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MS II Unit 3 > Path from Goljan > Flashcards

Path from Goljan Flashcards

1
Q

(arcus senilis/ophthalmia neonatorum): gray-opaque ring at the corneal margin, cholesterol deposits in corneal stroma

A

arcus senilis (senilie=elderly). may indicate hypercholesterolemia in older smoker

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2
Q

(arcus senilis/ophthalmia neonatorum): conjunctivitis from N gon or C trachomatis

A

opthalmia neonatorum (neonatorum=newborn)

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3
Q

in opthalmia neonatorum, which occurs in the first week (N gon/C trach)

A

N gon. (C trach occurs in the second week)

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4
Q

(bacterial/viral) conjunctivitis: purulent, pain but no blurry vision

A

bacterial

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5
Q

(bacterial/viral) conjunctivitis: watery exudates

A

viral

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6
Q

MCC bacterial conjunctivitis

A

S aureus (then S pneumoniae)

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7
Q

viral conjunctivitis caused by (adenovirus/HSV1): viral cause of pinkeye, lymphadenopathy, no tx

A

adenovirus

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8
Q

viral conjunctivitis caused by (adenovirus/HSV1): keratoconjunctivitis with dendritic ulcers noted with fluorscein staining, tx trifluridine opthalmic

A

HSV1

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9
Q

(stye/acanthamoeba infection): due to S aureus, infection of eyelid, tx with hot packs and dicloxacillin

A

stye

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10
Q

(stye/acanthamoeba infection): severe keratoconjunctivitis in pts who do not clean their contact lenses properly, tx with propamidine and polymyxin/neomycin/gramicidin

A

acanthamoeba

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11
Q

(chalazion/orbital cellulitis): granulomatous inflam involving the meibomian gland in eyelid

A

chalazion

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12
Q

(chalazion/orbital cellulitis): periorbital redness secondary to sinusitis

A

orbital cellulitis

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13
Q

(chalazion/orbital cellulitis): disappears without tx usually (if not, use surgery or corticosteroid)

A

chalazion

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14
Q

(chalazion/orbital cellulitis): caused by S pneumoniae, H influenzae, includes fever, proptosis, opthalmoplegia

A

orbital cellulitis

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15
Q

(orbital fracture/pterygium): raccoon eyes, vertical diplopia

A

orbital fracture

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16
Q

(orbital fracture/pterygium): raised, triangular encroachment of thickened conjunctiva on the nasal side of the conjunctiva, may grow onto the cornea, due to sun/wind/sand

A

pterygium

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17
Q

(pterygium/pinguecula): does not grow onto the cornea

A

pinguecula

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18
Q

(pterygium/pinguecula): yellow-white conjunctival degeneration at the junction of cornea and sclera on temporal side of conjunctiva

A

pinguecula, usually requires no tx

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19
Q

optic neuritis (inflam of optic nerve): MCC

A

multiple sclerosis (second MCC: methanol poisoning)

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20
Q

optic neuritis tx

A

corticosteroids

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21
Q

central retinal (artery/vein) occlusion: caused by hypercoagulable state like polycythemia vera

A

vein

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22
Q

central retinal (artery/vein) occlusion: caused by embolization of plaque material from adjacent vessels

A

arterial (from carotid or opthalmic artery, giant cell arteritis involving opthalmic artery)

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23
Q

central retinal (artery/vein) occlusion: sudden, painless, unilateral loss of vision, swelling of optic disk, blood and thunder appearance

A

vein

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24
Q

central retinal (artery/vein) occlusion: boxcar segmentation of blood in retinal veins, and cherry red macula

A

artery

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25
Q

central retinal (artery/vein) occlusion: pallor of optic disk

A

artery (due to narrowed arteries)

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26
Q

central retinal (artery/vein) occlusion: tx with acetazolamide to lower intraocular pressure, carbogen, hyperbaric O2

A

artery

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27
Q

central retinal (artery/vein) occlusion: tx with intravitreal injections, laser photocoagulation

A

vein

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28
Q

(chronic open angle/acute angle closure) glaucoma: decreased rate of aqueous outflow into the canal of Schlemm, common with severe near-sightedness, bilateral aching eyes, cupping of optic disks

A

chronic open angle

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29
Q

(chronic open angle/acute angle closure) glaucoma: night blindness and gradual loss of peripheral vision leading to tunnel vision and blindness

A

chronic open angle

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30
Q

(chronic open angle/acute angle closure) glaucoma: narrowing of anterior chamber angle, medical emergency

