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Step 1 High Yield > Rapid Review > Flashcards

Rapid Review Flashcards

1
Q

Abdominal pain, ascites, hepatomegaly

A

Budd-Chiari syndrome (posthepatic venous thrombosis)

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2
Q

Achilles tendon xanthoma

A

Familial hypercholesterolemia (decreased LDL receptor signaling)

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3
Q

Adrenal hemorrhage, hypotension, DIC

A

Waterhouse Friedrichsen syndrome (meningococcemia)

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4
Q

Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints

A

Marfan syndrome

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5
Q

Back pain, fever, night sweats, weight loss

A

Pott disease (vertebral TB)

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6
Q

Bilateral hilar adenopathy, uveitis

A

Sarcoidosis (noncaseating granulomas)

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7
Q

Blue sclera

A

Osteogenesis imperfecta (Type I collagen defect)

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8
Q

Bluish line on gingiva

A

Burton line (lead poisoning)

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9
Q

Bone pain, bone enlargement, arthritis

A

Paget disease of bone (increased osteoblastic and osteoclastic activity)

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10
Q

Bounding pulses, diastolic heart murmur, head bobbing

A

Aortic regurgitation

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11
Q

Café-au-lait spots, Lisch nodules (iris hamartoma)

A

Neurofibromatosis type I (+ pheochromocytoma, optic gliomas)

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12
Q

Café-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, mutliple endocrine abnormalities

A

McCune-Albright (mosaic G-protein signaling mutation)

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13
Q

Calf pseudohypertrophy

A

Muscular dystrophy (Duchenne = most common; X-linked deletion of dystrophin gene)

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14
Q

“Cherry-red spots” on macula

A

Tay-Sachs (acc. ganglioside); Nieman-Pick (acc. sphingomyelin); central retinal artery occlusion

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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)

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16
Q

Child w/ fever later develops red rash on face that spreads to body

A

“Slapped cheeks” (erythema infectiosum/fifth disease: parvovirus B19)

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17
Q

Chorea, dementia, caudate degeneration

A

Huntington disease (autosomal dominant CAG repeat expansion)

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18
Q

Chronic exercise intolerance w/ myalgia, fatigue, painful cramps, myoglobinuria

A

McArdle disease (muscle glycogen phosphorylase deficiency)

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19
Q

Conjugate lateral gaze palsy, horizontal diploplia

A

Internuclear ophthalmoplegia (damage to MLF; bilateral [MS], unilateral [stroke]

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20
Q

Continuous “machine-like” heart murmur

A

PDA (close w/ indomethacin; open/maintain with misoprostol)

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21
Q

Cutaneous/dermal edema due to connective tissue deposition

A

Myxedema (caused by hypothyroidism, Graves disease [pretibial])

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22
Q

Dark purple skin/mouth nodules in pt w/ AIDS

A

Kaposi sarcoma, ass. w/ HHV-8

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23
Q

Dermatitis, dementia, diarrhea

A

Pellagra (niacin [vit B3] deficiency)

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24
Q

Dilated cardiomyopathy, edema, alcoholism/malnutrition

A

Wet beriberi (thiamine [vit B1] deficiency)

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25
Q

Dog/cat bite resulting in infection

A

Pasteurella multocida

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26
Q

Dry eyes, dry mouth, arthritis

A

Sjögren syndrome (autoimmune destruction of exocrine glands)

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27
Q

Dysphagia (esophageal webs), glossitis, iron deficiency anemia

A

Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)

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28
Q

Enlarged, hard left supraclavicular node

A

Virchow node (abdominal metastasis)

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29
Q

Erythroderma, LAD, hepatosplenomegaly, atypical T cells

A

Mycosis fungoides (cutaneous T-cell lymphoma) or Sézary syndrome (mycosis fungoides + malignant T cells in blood)

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30
Q

Facial muscle spasm upon tapping

A

Chvostek sign (hypocalcemia)

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31
Q

Fat, female, forty, and fertile

A

Cholelithiasis

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32
Q

Fever, chills, headache, myalgia following antibiotic treatment for syphilis

A

Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)

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33
Q

Fever, cough, conjunctivitis, coryza, diffuse rash

A

Measles

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34
Q

Fever, night sweats, weight loss

A

B symptoms (staging) of lymphoma

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35
Q

Fibrous plaques in soft tissue of penis

A

Peyronie disease (connective tissue disorder)

