Step 1 Buzzwords Pathology
USMLE Step 1 Recall: Buzzwords for the Boards Second edition
Terms in this set (240)
True or false? Klinefelter syndrome cannot be diagnosed until puberty.
What form of sunlight is the most carcinogenic?
Ultraviolet B (UVB) sunlight
What rare disorder presents as a large, hard, irregular thyroid gland due to fibrous proliferation of connective tissue in the thyroid gland and extends to adjacent structures?
What are the rules of 10 regarding pheochromocytoma?
10% are bilateral, 10% malignant, and 10% familial, 10% in children, and 10% outside the adrenal gland
What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
What vasculitis is characterized by systemic vasculitis in small to medium-size vessels (except the lung); affecting young males; 30% HBsAg-positive; P-ANCA and autoantibodies against myeloperoxidase?
What is the term for white retinal spots surrounded by hemorrhage? In what condition are they seen?
Roth spots, and they are seen in bacterial endocarditis.
What triad consists of endothelial injury, changes in laminar flow, and hypercoagulation?
Virchow triad, associated with the formation of a thrombus.
What bone cell has receptors for PTH?
Osteoblasts (Remember, they modulate the function of osteoclasts.)
What is the term for normal cellular genes associated with growth and differentiation?
What form of anemia is diagnosed with sucrose lysis test and Ham test?
Paroxysmal nocturnal hemoglobinuria
What myeloid disorder is characterized by increased hematocrits, blood viscosity, basophils, and eosinophils; intense pruritus; and gastric ulcers due to histamine release from basophils, increased LAP, and plethora?
Polycethemia vera (Remember, polycytemia vera is a risk factor for acute leukemias.)
If you order a V/Q scan for suspected pulmonary emboli, is the filling defect seen on the ventilation or perfusion side?
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
What drug causes a sixfold increase in schizophrenia, can impair motor activity, and can cause lung problems?
What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
Which cerebral herniation results in compression of the anterior cerebral artery?
Cingulate gyrus herniation (subfalcine)
What pathology involves excessive fibrosis throughout the body via increased fibroblast activity, occurs in women more than men, and is most commonly seen in the third to the fifth decade?
What skin condition is a localized proliferation of melanocytes presenting as small, oval, light brown macules?
What tumor constitutes 40% of testicular tumors in children?
What are the four reasons for hypochromic microcytic anemia with a low MCV?
1. Sideroblastic anemias (i.e., porphyrin and heme synthesis disorders)
3. Iron deficiency
4. Lead poisoning
What is characterized by intense inflammatory reaction, an increase in the amounts of granulation tissue and wound contraction by myofibroblasts?
Healing by secondary intention
What thyroiditis presents as a tender, enlarged, firm thyroid gland, usually preceded by an upper respiratory viral illness?
de Quervain thyroiditis
What intrauterine deficiency leads to failure to thrive, mental retardation, motor incoordination, and stunted growth?
Iodine, resulting in congenital hypothyroidism
What pancreatic islet cell tumor is associated with MEN I syndrome?
What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
What disease arises from the adrenal medulla, displaces and crosses the midline, metastasizes early, is the most common solid tumor, and is seen in the 2- to 4-year-old age group?
What is the term for RBCs with smooth undulations on the surface of their membrane, commonly seen in uremia?
Burr cells (echinocytes)
Hepatoma and nonseminomatous testicular germ cell tumors
Placental alkaline phosphatase
Cancer of the lung, stomach, colon, and breast
What very aggressive lung cancer metastasizes early and is associated with smoking and paraneoplastic syndromes?
Small cell carcinoma (oat cell)
What bone disorder is characterized by brown tumors, bone pain, deformities, and fractures due to excessive PTH?
Osteitis fibrosa cystica (von Recklinghausen disease)
What glycogen storage disease is due to the following enzyme deficiencies?
Lysosomal glucosidase (acide maltase)
What cystic swelling of the chorionic villi is the most common precursor of choriocarcinoma?
In what condition do you see dimpling on the kidney's surface?
In patients with sickle cell disease?
Staphylococcus aureus (but they are more prone to salmonella infections)
In drug addicts?
True or false? An elevated serum osteocalcin level is a marker for increased bone formation.
True. Increased alkaline phosphatase levels also are associated with increased bone formation.
What is the most common opportunities infection of the CNS in HIV?
