From combank Flashcards

1
Q

Histology of Ewing sarcoma

A

Small blue cells with hyperchromatic nuclei and scant cytoplasm

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2
Q

Features of Ewing sarcoma

A

Male teens
Onion skinning around diaphysis
Expression of MIC2 antigen CD99; 11:22 translocation

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3
Q

Histology of osteosarcoma

A

Anaplastic stroll cells making tumor osteoid/bone matrix

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4
Q

How do you treat a coronal suture injury?

A

V-spread

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5
Q

Ehlers-Danlos is associated with what CV injury?

A

Berry aneurysm

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6
Q

GAA repeat

A

Friedreich ataxia

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7
Q

What cranial bone do you treat with an ear infection?

A

Temporal

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8
Q

Case that says medical professionals need to inform people who are in danger of their patient

A

Tarasoff v. Regents of the University of California

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9
Q

Sequence of ossification centers of the humerus

A

Shaft, capitulum, medial epicondyle, trochlea, lateral epicondyle

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10
Q

Lymphoma aggravated by alcohol

A

Hodgkin

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11
Q

People with higher risk of adhesive capsulitis

A

Female, diabetics, hypothyroid

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12
Q

Lab results of PC vera

A

Increased hematocrit, leukocytes and thrombocytosis

Decreased EPO d/t negative feedback

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13
Q

Elevated WBC with normal LAP

A

CLL

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14
Q

Histology of psoriasis

A

Alternating collections of neutrophils between layers of parakaratotic stratum and corneum

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15
Q

Concentric contraction

A

Approximation of origin and insertion

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16
Q

Guyon’s canal entrapment symtpoms

A

Ulnar nerve by the pisohamate ligament

Hypothenar atrophy, decreased abduction and/or adduction especially 4th and 5th digits

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17
Q

Nephrotic seen in patients with HIV or heroin abuse

A

FSGS

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18
Q

Histology of seborrheic keratosis

A

Intrepidermal horn cysts filled with cornfield cells containing melanin

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19
Q

Nerve that pierces the pronator teres

A

Median

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20
Q

Nerve injured in bicyclists

A

Median

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21
Q

Nerve that pierces the coracobrachialis

A

Musculocutaneous

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22
Q

Crutch palsy nerve

A

Radial

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23
Q

Blood type associated with increased risk of gastric tumors

A

A

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24
Q

Blood type associated with increased risk of peptic ulcers

A

O

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25
Q

Legg-Calve-Perthes disease

A

Avascular necrosis of femoral head
Boys 4-10
Limp, anterior hip or knee pain (referred pain via obturator); worse with exertion
TP:

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26
Q

Pyruvate dehydrogenase deficiency

A

Failure to convert pyruvate to acetyl coenzyme A
Lactic acidosis
Poor feeding, developmental delay, seizures, abnormal eye movements, ataxia, and mental delays

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27
Q

Seeing flashes of light is indicative of what toxicity?

A

Methanol

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28
Q

MOA of danazol?

A

Decreased FSH and LH from anterior pituitary

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29
Q

What acid/base disturbance is caused by rhabdo?

A

Metabolic acidosis

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30
Q

When does ABO incompatibility occur?

A

Mother - O

Child - A or B

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31
Q

What nerve is damaged in medial strabismus?

A

Abducens

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32
Q

Nasal polyps in children should lead you to check for what?

A

CF

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33
Q

What is bronchiectasis

A

Restrictive; dilation of bronchioles and bronchi

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34
Q

What two murmurs do not increase with increased preload?

A

HCM and MVP

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35
Q

Very loud/severe grade murmur with no symptoms

A

Small VSD

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36
Q

Dysbetalipoproteinemia

A

Defect of apoE
Elevated chylomicron remnants, IDL, LDL and VLDL
Type III

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37
Q

Abx that cause disulfiram like reactions

A

Metronidazole. procarbazine, Cefoperazone and cefamandole

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38
Q

Homan’s sign

A

Calf pain with forcible dorsiflexion of the foot; DVT

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39
Q

Case for informed consent

A

Schloendorff v. Society of New York Hospital

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40
Q

Defining feature of liposarcoma

A

Lipoblasts; vacuoles with scalloping of the nucleus and multiple mitoses

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41
Q

Nerve at risk in a distal spiral shaft fracture (Holstein-Lewis)?

