Step 1 Buzzwords Pathology
USMLE Step 1 Recall: Buzzwords for the Boards Second edition
Terms in this set (629)
What is the term for an abnormal amount of collagen type III that produces a large bulging scar, seen primarily in blacks?
True or false? Klinefelter syndrome cannot be diagnosed until puberty.
What form of sunlight is the most carcinogenic?
Ultraviolet B (UVB) sunlight
What renal pathology involves uniform thickening of the glomerular capillary wall, granular appearance under the microscope, and effacement of foot processes?
What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
What enzyme is deficient in chronic granulomatous disease of childhood?
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?
Rheumatic fever most commonly follows pharyngeal infections with what bacteria?
Group A β-hemolytic streptococci
What benign cardiac tumor is associated with tuberous sclerosis?
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 vascular pathology is associated with HTN in the upper extremities, hypotension in the lower extremities, and a radial-femoral delay?
Postductal coarctation of the aorta (adult)
What seronegative spondyloarthropathy is seen in HLA-B27-positive young females and presents with the triad of conjunctivitis, urethritis, and arthritis affecting the knees and ankles?
What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
A 20-year-old woman who was recently diagnosed with a sexually transmitted disease goes to the ER with a tender, painful, swollen, and erythematous knee (monoarticular). What organism is the likely culprit?
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
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 malignant bone tumor is associated with familial retinoblastoma?
What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?
Polycystic kidney disease of childhood
In what syndrome does the patient have angiomatosis; renal cell carcinomas; pheochromocytomas; retinal, cerebellar, medulla, or spinal cord hemangioblastomas; and epidermal cysts?
von Hippel-Lindu syndrome
What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
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.
A 70-year-old man complains of urinary urgency, nocturia, hestancy, postvoid dribbling, urinary retention, and a PSA result of 6.5 ng/mL. What is your diagnosis?
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result), these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease, when obstructive symptoms begin to occur.
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 type of PUD is characterized by the onset of burning epigastric pain immediately after eating?
What is the term for normal cellular genes associated with growth and differentiation?
Blue sclera is seen in what hereditary bone disorder?
What form of anemia is diagnosed with sucrose lysis test and Ham test?
Paroxysmal nocturnal hemoglobinuria
In what rare AR disorder do you see neutropenia, defective degranulation, and delayed microbial killing due to a problem in chemotaxis and migration?
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 transports iron in the blood?
What hematological malignancy is particularly likely to affect patients with Down syndrome?
ALL (nearly 15-20 times the normal risk)
What childhood pathology involves anterior bowing of the tibia, epiphyseal enlargements, and costochondral widening, with the endochondral bones being affected?
A Japanese man has weight loss, anorexia, early satiety, epigastric abdominal pain, and a palpable left supraclavicular lymph node. On endoscopy you find a large, irregular ulcer with elevated margins on the lesser curvature of the stomach. What is your diagnosis?
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?
What is the name of the tumor when gastric carcinoma spreads to the ovaries?
What condition results from a deficiency in the enzyme hexosaminidase A?
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 is the term for the syndrome consisting of hepatomegaly, ascites, and abdominal pain due to hepatic vein thrombosis?
What form of angina is characterized by
Coronary artery vasospasm, symptom occurrence at rest, ST segment elevation (during episode), and no signs on ECG?
Prinzmetal variant angina
Coronary artery luminal narrowing, symptom occurence during exertion, ST segment depression on ECG?
Coronary artery nonocclusive thrombus; symptom occurrence with increasing frequency, duration, intensity, and decreasing activity, frequently at rest?
Unstable (crescendo) angina
What skin condition is a localized proliferation of melanocytes presenting as small, oval, light brown macules?
What is the term for noneoplastic abnormal proliferation of cell size, shape, and cellular organization?
What diagnosis ensues from finding well-demarcated erythematous palques with silvery scales on the knees, elbows, and scalp along with nail and pitting and discoloration?
What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
What autoimmune liver disease is characterized by affecting a middle-aged woman with jaundice, pruritus, fatigue, xanthomas, increased direct bilirubin levels, and antimitochondrial Abs?
Primary biliary cirrhosis
What cell in chronic inflammation is derived from blood monocytes?
True or false? Pancreatic insufficiency results in vitamin B12 malabsorption.
True. Pancreatic enzymes begin the breakdown of vitamin B12-R complex in the duodenum.
What neuroendocrine tumor produces excess serotonin; is associated with diarrhea, flushing, bronchospasms, wheezing; and is diagnosed by findings of elevated urinary 5-HIAA levels?
What tumor constitutes 40% of testicular tumors in children?
What urinary metabolite is elevated in pheochromocytoma?
Vanillylmandelic acid (VMA)
A 25-year-old black woman presents with nonproductive cough, shortness of breath, fatigue, and malaise; she has bilateral hilar lymphadenopathy on chest radiography and elevated ACE levels. What do you diagnose?
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 disorder leads to IgG autoantibodies to the TSH receptor?
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 AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas?
A 20-year-old woman goes to the ER with ptosis, diplopia, weakness in her jaw muscles when chewing, and muscle weakness with repeated use. What is your diagnosis?
What is the term for RBCs with smooth undulations on the surface of their membrane, commonly seen in uremia?
Burr cells (echinocytes)
Name the cancer associated with the following tumor markers. (Some may have more than one answer.)
