IVMS Cell Biology and Pathology Flash Facts 2

Cell Biology and Pathology Flash Facts
Q2501:toxicity of K-sparing diuretics?
5001
hyperkalemia; antiandrogenic effects
5002
Q2502:mechanism of ACE inhibitors?
5003
inhibit ACE; reducing angiotensin II and preventing inactivation of bradykinin. Results in increased renin release
5004
Q2503:major toxicities of ACE inhibitors?
5005
cough; increased renin; hyperkalemia
5006
Q2504:What are the ACE inhibitors?
5007
Captopril; Enalapril; Lisinopril
5008
Q2505:mechanism of Losartan
5009
angiotensin II receptor inhibitor (does not produce cough)
5010
Q2506:What are podocytes?
5011
visceral epithelial cells
5012
Q2507:What are the spaces between the podocytes called?
5013
split pores
5014
Q2508:Which cells synthesis the glomerular BM?
5015
visceral epithelial cells (podocytes)
5016
Q2509:What keeps albumin out of urine?
5017
strong negative charge of Glomerular BM
5018
Q2510:What is responsible for charge of GBM?
5019
Heparan Sulfate (strong negative charge)
5020
Q2511:damage to visceral epithelial cell results in what?
5021
damage to BM and leaking of albumin into urine --> nephrotic syndrome
5022
Q2512:linear pattern outlining BM on Immunofluorescence
5023
goodpasture syndrome
5024
Q2513:subendothelial immune complex deposits in glomeruli on EM (granular)
5025
lupus
5026
Q2514:subepithelial immune complex deposits in glomeruli EM (granular)
5027
post-strep glomerulonephritis
5028
Q2515:only glomerulonephritis one can diagnose with IF
5029
IgA glomerulonephritis
5030
Q2516:granular pattern on IF. what does it mean?
5031
immunocomplex type III disease
5032
Q2517:anti BM antibodies is what type of immune complex disease?
5033
Type II
5034
Q2518:RBC casts in urine is unique to what class of diseases
5035
nephritic syndromes
5036
Q2519:serum ANA shows rim pattern. what does that mean?
5037
anti-DNA --> lupus
5038
Q2520:crescentic glomerulonephritis is most commonly seen in what syndrome?
5039
goodpasture's syndrome
5040
Q2521:cholesterol casts in urine that when polarized look like maltese crosses. what is the diagnosis?
5041
nephrotic syndrome
5042
Q2522:why does lipoid nephrosis occur (Minimal change disease)?
5043
loss of negative charge of GBM
5044
Q2523:Nephrotic syndrome associated with HIV
5045
FSGS
5046
Q2524:glomerular problem in HBV
5047
diffuse membraneous glomerulonephritis
5048
Q2525:glomerular problem in HCV
5049
Membranoproliferative glomerulonephritis
5050
Q2526:vasculitis associated with HBV
5051
polyarteritis nodosa
5052
Q2527:large golf-ball appearing glomeruli on H&E
5053
diabetic nephropathy
5054
Q2528:what happens to the GFR and creatinine clearance in early diabetic nephropathy?
5055
hyalinization of efferent arterioles; so Cr clearance and GFR increase. Also nonenzymatic glycosylation of BM cause microalbuminuria
5056
Q2529:ACE inhibitors do what to glomerular arterioles?
5057
less angiotensin II dilates efferent arteriole
5058
Q2530:mesangial cells split BM on EM. C3 deposited adjacent to but not within dense deposits. serum C3 is very low. what is the diagnosis?
5059
Type II membranoproliferative glomerulonephritis
5060
Q2531:properties of BUN
5061
blood urea nitrogen - secreted and reabsorbed in PCT
5062
Q2532:properties of Creatinine
5063
end-product of creatine - only filtered in kidney; neither reabsorbed nor secreted in kidney (can be in other places in very high levels)
5064
Q2533:normal BUN and Cr levels
5065
BUN - 9-10;Cr - 1 mg/dl
5066
Q2534:normal BUN/Cr
5067
10
5068
Q2535:pre-renal azotemia
5069
normal kidneys; but reduced Cardiac Output (e.g. CHF); ergo; GFR decreases. BUN/Cr >15
5070
Q2536:renal failure (oliguria; renal tubular casts)
5071
affects BUN and Cr equally (increased BUN and Cr in equal proportion) BUN/Cr normal (10/1)
5072
Q2537:most common cause of acute renal failure
5073
ischemic acute tubular necrosis
5074
Q2538:Cardiac output decreases and oliguria; what do you worry about most?
5075
ischemic acute tubular necrosis
5076
Q2539:most common cause of ischemic acute tubular necrosis
5077
not treating pre-renal azotemia
5078
Q2540:BUN:Cr ~ 10:1 with oliguria and renal tubular casts
5079
acute tubular necrosis
5080
Q2541:Why does acute tubular necrosis have such a bad diagnosis?
5081
ischemic cause also destroys basement membrane --> loss of structure --> can't regenerate renal tubular cell w/o BM. Even if one recovers; can never recover normal function
5082
Q2542:What parts of nephron is most susceptible to ischemia?
5083
straight portion of proximal tubule and thick ascending limb (medullary part). Affects Na/K/Cl co-transport
5084
Q2543:Nephrotoxic drugs;what are they and where do they affect? prognosis?
5085
gentamicin (aminoglycocides); dye from IV pyelograms; damages proximal tubule. prognosis good because they don't damage BM.
5086
Q2544:How do you separate pyelonephritis from low UTIs?
5087
acute pyelonephritis is infection of kidney proper and has fever with flank pain (CVA tenderness) and WBC casts
5088
Q2545:what is the mechanism of all UTIs
5089
ascending infection from introitus of urethra.
5090
Q2546:scarred kidney with blunted calyces (beneath scarring)
5091
chronic pyelonephritis
5092
Q2547:fever with rash; oliguria; eosinophiluria after starting drug
5093
acute drug-induced interstitial nephritis (methicillin)
5094
Q2548:what kinds of hypersensitivity are associated with acute drug-induced interstitial nephritis?
5095
combination of type I and type IV hypersensitivities
5096
Q2549:empty space on IV pyelogram
5097
analgesic nephropathy from acetaminophen and aspirin combo therapy long-term
5098
Q2550:what is the mechanism of analgesic nephropathy?
5099
acetaminophen --> produces free radicals that damage tubular cells of medulla;aspirin blocks PGE2 so Angiotensin II is unopposed and peritubular capillaries have decreased blood flow causing ischemia in renal papillaries
5100
Q2551:causes of renal papillary necrosis
5101
aspirin/acetaminophen long-term; diabetes; sickle-cell disease; acute pyelonephritis (from abscess formation)
5102
Q2552:BUN/Cr >10 for more than 3 months. what is the diagnosis?
5103
Chronic renal failure
5104
Q2553:results of chronic renal failure
5105
anemia; anion-gap metabolic acidosis; osteoporosis; osteomalacia; secondary hyperparathyroidism
5106
Q2554:uncontrolled essential hypertension (over ten years) causes what?
5107
nephrosclerosis --> hyaline arteriolosclerosis (cobblestone appearance of kidney)
5108
Q2555:person with uncontrolled HTN; wakes up with bad HA; dizzy; blurred vision; BP 240/140; papilledema and flamed hemorrhages; hard and soft exudates; BUN/Cr 80/8. what is diagnosis?
5109
malignant hypertension (shows petechia visible on surface of kidney)
5110
Q2556:Treatment of malignant hypertension?
5111
IV nitroprusside
5112
Q2557:pale; depressed-looking lesions on gross examination of kidney. what do you see on LM?
5113
pale infarction --> coagulation necrosis
5114
Q2558:causes of pale infarcts in kidneys in a patient with irregular irregular pulse?
5115
A-fib; causes thromboemboli
5116
Q2559:little white dots and microabscesses on gross exam of kidneys probably caused by what?
5117
pyelonephritis
5118
Q2560:hydronephrosis and increased pressure have what affect on renal cortex and medulla?
5119
compression atrophy
5120
Q2561:staghorn calculi; alkaline urine and smells of ammonia; what is the cause?
5121
urease (+) bacteria: proteus; klebsiella; staph
5122
Q2562:most common cause of compression atrophy?
5123
stone
5124
Q2563:what is the composition of staghorn calculi
5125
magnesium ammonium phosphate
5126
Q2564:mass in kidney adult what is it?
5127
renal adenocarcinoma
5128
Q2565:mass in kidney in kid with hypertension?
5129
wilm's tumor
5130
Q2566:cause of renal adenocarcinoma?
5131
derived from proximal tubule; most common cause is smoking
5132
Q2567:what are results of renal adenocarcinoma?
5133
produce ectopic EPO; PTH-like peptide; and like to invade renal vein
5134
Q2568:why hypertension in kid with Wilm's tumor?
5135
the tumor makes renin
5136
Q2569:findings in Wilm's tumor?
5137
embryonic kidney structures; aniridia and hemi-hypertrophy of an extremity --> sign that Wilm's tumor has genetic basis
5138
Q2570:genetic abnormality in Wilm's tumor?
5139
WT-1 tumor-suppressor gene on chrom 11. AD
5140
Q2571:most common organism in cystitis?
5141
E. coli
5142
Q2572:patient with increased urinary frequency; has positive leukocyte esterase; dysuria; neutrophils in urine; negative bacterial culture; negative nitrites. what is diagnosis?
5143
Chlamydia
5144
Q2573:causes of sterile pyuria?
5145
chlamydia; TB
5146
Q2574:most common cause of transitional cell carcinoma of bladder?
5147
smoking
5148
Q2575:cyclophosphamide is used to treat what?
5149
Wegener's
5150
Q2576:cyclophosphamide toxicity is prevented by what?
5151
Mesna
5152
Q2577:hypospadias is caused by what?
5153
failure of closure of urethral folds
5154
Q2578:most common cancer of penis is what? What is most common cause?
5155
squamous cell carcinoma due to lack of hygiene in uncircumcised penis. (shmegma)
5156
Q2579:what are two phases of testicular descent?
5157
tans-abdominal migration caused by mullerian inhibitory factor; and shortening of gubernaculum due to testosterone and dihydrotestosterone
5158
Q2580:undescended testicles before 2 years increased risk for what?
5159
seminomas in both testicles (even if appears normal)
5160
Q2581:streak ovaries put woman at risk for what?
5161
dysgerminomas
5162
Q2582:epididymitis at age <35 due to what?
5163
neisseria gonorrhea; chlamydia
5164
Q2583:epididymitis at ages >35 due to what?
5165
pseudomonas; E. coli
5166
Q2584:vericocoeles on what side and why?
5167
left; due to the spermatic vein on left is connected to left renal vein.
5168
Q2585:most common cause of male infertility
5169
vericocoele
5170
Q2586:what would happen if you block left renal vein?
5171
increases pressure on spermatic vein and causes vericocoele.
5172
Q2587:torsion of spermatic cord causes what?
5173
shortens the cord; so the testicle ascends into inguinal canal; pain; loss of cremasteric reflex
5174
Q2588:what is cremasteric reflex?
5175
scratching of scrotum causes the cremaster muscle to contract
5176
Q2589:hydrocoele is what?
5177
persistence of tunica vaginalis
5178
Q2590:painless enlargement of testicle has what on it's differential?
5179
cancer; cancer; cancer; cancer
5180
Q2591:most common cause of testicular cancer
5181
seminoma --> highly responsive to radiation
5182
Q2592:where do seminomas metastacize?
5183
para-aortic LNs
5184
Q2593:most common testicular tumor in kid? what's the tumor marker?
5185
yolk sac tumor (Alpha fetoprotein)
5186
Q2594:25 y/o male presents with unilateral gynecomastia and dyspnea. X-ray of lung shows numerous nodular masses. Where is the primary tumor and what kind?
5187
choriocarcinoma of testicle
5188
Q2595:why do choriocarcinomas develop gynecomastia?
5189
B-HCG is a leutinizing hormone analog --> acts like leutenizing hormone; so stimulates progesterone and causes duct growth in breast tissue
5190
Q2596:most common cause of testicular cancer in older men?
5191
malignant lymphoma metastaces
5192
Q2597:where in prostate gland does hyperplasia occur?
5193
periurethral area
5194
Q2598:where in prostate gland is cancer located?
5195
periphery (that's why you can feel it with your finger on rectal)
5196
Q2599:75 y/o man has urinary retention and massive bladder with dribbling urine. what is cause?
5197
BPH.
5198
Q2600:what hormone is totally responsible for prostate?
5199
dihydrotestosterone
5200
Q2601:BPH and prostate cancer is under the control of what hormone?
5201
dihydrotestosterone
5202
Q2602:how do you treat prostate cancer and BPH
5203
5-alpha-reductase inhibitor
5204
Q2603:most common cancer in men?
5205
prostate cancer
5206
Q2604:What is prerenal azotemia?
5207
selective rise in BUN during early renal failure
5208
Q2605:Define segmental. (kidney pathology)
5209
involving part of the glomerular tuft
5210
Q2606:hematuria; hypertension; oliguria; azotemia = ?
5211
Nephritic Syndrome; "I" = inflammation
5212
Q2607:LM findings in post-strep glomerulonephritis?
5213
lumpy bumpy and hypercellular w/ neutrophils
5214
Q2608:EM findings in post-strep glomerulonephritis?
5215
subepithelial humps (from deposition of cationic antigen)
5216
Q2609:IF findings in post-strep glomerulonephritis?
5217
granular
5218
Q2610:Goodpasture's is what type of hypersensistivity?
5219
type II (IgG binding directly to BM)
5220
Q2611:Goodpasture's IF?
5221
linear
5222
Q2612:Symptoms of Goodpasture's?
5223
hemoptysis; hematuria
5224
Q2613:Membranoproliferative glomerulonephritis EM?
5225
subendothelial humps; "tram track"
5226
Q2614:Course of crescentic glomerulonephritis?
5227
rapid (the Red Crescent is the Islamic Red Cross; an organization that provides relief during emergencies; like crescentic glomerulonephritis)
5228
Q2615:Course of Membranoproliferative glomerulonephritis?
5229
slow
5230
Q2616:IgA nephropathy IF and EM?
5231
mesangial deposits of IgA (Mes"A"ngium)
5232
Q2617:Which can be post infectious; IgA nephropathy or Goodpasture's?
5233
IgA nephropathy
5234
Q2618:Signs of nephrotic syndrome?
5235
massive proteinuria; hypoalbuminemia; generalized edema; hyperlipidemia (think "erotic" = an erection(edema) and ejaculate(massive proteinuria)
5236
Q2619:LM of membranous glomerulonephritis?
5237
diffuse capillary and basement membrane thickening
5238
Q2620:IF of membranous glomerulonephritis?
5239
granular
5240
Q2621:EM of membranous glomerulonephritis?
5241
spike and dome ("if you have a spike in your dome; you must be insane in the "membran"e;" -Chirag)
5242
Q2622:Minimal change disease EM?
5243
foot process effacement
5244
Q2623:Most common cause of childhood nephrotic syndrome?
5245
minimal change disease
5246
Q2624:Focal segmental glomerular sclerosis LM?
5247
segmental sclerosis and hyalinosis
5248
Q2625:Diabetic nephropathy LM?
5249
Kimmelstiel-Wilson lesions
5250
Q2626:SLE (5 patterns of renal involvement) LM?
5251
wire-loop appearance w/ extensive granular BM depsits in membranous glomerulonephritis pattern
5252
Q2627:What is the most common kidney stone?
5253
Calcium (with either oxalate of phosphate)
5254
Q2628:What kidney stone is associated with a bacterial infection?
5255
Ammonium magnesium phosphate (struivte) stones are associated with urase positive bugs that make ammonium
5256
Q2629:What are the two most common stone-forming bacteria?
5257
proteus vulgaris and Staph.
5258
Q2630:What stones are associated with gout?
5259
Uric acid stones
5260
Q2631:What else can cause uric acid stones?
5261
Any disease with high cell turnover (remember that uric acid is a by-product of DNA formation); so leukemia and myeloproliferative disease
5262
Q2632:What stones are associated with cystineuria?
5263
cystine stones
5264
Q2633:What two stones are radiolucent?
5265
Uric acid and cystine (the two purely metabolic causes)
5266
Q2634:What are the complications of stones?
5267
Hydronephrosis and pyelonephritis
5268
Q2635:What causes calcium stones?
5269
Anything that increases calcium in the blood; so high PTH; malignancy (bone breakdown; PTH production); vitamin D overdose.
5270
Q2636:Renal Cell Carcinoma: Is this a common renal cancer?
5271
Yes; the most common
5272
Q2637:Renal Cell Carcinoma: Who is prone to this?
5273
males; ages 50-70; smokers; gene deletions on chromosome 3
5274
Q2638:Renal Cell Carcinoma: This is a cancer of what cell type?
5275
renal tubule cells; histologically they appear clear.
5276
Q2639:Renal Cell Carcinoma: What are the clinical signs of this cancer?
5277
flank pain; fever; hematuria; palpable mass; secondary polycythemia
5278
Q2640:Renal Cell Carcinoma: How does it spread?
5279
It invades the renal veins and IVC; to spread hematogenously
5280
Q2641:Renal Cell Carcinoma: What hormones can it produce?
5281
ACTH; prolactin; Parathyroid-like hormone; gonadotropins and renin.
5282
Q2642:Wilm's Tumor: Who gets this cancer?
5283
Children 2-4 years
5284
Q2643:Wilm's Tumor: Is it common?
5285
The most common renal cancer in children
5286
Q2644:Wilm's Tumor: What is the chromosomal abnormality that leads to this?
5287
deletion of tumor suppressor gene WT1 on chromosome 11
5288
Q2645:Wilm's Tumor: What tetrad is it associated with?
5289
WAGR - Wilm's; Anirida (lack of an iris); Genitourinary malformation; and Retardation
5290
Q2646:Wilm's Tumor: How does it present?
5291
huge palpable mass and hemihypertrophy
5292
Q2647:Wilm's Tumor: What is the histological appearance?
5293
mixed - with stromal; mesenchymal; tubular; glomerular and fibrous elements
5294
Q2648:Transitional Cell Carcinoma: Where does this cancer occur?
5295
Urinary spaces (tract; calyces; pelvis; bladder)
5296
Q2649:Transitional Cell Carcinoma: Does it recur?
5297
yes; often
5298
Q2650:Transitional Cell Carcinoma: How does it spread?
5299
Local invasion
5300
Q2651:Transitional Cell Carcinoma: What can predispose you to it?
5301
Pee SAC toxins - Phenacetin; Smoking; Aniline dye (benezenes); and Cyclophsophimide.
5302
Q2652:Transitional Cell Carcinoma: How does it present?
5303
Hematuria
5304
Q2653:Dx;Bilateral renal Agenesis; limb deformities; facial deformities; pulmonary hypoplasia; oligohydraminos
5305
Potter's syndrome;[Potters can't Pee in utero]
5306
Q2654:where does a horseshoe kidney fuse?;what does it get trapped under?
5307
Fuse: Inferior poles;trapped under;Inferior Mesenteric Artery
5308
Q2655:Cast in urine;RBC cast;(3)
5309
Nephritic syndromes;;Ischemia;;Malignant HTN
5310
Q2656:Cast in urine;WBC casts
5311
Acute Pyelonephritis
5312
Q2657:Cast in urine;Granular casts
5313
Acute Tubular Necrosis
5314
Q2658:Cast in urine;Waxy cast
5315
Chronic Renal Failure
5316
Q2659:what is seen in urine w/ acute cystitis?;Bladder CA?
5317
Cystitis = WBCs;;Bladder CA = RBCs
5318
Q2660:Definition;Hypoalbuminemia; Edema; Hyperlipidemia; massive Proteinuria
5319
Nephrotic syndrome
5320
Q2661:(6) Nephrotic syndromes
5321
Membranous Glomerulonephritis;Minimal change;Focal Segmental Glomerular sclerosis;Diabetic Nephropathy;Renal amyloidosis;SLE nephropathy
5322
Q2662:Definition;Oliguria; Azotemia; HTN; hematuria; RBC casts
5323
Nephritic syndromes
5324
Q2663:Nephritic syndrome;"lumpy-bumpy" LM; subepithelial humps; granular pattern
5325
Acute Poststrep Glomerulonephritis
5326
Q2664:Nephrotic syndrome;granular pattern w/ "spike and dome" on EM
5327
Membranous GN
5328
Q2665:Nephritic syndrome commonly seen in children w/ pre-orbital and peripheral edema
5329
Acute Poststrep GN
5330
Q2666:MC type of kidney stone
5331
Calcium
5332
Q2667:Radiopaque Kidney stone caused by infection and cause staghorn calculi;(3) bugs causing stones
5333
Ammonium Magnesium Phosphate;(Struvite stones);Bugs;Proteus;Staph;Klebsiella
5334
Q2668:Kidney stone seen w/ leukemia and myeloproliferative disorders
5335
Uric acid stone
5336
Q2669:Dx;nephritis; nerve deafness; lens dislocation or cataracts
5337
Alport syndrome
5338
Q2670:Nephritic syndrome;splitting of the lamina densa
5339
Alport syndrome
5340
Q2671:(3) causes of renal Papillary Necrosis
5341
Diabetes;Acute Pyelonephritis;Chronic Phenacetin/NSAID use
5342
Q2672:when is the most critical time for Acute Tubular necrosis?;why?
5343
Initial Oliguric phase;can cause cardiac arrest from HyperK
5344
Q2673:(3) causes of Acute Tubular Necrosis
5345
Renal Ischemia;Crush injury;Toxins
5346
Q2674:Dx;PCT reabsorption defect leading to protein and glucose in the urine w/ systemic acidosis
5347
Falconi syndrome
5348
Q2675:Definition;Impaired tubular reabsorption of Tryptophan leading to Pellagra-like symptoms
5349
Hartnup Dz
5350
Q2676:Dx;coarse and asymmetric corticomedullary scarring of kidney; interstitial fibrosis; tubular atrophy; thyroidization; eosinophilic casts
5351
Chronic Pyelonephritis
5352
Q2677:(3) tests to look for to determine patient has Pre-Renal ARF;(and results)
5353
Urine Osmolality;(>500);Urine Na;(<10);FeNa;(<1%)
5354
Q2678:What test is good to Dx Intrarenal ARF?
5355
BUN/creatinine ratio < 15
5356
Q2679:(2) tests to help Dx Post-renal ARF
5357
Urine Na;(>40);FeNa;(>4)
5358
Q2680:Dx;flank pain; palpable mass; hematuria
5359
Renal cell CA
5360
Q2681:what cell has cancer in Renal cell CA?;what ectopic hormones can be produced?;(4)
5361
Polygonal Clear Cell;hormones;EPO; ACTH; PTH; Prolactin
5362
Q2682:(4)* causes of Transitional cell CA of bladder
5363
Pee SAC;Phenacetin;;Smoking;;Anline dyes;;Cyclophosphamide
5364
Q2683:Dx;child with Aniridia; GU malformation; Retardation; flank mass
5365
Wilms Tumor - MC kidney tumor of kids;(WT1 on chrom 11);WAGR complex
5366
Q2684:What is the primary disturbance in Metabolic acidosis?
5367
a decrease in bicarbonate
5368
Q2685:What is the compensation?
5369
A drop in CO2 by hyperventilation
5370
Q2686:What are common causes?
5371
diabetic ketoacidosis (production of ketone acids); diarrhea (loss of GI bicarb); salisylate overdose; acetazoleamide (diuretic) OD; lactic acidosis; renal failure (can't excrete organic acids); ethylene glycol ingestion
5372
Q2687:What is the primary disturbance in respiratory acidosis?
5373
A build-up in CO2
5374
5375
Increased bicarb reabosrobtion from the kidney
5376
Q2689:What are some common causes?
5377
COPD; airway obstruction; opiates and sedatives; guillan-barr or ALS;
5378
Q2690:What is the primary disturbance in metabolic alkalosis?
5379
increased bicarbonate
5380
5381
Increased CO2 by decreased respiration
5382
5383
Vomiting; hyperaldosteronism (increased H+ secretion); loop or thiazide diuretics (volume contraction)
5384
Q2693:What is the primary disturbance in respiratory alkalosis?
5385
A drop in CO2
5386
5387
increased excretion of bicarb by the kidney
5388
5389
hyperventilation; high altitude; pneumonia and pulmonary embolus (hypoxemia causes hyperventilation_
5390
Q2696:What is the Henderson Haselbach equation?
5391
pH = pKa + Log (HCO3-)/(.03*pCO2)
5392
Q2697:Is there an awesome graph on page 277 that you should know?
5393
Yes
5394
Q2698:Low pH; low pCO2 (low HCO3-)
5395
metabolic acidosis
5396
Q2699:Low pH; high pCO2 (high HCO3-)
5397
chronic respiratory acidosis
5398
Q2700:High pH; low pC02 (low HC03-)
5399
acute respiratory alkalosis
5400
Q2701:High pH; high pCO2 (high HCO3-)
5401
metabolic alkalosis
5402
Q2702:pH < 7.4
5403
acidosis
5404
Q2703:pH > 7.4
5405
alkalosis
5406
Q2704:Within acidosis: P (CO2) > 40
5407
Respiratory acidosis
5408
Q2705:Within acidosis: Hypoventilation or Hyperventilation
5409
HYPO
5410
Q2706:Within acidosis: Causes
5411
chronic lung disease; Acute lung disesae; Drugs (opioids; narcotics; sedatives); Weakening of Resp. muscles
5412
Q2707:Within acidosis: P (CO2) < 40
5413
Metabolic acidosis with compensation
5414
Q2708:Within acidosis: What should you do next?
5415
Check Anion Gap
5416
Q2709:Within acidosis: What is the normal anion gap?
5417
8-12 mEq/L
5418
Q2710:Within acidosis: Increased Anion Gap - 4 Causes
5419
Renal Failure; Lactic acidosis; Ketoacidosis; Aspirin ingestion
5420
Q2711:Within acidosis: Normal anion gap (4)
5421
Diarrhea; Sniffin' Glue; Renal Tubular acidosis; Hyperchloremia
5422
Q2712:pH > 7.4 pH > 7.4
5423
alkalosis
5424
Q2713:pH > 7.4 pCO2 < 40
5425
Respiratory alkalosis
5426
Q2714:pH > 7.4 Causes (2)
5427
HYPERventilation; aspirin ingestion (early)
5428
Q2715:pH > 7.4 pCO2 > 40
5429
metabolic alkalosis w/ compensation
5430
Q2716:pH > 7.4 Causes (4)
5431
vomiting; diuretic use; antacid use; hyperALDOsteronism
5432
Q2717:Anion gap acidosis: How do you calculate it
5433
Na - Cl - HCO3
5434
Q2718:Anion gap acidosis: What is normal?
5435
8-12 mEq/L
5436
Q2719:Anion gap acidosis: What is the mnemonic
5437
MUD PILES
5438
Q2720:Anion gap acidosis: M
5439
Methanol
5440
Q2721:Anion gap acidosis: U
5441
Uremia
5442
Q2722:Anion gap acidosis: D
5443
DKA
5444
Q2723:Anion gap acidosis: P
5445
Paraldehyde or Phenformin
5446
Q2724:Anion gap acidosis: I
5447
Iron tablets or INH
5448
Q2725:Anion gap acidosis: L
5449
Lactic Acidosis
5450
Q2726:Anion gap acidosis: E
5451
Ethanol; Ethylene Glycol
5452
Q2727:Anion gap acidosis: S
5453
Salicylates
5454
Q2728:Acid Base Compensations: Metabolic acidosis
5455
pCO2 = 1.5(HCO3) + 8 +/- 2
5456
Q2729:Acid Base Compensations: Metabolic alkalosis
5457
pCO2 increases 0.7 mm Hg per 1 mEq/L HCO3 increase
5458
Q2730:Acid Base Compensations: Respiratory acidosis (acute)
5459
HCO3 increases by 1 mEq/L for every 10 mmHg increase of pCO2
5460
Q2731:Acid Base Compensations: Respiratory acidosis (chronic)
5461
HCO3 increases by 3.5 mEq/L for every 10 mmHg increase of pCO2
5462
Q2732:Acid Base Compensations: Respiratory alkalosis (acute)
5463
HCO3 decreases by 2 mEq/L for every 10 mmHg decrease of pCO2
5464
Q2733:Acid Base Compensations: Respiratory alkalosis (chronic)
5465
HCO3 decreases by 5 mEq/L for every 10 mmHg decrease of pCO2
5466
Q2734:The deep inguinal ring lies lateral or medial to the inferior epigastric artery?
5467
Lateral
5468
Q2735:What is unusual about Chlamydia's cell wall?
5469
Lacks muramic acid
5470
Q2736:Symptoms of congenital CMV infection?
5471
Hepatosplenomegaly; periventricular brain calcification; petechial hemorrhages; and hydrops;Sensorineural deafness
5472
Q2737:Induction of hemolytic anemia in G6PD deficient patients are most often caused by which medications? (make a mnemonic)
5473
Sulfonamides; nitrofurantoin; dapsone; primaquine; and quinine
5474
5475
Lacks muramic acid
5476
5477
Lacks muramic acid
5478
Q2740:Induction of hemolytic anemia in G6PD deficient patients are most often caused by which medications? (make a mnemonic)
5479
Sulfonamides; nitrofurantoin; dapsone; primaquine; and quinine
5480
Q2741:Intranuclear inclusion bodies surrounded by halos?
5481
CMV - "owl eyes"
5482
Q2742:Symptoms of congenital CMV infection?
5483
Hepatosplenomegaly; periventricular brain calcification; petechial hemorrhages; and hydrops;Sensorineural deafness
5484
Q2743:What is located about 1/2 inch above the midpoint of the inguinal ligament?
5485
Deep inguinal ring
5486
Q2744:Toxoplasma gondii is capable of crossing the placenta in which stage of it's lifecycle?
5487
Tachyzoite
5488
Q2745:What are important causes of post-gonococcal urethritis?
5489
Chlamydia; mycoplasma; and ureaplasma
5490
Q2746:Frothy yellow vaginal discharge
5491
Trichomonas
5492
Q2747:Incomplete fusion of the processus vaginalis in males leads to?
5493
Hydrocele of the spermatic cord
5494
Q2748:Pleomorphic gram-negative rods in parallel short chains causing painful ulcer on penis?
5495
Haemophilus ducreyi
5496
Q2749:This space contains the sphincter urethrae muscle and the bulbourethral gland in the male?
5497
Deep perineal space
5498
Q2750:Granulomatosis infantiseptica?
5499
Lysteria monocytogenes in pregnancy
5500
Q2751:Which STD organisms induce endocytosis by epithelial cells?
5501
Neisseria gonorrhoeae and Chlamydia
5502
Q2752:The vagina of prepubertal girls and postmenopausal women is colonized by?
5503
Colonic and skin bacteria; including staph epidermidis
5504
Q2753:Herpes simplex virus 2 lays dormant in which cells?
5505
Neurons of the sacral ganglia
5506
Q2754:The filamentous gram-positive rod produces yellow granular deposits (sulfur granules) in the areas of its tissue invasion?
5507
Actinomyces israelli
5508
Q2755:Testes determining factor does what?
5509
Causes the indifferent gonad to develop into a testis with Sertoli cells; which secrete MIF; suppressing the paramesonephric ducts; thus preventing the formation of femal internal reproductive organs
5510
Q2756:Males with hyperprolactinemia have what affect on sexual function?
5511
interference with testosterone production causing a decrease in sperm count
5512
Q2757:Hydatiform mole progresses to choriocarcinoma at a rate of?
5513
2%
5514
Q2758:What is adenomyosis?
5515
Presence of endometrial glands within the myometrkjm of the uterus in addition to their normal location in the endometrium
5516
Q2759:Most spontaneously aborted fetuses in the first trimester are due to?
5517
chromosomal abnormalities
5518
Q2760:Ovarian metastasis of a mucin-producing adenocarcinoma?
5519
Krukenberg tumor
5520
Q2761:Hydatiform moles produce high levels of?
5521
hCG
5522
Q2762:Which type of breast cancer has the best progrnosis?
5523
Tubular carcinoma
5524
Q2763:XY male born with feminized external genitalia; testes retained within the abdominal cavity and otherwise normal male internal reproductive tracts;what could cause this?
5525
5 alpha reductase deficiency
5526
Q2764:How to diagnose chronic abacterial prostatitis?
5527
>10 leukocytes per high-power field;no bacteria are isolated from cultures of prostatic secretions
5528
Q2765:Flutamide? Mechanism?
5529
Chemo;Antiandrogen; inhibits the actions of androgens in target tissues. Used in prostate cancer
5530
Q2766:Ovarian tumor - Cystic sac containing thick mucinous fluid within a thin wall;Epithelial lining shows malignant features in the absence of stromal invasion?
5531
Borderline mucinous tumor
5532
Q2767:Presence of individual adenocarcinoma cells within the squamous epithelium of the skin near the nipple?
5533
Paget disease
5534
Q2768:Uterine tumor - Well demarcated borders and a whorled pattern on cut surface
5535
Leiomyoma
5536
Q2769:Classical presentation of a germ cell tumor in a 23 year old man?
5537
Non-painful swelling of the testis
5538
Q2770:T or F? Condyloma acuminatum contains koilocytes?
5539
5540
Q2771:Most common cause of acute bacterial prostatitis?
5541
Escherichia
5542
Q2772:This drug acts by inhibiting 5 alpha reductase to treat BPH
5543
Finasteride
5544
Q2773:T or F? Maturation of germ cells within the seminiferous tubules occurs in a concentric pattern with the less mature spermatogonia near the tubule center and the mature forms near the basal lamina
5545
FALSE - the opposite
5546
Q2774:Mature teratoma;aka?
5547
Dermoid cyst
5548
Q2775:Most common causes of maternal death in preeclampsia?
5549
Cerebral hemorrhage and ARDS
5550
Q2776:Sclerosing adenosis?
5551
A type of proliferative fibrocystic disease that is often seen with other variants of fibrocystic disease. Proliferation of small ducts; distorts glands and lobules into a whorled pattern. Increased risk for breast cancer
5552
Q2777:Type of endometrium bearing long; narrow; coiled glands lined by a single layer of columnar epithelium showing regular; uniform; small nuclei and clear apical vesicles
5553
Secretory endometrium
5554
Q2778:Tumor with endodermal sinuses that resemble primitive glomeruli?
5555
Yolk sac tumor
5556
Q2779:Differentiation of the male external genitals is dependent on?
5557
Dihydrotestosterone (via action of 5 alpha reductase on testosterone)
5558
Q2780:Key differences between seminomas in men and dysgerminomas in women?
5559
1. Seminomas are most common in the fourth decade; dysgerminomas in the third decade;2. Seminomas are relatively common; while dysgerminomas are rare
5560
Q2781:These agents induce the formation of surfactant lipids in the prevention of RDS in preterm babies;
5561
Corticosteroids
5562
Q2782:Pseudomyxoma peritonei is a potential complication of this tumor?
5563
Mucinous cystadenoma
5564
Q2783:T or F? Elevation of LDH is common in seminomas.
5565
True
5566
Q2784:Koilocytotic atypia is commonly observed with infection with?
5567
HPV
5568
Q2785:Most cases of male pseudohermaphrodites are due to?
5569
Testicular feminization syndrome
5570
Q2786:Most common variant of breast adenocarcinomoa?
5571
Invasive ductal carcinoma
5572
Q2787:Which phase accounts for most of variability in the length of the menstrual cycle?
5573
Follicular phase
5574
Q2788:T or F? Basal body temperature falls precipitously a few days prior to menstruation
5575
True
5576
Q2789:Intraductal papillomas - describe the favorable pathology?
5577
Presence of fibrovascular core; and both epithelial and myoepithelial cells in thepaipllary fronds
5578
Q2790:Alpha fetoprotein is a good marker for which cancers?
5579
Non-seminomatous germ cell tumors of the testes; endodermal sinus (yolk sac) ovarian tumors; hepatocellular carcinomas
5580
Q2791:Malignant mixed mullerian tumor?
5581
Tumor with 2 components (stromal and epithelial (endometrial glands)
5582
Q2792:Maternal blood levels of ; are dependent on a viable fetus?
5583
Estrioll
5584
Q2793:This tumor; in combination with ascites and hydrothorax; is referred to as Meigs' syndrome
5585
Thecoma-fibroma
5586
Q2794:Serous paipllary cystadenocarcinomas of the ovaries express which marker?
5587
CA-125
5588
Q2795:Three stages of spermatogenesis?
5589
Spermatocytogenesis; meiosis; and spermiogenesis
5590
Q2796:What are two types of ovarian tumors that can produce large amounts of steroid hormones?
5591
Sertoli-Leydic cell tumors (testosterone); and granulosa cell tumors (estrogen)
5592
Q2797:36 y/o man with painless enlargement of right testis. Biopsy - Round nests of cells with conspicuous nucleoli and clear cytoplasm; nests are separated by delicate fibrous septa containing numerous lymphocytes;
5593
Seminoma
5594
Q2798:Causative organism of lymphogranuloma venereum?
5595
Chlamydia
5596
Q2799:Bright reddish-pink; acellular ring around the ovum?
5597
Zona pellucida
5598
Q2800:Forms of penile carcinoma in situ?
5599
Bowen's disease; Bowenoid papulosis; and erythroplasia of Queyrat
5600
Q2801:Describe the lesions of Bowenoid paulosis?
5601
Multiple reddish-brown pauplar lesions
5602
Q2802:Most cases of dysfunctional uterine bleeding are due to?
5603
Anovulatory cycles
5604
Q2803:Histology of inflammatory breast cancer?
5605
Dermal lymphatic invasion by cancer cells; can cause orange peel appearance
5606
Q2804:Koilocytic?
5607
The characteristic nuclear and cytoplasmic changes shown by squamous epithelial cells infected by HPV
5608
Q2805:Name the mutations of the following syndromes: LiFraumeni; Cowden; and ataxia-telangiectasia
5609
LiFraumeni - p53;Cowden - gene of chromosome 10;Ataxiatelangiectasia - ATM gene
5610
Q2806:Gynecomastia; golden-brown testicular tumor; large uniform cells with indistinct cell borders; and rod-shaped crystals
5611
Leydig cell tumor (crystals of Reinke)
5612
Q2807:Struma ovarii?
5613
Monodermal teratomas can develop an appearance of mature thyroid tissue
5614
Q2808:T or F? Ductal carcinoma in situ can produce Paget disease?
5615
True
5616
Q2809:The first set of lymph nodes to which lymph from the testes drain?
5617
Para-aortic nodes; near where the testicular artery arises
5618
Q2810:First event in preeclampsia is thought to be?
5619
Placental ischemia
5620
Q2811:Condyloma acuminatum
5621
Verrucous wartlike lesions on vulva; perineum; vagina and cervix associated with HPV serotypes 6 and 11
5622
Q2812:Pelvic inflammatory disease
5623
Vaginal discharge (cervicitis); vaginal bleeding (endometritis); bilateral lower abdomainal and pelvic pain (salpingitis). Caused by n. gonorrhea and/or chlamydia. Complications: tubo-ovarian abscess; tubal scarring (granulomatous inflamation) with infertility and ectopic pregnancies
5624
Q2813:Cervical cancer risk factors
5625
Early age of first intercourse; multiple sexual partners; multiple pregnancies; oral contraceptives; smokking
5626
Q2814:Cervical cancer clinical features
5627
45 years old. Asymptomatic or postcoital bleeding; dyspareunia (painful intercourse); malodorous discharge. Caused by HPV types 16; 18; 31 and 33. Precursor lesion is cervical intraepithelial neoplasia
5628
Q2815:Endometriosis
5629
Presence of endometrial glands and stroma outside the uterus in ovaries; ligaments and pouch of Douglas. Presents with chronic pelvic pain; dysmenorrhea; dyspareunia (painful intercourse); rectal pain; constipation; infertility
5630
Q2816:Endometrial carcinoma risk factors
5631
Early menarche; late menapause; nulliparity; hypertension; diabetes; anovulation; estrogen-producing tumors; estrogenreplacement therapy; endometrial hyperplasia
5632
Q2817:Endometrial carcinoma clinical features
5633
55 year old with postmenopausal vaginal bleeding
5634
Q2818:Polycystic ovarian disease
5635
Females of reproductive age; oligomenorrhea; hirsutism; infertility. Lab: elevated LH; low FSH; high testosterone. Predisposes to endometrial cancer
5636
Q2819:Ovarian cystadenocarcinoma
5637
65 year old with malignant bilateral ovarian enlargement. Risk factors: BRCA-1. Marker: CA125
5638
Q2820:Metastatic tumors to the ovary primary sites
5639
Breast; colon; endometrial; gastric "signet-cell" Krukenberg tumor
5640
Q2821:Hydatidiform mole
5641
Tumor of placental trophoblastic tissue/ Excessive uterine enlargement; vaginal bleeding; high B-HCG. Complete mole: fertilization of an ovum without chromosomes. Partial mole: fertilization by two sperms (one 23X; one 23Y)
5642
Q2822:Choriocarcinoma
5643
Malignant germ cell tumor derived from the trophoblast
5644
Q2823:Fibrocystic change presentation
5645
Bilateral painful mass in young woman with menstrual variation
5646
Q2824:Fibroadenoma
5647
Movable mass that changes with mentrual cycles
5648
Q2825:Breast carcinoma risk factors
5649
BRCA-1; BRCA-2; p53; prior breast cancer; old age; nulliparity; obesity
5650
Q2826:Breast carcinoma clinical features
5651
Solitary painless mass in old woman with nipple retraction or skin dimpling or fixation to chest wall. Calcification on mamogram. MC variation is invasive ductal carcinoma
5652
Q2827:Benign prostatic hyperplasia
5653
Decreased caliber and force of stream; urgency; frequency; nocturia; dysuria. PSA is elevated. Rx.: 5-alpha reductase inhibitor
5654
Q2828:Prostate cancer
5655
Asymptomatic or lower back pain secondary to metastasis. High PSA. Metastasis to pelvic lymph nodes and lumbar spine with high alkaline phosphatase
5656
Q2829:The Adrenal cortex derives from what embryonic tissue?
5657
Mesoderm
5658
Q2830:The Adrenal medulla derives from what embryonic tissue?
5659
Neural creast
5660
Q2831:The Adrenal Zona Glomerulosa produces what?
5661
Aldosterone
5662
Q2832:The Adrenal Zona Fasciculata produces what?
5663
Cortisol; and some sex hormones
5664
Q2833:The Adrenal Zona Reticularis produces what?
5665
Sex hormones (androgens)
5666
Q2834:The Adrenal Medulla produces what?
5667
Catecholamines (Epinephrine and Norepinephrine)
5668
Q2835:What do beta islet cells produce?
5669
Insulin
5670
Q2836:What do alpha islet cells produce?
5671
Glucagon
5672
Q2837:What do delta islet cells produce?
5673
Somatostatin
5674
Q2838:What is the neurohypophysis?
5675
Posterior pituitary
5676
Q2839:What is the adenohypophysis?
5677
Anterior pituitary
5678
Q2840:What is the posterior pituitary derived from?
5679
Neuroectoderm
5680
Q2841:What is the anterior pituitary derived from?
5681
Oral ectoderm
5682
Q2842:What anterior pituitary cells are acidophils?
5683
The ones that produce GH or prolactin
5684
Q2843:What anterior pituitary cells are basophils?
5685
"B-FLAT";The ones that produce FSH; LH; ACTH; TSH
5686
Q2844:What hormones share a common alpha-subunit?
5687
TSH; LH; FSH and hCG
5688
Q2845:What regulates TSH release?
5689
Increased by TRH;Decreased by Somatostatin
5690
Q2846:What regulates Prolactin release?
5691
Increased by TRH;Decreased by Dopamine
5692
Q2847:What regulates ACTH release?
5693
Increased by CRH
5694
Q2848:What regulates GH release?
5695
Increased by GHRH;Decreased by Somatostatin
5696
Q2849:What regulates FSH release?
5697
Increased by GnRH
5698
Q2850:What regulates LH release?
5699
Increased by GnRH
5700
Q2851:What is the most common form of congenital adrenal hyperplasia?
5701
21-beta-hydroxylase deficiency
5702
Q2852:How many carbons do mineralocorticoids have?
5703
21 carbons
5704
Q2853:How many carbons do glucocorticoids have?
5705
21 carbons
5706
Q2854:How many carbons do androgens have?
5707
19 carbons
5708
Q2855:How many carbons do estrogens have?
5709
18 carbons
5710
Q2856:Where is PTH secreted from?
5711
Chief cells of parathyroid
5712
Q2857:What is the active form of Vitamin D
5713
1;25-(OH)2 vitamin D
5714
Q2858:What is the inactivated form of Vitamin D
5715
24;25-(OH)2 vitamin D
5716
Q2859:How is Vitamin D activated?
5717
The liver converts Vitamin D to 25-OH Vitamin D(storage form) and the kidney then converts it to 1;25(OH) Vitamin D
5718
Q2860:What is the storage form of Vitamin D?
5719
25-OH Vitamin D
5720
Q2861:Where is calcitonin secreted from?
5721
Parafollicular cells(C cells) of thyroid
5722
Q2862:What is the role of calcitonin?
5723
Oppose the actions of PTH;Secreted when serum Ca increases and it decreases bone resorption of calcium
5724
Q2863:What hormones are steroid hormones?
5725
"PET CAT";Progesterone; Estrogen; Testosterone; Cortisol; Aldosterone; Thyroxine and T3
5726
Q2864:Secretion and cell type of;Somatotrope cells
5727
Secretes GH;Acidophil
5728
Q2865:Secretion and cell type of;Mammotrope cells
5729
Secretes Prolactin;Acidophil
5730
Q2866:Secretion and cell type of;Corticotrope cells
5731
Secretes ACTH;Basophil
5732
Q2867:Secretion and cell type of;Gondadotrope cells
5733
Secretes LH & FSH;Basophil
5734
Q2868:Secretion and cell type of;Thyrotrope cells
5735
Secretes TSH;Basophil
5736
Q2869:What is the main form of thyroid hormone secreted by the thyroid?
5737
T4-Tetraiodothyronine
5738
Q2870:What is the most active form of thyroid hormone?
5739
T3-Triiodithyronine
5740
Q2871:What condition leads to increased Thyroxine-binding globulin(TBG)?
5741
Pregnancy;Increased estrogen leads to increased TBG
5742
Q2872:What condition leads to decreased Thyroxine-binding globulin(TBG)?
5743
Hepatic failure
5744
Q2873:What is Conn's syndrome?
5745
Primary hyperaldosteronism- an aldosterone secreting tumor
5746
Q2874:What is the most common tumor of the adrenal medulla in adults?
5747
Pheochromocytoma
5748
Q2875:What is the most common tumor of the adrenal medulla in children?
5749
Neuroblastoma
5750
Q2876:What is a/w pheochromocytomas?
5751
Neurofibromatosis; MEN types II & III
5752
Q2877:What is Wermer's syndrome?
5753
MEN type I
5754
Q2878:What is Sipple's Syndrome?
5755
MEN type II
5756
Q2879:Which type of MEN?;Pancreatic; parathyroid & pituitary tumors
5757
MEN type I
5758
Q2880:Which type of MEN?;Medullary carcinoma of the thyroid; pheochromocytoma & parathyroid tumors
