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rapid review COPY Flashcards

1
Q

abdominal pain
ascities
hepatomegaly

A

budd chiari syndrome

post hepatic venous thrombosis

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2
Q

abdominal pain
diarrhea
leukocytosis (WBCs up)
recent abx

A

c diff infection

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3
Q

achilles tendon xanthoma

A

familial hypercholesterolemia

decrease LDL receptor signalling

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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 def

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6
Q

anterior “drawer sign” positive

A

ACL injury

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7
Q

arachnodactyly
lens dislocation upward
aortic dissection
hyperflexible joints

A

marfans syndrome

fibrillin defect

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8
Q

athlete with polycythemia

A

secondary to erythropoietin injection

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9
Q

back pain
fever
night sweats

A

potts disease

vertebral TB

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10
Q

bilateral acoustic scwannomas

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 DKA

A

mucor or rhizopus fungal infection

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13
Q

blue sclera

A

osteogenesis imperfecta

type 1 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

increased OB and OC activity

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16
Q

bounding pulses
wide pulse pressure
diastolic heart murmur
head bobbing

A

aortic regurg

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17
Q

“butterfly” facial rash
raynaud phenomenon
young female

A

SLE

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18
Q 
cafe au lait spots
lisch nodules (iris hamartoma)
cutaneous neurofibromas
pheochromocytoma
optic gliomas
A

neurofibromatosis type 1

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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 LAD
desquamating rash
coronary aneurysms
red conjunctiva and tongue
hand foot changes
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)

due to 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 weeks to several months after an acute episode

