Usmle Step 1 First Aid

Front 1

often precedes squamous cell carcinoma

Back 1

actinic keratosis

Front 2

primary adrenocortical deficiency

Back 2

Addison's disease

Front 3

polyostotic fibrous dysplasia, precocious puberty, cafe-au-lait spots, short stature, young girls - diagnosis?

Back 3

Albright's syndrome

Front 4

hereditary nephritis with nerve deafness

Back 4

Alport's syndrome

Front 5

anti-basement membrane antibodies - diagnosis?

Back 5

Goodpasture's syndrome

Front 6

anticentromere antibodies - diagnosis?

Back 6

scleroderma (CREST)

Front 7

anti-double-stranded DNA antibodies (ANA antibodies) - diagnosis?
- what hypersensitivity type?

Back 7

SLE - type III hypersensitivity

Front 8

anti-epithelial cell antibodies - diagnosis?

Back 8

pemphigus vulgaris

Front 9

antigliadin antibodies - diagnosis?

Back 9

celiac disease

Front 10

antihistone antibodies - diagnosis?

Back 10

drug-induced SLE

Front 11

anti-IgG antibodies - diagnosis?

Back 11

rheumatoid arthritis

Front 12

antimitochondrial antibodies - diagnosis?

Back 12

primary biliary cirrhosis

Front 13

antineutrophil antibodies - diagnosis?

Back 13

vasculitis

Front 14

antiplatelet antibodies - diagnosis?

Back 14

idiopathic thrombocytopenic purpura

Front 15

arachnodactyly - diagnosis?

Back 15

Marfan's syndrome

Front 16

Argyll-Robertson pupil - diagnosis?

Back 16

neurosyphilis

Front 17

Arnold-Chiari malformation

Back 17

cerebellar tonsillar herniation

Front 18

Aschoff bodies - diagnosis?

Back 18

rheumatic fever

Front 19

atrophy of the mammillary bodies - diagnosis?

Back 19

Wernicke's encephalopathy

Front 20

Auer rods - diagnosis?

Back 20

acute myelogenous leukemia (especially promyelocytic type)

Front 21

autosplenectomy - diagnosis?

Back 21

sickle cell anemia

Front 22

Babinski's sign is associated with what?

Back 22

UMN lesion

Front 23

"bamboo spine" on x-ray

Back 23

ankylosing spondylitis

Front 24

basophilic stippling of RBCs - diagnosis?

Back 24

lead poisoning

Front 25

defective dystrophin, less severe than Duchenne's

Back 25

Becker's muscular dystrophy

Front 26

LMN CN VII palsy

Back 26

Bell's palsy

Front 27

Bence Jones proteins - possible diagnoses?
- in each case, what are the proteins?

Back 27

multiple myeloma - kappa or lambda light chains
Waldenstrom's macroglobulinemia - IgM

Front 28

IgA nephropathy - diagnosis?

Back 28

Berger's disease

Front 29

Bernard-Soulier disease - what is the defect?

Back 29

defect in platelet adhesion

Front 30

bilateral hilar adenopathy, uveitis - diagnosis?

Back 30

sarcoidosis

Front 31

Birbeck granules on EM - diagnosis?

Back 31

histiocytosis X (eosinophilic granuloma)

Front 32

bloody tap on LP - diagnosis?

Back 32

subarachnoid hemorrhage

Front 33

"blue bloater"

Back 33

chronic bronchitis

Front 34

blue-domed cysts - diagnosis?

Back 34

fibrocystic change of the breast

Front 35

blue sclera - diagnosis?

Back 35

osteogenesis imperfecta

Front 36

boot-shaped heart on x-ray - possible diagnoses?

Back 36

tetralogy of Fallot or RVH

Front 37

Bouchard's nodes - diagnosis?
- where are they located?
- why do they occur?

Back 37

osteoarthritis - on PIP secondary to osteophytes

Front 38

boutonniere deformity - diagnosis?

Back 38

rheumatoid arthritis

Front 39

branching rods in oral infection - diagnosis?

Back 39

Actinomyces israelii

Front 40

"brown tumor" of bone - possible diagnoses?
- what causes the brown color?

Back 40

hyperparathyroidism or osteitis fibrosa cystica (von Recklinghausen's disease)
- color is due to hemorrhage in cysts

Front 41

X-linked agammaglobulinemia

Back 41

Bruton's disease

Front 42

posthepatic venous thrombosis - diagnosis?

Back 42

Budd-Chiari syndrome

Front 43

Buerger's disease - what size arteries does it affect?

Back 43

small or medium-artery vasculitis

Front 44

Burkitt's lymphoma - what is the translocation?
- what virus is it associated with?
- appearance on histology?

Back 44

8:14 translocation
EBV
starry sky appearance

Front 45

Burton's lines - diagnosis?

Back 45

lead poisoning

Front 46

what types of ANCA are associated with Wegener's granulomatosis and microscopic polyangiitis?

Back 46

Wegener's - c-ANCA
MPA - p-ANCA

Front 47

cafe-au-lait spots on skin - diagnosis?

Back 47

neurofibromatosis

Front 48

calf pseudohypertrophy - diagnosis?

Back 48

Duchenne's muscular dystrophy

Front 49

Call-Exner bodies - diagnosis?

Back 49

granulosa-theca cell tumor of the ovary

Front 50

cardiomegaly with apical atrophy - diagnosis?

Back 50

Chagas' disease

Front 51

trypanosome infection - diagnosis?

Back 51

Chagas' disease

Front 52

painless chancre - diagnosis?

Back 52

primary syphilis

Front 53

painful chancroid - cause?

Back 53

Haemophilus ducreyi

Front 54

Charcot's triad of multiple sclerosis

Back 54

nystagmus, intention tremor, scanning speech

Front 55

Charcot's triad of cholangitis

Back 55

jaundice, RUQ pain, fever

Front 56

Charcot-Leyden crystals - diagnosis?
- what are they?

Back 56

bronchial asthma - eosinophil membranes

Front 57

what is the defect in Chediak-Higashi disease?

Back 57

phagocyte deficiency

Front 58

cherry-red spot on macula - possible diagnoses?

Back 58

Tay-Sachs or Niemann-Pick disease

Front 59

what are Cheyne-Stokes respirations, and in what circumstance do they occur?

Back 59

central apnea in CHF and increased intracranial pressure

Front 60

"chocolate cysts"

Back 60

endometriosis

Front 61

what does chronic atrophic gastritis predispose to?

Back 61

gastric carcinoma

Front 62

Chvostek's sign - what is it, and what does it indicate?

Back 62

facial muscle spasm upon tapping - sign of hypocalcemia

Front 63

DES exposure in utero predisposes to what?

Back 63

clear cell adenocarcinoma of the vagina

Front 64

clue cells - diagnosis?

Back 64

Gardnerella vaginitis

Front 65

Codman's triangle on x-ray - diagnosis?

Back 65

osteosarcoma

Front 66

cold agglutinins - possible diagnoses?

Back 66

Mycoplasma pneumonia or infectious mononucleosis

Front 67

cold intolerance - sign of what?

Back 67

hypothyroidism

Front 68

condylomata lata - diagnosis?

Back 68

secondary syphilis

Front 69

continuous machinery murmur - indicates what?

Back 69

patent ductus arteriosus

Front 70

what is the defect in Cori's disease?

Back 70

debranching enzyme deficiency

Front 71

cough, conjunctivitis, coryza, fever - diagnosis?

Back 71

measles

Front 72

Councilman bodies - diagnosis?

Back 72

toxic or viral hepatitis

Front 73

Cowdry type A bodies - caused by what?

Back 73

herpesvirus

Front 74

crescents in Bowman's capsule - diagnosis?

Back 74

rapidly progressive crescentic glomerulonephritis

Front 75

what is Crigler-Najjar syndrome?

Back 75

congenital unconjugated hyperbilirubinemia - due to absent UDP glucuronyl transferase

Front 76

acute gastric ulcer associated with severe burns

Back 76

Curling's ulcer

Front 77

currant-jelly sputum - diagnosis?

Back 77

Klebsiella

Front 78

Curschmann's spirals - diagnosis?
- what are they?

Back 78

bronchial asthma - whorled mucous plugs

Front 79

acute gastric ulcer associated with CNS injury

Back 79

Cushing's ulcer

Front 80

D-dimers - diagnosis?

Back 80

DIC

Front 81

depigmentation of neurons in substantia nigra - diagnosis?
- where is the defect?
- symptoms?

Back 81

Parkinson's disease - basal ganglia disorder
- rigidity, resting tremor, bradykinesia

Front 82

dermatitis, dementia, diarrhea - diagnosis?

Back 82

pellagra (niacin/vitamin B3 deficiency)

Front 83

dog or cat bite - infected with?

Back 83

Pasteurella multocida

Front 84

what is Dressler's syndrome?

Back 84

post-MI fibrinous pericarditis

Front 85

what is Dubin-Johnson syndrome?
- what is the defect?
- what is the pathologic consequence?

Back 85

congenital conjugated hyperbilirubinemia - due to defective liver excretion of conjugated bilirubin, causing black liver

Front 86

what is the defect in Duchenne's muscular dystrophy?
- what is the inheritance pattern?

Back 86

deleted dystrophin gene - X-linked recessive

Front 87

eburnation - diagnosis?

Back 87

osteoarthritis

Front 88

trisomy 18 associated with rocker-bottom feet, low-set ears, heart disease

Back 88

Edwards' syndrome

Front 89

what is Eisenmenger's complex?

Back 89

late cyanosis shunt (reversal of an uncorrected L-R shunt to an R-L shunt)

Front 90

elastic skin - diagnosis?

Back 90

Ehlers-Danlos syndrome

Front 91

where and what is Erb-Duchenne palsy?

Back 91

superior trunk injury to brachial plexus (C5-6) - "waiter's tip"

Front 92

erythema chronicum migrans - diagnosis?

Back 92

Lyme disease

Front 93

genetically inherited aplastic anemia

Back 93

Fanconi's anemia

Front 94

what is Fanconi's syndrome?

Back 94

proximal tubular reabsorption defect (causes excretion of many things - leads to, among other things, rickets, metabolic acidosis, hypokalemia)

Front 95

"fat, female, forty, and fertile" - at risk for?

Back 95

acute cholecystitis

Front 96

fatty liver - associated with?

Back 96

alcoholism

Front 97

ferruginous bodies - diagnosis?

Back 97

asbestosis

Front 98

colon polyps with osteomas and soft tissue tumors - diagnosis?

Back 98

Gardner's syndrome

Front 99

what is the defect in Gaucher's disease?

Back 99

glucocerebrosidase deficiency

Front 100

Ghon focus - diagnosis?

Back 100

primary TB

Front 101

what is Gilbert's syndrome?
- what is the deficiency?

Back 101

benign congenital unconjugated hyperbilirubinemia - due to mildly decreased UDP-glucouronyl transferase or decreased bilirubin uptake by liver

Front 102

what is the defect in Glanzmann's thrombasthenia?

Back 102

defect in platelet aggregation (defect in GPIIb/IIIa)

Front 103

autoantibodies against alveolar and glomerular basement membrane proteins - diagnosis?

Back 103

Goodpasture's syndrome

Front 104

Gowers' maneuver - diagnosis?
- what is the maneuver?

Back 104

Duchenne's - use of patient's arms to help legs pick self off floor

Front 105

idiopathic peripheral polyneuritis - diagnosis?

Back 105

Guillain-Barre syndrome

Front 106

"hair on end" (crew cut) appearance on x-ray - possible diagnoses?
- why does this happen?

Back 106

beta-thalassemia or sickle cell anemia - due to extramedullary hematopoiesis

Front 107

what is Hand-Schuller-Christian disease?

Back 107

chronic progressive histiocytosis (Langerhans cell histiocytosis)

Front 108

lots of HbF - diagnosis?

Back 108

thalassemia major

Front 109

HbS - diagnosis?

Back 109

sickle cell anemia

Front 110

conditions in which hCG is elevated

Back 110

choriocarcinoma, hydatidiform mole

Front 111

Heberden's nodes - diagnosis?
- where are they located?
- why do they occur?

Back 111

osteoarthritis - DIP swelling secondary to osteophytes

Front 112

Heinz bodies - diagnosis?

Back 112

G6PD deficiency

Front 113

hypersensitivity vasculitis associated with hemorrhagic urticaria and upper respiratory tract infections - diagnosis?

Back 113

Henoch-Schonlein purpura

Front 114

heterophil antibodies - diagnosis?
- caused by what?

Back 114

infectious mononucleosis - caused by EBV

Front 115

high-output cardiac failure (dilated cardiomyopathy) is associated with what vitamin deficiency?
- what is the disease called?

Back 115

vitamin B1 (thiamine) deficiency - wet beriberi

Front 116

HLA-B27 - associated with what diseases?

Back 116

Reiter's syndrome, ankylosing spondylitis, psoriasis, inflammatory bowel disease

Front 117

disease associated with HLA-DR3 or DR4
- what causes it?

Back 117

diabetes mellitus type 1 - autoimmune destruction of beta cells

Front 118

Homer Wright rosettes - diagnosis?

Back 118

neuroblastoma

Front 119

honeycomb lung on x-ray - diagnosis?

Back 119

interstitial fibrosis

Front 120

symptoms of Horner's syndrome

Back 120

ptosis, miosis, anhidrosis

Front 121

Howell-Jolly bodies - caused by what?

Back 121

splenectomy or nonfunctional spleen

Front 122

caudate degeneration - diagnosis?
- what is the inheritance pattern?

Back 122

Huntington's disease - autosomal dominant

Front 123

hyperphagia, hypersexuality, hyperorality, hyperdocility - diagnosis?
- what is the affected organ?

Back 123

Kluver-Bucy syndrome - affects amygdala

Front 124

hyperpigmentation of skin - diagnosis?

Back 124

primary adrenal insufficiency (Addison's disease)

Front 125

hypersegmented neutrophils - diagnosis?

Back 125

macrocytic anemia

Front 126

hypertension and hypokalemia - diagnosis?

Back 126

Conn's syndrome (aldosterone-secreting tumor)

Front 127

hypochromic microcytosis - possible diagnoses?

Back 127

iron deficiency anemia, lead poisoning

Front 128

increased alpha-fetoprotein in amniotic fluid/maternal serum - possible diagnoses?

Back 128

neural tube defects (anencephaly, spina bifida)

Front 129

increased uric acid levels - possible diagnoses?

Back 129

gout, Lesch-Nyhan syndrome, myeloproliferative disorders, use of loop and thiazide diuretics

Front 130

Janeway lesions - diagnosis?

Back 130

endocarditis

Front 131

what disease is the Jarish-Herxheimer reaction associated with, and what is it?

Back 131

syphilis - overaggressive treatment of an asymptomatic patient that causes symptoms due to rapid lysis

Front 132

what is the defect in Job's syndrome?

Back 132

neutrophil chemotaxis abnormality - due to failure of IFN-gamma production by helper T cells

Front 133

Kaposi's sarcoma - associated with?

Back 133

AIDS in MSM

Front 134

what is the defect in Kartagener's syndrome?

Back 134

dynein defect

Front 135

Kayser-Fleischer rings - diagnosis?

Back 135

Wilson's disease

Front 136

keratin pearls - diagnosis?

Back 136

squamous cell carcinoma

Front 137

Kimmelstiel-Wilson nodules - diagnosis?

Back 137

diabetic nephropathy

Front 138

bilateral amygdala lesions - diagnosis?

Back 138

Kluver-Bucy syndrome

Front 139

koilocytes - diagnosis?

Back 139

HPV

Front 140

Koplik spots - diagnosis?

Back 140

measles

Front 141

gastric adenocarcinoma with ovarian metastases

Back 141

Krukenberg tumor (Puneet, this one is for you)

Front 142

Kussmaul hyperpnea - diagnosis?

Back 142

diabetic ketoacidosis

Front 143

lens dislocation, aortic dissection, joint hyperflexibility - diagnosis?
- what is the defect?

Back 143

Marfan's syndrome - defect in fibrillin

Front 144

what is the defect in Lesch-Nyhan syndrome?

Back 144

HGPRT deficiency

Front 145

Lewy bodies - diagnosis?

Back 145

Parkinson's disease

Front 146

what is Libman-Sacks disease?

Back 146

endocarditis associated with SLE

Front 147

lines of Zahn - diagnosis?

Back 147

arterial thrombus

Front 148

Lisch nodules - diagnosis?

Back 148

neurofibromatosis (von Recklinghausen's disease)

Front 149

low serum ceruloplasmin - diagnosis?

Back 149

Wilson's disease

Front 150

lucid interval - associated with what head pathology?

Back 150

epidural hematoma

Front 151

"lumpy-bumpy" appearance of glomeruli on immunofluorescence - diagnosis?

Back 151

poststreptococcal glomerulonephritis

Front 152

lytic bone lesions on x-ray - diagnosis?

Back 152

multiple myeloma

Front 153

Mallory bodies - diagnosis?

Back 153

alcoholic liver disease

Front 154

esophagogastric lacerations - diagnosis?

Back 154

Mallory-Weiss syndrome

Front 155

what is the defect in McArdle's disease?

Back 155

muscle phosphorylase deficiency

Front 156

McBurney's sign - diagnosis?

Back 156

appendicitis

Front 157

MLF syndrome (internuclear ophthalmoplegia) - diagnosis?

Back 157

multiple sclerosis

Front 158

monoclonal antibody spike - possible diagnoses?
- what makes up the spike in each?

Back 158

multiple myeloma (IgG or IgA)
MGUS
Waldenstrom's macroglobulinemia (IgM)

Front 159

myxedema - diagnosis?

Back 159

hypothyroidism

Front 160

necrotizing vasculitis of the lungs (hemoptysis) and necrotizing glomerulonephritis - possible diagnoses?

Back 160

Wegener's or Goodpasture's

Front 161

needle-shaped, negatively birefringent crystals - diagnosis?

Back 161

gout

Front 162

Negri bodies - diagnosis?

Back 162

rabies

Front 163

nephritis, cataracts, hearing loss - diagnosis?
- what is the defect?

Back 163

Alport's syndrome
- type IV collagen defect

Front 164

neurofibrillary tangles - diagnosis?

Back 164

Alzheimer's disease

Front 165

what is the defect in Niemann-Pick disease?

Back 165

sphingomyelinase deficiency

Front 166

no lactation postpartum - diagnosis?
- what causes it?

Back 166

Sheehan's syndrome - due to pituitary infarction

Front 167

nutmeg liver - diagnosis?

Back 167

CHF

Front 168

occupational exposure to asbestos - associated with?

Back 168

malignant mesothelioma

Front 169

"Orphan Annie" nuclei - diagnosis?

Back 169

papillary carcinoma of the thyroid

Front 170

Osler's nodes - diagnosis?

Back 170

endocarditis

Front 171

owl's eye inclusion bodies - diagnosis?

Back 171

CMV

Front 172

eczematous dermatitis of nipple or areola - diagnosis?
- what is it a sign of?

Back 172

Paget's disease of breast
- sign of underlying neoplasm

Front 173

increased osteoblastic and osteoclastic activity - diagnosis?

Back 173

Paget's disease of bone (osteitis deformans)

Front 174

painless jaundice - diagnosis?

Back 174

pancreatic cancer (of head)

Front 175

palpable purpura on legs and buttocks - diagnosis?

Back 175

Henoch-Schonlein purpura

Front 176

bronchogenic apical tumor associated with Horner's syndrome

Back 176

Pancoast's tumor

Front 177

pannus - diagnosis?

Back 177

rheumatoid arthritis

Front 178

nigrostriatal dopamine depletion - diagnosis?

Back 178

Parkinson's disease

Front 179

periosteal elevation on x-ray - diagnosis?

Back 179

pyogenic osteomyelitis

Front 180

benign polyposis - diagnosis?

Back 180

Peutz-Jeghers syndrome

Front 181

penile fibrosis - diagnosis?

Back 181

Peyronie's disease

Front 182

Philadelphia chromosome (bcr-abl) - diagnosis?

Back 182

CML

Front 183

Pick bodies - diagnosis?

Back 183

Pick's disease

Front 184

progressive dementia, similar to Alzheimer's - diagnosis?

Back 184

Pick's disease

Front 185

"pink puffer" - diagnosis?
- what are the two types, and what causes them?

Back 185

emphysema
- centroacinar - due to smoking
- panacinar - due to alpha1-antitrypsin deficiency

Front 186

esophageal webs with iron deficiency anemia - diagnosis?

Back 186

Plummer-Vinson syndrome

Front 187

podagra - diagnosis?
- where is it located?

Back 187

gout - MP joint of hallux

Front 188

podocyte fusion - diagnosis?

Back 188

minimal change disease

Front 189

polyneuropathy, cardiac pathology, and edema - diagnosis?
- what causes it?

Back 189

wet beriberi (vitamin B1 deficiency)

Front 190

polyneuropathy preceded by GI or respiratory infection

Back 190

Guillain-Barre syndrome

Front 191

what is the defect in Pompe's disease?
- what significant finding is it associated with?

Back 191

lysosomal glucosidase deficiency
- cardiomegaly

Front 192

port-wine stain - diagnosis?

Back 192

hemangioma

Front 193

positive anterior "drawer sign" - diagnosis?

Back 193

anterior cruciate ligament injury

Front 194

what is Pott's disease?

Back 194

vertebral tuberculosis

Front 195

pseudopalisade tumor cell arrangement - diagnosis?

Back 195

glioblastoma multiforme

Front 196

pseudorosettes - diagnosis?

Back 196

Ewing's sarcoma

Front 197

ptosis, miosis, anhidroisis - diagnosis?
- often associated with what?

Back 197

Horner's syndrome
- Pancoast's tumor

Front 198

rash on palms and soles - possible diagnoses?

Back 198

secondary syphilis, Rocky Mountain Spotted Fever, coxsackie A virus

Front 199

recurrent vasospasm in extremities - diagnosis?

Back 199

Raynaud's syndrome

Front 200

RBC casts in urine - diagnosis?

Back 200

acute glomerulonephritis

Front 201

recurrent pulmonary Pseudomonas and S. aureus infections - associated with?

Back 201

cystic fibrosis

Front 202

red urine in the morning - diagnosis?

Back 202

paroxysmal nocturnal hemoglobinuria

Front 203

Reed-Sternberg cells - diagnosis?

Back 203

Hodgkin's lymphoma

Front 204

increased Reid index - diagnosis?

Back 204

chronic bronchitis (gland depth/total thickness of bronchial wall)

Front 205

Reinke crystals - diagnosis?

Back 205

Leydig cell tumor

Front 206

what are the symptoms of Reiter's syndrome?

Back 206

urethritis, conjunctivitis, arthritis

Front 207

renal cell carcinoma, cavernous hemangiomas, adenomas - diagnosis?

Back 207

von Hippel-Lindau disease

Front 208

renal epithelial casts in urine - diagnosis?

Back 208

acute toxic/viral nephrosis

Front 209

rhomboid crystals, positively birefringent - diagnosis?

Back 209

pseudogout

Front 210

rib notching - diagnosis?

Back 210

coarctation of aorta

Front 211

Roth's spots in retina - diagnosis?

Back 211

endocarditis

Front 212

what is Rotor's syndrome?
- what is the defect?
- similar to what disease?

Back 212

congenital conjugated hyperbilirubinemia
- defective liver excretion of bilirubin (similar to Dubin-Johnson, but milder)

Front 213

rouleaux formation of RBCs - diagnosis?

Back 213

multiple myeloma

Front 214

S3 - possible diagnoses?

Back 214

left-to-right shunt (VSD, PDA, ASD), mitral regurgitation, CHF (LV failure)

Front 215

S4 - possible diagnoses?

Back 215

aortic stenosis, hypertrophic subaortic stenosis

Front 216

Schiller-Duval bodies - diagnosis?

Back 216

yolk sac tumor

Front 217

senile plaques - diagnosis?

Back 217

Alzheimer's disease

Front 218

what is Sezary syndrome?

Back 218

cutaneous T-cell lymphoma

Front 219

what is Sheehan's syndrome?

Back 219

postpartum pituitary necrosis

Front 220

Schwartzman reaction - associated with?

Back 220

Neisseria meningitidis

Front 221

signet-ring cells - diagnosis?

Back 221

gastric carcinoma

Front 222

simian crease - diagnosis?

Back 222

Down syndrome

Front 223

Sipple's syndrome - also known as?

Back 223

MEN IIa

Front 224

dry eyes, dry mouth, arthritis - diagnosis?

Back 224

Sjogren's syndrome

Front 225

skip lesions - diagnosis?

Back 225

Crohn's

Front 226

slapped cheeks - diagnosis?

Back 226

erythema infectiosum (fifth disease)

Front 227

Smith antigen - diagnosis?

Back 227

SLE

Front 228

"smudge cell" - diagnosis?

Back 228

CLL

Front 229

soap bubble on x-ray - diagnosis?

Back 229

giant cell tumor of bone

Front 230

spike and dome on EM - diagnosis?

Back 230

membranous glomerulonephritis

Front 231

what is a Spitz nevus?

Back 231

benign juvenile melanoma

Front 232

splinter hemorrhages in fingernails - diagnosis?

Back 232

endocarditis

Front 233

starry-sky pattern - diagnosis?

Back 233

Burkitt's lymphoma

Front 234

"strawberry tongue" - diagnosis?

Back 234

scarlet fever

Front 235

streaky ovaries - diagnosis?

Back 235

Turner's syndrome

Front 236

string sign on x-ray - diagnosis?

Back 236

Crohn's disease

Front 237

subepithelial humps on EM - diagnosis?

Back 237

poststreptococcal glomerulonephritis

Front 238

suboccipital lymphadenopathy - diagnosis?

Back 238

rubella

Front 239

sulfur granules - diagnosis?

Back 239

Actinomyces israelii

Front 240

swollen gums, bruising, poor wound healing, anemia - diagnosis?
- what is this due to?
- why do these symptoms occur?

Back 240

scury - vitamin C (ascorbic acid) deficiency
- vitamin C is needed for hydroxylation of proline and lysine in collagen synthesis

Front 241

systolic ejection murmur (crescendo-decrescendo) - diagnosis?

Back 241

aortic valve stenosis

Front 242

t(8;14) - diagnosis?
- gene involved?

Back 242

Burkitt's lymphoma
- c-myc activation

Front 243

t(9;22) - diagnosis?
- gene involved?

Back 243

CML
- Philadelphia chromosome - bcr-abl hybrid

Front 244

t(14;18) - diagnosis?
- gene involved?

