Goljan High Yield 36 General EC Flashcards
1
Q
Physiologic effects of hemorrhage
A
drop in diastolic blood pressure, activation of RAA system from decreased renal blood flow and catecholamine stimulation, catecholamine release from the high pressure baroreceptors, increased reabsorption of sodium from the kidneys, release of ANP, release of ADH
2
Q
Opportunistic infections in AIDS
A
Pneumocystis CMV Cryptococcus MAI TB Herpes (esophagitis) Candida (thrush, esophagitis) Cryptosporidium (acid fast; diarrhea)
3
Q
Decreased uptake of DOPA and NOR
A
Cocaine
4
Q
Produces thymidine dimers
A
UVB light
If thymidine dimers not replaced with normal DNA by DNA repair enzymes, may result in cancer
5
Q
ESR increase with age
A
Probably abnormal and indicates a disease process rather than being an age-related finding
6
Q
Key elements in wound healing
A
Granulation Tissue and fibronectin
7
Q
MCC of death in 15-25 age bracket
A
Motor vehicle
Homicide for black male
8
Q
AR disease with absent DNA repair enzymes and increased incidence of UVB related skin cancer
A
Xeroderma pigmentosum
9
Q
Inhibited by CO and cyanide
A
Cytochrome oxidase
10
Q
XR disease with absent NADPH oxidase, absent respiratory burst, cannot kill catalase + S. aureus but can kill catalase negative strep
A
Chonic granulomatous disease
11
Q
Type of necrosis in acute MI
A
Coagulation necrosis
12
Q
Cause of atrophy in muslce
A
In a cast
Lack of muscle stimulation
13
Q
Non-disjunction in somatic cells
A
Mosaicism
14
Q
Mother gives disease to all her kids but son to none of his kids
A
Mitochondrial inheritance
15
Q
MC vitamin deficiency in alcoholics
A
folate
16
Q
MC metal deficiency in alcoholics
A
Magnesium
17
Q
Vitamin associated with pyruvate dehydrogenase
A
Thiamin (required to make ATP)
18
Q
NADPH oxidase conversion of molecular oxygen into superoxide free radicals. PMNs and monocytes only (no macrophages)
A
Respiratory burst
19
Q
In Caisson disease, what is decreased when a diver comes up too quickly
A
pressure of N2 in blood since it forms bubbles in the vessels and moves into tissue
20
Q
DES exposure, vaginal adenosis precursor
A
Clear cell adenocarcinoma of the vagina
21
Q
What happens to the other kidney if one is damaged
A
It undergoes hypertrophy
22
Q
Decreases the levels of vit K dependent factors, increased incidence of hemorrhagic strokes, potentiates the action of warfarin
A
Vit E toxicity
23
Q
Required for carboxylase reaction in the conversion of pyruvate to oxaloacetate
A
Biotin
24
Q
Involved in transamination reactions involving AST and ALT
A
Pyridoxine (B6)
25
Functions of ANP
opposite of ang-II
(inhibition of ADH release, inhibits ATII effect on stimulating thirst, inhibits aldosterone secretion, inhibits renal reabsorption of Na, and inhibits renin release
26
Chance of male with CF having a child. What about female?
<5% since the vas deferens never fully develop or are atretic
Females with CF can get pregnant but it is difficult owing to the thick cervical mucus
27
Vitamin supplements in CF
all of the fat soluble vitamins (D,A,E,K)
28
Woman is a pure vegan and is breast feeding her baby and the baby develops anemia
B12 deficiency
29
What does EBV attach to on B cells?
