Rapid Fire Flashcards
Most common cause of neural tube defects
Folate deficiency
Most common preventable cause of congenital malformations in the US
etOH use in pregnancy
Hyperflexible joints, arachnodactyly, aortic dissection, lens dislocation
Marfans - fibrillin defect
Hereditary nephritis, cataracts, sensorineural hearing loss
Alport syndrome - type IV collagen defect
“Worst headache of my life”
Subarachnoid hemorrhage
ruptured berry aneurysm:
- most common site anterior communicating a.
- Associated with APCKD (look in the kidney), Ehlers Danlos
Lucid interval following head trauma
epidural hematoma
Bloody CSF on LP
Subarachnoid hemorrhage
Most common cause of subdural hematoma
rupture bridging veins
Most common cause of epidural hematoma
rupture MMA
Most common cause of dementia
Alzheimers
Second most common cause of dementia
Vascular dementia
Extracellular amyloid deposits in gray matter
Abeta- alzheimers
Intracellular deposits of hyperphopshorylated tau protein
Neurofibrillary tangles of Alzheimers
Intracellular spherical aggregates of tau protein on silver stain
Pick bodies - frontotemporal dementia
Amyloid deposits in gray matter of the brain
senile plaques - Alzheimers
Drooling farmer
organophosphate poisoning - atropine is the antidote
Continuous, machinery-like heart murmur
PDA
“Boot shaped heart”
Right ventricular hypertrophy - Tetralogy of Fallot
Rib notching
coarctation of aorta
Most common congenital cardiac anomaly
VSD
Most common congenital cause of early cyanosis
Tetralogy of Fallot
Bounding pulses, head bobbing, diastolic murmur
Aortic regurgitation
Continuous, machine-like murmur
PDA
Bone enlargement, bone pain, arthritis
Paget disease of bone
Vertebral compression fractures
Osteoporosis
Swollen, hard, painful finger joints
Osteoarthritis
Swollen, boggy, painful finger joints
rheumatoid arthritis
Cartilage erosion with polished bone beneath
eburnation seen in osteoarthritis
Swollen, red, acutely painful great toe joint
gout
positively birefringent rhomboid-shaped crystals
pseudogout
negatively birefringement needle-shaped crystals
gout
Bamboo spine on xray
alkalizing spondylitis
HLA-B27
Seronegative spondyloarthropathies:
“PAIR” psoriatic arthritis, alkylosing spondylitis, IBD spondylitis, reactive arthritis
“Pencil in cup” deformity on XR of the finger
psoriatic arthritis
Anti-Smith and anti-dsDNA Ab
SLE
Anti-histone Ab
drug-induced SLE
Anti-centromere Ab
CREST (limited) scleroderma
Anti-topoisomerase Ab
Diffuse scleroderma
Anti-Jo 1 Ab
Polymyositis/dermatomyositis
Anti-Ro Ab
Sjogrens
Arthritis, dry mouth, and dry eyes
Sjogrens
Keratin pearls on skin biopsy
squamous cell carcinoma
Most common malignant skin tumor
Basal cell carcinoma
Positive anterior drawer sign of knee
ACL damage
Tenderness in anatomical snuffbox
scaffoid fracture
Stolen, hard, painful finger joints
OA
Swollen, boggy, painful finger joints
RA
Cartilage erosion with polished bone beneath
eburnation seen in OA
Swollen, red, acutely painful great toe joint
gout
positively birefringent rhomboid-shaped crystals
calcium pyrophosphate crystal of pseudo gout - blue color
Negatively birefringent needle-snapped crystals
monosodium urate crystal of gout - yellow color
Bamboo spine on xray
alkalizing spondylitis
HLA-B27
seronegative spondyloarthropathies: Psoriatic arthritis Alkalizing spondylitis IBD spondylitis reactive arthritis
“Pencil in cup” deformity on X-ray of finger
psoriatic arthritis
Anti-smith and anti-dsDNA Abs
SLE
Anti-histone Ab
drug-induced SLE
Anti-centromere Ab
CREST - limited scleroderma
Anti-topoisomerase Ab
diffuse scleroderma
Anti-Jo1 Ab
polymyositis/dermatomyositis
Anti-Ro Ab
Sjogrens
Arthritis, dry mouth, dry eyes
Sjogrens
Keratin pearls on skin bx
squamous cell carcinoma
Most common malignant skin tumor
