polycythemia
704
Q0353:Name/effect and cause of paraneoplastic syndrome associated with: Hepatocellular carcinoma
705
Cause: Erythropoietin;Effect: Polycythemia
706
Q0354:Name/effect and cause of paraneoplastic syndrome associated with: Thymoma
707
-Cause:Antibodies against presynaptic Ca2+ channels at neuromuscular junction;-Effect: Lambert-Eaton Syndrome (muscle weakness)
708
Q0355:Name/effect and cause of paraneoplastic syndrome associated with: Leukemia
709
Cause: Hypercalcemia due to excess nucleic acid turnover (ie; cytotoxic therapy);Effects;-Gout;-Urate nephropathy
710
Q0356:Name/effect and cause of paraneoplastic syndrome associated with: Lymphoma
711
Cause: Hypercalcemia due to excess nucleic acid turnover (ie; cytotoxic therapy);Effects;-Gout;-Urate nephropathy
712
Q0357:Paraneoplastic syndrome and neoplasm associated with: ACTH
713
Paraneoplastic syndrome: Cushing's syndrome;Neoplasm: Small cell lung carcinoma
714
Q0358:Paraneoplastic syndrome and neoplasm associated with: ACTH-like peptide
715
Paraneoplastic syndrome: Cushing's syndrome;Neoplasm: Small cell lung carcinoma
716
Q0359:Paraneoplastic syndrome and neoplasm associated with: ADH
717
Paraneoplastic syndrome: SIADH;Neoplasm: Small cell lung carcinoma with intracranial neoplasms
718
Q0360:Paraneoplastic syndrome and neoplasm associated with: PTH-related peptide
719
Paraneoplastic syndrome: Hypercalcemia;Neoplasms;Squamous cell lung carcinoma;-Renal cell carcinoma;-Breast carcinoma;-Multiple myeloma;-Bone metastasis (lysed bone) (not really a paraneoplastic syndrome for this one)
720
Q0361:Paraneoplastic syndrome and neoplasm associated with: TGF-beta
721
722
Q0362:Paraneoplastic syndrome and neoplasm associated with: TNF-alpha
723
724
Q0363:Paraneoplastic syndrome and neoplasm associated with: IL-1
725
726
Q0364:Paraneoplastic syndrome and neoplasm associated with: Erythropoietin
727
Paraneoplastic syndrome: Polycythemia;Neoplasms;-Renal cell carcinoma;-hemangioblastoma;-hepatocellular carcinoma
728
Q0365:Paraneoplastic syndrome and neoplasm associated with: Antibodies against Ca2+ channels
729
Paraneoplastic syndrome: Lambert-Eaton syndrome (muscle weakness due to presynaptic channels being destroyed);Neoplasms;-Thymoma;-Small-cell lung cancer
730
Q0366:Paraneoplastic syndrome and neoplasm associated with: Hyperuricemia due to excess nucleic acid turnover (ie cytotoxic therapy)
731
Paraneoplastic syndromes;-Gout;-Urate nephropathy;Neoplasms;-Leukemia;-Lymphoma
732
Q0367:For the following paraneoplastic syndrome; give the causes and associated neoplasms: Cushing's syndrome
733
Cause: ACTH or ACTH-like peptide;Neoplasm: Small cell lung carcinoma
734
Q0368:For the following paraneoplastic syndrome; give the causes and associated neoplasms: SIADH
735
Cause: ADH;Neoplasms: Small cell lung carcinoma with intracranial neoplasms
736
Q0369:For the following paraneoplastic syndrome; give the causes and associated neoplasms: Hypercalcemia
737
Causes;-PTH-related peptide;-TGF-beta;-TNF-alpha;-IL1;Neoplasms;-Squamous cell lung carcinoma;-Renal cell carcinoma;-Breast carcinoma;-Multiple myeloma;-Bone metastasis (lysed bone: technically not a paraneoplastic cause)
738
Q0370:For the following paraneoplastic syndrome; give the causes and associated neoplasms: Polycythemia
739
Cause: Erythropoietin;Neoplasms;-Renal cell carcinoma;Hemangioblastoma;-Hepatocellular carcinoma
740
Q0371:For the following paraneoplastic syndrome; give the causes and associated neoplasms: Lambert-Eaton syndrome (muscle weakness)
741
Cause: Antibodies against presynaptic Ca2+ channels at neuromuscular junction;Neoplasms;-Thymoma;-Small cell lung carcinoma
742
Q0372:For the following paraneoplastic syndrome; give the causes and associated neoplasms: Gout
743
Cause: Hyperuricemia due to excess nucleic acid turnover (ie cytotoxic therapy);Neoplasms;-Leukemias;-Lymphomas
744
Q0373:For the following paraneoplastic syndrome; give the causes and associated neoplasms: Urate nephropathy
745
Cause: Hyperuricemia due to excess nucleic acid turnover (ie cytotoxic therapy);Neoplasms;-Leukemias;-Lymphomas
746
Q0374:Primary tumors that metastasize to the brain
747
Lots of Bad Stuff Kills Glia;-Lung;-Breast;-Skin (melanoma);Kidney (renal cell carcinoma);-GI
748
Q0375:Primary tumors that metastasize to the liver
749
Cancer Sometimes Penetrates Benign Liver;By decreasing frequency;-Colon;-Stomach;-Pancreas;-Breast;-Lung
750
Q0376:Primary tumors that metastasize to bone
751
Primary Tumors Like Killing Bone;-Prostate (blastic);Thyroid/Testes;-Lung (Lytic);-Kidney;-Breast (Both lytic and blastic);Prostate and bone are most common
752
Q0377:% of brain tumors from metastases
753
50%
754
Q0378:% of liver tumors from metastases
755
Unspecified; but there are many more metastases than primary liver tumors
756
Q0379:% of bone tumors from metastases
757
Unspecified; but there are many more metastases than primary bone tumors
758
Q0380:Brain metastasis: Morphology
759
-Multiple;-Well circumscribed;-At gray/white border
760
Q0381:Incidence and mortality in men of the following cancer: Prostate
761
Incidence: 32%;Mortality: 13%
762
Q0382:Incidence in men of the following cancer: Lung
763
764
Q0383:Incidence in men of the following cancer: Colon and rectum
765
Incidence: 12%;Mortality: Unspecified
766
Q0384:Incidence and mortality in women of the following cancer: Breast
767
768
Q0385:Incidence and mortality in women of the following cancer: Lung
769
770
Q0386:Incidence and mortality in women of the following cancer: Colon and Rectum
771
Incidence: 13%;Mortality: Unspecified
772
Q0387:Type of necrosis found in: Kidney
773
Coagulative
774
Q0388:Type of necrosis found in: Brain
775
Liquefactive
776
Q0389:Type of necrosis found in: Tuberculosis
777
Caseous
778
Q0390:Type of necrosis found in: Pancreas
779
Fat
780
Q0391:Type of necrosis found in: Blood vessels
781
Fibrinoid
782
Q0392:Type of necrosis found in: Limbs
783
Gangrenous
784
Q0393:Type of necrosis found in: GI tract
785
Gangrenous
786
Q0394:receptor: alpha 1; G-protein class?
787
Gq
788
Q0395:receptor: alpha 2; G-protein class?
789
Gi
790
Q0396:receptor: beta 1; G-protein class?
791
Gs
792
Q0397:receptor: beta 2; G-protein class?
793
Gs
794
Q0398:receptor: M1; G-protein class?
795
Gq
796
797
Gi
798
799
Gq
800
Q0401:receptor: D1; G-protein class?
801
Gs
802
Q0402:receptor: D2; G-protein class?
803
Gi
804
Q0403:receptor: H1; G-protein class?
805
Gq
806
Q0404:receptor: H2; G-protein class?
807
Gs
808
Q0405:receptor: V1; G-protein class?
809
Gq
810
Q0406:receptor: V2; G-protein class?
811
Gs
812
Q0407:receptor: alpha 1; f(x)?
813
increase vascular smooth muscle contraction
814
Q0408:receptor: alpha 2; f(x)?
815
decrease sympathetic outflow; decrease insulin release
816
Q0409:receptor: beta 1; f(x)?
817
increase HR; increase contractility; increase renin; increase lipolysis; increase aqueous humor formation
818
Q0410:receptor: beta 2; f(x)?
819
vasodilation; bronchodilation; increase glucagon release
820
Q0411:receptor: M1; f(x)?
821
CNS
822
823
decrease HR
824
825
increase exocrine gland secretions
826
Q0414:receptor: D1; f(x)?
827
relaxes renal vascular smooth muscle
828
Q0415:receptor: D2; f(x)?
829
modulates transmitter release; especially in brain
830
Q0416:receptor: H1; f(x)?
831
increase nasal and bronchial mucus production; contraction of bronchioles; pruritus; and pain
832
Q0417:receptor: H2; f(x)?
833
increase gastric acid secretion
834
Q0418:receptor: V1; f(x)?
835
increase vascular smooth muscle contraction
836
Q0419:receptor: V2; f(x)?
837
increase H2O permeability and reabsorption in the collecting tubules of the kidney
838
Q0420:interphase
839
Gi; S; G2;precedes mitosis
840
Q0421:G1 (gap) phase
841
12 hrs. avg;cell growth: synthesis of carbs; proteins; lipids
842
Q0422:G0
843
LONG G1 state (almost stops cycling!);ex: muscle; nerve cells
844
Q0423:mitochondria + centrioles divide during ____ phase
845
S phase;(both contain DNA)
846
Q0424:cells perform their differentiated functions during ____ phase
847
G1/G0
848
Q0425:during G1; cells are _n
849
2n (diploid)
850
Q0426:during G2; cells are _n
851
4n (tetraploid)
852
Q0427:S
853
6-8 hrs avg;ALLDNA synthesis + chr replication happens here;also RNA synthesis rate increases; cell prepares for mitosis
854
Q0428:G2
855
3-4 hrs avg;resembles G1 except cell now TETRAPLOID (4n)
856
Q0429:in mitosis; cell goes from _n to _n
857
4n to 2n
858
Q0430:6 phases of mitosis
859
preprophase;prophase;metaphase;early anaphase;late anaphase;telophase
860
Q0431:preprophase
861
chr condense (recognizable);centrioles (barrel-like) visible in cytoplasm
862
Q0432:prophase
863
2 copies of each chromosome separated into single chromosome called CHROMATIDS;mitotic spindle forms;centrioles begin to separatre; microtubules assemble b/w them;near end; nuclear envelope starts to rupture
864
Q0433:metaphase
865
nuclear envelope + nucleolus disappear;spindle moves to where nucleus was;chr move to mid-spindle + attach to MT
866
Q0434:early anaphase
867
CHROMATIDS split longitudinally + migrate to cell poles;*note: after chromatids split; they are called chromosomes again
868
Q0435:late anaphase
869
chr aggregate at poles;CLEAVAGE FURROW begins to form (beginning of cytokinesis)
870
Q0436:chromatids/chromosomes
871
until ANAPHASE; each chromosome contains 2 sister chromatids;after ANAPHASE each chromatid = separate chromosome
872
Q0437:during G2; each chromosome consists of _________
873
2 sister chromatids; connected at centromere
874
Q0438:telophase (cytokinesis)
875
nucleolus forms;nuclear envelopes form around each set of daughter chromosomes;condensed chromatin expands again + begins to reappear;cytoplasm divides by deepening cleavage furrow until --> 2 daughter cells
876
Q0439:cells entering meiosis are called ________
877
primary gametes (spermatocytes or oocytes);have same DNA content as cell entering mitosis
878
Q0440:cells entering meiosis II are called ________
879
secondary gametocytes;contain 23 chromosomes (each consisting of 2 sister chromatids)
880
Q0441:meiosis occurs in______
881
germ cells (sperm; ova);2 parts; cell division in each resembles mitosis; but no DNA replication during either
882
Q0442:meiosis reduced chromosome # by ______
883
half
884
Q0443:genetic recombination occurs in
885
meiosis;exchange of chr segments;occurs b/w chr within tetrad;changes allelic linkages; does NOT change gene sequence
886
Q0444:stages of Meiosis I
887
prophase I;metaphase I;anaphase I;telophase I
888
Q0445:stages of meiosis II
889
prophase II;metaphase II;anaphase II;telophase II
890
Q0446:during meiosis II; _______ separate
891
sister chromatids (of the 23 chromosomes)
892
Q0447:recombinbation occurs b/w
893
chromatids within a tetrad
894
Q0448:meiotic prophase occurs in _ steps
895
3 (A;B;C)
896
Q0449:meiotic prophase A
897
chromosomes condense (visible); homologous chromosomes pair (except X;Y chr; centromeres of homologues don't pair)
898
Q0450:meiosis prophase step B
899
homologous chromosome pairing complete;4 chromatids appear (= tetrad)
900
Q0451:meiosis prophase step C
901
RECOMBINATION/CROSS-OVER
902
Q0452:recombination
903
chromatid segments exchanged b/w 2 paired homologous chromosomes
904
Q0453:chiasma
905
pt of exchange during recombination; shaped like an X
906
Q0454:cells resulting from meiosis II
907
spermatids;OR;ova (plus polar body)
908
Q0455:meiotic metaphase I
909
paired chromosomes line up on mitotic spindle;2 chromosomes of each homologous pair attach to MT going to opposite poles of cell
910
Q0456:meiotic anaphase I
911
both chromatids migrate to same end of cell
912
Q0457:meiotic telophase I
913
each daughter gets 1 part of each chromosome pair;each gets total 23 chromosomes
914
Q0458:2nd meiotic division
915
similar to meiotic division except NO PRIOR DNA SYNTHESIS;23 chromosomes divide at centromere;each new daughter cell gets 23 chromatids (HAPLOID)
916
Q0459:5 causes of tissue hypoxia
917
ischemia; hypoxemia; ETC block; uncoupled ETC; AV shunts
918
Q0460:Ultimate effects of tissue hypoxia
919
No O2 to accept electrons in ETC; no production of ATP. Na/K pump fails and cell swells (reversible change). Ribosomes fall from RER. Disruption of cell membrane and mitochondria induces apoptosis.
920
Q0461:Effects of low ATP in cell
921
Increased glycolysis to support ATPase pump. Anaerobic glycolysis produces lactate with decreased intracellular pH which denatures proteins (coagulation necrosis); cell swelling; entry of calcium and apoptosis
922
Q0462:Pathophysiology of cell injury in hypoxia
923
ETC fails due to lack of oxygen; 2. No ATP production in ETC increases anaerobic glycolysis (high citrate and AMP activate PFK-1); 3. increased lactate decreases cell pH which denatures proteins and produces coagulation necrosis; 4. ATPase fails and cell swells with fall off of ribosomes from RER; 5. disruption of cell membrane with entry of Ca activates phspholipase (lipid peroxidation); complement activation; nuclear enzymes with pyknosis and destruction of mitochondria and apoptosis
924
Q0463:What is methhemoglobin?
925
Hemoglobin with oxidized (Fe3+) iron that cant bind O2. Decreases SaO2 and produces cyanosis. Caused by nitro/sulfa compounds. Rx.: methylene blue
926
Q0464:Increased PACO2; decreased PaO2; decreased O2 content; decreased SaO2
927
Respiratory acidosis
928
Q0465:Normal PaO2 and SaO2; decreased Hb
929
Anemia
930
Q0466:Normal Hb; PaO2; decreased SaO2; decreased O2 content
931
CO poisoning or methhemoglobinemia
932
Q0467:CO poisoning tissue hypoxia
933
Decreased O2 content and SaO2; normal PaO2; left shift of dissociation curve and cytochrome oxidase inhibition all cause hypoxia. Produced by car exhaust; heaters; smoke inhalation; wood stoves. Rx.: 100% O2. First symptom: headache
934
Q0468:Factors that left-shift O2 dissociation curve and decrease P50
935
Decreased 2;3BPG; CO; MetHb; HbF; hypothermia; alkalosis
936
Q0469:Factors that right-shift O2 dissociation curve and increase P50
937
Increased 2;3BPG; fever; acidosis
938
Q0470:Causes of hypoxia with normal O2 content
939
Ischemia; cyanide poisoning; ETC uncouplers (alcohol; salicylates; dinitrophenol)
940
Q0471:Free radical metabolism
941
NADPH oxidase and spontaneous superoxide; Superoxide dismutase makes H2O2 from superoxide. Catalase breaks down H2O2. Gluthathione reductase and GSH peroxide breakdwon H2)2 using reduced GSH and NADPH from G6PDH in HMP shunt
942
Q0472:Causes of free radical injury
943
Aging process produces lipofuscin which peroxidates membrane; MPO system; O2 free radicals; ionizing radiation; acetaminophen (treat with acetylcyteine); CCl4 poisoning
944
Q0473:Features of apoptosis
945
Eosinophilic cytoplasm; pyknotic nucleus; no inflamatory infiltrate
946
Q0474:Physiologic examples of apoptosis
947
Thymus involution; Mullerian and Wolffian structure involution; gravid uterus
948
Q0475:Pathologic examples of apoptosis
949
Councilman bodies in viral hepatitis; psammoma bodies; cancer
950
Q0476:Coagulation necrosis
951
Denaturing and coagulation of proteins in cytoplasm (infarction). Pale Vs. hemorrhagic infarcts
952
Q0477:Liquefactive necrosis
953
Neutrophil destruction with hemolytic enzymes. Abesesses; wet gangrene; brain; pancreas
954
Q0478:Caseous necrosis
955
Combination of coagulation and liquefaction necrosis. Cheeselike material; casseating granulomas with macrophages
956
Q0479:Fat necrosis
957
Lipases on fatty tissue. Pancreas. Chalky-white appearance
958
Q0480:Fibrinoid necrosis
959
Histologically resembles fibrin. Eosinophilic mitral valve vegetations; immunocomplexes
960
Q0481:Fatty liver change
961
In alcoholics - liver stores excess tryglycerides because increased NADH produces glycerol 3P and increased acetate (acetyl CoA) increases FA synthesis. In kwashiorkor; no apolipoproteins for VLDL
962
Q0482:Regulation of apoptosis
963
Genes bcl-2 (inhibits apoptosis) prevents release of cytochrome C and binds protease activating factor (Apaf-1); p53 stimulates apoptosis. Mediated by caspases. Stimulated by cell injury; lack of hormones; Fas and TNF
964
Q0483:Rb suppressor gene and Rb protein
965
Located on chromosome 13. Produces unphosphorylated Rb protein which stops cell from entering S phase. Phosphorylation by cyclin D/cdk complex allows it to enter S phase. Mutation of Rb gene produces cancer
966
Q0484:cdk/cyclin D complex
967
When activated it phosphorylates Rb protein allowing cell to enter S phase
968
Q0485:p53 suppressor gene
969
Located on chromosome 17. Produces a protein that inactivates cyclin D/cdk complex preventing Rb protein phosphorylation which keeps cell in G1
970
Q0486:Name 5 characteristics of the metabolic syndrome
971
central obesity;atherogenic lipid patterns;hypertension;insulin resistance or diabetes;pro-inflammatory state; ie C-reactive protein
972
Q0487:Describe stable angina
973
Chest pain precipitated by exertion; relieved by rest or vasodilators.
974
Q0488:Describe unstable angina
975
Chest pain that is prolonged or recurrent at rest.
976
Q0489:Describe Prinzmetal angina
977
Intermittent chest pain at rest; usually caused by vasospasm.
978
Q0490:The two patterns of myocardial ischemic necrosis? Describe them.
979
Transmural: entire ventricular wall from endo- to epicardium;Subendocardial: limited to interior one third of ventricular wall
980
Q0491:Name 6 complications of myocardial infarction.
981
Arrhythmia: common cause of death in first hours after MI;Heart failure: depends on MI size;Myocardial rupture: risk highest 4-7 days after MI;Papillary muscle rupture;Mural thrombosis: forms over infarct in heart; can embolize;Ventricular aneurysm
982
Q0492:Timeline of GROSS morphological changes in acute myocardial infarction?
983
< 12 hrs: no gross changes;24 hrs: swelling; pale or red brown infarct with surrounding hyperemia;7 days: yellow infarcted area with red border;10 days: red vascular connective tissue gradually replaces necrotic tissue;5 weeks: pallor of infarct due to fibrosis;3-6 months: gray-white scar
984
Q0493:Timeline of MICROSCOPIC morphological changes in acute myocardial infarction?
985
< 6hrs: none;12-24hrs: nuclei disappear; striations lost; neutrophils infiltrate; coagulative necrosis apparent;3 days: macrophages replace neutrophils; phagocytose debris;7 days: growth of fibroblasts and new vessels in the lesion;2-4 weeks: collagen and matrix synthesis;>5 weeks: progressive fibrosis replaces lesion
986
Q0494:When do LDH; troponin; and CK-MB each peak in acute myocardial infarction?
987
LDH peaks at 3 days and persists;Troponin peaks at 24 hours and persists;CK-MB peaks at 24 hours and tapers to zero.
988
Q0495:Rheumatic fever: etiology
989
Immunologic disease. Streptococcal antigens elicit an antibody response that is reactive to human heart and other tissues.
990
Q0496:Rheumatic fever: name and characteristics of the classic histologic lesion?
991
Aschoff body;Focal interstitial myocardial inflammation with collagen; fibrinoid material; multinucleated giant cells; and large myocytes.
992
Q0497:Rheumatic fever: how long after what infection? What lab sign indicates recent infection?
993
1-4 weeks after Group A beta hemolytic streptococcus infection. Elevated anti-streptolysin (ASO) indicates recent infection.
994
Q0498:Rheumatic fever: non-cardiac manifestations
995
Fever; malaise; elevated ESR; arthralgias/arthritis/migratory polyarthritis; subcutaneous nodules; erythema marginatum; Sydenham chorea.
996
Q0499:Rheumatic fever: cardiac manifestations
997
Pancarditis (all 3 layers);Non-friable mitral and aortic vegetations; which after healing cause fibrosis; calcification; and deformation of the values. Chordae tendineae are also thickened and shortened.
998
Q0500:Organisms causing acute vs subacute bacterial endocarditis
999
Acute: staph aureus (also beta hemolytic strep and pneumococcus);Subacute: strep viridans (also enterococcus; HACEK organisms)
1000
Q0501:Complications of infective endocarditis?
1001
Distal embolization to brain or other tissues can lead to septic infarcts;Renal glomeruli involvement due to immune complex disease or septic emboli.
1002
Q0502:Suspect what if tricuspid valve is involved in infective endocarditis?
1003
IV drug use. 50% of cases of endocarditis in this population have tricuspid involvement.
1004
Q0503:Risk factors for infectious endocarditis?
1005
Congenital heart disease;Preexisting valvular heart disease;Artificial valve;IV drug use
1006
Q0504:What is nonbacterial thrombotic endocarditis associated with? What are its complications?
1007
Metastatic cancer and other wasting disorders;Valve deposits are sterile and made of fibrin; as a result emboli are sterile; not septic.
1008
Q0505:What is Libman-Sacks endocarditis?
1009
Occurs in SLE; is characterized by small fibrin vegetations forming on either or both sides of the valve leaflets.
1010
Q0506:What is endocarditis of the carcinoid syndrome?
1011
Caused by secretory products of carcinoid tumors such as serotonin and other vasoactive peptides and amines. They cause endocarditis resulting in thickened endocardial plaques; usually in the RIGHT of the heart because these substances are inactivated in the pulmonary circulation.
1012
Q0507:Most common valvular lesion?
1013
Mitral prolapse (7% of population)
1014
Q0508:Characteristic sound of mitral prolapse?
1015
Systolic murmur with midsystolic click.
1016
Q0509:Causes of mitral stenosis?
1017
Almost always rheumatic heart disease.
1018
Q0510:Causes of aortic stenosis?
1019
Age related calcific stenosis;Congenital bicuspid valve;Rheumatic valve
1020
Q0511:Causes of aortic regurgitation?
1021
Nondissecting aortic aneurysm;Rheumatic heart disease;Syphilitic aortitis with dilation of valve ring
1022
Q0512:Coarctation of aorta is more common in what syndrome?
1023
Turner's syndrome (monosomy X)
1024
Q0513:Congenital rubella syndrome includes what fetal defects?
1025
Cardiovascular (PDA and others);Microcephaly;Deafness;Cataracts;Growth retardation
1026
Q0514:What drug keeps PDA open? what drug closes it?
1027
Prostaglandin keeps it open;Indomethacin closes it.
1028
Q0515:Name three conditions associated with dilated cardiomyopathy.
1029
Alcoholism; thiamine deficiency; prior myocarditis.
1030
Q0516:What is a common cause of restrictive cardiomyopathy?
1031
Cardiac amyloidosis.
1032
Q0517:what are the morphological changes seen in hypertrophic cardiomyopathy?
1033
hypertrophy of all chamber walls especially the ventricular septum;Disoriented tangled and hypertrophied myocardial fibers;Left ventricular outflow obstruction.
1034
Q0518:What is the inheritance of hypertrophic cardiomyopathy?
1035
Usually autosomal dominant
1036
Q0519:what is the most common cause of myocarditis?
1037
Coxsackievirus
1038
Q0520:what is the most common tumor of the heart?
1039
Atrial myxoma
1040
Q0521:What is cor pulmonale? Name one common cause.
1041
Cor pulmonale is right ventricular hypertrophy or dilation secondary to lung disease or primary disease of pulmonary vasculature such as primary pulmonary hypertension;Emphysema is a common cause.
1042
Q0522:pansystolic murmur at LLSB radiating right towards midclavicular line that is medium pitched; has a blowing quality; increases on inspiration; S3; incr. JVP and "v" wave
1043
tricuspid regurg. The S3 sound is from the overdistended RV
1044
Q0523:harsh; shrill; midsystolic crescendo-decrescendo murmur; sometimes S4
1045
aortic stenosis
1046
Q0524:soft; blowing; pansystolic murmur; S3; elevated left atrial pressures;
1047
mitral regurg
1048
Q0525:immediate diastolic murmur in a middle-aged guy who has always had some problems keeping up
1049
bicuspid aortic valve
1050
Q0526:asymptomatic adult with prominant RV impulse; midsystolic ejection murmuer heard in pulmonic area and along the LSB; fixed splitting of S2
1051
classic for ASD
1052
Q0527:systolic ejection murmer on RSB that radiates to jugular
1053
aortic stenosis
1054
Q0528:opening snap and diastolic murmur
1055
mitral stenosis
1056
Q0529:incr. RV pressures --> RVH and PA dilation & crescdecresc murmur if severe; no RA enlargement
1057
pulmonary stenosis
1058
Q0530:child with a harsh systolic murmer and increased oxygen saturation in the RV
1059
VSD
1060
Q0531:Mitral/tricuspid regurgitation
1061
holosystolic; high-pitched 'blowing murmur';mitral: loudest at apex and radiates towards AXILLA;tricuspid: loudest at tricuspid area and radiates to right sternal border
1062
Q0532:Aortic stenosis
1063
crescendo-decrescendo systolic ejection murmur following an ejection click!!;LV>>aortic pressure during systole;radiates to carotids/apex;'pulsus parvus et tardus' - pulses weak compared to heart sounds
1064
Q0533:VSD
1065
holosystolic; harsh-sounding murmur;loudest at tricuspid valve
1066
Q0534:Mitral prolapse
1067
late systolic murmur with midsystolic click (MC);most frequent valvular lesion;loudest at S2
1068
Q0535:Aortic regurgitation
1069
immediate high-pitched 'blowing' diastolic murmur;wide pulse pressure when chronic
1070
Q0536:Mitral stenosis
1071
follows opening snap;secondary to rheumatic fever;delayed rumbling late diastolic murmur;LA>>>LV pressure during diastole;tricuspid stenosis differs because it gets louder with inspiration (more blood flows into RA upon inspiration)
1072
Q0537:PDA
1073
continuous machine-like murmur;loudest at time S2;(aorta --> pulmonary artery;the pressure difference is obscene and thus you have a continuous murmur)
1074
Q0538:Congenital heart defects associated with 22q11 syndrome
1075
truncus arteriosus; tetralogy of fallot
1076
Q0539:Down syndrome heart defects
1077
ASD; VSD; AV septal defect (endocardial cushion defect)
1078
Q0540:Congenital rubella!!!
1079
septal defects; PDA; pulmonary artery stenosis;(microcephaly; mental retardation; deafness; cataracts; growth retardation)
1080
Q0541:Turner's syndrome heart stuff
1081
coarctation of aorta
1082
Q0542:Marfan's syndrome heart stuff
1083
aortic insufficiency (late complication)
1084
Q0543:Offspring of diabetic mother
1085
transposition of great vessels
1086
Q0544:MC arteries affected by Monckenberg arteriosclerosis
1087
Radial and Ulnar arteries
1088
Q0545:Definition;Hyaline thickening of small arteries in Essential HTN and DM
1089
Arteriolosclerosis
1090
Q0546:Dx;"Onionskin" thickening of the arteriolar walls
1091
Hyperplastic Arteriolosclerosis;(Malignant HTN)
1092
Q0547:Definition;Dx specific to an aneurysm of the Ascending Aorta;where does it exert its effect?;what heart problem can it lead to?
1093
Syphillic (Leutic) Anneurysm;effects: Vaso Vasorum;leads to: Aortic valve incompetence
1094
Q0548:what may be confused w/ a MI if it wasn't for the normal serum enzymes?
1095
Dissecting Aneurysm
1096
Q0549:Definition;dilated small vessel surrounded by radiating fine channels and associated w/ hyperestrinism
1097
Spider Telangiectasia
1098
Q0550:Dx;Port-wine stain birthmark
1099
Hemangioma
1100
Q0551:Dx;Hemangioblastomas of the retina; cerebellum and medulla;What can it lead to?;what genetics? gene?
1101
Von Hippel-Lindau Dz;can lead to: Bilateral Renal Cell CA;genetics;Auto Dominant;deletion on VHL gene on chrom 3;(chrom 3 = 3 words in name VHL)
1102
Q0552:Malignant vascular tumor caused by Arsenic exposure
1103
Hemangiosarcoma
1104
Q0553:Dx;fever; weight loss; abd pain; HTN; cutaneous eruptions; arthralgia; vasculitis in arterioles and glomeruli of kidney;What is possible predisposing virus?
1105
Polyarteritis Nodosa;(P-ANCA);;virus: HBV
1106
Q0554:Dx;granulomatous vasculitis w/ eosinophilia and asthma; prominent in pulmonary vasculature
1107
Churg-Strauss syndrome
1108
Q0555:Dx;child w/ previous URI gets hemorrhagic urticaria of extensor surfaces; arthralgia; abd pain; melena
1109
Henoch-Schonlein purpura
1110
Q0556:Dx;necrotizing granulomatous vasculitis in lung and upper airway and necrotizing glomerulonephritis
1111
Wegener's Glanulomatosis;(C-ANCA)
1112
Q0557:Dx;unilateral HA; visual impairment; polymyalgia rheumatica (muscle pain); increased ESR
1113
Temporal arteritis;(Giant cell arteritis)
1114
Q0558:Dx;fever; arthritis; night sweats; myalgia; skin nodules; ocular disturbances; weak pulse in upper extremities; elevated ESR
1115
Takayasu's Arteritis
1116
Q0559:Dx;child w/ fever; congested conjuctiva; changes in lips/oral mucosa; lymphadenitis
1117
Kawasaki Dz
1118
Q0560:Dx;intermittent claudication; nodular phlebitis; cold sensitivity; heavy smoker
1119
Buerger's Dz;(Tx: quit smoking)
1120
Q0561:Dx;marked increase in diastolic BP; retinal hemorrhages; papilledema; "flea-bitten" kidney
1121
Malignant HTN
1122
Q0562:Definition;focal interstitial myocardial inflammation w/ fragmented collagen and fibrinoid material and some mulitnucleated giant cells; seen in Rheumatic fever
1123
Aschoff Body;(w/ Anitschkow's cells)
1124
Q0563:MC coronary artery for MI
1125
LAD
1126
Q0564:Definition;Autoimmune phenomenon resulting in fibrinous pericarditis post-MI
1127
Dressler's syndrome
1128
Q0565:what lab is elevated in Rheumatic Heart Dz?
1129
elevated ASO titer
1130
Q0566:Dx;fever; erythema marginatum; valvular damage; elevated ESR; polyarthritis; Sub-q nodules; chorea
1131
Rheumatic Heart Dz;(mitral = MC valve)
1132
Q0567:MCC of Subacute Endocarditis
1133
Strep Viridians
1134
Q0568:MCC of Acute Endocarditis
1135
Staph Aureus
1136
Q0569:Definiton;Endocarditis secondary to metastasis or renal failure
1137
Marantic endocarditis;(can result in peripheral emboli)
1138
Q0570:(3) congenital Right -> Left shunts
1139
3 Ts;Tetralogy of Fallot;;Transposition of great vessels;;Truncus Arteriosus
1140
Q0571:Dx;Fixed S2 split
1141
ASD
1142
Q0572:Definition;uncorrected VSD; ASD; or PDA leads to progressive pulmonary HTN. With Inc pulm resistance; shunt reverses from L -> R to ;R -> L; causing late cyanosis; clubbing and polycythemia
1143
Eisenmenger's syndrome
1144
Q0573:which congenital heart defect is not compatable with life unless a shunt is present?
1145
Transposition of great vessels
1146
Q0574:Dx;notching of ribs; HTN in upper extremities and weak pulses in lower extremities
1147
Coarctation of Aorta
1148
Q0575:Dx;continuous "machine-like" murmur
1149
PDA
1150
Q0576:what is given to close a PDA?
1151
Indomethacin
1152
Q0577:what is given to keep a PDA open?
1153
Prostaglandins;[PROp it open]
1154
Q0578:Congenital defect with;Congenital Rubella;(2)
1155
Septal defect;;PDA
1156
Q0579:Congenital defect with;Marfan's syndrome
1157
Aortic insufficiency
1158
Q0580:Congenital defect with;offspring of Diabetic mother
1159
Transposition of Great vessels
1160
Q0581:Murmur;systolic High-pitched "blowing"
1161
Mitral Regurg
1162
Q0582:Murmur;Midsystolic Click
1163
Mitral Prolapse
1164
Q0583:Murmur;Wide pulse-pressure
1165
Aortic Regurg
1166
Q0584:MC heart tumor in children
1167
Rhabdomyoma;(w/ Tuberous Sclerosis)
1168
Q0585:which type of emboli can lead to DIC?
1169
Amniotic fluid embloi
1170
Q0586:Dx;low CO; equilibrium of pressures in all 4 chambers; JVD; pulsus paradoxus
1171
Cardiac tamponade
1172
Q0587:(4) causes of Serous Pericarditis
1173
SLE;;RA;;Infection;;Uremia
1174
Q0588:(3)* causes of Fibrinous pericarditis
1175
Fiber in your RUM;Rheumatic fever;;Uremia;;MI
1176
Q0589:(4) signs of Tetralogy of Fallot
1177
PROVe;Pulmonary stenosis;;RVH;;Overriding Aorta;;VSD
1178
Q0590:developmental cause of Tetralogy of Fallot?
1179
Anterosuperior displacement of Infundibular septum
1180
Q0591:Definition;passage of emboli from the venous circulation into the arterial circulation via a R -> L shunt
1181
Paradoxic Emboli
1182
Q0592:True of false: 50% is classified as secondary HTN (usually resulting from renal disease)
1183
false. (90% essential/primary; 10% secondary)
1184
Q0593:read the questioner's mind: HTN predisposes individuals to this disease (the one John Ritter died of)
1185
aortic dissection
1186
Q0594:Pathology changes associated with HTN
1187
hyaline thickening & atherosclerosis
1188
Q0595:This awful term refers to a stiffening of the arteries that invovles the media. Particularly likely to occur at the radial & ulnar arteries.
1189
Monckeberg arteriosclerosis
1190
Q0596:Atherosclerosis: True or false: atherosclerosis is a disease of small sized arteries
1191
false. affects elastic; large & medium muscular arteries.
1192
Q0597:Atherosclerosis: Earliest sign of atherosclerotic disease
1193
fatty streak
1194
Q0598:Atherosclerosis: most likely location
1195
abdominal aorta. (then coronary artery; popliteal artery; and carotid artery)
1196
Q0599:Type of angina resulting from coronary artery spasm
1197
Prinzmetal's variant
1198
Q0600:This coronary artery branch is most commonly implicated in myocardial infarction
1199
LAD (left anterior descending)
1200
Q0601:most common cause of sudden cardiac death
1201
(lethal) arrhythmia
1202
Q0602:Solid tissues like the heart; brain; kidney and spleen have only a single blood supply (not so good collaterals). Therefore infarcts are more likely to be --?
1203
pale
1204
Q0603:2 instances where red infarct is likely
1205
(1) reperfusion (2) loose tissues with good collaterals - like the lungs or intestine
1206
Q0604:Evolution of MI: Rank the following vessels from most to least commonly occluded: RCA; LAD; circumflex
1207
LAD>RCA>circumflex
1208
Q0605:Evolution of MI: Histologic changes on day 1 of an MI?
1209
pallor of infarcted area; coagulative necrosis
1210
Q0606:Evolution of MI: days 2-4?
1211
dilated vessels (hyperemia); neutrophil invasion; extensive coagulative necrosis
1212
Q0607:Evolution of MI: days 5-10?
1213
yellow-brown softening of infarcted region; macrophages present; granulation tissue begins to grow in
1214
Q0608:Evolution of MI: after 7 weeks?
1215
infarct is gray-white; scar complete
1216
Q0609:Diagnosis of MI True or false: ECG is not diagnostic during the first 6 hours following an MI
1217
False; it is the gold standard within this time period
1218
Q0610:Diagnosis of MI What is the test of choice within the first 24 hours?
1219
CK-MB
1220
Q0611:Diagnosis of MI This enzyme is elevated from 4 hours up to 10 days after an MI and is the most specific protein marker
1221
cardiac troponin I
1222
Q0612:Diagnosis of MI on ecg; transmural infarction causes ______
1223
ST elevation; Q wave changes
1224
Q0613:MI complications: Most common (90% of patients)
1225
arryhthmias; esp. 2 days after infarct
1226
Q0614:MI complications: automimmune phenomen several weeks post-MI that results in fibrinous pericarditis
1227
Dressler's syndrome
1228
Q0615:MI complications: high risk of mortality
1229
cardiogenic shock (large infarcts)
1230
Q0616:MI complications: seen about a week after the infarction
1231
rupture of ventricular wall; septum; or papillary muscle
1232
Q0617:Cardiomyopathies Most common
1233
dilated (congestive) cardiomyopathy; heart looks like a ballon on X-ray
1234
Q0618:Cardiomyopathies True or False: substance abuse is a common cause of dilated cardiomyopathy
1235
True; cocaine and alcohol especially
1236
Q0619:Cardiomyopathies These two infectious diseases are associated with dilated myopathy
1237
coxsackievirus B and Chagas' disease
1238
Q0620:Cardiomyopathies True or false: hypertrophic cardiomyopathy causes systolic dysfunction
1239
False; dilated myopathy causes systolic dysfunction; hypertrophic causes diastolic
1240
Q0621:Cardiomyopathies Half of hypertrophic myopathies are inherited as an _________ trait (x-linked; dominant; etc.)
1241
autosomal dominant; major cause of sudden death in young athletes
1242
Q0622:Cardiomyopathies On echo in hypertrophic disease; the LV thickens and the chamber looks how?
1243
like a banana
1244
Q0623:Cardiomyopathies These "-osis" diseases are major causes of restrictive/obliterative cardiomyopathy
1245
sarcoidosis; amyloidosis; hemochromatosis; endocardial fibroelastosis; endomyocardial (Loffler's) fibrosis.also; scleroderma but it's not an -osis
1246
Q0624:Name two causes of holosystolic murmurs
1247
1) VSD; 2) mitral regurg; and 3) tricuspid regurg
1248
Q0625:Widened pulse pressure seen with this diastolic murmur
1249
aortic regurg
1250
Q0626:Describe the murmur associated with the most common valvular lesion
1251
Mitral prolapse; late systolic murmur following mid-systolic click
1252
Q0627:True or false: aortic stenosis causes a decrescendocrescendo murmur following an ejection click
1253
False; ejection click is followed by a crescendo-decrescendo systolic murmur
1254
Q0628:cause of a continuous murmur loudest at time of S2?
1255
patent ductus artieriosis
1256
Q0629:opening snap followed by late diastolic rumbling?
1257
mitral stenosis
1258
Q0630:most common heart tumor?
1259
metastasis
1260
Q0631:primary cardiac tumor in 1) adults and 2) children
1261
adults=myxoma (almost always in left atrium); children=rhabdomyoma
1262
Q0632:fun gross pathologic term for changes in liver with CHF?
1263
nutmeg
1264
Q0633:what are "heart failure cells"?
1265
hemosiderin-laden macrophages in lung
1266
Q0634:dyspnea on exertion; pulmonary edema; and paroxysmal nocturnal dyspnea are symptoms of?
1267
left heart failure
1268
Q0635:patient says "I have to sleep upright." the clinical term for this is?
1269
orthopnea
1270
Q0636:most pulmonary emboli arise from?
1271
DVT
1272
Q0637:True or false: Amniotic fluid can lead to DIC
1273
TRUE
1274
Q0638:what are the component of virchow's triad?
1275
stasis; hypercoagulability; endothelial damage
1276
Q0639:what is pulsus paradoxus?
1277
greater than 10 mmHg drop in systolic on inspiration
1278
Q0640:what is electrical alternans?
1279
characteristic of tamponade on ECG in which QRS complex height varies beat-to-beat
1280
Q0641:midsystolic cresendo-decrescendo murmur
1281
aortic stenosis
1282
Q0642:high-pitched; blowing murmur at the left sternal border
1283
aortic regurgitation
1284
Q0643:low pitched; mid dyastolic rumble
1285
1286
Q0644:midsystolic murmur at the base
1287
1288
Q0645:late mid-diastolic rumble
1289
mitral stenosis
1290
Q0646:high pitched holosystolic murmur at apex to axilla
1291
mitral regurgitation
1292
Q0647:What valve is usually involved in endocarditis?
1293
Mitral
1294
Q0648:What valve indicated drug use if it is involved?
1295
Tricuspid
1296
Q0649:Can endocarditis be non-bacterial?
1297
Yes. It can be secondary to metastasis; renal failure (maranctic or thrombotic); fungal
1298
Q0650:What type of endocarditis does s. Aureus cause?
1299
rapid onset; high virulence; tends to occur secondary to infection elsewhere
1300
Q0651:What do the vegetations look like
1301
Large.
1302
Q0652:What type of endocarditis does s. viridians cause?
1303
subacute. Tends to have smaller vegetations.
1304
Q0653:What predisposes you to s.viridins endocarditis?
1305
tends to occur on previously damaged valves; so rheumatic fever. It is commonly seen after dental work.
1306
Q0654:What are the 8 sings of endocarditis?
1307
JR=NO FAME Janeway lesions; Roth's spots; Nail-bed hemorrhages; Osler's nodes; Fever; Anemia; Murmur (new); Emboli
1308
Q0655:What do Janeway Lesions look like?
1309
multiple small flat erythematous lesions on palms and soles
1310
Q0656:What are roth spots?
1311
round white spots on the retina surrounded by hemorrhage.
1312
Q0657:What are osler's nodes?
1313
Tender raised lesions on the fingers and toes.
1314
Q0658:What is the etiology of these olser's nodes; roth spots; and janeway lesions?
1315
Bacterial vegetations flipping off the heart valve and lodging in the periphery.
1316
Q0659:What type of bacteria causes rheumatic fever?
1317
Group A beta-hemolytic strep
1318
Q0660:when does it occur?
1319
Children 5-15 years; four weeks after a bacterial infection
1320
Q0661:Is the bacteria responsible for the symptoms?
1321
No. RF is an autoimmune reaction of a cross-reactive protein that is found in the initial bacterial infection.
1322
Q0662:What are the non cardiac clinical signs of rheumatic fever?
1323
FEVERSS - Fever; Erythema marginatum; valve damage; Elevated ESR; Red-hot joints (migratory polyarthritis); Subcutaneous nodules; and St. Vitus dance (chorea)
1324
Q0663:What hear valves are effected?
1325
Mitral (most frequent); Aortic; Tricuspid (5%) - high pressure valves mainly.
1326
Q0664:What is an Aschoff body?
1327
classic histological sign of RF; found in the myocardium; contained fibrinoid material; fragmented collages; surrounded by giant cells.
1328
Q0665:What are the cardiac signs of RF?
1329
Verrucious vegetations on the valve; pancarditis; possible pericardial effusions and myocarditis (most common cause of death)
1330
Q0666:Name four causes of serous pericarditis.
1331
RAIL - Rheumatic Arthritis; Infection; Lupus; and Uremia
1332
Q0667:What is serous pericarditis?
1333
straw colored; protein rich exudates - non-purulent; and acute
1334
Q0668:What are three causes of fibirnous exudates?
1335
MI; Rheumatic fever; and Uremia
1336
Q0669:Cloudy pericardial exudates indicated what?
1337
Bacterial infection
1338
Q0670:What are two causes of Hemorrhagic pericarditis?
1339
malignancy and TB
1340
Q0671:What is hemorrhagic pericarditis?
1341
Bloody and inflammatory exudates
1342
Q0672:What are the clinical signs of pericardial exudates?
1343
pericardial pain; friction rub; decreased heart sounds; ST elevation throughout; and pulses paradoxes (like cardiac tamponade)
1344
Q0673:What are the long term sequela of pericarditis?
1345
chronic adhesive or constrictive pericarditis
1346
Q0674:What is constiricit pericadritis
1347
Fibrous scarring in the pericardium obliterates the space and constrict the right side of the heart (because it is less able to withstand the pressure)
1348
Q0675:What types of pericaditis lead to constrictive pericarditis
1349
TB and pyrogenic staph infections
1350
Q0676:Syphilitic Heart Disease: What part of the heart does syphilis damage?
1351
The vaso vasorum of the aorta
1352
Q0677:Syphilitic Heart Disease: What does this lead to?
1353
Dilation of the aorta and valve ring
1354
Q0678:Syphilitic Heart Disease: What clinical results does this have?
1355
it can cause an aortic aneurysm or valvular incompetence
1356
Q0679:Syphilitic Heart Disease: What parts of the aorta are effected
1357
ascending and arch
1358
Q0680:Syphilitic Heart Disease: What is the appearance or the aorta?
1359
Called a "tree-bark" appearance.
1360
Q0681:Lab findings in PAN
1361
p-anca. HBsAg+ in 30%; anemia; leukocytosis
1362
Q0682:Microscopic features of PAN
1363
Segmental necrotizing vasculitis in three stages: fibrinoid necrosis with neutrophils; fibroblast proliferation; nodular fibrosis with loss of internal elastic lamina
1364
Q0683:Lab findings in PAN
1365
p-anca. HBsAg+ in 30%; anemia; leukocytosis
1366
Q0684:Microscopic features of PAN
1367
Segmental necrotizing vasculitis in three stages: fibrinoid necrosis with neutrophils; fibroblast proliferation; nodular fibrosis with loss of internal elastic lamina
1368
Q0685:Clinical features of PAN
1369
Affects all organs except lungs. Fever; hematuria/renal failure/hypertension; abdominal pain/GI bleeding; myalgia/arthralgia
1370
Q0686:Clinical features of Wegner granulomatosis
1371
Bilateral pneumonitis with nodular and cavitary infiltrates; chronic sinusitis; nasopharyngeal ulcerations; renal disease
1372
Q0687:Microscopic features of Wegner granulomatosis
1373
Necrotizing vasculitis of small vessels (granulomas); necrotizing granulomas of respiratory tract; focal necrotizing glomerulonephritis
1374
Q0688:Lab findings in Wegner granulomatosis
1375
c-anca
1376
Q0689:Treatment of Wegner granulomatosis
1377
cyclophosphimide
1378
Q0690:Clinical features of temporal arteritis
1379
Throbbing unilateral headache; visual disturbances; jaw claudication
1380
Q0691:Microscopic features of temporal arteritis
1381
Segmental granulomatous vasculitis with multinucleated giant cells and fragmentation of the internal elastic lamina with intimal fibrosis and luminal thickening
1382
Q0692:Diagnosis; lab findings and treatment of temporal arteritis
1383
Dx.: biopsy of temporal artery. Lab: increased ESR. Rx.: steroids
1384
Q0693:Clinical features of Takayasu asteritis
1385
Loss of pulse in upper extremities; visual disturbances; neurologic abnormalities
1386
Q0694:Microscopic features of Takayasu arteritis
1387
Granulomatous vasculitis with massive intimal fibrosis; thickening of the aortic arch and narrowing of the major arterial branches
1388
Q0695:Clinical features of Buerger's disease
1389