CD21
30
Hypogonadism, mental retardation, and unilateral gynecomastia
Klinefelter syndrome
31
Hypogonadism and color blindness
Kallman syndrome (absent GnRH)
32
Hypogonadism, mental retardation, retinitis pigmentosum
Laurence-Moon-Biedl syndrome
33
Male with hypogonadism, mental retardation, short stature, and webbed neck
Noonan syndrome (similar to Turner's syndrome)
34
Hypogonadism and anosmia
Kallmann syndrome
35
Male pseudohermaphrodite with cryptorchidism
```
testicular feminization (absent androgen receptors
(sex-linked recessive)
```
Most common cause of male pseudohermaphroditism
36
Microdeletion syndrome with hypogonadism, mental retardation, short stature, and obesity
Prader-Willi syndrome
| Ch 15 deletion is of paternal origin
37
Patient with neurofibromatosis has severe diastolic hypertension
Pheochromocytoma
38
Complications of cyclophosphamide
hemorrhagic cystitis and transitional carcinoma of the bladder
39
Decline in deaths due to SIDS
Having baby sleep supine
(babies rebreathe their own CO2, those with immature central chemoreceptors do not respond to the respiratory acidosis by moving their heads and die)
40
Most important risk factor for increased morbidity/mortality in a single 25 year old black male
Unprotected sex
(AIDS #1 killer in this age bracket; also applies to women regardless of age, but not white men, where MVAs are #1 killer)
41
Several employees that work in a car assembly plant present with headache, nausea, vomiting, muscle weakness, and abdominal cramps
Lead poisoning from incineration of batteries; may change history to people making moonshine in an old car radiator
42
Newborn female presents with edema of the hands and feet and a cystic mass in the neck
Turner's syndrome with a 45 XO karyotype
43
Compare to mature breast milk, cow's milk has . . .
More vit K, B12, & Casein
Less ascorbic acid
(breast milk has low iron but it is better absorbed; casein is the key protein in cow's milk, while whey is the primary protein in breast milk)
44
Vitamin that is absent in colostrum
Vit D
45
Anemia in an infant that develops when switched from cow's milk to goat's milk
Goat's milk is low in folate, B6, iron
High in K, Cl, arachidonic acids, and linoleic acids
(when compared to cows milk)
46
Type of UV light with the greatest potential for producing a corneal burn
UVB
B is Bad
47
Retinal hemorrhages in young children
Possible child abuse (shaking syndrome)
48
Patient is stung by a bee and begins to have respiratory difficulty, flushing, and abdominal cramping. Treatment?
Aqueous epinephrine
49
Multiple wheals that later develop into vesicles and pustules
Fire ant bites
50
Painful bite (carrying some logs from outside, moving boxes in basement) followed by crampy pain in the thighs and abdomen
Black widow bite
Treat with muscle relaxant [Ca gluconate], tetanus prophylaxis, antivenin if available in severe case
51
In southwest, painful sting followed by local itching, paresthesias, N/V, and hypertesion
Scorpion bite
52
Painless bite beginning with a slightly tender red papular lesion on the arm that latter forms a hemorrhagic blister surrounded by purpura
Brown recluse spider bite
53
Extremely pruritic discrete, bright red papules on legs around the waist
Chigger bites
54
Child who ingested 30 adults aspirins will most likely develop
increased anion gap metabolic acidosis
(children unlike adults do not commonly develop mixed metabolic acidosis and respiratory alkalosis)
Treatment is to perform gastric lavage and add activated charcoal and to produce an alkaline urine for the increase excretion of the acid
55
What disease is more likely to infect the fetus after the first trimester
Syphilis
56
Engineer driving a train involved in a crash with an oncoming train was found to have THC metabolites in his urine- why did this occur
Delayed reaction time
| it also impairs the ability to judge speed and distances
57
Angiosarcoma of the liver-causes?
Vinyl chloride
Arsenic
Thorotrast
58
Cardiovascular age dependent changes
loss of elasticity of aorta
59
Respiratory age dependent changes
obstructive findings
60
Musculoskeletal age dependent changes
Osteoarthritis
61
CNS age dependent changes
```
cataracts,
presbycusis (inner ear degeneration)
otosclerosis (conductive hearing loss)
decreased smell and taste
arcus senilis
```
62
Immune system age dependent changes
Increased CD4
Decreased CD8
Increased autoantibodies
Decreased cellular immunity
63
Integument age dependent changes
```
Loss of elasticity
Increased collagen cross bridges
Increased body fat
Ecchymoses from vessel instability
Decreased skin turgor
```
64
Reproductive age dependent changes
Breast and vulvovaginal atrophy
decreased serum estrogens and increased gonadotropins
Testicular atrophy with decreased testosterone levels, prostate hyperplasia
65
Renal age dependent changes
```
Decrease GFR (40%)
Decreased creatinine clearance (important in dosing drugs to avoid toxicity)
```
66
Endocrine age dependent changes
Increased carbohydrate intolerance (less insulin receptors from increased adipose)
67
Target organs for acetaminophen injury
liver and kidneys (renal medulla)
| Free radical injury
68
Low AFP
Down syndrome
69
Block phospholipase A2 hence decreasing prostaglandin and leukotriene production
Decrease leukocyte adhesion (increase PMNs, decrease lymphocytes and eosinophils)
Corticosteroids
70
Tumor marker that is a gene product (oncofetal antigen). Hepatocellular carcinoma, germ cell tumors, )yolk sac or endodermal sinus tumors of testicle or ovary). Testicular/ovarian cancer.
