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Step 2 DIT > Associations 5 > Flashcards

Associations 5 Flashcards

1
Q

Cause basophilic stippling

A

Lead poisoining
Thalassemia
Alcohol use

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2
Q

Anemia + neurological symptoms

A 
Lead poisoning (microcytic)
B12 deficiency (macrocytic)
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3
Q

Sickle cell + aplastic anemia crisis

A

Parvovirus B19

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4
Q

Pancytopenia with hypocellularity and fatty infiltrates on BM biopsy

A

Aplastic anemia

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5
Q

Thalassemia more prevalent in which races

A

Alpha - African and Asian

Beta - Mediterannean

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6
Q

“Hair on end” skull x-ray

A

BM hyperplasia in sickle cell disease

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7
Q

Salmonella osteomyelitis

A

Assoc w/ sickle cell disease

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8
Q

Encapsulated organisms

A 
Strep pneumo
H. influenzae
N. meningitidis
Klebsiella
Salmonella
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9
Q

Complication of 10% sideroblastic anemia

A

Acute leukemia

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10
Q

Causes of eosinophilia

A 
DNAAACP
Drugs
Neoplasms
Allergies/asthma (Churg Strauss)
AIN
Adrenal insufficiency (Addisons)
CVD
Parasites
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11
Q

Type I hypersensitivity rxn

A

IgE / mast cell degranulation
Hives, pruritis, allergic rhinitis
Asthma, bronchospasm, angioedema
Anaphylaxis

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12
Q

Type II hypersensitivity rxn

A 
Cell-mediated / Complement cascade / IgM and IgG react w/ cellular antigens
Drug-induced or immune hemolytic anemia
Hemolytic disease of the newborn
Graves
Myasthenia gravis
ITP
Acute rheumatic fever
Goodpasture's
Bullous pemphigoid
Pemphigous vulgaris
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13
Q

Type III hypersensitiviy rxn

A

Immune complexes deposit in tissue and activate complement/ IgM and IgG bind soluble antigens
Arthus rxn
(serum sickness)
Glomerulonephritis

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14
Q

Type IV hypersensitivity rxn

A

Delayed / T-cell mediated
Transplant rejection
Contact dermatitis
PPD

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15
Q

von Willebrand disease

A

AD
vWF and sometimes factor VIII deficiency
+PTT and +BT (NORMAL platelet number)

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16
Q

Hemophilia

A

X-linked recessive
Factor VIII (A) or IX (B) deficiency
+PTT, normal PT/BT/platelet number

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17
Q

+Fibrin split products, +D-dimer

A

DIC

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18
Q

Common causes DIC

A 
STOP Making Thrombi
Sepsis
Trauma (including surgery)
Ob complications
Pancreatitis
Malignancy
Transfusions
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19
Q

MC inherited hypercoagulability disorder

A

Factor V Leiden mutation (40-50%)

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20
Q

SIRS criteria

A

2/4 for diagnosis
Temp >38.3 or 90
RR >20 or PaCO2 12K or 10% bands

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21
Q

Sepsis

A

SIRS = 2/4 criteria
Sepsis = SIRS + infection
Septic shock = Sepsis + hypotension

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22
Q

MCC malaria

A

Plasmodium falciparum

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23
Q

Common areas for malaria

A

Sub-Saharan Africa
SW/SE Asia (India)
Tropical S. America

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24
Q

India ink stain

A

Stain of CSF = cryptococcal meningitis

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25
Q

HIV + purple subcutaneous nodules or hemoptysis

A

Kaposi sarcoma (HHV-8) skin or lung lesions

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26
Q

HIV + diarrhea

A

Isospora, strongyloides

Cryptosporidium

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27
Q

HIV + Cough, fever, dyspnea

A

CD4 <200, non-productive cough: PCP

Acid-fast bacilli: TB

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28
Q

HIV + ataxia, apathy, tremor, intellectual decline

A

AIDS dementia, CD4 <100

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29
Q

HIV + odynophagia

A

Candida esophagitis

CD4 <200, gram stain on lesion scrapings

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30
Q

HIV + fever, weight loss, fatigue, abdominal pain, GI bleeding, skin lesions, dyspnea, meningitis or adrenal insufficiency

A

Histoplasmosis
CD4 <150
Bilateral infiltrates on CXR, positive serum/urine antigen

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31
Q

HIV + focal neurologic symptoms, HA, AMS

A

CD4 <50: Cryptococcal meningitis

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32
Q

HIV + vision loss, esophagitis, cellulitis, ulcers

A

CMV

CD4 <50, yellow infiltrates + hemorrhage on fundoscopy, viral titer to confirm

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33
Q

HIV + fatigue, weight loss, fever, diarrhea, abdominal pain, hepatosplenomegaly

A

MAC

CD4 <50, blood cultures

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34
Q

Thrombosis + erythromelalgia + pruritis (esp after warm bath)

