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1
Q

Stats for Case-Control Studies

A

Odds Ratio

ad/bc

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2
Q

Stats for Cohort Study

A

Relative Risk
(a/a+b) / (c/c+d)
with risk factor and disease / all with risk factor
without risk factor and disease / all without risk factor

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3
Q

Sensitivity

A

SNOUT
TP/ (TP + FN)
when neg, rules out disease

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4
Q

Specificity

A

SPIN
TN / (TN + FP)
when positive, rules in disease

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5
Q

PPV

A

varies directly with prevalence

low prevalence, low PPV

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6
Q

NPV

A

varies indirectly with prevalence

low prevalence, high NPV

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7
Q

Type 1 collagen

A

bone, tendon, skin, scars

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8
Q

Type 2 collagen

A

cartilage

car-two-lage

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9
Q

Type 3 collagen

A

Reticulin, blood vessels

vascular Ehlers Danlos

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10
Q

Type 4 collagen

A

basement membranes

Alport syndrome, Goodpastures

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11
Q

big testes, long face, jarge jaw, large ears, mitral valve prolapse

A

Fragile X

X linked FMR1 gene defect (CGG) repeats

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12
Q

Vitamin essential for maintenance of specialized spithelium, stored exclusively in the liver stellate cells

A

Vit A

Used to treat measles and AML-M3 (PML, auer rods)

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13
Q

Reactions using thiamine as a cofactor

A

Pyruvate dehydrogenase (PDH)
alphaketoglutarate dehydrogenase
transketolase (HMP shunt)
Branched Chain ketoacid dehydrogenase

TLCFN

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14
Q

Niacin deficiency

A

Pellagra
Diarrhea, dementia, dermatitis

Niacin is derived from tryptophan - Hartnup disease

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15
Q

Ethanol Metabolism

A

Uses up free NAD+
Increase NADH
Lactic Acidosis (pyruvate to lactate to regen NAD+)
Fasting hypoglycemia (prevents gluconeogenesis)
Fatty Change in liver