AFP
71
Tumor marker that is an enzyme. Hepatocellular carcinoma, yolk sac or endodermal sinus tumors of testicle or ovary
AAT
72
Tumor marker that is a hormone. Trophoblastic tumor in germ cell tumors of ovary/testis and placenta (benign=hyatidiform mole) (malignant=choriocarcinoma)
b-HCG
73
Tumor marker that is a protein. Small cell carcinoma of the lung, neuroblastoma
Bombesin
74
Tumor marker that is a protein. Multiple myeloma (excellent prognostic factor). Light chains in urine (Bence Jones protein)
B2-microglobulin
75
Tumor marker that is a glycoprotein (cancer antigen) in breast cancer
CA 15-3
76
Tumor marker that is a glycoprotein (cancer antigen) in pancreatic cancer (excellent marker)
CA 19-9
77
Tumor marker that is a glycoprotein (cancer antigen) in surface derived ovarian cancer
CA 125
78
Tumor marker that is a gene product (oncofetal antigen) in colorectal, pancreatic, breast, and SCC of the lung.
CEA
Bad prognostic sign if elevated preoperatively (greater incidence of undetected metastases)
79
Tumor marker that is an enzyme in Hodgkin's disease (non-specific tumor marker in general)
LDH
80
Tumor marker that is an enzyme in SCC of the lung, and neuroblastoma
NSE (neuron specific enolase)
81
Tumor marker that is a glycoprotein in prostate adenocarcinoma.
PSA
Excellent sensitivity but poor specificity (increased in prostate hyperplasia)
Excellent indicator of tumor burden.
Not increased after rectal exam
82
Virus associated with adults T cell leukemia/lymphoma
HTLV-1 (RNA)
83
Virus associated with hairy cell leukemia
HTLV-2 (RNA)
84
RNA virus associated with CNS malignant lymphoma
HIV
85
RNA virus associated with hepatocellular carcinoma
HCV
86
Virus associated with hepatocellular carcinoma
HBV
| aflatoxin B a cocarcinogen
87
DNA virus associated with Burkitt's lymphoma, nasopharyngeal carcinoma, and polyclonal malignant lymphoma
EBV
88
DNA virus associated with SCC of the cervix, vagina, vulva, and anus in homosexuals. Laryngeal papillomas (may progress to cancer)
HPV (16&18)
89
DNA virus associated with Kaposi's sarcoma
HSV-8
90
EM of zebra bodies in lysosomes in Niemann Pick disease
look like lamellar bodies in type II pneumocytes
91
Enamel injury in young woman
bulimia
Metabolic alkalosis from vomiting
Boerhaave's syndrome
92
Secondary amenorrhea
Anorexia nervosa
Decreased GnRH and gonadotropins
93
Decreased protein intake but normal total caloric intake (all carbs).
