High Yield

Front 1

Term

Back 1

Association

Hint 1

Notes

Front 2

Orientia tsutsugamushi

Back 2

black eschar, rash on trunks that spreads to extremities, chigger borne

Hint 2

Formerly Rickettsia tsutsugamushi

Front 3

Chlamydia trachomatis

Back 3

cell wall lacks muramic acid

Front 4

Reiter's Syndrome

Back 4

Urethritis, conjunctivitis/uveitis, arthritis

Front 5

Yersinia pestis

Back 5

antiphagocytic components F1 and VW

Hint 5

F1 and VW are active at 37C, which is why they are not virulent in the flea vector (25C)

Front 6

Type 3 Secretion System (T3SS)

Back 6

sensory probes used to detect presence of eukaryotic organisms, help bacteria infect

Hint 6

Shigella, Salmonella, Yersinia, Chlamydia, Pseudomonas, EHEC

Front 7

Red man syndrome

Back 7

Vancomycin

Hint 7

also ciprofloxacin, amphotericin B

Front 8

sporotrichosis

Back 8

rose thorns, gardeners

Hint 8

subcutaneous nodules that ulcerate and travel along lymphatics

Front 9

Histoplasma

Back 9

bird and bat droppings in mississippi and ohio

Hint 9

granulomas with calcifications on CXR

Front 10

Progressive supranuclear palsy

Back 10

widespread neuronal loss and gliosis in subcortical sites

Front 11

Middle meningeal artery

Back 11

found in middle cranial fossa

Front 12

Toxoplasmosis

Back 12

poorly cooked pork

Front 13

Mucor and Rhizopus

Back 13

>90 degree branching, ketoacidotic diabetics

Front 14

Buproprion

Back 14

seizures in bulimic or anorexic patients

Front 15

Torticollis

Back 15

involuntary twisting or devation of the neck, neck pain, sensory tick, abnormal head posture

Hint 15

acute or delayed complication of dopamine antagonist therapy (antipsychotics)

Front 16

Organ of Corti

Back 16

Contains hair cells that can be damaged by loud sounds

Front 17

Atherosclerosis of brain vessels

Back 17

commonly found in circle of willis, NOT in penetrating smaller arteries

Front 18

Subdural hematoma

Back 18

negative initial workup at time of trauma, delayed onset of symptoms (2 weeks), originates from bridging veins

Front 19

Internal branch of superior laryngeal nerve

Back 19

supplies sensory innervation to laryngeal mucosa above vocal cords

Hint 19

runs with superior laryngeal artery

Front 20

Subacute sclerosing panencephalitis

Back 20

caused by perinatal measles (rubeola) infection, manifests in childhood, teenager and leads to death

Front 21

Prions

Back 21

acute presentation of progressive ataxia and dementia, spongiform change

Hint 21

encephalopathy with axonal degneration, neuronal loss, gliosis, astrocytic proliferation

Front 22

Cushing reflex

Back 22

HTN and bradycardia due to increased ICP

Hint 22

autonomic response triggered by changes in the arterial-to-intracranial pressure gradient

Front 23

xerostromia

Back 23

Dry mouth

Front 24

Amide analgesics

Back 24

Have 2 "I's" in name

Front 25

Trihexyphenidyl

Back 25

muscarinic antagonist

Hint 25

used as adjunctive therapy in Parkinson disease

Front 26

Amitriptyline

Back 26

Strong anticholingergic effects

Hint 26

useful in depression and parkinsons

Front 27

vincristine

Back 27

peripheral neuropathy

Front 28

anterior ear canal innervation

Back 28

auriculotemporal nerve

Front 29

posterior half of ear canal innervation

Back 29

auricular branch of vagus

Front 30

both surfaces of lower auricle

Back 30

great auricular nerve

Front 31

cranial surface of upper auricle

Back 31

lesser occipital nerve

Front 32

viral encephalitis

Back 32

arthropod transmission during summer

Front 33

Blowout fracture

Back 33

maxillary sinus blood

Front 34

Prosopagnosia

Back 34

can't recognize faces

Front 35

cryptococcus

Back 35

latex particle agglutination

Front 36

nerve growth

Back 36

1 mm/day

Front 37

Lithium

Back 37

hypothyroidism

Hint 37

check TSH every 1 to 2 months

Front 38

Vecuronium

Back 38

ACh antagonist

Hint 38

reverse blockade with neostigmine

Front 39

Ki-67

Back 39

stains astrocyte neoplasms

Front 40

acanthamoeba

Back 40

free living amoeba that infects brain, usually in immunosuppressed

Front 41

cyclobenzaprine

Back 41

centrally acting skeletal muscle relaxant

Hint 41

structurally related to TCAs, has anticholingergic side effects

Front 42

schwann cells

Back 42

axonal regeneration

Front 43

toxoplasmosis

Back 43

ingestion of cysts in meat

Front 44

Pick's disease

Back 44

similar to AD, but with frontotemporal atrophy

Front 45

REM sleep decrease

Back 45

medication that causes decrease in ACh

Front 46

piriform cortex

Back 46

primary olfactory cortex

Hint 46

receives neurons from olfactory bulb

Front 47

Glaucoma (closed angle)

Back 47

painful, bluurred vision w/ halos around eyes

Hint 47

treat with IV acetazolemide

Front 48

Y. pestis

Back 48

prophylaxis is doxycycline, treatment is streptomycin or gentamycin

Front 49

lymphogranuloma venerum

Back 49

C. trachomatis L1-L3, fluctuant draining nodules

Front 50

Thiamine deficiency

Back 50

Wernicke-Korsakoff, Dry beriberi (polyneuritis), wet beriberi (cardiomyopathy)

Front 51

HIV encephalitis

Back 51

multinucleated giant cells

Front 52

S. pneumoniae attachment

Back 52

IgA protease cleaves IgA into Fc, which attaches to bacterium and allows attachment to Fc receptors on mucosal cells

Front 53

Phenylethanolamine=N-methyltransferase (PMNT)

Back 53

converts NE to E

Front 54

Halothane

Back 54

hepatitis w/ focal massive necrosis

Front 55

Cowdry Type A inclusions

Back 55

HSV-1 encephalitis, intranuclear viral inclusion bodies

Front 56

HSV-1

Back 56

most common cause of fatal, sporadic encephalitis cases in US

Front 57

area postrema

Back 57

floor of 4th ventricle, responds to chemical signals, vomit center

Front 58

Alar plate

Back 58

dorsal spinal cord

Hint 58

sensory or afferent portion

Front 59

basal plate

Back 59

ventral part of spinal cord

Hint 59

motor or efferent portion

Front 60

AChE inhibitors

Back 60

carbamylate AChE

Hint 60

often combined w/ prednisone to treat severe MG

Front 61

Pinealoma

Back 61

Parinaud syndrome (epward gaze palsy, light and accomodation deficit, failure of convergence

Front 62

Herpes zoster encephalitis

Back 62

Encephalitis + shingles

Hint 62

resistant to acyclovir

Front 63

General paresis

Back 63

general paraylsis of the insane, includes mental deterioration that precedes motor system deterioration

Hint 63

late sequela of syphilitic infection

Front 64

sagittal sinus thrombosis

Back 64

associated with hypercoagulable states

Hint 64

increased frequency during prego/postpartum

Front 65

Taenia solium

Back 65

cysticercosis, can invade CNS (neurocysticercosis)

Hint 65

parasitic infection by ingesting eggs in pork, found in south america and central america

Front 66

Cerebellar abscess

Back 66

otitis media is #1 cause

Front 67

Pituitary surgery

Back 67

approach via the sphenoid sinus transnasally

Front 68

Thyroglossal duct

Back 68

thyroid gland

Hint 68

failure of the duct to degenerate may lead to a thyroglossal duct cyst or a median cervical cyst

Front 69

Retinal angiomas

Back 69

Von hippel-lindau disease

Front 70

Nerve in tonsillar fossa

Back 70

glossopharyngeal nerve

Front 71

Bartonella henselae

Back 71

cat-scratch disease

Hint 71

stellate granulomas w/ central necrosis and gram neg organisms

Front 72

Target cells

Back 72

thalassemia, hemoglobin C disease, liver disease

Front 73

Reed-sternberg cell

Back 73

somatic hypermutation, CD15, CD30

Front 74

Nodular sclerosis hodgkin's lymphoma

Back 74

fibrotic bands

Front 75

Mast cells

Back 75

release histamine, serotonin, leukotrienes, platlet aggregating factor (PAF)

Hint 75

Giemsa stain = metachromasia of cytoplasm, granular cytoplasm

Front 76

Lines of Zahn

Back 76

cell-rich layers found in a thrombus that forms pre-mortem

Hint 76

post-mortem clots will not have lines of zahn

Front 77

Spontaneous bleeding

Back 77

20,000 platelet count

Front 78

E. coli K1 capsule

Back 78

neonatal meningitis

Hint 78

Listeria and GBS are other common causes of neonatal meningitis

Front 79

Hepatocellular carcinoma

Back 79

erythropoietin overproduction -> polycythemia

Hint 79

increased EPO is also associated with RCC and hemangioblastoma

Front 80

Burkitt Lymphoma

Back 80

t(8;14), t(8;22), t(2;8)

Front 81

Febuxostat

Back 81

xanthine oxidase inhibitor

Hint 81

given in conjunction with chemotherapy for leukemias and lymphomas to prevent hyperuricemia

Front 82

Sulfa drugs + hemolytic anemia

Back 82

G6PD

Front 83

Schuffner dots

Back 83

multiple brick-red dots in Romanovsky-stained blood smears

Hint 83

P. vivax occurs in western hemisphere

Front 84

Clarithromycin

Back 84

inhibits hepatic enzymes

Hint 84

if given with warfarin, enhances activity and may lead to anticoag and hematuria

Front 85

G6PD hemolytic drugs

Back 85

antimalarials, dapsone, sulfonamides

Front 86

Decreased ESR

Back 86

sickle-cell, polycythemia, CHF

Front 87

Increased ESR

Back 87

increased antibody formation: cancer, infection, prego, connective tissue diseases

Front 88

Smudge cells

Back 88

CLL

Hint 88

older individuals, indolent

Front 89

cirrhosis and coag factors

Back 89

If d-dimer is increased, that means that fibrin is still being made and that the real reason for a decrease in coag factors is consumption and not the cirrhosis

Front 90

FDPs vs. d-dimer

Back 90

FDP can be generated from degradation of fibrinogen or fibrin, while D-dimer derives exclusively from fibrin

Hint 90

FDP can be elevated due to plasmin-mediated breakdown of fibrinogen (primary fibrinolysis). Elevated FDP isn't enough for DIC. You must also have and increased D-dimer. People with cirrhosis can have decreased plasmin inhibiting proteins and this would lead to an increased FDP, which could incorrectly be diagnosed as DIC

Front 91

DIC

Back 91

exposure to lots of tissue factor over a brief period of time

Front 92

Celecoxib

Back 92

COX-2 inhibitor

Hint 92

used for pain management, contraindicated in sulfa allergy and coronary disease

Front 93

Pirioxicam

Back 93

indicated for moderate to severe pain associated with inflammatory disease

Front 94

TdT (terminal deoxynucleotidyl transferase)

Back 94

mediates N-nucleotide addition to junctions in gene segments

Hint 94

very primitive cell marker that is active when VDJ rearrangement occurs

Front 95

Cytoplasmic mu chains

Back 95

positive cells have completed VDJ rearrangement

Front 96

Babesia microti

Back 96

causes babesiosis transmitted by the Ixodes tick

Hint 96

B. burgdorferi and Ehrlichia phagocytophila are also trasnmitted by the Ixodes scapularis tick

Front 97

P-450 inducers

Back 97

quinidine, barbiturates, St. John's wort, Phenytoin, rifampin, griseofulvin, carbamazepine, chronic alcohol use

Hint 97

Queen Barb Steals Phen-phen and Refuses Greasy Carbs Chronically

Front 98

P-450 inhibitors

Back 98

sulfonamides, isoniazid, cimetidine, ketoconazole, erythromycin, grapefruit juice, acute alcohol use

Hint 98

Inhibit yourself form drinking beer from a KEG because it makes you Acutely SICk

Front 99

Epstein-Barr virus

Back 99

infects B-cells by attaching to CD21 receptor

Hint 99

cells that predominate in the blood during a EBV infection are CD8+ T-cells

Front 100

Chloroquine

Back 100

contraindicated in malarial patients with psoriasis

Hint 100

may lead to chloroquine retinopathy

Front 101

Malaria treatment

Back 101

Chloroquine is first choice, atovaquone/proguanil is alternative treatment

Front 102

Eosinophil granules

Back 102

crystalline core contains major basic protein (destroys parasites)

Hint 102

light component around the dense crystalline core contains histaminase, arylsulfatase, and other enzymes

Front 103

Gamma-carboxyglutamate residues

Back 103

vitamin K deficiency prevents gamma-carboxyglutmation and thus a deficiency in clotting factors

Front 104

Brushfield's spots

Back 104

white speckling of the iris

Hint 104

associated with Down Syndrome. Down syndrome also increases risk of VSD, ASD, ALL, Alzheimer's, duodenal atresia

Front 105

TGF-β

Back 105

stimulates production of basophils and suppresses production of eosinophils

Front 106

Neurofibromin gene (chromosome 17)

Back 106

inhibits p21 ras oncoprotein

Hint 106

mutation leads to neurofibromatosis type 1

Front 107

Merlin gene (chromosome 22)

Back 107

regulator of contact-dependent inhibition of proliferation

Hint 107

mutation leads to neurofibromatosis type 2

Front 108

Downey Type II Cells

Back 108

large, basophilic, vacuolated T-cells

Hint 108

associated with EBV

Front 109

Bone marrow expansion in calvarium

Back 109

sickle-cell, thalassemia

Front 110

Treatment of neonatal jaundice

Back 110

Phototherapy (light decomposes bilirubin) and riboflavin

Front 111

Warfarin overdose

Back 111

Both extrinsic and intrinsic pathways are affected

Hint 111

normally, during warfarin treatment, only PT is prolonged because factor VII is the only factor that is decreased enough to impair coag

Front 112

Streptokinase

Back 112

binds to and activates plasminogen

Front 113

DiGeorge Syndrome

Back 113

Patients present with tetany (hypocalcemia due to hypoPTH), recurrent infections, lack of type IV hypersensitivity

Hint 113

CATCH-22: Cardiac abnormality, Abnormal facies, Thymic aplasia, Cleft palate, Hypocalcemia, deletion on chromosome 22