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25
chest pain with ST depressions on EKG
unstable angina (negative troponins) or NSTEMI (positive troponins)
26
child uses arms to stand up from a squat
duchenne muscular dystrophy gowers sign
27
child with fever later develops a red rash on his face that spreads to his body
erythema infectiosum/fifth disease "slapped cheeks" appearance caused by parvovirus B19
28
chorea dementia caudate degeneration
huntington disease autosomal dominant CAG repeat expansion
29
chorioretinitis hydrocephalus intracranial calcifications
congenital toxoplasmosis
30
``` chronic exercise intolerance myalgia fatigue painful cramps myoglobinuria ```
McArdle disease skeletal muscle glycogen phosphorylase deficiency
31
cold intolerance
hypothyroidism
32
conjugate horizontal gaze palsy | horizontal diplopia
internuclear ophthalmoplegia due to damage to the MLF may be unilateral or bilateral
33
continuous "machine like" heart murmur
PDA close with indomethacin keep open with PGE analogs
34
cutaneous/dermal edema due to connective tissue deposition
myxedema caused by: hypothyroidism graves disease ([pretibial])
35
cutaneous flushing diarrhea bronchospasm
carcinoid syndrome right sided cardiac valvular lesions increased 5-HIAA
36
dark purple skin/mouth nodules in a patient with AIDS
kaposi sarcoma associated with HHV8
37
deep, labored breathing/hyperventilating
DKA kussmaul respirations
38
dermatitis dementia diarrhea
pellagra niacin deficiency (vit B3)
39
dilated cardiomyopathy edema alcoholism or malnutrition
wet beriberi | ``` thiamine deficiency vit B1 ```
40
dog or cat bite resulting in infection
pasteurella multocida cellulitis at the inoculation site
41
dry eyes dry mouth arthritis
Sjogren syndrome autoimmune destruction of exocrine glands
42
dysphagia (esophageal webs) glossitis iron def anemia
Plummer Vinson syndrome may progress to esophageal squamous cell carcinoma
43
elastic skin hypermobility of joints increased bleeding tendency
ehlers danlos syndrome type 5 collagen defect type 3 collagen defect seen in the vascular subtype of ehlers danlos
44
enlarged, hard left supraclavicular node
virchow node abdominal metastasis
45
episodic vertigo tinnitus hearing loss
meniere disease | the inner ear disorder
46
erythroderma LAD hepatosplenomegaly atypical T cells
mycosis fungoides (cutaneous T cell lymphoma) or sezary syndrome (mycosis fungoides + malignant T cells in blood)
47
facial muscle spasm upon tapping
chvostek sign hypocalcemia
48
fat female forty fertile
cholelithiasis aka gallstones
49
fever chills headache myalgia following abx treatment for syphilis
Jarisch Herxheimer reaction rapid lysis of spirochetes results in endotoxin like release
50
``` fever cough conjunctivitis coryza (nose mucosa inflamm) diffuse rash ```
measles
51
fever night sweats weight loss
B symptoms of lymphoma
52
Fibrous plaques in soft tissue of penis with abnormal curvature
peyronic disease connective tissue disorder
53
Golden brown rings around peripheral cornea
Wilson disease kayser fleischer rings due to copper accumulation
54
Gout intellectual disability self mutilating behavior in a boy
Lesch nyhan syndrome HGPRT deficiency x linked recessive
55
hamartomatous GI polyps | hyperpigmentation of the mouth/feet/hands/genitalia
peutz jeghers syndrome inherited benign polyposis can cause bowel obstruction increased cancer risk mainly GI
56
``` hepatosplenomegaly pancytopenia osteoporosis aseptic necrosis of femoral head bone crises ```
Gaucher disease glycocerebrosidase deficiency
57
hereditary nephritis sensorineural hearing loss cataracts
Alport syndrome mutation in collagen 4
58
hyperphagia hypersexuality hyperorality hyperdocility (agreeable and submissive)
Kluver Bucy syndrome bilateral amygdala lesions
59
hyperreflexia hypertonia babinski sign present
UMN damage
60
hyporeflexia hypotonia atrophy fasciculations
LMN damage
61
hypoxemia (low O2 in blood) polycythemia (hct high) hypercapnia (CO2 high)
chronic bronchitis hyperplasia of mucous cells "blue bloater"
62
Indurated, ulcerated genital lesion
painful with exudate= chancroid (haemophilus ducreyi) non painful= chancre (primary syphilis, treponema pallidum)
63
infant with cleft lip/palate microcephaly or holoprosencephaly polydactyly cutis aplasia
Patau syndrome trisomy 13
64
infant with hypoglycemia | hepatomegaly
``` cori disease (debranching enzyme deficiency) ``` or von gierke disease (glucose 6 phosphatase deficiency, more severe)
65
infant with microcephaly rocker bottom feet clenched hands structural heart defect
Edwards syndrome trisomy 18
66
jaundice | palpable distended non tender gallbladder
courvoisier sign distal malignant obstruction of the biliary tree
67
large rash with bull's eye appearance
erythema chronicum migrans from ixodes tick bite lyme disease= borrelia
68
lucid (clear) interval after traumatic brain injury
epidural hematoma middle meningeal artery rupture
69
male child recurrent infections no mature B cells
bruton disease x linked agammaglobulinemia
70
mucosal bleeding | prolonged bleeding time
glanzmann thrombasthenia defect in platelet aggregation due to lack of Gp2b/3a
71
muffled heart sounds distended neck veins hypotension
Beck triad of cardiac tamponade
72
multiple colon polyps osteomas/soft tissue tumors impacted/super-numerary teeth
Gardner syndrome a subtype of FAP
73
myopathy (infantile hypertrophic cardiomyopathy) exercise intolerance
pompe disease lysosomal alpha 1,4 glucosidase deficiency