Severe pain in affected extremity; thrombophlebitis; Raynaud phenomenon; ulceration and gangrene. Associated with heavy cigarette smoking
1390
Q0696:Microscopic features of Buerger's disease
1391
Recurrent neutrophilic vasculitis with microabseses; segmental thrombosis and vascular insuficiency
1392
Q0697:Clinical features of Kawasaki disease
1393
Affects children < 4. Acute febrile illness; conjuctivitis; maculopapular rash; lymphadenopathy; coronary aneurysms in 70% of cases
1394
Q0698:Microscopic features of Kawasaki disease
1395
Segmental necrotizing vasculitis with coronary aneurysms
1396
Q0699:Diseases that feature Raynaud phenomenon
1397
SLE; CREST; Buerger; atherosclerosis
1398
Q0700:Raynaud diseasse
1399
Small artery vasospasm resulting in blanching cyanosis of fingers and toes precipitated by cold temperature and emotions
1400
Q0701:Henoch-Schonlein purpura
1401
IgA-C3 immunocomplexes; IgA nephropathy (Berger disease); palpable purpura on buttocks
1402
Q0702:Major risk factors for atherosclerosis
1403
Hyperlipidemia; hypertension; smoking; diabetes
1404
Q0703:Most common sites for atherosclerosis
1405
Abdominal aorta followed by coronary arteries
1406
Q0704:Complications of atherosclerosis
1407
Ischemic heart disease; abdominal aortic aneurysm; peripheral vascular disease (pain; pulselessness; paresthesia; claudication); TIA (vertebral basilar oclussion); renovascular hypertension (high renin).
1408
Q0705:Pathophysiology of essential hypertension
1409
Retention of sodium and water with increase in stroke volume (systolic pressure). Sodium in smooth muscle opens up calcium channels with vasoconstriction of arterioles (increased diastolic pressure). Low renin hypertension.
1410
Q0706:Complications of hypertension
1411
Concentric ventricular hypertrophy; AMI; hyaline arteriosclerosis; nephrosclerosis and CRF; intracranial bleeds; athersoclerosis
1412
Q0707:Renovascular hypertension
1413
Atherosclerosis of renal artery orifice in males or fibromuscular hyperplasia in women. Severe hypertension; epigastric bruit. High renin hypertension. Screen with captopril.
1414
Q0708:Captopril screening test for renovascular hypertension
1415
In renovascular hypertension there's decreased RPF and high levels of renin and angiotensin II. With captopril (ACE inhibitor); there's loss of negative feedback on renin and exagerated high levels of renin post-stimulation. The test has the potential for renal failure if bilateral renal artery stenosis is present as AII is responsible for maintaining renal blood flow.
1416
Q0709:Ahterosclerotic aneurysms
1417
MC site is abdominal aorta below renal arteries (no vasa vasorum). Pulsitile mass with pain and abdominal bruit
1418
Q0710:Syphilitic aneurysm
1419
Obliterative endarteritis of vasa vasorum with ischemia and atrophy of ascending aorta; aortic insuficiency; airway encroachment and laryngeal nerve involvment (brassy cough)
1420
Q0711:Associated diseases of dissecting aortic aneurysm
1421
Marfan; Ehlers-Danlos; copper deficiency (no lysyl oxidase)
1422
Q0712:Signs and symptoms of dissecting aortic aneurysm
1423
Acute retrosternal severe chest pain; aortic insuficiency and cardiac tamponade
1424
Q0713:Phlebothrombosis Vs. Thrombophlebitis
1425
Phlebothrombosis is venous thrombosis of deep veins without inflamation or infection. Thrombophlebitis is venous thrombosis of superficial veins due to inflamation and infection
1426
Q0714:Signs; symptoms; diagnosis and complications of DVT
1427
Leg swelling; warmth; erythema. Increased venous pressure from deep to superficial veins (which drain in deep veins) produces varicosities in superficial system. Complications are thromboembolism; thrombophlebitis. Dx.: Doppler
1428
Q0715:Signs; symptoms and causes of thrombophlebitis
1429
Palpable cord; pain; induration; warmth; erythema. MCC is superficial varicose veins; phlebothrombosis; catherthers; drug abuse
1430
Q0716:Clinical features of varicose veins
1431
Edema; thrombosis; stasis dermatitis; ulcerations
1432
Q0717:Clinical features of superior vena cava syndrome
1433
Compression of SVN by primary lung cancer. Blue discoloration of the face; arms and shoulders; dizziness; convulsions; visual disturbances; distended jugular veins
1434
Q0718:Clinical features of Kaposi sarcoma
1435
Malignant endothelial cell tumor caused by HHV-8. Multiple red-purple patches; plaques or nodules. Spindle shaped cells
1436
Q0719:What will aspiration of a foreign body result in the lung?
1437
Obstruction atelectasis
1438
Q0720:Presence of fluid; air or tumor in the pleural space results in what type of atelectasis?
1439
Compression atelectasis
1440
Q0721:Contraction atelectasis is due to what cause?
1441
Fibrosis of the lung
1442
Q0722:Causes of patchy atelectasis
1443
Lack of surfactant (hyaline membrane disease of newborn or ARDS)
1444
Q0723:Clinical features of typical pneumonia
1445
Sudden onset; high fever; productive cough; tachypnea; pleuritic chest pain; consolidation on x-ray
1446
Q0724:Clinical features of atypical pneumonia
1447
Insidious onset; low fever; no cough; no consolidation
1448
Q0725:Differential diagnosis of rusty sputum
1449
Strep pneumonia; CHF; mitral stenosis; Goodpasture syndrome
1450
Q0726:Features of sarcoidosis
1451
"GRAIN": gammaglubilinemia; rheumathoid arthritis; ACE increase; interstitial fibrosis; non-casseating granuloma; bilateral lymphadenopathy
1452
Q0727:Causes of restrictive pulmonary disease
1453
Kyphoscoliosis; obesity; pneumoconiosis; ARDS; pulmonary fibrosis; sarcoidosis
1454
Q0728:Causes of obstructive pulmonary disease
1455
Asthma; emphysema; chronic brnchitis; bronchiectasis
1456
Q0729:Lung volumes in obstructive pattern
1457
Increased TLC; FRC and RV. Decreased FEV1; FVC; FEV1/FVC
1458
Q0730:Lung volumes in restrictive pattern
1459
Decreased; TLC; FEV1; FVC; FRC; RV. Increased or normal FEV1/FVC
1460
Q0731:Diagnosis criteria for chronic bronchitis
1461
Persistent cough and copius sputum production for at least 3 months in 2 consecutive years
1462
Q0732:Clinical features of chronic bronchitis
1463
Cough; sputum production; dyspnea; infections; hypoxia; cyanosis; weight gain. "Blue bloater"
1464
Q0733:Microscopic findings in chronic bronchitis
1465
Hypertrophy of bronchial mucous glands; globlet cell hyperplasia; mucus hypersecretion; bronchial metaplasia
1466
Q0734:Complications of chronic bronchitis
1467
Recurrent infections; cor pulmonale; lung cancer
1468
Q0735:Definition of emphysema
1469
destruction of alveolar septa resulting in enlarged air spaces and loss of elastic recoil
1470
Q0736:Etiology of emphysema
1471
Protease/antiprotease imbalance. Proteases are made by macrophages and neutrophils. Antiproteases are alpha-1antitrypsin; alpha-1-macroglubulin and secretory leukoprotease inhibitor
1472
Q0737:Features of centriacinar emphysema
1473
Proximal brnchioles involved; distal brnchioles spared; most common (95%); associated with smoking; worst in apical segments of upper lobes
1474
Q0738:Features of panacinar emphysema
1475
Entire acinus invololved; alpha-1-antitrypsin deficincy; worse in bases of lower lobes
1476
Q0739:Clinical features of emphysema
1477
Progressive dyspnea; pursing of lips and accesory muscles; barrel chest; weight loss; "Pink puffer"'
1478
Q0740:Clinical features of asthma
1479
Wheezing; severe dyspnea; coughing
1480
Q0741:Microscopic features of asthma
1481
Charcot-leyden crystals; mucous plugs; goblet cell hyperplasia and hypertrophy; eosinophils; edema; hypertrophy of smooth muscle; thick basement membranes
1482
Q0742:Clinical features of bronchiectasis
1483
cough; fever; malodorous purulent sputum; dyspnea; dilated bronchi extending out to pleura on x-ray
1484
Q0743:Etiology of bronchiectasis
1485
Bronchial obstruction; necrotizing pneumonia; cystic fibrosis; Kartagener syndrome
1486
Q0744:Definition of acute respiratory distress syndrome
1487
damage of alveolar epithelium and capillaries resulting in respiratory failure that is unresponsive to O2 treatment
1488
Q0745:Causes of ARDS
1489
shock; sepsis; trauma; gastric aspiration; radiation; O2 toxicity; drugs; infections
1490
Q0746:Clinical features of ARDS
1491
dyspnea; tachypnea; hypoxemia; cyanosis; use of accesory respiratory muscles. Bilateral lung opacity on x-ray
1492
Q0747:Microscopic features of ARDS
1493
interstitial and alveolar edema; interstitial inflamation; loss of type I pneumocytes; hyaline membrane formation
1494
Q0748:RDS of newborn
1495
Deficiency of surfactant in prematures (<28 weeks) and sons of diabetic mothers. Dyspnea; tachypnea; nasal flaring and cyanosis. Lecithin:sphyngomyelin < 2. Rx.: surfactant and dexamethasone
1496
Q0749:Causes of pulmonary edema
1497
left heart failure; mitral stenosis; fluid overload; nephrotic syndrome; liver disease
1498
Q0750:Microscopic features of pulmonary edema
1499
Intra-alveolar fluid; engorged capillaries; hemosiderin-ladden macrophages
1500
Q0751:Risk factors and genetics of bronchogenic CA
1501
Cigarette smoking; pneumoconiosis; pollution. Oncogenes: Lmyc (SCC); K-ras (adeno). Suppressor genes: p53 and Rb
1502
Q0752:Clinical features of bronchogenic CA
1503
Cough; sputum production; weight loss; anorexia; fatigue; dyspnea; hemoptysis; chest pain. Obstruction may produce emphysema; atelectasis; bronchiectasis or pneumonia
1504
Q0753:Lung adenocarcinoma
1505
Most common - 35%. More common in women. Peripheral gray mass; scarring and mucin-producing glands
1506
Q0754:Squamous cell carconima
1507
2nd most common - 30%. More common in males; related to smoking. Centrally located. Invasive squamous cells with desmosomes and keratin production; PTH production
1508
Q0755:Small cell carcinoma
1509
20%. More common in males; associated to smoking. Central location. Basophilic neurosecretory granules and paraneoplastic syndromes (ACTH; ADH)
1510
Q0756:Pancoast tumor
1511
Apical tumor causing Horner syndrome (ptosis; miosis; anhidrosis; enopthalmos)
1512
Q0757:Superior vena cava syndrome
1513
Obstruction; distended head and neck veins; plethora; facial edema
1514
Q0758:Effects of lung masses within the thorax structures
1515
Pancoast tumor; superior vena cava syndrome; esopahgeal obstruction; recurrent laryngeal nerve hoarseness; EatonLambert syndrome
1516
Q0759:Sites of metastasis of lung cancer
1517
Adrenals (>50%); liver; brain; bone
1518
Q0760:Eaton-lambert syndrome
1519
auto-antibodies against presynaptic Ca channels in neuromuscular junction
1520
Q0761:Metastasis to the lung
1521
Breast (most common)
1522
Q0762:Clara Cells
1523
found in bronchioles;non-ciliated columnar with secretory granules;secrete part of surfactant; degrade toxins; act as reserve cells
1524
Q0763:Goblet Cells
1525
found from trachea to terminal bronchioles;secrete mucus
1526
Q0764:Pseudocolumar Cells
1527
ciliated cells found from nose to respiratory bronchioles
1528
Q0765:When are lungs mature?
1529
L:S ratio > 2.0
1530
Q0766:Where does aspirant go?
1531
when standing; posterobasal segment of R. lower lobe;when supine; superior segment of R. lower lobe
1532
Q0767:Relation of artery to bronchus?
1533
RALS;on the right; pulmonary artery is anterior to bronchus;on left; pulmonary artery is superior to bronchus
1534
Q0768:At what levels do structures pass through diaphragm?
1535
T8=IVC;T10=oesophagus;T12=aorta; thoracic duct; azygous
1536
Q0769:Causes of neonatal RDS?
1537
prematurity;maternal DM with high insulin (insulin decreases surfactant synthesis);C-section (denies baby of the of stress/cortisol which increases surfactant synthesis)
1538
Q0770:Causes of Right Shift in O2-HgB curve?
1539
CADET face right;CO2;Acid/altitude;DPG;Exercise;Temperature
1540
Q0771:CO poisoning
1541
left shit in O2-HgB curve; decreases O2 binding capacity
1542
Q0772:Innervation of lungs (sensory)
1543
parietal pleura = phrenic (c3;c4;c5) refers to neck/shoulders and by intercostals;visceral pleura = vagus
1544
Q0773:when do you hear fremitus?
1545
lobar pneumonia
1546
Q0774:Paraneoplastic syndromes associated with lung cancer?
1547
squamous cell = PTHrP;small cell = ACTH; ADH; Eaton Lambert
1548
Q0775:Locations of Lung Cancers
1549
central = squamous; small S's;peripheral = adenocarcinoma
1550
Q0776:Relation of Lung Cancer with smoking
1551
all related; but adenocarcinoma the least related;S's
1552
Q0777:What's the difference between small and non-small cell carcinomas?
1553
for small cells; surgery is useless
1554
Q0778:Horner's Symptoms
1555
ptosis (droopy eyelid);miosis (pupil constriction);anhidrosis (lack of sweat)
1556
Q0779:COPD = also known as OLD: obstructive lung disease: why is it called obstructive?
1557
obstruction of AIR FLOW air trapping in lungs
1558
Q0780:COPD = also known as OLD: obstructive lung disease: what is the major PFT finding?
1559
FEV1 / FVC ration is decreased (hallmark finding)
1560
Q0781:COPD = also known as OLD: obstructive lung disease: name the 4 types of COPD
1561
1) Chronic Bronchitis (Blue Bloater) 2) emphysema (pink puffer) 3) asthma 4) bronchietasis
1562
Q0782:COPD = also known as OLD: obstructive lung disease: what is the definition of Chronic Bronchitis
1563
productive cough for >3 consecutive months in two or more years.
1564
Q0783:COPD = also known as OLD: obstructive lung disease: what do you expect on lung histology?
1565
hypertrophy of mucus-secreting glands in the bronchioles (Reid index of >50%)
1566
Q0784:COPD = also known as OLD: obstructive lung disease: leading cause is smoking: what are the physical findings for Chronic Bronchitis? (name 3)
1567
1)cyanosis 2) wheezing 3) crackles
1568
Q0785:what is the pathophysiological mechanism of EMPHYSEMA?
1569
destruction of fibrous septa/alveolar walls enlargement of air space and decreased total surface area for gas exchange
1570
Q0786:if the cause is smoking; what kind of emphysema would you see on histo slide?
1571
centri-acinar emphysema
1572
Q0787:what else can cause emphysema: (also may work synergistically with smoking): What kind of findings do you see in lung histo and name another organ affected?
1573
alpha 1-antitrypsin deficiency panacinar emphysema + liver cirrhosis
1574
Q0788:what causes the emphysema in this disorder?
1575
increased elastase activity to damage lung tissue.
1576
Q0789:name 4 findings of emphysema (in general)
1577
1) dyspnea; 2) decreased breath sounds 3) tachycardia 4) decreased I/E ratio
1578
Q0790:What is mechanism of asthma
1579
BRONCHIAL hypersensitivity/hyperresponsiveness REVERSIBLE bronchoconstriction
1580
Q0791:name 3 common asthma triggers
1581
1) viral URI 2) allergens 3) stress!!
1582
Q0792:name 7 asthma findings
1583
1) cough 2) wheezing 3) dyspnea 4) hypoxemia 5)decreased I/E ratio 6) tachypnea 7) pulsus paradoxus
1584
Q0793:BRONCHIECTASIS: what is its mechanism??
1585
chronic necrotizing infection of BRONCHI dilated airways; purulent sputum; recurrent infections; hemoptysis (see Robbins for a good discussion of this)
1586
Q0794:what disorders is bronchietasis commonly associated with?
1587
1) bronchial obstruction 2) cystic fibrosis 3) poor ciliary motility
1588
Q0795:What are classic PFT findings for RLD?
1589
decreased VC decreased TLC ; FEV1/FVC ration > 80%
1590
Q0796:Name the two MAJOR types of RLD
1591
1) poor breathing mechanics (EXTRA-pulmonary) 2) Interstitial lung diseases
1592
Q0797:Name 3 lung volumes that are increased in COPD
1593
increased TLC; increased FRC; increased RV
1594
Q0798:What 2 values are BOTH reduced in COPD and RLD?
1595
1) FEV1 and 2) FVC (think FEV1/FVC ratio) NOTE! in COPD; FEV1 is more dramatically reduced and thus the FEV1/FVC ratio is decreased
1596
Q0799:what is the main pathology resulting from asbestosis?
1597
DIFFUSE; interstitial fibrosis caused by inhaled asbestos Fibers.
1598
Q0800:What cancers are increased in pts with asbestosis?
1599
1) pleural mesothelioma 2) bronchogenic carcinoma (BC)
1600
Q0801:Major finding in lung w/ asbestosis?
1601
Ferruginous bodies: asbestos fibers coated with hemosiderin also 2) ivory white pleural plaques
1602
Q0802:Neonatal respiratory distress syndrome: What is the main cause
1603
surfactant deficiency --> to increased surface tension --> alveolar collapse
1604
Q0803:Neonatal respiratory distress syndrome: surfactant is made by which cells? After when?
1605
type 2 pneumocytes after 35th gestational week
1606
Q0804:Neonatal respiratory distress syndrome: what do you measure? Where do you get this fluid?
1607
lecithin-to-sphingomyelin ratio in the amniotic fluid = measure of lung maturation <1.5 in neonatal distress syndrome
1608
Q0805:Neonatal respiratory distress syndrome: what is surfactant made of (chemical name)
1609
dipalmitoyl phosph-tidyl-choline (DP-PTC)
1610
Q0806:Neonatal respiratory distress syndrome: treatment for poor maturation of lungs
1611
1) before birth = maternal steroids 2) after= artificial surfactant
1612
Q0807:Karta-gener's syndrome: what is this?
1613
immotile cilia due to dynein arm defect
1614
Q0808:Karta-gener's syndrome: results in what in female and male? (4 things)
1615
1) sterility (in male sperm also immotile) 2)bronchietasis 3)recurrent sinusitis (bacteria & particles not pushed out) 4) associated with situs inversus (e.g. dextro-cardia)
1616
Q0809:name the 3 main classes of cancers that affect parts of the lung
1617
1) bronchogenic carcinoma (with different subtypes) 2) carcinoid tumor 3) metastasis
1618
Q0810:list the 5 types of major bronchogenic carcinomas
1619
CENTRAL 1) squamous cell ca 2)small cell ca; PERIPHERAL 3) adenocarcinoma 4) bronchoalveolar ca 5) large cell ca
1620
Q0811:mnemonic: what is meant by SPHERE of symptoms?
1621
S= superior vena cava syndrome; P= pancoast tumor; H= Horner's syndrome; E= Endocrine (paraneoplastic); Recurrent laryngeal / hoarseness; E = Effusions (pleural OR pericardial)
1622
Q0812:What can a CARCINOID tumor cause?
1623
Carcinoid Syndrome = flushing; diarrhea; wheezing; and salivation
1624
Q0813:Metastases to lung is very common; LUNG cancer also prone to metastasize to what other parts?
1625
1) brain (epilepsy) 2) bone (fracture) 3)liver (jaundice + hepatomegaly)
1626
Q0814:What is Pancoast's tumor?
1627
it's a carcinoma of the apex of lung
1628
Q0815:what may Pancoast's tumor affect?
1629
may affect CSP= cervical sympathetic plexus causing Horner's syndrome
1630
Q0816:what is Horner's syndrome?
1631
P.A.M. is Horny = Ptosis; Anhydrosis; Miosis
1632
Q0817:1st AID breaks it down into TYPE/ ORGANISM/ CHARACTERISTICS = cover parts of this table and fill in the blanks
1633
1634
Q0818:what causes acute epiglottitis; which may be lifethreatening in young children?
1635
H. influenzae
1636
Q0819:MC nasal and laryngeal tumor
1637
Squamous cell CA
1638
Q0820:Dx;Decreased FEV1/FVC ratio
1639
COPD
1640
Q0821:Dx;Charcot-Leyden crystals; Curschmann spirals; bronchial smooth muscle hypertrophy
1641
Asthma
1642
Q0822:Definition;Productive cough occurring at least 3 consecutive months over at least 2 years;what change occurs w/ cells?
1643
Chronic Bronchitis;;(Inc mucous due to hyperplasia of mucous-secreting glands)
1644
Q0823:Definition;Dilation of air spaces w/ destruction of alveolar walls and lack of elastic recoil
1645
Emphysema
1646
Q0824:Type of emphysema dealing with smoking
1647
Centriacinar
1648
Q0825:Type of emphysema dealing with A-1-A deficiency;what gene is difficient in most severe?
1649
Panacinar;(piZZ - homozygous)
1650
Q0826:Type of emphysema dealing with blebbing or subpleural bullae
1651
Paraseptal
1652
Q0827:Definition;perminant abnormal bronchial dilation caused by chronic infection w/ inflammation and necrosis of the bronchial wall
1653
Bronchiestasis
1654
Q0828:Dx;dilated airways; copious purulent sputum; hemoptysis and recurrent pulmonary infections leading to lung abscess (obstruction)
1655
Bronchiectasis
1656
Q0829:Definition;Diffuse alveolar damage w/ resultant increase in alveolar permeability; causing a leak of protein-rich fluid from the alveoli and formation of intra-alveolar hyaline membrane
1657
Adult Respiratory Distress Syndrome (ARDS)
1658
Q0830:Definition;Group of environmental diseases caused by inhalation of inorganic dust particles
1659
Pneumoconioses
1660
Q0831:Dx;inhalation of carbon dust; marked by carboncarrying macrophages
1661
Anthracosis
1662
Q0832:Dx;progressive massive fibrosis w/ necrotic black fluid and dark macules around bronchioles
1663
Coal Miners Pneumoconiosis
1664
Q0833:Dx;diffuse interstitial fibrosis mainly in the lower lobes w/ ferruginous bodies and dense fibrocalcific plaques of parietal pleura;what can it lead to?
1665
Asbestosis;leads to: Mesothelioma
1666
Q0834:Dx;bilateral hilar lymphadenopathy; hypercalcemia; noncaseating granulomas
1667
Sarcoidosis
1668
Q0835:Dx;localized proliferation of histiocytes that have characteristic inclusions resembling tennis rackets (birbeck granules)
1669
Eosinophilic granulomas
1670
Q0836:Definition;Immune complex Dz w/ progressive fibrosis of the alveolar wall
1671
Idiopathic Pulmonary fibrosis
1672
Q0837:MCC of Pulmonary HTN
1673
COPD
1674
Q0838:MCC of interstitial pneumonia;(2)
1675
Mycoplama Pneumoniae;;Viruses
1676
Q0839:What virus produces a Giant cell pneumonia?
1677
Measles
1678
Q0840:What pneumonia is seen in people working with cattle or sheep?
1679
Rickettsial pneumonia;(Q-fever)
1680
Q0841:Dx;Gohn complex
1681
Primary TB
1682
Q0842:Pulmonary infection;Abscess and sinus tract formation w/ exudate containing sulfur granules
1683
Actinomycosis
1684
Q0843:Tx of Neonatal Respiratory Distress syndrome
1685
Give mother steroids before birth;(or artificial surfactant for infant)
1686
Q0844:MCC of Lobar pneumonia
1687
Pneumococcus
1688
Q0845:Definition;Carcinoma in the apex of the lung that may affect cervical sympathetic plexus
1689
Pancoast tumor
1690
Q0846:what are the (2) lung cancers that are central?;what do they have a causitive link to?
1691
Squamous cell;Small cell (Oat cell);;both: Smoking!
1692
Q0847:Dx;cough; hemoptysis; bronchial wheezing; pneumonic "coin" lesion on x-ray
1693
Lung Cancer
1694
Q0848:Describe the (3) peripheral Lung Cancers
1695
Adenocarcinoma;MC non-smoking; K-RAS oncogene;Bronchoalveolar;Tall columnar cells w/ along alveoli;Large cell;Undifferentiated
1696
Q0849:Dx;lung tumor of major bronchi that may also cause flushing; diarrhea; wheezing and salivation
1697
Carcinoid tumor
1698
Q0850:(5)* complications of Lung tumors
1699
SPHERE;Superior vena cava syndrome;Pancoast tumor;Horner's syndrome;Endocrine (paraneoplastic);Recurrent Laryngeal Sx (hoarsemess);Effusions (pleural or pericardial)
1700
Q0851:Causes of Respiratory sounds;Stridor
1701
Inspiratory sound from narrowing extrathoracic area ;(above glottis)
1702
Q0852:Causes of Respiratory sounds;Wheezing
1703
Narrowing of the intrathoracic airway during expiration
1704
Q0853:Causes of Respiratory sounds;Crackles
1705
Alveoli popping open ;due to;fluid (pneumonia; HF; ARDS) ;or fibrosis
1706
Q0854:Causes of Respiratory sounds;Dullness to Percussion
1707
fluid; pus; tumor or blood absorbing the sound b/t alveoli and chest wall
1708
Q0855:Causes of Respiratory sounds;Hyperresonance
1709
Air under the chest wall;(Pneumothorax)
1710
Q0856:Causes of Respiratory sounds;Fremitus / Egophany
1711
Consolidation;(Pneumonia)
1712
Q0857:Dx;Increased Cold Agglutinin
1713
Mycoplasma pneumonia
1714
Q0858:Dx;laryngeal edema; steeple sign; unusual cough
1715
Parainfluenza;(Croup)
1716
Q0859:Dx;inhaling quartz or talc
1717
Silicosis
1718
Q0860:what is the second MCC of lung CA?
1719
Radon gas
1720
Q0861:Dx;Tracheal deviation towards side of lesion;(one main one possible)
1721
Atelectasis;(Bronchial obstruction)
1722
Q0862:Dx;Tracheal deviation away from the side of lesion;(one main one possible)
1723
Pneumothorax;(Pleural Effusion)
1724
Q0863:Dx;bronchiectasis; recurrent sinusitis; infertility; situs inversus;defect?
1725
Kartagener's syndrome;(Dynein arm defect)
1726
Q0864:What is the most common cause of typical community acquired pneumonia?
1727
Streptococcus pneumoniae
1728
Q0865:What is the most common cause of atypical pnuemonia?
1729
Mycoplasma Pneumoniae
1730
Q0866:Interstitial pneumonia is;
1731
atypical
1732
Q0867:bronchopneumonia is;
1733
typical
1734
Q0868:signs of consolidation; in terms of percussion; egophany; tactile fremitus; whispered pectorliloquy
1735
dullness to percussion;egophany +;increased tactile fremitus;whipsered pectoriliquy +
1736
Q0869:Consolidation indicates atypical or typical pneumonia?
1737
Typical.
1738
Q0870:What is the most common source of nosocomial pneumonia infection?
1739
Respirators.
1740
Q0871:What pathogen is usu responsible for respirator contracted pneumo?
1741
Pseudomonas aeruginosa
1742
Q0872:What three pathogens are associated with nosocomial pneumo?
1743
Pseudomonas aeruginosa; Escheria coli; Staph aureus.
1744
Q0873:Most common cause of the common cold.
1745
Rhinovirus
1746
Q0874:What type of influenzavirus is most often involved?
1747
1748
Q0875:2nd most common cause of atypical pneumonia
1749
Chlamydia pneumoniae
1750
Q0876:Case: newborn: afebrile; staccato cough; conjunctivitis; wheezing. Pathogen?
1751
Chlamydia trachomatis
1752
Q0877:Water loving bacteria that causes green sputum
1753
Pseudomonas aeruginosa (respirators!)
1754
Q0878:Most common cause of pneumonia in alcoholics. Then another cause.
1755
Klebsiella pneumoniae or just S. pneumoniae.
1756
Q0879:How do you differentiate between the two common causes of pneumo in alcoholics?
1757
Klebsiella pneumoniae causes thick mucoid sputum; where as S pneumo does not.
1758
Q0880:What bacterial cause of pneumo is associated with water coolers and produce mists?
1759
Legionella pneumophila
1760
Q0881:Case: Pneumo with hyponatremia. Pathogen and pathophys?
1761
Legionella can cause tubulointerstitial disease with JG destruction learing to hyporeninemic hypoaldosteronism with hyponatremia; hyperk; and met acid.
1762
Q0882:What is the most common opportunistic fungal infection and where is it found in the community?
1763
Cryptococcus neoformans; found in pigeon poop.
1764
Q0883:What fungal infection is associated with Ohio/central Mississippi River valley? What 3 animals carry it?
1765
Histoplasma capsulatum. Bats; starlings; chickens. Thus assoc with cave explorers; spelunkers; and chicken farmers.
1766
Q0884:What systemic fungi is associated with the central and southeast US?
1767
Blastomyces dermatidis.
1768
Q0885:SW "Valley fever;" increases after earth quakes (in dust).
1769
Coccidioides immitis.
1770
Q0886:Cave explorer in the Arizona desert with nonproductive cough.
1771
Coccidioides; not Histoplasma. SW! dry!
1772
Q0887:I say pigeons; you say;
1773
Cryptococcus neoformans!
1774
Q0888:What yeast will be phagocytosed by macrophages?
1775
Histoplasma
1776
Q0889:A nasal polyp in a kid is most likely caused by;
1777
Cystic fibrosis.
1778
Q0890:A nasal polyp in an adult is most likely caused by;
1779
Allergies.
1780
Q0891:A woman with chronic pain has asthma. What else?
1781
A nasal polyp caused by NSAID use. Block cyclooxygenase; leave lipoxygenase path open. Leukotrienes C-D-E are increased; causing bronchoconstriction.
1782
Q0892:What is a medically significant A-a gradient?
1783
> 30
1784
Q0893:What causes an increased A-a gradient?
1785
Hypoxemia of pulmonary origin.
1786
Q0894:Calculate and A-a gradient in a pt breathing .3 O2 who has PCO2 of 80 mmHg and PaO2 of 40 mmHg.
1787
PAO2 = 0.3 (713) - 80/0.8 = 114 mmHg;A-a = 114-40 = 74 mm Hg; which is clinically significant
1788
Q0895:Name 3 causes of hypoxemia with a normal A-a gradient.
1789
1. Depression of medullary resp centers;- barbituates; brain injury;2. Upper Airway obstruction;-food block; epiglottitis; croup;3. Muscles of respiration dysfunction;-paralyzed diaphragm
1790
Q0896:Name 3 general causes of hypoxemia with an increased A-a gradient
1791
1. Ventilation defect;2. Perfusion defect;3. Diffusion defect
1792
Q0897:Example of a ventilation defect
1793
Airway collapse in ARDS - impaired O2 deliver to alveoli
1794
Q0898:Example of perfusion defect
1795
Pulmonary emobolus blocks blood flow to alveoli
1796
Q0899:2 Examples of Diffusion defects
1797
Interstitial Fibrosis;Pulmonary Edema;O2 can't diffuse alveoli->capillary
1798
Q0900:What is the most common cause of fever 24-36 hours after surgery?
1799
Resorption atelectasis;Ex: mucus plug obstructs airway; alveoli collapse.
1800
Q0901:On Tension pneumothorax; what side does the trachea deviate to?
1801
Contralateral - pushed by air compressing the lung.
1802
Q0902:With resorption atelectasis; what side does the trachea deviate to?
1803
Ipsilateral - goes where there is space.
1804
Q0903:What cell synthesizes surfactant?
1805
Type II pneumocytes.
1806
Q0904:What increases surfactant synthesis? (2) Decreases? (2)
1807
Increases: cortisol and thyroxine;Decreases: insulin (maternal diabetes); prematurity; c-section (less cortisol)
1808
Q0905:How does surfactant work?
1809
Prevents alveolar collapse on expiration by reducing surface tension.
1810
Q0906:Is Infant RDS a ventilation; perfusion; or diffusion defect?
1811
Ventilation; alveoli collapse.
1812
Q0907:infant RDS treatment
1813
PEEP
1814
Q0908:Free radicals from O2 thrx in infant RDS can cause;(2)
1815
blindness;bronchopulmonary dysplasia
1816
Q0909:What causes hypoglycemia in the newborn?
1817
Excess insulin from response to fetal hyperglycemia in maternal diabetes.
1818
Q0910:What causes hyaline membranes?
1819
proteins leaking out of damages pulmonary vessels
1820
Q0911:What causes ARDS? Pathophys.
1821
Pulmonary edema from acute alveolar capillary damage.
1822
Q0912:What causes capillary damage in ARDS?
1823
Acute damage ->macrophages release cytokines-> chemotactic to netrophils -> neuts transmigrate through pulm capillaries > leave holes -> protein leakage -> hyaline membranes
1824
Q0913:Gram + diplocci on sputum stain = ;How do you treat?
1825
Strep Pneumo. Treat with Penicillin G.
1826
Q0914:How do you prevent Pneumocystis in AIDS pts?
1827
Rx TMP/SMX (trimethoprim-sulfamethxazole) when CD4 is <200.
1828
Q0915:What 3 things can Aspergillus cause?
1829
1. Aspergilloma: fungus ball in old TB site; hemoptysis;2. Allergic reaction;3. Vessel invasion with hemorrhagic infarction and necrotic bronchopnuemo
1830
Q0916:Where do most PE's come from?
1831
Clot in femoral vein; NOT lower leg DVT.
1832
Q0917:Where will an aspiration mass go if you are sitting? supine? right sided? Which is most common?
1833
Sitting = R lower lobe; posterobasal;Supine = R lower lobe; superior seg;*most common;Right side= R upper lobe; superior seg
1834
Q0918:What 2 diagnostic tests are used to diagnose PE? Gold standard?
1835
1. VQ scan - V normal; Q off;2. Gold = pulm angiogram
1836
Q0919:How do you prevent Pneumocystis in AIDS pts?
1837
Rx TMP/SMX (trimethoprim-sulfamethxazole) when CD4 is <200.
1838
Q0920:What 3 things can Aspergillus cause?
1839
1. Aspergilloma: fungus ball in old TB site; hemoptysis;2. Allergic reaction;3. Vessel invasion with hemorrhagic infarction and necrotic bronchopnuemo
1840
Q0921:Where do most PE's come from?
1841
Clot in femoral vein; NOT lower leg DVT.
1842
Q0922:Where will an aspiration mass go if you are sitting? supine? right sided? Which is most common?
1843
Sitting = R lower lobe; posterobasal;Supine = R lower lobe; superior seg;*most common;Right side= R upper lobe; superior seg
1844
Q0923:What 2 imaging diagnostic tests are used to diagnose PE? Gold standard?
1845
1. VQ scan - V normal; Q off;2. Gold = pulm angiogram;NOT spiral CT;D-dimers also useful. Neg rules out PE.
1846
Q0924:Interstitial Fibrosis;Restrictive or Obstructive?;FEV1;FVC;FEV1/FVC;TLC
1847
Restrictive; all V decreased;FVC; TLC down;FEV1/FVC increased - FEV1 up bc of increased elasticity
1848
Q0925:What is Caplan syndrome?
1849
Rheumatoid nodules in lung + restrictive disease like Coal WP or Asbestos disease.
1850
Q0926:What does Coal WP do to TB risk? Cancer risk?
1851
Does not affect TB or cancer risk.
1852
Q0927:What does silicosis do to cancer and TB risk?
1853
Increases risk of cancer and TB
1854
Q0928:What do lung opacities contain in silicosis?
1855
Collagen and quartz. HARD as rocks; as they are made of rocks. Quartz is super fibrogenic
1856
Q0929:What is the most common lesion related to asbestos exposure? What is the most common disease process?
1857
1. Benign plueral plaques;2. Primary bronchogenic carcinoma;Mesothelioma takes longer to show up; thus less common than primary cancer
1858
Q0930:What 2 complications are common in all 3 pneumoconiosis? (silicosis; coalwp; asbetosis)
1859
Cor pulmonale;Caplan syndrome
1860
Q0931:What do roofing and working in shipyards expose you to?
1861
Asbetos
1862
Q0932:What do foundries (casting metal); sandblasting; and mines expose you to?
1863
Quartz / Silicosis
1864
Q0933:What is the most common sxs of Sarcoidosis?
1865
Dyspnea
1866
Q0934:What does sarcoidosis do to the lung?
1867
causes granulomas in interstitium and nodes; contain multinucleated giant cells
1868
Q0935:Name 3 other manifestations of sarcoidosis (outside the lung)
1869
1. Nodular skin lesions;2. Eye lesions;3. Granulomatous hepatitis;4. Enlarged lacrimal glands;5. increased ACE;6. Hypercalcemia
1870
Q0936:What is the likely cause of a pleural effusion in a young woman?
1871
SLE - Lupus;example of serositis
1872
Q0937:Farmer's Lung is caused by;
1873
Moldy hay = saccharopolyspora rectivirgula / thermophilic actinomyces;Type III hypersensitivity - immune complex mediated;Type IV with Chronic exposure -> granuloma
1874
Q0938:In Emphysema; compliance___ and elasticity___.
1875
Compliance increases (inhalation) ;Elasticity decreases (exhalation)
1876
Q0939:What's the difference between a transudate and an exudate?
1877
Transudate: ultrafiltrate of plasma. ex: heart failure;Exudate: protein-rich; cell-rich fluid;ex: pneumonia; infarction; metastasis
1878
Q0940:Pleural fluid protein / serum protein = 0.6;Transudate or exudate?
1879
over 0.5 = exudate ;(more protein in fluid than plasma)
1880
Q0941:Pleural fluid LDH/serum LDH = 0.7;Transudate or exudate?
1881
over 0.6 = Exudate
1882
Q0942:What lung cancer can cause Horner's syndrome and why?
1883
Pancoast tumor of superior sulcus - usu primary sq cell cancer in extreme apex. Can destroy superior cervical ganglion and cause horners (eye lid lag; miosis - pinpoint pupil; anhydrosis - no sweating)
1884
Q0943:What is the most common type of lung cancer?
1885
Metastatic more common than primary;Primary; most common is Adenocarcinoma.
1886
Q0944:Are cancers caused by smoking usually peripheral or central?
1887
Central;However; after filters were installed in cigarettes; the big carcinogens got filtered out. Now; peripheral cancers caused by the small carcinogens are increasing.
1888
Q0945:Which two cancers have the strongest association to smoking?
1889
1. Squamous cell;2. Small cell
1890
Q0946:Is adenocarcinoma related to smoking? Where in the lungs is it usually found.
1891
Adenocarcinoma is not usually associated with smoking; usually found peripherally.
1892
Q0947:What is the most important first step in evaluating a "coin lesion" on a chest x-rays.
1893
Compare size from previous x-rays.
1894
Q0948:What three cancers are most often associated with lung mets?
1895
1. Primary Breast;2. Colon; Renal Cell
1896
Q0949:What is the most common symptom of primary lung cancer? What about metastatic?
1897
Cough for primary; dyspnea for metestatic. (Still have dyspnea in primary.)
1898
Q0950:Where does primary lung cancer metastisize to?
1899
1. Hilar lymph nodes;2. Adrenal gland;3. Liver (50%); brain (20%); bone
1900
Q0951:Name 5 issues associated with CF that are not pulmonary.
1901
1. Malabsorption - pancreatic exocrine def;2. Type 1 diabetes - chronic pancreatitis;3. Male infertility;4. Meconium ileus in bebes;5. 2ary Biliary cirrhosis - bile duct obstruction by thick secretions
1902
Q0952:What is the most common respiratory pathogen in CF?
1903
pseudamonas aeruginosa
1904
Q0953:What is the most common cause of death in CF?
1905
Respiratory infection.
1906
Q0954:Most common cause of bronchiectasis in US? INternational?
1907
US - CF;Int - TB
1908
Q0955:What condition is associated with cupfuls of sputum production?
1909
Bronchiectasis; due to dilation of bronchi and bronchioles that get filled with pus. Ew.
1910
Q0956:Extrinsic asthma is associated with what type of hypersensitivity rxn?
1911
Type 1 - IgE dependent activation of Mast cells.
1912
Q0957:All these things are involved in asthma pathology. Tell me the story of how: Eotaxin; IL4; T cells; eosinophils; mast cells; major basic protein; IL5; histamine; cationic protein; LTC-D-E; Acetylcholine
1913
1. Inhaled allergen sensitizes by stimulating helper T cells (CD4Th2) that release IL 4 and IL 5;IL 4 - IgE production;IL 5 - production and activation of eosinophils;2. Antigens crosslink IgE on mast cells; release histamine + mediators -> bronchoconstriction; mucus; leukocytes;3. Late phase (4-8 hrs later);Eotaxin - chemotactic for eosinophils;Eosinophils release major basic protein and cationic protein; which damage epithelial cells and produce airway constriction;LTC-D-E cause prolonged bronchoconstriction;Acetylcholine causes airway muscle contraction.
1914
Q0958:How are IL4 and IL5 involved in extrinsic asthma?
1915
Released by Tcells;IL4 stimulates isotope switching to IgE production;IL5 stimulated production and activation of eosinophils.
1916
Q0959:Name two causes of emphysema
1917
1. Smoking;2. alpha-1-antitrypin def (AAT)
1918
Q0960:What causes airway collapse in emphysema?
1919
Loss of elastic tissue - loss of radial traction.
1920
Q0961:What causes panacinar emphysema? Centriacinar?
1921
Panacinar = AAT def;Centriacinar = smoking
1922
Q0962:Curschmann spirals and Charcot-Leyden crystals are histologic evidence of what disease?
1923
Asthma.
1924
Q0963:What lung cancer is associated with hypercalcemia?
1925
Squamous Cell
1926
Q0964:What lung cancer is associated with Cushings?
1927
Small Cell
1928
Q0965:(3) branches of the celiac trunk
1929
Left Gastric A;Splenic A;Common Hepatic A
1930
Q0966:(2) branches of the Common Hepatic Artery that supply the stomach
1931
Right Gastric A;Gastroduodenal A
1932
Q0967:trace the Gastroduodenal Artery to the spleen
1933
GDA -> R. Gastroepiploic A ->;L. Gastoepoploic A -> spleen;(Gastroepiploic AA supply blood to Greater curvature of stomach - can also be called Gastro-omenal AA)
1934
Q0968:Name the Veins that you would see varices in w/ portal HTN;(3 sets)
1935
Esophageal;Left gastric -> Azygos;External hemorrhoids;Superior -> Inferior rectal;Caput Medusae;Paraumbilical -> Inferior Epigastric
1936
Q0969:what does the Submucosa portion of the GI contain and control?
1937
Submucosa;meiSSner's plexus;control;Secretions; blood flow and absorption
1938
Q0970:what does the Muscularis portion of the GI contain and control?
1939
Muscularis;Myenteric Auerbach's plexus;control: Motility
1940
Q0971:what is the immunoglobulin of the gut?
1941
IgA
1942
Q0972:Definiton;Secrete alkaline mucous to neutralize acid contents entering the duodenum from the stomach
1943
Brunner's glands
1944
Q0973:what is the name of the structure where the hindgut meets the ectoderm in development?;why is it significant?
1945
Pectinate line;Above line: Internal hemorrhoids;Below line: External
1946
Q0974:Innervation; blood supply and pain level to Internal Hemorrhoids
1947
Nerves: Visceral innervation;Blood: Superior rectal A;Pain: none
1948
Q0975:Innervation; blood supply and pain level to;External Hemorrhoids
1949
Nerves: Somatic innervation;Blood: Inferior rectal (Pudendal branch);pain: Painful
1950
Q0976:what are the objects from lateral to medial in the Femoral Triangle?
1951
NAVEL;Nerve;Artery;Vein;(Empty);Lymphatics
1952
Q0977:what are the top; medial and lateral edges of the Femoral triangle?
1953
Top: Inguinal ligament;Medial: Adductor Longus m;Lateral: Sartorius m
1954
Q0978:What is Hasselbach's triangle made of?
1955
Lateral: Inferior Epigastric A;Medial: Rectus Abdominis;Bottom: Inguinal ligament
1956
Q0979:best landmark to determine of the inguinal hernia is Direct or Indirect
1957
Inferior Epigastric artery;[MDs don't LIe];Medial to artery = Direct;Lateral to artery = Indirect
1958
Q0980:why is the Indirect hernia more common in infants?
1959
failure of Processus Vaginalis to close
1960
Q0981:what is the primary cause of Achalasia?;secondary?
1961
Primary;Failure of LES to relax due to loss of Auerbach's plexus;Secondary;Chagas Dz
1962
Q0982:Dx;"Olive" mass in epigastric region and projectile vomiting at 2 weeks of age
1963
Pyloric stenosis
1964
Q0983:Dx;Infecton of GI causing PAS-positive macros in intestinal lamina propria and mesenteric nodes
1965
Whipple's Dz;(T. Whippelii)
1966
Q0984:Definition;epithelial tumor arising from precursor cells of the enamel origin
1967
Ameloblastoma
1968
Q0985:MC Salivary gland tumor
1969
Pleomorphic Adenoma
1970
Q0986:Dx;newborn w/ copious salivation assoc w/ choking; coughing and cyanosis on attempts at eating
1971
Tracheoesophageal fistula
1972
Q0987:Definiton;Acute gastritis in assoc w/ severe burns
1973
Curling Ulcer
1974
Q0988:Definiton;Acute gastritis in assoc w/ brain injury
1975
Cushing ulcer
1976
Q0989:Definition;focal damage to the gastric mucosa w acute inflammation; necrosis and hemorrhage
1977
Acute (erosive) Gastritis
1978
Q0990:Dx;Autoimmune dz; pernicious Anemia; Achlorhydria;where in stomach?
1979
Chronic (nonerosive) Gastritis Type A (3 As);(Fundal)
1980
Q0991:MC form of Chronic Gastritis;where in stomach?
1981
Type B;H. Pylori-assoc Gastritis;[B = Bug];(Antrum)
1982
Q0992:Dx;Pain greater w/ meals;Ulcer cause?
1983
Gastric;[Gastric = Greater w/ meals];Cause;low mucosal protection vs. acid;(H.pylori and NSAIDs)
1984
Q0993:Dx;Pain Decreases w/ meals;Ulcer cause?
1985
Duodenal ulcer;[Duodenal = Dec w/ meal];Cause: H.pylori
1986
Q0994:MC type of stomach cancer;(2) Extra-GI sites of involvement
1987
Adenocarcinoma;extra sites;Virchow node;;Krukenberg tumor - signet-ring cells in bilateral Ovary
1988
Q0995:Definition;Stomach cancer that is diffusely infiltrative (thickened; rigid appearance)
1989
Linitis Plastica
1990
Q0996:Definition;extreme enlargement of gastric rugae and possible loss of plasma proteins from altered mucosa
1991
Menetrier Dz;(giant hypertrophic gastritis);[MENE large Rugae]
1992
Q0997:Dx;colon inflammation w/ crypt abscesses and pseudopolyps
1993
Ulcerative colitis
1994
Q0998:Definition;twisting of portion of bowel around its mesentary
1995
Volvulus
1996
Q0999:remnant of Embryonic Vitelline duct
1997
Meckel's Diverticulum
1998
Q1000:Dx;inc serotonin; cutaneous flushing; diarrhea; bronchospasm; valvular lesions of right heart; RLQ mass
1999
Carcinoid tumor;(MC place = Appendix)
2000
Q1001:Definition;dilation of the colon due to the absence of ganglion cells;underlying cause?
2001
Hirschsprungs Dz;(colon SPRUNG open);cause: failure of neural crest cells to migrate
2002
Q1002:Dx;trisomy 21 patient w/ chronic constipation early in life
2003
Hirschsprungs Dz
2004
Q1003:MC place for ischemic bowel due to being poorly vascularized regions;(2)
2005
Splenic flexure;Rectosigmoid junction
2006
Q1004:Dx;Unexplained lower bowel bleeding
2007
Angiodysplasia
2008
Q1005:Dx;inflammation of the colon w/ flask-shaped ulcers
2009
Amebic colitis;(E. Histolytica infection)
2010
Q1006:Dx;barrium swallow has "apple core" lesion in lower GI
2011
Colorectal cancer
2012
Q1007:which polyp is benign?;which is most malignant?
2013
Benign: Tubular Adenoma;;most malignant: Villous Adenoma
2014
Q1008:Dx;polyps of the colon and small intestines and melanotic accumulations in the mouth; lips; hands and genitals
2015
Peutz-Jegher syndrome
2016
Q1009:Dx;adenomatous polyps w/ osteomas and soft tissue tumors
2017
Gardner syndrome
2018
Q1010:Dx;adenomatous polyps w/ tumors of the CNS
2019
Turcot syndrome
2020
Q1011:Causes of Micronodular Cirrhosis;(3)
2021
Metabolic insult;Wilsons Dz;;Alcohol;;Hemochromatosis
2022
Q1012:what type of shunt may releive portal HTN?;connecting what vessels?
2023
Portacaval shunt;between Splenic vein and Lt Renal vein
2024
Q1013:Another name for AST in lab
2025
SGOT
2026
Q1014:Dx;swollen; necrotic hepatocytes; PMN infiltrates; intracytoplasmic eosinophilic inclusions; fatty change; sclerosis around central vein
2027
Alcoholic Hepatitis
2028
Q1015:Best tx for staph food poisoning?
2029
Bed rest
2030