Front 114

Cat-scratch fever

Back 114

painful, enlarged lymph node w/o fever

Hint 114

biopsy of node shows granulomas with necrotic debris

Front 115

Uterine leiomyomas

Back 115

blood loss during menstruation leads to iron deficiency anemia

Front 116

extracellular bacterial infection

Back 116

high white count with left shift

Front 117

Birbeck granules

Back 117

Langerhans cell histiocytosis

Front 118

Heterophile antibody test

Back 118

diagnostic test for EBV/mononucleosis

Hint 118

another word for monospot

Front 119

EBV

Back 119

nasopharyngeal carcinoma, African form of Burkitt lymphoma, B-cell lymphoma

Front 120

French-American-British classification

Back 120

L for lymphoblastic, M for myeloblastic

Hint 120

1 for small uniform nuclei and scant cytoplasm, 2is variable lymphoblasts with irregular nuclei and more cytoplasm

Front 121

Hemoglobin A2

Back 121

B-thalassemia minor

Front 122

ABO incompatibility

Back 122

Mother is O and infant is A or B. Normally, IgM is produced by mother, but rarely, IgG can be produced and can cross the placenta

Hint 122

mild anemia, jaundice, + coombs test

Front 123

ticlopidine

Back 123

severe bone marrow toxicity

Hint 123

same mechanism as clopidogrel (inhibit ADP receptor)

Front 124

Polycythemia vera

Back 124

can progress to essential thrombocytosis and myelofibrosis, but does not progress to CML

Front 125

ergonavine

Back 125

triggers vasospasm in susceptible patients, use with angiography to diagnose prinzmetal angina

Front 126

baclofen

Back 126

treat spasticity

Hint 126

used in dystonia, symptomatic MS

Front 127

Waldenstrom's macroglobulinemia

Back 127

cancer of lymphocytes

Hint 127

IgM spike, no bone lytic lesions, hyperviscosity syndrome

Front 128

Xanthoma

Back 128

lipid laden histiocytes seen in hyperlipidemia (Touton cells)

Front 129

Variceal rupture

Back 129

engorgement of the azygos vein and the left gastric vein

Front 130

Atropine

Back 130

leads to rapid pulse with no change in blood pressure

Front 131

Lyme disease

Back 131

AV block

Front 132

Temporal arteritis

Back 132

focal granulomatous inflammation

Front 133

Coarctation

Back 133

rib notching, hypertension due to underperfused kidneys (RAAS activation)

Hint 133

occurs distal to the left subclavian artery near the region of the ductus arteriosus

Front 134

Loeffler endocarditis

Back 134

restrictive cardiomyopathy, prominent eosinophilic infiltrate

Front 135

Isolated elevated AST

Back 135

myocardial infarction

Front 136

Transposition of great vessels

Back 136

keep PDA open with PGE1 analog like alprostadil or misoprostal

Hint 136

PDA shunt must be open to keep oxygenated blood circulating

Front 137

VEGF

Back 137

secreted under hypoxic conditions by cells, such as muscle during exercise

Hint 137

levels rise to high levels within an hour after exercising

Front 138

Arteriolar rarefaction

Back 138

loss of arterioles (decreased arteriolar density) seen in severe hypertension

Front 139

Capillary wall-to-lumen ratio

Back 139

never changes because capillaries don't have smooth muscle in their walls

Front 140

Tenecteplase, alteplase

Back 140

tPA

Front 141

Beta thalassemia major

Back 141

large numbers of transfusions lead to iron overload and hemosiderosis, which eventually leads to cardiac failure

Front 142

Medial umbilical arteries

Back 142

arise from internal iliac arteries

Front 143

Guarnieri bodies (type B inclusions)

Back 143

diagnostic for poxvirus

Hint 143

poxvirus is the only DNA virus to replicate entirely in the cytoplasm

Front 144

koilocytic atypia

Back 144

squamous epithelial cells with characteristic cytoplasmic vacuoles

Hint 144

HPV

Front 145

Severing of IX and X

Back 145

tachycardia w/ hypertension

Hint 145

illusion that the patient has lost all blood pressure leads to increase in sympathetic stimulation

Front 146

Propranolol

Back 146

blunt or prevent the premonitory signs and symptoms (hunger, tachycardia, fatigue, tremors) or hypoglycemia

Hint 146

nonselective beta-blockers may even potentiate insulin-induced hypoglycemia

Front 147

hyperplastic arteriolosclerosis

Back 147

"onion-skinning" in vessel walls due to progressive laying down of fibrotic tissue by smooth muscle cells

Front 148

Procainamide

Back 148

reversible SLE, prolonged QT

Hint 148

contraindicated in long QT syndrome

Front 149

Charcot-Bouchard

Back 149

intracerebral hemorrhage

Hint 149

mostly found in small perforating vessels of the brain (lenticulostriate)

Front 150

Berry aneurysm

Back 150

subarachnoid hemorrhage

Hint 150

blood metabolites can lead to vasospasm

Front 151

valproic acid

Back 151

hepatotoxicity, neural tube defects in fetus

Front 152

Type II pneumocytes

Back 152

lamellar bodies which contain the surfactant

Front 153

Hemoptysis

Back 153

rupture of bronchial veins due to left heart failure

Front 154

Mucor

Back 154

epistaxis, severe facial sinus infection, frontal lobe abscess

Hint 154

DKA and leukemia

Front 155

Corynebacterium diptheria

Back 155

grow on tellurite agar, look for gram positive rod with metachromatic granules

Front 156

Hirano bodies

Back 156

intracytoplasmic proximal dendritic eosinophilic inclusions composed of actin

Hint 156

seen in AD

Front 157

Transposition of the great vessels

Back 157

associated with maternal diabetes

Front 158

Thiazide diuretics

Back 158

drug-induced gout

Front 159

Spironolactone

Back 159

blocks androgen receptors, leading to gynecomastia (can use eplerenone instead, because it's a more specific aldosterone receptor antagonist)

Hint 159

potassium sparing duiretic that is a competitive inhibitor of aldosterone receptors in the DCT

Front 160

Contractility of heart

Back 160

demonstrated by slope of graph…

Hint 160

increased by beta-1 agonists

Front 161

Muscarinic cholinergic receptor antagonist

Back 161

increases heart rate without changes in MAP

Front 162

Marfan

Back 162

defect in fibrillin

Front 163

ACE inhibitors

Back 163

delay progression of CHF by protecting ventricles from remodeling

Hint 163

first line treatment for CHF, HTN w/ diabetes, renal problems

Front 164

Indomethacin (NSAIDS)

Back 164

precipitate acute renal failure

Hint 164

decrease prostaglandin synthesis, which primarily affects the afferent arteriorle, leading to vasoconstriction

Front 165

beta blockers

Back 165

can cause AV block

Front 166

Rheumatic heart disease

Back 166

fibrous bridging between valve leaflets and calcifcation, "fish-mouth" appearance

Front 167

Calcification of mitral annulus

Back 167

beadlike calcifications of the annulus in elderly individuals

Front 168

Tiny vegetations along the line of closure of the valve leaflet

Back 168

marantic (nonbacterial thrombotic) endocarditis

Hint 168

marantic endocarditis: sterile vegetations as a result of a pro-coag effect from tumors of the colon and pancreas

Front 169

Indapamide

Back 169

non-thiazide diuretic which acts like thiazide, lead to decreased Ca in urine

Hint 169

indapamide, hydrochlorothiazide, metolazone are used in volume overloaded states and HTN

Front 170

Digoxin

Back 170

life-threatening cardiac dysrhythmias (paroxysmal supraventricular tachycardia)

Front 171

CHF

Back 171

S3 sound on auscultation

Front 172

Amlodipine

Back 172

Ca-channel blocker, works on smooth muscle

Hint 172

used for treatment of mild to moderate HTN and angina

Front 173

Left dominant coronary arteries

Back 173

PDA is supplied by the left CFX

Hint 173

infarction leads to ischemia of the posterior septum and posterior left ventricle

Front 174

Anemia

Back 174

increased stroke volume and cardiac output to make up for the low levels of Hb

Front 175

Neutrophil granule contents

Back 175

myeloperoxidase, lactoferrin, hydrolytic enzymes

Front 176

Granulomatosis infantisepticum

Back 176

vaginal transmission of listeria to neonate leads to early-onset sepsis or neonatal meningitis

Hint 176

formation of fatal granulomas

Front 177

Enterococcus faecium

Back 177

More likely to be resistant to vancomycin, less common than E. faecalis

Front 178

ethambutol

Back 178

red-green color blindness

Front 179

Isoniazid, pyrazinamide

Back 179

must be activated by bacterial enzymes from prodrug form

Front 180

Chlorthalidone

Back 180

thiazide diuretic

Front 181

Persistent truncus arteriosus

Back 181

goes along with a VSD, because the conotruncal ridges that are malformed in the truncus also give rise to the interventricular septum

Front 182

Adult polycystic kidney disease

Back 182

Give ACE inhibitor to treat HTN

Hint 182

the cysts impair perfusion of glomeruli, which triggers the secretion of renin by the juxtaglomerular complexes

Front 183

QRS complex prolongation

Back 183

can occur due to bundle branch block, which can be a result of coronary artery occlusion

Front 184

Cystic hygroma

Back 184

assoicated with Turner syndrome

Hint 184

Turner also associated with coarctation, aortic stenosis, webbed neck, lymphedema of the extremities, short stature, gonadal dysgenesis, hypothyroidism, and infertility

Front 185

Rib notching

Back 185

found in coarctation, due to anterograde flow through the intercostal artery via the subclavian (first intercostal artery) or internal thoracic artery (subsequent intercostal arteries)

Front 186

Venous drainage of ovary

Back 186

Right ovary: drain into pampiniform plexus, right gonadal (ovarian) vein, IVC

Hint 186

Left ovary: drain into pampiniform plexus, left gonadal (ovarian vein), left renal vein, IVC

Front 187

Central hemorrhagic necrosis of hepatic lobules

Back 187

CHF

Hint 187

mottled appearance (nutmeg liver)

Front 188

Minoxidil

Back 188

opens K-ATP channels and hyperpolarizes the membrane, resulting in relaxation of vascular smooth muscle

Hint 188

also hyperpolarizes pancreatic beta cells, leading to a decrease in insulin secretion in response to glucose

Front 189

Aortic stenosis

Back 189

increase in diastolic blood flow

Hint 189

AS causes an increase in systolic pressure in the LV, compressing the coronary arteries even further, thus making it necessary to increase blood flow during diastole even more so that in a normal heart

Front 190

AA Amyloid

Back 190

assoicated with chronic inflammatory disease

Front 191

AE Amyloid

Back 191

assoicated w/ medullary carcinoma of the thyroid and pancreatic islet cell adenomas

Hint 191

AE amyloid is not systemically distributed, but found directly in the neoplasm

Front 192

AF Amyloid

Back 192

assoicated w/ certain familial amyloidosis syndromes

Hint 192

distributed within peripheral nerves and kidney and senile cardiac amyloidosis in elderly

Front 193

AL Amyloid

Back 193

associated w/ myeloma and B-cell malignant lymphomas

Hint 193

produced by neoplastic cells which deposit in heart, GI, kidney, spleen, tongue

Front 194

Septic pulmonary edema

Back 194

due to increase vascular permeability

Front 195

Peaked T-wave

Back 195

hyperkalemia

Front 196

Constrictive pericarditis

Back 196

kussmaul sign, pericardial knock

Hint 196

usually due to TB or pyogenic staph infections

Front 197

kussmaul sign

Back 197

increase in systemic venous pressure on inspiration, due to impaired filling of the right ventricle

Front 198

Long QT syndrome

Back 198

don't use drugs that prolong QT, cause hypokalemia, or hypomagnesemia

Hint 198

agents that prolong QT include procainamide, sotalol, amiodarone, disopyramide, dofetilide, phenothiazines, and TCAs

Front 199

patent ductus arteriosus

Back 199

indomethacin to close, alprostadil (prostaglandin) to keep open

Front 200

Complete heart block (third degree heart block)

Back 200

ventricles beat independently of SA node activity and do not correspond to P waves

Hint 200

heart rate is usually 30-40 bpm. Stroke volume is increased so that CO remains constant to keep a constant BP, but pulse pressure still goes up a bit because SV increases

Front 201

Paraganglioma

Back 201

most often found in adrenal glands (pheochromocytoma), but most common extra-adrenal is carotid body tumor

Hint 201

catecholamines are the major secretory products (norepinephrine for non-adrenal, epinephrine for adrenal)

Front 202

Carotid body hyperplasia

Back 202

people living at altitude/high mountains

Front 203

Congenital rubella

Back 203

triad of PDA, cataracts, sensorineural deafness

Hint 203

Prego mother with rubella has classic postauricular and suboccipital lymphadenopathy

Front 204

Coxsackievirus A

Back 204

herpangina (mouth blisters), acute hemorrhagic conjunctivitis, hand-foot-mouth disease

Hint 204

both Coxsackie A and B cause aseptic meningitis and the common cold

Front 205

Coxsackievirus B

Back 205

myocarditis, pericarditis, pleurodyna, Bornholm disease (Devil's grip), hepatits

Hint 205

both Coxsackie A and B cause aseptic meningitis and the common cold

Front 206

Bornholm disease

Back 206

pleurodyna, often caused by coxsackie B, where there is severe pain in the lower chest, often on a specific side

Front 207

Reovirus

Back 207

only double stranded RNA virus (dsRNA)

Front 208

Hantavirus

Back 208

rodent borne virus (robovirus), unlike other bunyaviridae which are arthropod borne (arbovirus)

Hint 208

hemorrhagic fever and Hantavirus pulmonary syndrome (HPS): endothelial injury leads to edema in lungs and can lead to hypovolemic shock

Front 209

Clonidine

Back 209

centrally acting alpha 2 agonist that works at the locus ceruleus to inhibit NE release

Front 210

Dextramethorphan

Back 210

used for cough suppression

Hint 210

opioid

Front 211

Meperidine

Back 211

anti-ACh properties and pro CNS seizure activity

Front 212

Beaded pattern on angiography

Back 212

fibromuscular dysplasia

Hint 212

common cause of renovascular stenosis in women (renal bruits on examination)

