Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
227 Cards in this Set
- Front
- Back
|
Q: Most common cause of abdominal aortic aneurysm
|
A: Atherosclerosis (often associated with mutation in LDL receptor in familial hyperchloesterolemia)
|
|
|
Q: Sudden onset of excruciating substernal pain, often confused with myocardial infarction
|
A: Dissecting aortic aneurysm (caused by cystic medial necrosis, more common in Marfan syndrome)
|
|
|
Q: Vasculitis of the elderly, presenting as headache, facial pain, and/or impaired vision
|
A: Giant cell (temporal) arteritis (most common vasculitis, affecting branches of the carotid artery)
|
|
|
Q: Vast majority of cases are idiopathic, although they may be secondary to renal disease
|
A: Hypertension (other secondary causes include primary hyperaldosteronism, Cushing syndrome, and pheochromocytoma)
|
|
|
Q: Rapidly precipitating hypertension in an African American male with papilledema and retinal hemorrhages
|
A: Malignant hypertension (histologically characterized by hyperplastic arteriolosclerosis or "onion-skin" thickening of arterial walls)
|
|
|
Q: Pallor or cyanosis of fingers and toes caused by recurrent vasospasm of arterioles, often in young, healthy women
|
A: Raynaud disease (reaction to cold or emotion)
|
|
|
Q: Vasculitis primarily affecting the tibial and radial arteries
|
A: Thromboangiitis obliterans (Buerger disease) - associated with cigarette smoking
|
|
|
Q: Concentric hypertrophy of the left ventricle
|
A: Aortic stenosis or Hypertensive heart disease (occurs in response to left ventricular pressure overload)
|
|
|
Q: Congenital abnormality predisposing to calcify aortic stenosis
|
A: Bicuspid aortic valve
|
|
|
Q: Right heart failure due to intrinsic lung disease or primary disease of pulmonary vasculature
|
A: Chronic cor pulmonale
|
|
|
Q: Upper extremity hypertension with lower extremity hypotension
|
A: Coarctation of the aorta (postductal) - can radiologically detect notching of the ribs caused by enlargement of intercostal and internal mammary arteries
|
|
|
Q: Associated with cocaine abuse, alcohol abuse, and pregnancy; can also be idiopathic
|
A: Dilated cardiomyopathy (heart may be 3 times heavier than normal with dilation of all four chambers)
|
|
|
Q: Haphazard disarray of cardiac myofibrils
|
A: Hypertrophic cardiomyopathy (autosomal dominant mutation in the myosin heavy chain gene)
|
|
|
Q: Bulky, friable, nonsterile vegetations with the potential to embolize
|
A: Infective (bacterial) endocarditis (often caused by Strep viridans infection of mitral valve, or Staph aureus infection of tricuspid valve in IV drug users)
|
|
|
Q: Dyspnea, orthopnea, and paroxysmal nocturnal dyspnea caused by congestion of the lungs
|
A: Left heart failure
|
|
|
Q: Midsystolic click followed by a late systolic murmur
|
A: Mitral valve prolapse (most common valvular heart disease in the U.S., especially in young women; also associated with Marfan syndrome)
|
|
|
Q: Crushing or squeezing, substernal pain radiating down the left arm
|
A: Myocardial infarction (serum findings include elevated cardiac Troponins, CK-MB, and LDH)
|
|
|
Q: Causes include Coxsackie viruses A and B and Trypanosoma cruzi
|
A: Myocarditis
|
|
|
Q: Ball valve obstruction by left atrial mass
|
A: Myxoma (most common primary tumor of the heart in adults)
|
|
|
Q: Friable, sterile emboli caused by hypercoagulable states
|
A: Nonbacterial thrombotic (marantic) endocarditis (associated with disseminated intravascular coagulation and adenocarcinoma of the pancreas)
|
|
|
Q: Harsh waxing and waning murmur (machinery murmur)
|
A: Patent ductus arteriosus (closed with indomethacin administration, which decreases prostaglandin E levels)
|
|
|
Q: Friction rub
|
A: Pericarditis (causes include infections, rheumatic fever, myocardial infarction and uremia)
|
|
|
Q: Associated with cardiac amyloidosis, radiation injury, and sarcoidosis
|
A: Restrictive cardiomyopathy (manifests as decreased ventricular filling owing to reducing ventricular compliance)
|
|
|
Q: Migratory polyarthritis, erythema marginatum, subcutaneous nodules, Sydenham chorea, and pancarditis
|
A: Rheumatic Fever (Aschoff bodies in the myocardium are pathognomonic)
|
|
|
Q: Sequela of acute rheumatic fever
|
A: Rheumatic heart disease (fish mouth deformity from fusion of commissures; most common is mitral stenosis and then finally next most common is mitral and aortic stenosis)
|
|
|
Q: Peripheral edema, splenomegaly, and nutmeg liver
|
A: Right heart failure
|
|
|
Q: Precordial pain on exertion or increased cardiac workload, but relieved by rest
|
A: Stable angina (caused by decreased coronary artery flow from atherosclerotic narrowing)
|
|
|
Q: Right to left shunts
|
