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Review Game Flashcards

1
Q

What are the names of the spots on the iris for children with down syndrome?

A

Brushfield spots

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2
Q

A 26 year old pregnant female presents to ER with a myocardial infarction. She does not have a history of heart disease. What is the most likely cause?

A

Cocaine

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3
Q

Which diagnostic test may be the first indicator of hemochromatosis?

A
  • Elevated LFT
  • iron levels
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4
Q

Which spinal disorder in a tall youth should make you consider marfans?

A

scoliosis

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5
Q

Identify types of cancer that are related to BRCA 1 and 2

A
  • prostate
  • pancreatic
  • breast
  • ovarian
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6
Q

Patient presents with brown macules on lips, what condition may they have?

A

Peutz-jeghers

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7
Q

Which bacteria results from cat scratch?

A

bordetella henselae

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8
Q

Which infections are prevented by DTP vaccine series?

A
  • diphtheria
  • tetanus
  • pertussis
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9
Q

Which atypical pneumonia causing bacteria caused walking pneumonia in adolescents and teenagers?

A

mycoplasma pneumonia

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10
Q

Which medication is the most common cause of hypokalemia?

A

diuretics

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11
Q

What type of process is in place when there is direct hyperbilirubinemia?

A

blockage

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12
Q

What type of injury will cause hyperkalemia?

A

crush injury

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13
Q

What is the normal rate for erythrocyte sedimentation rate?

A

under 20

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14
Q

Identify three symptoms of HYPERthyroidism?

A
  • irritability
  • fast metabolism, hunger
  • heat intolerant
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15
Q

What is the name of the fatty eyelid deposit found in familial hypercholesterolemia?

A

xanthelasma

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16
Q

What are the three cardinal symptoms of acute chest syndrome in sickle cell anemia?

A
  • chest pain
  • dyspnea
  • fever
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17
Q

Which gram-negative bacillus is responsible for an infected hand wound after a bar fight?

A

eikenella corrodens

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18
Q

Which bacteria that causes pneumonia can be caused by sitting in a hot tub or working with water?

A

legionella pneumoniae

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19
Q

Which gram negative bacteria not typically found in the US is responsible for rice water stools?

A

cholera

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20
Q

Which gram negative bacteria which causes pneumonia is typically given person to person especially in hospital, displays currant jelly sputum?

A

klebsiella pneumonia

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21
Q

Which pathogenic organism responsible for diarrhea is obtained from eating undercooked pigs?

A

yersinia enterocolitica

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22
Q

Which of red blood cell indices classify macro micro normocytic?

A

MCV

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23
Q

Patient with low hemoglobin, low hematocrit, low iron, but ferritin is normal/ high. What type of anemia?
If there is low H&H, low iron and low ferritin, what type of anemia is this?

A
  • anemia of chronic disease
  • iron deficiency anemia
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24
Q

Why would ferritin be normal to high in anemia of chronic disease?

A

acute phase reactant

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25
Q

Which organ should we blame in the case of indirect hyperbilirubinemia?

A

liver

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26
Q

Identify two hormones that regulate calcium levels in the body?

A
  • parathyroid hormone
  • calcitonin
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27
Q

Which gram positive bacteria that grows in chains is most common cause of bacterial pneumonia?

A

streptococcus pneumonia

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28
Q

What is the normal value for a total WBC?

A

4.5-11

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29
Q

If you have a patient and they have an ESR above 100, what is the most likely occurrence you think is happening with this patient ?

A
  • overwhelming bacterial infection
  • cancer
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30
Q

What animal does the typical hallmark rash of lupus resemble?

A

butterfly

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31
Q

Which bacteria causes infections often in hospitals and immunocompromised patients and has a grape odor and causes a blue green pus?

A

pseudomonas aeruginosa

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32
Q

What is the name of the gram positive bacteria that causes white exudates, sore throat, and anterior cervical lymphadenopathy?

A

streptococcus pyogenes

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33
Q

Bacteria that causes us to have positive reactions at 10 millimeters because of our job?

A

mycobacterium tuberculosis

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34
Q

What is wrong specifically with a hypochromic erythrocyte?

