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Medicine > Kaplan Qbank > Flashcards

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

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2
Q

Parasite assoc w/

Bladder

A

Schistosoma Haematobium

Predisposes Squamous Cell Carcinoma of Bladder

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3
Q

Brain Parasite assoc w/

HIV

A

Toxoplasma Gondii

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4
Q

2 Brain Parasites assoc w/

Fresh water

A

Naegleria Fowleri

Acanthamoeba

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5
Q

Brain Parasite assoc w/

Dogs

A

Echinococcus Granulosis

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6
Q

2 Lung Parasites

A

Dirofilaria

Paragonimus Westermani

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7
Q

3 Small Intestinal Parasites

A

Ascaris

Taenia

Strongyloides

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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.

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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.

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10
Q 
Krukenberg Tumor
(ovarian MTS tumor)
A

MTS gastric signet-ring carcinoma to ovary

Assoc w/ endometrial hyperplasia + uterine bleeding

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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)

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12
Q

ARPKD
(Autosomal Recessive
Polycystic Kidney Disease)

A

Infantile ADPKD: earlier onset + more severe sympt

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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.
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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.

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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

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16
Q

Acetaminophen Toxicity Labs

A

Acute Liver injury

. Elevated AST, ALT (hepatocytes)
. Normal ALP (bile duct + billiary tree)
. Normal Amylase (pancreatitis)

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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

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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.

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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..
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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.

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21
Q

Long Thoracic Nerve Lesion

A

Nerve that innervates Serratus Anterior musc.

Lesion leads to winged scapula.

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22
Q

Axillary Nerve Lesion

A

Nerve that innervates Teres Minor + Deltoid musc.

Lesion leads to arm abduction weakness.

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23
Q

Dorsal Scapular Nerve Lesion

A

Nerve that innervates Rhomboideus Major + Minor musc.

Lesion leads to minor winging of scapula.

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24
Q

Suprascapular Nerve Lesion

A

Nerve that innervates Supraspinatus + Infraspinatus musc.

Lesion leads to difficulty elevating arm.

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25
Q

(ARDS) Acute Respi Distress Sd

Def + Dx

A

Non-cardiogenic pulmonary edema
Triggered by trauma, mult transfusions, pancreatitis
Onset several hrs after trigger
Dx via ABG (decreased PaO2/FiO2 ratio <200 mmHg)

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26
Q

Enzyme Def in:

Albinism (Classic AD form)

A

Tyrosinase Def

Aromatic AA Tyrosine cannot be converted to melanin in melanocytes, increasing risk of sunburn + skin cancer.

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27
Q

Enzyme Def in:

Maple Syrup Urine Disease

A

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.

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28
Q

Enzyme Def in:

Tay-Sachs Disease (AR)

A

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.

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29
Q 
Enzyme Def in:
Hunter Disease (X-Linked)
A

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.

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30
Q

Enzyme Def in:

Homocystinuria (AR)

A

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.

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31
Q

Translocation in:

t(14;18)(q32;q21)

A

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!

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32
Q

Translocation in:

t(11;14)(q13;q32)

A

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

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33
Q

Translocation in:

t(12;21)

A

Acute Lymphoblastic Leukemia (ALL) -t(12;21)

Favorable Px in kids

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34
Q

Translocation in:

t(9;22)

A

Chronic Myelogenous Leukemia (CML) -t(9;22)
Poor Px + adult presentation in:
Acute Lymphoblastic Leukemia (ALL)

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35
Q

Translocation in:

t(15;17)

A 
Acute Myelogenous Leukemia (AML) -t(15;17)
Promyelocytic type (APL)
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36
Q

Translocation in:

t(8;14) Or t(2;8) Or t(8;22)

A

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

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37
Q

Esophagus path:

Mallory-Weiss Tears

A

Lesions in Esophagus Mucosa
Caused by frequent vomiting (acute/chronic OH, bulimia)
Mild Upper GI bleeding

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38
Q

Esophagus path:

Boerhaave Sd

A

Esophagus tears through all layers!
Causes fluid/air in mediastinum (Pneumomediastinum)
Assoc w/ forceful vomiting, chest pain, pain on swallowing

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39
Q

Esophagus path:

Esophageal carcinoma

A

Either Adenocarcinoma or Squamous Cell Carcinoma

Onset as progressive dysphagia, not acute bleeding

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40
Q

Esophagus path:

Achalasia

A

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

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41
Q

Esophagus path:

Schatzki Rings

A

Benign mucosal rings at Esophagus squamocolumnar junction (below Aortic arch)
Caused by chronic GERD

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42
Q

Esophagus path:

Zenker Diverticulum

A

Evagination of Esophagus at Pharynx junction

Causes dysphagia + halitosis, not bleeding

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43
Q

Esophagus path:

Esophageal Varices

A

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

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44
Q

Plummer-Vinson Sd

A

. Hypochromic + Microcytic Anemia
. Esophageal webs
. Atrophic glossitis

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45
Q

2 Phases of Salicylate Poisoning

A 
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
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46
Q

Acetaminophen Poisoning

Symptoms + Rx

A

N+V, Abdominal pain, Hepatic Failure

Rx: N-Acetylcysteine within 8hrs prevents hepatic failure

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47
Q

Hydrochlorothiazide Poisoning

Symptoms

A 
Metabolic Alkalosis (via H+ excretion) [HyperGLUC]
HyperGlycemia
HyperlLipidemia
HyperUricemia
HyperCa+
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48
Q

Chronic Lead Poisoning

Symptoms

A

. Sideroblastic anemia (Basophilic stippling of RBCs)
. Neuropathy
. Kidney Dysfunction
. Abdominal pain

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49
Q

Chronic Mercury Poisoning

Symptoms

A

. CNS atrophy
. Gingivitis
. Gastritis
. Renal Tubular changes

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50
Q

Acute Mercury Poisoning

Symptoms

A

. GI Epithelium Necrosis

. Renal Tubular Necrosis

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51
Q

Sheehan Sd

A

Postpartum hemorrhage leads to hypopituitarism

Rx: Glucocorticoids + Thyroxine asap

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52
Q

How to Calculate
Serum Anion Gap?
Use? Normal Range?

A

Anion Gap = (Na+) - (HCO3 + Cl+)

. Used to determine b/t causes of Metabolic Acidosis
. Normal Range (8-16 mEq/L)

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53
Q

2 Causes of Metabolic Acidosis

w/ Elevated Anion Gap

A

. DM + Ketoacidosis

. Shock/HF + Lactic Acidosis

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54
Q

2 Causes of Metabolic Acidosis

w/ Normal Anion Gap

A

. Diarrhea + Loss of HCO3 (also K+)

. Renal Tubular Acidosis + Retention of H+

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55
Q

Primary Hypothyroidism

Lab Values

A

Thyroid Gland Problem:
. Elevated TRH, TSH
. Low T3, T4

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56
Q

Secondary Hypothyroidism

Lab Values

A

Anterior Pituitary Problem:
. Elevated TRH
. Low TSH, T3, T4

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57
Q

Hashimoto’s Thyroiditis

Lab Values

A

Autoimmune Damage to Thyroid Gland:
. Elevated TRH, TSH
. Low T3, T4
. Elevated Anti-Thyroglobulin Ab, Anti-Thyroid Peroxidase Ab

58
Q

T4 Rec Insensitivity

Lab Values

A

Loss of Negative Feedback by T4 Rec Problem:
. Elevated TRH, TSH, T3, T4
. Signs + Symptoms of Hypothyroidism

59
Q

Pregnancy + Trauma / Placental Abruption

leads to

A

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
Q

Pseudomixoma Peritonei

A

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
Q

Polycystic Ovarian Sd (PCOS)

A 
Young woman with Hirsutism, Amenorrhea, Obesity.
. Elevated LH, Testosterone
. Low FSH
. Cystic Follicles in the Ovary
Rx for HTN + Hirsutism (Spironolactone)
62
Q

Keloid Scar Formation

is due to

A

Aberrant form of wound healing with excessive Collagen I + III Synthesis following trauma.

