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Invaders And Defense > Buzzword Bingo > Flashcards

Buzzword Bingo Flashcards

Quick recall of key words and phrases

1
Q

allergic sinusitis, steroid-dependent asthma, and eosinophilia, with fleeting infiltrates on CXR

A

EGPA

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2
Q

Rash on palms and soles

A

Secondary syphilis; Rocky Mtn Spotted Fever (Rickettsia rickettsii); coxsackievirus

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3
Q

Does prior infection with most STIs protect against re-infection?

A

NOOO it doesn’t, so re-test patients!

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4
Q

Slapped cheek rash

A

Parvovirus B19

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5
Q

1 bacterial STD in the US

A

Chlamydia

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6
Q

2 bacterial STD in the US

A

Gonorrhea

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7
Q

Small lymphocytes and smudged cells with increased WBC

A

CLL

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8
Q

All patients with STIs should be evaluated for ___.

A

All patients with STIs should be evaluated for HIV! Why? Many STDs facilitate the transmission of HIV, such as chlamydia, gonorrhea, HSV, etc - anything that alters the mucosal integrity.

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9
Q

Acute monoarthritis is ___ until proven otherwise!

A

Acute monoarthritis is INFECTIOUS until proven otherwise!

Consequently, do a joint aspirate to rule out infection and aid in diagnosis.

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10
Q

Koplik spots -white spots on tongue that bleed when you scrape them

A

Measles

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11
Q

Limb girdle pain in older patients

A

Polymyalgia rheumatica. Resolves FAST with prednisone

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12
Q

Baby with deafness, cataracts, heart defects, microcephaly, mental retardation

A

exposure to rubella in utero

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13
Q

If you see polymyalgia rheumatica…

A

think Giant cell arteritis! affects aorta, carotid branches. They’re frequently found together.

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14
Q

CBFalpha - ETO fusion protein blocking differentiation

A

AML

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15
Q

BCR-ABL

A

CML

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16
Q

colon with fissures and fistulas

A

Crohn’s disease

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17
Q

t(11;14)

A

Mantle cell lymphoma

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18
Q

transmural inflammation of colon wall with non-necrotic granulomas

A

Crohn’s disease

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19
Q

Oral apthous ulcers and genital ulcers

A

Behcet’s disease

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20
Q

This vasculitis has an increased incidence in patients who are HLA-B51+

A

Behcet’s disease

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21
Q

Lower resp (hemoptysis, cavitating pulmonary lesions) + upper resp (sinusitis, epistaxis, saddle nose) + renal (hematuria and maybe nephritis)

A

Granulomatosis with polyangiitis (GPA) - ANCA-associated vasculitis

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22
Q

Continuous inflammation of colon without skip lesions

A

Ulcerative Colitis

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23
Q

Young person with an MI… and a PMH of a severe fever treated with IVIG and aspirin

A

Kawasaki disease

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24
Q

t(15;17)

A

Acute promyelocytic leukemia

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25
Q

t(8;14)

A

Burkitt lymphoma

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26
Q

MYC - Ig heavy chain locus, increasing B cell proliferation

A

Burkitt lymphoma

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27
Q

Really high basophil count

A

CML

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28
Q

t(9;22)

A

CML

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29
Q

treatable with ATRA and arsenic

A

APL (acute promyelocytic leukemia)

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30
Q

acanthosis nigricans

A

MetS, T2DM, stomach cancer

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31
Q

t(14;18)

A

Follicular lymphoma

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32
Q

resp and renal symptoms with positive C-ANCA (antibody against PR-3)

A

Granulomatosis with polyangiitis (GPA). Mnemonic is “Get a C GPA in C-PR to pass”

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33
Q

positive pathergy test - stick a needle in the skin and it forms a lump

A

Behcet’s disease

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34
Q

upregulation of Bcl2 due to microdeletion of regulatory microRNA on chromosome 13

A

CLL

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35
Q

Rice water stools

A

Cholera

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36
Q

CD13 and CD33

A

AML

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37
Q

long crystals with negative birefringence

A

Uric acid - gout

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38
Q

yellow plaques around eyes

A

xanthelesma - indicates elevated LDL, higher risk of stroke and CVD

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39
Q

Strawberry tongue

A

Kawasaki disease

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40
Q

CD19, CD10, TdT

A

B cell ALL

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41
Q

fascicular inflammatory infiltrate on muscle biopsy, both T and B cells

A

dermatomyositis

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42
Q

20% blasts or greater in bone marrow or blood (esp. marrow)

