USMLE STEP 1 and USMLE STEP 2 Highly tested topics The Complete Gold Collection
Page 1
USMLE E-BOOK
This is the GOLD collection of highly tested USMLE Step 1 and USMLE Step 2 topics listed in tables for easy review. These ’PEARLS’ will appear on your boards exams!
Diseases Addison’s Disease Addisonian Anemia Albright’s Syndrome Alport’s Syndrome Alzheimer’s Argyll-Robertson Pupil
Arnold-Chiari Malformation Barrett’s Bartter’s Syndrome Becker’s Muscular Dystrophy Bell’s Palsy Berger’s Berger’s Disease Bernard-Soulier Disease Berry Aneurysm Bowen’s Disease Brill-Zinsser Disease Briquet’s Syndrome Syndrome Broca’s Aphasia Brown-Sequard Bruton’s Disease Budd-Chiari Buerger’s Buerger’s Disease Burkitt’s Lymphoma
Caisson Disease Chagas’ Disease Chediak-Higashi Chediak-Higashi Disease Conn’s Syndrome Syndrome Cori’s Disease Creutzfeldt-Jakob Crigler-Najjar Syndrome Crohn’s Curling’s Ulcer Cushing’s
1.
Primary adrenocortical deficiency
2.
Pernicious anemia
3.
Polyostotic fibrous dysplasia, dysplasia, precocious precocious puberty, café au lait spots, short stature, stature, young young girls
4.
Hereditary nephritis with nerve deafness
5.
Progressive dementia
6. 7. 8. 9. 10.
Loss of light reflex constriction (contralateral or bilateral) “Prostitute’s Eye” – accommodates but does not react Pathognomonic for 3°Syphilis Lesion pretectal region of superior colliculus Cerebellar tonsil herniation herniation through foramen foramen magnum = see thoracolumbar meningomyelocele meningomyelocele
11.
Columnar metaplasia of lower esophagus (↑ risk of adenocarcinoma)- constant gastroesophageal reflux
(antibodies to intrinsic factor or parietal cells → ↓IF → ↓Vit B12 → megaloblastic anemia)
12. Hyperreninemia 13. Similar to Duchenne, but less less severe severe 14. CNVII palsy
(mutation, not a deficiency, in dystrophin protein)
(entire face; recall that UMN lesion only affects lower face)
15. IgA nephropathy causing hematuria in kids, usually following infection infection 16. Defect in platelet adhesion (abnormally large platelets & lack of platelet-surface glycoprotein) 17. Circle of Willis (subarachnoid bleed) Anterior Communicating artery 18. Often associated with ADPKD 19. Carcinoma in situ on shaft of penis (↑ risk of visceral ca) [compare w/ Queyrat] 20. Recurrences of of rickettsia prowazaki up to 50 50 yrs later 21. Somatization disorder 22. Psychological: multiple physical complaints without without physical pathology 23. Motor Aphasia (area 44 & 45) intact comprehension 24. Hemisection of cord
(contralateral loss of pain & temp / ipsilateral loss of fine touch, UMN / ipsi loss of consc. Proprio)
25. X-linked X-linked agammaglobinemia ( ↓ B cells) 26. Post-hepatic Post-hepatic venous thrombosis thrombosis = ab pain; hepatomegaly; ascites; portal HTN; HTN; liver failure 27. 28. 29. 30. 31. 32. 33.
Acute inflammation of medium and small arteries of extremities extremities → painful ischemia → gangrene Seen almost exclusively in young and middle-aged men who smoke. Small noncleaved cell lymphoma EBV 8:14 translocation Seen commonly commonly in jaws, abdomen, retroperitoneal retroperitoneal soft tissues Starry sky appearance Nitric gas emboli
34. Trypansoma infection infection - cardiomegaly with apical atrophy, achlasia 35. (AR) Phagocyte Phagocyte Deficiency = defect defect in microtubule microtubule polymerization 36. Neutropenia, albinism, albinism, cranial & peripheral neuropathy & repeated infections w/ strep & staph staph + 37. Primary Aldosteronism: HTN; retain Na & H2O; hypokalemia (causing alkalosis); ↓ renin 38. Type III Glycogenosis Glycogenosis – Glycogen storage storage disease
(debranching enz: amylo 1,6 glucosidase def. ↑ Glycogen)
39. Prion infection → cerebellar & cerebral degeneration 40. 41. 42. 43.
Congenital hyperbilirubinemia (unconjugated) (unconjugated) Glucuronyl transferase deficiency. deficiency. Can progress to Kernicterus Kernicterus Less severe form will respond respond to Phenobarbital Phenobarbital therapy IBD; ileocecum, transmural, transmural, skip lesions, lesions, cobblestones, cobblestones, lymphocytic infiltrate, infiltrate, granulomas
44.
(contrast to UC: limited to colon, mucosa & submucosa, crypt abscesses, pseudopolyps, pseudopolyps, ↑ colon cancer risk)
45. Clinically: ab pain & diarrhea; fever; malabsorption; fistulae b/t intestinal loops & abd structures 46. Acute gastric ulcer ulcer associated with severe burns
47. Disease: Hypercorticism 2° to ↑ ACTH from pituitary (basophilic adenoma) 48. Syndrome: hypercorticism of all other causes (1° adrenal or ectopic) 49. - moon face; buffalo hump; purple striae; hirsutism; HTN; hyperglycemia Page 2
USMLE E-BOOK
This is the GOLD collection of highly tested USMLE Step 1 and USMLE Step 2 topics listed in tables for easy review. These ’PEARLS’ will appear on your boards exams!
Diseases Addison’s Disease Addisonian Anemia Albright’s Syndrome Alport’s Syndrome Alzheimer’s Argyll-Robertson Pupil
Arnold-Chiari Malformation Barrett’s Bartter’s Syndrome Becker’s Muscular Dystrophy Bell’s Palsy Berger’s Berger’s Disease Bernard-Soulier Disease Berry Aneurysm Bowen’s Disease Brill-Zinsser Disease Briquet’s Syndrome Syndrome Broca’s Aphasia Brown-Sequard Bruton’s Disease Budd-Chiari Buerger’s Buerger’s Disease Burkitt’s Lymphoma
Caisson Disease Chagas’ Disease Chediak-Higashi Chediak-Higashi Disease Conn’s Syndrome Syndrome Cori’s Disease Creutzfeldt-Jakob Crigler-Najjar Syndrome Crohn’s Curling’s Ulcer Cushing’s
1.
Primary adrenocortical deficiency
2.
Pernicious anemia
3.
Polyostotic fibrous dysplasia, dysplasia, precocious precocious puberty, café au lait spots, short stature, stature, young young girls
4.
Hereditary nephritis with nerve deafness
5.
Progressive dementia
6. 7. 8. 9. 10.
Loss of light reflex constriction (contralateral or bilateral) “Prostitute’s Eye” – accommodates but does not react Pathognomonic for 3°Syphilis Lesion pretectal region of superior colliculus Cerebellar tonsil herniation herniation through foramen foramen magnum = see thoracolumbar meningomyelocele meningomyelocele
11.
Columnar metaplasia of lower esophagus (↑ risk of adenocarcinoma)- constant gastroesophageal reflux
(antibodies to intrinsic factor or parietal cells → ↓IF → ↓Vit B12 → megaloblastic anemia)
12. Hyperreninemia 13. Similar to Duchenne, but less less severe severe 14. CNVII palsy
(mutation, not a deficiency, in dystrophin protein)
(entire face; recall that UMN lesion only affects lower face)
15. IgA nephropathy causing hematuria in kids, usually following infection infection 16. Defect in platelet adhesion (abnormally large platelets & lack of platelet-surface glycoprotein) 17. Circle of Willis (subarachnoid bleed) Anterior Communicating artery 18. Often associated with ADPKD 19. Carcinoma in situ on shaft of penis (↑ risk of visceral ca) [compare w/ Queyrat] 20. Recurrences of of rickettsia prowazaki up to 50 50 yrs later 21. Somatization disorder 22. Psychological: multiple physical complaints without without physical pathology 23. Motor Aphasia (area 44 & 45) intact comprehension 24. Hemisection of cord
(contralateral loss of pain & temp / ipsilateral loss of fine touch, UMN / ipsi loss of consc. Proprio)
25. X-linked X-linked agammaglobinemia ( ↓ B cells) 26. Post-hepatic Post-hepatic venous thrombosis thrombosis = ab pain; hepatomegaly; ascites; portal HTN; HTN; liver failure 27. 28. 29. 30. 31. 32. 33.
Acute inflammation of medium and small arteries of extremities extremities → painful ischemia → gangrene Seen almost exclusively in young and middle-aged men who smoke. Small noncleaved cell lymphoma EBV 8:14 translocation Seen commonly commonly in jaws, abdomen, retroperitoneal retroperitoneal soft tissues Starry sky appearance Nitric gas emboli
34. Trypansoma infection infection - cardiomegaly with apical atrophy, achlasia 35. (AR) Phagocyte Phagocyte Deficiency = defect defect in microtubule microtubule polymerization 36. Neutropenia, albinism, albinism, cranial & peripheral neuropathy & repeated infections w/ strep & staph staph + 37. Primary Aldosteronism: HTN; retain Na & H2O; hypokalemia (causing alkalosis); ↓ renin 38. Type III Glycogenosis Glycogenosis – Glycogen storage storage disease
(debranching enz: amylo 1,6 glucosidase def. ↑ Glycogen)
39. Prion infection → cerebellar & cerebral degeneration 40. 41. 42. 43.
Congenital hyperbilirubinemia (unconjugated) (unconjugated) Glucuronyl transferase deficiency. deficiency. Can progress to Kernicterus Kernicterus Less severe form will respond respond to Phenobarbital Phenobarbital therapy IBD; ileocecum, transmural, transmural, skip lesions, lesions, cobblestones, cobblestones, lymphocytic infiltrate, infiltrate, granulomas
44.
(contrast to UC: limited to colon, mucosa & submucosa, crypt abscesses, pseudopolyps, pseudopolyps, ↑ colon cancer risk)
45. Clinically: ab pain & diarrhea; fever; malabsorption; fistulae b/t intestinal loops & abd structures 46. Acute gastric ulcer ulcer associated with severe burns
47. Disease: Hypercorticism 2° to ↑ ACTH from pituitary (basophilic adenoma) 48. Syndrome: hypercorticism of all other causes (1° adrenal or ectopic) 49. - moon face; buffalo hump; purple striae; hirsutism; HTN; hyperglycemia Page 2
Cushing’s Ulcer de Quervain’s Thyroiditis DiGeorge’s Syndrome Down’s Syndrome Dressler’s Syndrome Dubin-Johnson Syndrome Duchenne Muscular Dystrophy Edwards’ Syndrome Ehler’s-Danlos Eisenmenger’s Complex Erb-Duchenne Erb-Duchenne Palsy Ewing Sarcoma Eyrthroplasia of Queyrat Fanconi’s Syndrome Syndrome Felty’s Syndrome Syndrome Gardner’s Syndrome Gaucher’s Disease Gilbert’s Syndrome Glanzmann’s Glanzmann’s Thrombasthenia Goodpasture’s Grave’s Grave’s Disease Guillain-Barre Hamman-Rich Syndrome Hand-Schuller-Christian Hashimoto’s Thyroiditis Hashitoxicosis Henoch-Schonlein purpura Hirschprung’s Hirschprung’s Disease Horner’s Syndrome Huntington’s (Chromosome 4) Jacksonian Seizures Job’s Syndrome
Kaposi Sarcoma Kartagener’s Syndrome Kawasaki Disease Klinefelter’s Syndrome Kluver-Bucy Krukenberg Tumor Laennec’s Cirrhosis Lesch-Nyhan Letterer-Siwe Libman-Sacks
50. Acute gastric ulcer ulcer associated with CNS trauma 51. Self-limiting Self-limiting focal destruction (subacute thyroiditis) 52. 53. 54. 55.
Failure of 3rd & 4th pharyngeal p ouches formation: Thymus & Parathyroid Thymic hypoplasia → T-cell deficiency Hypoparathyroidism ! Tetany Trisomy 21 or translocation translocation – Simian Crease
56. Post-MI Fibrinous Pericarditis Pericar ditis
autoimmune
57. Congenital hyperbilirubinemia (conjugated ) = bilirubin transposrt is defective not conjugation 58. Striking brown-to-black brown-to-black discoloration discoloration of of the liver 59. Deficiency of dystrophin protein → MD X-linked recessive 60. Trisomy 18 61. Rocker-bottom feet , low ears, small lower jaw, heart disease 62. Defective collagen 63. Late cyanotic shunt (R →L) pulmonary HTN & RVH 2° to long-standing VSD, ASD, or PDA 64. Trauma to superior trunk of brachial plexus plexus
Waiter’s Tip
65. Malignant undifferentiated undifferentiated round cell tumor tumor of bone in boys <15yoa - t11;22 66. Carcinoma in situ on glans penis 67. Impaired proximal proximal tubular tubular reabsorption 2° to lead poisoning or Tetracycline
(glycosuria,
hyperphosphaturia, hyperphosphaturia, aminoaciduria, systemic acidosis)
68. Rheumatoid arthritis, neutropenia, neutropenia, splenomegaly splenomegaly 69. AD = adenomatous adenomatous polyps of colon, colon, osteomas & soft tissue tissue tumors 70. Lysosomal Storage Disease glucocerebrosidase deficiency – glucocerebroside accumulation 71. Hepatosplenomegaly, femoral head & long bone erosion, erosion, anemia 72. Benign congenital hyperbilirubinemia (unconjugated) (unconjugated) = ↓d glucuronyl transferase activity 73. Defective glycoproteins on platelets = deficient deficient platelet aggregation 74. Autoimmune: ab’s to glomerular & alveolar basement membranes. membranes. Seen in men in their 20’s 75. Autoimmune hyperthyroidism hyperthyroidism (TSI): (TSI): IgG Ab reactive w/ TSH receptors.
Low TSH & TRH – High T3 / T4
76. Polyneuritis following viral viral infection/ autoimmune (ascending muscle weakness & paralysis; usually self-limiting) 77. Idiopathic pulmonary fibrosis. Can see honey comb lung. 78. Chronic progressive histiocytosis 79. Autoimmune hypothyroidism. hypothyroidism. May May have transient hyperthyroidism. hyperthyroidism.
Low T3 /T4 & High TSH
80. Initial hyperthyroidism in Hashimoto’s Thyroiditis that precedes precedes hypothyroidism hypothyroidism 81. 82. 83. 84.
