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1
Q

most common pit. tumor

A

prolactinoma, amenorrhea, galactorrhea, decreased libido, and bilateral hemianopsia, erectile dysfunction. TX: dopamine agonist

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2
Q

sheehan syndrome

A

pit. infarct following a hypotensive event after giving birth, trouble with lactation and hypopituitarism

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3
Q

PSGN: post-strep glomer neph

A

edema, hematuria, hypertension, protienuria. enlarged hypercellular glomeruli, IgG & C3 deposits. “starry sky” or “lumpy bumpy” pattern. casued by strep A test: anti-streptolycin O

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4
Q

goodpasture syndrome

A

IgG basement membrane antibodies, causes hemoptysis, glomerulomehritis. crescent moon shapes on microscopy

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5
Q

wegener granulomatosis

A

upper respiratory tract, lungs and kidneys. hematuria, weight-loss, fever, resp. symptoms. c-ANCA +

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6
Q

skin CA w/ best prognosis

A

basal cell carcinoma

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7
Q

most common mets to brain (3)

A

lung, breast and melanoma

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8
Q

mesoderm forms?

A

dermis, most bones, muscles and visceral tissue

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9
Q

surface ectoderm forms?

A

epidermis and appendages, mammary glands, lens of the eye, others…

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10
Q

neuroectoderm forms?

A

CNS, preganglionic autonomic neurons, retina, pos. pit.

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11
Q

endoderm forms?

A

structures derived from inner lining of rimitive gut tube (thyroid follicular cells, epithelium of trachea, bronchi, lungs, liver, biliary tree, the pancreas, GI and bladder.

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12
Q

granulosa cell tumor

A

secrete estrogen, endometrial hyperplasia, endometrial carcinoma, carr-exner bodies (follicles filled with eosinophils

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13
Q

MS: s/s, diag, tx

A

progressive demylinating disease. diplopia, incontinence, loss of nerve function any where. diag: oliogoclonal bands in csf, mri = plaques in the brain and spinal chord. tx: corticosteroids

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14
Q

intestinal atresia belwo duodenum is caused by…

A

vascular occlusion in utero

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15
Q

signet-ring carcinoma

A

gastric adenocarcinoma, cells contain abundant mucin and can cause linitis plastica

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16
Q

hallmark PFT for COPD?

A

decreased FEV1/FVC ratio

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17
Q

Meckel’s Diverticulum

A

most common congenital anomaly of the small intestine- True Diverticulum
forms from incomplete obliteration of omphalmesenteric duct (connects midgut lumen to yolk sac cavity)
connected to ileum and often has other tissue present (typically gastric, pancreatic, colonic, jejunal, duodenal, and endometrial)
most commonly, gastric tissue.. which can cause ulcers. also can present with black tarry stolls (guaiac +).
99mmTc-pertechnetate scan detects presence of gastric mucosa
Rule of 2s: 2% of population, 2in in length, 2ft from ileocecal valve, 2% are asymptomatic, and males are 2x more likely to be affected

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18
Q

Annular Pancreas

A 
abnormal migration of ventral pancreatic bud leads to the head of the pancreas surrounding the duodenum. 
congenital anomoly (rare) that presents with sx of intestinal obstruction (recurrent bilious vomiting) soon after birth.
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19
Q

Cleft Lip vs Cleft Palate

A

cleft lip= failure of fusion of of maxillary and medial nasal processes (primary palate)
cleft palate= failure of fusion of the later palatine processes, the nasal septum and/or median palatine process (secondary palate)

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20
Q

Caudal Regression Syndrome

A

rare congenital abnormality. patients are born with agenesis of the sacrum and occasionally lumbar spine
experience resultant flaccid paralysis of the legs, dorsiflexed contractures of the feet and urinary incontinence.
frequently attributed to poorly controlled maternal diabetes.

