Random Topics Flashcards
Which MD presents with sx age 2-3, proximal muscle weakness, Gower sign, calf pseudohypertrophy, dilated cardiomyopathy, elevated CK, and treated with glucocorticoids?
Duchenne Muscular Dystrophy (absent dystrophin)
XLR inheritance
Which MD presents with milder weakness than Duchenne, cardiomyopathy, and presents age 5-15?
Becker Muscular Dystrophy
XLR inheritance
Which MD presents age 12-30, facial weakness, grip myotonia, dysphagia, arrhythmias, cataracts, excessive daytime sleepiness, and testicular atrophy?
Classic Myotonic Dystrophy
AD inheritance
Trinucleotide repeat in DMPK gene
What dx presents with parathyroid adenomas, pituitary adenomas, and pancreatic/GI tumors?
MEN1
What dx presents with medullary thyroid cancer and pheochromocytoma?
MEN2
How do you differentiate MEN2A from MEN2B?
MEN2A has parathyroid hyperplasia and MEN2B has mucosal neuromas and marfanoid habitus
Neuromas kind of look like B shape, and marfanoid habitus is a B-male
What dx presents with massive amounts of watery diarrhea, hypokalemia, episodic flushing, mass in the pancreatic tail, and can sometimes correspond with MEN1?
VIPoma
What dx presents with multiple ulcers in the stomach, duodenum, and small intestine, severe diarrhea, and thickened gastric folds on endoscopy?
Gastrinoma
Which dx causes bone pain and deformity, osteolytic or mixed lytic/sclerotic bone lesions, can cause hearing loss and radiculopathy, giant cell tumor or osteosarcoma, has elevated alk phos but normal calcium and phosphate, is a dysfunction of osteoclasts, and is treated with bisphosphonates?
Paget disease
Which dx causes bone pain and presents with elevated alk phos, elevated PTH, normal/decreased calcium, decreased phospate, and decreased Vit D?
Osteomalacia/Rickets
What’s the most common cause of unilateral nipple bleeding?
Intraductal papilloma
What tumor marker is elevated in hepatocellular carcinoma?
AFP
What 3 fetal conditions cause elevated maternal serum AFP?
- Open neural tube defects
- Ventral wall defects
- Multiple gestations
What 2 fetal conditions cause decreased maternal serum AFP?
- Trisomy 18
2. Trisomy 21
How do you differentiate between Trisomy 18 and Trisomy 21 on second-trimester quad screen?
Both:
- Decreased AFP
- Decreased estriol
Trisomy 18:
- Decreased B-hCG
- Normal Inhibin A
Trisomy 21:
- Increased B-hCG
- Increased Inhibin A
What tumor marker is elevated in non-seminomatous germ cell testicular tumors?
AFP
What 2 tumor markers are elevated in malignant biliary obstruction?
- AFP
2. Alk phos
What might a low level of PAPPA at 8-14 weeks gestation mean?
Increased risk of IUGR, premature delivery, preeclampsia, and stillbirth
Do seminomas have elevated AFP?
No
Do mixed germ cell tumors have elevated AFP?
Yes
Can mixed germ cell tumors metastasize to the anterior mediastinum?
Yes
Which testicular tumor has elevated hCG and LDH?
Seminoma
Which testicular tumor has elevated AFP and hCG?
Mixed germ cell tumor
Which testicular tumor can cause increased estradiol in a man?
Leydig
Which tumor can cause increased testosterone production in a female?
Sertoli-Leydig
Which ovarian tumor has elevated hCG and LDH?
Dysgerminoma
Which ovarian tumor in females grows quickly, often presenting with pelvic pain, and secretes AFP?
Yolk sac
Which ovarian tumor has elevated AFP and LDH?
Endodermal sinus tumor
Which ovarian tumor has elevated AFP only?
Immature teratoma
Which ovarian tumor has elevated AFP and hCG?
Embryonal carcinoma
Which ovarian tumor has elevated hCG only?
Choriocarcinoma
Which testicular tumor has elevated hCG and LDH?
Seminoma
Which testicular tumor has elevated AFP, hCG, and LDH?