Hypersensivity vasculitis = allergic purpura. Lesions have the same age. Hemmorhagic urticaria (with fever, arthralgias, GI & renal involvement) Associated with upper upper respiratory infections infections Aganglionic megacolon
85. Ptosis, miosis, anhidrosis (lesion of cervical sympathetic nerves often 2 ° to a Pancoast tumor) 86. AD: Progressive degeneration degeneration of caudate nucleus, putamen (striatum) (striatum) & frontal cortex
↓ GABA
87. Epileptic events originating in the primary motor cortex cortex (area 4) 1. 2. 3. 88. 89.
Immune deficiency: neutrophils fail to respond to chemotactic stimuli Defective neutrophilic chemotactic response = repeated infections Commonly seen in light-skinned, light-skinne d, red-haired girls ↑’d IgE levels Malignant vascular tumor (HHV8 in homosexual men)
90. Immotile cilia 2° to defective dynein arms
infection, situs inversus, sterility
91. Mucocutaneous lymph node syndrome in kids
(acute necrotizing vasculitis of lips, oral mucosa)
92. 47, XXY: Long arms, Sterile, Hypogonadism Hypogonadism 93. Bilateral lesions lesions of amygdala (hypersexuality; oral behavior) 94. Adenocarcinoma Adenocarcinoma with signet-ring signet-ring cells (typically originating from the the stomach) metastases to 95. the ovaries 96. Alcoholic cirrhosis 97. HGPRT deficiency deficienc y 98. Gout, retardation, self-mutilation self-mutilation 99. Acute disseminated disseminated Langerhans’ Langerhans’ cell histiocytosis 100. Endocarditis with small vegetations on valve leaflets 101. Associated with SLE Page 3
Lou Gehrig’s Mallory-Weis Syndrome Marfan’s McArdle’s Disease Meckel’s Diverticulum Meig’s Syndrome Menetrier’s Disease Monckeberg’s Arteriosclerosis Munchausen Syndrome Nelson’s Syndrome Niemann-Pick Osler-Weber-Rendu Syndrome Paget’s Disease Pancoast Tumor Parkinson’s Peutz-Jegher’s Syndrome (AD) Peyronie’s Disease Pick’s Disease – 2 Different Diseases Plummer’s Syndrome Plummer-Vinson Pompe’s Disease Pott’s Disease Potter’s Complex Raynaud’s Reiter’s Syndrome Reye’s Syndrome Riedel’s Thyroiditis Rotor Syndrome Sezary Syndrome Shaver’s Disease Sheehan’s Syndrome Shy-Drager Simmond’s Disease Sipple’s Syndrome Sjogren’s Syndrome Spitz Nevus Stein-Leventhal Stevens-Johnson Syndrome Still’s Disease Takayasu’s arteritis Tay-Sachs (AR) Tetralogy of Fallot Tourette’s Syndrome Turcot’s Syndrome Turner’s Syndrome
102. Amyotrophic Lateral Sclerosis
degeneration of upper & lower motor neurons
103. Bleeding from esophagogastric lacerations 2 ° to wretching (alcoholics) 104. Connective tissue defect: defective Fibrillin gene
Dissecting aortic aneurysm, subluxation of lenses
105. Type V Glycogenosis - Glycogen storage disease (muscle phosphorylase deficiency =
↑ Glycogen)
106. Rule of 2’s: 2 inches long, 2 feet from the ileocecum, in 2% of the population 107. Embryonic duct origin; may have ectopic tissue: gastric/pancreatic remnant of vitteline duct/yolk stalk 108. Triad: ovarian fibroma, ascites, hydrothorax – associated w/ fibroma of ovaries 109. Giant hypertrophic gastritis (enlarged rugae; plasma protein loss) 110. Calcification of the media (usually radial & ulnar aa.) 111. Factitious disorder (consciously creates symptoms, but doesn’t know why) 112. 1° Adrenal Cushings → surgical removal of adrenals → loss of negative feedback to pit uitary → Pituitary Adenoma 113. Lysosomal Storage Disease (sphingomyelinase deficiency – sphingomyelin accumulation) 114. “Foamy histiocytes” 115. Hereditary Hemorrhagic Telangiectasia. Seen in the Mormon’s of Utah. 116. Abnormal bone architecture (thickened, numerous fractures → pain) 117. Bronchogenic tumor with superior sulcus involvement → Horner’s Syndrome 118. Dopamine depletion in nigrostriatal tracts 119. Melanin pigmentation of lips, mouth, hand, genitalia + hamartomatous polyps of small intestine 120. Subcutaneous fibrosis of dorsum of penis 121. 1. Progressive dementia similar to Alzheimer’s 122. 1. Constrictive perica rditis – sequel to mediastinal tuberculosis 123. Calcium-frosting, unyielding layer – heart chambers may be unable to dilate to receive blood during diastole 124. Hyperthyroidism, nodular goiter, absence of eye signs (Plummer’s = Grave’s - eye signs) 125. Esophageal webs & iron-deficiency anemia, spoon-shaped nails, ↑ SCCA of esophagus 126. Type II Glycogenosis – Glycogen storage disease → cardiomegaly (α 1,4 Glucosidase deficiency: ↑ Glycogen) 127. Tuberculous osteomyelitis of the vertebrae 128. Renal agenesis → oligohydramnios → hypoplastic lungs, defects in extremities 129. Disease: recurrent vasospasm in extremities = seen in young, healthy women 130. Phenomenon: 2° to underlying disease (SLE or scleroderma) 131. Urethritis, conjunctivitis, arthritis non-infectious (but often follows infections), HLA-B27, polyarticular 132. Microvesicular fatty liver change & encephalopathy 133. 2° to aspirin ingestion in children following viral illness, especially VZV 134. Idiopathic fibrous replacement of thyroid 135. Congenital hyperbilirubinemia (conjugated ) 136. Similar to Dubin-Johnson, but no discoloration of the liver 137. Leukemic form of cutaneous T-cell lymphoma (mycosis fungoides) 138. Aluminum inhalation → lung fibrosis 139. Postpartum pituitary necrosis = hemorrhage & shock usually occurred during delivery 140. Parkinsonism with autonomic dysfunction & orthostatic hypotension 141. Pituitary cachexia – can occur from either pituitary tumors or Sheehan’s 142. MEN type IIa = pheochromocytoma, thyroid medullary CA, hyperparathyroidism 143. Triad: dry eyes, dry mouth, arthritis
↑ risk of B-cell lymphoma
144. Juvenile melanoma (always benign) 145. Polycystic ovary: see amenorrhea; infertility; obesity; hirsutism = ↑↑LH secretion 146. Erythema multiforme, fever, malaise, mucosal ulceration
(often 2° to infection = mycoplasma or sulfa drugs)
147. Juvenile rheumatoid arthritis (absence of rheumatoid factor) 148. Aortic arch syndrome 149. Loss of carotid, radial or ulnar pulses = pulseless disease. Night sweats. 150. Common in young Asian females 151. Gangliosidosis (hexosaminidase A deficiency → GM2 ganglioside) Cherry Red Spots of the Macula 152. 1.VSD, 2.overriding aorta, 3.pulmonary artery stenosis, 4.right ventricular hypertrophy 153. Involuntary actions, both motor and vocal
Txt w/ Pimozide
154. Colon adenomatous polyps plus CNS tumors 155. 45, XO = most common cause of Primary Amenorrhea. No Barr body on buccal smear. Page 4
Vincent’s Infection Von Gierke’s Disease Von Hippel-Lindau Von Recklinghausen’s Von Recklinghausen’s Disease of Bone
Von Willebrand’s Disease (AD) Waldenstrom’s macroglobinemia Wallenberg’s Syndrome Waterhouse-Friderichsen Weber’s Syndrome Wegener’s Granulomatosis Weil’s Disease Wermer’s Syndrome Wernicke’s Aphasia Wernicke-Korsakoff Syndrome Whipple’s Disease Wilson’s Disease Wiskott-Aldrich Syndrome Wolff-Chaikoff Effect Zenker’s Diverticulum Zollinger-Ellison Roger’s Disease Barlow’s Syndrome Bracht-Wachter Lesions Lutembacher’s Syndrome Schmidt’s Syndrome
156. “Trench mouth” – acute necrotizing ulcerative gingivitis due to Fusobacterium 157. Type I Glycogenosis – Glycogen storage disease (G6Ptase deficiency) – Glycogen accumulaiton 158. Hemangioma (or hemangioblastoma) = cerebellum, brain stem, & retina 159. Adenomas of the viscera, especially ↑ Renal Cell Carcinoma 160. Chromosome 3p 161. Neurofibromatosis & café au lait spots & Lisch nodules (Chromosome 17) 162. Osteitis fibrosa cystica (“brown tumor”) 2 ° to hyperparathyroidism = osteoclastic resorption w/ 163. fibrous replacement 164. Defect in platelet adhesion 2° to deficiency in vWF. ↑aPPT, ↑ Bleed time 165. Proliferation of IgM-producing lymphoid cells in men 50-70 yoa; PAS(+) Dutcher bodies 166. Posterior Inferior Cerebellar Artery (PICA) thrombosis “Medullary Syndrome” 167. Ipsilateral: ataxia, facial pain & temp; Contralateral: body pain & temp 168. Adrenal insufficiency 2° to DIC 169. DIC 2° to meningiococcemia 170. Paramedian Infarct of Midbrain 171. Ipsilateral: mydriasis; Contralateral: UMN paralysis (lower face & body) 172. Necrotizing granulomatous vasculitis of paranasal sinuses, lungs, kidneys, etc. 173. Icteric Leptospirosis non-icteric prgresses to renal failure & myocarditis 174. Dark field microscopy for dx 175. MEN type I = thyroid, parathyroid, adrenal cortex, pancreatic islets, pituitary 176. Sensory Aphasia
impaired comprehension
177. Thiamine deficiency in alcoholics; bilat eral mamillary bodies (mediodorsal nucleua) (confusion, ataxia, ophthalmoplegia)
178. Malabsorption syndrome (with bacteria-laden macrophages) & polyarthritis 179. Hepatolenticular degeneration (copper accumulation [Txt w/ Penicillamine ] & decrease in ceruloplasmin) 180. Mallory Bodies in the Liver & also w/ alcoholic hepatitis & Hyaline change 181. Chromosome 13 182. Immunodeficiency: combined B- &T-cell deficiency (thrombocytopenia & eczema) 183. ↓ IgM w/ ↑ IgA 184. High iodine level (−)’s thyroid hormone synthesis 185. Esophageal; cricopharyngeal muscles above UES 186. Gastrin-secreting tumor of pancreas
(or intestine) →
↑ acid → recurrent ulcers
187. Interventricular septal defect 188. Floppy vale syndrome – women b/t 20-40 yoa 189. Minute abscesses found in subacute bacter ial endocarditis 190. Combination of septum secundum atrial septal defect w/ mitral stenosis 191. Autoimmnue thyroid Disease (Hashimoto’s ) & insulin-dependent diabetes
Hallmark Findings Albumino-Cytologic Dissociation Antiplatelet Antibodies Arachnodactyly Aschoff Bodies Auer Rods Autosplenectomy
Babinski Basophilic Stippling of RBCs Bence Jones Protein Birbeck Granules Blue Bloater
192. Guillain-Barre
(markedly increased protein in CSF with only modest increase in cell count)
193. Idiopathic thrombocytopenic purpura 194. Marfan’s 195. Rheumatic fever 196. Acute promyelocytic leukemia (AML type M3) 197. Sickle cell anemia: switch a glu ! val in β chain 198. Low O2 ↑ sickling 199. Aplastic crisis w/ B19 (Parvovirus ssDNA) infection 200. Salmonella osteomyelitis 201. Vaso-occlusive painful crisises 202. Hydroxyurea as Txt ( ↑ HbF) & Bone marrow transplant 203. UMN lesion 204. Lead poisoning 205. Multiple myeloma free light chains (either kappa or lambda) 206. Waldenstrom’s macroglobinemia 207. Histiocytosis X (eosinophilic granuloma) 208. Chronic Bronchitis (at least 3 months for at least 2 years of ecessive mucus secretion & chronic recurrent productive cough) Page 5
Boot-Shaped Heart Bouchard’s Nodes Boutonniere’s Deformity Brown Tumor Brushfield Spots Call-Exner Bodies Cardiomegaly with Apical Atrophy Chancre Chancroid Charcot Triad Charcot-Leyden Crystals Cheyne-Stokes Breathing Chocolate Cysts Chvostek’s Sign Clue Cells Codman’s Triangle Cold Agglutinins Condyloma Lata Cotton Wool Spots Councilman Bodies Crescents In Bowman’s Capsule Currant-Jelly Sputum Curschmann’s Spirals Depigmentation Of Substantia Nigra
Donovan Bodies Eburnation Ectopia Lentis Erythema Chronicum Migrans Fatty Liver Ferruginous Bodies Ghon Focus / Complex Glitter Cells Gower’s Maneuver Heberden’s Nodes Heinz Bodies Heterophil Antibodies Hirano Bodies Hypersegmented PMNs Hypochromic Microcytic RBCs Jarisch-Herxheimer Reaction Joint Mice Kaussmaul Breathing Keratin Pearls Keyser-Fleischer Ring Kimmelstiel-Wilson Nodules Koilocytes Koplik Spots Lewy Bodies Lines of Zahn Lisch Nodules
209. Tetralogy of Fallot 210. Osteoarthritis (Proximal IP joint of the fingers) 211. Rheumatoid arthritis
flex proximal & extend distal IP joints
212. Hyperparathyroidism 213. Down’s 214. Granulosa cell tumor: associated w/ endometrial hyperplasia & carcinoma 215. Granuloma-Theca cell tumor 216. Chagas’ Disease 217. 1° Syphilis 218. Haemophilus ducreyi 219. Multiple sclerosis = nystagmus, intention tremor, scanning speech 220. Bronchial asthma 221. Cerebral lesion 222. Endometriosis 223. Hypocalcemia
facial spasm in tetany
224. Gardnerella vaginitis 225. Osteosarcoma 226. Mycoplasma pneumoniae 227. Infectious mononucleosis 228. 2° Syphilis 229. New coffee flavor at Bagel & Bagel 230. HTN 231. Aka, cytoid bodies seen w/ SLE (yellowish cotton wool fundal lesions) 232. Dying hepatocytes – HepB 233. Rapidly progressive (crescentic glomerulonephritis) 234. Klebsiella
235. Bronchial asthma 236. Parkinson’s 237. Granuloma inguinale (STD) 238. Osteoarthritis
(polished, ivory-like appearance of bone)
239. Marfan’s 240. Lyme Disease 241. Alcoholism 242. Asbestosis - & Iron laden 243. Tuberculosis (1 ° & 2°, respectively) 244. Acute Pyelonephritis 245. Duchenne’s MD 246. Osteoarthritis
use of arms to stand (Distal IP joint of the fingers)
247. G6PDH Deficiency 248. Infectious mononucleosis
(EBV)
249. Alzheimer’s 250. Megaloblastic anemia 251. Iron-deficiency anemia or β Thalassemia 252. Syphilis
over-aggressive treatment of an asymptomatic pt. that causes symptoms 2° to rapid lysis
253. Osteoarthritis
(fractured osteophytes)
254. Acidosis / Diabetic Ketoacidosis 255. Squamous Cell CA of skin
Actinic Keratosis is a precursor
256. Wilson’s 257. Diabetic nephropathy: Nodular Glomerulosclerosis nodules of mesangial matrix 258. HPV 6 & 11 (condyloma acuminatum - benign) and HPV 16 & 18 (malignant association) 259. Measles 260. Parkinson’s
(eosinophilic inclusions in damaged substantia nigra cells)
261. Arterial thrombus 262. Neurofibromatosis (von Recklinhausen’s disease) = pigmented iris hamartomas Page 6
Lumpy-Bumpy IF Glomeruli Mallory Bodies McBurney’s Sign Michealis-Gutmann Bodies Monoclonal Antibody Spike Myxedema Negri Bodies Neuritic Plaques Neurofibrillary Tangles Non-pitting Edema Notching of Ribs Nutmeg Liver Owls Eye Cells Painless Jaundice Pannus Pautrier’s Microabscesses Philadelphia Chromosome Pick Bodies 2 types of COPD Podagra Port-Wine Stain Posterior Anterior Drawer Sign Psammoma Bodies
Pseudohypertrophy Punched-Out Bone Lesions Rash on Palms & Soles Red Morning Urine Reed-Sternberg Cells Reid Index Increased Reinke Crystals Rouleaux Formation S3 Heart Sound S4 Heart Sound Schwartzman Reaction Smith Antigen
Soap Bubble on X-Ray Spike & Dome Glomeruli String Sign on X-ray Target Cells
263. Poststreptococcal glomerulonephritis – prototype of nephritic syndrome 264. Alcoholic hepatitis 265. Appendicitis (McBurney’s Point is 2/3 of the way from the umbilicus to anterior superior iliac spine) 266. Malakoplakia lesion on bladder due to macros & calcospherites (M-G Bodies): usually due to E. Coli 267. Multiple myeloma 268. MGUS 269. Hypothyroidism
this is called the M protein (usually IgG or IgA)
270. Rabies 271. Alzheimer’s 272. Alzheimer’s 273. Myxedema 274. Anthrax Toxin 275. Coarctation of Aorta 276. CHF = causing congested liver 277. CMV 278. Reed Sternburg Cells (Hodkins Lymphoma) 279. Aschoff cells seen w/ Rheumatic Fever 280. Pancreatic CA (head) 281. Rheumatoid arthritis, also see morning stiffnes that ↓ w/ joint use, HLA-DR4 282. Mycosis fungoides (cutaneous T-cell lymphoma), Sezary 283. CML 284. Pick’s Disease 285. Pink Puffer – Type A: Emphysema 286. Blue Bloater – Type B: Bronchitis 287. Emphysema Centroacinar – smoking 288. Gout (MP joint of hallux)
Panacinar - α1-antitrypsin deficiency
289. Hemangioma 290. Tearing of the ACL 291. Papillary adenocarcinoma of the thyroid 292. Serous papillary cystadenocarcinoma of the ovary 293. Meningioma 294. Mesothelioma 295. Seen w/ Duchenne muscular dystrophy @ the claf muscles, due to ↑ fat 296. Multiple myeloma 297. 2° Syphilis 298. RMSF 299. Coxsackie virus infection: Hand-Foot-Mouth Disease 300. Paroxysmal nocturnal hemoglobinuria. You would use Ham’s test to confirm. 301. Hodgkin’s Disease 302. Chronic bronchitis = ↑d ratio of bronchial gland to bronchial wall thickness 303. Leydig cell tumor 304. Multiple myeloma
RBC’s stacked as poker chips
305. L→R Shunt (VSD, PDA, ASD) 306. Mitral Regurg 307. LV Failure 308. Pulmonary Stenosis 309. Pulmonary HTN 310. Neisseria meningitidis impressive rash with bugs 311. SLE (also anti-dsDNA) 312. Malar Rash, Wire loop kidney lesions, Joint pain, False (+) syphilis test (VDRL) 313. 90% 14-45 yo females 314. also seen w/ use of INH; Procainamide; Hydralazine = SLE-like syndrome 315. Giant cell tumor of bone 316. Membranous glomerulonephritis = Nephrotic syndrome 317. Spike = basement membrane material & Dome = immune complex deposits (IgG orC3) 318. Crohn’s bowel wall thickening 319. Thalassemia
in α Thalassemia w/ no α gene: Hydrops Fetalis & Intrauterine death associations = HbBarts
Page 7
Tendinous Xanthomas Thyroidization of Kidney Tophi Tram-Track Glomeruli Trousseau’s Sign
320. Familial Hypercholesterolemia 321. Chronic pyelonephritis 322. Gout 323. Membranoproliferative GN: Nephritic syndrome –
basement membrane is duplicated into 2 layers
324. Visceral ca, classically pa ncreatic (migratory thrombophlebitis) 325. Hypocalcemia (carpal spasm) 326. These are two entirely different disease processes and different signs, but they unfortunately have the same name.
