foundations Flashcards
most common cause of neural tube defects
folate deficiency (most common vitamin deficiency in US)
most common preventable cause of congenital malformations in US
alcohol use during pregnancy
most common cause of intellectual disability in infants
FAS
drooling farmer
organophosphate poisioning
amyloid plaques in grey matter
senile plaques in AD
medical treatment for pheochromocytoma
α antagonist
selective α1 antagonist used to treat BPH
tamulosin
continous, machine-like heart murmur
PDA
“boot-shaped heart”
tetralogy of fallot (kid) or RVH due to COPD or pulm HTN (adult)
rib notching
coarctation of aorta
most common congenital cardiac anomaly
VSD
most common congenital cause of early cyanosis
tetralogy of fallot
bounding pulses, head-bobbing, diastolic murmur
aortic regurgitation
bone enlargement (hat size), bone pain, arthritis
Paget disease of bone
vertebral compression fracture
osteoporosis
positive anterior draw test
ACL injury
swollen, hard painful finger joints
osteoarthritis
swollen, boggy painful finger joints
rheumatoid arthritis
cartilage erosion with polished bone beneath
osteoarthritis (eburnation)
types of polyarthritis
osteoarthritis
rheumatoid arthritis
types of monoarthritis
gout (one joint at a time)
swollen, red, acutely painful great toe joint
gout (podgra)
positively birefringent rhomboid-shaped crystal
pseudogout
negatively birefringent needle-shaped crystal
gout
bamboo spine on xray
ankylosing spondylitis
HLA-B27
seronegative spondyloarthropathies
PAIR
anti-Smith + anti-dsDNA antibodies
SLE
anti-histone antibodies
drug-induced lupus
anti-centromere antibodies
CREST scleroderma (limited scleroderma) = Centromere
anti-topoisomerase antibodies
diffuse scleroderma
anti-Jo-I antibodies
polymyositis or dermatomyositis
arthritis + dry eyes + dry mouth
sjogren syndrome
most common cause of death in SLE
lupus nephritis
anti-Ro or anti-La antibodies
sjogren syndrome
anti-Ro = SS-A
anti-La = SS-B
keratin pearls on skin biopsy
squamous cell carcinoma
most common malignant skin tumor
basal cell carcinoma
main artery of pelvis
internal illiac artery
main nerve of pelvis
pudendal nerve
“bag of worms” scrotum
varicocele due to dilation of pampiniform plexus
most common cancer in men
prostate cancer
most common cause of urinary obstruction in men
BPH
most common treatment of ED
phosphodiesterase inhibitors
hepatic adenoma
OCP use
“grape-like” vaginal tumor
sarcoma botryoides
koilocytes
HPV infection
most common benign tumor in women
leiomyoma
“chocolate cyst” of ovary
endometriosis
“powder burn” lesion
endometriosis
most common cause of infertility in women
PCOS
midcycle pelvic pain associated with ovulation
mittelschmerz
ovarian tumor + ascites + hydrothorax (pleural effusion)
Meigs syndrome (fibroma ovarian tumor)
teratoma → hyperthryoidism
struma ovarii
“snowstorm” appearance on US
hyatidiform mole
most common genetic cause of ID
trisomy 21
second most common genetic cause of ID
fragile X syndrome
horseshoe kidney, congential heart defects, streak ovaries, cystic hygroma
turner syndrome
rocker bottom feet, clenched hands, microcephaly, prominent occiput, small jaw
trisomy 18
most common cancer in women in US
breast cancer
most common benign breast tumor
fibroadenoma
most common malignant breast cancer
invasive ductal carcinoma
“blue dome” in breast
fibrocystic change
treatment for ER+ breast cancer
tamoxifen
red, itchy, swollen rash on areola and nipple
Paget disease
branching, filamentous, G+ rods with sulfur granules
actinomyces israelii
standard treatment for T. pallidum
penicillin
cellulitis from cat or dog bite
Pasteurella multocida
painless, indurated, ulcerated genital lesion
chancre (1° syphilis)
moist, smooth, flat, white genital lesion
condyloma lata (2° syphilis)
large bull’s-eye rash
erythema migrans (lyme disease)
associated with Ghon focus or Ghon complex hilar lymphdenopathy
primary TB
associated with lung infiltrate in the apical-posterior segments of upper lobes
reactivation TB
standard initial treatment regimen for TB
RIPE Rifampin Isoniazid Pyrazinamide Ethambutol
eczema, recurrent cold abscesses (not hot), high serum IgE
hyper IgE syndrome
large phagosomal vesicles in neutrophils
Chediak-Higashi syndrome
depigmentation of substantia nigra (in BG)
parkinson disease
chorea, dementia, atrophy of caudate + putamen (in BG)
huntington disease
eosinophilic inculsion in cytoplasm of neurons
Lewy Bodies found in:
Parkinson disease
Lewy Body Dementia
Alzheimer disease (Lewy body type: NFT + plaques + lewy bodies)
adducting eye is unable to adduct (medial rectus palsy on affected side) and nystagmus in abducting eye on lateral gaze
normal convergence
internuclear opthalmoplegia (seen in MS)
degeneration of dorsal columns
tabes dorsalis (tertiary syphilis)
deymelinating disease in a young women
multiple sclerosis
mixed UMN + LMN disease
ALS
newborn with arm paralysis following difficult labor
erb-duchenne palsy
-dystocia
most common cause of dementia
alzheimer’s disease
second most common cause of dementia
vascular dementia
