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Pathology USMLE Step 1 First Aid
flash cards of pathology for students preparing usmle step 1
1495
Medical
Graduate
11/19/2011
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Term
Autosomal recessive diseases
(11)
 Definition
1. CF 2. albinism 3. alpha 1
antitrypsin deficiency 4.
phenylketonuria 5. thalassemias 6.
sicke cell anemia 7. glycogen
storage diseases 8.
mucopolysaccharidoses (except
Hunter's) 9. sphingolipidoses (except
Fabry's) 10.infant polycystic kidney
disease 11. hemochromatosis
Term
_____are associated with low
golic acid intake during
pregnancy
 Definition
Neural tube defects
Term
90% of adult polycystic kidney
disease cases are due to
mutation in _____.
 Definition
APKD1 (on chromosome 16)
Term
95% of Down's syndrome
cases are due to what?
 Definition
meiotic nondisjunction of
homologous chromosomes
(4% due to Robertsonian
translocation and 1% due to
Down mosaicism)
Term
A patent ductus arteriosus is
maintained by what 2 things?
 Definition
PGE synthesis and low oxygen
tension
Term
Abnormalities associated with
Marfan's syndrome:
 Definition
1. Skeletal: tall with long
extremities, hyperextensive
joints, long tapering fingers and
toes 2. Cardiovascular: cystic
medial necrosis of the aorta,
aortic incompetence, aortic
dissection, aortic aneurysm,
floppy mitral valve Ocular:
subluxation of lenses
Term
Adult polycystic kidney
disease is associated with
what other diseases or
disorders?
 Definition
polycystic liver disease BERRY
ANEURYSMS mitral valve
prolapse
Term
Babies with Fetal Alcohol
Syndrome are at higher risk
for developing what other
problems?
 Definition
pre and postnatal
developmental retardation
microcephaly facial
abnormalities limb
dislocation heart and lung
fistulas
Term
Becker's muscular dystrophy
is due to____.
 Definition
dystrophin gene mutations
(not deletions) Becker's is less
severe.
Term
Besides pulmonary infections,
what are some other
consequences of CF?
 Definition
infertility in males fatsoluable
vitamin deficiencies
(A,D,E,K)
Term
Causes of female
pseudohermaphroditism:
 Definition
excessive and inappropriate
exposure to androgenic
steroids during early
gestation (i.e., congenital
adrenal hyperplasia or
exogenous administration of
androgens during pregnancy)
Term
Characteristic murmur with a
patent ductus arteriosus.
 Definition
continuous, 'machine-like'
Term
Characteristics of Adult
polycystic kidney disease:
 Definition
always bilateral massive
enlargement of kidneys due
to multiple large cysts
patients present with pain,
hematuria, HTN, and
progressive renal failure
Term
Characteristics of Duchenne's
MD:
 Definition
onset before age 5 weakness
begins in the pelvic girdle
muscles and progresses
superiorly pseudohypertrophy
of calf muscles due to
fibrofatty replacement of
muscle cardiac myopathy use
of Gower's maneuver
Term
Characteristics of female
pseudohermaphroditism:
 Definition
ovaries present but external
genitalia are virilized or
ambiguous
Term
Characteristics of Fragile X
syndrome:
 Definition
macro-orchidism (enlarged
testes), long face with a large
jaw, large everted ears, and
autism
Term
Characteristics of Hereditary
Sperocytosis:
 Definition
spheroid erythrocytes
hemolytic anemia increased
MCHC splenectomy is
curative
Term
Characteristics of male
pseudohermaphroditism:
 Definition
testes present, but external
genitalia are female or
ambiguous
Term
Children may do this to
increase venous return with
R-to-L shunt.
 Definition
squat
Term
Compare the cholesterol
levels of heterozygores and
homozygotes with familial
hyperchlosterolemia:
 Definition
Heterozygotes (1 : 500)
cholest. levels around
300mg/dL Homozygotes
(very rare) cholest. levels over
700 mg/dL.
Term
Complications associated
with homozygous familial
hypercholesterolemia:
 Definition
severe atherosclerotic disease
early in life tendon
xanthomas (classically in the
Achilles tendon) Myocardial
Infarction before age 20
Term
Congenital heart defects are
often due to which infection?
 Definition
rubella
Term
Cri-du-chat syndrome results
from a congenital deletion on
which chromosome?
 Definition
short arm of chromosome 5
46 XX or XY, 5p-
Term
Define Meningocele:
 Definition
meninges herniate through
spinal canal defect picture on
p. 229
Term
Define Meningomyelocele
 Definition
meninges and spinal cord
herniate through spinal canal
defect picture on p.229
Term
Define
pseudohermaphroditism
 Definition
disagreement between the
phenotypic (external
genitalia) and gonadal (testes
vs. ovaries) sex.
