Kaplan Qbank Flashcards
1
Q
Parasite assoc w/
Megacolon, Megaesophagus,
+ Dilated Cardiomyopathy
A
Chagas Disease
(Intracellular protozoan parasite Tripanozoma Cruzi)
Transmitted via Reduviid bug bite in South America.
Rx: Nifurtimox
2
Q
Parasite assoc w/
Bladder
A
Schistosoma Haematobium
Predisposes Squamous Cell Carcinoma of Bladder
3
Q
Brain Parasite assoc w/
HIV
A
Toxoplasma Gondii
4
Q
2 Brain Parasites assoc w/
Fresh water
A
Naegleria Fowleri
Acanthamoeba
5
Q
Brain Parasite assoc w/
Dogs
A
Echinococcus Granulosis
6
Q
2 Lung Parasites
A
Dirofilaria
Paragonimus Westermani
7
Q
3 Small Intestinal Parasites
A
Ascaris
Taenia
Strongyloides
8
Q
Granulosa Cell Tumor
ovarian follicle tumor
A
Solid + yellow ovarian mass, can produce estrogen.
Induces endometrial hyperplasia + higher risk of endometrial carcinoma.
Tumor cells have follicle-like structures, inhibin stains positive.
9
Q
Dysgerminoma
ovarian cell tumor
A
Solid + tan ovarian mass, no hormone inbalance.
Clear cytoplasm + round/ovoid nuclei surrounded by abundant lymphocytic infiltrate.
+ Frec in mosaic Turner Sd + Pseudohermaphroditism.
10
Q
Krukenberg Tumor (ovarian MTS tumor)
A
MTS gastric signet-ring carcinoma to ovary
Assoc w/ endometrial hyperplasia + uterine bleeding
11
Q
ADPKD
(Autosomal Dominant
Polycystic Kidney Disease)
A
Progressive renal failure, hematuria, HTN, renal stones, cysts in kidneys + liver.
Mutation in PKD1 + PKD2 genes, onset 50s.
Assoc w/ berry aneurysms in circle of willis (ACA + PCA)
12
Q
ARPKD
(Autosomal Recessive
Polycystic Kidney Disease)
A
Infantile ADPKD: earlier onset + more severe sympt
13
Q
CAH
Congenital Adrenal Hyperplasia
A
21-Hydroxylase Def
Baby girl w/ ambiguous genitalia, vomiting, dehydration.
Aldosterone def (Hypo Na+, Hypo Cl-, Hyper K+) Cortisol def (hypoglycemia) Elevated 17-Hydroxyprogesterone, DHEA, Androstenedione, Renin.
14
Q
Klinefelter Sd
XXY
A
Tall, small penis + testes, infertility, gynecomastia, sparse body hair.
Abnormal clumped Leydig cells
Low Testosterone.
High GnRH, LH, FSH.
15
Q
4 Tumors w/ Psamomma Bodies
dystrophic calcifications
A
Necrosis cluster w/ crystallization of Ca+ salts
. Papillary Carcinoma of Thyroid
. Serous Papillary Cystadenocarcinoma of Ovary
. Meningioma
. Malignant Mesothelioma
16
Q
Acetaminophen Toxicity Labs
A
Acute Liver injury
. Elevated AST, ALT (hepatocytes)
. Normal ALP (bile duct + billiary tree)
. Normal Amylase (pancreatitis)
17
Q
Obesity Hypoventilation Sd (OHS)
Pickwickian Sd
A
Chronic alveolar hypoventilation assoc w/ obesity
> 90% have OSA (Obstructive Sleep Apnea)
Chronic respi acidosis w/ metab compensation, RVH
Rx is CPAP + weight loss
18
Q
Osmotic Demyelination Sd (ODS)
Central Pontine Myelinosis
A
Rapid correction (>8 mEq/d) of hypoNa+ (<120 mEq/L) after 2-3 days of adaptation can lead to demyelinating axons in central pons + Locked-In Sd.
