Micro 0 Flashcards
A patient with tinnitus, dizziness, headaches, and GI distress. What drug is causing these symptoms?
This patient presents with Cinchonism: Caused by quinine or quinidine.
What testicular tumor describes composed of cytotrophoblasts and syncytiotrophoblasts?
Choriocarcinoma.
What testicular tumor may present with initially with gynecomastia?
Leydig cell tumor.
Rarely a Sertoli tumor.
What testicular tumor describes with elevated AFP?
Yolk sac tumor.
What testicular tumor describes elevated beta-hCG?
- Choriocarcinoma
2. Embryonal carcinoma
What testicular tumor describes histological appearance similar to koilocytes (cytoplasmic clearing)?
Seminoma
Which medication overdose can be treated with sodium bicarbonate?
Bicarbonate alkalinizes urine, trapping weak acids. It is used to treat overdoses with weak acids such as aspirin.
What substances do cytotoxic T cells and NK cells use to induce apoptosis in the cells infected with virus?
Perforin and granzymes.
What highly damaging events can cause irreversible cell injury?
- Calcium influx
- Damage to the plasma membrane
- Rupture of the lysosomes
- Mitochondria permeability
- Damage to the nucleus.
What ovarian tumor is lined with fallopian tube-like epithelium?
Serous cystadenoma
What ovarian tumor is associated with ovarian tumor + ascites + hydrothorax?
Meigs syndrome of ovarian fibroma
What ovarian tumor is associated with multiple different tissue types?
Teratoma
What ovarian tumor is associated with elevated beta-hCG?
Choriocarcinoma, dysgerminoma
What ovarian tumor resembles bladder epithelium?
Brenner tumor.
What is the most common cause of DIC?
"STOP Making Thrombi" Sepsis Trauma Obstetric complications Pancreatitis Malignancy Transfusion
What is the most common cause of Heart murmur?
Mitral valve prolapse.
What is the most common cause of coronary artery involved in thrombosis?
Left anterior descending (LAD).
What is the most common cause of death in lupus patients?
Renal failure from lupus nephropathy.
What is the most common congenital heart anomaly?
Ventricular septal defect (VSD).
What are the clinical presentations of Addison disease?
Increased skin pigmentation. Hypotension. Weakness. Malaise. Anorexia. Weight loss.
What is the cause of Addison disease?
Autoimmune disease that attacks adrenal glands. It causes adrenal atrophy causing decreased aldosterone and cortisol.
What is the classical presentation of a brachial cleft cyst?
Neck mass that lies laterally along the anterior border of the sternocleidomastoid muscle.
It does not move with swallowing.
What pathology is associated with bilateral hilar lymphadenopathy?
Sarcoidosis. Also see noncasiating granulomas.
What pathology is associated with cherry-red spot on the macula?
- Tay-Sachs
- Niemann-Pick
- Central retinal artery occlusion
What pathology is associated with slapped-cheek rash on child?
Parvovirus B19.
What organism is associated with dog or cat bite?
Pasteurella multocida
What pathology is associated with facial muscle spasm upon tapping the cheek?
Chvostek’s sign (hypocalcemia).
What pathology is associated with cough, conjunctivitis, coryza?
Measles (the big three C’s).
What pathology is associated with nephritis, hearing loss and cataracts?
Alport syndrome.
What regulates prolactin secretion from the pituitary?
TRH increases prolactin secretion.
Dopamine inhibits prolactin secretion.
Prolaction inhibits prolactin release by increasing dopamine secretion.
What is the classic clinical presentation of a thyroglossal duct cyst?
Asymptomatic mass in the midline neck. Moves with swallowing. Often found in patients
What is HAART and what does it do?
HAART: Highly Active Antiretroviral Therapy (HAART).
It is a combination of at least 3 different HIV medication to attack the virus in different stages of replication cycle.
When is should a patient with HIV start HAART?
