USMLE General Pathology II
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235 terms
Terms | Definitions |
|---|---|
 What causes eccentric hypertrophy of the heart? | Volume overload, seen in aortic regurg for example. |
| How are the excess sarcomeres laid down in eccentric hypertrophy of the heart? | In series |
| What causes concentric hypertrophy of the heart? | Pressure overload, seen in aortic stenosis or systemic hypertension |
| How are new sacromeres laid down concentric hypertrophy? | In parallel...this leads to a decrease in ventricular size |
| What are two possible causes of homogenous hyalinization of arterioles? | Non-malignant hypertension and DM (Malignant would show onion-skin appearance) |
| What is the function of Beta-glucuronidase? | Cleaves biliruben glucuronides (conjugated biliruben) to unconjugated... It is released from hepatocytes during injury from infections and leads to pigmented gall stones. |
| What is Couvoisiers sign and what is it indicative of? | A palpable gallbladder.... Adenocarcinoma of the head of the pancreas |
| What are the top three causes of pancreatic cancer? | Older age Smoking DM |
| What cellular proteins do proliferative signals that enable increased cell synthesis upregulate? | CDK4, cyclin dependent kinase 4... This leads to the hyperphosphorylation of Rb gene, inactivating it and allowing transition from G1 to S phase. |
| What is the nature of the esophageal dysmotility in CREST? | The muscularis gets replaced by fibrous tissue, leading to an LES that is atonic and dilated. Regurgitation with heartburn and Barrett's may ensue. |
| DM, Anemia and Necrotic erythema that is painful and itchy are signs of... | A glucagonoma |
| What are the signs of a Glucagonoma? | DM Anemia Necrotic Erythema that is itchy |
| What portions of the kidney are most affected by ATN? | Proximal tubules>Thick ascending loop of Henle |
| What are the two major causes of renal artery stenosis? | Atherosclerotic plaques seen in elderly or Women of childbearing age who experience fibromuscular dysplasia |
| To what structural molecules does integrin bind in order to maintain attachment to the BM and extracellular matrix? | Fibronectin Collagen Laminin |
| What is the main function of RAS? | It is a component of the MAP kinase system that transmits signals from the cell surface receptors to the nucleus |
| What is 'coronary steal' phenomenon and what can cause it? | Ordinarily during cardiac ischemia due to obstruction, CORONARY MICROVESSELS around the obstruction dilate to allow increased flow of blood to the surrounding area. Treatment with Adenosine or Dipyridamole are vasodilators that can cause dilation of vessels further away from the obstruction, this 'stealing' the nutrients. |
| What is the C282Y gene mutation associated with? | HFE gene on Ch 6 and hemochromatosis |
| Duodenal ulcers not located within the duodenal bulb or proximal duodenum are indicative of... | Zollinger Ellison |
| What causes the obstruction in Hypertrophic cardiomyopathy? | The anterior leaflet of the mitral valve blocking ventricular outflow to the aorta |
| A loud P2 is indicative of ... | Pulmonary HTN |
| What is Kussmauls sign and what does it indicate? | A paradoxical rise in JVP during inspiration... Usually caused by some form of constrictive pericarditis |
| When are air-fluid levels commonly seen in the lungs? | In abscess formation |
| What is the pathophysiological cause of abscess formation within the lungs? | Lysozymal enzyme release from macrophages and neutrophils killing bacteria and leading to pus formation. |
| Cerebellar ataxia, Kyphoscoliosis, Hypertrophic cardiomyopathy and DM are together common to the disease: | Friederichs Ataxia |
| Common signs and symptoms of Friedrichs Ataxia? | Cerebellar ataxia Kyphoscoliosis Hypertrophic cardiomyopathy DM |
| First thing to do when you seen IDA of unknown origin? | Rule out a bleed |
| Most common outcome of Hep C infection is?? | Chronic carrier state without cirrosis or hepatocellular carcinoma |
| What antibodies are produced in Goodpastures? | Anti a-3 component of Type IV collagen |
| What are two diseases that are p-ANCA positive? | Churg Strauss and Microscopic polyangiitis |