A

Radial nerve

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42
Q

Parts of medicare

A

A: Inpatient hospital care, skilled nursing, hospice, and home health care
B: Outpatient care, doctors’ services, physical therapy, and occupational therapy
C: Combination of parts A and B
D: Prescription drug coverage

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43
Q

Contract between a physician and an HMO in which the HMO pays a flat fee per patient each month

A

Capitation

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44
Q

First line treatment for stable angina

A

NG and B-blocker

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45
Q

Where does somatosensory of the face relay through?

A

Ventral posteromedial nucleus of the thalamus

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46
Q

CS position for dorm of wrist

A

Extend and abduct - radial

Extend and adduct - ulnar

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47
Q

Difficulty reading aloud or repeating phrases indicates a lesion where?

A

Arcuate fasiculus

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48
Q

Skin manifestation of PSC and/or UC

A

Pyoderma gangrenosum
Skin lesion that is ulcerated with a purulent base and surrounding erythema
(seen w/ other inflammatory processes)

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49
Q

Familial lipoprotein lipase deficiency

A

Hypertriglyceridemia with low LDL and HDL levels
Type I
Can also occur w/ defect in apo CII

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50
Q

Position to treat a radial head tender point

A

Extension, forearm supination and slight valgus force

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51
Q

What medication is given to shrink fibroids prior to surgery?

A

Leuprolide

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52
Q

Repeated viral and fungal infections, splenomegaly and tetany

A

DiGeorge

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53
Q

Diagnostic marker for menopause

A

Elevated FSH (decreased negative feedback from ovaries releasing estrogen to pituitary)

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54
Q

Location of lateral ankle tenderpoint

A

Sinus tarsi

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55
Q

Which ab directly participates in opsonization?

A

IgG

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56
Q

t(12;21)

A

BALL w/good prognosis

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57
Q

t(9;22)

A

Philadelphia chromosome

CLL or BALL w/poor prognosis

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58
Q

t(15;17)

A

AML (APL specifically)

59
Q

CD34+

A

Hematopoietic stem cell

60
Q

CLL

A

CD5 and CD20

Smudge cells

61
Q

Negative LAP

A

CML

62
Q

Itching after bathing

A

Polycythemia Vera

63
Q

Tear drop RBC

A

Myelofibrosis

64
Q

t(14;18)

A

BCL2 and IgH

Follicular lymphoma

65
Q

t(11;14)

A

Mantle cell lymphoma

Cyclin D

66
Q

t(8;14)

A

Burkitt lymphoma

c-myc

67
Q

BPH treatment with SE of gynecomastia

A

Finesteride (5-alpha-reductase inhibitor)

68
Q

Grey-Turner sign and Cullen sign

A

Sign of pancreatic necrosis
Ecchymotic discoloration of the flank (GT)
Ecchymotic discoloration of the periumbilical region (C)

69
Q

Pompe Sx

A

Deficiency in alpha-1,4-glucosidase/acid maltase (Type II)

Hypotonia, CHF, cardiomegaly, exercise intolerance and systolic murmur, macroglossia, and hepatomegaly

70
Q

Von Geirke Sx

A

Deficiency of glucose 6-phosphatase (Type I)
Hepatomegaly,↑ glycogen in liver, hypoglycemia, increased LDH levels, lactic acidosis, ketosis, uric acid and seizures
(Cori (III) is same but milder; normal LDH)

71
Q

What chromosome is the Beta globin gene on?

A

11

72
Q

Sx of severe hypothermia

A

Core temp of 24 to 28°C (75 to 82°F)

Areflexia, oliguria, pulmonary edema, coma, hypotension, asystole, and ventricular arrhythmias

73
Q

Attachment sites of the dura

A

Foramen magnum, C2, C3, and S2

74
Q

SSC of the skin precursor lesion?

