Rapid Review Flashcards
1
Q
Abdominal pain, ascites, hepatomegaly
A
Budd-Chiari syndrome (posthepatic venous thrombosis)
2
Q
Achilles tendon xanthoma
A
Familial hypercholesterolemia (decreased LDL receptor signaling)
3
Q
Adrenal hemorrhage, hypotension, DIC
A
Waterhouse Friedrichsen syndrome (meningococcemia)
4
Q
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
A
Marfan syndrome
5
Q
Back pain, fever, night sweats, weight loss
A
Pott disease (vertebral TB)
6
Q
Bilateral hilar adenopathy, uveitis
A
Sarcoidosis (noncaseating granulomas)
7
Q
Blue sclera
A
Osteogenesis imperfecta (Type I collagen defect)
8
Q
Bluish line on gingiva
A
Burton line (lead poisoning)
9
Q
Bone pain, bone enlargement, arthritis
A
Paget disease of bone (increased osteoblastic and osteoclastic activity)
10
Q
Bounding pulses, diastolic heart murmur, head bobbing
A
Aortic regurgitation
11
Q
Café-au-lait spots, Lisch nodules (iris hamartoma)
A
Neurofibromatosis type I (+ pheochromocytoma, optic gliomas)
12
Q
Café-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, mutliple endocrine abnormalities
A
McCune-Albright (mosaic G-protein signaling mutation)
13
Q
Calf pseudohypertrophy
A
Muscular dystrophy (Duchenne = most common; X-linked deletion of dystrophin gene)
14
Q
“Cherry-red spots” on macula
A
Tay-Sachs (acc. ganglioside); Nieman-Pick (acc. sphingomyelin); central retinal artery occlusion
15
Q
Chest pain, pericardial effusion/friction rub, persistent fever following MI
A
Dresser syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 wks after acute episode)
16
Q
Child w/ fever later develops red rash on face that spreads to body
A
“Slapped cheeks” (erythema infectiosum/fifth disease: parvovirus B19)
17
Q
Chorea, dementia, caudate degeneration
A
Huntington disease (autosomal dominant CAG repeat expansion)
18
Q
Chronic exercise intolerance w/ myalgia, fatigue, painful cramps, myoglobinuria
A
McArdle disease (muscle glycogen phosphorylase deficiency)
19
Q
Conjugate lateral gaze palsy, horizontal diploplia
A
Internuclear ophthalmoplegia (damage to MLF; bilateral [MS], unilateral [stroke]
20
Q
Continuous “machine-like” heart murmur
A
PDA (close w/ indomethacin; open/maintain with misoprostol)
21
Q
Cutaneous/dermal edema due to connective tissue deposition
A
Myxedema (caused by hypothyroidism, Graves disease [pretibial])
22
Q
Dark purple skin/mouth nodules in pt w/ AIDS
A
Kaposi sarcoma, ass. w/ HHV-8
23
Q
Dermatitis, dementia, diarrhea
A
Pellagra (niacin [vit B3] deficiency)
24
Q
Dilated cardiomyopathy, edema, alcoholism/malnutrition
A
Wet beriberi (thiamine [vit B1] deficiency)
25
Dog/cat bite resulting in infection
Pasteurella multocida
26
Dry eyes, dry mouth, arthritis
Sjögren syndrome (autoimmune destruction of exocrine glands)
27
Dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
28
Enlarged, hard left supraclavicular node
Virchow node (abdominal metastasis)
29
Erythroderma, LAD, hepatosplenomegaly, atypical T cells
Mycosis fungoides (cutaneous T-cell lymphoma) or Sézary syndrome (mycosis fungoides + malignant T cells in blood)
30
Facial muscle spasm upon tapping
Chvostek sign (hypocalcemia)
31
Fat, female, forty, and fertile
Cholelithiasis
32
Fever, chills, headache, myalgia following antibiotic treatment for syphilis
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
33
Fever, cough, conjunctivitis, coryza, diffuse rash
Measles
34
Fever, night sweats, weight loss
B symptoms (staging) of lymphoma
35
Fibrous plaques in soft tissue of penis
Peyronie disease (connective tissue disorder)
36
Gout, intellectual disability, self-mutilating behavior in a boy
Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)
37
Hamartomatous GI polyps, hyper pigmentation of mouth/feet/hands
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; increase cancer risk, mainly GI)
38
Hepatosplenomegaly, osteoporosis, neurologic symptoms
Gaucher disease (glucocerebrosidase deficiency)
39
Hereditary nephritis, sensorineural hearing loss, cataracts
Alport syndrome (mutation in collagen IV); "Can't see, can't pee, can't hear high-C"
40
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Klüver-Bucy syndrome (bilateral amygdala lesion)
41
Hyperreflexia, hypertonia, Babinski sign present
UMN damage