A

acute leukemias

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43
Q

either JAK2, calreticulin, or cMPL mutation, with really high platelet count

A

essential thrombocytosis

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44
Q

cyclin D1 - Ig heavy chain locus

A

Mantle cell lymphoma

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45
Q

reticulin fibrosis in the marrow, with some having JAK2

A

primary myelofibrosis

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46
Q

Bcl2 - Ig heavy chain locus preventing apoptosis

A

Follicular lymphoma

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47
Q

Most common childhood systemic vasculitis

A

Henoch-Schonlein purpura

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48
Q

CD3, CD7, TdT

A

T cell ALL

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49
Q

rhomboid crystals with positive birefringence

A

Calcium pyrophosphate

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50
Q

hyposegmented neutrophils with hypogranulation, and ringed sideroblasts

A

myelodysplastic disorders

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51
Q

apple-green on polarization

A

Amyloidosis, which can occur in plasma cell disorders like multiple myeloma

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52
Q

abnormal nailfold exam

A

secondary Raynaud’s

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53
Q

photosensitive dermatitis, often with diarrhea and dementia

A

Pellagra = vitamin B3 (niacin) deficiency

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54
Q

black flies near rivers, causing blindness

A

onchocerchiasis, caused by onchocerca volvulus

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55
Q

Vasculitis associated with IgA nephropathy

A

Henoch-Schonlein purpura

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56
Q

Gauchon’s papules: hyperkeratotic papules

A

dermatomyositis

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57
Q

Tick bite from Ixodes??

A

Babesia, Anaplasma, Lyme

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58
Q

Speckled pattern ANA, Ro and La especially

A

Sjogren’s syndrome

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59
Q

weak shoulders and hips but strong hand grip

A

dermatomyositis or polymyositis

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60
Q

GI infection: afebrile watery diarrhea

A

ETEC, norovirus, cholera, C.perfringens, viral, Bacillus cereus (long incubation), cryptosporidia, C.diff (15% are febrile, though)

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61
Q

t(8;21)

A

AML

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62
Q

Palpable purpura, pauci-immune glomerulonephritis, but no nasopharyngeal involvement

A

Microscopic polyangiitis

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63
Q

counseling for patients on methotrexate

A

avoid pregnancy, avoid alcohol

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64
Q

PML-RARalpha fusion protein blocking differentiation

A

APL (acute promyelocytic leukemia)

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65
Q

muscle biopsy shows rimmed vacuoles and inflammatory infiltrate around muscle fibers

A

inclusion body myositis

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66
Q

nail spooning, aka koilonychia

A

iron deficiency

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67
Q

thin as a broom without edema

A

marasma = chronic starvation

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68
Q

Really high hematocrit, JAK2 mutation

A

polycythemia vera

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69
Q

Perianal pruritus in kids

A

Pinworm - enterobicus vermicularis

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70
Q

swollen belly with edema and fatty liver in a starving kid

A

kwashiorkor = not enough protein

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71
Q

P-ANCA, no granulomas, involves lungs/kidneys/skin

A

Microscopic polyangiitis

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72
Q

yellow-red papules on extensor surfaces

A

eruptive xanthoma - indicates elevated TGs, with increased risk of acute pancreatitis

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73
Q

MOA of echinocandins

A

Inhibits Beta glucan synthase in fungi

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74
Q

Punched out lytic bone lesions on X-Ray with monoclonal M spike

A

Multiple Myeloma

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75
Q

erythematous papules and plaques in genital and perineal region

A

extramammary Paget’s disease

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76
Q

MOA of Amphotericin B

A

Anti-fungal: binds ergosterol and causes membrane pores

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77
Q

inflammatory infiltrate around individual muscle fibers, mostly CD8+ T cells

A

polymyositis

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78
Q

sudden appearance of many seborrheic keratoses

A

adenocarcinoma of stomach or colon

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79
Q

itchy without any rash, “butterfly sign”

A

paraneoplastic pruritus, commonly found in lymphoma (esp. Hodgkin lymphoma) and leukemia

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80
Q

treatment for IBD-associated arthritis - what not to do

A

avoid NSAIDs!