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36
Q

Gout, intellectual disability, self-mutilating behavior in a boy

A

Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)

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37
Q

Hamartomatous GI polyps, hyper pigmentation of mouth/feet/hands

A

Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; increase cancer risk, mainly GI)

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38
Q

Hepatosplenomegaly, osteoporosis, neurologic symptoms

A

Gaucher disease (glucocerebrosidase deficiency)

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39
Q

Hereditary nephritis, sensorineural hearing loss, cataracts

A

Alport syndrome (mutation in collagen IV); “Can’t see, can’t pee, can’t hear high-C”

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40
Q

Hyperphagia, hypersexuality, hyperorality, hyperdocility

A

Klüver-Bucy syndrome (bilateral amygdala lesion)

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41
Q

Hyperreflexia, hypertonia, Babinski sign present

A

UMN damage

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42
Q

Hyporeflexia, hypotonia, atrophy, fasciculations

A

LMN damage

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43
Q

Hypoxemia, polycythemia, hypercapnia

A

“Blue bloater” (Chronic bronchitis: hyperplasia of mucous cells)

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44
Q

Indurated, ulcerated genital lesion

A

Nonpainful: chancre (primary syphilis: treponema pallidum)

Painful, w/ exudate: chancroid (Haemophilus ducreyi)
“You ‘do cry’ w/ H. ducreyi”

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45
Q

Infant w/ cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia

A

Patau syndrome (trisomy 13)

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46
Q

Infant w/ failure to thrive, hepatosplenomegaly, and neurodegeneration

A

Nieman-Pick disease (genetic sphingomyelinase deficiency)

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47
Q

Infant w/ hypoglycemia, failure to thrive, and hepatomegaly

A

Cori disease (debranching enzyme deficiency) or Von Gierke disease (glucose-6-P deficiency, more severe)

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48
Q

Infant w/ microcephaly, rocker-bottom feet, clenched hands, and structural heart defect

A

Edwards syndrome (trisomy 18)

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49
Q

Jaundice, palpable distended non-tender gallbladder

A

Courvoisier sign (distal obstruction of biliary tree)

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50
Q

Large rash w/ bull’s-eye appearance

A

Erythema chronicum migraines from Ixodes tick bite (Lyme disease: Borrelia)

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51
Q

Lucid interval after traumatic brain injury

A

Epidural hematoma (middle meningeal artery rupture)

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52
Q

Male child, recurrent infections, no mature B cells

A

Bruton disease (X-linked agammaglobulinemia)

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53
Q

Mucosal bleeding and prolonged bleeding time

A

Glanzmann thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)

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54
Q

Muffled hear sounds, distended neck veins, hypotension

A

Beck triad of cardiac tamponade

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55
Q

Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth

A

Gardner syndrome (subtype of FAP)

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56
Q

Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance

A

Pompe disease (lysosomal alpha-1,4-glucosidase deficiency)

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57
Q

Neonate w/ arm paralysis following difficult birth

A

Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: “waiter’s tip”

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58
Q

No lactation postpartum, absent menstruation, cold intolerance

A

Sheehan syndrome (pituitary infarction)

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59
Q

Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia

A

Multiple Sclerosis

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60
Q

Oscillating slow/fast breathing

A

Cheyne-Stokes respirations (central apnea in CHF or increased intracranial pressure)

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61
Q

Painful blue fingers/toes, hemolytic anemia

A

Cold agglutinin disease (AI hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis)

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62
Q

Painful, pale, cold fingers/toes

A

Raynaud phenomenon (vasospasm in extremities)

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63
Q

Painful, raised red lesions on pad of fingers/toes

A

Osler nodes (infective endocarditis, immune complex deposition)

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64
Q

Painless erythematous lesions on palms and soles

A

Janeway lesions (infective endocarditis, septic emboli/microabscesses)

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65
Q

Painless jaundice

A

Cancer of the pancreatic head obstructing bile duct

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66
Q

Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria

A

Henoch-Schönlein purpura (IgA vasculitis affecting skin and kidneys)

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67
Q

Pancreatic, pituitary, parathyroid tumors

A

MEN 1 (autosomal dominant)

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68
Q

Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia

A

Nephrotic syndrome

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69
Q

Pink complexion, dyspnea, hyperventilation

A

“Pink puffer” (emphysema: centriacinar [smoking], panacinar [alpha1-antitrypsin deficiency])