| What is characteristic of Churg-Strauss? | p-ANCA positive Eosinophilia Asthma or allergy Neuropathy, like wrist drop |
| What is more typically characteristic of CML or CLL on a blood smear? | More mature forms of WBCs and less Blast forms. |
| What ZONES of the prostate are affected in BPH? | Periurethral zone and Transitional zone |
| What are signs of fulmanant hepatitis induced by an inhaled anesthetic such as Halothane? | Increases in aminotransferases Increased PT time Eosinophilia Grossly contraction of the liver is seen |
| What are three causes of avascular necrosis of the femoral head? | SCA SLE due to vasculitis Alcohol and Corticosteroids for unknown reasons |
| What disease involves mutations in the synthesis of myelin, which is commonly manifest as a weakness of dorsiflexion? | Marie-Charcot-Tooth |
| What are three signs of a Hydatidiform mole? | Vaginal bleeding in the first trimester N/V Thecal-Lutein cysts |
| What are three signs of a pineal germinoma??? | Precocious puberty due to increased Beta-hCG Obstructive hydrocephalus Parinaud syndrome.... Paralysis of upward gaze and convergence! |
| Normal function of the C-MYC gene which is overexpressed in Follicular lymphoma? | Leads to transcription activation |
| Function of Cyclin D1 expressed in Mantle Cell lymphoma? | Promotes transition from the G1 stage to S stage of the cell cycle |
| Function of the BRCA1 and BRCA 2 genes? | DNA repair enzymes |
| How does Hep B cause hepatocellular carcinoma? | It integrates into the genome, leading to cellular injury and regenerative hyperplasia. Also it secretes HBx which impedes growth suppression |
| What condition shows Neutrophils at the tips of dermal papillae? | Dermatitis Herpetiformis associated with Celiac Disease |
| What genes are involved in the adenoma-to-carcinoma sequence in sporadic colon cancer and what are their roles? | APC-normally codes for intracellular attachement-- leads to polyp formation when mutated K-RAS: Normally controls cellular proliferation p53: Tumor Suppressor by regulating G1-S phase DCC...final gene, which when deleted causes CC |
| Use of which type of diuretics can cause hypercalcemia? | Thiazide diuretics |
| What age of SCA patients have splenic CONGESTION? | Children, up to early adulthood... By the time they are adults, autosplenectomy has occurred and the spleen is fibrosed and atrophied. |
| What two cancers is IL-2 treatment approved for and why does it work? | RCC and Melanoma... Promotes differentiation of T-cells that can fight tumors. |
| Heart defect that can be accentuated by the hand grip exercise? | VDS...hand grip increases afterload, forcing more blood from the LV to the RV. |
| How is malabsorption diagnosed? | Stool collection and subsequent staining with Sudan III to check for fecal fat content. |
| VDRL Positive antibodies and pleocytosis of the CSF fluid is DIAGNOSTIC of... | Tertiary syphillis. |
| What ZONE of the prostate is involved in Prostatic cancer? | Peripheral zone |
| How do you diagnose megacolon in an UC patient? | Flat plate X-ray of the abdomen |
| Involuntary head bobbing is a sign of... | Aortic regurgitation, comes with a widening pulse pressure |
| What is the cause of head bobbing in aortic regurgitation? | High amplitude pulsations in cranial arteries after a massive ejection of blood from the heart. |
| Medial degeneration of the aorta is associated with... | Dissection....More common cause is hypertension causing an intimal tear |
| Chromogranin A is a histochemical marker to stain... | Neuroendocrine tumors |
| Neuron Specific Enolase, NSE is a histochemical marker to stain... | Neuroendocrine tumors |
| What cancer(s) does Her-2/neu mutation predispose one to? | Ovarian and Breast cancer |
| What does Her-2/neu encode? | A 185 kD transmembrane protein with TK activity... It is an EGFR |
| How are carcinoid tumors easily recognizable? | There is next to NO variation in cell size or shape.... |
| What are two patient populations who are at risk for Vitamin E deficiency? | Fat malabsorbers and Those with Abetalipoproteinemia |
| What can exacerbate symptoms of MS? | Hot showers, or intense exercise. The excessive heat decreases neural transmission. |