Everyone with HIV regardless of CD4 count, definitely in anyone w/ CD4 count
What are some protease inhibitors?
All end with "navir": Saquinavir Ritonavir Indinavir Nelfinavir Fosamprinavir Lopinavir Tipranavir Atazanavir Darunavir
What does large “bull’s eye” rash suggest?
Erythema chronicum migrans (Lyme disease).
What does “strawberry tongue” suggest?
Kawasaki.
Scarlet fever.
Toxic shock syndrome.
What does “resting tremor, rigidity” suggest?
Parkinson disease.
What does “Rash on palm and soles” suggest?
Secondary syphilis.
Rocky Mountain spotted fever.
Coxsackie A virus.
What medications are used to shrink prolactinomas?
Dopamine agonists:
- Bromocriptine
- Cabergoline
In what pathology are smudge cells seen?
CLL.
In what pathology is port-wine stain in opthalmic division of trigeminal nerve seen?
Sturge-Weber syndrome.
In what pathoklogy do we see S3 heart sound?
- Dilated cardiomyopathy.
- Post-MI.
- Left ventricular failure.
- Mitral regurgitation.
- Left-to-Right shunt (VSD, ASD, PDA).
In what pathology do we see adrenal hemorrhage associated with meningococcemia?
Waterhouse-Friderichsen syndrome.
In what pathology do we see Ferruginous bodies?
Asbestosis.
What pathology do we see subepithelial humps on Electron Microscopy (EM)?
Postreptococcal glomerulonephritis.
In what pathology do we see Spike and dome on EM?
Membranous glomerulonephritis.
In what pathology do we see currant jelly stoool?
Intussusception.
In what pathology do we see adverse reaction from mixing succinylcholine with inhaled anesthetics?
Malignant hyperthermia.
A 48 year old woman has been suffering with progressive lethargy and extreme sensitivity to cold. What is the most likely diagnosis?
Hypothyroidism (Hashimoto’s).
What enzyme of the adrenal steroid synthesis pathway is inhibited by ketoconazole?
Desmolase.
What pathology gives lens-shaped lesion on head CT?
Epidural hematoma.
What pathology causes no milk production in the postpartum period?
Sheehan syndrome.
What pathology causes pigmented hamartomas in the iris?
Lish nodules (neurofibromatosis).
In what pathology do we see Howell-Jowell bodies?
They are DNA remnants inside RBC in asplenia.
What cancer is associated with asbestos?
Malignant mesothelioma and bronchogenic cancer.
In what pathology do we see Owl’s eye inclusions?
CMV.
In what pathology do we see Owl’s eye nucleus?
Reed-Sternberg cells (Hodgkin lymphoma).
In what pathology do we see Owl’s eye protozoan?
Giardia lamblia.
What is the most likely diagnosis of a 50 year-old-man with new, unexplained skin yellowing and no other symptoms?
Pancreatic cancer in head of pancreas.
What enzyme is deficient in PKU and what are the symptoms?
Enzyme deficient is phenylalanine hydroxylase. It causes musty body odor, growth retardation, mental retardation, seizures, eczema and fair skin.
What is the precursor molecule of ACTH synthesis?
Proopiomelanocortin (POMC).
What organism is associated with cat scratch?
Bartonella henselae.
What organism is associated with cat bite or dog bite?
Pasteurella multocida.
What organism is associated with cat feces?
Toxoplasma.
What organism is associated with puppy feces?
Yersenia enterocolitica.
What organism is associated with animal urine?
Leptospira.
What organism is associated with deer and rodent urine?
Hantavirus.
What are the hormones released from the anterior pituitary gland?
[MALT PFG]
- MSH: Melanin release; sexual arousal.
- ACTH: Cortisol release.
- LH: Testosterone production or Estrogen and progesterone production.
- TSH: Thyroid hormone production and secretion.
- Prolactin: Milk production and secretion.
- FSH: Follicular development or spermatogenesis.
