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1. CF 2. albinism 3.

alpha 1
antitrypsin deficiency 4.
phenylketonuria 5. thalassemias 6.
Autosomal recessive diseases sicke cell anemia 7. glycogen
storage diseases 8.
(11) mucopolysaccharidoses (except
Hunter's) 9. sphingolipidoses (except
Fabry's) 10.infant polycystic kidney
disease 11. hemochromatosis

_____are associated with low


golic acid intake during Neural tube defects
pregnancy.

90% of adult polycystic kidney


disease cases are due to APKD1 (on chromosome 16)
mutation in _____.

meiotic nondisjunction of
homologous chromosomes
95% of Down's syndrome
(4% due to Robertsonian
cases are due to what?
translocation and 1% due to
Down mosaicism)
A patent ductus arteriosus is PGE synthesis and low oxygen
maintained by what 2 things? tension

1. Skeletal: tall with long


extremities, hyperextensive
joints, long tapering fingers and
Abnormalities associated with toes 2. Cardiovascular: cystic
medial necrosis of the aorta,
Marfan's syndrome:
aortic incompetence, aortic
dissection, aortic aneurysm,
floppy mitral valve Ocular:
subluxation of lenses

Adult polycystic kidney


polycystic liver disease BERRY
disease is associated with
ANEURYSMS mitral valve
what other diseases or
prolapse
disorders?

pre and postnatal


Babies with Fetal Alcohol developmental retardation
Syndrome are at higher risk microcephaly facial
for developing what other abnormalities limb
problems? dislocation heart and lung
fistulas
dystrophin gene mutations
Becker's muscular dystrophy
(not deletions) Becker's is less
is due to____.
severe.

Besides pulmonary infections, infertility in males fat-


what are some other soluable vitamin deficiencies
consequences of CF? (A,D,E,K)

excessive and inappropriate


exposure to androgenic
Causes of female steroids during early
pseudohermaphroditism: gestation (i.e., congenital
adrenal hyperplasia or
exogenous administration of
androgens during pregnancy)

Characteristic murmur with a


continuous, 'machine-like'
patent ductus arteriosus.
always bilateral massive
enlargement of kidneys due
Characteristics of Adult to multiple large cysts
polycystic kidney disease: patients present with pain,
hematuria, HTN, and
progressive renal failure

onset before age 5 weakness


begins in the pelvic girdle
muscles and progresses
Characteristics of Duchenne's superiorly pseudohypertrophy
MD: of calf muscles due to
fibrofatty replacement of
muscle cardiac myopathy use
of Gower's maneuver

ovaries present but external


Characteristics of female
genitalia are virilized or
pseudohermaphroditism:
ambiguous

macro-orchidism (enlarged
Characteristics of Fragile X testes), long face with a large
syndrome: jaw, large everted ears, and
autism
spheroid erythrocytes
Characteristics of Hereditary hemolytic anemia increased
Sperocytosis: MCHC splenectomy is
curative

testes present, but external


Characteristics of male
genitalia are female or
pseudohermaphroditism:
ambiguous.

Children may do this to


increase venous return with squat
R-to-L shunt.

Heterozygotes (1 : 500)
Compare the cholesterol
cholest. levels around
levels of heterozygores and
300mg/dL Homozygotes
homozygotes with familial
(very rare) cholest. levels over
hyperchlosterolemia:
700 mg/dL.
severe atherosclerotic disease
Complications associated early in life tendon
with homozygous familial xanthomas (classically in the
hypercholesterolemia: Achilles tendon) Myocardial
Infarction before age 20

Congenital heart defects are


rubella
often due to which infection?

Cri-du-chat syndrome results


short arm of chromosome 5
from a congenital deletion on
46 XX or XY, 5p-
which chromosome?

meninges herniate through


Define Meningocele: spinal canal defect picture on
p. 229
meninges and spinal cord
Define Meningomyelocele: herniate through spinal canal
defect picture on p.229

disagreement between the


Define phenotypic (external
pseudohermaphroditism: genitalia) and gonadal (testes
vs. ovaries) sex.

failure of bony spinal canal to


close, but no structural
Define Spina bifida occulta: herniation. (usually seen at
lower vertebral levels) picture
on p. 299 (2002 edition)

46 XX or 47 XXY both ovary


Describe a true
and testicular tissue present;
hermaphrodite:
ambiguous genitalia
Uncorrected VSD, ASD, or
PDA leads to progressive
pulm. HTN. As pulm.
Describe Eisenmenger's resistance increases, the
syndrome: shunt changes from L to R to
R to L, which causes late
cyanosis (clubbing and
polycythemia).

Does coarctation of the aorta


affect males or females most 3:1 males to females
commonly?

Down's syndrome is
associated with increased or decreased
decreased levels of AFP?

Elevated ___ in amniotic fluid


is evidence of a neural tube AFP (alpha fetal protein)
defect.
aortic stenosis distal to
ductus arteriosus (postductal)
Explain the adult type of aDult is Distal to Ductus
coarctation of the aorta and associated with notching of
give some associated the ribs, hypertension in
symptoms. upper extremities, weak
pulses in lower extermities
(check femoral pulse)

aortic stenosis proximal to


Explain the infantile type of
insertion of ductus arteriosus
coarctation of the aorta. What
(preductal) 'INantile, IN close
is it commonly associated
to the heart.' associated with
with?
Turner's syndrome

In fetal period, shunt is R to L


(normal). In neonatal period,
Explain the pathogenesis of a lung resistance decreases and
patent ductus arteriosus: shunt becomes L to R with
subsequent RV hypertrophy
and failure (abnormal).

Aorta leaves RV (anterior) and


pulmonaryt trunk leaves LV
Explain the transposition of
(posterior) this leads to
the great vessels.
separation of systemic and
pulmonary circulations.
Colon becomes covered with
adenomatous polyps after
puberty 'FAP' F= five (deletion
Familial Adenomatous on chromosome 5) A=
Polyposis features: autosomal dominant
inheritance P= positively will
get colon cancer (100%
without resection)

café-au-lait spots, neural


tumors, Lisch nodules
Findings in Von (pigmented iris hamartomas),
Recklinghausen's disease: skeletal disorders (scoliosis),
and increased tumor
susceptibility

microcephaly, severe MR,


high pitched crying/mewing -
Findings of Cri-du-chat
(Cri-du-chat is French for cry
syndrome:
of the cat), cardiac
abnormalities

depression progressive
dementia choreiform
Findings with Huntington's
movements caudate atrophy
disease:
dec. levels of GABA and Ach
in the brain
Frequency of L-toR shunts: VSD>ASD>PDA

Gender identity is based on 1. external genitalia 2. sex of


what two things? upbringing

Genetic anticipation of Fragile


X syndrome may be shown by Triplet repeat (CGG)n
what?

Highest risk of development


of fetal alcohol syndrome at 3 to 8
__ to ___ weeks.
How does CF present in
Failure to thrive
infancy?

increased concentration of
How is CF diagnosed?
Cl- ions in sweat test

muscle biopsy increased


How is MD diagnosed?
serum CPK

Huntington's disease
manifests between the ages 20 and 50
of :
1 in 3000 births short
Incidence and characteristics stature, ovarian dysgenesis,
and Turner's syndrome: webbed neck, coarction of the
aorta

1 in 1000 births
Incidence and characteristics phenotypically normal, very
of double Y males: tall, severe acne, antisocial
behavior (seen in 1-2%)

1 in 8000 births severe MR,


rocker bottom feet, low-set
ears, micrognathia,
Incidence and characteristics congenital heart disease,
of Edward's syndrome: clenched hands (flexion of
fingers), prominent occiput.
Death usually occurs within 1
year of birth.

1 in 850 births testicular


atrophy, eunuchoid body
Incidence and characteristics
shape, tall, long extremities,
of Klinefelter's syndrome:
gynecomastia, female hair
distribution
1 in 6000 births severe MR,
microphthalmia,
microcephaly, cleft lip/palate,
Incidence and characteristics abnormal forebrain
of Patau's syndrome: structures, polydactly,
congenital heart disease
Death usually occurs within 1
year of birth.

Marfan's is due a mutation in


fibrillin
which gene?

Mechanism of Fetal Alcohol


inhibition of cell migration
Syndrome may be :

testicular feminization
(androgen insensitivity)
Most common form of male
results from a mutation in the
pseudohermaphroditism is
androgen receptor gene (X
____.
linked recessive); blind-end
vagina
1. VSD (ventricular septal
Name 3 examples of L-to-R
defect) 2. ASD (atrial septal
shunts. (late cyanosis) 'blue
defect 3. PDA (patent ductus
kids'
arteriosus)

The 3 T's' 1. Tetralogy of


Name 3 examples of R-to-L
Fallot 2. Transposition of
shunts. (early cyanosis) 'blue
great vessels 3. Truncus
babies'
arteriosus

1. heart defects 2. Hypospadias


(when the urethral canal is
open on the undersurface of
Name 7 common congenital the penis or on the perineum)
malformations 3. Cleft lip w/ or w/out cleft
palate 4. congenital hip
dislocation 5. Spina Bifida 6.
Anencephaly 7. Pyloric stenosis
1. Adult polycystic kidney disease
2. Familial hyperchloresterolemia
(type IIA) 3. Marfan's syndrome 4.
Name 8 autosomal-dominant Von Recklinghausen's disease
(NFT1) 5. Von Hippel-Lindau
diseases:
disease 6. Huntington's disease
7. Familial Adenomatous
Polyposis 8. Hereditary
Sperocytosis
Name an X-linked recessive
muscular disease that leads Duchenne's Muscular
to accelerated muscle Dystrophy
breakdown.

PROVe' 1. Pulmonary Stenosis


2. RVH (right ventricular
Name the 4 components of
hypertrophy) 3. Overriding
Tetralogy of Fallot.
aorta (overrides the VSD) 4.
VSD (ventricular septal defect)

Neural tube defects (spina


bifida and anencephaly) are
associated with increased AFP (alpha fetal protein)
levels of ___ in the amniotic
fluid and maternal serum.

Newborns of mothers who


fetal alcohol syndrome (the
consumed significant
number one cause of
amounts of alcohol
congenital malformations in
(teratogen) during pregnancy
the U.S.)
are at risk for _______.
Patau's syndrome = trisomy
13 (hint: Puberty - 13)
___

defective Cl- channel --> secretion


of abnormally thick mucus that plugs
lungs, pancreas, and liver -->
Pathogenesis of Cystic recurrent pulmonary infections
(Pseudomonas species and Staph
Fibrosis: aureus), chronic bronchitis,
bronchiectasis, pancreatic insufficiency
(malabsorption and steatorrhea),
meconium ileus in newborns.

Patients with Tetralogy of


cyanotic spells
Fallot often suffer _________.

Pyloric stenosis is associated polyhydramnios; projectile


with______. vomiting
True (from 1 in 1500 births in
T/F: Trisomy 21 is associated
women<20 to 1 in 25 births
with advanced maternal age.
in women>45)

Tetralogy of Fallot leads to


early cyanosis from a R-to-L VSD
shunt across the ____.

The defect in Von


17 (hint: 17 letters in
Recklinghausen's disease is
Recklinghausen's)
found on which chromosome?

The gene responsible for


Huntington's disease is 4 ; triplet repeat disorder
located on chromosome__.
The incidence of neural tube
defects is decreased by folate
maternal ingestion of what?

Transposition of great vessels


is a common congenital heart
diabetic
disease in offspring of _____
mothers.

Transposition of great vessels a shunt that allows adequate


is not compatible with life mixing of blood (VSD, PDA, or
unless what is present? patent foramen ovale)

Trisomy 18 is also known Edward's syndrome (hint:


as______. Election age = 18)
Turner's syndrome is the
primary amenorrhea
most common cause of what?

hemangioblastomas of
retina/cerebellum/medulla
Von Hippel-Lindau disease about half of affected
characteristics: individuals develop multiple
bilateral renal cell carcinomas
and other tumors

Von Hippel-Lindau disease is


VHL gene (tumor suppressor)
associated with the deletion
on chromosome 3 (3p)
of what gene?

mental retardation flat facial


profile prominent epicanthal
folds simian crease duodenal
What are some findings of atresia congenital heart disease
Down's syndrome? (most common malformation is
endocardial cushion defect)
Alzheimer's disease in individuals
over 35 increased risk of ALL
What does a heart with
Tetralogy of Fallot look like boot-shaped due to RVH
on x-ray?

What gender genetic disorder


has been observed with
Double Y males (XYY)
increases frequency among
inmates of penal institutions?

What is different about the


juvenile form of polycystic it is recessive
kidney disease?

requiring assistance of the


upper extermities to stand up
What is Gower's maneuver?
(indicates proximal lower
limb weakness)
What is the cause of a deleted dystrophin gene
Duchenne's MD? (hint: 'D' for deletion)

What is the cause of Tetralogy anterosuperior displacement


of Fallot? of the infundibular septum

What is the incidence of


1 in 700 births
Down's syndrome?

What is the most common


Tetralogy of Fallot
cause of early cyanosis?
What is the most common
chromosomal disorder and Down's syndrome (trisomy
cause od congenital mental 21)
retardation?

What is the most common


VSD
congenital cardiac anomaly?

What is the most common


lethal genetic disease of Cystic Fibrosis
Caucasians?

What is the second most


common cause of mental Fragile X syndrome
retardation?
Autosomal - recessive defect
What is the underlying cause
in CFTR gene on chromosome
of Cystic Fibrosis?
7

What is the underlying cause defective or absent LDL


of Familial receptor leading to elevated
hypercholesterolemia? LDL

Indomethacin PGE (may be


What is used to close a patent necessary to sustain life in
ductus arteriosus? What is conditions such as
used to keep it open? transposition of the great
vessels)

methylation and expression


Which gene is affected in
of the FMR 1 gene is affected
Fragile X?
in this X-linked disorder
Which genetic gender
disorder has an inactivated X Klinefelter's syndrome
chromosome (Barr body)?

Why are female carriers of X- because of random


linked recessive disorders inactivation of X
rarely affected? chromosomes in each cell

1. Fragile X 2. Duchenne's MD
3. hemophilia A and B 4.
Fabry's 5. G6PD deficiency 6.
X-linked recessive disorders Hunter's syndrome 7. ocular
(10) albimism 8. Lesch-Nyhan
syndrome 9. Bruton's
agammaglobulinemia 10.
Wiscott-Aldrich syndrome

Turner's syndrome (think:


XO = 'hugs and kisses' -XO- from
Tina Turner)
Klinefelter's syndrome one of
XXY = the most common causes of
hypogonadism in males

Approximately what
percentage of brain tumors 0.5
arise from metastasis?

Are basal cell carcinomas Locally invasive but rarely


invasive? metastasize

Yes. They are extremely


Are Ewing's sarcomas likely to aggressive with early
metastasize? metastasis. However, they are
responsive to chemotherapy.
Are meningiomas resectable? Yes

Are squamous cell


Locally invasive but rarely
carcinomas of the skin
metastasize
invasive?

Are the majority of adult


tumors supratentorial or Supratentorial
infratentorial?

Are the majority of childhood


tumors supratentorial or Infratentorial
infratentorial?
Common histopathology
often seen in squamous cell Keratin pearls
carcinomas of the skin?

Abnormal cells lacking


differentiation; like primitive
cells of the same tissue.
Define anaplasia Often equated with
undifferentiated malignant
neoplasms. Tumor giant cells
may be formed.

Abnormal growth with loss of


cellular orientation, shape,
and size in comparison to
Define dysplasia
normal tissue maturation. It is
reversible but is often a
preneoplastic sign.

Increase in the number of


Define hyperplasia
cells (reversible)
One adult cell type is
replaced by another
(reversible). It is often
Define metaplasia secondary to irritation and/or
environmental exposure (e.g.
squamous metaplasia in the
trachea and bronchi of
smokers)

Clonal proliferation of cells


Define neoplasia that is uncontrolled and
excessive

Do oncogenes cause a gain or


Gain of function
loss of function?

Do tumor suppressor genes Loss of function. Both alleles


cause a gain or loss of must be lost for expression
function? of disease
Very significant risk! The
Does a melanoma have a depth of the tumor often
significant risk of metastasis? correlates with the risk of
metastasis.

From what cells do


Arachnoid cells external to
meningiomas most commonly
the brain
arise?

Give 2 examples of a benign


1. Adenoma 2. Papilloma
tumor of epithelial origin.

Give 2 examples of a
1. Adenocarcinoma 2.
malignant tumor of epithelial
Papillary carcinoma
origin.
Give 2 examples of malignant
tumors of blood cell 1. Leukemia 2. Lymphoma
(mesenchymal) origin.

Give an example of a benign


tumor of blood vessel Hemangioma
(mesenchymal) origin.

Give an example of a benign


tumor of bone (mesenchymal) Osteoma
origin.

Give an example of a benign


tumor of more than one cell Mature teratoma
type.
Give an example of a benign
tumor of skeletal muscle Rhabdomyoma
(mesenchymal) origin.

Give an example of a benign


tumor of smooth muscle Leiomyoma
(mesenchymal) origin.

Give an example of a
malignant tumor of blood Angiosarcoma
vessel (mesenchymal) origin.

Give an example of a
malignant tumor of bone Osteosarcoma
(mesenchymal) origin.
Give an example of a
malignant tumor of more Immature teratoma
than one cell type.

Give an example of a
malignant tumor of skeletal Rhabdomysarcoma
muscle (mesenchymal) origin.

Give an example of a
malignant tumor of smooth Leiomyosarcoma
muscle (mesenchymal) origin.

Give an example of a
Acute Lymphoblastic
neoplasm associated with
Leukemia (ALL)
Down's Syndrome.
Tumor markers are used to
confirm diagnosis, to monitor
for tumor recurrence, and to
How are tumor markers used? monitor the response to
therapy. They should not be
used as a primary tool for
diagnosis.

How is prostatic Digital rectal exam (detect


adenocarcinoma most hard nodule) or by prostate
commonly diagnosed? biopsy

How often do primary brain


Very rarely
tumors undergo metastasis?

In what population is
Usually men under the age of
osteochondroma most often
25
found?
In which age group is
prostatic adenocarcinoma Men over the age of 50
most common?

Is malignant transformation Malignant transformation to


in osteochondroma common? chondrosarcoma is rare

TNM system T= size of


Name 1 common tumor
tumor, N=node involvement,
staging system.
and M=metastases

1. Downward transtentorial
Name 3 herniation syndromes
(central) herniation 2. Uncal
that can cause either coma or
herniation 3. Cerebellar
death when the herniations
tonsillar herniation into the
compress the brainstem
foramen magnum
Name 4 factors that 1. Paget's disease of bone 2.
predispose a person to Bone infarcts 3. Radiation 4.
osteosarcoma. Familial retinoblastoma

1. Cingulate herniation under


the falx cerebri 2. Downward
Name 4 possible routes of transtentorial (central)
herniation in the brain herniation 3. Uncal herniation
4. Cerebellar tonsillar
herniation into the foramen
magnum

1. Meningioma 2.
Name 5 primary brain tumors Glioblastoma multiforme 3.
with peak incidence in Oligodendroglioma 4.
adulthood. Schwannoma 5. Pituitary
adenoma

1. Medulloblastoma 2.
Name 5 primary brain tumors Hemangioblastoma 3.
with peak incidence in Ependymomas 4. Low-grade
childhood. astrocytoma 5.
Craniopharyngioma
Name 5 sites from which 1. Lung 2. Breast 3. Skin
tumor cells metastasize to (melanoma) 4. Kidney (renal
the brain. cell carcinoma) 5. GI

Name a common The nuclei of basal cell


histopathological sign of tumors have 'palisading'
basal cell carcinoma nuclei nuclei

Fair-skinned people (blue


Name a population at a
eyes and red hair have also
greater risk for melanoma.
been considered as factors)

Name the 5 primary tumors 1. Colon 2. Stomach 3.


that metastasize to the liver Pancreas 4. Breast 5. Lung
Name two of the most
common sites of metastasis
The liver and the lung
after the regional lymph
nodes

Name two presenting 1. Bitemporal hemianopsia


sequelae of a pituitary (due to pressure on the optic
adenoma. chiasm) 2. Hypopituitarism

On which chromosome is the


17p
p53 gene located?