| From what cells to RCCs arise? | Proximal tubule cells of the kidney |
| What is loss of albumin, along with IgG and Alpha-2 microglobulin in the kidney referred to as? | SELECTIVE loss of proteins... The filtration barrier is selecting for small and negatively charged molecules, with exclusion of larger molecules. |
| What are the two key Growth factors responsible for angiogenesis? | VEGF and FGF |
| What is the number one risk factor for an aortic dissection? | Hypertension, leading to an intimal tear and extravisation of blood between two aortic layers.... Cystic medial degeneration predisposes one as well , in Marfans, but it is not as common |
| By what mechanism of action do paraneoplastic syndromes work? | Autoimmune in nature... esp cerebellar degeneration, which is caused by several cancers |
| What is a 'red neuron? | A neuron responding to irreversible cellular injury... |
| What is characteristic of a red neuron? | Shrinkage of the cell body Eosinophilic cytoplasm Loss of Nissl substance....This begins at 12- 24 hours and are the first microscopic changes seen in neuronal death. |
| How is colon cancer associated with colitis different from sporadic of familial? | MULTIfocal MORE malignant MORE mucus/signet ring appearance p53 mutations develop before APC mutations Usually non-polypoid |
| What is the number one cause of a AAA? | Atherosclerosis, which weakens the underlying media |
| What are the vegetations on heart valves seen in bacterial endocarditis comprised of? | Fibrin and Platelets |
| Mitochondrial vacuolization is a sign of.... | Irreversible cellular injury. |
| What is a Sister Mary Joseph nodule? | Seen in the periumbilical region, it is a sign of GI malignancy metastasis similar to Virchow's node. |
| Onset of flank pain, hematuria and a left sided varicocele is suggestive of... | Left renal vein thrombosis, as the left testicle drains via the left testicular vein to the left renal vein. Be aware that This can occur in nephrotic syndrome, which is a hypercoagulable state due to the loss of antithrombin III in the kidney. |
| Pts with the adult type coarctation of the aorta are prone to... | Hypertensive damage, such as intracranial bleeds, LVF and Dissecting aneurisms. Coarctation can also predispose to Berry aneurisms |
| Bilateral sinusitis and a nasal polyp in a child are indicative of... | CF |
| Reduced iodine uptake, Increased ESR, with thyroid tenderness and features of thyrotoxicosis suggest... | DeQuevains Thyroiditis |
| Spindle cells with hair-like glial processes and microcysts within the brain suggest.... | Pilocytic astrocytoma... Rosenthal fibers are also present. |
| What brain tumor might illustrate Homer-Wright rosettes? | Medulloblastoma |
| What are several metabolites which when seen in the urine are indicative of Neuroblastoma?? | Homovanillic acid** and Vanillylmendelic acid |
| What immunohistochemical stains would be positive in a Neuroblastoma? | Chromogranin A NSE S-100 |
| Ependymal pseudorosettes and GFAP positive cell processes are indicative of an .... | Ependymoma |
| What is the most common small vessel vasculitis seen in children? | Henoch Schonlein Purpura!... Usually is preceded by an upper respiratory illness several weeks earlier |
| What does Henoch Schonlein Purpura involvement of the kidney resemble? | IgA nephropathy |
| What is the defect in cystinuria? | Defect in absorption of dibasic AAs ornithine, cystine, arginine and lysine |
| What is poor absorption of ornithine, cystine, arginine and lysine indicative of? | Cystinuria! |
| What is the main complication of Cystinuria?? | Cystine renal stones!... These are especially likely to form in acidic urine. Have a hexagonal shape! |
| What are three things that can destabilize an atherosclerotic plaque? | A lipid rich core A thin fibrous cap Inflammation in the surrounding area |
| What predisposes one to holoprosencephaly? | Edward or Patau syndrome! |
| What is 'disruption' in a developmental sense and what is an example? | Breakdown of a previously normal tissue... Can occur during amnion rupture, leading to amniotic bands that amputate previously normal limbs |
| What does the 'a' wave on a JVP tracing represent? | Atrial contraction |
