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Comprehensive first aid flashcards compilation:

Vitamin C ____ (promotes/inhibits) iron absorption by keeping it in the ____

(reduced/oxidized) state.
Promotes; reduced absorbic acid (ascorbic acid)
During auscultation of a patient with aortic stenosis, does the time between pulmonic and
aortic valvular closure change during inspiration?
Yes, it decreases, and P2 precedes A2 (this is known as paradoxical splitting)
A man with no surgical history decides to take five iron supplements a day. He later develops
a small bowel obstruction. What is the cause?
Chronic iron poisoning causing scarring, which leads to gastrointestinal obstruction
Deoxyuridine monophosphate (dUMP) is converted to deoxythymidine monophosphate
(dTMP) by which enzyme?
Thymidylate synthase
What conditions are caused by Echinococcus granulosus?
Hydatid cysts in liver (anaphylaxis if antigens are released; surgeons preinject ethanol to kill
cysts before removal)
A man with a history of alcohol and IV drug use presents with fever and productive cough.
Which three are the most likely pathogens?
This is pneumoniapathogens are Streptococcus pneumoniae, Klebsiella,
and Staphylococcus
Does enteropathogenic E. coli (EPEC) directly cause damage or act via a toxin?
EPEC does not produce a toxinit is directly pathogenic
A hardworking medical student on her surgery clerkship skips lunch to go to the OR. How
does this affect the action of FBPase-2 and PFK-2?
In fasting, increased glucagon raises cAMP/PKA, raising FBPase-2 and lowering PFK-2, which
lowers glycolysis and raises gluconeogenesis
How does the innate immune system recognize pathogens?
By toll-like receptors (TLRs), which are pattern recognition receptors that recognize
pathogen-associated molecular patterns (PAMPs)
In between meals, these two hormones help stimulate the use of fuel reserves.
Glucagon and adrenaline
What symptoms and signs do the letters in the mnemonic from Jane represent in bacterial
Fever, Roth spots, Osler nodes, murmur, Janeway lesions, anemia, nail-bed
hemorrhages, emboli
What immune cells utilize perforins and granzymes?
Killer (cytotoxic) T cells
A patient has central and peripheral demyelination with ataxia and dementia. Name
deficient enzyme, accumulated substrate, & inheritance.
Metachromatic leukodystrophy is caused by arylsulfatase A deficiency; cerebroside sulfate;
autosomal recessive
Microvilli and adherens junctions are composed of which two cytoskeletal elements?

Actin and myosin

Name seven diseases that can cause red rashes in children.
Measles, rubella, roseola (HHV-6), scarlett fever (group A Strep), varicella zoster virus, &
coxsackie A virus; parvoB19
Ribavirin acts by inhibiting the synthesis of ____ nucleotides by competitively inhibiting the
enzyme ____.
Guanine; IMP dehydrogenase
Quinidine causes symptoms of headache and tinnitus, which are collectively known as what?
What other side effect(s) can it cause?
Cinchonism, which can occur with all quinine derivatives; also causes torsades due to
increased QT interval, as well as thrombocytopenia
Amphotericin is used to treat which specific fungal infections?
Serious systemic mycoses, such as Cryptococcus, Blastomyces, Coccidioides, Aspergillus,
Histoplasma, Candida, Mucor
What are one biochemical similarity and one biochemical difference
between Shigella and Salmonella?
Salmonella produces hydrogen sulfide, but Shigella does not; neither can ferment lactose
A 25-year-old woman has had trouble getting pregnant and now complains of peripheral
vision loss. What is the cause of her infertility?
She likely has a prolactinoma (decreased GnRH, amenorrhea, infertility)
Rheumatic heart disease is an example of type ____ hypersensitivity and involves creation of
anti- ____ antibodies.
II; M protein
What are the two major toxicities associated with penicillin treatment?
Hypersensitivity reactions and hemolytic anemia
An AIDS patient develops disseminated Mycobacterium avium-intracellulare infection. What
drug could have likely prevented this?
Azithromycin, which is used for prophylaxis, particularly in patients with AIDS
What is the function of interleukin-6? By what cells is it produced?
Stimulates production of acute-phase reactants and immunoglobulins; Th2 cells and
The a, c, and v waves of the jugular venous pulse are associated with which physiologic
events, respectively?
Atrial contraction, right ventricular contraction, and filling against a closed tricuspid valve
An immunocompromised patient presents with ""soap bubble"" lesions in the brain. What
fungal infection is likely?
Cryptococcus neoformans
How does E. coli O157:H7 induce thrombocytopenia, anemia, and acute renal failure?
The toxin causes endothelial damage on which microthrombi form, leading to hemolysis, low
renal blood flow, and platelet consumption
What three findings indicate bacterial vaginosis?