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81
Q

Oxidase negative GNRs

A

Salmonella, shigella

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82
Q

Food poisoning from sprouts

A

EHEC

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83
Q

Granulomatous thickening/narrowing of aortic arch

A

Takayasu arteritis

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84
Q

rash, myalgia, spread by flying squirrels

A

epidemic typhus (R. prowazekii)

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85
Q

Elephantiasis affecting lower limbs, scrotal swelling

A

Wuchereria bancrofti - human filariasis

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86
Q

worm crawling in eye

A

loa loa

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87
Q

Eggs with points/spikes

A

Schistosomiasis. Lateral spine is mansoni, spine at the tip is haematobium, no spine is japonicum

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88
Q

Lower limb ulcer with protruding larva -> think prevention

A

Guinea worm: filter water through cloth to prevent infection

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89
Q

NVD with diplopia, dysphonia, dysphagia

A

Botulism from preformed toxin

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90
Q

Leads to HUS

A

EHEC and shigella

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91
Q

Eat raw veggies and get obstructive jaundice

A

Fasciola hepatica - liver fluke

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92
Q

Seizures manifesting with weird things in the brain, history of eating the larval stage of something

A

Human cysticercosis - taenia sodium (pork tapeworm) I infection of the brain when you eat the larva

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93
Q

Cigarette burn lesions, aka a tach-noir eschar

A

Rickettsia infection (no eschar in Rocky Mountain spotted fever)

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94
Q

Food poisoning from deli meat and hot dogs

A

Listeria

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95
Q

Unilateral headache and jaw claudication in an old lady

A

Giant cell arteritis

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96
Q

Disease spread by body louse - think refugee camps

A

Epidemic typhus - Rickettsia prowazekii

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97
Q

Suspect anaplasma or erlichia?

A

Treat with doxycycline immediately - don’t wait for testing to confirm!

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98
Q

Toxic megacolon

A

Clostridium difficile

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99
Q

erythema migrans

A

Lyme disease - Borellia burgdorferi

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100
Q

Asian female <40 with weak radial pulses and arthritis

A

Takayasu arteritis

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101
Q

Marrow full of weird-looking megakaryocytes with staghorn nuclei

A

Essential thrombocytosis

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102
Q

HepB seropositive with purpura, neuropathy, hypertension

A

HepB associated polyarteritis nodosa

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103
Q

Rotten egg smelling diarrhea

A

Salmonella

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104
Q

CD30, CD15

A

Hodgkin lymphoma

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105
Q

Rash on Allopurinol therapy… What should you do?

A

STOP the drug! Vasculitis with toxic epidermal necrolysis, which is predictably BAD

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106
Q

Drug for most tick bites?

A

Doxy - give early because it can prevent life-threatening disease. Can even use as prophylaxis if you identify the tick as Ixodes scapularis

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107
Q

GI infections: afebrile, hemorrhagic diarrhea

A

EHEC - enterohemorrhagic E.coli

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108
Q

Hypercalcemia, renal involvement, anemia, bone lytic lesions/back pain

A

Multiple myeloma

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109
Q

Heliotrope rash

A

Dermatomyositis

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110
Q

rash with unknown cause: how do you assess?

A

wear gloves because it might be syphilis

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111
Q

MOA of azole drugs

A

For fungal infections -> inhibit ergosterol synthesis

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112
Q

Second line for pseudomonas

A

Ticarcillin and piperacillin

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113
Q

Tx for gout

A

Colchicine, NSAIDs or steroids, may lower uric acid with diet and lifestyle and XO inhibitors (allopurinol, febuxostat)

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114
Q

Nausea and vomiting 3-6 hours after eating, followed by diarrhea

A

Staph preformed toxin, clinical diagnosis, look for toxin in food

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115
Q

Tx for pseudogout (calcium pyrophosphate)

A

Joint injection with steroids, treat causes including hypomagnesia, hypophosphate, hypoPTH, etc

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116
Q

Diarrhea, rotten egg taste when you belch

A

Giardia

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117
Q

Elevated ANA threshold?

A

> 1:160

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118
Q

Foci of lymphatic infiltrate in minor salivary glands

A

Sjögren’s syndrome

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119
Q

ABX for atypical bacteria

A

Tetracyclines, macrolides, fluoroquinolones

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120
Q

Nonhealing ulcer with overhanging borders in a patient with chronic GI symptoms

A

Pyoderma gangrenosum

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121
Q

Shoulder and hip stiffness that responds quickly to prednisone

A

Polymyalgia rheumatica

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122
Q

Palpable purpura, low C4, false positive RF

A

Cryoglobulinemic vasculitis

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123
Q

Excess of cryoglobulins: monoclonal IgG and IgM

A

Cryoglobulinemic vasculitis I: hyperviscosity syndrome, with mucosal bleeding

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124
Q

Most severe malaria

A

Plasmodium falciparum

125
Q

“Mechanic’s hands” with skin cracking, and interface dermatitis

A

Dermatomyositis

126
Q

Penicillin allergy, pregnant, and has syphilis?

