Ashley Flashcards
Translocation t(9;22)
CML
(Chronic Myeloid Leukemia)
- Mainly adults (64+)
- Associated w/ BCR-ABL hybrid
Translocation (11,22)
Ewing’s Sarcoma
- Patrick Ewing’s Jersey Number is 33. 11 + 22 = 33
Translocation (8,14)
Burkitt’s Lymphoma
Translocation (11,14)
Mantle Cell Lymphoma
Translocation (15,17)
AML M3
(Acute Myeloid Leukemia, Subtype M3)
- Tx: ATRA more effective against AML M3 subtype
- Complication: DIC (via breakage of Auer rods)
- Histo: Auer rods
Translocation (14,18)
Follicular Lymphoma
- BCL-2 (part of the intrinsic apoptotic pathway)
Translocation (12,21)
ALL
(Acute Lymphocytic Leukemia)
- (14,21) Down’s Syndrome acrocentric
DiGeorge Mnemonic
CATCH-22
(DiGeorge Syndrome)
- Cleft palate
- Abnormal facies
- Thymic aplasia (T-cell deficiency)
- Cardiac defects (conotruncal)
- Hypocalcemia (2/2 parathyroid aplasia—third pharyngeal pouch: inferior parathyroids are grown with thymus and descend together)
- 22q11: Microdeletion at chromosome 22q11
Causes QRS widening
TCA overdose
Dilated pupils, dry & flushed skin, urinary retention, constipation, tachycardia
Anticholinergic overdose
(Diphenhydramine overdose)
- Tx: Physostigmine
Myasthenia Gravis Tx
Pyridostigmine
Dx: Tensilon Test (Edrophonium)
AGMA Mnemonic
MUDPILES
- Methanol
- Uremia
- DKA
- Propylene Glycol
- INH/Iron, Isolyene Glycol
- Lactic acidosis
- Ethylene Glycol (antifreeze)
- Salicylates (late)
NAGMA Mnemonic
HARDASS
- Hyperalimentation (vitamins)
- Addison disease (primary adrenal insufficiency)
- RTA
- Diarrhea
- Acetazolamide (CA-inhibitor)
- Spironolactone (MRAs)
- Saline infusion
Absence of dark blue cytoplasmic staining upon nitroblue tetrazolium administration
Chronic Granulomatous Disease (CGD)
- Absence of dark blue staining indicates defective phagocytosis. In normal phagocytes, phagocytosis will result in dark blue cytoplasmic staining with NBT.
Giant peroxidase-positive granules within neutrophils and platelets
Chediak-Higashi Syndrome
Primary immunodeficiency disorder stemming from a defect in the lysosomal trafficking regulator gene, LYST, leading to microtubule dysfunction and failure of phagolysosome formation.
Paraneoplastic Syndromes of SCLC
Spherules containing endospores on sputum sample
Coccidiomycosis
(hiking in Arizona desert)
Mutation for melanoma
BRAF Kinase mutation (missense mutation)
- Because it is a Valine to Glutamic substitution at V600E
- Rx: Verumatinib
- 4 types:
- Acral lentigo, nodular, superficial,
Monitored to adjust heparin dosing when giving unfractionated heparin to a DVT pt
Activated Partial Thromboplastin Time
(For warfarin, it would be INR)
Most common complication of BPH
Hydronephrosis
(2/2 the backup of urine)
Growth over eyelid that does not go away with warm compresses. Dx & Tx?
Chalazion
Tx: Excision
SOB, UL breath sounds, JVD
Tension Pneumothorax
(Tx: Needle Decompression)
You get high calcium with this type of diuretic
Thiazides
Pt p/w dark urine and non-pruritic rash on hands. Dx & Tx?
Porphyria Cutanea Tarda
Tx: Hydroxychloroquine
Glossitis, stomatitis, dry rash. Vitamin deficiency?
Vitamin B2 Deficiency (Riboflavin)
Exposure to this drug is associated with tricuspid valve dysfunction
Fetal exposure to Lithium
Bilateral temporal hemianopsia
Pituitary tumor
Think panhypopituitary symptoms
Nephrotic syndrome associated w/ HCV
Membranoproliferative Glomerulonephritis
(MPGN)
Tuft of hair over newborn’s lumbosacral region
Neural tube defect
(Can be 2/2 mother having taken valproate during pregnancy)
Tx for Magnesium Sulfate toxicity
Calcium Gluconate
Reflexes w/ Magnesium Sulfate
Hyporeflexia (diminished)
Treatment of Torsades de Point
Magnesium Sulfate
- Drug-induced long QT: ABCDE
- Antiarrhythmics (Class IA, III)
- Antibiotics (macrolides)
- Anti”C”ychotics (e.g. haloperidol)
- Antidepressants (e.g. TCAs)
- Antiemetics (e.g. ondansetron)
Compares means between two groups
t-test
Bilateral presentation of trigeminal neuralgia
Multiple Sclerosis
Tx: Steroids then DMARDs(?)
