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Interesting Important Facts Flashcards

1
Q

Where are PSAMMoma bodies found?

A

Papillary thyroid
Serous ovary
Meningioma
Mesothelioma

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1
Q 
Free nerve endings
Meissner corpuscles
Pacinian corpuscles
Merkel discs
Ruffini corpuscles
A

Pain, temperature
Dynamic, fine/light touch, position sense
Vibration, pressure
Pressure, deep static touch, position sense
Pressure, slippage of objects along surface of skin, joint angle change

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2
Q

Causes of eosinophilia

A 
Neoplasm
Asthma
Allergy
Collagen vascular disease
Parasites
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3
Q

Mother is Rh- and has multiple Rh+ babies

A

Hemolytic disease of the newborn, erythroblastosis fetalis.

Attacks blood so extramedullary hematopoiesis

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4
Q

Anti nuclear antibody
Anti-dsDNA, anti-smith
Anti-histone antibody

A

SLE nonspecific
SLE
Drug induced SLE

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5
Q

Rheumatoid factor

Anti-CCP cytidine cyclic phosphate

A

Rheumatoid Arthritis

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6
Q

Anti-centromere

Anti-Scl-70 (anti-DNA topoisomerase 1)

A

Scleroderma CREST syndrome

Scleroderma diffuse

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7
Q

Anti mitochondrial

A

Primary biliary cirrhosis

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8
Q

IgA antiendomysial

IgA anti-tissue transglutaminase

A

Celiac disease

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9
Q

Anti basement membrane

A

Goodpasture’s syndrome

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10
Q

Anti-desmoglein

A

Pemphigus vulgaris

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11
Q

Antimicrosomal, antithyroglobulin

A

Hashimoto’s thyroiditis

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12
Q

Anti Jo 1
Anti SRP
Anti Mi 2

A

Polymyositis, dermatomyositis

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13
Q

Anti-SSA (anti-Ro)

Anti-SSB (anti-La)

A

Sjögren’s syndrome

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14
Q

Anti-U1 RNP (ribonucleoprotein)

A

Mixed connective tissue disease

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15
Q

Anti smooth muscle

A

Autoimmune hepatitis

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16
Q

Anti-glutamate decarboxylase

A

Type 1 diabetes mellitus

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17
Q

C-ANCA (PR3-ANCA)

A

Granulomatosis with polyangiitis (Wegener’s)

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18
Q

P-ANCA (MPO-ANCA)

A

Microscopic polyangiitis, Churg-Strauss syndrome

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19
Q

Surfactant producing cells

A

Type 2 pneumocytes

Clara cells, aka Club cells. These are also site for cytochrome p450 dependent mixed-function oxidase activity

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20
Q

Schilling test

A

Determines cause of B12 deficiency
If low go to next stage.
Stage 1: give radio labeled b12 and normal b12 and collect urine for 24 hrs. High= dietary deficiency
Stage 2: give R b12 and oral IF. High=pernicious anemia
Stage 3: give R b12 and antibiotics. high=pernicious anemia
Stage 4: give R b12 and pancreatic enzyme. High=pancreatic insufficiency
Low=other causes like ileal resection

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21
Q

Mallory bodies

A

Intracytoplasmic hyaline inclusions derived from cyto keratin intermediate filaments

Commonly seen in primary biliary cirrhosis, Wilson’s disease, chronic cholestatic syndromes, and hepatocellular tumors

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22
Q

Pyknosis, karyolysis, karyorrhexis

A

Pyk: nuclear condensation
Karyorrhexis: fragmentation
Karyolysis: dissolution

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23
Q

How much is 1U of blood?