74
neonate with arm paralysis following difficult birth
erb-duchenne palsy superior trunk (C5-C6) brachial plexus injury "waiter's tip"
75
No lactation postpartum absent menstruation cold intolerance
sheehan syndrome pituitary infarction
76
nystagmus intention tremor scanning speech bilateral internuclear ophthalmoplegia
multiple sclerosis
77
painful blue fingers/toes | hemolytic anemia
cold agglutination disease autoimmune hemolytic anemia caused by: mycoplasma pneumoniae infectious mononucleosis CLL
78
painful fingers/toes changing color from white to blue to red with cold or stress
raynaud phenomenon vasospasm in extremities
79
painful raised red lesions on pads of fingers/toes
osler nodes infective endocarditis immune complex deposition
80
painless erythematous lesions on the palms and soles
Janeway lesions infective endocarditis septic emboli microabscesses
81
painless jaundice
cancer of the pancreatic head obstructing bile duct
82
palpable purpura on buttocks/legs joint pain abdominal pain (child) hematuria
henoch schonlein purpura IgA vasculitis affecting skin and kidneys
83
pancreatic tumor pituitary tumor parathyroid tumor
MEN1 autosomal dominant
84
periorbital and/or peripheral edema proteinuria (>3.5g/day) hypoalbuminemia hypercholesterolemia
nephrotic syndrome
85
pink complexion dyspnea hyperventilation
emphysema "pink puffer" centriacinar (smoking) or panacinar (alpha1 antitrypsin deficiency)
86
``` polyuria renal tubular acidosis type 2 growth failure electrolyte imbalances hypophosphatemic rickets ```
fanconi syndrome multiple combined dysfunction of the proximal convoluted tubule
87
pruritic (itchy), purple, polygonal planar papules and plaques (6 P's)
lichen planus
88
ptosis miosis anhidrosis
horner syndrome sympathetic chain lesion
89
pupil accommodates but doesn't react
neurosyphilis argyll robertson pupil
90
rapidly progressive limb weakness that ascends following a GI/upper resp infection
guillain barre syndrome acute inflammatory demyelinating polyradiculopathy subtype
91
rash on the palms and soles
coxsackie A secondary syphilis rocky mountain spotted fever
92
recurrent cold abscesses (non inflamed) unusual eczema high serum IgE
hyper IgE syndrome job syndrome due to neutrophil chemotaxis abnormalitiy (staph abscesses)
93
red "currant jelly" sputum in alcoholic or diabetic patient
klebsiella pneumoniae pneumonia
94
red "currant jelly" stools
acute mesenteric ischemia (adults) intussusception (children)
95
Red, itchy, swollen rash of the nipple/areola
paget disease of the breast sign of underlying neoplasm
96
red urine in the morning | fragile RBCs
paroxysmal nocturnal hemoglobinuria
97
renal cell carcinoma (bilateral) hemangioblastomas angiomatosis pheochromocytoma
von Hippel Lindau disease dominant tumor supressor gene mutation
98
``` resting tremor rigidity akinesia postural instability shuffling gait ```
parkinsons disease loss of dopaminergic neurons in substantia nigra pars compacta
99
retinal hemorrhages with pale centers
roth spots bacterial endocarditis
100
severe jaundice in neonate
crigler najjar syndrome congenital unconjugated hyperbilirubinemia
101
severe RLQ pain with palpation of LLQ
rovsing sign acute appendicitis
102
severe RLQ pain with deep tenderness
McBurney sign acute appendicitis
103
``` short stature cafe au lait spots thumb/radial defects increased incidence of tumors/leukemia aplastic anemia ```
fanconi anemia genetic loss of DNA crosslink repair often progresses to AML
104
single palmar crease
down syndrome
105
situs inversus chronic sinusitis bronchiectasis infertility
kartagener syndrome dynein arm defect affecting cilia
106
skin hyperpigmentation hypotension fatigue
primary adrenocortical deficiency aka addisons disease causes increased ACTH and increased alpha MSH production
107
slow progressive muscle weakness in boys
becker muscular dystrophy x linked missense mutation in dystrophin less severe than duchenne
108
small irregular red spots on buccal/lingual mucosa with blue white centers
koplik spots due to measles -rubeola- virus
109
smooth, moist, painless, wart like white lesions on genitals
condylomata lata secondary syphilis
110
splinter hemorrhages in fingernails
bacterial endocarditis
111
"strawberry tongue"
scarlet fever | kawasaki disease
112
``` streak ovaries congenital heart disease horseshoe kidney cystic hygroma at birth short stature webbed neck lymphedema ```
turner syndrome 45XO
113
sudden swollen painful big toe joint | tophi (uric acid crystal deposits)
gout/podagra hyperuricemia
114
swollen gums mucosal bleeding poor wound healing petechiae
scurvy vit C deficiency cant hydroxylate proline/lysine for collagen synthesis
115
swollen hard painful finger joints
osteoarthritis osteophytes on PIP (bouchard nodes) and DIP (heberden nodes)
116
systolic ejection murmur | crescendo-decrescendo
aortic stenosis
117
``` telangiectasias recurrent epistaxis skin discoloration arteriovenous malformations GI bleeding hematuria ```
osler weber rendu syndrome hereditary hemorrhagic telangiectasia
118
thyroid tumor parathyroid tymor pheochromocytoma
MEN2A autosomal dominant RET mutation
119
thyroid tumor pheochromocytoma ganglioneuromatosis (mucosal neuromas)
MEN2B autosomal dominant RET mutation
120
toe extension/fanning upon plantar scrape
babinski sign UMN lesion
121
unilateral facial drooping involving forehead
LMN facial nerve CN7 palsy UMN lesions spare the forehead
122