On which chromosome is the


13q
Rb gene located?
On which chromosomes are BRCA 1 is on 17q and BRCA 2
the BRCA genes located? is on 13q

Out of the 6 primary tumors


Metastasis from the breast
that metastasize to bone,
and prostate are the most
which two are the most
common
common?

What 2 cancers are associated 1. Burkitt's lymphoma 2.


with EBV? Nasopharyngeal carcinoma

1. Aggressive malignant
What 2 neoplasms are
lymphomas (non-Hodgkins)
associated with AIDS?
2. Kaposi's sarcoma
What 2 neoplasms are
associated with Autoimmune Benign and malignant
disease (e.g. Hashimoto's thymomas
thyroiditis, myasthenia gravis,
etc.)?

What 2 neoplasms are


1. Secondary osteosarcoma 2.
associated with Paget's
Fibrosarcoma
disease of bone?

What 2 neoplasms are


associated with Tuberous 1. Astrocytoma 2. Cardiac
sclerosis (facial angiofibroma, rhabdomyoma
seizures, and mental
retardation)?

1. Neoplastic cells have not


invaded the basement
What are 2 characteristic
membrane 2. High
findings in carcinoma in situ?
nuclear:cytoplasmic ratio and
clumped chromatin
1. Cells have invaded the
basement membrane using
What are 2 characteristic
collagenases and hydrolases
findings of an invasive
2. Able to metastasize if they
carcinoma?
reach blood or lymphatic
vessels.

What are 2 neoplasms 1. Squamous cell carcinoma


associated with Xeroderma of the skin 2. Basal cell
pigmentosum? carcinoma of the skin

What are 3 disease findings 1. Metastases to bone 2.


associated with Alkaline Obstructive biliary disease 3.
Phosphatase? Paget's disease of bone

What are 6 primary tumors 1. Kidney 2. Thyroid 3. Testes


that metastasize to bone? 4. Lung 5. Prostate 6. Breast
Psammoma bodies. These are
What are a common
spindle cells concentrically
histopathological finding of
arranged in a whorled
meningiomas?
pattern.

Ependymal cell tumors most


commonly found in the 4th
What are ependymomas?
ventricle. May cause
hydrocephalus

1. Normal 2. Hyperplasia 3.
What are the steps in the
Carcinoma In Situ/Preinvasive
progression of neoplasia?
4. Invasion

What are two signs of bone An increase in serum alkaline


metastases in prostatic phosphatase and PSA
adenocarcinoma? (prostate-specific antigen)
What are two useful tumor Prostatic acid phosphatase
markers in prostatic and prostate-specific antigen
adenocarcinoma? (PSA)

What can be associated with


Sun exposure
the risk of melanoma?

What cancer is associated


with HBV and HCV (Hep B and Hepatocellular carcinoma
C viruses)?

What cancer is associated


with HHV-8 (Kaposi's
Kaposi's carcinoma
sarcoma-associated herpes
virus)?
What cancer is associated
Adult T-cell leukemia
with the HTLV-1 virus?

What cancers are commonly


Cervical carcinoma, penile,
associated with HPV (human
and anal carcinoma
papilloma virus)?

What causes the local effect


Tissue lump or tumor
of a mass?

Destruction of epithelial
What causes the local effect
surfaces (e.g. stomach, colon,
of a nonhealing ulcer?
mouth, bronchus)
Raised intracranial pressure
What causes the local effect in brain neoplasms. Also seen
of a space-occupying lesion? with anemia due to bone
marrow replacement.

What causes the local effect Pathologic fracture or


of bone destruction? collapse of bone

What causes the local effect Venous or lymphatic


of edema? obstruction

What causes the local effect Caused by ulcerated area or


of hemorrhage? eroded vessel
What causes the local effect
Pleural effusion, pericardial
of inflammation of a serosal
effusion, or ascites
surface?

What causes the local effect


of obstruction in the biliary Jaundice
tree?

What causes the local effect


of obstruction in the Pneumonia
bronchus?

What causes the local effect


of obstruction in the left Constipation
colon?
Any site with sensory nerve
What causes the local effect endings. Remember that
of pain? tumors in the brain are
usually painless.

What causes the local effect


of perforation of an ulcer in Peritonitis or free air
the viscera?

What causes the local effect


Tumor mass in the brain.
of seizures?

Compression or destruction
What causes the localized of nerve (e.g. recurrent
loss of sensory or motor laryngeal nerve by lung or
function? thyroid cancer causes
hoarseness)
Hyperuricemia due excess
What causes the nucleic acid turnover
paraneoplastic effect gout? (secondary to cytotoxic
therapy of various neoplasms)

What causes the ACTH or ACTH-like peptide


paraneoplastic effect of (secondary to small cell lung
Cushing's disease? carcinoma)

PTH-related peptide, TGF-a,


TNF-a, IL-2 (secondary to
What causes the squamous cell lung
paraneoplastic effect of carcinoma, renal cell
hypercalcemia? carcinoma, breast carcinoma,
multiple myeloma, and bone
metastasis)

Antibodies against
What causes the
presynaptic Ca2+ channels at
paraneoplastic effect of
NMJ (Thymoma, bronchogenic
Lambert-Eaton syndrome?
carcinoma)
What causes the
Erythropoietin (secondary to
paraneoplastic effect of
renal cell carcinoma)
Polycythemia?

What causes the ADH or ANP (secondary to


paraneoplastic effect of small cell lung carcinoma and
SIADH? intracranial neoplasms)

What chemical carcinogen is


commonly associated with
CCL4
the centrilobar necrosis and
fatty acid change?

What chemical carcinogen is


commonly associated with Nitrosamines
the esophagus and stomach?
What chemical carcinogen is Asbestos (Causes
commonly associated with mesothelioma and
the lungs? bronchogenic carcinoma)

What chemical carcinogen is


commonly associated with Arsenic
the skin (squamous cell)?

What chemical carcinogen(s)


are commonly associated with Aflatoxins and vinyl chloride
the liver?

Malignant cartilaginous
What is a chondrosarcoma?
tumor.
What is a common genetic
11;22 translocation
finding in Ewing's sarcoma?

What is a common gross


Characteristic 'onion-skin'
pathological sign seen in
appearance of bone
Ewing's sarcoma?

What is a common origin of a May be of primary origin or


chondrosarcoma? from osteochondroma

What is a common sign found


Codman's triangle (from
on the x-ray of a person with
elevation of periosteum)
osteosarcoma?
Benign childhood tumor.
Often confused with pituitary
What is a craniopharyngioma? adenoma because both can
cause bitemporal
hemianopsia. Calcification of
the tumor is common.

Anaplastic small cell


What is a Ewing's sarcoma?
malignant tumor.

Locally aggressive benign


What is a giant cell tumor? tumor around the distal
femur, proximal tibial region.

What is a gross pathological


Pearly papules
sign of basal cell carcinoma?
What is a helpful mnemonic
to remember the neoplasm
We ALL go DOWN together.
associated with Down's
Syndrome?

What is a helpful mnemonic


to remember the site of Lots of Bad Stuff Kills Glia
metastasis to the brain?

What is a helpful mnemonic


to remember the types of Cancer Sometimes Penetrates
cancer that metastasize to Benign Liver
the liver?

What is a helpful mnemonic


to remember what tumors BLT with a Kosher Pickle
metastasize to bone?
Most often a cerebellar
tumor. Associated with von
What is a Hemangioblastoma? Hippel Lindau syndrome
when found with
retinoblastoma.

Diffusely infiltrating glioma.


What is a low-grade In children, it is most
astrocytoma? commonly found in the
posterior fossa.

Highly malignant cerebellar


tumor. A form of primitive
neuroectodermal tumor
What is a medulloblastoma?
(PNET). Can compress 4th
ventricle causing
hydrocephalus

What is a neoplasm
Squamous cell carcinoma of
associated with actinic
the skin
keratosis?
What is a neoplasm
associated with Barrett's
Esophageal adenocarcinoma
esophagus (chronic GI
reflux)?

What is a neoplasm
commonly associated with
chronic atrophic gastritis, Gastric adenocarcinoma
pernicious anemia, and
postsurgical gastric
remnants?

What is an A relatively rare, slow


oligodendroglioma? growing, benign tumor.

Very nonspecific antigen


produced by 70% of colorectal
What is CEA
and pancreatic cancers and
(carcinoembryonic antigen)?
by gastric and breast
carcinoma
What is considered a
precursor to squamous cell Actinic keratosis
carcinoma?

What is considered to be a
precursor to malignant Dysplastic nevus
melanoma?

Histologic appearance of the


tumor. Usually graded I-IV
What is meant by the term
based on degree of
tumor grade?
differentiation and number of
mitoses per high-power field.

Based on site an size of


What is meant by the term primary lesion, spread to
tumor stage? regional lymph nodes, and
presence of metastases.
What is the characteristic
Characteristic 'double bubble'
appearance of a giant cell
or 'soap bubble' appearance
tumor on an x-ray?

Characteristic perivascular
What is the common rosettes. Rod-shaped
histopathology associated blepharoblasts (basal ciliary
with Ependymomas? bodies) found near the
nucleus.

Foamy cells and high


What is the common
vascularity are characteristic.
histopathology associated
Can produce EPO and lead to
with Hemangioblastoma?
polycythemia.

What is the common


Rosettes or perivascular
histopathology associated
pseudorosette pattern of cells
with medulloblastomas?
What is the common
Fried egg' appearance of cells
histopathology associated
in tumor. Often calcified.
with oligodendrogliomas?

What is the common Antoni A=compact palisading


histopathology associated nuclei; Antoni B=loose
with schwannoma? pattern

What is the common Pseudopalisading' tumor cells


histopathology found in border central areas of
Glioblastoma multiforme? necrosis and hemorrhage

What is the differentiation


Basal to apical differentiation
pattern of normal cells?
What is the histopathology
Spindle-shaped cells with
commonly associate with
multi-nucleated giant cells.
giant cell tumors?

What is the most common


Osteochondroma
benign bone tumor?

What is the most common


Usually found in sun-exposed
location of basal cell
areas of the body.
carcinoma of the skin?

What is the most common Commonly found in the


location of osteosarcoma? metaphysis of long bones
The lung is the most common
What is the most common origin of metastases. The
organ to 'send' metastases? breast and stomach are also
big sources.

Adrenal glands. This is due to


their rich blood supply. The
What is the most common
medulla usually receives
organ to receive metastases?
metastases first and then the
rest of the gland.

What is the most common


population to have Men age 30-60 years old
chondrosarcoma?

What is the most common Glioblastoma multiforme


primary brain tumor? (grade IV astrocytoma)
What is the most common
primary malignant tumor of Osteosarcoma
bone?

What is the most common


Prolactin secreting
type of pituitary adenoma?

What is the most likely


population to have Ewing's Boys under 15 years old.
sarcoma?

What is the origin of a Derived from the remnants of


craniopharyngioma? Rathke's pouch
What is the origin of a
Rathke's pouch
Pituitary adenoma?

Schwann cell origin. Often


localized to the 8th cranial
What is the origin of the
nerve (acoustic schwannoma).
Schwannoma?
Bilateral schwannoma found
in NF2.

What is the peak incidence of


20-40 years old
giant cell tumor?

What is the peak incidence of


Men 10-20 years old
osteosarcoma?
Prognosis is grave. Usually
What is the prognosis for
only have a year life
Glioblastoma multiforme?
expectancy.

What is the second most


common primary brain Meningioma
tumor?

What is the third most


common primary brain Schwannomas
tumor?

What neoplasias are Hepatocellular carcinoma and


associated with a- nonseminomatous germ cell
fetoprotein? tumors of the testis.
Hydatidiform moles,
What neoplasias are Choriocarcinomas, and
associated with B-hCG? Gestational trophoblastic
tumors.

What neoplasias are Ovarian and malignant


associated with CA-125? epithelial tumors

What neoplasias are Melanoma, neural tumors,


associated with S-100? and astrocytomas

What neoplasm is associated


with Cirrhosis (due to Hepatocellular carcinoma
alcoholism, Hep B, or Hep C)
What neoplasm is associated
Malignant melanoma
with Dysplastic nevi?

What neoplasm is associated


with Immunodeficiency Malignant lymphomas
states?

What neoplasm is associated


with Plummer-Vinson
syndrome (atrophic glossitis, Squamous cell carcinoma of
esophageal webs, and the esophagus
anemia; all due to iron
deficiency)

What neoplasm is associated


Colonic adenocarcinoma
with ulcerative colitis?
What oncogene is associated
with breast, ovarian, and erb-B2
gastric carcinomas?

What oncogene is associated


c-myc
with Burkitt's lymphoma?

What oncogene is associated


ras
with colon carcinoma?

What oncogene is associated


with Follicular and
bcl-2
undifferentiated lymphomas
(inhibits apoptosis)?
What tumor marker is
PSA (Prostatic acid
associated with Prostatic
phosphatase)
carcinoma?

What tumor suppressor gene


is associated with
Rb gene
Retinoblastoma and
osteosarcoma?

What type of metastases are


Osteoblastic metastases in
common in the late stages of
bone
prostatic adenocarcinoma?

What type of neoplasm is


Visceral malignancies
associated with Acanthosis
(stomach, lung, breast, and
nigricans (hyperpigmentation
uterus)
and epidermal thickening)
What type of skin cancer is
associated with excessive
Squamous cell carcinoma
exposure to sunlight or
arsenic exposure?

Where are chondrosarcomas Pelvis, spine, scapula,


usually located? humerus, tibia, or femur.

Where are Ewing's sarcomas Diaphysis of long bones,


most commonly found? pelvis, scapula, and ribs

Where are Glioblastoma


Cerebral hemispheres
multiformes found?
Where do giant cell tumors At epiphyseal end of long
most commonly occur? bones

Where do meningiomas most Convexities of hemispheres


commonly occur? and parasagital region

Where do oligodendrogliomas Most often found in the


most often occur? frontal lobes

Where do osteochondromas
Long metaphysis
commonly originate?
Where do squamous cell
carcinomas most commonly Hands and face
occur?

Where does prostatic From the posterior lobe


adenocarcinoma most (peripheral zone) of the
commonly arise? prostate gland

Which has more prognostic


Stage
value: tumor stage or grade?

Which is more common: Metastatic bone tumors are


metastasis to bone or primary far more common than
tumors of bone? primary tumors
Which is more common:
Metastasis to the liver is more
metastasis to the liver or
common
primary tumors of the liver?

Which tumor suppressor gene


is associated with most
p53
human cancers and the Li-
Fraumeni syndrome?

Which tumor suppressor


genes are associated with BRCA 1 and 2
breast and ovarian cancer?

___% of African-Americans
carry the HbS trait, and ___% 8%; 0.2
have the disease.
________ = defect of platelet
Glanzmann's thrombasthenia
aggregation

________ disease = defect of


Bernard-Soulier
platelet adhesion

_____= activation of
coagulation cascade leading
to microthrombi and global DIC (Disseminated
consumption of platelets, intravascular coagulation)
fibrin, and coagulation
factors.

1. Hydroxyurea (increased
2 therapies for sickle cell
HbF) 2. bone marrow
anemia:
transplantation
50% of Hodgkin's cases are
EBV
associated with which virus?

1. hemorrage 2. enzyme defects


(e.g., G6PD deficiency, PK deficiency)
3. RBC membrane defects (e.g.,
7 causes of normocytic hereditary spherocytosis) 4. Bone
Marrow disorders (e.g., aplastic
normochromic anemia: anemia, leukemia) 5.
Hemoglobinopathies (e.g., sickle
cell) 6. Autoimmune hemolytic
anemia 7. Anemia of chronic disease

Antiplatelet antibodies and


increased megakaryocytes are ITP
seen in ____.

Auer rods, myeloblasts,


AML
adults =
bcl-2 activation is associated
t(14;18) - Follicular
with which translocation and
lymphomas
which lymphomas?

bcr-abl hybrid is associated


with which translocation and t(9;22) - CML
which leukemia?

Blood smear of a Multiple


RBCs stacked like poker chips
Myeloma patient would show
(rouleau formation)
what?

Burkitt's lymphoma: '______'


appearance associated with starry sky' EBV Africa
what virus? endemic where?
c-myc activation is associated
with which translocation and t(8;14) - Burkitt's
which lymphoma?

radiation, benzene,
chloramphenicol, alkylating
agents, antimetabolites, viral
Causes of aplastic anemia: agents (HCV,CMV,EBV, herpes
zoster-varicella), Faconi's
anemia, idiopathic (immune-
mediated, primary stem cell
defect)

Causes of platelet
ITP, TTP, drugs, DIC
abnormalities:

CFU-GM (colony forming


monocytes, neutrophils and
unit-granulocyte-monocyte)
basophils
gives rise to which cells?
CLL is very similar to what SLL (small lymphocytic
lymphoma? lymphoma)

1. Hemarthroses (bleeding
Coagulation factor defects
into joints) 2. easy bruising 3.
(macrohemorrage) cause: (3)
prolonged PT and/or PTT

Common cause of macrocytic


Vit. B12/folate deficiency
megalobalstic anemia:

common in children,
lymphoblasts, most ALL
responsive to therapy =
Waldenstrom's also has an M
Compare Multiple Myeloma
spike, but large amounts of
with Waldenstrom's
IgM are produced (not IgA or
macroglobinemia:
IgG), no lytic lesions

aplastic crisis (due to B19


parvovirus infection)
Complications often seen in autosplenectomy inc. risk of
homozygotes (sickle cell encapsulated organism
disease) include: infection Salmonella
osteomyelitis painful crisis
(vaso-occlusive) and splenic
sequestration crisis

RBCs are small, round, with


Describe the RBCs of a
no central pallor less
parient with Hereditary
membrane therefore
spherocytosis.
increased MCHC

FAB classification L1: ALL-null, ALL-common


FAB classification L2: ALL- T

FAB classification L3: ALL- B

FAB classification M1: AML (without maturation)

FAB classification M2: AML (with maturation)


FAB classification M3: acute promyelocytic leukemia

acute myelomonocytic
FAB classification M4:
leukemia

FAB classification M5: acute monocytic leukemia

FAB classification M6: acute erythroleukemia


acute megakaryocytic
FAB classification M7:
leukemia

increased number of
circulating leukocytes in
General considerations of blood bone marrow infiltrates
leukemias: of leukemic cells leukemic
cell infiltrates in liver, spleen,
and lymph nodes also
common

t(8;14) c-myc gene moves


Genetics associated with
next to heavy chain Ig gene
Burkitt's lymphoma:
(14)

Gamma 4 tetramers, lacks all


Hb Barts =
4 alpha globin genes
hydrops fetalis and
Hb Barts results in what?
intrauterine fetal death

Beta 4 tetramers, lacks 3


Hb H =
alpha globin genes

Hereditary spherocytosis
causes intrinsic, extravascular
spectrin
hemolysis due to a _____
defect.

Hereditary spherocytosis is
gallstones, splenomegaly,
associated with what other
anemia and jaundice
problems?
Hereditary spherocytosis is
Direct Coomb's test
distinguished from warm
(Hereditary spherocytosis is
antibody hemolysis by what
Coomb's negative)
test?

Hodgkin's or NHL: which is


associated with HIV & NHL
immunosuppression?

Hodgkin's or NHL: which is


associated with mediastinal Hodgkin's
lymphadenopathy?

Hodgkin's or NHL: which one


displays a bimodal Hodgkin's (young and old)
distribution?
destructive bone lesions
How does Multiple Myeloma cause hypercalcemia
affect calcium levels? (punched-out lytic bone
lesions can be seen on x-ray)

In _____, the alpha globin


alpha thalassemia
chain is underproduced.

In _____, the beta chain is Beta-minor thalassemia


underproduced. (heterozygote)

In ______, the beta chain is Beta-major thalassemia


absent. (homozygote)
In anemia of chronic disease,
are these values increased or
decreased? 1. TIBC 2. ferritin 1. dec. 2. inc. 3. dec. 4. inc.
3. serum iron 4. storage iron 5. normal
in marrow macrophages 5. %
sat.

In Beta Thalassemia, cardiac secondary hemochromatosis


failure is often due to what? (due to transfusions)

In which hemorrhagic
DIC
disorder is PT increased?