Q1016:Bacterial infection from raw oyster?
2031
Cholera
2032
Q1017:What is the antibx of choice for severe cholera?
2033
Tetracycline
2034
Q1018:Tightly knotted ball of nematodes (15 to 35 cm in length); worms have tapered ends without hooks;species?
2035
Ascaris lumbricoides
2036
Q1019:Which Vibrio cholera serogroup is the most common cause of cholera epidemics?
2037
2038
Q1020:Celiac disease is associated with which HLAs? Predisposes to which neoplasms?
2039
HLA-B8 and DQW2; predisposes to T-cell lymphoma; and GI and breast cancer
2040
Q1021:The retropharyngeal space is located between which two layers of fascia?
2041
Buccopharyngeal layer of deep cervical fascia and the prevertebral layer of deep cervical fascia
2042
Q1022:Metoclopramide is used to treat;? can antagonize which receptors?
2043
Prokinetic agent used to treat GERD. Can antagonize dopamine receptors.
2044
Q1023:Both pancreatic buds form from evaginations from which part of the duodenum?
2045
Second part
2046
Q1024:Which antibiotic can cause a disulfiram-like reaction when taken with alcohol?
2047
Metronidazole
2048
Q1025:Which vessel gives off the short gastric arteries?
2049
Splenic artery
2050
Q1026:Internal hemorrhoids are produced by varicosities of which vein?
2051
Superior rectal vein
2052
Q1027:Misoprostol is what type of drug? Prophylaxis to prevent;?
2053
Prostaglandin analog to prevent NSAID-induced ulcers
2054
Q1028:Which muscle elevates the lower jaw during chewing? Moves the lower jaw forward? Backward?
2055
Medial pterygoid. Lateral pterygoid. Temporalis
2056
Q1029:Which salivary gland has the greatest % of mucus secreting cells? Serous?
2057
Sublingual. Parotid.
2058
Q1030:Which H2-receptor antagonist is a potent hepatic enzyme inhibitor?
2059
Cimetidine
2060
Q1031:What type of mucosa is normal for the distal esophagus?
2061
Non-keratinized; stratified; squamous epithelium
2062
Q1032:What ligament separates the greater peritoneal sac from the right portion of the lesser peritoneal sac?
2063
Gastrohepatic ligament
2064
Q1033:What type of heterotopia can occur in the small intestine without causing bleeding?
2065
Pancreatic heterotopia
2066
Q1034:The left renal vein drains into;?
2067
IVC
2068
Q1035:The splenorenal ligament contains which vessels?
2069
The splenic artery and vein
2070
Q1036:Mesalamine is indicated for the treatment of;?
2071
Ulcerative colitis.
2072
Q1037:Pseudomembranous colitis produces what kind of diarrhea?
2073
Greenish; foul-smelling watery diarrhea.
2074
Q1038:The right gastroepiploic artery is a branch of;?
2075
Gastroduodenal artery
2076
Q1039:Which anesthetic can cause idiosyncratic hepatic failure?
2077
Halothane
2078
Q1040:Elevated AST and ALT reveal what process in which tissue?
2079
Hepatocellular death
2080
Q1041:CCK is secreted in response to;?
2081
The presence of amino acids and fatty acids in the duodenum
2082
Q1042:Ondansetron selectively antagonizes which receptors?
2083
5HT3 receptors
2084
Q1043:Lipoprotein lipase is located where?
2085
External surface of endothelium of tissues with triglyceride needs such as muscle and lactating breast.
2086
Q1044:What type of stones can be seen in liver fluke infestation?
2087
Bilirubin stones
2088
Q1045:The free edge of the lesser omentum contains which three important structures?
2089
Common bile duct; hepatic artery; and the portal vein
2090
Q1046:What agents are absolutely contraindicated in patients with bowel obstruction?
2091
Prokinetics; such as metoclopramide
2092
Q1047:Gastroschisis? Caused by?
2093
Abdominal viscera protrude from the abdominal cavity at birth. Caused by incomplete fusion of the lateral body folds
2094
Q1048:Motilin is released by;?
2095
Small intestine
2096
Q1049:How does secretin affect the rate of stomach emptying?
2097
Decreases the rate of stomach emptying
2098
Q1050:Inferior rectal nerve is a branch of;?
2099
Pudendal nerve of the sacral plexus
2100
Q1051:Sepsis; hypotensions; and neutrophilia in an infant who has been started on oral foods;?
2101
Necrotizing enterocolitis.
2102
Q1052:Which narcotic is least likely to cause spasm of the sphincter of Oddi? Why?
2103
Meperidine; due to its anti-muscarinic properties.
2104
Q1053:Superior pancreaticoduodenal artery gets it's blood supply from? Inferior?
2105
Celiac trunk by means of the common hepatic artery. SMA.
2106
Q1054:Which tx for GERD could cause torsades de pointes when given with erythromycin?
2107
Cisapride.
2108
Q1055:Disulfiram?
2109
a drug used to support the treatment of chronic alcoholism by producing an acute sensitivity to alcohol.
2110
Q1056:This parasite can cause mild diarrhea; or more aggressive dysentery; peritonitis; or liver abscess formation;
2111
Entamoeba histolytica
2112
Q1057:Microabscesses in mesenteric lymph nodes is associated with which bug?
2113
Yersinia enteritis
2114
Q1058:Enlarged and ulcerated Peyer's patches are associated with which infection?
2115
Salmonella typhii
2116
Q1059:Cholera enterotoxin activates which enzyme?
2117
Adenylate cyclase
2118
Q1060:Megaloblastic anemia can be caused by which parasite?
2119
Diphyllobothrium latum
2120
Q1061:Kid vomits up a cylindrical white worm 30 cm long;How was this organism acquired?
2121
Ingestion of eggs from human feces (Ascaris lumbricoides)
2122
Q1062:Which hepatitis virus is a major cause of epidemics but does not cause significant mortality in pregnant women?
2123
Hepatitis A
2124
Q1063:A patient with dumping syndrome should eat small; frequent meals that are high in;?
2125
Fat
2126
Q1064:What deficiency could cause a decrease in serum calcium and phosphate?
2127
Vitamin D
2128
Q1065:Mini epidemic of pediatric diarrhea;?
2129
Yersinia
2130
Q1066:Traveler's diarrhea - empiric tx?
2131
Ciprofloxacin
2132
Q1067:Undercooked chicken - bloody diarrhea; abdominal pain; and fever;?
2133
Campylobacter jejuni
2134
Q1068:Liver abscesses - what parasite;?
2135
2136
Q1069:OOcysts 5-7 microns in diameter;organism? Where does it's sexual phase occur?
2137
Crytosporidiosis - invades the brush border of the intestinal epithelium
2138
Q1070:An obstruction in the common bile duct would affect the urine how?
2139
Increased urine bilirubin - tea-colored urine
2140
Q1071:Oval eggs flattened along one side? Causes anal pruritis?
2141
Enterobius vermicularis (pinworm)
2142
Q1072:Hep B infection causes what in the majority of cases?
2143
Subclinical disease followed by recovery
2144
Q1073:Darkly colored faceted stones with irregular shapes are associated with which infestation?
2145
Opisthorchis sinensis (oriental liver fluke)
2146
Q1074:Rotavirus symptoms in kids?
2147
Watery non-bloody diarrhea; often coupled with nausea and vomiting
2148
Q1075:Norwalk agent usually affects kids older than;?
2149
2150
Q1076:A stomach lesion on the lesser curvature with piled up ulcer edges suggests;?
2151
Gastric carcinoma
2152
Q1077:What are predisposing factors for gastric carcinoma?
2153
Pernicious anemia; chronic gastritis; achlorhydria; bacterial overgrowth; and neoplastic polyps
2154
Q1078:Achlorhydria?
2155
Absence of HCl in the stomach
2156
Q1079:Type A gastritis - increased or decreased likelihood of developing gastric carcinoma?
2157
Increased
2158
Q1080:Symptoms of fever; chills; hypotension; and fluidfilled blisters progressing to muscle necrosis;?
2159
Vibrio vulnificus
2160
Q1081:Nonmotile bug; cuases dysentery?
2161
Shigella
2162
Q1082:Plague bug?
2163
Yersinia pestis
2164
Q1083:Hypertrophic pyloric stenosis usually presents when?
2165
Several weeks of age
2166
Q1084:The parasympathetic preganglionic innervation to the internal anal sphincter is provided by which nerve?
2167
Pelvic nerve
2168
Q1085:Courvoisier sign?
2169
Painless distention of the gallbladder
2170
Q1086:Which bug produces exotoxin A?
2171
Staph aureus
2172
Q1087:Which apolipoprotein molecule activates lipoprotein lipase?
2173
CII
2174
Q1088:Supparative cholangitis can occur as a complication of infestation by;?
2175
Roundworm (ascaris lumbricoides) and the liver flukes Clonorchis sinensis and Fasciola hepatica
2176
Q1089:Which damaging agents could cause development of hepatocellular carcinoma in the setting of cirrhosis?
2177
HBV; alcohol; hemochromatosis
2178
Q1090:Loss of villi and intraepithelial lymphocytic infiltration?
2179
Celiac sprue
2180
Q1091:Granular; spherical; thin-walled cysts measuring 10-20 um in diameter;trichrome stains show up to four nuclei in most of the cysts;?
2181
2182
Q1092:scleral icterus typically reflects which fraction of biliribuin that binds tissues more avidly;?
2183
Uncojugated bilirubin
2184
Q1093:Which nodes drain the greater curvature of the stomach? The bladder and male internal genitalia? The distal stomach; pancreas and duodenum?
2185
Gastroepiploic nodes. Internal iliac nodes. Subpyloric nodes.
2186
Q1094:What are the most important predictors of a carcinoid's metastatic potential?
2187
Location and size
2188
Q1095:Acute hemorrhagic pancreatitis causes what changes to the pancreas?
2189
Autodigestion; chalky-white 'fat necrosis;' hemorrhagic; edematous
2190
Q1096:Name two polyposis syndromes that do not preispose for colon cancer?
2191
Juvenile polyposis syndrome and Peutz-Jeghers syndrome
2192
Q1097:Glands and sawtooth crypts with a proliferation of goblet and columnar epithelial cells - what type of polyp?
2193
Hyperplastic polyp
2194
Q1098:What is a pancreatic pseudocyst?
2195
Complication of pancreatitis - lined by granulation tissue and collagen; containing pancreatic juices and lysed blood.
2196
Q1099:Acetaminophen toxicity would cause elevation in which enzymes?
2197
AST and ALT
2198
Q1100:This is formed by herniation of the mucosa at a point of weakness at the junction of the pharynx and esophagus in the posterior hypopharyngeal wall?
2199
Zenkers diverticulum
2200
Q1101:What is the triad of Plumner-Vinson syndrome?
2201
Esophageal webs; atrophic glossitis; and iron-deficiency anemia
2202
Q1102:Markedly enlarged rugal folds can be seen in several conditions; including?
2203
Infiltrative cancer; lymphoma; hypersecretory gastropathy; and Menetrier disease
2204
Q1103:What is Menetrier disease?
2205
Men at rear protein losing enteropathy marked hyperplasia of mucus-secreting cells.
2206
Q1104:Tuberculosis GI involvement?
2207
Mass lesions and strictures
2208
Q1105:Oral squamous cell carcinoma is most often located;? Which HPV is associated with almost half of all oral cancers?
2209
Floor of the mouth. HPV16
2210
Q1106:Acute gastritis can be seen as a complication of which other conditions?
2211
Alcohol use; NSAIDs; smoking; shock; steroid use; and uremia
2212
Q1107:Which autoimmune disease is associated with atrophic gastritis?
2213
Pernicious anemia
2214
Q1108:Tumor composed of uniform round cells arranged in trabeculae; with a 'salt-and-pepper' chromatin pattern
2215
Carcinoid
2216
Q1109:Cardiac failure; megaesophagus in Brazilian man;?
2217
Chagas
2218
Q1110:One of the most common etiologic agents of infective esophagitis;?
2219
Herpes simplex
2220
Q1111:What parts of the liver are Zones 1; 2; and 3; associated with;?
2221
Zone 1 - periportal;Zone 2 - intermediate;Zone 3 - Central vein
2222
Q1112:Which liver zone contains the P450 oxidase enzyme system?
2223
Zone 3
2224
Q1113:Disease characterized by inflammation and fibrosis of the intrahepatic and extrahepatic bile ducts; producing alternating strictures and dilatation;?
2225
Primary sclerosing cholangitis
2226
Q1114:Usual cause of intestinal amebiasis; with small nuclei with distinctive tiny central karyosomes;?
2227
2228
Q1115:Most likely cause of sudden gastrointestinal obstruction?
2229
Intussusception
2230
Q1116:On biopsy; this protozoan appears crescent-shaped;?
2231
Giardia lamblia
2232
Q1117:Tumors from the penis; vagina; and anal canal drain to which lymph nodes?
2233
Medial side of the horizontal chain of the superficial group of inguinal lymph nodes
2234
Q1118:Eosinophilic cytoplasmic inclusions;?
2235
Mallory bodies
2236
Q1119:Predisposing condition to angiosarcoma in the liver?
2237
Vinyl chloride exposure (used in the rubber industry)
2238
Q1120:Liver steatosis would progress to what if the noxious stimulus is removed?
2239
Complete regression
2240
Q1121:Pancreatic calcifications constitute strong radiologic evidence of;?
2241
Chronic pancreatitis
2242
Q1122:T or F? Pernicious anemia is an autoimmune disease associated with atrophic gastritis
2243
True
2244
Q1123:Celiac sprue is located;?
2245
Proximal small bowel
2246
Q1124:Polycythemia vera woman develops progressive severe ascites and tender hepatomegaly;?
2247
Budd-Chiari
2248
Q1125:Definition;intracytoplasmic eosinophilic inclusions;what are they seen in?
2249
Mallory bodies;in: Alcoholic hepatitis
2250
Q1126:Dx;high unconjugated bilirubin w/o hemolysis; decreased UDP-glucuronyl transferase; stress induced; no sx
2251
Gilbert's syndrome
2252
Q1127:Dx;high unconjugated bilirubin w/o hemolysis; absent UDP-glucuronyl transferase; jaundice; kernicterus; CNS damage
2253
Crigler-Najjar syndrome
2254
Q1128:Dx;Increased Conjugated bilirubin; brown to black discoloration of liver
2255
Dubin-Johnson syndrome
2256
Q1129:Dx;hypergammaglobinemia and anti-smooth muscle Ab
2257
Autoimmune Hepatitis
2258
Q1130:Dx;severe obstructive jaundice; itching; hypercholesterolemia; xanthomas
2259
Primary Biliary cirrhosis;(Anti-mitochondrial Ab)
2260
Q1131:Definition;extrahepatic biliary obstruction causing increased pressure in intrahepatic ducts leading to injury and fibrosis; Inc Alk phos; Inc conjugated bilirubin
2261
Secondary Biliary Cirrhosis
2262
Q1132:Dx;tender hepatomegaly; ascites; polycythemia; hypoglycemia;what is elevated in serum?
2263
Hepatocellular CA;(elevated alpha-fetoprotein)
2264
Q1133:Definition;Inadequate hepatic copper excretion and failure of copper to enter circulation; leading to copper accumulation in organs
2265
Wilson's Dz;(Auto Resessive)
2266
Q1134:Dx;asterixis; parkinsonian sx; cirrhosis; low ceruloplasmin; dementia
2267
Wilson's Dz;ABCD;Asterixis;Basal ganglia sx;Copper accumulation/low Ceru;Dementia
2268
Q1135:Dx;occlusion of IVC or hepatic veins w/ centrilobular congestion and necrosis; assoc w/ polycythemia; abd CA; or complication of pregnancy
2269
Budd-Chiari syndrome
2270
Q1136:Hyperbilirubinemia type; urine bilirubin and urine urobilinogen changes for;Hepatocellular jaundice
2271
Conjugated/Unconjugated;Inc Urine Bilirubin;nml/Dec Urobilinogen
2272
Q1137:Hyperbilirubinemia type; urine bilirubin and urine urobilinogen changes for;Obstructive jaundice
2273
Conjugated;Inc Urine Bilirubin;Dec Urobilinogen
2274
Q1138:Hyperbilirubinemia type; urine bilirubin and urine urobilinogen changes for;Hemolytic jaundice
2275
Unconjugated;Absent urine Bilirubin;Inc Urobilinogen
2276
Q1139:Dx;hepatoencephalopathy in young children w/ virus who are given aspirin
2277
Reye's syndrome
2278
Q1140:what is chronic calcifying pancreatitis assoc with?
2279
alcoholism
2280
Q1141:what is chronic obstructive pancreatitis assoc with?
2281
Gallstones
2282
Q1142:Cause of Cholangiocarcinoma
2283
Liver fluke;(C.sinensis)
2284
Q1143:Dx;"Strawberry gallbladder"
2285
Cholesterolosis
2286
Q1144:what causes the GB to become enlarged and distended?
2287
Tumors (not stones)
2288
Q1145:(3) changes in the pancreas w/ Acute Pancreatitis
2289
Hemorrhagic Fat Necrosis;Calcium soaps (leading to HypoC);Pseudocysts
2290
Q1146:Dx;abdominal pain radiating to back; migratory thrombophlebitis; obstructive jaundice w/ palpable GB
2291
Pancreatic Adenocarcinoma
2292
Q1147:Dx;malabsorption problem w/ positive D-xylose test;what CA can it lead to?
2293
Celiac Sprue;;leads to: T-cell lymphoma
2294
Q1148:Diverticuli are blind pouches found in the:
2295
alimentary tract
2296
Q1149:Diverticuli are lined by:
2297
Mucosa; muscularis; and serosa
2298
Q1150:The 4 GI tract locations of diverticuli are:
2299
esophagus; stomach; duodenum and colon
2300
Q1151:Why are most diverticuli termed false?
2301
They lack or have an attenuated muscularis mucosa.
2302
Q1152:Percent of older patients likely to get diverticulosis (many diverticula):
2303
50% of patients >60
2304
Q1153:The reasons for increasing number of diverticula with age are:
2305
Increased intraluminal pressure and focal weaknes in the colonic wall.
2306
Q1154:What type of diet is diverticulosis associated with?
2307
low-fiber
2308
Q1155:Sx of diverticulosis?
2309
usually asymptomatic; sometimes vague discomfort.
2310
Q1156:Diverticulitis commonly presents with pain where?
2311
LLQ
2312
Q1157:Complications of diverticulitis include:
2313
perforation; peritonitis; abcess formation; bowel stenosis
2314
Q1158:What is intussuception?
2315
telecoping of 1 bowel segment into distal segment.
2316
Q1159:Complication of intussusception is:
2317
compromised blood supply.
2318
Q1160:What is volvulus?
2319
Twisting of portion of the bowel around its mesentery.
2320
Q1161:What volvulus lead to?
2321
obstruction.
2322
Q1162:What is the most common type of stomach cancer?
2323
adenocarcinoma
2324
Q1163:Is this cancer aggresive?
2325
Yes; it has early aggressive local spread and node/liver mets
2326
Q1164:Stomach Cancer is associated with what 3 etiologic factors?
2327
dietary nitrosamines; achlorhydria; chronic gastritis
2328
Q1165:What is stomach cancer termed when it is diffusely infiltrative with thickened and rigid appearance?
2329
Linitis plastica
2330
Q1166:What does Virchow's node signify?
2331
involvement of supraclavicular node by stomach mets
2332
Q1167:What is Krukenberg's tumor?
2333
bilateral stomach cancer mets to the ovary
2334
Q1168:What are characteristics of Krukenberg's tumor?
2335
Abundant mucus; "signet ring" cells
2336
Q1169:What is Hirschprung's diease?
2337
congential megacolon
2338
Q1170:What is missing?
2339
enteric nerve plexus (both Auerbach's and Meissner's). Seen on biopsy
2340
Q1171:What is the cause of this disease?
2341
failure of neural crest migration.
2342
Q1172:How does this disease present?
2343
Chronic constipation early in life.
2344
Q1173:Which part of the colon is dilated?
2345
That part proximal to the aganglionic segment - aganglionic portion is constricted.
2346
Q1174:The risk factors for colorectal cancer are:
2347
colorectal villous adenoma; IBD; low-fiber diet; age; FAP; HNPCC; personal and family hx. of colon cancer.
2348
Q1175:What is Peutz-Jeghers; and does it lead to colorectal cancer?
2349
It is a benign polyposis syndrome which is not a risk factor.
2350
Q1176:Who schould be screened for colorectal cancer and how?
2351
People over age 50; screen with stool occult blood test.
2352
Q1177:Cirrho in Greek means:
2353
tawny yellow
2354
Q1178:Cirrhosis is:
2355
diffuse fibrosis of the liver with destruction of norml architecture; nodular regeneration.
2356
Q1179:Cause of micronodular cirrhosis (nodules <3mm; uniform in size) is:
2357
metabolic insult
2358
Q1180:Causes of macronodular cirrhosis (nodules >3mm; varied in size) are?
2359
Significant liver injury leading to hepatic necrosis (postinfectious; drug-induced hepatitis)
2360
Q1181:Cirrhosis is assocated with what type of cancer?
2361
hepatocellular carcinoma
2362
Q1182:The effects of portal hypertension are:
2363
esophageal varices (hemetemesis; melena); peptic ulceration (melena); splenomegaly; caput medusae; ascites; hemmorhoids; and testicular atrophy
2364
Q1183:Portal hypertension may be relieved by what method?
2365
Portacaval shunt between splenic vein ad left renal vein.
2366
Q1184:What are the effects of liver cell failure?
2367
Coma; scleral icterus; fetor hepaticus (breath smells like a freshly opened corpse); spider nevi; gynecomastia; jaundice; loss of sexual hair; asterixis; bleeding tendency; anemia; ankle edema
2368
Q1185:Hepatocytes in alcoholic hepatitis are:
2369
swollen and necrotic
2370
Q1186:Other histologic changes seen in aloholic hepatitis are:
2371
neutrophil infiltration; mallory bodies (hyaline); fatty change; and sclerosis areound central vein
2372
Q1187:SGOT (AST):SGPT (ALT) ratio in alcoholic hepatitis is:
2373
usually more than 1.5 (A Scotch and Tonic: AST elevated)
2374
Q1188:What is Budd-Chiari Syndrome?
2375
Occlusion of the IVC or hepatic veins with centrilobular congestion and necrosis; leading to congestive liver disease
2376
Q1189:The features of congestive liver disease are:
2377
hepatomegaly; ascites; abdominal pain; and eventual liver failure
2378
Q1190:Budd-Chiari Syndrome is associated with what 3 conditions:
2379
polycythemia vera; pregnancy; hepatocellular carcinoma
2380
Q1191:Wilson's disease is?
2381
Copper accumulation; especially in liver; brain and cornea
2382
Q1192:It is due to what?
2383
failure of copper to enter circulation in the form of ceruloplasmin
2384
Q1193:What is another name for Wilson's Disease?
2385
Hepatolenticular degeneration
2386
Q1194:What are the symptoms of Wilson's Disease? (A;B;C6;D)
2387
Asterixis; basal ganglia degeneration (parkinsonian symptoms); Ceruloplasmin decrease; cirrhosis; corneal deposits (kayser-fleischer rings); copper accumulation; carcinoma (hepatocellular); choreiform movements; Dementia
2388
Q1195:Somatotropic adenoma would affect glucose tolerance how?
2389
Impaired glucose tolerance
2390
Q1196:Describe how coma could result from complications of DM II?
2391
Osmotic diuresis + dehydration = severe hyperosmolarity; Osmotic loss of water from neurons can produce coma
2392
Q1197:Even small amounts of insulin are sufficient to prevent;?
2393
Ketosis
2394
Q1198:Beta hydroxybutyrate is a;?
2395
Ketone body
2396
Q1199:An XY fetus with a mutated dysfunctional androgen receptor molecule would develop how?
2397
male sexual development is impaired and female external genitalia are formed;Because the androgen receptor in hypothalamic and pituitary tissue is also defective; normal testosterone suppression of pituitary gonadotrophs is absent
2398
Q1200:How does the pituitary affect the sensitivity of peripheral tissues to the action of insulin?
2399
GH - anti-insulin effects on liver and muscle. ACTH causes increased cortisol = decreased insulin sensitivity in peripheral tissues. TSH also tends to increase blood glucose levels
2400
Q1201:ANP is released when?
2401
When the atria are distended - suppresses the reninangiotensin-aldosterone system
2402
Q1202:Graves is caused by;?
2403
Increased production of thyroid-stimulating immunoglobulins
2404
Q1203:T or F? Hyperthyroidism and hypothyroidism are always associated with increased and decreased radioactive iodine uptake; respectively.
2405
False
2406
Q1204:The sweating and palpitations of hypoglycemia are caused by;?
2407
Epinephrin
2408
Q1205:Link the following: dissecting osteitis and chronic renal failure
2409
Hyperparathyroidism results from decreased serum calcium and increased serum phosphate (sequelae of renal failure). This may lead to osteomalacia and osteitis fibrosa cystica; which is classically associated with dissecting osteitis.
2410
Q1206:Thyrotoxic crisis is most commonly seen in which disease?
2411
Inadequately treated Graves' disease
2412
Q1207:What are the HLA associations of DM I ?
2413
DR3 and DR4
2414
Q1208:What are the two most dangerous hormonal deficiencies?
2415
Glucocorticoids and thyroid hormone
2416
Q1209:Why does mild renal failure cause hyperkalemia?
2417
Deficient renin production by the damaged kidney causes decreased secretion of aldosterone
2418
Q1210:What types of infections are more frequently considered with Addison's?
2419
Tuberculosis; fungal infections
2420
Q1211:How to clinically distinguish primary from secondary adrenocortical insufficiency?
2421
Secondary is not associated with skin hyperpigmentation (which results from increased production of ACTH precursor; which also stimulates melanocytes)
2422
Q1212:Nonenzymatic glycosylation is seen in which disease?
2423
Diabetes mellitus
2424
Q1213:Euthyroid sick syndrome?
2425
After systemic illnesses or stresses; there can be a decrease in 5'-monodeiodinase activity in peripheral tissues. Causes a decreased conversion of T4 to T3
2426
Q1214:Describe how a short-term vs long-term severe Mg deficiency affects PTH?
2427
Short-term - increased PTH;Long-term; severe - decreased PTH
2428
Q1215:Which zones of the adrenal cortex does Addison's affect?
2429
All three
2430
Q1216:Early manifestations of cretinism?
2431
Difficulty feeding; somnolence; failure to thrive; and constipation
2432
Q1217:Chronic thyoiditis is aka.?
2433
Hashimoto's thyroiditis
2434
Q1218:How would a decrease in GH affect IGF-1 release?
2435
Decrease
2436
Q1219:What is testicular feminization?
2437
Androgen insensitivity due to an androgen receptor defect
2438
Q1220:PTH acts on which biochemical pathway?
2439
Increased intracellular cAMP
2440
Q1221:Somatostatin would inhibit the release of what from the pituitary?
2441
GH and TSH
2442
Q1222:Antimicrosomal antibodies are seen in which thyroid condition?
2443
Hashimoto thyroiditis
2444
Q1223:ACTH affects which zones of the adrenal cortex?
2445
Inner two - fasciculata and reticularis
2446
Q1224:When is gynecomastia normal/common?
2447
Adolescent boys during puberty
2448
Q1225:hCG is in the same hormone family as;?
2449
TSH; FSH; and LH
2450
Q1226:T or F? In a patient with DM II; you would expect deactivation of fatty acid synthase
2451
False - fatty acid synthase is rapidly induced in the liver by high glucose and insulin levels
2452
Q1227:What is Chvostek's sign?
2453
Facial muscle contraction on tapping in front of the ear;Detects hypocalcemia
2454
Q1228:Tx for acute hypocalcemia?
2455
Calcium gluconate and cholecalciferol
2456
Q1229:Which metabolite helps to raise serum calcium by increasing proximal intestinal absorption of calcium?
2457
Cholecalciferol (Vit D3; 1;25-OH2-D3)
2458
Q1230:T or F? Hypercalcemia can 'hyperstabilize' excitable tissue membranes and reduce normal responsiveness
2459
True
2460
Q1231:Laron dwarfism?
2461
Congenital absence of growth hormone receptors;detected by an absence of GH binding protein; which is identical to the extracellular portion of the GH receptor
2462
Q1232:T or F? Plasma levels of proinsulin are increased in patients with insulinomas?
2463
True
2464
Q1233:Prolactin has close structural homology with;?
2465
GH
2466
Q1234:Child who develops weight loss despite increased food intake?
2467
Diabetes mellitus
2468
Q1235:Sheehan's syndrome?
2469
Hypopituitarism due to ischemic damage to the pituitary resulting from excessive hemorrhage during parturition
2470
Q1236:T or F? Somatotropes are basophils.
2471
False - they are acidophils
2472
Q1237:Which drugs are antidiabetic agents that increase insulin sensitivity through a variety of mechanisms that result in decreased hepatic gluconeogenesis and increased insulindependent muscle glucose uptake?
2473
Thiazolidinediones
2474
Q1238:Hyperthyroid patient with mononuclear cell infilitrate in thyroid with multinucleated giant cells; follicular disruption; and loss of colloid;?
2475
Subacute thyroiditis (aka granulomatous giant cell; de Quervain thyroiditis)
2476
Q1239:Which syndrome is associated with coarctation of the aorta?
2477
Turner syndrome
2478
Q1240:Elevated anion gap; decreased arterial blood pH; and elevated blood lactate is a rare complication of which drug?
2479
Metformin
2480
Q1241:This disease is characterized among other things by Hurthle cells (oncocytes) and associated with various thymic disorders
2481
2482
Q1242:Mucosal neuromas in a patient with a marfanoid syndrome is a marker for;?
2483
MEN III
2484
Q1243:Pituitary apoplexy is what? may result after;?
2485
Life-threatening infarction of the pituitary gland. May result after obstetric hemorrhage: Sheehan syndrome
2486
Q1244:How would clonidine affect pancreatic insulin secretion?
2487
Clonidine; an alpha2-receptor agonist; would inhibit pancreatic insulin secretion
2488
Q1245:T or F? Glucagon; gastrin; secretin; and CCK all stimulate insulin secretion
2489
True
2490
Q1246:Which category of drugs could blunt or prevent the premonitory signs and symptoms of acute episodes of hypoglycemia in a diabetic patient?
2491
Beta adrenergic blockers - such as propnalol
2492
Q1247:Solid balls of neoplastic follicular cells in a thyroid nodule biopsy?
2493
Papillary carcinoma
2494
Q1248:Riedel thyroiditis?
2495
Rocklike stroma; fibrous reaction that may involve adjacent structures
2496
Q1249:Which pancreatic tumor could cause necrotizing skin eruptions on the legs?
2497
Glucagonoma - alpha cell tumor
2498
Q1250:How does propylthioracil work?
2499
Inhibiting the peripheral conversion of T4 to T3
2500
Q1251:Which oncogene are MEN II and III associated with?
2501
Ret oncogene
2502
Q1252:Thyroid gland is enclosed by which fascia?
2503
Pretracheal fascia
2504
Q1253:GIP - how does it affect insulin secretion?
2505
Increases beta cell release of insulin
2506
Q1254:Nortriptyline - what is it; and how could it cause galactorrhea?
2507
A TCA; inhibits dopamine pathways; stimulating prolactin; which causes galactorrhea
2508
Q1255:What is the most reliable indicator of metastatic potential of a pheochromocytoma?
2509
The actual presence of distant metastases
2510
Q1256:How does adult polycystic kidney disease affect aldosterone?
2511
Pressure exerted by the cysts can compromise glomerular blood flow; stimulating increased renin and thus increased aldosterone
2512
Q1257:What is VMA and what is it used for?
2513
Vanillylmandelic acid; a norepinephrine metabolite. Urine levels of this can diagnose pheochromocytoma
2514
Q1258:Which one drains directly into the IVC: left renal vein or right renal vein?
2515
Right renal vein
2516
Q1259:Which thyroid condition frequently develops after a viral infection?
2517
Subacute granulomatous (de Quervain's thyroiditis)
2518
Q1260:Most common pituitary tumor? % of all pituitary tumors?
2519
Prolactinoma with hyperprolactinemia makes up 30% of pituitary tumors.
2520
Q1261:Characteristics of prolactinoma?
2521
Most common pituitary tumor;Chromophobic staining;In women; leads to amenorrhea; galactorrhea;Undergoes dystrophic calcification;Underlying cause for 1/4 cases of amenorrhea
2522
Q1262:Treatment for prolactinoma?
2523
Most commonly bromocriptine: a dopamine receptor agonist that causes the lesion to shrink;Surgery
2524
Q1263:What hypothalamic factors control release of the following pituitary hormones: TSH; PRL; ACTH; GH; FSH; LH?;Is the controlling factor stimulatory or inhibitory for each?
2525
TSH: stimulated by TRH; inhibited by somatostatin;Prolactin: inhibited by dopamine;ACTH: stimulated by CRH;GH: stimulated by GHRH; inhibited by somatostatin;FSH: stimulated by GnRH;LH: stimulated by GnRH
2526
Q1264:Characteristics of somatotropic adenoma?
2527
Second most common pituitary tumor;Acidophilic staining;Causes release of somatomedins by liver (IGF-I; somatomedin C);Causes gigantism if during childhood; acromegaly during adulthood;Causes local compression in sela turcica.
2528
Q1265:Characteristics of corticotropic adenoma?
2529
Hypercorticism (Cushing disease);Basophilic staining;Weight gain; moon facies; thin/atrophied skin; hirsuitism; HTN; hyperglycemia due to insulin resistance
2530
Q1266:Difference between Cushing disease and Cushing syndrome?
2531
"Syndrome" is hypercorticism regardless of cause; "disease" is in the case of corticotropic adenoma of the pituitary.
2532
Q1267:What is pituitary cachexia (Simmonds disease)? What are the 2 most common causes?
2533
Generalized panhypopituitarism leading to marked wasting;Pituitary tumors and Sheehan's syndrome (postpartum pituitary necrosis) are the most common causes.
2534
Q1268:What is Sheehan's syndrome?
2535
Ischemic necrosis of the pituitary during child birth; due to hypoperfusion. The pituitary enlarges during pregancy but its blood supply does not; hence it is suspectible to peripartum blood loss.
2536
Q1269:Symptoms of growth hormone deficiency?
2537
In children: growth retardation;In adults: increased insulin sensitivity with hypoglycemia; decreased muscle strength; and anemia.
2538
Q1270:Symptoms of gonadotropin deficiency?
2539
In children: retarded sexual maturation;In adult men: loss of libido/muscular mass; impotence; decreased body hair;In adult women: amenorrhea; vaginal atrophy
2540
Q1271:Result of TSH deficiency?
2541
Secondary hypothyroidism.
2542
Q1272:How to distinguish between deficiency of ACTH and primary adrenal failure (Addison disease)?
2543
In Addison disease B-melanocyte stimulating hormone is still high leading to hyperpigmentation of skin. Not true in ACTH deficency; where B-MSH is also low.
2544
Q1273:Function of oxytocin?
2545
Induces uterine contraction during labor; ejection of milk from mammary alveoli
2546
Q1274:Most common cause of SIADH?
2547
Small cell carcinoma of lung;Other tumors can also produce ectopic ADH.
2548
Q1275:Causes of ADH deficency (diabetes insipidus)?
2549
Tumors;Trauma;Inflammatory processes;Lipid storage disorders;etc.
2550
Q1276:What is empty sella syndrome?
2551
Pituitary hypofunction due to destruction of all or part of the pituitary.
2552
Q1277:What is Nelson syndrome?
2553
Large pituitary adenomas that develop after bilateral adrenalectomy: due to a loss of feedback inhibition on preexisting pituitary microadenomas.
2554
Q1278:What hormones are released by the neurohypophysis? Is it anterior or posterior?
2555
Oxytocin; ADH;Posterior
2556
Q1279:What hormones are released by the adenohypophysis? Is it anterior or posterior?
2557
TSH; prolactin; ACTH; GH; FSH; LH;Anterior
2558
Q1280:What is a craniopharyngioma?
2559
Benign childhood tumor from remnants of Rathke pouch;Often cystic or calcified;Not a true pituitary tumor; but can have mass effects that cause pituitary hypofunction.
2560
Q1281:What are the symptoms of a nonsecreting pituitary adenoma or other mass lesion in the sella?
2561
Hypopituitarism; headache; visual disturbances (bilateral hemianopsia due to optic chiasm pressure) and palsies (due to cranial nerve compression)
2562
Q1282:What is the most common congenital anomaly of the thyroid? other anomalies?
2563
thyroglossal duct cyst; it does not lead to alterations in thyroid function;Ectopic thyroid tissue may also be found anywhere along the course of the thyroglossal duct. (If removing these; be sure they are not the ONLY thyroid tissue!)
2564
Q1283:what are the causes of goiter?
2565
physiologic enlargement during puberty and pregnancy;iodine deficiency;Hashimoto thyroiditis;goitrogens: substances that suppress synthesis of thyroid hormones;dyshormonogenesis: failure of hormone synthesis due to enzyme defects
2566
Q1284:what is the difference between a hot nodule and cold nodule in the thyroid?
2567
most nodules are hypoplastic and do not take up radioactive iodine (cold);Some nodules are hyperplastic and actively produce thyroid hormone; and take up radioactive iodine (hot);Nonfunctional (cold) nodules are more likely to be malignant compared to functional (hot) nodules.
2568
Q1285:what are the causes and characteristics of myxedema?
2569
Therapy for hyperthyroidism; Hashimoto thyroiditis; idiopathic; iodine deficiency;Clinical characteristics include cold intolerance; weight gain; low voice; mental slowness; menorrhagia; constipation; dry skin; hair loss; puffiness of the face
2570
Q1286:what are the causes and characteristics of cretinism?
2571
Iodine deficiency; thyroid enzyme deficiency; poor thyroid development; failure of fetal thyroid dissent; trans placental transfer of antithyroid antibodies from a mother with autoimmune thyroid disease;Characteristics include severe mental retardation; impaired physical growth and dwarfism; a large tongue; and a protuberant abdomen
2572
Q1287:what are the symptoms of hyperthyroidism (thyrotoxicosis)?
2573
Restlessness; irritability; fatigability; tremor; heat intolerance and sweating; tachycardia; muscle wasting and weight loss; fine hair; diarrhea; menstrual abnormalities; and most importantly greatly increased T4.
2574
Q1288:what is Graves' disease? What is its mechanism? Susceptible individuals?
2575
Hyperthyroidism caused by a diffuse toxic goiter. It occurs more frequently in women than in men; and the incidence is increased in HLA-DR3 and HLA-B8 positive individuals. Exophthalmos is characteristic and unique;Autoimmune disease; with thyroid stimulating immunoglobulin (TSI) and thyroid growth immunoglobulin (TGI) causing hormone production and hyperplasia.
2576
Q1289:what are the three types of thyroiditis?
2577
Hashimoto thyroiditis;subacute granulomatous thyroiditis;Riedel thyroiditis
2578
Q1290:What is Hashimoto thyroiditis?;Who is susceptible?
2579
Autoimmune disorder; common cause of hypothyroidism. Histologically; massive infiltrates of lymphocytes with germinal center formation and Hurtle cells. Autoantibodies are present; including anti-thyroglobulin; antithyroid peroxidase; anti-TSH receptor; and anti-iodine receptor;Associated with increased incidence of pernicious anemia; diabetes mellitus; and Sjogren's syndrome. Associated with HLA-DR5 and HLA-B5.
2580
Q1291:What is subacute granulomatous thyroiditis? What appears to be a common cause?
2581
focal destruction of thyroid tissue and granulomatous inflammation caused by a variety of viral infections; including mumps and Coxsackie virus;Follows a self-limiting course of several weeks duration consisting of a flulike illness; pain and tenderness of the thyroid; and a transient hyperthyroidism.
2582
Q1292:what is Riedel thyroiditis?
2583
Idiopathic replacement of the thyroid by fibrous tissue; can mimic carcinoma.
2584
Q1293:What are the characteristics of papillary carcinoma of the thyroid? Common causes?
2585
the most common thyroid cancer;Histologically: papillary projection into gland-like spaces; empty "orphan Annie" nuclei; calcified spheres;excellent prognosis; even when the adjacent lymph nodes are involved;can be caused by long-term radiotherapy to the neck; or RET-PTC fusion gene
2586
Q1294:List the four types of malignant thyroid tumors. Which has the best prognosis and which has the worst?
2587
papillary carcinoma - best;follicular carcinoma;medullary carcinoma;undifferentiated carcinoma -worst
2588
Q1295:what are the characteristics of medullary carcinoma of the thyroid?
2589
Originates from C-cells in the thyroid; produces calcitonin;histologically: sheets of tumor cells in amyloid stroma;associated with multiple endocrine neoplasia II; III
2590
Q1296:What are the causes of primary hyperparathyroidism? What are the laboratory findings associated with it? What are the clinical manifestations?
2591
Most common cause is parathyroid adenoma. Primary parathyroid hyperplasia and carcinoma are less likely. PTHlike hormone can be produced by bronchogenic squamous cell carcinoma or renal cell carcinoma;Lab findings include hypercalcemia/hypercalciuria; decreased serum phosphorus/increased urinary phosphorus; increased serum alk.phos; and increased serum PTH;Clinical symptoms include cystic bone changes; "metastatic calcification"; renal calculi; peptic ulcer.
2592
Q1297:What are the causes of secondary hyperparathyroidism? What are the lab values and clinical characteristics?
2593
Commonly caused by hypocalcemia in chronic renal disease. Vitamin D conversion by the kidney is impaired; decreasing intestinal absorption of calcium;Lab values include decreased serum calcium; increased serum phosphorus; increased serum alkaline phosphatase; increased serum PTH. Clinical symptoms include osteoclastic bone disease and metastatic calcification;(Personal note: many apparent paradoxes in this disease)
2594
Q1298:What causes hypoparathyroidism? What are the symptoms?
2595
The most common cause is accidental surgical excision during thyroidectomy. Sometimes associated with congenital thymic hypoplasia (DiGeorge syndrome);Resulting in severe hypocalcemia; manifested as increased neuromuscular excitability and tetany.
2596
Q1299:What is pseudo-hypoparathyroidism?
2597
Multi-hormone resistance including PTH; and the pituitary hormones TSH; LH; and FSH;Clinical characteristics include unresponsiveness of the kidney to PTH; shortened fourth and fifth metacarpal and metatarsals; short stature; and other skeletal abnormalities.
2598
Q1300:What are the causes of Cushing's syndrome? What is the difference between Cushing's syndrome and Cushing's disease?
2599
Exogenous corticosteroid medication;Hyper production of ACTH by pituitary adenoma;Adrenal cortical adenoma or carcinoma;Ectopic production of ACTH (by small cell carcinoma of the lung);Cushing's syndrome results from increased circulating cortisol from any source; Cushing's disease refers to only hyper production of ACTH by pituitary adenoma.
2600
Q1301:What is primary hyperaldosteronism?
2601
Conn syndrome; usually due to an aldosterone producing adrenocortical adenoma or carcinoma;Causes hypertension; sodium and water retention; and hypokalemia;Decreased serum renin is present due to negative feedback from hypertension.
2602
Q1302:What is secondary hyperaldosteronism?
2603
Caused by stimulation of the renin angiotensin system. Serum renin is increased in contrast to primary hyperaldosteronism;Usually secondary to renal ischemia; renal tumors; and edema (cirrhosis; nephrotic syndrome; cardiac failure).
2604
Q1303:What is adrenal virilism?
2605
Congenital enzyme defects that lead to diminished cortisol production and compensatory increased ACTH. This leads to adrenal hyperplasia and androgenic steroid production;Deficiencies include 21-hydroxylase deficiency and 11-hydroxylase deficiency;Clinical characteristics include precocious puberty in males and virilism in females.
2606
Q1304:What is Addison disease? Symptoms and labs?
2607
Primary adrenocortical deficiency; usually due to idiopathic adrenal atrophy. Can also be caused by tuberculosis; metastatic tumor; and infection. Characteristics include hypotension; skin pigmentation; low serum sodium; chloride; glucose; bicarbonate and increased potassium.
2608
Q1305:What is Waterhouse-Friedrichsen syndrome?
2609
Catastrophic adrenal insufficiency and vascular collapse due to hemorrhagic necrosis of the adrenal cortex. Often associated with DIC and characteristically due to meningococcal meningitis (Neisseria meningitis).
2610
Q1306:What is a pheochromocytoma?
2611
Adrenal medulla tumor of chromaffin cells. Causes paroxysmal hypertension due to hyperproduction of catecholamines. Increased urinary excretion of catecholamines and metabolites (metanephrine; normetanephrine; vanillylmandelic acid). Can also cause hyperglycemia.
2612
Q1307:What is a neuroblastoma?
2613
A highly malignant catecholamine producing tumor occurring in early childhood. Urinary catecholamines and metabolites are seen as in pheochromocytoma. Hypertension is common. Originates in the adrenal medulla and presents as a large abdominal mass.
2614
Q1308:Epidemiology and etiological factors of type 1 diabetes mellitus?
2615
Usually early in life; less common than type 2 disease. The disease is due to failure of insulin synthesis by beta cells of the pancreatic islets. Cause may be due to genetic predisposition or autoimmune inflammation of the islets. Incidences significantly higher in individuals with a mutation in HLA DQ; and in HLA DR3/HLA DR4 positive individuals.
2616
Q1309:Clinical characteristics of type 1 diabetes?
2617
Without insulin replacement: carbohydrate intolerance with hyperglycemia leading to polyuria; polydipsia; weight loss; ketoacidosis; coma; and death. Ketoacidosis results from increased metabolism of fat leading to production of "ketone bodies".
2618
Q1310:What are etiologies of Cushings syndrome? Is ACTH always elevated?
2619
increased cortisol due to: 1. Cushings disease (primary pituitary adenoma) increased ACTH 2. Primary adrenal (hyperplasia/neoplasia) decreased ACTH 3. Ectopic ACTH production (ie- small cell lung ca) increased ACTH 4. Iatrogenic; decreased ACTH
2620
Q1311:Describe the clinical picture of Cushings.
2621
HTN; wt gain; moon facies; truncal obesity; buffalo hump; hyperglycemia (insulin resistance); skin change (thinning; striae); osteoporosis; immune suppression
2622
Q1312:T/F Conns syndrome is secondary hyperaldosteronism.
2623
False. Conns syndrome is primary hyperaldosteronism; caused by an aldosterone-secreting tumor. Results in HTN; hypokalemia; metabolic alkalosis; low plasma renin.
2624
Q1313:Which hyperaldosteronism is associated with high plasma renin?