urethritis conjunctivitis arthritis in a male
reactive arthritis associated with HLA B27
123
vascular birthmark (port wine stain) of the face
nevus flammeus | benign but associated with sturge weber syndrome
124
vomiting blood following gastroesophageal lacerations
mallory weiss syndrome alcoholics and bulimic patients
125
``` weight loss diarrhea arthritis fever adenopathy ```
whipple disease tropheryma whipplei
126
"worst headache of my life"
subarachnoid hemorrhage
127
increased AFP in amniotic fluid/maternal serum
dating error anencephaly spina bifida (open neural tube defects)
128
anti-centromere antibodies
scleroderma | CREST
129
anti-desmoglein (anti-desmosome) ab's
pemphigus vulgaris | blistering
130
anti-glomerular basement membrane ab's
goodpasture syndrome glomerulonephritis and hemoptysis
131
anti-histone ab's
drug induced SLE due to hydralazine isoniazid phenytoin procainamide
132
anti- IgG ab's
rheumatoid arthritis systemic inflammation joint pannus boutonniere deformity
133
anti- mitochondrial ab's (AMA's)
primary biliary cirrhosis female cholestasis portal HTN
134
anti-neutrophil cytoplasmic ab's (ANCA's)
microscopic polyangiitis eosinophilic granulomatosis with polyagnittis (MPO-ANCA/p-ANCA) primary sclerosing cholangitis (MPO-ANCA/p-ANCA) granulomatosis with polyangiitis (wegener; PR3-ANCA/c-ANCA)
135
anti-nuclear ab's (ANA's; anti-smith; anti-dsDNA)
SLE type 3 hypersensitivity
136
anti-platelet ab's
idiopathic thrombocytopenic purpura
137
anti-topoisomerase ab's
diffuse systemic scleroderma
138
anti- transglutaminase/anti-gliadin/anti-endomysial ab's
celiac disease diarrhea weight loss
139
"apple core" lesion on barium enema xray
colorectal cancer usually left sided
140
atypical lymphocytes
EBV
141
azurophilic peroxidase plus granular inclusions in granulocytes and myeloblasts
auer rods ``` AML especially APML (promyelocytic) M3 type ```
142
bacitracin response
sensitive= strep pyogens GAS resistance= strep agalactiae GBS
143
"bamboo spine" on xray
ankylosing spondylitis chronic inflammatory arthritis HLA B27
144
Basophilic nuclear remnants in RBCs
Howell Jolly bodies due to splenectomy or non functional spleen
145
basophilic stippling RBCs
lead poisoning or sideroblastic anemia
146
bloody or yellow tap on LP
subarachnoid hemorrhage
147
"boot shaped" heart on xray
TOF due to RV hypertrophy
148
branching gram positive rods with sulfur granules
actinomyces israeli
149
bronchogenic atypical lung tumor on imaging
pancoast tumor can compress cervical sympathetic chain and cause horner syndrome (lung apex tumor, causes shoulder pain)
150
"brown" tumor of bone
hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
151
cardiomegaly with apical atrophy
chagas disease trypanosoma cruzi
152
cellular crescents in Bowman capsule
rapidly progressive crescentic glomerulonephritis
153
"chocolate cyst" of ovary
endometriosis frequently involves both ovaries
154
circular grouping of dark tumor cells surrounding pale neurofibrils
homer wright rosettes neuroblastoma medulloblastoma
155
colonies of mucoid pseudomonas in lungs
CF autosomal recessive mutation in CFTR gene fat soluble vitamin def and mucous plugs
156
decreased AFP in amniotic fluid/maternal serum
down syndrome or other chromosomal abnormalities
157
degeneration of dorsal column fibers
``` tabes dorsalis (tertiary syphilis) ``` subacute combined degeneration (dorsal columns, lateral corticospinal, and spinocerebellar tracts affected)
158
"delta wave" on ekg short PR interval supraventricular tachycardia
wolff parkinson white syndrome bundle of kent bypasses the AV node
159
depigmentation of neurons in the substantia nigra
parkinsons disease basal ganglia disorder rigidity resting tremor bradykinesia
160
desquamated epithelium casts in sputum
curschmann spirals bronchial asthma can result in whorled mucous plugs
161
disarrayed granulosa cells arranged around collections of eosinophilic fluid
call exner bodies granulosa cell tumor of the ovary
162
dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia
koilocytes HPV predisposes to cervical cancer
163
electrical alternans | alternating amplitude on EKG
pericardial tamponade
164
enlarged cells with intranuclear inclusion bodies
"owl eye" appearance of CMV
165
enlarged thyroid cells with ground glass nuclei with central clearing
"orphan annie" eyes nuclei papillary carcinoma of the thyroid
166
eosinophil cytoplasmic inclusion in the liver cell
mallory body alcoholic liver disease
167
eosinophil cytoplasmic inclusion in the neuron
lewy body parkinson disease and lewy body dementia
168
eosinophilic globule in the liver
councilman body viral hepatitis, yellow fever represents hepatocytes undergoing apoptosis
169
eosinophilic inclusion bodies in the cytoplasm of hippocampal and cerebellar neurons
negri bodies of rabies
170
extracellular amyloid deposition in gray matter of the brain
senile plaques alzheimers disease
171
giant B cells with bilobed nuclei with prominent inclusions | "owl eyes"
Reed sternberg cells HL
172
glomerulus like structure surrounding vessel in germ cells
schiller duval bodies yolk sac tumor
173
"hair on end" or "crew cut" appearance on xray
beta thalaseema sickle cell disease due to marrow expansion
174
hCG elevated
choriocarcinoma hydatidiform mole (with and without embryo) multiple pregnancy
175
heart nodules | granulomatous
anschoff bodies rheumatic fever
176
heterophile ab's
infectious mononucleosis (EBV)
177
hexagonal double pointed needle like crystals in bronchial secretions
