Hy Review For Usmle Step 1: Review And Repro Pathology (D10)

Front 1

Nicotinic acetylcholine receptors are located where in the body?

Back 1

Autonomic ganglia, neuromuscular junction

Front 2

The function of IL-1

Back 2

1. pyrogen: inflammation and fever
2. Induces endothelium to express adhesion molecules
3. Acts as a chemokine to attract leukocytes.

Front 3

Who secretes IL-2 and what is/are the function(s)?

Back 3

Th1 secretes.
Stimulates the growth of Th and Tc

Front 4

The function of IL-3

Back 4

Supports the growth and differention of bone marrow stem cells (similar to GM-CSF)

Front 5

Who secretes IL-4, and what is/are the function(s)?

Back 5

Th2 secretes.
1. Positive feedback to induce Th2 differentiation
2. Promotes B cell growth.
3. Promotes class switching to IgE and IgG

Front 6

Who secretes IL-5, and what is/are the function(s)?

Back 6

Th2 secretes.
1. Promotes the differentiation of B cells.
2. Class switching to IgA
3. Stimulates the growth and differentiation of eosinophils.

Front 7

What is the main difference between delerium and dementia?

Back 7

In delerium, there is waxing/wanning of the level of consciousness, while there is no change in dementia.

Front 8

What are the layers of the epidermis?

Back 8

"Californians Like Girls in String Bikinis."
Stratum: Corneum, Lucidum, Granulosum, Spinosum, Basalis

Front 9

Where do you find T cells in the spleen?
Where do you find B cells in the spleen?

Back 9

T: paracortex of spleen
B: follicle of the cortex

Front 10

What structures arise from the paramesonephric ducts?

Back 10

Fallopian tubes, Uterus, and upper 1/3 of the vagina

*lower 2/3 from the Urogenital Sinus

Front 11

Involuntary withholding of a feeling from conscience awareness.
Defense mechanism?

Back 11

Repression (also the underlying defense mechanism of all other defense mechanisms).

Front 12

A veteran that can describe horrific war details w/o any emotion.
Defense mechanism?

Back 12

Isolation

Front 13

A child abuser was himself abused as a child.
Defense mechanism?

Back 13

Identification

Front 14

What defense mechanism may lead to multiple personalities?

Back 14

Dissociation

Front 15

Adult whining, bedwetting, crying.
Defense mechanism?

Back 15

Regression

Front 16

Which cancers are associated with PSA?

Back 16

Prostate cancer

Front 17

Which cancers are associated with AFP?

Back 17

Hepatocellular carcinoma
Yolk sac tumor

Front 18

Which cancers are associated with CA125?

Back 18

Ovarian cancer

Front 19

Which cancers are associated with elevated ALP?

Back 19

Met-to-bone
Obstructive biliary dz
Pagets Disease of the Bone

Front 20

Which cancers are associated with CEA?

Back 20

Colorectal and pancreatic cancers
Also a/w Gastric, Breast, and medullary Thyroid Cancers

Front 21

B-hCG is associated with what?

Back 21

Hydatidiform moles
Choriocarcinomas
Gestational trophoblastic tumor
(HCG)

Front 22

S100 is a marker seen in?

Back 22

Melanoma
Neural tumors
Astrocytoma

Front 23

The rate-limiting step in purine synthesis is?

Back 23

Glutamine PRPP aminotransferase

Front 24

The rate-limiting step in pyrimidine synthesis is?

Back 24

CPS II (Carbamoyl phosphate synthetase II)

Front 25

What is the main Risk Factor for Endometrial hyperlasia and carcinoma?

Back 25

Unopposed estrogen

Front 26

Menorrhagia with an enlarged uterus and no pelvic pain is characteristic of what?

Back 26

Leimyoma

Front 27

Pelvic pain that is only present during menstruation

Back 27

Endometriosis

Front 28

Menstruating tissue within the myometrium

Back 28

Adenomyosis (endometrial tissue in the myometrium)

Front 29

Malignant tumor of the uterine smooth muscle

Back 29

Leimyosarcoma

Front 30

Most common gynecologic malignancy

Back 30

Endometrial carcinoma

Front 31

Most common tumor of females

Back 31

Leiomyoma (fibroids)

Front 32

What is the main hormone that is responsible or initiates the cycle seen in Polycystic Ovarian Syndrome (Stein-Leventhal Syndrome)? What is the cycle?

