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Elliot Step 1 > Random > Flashcards

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1
Q

Causes of dilated cardiomyopathy?

A

ABCCCD

Alcohol; Beriberi; Coxsackie; Cocaine; Chagas; Doxorubicin; also hemochromatosis

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2
Q

Restrictive cardiomyopathy with endomyocardial fibrosis with a prominent eosinophilic infilitrate?

A

Lofflers syndrome

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3
Q

Vasculitis due to IgA deposition following upper respiratory tract infection?

A

Henoch Schonlein– see fibrinoid necrosis

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4
Q

Destruction of helminths?

A

Major basic protein released by eosinophils

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5
Q

CD4<50

A

Pneumocystis– TMP SMX
Toxoplasma– TMP SMX
Avium– Azithromycin

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6
Q

Treatment of histoplasma? (commonly seen in HIV patient from endemic area with CD4 under 150)

A

Itraconazole

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7
Q

Copper arsenic and gold antidote?

A

Penicillinamase

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8
Q

Erosions are in?

A

Mucosa only

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9
Q

Collaterals

a) superior epigastric to? aka internal thoracic or mammary
b) Sup pancreaticodudodenal
c) Middle colic
d) Superior rectal

A

a) inf epigastric (external iliac)
b) inf pancreaticodudoenal (SMA)
c) middle colic to left colic
d) superior rectal to middle and inferior rectal i.e. IMA to internal iliac

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10
Q

Rectum above pectinate drains into?

Below pectinate drains into?

A

Above inferior mesenteric vein– adenocarcinoma

Below internal iliac vein– squamous

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11
Q

Zone in liver commonly affected by viral hepatitis?

A

zone 1

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12
Q

Zone in liver first affected by ischemia?

A

zone 3– most sensitive to toxic injury

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13
Q

Two AA that are potent stimulators of gastrin?

A

Phenylalanine and tryptophan

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14
Q

Motilin receptor agonist used to stimulate intestinal peristalssis/

A

Erythromycin

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15
Q

How does gastrin increase acid secretion?

A

Through ECL cells–>histamine release (rather than acting directly on the parietal cells themselves)

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16
Q

ACh–>M3 activation–>?

A

Gq–>phospholipase C– IP3/Ca–>H/K atapase

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17
Q

only…..are absorbed by enterocytes?

A

Monosaccharides

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18
Q

What are bile acids conjugated to to make them water soluble?

A

Taurine and glycine

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19
Q

Malignant tumor with mucinous and squamous components of parotid gland– involves what nerve?

A

Mucoepidermoid carcinoma– involves facial nerve

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20
Q

ingestion of cleaning products associated with?

A

esophageal strictures

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21
Q

Esophageal squamous cell carcinoma?

A

Areas of keratinization in well differentiated tumor

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22
Q

65 yo male Pt. presents with steatorrhea, pain in joints, confusion

A

Whipples– PAS positive– foamy macrophages in LAMINA PROPRIA

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23
Q

3 key features of celic?

A

Intraepithelial CD8 T cells in lamina propria!
Cryp hyperplasia
Villous atrophy— see loss of villi on histology

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24
Q

Abetalipoproteinemia have RBCs associated with?

A

Thorny projections called acanthocytes

Cannot aborb essential fatty acids— mutation in microsomal triglyceride transfer protein– MTP

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25
Q

Pernicious anemia affects with part of stomach?

H pylori affects which part of stomach?

A

Anemia Body

Bacterium Antrum

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26
Q

Histology of Hpylori gastritis?

A

Intraepithelial neutrophils

subepithelial plasma cells

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27
Q

Gastric adenocarcinoma often presents with?

A

Acanthosis nigricans

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28
Q

Diffuse adenocarcinoma associated with?

A

Signet ring cellss

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29
Q

Hpylori virulence?

A

Flagella; adehsins; urease; CagA

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30
Q

Rupture of posterior wall of duodenum–?

A

bleeding form gastrodudodenal

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31
Q

ulcer perforations are more common….?

Ulcer hemorrhages are more common…?

A

1) perforationsa re more common anteriorly

2) Hemorrhages are more common posteriorly

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32
Q

String sign on barium swallow?

