Tulane (HIGH YIELD)

Question 1

What gestational structure secretes b-HCG?

Answer 1

Syncytiotrophoblasts (from outer layer of chorionic villi)

Question 2

Presentation and most common cause of hematosalpinx

Answer 2

Severe abd pain 6 wks post last menstrual period; tubular ectopic pregnancy (rupture leads to massive intraperitoneal hemorrhage)

Question 3

Preeclampsia symptom requirements

Answer 3

Proteinuria, HTN

Question 4

TORCH infections

Answer 4

Toxoplasmosis, Other (syphilis, varicella, parvovirus, HIV, but also listerosis and TB), Rubella, CMV, Herpes

Question 5

Syphilis treatment, broadly

Answer 5

Penicillin

Question 6

What differentiates borderline ovarian tumors from benign or malignant?

Answer 6

Epithelial proliferation, but not invasion

Question 7

What is Meigs syndrome?

Answer 7

Ovarian fibroma + pleural effusion, ascites

Question 8

High risk HPV proteins and effects

Answer 8

E6: incr. degradation of p53 interrupts cell death and DNA repair
E7: binds Rb, causing incr. proliferation

Question 9

Haplotype(s) associated with (type I) diabetes

Answer 9

HLA DR3/4 (both)

Question 10

Autoantibodies associated with Type I diabetes

Answer 10

GAD65, ICA

Question 11

Glucose-induced insulin secretion pathophys

Answer 11

Glucose enters pancreatic cell via GLUT2 transporter, glycolysis (glucokinase, etc) leads to incr. ATP, closing K+ channels, causing depolarization, which then opens voltage-gated Ca++ channel, leading to calcium influx which prompts insulin secretion

Question 12

Why is the inhibin A level important for prenatal screening?

Answer 12

Down’s syndrome

Question 13

Latency location of HSV-1

Answer 13

Trigeminal ganglia

Question 14

Latency location fo HSV-2

Answer 14

Lumbosacral (dorsal root) ganglia

Question 15

2 types of fibrocystic breast changes (incl. histopathology)

Answer 15

• Non-proliferative (no incr. risk of cancer): fibrosis, cysts, apocrine metaplasia (not unique), adenosis (just plain old regular adenosis)
• Proliferative (incr. risk of cancer): hyperplasia (atypical is worse), sclerosing adenosis (~ “complex sclerosing lesion”), small duct papillomas

Question 16

Medullary breast cancer genetics

Answer 16

BRCA1 (occurs in younger women)

Question 17

Breast tumor(s) that lack E cadherin

Answer 17

LCIS, invasive lobular carcinoma (leads to unique pattern of metastasis - CSF, body cavities, ovaries)

Question 18

Cushingoid symptoms

Answer 18

Cataracts
Ulcers
Striae
Hypertension
Immunosuppression
Necrosis (femoral head)
Glycosuria
Obesity (incl. facial plethora, buffalo hump), Osteoporosis
Infections, Impaired wound healing
Diabetes

Question 19

Leiomyosarcoma histopathologic differentiation

Answer 19

Coagulative tumor cell necrosis (required for dx)

Question 20

PCOS classic presentation

Answer 20

Obese young woman with infertility, oligomenorrhea and hirsutism (might also have insulin resistance)

Question 21

2 most common causes of hypercalcemia

Answer 21

Hyperparathyroidism, tumor (hypercalcemia of malignancy)

Question 22

Primary hyperparathyroidism classic sx

Answer 22

"Stones, bones, groans and moans"
Stones: Ca ox in kidney
Bones: osteitis fibrosa cystica
Groans: GI things - pancreatitis, PUD, constipation/pain/N/V
Moans: depression, etc

Question 23

Calcium correction equation

Answer 23

measured calcium + 0.8(4.0 - measured albumin)

Question 24

Cardiac sequelae of hypercalcemia

Answer 24

Shortened QT interval

Question 25

How to determine high Alk phos etiology?

Answer 25

GGT - high in liver disease, normal if elevated alk phos is from bone

Question 26

Differentiate osteoporosis from osteomalacia

Answer 26

Osteoporosis (“issue with density, not quality”): caused by decr. estrogen and old age, no pain
Osteomalacia: inadequate bone mineralization (Ca++ and phosphate deficiency) most commonly caused by vitamin D deficiency; sx incl. bone pain (esp hips) and muscle weakness

Question 27

Endodermal sinus tumor characteristics

Answer 27

Yolk sac tumors – “SAC” mnemonic – Schiller-Duvall bodies (aka glomeruloid), AFP, Children (most common type)

Question 28

MEN 2A syndrome

Answer 28

Medullary thyroid cancer, pheochromocytoma, hyperparathyroidism

Question 29

MEN 2B (i.e. MEN III) syndrome

Answer 29

MEN 2A + Mucosal neuromas, Marfans-esque sx

Question 30

Define Waterhouse-Freidrichson syndrome

Answer 30

Adrenal gland failure (e.g. hypotension, shock) d/t bleeding, caused by Neisseria meningitidis infection