5759
MEN type II
5760
Q2881:Which type of MEN?;Medullary carcinoma of the thyroid; pheochromocytoma; & oral & intestinal ganglioneuromatosis
5761
MEN type III
5762
Q2882:Which thyroid cancer?;Most common
5763
Papillary carcinoma of the thyroid
5764
Q2883:Which thyroid cancer?;"Ground-glass" nuclei
5765
5766
Q2884:Which thyroid cancer?;From parafollicular "C cells"
5767
Medullary carcinoma of the thyroid
5768
Q2885:Which thyroid cancer?;Produces calcitonin
5769
5770
Q2886:Which thyroid cancer?;a/w MEN types II & III
5771
5772
Q2887:Which thyroid cancer?;usually only in older patients
5773
Undifferentiated/anaplastic cancer of the thyroid
5774
Q2888:Which thyroid cancer?;a/w Hashimoto's thyroiditis
5775
Lymphoma of the thyroid
5776
Q2889:ret gene mutations are a/w what?
5777
MEN types II & III
5778
Q2890:Type I or Type II DM?;Viral or Immune destruction of beta-cells
5779
Type I DM
5780
Q2891:Type I or Type II DM?;a/w HLA-DR3 & DR4
5781
Type I DM
5782
Q2892:Type I or Type II DM?;Ketoacidosis more common
5783
Type I DM
5784
Q2893:Type I or Type II DM?;"Classic" symptoms of Diabetes more common
5785
Type I DM;Classic symptoms-polyuria; polydipsia; thirst; weight loss
5786
Q2894:Type I or Type II DM?;a/w obestity
5787
Type II DM
5788
Q2895:Type I or Type II DM?;Strong genetic predisposition
5789
Type II DM
5790
Q2896:What drug class?;Lispro
5791
Insulin- short acting
5792
Q2897:What drug class?;NPH
5793
Insulin-intermediate acting
5794
Q2898:What drug class?;Lente
5795
Insulin-long acting
5796
Q2899:What drug class?;Tolbutamide
5797
First generation sulfonylurea
5798
Q2900:What drug class?;Chlorpropamide
5799
5800
Q2901:What drug class?;Glyburide
5801
Second generation sulfonylurea
5802
Q2902:What drug class?;Glimepiride
5803
5804
Q2903:What drug class?;Glipizide
5805
5806
Q2904:What drug class?;Metformin
5807
Biguanides
5808
Q2905:What drug class?;Pioglitazone
5809
Glitazones
5810
Q2906:What drug class?;Rosiglitazone
5811
Glitazones
5812
Q2907:What drug class?;Acarbose
5813
alpha-glucosidase inhibitors
5814
Q2908:What drug class?;Miglitol
5815
5816
Q2909:What diabetes drug type is;Lispro
5817
Short-Acting Insulin
5818
Q2910:What diabetes drug type is;Insulin
5819
Short-Acting Insulin
5820
Q2911:What diabetes drug type is;NPH
5821
Intermediate-Acting Insulin
5822
Q2912:What diabetes drug type is;Lente
5823
Long-Acting Insulin
5824
Q2913:What diabetes drug type is;Ultralente
5825
Long-Acting Insulin
5826
Q2914:What diabetes drug type is;Tolbutamide
5827
5828
Q2915:What diabetes drug type is;Chlorpropamide
5829
5830
Q2916:What diabetes drug type is;Glyburide
5831
5832
Q2917:What diabetes drug type is;Glimepiride
5833
5834
Q2918:What diabetes drug type is;Glipizide
5835
5836
Q2919:What diabetes drug type is;Metformin
5837
Biguanide
5838
Q2920:What diabetes drug type is;Pioglitazone
5839
Glitazones
5840
Q2921:What diabetes drug type is;Rosiglitazone
5841
Glitazones
5842
Q2922:What diabetes drug type is;Acarbose
5843
5844
Q2923:What diabetes drug type is;Miglitol
5845
5846
Q2924:What structure contains the ovarian vessels?
5847
Suspensory ligament of ovaries
5848
Q2925:What structure contains the uterine vessels?
5849
Transverse cervical(cardinal);ligament
5850
Q2926:What structure contains the round ligament of the uterus & the uterine tubules & vessels
5851
Broad ligament
5852
Q2927:What does the acrosome of sperm derive from?
5853
Golgi apparatus
5854
Q2928:What is the food supply of sperm?
5855
Fructose
5856
Q2929:What kind of DNA do Spermatogonium have?
5857
2N diploid
5858
Q2930:What kind of DNA do Primary spermatocyte have?
5859
4N diploid
5860
Q2931:What kind of DNA do Secondary spermatocyte have?
5861
2N haploid
5862
Q2932:What kind of DNA do Spermatid have?
5863
1N haploid
5864
Q2933:What course do sperm take from production to ejaculation?
5865
SEVEN UP;Seminiferous tubules; Epididymis; Vas deferens; Ejaculatory ducts; (Nothing); Urethra; Penis
5866
Q2934:FSH stimulates which cells in the male?
5867
Sertoli cells;Aid in development of sperm
5868
Q2935:FSH stimulates which cells in the female?
5869
Granulosa cells;Aromatization of androgens
5870
Q2936:LH stimulates which cells in the male?
5871
Leydig cells;Testosterone release
5872
Q2937:LH stimulates which cells in the female?
5873
Thecal cells;Produces androgens
5874
Q2938:Which cell; leydig or sertoli; is found in interstitium between seminiferous tubules?
5875
Leydig cells
5876
Q2939:Which cell; leydig or sertoli; is found in the seminiferous tubules at the edge of the basement membrane?
5877
Sertoli cells
5878
Q2940:What converts testosterone to DHT?
5879
5-alpha-reductase
5880
Q2941:What inhibits 5-alpha-reductase?
5881
Finasteride;Blocks conversion of testosterone to DHT
5882
Q2942:What is the most potent androgen?
5883
Dihydrotestosterone(DHT)
5884
Q2943:Which androgen cannot be aromatized to an estrogen?
5885
DHT;Both Testosterone and androstenedione can be converted to estrogens
5886
Q2944:Which is the most potent estrogen?
5887
Estradiol
5888
Q2945:Which estrogen increases the most during pregnancy?
5889
Estriol
5890
Q2946:In what stage of the cell cycle do eggs arrest in for most of their life?
5891
Prophase of meiosis I
5892
Q2947:In what stage of the cell cycle do eggs arrest in after ovulation and until fertilization?
5893
Metaphase of meiosis II
5894
Q2948:How many days after fertilization does hCG become detectable in the urine?
5895
8 days
5896
Q2949:What is a/w Epispadias?
5897
Exstrophy of the bladder
5898
Q2950:What is the genotype of a complete mole?
5899
46; XX w/ all genes coming from the father
5900
Q2951:What is the genotype of an partial mole?
5901
Usually triploid
5902
Q2952:What strains of HPV are a/w cervical dysplasia?
5903
16 & 18
5904
Q2953:Which ovarian tumor;Equivalent to male seminoma
5905
Dysgerminoma
5906
Q2954:Which ovarian tumor;Sheets of uniform cells
5907
Dysgerminoma
5908
Q2955:Which ovarian tumor;Aggresive malignancy in ovaries & sacrococcygeal area of young children
5909
Yolk sac (endodermal sinus) tumor
5910
Q2956:Which ovarian tumor;Large; hyperchromatic syncytiotrophoblastic cells
5911
Choriocarcinoma
5912
Q2957:Which ovarian tumor;90% of ovarian germ cell tumors
5913
Teratoma
5914
Q2958:Which ovarian tumor;Contains cells from 2 or 3 germ layers
5915
Teratoma
5916
Q2959:Which ovarian tumor;May contain struma ovarii
5917
Teratoma;Struma ovarii- contains functional thyroid tissue
5918
Q2960:Which ovarian tumor;20% of ovarian tumors
5919
Serous cystadenoma
5920
Q2961:Which ovarian tumor;50% of ovarian tumors
5921
Serious cystadenocarcinoma
5922
Q2962:Which ovarian tumor;Frequently bilateral & lined w/ fallopian tube-like epithelium
5923
Serous cystadenoma
5924
Q2963:Which ovarian tumor;Multilocular cyst lined by mucus-secreting epithelium
5925
Mucinous cystadenoma
5926
Q2964:Which ovarian tumor;a/w Pseudomyxoma peritonei
5927
Mucinous cystadenocarcinoma
5928
Q2965:Which ovarian tumor;Resembles bladder epithelium
5929
Brenner tumor
5930
Q2966:Which ovarian tumor;Bundles of spindle-shaped fibroblasts
5931
Ovarian fibroma
5932
Q2967:Which ovarian tumor;Part of Meig's syndrome
5933
Ovarian fibroma;Meig's syndrome- triad of ovarian fibroma; ascites & hydrothorax
5934
Q2968:Which ovarian tumor;Can lead to precocious puberty
5935
Granulosa cell tumor
5936
Q2969:Which ovarian tumor;Secretes estrogen
5937
5938
Q2970:Which ovarian tumor;Can cause endometrial hyperplasia/carcinoma in adults
5939
5940
Q2971:Which ovarian tumor;Call-exner bodies
5941
Granulosa cell tumor;Call-exner bodies- small follicles filled w/ eosinophilic secretions
5942
Q2972:What is Pseudomyxoma peritonei
5943
intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor;a/w Mucinous cystadenocarcinoma
5944
Q2973:What breast condition?;Most common tumor in women under 25
5945
Fibroadenoma
5946
Q2974:What breast condition?;Lump w/ increased size and tenderness w/ pregnancy
5947
Fibroadenoma
5948
Q2975:What breast condition?;Benign tumor of lactiferous ducts
5949
Intraductal papilloma
5950
Q2976:What breast condition?;Presents w/ serous or bloody nipple discharge
5951
5952
Q2977:What breast condition?;Large; bulky mass of connective tissue & cysts
5953
Cystosarcoma phyllodes
5954
Q2978:What breast condition?;"Leaflike" projections
5955
Cystosarcoma phyllodes
5956
Q2979:What breast condition?;Early malignancy w/o basement membrane penetration
5957
Ductal carcinoma in situ
5958
Q2980:What breast condition?;Worst and most invasive breast cancer
5959
Invasive ductal carcinoma
5960
Q2981:What breast condition?;Cheesy consistency due to central necrosis
5961
Comedocarcinoma
5962
Q2982:What breast condition?;Fleshy; cellular; lymphocytic infiltrate
5963
Medullary carcinoma
5964
Q2983:What breast condition?;Eczematous patches on nipple
5965
Paget's disease of the breast
5966
Q2984:What breast condition?;Large cells w/ clear halo
5967
Paget's disease of the breast;Cells are called paget cells
5968
Q2985:What breast condition?;MCC of breast lumps age 25menopause
5969
Fibrocystic disease
5970
Q2986:What breast condition?;Diffuse breast pain & multiple lesions; often bilateral
5971
Fibrocystic disease
5972
Q2987:What breast condition?;Increased number of epithelial cell layers in terminal duct lobule
5973
Epithelial hyperplasia- Fibrocystic disease
5974
Q2988:What breast condition?;Increased acini & intralobular fibrosis
5975
Sclerosing type of Fibrocystic disease
5976
Q2989:What breast condition?;Hyperplasia of breast stroma
5977
Fibrosis type of Fibrocystic disease
5978
Q2990:What breast condition?;Breast abscess during breast feeding
5979
Acute mastitis
5980
Q2991:What breast condition?;Benign painless lump that forms due to injury to breast tissue
5981
Fat necrosis
5982
Q2992:Risk factors for Breast tumors
5983
Gender; age; early 1st menarche(<12 y.o.); delayed 1st pregnancy(>30 y.o.); late menopause(>50 y.o.); family history of 1st degree relative w/ breast cancer at young age
5984
Q2993:Most common pathogen in acute mastitis
5985
Staphylococcus aureus
5986
Q2994:What testicular tumor?;Painless testicular enlargement
5987
Seminoma
5988
Q2995:What testicular tumor?;Most common testicular tumor
5989
Seminoma
5990
Q2996:What testicular tumor?;Worst prognosis
5991
Embryonal carcinoma of the testicle
5992
Q2997:What testicular tumor?;Reinke crystals
5993
Leydig cell tumor
5994
Q2998:What testicular tumor?;Androgen producing tumor
5995
Leydig cell tumor
5996
Q2999:What testicular tumor?;Causes gynecomastia in men & precocious puberty in boys
5997
Leydig cell tumor
5998
Q3000:What testicular tumor?;Androblastoma from sex cord stroma
5999
Sertoli cell tumor
6000
Q3001:What testicular tumor?;Most common testicular cancer in older men
6001
Testicular lymphoma
6002
Q3002:What is the typical age of presentation of a seminoma?
6003
15-35 years old
6004
Q3003:What penile tumor?;Solitary crusty plaque on shaft or on scrotum
6005
Bowen disease- type of penile carcinoma in situ
6006
Q3004:What penile tumor?;Peak incidence in 5th decade of life
6007
6008
Q3005:What penile tumor?;Becomes invasive SCC in <10% of cases
6009
6010
Q3006:What penile tumor?;Red velvety plaques; usually involving the glans
6011
Erythroplasia of Queyrat- type of penile carcinoma in situ
6012
Q3007:What penile tumor?;Similar to Bowen disease
6013
Erythroplasia of Queyrat- type of penile carcinoma in situ
6014
Q3008:What penile tumor?;Multiple papular lesions
6015
Bowenoid papulosis- type of penile carcinoma in situ
6016
Q3009:What penile tumor?;Affects a younger age group than other penile tumors
6017
Bowenoid papulosis- type of penile carcinoma in situ
6018
Q3010:What penile tumor?;a/w HPV
6019
Penile squamous cell carcinoma
6020
Q3011:What penile tumor?;Rare in circumcised men
6021
Penile squamous cell carcinoma
6022
Q3012:What are the three layers of the skin
6023
Epidermis; dermis; subcutaneous tissue
6024
Q3013:What types of cells compose the epidermal layer of the skin
6025
Stratified squamous epithelium
6026
Q3014:What are the four layers of the epidermis
6027
Stratum Corneum;Stratum Granulosum;Stratum Spinosum;Stratum Basalis;Cocky Guys Save Babes
6028
Q3015:Hyperkeratosis affects which layer of the epidermis
6029
Stratus corneum
6030
Q3016:What types of cells compose the stratum basalis
6031
Columnar basal cells
6032
Q3017:What is a plaque
6033
Raised area of skin >1cm in diameter
6034
Q3018:What is a papule
6035
Raised area of skin <1cm in diameter
6036
Q3019:What is a macule
6037
Flat; discolored area of skin <1cm in diameter
6038
Q3020:What is a vesicle
6039
A raised; fluid-filled blister measuring <0.5cm in diameter
6040
Q3021:What are the small; encapsulated sensory receptors found in the dermis of the palms; soles; and digits of the skin (Hint: they are also involved in light discriminatory touch of hairless skin)
6041
Meissners corpuscles
6042
Q3022:What is the name of tactile disks that mediate light crude touch
6043
Merkel corpuscles
6044
Q3023:What are the large encapsulated sensory receptors found in deeper layers of skin that are involved in pressure; coarse touch; vibration; and tension
6045
Pacinian corpuscles
6046
Q3024:Where are pacinian corpuscles found
6047
Deep layers of skin;Joint capsules;Serous membranes;Mesenteries
6048
Q3025:What structures prevent diffusion across intracellular spaces
6049
Zona occludens (tight junctions)
6050
Q3026:What structures allow adjacent cells to communicate rapidly
6051
Gap junctions
6052
Q3027:What structure connects cells to underlying extracellular matrix
6053
Hemidesmosomes
6054
Q3028:What are structures that join adjacent cells together and provide anchoring points for intermediate filaments
6055
Desmosomes (macula adherens)
6056
Q3029:What is the function of Langerhans cells
6057
Antigen-presenting cells; Main inducers of antibody response
6058
Q3030:From where does the epidermis regrow after trauma or removal
6059
Hair follicles and sweat glands in the dermis
6060
Q3031:What is the term that describes the replacement of one adult cell type by another; often secondary to irritation and/or environmental exposure
6061
Metaplasia (reversible)
6062
Q3032:Which term describes an increased number of cells
6063
Hyperplasia (reversible)
6064
Q3033:What do you call the change of a cell to a less differentiated form
6065
Anaplasia
6066
Q3034:What is the term for abnormal growth with loss of orientation; shape; and size compared to normal cells
6067
Dysplasia (reversible)
6068
Q3035:Which enzymes do malignant cells use to metastasize
6069
Collagenases and hydrolases
6070
Q3036:Which rash is often described as a target lesion that has a red center; pale zone; and a dark outer ring
6071
Erythema multiforme
6072
Q3037:What are common causes of erythema multiforme
6073
Infections;Antibiotics;Radiation;Chemicals;Malignancy
6074
Q3038:What is the term for dilated; superficial blood vessels
6075
Telangiectasia
6076
Q3039:Which test is designed to ascertain whether a skin lesion will blanch as a result of pressure
6077
Diascopy. Used to determine whether a red lesion is bloodfilled or hemorrhagic
6078
Q3040:What are the most common causes of nonscarring alopecia
6079
Telogen effluvium;Androgenic alopecia;Alopecia areata;Tinea capitis;Traumatic alopecia
6080
Q3041:What are the most common causes of scarring alopecia
6081
Cutaneous lupus;Lichen planus;Folliculitis planus;Linear scleroderma
6082
Q3042:What is the easiest and quickest way to determine if a skin condition is fungal
6083
KOH preparation
6084
Q3043:An 8-month old presents with large; easily ruptured flaccid bullae; with large areas of desquamation of skin and a positive Nikolskys sign. What is the most likely diagnosis
6085
Staphylococcal scalded skin syndrome
6086
Q3044:What is the infectious agent that causes scalded skin syndrome
6087
6088
Q3045:What condition is described as having thin-walled vesicles or pustules that rupture to form golden-yellow crusts (honey crusts)
6089
Impetigo
6090
Q3046:What is the most common bacterial infection of the skin in children
6091
Impetigo
6092
Q3047:What bacteria cause impetigo
6093
Staph aureus or Strep pyogenes
6094
Q3048:What test is helpful to determine the organism involved in impetigo
6095
Culture and catalase tests
6096
Q3049:A sexually active 23 year old patient presents with painful vesicles on his penis and a slight fever. He refers to having the same type of vesicles multiple times a year. Multinucleated giant cells and ballooning of nuclei are seen microscopically. What is the likely diagnosis
6097
Herpes simplex infection
6098
Q3050:What is the treatment for herpes simplex type I
6099
Oral and topical acyclovir;Valacyclovir;Famciclovir
6100
Q3051:What infection causes unilateral; painful vesicles along a dermatome of the face or trunk
6101
Shingles (Herpes Zoster)
6102
Q3052:Which test can be used to assist in the diagnosis of herpes virus infection
6103
Tzank smear
6104
Q3053:Which disease of childhood presents with acute vesicular eruptions that occur in successive crops; so that the rash typically consists of vesicles at different stages of resolution
6105
Varicella or chicken pox
6106
Q3054:A 16 year old presents with multiple dome-shaped; umbilicated; waxy papules on the face and chest. What is the most likely diagnosis
6107
Molluscum contagiosum
6108
Q3055:How does molluscum contagiosum appear microscopically
6109
Epidermal hyperplasia producing a basin with moluscum bodies (Henderson-Patterson bodies)
6110
Q3056:What type of virus causes molluscum contagiosum
6111
Pox virus
6112
Q3057:A 35 year old patient with AIDS presents with multiple brownish/purplish macules on the trunk and lower extremities. What is the most likely diagnosis
6113
Kaposis sarcoma (HHV8)
6114
Q3058:A 7 year old present with multiple hard; roughsurfaced papules on his fingers and elbows. Diagnosis?
6115
Verruca vulagris (common wart)
6116
Q3059:What is the causative agent of verruca vulgaris
6117
HPV
6118
Q3060:What is the typical primary syphilis skin manifestation
6119
Painless indurated genital or lip ulcer (chancre)
6120
Q3061:What are the typical secondary syphilis skin manifestations
6121
Cutaneous lesions that are maculopapular or erythematosquamous; lesions on palms and soles; warts (condylomata lata) on anogenital region; and alopecia
6122
Q3062:What HPV serotypes cause the common wart
6123
HPV-1;2;4;7
6124
Q3063:A 24 year old man from the Northeast; visits the physician because of a centrifugally spreading; erythematous lesion on his right leg. The patient noticed the rash after he went hiking. Diagnosis?
6125
Erythema chronicum migrans (Lyme disease)
6126
Q3064:A mother brings her 5 year old son to the physician because she noted her son scratching a pinkish lesion on his neck. Upon examination; the physician notes a ring-shaped scaling plaque with central clearing and elevated borders. Diagnosis?
6127
Tinea corporis (ringworms)
6128
Q3065:How is ringworm acquired
6129
Tinea corporis is not due to a worm but due to a fungal infection
6130
Q3066:Skin infections are typically caused by what bacterium
6131
S. aureus
6132
Q3067:A 22 year old man presents with a rash that first appeared on his palms and soles; and then spread to his face and trunk. Diagnosis?
6133
Rocky Mountain spotted fever
6134
Q3068:What type of rash is seen in spotted fever
6135
An inward or centripetal spreading rash
6136
Q3069:What is used to test for typhus and Rocky mountain spotted fever
6137
Weil-Felix reaction
6138
Q3070:What is the treatment for Rocky mountain spotted fever
6139
Tetracyclines or chloramphenicol
6140
Q3071:A 26 year old female from Texas complains of small hypopigmented spots on her upper back that usually disappear in the winter months. Diagnosis?
6141
Tinea versicolor
6142
Q3072:What is the confirmatory test for tinea versicolor
6143
KOH preparation
6144
Q3073:Which diseases cause hand and foot lesions
6145
Syphilis;Hand-foot-and-mouth disease;Rocky Mountain spotted fever
6146
Q3074:A 25 year old sexually active male presents with a painful; nonindurated genital ulcer; and tender regional lymphadenopathy. Diagnosis?
6147
Chancroid
6148
Q3075:A 35 year old homeless woman visits a shelter physician because of multiple; extremely pruritic papules in her axilla; groin; and finger webs. The patient indicates her husband also has the same lesions. Diagnosis?
6149
Scabies
6150
Q3076:A 15 year old male on the school swim team visits the dermatologist because of itchiness on both his feet. He states he is not on any medication and has not had it before. Upon inspection; the physician notes erythematous; dry scaling lesions on both feet. Diagnosis?
6151
Tinea pedis
6152
Q3077:What is the treatment for tinea pedis
6153
Topical or oral antifungals
6154
Q3078:What is the rapid developing infection of the skin and fascia that may lead to death if not treated quickly
6155
Necrotizing fasciitis
6156
Q3079:What are the organisms responsible for necrotizing fasciitis
6157
Group A streptococci or Clostridium perfringens
6158
Q3080:A 67 year old Caucasian woman visits her dermatologist because of small reddish papules/pustules predominantly on her cheeks; nose; chin; and forehead. She states that her face becomes worse if she uses hot water or is in warm weather. Diagnosis?
6159
Rosacea
6160
Q3081:What is the treatment for Rosacea
6161
Avoid precipitating factors;Topical metronidazole;Sulfur lotions;Oral tetracyclines;Isotretinoin
6162
Q3082:A 12 year old male visits his physician because of a slap-like red mark on his cheek and a rash on his arms that appeared 1 day after the cheek rash. Upon physical examination; the physician notes malar erythema and a maculopapular rash on his extremities. Diagnosis?
6163
Fifth diseas (erythema infectiosum)
6164
Q3083:What causes fifth disease
6165
Parvovirus B19
6166
Q3084:What are the other complications of fifth disease
6167
Nonimmune fetal hydrops (virus infects and destroys fetal red blood cells);More severe anemia in patients with other type of chronic anemia (like aplastic crisis in sickle cell patient)
6168
Q3085:Which bacteria cause erythrasma
6169
Corynebacterium
6170
Q3086:What bacterium causes scarlet fever
6171
S. pyogenes (group A -hemolytic)
6172
Q3087:What type of rash is seen in typhus
6173
An outward or centrifugal-spreading rash
6174
Q3088:How do the rickettsiae cause severe tissue damage
6175
Organisms infect endothelial cells and cause vascular leakage; which results in hypovolemic shock; pulmonary edema; renal failure; and CNS damage
6176
Q3089:What does disseminated disease of coccidioidomycosis manifest as on the skin
6177
Verrucous plaques (usually on face);Subcutaneous abscesses;Pustular lesions
6178
Q3090:A 23 year old farmhand presents to the dermatologist with multiple red-violaceous nodules on the hand; fever; and history of diarrhea. During the examination; the patient states he is in charge of the cows on the farm. Diagnosis?
6179
Milkers nodules
6180
Q3091:What causes milkers nodules
6181
Paravaccinia virus
6182
Q3092:What group is paravaccinia in
6183
Double-stranded parapoxvirus
6184
Q3093:What disease may follow paravaccinia infection
6185
Bullous pemphigoid
6186
Q3094:A 16 year old female complains of fatigue; fever; sore throat; and lymphadenopathy. She leaves with a prescription for medication. Two days later she returns with a cutaneous rash on her face. What did the physician prescribe the patient
6187
Ampicillin
6188
Q3095:What is the most likely diagnosis for a patient who develops a rash after treatment with ampicillin
6189
Mononucleosis
6190
Q3096:What is the etiologic agent for mononucleosis
6191
EBV (HHV 4)
6192
Q3097:What are the classic criteria for diagnosing mononucleosis
6193
Lymphocytosis; presence of at least 10% atypical lymphocytes on peripheral smear; and a positive serologic test for EBV
6194
Q3098:What organism is responsible for tinea versicolor
6195
Malassezia furfur
6196
Q3099:What is used to treat tinea versicolor
6197
Topical miconazole;Selenium sulfide
6198
Q3100:A 45 year old rancher visits a dermatologist because of a black 2-cm lesion on his hand. He states that the lesion was itchy and had a reddish color a day or two ago. What is the most likely diagnosis
6199
Anthrax
6200
Q3101:What is the causative agent of anthrax
6201
Bacillus anthracis
6202
Q3102:A 36 year old migrant worker from Mexico visits the physician because of small disfiguring nodules forming on his ears and hands. The patient also states that he is losing sensation in the affected areas. Diagnosis?
6203
Leprosy
6204
Q3103:What is the causative agent of leprosy
6205
Mycobacterium leprae
6206
Q3104:What agent causes hand-foot-and-mouth disease
6207
Coxsackie virus type A-16
6208
Q3105:What are the signs and symptoms of hand-foot-andmouth disease
6209
Fever and malaise with small oval vesicles along creases of palms; soles; and lips
6210
Q3106:What is the most common type of bacterial infection in burn victims
6211
Pseudomonas aeruginosa infections
6212
Q3107:Dermatophytes include members of which genera
6213
Trichophyton; Microsporum; Epidermophyton
6214
Q3108:An inner-city child is brought to the physician because of patches of hair loss. His mother states that he has had this problem for at least a month. The lesions are painless and have some scaling. Diagnosis?
6215
Tinea capitis
6216
Q3109:What is the most likely etiologic organism of tinea capitis
6217
Trichophyton tonsurans
6218
Q3110:What is the treatment for tinea capitis
6219
Griseofulvin;Terbinafine
6220
Q3111:Which form of M. furfur generally causes disease
6221
Hyphal form
6222
Q3112:What is the most common type of skin cancer
6223
Basal cell carcinoma
6224
Q3113:What is the neoplasm that is often described as a pearly; red macule; papule; or nodule that is found on sunexposed areas of the head or neck
6225
6226
Q3114:What skin cancer is microscopically characterized by nests of palisading cells
6227
6228
Q3115:Which neoplasm is often described as a red papule; nodule; or plaque that may be hyperkeratotic or ulcerated on sun-exposed skin
6229
Squamous cell carcinoma
6230
Q3116:Arsenic causes which type of skin cancer
6231
6232
Q3117:Which neoplasm is microscopically characterized by nest of atypical squamous epithelial cells and keratin
6233
6234
Q3118:Which type of skin cancer results as a complication of severe burns 20-40 years later and has a higher risk of metastasis compared to its regular skin version
6235
6236
Q3119:Actinic keratosis lesions may transform into what type of skin cancer if left untreated
6237
6238
Q3120:What are some risk factors for squamous cell carcinoma
6239
Sun exposure;Ionizing radiation;Actinic keratosis;Immunosuppression;Arsenic;Industrial carcinogens
6240
Q3121:A 54 year old male visits the dermatologist because of a dark brown-black 5mm freckle in between his third and fourth toe. The patient stated that he noticed the freckle about a year and a half ago. The dermatologist biopsies the lesion and under the microscope; sees atypical confluent melanocytes with asymmetrical proliferation. Diagnosis?
6241
Melanoma
6242
Q3122:Which stains are used to test for melanoma
6243
S-100;HMB-45;MART-1
6244
Q3123:What is the most sensitive stain that could be used to test for melanoma and is almost always positive
6245
S-100
6246
Q3124:Large congenital nevi and dysplastic nevi may be precursor lesions for what type of cancer
6247
Melanoma
6248
Q3125:Which clinical criteria are used to help diagnose melanomas
6249
Aysmmetry;Border irregularity;Color variation;Diameter;ABCDs of melanoma
6250
Q3126:What is the term for a lesion that is a precursor or marker to melanoma
6251
Dysplastic nevus
6252
Q3127:How is dysplastic nevus syndrome inherited
6253
Autosomal dominant inheritance
6254
Q3128:What chromosome is dysplastic nevus syndrome located on
6255
Chromosome 1
6256
Q3129:What are the peak ages for melanoma
6257
40-70 years of age
6258
Q3130:What are risk factors for melanoma
6259
Sunburns;Chronic sun exposure;Fair skin;Dysplastic nevi
6260
Q3131:What is the most common subtype of melanoma
6261
Superficial spreading melanoma
6262
Q3132:Which type of melanoma has the best prognosis
6263
Lentigo maligna melanoma
6264
Q3133:Which type of melanoma has the worst prognosis
6265
Nodular melanoma
6266
Q3134:What is the most common type of melanoma in darkskinned individuals
6267
Acral-lentiginous melanoma
6268
Q3135:What is the most important prognostic parameter for melanoma
6269
Depth (Breslows thickness)
6270
Q3136:In what condition would you find cytoplasmic Birbeck granules through electron microscopy
6271
Histiocytosis X (Langerhans cell histiocytosis)
6272
Q3137:In histiocytosis X; proliferations of which cells is usually found in the epidermis
6273
Langerhans cells (macrophages)
6274
Q3138:What term describes full-thickness epithelia atypia with an intact basement membrane in a cancer biopsy
6275
Carcinoma in situ
6276
Q3139:A 40 year old male has rash of scaly red patches on his trunk; face; and extremities. A biopsy is taken and superficial dermal infiltrates of T-lymphocytes and a collection of atypical lymphocytes are seen within the epidermis. Diagnosis?
6277
Mycosis fungoides (cutaneous T-cell lymphomas)
6278
Q3140:What is mycosis fungoides called where there is blood involvement
6279
Sezary syndrome
6280
Q3141:Skin carcinogenesis is thought to be caused by the accumulation of mutations in which tumor suppressor gene
6281
p53
6282
Q3142:What type of carcinoma microscopically resembles metastatic small cell carcinoma from the lung or certain lymphomas
6283
Merkel cell carcinoma
6284
Q3143:Which HPV serotypes cause condyloma acuminatum
6285
HPV 6 and 11
6286
Q3144:What are tan/brown plaques or papules that have a stuck on appearance and may be found anywhere on the body of adults; except the palms and soles
6287
Seborrheic keratosis
6288
Q3145:What is the most common type of collagen in a keloid
6289
Type III collagen
6290
Q3146:What are the risk factors for keloid formation
6291
African-American race; <30 years of age; and increased skin tension in a wound
6292
Q3147:Single or multiple bright red papules measuring a few millimeters in diameter that occur predominantly on the trunks and limbs of patients over 40 years are what type of lesions
6293
Senile angiomas (cherry angiomas)
6294
Q3148:A 59 year old male visits his family physician because of loss of appetite; weight loss; and fatigue. During the physical examination; the physician notes dark; rough-looking skin in the axilla region. What should the physician suspect
6295
Internal cancer or an endocrine disorder
6296
Q3149:What skin condition is described as dark; roughlooking or velvety skin in the axilla or on the back of the neck
6297
Acanthosis nigricans
6298
Q3150:Which autosomal recessive disease is characterized by defective DNA repair and photosensitivity
6299
Xeroderma pigmentosa
6300
Q3151:Patients with xeroderma pigmentosa usually develop which skin lesions
6301
Basal cell carcinoma;Squamous cell carcinoma;Actinic keratosis;Melanoma in childhood
6302
Q3152:Exposure to UV light causes what type of dimmers in the skin
6303
Thymine-thymine dimmers
6304
Q3153:What are the multiple; light-brown; freckle-like lesions found in neurofibromatosis
6305
Caf au lait spots
6306
Q3154:Caf au lait spots usually grow along what structures
6307
Peripheral nerves
6308
Q3155:Hypopigmented macules or ash-leaf spots on the trunk or lower extremities are associated with what disease
6309
Tuberous sclerosis
6310
Q3156:What is the tuberous sclerosis triad
6311
Mental retardation;Epilepsy;Multiple angiofibromas
6312
Q3157:A unilateral port-wine stain of the forehead and upper eyelid is associated with what condition
6313
Sturge-Weber syndrome (encephalotrigeminal angiomatosis)
6314
Q3158:Which nerve is associated with Sturge-Weber syndrome
6315
Ophthalmic branch of the trigeminal nerve
6316
Q3159:What condition has whitish-red nodules especially on digits and over joints; and is associated with uric acid accumulation
6317
Gout
6318
Q3160:A 39 year old man comes to the physician because he has noted a bluish-black color on his ears; nose; and sclera. The patient also states that his urine is sometimes very dark. Diagnosis?
6319
Alkaptonuria
6320
Q3161:How is alkaptonuria inherited
6321
Autosomal recessive inheritance
6322
Q3162:What accounts for the discoloration of the skin and urine in alkaptonuria
6323
Deposition of homogentisic acid
6324
Q3163:Hemochromatosis has what manifestation in the skin
6325
Hyperpigmented bronze skin
6326
Q3164:Which connective tissue disorder is associated with hyperextensible fragile skin; loose joints; and a tendency toward easy bruising and bleeding
6327
Ehlers-Danlos syndrome
6328
Q3165:What is the cause of death for a patient with EhlersDanlos disease
6329
Arterial or intestinal rupture
6330
Q3166:What is the name of the group of autosomal recessive diseases of premature aging
6331
Progeria
6332
Q3167:Marfan syndrome is due to a defect in which gene
6333
Fibrillin-1 (FBN-1)
6334
Q3168:On which chromosome is the defect for Marfan syndrome
6335
15q21
6336
Q3169:What is the most common cause of death in a Marfan patient
6337
Ascending aortic dissection
6338
Q3170:How is albinism generally inherited
6339
6340
Q3171:What is lacking in the epidermis of albino patients
6341
Melanin
6342
Q3172:A 35 year old woman visits her physician because she recently noticed multiple small nodules on the back of her ankle. The patients vital signs are normal and she has no prior clinical illnesses. A blood test is taken that reveals Na 142; glucose 100; creatinine 1; BUN 17; cholesterol 310; triglycerides 412. What do the small nodules likely represent
6343
Xanthomas
6344
Q3173:What is the most likely cause of xanthomas
6345
Hyperlipidemia
6346
Q3174:A mother brings her 7 year old son to the physician because of two small masses on his right chest. The mother states that the child is adopted and does not know the childs family history. A 4 and 3 cm mass is palpated on his right pectoral; small tan lesions are seen on his back and right arm; and a small growth is seen on his iris. Diagnosis?
6347
Neurofibromatosis 1
6348
Q3175:On what chromosome is NF type 1 found
6349
Chromosome 17
6350
Q3176:What are other manifestations associated with NF type 1
6351
Optic gliomas;Bone abnormalities;Freckling of the axillary or genital area
6352
Q3177:What is the most common neurocutaneous disorder
6353
Neurofibromatosis
6354
Q3178:What condition is associated with multiple neuromas on the eyelid; lips; distal tongue; and/or oral mucosa
6355
MEN; Type 2b (III)
6356
Q3179:Epidermolysis bullosa acquisita (EBA) is associated with which disease
6357
Inflammatory bowel disease; especially Crohns disease
6358
Q3180:What haplotype is frequently found in patients with EBA
6359
HLA-DR2
6360
Q3181:Which drugs cause erythema multiforme or target lesions
6361
Aspirin;Penicillin;Sulfonamides;Phenytoin;Corticosteroids;Ci metidine;Allopurinol;Oral contraceptives
6362
Q3182:Which drugs cause Stevens-Johnson syndrome
6363
Sulfa drugs;Carbamazepine;Phenytoin;Valproic acid;Phenobarbital;Quinolones;Cephalosporins;Allopurinol;C orticosteroids;Aminopenicillins
6364
Q3183:Which drugs induce acne
6365
Lithium;Steroids;Androgens;Oral contraceptive pills
6366
Q3184:Which marker is associated with a genetic susceptibility to fixed-drug reactions
6367
HLA-B22
6368
Q3185:A 16 year old male with a clinical history of acne visits his family physician because he has a red rash on his face and various exposed parts. During the exam; he states the rash occurred after he spent a couple of hours outside playing football. What medication is he most likely taking
6369
Tetracyclines
6370
Q3186:A 75 year old female heart patient visits her dermatologist because her skin has begun to turn a light blue color. She is embarrassed to go in public because children say she looks like a smurf. What medication did her cardiologist most likely give her
6371
Amiodarone
6372
Q3187:What type of drug is Amiodarone
6373
Class III antiarrhythmic
6374
Q3188:What do you call a symmetrical; hyperpigmented lesion of the forehead and cheeks that occurs in women who are on oral contraceptives or pregnant
6375
Melasma
6376
Q3189:What are some common drugs that are associated with hyperpigmentation
6377
Bleomycin; Minocycline; Miodarone; Chloroquine; Gold; Chlorpromazine; 5-Fluorouracil; Daunorubicin; Busulfan
6378
Q3190:Which groups of patients have an increased risk of adverse drug reaction
6379
Women;Patients with Sjogrens syndrome;AIDS patients
6380
Q3191:Which drug causes red man syndrome usually during rapid IV infusion
6381
Vancomycin
6382
Q3192:A 24 year old female presents to the dermatologist because of target-like lesions on her right arm. The patient states she is taking some type of antibiotic for a urinary tract infection. What drug class most likely caused the lesions
6383
Sulfonamides
6384
Q3193:What is the most common cause of burns in children
6385
Scalds from hot liquids
6386
Q3194:What is the most common cause of burns in adults
6387
Accidents with flammable liquids
6388
Q3195:Which kind of burn affects only the epidermis
6389
First-degree burn
6390
Q3196:Which kind of burn usually blisters and affects the dermis and adnexal structures
6391
Second-degree burn
6392
Q3197:Which type of burn involves the entire thickness of the skin; including variable amount of underlying fat and causes loss of sensation in affected area
6393
Third-degree burn
6394
Q3198:The scar that follows a deep second and third degree burn is composed of what
6395
Hyalinized collagen
6396
Q3199:Sharply demarcated; silvery-white plaques on a patients elbows and knees are most likely what disorder
6397
Psoriasis
6398
Q3200:What conditions can trigger psoriasis
6399
Trauma; Infection; Drugs
6400
Q3201:Which major histocompatibility markers are associated with psoriasis
6401
HLA-CW6;B13;B17;B27
6402
Q3202:What disorder has scaly; thickened plaques that develop in response to persistent rubbing of pruritic sites
6403
Lichen simplex chronicus
6404
Q3203:Which disease results from the deposition of collagen in skin that causes a hardened and thickened appearance and is associated with Raynauds phenomenon
6405
Scleroderma
6406
Q3204:Which antibodies are associated with scleroderma
6407
Scl-70 (diffuse);Anticentromere antibodies (localized)
6408
Q3205:What other conditions are associated with scleroderma
6409
Hypertension;Gastrointestinal disease;Pulmonary fibrosis;Kidney disease
6410
Q3206:Which type of collagen is defective in osteogenesis imperfecta
6411
Type I collagen
6412
Q3207:Which disease is associated with a rash on the face; particularly the malar areas
6413
Systemic lupus erythematosus
6414
Q3208:Atopic dermatitis is associated with what conditions
6415
Asthma and allergic rhinitis
6416
Q3209:Which test is often helpful in the evaluation of patients with chronic contact dermatitis
6417
Patch test
6418
Q3210:What is the most common presentation of contact dermatitis
6419
Hand eczema; most likely due to occupational exposure
6420
Q3211:Contact dermatitis is what type of hypersensitivity reaction
6421
Type IV-delayed hypersensitivity
6422
Q3212:Eruptive forms of what condition may be associated with Reiter syndrome
6423
Psoriasis
6424
Q3213:Touch normal-appearing skin with a sliding motion and having the epidermis layer separated from the basal layer is what skin test
6425
Nikolskys sign
6426
Q3214:Which HLA types are increased in frequency in patients with dermatitis herpetiformis
6427
HLA-B8; DR3; DQW2
6428
Q3215:Which rheumatologic disease is associated with a diffuse red rash of trunk; periungual telangiectasis; proximal weakness; myositis on muscle biopsy; and elevated CPK and aldolase
6429
Dermatomyositis
6430
Q3216:Vitiligo is most commonly associated with what conditions
6431
Thyroid disease;Pernicious anemia;Addisons disease;Diabetes mellitus type 1
6432
Q3217:What are some clinical manifestations of type I hypersensitivity reactions
6433
Anaphylaxis;Urticaria;Exanthema;Angioedema
6434
Q3218:Urticaria is what type of hypersensitivity reaction
6435
IgE-mediated; type I hypersensitivity reaction
6436
Q3219:Autoantibodies to the intercellular junction of epidermal cells are found in which disease
6437
Pemphigus vulgaris
6438
Q3220:Pemphigus vulgaris is associated with which antibody
6439
IgG
6440
Q3221:What do the autoantibodies in pemphigus vulgaris target
6441
Desmocollins and desmogleins (transmembrane desmosomal glycoproteins)
6442
Q3222:Patients with pemphigus vulgaris have an increased incidence of which haplotypes
6443
HLA-DR4; DRw6
6444
Q3223:What do the autoantibodies in bullous pemphigoid target
6445
BP1 and BP2 in basement membrane
6446
Q3224:Bullous pemphigoid is an autoimmune disorder that rarely affects which part of the body in contrast to pemphigus vulgaris; which affects it frequently
6447
Oral mucosa
6448
Q3225:Dermatitis herpetiformis is associated with what condition
6449
Gluten-sensitive enteropathy
6450
Q3226:TB skin test; transplant rejection; and contact dermatitis are what type of hypersensitivity reaction
6451
Delayed type hypersensitivity reaction; type IV
6452
Q3227:What is the most likely vitamin deficiency that manifests as petechiae; echymoses; abnormal hair growth; bleeding gums; and poor wound healing
6453
Vitamin C (scurvy)
6454
Q3228:A 45 year old patient presents with intense hyperpigmentation; areas of epithelial desquamation; diarrhea; and confusion. What is the most likely deficient vitamin
6455
Niacin (nicotinic acid)
6456
Q3229:Which vitamin deficiencies have cutaneous manifestations
6457
Vitamin C;Vitamin A;Nicotinic acid;Riboflavin;Pyridoxine
6458
Q3230:What are some skin manifestations of kwashiorkor
6459
Dry skin;Patches of hypopigmentation;Skin peeling;Peripheral edema;Thin hair shafts
6460
Q3231:What condition would cause an increase in skin glycogen and acid -glucosidase in cultured fibroblasts
6461
Pompes disease (type II)
6462