| What does the 'c' wave on a JVP tracing represent? | Ventricular contraction forcing a pressure wave into the atrium |
| What does the 'v' wave on a JVP tracing represent? | Passive influx of venous blood into the atrium |
| Where on the body does dermatitis herpetiformis crop up? | On the extensor surfaces |
| What is characteristic of atopic dermatitis? | Intense pruritis with vesicles seen on the face, scalp, diaper area and arms. It is associated with allergic rhinitis and asthma, and is commonly cause by food allergy. |
| What is the most common origin of bacteria causing an abscess in the lung? | The OROPHARYNX |
| What causes the protein loss in Minimal change disease? | Loss of the negative charges of the Basement Membrane |
| What is the first lab test that should be done when Giant Cell Arteritis is suspected? | ESR... almost always is elevated... Follow with an arterial biopsy |
| Cutaneous, GI and Intracranial bleeds in a newborn should be associated with.... | Vitamin K deficiency... They begin to bleed from everywhere without clotting factors |
| What are the neurotransmitters decreased in Huntington's disease? | GABA and ACh |
| What is the most common cause of a prolonged PTT? | Lupus anticoagulant |
| What does a factor V Leiden mutation cause? | A factor Va that is resistant to inactivation by protein C...leads to thrombus formation. |
| What is the function of 5-HETE? | It is chemotactic for neutrophils... A product of the 5-lipoxygenase pathway |
| What are the three functions of LTs C, D and E 4? | Vasoconstriction Bronchoconstriction Increased vascular permeability |
| What type of necrosis does the pancreas undergo? | Enzymatic fat necrosis |
| Where do Curling's ulcers arise within the GI? | Proximal Duodenum |
| What is the underlying cause of bile stasis during pregnancy or OC pill use? | Progesterone decreases bile acid secretion and Estrogen upregulates HMG-CoA reductase in the liver, supersaturating the gallbladder with cholesterol |
| What is characteristic of the PT, PTT, Platelet count and Bleed time in HUS? | PT normal PTT normal Platelets decreased Bleed time prolonged |
| What is the triad of HUS? | Microangiopathic hemolytic anemia Thrombocytopenia Acute renal failure |
| What lab parameters are altered in HUS? | Decreased RBCs and HCT obviously Increased LDH Increased BUN Increased Creatinine |
| What is the underlying cause of mitochondrial swelling associated with ischemia? | Lack of ATP shuts down the Na+/K+ ATPase and Ca++ATPase activity leading to intracellular accumulations of Na+ and Ca++ that draw water. |
| What are classic findings of a Reye's syndrome patient? | Hepatic Failure without inflammation or damage Microsteatosis Encephalopathy-->Coma |
| What are Gottrens Papules? | Flat topped violacious nodules over the MCP, PIP and DIP joints, specific for dermatomyositis |
| What does Carcinoid syndrome cause in the RT side of the heart? | Murmurs, due to dense fibrous depositions around the valves with endocardial thickening...leads to pulmonary stenosis. |
| What is the aim of treatment for a 21-alpha hydroxylase deficiency? | To decrease the ACTH levels which are elevated because the liver cannot make cortisol---> all the precursors get shunted to make androgens but NOT testosterone. |
| If a patient is suffering from dementia, behavioral disinhibition and speech difficulties, one should think of ... | Picks disease, or other frontal lobe lesions |
| A subthalamic nucleus lesion would lead to... | Hemiballismus |
| What is Chronic mesenteric ischemia? | Due to atherosclerosis, patients do not receive adequate blood supply to the gut after a meal, which leads to severe gastric pain esp after eating with characteristic weight loss and a general lack of physical signs |
| What are the findings in Diabetic CN III neuropathy? | Ptosis and a down and out pupil due to loss of the somatic nerve fibers, but parasympathetics are intact so accomodation and light reflex will still be present... Contrast this with nerve compression, due to uncal herniation, which would cause loss of somatic and parasympathetic. |