Front 213

Atherosclerosis w/ foci of calcification

Back 213

indicates severe atherosclerotic disease

Front 214

Buerger disease

Back 214

recurrent inflammatory disorder that causes thrombosis in extremities

Hint 214

associated with heavy smokers

Front 215

metoprolol

Back 215

dyslipidemia

Hint 215

Other beta blockers can cause AV block

Front 216

Serotonin syndrome

Back 216

hyperthermia, muscle rigidity, cardiovascular collapse, flushing, diarrhea, seizures

Hint 216

treat with cyproheptadine

Front 217

Capillaries

Back 217

largest cross-sectional area of any vessel in the body

Hint 217

translates to slowest flow through the vessels compared to other vessels

Front 218

Furosemide

Back 218

can lead to problems if used with Digoxin

Hint 218

furosemide leads to hypokalemia, which can exacerbate the effects of digoxin

Front 219

Fully compensated coarctation

Back 219

blood flow below and above the coarct are no different than a normal person

Hint 219

check pulses to see if the resistance has changed (increased pulse = increased resistance)

Front 220

Endocardial cushions

Back 220

migration of neural crest cells is required for proper development of the endocardial cushions

Hint 220

Abnormal migration of neural crest cells in Down syndrome leads to cardiac defects

Front 221

Methemoglobinemia

Back 221

treat with methylene blue (enhances conversion of methemoglobin to hemoglobin by increasing activity of enzyme methemoglobin reductase) or ascorbic acid

Hint 221

methemoglobinemia can be caused my excessive adminstration of nitric oxide (NO) because the NO reacts with hemoglobin to produce methemoglobin

Front 222

Intense, static exercise

Back 222

skeletal muscle contracts, compressing the vessels, leading to decreased blood flow and increase vascular resistance

Front 223

dynamic, endurance exercise

Back 223

skeletal muscles relax after contraction allowing the vessels to dilate, leading to increased blood flow and decreased vascular resistance

Front 224

Dressler's syndrome

Back 224

fibrinous pericarditis

Front 225

Acebutolol, pindolol

Back 225

Beta blocker with intrinsic sympathomimetic activity

Hint 225

not good for patients with angina because it may exacerbate it, or patients with thyrotoxicosis

Front 226

Hypertension in pregnancy

Back 226

Methyldopa (converted to alpha-methylnNE, which stimulates alpha-2 receptors centrally and leads to decreased sympathetic outflow)

Front 227

MSFP

Back 227

a measure of the "tightness" with which the circulatory system is filled with blood

Hint 227

MSFP increases with more blood in the system and it's easier for blood to flow into the heart, which tends to increase venous return

Front 228

Graft vascular disease, graft arteriosclerosis

Back 228

develops years after transplantation and is due to intimal thickening of coronary arteries without associated atheroma formation or inflammation

Hint 228

no chest pain because transplanted hearts are denervated

Front 229

Niacin

Back 229

decreases hepatic LDL and VLDL production

Hint 229

side effects: flushing, hepatotoxicity, tachycardia, hypoalbuminemia, hyperglycemia. Aspirin can help reduce the flushing

Front 230

D-I-R-T

Back 230

VMAT inhibitors: lead to decreased reuptake of monoamines into the presynaptic terminal, which allows them to be broken down by MAO, decreasing the monoamine signalling

Hint 230

Deserpidine, Ibogaine, Reserpine, Tetrabenazine

Front 231

Eosinophilia

Back 231

C-H-I-N-A: Connective tissue disease, helminthic infections, idiopathic hypereosinophilic syndrome, Neoplasia, allergies

Front 232

Sphenopalatine artery

Back 232

branch of the maxillary artery

Hint 232

artery of epistaxis

Front 233

Suboccipital triangle

Back 233

can gain access to the vertebral artery through this zone

Front 234

Arteriosclerotic occlusive disease

Back 234

classic symptom is claudication and impotence

Hint 234

decreased arterial pulse at the ankle because vessels are narrowed

Front 235

Rheumatoid arthritis

Back 235

Restrictive amyloid cardiomyopathy

Front 236

Verapamil

Back 236

assoicated with accelerated progression of CHF in certain patients

Front 237

Reduviid bug

Back 237

Trypanosoma cruzi

Hint 237

Chagas disease

Front 238

Varicose veins

Back 238

Exacerbated by chronically high venous pressure in the legs

Front 239

Increased BUN, normal Creatinine

Back 239

prerenal cause of azotemia, such as decreased renal perfusion

Front 240

Kerley's lines

Back 240

septal edema seen on chest radiograph

Front 241

Heart failure cells

Back 241

alveolar macrophages with hemosiderin residue

Hint 241

sputum has a rusty color

Front 242

BNP (brain natriuretic peptide)

Back 242

secreted from ventricles in response to volume expansion and pressure overload

Hint 242

useful in diagnosis of LHF (increased)

Front 243

Arteriovenous fistula

Back 243

high-output heart failure due to bypass of the microcirculation and increased venous return

Hint 243

causes: trauma from knife wound, surgical shunt for hemodialysis, mosaic bone in Paget's disease (where the bone vessels form microfistulas)

Front 244

Hypercoagability

Back 244

at it's peak in the morning hours

Front 245

Prinzmetal angina

Back 245

pathophys thought to be due to thromboxane A2 or an increase in endothelin

Front 246

Myocarditis due to coxsackie

Back 246

lymphocytic infiltrate with focal areas of necrosis

Front 247

Superior vena cava syndrome

Back 247

extrinsic compression of SVC, usually from primary lung cancer

Hint 247

puffiness and blue discoloration of the face, arms, shoulders, retinal hemorhage, stroke

Front 248

Councilman bodies

Back 248

Eosinophilic/acidophilic inclusions in hepatocytes indicating apoptotic death

Hint 248

Yellow fever, viral hepatitis

Front 249

Viral Gastroenteritis

Back 249

#1 is rotavirus, #2 is norovirus

Front 250

Top 5 causes of pediatric red rash

Back 250

Measles, rubella, scarlet fever, roseola, erythema infectiosum (parvovirus)

Front 251

Spontaneous tendon rupture

Back 251

flouroquinolones

Front 252

HBV

Back 252

polyarteritis Nodosa and glomerulonephritis

Hint 252

immune complex deposition

Front 253

Sickle cell immunity against malaria

Back 253

Immune to P. falciparum because of decreased oxygen content in cells and because of increased splenic destruction of sickled cells

Front 254

Red man syndrome

Back 254

side effect of vancomycin, due to direct stimulation of mast cells

Hint 254

give antihistamines before administration of vancomycin or enfuse slowly

Front 255

Sulfonamides

Back 255

Steven Johnson syndrome side effect

Front 256

Ethacrynic acid

Back 256

non-sulfa diuretic used for people with sulfa allergies

Front 257

Thymine dimers

Back 257

caused by UV radiation

Hint 257

inability to repair the defect results in xeroderma pigmentosum, UV sensitivity, excessive freckling, and early onset skin cancer (basal cell, squamous cell, melanoma)

Front 258

Chronic granulomatous disease

Back 258

NADPH oxidase deficient, which prevents formation of oxygen radical products

Hint 258

myeloperoxidase uses a product of NADPH oxidase, hydrogen peroxide, to make it's own toxic chemicals to kill bacteria

Front 259

Velocardiofacial syndrome (DiGeorge Syndrome)

Back 259

malformation of third and fourth pharyngeal pouches, leading to thymic aplasia and absence of parathyroids

Hint 259

may present with tetanus due to hypocalcemia

Front 260

Recombinase A

Back 260

product of the recA gene, necessary for recombination of a linear piece of DNA into the recipient cell's chromosome

Hint 260

F+ to F- conjugation is possibly because there is no transfer of linear DNA (only DNA transfer that doesn't require homologous recombination to occur)

Front 261

Klebsiella pneumonia

Back 261

lobar caviation

Front 262

Reovirus

Back 262

needs its own polymerase enzyme in order to be infectious

Hint 262

other similar viruses include all negative-sense RNA viruses, reovirus (dsRNA), poxvirus (replicates in cytoplasm) and retrovirus

Front 263

Bruton x-linked agammaglobulinemia

Back 263

no peripheral B cells (no CD19+), low levels of IgG

Front 264

hyper-IgM Syndrome

Back 264

IgM-producing B cells cannot receive the signal to isotype switch, leads to severe pyogenic infections early in life

Hint 264

Deficiency in TH cells that express CD40L

Front 265

Dolichol

Back 265

substrate for the synthesis of glycoproteins, such as albumin

Front 266

Chronic rejection therapy

Back 266

Downregulation of T-lymphocyte activity

Front 267

Ascaris lumbricoides

Back 267

posses one of the most potent allergens in nature

Hint 267

leads to type I hypersensitivity

Front 268

Heterochromatin

Back 268

densly packed DNA around histones seen when the cell is undergoing mitosis

Hint 268

indicative of replicating cells and possibly a high grade cancer

Front 269

Unconjugated bilirubin

Back 269

not filtered by the glomerulus because it is water insoluble

Front 270

Anti-RNP antibodies

Back 270

marker for Mixed connective tissue disease (MCTD)

Hint 270

joint pain, myalgias, pleurisy, esophageal dysmotility, skin disease

Front 271

hemorrhagic cystitis

Back 271

cyclophosphamide: aklylating agent that causes DNA crosslinking, treats non-Hodgkin lymphoma, breast cancer, ovarian carcinoma

Hint 271

cyclophosphamide also causes bone-marrow suppression

Front 272

Neuroblastoma

Back 272

childhood tumor of sympathetic nerves along paravertebral chain or adrenal medulla

Hint 272

1p deletion and N-myc translocation, associated with poorer prognosis

Front 273

Mandibulofacial dysostosis

Back 273

abnormally formed mandible, ears, and palate

Hint 273

due to abnormal development of the first and second parhyngeal arches

Front 274

Hemochromatosis

Back 274

increased total body iron stores and can set off airport metal detectors

Front 275

Argyria

Back 275

blue-skin pigmentation due to silver poisoning

Front 276

Primidone

Back 276

P450 inducer

Front 277

Aldolase B (Fructose-1-phosphate aldolase)

Back 277

autosomal recessive disorder of fructose metabolism that leads to accumulation of fructose-1-phosphate

Hint 277

accumulation of F1P inhibits glycogenolysis and gluconeogenesis, causing severe hypoglycemia after ingestion of fructose

Front 278

Aldolase reductase

Back 278

reduces glucose to sorbitol and galactose to galactitol

Front 279

pseudomyxoma peritonei

Back 279

mucus producing tumor of ovary or appendix fills the peritoneal cavity

Front 280

gamma-glutamyl transpeptidase

Back 280

transports amino acids into cells

Hint 280

deficiency causes mental retardation, seizures, increased plasma and urine levels of glutathione

Front 281

Serum sickness

Back 281

caused by hypersensitivity to drugs: fever, urticaria, lymphadenopathy, arthralgias, Erythema multiforme in severe cases. Occurs 7-10 days after initial exposure because it takes that long for IgG generation

Hint 281

Tx: oral prednisone and diphenhydramine (for urticaria)

Front 282

Filaria infection

Back 282

body coats then with thin layer of IgE, triggering an eosinophil-mediated cytotoxicity and the release of vasoactive spasmogenic substrates form mast cells and basophils

Front 283

Exfoliatin

Back 283

proteolytic exotoxin produced by S. aureus that causes bullous impetigo and Staph scalded skin syndrome

Hint 283

cleaves desmogleins in desmosomes

Front 284

Neurocysticercosis

Back 284

swiss-cheese appearance on head CT

Hint 284

ingestion of T. solium eggs in food or water contaminated with human feces

Front 285

C3b

Back 285

product of the cleavage of C3, attaches to bacterial surfaces for opsonization by phagocytes (C3a binds to mast cells and basophils, leading to histamine release)

Hint 285

also involved in removal of immune complexes from serum

Front 286

Sickle Cell in African Americans

Back 286

due to natural selection because sickle cell individuals are resistant to malaria

Front 287

Tamoxifen

Back 287

used to treat ER+ breast cancers

Hint 287

side effect: endometrial carcinoma

Front 288

selective IgA deficiency

Back 288

most common immunodeficiency in US

Hint 288

increased atopic allergy, possibly because of the increased isotype switch to IgE

Front 289

K-complex and sleep spindles

Back 289

high amplitude single spike followed by trough, seen in stage 2 sleep

Front 290

Ammonium chloride

Back 290

used to treat amphetamine overdose

Hint 290

acidifies the urine and hastens amphetamine excretion

Front 291

Desmoplasia

Back 291

excessive fibrous tissue formation usually seen with malignant neoplasms

Front 292

Sjogren syndrome

Back 292

dry mouth (xerostomia), dry eyes (keratoconjuntivitis sicca, patients complain of "sand in eyes"), arthritis

Hint 292

autoantibodies anti-Ro (SS-A), anti-La (SSB), antinuclear, and RF

Front 293

Celecoxib

Back 293

selective COX2 inhibitor, involved in prostaglandins that are assoicated with inflammation and pain

Hint 293

cannot be used in patients with sulfa allergy

Front 294

I-cell disease (inclusion cell disease)

Back 294

lysosomal storage disorder due to failure of addition of mannose-6-phosphate to lysosome destined proteins

Hint 294

lysosomal proteins are secreted out of the cell. Leads to coarse facial features, clouded corneas, restricted joint movement, high plasma levels of lysosomal enzymes, often fatal in childhood

Front 295

Cyclin-CDK complexes

Back 295

see FA pg76

Front 296

Daclizumab

Back 296

monoclonal antibody against IL-2 receptor on activated T-cells

Hint 296

indicated for kidney transplant rejection prophylaxis along with cyclosporine and corticosteroids

Front 297

Repeated blood transfusions

Back 297

may lead to hemosiderosis

Hint 297

hemosiderin (coarse, golden-brown granules in cytoplasm of cells all around body)

Front 298

17 year old wants to get off life support

Back 298

parents cannot decide to stop the life support, so you must wait until the patient is of age and he can make the decision on his own

Front 299

Permeability of molecules through lipid bilayer

Back 299

CO2>O2>urea>glycerol>glucose>sodium

Front 300

hypokalemic periodic paralysis

Back 300

autosomal dominant, symptoms in first or second decade of life, severe muscle weakness, habitual high-salt diet, may be due to primary defect in calcium channels

Hint 300

during acute attacks: decreased serum potassium

Front 301

Hyper-IgM Syndrome

Back 301

multiple pyogenic infections at an early age

Front 302

C3 deficiency

Back 302

defects in opsonization of encapsulated bacteria and removal of immune complexes (increased risk for type III hypersensitivity)