Q3232:A 3 year old male presents to the physician with a photosensitive rash; cerebellar ataxia; mental disturbances; and aminoaciduria. Niacin levels are within normal range. What is the most likely diagnosis
6463
Hartnup disease
6464
Q3233:How is Hartnup disease inherited
6465
6466
Q3234:What are the cutaneous manifestations in Whipples disease
6467
Hyperpigmentation of scars and sun-exposed skin
6468
Q3235:A 32 year old woman visits her family physician because of rapid weight gain; profuse sweating; sudden abnormal hair growth; and easy bruising. Upon physical examination; the physician notes purplish striae on the abdomen; telangiectasia; thin skin; and an increase of fatty tissue on her back at the level of C6. What is the most likely diagnosis
6469
Cushings syndrome
6470
Q3236:Which test is used to diagnose Cushings disease
6471
Dexamethasone suppression test and 24 hour urinary measurement for cortisol
6472
Q3237:What is the most common cause of Cushings syndrome
6473
Iatrogenic
6474
Q3238:What hormone is increased in Cushings syndrome
6475
Cortisol
6476
Q3239:Patients with carcinoid syndrome may have which skin manifestation
6477
Episodes of flushing of the head; neck; and sometimes trunk
6478
Q3240:What are the metabolic causes of hyperpigmentation
6479
Porphyria cutanea tarda;Hemochromatosis;Vitamin B12 deficiency;Folic acid deficiency;Pellagra;Mallabsorption;Whipples disease
6480
Q3241:A 56-year-old man experienced chest pain and was admitted to the hospital suffering from an acute myocardial infarction. Five days later; he developed ventricular tachycardia; which progressed to ventricular fibrillation; and could not be resuscitated. The microscopic section shows an area of myocardium between an established infarct and normal myocardium. The myocytes in the figure show ;A. cell injury with undetermined ultimate fate ;B. early coagulation necrosis ;C. early liquefaction necrosis ;D. irreversible injury and will die within hours
6481
Option A (cell injury with undetermined ultimate fate) is correct. The cells show vacuolation due to loss of the ability to synthesize ATP via aerobic respiration. This; in turn; shuts down the Na+-K+ pump of the cell membrane. Sodium is no longer excluded from the cytosol; and water follows it into the cell; causing swelling and vacuolation. This is a reversible process.
6482
Q3242:. A 31-year-old woman has a mass on the right side of the neck lateral to the larynx. The mass is determined to be a well-differentiated tumor containing psammoma bodies. The tumor is most likely classified as a;A. follicular adenoma ;B. follicular carcinoma ;C. papillary adenoma ;D. papillary carcinoma
6483
Option D (papillary carcinoma) is correct. The presence of psammoma bodies is virtually diagnostic of papillary carcinoma; because these bodies are rarely seen in other thyroid neoplasms. Papillary carcinoma occurs most frequently in women between the ages of 20 and 50 years. Papillary carcinoma is the most common thyroid cancer and spreads via the lymphatic system. This type of thyroid cancer is more common in patients with a history of radiation exposure.
6484
Q3243:A total thyroidectomy is performed on a 42-year-old woman with a thyroid mass that appears to be encapsulated. There is evidence of both recent and past hemorrhage and numerous small; follicle-like structures composed of very uniform-appearing cells. Which of the following distinguishing features would suggest that this tumor is malignant?;A. Absence of papillary growth ;B. Absence of psammoma bodies ;C. Extension through the capsule ;D. Microfollicular pattern ;E. Presence of hemorrhage
6485
Option C (extension through the capsule) is correct. Invasion through the capsule of the tumor is one of the core characteristics used to determine if a follicular neoplasm of the thyroid is benign or malignant. Another characteristic is invasion of the tumor into the vasculature.
6486
Q3244:A 61-year-old man with chronic renal failure is being considered for a renal transplant. His serum calcium level is 7.6 mg/dL. Which of the following findings is most likely to be typical in this patient?;A. Bilateral adrenal hyperplasia ;B. Enlargement of all four parathyroid glands ;C. Functional parathyroid adenoma ;D. Hyperplasia of the adenohypophysis ;E. Hyperplasia of the thyroid follicular cells
6487
Option B (enlargement of all four parathyroid glands) is correct. The patient has secondary hyperparathyroidism associated with chronic renal failure. In such cases; the hypocalcemia caused by renal retention of phosphate leads to compensatory hyperplasia of the parathyroid glands. Typically; all four parathyroid glands are enlarged.
6488
Q3245:Two months ago; a 19-year-old man was brought to Cell Biology and Pathology Flash Facts the emergency department following an automobile accident in which he sustained severe lacerations and a ruptured spleen. He immediately received four units of packed red blood cells. He now has developed mild jaundice. Except for vague symptoms of fatigue; he is generally asymptomatic. Both his ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are 40 U/L. His alkaline phosphatase is within normal limits. Which of the following types of hepatitis is most likely to have caused this infection?;A. Hepatitis A (HAV) ;B. Hepatitis B (HBV) ;C. Hepatitis C 6489 (HCV) ;D. Hepatitis D (HDV) ;E. Hepatitis E (HEV)
Option C (hepatitis C) is correct. HCV has become the major cause of transfusion-related hepatitis since adequate screening methods for HBV have been developed. HCV was previously referred to as non-A; non-B hepatitis or chronic active hepatitis.
6490
Cell Q3246:For the pastBiology andweeks; aFlash Facts several Pathology 39-year-old woman has experienced fatigue; weakness; poor appetite; and weight loss. Physical examination shows hyperpigmentation of the skin and dark patches on the mucous membranes. Laboratory studies show her serum sodium level is 125 mEq/dL; and her serum potassium level is 6.0 mEq/dL. Which of the following is the most likely diagnosis?;A. Atrophic adrenals with dense lymphocytic infiltrate ;B. Carcinoid tumor of the vermiform appendix ;C. Functional follicular adenoma of the thyroid ;D. Granulosa cell tumor of the right ovary ;E. Hyperplasia of all 6491 four parathyroid glands
Option A (atrophic adrenals with dense lymphocytic infiltrate) is correct. This patient has Addison's disease; as suggested by the fatigue; weakness; poor appetite; and weight loss. Other characteristics include hyperpigmentation of the skin and dark patches on the mucous membranes. In developed countries; the most common cause of Addison's disease is autoimmune destruction of the adrenals; suggested by lymphoid infiltrates in the adrenal glands plus circulating antiadrenal antibodies. In developing countries; tuberculosis would also be a major cause.
6492
Q3247:For the past 6 months; an 18-year-old woman has had diarrhea; a fever; and cramping and left lower quadrant pain. Flexible sigmoidoscopy shows mucosal ulceration in the sigmoid colon. A biopsy shows transmural inflammation with occasional granulomas. Which of the following would differentiate Crohn's disease from ulcerative colitis?;A. History of fever ;B. History of prolonged diarrhea ;C. Involvement limited to the colon ;D. Presence of gross mucosal ulcerations ;E. Presence of transmural inflammation with granular formation
6493
Option E (presence of transmural inflammation with granular formation) is correct. Ulcerative colitis is essentially a disease of the mucosa; whereas Crohn's disease involves all layers of the bowel wall. A biopsy shows that this patient has transmural inflammation with occasional granulomas.
6494
Q3248:A 56-year-old man with a history of gastric ulceration and Helicobacter pylori infection has a lesion involving the stomach wall. A biopsy shows that the lesion is a mucosaassociated lymphoid tissue (MALT) lymphoma. Which of the following is the most likely source of this tumor?;A. B cells ;B. Histiocytes ;C. Natural killer (NK) cells ;D. T cells
6495
Option A (B cells) is correct. Mucosa-associated lymphoid tissue (MALT) lymphomas are low-grade B-cell lymphomas. Gastric MALT lymphoma has a strong association with H. pylori infection.
6496
Q3249:. A 18-year-old woman with mildly icteric sclerae has a total bilirubin of 5.5 mg/dL and a direct bilirubin of 0.4 mg/dL. She has no associated symptoms; and no history of exposure to hepatotoxins; blood products; or persons with known hepatitis. A brother is unaffected; but an uncle has a similar condition. This patient most likely has which of the following congenital hyperbilirubinemias? ;A. Crigler-Najjar syndrome; type I ;B. Crigler-Najjar syndrome; type II ;C. Dubin-Johnson syndrome ;D. Gilbert syndrome ;E. Rotor's syndrome
6497
Option D (Gilbert syndrome) is correct. Patients with this mild; inherited form of conjugated hyperbilirubinemia are healthy and have no functional or structural evidence of liver disease; except for an increase in unconjugated bilirubin.
6498
Q3250:A 51-year-old man with an 8-year history of cirrhosis has a mass lesion in the left lobe of the liver. A needle biopsy determines the lesion is hepatocellular carcinoma (HCC). In the United States; development of HCC is most commonly associated with which of the following?;A. Alcoholism ;B. Exposure to aflatoxin ;C. Hepatitis C (HCV) infection ;D. Microvesicular steatosis ;E. Neonatal hepatitis
6499
Option C (hepatitis C infection) is correct. HCV infection is most commonly associated with hepatocellular carcinoma. There is a marked reduction of cases of hepatitis B (HBV) in the United States due to the screening of blood used for transfusions.
6500
Q3251:A 12-year-old girl has metabolic acidosis and severe ketosis. Her blood glucose level is 460 mg/dL. Serologic studies for antibodies against b cells show a high titer of anti b cell antibodies. Which of the following is most significant concerning the finding of a high titer of these antibodies?;A. Are a serum marker for the destruction of b cells ;B. Are an indication of the development of type 2 diabetes mellitus ;C. Have caused the destruction of the b cells in the pancreatic islets;D. Form a complex with insulin that causes hyperglycemia
6501
Option A (are a serum marker for the destruction of b cells) is correct. It is currently thought that anti b cell antibodies arise from antigens released into the blood by the destruction of b cells; probably by cytotoxic T cells. Thus; they are a marker; not a cause; of b cell injury.
6502
Q3252:A 62-year-old woman with bilateral palpable masses in her abdomen has a creatinine level of 3.7 mg/dL and her blood urea nitrogen (BUN) is 32 mg/dL. During the past year; she has had hematuria with occasional small blood clots in her urine. Which of the following is the most likely diagnosis?;A. Medullary sponge kidney ;B. Nephronophthisis ;C. Polycystic kidney disease; autosomal dominant ;D. Polycystic kidney disease; autosomal recessive ;E. Renal dysplasia
6503
Option C (polycystic kidney disease; autosomal dominant) is correct. This clinical scenario of bilateral palpable abdominal masses and marked increase in creatine and BUN represents a fairly classic presentation of autosomal dominant (adult) polycystic disease.
6504
Q3253:A 24-year-old woman has painful urination with frequency and urgency. A physical examination shows an increase in heart rate and a temperature of 39.2\\'b0C (102.5\\'b0F). She appears ill and somewhat diaphoretic. A urine specimen is grossly red; and red blood cells (RBCs) are seen on microscopic examination. A urinalysis shows bacteria; polymorphonuclear leukocytes; and leukocyte casts. A nitrite test on a urine dipstick is positive. Which of the following is the most likely diagnosis?;A. Acute pyelonephritis ;B. Acute tubular necrosis ;C. Cystitis ;D. Nephrotic syndrome
6505
Option A (acute pyelonephritis) is correct. Leukocyte casts are formed only in the kidneys; and the presence of these casts is ample evidence of an infection of the renal parenchyma; characteristic of acute pyelonephritis.
6506
Q3254:A urinalysis of an asymptomatic 59-year-old man shows microscopic hematuria and mild prostatic hypertrophy. A CT scan of the abdomen shows a large mass in the left kidney. A needle biopsy confirms a diagnosis of renal cell carcinoma; clear-cell type. Radical nephrectomy indicates that the tumor appears to have invaded the man's left renal vein. If the tumor has metastasized; the most likely site of metastasis is;A. adrenal glands ;B. bones ;C. liver ;D. lungs ;E. regional lymph nodes
6507
Option D (lungs) is correct. Renal cell carcinoma is angioinvasive and tends to disseminate via the vascular system early in its history. If metastases occur; the lungs are involved in more than 50% of cases.
6508
Q3255:A 16-year-old girl whose mother was given diethylstilbestrol (DES) during her pregnancy because of threatened abortion wants to be evaluated in anticipation of problems associated with her mother's medical history. Which of the following conditions would represent a risk as a result of maternal use of DES?;A. Adenocarcinoma of the Bartholin's glands ;B. Adenocarcinoma of the endometrium ;C. Adenocarcinoma of the vagina ;D. Squamous cell carcinoma of the cervix ;E. Squamous cell carcinoma of the vulva
6509
Option C (adenocarcinoma of the vagina) is correct. A small percentage of female children born to women treated with DES (< 0.14%) eventually develop adenocarcinoma of the vagina. The tumor is usually detected between 15 and 20 years of age. The tumor cells contain abundant glycogen producing a so-called clear-cell carcinoma.
6510
Q3256:A 30-year-old woman fears that she will develop ovarian cancer because of her family history and is tested for the BRCA1 gene. This gene has a strong association with which of the following ovarian neoplasms?;A. Dysgerminoma ;B. Mixed M\\'fcllerian tumor ;C. Serous cystadenocarcinoma ;D. Yolk sac tumor
6511
Option C (serous cystadenocarcinoma) is correct. In women who are positive for the BRCA1 gene; the vast majority of ovarian tumors are serous cystadenocarcinomas. A woman who has a family history of ovarian cancer would be at risk for carrying the BRCA1 gene.
6512
Q3257:A 50-year-old woman with an infiltrating ductal carcinoma of the breast has a lumpectomy; followed by adjuvant radiation and chemotherapy. Tissue is sent to the laboratory to determine if any prognostic factors might be present in this woman. Which of the following findings would be associated with an extremely poor prognosis for this patient?;A. Estrogen receptors ;B. HER-2 neu amplification ;C. Mutated p53 oncoprotein ;D. Progesterone receptors
6513
Option B (HER-2 neu amplification) is correct. Tumors with oncogene amplification (HER-2 neu) tend to have a less favorable prognosis than those without this factor.
6514
Q3258:A 55-year-old slightly obese woman has had several bouts of intense right upper quadrant pain and now has scleral icterus. A cholecystectomy shows numerous spongy; laminated brown stones in the gallbladder. Brown gallstones are almost always associated with which of the following conditions?;A. Alcoholic cirrhosis ;B. Escherichia coli infection of the gallbladder ;C. History of mild b-thalassemia ;D. Hypercholesterolemia
6515
Option B (Escherichia coli infection of the gallbladder) is correct. Brown gallstones are almost always associated with E. coli cholecystitis. Bacteria may secrete b-glucuronidase; which hydrolyzes conjugated bilirubin to unconjugated bilirubin. The increase in concentration of unconjugated bilirubin is believed to produce the stones.
6516
Q3259:An endometrial biopsy of a 47-year-old woman with a history of irregular vaginal bleeding shows a welldifferentiated adenocarcinoma of the endometrium. A hysterectomy confirms tumor involvement of the corpus of the uterus and the cervix. Which of the following is a known risk factor for the development of endometrial carcinoma?;A. History of anovulatory menstrual cycles ;B. History of cervical human papillomavirus (HPV) infection ;C. Multiple pregnancies ;D. Thin body habitus
6517
Option A (history of anovulatory menstrual cycles) is correct. A history of irregular vaginal bleeding corroborates anovulatory menstrual cycles and is strongly associated with the development of endometrial cancer; probably because of prolonged estrogen stimulation.
6518
Q3260:A 40-year-old woman has enlarged lymph nodes in the axillae; groin; and cervical triangles. Biopsy of an axillary node shows complete effacement of the architecture of the nodes by nodular aggregates of lymphoma cells. Which of the following is the cell line of origin of this type of lymphoma?;A. B cell ;B. CD4+ T cell ;C. CD8+ T cell ;D. Histiocyte ;E. Natural killer (NK) cell
6519
Option A (B cell) is correct. The woman has follicular (nodular) lymphoma; a non-Hodgkin's (NHL) lymphoma that expresses B cell cluster of differentiation (CD) markers. All follicular (nodular) lymphomas are of B cell lineage.
6520
Q3261:A 64-year-old woman with a saccular aneurysm of the ascending aorta has ataxia and loss of joint position sense. She confabulates when the physician attempts to obtain a history. Which of the following organisms is capable of producing this constellation of findings?;A. Chlamydia trachomatis ;B. Haemophilus ducreyi ;C. Neisseria gonorrhoeae ;D. Treponema pallidum ;E. Trichomonas vaginalis
6521
Option D (Treponema pallidum) is correct. An aortic aneurysm with ataxia and impaired proprioception are characteristic of the tertiary stage of syphilis. The primary stage involves a painless genital ulcer and regional lymphadenopathy; and the secondary stage involves skin and mucosal lesions as well as possible meningeal; hepatic; renal; bone; and joint invasion.
6522
Q3262:When asked to speak to a women's group about risk factors for the development of breast cancer; the physician should tell the group that the histopathologic finding that carries the strongest risk factor for developing breast cancer is;A. apocrine metaplasia ;B. atypical lobular hyperplasia ;C. epithelial hyperplasia ;D. sclerosing adenosis
6523
Option B (atypical lobular hyperplasia) is correct. Atypical lobular hyperplasia is a moderate risk factor for the development of breast cancer.
6524
Q3263:A 51-year-old man has adenocarcinoma of the lesser curvature. Which of the following is the most important prognostic factor when evaluating a patient with this type of tumor?;A. Degree of differentiation ;B. Depth of invasion ;C. Gross growth pattern ;D. Histologic subtype of the carcinoma ;E. Presence of Helicobacter pylori
6525
Option B (depth of invasion) is correct. The morphologic feature with the greatest effect on clinical outcome in adenocarcinoma of the lesser curvature is depth of tissue invasion. Patients with carcinoma in the early stages (limited to the mucosa and submucosa) have a far better prognosis (90% survival with surgery) than patients with advanced carcinoma (<10% survival with surgery).
6526
Q3264:Individuals taking phenobarbital may be more susceptible to free radical injury by toxins such as carbon tetrachloride (CCl4). Phenobarbital induces which of the following subcellular changes? ;A. Additional receptor sites for CCl4 on the cell membrane of the hepatocytes;B. Atrophy of the Golgi zone within the hepatocytes ;C. Atrophy of the smooth endoplasmic reticulum (SER) within the;hepatocytes ;D. Increased formation of G proteins within the hepatocytes ;E. Marked hypertrophy of the SER within the hepatocytes
6527
Option E (marked hypertrophy of the SER within the hepatocytes) is correct. Phenobarbital induces hypertrophy of the SER and hence a marked increase in cytochrome p450 activity. The conversion of CCl4 into the toxic free radical CCl3 by the cytochrome p450 system causes the injury.
6528
Q3265:A 67-year-old retired airline pilot slipped on the ice; striking his head on the sidewalk. His history is unremarkable. A CT scan of the head shows no sign of hematoma; but does show atrophy of the cerebral hemispheres. The atrophy is most likely due to;A. decreased daily workload ;B. diminished blood supply ;C. inadequate nutrition ;D. loss of endocrine stimulation ;E. loss of innervation
6529
Option B (diminished blood supply) is correct. Atherosclerosis leads to reduced blood flow to the brain and is thought to be the major culprit in the etiology of cerebral atrophy in the elderly.
6530
Q3266:A 50-year-old man who has smoked two packs of cigarettes a day for 30 years has squamous metaplasia of the respiratory epithelium. His physician tells him that smoking is a major cause of metaplasia; but there are other causes for this change. Which of the following may also cause squamous metaplasia of bronchial mucosa?;A. Deficiency of folate ;B. Deficiency of vitamin A ;C. Excess vitaminB2 ;D. Excess vitamin C ;E. Excess vitamin D
6531
Option B (deficiency of vitamin A) is correct. Vitamin A and retinoids are necessary in maintaining the differentiation of epithelial cells. Deficiency of vitamin A causes squamous metaplasia of the respiratory tract epithelium as well as impaired vision; night blindness; and xerophthalmia.
6532
Q3267:When an acute inflammatory reaction develops in response to an injurious stimulus; endothelial cells and macrophages produce nitric oxide (NO). During acute inflammation; NO functions to ;A. cause pain ;B. induce smooth muscle contraction ;C. opsonize bacteria ;D. produce fever ;E. promote vasodilation
6533
Option E (promote vasodilation) is correct. NO is produced by nitric oxide synthase and is somewhat cytotoxic. NO causes the relaxation of vascular smooth muscle; leading to vasodilation.
6534
Q3268:A 61-year-old woman with a lengthy history of hypertension dies of an acute myocardial infarction (MI). At autopsy; the heart shows gross hypertrophy of the left ventricle. The adaptive mechanism responsible for the increase in the mass of the ventricle is most likely;A. fusion of individual muscle fibers into larger; stronger units ;B. increased cycling of cells out of G 0 ;1 phase ;C. increased individual cell size; with no mitotic activity ;D. increased mitotic rate and the production of more cells ;E. primarily an increase in individual cell size; with normal mitotic activity
6535
Option C (increased individual cell size; with no mitotic activity) is correct. The increase in cardiac and skeletal mass is due to an increase in the size of individual muscle fibers. These cells are not capable of significant mitotic activity.
6536
Q3269:Several weeks after sustaining a gunshot wound; the bullet is surgically removed from the shoulder of a 20-year-old man. Histologically; the lesion resembles a chronic inflammatory infiltrate; with numerous macrophages surrounding the bullet. In the chronic inflammatory response; macrophages are especially important because they are;A. capable of local proliferation ;B. easily recruited from the circulation ;C. involved in the production of numerous biologically active substances ;D. permanently localized to the site of inflammation
6537
Option C (involved in the production of numerous biologically active substances) is correct. Macrophages produce an abundance of biologically active substances (e.g; toxic free radicals; proteases; cytokines; growth factors; and angiogenesis factor); and all are involved in chronic inflammation.
6538
Q3270:A 30-year-old black woman who resides in North Carolina develops increasing shortness of breath. A physical examination shows lymphadenopathy in the axillae and groin. X-ray film of the chest shows a marked degree of hilar lymph node enlargement. A biopsy of an enlarged axillary lymph node shows numerous noncaseating granulomas. No organisms are identifiable; and acid-fast stains are negative. These findings are most likely caused by which of the following?;A. Coccidioidomycosis ;B. Cryptococcosis ;C. Histoplasmosis ;D. Sarcoidosis ;E. Tuberculosis
6539
Option D (sarcoidosis) is correct. Sarcoidosis typically produces noncaseating ("hard") granulomas; rather than lesions characterized by central caseous necrosis. In addition; multisystem involvement; including skin; lungs; lymph nodes; liver; spleen; eyes; and the small bones of the hand and feet; is typical. Sarcoidosis occurs mainly in individuals between the ages of 20 and 40 years; risk is higher in the black population.
6540
Q3271:A 63-year-old man has a history of congestive heart failure due to severe arteriosclerosis of the coronary arteries. He now has pitting edema of the ankles that extends about halfway up the lower part of his legs. The edema in this patient is most likely caused by which of the following mechanisms?;A. Decreased oncotic pressure in the vascular compartment ;B. Impaired lymphatic drainage of the legs ;C. Increased hydrostatic pressure in the vascular compartment ;D. Increased oncotic pressure in the extracellular compartment ;E. Increased vascular permeability
6541
Option C (increased hydrostatic pressure in the vascular compartment) is correct. In this patient; the increased pressure is the main cause of dependent edema. The failing right side of the heart (right atrium and ventricle) has led to an increase in intravascular hydrostatic pressure; which eventually causes a net movement of fluid from the vascular space to the extravascular space.
6542
Q3272:An 18-year-old man scheduled to undergo surgery to repair a hernia has a history of easy bruising and a tendency to bleed for an abnormally long time after an injury. Laboratory studies show prolonged bleeding time; normal prothrombin time; and slightly prolonged partial thromboplastin time. Which of the following is the most specific laboratory test that would confirm the suspected diagnosis of von Willebrand's disease?;A. Clot retraction test ;B. Factor VIII assay ;C. Ristocetin aggregation test ;D. Thrombin time
6543
Option C (ristocetin aggregation test) is correct. Ristocetin binds to platelets; activating von Willebrand's factor (vWF) receptors on the surface. If vWF is present; it forms a bridge between receptors on different platelets; causing platelet aggregation.
6544
Q3273:A 40-year-old man who was involved in an automobile accident is being treated for a fracture of the pelvis. The man is at increased risk of developing pulmonary emboli because of relative stasis of venous flow in his legs. Which of the following most accurately describes these emboli?;A. Most are clinically silent ;B. They are rare ;C. They commonly cause chronic pulmonary hypertension ;D. They typically cause pulmonary infarction ;E. They usually cause immediate death
6545
Option A (most are clinically silent) is correct. The majority of pulmonary emboli (60\\'9680%) are small; thus; they are clinically silent. Autopsy series are the source of most of the data; and the frequency of finding emboli tends to be related to the diligence of the pathologist.
6546
Q3274:A 54-year-old woman with severe right upper quadrant pain; fever; and jaundice is in shock when brought to the emergency department. A blood culture grows Escherichia coli. The presumptive diagnosis is acute cholecystitis. The most likely cause of shock is ;A. anaphylactic reaction ;B. cardiogenic shock ;C. endotoxemia ;D. hemorrhage ;E. neurogenic shock
6547
Option C (endotoxemia) is correct. Endotoxin (lipopolysaccharide); a component of the cell walls of gramnegative bacteria; binds to CD14 receptors. It causes a cascade of events that result in shock; metabolic failure; disseminated intravascular coagulopathy; and eventually multiple organ failure.
6548
Q3275:A 46-year-old woman delivers a newborn with the physical features associated with Down's syndrome (trisomy 21). A FISH (fluorescent in situ hybridization) assay shows the presence of three number 21 chromosomes. The most common mechanism causing trisomy 21 is;A. failure of lyonization ;B. formation of a ring chromosome ;C. meiotic nondisjunction of chromosome 21 in the ovum ;D. mitotic nondisjunction of chromosome 21 early in embryogenesis ;E. robertsonian translocation of the long arm of chromosome 21 to an acrocentric chromosome
6549
Option C (meiotic nondisjunction of chromosome 21 in the ovum) is correct. Down's syndrome typically affects children born of women over 35 years of age; and is of maternal origin but of undetermined etiology. The most common mechanism of trisomy 21 (>90% of cases) involves the meiotic nondisjunction of chromosome 21.
6550
Q3276:A 27-year-old man is a diagnosed with a diffuse large cell lymphoma. Genetic analysis of DNA from the lymphoma cells shows rearrangement of the immunoglobulin genes. Which of the following is the most likely origin of this lymphoma? ;A. B-cell lymphoma ;B. Histiocytic lymphoma ;C. Natural killer (NK) cell lymphoma ;D. T-cell lymphoma
6551
Option A (B-cell lymphoma) is correct. Somatic rearrangement of the immunoglobulin genes marks this lesion as a lymphoma of B cell origin. Lymphoma is a monoclonal lesion; so all of the tumor cells exhibit identical patterns of immunoglobulin gene rearrangement.
6552
Q3277:A 32-year-old woman has a family history of a high incidence of neoplasia involving multiple organ systems. She undergoes genetic screening for several tumor suppressor genes and oncogenes and is found to have Li-Fraumeni syndrome. The genetic defect associated with this syndrome is loss of one allele of which of the following genes?;A. bcl-2 ;B. NF-1 ;C. P53 ;D. RB ;E. WT1
6553
Option C (P53) is correct. Loss of one of the alleles of the P53 gene is the basis of the Li-Fraumeni syndrome. Patients with this syndrome have an increase in the development of malignant neoplasms arising in various anatomic locations. P53; a tumor suppressor gene that also has oncogene-like properties when mutated; produces an abnormal gene product that is not degraded with normal speed. Patients with a mutated or missing P53 gene have an increased risk of developing malignancies in various tissues.
6554
Q3278:The mechanism thought to be responsible for the increasingly aggressive behavior of malignant tumors is that they;A. are genetically labile ;B. cause the production of tumor necrosis factor-a (TNF-a) ;C. induce angiogenesis ;D. produce paraneoplastic syndromes
6555
Option A (are genetically labile) is correct. Malignant tumors are constantly mutating and forming new clones. Many of the clones die; but some will have a selective advantage with regard to growth; invasion; or metastasis.
6556
Q3279:A 32-year-old man has had vague abdominal discomfort; bloating; and diarrhea since returning from a camping trip 2 weeks ago where he routinely drank mountain stream water. Stool smears show triangular-shaped organisms containing two nuclei. Which of the following is the most likely cause of the diarrhea?;A. Balantidium coli ;B. Entamoeba histolytica ;C. Giardia lamblia ;D. Vibrio cholerae
6557
Option C (Giardia lamblia) is correct. G. lamblia is the most prevalent pathogenic intestinal protozoan. It attaches to the mucosa rather than invading it; thus; it tends to cause irregular (intermittent) watery diarrhea rather than dysentery. In some patients; it causes constipation; in others; it causes steatorrhea. Symptoms of giardiasis generally occur 1\\'963 weeks after infection.
6558
Q3280:A 50-year-old woman who has been taking estrogen daily; without interruption; for a long period of time is at significant risk for the development of ;A. endometrial adenocarcinoma ;B. endometrial atrophy ;C. enlarged corpora lutea ;D. ovarian teratoma
6559
Option A (endometrial carcinoma) is correct. The risk for development of endometrial adenocarcinoma is about 1.7\\'962.0 times the normal rate in patients who take unopposed estrogen on a continuous basis; without interruption.
6560
Q3281:A 17-year-old girl with Hodgkin's disease was treated successfully with aggressive chemotherapy; and the disease has been in remission for 2 years. She is now at increased risk for the development of a second malignant tumor. Which of the following changes is most likely caused by antineoplastic agents?;A. Depression of immune surveillance ;B. Depression of the mononuclear phagocyte system ;C. Induction of nonlethal mutations ;D. Induction of telomerase ;E. Promotion of tumor angiogenesis
6561
Option C (induction of nonlethal mutations) is correct. Most antineoplastic agents act on dividing cells at some specific point in the cell cycle. In damaging the reproductive function of the cell; accumulating nonlethal mutations may occur; which may result in the formation of a second neoplasm.
6562
Q3282:An 18-year-old college student who was seen drinking heavily at a party is found in his room completely unresponsive. When he is admitted to the emergency department; his blood alcohol level is 325 mg/dL. In a nonhabituated drinker; this level of blood alcohol is associated with;A. coma and respiratory collapse ;B. congestive cardiomyopathy ;C. development of acute yellow atrophy of the liver ;D. Korsakoff's syndrome ;E. Wernicke's encephalopathy
6563
Option A (coma and respiratory collapse) is correct. Alcohol acts as a central nervous system (CNS) depressant via mechanisms that are still unclear; but possibly by action on GABA receptors. At alcohol levels of 300\\'96400 mg/dL; coma and respiratory collapse are likely. Individuals who chronically abuse the substance will tolerate higher levels.
6564
Q3283:A 47-year-old man is brought to the emergency department after being exposed to an unknown dose of radiation due to malfunction of the industrial radiographic unit he operates. His coworkers think he may have received whole-body radiation exposure. Which of the following would be most sensitive to radiation exposure?;A. Bladder epithelium ;B. Cartilage ;C. Hair follicles ;D. Kidney ;E. Lymphoid tissue
6565
Option E (lymphoid tissue) is correct. Lymphoid tissue; hematopoietic tissue; spermatogonia; and ovarian follicles are all highly sensitive to radiation.
6566
Q3284:A 24-year-old man has a history of fever; weight loss; hypertension; and abdominal pain. Stool and urinalysis are positive for the presence of blood. Several nodular skin lesions are found. A biopsy shows necrotizing arteritis involving medium-sized muscular arteries. This constellation of findings is most suggestive of;A. Kawasaki disease ;B. polyarteritis nodosa ;C. syphilis ;D. systemic lupus erythematosus (SLE) ;E. Takayasu's arteritis
6567
Option B (polyarteritis nodosa) is correct. Necrotizing inflammation of affected arteries is characteristic of polyarteritis nodosa; a disease that typically involves medium-sized muscular arteries. This disease may involve fever and weight loss; and hypertension is common. Gastrointestinal lesions are the source of the abdominal pain. The disease may affect individuals of any age.
6568
Q3285:A 52-year-old man complains of general malaise. Physical examination shows an enlarged liver; and an MRI shows a mass in the left lobe of the liver. A liver biopsy confirms the mass as an angiosarcoma. The patient most likely has been exposed to which of the following toxins?;A. Carbon tetrachloride (CCl4) ;B. b-naphthylamine ;C. Nickel carbonyl ;D. Organophosphates ;E. Polyvinyl chloride
6569
Option E (polyvinyl chloride) is correct. Polyvinyl chloride; a known carcinogen; is associated with the development of hepatic angiosarcoma.
6570
Cell Biology and Pathology Flash Q3286:A 48-year-old man comes toFacts emergency the department because of severe chest pain. He is 5 ft 8 in tall and weighs about 90 kg (200 lb). He describes the pain as sudden in onset; producing a sensation of "tearing." Nitroglycerin spray provides no relief. An ECG shows no changes suggestive of an acute myocardial infarction (MI). Angiography shows a dissecting aneurysm of the aorta. The most likely antecedent condition associated with development of a dissecting aneurysm is;A. hypertension ;B. Marfan's syndrome ;C. severe atherosclerosis ;D. syphilis ;E. systemic 6571 lupus erythematosus (SLE)
Option A (hypertension) is correct. Over 90% of patients who develop a dissecting aneurysm; and who have neither Marfan's syndrome nor a localized connective tissue disorder; are hypertensive.
6572
Q3287:A 29-year-old woman has a soft midsystolic click on auscultation of the heart. Ultrasound examination shows a mitral valve prolapse. The most likely eventual outcome of this condition is ;A. embolism by platelet aggregates ;B. mitral valve incompetence ;C. mitral valve stenosis ;D. normal life
6573
Option D (normal life) is correct. A mitral value prolapse generally is benign. About 97% of female patients with the condition experience no significant untoward effects.
6574
Q3288:As a result of the decreased incidence of patients with chronic rheumatic fever; consequent damage to the cardiac valves has diminished. The most common antecedent condition leading to infectious myocarditis presently is;A. congenital heart disease;B. endocardial trauma;C. hypercoagulable state;D. leukemia;E. mucin-producing adenocarcinoma
6575
Option A(congenital heart disease) is correct. Rheumatic heart disease was once considered the most common condition that could lead to infectious endocarditis. Presently; congenital lesions; particularly those that produce a "jet" effect such as a small ventricular septal defect; are more common and are a risk factor for infective endocarditis.
6576
Q3289:A 63-year-old woman with a history of type 2 diabetes mellitus and an increasing exercise limitation is admitted to the hospital with severe influenza pneumonitis. She subsequently develops adult respiratory distress syndrome (ARDS) and dies 4 days after admission. Autopsy shows the heart encased in a 1-cm dense collagenous scar. Which of the following is the most likely cause of constrictive pericarditis?;A. Cryptococcosis ;B. Histoplasmosis ;C. Idiopathic ;D. Oat cell carcinoma ;E. Tuberculosis
6577
Option C (idiopathic) is correct. A well-defined history of a previous suppurative; hemorrhagic; or caseous pericarditis is often absent in the patient who dies of constrictive pericarditis.
6578
Q3290:A 72-year-old woman complains of feeling weak. Laboratory studies show a hematocrit of 18%; macrocytosis; hypersegmentation of neutrophils; and occasional giant platelets. Her lactate dehydrogenase (LDH) level is 2950 U/L; and her serum vitamin B12 is 27 pg/mL. Which of the following conditions most likely caused the increase in LDH? ;A. Cardiomyopathy ;B. Hypersplenism ;C. Ineffective erythropoiesis ;D. Intravascular hemolysis ;E. Liver failure
6579
Option C (ineffective erythropoiesis) is correct. Patients with vitamin B12 deficiency have hyperplasia of the red blood cell (RBC) elements in the bone marrow; but the developing RBCs are destroyed in the marrow before they can be released into the circulation. When RBCs are destroyed; they release their large quantity of LDH into the plasma.
6580
Q3291:A 22-year-old medical student volunteers for a hematology research project and is found to be lacking one of four a-globin genes. Previously; he had several hematologic studies that were within normal limits. The significance of this unexpected finding suggests that the student;A. has a moderate degree of erythroid hyperplasia in bone marrow ;B. has an abnormal hemoglobin concentration ;C. has numerous target cells in the peripheral blood ;D. is an asymptomatic carrier of a-thalassemia ;E. may develop severe hemolytic anemia if exposed to oxidant drugs
6581
Option D (is an asymptomatic carrier of a-thalassemia) is correct. Deletion of one of the four a-globin genes produces a silent carrier state; and no hematologic abnormalities are evident. One of the chromosome 16 genes carries this deficiency. If such an individual has offspring with another carrier; the children could have the a-thalassemia trait. There are four functional a-globin genes; thus; there are four possible degrees of a-thalassemia (based on the loss or one to four genes). This individual has the mildest form; the most severe form is associated with fetal death in utero.
6582
Q3292:A 36-year-old man has generalized lymphadenopathy. A histologic examination of a lymph node shows a marked degree of follicular hyperplasia. Which of the following findings would best determine that this condition is a benign reactive process rather than neoplastic?;A. Polyclonality on DNA hybridization studies ;B. Presence of broad increase in IgG on high-resolution electrophoresis ;C. Presence of surface IgG on the cell membrane of the proliferating cells ;D. Presence of translocation t (14;18)(q32;q21)
6583
Option A (polyclonality on DNA hybridization studies) is correct. Polyclonality is a sign of a benign process. Lymphoma is the result of monoclonal expansion of a single cell that has become malignant.
6584
Q3293:A patient has vague symptoms of weakness and fatigue and decreased exercise tolerance. Laboratory studies show a leukocyte count of 11;000/mm with 7% blasts on the peripheral smear. Bone marrow aspirate shows 40% myeloblasts. Acute myeloblastic leukemia is suspected. This patient is most likely between the ages of;A. birth to 2 years;B. 2-10 year;C. 10-15 years;D. 15-40 years;E. >40 years
6585
Option D is correct. Acute myeloblastic leukemia (AML) is primarily a disease of young adults.
6586
Q3294:A 67-year-old woman with a 15-year history of severe coronary artery disease and multiple infarcts of the left ventricle and interventricular septum is hospitalized with acute pulmonary edema. Which of the following conditions is the primary physiologic event leading to pulmonary edema?;A. Decreased plasma oncotic pressure ;B. Left-sided congestive heart failure ;C. Lymphatic obstruction ;D. Rightsided congestive heart failure ;E. Volume overload
6587
Option B (left-sided congestive heart failure) is correct. Failure of the left ventricle causes increased pressure in the pulmonary circulation; which leads to a net movement of fluid from the vascular to the extravascular compartment (Starling's hypothesis).
