Systemic Disease

Front 1

The four "-OR"s of inflammation?

Back 1

Dolor, Calor, Rubor, Tumor

Front 2

Cell type most associated with acute inflammation?

Back 2

Leukocyte

Front 3

Cell types most associated with cronic inflammation?

Back 3

Macrocyte, lymphocyte, plasma

Destroy tissue, leading to repair and neo

Front 4

Granulomatous inflammation involves collections of what type of cell?

Back 4

Macrophages.
Occurs in TB, histo, sarcoid

Front 5

TB skin test (PPD) criteria:

Back 5

>15mm healthy
>5 healthcare, immunocompromised

Front 6

What is a sign of TB (happens at night)

Back 6

*Night sweats

Front 7

The 4 types of immune responses are: (ACID)

Back 7

Anaphylactic
Cytotoxic
Immune-Complex
Delayed

Front 8

Describe Type 1 immune response

Back 8

Allergen activates B-lymphocyte and IgE antibodies produced. IgE degranulate mast cells and release histamine. Happens fast.

Front 9

Describe Type 2 immune response:

Back 9

Antibodies (IgM and IgG) bind intrinsic or extrinsic (in or out of cell) antigen and destroy it. Example: Rh disease, Pn allergy
2 things: Ab,Ag

Front 10

Describe Type 3 immune response:

Back 10

Ag/Ab complexes and call in complement which starts tearing up surrounding tissue. Ex: Lupus, RA.
3 things:Ab,Ag,complement

Front 11

Describe Type 4 immune response:

Back 11

Sensitized T-cells encounter antigen and release leukokinin, which activates macrophages.
Exp: TB skin test, contact dermatitis, corneal transplant, phylectenulosis (staph-bleph)

4 things: T-cell, antigen, leukokinin, macrophage

Front 12

Normal level of neutrophil and primary indication?

Back 12

<7800, bacteria

Front 13

Normal level of Eosinophil and primary indication?

Back 13

<500, parasite, allergy

Front 14

Normal level of Basophil and primary indication?

Back 14

<200, shock, acute inflammation

Front 15

Normal level of lymphocyte and primary indication?

Back 15

<3900, virus

Front 16

Normal level of monocyte and primary indication?

Back 16

<950, autoimmune

Front 17

Cholesterol:
Total
LDL
HDL
Triglyceride

Back 17

Total 200
LDL<100
HDL>40
Triglyceride:<150

Front 18

Normal WBC?

Back 18

4000-10,000

Front 19

AUTOIMMUNE diseases
gender
eye sign
type of hypersensitivity rxn

Back 19

women>men
dry eye
type 3

Front 20

Lupus

Back 20

Any organ
10:1 Female to male
Butterfly rash
(+)ANA
Disc edema, papilledema

Front 21

Rheumatoid Arthritis

Back 21

-Joint pain worse in morning
-40-50 yo
-Most common cause of scleritis
-Necrotizing scler=scleratomalacia perforans

Front 22

JRA

Back 22

*Most common cause of uveitis in kids*
Cronic bilateral non-granulomatous uveitis
1 joint = pauciarticular-affects eye

Front 23

Sjogren's triad

Back 23

Triad: Dry mouth, dry eye, arthritis

Front 24

Gout

Back 24

More common in men
Band K from Ca crystals
Formation of urate crystals in joints b/c of increased uric acid.

Front 25

Sarcoid

Back 25

Black females
(+)ACE (lung)

1-Anterior Granulomatous Uveitis
2-Vasculitis (candle wax)
3-Vitritis
4-Optic nerve disease
5-Bell's palsy

Front 26

Ankylosing Spondylitis

Back 26

-Young male
-Bamboo spine(straight), uveitis, aortic regurgitation
*HLA B27 (CRAP=autoimmune dz)

Front 27

Reiter's Syndrome

Back 27

-Triad:can't See, Pee, Climb a tree
-Males>Females
-HLA B27*

Front 28

MUSCULOSKELETAL disorders are low yield for boards.

Back 28

Low

Front 29

Osteoarthritis

Back 29

Not autoimmune
Worsens throughout day
Big joints

Front 30

Osteoporosis

Back 30

-Demineralization of bone
-decreased estrogen
-DEXA test (bone density)

Front 31

Fibromyalgia

Back 31

-woman 20-50yo
-Trigger points

Front 32

IMMUNODEFICIENCY

Back 32

Develop due to:
-Inherited defect
-disease that affect immune system

Front 33

Immunoglobulin A deficiency

Back 33

-Inherited loss of IgA (in tear film)
-Decreased mucosal defense
-Keratinization of cornea, recurrent URI

Front 34

AIDS

Back 34

-RNA infects then makes DNA
-loss of CD4 t-cells (helper)
-CD4 count <200 = AIDS
-ELISA for HIV Dd
-Western Blot to confirm ELISA

Front 35

AIDS opportunistic infections

Back 35

*Most common oc infection: Cytomegaloviris
-Pneumonia
-Histo
-TB
-Kaposi's Sarcoma (caused by herpes)

