Section 1
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What benign cardiac tumor is associated with tuberous sclerosis?
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Cards (600)
Section 1
(50 cards)
What benign cardiac tumor is associated with tuberous sclerosis?
Rhabdomyoma
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 childhood pathology involves anterior bowing of the tibia, epiphyseal enlargements, and costochondral widening, with the endochondral bones being affected?
Rickets
What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
Transient ischemic attack
What skin condition is a localized proliferation of melanocytes presenting as small, oval, light brown macules?
Benign lentigo
What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
Gastric ulcer
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?
Polyarteritis nodosa
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?
Reiter syndrome
What bone cell has receptors for PTH?
Osteoblasts (Remember, they modulate the function of osteoclasts.)
What drug causes a sixfold increase in schizophrenia, can impair motor activity, and can cause lung problems?
Marijuana
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 condition results from a deficiency in the enzyme hexosaminidase A?
Tay-Sachs disease
What is the term for an abnormal amount of collagen type III that produces a large bulging scar, seen primarily in blacks?
Keloid
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?
Riedel thyroiditis
What hematological malignancy is particularly likely to affect patients with Down syndrome?
ALL (nearly 15-20 times the normal risk)
What are the rules of 10 regarding pheochromocytoma?
10% are bilateral, 10% malignant, and 10% familial, 10% in children, 10% outside the adrenal gland, and 10x more likely to be seen on the USMLE than in real life
What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
Kimmelstiel-Wilson disease
What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
Tylosis
Blue sclera is seen in what hereditary bone disorder?
Osteogenesis imperfecta
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 form of angina is characterized by • Coronary artery nonocclusive thrombus; symptom occurrence with increasing frequency, duration, intensity, and decreasing activity, frequently at rest?
Unstable (crescendo) angina
What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
Swan-neck deformities
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 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
What is the term for the syndrome consisting of hepatomegaly, ascites, and abdominal pain due to hepatic vein thrombosis?
Budd-Chiari syndrome
What is the term for normal cellular genes associated with growth and differentiation?
Proto-oncogenes
What myeloid disorder is characterized by increased hematocrit, blood viscosity, basophils, and eosinophils; intense pruritus; and gastric ulcers due to histamine release from basophils, increased left atrial pressure, and plethora?
Polycythemia vera (Remember, polycythemia vera is a risk factor for acute leukemias.)
What is the name of the tumor when gastric carcinoma spreads to the ovaries?
Krukenberg tumor
What triad consists of endothelial injury, changes in laminar flow, and hypercoagulation?
Virchow triad, associated with the formation of a thrombus.
In what rare AR disorder do you see neutropenia, defective degranulation, and delayed microbial killing due to a problem in chemotaxis and migration?
Chédiak-Higashi syndrome
What cell in chronic inflammation is derived from blood monocytes?
Macrophages
What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
HIV
A 70-year-old man complains of urinary urgency, nocturia, hesitancy, 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 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.
True or false? Klinefelter syndrome cannot be diagnosed until puberty.
True
What renal pathology involves uniform thickening of the glomerular capillary wall, granular appearance under the microscope, and effacement of foot processes?
Membranous glomerulonephritis
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?
Scleroderma
What is the term for nonneoplastic abnormal proliferation of cell size, shape, and cellular organization?
Dysplasia
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
Rheumatic fever most commonly follows pharyngeal infections with what bacteria?
Group A β-hemolytic streptococci
What form of angina is characterized by • Coronary artery luminal narrowing, symptom occurrence during exertion, ST segment depression on ECG?
Stable angina
What diagnosis ensues from finding well-demarcated erythematous plaques with silvery scales on the knees, elbows, and scalp along with nail bed pitting and discoloration?
Psoriasis
Which cerebral herniation results in compression of the anterior cerebral artery?
Cingulate gyrus herniation (subfalcine)
In what syndrome does the patient have angiomatosis; renal cell carcinomas; pheochromocytomas; retinal, cerebellar, medulla, or spinal cord hemangioblastomas; and epidermal cysts?
von Hippel-Lindau syndrome
What enzyme is deficient in chronic granulomatous disease of childhood?
NADPH oxidase
What malignant bone tumor is associated with familial retinoblastoma?
Osteosarcoma
What form of anemia is diagnosed with sucrose lysis test and Ham test?
Paroxysmal nocturnal hemoglobinuria
What transports iron in the blood?
Transferrin
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?
Gastric carcinoma
What form of sunlight is the most carcinogenic?
Ultraviolet B (UVB) sunlight
Section 2
(50 cards)
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-19.9 and CEA
Pancreatic cancer
What disorder leads to IgG autoantibodies to the TSH receptor?
Graves disease
What very aggressive lung cancer metastasizes early and is associated with smoking and paraneoplastic syndromes?
Small cell carcinoma (oat cell)
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?
Neuroblastoma
What urinary metabolite is elevated in pheochromocytoma?
Vanillylmandelic acid (VMA)
What intrauterine deficiency leads to failure to thrive, mental retardation, motor incoordination, and stunted growth?
Iodine, resulting in congenital hypothyroidism
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?
Sarcoidosis
What neuroendocrine tumor produces excess serotonin; is associated with diarrhea, flushing, bronchospasms, wheezing; and is diagnosed by findings of elevated urinary 5-HIAA levels?
Carcinoid tumor
What is the term for RBCs with smooth undulations on the surface of their membrane, commonly seen in uremia?
Burr cells (echinocytes)
What is the term for the collapse of the vertebral body due to TB?
Pott disease
What are the most common causes of osteomyelitis • In patients with sickle cell disease?