Noninflammatory discharge, fishy odor (positive whiff test), and clue cells on microscopy
A man presents with easy bruising and ecchymoses. You found that he has defective crosslinking of tropocollagen. What disease does he have?
Ehlers-Danlos syndrome
In what population are glitazones/thiazolidinediones prescribed? What are the main side
effects of these drugs?
Type 2 diabetes mellitus (as monotherapy or in combination with other agents); weight gain,
edema, hepatotoxicity, heart failure
Which two cardiac structures are ultimately created by neural crest cell migration?
Ascending aorta and pulmonary trunk, which are created from the truncus arteriosus
What is the advantage of a fluorescence in situ hybridization analysis over a karyotype?
It allows researchers to localize anomalies at a molecular level, including deletions that are
too small to be seen on a karyotype
What are the most common uses for chloramphenicol?
Meningitis (Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae)
& Rocky Mountain spotted fever
A patient has a deficiency of vitamin B6. Will his body's processing of glutamate be changed?
Will any reactions be unaffected?
Yes, the conversion of glutamate to GABA requires vitamin B6; yes, the conversion of
glutamate to glutathione is unaffected
N. meningitidis and N. gonorrhoeae both ferment what type of sugar and produce which
type of immunoglobulin protease?
Both ferment glucose and produce IgA protease
How do you treat Trypanosoma cruzi infection?
A patient's infection becomes resistant to the macrolide antibiotic he is taking. By what
mechanism did this occur?
Methylation of the macrolide 23S ribosomal RNA binding site
In the embryonic heart, the smooth part of ventricles arise from the ____, and the
trabeculated part from the ____.
Bulbus cordis; primitive ventricle
Toxicities of the antifungal ____ include IV phlebitis, anemia, cardiac ____, nephrotoxicity, ____
BP, ____/____ (shake and bake).
Amphotericin B; arrhythmias; low blood pressure; fevers/chills (amphoterrible)
Mixed connective tissue disease can be associated with which autoantibodies?
Anti-U1 RNP (ribonucleoprotein)
Which oncogenic virus is associated with penile/anal carcinoma? Where else can it cause
Human papillomavirus (especially types 16 and 18); can cause head & neck or throat

A transplantation patient with a maculopapular rash, jaundice, hepatosplenomegaly, and

diarrhea is likely to have had what transplantation?
Bone marrow or liver (lymphocyte-rich tissue, initiating graft-versus-host disease)
potentially beneficial in bone marrow transplantation
On physical exam, a patient's pulse pressure is found to be decreased. Name four conditions
that may cause this finding in this patient.
Aortic stenosis, cardiogenic shock, tamponade, and advanced heart failure
What is the rate-determining enzyme of the HMP shunt? What are the positive regulators?
Negative regulators?
Glucose-6-phosphate dehydrogenase (G6PD); NADP+ positive; NADPH negative
A traveler who becomes ill with typhoid fever can transmit it to others, because the
pathogen can remain in what organ?
The gallbladder
Patients with life-threatening malaria or recurrent P. vivax/ovale infections should be tested
for what condition?
G6PD deficiency
What is the common name for Ancylostoma duodenale and Necator americanus?
A boy has neurodegeneration, cherry-red macula, lysosomes with onion skinning, & normal
liver. Name deficient enzyme and excess substrate.
Tay-Sachs disease is caused by hexosaminidase A deficiency (Tay-Sax [-Sachs] lacks
hexosaminidase); GM2 ganglioside
A 45-year-old male patient starts taking lidocaine. What type of arrhythmia may he have?
Class IB antiarrhythmics treat ventricular arrhythmia (especially after myocardial infarction)
and digitalis-induced arrhythmias
Describe how blood pressure is related to the transmission of impulses from the aortic arch
receptors to the medulla.
Aortic receptor afferents travel via the vagus to the solitary nucleus of the medulla in
response to increased blood pressure only
A woman has hyponatremia with low serum osmolarity and high urine osmolarity. What drug
works by antagonizing the defective pathway?
Demeclocycline (antidiuretic hormone antagonist, in tetracycline family) treats syndrome of
inappropriate secretion of antidiuretic hormone
A man has increased serum amyloid A, CRP, ferritin, fibrinogen, hepcidin and decreased
serum albumin and transferrin. What is going on?
Serum concentrations of acute-phase reactants change in both acute and chronic
inflammatory states
Tertiary syphilis disrupts the vasa vasorum and subsequently leads to what complications?
Dilation of the aorta leading to aneurysm or aortic valve incompetence
Which antiarrhythmics belong to class III?
Potassium channel blockers, such as amiodarone, ibutilide, dofetilide, sotalol (AIDS)
Why does catalase make organisms more pathogenic?