Virchow’s Node Warthin-Finkeldey Giant Cells WBC Casts Whipple’s Triad Wire Loop Glomeruli ↑ AFP in amniotic fluid or mother’s serum ↑ Uric Acid
↓ FEV1/FVC “Ground Glass” on chest x-ray (Hyaline)
Honey Combing of the lung Crescents Linear Ig Deposits 45 Degree Branch Points PAS(+) Dutcher Bodies “Ground Glass” in Abdomen (Hyaline) “Signet Ring” Cells Ground Glass Appearance (Hyaline) Congo Red Meningiomas & Progesterone Tuberous Sclerosis Triad Cowdry A Inclusions Devic’s Syndrome c-erb B2 Foster-Kennedy Syndrome Hoffman’s Sign Red Nucleus Destruction Ventral Spinocerebellar tr. Dorsal Spinocerebellar tr. Cuneocerebellar tr. Dorsal Column Lateral Spinothalamic tr. Ventral Spinothalamic tr. SVA GSE SSA GVA GVE
327. Supraclavicular node enlargement by met astatic carcinoma of the stomach 328. Measles 329. Pyelonephritis 330. CNS disfunction – Hypoglycemic episodes – glu injection reverses CNS Sympt’s 331. Lupus nephropathy, type IV (diffuse proliferative form) 332. Spina Bifida 333. Anencephaly 334. Gout 335. Lesch Nyhan 336. Myeloproliferative Disorders 337. Diuretics (Loop & Thiazides) 338. COPD 339. Due to Pneumocystis carinii 340. Seen w/ Atelectasia 341. Seen w/ Asbestosis (a restrictive lung disease) 342. Goodpastures syndrome (pneumonia w/ hemoptysis & r apidly progressive glomerulonephritis) 343. Goodpastures syndrome 344. Aspergillosis 345. Waldenstrom’s Macroglobulinemia = ↑IgM = Hyperviscosity 346. Seen in the hepatocytes of healthy carriers of HBsAg in liver biopsies 347. Cells that replace t he ovaries, due to Krukenberg’s tumor that has metastasized from the stomach 348. Seen w/ Progressive Multifocal Leukoencephalopathy oligodendrocytes 349. Nuclei seen in Papillary C A of the thyroid (malignant) 350. Shows amyloid deposition in p laques & vascular walls 351. Some meningiomas have Progesterone receptors = rap id growth in pregnancy can occur 352. Seizures; Mental retardation; Leukoderma (congenital facial white spots or macules): angiofibromas 353. Seen w/ Herpes Simplex Encephalitis – in oligodendroglia 354. “Neuromyelitis Optica” 355. A variant of multiple sclerosis: rapid demyelination of the optic nerve & spinal cord w/ paraplegia 356. Breast Cancer association 357. A tumor causing blindness & loss of smell w/ papilloedema 358. Flicking of the middle finger’s nail 359. Intention tremors of the arm 360. Unconscious proprioception of lower extremities 361. Unconscious prorpioception & fine motor movements 362. Unconscious proprioception & fine motor movements of upper extremities 363. Conscious proprioception of the body 364. Pain & Temperature sensation 365. Light touch perception 366. Taste & Smell 367. Muscles of the eye & of the tongue 368. Vision; Hearing; Equilibrium 369. Sensation of tongue; soft palate. Carotid Body & Sinus innervation 370. Edinger Westphal = parasympathetic eye innervation 371. Gland innervation = secretions Page 8
GSA SVE LMN Lesion Sensory Pathway Lesion Both UMN & LMN Lesion Both Sensory & Motor Lesion Suprachiasmatic Nucleus Ventromedial Nucleus Lateral Nucleus Arcuate Nucleus Mamillary Body Acanthocytes
372. Viscera 373. Pain & temperature of fa ce 374. Sensation of external ear 375. Innervation of muscles of masticaiton, facial expressions, larynx & pharynx 376. Werndig Hoffman (progressive infantile muscular atr ophy) 377. Poliomyelitis 378. Subacute Combined Degeneration = Friedrich’s Ataxia = B12 deficiency 379. Tabes Dorsalis (Neurosyphilis) 380. ALS = Lou Gherig’s Disease 381. Brown Sequard 382. Anterior Spinal artery Occlusion 383. Controls circadian rhythm 384. Satiety center. Savage behavior & obesity when lesioned 385. Induces eating. Starvation when lesioned 386. Releases PIF (dopa-ergic neurons) 387. Can have hemorrhages as seen in Wernicke’s Encephalopathy 388. RBSc w/ spiny projections. Seen in Abetalipoproteinemia.
Most Common… 1o Tumor arising from bone in adults Adrenal Medullary Tumor – Adults Adrenal Medullary Tumor – Children Agent of severe viral encephalitis Aggressive lung tumor Associated with gallstones Bacterial Meningitis – adults Bacterial Meningitis – elderly Bacterial Meningitis – newborns Bacterial Meningitis – toddlers Benign epithelial tumor of oral mucosa Benign fallopian tube tumor Benign ovarian tumor Benign tumor of soft tissue Benign tumor of the breast <25yoa Benign tumor of the liver Benign tumor of the vulva Benign uterine tumor Bone Tumors Brain Tumor – Child Brain Tumor –Adult Breast Carcinoma Breast Mass Bug in Acute Endocarditis Bug in debilitated, hospitalized pneumonia pt
389. Osteosarcoma 390. Pheochromocytoma: 5 P’s: ↑ Pressure; Pain (Headache); Perspiration; Palpitations; Pallor/Diaphoresis 391. Neuroblastoma 392. Herpes simplex 393. Small cell or oat cell 394. Adenocarinoma 395. Strep pneumoniae & in young adults = Neisseria meningitidis 396. Neisseria meningitidis 397. E. coli / Group BStrep.
398. Hib 399. Papilloma 400. Adenomatoid 401. Mature(Native) Teratoma = benign dermatoid 402. Lipoma 403. Fibroadenoma 404. Hemangioma 405. Hidroadenoma 406. Leiomyoma: estrogen sinsitive: changes size during pregnancy & menopause 407. Metasteses from Breast & Prostate 408. Medulloblastoma (cerebellum) 409. Astrocytoma (including Glioblastoma Multiforme) then: mets, meningioma, Schwannoma 410. Invasive Duct Carcinoma 411. Fibrocystic Change: premenopausic women (Carcinoma is the most common in post-menopausal women) 412. Staph aureus 413. Klebsiella
Page 9
Bug in Epiglottitis Bug in GI Tract Bug in IV drug user bacteremia / pneumonia Bug in PID Bug in Subacute Endocarditis CA of urinary collecting system Cardiac 1ry Tumor – Adults Cardiac 1ry Tumor – Child Cardiac Tumor – Adults Cardiomyopathy Cause of 2ry HTN Cause of Addison’s Cause of breast lumps Cause of chronic endometriosis Cause of Congenital Adrenal Hyperplasia Cause of Cushings Cause of Death in Alzheimer pts Cause of Death in Diabetics Cause of Death in premature Cause of Death in SLE pts. Cause of Dementia Cause of Dementia (2nd most common) Cause of Dwarfism Cause of Food poisoning Cause of Hematosalpynga Cause of Hypoparathyroidism Cause of Hypothyroidism Cause of Kidney infections Cause of Liver disease in US Cause of Malignancy in children Cause of Mental retardation Cause of Mental retardation (2nd most common) Cause of NaCl loss and Hypotension Cause of PID Cause of Portal cirrhosis Cause of Preventable Blindness Cause of Pulmonary HTN Cause of Secondary Hypertension Cause of SIADH Cause of UT Obstruction in men
414. Hib 415. Bacteroides (2nd – E. coli) 416. Staph aureus
417. N. Gonnorrhoeae 418. Strep Viridans
419. Transitional cell CA (assoc. w/ benzidine; βnaphthylamine; analine dyes; long term txt w/ cyclophosphamide) 420. Myxoma: “Ball Valve” 421. Rhabdomyoma – associated w/ Tuberous sclerosis 422. Metasteses 423. Dilated (Congestive) Cardiomyopathy: Alcohol, BeriBeri, Cocaine use, Coxsackie B, Doxorubicin 424. Systolic Dysfunction 425. Renal Disease 426. Autoimmune (2 nd – infection) 427. CA of the breast 428. TB 429. 21-Hydroxylase Deficiency: NaCl lost & Hypotension (then, 11- NaCl retention & HTN) 430. Exogenous Steroid Therapy (then, 1 ry ACTH, Adrenal Adenoma, Ectopic ACTH) 431. Pneumonia 432. MI 433. NRDS = hyaline membrane disease 434. Lupus Nephropathy Type IV (Diffuse Proliferative) = Renal Disease 435. Alzheimer’s 436. Multi-Infarct Dementia 437. Achondroplasia 438. Staph aureus
439. Ectopic pregnancy 440. Throidectomy 441. Corrective surgery I31 treatment 442. E. coli 443. Alcohol consumption 444. Acute leukemia 445. Down’s 446. Fragile X 447. 21 hydroxylase deficiency 448. N. ghonorrhea 449. Alcohol 450. Chlamydia (serotypes A,B,Ba,C) 451. COPD 452. Renal disease 453. Small Cell Carcinoma of the Lung 454. BPHyperplasia
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Cause Pernicious Anemia Chromosomal Disorder Common Tumor of the Appendix Congenital Cardiac Anomaly Congenital Early Cyanosis Coronary Artery Thrombosis Demyelinating Disease Dental Tumor Dietary Deficiency Disease of the Breast Disseminated Opportunistic Infection in AIDS Esophageal Cancer Fallopian Tube Malignancy Fatal Genetic Defect in Caucasians Female Tumor Form of Amyloidosis Form of Tularemia Germ Cell Tumor of Testes Gynecological Malignancy Gynecological Finding Heart Murmur Heart Valve in Bacterial Endocarditis Heart Valve in Bacterial Endocarditis in IV drug users Heart Valve involved in Rheumatic Fever Hereditary Bleeding Disorder Hormone secreted in Pituitary Adenoma Inherited disease of the Kidney Intracranial tumor in adults Islet Tumor Liver 1ry Tumor Liver Disease Location of Adenocarcinoma of the Pancreas Location of Adult Brain Tumors Location of Childhood Brain Tumors Lung Tumor, malignant or benign Lung Tumor, primary or secondary Lysosomal Storage Disease Malignancy in Women Malignancy of the Larynx
455. Chronic atrophic gastritis = no production of intrinsic factor 456. Down’s 457. Carcinoid tumor: flushing; diarrhea; bronchospasm; RHeart valvular lesions 458. Txt: Methysergide (5HT antagonist) 459. VSD (membranous > muscular) 460. Tetralogy of Fallot =right to left shunt 461. LAD artery: MI 462. Multiple Sclerosis: (Charcot Triad = nystagmus, intention tremor, scanning speech) 463. Periventricular plaques w/ ↓ Oligodenrocytes 464. ↑ IgG in CSF, Optic Neuritis, MLF Syndorme = Internuclear Ophthalmoplegia, bladder incontinence 465. Odontoma 466. Iron 467. Fibrocystic disease 468. CMV (Pneumocystis carinii is most common overall) 469. SCCA 470. AdenoCA 471. Cystic Fibrosis (chromosome 7q) 472. Leimyoma 473. Immunologic (Bence Jones protein in multiple myeloma is also c alled the Amyloid Light Chain) 474. Ulceroglandular 475. Seminoma (analogous to dysgerminoma of ovaries) 476. Endometrial Carcinoma 477. Endometrial CA 478. Mitral Valve Prolapse 479. Mitral 480. Tricuspid 481. Mitral then Aortic 482. Von Willebrand’s Disease 483. Prolactin 484. Adult polycystic kidney disease: associated w/ polycystic liver, Berry aneurysms, Mitral prolapse 485. APD1 – chromosome 16 486. Glioblastoma mulitforme 487. Insulinoma = β cell tumor 488. Hepatoma 489. Alcoholic Liver Disease 490. Head (99%) 491. Above Tentorium 492. Below Tentorium 493. Malignant 494. Secondary 495. Gaucher’s 496. Lung (2nd breast) 497. Glottic CA (squamous cell) Page 11
Malignancy of the Small Intestine Malignancy Vulva Malignant Eye Tumor in Kids Malignant Tumor of the Liver Motor Neuron Disease Muscular Dystrophy Nasal Tumor Neoplasm – Child Neoplasm – Child (2nd most common) Neoplasm of the West Neoplastic Polyp Nephrotic Syndrome in Adults Nephrotic Syndrome in Children Non Hodgkin’s Lymphoma Number of Deaths per year in Women Skin tumor Opportunistic infection in AIDS Ovarian Malignancy Ovarian Tumor Pancreatic Tumor Patient with ALL / CLL / AML / CML Patient with Goodpasture’s Patient with Reiter’s Pituitary Tumor Place for Primary Squamous Cell CA of esophagus Place for Peptic Ulcer Disease Primary Benign Salivary Tumor Primary Hyperparathyroidism Primary Malignancy of Bone Primary Malignancy of Small Intestine Pt. with Hodgkin’s Pt. with Minimal Change Disease Renal Malignancy Renal Malignancy of Early Childhood Salivary Tumor Secondary Hyperparathyroidism Sexually Transmitted Disease Site of Diverticula
498. Adenocarcinoma 499. Squamous cell CA 500. Retinoblastoma 501. Hepatocellular CA 502. ALS 503. Duchenne’s: Dystrophin deletion. Presents <5yoa weakness at pelvic girdles w/ upward pr ogression 504. Squamous cell CA 505. Leukemia 506. Medulloblastoma of brain (cerebellum) 507. Adeno CA of the rectum and/or colon 508. Tubular adenoma 509. Membranous Glomerulonephritis 510. Minimal Change (Lipoid Nephrosis) Disease (responds well to steroid txt) 511. Follicular small clear cell 512. Lung CA 513. Basal cell CA 514. PCP 515. Serous Cystadenocarcinoma 516. Hamartoma 517. Adeno (usually in the head) 518. ALL – Child / CLL – Adult over 60 / AML - Adult over 60 / CML – Adult 35-50 519. Young male 520. Male 521. Prolactinoma (2nd – Somatotropic “Acidophilic” Adenoma) 522. Mid 1/3 523. Lesser curvuture in antrum – associated w/ blood group O 524. Pleomorphic Adenoma (Mixed) – 90% localized to the parotid 525. Adenomas (followed by: hyperplasia, t hen carcinoma) 526. Osteosarcoma 527. Lymphoma 528. Young Male (except Nodular Sclerosis type – Female) 529. Young Child 530. Renal cell CA 531. Wilm’s tumor (neohroblastoma) – chromosome 11p 532. Pleomorphic adenoma 533. Hypocalcemia of Chronic Renal Failure 534. Chlamydia (sero types D-K) 535. Sigmoid Colon Page 12
Site of Embolic Occlusion Site of Metastasis Site of Metastasis (2nd most common) Sites of Atherosclerosis Skin CA of Fair Skinned People Skin Cancer Small Intestine Congenital Anomaly Stomach Cancer Testicular Tumor Thyroid Anomaly Thyroid CA Tracheoesophageal Fistula Tumor in men <20 Tumor of Infancy Tumor of the Stomach >50 years of age Type of Hodgkin’s Type of Non-Hodgkin’s Type of Portal Cirrhosis Type of Soft Tissue Tumor of Childhood Vasculitis (of medium & small arteries) Viral Encephalitis Worm Infection in US Worst Prognosis in Thyroid Cas Cause of Lobar Pneumonia Cause of Death b/t 24-44 yoa Cause of Pneumonia in Cystic Fibrosis Cause of Osteomyelitis in IV Drug Users Cause of Infection in Burn Pts Mental Problem in Males Intelligence Test
Paraphilia Metabolite seen w/ Pheochromocytoma Severe Shigella Bug in Otitis Media & Sinusitis in Kids Cause of a Solitary Brain Abscess Cause of Bacterial Diarrhea in U.S. Shigella Type
536. Middle cerebral aa: contralateral paralysis; aphasias; motor & sensory loss 537. Regional Lymph Nodes 538. Liver 539. Abdominal aorta > coronary > popliteal > carotid 540. Malignant melanoma 541. Basal Cell Carcinoma 542. Meckel’s diverticulum 543. Adeno – associated w/ blood group A 544. Seminoma = malignant painless testes growth 545. Thryoglossal duct cyst 546. Papillary CA 547. Lower esophagus joins trachea / upp er esophagus – blind pouch – polyhydramnios association 548. Germ cell tumor 549. Benign vascular tumor = port wine stain = Hemangioma 550. CA of stomach (adeno CA) 551. Mixed Cellularity (versus: lymphocytic predominance, lymphocytic depletion, nodular sclerosis) 552. Follicular, small cleaved 553. Micronodular 554. Rhabdomyosarcoma 555. Temporal Arteritis (branch of Carotid Artery) 556. HSV 557. Pinworm (2 nd – Ascaris) 558. Follicular CA 559. Strep. Pneumoniae 560. AIDS 561. Pseudomonas 562. Pseudomonas 563. Pseudomonas 564. Specific phobia 565. Stanford Binet (ages 6 & under) 566. WIPSI (ages 4-6) 567. WISK-R (for ages 6-17) 568. WAIS-R (for > 17 yoa) 569. Pedophilia 570. VMA: vanillylmandelic acid (NE metabolite) 571. Dysenteriae 572. Strep. Pneumoniae 573. A. Israelli 574. Campylobacter jejuni 575. S. Sonnei Page 13
Cause of Non-Ghonococcal Urethritis Pneumonia Urethritis Cause of Glomerulonephritis Cause of Viral Pneumonia
Complication of COPD Cause of Death w/ SLE Atrial Septal Defect Warm Antibody
576. Chlamydia trichomonas 577. Strep. Pneumoniae 578. N. ghonorrhea 579. IgA Nephropathy = Berger’s D isease 580. RSV – infants 581. Parainfluenza – kids 582. Influenza virus – adults 583. Adeno virus – military recruits 584. Pulmonary infections 585. Renal failure 586. Ostium Secundum Type 587. Most common form of immune hemolytic anemia 588. IgG auto antibodies to RBC 589. See spherocytosis; (+) Coombs’ test; complication to CLL 590. IgA Deficiency 591. Meckel’s Diverticulum: persistence of vitelline duct/yolk sac stalk 592. Fetal Alcohol Syndrome
Immunodeficiency Congenital GIT Anomaly Cause of Congenital Malformation
Pharmacology Autonomic Nervous System Epinephrine Norepinephrine GABA Muscarinic-r Bethanechol Pilocarpine Isoflurophate Pralidoxime Neostigmine Myasthenia Gravis Tubocurium Trimethaphan Pancurium Succinylcholine
α1 & Eye M-r & Eye Sympathetic Parasym. M3-r & Eye M2-r & Heart M3-r & Lung M3-r & GI Tacrine Atropine Glycoperrolate Pirenzepine
1. 2. 3. 4. 5. 6. 7. 8. 9.