Kwashiorkor
Fatty liver from decreased apolipoproteins, pitting edema, flaky paint dermatitis, "flag sign" in hair
94
Decreased total caloric intake. Loss of muscle mass
Marasmus
95
Squamous metaplasia in eyes, broncus, nyctalopia
Vit A deficiency
96
Increased intracranial pressure, hypercalcemia
Vit A deficiency
97
Yellow but sclera white
beta-carotenemia
*can be primary hypothyroidism from decreased conversion of B-carotenes into retinoic acid in the intestine (thyroxine is a cofactor)
98
Rickets vs osteomalacia
Craniotabes and rachitic rosary in rickets (not osteomalacia)
Both have increased unmineralized osteoid
99
Cerebellar dysfunction; hemolytic anemia
Vit E deficiency
100
Vit E toxicity
interferes with vit. K dependent factors leading to hemorrhagic diathesis (synergistic w/ warfarin)
101
Gums bleed when brushing teeth, glossitis, perifollicular hemorrhages, "tea and toast diet"
Vit. C deficiency
102
Thiamin deficiency
alcohol abuse MCC
Important biochemical reactions (need to make ATP): pyruvate dehydrogenase, transketolase, ketoglutarate, dehydrogenase
Ring hemorrhages in mamillary bodies and periventricular area
High output cardiac failure, congestive cardiomyopathy, peripheral neuropathy
103
Confusion, ataxia, nystagmus
Wernicke (thiamin deficiency)
104
Antegrade and retrograde memory deficits
Korsakoff (thiamin deficiency)
105
Niacin deficiency
Important biochemical reactions: NAD/NADH, NADP/NADPH
Pellagra
Tryptophan can be used to synthesize niacin (tryptophan decreased in Hartnup's, carcinoid syndrome [converted to serotonin])
106
Riboflavin deficiency
Important biochemical reactions: FMN and FAD
Synthesis of glutathione
Magenta tongue, neovascularization of cornea, angular stomatits
107
Pyridoxine deficiency
INH MCC
Transaminase (heme synthesis)
Sideroblastic anemia w/ ringed sideroblasts, neurotransmitter synthesis
absent in goats milk
108
Important in fatty acid synthase complex (co-enzyme reactions)
Pantothenic acid
109
Biotin deficiency
Required for carboxylation reactions (ie gluconeogenesis)
avidin in raw eggs binds
causes alopecia
110
Chromium (functions and disorders)
part of the glucose tolerance factor which potentiates insulin activity
Deficiency associated with glucose intolerance and peripheral neuropathy
111
Copper Functions
Cofactor in many enzymes involved in oxidation-reduction reactions Lysyl oxidase-collagen cross links
Superoxide dismutase-
Ferroxidase- converts Fe2+ to Fe3+ so it can bind transferrin
Tyrosinase-conversion of tyrosine to DOPA
112
Copper deficiency clinical disorders
Deficiency associated with
Microcytic hypochromic anemia (cannot bind transferrin)
Skeletal abnormalities (defective collagen)
Osteoporosis
Skin depigmentation (problem with tyrosinase)
Dissecting aortic aneurysms (defective collagen and elastic tissue)
Mencke's kinky hair syndrome (impaired utilization of copper)
113
Copper toxicity
Wilson's disease
AR w/ defect in excretion of copper into bile. It leads to liver damage and eventual deposition of free copper into the eye (Kayer-Fleischer ring) and lenticular nuclei in the brain. Total copper levels are decreased owing to a decrease in ceruloplasmin synthesis by the damaged liver, but free copper levels are increased
114
Selenium functions
Functions in the metalloenzyme GLUTATHIONE PEROXIDASE which is an anti-oxidant that destroys peroxides in the cytosol. It neutralizes peroxides in the cytosol, while vitamin E prevents peroxide formation in the membranes of cells. It inhibits DNA synthesis and stimulates the immune system.
It is also an enzyme
cofactor in the peripheral conversion of T4 into T3
115
Selenium deficiency
Muscle pain
Weakness
Cardiomyopathy
116
Zinc function
```
Cofactor in
Superoxide dismutase
Carbonic anhydrase
Alkaline phosphatase
Collagenases
Polymerases
Thymidine kinase
Alcohol dehydrogenase
```
117
Zinc deficiency
```
Growth retardation
Hypogonadism and infertility
Dysgeusia (decreased taste)
Rash around eyes and mouth
Impaired wound healing
Impaired cellular immunity
Deficiency is common in diabetics, alcoholics, and cirrhosis
```
118
Acrodermatitis enteropathica
Recessive disease characterized by decreased intestinal absorption of zinc
119
Goat's milk
vit B6 (pyridoxine) and folate deficiency
120
Functions of Vit. C
Reduce dietary iron from ferric to ferrous for reabsorption
Hydroxylation of proline and lysine (binding site for cross-bridges)
Prevents nitrosamination
Reduces metHb
121
Cyanosis not relieved by oxygen in a patient coming home from a camping trip
methemoglobinemia (water has nitrites that oxidized iron to ferric condition)
SaO2 not PaO2 is decreased
Methylene blue treatment of choice (ascorbic acid ancillary role)
122
HbF
left shifts Hb ODC, protects newborns with sickle cell disease and severe beta-thalassemia, increased with hydroxyurea, resistant to alkali/acid denaturation
123
Raising the upper limit of normal of a test
Increases specificity and positive predictive value (decreases sensitivity and predictive value of a negative test result)
124
Prevalence
Number of people with disease in the population studied
=Incidence * duration of disease
125
What part of adrenal cortex is atrophies in a patient on corticosteroids?