A
  • pale because it lacks hemoglobin
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35
Q

When your patient has a high alkaline phosphatase level what two organs are indicated?

A
  • liver
  • bones
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36
Q

At what percentage of the hemoglobin A1C do we tell the patient they have diabetes?

A

6.5%

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37
Q

Pt has been diabetic for 10 years, what is their goal A1C?

A

7.0

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38
Q

What 2 positively charged substances when released cause RBC (Rouleaux) stacking?

A
  • fibrinogens
  • immunoglobulins
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39
Q

What autoimmune disease leads to joint pain, muscle pain, and hardening of the skin of the hands and mouth?

A

scleroderma

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40
Q

What autoimmune disease manifests with dry membranes, dry eyes, vaginal dryness, and increased risk of lymphoma?

A

sjogrens syndrome

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41
Q

What test should be ordered when you suspect that Group A strep(strep pyogenes) is the cause of their rash, suspect they have rheumatic fever, or kidney damage?

A

ASO titer

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42
Q

Identify the letters of the 4 bacteria that are considered pathogenic on a stool culture, that is not E. coli?

A

SSYC:
- Shigella
- Salmonella
- Yersinia
- Campylobacter

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43
Q

What is the name of the primary dermatologic manifestation in early syphilis?

A

chancres

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44
Q

Which genotype is represented in klinefelter’s syndrome?

A

XXY

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45
Q

What is the appearance of the chest with a patient with turner’s syndrome?

A

wide chest/wide nipples

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46
Q

Which medication which we use to treat blood clots causes nasal hypoplasia as a teratogen?

A

warfarin

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47
Q

What type of palmar defect is present in fetal alcohol syndrome?

A

hockey stick crease

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48
Q

How is early onset alzheimer’s transmitted?

A

autosomal dominant

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49
Q

3 genes associated with early onset alzheimer’s?

A
  • APP
  • presenilin 1
  • presenilin 2
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50
Q

What is the medical term for spider fingers in Marfan’s syndrome?

A

arachnodactyly

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51
Q

What are the two pectus malformations with Marfan’s syndrome?

A
  • pectus excavatum
  • pectus carinatum
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52
Q

What is the name of the hereditary colorectal syndrome when the mutation occurs at the end of the FAP gene?

A

attenuated FAP

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53
Q

What gram negative diplococcus named after disease it causes purpura fulminans races, headache and stiff neck?

A

neisseria meningitidis

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54
Q

What bacteria causes trismus (lockjaw) and lives in soil?

A

clostridium tetani

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55
Q

Which pathogen results from eating spoiled food leads to bilateral eyelid drooping (ptosis), double vision, difficulty swallowing, and generalized muscle weakness?

A

clostridium botulinum

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56
Q

Which diarrhea pathogen is acquired from soft cheese and deli meat which is why these are contraindicated in pregnancy?

A

listeria monocytogenes

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57
Q

What is the most common reason for lymphocytosis?

A

viral infection

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58
Q

Which teratogen can cause intrauterine passage of meconium and can cause the baby to be born addicted so they have to be weaned off with morphine?

A

opioids

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59
Q

Which teratogen can cause placental previa, PPROM, and increases the chances of SIDS, and can also cause anal atresia?

A

tobacco use

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60
Q

Which teratogen can cause cyanosis and hypotonia in a newborn?

A

benzodiazepines

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61
Q

Which teratogen is the most dangerous SSRI for the fetus and can cause gastroschisis, oomphalocele, alone with craniosynostosis and anencephaly?

A

paroxetine (paxil)

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62
Q

Which medication used to treat blood pressure can cause oligohydramnios?

A

ACEs/ARBs

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63
Q

Providers wanting to prescribe accutane have to submit what type of registration?

A

iPLEDGE

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64
Q

DES daughters have an increased risk for what cancers?

A
  • cervical
  • vaginal (early onset)
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65
Q

Which medication when taken during pregnancy can cause amelia, meromelia, or phocomelia?

A

thalidomide

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66
Q

Which drug can cause neurotoxicity, cardiac toxicity, and hepatotoxicity on the fetus if taken during pregnancy?