What hereditary bone disorder is due to decreased osteoclast function, resulting in thick, sclerotic bones that fracture easily?
Osteopetrosis (Albers-Schonberg disease)
True or false? Pancreatic δ-cell tumors inhibit CCK secretion, leading to gallstones and steatorrhea.
True. δ-Cell tumors produce excess somatostatin, which inhibits CCK, gastrin (hypochlorhydria), and insulin secretion (diabetes).
What is the term for the speckled appearance of the iris in patients with Down syndrome?
What is the term for the collapse of the vertebral body due to TB?
What organ must metastasize for carcinoid heart disease to occur?
What condition results in the following CSF results?
Opening pressure 70 to 180 mmH2O; 0-10 WBCs (monocytes); glucose 45 to 85, protein 15 to 45
Opening pressure 450 mmH2O; 5 WBCs (90% lymphocytes); normal glucose and protein levels
Opening pressure 100 mmH2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
Opening pressure 250 mmH2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100
Opening pressure 400 mmH2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
What is the term for edema that has LDH below 200, protein level 2.5, and a specific gravity below 1.020?
Transudative; exudative has the opposite values and has an elevated cellular content.
What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
What type of healing occurs in a clean surgical incision?
What are the two most common viral infections in HIV?
CMV retinitis and HSV-2
What disorder is defined by inability of the lower esophageal sphincter to relax with swallowing and a bird beak barium swallow result?
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?
Cushing's disease (pituitary) has elevated ACTH and cortisol supression with dexamethasone, whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
What two Abs are used to diagnose Hashmoto's thyroiditis?
Antithyroglobulin and antimicrosomal Abs
Name the cancer associated with the following chemical agents. (Some may have more than one answer.)
Leukemias and lymphomas
Aromatic amines and azo dyes
Squamous cell carcinoma (skin, lung) and angiosarcoma of the liver
Chromium and nickel
Polycyclic aromatic hydrocarbons
What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
1. Autoimmune hypersplenism
5. Sickle cell anemia
What substance is used to test platelets' response in patients with von Willebrand disease?
What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
What estrogen-producing tumor of the female genital tract is characterized by Call-Exner bodies?
Granulosa cell tumor of the ovary
What AD syndrome involves 1000 or more edematous polyps, most commonly affects the colorectal area, and is associated with chromosome 5q21?
Familial polyposis coli
What is the term for osteophyte formation at the PIP joints in osteoarthritis? In the DIP joints?
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
What type of hemostasis in an intravascular space consists of fibrin, platelets, RBCs, and WBCs?
What is the most common primary malignant tumor in bone?
What is the most common infectious agent in HIV?
Pneumocystis (carinii) jiroveci
What myeloid disorder is characterized by dry bone marrow aspirations, splenomegaly, leukoerythroblastosis, teardrop RBC, and hyperuricemia due to increased cell turnover?
Myelofibrosis with myeloid metaplasia
What form of anemia is associated with IgG Abs against Rh antigens, positive direct Coombs test, and splenomegaly?
Autoimmune hemolytic anemia
What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
LC4, LD4, and LE4
What disorder of bone remodeling results in thick, weak bones and is associated with high-output cardiac failure?
Paget disease (osteitis deformans)
What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies?
Which of the following is not a risk factor for cholesterol gallstones: pregnancy, OCP use, female gender, hemolytic anemia, cirrhosis, and obesity? (May be more than one answer.)
Cirrhosis and hemolytic anemia, which are risk factors for pigmented gallstones.
What virus is associated with body cavity large B-cell lymphomas?
What germ cell tumor is seen in the 15- to 35-year-old age group, peaks when the person is 35 years of age, and is a bulky mass that spreads via the lymphatic system?
What is the term for excessive amounts of granulation tissue that can block re-epithelialization and wound healing?
What is released from the mitochondria to trigger apoptosis?
How much of a vessel must be stenosed to cause sudden cardiac death?
More than 75% of the vessel
What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN, hypokalemia, and low rennin levels?
Conn syndrome (primary hyperaldosteronism)
What sex cell tumor causes precocious puberty, masculinization, gynecomastia in adults, and crystalloids of Reinke?
Leydig cell tumor
Name four major risk factors for atherosclerosis.
DM, hypercholesterolemia, smoking, and HTN are major risk factors. Being male, obesity, sedentary lifestyle, homocysteine elevation, OCPs, and genetics are minor risk factors atherosclerosis.