A

acute angle closure

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31
Q

(chronic open angle/acute angle closure) glaucoma: precipitated by mydriatic agent, uveitis, lens dislocation, severe pain assoc with photophobia and blurry vision, red eye with steamy cornea, pupil fixed and nonreactive

A

acute angle closure

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32
Q

(chronic open angle/acute angle closure) glaucoma: tx with pilocarpine and systemic carbonic anhydrase inhibitor to lower pressure to allow for laser surgery

A

acute angle closure

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33
Q

(chronic open angle/acute angle closure) glaucoma: tx with beta blockers, then prostaglandins, alpha adrenergic agonists

A

chronic open angle

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34
Q

optic nerve atrophy: (red/pale) optic disk, due to optic neuritis or glaucoma, no effective tx

A

pale

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35
Q

(retinitis/uveitis): caused by sarcoidosis, ulcerative colitis, ankylosing spondylitis

A

uveitis

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36
Q

(retinitis/uveitis): caused by CMV (painless) and common in AIDS, VZV (painful)

A

retinitis

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37
Q

(retinitis/uveitis): inflam of iris, ciliary body, choroid. pain with blurry vision, miotic pupil, circumcorneal ciliary body vascular congestion, normal intraocular pressure, adhesions between iris and anterior lens capsule

A

uveitis

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38
Q

(retinitis/uveitis): tx with corticosteroids or atropine

A

uveitis

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39
Q

(retinitis/uveitis): cotton-wool exudates and hemorrhages, tx with ganciclovir or foscarnet

A

CMV retinitis

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40
Q

(dry/wet) type of macular degeneration: disruption of Bruch membrane in retina

A

both

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41
Q

(dry/wet) type of macular degeneration: thinning of retina and formation of yellowish white deposits called drusen

A

dry

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42
Q

(dry/wet) type of macular degeneration: vessels under retina hemorrhage causing retinal cells to die, creating blind spots or distorted central vision

A

wet

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43
Q

antioxidants (increase/decrease) risk of macular degeneration

A

decrease

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44
Q

tx macular degeneration with (pro/anti) angiogenics

A

anti

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45
Q

what type of infection can cause cataracts

A

rubella (CMV as well in congenital infections)

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46
Q

what kind of drugs can cause cataracts

A

corticosteroids

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47
Q

what type of tumor in children gives the ‘white eye reflex’

A

retinoblastoma

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48
Q

what type of cancer in adults affects the eye

A

melanoma

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49
Q

choanal atresia: MC congenital anomaly of nose. cyanosis during breast feeding. what causes child to “pink up” again?

A

crying

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50
Q

nasal polyps are (neoplastic/nonneoplastic) tumefactions that develop as a response to chronic inflam

A

nonneoplastic

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51
Q

nasal polyps are commonly assoc with which chronic disease

A

CF

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52
Q

nasal smear in allergic nasal polyps shows numerous (what cell type)

A

eosinophils

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53
Q

obstructive sleep apnea causes respiratory (alkalosis/acidosis) and hypoxemia

A

acidosis

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54
Q

complications of obstructive sleep apnea: secondary ______ and cor pulmonale (pulmonary HTN + right ventricular hypertrophy)

A

polycythemia

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55
Q

confirmatory test for ___: nocturnal polysomnography

A

OSA-obstructive sleep apnea

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56
Q

sinus infections: (maxillary/ethmoid) in adults

A

maxillary

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57
Q

MC bacterial pathogen causing sinusitis: (S aureus/H influenzae/S pneumoniae)

A

S pneumoniae

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58
Q

MCC sinusitis: (bacterial/viral) infection

A

viral URI

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59
Q

Most sensitive imaging test to diagnose sinusitis

A

CT

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60
Q

nasopharyngeal carcinoma: MC cancer of the nasopharynx, increased in Chinese (children/adults) and African (children/adults)

A

Chinese adults and African children

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61
Q

nasopharyngeal carcinoma is assoc with which virus

A

EBV

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62
Q

MCC laryngeal carcinoma: (EBV/cigarette smoking)

A

cigarette smoking, also alcohol, HPV 6 and 11

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63
Q

loss of lung volume due to inadequate expansion of airpsaces

A

atelectasis

64
Q

resorption atelectasis: MCC fever 24 to 36 hours after _____

A

surgery. also caused by aspiration of foreign material

65
Q

exudative tonsilitis: most likely pathogen (bacterial/viral)