19
Q
Surreptitious Thyroxine Dosing
A
Hyperthyroid condition (increased T4) and decreased Iodine uptake, suspect exogenous thyroxine. Endogenous hyperthyroidism would have increased Iodine uptake as well as increased T4..
20
Q
(Oculomotor) CN3 Compression
A
CN3 (Oculomotor) nerve passes b/t sup + inf cerebellar artery (by basilar artery)
An aneurysm + compression of CN3 leads to loss of adduction of that eye.
21
Q
Long Thoracic Nerve Lesion
A
Nerve that innervates Serratus Anterior musc.
Lesion leads to winged scapula.
22
Q
Axillary Nerve Lesion
A
Nerve that innervates Teres Minor + Deltoid musc.
Lesion leads to arm abduction weakness.
23
Q
Dorsal Scapular Nerve Lesion
A
Nerve that innervates Rhomboideus Major + Minor musc.
Lesion leads to minor winging of scapula.
24
Q
Suprascapular Nerve Lesion
A
Nerve that innervates Supraspinatus + Infraspinatus musc.
Lesion leads to difficulty elevating arm.
25
(ARDS) Acute Respi Distress Sd
| Def + Dx
Non-cardiogenic pulmonary edema
Triggered by trauma, mult transfusions, pancreatitis
Onset several hrs after trigger
Dx via ABG (decreased PaO2/FiO2 ratio <200 mmHg)
26
Enzyme Def in:
| Albinism (Classic AD form)
Tyrosinase Def
| Aromatic AA Tyrosine cannot be converted to melanin in melanocytes, increasing risk of sunburn + skin cancer.
27
Enzyme Def in:
| Maple Syrup Urine Disease
Alpha-Ketoacid Dehydrogenase Def
Branched-chain AA (alpha-ketoacids) cannot be metabolized and accumulate in blood, leading to metab ketoacidosis, motor prob + seizures, urine smell of maple syrup or burned sugar.
28
Enzyme Def in:
| Tay-Sachs Disease (AR)
Hexosaminidase A Def
Glycolipid disorder leads to accumulation of Ganglioside GM2 in neurons, cherry-red macula in retina, blindness, loss of developmental milestones, death before 5yrs.
29
```
Enzyme Def in:
Hunter Disease (X-Linked)
```
Iduronate 2-Sulfatase Def
Glycoprotein disorder leads to accumulation of Heparan + Dermatan Sulfate in urine, retardation, coarse facial features, hepatosplenomegaly, cardiac defects, clear corneas, short stature, hearing loss.
Severe form is lethal by 5yrs.
30
Enzyme Def in:
| Homocystinuria (AR)
Cystathionine Beta Synthase Def
Methionine cannot be produced, leading to accumulation of sulfur-containing AA Homocysteine.
Looks like Marfan, limited joint mobity, retard (severe form), increased risk of thrombosis (DVT, MI, Stroke) by 30s-40s.
31
Translocation in:
| t(14;18)(q32;q21)
Follicular B Cell Lymphoma - t(14;18)(q32;q21)
Xs 14 site involves Ig heavy chain locus (IgH)
Xs 18 site involves Bcl-2 oncogene
Translocation produces hybrid Bcl-2/IgH transcript
Bcl-2 inhibits apoptosis, so this raises cancer risk!