Catalase degrades H2O2 before myeloperoxidase converts it to microbicidal products

During fetal erythropoiesis, when does the bone marrow start producing fetal red blood
Week 18
What hormones use the inositol triphosphate signaling pathway?
GnRH, oxytocin, ADH (V1 receptor), TRH, histamine (H1), angiotensin II, gastrin (goat hag)
Mutation in which enzyme allows cytomegalovirus or herpes simplex virus to be resistant to
foscarnet treatment?
DNA polymerase
A patient presents with tertiary syphilis. What are the likely clinical findings?
Tabes dorsalis, gummas, aortitis, Argyll Robertson pupil
The products of phase II metabolism of drugs are typically excreted by what organ?
What two conditions can tuberculosis lead to following central nervous system invasion?
Parenchymal tuberculoma and meningitis
What enzyme system mediates phase I metabolism of drugs in the body?
Cytochrome P-450
A patient eats a meal and insulin is activated. What receptor does insulin bind to? By what
two pathways does it promote glycogen storage?
Tyrosine kinase dimer receptor; directly activates glycogen synthase and inhibits glycogen
phosphorylase via protein phosphatase
A 25-year-old man with an autosomal dominant familial dyslipidemia has pancreatitis. Which
disease does he likely have?
He has type IV familial dyslipidemia (hypertriglyceridemia) caused by hepatic
overproduction of VLDL
Why does the endometrial lining of the uterus undergo atrophy after menopause?
Because it loses growth signals from endogenous hormones
Which two -blockers are used to treat supraventricular tachycardia? What is their
mechanism of action?
Metoprolol and esmolol; decrease atrioventricular conduction velocity (class II
Catalase degrades H2O2 before it is converted to microbicidal products by myeloperoxidase
(enzyme). Name seven catalase-positive organisms.
Pseudomonas, Listeria, Aspergillus, Candida, E. coli, S. aureus, Serratia (you
need placess for yourcats [catalase])
The tumor suppressor gene associated with retinoblastoma and osteosarcoma has what
The Rb tumor suppressor gene inhibits E2F, blocking the G 1toS phase transition
Adding Streptococcus agalactiae to a culture of S. aureus results in an enlarged area of
hemolysis. Name the causative factor.

