Exam 4 studying Flashcards
Hirschsprung disease is due to a mutation in which gene?
A) RET
B) TP53
C) KRAS
D) BRCA1
A) RET for receptor tyrosine kinase
Which inflammatory bowel disease is associated with skip lesions and transmural inflammation?
A) Ulcerative colitis
B) Crohn’s disease
C) Irritable bowel syndrome
D) Diverticulitis
B) Crohn’s disease
Which starts in the rectum, UC or Crohn’s?
UC
What is the primary cause of acute appendicitis?
A) Infection with H. pylori
B) Obstruction of the appendiceal lumen
C) Chronic inflammatory bowel disease
D) GERD
B) Obstruction of the appendiceal lumen
What is the most common cause of cirrhosis?
Alcoholic liver disease
Which of the following hepatitis viruses is dependent on another virus for replication?
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis D
D) Hepatitis D
What is hepatitis D dependent on?
Hep B
What 2 types of hepatitis are CA risks?
B and C
List the mnemonics to remember the types of viral hepatitis
A: Acute, anus, abrupt [ending] (self limited)
B: Both [acute/chron], BBB (blood birth boinking)
C: Chronic, cancer, craving, IV
D: Dependent on Hep B
E: Endemic to third world
How do you remember the serology for Hep C?
If you’re c ured, you’re H C V negative
Antibody (-), HCV (+): New Dx
Antibody (+), HCV (+): Infxn Current
Antibody (+), HCV (-): Past Infxn
List the possible serology results for Hep B
HBsAg: Infection
HBeAg: Infectious
IgMsAg: Early Dz
IgGsAg: immune (previous infxn, Vx)
IgGcAg: infxn
DNA Quantum increase: infxn
DNA Quantum undetect.: previous infxn
How do you remember the the IgG core (IgGcAg) is from exposure/ infection?
“Core is hardcore”
True or false: Gallstones are a mechanical cause of acute pancreatitis
True
What is the most common cause of pancreatitis?
Alcohol use and gallstones
Which breast cancer marker is associated with the worst prognosis?
A) HER2-negative
B) HER2-positive
C) Triple-negative
D) ER-positive
C) Triple-negative
What is the most common benign tumor of the breast?
A) Fibroadenoma
B) Lipoma
C) Phyllodes tumor
D) Intraductal papilloma
A) Fibroadenoma
What is the most common cause of salpingitis?
A) Endometriosis
B) Gonorrhea and chlamydia
C) E. coli infection
D) Tuberculosis
B) Gonorrhea and chlamydia
What is salpingitis almost always linked to?
PID
Polycystic ovarian syndrome (PCOS) is most commonly associated with which hormonal imbalance?
A) Increased FSH
B) Increased LH
C) Decreased estrogen
D) Increased progesterone
B) Increased LH
What is the leading cause of ectopic pregnancy?
A) Pelvic inflammatory disease
B) Endometriosis
C) Polycystic ovarian syndrome
D) Uterine fibroids
A) Pelvic inflammatory disease
(because it can cause chronic salpingitis with scarring)
List 3 causes of neonatal jaundice
A) Increased bilirubin production
B) Liver dysfunction
C) Biliary obstruction
Which condition is associated with decreased serum ceruloplasmin?
A) Hemochromatosis
B) Wilson’s disease
C) Alpha-1 antitrypsin deficiency
D) Gilbert syndrome
B) Wilson’s disease
What is a common tumor marker for hepatocellular carcinoma?
A) CA-125
B) Alpha-fetoprotein (AFP)
C) CEA
D) PSA
B) Alpha-fetoprotein (AFP)
A painless scrotal mass that transilluminates is most likely a:
A) Hydrocele
B) Varicocele
C) Spermatocele
D) Testicular torsion
A) Hydrocele
Explain preeclampsia, preeclampsia with severe Sx, HEELP, and eclampsia
1) Gestational HTN = 140/90 >/=20wks
2) Preeclampsia = Gestational HTN + protein spillover
3) Preeclampsia with = Preeclampsia + headache/ vision changes
4) HEELP = preeclampsia + liver dysfunction (liver enzymes high & platelets low)
5) Eclampsia = Preeclampsia + seizures
What is considered positive for preeclampsia
BP 140/90 +
Protein to creatinine ratio: positive if > 0.3
More than 300 mg protein on 24-hour collection
List 3 primary factors in the development of esophageal varices
A) Cirrhosis
B) Increased distal plexus subepithelial venous plexus pressure
C) Portal hypertension
Zollinger-Ellison syndrome leads to peptic ulcer disease primarily due to:
A) Increased NSAID use
B) Hypersecretion of gastrin by tumors
C) Direct infection with H. pylori
D) Autoimmune-mediated atrophic gastritis
B) Hypersecretion of gastrin by tumors
What differentiates Crohn’s disease from ulcerative colitis on a histological level?
A) Presence of crypt abscesses
B) Continuous involvement of the colon
C) Transmural inflammation with fissures
D) Marked increase in goblet cell hyperplasia
C) Transmural inflammation with fissures
Which bacterial pathogen is most commonly implicated in pseudomembranous colitis?