Staphylococcus aureus (but they are more prone to salmonella infections)
What are the most common causes of osteomyelitis • Overall?
Staphylococcus aureus
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?
Ankylosing spondylitis
What cystic swelling of the chorionic villi is the most common precursor of choriocarcinoma?
Hydatidiform mole
What bone disorder is characterized by brown tumors, bone pain, deformities, and fractures due to excessive PTH?
Osteitis fibrosa cystica (von Recklinghausen disease)
What is the most common opportunistic infection of the CNS in HIV?
Toxoplasmosis
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?
Borrelia burgdorferi
What pancreatic islet cell tumor is associated with MEN I syndrome?
Gastrinoma
What thyroiditis presents as a tender, enlarged, firm thyroid gland, usually preceded by an upper respiratory viral illness?
de Quervain thyroiditis
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CEA
Cancer of the lung, stomach, colon, and breast
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?
Duodenal ulcer
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.
True or false? Pancreatic delta-cell tumors inhibit CCK secretion, leading to gallstones and steatorrhea.
True. Delta-Cell tumors produce excess somatostatin, which inhibits CCK, gastrin (hypochlorhydria), and insulin secretion (diabetes).
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 glycogen storage disease is due to the following enzyme deficiencies? • Muscle phosphorylase
McArdle's syndrome
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?
C5b-C9
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 glycogen storage disease is due to the following enzyme deficiencies? • Glucose-6-phosphatase
von Gierke's disease
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • alpha-Fetoprotein
Hepatoma and nonseminomatous testicular germ cell tumors
What form of coarctation of the aorta is associated with Turner syndrome?
Preductal (infantile)
What ovarian disease involves psammoma bodies?
Serocystadenocarcinoma
What are the four reasons for hypochromic microcytic anemia with a low MCV?
1. Sideroblastic anemias (i.e., porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Placental alkaline phosphatase
Seminoma
What are the most common causes of osteomyelitis • In neonates?
Streptococcus agalactiae
What glycogen storage disease is due to the following enzyme deficiencies? • Lysosomal glucosidase (acid maltase)
Pompe's disease
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Calcitonin
Medullary carcinoma of the thyroid
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-125
Ovarian cancer
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?
Myasthenia gravis
What AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas?
Familial hypercholesterolemia
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Beta-hCG
Choriocarcinomas and trophoblastic tumors
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • PSA and prostatic acid phosphatase
Prostate cancer
In what condition do you see dimpling on the kidney's surface?
Pyelonephritis
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?
Ewing's sarcoma
What tumor constitutes 40% of testicular tumors in children?
Teratoma
What are the most common causes of osteomyelitis • In drug addicts?
Pseudomonas
What is characterized by an intense inflammatory reaction, an increase in the amounts of granulation tissue and wound contraction by myofibroblasts?
Healing by secondary intention
What hereditary bone disorder is due to decreased osteoclast function, resulting in thick, sclerotic bones that fracture easily?
Osteopetrosis (Albers-Schönberg disease)
What is the term for the speckled appearance of the iris in patients with Down syndrome?
Brushfield spots
Section 3
(50 cards)
What disorder is due to a deficiency in tyrosinase?
Albinism
What condition results in the following CSF results? • Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
Viral meningitis
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.)
Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and parathyroid adenomas (or hyperplasia)
MEN IIa (or Sipple syndrome)
What condition results in the following CSF results? • Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
Bacterial meningitis
What AD syndrome involves 1000 or more edematous polyps, most commonly affects the colorectal area, and is associated with chromosome 5q21?
Familial polyposis coli
True or false? Removal of the ileum results in vitamin B12 deficiencies.
True. The ileum is the site where vitamin B12 is absorbed.
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Vinyl chloride
Angiosarcoma of the liver
What condition results in the following CSF results? • Opening pressure 450 mm H2O; 5 WBCs (90% lymphocytes); normal glucose and protein levels
Brain abscess
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 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 are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
What is the term for a reversible change in one cell type to another?
Metaplasia (usually to a more protective cell type)
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Naphthylamine
Bladder cancer
What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
Bronchioloalveolar carcinoma
What disorder is associated with spider angiomas, palmar erythema, gynecomastia, testicular atrophy, encephalopathy, abnormalities in clotting factors, and portal HTN?
Cirrhosis
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Alkylating agents
Leukemias and lymphomas
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 X-linked recessive disorder that is due to an abnormality in the 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 condition results in the following CSF results? • Opening pressure 250 mm H2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100
TB meningitis
What estrogen-producing tumor of the female genital tract is characterized by Call-Exner bodies?
Granulosa cell tumor of the ovary
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Asbestos
Mesothelioma and bronchogenic carcinoma
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Nitrosamines
Gastric cancer
What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
Heroin
What pancreatic islet cell tumor is associated with hypoglycemia, sweating, hunger, confusion, and increased C-peptide levels?
Insulinoma
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Polycyclic aromatic hydrocarbons
Bronchogenic carcinoma
What condition results in the following CSF results? • Opening pressure 70 to 180 mm H2O; 0-10 WBCs (monocytes); glucose 45 to 85, protein 15 to 45
Normal values
What catecholamine-hypersecreting tumor, a secondary cause of HTN, results in headache, diaphoresis, anxiety, tachycardia, and palpitations?
Pheochromocytoma
What CD4 T-cell receptor does the HIV virus bind to?
gp120
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
What liver tumor is associated with oral contraceptive pill use?
Hepatic adenomas
What two Abs are used to diagnose Hashimoto's thyroiditis?