42
Hyporeflexia, hypotonia, atrophy, fasciculations
LMN damage
43
Hypoxemia, polycythemia, hypercapnia
"Blue bloater" (Chronic bronchitis: hyperplasia of mucous cells)
44
Indurated, ulcerated genital lesion
Nonpainful: chancre (primary syphilis: treponema pallidum)
Painful, w/ exudate: chancroid (Haemophilus ducreyi)
"You 'do cry' w/ H. ducreyi"
45
Infant w/ cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia
Patau syndrome (trisomy 13)
46
Infant w/ failure to thrive, hepatosplenomegaly, and neurodegeneration
Nieman-Pick disease (genetic sphingomyelinase deficiency)
47
Infant w/ hypoglycemia, failure to thrive, and hepatomegaly
Cori disease (debranching enzyme deficiency) or Von Gierke disease (glucose-6-P deficiency, more severe)
48
Infant w/ microcephaly, rocker-bottom feet, clenched hands, and structural heart defect
Edwards syndrome (trisomy 18)
49
Jaundice, palpable distended non-tender gallbladder
Courvoisier sign (distal obstruction of biliary tree)
50
Large rash w/ bull's-eye appearance
Erythema chronicum migraines from Ixodes tick bite (Lyme disease: Borrelia)
51
Lucid interval after traumatic brain injury
Epidural hematoma (middle meningeal artery rupture)
52
Male child, recurrent infections, no mature B cells
Bruton disease (X-linked agammaglobulinemia)
53
Mucosal bleeding and prolonged bleeding time
Glanzmann thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
54
Muffled hear sounds, distended neck veins, hypotension
Beck triad of cardiac tamponade
55
Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
Gardner syndrome (subtype of FAP)
56
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
Pompe disease (lysosomal alpha-1,4-glucosidase deficiency)
57
Neonate w/ arm paralysis following difficult birth
Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip"
58
No lactation postpartum, absent menstruation, cold intolerance
Sheehan syndrome (pituitary infarction)
59
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
Multiple Sclerosis
60
Oscillating slow/fast breathing
Cheyne-Stokes respirations (central apnea in CHF or increased intracranial pressure)
61
Painful blue fingers/toes, hemolytic anemia
Cold agglutinin disease (AI hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis)
62
Painful, pale, cold fingers/toes
Raynaud phenomenon (vasospasm in extremities)
63
Painful, raised red lesions on pad of fingers/toes
Osler nodes (infective endocarditis, immune complex deposition)
64
Painless erythematous lesions on palms and soles
Janeway lesions (infective endocarditis, septic emboli/microabscesses)
65
Painless jaundice
Cancer of the pancreatic head obstructing bile duct
66
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria
Henoch-Schönlein purpura (IgA vasculitis affecting skin and kidneys)
67
Pancreatic, pituitary, parathyroid tumors
MEN 1 (autosomal dominant)
68
Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia
Nephrotic syndrome
69
Pink complexion, dyspnea, hyperventilation
"Pink puffer" (emphysema: centriacinar [smoking], panacinar [alpha1-antitrypsin deficiency])
70
Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets
Fanconi syndrome (proximal tubular reabsorption defect)
71
Pruritic, purple, polygonal planar papules and plaques (6 P's)
Lichen planus
72
Ptosis, miosis, anhidrosis
Horner syndrome (sympathetic chain lesion)
73
Pupil accommodates but doesn't react
Argyll Robertson pupil (neurosyphilis)
74
Rapidly progressive leg weakness that ascends following GI/upper resp infections
Guillain-Barré syndrome (acute autoimmune inflammatory demyelinating polyneuropathy)
75
Rash on palms and soles
Coxsackie A, secondary syphilis, Rocky Mt spotted fever
76
Recurrent colds, unusual eczema, high serum IgE
Hyper-IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)
77
Red "currant jelly" sputum in alcoholic or diabetic patients
Klebsiella pneumoniae
78
Red "currant jelly" stools
Acute mesenteric ischemia (adults); intussusception (infants)
79
Red, itchy, swollen rash of nipple/areola
Paget disease of the breast (sign of underlying neoplasm)
80
Red urine in the morning, fragile RBCs
Paroxysmal nocturnal hemoglobinuria
81
RCC (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma
von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