| What are two conditions that should come to mind when on a blood panel ONLY RBCs are decreased? | Parvovirus infection or Thymoma....This causes Pure Red Cell Aplasia. Thymectomy is curative. |
| When would a patient with congenital bicuspid valves begin to present with symptoms? | In their 60s |
| Alkaline phosphatase can be elevated in both bone disorders and bile duct disorders, how can you tell what is the cause? | Check the GGT! Will be elevated in bile duct issues. |
| What is the MOA of H. pylori induced gastric ulcers? | It causes decreased release of somatostatin, leading to unopposed gastrin release. |
| What is responsible for a holosystolic murmur heard beast over the left sternal border? | VSD |
| A spike and dome carotid pulse upstroke is caused by... | Hypertrophic obstructive cardiomyopathy |
| What is Breslow Thickness? | The depth of invasion of malignant melanoma... The most important prognostic factor. |
| What is the cause of pancytopenia associated with SLE? | Autoantibodies against RBCs, Warm Abs of IgG nature ITP like antibodies against platelets and WBC antibodies |
| What levels of cholesterol, bile acids and phospholipids gives the highest risk of gall stones? | Increased amounts of cholesterol in the presence of decreased amounts of bile acids. Normally bile acids emulsify cholesterol and make it water soluble. Supersaturation in the absence of bile acids leads to stone formation. |
| What is the main inducer of apoptosis in the body? | p53 gene |
| What is chronic lymphadema a risk factor for? | Angiosarcoma, which can present as violacious skin papules |
| What will Wilsons disease patients have increased in their urine? | Copper |
| What is the triad of Meniere's disease? | Tinnitis Vertigo Hearing loss, sensineureal... All of an EPISODIC nature |
| What is the underlying cause of Meniere's disease? | Increased volume and pressure to do increased endolymph in the vestibular apparatus |
| Tinnitis, vertigo and hearing loss should lead one to suspect... | Meniere's disease, esp if episodic Constant findings might point to a tumor at the cerebello-pontine angle |
| What are the features of anaplasia?! | Lack of differentiation, hyperchromatic nuclei and many mitosis, yadda but GIANT CELLS as well. |
| What is the histologic picture seen in Hep B viral infection of the liver? | Balloon degeneration and eosinophilic cytoplasm plus SPHERULES and TUBULES of HBsAg, giving a ground glass appearance. |
| What is the pathogenesis of Ca oxylate crystals forming in Crohns disease patients? | Terminal ileum damage leads to less bile acid absorption. This lack of bile acid absorption, as well as lipid absorption leads to lipids in the lumen binding Ca++, which normally binds oxylate. Now Oxylate gets absorbed and ends up in the kidney. |
| What are two liver risks of pts with Crohns? | Primary sclerosing cholangitis (higher risk in UC) and Cholangiocarcinoma |
| What is characteristic of the first week of a TB infection? | Intracellular proliferation of the bacteria... Not until weeks 2-4 does T-cell activation of macrophages via IFN-gamma release occur. |
| What causes lacunar infarcts in the brain? | Hypertensive arteriolosclerosis, leading to infarction with loss of mass leaving a 'lake' or lacuna less than 15 cm in diameter. Contrasts with Charcot Bouchard which are less than 1cm and show hemorragic stroke on CT |
| What cytokine causes cachexia and wasting in cancer patients? | TNF-alpha AKA cachexin... Suppresses appetite and lipoprotein lipase |
| Blowing holosystolic murmur heard best at cardiac apex radiating to the axilla??? | Mitral regurgitation |
| Mid-systolic ejection murmur heard best at right 2nd intercostal space radiating to the neck? | Aortic stenosis....called a crescendo-decrescendo murmur |
| What is HER-2/neu AKA and what type of receptor is it? | ERB-b2... it is an epidermal growth factor receptor and its present is associated with increased tumor aggressiveness. |
| ERB-b2 positive breast cancers should be treated with... | Trastuzumab...they are more aggressive. |
| What is the most frequent location of CRC and what are the S/S of tumor in this location? | Left sided...rectosigmoid colon. Alternating or changing bowel habits, esp constipation and diarrhea. |