Choriocarcinomas and trophoblastic tumors
CA-19.9 and CEA
Hepatoma and nonseminomatous testicular germ cell tumors
Medullary carcinoma of the thyroid
PSA and prostatic acid phosphatase
Placental alkaline phosphatase
Cancer of the lung, stomach, colon, and breast
What seronegative spondyloarthropathy is seen in HLA-B27-positive young men, involves the sacroiliac joints, has no subcutaneous nodules, and has a bamboo spine appearance on radiograph?
What disorder is associated with decreased platelet count, prolonged PT and PTT, decreased fibrinogen, and increased fibrin split products (D-dimers)?
Disseminated intravascular coagulation (DIC)
What spirochete is responsible for Lyme disease?
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)
von Gierke's disease
What ovarian disease involves psammoma bodies?
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?
What are the most common causes of osteomyelitis
In patients with sickle cell disease?
Staphylococcus aureus (but they are more prone to salmonella infections)
In drug addicts?
What malignant neoplasm of the bone is associated with Homer-Wright pseudorosettes; onion skinning of the periosteum on radiographs of the femur, pelvis, and tibia; and chromosome 11;22 translocation?
What lymphoma is characterized by CD19, CD20, CD5; CD23-negative; and chromosome 11;14 translocations?
Mantle cell lymphoma
What components of the complement cascade form the MAC?
True or false? HPV infection increases the risk of developing squamous cell carcinoma of the penis.
True. HPV serotypes 16 and 18 are risk factors for squamous cell carcinoma.
What form of coarctation of the aorta is associated with Turner syndrome?
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?
Which subset of MEN syndrome is associated with the following?
Medullary carcinoma of the thyroid, pheochromocytoma, and mucocutaneous neuromas
MEN III (or IIb)
Medullary carcinoma of the thyroid, pheochromocytoma, and parathyroid adenomas (or hyperplasia)
MEN IIa (or Sipple syndrome)
Parathyroid, pancreatic, and pituitary gland tumors and Zollinger-Ellison syndrome
MEN I (or Werner syndrome)
What X-linked recessive disease involves mental retardation, self-mutilation, choreoathetosis, spasticity, a decrease in HGPRT, and an increase in uricemia?
What disorder is associated with spider angiomas, palmar erythema, gynecomastia, testicular atrophy, encephalopathy, abnormalities in clotting factors, and portal HTN?
What is your diagnosis of a young, thin asymptomatic female with a midsystolic click on cardiac auscultation?
Mitral valve prolapse
What infection is associated with ring-enhancing lesions seen on computed tomography (CT) of the brain in an HIV-positive individual?
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
What is the term for a reversible change in one cell type to another?
Metaplasia (usually to a more protective cell type)
What liver tumor is associated with OCP use?
What CNS developmental abnormality is associated with downward displacement of the cerebellar vermis and medulla compressing the fourth ventricle and leading to obstructive hydrocephalus?
Arnold-Chiari malformation type 2
What disease involves a lack of both T cell-mediated and humoral immune responses that can be either X-linked or AR?
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
True or false? Removal of the ileum results in vitamin B12 deficiencies.
True. The ileum is the site where vitamin B12 is absorbed.
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 is the term for thickened, hyperpigmented skin in the axillae, groin, and skin folds associated with malignancies, obesity, and DM?
How many grams of protein must be excreted in 24 hours to produce the diagnosis of nephrotic syndrome?
>= 3.5g/day of protein, along with generalized edema, hypoalbuminemia, and hyperlipidemia
What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
What catecholamine-hypersecreting tumor, a secondary cause of HTN, results in headache, diaphoresis, anxiety, tachycardia, and palpitations?
What is the term for flattened nose, low-set ears, and recessed chin seen in patients with bilateral renal agenesis?
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 CD4 T-cell receptor does the HIV virus bind to?
What is the term for RBC fragments?
What disorder is due to a deficiency in tyrosinase?
What two Abs are used to diagnose Hashmoto's thyroiditis?
Antithyroglobulin and antimicrosomal Abs
What urease-producing gram-negative curved rod is associated with PUD and chronic gastritis?
Helicobacter pylori, which is also associated with an increased risk of gastric carcinoma
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
Mesothelioma and bronchogenic carcinoma
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 pancreatic islet cell tumor is associated with hypoglycemia, sweating, hunger, confusion, and increased C-peptide levels?
What substance is used to test platelets' response in patients with von Willebrand disease?
What X-linked recessive disorder that is due to an abnormality in dystrophin gene has onset by age 5 with progressive proximal muscle weakness, calf pseudohypertrophy, and elevated CPK levels?
Duchenne muscular dystrophy (Remember, Becker's is slower in progress, less severe, later in onset, and lacks cardiac involvement.)
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 prostaglandin is associated with maintaining patency of the ductus arteriosus?
PGE (along with low oxygen tension)
What is the term for dilated veins within the spermatic cord?
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 disease that involves mental retardation, flat face, muscle hypotonia, and a double-bubble sign on radiograph poses an increased risk of Alzheimer's disease and ALL?
Down syndrome (trisomy 21)
What form of anemia is associated with IgG Abs against Rh antigens, positive direct Coombs test, and splenomegaly?
Autoimmune hemolytic anemia
What urinary metabolite is increased in patients with carcinoid syndrome?
5-hydroxyindoleacetic acid (5-HIAA)
What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
Primary sclerosing cholangitis
What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
LC4, LD4, and LE4
What are the three Bs of adult polycystic kidneys?