A: Tetralogy of Fallot (most common), transposition of the great vessels, and persistent truncus arteriosus (early cyanosis)
|
|
|
Q: Prolonged or recurrent chest pain with increasing frequency, often at rest
|
A: Unstable (Crescendo, Preinfarction) angina - (a developing myocardial infarction)
|
|
|
Q: Most common congenital heart defect
|
A: Ventricular septal defect (may require surgical correction at birth, or if small, may close spontaneously)
|
|
|
Q: Leukemia most common in younger patients
|
A: ALL (acute lymphoblastic leukemia) - (peripheral blood smear shows predominance of lymphoblasts that stain positive for terminal deoxytransferase (TdT))
|
|
|
Q: Predominance of myeloblasts (sometimes with Auer rods) or early promyelocytes in the peripheral blood
|
A: AML (acute myeloid leukemia; auer rods = abnormal azurophilic granules in the cytoplasm, most abundant in M3 variant)
|
|
|
Q: t(15;17), resulting in PML-RAR alpha fusion protein
|
A: AML (acute myeloid leukemia); M3 variant (fusion gene encodes an abnormal retinoic acid receptor, blocking myeloid differentiation; treated with all-trans retinoic acid which induces cells to differentiate)
|
|
|
Q: Markedly hypocellular marrow
|
A: Aplastic anemia (often associated with chloramphenicol use)
|
|
|
Q: t(8;14)
|
A: Burkitt lymphoma (c-myc expression under the control of the Ig heavy chain gene)
|
|
|
Q: Marrow fibrosis with extensive extramedullary hematopoiesis and teardrop cells in peripheral blood
|
A: Chronic idiopathic myelofibrosis with myeloid metaplasia (agnogenic myeloid metaplasia)
|
|
|
Q: Smudge cells
|
A: CLL (chronic lymphocytic leukemia) - fragile lymphocytes destroyed or "smudged" during preparation of peripheral smear
|
|
|
Q: t(9;22)
|
A: CML (chronic myelogenous leukemia) - Philadelphia chromosome; creates bcr-abl fusion protein with increased tyrosine kinase activity
|
|
|
Q: Concomitant widespread microvascular thrombosis and hemorrhage due to consumption coagulopathy
|
A: DIC (disseminated intravascular coagulation) - Increase in fibrin split products and depletion of platelets and labile clotting factors II, VIII and fibrinogen
|
|
|
Q: Most common heritable cause of coagulability
|
A: Factor V Leiden (Hereditary resistance to activated Protein C)
|
|
|
Q: X-linked bleeding disorders
|
A: Factor VIII deficiency (classic hemophilia) and Factor IX deficiency (Christmas disease) - Prolonged partial thromboplastin time but normal bleeding time, platelet count, and prothrombin time in both diseases.
|
|
|
Q: t(14;18)
|
A: Follicular lymphoma (Most common form of non-Hodgkin lymphoma; expression of bcl-2 under the Ig heavy chain promoter)
|
|
|
Q: Drug sensitivity hemolytic anemia (i.e., primaquine, chloroquine, sulfonamides, nitrofurantoins)
|
A: Glucose-6-phosphate dehydrogenase (G6PD) deficiency (X-linked; common, especially in African and Mediterranean populations)
|
|
|
Q: Tumor cells with tartrate-resistant acid phosphatase (TRAP) and fine hair-like cytoplasmic projections
|
A: Hairy cell leukemia
|
|
|
Q: Synthesis of structurally abnormal globin chains
|
A: Hemoglobinopathies (i.e., Sickle cell anemia and hemoglobin C disease)
|
|
|
Q: Reticulocytosis and polychromatophilia with disappearance of serum haptoglobin
|
A: Hemolytic anemia (Haptoglobin is a hemoglobin-binding protein)
|
|
|
Q: Most common inherited hemolytic anemia in persons of northern European lineage
|
A: Hereditary spherocytosis (Usually autosomal dominant inheritance; most commonly ankyrin mutation leading to spectrin deficiency)
|
|
|
Q: Reed-Sternberg cells
|
A: Hodgkin disease (Binucleated giant cells with inclusion-like nucleoli)
|
|
|
Q: Target cells, splenomegaly, and a mild hemolytic anemia in African Americans
|
A: Homozygous hemoglobin C disease (Target cells may also be found in thalassemias)
|
|
|
Q: Hypochromic microcytic anemias
|
A: Iron deficiency anemia, thalassemia minor, and anemia of chronic disease
|
|
|
Q: Hypersegmented polys and hypercellular marrow
|
A: Megaloblastic anemia (Folate or vitamin B12 deficiency leads to defects in DNA synthesis, with accumulation of megaloblasts due to nuclear maturation problems)
|
|
|
Q: Punched out lytic bone lesions of the spine, cranium and ribs
|
A: Multiple myeloma (Peripheral blood smear may show rouleaux formation of RBC caused by hyperglobulinemia)
|
|
|
Q: Propensity for lower cervical, supraclavicular, and medistinal lymph nodes
|
A: Nodular sclerosis Hodgkin lymphoma (Only Hodgkin variant more common in females)
|
|
|
Q: Anti-parietal cell and anti-intrinsic factor antibodies with achlorhydria
|
A: Pernicious anemia (Parietal cells produce HCl and intrinsic factor; IF is required for vitamin B12 absorption in the terminal ileum)
|
|
|
Q: Leg ulcers and recurrent painful crises