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70
Q

Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets

A

Fanconi syndrome (proximal tubular reabsorption defect)

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71
Q

Pruritic, purple, polygonal planar papules and plaques (6 P’s)

A

Lichen planus

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72
Q

Ptosis, miosis, anhidrosis

A

Horner syndrome (sympathetic chain lesion)

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73
Q

Pupil accommodates but doesn’t react

A

Argyll Robertson pupil (neurosyphilis)

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74
Q

Rapidly progressive leg weakness that ascends following GI/upper resp infections

A

Guillain-Barré syndrome (acute autoimmune inflammatory demyelinating polyneuropathy)

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75
Q

Rash on palms and soles

A

Coxsackie A, secondary syphilis, Rocky Mt spotted fever

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76
Q

Recurrent colds, unusual eczema, high serum IgE

A

Hyper-IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)

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77
Q

Red “currant jelly” sputum in alcoholic or diabetic patients

A

Klebsiella pneumoniae

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78
Q

Red “currant jelly” stools

A

Acute mesenteric ischemia (adults); intussusception (infants)

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79
Q

Red, itchy, swollen rash of nipple/areola

A

Paget disease of the breast (sign of underlying neoplasm)

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80
Q

Red urine in the morning, fragile RBCs

A

Paroxysmal nocturnal hemoglobinuria

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81
Q

RCC (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma

A

von Hippel-Lindau disease (dominant tumor suppressor gene mutation)

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82
Q

Resting tremor, rigidity, akinesia, postural instability

A

Parkinson disease (nigrostriatal dopamine depletion)

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83
Q

Retinal hemorrhages w/ pale centers

A

Roth spots (bacterial endocarditis)

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84
Q

Severe jaundice in neonate

A

Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)

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85
Q

Severe RLQ pain w/ palpation of LLQ

A

Rovsing sign (acute appendicitis)

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86
Q

Severe RLQ pain w/ rebound tenderness

A

McBurney sign (acute appendicitis)

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87
Q

Short stature, increased incidence of tumors/leukemia, aplastic anemia

A

Fanconi anemia (genetic loss of DNA cross link repair; often progresses to AML)

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88
Q

Single palmar crease

A

Down syndrome

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89
Q

Situs inversus, chronic sinusitis, bronchiectasis, infertility

A

Kartagener syndrome (dynein arm defect affecting cilia)

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90
Q

Skin hyperpigmentation, hypotension, fatigue

A

Addison disease (primary adrenocortical insufficiency –> increased ACTH and increased alpha-MSH production)

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91
Q

Slow, progressive muscle weakness in boys

A

Becker muscular dystrophy (X-linked missense mutation in dystophin; less severe than Duchenne)

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92
Q

Small, irregular red spots on buccal/lingual mucosa w/ blue-white centers

A

Koplik spots (measles; rubeola virus)

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93
Q

Smooth, flat, moist, painless white lesions on genitals

A

Condylomata lata (secondary syphilis)

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94
Q

Splinter hemorrhages in fingernails

A

Bacterial endocarditis

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95
Q

“Strawberry tongue”

A

Scarlet fever, Kawasaki disease, toxic shock syndrome

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96
Q

Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema

A

Turner syndrome (45, XO)

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97
Q

Sudden swollen/painful big toe joint, tophi

A

Gout/podagra (hyperuricemia)

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98
Q

Swollen gums, mucosal bleeding, poor wound healing, petechiae

A

Scurvy (Vit C deficiency; can’t hydroxylate proline/lysine for collagen synthesis)

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99
Q

Swollen, hard, painful finger joints

A

Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP [Heberden nodes])

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100
Q

Systolic ejection murmur (crescendo-decrescendo)

A

Aortic valve stenosis

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101
Q

Medullary thyroid CA, parathyroid tumors, pheochromocytoma

A

MEN 2A (autosomal dominant ret mutation)

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102
Q

Medullary thyroid CA, pheochromocytoma, mucosal neuromas

A

MEN 2B (autosomal dominant ret mutation)

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103
Q

Toe extension/fanning upon plantar scrape

A

Babinski sign (UMN lesion)

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104
Q

Unilateral facial drooping involving forehead

A

Facial nerve (LMN CN VII palsy)

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105
Q

Urethritis, conjunctivitis, arthritis in a male

A

Reactive arthritis (ass. w/ HLA-B27)