A

Actinic keratosis

75
Q

Prophylaxis for travelers diarrhea

A

Cipro

76
Q

Trichophyton tonsurans

A

Black dot tinea capitis seen in AA
Colonizes and invades hair shafts
No fluorescence under woods lamp; KOH to hair shaft

77
Q

A 4-month-old male with generalized hypotonia, muscle weakness, respiratory distress, cardiomegaly and failure to thrive

A

Pompe’s disease; Alpha-1,4-glucosidase deficiency

78
Q

A newborn infant of Ashkenazi descent with severe hepatomegaly, hypoglycemia, hyperlipidemia, and lactic acidosis

A

von Gierke’s disease; G-6-p deficiency

79
Q

Location for needle decompression of tension pneumo

A

Second intercostal space in the midclavicular line

80
Q

Orphan Annie Eyes on thyroid biopsy

A

Papillary, most common, usually exposure to radiation

81
Q

Spinal tract for dull pain

A

Paleospinothalamic; C-fibers

82
Q

Normal V/Q level in the apex and base

A
  1. 30

0. 63

83
Q

Nerve making an OK sign tests

A

Anterior interosseous nerve (branch of median)

84
Q

Th1: what type of pathogens and what cells does it activate

A

Intracellular and autoimmunity

IFNgamma, IL2, LTalpha, IL10

85
Q

Th2: what type of pathogens and what cells does it activate

A

Extracellular parasites, allergy, asthma

IL4, 5, 13, 25, 10

86
Q

Th17: what type of pathogens and what cells does it activate

A

Extracellular bacteria, fungi, autoimmunity

IL21, 17, 22, 10

87
Q

Hurlers

A

AR, absence of a-L-iduronidase; accumulation of GAGs in the lysosome
Chronic diarrhea, poor feeding, macrocephaly, bulging frontal bones, depression of nasal bridge, enlarged lips, and/or protruding eyeballs
Corneal clouding

88
Q

Importance of tryptophan

A

Precursor to serotonin and B3

Carcinoid tumors and Hartnup can decrease levels

89
Q

Crush syndrome

A

Hypovolemic shock, hyperkalemia, heart failure, arrhythmias, acute respiratory distress, sepsis, DIC

90
Q

Location of Auerbach’s plexus

A

aka myenteric

Between the IC and OL layers of the muscularis externa

91
Q

Chapman’s point for the ileocecal area

A

Right proximal femur on the iliotibial band

ie Crohn’s disease

92
Q

Galactokinase deficiency

A

Infantile cataracts, failure to develop social smile or track objects
Accumulation of galactitol

93
Q

Classic galactosemia

A

G-1-p uridyltransferase deficiency
FtT, jaundice, hepatomegaly, cataracts, intellectual disability, E. coli infections
Starts as soon as infant starts feeding (lactose in breast milk)

94
Q

Homocystinuria

A
HOMOCYstinuria
Homocysteine
Osteoporosis
Marfanoid
Ocular changes (lens sublux down and in)
CV (thrombosis and atherosclerosis: Stroke/MI)
kYphosis
Intelectual disability
95
Q

Cori Disease

A

Type III; debranching enzyme (1,6 glycosidase)
VG but milder: normal blood lactate
Limit dextrin structures in cytosol

96
Q

McArdle

A

Type V; muscle glycogen phosphorylase

Myoglobinuria, arrhythmias

97
Q

Res ipsa loquitur

A

“the thing speaks for itself”

Obvious negligence

98
Q

Alcoholic cerebellar degeneration

A

Loss of Purkinje cells; worst in cerebellar vermis

Tremor

99
Q

Lynch Syndrome

A

Colorectal, endometrial and ovarian cancer
MSH2, MLH1, MSH6, PMS2
(mismatch repair genes)

100
Q

Homocystinuria

A

AR; inability to form cysteine (b/u of methionine and homocysteine)
Marfanoid, intellectual disability, thrombosis, downward lens (vs up in marfan), megaloblastic anemia, fair complexion

101
Q

Cause of tardive dyskinesia

A

Upregulation of dopamine receptors

102
Q

What sinus is mucor likely to affect?

A

Cavernous

103
Q

Normal cardiac output?

