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Red Flags Flashcards

1
Q

HLA A3

A

hemochromatosis

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2
Q

HLA B8

A

addison disease and myasthenia gravis

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3
Q

HLA B27

A

psoriatic arthritis, ankylosing spondylitis, IBD arthritis, reactive arthritis

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4
Q

HLA DQ2 and DQ8

A

celiac disease

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5
Q

HLA DR2

A

MS, hay fever, SLE, Graves, hashimoto, addison

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6
Q

HLA DR4

A

Rheumatorid arthritis, diabetes type 1, addison

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7
Q

HLA DR5

A

pernicous anemai- B12 def and hashimoto thyroiditis

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8
Q

incidence of cancer in Women

A

breast, lung, colon/rectum

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9
Q

mortality of cancer in Women

A

lung, breast, colon/rectum

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10
Q

incidence of cancer in Men

A

prostate, lung, colon/rectum

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11
Q

mortality of cancer in Men

A

lung, prostate, colon/rectum

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12
Q

acanthosis nigricans cancer association

A

gastric adenocarcinoma or DM

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13
Q

Leser Trelat sign

A

multiple sebohoric keratosis- GI adenocarcinoma and other visceral malignancies

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14
Q

Hypercalcemia from PTHrP what malig

A

squamous cell carcinoma of the lung, HEENT, renal, bladder, breast and ovarian

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15
Q

increase d1,25 vitamin D3 in cancer

A

lymphoma

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16
Q

Cushing syndrome cancer

A

small cell lung cancer

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17
Q

hyponatremia cancer

A

small cell lung cancer

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18
Q

polycythemia cancer

A

RCC, hepatocellular, hemangioblastoma, pheochromocytoma, leiomyoma

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19
Q

pure red cell aplasia cancer

A

thymoma

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20
Q

Good syndrome cancer

A

hypogammaglobulinemia- thymoma

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21
Q

Trousseau syndrome cancer

A

migratory superficial thrombophelibitis- adenocarcinoma of the pacreass

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22
Q

nonbacterial endocarditis- cancer

A

pancreatic cancer

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23
Q

Anti-NMDA receptor encephalitis- cancer

A

psych issues, memory, seizures, dyskinesias, autonomic instability, language dysfunction- ovarian teratoma

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24
Q

opsoclonus mycolonus ataxia- dancing eyes dancing feet- cancer

A

neuroblastoma and small cell lung cancer

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25
Q

Paraneoplastic cerebellar degeneration-cancer

A

small cell lung cancer, gynocology and breast cancer, and hodgekin lymphoma

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26
Q

Lambert Eaton Myasthenic syndrome- cancer

A

presynaptic membrane receptor- small cell lung cancer

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27
Q

myasthenia gravis- cancer

A

thymoma- postsynaptic

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28
Q

oncogenes are…

A

gain of function so increased cancer risk. Only need to damage one allele

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29
Q

tumor suppressor genes are….

A

loss of function- need to damage both alleles

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30
Q

steps of collagen synthesis

A

1- synthesis of prepro collagen into an alpha chain with increased glycine. 2. hydroxylation of praline and lysine with vitamin C. 3. glycosilation of pro collagen. 4. exocytosis. 5. cleave the ends to procolalgen to tropocollagen 6. cross linking of tropocollagen which can be blocked by sweet peas.

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31
Q

look at page 243 FA

A

picture of autonomic drugs

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32
Q

irregularly irregular- what are the risk factors and what conditions can it lead to

A

afib- excess alcohol, CAD, HTN- can leadto thrombus from the left atrial appendage. the AV node drives this rhythm

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33
Q

sawtooth waves- what is it

A

atrial flutter

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34
Q

erratic rhythm with no discernible waves-when does it tend to occur

A

v fib- first 48 post MI

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35
Q

PR interval prolongation- what is it

A

first degree AV block

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36
Q

longer longer longer drop- what is it

A

Mobitz I- second degree AV block

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37
Q

dropped beats that are not preceeded in change of PR interval

A

Mobitz II- second degree AV block

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38
Q

the atria and ventricles beat independently- what is it and what can cause it

A

third degree AV block- can be from Borrelia Burgdoferi

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39
Q

list the pressures of the heart in the different sites

A 
RA- 5
RV- 25/5
LA- 12
LV- 130/10
Pul artery- 25/10
Aorta- 130/90
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40
Q

when is PCWP>LVdia

A

mitral stenosis

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41
Q

what causes edema with capillary pressure increases

A

increased capillary press can be from HF

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42
Q

what causes edema with plasma protein changes

A

decreased plasma proteins, nephrotic syndrome, liver failure, protein malnutrition