Fasciculata and reticularis
| not glomerulosa
126
Apoptosis
individual cell necrosis
Normal involution of structures (atrophy, thymus)
Programmed cell death
Loss of Mullerian structures in males and Wolffian in females
Councilman (acidophilic) bodies
Psammoma bodies
Mechanism of atresia in the bowel (no lumen)
127
Hypercalcemia as paraneoplastic syndrome
PTHrP from SCC of lung or renal adenocarcinoma
128
Acanthosis nigricans
```
Insulin resistance
Stomach cancer (visceral malignancy)
```
129
Eaton-Lambert syndrome (Myasthenia-like)
Small cell carcinoma
130
Polymyositis paraneoplastic syndrome
Lung cancer
131
Oncogenesis in HPV
gene products E6 inhibits p53and E7 inhibits Rb
132
Metalloenzyme that aids tumor invasion of tissue
Type IV collagenase with Zinc cofactor
133
Smoker with history of peptic ulcer disease . . . advice?
Stop smoking
134
Normal karyotype in a child with Down syndrome
probable translocation w/ chromosome 21 sitting on top of ch 14
or acrocentric Robertsonian translocation of Ch 21
135
Sepsis in an elderly man with BPH
E. coli and can produce endotoxic shock
(warm shock due to activation of complement system and release of anaphylatoxins + release of NO from damaged endothelial cells)
136
DNA repair defects
Fanconi's anemia (cross-linking agents)
137
Effect of barbiturates and other drugs that enhance P450s
decrease heme and increased activity of ALA synthase (rate limiting enzyme in heme synthesis)
Dangerous in precipitating porphyric attacks
138
Genomic imprinting
did chromosome come from mother or father (ie Ch 15 microdeletion syndromes - Prader Willi and Angelman)
139
Normal changes in pregnancy
Greater increase in PV than RBC mass leading to decreased Hb
Increased:
GFR
CCr
Alkaline phosphatase
Decreased BUN, creatinine, and uric acid
Respiratory alkalosis from progesterone effect
Increased T4 and cortisol from increased synthesis of their binding proteins (free hormone normal)
140
Main difference in adult male and female labs
iron studies all lower in females
141
Increased alkaline phosphatase (osteoblasts from bone growth) and phosphate. Slight decrease in Hb
Children
142
Analytes increased with hemolyzed blood sample
LDH
| K
143
Lipid most affected by fasting
TG component coming from chylomicrons
| CH and HDL not affected
144
Enhance cytochrome system in the SER of the liver
Alcohol
Barbiturates
Increase in serum GGT
Decreased drug levels from increased metabolism
145
inhibit cytochrome system
H2 blockers, proton blockers, danger of drug toxicity
146
First sign of tissue hypoxia
Swelling of cell from inactiva Na/K ATPase
147
Examples of growth alterations
```
Atrophy
Hypertrophy
Hyperplasia
Metaplasia
Dysplasia
```
148
Examples of cell accumulations
```
Melanin
Fe
Ca (dystrophic, metastatic)
Glycogen
Bilirubin products
```
149
Free radicals
```
Superoxide
OH'
Peroxide
Acetaminophen
Fe increases formation via Fenton reaction
```
150
Types of cell necrosis
Coagulation (infarction-exception CNS)
Liquefactive (infections, brain infarct)
Caseous (TB, fungi)
Enzymatic fat necrosis (acute pancreatitis)
Fibrinoid (immunologic injury:small vessel vasculitis, vegetations in RHD and Libman Sacks)
Gummatous (tertiary syphilis)
151
Chemical mediators of inflammation
```
Histamine
C3a C3b C5a
LTB4
LTC-D-E4
Bradykinin
Prostaglandins
```
152
Factors increasing and decreasing adhesion molecule synthesis
```
Increase:
C5a
LTB4
Endotoxins
IL-1
TNF
```
Decrease:
Catecholamines
Corticosteroids
Lithium
153
Circumscribed red lesion containing multinucleated giant cells
Granuloma
Type IV hypersensitivity
Macrophages when activates become epitheloid cells and fuse into multinucleated giant cells
154
Key factors in wound healing