Term
Define Spina bifida occulta:
 Definition
failure of bony spinal canal to
close, but no structural
herniation. (usually seen at
lower vertebral levels) picture
on p. 299 (2002 edition)
Term
Describe a true
hermaphrodite:
 Definition
46 XX or 47 XXY both ovary
and testicular tissue present;
ambiguous genitalia
Term
Describe Eisenmenger's
syndrome
 Definition
Uncorrected VSD, ASD, or
PDA leads to progressive
pulm. HTN. As pulm.
resistance increases, the
shunt changes from L to R to
R to L, which causes late
cyanosis (clubbing and
polycythemia).
Term
Does coarctation of the aorta
affect males or females most
commonly?
 Definition
3:1 males to females
Term
Down's syndrome is
associated with increased or
decreased levels of AFP?
 Definition
decreased
Term
Elevated ___ in amniotic fluid
is evidence of a neural tube
defect.
 Definition
AFP (alpha fetal protein)
Term
Explain the adult type of
coarctation of the aorta and
give some associated
symptoms
 Definition
aortic stenosis distal to
ductus arteriosus (postductal)
aDult is Distal to Ductus
associated with notching of
the ribs, hypertension in
upper extremities, weak
pulses in lower extermities
(check femoral pulse
Term
Explain the infantile type of
coarctation of the aorta. What
is it commonly associated
with?
 Definition
aortic stenosis proximal to
insertion of ductus arteriosus
(preductal) 'INantile, IN close
to the heart.' associated with
Turner's syndrome
Term
Explain the pathogenesis of a
patent ductus arteriosus
 Definition
In fetal period, shunt is R to L
(normal). In neonatal period,
lung resistance decreases and
shunt becomes L to R with
subsequent RV hypertrophy
and failure (abnormal).
Term
Explain the transposition of
the great vessels.
 Definition
Aorta leaves RV (anterior) and
pulmonaryt trunk leaves LV
(posterior) this leads to
separation of systemic and
pulmonary circulations
Term
Familial Adenomatous
Polyposis features:
 Definition
Colon becomes covered with
adenomatous polyps after
puberty 'FAP' F= five (deletion
on chromosome 5) A=
autosomal dominant
inheritance P= positively will
get colon cancer (100%
without resection)
Term
Findings in Von
Recklinghausen's disease
 Definition
café-au-lait spots, neural
tumors, Lisch nodules
(pigmented iris hamartomas),
skeletal disorders (scoliosis),
and increased tumor
susceptibility
Term
Findings of Cri-du-chat
syndrome:
 Definition
microcephaly, severe MR,
high pitched crying/mewing -
(Cri-du-chat is French for cry
of the cat), cardiac
abnormalities
Term
Findings with Huntington's
disease:
 Definition
depression progressive
dementia choreiform
movements caudate atrophy
dec. levels of GABA and Ach
in the brain
Term
Frequency of L-toR shunts
 Definition
VSD>ASD>PDA
Term
Gender identity is based on
what two things?
 Definition
1. external genitalia 2. sex of
upbringing
Term
Genetic anticipation of Fragile
X syndrome may be shown by
what?
 Definition
Triplet repeat (CGG)n
Term
Highest risk of development
of fetal alcohol syndrome at
__ to ___ weeks.
 Definition
3 to 8
Term
How does CF present in
infancy
 Definition
Failure to thrive
Term
How is CF diagnosed
 Definition
increased concentration of
Cl- ions in sweat test
Term
How is MD diagnosed?
 Definition
muscle biopsy increased
serum CPK
Term
Huntington's disease
manifests between the ages
of :
 Definition
20 and 50
Term
Incidence and characteristics
and Turner's syndrome
 Definition
1 in 3000 births short
stature, ovarian dysgenesis,
webbed neck, coarction of the
aorta
Term
Incidence and characteristics
of double Y males:
 Definition
1 in 1000 births
phenotypically normal, very
tall, severe acne, antisocial
behavior (seen in 1-2%)
Term
Incidence and characteristics
of Edward's syndrome
 Definition
1 in 8000 births severe MR,
rocker bottom feet, low-set
ears, micrognathia,
congenital heart disease,
clenched hands (flexion of
fingers), prominent occiput.
Death usually occurs within 1
year of birth.
Term
Incidence and characteristics
of Klinefelter's syndrome
 Definition
1 in 850 births testicular
atrophy, eunuchoid body
shape, tall, long extremities,
gynecomastia, female hair
distribution
Term
Incidence and characteristics
of Patau's syndrome:
 Definition
1 in 6000 births severe MR,
microphthalmia,
microcephaly, cleft lip/palate,
abnormal forebrain
structures, polydactly,
congenital heart disease
Death usually occurs within 1
year of birth
Term
Marfan's is due a mutation in
which gene?