Front 303

Ornithine transcarbamylase deficiency

Back 303

Lethargic, unwilling to eat, poorly controlled RR/body temp, seizures, abnormal body movements

Hint 303

Increased urine orotic acid levels, decreased serum citrulline levels, elevated plasma glutamine

Front 304

Galactosemia

Back 304

absence of galactose-1-phosphate uridyltransferase, autosomal recessive

Hint 304

accumulation of toxic substances (galactitol), leads to failure to thrive, juandice, hepatomegaly, infantile cataracts, mental retardation

Front 305

Gamma-delta T-cells

Back 305

only category of T-cells that do not require education and selection in the thymus; these cells are found mostly in submucosa and intraepithelial spaces and may play a role in protecting the epithelium

Hint 305

have gamma-delta chain, as opposed to the much more common alpha-beta receptors

Front 306

Cleft lip

Back 306

lateral maxillary prominence fails to fuse with the medial nasal prominence

Front 307

Cleft palate

Back 307

palatine shelves (maxillary prominences) fail to fuse with each othe ror the primary palate (fused medial nasal prominences)

Front 308

Karyorrhexis

Back 308

pyknotic nucleus undergoes fragmentation followed by complete lysis

Hint 308

abscess necrosis is termed liquefactive necrosis

Front 309

PPD reaction

Back 309

macrophages are the most abundant cells types (CD14 positive) because they are recruited there by cytokines released by TH1 cells

Hint 309

there are also T-cells

Front 310

Acrodermatitis enteropathica

Back 310

inherited zinc deficiency

Front 311

Oxalate crystals in urine

Back 311

ethylene glycol poisoning

Front 312

Cytarabine

Back 312

inhibits DNA polymerase

Hint 312

used for AML in conjunction with an anthracycline

Front 313

Sublimation

Back 313

diversion of unacceptable impulses into more acceptable ones

Hint 313

mother whose child died of a disease who becomes active in a state or national organization designed to help families with the disease

Front 314

Graves disease

Back 314

type II hypersensitivity

Front 315

Hashimoto's thyroiditis

Back 315

type IV hypersensitivity

Front 316

Cretinism

Back 316

mental retardation, protuberant abdomen, puffy face, enlarged tongue

Hint 316

lack of thyroid hormone in a developing child prevents normal growth hormone synthesis and secretion, leading to dwarfism

Front 317

Measurement of body fluids

Back 317

plasma volume measured with 125-I-albumin; extracellular fluid volume can be measured using inulin

Hint 317

interstitial volume = extracellular fluid - plasma volume

Front 318

Ribozyme

Back 318

RNA complex that breaks down mRNA

Front 319

mycophenolate mofetil

Back 319

inhibits purine synthesis (guanine) and lymphocyte proliferation

Front 320

Perifollicular hemorrhage

Back 320

vitamin C deficiency

Front 321

HIV positive individuals

Back 321

can only make IgM antibodies because of deficient CD4 cells

Front 322

Homocystinuria

Back 322

due to cystathionine synthase deficiency

Hint 322

mental retardation, long limbs, tall stature, kyphosis, increased plasma homocysteine and methionine levels

Front 323

Azathioprine

Back 323

inhibits de novo purine synthesis and interacts with allopurinol

Front 324

Immunosuppression

Back 324

knocks down t-helper 1 cells, as opposed to HIV, which knocks down t-helper 2 cells

Front 325

first-order kinetics

Back 325

a constant proportion of the target is killed by the drug

Front 326

Clathrin

Back 326

receptor-mediated endocytosis at the plasma membrane, transfer of lysosomal enzymes from trans-golgi

Front 327

REM rebound

Back 327

When the patient stops taking the drugs, there is an increase in the number and intensity of dreams for several days following discontinuation

Hint 327

barbiturates, alcohol, phenothiazines, and MAO inhibitors decreased the amount of REM sleep while the patient is taking them

Front 328

Ecthyma gangrenosum

Back 328

pseudomonas infection of the foot with a black, necrotic center and raised erythematous edges

Hint 328

seen in diabetics

Front 329

obstructive sleep apnea syndrome

Back 329

first line treatment: weight loss and use of continuous positive airway pressure

Front 330

site-specific transduction

Back 330

integration of a temperate phage, integration of a fertility factor, and movement and insertion of transposons…no idea what this means

Front 331

Tongue fasciculations

Back 331

werdnig-hoffman (spinal muscular atrophy)

Front 332

hexagonal, benzene, staghorn crystals

Back 332

cystinuria

Hint 332

cystine crystals precipitate in acidic urine, so treat with acetazolamide

Front 333

Rheumatoid factor

Back 333

anti-IgG antibody

Front 334

Calreticulin, calnexin

Back 334

chaperone proteins that assist in protein folding within in RER

Hint 334

problems at this stage lead to polyubiquination which leads to degredation by proteosomes

Front 335

Early HIV infection

Back 335

follicular dendritic cells in germinal centers of lymph nodes are important reservoirs of HIV

Front 336

Interferon gamma

Back 336

released by T-lymphocytes and activate macrophages

Front 337

Bruton x-linked agammaglobulinemia

Back 337

mutation in cytoplasmic tyrosine kinase (bruton tyrosine kinase, btk)

Hint 337

gene is important in driving pre-B cells to become mature B cells

Front 338

pemphigus vulgaris

Back 338

autoimmune disease with antibodies against desmoglein 1 and 3

Hint 338

acantholysis: intraepidermal bullae involving skin and oral mucosa. Positive Nikolsky's sign (separation of epidermis when touching skin)

Front 339

F+ to F- conjugation

Back 339

principal means of transfer of drug resistance genes on plasmids

Hint 339

common in gram-negative bacilli

Front 340

Generalized transduction via bacteriophage

Back 340

transfer of methicillin and vancomycin resistance between S. aureus and imipenem resistance in P. aeruginosa

Hint 340

Also seen in specialized transduction

Front 341

Transformation

Back 341

S. pneumoniae transfer of drug resistance

Front 342

OCD

Back 342

assoicated with tourette's and ADHD

Front 343

ataxia telangiectasia

Back 343

telangiectasias of the skin and eyes, variable immunodeficiency, progressive ataxia

Hint 343

mutation of ATM gene (tumor suppressor gene)

Front 344

Neonatal hepatomegaly and hypoglycemic seizures

Back 344

think glycogen storage disease

Front 345

Fragile X syndrome

Back 345

get trinucleotide repeat test for diagnosis, not karyotype (might not show the defective X chromosome)

Front 346

Cherry-red spot on macula

Back 346

w/ hepatosplenomegaly = Niemann-Pick; w/o hepatosplenomegaly = Tay-Sachs

Front 347

Globoid cells

Back 347

Krabbe's disease

Front 348

NMDA channel

Back 348

ligand-gated AND voltage-gated cation channel

Front 349

Cachexia

Back 349

reduction in lean body mass, profound loss of appetite and weakness due to TNF-alpha, interferon-gamma, IL-1

Front 350

Long-chain acyl CoA dehydrogenase (LCAD) deficiency

Back 350

hypokalemic kypoketosis that leads to cardiomyopathy in childhood

Hint 350

also see accumulation of carnitine esters (long chain acyl carnitines), which rules out carnitine uptake deficiency in the DDx

Front 351

SCID

Back 351

IL-2 receptor deficiency is most common cause

Hint 351

also caused by adenosine deaminase deficiency and inability to produce MHC-II molecules

Front 352

Wiskott-Aldrich syndrome

Back 352

exzema, thrombocytopenia, and immunodeficiency

Hint 352

IgE is frequently increased; mutation is in Wiskott-Aldrich serum protein (WASP) on X chromosome

Front 353

Stomach cancer in Japanese

Back 353

due to food preservatives and smoked foods

Front 354

Opsonic antibody

Back 354

IgG

Hint 354

represents past exposure to an antigen, levels of IgG persist much longer than IgM

Front 355

IL-2

Back 355

produced by T-helper cells and can be used to treat various types of cancer

Hint 355

increases numbers of cytotoxic T-cells and NK cells

Front 356

Anticholinergic vs. stimulant overdose

Back 356

anticholinergics = dry skin, stimulants = sweaty skin

Front 357

migratory pulmonary infiltrates in asthmatic patient

Back 357

allergic bronchopulmonary aspergillosis

Front 358

MHC III

Back 358

encodes for complement and tumor necrosis factors

Front 359

T-cell independent B-cell activation

Back 359

non-protein carbohydrate mediated (LPS) leads to cluster differentiation of B-cells

Hint 359

mitogen mediated activation of B-cells leads to a polyclonal response directed at everything except mitogens!

Front 360

T-cell receptors

Back 360

only recognize polypeptides that are displayed with MHC

Front 361

J chain

Back 361

holds together secreted IgA dimer and pentameric IgM

Front 362

Secretory component or secretory piece

Back 362

picked up by IgA in epithelial cells before it is secreted, prevents proteolytic cleavage of IgA

Front 363

Decay Accelerating Factor (DAF)

Back 363

also known as CD55

Hint 363

deficiency leads to paroxysmal nocturnal hemoglobinuria

Front 364

Major Basic protein

Back 364

can cause epithelial damage

Hint 364

released by eosinophils

Front 365

Neuroblastoma

Back 365

N-myc

Front 366

Pneumocystis jiroveci diagnosis

Back 366

Direct fluorescent antibody test

Front 367

Bronchitis in smokers

Back 367

Haemophilus influenzae, Legionella, or Moraxella

Front 368

Megaloblastosis uncorrected with B12, folate

Back 368

deficiency in orotidine decarboxylase or orotidine phosphoribosyltransferase

Hint 368

orotic acid crystals in urine (white needle-shaped crystals)

Front 369

Sorafenib

Back 369

multi-kinase inhibitor used for renal cell carcinoma

Front 370

Bare lymphocyte syndrome

Back 370

Type of SCID where cells are unable to synthesize and express MHC II

Front 371

Omenn Syndrome

Back 371

type of SCID where there is a nonsense mutation in genes involved in early VDJ recombination

Front 372

Negative nitroblue tetrazolium test

Back 372

Chronic granulomatous disease

Front 373

Congenital Herpes Encephalitis

Back 373

HSV-2 in children, while adult encephalitis is usually HSV-1

Front 374

Tularemia

Back 374

Francisella tularensis causes a rupturing pustule following by an ulcer with involvement of regional lymph nodes

Front 375

Digoxin

Back 375

binds to K+ site of Na/K ATPase

Front 376

Mycobacterium avium intracellulare

Back 376

treat with azithromycin

Front 377

Peutz-Jeghers syndrome

Back 377

widespread "freckles" (spots of melanin pigmentation)

Hint 377

associated with carcinomas of pancreas and colon, as well as other sites

Front 378

Sacrococcygeal teratoma

Back 378

contain derivatives of all 3 germ layers, which means it arose from the primitive streak (stage before 3 germ layers develop)

Hint 378

sacrococcygeal is most common tumor site

Front 379

Transketolase

Back 379

thiamine-requiring enzyme of non-oxidative half of hexose monophosphate shunt

Hint 379

activity is used as a clinical marker of thiamine deficiency, such as Wernicke-Korsakoff syndrome

Front 380

Chocolate agar

Back 380

H. influenzae

Front 381

Charcoal yeast extract

Back 381

Legionella pneumophila

Front 382

Arthus Reaction

Back 382

swelling and inflammation at inoculation site within a day

Hint 382

type III hypersensitivity

Front 383

Fexofenadine

Back 383

antihistamine that doesn't cause sedation because it doesn't cross the BBB

Front 384

Fear of using public restrooms

Back 384

social phobia

Front 385

Salicylate intoxication

Back 385

tinnitus is classified as the threshold symptom for intoxication

Front 386

Duchenne and Becker Musuclar Dystrophy

Back 386

usually due to deletions or insertions, not single based changes (missense or nonesense)

Front 387

Marriage = emancipation

Back 387

allowed to make own decisions for medical treatment, regardless of how old she is

Front 388

C5a

Back 388

neutrophil chemotaxis to an area of damage/inflammation

Front 389

Keloid

Back 389

due to excessive collagen deposition

Hint 389

surprisingly small number of fibroblasts

Front 390

Warthin-Finkeldey (WF) giant cell

Back 390

pathognomonic for measles or the live attenuated measles vaccine

Front 391

Sirolimus

Back 391

hyperlipidemia, thrombocytopenia, leukopenia

Front 392

Lesch-Nyhan syndrome

Back 392

defective HGPRT

Hint 392

buildup of monosodium urate because HGPRT is not around to recycle purine bases, so they just turn into uric acid instead

Front 393

Pseudomonas culture

Back 393

blue green on iron-limited environment, colorless on blood agar

Front 394

Natural Killer (NK) cells

Back 394

carry out extracellular lysis of infected cells that do not have MHC I (RBCs)

Front 395

Adverse offects of oxytocin

Back 395

hyponatremia, seizures, subarachnoid hemorrhage

Front 396

metabolic alkalosis

Back 396

causes deprotonation of albumin COOH, resulting in COO- that can bind free calcium. Results in decreased free calcium levels

Front 397

Gynecomastia of puberty

Back 397

common in adolescents, frequently asymmetric and tender, usually regress before 20 years old

Hint 397

only reassurance is needed, no fine-needle aspiration

Front 398

Glucocorticoids

Back 398

normally catabolic in muscle and adipose tissue, but increase glycogen synthesis and accumulation in the liver

Front 399

Difference between primary and secondary Addison's

Back 399

Primary has hyperpigmentation and hyperkalemia while secondary doesn't

Front 400

Thyroid cancer w/ amyloid

Back 400

Medullary thyroid carcinoma

Front 401

Albrighty's hereditary osteodystrophy

Back 401

kidney unresponsiveness to PTH (pseudohypoparathyroidism)

Hint 401

hypocalcemia, shorted 4th/5th digits, short stature

Front 402

Tangier disease

Back 402

due to deficiency in ABCA1 cholesterol transporter (normally takes cholesterol from peripheral cells and attaches it to HDL to be transported back to the liver)

Hint 402

characteristic yellow-orange tonsils, lymph node enlargement, hepatomegaly, sensory neuropathy and muscle wasting of the hands; serum cholesterol is low due to lack of HDL

Front 403

Potassium iodide

Back 403

administered after radiation exposure (Chernobyl): competes with the converted radioactive iodide for the iodide pump. If enough is taken, normal iodide will saturate the thyroid gland and the radioactive iodide will be excreted