A

viral in most cases, use a culture to differentiate

66
Q

hairy leukoplakia pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)

A

EBV, pre AIDS defining lesion, glossitis assoc with bilateral white excrescences on lateral border of tongue

67
Q

herpes labialis pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)

A

HSV1

68
Q

mumps pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)

A

paramyxovirus, with increased serum amylase

69
Q

(mumps/herpes labialis/hand-foot-mouth dz) complications: meningoencephalitis, unilateral orchitis or oophoritis, pancreatitis

A

mumps

70
Q

herpangina pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)

A

coxsackievirus

71
Q

herpangina occurs in (adults/children)

A

children, painful vesicles or small white papules on erythematous base at junction of hard and soft palate

72
Q

hand-foot-mouth dz pathogen: (HSV1/paramyxovirus/coxsackievirus/EBV)

A

coxsackievirus, vesicles located in mouth and distal extremities, children

73
Q

cervicofacial draining sinus tract, sulfur granules in pus pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)

A

cervicofacial actinomyces: actinomyces israelii

74
Q

diptheria genus

A

corynebacterium. toxin produces “shaggy” gray pseudomebrane in posterior pharynx and upper airways

75
Q

peritonsillar abscess pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)

A

S pyogenes.

76
Q

“hot potato” voice, foul smelling breath, uvula deviates to one side: (diptheria/cervicofacial actinomyces/peritonsillar abscess/Ludwig angina)

A

peritonsillar abscess

77
Q

Ludwig angina infection from strep/eikenella corrodens, caused by:

A

dental extraction/trauma to floor of mouth. cellulitis involving submaxillary and sublingual space

78
Q

pharyngitis pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)

A

S pyogenes. potential for rheumatic fever and glomerulonephritis

79
Q

scarlet fever pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)

A

S pyogenes.

80
Q

increased risk for glomerulonephritis but no acute risk for rheumatic fever (scarlet fever/pharyngitis) due to S pyogenes

A

scarlet fever

81
Q

sialadenitis pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)

A

S aureus. bacterial inflam of major salivary gland, secondary to a calculus which obstructs the duct in postoperative patients

82
Q

molar teeth resemble mulberries, and incisors are tapered like a peg in which congenital infection

A

syphilis (treponema pallidum)

83
Q

acute necrotizing gingivitis aka Vincent gingivitis pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)

A

anaerobes: prevotella, fusobacterium, spirochetes

84
Q

oral thrush caused by which pathogen: (candida albicans/S pyogenes/anaerobes-prevotella-fusobacterium-spirochetes/actinomyces israelii/S aureus)

A

candida albicans

85
Q

Kaposi sarcoma in mouth: (soft/hard) palate is most common location, due to HHV8

A

hard

86
Q

dental caries caused by what pathogen that produces acid from sucrose fermentation

A

Strep mutans

87
Q

Behcet syndrome: recurrent aphthous ulcers, uveitis, genital ulcers. assoc with HLA-B__ and __

A

HLA-B51 and HLA-B27

88
Q

what drug discolors newly formed teeth and is therefore not recommended for children under 12

A

tetracycline

89
Q

what color teeth does congenital erythropoietic porphyria cause

A

reddish brown

90
Q

(Addison dz/Peutz-Jeghers syndrome): melanin pigmentation of lips and oral mucosa

A

P-J syndrome

91
Q

(Addison dz/Peutz-Jeghers syndrome): melanin pigmentation on buccal mucosa, increased ACTH stimulates melanocytes

A

Addison

92
Q

(glossitis/macroglossia) caused by: myxedema (primary hypothyroid), trisomy 21, systemic amyloidosis, MEN syndrome IIb

A

macroglossia. also caused by acromegaly

93
Q

(glossitis/macroglossia) caused by: iron def, Vit B12 or folate def, Vit C def/Scurvy, Pellagra/niacin def, Scarlet fever, EBV assoc hairy leukoplakia

A

glossitis

94
Q

hairy leukoplakia can progress via dysplasia to what type of cancer

A

SCC, therefore always biopsy these lesions

95
Q

MC site of leuko/erythroplakia:

A

vermillion border on lower lip

96
Q

leuko/erythroplakia risk factors

A

smoking/alcohol

97
Q

Wickham striae is assoc with what type of dysplasia/cancer

A

squamous dysplasia/SCC

98
Q

soap bubble appearance in mandible, MC odontogenic tumor

A

ameloblastoma

99
Q

MC risk factors for malignant tumors of oral cavity

A

HPV, tobacco, alcohol, denture irritation, lichen planus

100
Q

where do SCCs of the oral cavity metastasize to

A

superior jugular node

101
Q

(pleomorphic adenoma/Warthin tumor/mucoepidermoid carcinoma): heterotropic salivary gland tissue in lymph node

A

Warthin

102
Q

(pleomorphic adenoma/Warthin tumor/mucoepidermoid carcinoma): MC salivary gland tumor, female dominant, facial nerve involvement is a sign of malginancy

A

pleomorphic adenoma

103
Q

(pleomorphic adenoma/Warthin tumor/mucoepidermoid carcinoma): MC malignant salivary gland tumor, MC location is parotid gland

A

mucoepidermoid: mixture of neoplastic squamous and mucus secreting cells

104
Q

type (I/II) muscle fibers: fast twitch, white, poor in mitochondria, rich in ATPase enzymes

A

II

105
Q

type (I/II) muscle fibers: slow twitch, red, rich in mitochondria, rich in oxidative enzymes, poor in ATPase enzymes

A

I

106
Q

how do you get trichinosis?

A

T spiralis nematode from eating encysted larvae in pig muscles (calcified larvae visible on x ray)

107
Q

(trichinosis/invasive group A strep/tetanus): necrotizing fasciitis, myositis, toxic shock syndrome

A

group A strep

108
Q

(trichinosis/invasive group A strep/tetanus): caused by a gram positive anaerobic rod

A

tetanus

109
Q

(trichinosis/invasive group A strep/tetanus): spores in soil enter via closed wounds, skin popping among IV drug users, umbilical cord/circumcision site in newborns

A

tetanus

110
Q

(trichinosis/invasive group A strep/tetanus): muscle pain, periorbital edema, splinter hemorrhages

A

trichinosis

111
Q

(trichinosis/invasive group A strep/tetanus): pronounced eosinophilia

A

trichinosis

112
Q

(trichinosis/invasive group A strep/tetanus): toxin inhibits release of glycine/GABA by binding to ganglioside receptors on spinal afferent fibers

A

tetanus (tetanospasmin)

113
Q

(trichinosis/invasive group A strep/tetanus): complications include myocarditis, encephalitis.

A

trichinosis

114
Q

what pathogen causes gas gangrene

A

c perfringens

115
Q

alpha toxin (lecithinase) is virulence factor in what disease

A

c perfringens gas gangrene/myonecrosis

116
Q

(MD/DMD): XLR

A

DMD

117
Q

(MD/DMD): AD

A

myotonic dystrophy

118
Q

(MD/DMD): CTG trinucleotide repeat

A

MD

119
Q

(MD/DMD): increased serum CK at birth, decreases as muscles degenerate

A

DMD

120
Q

(MD/DMD): sagging face, frontal balding, cataracts, testicular atrophy, cardiac involvement

A

MD

121
Q

how to diagnose myasthenia gravis

A

tensilon/edrophonium test: inhibits ACh, increase in ACh reverses muscle weakness

122
Q

(myasthenia gravis/lambert eaton): autoantibodies against postsynaptic ACh receptor at NMJ, MC in women

A

MG

123
Q

(myasthenia gravis/lambert eaton): antibodies against presynaptic Ca2+ channels of NMJ, most commonly due to small cell carcinoma of lung

A

LE (paraneoplastic)

124
Q

(myasthenia gravis/lambert eaton): involves eyes

A

MG (LE usually spares the eyes)

125
Q

(myasthenia gravis/lambert eaton): assoc with thymic hyperplasia or thymoma

A

MG (thymectomy improves symptoms)

126
Q

(myasthenia gravis/lambert eaton): anticholinesterase agents do not improve symptoms

A

LE

127
Q

fluorescein dye showing dendritic corneal ulcer indicates (retinitis pigmentosum/HSV/C trachomatis/retinoblastoma)

A

HSV

128
Q

attenuation of retinal vessels and night blindness indicates (retinitis pigmentosum/HSV/C trachomatis/retinoblastoma)

A

retinitis pigmentosum

129
Q

both genes lost, clumsy, leukocoria, no red reflex indicates (retinitis pigmentosum/HSV/C trachomatis/retinoblastoma)

A

retinoblastoma

130
Q

blindness and inclusion bodies in a 6 year old, progressive scarring of conjunctiva and cornea indicates (CMV/retinitis pigmentosum/HSV/C trachomatis/retinoblastoma)