6588
Q3295:A 29-year-old man is brought to the emergency department after sustaining third-degree burns over 60% of his body. Twenty-four hours later; he develops adult respiratory distress syndrome (ARDS). Which of the following physiologic features would suggest a diagnosis of restrictive lung disease in this patient?;A. Decreased PaO2 ;B. Decreased pulmonary elastic recoil ;C. Decreased total lung volume ;D. Increased PaCO2;E. Increased pulmonary blood flow
6589
Option C (decreased total lung volume) is correct. All of the restrictive lung diseases; including ARDS; have a unifying physiologic abnormality\\: reduction in total lung capacity. This is often due to parenchymal lung disease; but it can also be the result of neuromuscular disease; skeletal diseases; pleural disease; and acute trauma such as bilaterally fractured ribs that produce a flail chest.
6590
Q3296:A 12-year-old child develops wheezing and dyspnea after petting a cat. The child is suffering from which of the following forms of asthma?;A. Allergic bronchopulmonary aspergillosis ;B. Atopic asthma ;C. Intrinsic nonreaginic asthma ;D. Intrinsic pharmacologic asthma ;E. Occupational asthma
6591
Option B (atopic asthma) is correct. Atopic; or allergic; asthma involves a type I hypersensitivity reaction. The binding of an inhaled specific allergen; such as cat dander; to IgE on the surface of a mast cell induces an attack of typical atopic asthma.
6592
Q3297:A 17-year-old boy works for a contractor sandblasting painted concrete surfaces during his summer vacation. In a dusty environment such as this; which of the following sizes of potentially inhaled dust particles has the greatest capacity for causing pulmonary injury?;A. <1 mm ;B. 1mm ;C. 5mm ;D. 10mm ;E. >20mm
6593
Option B (1 mm) is correct. Dust particles within the size range of 1mm have great potential for causing pulmonary injury. Bacteria fit nicely into this size range. Shape is also an important factor in considering capacity for pulmonary injury. Although objects such as asbestos fibers are quite long; they can also gain access to the terminal airways and alveoli because they are thin.
6594
Q3298:A 67-year-old woman is admitted to the hospital with symptoms of pleuritic chest pain; cough productive of rusty looking sputum containing innumerable neutrophils; and a temperature of 39.2\\'b0C (102.5\\'b0F). She is an alcoholic. X-ray film of the chest shows that most of the right middle lobe is opacified. Which of the following is the most likely cause of the infection?;A. Haemophilus influenzae ;B. Klebsiella pneumoniae ;C. Mycoplasma pneumoniae ;D. Staphylococcus aureus ;E. Streptococcus pneumoniae
6595
Option E 9Streptococcus pneumoniae) is correct. The x-ray film of the chest shows the presence of an intra-alveolar exudate with lobar or segmental consolidation;S. pneumoniae (pneumococcus) accounts for 90-95% of cases of lobar pneumonia. Alcoholism is a major risk factor for pneumonia and can lead to increased morbidity and mortality.
6596
Q3299:A 69-year-old man sees his physician because of increasing shortness of breath. X-ray film of the chest shows that most of the right lung is encased by a thick layer of moderately dense tissue. Pleural fluid is blood-tinged with numerous atypical cells. The patient is most likely to have a history of occupational exposure to which of the following substances?;A. Asbestos ;B. Formalin ;C. Hematite ;D. Nickel carbonyl ;E. Silica
6597
Option A (asbestos) is correct. About 90% of malignant mesotheliomas are related to occupational exposure to asbestos. Individuals who have been exposed to asbestos have an 8% risk of developing malignant mesothelioma. There is a long latent period; with the tumor appearing from about 20-40 years after exposure to the substance.
6598
Q3300:A 65-year-old woman is undergoing a physical examination when the physician notices her mucous membranes are somewhat pale and her tongue is beefy red to magenta colored. There is slight cracking of the skin around the angles of her mouth; and her fingernails are slightly spoonshaped. She has difficulty swallowing. Laboratory studies show a red blood cell count of 12 mL/kg and a hematocrit of 30%. The most likely cause of this patient's condition is a deficiency of;A. iron ;B. niacin ;C. pyridoxine ;D. riboflavin ;E. vitamin B12
6599
Option A (iron) is correct. The history and physical findings suggest that the woman has Plummer-Vinson syndrome; which is characterized by iron-deficiency anemia; glossitis; cheilosis; and dysphagia due to formation of upper esophageal webs.
6600
Q3301:A 43-year-old woman sees her physician because of a swollen gland on the left side of her neck. Examination shows a firm mass in the left parotid gland. On palpation; the mass does not move with the overlying skin. The most likely diagnosis is;A. acinic cell carcinoma ;B. adenoid cystic carcinoma ;C. mucoepidermoid carcinoma ;D. pleomorphic adenoma ;E. Warthin's tumor
6601
Option D (pleomorphic adenoma) is correct. This benign tumor accounts for about 50% of salivary gland tumors. The location of the tumor (in the left parotid gland) and the sex of the patient (female) increase the likelihood of the tumor being a pleomorphic adenoma.
6602
Q3302:A 54-year-old man with a history Facts Cell Biology and Pathology Flash of gastroesophageal reflex disease (GERD) is prescribed a proton pump inhibitor. He says he cannot afford the medication and is unable to adhere to the recommended treatment regimen; but instead relies on over-the-counter medications such as antacids and herbal remedies. Brush cytology of the esophagus shows marked reactive changes of the squamous cells as well as the presence of reactive glandular cells consistent with origin in the body of the stomach. This patient is most seriously at risk of developing ;A. adenocarcinoma ;B. esophageal candidiasis ;C. esophageal stenosis ;D. esophageal varices ;E. 6603 ulceration of the esophageal mucosa
Option A (adenocarcinoma) is correct. The presence of glandular cells in the esophageal brushing indicates that the patient has glandular metaplasia of the esophageal mucosa; or Barrett's esophagus (metaplastic columnar epithelium); a complication of chronic GERD. Adenocarcinoma of the esophagus is 30-40 times more likely to occur in patients with Barrett's esophagus.
6604
Q3303:A 42-year-old man has a boring midepigastric pain and occasional tarry stools. Over-the-counter antacids relieve the pain; and aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) generally aggravate it. X-ray film of the upper gastrointestinal tract shows the presence of a 1- to 2cm erosion in the duodenal mucosa about 4-cm distal to the pylorus. Which of the following is the most likely cause of this patient's condition?;A. Gastrinoma ;B. Helicobacter pylori infection ;C. Insulinoma ;D. NSAID ingestion ;E. Vitamin B12 deficiency
6605
Option B (Helicobacter pylori infection) is correct. Infection with ;H. pylori causes the development of most duodenal and many gastric ulcers. The mechanism by which the organism causes peptic ulcer disease is not well understood.
6606
Q3304:An autopsy of a 7-year-old boy who died of irreversible heart failure shows a patchy but focally dense infiltrate of chronic inflammatory cells; predominantly lymphocytes; in the myocardium. Cardiac myocytes in the vicinity of the lymphoid aggregates show focal necrosis. No abnormalities of the cardiac vasculature are evident. Light microscopy shows no organisms. Which of the following is most commonly associated with these findings?;A. Chronic toxoplasmosis ;B. Corynebacterium diphtheriae ;C. Lyme disease ;D. Recent acute viral illness ;E. Rubella
6607
Option D (recent acute viral illness) is correct. Infectious myocarditis is most often associated with an acute viral illness of recent occurrence (possibly with the past 5-30 days) involving an organ other than the heart. Offending organisms are typically coxsackievirus; echovirus; poliovirus; and influenza. Diagnosis of the etiologic agent often requires demonstration of a rising titer of antibody against the suspected virus.
6608
Q3305:Meckel's diverticulum is an uncommon congenital malformation that is usually a clinically silent condition. In some cases; Meckel's diverticulum can be confused with appendicitis in the presence of;A. heterotopic gastric tissue ;B. heterotopic pancreatic tissue ;C. obstruction of the small intestine ;D. roundworm infestation ;E. ulcerative colitis
6609
Option A (heterotopic gastric tissue) is correct. Meckel's diverticulum is a congenital malformation of the small intestine; and occurs in about 2% of the population. It is uncommon; but not rare. If the diverticulum contains heterotopic gastric mucosa; it may ulcerate and cause significant bleeding. It can produce symptoms similar to appendicitis (e.g; right lower quadrant pain).
6610
Q3306:A 4-year-old boy develops hemarthrosis of the right knee with no known preceding traumatic episode. He has not shown any previous abnormal bleeding tendencies associated with the usual childhood trauma. The patient's history suggests an X-linked recessive trait on his mother's side of the family. Which of the following studies would most likely be abnormal?;A. Bleeding time ;B. Partial thromboplastin time (PTT) ;C. Prothrombin time (PT) ;D. Thrombin time
6611
Option B (partial thromboplastin time) is correct. PTT is a measure of the intrinsic clotting pathway and is abnormal if factor VIII or factor IX activity is reduced. Although PTT is generally adequate to screen for hemophilia; factor VIII or factor IX assay are required to confirm the diagnosis. Hemophilia A and hemophilia B are not clinically distinguishable.
6612
Q3307:A febrile 23-year-old woman complains of fatigue; Cell Biology and Pathology Flash Facts right upper quadrant pain; and difficulty swallowing. Physical examination shows exudative tonsillitis; palatal petechia; tender cervical lymphadenopathy; splenomegaly; and tender hepatomegaly. A complete blood cell count shows mild microcytic anemia; lymphocytic leukocytosis with ~20% of the lymphocytes having atypical features; and a mild thrombocytopenia. Which of the following laboratory findings is expected in this patient?;A. Low total iron-binding capacity ;B. Normal serum ferritin ;C. Normal serum transaminases ;D. Positive hepatitis B surface antigen ;E. Positive heterophile 6613 antibody test
Option E (positive Biology and Pathology Flash test) is correct. The Cell heterophile antibody Facts patient most likely has infectious mononucleosis (IM); which is caused by the Epstein-Barr virus (EBV). The virus infects B cells initially by attaching to CD 21 receptors on the cell surface. Circulating T lymphocytes interact with the infected B cells and become antigenically stimulated; resulting in atypical lymphocytosis. The key screening test for IM is the Monospot test; which detects heterophile antibodies in the patient's serum. Heterophile antibodies unique to IM are IgM antibodies directed against horse red blood cells (RBCs). An agglutination reaction against horse RBCs is the basis for a 6614 positive Monospot test.
Q3308:A routine physical examination of an asymptomatic; normotensive 21-year-old African American woman is Cell Biology and Pathology Flash Facts normal; however; a urinalysis shows red blood cells (RBCs) with no casts. The patient says that she occasionally has had blood in her urine in the past. A urine culture is negative. Laboratory studies show;Serum blood urea nitrogen (BUN) 10 mg/dL ;Serum creatinine 1.0 mg/dL ;Hemoglobin 11.0 g/dL ;Mean corpuscular volume 78 ;Reticulocyte count; corrected 2% ;The peripheral smear shows occasional hypochromatic RBCs. Renal ultrasonography is normal. Which of the following is the next best step in the management of this patient?;A. Bone marrow examination ;B. Cystoscopy ;C. 6615 Renal biopsy ;D. Sickle cell preparation ;E. No further investigation is necessary
Option D (sickle cell preparation) is correct. The patient most likely has sickle cell trait; which causes recurrent microscopic hematuria. Although the percentage of sickle hemoglobin in sickle cell trait is only ~40%; with the remainder representing hemoglobin A; the oxygen tension in the renal medulla is low enough to induce sickling of the RBCs in the peritubular capillaries. This results in microinfarctions in the renal medulla and the potential for renal papillary necrosis and loss of both concentration and dilution of urine.
6616
Cell Biology and Pathology Flash Q3309:A 72-year-old man complains of Facts sudden onset of left flank pain and dizziness when he stands up quickly. When he is lying down; his blood pressure is 100/80 mm Hg; and his pulse is 110/min. When he is moved to a sitting position; his blood pressure is 80/60 mm Hg; and his pulse is 160/min. A pulsatile mass is palpated in the abdomen. The pathogenesis of the patient's flank pain and hypotension is most closely attributed to structural weakness of the aorta due to ;A. genetic defect in collagen ;B. genetic defect in fibrillin ;C. immunocomplex-mediated disease ;D. normal changes associated with aging6617 severe atherosclerosis ;E.
Option E (severe atherosclerosis) is correct. The patient has the classic triad of a ruptured abdominal aortic aneurysm: sudden onset of left flank pain; hypotension; and a pulsatile abdominal mass. Atherosclerotic damage of the abdominal aorta weakens the vessel wall; leading to outpouching of the aorta and the potential for rupture as the expansion increases wall stress.
6618
Q3310:An afebrile Biology and Pathology Flash Factswho is living in a Cell 35-year-old sheepherder Basque community in southern Arizona complains of recurrent right upper quadrant pain. The sheepherder says that he and his dog spend their days together tending the sheep. A complete blood cell count shows a marked increase in the percentage of eosinophils. An ultrasound of his liver shows a cystic mass with calcifications in the lining of the cyst. Which of the following most accurately describes the epidemiology of this patient's liver disease;;A. The dog ate infected sheep ;B. The dog is an intermediate host ;C. The sheep is a definitive host ;D. The sheepherder ate infected 6619 sheep ;E. The sheepherder is a definitive host
Option A (the dog ate infected sheep) is correct. The patient has echinococcosis due to the tapeworm Echinococcus granulosis or E. multilocularis. In the normal developmental cycle of the Echinococcus species; adult worms mate and lay eggs that develop into larvae. The larvae mature into adult worms; and the cycle repeats. Hosts containing the larval form are called intermediate hosts; while hosts containing the adult worms are called definitive hosts.
6620
Q3311:A 24-year-old professional weight lifter develops sudden onset of abdominal pain while bench-pressing 550 pounds. Within 10 minutes of the onset of pain; he becomes hypotensive and collapses. During emergency surgery; the surgeon finds clotted and unclotted blood filling the peritoneal cavity. Which of the following best explains the likely origin of the patient's intra-abdominal bleeding?;A. Ruptured abdominal aortic aneurysm ;B. Ruptured cavernous hemangioma of the liver ;C. Ruptured liver cell (hepatic) adenoma ;D. Ruptured splenic artery aneurysm
6621
Option C (ruptured liver cell adenoma) is correct. Professional weight lifters commonly use anabolic steroids to increase muscle mass and strength. One of the complications of anabolic steroids is the development of liver cell (hepatic) adenomas; which are benign tumors arising from hepatocytes. These tumors tend to rupture and produce intraperitoneal hemorrhage. Women taking estrogen-containing medications are subject to the same complication.
6622
Q3312:An 84-year-old man complains of lower back pain and inability to void urine over the past 24 hours. Physical examination shows point tenderness over the lower lumbar vertebrae and an enlarged bladder extending to the level of the umbilicus. The physician suspects metastatic prostate cancer. Which of the following is indicated as the first step in the management of this patient?;A. Digital rectal examination ;B. Prostate-specific antigen (PSA) ;C. Radionuclide bone scan ;D. Serum alkaline phosphatase ;E. Transrectal ultrasound with biopsy
6623
Option A (digital rectal examination) is correct. Prostate cancer is the most common cancer in men. Point tenderness over the vertebral bodies in an elderly patient is highly suggestive of metastatic prostate cancer; especially coupled with clinical evidence of urinary retention. Because prostate cancers develop in the peripheral zone of the prostate; they are palpated easily by digital rectal examination; especially if they have already spread beyond the gland.
6624
Q3313:A 35-year-old pharmacist complains of recurrent episodes of forgetfulness and tiredness. Physical examination is essentially unremarkable. Laboratory studies show a serum glucose level of 20 mg/dL. Additional studies on the same serum sample show a high serum insulin level and a low Cpeptide level. Based on these findings; which of the following is the most likely diagnosis?;A. Benign tumor involving b-islet cells in the pancreas;B. Ectopic secretion of an insulinlike factor ;C. Malignant tumor involving a-islet cells in the pancreas ;D. Surreptitiously injected human insulin
6625
Option D (surreptitiously injected human insulin) is correct. Normally; b-islet cells first synthesize preproinsulin in the rough endoplasmic reticulin. Preproinsulin then is delivered to the Golgi apparatus; where proteolytic reactions generate insulin and a cleavage peptide called C peptide. Hence; C peptide is a marker for endogenous synthesis of insulin. In this case; the patient has been injecting himself with insulin. This increases the serum insulin level; however; serum C peptide is decreased due to suppression of the b-islet cells by the exogenously administered insulin.
6626
Q3314:An autopsy performed on a 40-year-old man with dementia shows atrophy of the frontal and temporoparietal lobes of the brain. Histologic examination shows senile plaques. The pathogenesis of the dementia in this patient is most closely related to which of the following?;A. b-amyloid protein ;B. Decreased dopamine levels ;C. Slow virus disease ;D. Triplet repeat mutation
6627
Cell Biology and Pathology Flash Option A (b-amyloid protein) is correct.Facts Senile plaques are characteristic of Alzheimer's disease (AD); which is the most common cause of dementia in patients over 65 years of age. Senile plaques contain a core of A-b-amyloid surrounded by neurites. The explanation for the age disparity in this case is that the patient has Down syndrome with three functioning chromosome number 21 (e.g; trisomy 21). Chromosome 21 codes for an Alzheimer precursor protein (APP); part of which is amyloid-b (A- b) protein. This protein is toxic to neurons; hence the extra chromosome 21 codes for more of the 6628 protein; which results in AD at an early age.
Cell Biology and Pathology Q3315:A 30-year-old woman states Flash Factsoften burns her that she hands without feeling any pain. Physical examination shows decreased pain and temperature sensation in the upper extremities; atrophy of the intrinsic muscles of the hands; and abnormal deep tendon reflexes in the upper extremities. The pathogenesis of this patient's neurologic problems is most closely associated with which of the following?;A. Autoimmune destruction of myelin ;B. Fluid-filled cavity in the cervical spinal cord ;C. Superoxide free radical destruction of upper and lower motor neurons ;D. Tumor in the cervical 6629 spinal cord ;E. Vitamin B12 deficiency
Option B (fluid-filled cavity in the cervical spinal cord) is correct. The patient has syringomyelia; the development of an expanding fluid-filled cavity in the cervical spinal cord. This results in destruction of the crossed lateral spinothalamic tracts (loss of pain and temperature sensation); anterior horn cells (loss of the intrinsic muscles of the hand); and other tracts as the cavity expands. It is often confused with amyotrophic lateral sclerosis (ALS); however; in ALS there are no sensory abnormalities.
6630
Q3316:Common congenital malformations
6631
Heart defects;Hypospadias;Cleft lip;Congenital hip dislocation;Spina bifida;Anencephaly;Pyloric stenosis
6632
Q3317:Congenital malformation associated with projectile vomitting
6633
Pyloric stenosis
6634
Q3318:Right to left shunts (early cyanosis) blue babies name 3 causes
6635
3 T's;Tetralogy of Fallot;Transposition of great vessels;Truncus arteriosus
6636
Q3319:Child may squat to increase venous return - what type of shunt?
6637
Right to left
6638
Q3320:Left to right shunts (late cyanosis) - blue kids - name 3 causes
6639
VSD;ASD;PDA
6640
Q3321:Close with indomethacin
6641
PDA
6642
Q3322:Most common congenital cardiac anomaly
6643
VSD
6644
Q3323:Loud S1; wide; split; fixed S2
6645
ASD
6646
Q3324:Uncorrected VSD; ASD or PDA leads to progressive pulmonary hypertension. As pulmonary resistance increases shunt changes from Lto R to R to L which causes late cyanosis (clubbing and polycythemia);Diagnosis
6647
Eisenmengers syndrome
6648
Q3325:Name 4 parts of tetralogy of Fallot
6649
PROVe;Pulmonary stenosis;Right ventricular hypertrophy;Overriding aorta;VSD
6650
Q3326:What do you see on xray in patient with tetralogy of Fallot
6651
Boot shaped heart due to RVH
6652
Q3327:Cause of tetralogy of Fallot
6653
Anterosuperior displacement of infundibular septum
6654
Q3328:Patient suffers from "cyanotic spells"; x ray shows boot shaped heart - diagnosis?
6655
Tetraology of Fallot
6656
Q3329:Aorta leaves RV (anterior) and pulmonary trunk leaves LV (posterior) --> separation of systemic and pulmonary circulation. Not compatible with life unless a shunt is present to allow adequate mixing of blood (VSD; PDA or patent foramen ovale);Diagnosis?
6657
Transposition of great vessels
6658
Q3330:Cause of transposition of great vessels
6659
Failure of aorticopulmonary septum to spiral
6660
Q3331:Prognosis for transposition of great vessels
6661
Without surgical correction infants die within 1st month of life
6662
Q3332:In infantile type of coarctation of aorta - aortic stenosis is proximal or distal to insertion of ductus arteriosus?
6663
Proximal (preductal);INfantile = IN close to heart
6664
Q3333:In adult type of coarctation of aorta stenosis is distal or proximal to ductus arteriosus
6665
Distal (postductal);ADult= Distal to Ductus
6666
Q3334:This condition is associated with notching of ribs; hypertension in upper extremities and weak pulses in lower extremities
6667
Coarctation of aorta
6668
Q3335:What should you check in physical exam if suspect coarctation of aorta
6669
Femoral pulses
6670
Q3336:Male to female ratio for coarctation of aort
6671
3:01
6672
Q3337:In fetal period shunt is right to left (normal). In neonatal period; lung resistance decreases and shunt becomes left to right with subsequent RVH and failure (abnormal). Associated with a continuous "machine like" murmur - Name condition
6673
Patent ductus arteriosus
6674
Q3338:Patency of ductus arteriosus is maintained by?
6675
PGE synthesis and low O2 tension
6676
Q3339:What drug is used to close PDA
6677
Indomethacin
6678
Q3340:Name drug used to keep PDA open which may be necessary to sustain life in conditions such as transposition of great vessels
6679
PGE
6680
Q3341:Name defect associated with 22q11 syndromes
6681
Truncus arteriosus; tetralogy of Fallot
6682
Q3342:Name congenital cardiac defect associated with Down syndrome
6683
ASD;VSD
6684
Q3343:Name congenital cardiac defect associated with congenital rubella
6685
Septal defects;PDA
6686
Q3344:Name congenital cardiac defect associated with Turners syndrome
6687
Coarctation of aorta
6688
Q3345:Name congenital cardiac defect associated with offspring of a diabetic mother
6689
Transposition of great vessels
6690
Q3346:Most common chromosomal disorder and cause of congenital mental retardation
6691
Down syndrome
6692
Q3347:GI defect associated with Downs
6693
Duodenal atresia
6694
Q3348:Which cancer is in increased risk for patients with Downs
6695
ALL
6696
Q3349:Most common cardiac malformation in patients with Downs - cause?
6697
Septum primum type ASD due to endocardial cushion defects
6698
Q3350:Decreased levels of alpha fetoprotein;Increased beta HCG;Increased nuchal translucency - diagnosis
6699
Downs
6700
Q3351:Mental retardation; flat facial profile; prominent epicantal folds; simian crease - diagnosis?
6701
Downs trisomy 21
6702
Q3352:95% of Downs are caused by _ ;4% ?;1%
6703
Nondisjunction;4% - Robertsonian translocation;1% mosaicism
6704
Q3353:Edwards syndrome is also called?
6705
Trisomy 18 (Election age)
6706
Q3354:Baby is born with severe mental retardation; rocker bottom feet; low set ears; micrognathia (small jaw); congenital heart disease; clenched hands and prominent occiputdiagnosis + prognosis
6707
Edwards syndrome - trisomy 18;Death within 1 year
6708
Q3355:Pataus syndrome is also called
6709
Trisomy 13
6710
Q3356:Baby is born with severe mental retardation; microphthalmia; cleft lip/palate; abnormal forebrain structures; polydactyly; congenital heart disease - diagnosis + prognosis
6711
Pataus trisomy 13;Death within 1 year
6712
Q3357:Klinefelters genotype
6713
XXY
6714
Q3358:Testicular atrophy; eunuchoid body shape; tall; long extremities; gynecomastia; female hair distribution; presence of inactivated X chromosome (Barr body)
6715
Klinefelter syndrome
6716
Q3359:Common cause of hypogonadism see in infertility workup
6717
6718
Q3360:Genotype for Turners syndrome
6719
XO
6720
Q3361:Short stature; ovarian dysgenesis (streak ovary); webbing of neck; coarctation of aorta; no Barr body
6721
Turners
6722
Q3362:Most common cause of primary amenorrhea
6723
Turners
6724
Q3363:Phenotypically normal; very tall; severe acne; antisocial behavior; observed with increased freuency among inmates of penal institutions
6725
Double Y males XYY
6726
Q3364:What type of mutation is Duschennes
6727
Frameshift mutation --> deletion of dystrophin gene --> accelerated muscle breakdown
6728
Q3365:Inheritance for Duschennes
6729
X linked
6730
Q3366:Where does weakness begins in patients with Duschennes
6731
Pelvic girdle and moves superiorly
6732
Q3367:5 year old male presents with pseudohypertrophy of calf muscles and cardiac myopathy - name condition and cause
6733
Duschennes - replacement of muscle by fibrofatty tissue
6734
Q3368:7 year old male requires assistance of the upper extremities to stand up (proximal lower limb weakness) name phenomenon and condition
6735
Gowers maneuver - Duschennes muscular dystrophy
6736
Q3369:How do you diagnose muscular dystrophies
6737
By increased CPK and muscle biopsy
6738
Q3370:Disagreement between phenotypic (external genitalia) and gonadal (testes vs ovaries) sex
6739
Pseudohermaphroditism
6740
Q3371:Ovaries are present but external genitalia are virilized or ambiguous - name condition + cause
6741
Female pseudohermaphroditism;Due to excessive and inappropriate exposure to androgenic steroids during early gestation (congenital adrenal hyperplasia or exogenous administration of androgens during pregnancy)
6742
Q3372:Testes present but external genitalia are female or ambiguous - name condition + cause
6743
Male pseudohermaphroditism - androgen insensitivity syndrome (testicular feminization)
6744
Q3373:Both ovary and testicular tissue present; ambiguous genitalia - very rare;Possible genotypes?
6745
True hermaphrodite;46 XX or 47 XXY
6746
Q3374:Defect in androgen receptor resulting in normal appearing female; female external genitalia with rudimentary vagina; uterus and uterine tubes are absent. develops testicular tissue(often found in labia majora; surgically removed to prevent malignancy);Name condition + genotype + what happens to levels of estrogen; testosterone and LH
6747
Androgen insensitivity syndrome;46 XY;Levels of testosterone; estrogen and LH are all high
6748
Q3375:Unale to convert testosterone to DHT; ambiguous genitalia until puberty; when increased testosterone causes masculinization of genitalia;Name condition + what happens to levels of estrogen; testosterone and LH
6749
5 alpha-reductase defficiency;Testosterone and estrogen levels are normal; LH normal or increased
6750
Q3376:Congenital deletion of short arm of chromosome 5 leads to _
6751
Cri-du-chat syndrome
6752
Q3377:Microcephaly; severe mental retardation; high pitched crying/meowing; epicanthal folds; cardiac abnormalities
6753
Cri-du-chat syndrome
6754
Q3378:2nd most common cause of genetic mental retardation
6755
Fragile X
6756
Q3379:X linked defect affecting methylation and expression of FMR1 gene; associated with macro-orchidism (enlarged testes); long face with large jaw; large everted ears and autism
6757
Fragile X
6758
Q3380:What type of mutation is in Fragile X
6759
Triple repeat disorder (CGG) that may show genetic anticipation (germlike expansion in females)
6760
Q3381:Cleft palate;Abnormal facies;Thymic aplasia;Cardiac defects;Hypocalcemia;2 types of disorders
6761
22q11 syndromes - DiGeorge syndrome (thymic; parathyroid and cardiac defects) or velocardiofacial syndrome (palate; facial and cardiac defects)
6762
Q3382:Adult polycystic kidney disease - unilateral or bilateral
6763
ALWAYS bilateral
6764
Q3383:Patient presents with pain; hematuria; hypertension; progressive renal failure; 90% of mutations are due to mutation in APKD1 (chromosome 16)
6765
Adult polycystic kidney disease - massive enlargement of kidneys due to multiple large cysts
6766
Q3384:Name conditions associated with adult polycystic kidney disease
6767
Polycystic liver disease;BERRY ANEURYSMS;Mitral valve prolapse
6768
Q3385:What is the inheritance for adult form of polycystic kidney disease? ;juvenile?
6769
Adult - autosomal dominant;Juvenile - autosomal recessive
6770
Q3386:Patient has high cholesterol (heterozygotes 300; homozygotes - rare- 700); severe atherosclerotic disease early in life and tendon xanthomas (classically in Achilles tendon); MI may develop before age 20;Name disease and cause
6771
Familial hypercholesterolemia (hyperlipidemia type IIa);Elevated LDL owing to defective or absent LDL receptor
6772
Q3387:Cause of Marfans disease
6773
Fibrillin gene mutation -> connective tissue disorders
6774
Q3388:Skeletal abnormalities in Marfans syndrome
6775
Tall with long extremities; hyperextensive joints; and long; tapering fingers and toes
6776
Q3389:Cardiovascular abnormalities in Marfans syndrome
6777
Cystic medial necrosis of aorta --> aortic incometence and dissecting aortic aneurysms;Floppy mitral valve
6778
Q3390:Occular abnormality in Marfans syndrome
6779
Subluxation of the lens
6780
Q3391:Findings in neurofibromatosis type I (von Riecklinghausen disease)
6781
Cafe-au-lait spots;Neural tumors;Lisch nodules (pigmented iris hamartomas);Also marked by skeletal disorders (scoliosis) and increased tumor susceptibility
6782
Q3392:Gene coding for NFT type I (von Riecklinghausen disease) located where?
6783
Long arm of chromosome 17 (17 letters in Recklinghausen)
6784
Q3393:Gene coding for NFT type II is located where?
6785
On chromosome 22
6786
Q3394:Patient presents with bilateral acoustic neuromas; optic pathway gliomas; juvenile cataracts - diagnosis?
6787
Type II NFT
6788
Q3395:Findings: facial lesions (adenoma sebaceum); hypopigmented "ash leaf spots" on skin; cortical and retinal hamartomas; seizures; mental retardation; renal cysts; cardiac rhabdomyomas. Incomplete penetrance; variable presentation
6789
Tuberous sclerosis
6790
Q3396:Findings: hemangioblastomas of retina/cerebellum/medulla; about half of affected individuals develop multiple bilateral renal cell carcinomas and other tumors - name disease; which gene affected and inheritance
6791
Von Hippel Lindau disease;Deletion of VHL gene (tumor suppressor) on chromosome 3 (3p);Autosomal dominant
6792
Q3397:Findings - depression; progressive dementia; choreiform movements; caudate atrophy and decreased levels of GABA and Ach in brain; symptoms manifest between 20 and 50 - name disorder; what type of disorder; inheritance + which chromosome affected
6793
Huntingtons;Triplet repeat disorder;Autosomal dominant;Gene on chromosome 4
6794
Q3398:Colon becomes covered wiith adenomatous polyps after puberty. Progresses to cancer unless resected - name disease and chromosome on which deletion occurs+ inheritance pattern
6795
Familial adenomatous polyposis - deletion on chromosome 5; autosomal dominant
6796
Q3399:Spheroid erythrocytes; hemolytic anemia; increased MCHC - name disease + what is curative + inheritance pattern
6797
Hereditary spherocytosis;Splenectomy is curative;Autosomal dominant
6798
Q3400:Autosomal dominant cell-signalng defect of fibroblast growth factor (FGF) receptor 3. Results in dwarfism; short limbs but head and trunk are normal size - name disease
6799
Achondroplasia
6800
Q3401:Inheritance pattern for cystic fibrosis
6801
Autosomal recessive
6802
Q3402:Inheritance pattern for albinism
6803
Autosomal recessive
6804
Q3403:Inheritance pattern for alpha1-antitrypsin defficiency
6805
AR
6806
Q3404:Inheritance pattern for PKU
6807
AR
6808
Q3405:Inheritance pattern for thalassemias and sickle cell anemias
6809
AR
6810
Q3406:Inheritance pattern for glycogen storage disorders
6811
AR
6812
Q3407:Inheritance pattern for mucopolysaccharidoses ?;EXCEPT - >
6813
AR;EXCEPT Hunters
6814
Q3408:Inheritance pattern for sphingolipidoses- ?;EXCEPT?
6815
AR;EXCEPT Fabrys
6816
Q3409:Inheritance pattern for infant polycystic kidney disease
6817
AR
6818
Q3410:Inheritance pattern for hemochromatosis
6819
AR
6820
Q3411:Infertility in males with cystic fibrosis is due to?
6821
Absence of vas deferens
6822
Q3412:Which vitamins are defficient in patients with cystic fibrosis
6823
Fat soluble ADEK
6824
Q3413:Cystic fibrosis can present as _ in infancy
6825
Failure to thrive
6826
Q3414:Most common lethal genetic disease of Caucasians
6827
Cystic fibrosis
6828
Q3415:Treatment of cystic fibrosis
6829
N-acetylcysteine to loosen mucous plugs
6830
Q3416:Cause of cystic fibrosis + how it presents
6831
Autosomal recessive defect in CFTR gene on chromosome 7. Defective Cl channel -->secretion of abnormally thick mucus that plugs lungs; pancreas and liver --> recurrent pulmonary infections (Pseudomonas and S aureus); chronic bronchitis; bronchiectasis; pancreatic insufficiency (malabsorption and steatorrhea); meconium ileus in newborns
6832
Q3417:Diagnostic test for cystic fibrosis
6833
Increased concentration of Cl ions in sweat
6834
Q3418:Associated with low folic acid intake during pregnancy; elevated alpha fetoprotein in amniotic fluid and maternal serum
6835
Neural tube defects
6836
Q3419:Failure of bony spinal canal to close but no structural herniation; usually seen at lower vertebral levels
6837
Spina bifida occulta
6838
Q3420:Meninges herniate through spinal canal defect
6839
Meningocele
6840
Q3421:Meninges and spinal cord herniate through spinal canal defect
6841
Meningomyelocele
6842
Q3422:Mechanism of fetal alcohol syndrome
6843
Inhibition of cell migration
6844
Q3423:Newborn presents with postnatal developmental retardation; microcephaly; facial abnormalities; limb dislocation and heart and lung fistulas - probable cause?
6845
Fetal alcohol syndrome
6846
Q3424:# 1 cause of congenital malformation in USA
6847
Fetal alcohol syndrome
6848
Q3425:Increase in number of cells (reversible)
6849
Hyperplasia
6850
Q3426:One adult cell type is replaced by another (reversible) - often secondary to irritation and/or environmental exposure
6851
Metaplasia
6852
Q3427:Abnormal growth with loss cellular orientation; shape; and size in comparison to normal tissue maturation; commonly preneoplastic (reversible)
6853
Dysplasia
6854
Q3428:Abnormal cells lacking differentiation; like primitive cells of same tissue; often equated with undifferentiated malignant neoplasms; tumor giant cells may be formed
6855
Anaplasia
6856
Q3429:Clonal proliferation of cells that is uncontrolled and excessive
6857
Neoplasia
6858
Q3430:S-100
6859
Marker for melanoma; neural tumors; and astrocytomas
6860
Q3431:Gastric Adenocarcinoma markers
6861
CEA and bombesin
6862
Q3432:HCC markers
6863
AFP and alpha-1-AT
6864
Q3433:Plummer-Vinson syndrome triad
6865
Dysphagia (due to webs in the upper esophagus); atrophic glossitis; iron-deficiency anemia
6866
Q3434:Pulseless disease
6867
Takayasu arteritis - stenosis of aortic arch and its large branches with ischemia to upper part of the body
6868
Q3435:Trousseau Sign
6869
Migratory thromophlebitis associated with tumors of pancreas; lung; and colon
6870
Q3436:Colon Cancer tumor suppression genes
6871
APC; DCC; p53
6872
Q3437:Pancreatic Cancer tumor suppression gene
6873
DPC
6874
Q3438:Stomach Cancer tumor suppressor gene
6875
DCC
6876
Q3439:Peripheral nerve tumor suppressor gene
6877
NF-1 (neurofibromatosis 1)
6878
Q3440:Inadequate oxygenation is called _
6879
HYPOXIA
6880
Q3441:Most common cause of hypoxia is _
6881
Coronary artery atherosclerosis
6882
Q3442:CO and CN both inhibit _
6883
Cytochrome oxidase
6884
Q3443:How do you treat CO poisoning ?
6885
100% O2
6886
Q3444:Most adversely affected cell in tissue hypoxia _
6887
NEURONS
6888
Q3445:What do you see on ECG in subendocardial ischemia
6889
ST segment depression
6890
Q3446:Cytochrome C activates _
6891
Apoptosis
6892
Q3447:Most common cause of drug induced fulminant hepatitis
6893
ACETAMINOPHEN
6894
Q3448:Reperfusion injury can be caused by ?
6895
O2 and increase in cytosolic Ca
6896
Q3449:What is the difference between dystrophic and metastatic calcification
6897
Dystrophic calcification - calcification of necrotic tissue;Metastatic calcification - calcification of normal tissue
6898
Q3450:Decrease in size of tissue or organ is called _
6899
ATROPHY
6900
Q3451:Increase in cell size is called _
6901
HYPERTROPHY
6902
Q3452:Increase in number of cells _
6903
HYPERPLASIA
6904
Q3453:One cell type replaces another - this is called _
6905
METAPLASIA
6906
Q3454:Disordered cell growth is called _
6907
DYSPLASIA
6908
Q3455:In cerebral infarction - what type of necrosis?
6909
LIUEFACTIVE (NOT coagulative)
6910
Q3456:Most common cause of caseous necrosis
6911
Tuberculosis
6912
Q3457:What type of necrosis in acute pancreatitis
6913
Enzymatic fat necrosis
6914
Q3458:Programmed cell death is called _
6915
Apoptosis
6916
Q3459:Name apoptosis gene
6917
BAX
6918
Q3460:Name anti apoptosis gene
6919
BCL2
6920
Q3461:These cells release preformed histamine
6921
Mast cells
6922
Q3462:Primary leukocytes in acute inflammation
6923
Neutrophils
6924
Q3463:Responsible for "rolling" of neutrophils
6925
Selectins
6926
Q3464:Neutrophil adhesion molecules
6927
Beta 2 integrins
6928
Q3465:Directed migration of neutrophils is called _
6929
CHEMOTAXIS
6930
Q3466:Name 2 opsonins
6931
IgG and C3b
6932
Q3467:In Butons agammogloblinemia there is a defect in _
6933
OPSONIZATION
6934
Q3468:In Chediak Higashi syndrome patient cannot form _
6935
PHAGOLYSOSOMES
6936
Q3469:Most potent microbicidal system
6937
O2 dependent MPO system
6938
Q3470:End product of O2 dependent MPO system
6939
BLEACH
6940
Q3471:In chronic granulomatous disease there is absent _
6941
NADPH OXIDASE AND RESPIRATORY BURST
6942
Q3472:Most important chemical mediator of acute inflammation
6943
HISTAMINE
6944
Q3473:Most common cause of skin abscess
6945
Staph aureus
6946
Q3474:Most common cause of chronic inflammation
6947
INFECTION
6948
Q3475:Primary leukocytes in chronic inflammation
6949
Monocytes and macrophages
6950
Q3476:Granulation tissue is converted to _
6951
Scar tissue
6952
Q3477:Key adhesion glycoprotein in ECM
6953
Fibronectin
6954
Q3478:cell types in granuloma
6955
macrophages and CD4 helper T cells
6956
Q3479:Macrophages activated by gamma interferon from CD4 Th cells are called _
6957
Epithelioid cells
6958
Q3480:Most variable stage in cell cycle
6959
G1
6960
Q3481:Most critical phase in cell cycle
6961
G1 to S
6962
Q3482:Genes controlling G1 to S phases of cell cycle
6963
RB and TP53
6964
Q3483:Key adhesion glycoprotein in basement membrane
6965
LAMININ
6966
Q3484:IN Ehlers Danlos syndrome which collagen is defective
6967
Type I and type III
6968
Q3485:Cofactor in collagenase
6969
Zn
6970
Q3486:Most common cause of impaired wound healing
6971
Infections
6972
Q3487:In which vitamin defficiency is there decreased cross linking of collagen
6973
Vitamin C defficiency
6974
Q3488:Which drugs prevent scar formation
6975
Glucocorticoids
6976
Q3489:In keloids which type collagen is in excess
6977
type III
6978
Q3490:In lung injury which cell is repair cell
6979
TYPE II PNEUMOCYTE
6980
Q3491:What happens in brain with injury
6981
Proliferation of astrocytes and microglial cells
6982
Q3492:With peripheral nerve transection which cell is key cell in reinnervation
6983
Schwann cell
6984
Q3493:Predominant immunoglobulin in acute inflammation
6985
IgM
6986
Q3494:Predominant immunoglobulin in chronic inflammation
6987
IgG
6988
Q3495:Corticosteroid effect in blood
6989
Increased neutrophils;Decreased lymphocytes and eosinophils
6990
Q3496:Marker of necrosis and disease activity
6991
CRP
6992
Q3497:Marker of acute inflammation
6993
IgM
6994
Q3498:Sign of chronic inflammation
6995
Polyclonal gammopathy; increased IgG
6996
Q3499:Large granular lymphocytes in peripheral blood
6997
Natural killer cells
6998
Q3500:When does IgM and IgG synthesis begin
6999
After birth
7000
Q3501:Class I MHC is present on which cells
7001
All nucleated cells
7002
Q3502:Name antigen presenting cells
7003
B cells;Macrophages;Dendritic cells
7004
Q3503:Which HLA protein is associated with ankylosing spondylitis
7005
HLA B27
7006
Q3504:IgE activation of mast cells happens in which type of hypersensitivity
7007
Type I
7008
Q3505:Name potentially fatal type I hypersensitivity reaction
7009
Anaphylactic shock
7010
Q3506:Antibody dependent cytotoxic reactions are what type of hypersensitivity
