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190 Cards in this Set

  • Front
  • Back
multinucleated giant cells in biopsy of breast lump
fat necrosis
presence of active toxoplasmosis
most likely from reactivation in immunosuppressed state, most primary infections begin in childhood
osteoarthritis synovium finding
clear acellular fluid
anterior interosseus
innervates the flexor pollicis longus, lateral half of flexor digitorum profundus, and pronator quadratus
RV failure and dilatation
most common cause of TV regurge and often secondary to pulmonary HTN or LV failure
ACE Inhibitor affect on potassium
increase levels via lowered aldosterone
sodium absorption in distal tubule
increased by hyperkalemia
most common cause of ASD
failure of fusion of the septum primum and septum secundum
tumors associated with pseudomyxoma peritonei
mucinous cystadenoma/adenocarcinoma
hiso in humans
seen macrophages
hip fracture and bed rest
sarcococcygeal teratoma origin
remnants of the primative streak (contain all 3 germ layers)
comp of PDA ligation
left phrenic nerve lesion
azygous vein
formed from lumbar and subcostal veins, arches over root of lung to join SVC
hemizygous and accessory hemizygous veins
drain most of posterior intercostal veins
thoracic duct
on left: drains into left subclavian and drains whole body minus right arm and right side of chest and neck; right: right subclavian drains rest of body
Wilms tumor, aka:
benign tumor of ductal cells in kidney
gamma delta T cell
do not undergo thymic selection
Killer inhibitory receptor
on surface of NK cells, inhibits killing if attached to MHC I
moro reflex
startling event, lost at 3-6 months
palmar grasp reflex
lost at 1-2 months
tonic neck reflex
lost at 7-8 month
lost at 1 year
order of lost reflexes: (early-late)
palmar, moro, neck (PMN), babinski
sagittal sinus thrombosis
associated with hypercoagulable states (such as first few weeks postpartum)
tongue somatic sensation
venous vs arterial hematocrit
slightly great in veins due to chloride shift into RBC as they pass through the vasculature
tx of carcinoid syndrome
octreotide = inhibits synthesis and release of tumor hormones
major constituant of dense granules in eosinophils
major basic protein - functions in parasite destruction
eos have
histaminase and arylsulfatase other enzymes
histamine from
basophils and mast cells
lactoferrin found in
PMNs, used to kill bacteria
flexion abduction lateral rotation of the shoulder and flexion of the elbow
primordial follicles
inactive that contain primary oocytes surrounded by a single layer of flattened follicular cells
primary follicles
larger and contain central oocyte with one or several cuboidal follicular cells
secondary follicle
antrum forms in the primary follicle
graafian follicle
mature form - includes cumulus oophorus, corona radiata, theca interna, theca extrena, and zona pellucida
order of follicle
primordial, primary, secondary (antrum present), graafian (everything else present)
only antibody a baby can form in an acute infection
70% adult tumors above tentorium:
mets>astros (including glio)>mening>pituitary
mets in brain
round at junction of cortical gray and white matter
butterfly lesion
characteristic of GBM crossing the cerebral hemispheres
spherical lesion in brain
either a met or meningioma (found on surface of brain)
tx of choice for pneumococcus
aromatase inhibitor, used for estrogen dependent breast cancer
common cause otits media
h. inf, strep pneumo, strep pyo
upward lens dislocation
% of Downs with heart probs
ostum primum type of ASD is most common
most common abnormality
heart starts beating
4 weeks
touton giant cells
multinucleated cells (foamy) in xanthomas
classic ASD
prominent right ventricular cardiac impulse, systolic ejection murmur in pulmonic area, fixed splitting, L-R shunt V overload of right side
see digoxin think:
hypokalemia, toxicicty can cause ventricular dysrhythmias like PVC, also see ST scooping on ECG
drugs that decrease digoxin