basal cell carcinoma
main artery of the pelvis
internal iliac a
main nerve of pelvis
pudendal n
“bag of worms” scrotum
varicocele
most common cancer in men
prostate cancer
most common cause of urinary obstruction in men
BPH
most common treatment of ED
phosphodiesterase inhibitors
hepatic adenoma
OCP use
“Grape like” vaginal tumor
sarcoma botryoides
Koilocytes
HPV
Most common benign tumor in women
Leiomyoma
“Chocolate cyst” of ovary
endometrioma - endometriosis w/ ovary involvement
“Powder burn” lesion
endometriosis implants
Most common cause of infertility in women
PCOS
Mid cycle pelvic pain assoc w/ ovulation
Mittelschmerz
Ovarian tumor + ascites + hydrothorax
Meigs syndrome - fibromas
Teratoma –> hyperthyroidism
struma ovarii
“snowstorm” appearance on US
hydatidiform mole
Most common genetic cause of intellectual disability
down syndrome
second most common genetic cause of intellectual disability
fragile X syndrome
Horseshoe kidney, congenital heart defects, streak ovaries, and cystic hygroma
Turners syndrome
Rocker-bottom feet, clenched hands, microcephaly w/ prominent occiput and small jaw
Edward Syndrome - trisomy 18
Most common cancer in women in US
breast cancer -invasive ductal carcinoma
most common benign breast tumor
fibroadenoma
most common malignant breast tumor
infiltrating ductal carcinoma
blue dome cyst in the breast
fibrocystic change
treatment for ER+ breast cancer
tamoxifen - risk of endometrial cancer
Red, itchy, swollen rash on areola and nipple
Paget dz of breast
Treatment for absence seizures
ethosuximide
Toe extension upon stimulating the sole of the foot with a blunt instrument
Plantar (Babinski) reflex
Newborn with arm paralysis following a difficult labor
Erb-duchenne palsy
Dysphagia, glossitis, iron deficiency anemia
Plummer-Vinson Syndrome
Hematemesis with retching
Mallory-Weiss Tear
If severe - Boerhaave syndrome
Eczema, recurrent cold abscesses, high serum IgE
Hyper IgE syndrome (Job syndrome)
Large phagosomal vesicles in neutrophils
Chediak-Higashi syndrome
Mucin-filled cell with a peripheral nucleus
Signet ring cell (gastric adenoma, Krukenberg ovarian met, LCIS/invasive lobular carcinoma of breast)
MC type of stomach cancer
adenocarcinoma
ovarian met from gastric cancer
Krukenberg tumor
Gastric ulcerations and high gastrin levels
Zollinger-Ellison Sn
Acute gastric ulcer associated w/ elevated ICP or head trauma
Cushing Ulcer
Acute gastric ulcer associated w/ severe burns
curling ulcer
Wt loss, diarrhea, arthritis, fever, adenopathy, and hyperpigmentation
Whipple disease
Anti-transglutaminase/anti-gliadin antibodies
celiac disease
Vitamin given to pregnant women to prevent neural tube defects
Folic acid
Most common surgical emergency
appendicitis
Severe RLQ pain w/ rebound tenderness
McBurney’s point
GI hamartomas, hyperpigmentation of the mouth and hands
Peutz-Jeghers Syndrome
Multiple colon polyps, osteomas, soft tissue tumors
Gardner syndrome
“Apple core” lesion on barium enema
colon cancer
Most common site of colonic diverticula
sigmoid colon
“string sign” on contrast XR
crohn’s disease
“Lead pipe” appearance of colon on contrast XR
Ulcerative colitis
Severe hyperbilirubinemia in a neonate
Crigler Najjar Syndrome Type I
Mild, benign hyperbilirubinemia
Gilbert Syndrome
Hepatomegaly, abdominal pain, ascites
Budd-Chiari Syndrome
Green/yellow corneal deposits
Wilson dz
Low serum ceruloplasmin
Wilson dz
Cirrhosis, diabetes, hyper pigmentation
hemachromatosis
Chronic sinusitis, infertility, and situs inversus
Kartagener Syndrome
Chest pain, pericardial friction rub, persistent fever occurring several weeks after MI
Dressler Sn
Splinter hemorrhages under fingernails
infective endocarditis
Retinal hemorrhages w/ pale centers
Roth spots - infective endocarditis