82
Resting tremor, rigidity, akinesia, postural instability
Parkinson disease (nigrostriatal dopamine depletion)
83
Retinal hemorrhages w/ pale centers
Roth spots (bacterial endocarditis)
84
Severe jaundice in neonate
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
85
Severe RLQ pain w/ palpation of LLQ
Rovsing sign (acute appendicitis)
86
Severe RLQ pain w/ rebound tenderness
McBurney sign (acute appendicitis)
87
Short stature, increased incidence of tumors/leukemia, aplastic anemia
Fanconi anemia (genetic loss of DNA cross link repair; often progresses to AML)
88
Single palmar crease
Down syndrome
89
Situs inversus, chronic sinusitis, bronchiectasis, infertility
Kartagener syndrome (dynein arm defect affecting cilia)
90
Skin hyperpigmentation, hypotension, fatigue
Addison disease (primary adrenocortical insufficiency --> increased ACTH and increased alpha-MSH production)
91
Slow, progressive muscle weakness in boys
Becker muscular dystrophy (X-linked missense mutation in dystophin; less severe than Duchenne)
92
Small, irregular red spots on buccal/lingual mucosa w/ blue-white centers
Koplik spots (measles; rubeola virus)
93
Smooth, flat, moist, painless white lesions on genitals
Condylomata lata (secondary syphilis)
94
Splinter hemorrhages in fingernails
Bacterial endocarditis
95
"Strawberry tongue"
Scarlet fever, Kawasaki disease, toxic shock syndrome
96
Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema
Turner syndrome (45, XO)
97
Sudden swollen/painful big toe joint, tophi
Gout/podagra (hyperuricemia)
98
Swollen gums, mucosal bleeding, poor wound healing, petechiae
Scurvy (Vit C deficiency; can't hydroxylate proline/lysine for collagen synthesis)
99
Swollen, hard, painful finger joints
Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP [Heberden nodes])
100
Systolic ejection murmur (crescendo-decrescendo)
Aortic valve stenosis
101
Medullary thyroid CA, parathyroid tumors, pheochromocytoma
MEN 2A (autosomal dominant ret mutation)
102
Medullary thyroid CA, pheochromocytoma, mucosal neuromas
MEN 2B (autosomal dominant ret mutation)
103
Toe extension/fanning upon plantar scrape
Babinski sign (UMN lesion)
104
Unilateral facial drooping involving forehead
Facial nerve (LMN CN VII palsy)
105
Urethritis, conjunctivitis, arthritis in a male
Reactive arthritis (ass. w/ HLA-B27)
106
Vascular birthmark (port-wine stain)
Hemangioma (benign, but ass. w/ Sturge-Weber syndrome)
107
Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple disease (Tropheryma whipplei)
108
Anticentromere antibodies
Scleroderma (CREST)
109
Antidesmoglein (epithelial) antibodies
Pemphigus vulgaris (blistering)
110
Anti-glomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis & hemoptysis)
111
Antihistone antibodies
Drug induced SLE (hydrazine, INH, phenytoin, procainamide)
112
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniére deformity)
113
Antimitochondrial antibodies (AMAs)
Primary biliary cirrhosis (female, cholestasis, portal HTN)
114
Antineutrophil cytoplasmic antibodies (ANCAs)
Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA); granulomatosis w/ polyangiitis (Wegener; PR3-ANCA/c-ANCA)
115
Antinuclear antibodies (ANAs: anti-Smith & anti-dsDNA)
SLE (type III hypersensitivity)
116
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
117
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
118
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, distention, weight loss)
119
"Apple core" lesion on abdominal x-ray
Colorectal cancer (usually left-sided)
120
Azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts
Auer rods (AML, especially the promyelocytic [M3] type)
121
Bacitracin response
Sensitive: Streptococcus pyogenes (group A); resistant: Stretococcus agalactiae (group B)
122
"Bamboo spine" on x-ray
Akylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
123
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
124
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia
125
Bloody tap on LP
Subarachnoid hemorrhage
126
"Boot-shaped" heart on x-ray
Tetrolagy of Fallot, RVH
127
Branching gram-positive rods w/ sulfur granules
Actinomyces israelii
128
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress sympathetic ganglion and cause Horner syndrome)