|
A: Sickle cell anemia (homozygous HbSS disease) - patients also undergo autosplenectomy
|
|
|
Q: Reduced synthesis of structurally normal globin chains
|
A: Thalassemias (thalassemias are most common in Mediterranean populations)
|
|
|
Q: Vitamin deficiencies that result in bleeding disorders
|
A: Vitamin C deficiency, Vitamin K deficiency (Vitamin C is required for collagen synthesis and vessel integrity; Vitamin K is required for function of clotting factors II, VII, IX, and X)
|
|
|
Q: Most common hereditary bleeding disorder
|
A: von Willebrand disease (Prolonged partial thromboplastin time and bleeding time, but normal platelet count and prothrombin time)
|
|
|
Q: Positive direct Coombs test
|
A: Warm antibody hemolytic anemia (Differentiates warm antibody hemolytic anemia from hereditary spherocytosis)
|
|
|
Q: Most common bronchogenic carcinoma type in women and nonsmokers
|
A: Adenocarcinoma (Localize peripherally)
|
|
|
Q: Rapid onset of respiratory insufficiency refractory to oxygen therapy associated with sepsis, infections, aspiration, or trauma
|
A: Adult respiratory distress syndrome (diffuse alveolar damage) - Histologically characterized by intra-alveolar hyaline membranes
|
|
|
Q: Restrictive pulmonary diseases
|
A: Adult respiratory distress syndrome (diffuse alveolar damage), penumoconiosis, silicosis, sarcoidosis (Reduced total lung capacity because of decreased expansion of lung parenchyma)
|
|
|
Q: Harmless black pigment in the lungs
|
A: Anthracosis (Common in coal miners, urban dwellers, or smokers)
|
|
|
Q: Severe dyspnea, wheezing, hyperreactive airways, and bronchospasm triggered by various stimuli
|
A: Bronchial asthma (most commonly IgE mediated, Type I hypersensitivity reaction in the lung)
|
|
|
Q: Copious purulent sputum, hemoptysis, and recurrent lung infections which may lead to abscess
|
A: Bronchiectasis (bronchi and bronchioles can be dilated up to 4 times normal size)
|
|
|
Q: Neoplastic columnar and cuboidal epithelial cells that line the alveolar septa
|
A: Bronchioloalveolar carcinoma (tumor cells are also found loose in alveolar spaces)
|
|
|
Q: Persistant productive cough for at least 3 consecutive months in at least 2 consecutive years
|
A: Chronic bronchitis (Increased Reid index, which is a ratio of the thickness of mucous gland to the thickness of bronchiolar wall)
|
|
|
Q: Blue bloater
|
A: Chronic bronchitis (Cyanosis resulting from severe hypoxia)
|
|
|
Q: Heart failure cells
|
A: Chronic passive congestion of lung (Hemosiderin-laden macrophages)
|
|
|
Q: Pink puffer
|
A: Emphysema (Patient who overventilates and remains well-oxygenated)
|
|
|
Q: Dilation of air spaces with destruction of alveolar walls
|
A: Emphysema (Results from accelerated protease and elastase destruction of the lung)
|
|
|
Q: Chronic obstructive pulmonary disease (COPD)
|
A: Emphysema, chronic bronchitis, bronchiectasis, and bronchial asthma (Caused by airway narrowing or loss of elastic recoil of the lung, resulting in decreased forced expiratory volume at 1 second)
|
|
|
Q: Central region of caseating necrosis encircled by lymphocytes, plasma cells, and epithelioid cells
|
A: Granulomatous inflammation (Found in tuberculosis, fungal infections, and foreign body)
|
|
|
Q: Associated with asbestos exposure
|
A: Malignant mesothelioma (Neoplasm of visceral or parietal pleura or peritoneal neoplasm)
|
|
|
Q: Alpha-1-antitrypsin deficiency
|
A: Panacinar (panlobar) emphysema (Alpha-1-antitrypsin inhibits proteases, particularly elastase)
|
|
|
Q: Chills, fever, malaise, pleuritic pain, and rusty sputum
|
A: Pneumonia (More than 90% of lobar pneumonia is caused by Streptococcus pneumoniae; bronchopneumonia shows patchy consolidation)
|
|
|
Q: Cause of sudden death often in immobilized postoperative patients
|
A: Pulmonary embolism (Thrombi are most often from the deep veins of the lower extremities)
|
|
|
Q: Embolism obstructing the bifurcation of the pulmonary artery
|
A: Saddle embolus
|
|
|
Q: Noncaseating granulomas in the lungs often in a young, adult, African American female
|
A: Sarcoidosis (May be detected incidentally as bilateral hilar adenopathy)
|
|
|
Q: Most prevalent chronic occupational disease in the world
|
A: Silicosis
|
|
|
Q: Lung tumors with strongest correlation to smoking
|
A: Small cell carcinoma and Squamous cell carcinoma of the lung (Both types localize centrally near the hilus)
|
|
|
Q: Associated with SIADH and Cushing syndrome as paraneoplastic syndromes
|
A: Small cell carcinoma (Small cell carcinoma has the worst prognosis of bronchogenic carcinoma subtypes)
|
|
|
Q: Rupture of apical subpleural blebs in young patients
|
A: Spontaneous idiopathic pneumothorax
|
|
|