A

About 3% increase of hematocrit

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24
Q

SIRS criteria

A

Sepsis needs 2 or more

  • Wbc count: 12000 or band>10%
  • Heart rate>100
  • RR>20 or PCO238 (100.4)
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25
Q

Menopause causes what and what causes menopause

A 
Menopause causes: HAVOC
-hot flashes
-atrophy of the vagina
-osteoporosis
-coronary artery disease
Causes of meno:
Cessation of estrogen production because of a loss of ovarian sensativity to gonadotropin stimulation caused by decreased ovarian follicles and ovarian dysfunction
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26
Q

Sources of estrogen and potency

A

Ovary-estradiol
Placenta-estriol
Adipose-estrone
Estradiol>estrone>estriol

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27
Q

Anion gap equation

A

Na-(Cl+HCO3)

Normal anion gap 8-12 mEq/L

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29
Q

Cancer markers and association

A 
AFP in Hepatocellular carcinoma
CA 27.29 in Breast cancer
CA 19.9 in pancreatic cancer
CEA in colon cancer
PSA in prostate cancer
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30
Q

Tumor Lysis Syndrome

A

Sxs: Acute renal failure, HYPERphosphotemia, HYPOcalcemia, Metabolic acidosis. Prevented with the use of allopurinol (axanthine oxidase inhibitor)

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31
Q

In Metabolic acidosis with respiratory compensation you need to look at the Anoin gap

A

Normal: HARD ASS
Increased: MUDPILES

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32
Q

HARDASS

A 
Hyperalimentation
Addison's Disease
Renal Tubular Acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline
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33
Q

MUDPILES

A 
Methanol (formic Acid)
Uremia
Diabetic Ketoacidosis
Propylene Glycol
Iron tablets or Isoniazid
Lactic Acidosis
Ethylen glycol (oxalic acid)
Salicylates (late)
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34
Q

From birth to ovulation, in what phase remains the oocyte

A

Prophase 1

35
Q

Beta hCG is similar to what other hormones

A

TSH, FSH and LH

All share the same alpha subunit. It’s their beta subunit that confirms specific functionality

36
Q

VIPoma

A

Rare, commonly in tail of pancreas.
Causes relaxation of intestinal muscles, increased secretion of water and electrolytes: diarrhea, hypokalemia, hypochlorhydria (achlorhydria)

37
Q

Mittelschmerz

A

Woman suddenly develops abdominal pain in middle of menstraul cycle but everything points away from pregnancy.
- this is unilateral pain, due to bleeding from rupture of mature follicle

38
Q

Serum osmolality

A

=2xNa +BUN/3+glucose/20

Rough estimate mOsm/kg

39
Q

Causes for kidney stone formation

A

Increased urinary calcium- increased pth, immobilization, absorptive or renal hypercalciuria
Increased urinary oxalate-inflammatory bowel disease, small bowel resection
Increased uric acid excretion-hyperuricemia, gout
Abnormal urine pH
Urinary tract infection- urea splitters

40
Q

Causes of pancytopenia

A

Decreased production: aphasia, dysplasia (b12/folate), infiltration (leukemia, lymphoma, myeloma, fibrosis or metastasis)
Sequestration (hypersplenism)
Increased destruction: immune or nonimmune

41
Q

Drugs that cause aplastic anemia

A 
Chloramphenicol
Phenylbutazone
Gold salts
Sulfonamides
Phenytoin
Carbamazepine
Quinacrine 
Tolbutamide
42
Q

Dry tap for bone marrow biopsy

A

Hairy cell leukemia
Aplastic anemia
Myelofibrosis

43
Q

What is myelodysplasia?

A

Group of disorders broadly characterized by cytopenias(anemia, thrombocytopenia, neutropenia) associated with a dysmorphism or abnormal appearing and usually cellular bone marrow

“Old fart disease”

Epigenetic modifacation, chemo, genetics

44
Q

Renal clearance equation

A

Urine concentration x urine flow rate
——-———————————— ml/min
Plasma concentration

45
Q

Filtered load equation

A

GFR x plasma concentration. mg/min

46
Q

Renal plasma flow equation

A

Urine concentration x urine flow rate/ renal arterial concentration

47
Q

Filtered fraction equation

A

GFR/RPF

48
Q

Diabetes Mellitus Presentation

A

Polydipsia, Polyphagia, Lethargy, Stupor
Blurred vision, acetone breath, weight loss, Kussmal breathing (hyperventilation), Nausea, vomiting, Abdominal pain
Polyuria, Glycosuria

49
Q

Risk factors for suicide (require hospitalization)