Front 404

Diabetic ketoacidosis

Back 404

more 3-hydroxybutyrate is made compared to acetoacetate

Hint 404

plasma catecholamines and glucogon are usually increased due to a shift in metabolism to a starvation state

Front 405

Thiazolidinediones (pioglitazone, rosiglitazone)

Back 405

antidiabetic agent that increase insulin sensitivity, specifically peripheral tissues by release of adipokines

Hint 405

contraindicated in heart failure

Front 406

Androgen insensitivity syndrome

Back 406

defect in androgen receptor

Hint 406

phenotypically female w/ inguinal hernia, primary amenorrhea, external female genitalia, no uterus, lack of axillary and pubic hair

Front 407

Renal osteodystrophy

Back 407

secondary hyperparathyroidism due to renal failure

Hint 407

kidney can't excrete sufficient phosphate, which leads to PTH release, which increases bone resoprtion, leading to pathological fractures

Front 408

MEN 2B

Back 408

medullary carcinoma of thyroid, pheochromocytoma, oral and intestinal ganglioneuromatosis, marfanoid habitus

Front 409

Chronic renal insufficiency

Back 409

defect in renin production, leads to low aldosterone levels

Front 410

Lab findings in thyrotoxicosis

Back 410

increase in free and total T4, decrease in TSH

Hint 410

also increase in serum Ca2+ (bone tunover), increase in serum glucose (glycogenolysis), and decrease in serum cholesterol

Front 411

Sabouraud's agar

Back 411

culture fungi

Front 412

Heterophil mononucleosis test

Back 412

positive in EBV, negative in CMV

Front 413

activating mutation in the Ca-sensing receptor of the parathyroid

Back 413

hypothyroidism

Front 414

Anti-glutamate decarboxylase antibodies

Back 414

Type I diabetes

Front 415

Osteoporosis prevention

Back 415

raloxifene

Front 416

human chorionic gonadotropin

Back 416

same hormone family as TSH, FSH, and LH

Hint 416

mutation in TSH receptor may make it sensitive to hCG, and this would increase thyroid hormone during the first 10 weeks of pregnancy

Front 417

3-beta-hydroxysteroid dehydrogenase

Back 417

fetal adrenal cortex lacks this enzyme and therefore synthesizes mostly DHEA

Front 418

Thyrotoxic crisis

Back 418

occurs most commonly in patients with untreated Graves' in the presence of stress or trauma

Front 419

Methimazole, propothiouracil

Back 419

side effect: aplastic anemia, agranulocytosis

Front 420

MEN 1

Back 420

commonly presents with angiofibromas and lipomas

Front 421

Diazoxide

Back 421

opens ATP-sensitive potassium channels, leading to hyperpolarization of the islet cells and inhibiting insulin release

Hint 421

useful in insulinomas

Front 422

Hashimoto's thyroiditis

Back 422

increased risk of non-Hodkin B-cell lymphoma

Front 423

Familial hypocalciuric hypercalcemia (FHH)

Back 423

mutation in calcium-sensing receptor gene (CaSR)

Front 424

Normalizing serum glucose in diabetics

Back 424

acutely -> epinephrine, chronically -> cortisol

Hint 424

glucagon response in diabetics is not seen for some reason

Front 425

Kimmelstiel-Wilson nodule

Back 425

ovoid, hyaline, PAS-positive structures found in mesangial core of glomerulus

Hint 425

seen in diabetics

Front 426

soild balls of neoplastic follicular cells in thyroid

Back 426

characteristic of papillary carcinoma

Hint 426

associated with history of radiation to the neck

Front 427

finasteride

Back 427

inhibits 5-alpha-reductase

Hint 427

used to treat BPH

Front 428

Necrolytic migratory erythema (NME)

Back 428

classic symptom observed in glucagonoma

Hint 428

erythematous blisters and swelling at areas of greater friction

Front 429

Aldosterone deficiency

Back 429

salt wasting in excess of water wasting

Front 430

Infantile hypothyroidism

Back 430

neonatal thyroxine levels may be normal because of maternal-fetal thyroxine transfer

Front 431

Alpha-2 receptor agonists (clonidine)

Back 431

directly inhibit pancreatic insulin secretion

Front 432

glucagon

Back 432

rapidly raises blood glucose levels and leads to stimulation of insulin levels

Front 433

iodine staining intraepithelial inclusion bodies

Back 433

clamydia trachomatis

Hint 433

most common bacterial cause of sexual trasnmitted disease, leads to PID

Front 434

Pudendal nerve

Back 434

innervates the perineum, wraps around the ischial spine

Hint 434

palpation of the ischial spine allows the physician to locate the pudendal nerve

Front 435

Most common cause of spontaneous abortion

Back 435

chromosomal abnormalities

Hint 435

usually the fetus is lost in the 1st trimester

Front 436

Ectopic pregnancy

Back 436

most commonly due to delayed transport of the blastocyst

Front 437

Testicular torsion

Back 437

twisting and torsion of the spermatic cord w/ occlusion of the testicular artery and vein

Front 438

Tzanck smear

Back 438

test for HSV by touching slide to opened vesicle and look for multinucleated giant cells

Front 439

vaginitis w/ frothy yellow discharge

Back 439

trichomonas vaginalis

Front 440

Struma ovarii

Back 440

unilateral ovarian mass w/ symptoms of hyperthyroidism

Front 441

Schiller-duval bodies

Back 441

pathognomonic for yol sac (endodermal sinus tumor), resemble glomeruli

Front 442

Meigs' syndrome

Back 442

ovarian fibroma, ascites, pleural effusion/hydrothorax

Front 443

Walthard's rests

Back 443

islands of bladder-like transitional epithelium within fibrous stroma

Hint 443

seen in Brenner tumor of the ovary

Front 444

Progestin challenge

Back 444

will cause menstrual bleeding and confirm anovulation in a patient

Front 445

PID

Back 445

chalmydia is the most common cause, leading to type IV hypersensitivity response in the fallopian tubes that may result in infertility

Front 446

human placental lactogen (hPL)

Back 446

secreted by syncytiotrophoblasts; concentration rises throughout pregnancy and is proportional to fetal mass

Hint 446

anti-insulin activity

Front 447

Levonorgestrel

Back 447

high dose progesterone that disrupts endometrium and prevents implantation

Front 448

Bitot's spots

Back 448

buildup o fkeratin debris in conjunctiva

Front 449

Neimann-Pick disease type A

Back 449

CNS involvement

Hint 449

compared to type B, where there is no CNS involvement

Front 450

Infantile cirrhosis + hypotonia

Back 450

Anderson's disease (type IV glycogen storage disease)

Hint 450

deficiency in alpha 4,6-glucosidase (glycogen branching enzyme)

Front 451

Oral hairy leukoplakia

Back 451

EBV infection in HIV patients

Hint 451

nontender, adherent whitish lesion on tongue or oral mucosa due to hyperproliferation of lingual epithelial cells

Front 452

Lateral cervical cyst

Back 452

derived from second pharyngeal cleft that didn't obliterate

Front 453

Narcolepsy

Back 453

hypnopompic hallucinations, sleep paralysis, cataplexy, sleep attacks

Front 454

Spe-A, Spe-B, Spe-C

Back 454

involved in scarlet fever, transmitted via lysogenic converesion

Hint 454

lysogenic conversion: DNA of a temperate phage is inserted into bacterial chromosome and expressed

Front 455

Confidence interval

Back 455

Sample mean +/- Z * [SD/sqrt(n)]

Front 456

Lymphocyte common antigen (LCA)

Back 456

used to determine if there is a lymphoma

Front 457

DNA footprinting

Back 457

detect specific protein binding to DNA molecules by comparing fragmentation patterns of DNA w/ protein bound vs. protein unbound

Front 458

Decidua basalis

Back 458

composed of endometrium between the chorionic villi and the myometrium

Hint 458

derived from the mother

Front 459

Fluoroquinolones

Back 459

resistance to the topoisomerase inhibitor encoded on the chromosome

Hint 459

resistance via efflux pumps is encoded on plasmids

Front 460

Enzyme assays

Back 460

use amount of enzyme at Vmax so that the results are dependent on the amount of substrate

Front 461

myofibroblasts

Back 461

specialized subset of fibroblasts that express contractile proteins (actin and myosin)

Hint 461

principal mediators of wound contraction, which results in aesthetic and functional deficits

Front 462

Down's syndrome due to mosaicism

Back 462

mosaic Down syndrome patients have IQ scores that are 10-30 points higher than individuals with classic Down syndrome

Front 463

Multi-drug resistance

Back 463

transposons

Front 464

direct inguinal hernia

Back 464

passes medial to inferior epigastric artery

Front 465

Her-2/Neu

Back 465

receptor w/ intrinsic tyrosine kinase activity

Front 466

Anticholinergic agents

Back 466

anti-SLUDG properties: salivation, lacrimation, urination, defecation, gastrointestinal slowing

Front 467

Second generation anti-histamines

Back 467

few anticholingergic side effects

Front 468

Struma ovarii

Back 468

monodermal teratoma

Front 469

Bowen disease

Back 469

penile carcinoma in situ, solitary-whitish plaque that doesn't invade the basement membrane

Front 470

Vaginal candidiasis

Back 470

diagnosed by performing the germ-tube test (inoculation of a sample into animal serum)

Front 471

Arthroconidia

Back 471

diagnostic of dermatophytes

Front 472

Hyphae w/ rosettes of microconidia

Back 472

sporothrix schenckii

Front 473

macroconidia

Back 473

histoplasma cpasulatum

Front 474

Septic arthritis in otherwise healthy, sexually active adults

Back 474

N. gonorrhea

Front 475

Focal fat necrosis of breast

Back 475

multinucleated giant cell reaction, frequently due to trauma

Front 476

parvovirus

Back 476

exposure to pregnant women in first trimester may result in a fetus with aplastic anemia which leads to non-immune hydrops fetalis

Front 477

Syphilis tests

Back 477

VDRL to rule out, FTA-ABS to rule in

Front 478

microhemagglutination test

Back 478

treponeme-specific serologic test

Front 479

Batson venous plexus

Back 479

hematogenous spread of prostate cancer to vertebrae and pelvic bone

Front 480

Kallmann's syndrome

Back 480

autosomal dominant, maldevelopment of olfactory bulbs and GnRH-producing cells

Front 481

Paget's disease

Back 481

mucin is periodic acid-schiff (PAS) positive

Front 482

Rokitansky-Kuster Hauser (RKH) syndrome

Back 482

absence of upper vagina and uterus

Front 483

Arias-stella phenomenon

Back 483

exaggerated secretory phase during pregnancy

Front 484

Endometritis

Back 484

chronic due to IUD = actinomyces

Front 485

Rectal pouch of douglas

Back 485

site for collection of blood, malignant cells, pus, endometrial implants

Front 486

Stromal hyperthecosis

Back 486

bilateral ovarian enlargement, vacuolated stromal hilar cells that synthesize excess androgens, leading to hirsutism

Front 487

Ritter's disease

Back 487

staphylococcal scalded skin syndrome in newborns

Front 488

Acanthosis nigricans

Back 488

hyperplasia of stratum spinosum

Front 489

Marjolin ulcer

Back 489

SCC that arises from non-healing ulcer, burn wound, or osteomyelitis

Front 490

Follicle that contains a primary oocyte surrounded by a single layer of flattened follicular cells

Back 490

primitive and primordial follicles

Front 491

oocyte surrounded by one or several cuboidal follicular cells

Back 491

primary follicles

Front 492

follicle that extends through the entire cortex and bulges at the ovarian surface

Back 492

graafian follicle

Front 493

Secondary follicle

Back 493

oocyte surrounded by several layers of follicular cells and a small antrum (antrum is due to several spaces of the follicular mass fusing together)

Front 494

Preeclampsia

Back 494

cerebral hemorrhage and ARDS are most common causes of death

Front 495

CA-125

Back 495

tumor marker for papillary cystadenocarcinoma and other tumor types

Front 496

Premature menopause

Back 496

reduced inhibin levels, which may lead to increased FSH levels

Front 497

Verrucous lesion of vulva w/ tree-like proliferation of epithelium and fibrous stroma

Back 497

HPV

Front 498

hGH (growth hormone)

Back 498

produced by the placenta during pregnancy

Front 499

Testicular tumor w/ fibrous septa containing numerous lymphocytes

Back 499

seminoma

Front 500

Sertoli-only syndrome

Back 500

only sertoli cells are present (germinal cell aplasia), spermatogenesis is absent

Front 501

ulcerative genital lesion w/ pain and inguinal lymphadenopathy

Back 501

Haemophilus ducreyi: gram-negative, pleomorphic rod w/ characteristic "school of fish" pattern on gram-stain

Front 502

Granuloma inguinale

Back 502

Klebsiella granulomatis

Front 503

Dysfunctional uterine bleeding

Back 503

most commonly due to anovulatory cycles

Front 504

Chlamydia trachomatis

Back 504

unable to make ATP

Front 505

Intraductal papilloma

Back 505

benign, neoplastic tumors typically located near the nipple under the areola

Front 506

Endometrium w/ long, narrow, coiled glands lined by a single layer of columnar epithelium showing regular, uniform, small nuclei, and apical secretory vesicles

Back 506

secretory epithelium

Front 507

Choriocarcinoma

Back 507

likes to go to the lungs

Front 508

Radical mastectomy

Back 508

remove underlying tumor, axillary lymph nodes, some pectoralis

Front 509

18-alpha hydroxylase

Back 509

aldosterone synthase

Front 510

Progression of high grade cervical dysplasia

Back 510

60% presist at the same level of dysplasia

Front 511

N. gonorrhoea

Back 511

pili is the most important mechanism of pathogenesis; promotes adherence to mucosa and protection from phagocytosis, also antigenic variation

Front 512

acute epididymitis and orchitis

Back 512

N. gonorrhoea and C. trachomatis

Front 513

Chronic endometritis

Back 513

inflammatory infiltrate of lymphocytes, plasma cells, histiocytes

Front 514

HPV

Back 514

mechanism of pathogenesis similar to retinoblastoma and osteosarcoma

Front 515

Breast cancer metastasis to bone

Back 515

unusual in that it causes both lytic and blastic lesions

Front 516

Neonatal pneumonia preceeded by conjunctivitis

Back 516

Chlamydia

Hint 516

may present with a staccato cough, CXR w/ scattered infiltrates and hyperinflation of lungs

Front 517

Congenital lipoid adrenal hyperplasia

Back 517

mutation in steroidogenic acute regulatory protein (StAR): protein necessary for transport of cholesterol from the outer to inner mitochondrial membrane in adrenals and gonad