Q: Tumor associated with hypercalcemia due to elaboration of parathyroid hormone-related peptide (PTHrp)
|
A: Squamous cell carcinoma of the lung
|
|
|
Q: Fever, night sweats, weight loss, and hemoptysis
|
A: Tuberculosis (TB) - Ghon complex in primary TB (single lesion w/ hilar lymph involvement); multiple cavitary lesions in lung apices in secondary TB
|
|
|
Q: Difficulty swallowing due to increased tone of the lower esophageal sphincter
|
A: Achalasia (can be caused by destruction of the myenteric plexus in Chagas disease)
|
|
|
Q: Right lower quadrant pain, nausea, fever, and an elevated WBC
|
A: Acute appendicitis
|
|
|
Q: Serotonin elaboration causing flushing, diarrhea, bronchospasm, and right heart damage
|
A: Carcinoid syndrome (Carcinoid tumors of the appendix and rectum rarely metastasize)
|
|
|
Q: Increased CEA (carcinoembryonic antigen)
|
A: Carcinoma of the colon (Risk factor includes low fiber diet)
|
|
|
Q: Presents early as obstruction and crampy discomfort
|
A: Carcinoma of the rectosigmoid colon (Left-sided carcinoma)
|
|
|
Q: Fatigue, weakness, and iron deficiency anemia in older males
|
A: Carcinomas of the right colon (secondary to blood loss)
|
|
|
Q: Malabsorption that resolves upon withdrawal of wheat gliadins from the diet
|
A: Celiac sprue (Histologically characterized as flattening of the mucosal villi with inflammatory infiltrate)
|
|
|
Q: Persistent projectile vomiting usually appearing in the 2nd-3rd week of life
|
A: Congenital hypertrophic pyloric stenosis
|
|
|
Q: Skip lesions
|
A: Crohn disease (Discontinuous involvement of the intestinal mucosa visualized as a "string sign" on X-ray)
|
|
|
Q: Cobblestone appearance of the bowel mucosa
|
A: Crohn disease (Caused by inflammation and thickening of all three layers of the GI wall)
|
|
|
Q: Small sac-like outpouchings of the colon through the muscular wall, common in the elderly
|
A: Diverticulosis (Most commonly asymptomatic)
|
|
|
Q: Barrett esophagus is the only recognized precursor
|
A: Esophageal adenocarcinoma (Barrett esophagus = squamous to columnar metaplasia (specialized, intestinal type epithelium) in the distal esophagus)
|
|
|
Q: Can rupture producing massive hemorrhage into the esophageal lumen
|
A: Esophageal varices (often associated with portal hypertension, as in cirrhosis)
|
|
|
Q: 100% chance of colon cancer by midlife
|
A: Familial polyposis syndromes (Caused by autosomal dominant mutations in the APC gene with hundreds of adenomatous polyps carpeting the intestines)
|
|
|
Q: Signet ring cells
|
A: Gastric carcinoma, diffuse variant (Extensive infiltration of malignant cells can lead to linitis plastica or "leather bottle stomach"; metastasis bilaterally to the ovaries results in Krukenberg tumors)
|
|
|
Q: Weakness in the peritoneal wall allowing protrusions of bowel segments
|
A: Hernia
|
|
|
Q: Congenital absence of ganglion cells in the muscular or submucosal layers of the GI wall
|
A: Hirschsprung disease (congenital megacolon) - absence of ganglion cells is in the nondilated region of the colon
|
|
|
Q: Telescoping of one intestinal segment into another, usually in children
|
A: Intussusception
|
|
|
Q: Most common and innocuous congenital abnormality in the GI
|
A: Meckel diverticulum (failure of involution of the vitelline duct)
|
|
|
Q: Sharply punched out lesions in the stomach or duodenum
|
A: Peptic ulcer (Associated with NSAID use and Helicobacter pylori)
|
|
|
Q: Autosomal dominant disorder with multiple benign hamartomatous polyps and melanin pigmentation of the oral mucosa, hands, and genitals
|
A: Peutz-Jegher syndrome
|
|
|
Q: Recurs often and is difficult to completely resect because of proximity to the facial nerve
|
A: Pleomorphic adenoma (mixed tumor of the salivary gland) - most common salivary tumor
|
|
|
Q: Pseudomembranes consisting of fibrin, mucin, and inflammatory debris covering the colonic mucosa
|
A: Pseudomembranous colitis (caused by elaboration of exotoxins by Clostridium difficile)
|
|
|
Q: Toxic megacolon is a complication
|
A: Ulcerative colitis (destruction of neural plexus leading to massive dilation, gangrene, and imminent rupture of colon)
|
|
|
Q: Pseudopolyps
|
A: Ulcerative colitis (regenerating mucosal areas in the ulcerated mucosa and submucosa)
|
|
|
Q: Sudden right upper quadrant or epigastric pain with nausea, vomiting, and leukocytosis
|
A: Acute calculous cholecystitis (one of the most common indications for abdominal surgery)
|
|
|
Q: Micronodules on liver surface in early stages
|
A: Alcoholic cirrhosis
|
|
|
Q: Mallory bodies, neutrophilic infiltrate, and hepatocyte swelling and necrosis
|
A: Alcoholic hepatitis (mallory bodies = accumulation of cytokeratin intermediate filaments in hepatocytes)
|
|
|
Q: Most common liver disease in the U.S.