 Definition
fibrillin
Term
Mechanism of Fetal Alcohol
Syndrome may be
 Definition
inhibition of cell migration
Term
Most common form of male
pseudohermaphroditism is
____.
 Definition
testicular feminization
(androgen insensitivity)
results from a mutation in the
androgen receptor gene (X
linked recessive); blind-end
vagina
Term
Name 3 examples of L-to-R
shunts. (late cyanosis) 'blue
kids'
 Definition
1. VSD (ventricular septal
defect) 2. ASD (atrial septal
defect 3. PDA (patent ductus
arteriosus
Term
Name 3 examples of R-to-L
shunts. (early cyanosis) 'blue
babies'
 Definition
The 3 T's' 1. Tetralogy of
Fallot 2. Transposition of
great vessels 3. Truncus
arteriosus
Term
Name 7 common congenital
malformations
 Definition
1. heart defects 2. Hypospadias
(when the urethral canal is
open on the undersurface of
the penis or on the perineum)
3. Cleft lip w/ or w/out cleft
palate 4. congenital hip
dislocation 5. Spina Bifida 6.
Anencephaly 7. Pyloric stenosis
Term
Name 8 autosomal-dominant
diseases:
 Definition
1. Adult polycystic kidney disease
2. Familial hyperchloresterolemia
(type IIA) 3. Marfan's syndrome 4.
Von Recklinghausen's disease
(NFT1) 5. Von Hippel-Lindau
disease 6. Huntington's disease
7. Familial Adenomatous
Polyposis 8. Hereditary
Sperocytosis
Term
Name an X-linked recessive
muscular disease that leads
to accelerated muscle
breakdown
 Definition
Duchenne's Muscular
Dystrophy
Term
Name the 4 components of
Tetralogy of Fallot
 Definition
PROVe' 1. Pulmonary Stenosis
2. RVH (right ventricular
hypertrophy) 3. Overriding
aorta (overrides the VSD) 4.
VSD (ventricular septal defect
Term
Neural tube defects (spina
bifida and anencephaly) are
associated with increased
levels of ___ in the amniotic
fluid and maternal serum.
 Definition
AFP (alpha fetal protein
Term
Newborns of mothers who
consumed significant
amounts of alcohol
(teratogen) during pregnancy
are at risk for _______.
 Definition
fetal alcohol syndrome (the
number one cause of
congenital malformations in
the U.S.)
Term
Patau's syndrome = trisomy
___
 Definition
13 (hint: Puberty - 13)
Term
Pathogenesis of Cystic
Fibrosis
 Definition
defective Cl- channel --> secretion
of abnormally thick mucus that plugs
lungs, pancreas, and liver -->
recurrent pulmonary infections
(Pseudomonas species and Staph
aureus), chronic bronchitis,
bronchiectasis, pancreatic insufficiency
(malabsorption and steatorrhea),
meconium ileus in newborns
Term
Patients with Tetralogy of
Fallot often suffer _________.
 Definition
cyanotic spells
Term
Pyloric stenosis is associated
with______.
 Definition
polyhydramnios; projectile
vomiting
Term
T/F: Trisomy 21 is associated
with advanced maternal age.
 Definition
True (from 1 in 1500 births in
women<20 to 1 in 25 births
in women>45)
Term
Tetralogy of Fallot leads to
early cyanosis from a R-to-L
shunt across the ____.
 Definition
VSD
Term
The defect in Von
Recklinghausen's disease is
found on which chromosome?
 Definition
17 (hint: 17 letters in
Recklinghausen's
Term
The gene responsible for
Huntington's disease is
located on chromosome__.
 Definition
4 ; triplet repeat disorder
Term
The incidence of neural tube
defects is decreased by
maternal ingestion of what
 Definition
folate
Term
Transposition of great vessels
is a common congenital heart
disease in offspring of _____
mothers
 Definition
diabetic
Term
Transposition of great vessels
is not compatible with life
unless what is present?
 Definition
a shunt that allows adequate
mixing of blood (VSD, PDA, or
patent foramen ovale)
Term
Trisomy 18 is also known
as______.
 Definition
Edward's syndrome (hint:
Election age = 18)
Term
Turner's syndrome is the
most common cause of what?
 Definition
primary amenorrhea
Term
Von Hippel-Lindau disease
characteristics:
 Definition
hemangioblastomas of
retina/cerebellum/medulla
about half of affected
individuals develop multiple
bilateral renal cell carcinomas
and other tumors
Term
Von Hippel-Lindau disease is
associated with the deletion
of what gene?
 Definition
VHL gene (tumor suppressor)
on chromosome 3 (3p)
Term
What are some findings of
Down's syndrome
 Definition
mental retardation flat facial
profile prominent epicanthal
folds simian crease duodenal
atresia congenital heart disease
(most common malformation is
endocardial cushion defect)
Alzheimer's disease in individuals
over 35 increased risk of ALL
Term
What does a heart with
Tetralogy of Fallot look like
on x-ray?