A

Crohn’s disease

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33
Q

Crohns is Th?

UC is Th?

A

crohns th1

UC th2

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34
Q

Friable mucosal pseudopolyps with freely hanging mesentery?

A

Ulcerative colitis

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35
Q

Cause of appendicitis in children? adults?

A

Children? lymphoid hyperplasia

Adults? Fecalith

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36
Q

Difference between Meckels and omphaloesenteric cyst?

A

Meckels is PERSISTENT vitelline duct

Omphalomesenteric cyst is cystic dilation of vitelline duct

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37
Q

Child presents with painless rectal bleeding– what should you always suspect?

A

Meckels– persistence of vitelline duct– diagnose with pertechnate study

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38
Q

What does sessile mean?

A

Fixed in one place

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39
Q

Apple core lesion on barium swallow?

A

Colorectal cancer

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40
Q

Most common area of colorectal cancer?

A

Rectosigmoid then Ascending then descending

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41
Q

CEA tumor marker?

A

Good for monitoring recurrent of CRC; not for screening

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42
Q

Describe transition from normal colon to carcinoma

A

Loss of APC then KRAS mutation then Loss of p53

Remember: KRAS is an activating mutation!

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43
Q

Carcinoid tumors are derived from? what do you see on hisotlogy? may cause depletion of?

A

neuroendocrine cells–

See Dense core bodies–

Carcinoid tumors uses tryptophan to make 5HT– tryptophan is also used for niacin so may ahve niacin deficiency

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44
Q

Stimulates fibrosis?

Induces vascular remodeling and stimulates fibroblast growth factor for collagen synthesis

A

1–TGF beta stimulates fibrosis

2– PDGF induces vascular remodeling

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45
Q

Child comes in with hypoglycemia; hepatomegaly and fatty liver– what is MOA of causative agent?

A

Aspirin metabolites decrease beta oxidation by reversible inhibition of mitochondrial enzymes–REYES SYNDROME

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46
Q

Pathology of alcoholic hepatitis?

A

Swollen and necrotic hepatocytes with neutrophilic infiltration– mallory bodies are intracytoplasmic eosinophilic inclusions

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47
Q

Pathology of alcoholic cirrhosis?

A

Sclerosis around central vein (zone III)

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48
Q

Liver mass associated with oral contraceptive use?

A

Hepatic ADENoma

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49
Q

Misfolded gene product proteins aggregated in hepatocellular ER?

A

alpha 1 antitrypsan

This causes cirrhosis with PAS positive globules in liver

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50
Q

Hemochromatosis is associated with HLA…?

A

HLA3

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51
Q

Black gallstones? Brown?

A

Hemolysis

Brown= infection

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52
Q

MUMPs can cause acute pancreatitis

A

freebie

53
Q

Complication of acute pancreatitis?

A

Pancreatic pseudocyst lined by GRANULATION tissue which can rupture and hemorrhage

54
Q

Redness and tenderness on palpation of extremities

A

Migratory thrombophlebitis– Trousseaus syndrome– pancreatic carcinoma

55
Q

Southwestern blot detects?

A

DNA binding protein

56
Q

Path of primary biliary cirrhosis

A

lymphocytic infiltration and granulomatous destruction of intralobular ducts

57
Q

DDx for xanthelesama?

A

Primary biliary cirrhosis and hypercholesterolemia

58
Q

99mTc pertechtanate ?

A

Detects gastric mucosa

59
Q

Colonic diverticula?

A

outpouchings of mucosa and submucosa

60
Q

most common type of colonic polyp?

A

hyperplastic polyp– serrated appearance

61
Q

Two bugs that cause biliary tract infection?

A

Ascaris– roundworm

Clonorchis– endemic to china, korea, and vietnam– also increased risk for cholangiocarcinoma

62
Q

HEV infection?

A

In pregnant women associated with fulminant hepatitis and massive hepatic necrosis

63
Q

Pathology of viral hepatitis?

A

Inflammation of lobules and portal tracts characterized by apoptosis of hepatocytes

64
Q

Fibrosis in cirrhosis is mediated by?

A

TGF beta from stellate cells

65
Q

Thick mucoid capsule?

A

Klebsiella

66
Q

Legionella is best visualized by?

