Rapid Fire Facts Flashcards
MCC NTD
Folate deficiency
MC preventable cause of congenital malformaiton (USA)
Alcohol use during pregnancy
unable to hydroxylate proline and lysine 2/2 Vit C deficiency
scurvy
hyperflexible joints, arachnodactyly, aortic dissection, lens dislocation
Marfan
hereditary nephritis, cataracts, sensorineural hearing loss
Alport (type IV collagen)
stretchy skin, hypermobile joints
Classical ED (Type V collagen)
hemorrage, easy bruising, berry aneurisms, organ rupture
Vascular ED (Type III Collagen)
worst headache of my life
SAH
lucid interval following head trauma
epidural hematoma
bloody CSF on LP
SAH
MCC epidural hematoma
MMA rupture
MCC subdural hematoma
rupture of bridging veins
nucleus solitarius- vagus nucleus
sensory information, taste, baroreceptor, chemoreceptor, gi gut sensation
nucleus ambiguus- vagus nucleus
motor innervation to pharynx, larynx, and upper esophagus
dorsal motor nucleus
autonomic information to heart, lungs, upper GI tract
treatment for absence seizures
ethosuximide
treatment for tonic= clonic seizures
phenytoin, valproic acid, carbamazepine
medical treatment for pheochromocytoma
alpha- antagonist
selective alpha1- antagonist used to treat BPH
tamsulosin
continuous machine- like murmur
PDA
Boot- shaped heart
Tetralogy of Fallot
Rib- notching
CoA
MC congenital cardiac anomaly
VSD
MC early childhood agenesis
Tetralogy of Fallot
head bobbing, wide pulse pressure, diastolic decrescendo murmur
aortic regurgitation, often due to aortic root dilation (syphilis, marfan, bicuspid aortic valve, endocarditis, rhematic fever), progresses to left HF.
MC Cancer in men
prostate cancer
MCC urinary obstruction in men
BPH
MC treatment of erectile dysfunction
PDE-inhibitor eg sildenafil
hepatic adenoma
OCP use
grape- like vaginal tumor
sarcoma botryoides
koilocytes
HPV infection
MC benign tumor in women
leiomyoma
chocolate cyst in ovary
endometrioma or endometriosis
powder burn lesion
endometrioma or endometriosis of ovary`
MCC infertility in females
PCOS
Midcycle pelvic pain associated with ovulation
Mittelschmertz
ovarian tumor+ ascites+ hydrothorax
Meigs syndrome
teratoma leading to hyperthyroidism
struma ovarii
snowstorm appearance on ultrasound
hydatiform mole
MC genetic cause of intellectual disability
Trisomy 21
2nd most common genetic cause of intellectual disability
Fragile X
Horseshoe kidney, congenital heart defects, streak ovaries, cystic hygroma
Turner syndrome
Rocker bottom feet, clenched hands, microcephaly, with prominent occiput and lower jaw
Trisomy 18 (Edwards syndrome)
Most common cancer in women in the US
breast cancer
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
red, itchy, swollen rash in the areola and nipple
Paget disease
branching, filamentous, gram- positive rods with sulfur granules
actinomyces israelii
standard treatment for T. pallidum
penicillin
cellulitis from a dog or cat bite
pasteurella multocida
non-painful, indurated, ulcerated genital lesion
chancre (primary syphilis)
moist, smooth, flat, white genital lesion
condylomata lata (secondary syphilis)
large bull’s eye rash
erythema migrans (Lyme disease)
associated with ghon focus or ghon complex and hilar lymphadenopathy
primary tuberculosis
associated with lung infiltrate in the apical- posterior segments of upper lobes
reactivation tuberculosis
standard initial treatment regimen for TB
RIPE rifampin INH pyrazinamide ethambutol
Eczema, recurrent cold abscesses, high serum IgE
Hyperimmunoglobulin E (Job syndrome)
Large lysosomal vesicles in phagocytes
Chediak- Higashi disease
Toe extention (upgoing), upon stimulation of the sole of the foot with a blunt instrument
positive Babinski reflex
hyperreflexia, increased muscle tone, positive Babinski sign
UMN lesion
hyporeflexia, decreased muscle tone, muscle atrophy
LMN lesion
depigmentation of the substantia nigra