 Definition
boot-shaped due to RVH
Term
What gender genetic disorder
has been observed with
increases frequency among
inmates of penal institutions?
 Definition
Double Y males (XYY)
Term
What is different about the
juvenile form of polycystic
kidney disease
 Definition
it is recessive
Term
What is Gower's maneuver?
 Definition
requiring assistance of the
upper extermities to stand up
(indicates proximal lower
limb weakness)
Term
What is the cause of
Duchenne's MD?
 Definition
a deleted dystrophin gene
(hint: 'D' for deletion)
Term
What is the cause of Tetralogy
of Fallot?
 Definition
anterosuperior displacement
of the infundibular septum
Term
What is the incidence of
Down's syndrome?
 Definition
1 in 700 births
Term
What is the most common
cause of early cyanosis
 Definition
Tetralogy of Fallot
Term
What is the most common
chromosomal disorder and
cause od congenital mental
retardation
 Definition
Down's syndrome (trisomy
21)
Term
What is the most common
congenital cardiac anomaly?
 Definition
VSD
Term
What is the most common
lethal genetic disease of
Caucasians?
 Definition
Cystic Fibrosis
Term
What is the second most
common cause of mental
retardation?
 Definition
Fragile X syndrome
Term
What is the underlying cause
of Cystic Fibrosis?
 Definition
Autosomal - recessive defect
in CFTR gene on chromosome
7
Term
What is the underlying cause
of Familial
hypercholesterolemia?
 Definition
defective or absent LDL
receptor leading to elevated
LDL
Term
What is used to close a patent
ductus arteriosus? What is
used to keep it open
 Definition
Indomethacin PGE (may be
necessary to sustain life in
conditions such as
transposition of the great
vessels
Term
Which gene is affected in
Fragile X?
 Definition
methylation and expression
of the FMR 1 gene is affected
in this X-linked disorder
Term
Which genetic gender
disorder has an inactivated X
chromosome (Barr body)?
 Definition
Klinefelter's syndrome
Term
Why are female carriers of Xlinked
recessive disorders
rarely affected?
 Definition
because of random
inactivation of X
chromosomes in each cell
Term
X-linked recessive disorders
(10)
 Definition
1. Fragile X 2. Duchenne's MD
3. hemophilia A and B 4.
Fabry's 5. G6PD deficiency 6.
Hunter's syndrome 7. ocular
albimism 8. Lesch-Nyhan
syndrome 9. Bruton's
agammaglobulinemia 10.
Wiscott-Aldrich syndrome
Term
XO =
 Definition
Turner's syndrome (think:
'hugs and kisses' -XO- from
Tina Turner)
Term
XXY =
 Definition
Klinefelter's syndrome one of
the most common causes of
hypogonadism in males
Term
Approximately what
percentage of brain tumors
arise from metastasis
 Definition
0.5
Term
Are basal cell carcinomas
invasive?
 Definition
Locally invasive but rarely
metastasize
Term
Are Ewing's sarcomas likely to
metastasize
 Definition
Yes. They are extremely
aggressive with early
metastasis. However, they are
responsive to chemotherapy.
Term
Are meningiomas resectable?
 Definition
Yes
Term
Are squamous cell
carcinomas of the skin
invasive?
 Definition
Locally invasive but rarely
metastasize
Term
Are the majority of adult
tumors supratentorial or
infratentorial
 Definition
Supratentorial
Term
Are the majority of childhood
tumors supratentorial or
infratentorial?
 Definition
Infratentorial
Term
Common histopathology
often seen in squamous cell
carcinomas of the skin?
 Definition
Keratin pearls
Term
Define anaplasia
 Definition
Abnormal cells lacking
differentiation; like primitive
cells of the same tissue.
Often equated with
undifferentiated malignant
neoplasms. Tumor giant cells
may be formed
Term
Define dysplasia
 Definition
Abnormal growth with loss of
cellular orientation, shape,
and size in comparison to
normal tissue maturation. It is
reversible but is often a
preneoplastic sign.
Term
Define hyperplasia
 Definition
Increase in the number of
cells (reversible
Term
Define metaplasia
 Definition
One adult cell type is
replaced by another
(reversible). It is often
secondary to irritation and/or
environmental exposure (e.g.
squamous metaplasia in the
trachea and bronchi of
smokers)
Term
Define neoplasia
 Definition
Clonal proliferation of cells
that is uncontrolled and
excessive
Term
Do oncogenes cause a gain or
loss of function?
 Definition
Gain of function
Term
Do tumor suppressor genes
cause a gain or loss of
function?