In which hemorrhagic 1. Hemophilia A 2.


disorders is PTT increased? Hemophilia B 3. von
(4) Willibrand's disease 4. DIC
increased or decreased in
1. increased 2. decreased 3.
iron deficiency anemia? 1.
decreased
TIBC 2. ferritin 3. serum iron

Is Hodgkin's more common in men (except nodular


men or women? sclerosing type)

increased PT and PTT,


increased fibrin split products
Lab findings of DIC:
(D-dimers), decreased
platelet count

Lymphoblastic lymphoma
commonly presents with ALL and mediastinal mass
what?
ALL (B cell) Lymphoblastic
lymphoma, CLL (B)
Lymphocytic lymphoma,
Lymphomas derived from the Follicular center cell
B cell lineage: lymphoma, Immunoblastic
lymphoma (B), Plasmacytoid
lymphocytic lymphoma and
myeloma

ALL (T cell) Lymphoblastic


lymphoma, CLL (T)
Lymphomas derived from the Lymphocytic lymphoma,
T cell lineage: Immunoblastic lymphoma (T),
Sezary syndrome and mycosis
fungoides

Macrocytic anemia is defined


100
as MCV>____.

1. anemia (dec. RBCs) 2.


Marrow failure due to infections (dec. WBCs) 3.
leukemia can lead to (3) hemorrhage (decreased
platelets)
Microcytic, hypochromic
80
anemia = MCV<____.

most commonly associated


with Philadelphis
chromosome, myeloid stem CML
cell proliferation, may
accelerate to AML =

1. Hemophilia A 2.
Name 3 coagulopathies: Hemophilia B 3. von
Willibrand's disease

Name 3 etiologies of 1. iron deficiency 2.


microcytic, hypochromic Thalassemias 3. lead
anemia: poisoning
1. Qualitative platelet defects
Name 5 hemorrhagic
2. Vascular bleeding 3.
disorders that exhibit
Thrombocytopenia 4. Von
increased bleeding time.
Willibrand's disease 5. DIC

1. Small lymphocytic
lymphoma 2. Follicular
lymphoma (small cleaved cell)
Name 5 types of NHL:
3. Diffuse large cell 4.
Lymphoblastic lymphoma 5.
Burkitt's lymphoma

CML, Polycythemia rubra vera,


CML, Myelofibrosis, idiopathic
Name 9 chronic myeloid thrombocythemia, (chronic
leukemias: monocytic, chronic
myelomonocytic,
eosinophilic, chronic
erythroid) *last 4 are rare*

Hodgkin's: localized, single


group of nodes, extranodal
Nodal involvement and rare, contiguous spread NHL:
spread of Hodgkin's vs. NHL: multiple, peripheral nodes,
extranodal involvement
common, noncontiguous
spread
1. TIBC 250-400 micro
Normal values: 1. TIBC 2.
grams/ dl 2. 50-150 3.
Serum iron 3. % sat.
20-50 %

older adults,
lymphadenopathy,
hepatosplenomegaly, few
symptoms, indolent course, CLL
increased smudge cells in
peripheral blood smear, warm
Ab autoimmune hemolytic
anemia =

1. drugs that block DNA


Other causes of macrocytic synthesis (e.g., sulfa drugs,
anemia (2) AZT) 2. marked
reticulocytosis

pancytopenia with normal cell


Pathologic features of aplastic morphology, hypocellular
anemia: bone marrow with fatty
infiltration
Peak incidence of NHL
20-40
between what ages?

Philadelphia chromosome= t(9;22), bcr-abl

Plasma cells in Multiple


Myeloma produce large IgG (55%) and IgA (25%)
amounts of what?

1. mucous membrane
Platelet abnormalities bleeding 2. petechiae 3.
(microhemorrage) lead to: (4) purpura 4. prolonged
bleeding time
PMNs are hypersegmented in Vit. B 12 and folate
____ . deficiencies

PT and PTT: which one


measures the intrinsic and
PT (extrinsic) PTT (intrinsic)
which one measures the
extrinsic path?

Rank the prognoses of the NS and LP = excellent MC =


different types of Hodgkin's: intermediate LD = poor

Schistocytes are characteristic


TTP
of ___.
Sickle cell heterozygotes
malaria; (balanced
(sickle cell trait) are relatively
polymorphism)
____-resistant.

fatigue, malaise, pallor,


Symptoms of aplastic anemia: purpura, mucosal bleeding,
petechiae, infection

Mediterranean (hint:
Thalassemia is prevalent in
thalassa=sea. Think,
which populations?
thalaSEAmia)

The lymphoid stem cell gives


T cells and B cells
rise to: (2)
The majority of NHL involve T B cells (except lymphoblastic
cells or B cells? T cell origin)

withdrawal of offending
agent, allogenic bone marrow
Treatment of aplastic anemia: transplantation, RBC and
platelet transfusion, G-CSF or
GM-CSF

1. decreased serum
What are 2 indications of
haptoglobin 2. increased
hemolysis?
serum LDH

(mostly seen in Hodgkin's)


What are constitutional signs/
low grade fever, night sweats,
symptoms?
weight loss
gram-negative sepsis,
transfusion, trauma,
What are some other causes
malignancy, acute
of DIC?
pancreatitis, and nephrotic
syndrome

What genetics are involved


with follicular lymphoma t(14;18) bcl-2 expression
(small cleaved cell)?

What is another Beta chain


HbC defect. patients can be
mutation in which patients
HbC or HbSC (1 of each
have a milder disease than Hb
mutant gene)
SS patients?

pancytopenia characterized by
severe anemia, neutropenia,
and thrombocytopenia caused
What is aplastic anemia? by destruction of multipotent
myeloid stem cells, with
inadequate production or
release of differentiated cell
lines.
What is compensatorily
fetal hemoglobin (it is
increased in both forms of
inadequate, however)
Beta Thalassemia?

What is found in the urine of


Ig light chains (Bence Jones
patients with Multiple
protein)
Myeloma?

What is it called when CML --


blast crisis
> AML?

Reed-Sternberg cell
What is the characteristic cell (decreased numbers of RS
of Hodgkin's lymphoma? cells indicates a better
prognosis)
the monoclonal
What is the M spike? immunoglobin spike on
serum electrophoresis

What is the most common


von Willibrand's disease
bleeding disorder?

What is the most common


obstetric complications
cause of DIC?

What is the most common


primary tumor arising within Multiple Myeloma
bone in adults?
What is the name of a chronic
Sezary syndrome
T cell leukemia?

a single AA replacement in
What mutation causes sickle
the Beta chain (normal
cell anemia?
glutamic acid with valine)

renal insufficiency, increased


What other problems result
susceptibility to infections,
from Multiple Myeloma?
anemia, and amyloidosis

What precipitates sickling of


low oxygen or dehydration
cells?
What test is used to confirm
osmotic fragility test
Hereditary spherocytosis?

What test is used to


distinguish between immune
Direct Coomb's test
vs. non-immune RBC
hemolysis?

What type of cell is cancerous


Monoclonal plasma cell, 'fried
in Multiple Myeloma and what
egg' appearance
does it resemble?

Which 2 hemorrhagic
disorders have decreased 1. thrombocytopenia 2. DIC
platelet counts?
lymphoblastic lymphoma, and
Which 2 types of NHL occur in
Burkitt's lymphoma (20% of
children?
diffuse large cell type too)

Which Beta Thalassemia Beta Thal. major, (requires


results in severe anemia? blood transfusions)

Which coagulation factors are


(extrinsic) = Factors II, V, VII,
a part of the intrinsic and
and X (intrinsic) = all factors
which are a part of the
except VII and XIII
extrinsic path?

Which coagulation factors are Hemophilia A (factor VIII


deficient in each of the deficiency) Hemophilia B
Hemophilias? (factor IX deficiency)
Which one is associated with
neurological problems, folate
Vit. B12
deficiency or Vit. B12
deficiency?

Which type of Hodgkin's LP (lymphocyte predominant)


accounts for 6% of cases and - 6% LD (lymphocyte
which type is the most rare. depleted) - rare

Which type of Hodgkin's


commonly affects males LP
under 35?

Which type of Hodgkin's


commonly affects older males
LD
and is associated with
disseminated disease?
Which type of Hodgkin's has
the most Reed Sternberg Mixed Cellularity
cells?

Which type of Hodgkin's is


characterized by collagen NS (nodular sclerosing)
banding?

Which type of Hodgkin's is


NS (nodular sclerosing)
the most common? (65-75%)

Which type of Hodgkin's is


the second most common? MC (mixed cellularity)
(25%)
Which type of Hodgkin's
primarily affects young NS
adults, women>men?

Which type of NHL clinically


small lymphocytic lymphoma
presents like CLL?

Which type of NHL is difficult


follicular lymphoma
to cure?

Which type of NHL is most Lymphoblastic lymphoma


common in children? (very aggressive)
Which type of NHL is the most follicular lymphoma (small
common type in adults? cleaved cell)

Lymphoblastic lymphoma
Which types of NHL involve T (immature T cells) 20% of
cells? Diffuse large cell NHL (mature
T cells)

With iron overload 1. TIBC normal 2. Serum iron


(hemosiderosis) are values increased 3. % sat. increased
increased or decreased? 1. (100%) -see charts on p.238
TIBC 2. serum iron 3. %sat. of 2002 edition-

A patient with gallstones may


(1)epigastric/RUQ pain (2)
present with Charcot's triad.
fever (3)jaundice
What comprises the triad?
Failure of copper to circulate
in what form causes Wilson's ceruloplasmin
disease?

How can one distinguish Rotor's syndrome presents


between Dubin-Johnson similarly, except less severely
syndrome and Rotor's and no black liver(as seen in
syndrome? Dubin-Johnson)

How does Budd-Chiari


syndrome progress(in the Congestive liver disease
liver)?

How does cirrhosis/portal diffuse fibrosis, destroying


hypertension(HTN) affect liver normal structure, with
histology? nodular regeneration
How does Hirschsprung's Chronic constipation early in
disease first present? life

How does one diagnose


ultrasound
gallstones?

How does one differentiate micronodular(<3mm and


liver nodules, in the case of uniform) macronodular(>
cirrhosis? 3mm and varied)

How does one treat


cholecystectomy
gallstones?
Bird beak'--dilated
How is achalasia evidenced
esophagus with an area of
on a Barium swallow?
distal stenosis.

How is hepatocellular like renal cell carcinoma,


carcinoma spread? hematogenously

How is the hyperbilirubinemia


Dubin-Johnson syndrome--
in Dubin-Johnson syndrome
conjugated
different than in the other 2
hyperbilirubinemia (due to
hyperbilirubinemias(Gilbert's
defective liver excretion)
or Crigler-Najjar(type 1))?

How would you expect a Asymptomatically, with an


Gilbert's syndrome patient to elevated unconjugated
present? bilirubin
triple therapy (metronidazole,
In PUD, how can H.pylori be bismuth salicylate, amoxicillin
treated? or tetracycline with or without
a proton pump inhibitor

In what fatal childhood


hepatoencephalopathy is
there an association with viral Reye's syndrome
infections(VZV,influ.B) and
salicylates?

In Wilson's disease, where


(1)Liver (2)Brain (3)cornea
does copper accumulate(3)?

Is chronic pancreatitis
strongly associated with YES
alcoholism?
Is the dilation proximal, at, or
Proximal (results in a
distal to the aganglionic
'transition zone')
segment?

Low-fiber diets are associated


diverticulosis
with which of the following?

To what cancer is a chronic


Gastric carcinoma
gastritic patient predisposed?

What 3 common findings are (1)fatty liver (2)hypoglycemia


evident in a Reye's patient? (3)coma
What are 2 anti-androgen gynecomastia loss of sexual
effects of liver cell failure? hair

What are 2 extraintestinal migratory polyarthritis


manifestations of Crohn's? erythema nodosum

What are 2 main symptoms (1)pain Decreases with meals,


and a histological sign of (2)weight gain, hypertrophy
Duodenal ulcers? of Brunner's glands

What are 2 main symptoms of pain Greater with meals,


Gastric ulcers? weight loss
What are 2 signs of Crigler-
jaundice kernicterus(bilirubin
Najjar syndrome(other than
deposition in the brain)
hyperbilirubinemia)?

What are 2 types of Crohn's disease Ulcerative


Inflammatory Bowel Disease? colitis

What are 2 types of peptic


gastric ulcer duodenal ulcer
ulcer disease(PUD)?

(1)pregnancy (2)polycythemia
What are 3 associations of
rubra vera (3)hepatocellular
Budd-Chiari Syndrome?
carcinoma
What are 3 neuro effects of (1)asterixis, (2)scleral icterus,
liver cell failure? (3)coma

(1)Cholesterol stones (2)


What are 3 types of
Mixed stones (3)Pigment
gallstones?
stones

What are 4 potential (1)bleeding, (2)penetration,


complications of PUD? (3)perforation, (4)obstruction

(1)hepatomegaly (2)ascites (3)


What are 4 signs of
abdominal pain (4)eventual
congestive liver disease?
liver failure
(1)esophageal varices(-
>hematemesis), (2)melena,
What are 5 GI and 2 GU (3)splenomegaly, (4)caput
effects of portal HTN? medusae, (5)ascites and (1)
testicular atrophy, (2)
hemorrhoids

What are 5 possible (1)DIC (2)ARDS (3)Diffuse fat


consequences of acute necrosis (4)hypocalcemia (5)
pancreatitis? pseudocyst formation

Gallstones Ethanol Trauma


What are possible causes of Steroids Mumps
acute pancreatitis(GET Autoimmune disease
SMASHeD)? Scorpion sting
Hyperlipidemia Drugs

primary(autos. Recessive)
What are possible etiologies
secondary to chronic
of hemochromatosis?
transfusion therapy
Achalasia, Barrett's
What are risk factors for esophagus, Corrosive
esophageal cancer(ABCDEF)? esophagitis, Diverticuli,
Esophageal web, Familial

(1)strictures, (2)fistulas, (3)


What are some complications perianal disease, (4)
of Crohn's(4)? malabsorption-nutritional
depletion

(1)severe stenosis, (2)toxic


What are some complications
megacolon, (3)colorectal
of ulcerative colitis(3)?
carcinoma

What are the 2 types of


Type A(fundal) Type B(antral)
chronic gastritis?
What are the 3 forms of (1)diverticulum, (2)
Diverticular disease? diverticulosis, (3)diverticulitis

What are the 4 risk factors for (1)Female (2)Fat (3)Fertile (4)
gallstone development? Forty

Asterixis Basal ganglia


degeneration Cirrhosis,
What are the ABCD Ceruloplasmin decrease,
characteristics of Wilson's? Corneal deposits(Kayser-
Fleischer rings), Carcinoma
(hepatocell.), Choreiform
movements Dementia

Autoimmune disorder
characterized by
What are the characteristic 4
Autoantibodies to parietal
A's of type A gastritis?
cells, pernicious Anemia,
Achlorhydria
What are the respective
infectious(Crohn's)
etiologies of Crohn's and
autoimmune(UC)
Ulcerative colitis(UC)?

A secondary form can arise


What can achalasia arise from from Chagas' disease; can
and lead to? lead to progressive
dysphagia.

What can hemochromatosis (1)CHF (2)hepatocellular


lead to(2)? carcinoma

What cell tumor marker is


elevated in hepatocellular Alpha FetoProtein(AFP)
carcinoma?
What disorder is
characterized by increased
hemochromatosis
iron deposition in many
organs(up to 50g)?

What happens to hepatocytes


they become swollen and
as a result of alcoholic
necrotic
hepatitis?

What happens when


cholesterol and bilirubin
Gallstones
overwhelm solubilizing bile
acids and lecithin?

What histological changes, neutrophil infiltration,


other than to hepatocytes, Mallory bodies(hyaline),
does one see in liver increased fat, and sclerosis
hepatitis? around the central vein
BARRett's = Becomes
What is a mnemonic for
Adenocarcinoma, Results
Barrett's esophagus?
from Reflux.

The replacement of glandular


stratified squamous with
What is Barrett's esophagus?
gastric columnar epithelium
in distal esophagus.

What is failure of lower


Achalasia is due to the loss of
esophageal sphincter
the myenteric plexus.
relaxation due to?

What is hepatic vein or IVC


occlusion with centrilobular Budd-Chiari syndrome
congestion and necrosis?
What is recommended for
screen these patients over 50
patients over 50, in terms of
with stool occult blood test
CRC screening?

increased intraluminal
What is the cause of
pressure and focal weakness
diverticulosis?
in the colonic wall

(1)micronodular pigment
What is the classic triad of
cirrhosis (2)'bronze' diabetes
hemochromatosis?
(3)skin pigmentation

What is the discerning


Type B is caused by a Bug(H.
characteristic for type B
pylori)
gastritis?
What is the embryonic cause failure of neural crest
of Hirschsprung's disease? migration

H.pylori(100%)--lower
What is the etiology of mucosal protection or
duodenal ulcers? increased gastric acid
secretion

H.pylori(70%), NSAIDS both


What is the etiology of gastric
lower mucosal protection vs.
ulcers?
gastric acid

transmural inflamm.
COBBLESTONE mucosa,
What is the gross morphology
creeping FAT, bowel wall
of Crohn's?
thickening(string sign on x-
ray), linear ulcers, fissures
mucosal inflamm. Friable
What is the gross morphology
mucosal pseudopolyps with
of ulcerative colitis?
freely hanging mesentery

What is the incidence of


over 60y/o, 50%
diverticulosis in the elderly?

What is the microscopic


noncaseating granulomas
morphology of Crohn's?

What is the microscopic


morphology of ulcerative crypt abscesses and ulcers
colitis?
For Crohn's, think of a FAT
What is the mnemonic for
old CRONE SKIPping down a
Crohn's?
COBBLESTONE road.

What is the most common


epigastric abdominal pain
clinical sign of acute
radiating to the back
pancreatitis?

What is the most common


primary malignant tumor of hepatocellular carcinoma
the liver in adults?

What is the most common


mixed stones
type of gallstone?
significant liver injury leading
What is the primary cause of
to hepatic necrosis(e.g.
macronodules in the liver?
Infections, drug-induced)

What is the primary cause of


metabolic(e.g. Alcohol)
micronodules in the liver?

~6months (very aggressive--


What is the prognosis for
often already spread at
pancreatic adenocarcinoma?
presentation)

What is the term for inflamm.


diverticulitis
of diverticula?
What is the term used for
congenital megacolon
characterized by loss of Hirschsprung's disease
parasympathetic ganglion
cells?

What is the term used to


describe breath that smells
fetor hepaticus
like a freshly opened corpse,
as seen in liver cell failure?

What is the term used to


describe having many diverticulosis
diverticula?

What is the treatment for


plasmaphoresis phototherapy
Crigler-Najjar syndrome?
What is the treatment of repeated phlebotomy
hemochromatosis? deferoxamine

What is the treatment of


penicillamine
Wilson's disease(1 drug)?

(1)Abdominal pain radiating


to the back (2)Weight loss (3)
What is the typical
Anorexia (4)Migratory
presentation of a patient with
pancreatic adenocarcinoma(5 thrombophlebitis(Trousseau's
Sd) (5)Pancreatic duct
signs)?
obstruction(palpable
gallbladder)

Terminal ileum, small


What is the usual location of intestine, colon (but any part
Crohn's? can be affected)-- often SKIP
lesions, rectal sparing
colon (with continuous
What is the usual location of
lesions and rectal
ulcerative colitis?
involvement)

What lab values are SGOT(AST)/SGPT(ALT) >


characteristic in alcoholic 1.5,usually (A Scotch and
hepatitis? Tonic=AST elevation)

What lab values are


increased ferritin and
characteristic in
transferrin saturation
hemochromatosis?

What labs are elevated in amylase lipase(higher


acute pancreatitis? specificity)
What part of the GI tract is
most frequently involved in sigmoid colon
diverticulosis?

What risk group has an


increased incidence of PUD by smoking
2X?

What type of stones are seen


in patients with RBC
pigment stones
hemolysis,alcoholic
cirrhosis,biliary infection?

When do patients with


early in life(often die within a
Crigler-Najjar syndrome(type
few years)
I) usually present?
Where are pancreatic tumors pancreatic head (with
most often located? obstructive jaundice)

Where is the pain associated


left lower quadrant
with diverticulitis?

Which of the following are


effects of liver cell failure?
Anemia,
hypercoagulation,spider nevi, all, except hyper coagulation
jaundice,
gynecomastia,bleeding
tendency, ankle edema

Which of the following are


risk factors for colorectal
cancer(CRC):
age,smoking,personal and all, except for smoking
family history of colon
cancer, low-fiber diet,
hereditary non-polyposis
CRC?
Which of the following are
risk factors for colorectal
cancer: colorectal villous
adenomas, chronic all, except for Peutz-Jeghers
inflamm.bowel disease,
familial adenomatous
polyposis,Peutz-Jeghers?