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16
Q

Strictly ketogenic AAs

A

Leucine and Lysine

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17
Q

Ketogenic and Glucogenic AAs

A

Trp, Phe, Tyr, Ile, Thr

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18
Q

Glucose 6 Phosphotase deficieny

A

Von Gierke

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19
Q

lysosomal alpha1,4glucosidase deficiency

A

Pompe

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20
Q

debranching enzyme deficiency

A

Cori disease

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21
Q

skeletal muscle glycogen phosphorylase deficiency

A

McArdle

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22
Q

alpha-galactosidase A deficiency

A

Fabry’s

Ceramide trihexoside

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23
Q

Glucocerebrosidase (beta-glucosidase) deficiency

A

Gaucher’s

glucocerebroside

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24
Q

Sphingomyelinase deficiency

A

Neimann-Pick

sphingomyelin

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25
Hexosaminidase A deficiency
Tay-Sachs | GM2 ganglioside
26
Galactocerebrosidase deficiency
Krabbe
27
Arylsulfatase A deficiency
Metachromatic Leukodystrophy
28
alpha-L-iduronidase deficiency
Hurler Heperan sulfate, dermatan sulfate cataracts
29
iduronate sulfatase deficiency
Hunter heparan sulfate, dermatan sulfate NO cataracts
30
Encapsulated Organisms
Some Killers Have Pretty Nice Slimey Capsules ``` Strep pneumo and group B Klebs H flu Pseudomonas Neiserria m Salmonella Cryptococcus ```
31
Catalase Positive Organisms
Staph N Enterobacteriaceae Are Listed Catalase Postive ``` Staph Nocardia Entero Aspergillus Listeria Candida Pseudomonas ```
32
Urease positive organisms
K-PUNCHSS ``` Klebs Proteus Ureaplasma Nocardia Crytococcus H pylori Staph epi Staph sapro ```
33
Obligate aerboes
Nagging Pests Must Breathe Nocardia Pseudomonas MycoBacterium
34
Obligate anaerobes
Can't Breathe Air Clostridium Bacteroides Actinomyces
35
Obligate Intracellular Bugs
rickettsia, chlamydia | can't make any ATP
36
Facultative Intracellular Bugs
Some Nasty Bugs May Live FacultativeLY ``` Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersina pestis ```
37
ToRCHeS
``` Toxo Rubella CMV HIV HSV Syphilis ```
38
Antibiotics to Avoid in Pregnancy
``` Sulfa - kernicterus Aminoglycosides - ototox FQs - tendons Clarithromycin - toxic Tetracyclines - bones, teeth Ribavirin - teratogen Griseofulvin - teratogen Chloramphenicol - gray baby ```
39
HLA A3
Hemochromatosis
40
HLA B27
``` seronegative arthropathies Psoriatic arthritis ankylosing spondylitis IBD reactive arthritis (Reiter) ```
41
HLA DQ2/DQ8
celiac disease
42
HLA DR2
MS, SLE, Goodpasture
43
HLA DR3
t1dm, SLE, Graves
44
HLA DR4
t1dm, RA
45
HLA DR5
pernicious anemia, hashimoto's
46
Cytokines secreted by Macrophages
IL1,6,8,12, TNF-alpha
47
Cytokines secreted by T cells
IL2,3
48
cytokines secreted by Th1 cells
ifn-gamma
49
cytokines secreted by Th2 cells
IL4,5,10
50
IL-1
endogenous pyrogen
51
IL-2
stimulates t cells to divide
52
IL-3
bone marrow cell growth
53
IL-4
IgE class switching, Th2 growth and B cell growth
54
IL-5
IgA class switching, eosinophil growth
55
IL-6
endogenous pyrogen, acute phase proteins
56
IL-7
lymphoid differentiation
57
IL-8
major neutrophil chemotatic factor
58
IL-10
anti-inflamatory, inhibits Th1
59
IL-12
induces Th1 differentiation, activates NK cells
60
TNF-alpha
mediates septic shock, activates endothelium
61
IFN-gamma
antiviral, antitumor increases killing of virally infected cells, increases MHC expression in all cells responsible for forming granulomas
62
CD3
all T cells
63
CD 4
helper T cells
64
CD28
all t cells | binds B7 on the APC
65
CD40
``` b cells, needed for antibody class switching CD40L on Thelpers ```
66
CD8
killer t cells
67
CD19,20,21
B cell markers | 21- receptor for EBV
68
B7
binds CD28 on t cells | on antigen presenting cells
69
CD14
macrophage specific | binds LPS
70
CD56
unique NK cell marker
71
Anergy
t cell gets MHCII stimulation, but no co-stimulatory signal | refractory to further signaling
72
auto-antibody: ACh receptor
myasthenia gravis
73
auto-antibody: basement membrane
goodpasture
74
auto-antibody: cardiolipin, lupus anticoagulant
SLE, antiphospholipid syndrome
75
auto-antibody: centromere
limited scleroderma, CREST syndrome
76
auto-antibody: desmoglein
pemphigus vulgaris (thin walled blisters)
77
auto-antibody: dsDNA, Smith
specific for SLE
78
auto-antibody: glutamate decarboxylase
t1dm
79
auto-antibody: hemidesmosome
