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155 Cards in this Set

  • Front
  • Back
WBC differential, highest to lowest mnemonic
Neutrophils Like Making Everything Better
causes of eosinophilia - mnemonic
NAACP
neoplasia, asthma, allergies, collagen vascular dz, parasites (invasive)
HMWK
high molecular weight kininogen - adsorbs on biomaterials, activates intrinsic pathway (cofactor in kallekrein, hageman (xii) activation. def increases PTT
ADP in coagulation
binds p2y on platelet, causes exposure of many 2b3a receptors for fibrinogen binding
gp2b/2a - what does it bind?
fibrinogen. gp2 binds factor 1
ticlopidine and clopidogrel vs abciximab
t + c prevent gp2b3a receptor expression by blocking p2y receptor, abciximab directly binds gp2b3a
warfarin vs heparin
warfarin prevents activation of vitk (and 2,7,9,10,c,s). heparin activates AT3, which inactivates 2,7,9,10,11,12?)
basophilic stippling mnemonic
BASte the ox TAIL - thlassemias, anemias of chronic dz, lead poisoning (inhibition of ribonucleotide reductase)
rRNA accum in cytoplasm
siderblastic anemia
inability to incorporate Fe into Hb - fe accum in mitochondria
target cell mnemonic
HALT said the hunter! HbC, Asplenia, Liver dz, Thalassemia
deficiency in ALA synthase
x linked siderblastic anemia, tx is B6
causes of siderblastic anemia
alcoholism, lead poisoning, heredity. cannot incorporate Fe into heme
anemia w/ inc homocysteine and normal methylmalonic acid
folate def
anemia with inc homocysteine and inc methylmalonic acid
b12 def
hepcidin
increased during inflammation, decreases releace of Fe from macrophages, reasulting in anemia of chronic dz. dec fe, dec tibc, inc ferritin
Lead poisoning - enzymes effected and accum substrates
ala dehydratase + ferrochelatase, accumulate protoporphyrin and delta ALA
Acute Intermittent porphyria - enzymes and substrates
porphobilinogen deaminase (aka uroporphyrinogen synthase) - accumulate porphobilinogen, delta ALA
AIP - mnemonic
5 Ps, painful abdomen, pink urine, polyneuropathy, psychological distrubance, precipitated by drugs, porphobilinogen accumulation

tx glucose and heme
Porphyria cutanea tarda - enzymes and substrates
uroporphyrinogen decarboxylase, accumulate uroporphyrin.

blistering photosensitivity, MC porphyria
lead poisoning mnemonic
LEAD - lead lines on gums and bone, encephalopathy + erythrocyte basophilic stippling, abdominal colic and siderblastic anemia, drops (wrist, foot), dimercaprol, eDta, succimer
bernard soulier dz - defect, PC, BT, tx
gp1b, low PC, high BT, giant platelets, give platelets, defect in formation and adhesion to collagen
glanzmanns thormbasthenia - defect, PC, BT, tx
gp2b/3a, normal PC, high BT, defect in aggregation
idiopathic thrombocytopenic purpura
anti gp2b3a antibodies, PC down, BT up, peripheral destruction, increased megakaryocytes
thrombotic thrombocytopenic purpura
ADAMSTS13 defect (vWF metalloproteinase), dec degradation of multimers. large vWF multimers, Inc platelet agg, schitsocytes + LDH,
lab shows : inc fibrin split products (d dimers), dec fibrinogen, dec favtors V and VII
DIC
reduced increase in PTT on heparing administration. dz?
AT3 defiency
what increases risk of hemorrhagic skin necrosis following warfarin administration?
protein C and S defiency, cannot inactivate V and VII
nodular sclerosing hodgkins lymphoma
collagen banding around lacunar cells creates nodules of neoplastic cells. low number of RS cells, MC hodgkins
mantle cell lymphoma
NHL, older men, t(11:14), poor prognosis, CD5+
follicular lymphoma
t(14:18), 40% of NHL, bcl2 expression inhibits apoptosis, indolent waxing / waning lymphoma
diffuse large B-cell lymphoma
MC (50%) adult NHL, EBV / AIDS association
Mycosis fungiodes
indolent, adults w/ cutaneous nodules- CD4 cells, called sezary if leukemic phase occurs
Multiple myeloma vs waldenstorms macroglobulinemia
MM- CRAB, hypercalcemia, lytic bone lesions, back pain, anemia, renal failure, IgG and IgM
WM- IgM only, macroglobulinemia, no lytic lesions