Fibronectin and granulation tissue
155
MCC of delayed wound healing
Infection
156
Suppurative inflammation
abscess (s. aureus)
157
Cellulitis inflammation
strep pyogenes
158
Granulomatous inflammation cause
TB/systemic fungi
159
Pseudomembranous inflammation causes
diphtheria
| C. dif
160
Fibrinous inflammation example
pericarditis
161
Serous inflammation example
blister
162
p53 tumor suppressor gene (cancer and chromosome)
Most cancers
| chromosome 17
163
APC tumor suppressor gene (cancer and chromosome)
Familial polyposis
| Chromosome 5
164
BRCA-1 tumor suppressor gene (cancer and chromosome)
Breast/ovarian cancer
| Chromosome 17
165
BRCA-2 tumor suppressor gene (cancer and chromosome)
Breast cancer
| Chromosome 13
166
Rb tumor suppressor gene (cancer and chromosome)
Retinoblastoma
Osteosarcoma
Chromosome 13
167
Fragile X syndrome
SXR disease
MC genetic cause of mental retardation in males (Down's most common overall)
Triplet repeat
Macroorchidism at puberty
168
Cri-du-chat
Deletion of short arm of Chr5
Mental retardation
Cry like a cat
Relation with VSD
169
Marfan's syndrome
```
AD
Fibrillin defect in elastic tissue
Mitral valve prolapse w/ sudden death
Aortic dissection MCC of death
Dislocated lens
```
170
Brain tumors, meningioma, acoustic neuroma,
| Also pheochromocytoma, cafe au lait spots, Lisch nodules (hamartomas on iris)
Neurofibromatosis (AD)
171
Cerebellar hemangioblastomas
Pheochromocytoma
Renal adenocarcinoma
Von Hippel Lindau (AD)
172
Most common teratogen
Alcohol
173
Oncogene relationship erb-B2/HER2
codes for a growth factor receptor
Breast cancer
Ovarian cancer
Colon cancer
174
Oncogene relationship ras
codes for membrane associated G proteins that transduce signals received from growth factor receptors to the phosphatidyl inostitol second messenger system.
30% of all cancer
175
Oncogene relationship abl
produces non-receptor proteins located on the inner cell membrane surface
176
Oncogene relationship t(9:22)
leads to CML
177
Oncogene relationship c-myc
located in the nucleus and produce protein products that activate nuclear transcription
178
Oncogene relationship t(8:14)
translocation leading to Burkitt's lymphoma
179
Oncogene relationship N-myc
Neuroblastoma
180
Oncogene relationship ret
MEN IIa/IIIb
181
Oncogene relationship bcl-2
t(14:18)
| leads to inactivation of apoptosis gene on B cells leading to immortal cell and follicular B cell lymphoma
182
Grade of cancer
Well differentiated if you can tell what its origin is
Poorly differentiated if you cannot tell tissue of origin
183
Stage of caner
T=Tumor size
N=Nodal involvement
M=Metastasis
more important than grade
184
Squamous, adeno, or transitional tumor nomenclature
carcinoma
185
mesenchymal tumor nomenclature
sarcoma
186
Hamartoma
non-neoplastic proliferation of cells where they belong
| bronchial hamartoma, PJ polyp, hyperplastic polyp
187
Choristoma
non-neoplastic normal tissue where it normally isn't (ie pancreatic tissue in stomach)
188
Mixed tumor
2 tissues from same cell layer (ie parotid salivary gland tumor)
189
Teratoma
Tissues from all cell layers
190
Increased AG metabolic acidosis
AG=Na-(Cl+HCO3)
(12 is normal)
adding an acid and the anion of the acid replaces the bicarb used to buffer the H+ (ie lactate, acetoacetate, B-hydroxybutyrate, phosphate/sulfate [renal failure], salicylate, formate [methanol poisoning], oxalate [ethylene glycol poisoning], acetate)
191
Normal AG metabolic acidosis
Losing bicarb and bicarb is replaced by an equal number of Cl anions
192
Acute transplant rejection
within 3 months
| predominantly cellular immune reaction (type IV CD8)
193
Carcinogens causing transitional cell carcinoma of bladder, ureters, and renal pelvis
