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*USMLE* > Patho - General > Flashcards

Patho - General Flashcards

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USMLE® Step 1 flashcards
1
Q

Plummer-Vinson Syndrome

details and tx

A

dysphagia and IDA

IDA > weakness, fatigue and dyspnea
dysphagia via esophageal webbing
shiny red tongue via papillary atrophy

tx with iron supplementation

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2
Q

Tumors with Psammoma bodies

A

meningioma
papillary thyroid carcinoma
mesothelioma
papillary serous carcinoma of breast + ovary

MMPtPbo

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3
Q

Lambert-Eaton Myasthenic Syndrome

s/s, pathophys, associations, differential

A

S/S: GAIT issues, difficulty standing from chair/climbing stairs, AUTONOMIC issues (dry mouth, impotence), OCULOBULBAR issues (diplopia, ptosis, dysarthria/-phagia) and HYPORELFEXIA

pathophys: anti-VDCC autoantibodies affect ACh release
association: malignancy, especially SCLC
differential: myasthenia gravis does not have hyporeflexia, autonomic sx; LEMS has incremental response to repetitive stimulation (MG gets worse with repetitive stim)

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4
Q

Adenoma-Carcinoma sequence in colon cancer

A

Normal colon

APC inactivation with beta-catenin accumulation > hyperproliferative epithelium

KRAS activation > adenoma formation

p53 inactivation > carcinoma formation

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5
Q

Thymoma-associated paraneoplasia

A

myasthenia gravis

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6
Q

Cancer assoc. with hypercalcemia via hormone production (which cancer + which hormone)

A

SQUAMOUS cell lung cancer

PTHrP (not PTH)

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7
Q

Cancers assoc. with Cushing syndrome

other than pituitary or adrenal adenoma

A

SCLC or pancreatic cancer

ectopic ACTH or CRH

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8
Q

Paroxysmal Nocturnal Hemoglobinuria

pathophys, s/s, main organ involved + how?

A

mutation of PIGA gene > impaired GPI anchor protein > impaired anchoring of CD55 (DAF) and CD56 (MAC inhibitory protein) > complement-mediated hemolysis

hemolytic anemia
pancytopenia
thrombosis - at atypical sites; hepatic, portal + cerebral vv.
kidney - HEMOSIDEROSIS + thrombosis > CKD

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9
Q

MEN type 1

A

pituitary adenoma, primary hyperparathyroidism and pancreatic endocrine tumor

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10
Q

MEN type 2A

A

RET mutation

medullary thyroid cancer - more aggressive and earlier than sporadic MTC

pheochromocytoma

primary hyperparathyroidism (parathyroid hyperplasia)

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11
Q

MEN type 2B

A

RET mutation

medullary thyroid cancer - more aggressive and earlier than sporadic MTC

pheochromocytoma

mucosal neuromas
marfanoid habitus

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12
Q

Specific risk factors for PANCREATIC and PROSTATE cancer

A

pancreatic - smoking, obesity

prostate - age and african-american

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13
Q

Specific risk factors for BLADDER and RENAL cancers

A

renal - smoking, obesity, hypertension; toxin exposure (HEAVY METALS, PETROLEUM)

bladder - smoking, OCCUPATIONAL EXPOSURES (rubber, plastics, aromatic amine dyes, textiles, leather) SCHISTOSOMA haematobium and CYCLOPHOSPHAMIDE

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14
Q

Specific risk factors for GASTRIC and COLORECTAL cancers

A

gastric - dietary nitrate, alcohol/tobacco, H. pylori

colon - hereditary (HNPCC, FAP), IBD, obesity, charred/fried food

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15
Q

Specific risk factors for LIVER and BREAST cancers

A

liver - hepatitis B and C, cirrhosis, hemochromatosis, AFLATOXIN

breast - early menarche, late menopause, nulliparity, BRCA

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16
Q

Wilson’s Disease

epidem; organs affected; tx

A

rare AR; usually present at 5-40 y/o

mutations reduce ceruloplasmin and hepatobiliary copper secretion

liver damage - Cu is pro-oxidant
corneal deposits - Kayser-Fleischer ring (slit lamp)
basal ganglia deposits - cause atrophy

d-penicillamine or trietine for Cu chelation

17
Q

Kartagener Syndrome

inheritance + other name? triad + other s/s?