What is the term for a large VSD that leads to pulmonary HTN, RVH, and cyanosis due to right-to-left reversal of the shunt?
Eisenmenger syndrome, which can also occur with any left-to-right shunt
What leukemia affects a 4-year-old child with 3 months of fever, fatigue, generalized lymphadenopathy, CNS involvement, hepatosplenomegaly, bleeding, and platelet count below 100,000?
What are the three components of amyloid?
1. Fibrillary protein
2. Amyloid protein
What protein causes fibrinolysis?
What pancreatic islet cell tumor is associated with watery diarrhea, hypokalemia, and achlorhydria?
What GI pathology is associated with a positive string sign, an increase in the number of bloody stools, RLQ pain, skip lesions, terminal ileum most commonly affected, occurrence in women more than men, and an increased thickness of the bowel?
True or false? GERD is a cause of asthma.
True. Don't forget this in your differential diagnosis of an asthmatic.
Name the product or products of arachidonic acid:
Vasodilation and inhibition of platelet aggregation produced by vascular endothelium
PGE2, PGD2, and PGF2
Pain and fever
Chemotactic for neutrophils
Aerospace industry, nuclear reactors
Shipyards, brake linings, insulation, and old building construction
Note: Coal worker's pneumoconiosis is synonymous with black lung disease, an upper lob occupational disorder
Which B-cell neoplasm has the following cell surface markers: CD19, CD20, CD5 (T-cell marker), CD23; and are CD10-negative?
CLL (B-cell origin)
Is the AD or AR form of osteopetrosis malignant?
The AR form is malignant and AD is benign.
Name at lease three causes of metastatic calcification.
Remember the mnemonic PAM SMIDT
P, (hyper)Parathyroid/Paget disease
A, Addison's disease
M, Milk-alkali syndrome/metastatic cancer
M, Multiple myeloma
D, Vitamin D intoxication
What is the only subtype of Hodgkin's lymphoma that is most commonly seen in females?
What is the leading cause of preventable premature death and illness in the United States?
Macro-ovalocytes in the peripheral blood smear are from what cell in bone marrow?
Name the type of exudate, given the following examples.
What malignant neoplasm of the skin is associated with keratin pearls?
Squamous cell carcinoma
Name four chemotactic factors for neutrophils.
N-formyl-methionine, LTB4, C5a, and IL-8
What is the term for granuloma at the lung apex in TB?
What are the three platelet aggregating factors?
What foci of fibrinoid necrosis are surrounded by lymphocytes and macrophages throughout all the layers of the heart?
Aschoff bodies of rheumatic fever
What is the leading cause of primary hyperparathyroidism?
Chief cell adenoma (80%)
What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
What is the triad of fat embolism?
2. Hyperactive mental status
3. Occurrence within 24 to 48 hours of the initial insult (e.g., long bone fracture)
What condition is manifested by bilateral sarcoidosis of the parotid glands, submaxillary gland, and submandibular gland with posterior uveal tract involvement?
What bronchogenic carcinoma is associated with an elevated level of Ca2+, involves keratin pearls, occurs in men more than women, is associated with smoking, occurs in the major bronchi, and is seen in the central areas of the lung?
Squamous cell carcinoma
True or false? Being a white male increases your risk factor for testicular cancer.
Oddly enough, it is true. Cryptorchidism, Klinefelter syndrome, testicular feminization, and family history of testicular cancer are all risk factors.
Can an acute MI be diagnosed only by looking at an ECG?
No. Remember, tests do not diagnose, they confirm or refute your diagnosis. Also, diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI, elevated cardiac enzymes consistent with MI, and ST segment elevation of 2 mm or more in at least two contiguous leads.
True or false? Sickle cell anemia, Caisson disease, chronic steroid use, and Gaucher disease are causes of avascular necrosis of bone.
True. Fractures and trauma, however, are the most common causes.
How many cafe-au-lait spots are necessary for the diagnosis of neurofibromatosis type I?
At least six
What form of poisoning is associated with bitter almond-scented breath?
What highly undifferentiaed aggressive CNS tumor of primordial neuroglial origin develops in children and is associated with pseudorosettes?
Primitive neuroectodermal tumors (i.e., medulloblastomas and retinoblastomas)
True or false? Blood clots lack platelets.