2625
Secondary hyperaldosteronism. It is due to renal artery stenosis; chronic renal failure; CHF; cirrhosis; or nephrotic syndrome. Kidney perception of low intravascular volume results in an overactive renin-angiotensin sysem.
2626
Q1314:What is the tx for hyperaldosteronism?
2627
Spironolactone; a diuretic that works by acting as a aldosterone antagonist.
2628
Q1315:What characterizes addisons disease? (which hormones are elevated or deficient)? Is it associated with HTN or hypotension?
2629
Primary deficiency of aldosterone and cortisol due to adrenal atrophy; causing hypotension and skin hyperpigmentation. Adrenal atrophy; absence of hormone production; involves all 3 cortical divisions.
2630
Q1316:T/F In primary insufficiency decreased pituitary ACTH production is characterized by skin hyperpigmentation.
2631
False: increased ACTH causes MSH activity & hyperpigmentation
2632
Q1317:T/F Neuroblastoma is the most common tumor of adrenal medulla in adults.
2633
False. Pheochromocytoma is the most common tumor of adrenal medulla in adults. It is derived from chromaffin cells (arise from neural crest). It is associated with neurofibromatosis MEN types II and III.
2634
Q1318:Where does neuroblastoma occur?
2635
Neuroblastoma is the most common tumor of adrenal medulla in children. It can occur anywhere along the sympathetic chain.
2636
Q1319:Pheochromocytoma: secrete combination of two molecules
2637
epinephrine and norepinephrine
2638
Q1320:Pheochromocytoma: epidemiology (rule of 10's)
2639
10% malignant; 10% bilateral; 10% extra-adrenal; 10% calcify; 10% kids; 10% familial
2640
Q1321:Pheochromocytoma: symptoms - 5 P's
2641
(elevated blood) Pressure; Pain (headache); Perspiration; Palpitations; Pallor/diaphoresis --> relapsing and remittant
2642
Q1322:Pheochromocytoma: elevations in two lab values
2643
urinary VMA and serum catecholamines
2644
Q1323:Pheochromocytoma: association with two other endocrine diseases
2645
MEN II and III
2646
Q1324:Pheochromocytoma: treatment
2647
alpha-antagonists
2648
Q1325:Multiple Endocrine Neoplasia type I (Wermer's syndrome) - 3 P's
2649
Pancreas; Pituitary; and Parathyroid tumors
2650
Q1326:Multiple Endocrine Neoplasia type II (Sipple's syndrome)
2651
medullary carcinoma of thyroid; pheochromocytoma; parathyroid tumor; or adenoma
2652
Q1327:Multiple Endocrine Neoplasia type III
2653
medullary carcinoma of thyroid; pheochromocytoma; oral/intestinal ganglioneuromatosis
2654
Q1328:Hypothyroidism or hyperthyroidism myxedema is prominent in which one
2655
hypothyroidism
2656
Q1329:Hypothyroidism or hyperthyroidism chest pain; palpitations; arrhythmias
2657
hyperthyroidism
2658
Q1330:TSH is (increased/decreased) in primary hyperthyroidism? In primary hypothyroidism?
2659
hyper - decreased; hypo - increased
2660
Q1331:Graves' disease involves autoantibodies with what mechanism of action?
2661
stimulation of TSH receptors
2662
Q1332:three symptoms of Graves'
2663
ophthalmopathy; pretibial myxedema; diffuse goiter
2664
Q1333:Graves' is a type __ hypersensitivity
2665
type II
2666
Q1334:Hashimoto's thyroiditis: thyroid is (enlarged/not enlarged) and (tender/nontender)
2667
enlarged; nontender
2668
Q1335:Hashimoto's thyroiditis: autoimmune antibodies directed against ---
2669
microsomes
2670
Q1336:Hashimoto's thyroiditis: histology shows (type of cell) infiltrate
2671
lymphocytes (with germinal centers)
2672
Q1337:Subacute thyroiditis (de Quervain's): self-limited (hyper/hypo)thyroidism following ---
2673
hypothyroidism following flu-like illness
2674
Q1338:Subacute thyroiditis (de Quervain's): symptoms include
2675
jaw pain; tender thyroid gland; early hyperthyroidism
2676
Q1339:Thyroid cancer: most common; good prognosis; "ground glass" nuclei; psammoma bodies
2677
papillary carcinoma
2678
Q1340:Thyroid cancer: poor prognosis; uniform follicles
2679
follicular carcinoma
2680
Q1341:Thyroid cancer: calcitonin producing (C cells); sheets of cells
2681
medullary carcinoma (MEN II and III)
2682
Q1342:Thyroid cancer: older patients; horrible prognosis
2683
undifferentiated/anaplastic
2684
Q1343:Cretinism: caused by a lack of dietary --- or defect in -- formation
2685
iodine (endemic); T4 (sporadic)
2686
Q1344:Cretinism: symptoms include
2687
pot-belly; paleness; puffy face; protuberant tongue; protruding umbilicus
2688
Q1345:Acromegaly: caused by excess --- in adults
2689
growth hormone
2690
Q1346:Acromegaly: symptoms include
2691
large furrowed tongue; deep voice; large hands and feet; coarse facial features
2692
Q1347:Acromegaly: in children; leads to ---
2693
gigantism
2694
Q1348:Metyrapone stimulation test
2695
Metyrapone blocks 11OHase which stimulates ACTH and 11-deoxycortisol and decreases cortisol. If ACTH increases and 11-deoxycortisol decreases the problem is adrenal insuficiency. If both increase; the problem is pituitary insuficiency. If 11-deoxycortisol or ACTH dont change look for adrenal or ectopic Cushing's.
2696
Q1349:High dose dexamethasone suppression test
2697
Dexamethasone is a cortisol analog and should suppress ACTH and cortisol. If it does suppress cortisol its pituitary Cushing's. If it doenst; its adrenal or ectopic Cushing's
2698
Q1350:Clinical features of hyperthyroidism
2699
Tachychardia; palpitations; atrial fibrillation; systolic hypertension; nervousness; diaphoresis; tremors; diarrhea; weight loss. High free T4 and decreased TSH (if primary) or increased TSH (if secondary)
2700
Q1351:Graves disease
2701
IgG autoantibodies stimulate TSH receptors. Signs and symptoms of hyperthyroidism plus goiter; exophthalmus and pretibial myxedema (due to glycosamynoglycan deposition)
2702
Q1352:Effect of oral contraceptives and anbolic steroids on binding proteins
2703
Contraceptives increase binding proteins and increase toal levels of the hormone with normal TSH or ACTH. Anabolics do the opposite. Increased total T4 or total cortisol with normal TSH or ACTH indicates contraceptives. Decreased total T4 or cortisol with normal TSH or ACTH indicates anabolic steroids.
2704
Q1353:Clinical features of hypothyroidism
2705
Fatigue; cold sensitivity; decreased cardiac output; myxedema; constipation; anovulatory cycles. Low free T4 with high TSH (primary) or low TSH (secondary)
2706
Q1354:Cretinism
2707
Congenital hypothyroidism. Mental retardation; failure to thrive; stunted bone growth.
2708
Q1355:Hashimoto thyroiditis
2709
Anti-microsomal antibodies against thyroid gland produces hypothyroidism. Lymphocytic inflamation with germinal centers
2710
Q1356:Subacute thyroiditis
2711
Preceded by viral illness. Granulomatous inflamation
2712
Q1357:Reidel thyroiditis
2713
Destruction of the thyroid gland by dense fibrosis. Irregular hard thyroid that is adherent to trachea (dyspnea) and esopahgus (dysphagia)
2714
Q1358:Thyroid adenoma
2715
Painless solitary cold nodule that may be functional
2716
Q1359:Papillary thyroid carcinoma
2717
80% of malignant thyroid tumors. Papillary pattern; psammoma bodies; clear "orphan Annie" nuclei. Lymphatic spread to cervical nodes is common
2718
Q1360:Follicular thyroid carcinoma
2719
15% of malignant thyroid tumors. Hematogenous metastasis to bone or lungs
2720
Q1361:Medullary thyroid carcinoma
2721
5% of malignant thyroid tumors. Arises from C cells and produce calcitonin. May be associated with MEN II
2722
Q1362:Anaplastic thyroid carcionoma
2723
Firm enlarging mass that metastasizes to trachea and esophagus and causes dyspnea and dysphagia
2724
Q1363:Primary hyperparathyroidism
2725
Excess PTH with hypercalcemia caused by parathyroid adenoma (80%); hyperplasia (15%) or paraneoplastic syndromes (lung SCC and renal cell carcinoma). High serum Ca+ and PTH; kidney stones; osteoporosis; short QT interval.
2726
Q1364:Secondary hyperparathyroidism
2727
Caused by chronic renal failure (no phosphate excretion increases serum phosphate; decreasing Ca+ and increasing PTH); chronic renal failure also causes deficiency of alpha-1hydroxylase and vitamin D. Vitamin D deficiency and malabsorption
2728
Q1365:Functions of PTH
2729
Increase reabsorption of Ca+ in distal tubule; decreases phosphate reabsorption in proximal tubule; increases alpha-1hydroxylase in proximal tubule; binds to PTH receptor on osteoblast releasing IL-1 (osteoclast activating factor) to activate osteoclast resorption
2730
Q1366:Hypoparathyroidism
2731
Due to surgical removal of glands or DiGeorge syndrome. Hypocalcemia with low PTH; tetany; prolonged QT interval
2732
Q1367:Prolactinoma
2733
Hyperprolactinemia produces galactorrhea; amenorrhea (tumor mass inhibits GnRH) and infertility
2734
Q1368:GH producing adenoma
2735
High GH and somatomedin C (IGF-1) produce gigantism (in children; tall stature with long extremities) or acromegaly (in adults; prominent jaw; flat forehead; enlarged hands and feet; diabetes and visceromegaly)
2736
Q1369:Sheehan syndrome
2737
Ischemic necrosis of pituitary secondary to post partum hypotension results in panhypopituitarism
2738
Q1370:Diabetes insipidus
2739
Hypotonic polyuria; polydipsia; hypernatremia; dehydration. Central DI is due to lack of ADH. Nephrogenic DI is due lack of renal response to ADH.
2740
Q1371:SIADH
2741
Excesive ADH. Oliguria; water retention; hyponatremia; cerebral edema. Due to paraneoplastic syndrome (lung SCC) or trauma
2742
Q1372:Clinical features of Cushing's syndrome
2743
Thin extremeties (protein catabolism); truncal obesity and buffalo hump (hyperglycemia increases insulin with fat deposition); purple stria (low collagen in vessels); hyperlipidemia (hormone-sensitive lipase); hirsutism; hypertension and hypokalemic alkalosis (high aldosterone).
2744
Q1373:Differentiation of Cushing's syndrome
2745
High ACTH with dexamethasone suppression --> pituitary. High ACTH without dexamethasone suppression --> ectopic (lung SCC). Low ACTH --> adrenal. Low ACTH with low cortisol and adrenal atrophy --> steroid therapy (MCC). High ACTH produces skin pigmentation in pituitary and ectopic.
2746
Q1374:Conn syndrome
2747
Adrenocortical adenoma causes hypertension; hypernatremia; hypokalemia; metabolic alkalosis; tetany. High aldosterone and low renin
2748
Q1375:Waterhouse-Friderichsen syndrome
2749
Bilateral hemorrhagic infarction of the adrenals associated with menigococcemia. DIC; hypotension; shock.
2750
Q1376:Addison disease
2751
Autoimmune destruction of adrenal cortex due to abrupt withdrawal of corticosteroids; miliary TB or menincoccemia. Weakness; hyperpigmentation of skin (high ACTH); hypotension; hypoglycemia; poor response to stress
2752
Q1377:Pheochromocytoma
2753
Catecholamine-producing benign tumor of the adrenal medulla. Severe headaches; tachycardia; palpitationss; diaphoresis; anxiety; hypertension. Associated with MEN II. Elevated urinary vanillylmandelic acid (VMA) and catecholamines.
2754
Q1378:MEN I
2755
Tumors of the pituitary (non-functioning); parathyroids (hypercalcemia); and pancreas gastrinoma (zollinger-ellison)
2756
Q1379:MEN II
2757
Medullary carcinoma of thyroid; pheochromocytoma; parathyroid hyperplasia or adenoma
2758
Q1380:Pathophysiology of diabetic ketoacidosis
2759
Hyperglycemia (due to increased glycogenolysis and gluconeogenesis). Ketone bodies (low insulin and high cortisol/epinephrine activate hormone-sensitive lipase; Boxidation and ketogenesis). Osmotic diuresis and volume depletion with loss of potassium. Dilutional hyponatremia due to osmotic effect of hyperglycemia. Low insulin fails to activate lipoprotein lipase leading to hypertriglyceridemia.
2760
Q1381:Pathophysiology of diabetic vascular disease
2761
Non-enzymatic glycosylation and arteriosclerosis produces ischemic injury and diabetic foot. Accelerated atherosclerosis; abdominal aortic aneurysms and MI.
2762
Q1382:Pathophysiology of diabetic ocular disease
2763
Cataracts due to conversion of glucose into sorbitol by aldose reductase in the lens. Retinopathy with microaneurysms (non-proliferative) and neovascularization (proliferative)
2764
Q1383:Pathophysiology of diabetic neuropathy
2765
Destruction of Schwann cells with decreased peripheral sensitivity liads to pressure ulcers on bottom of diabetic foot
2766
Q1384:(4)* functions of T3
2767
4 Bs;Brain maturation;Bone growth;Beta-adrenergic effects;BMR increase
2768
Q1385:what is the cause of increased cortisol w/ low ACTH ;(aside from Cushings)?
2769
Chronic steroid use
2770
Q1386:(2) steps of Dexamethasone test to determine cause of Increased cortisol;(3 causes)
2771
1. Give LOW dose;(result: Lower cortisol = Healthy);(result: Higher cortisol = step 2);2. Give HIGH dose;(result: Lower cortisol = ACTH-producing tumor);(result: Higher cortisol = Cortisone producing tumor)
2772
Q1387:Dx;Low cortisol; High ACTH
2773
Primary Hypocortisol;(Addisons)
2774
Q1388:Dx;Low cortisol; Low ACTH
2775
Secondary Hypocortisol;(no ACTH; no skin pigmentation)
2776
Q1389:Dx;High cortisol; Low ACTH;(2)
2777
Primary Hypercortisol;(Cushings; chronic steroids)
2778
Q1390:Dx;High cortisol; High ACTH
2779
Secondary Hypercortisol;(Tumor)
2780
Q1391:Dx;HTN; hypoK; metabolic alkalosis; low plasma renin
2781
Primary Hyperaldosteronism;(Conn's syndrome)
2782
Q1392:Dx;HTN; hypoK; metabolic alkalosis; high plasma renin
2783
Secondary Hyperaldosteronism;;(CRF; CHF; renal artery stenosis; cirrhosis; anything that stimulates venous pooling)
2784
Q1393:Dx;low aldosterone; low cortisol; hypotension; skin pigmentation; Adrenal Atrophy; Absence of hormones; All 3 cortical divisions affected
2785
Addison's Dz;(Primary Hypoaldosteronism and Hypocortisol)
2786
Q1394:MC tumor of the adrenal medulla in children
2787
Neuroblastoma
2788
Q1395:Dx;elevated Pressure; HA Pain; Perspiration; Palpitations; Pallor
2789
Pheochromocytoma
2790
Q1396:Dx;kidney stones; stomach ulcers; pituitary tumor
2791
MEN I (Wermer's syndrome);3P = Pancreas; Pituitary; Parathyroid
2792
Q1397:Dx;medullary CA of thyroid; pheochromocytoma; parathyroid tumor
2793
MEN II - Sipple syndrome
2794
Q1398:Dx;medullary CA of thyroid; pheochromocytoma; mucosal neuromas
2795
MEN III
2796
Q1399:Dx;Inc ESR; jaw pain; very tender thyroid; hypothyroidism following flu-like illness
2797
Subacute Thyroiditis;(de Quervain's Thyroiditis)
2798
Q1400:MC thyroid anomaly
2799
Thyroglossal duct cyst
2800
Q1401:Dx;Increased TSH at thyroid
2801
Goiter
2802
Q1402:MCC of hypothyroidism
2803
Iodine deficiency
2804
Q1403:Dx;child w/ potbelly; pale; puffy-faced; impaired growth; protruding umbilicus and tongue; mental retardation;what is deficient?
2805
Cretinism;(Iodine deficiency)
2806
Q1404:Dx;hyperthyroidism; nodular goiter; no exophthalamos
2807
Plummer Dz
2808
Q1405:Dx;hypothyroidism w/ massive infiltrates of lymphocytes in germinal center
2809
2810
Q1406:Dx;previous radiation of neck; "ground-glass" nuclei in thyroid; psammoma bodies
2811
Papillary carcinoma of thyroid;(MC type of thyroid CA)
2812
Q1407:Dx;Increased Calcium; Decreased Phosphorus
2813
Primary Hyperparathyroidism;(Inc PTH)
2814
Q1408:Dx;Decreased Calcium; Decreased Phosphorus
2815
Secondary Hyperparathyroidism;(Dec Vit-D)
2816
Q1409:Dx;Decreased Calcium; Increased Phosphorus
2817
Primary Hypoparathyroidism;(Dec PTH)
2818
Q1410:Dx;Increased Calcium; Increased Phosphorus
2819
Secondary Hypoparathyroidism;(Inc Vit-D)
2820
Q1411:Dx;stones; bones (pain) and groans (constipation)
2821
Primary Hyperparathyroidism
2822
Q1412:Definition;cystic bone spaces filled w/ brown fibrous tissue as a result of the osteoclastic reabsorption in primary hyperparathyroidism;(2 names)
2823
Osteitis Fibrosa Cystica;(von Recklinghausen's syndrome)
2824
Q1413:Definition;bone lesions due to secondary hypoparathyroidism due to renal Dz
2825
Renal Osteodystrophy
2826
Q1414:(2) Physical exam signs of low calcium
2827
tapping facial nerve -> contraction of facial muscles;(Chvostek's sign);occlusion of Brachial artery w/ BP cuff -> carpal spasm;(Trousseau's sign)
2828
Q1415:Dx;Decreased Calcium; Increased Phosphorus; Increased PTH; shortened 4th/5th digits; short stature;what protein is deficient?
2829
Pseudohypoparathyroidism;(Dec Guanine Nucleotide BP)
2830
Q1416:Dx;kussmaul respirations; hyperthermia; N/V; Abd pain; psychosis; dehydration; fruity breath
2831
Diabetic Ketoacidosis
2832
Q1417:Dx;adrenal insufficiency due to hemorrhagic necrosis of adrenal cortex; assoc c/ DIC; due to Meningococcemia
2833
Waterhouse-Friderichsen syndrome
2834
Q1418:Dx;hyperinsulinemia and hypoglycenia; CNS dysfunction; reversal of CSN symptoms w/ glucose administration
2835
Insulinoma
2836
Q1419:Dx;hypresecretion of HCl in stomach; recurrent peptic ulcer Dz; hypergastrinemia
2837
Zollinger-Ellison syndrome
2838
Q1420:Dx;rare tumor w/ watery diarrhea; hypokalemia; achlorhydria
2839
VIPoma;(Inc VIP)
2840
Q1421:Dx;Adrenal hyperplasia; High BP; Low Cortisol; High Androgens
2841
11-Hydroxylase deficiency
2842
Q1422:Dx;Adrenal hyperplasia; Low BP; Low Cortisol; High Androgens
2843
2844
Q1423:Dx;Adrenal hyperplasia; High BP; Low Cortisol; Low Androgens
2845
2846
Q1424:Dx;Increase in Dilute Urine; Hyposmolar serum
2847
Primary Polydipsia
2848
Q1425:Dx;Increase in Dilute Urine; Hyperosmolar serum
2849
Diabetes Insipidus;(ADH deficiency = Neurogenic);(ADH receptor issue = Nephrogenic)
2850
Q1426:Dx;Increase in concentrated Urine; Hyposmolar serum
2851
SIADH
2852
Q1427:what receptors promote insulin secretion?;inhibit?
2853
promote: Beta receptors;inhibit: Alpha receptors
2854
Q1428:what stimulates both insulin and glucagon?
2855
Amino Acids
2856
Q1429:what hormone is needed for GH to function correctly?
2857
Thyroid hormones
2858
Q1430:Definition;causes the increased synthesis of cartilage in epiphyseal plates of long bones; is a good measure of GH secretion
2859
Insulin-like Growth Factor-1;(IGF-1: a somatomedian)
2860
Q1431:how is GH similar to glucagon?;insulin?
2861
glucagon: Inc blood glucose and fat;Insulin: Inc uptake of AA into cells
2862
Q1432:Calcium change w/ Acidosis
2863
Increased
2864
Q1433:Name bone calcium and phosphate
2865
Hydroxyapatite
2866
Q1434:blood cells which contain;heparin &;histamine
2867
basophil;mast cell
2868
Q1435:type of hypersensitivity reaction?;mast cell
2869
type I
2870
Q1436:fnx of cromolyn sodium
2871
prevents mast cell degranulation;(tx asthma)
2872
Q1437:major basic protein?
2873
in eosinophils for defending against protozoans
2874
Q1438:acute inflammatory response cell
2875
neutrophil
2876
Q1439:40-75% of WBC
2877
neutrophil
2878
Q1440:hypersegmented polys; what diseases
2879
B12 and folate deficiency
2880
Q1441:cell type?;kidney shaped nucleus;frosted glass cytoplasm
2881
monocyte
2882
Q1442:cell type?;CD19 & CD20
2883
B cell
2884
Q1443:cell type?;CD3
2885
T cell
2886
Q1444:gamma interferon affect on macrophage
2887
activation
2888
Q1445:what are the common causes of chronic blood loss?
2889
In the United States: menorrhagia; gastrointestinal bleeding;Worldwide: hook worm disease (necator americanus)
2890
Q1446:What groups are at risk for dietary deficiency of iron?
2891
Premature infants: human milk is low in iron; and newborn iron is depleted within six months. Pregnant women may also require iron supplements;The elderly are also at risk of dietary deficiency.
2892
Q1447:List the common symptoms of anemia as well as the symptoms of severe anemia.
2893
Common: pallor; fatigue; dyspnea on exertion;Severe: angina pectoris; glossitis; gastritis; koilonychia; and Plummer-Vinson syndrome.
2894
Q1448:What are the iron study patterns in iron deficiency anemia?
2895
Serum iron is low;TIBC is elevated;Serum ferritin is low.
2896
Q1449:How do you distinguish iron deficiency anemia from beta thalassemia minor?
2897
In beta thalassemia minor; the alpha-2 hemoglobin is increased.
2898
Q1450:What are the three peripheral blood findings in macrocytic anemias? What is seen in the bone marrow?
2899
pancytopenia; global macrocytosis; hypersegmented neutrophils;the bone marrow shows megaloblastic hyperplasia.
2900
Q1451:Name eight causes of vitamin B12 deficiency megaloblastic anemia.
2901
pernicious anemia; total gastric resection; disorders of the distal Ilium; a strict vegetarian diet; intestinal malabsorption syndromes; blind loop syndrome; broad-spectrum antibiotic therapy; Diphyllobothrium latum infestation (fish tapeworm)
2902
Q1452:How do you distinguish folate deficiency from vitamin B12 deficiency?
2903
There are no neurologic abnormalities in folate deficiency.
2904
Q1453:Name six causes of folate deficiency anemia.
2905
dietary deprivation in alcoholics or dieters;Pregnancy;phenytoin or oral contraceptive therapy;folate acid antagonist chemotherapy;relative deficiency in hemolytic anemia;intestinal malfunction due to sprue or Giardia
2906
Q1454:what are the iron study patterns in the anemia of chronic disease?
2907
Serum iron is low;TIBC is low;Serum ferritin is elevated.
2908
Q1455:what are some causes of aplastic anemia?
2909
Toxic exposure;dysfunction of cytotoxic T cells;radiation exposure;chemicals such as benzene;therapeutic drugs such as chloramphenicol; sulfonamides; gold salts; chlorpromazine; antimalarial drugs; and alkylating agents;Viral infection by parvovirus or hepatitis C.
2910
Q1456:Which antibodies mediate warm antibody autoimmune hemolytic anemia versus cold agglutinin disease?
2911
IgG: warm;IgM: cold
2912
Q1457:cold agglutinin disease is a complication of what diseases?
2913
infectious mononucleosis and mycoplasma pneumonia;it may be a chronic complication of lymphoid neoplasms.
2914
Q1458:What preventative measure can be taken to prevent erythroblastosis fetalis?
2915
administer anti-D IgG antiserum to D negative mothers at the time of delivery of a D positive child. this causes fetal red cells to be removed from maternal circulation.
2916
Q1459:What are the possible causes of erythroblastosis fetalis?
2917
Maternal alloimmunization to fetal Rh antigens;ABO incompatibility.
2918
Q1460:What is the pathophysiology of paroxysmal nocturnal hemoglobinuria?
2919
Defect in the PIG-A gene causes impaired synthesis of the GPI anchor; which fixes CD55; CD59; and CD8 proteins to the cell surface. These proteins protect red cells from compliment mediated lysis.
2920
Q1461:What are the possible molecular defects in hereditary spherocytosis? What is its inheritance?
2921
Spectrin; ankyrin; protein 4.1 or other RBC skeletal proteins;Autosomal dominant.
2922
Q1462:What is the pathophysiology of G6PD deficency? What is its inheritance?
2923
Lack of G6PD reduces the body's ability to deal with oxidative stress. G6PD is an X-linked disorder.
2924
Q1463:What are sources of oxidative stress that can cause an episode of hemolysis in G6PD?
2925
drugs such as primaquine (anti malarial); sulfonamides; other oxidant drugs;fava beans;infection
2926
Q1464:How can you differentiate the presentation of pyruvate kinase deficiency from G6PD deficiency?
2927
In contrast to G6PD deficiency anemia; pyruvate kinase deficiency anemia is chronic and sustained.
2928
Q1465:What is the inheritance of pyruvate kinase deficiency anemia?
2929
autosomal recessive.
2930
Q1466:What percentage of African-Americans carry the hemoglobin S gene? What advantages does the gene confer?
2931
Approximately 7%;The hemoglobin S gene confers resistance to malarial infection (Plasmodium falciparum).
2932
Q1467:Specifically; what is the genetic defect in hemoglobin S disorders?
2933
A point mutation on chromosome 11 in codon six of the beta globin gene results in a substitution of valine for glutamic acid.
2934
Q1468:What are the six symptoms of sickle cell anemia?
2935
severe hemolytic anemia;chronic leg ulcers;vaso-occlusive crises ;auto splenectomy;aplastic crises (parvovirus);infectious complications (salmonella osteomyelitis)
2936
Q1469:What are six clinical and laboratory signs of beta thalassemia?
2937
severe anemia;severe splenomegaly;distortion of skull facial bones and long bones;microcytosis; hypochromia; target cells;increased Hemoglobin F;generalized hemosiderosis
2938
Q1470:What is sickle-cell thalassemia?
2939
Co-inheritance of hemoglobin S and thalassemia of the beta globin gene. Clinically similar to sickle cell anemia but less severe.
2940
Q1471:What are possible causes of mechanical disruption leading to hemolysis? What is seen on the peripheral smear?
2941
aortic valve prosthetics;disseminated intravascular coagulation;thrombotic thrombocytopenic purpura;smear shows schistocytes or helmet cells
2942
Q1472:What is the spectrum of clinical abnormalities in alpha thalassemia according to the number of deletions?
2943
one deletion: no abnormalities;two to three deletions: mild to moderate thalassemic symptoms;four deletions: hydrops fetalis
2944
Q1473:What is hepcidin?
2945
A peptide hormone that decreases both intestinal iron absorption and the release of iron from macrophages. In anemia of chronic disease; proinflammatory cytokines induce hepatic synthesis of hepcidin. This causes serum iron to be low despite normal or even elevated iron stores (ferritin).
2946
Q1474:Anemia of Pregnancy
2947
not really anemia. inc plasma volume => dec Hct; RBC; Hg
2948
Q1475:Causes of anemia
2949
1) decreased production: hematopoietic cell damage (rad; drugs; inf) deficiency in factors (iron for heme; vit b12 + folate for DNA). 2) Inc loss: external blood loss or hemolysis
2950
Q1476:Acute Posthemorrhagic Anemia
2951
initially; no dec in Hct; RBC; Hg b/c parallel loss in volume. Reactive increase in platelet count. Then; hemodilution => detect anemia.
2952
Q1477:Iron deficiency anemia
2953
Causes: chronic blood loss; dietary deficiency; inc requirement. Sx: pallor; fatigue; DOE. Angina if CAD. Severe: glossitis; gastritis; koilonychia; Plummer-Vinson syndrome; pica. Lab: 1) dec Hct 2) smear: hypochromic; microcytic 3) dec serum Fe; inc TIBC 4) dec body iron stores (dec hemosiderin in bone marrow; dec serum ferritin)
2954
Q1478:Chronic blood loss
2955
Iron deficiency anemia (major cause). Menorrhagia; GI bleed (carcinoma; hookworm).
2956
Q1479:Dietary iron deficiency
2957
Iron deficiency anemia. Infants (milk is low in iron). Rarely elderly.
2958
Q1480:Increased iron requirement
2959
Pregnancy. Also; infants and preadolescents can outgrow stores.
2960
Q1481:Koilonychia
2961
spooning of the nails. A/w severe iron defiency
2962
Q1482:Plummer-Vinson syndrome
2963
partially obstructing upper esophageal webs a/w sever iron deficiency
2964
Q1483:Pica
2965
appetite for substances not fit as food or no nutritional value. A/w severe iron deficiency
2966
Q1484:DDx (hypochromic; microcytic)
2967
Anemia of chronic disease (low TIBC); ?-thalassemia (inc HgA2); Sideroblastic anemia
2968
Q1485:Megaloblastic anemia
2969
Def B12 or folate => dec DNA synth => delay divison => nuclear-cytoplasmic asynchrony (loose chromatin) => dec production + ineffective hematopoiesis. Megaloblasts (erythroid precursors) in marrow. Labs: 1) smear: pancytopenia; oval macrocyotsis (MCV > 110); hypersegmented PMN. 2) marrow: megaloblastic hyperplasia. 3) B12 (homocysteine; methyl malonic acid); folate levels. Folate tx will rev B12 anemia but not neuro sx
2970
Q1486:Pernicious anemia
2971
Autoimmune gastritis: Abs vs. IF (and parietal cells) => 1) B12 def 2) achlorhydria 3) inc risk gastric carcinoma. Sx: insidous onset; lemon yellow skin; stomatitis; glossitis; *posterolateral degeneration* (demyelination) =>ataxia; hyperreflexia; impaired vib/proprioception. No neuro w/ folate def. Lab: 1) smear: pancytopenia; macrocytosis; hypersegmented PMN. marrow: megaloblastic hyperplasia. 2) Anti-IF Ab (Anti-parietal cell less specific) 3) Schilling test
2972
Q1487:Schilling test
2973
Give B12 alone and B12+IF. 1) NL abs of b12 => dietary deficiency. 2) Abs corrected w/ IF => pernicious anemia 3) Abs not correct w/ If => malabsoprtion (Crohn's; blind-loop syndrome; giant tapeworm).
2974
Q1488:DDx B12 megaloblastic anemia
2975
Pernicious anemia; total gastric resection (no IF); ileum disorder (B12-IF abs); intestinal malabsoprtion syn; blind loop syn (bacterial overgrowth); broad spectrum abio (bacterial overgrowth); strict vegetarian; *diphyllobothrium latum*
2976
Q1489:Diphyllobothrium latum
2977
giant fish tapeworm. freshwater fish. b12 defiency (megaloblastic anemia)
2978
Q1490:Folate deficiency
2979
No neuro. Causes: dietary def (alcoholics; fad dieters); pregnancy; *phenytoin* (dec folate abs); *OC* (dec folate abs); folate antagonistic chemo; inc demand (hemolytic anemia); malabs (sprue; *Giardia lamblia*)
2980
Q1491:Giardia lamblia
2981
flagellated protozoa. ADEK + folate def (megaloblastic anemia). Campers injest cyst from mnt stream => trophozoite => coats SI => dec fat abs => stinky; greasy diarrhea. Homosexual males. Tx: metro ("flagyl").
2982
Q1492:Anemia of chronic disease
2983
A/w chronic infection; chronic immune disorders (RA); neoplasms; renal dz. Problem releasing iron from storage. IL1; TNF; IFN-g => dec EPO + inc hepcidin. 1) low serum Fe 2) *dec TIBC* (vs. iron def) 3) high storage in macrophages 4) high serum ferritin (reflects high stores). (Normochromic/normocytic or hypochromic/microcytic. Renal dz => macrocytic.)
2984
Q1493:Aplastic anemia
2985
pancytopenia; hypocellular marrow. Autoimmunity (CD8 T); radiation; benzene; *chloramphenicol (rev or irrev)*; sulfonamides; gold salts; chlorpromazine; alkylating agents; parvovirus; hep C (?).
2986
Q1494:Myelophthisic anemia
2987
Replacement of marrow by neoplasm or fibrosis => leukoerythroblastosis
2988
Q1495:Leukoerythroblastosis
2989
smear: small #s of nucleated RBC + immature granulocytic precursors
2990
Q1496:Hemolytic anemia
2991
1) Inc RBC destruction: maximal conjugation => unconjugated bilirubinemia (indirect) (acholruic jaundice); pigmented gallstones; inc urine urobilinogen; hemosiderosis (tx: deferoxamine). if intravascular => hemoglobinemia; hemoglobinuria; no haptoglobin. 2) compensatory inc RBS production: marrow erythroid hyperplasia; reticulocytosis/polychromatophilia (inc MCV)
2992
Q1497:Warm antibody autoimmune hemolytic anemia
2993
Most common immune hemolytic anemia. IgG. 2 to SLE; Hodgkin or non-Hodkin lymphoma. Usual hemolytic anemia fx + spherocytosis (loss of membrane) + positive direct Coombs test.
2994
Q1498:Cold agglutinin disease
2995
Anti-i IgM. Below 30. 2 to infectious mononucleosis (EBV) or Mycoplasma pneumoniae.
2996
Q1499:Chronic cold agglutinin disease
2997
Anti-i IgM. A/w lymphoid neoplasms; Raynaud's. Chronic hemolytic anemia exacerbated by cold weather. Sometimes: hemoglobinemia; hemoglobinuria.
2998
Q1500:Hemolytic disease of the newborn
2999
Erythroblastosis fetalis. Maternal ab vs. fetal RBC. Maternal alloimmunization (Rh blood group: mom=d; fetus=D). ABO incompatibility. => kernicterus (unconjugated bilirubin in CNS esp basal ganglia); hydrops fetalis (heart failure w/ generalized edema). Prevent: Anti-D IgG to mom at delivery/termination to prevent alloimmunization.
3000
Q1501:Paroxysmal nocturnal hemoglobinuria
3001
Acquired: somatic mutation in PIG-A => impaired GPI achnor synthesis. No CD55; CD59; C8 bp on RBC; granulocytes; platelets => complement-mediated lysis => pancytopenia; venous thrombosis; intravascular hemolytic anemia. Dx: CD59 neg RBC on flow. Old dx: Ham test.
3002
Q1502:Hereditary spherocytosis
3003
AD. Most common inherited intracorpuscular hemolytic anemia in whites. Spherocytes; splenomegaly (sequestered); *MCHC*; osmotic fragility; spectrin deficiency. Causes inc mut in: spectrin; ankyrin; protein 4.1; etc.
3004
Q1503:Hereditary elliptocyosis
3005
AD. Hemolysis; splenomegaly. Often no anemia.
3006
Q1504:G6PD deficiency
3007
XR. Most common enz def hemolytic anemia. Blacks + Mediterraneans. Acute; self-limited episodes of intravascular (Hg-emia; -uria) <= oxidative stress: inf; drugs (primaquine; sulfonamides; etc.) fava beans. => Heinz bodies (precipitated Hg) => Bite cells. R to p. falciparum infection.
3008
Q1505:Pyruvate kinase deficiency
3009
AR. 2nd most common enz def hemolytic anemia. Nonspherocytosis hemolytic anemia. Chronic/sustained (vs. G6PD def)
3010
Q1506:Hemoglobin S
3011
Blacks (R to falciparum infection). Pt mut codon 6 Glu=>Val (lose MstII site: prenatal dx by amnotic or chorionic villus sample). Polymerize @ low O2 tension => sickle => obstruct microvasc.
3012
Q1507:Duffy Fy
3013
a- b- phenotype. R to p. falciparum infection.
3014
Q1508:Sickle cell anemia
3015
Homozygous HbS. HbS polmerize @ low O2 tension => sickle => hemolytic anemia; chronic leg ulcers; painful crises (infection or dehydration); lung + spleen infarct (autosplenectomy => inf w/ encapsulated bact). Parvovirus => aplastic crises. Salmonella osteomyelitis.
3016
Q1509:Sickle cell trait
3017
Heterozygous HbS. No clinical consequence.
3018
Q1510:Hemoglobin C
3019
Blacks. homozygous: mild hemolytic anemia; splenomegaly; target cells; (intraerythrocyte xtals). HbSC ~ HbS.
3020
Q1511:Hemoglobin E
3021
Souteast Asia. Urban US. Clinical: similar to HbC.
3022
Q1512:HbA; S; C on PAGE
3023
HbA- (aspartate). HbS (valine). HbC+ (lysine).
3024
Q1513:? Thalassemia Major
3025
Mediterranean and US. Dec Hb synth + alpha chains aggregate (short life) + ineffective erythropoiesis + relative folate deficiency => anemia. Chronic hemolysis + transfusion => hemosiderosis (Tx: deferoxamine). Splenomegaly. Marrow expansion => skull; facial bones; long bone distortion. Smear: micro; hypo; target cells; anisocytosis; poikilocytosis. Test: inc HbF (alpha2 gamma2)
3026
Q1514:? Thalassemia Minor
3027
Heterozygous. Mild hypochromic microcytic anemia. Inc HbA2 (alpha2 delta2) (vs. iron def; ACD).
3028
Q1515:Sickle cell thalassemia
3029
~ sickle cell anemia (less severe).
3030
Q1516:Alpha thalassemia
3031
Ch 16. Southeast asia. 3a = silent carrier. 2a = a-thal trait. 1a = HbH dz. 0a = hydrops fetalis (Hb Barts: O2 affinity too high; no delivery).
3032
Q1517:Mechnical hemolytic anemas
3033
prosthetic aortic valve or microangiopathic hemolytic anemia (DIC; thrombotic thrombocytopenic purpura): partial occlusion of vessels. Schistocytes; helmet cells.
3034
Q1518:Heterophile+ infectious mononucleosis
3035
EBV invades B lymphocytes via CD21 receptors with atypical CD8 response; lymphocytosis and paracortex hyperplasia Fever; sore throat (gray-white membrane on tonsils) and tender lymphadenopathy
3036
Q1519:Heterophile- infectious mononucleosis
3037
Cytomegalovirus
3038
Q1520:Paul-Bunnell monospot test reaction
3039
IgM (heterophile) antibodies against EBV react with sheep red blood cells - postivie monospot test
3040
Q1521:Characteristics of acute lymphadenopathy
3041
Tender focal lymphadenopathy = bacterial. Generalized tender lymphadenopathy = viral
3042
Q1522:Characteristics of chronic lymphadenopathy
3043
Non-tender follicular hyperplasia (rheumathoid arthritis; toxoplasmosis; leukemia). Non-tender paracortical hyperplasia (viruses; drugs; SLE; leukemia).
3044
Q1523:Leukemoid reaction Vs. leukemia
3045
Leukemoid reaction lacks blast and has elevated leukocyte alkaline phosphatase (LAP) (TB; whooping cough). Chronic myelogenous leukemia has low LAP.
3046
Q1524:General signs and symptoms of leukemia
3047
Normo anemia; thrombocytopenia; leukocytosis or leukopenia; blast cells (>30%=acute); generalized non-tender lymphadenopathy; hepatosplenomegaly; bone pain and fever
3048
Q1525:Pre-B ALL
3049
Age < 15. Tdt+; CALLA+; cytoplasmic mu+
3050
Q1526:Mature B ALL
3051
Age < 15. Surface Igs present
3052
Q1527:B cell CLL
3053
Age > 60. 95% of CLL cases. Differentiated cells are CD19+; CD20+; CD23+; CALLA-
3054
Q1528:T cell CLL
3055
Age > 60. Mature T cell markers and hypogammaglubulinemia. Lymphocytosis and neutropenia
3056
Q1529:Adult T cell leukemia
3057
Caused by HTLV-1 retrovirus. Leukemia sypmtoms and signs wih lytic bone lessions and hypercalcemia (osteoclast activating factor)
3058
Q1530:AML
3059
15-60 years. Myeloblast proliferation. Auer rods are pathognomonic of myeloblasts. T(15;17). Abnormal retinoic acid receptor. Rx.: retinoic acid
3060
Q1531:CML
3061
15-60 years. Pluripotent cell proliferation. Philadelphia chromosome t(9;22). All cells increased with low LAP
3062
Q1532:PRV
3063
Increased erythroid precursors; hematocrit and viscocity. Decreased EPO. Normal SaO2. Increased basophils with histamine release (pruritus; gastric ulcers); plethora and cyanosis.
3064
Q1533:Follicular B-cell lymphoma
3065
MC lymphoma. B lymphocytes. t(14;18); Chr 14 has immunoglobulin heavy chain genes; chr 18 has bcl-2 gene (normally inhibits apoptosis).
3066
Q1534:Burkitt's lymphoma
3067
MC lymphoma in children. Starry-sky. t(8;14). African affects mandible; american affects abdomen
3068
Q1535:Mycosis fungoides
3069
CD4 T-cells. Generalized prutitic erythematous rash. PAS+
3070
Q1536:Histiocytosis X
3071
In children. Histiocytes are CD1+
3072
Q1537:Hodgkin lymphoma
3073
Reed-Sternberg cells are CD15+; CD30+. Fever; night sweats; weight loss; localized lymphadenopathy
3074
Q1538:Multiple myeloma
3075
Neoplasm of plasma cells. Anemia; bone pain; pathologic fractures; hypercalcemia; renal failure; light-chain amyloids (Bence-Jones protein).
3076
Q1539:t(15;17)
3077
AML translocation
3078
Q1540:t(9;22)
3079
CML philadelphia chromosome translocation. Forms a protein with tyrosine kinase activity
3080
Q1541:t(14;18)
3081
Follicular B-cell lymphoma translocation
3082
Q1542:t(8;14)
3083
Burkitt's lymphoma translocation
3084
Q1543:Lymphomas: Hodgkin's Versus NHL: Which one presents with Reed-Sternberg cells?
3085
Hodgkin's
3086
Q1544:Lymphomas: Hodgkin's Versus NHL: Which one is associated with HIV and immunosuppression?
3087
NHL
3088
Q1545:Lymphomas: Hodgkin's Versus NHL: Which one involves multiple; peripheral nodes; with common extranodal involvement?
3089
NHL
3090
Q1546:Lymphomas: Hodgkin's Versus NHL: Which one is localized to a single group of nodes; with contiguous spread and rare extranodal involvement?
3091
HL
3092
Q1547:Lymphomas: Hodgkin's Versus NHL: Which one presents with constitutional signs/symptoms: low-grade fever; night sweats; weight loss?
3093
HL (NHL has few signs/symptoms)
3094
Q1548:Lymphomas: Hodgkin's Versus NHL: Which one presents with mediastinal lymphadenopathy?
3095
HL
3096
Q1549:Lymphomas: Hodgkin's Versus NHL: Which one involves mostly the B cells (except lymphoblastic origin)?
3097
NHL
3098
Q1550:Lymphomas: Hodgkin's Versus NHL: Which one has hypergammaglobulinemia?
3099
neither. Multiple Myeloma has hypergammaglobulinemia; where the excess B cells are in the resting state.
3100
Q1551:Lymphomas: Hodgkin's Versus NHL: Which one has a 50% association with EBV?
3101
HL
3102
Q1552:Lymphomas: Hodgkin's Versus NHL: Which one has bimodal age distribution?
3103
HL (NHL has peak incidence at 20-40 years old)
3104
Q1553:Lymphomas: Hodgkin's Versus NHL: Which one has more common male presentation?
3105
HL
3106
Q1554:Hodgkin's What factors denote a good prognosis?
3107
Increased lymphocytes; decreased RS cells.
3108
Q1555:Hodgkin's Which HL type has the best prognosis?
3109
Nodular sclerosing (65-75%); which has least RS cells and lots of lymphocytes. Lymphocyte-predominant LH also has excellent prognosis.
3110
Q1556:Hodgkin's Which HL type is the most common?
3111
Nodular sclerosing; affecting women more than men and primarily young adults.
3112
Q1557:Hodgkin's What is the prognosis of mixed cellular HL?
3113
Intermediate. There are lots of lymphocytes but also lots of RS cells.
3114
Q1558:Hodgkin's Which HL type has the worst prognosis?
3115
Lymphocyte-depleted; which affects older males with disseminated disease.
3116
Q1559:Hodgkin's Which HL type has the most RS cells?
3117
Mixed cellular.
3118
Q1560:Which NHL type has only B cells?
3119
Small Lymphocytic lymphoma; follicular lymphoma; Burkitt's
3120
Q1561:Which NHL type has a mix of B cells and T cells?
3121
Diffuse large cell ; occurring mostly in elderly but sometimes in children.
3122
Q1562:Which NHL type has only T cells?
3123
Lymphoblastic Lymphoma; which has immature T cells. It is a very aggressive T-cell lymphoma.
3124
Q1563:Which type is associated with a t(8;14) c-myc gene mutation?
3125
Burkitt's Lymphoma; occurring mostly in children. Has a high-grade "starry sky" appearance.
3126
Q1564:Which type is associated with a t(14;18) mutation and overexpression of bcl-2?
3127
Follicular lymphoma; which is difficult to cure but has an indolent course.
3128
Q1565:Which type is associated with EBV infection and is endemic in africa?
3129
Burkitt's
3130
Q1566:Which is the most common childhood NHL?
3131
Lymphoblastic Lymphoma; which also presents with ALL and a mediastinal mass.
3132
Q1567:Which is the most common adult version of NHL?
3133
Follicular lymphoma.
3134
Q1568:Which NHL types occur in adults?
3135
Small lymphocytic lymphoma; follicular lymphoma.
3136
Q1569:Which NHL types occur in children?
3137
Lymphoblastic lymphoma; Burkitt's lymphoma.
3138
Q1570:Which NHL has a distribution of 80% adults and 20% children?
3139
Diffuse large cell lymphoma; which ALSO has an 80% B cells 20% T cell distribution.
3140
Q1571:Which low-grade NHL type presents like CLL?
3141
Small Lymphocytic lymphoma.
3142
Q1572:Leukemias: Peripheral and bone marrow characteristics
3143
Increased circulating leukocytes; bone marrow infiltrates of leukemic cells
3144
Q1573:Leukemias: Consequences of marrrow failure
3145
Anemia (dec. RBC's); infections (dec. WBC's); hemorrhage (dec. platelets)
3146
Q1574:Leukemias: Common organs of infiltration
3147
Liver; spleen; lymph nodes
3148
Q1575:Leukemias: Characteristics of acute leukemias
3149
Blasts predominate; children or elderly; short or drastic course
3150
Q1576:Leukemias: ALL characteristics (4)
3151
Lympholasts (pre-B or pre-T); children; most responsive to therapy; associated with Down's Syndrome
3152
Q1577:Leukemias: AML characteristics (3)
3153
Myeloblasts; adults; auer rods
3154
Q1578:Leukemias: Characteristics of chronic leukemias
3155
More mature cells; midlife age range; longer; less devastating course
3156
Q1579:Leukemias: CLL characteristics - cells
3157
Lymphocytes; non-Ab producing B cells; increased smudge cells on peripheral blood smear
3158
Q1580:Leukemias: CLL - population
3159
older adults
3160
Q1581:Leukemias: CLL - presentation and course
3161
lymphadenopathy; hepatosplenomegaly; few sx; indolent course
3162
Q1582:Leukemias: CLL is similar to?
3163
very similar to SLL (small lymphocytic lymphoma)
3164
Q1583:Leukemias: CLL is associated with?
3165
warm antibody autoimmune hemolytic anemia
3166
Q1584:Leukemias: CML cell characteristics
3167
Myeloid stem cells; increased neutrophils and metamyelocytes
3168
Q1585:Leukemias: CML translocation?
3169
Ph Chromosome; t(9;22); bcr-abl
3170
Q1586:Leukemias: CML acute complications?
3171
blast crisis (AML)
3172
Q1587:what chromosomal translocation? CML
3173
Ph chromosome; t(9;22); bcr-abl
3174
Q1588:what chromosomal translocation? Burkitt's lymphoma
3175
t(8;14); c-myc activation
3176
Q1589:what chromosomal translocation? Follicular lymphomas
3177
t(14;18); bcl-2 activation
3178
Q1590:what chromosomal translocation? AML- M3 type
3179
t(15;17); responsive to all-trans retinoic acid (ATRA)
3180
Q1591:what chromosomal translocation? Ewing's sarcoma
3181
t(11;22)
3182
Q1592:what chromosomal translocation? Mantle cell lymphoma
3183
t(11;14)
3184
Q1593:What are the chronic leukemias associated with Tlymphoblasts?
3185
Sezary Syndrome; CLL-T (both L2)
3186
Q1594:What are the acute leukemias associated with Tlymphoblasts?
3187
ALL-T (L2); ALL-null (L1); ALL-common(L1)
3188
Q1595:What are the chronic leukemias associated with Blymphoblasts?
3189
CLL-B (L3)
3190
Q1596:What are the acute leukemias associated with Blymphoblasts?
3191
ALL-B (L3)
3192
Q1597:What are the chronic leukemias associated with monoblasts?
3193
Chonic monocytic (M5); chronic myelomonocytic (M4)
3194
Q1598:What are the acute leukemias associated with monoblasts?
3195
Acute monocytic (M5); acute myelomonocytic (M5)
3196
Q1599:What are the chronic leukemias associated with myeloblasts?
3197
CML (M1; 2 and 3); Polycythemia rubra vera (M1); myelofibrosis (M1)
3198
Q1600:What are the acute leukemias associated with myeloblasts?
3199
AML (M2 and M1); Promyelocytic (M1)
3200
Q1601:What are the chronic leukemias associated with eosmyeloblasts?
3201
Eosinophilic (rare)
3202
Q1602:What are the chronic leukemias associated with normoblasts?
3203
Chronic erythroid (M6; rare)
3204
Q1603:What are the acute leukemias associated with normoblasts?
3205