Which of the following is a


blind pouch leading off the GI
tract lined by mucosa, diverticulum
muscularis, serosa?
Diverticulosis, diverticulum,
diverticulitis

Which of the following is a


common association between
cholesterol stones and
pigment stones: advanced age
obesity,Crohn's,cystic
fibrosis,age,clofibrate,
estrogens,multiparity,rapid
weight loss?

Which of the following is


associated with perforation,
Diverticulitis
peritonitis, abscesses, or
bowel stenosis?
Which of the following is
associated with
stress:Gilbert's, Dubin- Gilbert's
Johnson syndrome, or
Crigler-Najjar(type 1)?

Which of the following


syndromes have a mildly Gilbert's(Crigler-Najjar has an
decreased UDP-glucuronyl absence of UDP-glucuronyl
transferase: Gilbert's or transferase)
Crigler-Najjar(type 1)?

Which type of liver nodule is


associated with an increased
macronodules
risk of hepatocellular
carcinoma?

(1)Hepatitis B (2)Hepatitis C
With what 6 diseases does (3)Wilson's (4)
hepatocellular carcinoma Hemochromatosis (5)alpha 1
have an association? antitrypsin deficiency (6)
alcoholic cirrhosis
With what cancer is achalasia Increased risk for esophageal
associated? cancer.

An FEV1/FVC ratio greater


than 80% indicates what form Restrictive lung disease
of pulmonary disease?

Are bronchogenic carcinoma


Yes, very common
metastases common?

Decreased FEV1/FVC ratio are


the hallmark of what kind of COPD
pulmonary disease?
It causes increased recoil
How does interstitial fibrosis
(decreased compliance),
create a restrictive lung
thereby limiting alveolar
disease?
expansion.

- Cough - Hemoptysis -
How does lung cancer Bronchial obstruction -
commonly present? (5) Wheezing - Pneumonic 'coin'
lesion on x-ray

It leads to an increase in
How does surfactant
surface tension, resulting in
deficiency cause NRDS?
alveolar collapse

- Maternal steroids before


How to you treat NRDS? birth - Artificial surfactant for
infant
Identify: ivory-white pleural
Ferruginous bodies
plaques in the lung.

In COPD, are lung volumes


Increased (increasedTLC,
increased, decreased, or
increased FRC, increased RV)
normal?

In restrictive lung disease, are


lung volumes increased, Decreased
decreased, or normal?

In what occupations is
asbestosis most commonly Shipbuilders and plumbers
seen? (2)
Name three 'triggers' of - Viral URIs - Allergens -
asthma. Stress

Name three characteristics of


- Ptosis - Miosis - Anhidrosis
Horner's syndrome?

Name two extrapulmonary


- Poor muscular effort: polio,
(poor breathing mechanics)
myasthenia gravis - Poor
causes of restrictive lung
apparatus: scoliosis
disease.

Name two pulmonary (poor - Defective alveolar filling:


lung expansion) causes of pneumonia, ARDS, pulmonary
restrictive lung disease. edema - Interstitial fibrosis
Patients with asbestosis are at Pleural mesothelioma and
increased risk for what? (2) bronchogenic carcinoma

T/F Bronchiectasis is
associated with bronchial
True
obstruction, cystic fibrosis,
and poor ciliary motility.

T/F In obstructive (not


False, FEV1 and FVC are
restrictive) lung disease, FEV1
reduced in both
and FVC are reduced.

T/F Restricted lung expansion


causes decreased total lung
False, decreased VC and TLC
capacity and increased vital
capacity.
T/F Smokers with asbestosis
False, it increases
have a decreased risk of
synergistically
developing cancer.

What are asbestos fibers


coated with hemosiderin in Ferruginous bodies
the lung?

Intra-alveolar exudate ->


What are the characteristics
consolidation; may involve
of lobar pneumonia?
entire lung

What are the clinical findings - Wheezing - Crackles -


of chronic bronchitis? (3) Cyanosis
- Dyspnea - Decreased
What are the clinical findings
breath sounds - Tachycardia
of emphysema? (4)
- Decreased I/E ratio

- Symptoms: gradual
progressive dyspnea and
What are the symptoms and cough - Complications
complications of interstitial include cor pulmonale (can be
lung fibrosis? seen in diffuse interstitial
pulmonary fibrosis and
bleomycin toxicity)

What bronchogenic carcinoma


is associated with ectopic
hormone production (ADH, Small cell carcinoma
ACTH) and may lead to
Lambert-Eaton syndrome?

What bronchogenic carcinoma


is associated with ectopic
Squamous cell carcinoma
PTH-related peptide
production?
What bronchogenic carcinoma
Adenocarcinoma
is most common?

What bronchogenic carcinoma


is thought not to be related Bronchioalveolar carcinoma
to smoking?

What bronchogenic
SSquamous cell carcinoma
carcinomas are clearly linked
and SSmall cell carcinoma
to SSmoking?

What bronchogenic
carcinomas usually express - Squamous cell carcinoma -
tumors that arise centrally? Small cell carcinoma
(2)
What bronchogenic - Adenocarcinoma -
carcinomas usually express Bronchioalveolar carcinoma -
tumors that arise Large cell carcinoma--
peripherally? (3) undifferentiated

What carcinoma occurs in the


apex of the lung and may
affect the cervical Pancoast's tumor
sympathetic, causing Horner's
syndrome?

Chronic necrotizing infection


What causes bronchiectasis?
of bronchi

What causes neonatal


respiratory distress syndrome Surfactant deficiency
(NRDS)?
What cells make surfactant Type II pneumocytes most
and when is it made most abundantly after 35th week of
abundantly in fetuses? gestation

What COPD has a productive


cough for greater than three
months in two years and
hypertrophy of mucus- Chronic bronchitis
secreting glands in the
bronchioles (Reid index
greater than 50%)?

What COPD is characterized


by dilated airways, purulent
Bronchiectasis
sputum, recurrent infections,
and hemoptysis?

What COPD is due to an


enlargement of air spaces and
decreased recoil resulting Emphysema
from destruction of alveolar
walls?
What COPD is due to
bronchial
hyperresponsiveness which Asthma
causes reversible
bronchoconstriction?

What does inhaled asbestos It causes diffuse pulmonary


do to the lungs? interstitial fibrosis

What is the composition of Dipalmitoyl


surfactant: phosphatidylcholine

FEV1 and FVC are reduced in


What is the difference in
both, but in obstructive the
FEV1/FVC ratios between
FEV1 is more dramatically
obstructive and restrictive
reduced, resulting in a
lungs diseases?
decreased FEV1/FVC ratio
What is the leading cause of
Lung cancer
cancer death?

Superior vena caval syndrome


Pancoast's tumor Horner's
What is the SPHERE (acronym) syndrome Endocrine
of complications associated (paraneoplastic) Recurrent
with lung cancer? laryngeal symptoms
(hoarseness) Effusions
(pleural or pericardial)

What kind of pulmonary


diseases are caused by a Obstructive lung diseases
inhibition of air flow resulting (COPD)
in air trapping in the lungs?

What organisms are is the


most frequent cause of lobar Pneumococcus
pnuemonia?
What organisms are the most
- S. aureus - H. flu -
frequent cause of
Klebsiella - S. pyogenes
bronchopnuemonia? (4)

What organisms are the most


- Viruses (RSV, adenoviruses)
frequent cause of interstitial
- Mycoplasma - Legionella
(atypical) pnuemonia? (3)

What specific type of


emphysema is caused by Panacinar emphysema (and
alpha-1-antitrypsin liver cirrhosis)
deficiency?

What specific type of


emphysema is caused by Centriacinar emphysema
smoking?
The lecithin-to-
sphingomyelin ratio in the
What test is used to measure
amniotic fluid, usually less
in utero lung maturity?
than 1.5 in neonatal
respiratory distress syndrome

What type of lung cancer can


Carcinoid tumor
cause carcinoid syndrome?

What type of pneumonia is


characterized by acute
inflammatory infiltrates from
bronchioles into adjacent Bronchopneumonia
alveoli with a patchy
distribution affecting more
than one lobe?

What type of pneumonia is


characterized by diffuse
patchy inflammation localized Interstitial (atypical)
to interstial areas at alveolar pneumonia
walls and involves more than
one lobe?
Where does bronchogenic
- Brain (epilepsy) - Bone
carcinoma commonly
(pathologic fracture) - Liver
metastasize and how does it
(jaundice, hepatomegaly)
present? (3)

Why does alpha-1-antitrypsin


Increased elastase activity
deficiency cause emphysema?

Epilepsy is a disorder of
Define epilepsy.
recurrent seizures.

Define syrinx. Tube, as in syringe


Describe a myoclonic seizure. Quick,repetitive jerks

Describe a tonic-clonic Alternating stiffening and


seizure. movement (grand mal)

Describe a tonic seizure. Stiffening

A blank stare (petit mal- it's


Describe an absence seizure.
in 1st aid this way!!)
Describe an atonic seizure. drop' seizures

Broca's is nonfluent aphasia


Describe Broca's aphasia. with intact comprehension.
BROca's is BROken speech.

Sympathectomy of face
(lesion above T1).
Describe Horner's syndrome.
Interruption of the 3-neuron
oculosympathetic pathway.

Wernicke's is fluent aphasia


with impaired
Describe Wernicke's aphasia.
comprehension. Wernicke's is
Wordy but makes no sense.
How do patients present with
Worst headache of my life'
a subarachnoid hemorrhage?

-Optic neuritis (sudden loss


of vision) - MLF syndrome
(internuclear
How do pts present with MS? ophthalmoplegia) -
Hemiparesis -Hemisensory
symptoms -Bladder/bowel
incontinence

Through the bloodstream to


How does it spread?
the CNS

How does Werdnig-Hoffman


At birth as a 'floppy baby'
disease present?
How is Huntington's disease
Autosomal dominant
inherited?

How is the polio virus


Fecal-oral route
transmitted?

Higher prevalence with


How is the prevalence of MS
greater distance from the
geographically distributed?
Equator

In what persons is subdural Elderly individuals, alcoholics,


hemorrhage often seen? and blunt trauma
T/F. Partial seizures can not False- Partial seizures can
generalize. generalize.

What are 2 common


1. Toxo!Toxo!Toxo! 2.
organisms that target the
Cryptococcus
brain in AIDS pts?

What are 2 degenerative


1. Alzheimer's 2. Pick's
diseases of the cerebral
disease
cortex?

What are 2 degenerative


1. Huntington's disease 2.
diseases that affect the basal
Parkinson's disease
ganglia and brain stem?
What are 3 degenerative 1. Amyotrophic lateral
disorders of the motor sclerosis (ALS) 2. Werdnig-
neuron? Hoffman disease 3. Polio

1. Infections (herpesvirus or
What are associated with
C. jejuni) 2. Inoculations 3.
Guillain-Barre?
Stress

What are neurofibrillary Abnormally phosphorylated


tangles? tau protein

1. Multiple sclerosis (MS) 2.


Progressive multifocal
leukoencephalopathy (PML) 3.
What are some demyelinating Postinfectious
and dysmyelinating diseases? encephalomyelitis 4.
Metachromatic
Leukodystrophy 5. Guillain-
Barre syndrome
1. Epidural hematoma 2.
What are the 4 types of Subdural Hematoma 3.
intracranial hemorrhages? Subarachnoid hemorrhage 4.
Parenchymal hematoma

1. Absence 2. Myoclonic 3.
What are the 5 types of
Tonic-clonic 4. Tonic 5.
generalized seizures?
Atonic

What are the clinical


symptoms of Huntington's Dementia, chorea
disease?

TRAP= Tremor (at rest)


What are the clinical
cogwheel Rigidity Akinesia
symptoms of Parkinson's
Postural instability (you are
disease?
TRAPped in your body)
-Charcot joints -Shooting
What are the clinical pain -Argyll-Robertson Pupils
symptoms of Tabes dorsalis? -Absence of deep tendon
reflexes

What are the common causes -Tumors -Trauma -Stroke -


of seizures in adults? Infection

What are the common causes -Genetic -Infection -Trauma


of seizures in children? -Congenital -Metabolic

What are the common causes -Stroke -Tumor -Trauma -


of seizures in the elderly? Metabolic -Infection
Elevated CSF protein with
What are the lab findings in
normal cell count ('albumino-
Guillain-Barre syndrome?
cytologic dissociation')

-CSF with lymphocytic


pleocytosis with slight
What are the lab findings in
elevation of protein -Virus
poliomyelitis?
recovered from stool or
throat

What are the pathological


-Necrosis -Hemorrhage -
signs of glioblastoma
Pseudo-palisading
multiforme (GBM)?

-Muscle weakness and


What are the signs of LMN
atrophy -Fasciculations -
lesions seen in poliomyelitis?
Fibrillation -Hyporeflexia
1. Ptosis 2. Miosis 3.
What are the symptoms of
Anhidrosis and flushing of
Horner's?
affected side of face

-Malaise -Headache -Fever -


What are the symptoms of
Nausea -Abdominal pain -
poliomyelitis?
sore throat

What area of the brain is


affected by generalized Diffuse area
seizures?

What artery is compromised


Middle meningeal artery
in an epidural hematoma?
What blood vessels are
affected in subdural Rupture of bridging veins
hemorrhages?

What causes a parenchymal -HTN -Amyloid angiopathy -


hematoma? Diabetes Mellitus -Tumor

What causes poliomyelitis? Poliovirus

What chemical can


MPTP, a contaminant in illicit
Parkinson's disease be linked
street drugs
to?
Bilateral pain and
What clinical symptoms are temperature loss in the upper
present with syringomyelia? extremities with preservation
of touch sensation

-Symmetric ascending muscle


weakness beginning in the
What clinical symptoms are distal lower extremities -
present? Facial diplegia in 50% of cases
-Autonomic fx may be
severely affected

What congenital malformation


is often associated with Arnold Chiari Malformation
syringomyelia?

What damage does


cryptococcus cause in the Periventricular calcifications
brain?
What damage does
Diffuse (intracerebral)
toxoplasma cause in the
calcifications
brain?

-Adult polycystic kidney


What diseases are berry disease -Ehlers-Danlos
aneurysms associated with? syndrome -Marfan's
syndrome

What do partial seizures


One area of the brain
affect?

What does rupture of a berry


Stroke
aneurysm lead to?
What does the spinal tap
show in a subarachnoid Bloody or xanthochromic
hemorrhage?

What event is the rupture of


the middle meningeal artery Temporal bone fracture
secondary to?

What genes is the familial


Genes are chromosomes 1,
form of Alzheimer's
14, 19 and 21
associated with?

What is a complex partial


Impaired awareness
seizure?
What is a degenerative
Friedrich's ataxia
disorder of the
(olivopontocerebellar atrophy)
Spinocerebellar tract?

What is anhidrosis? Absence of sweating

What is another name for


Acute idiopathic polyneuritis
Guillain-Barre syndrome?

What is another symptom of


Tongue fasciculations
Werdnig-Hoffman disease?
What is another term for
Expressive aphasia
Broca's aphasia?

What is another term for


Receptive aphasia
Wernicke's aphasia?

What is miosis? Pupil constriction

What is PML associated with? JC virus


What is ptosis? Slight drooping of the eyelids

SIN 1. Scanning speech 2.


What is the classic triad of
Intention Tremor 3.
MS?
Nystagmus

What is the common name for


Lou Gehrig's disease
ALS?

Venous bleeding (less


What is the course of a
pressure) with delayed onset
subdural hemorrhage?
of symptoms
In most pts, the course is
What is the course of MS?
remitting and relapsing

Metastases> Astrocytoma
What is the incidence of brain
(including glioblastoma)>
tumors in adults?
Meningioma

Astrocytoma>
What is the incidence of brain
Medulloblastoma>
tumors in children?
Ependymoma

What is the most common


cause of dementia in the Alzheimer's disease
elderly?
What is the most common
complication of a berry Rupture of the aneurysm
aneurysm?

The bifurcation of the


What is the most common
anterior communicating
site for a berry aneurysm?
artery

Inflammation and
demyelination of peripheral
What is the pathogenesis of
nerves and motor fibers of
Guillain-Barre syndrome?
ventral roots (sensory effect
less severe than motor)

Degeneration of the dorsal


What is the pathogenesis of
columns and dorsal roots due
Tabes dorsalis?
to tertiary syphilis.
Associated with senile
What is the pathology of
plaques (beta-amyloid core)
Alzheimer's?
and neurofibrillary tangles

What is the pathology of Atrophy of the caudate


Huntington's disease? nucleus

-Periventricular plaques -
Preservation of axons -Loss
What is the pathology of MS? of oligodendrocytes -Reactive
astrocytic gliosis -Increased
protein (IgA) in CSF

Associated with Lewy bodies


What is the pathology of
and depigmentation of the
Parkinson's disease?
substantia nigra
Associated with Pick bodies,
What is the pathology of
intracytoplasmic inclusion
Pick's disease?
bodies

Destruction of anterior horn


What is the pathology of
cells, leading to LMN
poliomyelitis?
destruction

Softening and cavitation


What is the pathology of
around the central canal of
syringomyelia?
the spinal cord.

What is the prognosis for a


Very poor
pts diagnosed with a GBM?
What is the second most
common cause of dementia in Multi-infarct dementia
the elderly?

What is the shape of GBMs? Butterfly' glioma

What neural deficits are Impaired proprioception and


present in Tabes dorsalis? locomotor ataxia

What neural tracts are Crossing fibers of the


damaged? spinothalamic tract
What neurons are affected in Both the upper and lower
ALS? motor neurons

What neurons are affected in


Lower motor neurons only
Polio?

What seizures are categorized Awareness intact -Motor -


as simple partial? Sensory -Autonomic -Psychic

What tumor is Horner's


Pancoast's tumor
syndrome associated with?
Where are most brain tumors 70% are supratentorial
located in adults? (cerebral hemispheres)

Where are most childhood 70% below tentorium


brain tumors located? (cerebellum)

Where do berry aneurysms At the bifurcations in the


occur? Circle of Willis

Where does it initially The oropharynx and small


replicate? intestine
Where does the 3 neuron
oculosympathetic pathway The hypothalamus
project from?

1. Interomediolateral column
of the spinal cord 2. Superior
Where does the 3 neuron
cervical (sympathetic)
oculosympathetic pathway
ganglion 3. To the pupil,
project to?
smooth muscles of the
eyelids and the sweat glands

Where is Broca's area located? Inferior frontal gyrus

Where is Pick's disease The frontal and temporal


specific for? lobes
Where is the aopE-4 allele
Chromosome 19
located?

Where is the most common


C8-T1
site of syringomyelia?

Where is the p-App gene


21
located?

Where is Wernicke's area


Superior Temporal Gyrus
located?
Which demyelinating disease
is seen in 2-4% of AIDS PML
patients?

Chronic inflammatory disease


Define Ankylosing of spine & large joints,
spondylitis? sacroilitis, uveitis, &
aortic regurgitation

Chronic inflammatory disease


Define Ankylosing of spine & large joints,
spondylitis? sacroilitis, uveitis, &
aortic regurgitation

Autoimmune-mediated
Define Celiac sprue intolerance of gliadin (wheat)
leading to steatorrhea.
Autoimmune-mediated
Define Celiac sprue intolerance of gliadin (wheat)
leading to steatorrhea.

Precipitation of monosodium
Define Gout. urate crystals into joints due
to hyperuricemia.

Precipitation of monosodium
Define Gout. urate crystals into joints due
to hyperuricemia.

Excessive fibrosis &


collagen deposition
throughout the body;
Define Scleroderma
commonly sclerosis of the
skin, but also of CV & GI
systems & kidney
Excessive fibrosis &
collagen deposition
throughout the body;
Define Scleroderma
commonly sclerosis of the
skin, but also of CV & GI
systems & kidney

dry eyes, dry mouth, nasal


& vaginal dryness,
Define Sicca syndrome.
chronic bronchitis, reflux
esophagitis

dry eyes, dry mouth, nasal


& vaginal dryness,
Define Sicca syndrome.
chronic bronchitis, reflux
esophagitis

In what population is
ankylosing sponsylitis more males (10-30 year old)
commonly found?
In what population is
ankylosing sponsylitis more males (10-30 year old)
commonly found?