Back 244

follicular lymphoma
- bcl-2 activation

Front 245

tabes dorsalis - diagnosis?

Back 245

tertiary syphilis

Front 246

tendon xanthomas (classically Achilles) - diagnosis?

Back 246

familial hypercholesterolemia

Front 247

thumb sign on lateral x-ray - diagnosis?
- caused by what?

Back 247

epiglottitis - due to Haemophilus influenzae

Front 248

thyroidization of kidney - diagnosis?

Back 248

chronic bacterial pyelonephritis

Front 249

tophi - diagnosis?

Back 249

gout

Front 250

"tram-track" appearance on LM - diagnosis?

Back 250

membranoproliferative glomerulonephritis

Front 251

what is Trousseau's sign of malignancy?
- possible diagnoses?

Back 251

migratory thrombophlebitis
- visceral cancer or pancreatic adenocarcinoma

Front 252

what is Trousseau's sign of latent tetany?
- diagnosis?

Back 252

carpal spasm
- hypocalcemia

Front 253

what is Virchow's node?
- what is it a sign of?

Back 253

left supraclavicular node enlargement
- from metastatic carcinoma of the stomach

Front 254

what is Virchow's triad?
- predilection for what?

Back 254

blood stasis, endothelial damage, hypercoagulation
- pulmonary embolism

Front 255

neurofibromatosis with cafe-au-lait spots - diagnosis?

Back 255

von Recklinghausen's disease

Front 256

what is von Recklinghausen's disease of bone?

Back 256

osteitis fibrosa cystica ("brown tumor")

Front 257

adrenal hemorrhage associated with meningococcemia - diagnosis?

Back 257

Waterhouse-Friderichsen syndrome

Front 258

waxy casts in urine - diagnosis?

Back 258

chronic end-stage renal disease

Front 259

WBC casts in urine - diagnosis?

Back 259

acute pyelonephritis

Front 260

WBCs in urine - diagnosis?

Back 260

acute cystitis

Front 261

Wermer's syndrome - also known as?

Back 261

MEN type I

Front 262

what is Whipple's disease?
- caused by what?

Back 262

malabsorption syndrome caused by Tropheryma whippelii

Front 263

hepatolenticular degeneration - diagnosis?

Back 263

Wilson's disease

Front 264

"wire loop" appearance on LM - diagnosis?

Back 264

lupus nephropathy

Front 265

"worst headache of my life" - rupture of what?
- associated with what syndrome?

Back 265

rupture of berry aneurysm
- associated with adult polycystic kidney disease

Front 266

xanthochromia of CSF - diagnosis?

Back 266

subarachnoid hemorrhage

Front 267

xerostomia, arthritis, keratoconjunctivitis sicca - diagnosis?

Back 267

Sjogren's syndrome

Front 268

upper GI diverticulum

Back 268

Zenker's diverticulum

Front 269

gastrin-secreting tumor associated with ulcers - diagnosis?

Back 269

Zollinger-Ellison syndrome

Front 270

most common bacteremia/pneumonia among IV drug abusers

Back 270

S. aureus

Front 271

most common bacteria associated with cancer

Back 271

H. pylori

Front 272

most common bacteria found in GI tract
- 2nd most common?

Back 272

Bacterioides
- E. coli

Front 273

4 most common brain tumors in adults

Back 273

mets > astrocytoma (including glioblastoma multiforme) > meningioma > schwannoma

Front 274

most common brain tumor in kids
- location?

Back 274

medulloblastoma - in cerebellum

Front 275

most common supratentorial brain tumor in kids

Back 275

craniopharyngioma

Front 276

most common breast cancer

Back 276

infiltrating ductal carcinoma

Front 277

most common breast mass
- most common in post menopausal women?

Back 277

fibrocystic change
- carcinoma

Front 278

most common benign breast tumor

Back 278

fibroadenoma

Front 279

most common bug in debilitated, hospitalized pneumonia patient

Back 279

Klebsiella

Front 280

most common cardiac primary tumor in adults
- usual location and appearance?

Back 280

myxoma
- "ball and valve" in left atrium

Front 281

most common cardiac primary tumor in kids

Back 281

rhabdomyoma

Front 282

most common cardiac tumor in adults

Back 282

mets

Front 283

most common cardiomyopathy

Back 283

dilated cardiomyopathy

Front 284

most common chromosomal disorder
- what other disorders is it associated with?

Back 284

Down syndrome
- associated with ALL, Alzheimer's dementia, endocardial cushion defects

Front 285

most common chronic arrhythmia
- what is the patient at high risk for?

Back 285

atrial fibrillation - high risk of emboli

Front 286

most common congenital cardiac anomaly

Back 286

VSD

Front 287

most common cause of constrictive pericarditis

Back 287

tuberculosis

Front 288

most common coronary arteries involved in thrombosis

Back 288

LAD > RCA > LCA

Front 289

most common causes of early cyanosis

Back 289

tetralogy of Fallot, transposition of great vessels, truncus arteriosus

Front 290

most common causes of late cyanosis

Back 290

VSD, ASD, PDA

Front 291

how do you close a PDA?
- how do you keep it open?

Back 291

close with indomethacin
open with misoprostol

Front 292

most common demyelinating disease

Back 292

multiple sclerosis

Front 293

most common dietary deficit

Back 293

iron

Front 294

most common cause of epiglottitis

Back 294

Haemophilus influenzae type B

Front 295

most common esophageal cancer

Back 295

squamous cell carcinoma

Front 296

most common gene involved in cancer

Back 296

p53 tumor suppressor gene

Front 297

most common group affected by cystic fibrosis
- what dietary deficiency is associated with CF?
- what lung problems occur?

Back 297

Caucasians
- fat-soluble vitamin deficiencies
- mucous plugs and lung infections

Front 298

most common gynecologic malignancy

Back 298

endometrial carcinoma

Front 299

most common heart murmur

Back 299

mitral valve prolapse

Front 300

most common heart valve involved in bacterial endocarditis

Back 300

mitral

Front 301

most common heart valve involved in bacterial endocarditis in IV drug abusers

Back 301

tricuspid

Front 302

most common heart valve involved in rheumatic fever
- which is 2nd most common?

Back 302

mitral valve
- aortic is 2nd

Front 303

most common helminth infection in the U.S.
- 2nd most common?

Back 303

Enterobius vermicularis
- Ascaris lumbricoides is 2nd most common

Front 304

most common hereditary bleeding disorder

Back 304

von Willebrand's

Front 305

most common kidney stone
- 2nd most common?
- are they each radiopaque or radiolucent?
- how are the 2nd most common formed?

Back 305

calcium - radiopaque
2nd is ammonium - radiopaque
- formed by urease-positive organisms like Proteus vulgaris or Staphylococcus

Front 306

most common leukemia in adults

Back 306

AML

Front 307

most common liver disease

Back 307

alcoholic liver disease

Front 308

most common location of brain tumors in adults

Back 308

supratentorial

Front 309

most common location of brain tumors in kids

Back 309

infratentorial

Front 310

most common lysosomal storage disease

Back 310

Gaucher's disease

Front 311

most common male cancer

Back 311

prostatic carcinoma

Front 312

most common malignancy associated with noninfectious fever

Back 312

Hodgkin's disease

Front 313

most common malignant skin tumor
- does it metastasize?

Back 313

basal cell carcinoma
- only very rarely metastasizes

Front 314

most common mets to bone

Back 314

breast, lung, thyroid, testes, prostate, kidney

Front 315

most common mets to brain

Back 315

lung, breast, skin (melanoma), kidney (renal cell carcinoma), GI

Front 316

most common mets to liver

Back 316

colon, gastric, pancreatic, breast, lung carcinomas

Front 317

most common motor neuron disease

Back 317

ALS

Front 318

most common neoplasm in kids
- 2nd most common?

Back 318

ALL
- cerebellar medulloblastoma is 2nd

Front 319

most common nephrotic syndrome

Back 319

membranous glomerulonephritis

Front 320

most common obstruction of male urinary tract

Back 320

BPH

Front 321

most common opportunistic infection in AIDS

Back 321

Pneumocystis jiroveci pneumonia

Front 322

most common organ receiving mets
- why?

Back 322

adrenal glands
- rich blood supply

Front 323

most common organs sending mets

Back 323

lung > breast, stomach

Front 324

most common benign ovarian tumor

Back 324

serous cystadenoma

Front 325

most common malignant ovarian tumor

Back 325

serous cystadenocarcinoma

Front 326

most common pancreatic tumor
- which part of pancreas is affected?

Back 326

adenocarcinoma of the head of the pancreas

Front 327

most common age of patient with ALL

Back 327

child

Front 328

most common age of patient with CLL

Back 328

adult >60

Front 329

most common age of patient with AML

Back 329

adult >60

Front 330

most common age of patient with CML

Back 330

adult 35-50

Front 331

most common patient with Hodgkin's
- exception: nodular sclerosis type - what patient?

Back 331

young male
- nodular sclerosis type - female

Front 332

most common patient with minimal change disease

Back 332

young child

Front 333

most common patient with Reiter's

Back 333

male

Front 334

most common pituitary tumor
- 2nd most common? how does it stain?

Back 334

prolactinoma
- somatotropic adenoma is 2nd - acidophilic

Front 335

most common preventable cancer

Back 335

lung cancer

Front 336

most common primary bone tumor in adults

Back 336

multiple myeloma

Front 337

most common cause of primary hyperparathyroidism
- other causes?

Back 337

adenomas
- also hyperplasia and carcinoma

Front 338

most common primary liver tumor

Back 338

hepatoma

Front 339

most common renal tumor
- what diseases is it associated with?
- what paraneoplastic syndromes is it associated with?

Back 339

renal cell carcinoma
- von Hippel-Lindau and acquired polycystic kidney disease
- erythropoietin, renin, PTH, ACTH

Front 340

most common cause of secondary hyperparathyroidism

Back 340

hypocalcemia of chronic renal failure

Front 341

most common sexually transmitted disease

Back 341

Chlamydia

Front 342

most common site of diverticula

Back 342

sigmoid colon

Front 343

most common site of metastasis
- 2nd most common?

Back 343

regional lymph nodes
- liver is 2nd

Front 344

most common sites of atherosclerosis

Back 344

abdominal aorta > coronary > popliteal > carotid

Front 345

most common skin cancer

Back 345

basal cell carcinoma

Front 346

most common stomach cancer

Back 346

adenocarcinoma

Front 347

most common testicular tumor

Back 347

seminoma

Front 348

most common thyroid cancer

Back 348

papillary carcinoma

Front 349

most common tumor in men

Back 349

prostate carcinoma

Front 350

most common tumor in women

Back 350

leiomyoma (estrogen dependent)

Front 351

most common tumor of infancy

Back 351

hemangioma

Front 352

most common tumor of the adrenal medulla in adults
- benign or malignant?

Back 352

pheochromocytoma - benign

Front 353

most common tumor of the adrenal medulla in kids
- benign or malignant?

Back 353

neuroblastoma - malignant

Front 354

most common type of Hodgkin's

Back 354

nodular sclerosis

Front 355

most common type of non-Hodgkin's

Back 355

follicular (small cleaved)

Front 356

most common type of pituitary adenoma

Back 356

prolactinoma

Front 357

most common vasculitis
- poses risk for?
- what causes this?

Back 357

temporal arteritis
- risk of ipsilateral blindness - due to thrombosis of opthalmic artery

Front 358

most common cause of viral encephalitis

Back 358

HSV

Front 359

most common vitamin deficiency in the U.S.
- how long do body stores last?
- what patient population is most at risk?

Back 359

folic acid - stores last 3-4 months
- pregnant women at high risk

Front 360

most common cause of Addison's
- 2nd most common?

Back 360

autoimmune
- infection is 2nd

Front 361

most common cause of dissecting aneurysm

Back 361

hypertension

Front 362

most common cause of descending and abdominal aortic aneurysm

Back 362

atherosclerosis

Front 363

most common cause of ascending aortic aneurysm

Back 363

tertiary syphilis

Front 364

most common cause of bacterial meningitis in adults

Back 364

Streptococcus pneumoniae

Front 365

most common cause of bacterial meningitis in the elderly

Back 365

S. pneumoniae

Front 366

most common cause of bacterial meningitis in kids

Back 366

S. pneumoniae or Neisseria meningitidis

Front 367

most common cause of bacterial meningitis in newborns

Back 367

group B streptococcus

Front 368

most common cancer associated with AIDS

Back 368

Kaposi's sarcoma

Front 369

most common cause of congenital adrenal hyperplasia

Back 369

21-hydroxylase deficiency

Front 370

most common cause of cretinism

Back 370

iodine deficit/hypothyroidism

Front 371

most common cause of Cushing's syndrome
- 2nd most common?

Back 371

corticosteroid therapy
- excess ACTH secretion by pituitary is 2nd

Front 372

most common cause of death in CML

Back 372

blast crisis

Front 373

most common cause of death in SLE

Back 373

lupus nephropathy

Front 374

most common cause of dementia
- 2nd most common?

Back 374

Alzheimer's
- multi-infarct is 2nd

Front 375

most common causes of DIC

Back 375

Gram-negative sepsis, obstetric complications, cancer, burn trauma

Front 376

most common cause of ejection click

Back 376

aortic/pulmonic stenosis

Front 377

most common cause of food poisoning

Back 377

S. aureus

Front 378

most common cause of glomerulonephritis in adults

Back 378

IgA nephropathy (Berger's disease)

Front 379

most common cause of epidural hematoma
- is bleeding fast or slow?

Back 379

rupture of middle meningeal artery - fast bleeding

Front 380

most common cause of subdural hematoma
- is bleeding fast or slow?

Back 380

rupture of bridging veins due to trauma - slow bleeding

Front 381

most common cause of hemochromatosis
- causes risk of?

Back 381

multiple blood transfusions
- can cause CHF and increased risk of hepatocellular carcinoma

Front 382

most common cause of hepatic cirrhosis

Back 382

alcohol

Front 383

most common cause of hepatocellular carcinoma

Back 383

cirrhotic liver, often due to hepatitis B and C

Front 384

most common causes of holosystolic murmur

Back 384

VSD, tricuspid regurgitation, mitral regurgitation

Front 385

most common cause of secondary hypertension

Back 385

renal disease

Front 386

most common cause of hypoparathyroidism

Back 386

thyroidectomy

Front 387

most common cause of hypopituitarism

Back 387

adenoma

Front 388

most common infection in blood transfusion

Back 388

hepatitis C

Front 389

most common infection in burn victims

Back 389

Pseudomonas

Front 390

most common cause of "machine-like" murmur

Back 390

PDA

Front 391

most common cause of mental retardation
- 2nd most common?

Back 391

Down syndrome
- fragile X is 2nd

Front 392

most common cause of MI

Back 392

atherosclerosis

Front 393

most common cause of mitral valve stenosis

Back 393

rheumatic heart disease

Front 394

most common cause of myocarditis

Back 394

coxsackie B

Front 395

most common cause of nephrotic syndrome in adults

Back 395

membranous glomerulonephritis

Front 396

most common cause of nephrotic syndrome in kids
- how do you treat it?

Back 396

minimal change disease
- treat with corticosteroids

Front 397

most common cause of opening snap

Back 397

mitral stenosis

Front 398

most common cause of osteomyelitis

Back 398

S. aureus

Front 399

most common cause of osteomyelitis in patients with sickle cell disease

Back 399

Salmonella

Front 400

most common cause of osteomyelitis in IV drug abusers

Back 400

Pseudomonas

Front 401

most common causes of acute pancreatitis

Back 401

alcohol and gallstones

Front 402

most common cause of chronic pancreatitis in adults
- in kids?

Back 402

alcohol in adults
cystic fibrosis in kids

Front 403

most common cause of peau d'orange

Back 403

carcinoma of the breast

Front 404

most common cause of PID

Back 404

Neisseria gonorrhoeae

Front 405

most common cause of hospital-acquired pneumonia

Back 405

Klebsiella

Front 406

most common cause of pneumonia in cystic fibrosis or burn infection

Back 406

Pseudomonas aeruginosa

Front 407

most common cause of preventable blindness

Back 407

Chlamydia

Front 408

most common cause of primary amenorrhea
- what is the abnormality?

Back 408

Turner's - XO

Front 409

most common cause of primary hyperaldosteronism

Back 409

adenoma of adrenal cortex

Front 410

most common cause of primary hyperparathyroidism

Back 410

adenoma

Front 411

most common cause of pulmonary hypertension

Back 411

COPD

Front 412

most common cause of right heart failure due to a pulmonary cause

Back 412

cor pulmonale

Front 413

most common cause of right-sided heart failure

Back 413

left-sided heart failure

Front 414

most common cause of Sheehan's syndrome

Back 414

postpartum pituitary infarction secondary to hemorrhage

Front 415

most common cause of SIADH

Back 415

small cell carcinoma of the lung

Front 416

most common cause of UTI

Back 416

E. coli

Front 417

most common causes of UTI in young women

Back 417

E. coli and Staphylococcus saprophyticus

Front 418

heterochromatin vs. euchromatin

Back 418

HeteroChromatin = Highly Condensed (transcriptionally inactive)
euchromatin = less condensed, transcriptionally active ("truly transcribed")

Front 419

what nucleotides are purines?

Back 419

A,G (PURines = PURe As Gold)

Front 420

what nucleotides are pyrimidines?

Back 420

C,U,T (PYrimidines = CUT the PY)

Front 421

what functional group does thymine have?

Back 421

THYmine has a meTHYl

Front 422

what amino acids are needed for purine synthesis?

Back 422

Glycine, Aspartate, Glutamine (A and G are purines)

Front 423

hydroxyurea - mechanism of action?

Back 423

inhibits ribonucleotide reductase (converts ribonucleotides to deoxyribonucleotides)

Front 424

6-mercaptopurine - mechanism of action?

Back 424

blocks de novo purine synthesis

Front 425

5-fluorouracil - mechanism of action?

Back 425

inhibits thymidylate synthase (makes dTMP from dUMP)

Front 426

mechanism of action of methotrexate and trimethoprim

Back 426

inhibit dihydrofolate reductase (makes THF, which is needed for dTMP synthesis)

Front 427

transition vs. transversion

Back 427

transition - substituting purine for purine, e.g. (transItion = Identical type)
transversion - substituting purine for pyrimidine, e.g. (transVersion = conVersion between types)

Front 428

nonsense mutation

Back 428

change resulting in an early stop codon (Stop the nonsense!)

Front 429

fluoroquinolones - mechanism of action?

Back 429

inhibit DNA gyrase

Front 430

what is the defect in xeroderma pigmentosum?

Back 430

mutated endonucleases (for nucleotide excision repair) - prevents repair of thymidine dimers

Front 431

what is the defect in hereditary nonpolyposis colorectal cancer?

Back 431

mutated mismatch repair genes

Front 432

what are the 3 types of RNA, and what are their distinguishing characteristics?

Back 432

rRNA - most abundant (Rampant)
mRNA - longest (Massive)
tRNA - smallest (Tiny)

Front 433

mRNA start codon

Back 433

AUG (inAUGurates protein synthesis)

Front 434

mRNA stop codons

Back 434

UGA (U Go Away)
UAA (U Are Away)
UAG (U Are Gone)

Front 435

which types of RNA do the different types of RNA polymerase make?

Back 435

RNA polymerase I - rRNA
RNA polymerase II - mRNA
RNA polymerase III - tRNA
(numbered in order as products are used in protein synthesis)

Front 436

exons vs. introns

Back 436

exons are coding segments
introns are non-coding segments that are spliced out
(INtrons stay IN the nucleus, whereas EXons EXit and are EXpressed)

Front 437

tetracyclines - mechanism of action?

Back 437

bind 30S subunit and prevent attachment of aminoacyl-tRNA

Front 438

subunits that make up the eukaryotic vs. prokaryotic ribosome

Back 438

Eukaryotes: 40S + 60S = 80S (Even)
prOkaryotes: 30S + 50S = 70S (Odd)

Front 439

function of ribosome sites in protein synthesis

Back 439

going APE:
A site - incoming Aminoacyl-tRNA binds here
P site - accommodates growing Peptide
E site - holds Empty tRNA as it Exits

Front 440

functions of ATP and GTP in protein synthesis

Back 440

ATP - for tRNA charging (Activation)
GTP - for tRNA binding to ribosome and translocation (Gripping and Going places)

Front 441

aminoglycosides - mechanism of action?

Back 441

inhibit formation of initiation complex in protein synthesis and cause misreading of mRNA

Front 442

chloramphenicol - mechanism of action?

Back 442

inhibits 50S peptidyltransferase (which catalyzes peptide bond formation)

Front 443

mechanism of action of macrolides and clindamycin?

Back 443

bind 50S subunit and block translocation

Front 444

function of G1 and G2 phases in cell cycle

Back 444

Gap or Growth (duplication of cell contents, cell growth)

Front 445

function of S phase in cell cycle

Back 445

DNA Synthesis

Front 446

what is the defect in I-cell disease?

Back 446

lysosomal storage disorder - failure of addition of mannose-6-phosphate to lysosome proteins (normally targets proteins to lysosomes)
- so enzymes are secreted from cell instead of going to lysosomes

Front 447

name 5 drugs that act on microtubules (and what they're used for)

Back 447

mebendazole/thiabendazole (antihelminthic)
griseofulvin (antifungal)
vincristine/vinblastine (anti-cancer)
paclitaxel (anti-breast cancer)
colchicine (anti-gout)

Front 448

what is the defect in Chediak-Higashi syndrome?
- symptoms?

Back 448

defect in microtubule polymerization, causing decreased phagocytosis
- symptoms: recurrent pyogenic infections, partial albinism, peripheral neuropathy

Front 449

what is the defect in Kartagener's syndrome?
- symptoms?

Back 449

dynein arm defect, causing cilia to be immotile
- symptoms: infertility, bronchiectasis, recurrent sinusitis, situs inversus

Front 450

mechanism of action of cardiac glycosides (digoxin and digitoxin)?

Back 450

inhibit Na+/K+-ATPase, causing decreased Na+/Ca2+ exchange
- more Ca2+ in cell causes increased cardiac contractility

Front 451

location of the different types of collagen

Back 451

Be (So Totally) Cool, Read Books
type I: Bone, Skin, Tendon (type I: bONE)
type II: Cartilage (carTWOlage)
type III (Reticulin): blood vessels, uterus, fetal tissue
type IV: Basement membrane (type IV: under the floor)

Front 452

what is the defect in scurvy?

Back 452

vitamin C deficiency, so can't hydroxylate proline and lysine residues in collagen

Front 453

what is the defect in Ehlers-Danlos syndrome?
- which type of collagen is most affected?
- symptoms?

Back 453

faulty collagen synthesis, especially type III collagen
- symptoms: hyperextensible skin, tendency to bleed, hypermobile joints

Front 454

what is the defect in osteogenesis imperfecta?
- which type of collagen is most affected?
- symptoms?

Back 454

abnormal type I collagen synthesis
- symptoms: multiple fractures with minimal trauma (brittle bones), blue sclerae, hearing loss, dental imperfections

Front 455

what is the defect in Alport's syndrome?
- which type of collagen is most affected?
- symptoms?

Back 455

abnormal type IV collagen synthesis
- symptoms: hereditary nephritis, deafness, ocular disturbances (type IV collagen found in kidney, ears, and eyes)

Front 456

what is the defect in Marfan's syndrome?

Back 456

mutation in fibrillin (component of elastin)

Front 457

what disease can be caused by alpha1-antitrypsin deficiency?
- why does this occur?

Back 457

emphysema - due to excess elastase activity (alpha1-antitrypsin normally inhibits elastase)

Front 458

what blotting procedures are used to probe for DNA, RNA, and protein?

Back 458

SNoW DRoP:
Southern = DNA
Northern = RNA
Western = Protein

Front 459

Prader-Willi vs. Angelman's syndrome - inactivation of which parent's allele?

Back 459

Prader-Willi - deletion of Paternal allele
AngelMan's - deletion of Maternal allele

Front 460

what is the defect in hypophosphatemic rickets (vitamin D-resistant rickets)?
- what is the inheritance pattern?

Back 460

phosphate wasting at proximal tubule
- X-linked dominant

Front 461

what is the primary symptom in Leber's hereditary optic neuropathy?
- what causes this?
- what is the inheritance pattern?

Back 461

loss of central vision due to degeneration of retinal ganglion cells and axons
- mitochondrial inheritance

Front 462

what gene is mutated in achondroplasia?

Back 462

fibroblast growth factor receptor 3

Front 463

what gene is mutated in ADPKD?
- what chromosome is it on?

Back 463

APKD1 gene
- on chromosome 16 (16 letters in "polycystic kidney")

Front 464

what gene is mutated in familial adenomatous polyposis?
- what chromosome is it located on?

Back 464

APC gene
- chromosome 5 (5 letters in "polyp")

Front 465

what is the defect in familial hypercholesterolemia?

Back 465

defective or absent LDL receptor

Front 466

what is Osler-Weber-Rendu syndrome?

Back 466

hereditary hemorrhagic telangiectasia - disorder of blood vessels

Front 467

what is the defect in hereditary spherocytosis?

Back 467

defect in spectrin or ankyrin

Front 468

what chromosome is the mutation in Huntington's disease located on?

Back 468

chromosome 4 (hunting 4 food)

Front 469

what chromosome is the mutated gene in neurofibromatosis type 1 (von Recklinghausen's disease) located on?
- symptoms?

Back 469

chromosome 17 (17 letters in von Recklinghausen)
- symptoms: cafe-au-lait spots, neural tumors, Lisch nodules (iris hamartomas)

Front 470

what gene is mutated in neurofibromatosis type 2?
- what chromosome is it on?
- symptoms?

Back 470

NF2 gene on chromosome 22 (type 2 = 22)
- symptoms: bilateral acoustic neuromas, juvenile cataracts

Front 471

what are some symptoms of tuberous sclerosis?

Back 471

facial lesions, hypopigmented "ash leaf spots" on skin, cortical/retinal hamartomas, renal cysts, cardiac rhabdomyomas

Front 472

what are some symptoms of von Hippel-Lindau disease?
- what gene is mutated?
- what chromosome is it on?

Back 472

hemangioblastomas, bilateral renal cell carcinomas
- VHL gene (tumor suppressor) on chromosome 3 (von Hippel-Lindau = 3 words)

Front 473

what gene is mutated in cystic fibrosis, and how?
- treatment? how does it work?