bullous pemphigoid (tense blisters)
80
auto-antibody: Jo-1, SRP, Mi-2
polymyositis, dermatomyositis
81
auto-antibody: microsomal, thyroglobulin
hashimoto's
82
auto-antibody: mitochondrial
primary biliary cirrhosis
83
auto-antibody: ANA
SLE, nonspecific
84
auto-antibody:SCl70 (DNA topo 1)
diffuse scleroderma
85
auto-antibody: smooth muscle
autoimmune hepatits
86
auto-antibody: SSA (Ro), SSB (La)
Sjogren
87
auto-antibody: TSH receptor
Graves
88
auto-antibody: U1 RNP (ribonucleoprotein)
Mixed connective tissue disease
89
auto-antibody: cANCA (PR3 ANCA)
granulomatosis with polyangitis (Wegner)
90
auto-antibody: IgA endomysial, IgA TTG
celiac | tissue trans glutaminase
91
auto-antibody: pANCA (MPO ANCA)
microscopic polyangitis, Churg-Strauss
92
auto-antibody: Rheumatoid factor, CCP
IgM anti IgG | RA
93
retroperitoneal structures
SAD PUCKER Suprarenal (adrenals) Aorta and IVC Duodenum ``` Pancreas (except tail) Ureters Colon (up and down) Kidneys Esophagus (lower) Rectum ```
94
falciform ligament
fetal umbilical vein
95
hepatodoudenal ligament
holds the portal triad
96
layers of the gut wall
MSMS Mucosa Submucosa (Meissner plexus) Muscularis (Myenteric / Auerbach plexus) Serosa
97
Peyers patches
only in the illeum
98
SMA syndrome
transverse duodenum is entrapped between SMA and aorta, causing obstruction
99
Name six main collateral artery sets in the belly
``` Superior and inferior epigastric left and right gastric left and right gastroepiploic superior and inferior pancreaticoduodenal middle and left colic superior and middle/inferior rectal ```
100
Name three portosystemic anastomoses
left gastric - esophageal (to azygous) - varices paraumbilical - small epigastric - caput medusa superior rectal - mid/inf rectal - anorectal varices Gut, Butt, Caput
101
cholecystokinin
I cells (duodenum) increase panc/gall secretions (muscarinic), slow gastric emptying increased by fat, amino acids
102
gastrin
G cells (stomach antrum) increase H and motility increased by food, vagal stimulation ZE syndrome
103
Motilin
small bowel produces migrating motor complexes increased while fasting
104
Secretin
``` S cells (duodenum) increases panc bicarb secretion and bile secretion increased by fatty acids in the duodenum ```
105
Somatostatin
``` D cells (islets) D = down, slows everything down ```
106
stimulators of H release by parietal cells
Ach, vagus stim Gastrin, histamine, from enterochromaffin-like cells (most important)
107
uptake of glucose and galactose by gut lumen
SGLT1 (Na dependent) -> GLUT2 on bl
108
uptake of fructose by gut
GLUT5 (facilitated diffusion) -> GLUT2 on bl
109
iron absorption by the gut
duodenum, as Fe2 (2 goes in 2 the body)
110
folate absorption by the gut
jejunum and ileum
111
B12 absorption by the gut
terminal ileum, requires intrinsic factor
112
heme to biliverdin
heme oxygenase | makes bad bruises green
113
congenital defect of the bowel, may contain ectopic gastric mucosa or pancreatic tissue
``` Meckel diverticulum vitelline duct (omphalomesenteric duct) ```
114
Branced Amino Acids
Isoleucine, Leucine and Valine Maple Syrup Urine Disease
115
normal S2 splitting
increases with inspiration | drops pressure, increases venous return, more blood through the right side, longer for the pulmonary valve to close
116
wide s2 splitting
conditions that delay RV emptying | pulm stenosis, RBBB
117
fixed s2 splitting
ASD | l->r shunt causes increased flow through pulmonic regardless of breathing
118
paradoxical s2 splitting
split with expiration, no split with inspiration condtions that delay LV emptying aortic stenosis, LBBB
119
cardiac auscultation: inspiration
increases venous return | increases intensity of right heart sounds
120
cardiac auscultation: hand grip
increases systemic vascular resistance increase MR, AR, VSD decreases AS
121
cardiac auscultation: valsava, standing
decreases venous return decreases most mumurs increases hypertrophic cardiomyopathy murmur
122
cardiac auscultation: rapid squatting
increases venous return, preload increases AS decreases HCM
123
cardiac auscultation: holosystolic blowing
MR or TR
124
cardiac auscultation: holosystolic harsh, loudest at tricuspid area, increased with hand grip
VSD
125
cardiac auscultation: late systolic crescendo with a midsystolic click, over the apex
MVP
126
cardiac auscultation: early diastolic snap and rumbling diastolic mumur
mitral stenosis
127
explain pulsus paradoxus
decrease in systolic BP of >10 with inspiration increased venous return with little pericardial compliance will shove the ventricular septum over and compress the LV, resulting in decreased SV and BP tamponade, pericarditis, obstructive pulmonary diseases (asthma), croup