In what population is Celiac Assoc. w/ people of northern


sprue more commonly found? European descent

In what population is Celiac Assoc. w/ people of northern


sprue more commonly found? European descent

In what population is
Goodpasture's syndrome Men 20-40 y/o
more commonly found?
In what population is
Goodpasture's syndrome Men 20-40 y/o
more commonly found?

In what population is gout


Men
more commonly found?

In what population is gout


Men
more commonly found?

In what population is
Osteoarthritis more Common in older patients
commonly found?
In what population is
Osteoarthritis more Common in older patients
commonly found?

In what population is
> 50 y/o, both sexes
pseudogout more commonly
equally
found?

In what population is
> 50 y/o, both sexes
pseudogout more commonly
equally
found?

In what population is Reiter's


syndrome more commonly Strong predilection for males
found?
In what population is Reiter's
syndrome more commonly Strong predilection for males
found?

In what population is
- Common in females - 80%
Rheumatoid arthritis more
of RA pt's have positive
commonly found & what
rheumatoid factor (anti-IgG
the common autoimmune
Ab)
factor present?

In what population is
- Common in females - 80%
Rheumatoid arthritis more
of RA pt's have positive
commonly found & what
rheumatoid factor (anti-IgG
the common autoimmune
Ab)
factor present?

In what population is
sarcoidosis more commonly black females
found?
In what population is
sarcoidosis more commonly black females
found?

In what population is
scleroderma more commonly 75% female
found?

In what population is
scleroderma more commonly 75% female
found?

In what population is
females between the ages of
Sjogren's syndrome more
40 & 60
commonly found?
In what population is
females between the ages of
Sjogren's syndrome more
40 & 60
commonly found?

90% are female &


In what population is SLE between ages 14 & 45.
more commonly found? More common & severe
in black females

90% are female &


In what population is SLE between ages 14 & 45.
more commonly found? More common & severe
in black females

Diffuse scleroderma: widespread skin


involvement, rapid progression, early
visceral involvement. Assoc. w/ anti-
What are the 2 major
Scl-70 Ab CREST syndrome:
categories of scleroderma Calcinosis, Raynaud's phenomenon,
& what findings are they Esophageal dysmotility, Sclerodactyly
assoc w/? & Telangiectasia; limited skin
involvement, often confined to fingers
& face. More benign clinical
course - assoc w/ anticentromere Ab
Diffuse scleroderma: widespread skin
involvement, rapid progression, early
visceral involvement. Assoc. w/ anti-
What are the 2 major
Scl-70 Ab CREST syndrome:
categories of scleroderma Calcinosis, Raynaud's phenomenon,
& what findings are they Esophageal dysmotility, Sclerodactyly
assoc w/? & Telangiectasia; limited skin
involvement, often confined to fingers
& face. More benign clinical
course - assoc w/ anticentromere Ab

What are the associated sx's - Parotid enlargement - incr


& risks for Sjogren's risk of B-cell lymphoma -
syndrome? Assoc. w/ RA

What are the associated sx's - Parotid enlargement - incr


& risks for Sjogren's risk of B-cell lymphoma -
syndrome? Assoc. w/ RA

Blunting of villi, lymphocytes


What are the characteristic
in the lamina propria, &
findings in Celiac sprue?
abnormal D-xylose test
Blunting of villi, lymphocytes
What are the characteristic
in the lamina propria, &
findings in Celiac sprue?
abnormal D-xylose test

immune-mediated,
What are the common widespread noncaseating
characteristics of Sarcoidosis? granulomas & elevated
serum ACE levels

immune-mediated,
What are the common widespread noncaseating
characteristics of Sarcoidosis? granulomas & elevated
serum ACE levels

pulmonary hemorrhages,
What are the common gross
renal lesions, hemoptysis,
findings in Goodpasture's
hematuria, crescentic
syndrome?
glomerulonephritis
pulmonary hemorrhages,
What are the common gross
renal lesions, hemoptysis,
findings in Goodpasture's
hematuria, crescentic
syndrome?
glomerulonephritis

Lesch-Nyan disease, PRPP


excess, decreased excretion
of uric acid, or G6PD
What can cause gout? deficiency. Also assoc. w/ the
use of thiazide diuretics
which competitively ingibit
the secretion of uric acid.

Lesch-Nyan disease, PRPP


excess, decreased excretion
of uric acid, or G6PD
What can cause gout? deficiency. Also assoc. w/ the
use of thiazide diuretics
which competitively ingibit
the secretion of uric acid.

deposition of calcium
What causes pseudogout? pyrophosphate crystals w/in
the joint space
deposition of calcium
What causes pseudogout? pyrophosphate crystals w/in
the joint space

SLE causes LSE (Libman-Sacks


Endocarditis): vavular
What CV disease state can be vegetations found on both
caused by SLE? sides of valve (mitral valve
stenosis) & do not
embolize

SLE causes LSE (Libman-Sacks


Endocarditis): vavular
What CV disease state can be vegetations found on both
caused by SLE? sides of valve (mitral valve
stenosis) & do not
embolize

What drugs can induce a


- procainamide - INH -
commonly reversible SLE-like
phenytoin - hydralazine
syndrome?
What drugs can induce a
- procainamide - INH -
commonly reversible SLE-like
phenytoin - hydralazine
syndrome?

90% of cases are assoc w/


What immune marker aids in
B27 (gene which codes for
dx?
HLA MHC-I)

90% of cases are assoc w/


What immune marker aids in
B27 (gene which codes for
dx?
HLA MHC-I)

What is characteristic about needle-shaped &


gout crystals? negatively berefringent.
What is characteristic about needle-shaped &
gout crystals? negatively berefringent.

What is characteristic about


basophilic, rhomboid crystals
pseudogout crystals?

What is characteristic about


basophilic, rhomboid crystals
pseudogout crystals?

a seronegative
What is Reiter's syndrome? spondyloarthropath w/ a
HLA-B27 link
a seronegative
What is Reiter's syndrome? spondyloarthropath w/ a
HLA-B27 link

1. Urethritis (Can't pee) 2.


What is the 'classic triad' for Conjunctivities & ant.
Reiter's syndrome? uveitis (Can't see) 3. Arthritis
(Can't climb a tree)

1. Urethritis (Can't pee) 2.


What is the 'classic triad' for Conjunctivities & ant.
Reiter's syndrome? uveitis (Can't see) 3. Arthritis
(Can't climb a tree)

1. dry eyes (conjunctivitis,


What is the 'classic triad' for xerophthalmia) 2. dry mouth
Sjogren's syndrome? (dysphagia, xerostomia) 3.
arthritis
1. dry eyes (conjunctivitis,
What is the 'classic triad' for xerophthalmia) 2. dry mouth
Sjogren's syndrome? (dysphagia, xerostomia) 3.
arthritis

Mechanical: wear & tear


of joints leads to destruction
What is the classic pathology of articular cartilage,
for Osteoarthritis? subchondral bone formation,
sclerosis, osteophytes,
eburnation, &
Heberden's nodes (DIP)

Mechanical: wear & tear


of joints leads to destruction
What is the classic pathology of articular cartilage,
for Osteoarthritis? subchondral bone formation,
sclerosis, osteophytes,
eburnation, &
Heberden's nodes (DIP)

Autoimmune: inflammatory
d/o affecting synovial joints,
What is the classic pathology w/ pannus formation in joints
for Rheumatoid arthritis? (MCP, PIP), subcutaneous
rheumatoid nodules, ulnar
deviation, subluxation.
Autoimmune: inflammatory
d/o affecting synovial joints,
What is the classic pathology w/ pannus formation in joints
for Rheumatoid arthritis? (MCP, PIP), subcutaneous
rheumatoid nodules, ulnar
deviation, subluxation.

pain in weight-bearing joints


What is the Classic
after use (e.g.- at the end of
presentation for
the day), improving w/ rest.
Osteoarthritis?
No systemic sx's

pain in weight-bearing joints


What is the Classic
after use (e.g.- at the end of
presentation for
the day), improving w/ rest.
Osteoarthritis?
No systemic sx's

morning stiffness improving


What is the classic w/ use, symmetric joint
presentation for Rheumatoid involvement & systemic
arthritis? symptoms: fever, fatigue,
pleuritis, pericarditis
morning stiffness improving
What is the classic w/ use, symmetric joint
presentation for Rheumatoid involvement & systemic
arthritis? symptoms: fever, fatigue,
pleuritis, pericarditis

Anti-glomerular basement
What is the common
membrane antibodies
immunologic finding for
produce linear staining on
Goodpasture's syndrome?
immunofluorescence

Anti-glomerular basement
What is the common
membrane antibodies
immunologic finding for
produce linear staining on
Goodpasture's syndrome?
immunofluorescence

What is the common tx for allopurinol, probenecid,


gout? colchicine, & NSAID's.
What is the common tx for allopurinol, probenecid,
gout? colchicine, & NSAID's.

What is the common tx for


no tx
pseudogout?

What is the common tx for


no tx
pseudogout?

GRAIN Gammaglobulinemia
What is the descriptive Rheumatoid arthritis ACE
acrynym for Sarcoidosis? incr. Interstitial fibrosis
Noncaseating granulomas
GRAIN Gammaglobulinemia
What is the descriptive Rheumatoid arthritis ACE
acrynym for Sarcoidosis? incr. Interstitial fibrosis
Noncaseating granulomas

there are TWO Good Pastures


What is the useful memory for this disease: Glomerulus
tool for Goodpasture's & Pulmonary. Also, a
syndrome? type II (TWO) hypersensitivity
disease

there are TWO Good Pastures


What is the useful memory for this disease: Glomerulus
tool for Goodpasture's & Pulmonary. Also, a
syndrome? type II (TWO) hypersensitivity
disease

restrictive lung disease, bilateral


hilar lypmphadenopathy, erythema
nodosum, Bell's palsy, epithelial
What sx's is sarcoidosis granulomas containing microscopic
Schaumann & asteroid
commonly associated w/?
mobies, uveoparotitis, &
hypercalcemia (due to elevated
conversion of vit. D to its active
form in epithelioid macrophages)
restrictive lung disease, bilateral
hilar lypmphadenopathy, erythema
nodosum, Bell's palsy, epithelial
What sx's is sarcoidosis granulomas containing microscopic
Schaumann & asteroid
commonly associated w/?
mobies, uveoparotitis, &
hypercalcemia (due to elevated
conversion of vit. D to its active
form in epithelioid macrophages)

What the common pattern of Usually affects large joints


psudogout presentation? (classically the knee)

What the common pattern of Usually affects large joints


psudogout presentation? (classically the knee)

Asymmetric joint distribution.


Favored manifestation is
Where is gout commonly painful MTP joint in the big
manifested? toe (podagra). Tophus
formation (often on external
ear or Achilles tendon)
Asymmetric joint distribution.
Favored manifestation is
Where is gout commonly painful MTP joint in the big
manifested? toe (podagra). Tophus
formation (often on external
ear or Achilles tendon)

Adrenal Atrophy and Absence


Addison's disease is
of hormone production;
characterized by what
involves All three cortical
(remember 4 A's)?
divisions

All MEN syndromes have what


Autosomal Dominant
mode of inheritance?

An increased risk of
carcinoma with atypical cells
Epithelial hyperplasia
is seen in which type of
fibrocystic breast disease?
Blood filled, 'chocolate cysts'
Endometriosis
are seen in what condition?

- diarrhea - cutaneous
Carcinoid tumors result in flushing - asthmatic
what recurrent symptoms? (4) wheezing - right-sided
valvular disease

Those affected were


Cretin means 'Christ-like,' considered so mentally
why is that name used? retarded as to be incapable of
sinning.

Excess fat breakdown (usually


due to an increase in insulin
Diabetic ketoacidosis (DKA) is requirements) and increased
caused by what? ketogenesis from the increase
in free fatty acids, which are
then made into ketone bodies
Do leiomyosarcomas derive
No, they usually arise de novo
from other known tumors?

From where do
leiomyosarcomas often Cervix
protrude?

How do you treat carcinoid


Treat with octreotide
syndrome?

How do you treat


postmenopausal Estrogen replacement therapy
osteoporosis?
Hydatiform moles result in an
Beta-HCG
increase in what hormone?

Increase in what substance is


seen in the urine due to 5-HIAA
carcinoid tumors?

Is ACTH increased or
decreased when increased
cortisol is due to a primary Decreased
adrenal hyperplasia or
neoplasia?

Is ACTH increased or
decreased when increased
Decreased
cortisol is due to an
iatrogenic etiology?
Is ACTH increased or
decreased when increased
Increased
cortisol is due to Cushing's
disease?

Is ACTH increased or
decreased when increased
cortisol is due to ectopic Increased
ACTH production (e.g.,
carcinoid)?

Is plasma renin low or high in


Low
primary hyperaldosteronism?

Is plasma renin low or high in


secondary High
hyperaldosteronism?
Leiomyomas are sensitive to
Estrogen
what?

- Fasting serum glucose -


Name 3 common tests for
Glucose tolerance test -
evaluating DM?
HbA1c

- Coronary artery disease -


Name 3 specific example of
Peripheral vascular occlusive
large vessel atherosclerosis
disease and gangrene -
due to DM?
Cerebrovascular disease

1. Renal artery stenosis 2.


Name five possible causes of
Chronic renal failure 3. CHF
secondary
4. Cirrhosis 5. Nephritic
hyperaldosteronism?
syndrome
Ectopic ADH CNS disorders/
Name four causes of SIADH. head trauma Pulmonary
disease Drugs

1. Increased frequency of
Name four common urination 2. Nocturia 3.
presenting symptoms of Difficulty starting and
benign prostatic hyperplasia. stopping the stream of urine
4. Dysuria

- Small vessel disease - Large


Name four important chronic vessel atherosclerosis -
manifestations of DM. Neuropathy - Cataracts,
glaucoma

Name four risk factors of 1. Prolonged estrogen use 2.


endometrial carcinoma. Obesity 3. Diabetes 4. HTN
Name four treatment - Weight loss - OCPs -
modalities for polycystic Gonadotropin analogs -
ovarian syndrome. Surgery

1. Gender 2. Age 3. Early first


menarche (under 12) 4.
Name six risk factors of delayed first pregnancy (over
breast disease. 30) 5. Late menopause (over
50) 6. Family history of first
degree relative with breast
cancer at a young age.

- Polydipsia - Polyuria -
Polyphagia - Weight loss -
Name some of the acute
DKA (type1) - Hyperosmolar
manifestations of Diabetes
coma (type 2) - Unopposed
Mellitus (DM)? (7)
secretion of GH and Epi
(exacerbating hyperglycemia)

Name syndrome: increased


LH due to peripheral estrogen
production leads to Polycystic ovarian syndrome
anovulation and may manifest
in amenorrhea, infertility,
obesity, and hirsutism.
Name the autoimmune
hyperthyroidism with TSH
receptor antibodies, Graves' disease
opthalmopathy, pretibial
myxedema, and diffuse
goiter.

Name the benign breast


tumor: most common tumor
under 25 years; small, Fibroadenoma
mobile, firm mass with sharp
edges.

Name the benign breast


tumor: tumor of lactiferous
Intraductal papilloma
ducts; presents with nipple
discharge.

Name the benign breast


tumor: large, bulky mass of
connective tissue and cysts; Cystosarcoma phyllodes
breast surface has 'leaflike'
appearance.
Name the disease caused by
primary deficiency of
Addison's disease
aldosterone and cortisol due
to adrenal atrophy?

Name the histologic type of


fibrocystic breast disease: Cystic
fluid-filled.

Name the histologic type of


fibrocystic breast disease: Fibrosis
hyperplasia of breast stroma.

Name the histologic type of


fibrocystic breast disease:
increase in number of Epithelial hyperplasia
epithelial cell layers in
terminal duct lobule.
Name the histologic type of
fibrocystic breast disease:
Sclerosing
increased acini and
intralobular fibrosis.

Name the histologic type of


malignant breast disease:
Comedocarcinoma
cheesy consistency of tumor
tissue due to central necrosis.

Name the histologic type of


malignant breast disease:
Paget's disease
eczematous patches on
nipple.

Name the histologic type of


malignant breast disease:
Inflammatory
lymphatic involvement; poor
prognosis.
Name the histologic type of
malignant breast disease:
Infiltrating ductal
most common carcinoma;
firm, fibrous mass.

1. Excessive water retention


Name three characteristics of 2. Hyponatremia 3. Serum
inappropriate ADH secretion hypo-osmolarity with urine
(SIADH). osmolarity > serum
osmolarity

1. Vertebral crush fractures 2.


Name three fractures
Distal radius (Colle's)
commonly seen due to
fractures 3. Vertebral wedge
osteoporosis.
fractures

Pheochromocytomas may be
1. Neurofibromatosis 2. MEN
associated with what 3
type II 3. MEN type III
diseases?
T/F A partial hydatiform mole
is commonly triploid or True
tetraploid.

T/F DKA is common in Type 1


True
DM.

T/F DKA is common in Type 2


False, rare
DM.

T/F Endometriosis often


manifests with severe
True
menstrual-related pain and
often with infertility?
T/F Fibrocystic breast disease
usually does not indicate True
increased risk of carcinoma.

T/F Genotype of a complete


hydatiform mole is 46, XX False, it is 46, XX and Purely
and is purely maternal in Paternal in origin
origin.

T/F Glucose intolerance in


True
Type 1 DM is severe.

T/F Insulin is always


True
necessary to treat Type 1 DM.
T/F Insulin is always
False, sometimes
necessary to treat Type 2 DM.

T/F Leiomyomas often


True
present with multiple tumors.

T/F Leiomyomas often


transform into malignant False, it is rare
tumors.

T/F Leiomyomas progress to


False
leiomyosarcomas.
T/F Leiomyosarcomas: highly
aggressive, have a tendancy
True
to recur, and have an
increased incidence in blacks.

T/F Risk of breast disease is


increased by fibroadenoma False
and nonhyperplastic cysts.

T/F Type 1 diabetes is often


False
associated with obesity.

False. It is polygenic and only


T/F Type 1 diabetes is
weakly associated with
polygenic and strongly due to
genetic disposition, whereas
genetic disposition?
Type 2 is strongly associated.
T/F Women with endometrial
hyperplasia are at increased
risk for endometrial True
carcinoma which tends to
manifest with vaginal
bleeding?

Urinary VMA levels and


plasma catecholamines are
Pheochromocytoma
elevated due to what
neoplasms?

- hypertension - weight gain


- moon facies - truncal
obesity - buffalo hump -
What are the clinical effects of hyperglycemia (insulin
increased cortisol? (9) resistance) - skin changes
(thinning striae) -
osteoporosis - immune
suppression

What are the clinical effects of - Hypertension -


primary hyperaldosteronism? Hypokalemia - Metabolic
(4) alkalosis - Low plasma renin
What are the episodic
- Pressure - Pain (headache)
hyperadrenergic symptoms (5
- Perspiration - Palpitations -
P's) due to
Pallor/diaphoresis
pheochromocytomas?

Insulin deficiency (or


What are the primary
inefficiency) and glucagon
hormonal causes of DM?
excess

- 10% Malignant - 10%


What are the six 'Rule of 10's'
bilateral - 10% extraadrenal -
associated with
10% calcify - 10% kids - 10%
pheochromocytomas?
familial

Type 1 - viral or immune


What are theorized causes for destruction of pancreatic beta
Types 1 and 2 DM? cells Type 2 - Increased
resistance to insulin
What benign breast tumor
increases in size and Fibroadenoma
tenderness with pregnancy?

What breast disease is


common in postmenopausal
women and arises from Malignant tumors (carcinoma)
mammary duct epithilium or
lobular glands?

What causes Cushing's


Increased cortisol
Syndrome?

Defect in T4 formation or
What causes sporadic
developmental failure in
cretinism?
thyroid formation.
What condition can produce all
these symptoms: cold
intolerance, hypoactivity, weight
gain, fatigue, lethargy, decreased Hypothyroidism
appetite, constipation, weakness,
decreased reflexes, myxedema
(facial/periorbital), dry, cool skin,
and coarse, brittle hair?

What condition can produce


all these symptoms: heat
intolerance, hyperactivity,
weight loss, chest pain/ Hyperthyroidism
palpitations, arrhythmias,
diarrhea, increased reflexes,
warm, moist skin, and fine
hair?