acute erythroleukemia (M6)
3206
Q1604:What are the chronic leukemias associated with megakaryoblasts?
3207
Idiopathic thrombocytopenia (M7)
3208
Q1605:What are the acute leukemias associated wwith megakaryoblasts?
3209
acute megakaryocytic leukemias (M7)
3210
Q1606:What type of cell proliferates in MM; and what is its histologic appearance
3211
Monoclonal plasma cell; fried egg appearance
3212
Q1607:Where does MM arise?
3213
bone marrow
3214
Q1608:The 2 most common ab's; in order; are:
3215
IgG (55%); IgA (25%)
3216
Q1609:Common multiple myeloma symptoms are:
3217
lytic bone lesions and hypercalcemia; renal insifficiency; increased suscpetibility to infection; anemia
3218
Q1610:This disease is associated with:
3219
primary amyloidosis
3220
Q1611:Ig light chains are also called:
3221
Bence Jones proteins
3222
Q1612:3 key diagnostic features:
3223
lytic bone lesions on x-ray; M-spike on serum protein electrophoresis; Bence-Jones proteins in urine
3224
Q1613:Red blood cell appearance on peripheral smear:
3225
Rouleaux formation (poker chips)
3226
Q1614:What 2 differences are seen in Waldenstrom's macroglobulinemia?
3227
M-spike is IgM; no lytic lesions
3228
Q1615:Target cells
3229
increased RBC membrane. Hemoglobinopathies; thalassemia; liver disease.
3230
Q1616:Acanthocytes
3231
Irregular spicules on surface. Abetalipoproteinemia
3232
Q1617:Spherocytes
3233
Decreased RBC membrane. No central area of pallor. Spherocytosis
3234
Q1618:Schistocytes
3235
RBC fragments. Microangiopathic hemolytic anemia; trauma
3236
Q1619:Bite cells
3237
RBC with removed bits of cytoplasm. G6PDH deficiency.
3238
Q1620:Sickle cells
3239
Sickle cell anemia
3240
Q1621:Howell-Jolly bodies
3241
Remnants of nuclear chromatin. Severe anemias or patients without spleen
3242
Q1622:Ring sideroblasts
3243
Trapped iron in mitochondria. Prussian-blue stain. Sideroblastic anemia
3244
Q1623:Heinz bodies
3245
Denatured Hb. G6PDH deficiency
3246
Q1624:Basophilic stipling
3247
RNA remnants. Lead poisoning
3248
Q1625:Hypersegmented neutrophil
3249
Megaloblastic anemia
3250
Q1626:EPO stimuli
3251
Low SaO2 (hypoxemia; anemia < 7gm/Dl; left shifted O2 curve
3252
Q1627:Reticulocytes
3253
Immature RBC with no nucleous and bluish color in peripheral blood indicate effective erithropoiesis. Require 24 hours to become mature.
3254
Q1628:Reticulocyte normal and corrected count
3255
Normal reticulocyte count is 1.5%. Corrected count is Hct/45 * reticulocyte count. >3% --> marrow responds well. <3% marrow is not well. If polychromasia (shift cells) divide corrected count by two because shift cells take double the time to mature
3256
Q1629:Signs of anemia
3257
Palpitations; dizziness; angina; pallor; weakness
3258
Q1630:Hypochromic RBCs
3259
Increased central pallor
3260
Q1631:MCV < 80
3261
Iron deficiency; thalassemia; AOD; Sideroblastic
3262
Q1632:MCV 80-100; low reticulocyte count
3263
Marrow failure; aplastic anemia; leukemia; renal failure; AOD
3264
Q1633:MCV 80-100; high reticulocyte count
3265
Sickle cell; G6PDH deficiency; spherocytosis; AIHA; PNH
3266
Q1634:MCV > 100
3267
Folate or B12 deficiency
3268
Q1635:Causes of iron deficiency anemia
3269
Ulcers; menstrual bleeding; left colon cancer; elderly and poor children; malabsorption; gastrectomy; hookworm; PlummerVinson
3270
Q1636:Low serum iron; % saturation and serum ferritin with high TIBC
3271
Iron deficiency anemia
3272
Q1637:Low serum iron; TIBC and % saturation with high serum ferritin
3273
AOCD
3274
Q1638:High serum iron; serum ferritin and % saturation with low TIBC
3275
Sideroblastic anemia
3276
Q1639:AOCD
3277
Iron is trapped in bone marrow macrophages due to high levels of IL-1 and lactoferrin. High ferritin and low TIBC.
3278
Q1640:HbA
3279
alpha 2beta 2
3280
Q1641:HbF
3281
alpha 2gamma 2
3282
Q1642:Hb Barts
3283
gamma 4
3284
Q1643:HbH
3285
beta 4
3286
Q1644:alpha -thalassemia
3287
Carrier has one alpha gene deletion; asymptomatic. ALPHA Thal trait has two deletions. HbH disease three deletions with high HbH and Heinz bodies. Hydrops fetalis; four deletions; lethal; high Hb Barts
3288
Q1645:beta -thalassemia
3289
Minor; asymptomatic; 8% HbA2 and 5% HbF. Major develop symptoms 6 months after birth as HbF declines; jaundice; bilirubin gallstones; secondary hemochromatosis due to life-long transfusions; CHF; crecut skull x-ray; target cells. 90% HbF and HbA2
3290
Q1646:HbA2
3291
alpha 22
3292
Q1647:Lead poisoning anemia
3293
Sideroblastic anemia. Lead denatures ferrochelatase; ALA dehydrse and ribonuclease (coarse basophilic stipling). Ringed sideroblasts and basophilic stipling. Lead colic; peripheral neuropahty; cerebral edema; learning disabilities; bone in epiphysis on x-rays. high serum Pb; high urine -ALA; high serum iron; ferritin and %saturation with low TIBC. Risk fators: Pb paint; battery factory; pottery painter.
3294
Q1648:Iron overload anemia
3295
Sideroblastic anemia with ringed sideroblasts. Alcoholism (MCC); pyridoxine deficiency (required by ALA synthase); isoniazid treatment. High serum iron; % saturation; ferritin and decreased TIBC.
3296
Q1649:Factors that induce and prevent sickling
3297
Deoxygenation of Hb/right shifting dissociation curve (acidosis); increasing HbS concentration (dehydration); low O2 tension (altitude and renal medulla). HbF left shifts dissociation curve and prevent sickling (hydroxeurea Rx)
3298
Q1650:Pathophysiology of sickle cell disease
3299
Valine subsitutes glutamic acid in position 6 of beta Hb chain causing sickling and thrombi that occlude vessels (painful crisis); hand-foot swelling; autosplenectomy with HowellJolly bodies and increased risk of infections by encapsulated orgainsms; Salmonella osteomyelitis; parvovirus B19 aplastic crisis.
3300
Q1651:Pathophysiology of G6PDH deficiency
3301
Mutation causes defective protein folding with low G6PDH activity and low levels od reduced gluthathione needed to neutralize ROS. Oxidative stress; oxidative drugs (primaquine; sulfonamides; anti-TB); bacterial infections and fava beans cause red cell damage and hemolysis with Heinz body formation (seen with methylene blue or crystal violet stains)
3302
Q1652:Pathophysiology of spherocytosis
3303
Spectrin defect with decrease in RBC membrane leads to circular RBCs which are removed by macrophages in the spleen (extravascular hemolysis). Triad of anemia; splenomegaly and jaundice with risk of bilirubinate gallstones. Increased osmotic fragility test.
3304
Q1653:Pathophysiology of AIHA
3305
IgG autoantibodies against Rh antigens on RBC with macrophage removal in spleen cause splenomegaly. Differentiate from hereditary spherocytosis with positive direct Coombs test
3306
Q1654:Pathophysiology of PNH
3307
Low levels of decay accelerating factor (DAF) are not able to normally inhibit C3 convertase with increased sensitivity of cells to complement lysis. Slow breathing at night (retains CO2) and exercise produce acidosis which activates the complement system with pancytopenia and increased risk of aplastic anemia; leukemia and venous thrombosis
3308
Q1655:Direct Coomb's test
3309
Detects IgG or C3 on surface of RBCs. Positive in AIHA; negative in hereditary spherocytosis.
3310
Q1656:Indirect Coomb's test
3311
Detects autoantibodies in the serum. Often positive in AIHA
3312
Q1657:Pathophysiology of microangiopathic hemolytic anemia
3313
RBCs are damaged by calcium in stenotic valves (aortic stenosis MCC); fibrin clots in DIC and platelet plugs in ITP and HUS. Presence of schistocytes.
3314
Q1658:Sites for reabsorption of iron; folate and B12
3315
Iron: duodenum (Bilroth II; vitamin c deficiency and malabsorption syndromes produce deficiency). Folate: jejunum (contraceptives and alcohol decrease absorption). B12: terminal ileum (pernicious anemia; Crohn's and terminal ileum resection decrease absorption)
3316
Q1659:Pathophysiology of megaloblastic anemia
3317
Methyl THF is needed to make methylcobalamine to convert homocysteine into methione by methylTHF-homocysteine methyl transferase (requires cobalamine). Methylene THF is required by thymidilate synthetase to make nucleic acids. B12 is needed by methylmalonyl CoA mutase to make succinyl CoA.Tetrahydrofolate is made by dihydrofolate reductase (blocked by methotrexate and trimethropin). Deficiency of folate or B12 produces megaloblastic anemia with hypersegmented neutrophils (no nucleic acid synthesis); homocystinuria and methylmalonic aciduria.
3318
Q1660:Causes of folate deficiency
3319
Alcoholism (not beer); pregnancy; methotrexate; trimetrhoprim; phentoyn; birth control pills; celiac disease; leukemia
3320
Q1661:Causes of B12 deficiency
3321
Pernicious anemia; pure vegan diet; Crohn's disease; chronic pancreatitis (cant cleave R factor from saliva which protects B12); D. latum
3322
Q1662:Schilling's test
3323
Non-radioactive intramuscular B12 to saturate transcobalamin followed by radioactivee oral B12. No radioactive B12 detected in 24h urine confirms B12 absorption deficiency. Correct with intrinsic factor (pernicious anemia); pancreatic enzymes (chronic pancreatitis) or antibiotics (bacterial overgrowth)
3324
Q1663:describe structure of RBC
3325
biconcave;anucleate ;large surface:volume for easy gas exchange
3326
Q1664:how do RBCs derive energy
3327
glucose;90% anaerobic resp;10% HMP shunt
3328
Q1665:survival time of RBC
3329
120 days
3330
Q1666:what does membrane of RBC contain
3331
chloride-bicarb antiprot ;allows RBC to transport CO2 from periphery to lungs for elimination
3332
Q1667:WBC differential from highest to lowest:
3333
Neutrophils Like Making Things Better;Neutrophils;Lymphocytes;Monocytes;Eosinophils;Ba sophils
3334
Q1668:which WBC are granulocytes
3335
BEN ;basophils;eosinophils;neutrophils
3336
Q1669:which WBC are mononuclear cells
3337
monocytes;lymphocytes
3338
Q1670:what are the steps in forming a granulocyte
3339
pluripotent hematopoietic cell;myeloid stem cell;promyelocyte;myelocyte;metamyelocyte;stab cell;granulocyte
3340
Q1671:what are the precursors to monocyte
3341
pluripotent hematopoietic stem cell;myeloid stem cell;monoblast ;monoctye
3342
Q1672:what are the precursors to lymphocytes
3343
pluripotent hematopoietic cell ;lymphoid stem cell;lyphoblasts;B/T cell
3344
Q1673:what are the steps to RBC formation
3345
pluripotent hematopoietic stem cell;proerythroblast;reticulocyte;RBC
3346
Q1674:what are hte steps to platelet formation
3347
pluripotent hematopoietic stem cell;myeloid stem cell;megakaryoblast;megakaryocyte;platelet
3348
Q1675:what are granulocytes; platelets; and monocytes all derived from (what is common precursor)
3349
myeloid stem cell
3350
Q1676:what is contained in the granules of basophils
3351
heparin ;histamine;LTD4;other vasoactive amines
3352
Q1677:when is basophilic stippling seen
3353
thalassemia ;anemia of chronic dz ;iron deficiency anemia;lead poisoning
3354
Q1678:what do eosinophils react to?
3355
helminths and protazoa ;phagocytose ag-ab complexes
3356
Q1679:causes of eosinophilai
3357
NAACP ;neoplastic;asthma;allergies;collagen vascular dz;parasites
3358
Q1680:what is contained in the PMNL granules
3359
hydrolytic enzymes;lysozyme;MPO ;lactoferrin
3360
Q1681:where do B cells go after they are mature?
3361
migrate to peripheral lymphoid tissue (follices of LN; white pulp of spleen; unencapsulated lymphoid tissue)
3362
Q1682:when does B cell --> plasma cell
3363
when it encounters ag
3364
Q1683:appearance of plasma cell
3365
off center nucleus ;abundant RER;well developed golgi
3366
Q1684:causes of DIC
3367
STOP Making New Thrombi;Sepsis (gram -);Trauma;OB complications;Pancreatitis (acute) ;Malignancy;Neoplasm;Transfusion
3368
Q1685:causes of extravascular hemolytic anemia
3369
odd shapes of RBC (spherocytes; target cells; schistocytes; etc) ;autoimmune anemia
3370
Q1686:causes of intravascular hemolytic anemia
3371
destruction via complement and lysis;paroxysmal nocturnal hemoglobinuria;microangiopathic anemia
3372
Q1687:microangiopathic anemia
3373
seen when theres is an occlusion of a small BV; which leads to mechanical disruption of RBC (seen in DIC; TTP/HUS; SLE; malignancy)
3374
Q1688:jaundice in the hemolytic anemias
3375
not seen in intravascular hemolysis normally; b/c the macrophages eat all of the destroyed Hb
3376
Q1689:what is haptoglobin ;levels during hemolysis
3377
a "suicide protein" that carries Hb to the spleen to get broken down ;levels are low
3378
Q1690:treatment for spherocytosis
3379
splenectomy
3380
Q1691:process behind paroxysmal nocturnal hemoglobinuria
3381
acidosis normally develops during sleep; which predisposes cells to destruction via complement; but this is normally inhibited by DAF (which degrades complement); if not enough DAF --> lysis of RBC InTRAVASCULARLY!
3382
Q1692:how to dx G6PD deficiency during acute crisis?
3383
look at blood smear and look for Heinz bodies;when crisis is over; look for enzyme deficiency
3384
Q1693:how to dx autoimmune hemolytic anemia
3385
direct coomb's test (or indirect)
3386
Q1694:some kids can have extremely elevated wbc counts (>50;000) and this is not malignancy; what is it called?
3387
leukemoid reaction
3388
Q1695:why do howell-jolly bodies appear in pts w scd?
3389
if pts had working spleens; they would have been able to remove these abnormal cells
3390
Q1696:what should all SC pts be vaccinated against
3391
s. pneumonia
3392
Q1697:#1 cause of osteomyelitis in SCD;#2 cause?
3393
salmonella;s. aureus
3394
Q1698:why is hydroxyurea effective in treating SCD?
3395
it creates an incresae in HbF; which binds to O2 tighter than adult Hb.
3396
Q1699:what would you do with an african american person who presents with microscopic hematuria; and is asymptomatic and has a normal CBC?
3397
test for SCD!!;there may be sickling in the renal medulla and peritubular capillary (so they might be a carrier of the trait)
3398
Q1700:what does antithrombin III do?;what activates it?
3399
breaks down factors IX; X; XI ;heparin
3400
Q1701:factor V leiden?
3401
factor 5 is resistant to breakdown by APC ;leads to venous clots
3402
Q1702:protein c;what does it require
3403
breaks down factors V and VIII ;requires vit K and protein s
3404
Q1703:protein s
3405
required as a cofactor for APC
3406
Q1704:tPA
3407
activates plasmin; which breaks down fibrin
3408
Q1705:difference between multiple myeloma and waldenstrom's macroglobulinemia
3409
MM: IgG or IgA in high amounts (lytic bone lesions; renal insuff from increased Ig light chains excretion - Bence Jones proteins) ;W<: IgM in large amts (--> hyperviscosicty; no lytic bone lesions) ;both have M spike
3410
Q1706:which form of hodgkin's lymphoma has the worst prognosis
3411
lymphocyte depleted
3412
Q1707:translocation (9;22)
3413
Philadelphia chromosome;CML
3414
3415
Burkitt's lymphoma (c-myc activation)
3416
3417
follicular lymphoma (bcl2 expression)
3418
3419
M3 - AML
3420
3421
ewing sarcoma
3422
3423
mantle cell lymphoma
3424
Q1713:when is WAIHA seen
3425
chronic anemia seen with;SLE ;CLL ;some drugs
3426
Q1714:when is CAIHA seen
3427
infectious mononucleosis;m. pneumonia
3428
Q1715:which NHLs are seen in children
3429
burkitt's lymphoma;diffuse large cell;lymphoblastic lymphoma
3430
Q1716:smudge cells
3431
cll
3432
Q1717:philadelphia chromosome
3433
cml
3434
Q1718:auer rods
3435
aml
3436
Q1719:how to differentiate cml from leukemoid reaction
3437
cml has low alk-phos levels
3438
Q1720:what is a result of treating aml
3439
cells can release auer rods --> DIC
3440
Q1721:What are they general characteristics of Neoplasia?
3441
Uncontrolled disorderly proliferation of cells resulting in a benign or malignant tumor or neoplasm.
3442
Q1722:What is dysplasia?
3443
1) Reversible change;2) Often precedes malignancy;3) Morphologically manifests by disorderly amturation and spatial arrangement of cells marked variability in nuclear size and shape and increased often abnormal mitosis4) Exemplified by dysplasia of squamous epithelium of the cervix which is often a precursor of malignancy.
3444
Q1723:What are neoplasms?
3445
1) Resemblance to tissue of origin is close the neoplasm is termed WELL DIFFERENTIATED; if little resemblance to teh tissue of origin is seen it is POORLY DIFFERENTIATED2) Neoplasms grow at the expense of finction and vitality of normal tissue without benefit to the host and are largely independent of host control mechanism.
3446
Q1724:What is Carcinoma?
3447
Malignant tumor of epithelial origin
3448
Q1725:What is Squamous cell carcinoma?
3449
1) Originates from stratified squamous epithelium of for example the skin mouth esophagus and vagina as well as from areas of squamous metaplasia as in teh bronchi or the squamocolumnar junction of the uterine cervix2) marked by the production of keratin.
3450
Q1726:What is transitional cell carcinoma?
3451
Arises from the transitional cell epithelium of the urinary tract.
3452
Q1727:What is adenocarcinoma?
3453
Carcinoma of the glandular epithelium and includes amlignant tumors of the GI mucosa endometrium and pancreas2) Often associated with desmoplasia tumor-induced proliferation of non-neoplastic fibrous CT particularly in adenocarcinoma of the breast pancreas and prostate.
3454
Q1728:Wht is sarcoma?
3455
1) malignant tumor of mesenchymal origin2) Often used with a prefi that denotes the tissue of origin of the timor as in osteosarcomaa rhabdomyocarcoma leiomyosarcoma and liposarcoma.
3456
Q1729:What are eponymically named tumors?
3457
1) Burkitt lymphoma;2) Hodgkin disease;3) Wilms tumor
3458
Q1730:What is a teratoma?
3459
1) neoplasm derived from all three germ cell layers which may contain structures such as skin bone cartilage teeth and intestinal epithelium2) May be either malignant or benign;3) Usually arises in the ovaries or testes.
3460
Q1731:Describe Benign Tumors.
3461
1) Usually well differentiated and closely resemble teh tissue of origin;2) Do not metastasize and grow slowly. They can be harmful if their growth compresses adjacent tissues. For example benign intracranial tumors can be more lethal than some malignant skin tumors3) Tend to become encapsulated4) Denoted by the suffix -oma as in lipoma and fibroma5) Don't confuse this with some malignant neoplams as hepatoma melanoma lymphoma and mesotheliuma as well as several non-neoplastic swelings including granuloma and hematoma.
3462
Q1732:What is a papilloma?
3463
1) Papilloma is a benign neoplasm most often arrising form surface epithelium such as squamous epithelium of the skin larynx or tongue2) Consists of delicate finger-like epithelial processes overlyig a core of connective tissue stroma that contains blood vessels3) May also develop from transitional epithelium of the urinary bladder ureter or renal pelvis.
3464
Q1733:What is an adenoma?
3465
Benign neoplasm of glandular epithelium that occurs in several variants like papillary cystadenoma and fibroadenoma.
3466
Q1734:What is papillary cystadenoma?
3467
Characterized by adenomatous papillary processes that extend into cystic spaces as in cystadenoma of the ovary.
3468
Q1735:What is a fibroadenoma?
3469
Marked by proliferation of CT surrounding neoplastic glandular epithelium; for example fibroadenoma of the breast.
3470
Q1736:What are benign tumors of mesenchymal origin?
3471
1) Most often named by the tissue of origin; for example leiomyoma rhabdomoma lipoma fibroma and chondroma2) Include the most common neoplasm of women the uterine leiomyoma or fibroid tumor.
3472
Q1737:What is Choristoma?
3473
Small non-neoplastic area of normal tissue misplaced within another organ sucha as pancreatic tissue within the wall of the stomach.
3474
Q1738:What is a Hamartoma?
3475
Non-neoplastic disorganized tumor-like overgrowth of cell types that are regularly found within the affected organ; hemangioma an irregular accumulatoin of blood vessels is an example.
3476
Q1739:What is monoclonality?
3477
1) Denotes origin from a single precursor cell;2) Characteristic of most neoplasms; in contrast polyclonal proliferations are almost always non-neoplastic3) Assessed by a variety of approaches.
3478
Q1740:What do Glucose-6-phosphate dehydrogenase isoenzyme studies do?
3479
1) Offering compelling evidence for monoclonality of tumors; because of X inactivation in early embryonic life tissues of females heterozygous for G6PD isoenzymes consist of a mosaic of cell types with random cells expressing one or the other of the two isoenzymes2) monoclonal tumors express only one of the isoenzymes;3) Polyclonal cellular proliferations exhibit both isoenzymes.
3480
Q1741:How are immunoglobulins involved as indicators of monoclonality in malignancies of B cell origin?
3481
1) Produced by B cell malignant tumors and are demonstrable as cytoplasmic or surface immunoglobulin or in the case of multiple myeloma are secreted and are demonstrable in the serum2) Monoclonal the resultant mixture of immunoglobulin molecules will exhibit either kappa or lambda chain specificity but not both a characteristic finding in neoplastic B cell proliferations3) B cell or plasma cell proliferations are polyclonal they result in the production of heterogeneous immunoglobulin molecules some of which express kappa specificity and others that express lambda specificity.
3482
Q1742:What is immunoglobulin gene rearrangement in regards to being an indicator of monoclonality in malignancies of B cell origin?
3483
1) Characteristic of B cell maturation. The number of possible combinations achieved by rearrangement is almost countless; it can be assumed that each normal B cell is marked by a unique rearrangement pattern. Neoplastic proliferation results in large numbers of cells all demonstrating the same pattern of immunoglobulin gene rearrangement denoting their common origin form a single cell3) Assessed by molecular diagnostic techniques;4) Because immunoglobulin heavy chain rearrangement is limited to B cells this approach also demonstrates teh B cell origin of a tumor.
3484
Q1743:How are surface antigens idicators of monoclonality in malignancies of T cell origin?
3485
1) demonstrable as T cells mature; they may be characteristic of either the stage of maturation or functional subclass. Cellular proliferations in which large numbers of T cells share surface markers in common are suggestive of monoclonality2) In addition to many others include the CD4 antigen marking T helper cells and the CD8 antigen marking T suppressor and cytotoxic cells.
3486
Q1744:What is T cell receptor gene arrangement and how is it involved as an indicator of monoclonality in malignancies of T cell origin?
3487
1) Analogous to immunoglobulin gene rearrangement and is used in a similar manner to demonstrate both the T cell origin of a tuor and its monoclonality.
3488
Q1745:What is invasion of a tumor cell?
3489
1) Aggressive infiltration of adjacent tissues by a malignant tumor2) Often extends into lymphatics and blood vessels with the formation of tumor emboli that may be carried to distal sites. not all tumor emboli results in metastatic tumor implants and the presence of tumor cells withing blood vessels or lymphatics indicates only the penetration of basement membranes and is not synonymous with metastasis.
3490
Q1746:What are the six steps of metastasis?
3491
1) Growth and vascularization of the primary tumor;2) Invasiveness and penetration of basement membranes into lymphatics or blood vessels3) Transport and survival of tumor cells in the circulation4) Arrest of tumor emboli in the target tissue and passage again across basement membranes;5) Overcoming of target tissue defense mechanisms;6) Development of successful metastatic implants.
3492
Q1747:What are the preferential routes of metastasis?
3493
1) Vary with specific neoplasms;2) Carconomas tent to metastasize via lymphatic spread3) Sarcomas tend to invade blood vessels early resulting in widespread blood-borne dissemination4) Notable exceptions include renal cell and hepatocellular carcinoma which are market by early venous invasion and hematogenous dissemination.
3494
Q1748:What are the target organs of metastasis?
3495
1) Most commonly the liver lungs brain adrenal glands lymph nodes and bone marrow2) Rarely include skeletal muscle or the spleen.
3496
Q1749:What is tumor progression in regards to metastasis?
3497
1) Characterized by the accumulation of successive cytogenetic or molecular abnormalities2) Exemplified by the progression of changes from normal colonic epithelium to adenoma to carcinoma to metastasis with parallel changes in APC K-ras DCC p53 and possibly other genes3) Individual neoplastic cells within a tumor may have varying metastatic potential.
3498
Q1750:What is Cachexia and wasting?
3499
1) Origin is complex; it is characterized by weakness weight loss anorexia anemia infection and hyprmetabolism2) May be mediated in part by cachectin (TNF-alpha) a product of macrophages that promotes catabolism of fatty tissue.
3500
Q1751:What are the endocrine abnormalities of malignance?
3501
1) Caused by tumors of endocrine gland origin which may actively elaborate hormones leading to a variety of syndromes2) Pituitary abnormalities;3) Adrenocortical abnormalities;4) Ovarian abnormalities;5) Trophoblastic tissue abnormalities
3502
Q1752:What are pituitary abnormalities of malignancy?
3503
1) Prolactinoma leading to amenorrhea infertility and some times galactorrhea2) Somatotropic (acidophilic) adenoma leading to gigantism in children and acromegaly in adults3) Corticotropic (most often basophilic) adenoma leading to Cushing disease (adrenal hypercorticism of pituitary origin)
3504
Q1753:What are the adrenocortical abnormalities of malignancy?
3505
Include adrenogenital syndrome Conn syndrome and Cushing syndrome of adrenal origin resulting from adrenal cortical tumors.
3506
Q1754:What are ovarian abnormalities of malignancy?
3507
1) Granulosa-theca cell tumor leading to hyperestrinism;2) Sertoli-Leydig cell tumor leading to excess androgen production.
3508
Q1755:What are trophoblastic tissue abnormalities of malignancy?
3509
Include hyperproduction of human chorionic gonadotropin from hydatiform mole or choriocarcinoma.
3510
Q1756:List 6 endocrinopathies.
3511
1) Cushing syndrome;2) Inappropriate secretion of ADH;3) Hypercalcemia;4) Hypoglycemia;5) Polycythemia;6) Hyperthyroidism
3512
Q1757:What is Cushig syndrome in regards to paraneoplastic syndrome?
3513
Caused by production of ACTH-like substances by small cell carcinoma of the lung.
3514
Q1758:What is Inappropriate secretion of ADH in regards to paraneoplastic syndrome?
3515
Comes form a variety of tumors most commonly small cell carcinoma of the lung.
3516
Q1759:What is hypercalcemia as a paraneoplastic syndrome?
3517
Caused by metastatic disease in bone secretion of a substance similar to parathormone by squamous cell bronchogenic carcinoma or secretoin of a substance similar to osteoclast activating factor by the malignant plasma cells of multiple myeloma
3518
Q1760:What is Hypoglycemia in regards to paraneoplastic syndrome?
3519
Caused by secretion of insulin-like substances by hepatocellular carcinomas mesotheliomas and some sarcomas
3520
Q1761:What is Polycythemia in regards to paraneoplastic syndrome?
3521
Caused by elaboration of erythropoietin by renal tumors and other neoplams.
3522
Q1762:What is hyperthyroidism in regards to paraneoplastic syndrome?
3523
Caused by production of substances like thyroid-stimulating hormone by hydatidiform moles choriocarciomas and some lung tumors
3524
Q1763:What are neorologic abnormalities of paraneoplastic syndromes?
3525
1) May occur in the absence of metastatic disease;2) Include degenerative cerebral changes with dementia cerebellar changes with resultant gait dysfunction and peripheral neuropathies
3526
Q1764:What are skin lesions related to paraneoplastic syndromes?
3527
1) May be associated with visceral malignancies;2) Include acanthosis nigricans and dermatomyositis.
3528
Q1765:What coagulation abnormalities are associated with paraneoplastic syndromes?
3529
1) Include migratory thrombophlebitis associated with carcinoma of the pancreas and other visceral malignancies (Trousseau phenomenon) and disseminated intravascular coagulation associated with various neoplasms.
3530
Q1766:What are oncofetal antigens?
3531
1) Proteins normally expressed only in fetal or embryonic life; their expression by neoplastic cells is considered a manifestation of dediffrentiation;2) The undifferentiated neoplastic cells tend to resemble their embryonic counterparts3) Include carcinoembryonic antigen (CEA) which is associated with colon cancer and other cancers and preneoplastic processes and alpha-fetoprotein (AFP) which is associated with hepatocellular carcinoma and many germ cell tumors. AFP is also iincreased in fetal anencephaly and other neural tube defects.
3532
Q1767:What are direct-reacting carcinogens?
3533
Do not need to be chemically altered to act.
3534
Q1768:What are indirect-reacting carcinogens?
3535
Require metabolic conversion form procarcinogens to active ultimate carcinogensFor example a mucosal glucuronidase in the urinary bladder converts to beta-napthylamine glucuronide to the carcinogen beta-naphthylamine.
3536
Q1769:What are the stages of chemical carcinogenesis?
3537
Initiation and Promotion
3538
Q1770:What is Initiation?
3539
The first critical carcinogenic event and it is usually a reaction between a carcinogen adn DNA. Two or more agents may act together as cocarcinogens
3540
Q1771:What is promotion?
3541
Induced by a stimulator of cell proliferation and enhances the carcinogenic process. A promoter not a corcinogenic in itself enhances other agents' carcinogenicityFor example phorbol esters react with membrane receptors stimulating cell replication. This may enhance clonal selection resulting in cells with increasingly deleterious DNA changes.
3542
Q1772:How does exposure to UV radiation contribute to carcinogenesis?
3543
1) In the form of sunlight is clearly related to the frequency of skin cancers such as squamous cell and basal cell carcinomas and melanomas2) Thought to act by inducing dimer formation between neighboring thymine pairs in DNA. In most cases such dimers are successfully repaired by enzymatically mediated mechanisms. That skin cancer may be induced by such dimer formation is suggested by the greatly increased incidence of skin tumors seen in Xeroderma pigmentosum an autosomal recessive disorder characterized by failure of DNA excision repair mechanisms.
3544
Q1773:What is ionizing radiation and how is it carcinogenic?
3545
1) Classic cause of cancer exemplified by the increased incidence of cancers in those exposed to radiation2) skin cancer and myeloid leukemias in radiologists3) Lung cancer in uranium miners;4) Thyroid cancer in patients who have received head and neck radiation therapy;5) Acute and chronic myeloid (but not lymphoid) leukemias in survivors of atomic blasts6) Osteosarcoma in radium watch-dial workers.
3546
Q1774:How do DNA viruses contribute to carcinogenesis?
3547
1) Integrate viral DNA into host genomes perhaps resultig in host cell expression of viral mRNA coding for specific proteins;2) Include haman papillomavirus EVB hepatitis B virus as prominent suspects that play a role in human carcinogenesis.
3548
Q1775:How do retroviruses contribute to carcinogenesis?
3549
1) Marked by transcription of viral genomic RNA sequences into DNA by action of viral reverse transcriptase2) In the case of retroviruses that are tumorigenic in experimental animals are frequently characterized by substitutions of genomic sequences known as viral oncogenes.
3550
Q1776:What are viral oncogenes?
3551
1) named with a three-seter abreviation preceded by v for viral;2) exhibit homology for DNA sequences of man and other eukaryotic species; these eukaryotic DNA sequences are called proto-oncogenes or cellular oncogenes and are identified with the same three-letter abbreviations preceded by c for cellular.
3552
Q1777:What are the characteristics of Ras and G proteins?
3553
1) Located at the plasma membrane and have GTP binding and GTPase activities. GTPase hydrolytically converts active ras-GTP to ras-GDP2) Inactivated by ras-GTPase mediated by GTPase-activating protein (GAP);3) GTP activation of ras can stimulate or depress adenylate cyclase activity altering intracellular cAMP levels thus affecting cellular behavior.
3554
Q1778:Describe the mutation of the ras gene.
3555
1) Usually occurs at codon 12;2) Results in an aberrant p21 protein product with intact GTP binding but with a loss of GTPase activity. Mutant ras proteins can be activated by GTP binding but cannot be inactivated by GTPase activity3) ras is mutated in 25%-30% of malignancies.
3556
Q1779:What is growth factor or GF receptor activity in regard to oncogenesis?
3557
Cell Biology and alterations in expression orPathology Flash Facts in oncogene structural changes products may result in inappropriate activvation of receptor proteins or their oncogenic analogs thus mimicking the actions of growth factors2) On stimulation with the appropriate growth factor receptor proteins often demonstrate tyrosine kinase activity of their cytoplasmic domains3) Significant homologies occur between several oncogenes and the genes for cellular growth factors and their receptorsa) v-sis and the gene for beta chain of PDGF;b) v-erb and the gene for EGF receptor;c) v-fms and the gene for CSF-1 receptor;d) c-neu and the gene 3558EGF receptor for
Q1780:What are nuclear proteins in regard to oncogenesis?
3559
Some oncogene products including the protein products of myc fos and myb are confined to the cell nucleus.
3560
Q1781:What is promoter insertion in regard to oncogenes?
3561
1) Insertion of retroviral promoter or enhancer sequences into the host genome can lead to increased expression of a nearby oncogene2) This mechanism is similar to the promoterinduced hyperexpression associated with translocations characteristic of several human leukemias and lymphomas.
3562
Q1782:What are point mutations in regard to oncogenes?
3563
Exemplified by a single nucleotide changes in codon 12 of the ras family of genes associated with a number of human tumors.
3564
Q1783:What are chromosomal translocations in regard to oncogenes?
3565
Frequent association with malignancy seen in these genetic rearrangements has been clarified by demonstrating that important genes are situated at the sites of chromosomal breaks
3566
Q1784:What is 8;14 translocation?
3567
Burkitt lymphoma;c-myc proto-oncogene on chromosome 8 is translocated to a site adjacent to the imunoglobulin heavy chain locus on chromosome 14. Major regulatory sequences within the immunoglobulin gene are thought to increase the expression of c-myc
3568
3569
Follicular lymphoma;Immunoglobulin heavy chain locus on chromosome 14 si transposed to a site adjacent to bcl-2 an oncogene on chromosome 18. This results in enhanced expression of bcl-2 thus inhibiting apoptosis.
3570
3571
Chronic myeloid leukemia (CML);1) c-abl proto-oncogene on chromosome 9 is transposed to a site adjacent to bcr an oncogene on chromosome 222) The union of bcr adn abl results in a hybrid or chimeric bcr-abl fusion gene that codes for a protein with increased tyrosine kinase activity3) Altered chromosome carrying this hybrid gene the Philadelphia chromosome can be demonstrated by cytogenetic techniques in hematopoietic cells of patients with CML.
3572
3573
Acute proyelocytic leukemia (FAB M3 AML);1) The translocation involves the PML gene on chromosome 15 and the retinoic acid receptor (RAR) alpha gene on chromosome 172) Therapy wiht the retinoic acid analogue all-trans retinoic acid can result in maturation of these leukemic cells and clinical remission.
3574
Q1788:Describe gene amplification.
3575
1) Reduplication of the gene with multiple resultant genomic DNA copies and can sometimes result in a thousand or more copies of the amplified gene2) Extensive amplification can result in small free chromosome-like bodies called double minute chromosomes or in band-like structures within chromosomes called homogeneously staining regions (HSRs) which are both demonstrable cytogenetically
3576
Q1789:Name two neoplasms associated with gene amplification.
3577
Neuroblastoma and some Breast Cancers.
3578
Q1790:What is amplified in neuroblastoma?
3579
N-myc; correlates inversely with the degree of differentiation of the neuroblastoma cells.
3580
Q1791:What is amplified in some breast cancers?
3581
HER-2/neu oncogene; such amplification is associated with poor prognosis.
3582
Q1792:What are cancer suppressor genes (anti-oncogenes)?
3583
In contrast to oncogene mechanisms cancer suppressor genes promote cellular proliferation when the gene is inactivated (most often by deletion). A single residual copy of the antioncogene suppresses tuor formation but homozygous inactivation promotes the expressoin of the neoplastic phenotype.
3584
Q1793:Describe the anti-oncogene process using retinoblastoma.
3585
1) An intraocular childhood tumor caused by inactivation of the Rb gene. The two hit hypothesis of Knudson holds that two mutagenic events are requird to induce alterations on both chromosomes2) In the familial forms of retinoblastoma the gene on one chromosome in teh germline is inactivated or deleted and the gene on the other chromosome is affected by a somatic mutation3) In sporadic nonfamilial cases of retinoblastoma both deletions occur as somatic mutations.
3586
Q1794:What is the p53 tumor suppressor gene?
3587
1) Mutated in over 50% of all malignant tumors2) Has been called teh "guardian of the genome";3) In the seting of DNA damage causes cell cycle arrest in G1 providing time for DNA repair4) If repair is successful cells re-enter the cell cycle5) If not successful p53 product causes cell death by apoptosis6) Familial loss causes the Li-Fraumeni syndrome which is characterized by a wide variety of tumors: breast soft tissue sarcomas brain tumors and leukemias.
3588
Q1795:What are WT-1 and WT-2 tumor suppressor genes?
3589
1) Are located on chromosome 11;2) Inactivation or deletion of either is associated with Wilms timor the most common renal neoplasm of children.
3590
Q1796:What is the APC tumor suppressor gene?
3591
Inactivation is common in familial polyposis coli and adenocarcinoma of the coon as well as a few other tumors; gastric and esophageal.
3592
Q1797:What is the BRCA-1 tumor suppressor gene?
3593
Inactivation is associated with familial propensity to breast and ovarian carcinomas.
3594
Q1798:What is the BRCA-2 tumor suppressor gene?
3595
Inactivation is associated with breast cancer.
3596
Q1799:What is von Recklinghausen neurofibromatosis type 1 and NF-1?
3597
1) Characterized by multiple benign neurofibromas cafe au lait spots iris hamrtomas and an increased risk of developing fibrosarcomas2) Caused by mutations in the NF-1 tumor suppressor gene (which functions as a GAP protein that inactivates ras)
3598
Q1800:What is multiple endocrine neoplasia type II?
3599
1) Familial occurence of the combination of medullary thyroid carcinoma bilateral pheochromocytomas and hyperparathyroidism due to hyperplasia or tumor2) Caused by mutations of teh ret proto-oncogene that are transmitted i the germline. Thus demonstration of a ret mutation in a patient with medullary thyroid carcinoma would indicate the need for surveillance for the development of pheochromocytoma or hyperparathyroidism.
3600
Q1801:What is hereditary nonpolyposis colon cancer (HNPCC or Lynch syndrome)?
3601
1) Caused by an inherited mutation in certain DNA repair genes resulting in genomic instability2) Predisposes to mutations in other genes more diretly related to transformation.
3602
Q1802:What is Xeroderma pigmentosum?
3603
1) An autosomal recessive disorder;2) Manifest by an increased incidence of skin cancers (basal cell carcinoma squamous cell carcinoma malignant melanoma) caused by hypersensitivity to ultraviolet light3) Involves defects in genes that function in nucleotide excision repair which is required for repair of ultraviolet-induced pyrimidine (often thymine) dimers (cross-linked pyrimidine residues).
3604
Q1803:Describe the grading of cancer.
3605
Histopathologic evaluation of the lesion based on teh degree of cellular differentiation.
3606
Q1804:Describe the staging of cancer.
3607
1) Clinical assessment of the degree of localization or spread of the tumor2) Generally correlates better with prognosis than does histopathologic grading. However both approaches are useful3) Exemplified by teh generalized TNM system which evaluates the size and the extent of the tumor (T) lymph node involvement (N) and metastasis (M)4) Sometimes oriented toward specific tumors as exemplified by teh Dukes system for colorectal carcinoma and teh Ann Arbor system for Hodgkin disease adn non-Hodgkin lymphomas.
3608
Q1805:down syndrome associated neoplasm
3609
Acute Lymphoblastic Leukemia;we ALL go DOWN together
3610
Q1806:xeroderma pigmentosum assoc neoplasm
3611
squamus cell and basal cell carcinoma of skin
3612
Q1807:chronic atrophic gastritis pernicious anemia and postsurgical gastic remnants assoc neoplasia
3613
gastric adenocarcinoma
3614
Q1808:tuberculosis scerlosis (facial angiofibroma seizures mental retardation) assoc neoplasms
3615
astrocytoma and cardiac rhabdomyoma
3616
Q1809:actinic keratosis assoc neoplasm
3617
squamous cell carcinoma of skin
3618
Q1810:barret's esophagus assoc neoplasm
3619
esophageal adenocarcinoma
3620
Q1811:plummer-vinson syndrome (atrophic glossitis esophageal webs anemia all due to iron deficiency) assoc neoplasms
3621
squamous cell carcinoma of esophagus
3622
Q1812:cirrhosis assoc neoplasm
3623
hepatocellular carcinoma
3624
Q1813:ulcerative colitis assoc neoplasm
3625
colonic adenocarcinoma
3626
Q1814:paget's disease of bone assoc neoplasm
3627
2ndary osteosarcoma and fibrosarcoma
3628
Q1815:aids associated neoplasom
3629
aggressive malignant lymphomas (non hodgkins) and kaposi's sarcoma
3630
Q1816:acanthosis nigricans (hyperpigmentation and epidermal thickening) assoc neoplasm
3631
visceral malignancy (stomach lung breast uterus)
3632
Q1817:dysplastic nevus assoc neoplasm
3633
malignant melanoma
3634
Q1818:tumor associated w/ oncogenes gain of function;1 cmyc;2 bcl-2;3 erb-B2;4 ras
3635
1 burkitt's lymphoma;2 follicular and undifferentiated lymphomas (inhibits apoptosis);3 breast ovarian and gastric carcinomas;4 colon carcinoma
3636
Q1819:tymor and chromosome associated w/ homozygous loss of fx of tumor suppressor genes1 Rb;2 BRCA1 and 2;3 p53
3637
1 13q retinoblastoma osteosarcoma;2 17q 13q Breast and ovarian cancer;3 17p most human cancers li-fraumeni syndrome
3638
Q1820:tumors assiciated w/ tumor markers1 PSA;2 CEA;3 AFP;4 beta-hCG;5 CA-125;6 S-100;7 alkaline phosphatase
3639
1 prostatic carcinoma;2 carcinoembryonic antigen. produced by 70% colorectal and pancreatic cancers also by gastric and brast carcinomas;3 normally made by fetus. hepatocellular carcinomas. nonseminomatous germ cell tumors of the testis (i.e. ylk sac tumor);4 hydatiform moles choriiocarcinomas and gestational trophoblastic tumors;5 ovarian malignant epithelial tumors;6 melanoma neural tumors astrocytomas;7 metastases to bone obstructive biliary disease paget's disease of bone
3640
Q1821:tumors associated with Oncogenic viruses1 HTLV-1;2 HBV HCV;3 EBV;4 HPV;5 HHV-8
3641
1 adult t cell leukemia;2 hepatocellular carcinoma;3 burkitt's lymphoma nasopharyngeal carcinoma;4 cervical carcinoma (16 18) penile/anal carcinoma;5 kaposi's sarcoma
3642
Q1822:chemical carcinogens and affected organs1 aflatoxins vinyl chloride;2 nitrosamines;3 asbestos;4 arsenic;5 CCl4;6 Napthalene dyes
3643
1 Liver;2 esophagus stomach;3 lung (mesothelioma and bronchogenic carcinoma);4 skin (squamus cell);5 liver (centrilobular necrosis fatty change);6 bladder (transitional cell carcinoma)
3644
Q1823:Definition;when the resemblance to the tissue of origin is close
3645
Well-differentiated
3646
Q1824:(4) signs of Malignant Cancer
3647
Hyperchromatism;;Anaplasia (poor differentiation);;Inc Nuclear/cytoplasmic ratio;;prominent Nucleoli
3648
Q1825:the (3) types of CA from Epithelial origin
3649
Epithelial = "Carcinoma";Squamous Cell CA;;Adenocarcinoma;;Transitional Cell CA
3650
Q1826:Definition;reversible pre-neoplastic growth with loss of cellular orientation shape and size in comparison to normal tissue