Back 473

CFTR - deletion of Phe 508
- N-acetylcysteine cleaves disulfide bonds in mucus

Front 474

name 10 X-linked recessive disorders

Back 474

Be Wise, Fool's GOLD Heeds False Hope:
Bruton's agammaglobulinemia
Wiskott-Aldrich syndrome
Fragile X
G6PD defiency
Ocular albinism
Lesch-Nyhan syndrome
Duchenne's/Becker's muscular dystrophy
Hemophilia A and B
Fabry's disease
Hunter's syndrome

Front 475

what is the gene defect in Duchenne's muscular dystrophy?
- what is the defect in Becker's?

Back 475

Duchenne's = Deleted Dystrophin (frameshift mutation)
- Becker's = mutated dystrophin

Front 476

what are the symptoms of fragile X syndrome?

Back 476

macro-orchidism, long face, large jaw, large everted ears (fragile X = eXtra-large testes, jaw, ears)

Front 477

name 4 trinucleotide repeat expansion diseases
- what are the repeated segments for each?

Back 477

Try (trinucleotide) hunting for my fried eggs (X):
Huntington's disease - CAG
myoTonic dystrophy - CTG
Friedreich's ataxia - GAA
fraGile X syndrome - CGG

Front 478

name the 3 most common autosomal trisomies
- which chromosome?
- symptoms?

Back 478

Down syndrome - 21 (Drinking age) - flat facies, prominent epicanthal folds, simian crease
Edward's syndrome - 18 (Election age) - micrognathia, low-set ears, clenched hands with overlapping fingers
Patau's syndrome - 13 (Puberty) - cleft lip/Palate, holoProsencephaly, Polydactyly

Front 479

symptoms of 22q11 deletion syndromes
- what is the cause?
- 2 examples of syndromes?

Back 479

CATCH-22:
Cleft palate
Abnormal facies
Thymic aplasia (causes T cell deficiency)
Cardiac defects
Hypocalcemia due to parathyroid aplasia
- due to aberrant development of 3rd and 4th branchial pouches
- examples: DiGeorge syndrome, velocardiofacial syndrome

Front 480

vitamin A - other name?
- function?

Back 480

retinol
- constituent of visual pigments (retin-A)

Front 481

vitamin B1 - other name?
- what cofactor does it make?
- what types of reactions does this assist in?
- what diseases are caused by deficiency?

Back 481

thiamine
- TPP - for dehydrogenase reactions
- beriberi (Ber1Ber1) and Wernicke-Korsakoff syndrome

Front 482

vitamin B2 - other name?
- what cofactors does it make? how many ATP?
- symptoms of deficiency?

Back 482

riboflavin
- FAD and FMN (derived from riboFlavin) - FAD makes 2 ATP (B2)
- 2 C's: Cheilosis, Corneal vascularization

Front 483

vitamin B3 - other name?
- what cofactor does it make? how many ATP?
- what disease is caused by deficiency? symptoms?

Back 483

niacin
- NAD (derived from Niacin) - 3 ATP (B3)
- pellagra - 3 D's: Diarrhea, Dermatitis, Dementia

Front 484

vitamin B5 - other name?
- what cofactor does it make?

Back 484

pantothenate
- CoA (from pantothen-A)

Front 485

vitamin B6 - other name?
- what types of reactions does it participate in?

Back 485

pyridoxine
- transamination and decarboxylation reactions

Front 486

vitamin B12 - other name?

Back 486

cobalamin

Front 487

source of folate

Back 487

green leaves (FOLate from FOLiage)

Front 488

function of S-adenosyl-methionine

Back 488

transfers methyl units (SAM the methyl donor man)

Front 489

biotin - cofactor in what kind of reactions?
- cause of deficiency?

Back 489

carboxylation reactions
- ingestion of raw eggs, which contain avidin (AVIDin in egg whites AVIDly binds biotin)

Front 490

vitamin E - function?

Back 490

antioxidant that protects erythrocytes and membranes from damage (E for Erythrocytes)

Front 491

vitamin K - function?

Back 491

needed for proper function of clotting factors II, VII, IX, and X and proteins C and S (K is for Koagulation)

Front 492

disulfiram - mechanism of action?

Back 492

inhibits acetaldehyde dehydrogenase, causing accumulation of acetaldehyde

Front 493

kwashiorkor vs. marasmus - what are the causes and symptoms of each?

Back 493

kwashiorkor - protein malnutrition
- results from a protein-deficient MEAL: malnutrition, edema, anemia, liver fatty change
marasmus - energy malnutrition
- Marasmus results in Muscle wasting

Front 494

cell processes that take place in both mitochondria and cytoplasm

Back 494

HUGs take two:
Heme synthesis
Urea cycle
Gluconeogenesis

Front 495

hexokinase vs. glucokinase
- what do they do?
- where are they each located?
- high or low affinity?
- high or low Vmax?

Back 495

both convert glucose to glucose-6-phosphate
- hexokinase is everywhere and has high affinity and low Vmax
- glucokinase is in liver and beta cells of pancreas - has low affinity and high Vmax

Front 496

cofactors involved in pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase reactions

Back 496

TPP (B1), FAD (B2), NAD (B3), CoA (B5), lipoic acid

Front 497

purely ketogenic amino acids

Back 497

Lysine and Leucine

Front 498

substrates in TCA cycle

Back 498

Citrate Is Krebs' Starting Substrate For Making Oxaloacetate:
Citrate - Isocitrate - alpha-Ketoglutarate - Succinyl-CoA - Succinate - Fumarate - Malate - Oxaloacetate

Front 499

enzymes unique to gluconeogenesis (all irreversible)

Back 499

Pathway Produces Fresh Glucose:
Pyruvate carboxylase
PEP carboxykinase
Fructose-1,6-bisphosphatase
Glucose-6-phosphatase

Front 500

purposes of HMP shunt

Back 500

produce NADPH (for fatty acid/steroid biosynthesis and glutathione reduction to prevent oxidative damage)
produce pentose sugars (for nucleotide synthesis)

Front 501

what are Heinz bodies?
- what disease do they occur in?

Back 501

Heinz bodies = denatured Hemoglobin that precipitates within RBCs
- occur in G6PD deficiency (oxidative damage)

Front 502

what is the defect in fructose intolerance?

Back 502

deficiency of aldolase B (converts fructose-1-P to DHAP and glyceraldehyde)

Front 503

what is the defect in essential fructosuria?

Back 503

deficiency of fructokinase (converts fructose to fructose-1-P)

Front 504

what is the defect in classic galactosemia?
- symptoms?

Back 504

absence of galactose-1-phosphate uridyltransferase (converts galactose-1-P to glucose-1-P)
- failure to thrive, infantile cataracts (galactitol accumulates in eye)

Front 505

substrates in urea cycle

Back 505

Ordinarily, Careless Crappers Are Also Frivolous About Urination:
Ornithine - Carbamoyl phosphate - Citrulline - Aspartate - Argininosuccinate - Fumarate - Arginine - Urea

Front 506

what is the defect in phenylketonuria?
- symptoms?

Back 506

decrease in phenylalanine hydroxylase (converts Phe to Tyr) or in THB cofactor
- mental/growth retardation, fair skin, musty body odor (disorder of aromatic aa metabolism causes musty body odor)

Front 507

what is the defect in alkaptonuria?
- symptoms?

Back 507

deficiency of homogentisic acid oxidase (involved in Tyr degradation)
- dark connective tissue, pigmented sclera, urine turns black on standing

Front 508

what is the defect in albinism?

Back 508

deficiency of tyrosinase or defective tyrosine transporters (so can't make melanin from tyrosine)

Front 509

what is the defect in homocystinuria?

Back 509

defect in cystathionine synthase (in pathway converting homocysteine to cysteine) or in homocysteine methyltransferase (converts homocysteine to methionine) - both cause excess homocysteine

Front 510

what is the defect in cystinuria?
- what can result?

Back 510

defect of renal proximal tubule transporter for cysteine
- excess cystine in urine can cause precipitation of cystine kidney stones

Front 511

what is the defect in maple syrup urine disease?
- symptoms?

Back 511

defect in alpha-ketoacid dehydrogenase, which degrades branched amino acids (Ile, Leu, Val - I Love Vermont maple syrup from the branches of maple trees)
- urine smells like maple syrup, CNS defects

Front 512

what enzyme deficiency is a major cause of SCID?
- what patient population gets SCID?

Back 512

adenosine deaminase deficiency (excess ATP imbalances nucleotide pool and prevents DNA synthesis)
- SCID happens to kids

Front 513

what is the defect in Lesch-Nyhan syndrome?
- symptoms?

Back 513

absence of HGPRT (He's Got Purine Recovery Trouble) - enzyme of purine salvage pathway, so block leads to excess uric acid
- retardation, self-mutilation, gout

Front 514

what is the defect in orotic aciduria?
- findings?

Back 514

inability to convert orotic acid to UMP (in de novo pyrimidine synthesis pathway)
- orotic acid in urine, megaloblastic anemia

Front 515

function of insulin with regard to glucose

Back 515

Insulin moves glucose Into cells

Front 516

tissues that don't need insulin for glucose transport

Back 516

BRICK L:
Brain, RBCs, Intestine, Cornea, Kidney, Liver

Front 517

what are glycogen storage diseases types I-III and V?
- what enzymes are deficient in each?
- what specific organs do types II and V affect?

Back 517

Very Poor Carbohydrate Metabolism:
I = Von Gierke's disease
- glucose-6-phosphatase
II = Pompe's disease
- lysosomal alpha-1,4-glucosidase
- heart (cardiomegaly) - Pompe's trashes the Pump
III = Cori's disease
- debranching enzyme
V = McArdle's disease
- skeletal muscle glycogen phosphorylase
- muscle (McArdle's = Muscle)

Front 518

what is the defect in Fabry's disease?
- what substrate accumulates?

Back 518

deficient alpha-galactosidase A
- ceramide trihexoside accumulates

Front 519

what is the defect in Gaucher's disease?
- what substrate accumulates?

Back 519

deficient beta-glucocerebrosidase
- glucocerebroside accumulates

Front 520

what is the defect in Niemann-Pick disease?
- what substrate accumulates?

Back 520

deficient sphingomyelinase - no man picks (Niemann-Pick) his nose with his sphinger (sphingomyelinase)
- sphingomyelin accumulates

Front 521

what is the defect in Tay-Sachs disease?
- what substrate accumulates?

Back 521

deficient hexosaminidase A (Tay-SaX lacks heXosaminidase)
- GM2 ganglioside accumulates

Front 522

what is the defect in Krabbe's disease?
- what substrate accumulates?

Back 522

deficient galactocerebrosidase
- galactocerebroside accumulates

Front 523

what is the defect in metachromatic leukodystrophy?
- what substrate accumulates?

Back 523

deficient arylsulfatase A
- cerebroside sulfate accumulates

Front 524

what is the defect in Hurler's syndrome?
- what substrates accumulate?

Back 524

deficient alpha-L-iduronidase
- heparan sulfate and dermatan sulfate accumulate

Front 525

what is the defect in Hunter's syndrome?
- what substrates accumulate?
- what is the inheritance pattern?

Back 525

deficient iduronate sulfatase
- heparan sulfate and dermatan sulfate accumulate
- X-linked recessive (hunters aim for the X)

Front 526

Hunter's vs. Hurler's - which has corneal clouding?

Back 526

Hurler's
(hunters see clearly - no corneal clouding)

Front 527

citrate shuttle vs. carnitine shuttle - what metabolic pathways are they involved in?

Back 527

citrate - fatty acid synthesis (SYtrate = SYnthesis)
carnitine - fatty acid degradation (CARnitine = CARnage of fatty acids)

Front 528

statins - mechanism of action?

Back 528

inhibit HMG-CoA reductase

Front 529

functions of apolipoproteins A-I, B-100, C-II, B-48, and E

Back 529

A-I - activates LCAT
B-100 - Binds LDL receptor and mediates VLDL secretion
C-II - Cofactor for lipoprotein lipase
B-48 - mediates chylomicron secretion
E - mediates remnant (Extra) uptake

Front 530

direction of transport of LDL and HDL

Back 530

LDL - from liver to tissues (LDL is Lousy)
HDL - from periphery to liver (HDL is Healthy)

Front 531

what is the defect in hyperchylomicronemia?

Back 531

lipoprotein lipase deficiency or altered apolipoprotein C-II

Front 532

what is the defect in familial hypercholesterolemia?

Back 532

absent or decreased LDL receptors

Front 533

what is the defect in hypertriglyceridemia?

Back 533

hepatic overproduction of VLDL

Front 534

what is the defect in abetalipoproteinemia?

Back 534

deficiencies of apoB-100 and apoB-48 - unable to synthesize lipoproteins

Front 535

landmarks of 2nd week of fetal development

Back 535

rule of 2's:
- 2 germ layers (epiblast, hypoblast)
- 2 cavities (amniotic cavity, yolk sac)
- 2 components to placenta (cytotrophoblast, syncytiotrophoblast)

Front 536

landmark of 3rd week of fetal development

Back 536

rule of 3's:
- 3 germ layers (ectoderm, mesoderm, endoderm)

Front 537

landmarks of 4th week of fetal development

Back 537

rule of 4's:
- 4 heart chambers
- 4 limb buds grow

Front 538

what germ layer are odontoblasts derived from?

Back 538

neural crest (Crest toothpaste)

Front 539

symptoms of mesoderm defects

Back 539

VACTERL:
Vertebral defects
Anal atresia
Cardiac defects
Tracheo-Esophageal fistula
Renal defects
Limb defects

Front 540

at which days in fetal development do the amnion and chorion form?

Back 540

chorion forms at day 3
amnion forms at day 8

Front 541

what are the components of the umbilical cord?

Back 541

2 umbilical arteries
1 umbilical vein
urachus
all surrounded by Wharton's jelly

Front 542

structures that perform fetal erythropoiesis during development, in order

Back 542

Young Liver Synthesizes Blood:
Yolk sac (3-8 wk)
Liver (6-30 wk)
Spleen (9-28 wk)
Bone marrow (28+ wk)

Front 543

what is the adult derivative of the umbilical arteries?

Back 543

umbiLical arteries become mediaL umbilical ligaments

Front 544

what is the adult derivative of the allantois/urachus?

Back 544

allaNtois becomes mediaN umbilical ligaments

Front 545

what is the adult derivative of the 1st aortic arch?

Back 545

part of the MAXillary artery (1st arch is MAXimal)

Front 546

what are the adult derivatives of the 2nd aortic arch?

Back 546

Stapedial artery (Second arch) and hyoid artery

Front 547

what are the adult derivatives of the 3rd aortic arch?

Back 547

common Carotid artery and internal Carotid artery (C is 3rd letter of alphabet)

Front 548

what are the adult derivatives of the 4th aortic arch?

Back 548

aortic arch and right subclavian artery (4th arch = 4 limbs = systemic circulation)

Front 549

what is the defect in spina bifida occulta?
- in meningocele?
- in myelomeningocele?

Back 549

bony spinal canal fails to close, but no herniation
- meninges herniate through
- meninges and spinal cord herniate through

Front 550

what is Chiari type II?

Back 550

cerebellar tonsils herniate through foramen magnum

Front 551

what is Dandy-Walker?

Back 551

large posterior fossa, absent cerebellum, enlarged 4th ventricle

Front 552

what is the defect in holoprosencephaly?

Back 552

cerebral hemispheres do not separate across midline

Front 553

what is the defect in syringomyelia?
- symptom?

Back 553

enlarged central canal of spinal cord - damages crossing fibers of spinothalamic tract
- so bilateral loss of pain and temperature sense

Front 554

what germ layers are the different parts of the branchial apparatus derived from?

Back 554

CAP covers outside from inside:
Clefts = ectoderm
Arches = mesoderm
Pouches = endoderm

Front 555

innervations and general functions of derivatives of each branchial arch

Back 555

arch 1 - CN V2 and V3 - chewing
arch 2 - CN VII - facial expression
arch 3 - CN IX - stylopharyngeus
arch 4 - CN X - swallowing
arch 6 - CN X - speaking

Front 556

name some derivatives of branchial arch 1

Back 556

Meckel's cartilage (Mandible, Malleus, incus, sphenoMandibular ligament)
Muscles of Mastication (temporalis, Masseter, lateral and Medial pterygoids)
Mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini, anterior tongue

Front 557

what is the defect in Treacher Collins syndrome?
- symptoms?

Back 557

1st arch neural crest fails to migrate
- mandibular hypoplasia, facial abnormalities

Front 558

name some derivatives of branchial arch 2

Back 558

Stapes, Styloid process, lesser horn of hyoid, Stylohyoid ligament
muscles of facial expression, Stapedius, Stylohyoid, posterior belly of digastric

Front 559

name some derivatives of branchial arch 3

Back 559

greater horn of hyoid, stylopharyngeus (innervated by glossopharyngeal nerve)

Front 560

what are the derivatives of the 3rd branchial pouch?

Back 560

3rd pouch contributes to 3 structures:
thymus and inferior parathyroids

Front 561

what is the defect in DiGeorge syndrome?
- symptoms?

Back 561

aberrant development of 3rd and 4th branchial pouches (form thyroid and parathyroids)
- T-cell deficiency and hypocalcemia

Front 562

what ear bones and muscles derive from the 1st branchial arch?
- from the 2nd?

Back 562

1st: Malleus/incus, tensor tyMpani
2nd: Stapes, Stapedius

Front 563

embryologic components of diaphragm

Back 563

Several Parts Build Diaphragm:
Septum transversum
Pleuroperitoneal folds
Body wall
Dorsal mesentery of esophagus

Front 564

innervation of diaphragm

Back 564

C3,4,5 (keeps the diaphragm alive)

Front 565

what is the defect in gastroschisis?

Back 565

failure of lateral body folds to fuse, causes extrusion of abdominal contents

Front 566

what is the defect in Potter's syndrome?
- symptoms?

Back 566

bilateral renal agenesis in utero (due to malformed ureteric bud) causes oligohydramnios (babies with Potter's can't Pee in utero)
- limb deformities, face deformities, pulmonary hypoplasia

Front 567

adult derivatives of the mesonephric (wolffian) ducts

Back 567

SEED:
Seminal vesicles
Epididymis
Ejaculatory duct
Ductus deferens

Front 568

what is the defect in hypospadias?

Back 568

failure of urethral folds to close - causes abnormal opening of penile urethra on inferior side of penis (hypo is below)

Front 569

what is the defect in epispadias?
- what condition is associated with epispadias?

Back 569

faulty positioning of genital tubercle - causes abnormal opening of penile urethra on superior side of penis (Epispadias - you hit your Eye when you pEE)
- Extrophy of the bladder is associated with Epispadias

Front 570

only bacteria with a protein capsule

Back 570

Bacillus anthracis

Front 571

bacteria that do not Gram stain well

Back 571

These Rascals May Microscopically Lack Color:
Treponema
Rickettsia
Mycobacteria
Mycoplasma
Legionella pneumophila
Chlamydia

Front 572

what does PAS stain for?
- what does it diagnose?

Back 572

glycogen and mucopolysaccharides (PASs the sugar)
- Whipple's disease

Front 573

name 4 obligate aerobes

Back 573

Nagging Pests Must Breathe:
Nocardia
Pseudomonas aeruginosa (P. AERuginosa is an AERobe)
Mycobacterium tuberculosis
Bacillus

Front 574

name 3 obligate anaerobes

Back 574

anaerobes Can't Breathe Air:
Clostridium
Bacteroides
Actinomyces

Front 575

what type of bacteria are aminoglycosides ineffective against?

Back 575

anaerobes (aminO2glycosides require O2 to enter bacterial cell)

Front 576

name 2 obligate intracellular bacteria

Back 576

stay inside cells when it's Really Cold:
Rickettsia
Chlamydia

Front 577

name 8 facultative intracellular bacteria

Back 577

Some Nasty Bugs May Live FacultativeLY:
Salmonella
Neisseria
Brucella
Mycobacterium
Listeria
Francisella
Legionella
Yersinia

Front 578

what does a positive quellung reaction indicate?

Back 578

bacteria is encapsulated (quellung = capsular swellung)

Front 579

name 4 encapsulated bacteria

Back 579

Some Nasties Have Kapsules:
Streptococcus pneumoniae
Neisseria meningitidis
Haemophilus influenzae
Klebsiella pneumoniae

Front 580

name 4 urease-positive bacteria

Back 580

Particular Kinds Have Urease:
Proteus
Klebsiella
H. pylori
Ureaplasma

Front 581

what bacteria produce a yellow pigment?

Back 581

S. aureus (aureus = yellow)

Front 582

what bacteria produce a blue-green pigment?

Back 582

Pseudomonas aeruginosa (AERUGula is green)

Front 583

what bacteria produce a red pigment?

Back 583

Serratia marcescens (red maraschino cherries)

Front 584

function of Corynebacterium diphtheriae toxin

Back 584

inactivates elongation factor (EF-2)

Front 585

function of Vibrio cholerae toxin

Back 585

activates Gs, stimulating adenylyl cyclase - increases Cl- in gut and decreases Na+ absorption

Front 586

E. coli heat-labile toxin vs. heat-stable toxin

Back 586

heat-labile stimulates Adenylate cyclase, heat-stable stimulates Guanylate cyclase
("labile like the Air, stable like the Ground")

Front 587

function of Bordetella pertussis toxin

Back 587

inhibits Gi, causing increased cAMP

Front 588

function of C. tetani toxin

Back 588

blocks release of GABA and glycine

Front 589

function of C. botulinum toxin

Back 589

blocks release of acetylcholine

Front 590

function of Shigella toxin

Back 590

Shiga toxin cleaves host rRNA and enhances cytokine release

Front 591

location of endotoxin

Back 591

Gram-Negative cell wall
(N-dotoxin)

Front 592

name 5 bacterial toxins that are encoded in a lysogenic phage

Back 592

ABCDE:
ShigA-like toxin
Botulinum toxin
Cholera toxin
Diphtheria toxin
Erythrogenic toxin of Streptococcus pyogenes

Front 593

how do you distinguish between Staph. epidermidis and Staph. saprophyticus?

Back 593

NOvobiocin - Saprophyticus is Resistant, Epidermidis is Sensitive (on the office's staph retreat, there was NO StRES)

Front 594

how do you distinguish between Strep. pneumoniae and viridans?

Back 594

Optochin - Viridans is Resistant, Pneumoniae is Sensitive (OVRPS - overpass)

Front 595

how do you distinguish between group A and B strep?

Back 595

Bacitracin - group B strep are resistant, group A are Sensitive (B-BRAS)

Front 596

how do you distinguish between Staphylococci and Streptococci?

Back 596

catalase (Staph make catalase because they have more staff)

Front 597

what diseases does Streptococcus pneumoniae cause?

Back 597

MOPS (Most OPtochin Sensitive):
Meningitis
Otitis media
Pneumonia
Sinusitis

Front 598

what species of viridans group Strep causes subacute bacterial endocarditis?

Back 598

S. sanguis (blood - there is lots of blood in the heart)

Front 599

normal location of viridans Streptococci

Back 599

in the mouth (not afraid of-the-chin - op-to-chin resistant)

Front 600

sequelae of Strep pharyngitis

Back 600

rheumatic fever (PHever), glomerulonePHritis (due to PHaryngitis)

Front 601

symptoms of rheumatic fever

Back 601

no rheum for SPECCulation:
Subcutaneous nodules
Polyarthritis
Erythema marginatum
Chorea
Carditis

Front 602

what patients does Streptococcus agalactiae infect?

Back 602

babies (group B is for Babies)

Front 603

characteristics of Corynebacterium diphtheriae

Back 603

ABCDEFG:
ADP ribosylation (by toxin)
Beta-prophage (encodes toxin)
Corynebacterium
Diphtheriae
Elongation Factor 2 (ribosylated by toxin)
Granules

Front 604

main symptom of Clostridium tetani infection

Back 604

TETanic paralysis (TETanus)

Front 605

what are the sources of C. botulinum?

Back 605

BOTulinum - from bad BOTtles of food and honey

Front 606

what does C. perfringens infection cause?

Back 606

gas gangrene (PERFringens PERForates a gangrenous leg)

Front 607

what does C. difficile infection cause?

Back 607

DIfficile - causes DIarrhea and pseudomembranous colitis

Front 608

what is the only Gram-positive bacteria with endotoxin?

Back 608

Listeria monocytogenes

Front 609

what are the treatments for Actinomyces israelii and Nocardia asteroides?

Back 609

SNAP:
Sulfamethoxazole for Nocardia
Actinomyces gets Penicillin

Front 610

lepromatous vs. tuberculoid leprosy - which is worse?
- what causes the difference?

Back 610

LEpromatous is worse (LEthal)
- due to failed cell-mediated immunity

Front 611

what type of bacteria grow pink colonies on MacConkey's agar?
- name 5 examples

Back 611

lactose fermenters (lactose is KEE)
- MacConKEE's agar: Citrobacter, Klebsiella, E. coli, Enterobacter, Serratia

Front 612

how do you distinguish between Neisseria gonorrhoeae and meningitidis?

Back 612

MeninGococci ferment Maltose and Glucose
Gonococci ferment only Glucose

Front 613

what diseases does Haemophilus influenzae cause?

Back 613

HaEMOPhilus causes Epiglottitis, Meningitis, Otitis media, Pneumonia

Front 614

what special culture is needed to grow Haemophilus influenzae?

Back 614

chocolate agar with factors V (NAD) and X (hematin)
(when a child has the "flu", mom goes to the five (V) and dime (X) to buy some chocolate)

Front 615

how do you stain Legionella pneumophila?
- what special culture is needed to grow it?

Back 615

silver stain
- charcoal yeast extract with iron and cysteine
(French legionnaire with silver helmet sitting around charcoal fire with an iron dagger - he is no sissy/cysteine)

Front 616

what diseases does Pseudomonas aeruginosa cause?

Back 616

PSEUDOmonas - Pneumonia, Sepsis, External otitis, UTI, Diabetic Osteomyelitis

Front 617

antigen types found in Enterobacteriaceae
- are they glucose fermenters or nonfermenters?

Back 617

COFFEe:
Capsular (K) antigen
O antigen
Flagellar (H) antigen
Ferment glucose
Enterobacteriaceae

Front 618

what diseases does Klebsiella cause?
- what patients does it affect?

Back 618

4 A's:
Aspiration pneumonia
Abscess in lungs
Alcoholics
di-A-betics

Front 619

Salmonella vs. Shigella - which is motile?
- how are they transmitted?

Back 619

Salmonella (salmon swim)
- Food, Fingers, Feces, Flies

Front 620

name the spirochetes
- which is the biggest?

Back 620

BLT: Borrelia, Leptospira, Treponema
- Borrelia (B is Big)

Front 621

what is Weil's disease?