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43
Q

what causes edema with capillary permeability changes

A

toxins, infections, burns cause increased capillary permeability

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44
Q

what causes edema with interstitial fluid colloid osmotic pressure

A

lymphatic blockage from tumor, inflammation, surgery- causes increased colloid protein in the intersititum

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45
Q

dilated cardiomyopathy what is it from

A

alcohol abuse, wet beri beri, coxsackie B, viral myocarditis, chronic coke, chagas, doxarubicin, hemochromatosis, sarcoidosis, peripartum xrdiomyopathy

46
Q

what signs do you see of dilated cardiomyopathy

A

S3, HF, balloon heart on CXR

47
Q

what type of dysfunction do you get and what would you see on gross exam

A

eccentric hypertrophy and systolic dysfunction

48
Q

what are the causes of hypertrophic cardiomyopathy

A

beta myosin heavy chain mutation, frieerich ataxia

49
Q

what are the signs of hypertrophic cardiomyopathy

A

syncope during excretes ventricular arrythmia

50
Q

findings with hypertrophic cardiomyopathy

A

S4, systolic murmur, impaired mitral cage because of the leaflet moving forward leading to regard. Ventricular hypertrophy uneven on the septum leading to the outflow obstruction- diastolic dysfunction

51
Q

causes of restrictive infiltrative cardiomyopathy

A

sarcoidosis, amyloidosis, postradiation fibrosis, endocardial fibroelastosis, loffler- endomyocardial fibrosis with prominent eosinophilic infiltrate, hemochromatosis

52
Q

what type of dysfunction is associated with restrictive infiltrative cardiomyopathy

A

diastolic dysfunction with low voltage ECg because of thick myocardim

53
Q

what is the criteria for metabolic syndrome

A

increased abdominal circumference, increased TG, decreased HDL, increased BP, and increased fasting blood glucose

54
Q

hashimotos thyroditis

A

hypothyroidism and can be autoimmune with antithyroid peroxidase. It is associated with HLAD5 which has increased risk of B cell lymphoma. Can have hyperthyroid early because of follicle rupture

55
Q

what is the histologic findings with hashi

A

see hurtle cells with are large oxyphillic cells with granular cytoplasm. Lymphoid aggregates with gemrinal centers or follicular epithelial cells with mononuclear infiltration

56
Q

congential hypothydroidism

A

severe fetal hypothyroidism due to materna hypothyroidism, agenesis, dysgenesis(1), or iodine def, or dyshormongoestis. Pot belly, puffy face, umbilical hernia, large tongue and dumb

57
Q

subacute granulomatous thyroiditis

A

self limited sieges following a virus infection. tender granulomatous infalmmation

58
Q

Riedel thyroiditis

A

fibrous extension of the thyroid with inflammatory infiltrate can be from IgG related systemic diseases of autoimmune pancreatitis, retroperitoneal fibrosis, noninfectious aortitis

59
Q

Graves

A

hyperthyroid from thyroid stimulating global.

60
Q

what type of HSN is graves

A

II

61
Q

what stimulates the periorbital myxedema

A

it is from infiltration of retrorbital space by IFN game nd TNF alpha and there are increased GAGs which causes osmotic diffusion and can be exopthamosis

62
Q

thyroid storm

A

fever agitiation, delirum, diarrhea, coma, tachy

63
Q

treatment of a thyroid storm

A

beta blocker, propylthiouracil, corticosteroids, lugol

64
Q

what does beta blocker do during thyroid storm

A

it decreases the conversion of T4 to T3 because it blocks 5’ iodothyronase

65
Q

Jod Basedow

A

thyrotoxicosis from iodine replacement in a person with a hyper functioning autonomous nodule

66
Q

thyroid ademona

A

benign growth like follicular cancer but does not invade surrounding tissue

67
Q

papilalary carcinoma- histology

A

empty appearing nuclei with groves, central clearing, and psammoma bodies, and increased wit hRET and BraF and childhood radiation