Hypotension, distant heart sounds, distended neck veins
Cardiac tamponade
(+Pulsus paradoxus; +electrical alternans)
Responsible for secreting anti-Mullerian hormone during embryogenesis (suppressing development of internal female genitalia)
Sertoli Cells
Vessel branch most likely the source of esophageal variceal bleeding
L gastric vein (portal circulation) & Azygos vein (systemic circulation)
MCC of UTI
E. coli
then Staph saprophyticus, then Klebsiella
PNA with hyponatremia. Organism?
Legionella
(Cruises, water mist)
IgA attacks parietal cells
Pernicious Anemia
(autoimmune)
Best method for evaluating for possible cervical incompetence in pregnant pt w/ r/o cervical incompetence
Transvaginal ultrasound at 18 weeks gestation
Brisk reflexes = Hyper- or hyporeflexia?
Hyperreflexia
A larger circular or ovoid plaque (herald patch) most commonly on the trunk, followed by multiple smaller ovoid lesions which classically arrange themselves on a Christmas tree pattern on the back, sparin gthe face, palms, & soles. (+/- pruritus)
Pityriasis rosea
(2/2 HHV-6 or HHV-7)
Infection seen more often in sickle cell patients
Salmonella Osteomyelitis
(also Staph aureus osteomyelitis)
Infection seen more often in sickle cell patients
Salmonella Osteomyelitis
Dizziness caused by canalithiasis
BPPV
- Diagnosed w Dix-Hallpike Maneuver
- Treated w/ Epley Maneuver
Dizziness caused by increased endolymph production
Meniere’s Disease
Oligoclonal IgG bands on electrophoresis or LP
MS
(Multiple Sclerosis)
Reduces exophthalmos symptoms in MG patients
Prednisone
Drooling in fully-vaccinated child. Organism?
Strep pneumo
Folate is absorbed in the
Jejunum
(B12 in the terminal ileum)
Pancreatic pseudocyst - Tx?
Cystogastrostomy
(for drainage)
Pregestational diabetic in pregnancy requires this monthly until delivery
NST or Biophysical Profile
First line drug used to assist in pregnancy in PCOS pts
Letrozole (Aromatase Inhibitor)
(Clomiphene citrate is no longer first line)
Can haptoglobin be normal in hemolysis?
Yes, in Extravascular Hemolysis, such as Acute Splenic Sequestration Crisis, where abnormal sickled RBCs are sequestered in the spleen and can undergo extravascular destruction mediated by immune cells in the spleen, leading to acute anemia.
Definitive Tx for HELLP syndrome (Severe Pre-Eclampsia)
Delivery (CSx)
Pre-surgery Tx in Pheochromocytoma resection
Phenoxybenzamine
(irreversible α blockade)
Atypical schizophrenia Tx?
Quetiapine
Atypical schizophrenia Tx?
Quetiapine
Perimysial CD4+ infiltration and perifascicular atrophy
Dermatomyositis
Denervation and reinnervation of the muscle
ALS
(Neurodegenerative d/o that p/w asymmetric upper & lower motor neuron Sx, w/ preservation of mentation, bowel, bladder, sensory, & sexual function)
CD8+ infiltrating wihtin the fascicle
polymyositis
Lecithin:Sphingomyelin ratio <2
Give betamethasone
(to accelerate fetal lung maturity and increase surfactant production)
- <34 weeks gestation or <36w + L/S < 2 → Give betamethasone
Tension PTX vs Spontaneous PTX
Spontaneous PTX is ipsilateral; Tx = Chest tube thoracostomy
Tension PTX is contralateral; Tx = Needle thoracostomy
In pt with DKA, do this BEFORE giving them insulin
IV NS & Potassium
Calcium and Phosphate levels in Vitamin D deficiency
Decreased
(Hypocalcemia & Hypophosphatemia)
What PNA gives you low sodium?
Legionella
T-cell mediated hypersensitivity
Type IV Hypersensitivity
(e.g. Nickel allergy, poison oak)
MCC of mortality in burn pts
Hypovolemia
(2/2 loss of fluid due to impaired skin function)
Poxvirus
(Molluscum Contagiosum)
- Tx: Self-limited or cosmetic (curettage or liquid nitrogen)
Suspected temporal arteritis in pt p/w fever, HA, ↑ESR, & right scalp tenderness. Next step?
