gem Flashcards
50 bz, empty, 6 packs, coke, rage
borderline
high degree of parasitemia, severe hemolysis with renal failure, cerebral malaria
plasmodium faciparum
lose consciousness, less responsive, intracranial hemorrhage, CT bleeding
middle meningeal artery
weight loss, intermittent bloody diarrhea. colonoscopy: ulcers, inflamm changes. biopsy: superficial ulceration, acute inflamm, gland abscesses, chronic inflamm-all in mucosa
ulcertaive colitis
9yo, 8kg loss, thirst +frequent urination, RBG: 221, UA:+3 glucosuria..hyperglycemia
islet cell destruction
50yo, repeated symptomatic nephrolithiasis. Lab: hi calcium, high PTH
primary hyperparathyroidism
HPV classification into types
id types that have high oncogenic potential
pigmented lesion on back of left calf, melanoma
depth of dermal invasion
61yo, memory impairment, early onset Alzheimers (familial)
cerebral cortical atrophy of the frontal and temporal lobes including the hippocampus, along with numerous neuritic amyloid plaques in the neocortex
7yo c/o itching, dayare kids with worms…enterobius vermicularis
scotch tape test looking for ova
75yo farmer, red raised plaque on face. biopsy: cytologic atypia-lower epidermis layers+ hyperkeratosis, parakeratosis
precursor of squamous cell carcinoma
shake overshoot object, no rhythm
right cerebellar hemorrhage
64yo woman, fracture femoral head. boney trabeculae, thick osteoid
tx: Vit D
prostate ca, gleason score-conservative approach
gleason score of 2 (1+1)
progressive difficuly swallowing, mass in upper third, invasive SCC..development in US
cigarette smoking
hiatal hernia, hematemesis, severe retching
Mallory-Weiss tear
UA: hematuria, cytoscopy: papillary tumor in dome of bladder. bx: fibrovascular core, urothelial cells, cytologic atypia
major RF: cigarette smoking
roseola infantum (exanthem subitum), fever erythematous rash
HHV6
epigastric abdo pain radiates to back, afebrile, mid-epigastric region, no bowel sounds
cause: alcohol and gallstones
14yo girl, lower abdo pain, adnexal mass. high alpha fetoprotein; large necrotic r. ovarian tumor; histo: glomerulus-like structures (schiller-Duval bodies)
yolk sac carcinoma
ill defined lesion in pancreas head-obstructs common bile duct
fibrosis and infiltrating malig glands
femoral metaphysis, breaks through bone cortex. bx: neoplastic bone w/ anaplastic tumor cells
osteosarcoma
burning epigastric pain b/w meals, relievd with antacids/food, black tarry stools, no NSAIDS, upper endoscopy: ulcer in prox duodenum-amorphous cellular debris, neutrophils
H. pylori infection
NHL chemo, band-like vesicular rash
reactivation of VZV
obese, RUQ pain w/ fatty foods
w/u: gallstones
weight gin, fatigue, dizzy, memory, speech, dry skin, puffy face
TS level-determined if case d/t primary or secondary hypothyroidism
acute hep due to HCV-transmission
blood transfusion, contaminated needles, sexual contact
small cel ca of lung, SIADH manifestation
hyponatremia
toxo in AIDS pt
encephalitis
weak in left lower extremity, obese+hypertensive, no CN deficits, slightly weak on left side, no sensory deficits; weakness gonein an hr; no lesions on MRI
transient ischemic attack
smokes pack of cigs daily, drinks 6-12 beers daily, histo: microvesicular steatosis
liver will REVERT TO NML if he abstains form alcohol and tobacco
68yo man, CA-pneumo, discharged w/ 7day course AB. 4 days later: fever + profuse green watery diarrhea.
stool c diff toxin assay=best intial diagnostic test to determine cause of diarrhea
transmission of herpes encephalitis
respiratory transmission via sneezing/coughing from n infected person
3cm pancreatic mass; gastrinoma
multiple duodenal and jejunal ulcers
72 yo man, CP: new onset seizures, HA. MRI: large enhancing mass in left frontal lobe-crosses midline in corpus callosum. bx: highly cellular tumor w endothelial hyperplasia and necrosis
glioblastoma multiforme
african woman w/ severe dysuria, mild suprapubic tenderness, UA: RBC, many WBC, ova with spikes
schistosoma haematobium
Marfans
fibrillin-1 inherited defect
h/o milk production, ROS: intermittend HA for several mo; no meds, PE: bilat peripheral field visual deficits
elevated serum prolactin
delirium, hallucinations, disorganized thinking, impaired reality testing
schizophrenia
neonate, increased abdo distention; PE: depressed frontanels, wrinkled skin. abdo film: constricition above anus, hirschsprung
absence of ganglion cells in the constricted portion of bowel
45yo woman, fasting glucose: 140, PE: nml, repeat FBG: 154
T2DM
30yo recovering f/m viral URTI–>painful and enlarged thyroid gland
subacute (granulomatous) thyroiditis
1yo baby w/ croup, most likely route of transmission
respiratory transmission via sneezing/coughing f/m aninfected person
52yo woman, h/o DMT2, poorly controlled HTN and obesity, increased menstrual blood flow. endometrial biopsy: endometrial hyperplasia with atypia.
