COMLEX Review Flashcards
1
Q
Microbe causing meningitis + petichial rash
A
Neisseria meningitidis
2
Q
Pregnancy hormone that causes increase in maternal pancreatic islet cells
A
human placental lactogen
3
Q
Where is calcium absorbed in the kidney?
A
Distal convoluted tubule
4
Q
ABGs in someone going to high altitude
A
Resp. alkalosis, decreased HCO3 and pCO2
5
Q
What happens to LH and FSH in menopause?
A
First FSH increases then, late, LH increases
6
Q
Side-effects of long-term anabolic steroid use
A
Gynecomastia and hypogonadism
7
Q
Area of heart with slowest conduction velocity
A
AV node (0.01-0.05 m/sec)
8
Q
Female with dysmenorrhea and soft tissue tumor
A
Leiomyosarcoma (Uterine fibroids)
9
Q
Child with tuberous sclerosis and a cardiac mass
A
Rhabdomyoma
10
Q
Most common association with vitiligo
A
Thyroid disease
11
Q
Appearance of Molluscum contagiosum
A
Flesh-colored, domed, pearly, and umbilicated (dimpled)
12
Q
Appearance of lichen planus
A
Polygonal, pruritic, purple, flat-topped papules on skin, tongue, mucosa, genitals
13
Q
When to perform emergency surgery with AAA
A
Rupture, grows >1cm per year, diameter >5.5cm (men) or 4.5cm (women)
14
Q
What do you give diabetics with microalbuminuria?
A
ACE-Inhibitors
15
Q
Type of CNS tumor with psammoma bodies and whorled pattern?
A
Meningioma
16
Q
Most common primary CNS malignancy in adults?
A
Glioblastoma multiforme
17
Q
Finding on UA in patient with ARF?
A
Hyaline casts
18
Q
Meig’s Syndrome
A
Uterine fibroma, ascites, pleural effusion
19
Q
Japanese, pelvic pain, indigestion, and acanthosis nigricans?
A
Krukenberg tumor (mucin-producing gastric adenocarcinoma)
20
Q
What are the symptoms of carcinoid syndrome?
A
Flushing, wheezing, and diarrhea (Common location is appendix)
21
Q
Most common cancer of the thyroid? Forms psammoma bodies?
A
Papillary carcinoma
22
Q
Genetic mutation in seborrheic keratosis
A
FGFR3
23
Q
Multiple seborrheic keratoses is indicative of what cancer?
A
Gastrointestinal adenocarcinmoa (Referred to as Leser-Trelat sign)
24
Q
Insidious proximal muscle weakness, malar rash, heliotrope rash, perimysial inflammation, scaly eruption on fingers, shawl sign, Anti-Jo-1 Ab
A
Dermatomyositis
25
Insidious waxing and waning proximal weakness (usually involving shoulders and/or thighs), endomysial inflammation, Anti-Jo-1 Ab
Polymoyositis
26
Thyroid cancer with elevated calcitonin?
Medullary thyroid carcinoma
27
Smooth, shiny papules arranged in a circle on hands and feet of diabetics?
Granuloma annulare
28
Asbestos fibers are coated with what?
Iron and protein
29
MRI in patient with Huntington's will show what?
Caudate nucleus degeneration
30
Black female with restrictive lung disease, Bell's palsy, and elevated serum ACE?
Sarcoidosis
31
Symptoms of glucagonoma?
Hyperglycemia, anemia, venous thrombosis, infections, diarrhea, necrolytic erythema, bronze-colored induration
32
Seronegative spondyloarthropathies?
Psoriatic arthritis, anylosing spondylitis, Reiter's syndrome
33
Most severe type of osteogenesis imperfecta and its mode of inheritance?
Type 2, autosomal dominant
34
Tay-Sachs disease?
Deficiency: Hex-A; Accumulates: GM(2)-Gangliosides in CNS; Signs/Symptoms: Neurodegeneration, developmental delay, cherry-red spot on macula, **NO HEPATOSPLENOMEGALY**
35
Gaucher disease?