Start oral prednisone or they’re going to go blind
- Temporal arteritis = GCA (Giant Cell Arteritis)
Brazilian/Central American man with lump in his mouth, ulcers, immunocompromised
Paracoccidioides brasiliensis
Decreased levels of Vitamin D, there is ↓ __ absorption from GI tract, leading to ↓ __ levels
↓ Calcium
(↑ PTH)
Tumor that is GFAP+
Glioblastoma; Astrocytoma
(stains for astrocytes, Schwann cells, oligodendrocytes)
Serum sickness is Type __ Hypersensitivity
Type III Hypersensitivity
(Antibody-antigen complex deposition)
Male pattern baldness Tx MOA?
5-α reductase inhibition
(Finasteride; decreases conversion of testosterone to DHT)
- Used for BPH and male pattern baldness
Achondroplasia mode of inheritance?
AD
(Autosomal Dominant)
- Mutation in fibroblast growth factor receptor (FGFR3)
- Increases with increasing paternal age
Abnormal development of 1st branchial arch 2/2 neural crest dysfunction (mandible, middle ear bones, sphenomandibular structures, muscles of mastication, neck muscles including mylohyoid)
Treacher Collins Syndrome
(p/w mandibular hypoplasia & facial abnormalities)
Follows tonic-clonic seizures 2/2 vigorous muscle contraction
Post-ictal Lactic Acidosis
Tx: Observation as acidosis normalizes
Tx for post-ictal lactic acidosis
Observation
(as acidosis normalizes on its own)
Most common non-melanoma skin cancer in the US
Basal Cell Carcinoma
Pink or flesh-colored papule that is pearly or translucent with telangectasias
Basal Cell Carcinoma
Narrow M-spike of monoclonal IgM
Waldenstrom’s macroglobulinemia
(10% or more of BM infiltration by clonal lymphoplasmocytic cellsand a monoclonal IgM gammopathy)
M-spike of IgA and IgG
Multiple Myeloma
Repetitive brief headaches. Excruciating periorbital pain with lacrimation and rhinorrhea.
May present with Horner syndrome.
Cluster HA
(unilateral)
Tx: Sumatriptan, 100% O2
PPx: Verapamil
Steady pain > 30 min (typically 4–6 hr); constant. No photophobia or phonophobia. No aura.
Tension HA
(Bilateral)
CD15 + CD30
Biomarkers for Hodgkin’s Lymphoma
Biomarkers for Hodgkins Lymphoma
CD15 + CD30
Bilobed nuclei
Hodgkin Lymphoma
(Reed Sternberg cells)
- Biomarkers CD15, CD30
- B symptoms
- Associated w/ EBV
Ulcerative red lesion
Squamous Cell Carcinoma
- ↑ sun exposure
- ↑ immunosuppression
- ↑ arsenic exposure
- Precursor is actinic keratosis
Cholestatic pattern in pt with UC
PSC
Intra- and extrahepatic bile ducts will be obliterated
(Primary Sclerosing Cholangitis)
Acne rosacea Tx
Topical metronidazole
Patient w/ hypoglycemia in setting of low c-peptide
Factitious hypoglycemia due to exogenous insulin administration
Factitious Disorder
Psoas & Obturator signs are maneuvers that test for
Irritation of the respective muscles by an inflammatory process such as acute appendicitis, a ruptured appendix, or pelvic inflammatory disease (PID)
Supplies blood to the Left Atrium and Posterior Left Ventricle
Left Circumflex Artery (LCX)
Bony Landmark Origin of the ACL?
Posteromedial aspect of the lateral femoral condyle
- Insertion is on the anteromedial tibial plateau
- ACL tear is tested by Anterior Drawer test & Lachman test
Defect in Tyrosinase
Albinism
Tyrosinase converts DOPA to Melanin
DOPA = dihydroxyphenylalanine
Gram-positive rod that can be grown at 22°C in pt w/ h/o cancer or renal transplants
Listeria monocytogenes
- Usually presents as a common cause of meningitis in adults with cancer or h/o renal transplants
- Displays tumbling motility in broth
Decreases synaptic reuptake of norepinephrine and dopamine
Methylphenidate
Prevents conversion of xanthine to uric acid
Allopurinol
Inhibits microtubule polymerization
Colchicine
Drug used to diagnose asthma
Methacholine
GAA Trinucleotide Repeat
Friedrich Ataxia
- AR disorder characterized by spinal cord tract degeneration, leading to ataxia, muscle weakness, areflexia, loss of vibratory sense & proprioception, dysarthria, & MSK deformities (e.g. pes cavus, hammertoes, kyphoscoliosis).
CAG Trinucleotide Repeat
Huntington Disease
(also cause of spinocerebellar ataxia)
CGG Trinucleotide Repeat
Fragile X Syndrome
CTG Trinucleotide Repeat
Myotonic dystrophy
- p/w “loss of hand grip”, frontal baldness
45XO
Turner Syndrome
47XYY
Jacob Syndrome (“Supermale Syndrome”)
- Klinefelter is 47XXY