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362 Cards in this Set

  • Front
  • Back
What is the undelying cause of PCOS?
What are the clincial manifestations?
What is the tx?
Causes (FA 12 p. 545)

Clinical Px
Amenorrhea
Infertility
Obesity
Hirsutism
Impaired glucose tolerance

Tx
Wt loss
Metformin
Clomiphene
Leupolide
Spironolactone
A patieth with PCOS is most at risk for developing which type of cancer?
Endometrial cancer
Under what circumstances would you expect to see elevated LH?
Normal surge before ovulation

Menopause

PCOS

Androgen insensitivity syndrome
What Rx would you give to (-) prolactin secretion?
Dopamine analog
What ovarian tumor mathces the following statement:

Produces AFP?
Yolk-sac tumor
What ovarian tumor mathces the following statement:

Estrogen-secreting, leading to precocious puberty?
Granulosa theca cell tumor
What ovarian tumor mathces the following statement:

Intraperitoneal accumulation of mucinous material?
Mucinous cystadenocarcinoma
What ovarian tumor mathces the following statement:

Testosterone-secreting, leading to virilization?
Sertoli-Leydig cell tumor
What ovarian tumor mathces the following statement:

Psammoma bodies?
Serous cystadenocarcinoma
What ovarian tumor mathces the following statement:

Multiple different tissue types?
Teratoma
What ovarian tumor mathces the following statement:

Lined with fallopian tube-like epithelium?
Serous cystadenoma
What ovarian tumor mathces the following statement:

Ovarian tumor + ascites + hydrothorax?
Meigs syndrome of ovarian fibroma
What ovarian tumor mathces the following statement:

Call-Exner bodies?
Granulosa theca cell tumors
What ovarian tumor mathces the following statement:

Resembles bladder epithelium?
Brenner tumor
What ovarian tumor mathces the following statement:

Elevated B-hCG?
Choricocarcinoma

Dysgerminoma
What are the risk factors for ovarian cancer?
NOT being pregnant early in life

Late menopause

Early menarche
An obese woman presents with amenorrhea and increased levels of serum testosterone. What is the most likely Dx?
PCOS
Most common BENIGN ovarian tumor
Serous cystadenoma
Most common MALIGNANT ovarian tumor?
Serous cystadenocarcinoma
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies
Granulosa-theca cell tumor
What pathology fits the following HY phrase:

Thyroid cells with optically clear nuclei?
Papillary carcinoma
What pathology fits the following HY phrase:

Branching rods on oral infections?
Actinomyces israelli
What pathology fits the following HY phrase:

Eczema + recurrent infections + thrombocytopenia?
Wiskott-Aldrich syndrome
What pathology fits the following HY phrase:

Hemosiderinuria + thrombosis?
Paroxysmal nocturnal hemoglobinuria (PNH)
Which primary bone tumor fits the following description:

Most common malignant primary bone tumor of childern?
Osteosaroma
Which primary bone tumor fits the following description:

Most common benign bone tumor?
Osteosarcoma
Which primary bone tumor fits the following description:

11:22 translocation?
Ewing sarcoma
Which primary bone tumor fits the following description:

Soap-bubble appearance on XR?
Gaint-cell tumor
Which primary bone tumor fits the following description:

Onion-skin appearance of bone?
Ewing sarcoma
Which primary bone tumor fits the following description:

Codman's triangle on XR?
Osteosarcoma
Which primary bone tumor fits the following description:

Increased AFP on aminocentesis?
Neural tube defect

Acencephaly

Incorrect pregnancy dating
Monozygotic twins are delivered. One is pale and has a Hct of 15% and the other is flushed with a Hct of 55%. What is the cause of these features?
Twin-Twin Transfusion
A 15 yr old female states she is sexually active but that she knows she is not pregnant b.c she has never menstrucated. What would be the appropriate next step in managment?
Work-up for delayed puberty

Check Pregnancy test

Pt education: STD, contraception
A pregnant woman at 16 weeks of gestation px with antypically large abdomen and HTN. What abnormality might be seen on blood test, and what is the disorder?
Complete hydatidiform mole

Elevated B-hCG
A 25 yr old woman in her 3rd trimester has normal BP when standing and sitting. When supine, her BP drops to 90/50. What is the Dx?
IVC compression
What are the common causes of restrictive cardiomyopathy?
Sarcoid
Amyloid
Hemochromatosis
Loeffler disese
Endocardial fiber elastosis
Post-radiation fibrosis
What agents are commonly used as tocolytics?
Mg sulfate

Terbuline

Nifedipine

Indomethacin
What is the MOA of Mifepristone?
Competitively binds to progesterone receptors --> blocks the effects of progesterone
What are some of the condtions that can result in polyhydramnios?
Esophageal and duodenal atresia
A pregnant woman with previous C-section is at increased risk for which placental abnomralities?
Placenta previa

Placenta accreta
Placenta overlies cervical os

Painless vaginal bleeding

Requires a C-section
Placenta previa
Painful, life-theartening to fetus

Placenta separates from uterus

Bleeding inside uterus
Placenta abruption
Placenta attached to myometrium

Does NOT separage from myometrium after birth
Placenta accreta
When a young monkey is separeted from its mother, it becomes withdrawn, socially isolated, and grooms poorly. It is thought that this behavior is the monkey equivalent of what human problem?
Anaclitic depression
A wt lifter undergoes emergency surgery for a life threatening conditio. Examination of a section of his small bowel reveals focal hemorrhages. What is the process responsible for this?
Inguinal hernia