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106
Q

Vascular birthmark (port-wine stain)

A

Hemangioma (benign, but ass. w/ Sturge-Weber syndrome)

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107
Q

Weight loss, diarrhea, arthritis, fever, adenopathy

A

Whipple disease (Tropheryma whipplei)

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108
Q

Anticentromere antibodies

A

Scleroderma (CREST)

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109
Q

Antidesmoglein (epithelial) antibodies

A

Pemphigus vulgaris (blistering)

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110
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis & hemoptysis)

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111
Q

Antihistone antibodies

A

Drug induced SLE (hydrazine, INH, phenytoin, procainamide)

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112
Q

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniére deformity)

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113
Q

Antimitochondrial antibodies (AMAs)

A

Primary biliary cirrhosis (female, cholestasis, portal HTN)

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114
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA); granulomatosis w/ polyangiitis (Wegener; PR3-ANCA/c-ANCA)

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115
Q

Antinuclear antibodies (ANAs: anti-Smith & anti-dsDNA)

A

SLE (type III hypersensitivity)

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116
Q

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

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117
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

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118
Q

Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

A

Celiac disease (diarrhea, distention, weight loss)

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119
Q

“Apple core” lesion on abdominal x-ray

A

Colorectal cancer (usually left-sided)

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120
Q

Azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts

A

Auer rods (AML, especially the promyelocytic [M3] type)

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121
Q

Bacitracin response

A

Sensitive: Streptococcus pyogenes (group A); resistant: Stretococcus agalactiae (group B)

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122
Q

“Bamboo spine” on x-ray

A

Akylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

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123
Q

Basophilic nuclear remnants in RBCs

A

Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)

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124
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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125
Q

Bloody tap on LP

A

Subarachnoid hemorrhage

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126
Q

“Boot-shaped” heart on x-ray

A

Tetrolagy of Fallot, RVH

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127
Q

Branching gram-positive rods w/ sulfur granules

A

Actinomyces israelii

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128
Q

Bronchogenic apical lung tumor on imaging

A

Pancoast tumor (can compress sympathetic ganglion and cause Horner syndrome)

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129
Q

“Brown” tumor of bone

A

Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)

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130
Q

Cardiomegaly w/ apical atrophy

A

Chagas disease (Trypanosoma cruzi)

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131
Q

Cellular crescents in Bowman capsule

A

Rapidly progressive crescentic glomerulonephritis

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132
Q

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

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133
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

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134
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic fibrosis (AR mutation in CFTR gene –> fat-soluble vitamin deficiency and mucous plugs)

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135
Q

Decreased AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormality

136
Q

Degeneration of dorsal column nerves

A

Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)

137
Q

Depigmentation of neurons in substantial nigra

A

Parkinson Disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)

138
Q

Desquamated epithelium casts in sputum

A

Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)

139
Q

Disarrayed granulosa cells in eosinophilic fluid

A

Call-Exner bodies (granulosa-theca cell tumor of the ovary)

140
Q

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

141
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

142
Q

Enlarged thyroid cells w/ ground-glass nuclei

A

“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)

143
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

144
Q

Eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy Body (Parkinson disease)

145
Q

Eosinophilic globule in liver

A

Councilman body (toxic or viral hepatitis, often yellow fever)

146
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells

A

Negri bodies of rabies

147
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

148
Q

Gian B cells with bilobed nuclei with prominent inclusions (“Owl’s eye”)

A

Reed-Sternberg cells (Hodgkin lymphoma)

149
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

150
Q

“Hair on end” (crew-cut) appearance on x-ray

A

Beta-Thalassemia, sickle cell anemia (marrow expansion)

151
Q

hCG elevated

A

Choriocarcinoma, hydatiform mole (occurs w/ and without embryo, and multiple pregnancy)

152
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

153
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

154
Q

Hexagonal, double-pointed, needle-crystals in bronchial secretions

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

155
Q

High level of D-dimers

A

DVT, PE, DIC

156
Q

Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

A

Ghon comlex (primary TB: Mycobacterium bacilli)

157
Q

“Honeycomb lung” on x-ray or CT

A

Interstitial pulmonary fibrosis

158
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

159
Q

Hypersegmented neutrophils

A

Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic deficiency)

160
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Conn syndrome

161
Q

Hypochromic, microcytic anemia

A

Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)

