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Rapid Review Flashcards

1
Q

Abdominal pain, ascites, hepatomegaly

A

Budd-Chiari syndrome (posthepatic venous thrombosis)

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2
Q

Abdominal pain, diarrhea, leukocytosis, recent antibiotic use

A

Clostridium difficile infection

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3
Q

Achilles tendon xanthoma

A

Familial hypercholesterolemia (? LDL receptor signaling)

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4
Q

Adrenal hemorrhage, hypotension, DIC

A

Waterhouse-Friderichsen syndrome (meningococcemia)

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5
Q

Anaphylaxis following blood transfusion

A

IgA deficiency

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6
Q

Anterior “drawer sign” (+)

A

Anterior cruciate ligament injury

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7
Q

Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints

A

Marfan syndrome (fibrillin defect)

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8
Q

Athlete with polycythemia

A

2° to erythropoietin injection

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9
Q

Back pain, fever, night sweats

A

Pott disease (vertebral TB)

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10
Q

Bilateral acoustic schwannomas

A

Neurofibromatosis type 2

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11
Q

Bilateral hilar adenopathy, uveitis

A

Sarcoidosis (noncaseating granulomas)

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12
Q

Black eschar on face of patient with diabetic ketoacidosis

A

Mucor or Rhizopus fungal infection

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13
Q

Blue sclera

A

Osteogenesis imperfecta (type I collagen defect)

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14
Q

Bluish line on gingiva

A

Burton line (lead poisoning)

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15
Q

Bone pain, bone enlargement, arthritis

A

Paget disease of bone (? osteoblastic and osteoclastic activity)

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16
Q

Bounding pulses, diastolic heart murmur, head bobbing

A

Aortic regurgitation

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17
Q

Butterfly facial rash and Raynaud phenomenon in a young female

A

Systemic lupus erythematosus

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18
Q

Cafe?-au-lait spots, Lisch nodules (iris hamartoma), cutaneous neurofibromas, pheochromocytomas, optic gliomas

A

Neurofibromatosis type I, pheochromocytoma, optic gliomas

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19
Q

Cafe?-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities

A

McCune-Albright syndrome (mosaic G-protein signaling mutation)

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20
Q

Calf pseudohypertrophy

A

Muscular dystrophy (most commonly Duchenne, due to X-linked recessive frameshift mutation of dystrophin gene)

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21
Q

Cervical lymphadenopathy, desquamating rash, coronary aneurysms, red conjunctivae and tongue

A

Kawasaki disease (treat with IVIG and aspirin)

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22
Q

Cherry-red spots on macula

A

Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion

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23
Q

Chest pain on exertion

A

Angina (stable: with moderate exertion; unstable: with minimal exertion or at rest)

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24
Q

Chest pain, pericardial effusion/friction rub, persistent fever following MI

A

Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2-12 weeks after acute episode)

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25
Q

Chest pain with ST depressions on EKG

A

Unstable angina (troponins ?) or NSTEMI (troponins +)

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26
Q

Child uses arms to stand up from squat

A

Gowers sign (Duchenne muscular dystrophy)

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27
Q

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

A

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

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28
Q

Chorea, dementia, caudate degeneration

A

Huntington disease (autosomal dominant CAG repeat expansion)

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29
Q

Chorioretinitis, hydrocephalus, intracranial calcifications

A

Congenital toxoplasmosis

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30
Q

Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria

A

McArdle disease (skeletal muscle glycogen phosphorylase deficiency)

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31
Q

Cold intolerance

A

Hypothyroidism

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32
Q

Conjugate horizontal gaze palsy, horizontal diplopia

A

Internuclear ophthalmoplegia (damage to MLF; may be unilateral or bilateral)

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33
Q

Continuous “machine-like” heart murmur

A

PDA (close with indomethacin; open or maintain with PGE analogs)

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34
Q

Cutaneous/dermal edema due to connective tissue deposition

A

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

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35
Q

Cutaneous flushing, diarrhea, bronchospasm

A

Carcinoid syndrome (right-sided cardiac valvular lesions, 5-HIAA)

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36
Q

Dark purple skin/mouth nodules in a patient with AIDS

A

Kaposi sarcoma, associated with HHV-8

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37
Q

Deep, labored breathing/hyperventilation

A

Kussmaul respirations (diabetic ketoacidosis)

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38
Q

Dermatitis, dementia, diarrhea

A

Pellagra (niacin [vitamin B3] deficiency)

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39
Q

Dilated cardiomyopathy, edema, alcoholism or malnutrition

A

Wet beriberi (thiamine [vitamin B1] deficiency)

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40
Q

Dog or cat bite resulting in infection

A

Pasteurella multocida (cellulitis at inoculation site)

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41
Q

Dry eyes, dry mouth, arthritis

A

Sjo?gren syndrome (autoimmune destruction of exocrine glands)

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42
Q

Dysphagia (esophageal webs), glossitis, iron deficiency anemia

A

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

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43
Q

Elastic skin, hypermobility of joints, bleeding tendency

A

Ehlers-Danlos syndrome (type V collagen defect, type III collagen defect seen in vascular subtype of ED)

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44
Q

Enlarged, hard left supraclavicular node

A

Virchow node (abdominal metastasis)

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45
Q

Episodic vertigo, tinnitus, hearing loss

A

Meniere disease

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46
Q

Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells

A

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

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47
Q

Facial muscle spasm upon tapping

A

Chvostek sign (hypocalcemia)

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48
Q

Fat, female, forty, and fertile

A

Cholelithiasis (gallstones)

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49
Q

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

A

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

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50
Q

Fever, cough, conjunctivitis, coryza, diffuse rash

A

Measles

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51
Q

Fever, night sweats, weight loss

A

B symptoms (staging) of lymphoma

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52
Q

Fibrous plaques in soft tissue of penis with abnormalcurvature

A

Peyronie disease (connective tissue disorder)

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53
Q

Golden brown rings around peripheral cornea

A

Kayser-Fleischer rings (copper accumulation from Wilson disease)

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54
Q

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

A

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

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55
Q

Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands/genitalia

A

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

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56
Q

Hepatosplenomegaly, pancytopenia, osteoporosis, aseptic necrosis of femur, bone crises

A

Gaucher disease (glucocerebrosidase deficiency)

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57
Q

Hereditary nephritis, sensorineural hearing loss, cataracts

A

Alport syndrome (mutation in collagen IV)

