Memorize This Stuff Flashcards

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
Q

Hexosaminidase A deficiency

A

Tay-Sachs

GM2 ganglioside

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26
Q

Galactocerebrosidase deficiency

A

Krabbe

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27
Q

Arylsulfatase A deficiency

A

Metachromatic Leukodystrophy

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28
Q

alpha-L-iduronidase deficiency

A

Hurler
Heperan sulfate, dermatan sulfate
cataracts

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29
Q

iduronate sulfatase deficiency

A

Hunter
heparan sulfate, dermatan sulfate
NO cataracts

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30
Q

Encapsulated Organisms

A

Some Killers Have Pretty Nice Slimey Capsules

Strep pneumo and group B
Klebs
H flu
Pseudomonas
Neiserria m
Salmonella
Cryptococcus
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31
Q

Catalase Positive Organisms

A

Staph N Enterobacteriaceae Are Listed Catalase Postive

Staph
Nocardia
Entero
Aspergillus
Listeria
Candida
Pseudomonas
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32
Q

Urease positive organisms

A

K-PUNCHSS

Klebs
Proteus
Ureaplasma
Nocardia
Crytococcus
H pylori
Staph epi
Staph sapro
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33
Q

Obligate aerboes

A

Nagging Pests Must Breathe

Nocardia
Pseudomonas
MycoBacterium

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34
Q

Obligate anaerobes

A

Can’t Breathe Air

Clostridium
Bacteroides
Actinomyces

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35
Q

Obligate Intracellular Bugs

A

rickettsia, chlamydia

can’t make any ATP

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36
Q

Facultative Intracellular Bugs

A

Some Nasty Bugs May Live FacultativeLY

Salmonella
Neisseria
Brucella
Mycobacterium
Listeria
Francisella
Legionella
Yersina pestis
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37
Q

ToRCHeS

A
Toxo
Rubella
CMV
HIV
HSV
Syphilis
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38
Q

Antibiotics to Avoid in Pregnancy

A
Sulfa - kernicterus
Aminoglycosides - ototox
FQs - tendons
Clarithromycin - toxic
Tetracyclines - bones, teeth
Ribavirin - teratogen
Griseofulvin - teratogen
Chloramphenicol - gray baby
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39
Q

HLA A3

A

Hemochromatosis

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40
Q

HLA B27

A
seronegative arthropathies
Psoriatic arthritis
ankylosing spondylitis
IBD
reactive arthritis (Reiter)
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41
Q

HLA DQ2/DQ8

A

celiac disease

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42
Q

HLA DR2

A

MS, SLE, Goodpasture

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43
Q

HLA DR3

A

t1dm, SLE, Graves

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44
Q

HLA DR4

A

t1dm, RA

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45
Q

HLA DR5

A

pernicious anemia, hashimoto’s

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46
Q

Cytokines secreted by Macrophages

A

IL1,6,8,12, TNF-alpha

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47
Q

Cytokines secreted by T cells

A

IL2,3

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48
Q

cytokines secreted by Th1 cells

A

ifn-gamma

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49
Q

cytokines secreted by Th2 cells

A

IL4,5,10

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50
Q

IL-1

A

endogenous pyrogen

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51
Q

IL-2

A

stimulates t cells to divide

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52
Q

IL-3

A

bone marrow cell growth

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53
Q

IL-4

A

IgE class switching, Th2 growth and B cell growth

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54
Q

IL-5

A

IgA class switching, eosinophil growth

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55
Q

IL-6

A

endogenous pyrogen, acute phase proteins

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56
Q

IL-7

A

lymphoid differentiation

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57
Q

IL-8

A

major neutrophil chemotatic factor

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58
Q

IL-10

A

anti-inflamatory, inhibits Th1

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59
Q

IL-12

A

induces Th1 differentiation, activates NK cells

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60
Q

TNF-alpha

A

mediates septic shock, activates endothelium

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61
Q

IFN-gamma

A

antiviral, antitumor
increases killing of virally infected cells, increases MHC expression in all cells
responsible for forming granulomas