 Definition
Loss of function. Both alleles
must be lost for expression
of disease
Term
Does a melanoma have a
significant risk of metastasis
 Definition
Very significant risk! The
depth of the tumor often
correlates with the risk of
metastasis
Term
From what cells do
meningiomas most commonly
arise?
 Definition
Arachnoid cells external to
the brain
Term
Give 2 examples of a benign
tumor of epithelial origin.
 Definition
1. Adenoma 2. Papilloma
Term
Give 2 examples of a
malignant tumor of epithelial
origin.
 Definition
1. Adenocarcinoma 2.
Papillary carcinoma
Term
Give 2 examples of malignant
tumors of blood cell
(mesenchymal) origin
 Definition
1. Leukemia 2. Lymphoma
Term
Give an example of a benign
tumor of blood vessel
(mesenchymal) origin
 Definition
Hemangioma
Term
Give an example of a benign
tumor of bone (mesenchymal)
origin.
 Definition
Osteoma
Term
Give an example of a benign
tumor of more than one cell
type.
 Definition
Mature teratoma
Term
Give an example of a benign
tumor of skeletal muscle
(mesenchymal) origin
 Definition
Rhabdomyoma
Term
Give an example of a benign
tumor of smooth muscle
(mesenchymal) origin.
 Definition
Leiomyoma
Term
Give an example of a
malignant tumor of blood
vessel (mesenchymal) origin
 Definition
Angiosarcoma
Term
Give an example of a
malignant tumor of bone
(mesenchymal) origin
 Definition
Osteosarcoma
Term
Give an example of a
malignant tumor of more
than one cell type.
 Definition
Immature teratoma
Term
Give an example of a
malignant tumor of skeletal
muscle (mesenchymal) origin
 Definition
Rhabdomysarcoma
Term
Give an example of a
malignant tumor of smooth
muscle (mesenchymal) origin
 Definition
Leiomyosarcoma
Term
Give an example of a
neoplasm associated with
Down's Syndrome
 Definition
Acute Lymphoblastic
Leukemia (ALL)
Term
How are tumor markers used?
 Definition
Tumor markers are used to
confirm diagnosis, to monitor
for tumor recurrence, and to
monitor the response to
therapy. They should not be
used as a primary tool for
diagnosis
Term
How is prostatic
adenocarcinoma most
commonly diagnosed
 Definition
Digital rectal exam (detect
hard nodule) or by prostate
biopsy
Term
How often do primary brain
tumors undergo metastasis
 Definition
Very rarely
Term
In what population is
osteochondroma most often
found?

 Definition
Usually men under the age of
25
Term
In which age group is
prostatic adenocarcinoma
most common
 Definition
Men over the age of 50
Term
Is malignant transformation
in osteochondroma common?
 Definition
Malignant transformation to
chondrosarcoma is rare
Term
Name 1 common tumor
staging system
 Definition
TNM system T= size of
tumor, N=node involvement,
and M=metastases
Term
Name 3 herniation syndromes
that can cause either coma or
death when the herniations
compress the brainstem
 Definition
1. Downward transtentorial
(central) herniation 2. Uncal
herniation 3. Cerebellar
tonsillar herniation into the
foramen magnum
Term
Name 4 factors that
predispose a person to
osteosarcoma.
 Definition
1. Paget's disease of bone 2.
Bone infarcts 3. Radiation 4.
Familial retinoblastoma
Term
Name 4 possible routes of
herniation in the brain
 Definition
1. Cingulate herniation under
the falx cerebri 2. Downward
transtentorial (central)
herniation 3. Uncal herniation
4. Cerebellar tonsillar
herniation into the foramen
magnum
Term
Name 5 primary brain tumors
with peak incidence in
adulthood.
 Definition
1. Meningioma 2.
Glioblastoma multiforme 3.
Oligodendroglioma 4.
Schwannoma 5. Pituitary
adenoma
Term
Name 5 primary brain tumors
with peak incidence in
childhood
 Definition
1. Medulloblastoma 2.
Hemangioblastoma 3.
Ependymomas 4. Low-grade
astrocytoma 5.
Craniopharyngioma
Term
Name 5 sites from which
tumor cells metastasize to
the brain
 Definition
1. Lung 2. Breast 3. Skin
(melanoma) 4. Kidney (renal
cell carcinoma) 5. GI
Term
Name a common
histopathological sign of
basal cell carcinoma nucle
 Definition
The nuclei of basal cell
tumors have 'palisading'
nuclei
Term
Name a population at a
greater risk for melanoma
 Definition
Fair-skinned people (blue
eyes and red hair have also
been considered as factors
Term
Name the 5 primary tumors
that metastasize to the liver
 Definition
1. Colon 2. Stomach 3.
Pancreas 4. Breast 5. Lung
Term
Name two of the most
common sites of metastasis
after the regional lymph
nodes
 Definition
The liver and the lung
Term
Name two presenting
sequelae of a pituitary
adenoma.