3. Berry aneurysm
What AR disease involves a defect in AA 508 on chromosome 7, causing a defect in Cl- transportation that leads to recurrent pulmonary infections and an increase in viscid mucoid secretions along with pancreatic insufficiencies?
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
What law states that an enlarged, palpable gallbladder is more likely due to cancer than stone obstruction?
What is the term for air in the pleural space?
What disorder of bone remodeling results in thick, weak bones and is associated with high-output cardiac failure?
Paget disease (osteitis deformans)
What is the term to describe the increase in organ size due to the increase in cell size and function?
What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies?
True or false? Ethyl alcohol induces the cytochrome P-450 enzymes
What are the five components of portal HTN?
1. Caput medusae
2. Esophagreal varices
What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
Prader-Willi syndrome and Angelman syndrome, respectively
What CNS tumor arises from Rathke's pouch?
What is the triad of Reiter syndrome?
1. Peripheral arthritis
3. Nongonococcal urethritis
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.
Name the nephritic disease based on the immunoflurescent staining.
Mesangial deposits of IgA and C3
IgA nephropathy (Berger disease)
Smooth and linear pattern of IgG and C3 in the GBM
Granular deposits of IgG, IgM, and C3 throughout the glomerulus
What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
GP IIb/IIIa, which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
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 transmural inflammatory bowel disease can be found from the mouth to anus, has noncaseating granulomas, is discontinuous (skip lesions), and has a cobblestone appearance, thickening of the bowel wall, linear fissures, and aphthous ulcers with normal mucosa between?
Does ELISA or Western blot confirm whether a patient is HIV-positive?
ELISA screens and Western blot confirms the diagnosis.
What GN is highly associated with hepatitis B and C infections?
Membranoproliferative glomerulonephritis (MPGN)
What is the term for squamous to columnar metaplasia of the distal esophagus secondary to chronic inflammation?
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
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
Oxidation of Hgb forms what bodies in patients with G6PD deficiency?
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 virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma?
What normochromic, normocytic AD anemia has splenomegaly and increased osmotic fragility?
What does prepubertal hypersecretion of growth hormone lead to?
What enzyme is deficient in alkaptonuria?
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.
Name the AD disease associated with chromosome 15 in which the patient has long extremities, lax joints, pigeon chest, and posterior mitral leaflet prolapse and is prone to developing dissecting aortic aneurysm.
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
Eating fava beans can produce the Mediterranean type of what deficiency?
What form of hemophilia is X-linked recessive and due to a deficiency in factor VIII?
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 protein deficiency results in respiratory distress syndrome of newborns?
Deficiency in surfactant
What are the three components of amyloid?
1. Fibrillary protein
2. Amyloid protein
What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
What are the three left-to-right shunts?
What protein causes fibrinolysis?
What pancreatic islet cell tumor is associated with watery diarrhea, hypokalemia, and achlorhydria?
True or false? Obesity, DM, HTN, multiparity, early menarche, and late menapause are all risk factors for endometrial carcinoma.
False. They are all risk factors for endometrial carcinoma except multiparity. Nulliparity, estrogen-producing tumors, and estrogen replacement therapy are also risk factors for endometrial carcinoma.
What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?
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?
What is the most common fungal infection in HIV?
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
Vasoconstriction and platelet aggregation produced by platelets
Chemotactic for neutrophils
Vasodilation, bronchospasm, and increased vascular permeability
LTC4, LTD4, and LTE4
Which hepatitis B Ab indicated low transmissibility?
What pneumoconiosis is associated with exposure to the following occupations or materials?
Miners, metal grinders, and sandblasters
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
What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
What is the term to describe a decrease in the cell size and function usually associated with disuse?
Atrophy. Disuse can also be due to immobilization, ischemia, aging, and a host of other causes.
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)
What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur, humerus, and tibia?
What are the four DNA oncogenic viruses?
3. Hepatitis B
4. Kaposi sarcoma
Is the AD or AR form of osteopetrosis malignant?
The AR form is malignant and AD is benign.
What carcinoma produces hematuria, flank pain, and a palpable mass?
This is the triad of renal cell carcinoma
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?
What prion-associated CNs pathology produces rapidly progressive dementia with myoclonus, involuntary movements, and death within 6 to 12 months?
What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting, fissuring, and oozing?
Paget disease of the breast
What breast pathology involves malignant cells with halos invading the epidermis of the skin?
Paget disease of the breast
Macro-ovalocytes in the peripheral blood smear are from what cell in bone marrow?
Name the type of exudate, given the following examples.
What parasite is associated with squamous cell carcinoma of the urinary bladder?
What malabsorption syndrome produces abdominal distention, bloating, flatulence, diarrhea, steatorrhea, and weight loss shortly after eating bread products?
Celiac sprue (gluten-sensitive enteropathy)
What herpes virus is associated with Kaposi sarcoma?
What is the term for the copper corneal deposits found in Wilson's disease?
Name the six vitamin K-dependent coagulation factors.
Factors II, VII, IX, and X and proteins C and S.
What ovarian carcinoma is characterized by psammoma bodies?
A Marfanoid patient presents with Tearing retrosternal chest pain Radiating To her Back. What is your first diagnosis?
Dissecting aortic aneurysm. MI is also high on the list, but the highlighted words are buzzwords to look for dissection.