bronchial asthma | charcot leyden crystals eosinophilic granules
178
high level of D-dimer
DVT PE DIC
179
hilar LAD peripheral granulomatous lesion in midline or lower lung lobes (can calcify)
Ghon complex | primary TB, mycobacterium bacili
180
"honeycomb lung" on xray or CT
interstitial pulm fibrosis
181
hypercoagulability | leading to migrating DVTs and vasculitis
Trousseau syndrome adenocarcinoma of pancreas of lung
182
hypersegmented neutrophils
megaloblastic anemia B12 def= neuro symptoms folate def= no neuro symptoms
183
HTN hypokalemia metabolic alkalosis
primary hyperaldosteronism conn syndrome
184
hypochromatic microcytic anemia
iron def anemia lead poisoning thalassemia (fetal hemoglobin sometimes present)
185
intranuclear eosinophilic droplet like bodies
cowdry type A bodies | HSV or VZV
186
iron containing nodules in alveolar septum
ferruginous bodies | due to asbestosis increased lung cancer
187
keratin pearls on skin biopsy
SqCC
188
large granules in phagocytes | immunosuppr
chediak higashi disease cong failure of phagolysosome formation
189
"lead pipe" appearance of colon on abdominal imaging
ulcerative colitis loss of haustra
190
linear appearance of IgG deposition of glomeruli on immunoflorescence
good pastures syndrome
191
low serum ceruloplasmin
wilson disease | hepatolenticular degeneration copper accumulation
192
"lumpy bumpy" appearance of glomeruli on immunofluorescence
post strep glomerulonephritis due to deposition of IgG, IgM, and C3
193
lytic ("punched out") bone lesions on xray
multiple myeloma
194
mammary gland ("blue domed") cyst
fibrocystic chance of the breast
195
monoclonal ab spike
multiple myeloma (usually IgG or IgA) monoclonal gammopathy of undetermined significance (MGUS- consequence of aging) waldenstrom (M protein- IgM) macroglobulinemia primary amyloidosis
196
mucin filled cell with peripheral nucleus
"signet ring" gastric carcinoma
197
narrowing of bowel lumen on barium xray
"string sign" crohns disease
198
necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
granulomatosis with polyangiitis (wegner, PR3-ANCA/c-ANCA) and goodpastures syndrome (anti-basement membrane ab's)
199
needle shaped | negatively birefringent crystals
gout monosodium urate crystals
200
nodular hyaline deposits in glomeruli
kimmelstiel wilson nodules diabetic neuropathy
201
novobiocin response
sensitive= staph epidermidis resistant= staph saprophiticus
202
"nutmeg" appearance of liver
chronic passive congestion of the liver due to right hear failure or budd chiari syndrome
203
"onion skin" periosteal reaction
ewing sarcoma malignant small blue cell tumor
204
optochin sensitivity
sensitivity= strep pneumo | resistant= strep viridans strep mutans and strap sanguis
205
podocyte fusion or "effacement" on electron microscopy
minimal change disease child with nephrotic syndrome
206
protein aggregates in neurons from hyperphosphorylation of tau protein
neurofibrillary tangles (alzheimers disease) and pick bodies (picks disease)
207
psammoma bodies
meningiomas papillary thyroid carcinoma mesothelioma papillary serous carcinoma of the endometrium and ovary
208
pseudopalisading tumor cells on a brain biopsy
GBM
209
``` raised periosteum (creating a "codman triangle") ```
aggressive bone lesion due to osteosarcoma ewing sarcoma osteomyelitis
210
RBC casts in urine
glomerulonephritis
211
rectangular crystal like cytoplasmic inclusions in leydig cells
reinke crystals leydig cell tumors
212
recurrent infections eczema thrombocytopenia
wiskott aldrich syndrome
213
renal epithelial casts in urine
intrinsic renal failure ischemia or toxic injury
214
rhomboid crystals | positive birefringent
pseudogout calcium pyrophosphate dihydrate crystals
215
Rib notching | inferior surface, on cxr
coarctation of the aorta
216
ring enhancing brain lesion on CT/MRI in AIDS patient
toxoplasma gondii CNS lymphoma
217
sheets of medium sized lymphoid cells with scattered, pale, tingible body laden macrophages "starry sky" histology
burkitt lymphoma t (8;14) c-myc activation associated with EBV "starry sky" made of malignant cells
218
silver staining spherical aggregation of tau proteins in neurons
pick bodies pick disease- progressive dementia, changes in personality
219
"soap bubble" in femur or tibia on xray
giant cell tumor of bone generally benign
220
"spikes" on basement membrane | "dome like" subepithelial deposits
membranous nephropathy nephrotic syndrome
221
stacks of RBCs
rouleaux formation high ESR multiple myeloma
222
"steeple" sign on frontal cxr
croup parainfluenza virus
223
bacteria covered vaginal epithelial cells
"clue cells" gardnerella vaginalis
224
streptococcus bovis bacteremia
colon cancer
225
"tennis racket" shaped cytoplasmic organelles (EM) in langerhans cells
birbeck granules langerhans cell histiocytosis
226
thousands of polyps on colonoscopy
familial adenomatous polyposis autosomal dominant mutation of APC gene
227
thrombi made of white/red layers
lines of zahn arterial thrombus layers of platelets/RBCs
228
"thumb sign" on lateral neck xray
epiglottitis haemophilus influenzae
229
thyroid like appearance of the kidney
chronic pyelonephritis usually due to recurrent infections
230
"tram track" appearance of capillary loops of glomerular basement membranes on light microscopy
membranoproliferative glomerulonephritis
231
TG accumulation in liver cell vacuoles
fatty liver disease alcoholic or metabolic syndrome
232
increased uric acid levels
