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gem Flashcards

1
Q

50 bz, empty, 6 packs, coke, rage

A

borderline

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2
Q

high degree of parasitemia, severe hemolysis with renal failure, cerebral malaria

A

plasmodium faciparum

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3
Q

lose consciousness, less responsive, intracranial hemorrhage, CT bleeding

A

middle meningeal artery

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4
Q

weight loss, intermittent bloody diarrhea. colonoscopy: ulcers, inflamm changes. biopsy: superficial ulceration, acute inflamm, gland abscesses, chronic inflamm-all in mucosa

A

ulcertaive colitis

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5
Q

9yo, 8kg loss, thirst +frequent urination, RBG: 221, UA:+3 glucosuria..hyperglycemia

A

islet cell destruction

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6
Q

50yo, repeated symptomatic nephrolithiasis. Lab: hi calcium, high PTH

A

primary hyperparathyroidism

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7
Q

HPV classification into types

A

id types that have high oncogenic potential

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8
Q

pigmented lesion on back of left calf, melanoma

A

depth of dermal invasion

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9
Q

61yo, memory impairment, early onset Alzheimers (familial)

A

cerebral cortical atrophy of the frontal and temporal lobes including the hippocampus, along with numerous neuritic amyloid plaques in the neocortex

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10
Q

7yo c/o itching, dayare kids with worms…enterobius vermicularis

A

scotch tape test looking for ova

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11
Q

75yo farmer, red raised plaque on face. biopsy: cytologic atypia-lower epidermis layers+ hyperkeratosis, parakeratosis

A

precursor of squamous cell carcinoma

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12
Q

shake overshoot object, no rhythm

A

right cerebellar hemorrhage

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13
Q

64yo woman, fracture femoral head. boney trabeculae, thick osteoid

A

tx: Vit D

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14
Q

prostate ca, gleason score-conservative approach

A

gleason score of 2 (1+1)

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15
Q

progressive difficuly swallowing, mass in upper third, invasive SCC..development in US

A

cigarette smoking

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16
Q

hiatal hernia, hematemesis, severe retching

A

Mallory-Weiss tear

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17
Q

UA: hematuria, cytoscopy: papillary tumor in dome of bladder. bx: fibrovascular core, urothelial cells, cytologic atypia

A

major RF: cigarette smoking

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18
Q

roseola infantum (exanthem subitum), fever erythematous rash

A

HHV6

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19
Q

epigastric abdo pain radiates to back, afebrile, mid-epigastric region, no bowel sounds

A

cause: alcohol and gallstones

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20
Q

14yo girl, lower abdo pain, adnexal mass. high alpha fetoprotein; large necrotic r. ovarian tumor; histo: glomerulus-like structures (schiller-Duval bodies)

A

yolk sac carcinoma

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21
Q

ill defined lesion in pancreas head-obstructs common bile duct

A

fibrosis and infiltrating malig glands

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22
Q

femoral metaphysis, breaks through bone cortex. bx: neoplastic bone w/ anaplastic tumor cells

A

osteosarcoma

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23
Q

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

A

H. pylori infection

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24
Q

NHL chemo, band-like vesicular rash

A

reactivation of VZV

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25
Q

obese, RUQ pain w/ fatty foods

A

w/u: gallstones

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26
Q

weight gin, fatigue, dizzy, memory, speech, dry skin, puffy face

A

TS level-determined if case d/t primary or secondary hypothyroidism

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27
Q

acute hep due to HCV-transmission

A

blood transfusion, contaminated needles, sexual contact

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28
Q

small cel ca of lung, SIADH manifestation

A

hyponatremia

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29
Q

toxo in AIDS pt

A

encephalitis

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30
Q

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

A

transient ischemic attack

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31
Q

smokes pack of cigs daily, drinks 6-12 beers daily, histo: microvesicular steatosis

A

liver will REVERT TO NML if he abstains form alcohol and tobacco

32
Q

68yo man, CA-pneumo, discharged w/ 7day course AB. 4 days later: fever + profuse green watery diarrhea.

A

stool c diff toxin assay=best intial diagnostic test to determine cause of diarrhea

33
Q

transmission of herpes encephalitis

A

respiratory transmission via sneezing/coughing from n infected person

34
Q

3cm pancreatic mass; gastrinoma

A

multiple duodenal and jejunal ulcers

35
Q

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

A

glioblastoma multiforme

36
Q

african woman w/ severe dysuria, mild suprapubic tenderness, UA: RBC, many WBC, ova with spikes

A

schistosoma haematobium

37
Q

Marfans

A

fibrillin-1 inherited defect

38
Q

h/o milk production, ROS: intermittend HA for several mo; no meds, PE: bilat peripheral field visual deficits