no sx of lymphoma = MGUS
age groups for leukemias: CML, AML, CLL, ALL
ALL <15
CML 30-60
AML ~60 median onset
CLL > 60
leukemoid rxn
inc wbc w/ left shift (80% bands), inc leukocyte alp, no inc in alp is specific for CML
t(11:14)
man11e cell lymphoma
t(15:17)
acute promyelocytic, auer rods, DIC, isotretinoin
t(14,18)
follicular lymphoma, indolent, waxing / waning
t(11,22)
ewing sarcoma, malignant round cells in diaphysis of bone
t(9,22)
CML, philadelphia chromosome, imatanib
t(8,14)
burkitt's lymphoma, starry sky
S100 + CD1a
langerhans histiocytosis X - letterer siwe (baby), hands schuller christian (DI, lytic, exopthalmos), eosinophilic granuloma

birbeck tennis rackets
RBC up, WBC up, platelets up, philly neg, JAK2 pos
polycythemia vera
RBC normal, WBC normal, platelets up, philly neg, JAK2 pos
essential thrombocytosis
RBC down, WBC var, platelets var, philly neg, JAK2 pos
myelofibrosis
RBC down, WBC up, platelets up, philly pos, JAK2 neg
CML
hirudin, lepirudin, bivalrudin
directly inhibit thrombin, alternative to heparin for pts w/ HIT
aminocaproic acid
anti fibronolytic, treats OD of streptokinase, urokinase, tPA (ansteplase), anistreplase
thrombolytics - mechanism
aid directly or indirectly in cleavage of plasminogen to plasmin
ticlopidine vs clopidogrel:
which ones causes serious side effect?
ticlopidine (neutropenia) - both are irrev inhibitors of gp2b3a
etoposide
inhibits topoisomerase 2, blocking dna synth, myelosuppression, GI hair problems
6mp vs 6thioguanine
both activated by HGPRTase, but 6mp is degraded by XO, so cannot be given w/ allopurinol while 6TG can
hodgkin lymphoma tx (mnemonic)
ABVD - adriamycin (doxo), bleomycin, vincritine, dacarbazine
doxorubicin (adriamycin)
noncovalently intercalates DNA, breaks it. cardiotoxic, myelosuppression (give w/ molgramostim gmcsf)
bleomycin
G2 phase free radicates breaks DNA strands, pulm fibrosis, minimal myelosuppression
cyclophosphamide
covalently x-link DNA at guanine, hemorrhagic cystitis (mesna)
nitrosureas (-mustines)
alkylating agent for brain tumors including GBM, CNS toxicity
busulfan
alkylating agent, for CML, pulm fibrosis
antimetabolite drugs
good for leukemias - methotrexate, 5FU, 6MP, 5TG, Cytarabine
how to rescue bone marrow w/ mtx or 5FU
mtx - leucovorin (folinic acid)
5fu - thymidine - 5fu = photosenstivity
vincristine
binds / blocks microtubules - neurotoxic effects
vinblastine BLASTS bone marrow
paclitaxel
sTAX microtubules, doesnt let them collapse - ovarian and breast CA
cisplatin carboplatin
cross linker, nephro / ototoxic

amofostine prevents nephrotoxicity
hydroxyurea
ribonucleotide reductase inhibitor
tamoxifen vs raloxifene
both are anti ER, agonists in bone, tamox is partial agonist in endometrium, may cause cancer / hot flashes, ralox is endo antagonist
falciform ligament - contents
ligamentum teres, derived from fetal umbilical vein
hepatoduodenal ligament - contents
portal triad: hepatic artery, portal vein, common bile duct
gastrohepatic ligament - contents
gastric arteries (l gastric off celiac, r gastric off common hepatic)
gastrocolic ligament - contents
gastroepiploic arteries
gastrosplenic ligament - contents
short gastrics
spenorenal ligament - contents
splenic a. and v.
gi histo: brunners glands and crypts of lieberkuhn
deuodenum
gi histo: most goblet cells in small intestine
jejunum (its got jujubees)
gi histo: peyers patches and crypts of lieberkuhn
ileum, keeps you from gettin ill
gi histo: crypts but no villi
colon
circulation above pectinate line
portal - IMA, sup rectal a + v, IMV, portal system
circulation below pectinate line
caval, all I's - internal iliac, internal pudendal a, inf rectal a + v, int pudendal v, int iliac v, IVC
layers around spermatic cord
3 layers of fascia, 1 muscle. transversalis fascia (int spermatic fascia), cremaster m and fascia (int oblique), int and ext oblique fascia (ext spermatic)
contents of femoral triangle
to find your NAVEL, go lateral to medial