129
"Brown" tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
130
Cardiomegaly w/ apical atrophy
Chagas disease (Trypanosoma cruzi)
131
Cellular crescents in Bowman capsule
Rapidly progressive crescentic glomerulonephritis
132
"Chocolate cyst" of ovary
Endometriosis (frequently involves both ovaries)
133
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
134
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (AR mutation in CFTR gene --> fat-soluble vitamin deficiency and mucous plugs)
135
Decreased AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
136
Degeneration of dorsal column nerves
Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
137
Depigmentation of neurons in substantial nigra
Parkinson Disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
138
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
139
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
140
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
141
Enlarged cells with intranuclear inclusion bodies
"Owl eye" appearance of CMV
142
Enlarged thyroid cells w/ ground-glass nuclei
"Orphan Annie" eyes nuclei (papillary carcinoma of the thyroid)
143
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
144
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy Body (Parkinson disease)
145
Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
146
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells
Negri bodies of rabies
147
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
148
Gian B cells with bilobed nuclei with prominent inclusions ("Owl's eye")
Reed-Sternberg cells (Hodgkin lymphoma)
149
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
150
"Hair on end" (crew-cut) appearance on x-ray
Beta-Thalassemia, sickle cell anemia (marrow expansion)
151
hCG elevated
Choriocarcinoma, hydatiform mole (occurs w/ and without embryo, and multiple pregnancy)
152
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
153
Heterophile antibodies
Infectious mononucleosis (EBV)
154
Hexagonal, double-pointed, needle-crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
155
High level of D-dimers
DVT, PE, DIC
156
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon comlex (primary TB: Mycobacterium bacilli)
157
"Honeycomb lung" on x-ray or CT
Interstitial pulmonary fibrosis
158
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
159
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic deficiency)
160
Hypertension, hypokalemia, metabolic alkalosis
Conn syndrome
161
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
162
Increased AFP in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (neural tube defects)
163
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
164
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or CMV)
165
Iron-containing nodules in alveolar septum
Ferrugious bodies (asbestosis)
166
Keratin pearls on a skin biopsy
Squamous cell carcinoma
167
Large lysosomal vesicles in phagocytes, immunodeficiency
Chédiak-Higashi disease (congenital failure of phagolysosome formation)
168
"Lead pipe" appearance of colon on barium enema x-ray
Ulcerative colitis (loss of haustrau)
169
Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture syndrome
170
Low serum ceruloplasmin
Wison disease (hepatolenticular degeneration)
171
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
172
Lytic ("hole punched") bone lesions on x-ray
Multiple myeloma
173
Mammary gland ("Blue domed") cyst
Fibrocystic change of the breast
174
Monoclonal antibody spike
- monoclonal myeloma (usually IgG or IgA)
- monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
- Waldenstöm (M protein = IgM) macroglobulinemia
- primary amyloidosis
175
Mucin-filled cell with peripheral nucleus
"Signet ring" (gastric carcinoma)
176
Narrowing of bowel lumen on barium x-ray
"String sign" (Crohn disease)
177
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
178
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
179
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
180
Novobiocin response
Sensitive: Staph epidermidis; resistant: Staph saprophyticus
181
"Nutmeg" appearance of liver
Chronic passive congestion of liver due to right heart failure
182