Hint 517

deficiency in all steroid hormones (C21, C17, C18), absent response to ACTH and hCG, large, lipid-laden adrenals

Front 518

mixed testicular tumor

Back 518

male testicular tumor composed of multiple types of various tumors

Front 519

HTN and proteinuria before 20 weeks gestation

Back 519

hydatidiform mole

Front 520

Vagina swab of prepubertal girls and postmenopausal women

Back 520

Staphlyococcus epidermidis

Front 521

Acute bacterial prostatitis

Back 521

E. coli (over 35 years old)

Front 522

Dinoprostone

Back 522

prostaglandin E2

Hint 522

induces cervical softening and effacement, cervix to dilate, uterus to contract, helps induce labor

Front 523

Orchitis w/ obliterative endarteritis

Back 523

syphilis

Front 524

Bartholin's gland cyst

Back 524

obstruction, usually a sequela of a previous infection, leading to pain and swelling of the posterolateral part of the labia majora

Front 525

Chronic ACL injuries

Back 525

involve damage to medial meniscus (not lateral like acute ACL injuries)

Front 526

Triad junction

Back 526

consists of the T-tubule, the sarcoplasmic reticulum, and the 15 nm space between them

Front 527

anterior shoulder dislocation

Back 527

externally rotated and abducted

Front 528

posterior shoulder dislocation

Back 528

internally rotated and adducted

Front 529

I band

Back 529

most common site for muscle strains because it consists only of actin filaments

Front 530

Trendelenburg sign

Back 530

abnormal gait caused by weakness of abductor muscles of lower extremities due to lesion of the superior gluteal nerve

Front 531

osteoid

Back 531

newly formed bone matrix

Front 532

Carbonic anhydrase II deficiency

Back 532

autosomal recessive, triad of osteoporosis, renal tubular acidosis, and cerebral calcifications

Hint 532

CA II: generates carbonic acid from water and carbon dioxide

Front 533

McCune-Albright syndrome

Back 533

4 Ps: polyostotic fibrous dysplasia, pigmented skin lesions, precocious puberty

Hint 533

caused by non-inherited postzygotic activating mutation of Gs subunit leading to constitutive activity; example of genetic mosaicism

Front 534

Gardner syndrome

Back 534

autosomal dominant variant of FAP w/ osteomas, desmoid tumors, dental abnormalities, congenital hypertrophy of retinal pigmented epithelium, skin tumors, and extracolonic cancers (thyroid, hepatobiliary, CNS)

Front 535

Ollier's syndrome

Back 535

multiple enchondromas w/ 10-25% chance of malignant transformation to chondrosarcoma

Front 536

Maffucci's syndrome

Back 536

multiple enchondromas and soft tissue hemangiomas w/ 100% chance of malignant transformation to chondrosarcoma

Front 537

Complications of osteomyelitis

Back 537

sequestrum: areas of bone necrosis due to acute inflammation -> involucrum: new bone growth that forms a sheath around dead bone

Front 538

Legg-calve-perthes disease

Back 538

aseptic necrosis of femoral head ossification center, possibly due to problems w/ the medial femoral circumflex artery (main supply to the head of the femur)

Hint 538

clinical picture: limp to avoid pain (pain is usually in the anterior thigh) or painless limp, irregular appearance of the capital femoral epiphysis on xray,

Front 539

osteochondritis dessicans

Back 539

trauma to articular epiphysis -> ischmeia -> aseptic necrosis and failure of articular epiphyses

Front 540

pannus

Back 540

granulation tissue rich in inflammatory cells and fibroblasts that proliferates and releases cytokines -> destruction of articular cartilage w/ reactive fibrosis and eventual akylosis

Front 541

RA treatment

Back 541

First line: NSAIDS, DMARDs (disease-modifying antirheumatic drugs) such as sulfasalazine, hydroxychloroqiune, MTX

Hint 541

Second line: TNF-alpha inhibitors, Leflunomide (inhibits pyrimidine synthesis), Rituximab (anti-CD20 antibody binds CD20 on surface of B-cells leading to their destruction)

Front 542

Felty's syndrome

Back 542

RA + splenomegaly + leukopenia

Front 543

Caplan syndrome

Back 543

RA + intrapulmonary rheumatoid nodules + pneumoconiosis

Front 544

Popliteal (Baker's) Cyst

Back 544

increased intra-articular pressure -> outpouching of snovial sack posterior to knee

Front 545

Congenital 3rd degree heart block

Back 545

SS-A and SS-B antibodies can cross placenta and target AV node, leading to destruction

Front 546

Ankylosing spondylitis extra-articular manifestations

Back 546

anterior uveitis (monocular pain, photophobia, blurry vision), aortitis/aortic regurgitation, cardiac conduction defects (3rd degree block), involvement of thoracic spine -> decreased chest expansion -> restrictive pattern on PFTs

Front 547

Reiter sndrome

Back 547

classic triad (conjunctivitis, urethritis, arthritis)

Hint 547

also oral ulcers, keratoderma blenorrhagica (erythematous scaly hyperkeratotic skin lesions on palms and soles), circinate balanitis (red scaly area on glans penis w/ gray serpiginous annular edge that spreads outwards in phases

Front 548

Drug induced lupus

Back 548

Q CHIMPP: quinidine, chlorpromazine, hydralazine, isoniazid, methyldopa, penicillamine, procainamide

Hint 548

anti-histone antibodies

Front 549

Chronic infectious arthritis

Back 549

TB, Lyme disease

Front 550

Myasthenia gravis

Back 550

follicular B-cell hyperplasia in thymus, thymoma

Front 551

Lambert-Eaton syndrome

Back 551

small cell lung carcinoma

Front 552

Dermatomyositis

Back 552

antibody-mediated damage to blood vessels surrounding muscle fascicles -> perfascicular inflammation and atrophy

Front 553

Sarcoidosis

Back 553

lung (pulmonary fibrosis), skin (erythema nodosum w/ Schaumann and asteroid bodies), Eyes (anterior uveitis)

Hint 553

epithelioid histiocytes needed on biopsy for diagnosis; asteroid bodies and giant cells are also seen, but not required

Front 554

Linoleic acid

Back 554

precursor for arachadonic acid and essential fatty acid needed in diet

Front 555

recurrent miscarriages in the first trimester

Back 555

chromosomal abnormalities (robertsonian translocation)

Front 556

Congenital CMV

Back 556

heptaosplenomegaly, periventricular brain calcification, petechial hemorrhage (blueberry muffin rash),

Front 557

Familial gonadotropin-independent premature Leydig cell maturation

Back 557

mutation in the LH receptor causes it to be constitutively active

Hint 557

elevated testosterone, suppressed gonadotropin levels, Leydig cell hyperplasia, seminiferous tubule dysgenesis

Front 558

Barr body

Back 558

inactivation of X chromosome

Hint 558

seen in Klinefelters as well as in normal females

Front 559

LH receptors on Granulosa cells

Back 559

as follicle approaches ovulation, LH receptors begin to be expressed by granulosa cells, probably as a response to increased estrogen and FSH

Front 560

Congenital syphilis

Back 560

saddle nose, Hutchinson's teeth, mulberry molars, saber shins, interstitial keratitis, deafness

Hint 560

treat w/ penicillin

Front 561

Café-au-lait spots

Back 561

due to peripheral nerve tumors that induce hyperpigmentation of overlying skin

Hint 561

seen in tuberous sclerosis

Front 562

Gonococcal arthritis

Back 562

petechial rash, tenosynovitis, involvement of ankles and knees

Front 563

fibrillin

Back 563

component of elastin-associated microfibrils

Hint 563

abnormal in Marfan

Front 564

HLA-B27

Back 564

seronegative spondyloarthropathies, acute anterior uveitis

Front 565

Malignant otitis externa

Back 565

caused by P. aeruginosa, may spread to mastoid bone, temporal bone, sinuses, meninges, and brain

Hint 565

pseudomonas associated w/ ecthyma gangrenosum

Front 566

Familial pulmonary hypertension

Back 566

inactivating mutation in BMPR2 gene

Hint 566

BMPR2 gene normally functions to inhibit vascular smooth muscle proliferation

Front 567

Solubility of oxygen in blood

Back 567

inversely related to temperature (increase in temperature = decrease in O2 solubility)

Hint 567

oxygen content in blood = (Hb*1.34*%sat) + (0.0031*PaO2)

Front 568

Charcot-Leyden crystals

Back 568

hexagonal, double-pointed, needle-like crystals in bronchial secretions in asthmatic patients

Front 569

Curschmann's spirals

Back 569

desquamated epithelium casts in sputum seen in asthmatic patients

Hint 569

can lead to whorled mucous plugs

Front 570

osteopetrosis

Back 570

genetic disease characterized by reduced osteoclast activity resulting in diffuse symmetric skeletal sclerosis

Hint 570

leads to pancytopenia due to domnation of the marrow

Front 571

Mosaic pattern of newly formed woven bone

Back 571

paget's disease

Hint 571

increased risk of osteosarcoma

Front 572

Steroid myopathy

Back 572

caused by exogenous corticosteroid use or Cushing disease

Hint 572

can lead to insidious onset of muscle weakness of the proximal muscles w/ preferential atrophy of type II fibers

Front 573

Inclusion body myositis

Back 573

usually involves both distal and proximal muscles

Hint 573

inclusion bodies seen on biopsy (large rimmed vacuoles in muscle fibers)

Front 574

Cleidocranial dysostosis

Back 574

absence of part of the clavicles w/ broad skull, facial and dental anomalies

Hint 574

disorder of intramembranous ossification bones

Front 575

Clubbing of nails

Back 575

associated w/ lung cancer, mesothelioma, bronchiectasis, congenital cyanotic heart disease, hepatic cirrhosis

Hint 575

in these conditions, the clubbing is accompanied by formation of new subperiosteal bone (hypertrophic osteoarthropathy)

Front 576

Energy use during exercise

Back 576

0-10 seconds: stored ATP, creatine phosphate; 10-100 seconds: glycogen;

Front 577

Basic calcium phosphate

Back 577

seen in apatite-associated arthropathy

Hint 577

produces spherical clumps of nonbirefringent submicroscopic crystals

Front 578

Gout

Back 578

possibly abnormality in purine salvage pathway

Front 579

bacillus anthracis

Back 579

boxcar-shaped, gram positive rod

Front 580

extension of thumb

Back 580

radial nerve only

Hint 580

innervates extensor pollicus brevis and longus

Front 581

Long-term glucocorticoid use

Back 581

hypocalcemia (decreased Ca2+ uptake in the gut)

Front 582

Crutches

Back 582

damage to radial nerve

Front 583

Median nerve

Back 583

only nerve that traverses the carpal tunnel

Front 584

Still's disease

Back 584

seen in Juvenile rheumatoid arthritis (JRA)

Hint 584

fever, rash, polyarthritis

Front 585

Juvenile rheumatoid arthritis

Back 585

polyarticular JRA: disabling arthritis predominates

Hint 585

Pauciarticular JRA: arthritis limited to a few joints, uveitis w/ portential for blindness

Front 586

Lead poisoning

Back 586

associated w/ gout due to interstitial nephritis that leads to decreased excretion

Front 587

myotonic dystrophy

Back 587

most common adult muscular dystrophy, selective atrophy of type I fibers

Hint 587

autosomal dominant CTG repeat -> facial muscle weakness, sustained grip, frontal balding, cataracts, cardiac involvement (conduction defects)

Front 588

Dupuytren's contracture

Back 588

fibromatosis involving palmar fascia leads to contraction of single or multiple fingers

Hint 588

associated w/ alcoholism

Front 589

Desmoid tumor

Back 589

fibromatosis of anterior abdominal wall in women

Hint 589

associated w/ previous trauma and Gardner's polyposis syndrome

Front 590

periosteum

Back 590

torn during fracture -> supplies osteoblasts to produce new bone that reunites the two ends

Hint 590

can lead to hetertopic ossification (bone formed outside the regular bone)

Front 591

Fracture of neck of fibula

Back 591

damage to peroneal nerve

Front 592

Erythema multiforme

Back 592

erythematous patches w/ pale, vesicular, or eroded centers (target lesions) due to immune complex deposition in dermal blood vessels

Hint 592

causes: certain infections (HSV, enteroviruses, mycoplasma), drugs, neoplasia, foods; pathogenesis related to HSV involves triggering CD8+ cytotoxic cells -> apoptosis of some keratinocytes

Front 593

Rubella

Back 593

fine rash that begins at hairline and spreads down to torso in a child that is not very ill

Hint 593

also see cervical lymphadenopathy, NO KOPLIK

Front 594

Avulsion of lesser trocanter

Back 594

due to sudden strain of muscle that leads to reflex contraction that breaks the bone

Hint 594

psoas major inserts at the lesser trochanter

Front 595

Schaumann and asteroid bodies

Back 595

sarcoidosis

Hint 595

lupus pernio (rash on nose and cheeks) is also seen

Front 596

Coal miner's pneumoconiosis

Back 596

simple CWP: scattered coal macules in upper lobe

Hint 596

complicated CWP: requires years to develop, progression from simple CWP, lesions throughout lungs

Front 597

Anthracosis

Back 597

benign accumulation of coal dust found in urban dwellers

Front 598

Therapeutic supplemental O2 in NRDS

Back 598

retinopathy of prematurity and bronchopulmonary dysplasia

Front 599

recurrent idiopathic pleural effusions

Back 599

mesothelioma presentation

Front 600

surfactant synthesis

Back 600

increased cortisol, prolactin, thyroxine

Hint 600

decreased insulin

Front 601

Long-thoracic nerve

Back 601

innervates the serratus anterior

Front 602

pearly papules

Back 602

basal cell carcinoma

Hint 602

palisading of basal cell-like nuclei at edge of clusters of cells penetrating into the dermis

Front 603

genioglossus muscle

Back 603

protrude the tongue

Front 604

hypoglossus muscle

Back 604

retract the tongue

Front 605

palatoglossus muscle

Back 605

retract tongue and upward towards the palate

Front 606

scaphoid fracture

Back 606

pain in the anatomic snuffbox after a fall on outstretched hands is pathognomonic

Front 607

Axillary sheath

Back 607

contains the axillary artery, 3 cords of the brachial plexus and is found in the axilla

Front 608

anterior displacement of humerus

Back 608

damage to axillary nerve

Front 609

basophilic rhomboid crystals

Back 609

calcium pyrophosphate crystals

Hint 609

seen in pseudogout, radiographically dense, unlike the crystals of gouty arthritis