Deficiency: Glucocerebrosidase; Accumulates: Glucocerebrosides in RES; Signs/Symptoms: Aseptic necrosis of femur, bone crises, Gaucher cells, hepatosplenomegaly
36
Neimann Pick disease?
Deficiency: Sphingomyelinase; Accumulates: Sphingomyelin in CNS; Signs/Symptoms: Neurodegeneration, cherry-red spot on macula, hepatosplenomegaly
37
Fatigue, weight loss, night sweats, and chronic back pain in an immigrant?
Pott disease (does not have to have pulmonary involvement)
38
Most common cause of postrenal ARF in men?
BPH
39
Cause of waxy casts?
Chronic renal failure (e.g. diabetic)
40
Causes of brown, muddy casts?
Acute tubular necrosis (CHF, hemorrhage, dehydration, etc.)
41
Causes of hyaline casts?
Nonspecific (Dehydration, low urine flow, vigorous exercise, etc.)
42
Causes of red blood casts?
Glomerulonephritis (Nephritic syndrome, SLE, Goodpastures, PSGN, etc.)
43
Causes of white blood casts?
Acute pyelonephritis, acute tubulointerstitial nephritis
44
Paraneoplastic syndrome associated with squamous cell lung carcinoma?
PTHrP
45
Paraneoplastic syndrome associated with small cell lung carcinoma?
ACTH or ADH
46
Signs and symptoms of hereditary hemochromatosis?
Fatigue, polydipsia, polyuria, liver failure, weight loss, skin hyperpigmentation, arthritis, and dilated cardiomyopathy
47
Rash, headache, abdominal pain, HTN, and Hep B positive?
Polyarteritis nodosa
48
Signs and symptoms of tuberous sclerosis?
Hamartomas, mental retardation, seizures, angiofibromas of skin and kidneys, ash leaf spots, and cardiac rhabdomyoma
49
Benign childhood cerebellar tumor?
Pilocytic astrocytoma
50
Raised bumps in webs of fingers and toes?
Scabies
51
Pediatric patient with non-infectious bloody stools?
Meckel diverticulum
52
Most important prognostic feature of malignant melanoma?
Depth of the lesion
53
Bone tumor at the metaphysis that shows sunburst pattern and Codman's triangle?
Osteosarcoma
54
Peau d'orange in breast cancer is caused by what?
Contraction of the suspensory Cooper's ligaments
55
Necrotizing vasculitis, granulomas in lung, glomerulonephritis, chronic sinusitis, and c-ANCA?
Wegener's granulomatosis
56
Some causes of urinary incontinence and detrusor instability?
Frequent UTIs, bladder stones, bladder cancer, and foreign bodies
57
Patient with lymphoma and fluid in the pleural space?
Chylothorax: lymphoma blocks drainage of the thoracic duct and triglyceride-rich fluid leaks into the pleural space
58
Signs and symptoms of Henoch-Schonlein Purpura?
Rash, arthritis, hematuria, and abdominal pain. Follows viral URI. Mesangial IgA deposits on biopsy.
59
Enlarged uterine size and hCG \>100,000?
Complete molar pregnancy
60
Signs and symptoms of Freidreich's ataxia?
Staggering gait, nystagmus, pes cavus, hammer toes, and hypertrophic cardiomyopathy
61
Signs and symptoms of Reye's syndrome?
Fatty liver, hypoglycemia, vomiting, hepatomegaly, and coma
62
MOA of bisphosphonates
Decrease osetoCLAST activity
63
Virulence factors of Gonococci
IgA protease and antigenic variation of pilus
64
What is given with RIPE treatment for TB to prevent neurotoxicity?
Vitamin B6 (pyridoxine)
65
Interaction between TMP/SMX and warfarin?
TMP/SMX inhibits CYP450, increasing plasma levels of warfarin. Reduce warfarin levels accordingly.
66
What drug is used to treat hypercalcuria and calcium renal stones?
HCTZ (causes hypercalcemia)
67
Neurotransmitter synthesized in the locus ceruleus?