A

Polycythemia vera (also facial plethora, hepatosplenomegaly, visual disturbances, tinnitus)

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35
Q 
CRAB symptoms
hyperCalcemia
Renal insufficiency
Anemia
Back pain
A

Multiple myeloma

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36
Q

Bence Jones proteins

A

Multiple myeloma (UPEP)

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37
Q

M spike on SPEP

A

Multiple myeloma

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38
Q

Painless cervical lymphadenopathy

A

Hodgkin lymphoma

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39
Q

MC type Hodgkin lymphoma

A

Nodular sclerosis (men = women)

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40
Q

MC lymphoma in US

A

Diffuse large B cell (NHL)

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41
Q

EBV related lymphoma (Africa)

A

Burkitt (NHL)

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42
Q

Reed-Sternberg cells on LN biopsy

A

Hodgkin lymphoma

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43
Q

“Starry sky” pattern

A

Burkitt lymphoma (NHL)

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44
Q

T cell lymphoma

A

Peripheral (NHL)

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45
Q

14:18 translocation

A

Follicular small cell lymphoma (NHL)

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46
Q

8:14 translocation

A

Burkitt lymphoma (NHL)

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47
Q

B symptoms in lymphomas

A

Fever, night sweats, weight loss

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48
Q

Cleaved cells in LN biopsy

A

Follicular small cell lymphoma (NHL)

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49
Q

MC cancer in children

A

ALL

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50
Q

Pancytopenia in Down syndrome patient

A

ALL

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51
Q

Aeur rods + notched nuclei

A

AML

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52
Q

Smudge cells

A

CLL

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53
Q

BM biopsy w/ abundant blasts, +PAS, +tdt

A

ALL

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54
Q

Leukemia + bone pain

A

ALL

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55
Q

BM biopsy w/ abundant blasts, -PAS, +myeloperoxidase

A

AML

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56
Q

WBC > 50-100K

A

CML or CLL

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57
Q

Leukemia and lymphoma that are same disease

A

CLL and small lymphocytic lymphoma

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58
Q

Progresses to fatal blast crisis

A

CML

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59
Q

Leukemia in adults >65

A

CLL

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60
Q

Leukemia in adults 50-60

A

AML, CML

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61
Q

Numerous lymphocytes with irregular cytoplasmic projections

A

Hairy cell leukemia

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62
Q

t 9:22

A

Philadelphia chromosome (BCR-ABL)
CML
15% adult ALL (5% ALL overall), rare in AML

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63
Q

Short stature + abnormal skin pigmentation + horseshoe kidney + thumb abnormalities + fatigue + infections + pancytopenia on labs

A

Fanconi anemia (autosomal recessive)

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64
Q

Fatigue + dyspnea + craniofacial and thumb abnormalities + heart murmur + MR + hypogonadism + decreased Hgb/Hct but normal WBC/plt

A

Diamond-Blackfan anemia (congenital)

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65
Q

HTN + abdominal pain + diarrhea with no hematuria in kid: next step?

A

Neuroblastoma (check VMA and homovanillic acid in 24 hr urine; then CT)

66
Q

Mass in soft tissue/muscle in child: next step?

A

Rhabdomyosarcoma (MC soft tissue sarcoma in children) (CT/MRI to see extent, biopsy afterwards is diagnostic)

67
Q

Fall on outstretched hand

A

Colles fx

68
Q

Fall on flexed wrist

A

Smith fx

69
Q

Fall on outstretched hand, snuffbox tenderness

A

Scaphoid fx

70
Q

Pain in hand after punching hard surface

A

Boxer fx (5th metacarpal)

71
Q

Radial head dislocation w/ ulnar fx

A

Monteggia fx

72
Q

Ulnar dislocation (DRUJ) w/ radial fx

A

Galeazzi fx

73
Q

Complication of scaphoid fx

A

AVN

74
Q

Complication of anterior shoulder dislocation

A

Axillary nerve injury

75
Q

Complication of boxer fx

A

Infection, tendon laceration

76
Q

Complication of humerus fx

A

Radial nerve injury

77
Q

Complication of hip fx

A

AVN

78
Q

Complication of femur fx

A

Fat embolism, blood loss

79
Q

Complication of tibial fx

A

Compartment syndrome

80
Q

Complication of pelvic fx

A

Hypovolemic shock (massive blood loss)

81
Q

6Ps of compartment syndrome

A

Pain, Pallor, Poikilothermia, Pulselessness, Paresthesia, Paralysis

82
Q

Unhappy triad

A

ACL + MCL + lateral meniscus

83
Q

Hat doesn’t fit anymore

A

Paget’s disease of bone (much more common; bone scan)

Osteopetrosis (anemia; X-ray)