colestipol (bile acid binding resin), sulfas, phenytoin (via P450), sulfasalazine
most common cause of SCD
(sudden cardiac death) ischemic heart disease
sphenopalatine artery
terminal branch of maxillary artery
hCG levels during pregnancy
increase until tenth week then drop
progesterone and estrogen during pregnancy
increase throughout the pregnancy
human chorionic somatomammotripin, aka:
human placental lactogen, increases throughout pregnancy, similar structure to GH, anti insulin, facilitates energy supply of the fetus
"solid balls" in thyroid
papillary carcinoma - broken off papillary clusters are considered pathognomic, most common form
medullary carcinoma
presence of amyloid on biopsy
follicular carcinoma
follicular cells and colloid on biopsy, cant reliably distinguish from thyroid adenoma
nelson's syndrome
excessive hyperpigmentation secondary to increased ACTH
window period
neither HBsAg nor HBsAb are present
pancreas location
mostly retroperitoneal, tail is not
dudodenum retroperitoneal
parts 2-4
rhodamine positive cytoplasmic granules in liver
wilsons disease
PAS positive granules in liver
alpha-1 antitrypsin deficiency
mets to inguinal nodes
anorectal region
drainage to medial side of horizontal chain of superficial group of inguinal LN
penis, vagina, anal canal
rectal/colon cancer drainage
lymph node: below pectinate line --> inguinal nodes, above pectinate line --> iliac nodes (inside pelvic)
location of lipoprotein lipase
surface of vascular endothelium
pancreatic pseudocyst
complication of pancreatitis, lined by granulation tissue and collagen, rupture can cause release of digestive enzyme and subsequent GI hemorrhage
predisposing factors for gastric carcinoma
pernicious anemia, chronic gastritis, acholrhydria, bacterial overgrowth and neoplstic polyps
transferrin in iron deficiency
transferrin in beta thal
reduced, increased ferritin and plasma iron
anemia of chornic disease
associated with increased iron stores: elevated serum ferritin, decreased transferrin, increased BM iron deposits
elevated leukocyte AP
myeloid metaplasia
stage IV hodgkins
presence of disease outside of lymph nodes
gp Iib IIIa
binds fibrinogen (leads to fibrinogen bridging)
long saphenous vein
drains into superficial inguinal lymph nodes, most of the venous drainage of the leg
small saphenous vein
drains into popliteal fossa - drains the lateral aspect of the dorsum of the foot
rectus femoris arises from
anterior inferior iliac spine
grabbing something to break a fall
lesion of the lower part of brachial plexu that results in klumpke's palsy (C8-T1)
falling on shoulder
damage to upper brachial plexus
centrally acting skeletal muscle relaxant structurally related to TCAs, give anticholinergic side effects, used to relieve acute spasm, not in surgical setting
common interosseous artery
branches off ulnar artery below antecubital fossa and extends down to the lower third of the forearm
succinylcholine major side effect
hyperkalemia as prolongued muscle deploarization can cause increased release of K+ into the ECF; burns extensive injuries spinal cord injuries of muscular dystrophies significantly increase risk
GABA agonist used as a spasmolytic
corticosteroid action on bone
increased osteoclastic resorption and decreased osteoblastic formation
epiphyseal plate
cartilage that is radiolucent, the plate can produce a "line" crossing the bone near the end
primary center of ossification
middle of diaphysis, create medullary cavity
secondary center of ossicifation
cartilage in the epiphyseal plate, carilage cells hypertrophy, secrete collagen, then osteoblasts mineralize it
zones of cartilage
resting (normal hyaline cartilage), proliferation (chondrocytes undergo rapid mitosis forming sacks), maturation/hypertrophy (become enlarged contain lots of glycogen and secrete AP), calcification (chondrocytes dead or dying leaving cavities that will later be invaded by bone forming cells)
endochondrial vs intramembranous ossification
intramembranous doesn’t involve cartilage
axillary artery course