Norepinephrine
68
Neurotransmitter synthesized in the ventral tegmentum and substantia nigra?
Dopamine
69
Neurotransmitter synthesized in the raphe nucleus?
Serotonin
70
Neurotransmitter synthesized in the basal nucleus of Meynert?
Acetylcholine
71
Neutotransmitter synthesized in the nucleus accumbens?
GABA
72
ID and DOC for Staph aureus
Catalase +/coagulase +, Beta hemolytic, Methacillin, nafcillin, oxacillin
73
ID and DOC for Staph epidermidis
Catalase +/coagulase -,
74
ID and DOC for Strep pneumoniae
Catalase -/coagulase -, Optochin Sensitive, PCN
75
ID and DOC for Strep pyogenes
Catalase -, Beta hemolytic, Bacitracin sensitive, PCN
76
What does ingestion of benzene cause?
Aplastic anemia
77
What does ingestion of lead cause?
Microcytic anemia with increased protoporphyrin
78
What does ingestion of mercury cause?
Acute renal failure with brown casts and hemorrhagic gastritis
79
What does ingestion of cyanide cause?
Disruption of the ETC and depletion of ATP
80
MOA of cilastin? (Imipenem/cilastin)
Inhibits renal dehydropeptidase 1
81
Most severe side effect of macrolides?
Prolonged QT
82
Confirmation of chronic granulomatous disease?
Negative nitroblue tetrazolium staining test
83
Side effects of fluconazole?
Gynecomastia and inhibition of P450
84
Side effects of rifampin?
Orange body fluids, hepatotoxicity, induction of P450
85
Side effects of tetracycline?
Discoloration of teeth and inhibition of bone growth in children; photosensitivity
86
Side effects of macrolides?
Acute cholestatic hepatitis, prolonged QT, rash
87
Side effects of aminoglycosides?
Ototoxicity, neuromuscular blockade, and nephrotoxicity
88
Maneuver which increases afterload?
Handgrip
89
Maneuver which increases preload?
Squatting
90
Maneuver which decreases preload?
Valsalva/standing
91
Weght loss regimen?
Increase unsaturated fats, decrease saturated fats, 150 minutes of moderate or 75 minutes of vigorous exercise per week
92
When testing thyroid function what do you check first?
TSH
93
Difference between ETEC and cholera?
Same symptoms (nausea, diarrhea, cramps) but cholera is more severe; may cause dehydration
94
Schilling's test for pernicious anemia?
Oral radioactive B12 and IF followed by IM B12 causes normal urinary excretion of B12
95
Coagulation studies in vWD
Prolonged bleeding time and sometimes prolonged PTT (50%)
96
Neisseria meningitidis
Microbe causing meningitis + petichial rash
97
human placental lactogen
Pregnancy hormone that causes increase in maternal pancreatic islet cells
98
Distal convoluted tubule
Where is calcium absorbed in the kidney?
99
Resp. alkalosis, decreased HCO3 and pCO2
ABGs in someone going to high altitude
100
First FSH increases then, late, LH increases
What happens to LH and FSH in menopause?
101
Gynecomastia and hypogonadism
Side-effects of long-term anabolic steroid use
102
AV node (0.01-0.05 m/sec)
Area of heart with slowest conduction velocity
103
Leiomyosarcoma (Uterine fibroids)
Female with dysmenorrhea and soft tissue tumor
104
Rhabdomyoma
Child with tuberous sclerosis and a cardiac mass
105
Thyroid disease
Most common association with vitiligo
106
Flesh-colored, domed, and pearly
Appearance of Molluscum contagiosum
107
Polygonal, pruritic, purple, flat-topped papules on skin, tongue, mucosa, genitals
Appearance of lichen planus
108
Rupture, grows \>1cm per year, diameter \>5.5cm (men) or 4.5cm (women)
When to perform emergency surgery with AAA
109
ACE-Inhibitors
What do you give diabetics with microalbuminuria?
110
Meningioma
Type of CNS tumor with psammoma bodies and whorled pattern?