 Definition
1. Bitemporal hemianopsia
(due to pressure on the optic
chiasm) 2. Hypopituitarism
Term
On which chromosome is the
p53 gene located?
 Definition
17p
Term
On which chromosome is the
Rb gene located
 Definition
13q
Term
On which chromosomes are
the BRCA genes located
 Definition
BRCA 1 is on 17q and BRCA 2
is on 13q
Term
Out of the 6 primary tumors
that metastasize to bone,
which two are the most
common
 Definition
Metastasis from the breast
and prostate are the most
common
Term
What 2 cancers are associated
with EBV?
 Definition
1. Burkitt's lymphoma 2.
Nasopharyngeal carcinoma
Term
What 2 neoplasms are
associated with AIDS
 Definition
1. Aggressive malignant
lymphomas (non-Hodgkins)
2. Kaposi's sarcoma
Term
What 2 neoplasms are
associated with Autoimmune
disease (e.g. Hashimoto's
thyroiditis, myasthenia gravis,
etc.)?
 Definition
Benign and malignant
thymoma
Term
What 2 neoplasms are
associated with Paget's
disease of bone
 Definition
1. Secondary osteosarcoma 2.
Fibrosarcoma
Term
What 2 neoplasms are
associated with Tuberous
sclerosis (facial angiofibroma,
seizures, and mental
retardation)?
 Definition
1. Astrocytoma 2. Cardiac
rhabdomyoma
Term
What are 2 characteristic
findings in carcinoma in situ?
 Definition
1. Neoplastic cells have not
invaded the basement
membrane 2. High
nuclear:cytoplasmic ratio and
clumped chromatin
Term
What are 2 characteristic
findings of an invasive
carcinoma
 Definition
1. Cells have invaded the
basement membrane using
collagenases and hydrolases
2. Able to metastasize if they
reach blood or lymphatic
vessels.
Term
What are 2 neoplasms
associated with Xeroderma
pigmentosum
 Definition
1. Squamous cell carcinoma
of the skin 2. Basal cell
carcinoma of the skin
Term
What are 3 disease findings
associated with Alkaline
Phosphatase?
 Definition
1. Metastases to bone 2.
Obstructive biliary disease 3.
Paget's disease of bone
Term
What are 6 primary tumors
that metastasize to bone?
 Definition
1. Kidney 2. Thyroid 3. Testes
4. Lung 5. Prostate 6. Breast
Term
What are a common
histopathological finding of
meningiomas?
 Definition
Psammoma bodies. These are
spindle cells concentrically
arranged in a whorled
pattern
Term
What are ependymomas?
 Definition
Ependymal cell tumors most
commonly found in the 4th
ventricle. May cause
hydrocephalus
Term
What are the steps in the
progression of neoplasia?
 Definition
1. Normal 2. Hyperplasia 3.
Carcinoma In Situ/Preinvasive
4. Invasion
Term
What are two signs of bone
metastases in prostatic
adenocarcinoma?
 Definition
An increase in serum alkaline
phosphatase and PSA
(prostate-specific antigen)
Term
What are two useful tumor
markers in prostatic
adenocarcinoma
 Definition
Prostatic acid phosphatase
and prostate-specific antigen
(PSA)
Term
What can be associated with
the risk of melanoma
 Definition
Sun exposure
Term
What cancer is associated
with HBV and HCV (Hep B and
C viruses)?
 Definition
Hepatocellular carcinoma
Term
What cancer is associated
with HHV-8 (Kaposi's
sarcoma-associated herpes
virus)?
 Definition
Kaposi's carcinoma
Term
What cancer is associated
with the HTLV-1 virus
 Definition
Adult T-cell leukemia
Term
What cancers are commonly
associated with HPV (human
papilloma virus)?
 Definition
Cervical carcinoma, penile,
and anal carcinoma
Term
What causes the local effect
of a mass?
 Definition
Tissue lump or tumor
Term
What causes the local effect
of a nonhealing ulcer
 Definition
Destruction of epithelial
surfaces (e.g. stomach, colon,
mouth, bronchus
Term
What causes the local effect
of a space-occupying lesion
 Definition
Raised intracranial pressure
in brain neoplasms. Also seen
with anemia due to bone
marrow replacement
Term
What causes the local effect
of bone destruction
 Definition
Pathologic fracture or
collapse of bone
Term
What causes the local effect
of edema?
 Definition
Venous or lymphatic
obstruction
Term
What causes the local effect
of hemorrhage
 Definition
Caused by ulcerated area or
eroded vessel
Term
What causes the local effect
of inflammation of a serosal
surface?
 Definition
Pleural effusion, pericardial
effusion, or ascites
Term
What causes the local effect
of obstruction in the biliary
tree?
 Definition
Jaundice
Term
What causes the local effect
of obstruction in the
bronchus
 Definition
Pneumonia
Term
What causes the local effect
of obstruction in the left
colon?