Antithyroglobulin and antimicrosomal Abs
Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and mucocutaneous neuromas
MEN III (or IIb)
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Aromatic amines and azo dyes
Hepatocellular carcinoma
What X-linked recessive disease involves mental retardation, self-mutilation, choreoathetosis, spasticity, a decrease in HGPRT, and an increase in uricemia?
Lesch-Nyhan syndrome
What is the term for thickened, hyperpigmented skin in the axillae, groin, and skin folds associated with malignancies, obesity, and DM?
Acanthosis nigricans
What is the term for flattened nose, low-set ears, and recessed chin seen in patients with bilateral renal agenesis?
Potter facies
What substance is used to test platelets' response in patients with von Willebrand disease?
Ristocetin
What are the two most common viral infections in HIV?
CMV retinitis and HSV-2
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Chromium and nickel
Bronchogenic carcinoma
What organ must metastasize for carcinoid heart disease to occur?
Liver
Which subset of MEN syndrome is associated with the following? • Parathyroid, pancreatic, and pituitary gland tumors and Zollinger-Ellison syndrome
MEN I (or Wermer syndrome)
How many grams of protein must be excreted in 24 hours to produce the diagnosis of nephrotic syndrome?
>3.5 g/day of protein, along with generalized edema, hypoalbuminemia, and hyperlipidemia
What disease involves a lack of both T cell-mediated and humoral immune responses that can be either X-linked or AR?
Severe combined immunodeficiency disease
What is your diagnosis of a young, thin asymptomatic female with a midsystolic click on cardiac auscultation?
Mitral valve prolapse
Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone, whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
What type of healing occurs in a clean surgical incision?
Primary intention
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Arsenic
Squamous cell carcinoma (skin, lung) and angiosarcoma of the liver
What is the term for RBC fragments?
Schistocytes
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Benzenes
Leukemias
Section 4
(50 cards)
What is released from the mitochondria to trigger apoptosis?
Cytochrome c
What virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma?
EBV
What enzyme is deficient in alkaptonuria?
Homogentisic oxidase
What is the most common infectious agent in HIV?
Pneumocystis carinii
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)
How much of a vessel must be stenosed to cause sudden cardiac death?
More than 75% of the vessel
What are the three Bs of adult polycystic kidneys?
1. Big 2. Bilateral 3. Berry aneurysm
What disorder of bone remodeling results in thick, weak bones and is associated with high-output cardiac failure?
Paget disease (osteitis deformans)
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?
Seminoma
What are the five components of portal HTN?
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
Prader-Willi syndrome and Angelman syndrome, respectively
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)
Name the nephritic disease based on the immunofluorescent staining. • Mesangial deposits of IgA and C3
IgA nephropathy (Berger disease)
What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies?
Meningioma
What is the term to describe the increase in organ size due to the increase in cell size and function?
Hypertrophy
What CNS tumor arises from Rathke's pouch?
Craniopharyngioma
What prostaglandin is associated with maintaining patency of the ductus arteriosus?
PGE (along with low oxygen tension)
Name the nephritic disease based on the immunofluorescent staining. • Smooth and linear pattern of IgG and C3 in the GBM
Goodpasture disease
What form of hemophilia is X-linked recessive and due to a deficiency in factor VIII?
Hemophilia A
Name the nephritic disease based on the immunofluorescent staining. • Granular deposits of IgG, IgM, and C3 throughout the glomerulus
Postinfectious GN
Eating fava beans can produce the Mediterranean type of what deficiency?
G-6-PD deficiency
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 is the triad of Reiter syndrome?
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see, can't wee, can't kick with your knee
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 law states that an enlarged, palpable gallbladder is more likely due to cancer than stone obstruction?
Courvoisier's law
What urinary metabolite is increased in patients with carcinoid syndrome?
5-hydroxyindoleacetic acid (5-HIAA)
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 is the most common primary malignant tumor in bone?
Osteosarcoma
What does prepubertal hypersecretion of growth hormone lead to?
Gigantism
Does ELISA or Western blot confirm whether a patient is HIV-positive?
ELISA screens and Western blot confirms the diagnosis.
What virus is associated with body cavity large B-cell lymphomas?
HHV-8
What type of hemostasis in an intravascular space consists of fibrin, platelets, RBCs, and WBCs?
Thrombus
Oxidation of Hgb forms what bodies in patients with G-6-PD deficiency?
Heinz bodies
True or false? Ethyl alcohol induces the cytochrome P-450 enzymes.
True
What is the term for excessive amounts of granulation tissue that can block re-epithelialization and wound healing?
Proud flesh
What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints?
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
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 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
Name four major risk factors for atherosclerosis.
DM, hypercholesterolemia, smoking, and HTN are major risk factors. Being male, obesity, sedentary lifestyle, homocysteine elevation, oral contraceptive pills, and genetics are minor risk factors for atherosclerosis.
What is the term for air in the pleural space?
Pneumothorax
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.
Marfan syndrome
What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
LC4, LD4, and LE 4
What normochromic, normocytic AD anemia has splenomegaly and increased osmotic fragility?
Hereditary spherocytosis
What sex cell tumor causes precocious puberty, masculinization, gynecomastia in adults, and crystalloids of Reinke?
Leydig cell tumor
What form of anemia is associated with IgG Abs against Rh antigens, positive direct Coombs test, and splenomegaly?
Autoimmune hemolytic anemia
What GN is highly associated with hepatitis B and C infections?
Membranoproliferative glomerulonephritis (MPGN)
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?
Crohn disease
What myeloid disorder is characterized by dry bone marrow aspirations, splenomegaly, leukoerythroblastosis, teardrop RBCs, and hyperuricemia due to increased cell turnover?