| What drug is useful in treating rejection, esp of renal transplants? | Muromonab, an CD3 antibody that blocks T-cells |
| The liver is less prone to infarction that most organs due to its duel blood supply except in which notable case? | Liver transplant! Many of the collaterals get cut and are not re-anastomosed. |
| What disease condition show congestion, red hepatization, grey hepatization and resolution? | Lobar pneumonia |
| What is characteristic of the congestion stage of lobar pneumonia? | Occurs on day 1... Boggy feel to the lung grossly and it is filled with bacteria |
| What is characteristic of the red-hepatization stage of lobar pneumonia? | Occurs on days 2-3....The lung is grossly red and firm, with RBCs and neutrophils microscopically |
| What is characteristic of the grey-hepatization stage of lobar pneumonia? | Occurs on days 4-6. The lung is grossly grey and firm, with neutrophils and fibrin microscopically, but no RBCs |
| Ethylene glycol ingestion is characterized by... | An increased anion gap and Calcium oxylate crystal formation in the kidneys |
| What do C-ANCA antibodies target? | Neurophil proteinase 3 |
| How do you measure the Reid index? | Diameter of the mucus glands divided by the distance between the epithelium and the CARTILAGE but not including the cartilage. |
| On the USMLE if there is a pt with long standing joint pathology, think... | They are on high dose NSAIDS or corticosteroids |
| Breast tumor characterized by solid sheets of pleomorphic high grade cells and central necrosis in the ducts?? | Comedocarcinoma, a form of DCIS |
| What is the definition of mytonia? | Abnormally slow relaxation of the muscles |
| What is the underlying cause of mytonic dystrophy? | CTG triplet repeat on the myotonia protein kinase gene |
| What is characteristic of the disease Mytonic Dystrophy? | Inability to release doorknobs or handshakes...** CATARACTS** Often with frontal baldness and gonadal atrophy |
| Why is the lepromin skin test positive in patients with tuberculoid leprosy? | They have a strong CD4+ T-cell response to M. leprae that leads to induration. Those with Lepramatous leprosy do not have this response, and thus have a negative test. |
| What is Classic presentation of a patient with tuberculoid leprosy? | Areas on the skin that are hypopigmented and anesthatized... They will be absent of Acid fast bacteria on biopsy due to good CD4+ T cell immunity. |
| The intrinsic apoptosis pathway is mediated by.. | Mitochondria |
| The extrinsic apoptosis pathway is mediated by... | TNF, when it binds to TNF receptor 1 or Fas ligand |
| What is the most common cardiac abnormality predisposing to native valve bacterial endocarditis?? | MVP...Has similar consequences or presentation as Rheumatic fever induced endocarditis but is far more common, esp in the US. |
| Midsystolic click and a late systolic murmur are associated with... | MVP |
| What is BRAF and what is a mutation in BRAF associated with? | It is a protein kinase involved in activation of signalling pathways... Melanocyte proliferation occurs if mutated.. commonly seen in malignant melanomas |
| What is the mutation V600E associated with? | It is a mutation in the BRAF gene, where valine is replaced by glutamate... leads to melanocyte proliferation. |
| What is a common treatment for malignant melanoma? | Vemarufenib... Inhibitor of the mutated BRAF gene |
| What is Opsoclonus-myoclonus syndrome associated with? | Neuroblastoma...it is a paraneoplastic syndrome |
| What is characteristic of Opsoclonus myoclonus syndrome? | Non-rhythmic conjugate eye movements associated with myoclonus |
| What gene is defective in MEN I syndrome? | MENIN |
| What gene is defective in MEN II and III syndromes? | RET gene |
| How is pericarditis in SLE considered to be classified? | As Pleuritic (increases on inspiration) and Postural (Pain decreases upon sitting up and leaning forward) |
| ALL is considered to be of B-cell origin UNLESS: | The patient presents with a mediastinal mass, or evidence of such, including dysphagia, respiratory syndromes or SVC syndrome |
| How does a patient with factor XII deficiency present? | With Delayed and recurrent bleeding after trauma |