A

Desensitize and give penicillin

127
Q

Cold-agglutinating polyclonal IgG and monoclonal IgM or IgA with false positive RF

A

Cryoglobulinemic vasculitis II

128
Q

painful indurated veins, also referred to as migratory superficial thrombophlebitis

A

Trousseau’s sign, indicating adenocarcinoma, often of the pancreas

129
Q

Loss of lactobacillus, overgrowth of ___ leads to bacterial vaginosis

A

Gardnerella

130
Q

Oxidase positive GNR

A

Pseudomonas

131
Q

GI infection: febrile hemorrhagic diarrhea

A

Shigella, Salmonella, Campylobacter, Yersinia, Entamoeba histolytica, Vibrio hemolytica

132
Q

GI infection: febrile watery diarrhea

A

Salmonella, Campylobacter, EPEC, Yersinia

133
Q

First line therapy for pseudomonas

A

Cefepime and ceftazadime

134
Q

Auer rods - red lines in WBCs

A

AML (this is pathognomic!)

135
Q

When are uricosurics contraindicated?

A

These drugs increase uric acid excretion so they are contraindicated in renal failure/compromised renal function.

136
Q

Multiple eschars that are black with a white center after returning from travel

A

African tick bite fever - rickettsia africae

137
Q

Soft cheese and unpasteurized dairy

A

Listeria, salmonella, campylobacter, EHEC, yersinia

138
Q

P-ANCA with granulomatous necrotizing vasculitis and increased IgE

A

EGPA

139
Q

Disorders that may be associated with JAK2 mutations

A

Polycythemia vera; Essential thrombocytosis; Primary myelofibrosis

140
Q

Watery diarrhea with exposure to reptiles (turtles)

A

Salmonella - dx from stool culture

141
Q

Diarrhea, exposure to puppy

A

Campylobacter

142
Q

Osteomyelitis in a patient with Sickle Cell Disease

A

Salmonella

143
Q

Prevention of Haemophilus influenzae B

A

Immunization and give rifampin to exposed kids

144
Q

Infection associated with acute rejection of transplanted organs

A

CMV

145
Q

What organisms are you susceptible to without a functioning spleen?

A

Encapsulated organisms, especially S.pneumo, N.meningitidis, and HiB, but also Babesia, Plasmodium, Capnocytophaga

146
Q

Snake-like rash

A

Strongyloides stercoralis

147
Q

Diagnostic criteria for acute leukemias

A

Greater than or equal to 20% blasts, OR evidence of a recurrent cytogenetic abnormality associated with AML

148
Q

perineal and facial red rash

A

acrodermatitis enteropathica, from zinc deficiency

149
Q

Tx for strongyloides

A

Ivermectin

150
Q

High N:C ratio, clear spots indicative of nucleoli, fine chromatin

A

Blast cell

151
Q

More than one ring stage within RBC

A

Plasmodium falciparum

152
Q

Drugs for CMV

A

Valgancyclovir, ganciclovir, foscarnet, cidofovir

153
Q

Anemia risk with CML: what type is most likely?

A

Autoimmune hemolytic anemia

154
Q

Paravertebral mass staining positive for lambda or kappa light chains

A

Plasmacytoma

155
Q

Most common persistent watery diarrhea cause in AIDS patients

A

Cryptosporidium

156
Q

Diagnostic test for neurocysticercosis

A

Immunoblot assay or rarely biopsy demonstrating larva in brain tissue

157
Q

You find a plasmacytoma- what’s the next step?