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 syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?
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%)
In what X-linked recessive disease is there a decrease in the HMP shunt, along with Heinz body formation?
What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb-containing area?
True or false? Raynaud's phenomenon has no underlying pathology.
False. The disease has no associated pathology; the phenomenon is arterial insufficiency due to an underlying disease.
What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
What form of hemophilia is X-linked recessive and is due to a deficiency in factor IX?
What are the two reasons for megloblastic anemia with elevated MCV?
Vitamin B12 deficiency and folate deficiency
Is cigarette smoking associated with transitional cell carcinoma of the bladder?
Yes. It is also a cause of cancers of the lung, esophagus, ureter, and kidney, just to name a few.
What disease has multiple schwannomas, cafe-au-lait spots on the skin, and Lisch-nodules and is associated with chromosome 17q?
Neurofibromatosis I (chromosome 22 is with neurofibromatosis II and no Lisch nodules)
What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?
In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
What is the term for cytoplasmic remnants of RNA in RBCs, seen in lead poisoning?
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)
Upon seeing negatively birefringent needle-shaped crystals from a joint aspiration of the great toe, what form of arthritis do you diagnosis?
What condition is manifested by bilateral sarcoidosis of the parotid glands, submaxillary gland, and submandibular gland with posterior uveal tract involvement?
What female genital tract disorder is characterized by obesity, hirsutism, infertility, amenorrhea, elevated LH and testosterone levels, and low FSH levels?
Polycystic ovary disease (Stein-Leventhal syndrome)
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
What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
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.
What autoimmue syndrome is characterized by keratoconjunctivitis, corneal ulcers, xerostomia, and an increased risk of high-grade B-cell lymphomas? What two Ab tests are used in making the diagnosis?
Sjogren's syndrome; SS-A (Ro) and SS-B (La)
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.
What gene stimulates apoptosis when DNA repair is unable to be done?
Is ulcerative colitis or Crohn disease more commonly associated with primary sclerosing cholangitis?
What test uses p24 protein when diagnosing HIV?
How many cafe-au-lait spots are necessary for the diagnosis of neurofibromatosis type I?
At least six
What is the term for severe and protracted vomiting resulting in linear laceration at the gastroesophageal junction?
What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?
What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
What form of poisoning is associated with bitter almond-scented breath?
Name the type of hypersensitivity reaction based on the following properties.
Circulating Ab-Ag immune complexes deposited in the tissue result in neutrophil attraction and the release of lysosomal enzymes
Type III hypersensitivity (immune complex)
IgE-mediated release of chemical mediators from basophils and mast cells; need prior exposure to Ag in the past; eosinophils amplify and continue reaction; can be system or localized.
Type I hypersensitivity (anaphylactic)
IgG or IgM Abs against a specific target cell or tissue; complement-dependent or ADCC.
Type II hypersensitivity (cytotoxic)
Reaction-mediated by sensitized T-cells
Type IV hypersensitivity (cell-mediated)
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)
What syndrome is due to anti-GBM Abs directed against the lung and kidneys?
What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
What tumor is seen in the 2- to 4-year-old age group; does not cross the midline; has immature glomeruli, tubules, and stroma; and metastasizes late to the lungs?
What CNS tumor commonly produces tinnitus and hearing loss?
True or false? Anticentromere Abs are used in diagnosing CREST syndrome.
True. Scl-70 Abs are used in diagnosing diffuse scleroderma.
What AR CNS disorder presents early in childhood with gait ataxia, loss of deep tendon reflexes, impaired vibratory sensation, hand clumsiness, and loss of position sense?
What potent platelet aggregator and vasoconstrictor is synthesized by platelet?
Which type of cerebral herniation is associated with CN III palsy?
What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
What is the main type of cell involved in cellular immunity?
What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
What is the classic triad of TB?
Fever, night sweats, and hemoptysis
True or false? Blood clots lack platelets.
True. A thrombus has platelets, but clots do not.
What malignant tumor of the skin is associated with Birbeck granules?
What type of anemia is the result of a deficiency in intrinsic factor?
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
What cancer is particularly likely to affect English chimney sweeps?
Scrotal cancer, due to the high exposure to polycyclic aromatic hydrocarbons
What is the term for a raised fluid-filled cavity greater than 0.5 cm that lies between the layers of the skin?
What virus is associated with the endemic form of Burkitt lymphoma?
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
Name the four right-to-left congenital cardiac shunts.
Truncus arteriosus, Tricuspid atresia, Transposition of the great vessels, and Tetralogy of Fallot. (They all begin with T.)
What do low levels of Ca2+ and PO4 along with neuromuscular irritability indicate?
Does PT or PTT test the extrinsic coagulation pathway?
PT for extrinsic and PTT for intrinsic (remember, wPeT and hPiTT, which means warfarin, extrinsic, PT; heparin, intrinsic, PTT)
What leukemia is associated with four-leaf-clover lymphocytes on peripheral blood smear?
Adult T-cell leukemia
What ring is a weblike narrowing of the gastroesophageal junction?
With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
What rapidly progressive and aggressive T-cell lymphoma affects young males with a mediastinal mass (thymic)?
What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)?
Flea-bitten kidney (can also be seen in pyelonephritis)
True or false? Psammoma bodies are seen in medullary carcinoma of the thyroid.