128
Inulin CL
GFR | CR slightly overestimates
129
PAH CL
RPF
130
proteinuria leading to pellagra like symptoms
Hartnup disease decreased absorption of neutral AAs, including tryptophan B3 can be made from Trp, so get a decreased B3 lvl
131
Renal tubular defect: PCT
Fanconi increased excretion of basically everything AAs, glucose, phos, bicarb -> met acidosis Wilson's and toxins causes type 2 RTA
132
Renal tubular defect: thick ascending loop[
Bartter - AR Na/K/2CL defect hypoK, met alk and hypercalicuria
133
Renal tubular defect: DCT
Gitelman - AR, not as severe as Bartter NaCl resorbtive defect hypoK, met alk, no hypercalciuria
134
Renal tubular defect: collecting duct
Liddle - AD increased Na absorption (Enac) hypoK, met alk, hypertension
135
Causes of extracellular K shift (hyper K)
``` digitalis hyperosmolarity Insulin deficiency cell lysis acidosis (H/K exchange) Beta block ```
136
Causes of intracellular K shift (hypoK)
hypo-osmolarity insulin alkalosis Beta agonist
137
U waves on ECG
hypo K
138
Wide QRS and peaked T waves on ECG
hyper K
139
causes of anion gap met acidosis
``` MUDPILES Methanol Uremia DKA Propylene glycol Iron or INH Lactic acidosis Ethylene Glycol Salicylates ```
140
causes of non-gap met acidosis
``` HARD ASS hyperalimentation addison's RTA Diarrhea (increased Cl-) Acetazolamide Spironolactone Saline infusion ```
141
type 1 renal tubular acidosis
defect in alpha-intercalated cells (distal, ph > 5.5) decreased secretion of H+ hypokalemia (decreased resorption) caused by obstruction (mult myeloma), ampho B, analgelsic nephropathy
142
type 2 renal tubular acidosis
defect in PCT bicarb resorption (proximal, ph < 5.5) increased bicarb secretion; acidified by intercalated cells hypokalemia caused by Fanconi syndrome, toxins (lead, aminoglycosides), CA inhibitors
143
type 3 renal tubular acidosis
hyper K, ph < 5.5 hypoaldo situations, K sparing diuretics hyperK impairs ammonia generation in the PCT, decreased H excretion into the urine
144
urine cast: fatty (oval)
nephrotic syndrome
145
urine cast: granular, muddy brown
acute tubular necrosis
146
urine cast: waxy
chronic renal failure
147
AD kidney cysts in the medullary collecting ducts and shrunken kidneys
medullary cystic kidney disease
148
labs: pre-renal azotemia
serum BUN/Cr > 15-20 (due to fluid resorption) UNa < 20 FENa < 1% UOsm > 500 kidneys still work fine, can still concentrate the urine
149
nephrotic syndrome: kids
Minimal change disease nml LM, neg IF, foot process effacement EM damage mediated by cytokines (asso Hodgkin's) usually responds to steroids
150
nephrotic syndrome: hispanics, blacks, HIV patients
FSGS also asso with sickle cell and heroin foot process effacement like MCD, with findings on LM and neg IF
151
nephrotic syndrome: SLE and Caucasian adults
membranous nephropathy diffuse membrane thickening LM, subepithelial (podocyte side) granular deposits, SPIKE AND DOME on EM antibody to phospholipase A2
152
nephrotic syndrome: HBV, HCV and tram tracks
``` type 1 membranoproliferative subendothelial deposits (granular) split the GB membrane, causing the tram track appearance ```
153
nephrotic syndrome: C3 nephritic factor
type 2 MP intramembranous deposits low serum C3 C3 nephritic factor stabilizes C3 convertase
154
nephritic syndrome
hematuria, inflammed, hypercellular glomerulus
155
nephritic syndrome: after throat/skin infection
PSGN about 2 weeks after infection subepithelial deposits (granular)
156
nephritic syndrome: crescents
RPGN crescents are comprised of macs and fibrin get IF!! linear - goodpasture's granular - PSGN or DPGN neg - Wegners (cANCA), microscopic polyangitis or Churg-Strauss (p-ANCA)
157
nephritic syndrome: SLE
diffuse proliferative GN subendothelial C3 deposits wire-looping capillaries most common cause of death in SLE
158
nephritic syndrome: IgA deposits
Berger's (IgA) nephropathy mesangial IgA deposits, mesangial proliferation flares with URI/GI infection - 2-3 days after infection
159
renal tumor in tuberous sclerosis
angiomyolipoma
160
renal cell carcinoma paraneoplastic syndromes
EPO, renin, PTHrp, ACTH
161
wilms tumor defining cell type
blastema | mutations on chr11
162
WAGR syndrome
Wilms Aniridia Gential abnormality Retardation
163
Denys-Drash Syndrome
Wilms, progressive glomerular disease, male pseudohermaphroditism WT1 mutations
164
Beckwith-Wiedemann syndrome
wilms, neonatal hypoglycemia, muscular hemihypertrophy, organomegaly (esp tongue) WT2 mutations

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