A

Bone marrow biopsy to look for multiple myeloma

158
Q

Banana-shaped gametocytes

A

Plasmodium falciparum

159
Q

Low peripheral blood counts of one or more lineages, with hypercellular marrow for age

A

Myelodysplastic syndrome

160
Q

High N:C ratio with darker clumpy chromatin

A

Lymphocyte (not a blast)

161
Q

Eosinophilic lines that look kind of crystalline found in some cells with visible nucleoli and fine chromatin

A

Auer rods, indicative of AML

162
Q

Increased PMNs and band cells

A

Reactive neutrophilia

163
Q

Greatly increased granulocytes, including basophils and eosinophils; increased myelocytes, increased metamyelocytes

A

CML

164
Q

Hypercellular marrow full of myeloid cells and micromegakaryocytes

A

Seen in CML and myelodysplastic syndromes

165
Q

Erythrocytosis with low EPO levels, may be associated with thrombocytosis and mild neutrophilia

A

Polycythemia Vera

166
Q

Key feature distinguishing polycythemia vera from secondary polycythemia

A

Low EPO in PV

167
Q

Bone marrow biopsy finding in Polycythemia Vera

A

Hypercellular with increases in all lineages

168
Q

High PLTs without erythrocytosis or leukocytosis - rule out anemia, inflammation, and other malignancies

A

Essential thrombocytosis

169
Q

Teardrop RBCs and megakaryocytes with cloud-like nuclei

A

Primary myelofibrosis

170
Q

Monosomy 7; 5q deletion, trisomy 8

A

Myelodysplastic syndrome

171
Q

Intrinsic pathway of apoptosis

A

Bcl2 leads to activation of caspases via cytochrome C

172
Q

Extrinsic pathway of apoptosis

A

Mediated by Fas ligand, leads to activation of caspases

173
Q

RFs for endocarditis

A

Abnormal valve, turbulent flow, any way that bacteria can get in!

174
Q

Definition: defensins

A

Proteins that punch holes in bacterial cell walls - cleaved to active forms, and are very positively charged. Work based on electrostatic charges to enter membranes and make holes

175
Q

Definition: histatins

A

Cationic proteins in oral cavity designed to kill fungi

176
Q

C-type lectins

A

Proteins produced in gut, lead to pore formation in pathogens

177
Q

Panniculitis

A

Inflammation of subcutaneous fat

178
Q

Alternative complement pathway

A

C3 is hydrolyzed, activates cascade by auto-cleaving into C3bBb with help of factor B. This is a C3 convertase and leads to opsonization and signaling

179
Q

C1 inhibitor deficiency

A

Hereditary angioedema

180
Q

CD59 or CD55 deficiency (GPI-linked proteins)

A

Paroxysmal Nocturnal Hemoglobinuria

181
Q

Drug treatment for Paroxysmal Nocturnal Hemoglobinuria

A

Anti-C5 Ab

182
Q

Nitroblue Tetrazolium test (NBT test)

A

Turns blue in presence of ROS, so used to diagnose Chronic Granulomatous Disease

183
Q

Antigen-presenting cells of the skin

A

Langerhans cells

184
Q

Cancer of stratum basale

A

Basal cell carcinoma

185
Q

Uncomplicated pyelonephritis Tx

A

Levofloxacin, ciprofloxacin, or TMP-sulfa outpatient with close follow-up
IV ceftriaxone or an aminoglycoside inpatient

186
Q

Proteins linking keratinocytes

A

Desmosomes, linked by desmogleins (Dsg1, Dsg3)

187
Q

Layer of skin containing profillagrin and keratin, as well as hydrolases and natural moisturizing factors

A

Stratum granulosum

188
Q

Protein stabilizing stratum corneum

A

Fillagrin

189
Q

Osler nodes (swollen and tender distal digits)

A

Immunologic finding in endocarditis

190
Q

Autosomal dominant fillagrin mutation

A

Ichthyosis vulgaris

191
Q

Defective keratinization causing hard, plate-like scaling of skin and cracks and breaks

A

Lamellar ichthyosis

192
Q

Tiny waxy papules, AD inheritance

A

Punctuate keratoderma

193
Q

GNRs implicated in endocarditis

A

HACEK - haemophilus, agregatibacter, cardiobacterium, eikenella, kingella

194
Q

Rank emollients by oil content: cream, lotion, ointment

A

Ointment > cream > lotion. Ointments may feel greasy but are most protective. Lotions are less protective but more elegant.

195
Q

Extracellular matrix composition in dermis

A

Collagen, elastin, fibrillin. Fewer cells.

196
Q

GP cocci causing endocarditis

A

1 S. Aureus, also coagulase-negative staph

197
Q

Asymptomatic bacteruria <1month post-renal transplant?

A

Treat with fosfomycin

198
Q

Patient with history of valve defect… At risk for?

A

Infective endocarditis

199
Q

Collagen disorder with stretchy/fragile skin, wide scars, stretchy joints

A

Ehlers-Danlos type I

200
Q

Defective lipid barrier disorder of the skin that can be fatal without adequate treatment

A

Harlequin ichthyosis

201
Q

Libman-Sacks endocarditis

A

SLE!