Myelofibrosis with myeloid metaplasia
What is the term for dilated veins within the spermatic cord?
Varicocele
What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
Primary sclerosing cholangitis
Section 5
(50 cards)
What pneumoconiosis is associated with exposure to the following occupations or materials? • Aerospace industry, nuclear reactors
Berylliosis
True or false? Obesity, DM, HTN, multiparity, early menarche, and late menopause 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 leading cause of preventable premature death and illness in the United States?
Smoking
What pancreatic islet cell tumor is associated with watery diarrhea, hypokalemia, and achlorhydria?
VIPoma
What carcinoma produces hematuria, flank pain, and a palpable mass?
This is the triad of renal cell carcinoma
Name the type of exudate, given the following examples. • Rickettsial infection
Hemorrhagic exudates
What protein deficiency results in respiratory distress syndrome of newborns?
Deficiency in surfactant
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?
ALL
What protein causes fibrinolysis?
Plasmin
What are the three components of amyloid?
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
Name the type of exudate, given the following examples. • Parasitic infection
Eosinophilic exudates
What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
Porcelain gallbladder
What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?
Lisch nodules
What parasite is associated with squamous cell carcinoma of the urinary bladder?
Schistosoma haematobium
Macro-ovalocytes in the peripheral blood smear are formed from what cell in the bone marrow?
Megaloblasts
What is the term for the copper corneal deposits found in Wilson's disease?
Kayser-Fleischer rings
What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur, humerus, and tibia?
Caisson disease
What is the most common fungal infection in HIV?
Candida
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.
Name the type of exudate, given the following examples. • Uremic pericarditis
Fibrinous exudates
Which hepatitis B Ab indicates low transmissibility?
HBeAb
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
Name the product or products of arachidonic acid: • Pain and fever
PGE2
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?
Cystadenocarcinoma
What malignant neoplasm of the skin is associated with keratin pearls?
Squamous cell carcinoma
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?
Crohn disease
What herpes virus is associated with Kaposi sarcoma?
HHV 8
What breast pathology involves malignant cells with halos invading the epidermis of the skin?
Paget disease of the breast
What prion-associated CNS pathology produces rapidly progressive dementia with myoclonus, involuntary movements, and death within 6 to 12 months?
Creutzfeldt-Jakob disease
Is the AD or AR form of osteopetrosis malignant?
The AR form is malignant and AD is benign.
What are the four DNA oncogenic viruses?
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
Name the type of exudate, given the following examples. • Diphtheria infection
Pseudomembranous exudates
Name the type of exudate, given the following examples. • Meningococcal infection
Purulent exudates
What malabsorption syndrome produces abdominal distention, bloating, flatulence, diarrhea, steatorrhea, and weight loss shortly after eating bread products?
Celiac sprue (gluten-sensitive enteropathy)
What pneumoconiosis is associated with exposure to the following occupations or materials? • Miners, metal grinders, and sandblasters
Silicosis Note: Coal worker's pneumoconiosis is synonymous with black lung disease, an upper lobe occupational disorder
Name the type of exudate, given the following examples. • Sunburn
Serous exudates
Name the product or products of arachidonic acid: • Vasodilation, bronchospasm, and increased vascular permeability
LTC4, LTD4, and LTE4
Name the product or products of arachidonic acid: • Vasoconstriction and platelet aggregation produced by platelets
TXA2
Name the product or products of arachidonic acid: • Vasodilation
PGD2, PGE2, and PGF 2
What pneumoconiosis is associated with exposure to the following occupations or materials? • Shipyards, brake linings, insulation, and old building construction
Asbestosis
Name the product or products of arachidonic acid: • Chemotactic for neutrophils
LTB4
Name at least 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 S, Sarcoidosis M, Multiple myeloma I, Immobilization/idiopathic D, Vitamin D intoxication T, Tumors
Name the product or products of arachidonic acid: • Vasodilation and inhibition of platelet aggregation produced by vascular endothelium
PGI2
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 these are buzzwords to look for dissection.
What is the only subtype of Hodgkin's lymphoma that is most commonly seen in females?
Nodular sclerosis
What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
Myasthenia gravis
What are the three left-to-right shunts?
1. VSD 2. ASD 3. PDA
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)
True or false? GERD is a cause of asthma.
True. Don't forget this in your differential diagnosis of an asthmatic.
Section 6
(50 cards)
What CNS tumor commonly produces tinnitus and hearing loss?
Schwannoma
Name the type of hypersensitivity reaction based on the following properties. • Reaction-mediated by sensitized T-cells
Type IV hypersensitivity (cell-mediated)
What gene stimulates apoptosis when DNA repair is unable to be done?
p-53
What form of poisoning is associated with bitter almond-scented breath?
Cyanide
What is the term for granuloma at the lung apex in TB?
Simon focus
What disease has multiple schwannomas, café-au-lait spots on the skin, and Lisch nodules and is associated with chromosome 17q?
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
PKU
True or false? Anticentromere Abs are used in diagnosing CREST syndrome.
True. Scl-70 Abs are used in diagnosing diffuse scleroderma.
What potent platelet aggregator and vasoconstrictor is synthesized by platelets?
TXA2
What is the main type of cell involved in cellular immunity?
T lymphocyte
What highly undifferentiated aggressive CNS tumor of primordial neuroglial origin develops in children and is associated with pseudorosettes?
Primitive neuroectodermal tumors (i.e., medulloblastomas and retinoblastomas)
How many café-au-lait spots are necessary for the diagnosis of neurofibromatosis type 1?
At least six
What condition is manifested by bilateral sarcoidosis of the parotid glands, submaxillary gland, and submandibular gland with posterior uveal tract involvement?