Back 621

icterohemorrhagic leptospirosis (severe infection with Leptospira interrogans)

Front 622

symptoms of Lyme disease

Back 622

BAKE a Key Lyme pie:
Bell's palsy
Arthritis
Kardiac block
Erythema migrans

Front 623

which stage of syphilis is characterized by systemic disease?

Back 623

Secondary syphilis = Systemic

Front 624

what is the Argyll Robertson pupil?

Back 624

sign of tertiary syphilis - constricts with accommodation but is not reactive to light (prostitute's pupil - accommodates but doesn't react)

Front 625

which treponeme test is more specific and remains positive longest: FTA-ABS or VDRL?

Back 625

FTA-ABS (Find The Antibody ABSolutely)

Front 626

causes of VDRL false positives

Back 626

VDRL:
Viruses (mono, hepatitis)
Drugs
Rheumatic fever
Lupus/leprosy

Front 627

name 6 zoonotic bacteria

Back 627

Big Bad Bugs From Your Pet named Ella:
Bartonella henselae
Borrelia burgdorferi
Brucella
Francisella tularensis
Yersinia pestis
Pasteurella multocida

Front 628

what is the source of Brucella, and what does it cause?

Back 628

Unpasteurized dairy products - causes Undulant fever

Front 629

triad of symptoms caused by rickettsiae

Back 629

headache, fever, rash

Front 630

what distinguishes rickettsial rash from typhus rash?

Back 630

rickettsial rash starts on hands and feet and spreads inward
typhus rash starts centrally and spreads outward
(Rickettsia on the wRists, Typhus on the Trunk)

Front 631

what causes Q fever, and what distinguishes it from other rickettsiae?

Back 631

Coxiella burnetii
Q fever is Queer - no rash, no vector (transmitted by aerosol), negative Weil-Felix reaction, organism can survive outside for a long time

Front 632

what infections cause a palm and sole rash?

Back 632

drive CARS using palms and soles:
Coxsackievirus A
Rocky Mountain spotted fever
Syphilis

Front 633

Chlamydia elementary body vs. reticulate body - what is the function of each?

Back 633

Elementary body Enters the cell
Reticulate body Replicates in the cell

Front 634

what do the different serotypes of Chlamydia trachomatis cause?

Back 634

types A, B, C - in Africa, cause Blindness and Chronic infection
types L1-3 - cause Lymphogranuloma venereum
types D-K - cause everything else

Front 635

treatment for C. difficile

Back 635

metronidazole

Front 636

treatment for leprosy
- side effects?

Back 636

dapsone
- hemolysis, methemoglobinemia

Front 637

treatment for H. influenzae meningitis
- prophylaxis for close contacts?

Back 637

ceftriaxone
- rifampin prophylaxis

Front 638

treatment for Legionella

Back 638

erythromycin

Front 639

treatment for Pseudomonas

Back 639

aminoglycoside + extended-spectrum penicillin

Front 640

treatment for H. pylori

Back 640

triple therapy: bismuth, metronidazole, and tetracycline/amoxicillin

Front 641

treatment for Lyme disease

Back 641

doxycycline

Front 642

treatment for syphilis

Back 642

penicillin

Front 643

treatment for Gardnerella

Back 643

metronidazole

Front 644

treatment for Rickettsiae

Back 644

tetracycline

Front 645

treatment for Chlamydia

Back 645

erythromycin or tetracycline

Front 646

treatment for Mycoplasma pneumoniae

Back 646

tetracycline or erythromycin

Front 647

histoplasmosis - where is it contracted?
- microscopic appearance?

Back 647

Mississippi/Ohio river valleys
- macrophage filled with intracellular oval bodies

Front 648

blastomycosis - where is it contracted?
- microscopic appearance?
- preferred form at different temperatures?

Back 648

east of Mississippi river
- Blastomycosis = Big Broad-Based Budding
- cold = mold, heat = yeast

Front 649

coccidioidomycosis - where is it contracted?
- microscopic appearance?

Back 649

southwestern US
- spherule filled with endospores

Front 650

paracoccidioidomycosis - where is it contracted?
- microscopic appearance?

Back 650

Latin America
- budding yeast looks like captain's wheel

Front 651

treatment for local mycotic infection
- for systemic infection?

Back 651

fluconazole or ketoconazole
- amphotericin B for systemic

Front 652

what causes tinea versicolor?
- treatment?

Back 652

Malassezia furfur
- miconazole, selenium sulfide

Front 653

treatment for superficial Candida albicans infection
- for systemic infection?

Back 653

nystatin
- amphotericin B for systemic

Front 654

treatment for Pneumocystis jiroveci

Back 654

trimethaprim-sulfamethoxazole

Front 655

treatment for Sporothrix schenckii

Back 655

itraconazole or potassium iodide

Front 656

symptoms of Chagas' disease
- what causes it?
- what transmits it?
- treatment?

Back 656

dilated cardiomyopathy, megacolon, megaesophagus
- Trypanosoma cruzi transmitted by reduviid bug
- nifurtimox

Front 657

treatment for African sleeping sickness

Back 657

SURamin for blood-borne disease
MELArsoprol for CNS penetration
(it SURe is nice to go to sleep; MELAtonin helps with sleep)

Front 658

how is Leishmania transmitted?
- treatment?

Back 658

sandfly
- treat with sodium stibogluconate

Front 659

treatment for malaria

Back 659

chloroquine + primaquine to prevent relapse by dormant species in liver

Front 660

what organisms does the Ixodes tick transmit?

Back 660

Borrelia burgdorferi and Babesia

Front 661

what is the main symptom of Entamoeba histolytica infection?

Back 661

bloody diarrhea

Front 662

what are three main drugs used to treat nematode (roundworm) infections?

Back 662

meBENDazole (worms are BENDy), pyrantel pamoate, diethylcarbamazine

Front 663

what disease does Onchocerca volvulus cause?
- treatment?
- how is it transmitted?

Back 663

rIVER blindness
- IVERmectin
- blackflies

Front 664

what is the main drug used to treat cestode (tapeworm) and trematode (fluke) infections?

Back 664

praziquantel

Front 665

Taenia solium - what are the two types of infection?
- ingestion of which form causes each?

Back 665

intestinal tapeworms - caused by ingestion of larvae
cysticercosis - caused by ingestion of eggs

Front 666

infection by what causes cysts in liver?
- what happens if the cysts burst?

Back 666

Echinococcus granulosus
- anaphylactic reaction

Front 667

what parasite is associated with squamous cell carcinoma of the bladder?

Back 667

Schistosoma haematobium

Front 668

what parasite is associated with cholangiocarcinoma?

Back 668

Clonorchis sinensis

Front 669

what nematodes are spread by ingestion?

Back 669

you'll get sick if you EAT these:
Enterobius
Ascaris
Trichinella

Front 670

nematodes that spread cutaneously

Back 670

these get into your feet from the SANd:
Strongyloides
Ancylostoma
Necator

Front 671

what parasite can cause vitamin B12 deficiency?

Back 671

Diphyllobothrium latum

Front 672

what parasites can cause microcytic anemia?

Back 672

Ancylostoma and Necator

Front 673

what parasite can cause perianal pruritis?

Back 673

Enterobius

Front 674

what organism causes typhoid fever?

Back 674

Salmonella typhi

Front 675

name 3 organisms that cause typhus (and what kind of typhus they cause)

Back 675

Rickettsia prowazekii (epidemic)
Rickettsia typhi (endemic)
Rickettsia tsutsugamushi (scrub typhus)

Front 676

live vs. killed vaccines - what type of immunity is induced?

Back 676

live - humoral and cell-mediated immunity
killed - only humoral immunity

Front 677

which viral vaccines are killed vaccines?

Back 677

RIP Always:
Rabies
Influenza
Salk Polio
HAV

Front 678

Sabin vs. Salk polio vaccines - which is killed, and which is live?

Back 678

Sabin - live
SalK - Killed

Front 679

are DNA viruses single-stranded or double-stranded?
- exception?

Back 679

double-stranded
- parvovirus is exception ("part-of-a-virus")

Front 680

are DNA viruses linear or circular?
- exceptions?

Back 680

linear
- exceptions: papilloma, polyoma, hepadna are circular

Front 681

are RNA viruses single-stranded or double-stranded?
- exception?

Back 681

single-stranded
- exception: reovirus ("repeatovirus") is double-stranded

Front 682

are viruses haploid or diploid?
- exception?

Back 682

haploid
- exception: retroviruses are diploid

Front 683

where do DNA viruses replicate?
- exception?

Back 683

nucleus
- exception: poxvirus replicates in the cytoplasm

Front 684

where do RNA viruses replicate?
- exceptions?

Back 684

cytoplasm
- exceptions: influenza virus and retroviruses replicate in the nucleus

Front 685

name the nonenveloped viruses (and whether they are DNA or RNA)

Back 685

naked CPR and PAPP smear:
RNA: Calicivirus, Picornavirus, Reovirus
DNA: Parvovirus, Adenovirus, Papillomavirus, Polyomavirus

Front 686

name the DNA viruses

Back 686

HHAPPPPy:
Hepadna
Herpes
Adeno
Pox
Parvo
Papilloma
Polyoma

Front 687

do DNA viruses have icosahedral or complex nucleocapsids?
- exception?

Back 687

icosahedral
- exception: pox (complex)

Front 688

name the herpesviruses

Back 688

get herpes in a CHEVrolet:
CMV
HSV
EBV
VZV

Front 689

what does the Tzanck test look for?
- what does it test for?

Back 689

multinucleated giant cells
- HSV-1, HSV-2, VZV (Tzanck heavens I don't have herpes)

Front 690

what viruses are paramyxoviruses?

Back 690

PaRaMyxovirus:
Parainfluenza
RSV
Measles (rubeola)
Mumps

Front 691

what is the treatment for RSV?

Back 691

ribavirin

Front 692

what RNA viruses are negative-stranded?

Back 692

Always Bring Polymerase Or Fail Replication:
Arenavirus
Bunyavirus
Paramyxovirus
Orthomyxovirus
Filovirus
Rhabdovirus

Front 693

what RNA viruses are segmented?

Back 693

BOAR:
Bunyavirus
Orthomyxovirus
Arenavirus
Reovirus

Front 694

what viruses are picornaviruses?
- RNA or DNA viruses?

Back 694

PERCH on a peak (pico):
Poliovirus
Echovirus
Rhinovirus
Coxsackievirus
HAV
- RNA viruses (picoRNAvirus)

Front 695

what disease does rhinovirus cause?

Back 695

common cold (rhino has a runny nose)

Front 696

what virus causes yellow fever?

Back 696

flavivirus (flavi = yellow)

Front 697

what disease does rotavirus cause?

Back 697

infantile gastroenteritis (ROTA = RIght Out The Anus)

Front 698

genetic drift vs. genetic shift - which causes epidemics and which pandemics of influenza virus?

Back 698

drift - epidemics
shift - pandemics
(Sudden Shift is more deadly than graDual Drift)

Front 699

what are the main symptoms of measles?

Back 699

3 C's:
Cough, Coryza, Conjunctivitis + Koplik's spots

Front 700

what are the main symptoms of mumps?

Back 700

Parotitis, Orchitis, aseptic Meningitis
(make your parotid glands and testes as big as POM-poms)

Front 701

name 3 arboviruses
- what are arboviruses?

Back 701

ARBOvirus = ARthropod-BOrne virus
- Flavivirus, Togavirus, Bunyavirus (Fever Transmitted by Bites)

Front 702

what type of infection does hepatitis A cause?

Back 702

hep A:
usually Asymptomatic, Acute

Front 703

how is hepatitis B transmitted?

Back 703

hep B:
Blood-borne

Front 704

what type of infection does hepatitis C cause?
- what are possible sequelae?

Back 704

hep C:
Chronic infection
can cause Cirrhosis and Carcinoma

Front 705

what does hepatitis D require to infect?

Back 705

HBV
(hep D is Defective and Dependent on HBV)

Front 706

how is hepatitis E transmitted?
- what patient population is particularly at risk?

Back 706

hep E:
Enteric (can cause Epidemics)
Expectant mothers (pregnant women) have high mortality

Front 707

which hepatitis viruses are transmitted by fecal-oral route?

Back 707

hepatitis A and E ("the vowels hit your bowels")

Front 708

what does ABcAb indicate?

Back 708

IgM HBcAb - recent disease
IgG HBcAb - chronic disease

Front 709

what does HBeAb indicate?

Back 709

HBeAb = low transmissibility
(HBeAg = high transmissibility - Beware!)

Front 710

what receptors does HIV virus bind on T cells?
- on macrophages?

Back 710

T cells - CD4 and CXCR4
macrophages - CD4 and CCR5

Front 711

4 stages of HIV infection

Back 711

1 - Flulike (acute)
2 - Feeling fine (latent)
3 - Falling CD4 count
4 - Final crisis (AIDS)

Front 712

what is Bacillus cereus contracted from?

Back 712

reheated rice (food poisoning from reheated rice? Be serious/B. cereus!)

Front 713

4 most common causes of pneumonia in children

Back 713

Runts May Cough Sputum:
RSV
Mycoplasma
Chlamydia pneumoniae
Streptococcus pneumoniae

Front 714

most common cause of pneumonia in hospitalized and immunocompromised patients

Back 714

Staphylococcus

Front 715

most common cause of aspiration pneumonia

Back 715

anaerobes

Front 716

most common cause of osteomyelitis in diabetics and drug addicts

Back 716

Pseudomonas aeruginosa

Front 717

most common cause of osteomyelitis in sickle cell patients

Back 717

Salmonella

Front 718

name 7 bacteria that cause UTIs

Back 718

SSEEK PP:
Serratia marcescens
Staphylococcus saprophyticus
Escherichia coli
Enterobacter cloacae
Klebsiella pneumoniae
Proteus mirabilis
Pseudomonas aeruginosa

Front 719

name 6 infections that are transmitted in utero or during birth

Back 719

ToRCHeS:
Toxoplasma gondii
Rubella
CMV
HIV
HSV-2
Syphilis

Front 720

what organism causes a painful genital ulcer?

Back 720

Haemophilus ducreyi (it's so painful, you do cry)

Front 721

what is Fitz-Hugh-Curtis syndrome a complication of?
- what are the characteristics?

Back 721

PID
- infection of liver capsule with "violin string" adhesions to parietal peritoneum

Front 722

what is the most common nosocomial infection caused by respiratory therapy equipment?

Back 722

Pseudomonas AERuginosa (involves AIR)

Front 723

name 6 bacteriostatic antibiotics

Back 723

we're ECSTaTiC about bacteriostatics:
Erythromycin
Clindamycin
Sulfamethoxazole
Trimethoprim
Tetracyclines
Chloramphenicol

Front 724

name 6 bactericidal antibiotics

Back 724

Very Finely Proficient At Cell Murder:
Vancomycin
Fluoroquinolones
Penicillin
Aminoglycosides
Cephalosporins
Metronidazole

Front 725

penicillin - mechanism of action?
- toxicity?

Back 725

blocks transpeptidase cross-linking of cell wall
- hypersensitivity reaction

Front 726

what class of drugs are methicillin, nafcillin, and dicloxacillin?
- what bacteria are they used for?
- side effect of methicillin?

Back 726

penicillinase-resistant penicillins
- S. aureus (but not MRSA)
- interstitial nephritis

Front 727

what class of drugs are ampicillin and amoxicillin?
- which has greater oral bioavailability?
- what Gram-negative rods do they kill?

Back 727

aminopenicillins - extended spectrum (AMPed up penicillin)
- amOxicillin has greater Oral bioavailability
- HELPS kill enterococci: Haemophilus influenzae, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella

Front 728

name 3 antipseudomonal penicillins

Back 728

Ticarcillin, Carbenicillin, Piperacillin (TCP = Takes Care of Pseudomonas)

Front 729

what Gram-negatives are covered by 1st generation cephalosporins?
- by 2nd generation?

Back 729

1st: PEcK = Proteus mirabilis, E. coli, Klebsiella pneumoniae
2nd: HEN PEcKS = Haemophilus influenzae, Enterobacter aerogenes, Neisseria, Proteus mirabilis, E. coli, Klebsiella pneumoniae, Serratia marcescens

Front 730

side effect of cephalosporins

Back 730

disulfiram-like reaction with ethanol

Front 731

beta-lactamase-resistant monobactam
- what does it treat?
- who is it used for?

Back 731

aztreonam
- Gram-negative rods
- penicillin-allergic patients

Front 732

what is imipenem always administered with?
- why?

Back 732

cilastatin - inhibits renal dihydropeptidase I and decreases renal inactivation of imipenem (with imipenem, the kill is LASTIN with ciLASTATIN)

Front 733

side effects of carbapenems

Back 733

seizures, GI distress, rash

Front 734

vancomycin - mechanism of action?
- side effects?

Back 734

binds D-Ala-D-Ala on cell wall and blocks cell wall mucopeptide formation
- NOT many: Nephrotoxicity, Ototoxicity, Thrombophlebitis, red man syndrome

Front 735

what antibiotics block 30S and 50S ribosomal subunits?

Back 735

buy AT 30, CCELL at 50:
30S: Aminoglycosides, Tetracyclines
50S: Chloramphenicol, Clindamycin, Erythromycin, Lincomycin, Linezolid

Front 736

name 5 aminoglycosides
- mechanism of action?
- anaerobe coverage?
- side effects?

Back 736

mean GNATS: Gentamycin, Neomycin, Amikacin, Tobramycin, Streptomycin
- inhibit formation of 30S initiation complex
- no anaerobe coverage
- canNOT kill anaerobes: Nephrotoxicity, Ototoxicity, Teratogen

Front 737

uses of demeclocycline

Back 737

antibiotic
ADH antagonist (Demeclocycline = Diuretic in SIADH)

Front 738

tetracyclines - mechanism of action?
- what are they used for?
- side effects?

Back 738

block attachment of aminoacyl-tRNA to 30S
- VACUUM THe BedRoom: Vibro cholerae, Acne, Chlamydia, Ureaplasma Urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Borrelia burgdorferi, Rickettsia
- discolor teeth and inhibit bone growth, photosensitivity

Front 739

which tetracycline can be used in patients with renal failure? why?

Back 739

doxycycline - fecally eliminated

Front 740

chloramphenicol - mechanism of action?
- use?
- side effects?

Back 740

blocks 50S peptidyltransferase activity
- meningitis
- aplastic anemia, gray baby syndrome

Front 741

what two drugs are mainly used to treat anaerobes, and where?

Back 741

clindamycin - for anaerobes above the diaphragm
metronidazole - for anaerobes below the diaphragm

Front 742

clindamycin - mechanism of action?
- use?
- side effect?

Back 742

blocks 50S peptide bond formation
- anaerobes
- pseudomembranous colitis

Front 743

sulfonamides - mechanism of action?
- side effects?

Back 743

inhibit dihydropteroate synthetase (involved in folate synthesis)
- hemolysis in G6PD deficiency, nephrotoxicity, photosensitivity

Front 744

trimethoprim - mechanism of action?
- side effect? how can it be alleviated?

Back 744

inhibits dihydrofolate reductase (folate synthesis)
- bone marrow suppression (TMP = Treats Marrow Poorly) - alleviate with folinic acid

Front 745

fluoroquinolones - mechanism of action?
- side effects?

Back 745

inhibit DNA gyrase
- damage to cartilage, tendonitis, tendon rupture (fluoroquinoLONES hurt attachments to your BONES)

Front 746

what bacteria are treated with metronidazole?
- side effects?

Back 746

GET GAP on the metro:
Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes, H. Pylori
- disulfiram-like reaction with alcohol, metallic taste

Front 747

polymyxins - mechanism of action?
- side effects?

Back 747

act like detergents - bind and disrupt cell membranes of bacteria ('MYXins MIX up membranes)
- neurotoxicity, acute renal tubular necrosis

Front 748

solo prophylaxis against M. tuberculosis

Back 748

isoniazid

Front 749

anti-TB drugs
- side effect for all?
- side effect of ethambutol?

Back 749

INH-SPIRE: Streptomycin, Pyrazinamide, Isoniazid, Rifampin, Ethambutol
- hepatotoxicity
- ethambutol causes red-green color blindness

Front 750

isoniazid - mechanism of action?
- side effects?

Back 750

blocks synthesis of mycolic acids
- neurotoxicity, hepatotoxicity (INH Injures Neurons and Hepatocytes)

Front 751

rifampin - mechanism of action?
- side effects?

Back 751

4 R's:
RNA polymerase inhibitor
Revs up microsomal P-450
Red/orange body fluids
Rapid resistance if used alone

Front 752

treatment of MRSA

Back 752

vancomycin

Front 753

treatment of vancomycin-resistant enterococcus

Back 753

linezolid and streptogramins (quinupristin/dalfopristin)

Front 754

amphotericin B - mechanism of action?
- side effects?

Back 754

binds ergosterol and forms membrane pores (amphotericin "tears" holes in the membrane)
- fever/chills, nephrotoxicity, arrhythmias, anemia, IV phlebitis

Front 755

nystatin - mechanism of action?

Back 755

binds ergosterol and disrupts fungal membranes

Front 756

azoles - mechanism of action?
- side effects?

Back 756

inhibit fungal ergosterol synthesis
- gynecomastia, inhibit cytochrome P-450

Front 757

what drug is used to treat cryptococcal meningitis? why?

Back 757

fluconazole - can cross blood-brain barrier

Front 758

flucytosine - mechanism of action?
- use?
- side effect?

Back 758

blocks DNA synthesis
- systemic fungal infections
- bone marrow suppression

Front 759

caspofungin - mechanism of action?

Back 759

blocks synthesis of beta-glucan (part of fungal cell wall)

Front 760

terbinafine - mechanism of action?

Back 760

inhibits fungal squalene epoxidase (part of ergosterol synthesis)

Front 761

griseofulvin - mechanism of action?

Back 761

blocks mitosis by interfering with microtubule function

Front 762

amantadine - mechanism of action?
- used to treat?
- side effects?

Back 762

blocks viral uncoating (a man to dine takes off his coat), increases dopamine release
- Amantadine - used to treat influenza A and rubellA and Parkinson's
- ataxia, slurred speech (causes problems with the cerebellA)

Front 763

zanamavir/oseltamavir - mechanism of action?

Back 763

inhibit influenza neuraminidase

Front 764

ribavirin - mechanism of action?
- used for?
- side effect?

Back 764

inhibits IMP dehydrogenase (blocks nucleotide synthesis)
- RSV, chronic hepatitis C
- hemolytic anemia

Front 765

acyclovir - mechanism of action?
- used for?

Back 765

GTP analog - inhibits viral DNA polymerase
- HSV, VZV, EBV

Front 766

ganciclovir - mechanism of action?
- used for?
- side effects?

Back 766

GTP analog - inhibits viral DNA polymerase
- CMV
- leukopenia, neutropenia, thrombocytopenia

Front 767

foscarnet - mechanism of action?
- how is it unlike acyclovir and ganciclovir?
- side effect?

Back 767

pyrophosphate analog (FOScarnet = pyroFOSphate analot) - viral DNA polymerase inhibitor
- does not need to be activated by viral kinase to work
- nephrotoxic

Front 768

what class of drugs are saquinavir, ritonavir, indinavir, etc.?
- side effects?

Back 768

HIV protease inhibitors (NAVIR TEASE a proTEASE)
- hyperglycemia, lipodystrophy

Front 769

what class of drugs are zidovudine, didanosine, zalcitabine, stavudine, etc.?

Back 769

HIV nucleoside reverse transcriptase inhibitors (have you dined/vudine with my nuclear/nucleoside family?)

Front 770

name 3 HIV non-nucleoside reverse transcriptase inhibitors

Back 770

Never Ever Deliver nucleosides:
Nevirapine
Efavirenz
Delavirdine

Front 771

side effects of HIV reverse transcriptase inhibitors

Back 771

bone marrow suppression, peripheral neuropathy, lactic acidosis, rash, megaloblastic anemia

Front 772

name an HIV fusion inhibitor
- mechanism of action?

Back 772

enfuvirtide - binds viral gp41 and blocks conformational change necessary for fusion with CD4

Front 773

antibiotics to avoid in pregnancy

Back 773

SAFE Moms Take Really Good Care:
Sulfonamides
Aminoglycosides
Fluoroquinolones
Erythromycin
Metronidazole
Tetracyclines
Ribavirin
Griseofulvin
Chloramphenicol

Front 774

where do T cells and B cells mature?

Back 774

T cells = Thymus
B cells = Bone marrow

Front 775

what HLA genes encode MHC I?
- MHC II?

Back 775

MHC I - A, B, C (HLA I letter)
MHC II - DR, DP, DQ (HLA II letters)

Front 776

location of MHC I vs. II

Back 776

MHC I - on all nucleated cells
MHC II - only on APCs

Front 777

cytotoxic vs. helper T cells - which has CD4 and which has CD8?
- which MHC class do they each bind to?

Back 777

cytotoxic T cells - CD8 (binds MHC I)
helper T cells - CD4 (binds MHC II)
(product of CD and MHC = 8)

Front 778

what are the 2 signals needed for Th cell activation?

Back 778

1. MHC II presents antigen to TCR
2. B7 on APC binds CD28 on T cell

Front 779

what are the 2 signals needed for Tc cell activation?

Back 779

1. MHC I presents antigen to TCR
2. IL-2 from Th cell signals Tc cell to kill

Front 780

what are the 2 signals needed for B cell class switching?

Back 780

1. IL-4, IL-5, or IL-6 from Th2 cell
2. CD40 receptor on B cell binds CD40 ligand on Th cell

Front 781

characteristics of Fc portion of antibody

Back 781

Constant
Carboxy terminal of heavy chain
Complement-binding area
Carbohydrate side chains

Front 782

3 functions of antibodies

Back 782

1. opsonization
2. neutralization
3. complement activation (enhances opsonization and lysis of antigen)

Front 783

which immunoglobulin is found in mucous membrane secretions?

Back 783

IgA

Front 784

which immunoglobulin can be a dimer?
- which a pentamer?

Back 784

dimer: IgA
pentamer: IgM

Front 785

which immunoglobulin mediates type I hypersensitivity?

Back 785

IgE

Front 786

what is an Ig allotype?
- isotype?
- idiotype?

Back 786

allotype - epitope that differs among members of the same species (ALLotypes = different ALLeles)
isotype - epitope common to a single class of Ig
idiotype - epitope determined by antigen-binding site

Front 787

what is a thymus-independent antigen?
- what type of Ig is secreted in response?