A

C trachomatis

131
Q

capillary microaneuryms and T2DM indicate (sympathetic opthalmia/melanoma in uvea/macular degeneration/diabetic retinopathy)

A

diabetic retinopathy

132
Q

shade pulled over eye indicates (sympathetic opthalmia/melanoma in uvea/macular degeneration/diabetic retinopathy)

A

melanoma in uvea

133
Q

trauma to one eye then problems with other eye several days later incidates (sympathetic opthalmia/melanoma in uvea/macular degeneration/diabetic retinopathy)

A

sympathetic opthalmia

134
Q

medications that target vascular endothelial growth factor treat (sympathetic opthalmia/melanoma in uvea/macular degeneration/diabetic retinopathy)

A

macular degeneration

135
Q

decreased vision, headaches, deepening of optic cup with excavation indicate (macular dystrophy/intraretinal hemorrhage/glaucoma/retrolental fibroplasia)

A

glaucoma (increased pressure in eye)

136
Q

AR inheritance, build up of keratan sulfate indicates (macular dystrophy/intraretinal hemorrhage/glaucoma/retrolental fibroplasia)

A

corneal stromal macular dystrophy

137
Q

complication of sickle cell disease (macular dystrophy/intraretinal hemorrhage/glaucoma/retrolental fibroplasia)

A

intraretinal hemorrhage

138
Q

oxygen toxicity in premie causes (macular dystrophy/intraretinal hemorrhage/glaucoma/retrolental fibroplasia)

A

retrolental fibroplasia

139
Q

cotton wool spots, waxy exudates, flame shaped hemorrhages indicate (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma)

A

hypertensive retinopathy

140
Q

SLE treatment with glucocorticoids result in (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma)

A

cataracts

141
Q

cloudiness, elderly patient, loss of central vision indicate (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma) due to nuclear sclerosis

A

cataracts due to nuclear sclerosis (macular degeneration also causes loss of central vision but not cloudiness)

142
Q

eye pain, clouded vision, excavation of optic cup indicates (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma)

A

primary angle closure glaucoma (shallow anterior chamber obstructing aqueous humor outflow)

143
Q

elderly patient with cherry red foveola and sudden vision loss indicates (cataracts/central retinal artery occlusion/central retinal vein occlusion/hypertensive retinopathy/primary angle closure glaucoma)

A

central retinal artery occlusion

144
Q

rigid contact lenses correct (macular degeneration/keratoconus/papilledema)

A

keratoconus

145
Q

deposits in Bruch membrane (macular degeneration/keratoconus/papilledema)

A

macular degeneration

146
Q

increased intracranial pressure due to trauma induced slow growing subdural hematoma causes (macular degeneration/keratoconus/papilledema)

A

papilledema

147
Q

tender muscles, eosinophilia, diarrhea, fever indicate (Guillian Barre/Lambert Eaton/trichinosis/Werdnig Hoffman)

A

trich (from eating poorly cooked meat, parasite)

148
Q

1 year old with flaccid paralysis, atrophy of myofibers, death by age 3 indicate (Guillian Barre/Lambert Eaton/trichinosis/Werdnig Hoffman)

A

Werdnig Hoffman

149
Q

weight loss, proximal muscle weakness, cancer indicate (Guillian Barre/Lambert Eaton/trichinosis/Werdnig Hoffman)

A

LE (paraneoplastic)

150
Q

flu like illness followed by rapid motor weakness (Guillian Barre/Lambert Eaton/trichinosis/Werdnig Hoffman)

A

Guillian Barre

151
Q

fat redistribution, ecchymoses, rounded facies, increasing muscle weakness over 2 months (ALS/Cushing/malignant hyperthermia/dermatomyositis)

A

Cushing

152
Q

spasms, increased CK, myoglobinuria, Ca channel disorder (ALS/Cushing/malignant hyperthermia/dermatomyositis)

A

malignant hyperthermia

153
Q

progressive weakness, difficulty swallowing (ALS/Cushing/malignant hyperthermia/dermatomyositis)

A

ALS

154
Q

antibody and complement mediated damage to microvasculature (ALS/Cushing/malignant hyperthermia/dermatomyositis)

A

dermatomyositis

155
Q

non progressive weakness, Gomori stain (statin induced/congenital) myopathy

A

congenital myopathy

MS II Unit 3 (10 decks)

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