162
Q

Increased AFP in amniotic fluid/maternal serum

A

Dating error, anencephaly, spina bifida (neural tube defects)

163
Q

Increased uric acid levels

A

Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics

164
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or CMV)

165
Q

Iron-containing nodules in alveolar septum

A

Ferrugious bodies (asbestosis)

166
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

167
Q

Large lysosomal vesicles in phagocytes, immunodeficiency

A

Chédiak-Higashi disease (congenital failure of phagolysosome formation)

168
Q

“Lead pipe” appearance of colon on barium enema x-ray

A

Ulcerative colitis (loss of haustrau)

169
Q

Linear appearance of IgG deposition on glomerular basement membrane

A

Goodpasture syndrome

170
Q

Low serum ceruloplasmin

A

Wison disease (hepatolenticular degeneration)

171
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

172
Q

Lytic (“hole punched”) bone lesions on x-ray

A

Multiple myeloma

173
Q

Mammary gland (“Blue domed”) cyst

A

Fibrocystic change of the breast

174
Q

Monoclonal antibody spike

A
  • monoclonal myeloma (usually IgG or IgA)
  • monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
  • Waldenstöm (M protein = IgM) macroglobulinemia
  • primary amyloidosis
175
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” (gastric carcinoma)

176
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign” (Crohn disease)

177
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)

178
Q

Needle-shaped, negatively birefringent crystals

A

Gout (monosodium urate crystals)

179
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

180
Q

Novobiocin response

A

Sensitive: Staph epidermidis; resistant: Staph saprophyticus

181
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver due to right heart failure

182
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant round-cell tumor)

183
Q

Optochin response

A

Sensitive: Strep pneumo; resistant: viridans strep

184
Q

Periosteum raised from bone, creating triangular area

A

Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)

185
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child w/ nephrotic syndrome)

186
Q

Polished, “ivory-like” appearance of bone at cartilage erosion

A

Eburnation (osteoarthritis resulting in bony sclerosis)

187
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)

188
Q

Psammoma bodies

A

Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary

189
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma mutliforme

190
Q

RBC casts in urine

A

Acute glomerulonephritis

191
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

192
Q

Renal epithelial casts in urine

A

Acute toxic/viral renal injury

193
Q

Rhomboid crystals, positively birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

194
Q

Rib notching, LE claudication, decreased femoral pulses

A

Coarctation of the aorta

195
Q

Ring enhancing brain lesion in AIDS

A

Toxoplasma gondii, CNS lymphoma

196
Q

Sheets of medium-sized lymphoid cells w/ scattered pale, tingible body-laden macrophages (“starry sky” histology)

A

Burkitt lymphoma (t[8;14] c-myc activation, associated w/ EBV; “black sky” made up of malignant cells)

197
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

Pick bodies (Pick disease: progressive dementia, changes in personality)

198
Q

“Soap bubble” in femur or tibia on x-ray

A

Giant cell tumor of bone (generally benign)

199
Q

“Spikes” on basement membrane, “dome-like” sub epithelial deposits

A

Membranous glomerulonephritis (may progress to nephrotic syndrome)

200
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

201
Q

“Tennis racket”-shaped cytoplasmic organelles (EM) in Langerhans cells

A

Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)

202
Q

“Thumb sign” on lateral x-ray

A

Epiglottitis (Haemophilus influenzae)

203
Q

Thyroid-like appearance of kidney

A

Chronic bacterial pyelonephritis

204
Q

“Tram-track” appearance of capillary loops of glomerular basement membranes on light microscopy

A

Membranoproliferative glomerulonephritis

205
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

206
Q

“Waxy” casts w/ very low urine flow

A

Chronic end-stage renal disease

207
Q

WBC casts in urine

A

Acute pyelonephritis

208
Q

WBCs that look “smudged”

A

CLL (almost always B cell)

209
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Lupus nephropathy

210
Q

Yellowish CSF

A

Xanthochromia (e.g., due to subarachnoid hemorrhage)

211
Q

Tx: absence seizures

A

Ethosuximide

212
Q

Tx: acute promyelocytic leukemia (M3)

A

All-trans retinoic acid

213
Q

Tx: alcohol withdrawal

A

Benzodiazepines

214
Q

Anticoagulation during pregnancy

A

Heparin

215
Q

Tx: arrhythmia in damaged cardiac tissue

A

Class IB antiarrhythmic (lidocaine, mexiletine, tocainide)