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58
Q

Hyperphagia, hypersexuality, hyperorality, hyperdocility

A

Klu?ver-Bucy syndrome (bilateral amygdala lesion)

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59
Q

Hyperreflexia, hypertonia, Babinski sign present

A

UMN damage

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60
Q

Hyporeflexia, hypotonia, atrophy, fasciculations

A

LMN damage

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61
Q

Hypoxemia, polycythemia, hypercapnia

A

Blue bloater (chronic bronchitis: hyperplasia of mucous cells)

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62
Q

Indurated, ulcerated genital lesion

A

Nonpainful: chancre (1° syphilis, Treponema pallidum) Painful, with exudate: chancroid (Haemophilus ducreyi)

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63
Q

Infant with “cherry-red” spot on macula, hepatosplenomegaly, and neurodegeneration

A

Niemann-Pick disease (genetic sphingomyelinase deficiency)

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64
Q

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

A

Patau syndrome (trisomy 13)

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65
Q

Infant with hypoglycemia, hepatomegaly

A

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

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66
Q

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

A

Edwards syndrome (trisomy 18)

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67
Q

Jaundice, palpable distended non-tender gallbladder

A

Courvoisier sign (distal obstruction of biliary tree)

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68
Q

Large rash with bull’s-eye appearance

A

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

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69
Q

Lucid interval after traumatic brain injury

A

Epidural hematoma (middle meningeal artery rupture)

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70
Q

Male child, recurrent infections, no mature B cells

A

Bruton disease (X-linked agammaglobulinemia)

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71
Q

Mucosal bleeding and prolonged bleeding time

A

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

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72
Q

Muffled heart sounds, distended neck veins, hypotension

A

Beck triad of cardiac tamponade

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73
Q

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

A

Gardner syndrome (subtype of FAP)

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74
Q

Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance

A

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

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75
Q

Neonate with arm paralysis following difficult birth

A

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

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76
Q

No lactation postpartum, absent menstruation, cold intolerance

A

Sheehan syndrome (pituitary infarction)

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77
Q

Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia

A

Multiple sclerosis

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78
Q

Painful blue fingers/toes, hemolytic anemia

A

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

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79
Q

Painful fingers/toes changing color from blue to white to red with cold or stress

A

Raynaud phenomenon (vasospasm in extremities)

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80
Q

Painful, raised red lesions on pads of fingers/toes

A

Osler nodes (infective endocarditis, immune complex deposition)

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81
Q

Painless erythematous lesions on palms and soles

A

Janeway lesions (infective endocarditis, septic emboli/ microabscesses)

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82
Q

Painless jaundice

A

Cancer of the pancreatic head obstructing bile duct

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83
Q

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

A

Henoch-Scho?nlein purpura (IgA vasculitis affecting skin and kidneys)

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84
Q

Pancreatic, pituitary, parathyroid tumors

A

MEN 1 (autosomal dominant)

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85
Q

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

A

Nephrotic syndrome

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86
Q

Pink complexion, dyspnea, hyperventilation

A

Pink puffer (emphysema: centriacinar [smoking], panacinar [?1-antitrypsin deficiency])

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87
Q

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

A

Fanconi syndrome (multiple combined dysfunction of the proximal convoluted tubule)

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88
Q

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

A

Lichen planus

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89
Q

Ptosis, miosis, anhidrosis

A

Horner syndrome (sympathetic chain lesion)

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90
Q

Pupil accommodates but doesn’t react

A

Argyll Robertson pupil (neurosyphilis)

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91
Q

Rapidly progressive limb weakness that ascends following GI/upper respiratory infection

A

Guillain-Barre? syndrome (acute inflammatory demyelinating polyradiculopathy subtype)

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92
Q

Rash on palms and soles

A

Coxsackie A, 2° syphilis, Rocky Mountain spotted fever

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93
Q

Recurrent cold (noninflamed) abscesses, unusual eczema, high serum IgE

A

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

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94
Q

Red “currant jelly” sputum in alcoholic or diabetic patients

A

Klebsiella pneumoniae pneumonia

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95
Q

Red “currant jelly” stools

A

Acute mesenteric ischemia (adults), intussusception (children)

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96
Q

Red, itchy, swollen rash of nipple/areola

A

Paget disease of the breast (sign of underlying neoplasm)

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97
Q

Red urine in the morning, fragile RBCs

A

Paroxysmal nocturnal hemoglobinuria

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98
Q

Renal cell carcinoma (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma

A

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

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99
Q

Resting tremor, rigidity, akinesia, postural instability, shuffling gait

A

Parkinson disease (loss of dopaminergic neurons in substantia nigra pars compacta)

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100
Q

Retinal hemorrhages with pale centers

A

Roth spots (bacterial endocarditis)

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101
Q

Severe jaundice in neonate

A

Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)

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102
Q

Severe RLQ pain with palpation of LLQ

A

Rovsing sign (acute appendicitis)

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103
Q

Severe RLQ pain with rebound tenderness

A

McBurney sign (acute appendicitis)

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104
Q

Short stature, cafe? au lait spots, thumb/radial defects, ? incidence of tumors/leukemia, aplastic anemia

A

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

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105
Q

Single palmar crease

A

Down syndrome

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106
Q

Situs inversus, chronic sinusitis, bronchiectasis, infertility

A

Kartagener syndrome (dynein arm defect affecting cilia)

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107
Q

Skin hyperpigmentation, hypotension, fatigue

A

1° adrenocortical insufficiency (e.g., Addison disease) causes ACTH and ?-MSH production)

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108
Q

Slow, progressive muscle weakness in boys

A

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

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109
Q

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

A

Koplik spots (measles; rubeola virus)

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110
Q

Smooth, moist, painless, wart-like white lesions on genitals

A

Condylomata lata (2° syphilis)

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111
Q

Splinter hemorrhages in fingernails

A

Bacterial endocarditis

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112
Q

Strawberry tongue

A

Scarlet fever, Kawasaki disease

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113
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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114
Q

Sudden swollen/painful big toe joint, tophi

A

Gout/podagra (hyperuricemia)

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115
Q

Swollen gums, mucosal bleeding, poor wound healing, petechiae

A

Scurvy (vitamin C deficiency: can’t hydroxylate proline/lysine for collagen synthesis)

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116
Q

Swollen, hard, painful finger joints

A

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

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117
Q

Systolic ejection murmur (crescendo-decrescendo)

A

Aortic stenosis

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118
Q

Telangiectasias, recurrent epistaxis, skin discoloration, arteriovenous malformations, GI bleeding, hematuria