in the axiillary sheath which is surrounded by all three cords of the brachial plexus, aneurysm of the axillary artery can compress all of the cords
arises from the clavicle and acromion and insert in deltoid tuberosity of the humerus
rate of growth nerve following transection
1 mm/day
parkinsons lesion
SNc lies between the crus cerebri and the medbrain tegmentun
red nucleus
nucleus in the motor system, infput from parvicellular portion of the cerebellum and origin of the magnocellular portion
found in lateral portion of midbrain
viral encephalitis
such as herpes, transmitting by mosquitos, see high lymphocytes,
herniation of brain through bony defect
spina bifida aperta
complete failure of fusion of the neural plate associated with maflformation of the vertebral arches such that the underdeveloped nural plate is covered onwly with skin, no mass lesion present, major neurological defect
protruding spinal cord that you can see
tumor filling 4th ventricle
blocks CSF flow that results in increased intracranial pressure : N+V headache rigidity, MS change; in kids medullow and ependymom most frequent
alterations in medullary function
cardiorespiratory instability
characteristic sugar coating
refers to spread of medulloblastoma to subarachnoid space
auriculotemporal nerve
anterior aspect of external ear canal
auricular branch of X
posteior aspect of external ear canal
acanthoemba in brain
immunosuppressed patients, brain infection with multifocal hemorrhagic necrotizing meningoencephalitis
nevus flammeus
wine port stain seen in sturge-weber disease
sturge weber
occurs sporadically, resulting from mesodermal and ectodermal development problem
foramen spinosum
carries middle meningeal artery
middle meningeal artery
tear leads to incresased blood between inner skull and dura leads to blown pupil from pressure on the parasympathetic fibers in the pupil
superior orbital fissure
contains the ophthalmic vein and CN III, IV, VI (muscles of the eye)
parinaud's syndrome
clinical syndrome of problem with the vertical gaze center, can be caused by pineal tumor
vertical gaze center
superior colliculi and pretectal area of the dorsal midbrain
supreior cerebellar peduncle
efferents from the cerebellum
occipital corex lesions
often spare the macula (collateral blood supply)
empty sella syndrome
herniation into the sella causing atrophy of the pituitary generally have sufficient residual pituaitary parenchya to prevent hypopituitarism
neostigmine and physostigmine MOA
carbamylation of acetylcholineesterase
edrophonium MOA
competitive inhibition of AChE
phosphorylation of AChE
as with echothiophate cause irreversible inhibition, insectisides and nerve gasses do this
amnestic disorder
limited memory problems, loss of alteration in language and the loss of the ability to plan
marcus gunn pupil
constricts to light on contralateral side, not ipsilateral side
sublacine herniation
most likely to damage the cingulate gyrus since the falx separates the two hemispheres and the cingulate gyrus is in the medial aspect of the hemisphere above the corpus collosum
uncal herniation
midbrain damage and medial temporal lobe damage
cerebellar tensil herniate into foramen magnum
tonsillar herniation, medulla can be compressed
chronic meningitis
lymphocytes, plasma cells, macrophages, fibroblasts
location of recurrent laryngeal nerves
right side under subclavian, left side under the thorax
histology of renal cancer
clear cells - renal cell carcinoma; eosinophilic cells with mitochondria - oncocytoma; hamartomous blood vessels - angiomyolipoma; necrotic bacterial forms in macrophages - malakoplakia (can cause mass lesions in kidney without being a true tumor); embryonic glomerular structures - wilms tumor
diuretic contraindicated in renal failure
potassium sparing due to hyperkalemia exacerbation
contraindicated in nephrotic syndrome
high dose loop diuretics can cause hypovolemia, decreased perfusion, and acute renal failure
prerenal azotemia exacerbation
ACE inhibitors can lead to acute renal failure