α1, α2, β1, β2 α1, α2, β1 (no β2 activity) Causes an inhibitory cell hyperpolarization Uses DAG & IP3 as 2 nd messengers Parasympathetic control Cholinergic. ↑ GI & Bladder motility. Txt atonic bladder post-op Cholinergic. Pupillary constriciton= miosis. Ciliary constriction= accomodation.
10. 11. 12. 13.
“2PAM”. Reverses organophosphate binding to acetylcholinesterase Reversible acetylcholinesterase (-)r Txt Myasthenia Gravis Anitbodies to Ach-r. ↑’g muscular weakness due to Ach’s weak postsynaptic effect @ NMJ. Inactivates-r
14. 15. 16. 17.
Nondepol. Competitive cholinergic N-r (-)r. Prevents Ach binding but does not activate NMJ ↑ Histamine release= ↓ BP & ↑ bronchospasm Nonselectively binds N-r of the PS- and SNS
18. 19. 20. 21. 22.
More potent than tubocurium w/o histamine release Depol. Non competitive (-)r of muscle aciton Opens Na Ch.= fasciculations. Closes Na Ch.= paralysis. Continuous infusion. Mydriasis due to norepinephrine. Prazosin (-). Miosis due to Ach. Atropine (-).
23. 24. 25. 26. 27. 28. 29. 30. 31.
Post ganglionic symapthetic fibers releases norepinephrine Post ganglionic parasympathetic fibers release Ach Contracts sphincter = miosis. Contracts ciliary = accomodation. Negative chronotropy: ↓ HR = vagal arrest Negative inotropy: ↓ contractility Bronchospasm ↑secretions ↑ motility (cramps & diarrhea). Involuntary defecation Acetylcholine esterase (-)r. Txt Alzheimer’s
Txt acute glaucoma Organophosphate. Irreversible acetylcholinesterase (-)r
DOC w/ vagal arrest
32. M-r(-). Antispasmodic. Txt peptic ulcers. 33. M-r(-). Antispasmodic. Txt peptic ulcers. Page 14
Doxacurium β bungarotoxin α bungarotoxin α1 & Eye α1 & Arterioles α1 & Venules α1 & Sex Function ↑ Diastolic ↓ Diastolic β1 & Heart Phenylephrine β2(+) Asma Drugs Ritodrine/Turbutaline Phentolamine Terazosin Yohimbine Cardioselective NMJ Ecothiophate Pyridostigmine
34. 35. 36. 37.
Most potent competitive non-depol NMJ (-)r. No cardiovascular side effects. No Histamine release. Prevent the releasal of Ach from vesicles @ the pre synaptic nerve ending Irreversible N-r (-)r = ↓ action potentials Contracts radial muscle = mydriasis (pupil dilation)
38. 39. 40. 41.
Constiction: ↑TPR = ↑ Diastolic pressure = ↑ Afterload Constriction: ↑ Venous return = ↑ Preload Ejaculation ↑ α1 = ↑TPR
42. 43. 44. 45. 46. 47. 48. 49. 50. 51.
↑ β2; Direct acting vasodilators; (+)Cholinergics (+)chronotropism = ↑HR. (+)inotropism = ↑ contractility; ↑SV; ↑CO; ↑O2 consumption. ↑ conduction velocity α1 (+) Nasal decongestant. Metaproterenol; Albuterol; Terbutaline; Ritodrine; Salmeterol Relaxes myometrium used in pre-mature labor pains Epi reversal. Blocks α, vasodilation occurs. Pt goes from HyperTN to HypoTN. Txt pheochromocytoma = BP Txt BPH
52. ↑ sympathetic outflow = α2 (-). Txt impotence. 53. Pancuronium = ↑HR due to atropine-like anti muscarinic vagolytic effect & Gallamine (-)r 54. Irreversible cholinesterase (-)r. 55. Cholinomimetic that ↑s M & N-r effects. (-) acetylcholinesterase & plasma cholinesterase 56. DOC for the oral Txt of MG
Cardiology Digoxin Diltiazem Quinidine Verapamil Propranolol Diazoxide Niroprusside Reserpine Dobutamine Dopamine Esmolol Captopril Digoxin Dig. Toxicity Quinidine Lidocaine Flecanide Amiodarone NE Ach Atenolol Bretylium
1.
Nimodipine Atropine Nitrates Propranolol Verapamil Aspirin
23.
2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22.
24. 25. 26. 27. 28.
↓ AV nodal conduction/ inh. Na/K/Atpase = inc. Ca conc. in heart cells = inc. contraction force Txt black men. Txt AV nodal re entrance ↓ AV nodal conduction. Cinchonism. Anticholinergic= aggra vate MG. Hypotension= α block ↓ AV nodal conduction. ↓ BP. Negative inotrope= no CHF use ↓ AV nodal conduction. ↓ BP. Negative inotrope(= β block) Aggravates Asthma and Diabetes Melitus via β2 block. Balanced vasodilator. Balanced vasodilator. Unloads heart. ↑s cyanide= pre-txt w/ thiosulfate. Txt Acute HTN’v Crisis Txt severe & resistant HTN . Depletes CA. See stuffy nose. No to pts w/ pep tic ulcers. At high doses β2(+) offsets α1 = β1 ↑ CO w/o systemic vascular r esistance At low doses Txt Shock= dilates renal and mesenteric aa= maintain urine output Short acting β(-) Balanced vasodilator. Txt Outpt. CHF see dry cough(bradykinin induced) Txt CHF & Atrial Flutter - inotropic - ↓ K+ levels= dig. Toxicity Fatal ventricular arrhythmias w/ sever AV block ClassIa anti arrhythmic. Moderate Na Ch. Block ClassIb anit arrhythmic. Normalizes conduction. Txt initial MI= control arrhythmias ClassIc anti arrhythmic. Marked conduction slowing Long t1/2= need potent doses to obtain desired level for action. See blue skin, ocular deposits, Pulmonary Fibrosis. ↑ AV nodal conduction via β1. Metoprolol(-) β1 ↓ AV nodal conduction via M receptor. Atorpine(-) M-r Controls catecholamine induced arrhythmias Txt Malignant Ventricular Arrhythmias but causes passing catecholamine release that can aggravate arrhythmias briefly Txt Acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm ↓ excess vagal tone as seen in Sinus Bradycardia ↓ preload= venous pooling. ↓ MVO2= reflex tachy. ↑ ventr work= dec O2 demand Blocks reflex tachy but causes excess brady= ↑ diastole time= ↑ EDV ↑ O2 supply via ↓ in vasospasm Txt Prinzmetal’s variant angina Prevents arterial platelet adhesion (not DVThrombi). Inactivates COX= ↓ platelet production of TxA2, a potent vasoconstictor Page 15
Warfarin Heparin TPA Streptokinase Urokinase Colestipol Lovastatin Losartan Diazoxide Clonidine Methyldopa Phenytoin Procainamide Indopamide Thiazides β(-) ACEIs Epinephrine Norepi. Methyldopa Quinidine pre-txt ClassII “Gray man” Beperidil ACEIs Adenosine Enoxaparin Isoproterenol Variant angina Contraindicated in CHF
29. 30. 31. 32. 33.
(-)Vit. K dependent gamma carboxylation of clotting factors= anticoagulation state Dependent on Antithrombin III activation Binds to fibrin clots & activates plasminogen on the spot. Short t1/2, given IV. Does not discriminate b/t fibrin-based clots= bleeding & stroke complications arise From bacteria= allergies arise. Can see excess bleeding in post-op pts.
Human source. ↑ plasmin. Can see excess bleeding in post-op pts. Bile acid sequestrants. Interrupt bile acid reabsorption= ↑↑ LDL uptake. Cholestyramine same MOA. HMGCoA reductase(-)= ↑ LDL-r synthesis. Pravastatin/ Mevastatin same MOA. ↓ Aldosterone. ↑ Renin 2-3x’s 38. Txt insulinomas. Not balanced vasodilator= onlt dilates arterial smooth muscle 39. Central α2(+). ↓ TPR via ↓ symapthetic effect 40. Central α2(+). (++) Coombs= Hemolytic anemia 34. 35. 36. 37.
41. 42. 43. 44.
ClassIb. Reverses mild AV block due to digitoxin toxicity ClassIa. SLE like syndrome. Only Thiazide that will have no effect on cholesterol levels Older black men w/ HTN due to ↑ Renin.
45. 46. 47. 48. 49. 50. 51. 52. 53. 54.
Young white men w/o asthma (cause bronchospasm) (-) change AI ! AII. (-) Bradykinin inactivation. Captopril/ Enalapril Cause renal failure = use w/ caution in the elderly ↑ contraction rate & force via β1. ↑ systolic but ↓ diastolic BP. ↓ peripheral resistance via β2 vasodilaiton ↑ heart rate and ↑ systolic and diastolic BP ↑ peripheral blood vessel resistance DOC for pregnancy induced HTN Atrial arrhythmia pretxt w/ a drug that will ↓ ventricular response: Dig.; β(-); Ca Ch.(-)
β(-) ↓risk fo reinfarction & sudden death following MI Amiodarone: ClassIII antiarrhythmia Ca Ch(-). Limited clinical use due to Torsades de Pointes Vasodilate renal efferents > than afferent arterioles: ↓GFR & Filtration pressure ↓ Diabetic renal failure p rogression Its receptor is blocked by Methylxanthines (ie… Theophyline) Favored for the Txt of Reentrant Supra Ventricular Tachycardia Low molecular weight heparin = Oral anticoagulant ↑HR & ↓MAP Use Ca Ch. (-)r ie… Nifedipine 65. β (-)r = you don’t want to ↓ the heart’s pumping strength 55. 56. 57. 58. 59. 60. 61. 62. 63. 64.
CNS “TOM”
Butyrophenone Atypical D4 Flumazenil Methylphenidate Phenytoin Thiopental Carbamazepine Atypical D4-r Pimozide Risperidone Thioridazine Haloperidol
1. 2. 3. 4. 5. 6. 7. 8.
Short –acting BDZs: Triazolam Onazelam Midazolam Haloperidol & Droperidol Clozapine – Thioridazine – Olanzepine – Risperidone = Do not cause EPS BDZ antidote for OD Txt attention deficit disorder
9. Causes aplastic anemia/ gingival hyperplasia/ cleft lip & palate 10. Short acting Barb 11. DOC trigeminal neuralgia. Txt lennox gestaut seizures in kids 12. Thioridazine; Olamzapine; Clozapine 13. Txt Tourette’s 14. Good for negative symptoms 15. Most anti cholinergic neuroleptic 16. Neuroleptic malignant hyperthermia due to chronic D2 block. give Dantrolene and Bromocriptine Page 16
Imirpamine Clomirpramine Trazadone Bupropion SSRIs Fluoxetine Phenelzine Lithium
Alprazolam Propranolol κ -r µ-r Morphine & O2 Morphine Morphine OD Meperidine Hydromorphone Tramadol Naloxone Pentazocine Butorphenol Nalbuphene ↓ GABA ↓ Fast Na Ch. Methoxyflurane Enflurane Isoflurane Halothane Nitric Oxide Thiopental Kentamine Droperidol Fentanyl Midazolam Primidone C & A delta Fibers Esters Amides Amphetamine Bromocriptine Benztropine Amantidine Diphenhydramine Pergolide Ethosuximide Tranylcypromine SSRI & MAOI Labor opioids
17. 18. 19. 20.
Enurisis Txt OCD See aggressive behavior w/ use Priapism Helps to quit smoking
21. 22. 23. 24. 25. 26. 27. 28.
Primarily used for OCD Good for negative symptoms Irreversible MAOI Txt manic phase of Bipolar Disorder Causes goiter by (-) conversion of T4 to T3 Nephrogenic diabetes insipidus Low salt diet will lead to Li toxicity DOC stage fright
29. Social phobia 30. Spinal analgesia. Euphoria. ++euphoria. ++sedation. Constipation. 31. Supraspinal analgesia. Dysphoria. +respiratory depression. +sedation. 32. Admin. is contraindicated to pts on morphine sedation= ↓ CO2 sensitivity and O 2 admin. can stop breathing. 33. ↑ ICP = do not give to pt. with head trauma 34. 1.pinpoint pupils 2.↓’d respiraiton 3.coma 35. 36. 37. 38.