A

Osler-Weber-Rendu syndrome

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119
Q

Thyroid and parathyroid tumors, pheochromocytoma

A

MEN 2A (autosomal dominant RET mutation)

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120
Q

Thyroid tumors, pheochromocytoma, ganglioneuromatosis

A

MEN 2B (autosomal dominant RET mutation)

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121
Q

Toe extension/fanning upon plantar scrape

A

Babinski sign (UMN lesion)

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122
Q

Unilateral facial drooping involving forehead

A

LMN facial nerve (CN VII) palsy; UMN lesions spare the forehead

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123
Q

Urethritis, conjunctivitis, arthritis in a male

A

Reactive arthritis associated with HLA-B27

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124
Q

Vascular birthmark (port-wine stain) of the face

A

Nevus flammeus (benign, but associated with Sturge-Weber syndrome)

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125
Q

Vomiting blood following gastroesophageal lacerations

A

Mallory-Weiss syndrome (alcoholic and bulimic patients)

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126
Q

Weight loss, diarrhea, arthritis, fever, adenopathy

A

Whipple disease (Tropheryma whipplei)

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127
Q

Worst headache of my life

A

Subarachnoid hemorrhage

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128
Q

Anticentromere antibodies

A

Scleroderma (CREST)

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129
Q

Anti-desmoglein (epithelial) antibodies

A

Pemphigus vulgaris (blistering)

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130
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

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131
Q

Antihistone antibodies

A

Drug-induced SLE (e.g., hydralazine, isoniazid, phenytoin, procainamide)

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132
Q

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonnie?re deformity)

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133
Q

Antimitochondrial antibodies (AMAs)

A

1° biliary cirrhosis (female, cholestasis, portal hypertension)

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134
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

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

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135
Q

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

A

SLE (type III hypersensitivity)

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136
Q

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

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137
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

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138
Q

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

A

Celiac disease (diarrhea, weight loss)

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139
Q

Apple core lesion on barium enema x-ray

A

Colorectal cancer (usually left-sided)

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140
Q

Atypical lymphocytes

A

EBV

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141
Q

Azurophilic peroxidase ? granular inclusions in granulocytes and myeloblasts

A

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

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142
Q

Bacitracin response

A

Sensitive: S. pyogenes (group A); resistant: S. agalactiae (group B)

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143
Q

Bamboo spine on x-ray

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

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144
Q

Basophilic nuclear remnants in RBCs

A

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

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145
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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146
Q

Bloody or yellow tap on lumbar puncture

A

Subarachnoid hemorrhage

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147
Q

Boot-shaped heart on x-ray

A

Tetralogy of Fallot (due to RVH)

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148
Q

Branching gram-positive rods with sulfur granules

A

Actinomyces israelii

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149
Q

Bronchogenic apical lung tumor on imaging

A

Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)

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150
Q

Brown tumor of bone

A

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

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151
Q

Cardiomegaly with apical atrophy

A

Chagas disease (Trypanosoma cruzi)

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152
Q

Cellular crescents in Bowman capsule

A

Rapidly progressive crescentic glomerulonephritis

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153
Q

Chocolate cyst of ovary

A

Endometriosis (frequently involves both ovaries)

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154
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

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155
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic fibrosis (autosomal recessive mutation in CFTR gene fat-soluble vitamin deficiency and mucous plugs)

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156
Q

? AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormalities

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157
Q

Degeneration of dorsal column fibers

A

Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)

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158
Q

Delta wave on EKG, short PR interval, supraventricular tachycardia

A

Wolf-Parkinson-White syndrome (Bundle of Kent bypasses AV node)

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159
Q

Depigmentation of neurons in substantia nigra

A

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

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160
Q

Desquamated epithelium casts in sputum

A

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

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161
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

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

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162
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

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163
Q

Electrical alternans (alternating amplitude on EKG)

A

Pericardial tamponade

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164
Q

Enlarged cells with intranuclear inclusion bodies

A

Owl eye appearance of CMV

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165
Q

Enlarged thyroid cells with ground-glass nuclei with central clearing

A

Orphan Annie eyes nuclei (papillary carcinoma of the thyroid)

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166
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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167
Q

Eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy body (Parkinson disease)

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168
Q

Eosinophilic globule in liver

A

Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis

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169
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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170
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

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171
Q

Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eye”)

A

Reed-Sternberg cells (Hodgkin lymphoma)

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172
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

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173
Q

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

A

?-thalassemia, sickle cell disease (marrow expansion)

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174
Q

hCG elevated

A

Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)

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175
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

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176
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

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177
Q

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

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178
Q

High level of d-dimers

A

DVT, PE, DIC

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179
Q

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

A

Ghon complex (1° TB: Mycobacterium bacilli)

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180
Q

Honeycomb lung on x-ray or CT

A

Interstitial pulmonary fibrosis

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181
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

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182
Q

Hypersegmented neutrophils

A

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

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183
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Conn syndrome (primary hyperaldosteronism)

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184
Q

Hypochromic, microcytic anemia

A

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

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185
Q

Increased AFP in amniotic fluid/maternal serum

A

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

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186
Q

Increased uric acid levels

A

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

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187
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or VZV)

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188
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: chance of mesothelioma)

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189
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

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190
Q

Large granules in phagocytes, immunodeficiency

A

Che?diak-Higashi disease (congenital failure of phagolysosome formation)

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191
Q

Lead pipe appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

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192
Q

Linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

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193
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration)

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194
Q

Lumpy bumpy appearance of glomeruli on immunofluorescence

A

Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)

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195
Q

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

A

Multiple myeloma

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196
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

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197
Q

Monoclonal antibody spike

A

Multiple myeloma (usually IgG or IgA), Monoclonal gammopathy of undetermined significance (MGUS consequence of aging), Waldenstro?m (M protein = IgM) macroglobulinemia, Primary amyloidosis

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198
Q

Mucin-filled cell with peripheral nucleus

A

Signet ring (gastric carcinoma)

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199
Q

Narrowing of bowel lumen on barium x-ray

A

String sign (Crohn disease)

200
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

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

201
Q

Needle-shaped, negatively birefringent crystals

A

Gout (monosodium urate crystals)

202
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

203
Q

Novobiocin response

A

Sensitive: S. epidermidis; resistant: S. saprophyticus

204
Q

Nutmeg appearance of liver

A

Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome

205
Q

Onion skin periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

206
Q

Optochin response

A

Sensitive: S. pneumoniae; resistant: viridans streptococci (S. mutans, S. sanguis)