Front 610

Pulmonary embolism

Back 610

presents with the combination of respiratory alkalosis and hypoxemia

Hint 610

V/Q scan shows decreasd perfusion with areas of normal ventilation

Front 611

Rubella

Back 611

fine rash that begins at hairline and spreads down to torso in a child that is not very ill

Hint 611

also see cervical lymphadenopathy, NO KOPLIK

Front 612

Hampton's hump

Back 612

wedge shaped area of infarcted tissue seen in PE

Front 613

Methenamine silver stain

Back 613

Pneumocystis jiroveci

Front 614

Owl eye inclusions in immunocompromised/immunosuppressed individual

Back 614

CMV

Front 615

Emphysema

Back 615

loss of elastic recoil -> decreased FEV1, increased residual volume, increased TLC

Front 616

Old age lungs

Back 616

decreased elastic recoil and increased distensibility (compliance) of the lungs

Front 617

Aspiration of food

Back 617

leads to V/Q mismatch

Front 618

bacterial abscess

Back 618

results from bronchial obstruction or aspiration of oropharyngeal contents (especially in those predisposed to loss of consciousness)

Front 619

Forscheimer spots

Back 619

red spots on soft and hard palate, seen in Rubella

Front 620

Body, head, or pubic louse

Back 620

treat w/ permethrin

Front 621

Leser-trelat

Back 621

rapid increase in number of sborrheic keratosis

Hint 621

phenotypic marker for stomach adenocarcinoma

Front 622

Ichthyosis vulgaris

Back 622

most common inherited skin disorder (AD) w/ inreased thickness of stratum corneum

Front 623

Munro microabscesses

Back 623

neutrophil collections in stratum corneum seen in Psoriasis

Front 624

terbinafine

Back 624

treat onychomycosis

Front 625

RA biopsy

Back 625

proliferative synovitis w/ many lymphocytes, macrophages, and plasma cells because it is a chronic process

Hint 625

subcutaneous nodules seen in RA are areas of fibrinoid necrosis surrounded by palisading epitheliod cells

Front 626

Muscle tension

Back 626

passive tension (preload) increases as the muscle is stretched beyond it's resting length

Hint 626

total tension is passive tension + active tension. Active tension cannot be measured so must therefore be estimated using total tension - passive tension

Front 627

Re-epithelialization

Back 627

ingrowth of epidermal cells from underlying skin appendages such as hair follicles and sweat glands of the dermis

Front 628

Pseudo-horn cysts

Back 628

seborrheic keratosis

Front 629

Short saphenous vein and lymph drainage

Back 629

drains lateral side of dorsum of foot and runs on the posterior side to drain in to the popliteal lymph nodes

Front 630

Long saphenous vein and lymph drainage

Back 630

drains and runs on the medial side of the leg and drains into inguinal lymph nodes

Front 631

Splay

Back 631

glucosuria when seurm glucose is above 180 but below 350, and the transporters aren't quite saturated

Hint 631

due to nephron heterogeneity and low affinity of the Na-Glu transporters

Front 632

Aliskerin

Back 632

blocks renin activity

Front 633

Posterior dislocation of the clavicle

Back 633

impingement onto the trachea

Front 634

Gluteus medius/superior gluteal nerve

Back 634

trendelenberg sign: stand on 1 leg and contralateral hip drops

Front 635

Most common lung cancer

Back 635

bronchogenic adenocarcinoma

Hint 635

even though it's the most common in non-smokers, it's also the most common in smokers

Front 636

Oral candidiasis

Back 636

nystatin "swish and swallow"

Front 637

Succinylcholine

Back 637

depolarizing skeletal muscle relaxant; prolonged use may lead to release of substantial amounts of K+ -> hyperkalemia and arrythmias

Front 638

Erb's palsy

Back 638

due to defect in C5, C6 (musculocutaneous nerve) -> problem w/ biceps brachii

Front 639

Protein/serum ratio > 0.5

Back 639

exudate

Front 640

Reiter's syndrome

Back 640

Ureaplasma, Campylobacter, Chalmydia, Shigella, Salmonella, Yersinia

Front 641

Resistance in pseudomonas

Back 641

mutation of a porin protein

Front 642

Treatment of cutaneous burns

Back 642

silver sulfadiazine or mafenide (if they have sulfa allergy)

Hint 642

cidal for gram negative, gram positive bacteria, as well as fungi

Front 643

Fusobacterium

Back 643

anaerobe seen in lung abscesses

Hint 643

anaerobes like bacteroides, fusobacteirum, and peptococcus are all found in the oral cavity

Front 644

lung cancer specifically associated w/ lung scarring and old granulomatous disease

Back 644

adenocarcinoma

Hint 644

found peripherally

Front 645

BPH

Back 645

most common cause of postrenal azotemia

Front 646

calsequestrin

Back 646

binds Ca2+ after depolarization and as the muscle relaxes

Front 647

Mannitol salt agar

Back 647

Staph aureus can ferment mannitol, turning it yellow

Front 648

MPGN type I

Back 648

associated w/ secondary causes of MPGN such as HBV, HCV, syphilis, malaria

Front 649

Goodpasture syndrome

Back 649

renal crescentic glomerulonephritis + pulmonary involvement

Hint 649

anti-GBM antibodies can cross-react w/ pulmonary alveolar basement membranes

Front 650

Alport syndrome

Back 650

triad: hereditary nephritis, sensorineural deafness, ocular abnormalities

Hint 650

due to defect in collagen IV

Front 651

WAGR complex

Back 651

Wilms' tumor, Aniridia, Genitourinary malformation, mental-motor Retardation

Hint 651

Wilms': due to deletion of WT1 and WT2 on chromosome 11; Aniridia: due to deletion of PAX6 on chromosome 11

Front 652

blunting of calyces

Back 652

Chronic pyelonephritis due to chronic vesicoureteral reflux

Front 653

Dent's disease

Back 653

x-linked recessive condition of proximal tubule

Hint 653

leads to hypercalciuria and calcium kidney stones

Front 654

Max velocity of shortening of muscle

Back 654

due to rate of ccling of crossbridge attachments, which is basically hydrolysis of ATP (dependent on myosin ATPase)

Front 655

Chylous effusion

Back 655

unusual milky-white fluid that separates into a thin white layer (cells) and thicker clear layer (triglycerides)

Front 656

Step pneumoniae pneumonia treatment

Back 656

azithromycin

Front 657

P-pili of E. coli

Back 657

play a role in pathogenesis of UTIs

Front 658

Ciprofloxacin

Back 658

cytochrome inhibitor

Hint 658

used to treat H. influenza

Front 659

Diuretics and creatinine clearance

Back 659

loop diuretics are effective down to a GFR of 10

Hint 659

thiazide and potassium-sparing diuretics are effective only down to 40

Front 660

Dialysis cysts

Back 660

small shrunken kidneys with large cysts

Front 661

nitrate test

Back 661

most Enterobacteriaceae (gram-negative enteric rods) are able to form nitrite from nitrate

Hint 661

thus, this test is used to determine if a UTI is caused by enterobacteriaceae

Front 662

Expiratory flow rate

Back 662

the "effort-independent" portion of the curve is because the airways are collapsing and the patient can't blow air out any quicker

Front 663

Pickwickian syndrome

Back 663

morbidly obese individual w/ fatty neck causes intermittent airway obstruction that leads to acute respiratory acidosis

Hint 663

reduced O2, increase CO2, reduced pH, modestly increased bicarb

Front 664

oxybutynin

Back 664

antispasmodic effect on smooth muscle and inhibits the ACh action

Hint 664

treatment of urinary incontinence

Front 665

Plasmacytoma

Back 665

mass found in bone or oronasopharynx (involving soft tissue)

Hint 665

associated w/ a mild M-spike of IgG, may eventuall develop into multiple myeloma after 10-20 years

Front 666

Lung abscess

Back 666

MCC staph aureus, anaerobes

Front 667

Mycoplasma pneumonia tx

Back 667

Erythromycin

Front 668

Reserpine

Back 668

inhibits VMAT

Hint 668

allows degradation of dopamine by MOA

Front 669

AA amyloid in glomerulus

Back 669

tuberculosis and other chronic antigenic inflammatory diseases

Front 670

Corticosteroid effect on bone

Back 670

increase osteoclastic function as well as inhibit osteoblastic function

Front 671

Bartter's syndrome

Back 671

decreased NaCl transport in the ascending loop of Henle and early distal tubule

Hint 671

leads to hypochloremic, hypokalemic, hypercalciuric, hypotensive metabolic alkalosis. Resultant increase in ATII levels leads to ATII insensitivity of the vascular smooth muscle

Front 672

Auramine-rhodamine stain

Back 672

indicates mycobacterium tuberculosis

Front 673

Nitrofurantoin

Back 673

damages bacterial DNA

Hint 673

used for recurrent UTIs, side effects include pulmonary fibrosis and G6PD hemolytic anemia

Front 674

Vulvovaginal candidiasis tx

Back 674

miconazole, clotrimazole

Front 675

Crush injury

Back 675

leads to release of K+ from muscle and hyperkalemia

Front 676

Peripheral chemoreceptors

Back 676

respond first, before central chemoreceptors, to changes in PaCO2

Front 677

Collagen IV

Back 677

found in basement membrane, as well as the lens of the eye

Front 678

ACE inhibitors

Back 678

decreased GFR and further exacerbate acute renal failure

Front 679

Cyclosporine

Back 679

nephrotoxicity -> increased BUN and creatinine

Front 680

Klebsiella pneumonia tx

Back 680

third generation cephalosporin (cefotaxime, ceftriaxone, ceftazidime)

Front 681

Acetazolamide

Back 681

only diuretic that acts upstream of the macula densa -> increases NaCl in the rest of the tubules

Hint 681

results in the macula densa sensing more NaCl, which leads to constriction of the afferent arteriole

Front 682

Acute salicylate poisoning

Back 682

cause acute respiratory alkalosis and eventual metabolic acidosis

Front 683

Acute salicylate poisoning

Back 683

cause acute respiratory alkalosis and eventual metabolic acidosis

Front 684

Lysogenic phase in bacteria

Back 684

ShigA toxin, Botulinum, Clostridium, Diphtheria, Erythrogenic exotoxins of strep

Hint 684

ABCDE

Front 685

Cooperative play in children

Back 685

begins at 4 years of age

Front 686

Liquefactive necrosis

Back 686

result of hydrolytic enzymes released from dying cells

Front 687

Maternal estriol blood levels

Back 687

best indicator of fetal well-being

Hint 687

significant drop in maternal estriol may indicate fetal jeopardy

Front 688

LFA-1 and ICAM-1

Back 688

interaction necessary for tight binding of white cells to the endothelium which allows them to leave the vessel to go to an area of injury

Front 689

chronic alcohol and smoking

Back 689

induce cytochrome P450

Front 690

Raw oysters, contaminated seafood

Back 690

Vibrio vulnificus, V. parahaemolyticus

Hint 690

gram (-), comma-shaped rods that are isolated on alkaline media

Front 691

Type I Hypersensitivity

Back 691

IL-4 is produced to stimulate production of IgE

Front 692

Vibrio toxin

Back 692

similar to ETEC toxin

Hint 692

both activate adenylate cyclase by ADP ribosylation of GTP-binding protein

Front 693

Ketotifen

Back 693

selective, non-competitive histamine receptor antagonist and mast cell stabilizer

Front 694

Acute cholecystitis

Back 694

treat w/ third generation cephalosporin

Hint 694

treats gram negative, gram positive, and some anaerobes

Front 695

Most common gram (-) rod that infects children from maternal contamination in the birth canal

Back 695

E. coli

Hint 695

K1 is an important capsule antigen that aids in neonatal disease

Front 696

Scalene triangle syndrome (thoracic outlet syndrome)

Back 696

when the lower trunk of the brachial plexus and the subclavian artery are compressed between the anterior scalene and the middle scalene

Front 697

Aspirin-induced asthma

Back 697

inhibition of the cyclooxygenase pathway leads to too much leukotriene and bronchial constriction

Front 698

Pertussis

Back 698

bordetella pertussis increases histamine sensitivity, blocks lymphocytosis, increases cAMP (leads to edema), and also increases insulin secretion (leads to hypoglycemia)

Front 699

ketolorac

Back 699

NSAID

Front 700

Irritation of liver

Back 700

results in irriration of phrenic nerve -> pain in the right upper quadrant + radiant pain to the shoulder region

Front 701

Restrictive lung disease

Back 701

increased elasticity, decreased compliance

Front 702

Psoas abscess

Back 702

spinal infection (classically tuberculosis) spreads along the psoas sheath

Hint 702

leads to bulge on flank and contralateral buldge on groin

Front 703

tyrosine

Back 703

aromatic amino acid

Front 704

most common cause of death in cirrhosis

Back 704

esophageal variceal rupture

Front 705

pneumomediastinum in the setting of vomiting

Back 705

Boerhaave syndrome

Front 706

Pneumaturia

Back 706

colovesical fistula, may be caused by diverticulosis

Front 707

Intensely PAS-positive bacteria

Back 707

Tropheryma whippelii

Hint 707

causes Whipple's disease: arthralgias, diarrhea, lymphadenopathy; can also have cardiac and neuro manifestations

Front 708

Reyes syndrome in Kawasaki disease

Back 708

children and teens w/ kawasaki who require aspirin therapy SHOULD NOT discontinue aspirin and should consider vaccination to avoid viral infection

Front 709

Recurrent infections, thrombocytopenia, eczema

Back 709

Wiskott-aldrich syndrome

Front 710

Renal failure diet

Back 710

designed to control the amount of protein and phosphorus in a patient's diet: high-carbs, moderately fatty diet, limit sodium, limit total fluid intake

Front 711

Tolterodine

Back 711

blockade of muscarinic ACh receptors in bladder wall is used to reduce the effect of parasympathetic hyperactivity in patients w/ spinal cord transection that have incontinence

Front 712

Vasa recta

Back 712

poorly oxygenated part of kidney, can become an area of sickling

Front 713

Recurrent acute pyelonephritis

Back 713

kidney stones

Front 714

Increased arterial CO2 effect on brain

Back 714

increased CO2 dilates blood vessels in the brain leading to increased flow, while decreased CO2 leads to vasoconstriction

Hint 714

think about it this way: hyperventilation leads to dizziness, which means that your brain is not getting enough O2 because the blood vessels are constricting because CO2 levels are low