Anesthetic used during labor µ(+) used in renal failure Ambulatory txt for mod. to severe pain Txt opioid OD. Reverses respiratory depression
39. Part κ (+) & part µ(-) 40. Part κ (+) & part µ(-) 41. Part κ (+) & part µ(-) 42. ↓ seizure focus= Barbs & BDZs 43. ↓ electrical activity spread = Phenytoin & Carbamazepine 44. Can be nephrotoxic. Needs low MAC for anesthetic induction. 45. Can cause tonic/clonic muscle spasms 46. 47. 48. 49.
Can cause bronchospasm Can cause ventricular extrasystoles & Malignant hyperthermia & Hepatitis No effect on HR. Needs high MAC for anesthetic induction. Short acting Barb.
50. 51. 52. 53. 54. 55.
Dissociative anesthetic Can be used in combo w/ Fentanyl for neuroleptoanalgesic effect Neuroleptic tranquilizer. Has mild alpha block Can be used on combo w/ Droperidol for neuroleptoanalgesic effect Used transdermally for chronic pain Pre anesthetic. Induces amnesia
56. 57. 58. 59. 60. 61. 62. 63. 64.
Biotransformed to Phenobarb. First fibers to be blocked w/ anesthesia Procaine, Tetracaine, Benzocaine Broken down and make PABA (allergen) Lidocaine, Mepivaciane, Bupivaciane, Etidocaine= “i” before “caine” always an amide Metabolized in the liver DA reuptake (-)’r. MAOI. Parkinson’s txt D2(+). Used w/ L-Dopa for “on-off” phenomenon of Parkinson’s Ant M w/ some DA reuptake (-). Parkinson’s txt
65. ↓ DA reuptake. Can cause livido reticularis= skin mottling. 66. Txt early Parkinson’s stages 67. > Effective & longer acting than Bromocriptine 68. DOC for Absence seizures 69. MAOI = antidepressant 70. Fatal combo, especially seen with the use of Paroxetine or Fluoxetine (SSRIs) and Tranylcypromine (MAOI) 71. Meperidine & Nalbuphine Page 17
Desipramine causes
72. Sudden cardaic death in children
Anti-Infective
Hepatic coma DOC
7. 8. 9. 10. 11. 12. 13. 14.
Clavulanic acid
15.
Piperacillin
16. 17. 18.
Malaria profylaxis Used for extraerythrocytic forms Plasmodium vivax or P. ovale Quinolone derivative PABA structural analogs Inhibit Folic acid synthesis Should not be used in anuric pt due to production of (-) Nitrogen balance & ↑d BUN levels. Doxycycline is the exception 3rd generation cephalosporin DOC for bacterial meningitis in kids (ie… HiB) One dose txt of gonorrhea Neomycin (aminoglycoside) – it supresses the normal flora = ↓g NH4 production = ↓g free nitrogen levels in the bloodstream. Irreversible (-)r of β lactamases, but ot of transpeptidase = use w/ a β lactamase sensitive penicillin Txt Pseudomonas aeruginosa & Klebsiella Broad spectrum antibiotic Txt Mycobacterium tuberculosis
19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48.
Most commonly used drug for TB. Usually combined w/ Rifampin and/or Ethambutol Pre Txt w/ Pyridoxine (Vit B6) can prevent peripheral neuritis‘ Txt of Hookworm disease Depolarizing NMJ (-)r A = Aminoglycosides T = Tetracyclines C = Chloramphenicol E = Erythromycin (macrolide) L = Clindamycin L = Lincomycin Txt intraabdominal infections (ie… w/ Bacteroides fragilis) Traditional txt has been Clindamycin & Gentamycin Broad spectrum antibiotic Bone marrow depression (common) – Aplastic anemia (rare) Gray baby syndrome (chloramphenicol cannot be conjugated) DOC Typhoid Fever (symptomatic Salmonella infection) DOC HiB meningitis in kids – especially resistant strain to ampicillin Txt trypanosomiasis Txt Leishmaniasis & Amebiasis Good for anaerobic bacteria = Bacteroides fragilis DOC Trichomoniasis DOC Giardia lamblia TMP-SMX & Pentamidine Txt of Brucellosis & Cholera Txt Rocky Mountain Spotted Fever Txt spirochete infections = Lyme disease (Borrelia burgdorferi) (-) dihydrofolate reductase activity Long duration of action = given once every 3-4 weeks for Txt of Syphilis Txt Schistosomiasis (trematode [fluke] infections)
Primaquine Ciporfloxacin Sulfonamides Tertacyclines, anuria & the exception Ceftriazone
Streptomycin (aminoglycoside) Isoniazid Pyrantel Pamoate Buy “AT” 30, “CELL” at 50
Cefoxitin Chloramphenicol
Nifurtimox Metronidazole
Txt P. carinii Tetracycline TMP-SMX Benzathine Penicillin G Praziquantel Melarsoprol Stibogluconate Fluconazole Amphotericin B Ketoconazole MOA Griseofulvin MOA Mefloquine Chloroquine
4. 5. 6.
49. Txt Trypanosomiasis that has neurological symptoms 50. Txt Leishmaniasis 51. Txt fungal encephalitis 52. 53. 54. 55. 56. 57.
Polyene antifingal (-) fungal ergosterol synthesis = disrupts membrane Accumulates in keratinized layers of the skin = used in dermatomycoses infections Anti malarial Txt Chloroquine resistant strains = P. falciparum Txt for Malaria when inside RBC Page 18
58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79.
Nifurtimox Erythromycin Nystatin Acyclovir Imipenem Cefoperazone side effects Vancomycin Meropenem Nafcillin Peripheral neuropathy Sulfonamides & newborns “O.N.E.” for gonorrhea
Ribavirin
DOC Chagas disease due to Trypanosoma cruzi Used in pts allergic to penicillins Topical txt of superficial mycotic infections = Candidiasis Guanine analog Txt Herpes infections Used w/ Cilastatin Can cause seizures Bleeding due to vit K level alterations Contraindicated in pts w/ bleeding disorders Used for MRSS (methicillin resistant Staph. Aureus) “Red neck”: due to histamine release causes facial flushing used w/ Cilastatin Does not cause seizures (cf w/ Imipenem) Only penicillin that does not need dose adjustment in renal impairment Seen w/ use of: Metronidazole – Isoniazid – Vincristine – ddI – AZT – Allopurinol Kernicterus can occur Fluoroquinolones used in a one dose deal for gonorrhea: O = Ofloxacin N = Norfloxacin E = Enoxacin Txt RSV (Respiratory Syncytial Virus)
Anti-Neoplastics Cyclosporine Cyclophosphamide Cisplatin’s toxicities Methotrexate Leucovorin Rescue Bleomycin toxicities Azathiorine MOPP
Tamoxifen Flutamide Megestrol Fluoxymesterone Methotrexate Brain tumor Txt Streptozocin Cytarabine (AraC) Dactinomycin Etoposide Paclitaxel
80. 81. 82. 83. 84. 85.
Protects against rejections from organ transplants Does not induce bone marrow depression Alkylating agent of both purine & pyrimidine bases of DNA Txt CLL Nephro- & Ototoxicity Antimetabolite of folic acid: (-)dihydrofolate reductase
86. Can block/reduce Methotrexate = ↑ folic acid via a reduced folate 87. Pneumonitis & pulmonary fibrosis 88. Used in organ transplantation = kidney allografts 89. Allopurinol can ↑ its activity by (-) its biotransformation to xanthine oxidase 90. Chemotherapy used in the txt of Hodgkin’s disease 91. M = Mechlorethamine – nitrogen mustard 92. O = Oncovin (Vincristine) – prevents microtubule assembly 93. P = Procarbazine 94. P = Prednisone – glucocorticoid, inducing apoptosis 95. (-) estrogen receptor 96. Txt of breast tumors, can see associated endometrial CA 97. Antiandrogenic 98. Used w/ Leuprolide (LH-RH analog) 99. Txt prostatic CA 100. (-) progesterone receptor 101. Txt endometrial CA 102. Androgenic steroid 103. Txt mammary CA in postmenopausal women 104. Folic acid analog that (-) tetrahydrofolate synthesis by (-) dihydrofolate reductase 105. Txt of ALL 106. Txt of Psoriasis 107. Lomustine 108. Carmustine – Causes pulmonary fibrosis 109. Attaches to β cells 110. Txt of pancreatic insulinomas 111. Pyrimidine analog 112. DOC for AML 113. Used for Wilms tumor & rhabdomyosarcoma 114. Used for oat cell CA 115. Used for ovarian CA Page 19
Amifostine
116. Can ↓ nephrotoxicity due to chronic use of Cisplatin
Pathology Mobitz I Mobitz II P wave a wave T wave Wavy fibers Janeway’s lesions Osler’s nodes Thiamine defcy Fibrinous Pericarditis Serous Pericarditis Friction Rub Hemorrhagic Pericarditis Restrictive Cardiomyopathy PML’s infectious agent Edema
Adult Polycystic Kidney Disease Malignant HTN & Kidneys Nephritic signs Nephrotic signs Podocyte Effacement seen w/ ASO seen in Crescentic GN Hereditary Nephritis Membranoproliferative GN TypeI Membrano Proliferative GN deposits TypeII Membrano Proliferative GN deposits Focal segmental glomerulosclerosis deposits Cold agglutinins Scrofula Aspirin-Asthma Triad Ferruginous bodies Pancoast’s tumor causes
117. Usually due to inferior MI. Rarely goes into 3rd degree block. 118. Txt w/ Atropine or Isoproterenol. 119. BBB association. Often goes to 3rd degree AV block. Usually due to anterior MI. 120. Atrial depol. 121. LA contraction 122. Vetricular repol. 123. Eosinophilic bands of necrotic myocytes. Early sign of MI. 124. Acute bacterial endocarditis. 125. Nontender, erythematous lesions of palms & soles. 126. Subacute bacterial endocarditis. 127. Tender lesions of fingers & toes. 128. Wet Beri Beri heart. Dilated (congested) cardiomyopathy due to chronic alcohol consumption 129. Dyr Beri Beri = peripheral neuropathy 130. Wernicke-Korsakoff = ataxia; confusion; confabulation; memory loss 131. Associated w/ MI: Dressler’s 132. Associated w/ nonbacterial; viral (Coxsackie) infection; immunologic reaction. 133. Pericarditis association 134. Associated w/ TB or neoplasm 135. Aka infiltrative cardiomyopathy that stiffens the heart 136. Due to amyloidosis in the elderly 137. Due to , also see schaumann & asteroid bodies in young (<25 yoa). 138. JC Virus (Papovavirus = dsDNA, naked icosahedral capsid) 139. ↑Pc (more seeps out) 140. ↓πc (less reabsorbed) 141. ↑ permeability 142. Block lymphatic drainage 143. Commonly see liver cysts & Berry aneurysms along w/ kidney cysts. Hematuria & HTN also present. 144. 3 cysts in ea. Kidney w/ + family history confirms diagnosis 145. Petehial hemorrhages are seen on kidney surfaces = Flea-Bitten surface = young black men 146. Hematuria; RBC casts; HTN 147. Proteinuria; Hypoalbuminemia; Edema 148. Minimal Change (Lipoid nephrosis) disease 149. Acute post-streptococcal GN (due to βHGASrtep) 150. Anti streptolysin O 151. Rapidly progressive GN – nephritic syndrome 152. Associated w/ multi system disease or post-strep/post infectious glomerular nephritis 153. Alport’s syndrome. X linked 154. Renal disease w/ deafness & ocualr abnormalities 155. Can be secondary to complement deficiency; chronic infections; CLL 156. See tram tracking 157. C3 & IgG deposits 158. Only C3 deposits 159. Aka Dense deposit disease 160. IgM & C3 deposits 161. Seen in atypical pneumonia 162. It is IgM Ab with specificity for I Ag on adult RBCs 163. TB in the lymph nodes 164. Nasal polyps – Rhinitis – bronchoconstriction 165. Hemosiderin (pigment w/ Fe 3-) covered macrophages that have been pahgocytised 166. Ulnar nerve pain & Horner’s syndrome Page 20
Fatty degeneration Cloudy swelling Hydropic degeneration Liquefaction necrosis Coagulation necrosis Caseation necrosis Fibrinoid necrosis Fat necrosis Hemoptysis Pulmonary embolism Phlebothrombosis Saddle embolus Paradoxical embolism Tuberculoid granuloma Cellulitis PSA ↑↑5-HT ↑ αFeto Protein CEA Chromosome 13 Chromosome 11p Vinyl Chloride Agent Orange Parasites & CA Ochronosis
Lead poisoning
Heroin OD, clinically Fetal alcohol syndrome Atypical mycobacterium Cold abscesses Actinomyces isrealli Congenital Syphilis Warthin-Finkeledy cells
167. Made up primarily of triglycerides 168. Most commonly due to alcoholism which commonly leads to hepatic cirrhosis 169. Associated w/ CCl 4170. Failure of cellular Na pump 171. Seen in Fatty degeneration of the liver and in Hydropic (Vacuolar) degeneration of the liver 172. Severe form of cloudy swelling 173. Seen with hypokalemia induced by vomitting/diarrhea 174. Rapid enzymatic b reak down of lipids 175. Seen commonly in Brain & Spinal cord (CNS) injuries 176. Seen in suppurative infections = p us formation 177. Result of sudden ischemia 178. Seen in organs w/ end arteries limited collateral circulation) = heart, lung, kidney, spleen 179. Combination of both coagulation & liquefaction necrosis 180. Seen w/ M. tuberculosis & Histoplasma capsulatum infection 181. Seen in the walls of small arteries 182. Associated w/ malignant hypertension, polyarteritis nodosa, immune mediated vasculitis 183. Result of lipase actions liberated from pancreatic enzymes 184. Seen w/ Acute pancreatitis = saponification results 185. Blood in sputum 186. Most commonly thrombus from lower extremity vein 187. From a vein of lower extremities, of a pregnant uterus, in Congestive heart failure, bed ridden pt, 188. As a complicaiton in a pt w/ Pancreatic CA due to ↑d blood coagulability 189. Embolus lodged in bifurcation of pulmonary trunks 190. ↑↑ RV strain = RV & RA dilate = Acute cor Pulmonale 191. Right to Left shunt allows a venous embolism to enter arterial circulation 192. Patent ovale foramen or Atrial septal defect 193. Collection of macrophages w/o caseation 194. Seen w/ Sarcoidosis (non-caseating); Syphilis; Brucellosis and Leprotic infections 195. Spreading infection due to streptococcus 196. Prostate Specific Antigen = elevated in prostatic CA 197. In cases of metastatic carcinoid, txt w/ Methysergide (5HT antagonist) 198. Hepatocarcinoma 199. Neural tube defects 200. Carcinoembryonic Antigen = elevated in Colon CA 201. Retinoblastoma 202. Wilms tumor of the kidney 203. Associated w/ Angiosarcoma of the liver 204. Contains dioxin 205. Implicated as a cause of Hodgkin;s disease, non-Hodgkin’s lymphoma & soft tissue sarcomas 206. Schistosoma haematobium = Urinary bladder CA 207. S. mansoni = Colon CA 208. Aspergillus flavus = p otent hepatocarcinogen 209. Alkaptonuria 210. Error in tyrosine metabolism due to Homogentisic acid (oxidizes tyrosine) 211. Involving intervertebral disks = Ankylosing Spondilitis = Poker spine 212. See dark urine; dark c oloration of sclera, tendons, cartilage 213. Acid fast inclusion bodies 214. ↑ urinary coproprophyrin 215. Anemia: microcytic/ hypochromic 216. Stippling of the basophils 217. Gingival line & lead line in bones: x-ray 218. Mental retardation 219. Massive pulmonary edema w/ frothy fluid fr om the nostrils 220. Small head, small eyes, funnel chest, ASD, mental deficiency, and hirsutism 221. M. kanasasii & M. avium intracellulare 222. Liquefied TB lesions similar to p yogenic abscesses but lacking acute inflammation 223. Farmers infection 224. Lumpy jaw (from chewing grain) & PID (IUD), but most common is due to saprophyticus 225. Saddle nose, Saber shin, Hutchinson’s teeth, nerve deafness, interstitial keratitis 226. Reticuloendothelial giant cells on tonsils, lymph nodes, spleen Page 21