32
Translocation in:
| t(11;14)(q13;q32)
Mantle Cell Lymphoma (MCL) (+ Mult. Myeloma)
t(11;14)(q13;q32)
Xs 11 site involves Bcl-1 oncogene
Xs 14 site involves Ig heavy chain locus (IgH)
Translocation produces hybrid Bcl-1/IgH transcript
33
Translocation in:
| t(12;21)
Acute Lymphoblastic Leukemia (ALL) -t(12;21)
| Favorable Px in kids
34
Translocation in:
| t(9;22)
Chronic Myelogenous Leukemia (CML) -t(9;22)
Poor Px + adult presentation in:
Acute Lymphoblastic Leukemia (ALL)
35
Translocation in:
| t(15;17)
```
Acute Myelogenous Leukemia (AML) -t(15;17)
Promyelocytic type (APL)
```
36
Translocation in:
| t(8;14) Or t(2;8) Or t(8;22)
Burkitt Lymphoma
t(8;14) -> hybrid myc/IgH transcript
t(2;8) -> hybrid kappa Ig light chain/myc transcript
t(8;22) -> hybrid myc/lambda Ig light chain transcript
37
Esophagus path:
| Mallory-Weiss Tears
Lesions in Esophagus Mucosa
Caused by frequent vomiting (acute/chronic OH, bulimia)
Mild Upper GI bleeding
38
Esophagus path:
| Boerhaave Sd
Esophagus tears through all layers!
Causes fluid/air in mediastinum (Pneumomediastinum)
Assoc w/ forceful vomiting, chest pain, pain on swallowing
39
Esophagus path:
| Esophageal carcinoma
Either Adenocarcinoma or Squamous Cell Carcinoma
| Onset as progressive dysphagia, not acute bleeding
40
Esophagus path:
| Achalasia
Motor dysfunction of Lower Esophageal Sphincter (LES)
Difficulty swallowing, accumulation of food leads to dilation + megaesophagus, bleeding uncommon
Dx barium swallow with "Bird Beak" appearance
41
Esophagus path:
| Schatzki Rings
Benign mucosal rings at Esophagus squamocolumnar junction (below Aortic arch)
Caused by chronic GERD
42
Esophagus path:
| Zenker Diverticulum
Evagination of Esophagus at Pharynx junction
| Causes dysphagia + halitosis, not bleeding
43
Esophagus path:
| Esophageal Varices
Dilated + tortuous Submucosal Esophageal veins
Develop secondary to Portal HTN, after cirrhosis
+frec causes of cirrhosis (chronic OH, HCV)
Onset as life-threatening bleeding, no prior vomiting
44
Plummer-Vinson Sd
. Hypochromic + Microcytic Anemia
. Esophageal webs
. Atrophic glossitis
45
2 Phases of Salicylate Poisoning
```
1. Acute Respi Alkalosis
(high pH, low PCO2, near normal HCO3)
2. [12-24hrs later] Metabolic Acidosis
(lactic acidosis -> metab acidosis with low HCO3)
Also assoc w/ Tinnitus, N+V, Fever
```
46
Acetaminophen Poisoning
| Symptoms + Rx
N+V, Abdominal pain, Hepatic Failure
| Rx: N-Acetylcysteine within 8hrs prevents hepatic failure
47
Hydrochlorothiazide Poisoning
| Symptoms
```
Metabolic Alkalosis (via H+ excretion) [HyperGLUC]
HyperGlycemia
HyperlLipidemia
HyperUricemia
HyperCa+
```
48
Chronic Lead Poisoning
| Symptoms
. Sideroblastic anemia (Basophilic stippling of RBCs)
. Neuropathy
. Kidney Dysfunction
. Abdominal pain
49
Chronic Mercury Poisoning
| Symptoms
. CNS atrophy
. Gingivitis
. Gastritis
. Renal Tubular changes
50
Acute Mercury Poisoning
| Symptoms
. GI Epithelium Necrosis
| . Renal Tubular Necrosis
51
Sheehan Sd
Postpartum hemorrhage leads to hypopituitarism
| Rx: Glucocorticoids + Thyroxine asap
52
How to Calculate
Serum Anion Gap?
Use? Normal Range?