202
Q

Smaller vegetations, murmur 85%, insidious course, abnormal valve

A

Subacute bacterial endocarditis

203
Q

Splinter hemorrhages in nail beds, Janeway lesions on soles of feet, subconjunctival hemorrhage, retinal hemorrhage (Roth spots), petechiae

A

Embolic symptoms of infective endocarditis

204
Q

Dental procedures, mouth lesions, GI trouble, and endocarditis

A

Viridans strep - strep mutans

205
Q

Drugs that can lead to drug-induced lupus

A

Hydralazine, Procainamide, Isoniazid

206
Q

Colon lesions, colon cancer, stool changes, and endocarditis

A

Strep gallolyticus

207
Q

1 cause of acute bacterial endocarditis in all risk groups

A

S. Aureus

208
Q

GI, GU, UTI problems and endocarditis

A

Enterococcus faecalis

209
Q

Asymptomatic bacteruria in a pregnant woman?

A

Treat with fosfomycin (avoid nitrofurantoin in first trimester)

210
Q

Major Duke criteria

A

blood cultures positive (3 sets obtained, 2/3 are positive); echocardiogram is positive (transthoracic, then transesophageal)

211
Q

Replicating cuboidal layer of epithelium

A

Stratum basale

212
Q

S. Aureus growing in urine?

A

Probably not bacteruria from a UTI… Substantial chance this is due to systemic bacteremia, so check it out!!

213
Q

When to do dental prophylaxis with ABX

A

Prosthetic valve, known abnormal valve, Hx of transplant, previous endocarditis, other serious risk factors

214
Q

Histology reveals split below basal layer of epidermis, with linear deposition of C3 and IgG at basement membrane zone, from antibodies to BPAG1 and BPAG2

A

Bullous pemphigoid

215
Q

2 cause of uncomplicated UTI

A

Staph saprophyticus (honeymoon cystitis)

216
Q

Anti-inflammatory, pro-fibrotic cytokine

A

TGFbeta

217
Q

ABX that block transpeptidase crosslinking of peptidoglycan in cell walls by interfering with PBPs (broad category)

A

Beta-lactams

218
Q

Fissures and dry scale caused by dehydration, lack of natural moisturizing factors, lack of intercellular lipids, etc

A

Xerosis (dry skin)

219
Q

ABX options for uncomplicated cystitis

A

Nitrofurantoin (normal kidney function)
Fosfomycin or TMP-sulfa if <20% local resistance
Avoid fluoroquinolones

220
Q

Large vegetations, murmur 50% of time, rapid onset, high fever, normal valve

A

Acute bacterial endocarditis

221
Q

Criteria for suspecting sepsis: qSOFA

A

Systolic BP at or below 100, RR at 22 or above, altered mentation (GCS<15) - 2 out of 3 with suspicion of infection.

222
Q

3 cause of uncomplicated UTI

A

Other GN bacteria

223
Q

Thickened areas of skin over pressure points, AD inheritance

A

Focal keratoderma

224
Q

Autoantibody in mixed connective tissue disease

A

U1-RNP

225
Q

Lectin complement pathway

A

Mannose binding lectin recognizes carbohydrates on pathogen, activates cascade, leading to formation of C3 convertase, etc.

226
Q

AD fibrillin mutation presenting with tall height, long limbs, mitral valve prolapse, aortic dissection, stretchy

A

Marfan’s syndrome

227
Q

Keratinocytes starting to flatten out in this layer

A

Stratum spinosum

228
Q

Classical complement pathway

A

C1q binds to Ab (usually IgM), activates cascade by recruiting C1r and C1s -> cleaves C2, C4 forming C3 convertase, leading to C3b and C5b opsonization of pathogens

229
Q

Smith Ab/anti-dsDNA

A

SLE

230
Q

Granular IgG deposition in glomeruli suggests…

A

Type III hypersensitivity - immune complex deposition (SLE, post-strep glomerulonephritis)

231
Q

Cannot extend a blister by pulling laterally

A

Negative Nikolsky sign: subepidermal split

232
Q

Cuts, boils, skin infections, IV drug use, and endocarditis

A

S. Aureus

233
Q

Antibodies with centromere staining pattern, Scl-70

A

Scleroderma

234
Q

Anti-Scl70 is the antibody against…

A

DNA topoisomerase I

235
Q

Immunofluorescence of glomeruli in lupus nephritis

A

Granular pattern of IgG deposition

236
Q

Autosomal recessive disease with widespread blistering and scarring that may be deadly; involves lack of laminin and BPAG2