207
Q

Periosteum raised from bone, creating triangular area

A

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

208
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

209
Q

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

210
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

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

211
Q

Psammoma bodies

A

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

212
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

213
Q

RBC casts in urine

A

Glomerulonephritis

214
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

215
Q

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

216
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (e.g., ischemia or toxic injury)

217
Q

Rhomboid crystals, positively birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

218
Q

Rib notching

A

Coarctation of the aorta

219
Q

Ring-enhancing brain lesion in AIDS

A

Toxoplasma gondii, CNS lymphoma

220
Q

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

A

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

221
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

222
Q

Soap bubble in femur or tibia on x-ray

A

Giant cell tumor of bone (generally benign)

223
Q

Spikes on basement membrane, “dome-like” subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

224
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

225
Q

Steeple sign on CXR

A

Croup (parainfluenza virus)

226
Q

Stippled vaginal epithelial cells

A

Clue cells (Gardnerella vaginalis)

227
Q

Streptococcus bovis bacteremia

A

Colon cancer

228
Q

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

A

Birbeck granules (Langerhans cell histiocytosis)

229
Q

Thousands of polyps on colonoscopy

A

Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)

230
Q

Thrombi made of white/red layers

A

Lines of Zahn (arterial thrombus, layers of platelets/RBCs)

231
Q

Thumb sign on lateral neck x-ray

A

Epiglottitis (Haemophilus influenzae)

232
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

233
Q

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

A

Membranoproliferative glomerulonephritis

234
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

235
Q

Waxy casts with very low urine flow

A

Chronic end-stage renal disease

236
Q

WBC casts in urine

A

Acute pyelonephritis

237
Q

WBCs that look “smudged”

A

CLL (almost always B cell)

238
Q

Wire loop glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

239
Q

Yellowish CSF

A

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

240
Q

Absence seizures (treatment)

A

Ethosuximide

241
Q

Acute gout attack (treatment)

A

NSAIDs, colchicine, glucocorticoids

242
Q

Acute promyelocytic leukemia (M3) (treatment)

A

All-trans retinoic acid

243
Q

ADHD (treatment)

A

Methylphenidate, CBT, atomoxetine

244
Q

Alcoholism (treatment)

A

Disulfiram, acamprosate, naltrexone, supportive care

245
Q

Alcohol withdrawal (treatment)

A

Long-acting benzodiazepines

246
Q

Anorexia (treatment)

A

Nutrition, psychotherapy, mirtazapine

247
Q

Anticoagulation during pregnancy (treatment)

A

Heparin

248
Q

Arrhythmia in damaged cardiac tissue (treatment)

A

Class IB antiarrhythmic (lidocaine, mexiletine)

249
Q

B12 deficiency (treatment)

A

Vitamin B12 supplementation (work up cause with Schilling test)

250
Q

Benign prostatic hyperplasia (treatment)

A

?1-antagonists, 5?-reductase inhibitors, PDE-5 inhibitors

251
Q

Bipolar disorder (treatment)

A

Mood stabilizers (e.g., lithium, valproic acid, carbamazepine), atypical antipsychotics

252
Q

Breast cancer in postmenopausal woman (treatment)

A

Aromatase inhibitor (anastrozole)

253
Q

Buerger disease (treatment)

A

Smoking cessation

254
Q

Bulimia nervosa (treatment)

A

SSRIs

255
Q

Candida albicans (treatment)

A

Topical azoles (vaginitis); nystatin, fluconazole, caspofungin (oral/esophageal); fluconazole, caspofungin, amphotericin B (systemic)

256
Q

Carcinoid syndrome (treatment)

A

Octreotide

257
Q

Chlamydia trachomatis (treatment)

A

Doxycycline (+ ceftriaxone for gonorrhea coinfection), erythromycin eye drops (prophylaxis in infants)

258
Q

Chronic gout (treatment)

A

Xanthine oxidase inhibitors (e.g., allopurinol, febuxostat)

259
Q

Chronic hepatitis B or C (treatment)

A

IFN-? (HBV and HCV); ribavirin, simeprevir, sofosbuvir (HCV)

260
Q

Chronic myelogenous leukemia (treatment)

A

Imatinib

261
Q

Clostridium botulinum (treatment)

A

Antitoxin

262
Q

Clostridium difficile (treatment)

A

Oral metronidazole; if refractory, oral vancomycin

263
Q

Clostridium tetani (treatment)

A

Antitoxin

264
Q

CMV (treatment)

A

Ganciclovir, foscarnet, cidofovir

265
Q

Crohn disease (treatment)

A

Corticosteroids, infliximab, azathioprine

266
Q

Cryptococcus neoformans (treatment)

A

Fluconazole (in AIDS patients)

267
Q

Cyclophosphamide-induced hemorrhagic cystitis (treatment)

A

Mesna

268
Q

Depression (treatment)

A

SSRIs (first-line)

269
Q

Diabetes insipidus (treatment)

A

Desmopressin (central); hydrochlorothiazide, indomethacin, amiloride (nephrogenic)

270
Q

Diabetes mellitus type 1 (treatment)

A

Dietary intervention (low carbohydrate) + insulin replacement

271
Q

Diabetes mellitus type 2 (treatment)

A

Dietary intervention, oral hypoglycemics, and insulin (if refractory)

272
Q

Diabetic ketoacidosis (treatment)

A

Fluids, insulin, K+

273
Q

Enterococci (treatment)

A

Vancomycin, aminopenicillins/cephalosporins

274
Q

Erectile dysfunction (treatment)

A

Sildenafil, tadalafil, vardenafil

275
Q

ER ? breast cancer (treatment)

A

Tamoxifen

276
Q

Ethylene glycol/methanol intoxication (treatment)

A

Fomepizole (alcohol dehydrogenase inhibitor)

277
Q

Haemophilus influenzae (B) (treatment)

A

Rifampin (prophylaxis)

278
Q

Generalized anxiety disorder (treatment)

A

SSRIs, SNRIs (first line); buspirone (second line)

279
Q

Granulomatosis with polyangiitis (Wegener) (treatment)

A

Cyclophosphamide, corticosteroids

280
Q

Heparin reversal (treatment)

A

Protamine sulfate

281
Q

HER2/neu ? breast cancer (treatment)

A

Trastuzumab

282
Q

Hyperaldosteronism (treatment)

A

Spironolactone

283
Q

Hypercholesterolemia (treatment)

A

Statin (first-line)