A 
Male
Age(teens and elderly)
Depression
Previous attempts
Alcohol and drugs
Sickness
Organized plans
No spouse (single, widow, divorce)
Social support lacking
50
Q

Type 1 error

A

False positive error.
Rejecting null hypothesis incorrectly

*you saw a difference that did not exist

51
Q

Type 2 error

A

False negative error
Null hypothesis is not rejected when it should be

*blind to the truth

Increase the sample size to decrease this error

52
Q

Test results for prediabetes

  • higher values=Diabetes
  • lower vales=Normal
A

A1C: 5.7-6.4
Fasting Plasma Glucose: 100-125
Oral Glucose Tolerance Test: 140-199

53
Q

GFR Calculations

A

*Can assume Creatinine Clearance is equivalent
**the real equation is:
GFR=((140-AGE)(Kg))/(SCr x 72)

54
Q

Pre-Renal vs Renal vs Post renal

A

Prerenal: volume contraction due to blood or ECF fluid loss
Renal: Ischemic renal injury due to trauma or toxic renal injury due to anesthesia
Postrenal: retroperitoneal hemorrhage, clots in the bladder causing outlet obstruction

55
Q

Narcolepsy has a deficiency of what…
Hallucination before sleeping is called…
Hallucination after sleeping is called…

A

Orexin produced in lateral hypothalamus
Hypnagogic
Hypnopompic

56
Q

Deficiencies of these hormones cause what?
Acetylcholine
Dopamine
Epinephrine/norepinephrine

A

Alzheimer’s
Parkinson’s
Depression

57
Q

Transference vs countertransference

A

T: patient projects feelings about someone else on to the doctor
CT: doctor projects feelings about someone else on to the patient

58
Q

Clinical reflexes

A

S1-2 Achilles reflex
L3-4 patellar reflex
C5-6 biceps reflex
C7-8 triceps reflex

L1-2 cremaster reflex
S3-4 anal wink reflex

59
Q

Seminoma

A

Malignant, painless homogenous testicular enlargement. most common testicular tumor, most common in third decade,

Large cells in lobules with watery cytoplasm and fried egg appearance. Increased AFP. Excellent prognosis.

60
Q

Yolk sac tumor

A

Yellow, mucinous, aggressive malignancy, Schiller Duvall bodies resemble primitive glomeruli

Increased AFP.
Most common in 3 yr olds

61
Q

Choriocarcinoma

A

Malignant, disordered syncytiotrophoblastic and cytotrophoblastc elements. Hematogenous metastasis to brain and lungs. (May present with hemorrhagic stroke due to bleeding into metastasis)

Gynecomastia, sxs of hyperthyroidism ( hCG similar to TSH, LH, FSH)

Increased hCG

62
Q

Embryonal carcinoma

A

Malignant, hemorrhagic mass with necrosis, painful, worse prognosis than Seminoma. Often glandular or papillary morphology, Pure embryonal carcinoma is rare. most commonly mixed with other tumor types

May have increased hCG, and normal AFP when pure. Increased AFP levels When mixed

63
Q

Cremaster muscle derived from what abdominal muscle

A

Internal oblique

64
Q 
Mutations in these proteins cause what?
Alpha synuclein
Dystrophin
Huntingtin
Presenilin
Tau
A 
Parkinson's
Duchene muscular dystrophy
Huntingtons
Alzheimers
Frontotemporal dementia with Parkinsonism (AD, picks, palsy)
65
Q

Rheumatic Fever

A

comes from pharyngeal infection with Group A Beta hemolytic strept.

  • Affects Mitral>aortic»>tricuspid
  • Associated with Aschoff Bodies (granuloma with giant cells), Anitschkow cells (enlarged macrophages with ovoid, wavy, rod-like nucleus)
  • Immune mediated Type 2 HS, Ab to M protein cross react with self antigens
  • *Joint (migratory ppolyarthritis)
  • *Carditis
  • *Nodules in skin (subcutaneous)
  • *Erythema marginatum
  • *Sydenham Chorea
66
Q

Anti Hemidesmosomes

A

Bullous Pemphigoid

*Nikolsky sign in Negative (separation of epidermis upon manual stroking of skin doesnt happen)