3651
Dysplasia
3652
Q1827:Definition;a clonal proliferation of cells that is uncontrolled and excessive
3653
Neoplasia
3654
Q1828:Order of the "-plasias" in severity;(5)
3655
normal cells -> Hyperplasia ->;Metaplasia or Dysplasia >;Anaplasia -> Neoplasia (Carcinoma in situ) ->;Metastasis
3656
Q1829:what cancer type is often associated w/ Desmoplasia (proliferation of fibrous tissue)?;name (3) main sites
3657
Adenocarcinoma;sitesBreast;Pancreas;Prostate
3658
Q1830:Definition;Neoplasm derived from all (3) germ layers;where is it usually seen?
3659
Teratoma;;MC in ovaries and testis
3660
Q1831:Definition;benign neoplasm often arising from surface or transitional epithelium;what does it look like?
3661
Papilloma;;(finger-like projections)
3662
Q1832:Difference b/t Choristoma and Hamartoma
3663
Chroistomanormal tissus misplaced w/i another organ;Hamartomabenign tumor-like overgrowth of cells regularly found w/i the infected organ
3664
Q1833:Definition;denotes origin from a single precursor cell;what is opposite?
3665
Monoclonal;(neoplastic);oppositePolyclonal;(non-neoplastic)
3666
Q1834:what type of metastatic tumors are via Lymphatic spread?;spread in blood?
3667
Carcinoma = Lymphatic;;Sarcoma = Blood
3668
Q1835:Pituitary tumor Dx;amenorrhea infertility
3669
Prolactinoma;(sometimes galactorrhea)
3670
Q1836:Pituitary tumor Dx;gigantism in children and acromegaly in adults
3671
Somatotropic (Acidophilic) adenoma
3672
Q1837:Pituitary tumor Dx;causes Cushings disease ;(secondary adrenal hypercorticism)
3673
Corticotropic (Basophilic) adenoma
3674
Q1838:Paraneoplastic effect;Inc ACTH -> Cushing's syndrome
3675
Small cell CA of lung
3676
Q1839:Paraneoplastic effect;Inc ADH -> SIADH;(2)
3677
Small cell CA of lung;;intracranial neoplasms
3678
Q1840:Paraneoplastic effect;PTH-related peptide -> Hypercalcemia;(5)*
3679
Some Really Breaks My Bones;Squamous cell CA of lung;;Renal cell CA;;Breast CA;;Multiple Myeloma;;Bone metastasis
3680
Q1841:Paraneoplastic effect;TSH -> Hyperthyroidism;(2)
3681
Hydatiform moles;;Choriocarcinoma
3682
Q1842:Paraneoplastic effect;EPO -> Polycythemia;(2)
3683
Renal cell CA;;Hemangioblastoma
3684
Q1843:Paraneoplastic effect;Hyperuricemia -> Gout;(2)
3685
Leukemias;;Lymphomas
3686
Q1844:Order of primary tumors that metastasize toBrain;(5)*
3687
Lots of Bad Stuff Kills Glia;Lung;Breast;Skin (melanoma);Kidney;GI
3688
Q1845:Order of primary tumors that metastasize toLiver;(5)*
3689
Cancer Sometimes Penetrates Benign Liver;Colon;Stomach;Pancreas;Breast;Lung;(from bottom -> up)
3690
Q1846:Order of primary tumors that metastasize toBone;(5)*
3691
Bone Problems Likely to Kill;Breast;Prostate;Lung;Thyroid / Testis;Kidney
3692
Q1847:Tumor marker seen in 70% of colorectal and pancreatic cancers
3693
CEA
3694
Q1848:Malignancy w/ Chemical Carcinogen;Vinyl Chloride
3695
Angiosarcoma of Liver
3696
Q1849:Malignancy w/ Chemical Carcinogen;Cigarette smoke;(2)
3697
CA of Lung;CA of Larynx
3698
Q1850:Malignancy w/ Chemical Carcinogen;Alkylating agents
3699
Acute Leukemia
3700
Q1851:Malignancy w/ Chemical Carcinogen;Asbestos;(3)
3701
Mesothelioma;;Lung bronchogenic CA;;GI cancers
3702
Q1852:Malignancy w/ Chemical Carcinogen;Smoked fish w/ Nitrosamines;(2)
3703
Adenocarcinoma of stomach;;Esophageal CA
3704
Q1853:Malignancy w/ Chemical Carcinogen;Alcohol;(2)
3705
Mouth CA;;Esophageal CA
3706
Q1854:Malignancy w/ Chemical Carcinogen;Arsenic
3707
Squamous cell CA
3708
Q1855:Malignancy w/ Chemical Carcinogen;High-fat diet
3709
Breast CA
3710
Q1856:Malignancy w/ Chemical Carcinogen;Naphthalene (Aniline) dyes aromatic amines
3711
Transitional CA of bladder
3712
Q1857:Malignancy w/ Chemical Carcinogen;Benzene
3713
Acute Leukemia
3714
Q1858:Malignancy w/ Chemical Carcinogen;Diethylstilbestrol (DES)
3715
Clear cell CA of vagina
3716
Q1859:Malignancy w/ Chemical Carcinogen;Nickel Chromium Uranium
3717
Lung CA
3718
Q1860:Dx;atrophic glossitis esophageal webs anemia low iron;what CA does it lead to?
3719
Plummer-Vinson syndrome;CASquamous cell CA of Esophagus
3720
Q1861:Dx;facial angiofibromas seizures mental retardation;what CA does it lead to?;(2)
3721
Tuberous Sclerosis;CAAstrocytoma;Cardiac Rhabdomyoma
3722
Q1862:what is a common skin presentation seen in malignancies of the stomach lung breast and uterus?
3723
Acanthosis Nigracans
3724
Q1863:Oncogene assoc tumor;abl
3725
CML
3726
Q1864:Oncogene assoc tumor;c-myc
3727
Burkitt's lymphoma
3728
Q1865:Oncogene assoc tumor;bcl-2
3729
Follicular lymphoma
3730
Q1866:Oncogene assoc tumor;erb-B2;(3)*
3731
BOG;Breast;;Ovarian;;Gastric CA
3732
Q1867:Oncogene assoc tumor;ras
3733
Colon CA
3734
Q1868:Oncogene assoc tumor;L-myc
3735
Lung CA;[L = Lung]
3736
Q1869:Oncogene assoc tumor;N-myc
3737
Neuroblastoma;[N = Neuro]
3738
Q1870:Oncogene assoc tumor;ret;(2)
3739
MEN types 2 & 3
3740
Q1871:Tumor assoc w/ Supressor gene;Rb;(2);Chromosome?
3741
Retinoblastoma;;Osteosarcoma;chrom: 13q
3742
Q1872:Tumor assoc w/ Supressor gene;BRCA1 and 2;(2);Chromosome?
3743
Breast CA;Ovarian CA;chrom: 17q 13q
3744
Q1873:Tumor assoc w/ Supressor gene;p53;Chromosome?
3745
Most cancers;(Li-Fraumeni syndrome);chrom: 17p
3746
Q1874:Tumor assoc w/ Supressor gene;p16;Chromosome?
3747
Melanoma;;chrom: 9p
3748
Q1875:Tumor assoc w/ Supressor gene;APC;Chromosome?
3749
Colorectal CA;;chrom: 5q;(5 letters in "polyp")
3750
Q1876:Tumor assoc w/ Supressor gene;WT1;Chromosome?
3751
Wilms Tumor;;chrom: 11q
3752
Q1877:Tumor assoc w/ Supressor gene;NF1;Chromosome?
3753
Neurofibromatosis type 1;(Von Recklinghausen);chrom: 17q;(17 letters in Von Recklinghausen)
3754
Q1878:Tumor assoc w/ Supressor gene;NF2;Chromosome?
3755
Neurofibromatosis type 2;;chrom: 22q;(type 2 = 22)
3756
Q1879:Tumor assoc w/ Supressor gene;DPC;Chromosome?
3757
Pancreatic CA = PC;;chrom: 18q
3758
Q1880:Tumor assoc w/ Supressor gene;DCC;Chromosome?
3759
Colon CA = CC;;chrom: 18q
3760
Q1881:Tumor marker;alpha-fetoprotein;(2)
3761
Hepatocellular CA;;Germ cell tumor of testis;(yolk sac tumors)
3762
Q1882:Tumor marker;beta-hCG;(3)
3763
HCG;Hydatidiform moles;;Choriocarcinoma;;Gestational Trophoblastic tumor
3764
Q1883:Tumor marker;CA-125;(2)
3765
Ovarian CA;;malignant Epithelial tumors
3766
Q1884:Tumor marker;S-100;(3)*
3767
MAN;Melanoma;;Astrocytoma;;Neural tumors
3768
Q1885:Tumor marker;Alkaline phosphatase;(3)*
3769
MOP;Metastasis to Bone;;Obstructive Biliary Dz;;Paget's Dz of bone
3770
Q1886:Tumor marker;Bombesin;(3)
3771
Neuroblastoma;;Lung CA;;Gastric CA
3772
Q1887:(4)* tumors w/ Psammoma Bodies
3773
PSaMMoma;Papillary Thyroid;Serous Papillary Cystadenocarcinoma of Ovary;;Meningioma;;Mesothelioma
3774
Q1888:Virus assoc tumors;HTLV-1
3775
Adult T-cell Leukemia
3776
Q1889:Virus assoc tumors;HBV HVC
3777
Hepatocellular CA
3778
Q1890:Virus assoc tumors;EBV;(2)
3779
Burkitt's lymphoma;;Nasopharyngeal CA
3780
Q1891:Virus assoc tumors;HPV;(3)
3781
CAP it;Cervical CA (16 18);;Anal CA;;Penile CA
3782
Q1892:Virus assoc tumors;HHV-8
3783
Karposi's sarcoma
3784
Q1893:where is person most likely to have cancer?
3785
Skin;(skin has highest incidence but unable to quantify)
3786
Q1894:top (3) MCC of CA in male and female
3787
MaleProstate;Lung;Colorectal;FemaleBreast;Lung;Colorectal
3788
Q1895:top (2) MCC of death from CA;in male and female
3789
MaleLung;Prostate;FemaleLung;Breast
3790
Q1896:What is osteogenesis imperfecta
3791
A group of heritable diseases characterized by abnormal type I collagen
3792
Q1897:How many types of osteogenesis imperfecta are there
3793
4 (types I to IV)
3794
Q1898:What is the usual clinical presentation of osteogenesis imperfecta
3795
Multiple fractures; often with minimal trauma
3796
Q1899:Besides bone; what else is affected in osteogenesis imperfecta
3797
Teeth; skin; eyes
3798
Q1900:What are the characteristic eye findings in osteogenesis imperfecta
3799
Blue sclerae
3800
Q1901:What are the radiographic findings in osteogenesis imperfecta
3801
Thin and osteopenic bones; often with many foci of fracture callus
3802
Q1902:What is osteopetrosis
3803
An inherited disorder characterized by abnormally dense bone
3804
Q1903:What causes osteopetrosis
3805
Failure of osteoclastic cells by an unknown mechanism
3806
Q1904:What are 2 other names for osteopetrosis
3807
Marble bone disease;Alber-Schonberg disease
3808
Q1905:Why the name marble bone disease for osteopetrosis
3809
Bones look short and block-like; and are radiodense; like marble
3810
Q1906:What is the common clinical presentation of osteopetrosis
3811
Multiple fractures
3812
Q1907:Why are multiple fractures common in osteopetrosis
3813
Although bone is hyperdense; it is intrinsically disorganized. Consequently; it is weaker
3814
Q1908:What are 2 common conditions associated with osteopetrosis
3815
Anemia due to decreased marrow space;Blindness; deafness; and other cranial nerve involvement due to narrowing of neural foramina
3816
Q1909:What are the 2 genetic variants of osteopetrosis
3817
AR and AD
3818
Q1910:What variant of osteopetrosis is most severe
3819
The AR variant is fatal in infancy
3820
Q1911:What is osteoporosis
3821
A decrease in bone mass
3822
Q1912:What causes osteoporosis
3823
Impaired synthesis or increased resorption of bone matrix
3824
Q1913:Name 5 states with which osteoporosis is associated
3825
Postmenopause;Physical inactivity;Hypercorticism;Hyperthyroidism;Calcium deficiency
3826
Q1914:Describe the pathophysiology associated with osteoporosis of the elderly
3827
A continuous loss of bone occurs at the trabecular and cortical layers due to increased resorption
3828
Q1915:What commonly prescribed drug induces osteopenia
3829
Steroids
3830
Q1916:What commonly results from osteopenia
3831
Fractures
3832
Q1917:What are the calcium and phosphorus levels in the blood in patients with osteoporosis
3833
Normal
3834
Q1918:What is seen radiographically in patients with osteoporosis
3835
Diffuse radiolucency of bone
3836
Q1919:What is the treatment for osteoporosis
3837
No cure. Calcium supplements; exercise; and estrogen therapy (in some patients) help reduce the risk; however
3838
Q1920:What is the effect of PTH on bone
3839
It stimulates the active phase of bone remodeling
3840
Q1921:What are the two main causes of hyperparathyroidism
3841
Parathyroid hyperplasia and parathyroid adenoma
3842
Q1922:What are the two clinical features of hyperparathyroidism
3843
Bone pain and hypercalcemia
3844
Q1923:What are the significant laboratory values in hyperparathyroidism
3845
Calcium >11.5 mg/dl; Phosphorus <2.0 mg/dl
3846
Q1924:What is seen on bone histologic examination in hyperparathyroidism
3847
An increased number of osteoclasts
3848
Q1925:After bone is resorbed; what replaces it
3849
Fibrous tissue
3850
Q1926:What abnormality is often seen in the fibrous tissue of resorbed bone
3851
Hemosiderin pigment
3852
Q1927:What are the fibrous tissue lesions seen in resorbed bone called
3853
Brown tumors
3854
Q1928:How is hyperparathyroidism treated
3855
By removal of the parathyroid lesion
3856
Q1929:How does hypoparathyroidism affect bone
3857
It decreases the turnover rate
3858
Q1930:What is the most common reason for hypoparathyroidism
3859
Surgical removal of parathyroid glands
3860
Q1931:What are the clinical signs of hypoparathyroidism
3861
Signs of hypocalcemia; including soft tissue ossification and calcification; abnormal dentition; and otoscleorosis
3862
Q1932:What is seen on bone histologic examination in hypothyroidism
3863
Active osteoblasts and lack of osteoclasts
3864
Q1933:What is the treatment for hypoparathyroidism
3865
Administration of PTH or vitamin D
3866
Q1934:What is osteomalacia
3867
A bone abnormality caused by defective calcification of osteoid matrix
3868
Q1935:What causes osteomalacia
3869
Vitamin D deficiency
3870
Q1936:In what age group does osteomalacia typically occur
3871
Adults
3872
Q1937:What can osteomalacia mimic radiographically
3873
Osteoporosis
3874
Q1938:How is osteomalacia diagnosed
3875
By bone biopsy
3876
Q1939:What is the treatment for osteomalacia
3877
Correct vitamin D deficiency
3878
Q1940:What is osteomalacia called when secondary to renal disease
3879
Renal osteodystrophy
3880
Q1941:Define rickets
3881
Bone abnormality caused by defective calcification of osteoid matrix and increased thickness of epiphysial growth plates
3882
Q1942:What causes rickets
3883
Vitamin D deficiency
3884
Q1943:Describe the difference between rickets and osteomalacia
3885
Osteomalacia occurs in adults; rickets in children. Because bone growth is not complete in patients with rickets; skeletal deformities are common
3886
Q1944:What are six clinical manifestations of rickets
3887
Craniotabesthickening and softening of occipital and parietal bones;Late closing of fontanelles;Rachitic rosary costochondral swelling;Harrison groovedepression of insertion site of diaphragm into rib cage;Pigeon breast protrusion of sternum;Short stature caused by spinal deformity
3888
Q1945:What is the treatment for rickets
3889
Correction of vitamin D deficiency
3890
Q1946:Define scurvy
3891
Bone abnormality characterized by impaired osteoid matrix formation
3892
Q1947:What causes scurvy
3893
Vitamin C deficiency
3894
Q1948:How does vitamin C deficiency lead to impaired bone formation
3895
Failure of praline and lysine hydroxylation required for collagen synthesis
3896
Q1949:Name three clinical characteristics of scurvy
3897
Subperiosteal hemorrhage;Osteoporosis;Epiphysial cartilage not replaced by osteoid
3898
Q1950:Why does subperiosteal hemorrhage occur with scurvy
3899
Because of increased capillary fragility
3900
Q1951:What is seen on bone histologic examination in scurvy
3901
Decreased trabecular bone mass and abnormal osteoblasts
3902
Q1952:What is the treatment for scurvy
3903
Correction of vitamin C deficiency
3904
Q1953:What is pyogenic osteomyelitis
3905
Infection of the medullary and cortical portions of the bone; including the periosteum
3906
Q1954:What bones are commonly affected by pyogenic osteomyelitis in children
3907
Long bones
3908
Q1955:What bones are commonly affected by pyogenic osteomyelitis in adults
3909
Vertebrae
3910
Q1956:What is the usual causative organism of pyogenic osteomyelitis in children
3911
Staph aureus
3912
Q1957:What are the usual causative organisms (2) of pyogenic osteomyelitis in newborns
3913
Group B beta -hemolytic strep;E coli
3914
Q1958:What is the usual causative organism of pyogenic osteomyelitis in sickle cell anemia patients
3915
Salmonella organisms
3916
Q1959:What is the usual causative organism of pyogenic osteomyelitis in IV drug abusers
3917
Pseudomonas organisms
3918
Q1960:How do the causative bacteria of pyogenic osteomyelitis spread in the body
3919
Hematogenously
3920
Q1961:In adults; what is the usual cause of pyogenic osteomyelitis
3921
Complications from surgery and compound fractures
3922
Q1962:What portion of the bone is most commonly involved initially in pyogenic osteomyelitis
3923
Metaphysis
3924
Q1963:Name 3 reasons for persistent pyogenic osteomyelitis
3925
Necrotic bone acting as a locus for persistent infection;Pyogenic exudate compressing vascular supply of bone;Inflammation in relatively avascular areas of bone
3926
Q1964:Name 2 clinical symptoms of pyogenic osteomyelitis
3927
Fever; local bone pain
3928
Q1965:What are significant laboratory test values in pyogenic osteomyelitis
3929
Marked leukocytosis; fever; and increased sedimentation rate
3930
Q1966:What is a localized bone infection surrounded by granulation tissue called
3931
Brodie abscess
3932
Q1967:How is a Brodie abscess treated
3933
Drain or debride the abscess;Administer antibiotics
3934
Q1968:How frequently do flare-ups occur with chronic osteomyelitis
3935
It varies; with intervals of months to years
3936
Q1969:What is tuberculous osteomyelitis
3937
Bone infection due to spread of tuberculous organisms
3938
Q1970:How are tuberculous organisms spread
3939
Hematogenously
3940
Q1971:What is tuberculous osteomyelitis with spinal involvement called
3941
Pott disease
3942
Q1972:What bones does tuberculous osteomyelitis affect
3943
Spine;Hip;Long bones;Bones of the hands and feet
3944
Q1973:What happens to bone affected by tuberculous osteomyelitis
3945
Progressive destruction; with little ossification
3946
Q1974:What is histiocytosis X
3947
A group of disorders affecting other organs systems in addition to bone. It is characterized by proliferation of histiocyte cells
3948
Q1975:Histiocyte cells are similar to what epidermal cells
3949
Langerhans cells
3950
Q1976:What are characteristic markers of histiocytic cells
3951
Birbeck granules
3952
Q1977:What do Birbeck granules look like
3953
Tennis rackets
3954
Q1978:Name 3 variants of histiocytosis X
3955
Eosinophilic granuloma;Hand-Schuller-Christian disease;Letterer-Siwe disease
3956
Q1979:What is characteristic of eosinophilic granuloma
3957
Histiocytic proliferation with inflammatory cells; including many eosinophils
3958
Q1980:What is the clinical presentation of eosinophilic granuloma
3959
Solitary bone lesion
3960
Q1981:Does extraskeletal involvement occur in eosinophilic granuloma
3961
Yes; commonly in the lung
3962
Q1982:What is the prognosis in eosinophilic granuloma
3963
Best of all variants of histiocytosis X. Lesions sometimes heal without treatment
3964
Q1983:What is characteristic of Hand-Schuller-Christian disease
3965
Histiocyte proliferation with inflammatory cells
3966
Q1984:What is affected in Hand-Schuller-Christian disease
3967
Bone;Liver;Spleen;Other tissues
3968
Q1985:What population is affected by Hand-SchullerChristian disease
3969
Children less than 5 years old
3970
Q1986:List the classic triad of Hand-Schuller-Christian disease
3971
Skull lesions;Diabetes insipidus;Exophthalamos
3972
Q1987:What is the prognosis in Hand-Schuller-Christian disease
3973
Better than Letterer-Siwe; worse than eosinophilic granuloma
3974
Q1988:What is characteristic of Letterer-Siwe disease
3975
Widespread histiocyte proliferation
3976
Q1989:What population is affected by Letterer-Siwe disease
3977
Infants
3978
Q1990:What are 5 clinical findings in Letterer-Siwe disease
3979
Hepatosplenomegaly;Lymphadenopathy;Pancytopenia;Pulm onary involvement;Recurrent infections
3980
Q1991:What is the course of Letterer-Siwe disease
3981
Aggressive and fatal
3982
Q1992:What is another name for unicameral bone cyst
3983
Solitary bone cyst
3984
Q1993:What is the cause of unicameral bone cyst
3985
Unknown
3986
Q1994:What population is affected by unicameral bone cysts
3987
Young males
3988
Q1995:What portion of bone is affected by unicameral bone cysts
3989
Distal ends of long bones
3990
Q1996:Name 3 clinical signs of unicameral bone cysts
3991
Pain;Soft tissue swelling;Occasional fractures
3992
Q1997:What is seen on radiography of unicameral bone cysts
3993
Radiolucent area with smooth; thin cortex
3994
Q1998:What is the appearance of unicameral bone cysts on gross pathology
3995
Multiloculated cavity
3996
Q1999:What is the treatment for unicameral bone cysts
3997
Curettage with insertion of bone chips
3998
Q2000:What is the prognosis with unicameral bone cysts
3999
Excellent; with few recurrences
4000
Q2001:What population is affected by aneurysmal bone cysts
4001
Females in 2nd to 3rd decade of life
4002
Q2002:What portion of bone is usually affected with aneurysmal bone cysts
4003
Metaphysis of long bones;Vertebrae
4004
Q2003:Name the 2 clinical signs of aneurysmal bone cysts
4005
Pain;Soft tissue swelling
4006
Q2004:What is seen on radiography of aneurysmal bone cysts
4007
Circumscribed zone of rarefaction; with extension into soft tissues
4008
Q2005:What is the size range of aneurysmal bone cysts
4009
Up to 20 cm
4010
Q2006:What is the gross pathology of aneurysmal bone cysts
4011
Bone is greatly distorted with irregular outlines. It appears spongy; with cystic spaces of various sizes
4012
Q2007:Give 2 histologic differential diagnoses of aneurysmal bone cysts
4013
Giant cell tumor of bone;Telangiectatic osteosarcoma
4014
Q2008:How are aneurysmal bone cysts treated
4015
Removal of entire lesion with insertion of bone chips
4016
Q2009:What is the prognosis with aneurysmal bone cysts
4017
Recurrences occur 20% to 30% of the time
4018
Q2010:Fibrous dysplasia most commonly affects what bones
4019
Ribs; femur; tibia; maxilla
4020
Q2011:Is fibrous dysplasia monostotic or polyostotic
4021
80% monostotic; 20% polyostotic
4022
Q2012:Polyostotic lesions are part of what syndrome
4023
Albright syndrome
4024
Q2013:What bone complications occur in fibrous dysplasia
4025
Deformity secondary to repeated fractures
4026
Q2014:Describe the radiographic appearance of fibrous bone dysplasia
4027
Well-defined zones of rarefaction surrounded by narrow rims of sclerotic bone
4028
Q2015:Describe the major histologic feature of fibrous dysplasia
4029
Proliferation of fibroblasts; which produce a dense collagenous matrix
4030
Q2016:What is the treatment for monostotic bone lesions
4031
Curettage or local resection
4032
Q2017:What is the treatment for polyostotic bone lesions
4033
Conservation (nonsurgical); because lesions stop growing after puberty
4034
Q2018:What is another name for osteochondroma
4035
Exostosis
4036
Q2019:Define osteochondroma
4037
Bony growth covered by a cartilaginous cap
4038
Q2020:What is osteochondromas claim to fame
4039
Most common benign tumor of bone
4040
Q2021:Where does osteochondroma originate
4041
In the metaphysis
4042
Q2022:What are the 2 most frequent locations for osteochondroma
4043
Distal femur;Proximal tibia
4044
Q2023:What population is most commonly affected by osteochondroma
4045
Males under 25 years of age
4046
Q2024:Does osteochondroma undergo transformation to a malignant tumor
4047
Rarely
4048
Q2025:Describe the clinical symptoms of osteochondroma
4049
Pain and compression of adjacent structures
4050
Q2026:What is the prognosis of osteochondroma
4051
Excellent. Resection is usually curative
4052
Q2027:What is giant cell tumor
4053
Benign tumor characterized by multinucleated giant cells and fibrous stroma
4054
Q2028:Where does giant cell tumor originate
4055
Epiphysis of long bones
4056
Q2029:What are the 2 most frequent locations of giant cell tumor
4057
Distal femur;Proximal tibia
4058
Q2030:How does giant cell tumor appear radiographically
4059
Soap bubble appearance
4060
Q2031:What population is most commonly affected by giant cell tumor
4061
Females 20 to 40 years old
4062
Q2032:What is the course of giant cell tumor
4063
Although benign; it is locally aggressive
4064
Q2033:What is the prognosis of giant cell tumor
4065
Frequently recurs after local curettage
4066
Q2034:What is enchondroma
4067
Benign intramedullary cartilaginous neoplasm
4068
Q2035:Where does enchondroma most frequently occur
4069
Hands and feet
4070
Q2036:What population is most commonly affected by enchondroma
4071
All age groups
4072
Q2037:What is osteoma
4073
Benign tumor of mature bone
4074
Q2038:What are the 2 most frequent locations of an osteoma
4075
Skull;Facial bones
4076
Q2039:What population is most commonly affected by osteoma
4077
Males of any age
4078
Q2040:Osteoma occurring as multiple lesions; with intestinal polyps and soft tissue tumors; is known by what name
4079
Gardner syndrome
4080
Q2041:What are the clinical features of osteoma
4081
It is asymptomatic; unless drainage of paranasal sinus is blocked
4082
Q2042:What is the prognosis of osteoma
4083
Excellent. Resection is curative
4084
Q2043:What is osteoid osteoma
4085
Neoplastic proliferation of osteoid and fibrous tissue
4086
Q2044:What are the most frequent locations of osteoid osteoma
4087
Ends of diaphysis of femur or tibia
4088
Q2045:What population is most commonly affected by osteoid osteoma
4089
Males less than 25 year old
4090
Q2046:What are the clinical features of osteoid osteoma
4091
Increasing pain; worse at night; relieved by aspirin
4092
Q2047:How does osteoid osteoma appear radiographically
4093
Central radiolucent area surrounded by sclerotic bone
4094
Q2048:What is the central radiolucent area in an osteoid osteoma called
4095
Nidus
4096
Q2049:What is the nidus of osteoid osteoma; microscopically
4097
Osteoblasts; calcification; and multinucleate giant cells
4098
Q2050:What is the prognosis for osteoid osteoma
4099
Excellent. Resection of nidus and sclerotic bone is curative
4100
Q2051:Name the 2 most frequent locations of osteoblastoma
4101
Vertebrae and long bones
4102
Q2052:What population is most commonly affected by osteoblastoma
4103
Males under 30
4104
Q2053:What are the clinical features of osteoblastoma
4105
Usually none
4106
Q2054:Radiographically; how does osteoblastoma appear
4107
Well-circumscribed lesion surrounded by sclerotic bone
4108
Q2055:What treatment for osteoblastoma allows the best prognosis
4109
Results are excellent when the lesion is removed by curettage
4110
Q2056:Give another name for osteosarcoma
4111
Osteogenic sarcoma
4112
Q2057:State osteosarcomas claim to fame
4113
Osteosarcoma is the most common primary malignant tumor of bone
4114
Q2058:Define osteosarcoma
4115
Malignant osteoid and bone-producing neoplasm
4116
Q2059:What causes osteosarcoma
4117
The cause is unknown
4118
Q2060:Name the 2 most frequent locations of osteosarcoma
4119
Distal femur and proximal tibia
4120
Q2061:What population is most commonly affected by osteosarcoma
4121
Males 10-20 years old
4122
Q2062:What are the clinical features of osteosarcoma
4123
Pain; swelling; and pathologic fractures
4124
Q2063:What are the significant laboratory values of osteosarcoma
4125
A 2-3 fold increase in alkaline phosphatase levels
4126
Q2064:Radiographically; elevation of periosteum is called what
4127
Codman triangle
4128
Q2065:How does osteosarcoma spread
4129
Hematogenously
4130
Q2066:Name the 4 factors predisposing to osteosarcoma
4131
Paget disease;Ionizing radiation;Bone infarcts;Familial retinoblastoma
4132
Q2067:How does osteosarcoma appear on gross pathology
4133
Large necrotic and hemorrhagic mass
4134
Q2068:What is the microscopic appearance of osteosarcoma
4135
Malignant stroma containing osteoid and bone
4136
Q2069:How is osteosarcoma treated
4137
Surgical amputation of affected limb; and adjunctive chemotherapy
4138
Q2070:What is the prognosis for osteosarcoma
4139
Poor; 5 year survival rate is 5% to 20%
4140
Q2071:What is chondrosarcoma
4141
Malignant cartilaginous neoplasm
4142
Q2072:Name the 4 most frequent locations of chondrosarcoma
4143
Proximal femur; proximal humerus; pelvis; spine
4144
Q2073:What population is most commonly affected by chondrosarcoma
4145
Males 30-60 years old
4146
Q2074:Name three clinical features of chondrosarcoma
4147
Pain; swelling; and presence of mass for several years
4148
Q2075:Radiographically; how does chondrosarcoma appear
4149
Cortical destruction with occasional medullary involvement
4150
Q2076:From what two preexisting cartilaginous tumors can chondrosarcoma arise
4151
Multiple familial osteochondromatosis;Multiple enchondromatosis
4152
Q2077:How does chondrosarcoma appear on gross pathology
4153
Lobulated white or gray mass; with mucoid material and calcification
4154
Q2078:What is chondrosarcomas microscopic appearance
4155
Poorly developed cartilage cells with anaplastic cells
4156
Q2079:What is the treatment for chondrosarcoma
4157
Total resection; if possible
4158
Q2080:What is the prognosis for chondrosarcoma
4159
Chondrosarcoma is slow growing; but has a high tendency to recur; 10 year survival rate is 50-60%
4160
Q2081:What is Ewing sarcoma
4161
Undifferentiated round cell malignant tumor
4162
Q2082:In what 4 areas does Ewing sarcoma occur most often
4163
Long bones; pelvis; scapula; ribs
4164
Q2083:What population is most commonly affected with Ewing sarcoma
4165
Males less than 15 years
4166
Q2084:What are the clinical features of Ewing sarcoma
4167
Pain; swelling; and presence of mass for several years
4168
Q2085:How does Ewing sarcoma appear radiographically
4169
Destructive appearance
4170
Q2086:What does subperiosteal reactive new bone resemble
4171
Onion skin
4172
Q2087:The early phase of Ewing sarcoma mimics what other disease
4173
Acute osteomyelitis
4174
Q2088:What genetic defect is present in Ewing sarcoma
4175
11;22 translocation
4176
Q2089:Where does Ewing sarcoma arise
4177
Undifferentiated mesenchymal cells of the medullary cavity
4178
Q2090:How does Ewing sarcoma appear on gross pathology
4179
Hemorrhagic and necrotic destruction of medullary cavity
4180
Q2091:Microscopically; what is seen with Ewing sarcoma
4181
Undifferentiated small round cells in sheets or cords
4182
Q2092:How is Ewing sarcoma treated
4183
Amputation of limb; possibly chemotherapy
4184
Q2093:What is the prognosis with Ewing sarcoma
4185
Poor. Malignant course with early metastases; the 5 year survival rate is 0-12%
4186
Q2094:Give another name for osteitis deformans
4187
Paget disease of the bone
4188
Q2095:Define osteitis deformans
4189
Bone disease characterized by abnormal bony architecture with increases in osteoblastic and osteoclastic activity; and a high turnover rate
4190
Q2096:Name the five most common locations of osteitis deformans
4191
Spine; pelvis; skull; femur; and tibia
4192
Q2097:What population is most commonly affected with osteitis deformans
4193
Elderly persons
4194
Q2098:What causes osteitis deformans
4195
Cause is unknown; an infectious nature is postulated
4196
Q2099:Describe the clinical features of osteitis deformans
4197
Pain; fracture; and skeletal deformities; deafness when skull is involved; short stature when spine is involved
4198
Q2100:Is osteitis deformans monostotic or polyostotic
4199
Both
4200
Q2101:Microscopically; how does osteitis deformans appear
4201
Marked medullary fibrosis; disorganization of normal trabecular pattern
4202
Q2102:What is the treatment for osteitis deformans; and why?
4203
Calcitonin or one of the diphosphonates. They decrease resorption; and thus decrease the high turnover rate
4204
Q2103:What is avascular necrosis
4205
Necrosis of bone; usually the femoral head; caused by infarction
4206
Q2104:Give 3 possible causes of avascular necrosis
4207
Emboli;Decompression syndrome (the bends);Sickle cell anemia
4208
Q2105:Radiologically; what is seen with avascular necrosis
4209
Reparative foci replacing necrotic bone
4210
Q2106:With what other conditions is avascular necrosis commonly associated
4211
Alcoholism;Corticosteroid treatment;Hyperuricemia;SLE;Trauma
4212
Q2107:What is the treatment for avascular necrosis
4213
Hemiarthroplasty
4214
Q2108:When avascular necrosis occurs in the femoral head of children; what is it called
4215
Legg-Calve-Perthes disease
4216
Q2109:What disease is characterized by pain in weightbearing joints; is worse after use; has crepitation with motion; no signs of inflammation; and is seen in the middle-aged population
4217
Osteoarthritis; aka degenerative joint disease
4218
Q2110:What are signs of osteoarthritis on x-ray
4219
Joint space narrowing; osteophytes
4220
Q2111:What are Herberdens nodules
4221
Palpable DIP joints with osteophytes
4222
Q2112:What are Bouchards nodules
4223
Palpable PIP joints with osteophytes
4224
Q2113:What are some treatments of osteoarthritis
4225
NSAIDs and weight reduction to reduce strain on joints
4226
Q2114:A 4 year old boy presents with arthralgias; soft hyperextensible skin; corneal and scleral abnormalities; joint laxity; and easy bruising. Diagnosis?
4227
Ehlers-Danlos syndrome
4228
Q2115:A 32 year old female presents to your office complaining of morning stiffness for greater than 1 hour; pain in joints bilaterally; with fatigue and hand deformations over time. Diagnosis?
4229
Rheumatoid arthritis
4230
Q2116:Which joints are most commonly involved in RA
4231
Wrists; PIP; and metacarpophalangeal
4232
Q2117:What are some common findings with RA
4233
Fever;Malaise;Pericarditis;Pleural effusions;Uveitis;Subcutaneous nodules
4234
Q2118:Which lab test should you order when you suspect RA
4235
Rheumatoid factor
4236
Q2119:What is rheumatoid factor
4237
Immunoglobin M antibody to fragment crystallizable (Fc) portion of IgG
4238
Q2120:What is the name for the chronic inflammation of cartilage found in RA
4239
Pannus
4240
Q2121:What disease would be expected in a young woman that suffers with RA-like symptoms (polyarthritis); leukopenia; leg ulcers; and splenomegaly?
4241
Feltys syndrome
4242
Q2122:What disease is similar to RA (bilateral joint pain; fever) but is seen in children; along with rash and hepatosplenomegaly
4243
Stills disease (juvenile RA);*Kids cant sit Still when their joints hurt
4244
Q2123:What is different about pediatric RA
4245
It is often RF negative
4246
Q2124:A 5 year old child presents with complaints in two joints. Which disease is this
4247
Pauciarticular juvenile RA
4248
Q2125:What is a child with pauciarticular RA at risk for
4249
Iritis (do slit-lamp test)
4250
Q2126:A 43 year old male presents to your clinic with a history of falling on his knee two days ago. Since then; the knee has become red; swollen; and warm. Diagnosis?
4251
Septic joint
4252
Q2127:How can you diagnose septic joint
4253
Arthrocentesis with high white blood cells/ neutrophil count and Grams stain
4254
Q2128:What is the most common causative organism of septic joint
4255
Staphylococcus aureus
4256
Q2129:What are some common organisms that are found uniquely in the joints of infants and young children
4257
Group B streptococci;Haemophilus influenzae
4258
Q2130:What are some common organisms associated with implantable devices and prosthetics
4259
Staph aureus;Staphylococcus epidermidis;Gram-negative bacilli
4260
Q2131:A 23 year old male; sexually active college student arrives at your clinic complaining of a swollen red knee and urethritis. What organism is the most likely
4261
Neisseria gonorrhoeae
4262
Q2132:How is the diagnosis made in a patient with gonorrhea
4263
Urethral swab
4264
Q2133:How do you treat gonorrhea
4265
Ceftriaxone
4266
Q2134:Which organism should be suspected in a patient with diabetes and osteomyelitis
4267
Pseudomonas
4268
Q2135:Which organism should be suspected in a sickle cell patient with osteomyelitis
4269
Salmonella
4270
Q2136:A 65 year old white male presents to clinic with a 2 hour history of sudden onset of extreme pain in his great toe. What disease should be suspected in this patient
4271
Gout
4272
Q2137:What is podagra
4273
Gout of the metatarsophalangeal joint of the big toe
4274
Q2138:What other findings should be looked for in a patient with gout
4275
Tophi; subcutaneous deposits of uric acid crystals
4276
Q2139:How do tophi appear on x-ray
4277
Punched out lesions
4278
Q2140:What lab tests help to diagnose gout
4279
Uric acid level;Joint fluid aspiration of needle-shaped crystals with negative birefringence
4280
Q2141:What are contributing factors for gout
4281
Thiazide diuretics;Lesch-Nyhan syndrome;Diets with high protein and alcohol
4282
Q2142:What is the treatment for gout
4283
AcuteColchicine; NSAIDs;MaintenanceAllopurinol
4284
Q2143:What diseases are associated with pseudogout
4285
Hyperparathyroidism;Hemochromatosis
4286
Q2144:A 12 year old presents with migratory polyarthritis; rash; fever; and general malaise. She recalls having a sore throat about 3 weeks ago but did not get treatment. Diagnosis?
4287
Acute rheumatic fever
4288
Q2145:What are the Jones criteria of rheumatic fever
4289
Fever;Erythema marginatum;Verrucous valvular vegetations;Erythrocyte sedimentation rate increase;aRthritis;Subcutaneous nodules;Chorea (Sydenham s);Preceded by Streptococcus infection;*FEVERS and Chorea preceded by a Streptococcus infection
4290
Q2146:What is the distinctive inflammatory heart lesion associated with rheumatic fever
4291
Aschoffs bodies
4292
Q2147:What is the causative organism of the sore throat in rheumatic fever
4293
Group A beta -hemolytic streptococci
4294
Q2148:What is the actual cause of rheumatic fever
4295
Hypersensitivitycross reaction antibodies against M protein of Streptococci
4296
Q2149:Which titers are elevated with rheumatic fever
4297
Antistreptolysin O titer; ESR
4298
Q2150:Which hematologic disease is associated with avascular necrosis of the femoral head
4299
Sickle cell anemia
4300
Q2151:A patient presents with urethritis; conjunctivitis; arthritis; and happens to be HLA-B27 positive. Diagnosis?
4301
Reiter disease;*Cant pee; cant see; cant kick with your knee
4302
Q2152:Previous exposure to which bacteria can precipitate Reiter disease
4303
Chlamydiae;Shigella;Salmonella;Campylobacter;Yersinia species
4304
Q2153:A 35 year old white male presents with diffuse red/purple plaques with silver scale on extensor surfaces and scalp. What disease is suspected
4305
Psoriasis
4306
Q2154:What other symptoms are common with psoriasis
4307
Nail pitting;Psoriatic arthritis with sausage digits
4308
Q2155:What is the most common form of psoriatic arthritis
4309
Asymmetric arthritis in fingers or toes
4310
Q2156:What is the phenomenon that describes the development of a psoriatic plaque in an area of previous trauma
4311
Koebner phenomenon
4312
Q2157:What is the name of the sign that occurs when a small amount of scale is removed from a psoriatic plaque; leaving small bleeding points behind
4313
Auspitz sign
4314
Q2158:What can precipitate an outbreak of psoriasis
4315
Infection;Stress;Sunburn;Drugs beta -blockers; lithium; and antimalarials
4316
Q2159:What is used to treat psoriasis
4317
Psoralen ultraviolet A (PUVA);Retinoids;Methotrexate;Cyclosporin
4318
Q2160:What HLA type is associated with psoriatic arthritis
4319
HLA-B27
4320
Q2161:A 28 year old African-American female presents to the clinic with new onset of fatigue; weight loss; joint pain; and Raynauds phenomenon. On exam; she is found to have a malar rash. Diagnosis?
4321
SLE
4322
Q2162:What are the official criteria for the diagnosis of SLE
4323
Oral ulcers;Renal disorder;Photosensitivity;Hematologic (anemias; cytopenias);Arthritis (nonerosive synovitis);Neurologic (seizures; psychosis);Serositis;Malar rash;Antinuclear antibody;Immunologic (anti-DNA; antiSmith; false positive rapid plasma reagin/Venereal Disease research Laboratory [RPR/VDRL]);Discoid rash;*The ORPHANS MAID has Lupus;*Need 4/11 criteria for diagnosis
4324
Q2163:In which sex and race is SLE most common and severe
4325
Black females
4326
Q2164:What cardiac lesion is associated with SLE in the adult and consists of nonbacterial verrucous valvular vegetations
4327
Libman-Sacks endocarditis
4328
Q2165:What are some causes for chest pain in a patient with SLE
4329
Pleuritis;Pericarditis
4330
Q2166:A 30 year old white male presents with new onset of SLE-like symptoms. Which drugs can cause these
4331
Hydrazine;INH;Procainamide;Phenytoin;*You wont be HIPP with drug-induced Lupus
4332
Q2167:Which antibody system is associated with druginduced Lupus
4333
Antihistone
4334
Q2168:How are the manifestations of SLE in the kidney classified
4335
Type Iappears normal by light microscopy;Type II mesangial lupus glomerulonephritis;Type IIIfocal proliferative glomerulonephritis;Type IVdiffuse proliferative glomerulonephritis;Type Vmembranous glomerulonephritis
4336
Q2169:What are wire-loop lesions in the kidney and what do they represent
4337
Thickening of the capillary wall found in diffuse proliferative glomerulonephritis; indicate a poor prognosis with SLE
4338
Q2170:Which neoplasm is associated with SLE and myasthenia gravis
4339
Thymoma
4340
Q2171:Which antibody is sensitive but not specific for the diagnosis of SLE
4341
Antinuclear antibody
4342
Q2172:Which two antibodies are very specific for SLE
4343
Anti-Smith;Antidouble-stranded DNA
4344
Q2173:A black female with SLE delivered an infant with bradycardia; which is later found to have AV-block. What autoantibody could have caused this congenital heart block
4345
Anti-Rho antibodies which cross the placenta
4346
Q2174:Which two HLA types is SLE linked to
4347
HLA-DR2 and HLA-DR3
4348
Q2175:An 18 year old female patient presents with a 5 week history of arthritis; fever; 15lb weight loss; and diarrhea. What diseases should be considered
4349
Inflammatory bowel diseaseCrohns and ulcerative colitis
4350
Q2176:On physical exam; a patient is found to have a right lower quadrant abdominal mass and positive fecal occult blood. Radiographic studies show a thickened terminal ileum; skip lesions; and areas of stricture. Diagnosis?
4351
Crohns disease
4352
Q2177:What are systemic symptoms of Crohns disease
4353
Aphthous ulcers;Erythema nodosum;Uveitis
4354
Q2178:What is the cause of Crohns disease
4355
Idiopathic;Associated with HLA-B27
4356
Q2179:What findings would be expected on gross examination of a biopsy taken for a small bowel with Crohns disease
4357
Sharp demarcation of diseased bowel (skip lesions); Linear ulcers; Cobblestone mucosa; Sinus tract/fistula formation; Creeping fat around the bowel surface; *The old Crohn skips down the cobblestone tract
4358
Q2180:What findings would be expected histologically in Crohns disease
4359
Transmural inflammation of bowel wall; Noncaseating granulomas; Mucosal damage; Ulceration
4360
Q2181:What are treatment options for Crohns disease
4361
Sulfasalazine; Corticosteroids; Bowel rest; Surgery (fistulas; obstruction); B12 supplements for malabsorption
4362
Q2182:A 22 year old white female presents with a 2 week history of migratory polyarthritis; 15 lb weight loss; and grossly bloody mucoid diarrhea. Diagnosis?
4363
Ulcerative colitis
4364
Q2183:What features are characteristics of ulcerative colitis
4365
Continuous involvement beginning at rectum; Microabscesses; Pseudopolyps; Superficial ulceration
4366
Q2184:A patient with established ulcerative colitis presents to the ER with high fever and symptoms of shock and abdominal distention. What must be suspected
4367
Toxic megacolon
4368
Q2185:What systemic illnesses do patients with ulcerative colitis exhibit
4369
Toxic megacolon; Colon cancer; Primary sclerosing cholangitis; Pyoderma gangrenosum; Uveitis; Erythema nodosum
4370
Q2186:What are the major differences that separate UC from Crohns
4371
No skip lesions; no granulomas; no fistulas/sinuses in ulcerative colitis
4372
Q2187:A 45 year old white female presents with a 3 month history of diarrhea; fatty white stools; and a rash that was diagnosed as dermatitis herpetiformis. What is her probable diagnosis
4373
Celiac sprue
4374
Q2188:What causes celiac sprue
4375
Antigliaden antibody (IgA antiendosomal)
4376
Q2189:What pathology would be seen in biopsy of celiac sprue
4377
Blunting of villi; Lymphocytes in the lamina propria
4378
Q2190:What dietary recommendations should celiac sprue patients follow
4379
Avoid all foods containing gliadin (gluten); including wheat and beer
4380
Q2191:A 33 year old white male complains of joint pain. He mentions that he has noticed an increase in pigmentation along with frequent urination and a strange tendency to set off metal detectors. Diagnosis?
4381
Hemochromatosis
4382
Q2192:What are the symptoms for hemochromatosis
4383
Bronze diabetes; Congestive heart failure; Micronodular cirrhosis
4384
Q2193:What type of cancer are patients with hemochromatosis at risk of
4385
Hepatocellular cancer
4386
Q2194:What is the cause of the symptoms of hemochromatosis
4387
Increased iron deposition
4388
Q2195:Besides increased iron supply; what are other important lab findings in hemochromatosis
4389
Increased ferritin;Increased transferrin;Positive Prussin blue stain
4390
Q2196:What is the inheritance pattern of primary hemochromatosis
4391
Autosomal recessive
4392
Q2197:What is the cause of hemochromatosis as a secondary disorder
4393
Chronic blood transfusions
4394
Q2198:What are treatment options for hemochromatosis
4395
Phlembotomy; Deferoxamine
4396
Q2199:An 18 year old football player complains of joint pain; bruising; and somewhat limited range of motion. He reports that he has always been a free bleeder. Diagnosis?
4397
Hemarthroses associated with hemophilia
4398
Q2200:A 15 year old boy scout complains of a 2 week history of flu-like illness and joint pain which started in his left knee; and now is in his right knee. It all began after a camping trip in Connecticut. Diagnosis?
4399
Lyme disease
4400
Q2201:What causes Lyme disease
4401
Borrelia burgdorferi; which is transmitted by Ixodes tick bites
4402