A

Junctional EB

237
Q

1 therapy for T.pallidum

A

Penicillin

238
Q

Increased cancer risk in Sjogren’s

A

Lymphoma

239
Q

Pattern of immunofluorescence in Goodpasture disease

A

Linear IgG deposition

240
Q

Polyclonal B and T cells infiltrating salivary gland

A

Sjögren’s syndrome

241
Q

TdT+ blasts without surface Ig but with CD19 (probably)

A

B cell ALL

242
Q

Papules and vesicles on extensors, very pruritic, with IgA at the tips of dermal papillae

A

Dermatitis herpetiformis

243
Q

Histology showing fibrotic thickening of skin

A

Probably scleroderma

244
Q

Watermelon stomach

A

Telangiectasias of stomach in scleroderma

245
Q

Centromere pattern - 30-60 small dots on ANA test

A

Specific for systemic sclerosis

246
Q

“Starry sky” LN biopsy with lots of tingible body macrophages

A

Burkitt’s lymphoma (t(8;14), Myc-Ig heavy chain)

247
Q

Hands fixed into claw-like positions due to deposition of fibrous tissue

A

Sclerodactyly

248
Q

Vasculitis of arteries above the base of the skull

A

Giant cell arteritis

249
Q

Autoantibody that’s highly suggestive of polymyositis/dermatomyositis

A

Jo-1

250
Q

Which of the following can resolve spontaneously: bullous pemphigoid, pemphigus vulgaris, or cicatricial pemphigoid?

A

Bullous pemphigoid - can resolve spontaneously or be treated with oral minocycline

251
Q

Giant cell arteritis suspected… What to do next?

A

Steroids emergently, before biopsy comes back

252
Q

Can lab findings alone diagnose UTI?

A

No! You need the clinical context

252
Q

Molecules causing degradation in tissue remodeling

A

Matrix metalloproteases

254
Q

Gash in skin from a sharp force injury, with tissue divided to the depth of the wound

A

Incision or stab

255
Q

Bug associated with 30% of cases of polyarteritis nodosa

A

Hepatitis B

256
Q

This step of scar formation is characterized by lots of new vasculature, loose collagen, fibroblasts, and background macrophages

A

Granulation tissue

257
Q

Factors involved in angiogenesis and pericyte detachment

A

ANG1/ANG2, with Notch signaling regulating branching pattern

258
Q

Factor inducing endothelial cell migration and proliferation

A

VEGF-A

259
Q

Vasculitis with c-ANCA

A

Granulomatosis with polyangiitis (GPA)

260
Q

Thickened area of skin over whole palm or sole, AD inheritance

A

diffuse keratoderma

261
Q

1 cause of uncomplicated cystitis

A

E. Coli

262
Q

Minimal tissue loss, small or sutured wound: Healing by _____ intention

A

Healing by first intention

263
Q

Large, open wound with extensive tissue loss: Healing by _____intention

A

Healing by second intention (think large amounts of wound contraction, like in diabetic foot ulcers)

264
Q

Cat bite infection

A

Pasturella multocida

265
Q

Gash in skin from a blunt force injury, with tissue bridging across the gap

A

Laceration

266
Q

Row of tombstones on histology

A

Pemphigus vulgaris: split between stratum basale and stratum spinosum

267
Q

Life-threatening organ dysfunction from dysregulated host response to infection

A

Sepsis

268
Q

Complicated cystitis causative factors

A

E. Coli but also pseudomonas, more gram positives

271
Q

Flat lesion >0.5 cm

A

Patch

273
Q

Human bite infection (think bar fight!)

A

Eikenella corrodens

275
Q

Organism that forms opportunistic infections in burns

A

Pseudomonas

276
Q

Infection of traumatic open wound, causing severe tissue destruction

A

Clostridium perfringens

277
Q

Definition of septic shock

A

Vasopressors required to keep MABP at or above 65 AND serum lactate >2 without hypovolemia

278
Q

Pulmonary HTN in an autoimmune disease

A

Probably systemic sclerosis

279
Q

In a septic patient, when does organ dysfunction actually develop?

A

Before blood pressure drops, frequently - occurs when microvascular abnormalities like thrombin occur, which frequently takes place before patients become hypotensive.