284
Q

Hypertriglyceridemia (treatment)

A

Fibrate

285
Q

Immediate anticoagulation (treatment)

A

Heparin

286
Q

Infertility (treatment)

A

Leuprolide, GnRH (pulsatile), clomiphene

287
Q

Influenza (treatment)

A

Oseltamivir, zanamivir

288
Q

Kawasaki disease (treatment)

A

IVIG, high-dose aspirin

289
Q

Legionella pneumophila (treatment)

A

Macrolides (e.g., azithromycin)

290
Q

Long-term anticoagulation (treatment)

A

Warfarin, dabigatran, rivaroxaban and apixaban

291
Q

Malaria (treatment)

A

Chloroquine, mefloquine, atovaquone/proguanil (for blood schizont), primaquine (for liver hypnozoite)

292
Q

Malignant hyperthermia (treatment)

A

Dantrolene

293
Q

Medical abortion (treatment)

A

Mifepristone

294
Q

Migraine (treatment)

A

Abortive therapies (e.g., sumatriptan, NSAIDs); prophylaxis (e.g., propranolol, topiramate, CCBs, amitriptyline)

295
Q

Multiple sclerosis (treatment)

A

Disease-modifying therapies (e.g., ?-interferon, natalizumab); for acute flares, use IV steroids

296
Q

Mycobacterium tuberculosis (treatment)

A

RIPE (rifampin, isoniazid, pyrazinamide, ethambutol)

297
Q

Neisseria gonorrhoeae (treatment)

A

Ceftriaxone (add doxycycline to cover likely concurrent C. trachomatis)

298
Q

Neisseria meningitidis (treatment)

A

Penicillin/ceftriaxone, rifampin (prophylaxis)

299
Q

Neural tube defect prevention (treatment)

A

Prenatal folic acid

300
Q

Osteomalacia/rickets (treatment)

A

Vitamin D supplementation

301
Q

Osteoporosis (treatment)

A

Calcium/vitamin D supplementation (prophylaxis); bisphosphonates, PTH analogs, SERMs, calcitonin, denosumab (treatment)

302
Q

Patent ductus arteriosus (treatment)

A

Close with indomethacin; open or maintain with PGE analogs

303
Q

Pheochromocytoma (treatment)

A

?-antagonists (e.g., phenoxybenzamine)

304
Q

Pneumocystis jirovecii (treatment)

A

TMP-SMX (prophylaxis in AIDS patient)

305
Q

Prolactinoma (treatment)

A

Cabergoline/bromocriptine (dopamine agonists)

306
Q

Prostate adenocarcinoma/uterine fibroids (treatment)

A

Leuprolide, GnRH (continuous)

307
Q

Prostate adenocarcinoma (treatment)

A

Flutamide

308
Q

Pseudomonas aeruginosa (treatment)

A

Antipseudomonal penicillins, aminoglycosides, carbapenems

309
Q

Pulmonary arterial hypertension (idiopathic) (treatment)

A

Sildenafil, bosentan, epoprostenol

310
Q

Rickettsia rickettsii (treatment)

A

Doxycycline, chloramphenicol

311
Q

Schizophrenia (negative symptoms) (treatment)

A

Atypical antipsychotics

312
Q

Schizophrenia (positive symptoms) (treatment)

A

Typical and atypical antipsychotics

313
Q

SIADH (treatment)

A

Fluid restriction, IV hypertonic saline, conivaptan/tolvaptan, demeclocycline

314
Q

Sickle cell disease (treatment)

A

Hydroxyurea ( fetal hemoglobin)

315
Q

Sporothrix schenckii (treatment)

A

Itraconazole, oral potassium iodide

316
Q

Stable angina (treatment)

A

Sublingual nitroglycerin

317
Q

Staphylococcus aureus (treatment)

A

MSSA: nafcillin, oxacillin, dicloxacillin (antistaphylococcal penicillins); MRSA: vancomycin, daptomycin, linezolid, ceftaroline

318
Q

Streptococcus bovis (treatment)

A

Penicillin prophylaxis; evaluation for colon cancer if linked to endocarditis

319
Q

Streptococcus pneumoniae (treatment)

A

Penicillin/cephalosporin (systemic infection, pneumonia), vancomycin (meningitis)

320
Q

Streptococcus pyogenes (treatment)

A

Penicillin prophylaxis

321
Q

Temporal arteritis (treatment)

A

High-dose steroids

322
Q

Tonic-clonic seizures (treatment)

A

Levetiracetam, phenytoin, valproate, carbamazepine

323
Q

Toxoplasma gondii (treatment)

A

Sulfadiazine + pyrimethamine

324
Q

Treponema pallidum (treatment)

A

Penicillin

325
Q

Trichomonas vaginalis (treatment)

A

Metronidazole (patient and partner)

326
Q

Trigeminal neuralgia (tic douloureux) (treatment)

A

Carbamazepine

327
Q

Ulcerative colitis (treatment)

A

5-ASA preparations (e.g., mesalamine), 6-mercaptopurine, infliximab, colectomy

328
Q

UTI prophylaxis (treatment)

A

TMP-SMX

329
Q

Warfarin reversal (treatment)

A

Fresh frozen plasma (acute), vitamin K (chronic)

330
Q

Actinic (solar) keratosis (MCM cause/important assoc.)

A

Precursor to squamous cell carcinoma

331
Q

Acute gastric ulcer associated with CNS injury (MCM cause/important assoc.)

A

Cushing ulcer (? intracranial pressure stimulates vagal gastric H+ secretion)

332
Q

Acute gastric ulcer associated with severe burns (MCM cause/important assoc.)

A

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

333
Q

Alternating areas of transmural inflammation and normal colon (MCM cause/important assoc.)

A

Skip lesions (Crohn disease)

334
Q

Aortic aneurysm, abdominal (MCM cause/important assoc.)

A

Atherosclerosis

335
Q

Aortic aneurysm, ascending or arch (MCM cause/important assoc.)

A

3° syphilis (syphilitic aortitis), vasa vasorum destruction

336
Q

Aortic aneurysm, thoracic (MCM cause/important assoc.)

A

Marfan syndrome (idiopathic cystic medial degeneration)

337
Q

Aortic dissection (MCM cause/important assoc.)

A

Hypertension

338
Q

Atrophy of the mammillary bodies (MCM cause/important assoc.)

A

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

339
Q

Autosplenectomy (fibrosis and shrinkage) (MCM cause/important assoc.)