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21
Q

Craniopharyngiomas

A

calcified cystic tumors, most commonly found in kids and young adults. They arise from the remnants of Rathke’s pouch. Usually filled with a yellow viscous fluid, rich in cholesterol.
Usually cause h/a, growth failure, and bilateral hemianopia

22
Q

Nephrotic Syndromes

A 
Focal Segmental Glomerulosclerosis
Membranous Nephropathy
Minimal Change Disease (lipoid nephrosis)
Amyloidosis
Membranoproliferative glomerulonephritis
Diabetic Glomerular Nephropthy
23
Q

Nephritic Syndromes

A

Acute Post-Strep Glomerulonephritis
Rapidly Progressive (cresentric) glomerulonephritis
Diffuse proliferative glomerulonephritits
Berger’s Disease (IgA Nephropathy)
Alport Syndrome

24
Q

Berger’s Disease

A

Ig A Nephropthy
related to henoch-schonlein purpura
IgA based immune complex deposits in mesangium
can present with flares of a URI or acute gastroenteritis

25
Diffuse Proliferative Glomerulonephritits
Due to SLE or MPGN (membranoproliferative) Wire looping of capillaries IgG based immune coplexes with C3 deposits and granular appearance Most common cause of death for SLE pt's
26
Rapidly Progressive Glomerulonephritis
Cresentric Glomerulonephritis looks like crescent moon, made of fibrin and plasma proteins with glomerular pareital cells, monocytes, and macrophages Can be from Goodpasutres (hematuria/hemeoptysis), Wegener's (c-ANCA), or Microscopric polyanginitis (p-ANCA) Has a poor prognosis (renal failure in day/weeks)
27
Acute Post-Strep Glomerulonephritis
lumpy bumpy appearance with subepithelial immune complex humps and a granular appearance due to IgG, IgM, and C3 deposition along GBM and mesangium mostly in kids with perioribital edema, dark urine, and HTN. will resolve spontaneously
28
Diabetic Glomerulonephropathy
nonenzymatic glycosylation of GBM increasing the permeabilty and thickening the BM See Kimmelsteil-Wilson lesions- mesangial expansion, GBM thickening, and eosinophilic nodular glomerulosclerosis
29
Membranoproliferative Glomerulonephritis
Can also be nephritic TypeI: subendothelial IC deposits - tram-track appearance bc GBM has split from the mesangial ingrowth Assoicted with HBV, HCV TypeII: intermembranous IC deposits, "dense deposits" Associted with C3 nephritic factor
30
Amyloidosis
Congo Red-stain shows apple green bifringence under unpolarized light pathogenesis: excessive delivery of light chain proteins that overwhelms the ability of the renal tubules for reabsorption. The excess light chains complex with a glycoprotein found in urine called uromodulin (tamm-horsfall protein) to form light chain casts. Associated with chronic conditions like MM, TB, RA
31
Minimal Change Disease
glomeruli lok normal under light microscopy. see foot process effacement under electomicroscopy Selective loss of albumin, not globulins, caused by GBM polyion loss Maybe triggered by recent infection or immune stimulus Usually in kids Tx: corticosteroids
32
Membranous nephropathy
diffuse capillary GBM thickening. will see "spike and dome" appearance with subepithelial deposits 2nd most common cause of primary nephrotic syndrome in adults. Can be idiopathic or caused by syphilis, HBV, HCV, malaria, malignancy, SLE, gold salts and penicillamine tx: prednisone
33
Focal Segmental glomerulosclerosis
segmental sclerosis and hyalinosis with effacement of foot processes **MOST COMMON cause of nephrotic syndrome in adults associated with HIV, heroin use, massive obesity, INF tx, and chronic kidney disease to congenital absence or surgical removal
34
Tranistional Cell Carcinoma Risk Factors
Pee SAC Phenacetin Smoking, Aniline Dyes, and Cyclophosphamide "Risk factors are smoking (most common), radiation exposure, aniline dyes, artificial sweeteners, and cyclophosphamide. Working with rubber, leather, textiles and paint products also increases the risk of bladder cancer. The classic presentation is painless hematuria. Frequency, dysuria, and urgency are common manifestations of the condition."