111
Glioblastoma multiforme
Most common primary CNS malignancy in adults?
112
Hyaline casts
Finding on UA in patient with prerenal ARF?
113
Uterine fibroma, ascites, pleural effusion
Meig's Syndrome
114
Krukenberg tumor (mucin-producing gastric adenocarcinoma)
Japanese, pelvic pain, indigestion, and acanthosis nigricans?
115
Flushing, wheezing, and diarrhea (Common location is appendix)
What are the symptoms of carcinoid syndrome?
116
Papillary carcinoma
Most common cancer of the thyroid? Forms psammoma bodies?
117
FGFR3
Genetic mutation in seborrheic keratosis
118
Gastrointestinal adenocarcinmoa (Referred to as Leser-Trelat sign)
Multiple seborrheic keratoses is indicative of what cancer?
119
Dermatomyositis
Insidious proximal muscle weakness, scaly eruption on fingers, "shawl sign"
120
Polymoyositis
Insidious, waxing and waning weakness, cracking of skin, Anti-Jo-1 Ab
121
Medullary thyroid carcinoma
Thyroid cancer with elevated calcitonin?
122
Granuloma annulare
Smooth, shiny papules arranged in a circle on hands and feet of diabetics?
123
Iron and protein
Asbestos fibers are coated with what?
124
Caudate nucleus degeneration
MRI in patient with Huntington's will show what?
125
Sarcoidosis
Black female with restrictive lung disease, Bell's palsy, and elevated serum ACE?
126
Hyperglycemia, anemia, venous thrombosis, infections, diarrhea, necrolytic erythema, bronze-colored induration
Symptoms of glucagonoma?
127
Psoriatic arthritis, anylosing spondylitis, Reiter's syndrome
Seronegative spondyloarthropathies?
128
Type 2, autosomal dominant
Most severe type of osteogenesis imperfecta and its mode of inheritance?
129
Deficiency: Hex-A; Accumulates: GM(2)-Gangliosides in CNS
Tay-Sachs disease?
130
Deficiency: Beta-glucosidase; Accumulates: Cerebrosides in RES
Gaucher disease?
131
Deficiency: Sphingomyelinase; Accumulates: Sphingomyelin in CNS
Neimann Pick disease?
132
Pott disease (does not have to have pulmonary involvement)
Fatigue, weight loss, night sweats, and chronic back pain in an immigrant?
133
BPH
Most common cause of postrenal ARF in men?
134
Chronic renal failure (e.g. diabetic)
Cause of waxy casts?
135
Acute tubular necrosis (CHF, hemorrhage, dehydration, etc.)
Causes of brown, muddy casts?
136
Nonspecific (Dehydration, low urine flow, vigorous exercise, etc.)
Causes of hyaline casts?
137
Glomerulonephritis (Nephritic syndrome, SLE, Goodpastures, PSGN, etc.)
Causes of red blood casts?
138
Acute pyelonephritis, acute tubulointerstitial nephritis
Causes of white blood casts?
139
PTHrP
Paraneoplastic syndrome associated with squamous cell lung carcinoma?
140
ACTH or ADH
Paraneoplastic syndrome associated with small cell lung carcinoma?
141
Fatigue, polydipsia, polyuria, liver failure, weight loss, skin hyperpigmentation, arthritis, and dilated cardiomyopathy
Signs and symptoms of hereditary hemochromatosis?
142
Polyarteritis nodosa
Rash, headache, abdominal pain, HTN, and Hep B positive?
143
Hamartomas, mental retardation, seizures, angiofibromas of skin and kidneys, ash leaf spots, and cardiac rhabdomyoma
Signs and symptoms of tuberous sclerosis?
144
Pilocytic astrocytoma
Benign childhood cerebellar tumor?
145
Scabies
Raised bumps in webs of fingers and toes?
146
Meckel diverticulum
Pediatric patient with non-infectious bloody stools?
147
Depth of the lesion
Most important prognostic feature of malignant melanoma?