False. Elevated calcitonin levels are seen in medullary carcinoma of the thyroid. Psammoma bodies are seen in papillary carcinoma of the thyroid and ovaries, as well as meningiomas.
What is the lecithin:spingomyelin ratio in respiratory distress syndrome of newborns?
What syndrome has loss of deep tendon reflexes, muscle weakness, and ascending paralysis preceded by a viral illness?
What form of endocarditis do patients with SLE commonly encounter?
What is the term for black pigmentation of the colon associated with laxative abuse?
Are the following major or minor Jones criteria of rheumatic fever?
Elevated acute phase reactants (e.g., ESR)
What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?
Which hepatitis strain is a defective virus that can replicate only inside HBV-infected cells?
What are the three main components of amyloid?
Fibrillary protein, amyloid protein, and glycosaminoglycans (heparin sulfate mainly)
What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100,000); decreased LAP levels; and nonspecific symptoms of fatigue, malaise, weight loss, and anorexia?
What is the difference between a Ghon focus and a Ghon complex?
A Ghon focus is a TB tubercle, whereas a Ghon complex is a focus with hilar lymph node involvement.
In what disease do you see horseshoe kidneys, rockerbottom feet, low-set ears, micrognathia, and mental retardation?
Edward syndrome (trisomy 18)
What parasitic infection is associated with cholangiocarcinoma?
What disorder is associated with loss of polarity, anaplasia, plenomorphism, discohesiveness, increase in the nuclear:cytoplasmic ratio, hyperchronmasia, and increase in the rate of mitosis?
What is the term for telescoping of the proximal bowel into distal segment presenting as abdominal pain, currant jelly stools, and intestinal obstruction?
What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
What type of erythema do you see in
What benign bone tumor is associated with Gardner syndrome?
What renal calculus is associated with urea-splitting bacteria?
Magnesium ammonium phosphate (struvite)
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?
What slow-growing CNS tumor in 30- to 50-year-old patients with a long history of seizures has fried egg cellular appearance in a network of chicken wire?
Goodpasture Ag is a component of what type of collagen?
Type IV collagen
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.
After traveling in a plane across the Atlantic Ocean, an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
What cell type involves humoral immunity?
What is the first sign of megaloblastic anemia on a peripheral blood smear?
What is the term for gastric ulcers associated with severely burned or traumatic patients?
Curling ulcers (think curling iron = burn)
What syndrome arises from mutation in the fibrillin gene (FBN1) on chromosome 15q21?
What AD disorder is characterized by degeneration of GABA neurons in the caudate nucleus resulting in atrophy, chorea, dementia, and personality changes?
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 the unidirectional attraction of cells toward a chemical mediator released during inflammation?
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 small- to medium-sized vasculitis is seen in a 35-year-old man who is heavy smoker presenting with claudication symptoms in the upper and lower extremities?
Buerger disease (thromboangiitis obliterans)
What is the term for pelvic inflammatory disease of the fallopian tubes?
What disease with familial mental retardation produces large, everted ears and macro-orchidism?
Fragile X syndrome
What type of skin carcinoma occuring on sun-exposed sites has a low level of metastasis?
Squamous cell carcinoma
What is the tetrad of tetralogy of Fallot?
VSD, RVH, overriding aorta, and pulmonary stenosis
What is the term for chronic necrotizing pulmonary infections resulting in permanent airway dilation and associated with Kartagener syndrome?
What is an elevated, fluid-filled cavity between skin layers up to 0.5 cm?
Vesicle (e.g., poison ivy)
What is the term for panhypopituitarism secondary to ischemic necrosis and hypotension pospartum?
What disease is diagnosed by findings of ANAs and anti-SCL-70 antibodies?
What is the name of the ovarian cyst containing ectodermal, endodermal, and mesodermal elements (i.e., skin, hair, teeth and neural tissue)?
Teratoma (dermoid cyst)
What syndrome is seen in iron-deficient middle-aged women with esophageal webs?
What are the three-causes of transudate?
CHF, cirrhosis, and nephrosis
A chronic alcohol abuser goes to the ER with weakness, a sore, beefy red tongue, loss of vibration and position sense, arm and leg dystaxia, elevated levels of methylmalonic acid in the urine, and anemia with an MCV above 105 fL. What is your diagnosis, and how will you monitor his response to treatment?
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working, you will see an increased reticulocyte count on the peripheral smear in about 5 days.
What form of GN is characteristically associated with crescent formation?
Rapidly progressive glomerulonephritis (RPGN)
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
What pathology is associated with elevated levels of Ca2+, cardiac arrhythmias, bone resorption, kidney stones, and metastatic calcifications?
What type of metal poisoning causes mental retardation, somnolence, convulsions, and encephalopathy?
What syndrome is rheumatoid arthritis with pneumoconiosis?
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 precipitation of calcium phosphate in dying or necrotic tissue?
What congenital small bowel outpouching is a remnant of the vitelline duct?
What type of crystals are associated with gout?
Monosodium urate crystals
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 disease is seen in the 20- to 40-year-old age group, is more prevalent in women than men, involves diarrhea with or without bloody stools, starts in the rectum and ascends without skipping areas, includes pseudopolyps, and has a thickness of the bowel that does not change?
What disorder causes joint stiffness that worsens with repetitive motion, crepitus, effusions, and swelling and commonly affects the knees, hips, and spine?
What condition is characterized by a 46XY karyotype, testes present, and ambiguous or female external genitalia?