gout lesch nyhan syndrome tumor lysis syndrome loop and thiazide diuretics
233
"waxy" casts with very low urine flow
chronic end stage renal disease
234
WBC casts in urine
acute pyelonephritis
235
WBCs that look "smudged"
CLL almost always B cell
236
"wire loop" glomerular capillary appearance on light microscopy
diffuse proliferative glomerulonephritis usually seen with lupus
237
yellowish CSF
xanthochromia due to subarachnoid hemorrhage
238
absence seizures tx
ethosuximide
239
acute gout attack tx
NSAIDS colchicine GCs
240
acute promyelocytic leukemia (M3) tx
all trans retinoic acid
241
ADHD tx
``` methylphenidate amphetamines CBT atomoxetine guanfacine clonidine ```
242
alcoholism tx
disulfiram acamprosate naltrexone supportive care
243
alcohol withdrawal tx
long acting benzo's
244
anorexia tx
nutrition psychotherapy mirtazapine
245
arrhythmia in damaged cardiac tissue tx
``` class 1B antiarrhythmics (lidocaine mexiletine) ```
246
BPH tx
alpha 1 antagonists 5 alpha reductase inhibitors PDE5 inhibitors
247
bipolar tx
``` mood stabilizers (lithium valproic acid carbamazepine) atypical antipsychotics ```
248
breast cancer in post menopausal women tx
aromatase inhibitors | anastrozole
249
buerger disease tx
smoking cessation
250
bulimia nervosa tx
SSRIs
251
candida albicans tx
topical azoles (vaginitis) nystatin fluconazole caspofungin (oral/esophageal) fluconazole caspofungin amphotericin B (systemic)
252
carcinoid syndrome tx
octreotide
253
chlamydia trachomatis tx
doxycycline (plus ceftriaxone for gonorrhea coinfection) erythromycin eye drops (conjunctivits prophylaxis in infants)
254
chronic gout tx
xanthine oxidase inhibitors (allopurinol febuxostat) pegloticase probenecid
255
chronic hep B or hep C tx
interferon alpha (HBV and HCV) | ribavirin simeprevir sofosbuvir HCV
256
chronic myelogenous leukemia tx
imatinib
257
clostridium botulinum tx
antitoxin
258
clostridium difficile tx
oral metronidazole if refractory, give oral vancomycin
259
clostridium tetani tx
antitoxin
260
CMV tx
ganciclovir foscarnet cidofovir
261
Crohn disease tx
corticosteroids infliximab azathioprine
262
cryptococcus neoformans tx
fluconazole (in AIDS patients)
263
cyclophosphamide induced hemorrhagic cystitis tx
mesna
264
depression tx
SSRIs (first line)
265
diabetes insipidus tx
desmopressin (central) hydrochlorothiazide indomethacin amiloride (nephrogenic)
266
DM1 tx
dietary intervention low carbs insulin replacement
267
DM2 tx
dietary intervention oral hypoglycemics insulin if refractory
268
DKA tx
fluids insulin potassium
269
drug of choice for anticoagulation during pregnancy
heparin
270
enterococci tx
vancomycin | aminopenicillins/cephalosporins
271
erectile dysfunction tx
sildenafil tadalafil vardenafil
272
ER positive breast cancer tx
tamoxifen
273
ethylene glycol/methanol intoxication tx
fomepizole | alcohol dehydrogenase inhibitor
274
Hib tx
rifampin (prophylaxis)
275
generalized anxiety disorder tx
SSRIs SNRIs (first line) buspirone (second line)
276
granulomatosis with polyangiitis (wegner) tx
cyclophosphamide | corticosteroids
277
heparin reversal tx
protamine sulfate
278
HER2/neu positive breast cancer tx
trastuzumab
279
hyperaldosteronism tx
spironolactone
280
hypercholesterolemia tx
statin (first line)
281
hypertriglyceridemia tx
fibrate
282
immediate anticoagulation tx
heparin
283
infertility tx
leuprolide GnRH (pulsatile) clomiphene
284
influenza tx
oseltamivir | zanamivir
285
kawasaki disease tx
IVIG | high dose aspirin
286
legionella pneumophila tx
macrolides | azithromycin
287
long term anticoagulation tx
warfarin dabigatran rivaroxaban apixaban
288
malaria tx
chloroquine mefloquine atovaquone/proguanil (for blood schizont) primaquine (for liver hypnozoite)
289
malignant hyperthermia tx
dantrolene
290
medical abortion drug
mifepristone
291
migraine tx
abortive therapies (sumatriptan NSAIDs) ``` prophylaxis (propranolol topiramate CCB amitriptyline) ```
292
MS tx
disease modifying therapies (beta interferon natalizumab) for acute flares use IV steroids
293
mycobacterium tuberculosis tx
RIPE (rifampin isoniazid pyrazinamide ethambutol)
294
neisseria gonorrhoeae tx
ceftriaxone | add doxycycline to cover likely concurrent C trachomatis
295
neisseria meningitidis tx
penicillin/ceftriaxone | rifampin (prophylaxis)
296
neutal tube defect prevention
prenatal folic acid
297
osteomalacia/rickets tx
vitamin D supplementation
298
osteoporosis tx
``` calcium/vitamin D supplementation (prophylaxis) biphosphonates PTH analogs SERMs calcitonin denosumab (treatment) ```
299
PDA tx
close with indomethacin keep open with PGE analogs
300
pheochromocytoma tx
alpha blockers | phenoxybenzamine
301
pneumocystis jirovecii tx
TMP-SMX (prophylaxis and treatment in immunosuppr patients)
302
prolactinoma tx
cabergoline/bromocriptine | dopamine agonists
303
prostate adenocarcinoma/uterine fibroid tx
leuprolide | GnRH (continuous)
304
prostate adenocarcinoma
flutamide
305
pseudomonas aeruginosa tx
anti-pseudomonal penicillins aminoglycosides carbapenems
306
pulmonary arterial hypertension (idiopathic) tx
sildenafil bosentan epoprostenol
307
rickettsia rickettsii tx
doxycycline | chloramphenicol
308
schizophrenia (negative symptoms) tx
atypical antipsychotics
309
schizophrenia (positive symptoms) tx
typical and atypical antipsychotics
310
SIADH tx
fluid restriction IV hypertonic saline conivaptan/tolvaptan demeclocycline
311
sickle cell disease tx
hydroxyurea | increases fetal hemoglobin
312
sporothrix schenckii tx