Heart valve most commonly involved in infective endocarditis
Mitral valve
Heart valve most commonly involved in an IV drug user w/ infective endocarditis
Tricuspid valve
Granulomatous nodules in the heart
Aschoff bodies - rheumatic heart disease
MC primary cardiac tumor in adults
Left atrial myxoma
MC primary cardiac tumor in children
Rhabdomyoma
MC cause of constrictive pericarditis
US: lupus
developing countries - TB
c-ANCA
granulomatosis w/ polyangiitis
p-ANCA
Churg-Strauss (eosinophilic granulomatosis w/ polyangiitis)
microscopic polyangiitis
Tx for thromboangiitis obliterans
smoking cessation
Tx for giant cell arteritis
High dose steroids
Branching, filamentous, gram + rods w/ sulfur granules
Actinomyces israelii
Standard treatment for T palladium
PCN G
Cellulitis from dog or cat bite
Pasturella multocida
a non-painful indurated ulcerated genital lesions
chancre of primary syphilis
moist, smooth, flat, white genital lesion
condylomata lata - secondary syphilis
large bull’s eye rash
erythema migrans - lyme dz
Associated w/ Ghon focus or Ghon complex
primary TB
Associated w/ lung infiltrate in the apical-posterior segments of upper lobes of lung
reactivation TB
Standard initial treatment of TB
2 mo: "RIPE" Rifampin Isoniazid + Vit B6 Pyrazimamide Ethambutol
4 mo: Isoniazid + Vit B 6, rifampin
“Strawberry” cervix
Trichomonas vaginalis
Clue cells
Gardnerella vaginalis
Bacteria w/ school of fish appearance
Haemophilus ducreyi
Dark purple lesions on skin in an HIV patient
Kaposi sarcoma HHV8
Temporal lobe encephalitis
HSV1
“Owl’s eye” inclusion in organ tissue
CMV
Intranuclear eosinophilic droplets
Type A cowry - HSV, VZV, CMV
Aplastic anemia in sickle cell patient
Parvovirus B19
Child with fever and “slapped cheek” rash on the face that spreads to his body
Fifth dz - parvovirus B19
Fever, runny nose, cough, conjunctivitis, and diffuse rash
rubeola (measles)
Small, irregular, blue-gray spots on buccal mucosa, surrounded by a base of red
Koplick’s spots (measles)
Dark purple nodules on skin in an HIV pt
Kaposi sarcoma
Large cells w/ owl’s eye inclusions
CMV
Treatment for CMV
Ganciclovir
MC opportunistic infection in HIV pts
PCP - pneumocystis jirovecii pneumonia
Drug used to prevent Pneumocystis pneumonia
TMP-SMX
Treatment for oral candidiasis
nystatin, fluconazole
MC opportunistic infection in HIV patients
pneumocystis jirovecii pneumonia
Prophylaxis for pneumocystis pneumonia in AIDS pts
TMP-SMX at CD4 less than 200
Tx for systemic candidiasis
Fluconazole
Amphotericin B, echinocandin
Treatment for sporothrix schenchii
Itraconazole
Potassium iodide
Ring enhancing brain lesion in HIV pt
Toxoplasma gondii
Tx for Trichomonas vaginalis
Metronidazole
MC protozoal diarrhea
Giardia lamblia
Elevated D dimer
PE, DVT
Hypercoagulability, endothelial damage, stasis of blood
Virchow’s triad
Blue bloater
Hypoxemia, hypercapnia – Chronic bronchitis
Pink puffer
Dyspnea, hyperventilation – emphysema
Curshmann spirals
Shed epithelium from mucus glands - asthma
Bilateral hilar adenopathy, uveitis
Sarcoidosis
Antiglomerular BM Abs
Good pasture Sn
Honeycomb lung on CT
Idiopathic pulmonary fibrosis
“Tennis Racket” shaped cytoplasmic organelles
Birbeck granules in Pulmonary Langerhans Cell Histiocytosis
Iron-containing nodules in the alveolar septum
Ferruginous bodies – asbestosis
Lung cancer associated with SIADH
Smal cell lung cancer
Tumor assoc w/ Horner Sn
Pancoast tumor
Lung cancer assoc w/ hypercalcemia
Squamous cell carcinoma of lung
Lung cancer associated w/ Cushing Sn
Small cell lung cancer
Lung cancer assoc w/ weakness
Small cell lung cancer
Substances associated w/ lung cancer
Smoke, radon, silica, asbestosis
A boy with self mutilating behavior, intellectual disability and gout
Lesch-Nyhan syndrome
Orotic acid in urine with elevated serum ammonia