Mikulicz syndrome
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 is the term for cytoplasmic remnants of RNA in RBCs, seen in lead poisoning?
Basophilic stippling
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 autoimmune 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?
Sjögren's syndrome; SS-A (Ro) and SS-B (La)
What test uses p24 protein when diagnosing HIV?
ELISA test
What is the triad of fat embolism?
1. Petechiae 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 diagnose?
Gout
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.
What syndrome is due to Abs directed to presynaptic calcium channels and causes axial and girdle muscle weakness that improves with repeated use?
Eaton-Lambert syndrome
What is the leading cause of primary hyperparathyroidism?
Chief cell adenoma (80%)
What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
Volvulus
What foci of fibrinoid necrosis are surrounded by lymphocytes and macrophages throughout all the layers of the heart?
Aschoff bodies of rheumatic fever
What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?
Waterhouse-Friderichsen syndrome
What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
Syphilitic
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 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 is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb-containing area?
Target cell
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.
In what X-linked recessive disease is there a decrease in the HMP shunt, along with Heinz body formation?
G-6-PD deficiency
Name the type of hypersensitivity reaction based on the following properties. • IgG or IgM Abs against a specific target cell or tissue; complement-dependent or ADCC.
Type II hypersensitivity (cytotoxic)
What is the term for severe and protracted vomiting resulting in linear lacerations at the gastroesophageal junction?
Mallory-Weiss syndrome
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?
Wilms tumor
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?
Friedreich ataxia
Name four chemotactic factors for neutrophils.
N-formyl-methionine LTB4 C5a IL-8
What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?
Metastatic calcification
What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
Intraductal papilloma
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
Is ulcerative colitis or Crohn disease more commonly associated with primary sclerosing cholangitis?
Ulcerative colitis
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)
What syndrome is due to anti-GBM Abs directed against the lung and kidneys?
Goodpasture syndrome
What are the three platelet aggregating factors?
1. ADP 2. PG 3. TXA2
Which type of cerebral herniation is associated with CN III palsy?
Transtentorial (uncal)
Name the type of hypersensitivity reaction based on the following properties. • 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)
In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
Malignant mesothelioma
What form of hemophilia is X-linked recessive and is due to a deficiency in factor IX?
Hemophilia B
What are the two reasons for megaloblastic anemia with elevated MCV?
Vitamin B12 deficiency and folate deficiency
Section 7
(50 cards)
What type of erythema do you see in • Rheumatic fever?
Erythema marginatum
What leukemia is associated with four-leaf-clover lymphocytes on peripheral blood smear?
Adult T-cell leukemia
What type of erythema do you see in • Stevens-Johnson syndrome?
Erythema multiforme
True or false? Blood clots lack platelets.
True. A thrombus has platelets, but clots do not.
Are the following major or minor Jones criteria of rheumatic fever? • Sydenham chorea
Major
What syndrome has loss of deep tendon reflexes, muscle weakness, and ascending paralysis preceded by a viral illness?
Guillain-Barré syndrome
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?
Oligodendroglioma
Are the following major or minor Jones criteria of rheumatic fever? • Erythema marginatum
Major
What malignant tumor of the skin is associated with Birbeck granules?
Histiocytosis X
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)
Name the four right-to-left congenital cardiac shunts.
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
What ring is a weblike narrowing of the gastroesophageal junction?
Schatzki ring
Are the following major or minor Jones criteria of rheumatic fever? • Arthralgias
Minor
What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
Amanita phalloides
What are the three main components of amyloid?
Fibrillary protein, amyloid protein, and glycosaminoglycans (heparin sulfate mainly)
Goodpasture Ag is a component of what type of collagen?
Type IV collagen
Are the following major or minor Jones criteria of rheumatic fever? • Pericarditis
Major
What parasitic infection is associated with cholangiocarcinoma?
Clonorchis sinensis
Are the following major or minor Jones criteria of rheumatic fever? • Migratory polyarthritis
Major
Are the following major or minor Jones criteria of rheumatic fever? • Subcutaneous nodules
Major
What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?
Bcl-2
Are the following major or minor Jones criteria of rheumatic fever? • Fever
Minor
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.
What cancer is particularly likely to affect English chimney sweeps?
Scrotal cancer, due to the high exposure to polycyclic aromatic hydrocarbons
What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
Melasma
Are the following major or minor Jones criteria of rheumatic fever? • Elevated acute phase reactants (e.g., ESR)
Minor
Which hepatitis strain is a defective virus that can replicate only inside HBV-infected cells?
Hepatitis D
What type of erythema do you see in • Ulcerative colitis?
Erythema nodosum
What form of endocarditis do patients with SLE commonly encounter?
Libman-Sacks endocarditis
What is the classic triad of TB?
Fever, night sweats, and hemoptysis
What is the term for telescoping of the proximal bowel into the distal segment presenting as abdominal pain, currant jelly stools, and intestinal obstruction?
Intussusception
What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100, 00); decreased LAP levels; and nonspecific symptoms of fatigue, malaise, weight loss, and anorexia?
CML
With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
Henoch-Schönlein purpura
What is the lecithin:sphingomyelin ratio in respiratory distress syndrome of newborns?
<2
What is the term for black pigmentation of the colon associated with laxative abuse?
Melanosis coli
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)
What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate?
Hypoparathyroidism
What benign bone tumor is associated with Gardner syndrome?
Osteoma
What rapidly progressive and aggressive T-cell lymphoma affects young males with a mediastinal mass (thymic)?
Lymphoblastic lymphoma
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.