A

methamphetamine

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67
Q

What is the name of the crease on the palm of an individual with DS?

A

simian crease

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68
Q

An individual with DS can have extra space between which toes?

A

1 and 2

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69
Q

Why do individuals with DS have an increased risk of Alzheimer’s?

A

APP gene found on chromosome 21

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70
Q

What is the genotype of turner syndrome?

A

XO

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71
Q

What are some characteristics of an individual with turners syndrome?

A
  • short stature
  • primary amenorrhea
  • increased risk of cardiac issues
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72
Q

In which syndrome is the paternal copy inactivated so only the maternal copy is active?

A

angelman syndrome

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73
Q

In which syndrome is the maternal copy inactivated, so only the paternal copy is active?

A

prader-willi syndrome

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74
Q
  • Which APOE gene reduces risk of alzheimer’s?
  • Which one means an individual has no risk and is most common?
  • Which one means an individual is at an increased risk?
A
  • APOE epsilon 2
  • APOE epsilon 3
  • APOE epsilon 4
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75
Q

How many CAG repeats to say that the patient and kids will develop Huntington’s disease?

A

over 40

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76
Q

Which NF is more common?

A

NF 1

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77
Q

Which NF is associated with cafe-au-lait macules, cutaneous neurofibromas, plexiform neurofibromas, optic gliomas, and tibia bowing?

A

NF 1

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78
Q
  • What does NF1 mutation suppress?
  • What about NF2?
A
  • neurofibromin
  • merlin
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79
Q

Which NF presents with bilateral vestibular schwannomas, subtle cutaneous tumors, and tumors of the spine an meninges?

80
Q

What are the genes associated with PKD?

A
  • polycystin 1 (PKD 1: more common, worse severity)
  • polycystin 2 (PKD 2: less common, less severe)
81
Q

What is the biggest worry with PKD?

A

intracranial aneurysm

82
Q

Hereditary hemochromatosis is more common in what individuals? What are some manifestations? What is it potentiated by?

A
  • males (onset after 40)
  • hepatomegaly, elevated liver enzymes, bronze skin
  • alcoholism and hepatitis
83
Q
  • Hemophilia A is a deficiency in what factor?
  • What about Hemophilia B? What is another name for this?
  • What about Hemophilia C?
A
  • Factor 8
  • Factor 9; Christmas disease
  • Factor 11
84
Q

What factor does VWD affect?

85
Q

What is the inheritance of VWD type 1, 2, and 3?
- What is their severity?

A
  • type 1: AD; mild
  • type 2: AD or AR; moderate to severe
  • type 3: AR; severe
86
Q

What can you use to aid in marfan syndrome diagnosis?

A

ghent criteria

87
Q

If a young person comes passes away from aortic dissection, what condition could they have had?

88
Q

What are the 4 Ps of aneurysms?

A
  • palor
  • pulseless
  • paralysis
  • paresthesia
89
Q

In which condition does the left ventricle become thickened and is inherited in an AD manner and is associated with dyspnea upon exertion?

A

hypertrophic cardiomyopathy

90
Q

In which condition does the right ventricle become replaced with scar tissue and is inherited in an AD manner and is associated with arrythmias?

A

arrhythmogenic cardiomyopathy

91
Q

What should you suspect in individuals who have Ashkenazi Jewish ancestry that come to see you and have breast cancer?

92
Q

What is the 2nd most common gynecological cancer?

93
Q

Which colorectal cancer (FAP) has mutations in the middle of the gene?

A

classic FAP

94
Q

Which colorectal cancer is associated with uterine cancer and an individual will have less than 100 polyps?

A

lynch syndrome

95
Q

What are gram-positive bacteria that we should know the names of?

A

“super silly baddies make cute clinicians”
- Staph
- Strep
- Bacillus
- Mycobacterium
- Clostridium
- Corynebacterium

96
Q

What are some examples of atypical bacteria?

A
  • mycoplasma
  • chlamydia
  • legionella
97
Q

Which bacteria are true pathogens?