Ornithine transcarbamoylase deficiency
Orotic acid in the urine w/ normal serum ammonia
Orotic aciduria
Megaloblastic anemia that does not improve with folate and B12
Orotic aciduria
Bluish-colored lines on gingivae
Burton’s lines (lead poisoning)
Treatment of choice for rickets and osteomalacia
Vit D
Swollen gums, poor wound healing, bleeding mucous membranes, spots on skin
Scurvy (Vit C deficiency)
MC vitamin deficiency in US
Folate deficiency – B9
Hypersegmented neutrophils
Megaloblastic anemia – B12/folate B9
Dilated cardiomyopathy, edema, polyneuropathy
Wet Beriberi – vit B1 deficiency
MC class of medication for bulimia
SSRI- fluoxetine
MC medication for ADHD
Methylphenidate (Ritalin)
Medical tx for alcohol withdrawal
Benzodiazepines
Atrophy of mammillary bodies
Wernicke encephalopathy
Korsakoff Sn
Treatment for central DI
desmopressin - intranasal
Treatment for nephrogenic DI
HCTZ, indomethacin, amiloride
Tx for lithium-induced nephrogenic DI
amiloride
Inability to breastfeed, amenorrhea, cold intolerance
Sheehan Sn
Infertility, galactorrhea, and bitemporal hemianopia
Prolactinoma
MC causes of cushing syndrome
- exogenous steroid use
- ectopic ACTH secretion
- ACTH-secreting pituitary adenoma – Cushing Dz
- Adrenal tumor that secretes cortisol
MC cause of primary hyperaldosteronism
Adrenal adenoma
Medical tx for hyperaldosteronism
Spironolactone or eplerenone
Adrenal dz assoc w/ skin hyperpigmentation
Addison dz
HTN, hypokalemia, metabolic alkalosis
Conn Sn – primary hyperaldosteronism
MC tumor of adrenal gland
Benign, non-functioning adrenal adenoma
MC tumor of adrenal medulla in adults
Pheochromocytoma
MC tumor of ardrenal mdulla in kids
Neuroblastoma
Medical tx for pheochromocytoma
Nonselective alpha blocker – phenoxybenzamine
Pheochromocytoma, medullary thyroid cancer, hyperparathyroidism
MEN2A
Pheochromocytoma, medullary thyroid cancer, and mucosal neuromas
MEN2B
MC thyroid cancer
Papillary thyroid carcinoma
Enlarged thyroid cells with ground glass nuclei
Orphan Annie Eyes nucleus – papillary thyroid carcinoma
Most likely electrolyte abnormality with perioral tingling, perioral paresthesias, recent thyroidectomy
Hypocalcemia
MC cause of hypercalcemia
Primary hyperthyroidism
MC cause of primary hyperparathyroidism
Parathyroid adenoma
MC cause of secondary hyperparathyroidism
Chronic renal failure
MC cause of hypoparathyroidism
Accidental parathyroidectomy
Facial muscle spasm when tapping on cheek
Chvostek sign
Parathyroid, pancreatic, and pituitary tumors
MEN1
Preferred anticoagulant for immediate anticoagulation
Heparin or LMW heparin
Preferred anticoagulant for long term anticoagulation
Warfarin
Preferred anticoagulant during pregnancy
Heparin or LMW heparin
Causes of hypochromic, microcytic anemia
Iron deficiency, thalassemia
Lead poisoning
Anemia of chronic dz
Skull xray shows “hair on end” appearance
Beta thalassemia
Sickle cell dz
Basophilic stippling of RBCs
Lead poisoning
Cold temperatures -> painful cyanosis of the fingers and toes with hemolytic anemia
Cold autoimmune hemolytic anemia
Red urine in the morning and fragile RBCs
Paroxysmal nocturnal hemoglobinuria
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies – asplenia
Autosplenectomy
Sickle cell disease
Drug used to treat sickle cell disease
Hydroxyurea
Antiplatelet antibodies
Immune thrombocytopenia
Bleeding disorder with GpIb deficiency
Bernard-Soulier disease
MC inherited bleeding disorder
Von Willebrande dz
Cancer MC associated w/ noninfectious fever
Hodgkin lymphoma
Sheets of lymphoid cells, “starry sky” appearance
Burkitt lymphoma
Large B cells with bilobed nuclei and prominent “owl’s eye” inclusions
Reed-Sternberg cells of Hodgkin lymphoma
Smudge cells
CLL
Reddish-pink rods in cytoplasm of leukemic blasts
Auer Rods (AML)