35
Acute Tubular Necrosis
**MOST COMMON CAUSE OF INTRINSIC RENAL FAILURE** associted with renal ischemia from shock, sepsis, or a crush injury (myoglobinuria), drugs, or toxins See muddy brown (granular) casts Occurs in 3 stages: 1. inciting phase, maintenance/oliguric (when death usually occurs), and recovery phase (self-reversible in some cases, may become hypokalemic)
36
Disease states that can cause renal papillary necrosis
DM, Acute pyelonephritis, Chronic phenaticin use, and sickle cell anemia/trait
37
Renal Osteodystrophy
consequence of renal failure that causes a failure of Vit D hydroxylation , hypocalcemia, and hyperphosphatemia. secondary hyperparathyroidism the hyperphosphatemia decreases serum Ca by causing tissue calcifications and Ca is furhter decreased by a lack of 1,25 OH Vit D, decreasing intestinal Ca reabsorption
38
Medullary Cystic Disease
inherited disease cauing tubulointerstital and progressive renal insufficency with inability to concentrate urine No cysts Shrunken kidneys Poor prognosis
39
Acute Interstitial Nephritis (AIN)
fever, rash, eosinophilia, white blood cell casts, hematuria and eosinophiluria. Most commonly if from allergic reaction to a drug (penicillins, cephalosporins, NSAIDs, phenytoin, diuretics, and sulfonamides). Also from infectious diseases or immunologic diseases (Sjogren's, SLE, sarcoid). Intrinsic renal failure: BUN:Creatinine ratio of 40mEq/L, and FENa >2%, urine osmalility <350 mosm/kg. and hyperkalemia
40
"Fried Egg" appearance
Clear cytoplasm with round nucleus
41
Giant Cell Tumor (Osteoclastoma)
aggressive benign bone tumor at epiphyseal end of long bones 20-40yo usually distal femur/proximal tibia (knee area) Double Bubble on Xray Spindle shaped with multinucleated giant cells
42
Osteochondroma
Most common benign tumor males <25yo mature bone with cartilage cap usually from long metaphysis can turn into chondrosarcoma, but rare
43
Ewing's Sarcoma
malignant bone tumor at diaphysis of long bone, pelvis, scapular, or ribs boys <15yo anaplastic small blue cell malignant cell that is aggressive with early mets responsive to chemo Onion skin appearance in bone associated with t11:22 translocation
44
Osteosarcoma
2nd most common malignant bone tumor male>female 10-20yo risks: pagets, bone infarcts, radiation, familial retinoblastoma X-ray: Codman’s triangle (elevation of periosteum) or sunburst pattern. Aggressive. Treat with surgical en bloc resection (with limb salvage) and chemotherapy.
45
Chondrosarcoma
men 30-60 yo usually in pelvis, scapula, spine, humerus, tibia or femur malignant cartilaginous tumor- expansive glistening mass within medullary cavity
46
Rheumatoid Factor
anti-IgG antibody
47
Sjogren's
lymphocytic infiltration of exocrine glands (esp. salivary and lacrimal) classic triad: dry eyes, dry mouth, arthritis
48
Pseduogout vs. Gout
Pseduogout: weakly birefringent rhomboid crystals (blue), crystals made from calcium pryophosphate, men and women equally affected Gout: negatively birefringent needle shaped crystals (yellow), made from urate, men mostly affected
49
most common site of osteonecrosis
femoral head
50
Polymyositis
progressive, symmetrical proximal muscle weakness (usually shoulders) endomysial inflammation with CD8
51
Dermatomyositis
polymoysitis by with malar rash also, gattron's papules (DIP), helotrope rash "mechanic's hands and shawl and face rash" perimysial inflammation and atrophy with CD4
52
Lambert-Eaton Myesthenic Syndrome
autoantibodies to presynaptic Ca++ channel decreasig ACh release proximal muscle weakness that improves with use associated with small cell lung caner AChE inhibitors will NOT help

comlex (18 decks)

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