nitrite reactivity
all enterobacteria, enterococci (gut streptococci) cannot
only freely filtered and secreted substance in PT
pudendal nerve
leaves pelvis through greater scieatic foramen, waps around ishcail spine and supraspinatous lig to enter lesser sciatic foramen, palpation of ischial spine indicates location for block
sacrospinus ligament
separates greater sciatic forament (posterior) from lesser sciatic foramen (anterior)
bartholin gland cyst
typically sequela of previous infection, csts lined by transitional epithelium or metaplastic squamous epithelium
lichen sclerosis
gray, parchment-like thinned epidermis
vestibular adenitis
tender posterior introitus with focal ulcerations
vulvar squamous hyperplasia
white plaque
CMV congenital
HSM, jaundice, petechiae, brain calcification, high mortality
first choice for syphilis Dx
VDRL for stage I and II, FTA-ABS for tertiary
intraductal papillomas
small benign neoplastic papillary tumors in larger ducts, near nipple, malignant counterpart = papillary ductal carcinoma of the breast
complex branching glands versus long narrow coiled glands in endometrium
complex - complex hyperplasia
simple (cystic) hyperplasia of endometrium
cystically dilated glands without cellular atypia
inflammatory breast CA
lymphatic invasion, blockage --> peau d'orange
paget cells
intraepidermal malignant cells, seen in paget disease of nipple in which ductal CA spreads intraepidermally to the skin of the nipple and areola
theophylline side effects
tachycardia, insomnia, agitation
klebsiella tx
third gen cephalo: cefotoxime, ceftriaxone, ceftazidime
findings in sarcoidosis
uveitis, erythema nodosum, arthritis, central and peripheral neuropathis, cardiomyopathy, hypercalcemia; sx = fatigue exertional dyspnea, non-productive cough
systemic sclerosis
involves skin 100%, esophagus 75%
bilateral fluffy chest infiltrates
PCP, hat shaped silver stained cyts
pulmonary edema
proteinaceous granular precipitate ni alveoli, engorged alveolar capillaries, hemosiderin-laden macrophages
paramyxovirus genome
negative sense RNA, carries RNA dep RNA pol with it
SS- RNA viruses
all helical capsid ones minus corona (its SS +)
Ghon complex
primary TB, usually hilar lymph node involvement
tuberculous bronchopneumonia
caused by TB in highly sensitized individuals, aggressive and leads to consolidation without well formed granulomas
gram negative rod encapsulated oxidase positive aerobic
pseudomonas resistance mech
mutation of porin protein, restricts flow of many antibiotics; also beta lactam and topoisomerase mutations (both less important than porin mutations)
gentamicin and chloramphenicol resistance MOA
acetyltransferase production
immunity to s pneumo
IgG antibodies to surface acidic polysaccharide
immunity to strep pyo
anti M protein
C carbohydrate
used to differentiate beta hemolytic streptococci
give corticosteroids to mom as soon as preterm delivery becomes evident, acts to increase surfactant formation
Skin/connective tissue
central ulceration with rolled edge on sun exposed area
basal cell carcinoma
transient, nonpitting erythematous wheals
verruca vulgaris
common wart: well demarcated verrucous papules, often on hands
stasis dermtitis
complication of lower leg edema, edema, erythema, mild scaling, brwon discoleration, don’t necessarily feel that bad
lichen simplex chronicus
very itchy, tends to be localized, not typically accompanied by ankle edema
nummular dermatitis
coin-shaped itchy lesions that may involve legs
seborrheic dermatitis
diffuse scaling (dandruff) of scalp
albinism increased risk of which cancer?
usually squamous cell, also get basal cell
paget disease in skin
presence of adenocarcinoma in skin (as with breast cancer)
shingles tx
famciclover and valacyclovir are preferred for varicella zoster over acyclovir because of better pharmacodynamics
oka strain live attenuated vaccine
for varicella zoster
pooled immune globulin or VZ immunoglobulin Vzi
can be given to immunosuppressed patients, not as good for active infections