A
  • Strep pneumoniae
  • Staph aureus
  • E. coli
  • Pseudomonas aeruginosa
  • Candida albicans
  • Klebsiella pneumoniae
98
Q

If an individual comes in with a systemic fungal infection (fungal pneumonia), what might be going on?

A
  • HIV
  • Immunocompromised
  • Cancer
99
Q

Which fungi need keratin to grow and what are some different types?

A

dermatophytes:
- tinea pedis (athletes foot)
- tinea corporis (ringworm)
- tinea capitis (scalp ringworm)

100
Q

What are some diarrhea risk factors?

A
  • drinking untreated water
  • swimming in poorly treated pools
  • working with animals or on farm
  • daycare
  • handling soil
101
Q

What are different testing options to diagnose parasitic infections?

A
  • blood smears
  • stool cultures
  • stool for ova and parasites
  • CBC (elevated eosinphils)
  • antigen testing
102
Q

What type of amenia is the most common form and may be from poor diet, pregnancy, gastric by-pass?

A

iron deficiency anemia

103
Q

What type of anemia results for lower levels of B12 or folate?

A

vitamin deficiency anemia?

104
Q

What type of anemia results from destroying RBCs and can be from a snake bite?

A

hemolytic anemia

105
Q

What type of anemia occurs in the presence of multiple chronic conditions?

A

anemia of chronic disease

106
Q

What are the types of WBCs?

A
  • monocytes
  • lymphocytes
  • granulocytes (eosinophils, basophils, neutrophils-most abundant)
107
Q

If you observe a left shift with neutrophils (higher presence of immature neutrophils), what can you rule out?

108
Q

What results from radiation or chemo, measles or influenza, aplastic anemia, alcohol abuse, and poor nutrition or gastric bypass?

A

leukopenia

109
Q

What condition is associated with viral infections vs bacterial infections? (CMV, Mono, MMR)

A

lymphocytosis

110
Q

What can lead to lymphopenia?

A
  • compromised states
  • malignancy
  • sepsis from bacterial or fungal infections
  • corticosteroids
111
Q

What causes monocytosis?

A
  • bacterial infections
  • viral infections
  • parasitic infections
  • chronic inflammatory diseases
112
Q

What causes eosinophilia?

A
  • parasites
  • allergic reaction disorders
113
Q

What causes eosinopenia?

A

bacterial infections

114
Q

What causes thrombocytosis?

A
  • post surgery
  • malignancy
  • acute blood loss
  • iron deficiency anemia
115
Q

If an individual is living at high altitudes or hiking at high altitudes or has COPD, what condition might they have (labs)?

A

erythrocytosis

116
Q

What can lead to erythrocytopenia?

A
  • bleeding
  • bone marrow failure
  • poor nutrition
  • pregnancy
117
Q
  • Small, low RBC volumes is (…)
  • Larger than normal RBC volumes is (…)
A
  • microcytic
  • macrocytic
118
Q

What value describes RBC color as normochromic, hyperchromic (red), and hypochromic (pale)?

119
Q

Hypochromic RBC are associated with what condition?

A

iron deficiency anemia

120
Q

What describes the variation in RBC volume and size and a high value can be associated with immature RBC being sent out?

121
Q

Normocytic anemia (low H&H, normal MCV) is associated with what?

A

ACD (75%), hemolytic anemia

122
Q

Microcytic anemia (low H&H, low MCV) is associated with what?

A
  • IDA
  • ACD (25%)
123
Q

Macrocytic anemia (low H&H, high MCV) is associated with what?

A
  • alcoholism
  • liver disease
  • B12 or folate deficiency
124
Q

Why would reticulocytes be elevated?

A
  • hemolytic anemia
  • blood loss
  • bone marrow disorder
125
Q

Why would reticulocytes be decreased?

A
  • IDA
  • vitamin deficiency anemia
  • decreased EPO
  • bone marrow failure
126
Q

What can hemoglobin electrophoresis help diagnose?

A

sickle cell anemia

127
Q

What is beta thalassemia more common in?

A
  • asians
  • african descent
  • mediterranean
128
Q

What are proteins that serve as chemical messengers that promote interactions and communication between cells and can increase inflammation or reduce it?