PD
chorea, dementia, atrophy of caudate and putamen
Huntington
eosinophlic inclusions in the cytoplasm of neurons
Lewy bodies
conjugate lateral gaze palsy, with nystagmus and diplopia during lateral gaze
internuclear ophthalmoplegia
degeneration of dorsal columns
tabes dorsalis
demyelinating disease in a young woman
multiple sclerosis
mixed upper and lower motor neuron disease
ALS
newborn with arm paralysis following a difficult labor
Erb- Duchenne palsy
MCC dementia
AD
2nd MCC dementia
vascular dementia
extracellular amyloid deposits in grey matter
AD
intracellular deposits of hyperphosphorylated tau protein
AD
Intracellular spherical aggregates of tau protein seen on silver stain
these are pick bodies, seen in fronto- temporal lobe dementia
Dysphagia, glossitis, and IDA
Plummer- Vinson syndrome
Hematemesis with retching
Mallory- Weiss tear
Mucin- filled cell with a peripheral nucleus
signet- ring cell (gastric CA, LCIS)
most common type of stomach cancer
adenocarcinoma
ovarian mets from gastric cancer
krukenberg tumor
gastric ulcerations and high gastrin levels
ZE syndrome
acute gastric ulcer associated with elevated ICP or head trauma
Cushing ulcer
acute gastric ulcer associated with severe burns
Curling ulcer
weight loss, diarrhea, arthritis, fever, adenopathy, hyperpigmentation
whipple disease
anti- transglutaminase/ anti-gliadin antibodies
Celiac disease
Vitamin given to pregnant women to prevent NTD
Folic acid
most common surgical emergency
appendicitis
severe RLQ pain with rebound tenderness
McBurney’s sign
Adenomatous polyps (precancerous)
tubular adenomas
tubulovillous adenomas
villous adenomas (the most precancerous)
GI hamartomas, hyperpigmentation of the mouth and hands
Peutz-Jaghers syndrome
Multiple colon polyps, osteomas, soft tissue tumors
Gardner syndrome, all lumpy bumpy
“Apple core” lesion on barium enema
Colorectal cancer until proven otherwise
most common site of colonic diverticula
sigmoid colon
“string sign” on contrast xray
Crohn disease (transmural inflammation leads to narrow lumen and thick wall in short stretches)
“lead pipe” appearance of colon on contrast xray
Ulcerative colitis:autoimmune attack on the colon mucosa/submucosa leads to lead pipe appearance on imaging
painless jaundice
pancreatic cancer
MCC acute pancreatitis
gallstones, alcohol
MCC chronic pancreatitis
alcohol abuse
severe hyperbilirubinemia in a neonate
Crigler- Najjar syndrome type I
Mild, benign hyperbilirubinemia
Gilbert syndrome
triglyceride accumulation in hepatocytes
fatty liver disease
eosinophilic inclusions in the cytoplasm of hepatocytes
Mallory bodies, typically seen in alcoholic liver disease
cancer closely linked to cirrhosis
HCC
hepatomegaly, abdominal pain, ascites.
ascites without JVD
Budd- Chiari syndrome
green/ yellow corneal deposits
Keyser- Fleischer rings of Wilson disease
low ceruloplasmin
Wilson disease
Cirrhosis, diabetes, hyperpigmentation
hemochromatosis
chronic sinusitis, infertility, situs inversus
Kartagener syndrome
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 spiral, Charcot Leyden crystals
asthma
bilateral hilar adenopathy, uveitis
sarcoidosis
vasculitis and glomerulonephritis
goodpasture, wegener
anti- glomerular basement membrane antibodies
Goodpasture syndrome
Honeycomb lung on xray
idiopathic pulmonary fibrosis
“tennis racket” shaped cytoplasmic organelles
birbeck granules (LCH)
iron- containing nodules in the alveolar septum
ferruginous bodies (asbestosis)
lung cancer associated with SIADH
small cell lung cancer
tumor associated with Horner syndrome
Pancoast tumor
lung cancer associated with hypercalcemia
squamous cell lung cancer
lung cancer associated with ACTH (Cushing)
small cell lung cancer
lung cancer associated with weakness
small cell lung cancer with Lambert Eaton syndrome
substances associated with lung cancer