Male pseudohermaphrodite (dude looks like a lady!)
What is the term for RBC remnants of nuclear chormatin in asplenic patients?
What is the term for gastric ulcers associated with increased intracranial pressure?
What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
Hemolytic uremic syndrome
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.
What vascular tumor associated with von Hippel-Lindau syndrome involves the cerebellum, brainstem, spinal cord, and retina?
How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?
At least 5 lobes
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 CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
True or false? Elevated ASO titers and serum complement levels are associated with poststreptococcal GN.
False. ASO titers are elevated, but serum complement levels are decreased.
What glycoprotein allows platelets to adhere to von Willebrand factor?
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)
Is an anti-HAV IgG Ab associated with immunization or recent infection?
Anti-HAV IgG Abs are associated with immunization or a prior infection. Anti-HAV IgM is associated with acute or recent infection.
Which integrin mediates adhesion by binding to lymphocyte function-associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
Intercellular adhesion molecule (ICAM) 1
Name the cerebral vessel associated with the following vascular pathologies.
Berry aneurysm in the circle of Willis
Bridging veins draining into the sagittal sinus
Middle meningeal artery
True or false? Live vaccines are constraindicated in patients with SCID.
What is the term for the round intracytoplasmic eosinophilic inclusions containing α-synuclein found in the dopaminergic neurons of the substantia nigra?
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 syndrome results if the enzyme α-1-iduronidase is deficient? L-iduronate sulfatase deficiency?
Hurler syndrome and Hunter syndrome, respectively
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 is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs?
What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
True or false? Patients with Turner syndrome have no Barr bodies.
True. Remember, the second X chromosome is inactivated, an so is the Barr body. Turner syndrome has only one X chromosome.
What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?
What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?
What vasculitis affects a 30-year-old Asian female having visual field deficits, dizziness, decreased blood pressure, and weakened pulses in the upper extremities?
Takayasu arteritis (medium-size to large vessels)
A 20-year-old college student has fever, grey-white membranes over the tonsils, posterior auricular lymphadenitis, and hepatosplenomegaly. What is your diagnosis? What test do you order to confirm your diagnosis?
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember, it may be negative in the first week of the illness, so retest if you have a high index of suspicion.)
What cell type is commonly elevated in asthma?
What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?
Medullary carcinoma of the thyroid
What illegal drug can cause rhabdomyolysis, MI, cerebral infarct, and lethal cardiac arrhythmias?
What AA is substitued for glutamic acid at position 6 on the β-chain in patients with sickle cell anemia?
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 type of GN, associated with celiac disease and dermatitis herpetiformis, has mesangial deposits of IgA, C3, properdin, IgG, and IgM?
Berger disease (IgA nephropathy)
What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus, dilatation of the lateral and third ventricles, and signs of extrapyramidal lesions?
What pattern of inheritance is G6PD deficiency
What adenocarcinoma presents with elevated levels of acid phosphatase, dihydrotestosterone, PSA, and bone pain?
Is Dubin-Johnson or Rotor syndrome associated with black pigmentation of the liver?
Both are AR with conjugated hyperbilirubinemia, but Dubin-Johnson syndrome is differentieated from Rotor by the black pigmentation of the liver.
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 term for programmed cell death?
Apoptosis (Remember, there is a lack of inflammatory response.)
What potentially fatal disease occurs in children who are given ASA during a viral illness?
What metal poisoning produces microcytic anemia with basophilic stippling?
What inflammatory bowel disorder is continuous, with extensive ulcerations and pseudopolyps, and is associated with HLA-B27?
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.)
Which hepatitis B Ag correlates with infectivity and viral proliferation?
What disease involves cold skin abscesses due to a defect in neutrophil chemotaxis and a serum IgE level higher than 2000?
What female pathology is associated with endometrial glands and stroma outside the uterus commonly affecting the ovaries as chocolate cysts?
What is the karyotype in Turner syndrome?
What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon?
Hirschsprung disease (aganglionic megacolon)
What syndrome is associated with gastrin-producing islet cell tumor resulting in multiple intractable peptic ulcers?
What type of collagen is associated with keloid formation?
The "tea-and-toast" diet is classically associated with what cause of megaloblastic anemia?
Folate deficiency (very common in the elderly)
What is the term for ascending bacterial infection of the renal pelvis, tubules, and interstitium causing costoverterbral angle tenderness, fever, chills, dysuria, frequency, and urgency?
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?
With what is cherry red intoxication associated?
Acute CO poisoning
What are the four most common causes of femoral head necrosis?
3. Scuba diving
4. Sickle cell anemia
What are the four signs of acute inflammation?
Rubor (red), dolor (pain), calor (heat), tumor (swelling); also sometimes there is loss of function
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
Which form of emphysema is associated with an α1-antitrypsin deficiency?
An 80-year-old woman presents to you with right-sided temporal headache, facial pain and blurred vision on the affected side, and an elevated ESR. Your diagnosis?
Temporal arteritis (giant cell arteritis)
What type of neurofibromatosis is associated with bilateral acoustic shwannomas?
What disorder is due to a deficiency in the enzyme glucocerebrosidase?
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 viral infection in patients with sickle cell anemia results in aplastic crisis?
What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
What CNS developmental abnormality is associated with 90% of syringomyelia?
Arnold-Chiari malformation type 2
What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
A 30-year-old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis?