A

Sickle cell disease (hemoglobin S)

340
Q

Bacteria associated with gastritis, peptic ulcer disease, and stomach cancer (MCM cause/important assoc.)

A

H. pylori

341
Q

Bacterial meningitis (adults and elderly) (MCM cause/important assoc.)

A

S. pneumoniae

342
Q

Bacterial meningitis (newborns and kids) (MCM cause/important assoc.)

A

Group B streptococcus/E.coli (newborns), S. pneumoniae/N. meningitidis (kids/teens)

343
Q

Bilateral ovarian metastases from gastric carcinoma (MCM cause/important assoc.)

A

Krukenberg tumor (mucin-secreting signet ring cells)

344
Q

Bleeding disorder with GpIb deficiency (MCM cause/important assoc.)

A

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

345
Q

Brain tumor (adults) (MCM cause/important assoc.)

A

Supratentorial: metastasis, astrocytoma (including glioblastoma multiforme), meningioma, schwannoma

346
Q

Brain tumor (kids) (MCM cause/important assoc.)

A

Infratentorial: medulloblastoma (cerebellum) or supratentorial: craniopharyngioma

347
Q

Breast cancer (MCM cause/important assoc.)

A

Invasive ductal carcinoma

348
Q

Breast mass (MCM cause/important assoc.)

A

Fibrocystic change, carcinoma (in postmenopausal women)

349
Q

Breast tumor (benign) (MCM cause/important assoc.)

A

Fibroadenoma

350
Q

Cardiac 1° tumor (kids) (MCM cause/important assoc.)

A

Rhabdomyoma, often seen in tuberous sclerosis

351
Q

Cardiac manifestation of lupus (MCM cause/important assoc.)

A

Marantic/thrombotic endocarditis (nonbacterial)

352
Q

Cardiac tumor (adults) (MCM cause/important assoc.)

A

Metastasis, myxoma (90% in left atrium; “ball and valve”)

353
Q

Cerebellar tonsillar herniation (MCM cause/important assoc.)

A

Chiari II malformation

354
Q

Chronic arrhythmia (MCM cause/important assoc.)

A

Atrial fibrillation (associated with high risk of emboli)

355
Q

Chronic atrophic gastritis (autoimmune) (MCM cause/important assoc.)

A

Predisposition to gastric carcinoma (can also cause pernicious anemia)

356
Q

Clear cell adenocarcinoma of the vagina (MCM cause/important assoc.)

A

DES exposure in utero

357
Q

Congenital adrenal hyperplasia, hypotension (MCM cause/important assoc.)

A

21-hydroxylase deficiency

358
Q

Congenital cardiac anomaly (MCM cause/important assoc.)

A

VSD

359
Q

Congenital conjugated hyperbilirubinemia (black liver) (MCM cause/important assoc.)

A

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

360
Q

Constrictive pericarditis (MCM cause/important assoc.)

A

TB (developing world); idiopathic, viral illness (developed world)

361
Q

Coronary artery involved in thrombosis (MCM cause/important assoc.)

A

LAD > RCA > circumflex

362
Q

Cretinism (MCM cause/important assoc.)

A

Iodine deficit/congenital hypothyroidism

363
Q

Cushing syndrome (MCM cause/important assoc.)

A

Iatrogenic (from corticosteroid therapy), Adrenocortical adenoma (secretes excess cortisol) , ACTH-secreting pituitary adenoma (Cushing disease) Paraneoplastic (due to ACTH secretion by tumors)

364
Q

Cyanosis (early; less common) (MCM cause/important assoc.)

A

Tetralogy of Fallot, transposition of great vessels, truncus arteriosus

365
Q

Cyanosis (late; more common) (MCM cause/important assoc.)

A

VSD, ASD, PDA

366
Q

Death in CML (MCM cause/important assoc.)

A

Blast crisis

367
Q

Death in SLE (MCM cause/important assoc.)

A

Lupus nephropathy

368
Q

Dementia (MCM cause/important assoc.)

A

Alzheimer disease, multiple infarcts (vascular dementia)

369
Q

Demyelinating disease in young women (MCM cause/important assoc.)

A

Multiple sclerosis

370
Q

DIC (MCM cause/important assoc.)

A

Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery

371
Q

Dietary deficit (MCM cause/important assoc.)

A

Iron

372
Q

Diverticulum in pharynx (MCM cause/important assoc.)

A

Zenker diverticulum (diagnosed by barium swallow)

373
Q

Ejection click (MCM cause/important assoc.)

A

Aortic stenosis

374
Q

Esophageal cancer (MCM cause/important assoc.)

A

Squamous cell carcinoma (worldwide); adenocarcinoma (U.S.)

375
Q

Food poisoning (exotoxin mediated) (MCM cause/important assoc.)

A

S. aureus, B. cereus

376
Q

Glomerulonephritis (adults) (MCM cause/important assoc.)

A

Berger disease (IgA nephropathy)

377
Q

Gynecologic malignancy (MCM cause/important assoc.)

A

Endometrial carcinoma (most common in U.S.); cervical carcinoma (most common worldwide)

378
Q

Heart murmur, congenital (MCM cause/important assoc.)

A

Mitral valve prolapse

379
Q

Heart valve in bacterial endocarditis (MCM cause/important assoc.)

A

Mitral > aortic (rheumatic fever), tricuspid (IV drug abuse)

380
Q

Helminth infection (U.S.) (MCM cause/important assoc.)

A

Enterobius vermicularis, Ascaris lumbricoides

381
Q

Hematoma—epidural (MCM cause/important assoc.)

A

Rupture of middle meningeal artery (trauma; lentiform shaped)

382
Q

Hematoma—subdural (MCM cause/important assoc.)

A

Rupture of bridging veins (crescent shaped)

383
Q

Hemochromatosis (MCM cause/important assoc.)

A

Multiple blood transfusions or hereditary HFE mutation (can result in heart failure, “bronze diabetes,” and ? risk of hepatocellular carcinoma)

384
Q

Hepatocellular carcinoma (MCM cause/important assoc.)

A

Cirrhotic liver (associated with hepatitis B and C and with alcoholism)

385
Q

Hereditary bleeding disorder (MCM cause/important assoc.)

A

von Willebrand disease

386
Q

Hereditary harmless jaundice (MCM cause/important assoc.)

A

Gilbert syndrome (benign congenital unconjugated hyperbilirubinemia)

387
Q

HLA-B27 (MCM cause/important assoc.)