Anion Gap = (Na+) - (HCO3 + Cl+)
. Used to determine b/t causes of Metabolic Acidosis
. Normal Range (8-16 mEq/L)
53
2 Causes of Metabolic Acidosis
| w/ Elevated Anion Gap
. DM + Ketoacidosis
| . Shock/HF + Lactic Acidosis
54
2 Causes of Metabolic Acidosis
| w/ Normal Anion Gap
. Diarrhea + Loss of HCO3 (also K+)
| . Renal Tubular Acidosis + Retention of H+
55
Primary Hypothyroidism
| Lab Values
Thyroid Gland Problem:
. Elevated TRH, TSH
. Low T3, T4
56
Secondary Hypothyroidism
| Lab Values
Anterior Pituitary Problem:
. Elevated TRH
. Low TSH, T3, T4
57
Hashimoto's Thyroiditis
| Lab Values
Autoimmune Damage to Thyroid Gland:
. Elevated TRH, TSH
. Low T3, T4
. Elevated Anti-Thyroglobulin Ab, Anti-Thyroid Peroxidase Ab
58
T4 Rec Insensitivity
| Lab Values
Loss of Negative Feedback by T4 Rec Problem:
. Elevated TRH, TSH, T3, T4
. Signs + Symptoms of Hypothyroidism
59
Pregnancy + Trauma / Placental Abruption
| leads to
Amniotic Fluid Embolism + Respiratory Distress
Rupture of Uterine / Cervical veins allows Amniotic Fluid into Maternal Circulation, leading to small Pulmonary Infarcts.
. Rx for Respi Distress, DIC, immediate Cesarean.
60
Pseudomixoma Peritonei
Gelatin-Like Mucus-Producing Tumor that fills the Peritoneal Cavity
Can be Benign (Mucinous Cystadenoma)
Or Malignant (Mucinous Cystadenocarcinoma)
Usual origin sites are Ovary or Appendix.
61
Polycystic Ovarian Sd (PCOS)
```
Young woman with Hirsutism, Amenorrhea, Obesity.
. Elevated LH, Testosterone
. Low FSH
. Cystic Follicles in the Ovary
Rx for HTN + Hirsutism (Spironolactone)
```
62
Keloid Scar Formation
| is due to
Aberrant form of wound healing with excessive Collagen I + III Synthesis following trauma.
63
Diabetes Insipidus (DI)
. Polyuria, Polydipsia, HyperNa+
Can be Nephrogenic (Kidneys resistant to ADH)
Or Neurogenic/Central (inadequate ADH secretion)
. Dx w/ Desmopressin Test
(H2O restriction + Adm ADH analog - if urine osmolarity elevates, it is Central, if not, it is Nephrogenic!)
64
Men > 50 w/ Non-Traumatic
New Onset of Low Back Pain
Most Commonly due to
Bone Metastatis from Prostate Cancer
. Multiple Bone Lesions (sclerotic osteoblasts)
Dx w/ PSA Test (Prostate Specific Antigen)
65
Black Pigment Gallstones
Stone composed of Ca+ Bilirubinate
. High in Unconjugated Bilirubin
. Low in Cholesterol
Assoc w/ Hemolytic Anemia
66
Brown Pigment Gallstones
Mixed stone composed of Unconjugated Bilirubin + Cholesterol.