Front 715

Mycobacterium avium intracellulare treatment

Back 715

clarithromycin, rifabutin, and ethambutol

Front 716

CFTR

Back 716

Anionic channel that is gated by ATP hydrolysis and involves regulation by protein kinase A

Front 717

Vulvovaginitis

Back 717

associated w/ high vaginal pH, diabetes, and use of antibiotics

Front 718

Alosetron

Back 718

5-HT3 antagonist used for diarrhea-predominant irritable bowel syndrome

Hint 718

restricted access usage in US because of serious gastrointestinal adverse effects like ischemic colitis

Front 719

Kaposi sarcoma

Back 719

spindle-cell neoplasm that is highly associated w/ AIDS and HHV-8

Hint 719

similar in appearance to angiosarcoma (proliferating stromal cells and endothelium creating vascular channels that contain blood cells)

Front 720

Budd-chiari

Back 720

caused by polycythemia vera, OCPs, pregnancy, HCC, chronic infections

Front 721

PAS-positive stuff

Back 721

alpha1-antitrypsin globules in liver, Kimmelsteil-Wilson nodules in kidney, Paget's disease of the nipple

Front 722

Neonate w/ cirrhosis and E. coli sepsis

Back 722

Galactosemia due to galactose-1-phosphate uridyltransferase (GALT) deficiency

Front 723

hemochromatosis

Back 723

classic triad: micronodular cirrhosis, Diabetes Mellitus, bronze skin pigmentation

Front 724

Protozoa that infects small intestine and look crescent-shaped next to the epithelial brush border

Back 724

giardia lamblia

Front 725

Entamoeba histolytica

Back 725

usually infects the large intestine or liver

Front 726

Necrotizing enterocolitis

Back 726

most common when infants are started on oral foods, especially formula fed children

Hint 726

present w/ distended abdomen and gangrene of the terminal ileum and ascending colon

Front 727

Increased IL-10

Back 727

can decrease contact dermatitis

Hint 727

IL-10 is produced by TH2 and inhibits TH1 (stimulate cell-mediated immunity and delayed hypersensitivity)

Front 728

Prolonged antibiotics

Back 728

deficiency in gut bacteria lead to vitamin K deficiency -> bleeding and blood in stools

Front 729

RUQ pain + bloody diarrhea

Back 729

Entamoeba histolytica

Front 730

Parvovirus in adults

Back 730

no slapped cheeks, instead arthralgias and arthritis

Front 731

Lipoprotein lipase

Back 731

located on the luminal surface of vascular endothelium of adipose tissue

Front 732

MI necrotic changes on light microscopy

Back 732

become evident after 4-12 hours

Hint 732

3 days: coag necrosis will advance and neutrophils will invade; 5-7 days: necrotic debris is removed and granulation tissue is formed

Front 733

Trientine

Back 733

second line agent for Wilson's disease

Hint 733

because 30% of patients can't handle long term penicillamine

Front 734

Wilson's disease diagnosis

Back 734

slit-lamp examination of the eyes demonstrates Kayser-Fleischer rings in Descemet membrane of the cornea

Front 735

Gastric carcinoma

Back 735

H. pylori is the strongest association, followed by smoking, then pernicious anemia, then EtOH

Front 736

Menkes disease (Elhers-Danlos type IX)

Back 736

depigmented, lusterless hair along w/ facial, ocular, vascular, and cerebral manifestations

Hint 736

due to a mutation in copper transport that leads to a defective Lysyl Oxidase enzyme, which is responsible for crosslinking collagen fibers

Front 737

bifid ventral pancreatic bud

Back 737

causes rotation around the duodenum distal to the ampulla of vater, which leads to obstruction

Hint 737

presents w/ bilious vomiting, polyhydramnios, double bubble sign

Front 738

Thiazolidinediones (pioglitazone, rosiglitazone)

Back 738

decreases TGs, insulin, Glucose levels, and increases HDL

Front 739

Gastric heterotopia

Back 739

occurs in small intestine and can produce enough acid to cause PUD

Front 740

Amoebae w/ ingested erythrocytes

Back 740

entamoeba histolytica

Front 741

Choledocholithiasis

Back 741

colicky RUQ pain

Hint 741

compared to cholecystitis, which is constant RUQ pain

Front 742

Lactulose

Back 742

given for treatment of hepatic encephalopathy

Hint 742

lactulose is degraded by gut bacteria, resulting in acidic pH, which shifts the equilibrium from NH3 to NH4+ and this minimizes gut absorption of ammonia

Front 743

Medium-chain acyl CoA dehydrogenase (MCAD) deficiency

Back 743

important in breaking down C-8, C-10 acylcarnitines after LCAD has made them.

Hint 743

medium chain length fatty acids accumulate, eventually spilling out of the mitochondria via the carnitine shuttle. Inability to conduct beta-oxidation results in low ATP levels (low ATP inhibits the urea cycle, leading to hyperammonemia)

Front 744

Octreotide

Back 744

used to treat variceal bleeding, acromegaly, diarrhea in various endocrine disordesr

Front 745

Differentiating feature between anti-ACh agents and botulinum toxin

Back 745

skeletal muscle weakness (seen in botulinum)

Front 746

Hantavirus pulmonary syndrome

Back 746

most common in four corners of the US, bunyaviridae

Hint 746

the virus is inhaled from aerosolized secretions from the common deer mouse, begins with nonspecific prodrome followed 4-5 days later by respiratory symptoms that progress to ARDS

Front 747

Ehrlichiosis

Back 747

caused by Ehrlichia phagocytophila, an intracellular bacterium transmitted by Ixodes

Hint 747

similar to rocky mountain spotted fever, but doesn't have a rash. Pathognomonic berry-like clusters of organisms in granulocytes

Front 748

Tinkly bowel sounds

Back 748

small intestinal obstruction

Front 749

Prochlorperazine

Back 749

phenothiazine that blocks dopamine receptors in the floor of the fourth ventricle (postrema)

Hint 749

used as an antiemetic

Front 750

Cystic artery

Back 750

found in the hepatoduodenal ligament

Front 751

obstructive sleep apnea syndrome

Back 751

hypoxemia w/ hypercapnia

Front 752

Gastroschisis

Back 752

caused by incomplete fusion of the lateral body folds

Hint 752

as opposed to failure of the intestinal loop to retract from the umbilical cord, which is seen in omphalocele

Front 753

Conjunctivitis caused by gram negative pleiomorphic rods

Back 753

H. influenzae

Hint 753

culture on chocolate agar w/ X and V or co-culture w/ S. aureus

Front 754

RhD-positive attack on newborn

Back 754

type II hypersensitivity

Front 755

Superior vena cava syndrome

Back 755

usually due to small cell carcinoma

Front 756

Roth's spots

Back 756

small white spots surrounded by hemorrhage bilaterally on the retina

Front 757

Goodpasture syndrome is most similar to bullous pemphigoid

Back 757

these are both cytotoxic type II hypersensitivity

Hint 757

Graves' disease, on the other hand, is type II, but it's noncytotoxic

Front 758

GI hormones w/ trophic properties

Back 758

Gastrin (intestinal mucosal growth), CCK (pancreatic growth), and secretin (pancreatic growth)

Front 759

Cyclophosphamide

Back 759

coadminister w/ mesna to prevent hemorrhagic cystitis

Front 760

Celiac sprue

Back 760

limited to the proximal small bowel (jejunum mostly)

Front 761

Salicylate poisoning

Back 761

made worse by things that acidify the urine, like NH4Cl

Hint 761

treated w/ bicarb to alkalinize the urine

Front 762

Aprepitant

Back 762

NK1 antagonist (blocks the action of human substance P) used to treat nausea and vomiting in patients who are on chemo

Front 763

Dumping syndrome

Back 763

occurs after gastric bypass surgery because food is being delivered to small intestine too quickly

Hint 763

instruct to eat smaller meals with less carbs, high protien, and more fats, because fats are absorbed more slowly and lead to less contraction by the small intestine, which helps improve the diarrhea symptoms of dumping syndrome

Front 764

Slaughterhouse workers, veterinarians, and farmers

Back 764

Brucellosis

Hint 764

undulating fever, lymphadenopathy, hepatosplenomegaly

Front 765

Vibrio vulnificus

Back 765

after eating raw shelfish -> septicemia, fever, chills, hypotension, fluid-filled blisters that progress to muscle necrosis of the lower limbs

Hint 765

gastroenteritis + cellulitis

Front 766

Vinyl chloride

Back 766

angiosarcoma of liver

Hint 766

seen in rubber industry

Front 767

Ursodiol (ursodeoxycholic acid)

Back 767

primary bile acid that acts by reducing cholesterol synthesis and secretion into bile and is effective in dissolving small cholesterol gallstones in some patients

Front 768

Gastrinoma

Back 768

proliferation of parietal cells in the body of the stomach due to increased gastrin levels (trophic effect)

Front 769

Neonatal CMV vs toxo

Back 769

CMV has periventricular calcifications, while toxo has calcifications distributed throughout the cortex and basal ganglia

Front 770

hCG lacks MHC antigens

Back 770

this is why it doesn't evoke and immune response

Front 771

heterogenous complex of diseases w/ onset of recurrent bacterial infections secondary to markedly decreased antibody levels that becomes evident in 2nd or 3rd decade of life

Back 771

Common variable immunodeficiency (CVID)

Hint 771

patients can have intact cell-mediated immunity or deficient t-cell mediate immunity

Front 772

Drugs that cause SIADH

Back 772

antidepressants (TCAs, SSRIs, MAOIs), antipsychotics, carbamazepine, antineoplastics

Front 773

Coxsackie virus A infection of neonates

Back 773

involvement of heart, liver, and brain that resolves without sequelae

Hint 773

CMV causes similar disease, except it has major sequelae

Front 774

Rocky Mountain spotted fever

Back 774

intracellular infection of endothelial cells

Front 775

finger-clubbing, hypertrophy pulmonary osteoarthropathy

Back 775

associated w/ bronchogenic carcinoma, benign mesothelioma, and diaphragmatic neurilemmoma

Front 776

Tularemia

Back 776

found in missouri, arkansas, oklahoma

Hint 776

ulcerative form is the most common, but there is also a pneumonic form that shows granulomas and stuff

Front 777

risk for becoming oral malignancy

Back 777

leukoplakia

Front 778

Hartnup disease

Back 778

defect in amino acid transport in renal and intestinal epithelium

Hint 778

see free amino acids in urine and symptoms similar to pellagra, except that there is a normal amount of niacin (tryptophan is a precursor of niacin)

Front 779

types of stains

Back 779

sudan stain (fat), Ziehl-Neelsen (aka acid-fast), reticulin (cirrhosis/fibrosis), Prussian blue (iron)

Front 780

X-linked immunodeficiency disorders

Back 780

Bruton, Wiskott-Aldrich, and some SCID

Front 781

docusate sodium

Back 781

stool softener

Front 782

microvilli

Back 782

contain actin and myosin filaments

Front 783

microsomal transfer protein

Back 783

essential for packaging of hepatic TGs and other components to be secreted as chylomicrons

Hint 783

deficiency leads to low chylomicrons, VLDL, LDL, as well as deficiency of fat-soluble vitamins

Front 784

HNPCC

Back 784

microsatellite instability is a characteristic of mutations in this gene (MLH1 gene)

Front 785

pigment stones in gallbladder

Back 785

associated w/ clonorchis sinensis

Front 786

Kernicterus

Back 786

unconjugated bilirubin deposition in basal ganglia

Front 787

Pregnant mother takes sulfa drugs in 3rd trimester

Back 787

results in kernicterus of the newborn

Front 788

tripolar mitosis

Back 788

abnormal mitotic spindle

Front 789

Campylobacter jejuni

Back 789

grows at 42 C

Front 790

liposarcoma

Back 790

pleomorphic lipocytes that resemble embryonal lipoblasts. Cytoplasm of cells is filled w/ lipid vacuoles that indent the nuclear membrane

Front 791

Full blown AIDS related infections

Back 791

HIV encephalopathy, PCP, Kaposi, cryptosporidiosis, Myco avium intracellulare

Front 792

Cryptosporidium mechanism

Back 792

intracellular multiplication in brush border and lysis of cells leading to severe watery diarrhea

Hint 792

this is as opposed to Entamoeba and Shigella, which invade the submucosa and cause dysentery

Front 793

Compensatory response in COPD

Back 793

increased renal ammonium secretion

Front 794

Ulcerative colitis

Back 794

increased risk of seeing another IBD (Crohn) in the family

Front 795

Megestrol acetate

Back 795

increases apetite in patients on antineoplastic drugs

Front 796

Gastrin location

Back 796

found mostly in antrum of stomach, but also in the jejunum and duodenum

Front 797

Telomerase

Back 797

a reverse transcriptase that is inhibited by NNRTIs and NRTIs in patients w/ HIV

Front 798

Most common cause of trisomy induced abortion

Back 798

trisomy 16

Front 799

cytoplasmic blebbing

Back 799

indicates apoptosis

Front 800

cysts with 4 nuclei

Back 800

Entamoeba histolytica

Front 801

Theophylline

Back 801

causes seizures

Hint 801

used in acute asthma management

Front 802

Secretin stimulation test

Back 802

used for Zollinger ellison, because it inhibits antral gastrin secretion, but stimulates pancreatic gastrin secretion

Front 803

Valproic acid

Back 803

assoicated w/ thrombocytopenia

Front 804

GIP

Back 804

only GI hormone released by fats, proteins, AND carbs

Hint 804

secretin (fat), CCK (fat and protein), gastrin (protein), motilin (fat)

Front 805

Mixed acidosis

Back 805

cardiopulmonary arrest

Hint 805

leads to a high arterial carbon dioxide due to respiratory standstill and metabolic acidosis due to lactic acidosis

Front 806

Glassy intranuclear eosiniphilic inclusions and punch out lesions in esophagus

Back 806

HSV, most commonly in immunocompromised

Front 807

Erythrogenic malarial infection is cleared by what immune cell

Back 807

NK cell b/c RBCs don't have MHC

Front 808

Pancreatic pseudocyst rupture

Back 808

the pseudocyst is filled w/ pancreatic enzymes and lysed blood and rupture may trigger severe gastrointestinal hemorrhage

Front 809

Panic attack

Back 809

assoicated w/ hypertension and peptic ulcer disease

Front 810

Metformin

Back 810

side effect: lactic acidosis

Front 811

Meclizine

Back 811

H1 receptor antagonist that's considered an antiemetic