7011
Type II
7012
Q3507:Activation of compliment by circulating antigenantibody complexes is what type of hypersensitivity
7013
Type III
7014
Q3508:Name antibody activated hypersensitivity reactions
7015
Type I; II; III
7016
Q3509:Which type of hypersensitivity has to do with cellular immunity
7017
Type IV
7018
Q3510:What is the most important requirement for successful transplantation
7019
ABO blood group compatibility
7020
Q3511:Type of transplant with best survival rate
7021
Autograft (self to self)
7022
Q3512:Hyperacute rejection of transplant - is it reversible? what type of hypersensitivity?
7023
Irreversible; type II hypersensitivity
7024
Q3513:Most common type of transplant rejection - what typ of hypersensitivity?
7025
Acute rejection - type IV and type II hypersensitivity
7026
Q3514:Is chronic rejection of transplant reversible
7027
Irreversible
7028
Q3515:What are symptoms and signs of graft versus host reactions
7029
Jaundice;Diarrhea;Dermatitis
7030
Q3516:Most common cardiac finding in SLE
7031
Fibrinous pericarditis with effusion
7032
Q3517:Most common drug associated with drug induced lupus
7033
Procainamide
7034
Q3518:What type of antibodies are present in drug induced lupus
7035
Antihistone antibodies
7036
Q3519:What two tests can confirm SLE
7037
Anti double stranded DNA;Anti Smith antibodies
7038
Q3520:In systemic sclerosis there is excess _
7039
Collagen deposition
7040
Q3521:Most common initial sign of systemic sclerosis
7041
Raynaud phenomenon
7042
Q3522:What type of antibodies are present with systemic sclerosis
7043
Anti-topoisomerase antibodis
7044
Q3523:What does CREST syndrome stand for
7045
Calcinosis;Raynauds phenomenon;Esophageal dysfunction;Sclerodactyly;Telangiectasia
7046
Q3524:In dermatomyositis and polymyositis there is increased _
7047
Serum creatine kinase
7048
Q3525:Im MCTD (mixed connective tissue disease) what kind of antibodies are present
7049
Anti RNP antibodies
7050
Q3526:Most common congenital immunodefficiency
7051
IgA defficiency
7052
Q3527:Most common acquired immunodefficiency disease worldwide
7053
AIDS
7054
Q3528:Pediatric AIDS is mostly due to _ transmission
7055
Vertical (mother to child)
7056
Q3529:HIV is cytotoxic to what type of cells? which immunity is lost?
7057
CD4 T cells;Loss of cell mediated immunity
7058
Q3530:Which protein is detected in ELISA test screen for HIV
7059
anti gp 120
7060
Q3531:Which test confirms HIV
7061
Western blot
7062
Q3532:Which cells are reservoir cells for HIV
7063
Follicular dendritic cells in lymph nodes
7064
Q3533:Most common CNS fungal infection in AIDS
7065
Cryptococcosis
7066
Q3534:Most common malignancy in AIDS
7067
Kaposis sarcoma
7068
Q3535:Most common cause of blindness in AIDS
7069
CMV
7070
Q3536:In hereditary angioedema there is defficiency of what?
7071
C1 esterase inhibitor
7072
Q3537:Which protein exhibits apple green birefringence in polarized light
7073
Amyloid
7074
Q3538:Which protein is associated with Alzheimers disease in Down syndrome
7075
Beta amyloid
7076
Q3539:Major cation of extracellular fluid
7077
Na
7078
Q3540:Major cation of intracellular fluid
7079
7080
Q3541:Water movement between extracellular and intracellular fluid compartments is called? What is it controlled by?
7081
OSMOSIS - controlled by serum Na
7082
Q3542:Formula for calculating serum Na
7083
Total body Na/ Total body water
7084
Q3543:What is the sign of volume depletion
7085
Decreased total body Na
7086
Q3544:In which conditions would you see increase in total body Na
7087
Pitting edema;Body cavity effusions
7088
Q3545:What happens to Na in isotonic loss or gain
7089
Serum Na normal
7090
Q3546:What two signs describe hypotonic disorders
7091
Hyponatremia;ICF expansion
7092
Q3547:In which conditions would you see pitting edema
7093
Right sided heart failure;Cirrhosis;Nephrotic syndrome
7094
Q3548:Which signs describe hypertonic disorders
7095
Hypernatremia or hyperglycemia;ICF conraction
7096
Q3549:What happens to Posm and Na in hyperglycemia
7097
Increased Posm;Decreased serum Na
7098
Q3550:What happens to K in alkalosis
7099
Shifts into cell
7100
Q3551:What happens to K in acidosis
7101
Shifts out of cell
7102
Q3552:Most common cause of hypokalemia
7103
Loop and thiazide diuretics
7104
Q3553:What does ECG show in hypokalemia
7105
U wave
7106
Q3554:Most common cause of hyperkalemia
7107
Renal failure
7108
Q3555:What does ECG show in hyperkalemia
7109
Peaked T waves
7110
Q3556:What does PaCO2 have to be to diagnose respiratory acidosis
7111
>45 mm Hg
7112
Q3557:What does PaCO2 have to ne to diagnose respiratory alkalosis
7113
< 33 mmHg
7114
Q3558:What happens in increased anion gap metabolic acidosis
7115
Anions of acid replace HCO3
7116
Q3559:What happens in normal anion gap metabolic acidosis
7117
Cl anions replace HCO3
7118
Q3560:What is the level of HCO3 have to be to diagnose metabolic acidosis
7119
< 22 mE/L
7120
Q3561:Most common cause of metabolic alkalosis
7121
Loop and thiazide diuretics
7122
Q3562:What does HCO3 have to be to diagnose metabolic alkalosis
7123
> 28 mEq/L
7124
Q3563:With _ intoxication there is often mixture of primary metabolic acidosis and primary respiratory alkalosis
7125
SALICYLATE
7126
Q3564:Excess fluid in interstitial space is called _
7127
EDEMA
7128
Q3565:Protein poor and cell poor fluid is called _
7129
TRANSUDATE
7130
Q3566:Protein rich and cell rich fluid is called _
7131
EXUDATE
7132
Q3567:Is there transudate or exudate in pitting edema? What happens to hydrostatic and oncotic pressures?
7133
Transudate;Increased hydrostatic pressure ;Decreased oncotic pressure
7134
Q3568:Most common site for venous thrombosis
7135
Deep vein of lower extremity under knee
7136
Q3569:Name anticoagulants that are used for prevention of venous thrombosis
7137
Warfarin and Heparin
7138
Q3570:Prevents formation of arterial thrombi
7139
Aspirin
7140
Q3571:How do you prevent mixed thrombus
7141
Aspirin + anticoagulant therapy
7142
Q3572:Majority of pulmonary thromboembolism originate in _
7143
Femoral veins
7144
Q3573:Majority of systemic embolisms originate in _
7145
Left side of the heart
7146
Q3574:Most common cause for fat embolism
7147
Fracture of long bones
7148
Q3575:Signs and symptoms of amniotic fluid embolism
7149
Abrupt onset dyspnea;Hypotension;Bleeding (DIC)
7150
Q3576:What happens in decompression sickness
7151
Nitrogen gas bubbles occlude vessel lumens
7152
Q3577:Two serious potential complications of scuba diving
7153
Pneumothorax and pulmonary embolism
7154
Q3578:Most common cause of hypovolemic shock
7155
Blood loss
7156
Q3579:Most common cause of cardiogenic shock
7157
acute MI
7158
Q3580:What happens to cardiac output in hypovolemic shock? Cardiogenic shock? septic shock?
7159
Hypovolemic shock - decreased CO;Cardiogenic shock decreased CO;Septic shock - increased CO
7160
Q3581:What happens to left ventricular end-diastolic pressure in hypovolemic shock? cardiogenic shock? septic shock?
7161
Decreased in hypovolemic and septic shock; increased in cardiogenic shock
7162
Q3582:What happens to peripheral vascular resistance in hypovolemic shock? cardiogenic shock? septic shock?
7163
Increased in cardiogenic and hypovolemic shock; decreased in septic shock
7164
Q3583:Most common cause of death in shock
7165
Multiorgan failure
7166
Q3584:What type of mutation occurs with sickle cell disease/trait
7167
Missense mutation
7168
Q3585:With beta thalassemia major what type of mutation
7169
Nonsense mutation with stop codon
7170
Q3586:In Tay Sachs disease what type of mutation
7171
Frameshift mutation
7172
Q3587:Additional trinucleotide repeats increases disease severity in future generations - this is called _
7173
ANTICIPATION
7174
Q3588:Most common type of mendelian disorder
7175
Autosomal recessive
7176
Q3589:Both parents must have mutant gene - what type of inheritance
7177
Autosomal recessive
7178
Q3590:Enzyme defficiencies disorders usually involve what type of inheritance
7179
AR
7180
Q3591:In PKU what is increased and what is decreased
7181
Phenylalanine increased;Tyrosine decreased
7182
Q3592:What is defficient in Von Gierkes disease
7183
Glucose 6 phosphatase
7184
Q3593:Most common AR disorder
7185
Hemochromatosis
7186
Q3594:Heterozygotes with dominant mutant gene express disease - type of inheritance
7187
AD
7188
Q3595:Individual with mutant gene doesnt express disease this is called
7189
Reduced penetrance
7190
Q3596:Most common AD disorder
7191
Von Willebrand disease
7192
Q3597:Asymptomatic female carrier transmits mutant gene to 50% of sons - what type of inheritance
7193
XR
7194
Q3598:Most common x linked disorder
7195
Fragile X syndrome
7196
Q3599:In which x linked inheritance femaler carriers are symptomatic
7197
XD
7198
Q3600:Number of Barr bodies?
7199
Number of chromosomes - 1
7200
Q3601:Unequal separation of chromosomes in meiosis is called _
7201
Nondisjunction
7202
Q3602:Nondisjunction of chromosomes in mitosis is called _
7203
Mosaicism
7204
Q3603:Which chromosomal defect is present in cri du chat syndrome
7205
Deletion short arm chromosome 5
7206
Q3604:Most cases of Down syndrome occur due to _
7207
Nondisjunction
7208
Q3605:Most common genetic cause of mental retardation
7209
Down syndrome
7210
Q3606:Most important risk factor for bearing offspring with trisomy syndromes
7211
Advanced maternal age
7212
Q3607:45; x caryotype is present in which condition
7213
Turner syndrome
7214
Q3608:Most common genetic cause of primary amenorrhea
7215
Turners syndrome
7216
Q3609:"Menopause before menarche"
7217
Turners syndrome
7218
Q3610:Which hormones are decreased and which are increased in Klinefelters syndrome
7219
Testosterone and inhibin decreased;LH and FSG increased
7220
Q3611:Which chromosome determines genetic sex of individual
7221
Y chromosome
7222
Q3612:Most common cause of pseudohermaphroditism? What is defficient in this disease?
7223
Testicular feminization;Androgen receptors
7224
Q3613:Most common pathogen causing congenital infection
7225
CMV
7226
Q3614:Name TORCH infections
7227
Toxoplasmosis;Other agents;Rubella;CMV;Herpes simplex
7228
Q3615:Most common cause of stillbirth
7229
Abruptio placentae
7230
Q3616:Common cause of spontaneous abortions
7231
Trisomy 16
7232
Q3617:Most common cause for large for gestational age babies
7233
Maternal diabetes
7234
Q3618:Most common cause of neonatal morbidity/mortality
7235
Prematurity
7236
Q3619:Triple marker for Down syndrome
7237
Decreased AFP;Increased hCG;Decrease in unconjugated urine
7238
Q3620:Most important preventable cause of disease and death in US
7239
Smoking
7240
Q3621:Do women or men have less gastric alcohol dehydrogenase and therefore reach hight alcohol levels
7241
Women
7242
Q3622:Most common cause of thiamine defficiency
7243
Alcohol abuse
7244
Q3623:Increased anion gap metabolic acidosis is caused by _
7245
Lactic acid and beta-hydroxybutyric acid
7246
Q3624:Most common systemic complication of intravenous drug use
7247
Hepatitis B
7248
Q3625:Oral contraceptives decrease risk for which cancers
7249
Endometrial and ovarian
7250
Q3626:Most common cause of hypertension in young woman
7251
Oral contraceptives
7252
Q3627:Most common cause of death in burn victims
7253
sepsis caused by Pseudomonas
7254
Q3628:Least sensitive tissue to radiation
7255
Bone
7256
Q3629:First hematological sign of total body radiation
7257
Lymphopenia
7258
Q3630:Most frequent type of cancer caused by radiation
7259
Acute leukemia
7260
Q3631:Which UV light is most damaging and how
7261
UVB - increase in pyrimidine dimers distorts DNA helix
7262
Q3632:Most common UVB related skin cancer
7263
7264
Q3633:Where does carbohydrate digestion begin
7265
Mouth
7266
Q3634:Where does protein digestion begin
7267
Stomach
7268
Q3635:Where does fat digestion begin
7269
Small intestine
7270
Q3636:What is characteristic feature of kwashiorkor
7271
Pitting edema
7272
Q3637:What is characteristic feature of marasmus
7273
Extreme muscle wasting
7274
Q3638:Most common cause of death in anorexia nervosa
7275
Ventricular arrythmia
7276
Q3639:What is the complication caused by vomitting in bulimia nervosa
7277
Hypokalemic metabolic alkalosis
7278
Q3640:Which gene is usually defective in obesity
7279
Leptin gene
7280
Q3641:First sign of vitamin A defficiency
7281
Night blindness
7282
Q3642:Most common cause of vitamin D defficiency
7283
Renal failure
7284
Q3643:Vitamin E toxicity causes _
7285
Decreased synthesis of vitamin K dependent coagulation factors
7286
Q3644:Most common cause of vitamin K defficiency in hospital
7287
Broad spectrum antibiotics
7288
Q3645:Rat poison contains _ derivatives
7289
Coumarin
7290
Q3646:People on corn based diets are defficient in _
7291
Tryptophan and niacin
7292
Q3647:Three D's of pellagra
7293
Dermatitis ;Diarrhea;Dementia
7294
Q3648:Most common cause of vitamin B12 defficiency
7295
Perncious anemia
7296
Q3649:Most common cause of folate defficiency
7297
Alcohol abuse
7298
Q3650:Defficiency of ascorbic acid is called _
7299
Scurvy
7300
Q3651:Poor wound healing; poor taste and perioral rash are signs of what defficiency
7301
Zn
7302
Q3652:Iodide defficiency results in _
7303
Multinodular goiter
7304
Q3653:Benign tumors are of what origin
7305
Epithelial or connective tissue
7306
Q3654:Tumor that has derivatives of ectoderm; endoderm and mesoderm is called_
7307
Teratoma
7308
Q3655:Carcinomas derive from?
7309
Squamous;Glandular (adenocarcinoma);Transitional epithelium
7310
Q3656:Sarcoma derives from?
7311
Connective tissue
7312
Q3657:Non neoplastic overgrowth of tissue is called _
7313
Hamartoma
7314
Q3658:Which cancer invades tissue but doesnt metastasize
7315
Basal cell carcinoma of skin
7316
Q3659:Which metastasis have greater prognostic significance nodal or extranodal
7317
Extranodal (liver; etc)
7318
Q3660:Name 3 routes of metastasis
7319
Lymphatic;Hematogenic;Seeding of body cavities
7320
Q3661:2 types of bone metastasis
7321
Osteoblastic (radiodense);Osteolytic (radioluscent)
7322
Q3662:Most common cause of cancer deaths in adults
7323
Lung cancer
7324
Q3663:Precursor of squamous cell carcinoma
7325
Actinic (solar) keratosis
7326
Q3664:How can you reduce risk for developing gastric lymphoma and adenocarcinoma
7327
Treat H pylori
7328
Q3665:Most common type of mutation in cancer
7329
Point mutation
7330
Q3666:Which genes protect from unregulated cell growth? Which are involved in normal growth and repair?
7331
Suppressor genes;Proto- oncogenes
7332
Q3667:What is the most effective host defense against cancer
7333
Cytotoxic CD8 T cells
7334
Q3668:What is the most common cause of death in cancer
7335
Gram negative sepsis
7336
Q3669:What is the most common paraneoplastic syndrome
7337
Hypercalcemia
7338
Q3670:Diet derived triglyceride
7339
Chylomicron
7340
Q3671:Liver derived triglyceride
7341
VLDL
7342
#NAME?
7343
LDL
7344
Q3673:Removes cholesterol from plaques for disposal in the liver
7345
HDL
7346
Q3674:Pathognomonic lesion of atherosclerosis
7347
Fibrous cap
7348
Q3675:Excellent marker of disrupted fibrous plaques
7349
CRP
7350
Q3676:Most common site for atherosclerosis
7351
Abdominal aorta
7352
Q3677:2 conditions associated with hyaline arteriosclerosis
7353
DM;Hypertension
7354
Q3678:Most common aneurysm in men>55 years of age
7355
Abdominal aortic aneurysm
7356
Q3679:Rupture of aneurysm triad
7357
Left flank pain;Hypotension;Pulsatile mass
7358
Q3680:2 conditions of aortic arch aneurysm
7359
Tertiary syphillis;Vasculitis of vasa vasorum
7360
Q3681:Most common cause of death in Marfan syndrome and EDS
7361
Aortic dissection
7362
Q3682:Most common cause of death with aortic dissection
7363
Cardiac tamponade
7364
Q3683:Symptoms and signs of small vessel vasculitis
7365
Palpable purpura
7366
Q3684:Symptoms and signs of medium sized vessel vasculitis
7367
Thrombosis;Aneurysm formation
7368
Q3685:Most common type of hypertension
7369
Essential hypertension
7370
Q3686:Most common cause of secondary hypertension
7371
Renovascular hypertension
7372
Q3687:Ventricular hypertrophy occurs due to_
7373
Increased afterload or increased preload
7374
Q3688:Pulmonary edema is seen in which heart failure
7375
Left
7376
Q3689:First cardiac sign of LHF
7377
S3
7378
Q3690:Increases intensity for left sided heart murmurs and abnormal heart sounds
7379
Expiration
7380
Q3691:Increases intensity of right sided heart murmurs and abnormal heart sounds
7381
Inspiration
7382
Q3692:Inrease in venous hydrostatic pressure occurs in which heart failure
7383
Right
7384
Q3693:Most common manifestation of CAD
7385
Angina pectoris
7386
Q3694:Subendocardial ischemia with ST segment depression is what type of angina
7387
Stable
7388
Q3695:Vasospasm with transmural ischemia and ST segment elevation is what type of angina
7389
Prinzmetals angina
7390
Q3696:Most common cause of death in acute MI
7391
Ventricular fibrillation
7392
Q3697:Most common cause of death in CHF
7393
Ventricular aneurysm
7394
Q3698:Gold standard for diagnosis of acute MI
7395
Cardiac troponin I and T
7396
Q3699:ECG findings in acute MI
7397
Inverted T waves; elevated ST segments; Q waves
7398
Q3700:Stimuli for EPO
7399
Hypoxemia;Left-shifted OBC;High altitude
7400
Q3701:Where is EPO synthesized?
7401
In endothelial cells of peritubular capillaries
7402
Q3702:Measure of effective erythropoiesis; corrected for the degree of anemia
7403
Reticulocyte count
7404
Q3703:Extramedullary hematopoiesis most often occurs where?
7405
In liver and spleen
7406
Q3704:What happens to Hb; Hct and RBC count in thalassemia
7407
Hb; Hct decreased;RBC count increased
7408
Q3705:What happens to RDW in iron defficiency
7409
Increased
7410
Q3706:End product of heme degradation in macrophage
7411
Unconjugated bilirubin
7412
Q3707:What is the main source of energy in mature RBC
7413
Anaerobic glycolysis
7414
Q3708:Serum ferritin is _ in iron defficiency anemia
7415
Decreased
7416
Q3709:Serum ferritin is _ in ACD; iron overload disease
7417
Increased
7418
Q3710:Serum iron is _ in iron defficiency; ACD
7419
Decreased
7420
Q3711:Serum iron is _ in iron overload disease
7421
Increased
7422
Q3712:If serum total iron binding capacity is decreased it means that transferin is _
7423
Decreased
7424
Q3713:In microcytic anemia there is defect in _
7425
Synthesis of Hb (heme + globin chain)
7426
Q3714:Iron defficiency most often caused by _
7427
Bleeding
7428
Q3715:Most common anemia in hospitalized patients
7429
ACD - anemia of chronic disease
7430
Q3716:With sideroblastic anemia there is defect in _
7431
Heme synthesis in mitochondria; ringed sideroblasts
7432
Q3717:Most common cause of sideroblastic anemia
7433
Alcohol
7434
Q3718:Most common cause of pyridoxine defficiency
7435
Isoniazid
7436
Q3719:In lead poisoning where does lead deposit
7437
Epiphyses
7438
Q3720:Most common cause of vitamin B12 defficiency
7439
Pernicious anemia
7440
Q3721:Which drug inhibits intestinal conjugase
7441
Phenytoin
7442
Q3722:Monoglutamate reabsorption is inhibited by _
7443
Alcohol and oral contraceptives
7444
Q3723:Most common cause of folate defficiency
7445
Alcohol
7446
Q3724:McArdle
7447
glycogen storage disease;muscle
7448
Q3725:von Gierke
7449
glycogen storage disease;liver and kidneys
7450
Q3726:Wilson
7451
Copper metabolism #;liver and brain
7452
Q3727:Galactosemia
7453
galactose metabolism #;liver; lens; brain
7454
Q3728:Turcot
7455
CNS: gliomas;GI tract: adenomas
7456
Q3729:Caroli
7457
congenital malformation bile ducts
7458
Q3730:May-White
7459
familial progressive myoclonus epilepsy with lipomas; deafness; ataxia
7460
Q3731:Crigler-Najjar
7461
Unconjugated bili- severe
7462
Q3732:Gilbert
7463
Unconjugated bili- mild
7464
Q3733:Dubin-Johnson
7465
conjugated bili- mild
7466
Q3734:Rotor
7467
conjugated bili- mild
7468
Q3735:Sturge-weber
7469
leptomeningial angiomatosis; port-wine stain; mental retardation; seizures; hemiplegia
7470
Q3736:Von hippel lindau
7471
capillary hemangioblastoma;retinal angiomas;renal ca ;cysts or ang# any organ
7472
Q3737:Gardner
7473
fam. colon ca; and osteomas; epidermal cysts; fibromatosis; abnormal teeth; thyroid ca; duodenal ca; pigmented ocular fundus; desmoid tumors
7474
Q3738:Menkes
7475
copper deficiency -> #collagen crosslinking -> depigmented lusterless hair; facial/ocular/vascular/cerebral #
7476
Q3739:Milroy
7477
congenital lymphatic malformation / lymphedema
7478
Q3740:Wermer
7479
MEN 1;parathyroid (hypercalcemia; kidney stones);pituitary;pancreas (ulcers)
7480
Q3741:Sipple
7481
MEN 2a;pheochromo;parathyroid;thyroid
7482
Q3742:shy-drager
7483
ANS failure -> orthostatic hypotension and parkinsonism
7484
Q3743:Budd-Chiari
7485
IVC or hepatic vein occlusion (caused by malignancy or congenital IVC webs)
7486
Q3744:Bloom's
7487
auto rec = small body size; immunodeficiency; light-sensitive facial erythema; predisp cancer
7488
Q3745:Rett
7489
only females; severe impairment; characteristic hand wringing movements
7490
Q3746:Churg-Strauss
7491
allergic granulomatosis and angiitis -> asthma and eosinophilia and vasculitis
7492
Q3747:Reye
7493
postviral/aspirin -> enlarged distorted mitochrondria -> esp. liver (disruption biochemical pathways -> microvesicular steatosis); brain (edema). 75% mild; 25% coma; liver failure or cns#; incr ammonia
7494
Q3748:Wiskott-Aldrich
7495
thrombocytopenia; eczema; recurrent sinopulmonary infections;low IgM; high IgE; IgG; IgA; defective response to polysaccharide antigens (defect T cells prevents binding to B cells);12% chance of non-hodgkin lymphoma!
7496
Q3749:Chediak-Higashi
7497
no lysosomal enzymes in phagosomes -> giant inclusions -> infections (neutropenia); albinism; nerve deficits; bleeding diathesis
7498
Q3750:Tuberous sclerosis
7499
MR; seizures; hypopigment (!!); angiofibromata (adenoma sebaceum); large cortical hamartomas; renal angiomyolipomas; cardial rhabdomyomas
7500
Q3751:de Quervain
7501
postviral destruction thyroid causing hyper than hypo
7502
Q3752:Nelson
7503
extreme hyperpigmentation after adrenalectomy
7504
Q3753:Eisenmenger
7505
shift from L-R shunt to R-L dus to pulm HT
7506
Q3754:Dressler's
7507
complication MI -> autoimmune fibrinous pericarditis with fever and peripleural chest pain (several weeks after MI)
7508
Q3755:Peutz-jeghers
7509
polyps (complex branching pattern; benign); melanin spots and incr risk breast/pancreas/overy/uterus/lung ca
7510
Q3756:Potter
7511
bilateral renal agenesis -> oligohydramnios
7512
Q3757:Lesch-Nyhan
7513
purine metabolism# (no HGPRT);aggressive; self-mutilation; gout; gouty nephropathy; yellow-orange crystals of uric acid in diaper
7514
Q3758:maple syrup disease
7515
branched chain amino acid #;motor abnormalities and seizures
7516
Q3759:phenylketonuria
7517
aromatic amino acid metabolism #;mental retardation
7518
Q3760:orotic aciduria
7519
pyrimidine metabolism #;retarder growtha nd development and megaloblastic anemia
7520
Q3761:homocystinuria
7521
sulfur containing amino acid #;mental retardation; dislocation of lenses; osteoporosis; thrombosis
7522
Q3762:Binswanger
7523
subcortical leukencephalopathy ;Diffuse loss of deep white matter - ass hypertension
7524
Q3763:Albinism
7525
copper-dependent tyrosinase deficiency -> block production melanin from aromatic amino acid tyrosine
7526
Q3764:Pickwickian syndrome
7527
= obesity hypoventilation syndrome;obesity and sleep apnea
7528
Q3765:What are the risk factors for HTN?
7529
increased age;obesity;diabetes;smoking;genetics;blacks > whites > Asians
7530
Q3766:What does HTN predispose?
7531
atherosclerosis;stroke;CHF;renal failure;retinopathy;aortic dissection
7532
Q3767:Monckeberg atherosclerosis
7533
calcification of the arteries; esp. radial or ulnar;usually benign
7534
Q3768:atreriolosclerosis
7535
hyaline thickening of small arteries in essential HTN;hyperplastic "onion-skinning" in malignant HTN
7536
Q3769:atherosclerosis
7537
disease of elastic arteries and large and medium-sized muscular arteries
7538
Q3770:What are the risk factors in developing atherosclerosis?
7539
smoking;HTN;diabetes mellitus;hyperlipidemia;family history
7540
Q3771:What are the complications of atherosclerosis?
7541
aneurysms;ischemia;infarcts;peripheral vascular disease;thrombus;emboli
7542
Q3772:Where do atherosclerotic plaques tend to form?
7543
abdominal aorta > coronary artery > popliteal artery > carotid artery
7544
Q3773:What is the progression of atherosclerosis?
7545
fatty streaks -> proliferative plaque -> complex atheromas
7546
Q3774:stable angina
7547
most common form of angina;pain precipitated by exertion and is relieved by rest or vasodilators (e.g; nitroglycerine)
7548
Q3775:Prinzmetal's angina
7549
intermittent chest pain at rest;caused by vasospasm
7550
Q3776:unstable/cresendo angina
7551
prolonged or recurrent pain at rest;often indicative of imminent MI
7552
Q3777:Which type of angina has pain that is relieved by rest?
7553
stable angina
7554
Q3778:Which type of angina has pain that gets worse during rest
7555
Prinzmetal's angina;unstable/cresendo angina
7556
Q3779:Which type of angina has intermittent chest pain at rest?
7557
Prinzmetal's angina
7558
Q3780:Which type of angina is caused by vasospasms?
7559
Prinzmetal's angina
7560
Q3781:Which type of angina is relieved by vasodilators?
7561
stable angina
7562
Q3782:Which type of angina is indicative of imminent MI?
7563
unstable/cresendo angina
7564
Q3783:Which type of angina is a result of severe narrowing of atheroscclerotic coronary vessels?
7565
stable angina
7566
Q3784:What is the most common form of angina?
7567
stable angina
7568
Q3785:Where do red (hemorrhagic) infarcts occur?
7569
loose tissue w/ collaterals (e.g; lungs; intestine) or following reperfusion
7570
Q3786:Where do pale infarcts occur?
7571
in solid tissues w/ single blood supply (e.g; brain; heart; kidney; spleen)
7572
Q3787:Which coronary arteries are occluded the most? the least?
7573
LAD > RCA > circumflex
7574
Q3788:When is an MI maximally yellow and soft?
7575
10 days post-MI
7576
Q3789:When are contraction bands visible on an MI?
7577
4 hours post-MI
7578
Q3790:When is ECG the best method of diagnosis of an MI?
7579
w/in the first 6 hours post-MI
7580
Q3791:When does cardiac troponin I begin to rise? How long does it stay elevated?
7581
rises after 4 hours;elevated for 7-10 days
7582
Q3792:What is the test of choice for MI in the first 24 hours post-MI?
7583
CK-MB
7584
Q3793:How long does LDH stay elevated post-MI?
7585
2-7 days
7586
Q3794:Is AST specific for liver?
7587
no;can also be found in cardiac; liver and skeletal muscle cells
7588
Q3795:ST elevation
7589
transmural infarct
7590
Q3796:ST depression
7591
subendocardial infarct
7592
Q3797:Q waves
7593
transmural infarct
7594
Q3798:What are the complications of an MI?
7595
cardiac arrhythmia;LV failure and pulmonary edema;cardiogenic shock;rupture of ventricular free wall; interventricular septum; papillary muscle; cardiac tamponade;thromboembolism - mural thrombus;fibrinous pericarditis (friction fub);Dressler's syndrome (autoimmune pheenomenon resulting in fibrinous pericarditis)
7596
Q3799:What is the most common cardiomyopathy?
7597
dilated (congestive) cardiomyopathy - 90%
7598
Q3800:What type of cardiomyopathy causes systolic dysfunction?
7599
dilated (congestive) cardiomyopathy
7600
Q3801:What type of cardiomyopathy causes diastolic dysfunction?
7601
hypertrophic cardiomyopathy
7602
Q3802:hypertrophic cardiomyopathy
7603
walls of LV are thickened (esp. the ventricular septum) and chamber becomes banana shaped;cause of sudden death in young athletes;50% inheriited as autosomal dominant trait;characterized microscopically by disoriented and tangled myocardial fibers
7604
Q3803:dilated cardiomyopathy
7605
most comon form of cardiomyopathy;characterized by dilation of both ventricles and by both right- and left-sided heart failure
7606
Q3804:restrictive cardiomyopathy
7607
caused by infiltrative processes w/in myocardium that results in stiffening of the heart muscle -> interferes w/ pumping action;exemplified by cardiac amloidosis -> right- and leftsided heart failure
7608
Q3805:mitral regurgitation
7609
holosystolic high-pitched "blowing murmur";loudest at apex
7610
Q3806:aortic stenosis
7611
crescendo-decrescendo systolic ejection murmur following ejection click;LV >> aortic pressure during systole;radiates to carotids/apex
7612
Q3807:VSD
7613
holosystolic murmur
7614
Q3808:mitral prolapse
7615
late systolic murmuc w/ midsystolic click;most frequent valvular lesion
7616
Q3809:aortic regurgitation
7617
immediate high-pitched "blowing" diastolic murmur;wide pulse pressure
7618
Q3810:mitral stenosis
7619
follows opening snap;delayed rumbling late diastolic murmur;LA >> LV pressure during diastole
7620
Q3811:patent ductus arteriosus
7621
continusos machine-like murmur;loudest at time of S2
7622
Q3812:What are the causes of serous pericarditis?
7623
SLE;rheumatoid arthritis;infection;uremia
7624
Q3813:What are the causes of fibrinous pericarditis?
7625
uremia;MI;rheumatic fever
7626
Q3814:What are the causes of hemorrhagic pericarditis?
7627
TB;malignancy
7628
Q3815:What are the findings in hemorrhagic pericarditis?
7629
pericardial pain;friction rub;ECG chances (diffuse ST elevations in all leads);pulsus paradoxus;distant heart sounds
7630
Q3816:syphilitic heart disease
7631
tertiary syphilis disrupts the vasa vasorum of the aorta -> dilation of the aorta and valve ring;"tree bark" appearance of the aorta
7632
Q3817:Buerger's disease;(aka thromboangiitis obliterans)
7633
acute inflammation involving small to medium size arteries of the extremities; extending to adjacent veins and nerves;clearly assoc. w/ smoking
7634
Q3818:What is the treatment for Buerger's disease?
7635
quit smoking
7636
Q3819:Takayasu's arteritis
7637
inflammation and stenosis of medium and large sized arteries w/ freq. involvement of the aortic arch and its branches -> arotic arch syndrome;assoc. w/ elevated ESR;primarily affects young Asian females
7638
Q3820:What are the clinical symptoms of Tayakasu's arteritis?
7639
(FAN ON MY SKIN On Wednesday);Fever;Arthritis;Night sweats;MYalgia;SKIN nodules;Ocular disturbances;Weak pulses in upper extremities
7640
Q3821:Takayasu's arteritis primarily affects what population?
7641
young Asian females
7642
Q3822:Buerger's diease affects what vessels?
7643
small and intermediate vessels of the extremities
7644
Q3823:Takayasu's arteritis involves what vessels?
7645
medium and large arteries w/ frequent involvement of the aortic arch and its branches
7646
Q3824:temporal arteritis;(giant cell arteritis)
7647
most common vasculitis that affects medium and small arteries; usually branches of carotid artery
7648
Q3825:What are the clinical symptoms of temporal arteritis?
7649
unilateral headache;jaw claudication;imparied vision (occlusion of opthalmic artery -> blindness)
7650
Q3826:What population does temporal arteritis affect most?
7651
elderly females
7652
Q3827:Temporal arteritis is associated w/ what lab finding?
7653
elevated ESR
7654
Q3828:polyarteritis nodosa
7655
necrotizing immue complex inflammation of medium-sized muscular arteries; typically involving renal and visceral vessels
7656
Q3829:What is the treatment for polyarteritis nodosa?
7657
corticosteroids;cyclophosphamide
7658
Q3830:Wegner's granulomatosis
7659
characterized by focal necrotizing vasculitis and necrotizing granulomas in the lung and upper airway and by necrotizing glomerulonephritis
7660
Q3831:What is a strong marker for Wegner's granulomatosis?
7661
C-ANCA
7662
Q3832:What is the treatment for Wegner's granulomatosis?
7663
cyclophosphamide and corticosteroids
7664
Q3833:microscopic polyangiitis
7665
similar to Wegner's granulomatosis but lacks granulomas;P- or C-ANCA
7666
Q3834:Churg-Strauss syndrome
7667
granulomatous vasculitis w/ eosinophilia
7668
Q3835:What organs are involved in Churg-Strauss syndrome?
7669
lung; heart; skin; kidneys; nerves
7670
Q3836:Kawasaki's disease
7671
acute; self-limiting disease of infants/kids;acute necrotizing vasculitis of small/medium-sized vessels
7672
Q3837:People w/ Kawasaki's disease may develop what?
7673
coronary aneurysms
7674
Q3838:what does uremia do to the bone marrow?
7675
makes it less responsive to EPO
7676
Q3839:what is hydroxyurea used for?
7677
increases production of fetal hemoglobin HbF
7678
Q3840:what are Howell Jolly bodies?
7679
inclusions of nuclear chromatin remnants seen in RBCs of pts with hypoactive splenic function
7680
Q3841:why should sickle cell patients consider prophylactice cholecystectomy?
7681
70% of sickle cell patients develop symptomatic cholelithiasis
7682
Q3842:why does hepatosplenomegaly develop in thalassemia pts?
7683
increased hemolysis of abnormal RBCs by macrophages in the spleen and liver; extramedullary hematopoiesis
7684
Q3843:where is dietary iron absorbed and in what form?
7685
absorbed in proximal duodenum; we eat Fe+++ and absorb as Fe++
7686
Q3844:why do pts with chronic disease develop anemia?
7687
1. chronic inflammation leads to more cytokines in blood and resulting increase in phagocytic activity destroying RBCs;2. cytokines inhibit renal secretion of EPO;3. lactoferrin released by inflammatory cells binds serum iron and makes it unavailable for erythropoiesis
7688
Q3845:what's the big picture problem in anemia of chronic disease and iron?
7689
high iron stores; but unavailable to the body
7690
Q3846:what does B12 do?
7691
1. catalyzes conversion of homocysteine to methionine;2. catalyzes conversion of methyltetrahydrofolate to tetrahydrofolate;3. converts methylmalonic acid to succinyl CoA
7692
Q3847:what is tetrahydrofolate?
7693
form of folic acid used in DNA synthesis
7694
Q3848:what is G6PD?
7695
the rate-limiting step in HMP pathway for NADPH production
7696
Q3849:what is glutathione?
7697
after reduction by NADPH; it combats oxidatative damage in cells
7698
Q3850:what is primary hemostasis?
7699
production of the temporary platelet plug
7700
Q3851:how does tPA work as a clot buster?
7701
it's an enzyme that activates plasminogen; converting it to plasmin which cleaves fibrin strands
7702
Q3852:how does heparin work?
7703
stimulates antithrombin III; which inhibits thrombin (factor II)
7704
Q3853:what is microangiopathic hemolytic anemia?
7705
hemolytic anemia due to intravascular fracture of RBCs
7706
Q3854:E. coli 0157 and Shigella species are known for causing what heme dysfunction?
7707
TTP or HUS
7708
Q3855:what's the main problem in TTP or HUS?
7709
endothelial damage leads to platelet consumption
7710
Q3856:what does desmopressin acetate (DDAVP) do?
7711
stimulates the liver to produce plasma clotting factors
7712
Q3857:what are 2 common causes of acquired platelet dysfunction?
7713
uremia and NSAIDs
7714
Q3858:how do clopidogrel and ticlopidine work?
7715
these 2 antiplatelet drugs block platelet-ADP receptor activation
7716
Q3859:how do abciximab; eptifibatide and tirofiban work?
7717
inhibit platelet GpIIb-IIIa receptor which mediates aggregation via a "fibrinogen bridge"
7718
Q3860:what anticoagulant can cause thrombocytopenia?
7719
heparin in 1-3% of pts;;can cause 2 syndromes;HITS: heparin induced thrombocytopenia syndrome;HITT: heparin induced thrombocytopenia thrombosis
7720
Q3861:how can ITP be treated?
7721
prednisone to slow the immune-mediated destruction of platelets
7722
Q3862:What is the term for an abnormal amount of collagen type III that produces a large bulging scar; seen primarily in blacks?
7723
Keloid
7724
Q3863:True or false? Klinefelter syndrome cannot be diagnosed until puberty.
7725
True
7726
Q3864:What form of sunlight is the most carcinogenic?
7727
Ultraviolet B (UVB) sunlight
7728
Q3865:What renal pathology involves uniform thickening of the glomerular capillary wall; granular appearance under the microscope; and effacement of foot processes?
7729
Membranous glomerulonephritis
7730
Q3866:What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
7731
HIV
7732
Q3867:What enzyme is deficient in chronic granulomatous disease of childhood?
7733
NADPH oxidase
7734
Q3868:What rare disorder presents as a large; hard; irregular thyroid gland due to fibrous proliferation of connective tissue in the thyroid gland and extends to adjacent structures?
7735
Riedel thyroiditis
7736
Q3869:Rheumatic fever most commonly follows pharyngeal infections with what bacteria?
7737
Group A beta -hemolytic streptococci
7738
Q3870:What benign cardiac tumor is associated with tuberous sclerosis?
7739
Rhabdomyoma
7740
Q3871:What are the rules of 10 regarding pheochromocytoma?
7741
10% are bilateral; 10% malignant; and 10% familial; 10% in children; 10% outside the adrenal gland; and 10x more likely to be seen on the USMLE than in real life
7742
Q3872:What vascular pathology is associated with HTN in the upper extremities; hypotension in the lower extremities; and a radial-femoral delay?
7743
Postductal coarctation of the aorta (adult)
7744
Q3873:What seronegative spondyloarthropathy is seen in HLA-B27positive young females and presents with the triad of conjunctivitis; urethritis; and arthritis affecting the knees and ankles?
7745
Reiter syndrome
7746
Q3874:What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
7747
Tylosis
7748
Q3875:A 20-year-old woman who was recently diagnosed with a sexually transmitted disease goes to the ER with a tender; painful; swollen; and erythematous knee (monoarticular). What organism is the likely culprit?
7749
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
7750
Q3876:What vasculitis is characterized by systemic vasculitis in small to medium- size vessels (except the lung); affecting young males; 30% HBsAg-positive; P-ANCA and autoantibodies against myeloperoxidase?
7751
Polyarteritis nodosa
7752
Q3877:What malignant bone tumor is associated with familial retinoblastoma?
7753
Osteosarcoma
7754
Q3878:What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?
7755
Polycystic kidney disease of childhood
7756
Q3879:In what syndrome does the patient have angiomatosis; renal cell carcinomas; pheochromocytomas; retinal; cerebellar; medulla; or spinal cord hemangioblastomas; and epidermal cysts?
7757
von Hippel-Lindau syndrome
7758
Q3880:What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
7759
Swan-neck deformities
7760
Q3881:What is the term for white retinal spots surrounded by hemorrhage? In what condition are they seen?
7761
Roth spots; and they are seen in bacterial endocarditis.
7762
Q3882:A 70-year-old man complains of urinary urgency; nocturia; hesitancy; postvoid dribbling; urinary retention; and a PSA result of 6.5 ng/mL. What is your diagnosis?
7763
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result); these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease; when obstructive symptoms begin to occur.
7764
Q3883:What triad consists of endothelial injury; changes in laminar flow; and hypercoagulation?
7765
Virchow triad; associated with the formation of a thrombus.
7766
Q3884:What bone cell has receptors for PTH?
7767
Osteoblasts (Remember; they modulate the function of osteoclasts.)
7768
Q3885:What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
7769
Gastric ulcer
7770
Q3886:What is the term for normal cellular genes associated with growth and differentiation?
7771
Proto-oncogenes
7772
Q3887:Blue sclera is seen in what hereditary bone disorder?
7773
Osteogenesis imperfecta
7774
Q3888:What form of anemia is diagnosed with sucrose lysis test and Ham test?
7775
Paroxysmal nocturnal hemoglobinuria
7776
Q3889:In what rare AR disorder do you see neutropenia; defective degranulation; and delayed microbial killing due to a problem in chemotaxis and migration?
7777
Chdiak-Higashi syndrome
7778
Q3890:What myeloid disorder is characterized by increased hematocrit; blood viscosity; basophils; and eosinophils; intense pruritus; and gastric ulcers due to histamine release from basophils; increased left atrial pressure; and plethora?
7779
Polycythemia vera (Remember; polycythemia vera is a risk factor for acute leukemias.)
7780
Q3891:If you order a V/Q scan for suspected pulmonary emboli; is the filling defect seen on the ventilation or perfusion side?
7781
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
7782
Q3892:What transports iron in the blood?
7783
Transferrin
7784
Q3893:What hematological malignancy is particularly likely to affect patients with Down syndrome?
7785
ALL (nearly 1520 times the normal risk)
7786
Q3894:What childhood pathology involves anterior bowing of the tibia; epiphyseal enlargements; and costochondral widening; with the endochondral bones being affected?
7787
Rickets
7788
Q3895:A Japanese man has weight loss; anorexia; early satiety; epigastric abdominal pain; and a palpable left supraclavicular lymph node. On endoscopy you find a large; irregular ulcer with elevated margins on the lesser curvature of the stomach. What is your diagnosis?
7789
Gastric carcinoma
7790
Q3896:What drug causes a sixfold increase in schizophrenia; can impair motor activity; and can cause lung problems?
7791
Marijuana
7792
Q3897:What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
7793
Transient ischemic attack
7794
Q3898:What is the name of the tumor when gastric carcinoma spreads to the ovaries?
7795
Krukenberg tumor
7796
Q3899:What condition results from a deficiency in the enzyme hexosaminidase A?
7797
Tay-Sachs disease
7798
Q3900:Which cerebral herniation results in compression of the anterior cerebral artery?
7799
Cingulate gyrus herniation (subfalcine)
7800
Q3901:What pathology involves excessive fibrosis throughout the body via increased fibroblast activity; occurs in women more than men; and is most commonly seen in the third to the fifth decade?
7801
Scleroderma
7802
Q3902:What is the term for the syndrome consisting of hepatomegaly; ascites; and abdominal pain due to hepatic vein thrombosis?
7803
Budd-Chiari syndrome
7804
Q3903:What form of angina is characterized by;? Coronary artery vasospasm; symptom occurrence at rest; ST segment elevation (during episode); and no signs on ECG?
7805
Prinzmetal variant angina
7806
Q3904:What form of angina is characterized by;? Coronary artery luminal narrowing; symptom occurrence during exertion; ST segment depression on ECG?