extracellular amyloid deposits in grey matter
amyloid plaque (AD)
intracellular deposits of hyperphosphorlated tau protein
neurofibrillary tangles (AD)
intracellular spherical aggregates of tau protein seen on silver stain
Pick bodies (frontotemporal dementia)
dysphagia, glossitis, IDA
plummer-vinson syndrome
hematemesis with retching
mallory-weis tear
mucin-filled cell with peripheral nucleus
signet ring cell (gastric adenocarcinoma, LCIS)
most common type of stomach cancer
gastric adenomcarcinoma
bilateral ovarian mets from gastric cancer
krukenburg tumor
gastric ulceration + high gastrin levels
zollinger-ellison syndrome
acute gastric ulcer associated with elevated ICP or head trauma
cushing ulcer
acute gastric ulcer associated with severe burns
curling ulcer
weight loss, diarrhea, arthritis, fever, adenopathy, hyperpigmentation
whipple disease
anti-transglutaminase/anti-gliadin antibodies
celiac disease
most common surgical emergency
appendicitis
severe RLQ pain with rebound tenderness
McBurney’s point
GI hamartomas, hyperpigmentation of mouth + hands
Peutz Jegher syndrome
multiple colon polyps + osteomas + soft tissue tumors
Gardner syndrome
“apple core” lesion on barium enema
colon cancer until proven otherwise
visual hallucinations
repeated falls
syncopal episodes
lewy body dementia
most common site of colonic diverticula
sigmoid colon
“string sign” on contrast xray
chron’s disease
“lead pipe” appearance of colon on contrast x-ray
ulcerative colitis
painless jaundice
pancreatic adenocarcinoma in head of pancreas
most common cause of acute pancreatitis
gallstone and alcohol
most common cause of chronic pancreatitis
alcohol abuse
severe hyperbilirubinemia in neonate
crigler-najjar syndrome type I
mild, benign hyperbilrubinemia
gilbert syndrome
bilateral bell’s palsy
Lyme disease or
guillan-barre syndrome
TG accumulation in hepatocytes
fatty liver disease
eosinophilic inclusions in cytoplasm of hepatocytes
mallory body (commonly due to chronic alcoholism) other causes: alcohol: alcoholic hepatitis cirrhosis wilson disease 1° biliary cirrhosis HCC
cancer closely linked to cirrhosis
hepatocellular carcinoma
hepatomegaly, ascites, abdominal pain (no JVD)
wilson disease
green/yellow corneal deposits
kayser-fleischer rings (wilson disease)
low serum ceruloplasmin
wilson disease
cirrhosis
diabetes
hyperpigmentation
hemachromatosis
chronic sinusitis, infertility, situs inversus, bronchiectasis
Kartagener syndrome: primary ciliary dyskinesia
elevated D dimer
DVT or PE
hypercoagulability, endothelial damage, stasis of blood
virchow’s triad
blue bloater
hypoxemia, hypercapnia:
chronic bronchitis
pink puffer
dyspnea, hyperventilation:
emphysema
curschmann spirals
shed epithelium from mucus plugs: asthma
bilateral hilar adenopathy, uveitis
sarcoidosis
vasculitis + glomerulonephritis
goodpasture syndrome or granulomatosis with polyangitis
anti-glomerular basement membrane antibodies
goodpasture syndrome
honeycomb lung on xray
idiopathic pulmonary fibrosis
“tennis racket” shaped cytoplasmic organelles
birbeck granules: langerhans cell histiocytosis (eosinophilic granulomas)
iron-containing nodules in alveolar septum
ferruginous bodies (asbestosis)
lung cancer associated with SIADH
small cell carcinoma
tumor associated with horner syndrome
pancoast tumor
lung cancer associated with hypercalcemia
squamous cell carcinoma
lung cancer associated with cushing syndrome
small cell carcinoma
lung cancer associated with weakness
small cell carcinoma (lambert-eaton syndrome)
substances associated with lung cancer
smoking
coal mine: silica, radon (basement)
asbestos
weightlifter with focal hemorrhages in small bowel due to
inguinal hernia (common in weightlifters)
why is nitroglycerin used to treat angina (myocardial ischemia)
causes systemic venous vasodilation →↓ preload! → ↓ myocardial O2 demand (no effect on dilating coronary arteries - already maximally dilated by endogenous NO)
chest pain, pericardial friction rub, persistent fever occurring several weeks after an MI
Dressler syndrome
splinter hemorrhages under fingernails
infective endocarditis
retinal hemorrhages with pale centers
roth spots (infective endocarditis)
heart valve most commonly involved in infective endocarditis
mitral valve
heart valve most commonly involved in an IVDU with infective endocarditis
tricuspid valve
granulomatous nodules (granulomas) in heart focal myocardial inflammation with multinucleate giant cells
Aschoff bodies (rheumatic heart disease)
most common primary cardiac tumor in adults
left atrial myxoma
most common primary cardiac tumor in children
rhabdomyoma
most common cause of constrictive pericarditis
lupus: US
developing countries: TB
c-ANCA vasculitis
granulomatosis with polyangiitis (wegener’s)
p-ANCA vasculitis
eosinophlic granulomatosis with polyangiitis (churg-straus)
microscopic polyangiitis
treatment for thromboangiitis obliterans
stop smoking
treatment for giant cell arteritis
high dose steroid for several months
IVDU presents with chest pain, dyspnea, tachycardia, tachypnea. what is most likely cause?