A

Ankylosing spondylitis, reactive arthritis, ulcerative colitis, psoriatic arthritis

388
Q

HLA-DR3 (MCM cause/important assoc.)

A

Diabetes mellitus type 1, SLE, Graves disease, Hashimoto thyroiditis

389
Q

HLA-DR4 (MCM cause/important assoc.)

A

Diabetes mellitus type 1, rheumatoid arthritis

390
Q

Holosystolic murmur (MCM cause/important assoc.)

A

VSD, tricuspid regurgitation, mitral regurgitation

391
Q

Hypercoagulability, endothelial damage, blood stasis (MCM cause/important assoc.)

A

Virchow triad ( risk of thrombosis)

392
Q

Hypertension, 2° (MCM cause/important assoc.)

A

Renal disease

393
Q

Hypoparathyroidism (MCM cause/important assoc.)

A

Accidental excision during thyroidectomy

394
Q

Hypopituitarism (MCM cause/important assoc.)

A

Pituitary adenoma (usually benign tumor)

395
Q

Infection 2° to blood transfusion (MCM cause/important assoc.)

A

Hepatitis C

396
Q

Infections in chronic granulomatous disease (MCM cause/important assoc.)

A

S. aureus, E. coli, Aspergillus (catalase ?)

397
Q

Intellectual disability (MCM cause/important assoc.)

A

Down syndrome, fragile X syndrome

398
Q

Kidney stones (MCM cause/important assoc.)

A

Calcium = radiopaque; Struvite (ammonium) = radiopaque (formed by urease ? organisms such as Klebsiella, Proteus species, and S. saprophyticus); Uric acid = radiolucent

399
Q

Late cyanotic shunt (uncorrected left to right becomes right to left) (MCM cause/important assoc.)

A

Eisenmenger syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)

400
Q

Liver disease (MCM cause/important assoc.)

A

Alcoholic cirrhosis

401
Q

Lysosomal storage disease (MCM cause/important assoc.)

A

Gaucher disease

402
Q

Male cancer (MCM cause/important assoc.)

A

Prostatic carcinoma

403
Q

Malignancy associated with noninfectious fever (MCM cause/important assoc.)

A

Hodgkin lymphoma

404
Q

Malignancy (kids) (MCM cause/important assoc.)

A

ALL, medulloblastoma (cerebellum)

405
Q

Metastases to bone (MCM cause/important assoc.)

A

Prostate, breast > lung > thyroid

406
Q

Metastases to brain (MCM cause/important assoc.)

A

Lung > breast > genitourinary > melanoma > GI

407
Q

Metastases to liver (MCM cause/important assoc.)

A

Colon >> stomach, pancreas

408
Q

Mitochondrial inheritance (MCM cause/important assoc.)

A

Disease occurs in both males and females, inherited through females only

409
Q

Mitral valve stenosis (MCM cause/important assoc.)

A

Rheumatic heart disease

410
Q

Mixed (UMN and LMN) motor neuron disease (MCM cause/important assoc.)

A

Amyotrophic lateral sclerosis

411
Q

Myocarditis (MCM cause/important assoc.)

A

Coxsackie B

412
Q

Nephrotic syndrome (adults) (MCM cause/important assoc.)

A

Focal segmental glomerulosclerosis

413
Q

Nephrotic syndrome (kids) (MCM cause/important assoc.)

A

Minimal change disease

414
Q

Neuron migration failure (MCM cause/important assoc.)

A

Kallmann syndrome (hypogonadotropic hypogonadism and anosmia)

415
Q

Nosocomial pneumonia (MCM cause/important assoc.)

A

S. aureus, Pseudomonas, other enteric gram-negative rods

416
Q

Obstruction of male urinary tract (MCM cause/important assoc.)

A

BPH

417
Q

Opening snap (MCM cause/important assoc.)

A

Mitral stenosis

418
Q

Opportunistic infection in AIDS (MCM cause/important assoc.)

A

Pneumocystis jirovecii pneumonia

419
Q

Osteomyelitis (MCM cause/important assoc.)

A

S. aureus (most common overall)

420
Q

Osteomyelitis in sickle cell disease (MCM cause/important assoc.)

A

Salmonella

421
Q

Osteomyelitis with IV drug use (MCM cause/important assoc.)

A

Pseudomonas, Candida, S. aureus

422
Q

Ovarian tumor (benign, bilateral) (MCM cause/important assoc.)

A

Serous cystadenoma

423
Q

Ovarian tumor (malignant) (MCM cause/important assoc.)

A

Serous cystadenocarcinoma

424
Q

Pancreatitis (acute) (MCM cause/important assoc.)

A

Gallstones, alcohol

425
Q

Pancreatitis (chronic) (MCM cause/important assoc.)

A

Alcohol (adults), cystic fibrosis (kids)

426
Q

Patient with ALL /CLL /AML /CML (MCM cause/important assoc.)

A

ALL: child, CLL: adult > 60, AML: adult ? 65, CML: adult 45-85

427
Q

Pelvic inflammatory disease (MCM cause/important assoc.)

A

C. trachomatis, N. gonorrhoeae

428
Q

Philadelphia chromosome t(9;22) (BCR-ABL) (MCM cause/important assoc.)

A

CML (may sometimes be associated with ALL/AML)

429
Q

Pituitary tumor (MCM cause/important assoc.)

A

Prolactinoma, somatotropic adenoma

430
Q

1° amenorrhea (MCM cause/important assoc.)

A

Turner syndrome (45,XO)

431
Q

1° bone tumor (adults) (MCM cause/important assoc.)

A

Multiple myeloma

432
Q

1° hyperaldosteronism (MCM cause/important assoc.)

A

Adenoma of adrenal cortex

433
Q

1° hyperparathyroidism (MCM cause/important assoc.)

A

Adenomas, hyperplasia, carcinoma

434
Q

1° liver cancer (MCM cause/important assoc.)

A

Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, ?1-antitrypsin deficiency, Wilson disease)

435
Q

Pulmonary hypertension (MCM cause/important assoc.)

A

COPD

436
Q

Recurrent inflammation/thrombosis of small/medium vessels in extremities (MCM cause/important assoc.)

A

Buerger disease (strongly associated with tobacco)

437
Q

Renal tumor (MCM cause/important assoc.)

A

Renal cell carcinoma: associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndromes (EPO, renin, PTHrP, ACTH)

438
Q

Right heart failure due to a pulmonary cause (MCM cause/important assoc.)

A

Cor pulmonale

439
Q

S3 heart sound (MCM cause/important assoc.)