7807
Stable angina
7808
Q3905:What form of angina is characterized by;? Coronary artery nonocclusive thrombus; symptom occurrence with increasing frequency; duration; intensity; and decreasing activity; frequently at rest?
7809
Unstable (crescendo) angina
7810
Q3906:What skin condition is a localized proliferation of melanocytes presenting as small; oval; light brown macules?
7811
Benign lentigo
7812
Q3907:What is the term for nonneoplastic abnormal proliferation of cell size; shape; and cellular organization?
7813
Dysplasia
7814
Q3908:What diagnosis ensues from finding well-demarcated erythematous plaques with silvery scales on the knees; elbows; and scalp along with nail bed pitting and discoloration?
7815
Psoriasis
7816
Q3909:What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
7817
Kimmelstiel-Wilson disease
7818
Q3910:What autoimmune liver disease is characterized by affecting a middle-aged woman with jaundice; pruritus; fatigue; xanthomas; increased direct bilirubin levels; and antimitochondrial Abs?
7819
Primary biliary cirrhosis
7820
Q3911:What cell in chronic inflammation is derived from blood monocytes?
7821
Macrophages
7822
Q3912:True or false? Pancreatic insufficiency results in vitamin B12 malabsorption.
7823
True. Pancreatic enzymes begin the breakdown of vitamin B12-R complex in the duodenum.
7824
Q3913:What neuroendocrine tumor produces excess serotonin; is associated with diarrhea; flushing; bronchospasms; wheezing; and is diagnosed by findings of elevated urinary 5-HIAA levels?
7825
Carcinoid tumor
7826
Q3914:What tumor constitutes 40% of testicular tumors in children?
7827
Teratoma
7828
Q3915:What urinary metabolite is elevated in pheochromocytoma?
7829
Vanillylmandelic acid (VMA)
7830
Q3916:A 25-year-old black woman presents with nonproductive cough; shortness of breath; fatigue; and malaise; she has bilateral hilar lymphadenopathy on chest radiography and elevated ACE levels. What do you diagnose?
7831
Sarcoidosis
7832
Q3917:What are the four reasons for hypochromic microcytic anemia with a low MCV?
7833
1. Sideroblastic anemias (i.e; porphyrin and heme synthesis disorders) ;2. Thalassemia ;3. Iron deficiency ;4. Lead poisoning
7834
Q3918:What is characterized by an intense inflammatory reaction; an increase in the amounts of granulation tissue and wound contraction by myofibroblasts?
7835
Healing by secondary intention
7836
Q3919:What thyroiditis presents as a tender; enlarged; firm thyroid gland; usually preceded by an upper respiratory viral illness?
7837
de Quervain thyroiditis
7838
Q3920:What disorder leads to IgG autoantibodies to the TSH receptor?
7839
Graves disease
7840
Q3921:What intrauterine deficiency leads to failure to thrive; mental retardation; motor incoordination; and stunted growth?
7841
Iodine; resulting in congenital hypothyroidism
7842
Q3922:What pancreatic islet cell tumor is associated with MEN I syndrome?
7843
Gastrinoma
7844
Q3923:What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
7845
Duodenal ulcer
7846
Q3924:What disease arises from the adrenal medulla; displaces and crosses the midline; metastasizes early; is the most common solid tumor; and is seen in the 2-to 4-year-old age group?
7847
Neuroblastoma
7848
Q3925:What AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas?
7849
Familial hypercholesterolemia
7850
Q3926:A 20-year-old woman goes to the ER with ptosis; diplopia; weakness in her jaw muscles when chewing; and muscle weakness with repeated use. What is your diagnosis?
7851
Myasthenia gravis
7852
Q3927:What is the term for RBCs with smooth undulations on the surface of their membrane; commonly seen in uremia?
7853
Burr cells (echinocytes)
7854
Q3928:Name the cancer associated with the following tumor markers. (Some may have more than one answer.);? Beta-hCG
7855
Choriocarcinomas and trophoblastic tumors
7856
Q3929:Name the cancer associated with the following tumor markers. (Some may have more than one answer.);? CA-125
7857
Ovarian cancer
7858
Q3930:Name the cancer associated with the following tumor markers. (Some may have more than one answer.);? CA-19.9 and CEA
7859
Pancreatic cancer
7860
Q3931:Name the cancer associated with the following tumor markers. (Some may have more than one answer.);? alphaFetoprotein
7861
Hepatoma and nonseminomatous testicular germ cell tumors
7862
Q3932:Name the cancer associated with the following tumor markers. (Some may have more than one answer.);? Calcitonin
7863
7864
Q3933:Name the cancer associated with the following tumor markers. (Some may have more than one answer.);? PSA and prostatic acid phosphatase
7865
Prostate cancer
7866
Q3934:Name the cancer associated with the following tumor markers. (Some may have more than one answer.);? Placental alkaline phosphatase
7867
Seminoma
7868
Q3935:Name the cancer associated with the following tumor markers. (Some may have more than one answer.);? CEA
7869
Cancer of the lung; stomach; colon; and breast
7870
Q3936:What seronegative spondyloarthropathy is seen in HLA-B27positive young men; involves the sacroiliac joints; has no subcutaneous nodules; and has a bamboo spine appearance on radiograph?
7871
Ankylosing spondylitis
7872
Q3937:What disorder is associated with decreased platelet count; prolonged PT and PTT; decreased fibrinogen; and increased fibrin split products (D-dimers)?
7873
Disseminated intravascular coagulation (DIC)
7874
Q3938:What spirochete is responsible for Lyme disease?
7875
Borrelia burgdorferi
7876
Q3939:What very aggressive lung cancer metastasizes early and is associated with smoking and paraneoplastic syndromes?
7877
Small cell carcinoma (oat cell)
7878
Q3940:What bone disorder is characterized by brown tumors; bone pain; deformities; and fractures due to excessive PTH?
7879
Osteitis fibrosa cystica (von Recklinghausen disease)
7880
Q3941:What glycogen storage disease is due to the following enzyme deficiencies?;? Lysosomal glucosidase (acid maltase)
7881
Pompe's disease
7882
Q3942:What glycogen storage disease is due to the following enzyme deficiencies?;? Muscle phosphorylase
7883
McArdle's syndrome
7884
Q3943:What glycogen storage disease is due to the following enzyme deficiencies?;? Glucose-6-phosphatase
7885
von Gierke's disease
7886
Q3944:What ovarian disease involves psammoma bodies?
7887
Serocystadenocarcinoma
7888
Q3945:What cystic swelling of the chorionic villi is the most common precursor of choriocarcinoma?
7889
Hydatidiform mole
7890
Q3946:In what condition do you see dimpling on the kidney's surface?
7891
Pyelonephritis
7892
Q3947:What are the most common causes of osteomyelitis;? Overall?
7893
7894
Q3948:What are the most common causes of osteomyelitis;? In neonates?
7895
Streptococcus agalactiae
7896
Q3949:What are the most common causes of osteomyelitis;? In patients with sickle cell disease?
7897
Staphylococcus aureus (but they are more prone to salmonella infections)
7898
Q3950:What are the most common causes of osteomyelitis;? In drug addicts?
7899
Pseudomonas
7900
Q3951:What malignant neoplasm of the bone is associated with Homer-Wright pseudorosettes; onion skinning of the periosteum on radiographs of the femur; pelvis; and tibia; and chromosome 11;22 translocation?
7901
Ewing's sarcoma
7902
Q3952:What lymphoma is characterized by CD19; CD20; CD5; CD23-negative; and chromosome 11;14 translocations?
7903
Mantle cell lymphoma
7904
Q3953:What components of the complement cascade form the MAC?
7905
C5bC9
7906
Q3954:True or false? HPV infection increases the risk of developing squamous cell carcinoma of the penis.
7907
True. HPV serotypes 16 and 18 are risk factors for squamous cell carcinoma.
7908
Q3955:What form of coarctation of the aorta is associated with Turner syndrome?
7909
Preductal (infantile)
7910
Q3956:True or false? An elevated serum osteocalcin level is a marker for increased bone formation.
7911
True. Increased alkaline phosphatase levels also are associated with increased bone formation.
7912
Q3957:What is the most common opportunistic infection of the CNS in HIV?
7913
Toxoplasmosis
7914
Q3958:What hereditary bone disorder is due to decreased osteoclast function; resulting in thick; sclerotic bones that fracture easily?
7915
Osteopetrosis (Albers-Sch?nberg disease)
7916
Q3959:True or false? Pancreatic delta-cell tumors inhibit CCK secretion; leading to gallstones and steatorrhea.
7917
True. Delta-Cell tumors produce excess somatostatin; which inhibits CCK; gastrin (hypochlorhydria); and insulin secretion (diabetes).
7918
Q3960:What is the term for the speckled appearance of the iris in patients with Down syndrome?
7919
Brushfield spots
7920
Q3961:What is the term for the collapse of the vertebral body due to TB?
7921
Pott disease
7922
Q3962:What organ must metastasize for carcinoid heart disease to occur?
7923
Liver
7924
Q3963:Which subset of MEN syndrome is associated with the following?;? Medullary carcinoma of the thyroid; pheochromocytoma; and mucocutaneous neuromas
7925
MEN III (or IIb)
7926
Q3964:Which subset of MEN syndrome is associated with the following?;? Medullary carcinoma of the thyroid; pheochromocytoma; and parathyroid adenomas (or hyperplasia)
7927
MEN IIa (or Sipple syndrome)
7928
Q3965:Which subset of MEN syndrome is associated with the following?;? Parathyroid; pancreatic; and pituitary gland tumors and Zollinger-Ellison syndrome
7929
MEN I (or Wermer syndrome)
7930
Q3966:What X-linked recessive disease involves mental retardation; self-mutilation; choreoathetosis; spasticity; a decrease in HGPRT; and an increase in uricemia?
7931
Lesch-Nyhan syndrome
7932
Q3967:What disorder is associated with spider angiomas; palmar erythema; gynecomastia; testicular atrophy; encephalopathy; abnormalities in clotting factors; and portal HTN?
7933
Cirrhosis
7934
Q3968:What is your diagnosis of a young; thin asymptomatic female with a midsystolic click on cardiac auscultation?
7935
Mitral valve prolapse
7936
Q3969:What infection is associated with ring-enhancing lesions seen on computed tomography (CT) of the brain in an HIV-positive individual?
7937
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
7938
Q3970:What is the term for a reversible change in one cell type to another?
7939
Metaplasia (usually to a more protective cell type)
7940
Q3971:What liver tumor is associated with oral contraceptive pill use?
7941
Hepatic adenomas
7942
Q3972:What CNS developmental abnormality is associated with downward displacement of the cerebellar vermis and medulla compressing the fourth ventricle and leading to obstructive hydrocephalus?
7943
Arnold-Chiari malformation type 2
7944
Q3973:What disease involves a lack of both T cell-mediated and humoral immune responses that can be either X-linked or AR?
7945
Severe combined immunodeficiency disease
7946
Q3974:What condition results in the following CSF results?;? Opening pressure 70 to 180 mm H2O; 010 WBCs (monocytes); glucose 45 to 85; protein 15 to 45
7947
Normal values
7948
Q3975:What condition results in the following CSF results?;? Opening pressure 450 mm H2O; 5 WBCs (90% lymphocytes); normal glucose and protein levels
7949
Brain abscess
7950
Q3976:What condition results in the following CSF results?;? Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
7951
Viral meningitis
7952
Q3977:What condition results in the following CSF results?;? Opening pressure 250 mm H2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100
7953
TB meningitis
7954
Q3978:What condition results in the following CSF results?;? Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
7955
Bacterial meningitis
7956
Q3979:True or false? Removal of the ileum results in vitamin B12 deficiencies.
7957
True. The ileum is the site where vitamin B12 is absorbed.
7958
Q3980:What is the term for edema that has LDH below 200; protein level 2.5; and a specific gravity below 1.020?
7959
Transudative; exudative has the opposite values and has an elevated cellular content.
7960
Q3981:What is the term for thickened; hyperpigmented skin in the axillae; groin; and skin folds associated with malignancies; obesity; and DM?
7961
Acanthosis nigricans
7962
Q3982:How many grams of protein must be excreted in 24 hours to produce the diagnosis of nephrotic syndrome?
7963
>3.5 g/day of protein; along with generalized edema; hypoalbuminemia; and hyperlipidemia
7964
Q3983:What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
7965
Heroin
7966
Q3984:What catecholamine-hypersecreting tumor; a secondary cause of HTN; results in headache; diaphoresis; anxiety; tachycardia; and palpitations?
7967
Pheochromocytoma
7968
Q3985:What is the term for flattened nose; low-set ears; and recessed chin seen in patients with bilateral renal agenesis?
7969
Potter facies
7970
Q3986:What type of healing occurs in a clean surgical incision?
7971
Primary intention
7972
Q3987:What are the two most common viral infections in HIV?
7973
CMV retinitis and HSV-2
7974
Q3988:What disorder is defined by inability of the lower esophageal sphincter to relax with swallowing and a bird beak barium swallow result?
7975
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
7976
Q3989:Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?
7977
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone; whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
7978
Q3990:What CD4 T-cell receptor does the HIV virus bind to?
7979
gp120
7980
Q3991:What is the term for RBC fragments?
7981
Schistocytes
7982
Q3992:What disorder is due to a deficiency in tyrosinase?
7983
Albinism
7984
Q3993:What two Abs are used to diagnose Hashimoto's thyroiditis?
7985
Antithyroglobulin and antimicrosomal Abs
7986
Q3994:What urease-producing gram-negative curved rod is associated with PUD and chronic gastritis?
7987
Helicobacter pylori; which is also associated with an increased risk of gastric carcinoma
7988
Q3995:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Alkylating agents
7989
Leukemias and lymphomas
7990
Q3996:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Aromatic amines and azo dyes
7991
Hepatocellular carcinoma
7992
Q3997:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Arsenic
7993
Squamous cell carcinoma (skin; lung) and angiosarcoma of the liver
7994
Q3998:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Asbestos
7995
Mesothelioma and bronchogenic carcinoma
7996
Q3999:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Naphthylamine
7997
Bladder cancer
7998
Q4000:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Benzenes
7999
Leukemias
8000
Q4001:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Vinyl chloride
8001
Angiosarcoma of the liver
8002
Q4002:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Chromium and nickel
8003
Bronchogenic carcinoma
8004
Q4003:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Polycyclic aromatic hydrocarbons
8005
Bronchogenic carcinoma
8006
Q4004:Name the cancer associated with the following chemical agents. (Some may have more than one answer.);? Nitrosamines
8007
Gastric cancer
8008
Q4005:What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
8009
1. Autoimmune hypersplenism ;2. Trauma ;3. Anemia ;4. Spherocytosis ;5. Sickle cell anemia
8010
Q4006:What pancreatic islet cell tumor is associated with hypoglycemia; sweating; hunger; confusion; and increased Cpeptide levels?
8011
Insulinoma
8012
Q4007:What substance is used to test platelets' response in patients with von Willebrand disease?
8013
Ristocetin
8014
Q4008:What X-linked recessive disorder that is due to an abnormality in the dystrophin gene; has onset by age 5 with progressive proximal muscle weakness; calf pseudohypertrophy; and elevated CPK levels?
8015
Duchenne muscular dystrophy (Remember; Becker's is slower in progress; less severe; later in onset; and lacks cardiac involvement.)
8016
Q4009:What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
8017
Bronchioloalveolar carcinoma
8018
Q4010:What estrogen-producing tumor of the female genital tract is characterized by Call-Exner bodies?
8019
Granulosa cell tumor of the ovary
8020
Q4011:What AD syndrome involves 1000 or more edematous polyps; most commonly affects the colorectal area; and is associated with chromosome 5q21?
8021
Familial polyposis coli
8022
Q4012:What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints?
8023
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
8024
Q4013:What prostaglandin is associated with maintaining patency of the ductus arteriosus?
8025
PGE (along with low oxygen tension)
8026
Q4014:What is the term for dilated veins within the spermatic cord?
8027
Varicocele
8028
Q4015:What type of hemostasis in an intravascular space consists of fibrin; platelets; RBCs; and WBCs?
8029
Thrombus
8030
Q4016:What is the most common primary malignant tumor in bone?
8031
Osteosarcoma
8032
Q4017:What is the most common infectious agent in HIV?
8033
Pneumocystis carinii
8034
Q4018:What myeloid disorder is characterized by dry bone marrow aspirations; splenomegaly; leukoerythroblastosis; teardrop RBCs; and hyperuricemia due to increased cell turnover?
8035
Myelofibrosis with myeloid metaplasia
8036
Q4019:What disease that involves mental retardation; flat face; muscle hypotonia; and a double-bubble sign on radiograph poses an increased risk of Alzheimer's disease and ALL?
8037
Down syndrome (trisomy 21)
8038
Q4020:What form of anemia is associated with IgG Abs against Rh antigens; positive direct Coombs test; and splenomegaly?
8039
Autoimmune hemolytic anemia
8040
Q4021:What urinary metabolite is increased in patients with carcinoid syndrome?
8041
5-hydroxyindoleacetic acid (5-HIAA)
8042
Q4022:What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
8043
Primary sclerosing cholangitis
8044
Q4023:What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
8045
LC4; LD4; and LE 4
8046
Q4024:What are the three Bs of adult polycystic kidneys?
8047
1. Big ;2. Bilateral ;3. Berry aneurysm
8048
Q4025:What AR disease involves a defect in AA 508 on chromosome 7; causing a defect in Cl- transportation that leads to recurrent pulmonary infections and an increase in viscid mucoid secretions along with pancreatic insufficiencies?
8049
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
8050
Q4026:What law states that an enlarged; palpable gallbladder is more likely due to cancer than stone obstruction?
8051
Courvoisier's law
8052
Q4027:What is the term for air in the pleural space?
8053
Pneumothorax
8054
Q4028:What disorder of bone remodeling results in thick; weak bones and is associated with high-output cardiac failure?
8055
Paget disease (osteitis deformans)
8056
Q4029:What is the term to describe the increase in organ size due to the increase in cell size and function?
8057
Hypertrophy
8058
Q4030:What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies?
8059
Meningioma
8060
Q4031:True or false? Ethyl alcohol induces the cytochrome P-450 enzymes.
8061
True
8062
Q4032:What are the five components of portal HTN?
8063
1. Caput medusae ;2. Esophageal varices ;3. Ascites ;4. Splenomegaly ;5. Hemorrhoids
8064
Q4033:What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
8065
Prader-Willi syndrome and Angelman syndrome; respectively
8066
Q4034:What CNS tumor arises from Rathke's pouch?
8067
Craniopharyngioma
8068
Q4035:What is the triad of Reiter syndrome?
8069
1. Conjunctivitis;2. Nongonococcal urethritis ;3. Peripheral arthritis ;Can't see; can't wee; can't kick with your knee
8070
Q4036:Which of the following is not a risk factor for cholesterol gallstones: pregnancy; OCP use; female gender; hemolytic anemia; cirrhosis; and obesity? (May be more than one answer.)
8071
Cirrhosis and hemolytic anemia; which are risk factors for pigmented gallstones.
8072
Q4037:Name the nephritic disease based on the immunofluorescent staining;? Mesangial deposits of IgA and C3
8073
IgA nephropathy (Berger disease)
8074
Q4038:Name the nephritic disease based on the immunofluorescent staining;? Smooth and linear pattern of IgG and C3 in the GBM
8075
Goodpasture disease
8076
Q4039:Name the nephritic disease based on the immunofluorescent staining;? Granular deposits of IgG; IgM; and C3 throughout the glomerulus
8077
Postinfectious GN
8078
Q4040:What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
8079
GP IIb/IIIa; which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
8080
Q4041:What virus is associated with body cavity large B-cell lymphomas?
8081
HHV-8
8082
Q4042:What germ cell tumor is seen in the 15-to 35-year-old age group; peaks when the person is 35 years of age; and is a bulky mass that spreads via the lymphatic system?
8083
Seminoma
8084
Q4043:What transmural inflammatory bowel disease can be found from the mouth to anus; has noncaseating granulomas; is discontinuous (skip lesions); and has a cobblestone appearance; thickening of the bowel wall; linear fissures; and aphthous ulcers with normal mucosa between?
8085
Crohn disease
8086
Q4044:Does ELISA or Western blot confirm whether a patient is HIV-positive?
8087
ELISA screens and Western blot confirms the diagnosis.
8088
Q4045:What GN is highly associated with hepatitis B and C infections?
8089
Membranoproliferative glomerulonephritis (MPGN)
8090
Q4046:What is the term for squamous to columnar metaplasia of the distal esophagus secondary to chronic inflammation?
8091
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
8092
Q4047:What is the term for excessive amounts of granulation tissue that can block re-epithelialization and wound healing?
8093
Proud flesh
8094
Q4048:What is released from the mitochondria to trigger apoptosis?
8095
Cytochrome c
8096
Q4049:How much of a vessel must be stenosed to cause sudden cardiac death?
8097
More than 75% of the vessel
8098
Q4050:Oxidation of Hgb forms what bodies in patients with G-6-PD deficiency?
8099
Heinz bodies
8100
Q4051:What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN; hypokalemia; and low rennin levels?
8101
Conn syndrome (primary hyperaldosteronism)
8102
Q4052:What virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma?
8103
EBV
8104
Q4053:What normochromic; normocytic AD anemia has splenomegaly and increased osmotic fragility?
8105
Hereditary spherocytosis
8106
Q4054:What does prepubertal hypersecretion of growth hormone lead to?
8107
Gigantism
8108
Q4055:What enzyme is deficient in alkaptonuria?
8109
Homogentisic oxidase
8110
Q4056:What sex cell tumor causes precocious puberty; masculinization; gynecomastia in adults; and crystalloids of Reinke?
8111
Leydig cell tumor
8112
Q4057:Name four major risk factors for atherosclerosis.
8113
DM; hypercholesterolemia; smoking; and HTN are major risk factors. Being male; obesity; sedentary lifestyle; homocysteine elevation; oral contraceptive pills; and genetics are minor risk factors for atherosclerosis.
8114
Q4058:Name the AD disease associated with chromosome 15 in which the patient has long extremities; lax joints; pigeon chest; and posterior mitral leaflet prolapse and is prone to developing dissecting aortic aneurysm.
8115
Marfan syndrome
8116
Q4059:What is the term for a large VSD that leads to pulmonary HTN; RVH; and cyanosis due to right-to-left reversal of the shunt?
8117
Eisenmenger syndrome; which can also occur with any left-toright shunt
8118
Q4060:Eating fava beans can produce the Mediterranean type of what deficiency?
8119
G-6-PD deficiency
8120
Q4061:What form of hemophilia is X-linked recessive and due to a deficiency in factor VIII?
8121
Hemophilia A
8122
Q4062:What leukemia affects a 4-year-old child with 3 months of fever; fatigue; generalized lymphadenopathy; CNS involvement; hepatosplenomegaly; bleeding; and platelet count below 100; 000?
8123
ALL
8124
Q4063:What protein deficiency results in respiratory distress syndrome of newborns?
8125
Deficiency in surfactant
8126
Q4064:What are the three components of amyloid?
8127
1. Fibrillary protein ;2. Amyloid protein ;3. Glycosaminoglycans
8128
Q4065:What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
8129
Myasthenia gravis
8130
Q4066:What are the three left-to-right shunts?
8131
1. VSD ;2. ASD ;3. PDA
8132
Q4067:What protein causes fibrinolysis?
8133
Plasmin
8134
Q4068:What pancreatic islet cell tumor is associated with watery diarrhea; hypokalemia; and achlorhydria?
8135
VIPoma
8136
Q4069:True or false? Obesity; DM; HTN; multiparity; early menarche; and late menopause are all risk factors for endometrial carcinoma.
8137
False. They are all risk factors for endometrial carcinoma except multiparity. Nulliparity; estrogen-producing tumors; and estrogen replacement therapy are also risk factors for endometrial carcinoma.
8138
Q4070:What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?
8139
Lisch nodules
8140
Q4071:What GI pathology is associated with a positive string sign; an increase in the number of bloody stools; RLQ pain; skip lesions; terminal ileum most commonly affected; occurrence in women more than men; and an increased thickness of the bowel?
8141
Crohn disease
8142
Q4072:What is the most common fungal infection in HIV?
8143
Candida
8144
Q4073:True or false? GERD is a cause of asthma.
8145
True. Don't forget this in your differential diagnosis of an asthmatic.
8146
Q4074:Name the product or products of arachidonic acid;? Vasodilation and inhibition of platelet aggregation produced by vascular endothelium
8147
PGI2
8148
Q4075:Name the product or products of arachidonic acid;? Vasodilation
8149
PGD2; PGE2; and PGF 2
8150
Q4076:Name the product or products of arachidonic acid;? Pain and fever
8151
PGE2
8152
Q4077:Name the product or products of arachidonic acid;? Vasoconstriction and platelet aggregation produced by platelets
8153
TXA2
8154
Q4078:Name the product or products of arachidonic acid;? Chemotactic for neutrophils
8155
LTB4
8156
Q4079:Name the product or products of arachidonic acid;? Vasodilation; bronchospasm; and increased vascular permeability
8157
LTC4; LTD4; and LTE4
8158
Q4080:Which hepatitis B Ab indicates low transmissibility?
8159
HBeAb
8160
Q4081:What pneumoconiosis is associated with exposure to the following occupations or materials?;? Miners; metal grinders; and sandblasters
8161
Silicosis;Note: Coal worker's pneumoconiosis is synonymous with black lung disease; an upper lobe occupational disorder
8162
Q4082:What pneumoconiosis is associated with exposure to the following occupations or materials?;? Aerospace industry; nuclear reactors
8163
Berylliosis
8164
Q4083:What pneumoconiosis is associated with exposure to the following occupations or materials?;? Shipyards; brake linings; insulation; and old building construction
8165
Asbestosis
8166
Q4084:What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
8167
Porcelain gallbladder
8168
Q4085:What is the term to describe a decrease in the cell size and function usually associated with disuse?
8169
Atrophy. Disuse can also be due to immobilization; ischemia; aging; and a host of other causes.
8170
Q4086:Which B-cell neoplasm has the following cell surface markers: CD19; CD20; CD5 (T-cell marker); CD23; and are CD10-negative?
8171
CLL (B-cell origin)
8172
Q4087:What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur; humerus; and tibia?
8173
Caisson disease
8174
Q4088:What are the four DNA oncogenic viruses?
8175
1. HPV ;2. EBV ;3. Hepatitis B ;4. Kaposi sarcoma
8176
Q4089:Is the AD or AR form of osteopetrosis malignant?
8177
The AR form is malignant and AD is benign.
8178
Q4090:What carcinoma produces hematuria; flank pain; and a palpable mass?
8179
This is the triad of renal cell carcinoma
8180
Q4091:Name at least three causes of metastatic calcification.
8181
Remember the mnemonic PAM SMIDT;P; (hyper) Parathyroid/ Paget disease;A; Addison's disease;M; Milkalkali syndrome/metastatic cancer;S; Sarcoidosis;M; Multiple myeloma;I; Immobilization/idiopathic;D; Vitamin D intoxication;T; Tumors
8182
Q4092:What is the only subtype of Hodgkin's lymphoma that is most commonly seen in females?
8183
Nodular sclerosis
8184
Q4093:What is the leading cause of preventable premature death and illness in the United States?
8185
Smoking
8186
Q4094:What prion-associated CNS pathology produces rapidly progressive dementia with myoclonus; involuntary movements; and death within 6 to 12 months?
8187
Creutzfeldt-Jakob disease
8188
Q4095:What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting; fissuring; and oozing?
8189
Paget disease of the breast
8190
Q4096:What breast pathology involves malignant cells with halos invading the epidermis of the skin?
8191
Paget disease of the breast
8192
Q4097:Macro-ovalocytes in the peripheral blood smear are formed from what cell in the bone marrow?
8193
Megaloblasts
8194
Q4098:Name the type of exudate; given the following examples;? Sunburn
8195
Serous exudates
8196
Q4099:Name the type of exudate; given the following examples;? Uremic pericarditis
8197
Fibrinous exudates
8198
Q4100:Name the type of exudate; given the following examples;? Parasitic infection
8199
Eosinophilic exudates
8200
Q4101:Name the type of exudate; given the following examples;? Diphtheria infection
8201
Pseudomembranous exudates
8202
Q4102:Name the type of exudate; given the following examples;? Meningococcal infection
8203
Purulent exudates
8204
Q4103:Name the type of exudate; given the following examples;? Rickettsial infection
8205
Hemorrhagic exudates
8206
Q4104:What parasite is associated with squamous cell carcinoma of the urinary bladder?
8207
Schistosoma haematobium
8208
Q4105:What malabsorption syndrome produces abdominal distention; bloating; flatulence; diarrhea; steatorrhea; and weight loss shortly after eating bread products?
8209
Celiac sprue (gluten-sensitive enteropathy)
8210
Q4106:What herpes virus is associated with Kaposi sarcoma?
8211
HHV 8
8212
Q4107:What is the term for the copper corneal deposits found in Wilson's disease?
8213
Kayser-Fleischer rings
8214
Q4108:Name the six vitamin Kdependent coagulation factors.
8215
Factors II; VII; IX; and X and proteins C and S.
8216
Q4109:What ovarian carcinoma is characterized by psammoma bodies?
8217
Cystadenocarcinoma
8218
Q4110:A marfanoid patient presents with tearing retrosternal chest pain radiating to her back. What is your first diagnosis?
8219
Dissecting aortic aneurysm. MI is also high on the list; but these are buzzwords to look for dissection.
8220
Q4111:What malignant neoplasm of the skin is associated with keratin pearls?
8221
8222
Q4112:Name four chemotactic factors for neutrophils.
8223
N-formyl-methionine;LTB4;C5a;IL-8
8224
Q4113:What is the term for granuloma at the lung apex in TB?
8225
Simon focus
8226
Q4114:What are the three platelet aggregating factors?
8227
1. ADP ;2. PG ;3. TXA2
8228
Q4115:What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?
8229
Waterhouse-Friderichsen syndrome
8230
Q4116:What foci of fibrinoid necrosis are surrounded by lymphocytes and macrophages throughout all the layers of the heart?
8231
Aschoff bodies of rheumatic fever
8232
Q4117:What is the leading cause of primary hyperparathyroidism?
8233
Chief cell adenoma (80%)
8234
Q4118:In what X-linked recessive disease is there a decrease in the HMP shunt; along with Heinz body formation?
8235
G-6-PD deficiency
8236
Q4119:What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb-containing area?
8237
Target cell
8238
Q4120:True or false? Raynaud's phenomenon has no underlying pathology.
8239
False. The disease has no associated pathology; the phenomenon is arterial insufficiency due to an underlying disease.
8240
Q4121:What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
8241
8242
Q4122:What form of hemophilia is X-linked recessive and is due to a deficiency in factor IX?
8243
Hemophilia B
8244
Q4123:What are the two reasons for megaloblastic anemia with elevated MCV?
8245
Vitamin B12 deficiency and folate deficiency
8246
Q4124:Is cigarette smoking associated with transitional cell carcinoma of the bladder?
8247
Yes. It is also a cause of cancers of the lung; esophagus; ureter; and kidney; just to name a few.
8248
Q4125:What disease has multiple schwannomas; caf-au-lait spots on the skin; and Lisch nodules and is associated with chromosome 17q?
8249
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
8250
Q4126:What syndrome is due to Abs directed to presynaptic calcium channels and causes axial and girdle muscle weakness that improves with repeated use?
8251
Eaton-Lambert syndrome
8252
Q4127:In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
8253
Malignant mesothelioma
8254
Q4128:What is the term for cytoplasmic remnants of RNA in RBCs; seen in lead poisoning?
8255
Basophilic stippling
8256
Q4129:What is the triad of fat embolism?
8257
1. Petechiae ;2. Hyperactive mental status ;3. Occurrence within 24 to 48 hours of the initial insult (e.g; long bone fracture)
8258
Q4130:Upon seeing negatively birefringent needle-shaped crystals from a joint aspiration of the great toe; what form of arthritis do you diagnose?
8259
Gout
8260
Q4131:What condition is manifested by bilateral sarcoidosis of the parotid glands; submaxillary gland; and submandibular gland with posterior uveal tract involvement?
8261
Mikulicz syndrome
8262
Q4132:What female genital tract disorder is characterized by obesity; hirsutism; infertility; amenorrhea; elevated LH and testosterone levels; and low FSH levels?
8263
Polycystic ovary disease (Stein-Leventhal syndrome)
8264
Q4133:What bronchogenic carcinoma is associated with an elevated level of Ca2+; involves keratin pearls; occurs in men more than women; is associated with smoking; occurs in the major bronchi; and is seen in the central areas of the lung?
8265
8266
Q4134:What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
8267
PKU
8268
Q4135:True or false? Being a white male increases your risk factor for testicular cancer.
8269
Oddly enough; it is true. Cryptorchidism; Klinefelter syndrome; testicular feminization; and family history of testicular cancer are all risk factors.
8270
Q4136:Can an acute MI be diagnosed only by looking at an ECG?
8271
No. Remember; tests do not diagnose; they confirm or refute your diagnosis. Also; diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI; elevated cardiac enzymes consistent with MI; and ST segment elevation of 2 mm or more in at least two contiguous leads.
8272
Q4137:What autoimmune syndrome is characterized by keratoconjunctivitis; corneal ulcers; xerostomia; and an increased risk of high-grade B-cell lymphomas? What two Ab tests are used in making the diagnosis?
8273
Sj?gren's syndrome; SS-A (Ro) and SS-B (La)
8274
Q4138:True or false? Sickle cell anemia; Caisson disease; chronic steroid use; and Gaucher disease are causes of avascular necrosis of bone.
8275
True. Fractures and trauma; however; are the most common causes.
8276
Q4139:What gene stimulates apoptosis when DNA repair is unable to be done?
8277
p-53
8278
Q4140:Is ulcerative colitis or Crohn disease more commonly associated with primary sclerosing cholangitis?
8279
Ulcerative colitis
8280
Q4141:What test uses p24 protein when diagnosing HIV?
8281
ELISA test
8282
Q4142:How many caf-au-lait spots are necessary for the diagnosis of neurofibromatosis type 1?
8283
At least six
8284
Q4143:What is the term for severe and protracted vomiting resulting in linear lacerations at the gastroesophageal junction?
8285
Mallory-Weiss syndrome
8286
Q4144:What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?
8287
Metastatic calcification
8288
Q4145:What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
8289
Volvulus
8290
Q4146:What form of poisoning is associated with bitter almondscented breath?
8291
Cyanide
8292
Q4147:Name the type of hypersensitivity reaction based on the following properties;? Circulating Ab-Ag immune complexes deposited in the tissue result in neutrophil attraction and the release of lysosomal enzymes.
8293
Type III hypersensitivity (immune complex)
8294
Q4148:Name the type of hypersensitivity reaction based on the following properties;? IgE-mediated release of chemical mediators from basophils and mast cells; need prior exposure to Ag in the past; eosinophils amplify and continue reaction; can be system or localized.
8295
Type I hypersensitivity (anaphylactic)
8296
Q4149:Name the type of hypersensitivity reaction based on the following properties;? IgG or IgM Abs against a specific target cell or tissue; complement-dependent or ADCC.
8297
Type II hypersensitivity (cytotoxic)
8298
Q4150:Name the type of hypersensitivity reaction based on the following properties;? Reaction-mediated by sensitized Tcells
8299
Type IV hypersensitivity (cell-mediated)
8300
Q4151:What highly undifferentiated aggressive CNS tumor of primordial neuroglial origin develops in children and is associated with pseudorosettes?
8301
Primitive neuroectodermal tumors (i.e; medulloblastomas and retinoblastomas)
8302
Q4152:What syndrome is due to anti-GBM Abs directed against the lung and kidneys?
8303
Goodpasture syndrome
8304
Q4153:What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
8305
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
8306
Q4154:What tumor is seen in the 2-to 4-year-old age group; does not cross the midline; has immature glomeruli; tubules; and stroma; and metastasizes late to the lungs?
8307
Wilms tumor
8308
Q4155:What CNS tumor commonly produces tinnitus and hearing loss?
8309
Schwannoma
8310
Q4156:True or false? Anticentromere Abs are used in diagnosing CREST syndrome.
8311
True. Scl-70 Abs are used in diagnosing diffuse scleroderma.
8312
Q4157:What AR CNS disorder presents early in childhood with gait ataxia; loss of deep tendon reflexes; impaired vibratory sensation; hand clumsiness; and loss of position sense?
8313
Friedreich ataxia
8314
Q4158:What potent platelet aggregator and vasoconstrictor is synthesized by platelets?
8315
TXA2
8316
Q4159:Which type of cerebral herniation is associated with CN III palsy?
8317
Transtentorial (uncal)
8318
Q4160:What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
8319
Syphilitic
8320
Q4161:What is the main type of cell involved in cellular immunity?
8321
T lymphocyte
8322
Q4162:What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
8323
Melasma
8324
Q4163:What is the classic triad of TB?
8325
Fever; night sweats; and hemoptysis
8326
Q4164:True or false? Blood clots lack platelets.
8327
True. A thrombus has platelets; but clots do not.
8328
Q4165:What malignant tumor of the skin is associated with Birbeck granules?
8329
Histiocytosis X
8330
Q4166:What type of anemia is the result of a deficiency in intrinsic factor?
8331
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
8332
Q4167:What cancer is particularly likely to affect English chimney sweeps?
8333
Scrotal cancer; due to the high exposure to polycyclic aromatic hydrocarbons
8334
Q4168:What is the term for a raised fluid-filled cavity greater than 0.5 cm that lies between the layers of the skin?
8335
Bulla
8336
Q4169:What virus is associated with the endemic form of Burkitt lymphoma?
8337
EBV
8338
Q4170:With which pituitary adenoma is an elevated somatomedin C level associated?
8339
GH-producing adenoma
8340
Q4171:What three criteria allow you to differentiate an ulcer from an erosion or carcinoma?
8341
1. Less than 3 cm ;2. Clean base ;3. Level with the surrounding mucosa
8342
Q4172:Name the four right-to-left congenital cardiac shunts.
8343
Truncus (1) arteriosus;Transposition of the (2) great vessels;Tri(3)cuspid atresia;Tetra(4)logy of Fallot;They all begin with T
8344
Q4173:What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate?
8345
Hypoparathyroidism
8346
Q4174:Does PT or PTT test the extrinsic coagulation pathway?
8347
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT; which means warfarin; extrinsic; PT; heparin; intrinsic; PTT)
8348
Q4175:What leukemia is associated with four-leaf-clover lymphocytes on peripheral blood smear?
8349
Adult T-cell leukemia
8350
Q4176:What ring is a weblike narrowing of the gastroesophageal junction?
8351
Schatzki ring
8352
Q4177:With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
8353
Henoch-Sch?nlein purpura
8354
Q4178:What rapidly progressive and aggressive T-cell lymphoma affects young males with a mediastinal mass (thymic)?
8355
Lymphoblastic lymphoma
8356
Q4179:What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)?
8357
Flea-bitten kidney (can also be seen in pyelonephritis)
8358
Q4180:True or false? Psammoma bodies are seen in medullary carcinoma of the thyroid.
8359
False. Elevated calcitonin levels are seen in medullary carcinoma of the thyroid. Psammoma bodies are seen in papillary carcinoma of the thyroid and ovaries; as well as meningiomas.
8360
Q4181:What is the lecithin:sphingomyelin ratio in respiratory distress syndrome of newborns?
8361
<2
8362
Q4182:What syndrome has loss of deep tendon reflexes; muscle weakness; and ascending paralysis preceded by a viral illness?
8363
Guillain-Barr syndrome
8364
Q4183:What form of endocarditis do patients with SLE commonly encounter?
8365
Libman-Sacks endocarditis
8366
Q4184:What is the term for black pigmentation of the colon associated with laxative abuse?
8367
Melanosis coli
8368
Q4185:Are the following major or minor Jones criteria of rheumatic fever?;? Fever
8369
Minor
8370
Q4186:Are the following major or minor Jones criteria of rheumatic fever?;? Migratory polyarthritis
8371
Major
8372
Q4187:Are the following major or minor Jones criteria of rheumatic fever?;? Subcutaneous nodules
8373
Major
8374
Q4188:Are the following major or minor Jones criteria of rheumatic fever?;? Elevated acute phase reactants (e.g; ESR)
8375
Minor
8376
Q4189:Are the following major or minor Jones criteria of rheumatic fever?;? Arthralgias
8377
Minor
8378
Q4190:Are the following major or minor Jones criteria of rheumatic fever?;? Pericarditis
8379
Major
8380
Q4191:Are the following major or minor Jones criteria of rheumatic fever?;? Erythema marginatum
8381
Major
8382
Q4192:Are the following major or minor Jones criteria of rheumatic fever?;? Sydenham chorea
8383
Major
8384