| What are characteristic changes in the heart caused by longstanding HTN? | Increased thickness of the LV wall WITH decreased LV cavity size due to concentric hypertrophy |
| What are two main causes of an increase in the size of the heart chambers?? | Any of the causes of DCM, such as alcohol, beriberi, etc... or MI due to volume overload |
| What are 'senile plaques' in Alzheimer's disease made of? | Amyloid deposits with an A-Beta amyloid core...extracellular |
| Massive interstitial inflammation with neutrophils as well as glomerular hypercellularity is likely caused by... | Acute pyelonephritis, with Hematuria, Pyuria, WBC casts and CVA tenderness... Nephritic syndromes do not involve the interstitium. |
| An excessive increase in the amount of Matrix Metalloproteins in a healing wound foreshadow a... | Contracture...They encourage myofibroblast accumulation and scar remodelling... Often seen in palms and soles |
| An OGTT is primarily reserved for use in | Checking Gestational diabetes. |
| What are fenfluramine, dexfenfluramine and phentermine and what is a common side effect? | Appetite suppressants! Use for greater than 3 months is associated with pulmonary HTN, leading to RV hypertrophy, Cor-Pulmonale and lethal arrhythmias |
| What are Glioblastoma multiforme derived from? | Astrocytes---GFAP positive! |
| What is the strongest known risk factor associated with Cervical carcinoma?? | HPV infection... Smoking is an independent risk factor of lesser significance. |
| What are common problems associated with the RECOVERY phase of ATN? | HYPOKALEMIA** Hypocalcemia and massive dehydration as kidneys regain function. |
| What are problems associated with the Maintenance phase of ATN? | Metabolic acidosis Hyperkalemia with peaked T-waves Hyponatremia Hypocalcemia |
| Multiple paraseptal and subpleural cystic airspace enlargement is characteristic of ... | HONEYCOMB LUNG...seen in idiopathic pulmonary fibrosis. |
| What is Polycystic Ovarian Syndrome AKA? | Stein-Leventhal Syndrome... |
| What is the treatment for PCOS? | Gonadotrophin analogs or Clomiphene! A SERM, selective estrogen receptor modulator that blocks the negative feedback of estrogen on the pituitary gland... |
| What lab findings are characteristic of PCOS? | Increased estrogen Increased androgens--> hirsutism Increased LH leading to anovulation Decreased FSH |
| What are the clinical findings of a patient with PCOS? | Bilaterally enlarged ovaries Amenorrhea or oligomenorrhea Infertility Obesity Hirsutism |
| What are PCOS patients at increased risk of acquiring? | Endometrial cancer, due to increased estrogen production. |
| What is the superior sulcus? | The groove formed by the subclavian vessels.. |
| Where are Pancoast tumors usually located and what are the associated clinical findings? | Usually in the Superior Sulcus... Horner's syndrome Shoulder pain radiating to scapula, axilla Edema of upper limb due to subclavian vein obstruction. Atrophy of the hand muscles if it impinges on nerves Paraplegia if it spreads to the spinal cord |
| What are the two most vulnerable areas of the brain to ischemia? | The Pyramidal cells of the hippocampus (known as Sommer's Sector) and The Purkinje cells of the Cerebellum |
| Why is aldosterone and Na+ wasting decreased in Nephrotic syndrome? | Decreased plasma protein levels lead to intravascular fluid loss to the interstitium... Leads to decreased renal perfusion and increased RAAS... |
| *The slope of a volume to pressure ratio in the heart represents what WRT the heart ? | Compliance! If the slope is decreased, it indicates a diastolic or filling defect |
| What can uncal herniation lead to? | Down and out pupil with loss of parasympathetics AND Ipsilateral or Contralateral hemiplegia depending on which cerebral peduncle is compressed. If duret hemorrhages occur, they are in the midbrain, pons and are caused by basilar artery rupture..usually fatal. |
| How is Acanthosis nigricans described grossly? | Hyper-pigmented plaques, esp in skin folds, with a velvety texture. |
| What is Benign Acanothsis nigricans associated with? | Insulin resistance....Insulin and IGF induce dermal proliferation |
| What is Malignant Acanthosis nigricans associated with? | Malignant neoplasms of the GI and GU tracts, esp gastric adenocarcinoma |
