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39 Cards in this Set

  • Front
  • Back
What is the most common primary malignant bone tumor?
multiple myeloma
what primary bone tumor has a 11; 22 translocation?
Ewings sarcoma-
get eWings and Onion rings ( onion skinning appearance on bone)
What primary bone tumor has a soap bubble appearance on x ray?
giant cell tumor- osteoclastoma
What primary bone tumor has onion skin appearance of bone?
Ewings sarcoma
What primary bone tumor is codman's triangle ( periosteal elevatioon) on xray?
osteosarcoma
primary bone tumor that may arise from osteochondrome or appear as primary tumor
chondrosarcoma, in pelvis, scapula, spine, humerus, tiba or femur in men 30-60
primary bone tumor that has anaplastic small cell, aggressive mets, good chemo response
Ewings sarcoma ( this seems important- lots of questions on it)
primary bone tumor that is most common malignant bone tumor is children.
osteosarcoma
You are conducting a study trying to determine the reduction in risk of developing a relapsing depressive episode with antidepressant X when compared to a placebo treatment. What is this
Determination called?
absolute risk reduction
What is attributable risk?
difference in risk between exposed and unexposed groups or proportion of disease occurences that are attributable to the exposure ( all smokers with lung cancer/ all smokers)- (nonsmokers with lung cancer/ all nonsmokers)
how do you calculate attributable risk?
(a/a+b)- (c/c+d)
A 34--‐year--‐old man is seen in the office. On exam he has corneal arcus and tendon xanthomas. Lab studies reveal markedly elevated LDL. What genetic disease does this patient have, and what is the pathophysiology?
IIa familial hypercholesteroemia
autosomal dominant
absent or decreased LDL receptors
A 34--‐year--‐old man is seen in the office. On exam he has corneal arcus and tendon xanthomas. Lab studies reveal markedly elevated LDL. What else is this patient at risk for?
accelerated atherosclerosis
coronary disease
strokes
AAA
tendon (Achilles) xanthomas
corneal arcus
A 56--‐year--‐old man develops diarrhea after a course of clindamycin while in the hospital. For which infections is vancomycin a good choice?
vancomycin will treat Gram positive infections only.
Serious multidurg resistant organisms like Staph aureus and C diff
How is vancomycin resistance brought about?
resistance occurs with amino acid change of D-ala D-ala to D-ala D-lac when binding to cell wall
. A 22--‐year--‐old man had an exploratory laparotomy with excision of 7 cm of small bowel after sustaining a gunshot wound to the abdomen. Postoperatively he is sent to recover in the ICU because of concern for hemorrhage. That night the intern is called to the bedside because the patient Has developed increasing tachycardia and decreased pulse pressure. What is pulse pressure?
pulse pressure= systolic pressure - diastolic (120-80=40 pulse pressure)
What is the equation for MAP?
MAP = 2/3 diastolic pressure + 1/3 systolic pressure
MAP= CO X total peripheral resistance
A 54--‐year--‐old obese Hispanic male with a family history of type 2 diabetes mellitus has been experiencing polyuria and polydipsia over the past 3--‐4 weeks. Given the patient’s presentation, a random blood glucose and urinalysis are obtained. The patient’s random blood glucose is 110 mg/dL.
Urinalysis reveals no glycosuria or proteinuria, but there is a decreased urine specific gravity. The patient goes on to have an increased serum osmolality and a normal fasting blood glucose, glucose tolerance test and HgbA1c. What does he have?
diabetes insipidus
What are the diagnostic tests for diabetes insipidus?
water deprivation test- in diabtetes insipidus urine osmolality doesnt increase like in normal person
desmopressin challenge- central- urine osmolality will work and will fix problem, wont fix it in nephrologic DI
What are causes of Diabetes Insipidus
central- pituitary tumor, surgery, histiocytosis X ( affects pituitary)
renal- hereditary or secondary to hypercalcemia, lithium, demeclocycline (ADH anatgonist) tetracycline
7. A 60--‐year--‐woman has a protein electrophoresis study performed while being worked up for
a persistent skin rash. The test found an elevation of a Monoclonal immunoglobin incidentally. The patient denies any symptoms other than her rash and x--‐rays show no lytic lesions. Based
on the information so far, what might this patient’s condition be classified as in reference to her elevated monoclonal immunoglobulin?
