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Conception ;) Flashcards

1
Q

Barrett Esophagus:

  • Histology
  • Caused by?
  • Leads to?
A
  • Histology has to show goblet cells in esophageal epitheluim
  • GERD
  • Leads to adenocarcinoma
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2
Q

GIST marker?

A

CD117 or C-KIT

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3
Q

Blood smear from baby: RBCs + acanthocytes

A

Abetalipoproteinemia

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4
Q

Episodic painful diahhrea. Normal colon biopsy & colonoscopy. Cause?

A

IBS

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5
Q

Patient with Ulcerative Colitis. Features?

A

Continuous lesion from rectum to cecum.

(No skip lesions, no fistula/fissure, no perianal dis)

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6
Q

Patient with a ton of mucin in abdominal cavity found during surgery. Origin?

A

Appendix– pseduomyxoma peritonii from appendiceal mucinous cystadenocarcinoma

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7
Q

Patient vomiting blood after alocholic binge. Was vomiting a lot but no blood, except for recently.
Normal stool.

A

Mallory Weiss

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8
Q

Patient has ulcer. Admitted to hospital. Why?

A

Blood vessel running through ulcer– could rebleed.

OR

Clot formation over ulcer

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9
Q

70-year old mad with changing bowel habits. Finds blood in stool.

A

Colon Cancer

(rapidly growing– neovasculization cannot keep up, so ulcer in center)

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10
Q

Patient in ER with sudden onset RUQ pain radiating to R scapula.

  • Multiple children
  • Birth Control (high estrogen)
  • Murphey’s sign +
  • Rebound tenderness
  • Guarding
A

Acute Cholecystitis

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11
Q

Patient had X-ray– showed GAS above duodenum, below diaphragm.

Dx? Management?

A

Peptic Ulcer perforation– GO DIRECTLY INTO SURGERY!

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12
Q

Patient with visible distention in Gall Bladder area.

Palpation– soft & bloated (no stones)

A

Obstructive Jaundice secondary to Pancreatic Cancer

Cancer of Head of Pancreas: blocks exocrine ducts & common bile duct

Tx: remove head of pancreas

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13
Q

Patient recently married- has active sex life.

UTI causative agent?

A

Staph saprophyticus

(Honeymood cystitis)

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14
Q

Microorganism associated with BPH in men?

A

Enterococcus faecalis

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15
Q

Patient with amebiasis, bloody diarrhea.

Dx?

A

Stool sample- ova & parasites (trophozoites with 2 nuclei, cysts w/4)

(Can also cause liver abscess, flask shaped ulcers)

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16
Q

34yo patient in January with diarrhea, no blood or mucus. Crypt cell hyperplasia and blunted villi.

A

Norovirus: naked + ssRNA

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17
Q

Child with pinworms.

  • Transmission?
  • Dx?
  • Tx?
A
  • HAND TO HAND!
  • Scotch tape test for Dx
  • Treat entire family
  • eggs NOT in feces
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18
Q

Ranitidine: MOA

A

H2 antagonists– decreases cAMP production in parietal cells, decreasting acid production

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19
Q

Entecavir: pharmacokinetics

A

Guanosine nucleotide analogue

100% bioavailability on empty stomach!

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20
Q

Patient with low self esteem, percectionist, dependent, had anxiety & OCD. Resistent to treatment.

A

Anorexia

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21
Q

Patient with massive blood loss– treated with defib. What rhythms can you use defib on?

A

Ventricular Tachycardia

Ventricular Fibrillation

NOT PEA, NOT a.fib (use epinephrine)

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22
Q

Young african american child with pigmented stones in gall bladder?

A

Peripheral blood smear– child probably has blood disorder like sickle cell or B-thal

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23
Q

Patient with abdominal pain- during surgery, calcifications are found.

A

Fat necrosis from pancreatitis

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24
Q

Alcoholic with slight elevation of AST/ALT. What is expected in liver histology?