CAMP factor made by Streptococcus agalactiae (CAMP stands for the authors of the test, not
cyclic AMP)
A 68-year-old man with chronic hypertension recently had a cardiac stent placement. Why is
hydralazine contraindicated in this patient?
Hydralazine is contraindicated in angina and coronary artery disease, because it causes a
drop in BP that induces compensatory tachycardia
Which hematologic disorder can cause both dilated cardiomyopathy and
restrictive/obliterative cardiomyopathy?
Km is defined as concentration of substrate at 1/2 V max
Postpartum blues often resolve in ____; postpartum depression can last as long as ____;
postpartum psychosis often lasts ____.
10 days; a year or more; 4 to 6 weeks
A 55-year-old man has unstable angina. What are the effects of nitrates, -blockers, or both
on heart rate?
-blockers decrease heart rate, nitrates increase heart rate (as a reflex response), a
combination of both decreases heart rate
How can fructose enter glycolysis quickly?
Via aldolase B, as fructose skips the rate-limiting step of phosphofructokinase
How can fructose enter glycolysis quickly?
Via aldolase B, as fructose skips the rate-limiting step of phosphofructokinase
Describe the effect of each inhibitor type on Vmax: reversible competitive, irreversible
competitive, and; noncompetitive.
Reversible competitive is unchanged; irreversible competitive decreases; noncompetitive
Elevated levels of alkaline phosphatase can be associated with which three disease
Seminoma (placental ALP), Paget disease of the bone, and metastases to bone or liver
A few hours after your patient fills his prescription to help with his PTSD, he calls you saying
he is feeling dizzy. Why?
Prazosin (an 1-selective blocker) can cause orthostatic hypotension on initial doses
A boy has recurrent infections (viral, bacterial, protozoal), faulty IL-2 receptors, and no
germinal centers in lymph nodes. Treatment?
Treatment of choice is bone marrow transplantation (no allograft rejection) for this patient
with severe combined immunodeficiency (SCID)
A patient with abnormally low LDL receptors may have a defect in which vesicular trafficking
What vital sign may be used to approximate afterload?
Mean arterial pressure
Amphotericin B binds to ____ (unique to fungi); this creates membrane pores, allowing
leakage of ____, requiring ____ and ____ supplements.

Ergosterol; electrolytes; K and Mg because of altered renal tubule permeability

(amphotericin tearsholes in fungal membranes)
A patient presents with signs of hyperammonemia. Workup shows increased ornithine and
normal urea cycle enzyme levels. Diagnosis?
Hereditary N-acetylglutamate deficiency
Name the enzyme produced by E. coli that breaks down lactose into glucose and galactose.
A patient is treated for the lepromatous form of M. leprae. How does his regimen differ from
a patient with the tuberculoid form?
For the lepromatous form, clofazimine is added to the regimen of dapsone and rifampin,
which are commonly used for the tuberculoid form
The GLP-1 analogs and DPP-4 inhibitors have similar actions. How do their side effect profiles
GLP-1 analogs (-tide) can cause nausea, vomiting, pancreatitis, & DPP-4 inhibitors (-gliptin)
can cause mild urinary or respiratory infections
Multiple sclerosis and Guillain-Barr syndrome are mediated by____(B/T) cells in a
type____(I/II/III/IV) hypersensitivity reaction.
The defect that leads to familial adenomatous polyposis is found in the ____ gene on
chromosome ____.
APC; 5 (five letters in ""polyp"")
A woman with ascending weakness is diagnosed with Guillain-Barr. Pathologically speaking,
what has happened to her nerves?
An autoimmune reaction against the peripheral nerve endoneurium has resulted in an
inflammatory infiltrate and impaired function
What is the mechanism of action of sumatriptan?
5-HT1B/1D (serotonin receptor) agonist that inhibits the trigeminal nerve, prevents vasoactive
peptide release, induces vasoconstriction
A woman with a spinal cord lesion has diminished sense of pressure, vibration, touch, &
proprioception in her arms. What tract is affected?
Lateral dorsal column; fasciculus cuneatus (dorsal column is organized as you are, with
hands at sides, arms outside, legs inside)
What disorder is most commonly associated with anti-Jo-1, anti-SRP, and anti-Mi-2
Polymyositis or dermatomyositis
Identify the reaction that links the Cori cycle to the alanine cycle and allows ammonia to
enter the alanine cycle.
The conversion of pyruvate into alanine in muscles, reacting with glutamate (carries the
ammonia, becomes -ketoglutarate)
A 35-year-old man complains of pain and swelling along the inguinal lymph nodes that have
begun to ulcerate. Likely cause and treatment?
Chlamydia trachomatis types L1, L2, and L3; doxycycline

Which medications can cause Stevens-Johnson syndrome?