radon, smoking, asbestos, silica
common cause of PNA in immunocompromised patients
pneumocystis jirovecii, (PCP)
MCC atypical/walking PNA
mycoplasma pneumoniae
common causative agent for PNA in alcoholics
Klebsiella pneumoniae
interstitial pneumonia in bird handlers
chlamidophila psittaci
cause of PNA in patient with hx of exposure to bats and bat droppings
histoplasma
often causes PNA in patient recently from SoCal, NM, West TX
coccidiodes immitus
PNA associated with “currant jelly” sputum
Klebsiella pneumoniae
Qfever
coxiella burnetii
associated with PNA acquired from air conditioners
legionella pneumophila
MCC PNA in children 1 yo or younder
RSV
MCC PNA in neonate (birth- 28 days)
GBS or E. Coli
MCC PNA in children and young adults (including college students, military recruits, prison inmates)
Mycoplasma pneumoniae
MCC viral pneumonia
RSV
Causes of wool- sorters disease (life-threatening PNA)
Bacillus anthracis
Common PNA in ventilator patients and those with cystic fibrosis
Pseudomonas aeruginosa, MRSA
Pontiac fever
Legionella pneumophila
Chest pain, pericardial friction rub, persistent fever occurring several weeks after an MI
Dressler syndrome
post- MI cardiac tamponade
rupture of the ventricular wall
post- MI severe mitral regurg
rupture of papillary muscle
post MI new VSD
rupture of intraventricular suptum
post MI stroke
mural thrombus leading to embolus
splinter hemorrhages under the fingernails
infective endocarditis
retinal hemorrhages with 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 with infective endocarditis
tricuspid valve
granulomatous nodules in the heart
Aschoff bodies (rheumatic heart disease)
most common primary cardiac tumor in adults
left atrial myxoma
most common primary cardiact tumor in children
rhabdomyoma
most common cause of constrictive pericarditis
US: lupus, in developing countries TB
c-ANCA
granulomatosis with polyangiitis
p-ANCA
Churg- Strauss, microscopic polyangiitis
treatment for thromboangiitis obliterans
smoking cessation
treatment for giant cell arteritis
steroids, high dose
currant jelly sputum
klebsiella pneumoniae
osteomyelitis in a patient with SCD
salmonella
“strawberry” cervix
trichomonas vaginalis
clue cells
gardnerella vaginalis
bacteria with “school of fish” appearance
haemophilus ducreyi
a boy with self- mutilating behavior, intellectual disability, and gout
lesch- nyhan syndrome
orotic acid in urine and elevated serum ammonia
ornithin transcarbamylase deficiency
orotic acid in the urine + normal serum ammonia
orotic aciduria
megaloblastic anemia that does not improve with folate and B 12
orotic aciduria
most common medications for ADHD
methylphenidate (Ritalin)
most common class of medication for bulimia nervosa
SSRI (eg fluoxetine)
medical treatment for alcohol withdrawal
benzodiazepines
most effective treatment for alcohol abuse
alcoholics anonymous
artophy of the mammillary bodies
Wernicke encephalopathy
treatment for central DI
Desmopressin
Treatment for nephrogenic DI
HCTZ, indomethacin, amiloride
Treatmtent for lithium-induced nephrogenic DI
Amiloride
Bluish- colored lines on the gingivae
Burton’s lines (lead poisoning)
Treatment of choice for rickets or osteomalacia
Vitamin D
Swollen gums, poor wound healing, bleeding mucous membranes, spots on the skin
Scurvy (vitamin C deficiency)
most common vitamin deficiency in the US
folate deficiency
hypersegmented neutrophils
megaloblastic anemia
dilated cardiomyopathy, edema, polyneuropathy
wet beriberi (vitamin B1 deficiency)
inability to breastfeed, amenorrhea, cold intolerance
Sheehan syndrome
infertility, galactorrhea, and bitemporal hemianopia
prolactinoma
cells that produce catecholamines
chromaffin cells
cells that produce Aldosterone
zona glomerulosa
cells that produce cortisol, sex hormones
zona fasciculata
where in the adrenal gland would you find a pheochromocytoma?