A

silver stain

67
Q

IgM against RBCs causing cold hemolytic anemia?

A

Mycoplasma pneumonia

68
Q

Causes pneumonia; does not require arthropod vector (survives as highly resistant endospores and does not produce a skin rash

A

Coxiella– things that distinguish it from other rickettsia

69
Q

Where does mutant A1AT accumulate?

A

Misfolded protein accumulates in endoplasmic reticulum of hepatocytes– PAS positive globules in hepatocytes

70
Q

What is the cause of the hypoxemia in emphysema?

A

DESTRUCTION OF CAPILLARIES IN ALVEOLAR SAC

71
Q

WHAT IS CAUSE OF HYPOXEMIA IN EMPHYSEMA

A

DESTRUCTION OF CAPILLARIES IN ALVEOLAR SACS

72
Q

Path of asthma?

A

1) epithelial desquamation
2) smooth muscle hypertrophy
3) mucous plugging
4) BM thickening
5) NO destruction of alveoli or fibrosis

73
Q

Charcot leyden crystals?

A

Eosinophils derived crystals seen in asthma

74
Q

Antimetabolite that causes photosensitivity?

A

5FU

75
Q

idiopathic pulmonary fibrosis mediated by?

A

tgf beta

76
Q

honeycomb lung

A

pulmonary fibrosis

77
Q

joint pain; coal worker; fibrosis of lungs

A

Caplan syndrome= RA plus diffuse fibrosis– results in carbon laden macrophages that are not clinically significant

78
Q

egg shell calcifications

A

silicosis– increased risk for TB

79
Q

lung cancer derived from neuroendocrine cells?

A

small cell– may produce ADH or ACTH or cause eaton lambert

80
Q

lung cancer that may produce PTHrP

A

squamous cell

81
Q

adenocarcinomas are found?

A

peripherally

82
Q

Columnar cells that grow along preexisting bronchioles and alveoli– type of lung cancer

A

Bronchioalveolar carcinoma– may present with pneumonia like consolidation on imaging

ON HISTOLOGY LOTS OF DARK PINK (NO CELLULARITY) WITH CONNECTING TALL COLUMNAR CELLS

83
Q

Polyp like mass in bronchus?

A

Carcinoid– chromogranin positive

84
Q

granulomatous vasculitis?

A

temporal arteritis

85
Q

Young adult; melena with abdominal pain; skin lesions; hypertension; confusion

A

Polyarteritis nodosa– spares the LUNGS; associated with Hep B surface antigen

86
Q

String of pearls appearance on imaging; fibrinoid necrosis; vasculitis

A

Polyarteritis nodosa

87
Q

45 yo man sinusitis and ulcer in nasopharynx, coughing up blood; hematuria

A

Wegeners; rapidly progressive glomerulonephritis causes the hematuria

88
Q

What is the difference between wegeners and microscopic polyangitis

A

microscopic polyangitis does not have granulomas OR nasopharyngeal involvement

89
Q

Churg strauss particularly affects?

A

Lung and heart; eosinphils in multiple organs; p-ANCA levels correlate with disease activity

90
Q

Purple spot on but and legs; GI pain and bleeding; hematuria; child was sick two weeks ago

A

IgA nephropathy– henoch shonlein purpura

91
Q

Describe pathogenesis of arteriosclerosis?

A

1) Damage to endothelium and lipid leak into intima–>2) lipids are oxidized and then consumed by macrophages via scavenger receptors resulting in foam cells–>3)Inflammation and healing leads to deposition of ECM and proliferation of smooth msucle

92
Q

Describe pathogenesis of arteriosclerosis?

A

1) Damage to endothelium and lipid leak into intima–>2) lipids are oxidized and then consumed by macrophages via scavenger receptors resulting in foam cells–>3)Inflammation and healing leads to deposition of ECM and proliferation of smooth msucle

93
Q

Intrinsic tyrosine kinase/

A

Insulin (intrinsic); think growth factors; IGF; PDGF

94
Q

RPF is best estimated using?

A

PAH

95
Q

hyperplastic arteriolosclerosis is a consequence of?

A

malignant hypertension

96
Q

hypotension pulsatile mass and flank pain?