Diphyllobothrium latum Subacute Bacterial Endocarditis Acute Bacterial Endocarditis Mitral Insufficiency Left Anterior Descending branch Left Circumflex branch Dissecting Aneurysm
Cor Pulmonale Acute Cor Pulmonale Bronchopneumonia Lobar pneumonia
Bronchiectasis Cold Agglutinins Panlobular Emphysema Bulla Farmer’s Lung Bagassosis Silo-Filler’s Lung G6PDH Deficiency HbF ↑↑ Multiple Myeloma Hodgkin’s Disease Polyarteritis Nodosa Sprue Regional Enteritis Whipple’s Disease Kulchitsky cells Ulcerative Colitis
Vaginal Adenosis Scirrhous Carcinoma Hofbauer Cells
227. Seen with Rubeola (measles) due to paramyxovirus 228. Tapeworm infection causing megaloblastic anemia by consuming large amount of vit B12 in the host 229. α Hemolytic Streptococci (S. viridans) = usually in pt w/ pre-existing heart problem 230. Staph aureus, β Hemolytic Streptococci, E. coli 231. Common among drug addicts & diabetics 232. Ruptured papillary muscle 233. Branch of the Left Coronary artery 234. Highest frequency of thrombotic occlusion 235. MI = anterior wall of the LV, especially in ap ical part of interventricular septum 236. Branch of the Left Coronary artery 237. Occlusion = MI of posterior/lateral wall of the LV 238. False aneurysm: it is splitting of the media of the aorta 239. Usually accompanied w/ long history of severe hypertension, also seen w/ familial hyperlipidemia, atherosclerotic disease, Marfan’s Collagen disease 240. Zones of medial necrosis +/- slitlike cysts = Medial Cystic Necrosis of Erdheim 241. Right ventricular strain, associated w/ right ventricular hypertrophy 242. Sudden right ventricular strain due t o a massive pulmonary embolism 243. Lobular (rather than lobar) 244. Due to Staph aureus; Pseudomonas aeruginosa; Klebsiella; E. coli 245. Abscess formation is common 246. Due to Strep. Pneumoniae infection (5% due to Klebsiella) 247. Red Hepatization: days 1-3 of the pneumonia 248. Gray Hepatization: days 3-8 of untreated pneumonia 249. Complicaitons: pleural effusion; atelectasia; fibrinous pleuritis; empyema; fibrinous pericarditis; otitis media 250. Permanent dilatation of the b ronchi – predisposed by chronic sinusitis and post nasal drip 251. Supparation associated 252. Lower lobe > than upper lobe involvement 253. Found w/ Mycoplasma pneumoniae 254. α1 – antitrypsin deficiency, causing elastase ↑ = ↑ compliance in the lung 255. Associated w/ Emphysema = “Bleb” = outpouching - If it ruptures causes Pneumothorax 256. Due to Micropolyspora faeni (thermophilic actinomycetes) 257. Due to M. vulgaris (actinomycetes) 258. Inhalation of sugar cane dust 259. Due to Nitrogen dioxide from nitrates in corn 260. Sex-linked chronic hemolytic anemia w/o challenge or after eating fava beans 261. Heinz Bodies appear in RBCs 262. Sickle Cell Anemia 263. Lytic lesions of flat bones (“salt & pepper lesions”) = vertebrae, ribs, skull; Hypercalcemia; Bence-Jones protein casts 264. Malignant neoplasm of the lymph nodes causing pruritis; fever = looks like an acute infection 265. Reed Sternberg cells 266. Immune complex disease of Ag-Ab complexes on blood vessel wall 267. Half of the immune complexes have Hepatitis B Ag 268. Can see fever; abd.pain; ↓ wt; HTN; muscle aches 269. Celiac disease due to a gluten-induced enteropathy = small intestine villi are blunted 270. High titers of anti-gliadin Abs & ↑ IgA levels 271. Crohn’s Disease 272. Association w/ Arthritis; Uveitis; Erythema Nodosum 273. Intestinal Lipodystrophy = malabsorption syndrome 274. Neural cest cells from which carcinoids arise = of the Bronchi; GIT; Pancreas 275. Inflammatory disease of the colon w/ ↑ colon CA incidence 276. Crypt abscess in the crypts of Lieberkuhn 277. Pseudopolyps when ulcers are deep 278. Not transmural involvement 279. Women exposed to DES (Diethylstilbesterol) in utero before the 18 th week of pregnancy 280. Some develop clear cell adenocarcinoma of the vagina & cervix 281. Infiltrating Duct Carcinoma w/ fibrosis – most common type of breast ca rcinoma 282. Lipid laden macrophages seen in villi of Erythroblastosis Fetalis Page 22
Retinopathy of Prematurity IgA deficiency Priamry Sjorgen’s Secondary Sjorgen’s LDH1 & LDH2 LDH3 LDH4 & LDH5 Keratomalacia Metabisfite Test Microangiopathic Hemolytic Anemia Wright’s stain Mononucleosis T(8;14) T(9;22) Langerhan Cell Histiocytosis Myeloid Metaplasia Multiple Myeloma
T(14;18) Focal Segmental GN exs Nephrotic Syndrome exs Schistosoma Haematobium Penicillin Resistant PID Duret Hemorrhages Hypertensive Hemorrhage Cerebral Embolism from Neurosyphilis 5pTrisomy 13 Acute Cold Agglutinaiton Chronic Cold Agglutinaiton RBC Osmotic Fragility Non-Hodgkin’s Lymphomas
Singer’s Nodules Paraseptal emphysema
283. Retrolental Fibroplasia = cause of bindness in premies due t o high O2 concentrations 284. Pt has recurrent infections & diarrhea w/ ↑ respiratory tract al lergy & autoimmune diseases 285. If given blood w/ IgA = develop severe, fatal anaphylaxis reaction 286. Dry eyes & dry mouth, arthritis. ↑ risk for B cell lymphoma. HLA-DR3 frequent. Autoimmune disease. 287. Rheumatoid arthritis, SLE, or systemic sclerosis association 288. RA association shows HLA-DR4 289. Myocardium. LDH1 higher than LDH2 = Myocardial Infarction 290. Lung tissue 291. Liver cells 292. Severe Vit A deficiency. See Bitot’s spots in the eyes = gray plaques = thickened, keratinized ET 293. Suspending RBCs in a low O2 content solution 294. Can detect Hemoglobin S, which sickles in low O2 295. Can be due to Hemolyitc Uremic Syndrome & Thrombotic Thrombocytopenic Purpura (TTP) 296. See Helmet cells 297. Stain for Burkitt’s lymphoma 298. Due to EBV infeciton 299. If Mono is treated w/ Ampicillin, thinking that it is a strep pharyngitis, a rash will occur. 300. Burkitt’s lymphoma = c-myc oncogene overexpression 301. CML = c-abl/bcr gene formation = Philadelphia translocation 302. Letter Siwe syndrome; Hand Schuller Christian Disease; Eosinophilic Granuloma 303. Birbeck granules are present = tennis racket shape 304. Alkaline phosphatase ↑/normal compare to CML = low to absent 305. Anemia; splenomegaly; platelets > 1 million = extensive extra-medullary hematopoiesis 306. Weakness; wt. loss; recurrent infection; proteinuria; anemia; ↑ proliferation of plasma cells in BM = plasma cell dx 307. Serum M protein spike – most often of IgG or IgA 308. Hypercalcemia (↑ bone destruction) 309. NH Lymphoma = bcl2 proto-oncogene overexpression seen w/ Small Cleaved Cell (Follicualr) Lymphoma 310. IgA Focal GN = Berger’s disease; SLE; PAN; Schonlein-Henoch purpura (anaphylactoid purpura) 311. Focal (Segmental) GN; Membranous GN; Lipoid (Minimal Change) GN; Membranoproliferative GN; Hep B; Syphilis; Penicillamine 312. Infection is assocaited w/ Squamous cell CA of the Bladder (most common Bladder CA is transitional cell type) 313. Associated w/ portal HTN due to intrahepatic obstruction 314. PID is usually due to N. Gonorrhoeae, but if unresponsive to penicillin think of Bacteroides species 315. Severe ↑ in ICP w/ downward diplacement of cerebellar tonsils into Foramen Magnum causing a compression on the brainstem w/ hemorrhaging into the pons & midbrain 316. Nearly always associated w/ death due to damage to the vital centers in these areas 317. Predilection for lenticulostriate arteries = putamen & internal capsule hemorrhages 318. MI w/ Mural Thrombi; Atrial Fib Thrombi = Marantic thrombi; L-sided Bacterial Endocarditis; Paradoxical Embolism of septal defect 319. Tabes Dorsalis = ↓ joint position sensation, ↓ pain sensation, ataxia, Argyl Robertson pupils 320. Syphilitic meningitis 321. Paretic neurosyphilis 322. Cri di Chat: mental retar dation; small head; wide set eyes; low set ears; cat-like cry 323. Patau’s: small head & eyes; cleft lip & palate; many fingers 324. Abs to I blood group Ag. Mediated by IgM Abs 325. Complication of EBV or Mycoplasma pneumoniae infections 326. Associated w/lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold. IgM Abs 327. Hereditary Spherocytosis 328. Small Lymphocytic: low grade B cell lymphoma of the elderly. Related to CLL. 329. Small Cleaved cell (Follicualr): low grade B cell lymphoma of the elderly. T(14;18) bcl-2 oncogene 330. Large Cell 331. Lymphoblastic: high grade T cell lymphoma of kids progressing to T-ALL 332. Small Non Cleaved = Burkitt’s: high g rade B cell lymphoma. EBV infection. Starry sky histo appearance. T(8;14) c-myc proto-oncogene. Related to B-ALL 333. Benign laryngeal polyps associated w/ smoking & overuse of t he voice 334. Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax Page 23
Superior Vena Cava Syndrome Betel nuts Fundal (Type A) Gastritis Antral (Type B) Gastritis Primary Biliary Cirrhosis Acute Pancreatitis Radiating Back Pain Complete Hydatidiform Mole Partial Hydatidiform Mole Cold Nodules Acidophils Basophils Lacunar Strokes CSF of Bacterial Meningitis CSF of Viral Meningitis Marble Bone Disease C5a C3b Anaphylotoxins Vasoactive Mediators Platelet Aggregation Platelet Antagonist Intrinsic Pathway Extrinsic Pathway Lines of Zahn Currant Jelly appearance Emigration: Chemotaxis
Transudate Exudate Hurler’s Galactosemia Phenylketonuria Autosomal Dominant Diseases
Autosomal Recessive Diseases
335. Obstructed due to bronchogenic carcinoma. Causing swollen face & cyanosis. 336. Associated to oral cancer. 337. Antibodies to parietal cells; pernicious anemia; autoimmune diseases 338. Associated w/ Helicobacter (Camp ylobacter) pylori infection. 90% of duodenal ulcer 339. Autoimmune origin; middle aged women; anti-mitochondrial Abs 340. Jaundice; itching; hypercholesterolemia (can see cutaneous xanthomas) 341. ↑ pancreatic enzymes = fat necrosis; sapponification = hypocalcemia; ↑ serum amylase 342. Severe epigastric ab p ain; prostration; radiation to the back 343. Chronic pancreatitis 344. No embryo. Paternal derivation only. 46XX 345. Embryo. 2 or more sprems fertilized 1 ovum: triploidy/tetraploidy occurs 346. Hypoplastic Goiter nodules that do not ta ke up radio active iodine. [Opposite: hot & do take up iodine] 347. Mammotrophs = Prolactin 348. Somatotrophs = GH 349. Thyrotrophs = TSH 350. Gonadotrophs = LH 351. Corticotrophs = ACTH & FSH 352. Small/focal aa occlusions. Purely motor or sensory. 353. Sensory: lesion of thalamus 354. Motor: lesion of internal capsule 355. ↓ Glucose; ↑ Protein; ↑ Neutrophils; ↑ Pressure 356. Normal Glucose; +/-↑ Protein; ↑ Lymphocytes 357. Osteoporosis: Albers-Schonberd Disease = inspite of ↑d bone density, many fractures = ↓ osteoclasts 358. Involved in Chemotaxis (for Neutrophils) 359. Involved in Opsonization (& IgG) 360. C3a & C5a (mediate Histamine release from Basophils & Mast cells) 361. Vasoconstriction: TxA2; LTC 4; LTD4; LTE4; PAF 362. Vasodilation: PGI 2; PGD2; PGE2; PGF2α; Bradykinin; PAF 363. ↑d Vascular Permeability: Hist.; 5HT; PGD 2; PGE2; PGF2α; LTC4; LTD4; LTE4; Bradykinin; PAF 364. ADP; Thrombin; TxA2; collagen; Epinephrine; PAF 365. Prostacyclin (PGI 2) 366. F XII (Hagman): APTT 367. F VII: PT 368. Aterial thrombi = pale red colored (dark red is venous thrombi) 369. Post mortem clots 370. Margination 371. Pavementing 372. Adhesion 373. Chemotaxis 374. Phagocytosis 375. Intracellular microbial killing 376. Specific gravity < 1.012 – low protein 377. Specific gravity > 1.020 – high protein 378. Lysosomal storage disease α L Iduronidase – Heparan/Dermatan Sulfate accumulation 379. Deficiency of Galactose 1 Phosphate Uridyl Transferase. ↑ Galactose 1 Phosphate 380. Deficiency: Phenylalanine Hydroxylase. ↑ Phenyalanine & degradation products 381. Mousy body odor 382. Adult Poly Cystic Kidney Disease 383. Familial Hypercholestrolemia Disease 384. Hereditary Hemorrhagic Telengectasia (Osler-Weber-Rendu) 385. Hereditary Spherocytosis 386. Huntington’s Disease (chromosome 4p) 387. Marfan’s Syndrome 388. Neurofibromatosis (von Recklinghausen’s) 389. Tuberous Sclerosis 390. Von Hippel Lindau Disease 391. Tay-Sachs 392. Gaucher’s Page 24
X Linked Recessive Diseases
Hypersensitivity Reactions “ACID”
Transplant Rejections
Blood Metastasis Lymph Metastasis Aflatoxin Cleft Lip Cleft Palate Craniopharyngioma Lateral Geniculate Nucleus Medial Geniculate Body Lung Development
Heart’s 1st Beat Foregut Midgut Hindgut Hypnagogic Hallucinaitons Type I Error Subdural Hematoma Epidural Hematoma Type II Error Power Sensitivity Specificity Positive Predictive Value Negative Predictive Value Odds Ratio d-Dimers Delusion Loose Association 5 Stages of Death