280
Q

SSA Ro/SSB La

A

Sjogren’s Syndrome

281
Q

Management of sepsis

A

1) Emergent vascular access and fluid resuscitation

2) Draw blood cultures but give broad-spectrum ABX within one hour!!!

282
Q

This microbiome technique looks at the 16s subunit of bacterial ribosomes, and can be performed from samples or isolates, but takes a while and is labor-intensive.

A

Gene sequencing of rRNA

283
Q

Small flat lesion <0.5 cm

A

Macule

284
Q

Intracellular proteins involved in the hemidesmosome

A

BPAG1, BPAG2, integrins

285
Q

Pruritic, purple, polygonal papules and plaques found on wrist, in mouth, on genitals, may koebnerize

A

Lichen planus

287
Q

Viable bacteria in the blood

A

Bacteremia

288
Q

Protein that traverses the lamina lucida of the basement membrane zone of the epidermis

A

BPAG2

289
Q

Proteins that make up the lamina densa

A

Laminin 5, collagen IV

290
Q

Painful mucosal erosions, especially on oral mucosa; flaccid blisters and erosions on skin; antibodies against Dsg3

A

Pemphigus vulgaris

291
Q

Can extend a blister pulling laterally

A

Positive Nikolsky sign: bulla or vehicle is epidermal

292
Q

Granulomatous of aortic arch or its branches

A

Takayasu arteritis

293
Q

Pemphigus vulgaris immunofluorescence

A

IgG and C3 throughout entire epidermis, from antibody against Dsg3

294
Q

Describe pathology findings in cicatricial pemphigoid

A

Looks like bullous pemphigoid, with subepidermal split below the basal layer and linear IgG and C3 at the BMZ. Ab against BPAG2 and laminin 5

295
Q

Tx for pemphigus vulgaris, cicatricial pemphigoid

A

Topical corticosteroids, oral corticosteroids, may add immunosuppressants

296
Q

Geometric pattern of papules, plaques, vesicles that occur without family history of atopy, and with specific activity or exposure

A

Allergic contact dermatitis

297
Q

Tense adherent bullae or vesicles on an erythematous base, often presenting as new-onset itching in an elderly patient

A

Bullous pemphigoid

298
Q

Autosomal dominant disease characterized by blisters on extremities including palms and soles presenting with mechanical stress, involving Keratins 5 and 14

A

EB simplex

299
Q

AD or AR disease (AR more severe) involving lack of or abnormal collagen VII, leading to severe scarring and deformity

A

Dystrophic EB

300
Q

Rash associated with celiac disease

A

Dermatitis herpetiformis

301
Q

Antibodies to check in dermatitis herpetiformis

A

Look for anti-gliadin and anti-tissue transglutaminase antibodies

302
Q

Symmetric rash on extensors, buttocks, occipital scalp associated with GI involvement on biopsy

A

Dermatitis herpetiformis

303
Q

Plaques on scalp, extensor surfaces, etc with thin silvery “micaceous” scale, sharply circumscribed, not particularly itchy

A

Psoriasis

304
Q

Plaques on flexor surfaces, more irregular with an indistinct border, very pruritic, may have excoriations, may have some white scale or serous crusting

A

Eczema (atopic dermatitis)

305
Q

CREST syndrome: Calcinosis, Reynaud’s, esophageal dysmotility, sclerodactyly, telangiectasias

A

Form of limited scleroderma, associated with anti-centromere antibody.

306
Q

Atopic triad

A

Asthma, allergic rhinitis, atopic dermatitis

307
Q

Vasculitides with p-ANCA

A

EGPA, MPA

308
Q

Patient with pityriasis alba may have a predisposition towards ___

A

Atopic dermatitis

310
Q

Redness, scaling, and sclerosis as a response to chronic leg edema

A

Stasis dermatitis

323
Q

This microbio technique identifies isolates based on protein content, and is quick and easy to perform, but does require enough biomass from the isolate.

A

Mass spectrometry (MALDI-TOF)

324
Q

Factors contributing to poor wound healing

A

Vitamin C deficiency, steroids (decreased TGF-beta), infection, diabetes (vascular compromise but also decreased TGF-beta, increased infection, neutrophil dysfunction, neuropathy)

327
Q

Shark bite, seafood/saltwater injury

A

Vibrio vulnificans

339
Q

Dog bite infection

A

Capnocytophaga canimorsus

340
Q

Technique for escaping adaptive immunity

A

Antigenic variation

Invaders And Defense (4 decks)

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