Assoc w/ Biliary Tree Infection (Common Bile Duct)
(Chinese Liver Fluke - Chlonorchis Sinensis)
67
Cholesterol Gallstones
```
Stone mostly composed of Cholesterol
. High in Cholesterol
. Low in Unconjugated Bilirubin
Assoc w/
4 F's (Forties, Fat, Fertile, Female)
High Estrogen (OCP, Pregnancy)
```
68
```
Suppressor Gene (+ Xs) for
Hereditary Breast + Ovary Cancer
```
BRCA-1
| . Xs 17q12-21
69
```
Suppressor Gene (+ Xs) for
Hereditary Breast Cancer
```
BRCA-2
| . Xs 13q12-13
70
Suppressor Gene (+ Xs) for
Von Hippel-Lindau Disease
+ Renal Cell Carcinoma
VHL
| . Xs 3p25
71
2 Suppressor Genes (+ Xs) for
| Wilms Tumor
WT-1
. Xs 11p13
WT-2
. Xs 11p15
72
Suppressor Gene (+ Xs) for
Retinoblastoma
+ Osteosarcoma
Rb
| . Xs 13q14
73
```
Suppressor Gene (+ Xs) for
Lung, Breast, Colon Cancer
```
p53
| . Xs 17p13.1
74
Suppressor Gene (+ Xs) for
Adenomatous Polyps
+ Colon Cancer
APC
| .Xs 5q21
75
```
Suppressor Gene (+ Xs) for
Colon Cancer
```
DCC
| . Xs 18q21
76
```
Suppressor Gene (+ Xs) for
Neurofibromas
```
NF-1
| .Xs 17q11.2
77
Suppressor Gene (+ Xs) for
Acoustic Neuromas
+ Meningiomas
NF-2
| .Xs 22q12
78
Serum Marker for
| Pancreatic Cancer
Elevated CA-19-9
79
```
Serum Marker for
Ovarian Cancer (epithelial origin)
```
Elevated CA-125
80
Serum Marker for
| Lung, Stomach, Pancreas, Colon Cancer
Carcinoembryonic Ag
81
Serum Marker for
Squamous Cell Lung Carcinoma
+ Renal Cell Carcinoma
Parathyroid-Related Peptide (PTH-rP)
| Assoc w/ Paraneoplastic Sd
82
```
Serum Marker for
Testicular Cancer (Germ-Cell Tumors)
```
Alpha-Fetoprotein (AFP)
| Or Beta-Human Chorionic Gonadotrophin (BHCG)
83
Erythema Multiforme
Signs + Symptoms
Common Triggers
Erythematous Skin Lesions w/ Palms, Soles, Mucosa involvement
Mediated by CD4 + CD8 T Cells targeting Epit cells
Target-Like Lesions (pale, vesicular, eroded centers)
Triggered by:
. Infection (HSV-1 Or 2, Mycoplasma Pneumoniae)
. Drugs (Penicillin, Sulfas, Allopurinol)
84
Pilocytic Astrocytoma
| #1 Kids Brain Tumor
Location in Posterior Fossa, Cerebellar Hemispheres
Cyst w/ a Mural Nodule
Elongated Astrocytes w/ IC corkscrew inclusions called Rosenthal Fibers)
Stains w/ GFAP
85
Ependymoma
| Kids Brain Tumor
Location lining Ventricular Walls (4th Ventricle)
Ependymal Cells organize around:
. Small Vessels (Perivascular Pseudorosettes)
. Small Lumina (True Ependymal Rosettes)
86
Medulloblastoma
| Kids Brain Tumor
Location in Midline Posterior Fossa
Invades Cerebellar Vermis
Solid, Non-Cystic
Small undifferentiated cells arranged in Homer-Wright Rosettes
87
Lung Squamous Cell Carcinoma
Strong Assoc w/ Smoking
Central Location on CXR
May form Cavitary Lesion w/ Central Necrosis
May have Signs + Symptoms of Pancoast Tumors
88
Pancoast Tumors
| Signs + Symptoms
Tumor that compress adjacent structures, lead to:
. Horner Sd (Ptosis, Miosis, Anhidrosis, Enophthalmos)
. Ulnar Nerve Pain (compression in Brachial Plexus)
. SVC Sd (Facial Edema, JVD)
. Erosion of Adjacent Vertebral Structures
89
Bronchioalveolar Carcinoma
Not Assoc w/ Smoking
Arises from Type II Pneumocytes
Peripheral Pneumonia-like consolidation on CXR
90
Bronchogenic Adenocarcinoma
Assoc w/ Non-Smoking Females
| Ill-Defined Solid Peripheral Lesion on CXR
91
Metastatic Brain Cancer
| Location
Round Tumor(s) at Junction of Cortical Gray + White Matter (most distant of arterial blood supply)
92
Glioblastoma Multiforme
| Grade IV Astrocytoma
Arising in White Matter in older adults
Irregular Tumor w/ Ring-Enhancing Lesion.