infective endocarditis of tricuspid valve → septic pulmonary emboli
patient in MVA presents with chest pain, dyspnea, tachycardia, tachypnea. what is most likely cause?
tension pneumothorax: air in pleural space
fat embolus
post-op patient presents with chest pain, dyspnea, tachycardia, tachypnea. what is most likely cause?
pulmonary embolism from DVT
“currant jelly” sputum
Klebsiella
osteomyelitis in sickle cell disease patient
salmonella
“strawberry” cervis
trichomonas vaginalis
clue cells
bacterial vaginosis from gardnerella vaginalis
bacteria with “school of fish” appearance
Haemophilus ducreyi - causes chancroids
boy with self-mutilating behavior, ID, gout
Lesch-Nyhan syndrome
orotic acid in urine + elevated serum ammonia
ornithine transcarbamylase deficiency
orotic acid in urine + normal serum ammonia
oritic aciduria
megaloblastic anemia that does not improve with folate + vit B12
orotic aciduria
cafe-au-lait spots
neurofibromatosis type 1
McCune-Albright syndrome
most common cause of hypoparathyroidism
thryoidectomy
most common cause of mets to brain
lung breast skin (melanoma) renal cell carcinoma GI tract
most common type of lysosomal storage disease
guacher disease
most common cause of myocarditis
coxsackie virus
echovirus
most common med for ADHD
methylphenidate
most common class of medications for bulimia nervosa
SSRI: fluoxetine
medical treatment for alcohol withdrawal
BZD
most effective treatment for alcohol abuse
AA
atrophy of mamillary bodies
wernicke-korsakoff syndrome (thiamine deficiency - B1)
treatment of central DI (no ADH from hypothalamus)
intranasal desmopressin (ADH analog)
treatment of nephrogenic DI (kidney doesn’t respond to ADH)
hydrochlorothiazide: ↑ H20 reabsorption in PT
indomethacin:
amiloride: block Na channel in principal cells
treatment for lithium-induced nephrogenic DI
amiloride - block Na channel in principal cells which is used by lithium
subluxation of lens
homocystinuria (downward lens dislocation) marfan syndrome (upward lens dislocation)
bluish-colored lines on gingivae
Burton’s lines (lead poisioning)
treatment of choice for rickets or osteomalacia
vitamin D
swollen gums, poor wound healing, bleeding mucous membranes, spots on skin
scurvy: collagen synthesis defect (vitamin C deficiency)
most common vitamin deficiency in US
folate
hypersegmented neutrophils
megaloblastic anemia in vitamin B9 or B12
dilated CM, edema, polyneuropathy
wet beriberi: thiamin deficiency (B1)
infertility, galactorrhea, bitemporal hemianopia
prolactinoma (pituitary adenoma)
inability to breastfeed, amenorrhea, cold intolerance
sheehan syndrome
most common causes of cushing syndrome
exogenous steroid use
ectopic ACTH tumor (small cell lung cancer)
ACTH-pituitary adenoma (cushing disease)
adrenal adenoma secreting cortisol
most common tumor of adrenal gland
benign, non-functioning adrenal adenoma
most common tumor of adrenal medulla in adult
pheochromocytoma
most common tumor of adrenal medulla in kids
adrenal neuroblastoma
most common cause of primary hyperaldosteronism
adrenal adenoma
treatment for hyperaldosteronism
spironolactone/eplerenone
treatment for pheochromocytoma
nonselective α blocker: phenoxybenzamine
pheochromocytoma
medullary thyroid cancer
hyperparathyroidism
MEN 2A
pheochromocytoma
medullary thyroid cancer
nucosal neuroma
MEN 2B
adrenal disease associated with skin hyperpigmentation
1° adrenal insufficiency: addison
HTN
hypokalemia
metabolic alkalosis
hyperaldosteronism: Conn syndrome