A

abdominal aortic aneurysm

97
Q

EKG shows what on prinzemetal angina?

A

transumural ischemia===st segment elevation

98
Q

Infarcation of posterior wall caused by block in which artery?

A

Right coronary artery

99
Q

infarcatino of left circumflex causes?

A

lateral wall infarction

100
Q

Morphological changes of myocardium at 12 hours? 48 hours; 5 days? 2 weeks? months?

A

12 hours= coagulative necrosis; dark discoloration– removes nucleus; at risk for arrhythmia
48 hours= neutrophils– fibrinous pericarditis may arise (chest pain with friction rub)

5 days= macrophages– may lead to rupture of ventricular free wall–>cardiac tamponade

2 weeks= red border emerges as granulation tissue enters from edge of infarct– granulation tissue with plump fibroblasts, collagen, and blod vessels are seen on histology

months= white scar; fibrosis; dressler syndrome, aneurysm mural thrombus

101
Q

6 drugs that cause hyperkalemia?

A

1) ARBs 2) ACEI 3) Nonselective Beta blockers 4) Cardiac glycosides 5) K sparing diuretics 6) NSAIDs

102
Q

Paradoxical splitting caused by?

A

Delayed left ventricular ejection

103
Q

Heart findings in marfans?

A

Cystic medial degeneration of aorta

104
Q

Murmurs that are increased by valsalva or abrupt standing?

A

Mitral valve prolapse or HCM

105
Q

Mitral valve prolapse and HCM decrease on?

A

Squatting or passive leg raise

106
Q

Which ions are increased in myocytes when there is no ATP?

A

Ca and Na

107
Q

Prevents cholesterol reabsorption at small intestine brush border

A

ezetimibe

108
Q

Gray hepatization ?

A

degradation of RBCs within the pulmonary exudate

109
Q

Alveolar exudate contains neutrophils, fibrin, and erythrocytes

A

Red hepatization

110
Q

Gynecomastia and galactorrhea– lung cancer?

A

Large cell (large breasts)

111
Q

thrombocytopenia; hypoxemia; neurologic abnormaltities; petechial rash

A

fat embolus– platelets coat fat microglobules causing thrombocytopenia

112
Q

Eggshel calcification

A

silicosis– may disrupt phagolysosomes and impair macrophages increasing susceptibility to TB

113
Q

Asbestosis affects this part of the lung while silicosis affects this part of the lugn

A

Silicosis upper

Asbestosis lower

114
Q

initial damage of alveoli in ARDS is dt?

A

release of neutrophilic substances toxic to alveolar wall, activation of coagulation cascade and oxygen derived free radicals–WHITE OUT ON CHEST XRAY

115
Q

white out on chest xray?

A

ARDS

116
Q

Difference in physical findings between pleural effusion and atelectasis (bronchial obsturction)?

A

atelectasis has tracheal deviation (toward side of lesion) while pleural effusion doesn’t

117
Q

hemorrhagic pleural effusions and pleural thickening

A

Mesothelioma– and see psammoma bodies

118
Q

intraalveolar exudate?

A

lobar pneumonia

119
Q

treatment of paroxysmal nocturnal hemoglobinuria

A

eculizumab

120
Q

venous thrombosis; pancytopenia; and hemolytic anemia

A

PNH

121
Q

Endomyocardial fibrosis with prominent eosinophilic infiltrates and hemochromatosis

A

Lofflers syndrome

122
Q

White spots on retina surrounded by hemorrhage

A

roth spots of bacterial endocarditis

123
Q

Drugs/states that cause digoxin toxicity

A

renal failure; hypokalemia; quinidine

124
Q

class of antiarrhythmics that cause thrombocytopenia?

A

IA

125
Q

high hcg

A

Downsyndrome, chorio, dysgerminoma,hydaditiform mole

126
Q

Prevent nephrotoxicity of cisplatin with?

A

amifostine

127
Q

1 of 2 viruses that infect a cell has a mutation that results in a nonfunctional protein. the nonmutated virus helps out the mutated one by making a functional protein that serves both viruses

A

Complementation

128
Q

Genome of virus A coated with surface proteins of virus b?

A

Phenotypic mixing

Elliot Step 1 (32 decks)

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