Herniated bowel bcomes incarcerated
What prenatal US finding is a clue that the fetus may have Down Syndrome?
Nucal translucency
What is the most common event that causes Down syndrome?
Meiotic Non-disjunction
What gene is affected in Fragile X syndrome?
FMR1 gene
What are the clincial features of Fragile X syndrome?
Autism

Large jaw

Facial elongation

Everted ears

MVP
What are the clinical features of Williams syndrome?
MR

Elfin facies

Friendliness

CV defects (valvular defect)
What are the possible defects in cases of chromosome 21q11 deletion?
Abnormal facies

Celft palate

Thymic aplasia

HypoCa

Cardiac defects
What are the distinguishing characteristics of Klinefelter syndrome and Turner Syndrome?
Klinefelter Syndrome
Male (XXY)
Very tail, long extremities
Testicular atrophy and gynecomastica

Turner Syndrome
Female (XO)
Short stature, neck webbing, shield chest
Primary amenorrhea
Most common genetic cause of MR
Down Syndrome
2nd most common genetic cause of MR
Fragile X syndrome
Horsehoe kidney, congential heart defects, streak ovaries, cystic hygroma
Turner syndrome
Rocker-bottom feet, clenched hands, microcephaly with prominent occiput small jaw
Trisomy 18
Edwards syndrome
What pathology matches the following statement:

Focal myocardial inflammation with multinucleated gaint cells?
Ashcoff bodies (Rheumatic fever)
What pathology matches the following statement:

Eosinophilic cytoplasmic globules in liver near nucleus?
Mallory bodeis (EtOHic liver disease)
What pathology matches the following statement:

Desquamated epithelial casts in sputum?
Curschmann spiralis (Bronchial asthma)
What pathology matches the following statement:

Pseudopalisading tumor cell arrangement?
Glioblastoma
What pathology matches the following statement:

Eleavted serum uric acid?
Gout

Lesch-Nyhan Syndrome

Myeloproliferative disorder

Diuretics (loops, thiazides)
What are the common causes fo meningitis in the following age range:

Newborn to 6 mos?
Group B strep

E. coli

Listeria moncytogenes
What are the common causes fo meningitis in the following age range:

6 mos to 6 yo?
Strep pneumoniae

N. meningitidis

H. influ

Enterovirus
What are the common causes fo meningitis in the following age range:

6 yo to 60 yo?
Strep pneumoniae

N. meningitidis

Enterovirus

HSV
What are the common causes fo meningitis in the following age range:

Over 60 yo?
Strep pneumonia

Gram Neg rods

Listeria
What structures form Hesselbach's triangle?
Inferior epigastric artery

Rectus abdominis m.

Inguinal ligament
What genetic defect is responsible for achondroplasia?
FGF receptor cell signaling defect
A genetic defect in which proteins results in hereditary spherocytosis?
Spectrin

Ankyrin
What AD disease fits the following statement:

Associated with floppy mitral valve, dissecting aortic aneurysm, berry aneurysm?
Marfan syndrome
What AD disease fits the following statement:

Associated with MVP, liver disease, berry aneurysms?
ADPKD
What AD disease fits the following statement:

Neural tumors and pigmented iris hamartomas?
NF Type 1
What AD disease fits the following statement:

Very strong assocation with colon cancer?
Familial adenomatous polyposis
What AD disease fits the following statement:

MI before age of 20?
Familial hypercholesteroiemia
What AD disease fits the following statement:

Hemangioblastoma of retina/cerebellum/medulla?
von Hippel-Lindau
What AD disease fits the following statement:

Increased MCHC, hemolytic anemia?
Hereditary spherocytosis
What AD disease fits the following statement:

Bilateral acoutic neuromas?
NF Type 2
What AD disease fits the following statement:

Facial lesions, seizure disorder, cancer risk?
Tuberous sclerosis
What AD disease fits the following statement:

Caudate atrophy, dementia?
Huntington's disease
What AD disease fits the following statement:

Cystic medial necrosis of aorta?
Marfan's Syndrome
What AD disease fits the following statement:

Defect of fibroblast growth factor (FGF) receptor 3?
Achondroplasia
What are some of the disorders resulting from trinucleotide repeats?
Huntington's

Fragile X Syndrome

Friedreich ataxia

Myotonic dystrophy
What HY path fits the following statement:

Strawberry tongue?
Scarlet fever

Kawasaki disease

Toxic shock syndrome
What HY path fits the following statement:

Testing tremor, rigidity?
Parkinson disease
What HY path fits the following statement:

Rash on palms and soles?
Secondary syphilis

Rocky Mt Spotted Fever

Cox A virus
What HY path fits the following statement:

What are the toxic SEs of tricyclic antidepressants?
Convulsions

Coma

Cardiotoxicity

Hyperpyrexia

Respiratory depression
In which glomerular disease would you expect the following change:

IF: Anti-GBM Ab?
Goodpasture syndrome
In which glomerular disease would you expect the following change:

LM: Kimmelstiel-Wilson Lesions?
Diabetic nephropathy
In which glomerular disease would you expect the following change:

EM: "Spike and dome" appearance
Membranous GN
In which glomerular disease would you expect the following change:

EM: "Tram track" appearance on subendothelial humps
membranoproliferative GN
In which glomerular disease would you expect the following change:

EM: Subepithelial humps?
Acute post-strep GN
What is the name of the genetic disease that fits the following description:

Marcoorchidism and autism?
Fragrile X syndome
What is the name of the genetic disease that fits the following description:

Endocardial cushion defects are common?
Down syndrome
What is the name of the genetic disease that fits the following description:

Recurrent pulmonary infections, steatorrhea?
Cystic fibrosis
What is the name of the genetic disease that fits the following description:

Associated with Alzheimer disease after age 35?
Down Syndrome
What is the name of the genetic disease that fits the following description:

Excess fibro-fatty tissue deposits amongst muscle?
Duchenne muscular dystrophy
What gene is defective in cystic fibrosis?
CFTR gene on chromosome 7
What is the traditional test used to dx cystic fibrosis?
Sweat Chloride Test
Inheritance pattern of the following disorders:

ADPKD
Familial adenomatous polypsis
Familial hypercholesterolemia
Hereditary spherocytosis
Huntington's disease
Marfan Syndrome
Infantile PKD
Hemochromatosis
AD
Inheritance pattern of the following disorders:

Mucopolysaccharides (expect Hunter's)
Phenylketouria (PKU)
Sickle cells anemia
Thalassemia
AR
Inheritance pattern of the following disorders:

Bruton agammaglobuliemia
Wiskott-Aldrich syndrome
Fabry disease
G6PD deficiency
Lesch-Nyhan Syndrome
Duchenne muscular dystrophy
Hemophilia A and B
XR
What is the clincial use of clomiphene?
Infertility
Partial agonist estrogen receptors in hypothalamus
Induces FSH secretion
Stimulates follicles
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Minocycline?
Tetracycline
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Gentamycin?
Aminoglycoside
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Erythromycin?
Macrolides
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Tobramycin?
Aminoglycosides
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Azithromycin?
Macrolides
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Doxycycline?
Tetracycline
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Amikacin?
Aminoglycosides
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Neomycin?
Aminoglycoside
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Clarithromycin?
Macrolide
Classify the following Abx as an aminoglycoside, macrolide, or tetracycline:

Clindamycin?
Protein synthesis inhibitor (linezoamide)
What pathology fits the following description:

Smudge cell?
CLL
What pathology fits the following description:

S3 heart sound
Dilate cardiomyopathy

Post-MI

LV failure

MR

L to R shunt
What pathology fits the following description:

Adrenal hemorrhage associated with meningococcemia?
Waterhouse-Friderichsen Syndrome
What pathology fits the following description:

Ferruginous bodies?
Asbestosis
What pathology fits the following description:

Myocyte disarray?
Hypertrophic cardiomyopathy
What pathology fits the following description:

Currant jelly stool?
Intussusception
What pathology fits the following description:

Sacroilitis?
Ankylosing spongylitis
Adverse rxn from mixing succinylcholine with inhaled anesthetics?
Malignant hyperthermia
Other than Rx, what are some other causes of gynecomastia?
Klinefiter syndrome

Hyperestrogen states

Old age

Cirrhosis

Testicular tumors
What organism is most commonly responsible for acute mastitis?
Staph aureus
What is the classic presenting complaints in a patient with intraductal papilloma?
"Straw-colored"/ yellow nipple discharge

+/- bloody discharge
What breast pathology fits the following description:

Most common breat tumor in women under 25?
Fibroadenoma
What breast pathology fits the following description:

Most common breast mass in postmenopausal women?
Invasive ductal carcinoma
What breast pathology fits the following description:

Most common breast mass in premenopausal women?
Fibrocystic change of breast
What breast pathology fits the following description:

Most common form of breast cancer?
Invasive ductal carcinoma
What breast pathology fits the following description:

Small, mobile, firm mass with sharp edges in 24 yr old woman?
Fibroadenoma
What breast pathology fits the following description:

Histo: "Leaf-like projections"?
Phyllodes tumor
What breast pathology fits the following description:

Signet ring cells?
Lobular carcinoma in situ

Invasive lobular carcinoma
What breast pathology fits the following description:

Loss of e-cadherin cell adhesion gene on chromosome 16?
Invasive lobular carcinoma
What breast pathology fits the following description:

Always ER (+) and PR (+)?
Lobular carcinoma in situ

Invasive lobular carcinoma
What breast pathology fits the following description:

Commonly presents with nipple discharge?
Intraductal papilloma
What breast pathology fits the following description:

Eczematous patches on nipple?
Paget disease of breast
What breast pathology fits the following description:

Multiple bilateral fluid-filled lesions wtih diffuse breast pain?
Fibrocystic change of breast
What breast pathology fits the following description:

Firm, fibrous mass in 55 yr old woman?
Invasive ductal carcinoma
A 58 yr old postmenopausal woman is on tamoxifen. What is she at increased risk of acquiring?
Endometrial cancer
Most common cancer in women in US
Breat cancer
Most common benign breast tumor
FIbroadenoma
Most common malignant breast tumor
Infiltrating ductal carcinoma
Blue dome cyst in breast
Fibrocystic change
Tx for ER (+) breast cancer
Tamoxifen
Red, itchy, swollen rash on areola and nipple
Paget disease of breast
What are some of the clincial effects of zinc deficiency?
Delayed wound healing
Hypogonadism
Decreased adult hair (axillary, facial, pubic)
Problems with taste and smell
Predisposition to cirrhosis from EtOH
What is the cause of anemia given the following statement:

Microcytic anemia and > 3.5% HbA2?
Beta-thalassemia minor
What is the cause of anemia given the following statement:

Megaloblastic anemia not correctable by Vit B12 or folate?
Orotic aciduria
What is the cause of anemia given the following statement:

Megaloblastic anemia along with peripheral neuropathy?
Vit B12 deficiency
What is the cause of anemia given the following statement:

Microcytic anemia + basophilic stippling?
Lead poisioning
What is the cause of anemia given the following statement:

Microcytic anemia reversible with vit B6?
Sideroblastic anemia
What is the cause of anemia given the following statement:

HIV positive patient with macrocytic anemia?
Zidovudine
What is the cause of anemia given the following statement:

Normocytic anemia + Red urine in the morning?
Paroxysmal nocturnal hemoglobiauria
What is the cause of anemia given the following statement:

Normocytic anemia and elevated Cre?
Chronic kidney disease
What type of cancer is associated with the following tumor suppressor:

Rb?
Retinoblastoma

Osteosarcoma
What type of cancer is associated with the following tumor suppressor:

DPC?
Pancreatic cancer
What type of cancer is associated with the following tumor suppressor:

p53?
Most cancers
What type of cancer is associated with the following tumor suppressor:

APC?
colorectal cancer associated with FAP
What type of cancer is associated with the following tumor suppressor:

WTI?
Wilm's tumor
What type of cancer is associated with the following tumor suppressor:

BRCA 1?
Breast and ovarian cancer
What type of cancer is associated with the following tumor suppressor:

BRCA 2?
Breast cancer
What name is given to chronic compulsive hair pulling common in young girls?
Trichotillomania
What stimulant medications are commonly used in tx of ADHD?
Methyphenidate

Dextroamphetamine
Which childhood psychiatric disorder matches the following statement:

Females only, loss of previously acquire purposeful hand skills b/t 6-30 months?
Rett syndrome
Which childhood psychiatric disorder matches the following statement:

Impairments in social interactions, communications, play, repetitive behaviors?
Autistic disorder
Which childhood psychiatric disorder matches the following statement:

Impairment in social interactions (but not avoidance), no language delay?
Asperger's disorder
Which childhood psychiatric disorder matches the following statement:

Ignoring the basic rights of others?
Conduct disorder
Which childhood psychiatric disorder matches the following statement:

Stereotyped hand movements?
Rett syndrome
Which childhood psychiatric disorder matches the following statement:

Characterized by hostility, annoyance, vindictiveness, disobedience, and resentfulness?
Oppositional defiant disorder
Which childhood psychiatric disorder matches the following statement:

Multiple motor and vocal tics?
Tourette's syndrome
Which childhood psychiatric disorder matches the following statement:

Impulsive and inattentive?
ADHD
Which childhood psychiatric disorder matches the following statement:

7 yr old that avoids going to school stay home with parent?
Separation anxiety disorder
What is the difference b/t binge eating disorder and compulsive eating disorder?
Binge eating disorder
Negative feelings towards food
Binges are expression of deeper problem

Compulsive eating disorder
pt obsessed with food
Most common Rx for ADHD
Methylphenidate
Most common medication for bulimia nervosa
SSRIs
What eye abnormality is seen in a patient with MS and internuclear ophthalmoplegia?
MLF syndrome
Convergence is normal
On lateral gaze: aBducting eye has nystagmus; aDducting eye is unable to aDduct
A man in his 40s begins to develop early dementia and uncontrollable movements of his UEs/ In what portion of the brain do you expect to see atrophy?
Huntington's disease
Caudate and putamen
A pateint with cortical lesion and left arm paralysis is unaware of his neurologic deficiency. Where is the lesion?
Non-Dominant Right parietal lobe
Spatial neglect syndrome/ Hemineglect syndrome
Mydriasis
Used topically as VC
Cocaine
Nystagmus when looking up/down and aBducting/aDducting
Crazy and violent
PCP
Miosis
Drooling and sweating
Organophosphate
Miosis
Constipation
Morphine
Mydriasis
Used for ADHD
Amphetamines
Red eye
Social withdrawal
Marijuana
Mydriasis
Hallucinations and flashbacks
LSD
What Rx intoxication or withdrawal is causing the following Sx in the following patients:

Post-op constipation and/or respiratory depression?
Opioids intoxication
What Rx intoxication or withdrawal is causing the following Sx in the following patients:

Severe depression, headache, fatigue, insomnia/hypersomnia, hunger?
Cocaine withdrawal

Amphentamine withdrawal
What Rx intoxication or withdrawal is causing the following Sx in the following patients:

Pinpoint pupils, N/V, seizures?
Opioid overdose
What Rx intoxication or withdrawal is causing the following Sx in the following patients:

Belligerence, impulsiveness, nystagmus, homicidal ideations, psychosis?
PCP intox
What Rx intoxication or withdrawal is causing the following Sx in the following patients:

Headache, anxiety/depression, wt gain?
Nicotine or caffeine withdrawal
What Rx intoxication or withdrawal is causing the following Sx in the following patients:

Anxiety/depression, delusions, hallucinations, flashbacks?
LSD intox.
What Rx intoxication or withdrawal is causing the following Sx in the following patients:

Euphoria, social withdrawal, impaired judgment, hallucinations?
Marijuana Intox.
What Rx intoxication or withdrawal is causing the following Sx in the following patients:

Rebound anxiety, tremors, seizures, life-threatening?
Withdrawal from EtOH, Benzos, or Barbs
What weak opioid agonist is commonly used in chronic pain control prior to prescribing stronger opioids?
Tramadol
What is the tx for a patient that is overly intoxicated with the following:

EtOH intoxicaiton?
Fluids

Respiratory monitoring

Blood EtOH monitoring

Time
What is the tx for a patient that is overly intoxicated with the following:

Benzo Intoxication?
Flumazenil
What is the tx for a patient that is overly intoxicated with the following:

PCP Intoxicaiton?
Benzo

Haloperidol
What is the tx for a patient that is overly intoxicated with the following:

Opioid Intoxication?
Naloxone

Naltrexone
Which neoplasm is associated with the following statement:

Nitrosamines?
Stomach cancer

Esophageal cancer

Colon cancer
Which neoplasm is associated with the following statement:

Asbestos?
Mesothelioma

Bronchogenic carcinoma
Which neoplasm is associated with the following statement:

Naphthalene?
Transitional cell carcinoma of the Bladder
Which neoplasm is associated with the following statement:

Arsenic?
Squamous cell carcinoma of skin

Angiosarcoma of Liver
Which neoplasm is associated with the following statement:

EBV?
Burkitt's lymphoma

Hodgkins lymphoma

Nasopharyngeal carcinoma
Which neoplasm is associated with the following statement:

HPV?
Cervical cancer

Penile/anal carcinoma
Which neoplasm is associated with the following statement:

Schistosoma haematabium?
Squamous cell carcinoma of Bladder
What is the cause of ITP?
Anti-Gp2b/3a Ab
What is the MOA of the following Rx:

Streptokinase?
Converts plasminogen to plasmin which cleaves fibrin
What is the MOA of the following Rx:

Aspirin?
Irreversibly (-) COX 1 and 2 by acetylation --> decreases Thromboxane A2 and PG
What is the MOA of the following Rx:

Clopidogrel?
Blocks ADP receptors
What is the MOA of the following Rx:

Abciximab?
Binds to Gp2b/3a
What is the MOA of the following Rx:

Tirofiban?
Binds to Gp2b/3a
What is the MOA of the following Rx:

Ticlopidine?
blocks ADP receptors
What is the MOA of the following Rx:

Enoxaparin?
Catalyzes AT 3 formation and activation
What is the MOA of the following Rx:

Eptifibatide?
Binds Gp2b/3a receptor on platelets
What are some of the (+) Sx of schizophrenia?
What are some of the (-) Sx?
(+) Sx
Delusions
Auditory
Hallucinations
Disorganized speech (loose associations)
Disorganzied/catatonic behavior

(-) Sx
Flat affect
Social withdrawal
Lack of motivation
Lack of speech/thought
Thought blocking
Poor grooming
High potency neuroleptics

"Try to FLy High"
Thiothixene

Trifluoperazine

Fluphenazine

Loxapine

Haloperidol
Low potency neuroleptics

"Cheating Thieves are low"
Chlorpromazine

Thioridazine
Atypical antipsychotics

"It's atypical for Old Closets to Quietly Risper from A to Z"
Olanzapine

Clozapine

Quetiapine

Risperidone

Aripiprazole

Ziprasidone
What are the clincial features of neuroleptic malignant syndrome? How is it treated?
Clinical Px: "FEVER"
Fever
Enephalopathy --> delirium/MS changes
Vitals unstable
Elevated enzymes --> myoglobinuria
Rigiditiy of mm.

Tx: Dantrolene (D2 agonist)
What forms of leukemia match the following statement:

Most common leukemia in childerm?
ALL
What forms of leukemia match the following statement:

Most common leukemia in adults in US?
CL
What forms of leukemia match the following statement:

Characteristic Auer rods?
AML
What forms of leukemia match the following statement:

Greater than 20% blasts in marrow?
Acute leukemia
What forms of leukemia match the following statement:

Leukemia with more mature cells and less than 5% blasts?
Chronic leukemias
What forms of leukemia match the following statement:

PAS (+) acute leukemia?
ALL
What forms of leukemia match the following statement:

Always positive for t (9.22)?
CML
What forms of leukemia match the following statement:

Acute leukemia positive for peroxidase?
AML
What forms of leukemia match the following statement:

Solid sheets of lyphoblasts in marrow?
ALL
What forms of leukemia match the following statement:

Always associated with BCR-ABL gene?
CML
What histo changes takes place in trachea of smokers?
Metaplasia
Columnar --> squamous epithelium
What are the criteria for teh dx of major depressive episode?

"SIG E CAPS"
Sleep disturbance

Loss of Interest

Guilt/feeling of worthlessness

Energy loss

Concentration loss

Appetite/wt changes

Psychomotor retardation/agitation

Suicidal ideations

Depressed mood
What is atypical depression?
Hypersomnia

Overeating

Mood reactivity

Rejection hypersensitivity
A patient mentions that he had had thoughts of suicide. What question should you ask to help determine how high-risk he is?