MGUS- monoclonal gammaopathy of undetermined significance
monoclonal plasma cell expansion without symptoms of multiple myeloma
8. You are seeing a 12--‐year--‐old male for an ER follow--‐up appointment for a new onset seizure. Your neurological exam is normal but you notice that patient has several scattered hypopigmented plaques and macules over his skin. You are concerned that a combination of
The hypopigmented lesions and seizures might point towards a diagnosis of tuberous sclerosis. What are these hypopigmented lesions called? What other dermatologic findings
Are associated with tuberous sclerosis?
hypopigmented (ash lead spots)
hamartomas in CNS, skin, organs
mental retardation too
8. You are seeing a 12--‐year--‐old male for an ER follow--‐up appointment for a new onset seizure. Your neurological exam is normal but you notice that patient has several scattered hypopigmented plaques and macules over his skin. You are concerned that a combination of
The hypopigmented lesions and seizures might point towards a diagnosis of tuberous sclerosis. What neoplasms are ptients with tuberous sclerosis at risk for developing?
hamartomas in CNS, skin, organs, cardiac rhabdomyoma, renal angiomyolipoma, subependymal giant cell astrocytoma, sebeous adenoma
A 4--‐month--‐old male infant has been diagnosed with failure to thrive. The infant has coarse facial features and clouded corneas. The laboratory workup for this patient reveals
High plasma levels of lysosomal enzymes. You suspect the patient has mucolipidosis II, also
Called I--‐cell disease. What is the primary pathophysiology and what are some other
Features of I--‐cell disease?
inherited lysosomal storage disorder- failure of addition of mannose-6-phosphate to lysosome proteins (enzymes are secreted outside the cell instead of being targeted to lysomsome)
course facial features
clouded corneas
restricted joint movement
high plasma levels of lysosomal enzymes
often fatal in childhood
An 18--‐year--‐old female is seen for lower abdominal pain, nausea, and vomiting. She has
Vaginal discharge and reports having multiple sex partners. Upon palpation of the cervix during bimanual vaginal exam, the patient screams in agony. Which bacteria are well known
For being obligate intracellular bacteria? Why can’t these bacteria replicate extracellularly?
It's my baby plush toy chlamydia!!!!
rickettsia (rocky mountain spotted fever) is also intracellular but I don't think that's in her vagina but I'm not a doctor yet.
These intracellular bacteria can't make their own ATP so they can't reproduce extracellularly
asthma exacerbation hypersensitivity rxn
type 1
poison ivy dermatitis hypersensitivity rxn
type 4
goodpasture syndrome hypersensitivity rxn type
type 2
arthus reaction (from tetanus vaccine) type
type 3
anaphylaxis hypersensitivity rxn
type 1
serum sickness hypresensitivity reacton
type 3
autoimmune hemolytic anemia hypersensitivity reaction type
type 2
liver transplant rejection reaction
type 4
rh incompatability ( erythroblastosis fetalis) hypersenstivity reaction
type 2 because you didnt give RhoGam at 28 weeks and postpartumly
TB skin test hypersensitivity reaction
type 4
An echocardiogram reveals a dilated cardiomyopathy in the evaluation of a 53--‐year--‐old man with chest pain. You discover in the patient’s history that the patient does not drink alcohol. Other than chronic alcohol abuse, what are some other potential causes of dilated cardiomyopathy? What heart sounds might be present in a patient with dilated cardiomyopathy?
caused by wet beriberi (thiamine deficiency) coxsackie B virus myocarditis, chronic cocoaine use, chagas disease, doxorubicin toxicity, hemochromoatosis and peripartum cardiomyopathy.
you'll hear S3
. You have a patient who is experiencing progressive difficulty with swallowing liquids and solid food. Subsequently, the patient undergoes a barium swallow that reveals stenosis of the lower esophageal sphincter. What is the diagnosis associated with this barium swallow finding? What are
Some common causes of this diagnosis?
It's achalasia!!
can be:
idiopathic
2ndary to chagas
2ndary from scleroderma(CREST)
from amyloidosis or sarcoidosis
see birds beak on barium swallow
What is the problem in compartment syndrome, and what is the treatment?
tissue swells- can be from exercise in an inactive person- causing vascular compromise
must. cut. fascia!!!!
What is kallmans syndrome?
defenctive GnRH so hypogonadism and ansomia.