itraconazole | oral potassium iodide
313
stable angina tx
sublingual nitroglycerin
314
staph aureus tx
MSSA= nafcillin oxacillin dicloxacillin anti-staph penicillins MRSA= vanco daptomycin linezolid ceftaroline
315
strep bovis tx
penicillin prophylaxis | evaluation for colon cancer if linked to endocarditis
316
strep pneumo tx
penicillin/cephalosporin (systemic infection, pnu) vanco (meningitis)
317
strep pyogens (GAS) tx
penicillin prophylaxis
318
temporal arteritis tx
high dose steroids
319
tonic clonic seizures tx
levetiracetam phenytoin valproate carbamazepine
320
toxoplasma gondii tx
sulfadiazine and pyrimethamine
321
treponema pallidum tx
penicillin
322
trichomonas vaginalis tx
metronidazole | patient and partner
323
trigeminal neuralgia (tic douloureux) tx
carbamazepine
324
ulcerative colitis tx
5-ASA preparations (mesalamine) 6-mercaptopurine infliximab colectomy
325
UTI prophylaxis tx
TMP-SMX
326
warfarin reversal tx
FFP acute vit K non acute
327
actinic (solar) keratosis
precursor to SqCC
328
acute gastric ulcer assoc with CNS injury
cushing ulcer increased ICP stimulates vagal gastric H+ secretion
329
acute gastric ulcer assoc with severe burns
Curling ulcer greatly reduced plasma volume results in sloughing of gastric mucosa
330
age ranges for patients with ALL CLL AML CML
ALL= child CLL= adult >60 AML= adult 65 yo CML= adult 45-85
331
alternating areas of transmural inflammation and normal colon
skip lesions crohns disease
332
aortic aneurysm | abdominal
atherosclerosis
333
aortic aneurysm | ascending or arch
tertiary syphilis (syphilitic aortitis) vasa vasorum destruction
334
aortic aneurysm | thoracic
marfan syndrome | idiopathic cystic medial degeneration
335
aortic dissection
hypertension
336
atrophy of the mammillary bodies
``` wernicke encephalopathy (thiamine def causing ataxia, ophthalmoplegia, and confusion) ```
337
autosplenectomy | fibrosis and shrinkage
sickle cell disease | hemoglobin S
338
bacteria assoc with gastritis PUD gastric cancer (adenocarcinoma and MALToma)
H pylori
339
bacterial meningitis (adult and elderly)
strep pneumo
340
bacterial meningitis (newborn and kids)
GBS/Ecoli/Listeria (newborns) strep pneumo/neisseria mening (kids/teens)
341
bilateral ovarian metastases from gastric carcinoma
krukenberg tumor | mucin secreting signet ring cells
342
bleeding disorder with Gp1b def
bernard soulier syndrome defect in platelet adhesion to vWF
343
brain tumor (adults)
supratentorial metastasis astrocytoma (including GBM) meningioma schwannoma
344
brain tumor (kids)
infratentorial medulloblastoma (cerebellum) supratentorial craniopharyngioma
345
breast cancer
invasive ductal carcinoma
346
breast mass
fibrocystic change | carcinoma (in postmenopausal women)
347
breast tumor (benign, young woman)
fibroadenoma
348
cardiac primary tumor (kids)
rhabdomyoma | often seen in tuberous sclerosis
349
cardiac manifestations of lupus
marantic/thrombotic endocarditis (nonbacterial)
350
cardiac tumor (adults)
mets | myxoma (90% in LA, "ball valve")
351
cerebellar tonsillar herniation
chiari 1 malformation
352
chronic arrhythmia
a fib | assoc with risk of emboli
353
chronic atrophic gastritis | autoimmune
predisposition to gastric carcinoma can also cause pernicious anemia
354
clear cell adenocarcinoma of the vagina
DES exposure in utero
355
congenital adrenal hyperplasia | hypotension
21 hydroxylase def
356
cong cardiac anomaly
VSD
357
cong conjugated hyperbilirubinemia | black liver
dubin johnson syndrome inability of hepatocytes to secrete conjugated bilirubin into bile
358
constrictive pericarditis
TB (developing world) | idiopathic viral illness developed world
359
cretinism
iodine deficit | cong hypothyroidism
360
cushing syndrome
iatrogenic (steroid tx) adrenocortical adenoma (secreting cortisol) ACTH secreting pituitary adenoma (cushing disease) paraneoplastic (due to ACTH secreting tumor)
361
cyanosis (early, less common)
TOF transposition of the great vessels truncus arteriosus
362
death in CML
blast crisis
363
death in SLE
lupus nephropathy
364
dementia
``` alzheimers disease multiple infarcts (vasc dementia) ```
365
demyelinating disease in young women
MS
366
DIC
``` severe sepsis obstetric complications cancer burns trauma major surgery acute pancreatitis APL ```
367
diverticulum in pharynx
zenker diverticulum | diagnosed by barium swallow
368
ejection click
aortic stenosis
369
esophageal cancer
SqCC (worldwide) adenocarcinoma (USA)
370
food poisoning (exotoxin mediated)
staph aureus | b. cereus
371
gastric cancer
adenocarcinoma
372
glomerulonephritis (adults)
berger disease | IgA nephropathy
373
gynecologic cancer
endometrial carcinoma (most common in USA) cervical carcinoma (most common worldwide)
374
heart murmur | congenital
MVP
375
heart valve in bacterial endocarditis
mitral>aortic (rheumatic fever) tricuspid= IVDA
376
helminth infection (USA)
ascaris lumbricoides
377
hematoma-epidural
rupture of the middle meningeal artery trauma lentiform shaped
378
hematoma- subdural
rupture of bridging veins | crescent shaped
379
hemochromatosis
multiple blood transfusions hereditary HFE mutation can result in heart failure "bronze DM" and liver carcinoma
380
hepatocellular carcinoma
cirrhotic liver assoc with hep B and hep C and alcoholism
381
hereditary bleeding disorder
von willebrand disease
382
hereditary harmless jaundice
gilbert syndrome benign cong unconjugated hyperbilirubinemia
383
HLA B27
psoriatic arthritis ankylosing spondylitis IBD assoc arthritis reactive arthritis (formely reiter syndrome)