|
A: Alcoholic liver disease
|
|
|
Q: Fatal thrombotic occlusion of the hepatic veins associated with polycythemia vera and other hypercoagulable states
|
A: Budd-Chiari syndrome
|
|
|
Q: Obstructive jaundice with palpably enlarged gallbladder
|
A: Carcinoma of the head of the pancreas or carcinoma of the extrahepatic biliary ducts and ampulla of Vater (Courvoisier Law = obstructive jaundice with palpable gallbadder indicates probable tumor; jaundice with nonpalpable gallbladder indicates probable gallstones)
|
|
|
Q: Obese multiparous woman with fat intolerance
|
A: Cholelithiasis (gallstones)
|
|
|
Q: Grossly distended abdomen, esophageal varices, caput medusae, and hemorrhoids
|
A: Cirrhosis (caused by portal hypertension and active portocaval anastomoses
|
|
|
Q: Palmar erythema, spider angiomatas, and gynecomastia
|
A: Cirrhosis (all caused by hyperestrinism)
|
|
|
Q: Soft, yellow, greasy liver
|
A: Fatty liver (hepatic steatosis)
|
|
|
Q: Asterixis
|
A: Hepatic (portosystemic) encephalopathy (flapping tremor and neurologic sign, caused by nitrogenous metabolites which cannot be detoxified by the damaged liver)
|
|
|
Q: Most common primary malignancy of the liver
|
A: Hepatocellular carcinoma (often associated with Hepatitis B infection)
|
|
|
Q: Increase in AFP (Alpha-fetoprotein)
|
A: Hepatocellular carcinoma (also present in yolk sac tumors)
|
|
|
Q: Triad of cirrhosis, skin pigmentation, and diabetes mellitus ("bronze diabetes")
|
A: Idiopathic hemochromatosis (primary defect in iron absorption leading to a net accumulation)
|
|
|
Q: Macronodular pattern on liver surface
|
A: Posthepatitic (postnecrotic, macronodular) cirrhosis
|
|
|
Q: Middle-aged female with pruritus, jaundice, xanthomas, and antimitochondrial antibodies
|
A: Primary biliary cirrhosis (histologically characterized by granulomatous destruction of intrahepatic bile ducts)
|
|
|
Q: Biliary tract disease, commonly seen in association with ulcerative colitis
|
A: Primary sclerosing cholangitis (histologically characterized by onion-skin fibrosis of bile ducts)
|
|
|
Q: Councilman bodies
|
A: Viral hepatitis (apoptotic hepatocytes)
|
|
|
Q: Hepatolenticular degeneration causing extrapyramidal motor signs
|
A: Wilson disease (copper deposits in the liver, cornea of the eye (Kayser-Fleischer rings), and putamen and lenticular nuclei of the basal ganglia)
|
|
|
Q: Osteoblastic metastases with increase in serum alkaline phosphatase in an older male
|
A: Carcinoma of the prostate (most common carcinoma in males; often arises in the peripheral zone of the prostate)
|
|
|
Q: Maternal exposure to DES (diethylstilbestrol)
|
A: Clear cell carcinoma of the vagina in daughters
|
|
|
Q: Predisposes to male germ cell tumors even if surgically corrected
|
A: Cryptochidism (undescended testes)
|
|
|
Q: Toxemia with CNS involvement, including convulsions and coma in a pregnant woman
|
A: Eclampsia
|
|
|
Q: Most common cause of hematosalpinx
|
A: Ectopic pregnancy (chronic pelvic inflammatory disease may predispose to ectopic pregnancy)
|
|
|
Q: Leukorrhea and irregular bleeding in a postmenopausal woman
|
A: Endometrial carcinoma (risk factors include obesity, diabetes, hypertension, infertility, and endometrial hyperplasia)
|
|
|
Q: Leading cause of infertility, with menstrual irregularities, severe dysmenorrhea, and intrapelvic bleeding in a young woman
|
A: Endometriosis ("Chocolate cysts" or blood- and debris-filled cysts in ovaries may develop)
|
|
|
Q: Discrete, rubbery, movable mass in the inner lower quadrant of the breast of a young female
|
A: Fibroadenoma (most common benign tumor of the female breast)
|
|
|
Q: Blue-domed cysts and dense fibrosis that produce palpable lumps and mammographic densities
|
A: Fibrocystic change of the breast (epithelial cell lining around cysts shows apocrine metaplasia)
|
|
|
Q: Bleeding with passage of grape-like structures, increased hCG, and rapid increase in uterine size
|
A: Hydatidiform mole (similar presentation without uterine enlargement = choriocarcinoma)
|
|
|
Q: Most common cause of scrotal enlargement
|
A: Hydrocele (clear, serous fluid can be seen upon transillumination of scrotal sac)
|
|
|
Q: Tumor with tendency to affect both breasts
|
A: Infiltrating lobular carcinoma
|
|
|