216
Q

Tx: bipolar disorder

A

Lithium, valproate, carbamazepine, lamotrigine (mood stabilizers)

217
Q

Tx: Candida albicans

A

Amphotericin B (systemic), nystatin (oral thrush), azoles (vaginitis)

218
Q

Tx: Carcinoid syndrome

A

Octreotide

219
Q

Tx: chronic hepatitis

A

IFN-alpha

220
Q

Tx: CML

A

Imatinib

221
Q

Tx: CMV

A

ganciclovir

222
Q

Tx: Crohn disease

A

Corticosteroids, infliximab, methotrexate, azathioprine

223
Q

Tx: Cryptococcus neoformans

A

Fluconazole (prophylaxis in AIDS patients)

224
Q

Tx: Diabetic ketoacidosis

A

Fluids, insulin, potassium

225
Q

Tx: ethylene glycol/methanol intoxication

A

Fomepizole (alcohol dehydrogenase inhibitor)

226
Q

Tx: H. influenza B

A

Rifampin (prophylaxis)

227
Q

Tx: Generalized anxiety disorder

A

Buspirone

228
Q

Tx: heparin toxicity (acute)

A

protamine sulfate

229
Q

Tx: NER2/neu pos. breast CA

A

Trastuzumab

230
Q

Tx: hyperaldosteronism

A

Spironolactone

231
Q

Tx: hypertriglyceridemia

A

Fibrate

232
Q

Tx: malaria

A

chloroquine/mefloquine (for blood schizont), primaquine (for liver hypnozoite)

233
Q

Tx: malignant hyperthermia

A

Dantrolene

234
Q

Tx: Migraine

A

Sumatriptan

235
Q

Tx: Multiple sclerosis

A

Beta-interferon, immunosuppresion, natalizumab

236
Q

Tx: Mycobacterium tuberculosis

A

RIPE (rifampin, INH, pyrazinamide, ethambutol)

237
Q

Tx: prolactinoma

A

Bromocriptine (dopamine agonist)

238
Q

Tx: prostate cancer/uterine fibroids

A

Leuprolide, GnRH (continuous)

239
Q

Tx: Pulmonary arterial hypertension (idiopathic)

A

Sildenafil, bosentan, epoprostenol

240
Q

Tx: SIADH

A

Demeclocycline, lithium, vasopressin receptor antagonists

241
Q

Tx: Sickle cell anemia

A

Hydroxyurea (increased fetal hemoglobin)

242
Q

Tx: Sporothrix schenckii

A

Oral potassium iodide

243
Q

Tx: tonic-clonic seizures

A

Phenytoin, valproate, carbamazepine

244
Q

Tx: trigeminal neuralgia (tic douloureux)

A

Carbamazepine

245
Q

Acute gastric ulcer associated w/ CNS injury

A

Cushing ulcer (increased intracranial pressure stimulates vagal gastric secretion)

246
Q

Acute gastric ulcer associated w/ severe burns

A

Curling ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)

247
Q

Alternating areas of transmural inflammation and normal colon

A

Skip lesions (Crohn disease)

248
Q

Atrophy of mammillary bodies

A

Wernicke encephalopathy (thiamine deficiency causing ataxia, ophthalmoplegia, and confusion)

249
Q

Bleeding disorder w/ GpIb deficiency

A

Bernar-Soulier syndrome (defect in platelet adhesion to von Willebrand factor)

250
Q

Cardiac manifestation of lupus

A

Libman-Sacks endocarditis (non-bacterial, affecting both sides of mitral valve)

251
Q

Cerebellar tonsillar herniation

A

Chiari II malformation

252
Q

Congenital adrenal hyperplasia, hypotension

A

21-hydroxylase deficiency

253
Q

Congenital conjugated hyperbilirubinemia (black liver)

A

Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)

254
Q

Hepatocellular carcinoma

A

Cirrhotic liver (associated w/ hepatitis B & C and with alcoholism)

255
Q

HLA-B27

A

Ankylosing spondylitis, reactive arthritis, ulcerative colitis, psoriatic arthritis

256
Q

HLA-DR3 or -DR4

A

Diabetes mellitus type 1, rheumatoid arthritis, SLE

257
Q

Infections in chronic granulomatous disease

A

Staph aureus, E. col, Aspergillus (catalase +)