84
Q

Blue sclerae

A

Osteogenesis imperfecta

85
Q

Sudden severe pain and swelling in one joint (first MTP, ankle, foot, knee MC)

A

Gout

86
Q

Sudden severe pain and swelling in one joint (ankle, wrist MC)

A

Pseudogout

87
Q

Needle-shaped negatively birefringent crystals (yellow)

A

Gout

88
Q

Rhomboid-shaped positively birefringent crystals (blue)

A

Pseudogout

89
Q

MCC septic arthritis

A

S. aureus

N. gonorrhea in young, sexually active

90
Q

Joint aspirate w/ <2000 WBC

A

Osteoarthritis

Trauma

91
Q

Joint aspirate w/ 5-50,000 WBC

A

Inflammatory (RA, gout, pseudogout, etc)

92
Q

Joint aspirate w/ >50,000 WBC

A

Septic joint

93
Q

MCC osteomyelitis

A

S. aureus
Consider Salmonella in sickle cell
Consider Pseudomonas in IVDU, old tennis shoe/nail

94
Q

Radiology for osteomyelitis

A

MRI most useful

95
Q

Erythema chronicum migrans

A

Lyme disease

96
Q

B/L Bell’s palsy

A

Think Lyme disease

97
Q

Heberden nodes

A

Osteoarthritis, DIP joints

98
Q

Bouchard nodes

A

Osteoarthritis, PIP joints

99
Q

MC adult bone tumor

A

Metastases

Lung = lytic, Prostate = blastic, Breast = both; Thyroid, Lymphoma, RCC

100
Q

MC primary malignant bone tumor

A

Osteosarcoma

101
Q

MC benign bone tumor

A

Osteochondroma

102
Q

Sunburst bone lesion +/- Codman’s triangle

A

Osteosarcoma (more common in adolescents)

Codman = new periosteal bone formation at diaphyseal end of lesion

103
Q

Onion skin lesion +/- Codman’s triangle

A 
Ewing sarcoma (5-15 yo)
(Codman = new periosteal bone formation at diaphyseal end of lesion)
104
Q

Complications of scleroderma

A

Pulmonary fibrosis
Heart failure
ARF from renal hypertension

105
Q

Complications of polymyositis and dermatomyositis

A

Interstitial lung disease

Increased risk of several malignancies

106
Q

Associated w/ polymyalgia rheumatica

A

Temporal arteritis

107
Q

Positive Barlow or Ortalani maneuver

A

Developmental hip dysplasia

108
Q

Positive Galeazzi sign

A

Developmental hip dysplasia (knees at unequal heights when hips and knees are flexed)

109
Q

Radiology to dx developmental hip dysplasia

A

Ultrasound (X-ray not useful until >4 months)

110
Q

JIA w/ <4 joints and uveitis or iridocyclintis

A

Pauciarticular

111
Q

JIA w/ >4 joints, symmetric, and hand deformities

A

Polyarticular

112
Q

JIA w/ systemic symptoms usu before joint pain

A

Systemic (Still’s disease)

113
Q

MC fracture in children

A

Clavicular

114
Q

Difficulty walking + Gower maneuver + calf pseudohypertrophy

A

Duchenne muscular dystrophy (x-linked)

115
Q

MCC cellulitis

A

S. aureus, GAS (pyrogenes)

116
Q

Apocrine gland inflammation (axilla, groin, perineum)

A

Hirdradenitis suppurativa

117
Q

S/Sx necrotizing fasciitis

A

Extreme pain w/o cellulitis or outside borders
Erythema + bulla or blisters
Crepitus
DM w/ foot ulcer w/ systemic symptoms
Perineal cellulitis w/ abrupt onset and rapid spread (Fournier’s gangrene)

118
Q

Dry gangrene cause, s/sx

A

Gradual skin necrosis from vascular insufficiency

Ache/cold/pallor -> bluish/black/hard/dry

119
Q

Wet gangrene cause, s/sx

A

Necrosis from infection or acute vascular obstruction

Bruised, swollen, blistering, +pus

120
Q

Gas gangrene cause, s/sx

A

C. perfringens

Pale/swelling around injury -> dark purplish-red, tense, tender, +crepitus w/ systemic symptoms

121
Q

Yellow crusted lesion around mucocutaneous surfaces

A

Impetigo

122
Q

Causes of impetigo

A

S. aureus, GAS (pyrogenes)

123
Q

Cause of necrotizing fasciitis

A

GAS (pyrogenes) or multiple pathogens

124
Q

Herpes simplex virus types

A

HSV 1 - oral ulcers
HSV 1 - genital ulcers
(herpes zoster) - VZV

125
Q

Tzanck smear

A

Finds multi-nucleated giant cells on sample of lesion in HSV or VZV

126
Q

Teardrop vesicles

A

Chicken pox (VZV)