Q: Nodule of rock hard consistency in the upper outer quadrant of the breast of a postmenopausal woman
|
A: Invasive (infiltrating) carcinoma of the breast (histologically characterized by nests of tumor cells in a scirrhous, or scar-like, dense, hard stroma)
|
|
|
Q: Most common benign tumor in females
|
A: Leiomyoma (benign tumor of the smooth muscle of the uterus)
|
|
|
Q: Germ cell tumor that may contain hair, teeth, cartilage, and/or glands
|
A: Mature cystic teratoma (dermoid cyst) - tumor is derived from all three germ cell layers
|
|
|
Q: Presents as urinary urgency, frequency, and nocturia in an older male
|
A: Nodular hyperplasia of the prostate (benign prostatic hyperplasia) - commonly arises in the periurethral and transition zones of the prostate causing compression of the urethra
|
|
|
Q: Eczematoid lesion of the nipple, often with underlying ductal carcinoma
|
A: Paget disease of the breast
|
|
|
Q: Psammoma bodies
|
A: Papillary serous cystadenocarcinoma of the ovary (also in papillary carcinoma of the thyroid and meningioma)
|
|
|
Q: Young female with amenorrhea, infertility, obesity, and hirsutism
|
A: Polycystic ovary (Stein-Leventhal) syndrome - may be caused by excess secretion of luteinizing hormone
|
|
|
Q: Insidious onset of hypertension, edema, proteinuria, and headache after the 32nd week of pregnancy
|
A: Preeclampsia
|
|
|
Q: Salt-losing hyponatremia leading to hypotension and virilization of female infants
|
A: 21-hydroxylase deficiency (most common enymatic defect in congenital adrenal hyperplasis)
|
|
|
Q: Prognathism, enlargement of the face, viscera, feet and hands (sausage-like fingers)
|
A: Acromegaly (growth hormone hypersecretion caused by somatotroph cell adenoma)
|
|
|
Q: Epigastric pain radiating to the back with an increase in serum amylase and lipase
|
A: Acute pancreatitis (major association with alcoholism and gallstones)
|
|
|
Q: Migratory thrombophlebitis (Trousseau syndrome)
|
A: Carcinoma of the pancreas
|
|
|
Q: Severe retardation, short stature, coarse facies, protruding tongue, and umbilical hernia
|
A: Cretinism (hypothyroidism in children)
|
|
|
Q: Moon facies, hypertension, and accumulation of truncal fat
|
A: Cushing syndrome (caused by the action of cortisol)
|
|
|
Q: Most commonly caused by iatrogenic corticosteroid therapy
|
A: Cushing syndrome
|
|
|
Q: Marked increase in free water clearance
|
A: Diabetes insipidus (caused by lack of ADH)
|
|
|
Q: Increased Hemoglobin A1c (HbA1c)
|
A: Diabetes mellitus (HbA1c = serum marker for nonenzymatic glycosylation of proteins)
|
|
|
Q: Loss of pain sensation in extremities
|
A: Diabetic neuropathy
|
|
|
Q: Retinal microaneurysms and cotton-wool spots
|
A: Diabetic retinopathy
|
|
|
Q: Female with staring gaze and exophthalmos
|
A: Graves' disease (characterized by anti-TSH receptor antibodies in serum)
|
|
|
Q: Most common cause of hypothyroidism in iodine sufficient areas
|
A: Hashimoto thyroiditis (histologically characterized by dense lymphocytic infiltrate and germinal centers in the thyroid)
|
|
|
Q: Hypoglycemia and CNS impairment, which are reversed upon glucose administration, and increased serum C-peptide
|
A: Insulinoma (patients surreptitiously administering insulin do not have increased C-peptide levels in serum)
|
|
|
Q: General apathy, cold intolerance, obesity, and constipation
|
A: Myxedema (hypothyroidism)
|
|
|
Q: Most common thyroid carcinoma associated with exposure to ionizing radiation
|
A: Papillary carcinoma of the thyroid (histologically characterized by papillae lined "Orphan Annie" nuclei or empty looking nuclei)
|
|
|
Q: Paroxysmal hypertension, tachycardia, sweating, tremor and hyperglycemia
|
A: Pheochromocytoma
|
|
|
Q: Causes compression of the optic chiasm resulting in bitemporal hemianopsia
|
A: Pituitary adenoma (often visualized as radiographic enlargment of sella turcica)
|
|
|
Q: Hypotension, hyperpigmentation, and decreased heart rate
|
A: Primary adrenal cortical insufficiency (Addison disease)
|
|
|
Q: Salt-retaining hypertension, hypernatremia, hypokalemic alkalosis, and decreased plasma renin
|
A: Primary hyperaldosteronism (as opposed to increased plasma renin in secondary hyperaldosteronism)
|
|
|
Q: Osteitis fibrosis cystica
|