A

Steatohepatitis (liver cell injury + fibrosis)

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25
Q

Patient with Progressive Dysphagia: couldn’t eat solids at first, now can’t drink liquids. Smoker. What would you find on endoscopy?

A

Squamous Cell Carcinoma

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26
Q

Patient with multiple carcinoids in stomach. B12 deficiency. Cause?

A

Autoimmune Chronic Gastritis

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27
Q

RBC Fragility test— cells lysed in hypotonic soln

A

Hereditary Spherocytosis

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28
Q

Gross picture of African child with jaw enlarged, skin open.

A

Burkitt’s Lymphoma (assoc w/EBV)

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29
Q

Patient with urethritis, conjunctivitis, arthritis, and diarrhea.

A

Reactive Arthritis

(associated with Whipple, Chron’s, Celiac)

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30
Q

Patient has GERD– doctor finds something on endoscopy that is cause to worry. What does the patient CURRENTLY have?

A

Picture of GERD (NOT Sq Cell CA)

31
Q

Patient with chronic Lower UTIs. Now has Flank Pain in CVA. Causative agent is G(-) rod, enterobactericiae, lactose-fermenting, pink colonies on MacConkey, ox(-), nitrate(+)

A

E.coli causing PYELONEPHRITIS (NOT cystitis)

32
Q

What is the benefit of antibiotic therapy in H.pylori infection?

A

Reduce recurrence.

(does NOT speed up clearance of sx)

33
Q

Patient with HCV has only modest increase in ALT & AST. Why?

A

Hep C intereferes with immunity– few hepatocytes are being killed/

Chronic because viremia is high all the time.

34
Q

Young girl ate something bad- diarrhea.

Invasive bug– Campylobacter jejuni. What did she eat?

A

Undercooked chicken

35
Q

Pathogenesis of Giardia Lamblia

A

Millions of trophozoites disrupt brush border

(cysts won’t make you ill)

36
Q

Methotrexate: MOA

A

Inhibits DHFR- used for Chron’s

37
Q

Clinical Use of Omeprazole?

A

PPI (+ clarithromycin + amoxicillin/metronidazole) 14 day tx

38
Q

Something goes wrong at the hospital. You want to fix it. Next step?

A

Flow diagram to outline vulnerabilities in the system that can be improved.

39
Q

Tumor. Diagnose H.pylori. Next step?

A

Give antibitoics– want to decrease risk of B-cell lymphoma

40
Q

Patient with abrupt hematuria. Had sore throat 2 weeks ago. See epithelial humps in EM. IF shows granular IgG/C3 deposits. Neutrophil hypercellularity.

A

Acute Proliferative Glomerulonephritis (Post-strep)

41
Q

EM of thin basement membrane.

Prognosis?

A

Excellent- normla renal function

42
Q

Patient with Polycystic Kidney Disease- AD-PKD. How would you screen for other serious complications?

A

Cerebral Angiogram

(Also screen for Liver failure in AR-PKD)

43
Q

Rapidly Progressive Glomerulonephritis Type III: pathology?

A

Crescents

IF: negative

Pauci-immune

Test for ANCA in blood serum

44
Q
A

Achalasia- barium swallow x-ray

Left side

45
Q

How can you diagnose Chronic Pancreatitis?

A

Pancreatic calcification

(don’t expect as many on exam)

46
Q
A

Bladder calculi (vesicular stone)

won’t be this obvi

47
Q

Patient with Acute Tubular Necrosis. What will you see in urine sediment?

A

Granular cast.

48
Q

Patient with high AST & ALT

Heptatitis(+) but serum results negative for every hepatitis

A

HEPATITIS E

49
Q

Patient with infection with G(+), spore–forming rod, anaerobe, cat(-)

How do we prevent spread?

A

C.dificil- MCC nocosomial diarrhea

Use barrier protection & wash hands w/soap & water

50
Q

Patient ate undercooked pork. What clinical findings?