"Onion skin" periosteal reaction
Ewing sarcoma (malignant round-cell tumor)
183
Optochin response
Sensitive: Strep pneumo; resistant: viridans strep
184
Periosteum raised from bone, creating triangular area
Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)
185
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child w/ nephrotic syndrome)
186
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
187
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
188
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
189
Pseudopalisading tumor cells on brain biopsy
Glioblastoma mutliforme
190
RBC casts in urine
Acute glomerulonephritis
191
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
192
Renal epithelial casts in urine
Acute toxic/viral renal injury
193
Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
194
Rib notching, LE claudication, decreased femoral pulses
Coarctation of the aorta
195
Ring enhancing brain lesion in AIDS
Toxoplasma gondii, CNS lymphoma
196
Sheets of medium-sized lymphoid cells w/ scattered pale, tingible body-laden macrophages ("starry sky" histology)
Burkitt lymphoma (t[8;14] c-myc activation, associated w/ EBV; "black sky" made up of malignant cells)
197
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
198
"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
199
"Spikes" on basement membrane, "dome-like" sub epithelial deposits
Membranous glomerulonephritis (may progress to nephrotic syndrome)
200
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
201
"Tennis racket"-shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)
202
"Thumb sign" on lateral x-ray
Epiglottitis (Haemophilus influenzae)
203
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
204
"Tram-track" appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
205
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
206
"Waxy" casts w/ very low urine flow
Chronic end-stage renal disease
207
WBC casts in urine
Acute pyelonephritis
208
WBCs that look "smudged"
CLL (almost always B cell)
209
"Wire loop" glomerular capillary appearance on light microscopy
Lupus nephropathy
210
Yellowish CSF
Xanthochromia (e.g., due to subarachnoid hemorrhage)
211
Tx: absence seizures
Ethosuximide
212
Tx: acute promyelocytic leukemia (M3)
All-trans retinoic acid
213
Tx: alcohol withdrawal
Benzodiazepines
214
Anticoagulation during pregnancy
Heparin
215
Tx: arrhythmia in damaged cardiac tissue
Class IB antiarrhythmic (lidocaine, mexiletine, tocainide)
216
Tx: bipolar disorder
Lithium, valproate, carbamazepine, lamotrigine (mood stabilizers)
217
Tx: Candida albicans
Amphotericin B (systemic), nystatin (oral thrush), azoles (vaginitis)
218
Tx: Carcinoid syndrome
Octreotide
219
Tx: chronic hepatitis
IFN-alpha
220
Tx: CML
Imatinib
221
Tx: CMV
ganciclovir
222
Tx: Crohn disease
Corticosteroids, infliximab, methotrexate, azathioprine
223
Tx: Cryptococcus neoformans
Fluconazole (prophylaxis in AIDS patients)
224
Tx: Diabetic ketoacidosis
Fluids, insulin, potassium
225
Tx: ethylene glycol/methanol intoxication
Fomepizole (alcohol dehydrogenase inhibitor)
226
Tx: H. influenza B
Rifampin (prophylaxis)
227
Tx: Generalized anxiety disorder
Buspirone
228
Tx: heparin toxicity (acute)
protamine sulfate
229
Tx: NER2/neu pos. breast CA
Trastuzumab
230
Tx: hyperaldosteronism
Spironolactone
231
Tx: hypertriglyceridemia
Fibrate
232
Tx: malaria
chloroquine/mefloquine (for blood schizont), primaquine (for liver hypnozoite)
233
Tx: malignant hyperthermia
Dantrolene
234
Tx: Migraine
Sumatriptan
235
Tx: Multiple sclerosis
Beta-interferon, immunosuppresion, natalizumab
236
Tx: Mycobacterium tuberculosis
RIPE (rifampin, INH, pyrazinamide, ethambutol)
237
Tx: prolactinoma
Bromocriptine (dopamine agonist)
238
Tx: prostate cancer/uterine fibroids
Leuprolide, GnRH (continuous)
239
Tx: Pulmonary arterial hypertension (idiopathic)
Sildenafil, bosentan, epoprostenol
240
Tx: SIADH
Demeclocycline, lithium, vasopressin receptor antagonists
241
Tx: Sickle cell anemia
Hydroxyurea (increased fetal hemoglobin)
242
Tx: Sporothrix schenckii
Oral potassium iodide
243
Tx: tonic-clonic seizures
Phenytoin, valproate, carbamazepine
244
Tx: trigeminal neuralgia (tic douloureux)
Carbamazepine
245
Acute gastric ulcer associated w/ CNS injury