| Damage to the subthalamic nucleus can lead to ... | Hemiballismus CONTRALATERAL to the lesion. |
| What is seen in the liver histologically in Dubin-Johnson syndrome? | Dense pigments of epinephrine metabolites in lysozymes |
| What are brown biliary tract stone associated with? | Conjugated biliruben stones, common in biliary tract infection |
| What are black biliary tract stones associated with? | Chronic Hemolysis |
| Gallbladder hypomotility will primarily lead to.. | Biliary sludge caused by bile precipitation |
| What part of the SC does Tabes Dorsalis affect? | Dorsal columns, leading to decreased proprioception, vibration and a positive Rombergs |
| What is more prominent in the US, adenocarcinoma or Sq. cell carcinoma of the esophagus? | Adenocarcinoma |
| What are three things associated with Arnold Chiari Malformation II? | Lumbar meningiomyelocoele Syringomyelia Hydrocephalus...caused by abnormally sized medulla and cerebellum caused by decreased posterior fossa size |
| What are the main endocrine changes in Cryptorchidism? | The seminiferous tubules are affected most...leads to no formation of sperm, or Inhibin, leading to increased FSH production caused by no negative feedback |
| Bile wasting in Crohn's disease is responsible for... | Oxylate crystal stone in the kidneys, and cholesterol stones in the Gall-bladder due to an increased cholesterol:bile acid ratio. |
| What is the number 1 COD in DM? | MI |
| What is the number one cause of end stage renal failure? | DM |
| What is abetalipoproteinemia? | Inherited inability to form chylomicrons... Characterized in the first year of life by malabsorption, failure to thrive, ataxia and ACANTHOCYTES in the blood |
| What is the most common site of intussception? | Ileocecal valve...Note the INTRALUMINAL mass, unlike a Meckel's... |
| What is characteristic of intussception? | Intermittent colicky pain and current jelly stools |
| What gene mutation is Aflatoxin from Aspergillus known to cause? | An G:C-T:A transversion mutation in p53 |
| What is Pituitary apoplexy? | Hemorrhage into an preexisting pituitary adenoma... |
| What can pituitary apoplexy lead to? | Cardiovascular collapse due to lack of ACTH causing adrenocortical insufficiency. |
| What is the cause of the blue tinge to reticulocytes? | Residual ribosomal RNA....reticulocytes still do not have a nucleus |
| What are two things that A-fib can lead to cardiovascularly speaking....(not emboli) | Loss of the atrial kick causes lower preload, end diastolic volume in the LV...This can lead to dangerous hypotension. Also.. Loss of the contractility leads to back-up of blood into the pulmonary system...Pulm edema. |
| What are three things that decrease risk of Ovarian Cancer? | Multiparity Breast feeding OC pills... anything that decreases the number of ovulatory cycles, so there is less need of the ovarian epithelium to regenerate |
| What are 4 things that increase LV and RV preload? | Squatting, Sitting, Lying Supine, Passive Leg Raises |
| What are 2 things that decrease LV and RV preload? | Valsalva maneuver and Sudden standing |
| What does decreasing venous return in a pt with HCM cause? | A louder murmur |
| What cellular changes are seen histologically in Actinic Keratosis? | Hyperkaratosis: Hyperplasia of the S. corneum Parakaratosis: Abnormal retainment of nuclei in the S. corneum |
| What does Actinic Keratosis look like on gross? | Small red-brown lesions with a sandpaper like texture |
| The structure of b-hCG is similar to... | TSH, FSH and LH...can lead to hyperthyroid type symptoms in pts with b-hCG secreting tumors. |
| Pre-eclampsia can progress to... | Eclampsia, dur or HELLP syndrome |
| What is the most common site of metastasis from RCC? | Lungs |
| What is acanthosis? | Hyperplasia of the spinous layer of the epidermis... Associated with psoriasis |
| What is spongiosus? | Intercellular epidermal edema, with an increased width between cells.. Associated with Eczematous dermatitis |
| What are the histological findings of Urticaria? | Superficial dermal edema, with no epidermal changes. |
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