127
Q

Grouped vesicles

A

Shingles (VZV) or HSV

128
Q

Temporal lobe encephalitis

A

Herpes (esp newborn)

129
Q

Complications of VZV

A

Adult PNA, encephalitis

Newborn varicella

130
Q

Myalgia, malaise, HA, fever proceeding to lesions in

A

Chicken pox (VZV)

131
Q

HPV types

A

1-4 - skin warts
6, 11 - genital warts
16, 18, 31, 33 - cervical cancer

132
Q

Painless, small, shiny/pearly, flesh colored papules w/ central umbilication

A

Molluscum contagiosum

133
Q

Macules that do not tan w/ “spaghetti and meatballs” on KOH prep (short hyphae + spores)

A

Tinea versicolor / Pityriasis versicolor

Malassezia furfur

134
Q

Irritant rash vs intertrigo (candida albicans)

A

Intertrigo MC in skin creases, irritant usu avoids
Intertrigo can have ‘satellite’ lesions away from rash
Intertrigo KOH prep has pseudohyphae

135
Q

Infectious causes of EM/SJS/TEN

A

HSV and Mycoplasma pneumonia

136
Q

Drug causes of EM/SJS/TEN

A

Penicillins, sulfonamides
NSAIDs
OCPs
Anticonvulsant medications

137
Q

EM vs SJS vs TEN

A 
EM = mild disease, macules, plaques, vesicles, target lesions, esp palms/soles
SJS = EM involving mucous membranes, skin sloughing 30% surface area
138
Q

Pruritic, erythematous plaques w/ yellow, greasy scales most commonly on face or scalp

A

Seborrheic dermatitis (or cradle cap in babies)

139
Q

Dry skin patches w/ papules most commonly on flexor surfaces, face/scalp in infants

A

Atopic dermatitis (eczema)

140
Q

Well-defined red plaques w/ silvery scales on extensor surfaces that bleed easily w/ scale removal (Auspitz sign)

A

Psoriasis

141
Q

Herald patch + pruritic papules covered with white scale in “christmas tree” pattern

A

Pityriasis rosea

142
Q

Subcutaneous fat inflammation -> painful, erythematous nodules esp on anterior tibias

A

Erythema nodosum

143
Q

Conditions associated w/ erythema nodosum

A 
SPUD BITS
Strep infections
Pregnancy
Unknown/idiopathic
Drugs
Behcet's
IBD
TB
Sarcoidosis
144
Q

Pruritic, purple, polygonal papules and plaques that are shiny and flat, most commonly on flexor surfaces of extremities, possibly on mucus membranes/genitals

A

Lichen Planus

145
Q

Infections associated w/ lichen planus

A 
HIV (younger patients)
Hep C (older patients)
146
Q

Decubitus ulcer stages

A

I - color/consistency/temp change of skin
II - superficial skin abrasion, shallow crater
III - full thickness skin loss + SQ damage, deep crater
IV - muscle, bone or supporting structure damage

147
Q

Eczematous dermatitis w/ inflammatory papules, scaly and crusted erosions, increased pigmentation, stippling w/ recent and old hemorrhages, possible ulceration

A

Stasis dermatitis

148
Q

Flaccid, easily ruptured bullae (+Nikolsky sign) w/ oral lesions

A

Pemphigus vulgaris (anti-desmosome Abs)

149
Q

Tense, hard, difficult to rupture bullae w/o oral lesions

A

Bullous pemphigoid (anti-hemidesmosome Ab)

150
Q

Chronic blistering lesions on sun-exposed skin

A

Porphyria cutanea tarda

151
Q

Porphyria cutanea tarda associations

A

Hep C, alcoholism

Iron overload, estrogen use, smoking

152
Q

Pigmented plaques that appear to be stuck onto skin

A

Seborrheic keratosis

153
Q

Black velvety plaques on flexor surfaces, body folds

A

Acanthosis nigricans

154
Q

Acanthosis nigricans associated with what

A

Obesity
DM
Malignancies

155
Q

Rough lesions on sun-exposed skin that are easier to feel than see

A

Actinic keratosis

156
Q

Circular rash w/ central clearing on trunk/arms

A

Tinea corporis

157
Q

Sharply demarcated patches of hypopigmentation

A

Vitiligo

158
Q

Hyperpigmentation in pregnancy

A

Melasma

159
Q

Vitiligo associated comorbidities

A 
Thyroid disease (30%) - Graves, AI
Pernicious anemia, DM I, primary adrenal insufficiency, hypopituitarism, alopecia areata, AI hepatitis
160
Q

Asymptomatic, inflammatory, non-scarring areas of complete hair loss

A

Alopecia areata

161
Q

Stress-related diffuse hair loss

A

Telogen effluvium

162
Q

Male-pattern baldness (men or women)

A

Androgenic alopecia

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