A

4-8 L/min

104
Q

Scoliosis brace

A

With curve 20-45 degrees
CTLSO (Milwaukee brace) when apex is above T7
TLSO when below

105
Q

Roseola vs Rubella

A

Roseola rash starts on trunk

Rubella rash starts on face

106
Q

Myotonic dystrophy type 1

A

CTG repeat d.t instability during maternal meiosis
Muscle weakness and myotonia (slowed relaxation), cardiac conduction abnormalities, cataracts, testicular failure, hypogammaglobulinemia, impaired sleep, insulin resistance, and excessive daytime sleepiness

107
Q

CD on Reed Sternberg Cells

A

CD15 and CD30

108
Q

Cause of nosocomial pneumonia due to use of a respirator

A

P. aeruginosa

109
Q

Atelectasis

A

Alveolar collapse with exhalation

110
Q

Dz states with decreased lung compliance

A

Pneumonia, pulmonary edema, pulmonary fibrosis

111
Q

Dz states with increased lung compliance

A

Emphysema (COPD), aging

112
Q

Location of highest and lowest air flow resistance

A

Medium bronchi

Terminal bronchioles

113
Q

V/Q in pulmonary edema

A

<1

114
Q

V/Q in pulmonary embolism

A

close to infinity

115
Q

Juxtaglomerular cell tumor (JGCT)

A

Well circumscribed with fibrous capsule with a yellow or gray-tan color and frequent hemorrhaging
Monotonous polygonal cells with entrapped normal tubules
Positive for renin, vimentin and CD34
Secrete renin

116
Q

Sleep stages

A
BATS Drink Blood
Awake/open - beta
Awake/closed - alpha
1 - theta
2 - spindles and K-waves
3 and 4 - delta
REM - beta
117
Q

NT changes during REM

A

AChE goes up

Norepi goes down

118
Q

Sinus affected in sinusitis?

A

Maxillary

119
Q

Cause of osteoporosis

A

Increased osteoclast activity

120
Q

Hormone changes in PCOS

A

Increased LH, decreased FSH
No FSH -> no ovulation
More LH -> more androgens

121
Q

Penile SCC is associated with what?

A

HPV

122
Q

Sequele to unilateral renal agenesis

A

FSGS

123
Q

Posterior extensor forearm muscles innervated by the radial nerve

A

Brachioradialis, extensor carpi radialis longus, supinator, and triceps
Radials are BEST

124
Q

Supination of the foot

A

Adduction, inversion and plantar flexion

125
Q

Somatostatinoma

A

Inhibits secretion of insulin, glucagon, gastrin, and growth hormone
Results in diabetes mellitus, cholelithiasis, steatorrhea, and hypochlorhydria

126
Q

Echinococcus granulosus

A

Hydatid cysts in liver, lungs and brain

Tapeworm from dogs

127
Q

Taenia solium

A

Ingestion of larvae encysted in undercooked pork meat
Tapeworms
Neurocysticercosis: multiple calcified lesions on MRI

128
Q

Key cell in chronic endometritis

A

Plasma cell (indicates cx inflammation)

129
Q

Innervation to biceps femoris

A

Common peroneal branch and tibial branch of sciatic nerve

130
Q

Leading cause of death by age group

A

<1 congenital anomalies
1-44: injury
45-64: neoplasm
65+: heart disease

131
Q

What articulation is most important to respiratory mechanism?

A

SBS: occiput and sphenoid

132
Q

Cruzan v. Director, Missouri Department of Health

A

Right to refuse life sustaining treatments (including feeding tube)

133
Q

The Patient Self-Determination Act

A

Ask about advanced directive etc

134
Q

Otosclerosis

A

AD w/ incomplete penetrance
B/l conductive hearing loss
Fixation of the middle ear bones, most commonly the stapes, interferes with sound conduction

135
Q

Nerve and sequela of injury at medial epicondyle

A

Ulnar nerve (medial cord); claw hand (unopposed extension of MCP and flexion of distal fingertips)

136
Q

Endocrine cause of SIADH

A

Hypothyroid

137
Q

Pagets indicates what underlying cancer

A

Ductal carcinoma (can be invasive)

138
Q

APS-1

A

AR; mutation of AIRE gene

Mucocutaneous candidiasis, hypoparathyroid, Addison’s

139
Q

St. Johns Wort and CYP450

A

Induces

140
Q

Brodman’s area 22

A

Wenicke’s area

141
Q

Bombesin tumor marker

A

Neuroblastoma

142
Q

HepE features

A

Icosahedral, non enveloped single-stranded RNA virus

143
Q

How do you treat OD of 5-FU?

A

Thymidine