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer, which is commonly unilateral, single nodule, no variation with menstruation, and no changes during pregnancy.
What disease is X-linked recessive, is associated with eczema thrombocytopenia and an increased chance of developing recurrent infections, involves a decrease in serum IgM and in the T cell-dependent paracortical areas of the lymph nodes, and means that patient is likely to develop malignant lymphoma?
Which form of melanoma carries the worst prognosis?
Patients with sickle cell anemia are at increased risk for infection from what type of organisms?
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 Hgb-derived endogenous pigment is found in areas of hemorrhage or bruises?
What is a palable, elevated solid mass up to 0.5 cm?
True or false? Monocytosis is seen in TB.
What pathology is associated with podagra, tophi in the ear, and PMNs with monosodium urate crystals?
What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficle, ischemia, Staphylococcus, Shigella, or Candida infection?
What do the risk factors late menopause, early menarche, obesity, nulliparity, excessive estrogen, genetic factor p53, and brc-abl characterize?
What thyroid carcinoma is associated with radiation exposure, psammoma bodies, and Orphan Annie eye nuclei?
Papillary carcinoma of the thyroid
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?
Which hepatitis B serology markers - HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA - are associated with the following periods?
HBcAb IgG and HBsAb IgG
HBcAb IgM, HBV-DNA, HBeAg, HBsAg
HBcAb IgG, HBV-DNA, HBeAg, HBsAg
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
Seen as dead tissue with liquefactive necrosis?
Due to lipase activity and has a chalky white appearance
Soft, friable, cottage-cheese appearing; characteristically seen in TB
Histologically resembles fibrin
Name two of three enzymes that protect the cell from oxygen-derived free radicals.
Superoxide dismutase, glutathione peroxidase, catalase
What are the rules of 2 for Meckel diverticulum?
2% of population, 2 cm long, 2 feet from ileocecal valve, 2 years old, and 2% of carcinoid tumors
What aneurysm of the circle of Willis is associated with polycystic kidney disease?
A 20-year-old black woman goes to you with nonspecific joint pain, fever, and a malar rash over the bridge of her nose and on her checks. This is a classic example of what autoimmune disease? What are three autoantibody tests you could order to make the diagnosis?
SLE; ANA, anti-dsDNA and anti-Sm (anti-Smith)
True or false? Excess lead deposits in the oral cavity.
True. It deposits at the gingivodental line, known as the lead line.
What is the term for increased iron deposition resulting in micronodular cirrhosis, CHF, diabetes, and bronzing of the skin?
What AR disorder is due to a deficiency in glycoprotein IIb-IIIa, resulting in a defect in platelet aggregation?
What protein-losing enteropathy has grossly enlarged rugal fold in the body and fundus of the stomach in middle-aged males, resulting in decreased acid production and an increased risk of gastric cancer?
What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities, red cell aplasia, and muscle weakness?
Which subtype of AML is most commonly associated wtih Auer rods?
M3 (promyelocytic leukemia)
What condition results from a 46XX karyotype and female internal organs with virilized external genitalia?
Two weeks after her son has a throat infection, a mother takes the boy to the ER because he has fever, malaise, HTN, dark urine, and periorbital edema. What is your diagnosis?
What X-linked recessive immune disorder is characterized by recurrent infections, severe thrombocytopenia, and eczema?
What form of arthritis is associated with calcium pyrophosphate crystals?
What is the term for excessive production of collagen that flattens out and does not extend beyond the site of the injury?
What is the term for inflamed, thickened skin on the breast with dimpling associated with cancer?
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 disease is seen in children younger than 5 years of age and is characterized by X-linked recessive cardiac myopathies, calf pseudohypertrophy, lordosis, protuberant belly, an increase then a decrease in CPK, and death commonly in the second decade of life?
Duchenne muscular dystrophy
What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
Giant cell bone tumor (osteoclastoma)
What nephritic syndrome has effacement of the epithelial foot processes without immune complex deposition?
Minimal change disease
What is the term for tissue-based basophils?
What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
Is splenomegaly more commonly associated with intravascular or extravascular hemolysis?
Extravascular hemolysis if it occurs in the spleen; if in the liver, it results in hepatomegaly.
What cancer of the male genitourinary system is associated with osteoblastic bony metastasis?
What stromal tumor in males is characterized histologically with crystalloids of Reinke?
Leydig cell tumor
What pulmonary disease, most commonly associated with smoking, results in enlarged, overinflated lungs owing to the destruction of the alveolar walls with diminished elastic recoil?
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
What chronic systemic inflammatory disease commonly seen in women ages 20 to 50 is a progressive, symmetric arthritis affecting the hands, wrists, knees, and ankles that improves with increased activity?
Name the following descriptions associated with bacterial endocarditis:
Painful subcutaneous nodules on fingers and toes
Painless hyperemic lesions on the palms and soles
What two CD cell surface markers do Reed-Sternberg cells stain positive for?
CD15 and CD30
What two lysosomal storage diseases have cherry-red spots on the retina?
Niemann-Pick and Tay-Sachs diseases
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.
What syndrome has multiple adenomatous colonic polyps and CNS gliomas?
What is the term for a venous embolus in the arterial system?
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
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 mass of the Hgb molecule/RBC
Average volume of a RBC
Average Hgb concentration/given volume of packed RBCs
What cardiomyopathy is due to a ventricular outflow obstruction as a result of septal hypertrophy and leads to sudden cardiac death in young athletes?