258
Q

Kidney stones

A
  • Calcium = radiopaque
  • Struvite (ammonium) = radiopaque (formed by urease + organisms such as Proteus vulgarism or Staphylococcus)
  • Uric acid = radiolucent
259
Q

Metastases to bone

A

Prostate, breast > lung > thyroid

260
Q

Metastases to brain

A

Lung > breast > genitourinary > melanoma > GI

261
Q

Metastases to liver

A

Colon&raquo_space; stomach, pancreas

262
Q

Mitral valve stenosis

A

Rheumatic heart disease

263
Q

Mixed (UMN and LMN) motor neuron disease

A

Amyotrophic lateral sclerosis

264
Q

Osteomyelitis in sickle cell disease

A

Salmonella

265
Q

Nephrotic syndrome (adults)

A

Focal segmental glomerulosclerosis

266
Q

Nephrotic syndrome (kids)

A

Minimal change disease

267
Q

Philadelphia chromosome t(9;22) (bcr-abl)

A

CML (may sometime be associated w/ ALL/AML)

268
Q

S4

A

Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)

269
Q

SIADH

A

Small cell carcinoma of the lung

270
Q

Stomach ulcerations and high gastrin levels

A

Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)

271
Q

t(14;18)

A

Follicular lymphomas (bcl-2 activation)

272
Q

t(8;14)

A

Burkitt lymphoma (c-myc activation)

273
Q

t(9;22)

A

Philadelphia chromosome, CML (bcr-abl fusion)

274
Q

Thyroid cancer

A

Papillary carcinoma

275
Q

Schizophrenia

A

> 6 months

276
Q

Brief psychotic disorder

A

< 1 month

277
Q

Schizophreniform

A

1-6 months

278
Q

Schizoaffective disorder

A

At least 2 weeks of stable mood w/ psychotic symptoms, plus a major depressive, manic, or mixed episode

279
Q

Generalized anxiety disorder

A

> 6 months

280
Q

Adjustment disorder

A

Identifiable psychosocial stressor; lasting < 6 months

281
Q

PTSD

A

> 1 month

282
Q

Acute stress disorder

A

3 days - <1 month

283
Q

Schizoid

A

Voluntary social withdrawal. Content with social isolation

Cluster A. “Schizoids avoid”

284
Q

Schizotypal

A

Eccentric appearance, odd beliefs or magical thinking

Cluster A

285
Q

Down syndrome

A

Quad screen: decreased AFP, increased hCG, decreased estriol, increased inhibin A

286
Q

Edwards syndrome

A

Quad screen: decreased AFP, decreased hCG, decreased estriol, decreased/normal inhibin A

287
Q

Vit B3

A

Niacin

  • NAD+/NADP+ (redox rxns)
  • derived from tryptophan

Deficiency - Pellagra

288
Q

Vit B6

A

Pridoxine
- converted to pyridoxal phosphate

Deficiency - convulsions, hyperirritability, peripheral neuropathy, sideroblastic anemias

289
Q

Vit B7

A

Biotin

- cofactors for carboxylation enzymes

290
Q

Vit B9

A

Folic Acid

  • inverted to THF
  • important role in DNA/RNA synth

Deficiency - macrocytic, megaliths stop anemia; NO neuro sxs; normal methylmalonic acid

291
Q

Vit B12

A

Cobalamin

Deficiency- macrocytic, megaliths stick anemia; *paresthesias; increased methylmalonic acid.

292
Q

Essential fructosuria

A

Defect in fructokinase

Benign - fructose appears in blood/urine

293
Q

Fructose intolerance

A

Deficient aldolase B

Sxs: hypoglycemia, jaundice, hepatomegaly, vomiting

294
Q

Galactokinase deficiency

A

Relatively mild
- galctitol accumulates

Infantile cataracts

295
Q

Classic galactosemia

A

Absence of galactose-1-P uridyltransferase

Sxs: fail to thrive, jaundice, hepatomegaly, infant cataracts, intellectual disability.