393. Niemann-Pick 394. Hurler’s 395. Von Gierke’s 396. Pompe’s 397. Cori’s 398. McArdle’s 399. Galactosemia 400. PKU 401. Alcaptonuria 402. Hunter’s Syndrome (L-Iduronosulfate Sulfatase deficincy, ↑ Heparan/Dermatan Sulfate) 403. Fabry’s Disease (α Galactosidase A deficiency, ↑ Ceremide Trihexoside) 404. Classic Hemophilia A (Factor VIII deficiency, F8 Gene on X chromosome is bad, ↑ Ceremide Trihexoside) 405. Lisch-Nyhan Syndrome (HGPRT deficiency, ↑ Uric acid) 406. G6Phosphatase deficiency (G6PDH deficiency, ↑ Ceremide trihexoside) 407. Duchenne’s Muscular Dystrophy (Dystrophin deficinecy, ↑ Ceremide Trihexoside) 408. Type I (Anaphylactic): IgE mediated. Exs: Hay Fever; Allergic asthma; Hives 409. Type II (Cytotoxic): Warm Ab autoimmune hemolytic anemia; hemolytic transfusion reactions; Erythroblastosis Fetalis; Grave’s Disease; Goodpastures 410. Type III (Immune Complex): Insoluble complement bound aggregates of Ag-Ab complexes. Exs: Serum sickness; Arthus Reaction; Polyarteritis Nodosa; SLE; Immune Complex Mediated Glomerular Disease 411. Type IV (Delayed = Cell mediated immunity): Delayed hypersensitivity. Involves memory cells. Exs: Tuberculin reaction; Contact dermatitis; Tumor cell killing; Virally infected cell killing 412. Hyperacute Rejection = occurs w/in minutes of transplant. Ab mediated. 413. Acute Rejection = occurs w/in days to months of transplant. Lymphocytes & macrophages. Only rejection type that can be treated w/ therapy. 414. Chronic Rejection = occurs months to years of transplant. Ab mediates vascular damage. 415. Sarcoma, exception – renal cell CA: early venous invasion 416. Carcinoma, exception – renal cell CA: early venous invasion 417. Seen w/ Aspergillus. ↑ risk for Hepatocellular CA 418. Incomplete fusion of maxillary prominence w/ median nasal prominence 419. Incomplete fusion of lateral palatine process w/ each other & median nasal prominence & medial palatine prominence 416. Pituitary tumor - usually calcified Inolved in Vision relay Involved in Hearing relay Glandular: 5-17 fetal weeks Canalicular 13-25 fetal weeks Terminal Sac 24 weeks to birth Alveolar period birth-8yoa 21-22 days Mouth ! Common Bile Duct - supplied by Celiac Artery Duodenum, just below Common Bile Duct ! Splenic flexure of the Colon supplied by Superior Mesenteric artery Splenic Flexure ! Butt crack ! supplied by Inferior Mesenteric Artery Narcolepsy α: “Convicting the innocent” – accepting experimental hypothesis/rejecting null hypothesis Ruptured cerebral bridging veins Ruptured middle meningeal artery “intervals of lucidness”, 2 ry to Temporal bone fracture β: “Setting the guilty fr ee” – fail to reject the null hypotesis when it was false 1-β TP/TP + FN TN/TN + FP TP/TP + FP TN/TN + FN ad/bc DIC Disorder of thought content Skip from topic to topic Denial – Anger – Bargaining – Depression – Acceptance Page 25
1st Branchial Arch 2nd Branchial Arch Median nerve lesion Radial nerve lesion Common peroneal lesion Diract inguinal hernia Indirect inguinal hernia @ Diaphragm T8, T10, T12 Hemiballism O Linked Oligosaccharide N Linked Oligosaccharide MLF Syndrome ADA Deficiency Raphe Nucleus β waves Irreversible Glycolysis Enzymes Irreversible Gluconeogenesis Enzymes
Pellagra
TLCFN LCAT or PCAT HMGCoA Reductase Ketogenic amino acids Glucogenic amino acids Keto & Gluco amino acids Carnitine Shuttle Cori Cycle (-) Na+ Pump (ATPase) TCA Cycle Products Cones Rods Gastrula Epiblast Sydenham’s Chorea (+) Frei Test
Meckel’s cartillage – gives rise to incus/malleus bones of ear Reichert’s cartillage – gives rise to stapes bone of ear No pronation Wrist drop – seen w/ humerus fracture Foot drop. No dorsiflexion or eversion of the foot Goes through superficial inguinal ring. Medial to inferior epigastric artery Seen in older men Goes through deep & superficial inguinal ring Lateral to inferior epigastric artery Seen in young boys – processus vaginalis did not close T8 = Inferior vena cava T10 = Esophagus/ Vagus T12 = Aorta/ Thoracic duct/ Azygous vein Wild flailing of 1 arm. Lesion of the sub thalamic nucleus In the Golgi In the RER Internuclear Ophthalmoplegia: medial rectus palsy on lateral g aze; Nystagmus on abducting eye. Seen w/ MS SCID Initiation of sleep via 5HT predominance Alert; Awake; Active mind – also seen in REM, therefore we say “par adoxical sleep” Hexokinase PhosphoFructo Kinase = Rate Limiting Step Pyruvate Kinase Pyruvate Dehydrogenase PyruvateCarboxy Kinase PEPCarboxyKinase Fructose 1,6 BiPhosphatase Glucose 6 Phosphatase **muscle dose not take part in Gluconeogenesis, only takes place in the liver, kidney & GI epithelium Diarrhea, Dermatitis, Dementia Niacin Deficiency (Vit B3 deficiency) Hartnup’s Disease Malignant Carcinoid Syndrome INH use Needed as co-factor for Pyruvate DH complex & α Ketoglutarate DH complex Esterification of cholesterol: lecithin cholesterol acetyltransferase Lecithin = Phosphatidylcholine, therefore phosphotidylcholine acetyltransferase Rate limiting step in cholesterol synthesis Changes HMGCoA ! Mevalonate (-) by Lovastatin Leucine & Lysine Methionine, Threonine, Valine, Arginine, Histadine Phenylalanine, Trytophan, Isoleucine Feeds FA into the mitochondria for their consumption Keeps muscles working anaerobically. Transfers lactate to the liver to make glucose which is sent back into the muscles for energy use Ouabain [(-) K + pump] Vanadate [(-) phosphorylation] Digoxin [↑ heart contractility] “Citric Acid Is Krebs Starting Substrate For Mitochondrial Oxidation” Citrate ! Aconitate ! Isocitrate ! α Ketoglutarate ! Succinyl ! Succinate ! Fumarate ! Malate !OAA Color vision. Contain Iodopsin = Red-Blue-Green specific pigment. For acuity. Contain Rhodopsin pigment. High sensitivity. Concentrated in the fovea. Night vision. Seen @ 3rd week: Ecto, Meso & Endo @ 2nd week: forms the primitive streak, from which Meso & Endo come from. Directly gives rise to Ecto. Post streptococcal infection. Necrotizing arteritis of the caudate, putamen, thalamus Chlamydia trachomatis types L1, L2, L3 = Lymphogranuloma venereum Page 26
Sabouraud’s Agar FMR1 Gene Defect Barr Body Aortic Insufficiency Signs Scleroderma :”CREST” Cretinism Hemochromatosis Triad
Culture for all Fungi ie…Culture Cryptococcus neofromans which is found in pigeon droppings Fragile X Syndrome: macro-orchidism; long face; large jaw; large everted ears; autism, mental retardation Present in Kleinfelters: Male: XXY Not present in Turner’s: Female: XO Traube Sign = Pistol shot sound over the femoral vessels Corrigan pulse = water hammer pulse over coratid artery = aortic regurgitation Calcinosis; Raynauds; Esophageal; Sclerodactyl; Telangiectasis Sporadic: bad T4 phosphorylation or developmental failure of thyroid formation Endemic: no Iodine in diet: protruding belly & belly button Micronodular pigment cirrhosis; Bronze Diabetes; Skin pig mentation = due to ↑ Fe3+ deposition
Highly Tested Drug Side Effects 420.
Clozapine, Chloramphenical
421. 422. 423. 424.
Chloramphenicol NSAIDs Benzene Tricyclics
425. 426. 427.
Doxorubicin Daunorubicin Fluoroquinolones (Ciprofloxacin & Norfloxacin)
428.
Quinidine
429.
ACE Inhibitors
430.
Lithium (Txt w/ Amiloride)
431. 432. 433.
Metronidazole Sulfonylureas (1 st generation) Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine)
434.
Tetracycline
435. 436. 437. 438.
Valproic Acid Halothane Acetaminophen Phenytoin
439.
Chloramphenicol
440. 441. 442. 443. 444. 445. 446. 447. 448. 449.
Cimetidine Azoles Spironolactone Digitalis Sulfonamides Isoniazid Aspirin Ibuprofen Primaquine Isoniazid
Monday Disease
450. 451. 452. 453. 454. 455. 456. 457. 458. 459. 460. 461. 462. 463.
Niacin Tamoxifen Ca++ Channel Blockers Barbiturates – Phenobarbital Phenytoin Carbamazepine Rifampin Cimetidine Ketoconazole Methicillin NSAIDs (except Aspirin) Furosemide Sulfonamides Nitroglycerin Industrial exposure → tolerance during week → loss of tolerance during weekend → headache, -
Orange Body Fluids
464.
Agranulocytosis Aplastic Anemia Atropine-like Side Effects Cardiotoxicity Cartilage Damage in Children Cinchonism Cough Nephrogenic Diabetes Insipidus Disulfiram-like Effect Extrapyramidal Side Effects Fanconi’s Syndrome Fatal Hepatotoxicity (necrosis) Gingival Hyperplasia Gray Baby Syndrome Gynecomastia
Hemolytic Anemia in G6PD-deficiency
Hepatitis Hot Flashes, Flushing Induce CP450
Inhibit CP450 Interstitial Nephritis
ach, dizziness upon re-exposure
Rifampin Page 27
Osteoporosis Positive Coombs’ Test Pulmonary Fibrosis Red Man Syndrome Severe HTN with Tyramine SLE-like Syndrome Tardive Dyskinesia Tinnitus
465. 466. 467.
Heparin Corticosteroids Methyldopa
468. 469. 470.
Bleomycin Amiodarone Vancomycin
471.
MAOIs
472. 473. 474. 475. 476. 477. 478.
Procainamide Hydralazine INH Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine) Clozapine: only antipsychotic to not give you tardive dyskinesia Aspirin Quinidine
Microbiology Lactose formers
Non lactose formers
May lack color
↑ cAMP
Have Capsules [ie… are Quellung Reaction (+)]
Dimorphic Fungi
Have β Prophage
Spore Forming Bacteria IgA Proteases Widal Test
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43.
“CEEK” Citrobacter Enterobacter E.Coli (K1 capsule most important) Klebsiella “SHYPS” Motile: Shigella make H2S Yersinia enterolytica (AKA Pestis) Proteus Non Motile: noH2S Salmonella “These rascals may microscopically lack color”: Treponema Ricksetta Mycobacterium Mycoplasma Legionella Chlamydia “CAPE” Cholera Anthracis (Poly D glutamate capsule) Pertusis (via Gi) E.coli (LT enterotoxin) “Some killers have pretty nice capsules” Strep. Pneumoniae Klebsiella HiB Pseudamona Aeroginosa Neisseria meningitis Cryptococcus neoformans (only encapsulated fungal pathogen) “Can Also Have Both Shapes” Cocciodes Aspergillus Histolpasma Blastomyces Sprothrix schenkii “OBED” O = Salmonella B = Botulinum E = Erythrogenic strep D = Diptheria Bacilus & Clostridium (have calcium di-picolinate) Neisseria, Haemophilus, S. pneumoniae Salmonella ( Salmonella begins in the ileocecal region) agglutination indicates Abs to O, H, Vi Salmunella Ags Page 28
Wayson’s Stain Pneumonic Plaque Transmission Splenectomy Invasins Fusiform S. viridans Obligate Aerobes Obligate Anaerobes Staph aureus Spirochetes Non Motile Gram (+) Rods Acid Fast Organisms Pigment Producing Bacteria
Bacterial Morphology
Inclusion Bodies
Schistosoma Japonicum Monsoni Schistosoma Haematolium Non Human Schistosom Clonorchichis Fasciola Hepatica Fasciola Biski Paragonimus Westermani Oxidase (+) Micro Aerophilic Urease (+)
Coagulase (+) Obligate Intracellular Bacteria Protozoa Obligate Non Intracellular Parasites Haemophilus Factors All cocci are “Eaton Fried Eggs” Mycoplasma
Sabrands Malassazia furfur
44. 45. 46. 47.
Yersinia Person to person cf w/ Bubonic plaque that was via infected flea Predisposes to septicemia Yersinia pseudotuberculosis
48. 49. 50. 51.
Vincent’s trench mouth Dextran mediated adherence Pseudomonas & Mycobacterium Clostridium, Actinomyces, Bacteroides
52. A Protein, Catalase +/ Coagulase + 53. Treponema, Borrelia, Leptospira 54. Corenybacterium D & Nocardia 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76.
Mycobacterium; Cryptosporidium; Nocardia (partially); Legionella micdadei; Isospora Serratia – red (can cause pseudohemoptysis) Pseudomonas A – piocyanin blue/green Staph Aureus – yellow – Protein A Mycobacteria – photo/scoto chromogenic – caritinoid – yellow/orange Corneybacterium D – black/gray – pseudomembrane plaque in throat Bacteroides (Porphyromonas) melaninogenicus – black (heme) E. coli – irredescent green sheen Pneumococci – lancet shaped diplococci Neisseria – kidney bean shaped diplococci Camphylobacter – gulls’ wings/comas Vibrio Cholera – coma shaped Corneybacterium D – club shaped (nonmotile, G+Rod) Yersinia – safety pin seen in Wayson’s stain Rabies – Negri bodies – intracytoplasmic Pox virus – Guarnieri – intracytoplasmic & acidophilic CMV – Owl’s eyes – intracytoplasmic & intranuclear HSV – Cowdry bodies – intranuclear Intestinal – contact w/ bad water Vesicular – contact w/ bad water Swimmer’s itch – contact w/ bad water Chinese liver fluke – eating raw fish. Txt: Praziquantel
77. 78. 79. 80.
Sheep – eating raw fish. Txt: Praziquantel Giant intestinal flukes – eating raw fish. Txt: Praziquantel Lung fluke – eating raw fish. Txt: Praziquantel Neiserria and most Gram (-)s
81. 82. 83. 84. 85. 86. 87.
Camphylobacter & Helicobacter All Proteus – can cause Staghorn/Struvite calculi (NH4- Mg2- stones): alkaline urine Ureaplasma Campylobacter pylori (Helicobacter) Cryptococcus Nocardia Staph A & Yersenia pestis
88. Chlamydia Pistacci (Chlamydia do not make own ATP); Mycobacterium Leprae; all Rickettsia except Roachalimea (make suficient ATP to survive) 89. Plasmodium; Toxoplasma ghondi; Babesin; Leishmania; Trypanosoma Cruzi 90. Treponema palidum & Pneumocystis Carinii (cannot be cultured on inert media but can be found extra cellularly in the body) 91. X = Protoporphyrin & V = NAD 92. 93. 94. 95. 96. 97. 98. 99.
Gram (+) except for Neisseria & Moraxella Mycoplasma pneumoniae has fried egg colonies on Eaton agar (needs cholesterol) No cell wall. Membrane has cholesterol. Smallest living bacteria. P1 protein inhs ciliary action Fried egg colonies Atypical pneumonia – young adults Fungal media Spaghetti & meat ball Page 29
Measles’ 3C’s Non Motile Bacilli & Clostridium Bloody diarrhea agents YW-135CA Indian Ink Naegleria causes Need Cysyeine for growth
Endotoxins, G(+) or G(-) Ecthyma Gangrenosum, seen w/ Endospores G(+) Multi Brain Abscess Single Brain Abscess ↑ risk for Strep pneum Infection α Hemolysis/Optochin Sensitive α Hemolysis/Optochin Resistant Staph. Saprophyticus Staph. Epidermidis β Hemolysis/Bacitracin Sensitive
β Hemolysis/Bacitracin Resistant EFII Ribosylation Bacillus Anthracis: 3 toxins (work via adenylate cyclase)
Woolsorter’s Disease Grows in Rice Clostridium Perfringens Clostridium Difficile Spastic Paralysis toxin Clostridium Botulinum Infant Botulinum Thayer Martin Agar DOC for N. gonorrhoeae K1 E. Coli Capsular Ag The A’s of Klebsiella Rice H2O Diarrhea Raw seafood intoxicaiton Helicobacter Txt ↑ risk of P. aeroginosa infection Contact lens’ infection Cat Bites Undulant Fever Bordet Gengou Agar Lowenstein-Jensen medium Cat Scratch Disease
100. Cough – Coryza – Conjunctivitis. Can also have photophobia 101. May lead to subacute Sclerosing Panencephalitis 102. B. Anthracis & C. Perfringens 103. EIEC – EHEC – Shigella - Yersenia enterocolitica – Entaemeba histolytica – Salmonella – Campylobacter jejuni 104. N. meningitidis vaccine capsualr polysaccharide strains 105. Cryptococcus neoformans 106. Colonization in the nasal passages after swimming 107. “Ella likes cysteine”: 108. Francisella 109. Brucella 110. Legionella 111. Pasturella 112. Gram (-): N. meningitidis 113. Pseudomonas aeroginosa. Target shaped skin lesions w/ a black center and red ring surrounding the lesion 114. Gram (+): Bacillus & Clostridium – made up of dipicolinate & Keratin 115. Nocardia 116. 117. 118. 119.