"SAD PERSONS"
Sex

Age

Depression

Previous attempts

Ethanol

Rational thinking loss

Sickness

Organizated plan

No social support

State future intent
A pateint tries to commit suicide by slitting her wrists. After she is appropriately managed in the ER, what question would you ask the patient in order to determine her level of cmmitment of trying to take her own life?
"What did you do after the suicide attempt?"
A 28 yr old woman has Sx of mild depression for 6 years. What's the dx?
Dysthymia
Sliver stain: Gram neg rods
Legionella
What blood test is done to confirm SLE dx?
ANA
What is the MOA for the following Rx class:


SSRI?
5-HT reuptake inhibitor
What is the MOA for the following Rx class:

SNRI?
(-) 5-HT3 and NE reuptake
What is the MOA for the following Rx class:

TCA?
Block reuptake of NE and 5-HT3
What is the MOA for the following Rx class:

MAOI?
Nonselective MAO inhibition --> (-) enzyme that metabolizes and inactivates NE
What antidepressants fit into the following Rx class:

SSRI?
Fluoxetine

Sertraline

Paroxetine

Citalopram

Fluvoxamine
What antidepressants fit into the following Rx class:

NDRI?
Bupropion
What antidepressants fit into the following Rx class:

TCA?
Imipramine

Amitripyline

Desipramine

Nortriptyline

Clomipramine

Doxepin
What antidepressants fit into the following Rx class:

MAOI?

"Take Pride in Shanghai"
Tranylcypromine

Phenelzine

Selegiline
What antidepressants fit into the following Rx class:

SNRI?
Venlafaxine

Duloxetine

Milnacipran

Nefazodone
What antidepressants fit into the following Rx class:

Tetracyclines?
"-iptyline"

"-ipramine"

Trazodone

Mirtazapine
Which antidepressant matches the following statement:

SE: priapism?
Trazodone
Which antidepressant matches the following statement:

Lowers the seizure threshold?
Bupropion

TCAs
Which antidepressant matches the following statement:

Works well with SSRIs and increases REM sleep?
Trazodone
Which antidepressant matches the following statement:

Appetite stimulant that is likely to result in wt gain?
Mirtazapine
Which antidepressant matches the following statement:

Can be used for smoking cessation?
Bupropion
Which antidepressant matches the following statement:

Can be used for bedwtting in children?
Imipramine
What are the Sx of TCA overdose?
Convulsions

Coma

Cardiotoxicity

Hyperpyrexia

Respiratory depression
What are the Sx of serotonin syndrome?
M. rigidity

Hyperthermia

CV collapse
What happens if you ingest tyramine while on MAOIs?
HTN crisis

Hemorrhagic stroke

Arrhythmias
Tx for claustrophobia?
Benzodiazepine
A young woman is anxious about a pap smear and is told to relax and to imagine going though the steps of the exam. What does this process exemplify?
Systematic desensitization
A nurse has episodes of hypoglycemia. Blood analysis reveals no elevation in C-peptide. What is the dx?
Malingering/Factiticous disorder
Exogenous insulin
What somatoform disorder mathcs the following description:

Unexplained pain?
Pain disorder
What somatoform disorder mathcs the following description:

Patient with normal anatomy is convinced a part of their anatomy is abnormal?
Body dysmorphic disorder
What somatoform disorder mathcs the following description:

Unexplained loss of sensory or motor function (tests and PE are negative)?
Conversion disorder
What somatoform disorder mathcs the following description:

Unwavering belief by the patien that she has a specific disease (despite medial reassurance)?
Hypochondriasis
What somatoform disorder mathcs the following description:

Unexplained complaints in multiple organ systems?
Somatization disorder
What somatoform disorder mathcs the following description:

False belief of being pregnant?
Pseudocyesis
Which ECG leads will show evidence of ischemia in inferior wall MI?
Lead 2, 3 and avF
A 40 yr old woman tells you during an office visit that she love you. You refer her to someone else, and she attempts suicide. What type of personality disorder does she have?
Borderline personality disorder
Patient claims you are the best doctor in the whole world but says your nurse is very disrespectful. On a later date, she threatens to change doctors b/c you will not get a particular labe test. You notice cuts on her forearm and she says they are cat straches. What type of personality disorder does the patient have?
Borderline personality disorder
A person demands only the best and most famous doctor in town. What personaltiy disorder does this person have?
Narcissistic personality disoder
What are the cluster A personality disorders?
Paranoid

Schizoid

Schizotypal
What are cluster B personality disorders?
Antisocial

Borderline

Histamine

Narcissistic
What are the cluster C personality disorders?
Avoidant

Obsessive-compulsive dependent
Which immune deficiency matches the following description:

Anaphylaxis on exposure to blood products with IgA?
Selective Ig Deficiency (B cell disorder)
Which immune deficiency matches the following description:

Coarse facial features, abscesses, eczema?
Hyper-IgE Syndrome aka Job Syndrome (T cell disorder)
Which immune deficiency matches the following description:

Thrombocytopenia, purpura, infections, eczema?
Wiskott-Aldrich syndrome (B and T cell disorder)
Which immune deficiency matches the following description:

Delayed separation of the umbilicus?
Leukocyte Adhesion Deficiency Type 1 (Phagocytic disorder)
Which immune deficiency matches the following description:

Neuro defects, partial albinism, recurrent infections?
Chediak-Higashi syndrome (Phagocytic disorder)
Systolic mumur

LEFT midclavicular line

Loudest at the apex and radiates toward axilla

Enhanced on LEFT lateral side

Incresed TRP (squatting, hand grip)

Increased LA return (expiration)
MR
Diastolic mumur

RIGHT 2nd/3rd intercostal space

Wide pulse P

Bounding pulse

Head bobbing

VD decreases murmur intensity
AR
Where does new bone formation take place in growing long bones?
Epiphyseal plate
What cells types are most similar to osteoclasts?
Macrophages/monocytes
Which bony disease fit the following description:

Reversible when vit D is replaced?
Osteomalacia

Rickets
Which bony disease fit the following description:

Excess osteoclastic activity results in disorganized architecture?
Paget's disease of the bone
Which bony disease fit the following description:

Bone is replaced by fibroblasts, collagen, and irregular bony trabeculae?
Polyostotic fibrous dysplasia
Which bony disease fit the following description:

Soft bones due to defective mineralization of osteoid?
Osteomalacia

Rickets
Which bony disease fit the following description:

Failure of bone resorption --> thickened and dense bones?
Osteopetrosis (marble bone disease)
Which bony disease fit the following description:

Genetic deficiency of carbonic anhydrase II?
Osteopetrosis
Paget Disease
Serum Ca?
Serum P?
Alk Phos?
PTH?
Serum Ca: nornal
Serum P: normal
Alk Phos: Increased
PTH: normal
Osteomalacia/Rickets
Serum Ca?
Serum P?
Alk Phos?
PTH?
Serum Ca: Decreased
Serum P: Decreased
Alk Phos: normal/increased
PTH: Increased
Osteitis fibrosa cystica
Serum Ca?
Serum P?
Alk Phos?
PTH?
Serum Ca: Increased
Serum P: Decreased
Alk Phos: Increased
PTH: Increased
Osteoporosis
Serum Ca?
Serum P?
Alk Phos?
PTH?
Serum Ca: normal
Serum P: normal
Alk Phos: normal
PTH: normal
Osteopetrosis
Serum Ca?
Serum P?
Alk Phos?
PTH?
Serum Ca: Normal
Serum P: Normal
Alk Phos: Normal
PTH: Normal
Renal Insuffiency
Serum Ca?
Serum P?
Alk Phos?
PTH?
Serum Ca: Decreased
Serum P: Increased
Alk Phos: Nomral
PTH: Increased
Primary HyperPTHism
Serum Ca?
Serum P?
Alk Phos?
PTH?
Serum Ca: Increased
Serum P: Decreased
Alk Phos: Increased
PTH: Increased
Which primary bone tumor fits the following description:

Most common malignant primary bone tumor in adults?
Multiple myeloma
Which primary bone tumor fits the following description:

Most common bengin bone tumor?
Osteochondroma
Which primary bone tumor fits the following description:

11;22 translocation?
Ewing sarcoma
Which primary bone tumor fits the following description:

May actually be a hamartoma?
Osteochondroma
Which primary bone tumor fits the following description:

Codman's triangle on XR?
Osteosarcoma
Which primary bone tumor fits the following description:

Associaed wtih Gardner syndrome?
Osteoma
Which primary bone tumor fits the following description:

Bone enlargement, bone pain, and arthritis, increased hat size
Paget's disease of the bone
Which primary bone tumor fits the following description:

Vertebral compression fractures
Osteoporosis
When does implantation of the ovum take place?
6 days after fertilization
What ligments are typically injured during an ankle sprain?
1) Anterior talofibular ligament

2) Calcaneofibular ligament

3) Posterior talofibular ligament
What is the leading cause of knee pain in patients younger than 45?
Patellofemoral syndrome
What is the other name for housemaid's knee?
Prepatellar bursitis
Which muscles of the Rotator cuff are responsbile for the following action:

Initial 15 degrees of arm aBduction?
Supraspinatus m.
Empty can test
Which muscles of the Rotator cuff are responsbile for the following action:

Lateral rotation of arm?
Infraspinatous m.

Teres minor m.
Which muscles of the Rotator cuff are responsbile for the following action:Medial rotation of arm?
Subscapularis m.
Which Abx class is known to increase the risk of tendon rupture in adults?
Fluoroquinolones
Anterior drawer sign
ACL tear
Bones of the wrist

"Some Lovers Try Positions That They Cannot Handle"
Scaphoid

Lunate

Triquetrum

Prisiform

Trapezium

Trapezoid

Capitate

Hamate
What is the classic feature of OA?
Pain in wt bearing joints at end of the day (after use) that improves with rest
By what mechanism do NSAIDS cause renal disease?
(-) PG --> renal VC --> decrease renal perfusion
What Rx are used in tx of acute gout exacerbation?
NSAIDS

Colchicine

Steriods
What Rx can be used in tx of chronic gout?
Probenecid

Allopurinol

Fe buxostat

Longterm NSAIDs, colchicine
What are the classic Sx of Sjogren syndrome?
Xerophthalmia
Dry eyes, "Sand in my eyes"