Back 787

no peptide component
- IgM only (can't be presented on MHC to T cells, so no T cell activation of B cells for class switching)

Front 788

what are the functions of IL-1-5?

Back 788

hot T-Bone stEAk:
IL-1 - inflammatory response, fever (hot)
IL-2 - stimulates T cells
IL-3 - stimulates Bone marrow
IL-4 - stimulates IgE production
IL-5 - stimulates IgA production

Front 789

what is the function of IL-8?
- what is it secreted by?

Back 789

recruits neutrophils to clear infections (clean up on aisle 8)
- secreted by macrophages

Front 790

what activates the classic complement pathway?

Back 790

IgG or IgM (GM makes classic cars)

Front 791

what is the function of decay-accelerating factor (DAF) and C1 esterase inhibitor?
- what does deficiency of each cause?

Back 791

prevent complement activation on self-cells
- deficiency of C1 esterase inhibitor - hereditary angioedema
- deficiency of DAF - paroxysmal nocturnal hemoglobinuria (complement-mediated lysis of RBCs)

Front 792

what is the function of C3b?

Back 792

opsonization (C3b Binds Bacteria)

Front 793

what is the function of C3a and C5a?

Back 793

C3a, C5a - Anaphylaxis

Front 794

what does deficiency of C5-C8 predispose to?

Back 794

Neisseria bacteremia

Front 795

what are the functions of interferons?

Back 795

interferons interfere with virus activity in uninfected cells:
- alpha- and beta-interferons cause production of viral protein-inhibiting ribonuclease
- gamma-interferons stimulate MHC I and II expression
- also activate NK cells

Front 796

with what infections are patients given preformed antibodies (passive immunity)?

Back 796

given antibodies To Be Healed Rapidly:
Tetanus toxin
Botulinum toxin
HBV
Rabies virus

Front 797

what cytokine plays a major role in granulomas?
- what secretes it?
- what does it do?

Back 797

IFN-gamma
- secreted by Th1 cells
- stimulates macrophages

Front 798

what are the 4 types of hypersensitivity reactions?

Back 798

ACID:
I - Anaphylactic and Atopic
II - Cytotoxic (antibody-mediated)
III - Immune complex
IV - Delayed (cell-mediated)

Front 799

what is serum sickness?
- what type of hypersensitivity reaction?
- how is the Arthus reaction different?

Back 799

antibodies to foreign serum protein or drug form - immune complexes deposit in tissues and fix complement - tissue damage
- type III hypersensitivity
- Arthus reaction - local intradermal injection of antigen, so complexes formed locally in skin

Front 800

what initiates type IV hypersensitivity reactions?
- give 3 examples

Back 800

4 T's:
T lymphocytes
- Transplant rejections, TB skin tests, Touching (contact dermatitis)

Front 801

what is the defect in Bruton's agammaglobulinemia?
- what is the major symptom?
- what is the inheritance pattern?

Back 801

defect in tyrosine kinase gene - causes decreased production of B cells
- recurrent Bacterial infections after maternal IgG levels decline
- X-linked recessive (affects Boys)

Front 802

what is the defect in severe combined immunodeficiency?

Back 802

defect in early stem-cell differentiation - decreased production of B and T cells

Front 803

what causes hyper-IgM syndrome?

Back 803

defect in CD40 ligand on Th2 cells - inability to class switch

Front 804

what is the defect in Wiskott-Aldrich syndrome?
- what are the main symptoms?

Back 804

defect in ability to mount IgM response - low IgM, high IgE and IgA (Aldrich)
- WIPE: recurrent Infections, thrombocytopenic Purpura, Eczema

Front 805

what is the defect in Job's syndrome?
- symptoms?

Back 805

failure of IFN-gamma production, so no neutrophil chemotaxis
- FATED: coarse Facies, cold staphylococcal Abscesses, retained primary Teeth, increased IgE, Dermatologic problems

Front 806

what is the defect in Chediak-Higashi syndrome?

Back 806

defect in microtubule function and thus lysosomal emptying of phagocytic cells

Front 807

what is the defect in chronic granulomatous disease?

Back 807

lack of NADPH oxidase - defect in microbicidal activity of neutrophils

Front 808

what is the defect in chronic mucocutaneous candidiasis?

Back 808

T-cell dysfunction, specifically against Candida albicans

Front 809

what is the defect in ataxia-telangiectasia?

Back 809

defect in DNA repair enzymes with associated IgA deficiency

Front 810

what is the defect in common variable immunodeficiency?

Back 810

defect in B cell maturation - normal number of circulating B cells, but decreased plasma cells

Front 811

what diseases are associated with HLA-B27?

Back 811

PAIR:
Psoriasis
Ankylosing spondylitis
Inflammatory bowel disease
Reiter's syndrome

Front 812

cyclosporine - mechanism of action?
- side effects?

Back 812

inhibits calcineurin, preventing production of IL-2 (blocks T cell activation)
- susceptibility to infection, nephrotoxic

Front 813

tacrolimus - mechanism of action?
- side effects?

Back 813

binds FK-binding protein, inhibiting IL-2 secretion (blocks T cell activation)
- nephrotoxic, peripheral neuropathy

Front 814

azathioprine - mechanism of action?
- side effects?
- what is the effect of simultaneous allopurinol?

Back 814

blocks nucleic acid synthesis - toxic to proliferating lymphocytes
- bone marrow suppression
- increased toxicity (since drug is metabolized by xanthine oxidase)

Front 815

muromonab - mechanism of action?

Back 815

binds CD3 on T cell surface and blocks T cell signal transduction

Front 816

sirolimus - mechanism of action?
- side effects?

Back 816

binds mTOR and blocks T cell proliferation in response to IL-2
- hyperlipidemia, thrombocytopenia, leukopenia

Front 817

mycophenolate mofetil - mechanism of action?

Back 817

inhibits de novo guanine synthesis - blocks lymphocyte production

Front 818

daclizumab - mechanism of action?

Back 818

binds IL-2 receptor on activated T cells

Front 819

loading dose equation
- maintenance dose equation

Back 819

loading = Cp x Vd/F
maintenance = Cp x Cl/F

Front 820

name 3 zero-order elimination drugs

Back 820

PEA (pea is round, like 0):
Phenytoin
Ethanol
Aspirin

Front 821

therapeutic index equation

Back 821

TILE:
TI = LD50/ED50
(LD50 = median lethal dose, ED50 = median effective dose)

Front 822

what G-protein class is associated with each receptor type?

Back 822

qiss and qiq till you're siq of sqs:
qiss = alpha1, alpha2, beta1, beta2
qiq = M1, M2, M3
siq = D1, D2, H1
sqs = H2, V1, V2

Front 823

bethanechol - mechanism of action?
- used for?

Back 823

muscarinic agonist
- used for postoperative ileus and urinary retention - activates Bowel and Bladder smooth muscle (Beth Anne, call me if you want to activate your Bowels and Bladder)

Front 824

pilocarpine - mechanism of action?
- used for?

Back 824

muscarinic agonist
- stimulates sweat, tears, saliva (PILocarpine - PILE on the sweat and tears)

Front 825

methacholine - mechanism of action?
- used for?

Back 825

muscarinic agonist
- challenge test for diagnosing asthma (bronchoconstricts)

Front 826

neostigmine and pyridostigmine - mechanism of action?
- used for?
- CNS penetration?

Back 826

anticholinesterases
- myasthenia gravis
- NO CNS penetration (NEO CNS)

Front 827

physostigmine - mechanism of action?
- used for?

Back 827

anticholinesterase
- glaucoma (PHYS is for EYES)

Front 828

echothiophate - mechanism of action?
- used for?

Back 828

anticholinesterase
- glaucoma

Front 829

symptoms of cholinesterase inhibitor poisoning
- what is the antidote?

Back 829

DUMBBELSS:
Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, Salivation
- antidote: atropine + pralidoxime (regenerates cholinesterase)

Front 830

benztropine - mechanism of action?
- used for?

Back 830

muscarinic antagonist
- PARKinson's disease (PARK my BENZ)

Front 831

scopolamine - mechanism of action?
- used for?

Back 831

muscarinic antagonist
- motion sickness

Front 832

ipratropium - mechanism of action?
- used for?

Back 832

muscarinic antagonist
- asthma, COPD (I pray/ipra- I can breathe soon)

Front 833

oxybutynin, glycopyrrolate - mechanism of action?
- used for?

Back 833

muscarinic antagonists
- reduce bladder urgency/spasms

Front 834

methscopolamine, pirenzepine, propantheline - mechanism of action?
- used for?

Back 834

muscarinic antagonists
- peptic ulcer treatment

Front 835

atropine - mechanism of action?
- side effects?

Back 835

muscarinic antagonist
- hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter

Front 836

hexamethonium - mechanism of action?

Back 836

nicotinic antagonist (put a HEX on smokers/nicotine) - ganglionic blocker

Front 837

what are low doses of epinephrine selective for?

Back 837

beta1 receptors (Blow - low = beta1)

Front 838

what is norepinephrine selective for?

Back 838

alpha > beta1 (NO beta2 activity)

Front 839

what is isoproterenol selective for?

Back 839

beta receptors only

Front 840

dobutamine - mechanism of action?

Back 840

beta1 agonist

Front 841

phenylephrine - mechanism of action?

Back 841

alpha1 agonist

Front 842

albuterol and terbutaline - mechanism of action?

Back 842

beta2 agonists

Front 843

ritodrine - mechanism of action?
- used for?

Back 843

beta2 agonist
- reduces premature uterine contractions

Front 844

amphetamine and ephedrine - mechanism of action?

Back 844

indirect sympathetic agonists - release stored catecholamines

Front 845

cocaine - mechanism of action?

Back 845

indirect sympathetic agonist - catecholamine uptake inhibitor

Front 846

clonidine and alpha-methyldopa - mechanism of action?
- used for?

Back 846

alpha2 agonists
- hypertension

Front 847

name 4 selective beta2 agonists

Back 847

MAST:
Metaproterenol
Albuterol
Salmeterol
Terbutaline

Front 848

phenoxybenzamine and phentolamine - mechanism of action?
- used for?
- what is the difference?

Back 848

nonselective alpha blockers
- pheochromocytoma
- phenoxybenzamine is irreversible, phentolamine is reversible

Front 849

prazosin, terazosin, doxazosin - mechanism of action?

Back 849

selective alpha1 blockers

Front 850

mirtazapine - mechanism of action?
- used for?

Back 850

selective alpha2 blocker
- depression

Front 851

name 5 selective beta1 antagonists

Back 851

A BEAM of beta1 blockers:
Acebutolol
Betaxolol
Esmolol
Atenolol
Metoprolol

Front 852

name 2 non-selective alpha and beta antagonists

Back 852

carvedilol, labetalol

Front 853

name 2 partial beta agonists

Back 853

Partial beta Agonists:
Pindolol
Acebutolol

Front 854

antidote for methemoglobin toxicity

Back 854

METHylene blue (for METHemoglobin), vitamin C

Front 855

symptoms of lead poisoning
- treatment?

Back 855

LEAD:
Lead Lines on gingivae (Burton's lines)
Encephalopathy, Erythrocyte basophilic stippling
Abdominal colic, sideroblastic Anemia
Drops (wrist and foot drop)
- treatment: dimercaprol and EDTA, succimer for kids (it sucks to be a kid with lead poisoning)

Front 856

drugs that cause atropine-like side effects

Back 856

tricyclics

Front 857

name 2 drugs that cause coronary vasospasm

Back 857

cocaine, sumatriptan

Front 858

drugs that cause cutaneous flushing

Back 858

niacin, calcium channel blockers, adenosine, vancomycin

Front 859

name 2 drugs that cause dilated cardiomyopathy

Back 859

doxorubicin, daunorubicin

Front 860

drugs that cause torsades de pointes

Back 860

class III (sotalol) and IA (quinidine) antiarrhythmics, cisapride

Front 861

name 5 drugs that cause agranulocytosis

Back 861

clozapine, carbamazepine, colchicine, propylthiouracil, methimazole

Front 862

drugs that cause aplastic anemia

Back 862

chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole

Front 863

what drug causes a direct Coombs-positive hemolytic anemia?

Back 863

methyldopa

Front 864

what drug causes gray baby syndrome?

Back 864

chloramphenicol

Front 865

drugs that cause hemolysis in G6PD deficient patients

Back 865

hemolysis IS PAIN:
Isoniazid
Sulfonamides
Primaquine
Aspirin
Ibuprofen
Nitrofurantoin

Front 866

drugs that cause megaloblastic anemia

Back 866

having a blast with PMS:
Phenytoin
Methotrexate
Sulfa drugs

Front 867

what drugs cause thrombotic complications?

Back 867

OCPs (estrogens/progestins)

Front 868

what drugs cause cough?

Back 868

ACE inhibitors

Front 869

name 3 drugs that cause pulmonary fibrosis

Back 869

bleomycin, busulfan, amiodarone

Front 870

what drugs cause acute cholestatic hepatitis?

Back 870

macrolides

Front 871

name 3 drugs that cause hepatic necrosis

Back 871

halothane, valproic acid, acetaminophen

Front 872

what drug causes hepatitis?

Back 872

isoniazid

Front 873

name 2 drugs that cause pseudomembranous colitis

Back 873

clindamycin, ampicillin

Front 874

name 6 drugs that cause gynecomastia

Back 874

Some Drugs Create Awesome Knockers:
Spironolactone
Digitalis
Cimetidine
Alcohol
Ketoconazole
estrogens

Front 875

name 2 drugs that cause hot flashes

Back 875

tamoxifen, clomiphene

Front 876

what drug causes gingival hyperplasia?

Back 876

phenytoin

Front 877

what drugs cause gout?

Back 877

furosemide, thiazides

Front 878

what drugs cause osteoporosis?

Back 878

corticosteroids, heparin

Front 879

what drugs cause photosensitivity?

Back 879

SAT for a photo:
Sulfonamides
Amiodarone
Tetracycline

Front 880

what drugs cause Stevens-Johnson syndrome?

Back 880

ethosuximide, lamotrigine, carbamazepine, phenobarbital, phenytoin, sulfa drugs, penicillin, allopurinol

Front 881

name 4 drugs that cause SLE-like syndrome

Back 881

it's not HIPP to have lupus:
Hydralazine
Isoniazid
Procainamide
Phenytoin

Front 882

what drugs cause tendonitis, tendon rupture, and cartilage damage?

Back 882

fluoroquinolones

Front 883

what drug causes Fanconi's syndrome?

Back 883

expired tetracycline

Front 884

what drugs cause interstitial nephritis?

Back 884

methicillin, NSAIDs, furosemide

Front 885

name 2 drugs that cause hemorrhagic cystitis
- how can you prevent this?

Back 885

cyclophosphamide, ifosfamide
- prevent with mesna

Front 886

name 2 drugs that cause cinchonism

Back 886

quinidine, quinine

Front 887

name 2 drugs that cause diabetes insipidus

Back 887

lithium, demeclocycline

Front 888

name 4 drugs that cause a Parkinson-like syndrome

Back 888

haloperidol, chlorpromazine, reserpine, metoclopramide

Front 889

name 3 drugs that cause seizures

Back 889

bupropion, imipenem/cilastatin, isoniazid

Front 890

what drugs cause tardive dyskinesia?

Back 890

antipsychotics

Front 891

what drugs cause a disulfiram-like reaction?

Back 891

metronidazole, 1st generation sulfonylureas, certain cephalosporins, procarbazine

Front 892

what drugs are nephrotoxic and neurotoxic?

Back 892

polymyxins

Front 893

what drugs are nephrotoxic and ototoxic?

Back 893

aminoglycosides, vancomycin, loop diuretics, cisplatin

Front 894

name 7 drugs that are P-450 inducers

Back 894

Queen Barb Steals Phen-phen and Refuses Greasy Carbs:
Quinidine
Barbiturates
St. John's wort
Phenytoin
Rifampin
Griseofulvin
Carbamazine

Front 895

name 6 drugs that are P-450 inhibitors

Back 895

inhibit yourself from drinking from a KEG because you'll get SICk:
Sulfonamides
Isoniazid
Cimetidine
Ketoconazole
Erythromycin
Grapefruit juice

Front 896

transudate vs. exudate

Back 896

transudate is hypocellular and protein poor
exudate is cellular and protein rich

Front 897

what receptors mediate tight neutrophil binding to endothelium?

Back 897

ICAM-1 on endothelium binds integrin on leukocyte
(hold on tight to your CAMera)

Front 898

what is AL amyloid derived from?
- AA amyloid?
- A-CAL amyloid?

Back 898

AL = Light chains (multiple myeloma)
AA = Acute-phase reactant (chronic inflammatory disease)
A-CAL = calcitonin (medullary carcinoma of the thyroid)

Front 899

tumor grade vs. stage
- which is more prognostic?

Back 899

grade = degree of differentiation
Stage = degree of Spread
- stage is more prognostic

Front 900

what tumor type is l-myc gene associated with?

Back 900

L-myc = Lung tumor

Front 901

what tumor type is n-myc gene associated with?

Back 901

N-myc = Neuroblastoma

Front 902

what gene is associated with melanoma? what chromosome is it on?

Back 902

p16 on 9p (melaNoma is on Nine)

Front 903

what chromosome is NF2 on?

Back 903

22q (type 2 = 22)

Front 904

what cancer is DPC gene associated with?

Back 904

pancreatic cancer (Deleted in Pancreatic Cancer)

Front 905

what cancer is DCC gene associated with?

Back 905

colon cancer (Deleted in Colon Cancer)

Front 906

what tumor types are associated with elevated beta-hCG?

Back 906

HCG:
Hydatidiform moles
Choriocarcinomas
Gestational trophoblastic tumors

Front 907

what does TRAP stain test for?

Back 907

hairy cell leukemia (TRAP the hairy animal)

Front 908

name 4 tumors that have psammoma bodies

Back 908

PSaMMoma:
Papillary adenocarcinoma of thyroid
Serous papillary cystadenocarcinoma of ovary
Meningioma
Mesothelioma

Front 909

what primary tumors metastasize to brain?

Back 909

Lots of Bad Stuff Kills Glia:
Lung, Breast, Skin, Kidney, GI

Front 910

what primary tumors metastasize to liver?

Back 910

Cancer Sometimes Penetrates Benign Liver:
Colon, Stomach, Pancreas, Breast, Lung

Front 911

what primary tumors metastasize to bone?
- are lung, prostate, and breast tumors osteoblastic or osteolytic?

Back 911

P.T. Barnum Loves Kids:
Prostate, Thyroid, Testes, Breast, Lung, Kidney
- Lung = Lytic
- prostate = blastic
- Breast = Both

Front 912

case-control vs. cohort study
- do they use odds ratio or relative risk?

Back 912

case-control - compare group with disease to those without (retrospective)
- odds ratio
cohort - compare group with risk factor to those without (prospective)
- relative risk

Front 913

sensitivity vs. specificity

Back 913

sensitivity - how well a test identifies truly ill people (SNOUT - rules OUT)
specificity - how well a test identifies truly well people (SPIN - rules IN)

Front 914

positive predictive value vs. negative predictive value

Back 914

PPV - proportion of positive tests that are true positives
NPV - proportion of negative tests that are true negatives

Front 915

prevalence vs. incidence

Back 915

prevalence = percent of people affected in a population
incidence = new incidents in a given time period/total population at risk

Front 916

type I vs. type II error

Back 916

type I (alpha) - saying that there is a difference when none exists (you "saw" a difference)
type II (beta) - saying there is not a difference when one exists (you did not "see" a difference)

Front 917

t-test vs. ANOVA vs. chi-squared

Back 917

t-test - difference between 2 means
ANOVA - difference between 3+ means
chi-squared - difference between percentages or proportions of categorical outcomes (not means)

Front 918

types of disease prevention

Back 918

PDR:
primary - Prevent disease occurrence
secondary - Detect disease early
tertiary - Reduce disability from disease

Front 919

name some reportable diseases

Back 919

Hep Hep Hep Hooray, the SSSMMART Chick is Gone:
Hep A, Hep B, Hep C
HIV
Salmonella, Shigella, Syphilis
Measles, Mumps
AIDS
Rubella
Tuberculosis
Chickenpox
Gonorrhea

Front 920

4 things required for a malpractice claim to be valid

Back 920

4 D's:
Duty of physician to patient
Dereliction - physician breached duty
Damage to patient
Direct - breach of duty caused harm directly

Front 921

what does Apgar score evaluate?

Back 921

Appearance, Pulse, Grimace, Activity, Respiration

Front 922

what are the verbal milestones at age 2?

Back 922

200 words and 2 word sentences at age 2

Front 923

at what age does toilet training take place?

Back 923

age 3 (pee at age 3)

Front 924

how many blocks can be stacked at 1, 2, and 3 years?

Back 924

3 at age 1, 6 at age 2, 9 at age 3 (age in years x 3)

Front 925

at what age can a child ride a tricycle?

Back 925

age 3 (3-cycle)

Front 926

what are the Kubler-Ross grief stages?

Back 926

Denial, Anger, Bargaining, Grieving, Acceptance
(Death Arrives Bringing Grave Adjustments)

Front 927

what EEG waveforms are associated with the different sleep stages?

Back 927

BATS Drink Blood:
Beta - awake, eyes open
Alpha - awake, eyes closed
Theta - stage 1 (light sleep)
Sleep spindles/K complexes - stage 2 (deeper)
Delta - stage 3-4 (deepest)
Beta - REM

Front 928

name 5 causes of eosinophilia

Back 928

NAACP:
Neoplastic
Asthma
Allergic processes
Collagen vascular diseases
Parasites

Front 929

what is the defect in factor V Leiden?

Back 929

mutant factor V that cannot be degraded by protein C - thrombosis

Front 930

functions of von Willebrand factor

Back 930

mediates linking of platelet Gp1b receptor to subendothelial collagen
carries and protects factor VIII

Front 931

function of GpIIb/IIIa receptor on platelets
- what upregulates it?

Back 931

platelet cohesion - binds fibrinogen and links platelets together
- ADP binding to platelet

Front 932

function of protein C

Back 932

with protein S, cleaves and inactivates factors V and VIII

Front 933

name 4 diseases that have target cells

Back 933

"HALT," said the hunter to his target:
HbC disease
Asplenia
Liver disease
Thalassemia

Front 934

name 4 diseases that have basophilic stippling:

Back 934

TAIL:
Thalassemias
Anemia of chronic disease
Iron deficiency
Lead poisoning

Front 935

what are Howell-Jolly bodies?
- when are they seen?

Back 935

nuclear remnants in RBCs
- asplenia or hyposplenia

Front 936

what enzymes are affected in lead poisoning?

Back 936

ferrochelatase and ALA dehydratase

Front 937

what enzyme is affected in acute intermittent porphyria?

Back 937

uroporphyrinogen I synthase

Front 938

what enzyme is affected in porphyria cutanea tarda?

Back 938

uroporphyrinogen decarboxylase

Front 939

what are the symptoms of porphyria?

Back 939

5 P's:
Painful abdomen, Pink urine, Polyneuropathy, Psychological disturbances, Precipitated by drugs

Front 940

warm and cold agglutinins - which Ig type are they each associated with?

Back 940

warm = IgG (warm weather is Great)
cold = IgM (cold ice cream - MMM)

Front 941

name 7 causes of DIC

Back 941

STOP Making New Thrombi:
Sepsis
Trauma
Obstetric complications
acute Pancreatitis
Malignancy
Nephrotic syndrome
Transfusion

Front 942

what is the defect in ITP?

Back 942

anti-GpIIb/IIIa antibodies cause platelet destruction

Front 943

what is the defect in TTP?

Back 943

defect in vWF-cleaving enzyme - large vWF multimers increase platelet aggregation

Front 944

what is the defect in hemophilia A?

Back 944

factor VIII deficiency

Front 945

what is the defect in hemophilia B?

Back 945

factor IX deficiency

Front 946

extrinsic vs. intrinsic coagulation cascade - which bleeding time test is used to test each?

Back 946

extrinsic = PT
intrinsic = PTT

Front 947

what is the defect in Glanzmann's thrombasthenia?

Back 947

decreased GpIIb/IIIa

Front 948

what is the defect in Bernard-Soulier disease?

Back 948

decreased Gp1b

Front 949

which type of Hodgkin's lymphoma is associated with very high numbers of Reed-Sternberg cells?

Back 949

mixed cellularity type

Front 950

symptoms of multiple myeloma

Back 950

CRAB:
hyperCalcemia
Renal insufficiency
Anemia
Bone/Back pain

Front 951

which leukemia is TdT+?

Back 951

ALL (marker of pre-T and pre-B cells)

Front 952

which leukemia response to all-trans retinoic acid?
- why?

Back 952

AML - induces differentiation of myeloblasts

Front 953

which leukemia has smudge cells?

Back 953

CLL

Front 954

what distinguishes leukemoid reaction from leukemia?

Back 954

leukocyte alkaline phosphatase level (only secreted by normal benign leukocytes - so only in leukemoid reaction)

Front 955

what is the defect in Langerhans cell histiocytoses?
- what is a characteristic EM finding?

Back 955

proliferative disorder of dendritic cells (Langerhans cells)
- Birbeck granules (look like tennis rackets)

Front 956

what condition are teardrop cells found in?

Back 956

myelofibrosis

Front 957

heparin - mechanism of action?
- side effects?
- use what to rapidly reverse?

Back 957

activates antithrombin III
- bleeding, HIT
- protamine sulfate

Front 958

what tests are used to monitor heparin and warfarin?

Back 958

heparin - PTT
warfarin - PT (the EX-PresidenT went to WAR)

Front 959

lepirudin and bivalirudin - mechanism of action?
- used for?

Back 959

directly inhibit thrombin
- HIT (heparin alternative)

Front 960

warfarin - mechanism of action?
- side effects?
- use what to rapidly reverse?

Back 960

inferferes with gamma-carboxylation of vitamin K-dependent clotting factors
- teratogenic, skin/tissue necrosis
- vitamin K and fresh frozen plasma

Front 961

name 3 thrombolytics
- mechanism of action?
- treat toxicity with what?

Back 961

streptokinase, urokinase, tPA
- aid conversion of plasminogen to plasmin
- aminocaproic acid

Front 962

clopidogrel and ticlopidine - mechanism of action?
- side effect of ticlopidine?

Back 962

block ADP receptors, preventing GpIIb/IIIa expression
- neutropenia

Front 963

abciximab - mechanism of action?

Back 963

binds and blocks GpIIb/IIIa

Front 964

methotrexate - mechanism of action?
- used for?
- side effect? reverse with?