63
Q

Diabetes Insipidus (DI)

A

. 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
Q

Men > 50 w/ Non-Traumatic
New Onset of Low Back Pain
Most Commonly due to

A

Bone Metastatis from Prostate Cancer
. Multiple Bone Lesions (sclerotic osteoblasts)
Dx w/ PSA Test (Prostate Specific Antigen)

65
Q

Black Pigment Gallstones

A

Stone composed of Ca+ Bilirubinate
. High in Unconjugated Bilirubin
. Low in Cholesterol
Assoc w/ Hemolytic Anemia

66
Q

Brown Pigment Gallstones

A

Mixed stone composed of Unconjugated Bilirubin + Cholesterol.
Assoc w/ Biliary Tree Infection (Common Bile Duct)
(Chinese Liver Fluke - Chlonorchis Sinensis)

67
Q

Cholesterol Gallstones

A 
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
Q 
Suppressor Gene (+ Xs) for
Hereditary Breast + Ovary Cancer
A

BRCA-1

. Xs 17q12-21

69
Q 
Suppressor Gene (+ Xs) for
Hereditary Breast Cancer
A

BRCA-2

. Xs 13q12-13

70
Q

Suppressor Gene (+ Xs) for
Von Hippel-Lindau Disease
+ Renal Cell Carcinoma

A

VHL

. Xs 3p25

71
Q

2 Suppressor Genes (+ Xs) for

Wilms Tumor

A

WT-1
. Xs 11p13

WT-2
. Xs 11p15

72
Q

Suppressor Gene (+ Xs) for
Retinoblastoma
+ Osteosarcoma

A

Rb

. Xs 13q14

73
Q 
Suppressor Gene (+ Xs) for
Lung, Breast, Colon Cancer
A

p53

. Xs 17p13.1

74
Q

Suppressor Gene (+ Xs) for
Adenomatous Polyps
+ Colon Cancer

A

APC

.Xs 5q21

75
Q 
Suppressor Gene (+ Xs) for
Colon Cancer
A

DCC

. Xs 18q21

76
Q 
Suppressor Gene (+ Xs) for
Neurofibromas
A

NF-1

.Xs 17q11.2

77
Q

Suppressor Gene (+ Xs) for
Acoustic Neuromas
+ Meningiomas

A

NF-2

.Xs 22q12

78
Q

Serum Marker for

Pancreatic Cancer

A

Elevated CA-19-9

79
Q 
Serum Marker for
Ovarian Cancer (epithelial origin)
A

Elevated CA-125

80
Q

Serum Marker for

Lung, Stomach, Pancreas, Colon Cancer

A

Carcinoembryonic Ag

81
Q

Serum Marker for
Squamous Cell Lung Carcinoma
+ Renal Cell Carcinoma

A

Parathyroid-Related Peptide (PTH-rP)

Assoc w/ Paraneoplastic Sd

82
Q 
Serum Marker for
Testicular Cancer (Germ-Cell Tumors)
A

Alpha-Fetoprotein (AFP)

Or Beta-Human Chorionic Gonadotrophin (BHCG)

83
Q

Erythema Multiforme
Signs + Symptoms
Common Triggers

A

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
Q

Pilocytic Astrocytoma

#1 Kids Brain Tumor

A

Location in Posterior Fossa, Cerebellar Hemispheres
Cyst w/ a Mural Nodule
Elongated Astrocytes w/ IC corkscrew inclusions called Rosenthal Fibers)
Stains w/ GFAP

85
Q

Ependymoma

Kids Brain Tumor

A

Location lining Ventricular Walls (4th Ventricle)
Ependymal Cells organize around:
. Small Vessels (Perivascular Pseudorosettes)
. Small Lumina (True Ependymal Rosettes)

86
Q

Medulloblastoma

Kids Brain Tumor

A

Location in Midline Posterior Fossa
Invades Cerebellar Vermis
Solid, Non-Cystic
Small undifferentiated cells arranged in Homer-Wright Rosettes

87
Q

Lung Squamous Cell Carcinoma

A

Strong Assoc w/ Smoking
Central Location on CXR
May form Cavitary Lesion w/ Central Necrosis
May have Signs + Symptoms of Pancoast Tumors

88
Q

Pancoast Tumors

Signs + Symptoms

A

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
Q

Bronchioalveolar Carcinoma

A

Not Assoc w/ Smoking
Arises from Type II Pneumocytes
Peripheral Pneumonia-like consolidation on CXR