With which pituitary adenoma is an elevated somatomedin C level associated?
GH-producing adenoma
What is the term for a raised fluid-filled cavity greater than 0.5 cm that lies between the layers of the skin?
Bulla
What type of acute metal poisoning involves stomach and colon erosion and acute tubular necrosis?
Mercury
What type of anemia is the result of a deficiency in intrinsic factor?
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
What three criteria allow you to differentiate an ulcer from an erosion or carcinoma?
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
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?
Waldenström's macroglobulinemia
What virus is associated with the endemic form of Burkitt lymphoma?
EBV
What renal calculus is associated with urea-splitting bacteria?
Magnesium ammonium phosphate (struvite)
What disorder is associated with loss of polarity, anaplasia, pleomorphism, discohesiveness, increase in the nuclear:cytoplasmic ratio, hyperchromasia, and increase in the rate of mitosis?
Malignancy
In what disease do you see horseshoe kidneys, rockerbottom feet, low-set ears, micrognathia, and mental retardation?
Edward syndrome (trisomy 18)
Section 8
(50 cards)
What vitamin deficiency may result in sideroblastic anemia?
Vitamin B6
What is the term for chronic necrotizing pulmonary infections resulting in permanent airway dilation and associated with Kartagener syndrome?
Bronchiectasis
What disease is diagnosed by findings of ANAs and anti-SCL-70 antibodies?
Scleroderma
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 disease with familial mental retardation produces large, everted ears and macro-orchidism?
Fragile X syndrome
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.
How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?
At least 5 lobes
What syndrome is rheumatoid arthritis with pneumoconiosis?
Caplan syndrome
What atypical pneumonia can be diagnosed with elevated cold agglutinin titers?
Mycoplasma pneumoniae
What is the term for gastric ulcers associated with severely burned or traumatic patients?
Curling ulcers (think curling iron = burn)
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Pancreas
Stable
IgE-mediated mast cell release, C3a and C5a, and IL-1 all trigger the release of what vasoactive amine?
Histamine
What type of skin carcinoma occurring on sun-exposed sites has a low level of metastasis?
Squamous cell carcinoma
What is the term for panhypopituitarism secondary to ischemic necrosis and hypotension postpartum?
Sheehan 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 precipitation of calcium phosphate in dying or necrotic tissue?
Dystrophic calcification
Influx of what ion is associated with irreversible cell injury?
Massive influx of calcium
What is the tetrad of tetralogy of Fallot?
VSD, RVH, overriding aorta, and pulmonary stenosis
What small- to medium- sized vasculitis is seen in a 35-year-old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities?
Buerger disease (thromboangiitis obliterans)
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)
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 is the name of the ovarian cyst containing ectodermal, endodermal, and mesodermal elements (i.e., skin, hair, teeth and neural tissue)?
Teratoma (dermoid cyst)
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Skeletal muscle
Permanent
What syndrome is seen in iron-deficient middle-aged women with esophageal webs?
Plummer-Vinson syndrome
What disorder causes joint stiffness that worsens with repetitive motion, crepitus, effusions, and swelling and commonly affects the knees, hips, and spine?
Osteoarthritis
What congenital small bowel outpouching is a remnant of the vitelline duct?
Meckel diverticulum
What are the three causes of transudate?
CHF, cirrhosis, and nephrosis
What is the term for RBC remnants of nuclear chromatin in asplenic patients?
Howell-Jolly bodies
What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning?
Mees lines
What is the first sign of megaloblastic anemia on a peripheral blood smear?
Hypersegmented neutrophils
What is the term for gastric ulcers associated with increased intracranial pressure?
Cushing's ulcers
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 AD disorder is characterized by degeneration of GABA neurons in the caudate nucleus resulting in atrophy, chorea, dementia, and personality changes?
Huntington disease
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?
Ulcerative colitis
What is the tumor at the bifurcation of the right and left hepatic ducts?
Klatskin tumor
What condition is characterized by a 46XY karyotype, testes present, and ambiguous or female external genitalia?
Male pseudohermaphrodite (dude looks like a lady!)
What cell type involves humoral immunity?
B lymphocyte
What is the term for pelvic inflammatory disease of the fallopian tubes?
Salpingitis
What type of metal poisoning causes mental retardation, somnolence, convulsions, and encephalopathy?
Lead
What vascular tumor associated with von Hippel-Lindau syndrome involves the cerebellum, brainstem, spinal cord, and retina?
Hemangioblastoma
What is the term for TB with the cervical lymph node involved?
Scrofula
What is the triad of Felty syndrome?
Neutropenia, splenomegaly, and rheumatoid arthritis
What type of crystals are associated with gout?
Monosodium urate crystals
What pathology is associated with elevated levels of Ca2+, cardiac arrhythmias, bone resorption, kidney stones, and metastatic calcifications?
Primary hyperparathyroidism
What syndrome arises from mutation in the fibrillin gene (FBN1) on chromosome 15q21?
Marfan syndrome
What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation?
Chemotaxis
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Epidermis
Labile
If a peripheral blood smear shows schistocytes, reticulocytes, and thrombocytopenia, is it more commonly seen in patients with ITP or TTP?
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
Section 9
(50 cards)
What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?
Auspitz sign
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Osteoblasts
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states, do not proliferate.)
Name the cerebral vessel associated with the following vascular pathologies. • Epidural hemorrhage
Middle meningeal artery
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 ɑ-1-iduronidase is deficient? L-iduronate sulfatase deficiency?
Hurler syndrome and Hunter syndrome, respectively
What potentially fatal disease occurs in children who are given aspirin during a viral illness?