Back 964

inhibits dihydrofolate reductase, blocking nucleotide synthesis
- cancer, abortion, autoimmune diseases
- myelosuppression - reverse with leucovorin

Front 965

5-fluorouracil - mechanism of action?
- side effect? reverse with?

Back 965

inhibits thymidylate synthase, blocking nucleotide synthesis
- myelosuppression - reverse with thymidine

Front 966

6-mercaptopurine - mechanism of action?
- metabolized by?

Back 966

blocks purine synthesis
- xanthine oxidase

Front 967

cytarabine - mechanism of action?

Back 967

inhibits DNA polymerase

Front 968

cyclophosphamide and ifosfamide - mechanism of action?
- side effects? reverse with?

Back 968

alkylating agents (cross-link DNA)
- myelosuppression, hemorrhagic cystitis - reverse latter with mesna

Front 969

carmustine, lomustine, semustine - class?
- mechanism of action?
- used for?

Back 969

nitrosoureas
- alkylate DNA
- brain tumors (cross blood-brain barrier)

Front 970

cisplatin and carboplatin - mechanism of action?
- side effects?

Back 970

cross-link DNA
- nephrotoxic and ototoxic

Front 971

busulfan - mechanism of action?
- side effect?

Back 971

alkylates DNA
- pulmonary fibrosis

Front 972

doxorubicin and daunorubicin - mechanism of action?
- side effect?

Back 972

intercalate in DNA
- dilated cardiomyopathy

Front 973

dactinomycin - mechanism of action?
- used for?

Back 973

intercalates in DNA
- childhood tumors (kids ACT out - dACTinomycin)

Front 974

bleomycin - mechanism of action?
- side effect?

Back 974

forms free radicals, causing DNA breaks
- pulmonary fibrosis

Front 975

hydroxyurea - mechanism of action?
- used for?

Back 975

inhibits ribonucleotide reductase, blocking DNA synthesis
- cancer, sickle cell anemia

Front 976

etoposide - mechanism of action?

Back 976

blocks topoisomerase II

Front 977

prednisone - side effects?

Back 977

Cushing-like symptoms

Front 978

tamoxifen and raloxifene - mechanism of action?
- used for?
- side effect of tamoxifen?

Back 978

estrogen receptor antagonists in breast
- estrogen-positive breast cancers
- increased risk of endometrial carcinoma (partial agonist effect)

Front 979

trastuzumab - mechanism of action?
- used for?

Back 979

monoclonal antibody against HER-2
- HER-2-positive breast cancer

Front 980

imatinib - mechanism of action?

Back 980

bcr-abl tyrosine kinase inhibitor

Front 981

vincristine and vinblastine - mechanism of action?
- side effects?

Back 981

block microtubule polymerization, blocking mitotic spindle
- vincristine - neurotoxic
- vinBLASTine - myelosuppression (BLASTs Bone marrow)

Front 982

paclitaxel - mechanism of action?

Back 982

block microtubule depolymerization (mitotic spindle can't break down)

Front 983

structures in carotid sheath

Back 983

internal jugular vein
common carotid artery
vagus nerve

Front 984

relationship between resistance and viscosity, length and vessel radius

Back 984

directly related to viscosity and length
inversely related to radius^4

Front 985

what is wide S2 splitting associated with?

Back 985

pulmonic stenosis (delayed RV emptying)

Front 986

what is fixed S2 splitting associated with?

Back 986

ASD (increased flow through pulmonic valve)

Front 987

what is paradoxical S2 splitting associated with?
- what occurs on inspiration?

Back 987

aortic stenosis (delayed LV emptying)
- P2 and A2 move closer together, eliminating the split

Front 988

murmur increases in intensity on inspiration - which side is the defect?

Back 988

right side (more blood flows into RA)

Front 989

murmur increases in intensity on expiration - which side is the defect?

Back 989

left side (more blood flows into LA)

Front 990

what causes U wave in EKG?

Back 990

hypokalemia, bradycardia

Front 991

what is the characteristic EKG finding in Wolff-Parkinson-White syndrome?
- what causes it?

Back 991

delta wave
- ventricles begin to depolarize early due to accessory bundle of Kent that bypasses AV node

Front 992

treatment for atrial fibrillation?

Back 992

warfarin

Front 993

1st degree AV block

Back 993

prolonged PR interval

Front 994

2nd degree AV block - Mobitz type I and II
- which is Wenckebach?

Back 994

type I = Wenckebach - progressive lengthening of PR interval until a QRS is dropped
type II - no lengthening of PR interval, but occasional dropped beats

Front 995

3rd degree AV block

Back 995

atria and ventricles beat independently of each other
(P waves have no relation to QRS waves)

Front 996

Cushing triad
- what is it a sign of?

Back 996

hypertension, reflex bradycardia, respiratory depression
- sign of increased intracranial pressure (constricts arterioles - cerebral hypoperfusion - sympathetic response causes HTN)

Front 997

name the 5 right-to-left congenital shunts in the heart

Back 997

5 T's:
Truncus arteriosus
Transposition of the great vessels
Tricuspid atresia
Tetralogy of Fallot
Total anomalous pulmonary venous return

Front 998

left-to-right shunts and right-to-left shunts in the heart - which has early vs. late cyanosis?

Back 998

right-to-left - early cyanosis
left-to-right - late cyanosis

Front 999

what is Eisenmenger's syndrome?

Back 999

reversal of a left-to-right shunt due to progressive pulmonary hypertension

Front 1000

what are the elements of tetralogy of Fallot?

Back 1000

PROVe:
Pulmonary stenosis
Right ventricular hypertrophy
Overriding aorta
VSD

Front 1001

location of infantile vs. adult coarctation of the aorta

Back 1001

INfantile = proximal to ductus arteriosus (IN close to heart)
aDult = Distal to Ductus arteriosus

Front 1002

what is Prinzmetal's angina?

Back 1002

angina at rest due to coronary artery spasm

Front 1003

what causes red infarcts?

Back 1003

hemorrhagic - occur in tissues with collateral circulation (liver, lungs, etc.) or due to REperfusion injury (REd)

Front 1004

what is the most specific and long-lasting marker of MI?

Back 1004

troponin

Front 1005

what is Dressler's syndrome?

Back 1005

autoimmune fibrinous pericarditis several weeks post-MI

Front 1006

causes of dilated cardiomyopathy

Back 1006

Alcohol abuse
Beriberi
Coxsackie B
Cocaine use
Chagas' disease
Doxorubicin toxicity

Front 1007

which type of dysfunction (systolic or diastolic) does each type of cardiomyopathy cause?

Back 1007

dilated - systolic
hypertrophic - diastolic
restrictive - diastolic

Front 1008

name 6 types of emboli

Back 1008

FAT BAT:
Fat
Air
Thrombus
Bacteria
Amniotic fluid
Tumor

Front 1009

what causes acute vs. subacute endocarditis?
- normal or previously damaged heart valves?

Back 1009

acute - S. aureus, affects previously normal valves
subacute - viridans strep, affects abnormal or diseased valves

Front 1010

symptoms of bacterial endocarditis

Back 1010

FROM JANE:
Fever
Roth's spots
Osler's nodes
Murmur
Janeway lesions
Anemia
Nail-bed hemorrhage
Emboli

Front 1011

what is Libman-Sacks endocarditis?

Back 1011

verrucous, sterile endocarditis associated with lupus (SLE causes LSE)

Front 1012

symptoms of rheumatic heart disease

Back 1012

FEVERSS:
Fever
Erythema marginatum
Valve damage
ESR increased
Red-hot joints (migratory polyarthritis)
Subcutaneous nodules (Aschoff bodies), St. Vitus' dance (chorea)

Front 1013

pulsus paradoxus (Kussmaul's pulse) - what is it, and what is it a sign of?

Back 1013

pulse decreases during inspiration
- due to compression of heart by cardiac tamponade, pericarditis, etc.

Front 1014

triad of findings in Wegener's granulomatosis
- marker of disease?
- treatment?

Back 1014

vasculitis, granulomas in lung, glomerulonephritis
- c-ANCA
- cyclophosphamide and corticosteroids

Front 1015

what are the p-ANCA vasculitides, and what are their characteristics?

Back 1015

microscopic polyangiitis - like Wegener's, but no granulomas
Churg-Strauss syndrome - granulomatous with eosinophilia

Front 1016

what are the symptoms of Sturge-Weber disease?

Back 1016

port-wine stain on face
leptomeningeal angiomatosis

Front 1017

what is the distinguishing feature of Henoch-Schonlein purpura?
- what organs are affected?

Back 1017

IgA
- affects skin, joints, GI

Front 1018

what size vessels are affected by Buerger's disease?
- what patients does it affect?

Back 1018

small and medium vessels
- heavy smokers

Front 1019

what patients are affected by Kawasaki disease?
- what is a common sequela?

Back 1019

kids, Asians
- coronary aneurysm

Front 1020

what is polyarteritis nodosa?
- what disease is it associated with?

Back 1020

immune complex inflammation of medium-sized muscular arteries
- hepatitis B

Front 1021

what is Takayasu's arteritis?
- symptoms?

Back 1021

granulomatous thickening of aortic arch/proximal great vessels ("pulseless disease")
- FAN MY SKIN On Wednesday: Fever, Arthritis, Night sweats, MYalgia, SKIN nodules, Ocular disturbances, Weak pulses

Front 1022

reserpine and guanethidine - mechanism of action?
- used for?

Back 1022

decrease norepinephrine release
- hypertension

Front 1023

losartan - mechanism of action?

Back 1023

angiotensin II receptor blocker

Front 1024

hydralazine - mechanism of action?
- affects arterioles or veins more?
- used for?
- side effects?

Back 1024

increases cGMP, causing smooth muscle relaxation
- arterioles
- hypertension
- lupus-like syndrome, compensatory tachycardia

Front 1025

minoxidil - mechanism of action?
- used for?
- side effect?

Back 1025

opens K+ channels, hyperpolarizing and relaxing smooth muscle
- hypertension
- hypertrichosis

Front 1026

name 3 calcium channel blockers
- mechanism of action?
- which has strongest effect on vasculature, and which on heart?
- side effects?

Back 1026

nifedipine, verapamil, diltiazem
- block voltage-dependent calcium channels of cardiac and smooth muscle
- vasculature = nifedipine, heart = verapamil
- cardiac depression, peripheral edema, constipation

Front 1027

nitroglycerin - mechanism of action?
- does it affect arteries or veins more?

Back 1027

releases NO in smooth muscle, increasing cGMP and relaxing
- veins (decreases preload)

Front 1028

nitroprusside - mechanism of action?
- used for?

Back 1028

releases NO, increasing cGMP and relaxing smooth muscle
- malignant hypertension

Front 1029

fenoldopam - mechanism of action?
- used for?

Back 1029

D1 receptor agonist - relaxes renal vascular smooth muscle
- malignant hypertension

Front 1030

diazoxide - mechanism of action?
- used for?

Back 1030

K+ channel opener - hyperpolarizes and relaxes vascular smooth muscle
- malignant hypertension

Front 1031

statins - mechanism of action?
- side effects?

Back 1031

HMG-CoA reductase inhibitors
- increased LFTs, rhabdomyolysis

Front 1032

niacin - mechanism of action?
- side effect?

Back 1032

inhibits adipose tissue lipolysis, reduces hepatic VLDL secretion
- flushing

Front 1033

cholestyramine, colestipol, colesevelam - mechanism of action?
- side effects?
- contraindicated in whom?

Back 1033

prevent intestinal reabsorption of bile acids, so liver must use cholesterol to make more
- GI discomfort, decreased absorption of fat-soluble vitamins
- patients with gallstones

Front 1034

ezetimibe - mechanism of action?

Back 1034

prevent cholesterol reabsorption in small intestine

Front 1035

gemfibrozil, clofibrate, fenofibrate - mechanism of action?
- side effects?

Back 1035

upregulate LPL, which degrades triglycerides in VLDL
- myositis, increased LFTs

Front 1036

digoxin - mechanism of action?
- effects increased by?
- antidote?

Back 1036

blocks Na+/K+-ATPase, causing increased Ca2+ in the cell (indirect inhibition of Na+/Ca2+ exchanger)
- renal failure, hypokalemia, quinidine
- normalize K+, lidocaine, anti-digoxin Fab fragments, Mg2+, cardiac pacer

Front 1037

class IA antiarrhythmics - name 3
- mechanism of action?
- effect on action potential duration?
- side effects?

Back 1037

Quinidine, Procainamide, Disopyramide (the Queen Proclaims Diso's pyramid)
- Na+ channel blockers
- increase AP duration
- quinidine - cinchonism, torsades de pointes
- procainamide - SLE-like syndrome

Front 1038

class IB antiarrhythmics - name 3
- mechanism of action?
- effect on action potential duration?

Back 1038

Lidocaine, Mexiletine, Tocainide (I'd Buy Lidy's Mexican Tacos)
- Na+ channel blockers
- decrease AP duration

Front 1039

class IC antiarrhythmics - name 3
- mechanism of action?
- effect on action potential duration?

Back 1039

flecainide, encainide, propafenone
- Na+ channel blockers
- no effect on AP duration

Front 1040

class II antiarrhythmics - mechanism of action?
- side effects?

Back 1040

beta-blockers, so block phosphorylation and activation of calcium channels
- asthma exacerbation, cardiovascular slowing, CNS sedation

Front 1041

class III antiarrhythmics - name 3
- mechanism of action?
- effect on action potential duration?
- side effects?

Back 1041

sotalol, ibutilide, amiodarone
- K+ channel blockers
- increase AP duration
- torsades de pointes; amiodarone - pulmonary fibrosis, hepatotoxicity, photodermatitis, blue corneas, hypo/hyperthyroidism (check PFTs, LFTs, and TFTs when using amiodarone)

Front 1042

class IV antiarrhythmics - name 2
- mechanism of action?
- side effects?

Back 1042

verapamil, diltiazem
- Ca2+ channel blockers
- constipation, CV slowing

Front 1043

adenosine - mechanism of action?
- used for?

Back 1043

increases K+ efflux from cells, hyperpolarizing
- AV nodal arrhythmias

Front 1044

spatial relationship of pulmonary artery to bronchus in each lung hilum

Back 1044

pulmonary artery is RALS - Right Anterior, Left Superior

Front 1045

spinal levels of structures perforating diaphragm

Back 1045

T8: IVC
T10: esophagus, vagus
T12: aorta, thoracic duct, azygous vein
(I 8 10 eggs at 12)

Front 1046

innervation of diaphragm

Back 1046

C3,4,5 (keeps the diaphragm alive) - phrenic nerve

Front 1047

muscles of inspiration during exercise

Back 1047

inSpiration = external intercostals, Scalene muscles, Sternomastoids

Front 1048

which form of hemoglobin has higher O2 affinity?

Back 1048

R (relaxed) form
(when you're Relaxed, you do your job better - carry O2)

Front 1049

left and right shifts in the oxygen hemoglobin curve are associated with what changes in O2 affinity?

Back 1049

left shift = increased affinity
right shift = decreased affinity

Front 1050

what gene is mutated in primary pulmonary hypertension?
- what does it normally do?

Back 1050

BMPR2 - normally inhibits vascular smooth muscle proliferation

Front 1051

in which situation does 100% O2 improve PO2 - airway obstruction or blood flow obstruction?

Back 1051

blood flow obstruction

Front 1052

what is the defect in chronic bronchitis?

Back 1052

increased Reid index (hypertrophy of mucus-secreting glands in bronchioles)

Front 1053

chronic bronchitis vs. emphysema - which has early and which has late-onset hypoxemia?

Back 1053

chronic bronchitis - early-onset (due to shunting because of mucus obstruction)
emphysema - late-onset (due to eventual loss of capillary beds)

Front 1054

obstructive vs. restrictive lung disease - high or low FEV1/FVC ratio?

Back 1054

obstructive - low FEV1/FVC
restrictive - high FEV1/FVC

Front 1055

what is the defect in neonatal respiratory distress syndrome?

Back 1055

surfactant deficiency

Front 1056

what is the defect in acute respiratory distress syndrome?

Back 1056

alveolar damage by many different causes leads to protein-rich leakage into air spaces

Front 1057

bronchial obstruction vs. tension pneumothorax - which way does the trachea deviate?

Back 1057

bronchial obstruction - toward lesion
tension pneumothorax - away from lesion

Front 1058

complications of lung cancer

Back 1058

SPHERE of complications:
Superior vena cava syndrome
Pancoast's tumor
Horner's syndrome
Endocrine (paraneoplastic)
Recurrent laryngeal symptoms (hoarseness)
Effusions (pleural or pericardial)

Front 1059

squamous cell carcinoma of lung - location?
- major risk factor?
- paraneoplastic syndrome?

Back 1059

central (Squamous = Sentral)
- Smoking
- PTH-related peptide

Front 1060

most common lung cancer in females and nonsmokers

Back 1060

adenocarcinoma

Front 1061

small cell carcinoma of lung - location?
- paraneoplastic syndromes?

Back 1061

central (Small = Sentral)
- ACTH or ADH, Lambert-Eaton syndrome

Front 1062

what do carcinoid tumors secrete?

Back 1062

serotonin

Front 1063

Pancoast's tumor - location?
- consequence?

Back 1063

apex of lung
- compresses cervical sympathetic plexus, causing Horner's syndrome

Front 1064

name 3 1st generation H1 blockers
- side effects?

Back 1064

diphenhydramine, dimenhydrinate, chlorpheniramine
- sedation, antimuscarinic, anti-alpha-adrenergic

Front 1065

name 3 2nd generation H1 blockers
- advantage over 1st generation?

Back 1065

loratadine, fexofenadine, cetirizine
- less sedating - decreased entry into CNS

Front 1066

which beta2-agonist is used in acute asthma attacks vs. long-term control?

Back 1066

albuterol - acute
salmeterol - long-acting

Front 1067

theophylline - mechanism of action?
- side effects?

Back 1067

inhibits phosphodiesterase, decreasing cAMP hydrolysis - so increased cAMP leads to bronchodilation
- cardiotoxic, neurotoxic

Front 1068

cromolyn - mechanism of action?
- used for?

Back 1068

prevents release of mast cell contents
- asthma prophylaxis (not acute attacks)

Front 1069

zileuton - mechanism of action?
- used for?

Back 1069

blocks conversion of arachidonic acid to leukotrienes
- asthma

Front 1070

zafirlukast, montelukast - mechanism of action?
- used for?

Back 1070

block leukotriene receptors
- asthma

Front 1071

guaifenesin - used for?

Back 1071

expectorant - removes excess sputum

Front 1072

what is secreted by each layer of the adrenal glands?

Back 1072

zona glomerulosa - aldosterone (salt)
zona fasciculata - cortisol (sugar)
zona reticularis - sex hormones (sex)
medulla - catecholamines

Front 1073

name the hormones secreted by the anterior pituitary
- which are secreted from basophils?

Back 1073

FLAT PiG - FSH, LH, ACTH, TSH, prolactin, GH
- B-flat - FSH, LH, ACTH, TSH are secreted by basophils

Front 1074

what hormones are secreted by the different pancreatic islet cells?
- where is each cell type located?

Back 1074

alpha - glucagon (peripheral)
beta - insulin (central - INSulin INSide)
delta - somatostatin (interspersed)

Front 1075

prolactin regulation - what upregulates it, what inhibits it, and what does it upregulate and inhibit?

Back 1075

upregulated by TRH
inhibited by dopamine
prolactin upregulates dopamine and inhibits GnRH

Front 1076

what does somatostatin do?

Back 1076

inhibits GH and TSH

Front 1077

what is secreted in 17-alpha hydroxylase deficiency?
- symptoms?

Back 1077

aldosterone
- hypertension, hypokalemia, pseudohermaphroditism (due to lack of testosterone)

Front 1078

what is secreted in 21-alpha hydroxylase deficiency?
- symptoms?

Back 1078

sex hormones
- masculinization, hypotension, hyperkalemia

Front 1079

what is secreted in 11-beta hydroxylase deficiency?
- symptoms?

Back 1079

sex hormones
- masculinization, hypertension (since 11-deoxycorticosterone can act like aldosterone)

Front 1080

what substances alter phosphate levels, and how?

Back 1080

PTH - increases phosphate excretion in kidney (Phosphate Trashing Hormone)
vitamin D - increases phosphate absorption in gut

Front 1081

what ions regulate PTH secretion, and how?

Back 1081

low Ca2+ - increased PTH
low Mg2+ - decreased PTH

Front 1082

where is calcitonin secreted from?
- function?

Back 1082

parafollicular (C) cells of thyroid
- decreases bone resorption (opposite of PTH) - calciTONin TONes down calcium levels

Front 1083

functions of T3

Back 1083

4 B's:
Brain maturation
Bone growth
Beta1-adrenergic effects
Basal metabolic rate increased

Front 1084

which endocrine hormones signal via cAMP?

Back 1084

FLAT CHAMP:
FSH, LH, ACTH, TSH
CRH, hCG, ADH, MSH, PTH
(+ calcitonin and glucagon)

Front 1085

which hormones signal via IP3?

Back 1085

GGOAT:
GnRH, GHRH
Oxytocin
ADH (V1 receptor)
TRH

Front 1086

treatment for Conn's syndrome
- why?

Back 1086

spironolactone - acts as an aldosterone antagonist

Front 1087

what is the defect in Sheehan's syndrome?

Back 1087

enlargement of anterior pituitary during pregnancy (increased lactotrophs) without increased blood supply - infarction of pituitary after severe bleeding of delivery

Front 1088

treatment for pheochromocytoma

Back 1088

phenoxybenzamine (irreversible alpha-antagonist)

Front 1089

symptoms of pheochromocytoma

Back 1089

5 P's:
elevated blood Pressure
Pain (headache)
Perspiration
Palpitations
Pallor

Front 1090

rule of 10's for pheochromocytoma

Back 1090

10% malignant
10% bilateral
10% extra-adrenal
10% calcify
10% kids
10% familial

Front 1091

tumors of MEN 1, 2A, and 2B

Back 1091

MEN 1: Parathyroid, Pituitary, Pancreatic (3 P's)
MEN 2A: medullary thyroid carcinoma, Pheochromocytoma, Parathyroid (2 P's)
MEN 2B: medullary thyroid carcinoma, Pheochromocytoma, oral/intestinal ganglioneuromatosis (1 P)

Front 1092

what gene is mutated in MEN 2A and 2B?

Back 1092

ret oncogene

Front 1093

what diseases are associated with a tender and a non-tender thyroid?

Back 1093

tender - subacute thyroiditis (de Quervain's)
nontender - Hashimoto's thyroiditis

Front 1094

what is the defect in Riedel's thyroiditis?

Back 1094

thyroid replaced by fibrous tissue - hypothyroidism

Front 1095

Jod-Basedow phenomenon

Back 1095

thyrotoxicosis upon iodine replenishment in a patient with an iodine deficient goiter

Front 1096

characteristics of papillary thyroid carcinoma

Back 1096

ground-glass nuclei (Orphan Annie), psammoma bodies

Front 1097

what cell do medullary thyroid carcinomas derive from?
- what hormone do they produce?

Back 1097

parafollicular (C) cells
- calcitonin

Front 1098

symptoms of hyperparathyroidism

Back 1098

stones, bones, and groans:
hypercalcemia and hypercalciuria (renal stones)
bone resorption and increased alkaline phosphatase (bones)
weakness and constipation (groans)

Front 1099

what is the other name for osteitis fibrosa cystica?
- defect?

Back 1099

von Recklinghausen's syndrome
- cystic bone spaces filled with brown fibrous tissue

Front 1100

renal osteodystrophy - what is the defect?

Back 1100

renal disease causes secondary hyperparathyroidism, which causes bone lesions

Front 1101

what are the signs of hypoparathyroidism?

Back 1101

Chvostek's sign - tapping of facial nerve causes facial spasm
Trousseau's sign - occlusion of brachial artery causes carpal spasm

Front 1102

what is pseudohypoparathyroidism?

Back 1102

kidney is unresponsive to PTH

Front 1103

causes of hypercalcemia

Back 1103

CHIMPANZEES:
Calcium ingestion, Hyperparathyroid, Hyperthyroid, Iatrogenic, Multiple myeloma, Paget's disease, Addison's disease, Neoplasms, Zollinger-Ellison syndrome, Excess vitamin D or A, Sarcoidosis

Front 1104

treatment for prolactinoma

Back 1104

bromocriptine (dopamine agonist)

Front 1105

which HLA genes are associated with diabetes mellitus type 1?

Back 1105

HLA-DR3 and DR4

Front 1106

what is the cause of central vs. nephrogenic diabetes insipidus?

Back 1106

central - lack of ADH
nephrogenic - kidney is unresponsive to ADH

Front 1107

treatment for SIADH

Back 1107

demeclocycline (ADH antagonist)

Front 1108

rule of 1/3s for carcinoid tumors

Back 1108

1/3 metastasize
1/3 present with a 2nd malignancy
1/3 multiple

Front 1109

treatment for carcinoid syndrome

Back 1109

octreotide

Front 1110

what is the defect in Zollinger-Ellison syndrome?

Back 1110

gastrin-secreting tumor - causes recurrent ulcers

Front 1111

name 2 sulfonylureas
- mechanism of action?
- used for?
- side effects?

Back 1111

glyburide, glipizide
- close K+ channel in islet beta cell, depolarizing the cell and triggering insulin secretion
- type 2 diabetes
- hypoglycemia, disulfiram-like effect (1st generation)

Front 1112

metformin - used for?
- side effect?

Back 1112

type 1 and 2 diabetes
- lactic acidosis

Front 1113

pioglitazone and rosiglitazone - mechanism of action?
- side effects?

Back 1113

increase target cell's response to insulin
- edema, hepatotoxicity, CV toxicity

Front 1114

acarbose and miglitol - mechanism of action?

Back 1114

inhibit intestinal alpha-glucosidases, decreasing glucose absorption

Front 1115

pramlintide - mechanism of action?

Back 1115

decreases glucagon

Front 1116

exenatide - mechanism of action?

Back 1116

GLP-1 mimetic - increases insulin and decreases glucagon release

Front 1117

orlistat - mechanism of action?
- used for?

Back 1117

inhibits pancreatic lipases, decreasing fat metabolism (orlistat gets rid of fat)
- obesity

Front 1118

sibutramine - mechanism of action?
- used for?

Back 1118

serotonin and norepinephrine reuptake inhibitor
- obesity

Front 1119

propylthiouracil and methimazole - mechanism of action?
- used for?
- side effects?