148
Osteosarcoma
Bone tumor at the metaphysis that shows sunburst pattern and Codman's triangle?
149
Contraction of the suspensory Cooper's ligaments
Peau d'orange in breast cancer is caused by what?
150
Wegener's granulomatosis
Necrotizing vasculitis, granulomas in lung, glomerulonephritis, chronic sinusitis, and c-ANCA?
151
Frequent UTIs, bladder stones, bladder cancer, and foreign bodies
Some causes of urinary incontinence and detrusor instability?
152
Chylothorax: lymphoma blocks drainage of the thoracic duct and triglyceride-rich fluid leaks into the pleural space
Patient with lymphoma and fluid in the pleural space?
153
Rash, arthritis, hematuria, and abdominal pain. Follows viral URI. Mesangial IgA deposits on biopsy.
Signs and symptoms of Henoch-Schonlein Purpura?
154
Complete molar pregnancy
Enlarged uterine size and hCG \>100,000?
155
Staggering gait, nystagmus, pes cavus, hammer toes, and hypertrophic cardiomyopathy
Signs and symptoms of Freidreich's ataxia?
156
Fatty liver, hypoglycemia, vomiting, hepatomegaly, and coma
Signs and symptoms of Reye's syndrome?
157
Decrease osetoCLAST activity
MOA of bisphosphonates
158
IgA protease and antigenic variation of pilus
Virulence factors of Gonococci
159
Vitamin B6 (pyridoxine)
What is given with RIPE treatment for TB to prevent neurotoxicity?
160
TMP/SMX inhibits CYP450, increasing plasma levels of warfarin. Reduce warfarin levels accordingly.
Interaction between TMP/SMX and warfarin?
161
HCTZ (causes hypercalcemia)
What drug is used to treat hypercalcuria and calcium renal stones?
162
Norepinephrine
Neurotransmitter synthesized in the locus ceruleus?
163
Dopamine
Neurotransmitter synthesized in the ventral tegmentum and substantia nigra?
164
Serotonin
Neurotransmitter synthesized in the raphe nucleus?
165
Acetylcholine
Neurotransmitter synthesized in the basal nucleus of Meynert?
166
GABA
Neutotransmitter synthesized in the nucleus accumbens?
167
Catalase +/coagulase +, Beta hemolytic, Methacillin, nafcillin, oxacillin
ID and DOC for Staph aureus
168
Catalase +/coagulase -,
ID and DOC for Staph epidermidis
169
Catalase -/coagulase -, Optochin Sensitive, PCN
ID and DOC for Strep pneumoniae
170
Catalase -, Beta hemolytic, Bacitracin sensitive, PCN
ID and DOC for Strep pyogenes
171
Aplastic anemia
What does ingestion of benzene cause?
172
Microcytic anemia with increased protoporphyrin
What does ingestion of lead cause?
173
Acute renal failure with brown casts and hemorrhagic gastritis
What does ingestion of mercury cause?
174
Disruption of the ETC and depletion of ATP
What does ingestion of cyanide cause?
175
Inhibits renal dehydropeptidase 1
MOA of cilastin? (Imipenem/cilastin)
176
Prolonged QT
Most sever side effect of macrolides?
177
Negative nitroblue tetrazolium staining test
Confirmation of chronic granulomatous disease?
178
Gynecomastia and inhibition of P450
Side effects of fluconazole?
179
Orange body fluids, hepatotoxicity, induction of P450
Side effects of rifampin?
180
Damage to tendons, cartilage, and bone
Side effects of tetracycline?
181
GI discomfort and acute cholestatic hepatitis
Side effets of macrolides?
182
Ototoxicity and nephrotoxicity
Side effects of aminoglycosides?
183
Handgrip
Maneuver which increases afterload?
184
Squatting
Maneuver which increases preload?
185
Valsalva/standing
Maneuver which decreases preload?
186
Increase unsaturated fats, decrease saturated fats, 150 minutes of moderate or 75 minutes of vigorous exercise per week
Weght loss regimen?
187
TSH
When testing thyroid function what do you check first?