Cushing ulcer (increased intracranial pressure stimulates vagal gastric secretion)
246
Acute gastric ulcer associated w/ severe burns
Curling ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
247
Alternating areas of transmural inflammation and normal colon
Skip lesions (Crohn disease)
248
Atrophy of mammillary bodies
Wernicke encephalopathy (thiamine deficiency causing ataxia, ophthalmoplegia, and confusion)
249
Bleeding disorder w/ GpIb deficiency
Bernar-Soulier syndrome (defect in platelet adhesion to von Willebrand factor)
250
Cardiac manifestation of lupus
Libman-Sacks endocarditis (non-bacterial, affecting both sides of mitral valve)
251
Cerebellar tonsillar herniation
Chiari II malformation
252
Congenital adrenal hyperplasia, hypotension
21-hydroxylase deficiency
253
Congenital conjugated hyperbilirubinemia (black liver)
Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)
254
Hepatocellular carcinoma
Cirrhotic liver (associated w/ hepatitis B & C and with alcoholism)
255
HLA-B27
Ankylosing spondylitis, reactive arthritis, ulcerative colitis, psoriatic arthritis
256
HLA-DR3 or -DR4
Diabetes mellitus type 1, rheumatoid arthritis, SLE
257
Infections in chronic granulomatous disease
Staph aureus, E. col, Aspergillus (catalase +)
258
Kidney stones
- Calcium = radiopaque
- Struvite (ammonium) = radiopaque (formed by urease + organisms such as Proteus vulgarism or Staphylococcus)
- Uric acid = radiolucent
259
Metastases to bone
Prostate, breast > lung > thyroid
260
Metastases to brain
Lung > breast > genitourinary > melanoma > GI
261
Metastases to liver
Colon >> stomach, pancreas
262
Mitral valve stenosis
Rheumatic heart disease
263
Mixed (UMN and LMN) motor neuron disease
Amyotrophic lateral sclerosis
264
Osteomyelitis in sickle cell disease
Salmonella
265
Nephrotic syndrome (adults)
Focal segmental glomerulosclerosis
266
Nephrotic syndrome (kids)
Minimal change disease
267
Philadelphia chromosome t(9;22) (bcr-abl)
CML (may sometime be associated w/ ALL/AML)
268
S4
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
269
SIADH
Small cell carcinoma of the lung
270
Stomach ulcerations and high gastrin levels
Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
271
t(14;18)
Follicular lymphomas (bcl-2 activation)
272
t(8;14)
Burkitt lymphoma (c-myc activation)
273
t(9;22)
Philadelphia chromosome, CML (bcr-abl fusion)
274
Thyroid cancer
Papillary carcinoma
275
Schizophrenia
> 6 months
276
Brief psychotic disorder
< 1 month
277
Schizophreniform
1-6 months
278
Schizoaffective disorder
At least 2 weeks of stable mood w/ psychotic symptoms, plus a major depressive, manic, or mixed episode
279
Generalized anxiety disorder
> 6 months
280
Adjustment disorder
Identifiable psychosocial stressor; lasting < 6 months
281
PTSD
> 1 month
282
Acute stress disorder
3 days - <1 month
283
Schizoid
Voluntary social withdrawal. Content with social isolation
Cluster A. "Schizoids avoid"
284
Schizotypal
Eccentric appearance, odd beliefs or magical thinking
Cluster A
285
Down syndrome
Quad screen: decreased AFP, increased hCG, decreased estriol, increased inhibin A
286
Edwards syndrome
Quad screen: decreased AFP, decreased hCG, decreased estriol, decreased/normal inhibin A
287
Vit B3
Niacin
- NAD+/NADP+ (redox rxns)
- derived from tryptophan
Deficiency - Pellagra
288
Vit B6
Pridoxine
- converted to pyridoxal phosphate
Deficiency - convulsions, hyperirritability, peripheral neuropathy, sideroblastic anemias
289
Vit B7
Biotin
| - cofactors for carboxylation enzymes
290
Vit B9
Folic Acid
- inverted to THF
- important role in DNA/RNA synth
Deficiency - macrocytic, megaliths stop anemia; NO neuro sxs; normal methylmalonic acid
291
Vit B12
Cobalamin
Deficiency- macrocytic, megaliths stick anemia; *paresthesias; increased methylmalonic acid.
292
Essential fructosuria
Defect in fructokinase
Benign - fructose appears in blood/urine
293
Fructose intolerance
Deficient aldolase B
Sxs: hypoglycemia, jaundice, hepatomegaly, vomiting
294
Galactokinase deficiency
Relatively mild
- galctitol accumulates
Infantile cataracts
295
Classic galactosemia
Absence of galactose-1-P uridyltransferase
Sxs: fail to thrive, jaundice, hepatomegaly, infant cataracts, intellectual disability.