in the MEDULLA
BAM CUSHINGOID
Buffalo humo
Amenorrhea
Moon facies
Crazy, insomniac Ulcers Skin changes HTN Infection (immunosuppression) Necrosis of femoral head Glaucoma OSTEOPOROSIS (reduced bone formation) Immunosuppression Diabetes
Most common causes of Cushing syndrome
exogenous steroid use
ectopic ACTH secretion
ACTH- secreting pituitary adenoma
Adrenal tumor that secretes cortisol
most common tumor of the adrenal gland
benign, non-functioning adrenal adenoma in the cortex
most common tumor of the adrenal medulla (in adults)
pheochromocytoma
most common tumor of the adrenal medulla (in kids)
adrenal neuroblastoma
MCC primary hyperaldosteronism
Adrenal adenoma
medical treatment for hyperaldosteronism
spironolactone or eplerenone
medical treatment for pheochromocytoma
irreversible, nonselective alpha inhibitor
phenoxybenzamine
phentolamine
pheochromocytoma, medullary thyroid cancer, hyperparathyroidism
MEN2A
pheochromocytoma, medullary thyroid cancer, mucosal neuroma
MEN2B
adrenal disease associated with skin hyperpigmentation
Addison disease (primary hypoaldosteronism)
HTN, hypokalemia, metabolic alkalosis
Conn syndrome (excessive aldosterone production)
eye changes: proptosis, edema, injection and hyperthyroidism
Graves’ disease
thyrotoxicosis and history of thyroidectomy or radioablation of thyroid
too much exogenous thyroid hormone
most common thyroid cancer
papillary thyroid cancer
cold intolerance
hypothyroidism
enlarged thyroid cells with ground glass nuclei
papillary thyroid cancer
standard treatment for DKA
IV fluids, IV insulin, potassium replacement
standard treatment for 1DM
insulin
standard treatment for 2DM
low- carb diet, weightloss, oral hypoglycemic drugs, insulin
Causes of lipodystrophy (abnormal fat distribution)
leptin deficiency
HIV medications, especially protease inhibitors
MCC primary hyperparathyroidism
parathyroid adenoma or hyperplasia
MCC secondary hyperparathyroidism
chronic renal failure
MCC hypoparathyroidism
accidental parathyroidectomy
Facial muscle spasm when tapping on the cheek
Chvostek
Parathyroid, pancreatic, and pituitary tumors
MEN1
preferred anticoagulant for immediate anticoagulation
heparin or LMWH
preffered anticoagulant for long-term anticoagulatn
warfarin
preferred anticoagulant during pregnancy
heparin or LMWH
causes of hypochromic, microcytic anemia
iron deficiency, thalessemia, lead poisoning
hypersegmented neutrophils
macrocytic, megaloblastic anemia due to B12 or folate deficiency
skull xray shows hair-on-end appearance
beta thalassemia major or SCD
basophilic stippling of RBCs
lead poisoning
painful cyanosis of fingers and toes with hemolytic anemia
cold agglutinin autoimmune hemolytic anemia
Red urine in the morning and freagile RBCs
paroxysmal nocturnal hemoglobinuria
basophilic nuclear remnants in RBCs
howell- jolly bodies
autosplenectomy
SCD
drug used to treat SCD
hydroxyurea
antiplatelet antibodies
immune thrombocytopenia
bleeding disorder with gp1b deficiency
Bernard-soulier syndrome
most common inherited bleeding disorder
vWF disease
cancer most commonly associated with noninfectious fever
Hodgkin lymphoma
sheets of lymphoid cells with a “Starry sky” appearance (macrophage are the stars)
Burkitt lymphoma
Large B cells with bilobed nuclei and prominent “owl’s eye inclusions”
Reed Sternberg cells
“smudge cells”
CLL
“punched out” lytic bone lesions
Multiple myeloma
RBCs clumped together like a stack of coins
Rouleaux formation (MM)
monoclonal antibody spike
MM, MGUS, Waldenstrom macroglobulinemia
Reddish-pink rods in the cytoplasm of leukemic blasts
Auer rods (AML)
dark purple nodules on the skin in an HIV patient
Kaposi sarcoma
Temporal lobe encephalitis
HSV-1
“Owl’s eye” inclusions in organ tissue
CMV
intranuclear eosinophilic droplets
HSV
type A Cowdry bodies
aplastic anemia in a sickle cell patient
parvovirus B19
child with fever and “slapped cheek” rash on face that spreads to body
parvovirus B19 (fifth disease)
fever, runny nose, cough, conjunctivitis, diffuse rash
rubeola (measles)
small, irregular blue-grey spots on the buccal mucosa, surrounded by a base of red
Koplik’s spots (measles)
dark purple nodules on the skin in an HIV patient
Kaposi sarcoma, HHV8
Large cells with owl’s eye inclusions
CMV
Treatment for CMV
ganciclovir
MC opportunistic infection in HIV patients
pneumocystic jirovecii PNA (PCP)
drug used to prevent pneumocystis PNA
TMX- SMX after CD4
treatment for oral candidiasis
nystatin, fluconazole
most common opportunistic infection in HIV patients
PCP
prophylaxis for crytococcus in AIDS patients
fluconazole
prophylaxis for PCP
TMP-SMX
Treatment for systemic candidiasis
fluconazole for immunocompetant
amphotericin B and echinocandin for immunocompromised
treatment for sporothrix schenkii
itraconazole, potassium iodide
ring- enhancing brain lesion in HIV patient
toxoplasmosia gongii
treatment for trichomonas vaginalis
metronidazole for pt and partner
most common protozoal diarrhea
giardia lamblia
most common helminth infection in the US
Enterobius vermicularis (pinworm)
second most common helminth infection in the US
ascaris lumbricoides (giant roundworm)