Can cause "Butterfly" Lesion (Crossing b/t Hemispheres)
93
3 Causes of Loss of
| Peripheral Vision
. Pituitary Tumors (impinges on Optic Chiasm)
. Craniopharyngioma (impinges on Optic Chiasm)
. Glaucoma
94
2 Causes of Photophobia
. Meningitis
| . Subarachnoid Hemorrhage (chemical meningitis)
95
Warfarin
| Vit. K Antagonist
Vit. K necessary for Clotting Factors 2, 7, 9, 10
Warfarin Normal Dose (mainly factor 7) leads to:
. Normal PTT + Prolonged PT/INR
In Warfarin OD/Vit. K Def:
. Both PT + PTT Prolonged
96
CI of Warfarin + Itraconazole
Warfarin is metab by CYP450
Itraconazole is a potent inhibitor of CYP450
Can lead to Warfarin OD
97
Broca's Aphasia
| Lesion Loc + Sympt
Damage to Inferior Frontal Gyrus (can't speak well, but understands)
If damage extends to Primary Motor Cortex, also has contralateral paralysis to upper face or upper limb.
98
Syringomyelia
Damage to Spinothalamic Tract (in central canal of spinal cord)
Assoc w/ Chiari Malformation
Causes Bilateral Loss of Pain + Temp at level of lesion
99
Aortic Valve Regurgitation
```
Dyastolic Murmur (heard on Lower Left Sternal Border)
Ao Insuficiency leads to:
Wide Pulse Pressure (like 160/50)
Elevated LV preload -> LVHF
head bobbing (water hammer pulse)
Possible cause -> Bacterial Endocarditis
```
100
Aortic Valve Stenosis
Systolic Ejection Murmur (heard on Upper Right Sternal Border)
Ao Stenosis leads to:
Lower Systole, normal Diastole
Harsh Thrill Sound radiating to Carotids
Possible Causes (Age Ao calcification, Bicuspid Ao)
101
Pleural Effusion
| Exudative vs. Transudative causes
. Exudative
Milky while fluid (lipid-rich chylomicrons - lymphoma)
Straw colored fluid (Lymphocyte rich - TB)
Yellow-green fluid (pus + lymphocytes - Pneumonia)
. Transudative
Clear yellow fluid (like serum)
Causes (CHF, Liver Failure, Nephrotic Sd, etc)
102
```
Light Criteria (3)
For Dx b/t Exudate + Transudate
```
Fluid Dx is Exudate if 1 or more is:
. Pleural Fluid Protein : Serum Ratio > 0.5 OR
. Pleural Fluid LDH : Serum Ratio > 0.6 OR
. Pleural Fluid LDH > 2/3 upper limit of N Serum LDH.
103
Enzyme Def + Sympt in TTP
| Thrombotic Thrombocytopenic Purpura
. ADAMTS 13 Metalloprotease Def
Leads to low degratation of vWF Multimers, elevated Platelet aggregation + thrombosis.
. Pentad of Sympt (FAT RN)
Fever, Anemia, Thrombocytopenia, Renal failure, Neurologic sympt.
104
2 Types of Embryonic Bone Formation
| + Examples
. Endochondral Ossification (w/ cartilage model)
Axial + Appendicular skeleton, Base of Skull
. Membranous Ossification (w/o cartilage model)
Seen in Calvarium, Facial bones, Clavicles
105
9 Causes of Renal Papillary Necrosis
| POSTCARDS
Pyelonephritis, Obstruction of Urogenital Tract, Sickle Cell Disease, TB, Chronic Liver Disease, Analgesic abuse, Renal Tx Rejection, DM, Systemic Vaculitis
106
DM I has Beta Cell Auto-Ab to which enzyme?
Glutamic Acid Decarboxylase
107
Common Complication of Chemo in AML?
| Acute Myelogenous Leukemia
Chemo + rapid lysis of these cells can trigger DIC.
| AML (type M3) have Auer Rods in azurophilic granules, and along with other factors, can contribute to the coagulopathy.