384
HLA DR3
``` DM1 SLE graves disease hashimoto thyroiditis (HLA DR5 too) addisons disease ```
385
HLA DR4
DM1 rheumatoid arthritis addison disease
386
holosystolic murmur
VSD tricuspid regurg mitral regurg
387
hypercoagulability endothelial damage blood stasis
virchow triad increased risk of thrombosis
388
hypertension | secondary
``` renal artery stenosis chronic kidney disease (polycystic kidney disease diabetic nephropathy) hyperaldosteronism ```
389
hypoparathyroidism
accidental excision during thyroidectomy
390
hypopituitarism
pituitary adenoma | usually a benign tumor
391
infection secondary to blood transfusion
hep C
392
infections in chronic granulomatous disease
catalase positive bugs staph aureus e coli aspergillus
393
intellectual disability
down syndrome | fragile x syndrome
394
kidney stones
calcium= radiopaque struvite (ammonium)= radiopaque formed by urease positive bugs like klebsiella, proteus, and staph saprophiticus uric acid= radiolucent cysteine= radiolucent
395
late cyanotic shunt | uncorrected becomes left to right
eisenmenger syndrome caused by ASD VSD PDA results in pulm HTN and polycythemia
396
liver disease
alcoholic cirrhosis
397
lysosomal storage disease
gaucher disease
398
cancer assoc with non infectious fever
HL
399
cancer (kids)
leukemia brain tumor
400
mets to bone
prostate cancer breast cancer >lung cancer thyroid cancer kidney cancer
401
mets to brain
lung>breast>prostate>melanoma> GI
402
mets to liver
colon>> stomach>pancreas
403
microcytic anemia
iron def
404
mitochondrial inheritence
disease occurs in both males and females inherited only by mom
405
mitral valve stenosis
rheumatic heart disease
406
mixed UMN and LMN disease
ALS | amyotrophic lateral sclerosis
407
myocarditis
coxsackie B
408
nephrotic syndrome (adults)
membranous nephropathy
409
nephrotic syndrome (kids)
minimal change disease
410
neuron migration failure
kallman syndrome hypogonadotrophic hypogonadism and anosmia
411
nosocomial pnu
staph aureus pseudomonas enteric gram negative rods
412
obstruction of male urinary tract
BPH
413
opening snap
mitral stenosis
414
opportunistic infection in AIDS
PJ pnu
415
osteomyelitis
staph aureus | most common overall
416
osteomyelitis in sickle cell disease
salmonella
417
osteomyelitis in IVDA
pseudomonas candida staph aureus
418
ovarian tumor (benign, bilateraly)
serous cystadenoma
419
ovarian tumor (cancer)
serous cystadenocarcinoma
420
pancreatitis (acute)
gallstones | alcohol
421
pancreatitis (chronic)
alcohol = adults CF (kids)
422
PID
chlamydia | gonorrhea
423
philadelphia chromosome t (9;22) BCR-ABL
CML sometimes assoc with ALL/AML
424
pituitary tumor
prolactinoma | somatotrophic adenoma
425
primary amenorrhea
turner syndrome 45 XO or 45XO/46XX mosaic
426
primary bone tumor (adults)
multiple myeloma
427
primary hyperaldosteronism
adrenal hyperplasia or adenoma
428
primary hyperparathyroidism
adenomas hyperplasia carcinoma
429
primary liver cancer
``` hepatocellular carcinoma (chronic hepatitis cirrhosis hemochromatosis alpha 1 antitrypsin def wilson disease) ```
430
pulm HTN
``` idiopathic heritable left heart disease (HF) lung disease (COPD) hypoxemic vasoconstriction (OSA) thromboembolic (PE) ```
431
recurrent inflamm/thrombosis of small/medium vessels in extremities
buergers disease (tobacco assoc)
432
refractory peptic ulcers and high gastrin levels
zollinger ellison syndrome gastrinoma of the duodenum or pancreas assoc with MEN1
433
renal tumor
renal cell carcinoma (assoc with von hippel lindau and cigarette smoking) ``` paraneoplastic syndromes (EPO renin PTHrP ACTH) ```
434
right heart failure due to pulm cause
cor pulmonale
435
S3 heart sound
increased ventricular filling pressure (mitral regurg HF) common in dilated ventricles
436
S4 heart sound
stiff/hypertrophic ventricle (aortic stenosis restrictive cardiomyopathy)
437
sexually transmitted disease
chlamydia and gonorrhea
438
SIADH
SCC of the lung
439
site of diverticula
sigmoid colon
440
sites of atherosclerosis
abdominal aorta> coronary artery> popliteal artery>carotid artery
441
t (14; 18)
follicular lymphoma (BCL-2 activation anti-apoptotic oncogene)
442
t (9;22)
philadelphia chromosome CML BCL-ABL activation tryosine kinase oncogene
443
t (8; 14)
burkitt lymphoma c-myc fusion transcription factor oncogene
444
temporal arteritis
risk of ipsalateral blindness due to occlusion of the ophthalmic artery polymyalgia rheumatica
445
testicular tumor
seminoma (malignant radiosensitive) increase in placental ALP
446
thyroid cancer
papillary carcinoma | childhood irradiation
447
tumor in women
leiomyoma (estrogen dependent not pre cancerous)
448
tumor in infancy
strawberry hemangioma | grows rapidly and regresses spontaneously by childhood
449
tumor of the adrenal medulla (adults)
pheochromocytoma | usually benign
450
tumor of the adrenal medulla (kids)
neuroblastoma | malignant
451
type of HL
nodular sclerosing (vs mixed cellularity, lymphocytic predominance, lymphocytic depletion)
452
type of NHL
diffuse large B cell lymphoma
453
UTI
``` ecoli staph saprophyticus (young women) ```
454
vertebral compression fracture
osteoporosis type 1= post menopausal women type 2= elderly man or woman
455
viral encephalitis affecting the temporal lobe
HSV 1
456
vitamin def USA
folate = pregnant women at high risk, body stores for 3-4 month supply, prevents NTDs

STEP 1 (11 decks)

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