Q2202:A boy scout with Lyme disease recalls a strange bulls eye rash that appeared and then disappeared before he could get an appointment. What is the rash called
4403
Erythema chronicum migrans
4404
Q2203:What cardiac complications are possible with Lyme disease
4405
First-degree AV-block
4406
Q2204:What are the treatments for Lyme disease
4407
Tetracycline; Doxycycline
4408
Q2205:A 34 year old abstinent Asian patient presents with a several year history of arthritis; recurrent genital and oral ulcers; and a painful rash over the pretibial areas. Diagnosis?
4409
Behcets disease
4410
Q2206:An 18 year old man presents with migratory arthritis; currently in his ankle; a rash; and pain with urination. A Gram s stain of urethral discharge shows gram-negative cocci. Diagnosis?
4411
Gonococcal arthritis
4412
Q2207:A 24 year old man recently diagnosed and treated for chlamydia complains of persistent joint pain with tender Achilles tendons and eye irritation. Diagnosis?
4413
Reiters reactive arthritis
4414
Q2208:A 28 year old male presents with a 2 week history of joint pain; fever; malaise; as well as a new rash all over his body including his palms and soles. Diagnosis?
4415
Secondary (disseminated) syphilis
4416
Q2209:A patient with syphilis describes two papular lesions on his penis that are gray-white. What are these lesions
4417
Condylomata lata of the secondary stage of syphilis
4418
Q2210:A patient with syphilis admits that initially he had a red; firm; painless sore on his penis 6 weeks ago; but it disappeared. What is the lesion called
4419
Chancrethe primary stage of syphilis
4420
Q2211:What is the best way to diagnose syphilis in the primary stage
4421
Darkfield exam
4422
Q2212:Which serologic test detects syphilis the earliest; is the most specific; and stays positive even after treatment
4423
Fluorescent treponemal antibody absorption test (FTA-ABS)
4424
Q2213:Which serologic tests are used for presumptive diagnosis of syphilis
4425
VDRL and RPR
4426
Q2214:What are treatment options for syphilis in primary and secondary stages
4427
Penicillin Gintramuscular
4428
Q2215:What is the classic reaction hours after treatment for syphilis that involves shaking chills; sore throat; myalgia; and malaise
4429
Jarisch-Herxheimer reaction
4430
Q2216:If a patient with secondary syphilis is not treated; what are some outcomes in the following years
4431
One third of patients get tertiary syphilis (1-40 years after infection); Two thirds have no further symptoms
4432
Q2217:What are some of the findings in tertiary syphilis
4433
Iritis (Argyll Robertson pupil); Aortitis; Neurosyphilis (tabes dorsalis; paresis); Gummas
4434
Q2218:A 20 year old black male presents with a 1 month history of worsening back pain that is worse in the morning and improves with exercise. What is the suspected diagnosis
4435
Ankylosing spondylitis
4436
Q2219:What are some associated findings with ankylosing spondylitis
4437
Positive family history; Uveitis; Anemia
4438
Q2220:What clinical test for ankylosing spondylitis should be performed in the office
4439
Schober testdecreased angle of anterior flexion of the back; eliciting pain
4440
Q2221:What is the genetic association of ankylosing spondylitis
4441
AR; HLA-B27
4442
Q2222:What is classic sign of ankylosing spondylitis on radiographs
4443
Bamboo spine
4444
Q2223:A 45 year old male smoker complains of cold sensitivity and pain in his fingers. Some fingers have signs of gangrene. What is he suffering from
4445
Buergers disease (smoking and thromboangiitis obliterans)
4446
Q2224:What are the signs and symptoms of Buergers disease
4447
Intermittent claudication of small vessels; Raynauds phenomenon; Nodular phlebitis
4448
Q2225:What HLA types are increased in patients with Buergers disease
4449
HLA-A9 and HLA-B5
4450
Q2226:What is the treatment for Buergers disease
4451
Stop smoking
4452
Q2227:A 22 year old Asian female presents to your office with arthritis; fevers; night sweats; change in vision; and skin nodules. On physical exam; she is found to have weak and uneven pulses in the upper extremities. What disease should be ruled out
4453
Takayasus arteritis (pulselessness disease)
4454
Q2228:What vessels does Takayasu's arteritis affect
4455
Medium and large arteries
4456
Q2229:What lab test is usually abnormal in Takayasus arteritis
4457
ESR (elevated)
4458
Q2230:What imaging test should be done to confirm Takayasus arteritis
4459
Angiogram
4460
Q2231:In Takayasusus arteritis; what would an angiogram reveal
4461
Thickening (granulomatous inflammation) of the aortic arch and proximal vessels
4462
Q2232:What are some complications of Takayasus arteritis
4463
Pulmonary hypertension; Stroke
4464
Q2233:A 4 year old Japanese female presents to the ER with a 5 day history of fever above 102; arthritis; bright red lips; swollen hands and feet; and swollen lymph nodes. Diagnosis
4465
Kawasaki disease (mucocutaneous lymph node syndrome)
4466
Q2234:What are the criteria for a diagnosis of Kawasaki disease
4467
Fever >5 days; Lymphadenopathy; Bilateral conjunctival injection; Mucosal changes (fissuring; injection; strawberry tongue; erythema); Extremitiy changes (edema; erythema); Rash (truncal; may be desquamative); Arthritis (may be present)
4468
Q2235:What are the major complications of Kawasaki disease
4469
Myocardial infarction and coronary artery aneurysms
4470
Q2236:What autoantibodies are found in Kawasaki disease
4471
Antiendothelial antibodies
4472
Q2237:Which vessels does Kawasaki disease typically affect
4473
Large; medium; and small arteries
4474
Q2238:What should be done if Kawasaki disease is suspected
4475
Treat with aspirin and IV immunoglobuliins
4476
Q2239:Why is Kawasaki disease one of the only indications for using aspirin in children
4477
Reyes syndrome limits the use of aspirin in children; except in the treatment for Kawasaki disease
4478
Q2240:A 7 year old boy presents with arthritis; lower extremity palpable purpura; abdominal pain; and blood in the stool and urine. Diagnosis?
4479
Henoch-Schonlein purpura
4480
Q2241:What are two common histories with HenochSchonlein purpura
4481
Post-streptococcal infection or upper respiratory infection; History of insect bites
4482
Q2242:What types of immune complexes are found in tissue biopsy of Henoch-Schonlein purpura
4483
IgA dominant
4484
Q2243:Which vessels are mainly affected in HenochSchonlein purpura
4485
Small vessels (capillaries; venules; and arterioles)
4486
Q2244:A young man presents with arthritis; asthma; allergy; weight loss; fever; and vasculitis. What disease is suspected
4487
Churg-Strauss syndrome
4488
Q2245:What are some laboratory findings of Churg-Strauss syndrome
4489
Blood eosinophilia; Increased IgE
4490
Q2246:Which vessels are affected in Churg-Strauss syndrome
4491
Small and medium sized vessels
4492
Q2247:Which autoantibody groups are associated with Churg-Strauss
4493
Antineutrophil cytoplasmic antibody (ANCA); Antimyeloperoxidase
4494
Q2248:A 65 year old female presents with increasing headache; vision changes; scalp pain; and jaw pain. She also complains of a few previous months of aching joints and muscles. What should immediately be suspected
4495
Temporal (giant cell) arteritis
4496
Q2249:What should be done immediately when temporal (giant cell) arteritis is suspected
4497
Start high-dose steroids
4498
Q2250:What is the major complication of temporal arteritis that prompts administration of steroids
4499
Blindness
4500
Q2251:Which lab test is elevated in temporal arteritis
4501
ESR
4502
Q2252:What is the diagnostic test that confirms temporal arteritis
4503
Temporal artery biopsy
4504
Q2253:What would a biopsy of temporal arteritis show
4505
Granulomatous arteritis
4506
Q2254:What other disease is strongly associated with temporal arteritis
4507
Polymyalgia rheumatica
4508
Q2255:A 42 year old male presents with chronic sinusitis; hemoptysis; necrotizing granulomas of the nose and palate; and a previous diagnosis of crescentic glomerulitis. Diagnosis?
4509
Wegeners granulomatosis
4510
Q2256:Which vessels are usually affected in Wegeners granulomatosis
4511
Medium and small vessels of the respiratory tract and kidneys
4512
Q2257:Which antibody is found in Wegeners
4513
Cytoplasmic-ANCA (c-ANCA); predominantly antiproteinase 3
4514
Q2258:What deformity is associated with Wegeners
4515
Saddle nose deformity
4516
Q2259:Besides Wegeners; what is the other disease that involves both the respiratory tract (hemoptysis) and kidney (renal failure)
4517
Goodpastures syndrome
4518
Q2260:What is the antibody associated with Goodpastures syndrome
4519
Antiglomerular basement membrane
4520
Q2261:What does immunoflorescence of affected tissue in Goodpastures syndrome show
4521
Linear deposits of IgG and C3 in the glomerular basement membrane
4522
Q2262:A 40 year old black female present with increasing shortness of breath; polyarthritis; change in vision; fevers; and malaise. On chest x-ray; there is bilateral hilar lymphadenopathy. What is the most likely diagnosis
4523
Sarcoidosis
4524
Q2263:What electrolyte abnormality is common with sarcoidosis
4525
Hypercalcemia
4526
Q2264:On biopsy of affected tissue; what is the classic finding in sarcoidosis
4527
Noncaseating granulomas
4528
Q2265:What skin findings are associated with sarcoidosis
4529
Erythema nodosum; Lupus pernio
4530
Q2266:A 26 year old white male presents with malaise; fever; weight loss; hypertension; ab pain; and melena. He has a history of hepatitis B and drug use. What disease is suspected
4531
Polyarteritis nodosa (PAN)
4532
Q2267:How is a diagnosis of polyarteritis made
4533
Tissue biopsy showing transmural necrotizing arteritis of medium-sized arteries
4534
Q2268:What is the treatment for polyarteritis nodosa
4535
Steroids and cyclophosphamide
4536
Q2269:What is the disease that is a variation of polyarteritis nodosa; which affects smaller arterioles; capillaries; and venules rather than the larger vessels
4537
Microscopic polyangiitis (leukocytoclastic vasculitis)
4538
Q2270:What clinical symptoms do patients with microscopic polyangiitis have
4539
Hemoptysis; Hematuria; Abdominal pain/blood in stool; Skin findings (purpura)
4540
Q2271:Which antibody is microscopic polyangiitis most closely associated with
4541
p-ANCA
4542
Q2272:A 50 year old man presents with fever; arthralgias; and palpable purpura on the lower extremities after starting several new medications. What is the most likely diagnosis
4543
Hypersensitivity angiitis
4544
Q2273:How is the diagnosis of hypersensitivity angiitis made
4545
Skin biopsy showing infiltration of dermal capillaries
4546
Q2274:A 55 year old white female presents with polyarthritis; dysphagia and reflux esophagitis; pulmonary fibrosis; and hypertension. On exam; her face appears tight and masklike and she has swelling of the hands and thickening of the skin. What is the most likely diagnosis
4547
Scleroderma (systemic scleroderma)
4548
Q2275:What is the autoantibody that is most closely associated with scleroderma
4549
Anti-DNA topoiosomerase I (anti-Scl-70)
4550
Q2276:What is the more limited version of scleroderma
4551
CREST syndrome
4552
Q2277:What are the characteristics of CREST syndrome
4553
Calcinosis (subcutaneous); Raynaud phenomenon; Esophageal dysfunction; Sclerodactyly; Telangiectasia
4554
Q2278:What antibodies are most closely associated with CREST syndrome
4555
Anticentromere antibody
4556
Q2279:A 50 year old white female presents with very dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca). She reports that she has several dental caries filled recently. What is the most likely syndrome
4557
Sjogrens disease
4558
Q2280:What are some GI symptoms commonly associated with Sjogrens
4559
Constipation and pancreatic insufficiency due to gland destruction
4560
Q2281:How is Sjogrens disease diagnosed
4561
Lip biopsy; Schirmers test (showing decreased lacrimation)
4562
Q2282:What autoantibodies are associated with Sjogrens disease
4563
Antinuclear antibody (ANA) (nonspecific) and antinucleoprotein antibodies (SS-A[Ro] and SS-B)
4564
Q2283:What are patients with Sjogrens at risk for developing
4565
Lymphoma
4566
Q2284:A 23 year old white female presents with a 6 month history of weight loss; muscle weakness; palpitations; diarrhea; and fine tremor. Tachycardia and exophthalmos are present. What do you suspect
4567
Graves disease (diffuse toxic goiter)
4568
Q2285:What autoantibody causes Graves disease
4569
Thyroid-stimulating hormone (TSH)-receptor antibody
4570
Q2286:A 23 year old white female develops limb weakness; ptosis; diplopia; and difficulty chewing. Weakness improves after rest. Sensation and reflexes remain intact and normal. What disease is suspected
4571
Myasthenia gravis
4572
Q2287:How is the diagnosis of myasthenia gravis confirmed
4573
Edrophonium challenge temporarily improves muscle strength
4574
Q2288:What is edrophonium
4575
Anticholinesterase inhibitor
4576
Q2289:What causes myasthenia gravis
4577
Antiacetylcholine-receptor antibody
4578
Q2290:What HLA type is associated with myasthenia gravis
4579
HLA-DR3
4580
Q2291:What diseases are associated with myasthenia gravis
4581
Thymoma; Thyrotoxicosis
4582
Q2292:What treatments are available for myasthenia gravis
4583
Anticholinesterase drugs; Corticosteroids; Thymectomy; Plasmapheresis
4584
Q2293:A 55 year old white woman presents with 1 month history of proximal muscle weakness and pain; increasing fatigue; and malaise. What disease should be ruled out
4585
Polymyositis
4586
Q2294:What lab finding support the diagnosis of polymyositis
4587
Increased ESR; Increased CPK; Increased aldolase; Increase LDH; Antinuclear may be positive; Abnormal electromyography
4588
Q2295:What is the only specific test that provides a definitive diagnosis of polymyositis
4589
Muscle biopsy showing lymphoid inflammation
4590
Q2296:What disease is characterized by symptoms and lab values similar to polymyositis; but also has a lilac edematous rash on the eyelids
4591
Dermatomyositis
4592
Q2297:What is the name of the rash on the eyelids found in dermatomyositis
4593
Heliotrope rash
4594
Q2298:What are patients with dermatomyositis and polymyositis at an increased risk of developing
4595
Ovarian cancer
4596
Q2299:What is the treatment for dermatomyositis and polymyositis
4597
High-dose steroids
4598
Q2300:A 55 year old white female complains of 3 months of neck stiffness; pelvic and pectoral girdle weakness; and pain; fatigue; and malaise. What is the most likely diagnosis
4599
Polymyalgia rheumatica
4600
Q2301:What lab values would be abnormal in polymyalgia rheumatica
4601
Elevated ESR
4602
Q2302:With what disease is polymyalgia rheumatica associated
4603
Temporal arteritis
4604
Q2303:A 45 year old white woman presents with a 2 month history of decreased sleep and several (>11) very tender points on her anterior and posterior torso and neck that produce extreme pain with palpation. She has a history of anxiety disorder and depression. Diagnosis?
4605
Fibromyalgia
4606
Q2304:What lab values should be evaluated in fibromyalgia
4607
CBCnormal; ESRnormal
4608
Q2305:How should a patient with fibromyalgia be treated
4609
NSAIDs and antidepressants
4610
Q2306:Dx;autosomal dominant trait leading to the failure of longitudinal bone growth; causing short limbs
4611
Achondroplasia
4612
Q2307:Dx;Pannus formation in joints
4613
Rheumatoid Arthritis
4614
Q2308:Dx;increased bone resorption due to decreased estrogen levels
4615
Osteoporosis (type 1);(type 2 is men and women >70)
4616
Q2309:(2) common fractures due to Osteoporosis
4617
Vertebral crush fractures;;Collies distal Radius Fx
4618
Q2310:Definition;failure of normal bone resorption leading to thick; dense bones due to abnormal function of Osteoclasts; no labs elevated; "marble bone Dz"
4619
OsteoPETrosis
4620
Q2311:Definition;increase in oseteoblastic and osteoclastic activity; all labs normal except great increase in Alk Phos
4621
Padget Dz of the Bone
4622
Q2312:Dx;bone replaced w/ fibroblasts and collagen (PFD) in unilateral bones; precocious puberty; unilateral pigmented skin
4623
Albright's syndrome
4624
Q2313:Definition;pain and stiffness in shoulders and hips; often w/ fever and weight loss in pt >50yo;what is it assoc w/?
4625
Polymyalgia rheumatica;;assoc w: Temporal (giant cell) arteritis
4626
Q2314:what joint problem can be caused by G6PD deficiency?
4627
Gout
4628
Q2315:Dx;painful MTP joint; formations on external ear or achilles tendon;test?
4629
Gout;(Tophus formations are on ear and achilles);Test: joint aspiration;(Needle-shaped Negatively birefringement)
4630
Q2316:Dx;calcium crystals in the knee;test?
4631
Pseudogout;Test: joint aspiration;(Basophilic; rhomboid; Positively Birefringement)
4632
Q2317:Dx;Gammaglobinemia; RA; ACE increase; Interstitial lung fibrosis; Noncaseating granulomas
4633
Sarcoidosis;"GRAIN"
4634
Q2318:(2) types of Seronegative spondyloarthropathies ;(arthritis w/o rheumatoid factor)
4635
Ankylosing Spondylitis;Reiter's syndrome
4636
Q2319:Dx;chronic inflammatory dz of spine and sacroiliac joints; uveitis and aortic regurg
4637
Ankylosing Spondylitis
4638
Q2320:Dx;Urethritis; conjunctivitis and anterior uveitis and arthritis
4639
Reiter's syndrome;(Can't see; can't pee; can't climb a tree)
4640
Q2321:Dx;an acquired loss of melanocytes in descrete areas of skin that appear as depigmented white patches
4641
Vitiligo
4642
Q2322:Definition;epidermal hyperplasia and hyperpigmentation most often in flexural areas and a marker of visceral malignancy
4643
Acanthosis Nigricans
4644
Q2323:Dx;port-wine stain on the face; ipsilateral glaucoma; vascular lesions of ocular tissue; extensive hemangiomatous involvement of meninges
4645
Sturge-Weber syndrome
4646
Q2324:Dx;pruitic eruption; commonly on the flexor surfaces;(2 names)
4647
Atopic Dermatitis;(Eczema)
4648
Q2325:Dx;Epidermal hyperplasia w/ parakeratotic scaling especially on knees and elbows;what layer of skin is increased?;Decreased?
4649
Psoriasis;;Inc Spinosum;Dec Granulosum
4650
Q2326:Definition;Pruritic papules and vesicles associated w/ Celiac sprue
4651
Dermatitis Herpetiformis
4652
Q2327:Dx;Pruitic; purple; polygonal papules; infiltrate of lymphocytes at the dermalepidermal junction
4653
Lichen Planus;[Lymphocytes = Lichen]
4654
Q2328:Definition;assoc w/ infections; drugs; CA and autoimmune Dz; presents w/multiple types of lesions including macules; papules; vesicles and Target lesions
4655
Erythema Multiforme
4656
Q2329:Dx;erythema multiforme; high fever; bulla formation and necrosis; ulceration of skin; high mortality rate
4657
Stevens-Johnson syndrome
4658
Q2330:Dx;common benign flat pigmented squamous epithelial proliferation of keratin-filled (horn) cysts that look pasted-on
4659
Seborrheic Keratosis
4660
Q2331:Definition;subepidermal blistering w/ characteristic inflammatory infiltrate of eosinophils in the surrounding dermis;auto Ab against epidermal BM
4661
Bullous Pemphigoid
4662
Q2332:Dx;Blistering of oral mucosa with extensive skin involvement following; breakdown of cell-to-cell junctions w/ sparing of basement layer; auto Ab against epidermal cell surface
4663
Pemphigus Vulgaris
4664
Q2333:Dx;skin cancer of face and hands w/ keratin "pearls"
4665
Squamous cell CA
4666
Q2334:Dx;skin cancer in sun-exposed areas of body; pearly papules w/ "palisading" nuclei
4667
Basal cell CA
4668
Q2335:Dx;skin CA that can metastasize;what characteristic correlates to increased risk of metastasis?
4669
Melanoma;;(Inc Depth of tumor = Inc Mets)
4670
Q2336:what is common w/ all primary metatastic bone tumors?
4671
they are all "Sarcomas"
4672
Q2337:Dx;epiphyseal tumor at end of long bone (usu at knee) w/ spindle-shaped cells and "soap bubble" or "double bubble"
4673
Giant cell Tumor;;(MC female bone tumor)
4674
Q2338:Dx;bone growth covered by a cap of cartilage; usu in men < 25yo
4675
Osteochondroma
4676
Q2339:Dx;benign neoplasm of intermedullary bone usu in fingers and toes and w/o pain
4677
Endochondroma
4678
Q2340:Dx;replacement of intermedullary bone w/ fibrous tissue; "ground-glass" appearance on x-ray; "Chinese character" w/o osteoblasts
4679
Fibrous Displasia
4680
Q2341:Definition;;Giant cell-like bone tumor of metaphysis or vertebrae; pain and swelling; hemorrhagic cysts w/ giant cells
4681
Aneurysmal Bone Cyst
4682
Q2342:Dx;males < 25yo w/ central "nidus" of osteoid surrounded by a shell; painful (wake from sleep); responsive to aspirin
4683
Osteoid Osteoma
4684
Q2343:Dx;boys < 15yo w/ tumor of pelvis or shaft of long bones; small round blue cell tumor; PAS+; "Onionskin" look to bone;what translocation?
4685
Ewing Sarcoma;[eWINGS and Onion rings];t(11;22)
4686
Q2344:Dx;bone tumor w/ osteoid spindle cells; usu the knee; painful and aggressive; Inc Alk Phos; elevation of periosteum ;(Codman's triangle)
4687
Osteosarcoma;(MC primary bone malignancy)
4688
Q2345:Dx;malignant cartilaginous tumor in the central skeleton; painful and slow-growing; bluish-white appearance w/ sectioning
4689
Chondrosarcoma
4690
Q2346:Dx;weakness in proximal muscles of extremities; later compensatory hypertrophy of distal site (calf) and eventual pseudohypertrophy; Inc serum CK; death from weak resp muscles;genetics?
4691
Duchenne Muscular Dystrophy;(frameshift deletion of Dystrophin)
4692
Q2347:Definition;similar to DMD; but less severe; segmental deletions in Dystrophin
4693
Becker muscular dystrophy
4694
Q2348:Dx;Inability to relax muscles once contracted; weakness; cataracts and testicular atrophy
4695
Myotonic Dystrophy;(CTG repeats - Auto Dominant)
4696
Q2349:Dx;weakness of extraocular and facial muscles; muscle weakness w/ use and recovery w/ rest; difficult chewing; swallowing; resp failure; more common in women
4697
Myasthenia Gravis;(Ab to ACh receptor)
4698
Q2350:Definition;paraneoplastic syndrome w/ clinical manifestations similar to those of myasthenia gravis
4699
Lambert-Eaton syndrome;(MC w/ Small cell CA of Lung)
4700
Q2351:Dx;pigeon breast; string-of-beads in costochondrial junction; depression along line of insertion of diaphragm to rib cage (Harrison groove); High-output Cardiac failure
4701
Rickets;(Vit D deficiency)
4702
Q2352:Achondroplasia?
4703
mutation of fibroblast growth factor receptor 3
4704
Q2353:What happens with the mutation of FGFR3?
4705
results in the reduction of the proliferation of chondrocytes on growth plate
4706
Q2354:Morphology of Achondroplasia?
4707
zones of proliferation and hypertrophy are narrowed and disorganized and contain clusters of large chondrocytes instead of well-formed columns
4708
Q2355:Osteogenesis Imperfecta?
4709
deficiency in synthesis of type 1 collagen
4710
Q2356:deficiency in synthesis of type 1 collagen?
4711
incorporation of defective alpha2 chains that cause instability and degradation of the triple helix
4712
Q2357:Osteogenesis Imperfecta Type II
4713
fatal in utero or during the perinatal period;fetus is still within the womb
4714
Q2358:Findings for Osteogeness Imperfecta?
4715
extreme skeletal fragility;blue sclerae caused by a decrease in collagen content; exposing the coridal veins;hearing loss related to both a sensorineural deficit and impeded conduction owing to abnormalities in the bones of the middle and inner ear;dental imperfections due to a deficiency of dentin;
4716
Q2359:Mucopolysaccharidoses
4717
caused by deficiencies in the enzymes
4718
Q2360:Deficient enzymes in Mucopolysaccharidoses
4719
that degrade dermatan sulfate; heparan sulfate; and keratan sulfate
4720
Q2361:Mucopolysaccharidoses
4721
abnormalities in hyaline cartilage
4722
Q2362:Signs of Mucopolysaccharidoses
4723
patients are frequently of short stature and have chest wall abnormalities and malformed bones
4724
Q2363:Hunter's syndrome
4725
associated with increased tissue stores and excretion of dermatan sulfate and heparan sulfate
4726
Q2364:Senile Osteoporosis
4727
continuous loss of bone at both the trabecular and cortical layers; which become thinner by internal resorption
4728
Q2365:Steroid-induced Osteoporosis
4729
catabolic effect of corticosteroids may affect trabecular bone; producing a decrease in bone formation
4730
Q2366:Effects of Steroids on Caclium absorption
4731
steroids also decrease intestinal absorption and renal resorption of calcium; so that less calcium reaches the bone
4732
Q2367:Post-menopausal osteoporosis
4733
most common after the fifth decade of life;decreased remodeling and decreased amount of bone deposited by osteoblasts;b/c lack of estrogen
4734
Q2368:Immobilization osteoporosis
4735
confinement of bed results in a loss of 30% of initial bone volume;lack of exercise seems to be the cause;
4736
Q2369:anorexia nervosa and osteoporosis
4737
anorexia nervosa leads to osteoporosis in women b/c of loss of menstrual period;reduction in bone mass with normal bone mineralization
4738
Q2370:Osteopetrosis
4739
Marble bone disease; Albers-Schonberg disease
4740
Q2371:Osteopetrosis
4741
osteoclast dysfunction;stonelike quality of the bones; however; the bones are abnormally brittle and fracture like a piece of chalk
4742
Q2372:Osteopetrosis xray findings
4743
Erlenmeyer flask
4744
Q2373:Deficiency seen in Osteopetrosis
4745
carbonic anhydrase II deficiency
4746
Q2374:Morphology of Osteopetrosis
4747
osteoclasts lack the usual ruffled borders and show decreased functioning
4748
Q2375:Clinical features of Osteopetrosis
4749
fractures; anemia; hydrocephaly are often seen;
4750
Q2376:Paget Disease (Osteitis Deformans)
4751
haphazard arrangement of cement lines
4752
4753
can often lead to bell's palsy if impinging on the CN VII
4754
4755
predilection for the skull; pelvis; tibia; and femur
4756
Q2379:Paget Disease (Osteitis Deformans) Lab findings
4757
serum alkaline phosphatase level is markedly elevated/increased levels of urinary hydroxyproline;
4758
Q2380:X ray findings ofr Pagets
4759
bone lysis and reformation are characteristic;
4760
Q2381:Pathology of Pagets
4761
"mosaic" pattern of osteoclasts;so termed b/c of cement like material forms narrow boundaries
4762
Q2382:Cancer associated with Pagets Disease
4763
often associated with Osteosarcoma
4764
Q2383:Treatment for Pagets
4765
administration of calcitonin; which decreases the resorption
4766
Q2384:Signs and Symptoms of Pagets
4767
bone pain; fractures; and deformities;deafness when skull is affected;height distortion due to vertebral compression
4768
Q2385:Osteonecrosis (AvascularNecrosis)Differential Diagnosis
4769
1) mechanical vascular interruption (fracture);2) corticosteroids;3)thrombosis and embolism (nitrogen bubbles in dysbarism)4) vessel injury (vasculitis; radiation therapy)5) increased intraosseous pressure with vascular compression;6) venous hypertension
4770
Q2386:Osteonecrosis course
4771
chronic pain that is initially associated only with activity but then becomes progressively more constant until finally it is present at rest
4772
Q2387:MCC bilateral segmental osteonecrosis or avascular necrosis (AVN) of the femoral head
4773
systemic steroid therapy
4774
Q2388:Osteomyelitis
4775
inflammation of the medullary and cortical portions of bone; including the periosteum
4776
Q2389:Osteomyelitis bones affected; child vs adult
4777
children; the long bones are most often affected; in adults; the vertebrae
4778
Q2390:Osteomyelitis Pathogenesis
4779
1) Most commonly; the hematogenous spread of bacteria from a distant focus of sepsis;2) Invasion of bone from adjacent septic arthritis or soft tissue abscesses;3) Penetrating trauma;4) Complication of fractures;5) Complications of surgery
4780
Q2391:Osteomyelitis increased risk
4781
pts with sickle cell disease; hemodialysis patients; patients with bone or joint prostheses; and intravenous drug abusers
4782
Q2392:Pyogenic Osteomyelitis caused by
4783
Staphylococcus aureus is responsible for 80% to 90% of the cases
4784
Q2393:What are in utero manifestations of complete/bilateral renal agenesis? How common is this?
4785
Oligohydramnios occurs because the renal system is not excreting fluids swallowed by the fetus;This results in the oligohydramnios sequence: multiple fetal abnormalities including hypoplastic lung; defects in extremities; etc.
4786
Q2394:What are the clinical manifestations of the nephrotic syndrome?
4787
Massive proteinuria: >4 g per day;Hypoalbuminemia: <3 g per deciliter;Generalized Edema;Hyperlipidemia and Hypercholesterolemia: due to increased hepatic lipoprotein synthesis
4788
Q2395:What is Minimal Change Disease?
4789
Prototypical nephrotic syndrome. Most often in young children but can occur in older individuals;Light microscopy shows normal glomeruli;Electron microscopy is normal except for effacement of epithelial foot processes;Responds well to steroid therapy;Pathogenesis may be related to mutations in nephrin.
4790
Q2396:What is focal segmental glomerulosclerosis?
4791
Like the name: focal; involving only a subset of glomeruli; segmental; involving only a portion of the glomerular tuft;Symptoms include nephrotic syndrome or non-nephrotic proteinuria. Like minimal change disease; there is a loss of foot processes. There is also sclerosis -- collapse of the basement membranes; increase in matrix; and hyalinosis of the capillary wall with possible obstruction;Responds poorly to steroids.
4792
Q2397:What is membranous glomerulonephritis?
4793
An immune complex disease of unknown etiology that causes the nephrotic syndrome and azotemia;Light microscopy shows thickened capillary walls due to a five to 10 fold thickening of the basement membrane. Epimembranous (subepithelial) deposits with a spike and dome appearance. Granular pattern on immunofluorescence.
4794
Q2398:What is diabetic nephropathy?
4795
Dramatic thickening of the entire glomerular basement membrane; seen by electron microscopy;Other changes include an increase in mesangial matrix in both a diffuse and nodular (Kimmelstiel-Wilson nodules) pattern.
4796
Q2399:What is renal amyloidosis?
4797
Presents with nephrotic syndrome; due to subendothelial and mesangial amyloid deposits;Often caused by chronic inflammatory diseases such as rheumatoid arthritis or plasma cell disorders such as multiple myeloma.
4798
Q2400:What are the five patterns of lupus nephropathy?
4799
Type 1: no observable renal involvement;Type 2: mesangial cell and matrix proliferation; with slight proteinuria and minimal hematuria;Type 3: focal proliferative -- not all glomeruli involved; but some severely damaged;Type 4: diffuse proliferative -- all glomeruli involved with inflammation; thromboses; mesangial proliferation; and scarring. Also see wire loop abnormalities; endothelial cell proliferation; and subendothelial immune complex deposition;Type 5: membranous form -- same as primary membranous glomerulonephritis
4800
Q2401:What are the characteristics of the nephritic syndrome?
4801
Oliguria; azotemia; hypertension; hematuria with red cell casts. Patients often report having "smoky brown urine".
4802
Q2402:What is poststreptococcal glomerulonephritis?
4803
Prototype of the nephritic syndrome. Immune complex disease due to GAS infection. 95% show complete recovery; but a small minority develops rapidly progressive glomerulonephritis;Causes an inflammatory reaction with renal surface petechiae; enlarged; hypercellular glomeruli; normal basement membrane thickness; subepithelial bumps; and "lumpy bumpy" immunofluorescence.
4804
Q2403:What is rapidly progressive (crescentic) glomerulonephritis (RPGN)?
4805
Nephritic syndrome that progresses to renal failure within weeks or months. Crescents are formed by fibrin deposition in Bowman space and proliferation of epithelial cells;Type I: anti-GBM disease;Type II: poststreptococcal (50%);Type III: pauci-immune; associated with ANCAs
4806
Q2404:What is Goodpasture's syndrome?
4807
Nephritic syndrome; pneumonitis with hemoptysis; and RPGN crescentic glomerulonephritis due to anti-glomerular basement membrane antibodies;Fluorescent antibody staining demonstrates a linear pattern.
4808
Q2405:What is focal glomerulonephritis?
4809
Focal and segmental inflammatory changes (contrast to sclerotic changes in focal segmental glomerulosclerosis);Due to immune complexes; often secondary to SLE; subacute bacterial endocarditis; polyarteritis nodosa; Goodpasture's syndrome; Wegener granulomatosis; and IgA nephropathy. Can also be idiopathic.
4810
Q2406:What is Alport syndrome?
4811
Hereditary nephritis associated with nerve deafness; and ocular disorders (lens dislocation; cataracts);Due to a mutation of the Alpha-5 chain of type IV collagen; often causes endstage renal disease by 30 years of age;Microscopically; irregular glomerular basement membrane thickening/thinning with foci of splitting of the lamina densa.
4812
Q2407:ureter crosses anterior to the origin of what artery to enter the pelvis?
4813
external iliac
4814
Q2408:ovoid; PAS-positive hyaline masses
4815
Kimmelstiel-Wilson nodule - most specific lesion of diabetic glomerulosclerosis
4816
Q2409:nephrotic syndrome in IV drug user or HIV nephropathy
4817
focal segmental glomerulosclerosis
4818
Q2410:renal pathology associated with DIC?
4819
diffuse cortical necrosis
4820
Q2411:Potter's syndrome?
4821
bilateral renal agenesis - oligohydraminos; limb & facial deformities;pulmonary hypoplasia
4822
Q2412:cause of Potter's syndrome?
4823
malformation of ureteric bud
4824
Q2413:why do kidneys stay low in abdomen in horseshoe kidney?
4825
get trapped under IMA
4826
Q2414:RBC casts in urine
4827
glomerular inflammation (nephritic syndromes); ischemia; or malignant hypertension
4828
Q2415:WBC casts in urine
4829
tubulointerstitial disease; acute pyelonephritis; glomerular disorders
4830
Q2416:granular casts in urine
4831
acute tubular necrosis
4832
Q2417:waxy casts in urine
4833
advanced renal disease/CRF
4834
Q2418:hyaline casts in urine
4835
nonspecific
4836
Q2419:LM: glomeruli enlarged and hypercellular; neutrophils; lumpy-bumpy; EM: subepithelial humps; IF: granular pattern
4837
acute postreptococcal glomerulonephritis
4838
Q2420:LM and IF: crescent moon shape
4839
rapidly progressive (crescentic) glomerulonephritis
4840
Q2421:finding on immunofluorescence in Goodpasture's?
4841
linear pattern; anti-GBM IgG Abs
4842
Q2422:IF and EM findings in Berger's disease?
4843
mesangial IgA deposits (Berger's also known as IgA nephropathy)
4844
Q2423:split basement membrane with nerve deafness and lens dislocation or cataracts
4845
Alport's syndrome
4846
Q2424:mutation in Alport's? characteristic findings?
4847
collagen IV; nerve deafness and ocular disorders
4848
Q2425:hematuria; hypertension; oliguria; azotemia
4849
nephritic syndrome
4850
Q2426:findings in nephrotic syndrome
4851
massive proteinuria; hypoalbuminemia; peripheral and periorbital edema; hyperlipidemia
4852
Q2427:LM: diffuse capillary and BM thickening; IF: granular pattern; EM: spike and dome
4853
membranous glomerulonephritis
4854
Q2428:findings in minimal change disease/lipoid nephrosis?
4855
LM: normal glomeruli; EM: foot process effacement
4856
Q2429:LM: segmental sclerosis and hyalinosis
4857
focal segmental glomerular sclerosis - most severe disease in HIV patients
4858
Q2430:findings in diabetic nephropathy
4859
LM: Kimmelstiel-Wilson lesions; basement membrane thickening; glomeruli appear like golf balls
4860
Q2431:findings in membranous glomeruloneprhitis in SLE
4861
wire-loop lesion with subepithelial deposits
4862
Q2432:most common type of kidney stones?
4863
calciium oxalate; calcium phosphate; or both
4864
Q2433:second most common type of kidney stone; can form staghorn calculi that can be nidus for UTIs
4865
ammonium magnesium phosphate (struvite)
4866
Q2434:infection with what type of organism leads to struvite kidney stones?
4867
urease-positive bugs - proteus vlugaris; staph; klebsiella
4868
Q2435:kidney stones often seen as a result of diseases with increased cell turnover; such as leukemia and myeloproliferative disorders
4869
uric acid
4870
Q2436:types of radiolucent kidney stones?
4871
uric acid and cystine
4872
Q2437:gene association with renal cell carcinoma?
4873
deletion of VHL gene on chromosome 3
4874
Q2438:where does renal cell carcinoma originate?
4875
renal tubule cells (polygonal clear cells)
4876
Q2439:renal cell carcinoma is associated with what syndromes?
4877
paraneoplastic (ectopic EPO; ACTH; PTHrP; and prolactin)
4878
Q2440:gene association with Wilm's tumor?
4879
deletion of tumor suppressor WT1 on chromosome 11
4880
Q2441:WAGR complex?
4881
Wilm's tumor; Aniridia; genitourinary malformation; and mental-motor retardation
4882
Q2442:most common tumor of the urinary tract system?
4883
transitional cell carcinoma
4884
Q2443:transitional cell carcinoma is associated with what?
4885
problems in your Pee SAC;phenacetin; smoking; analine dyes; and cyclophosphamide
4886
Q2444:white cell casts in urine are pathognomonic for what?
4887
acute pyelonephritis
4888
Q2445:chronic pyelonephritis clinical manifestations?
4889
coarse; asymmetric corticomedullary scarring and blunted calyces; tubules can contain eosinophilic casts (thyroidization of the kidney)
4890
Q2446:most common cause of acute renal failure?
4891
acute tubular necrosis
4892
Q2447:what is acute tubular necrosis associated with?
4893
renal ischemia (e.g. shock); crush injury (myoglobinuria); toxins
4894
Q2448:when does death most often occur in ATN?
4895
during initial oliguric stage
4896
Q2449:what is renal papillary necrosis associated with?
4897
diabetes; acute pyelonephritis; chronic phenacitin use; sickle cell anemia
4898
Q2450:what is uremia?
4899
clinical syndrome marked by increased BUN and creatinine and associated symptoms
4900
Q2451:metabolic consequences seen in renal failure?
4901
1. Anemia (decreased EPO);2. Renal osteodystrophy (failure of active vitamin D production);3. Hyperkalemia;4. metabolic acidosis due to decreased acid secretion and decreased HCO3generation;5. Uremic encephalopathy;6. Sodium and H2O excess --> CHF and pulmonary edema;7. Chronic pyelonephritis;8. Hypertension
4902
Q2452:low serum chloride concentration is caused by what?
4903
is secondary to metabolic alkalosis; hypokalemia; hypovolemia; increased aldosterone
4904
Q2453:high serum chloride concentration is secondary to what?
4905
non-anion gap acidosis
4906
Q2454:most common cause of nephrotic syndrome in adults?
4907
membranous glomerulonephritis
4908
Q2455:Obese male aged 50-70 years; smoker; with hematuria and palpable mass; fever; weight loss. what is diagnosis?
4909
Renal cell carcinoma
4910
Q2456:loop diuretic indicated for the treatment of edema associated with CHF; cirrhosis; and renal disease?
4911
furosemide (also HTN and hypercalcemia)
4912
Q2457:two principal causes of rapidly progressive glomerulonephritis?
4913
anti-glomerular basement membrane and primary systemic vasculitis
4914
Q2458:drugs implicated in the pathogenesis of acute interstitial nephritis?
4915
NSAIDs; beta-lactam antibiotics (penicillins and cephalosporins); sulfonamides; diuretics (furosemide and thiazides); phenytoin; cimetidine; methyldopa
4916
Q2459:EM: subendothelial humps; mesangial proliferation (splits BM)
4917
membranoproliferative glomerulonephritis
4918
Q2460:What does the presence of casts in the urine indicate?
4919
hematuria/pyuria is of renal origin
4920
Q2461:What do RBCs in urine with no casts indicate?
4921
Bladder cancer
4922
Q2462:What does WBCs in urine with no casts inddicate?
4923
Acute cystitis
4924
Q2463:This nephritic syndrome is most frequently seen in children and presents with peripheral and periorbital edema
4925
Acute poststreptococcal glomerulonephritis. resolves spontaneously
4926
Q2464:Outcome of Membranoproliferative glomerulonephritis?
4927
slowly progresses to renal failure
4928
Q2465:outcome of Rapidly progressive glomerulonephritis?
4929
rapid course to renal failure. number of crescents indicates prognosis
4930
Q2466:this is a common cause of recurrent hematuria in young patients
4931
IgA nephropathy (Berger's disease)
4932
Q2467:Immunofluorescent congo red stain of glomeruli show apple-green birefringence. What is the diagnosis?
4933
Amyloidosis
4934
Q2468:Amyloidosis is associated with what conditions?
4935
multiple myeloma; chronic conditions; TB; rheumatoid arithritis
4936
Q2469:Which conditions may lead to hypercalciuria and stones?
4937
hypercalcemic conditions: cancer; increased PTH; increased vitamin D; milk-alkali syndrome
4938
Q2470:child aged 2-4 presents with huge; palpable flank mass; hemihypertrophy. The mass contains embryonic glomerular structures. What is the tumor?
4939
Wilms' tumor
4940
Q2471:What causes diffuse cortical necrosis?
4941
likely due to a combination of vasospasm and DIC. Associated with obstetric catastrophes and sepsis
4942
Q2472:acute interstitial renal inflammation with fever; rash; eosinophilia and hematuria beginning 2 weeks after taking what drugs?
4943
Drug-induced interstitial nephritis; penicillins; NSAIDS; diuretics
4944
Q2473:Patient presents with acute renal failure. labs show Urine osmolality >500; Urine Na <10; Fe(Na) <1% and BUN/Cr >20. Where is the problem
4945
Prerenal
4946
Q2474:Patient presents with acute renal failure. labs show Urine osmolality <350; Urine Na >20; Fe(Na) >2% and BUN/Cr <15. Where is the problem
4947
Renal
4948
Q2475:Patient presents with acute renal failure. labs show Urine osmolality <350; Urine Na >40%; BUN/Cr >15. What is the cause?
4949
post-renal; generally outflow obstruction due to stones; BPH or neoplasia
4950
Q2476:What is Fanconi's syndrome? What are its complications?
4951
Defect in proximal tubule transport. Complications include rickets; osteomalacia; hypokalemia; metabolic acidosis
4952
Q2477:patient presents with flank pain; hematuria; hypertension; urinary infection and progressive renal failure. US shows multiple; large; bilateral renal cysts. What is the underlying cause?
4953
APKD from AD mutation in APKD1 gene
4954
Q2478:low serum Na causes what?
4955
disorientation; stupor; coma
4956
Q2479:high serum Na causes what?
4957
neurologic: irritability; delirium; coma
4958
Q2480:low serum K causes what?
4959
U waves on ECG; flattened T waves; arrhythmias; paralysis
4960
Q2481:high serum K causes what?
4961
peaked T waves; wide QRS; arrhythmias
4962
Q2482:low serum Ca causes what?
4963
tetany; neuromuscular irritability
4964
Q2483:high serum Ca causes what?
4965
delirium; renal stones; abdominal pain; not necessarily calciuria
4966
Q2484:low serum Mg causes what?
4967
neuromuscular irritability; arrhythmias
4968
Q2485:high serum Mg causes what?
4969
delirium; decreased DTRs; cardiopulmonary arrest
4970
Q2486:low serum PO4 causes what?
4971
low-mineral ion product causes bone loss; osteomalacia
4972
Q2487:high serum PO4 causes what?
4973
high-mineral ion product causes metastatic calcification; renal stones
4974
Q2488:mechanism of mannitol?
4975
osmotic diuretic; increased tubular fluid osmolarity; producing increased urine flow. works in PCT
4976
Q2489:mannitol contraindications?
4977
anuria; CHF
4978
Q2490:mechanism of acetazolamide?
4979
Carbonic anhydrase inhibitor. Acts in PCT. depletion of HCO3
4980
Q2491:major toxicity of acetazolamide?
4981
hyperchloremic metabolic acidosis
4982
Q2492:mechanism of furosemide?
4983
loop diuretic. inhibits Na/K/Cl cotransport in thick ascending limb. reduces hypertonicity of medulla preventing concentration of urine in the collecting tubule. also promotes loss of Ca due to decreased electrochemical gradient
4984
Q2493:major toxicity of furosemide?
4985
OH DANG!;Ototoxicity; Hypokalemia; Dehydration; Allergy (sulfa); Nephritis (interstitial); Gout
4986
Q2494:mechanism of ethacrynic acid
4987
loop diuretic blocks Na/K/Cl cotransporter; reduces ability to concentrate urine
4988
Q2495:major toxicity of ethacrynic acid
4989
gout
4990
Q2496:mechanism of hydrochlorothiazide
4991
thiazide diuretic. inhibits NaCl reabsorption in early distal tubule; reducing diluting capacity of nephron. decreases Ca excretion
4992
Q2497:toxicities of hydrochlorothiazide
4993
hypokalemic metabolic acidosis; hypercalcemia; sulfa allergy
4994
Q2498:What are the K sparing diuretics?
4995
Spironolactone; Triamterene; Amiloride; eplerenone
4996
Q2499:Mechanism of spironolactone?
4997
competitive aldosterone receptor antagonist in cortical collecting tubule
4998
Q2500:mechanism of Triamterene and amiloride?
4999