108
Lab for Cystitis/UTI Dx
. Leukocyte Esterase (>10 Leukocytes = inflammation)
. Nitrites (GN Bact = E. Coli, Klebsiella, P. Mirabilis)
If Leukocyte Esterase positive + Nitrite negative, think GP Bact.
109
Pheochromocytoma Lab Dx
. Elevated Urinary VMA (Vanillylmandelic Acid) OR
| . Elevated Urinary HVA (Homovanyllic Acid)
110
(SBO) Small Bowel Obstruction
. Distended Abdomen, N+V, Dyspnea, Chest pain, Jaundice, Peripheral Eosinophilia
. High-pitched (Tinkly) bowel sounds on Auscultation
111
Blowing Pansystolic Murmur
| Dx by Location
. Tricuspid Regurg (radiates to Right Side of Heart)
| . Mitral Regurg (radiates to Left Side of Heart)
112
Mid-Systolic Crescendo-Decrescendo Murmur
| Dx by Location
. Aortic Stenosis (Right Sternal border)
| . Pulmonic Stenosis (Left Sternal border)
113
S3 Heart Sound
| Dx by Location
. Right Ventricular Overload (seek Tricuspid Regurg)
| . Left Ventricular Overload (seek Mitral Regurg)
114
How does Breathing Accentuate Murmur Intensity?
. Right-side Murmurs (increase on inspiration - due to increase in venous return to heart)
. Left-side Murmurs (increase on expiration)
115
2 Types of Hyperlipidemia
. Def in Endothelial Cell Lipoprotein Lipase (cleans Tg from chylomicron, leads to hyperchylomicronemia)
. Def in Apolipoprotein CII (activates Lipoprotein Lipase, leads to elevated Tg + cholesterol, xanthomas, acute pancreatitis, hepatosplenomegaly)
116
Alipoprotein AI
| Location, Function, Deficiency
. Found in HDL, clears cholesterol from arterial walls.
| . Mutation affecting function leads to premature CAD (coronary artery disease) w/ very low HDL.
117
Alipoprotein B48
| Location, Function, Deficiency
. Found in Chylomicrons, protein that combines components to form chylomicrons.
. Def (abetalipoproteinemia) leads to Steatorrhea, Malnutrition, Vit. A, D, E, K Def, Ataxia, RBC Acantholysis
118
Alipoprotein B100
| Location, Function, Deficiency
. Found in VLDL, IDL, LDL, similar structural role as B48 with chylomicrons.
. Def (abetalipoproteinemia) leads to Steatorrhea, Malnutrition, Vit. A, D, E, K Def, Ataxia, RBC Acantholysis
119
Alipoprotein E
| Location, Function, Deficiency
. Found in all lipoproteins + chylomicrons, helps lipoprotains bind to cell surface receptos.
. Def (dysbetallipoproteinemia) leads to increased Tg + Total Cholesterol, decreased HDL, xanthomas + premature atherosclerosis.
120
Hereditary Spherocytosis
Def in Erythrocyte cytoskeletal proteins Spectrin OR Ankyrin
Leads to spherical + osmotically fragile RBC
Elevated Splenic RBC destruction leads to extravascular hemolytic anemia, jaundice, splenomegaly, and black pigment gallstones.
121
2 Cytotoxic effects of H. Pylori
. Produces Urease, breaking down Urea to Co2 + Ammonia (NH3), leading to Ammonium ion NH4 that damages epithelial cells, leading to ulcer.
. Produces Vacuolating Toxin A (VacA), potentiated by NH4, and is also damaging to gastric mucosa.
122
Idiopathic Thrombocytopenic Purpura (ITP)
. Decreased Platelets
| . Normal RBC
123
Hemolytic Uremic Sd (HUS) OR
| Thrombothic Thrombocytopenic Purpura (TTP)
. Decreased Platelets
| . Fragmented RBC
124
Microangiopathic Hemolytic Anemia
. Fragmented RBC
| . Platelet levels vary depending on Platelet consumption + Bone Marrow Response.