Yolk sac
Which testicular tumor has VERY elevated hCG and elevated LDH?
Choriocarcinoma
Follows a pregnancy
Which testicular tumor has elevated AFP, hCG, and LDH?
Embryonal carcinoma
Which testicular tumor has just elevated AFP but doesn’t have to?
Teratoma
Which 2 ovarian tumors can cause increased estrogen in a female?
Granulosa (malignant) & thecoma (benign)
Polymyositis vs. Polymyalgia Rheumatica?
Polymyositis: proximal muscle weakness, elevated ANA & CK
Polymyalgia Rheumatica: Pain in shoulders, hip girdle, elevated ESR & CRP
What are the conditions that require an x-ray of the ankle?
Pain at the malleolar zone and 1 of the following:
- Tender at posterior margin/tip of medial malleolus
- Tender at posterior margin/tip of lateral malleolus
- Unable to take 2 steps on each foot
What are the conditions that require an x-ray of the foot?
Pain at the midfoot zone and 1 of the following:
- Tender at the navicular
- Tender at the base of the 5th metatarsal
- Unable to take 2 steps on each foot
What category of dx presents with oliguria, hematuria, HTN, RBC casts, and edema?
Nephritic syndrome
What dx presents with cola colored urine, edema, HTN, and occurs after GAS infex?
Post-infectious glomerulonephritis
What dx presents with episodic gross hematuria after URI or GI infex, often seen in young males?
IgA nephropathy (Berger’s disease)
What dx presents with fever, WL, hematuria, respiratory, and sinus sx, and hemoptysis?
Wegener’s granulomatosis
What dx presents with hematuria, hemoptysis, dyspnea, respiratory failure in males in their mid-20s?
Goodpasture’s syndrome
What dx presents with hematuria, deafness, and eye disorders?
Alport’s syndrome
What are the 5 nephritic syndromes?
“Nephritic WIG AP”
Wegener’s
IgA
Goodpasture’s
Alport
Post-infectious
What category of dx presents with edema, HLD, proteinuria, and hypoalbuminemia?
Nephrotic syndrome
What dx presents with sudden onset of edema in kids?
Minimal change disease
What dx presents with edema, HLD, proteinuria, in a young African American male with uncontrolled HTN?
FSGS
What dx presents with edema, HLD, proteinuria, and is associated with HBV, syphilis, malaria, and gold?
Membranous nephropathy
What dx presents in a diabetic patient with edema, HLD, and proteinuria?
Diabetic nephropathy
What dx presents with proteinuria, edema, in a patient with lupus?
Lupus nephritis
What dx presents with proteinuria, edema, in a patient with multiple myeloma or RA?
Renal amyloidosis
What dx presents with proteinuria, edema, and may be associated with HCV, cryoglobulinemia, and subacute bacterial endocarditis?
Membranoproliferative nephropathy
What are the 7 types of nephrotic syndrome?
“MMM FRLD”
Membranoprolif
Membranous
Minimal change
FSGS
Renal Amyloid
Lupus Nephritis (weird yes)
Diabetic
Which type of kidney stone is associated with calciuria and alkaline urine?
Calcium
Which type of kidney stone is associated with staghorn calculi and urease-producing organisms?
Struvite
Which type of kidney stone is associated with gout and acidic urine?
Uric acid
Which type of kidney stone is associated with a genetic disorder of transport of COLA aa’s?
Cystine
What’s the first step in suspected Cushing syndrome?
Low dose dexamethasone suppression test
After the low dose dex, what are the 2 options?
If ACTH is suppressed, this means it’s an ectopic source
If ACTH is elevated, then do either a high-dose dex test OR a CRH test
What does the following result mean?:
Low dose dex: ACTH elevated
High dose dex: ACTH suppressed
Cushing disease (pituitary)
What does the following result mean?:
Low dose dex: ACTH elevated
High dose dex: ACTH not suppressed
Ectopic ACTH secretion
What does the following result mean?:
Low dose dex: ACTH elevated
CRH stimulation test: ACTH and cortisol elevated
Cushing disease (pituitary)
What does the following result mean?:
Low dose dex: ACTH elevated
CRH stimulation test: ACTH and cortisol not elevated
Ectopic
What does the following result mean?:
Low dose dex: ACTH suppressed
Exogenous glucocorticoids or adrenal tumor
What are the 3 options for initial steps to diagnose Cushing syndrome?