IVMS Cell Biology and Pathology Flash Facts I

Загружено:

Сведения о документе

Авторское право

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

IVMS Cell Biology and Pathology Flash Facts I

Загружено:

Авторское право:

Cell Biology and Pathology Flash Facts

Q0001:Three cell types with regard to cell cycle

Cell Biology and Pathology Flash Facts

Permanent; Stable; Labile

Cell Biology and Pathology Flash Facts

Q0002:Rough Endoplasmic Reticulum rich cells

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q0003:Cell cycle: Permanent cells

Cell Biology and Pathology Flash Facts

Remain in G0. If they regenerate; they regenerate from stem cells.

Cell Biology and Pathology Flash Facts

Q0004:Cell cycle: Stable cells

Cell Biology and Pathology Flash Facts

Enter G1 from G0 when stimulated

Cell Biology and Pathology Flash Facts

Q0005:Cell cycle: Labile cells

Cell Biology and Pathology Flash Facts

Never go to G0; divide rapidly with a short G1

Cell Biology and Pathology Flash Facts

Q0006:Smooth Endoplasmic Reticulum: Functions

Cell Biology and Pathology Flash Facts

-Steroid synthesis;-Detoxification of drugs and poisons

Cell Biology and Pathology Flash Facts

Q0007:Permanent cells: cell types

Cell Biology and Pathology Flash Facts

-Neurons;-Skeletal and cardiac muscle;-RBCs (regenerate from stem cells)

Cell Biology and Pathology Flash Facts

Q0008:Stable cells: cell types

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q0009:Smooth Endoplasmic Reticulum rich cells

Cell Biology and Pathology Flash Facts

-Liver hepatocytes;-Steroid hormone-producing cells of the adrenal cortex

Cell Biology and Pathology Flash Facts

Q0010:Labile cells: cell types

Cell Biology and Pathology Flash Facts

-Bone marrow;-Gut epithelium;-Skin;-Hair follicles;(think about chemotherapy side effects)

Cell Biology and Pathology Flash Facts

Q0011:Rough Endoplasmic Reticulum: Functions

Cell Biology and Pathology Flash Facts

-Synthesis of secretory (exported) proteins;-N-linked oligosaccharide addition to many proteins

Cell Biology and Pathology Flash Facts

Q0012:Neurons: name of Rough Endoplasmic Reticulum and its function

Cell Biology and Pathology Flash Facts

Nissl bodies sytnhesize enzymes (eg ChAT) and peptide neurotransmitters.

Cell Biology and Pathology Flash Facts

Q0013:6 functions of Golgi apparatus

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q0014:I-cell disease: Presentation

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q0015:3 types of vesicular trafficking proteins

Cell Biology and Pathology Flash Facts

COPI; COPII; and Clathrin

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Retrograde Intracellular transport: cis-Golgi to RER

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Anterograde Intracellular transport: RER to cis-Golgi

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts