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Daily Flashcard Quizzes > 7/31 > Flashcards

7/31 Flashcards

1
Q

lowers LDL

inhibits HMG CoA reductase in liver, so more LDL is cleared from circulation with increased LDL receptors

A

statin

myopathy, hepatotoxicity

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2
Q

lowers LDL
bile acid binding resins
liver must use cholesterol to make more

A

Cholestyramine

GI upset

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3
Q

lowers LDL

blocks intestinal absorption of cholesterol at brush border

A

Ezetimibe

diarrhea

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4
Q

lowers Triglycerides
upregulates LPL to increase triglyceride clearance
activates PPAR-alpha to induce HDL synthesis

A

Fibrates

myopathy, esp with statins
cholesterol gallstones

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5
Q

lowers LDL, increases HDL
inhibits lipolysis via inibiting HPL
reduces hepatic VLDL synthesis

A

Niacin/B3

red/flushed face
hyperglycemia
hyperuricemia

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6
Q

GLP-1 agonist

decrease gastric emptying

A

Exentide

pancreatitis
requires some functional beta cells

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7
Q

DPP-4 inhibitor

decrease gastric emptying by preventing breakdown of GLP-1

A

-gliptans

nasopharyngitis

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8
Q

inhibits TPO and 5’deiodinase

inhibits TPO only

A

PTU

methimazole

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9
Q

bind hydroxyappetite to inhibit osteoclasts

A

bisphosphonate

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10
Q

inspiration ____ venous return

A

increases

it drops intrathoracic pressure

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11
Q

valsalva ____ intrathoracic pressure

A

increases

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12
Q

standing up ____ preload

A

decreases

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13
Q

rapid squatting or leg raise ____
venous return
preload
afterload

A

increase
increase
increase

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14
Q

serum tumor markers:

Alk phos

A

bone or liver

seminoma

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15
Q

serum tumor markers:

AFP

A

HCC
yolk sac tumor
mixed germ cell tumor

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16
Q

serum tumor markers:

beta-hCG

A 
Hydatidiform moles
Choriocarcinomas
Gestational Trophoblastic disease
(HCG)
testicular cancer
mixed germ cell tumor

produced by syncytiotrophoblasts of placenta

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17
Q

CA 15-3/CA 27-29

A

breast cancer

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18
Q

CA 19-9

A

pancreatic adenocarcinoma

“9 = P”

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19
Q

CA 125

A

ovarian cancer

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20
Q

calcitonin

A

medullary thyroid cancer

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21
Q

thyroid:
most absence of capsular vascular invasion
“colloid-containing micro follicles”
usually nonfunctional, painless

A

thyroid adenoma

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22
Q 
thyroid:
most common, excellent prognosis
Orphan Annie Eyes
psammoma bodies
nuclear grooves
RET and BRAF mutations
ionizing radiation
A

Papillary carcinoma

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23
Q

thyroid:
invades thyroid capsule and vasculature
UNIFORM follicles
RAS mutation

A

follicular carcinoma

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24
Q 
thyroid:
from parafollicular C cells
produces calcitonin
sheets of cells in amyloid stroma (Congo Red)
MEN2A/B (RET) mutation
A

Medullary carcinoma

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25
Q

thyroid:
older pts
invading local structures
pleomorphic giant cells

A

undifferentiated/anaplastic carcinoma

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26
Q

ovarian:
Call-Exner bodies
collections of eosinophilic fluid
appress yellow

A

granulosa cell tumor

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27
Q 
ovarian:
aggressive
ovaries and testicles
yellow, friable, sold mass
Schiller-Duval bodies (~glomeruli)
AFP tumor marker
A

Yolk sac (endodermal sinus) tumor

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28
Q

ovarian:
GI malignancy that metastasizes to ovaries
mucin secreting signet cell adenocarcinoma

A

Krukenberg tumor

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29
Q

uniformly enlarged, soft, globular uterus

extension of endometrial tissue into myometrium

A

adenomyosis

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30
Q

estrogen sensitive endometrial tumor
irregular uterine enlargement
consipation, urinary problems

A

leiomyoma/fibroid

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31
Q

postmenopausal vaginal bleeding, anovulatory cycles, hormone replacement therapy, PCOS, etc
excess unopposed estrogen

A

endometrial hyperplasia

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32
Q

older F, vaginal bleeding
estrogen without progesterones
Histology: atypical endometrial cells that form glands

A

endometrial carcinoma

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33
Q

uterine tenderness, fever, tachy

retained products of conception or foreign body

A

endometritis

decidua infection

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34
Q

endometrial tissue outside endometrial cavity

chocolate cyst

A

endometriosis

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35
Q 
CNS:
"butterfly"
"pseudopalisading" pleomorphic tumor cells border central areas of necrosis
GFAP positive
found in cerebral hemispheres
A

glioblastoma (astrocytoma)

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36
Q 
CNS:
arachnoid cell origin
dural attachment "tail"
asymptomatic,, or seizures
spindle cells in whorled pattern
psammoma bodies
A

meningioma

spider in the bathtub

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37
Q

VHL CNS tumor

most often cerebellar

A

hemangioblastoma

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38
Q 
CNS:
cerebellopontine angle,
CN8
hearing loss
S-100 +
A

schwannoma

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39
Q 
CNS:
frontal lobe
chicken wire capillaries
fried egg oligodendrocytes 
often calcified
A

oligodendroglioma

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40
Q

CNS:
posterior fossa/cerebelum
GFAP +
Rosenthal fibers- eosinophilic corkscrew fibers

A

pilocytic astrocytoma

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41
Q

CNS:
compress 4th ventricle, causing noncommunicating hydrocephalus
Homer-Wright Rosettes
small blue cells

A

medulloblastoma

Water Boy

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42
Q

CNS:
4th ventricle
perivascular rosettes
rod-shaped blepharoplasty (basal ciliary bodies)

A

ependymoma

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43
Q

CNS
confused w/ pituitary adenoma for bitemporal hemianopia
remnant sof Rathke pouch
calcifications
cholesterol crystals found in “motor oil or wet keratin”

A

craniopharyngioma

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44
Q

CNS:
Parinaud syndrome (compression of tectum, vertical gaze palsy)
obstructive hydrocephalus
precocious puberty in M (beta-HCG)
histologically similar to germ cell tumors

A

pinealoma

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45
Q

hypercellular glomeruli
starry sky- granular IF
IgG, IgM, C4 deposition in GBM
sub epithelial immune complex humps on EM
most frequently seen in children 2/2 strep infection
Type 3 HSN

A

PSGN

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46
Q

crescent moon shape on

crescents made of Fibrin (crescent rolls have fiber) and plasma proteins and macrophages

A

RPGN

includes Goodpasture, Wegener
Microscopic polyangitis

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47
Q

Pauli-Immune RPGN
no BM deposits
c-ANCA

A

Wegener

Granulomatous with polyangiitis

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48
Q

type 2 HSN
antibodies to GBM and alveolar BM
linear IF

A

Goodpasture syndrome

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49
Q

SLE renal problem
“wire looping” capillaries
immune complex deposition

A

diffuse proliferative glomerulonephritis

membranoproliferative GN

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50
Q

IgA deposits in mesangium

renal path of Henoch-Schonlein Purpura

A

IgA nephropathy

Berger disease

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51
Q

episodic gross hematuria that occurs w/ resp or GI infection (IgA is secreted by mucosal linings)

A

IgA nephropathy

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52
Q

mutated type 4 collagen- splitting GBM

old, can’t see, can’t pee, can’t hear a bee, basket-weave”

A

Alport

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53
Q

renal “tram track” on PAS stain 2/2 GBM splitting

A

membranoproliferative GN

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54
Q

effacement of foot processes
recurrent infections, immunization
hypoalbinemia

A

MCD

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55
Q

segmental sclerosis

focal deposits of IgM, C3

A

FSGN

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56
Q

diffuse GBM thickening
spike and dome appearance
SLE
antibodies to PLA2 receptor

A

membranous GN

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57
Q

Kimmelstiel-Wilson lesions

A

diabetic GN

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58
Q

telangiectasis, epistaxis, AV malformations, GI bleeds, hematuria

A

Hereditary hemorrhagic telangiectasia

AKA Osler Weber Rendu syndrome

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59
Q 
TP53
"SBLA" cancer syndrome
sarcoma
breast
leukemia
adrenal gland
A

Li Fraumeni

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60
Q 
cafe au last spots
cutaneous neurofibromas
optic gliomas
pheochromocytoma,
Lisch nodules
A

NF1

Von Recklinghausen

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61
Q

unilateral cafe au last spots
precos=cious puberty
polyostotic fibros dysplasia/osteolytic leiosns
endocrine abnormalities

A

McCune Albright Syndrome

62
Q

renal cysts
RCC
hemangioblastomas of cerebellum

A

VHL

63
Q

neurocutaneous disorder w/ multi-organs

benign hamartomas

A

tuberous sclerosis

64
Q 
port wine stain
leptomeningeal angioma- seizures
intellectual disability
scleral hemangioma
tram track calcifications
GNAQ gene
neural crest derivatives
A

Sturge Weber

65
Q

ischemia/infarcts in most tissues
cell outlines preserved
anucleated cells

A

Coagulative necrosis

66
Q 
bacterial abscesses
brain infarcts
neutrophils release Lysosomal enzymes
pus
CSF-filled spaces
viscous, liquid mass
A

liquefactive necrosis

67
Q

TB,
systemic fungi necrosis
granular debris
cheesy appearance

A

Caseous necrosis

68
Q

damaged cells release Lipase
saponification- chalky white
pancreatitis!!!
trauma

A

fat necrosis

69
Q

immune rxns in vessels
immune complexes combine with fibrin to cause vessel wall damage
walls are thick and pink

A

fibrinoid necrosis

70
Q

the artery that gives you the “pie” vision loss

A

MCA

71
Q

the artery that gives you hemianopia with macular sparing

A

PCA

72
Q

down and out gaze

A

CN3 palsy

73
Q

compensatory head tilt for vision

A

CN4 palsy

74
Q

headache:
periorbital pain
unilateral
lacrimation

A

cluster

75
Q

headache:
bilateral- band like pattern around forehead
steady pain
no other problems

A

tension

76
Q 
headache:
pulsating
aura
photophobia/phonophobia
unilateral
Nausea
disabling
A

migraine

77
Q

normal melanocytes
low melanin production
low enzyme activity

A

albinism

78
Q

autoimmune destruction of melanocyte cells

A

vitiligo

79
Q

envelope or dumbbell shaped stone

square with X

A

calcium oxalate

80
Q

wedge shaped prism stone

A

calcium phosphate

81
Q

coffin lid stone

AKA struvite

A

ammonium magnesium phosphate

82
Q

rhomboid, yellow brown diamond stone

A

uric acid

83
Q

hexagon flat stone

A

cystine

6 sides

84
Q

binds PBP transpeptidases to prevent cross linking

A

penicillin

85
Q

inhibits cell wall synthesis by incorporating into the wall precursors
structural wall analog

A

vancomycin

86
Q

from T cells in response to IL-12 from macrophages
stimulates macrophages to kill phagocytized pathogens
inhibits differentiation of Th2

A

interferon gamma

87
Q

mediates septic shock
activates endothelium
causes WBC recruitment, vascular leak
causes cachexia in malignancy

A

TNF-alpha

88
Q

anticardiolipin,
anti-dsDNA
anti-Smith
anti-nuclear

A

SLE

89
Q

anti-centromere

A

CREST

90
Q

anti-desmoglein/desmosome

A

pemphigus vulgaris

91
Q

anti0GAD65

A

T1DM

92
Q

anti-hemidesmosome

A

villous pemphigoid

93
Q

anti-histone

A

drug induced lupus

94
Q

anti-Jo-1,
anti-SRP,
anti-Mi-2

A

polymyositis, dermatomyositis

95
Q

anti-microsomal

anti-thyroglobulin

A

Hashimoto

96
Q

anti-mitochondrial

A

PBC

97
Q

anti-parietal cell

A

pernicious anemia

98
Q

anti-PLA2

A

primary membranous nephropathy

99
Q

anti-Scl-70

anti-DNA topoisomerase I

A

Scleroderma diffuse

100
Q

anti-Smooth muscle

A

autoimmune hepatitis

101
Q

anti-SSA,

anti-SSB (anti-Ro, anti-La)

A

Sjogren syndrome

102
Q

anti-TSH receptor

A

Graves

103
Q

anti-tissue transglutaminase

A

Celiac

104
Q

p-ANCA

A

microscopic polyangiitis

eosinophilic granulomatosis with polyangitits (Churg Strauss)

105
Q

c-ANCA

A

Wegener

106
Q

IgM against IgG Fc

anti-CCP (more specific)

A

Rheumatoid arthritis

107
Q

cross-link IgE on presensitized mast cells
pre-formed antibody

allergic, anaphylaxis

A

type 1 HSN

108
Q 
antibody mediated
IgM, IgG bind to fixed antigen on enemy cell
antibody and complement lead to MAC
cytotoxic 
Coombs tests
A

Type 2 HSN

109
Q

antigen-antibody (IgG) complexes activate complement, which attracts neutrophils to release lysosomal enzymes
serum sickness

A

Type 3 HSN

110
Q 
T cell mediated 
sensitized T cells encounter antigen and release cytokines to activate macrophages
Transplant rejections
TB skin test
Touching (contact dermatitis)
T cells
A

type 4 HSN

111
Q

pre-existing recipient antibodies react to donor antigen (typ 2 HSN) and activate complement
within minutes/hrs

A

hyper acute transplant rejection

112
Q

“dense interstitial lymphocytic infiltrate”

cellular:
CD8+ T cells activated against donor MHCs (type 4 HSN)

humoral:
antibodies develop after the transplant to activate complement

weeks/months

A

acute transplant rejection

113
Q

CD4 T cells respond to recipient APCs presenting donor peptides, including allogenic MHC

both cellular and humoral components (type 4 and 2)

months/yrs of lymphocytic infiltrate, fibrosis, and tissue destruction

A

chronic graft rejection

114
Q

grafted donor T cells proliferate and reject host cells
severe organ dysfunction
type 4 HSN
usually in bone marrow and liver transplant- rich in lymphocytes

A

graft vs host disease

115
Q 
vasculitis with asthma,
sinusitis
skin nodules
kidneys
eosinophilia
p-ANCA
A

Chung Strauss

Eosinophilic granulomatosis with polyangiiits

116
Q 
vasculitis with 
URI
palpable purpura on but
arthralgia
GI pain
IgA immune complex deposition w/ Berger disease)
A

Hence Schonlein purport

117
Q

similar to Wegener, but no nasopharyngeal involvement

p-ANCA

A

Microscopic polyangiitis

118
Q 
vasculitis
asian children
conjunctival injection
rash
adenopathy
strawberry tongue
hand/foot edema and erythema
fever
"CRASH and burn"
may develop coronary artery aneurysms
A

Kawasaki

119
Q

vasculitis
Hep B association
typically in renal and visceral vessels that are NOT lungs
transmural inflammation of arterial wall with fibrinoid necrosis

A

polyarteritis nodosa

120
Q 
associated with polymyalgia rheumatica (pain in shoulder, torso, pelvis)
headache
jaw claudication
blindness
focal granulomatous inflammation
elevated ESR!!!! and CRP!!!!!
A

giant cell arteritis

121
Q 
vasculitis 
Asian female adults
"Pulseless disease" (weak UE pulse)
granulomatous thickening/narrowing of aortic arch and proximal great vessels
elevated ESR
A

Takaysu arteritis

122
Q

false positive VDRL/PRP and prolonged PTT (paradoxical with hyper coagulable state)
history of thrombosis and recurrent abortions
anti-cardiolipin antibodies

A

antiphospholipid syndrome

123
Q

high CD4/CD8 ratio
high ACE levels
high Ca

A

Sarcoidosis

124
Q

symmetric proximal muscle weakness
patchy necrosis/inflammation with CD8 cells
most often involves shoulder

anti-Jo-1
anti-SRP
anti-Mi-2
high CK

+ includes malaria rash,
Gottron papules
shawl and face rash
mechanics hands

A

polymyositis

dermatomyositis

125
Q

increase bleeding time means

A

defects in platelet plug formation

126
Q

defect in plt plus formation

low Gp1b plt/VWF adhesion

A

Bernard Soulier Syndrome

127
Q

low Gp2b/3a plt/plt aggregation

A

Glanzmann thrombocytopenia

128
Q

thrombocytopenia
microangiopathic hemolytic anemia
acute renal failure
typically in children w/ diarrhea

A

HUS

129
Q

anti-Gp2b/3a antibodies
splenic macrophage consumption of pltatelet/antibody complex
commonly 2/2 viral illness

A

ITP

130
Q 
ADAMTS 13 
unable to degrade VWF multimers
large platelet adhesions, platelet aggregation, thrombosis
elevated LDH
NEURO symptoms
A

TTP

131
Q

low fibrinogen
D-dimers
abnormal coag cascade and bleeding time

A

DIC

132
Q 
increased bleeding time
normal platelet count
mucosal bleeding
normal PT
normal/high PTT
A

VWF

133
Q

defect in BTK
no B cell maturation (no germinal centers)
X linked Recessie
recurrent infections after 6 months (no maternal IgG)
low Ig in all classes
absent lymph nodes and tonsils

A

X linked Bruton agammaglobulinemia

134
Q 
mostly asymptomatic
can see airway/GI infections
Autoimmune disease
Anaphylaxis to IgA blood products
low IgA
A

selective IgA deficiency

135
Q

defect in B cell differentiation
can be acquired in 20s/30s
increased risk of various diseases

A

common variable immunodeficiency

136
Q 
cleft palate
abnl facies
thymic aplasia/ T cell deficiency
cardiac defects
hypocalcemia 2/2 parathyroid hypoplasia
22q11.2 deletion
failure to develop 3rd and 4th pharyngeal pouch
A

thymic aplasia

DiGeorge syndrome

137
Q

disseminated mycobacterial and fungal infections
may present after BCG vaccine
macrophages –> IL-12 –> T cells and NK cells –> IFN gamma
low IFN-gamma!!

A

IL-12 receptor deficiency

138
Q 
coarse facies
cold staph abscesses
retained teeth
high IgE
derm problems
deficiency of Th17 cells
impaired recruitment of neutrophils
A

hyper-IgE syndrome (Job syndrome)

139
Q

chronic diarrhea, thrush, failure to thrive
recurrent infections
ADENOSINE DEAMINASE DEFICIENCY
absence of thymic shadow, germinal centers, and T cells
low TRECs

A

SCID

140
Q 
triad:
cerebellar defects (ataxia)
spider angiomas
IgA deficiency
defects in ATM gene, failure to repair DNA double strand breaks, cell cycle arrest
A

ataxia telangiectasia

141
Q 
severe pyogenic infections and opportunistic infections early in life
commonly 2/2 CD40L on Th cells, class switching defect
A

hyper IgM syndrome

142
Q 
WAX TIE:
X-linked
Thrombocytopenia
Recurrent infections
Eczema
mutated WAS gene
high IgA, IgE
A

Wiskott Aldrich syndrome

143
Q

recurrent skin/mucosal infections with absent pus formation
delayed separation of umbilical cord
defect in LFA-1 intern (CD18)
impaired migration and chemotaxis

A

LAD

144
Q 
recurrent pyogenic infections by staph and strep
partial albinism
peripheral neuropathy
progressive neurodegeneration
giant granules in granulocytes and plts
pancytopenia
defect in LYST
microtubule dysfunction in phagosome-lysome fusion!!!!
A

Chediak Higashi syndrome

145
Q

susceptible to catalase + organisms
defect of NADPH oxidase, low ROS, low Respiratory burst in neutrophils,
impaired intracellular killing

A

CGD

cats gain dominance

146
Q

jaw jerk reflex

A

CN 5-3 both

147
Q

pupillary reflex

A

CN2

CN3

148
Q

gag reflex

A

CN 9

CN 10

149
Q

CN 5 lesion

A

jaw deviates toward side of lesion

150
Q

CN 10 lesion

A

uvula deviates away

“U and V”

151
Q

CN 11 lesion

A

weakness turning head to contralateral side of lesion

shoulder droop on same side as lesion

152
Q

CN 12 lesion

A

tongue deviates toward side of lesion

Daily Flashcard Quizzes (21 decks)

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