- Low dose dex
- Late night salivary cortisol
- 24-hour urinary cortisol
What is a normal anion gap?
8-12
What is an elevated anion gap?
Above 12
CO2 is an ____?
Acid
Bicarb is a ____?
Base
What does the mnemonic “MUDPILES” stand for in elevated anion gap metabolic acidosis?
Methanol
Uremia
DKA
Propylene glycol Iron tablets Lactic acidosis Ethylene glycol Salicylates
What does the mnemonic “HARDASS” stand for in normal anion gap metabolic acidosis?
Hyperalimentation
Addison disease
RTA
Diarrhea
Acetazolamide
Spironolactone
Saline infusion
What is the equation for anion gap?
Na - (Cl+HCO3)
What are the 4 causes of metabolic alkalosis?
- Loop diuretics
- Vomiting
- Antacid use
- Hyperaldosteronism
What’s the BUN:Creatinine ratio in prerenal azotemia?
> 20:1
What’s the BUN:Creatinine ratio in ATN?
<20:1
What’s the FENa in prerenal azotemia?
<1%
What’s the FENa in ATN?
> 1%
What’s the urine sodium in prerenal azotemia?
<20
What’s the urine sodium in ATN?
> 20
What’s the urine osmolality in prerenal azotemia?
> 500
What’s the urine osmolality in ATN?
<300
What knee injury results from a noncontact twisting mechanism, forced hyperextension, or impact to an extended knee?
ACL
What knee injury has a positive valgus stress test?
MCL
What knee injury has a positive varus stress test?
LCL
What knee injury results from directed force to the front of the flexed knee?
PCL
What knee injury has a positive McMurray test and may have clicking or locking?
Meniscal
The OS is ___?
MS
Which condition is fixed splitting heard in?
ASD
What causes pulsus alternans?
Cardiac tamponade
What causes pulsus parvus et tardus?
Aortic stenosis
What’s the FEV1/FVC ratio in asthma?
Low
What’s the FEV1/FVC ratio in COPD?
Low
What are the 5 causes of low MCV anemia?
- Iron deficiency
- Thalassemia
- Sideroblastic
- Anemia of chronic dz
- Spherocytosis
What are the 4 causes of normocytic anemia?
- Blood loss
- Hemolysis
- Anemia of chronic dz
- Aplasia
What are the 6 causes of macrocytic anemia?
- Vit B12 & folate deficiency
- Alcoholism
- Liver disease
- Drugs
- Mydelodysplastic syndrome
- Sideroblastic
If reticulocytes are high, what type of anemia is it (only 2 options)?
Hemolytic or chronic blood loss (both normocytic)
How do you calculate NNT?
NNT = 1/ARR
How do you calculate ARR?
Percent 1 - percent 2
in decimal forms
How do you calculate ARP?
ARP = (RR-1)/RR
What is this question asking:?
“What percent of colorectal carcinoma in women with high fat consumption could be attributable to diet?”
ARP
What is the following asking:?
“How many patients with diabetes undergoing PCI need to be treated with efrenzia to prevent 1 additional event, as compared with clopidogrel?”
NNT
What is the definition of Hazard Ratio?
If it’s <1, the treatment group had a lower event rate
If it’s >1, the treatment group had a higher event rate
Sensitivity =
Sensitivity = A/(A+C)
Specificity =
Specificity = D(B+D)
What does a cross-sectional study measure?
Disease prevalence
What does a case-control study measure?
Odds ratio
What does a cohort study measure?
Relative risk
What does a cohort study measure?
Relative risk
What are the percents for the bell curve for the first, second, and third SD’s?
68%
95%
99.7%
Which test checks for differences between means of 2 groups?
t-test
Which test checks for differences between means of 3+ groups?
ANOVA
Which test checks for differences between 2 or more percentages of categorical outcomes? Eg: comparing the percentage of members of 3 diff ethnic groups who have HTN?
Chi-square