Penicillin, carbamazepine phenytoin, lamotrigine, allopurinol, phenobarbital, sulfa drugs,
ethosuximide [PCP LAPSE]
During lysogeny, which is a ____ form of transduction, the genes for a bacterial toxin are
encoded in a lysogenic ____.
Specialized; phage
Bind to an ATP-dependent K+(KATP) channel on the cell membrane of pancreatic beta cells:
sulfonylureas; meglitinides
An 80-year-old man with coronary artery disease presents with 6 months of weight loss due
to pain after eating. What do you suspect?
Ischemic colitis
At a cookout, a girl becomes ill. Labs show elevated levels of Shiga toxin. What is the
disease, pathogen, and toxin mechanism of action?
Hemolytic-uremic syndrome (HUS); Shigella toxin; elevated cytokine release (Shiga-like toxin
= EHEC also causes HUS)
A patient suffers from a heritable form of cardiac and neurologic amyloidosis. What mutation
is responsible?
The patient has ATTR neurologic/cardiac amyloidosis, due to a transthyretin (TTR or prealbumin) gene mutation
What are the roles for TGF- in wound healing?
Angiogenesis, fibrosis, cell cycle arrest
Chemotherapy related nausea give ondansetron for that
What is the mechanism of action of metronidazole?
Forms free radical toxic metabolites in the bacterial cell that damage DNA
A 16-year-old boy has warm red swelling at the site of a cut on his foot. You suspect S.
aureus. What protein promotes its virulence?
Protein A prevents opsonization and phagocytosis of S. aureus by binding the Fc region of
A recently postpartum woman who had severe hemorrhage during delivery is unable to
breast-feed. Pathophysiology?
Sheehan syndrome (an ischemic infarction of the pituitary following postpartum bleeding
causes hypopituitarism)
The brain of an elderly man shows cystic cavities with reactive gliosis. What type of stroke
did he have, and how long ago did he have it?
Ischemic stroke (results in liquefactive necrosis); reactive gliosis is seen 12 weeks after
ischemic event.
Why must you test for latent tuberculosis before starting an antitumor necrosis factor
Because these medications (anti-TNF) break down granulomas and can predispose to
disseminated disease

A 27-year-old man has spastic paralysis. You suspect C. tetanus infection. Name the toxin
and explain its mechanism of action.
Tetanospasmin exotoxin; it blocks glycine and GABA (both are inhibitory neurotransmitters)
release from Renshaw cells in the spinal cord
Isoniazid decreases production of mycolic acids; KatG (catalase-peroxidase found in the
bacteria) converts it to the active metabolite
Which two cortical areas are connected by the arcuate fasciculus? What are their functions?
Associative auditory cortex temporal lobe (Wernicke in dominant hemisphere); motor speech
area frontal lobe (Broca in dominant hemisphere)
The mnemonic ABCDEFG is useful for remembering key information about Corynebacterium
diphtheriae. State this mnemonic.
ADP ribosylation; beta- (-)prophage; Corynebacterium diphtheriae; elongation factor
2; granules
Staphylococcal scalded skin syndrome is caused by an ____ that destroys the keratinocyte
attachments in the stratum ____.
Exotoxin; granulosum
A 10-year-old girl has BP of 140/90, potassium of 3.0, & no secondary sex traits. What other
sign would a boy with this enzyme deficiency have?
XY males with 17-hydroxylase deficiency have pseudohermaphroditism (from low DHT)
with ambiguous genitalia & undescended testicles
LBBB - reversed split S2
Split S2 - mitral regurgitation
Opening snap - mitral stenosis
Hypomagnasemia SE of: foscarnet; amphotericin B
SE of corticosteroids = Hyperlipidemia
List the symptoms of hyper-IgE (Job) syndrome using the mnemonic fated.
Coarse facies; noninflamed staphylococcal abscesses; retained primary teeth; high
Ig E;dermatologic issues
A patient with -thalassemia major has increased risk of infection by what bacteria, leading
to aplastic crisis?
Parvovirus B19
Visible dilated capillary proliferation within the skin secondary to the effects of liver failure
and cirrhosis is called what?
Spider nevi
Which method of DNA repair repairs double-stranded breaks?
Nonhomologous end joining (mutated in Ataxia telangiectasia)
Depigmented 'ash-leaf' spots - tuberous sclerosis
Cerebellar hemangiomas - von Hippel-Lindau syndrome
What are the clinical uses of rituximab? (Mab against CD20)