What condition is associated


with the expressions
'honeycombed uterus' and Hydatiform mole
'cluster of grapes'
appearance?

What condition is caused by


increased bone resorption
due to decreased estrogen Type 1 Osteoporosis
levels (seen postmenopausal
by 10-15 years)?
What condition is
characterized by non-
neoplastic endometrial Endometriosis
glands/stroma in abnormal
locations outside the uterus?

What disease is characterized


by intense thirst and polyuria
together with an inability to
concentrate urine with fluid diabetes insipidus
restriction owing to lack of
ADH or to a lack of renal
response to ADH. Caused by
lithium demeclocycline.
What disease may be due to an
age-related increase in estradiol
with sensitization of the prostate
to the growth promoting effects
of DHT? It is characterized by Benign prostatic hyperplasia
nodular enlargement of the
periurethral lobes of the prostate
gland compressing the urethra
into a vertical slit?

What diuretic acts as an


aldosterone antagonist used
Spironolactone
to treat primary
hyperaldosteronism?
What endocrine pathology
may produce these findings:
pot-bellied, pale, puffy-faced Cretinism
child with protruding
umbilicus and protuberant
tongue?

What fractures cause acute


back pain, loss of height, and Vertebral crush fractures
kyphosis?

What gynecologic tumor is


often bulky with areas of Leiomyosarcoma
necrosis and hemorrhage?

What is a pathologic ovum


resulting in cystic swelling of
chorionic villi and Hydatiform mole
proliferation of chorionic
epithelium?
What is an abnormal
endometrial gland
proliferation usually caused Endometrial hyperplasia
by excess estrogen
stimulation?

1/3 metastasize 1/3 present


What is the 'Rule of 1/3s' for
with second malignancy 1/3
carcinoid tumors?
multiple

What is the etiology of


Cushing's Syndrome caused Primary pituitary adenoma
by Cushing's disease?

What is the etiology of


An aldosterone-secreting
primary hyperaldosteronism
tumor
(Conn's syndrome)?
What is the etiology of small Diffuse thickening of the
vessel disease due to DM? basement membrane

What is the most common


gynecologic malignancy, with Endometrial carcinoma
a peak age of 55-65 y/o?

What is the most common of


Leiomyoma
all tumors in females?

What is the most common


site of ectopic endometrial Ovary
tissue?
What is the most common
tumor of the adrenal medulla Pheochromocytoma
in adults?

What is the most common


tumor of the adrenal medulla Neuroblastoma
in children?

What is the most common


Carcinoid tumor
tumor of the appendix?

Kidney perception of low


What is the pathophysiology
intravascular volume results
of secondary
in an overactive renin-
hyperaldosteronism?
angiotensin system.
What metabolic reaction is
responsible for the chronic Nonenzymatic glycosylation
manifestations of DM?

What neoplasms secrete high


levels of serotonin (5HT) that Carcinoid tumors
does not get metabolized by (neuroendocrine cells)
the liver due to liver especially of the small bowel
metastases?

What non-selective,
irreversible alpha blocker is
Phenoxybenzamine
used to treat pts with
pheochromocytomas?

What phenotypic difference


Primary insufficiency results
can distinguish between
in hyperpigmentation due to
primary and secondary
increased MSH.
causes of Addison's disease?
What substance causes
cataract formation in DM Sorbitol accumulation
patients?

What syndrome is caused by a


gastrin-secreting tumor that
is usually located in the Zollinger-Ellison syndrome
pancreas, causes recurrent
ulcers, and may be associated
with MEN type 1?

What three organs (3 P's) are - Pancreas - Pituitary -


involved in MEN type I? Parathyroid

What type of respirations are


Kussmaul respiration
seen in diabetic ketoacidosis?
- Retinopathy - hemorrhage,
exudates, and
Where (and in what forms) is microaneurysms -
small vessel disease from DM Nephropathy - nodular
seen most prominently? sclerosis, progressive
proteinuria, chronic renal
failure, arteriosclerosis
leading to HTN

Wherever endemic goiter is


Where does endemic
prevalent (lack of dietary
cretinism occur?
iodine).

life threatening
mucormycosis, Rhizopus
Whether the complications of
infection, cerebral edema,
diabetes Q. as it does is
cardiac arrhythmias, heart
failure

Which type of Multiple


Endocrine Neoplasia (MEN) is
associated with medullary
carcinoma of the thyroid, Type III (formerly MEN IIb)
pheochromocytoma, and oral
and intestinal
ganglioneuromatosis
(mucosal neuromas)?
Which type of Multiple
Endocrine Neoplasia (MEN) is
associated with medullary
carcinoma of the thyroid, Type II (Sipple's syndrome)
pheochromocytoma,
parathyroid tumor, or
adenoma?

Which type of Multiple


Endocrine Neoplasia (MEN) is
associated with pancreas (e.g. Type I (Wermer's syndrome)
ZE syndrome, insulinomas,
VIPomas), parathyroid and
pituitary tumors?

Which type of osteoporosis


affects men and women over Type 2 (Senile) Osteoporosis
70 y/o?

Hyperglycemia increases
intracellular sorbitol (which is
Why is intracellular
associated with depletion)
myoinositol depleted in DM?
and may also directly inhibit
myoinositol uptake
Will total T4, free T4, and T3
All increased - Increased total
uptake be increased or
T4 - Increased free T4 -
decreased (respectively) in
Increased T3 uptake
primary hyperthyroidism?

Will total T4, free T4, and T3 All decreased (remember: TSH
uptake be increased or is increased) - Decreased
decreased (respectively) in total T4 - Decreased free T4
primary hypothyroidism? - Decreased T3 uptake

Will TSH be increased or


decreased in primary Increased
hyperthyroidism?

Will TSH be increased or


decreased in primary Increased
hypothyroidism?
Are most pericardial effusions
serous
serous or hemorrhagic?

Bacterial endocarditis of
which valve is associated with Tricuspid
IV drug abuse?

ST elevation (transmural
Characterize EKG changes in
ischemia) and Q waves
an MI
(transmural infarct)

elevated 1-3 days post MI.


characterize the AST levels in Nonspecific enzyme found in
an MI heart, liver, and skeletal
muscle
Elevated between 4 hrs. and
Characterize the cardiac
7-10 days post MI most
troponin I levels in an MI.
specific protein marker for MI

Characterize the CK-MB elevated in the first 24 hrs.


levels in an MI post MI

Characterize the LDH1 levels elevated from 2 to 7 days


in an MI post MI

Most frequent valvular lesion,


Describe a mitral prolapse esp. in young women. Late
murmur? systolic murmur ending with
2nd heart sound
High pitched holosystolic
Describe a mitral
(continuous sound
regurgitation murmur?
throughout systole)

Rumbling late diastolic


Describe a mitral stenosis murmur when LA>>LV
murmur during diastole. Begins in late
diastole

holosystolic murmur
Describe a vent. Septal defect
(continuous throughout
(VSD) murmur.
systole)

high-pitched 'blowing'
Describe an aortic murmur, beginning
regurgitation murmur immediately in diastole. Wide
pulse pressure
Crescendo-decrescendo
systolic murmur, with
Describe an aortic stenosis LV>>aortic pressure
murmur during systole. Follows an
'ejection click,' and ends
before 2nd heart sound

Continuous machine-like
Describe an patent ductus
murmur. Loudest at the time
arteriosus (PDA) murmur.
of 2nd heart sound

Describe the bacterial


Small vegetations on
growths in subacute bact.
congentially abnormal valves
Endocarditis.

Describe the bacterial


Large vegetations on
growths of acute bact.
previously normal valves
endocarditis?
Describe the onset of Staph.
rapid, acute onset
Aureus endocarditis.

Describe the onset of


Streptoccus viridans Insidious, subacute onset
endocarditis.

During what weeks of


20 weeks gestation to 6
pregnancy does preeclampsia
weeks postpartum
present?

It can resolve without scarring


How can pericarditis or it can lead to chronic
progress? adhesive or chronic
constrictive pericarditis
1. Fatty streaks in arteries 2.
How does atherosclerosis
Proliferative plaques 3.
progress?
Complex atheromas

How does Prinzmental's


chest pain at rest
variant angina present?

How does stable angina


chest pain with exertion
present?

Causes dilation of the aorta


How does syphilis change the and valve ring. Can result in
aorta? aortic aneurysm or aortic
valve incompetence
How does unstable/crescendo
Worsening chest pain
angina present?

Coronary heart dz, CVA, CHF,


To what does HTN predispose
renal dz, and aortic
one?(5)
dissection

1. Hemolysis 2. Elevated LFT


What are associations of
(liver fxn test) 3. Low
preeclampsia?(3)
platelets

1. Headache 2. Blurred vision


3. Abdominal pain 4. Edema
What are clinical features of
of face and extremities 5.
preeclampsia?(6)
Altered mentation 6.
Hyperreflexia
1. Card. Arrhythmia(90%) 2.
LV failure and pul. Edema
(60%) 3. Thromboembolism:
What are complications from mural thrombus 4.
an MI?(7) Cardiogenic shock 5. Physical
trauma 6. Fibrinous
pericarditis 7. Dressler's
syndrome

1. Chordae rupture 2.
What are complications of Glomerulonephritis 3.
bacterial endocarditis?(4) Suppurative pericarditis 4.
Emboli

1. Vent wall rupture 2.


Interventricular. Septum
What are examples traumatic rupture 3. Papillary muscle
MI complications?(4) rupture (4-10 days post-MI)
4. Cardiac tamponade (heart
compression)

What are fat emboli Long bone fractures and


associated with?(2) liposuction
Small erythematous lesions
What are Janeway lesions?
on palms or soles

Secondary to metastasis or
What are nonbacterial causes
renal failure (marantic/
of endocarditis?(2)
thrombotic endocarditis)

tender raised lesions on


What are olser nodes?
finger or toe pads

1. Angina(CAD narrowing>
What are possible 75%) 2. Myocardial infarction
manifestations of ischemic 3. Sudden cardiac death 4.
heart disease?(4) Chronic ischemic heart
disease
Increased age, obesity,
What are risk factors for diabetes, smoking, genetics,
hypertension?(6) race
(black>white>asian)

round white spots on retina


What are Roth's spots?
surrounded by hemorrhage

What are some Agina and claudication. Can


atherosclerosis symptoms? be asymptomatic

1. Preexisting HTN 2.
What are some risk factors for
Diabetes 3. Chronic renal dz
preecalmpsia?(4)
4. Autoimmune dz
1.Primary (essential) HTN,
What are the 2 major causes related to ?CO and ?TPR 2.
of HTN? Secondary HTN, usually
related to renal dz

What are the 3 most common


LAD>RCA>circumflex
sites of an MI?

stable angina, prinzmetal's


What are the 3 types of
variant, and unstable/
angina in ischemic heart dz?
crescendo

1. Aortic stenosis 2. Aortic


regurgitation 3. Mitral
What are the 7 types of heart stenosis 4. Mitral
murmurs? regurgitation 5. Mitral
prolapse 6. Vent. Septal
defect 7. Patent ductus
arteriosus
What are the causes/
A large infarct with a high
associations of cardiogenic
incidence of mortality
shock?

aneurisms, ischemia, infarcts,


What are the complications of
peripheral vasc dz thrombus,
atherosclerosis?(6)
and emboli

1. Chronic alcohol abuse 2.


Beriberi (wet) 3. Coxacke
What are the etiologies of
virus B postviral myocarditis
dilated cardiomyopthy? (6)
4. Cocaine use 5. Chagas dz.
6. Doxirubicin toxicity

1. Unilateral headache 2. Jaw


claudication 3. Impaired
What are the finding in vision 4. Systemic
temporal arteritis? involvement with polymyalgia
rheumatica (in 50% of
patients)
Intermittent claudication,
superficial nodular phlebitis,
What are the findings in cold sensitivity (Raynauld's
Buerger's dz? phenom.), severe pain in
affected part; may lead to
gangrene.

1. Pericardial pain 2. Friction


What are the findings in
rub 3. EKG changes 4. Pulsus
pericarditis?(4)
paradoxicus

1. C-ANCA positive 2. CXR


What are the findings of reveals large nodular lesions
Wegener's granulomatosis?(3) 3. Hematuria and red cell
casts

1. Sarcoidosis 2. Amyloidosis
What are the major causes of
3. Endocardial fibroelastosis
restrictive/obliterative
4. Endomyocardial fibrosis
cardiomyopathy?(4)
(Loffler's)
What are the possible lab thrombocytopenia and
findings in preeclampsia?(2) hyperuricemia

What are the risk factors of smoking, HTN, diabetes


atherosclerosis?(4) mellitus, and hyperlipidemia

1. Fever 2. Erythema
What are the signs and symp marginatum 3. Valvular
of rheumatic fever or damage 4. ESR increase 5.
rheumatic heart dz?(7) Polyarthritis 6. Subcutaneous
nodules 7. Chorea

JR= NO FAME 1. Janeway


What are the signs and symp. lesions 2. Roth's spots 3. Nail
bed hemorrhages 4. Osler
of bacterial endocarditis?(8)
nodes 5. Fever 6. Anemia 7.
Murmur 8. Emobli
1. Cotton wool spots 2.
Microaneurysms 3.
What are the signs of Pericarditis 4. Myocarditis 5.
polyarteritis nodosa?(7) Palpable purpura 6. Elevated
ESR 7. P-ANCA positive
serum

What are the symptoms of a Chest pain, tachypnea, and


pulmonary embolus? (3) dyspnea

Severe retrosternal pain, pain


What are the symptoms of an in left arm or jaw, shortness
MI?(5) of breath, fatigue, and
adrenergic symptoms

fever, weight loss, malaise,


What are the symptoms of
abdominal pain, myalgia, and
polyarteritis nodosa?(6)
HTN
What are the symptoms of Fever, arthritis, night sweats,
Takaysu's arteritis?(6) myalgia, and skin nodules

1. Perforation of nasal
septum 2. Chronic sinusitis 3.
What are the symptoms of
Wegeners granulomatosis? (7) Otitis media 4. Mastoiditis 5.
Cough 6. Dyspnea 7.
Hemoptysis

1. Fat 2. Air 3. Thrombus 4.


What are the types of emboli?
Bacteria 5. Amniotic fluid 6.
(6)
Tumor

1. Infection 2. Ischemic heart


What can cause pericarditis? dz 3. Chronic renal failure
(4) leading to uremia 4.
Connective tissue dz
What causes acute bact.
Staphyloccus aureus
Endocarditis?

What causes cardiac dilation greater ventricle end-


in CHF? diastolic volume

What causes dyspnea on failure of LV output to


exertion in CHF? increase during exercise

increased central venous


What causes hepatomegaly in press.?increased resistance
CHF? to portal flow. Rarely leads to
'cardiac cirrhosis.'
Pooling of blood in lungs
when supine adds volume to
What causes othopenea
congested pul. Vasculature
(dyspnea when supine) in
system; increased venous
CHF?
return not put out by left
ventricle.

Failure of left heart to keep


What causes Paroxysmal up with rt. Heart output ?
nocturnal dyspnea and acute rise pul. Venous and
pulmonary edema in CHF? capillary press. ? transudation
of fluid

What causes prinzmental's


coronary artery spasm
variant angina?

LV failure?increased pul.
Venous press.? pul. Venous
What causes pulmonary distention and transudation
congestion in CHF? of fluid. Presence of
hemosiderin-laden
macrophages (heart failure
cells).
What causes pulmonary 95% of pulmonary emboli
emboli? arise from deep leg veins

Pharyngeal infection with


group A, ? hemolytic
What causes rheumatic fever? streptococci leads to cross
reactivity with self (not due to
direct effects of bacteria)

What causes stable angina? atherosclerosis

What causes sudden cardiac Most commonly from lethal


death? arrhythmia
What causes the edema seen RV failure?increased venous
in CHF? press.? fluid transudation

What causes unstable/ thrombosis in a branch of the


crescendo angina? coronary artery

1. Infarct appears pale 2.


Tissue surrounding infarct
What happens 2-4 days after shows acute inflammation 3.
an MI?(5) Dilated vessels (hyperemia) in
infarct 4. Neutrophil
emigration 5. Extensive
coagulative necrosis

1. A hyperemic boarder forms


around the infarct 2. The infarct
shows central softening with
What happens 5-10 days brown/yellow color 3. An outer
after an MI?(4) zone (ingrowth of granulation
tissue) forms around infarct 4.
Neutrophils and macrophages
infiltrate infarcted tissue
1. The Occluded artery
causing the MI is recanalized
What happens by 7 weeks 2. The infarct area is gray/
post-MI?(3) white 3. The infarcted tissue
shows contracted, complete
scarring

What happens to contractility,


cardiac output, and effective all decrease
atrial blood volume in CHF?

What happens to renal blood


decreases
flow in CHF?

What happens to renin,


angiotensin II, and all increase
aldosterone in CHF
What happens to sympathetic
increases
nervous activity in CHF?

1. Appearance of a pale
infarcted area 2. Coagulative
necrosis in the infarct 3.
What happens to the heart 1 Release of necrotic cells in
day after an MI?(5) the blood 4. Beginning of
neutrophil emigration 5.
Artery supplying infarcted
tissue is occluded

What happens to urinary


excretion of water and Na in decrease
CHF?

What happens to venous


increases
pressure in CHF?
What histologic part of the
vasa vasorum
aorta is affected by syphilis?

What is 'pulseless disease'? Takayasu's arteritis

A hemorrhagic infarct
What is a red infarct? associated with reperfusion
of infarcted tissue

What is an association of Hepatitis B infection (30% of


polyarteritis nodosa? patients)
Known as smoker's disease
and thromboangitis
obliterans; idiopathic,
What is Buerger's disease? segmental, thrombosing
vasculitis of intermediate and
small peripheral arteries and
veins.

Progressive onset of CHF over


What is chronic ischemic
several years due to chronic
heart dz?
ischemic myocardial damage

an autoimmune phenomenon
resulting in fibrinous
What is Dressler's syndrome?
pericarditis several weeks
post-MI

The addition of seizures to


What is eclampsia?
the preeclampsia triad
A friction rub of the
What is fibrinous pericarditis? pericardium usually 3-5 days
post-MI

What is hypertrophic
Familial hypertrophy, usually
cardiomyopathy (formerly
asymmetric, involving the
IHSS: idiopathic hypertrophic
interventricular septum
subaortic stenosis)?

Necrotizing immune complex


inflammation of small or
What is polyarteritis nodosa? medium-sized muscular
arteries, typically involving
renal or visceral vessels.

A triad of HTN, protenuria,


What is preeclampsia? and edema that occurs in
pregnancy
death from cardiac causes
What is sudden cardiac death? within 1 hr. of onset of
symptoms

Thickening of aortic arch and


proximal great vessels
What is Takayasu's arteritis? causing weak pulses in
extremities and ocular
disturbances.

Vasculitis that affects medium


and small arteries, usually
What is temporal arteritis?
branches of the carotid
artery.

What is the appearance of a Walls of LV are thickened,


heart with hypertrophic chamber becomes banana
cardiomyopathy? shaped on echocardiogram
What is the appearance of an
Tree bark appearance
aorta affected by syphilis?

What is the incidence of


7% of pregnant women
preeclampsia?

What is the inheritance


pattern of hypertrophic AD
cardiomyopathy?

What is the most common Dilated (congested)


cardiomyopathy? cardiomyopathy (90%)
What is the most common
metastases
heart tumor

What is the most common


primary cardiac tumor in Myxoma
adults?

What is the most common


primary cardiac tumor in rhabdomyoma
children

What is the most common


temporal arteritis
vasculitis?
What is the treatment for
stop smoking
Buerger's dz?

What is the treatment for


Responds well to steroids
temporal arteritis?

IV Magnesium sulfate and


What is the treatment of
diazepam This is a medical
eclampsia?
emergency

What is the treatment of Corticosteroids, azathioprine,


polyarteritis nodosa? and/or cyclophosphamide
Deliver the fetus ASAP.
What is the treatment of
Otherwise rest, salt
preeclampsia?
restriction, treatment of HTN

cyclophosphamide,
What is the treatment of
corticosteroids, and/or
wegener's granulomatosis?
methotrexate

What is the x-ray appearance


of a heart with dilated Dilated: looks like a balloon
myopathy?