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62
Q

CD3

A

all T cells

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63
Q

CD 4

A

helper T cells

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64
Q

CD28

A

all t cells

binds B7 on the APC

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65
Q

CD40

A
b cells, needed for antibody class switching
CD40L on Thelpers
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66
Q

CD8

A

killer t cells

67
Q

CD19,20,21

A

B cell markers

21- receptor for EBV

68
Q

B7

A

binds CD28 on t cells

on antigen presenting cells

69
Q

CD14

A

macrophage specific

binds LPS

70
Q

CD56

A

unique NK cell marker

71
Q

Anergy

A

t cell gets MHCII stimulation, but no co-stimulatory signal

refractory to further signaling

72
Q

auto-antibody: ACh receptor

A

myasthenia gravis

73
Q

auto-antibody: basement membrane

A

goodpasture

74
Q

auto-antibody: cardiolipin, lupus anticoagulant

A

SLE, antiphospholipid syndrome

75
Q

auto-antibody: centromere

A

limited scleroderma, CREST syndrome

76
Q

auto-antibody: desmoglein

A

pemphigus vulgaris (thin walled blisters)

77
Q

auto-antibody: dsDNA, Smith

A

specific for SLE

78
Q

auto-antibody: glutamate decarboxylase

A

t1dm

79
Q

auto-antibody: hemidesmosome

A

bullous pemphigoid (tense blisters)

80
Q

auto-antibody: Jo-1, SRP, Mi-2

A

polymyositis, dermatomyositis

81
Q

auto-antibody: microsomal, thyroglobulin

A

hashimoto’s

82
Q

auto-antibody: mitochondrial

A

primary biliary cirrhosis

83
Q

auto-antibody: ANA

A

SLE, nonspecific

84
Q

auto-antibody:SCl70 (DNA topo 1)

A

diffuse scleroderma

85
Q

auto-antibody: smooth muscle

A

autoimmune hepatits

86
Q

auto-antibody: SSA (Ro), SSB (La)

A

Sjogren

87
Q

auto-antibody: TSH receptor

A

Graves

88
Q

auto-antibody: U1 RNP (ribonucleoprotein)

A

Mixed connective tissue disease

89
Q

auto-antibody: cANCA (PR3 ANCA)

A

granulomatosis with polyangitis (Wegner)

90
Q

auto-antibody: IgA endomysial, IgA TTG

A

celiac

tissue trans glutaminase

91
Q

auto-antibody: pANCA (MPO ANCA)

A

microscopic polyangitis, Churg-Strauss

92
Q

auto-antibody: Rheumatoid factor, CCP

A

IgM anti IgG

RA

93
Q

retroperitoneal structures

A

SAD PUCKER

Suprarenal (adrenals)
Aorta and IVC
Duodenum

Pancreas (except tail)
Ureters
Colon (up and down)
Kidneys
Esophagus (lower)
Rectum
94
Q

falciform ligament

A

fetal umbilical vein

95
Q

hepatodoudenal ligament

A

holds the portal triad

96
Q

layers of the gut wall

A

MSMS

Mucosa
Submucosa (Meissner plexus)
Muscularis (Myenteric / Auerbach plexus)
Serosa

97
Q

Peyers patches

A

only in the illeum

98
Q

SMA syndrome

A

transverse duodenum is entrapped between SMA and aorta, causing obstruction

99
Q

Name six main collateral artery sets in the belly

A
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
Q

Name three portosystemic anastomoses

A

left gastric - esophageal (to azygous) - varices
paraumbilical - small epigastric - caput medusa
superior rectal - mid/inf rectal - anorectal varices
Gut, Butt, Caput

101
Q

cholecystokinin

A

I cells (duodenum)
increase panc/gall secretions (muscarinic), slow gastric emptying
increased by fat, amino acids