90
Q

Bronchogenic Adenocarcinoma

A

Assoc w/ Non-Smoking Females

Ill-Defined Solid Peripheral Lesion on CXR

91
Q

Metastatic Brain Cancer

Location

A

Round Tumor(s) at Junction of Cortical Gray + White Matter (most distant of arterial blood supply)

92
Q

Glioblastoma Multiforme

Grade IV Astrocytoma

A

Arising in White Matter in older adults
Irregular Tumor w/ Ring-Enhancing Lesion.
Can cause “Butterfly” Lesion (Crossing b/t Hemispheres)

93
Q

3 Causes of Loss of

Peripheral Vision

A

. Pituitary Tumors (impinges on Optic Chiasm)
. Craniopharyngioma (impinges on Optic Chiasm)
. Glaucoma

94
Q

2 Causes of Photophobia

A

. Meningitis

. Subarachnoid Hemorrhage (chemical meningitis)

95
Q

Warfarin

Vit. K Antagonist

A

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
Q

CI of Warfarin + Itraconazole

A

Warfarin is metab by CYP450
Itraconazole is a potent inhibitor of CYP450
Can lead to Warfarin OD

97
Q

Broca’s Aphasia

Lesion Loc + Sympt

A

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
Q

Syringomyelia

A

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
Q

Aortic Valve Regurgitation

A 
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
Q

Aortic Valve Stenosis

A

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
Q

Pleural Effusion

Exudative vs. Transudative causes

A

. 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
Q 
Light Criteria (3)
For Dx b/t Exudate + Transudate
A

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
Q

Enzyme Def + Sympt in TTP

Thrombotic Thrombocytopenic Purpura

A

. 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
Q

2 Types of Embryonic Bone Formation

+ Examples

A

. Endochondral Ossification (w/ cartilage model)
Axial + Appendicular skeleton, Base of Skull
. Membranous Ossification (w/o cartilage model)
Seen in Calvarium, Facial bones, Clavicles

105
Q

9 Causes of Renal Papillary Necrosis

POSTCARDS

A

Pyelonephritis, Obstruction of Urogenital Tract, Sickle Cell Disease, TB, Chronic Liver Disease, Analgesic abuse, Renal Tx Rejection, DM, Systemic Vaculitis

106
Q

DM I has Beta Cell Auto-Ab to which enzyme?

A

Glutamic Acid Decarboxylase

107
Q

Common Complication of Chemo in AML?

Acute Myelogenous Leukemia

A

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
Q

Lab for Cystitis/UTI Dx

A

. Leukocyte Esterase (>10 Leukocytes = inflammation)
. Nitrites (GN Bact = E. Coli, Klebsiella, P. Mirabilis)
If Leukocyte Esterase positive + Nitrite negative, think GP Bact.

109
Q

Pheochromocytoma Lab Dx

A

. Elevated Urinary VMA (Vanillylmandelic Acid) OR

. Elevated Urinary HVA (Homovanyllic Acid)

110
Q

(SBO) Small Bowel Obstruction

A

. Distended Abdomen, N+V, Dyspnea, Chest pain, Jaundice, Peripheral Eosinophilia
. High-pitched (Tinkly) bowel sounds on Auscultation

111
Q

Blowing Pansystolic Murmur

Dx by Location

A

. Tricuspid Regurg (radiates to Right Side of Heart)

. Mitral Regurg (radiates to Left Side of Heart)

112
Q

Mid-Systolic Crescendo-Decrescendo Murmur

Dx by Location

A

. Aortic Stenosis (Right Sternal border)

. Pulmonic Stenosis (Left Sternal border)

113
Q

S3 Heart Sound

Dx by Location

A

. Right Ventricular Overload (seek Tricuspid Regurg)

. Left Ventricular Overload (seek Mitral Regurg)

114
Q

How does Breathing Accentuate Murmur Intensity?

A

. Right-side Murmurs (increase on inspiration - due to increase in venous return to heart)
. Left-side Murmurs (increase on expiration)

115
Q

2 Types of Hyperlipidemia

A

. 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
Q

Alipoprotein AI

Location, Function, Deficiency

A

. Found in HDL, clears cholesterol from arterial walls.