A: Primary hyperparathyroidism (cysts, fibrinous accumulation, and focal hemorrhage in bone; also called brown tumor of bone)
|
|
|
Q: Premenopausal woman with amenorrhea, galactorrhea, loss of libido, and infertility
|
A: Prolactinoma (most common hyperfunctioning pituitary adenoma)
|
|
|
Q: Most common cause of secondary hyperparathyroidism
|
A: Renal failure
|
|
|
Q: Peripartal hypotension resulting in necrosis and destruction of the anterior pituitary
|
A: Sheehan syndrome
|
|
|
Q: Excessive resorption of free water with hyponatremia and cerebral edema, but no peripheral edema
|
A: SIADH (syndrome of inappropriate antidiuretic hormone secretion)
|
|
|
Q: Tremor, tachycardia, heat intolerance, and increase in appetite with decrease in weight
|
A: Thyrotoxicosis (hyperthyroidism) - most commonly caused by Graves' disease
|
|
|
Q: Hypergastrinemia, hyperchlorhydria, and recurrent peptic ulcer disease
|
A: Zollinger-Ellison syndrome
|
|
|
Q: Marker of visceral malignancy
|
A: Acanthosis nigricans (thickened and hyperpigmented areas commonly found in flexural areas)
|
|
|
Q: Pearly papules with superficial telangiectases
|
A: Basal cell carcinoma (almost never metastasizes)
|
|
|
Q: Type IV hypersensitivity reaction in the skin
|
A: Contact dermatitis (primarily T cell and macrophage mediated immunity)
|
|
|
Q: Extremely pruritic vesicular lesions associated with celiac disease
|
A: Dermatitis herpetiformis (may respond to a gluten-free diet)
|
|
|
Q: Abnormal proliferation of connective tissue of skin scars that results in a large raised tumor-like lesions
|
A: Keloid (more common in African Americans)
|
|
|
Q: Black-blue papule with irregular borders
|
A: Malignant melanoma (depth of invasion correlates with prognosis)
|
|
|
Q: Tumor arising from actinic keratosis
|
A: Squamous cell carcinoma
|
|
|
Q: Antimelanocyte antibodies associated with cell loss in discrete areas of skin
|
A: Vitiligo (often associated with other autoimmune diseases like pernicious anemia)
|
|
|
Q: Yellowish tumor-like nodules composed of focal dermal collections of lipid-laden macrophages
|
A: Xanthoma
|
|
|
Q: Major genetic cause of dwarfism
|
A: Achondroplasia (most cases are due to new mutations, although may also be autosomal dominant)
|
|
|
Q: HLA-B27
|
A: Ankylosing spondylitis (fusion of vertebrae as articular cartilage is destroyed)
|
|
|
Q: Young boy presents with clumsiness and difficulty walking with pseudohypertrophy of calf muscles
|
A: Duchenne muscular dystrophy (X-linked; due to dystrophin deficiency; increased serum creatine kinase)
|
|
|
Q: Small, round, blue, cell tumor of bone in children
|
A: Ewing sarcoma (reactive periosteal bone layers form an "onion-skin" appearance)
|
|
|
Q: Arthritis associated with monosodium urate crystals in metatarsophalangeal (MTP) joints (podagra)
|
A: Gout (crystal deposits form tophi)
|
|
|
Q: Tumor-like formations in bone with cafe au lait spots and precocious puberty
|
A: McCune-Albright syndrome (polyostotic fibrous dysplasia with endocrine dysfunction)
|
|
|
Q: Dramatically improves with anticholinesterase drugs
|
A: Myasthenia gravis (disease caused by antiacetylcholine receptor antibodies)
|
|
|
Q: Wear-and-tear arthritis
|
A: Osteoarthritis (eburnation ("polished ivory" appearance) is caused by erosion of cartilage and articular bone surfaces
|
|
|
Q: Blue sclerae and multiple childhood fractures
|
A: Osteogenesis imperfecta (Blue sclerae caused by a decrease in collagen content making them translucent)
|
|
|
Q: Kyphosis and lordosis in a postmenopausal female
|
A: Osteoporosis (Age-related changes and estrogen deficiency increase bone loss)
|
|
|
Q: Most common primary malignancy of bone, frequently occurring in the knee of a male under 20 years old
|
A: Osteosarcoma (may see Codman triangle on X-ray as tumor lifts the periosteum; often associated with familial retinoblastoma)
|
|
|
Q: Headache, enlargement of the head, visual disturbances, and deafness
|
A: Paget disease of bone (osteitis deformans) - histologically characterized as a mosaic pattern of bone with irregular cement lines
|
|
|
Q: Ulnar deviation of the fingers
|
A: Rheumatoid arthritis (may also find swan-neck deformity)
|
|
|
Q: Patients present with morning stiffness with symmetric involvement of the proximal interphalangeal joints