Back 1119

inhibit organification and coupling of thyroid hormone synthesis (propylthiouracil also decreases conversion of T4 to T3)
- hyperthyroidism
- rash, agranulocytosis, aplastic anemia

Front 1120

levothyroxine and triiodothyronine - used for?

Back 1120

thyroxine replacement in hypothyroidism

Front 1121

demeclocycline - mechanism of action?
- used for?
- side effects?

Back 1121

ADH antagonist
- SIADH
- photosensitivity, abnormalities of bone and teeth (like all tetracyclines), diabetes insipidus

Front 1122

what nerve plexus is in the intestinal submucosa?
- in the muscularis externa?
- what do they each control?

Back 1122

Submucosa = Submucosal plexus (Meissner's)
- controls Secretions
Muscularis = Myenteric plexus (Auerbach's)
- controls Motility

Front 1123

structures that derive from foregut
- from midgut?
- from hindgut?

Back 1123

stomach to proximal duodenum + liver, gallbladder, pancreas
- distal duodenum to proximal 2/3 of transverse colon
- distal 1/3 of transverse colon to upper rectum

Front 1124

where are varices seen in portal hypertension?

Back 1124

gut, butt, and caput:
esophageal, internal hemorrhoids, and caput medusae

Front 1125

which liver zones are affected first in viral hepatitis vs. alcoholic hepatitis?

Back 1125

viral - periportal zone (virus reaches here from blood first)
alcoholic - centrilobular zone (most sensitive to toxic injury)

Front 1126

organization of vessels in femoral region

Back 1126

you go from lateral to medial to find your NAVEL:
femoral Nerve - femoral Artery - femoral Vein - Empty space - Lymphatics

Front 1127

what patients get indirect inguinal hernias?
- why?

Back 1127

infants - due to failure of processus vaginalis to close

Front 1128

what are the boundaries of Hesselbach's triangle?
- which type of hernia protrudes through here?

Back 1128

inferior epigastric artery, rectus abdominis, inguinal ligament
- direct inguinal hernias

Front 1129

indirect vs. direct inguinal hernias - what is the spatial relationship to the inferior epigastric vessels?

Back 1129

MDs don't LIe:
Medial to vessels = Direct
Lateral to vessels = Indirect

Front 1130

where do femoral hernias protrude?
- what patients get them?

Back 1130

below inguinal ligament lateral to pubic tubercle
- women

Front 1131

what do B/plasma cells in Peyer's patches secrete?

Back 1131

IgA - the Intra-gut Antibody

Front 1132

which salivary glands secrete most serous vs. most mucinous saliva?

Back 1132

parotid = Serous (on the Sides)
sublingual = Mucinous (in the Middle)

Front 1133

what is the function of cholecystokinin?
- what cells secrete it?

Back 1133

increased pancreatic secretion and gallbladder contraction
- secreted by I cells in small intestine

Front 1134

what is the function of secretin?
- what cells secrete it?

Back 1134

increased bicarbonate and bile secretion, decreased gastric acid secretion
- secreted by S cells in duodenum

Front 1135

what is the function of somatostatin?

Back 1135

inhibitory - decreases secretion of all GI fluids (anti-GH)

Front 1136

what is the function of glucose-dependent insulinotropic peptide?
- what cells secrete it?

Back 1136

decreases gastric acid secretion, increases insulin release
- secreted by K cells in small intestine

Front 1137

what is the function of vasoactive intestinal polypeptide (VIP)?
- where is it secreted from?

Back 1137

increased intestinal fluid secretion, relaxation of sphincters
- secreted from parasympathetic ganglia

Front 1138

what is the function of motilin?

Back 1138

produces migrating motor complexes in the fasting state

Front 1139

what is the defect in achalasia?

Back 1139

loss of myenteric plexus leads to failure of lower esophageal sphincter to relax

Front 1140

what is Boerhaave syndrome?

Back 1140

transmural esophageal rupture due to violent retching (Boerhaave = been-heaving)

Front 1141

what are the symptoms of Plummer-Vinson syndrome?

Back 1141

triad:
- dysphagia (esophageal webs)
- glossitis
- iron-deficiency anemia

Front 1142

risk factors for esophageal cancer

Back 1142

ABCDEF:
Alcohol, Achalasia
Barrett's esophagus
Cigarettes
Diverticula
Esophageal webs, Esophagitis
Familial

Front 1143

causes of Curling's vs. Cushing's ulcer in stomach

Back 1143

Curling's - burns lead to sloughing of mucosa (burned by the Curling iron)
Cushing's - brain injury leads to increased vagal stimulation and increased H+ production (always Cushion the brain)

Front 1144

chronic gastritis type A vs. type B - causes and location in stomach?

Back 1144

type A - Autoimmune (pernicious Anemia), affects Body
type B - due to H. pylori Bacteria, affects Antrum

Front 1145

what is the defect in Menetrier's disease?

Back 1145

gastric hypertrophy with atrophy of parietal cells (rugae look like brain gyri)

Front 1146

gastric vs. duodenal ulcers - associated with weight gain or weight loss? why?

Back 1146

Gastric ulcer - pain is Greater with meals, leading to weight loss
Duodenal ulcer - pain Decreases with meals, leading to weight gain

Front 1147

what are the features of Crohn's that distinguish it from ulcerative colitis?

Back 1147

old crone and a fat granny (creeping fat, granulomas) skipping (skip lesions) down a cobblestone road (cobblestone mucosa) away from the wreck (rectal sparing)

Front 1148

what is intussusception?

Back 1148

telescoping of 1 bowel segment into a distal segment

Front 1149

what is the defect in Hirschsprung's disease?

Back 1149

failure of neural crest cell migration causes lack of enteric nerve plexuses and leads to congenital megacolon proximal to aganglionic segment

Front 1150

what is the defect in meconium ileus?
- what patients does it affect?

Back 1150

meconium plug obstructs intestine
- cystic fibrosis patients

Front 1151

which type of colon polyps are more likely to be malignant?

Back 1151

villous (so villainous)

Front 1152

what is Gardner's syndrome?

Back 1152

FAP with osseous and soft tissue tumors and retinal hyperplasia

Front 1153

what is Turcot's syndrome?

Back 1153

FAP with brain involvement (TURcot = TURban)

Front 1154

alcoholic vs. viral hepatitis - which has higher ALT and which AST?

Back 1154

alcoholic - AST (toASTed)
viral - ALT

Front 1155

causes of micronodular vs. macronodular cirrhosis

Back 1155

micronodular - toxic insult (alcohol, iron, copper)
macronodular - significant injury and necrosis (infectious or drug-induced)

Front 1156

symptoms of Wilson's disease
- treatment?

Back 1156

ABCD:
Asterixis
Basal ganglia degeneration (parkinsonian)
Ceruloplasmin decreased, Cirrhosis, Corneal deposits, Copper accumulation, Carcinoma of liver, Choreiform movements
Dementia
- treat with penicillamine

Front 1157

symptoms of hemochromatosis
- treatment?
- which HLA is it associated with?

Back 1157

Hemochromatosis Can Cause Deposits:
Cirrhosis (micronodular)
CHF
Diabetes mellitus (bronze diabetes due to skin pigmentation)
- treat with phlebotomy and deferoxamine
- HLA-A3

Front 1158

Charcots triad of cholangitis

Back 1158

jaundice, fever, RUQ pain

Front 1159

causes of acute pancreatitis

Back 1159

GET SMASHeD:
Gallstones, Ethanol, Trauma
Steroids, Mumps, Autoimmune disease, Scorpion sting, Hypercalcemia/lipidemia, Drugs

Front 1160

what tumors are associated with CEA and CA-19-9 markers?

Back 1160

CEA - colorectal cancer
CEA and CA-19-9 - pancreatic cancer

Front 1161

what is Trousseau's syndrome, and what is it a sign of?

Back 1161

migratory thrombophlebitis (redness and tenderness in extremities)
- sign of pancreatic adenocarcinoma

Front 1162

what is Courvoisier's sign, and what does it indicate?

Back 1162

obstructive jaundice with a palpable gallbladder - sign of pancreatic adenocarcinoma

Front 1163

cimetidine, ranitidine, famotidine, nizatidine - mechanism of action?
- side effects of cimetidine?

Back 1163

H2 blockers - decrease H+ secretion by parietal cells
- P-450 inhibitor, antiandrogenic, decreased renal creatinine excretion

Front 1164

omeprazole, lansoprazole - mechanism of action?

Back 1164

gastric parietal cell proton pump inhibitors

Front 1165

bismuth, sucralfate - mechanism of action?

Back 1165

bind ulcer base and allow bicarbonate to reestablish pH gradient (protection)

Front 1166

triple therapy of H. pylori ulcers

Back 1166

metronidazole, amoxicillin/tetracycline, bismuth

Front 1167

misoprostol - mechanism of action?
- used for?

Back 1167

PGE1 analog - increases secretion of gastric mucus barrier
- prevent NSAID-induced peptic ulcers, maintain patent ductus arteriosus, induce labor

Front 1168

name 2 muscarinic antagonists used to treat peptic ulcers

Back 1168

pirenzipine, propantheline

Front 1169

aluminum hydroxide - used for?
- side effects?

Back 1169

antacid
- constipation (aluminimum amount of feces), proximal muscle weakness

Front 1170

magnesium hydroxide - used for?
- side effects?

Back 1170

antacid
- diarrhea (Mg = Must go to the bathroom), hyporeflexia, cardiac arrest

Front 1171

sulfasalazine - mechanism of action?
- used for?
- side effects?

Back 1171

antibacterial and anti-inflammatory
- IBD (both forms)
- malaise, sulfonamide toxicity, oligospermia

Front 1172

ondansetron - mechanism of action?

Back 1172

serotonin antagonist - anti-emetic

Front 1173

metoclopramide - mechanism of action?
- used for?
- side effect?

Back 1173

D2 receptor antagonist - increases contractility, sphincter tone, and motility in gut
- post-surgical gastroparesis
- parkinsonian symptoms

Front 1174

layers of epidermis

Back 1174

Californians Like Girls in String Bikinis:
stratum Corneum
stratum Lucidum
stratum Granulosum
stratum Spinosum
stratum Basale

Front 1175

unhappy triad knee injury

Back 1175

damage to medial collateral ligament, medial meniscus, and anterior cruciate ligament

Front 1176

what does positive anterior drawer sign indicate?

Back 1176

damage to ACL

Front 1177

what does abnormal passive abduction of the knee indicate?

Back 1177

damage to MCL

Front 1178

rotator cuff muscles
- what do they each do?

Back 1178

SITS:
Supraspinatus - abduction
Infraspinatus - lateral rotation
Teres minor - adduction and lateral rotation
Subscapularis - medial rotation and adduction

Front 1179

damage to which nerve causes "Saturday night palsy"?

Back 1179

radial nerve (compression of axilla)

Front 1180

proximal median nerve lesion causes what?

Back 1180

ape hand (can't oppose thumb)

Front 1181

distal median nerve lesion causes what?

Back 1181

Pope's blessing (median claw) when asked to bend fingers and ulnar deviation of wrist upon flexion

Front 1182

proximal ulnar nerve lesion causes what?

Back 1182

radial deviation of wrist upon flexion

Front 1183

distal ulnar nerve lesion causes what?

Back 1183

ulnar claw hand (Pope's blessing) when asked to straighten fingers

Front 1184

musculocutaneous nerve lesion causes what?

Back 1184

inability to flex arm at elbow

Front 1185

axillary nerve lesion causes what?

Back 1185

inability to abduct arm (deltoid muscle)

Front 1186

what causes Erb-Duchenne palsy?

Back 1186

lesion to upper trunk of brachial plexus (C5,6)

Front 1187

what causes Klumpke's palsy?
- what is the motor deficit?

Back 1187

lesion to lower trunk of brachial plexus (C8,T1)
- loss of lumbrical function - total claw hand (MCP joints extended, PIP and DIP flexed)

Front 1188

function of radial nerve
- what muscles does it innervate?
- what is the sign of a lesion?

Back 1188

great extensor nerve
- BEST: Brachioradialis, Extensors of wrist and fingers, Supinator, Triceps
- wrist drop

Front 1189

what muscles are contained in the thenar and hypothenar eminences?

Back 1189

OAF:
thenar - Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis
hypothenar - Opponens digiti minimi, Abductor digiti minimi, Flexor digiti minimi

Front 1190

function of dorsal vs. palmar interosseous muscles

Back 1190

PAD DAB:
Palmars ADduct
Dorsals ABduct

Front 1191

motor function of obturator nerve

Back 1191

thigh adduction

Front 1192

motor function of femoral nerve

Back 1192

thigh flexion and leg extension

Front 1193

motor function of common peroneal vs. tibial nerve
- what are the signs of damage?

Back 1193

PED:
Peroneal Everts and Dorsiflexes foot (if damaged, foot droPED)
TIP:
Tibial Inverts and Plantarflexes foot (if damaged, can't stand on TIPtoes)

Front 1194

motor function of superior gluteal nerve
- what symptom occurs if damaged?

Back 1194

thigh abduction
- positive Trendelenburg sign

Front 1195

type 1 vs. type 2 muscle fibers - what are the characteristics?

Back 1195

type 1 - slow twitch, red fibers, oxidative phosphorylation ("one slow red ox")
type 2 - fast twitch, white fibers, anaerobic glycolysis

Front 1196

what is the defect in osteopetrosis?

Back 1196

failure of normal bone resorption (abnormal osteoclasts) due to carbonic anhydrase deficiency

Front 1197

what is the defect in polyostotic fibrous dysplasia?

Back 1197

bone replaced by fibroblasts, collagen, irregular bony trabeculae

Front 1198

what is McCune-Albright syndrome?

Back 1198

polyostotic fibrous dysplasia + endocrine abnormalities (precocious puberty) and cafe-au-lait spots

Front 1199

giant cell tumor of bone - what cell type?
- located where?
- appearance on x-ray?

Back 1199

osteoclastoma
- epiphyseal ends of long bones
- soap bubble/double bubble

Front 1200

Ewing's sarcoma - what is it?
- appearance?
- chromosome translocation?

Back 1200

small blue cell tumor of bone
- onion-skin appearance (Ewings and onion rings)
- t(11;22)

Front 1201

what HLA type is rheumatoid arthritis associated with?

Back 1201

HLA-DR4

Front 1202

what are the symptoms of Sjogren's syndrome?
- diagnostic autoantibodies?
- how is Sicca syndrome different?

Back 1202

xerophthalmia (dry eyes), xerostomia (dry mouth), arthritis
- SS-A (Ro), SS-B (La)
- Sicca syndrome - dryness, but no arthritis

Front 1203

symptoms of Reiter's syndrome

Back 1203

conjunctivitis/uveitis, urethritis, arthritis ("can't see, can't pee, can't climb a tree")

Front 1204

what disease is associated with "pencil-in-cup" deformity?

Back 1204

psoriatic arthritis

Front 1205

symptoms of lupus

Back 1205

I'M DAMN SHARP:
Immunoglobulins (anti-dsDNA, anti-Sm), Malar rash
Discoid rash, ANA, Mucositis, Neurologic disorders
Serositis, Hematologic disorders, Arthritis, Renal disorders, Photosensitivity

Front 1206

characteristics of sarcoidosis

Back 1206

GRAIN:
Gammaglobulinemia
Rheumatoid arthritis
ACE increase
Interstitial fibrosis
Noncaseating granulomas

Front 1207

what is the defect in polymyositis?
- dermatomyositis?
- significant findings?

Back 1207

CD8+ T-cell injury to myofibers - progressive symmetric proximal muscle weakness
- dermatomyositis = polymyositis + malar/heliotrope rash, Gottron's papules
- increased CK, ANA, anti-Jo-1

Front 1208

what is the defect in myasthenia gravis?
- Lambert-Eaton syndrome?
- for each, do symptoms improve or worsen with muscle use?

Back 1208

autoantibodies to postsynaptic ACh receptors - worsens with muscle use
- autoantibodies to presynaptic Ca2+ channels - improves with muscle use

Front 1209

what disease is associated with anti-Scl-70 antibody (anti-DNA topoisomerase)?

Back 1209

diffuse scleroderma

Front 1210

symptoms of CREST syndrome
- what marker is it associated with?

Back 1210

Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasia
- antiCentromere antibody

Front 1211

what is Auspitz sign, and what is it associated with?

Back 1211

psoriasis - bleeding when scales are scraped off

Front 1212

what is the defect in albinism?

Back 1212

defect in tyrosinase, so unable to make melanin (normal number of melanocytes)

Front 1213

what is the defect in vitiligo?

Back 1213

patches with decreased number of melanocytes

Front 1214

what is melasma?

Back 1214

hyperpigmentation associated with pregnancy

Front 1215

honey-colored crusting - diagnosis?

Back 1215

impetigo

Front 1216

white painless plaques on tongue - diagnosis?
- caused by what?

Back 1216

hairy leukoplakia
- EBV

Front 1217

what is the defect in pemphigus vulgaris?
- what sign is associated with it?
- how is it different from bullous pemphigoid?

Back 1217

IgG auto-antibody against desmosomes
- Nikolsky's sign - separation of epidermis upon manual stroking
- bp = auto-antibodies against hemidesmosomes (Ab's are "bullow" the epidermis), negative Nikolsky

Front 1218

pruritic papules with deposits of IgA at the tips of the dermal papillae - diagnosis?
- associated with what disease?

Back 1218

dermatitis herpetiformis
- celiac disease

Front 1219

symptoms of lichen planus
- what disease is it associated with?

Back 1219

Pruritic Purple Polygonal Papules, Wickham's striae
- hepatitis C

Front 1220

main symptom of pityriasis rosea

Back 1220

herald patch followed by "Christmas tree" distribution

Front 1221

what is actinic keratosis a precursor to?

Back 1221

squamous cell carcinoma

Front 1222

function of LTB4
- what do other leukotrienes do?

Back 1222

neutrophil chemotaxis (neutrophils arrive B4 others)
- bronchoconstriction

Front 1223

function of PGI2

Back 1223

inhibits platelet aggregation, vasodilation (all opposite TXA2)

Front 1224

aspirin - mechanism of action?
- side effects?

Back 1224

irreversible COX inhibitor
- GI upset, Reye's syndrome, renal failure

Front 1225

NSAIDs - mechanism of action?
- use?

Back 1225

reversible COX inhibitors
- antipyretic, analgesic, anti-inflammatory

Front 1226

celecoxib - mechanism of action?

Back 1226

COX2 inhibitor, so less GI toxic than other NSAIDs

Front 1227

acetaminophen - mechanism of action?
- side effect? why? antidote?

Back 1227

reversible COX inhibitor
- hepatic necrosis (metabolite depletes glutathione) - antidote is N-acetylcysteine (regenerates glutathione)

Front 1228

activity of aspirin and acetaminophen, as compared to NSAIDs

Back 1228

acetaminophen = NSAID - anti-inflammatory
aspirin = NSAID + antiplatelet

Front 1229

etidronate, pamidronate, alendronate, risedronate - mechanism of action?
- used for?

Back 1229

bisphosphonates - inhibit osteoclast activity
- osteoporosis, Paget's disease of bone

Front 1230

colchicine - mechanism of action?
- used for?

Back 1230

depolymerizes microtubules, impairing leukocyte chemotaxis
- acute/chronic gout

Front 1231

probenecid - mechanism of action?
- used for?

Back 1231

inhibits uric acid reabsorption in proximal tubule
- chronic gout

Front 1232

allopurinol - mechanism of action?
- used for?

Back 1232

inhibits xanthine oxidase
- chronic gout, tumor lysis syndrome

Front 1233

etanercept - mechanism of action?

Back 1233

recombinant TNF receptor that sequesters TNF
(etanerCEPT is a TNF decoy reCEPTor)

Front 1234

infliximab - mechanism of action?

Back 1234

anti-TNF Ab
(INFLIXimab INFLIX pain on TNF)

Front 1235

what structures do ureters pass under?

Back 1235

uterine artery, ductus deferens

Front 1236

fluid compartments in body

Back 1236

60-40-20 rule:
60% total body water
40% intracellular
20% extracellular

Front 1237

clearance calculation

Back 1237

Cx = UxV/Px

Front 1238

how is GFR estimated?
- effective renal plasma flow?

Back 1238

GFR = inulin clearance (or creatinine clearance)
EPRF = PAH clearance

Front 1239

free water clearance calculation

Back 1239

CH2O = V-Cosm
Cosm = UosmV/Posm

Front 1240

does angiotensin II cause acidosis or alkalosis?

Back 1240

alkalosis - stimulates Na+/H+ exchange in proximal tubule, so H+ is excreted

Front 1241

effect of aldosterone in collecting tubules

Back 1241

inserts more Na+ channels to increase Na+ reabsorption

Front 1242

which segments of the kidney does PTH act on?

Back 1242

proximal tubule - inhibits Na+-phosphate cotransport
distal tubule - increases Ca2+/Na+ exchange

Front 1243

effect of prostaglandins on kidney

Back 1243

vasodilate afferent arterioles - increase GFR (this is why NSAIDs can cause acute renal failure

Front 1244

causes of anion gap metabolic acidosis

Back 1244

MUD PILES:
Methanol, Uremia, Diabetic ketoacidosis
Paraldehyde/Phenformin, Iron tablets/INH, Lactic acidosis, Ethylene glycol, Salicylates

Front 1245

what is the defect in type 1 renal tubular acidosis?
- type 2?
- type 4?

Back 1245

type 1 - defect in H+/K+-ATPase of collecting tubules, so can't secrete H+
type 2 - defect in proximal tubule bicarbonate absorption
type 4 - hypoaldosteronism

Front 1246

nephritic vs. nephrotic syndromes

Back 1246

nephrItic = Inflammatory (hematuria)
nephrOtic = massive prOteinuria

Front 1247

diffuse proliferative glomerulonephritis - associated with what?
- appearance on microscopy?

Back 1247

SLE
- wire looping of capillaries

Front 1248

membranous glomerulonephritis - associated with what?
- appearance on EM?

Back 1248

SLE
- spike and dome appearance

Front 1249

GBM splitting is associated with what diseases?

Back 1249

Alport's syndrome (nephritic)
membranoproliferative glomerulonephritis (nephrotic)

Front 1250

what disease is associated with subendothelial deposits in glomerulus?

Back 1250

lupus glomerulonephritis (diffuse proliferative glomerulonephritis)

Front 1251

mesangial deposits - diagnosis?

Back 1251

IgA nephropathy (Berger's disease)

Front 1252

what are struvite kidney stones caused by?

Back 1252

infection with urease-positive bacteria

Front 1253

are uric acid stones radiolucent or radiopaque?

Back 1253

Uric acid = radiolUcent

Front 1254

WAGR complex

Back 1254

Wilms' tumor
Aniridia
Genitourinary malformation
Retardation

Front 1255

risk factors for transitional cell carcinoma

Back 1255

Pee SAC:
Phenacetin
Smoking
Aniline dyes
Cyclophosphamide

Front 1256

conditions that cause renal papillary necrosis

Back 1256

diabetes mellitus
acute pyelonephritis
chronic phenacetin use
sickle cell anemia

Front 1257

does renal failure cause acidosis or alkalosis?

Back 1257

acidosis - failure to secrete H+ and reabsorb bicarbonate

Front 1258

what are the EKG findings in hyper- and hypokalemia?

Back 1258

hyperkalemia - peaked T waves
hypokalemia - U waves, flattened T waves

Front 1259

mannitol - mechanism of action?

Back 1259

osmotic diuretic - increases tubular fluid osmolarity, causing increased urine flow

Front 1260

acetazolamide - mechanism of action?
- used for?
- side effects?

Back 1260

carbonic anhydrase inhibitor - decreases bicarbonate reabsorption in proximal tubule
- glaucoma, metabolic alkalosis, altitude sickness
- metabolic ACIDosis (ACIDazolamide), sulfa allergy

Front 1261

furosemide - mechanism of action?
- side effects?

Back 1261

loop diuretic - inhibits Na+-K+-2Cl- cotransport in thick ascending limb, increases calcium excretion (Loops Lose calcium)
- OH DANG: Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis, Gout

Front 1262

ethacrynic acid - mechanism of action?
- used for?

Back 1262

same as loop diuretics - inhibits Na+-K+-2Cl- reabsorption in thick ascending limb
- diuresis in patients with sulfa allergies

Front 1263

hydrochlorothiazide - mechanism of action?
- side effects?

Back 1263

thiazide diuretic - inhibits NaCl reabsorption in distal tubule, decreases calcium excretion
- hypokalemia, metabolic alkalosis, hyperGLUC (hyperGlycemia, Lipidemia, Uricemia, Calcemia)

Front 1264

name 3 K+-sparing diuretics
- mechanisms of action?
- side effects?

Back 1264

Spironolactone, Triamterene, Amiloride (K+ STAys)
- spironolactone - aldosterone receptor antagonist in collecting duct
- triamterene and amiloride - block Na+ channels in collecting duct
- hyperkalemia, antiandrogen effects (spironolactone)

Front 1265

captopril, enalapril, lisinopril - mechanism of action?
- side effects?

Back 1265

ACE inhibitors
- CAPTOPRIL: Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower angiotensin II, hyperkalemia

Front 1266

embryologic origins of CNS, PNS, and microglia

Back 1266

CNS - neuroectoderm
PNS - neural crest
Microglia - Mesoderm (like Macrophages)

Front 1267

function of Meissner's corpuscles, Pacinian corpuscles, and Merkel's disks

Back 1267

Meissner's corpuscles - dynamic fine touch (adapt quickly)
Pacinian corpuscles - vibration and pressure
Merkel's disks - static touch (adapt slowly)

Front 1268

functions of hypothalamus

Back 1268

TAN HATS:
Thirst/water balance
Adenohypophysis control
Neurohypophysis control
Hunger
Autonomic regulation
Temperature regulation
Sexual urges

Front 1269

what does lateral area of hypothalamus control?

Back 1269

hunger (if lateral area is damaged, you shrink laterally - anorexia)

Front 1270

what does ventromedial area of hypothalamus control?

Back 1270

satiety (if ventromedial area is damaged, you grow ventrally and medially - hyperphagia)

Front 1271

what does anterior hypothalamus control?
- posterior hypothalamus?

Back 1271

cooling, pArasympathetic (A/C - anterior cooling)
- heating, sympathetic

Front 1272

what does septal nucleus of hypothalamus control?

Back 1272

Septal nucleus = Sexual urges

Front 1273

what does suprachiasmatic nucleus of hypothalamus control?

Back 1273

circadian rhythm

Front 1274

what do LGN and MGN of thalamus control?