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis, or IHSS)
Which HPV serotypes are associated with condyloma acuminatum?
HPV serotypes 6 and 11
Which form of melanoma carries the best prognosis?
Lentigo maligna melanoma
What is the term for an increase in the number of cells in a tissue?
A 60-year-old man has back pain (compression spinal fracture), hypercalcemia, increased serum protein, Bence-Jones proteinuria, and monoclonal M-spike on serum electrophoresis. What is your diagnosis?
What is the term for pus in the pleural space?
What is a flat, circumscribed nonpalpable pirgmented change up to 1 cm?
Macule (e.g., a freckle)
Name the macrophage based on its location:
Pulmonary alveolar macrophages
Connective tissue macrophages
What is the term for a large, immature RBC that is spherical, blue, and without a nucleus?
What testicular tumor of infancy is characterized by elevated α-fetoprotein levels and Schiller-Duval bodies?
Yolk sac tumor
Starry sky appearance of macrophages is pathognomonic of what lymphoma?
In which region of the lung are 75% of the pulmonary infarcts seen?
For what disease are SS-A(Ro), SS-B(La), and R-ANA diagnostic markers?
What HPV serotypes are associated with increased risk of cervical cancer?
HPV serotypes 16, 18, 31, and 33
Do the following structures pick up stain from hematoxylin or eosin?
What commonly encountered overdose produces headache, tinnitus, respiratory alkalosis, metabolic acidosis, confusion, vomiting, and tachypnea?
What AR syndrome is due to a deficiency of glycoprotein Ib, resulting in a defect in platelet adhesion?
What AD renal disorder is associated with mutations of the PKD 1 gene on chromosome 16 and berry aneurysms in the circle of Willis and presents in the fifth decade with abdominal masses, flank pain, hematuria, HTN, and renal insufficiency?
Adult polycystic kidney disease
Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute?
Months to years after transplantation; gradual onset of HTN, oliguria, and azotemia; seen as intimal fibrosis of the blood vessels and interstitial lymphocytes
Immediately after transplantation; seen as a neutrophilic vasculitis with thrombosis
Weeks to months after transplantation; abrupt onset of oliguria and azotemia; seen as neutrophilic vasculitis and interstitial lymphocytes
What type of collagen is abnormal in patients with osteogenesis imperfecta?
Type I (makes sense, since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
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 disease has autoantibodies to IgG, occurs in women more than men, and includes exophthalmos, pretibial myxedema, nervousness, heart palpitations, and fatigue?
What condition is defined by both testicular and ovarian tissues in one individual?
A mother takes her 2-week-old infant to the ER because the baby regurgitates and vomits after eating and has peristaltic waves visible on the abdomen and a palpable mass in the right upper quadrant. What is your diagnosis?
What variant of polyarteritis nodosa is associated with bronchial asthma, granulomas, and eosinophilia?
What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor?
What B-cell neoplasm is seen in males with massive splenomegaly, produces dry tap on bone marrow aspirations, and stains positive for tartrate-resistant acid phosphatase (TRAP)?
Hairy cell leukemia
What form of nephritic syndrome is associated with celiac sprue and Henoch-Schonlein purpura?
What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia, tetany, and T-cell deficiency?
What is the treatment for physiologic jaundice of newborns?
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
What chronic inflammatory WBC is associated with IgE-mediated allergic reactions and parasitic infections?
What AD syndrome produces hamartomatous polyps in the small intestine and pigmentation of the lips and oral mucosa?
What is the term for formation of a stable fibrin-platelet plug to stop bleeding?
True of false? All of the following are risk factors for breast cancer: early menses, late menopause, history of breast cancer, obesity, and multiparity.
False. All except multiparity are risk factors for breast cancer. Nulliparity, increasing age, and family history in first-degree relative are also risk factors. Memorize this list!
Is jugular venous distention a presentation of isolated left or right heart failure?
Name the hepatitis virus based on the following information.
Small circular RNA virus with defective envelope
Enveloped RNA flavivirus
Naked capsid RNA calicivirus
Enveloped DNA hepadnavirus
Naked capsid RNA picornavirus
What AR disease involves a decreased amount of sphignomyelinase, massive organomegaly, zebra bodies, and foamy histiocytes and is associated with chromosome 11p?
What is the term for hypoperfusion of an area involving only the inner layers?
What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
Marrow failure, cancer, and leukemia
Notching of the ribs, seen on chest radiograh in patients with postductal coarctation of the aorta, is due to collateralization of what arteries?
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
What is the physiologic storage form of iron?
What is the term for occlusion of a blood vessel due to an intravascular mass that has been carried downstream?
What AR disorder of copper metabolism can be characterized by Kayser-Fleischer rings, decreased ceruloplasmin levels, and increased urinary copper excretion and tissue copper levels?
Wilson disease. (Remember, patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Name the cancer associated with the following oncogenes. (Some may have more than one answer)
Small cell cancer of the lung
hst-1 and int-2
Melanoma, cancer of the stomach and bladder
MEN II and III syndromes
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 AD GI neoplasia produces multiple adenomatous polyps, osteomas, fibromas, and epidural inclusion cysts?
What disease involves microcephaly, mental retardation, cleft lip or palate, and dextrocardia?
Patau syndrome (trisomy 13)
What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex-mediated; and is seen as lumpy-bumpy subepithelial deposits?
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?
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