Focal necrotizing vasculitis


and granulomas in the lung
What is Wegner's
and upper airway with
granulomatosis?
necrotizing
glomerulonephritis
What kind of effusions are
found in pericarditis
hemorrhagic
associated with TB or
malignancy?

What kind of effusions are


found in pericarditis Serous of fibrinous
associated with renal failure?

What lab finding is seen in


Takayasu's arteritis or elevated ESR
temporal arteritis?

What part of the heart/


Aortic root and ascending
vasculature can be damaged
aorta
by syphilis?
What percentage of HTN is
90%
primary?

What percentage of HTN is


10%
secondary?

What population is associated


with death from hypertrophic young athletes
cardiomyopathy?

Virchow's triad: 1. Stasis 2.


What predisposes one to deep
Hypercoagulability 3.
vein thromosis?(3)
Endothelial damage
What stage of syphilis can
tertiary
affect the heart?

1. Ankle and sacral edema 2.


Hepatomegaly (nutmeg liver)
3. Pulmonary congestion 4.
What symptoms are Dyspnea on exertion 5.
associated with CHF?(8) Paroxysmal nocturnal
dyspnea 6. Pulmonary edema
7. Orthopnea (dyspnea when
supine) 8. Cardiac dilation

1. EKG (the gold standard) 2.


What tests are used to
Cardiac troponin I 3. CK-MB
diagnose an MI?(5)
4. LDH1 5. AST

What type of bacterial


Subacute endocarditis from
endocarditis is associated
Strep. Viridans infection
with dental procedures?
What type of embolus is amniotic fluid, especially
associated with DIC? postpartum

Viruses, TB, pyogenic


What types of infections bacteria; often by direct
cause pericarditis? spread from lung or
mediastinal lymph node

What visual complication can occlusion of ophthalmic


temporal arteritis cause? artery leading to blindness

90% occur in the atria, mostly


Where do myxomas occur? LA. Myxomas are described
as a 'ball valve' obstruction.
Solid tissues with single
Where do pale infarcts occur? blood supply: brain, heart,
kidneys, and spleen

Loose tissue with collaterals:


Where do red infarcts occur?
lungs or intestine

Where does a MI usually In the left anterior


occur? descending coronary artery

The elastic arteries and


Where histologically does
medium to large muscular
atherosclerosis occur?
arteries
Where, anatomically, does abdominal aorta>coronary
atherosclerosis most occur? art>popliteal art>carotid
(4) art

Which valve is most


frequently involved in Mitral
bacterial endocarditis?

Which valves are most mitral>aortic>>tricus


affected by rheumatic heart pid (high pressure valves
dz? most affected)

Primarily affects young Asian


Who gets Takayasu's arteritis?
females
Who gets temporal arteritis? Affects elderly females

Failure to make urine and


Define renal failure.
excrete nitrogenous wastes

How do you calculate anion Na-(Cl + HCO3) = 8-12 mEq/


gap? L

How do you treat minimal


Responds well to steroids
change disease?
How does acute
poststreptococcal Spontaneously
glomerulonephritis resolve?

How does renal cell


Invades the IVC and spreads
carcinoma spread
hematogenously
metastically?

How does transitional cell


Hematuria
carcinoma present?

How does Wilms' tumor


Huge, palpable flank mass
present?
In what epidemiological
group is renal cell carcinoma Men ages 50-70
most common?

T/F: Ammonium magnesium


phosphate kidney stones are TRUE
radiopaque

T/F: Calcium kidney stones


TRUE
are radiopaque.

T/F: Calcium kidney stones


FALSE
do not recur.
T/F: Cystine kidney stones FALSE, cystine stones are
are radiopaque. radiolucent

T/F: Transitional cell False, transitional cell


carcinoma is cured by carcinoma often recurs after
surgical removal. removal

T/F: Uric acid kidney stones FALSE, uric acid stones are
are radiopaque radiolucent

What additional sx are seen in


Peripheral and periorbital
a pt with acute streptococcal
edema
glomerulonephritis?
What age group is
poststreptococcal
Children
glomerulonephritis most
common?

1. Acute lung disease 2.


Chronic lung disease 3.
What are 4 causes of
Opioids, narcotics, sedatives
hypoventilation?
4. Weakening of respiratory
muscles

What are the 2 forms of renal


Acute and chronic
failure?

What are the 2 main


symptoms present in Hemoptysis, hematuria
Goodpasture's syndrome?
1. Calcium 2. Ammonium
What are the 4 major types of
magnesium phosphate 3. Uric
kidney stones?
acid 4. Cystine

Acute poststreptococcal
glomerulonephritis Rapidly
progressive (crescentic)
What are the 5 nephritic glomerulonephritis
syndromes? Goodpasture's syndrome
Membranoproliferative
glomerulonephritis Berger's
disease

1. Membranous
glomerulonephritis 2. Minimal
What are the 5 nephrotic change disease (lipoid
syndromes? nephrosis) 3. Focal segmental
glomerular sclerosis 4.
Diabetic nephropathy 5. SLE

What are the causes and -Kids- rickets -Adults-


signs of calcium ion osteomalacia -Contributes to
deficiency? osteoporosis -Tetany
What are the causes and -Low serum calcium ion -can
signs of phosphate toxicity? cause bone loss -renal stones

What are the causes of Secondary to emesis,


chloride ion deficiency? diuretics, renal disease

-Diabetic ketoacidosis -
What are the causes of Diarrhea -Lactic Acidosis -
metabolic acidosis? Salicylate OD -Acetazolamide
OD

What are the causes of


-COPD -Airway obstruction
respiratory acidosis?
What are the causes of -High altitude -
respiratory alkalosis? Hyperventilation

What are the characteristics


of acute poststreptococcal
Granular pattern
glomerulonephritis seen with
immunofluorescence?

What are the characteristics


of acute poststreptococcal
Subepithelial humps
glomerulonephritis seen with
the electron microscope?

What are the characteristics


Glomeruli enlarged and
of acute poststreptococcal
hypercellular neutrophils
glomerulonephritis seen with
'lumpy-bumpy'
the light microscope?
What are the characteristics
of rapidly progressive
(crescentic) Crescent-moon shape
glomerulonephritis seen on
LM and IF?

-Hematuria -Palpable mass -


What are the clinical features
Secondary polycythemia -
of renal cell carcinoma?
Flank pain -Fever

What are the clinical I' = inflammation; hematuria,


symptoms of a nephritic hypertension, oligouria,
syndrome? azotemia

What are the clinical O = proteinuria


symptoms of nephrotic Hypoalbuminuria Generalized
syndromes? edema Hyperlipidemia
1. Anemia 2. Renal
osteodystrophy 3.
What are the consequences of Hyperkalemia 4. Metabolic
renal failure? acidosis 5. Uremia 6. Sodium
and water excess 7. Chronic
pyelonephritis 8. HTN

What are the factors


-Increased pH -Increased
associated metabolic
PCO2 -Increased HCO3-
alkalosis?

What are the factors


-Decreased pH -Decreased
associated with metabolic
PCO2 -Decreased HCO3-
acidosis?

What are the factors


-Decreased pH -Increased
associated with respiratory
PCO2 -Increased HCO3-
acidosis?
What are the factors
-Increased pH -Decreased
associated with respiratory
PCO2 -Decreased HCO3-
alkalosis?

-Muscle contraction -
What are the functions of
Neurotransmitter release -
calcium ion?
Bones, teeth

-Extracellular fluid -Maintains


What are the functions of
plasma volume -Nerve/
sodium ion?
muscle function

-Fluid/electrolyte balance -
What are the functions of the
Gastric acid -HCO3/Cl shift in
chloride ion?
RBC
What are the functions of the -Bones, teeth -Enzyme
magnesium ion? cofactor

-ATP -nucleic acids -


What are the functions of the
Phosphorylation -Bones,
phosphate ion?
teeth

What are the functions of the -Intracellular fluid -Nerve/


potassium ion? muscle function

What are the signs of


-Diarrhea -Alcoholism
magnesium ion deficiency?
What are the signs of -Decreased reflexes -
magnesium ion toxicity? Decreased respirations

What are the signs of -Kids- rickets -Adults-


phosphate deficiency? osteomalacia

What are the signs of


-EKG changes -Arrhythmia
potassium ion toxicity?

What bugs cause ammonium Urease-positive bugs such as


magnesium phosphate kidney Proteus vulgaris or
stones? Staphylococcus
What calcium molecules form Calcium oxalate or calcium
calcium kidney stones? phosphate or both

What can excess Na and


CHF and pulmonary edema
water cause?

What can the hyperkalemia


associated with renal failure Cardiac arrhythmias
lead to?

1. Vomiting 2. Diuretic use 3.


What causes metabolic
Antacid use 4.
alkalosis?
Hyperaldosteronism
What causes renal Failure of active vitamin D
osteodystrophy? production

What characteristics of
Berger's disease are seen with Mesangial deposits of IgA
IF and EM?

What characteristics of focal


segmental glomerular Segmental sclerosis and
sclerosis are seen with the hyalinosis
LM?

What characteristics of Linear pattern Anti-


Goodpasture's syndrome are glomerular basement
seen with IF? membrane antibodies
What characteristics of
Membranoproliferative subendothelial humps 'tram
glomerulonephritis are seen track'
with the EM?

What characteristics of
membranous
Granular pattern
glomerulonephritis are seen
with IF?

What characteristics of
membranous
Spike and Dome'
glomerulonephritis are seen
with the EM?

What characteristics of
Diffuse capillary and
membranous
basement membrane
glomerulonephritis are seen
thickening
with the LM?
What characteristics of
minimal change disease are Foot process effacement
seen with the EM?

What characteristics of
minimal change disease are Normal glomeruli
seen with the LM?

Wire-loop appearance with


extensive granular
What characteristics of SLE subendothelial basement-
are seen with the LM? membrane deposits in
membranous
glomerulonephritis pattern

What defines metabolic -pH less than 7.4 -PCO2 less


acidosis? than 40 mm Hg
What defines metabolic -pH greater than 7.4 -PCO2
alkalosis with compensation? greater than 40 mm Hg

What defines respiratory -pH less than 7.4 -PCO2


acidosis? greater than 40mm Hg

What defines respiratory -pH greater than 7.4 -PCO2


alkalosis? less than 40 mm Hg

Diseases with increased cell


What diseases often cause proliferation and turnover,
uric acid kidney stones? such as leukemia and
myeloproliferative disorders
What disorders can lead to 1. Cancer 2. Increased PTH 3.
hypercalcemia and thus Increased vitamin D 4. Milk-
kidney stones? alkali syndrome

1. Renal failure 2. Lactic


What disorders cause an
acidosis 3. Ketoacidosis (DM)
increased anion gap?
4. Aspirin ingestion

What disorders cause 1. Diarrhea 2. Glue sniffing 3.


metabolic acidosis and Renal tubular acidosis 4.
normal anion gap? Hyperchloremia

Wilms' tumor Aniridia


What disorders make up the
Genitourinary malformation
WAGR complex?
mental-motor Retardation
What does potassium -Weakness -Paralysis -
deficiency cause? Confusion

What factors are associated Exposure to


with transitional cell cyclophosphamide, smoking,
carcinoma? phenacetin, and aniline dyes

Renal cell carcinoma is


What genetic disorder and
associated with von Hippel-
mutation are associated with
Lindau and gene deletion in
renal cell carcinoma?
chromosome 3

Deletion of tumor
What genetic disorder is
suppression gene WT-1 on
associated with Wilms' tumor?
chromosome 11
What is a common cause of Membranous
adult nephrotic syndrome? glomerulonephritis

What is acute renal failure


Hypoxia
often due to?

IgA nephropathy -Mild


What is Berger's disease?
disease -Often postinfectious

What is chronic failure due to? HTN and diabetes


What is the 2nd most
Ammonium magnesium
common type of kidney
phosphate
stone?

What is the cause of


Secondary to malabsorption
magnesium ion deficiency?

What is the cause of


Vomiting
metabolic alkalosis?

What is the cause of Secondary to injury, illness or


potassium ion deficiency? diuretics
What is the cause of sodium
Secondary to injury or illness
deficiency?

What is the compensatory


mechanism of metabolic Hypoventilation
alkalosis?

What is the compensatory


mechanism of respiratory Renal HCO3- secretion
alkalosis?

What is the compensatory


response to metabolic Hyperventilation
acidosis?
What is the compensatory
response to respiratory Renal HCO3- reabsorption
acidosis?

What is the course of


Slowly progresses to renal
membranoproliferative
failure
glomerulonephritis?

What is the course of rapidly


Rapid course to renal failure
progressive (crescentic)
from one of many causes
glomerulonephritis?

What is the Henderson- pH = pKa + log [(HCO3-)/


Hasselbalch equation? (0.03*PCO2)]
What is the most common
Minimal change disease
cause of childhood nephrotic
(lipoid nephrosis)
syndrome?

What is the most common


renal malignancy of early Wilms' tumor
childhood (ages 2-4)?

What is the most common


Renal cell carcinoma
renal malignancy?

What is the most common


tumor of the urinary tract Transitional cell carcinoma
system?
What is the primary
disturbance in respiratory Increased PCO2
acidosis?

What is the primary


disturbance of metabolic HCO3- decrease
acidosis?

What is the primary


disturbance of metabolic Increased HCO3-
alkalosis?

What is the primary


disturbance of respiratory Decreased PCO2
alkalosis?
What is the sign of calcium
Delirium
ion toxicity?

What is the sign of sodium


Delirium
ion toxicity?

What lesions are seen on the


Kimmelstiel-Wilson lesions
LM in diabetic nephropathy?

MUD PILES 1. Methanol 2.


Uremia (chronic renal failure)
3. Diabetic ketoacidosis 4.
What might an elevated anion Paraldehyde or Phenformin 5.
gap indicate? Iron tablets or INH 6. Lactic
acidosis (CN-, CO, shock) 7.
Ethanol or Ethylene glycol 8.
Salicylates
What paraneoplastic
Ectopic EPO, ACTH, PTHrP,
syndromes are associated
and prolactin
with renal cell carcinoma?

What severe complications Hydronephrosis


may kidney stones lead to? Pyelonephritis

What social factor increases


the incidence of renal cell Smoking
carcinoma?

What type of hypersensitivity


contributes to the
Type II hypersensitivity
pathogenesis of
Goodpasture's syndrome?
Where can transitional cell -Renal calyces -Renal pelvis -
carcinoma occur? Ureters -Bladder

Where does renal cell Renal tubule cells, polygonal


carcinoma originate? clear cells

Which kidney stone is often


Cystine
secondary to cystinuria?

Which kidney stone is


strongly associated with Uric acid kidney stones
gout?
Which of the nephrotic
Focal segmental glomerular
syndromes are worse in HIV
sclerosis
pts?

Which type of kidney stones


constitute the majority of Calcium
kidney stones (80-85%)?

Why are ammonium Ammonium magnesium


magnesium phosphate kidney phosphate stones can form
stones often associated with large struvite calculi that can
UTIs? be a nidus for UTIs

Why does renal failure cause


Failure of EPO production
anemia?
Due to decreased acid
Why does renal failure cause
secretion and decreased
metabolic acidosis?
generation of HCO3-

-Physiologic tolerance and


dependence with syptoms of
withdrawal when intake is
Define/Describe Alcoholism: interrupted. -Continued
drinking despite medical and
social contraindications and
life disruptions.

In alcoholics, what causes


Vitamin B1 (thiamine)
Wernicke-Korsakoff
deficiency
syndrome?

Is Korsakoff's syndrome
NO
reversible?
Wernicke-Korsakoff
syndrome is associated with
periventricular hemorrage/ Mamillary bodies
necrosis in which part of
brain?

-Jaundice -Hypoalbuminemia
-Coagulation factor
What are the accompanying deficiencies -Portal
symptomes of Alcoholic hypertension -Peripheral
cirrhosis? edema and ascites -
Encephalopathy -Neurologic
manifestations (e.g., asterixis,
flapping tremor of the hands)

-Toxicity (especially in the


What are the bodily effects of
brain) -Fatty liver -Increased
ethanol? (3)
NADH/HAD

-Increases lactate/pyrubate -
Inhibits gluconeogenesis -
What are the effects of
Inhibits fatty acid oxidation -
increased NADH/NAD (from
Inhibits glycerophosphate
ethanol use)? (4)
dehydrogenase leading to
elevated glycerophosphate
-Alcoholoic hepatitis and
cirrhosis -Pancreatitis -Dilated
cardiomyopathy -Peripheral
What are the long term neuropathy -Cerebellar
consequences of alcohol use? degeneration -Wernicke-
Korsakoff syndrome -Testicular
atrophy and hypertension -
Mallory-Weiss syndrome

-tremor -tachycardia -
What are the symptoms of
hypertension -malaise -
alcohol withdrawel?
nausea -delerium tremens

Progression of Wernicke's
What is Korsakoff's encephalopathy to memory
syndrome? loss, confabulation, and
confusion

Longitudinal lacerations at
the gastroesophageal
What is Mallory-Weiss junction caused by excessive
syndrome? vomitting with failure of
Lower Esophageal Sphincter
relaxation that could lead to
fatal hematemesis.
What is the treatment for
Wernicke-Korsakoff IV vitamin B1 (thiamine)
syndrome?

What is the triad of symptoms


1. Psychosis 2.
for Wernicke's
Ophthalmoplegia 3. Ataxia
encephalopathy?

What supportive group has


Alcoholics Anonymous
been mose successful in
(sorry… it was in the book :)
sustaining abstinence?