Non-Hodgkin lymphoma, rheumatoid arthritis (with methotrexate), idiopathic

thrombocytopenic purpura
In which cholesterol forms is apolipoprotein B-48 found? B-100? C-II?
B-48 = chylomicrons, chylomicron remnants; B-100 = VLDL, IDL, LDL; C-II = chylomicrons,
VLDL, HDL (E is on all except LDL)
Bi-temporal hemianopsia pituitary adenoma.
Kawasakis Epileptic Seizures
CML Myeloproliferators; 9:22; Philly Chromosomes; Fuse the BCR and ABL; Transforms to
Blast Crisis; The fusion gene creates the 210 kDA protein for proliferation; STI-571; IMATINIB
blocking the binding site Of ATP tyrosine kinase inhibitor (Drug of Choice);
Chagas Disease: Megacolon, Achalasia, Dilated Cardiomyopathy (Systolic dysfunction); bite
by reduviid kissing bug;
Esophagitis bisphosphonates
What is the treatment of choice for amyotrophic lateral sclerosis?
Riluzole - anti-glutamate drug
A 60-year-old man has tricuspid stenosis. Would the murmur be louder on inspiration or
Inspiration (right heart sounds are louder on inspiration)
If an antifungal drug ends in -azole (e.g., fluconazole, ketoconazole, clotrimazole), what is its
Inhibits fungal synthesis of sterols (ergosterol) by preventing P-450 enzymes from converting
lanosterol to ergosterol
A newborn is diagnosed with cystathionine synthase deficiency. If left untreated, what
findings would develop? Homocysteinuria
Elevated urine homocysteine, mental retardation, osteoporosis, tall build, kyphosis, lens
subluxation (down/in), thrombosis, atherosclerosis
Thrombolytics (-plase, eg tPA)- They directly or indirectly aid the conversion of plasminogen
to plasmin, which initiates fibrinolysis
Thalamus: VPM = Make up (face sensation); MGN = Music (Auditory); LGN = Light (Vision)
A patient with pelvic inflammatory disease has violin string adhesions of parietal peritoneum
to her liver. What syndrome is this?
Fitz-HughCurtis syndrome
What are the CLUES for Vasculitis or Intravascular Hemolysis?
Shistocytes Burr cells, Helmet cells
Myelosuppression/agranulocytosis is/are most characteristically caused by: Gancyclovir
Agonist of the A1 receptor in the AV node adenosine
Binds to 50S subunit, inhibiting peptidyl transferase chloramphenicol
Binds to 50S subunit, inhibiting translocation (movement of tRNA from acceptor site to
peptidyl site) macrolides, clindamycin

Inhibits Th1 cytokine production - IL-10

Activates NK cells - IL-12
Glycemic control in diabetes is most likely to be worsened by which one of the following:
cyclosporine (which is used to prevent transplant rejection)
Chorea, dementia - Wilson's disease
Arthritis hemochromatosis
Ivabradine the first selective sinus node If channel inhibitor; SE = Bradycardia
Prevents stimulation of glutamate receptors- riluzole (used in treatment of ALS)
Bivalirudin - Reversible direct thrombin inhibitor ;Prevents blood clots during angioplasty
Synthesized in the locus ceruleus norepinephrine
Left subclavicular thrill - patent ductus arteriosus
Acts as the FAS receptor, involved in apoptosis - CD95
Small, blue cells. Rosette pattern of cells with many mitotic figures medulloblastoma
The most common primary brain tumor in children - pilocytic astrocytoma
Which vitamin is essential for differentiation of epithelial cells into specialized tissue like
pancreatic cells and mucus-secreting cells?
Vitamin A (retinol)
What is the role of COPI in vesicular trafficking?
Retrograde movement from the Golgi apparatus to the endoplasmic reticulum
A woman has sudden flailing of her right arm and right leg. What is this? What is the
characteristic associated lesion?
Hemiballismus (half-of-body ballistic); lesion in contralateral subthalamic nucleus (e.g.,
due to a lacunar stroke)
In patients with achalasia, the lower esophageal sphincter cannot relax because of loss of
this innervation.
The myenteric (Auerbach) plexus
Is associated with nephrotic syndrome - Plasmodium malariae
Catabolism of very long chain fatty acids and amino acids peroxisome
Degradation of protein molecules that have been tagged with ubiquitin proteasome
Leptin - Increased secretion of melanocyte-stimulating hormone (MSH) and corticotrophinreleasing hormone (CRH) ---- (inhibits hunger)
What pathology underlies the development of restrictive lung disease in patients with
Interstitial fibrosis
"pico-rna-virus" literally means small RNA virus. With an icosahedral capsid.