- GH: Stimulates growth.
What effect does adiposity generated leptin has on the hypothalamus?
Inhibits the lateral area and stimulates ventromedial area of hypothalamus causing satiety.
What pathology has anti-desmoglein antibodies?
Pemphigus vulgaris.
What pathology has anti-basement membrane antibodies?
Goodpasture syndrome.
What pathology causes cough, conjunctivitis, coryza and fever?
Measles.
What pathology has Councilman bodies?
Apoptotic liver cells (viral hepatitis, yellow fever).
What pathology causes green/yellow pigment just within the corneoscleral margin?
Kayser-Fleischer rings (Wilson disease).
In what pathology do we see anticentromere antibodies?
CREST scleroderma.
In what pathology do we see dementia + eosinophilic inclusions in neurons?
Lewy body dementia.
In what pathology do we see anti-dsDNA antibodies?
Lupus nephritis.
What are the side effects of Orlistat?
Steatorrhea, GI discomfort, reduced absorption of fat-soluble vitamins.
What enzyme converts glucose to sorbitol?
Aldose reductase.
What is the difference between a case control study, a cohort study, and a clinical trial? Which one allows you to generate odds ratio and which one for relative risk?
Case control: Starts w/ population w/ specific outcome, then seeks exposure.
Cohort: Starts w/ exposed population and then looks for specific outcome.
Clinical: Intervention performed and then difference in outcomes sought.
Case-control and cohort are observational while clinical is experimental.
Cohort study allows you to calculate relative risk while case-control for odds ratio.
In addition to colon cancer, what is one of the most common causes of GI bleeding in the elderly?
Angiodysplasia.
Which vasculitis causes necrotizing granulomas of lung and necrotizing glomerulonephritis?
Granulomatosis w/ polyangiitis.
Which type of vasculitis causes necrotizing immune complex inflammation of visceral/renal vessels?
Polyarteritis nodosa.
Which type of vasculitis is seen in young asian women?
Takayasu arteritis.
Which type of vasculitis is seen in young asthmatics?
Churg-Strauss syndrome.
Which type of vasculitis is seen in infants and young children; involved coronary arteries?
Kawasaki disease.
Which type of vasculitis is the most common?
Temporal arteritis (giant cell arteritis).
Which type of vasculitis is associated with hepatitis B infection?
Polyarteritis Nodosa.
What is the antidote for acetaminophen?
N-acetylcysteine.
What is the antidote for Salicylates?
Sodium bicarbonate because aspirin is a weak acid and to trap it we need to alkalanize the urine.
Also use dialysis.
What is the antidote for amphetamines?
Ammonium chloride because they are weak bases so we are going to acidify the urine to trap it.
What is the antidote for anticholinasterase and organophosphates?
Atropine blocks the effects of said toxins.
Pralidoxime regenerates pseudocholinestarase.
What is the antidote for antimuscarinic, anticholinergic agents?
Physostigmine.
What testicular tumor has histologically may have alveolar or tubular appearance, sometimes with papillary convolutions?
Embryonal carcinoma.
What testicular tumor is composed of multiple tissue types?
Teratoma.
What testicular tumor has histologic endodermal sinus structures (Schiller-Duval bodies)?
Yolk sac tumor.
What testicular tumor has 25% that have cytoplasmic rod-shaped crystalloids of Reinke?
Leydig cell tumor.
What testicular tumor has androgen producing and associated with precocious puberty?
Leydig cell tumor > Sertoli cell tumor.
What organism is the most frequent cause of balanitis?
Candida albicans.
What cells respond to FSH?
Granulosa cells.
What is the two-cell theory of estradiol production?
There is no one cell that can make estrogen alone in the ovaries; it takes two cells to make it: Theca cells make androstenedione and then Granulosa cells convert it to estradiol.
What drug would you give to inhibit prolactine secretion?
Dopamine analog (e.g. bromocriptine).