Back 32

Luteinizing Hormone (LH)

It increases androgren production from Theca cells (hirsutism)--> androgen peripheral conversion to estrogen (incr endometrial cancer risk)--> estrogen has a positive feedback to LH.

Front 33

OCPs are ideal for PCOS treatment. Why?

Back 33

1. Progesterone protects endometrial lining (estrogen counteraction)
2. Negative feedback to LH
3. Increases SHBG (sex-hormone binding globulin)

Front 34

Define abruptio placentae

Back 34

Abrupt detachment of placenta from uterine wall causing painful bleeding in the 3rd trimester. Results in Fetal Death.
*a/w DIC, incr risk w/smoking, HTN, cocain.

Front 35

Define placenta accreta

Back 35

Defective decidual layer allows placenta to attach to myometrium, and does not separate during birth. Results in massive bleeding.
*RF: prior C-section, inflammation, and placenta previa
*"accreta"= encased in"--> myometrium.

Front 36

Define placenta previa

Back 36

Attachement of the placenta to lower uterine segment. May occlude the internal os. Painless bleeding
*RF: multiparity and prior C-section (due to scarring)

Front 37

A patient comes in with sudden abdominal pain. She is (+) for hCG, and you confirm your suspicion w/ultrasound. What is the Dx/what should you be thinking about?

Back 37

Ectopic pregnancy (bleeding is +/-)

Front 38

Which drugs can induce gynecomastia?

Back 38

"Some Drugs Create Awesome Knockers."
Spironolactone, Digitalis, Cimetidine, Alcohol, Ketoconazole

Front 39

What is the most common cause of "breast lumps" in 25yo until menopause?

Back 39

Fibrocystic change/disease.
(benign, but PAINFUL; multiple and bilateral; fluctuation in size).

Front 40

Dimpling of the breast means there is involvement of...?

Back 40

Suspensory Ligament

Front 41

A new nipple retraction indicates involvement of...?

Back 41

Lactiferous Duct

Front 42

A firm, fibrous mass is found in a 55yo woman. What do you suspect?

Back 42

Invasive ductal carcinoma, because it is the most common (76%) and WORST breast cancer.

Front 43

A bloody or serous (yellowish) discharge is noted from the nipple of a woman with a small lump. What do you suspect?

Back 43

Intraductal papilloma (grows in lactiferous ducts, typically beneath the areola)

Front 44

Which cranial nerves run through the Cavernous Sinus?

Back 44

3, 4, 5(1) and 5(2), 6

Front 45

Which major artery runs through the Cavernous Sinus?

Back 45

Internal Carotid Artery

Front 46

Small Cell Lung Cancer can secrete which two products? What Effect/syndrome results?

Back 46

1. ACTH or ACTH-like peptide resulting in Cushing's Syndrome.
2. ADH resulting in SIADH (can also be due to an intracranial neoplasm).

Front 47

Squamous Cell Lung Cancer, Renal Cell Carcinoma, and Breast Carcinoma all secrete what peptides/products? What is the result?

Back 47

PTH-related peptide, TGF-B, TNF, IL-1
--> HYPERCALCEMIA.

Front 48

Which neoplasms produce EPO, resulting in polycythemia?

Back 48

Renal Cell Carcinoma, Hemangioblastoma, Hepatocellular Carcinoma, and Pheochromocytoma.

Front 49

Pruritic, purple, polygonal papules

Back 49

Lichen Planus

Front 50

Pruritic vesicles a/w celiac disease (and deposits of IgA at the tips of dermal papilla)

Back 50

Dermatitis herpetiformis

Front 51

Parakeratotic scaling (nuclei still in the stratum corneum)

Silvery scaling (knees, elbows)

Auspitz sign (bleeding when scratching)

Back 51

Psoriasis

Front 52

Keratin-filled cysts that looks pasted on

Back 52

Seborrheic keratosis

Front 53

Which cranial nerves run through the Cavernous Sinus?

