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USMLE STEP 1 - OLD > Gastroenterology & Hepatology > Flashcards

Gastroenterology & Hepatology Flashcards

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USMLE® Step 1 flashcards
1
Q

Painful, superficial ulceration of the oral mucosa characterized by a grayish base (granulation tissue) surrounded by erythema?

A

Aphthous ulcer

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2
Q

Clinical triad of Behcet’s syndrome?

A

Recurrent aphthous ulcers + genital ulcers + uveitisPatients may also present with erythema nodosum = painful, red, subcutaneous, elevated nodules, typically located over the anterior aspect of the tibia.

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3
Q

Pathophysiology of Behcet’s syndrome?

A

Immune complex small vessel vasculitis

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4
Q

Pathophysiology of cleft lip/palate?

A

Failure of fusion of the facial processes/prominences

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5
Q

Vesicular lesions of the oral mucosa that rupture, resulting in shallow, painful red ulcers?

A

Oral herpes

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6
Q

Viral cause of oral herpes?

A

HSV-1

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7
Q

Oral herpes - primary infection vs. re-infection?

A

Primary infection presents with fever and lymphadenopathy, re-infection does not.

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8
Q

Site of HSV-1 latency?

A

Cranial sensory ganglia (trigeminal ganglia) HSV-1 virus remains dormant in trigeminal nerve sensory ganglia until stress/sunlight/menses precipitates reactivation and re-infection.

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9
Q

Bacterial cause of dental caries?

A

Streptococcus mutans

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10
Q

Pathophysiology of dental caries?

A

Streptococcus mutans produces acid from sucrose fermentation, which erodes enamel.

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11
Q

Inflammatory skin condition characterized by erythematous macules/papules that resemble target lesions (“bull’s eye lesions”) that can become bullous?

A

Erythema multiforme

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12
Q

Erythema multiforme that involves the mouth = ?

A

Stevens-Johnson syndrome

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13
Q

Melanin pigmentation present on the buccal mucosa?

A

Addison disease

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14
Q

Pathophysiology of melanin pigmentation on the buccal mucosa in Addison disease?

A

Increased ACTH stimulates melanocytes

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15
Q

Melanin pigmentation of the lips and oral mucosa?

A

Peutz-Jeghers syndrome

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16
Q

Glossitis a/wbilateral white excrescences on the lateral border of the tongue?

A

Hairy leukoplakia (pre-AIDS defining lesion)

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17
Q

Viral cause of hairy leukoplakia?

A

EBV

18
Q

Histology of leukoplakia/erythroplakia?

A

Squamous hyperplasia of the epidermis

19
Q

Which of the following 4 may progress to oral cancer? Oral candidiasis, hairy leukoplakia, leukoplakia, erythroplakia

A

Leukoplakia and erythroplakia - May progress into squamous dysplasia or invasive squamous cell carcinoma (SCC)Erythroplakia > leukoplakia re: progression to oral cancer

20
Q

Wickham striae (fine, white, lacy lesions) on the buccal mucosa?

A

Lichen planus

21
Q

Most common benign tumor in the oral cavity?

A

Squamous papilloma(Exophytic tumor with a fibrovascular core)

22
Q

Major risk factors for squamous cell carcinoma of the oral cavity?

A

Tobacco and alcohol (synergistic)HPV

23
Q

Squamous cell carcinoma of the oral cavity site of metastasis?

A

Tonsillar node (superior jugular node)

24
Q

Most common cancer of upper lip?

A

Basal cell carcinoma

25
Q

Most common cancer of lower lip?

A

Squamous cell carcinoma

26
Q

Malignancy of the oral cavity associated with UV-B light expsure?

A

Basal cell carcioma

27
Q

Malignancy of the oral cavity a/w smokeless tobacco?

A

Verrucous carcinoma

28
Q

Major salivary glands?

A

Parotid, submandibular, and sublingual

29
Q

Mumps clinical features?

A

Bilateral parotitisUnilateral orchitis/oophoritisPancreatitisMeningoencephalitis(Sterility is rare b/c of unilateral involvement of testes/ovaries, but more common in adolescence and adulthood. Childhood mumps rarely involves testes/ovaries).

30
Q

Laboratory finding in mumps?

A

Elevated serum amylase 2/2 parotitis and/or pancreatitis

31
Q

Bacterial inflammation of a major salivary gland?

A

Sialdenitis

32
Q

Bacterial cause of sialdenitis?

A

Staphylococcus aureus

33
Q

MCC sialdenitis in post-op patients?

A

Inflammation of major salivary gland 2/2 calculus (stone) obstructing the duct (sialolithiasis)

34
Q

Clinical triad of Sjogren syndrome?

A

Keratoconjunctiva sicca (dry eyes), xerostomia (dry mouth), and an associated connective tissue disease (most often rheumatoid arthritis)

35
Q

Pathophysiology of Sjogren syndrome?

A

Autoimmune destruction of the minor salivary and lacrimal glands

36
Q

Sjogren syndrome is a/w increased incidence of what cancer?

A

Lymphoma

37
Q

Presents as a mobile, painless, circumscribed mass at the angle of the jaw?

A

Pleomorphic adenoma

38
Q

Salivary gland tumors:Epithelial cells intermixed with myxomatous and cartilaginous stroma

A

Pleomorphic adenoma (mixed tumor) - BenignMost common tumor of salivary glands

39
Q

Salivary gland tumors:Heterotopic (ectopic) salivary gland tissue trapped in a lymph node

A

Warthin tumor (papillary cystadenoma lymphomatosum) - Benign- Cystic tumor with abdundant lymphocytes and germinal centers (cystic glandular structures locayed within benign lymph node tissue).

40
Q

Salivary gland tumors:Mixture of neoplastic squamous cells and mucus-secreting cells

A

Mucoepidermoid carcinoma - MalignantMost common malignant tumor of salivary glands

41
Q

Sign that pleomorphic adenoma has transformed into a malignant carcinoma?

A

Facial nerve involvement/damage (facial nerve runs through parotid gland)

USMLE STEP 1 - OLD (12 decks)

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