188
Same symptoms (nausea, diarrhea, cramps) but cholera is more severe; may cause dehydration
Difference between ETEC and cholera?
189
Oral radioactive B12 and IF followed by IM B12 causes normal urinary excretion of B12
Schilling's test for pernicious anemia?
190
Prolonged bleeding time and sometimes prolonged PTT (50%)
Coagulation studies in vWD
191
Bernard-Soulier Syndrome
Mechanism: Decreased GpIb; Findings: Decreased platelet count, increased bleeding time; Defect in platelet adhesion
192
Glanzmanns's Thrombasthenia
Mechanism: Decreased GpIIb/IIIa; Findings: Normal platelet count, increased bleeding time, no platelet clumping; Defect in platelet aggregation
193
Idiopathic thrombocytopenic purpura (ITP)
Mechanism: Anti-GpIIb/IIIa antibodies; Findings: Decreased platelet count, increased bleeding time, megakaryocytes, normal PT/PTT; Splenic marcophages consume platelet/Ab complexes
194
Thrombotic thrombocytopenic purpura (TTP)
Mechanism: Deficiancy of ADAMTS 13 (vWF metalloprotease) -\> decreased degredation of vWF; Findings: Decreased platelets, increased bleeding time, increased platelet aggregation and thrombosis, schistocytes and increased LDH, normal PT/PTT; Neurologic and renal symptoms, fever, thrombocytopenia, and microangiopathic hemolytic anemia
195
Hemolytic-uremic syndrome (HUS)
TTP without neurologic symptoms; Associated with E. coli O157:H7
196
Burkitt's Lymphoma
t(8;14) translocation: c-myc. Starry sky appearance. Associated with EBV. Jaw lesions or pelvic/abdominal mass.
197
Mantle Cell Lymphoma
t(11:14) translocation: cyclin D1. CD5+ cells. Older males most common.
198
Follicular Lymphoma
t(14;18) translocation: bcl-2. Difficult to cure. Bcl-2 inhibits apoptosis.
199
Acute lymphoblastic leukemia/lymphoma
Age \< 15. Can present with mediastinal mass. Greatly increased lymphoblasts in blood and bone marrow. TdT+. Associated with Down's syndrome. 85% are B-ALL (usually in kids), 15% are T-ALL (usually in teens). t(12;21) has better prognosis.
200
Small lymphocytic lymphoma (SLL) / Chronic lymphocytic leukemia (CLL)
Age \> 60. Smudge cells in peripheral blood smear. Can cause autoimmune hemolytic anemia (cold or warm). CLL has \> 4,000 WBC/mm3. Can transform to DLBCL (Richter syndrome).
201
Hairy Cell Leukemia
Adults. Mature B-cell tumor. Cells have filamentous, hair-like projections. Strains TRAP+. Excellent prognosis. Splenomegaly and DRY bone marrow aspiration.
202
Acute Myelogenous Leukemia (AML)
Age around 65. Auer rods (peroxidase+ cytoplasmic inclusions commonly seen in acute promyelocytic leukemia [M3]). MPO+. Greatly increased myeloblasts (\>20% in bone marrow) in blood and marrow. M3 subtype: t(15;17) translocation. Responds to all-trans retinoic acid.
203
Chronic myelogenous leukemia (CML)
Age usually 30-60. Philadelphia chromosome: t(9;22) bcr-abl translocation causes constitutive RAS/STAT/AKT activity. Increased neutrophils, metamyelocytes, and basophils. Low leukocyte alkaline phosphatase (LAP) vs. leukemoid reaction. Treatment: Imatinib
204
Langerhans cell histiocytosis
Proliferation of dendritic (Langerhans) cells. Lytic bone lesions and skin rash. Cells are S-100+ and CD1a+. Birbeck granules (tennis rackets) on EM.
205
Latent TB treatment?
9 months of isoniazid
206
Snake venom antitoxin reaction five days later of fever, rash, and polyarthritis?
Serum sickness, type III hypersensitivity reaction