Front 36

Describe the 4 types of necrosis:
Coagulative
Liquefactive
Caseous
Fat

Back 36

-Coagulative: structure of cell remains, integral structural proteins denatured (myocardial infarction)
-LiqueFactive: Cell remains but turns gray (LLung, FFungal)
-Caseous: white and cheesy (ex TB)
-Fat: adipose tissue; white lesions

Front 37

GENETIC disorders

Back 37

happens to the genes :-)

Front 38

Down's syndrome

Back 38

-Most common chromosomal disorder 1/700
-Extra 21 chromosome (Trisomy 21)
-Glaucoma, Strabismus, cong cataracts, simian crease(hand), epicanthal folds, Keratoconus (TDOME)

Front 39

Edward's Syndrome(Trisomy 18)

Back 39

-extra 18 chromosome
-Microphthalmos
-Death within 1 yr

Front 40

Klinefelter's Syndrome

Back 40

-XXY (xtra X chromosome)
-Calvin Kline is femmy (gynecomastia, hypogonadism)

Front 41

Turner's Syndrome

Back 41

-X0 (female missing 1 X)
-25% have ocular findings:strab, amblyopia, accomodative, CI
-Amenorrhea (no menstrual cycle)
-Keratoconus (TDOME)

Front 42

AUTOSOMAL DOMINANT:
facts and diseases

Back 42

Equally male:femal
Several generations
AFTER puberty

"Marfan Dominates at hunting because his familial polyposed gardner gives him neurofiber"
Marfan's
Huntington's
Familial Adenomatous polyposis
Gardner's
Neurofibromatosis

Front 43

Neurofibromatosis (triad)

Back 43

Tumor-forming nerve cells
*Triad:
1-Cafe au Lait spots(brown spots in skin)
2-Neurofibromas
3-Lisch nodules

Front 44

Marfan's Syndrome

Back 44

-Connective Tissue disorder
-Subluxation of lens (up, out), retinal D.
-Cardiovascular defects

Front 45

Huntington's Chorea

Back 45

-Dementia and muscle movements
*Slows saccades

Trick: dominant hunter needs good muscles

Front 46

Familial Adenomatous Polyposis (FAP)

Back 46

-Deletion on Chromosome 5 results in hundreds of polyps on colon post puberty
-100% get colon cancer
-Gardner's syndrome is a variant of FAP that has 4 or more CHRPE's

Front 47

AUTOSOMAL RECESSIVE:
facts and diseases

Back 47

-One generation
-25% of offspring from 2 carrier parents
-Often more severe than dominant
-often Presents in childhood


"Recessive SICKle Cysts hide in ketonuria"
Sickle cell
Cystic Fibrosis
Phenylketonuria

Front 48

Sickle Cell Anemia
-what substitution causes it?

Back 48

Single base-pair mutation where Valine is substituted for Glutamic Acid.
-retinal ischemia, Neo (seafan)

Trick: V over G = victory for sickle cell

Front 49

Cystic Fibrosis

Back 49

-Disfuntional Cl pumps
-Pulmonary infections, fat vitamin deficiency
-Most common lethal genetic disease among caucasians (1/2000)
-ddx using cloride sweat test

Front 50

Phenylketonuria (PKU)

Back 50

-Mutation to enzyme Phenylalanine Hydroxylase
-leads to buildup of phenylalanine and mental retardation

Front 51

X-LINKED:
facts and diseases

Back 51

-If recessive, can't be passed from dad to son
-Sons of heterozygous mothers have 50% chance of infection

"Ten(X) fragile duchmen"
Fragile X
Duchenne's Muscular Dystrophy

Front 52

Fragile X

Back 52

-2nd most common genetic mental retardation (2nd to Down's)
-Large testes, long face/jaw/ears, autism

Front 53

Duchenne's Muscular Dystrophy

Back 53

-Deletion of gene encoding Dystrophin
-Weakness of muscle and breakdown; begins in pelvic girdle

Front 54

Osteogenesis Imperfecta

Back 54

-Multiple fractures; affects collagen synthesis
-Blue sclera, keratoconus (TDOME), megalocornea

Front 55

Leber's hereditary optic Neuropathy

Back 55

-Mitochondrial disorder (maternal inheritance)
-Loss of central vision
-Men in late 20's, early 30's

Front 56

ANEMIA:
facts and test

Back 56

Decreased Hgb
CBC: normal WBC 6-10k

Front 57

Iron Deficiency anemia

Back 57

-Most common anemia (50%)
-Often results from GI blood loss

Front 58

Aplastic Anemia

Back 58

-Worse kind of anemia
-Bone marrow malfunctions
-Can be caused by chloramphenicol, ACETAZOLAMIDE, chemo drugs

Front 59

vitamin b12 deficency

Back 59

-Often cause by pernicious anemia(autoantibodies against stomach lining result in malabsorbsion)
-B12 shots for elderly