excess estrogen stimulation
15yo, proteinuria, paresthesias. fhx: mom mild stroke, dad renal failure, enzyme analysis: deficient alpha galactosidase
Fabry Dz
4yo from Ecuador, high fever, cough, skin rash (3d), from behind ears to body. PE: extensive maculopapular rash on face, neck, trunk, limbs. Koplik spots on buccal surface.
measles virus
mc type of malignant tumor found in the liver
metastatic tumor
67 yo, new onset bizarre behavior; weak right arm . CT: large intradural extraparenchymal mass compressing L frontal and parietal lobes
meningeoma
intrahepatic bile duct destruction-granulomatous inflamm
positive serum antimitochondrial antibodies
57yo male, c/o weight loss, early satiety, abdo pain. stomach wall diffusely thickened, “leather bottle”, perigastric lymphadenopathy
histo: malignant signet ring cells penetrating gastric wall
37yo male, CP:bp=180/110; diagnostic: INC serum sodium, DEC serum potassium, solitary adrenal mass
Conn syndrome (primary hyperaldosteronism)
>3hr morning stiffness, most jts, 3 mo…walking on stones..bilat symmetric swollen, tender PIJ, MJ, knees
RA
mc c/o urinary outlet obstruction in a man
BPH (benign prostatic hyperplasia)
foci of calcification in both breasts. breast bx: cystic dilatation, apocrine metaplasia, ductal epithelial hyperplasia without atypia
fibrocystic change
25 yo woman w/ thyroid mass; euthyroid; FNA: abnml cells in “nests”. immunoperoxidase staining for calcitonin of thyroid tumor is positive. neoplasm has Congo Red staining-amyloid. 2 episodes of: tachycardia, palpitations, HA, sweating, tremor.
MEN (multiple endocrine neoplasia)
nontender mass, no change in overlying skin, no nipple discharge, no axillary lymphadenopathy
delicate stroma around compressed, distorted slit-like glandular spaces sharply delineated from the surrounding tissue
doesnt respond/pay attn to question; stares at water pitcher, puts head down on table for 5 min
complex partial seizure
most likely cause and route of placental infection
bacterial/ascending through cervical canal
diverticulosis
hematochezia
increasingly short-tempered, diarrhea, weight loss, weak proximal muscles, PE: 132/74, pulse: 120 and irregular; fine tremor of outstretched hands, brisk reflexes.
Graves Disease
acid fast stain of feces: oocyts; 29yo woman with AIDS, profuse watery diarrhea, RUQ pain for 1 month; quit combo HAART therapy
cryptosporidium parvum
23yo soldier, shock, severe HTN, high temp, skin petechiae. spinal tap: neutrophils with gram neg diplococci
Waterhouse-Friderichsen syndrome
CT brain scan of comatose pt in ER: deep hemorrhage in right putamen is most likely d/t:
HTN
5yo previously healthy boy admitted d/t fever, HA, neck pain. lumbar puncture: 1500 WBC w/ 70% neutrophils, protein 70 mg/dL, glucose 20mg/dL (serum glucose 85 mg/dL)
pneumococcal meningitis
how do you differentiate between secretory and osmotic diarrhea?
secretory: do NOT improve with fasting
osmotic: DO improve with fasting
bacterial meningitis=inflamm of the meninges that generally is found in:
subarachnoid space
down, dropped appetite, disrupted sleep, feels like a loser
major depression
acquired through the skin
strongyloides stercoralis
young man w/ long h/o intermittent episodes of bloody diarrhea. colonoscopy: pseudopolyps w/ diffuse pancolitis…INC r/o:
colon cancer
17yo female, vague pelvic pain; large left adnexal mass; abdo CT scan: solid cystic ovarian mass. sx: solid with a few areas of necrosis. histo: differentiated cartilage and bone admixed w/ immature mesenchymal cells and foci of immature neuroepithelial elements
immature teratoma
liver biopsy for quantitative iron and copper studies
Wilson disease and hemochromatosis
18yo man hernia sx; post-op: jaundice, but no: abdo pain, dark urine, pruritus, fever, hemolysis. jaundice resolves in several days
post-op day #2 serum indirect bilirubin is elevated
56 yo woman, basal cell carcinoma-typical behavior?
slow growing, unlikely to have metastasized
20yo womna w/ numbness in her arms for 1 mo, electrical sensation shooting down her arms and spine when she bends her head forward. partial loss of vision in left eye. brain MRI scan: periventricular high signal white matter lesions bilat
MS
69 yo male w/ systolic HF readjust diuretic dosage upwards b/c increased dependent edema. 2 days later cannot bear weight on swolle, red, warm right knee. arthrocentesis of knee: elongated, needle-shaped crystals; under polarized light: negatively birefringent
monosodium urate