True. A thrombus has platelets, but clots do not.
What cancer is particularly likely to affect English chimney sweeps?
Scrotal cancer, due to the high exposure to polycyclic aromatic hydrocarbons
With which pituitary adenoma is an elevated somatomedin C level associated?
What three criteria allow your to differentiate an ulcer from an erosion or carcinoma?
1. Less than 3 cm
2. Clean base
3. Level with the surrounding mucosa
What do low levels of Ca2+ and PO4 along with neuromuscular irritability indicate?
What ring is a weblike narrowing of the gastroesophageal junction?
What rapidly progressive and aggressive T-cell lymphoma affects young males with a mediastinal mass (thymic)?
What is the term for black pigmentation of the colon associated with laxative abuse?
What are the three main components of amyloid?
Fibrillary protein, amyloid protein, and glycosaminoglycans (heparin sulfate mainly)
What parasitic infection is associated with cholangiocarcinoma?
What lymphoma is associated with bleeding and cryoglobulin precipitation at low temperatures, headache and confusion due to hyperviscosity, IgM M-protein spike on serum electrophoresis, and Russell bodies?
What type of acute metal poisoning involves stomach and colon erosion and acute tubular necrosis?
If a peripheral blood smear shows shistocytes, reticulocytes, and thrombocytopenia, is it more commonly seen in patients with ITP or TTP?
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
What atypical pneumonia can be diagnosed with elevated cold agglutinin titers?
What is the triad of Felty syndrome?
Neutropenia, splenomegaly, and rheumatoid arthritis
What is the term for a benign melanocytic tumor associated with sun exposure that presents as tan-to-brown colored and has sharply defined well-circumscribed borders?
Benign nevus (mole)
What type of skin carcinoma occuring on sun-exposed sites has a low level of metastasis?
Squamous cell carcinoma
What is an elevated, fluid-filled cavity between skin layers up to 0.5 cm?
Vesicle (e.g., poison ivy)
What vitamin deficiency may result in sideroblastic anemia?
What is the term for TB with the cervical lymph node involved?
Influx of what ion is associated with irreversible cell injury?
Massive influx of calcium
True or false? All of the following are risk factors for cervical cancer: multiple pregnancies, early age of intercourse, multiple sexual partners, OCP use, smoking, HIV, and STDs.
True. Don't forget this list; you will be asked.
What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning?
What is the tumor at the bifurcation of the right and left hepatic ducts?
IgE-mediated mast cell release, C3a and C5a, and IL-1 all trigger the release of what vasoactive amine?
What is the term for RBC remnants of nuclear chormatin in asplenic patients?
Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
Osteomalacia. Osteoporosis has normal levels of calcium, phosphorus, and alkaline phosphatase.
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following exmples.
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states, do not proliferate.)
What encephalitis is associated with the JC virus?
Progressive multifocal leukoencephalopathy
Hereditary angioneurotic edema (AD) produces local edema in organs (e.g., GI, skin, respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides?
C1 esterase inhibitor (C1INH)
Which integrin mediates adhesion by binding to lymphocyte function-associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
Intercellular adhesion molecule (ICAM) 1
In which form of emphysema, panacinar or centriacinar, is the effect worse in the apical segments of the upper lobes?
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
What percentage of the bone marrow must be composed of blast for leukemia to be considered?
At least 30% blast in the bone marrow
What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
What endogenous pigment found in the substantia nigra and melanocytes is formed by the oxidation of tyrosine to dihydroxyphenylalanine?
What tumor marker is associated with seminomas?
Placental alkaline phosphatase
What oxygen-dependent killing enzyme requires hydrogen peroxide and halide (Cl-) to produce hypochlorous acid?
What condition results in a strawberry gallbladder?
What three chemical agents are associated with angiosarcomas of the liver?
Arsenic, thorotrast, and vinyl chloride
What is the pentad of TTP?
Neurologic symptoms, Renal failure, Thrombocytopenia, Fever, Microangiopathic hemolytic anemia (Don't forget it. When I was an intern, my senior resident asked me this quesiton more times than I would like to remember.)
The "tea-and-toast" diet is classically associated with what cause of megaloblastic anemia?
Folate deficiency (very common in the elderly)
How can a deficiency in adenosine deaminase be a bone marrow suppressor?