Reye syndrome
What condition results in a strawberry gallbladder?
Cholesterolosis
What is the term for programmed cell death?
Apoptosis (Remember, there is a lack of inflammatory response.)
What illegal drug can cause rhabdomyolysis, MI, cerebral infarct, and lethal cardiac arrhythmias?
Cocaine
What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?
Medullary carcinoma of the thyroid
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)
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.
True or false? Live vaccines are contraindicated in patients with SCID.
True
What three chemical agents are associated with angiosarcomas of the liver?
Arsenic, thorotrast, and vinyl chloride
What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
Fitz-Hugh-Curtis syndrome
What endogenous pigment found in the substantia nigra and melanocytes is formed by the oxidation of tyrosine to dihydroxyphenylalanine?
Melanin
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.
What glycoprotein allows platelets to adhere to von Willebrand factor?
GP Ib
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Hematopoietic cells
Labile
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?
Huntington disease
Name the cerebral vessel associated with the following vascular pathologies. • Subdural hemorrhage
Bridging veins draining into the sagittal sinus
What pattern of inheritance is G-6-PD deficiency?
X-linked recessive
What AA is substituted for glutamic acid at position 6 on the Beta-chain in patients with sickle cell anemia?
Valine
What adenocarcinoma presents with elevated levels of acid phosphatase, dihydrotestosterone, PSA, and bone pain?
Prostatic carcinoma
What tumor marker is associated with seminomas?
Placental alkaline phosphatase
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Kidney
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Fibroblasts
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Smooth muscle
Stable
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)
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • CNS neurons
Permanent
What encephalitis is associated with the JC virus?
Progressive multifocal leukoencephalopathy
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Mucosal epithelium
Labile
What metal poisoning produces microcytic anemia with basophilic stippling?
Lead poisoning
Which integrin mediates adhesion by binding to lymphocyte function- associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
Intercellular adhesion molecule (ICAM) 1
What cell type is commonly elevated in asthma?
Eosinophil
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 type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?
Hgb F
What inflammatory bowel disorder is continuous, with extensive ulcerations and pseudopolyps, and is associated with HLA-B27?
Ulcerative colitis
What is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs?
CHF
Name the cerebral vessel associated with the following vascular pathologies. • Subarachnoid hemorrhage
Berry aneurysm in the circle of Willis
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Liver
Stable
What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
Pseudogout
What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
Astrocytoma
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.)
True or false? Patients with Turner syndrome have no Barr bodies.
True. Remember, the second X chromosome is inactivated, and so is the Barr body. Turner syndrome has only one X chromosome.
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)
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Cardiac muscle
Permanent
What oxygen-dependent killing enzyme requires hydrogen peroxide and halide (Cl-) to produce hypochlorous acid?
Myeloperoxidase
Is Dubin-Johnson or Rotor syndrome associated with black pigmentation of the liver?
Both are AR with conjugated hyperbilirubinemia, but Dubin-Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
What is the term for the round intracytoplasmic eosinophilic inclusions containing ɑ-synuclein found in the dopaminergic neurons of the substantia nigra?
Lewy bodies
Section 10
(50 cards)
What CNS developmental abnormality is associated with 90% of syringomyelia?
Arnold-Chiari malformation type 2
What is the term for ascending bacterial infection of the renal pelvis, tubules, and interstitium causing costovertebral angle tenderness, fever, chills, dysuria, frequency, and urgency?
Pyelonephritis
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 is a palpable, elevated solid mass up to 0.5 cm?
Papule
What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
Klinefelter syndrome
What are the four most common causes of femoral head necrosis?
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
What chemical can be dangerous if you work in the aerospace industry or in nuclear plants?
Beryllium
What disease involves cold skin abscesses due to a defect in neutrophil chemotaxis and a serum IgE level higher than 2000?
Job syndrome
What are the four signs of acute inflammation?
Rubor (red), dolor (pain), calor (heat), tumor (swelling); also sometimes there is loss of function
What do the risk factors late menopause, early menarche, obesity, nulliparity, excessive estrogen, genetic factor p53, and brc-abl characterize?
Breast cancer
What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile, ischemia, Staphylococcus, Shigella, or Candida infection?
Pseudomembranous colitis
What syndrome is associated with gastrin-producing islet cell tumor resulting in multiple intractable peptic ulcers?
Zollinger-Ellison syndrome
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Acute infection
HBcAb IgM, HBV-DNA, HBeAg, HBsAg
Name the type of necrosis. • The most common form of necrosis; denatured and coagulated proteins in the cytoplasm
Coagulative necrosis
What type of neurofibromatosis is associated with bilateral acoustic schwannomas?
Type 2
Which form of melanoma carries the worst prognosis?
Nodular melanoma
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 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 question more times than I would like to remember.)
What viral infection in patients with sickle cell anemia results in aplastic crisis?
Parvovirus B 19
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Immunization
HBsAb IgG
What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
Boutonnière deformities
Which form of emphysema is associated with an alpha1-antitrypsin deficiency?
Panacinar
Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, TIBC, and percent saturation; increased ferritin
Anemia of chronic disease
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)
Name the hypochromic microcytic anemia based on the following laboratory values. • Normal iron, TIBC, percent saturation, and ferritin
Thalassemia minor
True or false? Atelectasis is an irreversible collapse of a lung.
False. Atelectasis is a reversible collapse of a lung.
Name the hypochromic microcytic anemia based on the following laboratory values. • Increased iron, decreased TIBC, increased percent saturation, increased ferritin
Sideroblastic anemia
What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
Onion skinning
What type of collagen is associated with keloid formation?