67
Q

Anti Desmoglein

A

Pemphigus Vulgaris
*Nikolsky sign is positive
(Desmosomes attacked)

68
Q

Dermatitis herpetiformis

A

IgA deposits at tips of dermal papillae. Associated with celiac disease. Pruritis papules, vescicles, and bullae (usually at elblows)

69
Q

I Cell Disease

A

Inherited Lysosomal storage disorder. Defect in N acetylglucosaminyl-1-phosphotranferase. Mannose residues not phosphorylated by Golgi apparatus. this causes it to be exocytosed instead of broken down.
*course facial features, clouded corneas, restricted joint ovement, high plasma levels of lysosomal enzymes. Often fatal

70
Q

Chvostek’s Signs

A

facial twitch due to hypocalcemia

71
Q

cluster headaches

A

Unilateral
last 15min-3 hours, repetative
*Excruciating periorbital pain with lacrimation and rhinorrhea. May induce horner syndrome (ptosis), more common in males
Treat with O2 therapy. Sumatriptan

72
Q

Tension Headaches

A

Bilateral
>30min, constant, 4-6hrs
*Steady pain, no photophobia or phonophobia or auras
Tx: Analgesics, NSAIDS, Acetaminophen. Amitrptyline for chronic pain

73
Q

Migraine

A

Unilateral
4-72 hrs
*pulsating pain with nausea, photophobia, phonophobia, aura.
**Due to irritation of CN 5, meninges, Blood vessels, p Calcitonin gene
Tx: Abortive therapies: Sumatriptan, NSAIDS, Prophylaxis: Propranolol, topiramide, Ca channel blockers, amitriptyline

74
Q

Migraine

A

Unilateral
4-72 hrs
*pulsating pain with nausea, photophobia, phonophobia, aura.
**Due to irritation of CN 5, meninges, Blood vessels, p Calcitonin gene
Tx: Abortive therapies: Sumatriptan, NSAIDS, Prophylaxis: Propranolol, topiramide, Ca channel blockers, amitriptyline

75
Q

Myasthenia Gravis

A

Most common NMJ disorder.
Ab to postsynaptic AChR
*Ptosis, diplopia, weakness, worsens with use
*Associated with Thymoma, Thymic hyperplasia
Tx: Give AChR inhibitor to reverse Sxs

76
Q

Lamber Eaton Myasthenic Syndrome

A

Ab against Ca Channles on Presynaptic terminal= Decreased ACh release

  • Proximal muscle weakness, autonomic SXS(dry mouth, impotence)
  • Associated with Small Cell Lung Cancer
77
Q

SLE

RASH OR PAIN

A 
Rash (malar or discoid)
Arthritis
Soft tissue/Serositis
Hematologic disorders (cytopenias)
Oral/nasopharyngeal ulcers
Renal Disease, Raynaud Phen.
Photosensativity, +VDRL/RPR
ANA
Immunosuppresants
Neurologic Disorders (Seizures, psychosis)
78
Q

SLE Presentation

A

Rash, joint pain, fever, most commonly fertile female, african descent.

  • Libman Sacks endocarditis- nonbacterial, wartlike vegetations on both sides of valve
  • *Nephritic: Diffuse proliferative glomerulonephritis
  • *Nephrotic: Membranous Glomerulonephritis
79
Q

Antimicrosomal Antibody

A

Hashimoto Thyroiditis

80
Q

Trisomy 13

A

Patau’s syndrome

Cleft lip, microphthalmia, mental retardation, polydactyly, Congential Heart disease, renal defects

81
Q

Trisomy 18

A

Edward’s syndrome
Severe mental retardation, micrognathia, low set ears, congenital heart defects, limited hip abduction and rocker bottom feet

82
Q

Deletion of 11p13

A

Wilm’s tumor and aniridia and Genital anomalies and mental retardation
*Wilms=most common childhood renal tumor and 4th most common pediatriac malignancy in US

83
Q

Deletion of 5p

A

Cri-Du-Chat syndrome

cry sounds like meowing kitten, microcephaly, mental retardation, epicanthal folds, and cardiac defects

Interesting Important Facts (13 decks)

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