. Mutation affecting function leads to premature CAD (coronary artery disease) w/ very low HDL.

117
Q

Alipoprotein B48

Location, Function, Deficiency

A

. 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
Q

Alipoprotein B100

Location, Function, Deficiency

A

. 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
Q

Alipoprotein E

Location, Function, Deficiency

A

. 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
Q

Hereditary Spherocytosis

A

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
Q

2 Cytotoxic effects of H. Pylori

A

. 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
Q

Idiopathic Thrombocytopenic Purpura (ITP)

A

. Decreased Platelets

. Normal RBC

123
Q

Hemolytic Uremic Sd (HUS) OR

Thrombothic Thrombocytopenic Purpura (TTP)

A

. Decreased Platelets

. Fragmented RBC

124
Q

Microangiopathic Hemolytic Anemia

A

. Fragmented RBC

. Platelet levels vary depending on Platelet consumption + Bone Marrow Response.

125
Q

Glanzmann Thrombasthenia OR

Von Willebrand Disease

A

. Normal Platelets w/ Decreased Function

. Normal RBC

126
Q 
Primary Aldosteronism (Conn Sd)
Sympt + Causes
A

. Resistant HTN, HypoK+, Episodic Weakness/Paralysis, Paresthesias.
. Caused by Bilat Adrenal Hyperplasia, OR Aldosterone-secreting Adrenal Adenoma.

127
Q

Androgen Insensitivity Sd (AIS)

A

. 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
Q

Turner Sd

A

. Girl w/ Short Stature, Delayed Puberty, Altered Facies, Webbed Neck
. Increased FSH, LH
. Decreased Estrogen + Inhibin

129
Q

Lambert-Eaton Myasthenic Sd (LEMS)

A

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
Q

CNS Lymphoma

A

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
Q

De Quervain Thyroiditis

A

. Post-Viral infection Subacute Thyroiditis
. 1st hyperthyroid, then hypothyroid
. granulomatous inflammation w/ giant cells
. later recovery to euthyroid state.

132
Q

Hashimoto Thyroiditis

A

. Anti-Microsomal Ab
. painless goiter
. dense lymphocytic infiltrate w/ germinal centers.
. assoc w/ Thyroid Lymphoma.

133
Q

Graves Disease

A

. TSH receptor Ab
. persistent hyperthyroidism + painless goiter
. proptosis + pre-tibial myxedema.

134
Q

Sarcoidosis

A 
. Bilat Hilar Lymphadenopathy
. 30-50s african americans
. nonspecific joint inflammation
. erythema nodosum (bumps on legs)
. elevated ACE + HyperCa+
135
Q

Hypertrophic Osteoarthropathy

HOA

A

. Digital clubbing (bowed fingernails)
. arthritis
. new bone formation in Subperiosteal space
. assoc w/ Lung Ca, Congenital Cyanotic Heart Dis, Liver Disease

136
Q

Hartnup Disease

A

. Pellagra-like (Diarrhea, Dermatitis, Dementia)
. Due to AA Transporter Def (in GI + renal epit cells)
. Low AA absorption, High AA renal elim

137
Q 
Rheumatoid Arthritis (RA)
Labs
A

Like Sjogren Sd
. SS-A (Ro) Ab positive
. SS-B (La) Ab positive

138
Q

Systemic Lupus Erythematosus (SLE)

Labs

A

. Anti ds-DNA Ab positive

139
Q

Polyangitis Labs
(both microscopic +
eosinophilic granulomatous [Churg-Strauss Sd])

A

. p-ANCA Ab positive

140
Q

Paget Breast Disease

A

. Ulcerating lesion on/near nipple, Cytokeratin positive
. if palpable mass, Invasive Ductal Carcinoma
. if no mass, Ductal Carcinoma In Situ.

141
Q

Acute Mastitis

A

. Nursing women get bact infection (S. Aureus) via nipple cracks in skin
. inflammation, tissue necrosis, abscess formation.

142
Q

10 Layers to Lumbar Puncture

A

. Skin, Superficial Fascia, Deep Fascia
. Supraspinous Ligament, Interspinous Ligament
. Interlaminar Space, Epidural Space
. Dura, Arachnoid, Subarachnoid Space

Medicine (7 decks)

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