Front 60

Folic Acid deficiency

Back 60

-Common in alcholics.
-Deficiencies in pregnancy can lead to neural tube defects (spina bifida)

Front 61

Multiple Mylenoma

Back 61

Malignant Plasma cells take over bone marrow.
-Bone pain

Front 62

Lymphoma (lymph tumor)

Back 62

-Proliferation of lymph tissue in solid tissues such as nodes, spleen
-2 types: Hodgkins/non-hodgkins

Front 63

Hodgkin's Lymphoma

Back 63

-40% of lymphomas
-15-30 yo
-Reed-Sternberg cells (owl eyes)
-50% association w/ Epstein Barr

Front 64

Non-hodgkin's Lymphoma

Back 64

60% of lymphomas
No reed-sternberg cells
Abdominal predilection

Front 65

Acute Myeloblastic Leukemia

Back 65

-Excessive MyeloBLASTS (immature cells)
-AML MMore serious, ALL (Acute Lymphoblastic Leukemia) LLess serious
*ROTH SPOT = leukemia

Front 66

Chronic Myelocytic Leukemia

Back 66

"See Me Later in Philly"
-25-60yo
-90% have Philadelpia chromosome

Front 67

Chronic Lymphocytic Leukemia

Back 67

-Older ~50
-Better survival rate

Front 68

Leukopenia

Back 68

Decrease in number of WBC (4,000-10,000 is normal)

Front 69

Leukocytosis

Back 69

Increase in number of WBC

Front 70

Neutrophilia

Back 70

Increase in neutrophils (1500-7800 normal)

Front 71

Thrombcytosis

Back 71

Elevated platelet count (normal 150,000-450,000)

Front 72

Pancytopenia

Back 72

Decrease in (PAN=all) red, white, platlets

Front 73

Thrombocytopenia

Back 73

Decrease in platelets

Front 74

Benign tumors:
Adenomas
Cystadenomas

Back 74

Adenomas: epith tumor from gland
Papilloma: epith tumor, finger-like projections

Front 75

Carcinoma (general term)

Back 75

Malignant Tumor derived from epithelium

Front 76

Sarcoma (general term)

Back 76

Malignant Tumor derived from mesenchymal (connective) tissue (ie bone)

Front 77

Rhabdomyosarcoma

Back 77

-CT cancer
**most common PRIMARY orbital malignancy

Front 78

Metaplasia

Back 78

change from one mature cell type to another

Front 79

Dysplasia

Back 79

Abnormal growth of epith cells due to disruption of cell maturation

Front 80

Malignant Melanoma

Back 80

Most common skin cancer in young women

Front 81

Basal Cell Carcinoma

Back 81

-Central ulceration, telangiectasia
-Most common around eye

Front 82

Squamous Cell carcinoma

Back 82

-Stratum spinosum layer of epidermis
-Often arises from Actinic Keratosis
-No telangiectasia; 2nd most common around eye

Front 83

Non-cancerous lesions
Eczema:
Psoriasis:
Tinea Corporis:
Impetigo:

Back 83

Eczema: itch (pruritis)
Psoriasis: itch and scales
Tinea Corporis: Ring worm, KOH test
Impetigo: Gram +, yellow crusted lesions

Front 84

Where is the tuning fork located?
1-Weber Test
2-Rinne Test

Back 84

1-Tuning fork on forehead
2-In air by ear or mastoid process

-They test for conduction vs sensory defects
-Normal ear = air better than bone
-Plugged ear = reduced conduction = hears Weber better

Front 85

Transient Ischemic Attack

Back 85

-Less than 24hr, usually less that 15 min.
-Common cause is embolism
-Carotid artery TIA will result in contralateral limb numbness and ipsilateral vision symptoms (amaurosis fugax)

Front 86

Hollenhorst plaque

Back 86

Embolism found in retinal vasculature

Front 87

Strokes: risks, types

Back 87

-HTN*, DB, hyperlipidemia
-Ischemic(80%) & Hemorrhagic

Front 88

Internal carotid stroke symptoms:

Back 88

Ipsilateral blindness, contralateral paresis

Front 89

Middle cerebral symptoms:

Back 89

Homonymous hemianopsia, hemiplegia, Broka's (broken speech) or Wernicke's (wordyspeech) aphasia

Front 90

Cluster Headaches

Back 90

-Men 30-50yo
-orbital or temporal in location
-smokers or alcoholics
-*red eyes, nasal stuffiness, induced horners syndrome.

Front 91

Tension headaches

Back 91

-All ages, more female
-Stress
-*Band-like distribution

Front 92

Migranes

Back 92

-More women
-Triggering factors
-Aura, nausea, photophobia
-*4-72hrs

Front 93

Temporal Arteritis HA

Back 93

-Older than 55
-Jaw claudation, scalp tenderness
-Polymyalgia Rheumatica (fatigue, morning stiffness)
-CRP, ESR, WBC, biopsy

Front 94

Brain tumor

Back 94

**Interrupt sleep
-More than just HA