Aniline dyes
Benzidine
Cyclophosphamide
Phenacetin
194
Carcinogen causing angiosarcoma of the liver
Vinyl chloride
195
Carcinogen causing small cell carcinoma of the lung, squamous cancers of the oral cavity, esophagus, larynx, lung, and cervix. And Transitional carcinoma of bladder and adenocarcinoma of pancreas
Polycyclic hydrocarbons
(tobacco smoke)
Alcohol is a cocarcinogen for oral, esophageal and laryngeal cancers
196
Carcinogens causing lung cancerq
```
Chromium
Uranium (radon gas)
```
197
Carcinogen causing lung and nasal cavity cancer
Nickel
198
Carcinogen causing nasal cavity cancer
Woodworking
199
Carcinogen causing angiosarcoma of liver, and hepatocellular carcinoma
Thorotrast
200
Carcinogen causing angiosarcoma of liver, squamous carcinoma of skin, and lung cancer
Arsenic
201
Carcinogen causing liver cell adenomas, hepatocellular carcinoma
Oral contraceptives
202
Carcinogen causing hepatocellular carcinoma
Aflatoxins
| Aspergillus : cocarcinogen with HBV
203
Carcinogen causing prostate cancer and lung cancer
Cadmium
204
Carcinogen causing verrucous carcinoma in mouth
Chewing tobacco
205
Carcinogen causing acute leukemia and malignant lymphoma
Alkylating agents
206
Carcinogen causing acute leukemia
Benzene
207
Carcinogen causing clear cell adenocarcinoma of cervix and vagina
DES exposure in utero
208
Carcinogen causing Esophageal and gastric cancers
Nitrosamines
| inhibited by ascorbic acid and refrigeration
209
Carcinogen causing squamous carcinoma of the skin (scrotum in chimney sweeps)
Tars, soots, oils
210
Increased in acute/chronic inflammation and monoclonal gammopathies. Best initial screen for temporal arteritis, zero in HbSS disease and polycythemias
ESR
211
Lymph node most common metastasis and primary tumor
MC metastasis from breast
MC primary NHL
212
Lung most common metastasis and primary tumor
MC metastasis from breast
MC primary adenocarcinoma
213
Bone most common metastasis and primary tumor
MC metastasis from breast
MC primary Multiple myeloma
214
Liver most common metastasis and primary tumor
MC metastasis from lung
MC primary hepatocellular carcinoma
215
Adrenal most common metastasis and primary tumor
MC metastasis from lung
MC primary adenocarcinoma
216
Brain most common metastasis and primary tumor
MC metastasis from lung
MC primary glioblastoma multiforme
217
Have synergistic effect on producing cancers of the oral cavity, esophagus, and larynx
Smoking + alcohol
218
Birth control pills protect against
Gonorrhea
| not chlamydia or ovarian cancer
219
CO poisoning
necrosis of the globus pallidus
Parkinson's; SaO2 decreased, PaO2 normal
L shift ODC
inhibit cytochrome oxidase
220
Respiratory acidosis
increase PaCO2, decrease PaO2 and SaO2
221
Normal PaO2 and SaO2 but decreased Hb
Anemia
222
Normal serum calcium/phosphate but deposits of calcium into damaged tissue, atherosclerotic plaques enzymatic fat necrosis, perivascular calcification in CMV
Dystrophic calcification
223
Increased serum calcium and/or phosphate with deposition of Ca in normal tissue.
Metastatic calcification
| nephrocalcinosis in primary hyperparathyroidism, calcification of basal ganglia in primary hypoparathyroidism
224
Contain stem cells. Examples are bone marrow stem cells, stratum basalis of skin, and base of intestinal glands
Labile cells
225
Cells in Go phase and must be stimulated to go into G1 phase
Stable cells
Most parenchymal cells in organs, smooth muscle, and neuroglial cells
226
Cannot enter the cell cycle.
Permanent cells
Skeletal muscle, cardiac muscle, and neurons
227
Most common bone metastasized to
Vertebra
Due to Batson vertebral plexus which communicates with the vena cava
