Usmle Step 1 - May 7 & 8 (Pathology)

Front 1

What are the causes of a low ESR?

Back 1

1) Altered shape (e.g. Sickle Cell)
2) Polycythemia
3) CHF

Front 2

What intermediate filament stain is used to ID sarcomas (mostly; some carcinomas)?

Back 2

Vimentin stain (stains CT)

Front 3

What intermediate filament stain is used to ID leiomyosarcomas and rhabdomyosarcomas?

Back 3

Desmin stain (stains muscle tissue)

Front 4

What intermediate filament stain is used to ID carcinomas?

Back 4

Cytokeratin stain (for epithelial cells)

Front 5

What intermediate filament stain is used to ID adrenal neuroblastomas and primitive neuroectodermal tumors?

Back 5

Neurofilament stains

Front 6

What cytokines mediate cachexia?

Back 6

TNF-α
IFN-y
IL-6

Front 7

What neoplasms are a/w Down syndrome?

Back 7

ALL
AML

(other dz a/w = AL-zheimers)

Front 8

What are the classic features of Plummer-Vinson syndrome?

Back 8

DEFG of Plummer-Vinson:
-Dysphagia (Esophageal web)
-Fe deficiency (anemia)
-Glossitis

Predisposes to Squamous Cell Carcinoma of the Esophagus

Front 9

What screening test would you do for someone w/ Hepatitis B or C?

Back 9

AFP test

checking for HCC

Front 10

What are the features of Paget's disease of bone?

Back 10

The H's of Paget's:
-hurt (bone pain)
-h/a
-hearing loss
-hat size
-heart failure

Front 11

What chronic disease is a/w Acanthosis Nigricans? What neoplasm?

Back 11

DM

Gastric (and other visceral cancers)

Front 12

What neoplasm is a/w actinic keratosis?

Back 12

Squamous cell cancer of skin

Front 13

What neoplasm is a/w Radiation exposure?

Back 13

1) Sarcoma
2) Papillary thyroid cancer

Front 14

What neoplasm is a/w Barrett's esophagus?

Back 14

Esophageal Adenocarcinoma

Front 15

What neoplasm is a/w Sjogren's syndrome?

Back 15

B-Cell lymphomas

Front 16

What neoplasm is a/w Ataxia-Telangiectasia?

Back 16

Lymphomas
Leukemias (Acute)

Front 17

What does the abl gene code for and what neoplasms are a/w it?

Back 17

Tyrosine kinase (non-receptor)

Front 18

What does the c-myc gene code for and what neoplasms are a/w it?

Back 18

Transcription factor

Burkitt's Lymphoma

Front 19

What does the bcl-2 gene code for and what neoplasms are a/w it?

Back 19

Anti-apoptosis molecule

Lymphomas (follicular and undifferentiated)

Front 20

What does the erb-B2 gene code for and what neoplasms are a/w it?

Back 20

Tyrosine kinase

Carcinomas:
- Breast
- Ovaries
- Gastric

Front 21

What does the ras gene code for and what neoplasms are a/w it?

Back 21

GTPase
NOTE: most common oncogene

K-ras = colon, lung, pancreas
H-ras = bladder, kidney (H2O)
N-ras = melanoma, heme

Front 22

What does the L-myc gene code for and what neoplasms are a/w it?

Back 22

Transcription factor

L-ung tumor (small cell = "little")

Front 23

What does the N-myc gene code for and what neoplasms are a/w it?

Back 23

Transcription factor

N-euroblastoma (adreNal)

Front 24

What does the ret gene code for and what neoplasms are a/w it?

Back 24

Tyrosine kinase

MEN IIA & IIB

Front 25

What does the c-kit gene code for and what neoplasms are a/w it?

Back 25

Cytokine receptor

GIST = Gastrointestinal Stromal Tumor

Front 26

What tumor is a/w the tumor suppressor Rb?

Back 26

Retinoblastoma
Osteosarcoma

R-etina, b-one

Front 27

What tumor is a/w the tumor suppressor p16?

Back 27

Melanoma

Front 28

What tumor is a/w the tumor suppressor APC?

Back 28

Colorectal cancer (think FAP)

Front 29

What tumor is a/w the tumor suppressor DPC?

Back 29

Pancreatic cancer
(D-eleted in P-ancreatic C-ancer)

Front 30

What tumor is a/w the tumor suppressor DCC?

Back 30

Colon cancer
(D-eleted in C-olon C-ancer)

Front 31

What cancer is a/w HTLV-1?

Back 31

Adult T-Cell Leukemia/Lymphoma

Front 32

What cancer is a/w HCV?

Back 32

1) HCC
2) Papillary thyroid cancer

Front 33

What cancer is a/w EBV?

Back 33

4 cancers:
1) Burkitt's lymphoma
2) Hodgkin's lymphoma
3) Nasopharyngeal carcinoma
4) Oral hairy leukoplakia

Front 34

What cancer is a/w HIV?

Back 34

Primary CNS Lymphoma

(also Kaposi's sarcoma)

Front 35

What infection and associated cancer would you expect in a 3rd world patient w/ hematuria?

Back 35

Schistosoma haematobium

Squamous cell carcinoma of the Bladder

Front 36

What cancer is a/w Strep bovis?

Back 36

Colon cancer

Front 37

What paraneoplastic effect is a/w Small cell lung cancer?

Back 37

SCL:
- S-IADH (ADH)
- C-Cushings (ACTH)
- L-ambert Eaton (Ab's vs pre-synaptic Ca2+)

Front 38

What cancers cause hypercalcemia?

Back 38

- Squamous cell lung
- RCC
- MM
- Breast

Front 39

Which cancers cause polycythemia?

Back 39

d/t EPO production:
- RCC
- HCC
- Pheochromocytoma
- Hemangioblastoma

R-eally H-ave P-lenty of H-eme!

Front 40

What paraneoplastic effect is a/w thymoma?

Back 40

Lamber-Eaton Syndrome

(Ab's to the presynaptic Ca2+ channels)

Front 41

What cancers are associated with hyperuricemia?

Back 41

Leukemia and Lymphoma
(excess nucleic acid turnover)

Front 42

What are the cancers that metastasize to the brain?

Back 42

L-ots of B-rain K-illing M-ets:
1) Lung
2) Breast
3) Kidney
4) Melanoma

Front 43

What cancers metastasize to the bone?

Back 43

P-B-L & T-est T-aking give medical educators BONErs:
1) P-rostate & B-reast
2) L-ung
3) T-hyroid & T-estes

Front 44

What cancers metastasize to the liver?

Back 44

GI cancers:
1) Colon
2) Stomach
3) Pancreas

Front 45

How long does a constant infusion of a drug take to reach 94% concentration?

Back 45

4 t1/2

1 t1/2 = 50%
2 t1/2 = 75%
3 t1/2 = 87.5%

Front 46

What are common examples of zero-order elimination drugs?

Back 46

PEA (round like a zero):
- Phenytoin
- EtOH
- ASA