A

AR “primary ciliary dyskinesia”

triad = chronic sinusitis, bronchiectasis, situs inversus

Impaired ciliary clearance > chronic cough, sinusitis and bronchiectasia

Situs inversus - in 50% pts

Infertility - sperm flagella / fallopian cilia issues

18
Q

Tumor Grade vs. Stage

A

Grade - degree of differentiation of cells

Stage - degree of expansion + invasion (TNM); more important for prognosis!

19
Q

Turner syndrome

internal abnormalities (not musculoskeletal) + their consequences

A

CV - bicuspid aorta or COARCTATION

renal - HORSESHOE kidney

repro - STREAK OVARY, infertility, amenorrhea

20
Q

What is the gating mechanism for CFTR chloride channel?

A

ATP-gated

must bind 2 ATP before the chloride channel open

21
Q

Hemochromatosis

inheritance? main organs affected? TRIAD? labs?

A

AR disorder > high GI iron absorption

iron overload in parenchymal organs like heart, liver, pancreas

liver - HEPATOMEGALY, pain, HYPERPIGMENTATION
pancreas - islet destruction > DM (“bronze diabetes”)
impotence
arthropathy
cardiac dysfunction + enlargement

mildly high LFTS
elevated plasma iron, >50% transferrin saturation, high ferritin

22
Q

What is “oncosis”?

A

ischemic cell death

ATP depletion > ionic pump malfunction, swelling, cytosol clearing, ER/Golgi dilation, mitochondrial condensation, chromatin clumping, and cytoplasmic blebbing

23
Q

Bone mets

mnemonic for which are most common

which are lytic/blastic/mixed?

(aka lucent vs. sclerotic lesions on imaging)

A

Prostate, Breast > Kidney, Thyroid, Lung

(lead kettle = PB KTL)

SCLC, Prostate - blastic
NSCLC, Kidney, Thyroid - all lytic
Breast - mixed

24
Q

Peutz-Jegher syndrome

inheritance

s/s

complications

A

AD

Multiple hamartomas in GI tract
Hyperpigmentation of mouth, lips, hands + genitals

incr. risk of BREAST and GI cancers

25
Q

What is CHORISTOMA vs. HAMARTOMA?

A

choristoma - normal tissue in abnormal location (gastric epith in Meckel diverticulum)

hamartoma - disorganized overgrowth of tissue in native location (P-J syndrome)

26
Q

Aside from the “PB KTL” common primary tumors giving mets to bone…

what are some other cancers that give bone mets?

A

blastic - Hodgkin

mixed - GI tumors

lytic - MM, NHL and melanoma

27
Q

4 mechanisms of reperfusion injury

2 intracellular/biochem-related; 2 inflammation related

A
  1. ROS formation - by parenchyma, endoth. + WBCs
  2. Mitochondrial permeability increase - irreversible
  3. Neutrophil infiltration
  4. Complement activation
28
Q

Cellular mechanism responsible for rapid release of CREATINE KINASE into circulation in reperfusion injury

(it’s very simple…)

A

cell membrane damage

29
Q

A neoplasm is described as “not invading the stroma or vessels” but otherwise sounds malignant (rapid growth, causing significant symptoms, atypical cells etc.)…

is it considered benign or malignant?

A

still MALIGNANT just is “IN SITU” because it doesn’t invade past BM

(ex: pulmonary adenocarcinoma in situ - columnar mucinous cells in alveoli)

*USMLE* (28 decks)

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