102
Q

gastrin

A

G cells (stomach antrum)
increase H and motility
increased by food, vagal stimulation
ZE syndrome

103
Q

Motilin

A

small bowel
produces migrating motor complexes
increased while fasting

104
Q

Secretin

A
S cells (duodenum)
increases panc bicarb secretion and bile secretion
increased by fatty acids in the duodenum
105
Q

Somatostatin

A
D cells (islets)
D = down, slows everything down
106
Q

stimulators of H release by parietal cells

A

Ach, vagus stim
Gastrin,
histamine, from enterochromaffin-like cells (most important)

107
Q

uptake of glucose and galactose by gut lumen

A

SGLT1 (Na dependent) -> GLUT2 on bl

108
Q

uptake of fructose by gut

A

GLUT5 (facilitated diffusion) -> GLUT2 on bl

109
Q

iron absorption by the gut

A

duodenum, as Fe2 (2 goes in 2 the body)

110
Q

folate absorption by the gut

A

jejunum and ileum

111
Q

B12 absorption by the gut

A

terminal ileum, requires intrinsic factor

112
Q

heme to biliverdin

A

heme oxygenase

makes bad bruises green

113
Q

congenital defect of the bowel, may contain ectopic gastric mucosa or pancreatic tissue

A
Meckel diverticulum
vitelline duct (omphalomesenteric duct)
114
Q

Branced Amino Acids

A

Isoleucine, Leucine and Valine

Maple Syrup Urine Disease

115
Q

normal S2 splitting

A

increases with inspiration

drops pressure, increases venous return, more blood through the right side, longer for the pulmonary valve to close

116
Q

wide s2 splitting

A

conditions that delay RV emptying

pulm stenosis, RBBB

117
Q

fixed s2 splitting

A

ASD

l->r shunt causes increased flow through pulmonic regardless of breathing

118
Q

paradoxical s2 splitting

A

split with expiration, no split with inspiration
condtions that delay LV emptying
aortic stenosis, LBBB

119
Q

cardiac auscultation: inspiration

A

increases venous return

increases intensity of right heart sounds

120
Q

cardiac auscultation: hand grip

A

increases systemic vascular resistance
increase MR, AR, VSD
decreases AS

121
Q

cardiac auscultation: valsava, standing

A

decreases venous return
decreases most mumurs
increases hypertrophic cardiomyopathy murmur

122
Q

cardiac auscultation: rapid squatting

A

increases venous return, preload
increases AS
decreases HCM

123
Q

cardiac auscultation: holosystolic blowing

A

MR or TR

124
Q

cardiac auscultation: holosystolic harsh, loudest at tricuspid area, increased with hand grip

A

VSD

125
Q

cardiac auscultation: late systolic crescendo with a midsystolic click, over the apex

A

MVP

126
Q

cardiac auscultation: early diastolic snap and rumbling diastolic mumur

A

mitral stenosis

127
Q

explain pulsus paradoxus

A

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
Q

Inulin CL

A

GFR

CR slightly overestimates

129
Q

PAH CL

A

RPF

130
Q

proteinuria leading to pellagra like symptoms

A

Hartnup disease
decreased absorption of neutral AAs, including tryptophan
B3 can be made from Trp, so get a decreased B3 lvl

131
Q

Renal tubular defect: PCT

A

Fanconi
increased excretion of basically everything
AAs, glucose, phos, bicarb -> met acidosis
Wilson’s and toxins
causes type 2 RTA

132
Q

Renal tubular defect: thick ascending loop[

A

Bartter - AR
Na/K/2CL defect
hypoK, met alk and hypercalicuria

133
Q

Renal tubular defect: DCT

A

Gitelman - AR, not as severe as Bartter
NaCl resorbtive defect
hypoK, met alk, no hypercalciuria

134
Q

Renal tubular defect: collecting duct

A

Liddle - AD
increased Na absorption (Enac)
hypoK, met alk, hypertension

135
Q

Causes of extracellular K shift (hyper K)