Actinomyces israelli Asplenic; Sickle cell anemia; immunocompromising illness Strep. Pneumoniae Strep. Viridans (Subacute Endocarditis)
120. Novobiocin Resistant (UTIs) 121. Novobiocin sensitive (Endocarditis in IVDUs) 122. Strep. Pyogenes (pharyngitis; Scarlet fever; cellulitis; impetig o; Rheumatic fever)) 123. Hyaluronic capsule; non-motile; M proteins; Endotoxin A 124. Strep. Agalactiae (Diabetes predisposes to infection) 125. Diphtheria toxin & Pseudomonas exotoxon A 126. Protective Antigen (PA) 127. Lethal Factor = toxic to macrophages 128. Edema Factor = ↑ cAMP 129. Bacillus anthracis. DOC: Penicillin 130. Bacillus Cereus 131. Double Zone β Hemolysis (test) 132. Lecithinase: α toxin = lyses RBCs 133. 80% of gas gangrene (myonecrosis) cases 134. 2 Toxins: Enterotoxin (Exotoxin A) & Cytotoxin (Exotoxin B) 135. Pseudomembranous colitis (can be precip itated by clindamycin/ampicillin) 136. Clostridium Tetani toxin 137. Bad canned foods have neurotoxin = flaccid paralysis (block Ach release) 138. Floppy Baby Syndrome. Pre formed toxin in honey 139. Neisseria ID 140. Ceftriazone 141. Related w/ neonateal meningitis 142. Alcoholics 143. Aspiration pneumonia 144. Abscesses in the lungs 145. Vibrio Cholera: metabolic acidosis 146. Vibrio parahemolyticus 147. Bismuth salts; Metronidazole; Tetracycline (or amoxicillin) 148. Burn patients & Cystic fibrosis 149. Pseudomonas aeroginosa 150. Pasteurella multocida 151. Brucella 152. Bordetella pertusis ID 153. M. tuberculosis ID 154. Bartonella henselae. Leion can resemble Kaposi’s sarcoma. Page 30
Pink Eye True Hemaphrodite Pseudo Hemaphrodite Male Pseudo Hemaphrodite HLA Genes Location Parvovirus B19 Interferon MOA Acute Hemorrhagic Conjunctivitis Parainfluenza Causes… Swimming Pool Conjunctivitis RSV Removed tonsils, find what virus Bone Fever HbsAg HbeAg Anti-Hbc Filamentous Bacteria Listeria contaminates Shiga like Toxin Necrotizing Fasciitis Relapsing Fever Loffler’s Medium Chlamydiae Developmental Cycle
Trench Fever “Spotted Fever” Members Thrush Txt Rose Bush Thorns Contact lens solution infection Filiariasis Causant Freshwater lake infection Reduviid bug bite Schistosoma Haematobium causes Schistosoma Mansoni causes Snail, intermediate host of… Ixodes scapularis transmits Nantucket Protozoa Infection by Reduviid Bug Infection by TseTse Fly Infection by Sandfly
155. Toxoplasmosis 156. Adenovirus (type 8) 157. Testes & Ovaries are present 158. External genitalia does not coincide w/ gonads 159. Testicular Feminization 160. 6p 161. Fifth Disease: Erythema Infectiosum (ssDNA). Linked w/ sicle cell anemia 162. Inhibits viral replicat ion (translation or transcription) 163. Seen w/ infections from Enterovirus & Coxsackie A 164. Croup (Laryngotracheobronchitis) 165. Adenovirus (types 3 & 4) 166. Bronchiolitis in infants 167. In 80%, Adenovirus. In the immunosuppressed, activation can occur 168. Dengue: Group B Togavirus, from the Arbovirus, transmitted by mosquitos 169. Appears in blood soon after infection, before onset of acute illness 170. Disappears w/in 4-6 months after the start of clinical illness 171. Appears early acute phase, indicates higher risk of transmitting the disease 172. Disappears before HbsAg is gone 173. Present in beginning of clinical illness 174. Seen in the “window phase” 175. Actinomycetes = Nocardia; Actinomyces; Streptomyces 176. Milk, cheese, vegetables (coleslaw) in recent infections 177. E. Coli 0157/H7: Hemorrhagic colitis & Hemorrhagic uremic syndrome 178. Group A Streptococci 179. Borrelia recurrentis 180. Corneybacterium diphtheriae 181. Elementary Body: infeccious particle that Enters the cell 182. Reticulate Body: made from elementary body. Replicates, differentiates and releases elementary bodies to infect other cells 183. W/ infection you will see Glycogen containing inclusions 184. Cell wall lacks muramic acid 185. Rochalimaea quintana 186. Rickettssia rickettsii (RMSF) & R. akar i (rickettsial pox) in the U.S. 187. R. sibirica (tick typhus in China) & R. australis (typhus in Australia) 188. Nystatin txts candidiasis of the mouth 189. Have Sporothrix schenckii 190. Acanthamoeba 191. Wucheria bancrofti (infection aka elephantitis & wucheriasis 192. Causes amebic meningoencephalitis due to Naegleria fowleri 193. Transmits Trypanoma cruzi (Chagas’ disease): Romana’s Sign 194. Bladder calcificaiton & cancer 195. Presinusoidal HTN, splenomagaly, esophageal varices 196. Schistosomiasis 197. Babesia (clinically rembles malaria) & Borelia burgdorferi 198. Babesia microt 199. Trypansoma cruzi: Chagas’ Disease 200. Trypansoma brucei gambiense & rhodiense: African Sleeping Sickness 201. Leishmaniasis: Mucocutaneous Diseases by L. braziliensis & Visceral Disease by L. donovani & Dermal Leishman by L. tropica, mexicana, peruviana
Infection by Ixodes Tick Infection by Anopheles Mosquito Trophozoites w/ “Face-Like” Appearance Nonseptate Hyphae Histoplasmosis Geography Coocidioidomycosis Geography Blastomycosis Geography
202. Babesia microti: Babesiosis & Borrelia burgdorferi: Lyme Disease 203. Malaria 204. Giardia lamblia 205. Zygomycosis: Rhizopus & Mucor. Only mycosis w/o septate. 206. Ohio, Mississippi, Misouri River valleys 207. Southwestern deserts, California 208. States east of Mississippi River Page 31
Infect Ketoacidotic Diabetics.
Paracoccidioidomycosis Geography Roseola Infection, aka Herpangina Orthomyxovirus
Paramyxovirus
Togavirus
Flaviviris Bunyavirus IgA Protease Activity
Diphtheria: ABCDEFG
Only ssDNA Only dsRNA Naked RNA 2 circular DNAs BK Hepadna, Retrovirus? Picornovirus: “PERCH” Hemorrhagic Fevers Segmented viruses Eclipse Phase Latent Phase Naked Capsid Virus Enveloped Virus Interferon AIDS structural prots AIDS regulatory prots AIDS gp41 env prot AIDS gp120 env prot AIDS p17 gag prot AIDS p24 gag prot AIDS p7p9 gag prot DNA Viruses
209. Latin America 210. Exanthema Subitum: “ Sixth Disease” (Human Herpes Virus-6 dsDNA, enveloped) 211. “Hand-Foot-and-Mouth” Disease: Coxsackie A (Picornavirus +ssRNA) 212. –ssRNA, enveloped virus. 213. Spike Glycoproteins (peplomeres): HA = Hemagluttinin & NA = Neuraminidase. These peplomeres are what give the virus antigenis variation 214. Influenza A & B 215. –RNA, enveloped. Most common cause of r espiratory infections in kids 216. Mumps 217. Croup(Parainfluenza virus) 218. Rubeola(Measles virus) 219. RSV 220. +ssRNA, enveloped 221. 3 Day Measles: German Measles: Rubella/ Rubivirus 222. Encephalitis viruses: Alphaviruses: Eastern (more severe) and Western Equine Encephalitis 223. Dengue Fever – icterus & hemorrhage w/ blac vomit 224. Yellow fever 225. St. Louis Encephalitis – no hepatitis or hemorrhage 226. –ssRNA, enveloped 227. California Encephalitis – severe bifrontal headaches 228. Hantavirus – hemorrhagic fever w/ acute resp. distress syndrome 229. H. Influenzae (needs factors V & X for growth) 230. Strep. Pneumoniae 231. N. meningitidis 232. N. gonnorhoae 233. W/ this activity these bugs are able to colonize the oral mucosa. 234. Adenopathy 235. β Prophage encodes the exotoxin 236. Corneybacteria is Club shaped 237. Diphtheria 238. Elongation Factor II 239. Granules (metachromatic) 240. Parvovirus: “Part of a virus” 241. Reovirus, “RepeatOvirus” 242. “Naked for CPR”: Calcivirus; Picornovirus; Reovirus 243. Papovavirus & Hepadnavirus 244. Papovavirus. Seen in kidney transplant patients (causes renal disease) 245. No, but has reverse transcriptase 246. Poiliovirus; Echo; Rhino; Coxsackie; Hep A 221. Filovirus & Bunyavirus (Hantavirus) All are RNA: Orthomyxo; Arena; Bunya; Reo No internal virus. 1 total virus per cell No external virus. Extracellular virus found Nucleocapsid. DNA or RNA + Structural proteins Membrane. Nucleocapsid + Glycoprotein Non virus specific. Works by RNA endonuclease = digests viral DNA + inh viral prot synth Gag, pol, env Tat, rev, nef Transmembrane Surface Matrix Capsid Nucleocapsid E
Brick. Rep In Cyto AH H PPP --- ico Rep in Nuc Page 32
A = Adeno H = Herpes H= Hepadna P = Pox P = Parvo
SS
P = Papova
Circ E
(+) RNA Viruses
C = Calici P = Picorno R = Reo F = Flavi T = Toga C = Corona
C P R F T C ------ ico (+) Linear. No segment. Rep in Cyto Helical R-Tase & Rep in Nuc 8
(-) RNA Viruses
2
3
F O R P A B ---- (-) E Helical Linear. Non seg.
F = Filo O = Orthomyxo R = Rhabdo P = Paramyxo A = Arena B = Bunya
Bullet Anti sense
Hepatitis Window Period Hepatitis
A Picorna
Downey Type II cells Infection by Aedes Mosquito “Hot T-Bone stEAk”: ILs
ILs Secreted by CD4s ILs Secreted by Macrophages C5a C5 Convertase Only Richettssia not Intracellular Plasmodium Life Cycle
Acanthamoeba Mucor, Rhizopus, Absidia Cryptococcus Neoformans Candida Aspergillus Fumigatum Cocciodes Histoplasma Cap Blastomycosis Sporothrix Schenkii PCP
After HbsAg disappears & Before HbsAb appears B Hepadna EBV
C Flavi
D Delta
E Calici
Yellow Fever: Flavivirus: Black vomit, jaundice, high fever IL1 = ↑ Temp: HOT IL2 = stimulate T cells IL3 = stimulate Bone Marrow stem cells’ growth & differentiation (GM CSF) IL4 = stimulate IgE (& IgG) IL5 = stimulate IgA (& eosinophils) IL2, IL4, IL5, IFN gamma IL1 & TNF α Neutral chemotaxis. When it is w/ C3a, particip ates in anaphylaxis When both Alternative and Classic pathways come together Alternative: C3b, Bb, C3b + C3a ! C5 Classic: 2b, 3b, C3a + C4b ! C5 Quintana Sporozoites: from blood to liver Primary tissue schizont Trophozoites: in RBC Erythrocytic schizont Merozoite: ruptured RBC Gametozyte Zygote: inside the mosquito Star shaped cysts Nonseptate, filamentous, 90 degree branching, indian in, capsular halos Monomorphic Yeast normally, pseudo & true hyphae in tissue infections 45 degree branching point, asoc’d w/ cystic fibrosis & burns pt Hyphae in wild. Artroconidia. Arthocondida & Hyphae. Sherules w/ endospores Hyphae in wild. Microcondida w/ tuberculate macrocondida. Fac intracellular. In t he tissue it’s a yeast w/ a small neck. Hyphae in wild Hypahe in wild. Potas iodide in milk. Pneumonia in alcoholics. Obligate parasite. Kills type I pneumo cells. Ground glass Page 33
E. Coli; V. Cholera; Bordetella Pertussis Trichophyton: SHN
Gram (-) Bugs w/ Exotoxins Dermatophytes
Microsporium: SH Epidermophyton: SN Tinea tavus: permanent hair loss
Transmission Cysts Cysts Cysts Cysts Trophozoites
E. Histolitica Giardia Cryptosporidium Balantium C. Trichomonas V.
Diagnosis Trophozoites or cysts in stool Trophozoites or cysts in stool Acid fast oocysts Trophozoites or cysts in stool Motile trophozoites
Fever
Fever Spike
Vivax
Benign 3 degrees
48h
Enlarged Host Cell
Ovale
Benign 3 degrees
48h
Oval/Jagged
Malariae
4 degrees of Malarial
72hrregular
Crescent
Falciparum
Malignant 3 degrees
Miscellaneous 1. Fastest growing tumor – Burkitt’s 2. PE’s are found in half of all autopsies 3. Courvoisier’s Law: tumors that obstruct the common bile duct cause enlarged gallbladders, but obstructing gallstones do not (too much scarring), so if you can palpate the gallbladder you’e probably looking at cancer. 4. Only DNA virus to replicate in cytoplasm: Pox 5. Only RNA virus to replicate in nucleus: Influenza 6. Bacillus anthracis has the only protein capsule 7. Bordetella pertussis (Whooping Cough) elicits lymphocytosis rather than granulocytosis 8. Bronchioalveolar carcinomas grow without destroying the normal architecture of the lung 9. Cryptococcus neoformans often lacks a capsule and, when stained with GMS, looks just like Pneumycistis carinii , except that Cryptococcus lacks the prominent nucleoli. 10. Weil Felix reaction: (+)R. rickettssi & (+)Proteus vulgaris & P. mirabilis 11. Treponema pallidum (Syphilis) tests: 1)VDRL 2)FTA-Abs: most widely used 3)TPI (immobilization test – most expensive but the Gold Standard) Cytokine IL 1 IL 2 IL 3 IL 4 IL 5 IL 6 IFN α IFN β IFN gamma TNF α TNF β
Source 12. Monocytes, macrophages 13. Macrophages, T & NK cells 14. T cells 15. T cells 16. T cells 17. T cells, monocytes 18. B cells, macrophages 19. Fibroblasts 20. T & NK cells 21. Macrophages, T & NK cells 22. T cells
Function Stimulates T cell proliferation & IL2 produciton Stim prolif of B, T & NK cell GF of tissue mast cells & hematopoietic stem cells ↑ growth of B & T cells/ ↑ HLA II Ags Maturation of B ! plasma cell Maturation of B & T cell/ (-) fibroblasts Antiviral activity Antiviral activity Antiviral activity, (+) macrophages, ↑ HLA II Ags T cell prolif, IL 2 prod, cytotoxicity T cell prolif, IL 2 prod, cytotoxicity
Tumor Suppressor Genes Genes VHL APC WT-1
Chrom. Associated Tumors 3p Von Hippel Lindau, Renal Cell CA 5p Familial adenomatous polyposis, Colon CA 11p Wilm’s tumor Page 34
Rb BRCA-2 p53 NF-1 BRCA-1 DCC DPC NF-2
13q 13q 17p 17q 17q 18q 18q 22q
Retinoblastoma, Osteosarcoma Breast CA Most human Cas Neurofibromatosis type 1 Breast CA, Ovarian CA Colon & Stomach CA Pancreatic CA Neurofibromatosis type 2 = bilateral acoustic neuroma
Physiology Equations Resistance in Series: Add all Resistance in Parallel: Invert the answer RENAL:
Filtration Fraction =
GFR
GFR: Glomerular Filtration Rate RPF: Renal Plasma Flow
RPF
Filtered Load = GFR x [Conc]
Clearance =
Excretion Rate = [Urine] x VelUrine
[Urine] xVel (Urine) [ Plasma]
Renal Blood Flow =
or
Excretion
Clearance of PAH = [ERPF]
[ Plasma]
ERPF
Free Water Clearance = VelUrine -
1 − Hct
ERPF: Eff renal plasma flow
Urine(osm) xVel (urine) P (osm)
CARDIO:
CO = HR x SV
CO =
O 2(consumed ) PulmonaryA − VO 2difference
MAP = Diastolic + 1/3 Pulse Pressure
CO =
MAP TPR
Pulse Pressure = Systolic – Diastolic
MAP = TPR x CO
F=
P 1 − P 2 R
LUNGS:
PAO2 = (760 – 47) FO2 -
PACO2 R
Where: FO2 = [O2]
PACO2 = Alv. Press. Of CO2
R = Resp. Exchange Ratio
Page 35
CO 2 produced O 2consumed
≅ .8 or 1