125
Glanzmann Thrombasthenia OR
| Von Willebrand Disease
. Normal Platelets w/ Decreased Function
| . Normal RBC
126
```
Primary Aldosteronism (Conn Sd)
Sympt + Causes
```
. Resistant HTN, HypoK+, Episodic Weakness/Paralysis, Paresthesias.
. Caused by Bilat Adrenal Hyperplasia, OR Aldosterone-secreting Adrenal Adenoma.
127
Androgen Insensitivity Sd (AIS)
. Androgen Rec Def leads to normal appearing female (46X,Y)
. Fem External Genitalia, scant Axillary + Pubic hair
. Rudimentary Vagina w/o Uterus + Fallopian Tubes
. Normal Testes
. Elevated Testosterone, Estrogen, LH
128
Turner Sd
. Girl w/ Short Stature, Delayed Puberty, Altered Facies, Webbed Neck
. Increased FSH, LH
. Decreased Estrogen + Inhibin
129
Lambert-Eaton Myasthenic Sd (LEMS)
Paraneoplastic Sd assoc w/ Small Cell Lung Carcinoma
(neuroendocrine tumor w/ blue cells + stains w/ cytokeratin, chromogranin)
Presynaptic disorder impairs Ach release (Voltage Ca+ Channel Auto-Ab) leads to musc weakness in arms + legs, increase strength w/ repetition, low reflexes.
130
CNS Lymphoma
High-Grade Non-Hodgkin B Cell Lymphoma
Blue Cell tumor, LCA Positive (Leukocyte Common Ag)
Assoc w/ HIV/AIDS
Brain lesion leads to seizures.
131
De Quervain Thyroiditis
. Post-Viral infection Subacute Thyroiditis
. 1st hyperthyroid, then hypothyroid
. granulomatous inflammation w/ giant cells
. later recovery to euthyroid state.
132
Hashimoto Thyroiditis
. Anti-Microsomal Ab
. painless goiter
. dense lymphocytic infiltrate w/ germinal centers.
. assoc w/ Thyroid Lymphoma.
133
Graves Disease
. TSH receptor Ab
. persistent hyperthyroidism + painless goiter
. proptosis + pre-tibial myxedema.
134
Sarcoidosis
```
. Bilat Hilar Lymphadenopathy
. 30-50s african americans
. nonspecific joint inflammation
. erythema nodosum (bumps on legs)
. elevated ACE + HyperCa+
```
135
Hypertrophic Osteoarthropathy
| HOA
. Digital clubbing (bowed fingernails)
. arthritis
. new bone formation in Subperiosteal space
. assoc w/ Lung Ca, Congenital Cyanotic Heart Dis, Liver Disease
136
Hartnup Disease
. Pellagra-like (Diarrhea, Dermatitis, Dementia)
. Due to AA Transporter Def (in GI + renal epit cells)
. Low AA absorption, High AA renal elim
137
```
Rheumatoid Arthritis (RA)
Labs
```
Like Sjogren Sd
. SS-A (Ro) Ab positive
. SS-B (La) Ab positive
138
Systemic Lupus Erythematosus (SLE)
| Labs
. Anti ds-DNA Ab positive
139
Polyangitis Labs
(both microscopic +
eosinophilic granulomatous [Churg-Strauss Sd])
. p-ANCA Ab positive
140
Paget Breast Disease
. Ulcerating lesion on/near nipple, Cytokeratin positive
. if palpable mass, Invasive Ductal Carcinoma
. if no mass, Ductal Carcinoma In Situ.
141
Acute Mastitis
. Nursing women get bact infection (S. Aureus) via nipple cracks in skin
. inflammation, tissue necrosis, abscess formation.
142
10 Layers to Lumbar Puncture
. Skin, Superficial Fascia, Deep Fascia
. Supraspinous Ligament, Interspinous Ligament
. Interlaminar Space, Epidural Space
. Dura, Arachnoid, Subarachnoid Space