It causes a buildup of dATP, which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate, a precursor of DNA, resulting in overall bone marrow suppresion.
Which phenotype of osteogenesis imperfecta is incompatible with life?
What are the four most common causes of femoral head necrosis?
3. Scuba diving
4. Sickle cell anemia
Name the hypochromic microcytic anemia based on the following laboratory values.
Increased iron, decreased TIBC, increased percent saturation, increased ferritin
Decreased iron, TIBC, and percent saturation; increased ferritin
Anemia of chronic disease
Decreased iron, percent saturation, and ferritin; increased TIBC
Iron deficiency anemia
Normal iron, TIBC, percent saturation, and ferritin
What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
True or false? Atelectasis is an irreversible collapse of a lung.
False. Atelectasis is a reversible collapse of a lung.
What CNS developmental abnormality is associated with 90% of syringomyelia?
Arnold-Chiari malformation type 2
Which form of melanoma carries the worst prognosis?
How many major and/or minor Jones criteria are required for the diagnosis of rheumatic fever?
Two major or one major and two minor
What skin carcinoma is a superficial dermal infiltrate of T lymphocytes seen in males more than 40 years old and presents as scaly red patches or plaques?
Mycosis fungoides (cutaneous T-cell lymphoma)
What is a palable, elevated solid mass up to 0.5 cm?
True or false? Monocytosis is seen in TB.
Name three opsonins.
Fc portion of IgG, C3b, and mannose-binding proteins
What chemical can be dangerous if you work in the aerospace industry or in nuclear plants?
Name the type of necrosis.
The most common form of necrosis; denatured and coagulated proteins in the cytoplasm
Seen as dead tissue with coagulative necrosis
Due to lipase activity and has a chalky white appearance
Histologically resembles fibrin
Name two of three enzymes that protect the cell from oxygen-derived free radicals.
Superoxide dismutase, glutathione peroxidase, catalase
What is the term for increased iron deposition resulting in micronodular cirrhosis, CHF, diabetes, and bronzing of the skin?
What condition results from a 46XX karyotype and female internal organs with virilized external genitalia?
What is the term for excessive production of collagen that flattens out and does not extend beyond the site of the injury?
What rare vasculitis has the following characteristics: males aged 40 to 60; affecting small arteries and veins; involving nose, sinuses, lungs, and kidneys; C-ANCA and autoantibodies against proteinase 3?
What retrovirus is associated with adult T-cell leukemia?
What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
Giant cell bone tumor (osteoclastoma)
What stromal tumor in males is characterized histologically with crystalloids of Reinke?
Leydig cell tumor
What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
Factor XII for the intrinsic; factor VII for the extrinsic pathway
True or false? Increased LAP is associated with CML.
False. Increased LAP is seen in stress reactions and helps differentiate benign conditions from CML, which has low LAP levels.
Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
What is the name for the following RBC indices?
The coefficient of variation of the RBC volume
Average Hgb concentration/given volume of packed RBCs
Which form of melanoma carries the best prognosis?
Lentigo maligna melanoma
What is a flat, circumscribed nonpalpable pirgmented change up to 1 cm?
Macule (e.g., a freckle)
Connective tissue macrophages
What testicular tumor of infancy is characterized by elevated α-fetoprotein levels and Schiller-Duval bodies?
Yolk sac tumor
In which region of the lung are 75% of the pulmonary infarcts seen?
What HPV serotypes are associated with increased risk of cervical cancer?
HPV serotypes 16, 18, 31, and 33
What coronary artery vasculitis is seen in Japanese infants and children less than 4 years old with acute febrile illness, conjunctivitis, maculopapular rash, and lymphadenopathy?
What condition is defined by both testicular and ovarian tissues in one individual?
What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor?
How many months in how many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
3 months of symptoms in 2 consecutive years
Small cell cancer of the lung
hst-1 and int-2
Melanoma, cancer of the stomach and bladder
Pancreas and colon
Mantle cell lymphoma
CML and ALL
hst-1, int-2, erb-2, and erb-3
Ki-ras and erb-2
Squamous cell carcinoma of the lung
What are the three most common sites for left-sided heart embolisms to metastasize?
Brain, spleen, and kidney
With what two pathologies is a honeycomb lung associated?
Asbestosis and silicosis
What AD disorder due to a mutation in fibroblast growth factor receptor 3 results in normal-size vertebral column and skull and short, thick extremities?