Xerostomia
Dry mouth

Arthritis
Swollen, red, acutely painful great toe joint
Gout
Swollen, hard; painful finger joints?
RA
Swollen, boggy; painful finger joints?
OA
Arthritis, dry mouth, dry eyes?
Sjogren syndrome
Postitively birefringent rhomboid-shaped crystals?
Pseudogout
Negatively birefringent needle-shaped crystals?
Gout
Cartialge erosion with polished bone beneath?
OA
Painful lesions on fingertips
Osler node
Infective endocarditis
Bony growths on knuckles of ppl with OA
PIP joint: Bouchard

DIP joint: Heberden
HLA B27 (+)

"PAIR"
Psoriatic arthritis

Ankylosing spondylitis at SI joint

IBD

Reactive arthritis (Reiter syndrome)
What is the mechanism and time-frame of acute transplant rejection?
Mechanism
Cell-mediated due to CTLs reacting against foreign MHCs

Time-frame:
Weeks following transplant
What are the manifestations of CREST scleroderma?
Calcinosis

Raynaud's phenomenon

Esophageal dysmotility

Sclerodactyly

Telangiectasia

Anti-centromere Ab
A patient presents with photosenstiivity, arthritis, renal disease and recurrent oral ulcers is taking primaquine and NSAIDs. What type of check-up should she be receiving twice a year?
Dx: SLE
Renal evaluation b.c of Renal disease
What is the cause of Duchenne muscular dystrophy?
Frame shifted mutation --> dystrophin gene deletion
What are some of the characteristics of polymyositis that distinguish it from polymyalgia rheumatic?
Polymyositis
Progressive symmetric proximal m. weakness
Increased CK
Increased aldolase
(+) ANA
(+) Anti-Jo 1

Polymyagia rheumatic
Joint pain but NO m. pain
Malar rash
Gottorn's papule
Mechanics hand
Normal CK
Normal aldolase
What Rx category is often used in tx of Myasthenia gravis?
AChE inhibitors
Bamboo spine
Ankylosing spndylitis
Anti-smith and anti-dsDNA Ab
SLE
Anti-histone Ab
Drug-induced SLE
Anti-centromere Ab

"C for centromere and CREST"
CREST scleroderma
Anti-topoisomerase Ab
Diffuse systemic scleroderma
Most common cause of death in SLE
Lupus nephropathy
"Loop-wire"
Most common cardiac manifestation of SLE
Libmann-Sacks endocarditis
Painless oral ulcers
SLE
In which genetic disorder would you find acanthocytosis of RBCs and excess lipids in enterocytes?
Abetalipoproteinemia
FGF receptor 3
Achondroplasia
FMR1 gene?
Fragile X Syndrome
Caused by epidermis hyperproliferation

Px: yellow greasy scales on scalps or erythema/white flaky scales on face
Seborrheic dermatitis
Cradle cap
What are some of the hallmark features of necrotizing fasciitis?
What organism causes this infection?
Px: Rapidly spreading cellulitis; Tenderness beyond red borders

Organism
Anaerobic bacteria
Group A strep (Strep pyogenes)
What organism causes painless white patches on the tongue that cannot be scraped off?
Hairy leukoplakia
AIDS patients with EBV
Which skin disorder matches the following statement:

Pruritic, purple, polygonal papules?
Lichen planus
Which skin disorder matches the following statement:

Life threatening rash with bullae?
Stevens-Johnson Syndrome

Toxic epidermal necrolysis

Pemphigus vulgaris
Which skin disorder matches the following statement:

Pruritis assocatied wtih asthma?
Atopic dermatitis (eczema)
Which skin disorder matches the following statement:

Pruritic vesicles associated with celiac disease?
Dermatitis herpetiforms
Which skin disorder matches the following statement:

Allergy to nickel?
Allergic contact dermatitis (Type 4 HSN rxn)
Which skin disorder matches the following statement:

Thickened scar esp. around face/chest?
Keloid (hypertrophic scarring)
Which skin disorder matches the following statement:

(-) Nikolsy's sign

Spares oral mucosa

Ab against epidermal BM (hemidesmosomes)?
Bullous pemphigoid
Which skin disorder matches the following statement:

(+) Nikolsy's sign

Oral mucosa ulcers

Ab against cell-cell adhesions (desmosomes)?
Pemphigus vulgaris
Which skin disorder matches the following statement:

Parakeratotic scaling?
Psorasis
Which skin disorder matches the following statement:

Keratin-filled cysts?
Seborrheic keratosis
Which skin disorder matches the following statement:

Sand-paper; predisposition to sqaumous cell cancer?
Actinic keratsis
Which skin disorder matches the following statement:

Skin rash and proximal muscle weakness?
Dermatomyositis
Which skin disorder matches the following statement:

Honey-crusting leions common about the nose and lips?
Impetigo
Which skin disorder matches the following statement:

Hyperkeratosis and koilocytosis?
Verrucae
Which skin disorder matches the following statement:

Histo: palisading nuclei?
Basal cell carcinoma of skin
Which skin disorder matches the following statement:

Nuclei in stranum corneum?
Psorasis
Keratin pearls on skin biopsy
Squamous cell carcinoma of skin
Most common malignant skin tumor
Basal cell carcinoma of skin