68
Q

follicular cacinoma

A

thyroid capsule and vessels are invaded have uniform follicles- RAS mutation

69
Q

medullary carcinoma- stain and histology

A

parafollicular C cells produce calcitonin sheets of cells in an amyloid stroma- from Ret mutation- stains with congo red

70
Q

anaplastic thyroid cancer

A

older patient with fibrous local invasion of the thyroid

71
Q

what type of cancer is associated with hashimoto thyroiditis

A

B cell lymphoma

72
Q

what are the branches of the celiac artery

A

common hepatic, splenic, and left gastric arteries

73
Q

what are the short gastric off of and what does it supply

A

spelenic artery and its doing the fundus

74
Q

what are the branches of the common hepatic artery

A

right gastric, proper haptic, gastroduodenal

75
Q

the prosencephalon forms the

A
  • telencephalon cerebral hemispheres and basal ganglia

- diencephalon- thalamus, hypothalamus, optic nerve

76
Q

the mesencephalon forms the

A

mesencephalon- midbrain

77
Q

the rhombencephalon forms the

A
  • metencephalon- pons or cerebellum

- myelencephalon- medulla

78
Q

what hormones does the hypothalamus make

A

ADH and oxytocin

79
Q

what carries the hypothalamic hormones down the icons to the posterior pituitary

A

neurophysins- mutations in this can cause DI from decreased ADh release

80
Q

lateral area of hypothalamus

A

hunger- destruction leads to anorexia, failure to thrive in infants, and stimulate by gherkin and inhibited by leptin

81
Q

ventreomedial area of hypothalamus

A

satiety-destruction leads to hyperphagia, stimulated by leptin

82
Q

what can cause destruction of the ventromedial nucelus

A

craniopharyngioma

83
Q

anterior hypothalamus

A

cooling and parasympathic

84
Q

posterior hypothalamus

A

heating and it is sympathtic

85
Q

suprachiasmatic nuc

A

circadian rhythm

86
Q

supraoptic nucelus secretes what

A

ADH

87
Q

arcutate nucles secretes what

A

pulsatile GnRH

88
Q

preoptic nucelus secretes

A

GnRH

89
Q

paraventrirular secretes

A

oxytocin secretion

90
Q

what regulates melatonin

A

pineal gland from light and dark

91
Q

what is OA

A

mechanical wear and tear leading to chrondrocye degradation, and it is age, obesity, and joint trauma, and pain n weight bearing joints, and knee cartilage is los. There are osteophytes, joint narrowing,and subchondral sclerosis, and does not involve the MCP

92
Q

tight junction

A

zonula occlusents- prevents paracellular movement of solutes and is composed of claudins and occludins

93
Q

adheres junction- zone adhrenes

A

forms the belt around and actin skeleton loss of this leads to mets- E cadherns

94
Q

desmosomes

A

structural support via intermediate filament interactions

95
Q

gap junctions

A

channel proteins called conexons permit electrical and chemical communication between cells

96
Q

hemidesmosomes

A

connets keratin n basal cells underlying the basal membrane

97
Q

integrins

A

membrnae proteins that maintain, integrity of basolateral membrane by binding to collagen and lamina in the bm by hibrodnectin

98
Q

inspiratory reserve volume

A

air that still be breathed in after a normal reespiration

99
Q

tidal volume

A

air that moves into lung with each quiet inspiration, typically 500ml

100
Q

expiratory reserve volume

A

air that can still be breathed out after normal expiration

101
Q

residual volume

A

air in lung after maximal expiration

102
Q

inspiratory capacity

A

IRV+TV

103
Q

functional residual capacity

A

RV+ERV- volume of gas in lungs after normal expiration includes RV.

104
Q

vital capacity

A

TV+IRV+ERV maximum volume of gas that can be expired after a maximal inspiration

105
Q

total lung capacity

A

IRV+TV+RV+ERV volume of gas present in lungs after inspiration can include the RV. IC+FRC and VC+RV

106
Q

physiologic dead space

A

include the anatomic dead space plus the airways that are not contributing like the poorly perfused well ventilated apex of the lung

107
Q

pathologic dead apce

A

it is a part of the respiraotry zone that is unable to perform gas exchange, and it is unable to perform gas exchange. Ventilated but not perfused

108
Q

when is the anatomic dead space equal to physiologic dead space

A

in the normal lung

109
Q

what does the minute ventilation not include

A

anatomic dead space

110
Q

draw the pressure volume loops

A

FA619

Step1 (9 decks)

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