129
Q

Individuals with gastric bypass or low iron levels could have what ordered?

A

serum iron

130
Q

What increases serum iron?

A
  • alcoholic cirrhosis
  • viral hepatitis
  • high iron intake
  • hereditary hemochromatosis
131
Q

What decreases serum iron?

A
  • colon cancer
  • renal disease
  • inadequate absorption (gastric bypass)
  • increased demand (pregnancy)
  • decreased intake (poor diet)
132
Q

What is the gold standard for identifying states of anemia?

A

serum ferritin

133
Q

What is the storage unit for iron?

134
Q

What are indications for testing ferritin?

A
  • helps identify all causes of anemia
  • differentiate b/w IDA and ACD/IDA
  • monitor pts on iron therapy
135
Q
  • What serum ferritin value is associated with IDA?
  • What about ACD?
136
Q

What is responsible for iron transport in the body? What is this synthesized by?

A

transferrin; liver

137
Q

Transferrin is decreased during (…) infections

138
Q

What does an increased total iron binding capacity (TIBC) mean? What condition is this associated with?

A
  • empty seats available; less transferrin binding
  • IDA, pregnancy
139
Q

What does decreased TIBC mean? What conditions are associated with this?

A
  • seats are full; more transferrin binding
  • ACD, hemochromatosis
140
Q

If an individual comes in younger than 40 with COPD symptoms and they do not smoke, what might they have?

A

alpha-1-antitrypsin deficiency

141
Q

What alleles are associated with alpha-1-antitrypsin? What is its inheritance?

A
  • M, Z, S
  • autosomal codominant
142
Q

What is synthesized mainly in the liver and is composed of amino acids which are gained through proper diet intake and transports protein for thyroxine and vitamin A?

A

prealbumin

143
Q

Prealbumin may have increased levels during when?

A
  • pregnancy
  • long term renal disease
  • steroid/alcohol use
144
Q

Prealbumin may be decreased when?

A
  • liver disease
  • eating disorder
  • malnutrition
145
Q

Where is haptoglobin produced? This is also a what? What does it bind to?

A
  • liver
  • APR
  • binds free hemoglobin when RBC are destroyed
146
Q

What transports hemoglobin back to the liver where the heme is converted to bilirubin?

A

haptoglobin

147
Q

What is very useful when looking for signs of hemolytic anemia due to there being a depletion of this due to excessive need?

A

haptoglobin

148
Q

When can haptoglobin increase?

A

inflammation and infection

149
Q

What causes haptoglobin to decrease?

A
  • hemolytic anemia of any cause
  • transfusion reaction
150
Q

What are C3 and C4 considered? This means they will increase in states of what?

A
  • APR
  • inflammatory, infection, cancer
151
Q

What test can you use to test specific complement factors or the entire complement system?

152
Q
  • What needs to be present for a normal CH50?
  • What does a decreased MC50 mean?
  • What does an MC50 of zero mean?
A
  • all 9 proteins
  • decreased complement activity
  • one of pathway components completely absent
153
Q

If a patient has an undetectable CH50, what can you order next?

154
Q

What leads to decreased C3 and C4?

A
  • lupus
  • cirrhosis
  • hepatitis
155
Q

Immunoglobulin usually found in secretions and along the mucosal epithelium

156
Q

Found to activate basophils and mast cells (immunoglobin) that increased with chronic infections (leprosy, TB, malaria)

157
Q

Allergic reactions and parasitic infections (immunoglobulin)

158
Q

MAJOR antibody produced when an antigen is encountered; most prevalent antibody and has the longest half-life?

159
Q

Initial antibody secreted after an immune challenge; indicated recent infection?

160
Q

Neoplastic disorder which causes proliferation of a monoclonal immunoglobulin, usually IgG and IgA

A

multiple myeloma

161
Q

The big spike in the gamma portion on serum electrophoresis is (…)

A

m spike/m protein

162
Q

What can the CMP measure?