 Definition
Constipation
Term
What causes the local effect
of pain?
 Definition
Any site with sensory nerve
endings. Remember that
tumors in the brain are
usually painless.
Term
What causes the local effect
of perforation of an ulcer in
the viscera
 Definition
Peritonitis or free air
Term
What causes the local effect
of seizures?
 Definition
Tumor mass in the brain.
Term
What causes the localized
loss of sensory or motor
function
 Definition
Compression or destruction
of nerve (e.g. recurrent
laryngeal nerve by lung or
thyroid cancer causes
hoarseness
Term
What causes the
paraneoplastic effect gout
 Definition
Hyperuricemia due excess
nucleic acid turnover
(secondary to cytotoxic
therapy of various neoplasms)
Term
What causes the
paraneoplastic effect of
Cushing's disease
 Definition
ACTH or ACTH-like peptide
(secondary to small cell lung
carcinoma)
Term
What causes the
paraneoplastic effect of
hypercalcemia
 Definition
PTH-related peptide, TGF-a,
TNF-a, IL-2 (secondary to
squamous cell lung
carcinoma, renal cell
carcinoma, breast carcinoma,
multiple myeloma, and bone
metastasis)
Term
What causes the
paraneoplastic effect of
Lambert-Eaton syndrome?
 Definition
Antibodies against
presynaptic Ca2+ channels at
NMJ (Thymoma, bronchogenic
carcinoma)
Term
What causes the
paraneoplastic effect of
Polycythemia?
 Definition
Erythropoietin (secondary to
renal cell carcinoma)
Term
What causes the
paraneoplastic effect of
SIADH
 Definition
ADH or ANP (secondary to
small cell lung carcinoma and
intracranial neoplasms)
Term
What chemical carcinogen is
commonly associated with
the centrilobar necrosis and
fatty acid change
 Definition
CCL4
Term
What chemical carcinogen is
commonly associated with
the esophagus and stomach?
 Definition
Nitrosamines
Term
What chemical carcinogen is
commonly associated with
the lungs?
 Definition
Asbestos (Causes
mesothelioma and
bronchogenic carcinoma)
Term
What chemical carcinogen is
commonly associated with
the skin (squamous cell)?
 Definition
Arsenic
Term
What chemical carcinogen(s)
are commonly associated with
the liver?
 Definition
Aflatoxins and vinyl chloride
Term
What is a chondrosarcoma?
 Definition
Malignant cartilaginous
tumor.
Term
What is a common genetic
finding in Ewing's sarcoma?
 Definition
11;22 translocation
Term
What is a common gross
pathological sign seen in
Ewing's sarcoma
 Definition
Characteristic 'onion-skin'
appearance of bone
Term
What is a common origin of a
chondrosarcoma
 Definition
May be of primary origin or
from osteochondroma
Term
What is a common sign found
on the x-ray of a person with
osteosarcoma?
 Definition
Codman's triangle (from
elevation of periosteum
Term
What is a craniopharyngioma?
 Definition
Benign childhood tumor.
Often confused with pituitary
adenoma because both can
cause bitemporal
hemianopsia. Calcification of
the tumor is common.
Term
What is a Ewing's sarcoma?
 Definition
Anaplastic small cell
malignant tumor
Term
What is a giant cell tumor?
 Definition
Locally aggressive benign
tumor around the distal
femur, proximal tibial region.
Term
What is a gross pathological
sign of basal cell carcinoma?
 Definition
Pearly papules
Term
What is a helpful mnemonic
to remember the neoplasm
associated with Down's
Syndrome?
 Definition
We ALL go DOWN together
Term
What is a helpful mnemonic
to remember the site of
metastasis to the brain?
 Definition
Lots of Bad Stuff Kills Glia
Term
What is a helpful mnemonic
to remember the types of
cancer that metastasize to
the liver?
 Definition
Cancer Sometimes Penetrates
Benign Liver
Term
What is a helpful mnemonic
to remember what tumors
metastasize to bone?
 Definition
BLT with a Kosher Pickle
Term
What is a Hemangioblastoma
 Definition
Most often a cerebellar
tumor. Associated with von
Hippel Lindau syndrome
when found with
retinoblastoma
Term
What is a low-grade
astrocytoma
 Definition
Diffusely infiltrating glioma.
In children, it is most
commonly found in the
posterior fossa
Term
What is a medulloblastoma
 Definition
Highly malignant cerebellar
tumor. A form of primitive
neuroectodermal tumor
(PNET). Can compress 4th
ventricle causing
hydrocephalus
Term
What is a neoplasm
associated with actinic
keratosis
 Definition
Squamous cell carcinoma of
the skin
Term
What is a neoplasm
associated with Barrett's
esophagus (chronic GI
reflux)?
