Kirila and Dobson random stuff Flashcards
What is MUDPILES?
- Methanol
- Uremia
- DKA
- Paraldeyde
- Iron and Isoniazid
- Lactic acidosis
- Ethanol/ethylene glycol
- Salicylates
HAGMA DDx
What is GOLDMARK
- Glycols
- Oxoproline (acetaminophen toxicity)
- L lactic acidosis
- D lactic acidosis
- colonic metabolism of carbs by bacteria, seen in short bowel syndrome
- Methanol
- Aspirin
- Renal failure
- Ketoacidosis
HAGMA Metabolic Acidosis
What acid base disorder is Hyperkalemia assoc. with?
acidosis
What electrolyte abnormality is alkalosis assoc. with?
hypokalemia
Metabolic alkalosis DDx?
- vomit or NG tube suctioning
- Diuretics
- Volume depletion
- Excess mineralocorticoid
DURHAAM?
- Diarrhea
- Ureteral diversion
- RTA
- Hyperalimentation
- Acetazolamide
- Addisons
- Miscellaneous
- toluene toxicity from glue sniffing, pancreatic fistula, meds
NAGMA
In metabolic alkalosis, when will a patient be saline responsive?
If they are hypovolemic (contrarction alkalosis or Cl deficiency alkalosis)
In what state would a patient with metabolic alkalosis not be saline responsive?
Euvolemia or hypervolemia
What causes increased serum osmolality gap?
- Methanol
- Ethanol
- Diethylene glycol
- Isopropyl alcohol
- Ethylene glycol
COPD is associated with what acid base disorder?
Respiratory acidosis
What can lisinopril do to electrolytes?
up potassium
Interstitital Cystitis?
- unknown etiology occurs in women
- pain pressure discomfort related to bladder assoc. with urinary tract sx for 6+ weeks in absence of infection
- Mucosal fissures and punctate hemorrhages present
- mast cells present
Malakoplakia?
- chornic inflammatory reaction in bladder due to macrophage dysfunction
- assoc. with E.coli chronic infection
- Michaelis Gutmann bodies
- laminated concretions from deposition of calcium in enlarged lysosomes of macrophages
Polypoid cystitis?
Inflammatory lesion fromo irritation of bladder mucosa due to instrumentation. Bladder mcuosa has broad bulbous polypoid projections due to edema. may be mistaken for papillary urothelial carcinoma.
Cystitis glandularis and cystitis cystica?
- arise in setting of inflammation and metaplasia
- extensive multifoal intestinal metaplasa is precursor to adenocarcinoma
Squamous metaplasia?
- response to chronic injury
- extensive multifocal keratinizing squamous metaplais precursor to dysplasticlesions and in situ scc
Nephrogenic adenoma?
- not true form of metaplasia
- urothelium is foally replaced by cuboidal epithelium that looks papillary
- produce signs and sx of cancer but not cancerous’
Bladder cancer prognosis and most common type of cell line?
- urothelial neoplasms most common type
- lamina propria worsens prognosis and detrusor invasion has major decrease in survival
Most common type of bladder carcinoma in kids?
Embryonal rhabdomyosarcoma, manifests as polypoid grape like mass
Common bladder sarcoma in adults
Leiomyosarcoma
Seminoma?
- most common GCT peak in 4th decade
- large round polyheadral cells distinct clear watery cytoplasm
- stains for KIT & OCT¾
- elevated hCG
- best prognosis
Embryonal carcinoma?
- 20-30 yr
- large anaplastic cells, hyperchormatic nuclei with prominent nucleoli
- vasuclar invasion
- aggressive chemo
- negative kit positive OCT¾
Yolk sac tumor?
- Schiller Duval bodies has to be yolk sac tumor- malignant cells surrounding vascular core
- Eosinophilic hyaline like globules with AFP
- the pre pubertal tumor is the most common testicular tumor in kids up to 3 and has good prognosis
Choricocarcionoma?
- highly malignant GCT
- syncytiotrophoblasts are the large multinucleated cells with eosinophilic vacuolated cytoplasm containing hCG
- Cytotrophoblasts are polygnal with distinct borders and clear cytoplasm
- Hemorrhage and necrosis common
- aggressive chemo
Teratoma?
- multiple germ cell componenets
- second most common in infants and kids to yolk sac
- adults is rare
Presentation of testicular cancers?
- painless enlargement of testis (osmosis had painless hematuria also)
- weight loss, maybe fever
- If lymphoma then constitutional symptoms
- any solid mass is considred neoplastic until proven otherwise
- DO NOT BIOPSY
Leydig cell tumor? (sex cord gonadal tumor)
- Reinke crystalloids
- large cells round or polygonal cell outlines, abundant granular eosinophilic cytoplasm
- lipid droplets vacuoles or lipofuscin in cytoplasm
- excision is tx
- yellow bc steroid secreting
Sertoli cell tumors?
- rare & hormonally silent
- most are benign but some are malignant
- assoc with carney complex, peutz jeghers, and FAP
- cells arranged in trabeculae that form cord like structures
- excision is tx
Primary testicular lymphoma,
rare and common over 60, most are difffuse large B cell
What zone of prostate does BPH affect the most?
Transition zone
What is the most common form of cancer in men?
Adenocarcinoma of prostate
Risks for prostatic adenocarcinoma?
- red meat
- androgen dependence
- genetics
- DNA methylation
Where does carcinoma of the prostate arise?
Peripiheral zone
RPF/Ormond disease?
- extensive fibrosis in retroperitoneum centered over anterior surfce of 4th and 5th lumbar
- entrapment & obstruction of ureters
- ureters deviate to midline on imagining with contrast
- late to middle age males
- AI response to ceroid that leaked through artery walls from atheromatous plaques
- spectrum of IgG4 disease
- methysergide and methyldopa and adrenergic blockers associated
25 yr old male from indonesia complains about a painful enlarged right testicle, he has a fever, and N/V.Here are the biopsies. What could be the causative agent?
mycobacteria causing orchitis
Testicular torsion sx?
- edematous tender indurated testicle
- testicle is horizontal and high riding
- cremasteric reflex is absent
- Phren sign is + (lift scrotum and pain relieves iin the epididymitis and increases in torsion)
- doppler shows decreaased perfusion