Type III
Patients with sickle cell anemia are at increased risk for infection from what type of organisms?
Encapsulated bacteria
What pathology is associated with podagra, tophi in the ear, and PMNs with monosodium urate crystals?
Gout
The "tea-and-toast" diet is classically associated with what cause of megaloblastic anemia?
Folate deficiency (very common in the elderly)
What thyroid carcinoma is associated with radiation exposure, psammoma bodies, and Orphan Annie eye nuclei?
Papillary carcinoma of the thyroid
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Chronic infection
HBcAb IgG, HBV-DNA, HBeAg, HBsAg
What is the karyotype in Turner syndrome?
45XO
Which phenotype of osteogenesis imperfecta is incompatible with life?
Type II
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 the patient is likely to develop malignant lymphoma?
Wiskott-Aldrich syndrome
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 pregnancy.
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)
With what is cherry red intoxication associated?
Acute CO poisoning
What female pathology is associated with endometrial glands and stroma outside the uterus commonly affecting the ovaries as chocolate cysts?
Endometriosis
What Hgb-derived endogenous pigment is found in areas of hemorrhage or bruises?
Hemosiderin
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 suppression.
What disorder is due to a deficiency in the enzyme glucocerebrosidase?
Gaucher disease
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Window period
HBcAb IgM
True or false? Monocytosis is seen in TB.
True
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Prior infection
HBcAb IgG and HBsAb IgG
Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, percent saturation, and ferritin; increased TIBC
Iron deficiency anemia
Name three opsonins.
Fc portion of IgG, C3b, and mannose-binding proteins
Which hepatitis B Ag correlates with infectivity and viral proliferation?
HBeAg
Section 11
(50 cards)
What is the term for inflamed, thickened skin on the breast with dimpling associated with cancer?
Peau d'orange
What form of arthritis is associated with calcium pyrophosphate crystals?
Pseudogout
What stromal tumor in males is characterized histologically with crystalloids of Reinke?
Leydig cell tumor
What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition?
Minimal change disease
Name the type of necrosis. • Histologically resembles fibrin
Fibrinoid necrosis
Name the type of necrosis. • Seen as dead tissue with liquefactive necrosis?
Liquefaction necrosis
What is the name for the following RBC indices? • Average Hgb concentration/given volume of packed RBCs
Mean corpuscular hemoglobin concentration (MCHC)
What cancer of the male genitourinary system is associated with osteoblastic bony metastasis?
Prostatic carcinoma
Name the type of necrosis. • Due to lipase activity and has a chalky white appearance
Fat necrosis
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 aneurysm of the circle of Willis is associated with polycystic kidney disease?
Berry aneurysm
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 malignant neoplasm of the bone has a soap bubble appearance on radiograph?
Giant cell bone tumor (osteoclastoma)
Name the three enzymes that protect the cell from oxygen-derived free radicals.
Superoxide dismutase, glutathione peroxidase, catalase
What is the name for the following RBC indices? • Average volume of a RBC
Mean corpuscular volume (MCV)
What is the term for excessive production of collagen that flattens out and does not extend beyond the site of the injury?
Hypertrophic scar
Name the type of necrosis. • Soft, friable, cottage-cheese appearing; characteristically seen in TB
Caseous necrosis
What chronic systemic inflammatory disease commonly seen in women aged 20 to 50 is a progressive, symmetric arthritis affecting the hands, wrists, knees, and ankles that improves with increased activity?
Rheumatoid arthritis
What is the name for the following RBC indices? • The coefficient of variation of the RBC volume
Red blood cell distribution width index (RDW)
What X-linked recessive immune disorder is characterized by recurrent infections, severe thrombocytopenia, and eczema?
Wiskott-Aldrich syndrome
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
Name the type of necrosis. • Seen as dead tissue with coagulative necrosis
Gangrenous necrosis
What syndrome has multiple adenomatous colonic polyps and CNS gliomas?
Turcot syndrome
Name the following descriptions associated with bacterial endocarditis: • Painless hyperemic lesions on the palms and soles
Janeway lesions
Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
Embolic
Name the following descriptions associated with bacterial endocarditis: • Painful subcutaneous nodules on fingers and toes
Osler nodes
What retrovirus is associated with adult T-cell leukemia?
HTLV-1
Name the following descriptions associated with bacterial endocarditis: • Retinal emboli
Roth spots
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?
Poststreptococcal GN
What is the name for the following RBC indices? • Average mass of the Hgb molecule/RBC
Mean corpuscular hemoglobin (MCH)
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?
Hemochromatosis
Which HPV serotypes are associated with condyloma acuminatum?
HPV serotypes 6 and 11
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.
Which form of melanoma carries the best prognosis?
Lentigo maligna melanoma
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?
Ménétrier's disease
What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
Osteosarcoma
What is the term for tissue-based basophils?
Mast cells
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.
What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities, red cell aplasia, and muscle weakness?
Myasthenia gravis
What two CD cell surface markers do Reed- Sternberg cells stain positive for?
CD15 and CD30
Which subtype of AML is most commonly associated with Auer rods?
M3 (promyelocytic leukemia)
What condition results from a 46XX karyotype and female internal organs with virilized external genitalia?
Female pseudohermaphrodite
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?
Emphysema
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)
What two lysosomal storage diseases have cherry-red spots on the retina?
Niemann-Pick and Tay-Sachs diseases
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 cheeks. 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? Increased leukocyte alkaline phosphatase (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 AR disorder is due to a deficiency in glycoprotein IIb-IIIa, resulting in a defect in platelet aggregation?
Glanzmann syndrome
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?
Wegener granulomatosis
Section 12
(50 cards)