296
Ornithine transcarbamylase deficiency
Urea cycle disorder
- excess carbamoyl phosphate is converted to orotic acid
- decreased BUN, sxs of hyperammonia
297
Homocystinuria
Findings: increased homocysteine in urine, intellectual disability, osteoporosis, tall stature, kyphosis, lens subluxation, thrombosis, atherosclerosis
298
Maple syrup urine disease
Due to decreased alpha-ketoacid dehydrogenase (B1)
Tx: restrict leucine, isoleucine, valine in diet
299
Diphtheria toxin
Inactivation of EF-2
300
Exotoxin A
Pseudomonas
Inactivation of EF-2
301
Shiga toxin
Inactivates 60S ribosome by removing adenine from rRNA
302
Shiga-like toxin
EHEC
Inactivates 60S ribosome by removing adenine from rRNA
Enhances cytokines release, causing HUS; does not invade host
303
Heat-Labile toxin
ETEC
Over activates adenylate cyclase--> Cl- secretion in gut and H2O efflux
Watery diarrhea (Travelers diarrhea)
304
Heat-stable toxin
ETEC
Over activates guanylate cyclase --> decreased resorption of NaCl and H2O in gut
Watery diarrhea (travelers diarrhea)
305
Cholera toxin
Increased cAMP by permanently activating Gs --> increased Cl- secretion in gut and H2O efflux
"Rice-water" diarrhea
306
Pertussis toxin
Overactivates adenylate cyclase by disabling Gi, impairing phagocytosis to permit survival of microbe
307
Alpha toxin
C. Perfringens
Phospholipase (lecithinase) that degrades tissue and cell membranes
308
Streptolysin O
Strep pyogenes
Protein that degrades cell membrane; host antibodies against toxin (ASO) used to diagnose rheumatic fever
309
Lactose-fermenting G(-) rods
```
Citrobacter
Klebsiella
E. Coli
Enterobacter
Serratia
```
310
HIV env gene
gp120 - attachment to host CD4+ T cell
gp41 - fusion and entry
311
HIV gag gene
p24 - capsid protein
312
HIV pol gene
Reverse transcriptase, aspartate protease, integrase
313
CSF findings in bacterial meningitis
Increased PMNs, increased protein, DECREASED sugar
314
CSF findings in Viral meningitis
Increased LYMPHOCYTES, NORMAL sugar
315
Congenital toxoplasmosis
Triad: chorizo retinitis, hydrocephalus, intracranial calcifications
316
Congenital rubella
Triad: PDA, cataracts, deafness ( ~ "blueberry muffin" rash)
317
Congenital CMV
Hearing loss, seizures, petechial rash
318
Congenital HSV-2
Encephalitis, hermetic lesions
319
Congenital parvovirus B-19
Hydrops fetalis
320
Anti-smooth muscle
Autoimmune hepatitis
321
Anti-TSH receptor
Graves
322
c-ANCA (PR3-ANCA)
Granulomatosis with polyangiitis
323
p-ANCA (MPO-ANCA)
Microscopic polyangiitis, Churg-Strauss syndrome
324
anti-CCP
Rheumatoid arthritis
325
anti-thyroglobulin
Hashimoto
326
Cyclosporine
Calcinuerin inhibitor
- prevents IL-2 transcription
Nephrotoxic & gingival hyperplasia
327
Tacrolimus
Calcineurin inhibitor
| - prevents IL-2 transcription
328
Azathioprine
Antimetabolite precursor of 6-mercaptopurine
-blocks nucleotide synthesis
Degraded by xanthine oxidase
329
Glucocorticoids
Inhibit NF-kB
| - decrease transcription of many cytokines
330
Rituximab
CD20
331
Trastuzumab
HER2/neu
332
Infliximab
| Adalimumab
TNF-alpha
333
Denosumab
RANKL
334
Renal clearance
Cx = UxV/Px
335
Glomerular Filtration Rate
GFR= Uinulin X V/Pinulin = Cinulin
336
Effective renal plasma flow
ERPF = U(pah) x V/P(pah)
RBF = RPF/(1-Hct)
337
Filtration fraction
FF=GFR/RPF
Normal = 20%