|
A: Rheumatoid arthritis (majority have rheumatoid factor, an autoantibody directed against the Fc region of IgG, in their serum)
|
|
|
Q: Meningitis, with increased mononuclear cells, normal or increased protein, and normal glucose in CSF
|
A: Acute aseptic (viral) meningitis
|
|
|
Q: Neurofibrillary tangles and senile Beta-amyloid plaques in elderly patients
|
A: Alzheimer disease (associated with mutations on chromosomes 21, 19, 14, and 1)
|
|
|
Q: Common neurodegenerative diseases with dementia
|
A: Alzheimer disease, Huntington disease, and Pick disease
|
|
|
Q: Degeneration of the upper and lower motor neurons of the lateral and ventral corticospinal tracts
|
A: Amyotrophic lateral sclerosis (ALS) - may be associated with mutations of superoxide dismutase
|
|
|
Q: Most common cause of cerebral embolic infarcts
|
A: Cerebral atherosclerosis (most common location is the middle cerebral artery)
|
|
|
Q: Changes in memory and behavior followed by rapid dementia and startle myoclonus
|
A: Creutzfeld-Jakob disease (histologically characterized by spongiform change; transmission via prion protein)
|
|
|
Q: Rupture of middle meningeal artery because of skull fracture
|
A: Epidural hematoma (can be rapidly fatal)
|
|
|
Q: Most common primary intracranial neoplasm
|
A: Glioblastoma multiforme (as opposed to the most common intracranial neoplasm overall which is metastases to the brain)
|
|
|
Q: Pseudopalisading arrangement of malignant nuclei
|
A: Glioblastoma multiforme
|
|
|
Q: Patients present with involuntary jerky movements or writhing of the extremities
|
A: Huntington disease (autosomal dominant disease associated with trinucleotide repeat expansions)
|
|
|
Q: Atrophy of the caudate, putamen, and globus pallidus
|
A: Huntington disease (caudate atrophy leads to "bat wing" lateral ventricles)
|
|
|
Q: Most common cause of primary brain parenchymal hemorrhage
|
A: Hypertension
|
|
|
Q: One of the most common intracranial tumors in children
|
A: Medulloblastoma
|
|
|
Q: Tumor pushes on (rather than infiltrates) adjacent parenchyma
|
A: Meningioma (slow growing and often surgically resectable)
|
|
|
Q: Charcot triad: nystagmus, intention tumor, and scanning speech
|
A: Multiple sclerosis (in a gross specimen, glassy, dirty tan periventricular plaques indicate demyelination in white matter)
|
|
|
Q: Associated with folate deficiency during the initial weeks of gestation
|
A: Neural tube defects (Alpha-fetoprotein level is elevated in maternal serum)
|
|
|
Q: Multiple neurofibromas on the skin, cafe au lait spots, and Lisch nodules (pigmented hamartomas on the iris)
|
A: Neurofibromatosis Type-1 (von Recklinghausen disease) - autosomal dominant mutation in the NF-1 gene
|
|
|
Q: Rigid expressionless face and a pill-rolling tremor
|
A: Parkinson disease
|
|
|
Q: Atrophy and gross depigmentation of the dopamine-producing cells of the substantia nigra and locus coeruleus
|
A: Parkinson disease (histologically characterized by Lewy bodies which are intracytoplasmic, eosinophilic inclusions within neurons)
|
|
|
Q: Spinal tap with numerous leukocytes, decreased glucose and increased protein
|
A: Pyogenic (bacterial) meningitis
|
|
|
Q: Most common cause of subarachnoid hemorrhage
|
A: Rupture of a berry aneurysm (most common location of berry aneurysms is the Circle of Willis)
|
|
|
Q: Intracranial tumor presenting with tinnitus and hearing loss
|
A: Schwannoma (acoustic neuroma) - involves CN VII and VIII at the cerebellopontine angle
|
|
|
Q: "Worst headache of my life", vomiting, loss of consciousness, and blood in the CSF
|
A: Subarachnoid hemorrhage
|
|
|
Q: Intracranial hemorrhage due to disruption of the bridging veins
|
A: Subdural hematoma
|
|
|
Q: Loss of pain and temperature sensation in the upper extremities
|
A: Syringomyelia
|
|
|
Q: Weakness, paresthesia, and "pins-and-needles" feeling
|
A: Vitamin B12 deficiency (affects the lateral and posterior columns)
|
|
|
Q: Hemorrhage into the mammillary bodies and dorsal medial gray matter around the cerebral aqueducts
|
A: Wernicke-Korsakoff syndrome
|
|
|
Q: Confusion, paralysis of the lateral rectus, and ataxia with memory loss and confabulation
|
A: Wernicke-Korsakoff syndrome (caused by thiamine deficiency, typically in alcoholics)
|