Back 53

3, 4, 5(1) and 5(2), 6

Front 54

Which major artery runs through the Cavernous Sinus?

Back 54

Internal Carotid Artery

Front 55

Small Cell Lung Cancer can secrete which two products? What Effect/syndrome results?

Back 55

1. ACTH or ACTH-like peptide resulting in Cushing's Syndrome.
2. ADH resulting in SIADH (can also be due to an intracranial neoplasm).

Front 56

Squamous Cell Lung Cancer, Renal Cell Carcinoma, and Breast Carcinoma all secrete what peptides/products? What is the result?

Back 56

PTH-related peptide, TGF-B, TNF, IL-1
--> HYPERCALCEMIA.

Front 57

Which neoplasms produce EPO, resulting in polycythemia?

Back 57

Renal Cell Carcinoma, Hemangioblastoma, Hepatocellular Carcinoma, and Pheochromocytoma.

Front 58

Pruritic, purple, polygonal papules

Back 58

Lichen Planus

Front 59

Pruritic vesicles a/w celiac disease (and deposits of IgA at the tips of dermal papilla)

Back 59

Dermatitis herpetiformis

Front 60

Honey crusting lesions common about the nose and lips

Back 60

Impetigo caused by Staph aureus or pyogenes

Front 61

Parakeratotic scaling (nuclei still in the stratum corneum)

Silvery scaling (knees, elbows)

Auspitz sign (bleeding when scratching)

Back 61

Psoriasis

Front 62

Keratin-filled cysts that looks pasted on

Back 62

Seborrheic keratosis

Front 63

Hyperkeratosis and koilocytosis

Back 63

Verruca of HPV

Front 64

Composed of cytotrophoblasts and synctiotrophoblasts. Which testicular tumor? Germ or non-germ cell?

Back 64

Choriocarcinoma (germ cell)

Front 65

Which testicular tumor may present initially w/gynecomastia? Germ or non-germ cell tumor?

Back 65

Leydig cell tumor (nongerm cell)

Front 66

Which two germ-cell tumors of the testicles may show an increases in alpha-fetoprotein (AFP)? Which one also may show a rise in beta-hCG?

Back 66

Yolk sac (endodermal sinus) and Embryonal carcinoma (b-hCG possible).

Front 67

Most common testicular tumor?

Back 67

Seminoma

Front 68

Most common testicular tumor in infants and children up to 3yo?

Back 68

Yolk sac (endodermal sinus) tumor

Front 69

Most common testicular tumor in men over 60 yo?

Back 69

Testicular Lymphoma

Front 70

Which yellow testicular tumor has glomeruli-like structures and an increase in AFP? What are these structures called?

Back 70

Yolk-sac tumor. Schiller-Duval bodies

Front 71

25% of these tumors have cytoplasmic-rod shaped crystalloids of Reinke.
If you don't know, it also makes androgens resulting in gynecomastia due to peripheral conversion.

Back 71

Leydig cell tumor

Front 72

Finasteride MoA? S/e?

Back 72

MoA: 5alpha-reductase inhibtor, so you have decreased DHT (used to tx BPH)

s/e: gynecomastia

Front 73

A nonsteroidal competitive inhibitor of androgens at the testosterone receptor, used in prostate carcinoma

Back 73

Flutamide

Front 74

How does clomiphene work?
What is it's clinical use?

Back 74

A partial agonist of the estrogen receptor in the hypothalamus. Prevents normal feedback inhibition and increases LH ad FSH--> stimulates ovulation
Used for infertility and PCOS.

Front 75

What is the most common heart murmur?

Back 75

Mitral Valve Prolapse

Front 76

What is the most common artery involved in thrombosis?

Back 76

Left Anterior Descending Artery

Front 77

What is the most common cause of death in lupus patients?

Back 77

Lupus Nephropathy

Front 78

What is the most common heart anomaly?

Back 78

VSD

Front 79

Where does testicular cancer first metastasize to?

Back 79

Para-aortic Lymph nodes