A

Taenia solium (human is def. host)

CT scan shows focal seizures from cyticerocosis

51
Q

Food preparer with cut on finger. Not sick. Boils eggs for easter egg hunt. All children get sick within a few hours.

G(+), cluster forming, cat(+), coag (+), osmotolerant. Yellow in manitol salt

52
Q

What is this? Pathogenesis?

A

Hepatitis A

CD8+ T lymphocyte-mediated cytotoxicity kills hepatocytes (this is why liver enzymes are high)

53
Q

Odansetron: clinical use

A

Chemo-induced Acute N/V

54
Q

Patient with exertional angina with COPD & severe constipation. What do you give?

A

Isosorbide mononitrate (NITRATE)

NOT Ca2+ channel blocker– (verapamil, diltiazem) C/I in constipation

NOT b-blocker (C/I in COPD)

55
Q

Nephritic Syndrome w/ mesangial pattern– what are the depositis/

A

IgA

(Lupus class I looks like this but full house IF)

56
Q

What is this?

A

Stage 2 Membranous Glomerulonephritis

57
Q

SLE, Lupus Nephritis- global & diffuse. What stage?

A

Stage IV: global diffuse proliferative GN, full house

(Stage I almost normal, Stage II like IgA Nephropathy but full house, Stage III- focal prolif GN and full house)

58
Q

Patient found unconscious in home– suffers from diffuse tubular necrosis of proximal tubules. What is the cause?

A

Toxins (diffuse necrosis only in the PCT)

(ischemic would show patchy)

59
Q

Patient on drug for illness, develops sx of nephritis w/marked eosinophilia.

A

Acute drug-induced intestinal nephritis. Would see eosinophil cast.

60
Q

How do you prevent contrast-induced nephropathy?

A

Normal saline

61
Q

How can you det if Metabolic Acidosis is anion gap or non-anion gap?

A

Anion Gap < 14

Non-anion gap > 14

62
Q

Patient on desmopression. Water-deprivation test shows hypernatremia. Cause?

A

Diabetes insipidus

63
Q

Stage II CKD

GFR 60-89

Management?

A

Treat HTN

(Stage 3- start intervention)

(Stage 3-5: dialysis)

(Stage 4-5: transplant)

64
Q

Most important cause of osteodystrophy in CKD?

A

1,24-dihydroxycholecalciferol

65
Q

Mechanism of vibrio cholerae?

A

Enterotoxin, cholera toxin

Heat-labile, increases activity of adenylate cyclase -> increase cAMP

66
Q

Ummunocompromised patient with AIDS– painful swallowing.

White spots seen on endoscopy

Cobble-stone appearance on barium swallow

How to dx?

A

Candida grows as white colonies on blood agar

67
Q

Thiazide MOA

A

Block thiazide-sensitive Na+/Cl- symporter in DCT

68
Q

Patient has tumor of collecting duct– after removal you see that it is tan with central fibrotic scars. Cells have abudnant eosinophilic cytoplasm. What is the risk that this would kill the patient?

A

<10%– oncocytoma is sually benign

69
Q

What is the most common tumor in people with tuberous sclerosis?

A

Renal angiomyolipoma

70
Q

Transplant patient with tubulitis 6mo after transplant. What typ of rejection?

A

Acute cellular rejection.

71
Q
A

Clear Cell Renal Cell Carcinoma

Cear cells (glycogen) with peripheral nuclei

72
Q

Do coloscopy of bladder– see region with red mucosa. Nothing else wrong. Not invasive. Cause?

A

Urothelial carcinoma in situ.

73
Q

Patient with Rheumatoid Arthritis, nephrotic syndrome, & edema. RA is worse now.

A

Low oncotic pressure- water leaked from blood vessels to interstitial tissues

74
Q

Patient with protein level of 4+ in urine (proteinuria), facial edema, no hematuria. Acute onset.

A

Minimal change disease

Treat with steroids

S4M2 (10 decks)

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