A
  • kidney function
  • liver function
  • electrolytes
  • proteins
  • glucose monitoring
163
Q
  • What decreases sodium loss in kidneys?
  • What increases sodium loss in the kidneys?
A
  • aldosterone
  • natriuretic hormone
164
Q

How does ADH regulate sodium?

A
  • decreased ADH increases urination
  • increased ADH decreases urination
165
Q

What causes hyponatremia?

A
  • GI losses
  • Renal disease
  • medications (treatment for hypertension)
  • Dietary sodium intake
166
Q

If an elderly patient falls and can’t reach water or is not given free access to water, what condition may they develop?

A

hypernatremia

167
Q

What medication is associated with hyperkalemia?

A

ACE inhibitors

168
Q

What can lead to hypoglycemia?

A
  • insulin/oral anti-diabetic medication overdose
  • starvation
  • insulin-secreting tumors
169
Q

What can lead to hyperglycemia?

A
  • diabetes (most common)
  • stress
  • pancreatitis
  • oral corticosteroids
170
Q

What increases BUN?

A
  • high protein diet
  • GI bleeding
  • dehydration
  • renal failure
171
Q

What decreases BUN?

A
  • low protein diet
  • liver failure
  • overhydration
172
Q

What should you expect if you see an individual with decreased BUN but they look healthy?

A

overhydration

173
Q

What is the main reason for increased creatinine?

A

diabetic renal disease
- others: medication, dehydration, sepsis, urinary tract obstruction

174
Q

What is the main reason for decreased creatinine?

A

decreased muscle mass
- others: debilitation

175
Q
  • What is pre-renal BUN/Creatinine ratio associated with?
  • What is the ratio value?
A
  • abnormalities that decrease BF to kidney
  • > 20:1
176
Q
  • What is intra-renal BUN/creatinine ratio associated with?
  • What is the ratio value?
A
  • structural kidney abnormalities
  • < 10:1
177
Q

What is post-renal BUN/creatine ratio associated with?
What is the ratio value?

A
  • obstruction of collecting system
  • > 20:1; early looks like pre-renal, late will look like intra
178
Q

What is the most common cause of hypercalcemia?

A

hyperparathyroidism

179
Q

What is the most common cause of hypocalcemia?

A

hypoparathyroidism (hypoalbuminemia; vitamin D deficiency)

180
Q

What is the normal percent of indirect bilirubin? direct?

A
  • 70-85%
  • 15-30%
181
Q

What causes indirect hyperbilirubinemia?

A

liver issues - any disease that increases RBC destruction

182
Q

What is the most abundant serum protein?

183
Q

What causes hypoproteinemia?

A
  • hepatic failure/disease
  • malnutrition
  • renal disease
184
Q

What causes hyperproteinemia?

A
  • dehydration
  • malignancy
  • infections
185
Q
  • Regulator of osmotic balance between intravascular and interstitial spaces
    Pulls water into the circulatory system
  • Transporter for drugs, bilirubin, calcium and thyroid hormones and other hormone enzymes
  • Relatively long half life of 12-18 so bad indicator of chronic liver disease
186
Q

What are the 3 enzymes in LFTs?

A
  • ALP
  • AST
  • ALT
187
Q

Cancer metastasizing to bone or primary cancer of the bone can lead to elevation in which LFT?

188
Q

What tissues can AST be found in?

A
  • heart
  • liver
  • skeletal mm
189
Q

Where can you find ALT?

190
Q

Which LFT is specific to the liver?

191
Q

What causes major increase if ALT?

192
Q
  • What should you think if AST:ALT >1?
  • What about <1?
A
  • alcohol cirrhosis (frequently >2); tumor of liver
  • viral hepatitis
193
Q

If ALP is elevated, what can you use to differentiate between bone or liver?

194
Q

What can increase GGT?

A

liver disease (hepatitis, cirrhosis, alcoholic liver disease, liver cancer)

195
Q

What can you order when you want to know renal and hydration status of pt but not concerned with liver?

196
Q

What are some indications for LFT?

A
  • jaundice
  • dark urine
  • hepatitis, hemochromatosis screening
  • medication monitoring
  • known liver disease
  • alcohol abuse

Clinical Science (18 decks)

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