A
digitalis
hyperosmolarity
Insulin deficiency
cell lysis
acidosis (H/K exchange)
Beta block
136
Q

Causes of intracellular K shift (hypoK)

A

hypo-osmolarity
insulin
alkalosis
Beta agonist

137
Q

U waves on ECG

A

hypo K

138
Q

Wide QRS and peaked T waves on ECG

A

hyper K

139
Q

causes of anion gap met acidosis

A
MUDPILES
Methanol
Uremia
DKA
Propylene glycol
Iron or INH
Lactic acidosis
Ethylene Glycol
Salicylates
140
Q

causes of non-gap met acidosis

A
HARD ASS
hyperalimentation
addison's
RTA
Diarrhea (increased Cl-)
Acetazolamide
Spironolactone
Saline infusion
141
Q

type 1 renal tubular acidosis

A

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
Q

type 2 renal tubular acidosis

A

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
Q

type 3 renal tubular acidosis

A

hyper K, ph < 5.5
hypoaldo situations, K sparing diuretics
hyperK impairs ammonia generation in the PCT, decreased H excretion into the urine

144
Q

urine cast: fatty (oval)

A

nephrotic syndrome

145
Q

urine cast: granular, muddy brown

A

acute tubular necrosis

146
Q

urine cast: waxy

A

chronic renal failure

147
Q

AD kidney cysts in the medullary collecting ducts and shrunken kidneys

A

medullary cystic kidney disease

148
Q

labs: pre-renal azotemia

A

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
Q

nephrotic syndrome: kids

A

Minimal change disease
nml LM, neg IF, foot process effacement EM
damage mediated by cytokines (asso Hodgkin’s)
usually responds to steroids

150
Q

nephrotic syndrome: hispanics, blacks, HIV patients

A

FSGS
also asso with sickle cell and heroin
foot process effacement like MCD, with findings on LM and neg IF

151
Q

nephrotic syndrome: SLE and Caucasian adults

A

membranous nephropathy
diffuse membrane thickening LM, subepithelial (podocyte side) granular deposits, SPIKE AND DOME on EM
antibody to phospholipase A2

152
Q

nephrotic syndrome: HBV, HCV and tram tracks

A
type 1 membranoproliferative
subendothelial deposits (granular) split the GB membrane, causing the tram track appearance
153
Q

nephrotic syndrome: C3 nephritic factor

A

type 2 MP
intramembranous deposits
low serum C3
C3 nephritic factor stabilizes C3 convertase

154
Q

nephritic syndrome

A

hematuria, inflammed, hypercellular glomerulus

155
Q

nephritic syndrome: after throat/skin infection

A

PSGN
about 2 weeks after infection
subepithelial deposits (granular)

156
Q

nephritic syndrome: crescents

A

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
Q

nephritic syndrome: SLE

A

diffuse proliferative GN
subendothelial C3 deposits
wire-looping capillaries
most common cause of death in SLE

158
Q

nephritic syndrome: IgA deposits

A

Berger’s (IgA) nephropathy
mesangial IgA deposits, mesangial proliferation
flares with URI/GI infection - 2-3 days after infection

159
Q

renal tumor in tuberous sclerosis

A

angiomyolipoma

160
Q

renal cell carcinoma paraneoplastic syndromes

A

EPO, renin, PTHrp, ACTH

161
Q

wilms tumor defining cell type

A

blastema

mutations on chr11

162
Q

WAGR syndrome

A

Wilms
Aniridia
Gential abnormality
Retardation

163
Q

Denys-Drash Syndrome

A

Wilms, progressive glomerular disease, male pseudohermaphroditism
WT1 mutations

164
Q

Beckwith-Wiedemann syndrome

A

wilms, neonatal hypoglycemia, muscular hemihypertrophy, organomegaly (esp tongue)
WT2 mutations