A) Shigella
B) Clostridium difficile
C) Vibrio cholerae
D) Campylobacter jejuni
B) Clostridium difficile
What is the primary reason for increased colon cancer risk in long-standing inflammatory bowel disease?
A) Increased dietary exposure to carcinogens
B) Chronic inflammatory damage leading to epithelial dysplasia
C) Direct viral transformation of colon epithelial cells
D) Bacterial overgrowth causing excessive DNA damage
B) Chronic inflammatory damage leading to epithelial dysplasia
Which condition is most commonly associated with increased risk of hepatocellular carcinoma?
A) Hepatitis A infection
B) Chronic liver disease with cirrhosis
C) Acute cholangitis
D) Primary biliary cholangitis
B) Chronic liver disease with cirrhosis
Which finding is most characteristic of alpha-1 antitrypsin deficiency liver injury?
Misfolded A1AT protein accumulation in hepatocytes
Which hepatitis virus is most likely to cause chronic infection and hepatocellular carcinoma?
Hepatitis C
Why does non-alcoholic fatty liver disease (NAFLD) increase in prevalence with metabolic syndrome?
A) Increased mitochondrial damage from alcohol-like toxins
B) Impaired insulin signaling leading to hepatic lipid accumulation
C) Direct cytotoxicity of glucose on hepatocytes
D) Genetic mutations affecting hepatic bile secretion
B) Impaired insulin signaling leading to hepatic lipid accumulation
Which of the following is the most common site of implantation in an ectopic pregnancy?
A) Isthmus of the fallopian tube
B) Cervical canal
C) Ampullary portion of the fallopian tube
D) Ovarian surface
C) Ampullary portion of the fallopian tube`
What is the primary mechanism by which estrogen contributes to hypercoagulability in pregnancy?
A) Increased platelet production
B) Upregulation of fibrinolytic enzymes
C) Increased hepatic production of clotting factors II, VII, IX, and X
D) Suppression of von Willebrand factor
C) Increased hepatic production of clotting factors II, VII, IX, and X (2, 7, 9, 10)
What is the primary pathophysiological feature of preeclampsia?
Defective trophoblastic invasion leading to placental ischemia
In gestational diabetes, what hormone(s) contribute(s) to insulin resistance by antagonizing insulin receptors? Select all that apply
A) Estrogen
B) hCG
C) Placental growth hormone
D) Oxytocin
B) hCG
C) Placental growth hormone
What is the underlying cause of kernicterus in neonatal jaundice?
A) Increased free bilirubin crossing the blood-brain barrier
B) Direct bilirubin toxicity to erythrocytes
C) Autoimmune hemolysis from maternal antibodies
D) Defective hepatic conjugation of bilirubin
A) Increased free bilirubin crossing the blood-brain barrier
Which of the following STDs has an increased risk of causing neonatal meningoencephalitis? (lethargy, irritability, seizures)
A) Gonorrhea
B) Syphilis
C) Herpes simplex virus
D) Chlamydia
C) Herpes simplex virus
1) Which male reproductive tumor is most likely to secrete hCG?
2) Which testicular tumor is associated with elevated alpha-fetoprotein (AFP)?
1) Seminoma
2) Yolk sac tumor
Which histological feature best differentiates benign prostatic hyperplasia (BPH) from prostate cancer?
A) Prostate cancer begins at the peripheral zone, whereas BPH occurs in the transitional zone
B) BPH contains necrotic areas, whereas cancer does not
C) BPH presents with nuclear pleomorphism and high mitotic activity
D) Prostate cancer is composed of hyperplastic glandular elements only
A) Prostate cancer begins at the peripheral zone, whereas BPH occurs in the transitional
Acute liver failure is characterized by hepatic encephalopathy developing within how many months of diagnosis?
A) 3 months
B) 6 months
C) 12 months
D) 24 months
B) 6 months
Which of the following is a key symptom of hepatic encephalopathy?
A) Kayser-Fleischer rings
B) Asterixis
C) Splenomegaly
D) Jaundice
B) Asterixis
(^ ammonia levels)
Which hepatitis virus is RNA-based and is primarily transmitted through IV drug use?
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Hepatitis E
C) Hepatitis C
(Hep A is also RNA but fecal-oral)
What laboratory finding confirms chronic hepatitis B infection?
A) Positive IgM Surface Antigen
B) Positive IgG Core Antigen
C) Positive HbsAg
D) Undetectable DNA Quant
C) Positive HbsAg
Which inherited metabolic liver disease is caused by defective copper metabolism?
Wilson’s Disease
Which type of drug-induced liver disease is dose-dependent?
Predictable (intrinsic) reaction
What is the most sensitive lab finding for Wilson’s disease?
A) Decreased serum ceruloplasmin
B) Increased urinary copper excretion
C) Increased hepatic copper content
D) Elevated alkaline phosphatase
C) Increased hepatic copper content