A

elevated serum prolactin

39
Q

delirium, hallucinations, disorganized thinking, impaired reality testing

A

schizophrenia

40
Q

neonate, increased abdo distention; PE: depressed frontanels, wrinkled skin. abdo film: constricition above anus, hirschsprung

A

absence of ganglion cells in the constricted portion of bowel

41
Q

45yo woman, fasting glucose: 140, PE: nml, repeat FBG: 154

A

T2DM

42
Q

30yo recovering f/m viral URTI–>painful and enlarged thyroid gland

A

subacute (granulomatous) thyroiditis

43
Q

1yo baby w/ croup, most likely route of transmission

A

respiratory transmission via sneezing/coughing f/m aninfected person

44
Q

52yo woman, h/o DMT2, poorly controlled HTN and obesity, increased menstrual blood flow. endometrial biopsy: endometrial hyperplasia with atypia.

A

excess estrogen stimulation

45
Q

15yo, proteinuria, paresthesias. fhx: mom mild stroke, dad renal failure, enzyme analysis: deficient alpha galactosidase

A

Fabry Dz

46
Q

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.

A

measles virus

47
Q

mc type of malignant tumor found in the liver

A

metastatic tumor

48
Q

67 yo, new onset bizarre behavior; weak right arm . CT: large intradural extraparenchymal mass compressing L frontal and parietal lobes

A

meningeoma

49
Q

intrahepatic bile duct destruction-granulomatous inflamm

A

positive serum antimitochondrial antibodies

50
Q

57yo male, c/o weight loss, early satiety, abdo pain. stomach wall diffusely thickened, “leather bottle”, perigastric lymphadenopathy

A

histo: malignant signet ring cells penetrating gastric wall

51
Q

37yo male, CP:bp=180/110; diagnostic: INC serum sodium, DEC serum potassium, solitary adrenal mass

A

Conn syndrome (primary hyperaldosteronism)

52
Q

>3hr morning stiffness, most jts, 3 mo…walking on stones..bilat symmetric swollen, tender PIJ, MJ, knees

A

RA

53
Q

mc c/o urinary outlet obstruction in a man

A

BPH (benign prostatic hyperplasia)

54
Q

foci of calcification in both breasts. breast bx: cystic dilatation, apocrine metaplasia, ductal epithelial hyperplasia without atypia

A

fibrocystic change

55
Q

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.

A

MEN (multiple endocrine neoplasia)

56
Q

nontender mass, no change in overlying skin, no nipple discharge, no axillary lymphadenopathy

A

delicate stroma around compressed, distorted slit-like glandular spaces sharply delineated from the surrounding tissue

57
Q

doesnt respond/pay attn to question; stares at water pitcher, puts head down on table for 5 min

A

complex partial seizure

58
Q

most likely cause and route of placental infection

A

bacterial/ascending through cervical canal

59
Q

diverticulosis

A

hematochezia

60
Q

increasingly short-tempered, diarrhea, weight loss, weak proximal muscles, PE: 132/74, pulse: 120 and irregular; fine tremor of outstretched hands, brisk reflexes.

A

Graves Disease

61
Q

acid fast stain of feces: oocyts; 29yo woman with AIDS, profuse watery diarrhea, RUQ pain for 1 month; quit combo HAART therapy

A

cryptosporidium parvum

62
Q

23yo soldier, shock, severe HTN, high temp, skin petechiae. spinal tap: neutrophils with gram neg diplococci

A

Waterhouse-Friderichsen syndrome

63
Q

CT brain scan of comatose pt in ER: deep hemorrhage in right putamen is most likely d/t:

A

HTN

64
Q

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)

A

pneumococcal meningitis

65
Q

how do you differentiate between secretory and osmotic diarrhea?

A

secretory: do NOT improve with fasting
osmotic: DO improve with fasting

66
Q

bacterial meningitis=inflamm of the meninges that generally is found in:

A

subarachnoid space

67
Q

down, dropped appetite, disrupted sleep, feels like a loser

A

major depression

68
Q

acquired through the skin

A

strongyloides stercoralis

69
Q

young man w/ long h/o intermittent episodes of bloody diarrhea. colonoscopy: pseudopolyps w/ diffuse pancolitis…INC r/o:

A

colon cancer

70
Q

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

A

immature teratoma

71
Q

liver biopsy for quantitative iron and copper studies

A

Wilson disease and hemochromatosis

72
Q

18yo man hernia sx; post-op: jaundice, but no: abdo pain, dark urine, pruritus, fever, hemolysis. jaundice resolves in several days

A

post-op day #2 serum indirect bilirubin is elevated

73
Q

56 yo woman, basal cell carcinoma-typical behavior?

A

slow growing, unlikely to have metastasized

74
Q

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

A

MS

75
Q

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

A

monosodium urate

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