What treatment is used to


condition the patient
Disulfiram
negatively against alcohol
use?
Often precedes squamous cell
Actinic keratosis
carcinoma

Autoimmune (infection is the


Addison's
second most common cause)

Guillain-Barre (increased
Albumino-cytologic
protein in CSF with only
dissociation
modest increase in cell count)

Aneurysm, dissecting HTN


Anti-basement membrane Goodpasture's syndrome

Anti-centromere antibodies Scleroderma (CREST)

Anti-double-stranded-DNA
SLE (type III hypersensitivity)
antibodies (ANA antibodies)

Anti-epithelial cell Pemphigus vulgaris


Anti-gliadin antibodies Celiac disease

Anti-histone Antibodies Drug-induced SLE (cf. SLE)

Anti-IgM antibodies Rheumatoid arthritis

Anti-mitochondrial
Primary biliary cirrhosis
antibodies
Anti-neutrophil antibodies Vasculitis

Idiopathic thrombocytopenic
Antiplatelet antibodies
purpura

Aortic aneurysm, abdominal


Atherosclerosis
& descending aorta

Aortic aneurysm, ascending Tertiary syphilis


Arachnodactyly Marfan's syndrome

Argyll-Robertson pupil Neurosyphilis

Aschoff bodies Rheumatic fever

Atrophy of the mamillary


Wernicke's encephalopathy
bodies
Acute myelogenous leukemia
Auer rods (especially the promyelocytic
type)

Autosplenectomy Sockle cell anemia

Babinski sign Upper motor neuron lesion

Bacteremia/pneumonia (IVDA) Staphylococcus aureus


Bacteria associated with
Helicobacter pylori
cancer

Bacteroides (second most


Bacteria found in GI tract
common is Escherichia coli)

Bacterial meningitis (adults) Neisseria meningitidis

Bacterial meningitis (elderly) Streptococcus pneumoniae


Bacterial meningitis (kids) Haemophilus influenza type B

Bacterial meningitis
Escherichia coli
(newborns)

Baker's cyst in popliteal fossa Rheumatoid arthritis

Bamboo spine' on xray Ankylosing spondylitis


Basophilic stippling of RBC's Lead poisoning

Multiple myeloma (kappa or


lambda Ig light chains in
Bence-Jones proteins
urine) Waldenstrom's
macroglobinemia (IgM)

Bilateral hilar adenopathy,


Sarcoidosis
uveitis

Histiocytosis X (eosinophilic
Birbeck granules on EM
granuloma)
Bloody tap on LP Subarachnoid hemorrhage

Fibrocystic change of the


Blue-domed cysts
breast

Blue bloater' Chronic bronchitis

Blue sclera Osteogenesis imperfecta


Tetralogy of Fallot; RV
Boot-shaped heart on x-ray
hypertrophy

Osteoarthritis (PIP swelling


Bouchard's nodes
secondary to osteophytes)

Boutonniere's deformity Rheumatoid arthritis

Brain tumor - supratentorial


Craniopharyngioma
(kids)
Astrocytoma (including
glioblastoma multiforme) >
Brain tumor (adults)
mets > meningioma >
Schwannoma

Brain tumor (kids) Medullobastoma (cerebellum)

Branching rods in oral


Actinomyces israelii
infection

Infultrating ductal carcinoma


Breast cancer (in the US, one in nine women
will develop breast cancer)
Fibrocystic change (in post-
menopausal women,
Breast mass
carcinoma is the most
common)

Breast tumor (benign) Fibroadenoma

Hemorrhage causes brown


color of osteolytic cysts:
Brown tumor'of bone Hyperparathyroidism; Osteitis
fibrosa cystica (von
Recklinghausen's disease)

Brushfield's spots Down syndrome


Bruton's lines Lead poisoning

Bug in debilitated,
hospitalized pneumonia Klebsiella
patient

C-ANCA Wegerner's granulomatosis

Café au lait spots on skin Neurofibromatosis


Duchenne's muscular
Calf pseudohypertrophy
dystrophy

Granulosa/thecal cell tumor


Call-Exner bodies
of the ovary

Cancer associated with AIDS Kaposi's sarcoma

Cardiac primary tumor Myxoma (4:1 left to right


(adults) atrium; 'ball & valve')
Cardiac primary tumor (kids) Rhabdomyoma

Cardic tumor (adults) Mets

Cardiomegaly with apical


Cagas' disease
atrophy

Cardiomyopathy Dilated cardiomyopathy


Mycosis fungoides (cutaneous
Cerebriform nuclei
T-cell lymphoma)

Chancre Primary syphilis (not painful)

Chancroid Haemophilus ducreyi (painful)

Multiple sclerosis (nystagmus,


intention tremor,scanning
Charcot's triad
speech); Cholangitis
(jaundice, RUQ, fever)
Bronchial asthma (eosinophil
Charcot-Leyden crystals
membranes)

Tay-Sachs, Niemann-Pick
Cherry-red spot on macula disease, central retinal artery
occlusion

Hypocalcemia (facial muscle


Chevostek's sign
spasm upon tapping)

Central apnea in CHF &


Cheyne-Stokes respirations
increased ICP
Endometriosis (frequently
Chocolate cysts'
involve both ovaries)

Down syndrome (associated


with ALL, Alzheimer's
Chromosomal disorder
dementia, & endocardial
cushion defects)

Atrial fibrillation (associated


Chronic arrhythmia
w/ high risk of emboli)

Predisposition to gastric
Chronic atrophic gastritis
carcinoma
Clue cells Gardnerella vaginitis

Codman's triangle on x-ray Osteoasarcoma

Mycoplasma pneumoniae;
Cold agglutinins
Infectious mononeucleosis

Cold intolerance Myxedema


Condyloma lata Secondary syphilis

Congenital adrenal
21-Hydroxylase deficiency
hyperplasia

Congenital cardiac anomaly VSD

Constrictive pericarditis Tuberculosis


Continuous machinery
Patent ductus arteriosus
murmur

Coronary artery involved in


LAD > RCA > LCA
thrombosis

Cotton wool spots Chronic hypertension

Cough, conjunctivitis, coryza


Measles
+ fever
Councilman bodies Toxic or viral hepatitis

Cowdry type A bodies Herpes virus

Crescents in Bowman's Rapidly progressive crescentic


capsule glomerulonephritis

Cretinism Hypothyroidism/iodine deficit


Currant-jelly sputum Klebsiella

Bronchial asthma (whorled


Curschmann's spirals
mucous plugs)

Corticosteroid therapy
(second most common cause
Cushing's syndrome
is excess ACTH secretion by
pituitary)

Tetralogy of Fallot,
Cyanosis (early; less common) transposition of great vessels,
truncus arteriosus
D-dimers DIC

Death in CML Blast crisis

Death in SLE Lupus nephropathy

Alzheimer's (second most


Dementia
common is multi-infarct)
Demyelinating disease Multiple sclerosis

Parkinson's disease (basal


Depigmentation of neurons in
ganglia disorder -- rigidity,
substantia nigra
resting tremor, bradykinesia)

Dermatitis, dementia, Pellagra (Niacin, vitamin B3


diarrhea deficiency)

Diabetes insipidus +
Hand-Schuller-Christian
exopthalmos + lesions of
disease
skull
Gram-negative sepsis,
DIC obstetric complications,
cancer, burns trauma

Dietary deficit Iron

Dog or cat bite Pasteurella multocida

Donovan bodies Granuloma inguinale


Ejection click Aortic/pulmonic stenosis

Elastic skin Ehlers-Danlos syndrome

Epiglottitis Haemophilus influenza type B

Erythema chronicum migrans Lyme disease


Esophageal cancer Squamous cell carcinoma

Fat, female, forty, &


Acute cholecystitis
fertile'

Fatty liver Alcoholism

Ferruginous bodies Asbestosis


Food poisoning Staphylococcus aureus

Ghon complex Secondary TB

Ghon focus Primary TB

IgA nephropathy (Berger's


Glomerularnephritis (adults)
disease)
Duchenne's (use of patient's
Gower's maneuver arms to help legs pick self off
the floor)

Caucasians (fat-soluble
Group affected by cystic
vitamin deficiencies, mucous
fibrosis
plugs/lung infections)

Gynecologic malignancy Endometrial carcinoma

Hair on end' appearance on


Beta-thalassemia
x-ray
Hampton's hump on x-ray Pulmonary embolism

HbS Sickle cell anemia

Choriocarcinoma;
HCG elevated Hyadatidiform mole (occurs
with & without embryo)

Heart murmur Mitral valve prolapse


Heart valve (rheumatic fever) Mitral valve (aotric is second)

Heart valve in bacterial


Mitral
endocarditis

Heart valve in bacterial


Tricuspid
endocarditis in IVDA

Osteoarthritis (DIP swelling


Heberden's nodes
secondary to osteophytes)
Heinz bodies G6PD deficiency

Enterobius vermicularis
Helminth infection (US) (Ascaris lumbricoides is
second most common)

Rupture of middle meningeal


Hematoma - epidural artery (arterial bleeding is
fast)

Rupture of bridging veins


Hematoma - subdural (trauma; venous bleeding is
slow)
Multiple blood transfusions
(can result in CHF, and
Hemochromocytosis
increases risk of
hepatocellular carcinoma)

Hepatic cirrhosis EtOH

Cirrhotic liver (often


Hepatocellular carcinoma associated with hepatitis B
& C)

Hereditary bleeding disorder Von Willebrand's


Infectious mononucleosis
Heterophil antibodies
(EBV)

Hgb F Thalassemia major

High output cardiac failure Wet beriberi (thiamine,


(dilated cardiomyopathy) vitamin B1 deficiency)

Reiter's syndrome, ankylosing


HLA-B27
spondylitis
DM type 1 (caused by
HLA-DR3 or DR4 autoimmune destruction of
beta cells)

Holosystolic murmur VSD, tricuspid regurgitation

Homer-Wright rosettes Neuroblastoma

Honeycomb lung on x-ray Interstitial fibrosis


Splenectomy (or non-
Howell Jolly bodies
functional spleen)

Hyperphagia + hypersexuality Kluver-Bucy syndrome


+ hyperorality + hyperdocile (amygdala)

Primary adrenal insufficiency


Hyperpigmentation of skin
(Addison's disease)

Hypersegmented neutrophils Macrocytic anemia


Cushing & Conn
Hypertension + hypokalemia
syndromes

Hypertension, secondary Renal disease

Hypochromic microcytosis Iron-deficiency anemia

Hypoparathyroidism Thyroidectomy
Hypopituitarism Adenoma

Increase alpha-fetoprotein in
amniotic fluid/maternal Anencephaly; Spina bifida
serum

Gout; Lesch-Nyhan;
Increased uric acid levels Myeloproliferative disorders;
Loop & thiazide diuretics

Infection in blood transfusion Hepatitis C


Infection in burn victims Klebsiella

Adenovirus (cause
Intussesception hyperplasia of Peyer's
patches)

Janeway lesions Endocarditis

Syphilis; over-aggressive
treatment of an symptomatic
Jarisch-Herxheimer reaction
patient that causes symptoms
due to rapid lysis
Homosexual AIDS patients
Kaposi's sarcoma (not associated with IVDA
acquired HIV/AIDS)

Kayser-Fleischer rings Wilson's disease

Keratin pearls Squamous cell carcinoma

Calcium = radiopaque (2nd


most common is ammonium
= radiolucent; formed by
Kidney stones
urease positive organisms
like Proteus vulgaris or
Staphylococcus)
Kimmelstiel-Wilson nodules Diabetic nephropathy

Koilocytes HPV

Koplik spots Measles

Kussmaul hyperpnea Diabetic ketoacidosis


Lens dislocation + aortic
Marfan's disease (fibrillin
dissection + joint
deficit)
hyperflexibility

Leukemia (adults) AML

Lewy bodies Parkinson's disease

Lines of Zahn Arterial thrombus


Neurofibromatosis (von
Lisch nodules
Recklinghausen's disease)

Liver disease Alcoholic liver disease

Location of brain tumors


Supratentorial
(adults)

Location of brain tumors


Infratentorial
(kids)
Low serum ceruloplasmin Wilson's disease

Lucid interval Epidural hematoma

Lumpy Bumpy' appearance of


Poststreptococal
glomeruli on
glomerulonephritis
immunoflourescence

Lysosomal storage disease


Gaucher's
disorder
Lytic bone lesions on x-ray Multiple myeloma

Machine-like' murmur PDA

Male cancer Prostatic carcinoma

Malignancy associated with


Hodgkin's
infectious fever
Basal cell carcinoma (rarely
Malignant skin tumor
metastasizes)

Mallory bodies Alcoholic liver disease

McBurney's sign Appendicitis

Down syndrome (Fragile X is


Mental retardation the second most common
cause)
Breast, lung, thyroid, testes,
Mets to bone
prostate

Lung, breast, skin


Mets to brain (melanoma), kidney (renal cell
carcinoma), GI

Colon, gastric, pancreatic,


Mets to liver breast, & lung
carcinomas

MI Atherosclerosis
Mitral valve stenosis Rheumatic heart disease

MLF syndrome (INO) Multiple sclerosis

Multiple myeloma (called the


M protein; usually IgG or IgA);
Monoclonal antibody-spike MGUG; Waldenstrom's (M
Protein = IgM)
macroglobulinemia

Motor neuron disease ALS


Myocarditis Coxsackie B

Myxedema Hypothyroidism

Necrotizing vasculitis (lungs) Wegener's &


& necrotizing Goodpasture's (hemoptysis
glomerulitis & glomerular disease)

Needle-shaped, negatively
Gout
bifringent crystals
Negri bodies Rabies

ALL (2nd most common is


Neoplasm (kids)
cerebellar medulloblastoma)

Nephritis + cataracts +
Alport syndrome
hearing loss

Minimal change disease


(associated with infections/
Nephrotic syndome (kids)
vaccinations; treat with
corticosteroids)
Membranous
Nephrotic syndrome
glomerulonephritis

Membranous
Nephrotic syndrome (adults)
glomerulonephritis

Neurofibrillary tangles Alzheimer disease

No lactation postpartum Sheehan's syndrome


Nutmeg liver Congestive heart failure

Obstruction of male urinary


BPH
tract

Occupational exposure to
Malignant mesothelioma
asbestos

Oncogene involved in cancer p53 Suppressor


Opening snap Mitral stenosis

Opportunistic infection in
PCP
AIDS

Adrenal glands (due to rich


Organ receiving mets
blood supply)

Organ sending mets Lung > breast, stomach


Papillary carcinoma of the
Orphan Annie cells
ovary

Osler's nodes Endocarditis

Osteomyelitis Staphylococcus aureus

Osteomyelitis in patients with


Salmonella
sickle cell disease
Osteomyelitis with IVDA Pseudomonas

Ovarian tumor (benign) Hamartoma

Ovarian tumor (malignant) Serous cystadenoma

Owl's eye CMV


P-ANCA Polyarteritis nodosa

Painless jaundice Pancreatic cancer (head)

Palpable purpura on legs


Henoch-Schonlein purpura
& buttocks

Adenocarcinoma (head of
Pancreatic tumor
pancreas)
Pancreatitus (acute) EtOH and gallstones

EtOH (adults), cystic fibrosis


Pancreatitus (chronic)
(kids)

Pannus Rheumatiod arthritis

ALL - Child / CLL - Adult over


Patient with ALL/CLL/AML/
60 / AML - Adult over 60 /
CML
CML - Adult 35-50
Young male (except nodular
Patient with Hodgkin's
sclerosis type - female)

Patient with minimal change


Young child
disease

Patient with Reiter's Male

Peau d'orange Carcinoma of the breast


Neisseria gonorrhoeae
Pelvic inflammatory disease
(monoarticular arthritis)

Periosteal elevation on x-ray Pyogenic osteomyelitis

Philadelphia chromosome CML (may sometimes be


(bcr;abl) associated with AML)

Pick bodies Pick's disease


Emphysema (centroacinar
(smoking), panacinar
Pink puffer'
(alpha1-antitrypsin
deficiency))

Prolactinoma (2nd -
Pituitary tumor somatotropic 'acidophilic'
adenoma)

Pneumonia, hospital-acquired Klebsiella

Pneumonia, in CF, burn


Pseudomonas aeruginosa
infection
Podagra Gout (MP joint of hallux)

Podocyte fusion Minimal change disease

Polyneuropathy preceded by
Guillian-Barre syndrome
GI or respiratory infection

Polyneuropathy, cardiac Dry beriberi (thiamine,


pathology, & edema vitamine B1 deficiency)
Port-wine stain Hemangioma

Posterior anterior 'drawer Anterior cruciate ligament


sign' injury

Preventable blindness Chlamydia

Preventable cancer Lung cancer


Primary amenorrhea Turner's (XO)

Primary bone tumor (adults) Multiple myeloma

Primary hyperaldosteronism Adenoma of adrenal cortex

Adenomas (followed by:


Primary hyperparathyroidism
hyperplasia, then carcinoma)
Primary hyperparathyroidism Adenoma

Primary liver tumor Hepatoma

Caused by apoptosis of tumor


cells with dystrophic calcification
& found in: Papillary
adenocarcinoma of the thyroid
Psammoma bodies
(most common cancer of the
thyroid); Serous papillary
cystadenocarcinoma of the ovary;
Meningioma, Mesothelioma

Pseudopalisade tumor cell


Glioblastoma multiforme
arrangement
Pseudorosettes Ewing's sarcoma

Horner's syndrome
Ptosis, miosis, anhidrosis
(Pancoast's tumor)

Pulmonary hypertension COPD

Pus, empyema, abscess Staphylococcus aureus


Secondary syphilis; Rocky
Rash on palms & soles
Mountain Spotted Fever

RBC's in urine Bladder carcinoma

RBC casts in urine Acute glomerulonephritis

Recurrent pulmonary
Pseudomonas and
Cystic fibrosis
Staphylococcus aureus
infections
Paroxysmal nocturnal
Red urine in the morning
hemoglobinuria

Reed-Sternberg cells Hodgkin's lymphoma

Reid index (increased) Chronic bronchitis

Reinke crystals Leydig cell tumor


Renal cell carcinoma +
cavernous hemangiomas + Von Hippel - Lindau disease
adenomas

Renal epithelial casts in urine Acute toxic/viral nephrosis

Renal cell carcinoma -


associated with von Hippel-
Lindau & acquired
Renal tumor polycystic kidney disease;
paraneoplastic syndromes
(erythropoietin, renin, PTH,
ACTH)

Rhomboid crystals, positively


Pseudogout
bifringent
Rib notching Coarctation of aorta

Right-sided heart faulure Left-sided heart failure

Right heart failure due to a


Cor pulmonale
pulmonary cause

Roth spots in retina Endocarditis


Rouleaux formation (RBC's) Multiple myeloma

Russell bodies Multiple myeloma

Left to right shunt (VSD, PDA,


S3 ASD); Mitral regurgitation; LV
failure (CHF)

Aortic stenosis, hypertrophic


S4
subaortic stenosis
Schiller-Duval bodies Yolk sac tumor

Schwarzman reaction Neisseria meningitidis

Secondary Hypocalcemia of chronic renal


hyperparathyroidism failure

Senile plaques Alzheimer's disease


Sexually transmitted disease Chlamydia

Postpartum pituitary
Sheehan's syndrome
infarction

Small cell carcinoma of the


SIADH
lung

Signet ring cells Gastric carcinoma


Simian crease Down syndrome

Site of diverticula Sigmoid colon

Site of metastasis Regional lymph nodes

Site of metastasis (2nd most


Liver
commond)
Abdominal aorta >
Sites of atherosclerosis coronary > popliteal >
carotid

Skin cancer Basal cell carcinoma

Skip lesions Crohn's

Erythema infectiosum (fifth


Slapped cheeks
disease)'
Smith antigen SLE

Smudge' cell CLL

Soap bubble on x-ray Giant cell tumor or bone

Membranous
Spike & dome on EM
glomerulonephritis
Splinter hemorrhages in
Endocarditis
fingernails

Starry-sky pattern Burkitt's lymphoma

Stomach cancer Adenocarcinoma

Strawberry tongue' Scarlet fever


Streaky ovaries Turner's syndrome

String sign on x-ray Crohn's disease

Poststreptococal
Subepithelial humps on EM
glomerulonephritis

Suboccipital
Rubella
lymphadenopathy
Sulfur granules Actinomyces israelii

Surgical wound Staphylococcus aureus

Scurvy (ascorbic acid, vitamin


C deficiency) - vitamin C is
Swollen gums, bruising, poor
necessary for hydroxylation
wound healing, anemia
of proline & lysine in
collagen synthesis

Systolic ejection murmur


Aortic valve stenosis
(crescendo-decrescendo)
Follicular lymphomas (bcl-2
t(14; 18)
activation)

Burkitt's lymphoma (c-myc


t(8;14)
activation)

Philadelphia chromosome,
t(9;22)
CML (bcr-abl hybrid)

Tabes dorsalis Tertiary syphilis


Target cells Thalassemia

Tendon xanthomas
Familial hypercholesterolemia
(classically Achilles)

Testicular tumor Seminoma

Thumb sign on lateral x-ray Epiglottitis


Myasthenia gravis (present in
Thymoma
20% of those with MG)

Thyroid cancer Papillary carcinoma

Chronic bacterial
Thyroidization of kidney
pyelonephritis

Tophi Gout
Lower esophagus joins
Tracheoesophageal fistula trachea/upper esophagus -
blind pouch

Tram-track' appearance on Membranoproliferative


LM glomerulonephritis

Traumatic open wound Clostridium perfringens

Visceral cancer; pancreatic


adeneocarcinoma (migratory
Trousseau's sign
thrombophlebitis);
Hypocalcemia (carpal spasm)
Tumor in men Prostate carcinoma

Leiomyoma (estrogen
Tumor in women
dependent)

Tumor of infancy Hemangioma

Tumor of the adrenal medulla


Pheochromocytoma (benign)
(adults)
Tumor of the adrenal medulla
Neuroblastoma (malignant)
(kids)

Mixed cellularity (versus:


lymphocytic predominance,
Type of Hodgkin's
lymphocytic depletion,
nodular sclerosis)

Type of non-Hodgkin's Follicular, small cleaved

Type of pituitary adenoma Prolactinoma


UTI Escherichia coli

UTI (young women) Staphylococcus saprophyticus

Temporal arteritis (risk of


ipsilateral blindness due to
Vasculitis
thrombosis of ophthalmic
artery)

Viral encephalitis HSV


Left supraclavicular node
Virchow's node enlargement from metastatic
carcinoma of the stomach

Pulmonary embolism (triad =


Virchow's triad blood stasis, endothelial
damage, hypercoag.)

Folic acid (pregnant women


Vitamin deficiency (US) are at high risk; body stores
only 3-4 month supply)

Chronic end-stage renal


Waxy casts
disease
WBC's in urine Acute cystitis

WBC casts in urine Acute pyelonephritis

Wire loop' appearance on LM Lupus nephropathy

Berry aneurysm - associated


Worst headache of my life' with adult polycystic kidney
disease
Xanthochromia (CSF) Subacrachnoid hemorrhage

Xerostomia + arthritis +
Sjogren's syndrome
keratoconjunctivitis sicca