nerve artery vein empty lymph
indirect vs direct hernia - mnemonic
MDs dont LIe

Medial direct, lateral indirect
where do IgA secreting cells reside?
peyers B-cells are stimulated into germinal centers, diff into IgA plasma cells that reside in lamina propria. needs secretory component
plummer vinson syndrome triad
fe def anemia, dysphagia (webs) and glossitis
ABCs of esophageal cancer
Alcohol/Achalasia
Barretts
Cigarettes
Diverticuli
Esophageal webs / esphagitis
Familial
whipple's dz - whats it really similar to?
lyme dz + diarrhea - arthralgias, cardiac and neuro problems. tx w/ penicillin.
curling vs cushing ulcers
get burned by curling iron, low blood vol causes sloughing.
always cushion brain
type A chronic gastritis
Autoimmune, antibody mediated, macrocytic Anemia, Achlorhydria, occurs in Body
type B chronic gastritis
Bacterial, occurs in Antrum
Mentrier dz
edema ascites from protein loss, brain gyri, inc adenoCA risk, low HCl high gastrin
three signs of stomach CA
virchows node, st mary josephs nodule, krukenberg tumor, acanthosis nigricans
L vs R colon cancer
distal left = obstruction
proximal right = anemia

right better prognosis
peutz jeghers
AD, multiple non mal. hamartomas in gi, hyperpigmented mouth lips genetalia, inc risk CRC, brca, gyny ca
Gardners
FAP + osseous + soft tissue tumors
turcots
FAP + malignant CNS tumors
ABCDs of Wilsons
Asterixis, Basal ganglia degeneration, Ceruloplasmin down, Cirrhosis, Corneal deposits, Copper accum, Carcinoma, Choreiform movements, Dementa, Hemolytic anemia, hepatolenticular degenration
PBC vs PSC
PBC - ANA+ granulomas, anti mito antibodies, inc HCC risk, women
PSC - concentric beading, intra+extrahepatic, cholangiosarcoma risk, in MEN - ass w/ UC, hyperIGM
charcot's triad of cholangitis
jaundice, fever, ruq paint
Acute pancreatitis mnemonic
GET SMASHED - gallstones, ethanol, trauma, steroids, mumps, autoimmune, scorpion sting, hypercalc/lipidemia, ERCP, drugs (sulfa)
proton pump inhibitors - reversible or irreversible?
irreversible
muscarinic antagonists for acid hypersecretion
pirenzepine + propantheline - blocks M1 on ECL, M3 on parietal cell
ondansetron
5ht3 antagonist, central acting antiemetic, for postoperative nausea and chemo
metoclopramide vs domperidone
D2 rec antagonists, increase gastric tone / motility. met has parkinsonian effects, crosses BBB, both interact w/ diabetic + digoxin agents due to K+ opening Gi
Pituitary gland - basophils?
B-FLAT
Pituitary gland - acidophils?
PG - not B-flat, remainder of PiG
CAH - hypotension, salt wasting
21 alpha hydroxylase
What do all CAHs have in common?
decreased cortisol, increased ACTH -> adrenal hyperplasia
CAH - sexual infantilism in XX or external female w/ no internal female organs in XY
17 alpha hydroxylase
masculinization w/ hypertension
11 beta hydroxylase
masculinization w/ hypotension
21 alpha hydroxylase
decreased cortisol and mineralocorticoids
21 alpha hydroxylase
decrased cortisol, aldosterone and corticosterone, increased 11-DOC (mineralocorticoid)
11 beta hydroxylase
decreased serum Mg+2?
decreases Pth secretion. less competition from Ca+2
common causes of decreased serum Mg+2?
diarrhea, diuretics, AG and alcohol abuse.
sex hormone binding globulin - what does it have higher affinity for?
testosterone, so increasing SHBG decreases free T.
increase SHBG in men?
gynecomastia
decrease SHBG in women?
hirsutism
cortisol's effect on epinephrine?
upregulates alpha1 receptors, raising blood pressure
thyroxine's effect on epinephrine?
upregulates beta1 receptors, increasing CO, HR, SV
T3 functions - mnemonic
4B's - brain maturation, bone growth, beta adrenergic effects, BMR up.
what increases / decreases TBG?
thyroid binding globulin.. increased by Estrogen/OCPs, decreased by hepatic failure
low TBG and high T4?
exogenous thyroid hormone - also low TSH, high T4, T3 and rT3
normal TSH?
always euthyroid
electrolyte imbalances:

Na+ n/c
K+ down
HCO3- up
primary mineralocorticoid excess (Na+ is normal because of ANP releace w/ increased plasma volume.)
electrolyte imbalances:

Na+ down
K+ up
HCO3- down
primary adrenocortical insufficiency (addisons)
electrolyte imbalances:

Na+ n/c
K+ down
HCO3- down
renal tubular acidosis
electrolyte imbalances:

Na+ down
K+ down
HCO3- up
diuretic use (alkalosis 2/2 dec K+/H+)
electrolyte imbalances:

Na+ down
K+ n/c
HCO3- n/c
SIADH (ADH overpowers aldosterone)
pot bellied, pale, puffy faced child w/ protruding umbilicus and protuberant tongue dx?
cretinism aka fetal hypothyroidism
Hypercalcemia causes?
CHIMPANZEES
Calcium ingestion, Hyperparathyroid, Hyperthyroid, Iatrogenic (thiazides), Multiple myeloma, Paget's, Addison's, Neoplasms, Zollenger Ellison, Excess vitamin D, Excess vitamin A, Sarcoidosis
osteitis fibrosa cystica mnemonic
"stones bones and groans", cystic bone spaces filled w/ brown fibrous tissue. 2/2 primary hyperparathyroidism. groans = constipation, stones = renal stones.
pseudohypoparathyroidism
albright's hereditary osteodystrophy. AD, kidney not responsive to PTH. Hypocalcemia, shortened 4th and 5th digits, short stature.
hyponatremia + urine osmolarity > plasma osmolarity = ?
SIADH

tx: demeclocycline
SIADH causes?
Ectopic ADH (small cell ca)
cns disorders / head trauma
pulm dz
drugs (ie cyclophosphamide)
MEN2a and b - what do they both have?
pheochromocytoma and medullary thyroid cancer
MEN2a and b - how are they different?
MEN2a aka sipple syndrome also has parathyroid tumor (normal Ca+2)

MEN2b has oral / intestinal ganglioneuromatosis / marfanoid habitus / low Ca+2
which diabetic drugs dont cause hypoglycemia?
thiazolidinediones and metformin
biguanides / metformin toxicity
lactic acidosis - contraindicated in renal failure
drugs for post prandial hyperglycemia?
short acting insulins: lispro, aspart, regular

alpha glucosidase inhibitors : acarbose and miglitol
exenatide MOA
GLP-1 mimetic, inc insulin, dec glucagon - nausea vomiting pancreatitis
pramlintide
mimetic decreases glucagon, causes nausea, vomiting, diarrhea
which long acting insulins require 1 and 2 shots per day?
1 for glargine
2 for NPH

total = 4 and 5 shots
sibutramine
sympathomimetic serotonin and NE reuptake inhibitor - anorexiant. may cause htn and tachycardia
propylthiouracil vs methimazole
both inhibit organification of iodide and coupling of thyroid hormone synthesis. PTU decreases peripheral conversion of T4 to T3.

agranulocytosis / aplastic anemia
kallmann syndrome
low FSH, LH from anterior pituitary, primary amenorrhea, no 2ndary sexual characters,, AD inheritance, occurs in men and women, delayed puberty (hypogonatotropic hypogonadism)
HELLP syndrome
hemolysis, elevated lfts, low platelets, associated w/ preeclampsia, mortality due to cerebral hemorrhage and ards
tx for eclampsia
iv mgso4 and diazepam.
bed rest, salt restriction, tx of htn (hydralazine)
PCOS
inc LH, inc ovarian stromal stim, inc androgens, inc estrogens, inc pituitary sensitivity to LRL, inc pit LH release. LOW FSH. Tx: increase FSH to break cycle, spironolactone anti androgen
epithelial ovarian tumors
My Med Students Consistently Beat Exams

Mucinous, Mixed, Serous, Clear cell, Brenner, Endometrioid
meig's triad
ovarian fibroma, ascites, hydrothorax (often left sided pleural effusion)
granulosa cell tumor
call exner bodies - small follicles filled w/ eosinophilic secretions, precocious puberty, uterine bleeding
radial nerve innervation
its the BEST
brachioradialis, extensors of the hand, supinator, triceps
radial nerve innervation
its the BEST
brachioradialis, extensors of the hand, supinator, triceps
contents of thenar compartment
OAF
opponens pollicis, abductor pollicis brevis and flexor pollicis brevis
contents of hypothenar compartment
OAF
opponens digiti minimi, abductor digiti minimi, flexor digiti minimi
dorsal interossei
abduct dabs
palmar interossei
adduct pads