Back 1274

LGN - vision (Lateral = Light)
MGN - auditory (Medial = Music)

Front 1275

what do VPL and VPM of thalamus control?

Back 1275

VPL - body sensation
VPM - facial sensation (you put Make-up on your face)

Front 1276

what do VA/VL nuclei of thalamus control?

Back 1276

motor (anterior to sensation, just like in cortex)

Front 1277

functions of limbic system

Back 1277

5 F's:
Feeding, Fleeing, Fighting, Feeling, and sex

Front 1278

functions of superior, middle, and inferior cerebellar peduncles

Back 1278

middle - receives contralateral cortical input
inferior - receives ipsilateral proprioceptive input
superior - output to contralateral cortex

Front 1279

name the cerebellar deep nuclei, from lateral to medial

Back 1279

Don't Eat Greasy Foods:
Dentate, Emboliform, Globose, Fastigial

Front 1280

which pathway in basal ganglia does each type of dopamine receptor act on?

Back 1280

D1 receptors stimulate the excitatory pathway
D2 receptors inhibit the inhibitory pathway

Front 1281

what is the defect in Parkinson's disease?
- symptoms?
- characteristic pathology?

Back 1281

degeneration and depigmentation of the substantia nigra pars compacta (loss of dopaminergic neurons - so decreased stimulation of basal ganglia)
- TRAP: Tremor at rest, cogwheel Rigidity, Postural instability
- Lewy bodies

Front 1282

what is the defect in hemiballismus?

Back 1282

contralateral subthalamic nucleus lesion - so loss of inhibition of thalamus

Front 1283

what is the defect in Huntington's disease?

Back 1283

expansion of CAG repeats - atrophy of caudate nucleus

Front 1284

what is athetosis?
- what is it characteristic of?

Back 1284

slow writhing movements of fingers
- basal ganglia lesion (Huntington's disease)

Front 1285

what is the cause of intention tremor?

Back 1285

cerebellar dysfunction

Front 1286

major symptom of frontal lobe damage

Back 1286

Damage = Disinhibition

Front 1287

what is the consequence of a parietal lobe lesion?

Back 1287

contralateral spatial neglect

Front 1288

what is the consequence of a lesion to the reticular activating system?

Back 1288

reduced levels of arousal and wakefulness

Front 1289

cerebellar hemispheres vs. vermis - which affects limbs vs. trunk?
- does damage affect contralateral or ipsilateral side?

Back 1289

hemispheres - laterally located, so affect lateral limbs
vermis - centrally located, so affect central body
- damage affects ipsilateral side

Front 1290

damage to paramedian pontine reticular formation vs. frontal eye fields - what is the major symptom?

Back 1290

PPRF - eyes look away from side of lesion
frontal eye fields - eyes look toward side of lesion

Front 1291

what is the result of damage to the hippocampus?

Back 1291

anterograde amnesia (unable to make new memories)

Front 1292

what causes Wallenberg's syndrome?
- symptoms?

Back 1292

PICA infarct
- nystagmus, ipsilateral ataxia, Horner's syndrome

Front 1293

what causes locked-in syndrome?

Back 1293

basilar artery infarct

Front 1294

what disease are Charcot-Bouchard microaneurysms associated with?
- what part of circulation do they affect?

Back 1294

chronic hypertension
- small deep vessels (basal ganglia, thalamus, etc.)

Front 1295

bloody or yellow spinal tap - diagnosis?

Back 1295

subarachnoid hemorrhage

Front 1296

what connects lateral ventricles to 3rd ventricle?

Back 1296

foramen of Monro

Front 1297

relative locations of foramina of Luschka and Magendie

Back 1297

Luschka = Lateral
Magendie = Medial

Front 1298

symptoms of hydrocephalus

Back 1298

dementia, gait problems, urinary incontinence

Front 1299

lower extent of spinal cord
- lower extent of subarachnoid space
- where should lumbar puncture be performed?

Back 1299

L1-L2
- S2
- between L3 and L5 (to keep the spinal cord alive)

Front 1300

organization of spinal tracts with respect to legs and arms

Back 1300

corticospinal and spinothalamic - Legs are Lateral
DC-ML - legs are medial, arms are lateral (peel off as you move down spinal cord)

Front 1301

lower muscle mass and tone, decreased reflexes, downgoing toe - UMN or LMN lesion?

Back 1301

LMN - everything lowered

Front 1302

what is the defect in poliomyelitis and Werdnig-Hoffman disease?

Back 1302

destruction of anterior horns of spinal cord - lower motor neuron lesion

Front 1303

what part of the spinal cord is spared in occlusion of the anterior spinal artery?

Back 1303

dorsal columns

Front 1304

what part of the spinal cord is affected in tabes dorsalis?

Back 1304

dorsal columns

Front 1305

what part of the spinal cord is affected in syringomyelia?

Back 1305

crossing fibers of spinothalamic tract (so bilateral loss of pain and temperature sense)

Front 1306

symptoms of Werdnig-Hoffman disease

Back 1306

floppy baby, tongue fasciculations (early death)

Front 1307

dermatome of the neck

Back 1307

C3

Front 1308

dermatome at the nipple

Back 1308

T4 (teat pore)

Front 1309

dermatome at the umbilicus

Back 1309

T10 (belly butTEN)

Front 1310

dermatome at the inguinal ligament

Back 1310

L1 (IL = inguinal ligament)

Front 1311

dermatome of the kneecaps

Back 1311

L4 (down on L4s)

Front 1312

innervation of the penis

Back 1312

S2,3,4 (keeps the penis off the floor)

Front 1313

function of muscle spindles vs. Golgi tendon organs

Back 1313

muscle spindles monitor muscle length - activate motor neurons when stretched
Golgi Tendon organs monitor muscle Tension - inhibit motor neurons

Front 1314

spinal levels of arm and leg reflexes

Back 1314

ankle - S1,2
knee - L3,4
biceps - C5,6
triceps - C7,8

Front 1315

cranial nerves that lie medially at brain stem

Back 1315

III, VI, XII

Front 1316

function of superior and inferior colliculi

Back 1316

superior - vertical gaze
inferior - auditory
(eyes are above ears)

Front 1317

what is the defect in Parinaud syndrome?

Back 1317

lesion in superior colliculi - so paralysis of conjugate vertical gaze

Front 1318

are CN I-XII sensory, motor, or both?

Back 1318

I, II - Sensory (Some Say)
III, IV - Motor (Marry Money)
V - Both (But)
VI - Motor (My)
VII - Both (Brother)
VIII - Sensory (Says)
IX, X - Both (Big Brains)
XI, XII - Motor (Matter Most)

Front 1319

what are the functions of the three vagal nuclei?

Back 1319

nucleus Solitarius - visceral Sensory information
nucleus aMbiguus - Motor innervation of pharynx, larynx, and esophagus
dorsal motor nucleus - autonomics to thorax

Front 1320

what openings in the skull do CN V divisions exit through?

Back 1320

CN V must exit due to Standing Room Only:
V1 - Superior orbital fissure
V2 - foramen Rotundum
V3 - foramen Ovale

Front 1321

what cranial nerves exit through the superior orbital fissure?

Back 1321

CN III, IV, V1, VI (all eye nerves except CN II)

Front 1322

what cranial nerves exit through the internal auditory meatus?

Back 1322

CN VII, VIII (ear nerves)

Front 1323

what cranial nerves exit through the jugular foramen?

Back 1323

CN IX, X, XI

Front 1324

what cranial nerves pass through the cavernous sinus?
- what are the symptoms of cavernous sinus syndrome?

Back 1324

CN III, IV, V1, V2, VI
- opthalmoplegia, ophthalmic and maxillary sensory losses (due to nerve compression)

Front 1325

symptoms of UMN vs. LMN facial lesion

Back 1325

UMN - contralateral paralysis of lower face only (upper face gets bilateral innervation)
LMN - ipsilateral paralysis of whole face

Front 1326

what is Bell's palsy a complication of?

Back 1326

ALexander graHam Bell with STD:
AIDS
Lyme disease
Herpes zoster
Sarcoidosis
Tumors
Diabetes

Front 1327

what muscles close the jaw?
- what muscle opens it?

Back 1327

close - Masseter, teMporalis, Medial pterygoid (M's Munch)
open - Lateral pterygoid (Lowers)

Front 1328

perilymph vs. endolymph - what is the predominant ion in each?

Back 1328

perilymph = Na+ (outside cell)
endolymph = K+ (inside cell)

Front 1329

which parts of inner ear detect linear vs. angular acceleration?

Back 1329

utricle and saccule - linear (contain maculae)
semicircular canals - Angular (contain Ampullae)

Front 1330

open vs. closed angle glaucoma - what is the difference, and which is painful?

Back 1330

open - obstructed outflow through canal of Schlemm (painless)
closed - obstruction of flow between lens and iris (painful)

Front 1331

down and out eye - diagnosis?

Back 1331

CN III damage
(since lateral rectus and superior oblique still functional)

Front 1332

what is strabismus?

Back 1332

misalignment of eyes

Front 1333

what is amblyopia?

Back 1333

reduction of vision due to disuse in critical period

Front 1334

innervation of pupillary constriction vs. dilation

Back 1334

constriction - CN III (parasympathetic)
dilation - T1 sympathetics

Front 1335

what is the Marcus Gunn pupil?

Back 1335

afferent pupillary defect, so decreased bilateral constriction when light is shone in affected eye

Front 1336

what are the functions of the outer and inner parts of CN III, and what can damage each part?

Back 1336

inner - carries output to ocular muscles (affected by vascular disease)
outer - carries parasympathetic output (affected by compression)

Front 1337

what is the defective protein in Lewy body dementia?
- symptoms?

Back 1337

alpha-synuclein defect
- parkinsonism + dementia and hallucinations

Front 1338

what is the defect in progressive multifocal leukoencephalopathy?
- what causes it?

Back 1338

demyelination of CNS
- JC virus

Front 1339

what is the defect in Charcot-Marie-Tooth disease?

Back 1339

hereditary defect in production of proteins needed for peripheral nerves/myelin sheath

Front 1340

stain for astrocytes (and astrocytomas)

Back 1340

GFAP

Front 1341

microscopic appearance of oligodendroglioma

Back 1341

fried egg cells with chicken-wire capillary pattern

Front 1342

Rosenthal fibers - diagnosis?

Back 1342

pilocytic astrocytoma

Front 1343

latanoprost - used for?
- mechanism of action?
- side effect?

Back 1343

glaucoma
- increases outflow of aqueous humor
- darkens iris

Front 1344

butorphanol - mechanism of action?
- what distinguishes it from other drugs in its class?

Back 1344

partial agonist at opioid mu receptors, agonist at kappa receptors
- less respiratory depression

Front 1345

tramadol - mechanism of action?

Back 1345

weak opioid agonist, inhibits serotonin and NE reuptake (works on multiple receptors - "tram it all" in)

Front 1346

phenytoin - mechanism of action?
- used for?
- side effects?

Back 1346

Na+ channel inactivation
- tonic-clonic seizures, prophylaxis of status epilepticus
- ataxia, gingival hyperplasia, hirsutism, teratogenic, megaloblastic anemia, SLE-like syndrome, P-450 induction

Front 1347

carbamazepine - mechanism of action?
- used for?
- side effects?

Back 1347

Na+ channel inactivation
- tonic-clonic seizures, partial seizures, trigeminal neuralgia
- agranulocytosis, aplastic anemia, liver toxicity, teratogenic, P-450 induction

Front 1348

lamotrigine - mechanism of action?
- side effect?

Back 1348

blocks voltage-gated Na+ channels
- Stevens-Johnson syndrome

Front 1349

gabapentin - mechanism of action?
- used for?
- side effects?

Back 1349

increases GABA release
- seizures, peripheral neuropathy
- sedation, ataxia

Front 1350

topiramate - mechanism of action?
- side effects?

Back 1350

blocks Na+ channels, increases GABA action
- sedation, kidney stones

Front 1351

phenobarbital - mechanism of action?
- what patients is it used for?
- side effects?

Back 1351

increases GABA action by increasing DURATion of Cl- channel opening (barbiDURATe)
- pregnant women, children
- sedation, P-450 induction

Front 1352

valproic acid - mechanism of action?
- used for?
- side effects?

Back 1352

Na+ channel inactivation, increases GABA concentration
- tonic-clonic seizures, myoclonic seizures
- hepatotoxicity, neural tube defects

Front 1353

ethosuximide - mechanism of action?
- used for?
- side effects?

Back 1353

blocks thalamic T-type Ca2+ channels
- absence seizures
- EFGH: Ethosuximide - Fatigue, GI distress, Headache, Stevens-Johnson syndrome

Front 1354

benzodiazepines - mechanism of action?
- used for?
- side effects?
- treat overdose with?

Back 1354

increase GABA action by increasing FREquency of Cl- channel opening (FREnzodiazepines)
- acute status epilepticus, seizures of eclampsia
- sedation, dependence
- flumazenil

Front 1355

name the short-acting benzodiazepines
- what is the problem with them?

Back 1355

TOM thumb: Triazolam, Oxazepam, Midazolam
- highest addictive potential

Front 1356

side effects of inhaled anesthetics

Back 1356

hepatotoxicity, nephrotoxicity, malignant hyperthermia

Front 1357

what drugs are used as intravenous anesthetics?

Back 1357

B.B. King on OPIATES PROPoses FOOLishly:
Barbiturates
Benzodiazepines
Ketamine
Opiates
Propofol

Front 1358

ketamine - mechanism of action?
- used for?
- side effects?

Back 1358

blocks NMDA receptors
- IV anesthetic
- hallucinations, bad dreams

Front 1359

what IV anesthetics are used for short surgical procedures?

Back 1359

thiopental, propofol

Front 1360

with anesthetics, what qualities do solubility in blood and lipids determine?

Back 1360

low blood solubility - rapid induction and recovery
high lipid solubility - high potency

Front 1361

name 3 ester-type and 3 amide-type local anesthetics
- mechanism of action?
- side effects?

Back 1361

esters - procaine, cocaine, tetracaine
amides - lIdocaIne, mepIvicaIne, bupIvacaIne (amIdes have 2 I's)
- block Na+ channels
- CNS excitation, CV toxicity, arrhythmias

Front 1362

order of loss of sensation types with local anesthetics

Back 1362

pain > temperature > touch > pressure

Front 1363

name 1 depolarizing neuromuscular blocker and 2 nondepolarizing neuromuscular blockers

Back 1363

depolarizing: succinylcholine
nondepolarizing: tubocurarine, pancuronium

Front 1364

dantrolene - used for?
- mechanism of action?

Back 1364

malignant hyperthermia, neuroleptic malignant syndrome
- prevents Ca2+ release from sarcoplasmic reticulum

Front 1365

name 3 dopamine agonists used in Parkinson's

Back 1365

bromocriptine, pramipexole, ropinirole

Front 1366

amantadine and L-dopa - mechanism of action?
- used for?
- side effect of L-dopa? what drug is given to reduce this?

Back 1366

increase dopamine in CNS
- Parkinson's
- arrhythmias from peripheral conversion to dopamine
- carbidopa inhibits peripheral conversion of L-dopa to dopamine

Front 1367

selegiline - mechanism of action?
- used for?

Back 1367

MAO-B inhibitor, preventing dopamine breakdown
- Parkinson's

Front 1368

entacapone, tolcapone - mechanism of action?
- used for?

Back 1368

COMT inhibitors, preventing dopamine breakdown
- Parkinson's

Front 1369

benztropine - mechanism of action?
- used for?

Back 1369

antimuscarinic
- Parkinson's - curbs excess cholinergic activity, improving tremor and rigidity

Front 1370

sumatriptan - mechanism of action?
- used for?
- side effect?

Back 1370

serotonin agonist - inhibits trigeminal activation and vasoactive peptide release
- migraines, cluster headaches
- coronary vasospasm

Front 1371

memantine - mechanism of action?
- used for?

Back 1371

NMDA receptor antagonist
- Alzheimer's

Front 1372

donepezil - mechanism of action?
- used for?

Back 1372

acetylcholinesterase inhibitor
- Alzheimer's

Front 1373

mature defense mechanisms

Back 1373

mature women wear a SASH:
Sublimation
Altruism
Suppression
Humor

Front 1374

what is conduct disorder?
- difference from oppositional defiant disorder?

Back 1374

repetitive behavior violating social norms in a child <18
- defiance toward authority, but no serious violations of social norms

Front 1375

autistic disorder vs. Asperger's disorder

Back 1375

autism - language and social impairment, below-normal intelligence
Asperger's - milder, no language impairment, normal intelligence

Front 1376

characteristics of Rett's disorder

Back 1376

loss of development, mental retardation, stereotyped hand-wringing

Front 1377

major characteristic of childhood disintegrative disorder

Back 1377

regression in multiple areas of functioning after at least 2 years of normal development

Front 1378

hypnagogic vs. hypnopompic hallucinations

Back 1378

hypnaGOgic - occur while GOing to sleep
hypnopompic - occur while waking from sleep

Front 1379

progression of schizophrenic diseases

Back 1379

<1 month - brief psychotic disorder
1-6 months - schizophreniform disorder
>6 months - schizophrenia

Front 1380

what is dissociative identity disorder?

Back 1380

2+ distinct identities or personalities (multiple personality disorder)

Front 1381

what is depersonalization disorder?

Back 1381

feelings of detachment from self

Front 1382

what is a dissociative fugue?

Back 1382

abrupt change in geographic location with inability to recall past, confusion about identity, or assumption of a new identity

Front 1383

characteristics of manic episode

Back 1383

maniacs DIG FAST:
Distractibility, Irresponsibility, Grandiosity
Flight of ideas, goal-directed Activity, Agitation, decreased need for Sleep, Talkativeness

Front 1384

mood stabilizers used in bipolar disorder

Back 1384

lithium, valproic acid, carbamazepine

Front 1385

symptoms of major depressive episode

Back 1385

SIG E CAPS:
Sleep disturbance, loss of Interest, Guilt
loss of Energy
loss of Concentration, Appetite changes, Psychomotor retardation or agitation, Suicidal ideations
depressed mood

Front 1386

symptoms of panic disorders

Back 1386

PANICS:
Palpitations, Paresthesias
Abdominal distress
Nausea
Intense fear of dying or losing control, lIghtheadedness
Chest pain, Chills, Choking, disConnectedness
Sweating, Shaking, Shortness of breath

Front 1387

what is malingering?

Back 1387

consciously faking a disorder in order to attain a specific gain

Front 1388

what is factitious disorder?
- 2 examples?

Back 1388

consciously creating symptoms in order to assume "sick role" and get medical attention
- Munchausen's syndrome and Munchausen's syndrome by proxy

Front 1389

what is conversion?

Back 1389

motor or sensory symptoms following an acute stressor

Front 1390

name the cluster A personality disorders

Back 1390

paranoid
schizoid
schizotypal

Front 1391

schizoid vs. schizotypal personality disorder?

Back 1391

schizoid - voluntary social withdrawal, limited emotional expression
schizotypal - eccentric appearance, magical thinking, interpersonal awkwardness

Front 1392

name the cluster B personality disorders

Back 1392

antisocial
borderline
histrionic
narcissistic

Front 1393

name the cluster C personality disorders

Back 1393

avoidant
obsessive-compulsive
dependent

Front 1394

name 4 types of depressant

Back 1394

alcohol, opioids, barbiturates, benzodiazepines

Front 1395

treatment for delirium tremens

Back 1395

benzodiazepines

Front 1396

name 4 stimulants

Back 1396

amphetamines, cocaine, caffeine, nicotine

Front 1397

name 3 hallucinogens

Back 1397

PCP, LSD, marijuana

Front 1398

treatment for heroin overdose
- for heroin detoxification?

Back 1398

naloxone/naltrexone
- methadone or suboxone (fewer withdrawal symptoms)

Front 1399

treatment for ADHD

Back 1399

methylphenidate

Front 1400

haloperidol, fluphenazine, thioridazine - mechanism of action?
- side effects?

Back 1400

typical antipsychotics - block D2 receptors
- extrapyramidal side effects (akinesia, akathisia), tardive dyskinesia, neuroleptic malignant syndrome

Front 1401

symptoms of neuroleptic malignant syndrome
- treatment?

Back 1401

FEVER:
Fever
Encephalopathy
Vitals unstable
Elevated enzymes
Rigidity of muscles
- treat with dantrolene

Front 1402

name 3 atypical antipsychotics
- mechanism of action?
- side effect of clozapine?

Back 1402

olanzapine, clozapine, risperidone (it's not atypical for old closets to risper)
- block serotonin, alpha, H1, and dopamine receptors
- agranulocytosis

Front 1403

side effects of lithium

Back 1403

LMNOP:
Lithium side effects -
Movement (tremor)
Nephrogenic diabetes insipidus (ADH antagonist)
hypOthyroidism
Pregnancy problems

Front 1404

buspirone - mechanism of action?
- used for?

Back 1404

stimulates serotonin receptors
- generalized anxiety disorder

Front 1405

name 2 tricyclic antidepressants
- mechanism of action?
- side effects?

Back 1405

imipramine, amitriptyline
- block reuptake of NE and serotonin
- tri-C's: Convulsions, Coma, Cardiotoxicity

Front 1406

name 4 SSRIs
- side effects?

Back 1406

fluoxetine, paroxetine, sertraline, citalopram
- sexual dysfunction, serotonin syndrome

Front 1407

bupropion - used for?
- side effects?
- why is it a good substitute for SSRIs?

Back 1407

smoking cessation, depression
- stimulant effects, seizure in bulimic patients
- no sexual side effects

Front 1408

venlafaxine and duloxetine - mechanism of action?
- used for?

Back 1408

inhibits serotonin and NE reuptake
- depression

Front 1409

mirtazapine - mechanism of action?
- used for?
- side effects?

Back 1409

alpha2 antagonist, serotonin receptor antagonist
- depression
- sedation, weight gain, dry mouth

Front 1410

maprotiline - mechanism of action?
- used for?
- side effects?

Back 1410

blocks NE reuptake
- depression
- sedation, hypotension

Front 1411

trazodone - mechanism of action?
- used for?
- side effects?

Back 1411

blocks serotonin reuptake
- insomnia
- sedation, priapism, hypotension

Front 1412

phenelzine and tranylcypromine - mechanism of action?
- used for?
- side effect?

Back 1412

MAO inhibitors - increase levels of amine neurotransmitters
- depression
- hypertensive crisis with tyramine ingestion

Front 1413

what vessels are contained within:
- suspensory ligament of ovaries?
- transverse cervical ligament?
- round ligament of uterus?

Back 1413

SLO - ovarian vessels
TCL - uterine vessels
RLU - none (round = 0)

Front 1414

pathway of sperm during ejaculation

Back 1414

SEVEn UP:
Seminiferous tubules - Epididymis - Vas deferens - Ejaculatory duct - Urethra - Penis

Front 1415

what are Sertoli and Leydig cells stimulated by, and what do they secrete?

Back 1415

Sertoli - stimulated by FSH to secrete ABP and inhibin (and MIF in utero)
Leydig - stimulated by LH to secrete testosterone

Front 1416

which estrogen increases the most in pregnancy?

Back 1416

estriol (1000x - marker of fetal well-being)

Front 1417

what are theca and granulosa cells stimulated by, and what do they secrete?

Back 1417

theca - stimulated by LH to secrete androstenedione
granulosa - stimulated by FSH to secrete estrogen

Front 1418

which parts of meiosis are oocytes arrested in, and when?

Back 1418

meiosis I arrested in prOphase until Ovulation
meiosis II arrested in METaphase until fertilization (an egg MET a sperm)

Front 1419

what is the defect in 5-alpha-reductase deficiency?
- major symptom?

Back 1419

unable to convert testosterone to DHT
- ambiguous genitalia until puberty, when increased testerone causes growth of penis

Front 1420

symptoms of preeclampsia
- eclampsia?

Back 1420

hypertension, proteinuria, edema
- eclampsia also has seizures

Front 1421

what is the major marker of ovarian cancer?

Back 1421

CA-125

Front 1422

what is a Brenner tumor?

Back 1422

Brenner = Benign ovarian tumor that looks like Bladder

Front 1423

what is Meigs' syndrome?

Back 1423

triad of ovarian fibroma, ascites, hydrothorax

Front 1424

microscopic appearance of seminoma

Back 1424

fried egg cells in lobules with watery cytoplasm

Front 1425

yolk sac tumors in both men and women are associated with what tumor marker?

Back 1425

AFP

Front 1426

characteristics of Bowen's disease vs. erythroplasia of Queyrat

Back 1426

Bowen's - gray solitary crusty plaque on shaft of penis or scrotum
Queyrat - red velvety plaques on glans penis

Front 1427

finasteride - mechanism of action?
- used for?

Back 1427

5-alpha-reductase inhibitor (decreased conversion of testosterone to DHT)
- BPH, male-pattern baldness

Front 1428

flutamide - mechanism of action?
- used for?

Back 1428

competitive inhibitor of testosterone receptor
- prostate carcinoma

Front 1429

leuprolide - mechanism of action?
- used for?

Back 1429

GnRH analog (agonist when pulsatile delivery, antagonist when continuous) - leuprolide can be used in lieu of GnRH
- infertility (pulsatile), prostate cancer (continuous)

Front 1430

sildenafil and vardenafil - mechanism of action?
- side effect?

Back 1430

inhibit cGMP phosphodiesterase, so increased cGMP - causes smooth muscle relaxation and increased erection (sildenafil/vardenafil fill the penis)
- impaired blue-green color vision

Front 1431

mifepristone - mechanism of action?
- used for?

Back 1431

progesterone receptor inhibitor
- termination of pregnancy

Front 1432

dinoprostone - mechanism of action?
- used for?

Back 1432

PGE2 analog
- induce labor (dilates cervix and uterine contraction)

Front 1433

ritodrine and terbutaline - mechanism of action?
- used for?

Back 1433

beta2 agonists
- relax uterus and reduce premature contractions

Front 1434

anastrozole, exemestane - mechanism of action?
- used for?

Back 1434

aromatase inhibitors
- breast cancer

Front 1435

clomiphene - mechanism of action?
- used for?

Back 1435

partial agonist of estrogen receptors in pituitary gland - prevents normal feedback inhibition and promotes LH and FSH release
- infertility, PCOS

Front 1436

tamoxifen - mechanism of action?
- used for?

Back 1436

estrogen receptor antagonist in breast
- ER-positive breast cancer

Front 1437

raloxifene - mechanism of action?
- used for?

Back 1437

estrogen receptor partial agonist in bone
- osteoporosis