Q4193:What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?
8385
Bcl-2
8386
Q4194:Which hepatitis strain is a defective virus that can replicate only inside HBV-infected cells?
8387
Hepatitis D
8388
Q4195:What are the three main components of amyloid?
8389
Fibrillary protein; amyloid protein; and glycosaminoglycans (heparin sulfate mainly)
8390
Q4196:What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100; 00); decreased LAP levels; and nonspecific symptoms of fatigue; malaise; weight loss; and anorexia?
8391
CML
8392
Q4197:What is the difference between a Ghon focus and a Ghon complex?
8393
A Ghon focus is a TB tubercle; whereas a Ghon complex is a focus with hilar lymph node involvement.
8394
Q4198:In what disease do you see horseshoe kidneys; rockerbottom feet; low-set ears; micrognathia; and mental retardation?
8395
Edward syndrome (trisomy 18)
8396
Q4199:What parasitic infection is associated with cholangiocarcinoma?
8397
Clonorchis sinensis
8398
Q4200:What disorder is associated with loss of polarity; anaplasia; pleomorphism; discohesiveness; increase in the nuclear:cytoplasmic ratio; hyperchromasia; and increase in the rate of mitosis?
8399
Malignancy
8400
Q4201:What is the term for telescoping of the proximal bowel into the distal segment presenting as abdominal pain; currant jelly stools; and intestinal obstruction?
8401
Intussusception
8402
Q4202:What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
8403
Amanita phalloides
8404
Q4203:What type of erythema do you see in;? Ulcerative colitis?
8405
Erythema nodosum
8406
Q4204:What type of erythema do you see in;? Rheumatic fever?
8407
Erythema marginatum
8408
Q4205:What type of erythema do you see in;? StevensJohnson syndrome?
8409
Erythema multiforme
8410
Q4206:What benign bone tumor is associated with Gardner syndrome?
8411
Osteoma
8412
Q4207:What renal calculus is associated with urea-splitting bacteria?
8413
Magnesium ammonium phosphate (struvite)
8414
Q4208:What lymphoma is associated with bleeding and cryoglobulin precipitation at low temperatures; headache and confusion due to hyperviscosity; IgM M-protein spike on serum electrophoresis; and Russell bodies?
8415
Waldenstr?m's macroglobulinemia
8416
Q4209:What type of acute metal poisoning involves stomach and colon erosion and acute tubular necrosis?
8417
Mercury
8418
Q4210:What slow-growing CNS tumor in 30-to 50-year-old patients with a long history of seizures has fried egg cellular appearance in a network of chicken wire?
8419
Oligodendroglioma
8420
Q4211:Goodpasture Ag is a component of what type of collagen?
8421
Type IV collagen
8422
Q4212:If a peripheral blood smear shows schistocytes; reticulocytes; and thrombocytopenia; is it more commonly seen in patients with ITP or TTP?
8423
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
8424
Q4213:After traveling in a plane across the Atlantic Ocean; an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
8425
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
8426
Q4214:What cell type involves humoral immunity?
8427
B lymphocyte
8428
Q4215:What is the first sign of megaloblastic anemia on a peripheral blood smear?
8429
Hypersegmented neutrophils
8430
Q4216:What is the term for gastric ulcers associated with severely burned or traumatic patients?
8431
Curling ulcers (think curling iron = burn)
8432
Q4217:What syndrome arises from mutation in the fibrillin gene (FBN1) on chromosome 15q21?
8433
Marfan syndrome
8434
Q4218:What AD disorder is characterized by degeneration of GABA neurons in the caudate nucleus resulting in atrophy; chorea; dementia; and personality changes?
8435
Huntington disease
8436
Q4219:What atypical pneumonia can be diagnosed with elevated cold agglutinin titers?
8437
Mycoplasma pneumoniae
8438
Q4220:What is the triad of Felty syndrome?
8439
Neutropenia; splenomegaly; and rheumatoid arthritis
8440
Q4221:What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation?
8441
Chemotaxis
8442
Q4222:What is the term for a benign melanocytic tumor associated with sun exposure that presents as tan-to-brown colored and has sharply defined well-circumscribed borders?
8443
Benign nevus (mole)
8444
Q4223:What small- to medium- sized vasculitis is seen in a 35-year-old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities?
8445
Buerger disease (thromboangiitis obliterans)
8446
Q4224:What is the term for pelvic inflammatory disease of the fallopian tubes?
8447
Salpingitis
8448
Q4225:What disease with familial mental retardation produces large; everted ears and macro-orchidism?
8449
Fragile X syndrome
8450
Q4226:What type of skin carcinoma occurring on sunexposed sites has a low level of metastasis?
8451
8452
Q4227:What is the tetrad of tetralogy of Fallot?
8453
VSD; RVH; overriding aorta; and pulmonary stenosis
8454
Q4228:What is the term for chronic necrotizing pulmonary infections resulting in permanent airway dilation and associated with Kartagener syndrome?
8455
Bronchiectasis
8456
Q4229:What is an elevated; fluid-filled cavity between skin layers up to 0.5 cm?
8457
Vesicle (e.g; poison ivy)
8458
Q4230:What is the term for panhypopituitarism secondary to ischemic necrosis and hypotension postpartum?
8459
Sheehan syndrome
8460
Q4231:What disease is diagnosed by findings of ANAs and anti-SCL-70 antibodies?
8461
Scleroderma
8462
Q4232:What is the name of the ovarian cyst containing ectodermal; endodermal; and mesodermal elements (i.e; skin; hair; teeth and neural tissue)?
8463
Teratoma (dermoid cyst)
8464
Q4233:What syndrome is seen in iron-deficient middle-aged women with esophageal webs?
8465
Plummer-Vinson syndrome
8466
Q4234:What are the three causes of transudate?
8467
CHF; cirrhosis; and nephrosis
8468
Q4235:A chronic alcohol abuser goes to the ER with weakness; a sore; beefy red tongue; loss of vibration and position sense; arm and leg dystaxia; elevated levels of methylmalonic acid in the urine; and anemia with an MCV above 105 fL. What is your diagnosis; and how will you monitor his response to treatment?
8469
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working; you will see an increased reticulocyte count on the peripheral smear in about 5 days.
8470
Q4236:What form of GN is characteristically associated with crescent formation?
8471
Rapidly progressive glomerulonephritis (RPGN)
8472
Q4237:What vitamin deficiency may result in sideroblastic anemia?
8473
Vitamin B6
8474
Q4238:What is the term for TB with the cervical lymph node involved?
8475
Scrofula
8476
Q4239:Influx of what ion is associated with irreversible cell injury?
8477
Massive influx of calcium
8478
Q4240:What pathology is associated with elevated levels of Ca2+; cardiac arrhythmias; bone resorption; kidney stones; and metastatic calcifications?
8479
Primary hyperparathyroidism
8480
Q4241:What type of metal poisoning causes mental retardation; somnolence; convulsions; and encephalopathy?
8481
Lead
8482
Q4242:What syndrome is rheumatoid arthritis with pneumoconiosis?
8483
Caplan syndrome
8484
Q4243:True or false? All of the following are risk factors for cervical cancer: multiple pregnancies; early age of intercourse; multiple sexual partners; OCP use; smoking; HIV; and STDs.
8485
True. Don't forget this list; you will be asked.
8486
Q4244:What is the term for precipitation of calcium phosphate in dying or necrotic tissue?
8487
Dystrophic calcification
8488
Q4245:What congenital small bowel outpouching is a remnant of the vitelline duct?
8489
Meckel diverticulum
8490
Q4246:What type of crystals are associated with gout?
8491
Monosodium urate crystals
8492
Q4247:What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning?
8493
Mees lines
8494
Q4248:What is the tumor at the bifurcation of the right and left hepatic ducts?
8495
Klatskin tumor
8496
Q4249:IgE-mediated mast cell release; C3a and C5a; and IL-1 all trigger the release of what vasoactive amine?
8497
Histamine
8498
Q4250:What disease is seen in the 20-to 40-year-old age group; is more prevalent in women than men; involves diarrhea with or without bloody stools; starts in the rectum and ascends without skipping areas; includes pseudopolyps; and has a thickness of the bowel that does not change?
8499
Ulcerative colitis
8500
Q4251:What disorder causes joint stiffness that worsens with repetitive motion; crepitus; effusions; and swelling and commonly affects the knees; hips; and spine?
8501
Osteoarthritis
8502
Q4252:What condition is characterized by a 46XY karyotype; testes present; and ambiguous or female external genitalia?
8503
Male pseudohermaphrodite (dude looks like a lady!)
8504
Q4253:What is the term for RBC remnants of nuclear chromatin in asplenic patients?
8505
Howell-Jolly bodies
8506
Q4254:What is the term for gastric ulcers associated with increased intracranial pressure?
8507
Cushing's ulcers
8508
Q4255:What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
8509
Hemolytic uremic syndrome
8510
Q4256:Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
8511
Osteomalacia. Osteoporosis has normal levels of calcium; phosphorus; and alkaline phosphatase.
8512
Q4257:What vascular tumor associated with von HippelLindau syndrome involves the cerebellum; brainstem; spinal cord; and retina?
8513
Hemangioblastoma
8514
Q4258:How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?
8515
At least 5 lobes
8516
Q4259:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Epidermis
8517
Labile
8518
Q4260:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Skeletal muscle
8519
Permanent
8520
Q4261:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Pancreas
8521
Stable
8522
Q4262:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? CNS neurons
8523
Permanent
8524
Q4263:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Fibroblasts
8525
Stable
8526
Q4264:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Hematopoietic cells
8527
Labile
8528
Q4265:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Liver
8529
Stable
8530
Q4266:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Smooth muscle
8531
Stable
8532
Q4267:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Cardiac muscle
8533
Permanent
8534
Q4268:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Mucosal epithelium
8535
Labile
8536
Q4269:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Kidney
8537
Stable
8538
Q4270:Name the type of regeneration (i.e; labile; stable; or permanent) based on the following examples;? Osteoblasts
8539
Stable;(Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states; do not proliferate.)
8540
Q4271:What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
8541
Astrocytoma
8542
Q4272:True or false? Elevated ASO titers and serum complement levels are associated with poststreptococcal GN.
8543
False. ASO titers are elevated; but serum complement levels are decreased.
8544
Q4273:What glycoprotein allows platelets to adhere to von Willebrand factor?
8545
GP Ib
8546
Q4274:What encephalitis is associated with the JC virus?
8547
Progressive multifocal leukoencephalopathy
8548
Q4275:Hereditary angioneurotic edema (AD) produces local edema in organs (e.g; GI; skin; respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides?
8549
C1 esterase inhibitor (C1INH)
8550
Q4276:Is an anti-HAV IgG Ab associated with immunization or recent infection?
8551
Anti-HAV IgG Abs are associated with immunization or a prior infection. Anti-HAV IgM is associated with acute or recent infection.
8552
Q4277:Which integrin mediates adhesion by binding to lymphocyte function associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
8553
Intercellular adhesion molecule (ICAM) 1
8554
Q4278:Name the cerebral vessel associated with the following vascular pathologies;? Subarachnoid hemorrhage
8555
Berry aneurysm in the circle of Willis
8556
Q4279:Name the cerebral vessel associated with the following vascular pathologies;? Subdural hemorrhage
8557
Bridging veins draining into the sagittal sinus
8558
Q4280:Name the cerebral vessel associated with the following vascular pathologies;? Epidural hemorrhage
8559
Middle meningeal artery
8560
Q4281:True or false? Live vaccines are contraindicated in patients with SCID.
8561
True
8562
Q4282:What is the term for the round intracytoplasmic eosinophilic inclusions containing-synuclein found in the dopaminergic neurons of the substantia nigra?
8563
Lewy bodies
8564
Q4283:In which form of emphysema; panacinar or centriacinar; is the effect worse in the apical segments of the upper lobes?
8565
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
8566
Q4284:What syndrome results if the enzyme -1-iduronidase is deficient? L-iduronate sulfatase deficiency?
8567
Hurler syndrome and Hunter syndrome; respectively
8568
Q4285:What percentage of the bone marrow must be composed of blast for leukemia to be considered?
8569
At least 30% blast in the bone marrow
8570
Q4286:What is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs?
8571
CHF
8572
Q4287:What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
8573
Fitz-Hugh-Curtis syndrome
8574
Q4288:True or false? Patients with Turner syndrome have no Barr bodies.
8575
True. Remember; the second X chromosome is inactivated; and so is the Barr body. Turner syndrome has only one X chromosome.
8576
Q4289:What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?
8577
Auspitz sign
8578
Q4290:What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?
8579
Hgb F
8580
Q4291:What vasculitis affects a 30-year-old Asian female having visual field deficits; dizziness; decreased blood pressure; and weakened pulses in the upper extremities?
8581
Takayasu arteritis (medium-size to large vessels)
8582
Q4292:A 20-year-old college student has fever; grey-white membranes over the tonsils; posterior auricular lymphadenitis; and hepatosplenomegaly. What is your diagnosis? What test do you order to confirm your diagnosis?
8583
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember; it may be negative in the first week of the illness; so retest if you have a high index of suspicion.)
8584
Q4293:What cell type is commonly elevated in asthma?
8585
Eosinophil
8586
Q4294:What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
8587
Pseudogout
8588
Q4295:What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?
8589
8590
Q4296:What illegal drug can cause rhabdomyolysis; MI; cerebral infarct; and lethal cardiac arrhythmias?
8591
Cocaine
8592
Q4297:What AA is substituted for glutamic acid at position 6 on the Beta-chain in patients with sickle cell anemia?
8593
Valine
8594
Q4298:What endogenous pigment found in the substantia nigra and melanocytes is formed by the oxidation of tyrosine to dihydroxyphenylalanine?
8595
Melanin
8596
Q4299:What tumor marker is associated with seminomas?
8597
Placental alkaline phosphatase
8598
Q4300:What type of GN; associated with celiac disease and dermatitis herpetiformis; has mesangial deposits of IgA; C3; properdin; IgG; and IgM?
8599
Berger disease (IgA nephropathy)
8600
Q4301:What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus; dilatation of the lateral and third ventricles; and signs of extrapyramidal lesions?
8601
Huntington disease
8602
Q4302:What pattern of inheritance is G-6-PD deficiency?
8603
X-linked recessive
8604
Q4303:What adenocarcinoma presents with elevated levels of acid phosphatase; dihydrotestosterone; PSA; and bone pain?
8605
Prostatic carcinoma
8606
Q4304:Is Dubin-Johnson or Rotor syndrome associated with black pigmentation of the liver?
8607
Both are AR with conjugated hyperbilirubinemia; but DubinJohnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
8608
Q4305:What oxygen-dependent killing enzyme requires hydrogen peroxide and halide (Cl-) to produce hypochlorous acid?
8609
Myeloperoxidase
8610
Q4306:What condition results in a strawberry gallbladder?
8611
Cholesterolosis
8612
Q4307:What three chemical agents are associated with angiosarcomas of the liver?
8613
Arsenic; thorotrast; and vinyl chloride
8614
Q4308:What is the term for programmed cell death?
8615
Apoptosis (Remember; there is a lack of inflammatory response.)
8616
Q4309:What potentially fatal disease occurs in children who are given aspirin during a viral illness?
8617
Reye syndrome
8618
Q4310:What metal poisoning produces microcytic anemia with basophilic stippling?
8619
Lead poisoning
8620
Q4311:What inflammatory bowel disorder is continuous; with extensive ulcerations and pseudopolyps; and is associated with HLA-B27?
8621
Ulcerative colitis
8622
Q4312:What is the pentad of TTP?
8623
Neurologic symptoms;Renal failure;Thrombocytopenia;Fever;Microangiopathic hemolytic anemia;(Don't forget it. When I was an intern; my senior resident asked me this question more times than I would like to remember.)
8624
Q4313:Which hepatitis B Ag correlates with infectivity and viral proliferation?
8625
HBeAg
8626
Q4314:What disease involves cold skin abscesses due to a defect in neutrophil chemotaxis and a serum IgE level higher than 2000?
8627
Job syndrome
8628
Q4315:What female pathology is associated with endometrial glands and stroma outside the uterus commonly affecting the ovaries as chocolate cysts?
8629
Endometriosis
8630
Q4316:What is the karyotype in Turner syndrome?
8631
45XO
8632
Q4317:What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon?
8633
Hirschsprung disease (aganglionic megacolon)
8634
Q4318:What syndrome is associated with gastrin-producing islet cell tumor resulting in multiple intractable peptic ulcers?
8635
Zollinger-Ellison syndrome
8636
Q4319:What type of collagen is associated with keloid formation?
8637
Type III
8638
Q4320:The "tea-and-toast" diet is classically associated with what cause of megaloblastic anemia?
8639
Folate deficiency (very common in the elderly)
8640
Q4321:What is the term for ascending bacterial infection of the renal pelvis; tubules; and interstitium causing costovertebral angle tenderness; fever; chills; dysuria; frequency; and urgency?
8641
Pyelonephritis
8642
Q4322:How can a deficiency in adenosine deaminase be a bone marrow suppressor?
8643
It causes a buildup of dATP; which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate; a precursor of DNA; resulting in overall bone marrow suppression.
8644
Q4323:Which phenotype of osteogenesis imperfecta is incompatible with life?
8645
Type II
8646
Q4324:With what is cherry red intoxication associated?
8647
Acute CO poisoning
8648
Q4325:What are the four most common causes of femoral head necrosis?
8649
1. Steroids ;2. Alcohol ;3. Scuba diving ;4. Sickle cell anemia
8650
Q4326:What are the four signs of acute inflammation?
8651
Rubor (red); dolor (pain); calor (heat); tumor (swelling); also sometimes there is loss of function
8652
Q4327:Name the hypochromic microcytic anemia based on the following laboratory values;? Increased iron; decreased TIBC; increased percent saturation; increased ferritin
8653
Sideroblastic anemia
8654
Q4328:Name the hypochromic microcytic anemia based on the following laboratory values;? Decreased iron; TIBC; and percent saturation; increased ferritin
8655
Anemia of chronic disease
8656
Q4329:Name the hypochromic microcytic anemia based on the following laboratory values;? Decreased iron; percent saturation; and ferritin; increased TIBC
8657
Iron deficiency anemia
8658
Q4330:Name the hypochromic microcytic anemia based on the following laboratory values;? Normal iron; TIBC; percent saturation; and ferritin
8659
Thalassemia minor
8660
Q4331:Which form of emphysema is associated with an alpha1-antitrypsin deficiency?
8661
Panacinar
8662
Q4332:An 80-year-old woman presents to you with rightsided temporal headache; facial pain and blurred vision on the affected side; and an elevated ESR. Your diagnosis?
8663
Temporal arteritis (giant cell arteritis)
8664
Q4333:What type of neurofibromatosis is associated with bilateral acoustic schwannomas?
8665
Type 2
8666
Q4334:What disorder is due to a deficiency in the enzyme glucocerebrosidase?
8667
Gaucher disease
8668
Q4335:What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
8669
Boutonnire deformities
8670
Q4336:True or false? Atelectasis is an irreversible collapse of a lung.
8671
False. Atelectasis is a reversible collapse of a lung.
8672
Q4337:What viral infection in patients with sickle cell anemia results in aplastic crisis?
8673
Parvovirus B 19
8674
Q4338:What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
8675
8676
Q4339:What CNS developmental abnormality is associated with 90% of syringomyelia?
8677
Arnold-Chiari malformation type 2
8678
Q4340:What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
8679
Onion skinning
8680
Q4341:A 30-year-old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis?
8681
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer; which is commonly unilateral; single nodule; no variation with pregnancy.
8682
Q4342:What disease is X-linked recessive; is associated with eczema thrombocytopenia and an increased chance of developing recurrent infections; involves a decrease in serum IgM and in the T cell-dependent paracortical areas of the lymph nodes; and means that the patient is likely to develop malignant lymphoma?
8683
Wiskott-Aldrich syndrome
8684
Q4343:Which form of melanoma carries the worst prognosis?
8685
Nodular melanoma
8686
Q4344:Patients with sickle cell anemia are at increased risk for infection from what type of organisms?
8687
Encapsulated bacteria
8688
Q4345:How many major and/or minor Jones criteria are required for the diagnosis of rheumatic fever?
8689
Two major or one major and two minor
8690
Q4346:What skin carcinoma is a superficial dermal infiltrate of T lymphocytes seen in males more than 40 years old and presents as scaly red patches or plaques?
8691
Mycosis fungoides (cutaneous T-cell lymphoma)
8692
Q4347:What Hgb-derived endogenous pigment is found in areas of hemorrhage or bruises?
8693
Hemosiderin
8694
Q4348:What is a palpable; elevated solid mass up to 0.5 cm?
8695
Papule
8696
Q4349:True or false? Monocytosis is seen in TB.
8697
True
8698
Q4350:What pathology is associated with podagra; tophi in the ear; and PMNs with monosodium urate crystals?
8699
Gout
8700
Q4351:What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile; ischemia; Staphylococcus; Shigella; or Candida infection?
8701
Pseudomembranous colitis
8702
Q4352:What do the risk factors late menopause; early menarche; obesity; nulliparity; excessive estrogen; genetic factor p53; and brc-abl characterize?
8703
Breast cancer
8704
Q4353:What thyroid carcinoma is associated with radiation exposure; psammoma bodies; and Orphan Annie eye nuclei?
8705
8706
Q4354:Name three opsonins.
8707
Fc portion of IgG; C3b; and mannose-binding proteins
8708
Q4355:What chemical can be dangerous if you work in the aerospace industry or in nuclear plants?
8709
Beryllium
8710
Q4356:Which hepatitis B serology markersHBcAb IgG; HBcAb IgM; HBeAg; HBsAb IgG; HBsAg; HBV-DNAare associated with the following periods?;? Window period
8711
HBcAb IgM
8712
Q4357:Which hepatitis B serology markersHBcAb IgG; HBcAb IgM; HBeAg; HBsAb IgG; HBsAg; HBV-DNAare associated with the following periods?;? Immunization
8713
HBsAb IgG
8714
Q4358:Which hepatitis B serology markersHBcAb IgG; HBcAb IgM; HBeAg; HBsAb IgG; HBsAg; HBV-DNAare associated with the following periods?;? Prior infection
8715
HBcAb IgG and HBsAb IgG
8716
Q4359:Which hepatitis B serology markersHBcAb IgG; HBcAb IgM; HBeAg; HBsAb IgG; HBsAg; HBV-DNAare associated with the following periods?;? Acute infection
8717
HBcAb IgM; HBV-DNA; HBeAg; HBsAg
8718
Q4360:Which hepatitis B serology markersHBcAb IgG; HBcAb IgM; HBeAg; HBsAb IgG; HBsAg; HBV-DNAare associated with the following periods?;? Chronic infection
8719
HBcAb IgG; HBV-DNA; HBeAg; HBsAg
8720
Q4361:Name the type of necrosis;? The most common form of necrosis; denatured and coagulated proteins in the cytoplasm
8721
Coagulative necrosis
8722
Q4362:Name the type of necrosis;? Seen as dead tissue with coagulative necrosis
8723
Gangrenous necrosis
8724
Q4363:Name the type of necrosis;? Seen as dead tissue with liquefactive necrosis?
8725
Liquefaction necrosis
8726
Q4364:Name the type of necrosis;? Due to lipase activity and has a chalky white appearance
8727
Fat necrosis
8728
Q4365:Name the type of necrosis;? Soft; friable; cottagecheese appearing; characteristically seen in TB
8729
Caseous necrosis
8730
Q4366:Name the type of necrosis;? Histologically resembles fibrin
8731
Fibrinoid necrosis
8732
Q4367:Name the three enzymes that protect the cell from oxygen-derived free radicals.
8733
Superoxide dismutase; glutathione peroxidase; catalase
8734
Q4368:What are the rules of 2 for Meckel diverticulum?
8735
2% of population; 2 cm long; 2 feet from ileocecal valve; 2 years old; and 2% of carcinoid tumors
8736
Q4369:What aneurysm of the circle of Willis is associated with polycystic kidney disease?
8737
Berry aneurysm
8738
Q4370:A 20-year-old black woman goes to you with nonspecific joint pain; fever; and a malar rash over the bridge of her nose and on her cheeks. This is a classic example of what autoimmune disease? What are three autoantibody tests you could order to make the diagnosis?
8739
SLE; ANA; anti-dsDNA and anti-Sm (anti-Smith)
8740
Q4371:True or false? Excess lead deposits in the oral cavity.
8741
True. It deposits at the gingivodental line; known as the lead line.
8742
Q4372:What is the term for increased iron deposition resulting in micronodular cirrhosis; CHF; diabetes; and bronzing of the skin?
8743
Hemochromatosis
8744
Q4373:What AR disorder is due to a deficiency in glycoprotein IIb-IIIa; resulting in a defect in platelet aggregation?
8745
Glanzmann syndrome
8746
Q4374:What protein-losing enteropathy has grossly enlarged rugal fold in the body and fundus of the stomach in middleaged males; resulting in decreased acid production and an increased risk of gastric cancer?
8747
Mntrier's disease
8748
Q4375:What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities; red cell aplasia; and muscle weakness?
8749
Myasthenia gravis
8750
Q4376:Which subtype of AML is most commonly associated with Auer rods?
8751
M3 (promyelocytic leukemia)
8752
Q4377:What condition results from a 46XX karyotype and female internal organs with virilized external genitalia?
8753
Female pseudohermaphrodite
8754
Q4378:Two weeks after her son has a throat infection; a mother takes the boy to the ER because he has fever; malaise; HTN; dark urine; and periorbital edema. What is your diagnosis?
8755
Poststreptococcal GN
8756
Q4379:What X-linked recessive immune disorder is characterized by recurrent infections; severe thrombocytopenia; and eczema?
8757
Wiskott-Aldrich syndrome
8758
Q4380:What form of arthritis is associated with calcium pyrophosphate crystals?
8759
Pseudogout
8760
Q4381:What is the term for excessive production of collagen that flattens out and does not extend beyond the site of the injury?
8761
Hypertrophic scar
8762
Q4382:What is the term for inflamed; thickened skin on the breast with dimpling associated with cancer?
8763
Peau d'orange
8764
Q4383:What rare vasculitis has the following characteristics: males aged 40 to 60; affecting small arteries and veins; involving nose; sinuses; lungs; and kidneys; C-ANCA and autoantibodies against proteinase 3?
8765
Wegener granulomatosis
8766
Q4384:What retrovirus is associated with adult T-cell leukemia?
8767
HTLV-1
8768
Q4385:What disease is seen in children younger than 5 years of age and is characterized by X-linked recessive cardiac myopathies; calf pseudohypertrophy; lordosis; protuberant belly; an increase then a decrease in CPK; and death commonly in the second decade of life?
8769
Duchenne muscular dystrophy
8770
Q4386:What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
8771
Giant cell bone tumor (osteoclastoma)
8772
Q4387:What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition?
8773
Minimal change disease
8774
Q4388:What is the term for tissue-based basophils?
8775
Mast cells
8776
Q4389:What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
8777
Osteosarcoma
8778
Q4390:Is splenomegaly more commonly associated with intravascular or extravascular hemolysis?
8779
Extravascular hemolysis if it occurs in the spleen; if in the liver; it results in hepatomegaly.
8780
Q4391:What cancer of the male genitourinary system is associated with osteoblastic bony metastasis?
8781
Prostatic carcinoma
8782
Q4392:What stromal tumor in males is characterized histologically with crystalloids of Reinke?
8783
Leydig cell tumor
8784
Q4393:What pulmonary disease; most commonly associated with smoking; results in enlarged; overinflated lungs owing to the destruction of the alveolar walls with diminished elastic recoil?
8785
Emphysema
8786
Q4394:What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
8787
Factor XII for the intrinsic; factor VII for the extrinsic pathway
8788
Q4395:What chronic systemic inflammatory disease commonly seen in women aged 20 to 50 is a progressive; symmetric arthritis affecting the hands; wrists; knees; and ankles that improves with increased activity?
8789
Rheumatoid arthritis
8790
Q4396:Name the following descriptions associated with bacterial endocarditis;? Retinal emboli
8791
Roth spots
8792
Q4397:Name the following descriptions associated with bacterial endocarditis;? Painful subcutaneous nodules on fingers and toes
8793
Osler nodes
8794
Q4398:Name the following descriptions associated with bacterial endocarditis;? Painless hyperemic lesions on the palms and soles
8795
Janeway lesions
8796
Q4399:What two CD cell surface markers do Reed- Sternberg cells stain positive for?
8797
CD15 and CD30
8798
Q4400:What two lysosomal storage diseases have cherry-red spots on the retina?
8799
Niemann-Pick and Tay-Sachs diseases
8800
Q4401:True or false? Increased leukocyte alkaline phosphatase (LAP) is associated with CML.
8801
False. Increased LAP is seen in stress reactions and helps differentiate benign conditions from CML; which has low LAP levels.
8802
Q4402:What syndrome has multiple adenomatous colonic polyps and CNS gliomas?
8803
Turcot syndrome
8804
Q4403:What is the term for a venous embolus in the arterial system?
8805
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
8806
Q4404:Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
8807
Embolic
8808
Q4405:What is the name for the following RBC indices?;? The coefficient of variation of the RBC volume
8809
Red blood cell distribution width index (RDW)
8810
Q4406:What is the name for the following RBC indices?;? Average mass of the Hgb molecule/RBC
8811
Mean corpuscular hemoglobin (MCH)
8812
Q4407:What is the name for the following RBC indices?;? Average volume of a RBC
8813
Mean corpuscular volume (MCV)
8814
Q4408:What is the name for the following RBC indices?;? Average Hgb concentration/given volume of packed RBCs
8815
Mean corpuscular hemoglobin concentration (MCHC)
8816
Q4409:What cardiomyopathy is due to a ventricular outflow obstruction as a result of septal hypertrophy and leads to sudden cardiac death in young athletes?
8817
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis; or IHSS)
8818
Q4410:Which HPV serotypes are associated with condyloma acuminatum?
8819
HPV serotypes 6 and 11
8820
Q4411:Which form of melanoma carries the best prognosis?
8821
Lentigo maligna melanoma
8822
Q4412:What is the term for an increase in the number of cells in a tissue?
8823
Hyperplasia
8824
Q4413:A 60-year-old man has back pain (compression spinal fracture); hypercalcemia; increased serum protein; BenceJones proteinuria; and monoclonal M-spike on serum electrophoresis. What is your diagnosis?
8825
Multiple myeloma
8826
Q4414:What is the term for pus in the pleural space?
8827
Empyema
8828
Q4415:What is flat; circumscribed nonpalpable pigmented change up to 1 cm?
8829
Macule (e.g; a freckle)
8830
Q4416:Name the macrophage based on its location;? Liver macrophages
8831
Kupffer cells
8832
Q4417:Name the macrophage based on its location;? Bone macrophages
8833
Osteoclasts
8834
Q4418:Name the macrophage based on its location;? Brain macrophages
8835
Microglia
8836
Q4419:Name the macrophage based on its location;? Lung macrophages
8837
Pulmonary alveolar macrophages
8838
Q4420:Name the macrophage based on its location;? Connective tissue macrophages
8839
Histiocytes
8840
Q4421:Name the macrophage based on its location;? Epidermal macrophages
8841
Langerhans cells
8842
Q4422:What is the term for a large; immature RBC that is spherical; blue; and without a nucleus?
8843
Reticulocyte
8844
Q4423:What testicular tumor of infancy is characterized by elevated-fetoprotein levels and Schiller-Duval bodies?
8845
Yolk sac tumor
8846
Q4424:Starry sky appearance of macrophages is pathognomonic of what lymphoma?
8847
Burkitt lymphoma
8848
Q4425:In which region of the lung are 75% of the pulmonary infarcts seen?
8849
Lower lobe
8850
Q4426:For what disease are SS-A(Ro); SS-B(La); and R-ANA diagnostic markers?
8851
Sj?gren disease
8852
Q4427:What HPV serotypes are associated with increased risk of cervical cancer?
8853
HPV serotypes 16; 18; 31; and 33
8854
Q4428:Do the following structures pick up stain from hematoxylin or eosin?;? Nuclei
8855
Hematoxylin
8856
Q4429:Do the following structures pick up stain from hematoxylin or eosin?;? Nucleoli
8857
Hematoxylin
8858
Q4430:Do the following structures pick up stain from hematoxylin or eosin?;? Cytoplasm
8859
Eosin
8860
Q4431:Do the following structures pick up stain from hematoxylin or eosin?;? Collagen
8861
Eosin
8862
Q4432:Do the following structures pick up stain from hematoxylin or eosin?;? RBCs
8863
Eosin
8864
Q4433:Do the following structures pick up stain from hematoxylin or eosin?;? Calcium
8865
Hematoxylin
8866
Q4434:Do the following structures pick up stain from hematoxylin or eosin?;? Bacteria
8867
Hematoxylin
8868
Q4435:Do the following structures pick up stain from hematoxylin or eosin?;? Fibrin
8869
Eosin
8870
Q4436:Do the following structures pick up stain from hematoxylin or eosin?;? Thyroid colloid
8871
Eosin
8872
Q4437:What commonly encountered overdose produces headache; tinnitus; respiratory alkalosis; metabolic acidosis; confusion; vomiting; and tachypnea?
8873
ASA (salicylate)
8874
Q4438:What AR syndrome is due to a deficiency of glycoprotein Ib; resulting in a defect in platelet adhesion?
8875
Bernard-Soulier syndrome
8876
Q4439:What AD renal disorder is associated with mutations of the PKD 1 gene on chromosome 16 and berry aneurysms in the circle of Willis and presents in the fifth decade with abdominal masses; flank pain; hematuria; HTN; and renal insufficiency?
8877
Adult polycystic kidney disease
8878
Q4440:Based on the following information; is the renal transplantation rejection acute; chronic; or hyperacute?;? Months to years after transplantation; gradual onset of HTN; oliguria; and azotemia; seen as intimal fibrosis of the blood vessels and interstitial lymphocytes
8879
Chronic rejection
8880
Q4441:Based on the following information; is the renal transplantation rejection acute; chronic; or hyperacute?;? Immediately after transplantation; seen as a neutrophilic vasculitis with thrombosis
8881
Hyperacute rejection
8882
Q4442:Based on the following information; is the renal transplantation rejection acute; chronic; or hyperacute?;? Weeks to months after transplantation; abrupt onset of oliguria and azotemia; seen as neutrophilic vasculitis and interstitial lymphocytes
8883
Acute rejection
8884
Q4443:What type of collagen is abnormal in patients with osteogenesis imperfecta?
8885
Type I (makes sense; since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
8886
Q4444:What coronary artery vasculitis is seen in Japanese infants and children less than 4 years old with acute febrile illness; conjunctivitis; maculopapular rash; and lymphadenopathy?
8887
Kawasaki disease
8888
Q4445:What disease has IgG autoantibodies; occurs in women more than men; and includes exophthalmos; pretibial myxedema; nervousness; heart palpitations; and fatigue?
8889
Graves disease
8890
Q4446:What condition is defined by both testicular and ovarian tissues in one individual?
8891
True hermaphrodism
8892
Q4447:A mother takes her 2-week-old infant to the ER because the baby regurgitates and vomits after eating and has peristaltic waves visible on the abdomen and a palpable mass in the right upper quadrant. What is your diagnosis?
8893
Pyloric stenosis
8894
Q4448:What variant of polyarteritis nodosa is associated with bronchial asthma; granulomas; and eosinophilia?
8895
Churg-Strauss syndrome
8896
Q4449:What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor?
8897
Laminin
8898
Q4450:What B-cell neoplasm is seen in males with massive splenomegaly; produces dry tap on bone marrow aspirations; and stains positive for tartrate-resistant acid phosphatase (TRAP)?
8899
Hairy cell leukemia
8900
Q4451:What form of nephritic syndrome is associated with celiac sprue and Henoch- Sch?nlein purpura?
8901
IgA nephropathy
8902
Q4452:What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia; tetany; and T-cell deficiency?
8903
DiGeorge syndrome
8904
Q4453:What is the treatment for physiologic jaundice of newborns?
8905
Phototherapy
8906
Q4454:How many months in how many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
8907
3 months of symptoms in 2 consecutive years
8908
Q4455:What chronic inflammatory WBC is associated with IgE-mediated allergic reactions and parasitic infections?
8909
Eosinophils
8910
Q4456:What AD syndrome produces hamartomatous polyps in the small intestine and pigmentation of the lips and oral mucosa?
8911
Peutz-Jeghers syndrome
8912
Q4457:What is the term for formation of a stable fibrin platelet plug to stop bleeding?
8913
Hemostasis
8914
Q4458:True or false? All of the following are risk factors for breast cancer: early menses; late menopause; history of breast cancer; obesity; and multiparity.
8915
False. All except multiparity are risk factors for breast cancer. Nulliparity; increasing age; and family history in first-degree relative are also risk factors. Memorize this list!
8916
Q4459:Is jugular venous distention a presentation of isolated left or right heart failure?
8917
Right-sided
8918
Q4460:Name the hepatitis virus based on the following information;? Small circular RNA virus with defective envelope
8919
Hepatitis D
8920
Q4461:Name the hepatitis virus based on the following information;? Enveloped RNA flavivirus
8921
Hepatitis C
8922
Q4462:Name the hepatitis virus based on the following information;? Naked capsid RNA calicivirus
8923
Hepatitis E
8924
Q4463:Name the hepatitis virus based on the following information;? Enveloped DNA hepadnavirus
8925
Hepatitis B
8926
Q4464:Name the hepatitis virus based on the following information;? Naked capsid RNA picornavirus
8927
Hepatitis A
8928
Q4465:What AR disease involves a decreased amount of sphingomyelinase; massive organomegaly; zebra bodies; and foamy histiocytes and is associated with chromosome 11p?
8929
Niemann-Pick disease
8930
Q4466:What is the term for hypoperfusion of an area involving only the inner layers?
8931
Mural infarct
8932
Q4467:What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
8933
Marrow failure; cancer; and leukemia
8934
Q4468:Notching of the ribs; seen on chest radiograph in patients with postductal coarctation of the aorta; is due to collateralization of what arteries?
8935
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
8936
Q4469:What is the physiologic storage form of iron?
8937
Ferritin
8938
Q4470:What is the term for occlusion of a blood vessel due to an intravascular mass that has been carried downstream?
8939
Embolism
8940
Q4471:What AR disorder of copper metabolism can be characterized by Kayser- Fleischer rings; decreased ceruloplasmin levels; and increased urinary copper excretion and tissue copper levels?
8941
Wilson disease. (Remember; patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
8942
Q4472:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? c-myc
8943
Burkitt lymphoma
8944
Q4473:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? L-myc
8945
Small cell cancer of the lung
8946
Q4474:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? hst-1 and int-2
8947
Melanoma; cancer of the stomach and bladder
8948
Q4475:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? et
8949
MEN II and III syndromes
8950
Q4476:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? Ki-ras
8951
Pancreas and colon
8952
Q4477:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? cyclin D
8953
Mantle cell lymphoma
8954
Q4478:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? N-myc
8955
Neuroblastoma
8956
Q4479:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? CDK4
8957
Melanoma
8958
Q4480:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? abl
8959
CML and ALL
8960
Q4481:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? hst-1; int-2; erb-2; and erb-3
8961
Breast cancer
8962
Q4482:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? sis
8963
Astrocytoma
8964
Q4483:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? Ki-ras and erb-2
8965
Lung cancer
8966
Q4484:Name the cancer associated with the following oncogenes. (Some may have more than one answer);? erb-1
8967
Squamous cell carcinoma of the lung
8968
Q4485:What AD GI neoplasia produces multiple adenomatous polyps; osteomas; fibromas; and epidural inclusion cysts?
8969
Gardner syndrome
8970
Q4486:What disease involves microcephaly; mental retardation; cleft lip or palate; and dextrocardia?
8971
Patau syndrome (trisomy 13)
8972
Q4487:What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex mediated; and is seen as lumpy-bumpy subepithelial deposits?
8973
Postinfectious GN
8974
Q4488:What are the three most common sites for left-sided heart embolisms to metastasize?
8975
Brain; spleen; and kidney
8976
Q4489:With what two pathologies is a honeycomb lung associated?
8977
Asbestosis and silicosis
8978
Q4490:What AD disorder due to a mutation in fibroblast growth factor receptor 3 results in normal-size vertebral column and skull and short; thick extremities?
8979
Achondroplasia
8980