A

? ventricular filling pressure (e.g., mitral regurgitation, HF), common in dilated ventricles

440
Q

S4 heart sound (MCM cause/important assoc.)

A

Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)

441
Q

2° hyperparathyroidism (MCM cause/important assoc.)

A

Hypocalcemia of chronic kidney disease

442
Q

Sexually transmitted disease (MCM cause/important assoc.)

A

C. trachomatis (usually coinfected with N. gonorrhoeae)

443
Q

SIADH (MCM cause/important assoc.)

A

Small cell carcinoma of the lung

444
Q

Site of diverticula (MCM cause/important assoc.)

A

Sigmoid colon

445
Q

Sites of atherosclerosis (MCM cause/important assoc.)

A

Abdominal aorta > coronary artery > popliteal artery > carotid artery

446
Q

Stomach cancer (MCM cause/important assoc.)

A

Adenocarcinoma

447
Q

Stomach ulcerations and high gastrin levels (MCM cause/important assoc.)

A

Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)

448
Q

t(14;18) (MCM cause/important assoc.)

A

Follicular lymphomas (BCL-2 activation, anti-apoptotic oncogene)

449
Q

t(8;14) (MCM cause/important assoc.)

A

Burkitt lymphoma (c-myc fusion, transcription factor oncogene)

450
Q

t(9;22) (MCM cause/important assoc.)

A

Philadelphia chromosome, CML (BCR-ABL activation, tyrosine kinase oncogene)

451
Q

Temporal arteritis (MCM cause/important assoc.)

A

Risk of ipsilateral blindness due to occlusion of ophthalmic artery; polymyalgia rheumatica

452
Q

Testicular tumor (MCM cause/important assoc.)

A

Seminoma (malignant, radiosensitive)

453
Q

Thyroid cancer (MCM cause/important assoc.)

A

Papillary carcinoma

454
Q

Tumor in women (MCM cause/important assoc.)

A

Leiomyoma (estrogen dependent, not precancerous)

455
Q

Tumor of infancy (MCM cause/important assoc.)

A

Strawberry hemangioma (usually regresses spontaneously by childhood)

456
Q

Tumor of the adrenal medulla (adults) (MCM cause/important assoc.)

A

Pheochromocytoma (usually benign)

457
Q

Tumor of the adrenal medulla (kids) (MCM cause/important assoc.)

A

Neuroblastoma (malignant)

458
Q

Type of Hodgkin lymphoma (MCM cause/important assoc.)

A

Nodular sclerosing (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)

459
Q

Type of non-Hodgkin lymphoma (MCM cause/important assoc.)

A

Diffuse large B-cell lymphoma

460
Q

UTI (MCM cause/important assoc.)

A

E. coli, Staphylococcus saprophyticus (young women)

461
Q

Vertebral compression fracture (MCM cause/important assoc.)

A

Osteoporosis (type I: postmenopausal woman; type II: elderly man or woman)

462
Q

Viral encephalitis affecting temporal lobe (MCM cause/important assoc.)

A

HSV-1

463
Q

Vitamin deficiency (U.S.) (MCM cause/important assoc.)

A

Folate (pregnant women are at high risk; body stores only 3- to 4-month supply; prevents neural tube defects)

464
Q

Sensitivity

A

Sensitivity = TP / (TP + FN)

465
Q

Specificity

A

Specificity = TN / (TN + FP)

466
Q

Positive predictive value

A

PPV = TP / (TP + FP)

467
Q

Negative predictive value

A

NPV = TN / (FN + TN)

468
Q

Odds ratio (for case-control studies)

A

OR = (a/c)/(b/d)= ad/bc

469
Q

Relative risk

A

RR =[a/(a + b)]/[c/(c + d)]

470
Q

Attributable risk

A

AR= a/(a+b)?c/(c+d)

471
Q

Relative risk reduction

A

RRR = 1 ? RR

472
Q

Absolute risk reduction

A

ARR=c/(c+d)-a/(a+b)

473
Q

Number needed to treat

A

NNT = 1/absolute risk reduction

474
Q

Number needed to harm

A

NNH = 1/attributable risk

475
Q

Hardy-Weinberg equilibrium

A

p2 +2pq+q2 =1 p+q = 1

476
Q

Volume of distribution

A

Vd = amount of drug in the body plasma drug concentration

477
Q

Half-life

A

t1?2 = (0.693 × Vd)/CL

478
Q

Drug clearance

A

CL = rate of elimination of drug = Vd × Ke (elimination constant) plasma drug concentration

479
Q

Loading dose

A

LD = (Cp × Vd)/F

480
Q

Maintenance dose

A

D = (Cp × CL × ?)/ F

481
Q

Cardiac output equation

A

CO = rate of O2 consumption/(arterial O2 content ? venous O2 content); CO = stroke volume × heart rate

482
Q

Mean arterial pressure equation

A

MAP = cardiac output × total peripheral resistance MAP = 2 ?3 diastolic + 1 ?3 systolic

483
Q

Stroke volume equation

A

SV = EDV - ESV

484
Q

Ejection fraction equation

A

EF= SV/EDV =(EDV?ESV)/EDV

485
Q

Resistance equation

A

Resistance = driving pressure (?P) = 8? (viscosity) × length flow (Q) ?r4

486
Q

Capillary fluid exchange equation

A

Jv = net fluid flow = Kf[(Pc ? Pi) ? ?(?c ? ?i)]

487
Q

Renal clearance equation

A

Cx = UxV/Px

488
Q

Glomerular filtration rate equation

A

GFR = Uinulin × V/Pinulin = Cinulin; GFR = Kf [(PGC - PBS) - (?GC - ?BS)]

489
Q

Effective renal plasma flow equation

A

eRPF = U(PAH) × V/P(PAH) = C(PAH)

490
Q

Renal blood flow equation

A

RBF = RPF/(1?Hct)

491
Q

Filtration fraction equation

A

FF = GFR/RPF

492
Q

Henderson-Hasselbalch equation (for extracellular pH)

A

pH = 6.1 + log [HCO3?]/(0.03 Pco2 )

493
Q

Winters formula equation

A

Pco2 =1.5[HCO3-]+8±2

494
Q

Physiologic dead space equation

A

VD = VT × (PaCO2 ? PECO2)/PaCO2

495
Q

Pulmonary vascular resistance equation

A

PVR = (P[pulm artery] - P[L atrium])/ cardiac output

496
Q

Alveolar gas equation

A

PAo2 = PIo2 - Paco2/R

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