296
Q

Ornithine transcarbamylase deficiency

A

Urea cycle disorder

  • excess carbamoyl phosphate is converted to orotic acid
  • decreased BUN, sxs of hyperammonia
297
Q

Homocystinuria

A

Findings: increased homocysteine in urine, intellectual disability, osteoporosis, tall stature, kyphosis, lens subluxation, thrombosis, atherosclerosis

298
Q

Maple syrup urine disease

A

Due to decreased alpha-ketoacid dehydrogenase (B1)

Tx: restrict leucine, isoleucine, valine in diet

299
Q

Diphtheria toxin

A

Inactivation of EF-2

300
Q

Exotoxin A

A

Pseudomonas

Inactivation of EF-2

301
Q

Shiga toxin

A

Inactivates 60S ribosome by removing adenine from rRNA

302
Q

Shiga-like toxin

A

EHEC

Inactivates 60S ribosome by removing adenine from rRNA

Enhances cytokines release, causing HUS; does not invade host

303
Q

Heat-Labile toxin

A

ETEC

Over activates adenylate cyclase–> Cl- secretion in gut and H2O efflux

Watery diarrhea (Travelers diarrhea)

304
Q

Heat-stable toxin

A

ETEC

Over activates guanylate cyclase –> decreased resorption of NaCl and H2O in gut

Watery diarrhea (travelers diarrhea)

305
Q

Cholera toxin

A

Increased cAMP by permanently activating Gs –> increased Cl- secretion in gut and H2O efflux

“Rice-water” diarrhea

306
Q

Pertussis toxin

A

Overactivates adenylate cyclase by disabling Gi, impairing phagocytosis to permit survival of microbe

307
Q

Alpha toxin

A

C. Perfringens

Phospholipase (lecithinase) that degrades tissue and cell membranes

308
Q

Streptolysin O

A

Strep pyogenes

Protein that degrades cell membrane; host antibodies against toxin (ASO) used to diagnose rheumatic fever

309
Q

Lactose-fermenting G(-) rods

A 
Citrobacter 
Klebsiella
E. Coli 
Enterobacter 
Serratia
310
Q

HIV env gene

A

gp120 - attachment to host CD4+ T cell

gp41 - fusion and entry

311
Q

HIV gag gene

A

p24 - capsid protein

312
Q

HIV pol gene

A

Reverse transcriptase, aspartate protease, integrase

313
Q

CSF findings in bacterial meningitis

A

Increased PMNs, increased protein, DECREASED sugar

314
Q

CSF findings in Viral meningitis

A

Increased LYMPHOCYTES, NORMAL sugar

315
Q

Congenital toxoplasmosis

A

Triad: chorizo retinitis, hydrocephalus, intracranial calcifications

316
Q

Congenital rubella

A

Triad: PDA, cataracts, deafness ( ~ “blueberry muffin” rash)

317
Q

Congenital CMV

A

Hearing loss, seizures, petechial rash

318
Q

Congenital HSV-2

A

Encephalitis, hermetic lesions

319
Q

Congenital parvovirus B-19

A

Hydrops fetalis

320
Q

Anti-smooth muscle

A

Autoimmune hepatitis

321
Q

Anti-TSH receptor

A

Graves

322
Q

c-ANCA (PR3-ANCA)

A

Granulomatosis with polyangiitis

323
Q

p-ANCA (MPO-ANCA)

A

Microscopic polyangiitis, Churg-Strauss syndrome

324
Q

anti-CCP

A

Rheumatoid arthritis

325
Q

anti-thyroglobulin

A

Hashimoto

326
Q

Cyclosporine

A

Calcinuerin inhibitor
- prevents IL-2 transcription

Nephrotoxic & gingival hyperplasia

327
Q

Tacrolimus

A

Calcineurin inhibitor

- prevents IL-2 transcription

328
Q

Azathioprine

A

Antimetabolite precursor of 6-mercaptopurine
-blocks nucleotide synthesis

Degraded by xanthine oxidase

329
Q

Glucocorticoids

A

Inhibit NF-kB

- decrease transcription of many cytokines

330
Q

Rituximab

A

CD20

331
Q

Trastuzumab

A

HER2/neu

332
Q

Infliximab

Adalimumab

A

TNF-alpha

333
Q

Denosumab

A

RANKL

334
Q

Renal clearance

A

Cx = UxV/Px

335
Q

Glomerular Filtration Rate

A

GFR= Uinulin X V/Pinulin = Cinulin

336
Q

Effective renal plasma flow

A

ERPF = U(pah) x V/P(pah)

RBF = RPF/(1-Hct)

337
Q

Filtration fraction

A

FF=GFR/RPF

Normal = 20%

Step 1 High Yield (1 decks)

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