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Kaplan QBank > Random Facts > Flashcards

Random Facts Flashcards

1
Q

Multiple myeloma intracellular inclusion bodies

A

Russell bodies (filled with immunoglobulins)

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2
Q

Secondary sexual characteristics

A

Breast development is estrogen

But in females pubic and axillary hair is testosterone

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3
Q

Progressive supranuclear palsy

A

Truncal dystonia
Pseudobulbar palsy
Ophthalmoplegia
Bradykinesia

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4
Q

Pre-renal failure vs. ATN

A

FENa < 1% vs > 2%

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5
Q

Von Recklinghausen disease

A

Neurofibromatosis I

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6
Q

Hashimoto thyroiditis cancer risk

A

Non-Hodgkin B-cell lymphoma (thyroid)
More specifically, diffuse large B cell lymphoma
Associated with MALToma
Can cause tracheal/esophageal compression

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7
Q

Unilateral flank pain radiating to the GROIN

A

Ureteral irritation - kidney stone

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8
Q

DCC (Deleted in Colorectal Cancer) is associated with

A

DPC (Deleted in Pancreatic Cancer) on Chr18q

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9
Q

ABO incompatibility in newborn

A

Low hematocrit and jaundice hours after birth
Typically O mother against A or B newborn
A is more common and milder
B is more severe with hemolysis
Does not cause hydrops fetalis like anti-Rh does
Low A or B expression leads to mild disease
Splenic clearance rather than intravascular hemolysis
Microspherocytes produced from splenic clearance of antibody-tagged A/B groups

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10
Q

Diffuse renal cortical necrosis in the setting of infection

A

Caused by DIC

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11
Q

Ito cells

A

Also called stellate cells
Lives in the space of Disse in the liver
Stores fats and vitamin A

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12
Q

BPs in aortic regurgitation

A

Elevated pulse pressure w/ normal or low MAP

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13
Q

PVCs

A

Usually not preceded by a P wave
Abnormal nodal generation in the ventricles
Main effect is decreased preload on the beat
Atrial contraction w/ ventricular contraction causes significantly higher atrial pressures and a CANNON A wave

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14
Q

Triggers of aldosterone release

A

1) Angiotensin II
2) High potassium
NOT affected by ACTH

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15
Q

Hemochromatosis iron load

A

Some patients can exceed 50g which is large enough to trigger airport metal detectors

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16
Q

Lung adenocarcinoma risk

A

Old scaring and inflammation (such as from pneumonia)

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17
Q

Chronic meningitis causes

A

Most common is tuberculosis
Also present are Brucellosis, syphilis & fungal infections
Lymphocytes, plasma cells and macrophages
Protein UP, glucose DOWN and ICP mild UP

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18
Q

Anti-helminth medication that is safe in pregnancy

A

Pyrantel palmoate

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19
Q

Neisseria gonorrhea presentation

A

Affects the knee and ankle most often
Also petechial rash over tendon sheath (tenosynovitis)
CAN be blood culture negative and still cause significant disease because of the large load in joints

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20
Q

Nonimmunogenic bacterial capsules

A 
Neisseria meningitidis (but not gonorrhea)
Steptococcus pyogenes
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21
Q

Superior rectus testing

A

Ability to elevate the eye when abducted

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22
Q

Inferior oblique testing

A

Ability to elevate the eye when adducted

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23
Q

Inferior rectus testing

A

Ability to depress the eye when abducted

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24
Q

Superior oblique testing

A

Ability to depress the eye when adducted

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25
Q

Diabetes mellitus II and ADH interaction

A

DM II can cause significant osmotic diuresis and over time abolish the medullary solute gradient required for the reabsorption of water from the collecting ducts under the influence of ADH - supplemental ADH will not work

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26
Q

“Broad-spectrum antibiotics” trigger

A

Depletion of gut flora
Can cause C. difficile if not covered
Can cause vitamin K deficiency & bleeding complication

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27
Q

Mistreatment of EBV mononucleosis

A

Mistaken for strep pharyngitis

Treat w/ amoxicillin and leads to maculopapular rash 1-2 weeks later

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28
Q

NO and atherosclerosis

A

NO has anti-atherosclerotic properties and is downregulated in fatty-streaks that progress

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29
Q

Dividing line for sensation IX and X

A

Upper vs lower poster pharynx

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30
Q

Increased rise in glomerular capillary oncotic pressure

A

Means decreased RPF (RBF)

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31
Q

Bence-Jones protein composition

A

Full IgGs are not filtered by the normal kidney

Light chain can be filtered and is usually kappa

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32
Q

Short saphenous vein drainage

A

Only drains the lateral dorsum of the foot (drains into popliteal fossa)
The rest of the lower extremities drains by the long saphenous vein into the inguinal region

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33
Q

Phage toxins

A 
C. botulinum
Cholera toxin
Shiga toxin
Diptheria toxin
Erythrogenic toxin of S. pyogenes
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34
Q

CD14 cell type

A

Macrophages (endotoxin receptor)

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35
Q

Phenotypic distinction between pemphigus and goid

A

Vulgaris affects the oral mucosal membrane and the bulla are flaccid

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36
Q

Creatinine estimation of GFR

A

Overestimates GFR because it is secreted in the PCT

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37
Q

Keratoderma blennorrhagicum

A

Complication of Reiter syndrome
(Conjunctivitis, urethritis, arthritis)
1) Lesions of the palm and sole that looks like pustular psoriasis
2) Lesions of the tongue w/ ulceration and microabscesses known as spongiform pustules
3) Balanitis circinata

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38
Q

Endometritis histology requirement

A

Endometrial hyperproliferation with marked inflammatory cell infiltration - presence of plasma cells required

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39
Q

Locked-in syndrome damage

A

Basillar artery infarction affecting the ventral pons, disruption the corticospinal and corticobulbar fibers, leading to no facial, pharyngeal or limb movements
Only vertical eye movements and eyelid is preserved

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40
Q

Gastroschisis

A

Incomplete fusion of the lateral body folds

Typically occurs just right of the midline where the right umbilical vein regresses

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41
Q

Exceptions to permission

A

1) Emergency
2) Therapeutic privilege
3) Patient incompetency
4) Waiver by patient

42
Q

Neonatal chlamydia infection

A

Conjunctivitis precedes pneumonia
Tachypnea, hypoxemia, crackles, wheezing and MOST importantly EOSINOPHILIA
Can also have staccato cough (single cough broken up by inspiration)
X-ray shows scattered infiltrates with hyperinflation

43
Q

Metoprolol side effects

A

Dyslipidemia, sexual dysfunction, bronchospasm

44
Q

Mean circulatory filling pressure

A

The pressure in the circulatory system if the heart is stopped
Used as a generalized measurement of tone in the vasculature - increased MCFP increases cardiac return

45
Q

RecA in bacteria

A

Recombinase A is used to carryout homologous recombination which is used to transfer DNA - only F+ to F- does not require recA and is purely a replicative process

46
Q

Atrophic gastritis histology

A

Gastric epithelium undergoes intestinal metaplasia
Associated with pernicious anemia
Develops megaloblastic anemia over several years
Replacement of gastric parietal and chief cells with goblet cells

47
Q

Acute intermittent porphyria inheritance method

A

Autosomal dominant

Triggered by certain drugs such that ramps up P450

48
Q

Medulloblastoma histology

A

Both glial and neuronal differentiation
Primitive neuroectoderm tumor
Highly differentiated and has neuroglial precursor
Commonly occurs in children (75%) in cerebellar vermis
Vermis leads to truncal ataxia
Adults typically in cerebellar hemispheres
Densely packed cells w/ occasional GFAP and rosettes

49
Q

Friedreich ataxia

A

Autosomal resessive - most common hereditary ataxia
Chr9 MITCHONDRIAL protein frataxin w/ GAA repeats
Iron-binding protein - lack leads to iron overload stress
Demyelination of large fibers:
1) Peripheral nerves
2) Dorsal columns
3) Spinocerebellar tract
4) Corticospinal tract
Progressive ataxia and discoordination
Scoliosis and rocker-bottom feet

50
Q

Lactoferrin

A

Contained in the specific granules of neutrophils

Binds iron and interferes w/ metabolism to stop growth

51
Q

Myeloperoxidase location

A

Azurophilic granules of neutrophils

52
Q

Lacunar cells

A

Nodular sclerosing Hodgkin lymphoma

53
Q

Spinal anesthesia effects on cardiac function curve

A 
Blocks sympathetic nervous system
Decreases MSFP (shift venous return to left)
Decreases cardiac contractility (rotates CO down)
54
Q

Philadelphia chromosome

A

t(9;22)

55
Q

How can orotic aciduria also cause microcytosis

A

d-ALA synthase has a short half life and requires constant synthesis - decrease pyrimidines not only decreases DNA synthesis but also RNA, and thus decreased transcription as well!

56
Q

Bile acid circulation

A

Primary bile acid - 90% reabsorbed (conjugated) in distal ileum - 10% moves onto the colon and becomes deconjugated - secondary bile acid - 8% reabsorbed passively and reconjugated by hepatocytes - remaining 2% excreted into feces

57
Q

Rosenthal fibers

A

Pilocytic astrocytoma

58
Q

Thyroid hormone regulation of growth

A

T3 induces GH secretion from anterior pituitary

59
Q

Menkes disease

A

Autosomal recessive
Mutation in ATP7A which transports copper from intestinal mucosal cells into bloodstream
Severe copper deficiency (low ceruloplasmin; low Cu)
1) Lysyl oxidase (collagen disorder - skin and vessels)
2) Tyrosinase (depigmentation - skin and hair)
3) Cytochrome C oxidase (metabolics - neuro)

60
Q

4 degree bacterial selection

A

Listeria monocytogenes or Yersinia enterocolitica

61
Q

42 degree bacterial selection

A

Campylobacter jejuni

62
Q

Sorbitol MacConkey bacterial selection

A

EHEC is the only E. coli species that does NOT ferment sorbitol

63
Q

Alternative treatment for Leishmaniasis

A

Limited cutaneous = sodium stibogluconate

Diffuse cutaneous and visceral = amphotericin B

64
Q

APC chromosome #

A

5

65
Q

Frataxin chromosome #

A

9

66
Q

BRCA chromosome #

A

17

67
Q

VHL chromosome #

A

3

68
Q

Long-term hypertension and vascular remodeling

A

DECREASED arteriolar density due to “arteriolar rarefaction” phenomenon where persistent hyperperfusion of tissues leads to vasoconstriction and eventual resorption of arterioles

69
Q

Mechanism of basophilic stippling in erythrocytes

A

Stipples are aggregated ribosomes

Lead inhibits 5-nucleotidase which degrades rRNA in ribosomes and inhibition leads to decreased turnover

70
Q

Strange pulmonary paraneoplastic syndrome

A

Hypertrophic osteoarthropathy

1) Bronchogenic carcinoma
2) Benign mesothelioma
3) Diaphragmatic neurilemmona

71
Q

Cardiac tamponade vs restrictive pericarditis

A

NO Kussmaul sign (increased JVD on inspiration)

Prominent X descent but dulled or no Y descent vs. prominent X and Y descents

72
Q

Needle passage in lumbar puncture

A

Skin - superficial fascia - deep fascia - supraspinous ligament - interspinous ligament - ligamentum flavum - epidural space - dura - arachnoid - subarachnoid space

1) Epidural anesthesia = epidural space
2) Spinal anesthesia = subarachnoid space

73
Q

Additional neoplasms in MEN 1

A

Angiofibroma
Lipoma
Most common pancreatic carcinoma secretes gastrin

74
Q

Tonic vs atonic seizures

A

Full body tension vs relaxation (both patients fall)
Atonic more common in adults while tonic is in children
Atonic rarely has postictal state and is brief

75
Q

Neonatal jaundice treatment ADDITION

A

Phototherapy and phenobarbital

Riboflavin is also sensitive to light and will degrade (MUST supplement B2 as well)

76
Q

Most common bacterial STD in USA

A

C. trachomatis

77
Q

ELEK test

A

Immunodiffusion test to identify toxin-producing strains of Corynebacterium diphtheriae

78
Q

Xeroderma pigmentosum

A

Autosomal recessive

Defect in nucleotide excision repair leading to accumulation of thymine dimers

79
Q

Neuroblastoma

A

Normally asymptomatic and detected on physical exam
Pain and neurological symptoms arise from spinal cord invasion and compression
1p deletion and/or N-myc amplification
N-myc amplification associated with poorer prognosis
Cellular aneuploidy and younger age at presentation actually gives better prognosis

80
Q

Malarial defense

A

Erythrogenic phase - main protection is NK cells because RBCs do not express MHC I and cannot be recognized by cytotoxic T cells
Also protection from antibodies, complement, opsonization and splenic clearance

81
Q

Heparin-induced thrombocytopenia

A

HIT I occurs 1-2 days after administration and is NOT an immune-mediated process
HIT II also called heparin-induced thrombocytopenia and THROMBOSIS (HITT) occurs 7-14 days after and requires acute anticoagulation to prevent infarctions (usually with lepirudin)

82
Q

Distinct swelling of a solitary finger/toe after URI/GI

A 
Reiter syndrome
Also seen in psoriatic arthritis
Chlamydia
Campylobacter
Salmonella
Shigella
Yersinia
83
Q

Schuffner dots

A

Seen on peripheral blood smear in patients infected with malaria specific for vivax and ovale

84
Q

Diseases co-infected with Lyme

A

1) Babesia microti

2) Ehrlichia chaffeensis

85
Q

Menetrier disease mechanism

A

Increased TGF-a leading to gastric mucus-cell hyperplasia and rugae thickening
Also known as protein-losing gastroenteropathy

86
Q

Berry-like clusters inside phagocytes (morulae)

A

Human granulocytic anaplasmosis
Formerly called human granulocytic ehrlichiosis
Caused by Anaplasma phagocytophilum
Transmitted by ixodes ticks
Presents like Rocky mountain spotted fever but without the rash

87
Q

Intramembranous bones

A

Skull
Clavicles
Cleidocranial dysostosis - absence of part of the clavicle with a broad skull and facial/dental abnormalities

88
Q

Another name for De Quervain thyroiditis

A

Subacute granulomatous thyroiditis
Tender and painful thyroid enlargement with mild thyroid hormone elevation and TSH depression
Occurs after an viral infection
granulomas with multinucleated giant cells

89
Q

Absence (petit-mal) seizure induction

A

Can be induced by hyperventilating

3-Hz spike and wave complex on EEG

90
Q

Conditions that decrease ESR

A

1) Sickle-cell
2) Polycythemia
3) Congestive heart failure

91
Q

Liver metabolic functions in cirrhosis

A

Phase I functions (oxidation) decreased
Phase II functions (conjugation) remains fairly normal
This is why conjugated bilirubin levels remain relatively balanced throughout liver disease until end-stage

92
Q

Grey baby syndrome symptoms

A

In order of appearance

1) Abdominal distension (w or w/o emesis)
2) Pallor and cyanosis
3) Vasomotor collapse
4) Irregular breathing
5) Greenish stool
6) Lactic acidosis

93
Q

Paraneoplastic cerebellar degeneration

A

1) Lung
2) Ovarian
3) Breast
4) Hodgkin’s lymphoma

94
Q

Leser-Trelat sign

A

Sudden eruption of countless seborrheic keratoses, usually with an inflammatory base on the back and trunk

1) Pancreatic
2) Hepatic
3) Colorectal
4) Gastric
5) Lung
6) Breast

95
Q

Necrolytic migratory erythema

A

Red blistering rash that spreads across the lower abdomen, buttocks, perineum and groin
Immunofluorescence negative
Parakeratosis and epidermal necrosis
Associated with GLUCAGONOMA

96
Q

Pyoderma gangrenosum

A

Necrotic ulcer that initially appears like a bug bite but progresses into a large deep ulcer; typically on the leg
Bullous, pustular, vegetative and peristomal
Thought to be due to neutrophil dysfunction
1) Ulcerative colitis
2) Crohn’s disease
3) Rheumatoid arthritis
4) Seronegative arthritis
5) Hematological cancers (MM in particular)

97
Q

Acanthosis nigricans as paraneoplastic syndrome

A

Mnemonic GLU

1) Gastric
2) Lung
3) Uterine

98
Q

Pertussis side effects

A

ADP-ribosylation of Gi increases cAMP

1) Lymphocyte dysfunction
2) Increased insulin release and HYPOGLYCEMIA
3) Increased histamine sensitivity

99
Q

Most common cause of spontaneous abortion

A

Massive chromosomal abnormalities

1) Trisomy 16
2) Triploidy (2 sperms)
3) 46 XO (VIABLE)

100
Q

Glucagon - epinephrine - cortisol

A

Glucagon - only decreases glycogen synthesis in LIVER
Epinephrine - increases glycogenolysis EVERYWHERE
Cortisol - increases glycogenolysis in muscle and fat but DECREASES glycogenolysis and INCREASES glycogen synthesis in the liver

101
Q

Cortisol effect on bone

A

Osteoblast - decrease function and proliferation
Osteoclast - stimulate differentiation but increasing RANKL expression and decreasing osteoprotegerin expression
Also decreases Ca intestinal absorption and increases renal Ca excretion

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