IVMS Cell Biology and Pathology Flash Facts 2

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Cell Biology and Pathology Flash Facts

Q2501:toxicity of K-sparing diuretics?

Cell Biology and Pathology Flash Facts

hyperkalemia; antiandrogenic effects

Cell Biology and Pathology Flash Facts

Q2502:mechanism of ACE inhibitors?

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q2503:major toxicities of ACE inhibitors?

Cell Biology and Pathology Flash Facts

cough; increased renin; hyperkalemia

Cell Biology and Pathology Flash Facts

Q2504:What are the ACE inhibitors?

Cell Biology and Pathology Flash Facts

Captopril; Enalapril; Lisinopril

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

angiotensin II receptor inhibitor (does not produce cough)

Cell Biology and Pathology Flash Facts

Q2506:What are podocytes?

Cell Biology and Pathology Flash Facts

visceral epithelial cells

Cell Biology and Pathology Flash Facts

Q2507:What are the spaces between the podocytes called?

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q2508:Which cells synthesis the glomerular BM?

Cell Biology and Pathology Flash Facts

visceral epithelial cells (podocytes)

Cell Biology and Pathology Flash Facts

Q2509:What keeps albumin out of urine?

Cell Biology and Pathology Flash Facts

strong negative charge of Glomerular BM

Cell Biology and Pathology Flash Facts

Q2510:What is responsible for charge of GBM?

Cell Biology and Pathology Flash Facts

Heparan Sulfate (strong negative charge)

Cell Biology and Pathology Flash Facts

Q2511:damage to visceral epithelial cell results in what?

Cell Biology and Pathology Flash Facts

damage to BM and leaking of albumin into urine --> nephrotic syndrome

Cell Biology and Pathology Flash Facts

Q2512:linear pattern outlining BM on Immunofluorescence

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q2513:subendothelial immune complex deposits in glomeruli on EM (granular)

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q2514:subepithelial immune complex deposits in glomeruli EM (granular)

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q2515:only glomerulonephritis one can diagnose with IF

Cell Biology and Pathology Flash Facts

Cell Biology and Pathology Flash Facts

Q2516:granular pattern on IF. what does it mean?

Cell Biology and Pathology Flash Facts

immunocomplex type III disease

Cell Biology and Pathology Flash Facts

Q2517:anti BM antibodies is what type of immune complex disease?

Cell Biology and Pathology Flash Facts