Random Facts Flashcards
1
Q
Multiple myeloma intracellular inclusion bodies
A
Russell bodies (filled with immunoglobulins)
2
Q
Secondary sexual characteristics
A
Breast development is estrogen
But in females pubic and axillary hair is testosterone
3
Q
Progressive supranuclear palsy
A
Truncal dystonia
Pseudobulbar palsy
Ophthalmoplegia
Bradykinesia
4
Q
Pre-renal failure vs. ATN
A
FENa < 1% vs > 2%
5
Q
Von Recklinghausen disease
A
Neurofibromatosis I
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
7
Q
Unilateral flank pain radiating to the GROIN
A
Ureteral irritation - kidney stone
8
Q
DCC (Deleted in Colorectal Cancer) is associated with
A
DPC (Deleted in Pancreatic Cancer) on Chr18q
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
10
Q
Diffuse renal cortical necrosis in the setting of infection
A
Caused by DIC
11
Q
Ito cells
A
Also called stellate cells
Lives in the space of Disse in the liver
Stores fats and vitamin A
12
Q
BPs in aortic regurgitation
A
Elevated pulse pressure w/ normal or low MAP
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
14
Q
Triggers of aldosterone release
A
1) Angiotensin II
2) High potassium
NOT affected by ACTH
15
Q
Hemochromatosis iron load
A
Some patients can exceed 50g which is large enough to trigger airport metal detectors
16
Q
Lung adenocarcinoma risk
A
Old scaring and inflammation (such as from pneumonia)
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
18
Q
Anti-helminth medication that is safe in pregnancy
A
Pyrantel palmoate
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
20
Q
Nonimmunogenic bacterial capsules
A
Neisseria meningitidis (but not gonorrhea) Steptococcus pyogenes
21
Q
Superior rectus testing
A
Ability to elevate the eye when abducted
22
Q
Inferior oblique testing
A
Ability to elevate the eye when adducted
23
Q
Inferior rectus testing
A
Ability to depress the eye when abducted
24
Q
Superior oblique testing
A
Ability to depress the eye when adducted
25
Diabetes mellitus II and ADH interaction
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
26
"Broad-spectrum antibiotics" trigger
Depletion of gut flora
Can cause C. difficile if not covered
Can cause vitamin K deficiency & bleeding complication
27
Mistreatment of EBV mononucleosis
Mistaken for strep pharyngitis
| Treat w/ amoxicillin and leads to maculopapular rash 1-2 weeks later
28
NO and atherosclerosis
NO has anti-atherosclerotic properties and is downregulated in fatty-streaks that progress
29
Dividing line for sensation IX and X
Upper vs lower poster pharynx
30
Increased rise in glomerular capillary oncotic pressure
Means decreased RPF (RBF)
31
Bence-Jones protein composition
Full IgGs are not filtered by the normal kidney
| Light chain can be filtered and is usually kappa
32
Short saphenous vein drainage
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
33
Phage toxins
```
C. botulinum
Cholera toxin
Shiga toxin
Diptheria toxin
Erythrogenic toxin of S. pyogenes
```
34
CD14 cell type
Macrophages (endotoxin receptor)
35
Phenotypic distinction between pemphigus and goid
Vulgaris affects the oral mucosal membrane and the bulla are flaccid
36
Creatinine estimation of GFR
Overestimates GFR because it is secreted in the PCT
37
Keratoderma blennorrhagicum
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
38
Endometritis histology requirement
Endometrial hyperproliferation with marked inflammatory cell infiltration - presence of plasma cells required
39
Locked-in syndrome damage
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
40
Gastroschisis
Incomplete fusion of the lateral body folds
| Typically occurs just right of the midline where the right umbilical vein regresses
41
Exceptions to permission
1) Emergency
2) Therapeutic privilege
3) Patient incompetency
4) Waiver by patient
42
Neonatal chlamydia infection
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
Metoprolol side effects
Dyslipidemia, sexual dysfunction, bronchospasm
44
Mean circulatory filling pressure
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
RecA in bacteria
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
Atrophic gastritis histology
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
Acute intermittent porphyria inheritance method
Autosomal dominant
| Triggered by certain drugs such that ramps up P450
48
Medulloblastoma histology
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
Friedreich ataxia
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
Lactoferrin
Contained in the specific granules of neutrophils
| Binds iron and interferes w/ metabolism to stop growth
51
Myeloperoxidase location
Azurophilic granules of neutrophils
52
Lacunar cells
Nodular sclerosing Hodgkin lymphoma
53
Spinal anesthesia effects on cardiac function curve
```
Blocks sympathetic nervous system
Decreases MSFP (shift venous return to left)
Decreases cardiac contractility (rotates CO down)
```
54
Philadelphia chromosome
t(9;22)
55
How can orotic aciduria also cause microcytosis
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
Bile acid circulation
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
Rosenthal fibers
Pilocytic astrocytoma
58
Thyroid hormone regulation of growth
T3 induces GH secretion from anterior pituitary
59
Menkes disease
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
4 degree bacterial selection
Listeria monocytogenes or Yersinia enterocolitica
61
42 degree bacterial selection
Campylobacter jejuni
62
Sorbitol MacConkey bacterial selection
EHEC is the only E. coli species that does NOT ferment sorbitol
63
Alternative treatment for Leishmaniasis
Limited cutaneous = sodium stibogluconate
| Diffuse cutaneous and visceral = amphotericin B
64
APC chromosome #
5
65
Frataxin chromosome #
9
66
BRCA chromosome #
17
67
VHL chromosome #
3
68
Long-term hypertension and vascular remodeling
DECREASED arteriolar density due to "arteriolar rarefaction" phenomenon where persistent hyperperfusion of tissues leads to vasoconstriction and eventual resorption of arterioles
69
Mechanism of basophilic stippling in erythrocytes
Stipples are aggregated ribosomes
| Lead inhibits 5-nucleotidase which degrades rRNA in ribosomes and inhibition leads to decreased turnover
70
Strange pulmonary paraneoplastic syndrome
Hypertrophic osteoarthropathy
1) Bronchogenic carcinoma
2) Benign mesothelioma
3) Diaphragmatic neurilemmona
71
Cardiac tamponade vs restrictive pericarditis
NO Kussmaul sign (increased JVD on inspiration)
| Prominent X descent but dulled or no Y descent vs. prominent X and Y descents
72
Needle passage in lumbar puncture
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
Additional neoplasms in MEN 1
Angiofibroma
Lipoma
Most common pancreatic carcinoma secretes gastrin
74
Tonic vs atonic seizures
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
Neonatal jaundice treatment ADDITION
Phototherapy and phenobarbital
| Riboflavin is also sensitive to light and will degrade (MUST supplement B2 as well)
76
Most common bacterial STD in USA
C. trachomatis
77
ELEK test
Immunodiffusion test to identify toxin-producing strains of Corynebacterium diphtheriae
78
Xeroderma pigmentosum
Autosomal recessive
| Defect in nucleotide excision repair leading to accumulation of thymine dimers
79
Neuroblastoma
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
Malarial defense
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
Heparin-induced thrombocytopenia
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
Distinct swelling of a solitary finger/toe after URI/GI
```
Reiter syndrome
Also seen in psoriatic arthritis
Chlamydia
Campylobacter
Salmonella
Shigella
Yersinia
```
83
Schuffner dots
Seen on peripheral blood smear in patients infected with malaria specific for vivax and ovale
84
Diseases co-infected with Lyme
1) Babesia microti
| 2) Ehrlichia chaffeensis
85
Menetrier disease mechanism
Increased TGF-a leading to gastric mucus-cell hyperplasia and rugae thickening
Also known as protein-losing gastroenteropathy
86
Berry-like clusters inside phagocytes (morulae)
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
Intramembranous bones
Skull
Clavicles
Cleidocranial dysostosis - absence of part of the clavicle with a broad skull and facial/dental abnormalities
88
Another name for De Quervain thyroiditis
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
Absence (petit-mal) seizure induction
Can be induced by hyperventilating
| 3-Hz spike and wave complex on EEG
90
Conditions that decrease ESR
1) Sickle-cell
2) Polycythemia
3) Congestive heart failure
91
Liver metabolic functions in cirrhosis
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
Grey baby syndrome symptoms
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
Paraneoplastic cerebellar degeneration
1) Lung
2) Ovarian
3) Breast
4) Hodgkin's lymphoma
94
Leser-Trelat sign
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
Necrolytic migratory erythema
Red blistering rash that spreads across the lower abdomen, buttocks, perineum and groin
Immunofluorescence negative
Parakeratosis and epidermal necrosis
Associated with GLUCAGONOMA
96
Pyoderma gangrenosum
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
Acanthosis nigricans as paraneoplastic syndrome
Mnemonic GLU
1) Gastric
2) Lung
3) Uterine
98
Pertussis side effects
ADP-ribosylation of Gi increases cAMP
1) Lymphocyte dysfunction
2) Increased insulin release and HYPOGLYCEMIA
3) Increased histamine sensitivity
99
Most common cause of spontaneous abortion
Massive chromosomal abnormalities
1) Trisomy 16
2) Triploidy (2 sperms)
3) 46 XO (VIABLE)
100
Glucagon - epinephrine - cortisol
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
Cortisol effect on bone
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