Unlike the other picornaviruses (enterovirus), what type of infection does

rhinovirus not cause? Why?
Gastrointestinal tract infections; it is acid labile and therefore destroyed by stomach acid
You diagnose a patient with pseudohypoparathyroidism (Albright hereditary Osteodystropy
Autosomal Dominant). Do you expect him to have high or low parathyroid hormone (PTH)?
High (target organ [kidney] resistance to PTH causes low calcium, which causes increased
secretion of PTH)
A mottled purplish discoloration of the skin - Livedo reticularis caused by amantadine
Dopamine causes renal vasodilation
Opsoclonus-myoclonus neuroblastoma -- increased N-myc
Dystonia prolonged muscle contraction impaired basal ganglia
Aflatoxin mutation p53 hepatocellular carcinoma
Formation of coronary artery aneurysms is the most serious complication of Kawasaki
disease. (fever, conjunctivitis)
DIC pt bleeds; Coagulation cascade is activated; PT and PTT are prolonged; low fibrinogen.
TTP-HUS only platelets are activated; normal PT, PTT and fibrinogen.
Factor V Leiden mutation, which causes factor Va resistance to inactivation by activated
protein C, may account for approximately 20% of cases of atypical venous thrombosis which
can cause PE.
Polycystic ovarian syndrome (PCOS) is associated with oligomenorrhea, obesity, hirsutism
and polycystic ovaries. These patients are at increased risk for developing endometrial
adenocarcinoma and type 2 diabetes mellitus.
Toxic megacolon is a well-recognized complication of ulcerative colitis. Abdominal pain and
distention, along with fever, diarrhea, and signs of shock are typical. Plain abdominal X-ray
should be used for diagnosis. Barium contrast studies and colonoscopy are contraindicated
due to risk of perforation.
Mononuclear, parenchymal infiltration with well-developed
characteristic histological finding of Hashimotos thyroiditis.




Schistocytes (helmet cells) are fragmented erythrocytes. They occur in microangiopathic

hemolytic anemias (DIC, HUS, UP) and due to RBC destruction by prosthetic cardiac valves.
Hemolytic anemias are characterized by a decreased serum haptoglobin level as well as an
increased LDH and bilirubin.
Hepatic angiosarcoma is associated with exposure to carcinogens such as arsenic,
thorotrast, and polyvinyl chloride. Tumor cells express CD 31, an endothelial cell marker.
Normal pressure hydrocephalus occurs in elderly patients. It causes the triad of ataxic gain
and urinary incontinence, then dementia.
Foscarnet - pyrophosphate analog which inhibits viiral DNA polymerase
Memantine - NMDA receptor antagonist used for Alzheimer
Antipsychotics may cause neuroleptic malignant syndrome

Azathioprine may cause toxicity in patients with thiopurine methyltransferase deficiency;

Azathioprine is metabolised to the active compound mercaptopurine, a purine analog that
inhibits purine synthesis.
Amiodarone may cause corneal deposits
Mumps complication orchitis
Bendazoles - binds B-tubulin to inhibit its polymerization and microtubule assembly, also
inhibits glucose uptake
Exhibits zero-order kinetics heparin (plus PEA)
Beta-blockers may cause cold peripheries
Sulphasalazine may cause oligospermia
Crohn's disease granulomas
Over-expression of cyclin D1 - mantle cell lymphoma
Acute promyelocytic leukemia (M3) - PML/RAR fusion gene
Heinz bodies thalassemia
Rheumatoid arthritis x-ray findings include juxta-articular osteoporosis