 Definition
Esophageal adenocarcinoma
Term
What is a neoplasm
commonly associated with
chronic atrophic gastritis,
pernicious anemia, and
postsurgical gastric
remnants
 Definition
Gastric adenocarcinoma
Term
What is an
oligodendroglioma
 Definition
A relatively rare, slow
growing, benign tumor
Term
What is CEA
(carcinoembryonic antigen
 Definition
Very nonspecific antigen
produced by 70% of colorectal
and pancreatic cancers and
by gastric and breast
carcinoma
Term
What is considered a
precursor to squamous cell
carcinoma?
 Definition
Actinic keratosis
Term
What is considered to be a
precursor to malignant
melanoma?
 Definition
Dysplastic nevus
Term
What is meant by the term
tumor grade?
 Definition
Histologic appearance of the
tumor. Usually graded I-IV
based on degree of
differentiation and number of
mitoses per high-power field
Term
What is meant by the term
tumor stage
 Definition
Based on site an size of
primary lesion, spread to
regional lymph nodes, and
presence of metastases
Term
What is the characteristic
appearance of a giant cell
tumor on an x-ray?
 Definition
Characteristic 'double bubble'
or 'soap bubble' appearance
Term
What is the common
histopathology associated
with Ependymomas?
 Definition
Characteristic perivascular
rosettes. Rod-shaped
blepharoblasts (basal ciliary
bodies) found near the
nucleus.
Term
What is the common
histopathology associated
with Hemangioblastoma
 Definition
Foamy cells and high
vascularity are characteristic.
Can produce EPO and lead to
polycythemia
Term
What is the common
histopathology associated
with medulloblastomas
 Definition
Rosettes or perivascular
pseudorosette pattern of cells
Term
What is the common
histopathology associated
with oligodendrogliomas
 Definition
Fried egg' appearance of cells
in tumor. Often calcified
Term
What is the common
histopathology associated
with schwannoma?
 Definition
Antoni A=compact palisading
nuclei; Antoni B=loose
pattern
Term
What is the common
histopathology found in
Glioblastoma multiforme
 Definition
Pseudopalisading' tumor cells
border central areas of
necrosis and hemorrhage
Term
What is the differentiation
pattern of normal cells?
 Definition
Basal to apical differentiation
Term
What is the histopathology
commonly associate with
giant cell tumors?
 Definition
Spindle-shaped cells with
multi-nucleated giant cells
Term
What is the most common
benign bone tumor
 Definition
Osteochondroma
Term
What is the most common
location of basal cell
carcinoma of the skin?
 Definition
Usually found in sun-exposed
areas of the body.
Term
What is the most common
location of osteosarcoma?
 Definition
Commonly found in the
metaphysis of long bones
Term
What is the most common
organ to 'send' metastases?
 Definition
The lung is the most common
origin of metastases. The
breast and stomach are also
big sources
Term
What is the most common
organ to receive metastases
 Definition
Adrenal glands. This is due to
their rich blood supply. The
medulla usually receives
metastases first and then the
rest of the gland.
Term
What is the most common
population to have
chondrosarcoma
 Definition
Men age 30-60 years old
Term
What is the most common
primary brain tumor?
 Definition
Glioblastoma multiforme
(grade IV astrocytoma)
Term
What is the most common
primary malignant tumor of
bone?
 Definition
Osteosarcoma
Term
What is the most common
type of pituitary adenoma?
 Definition
Prolactin secreting
Term
What is the most likely
population to have Ewing's
sarcoma?
 Definition
Boys under 15 years old
Term
What is the origin of a
craniopharyngioma
 Definition
Derived from the remnants of
Rathke's pouch
Term
What is the origin of a
Pituitary adenoma?
 Definition
Rathke's pouch
Term
What is the origin of the
Schwannoma
 Definition
Schwann cell origin. Often
localized to the 8th cranial
nerve (acoustic schwannoma).
Bilateral schwannoma found
in NF2.
Term
What is the peak incidence of
giant cell tumor?
 Definition
20-40 years old
Term
What is the peak incidence of
osteosarcoma
 Definition
Men 10-20 years old
Term
What is the prognosis for
Glioblastoma multiforme?
 Definition
Prognosis is grave. Usually
only have a year life
expectancy
Term
What is the second most
common primary brain
tumor
 Definition
Meningioma
Term
What is the third most
common primary brain
tumor?
 Definition
Schwannomas
Term
What neoplasias are
associated with afetoprotein?
 Definition
Hepatocellular carcinoma and
nonseminomatous germ cell
tumors of the testis
Term
What neoplasias are
associated with B-hCG?
 Definition
Hydatidiform moles,
Choriocarcinomas, and
Gestational trophoblastic
tumors.
Term
What neoplasias are
associated with CA-125?
 Definition
Ovarian and malignant
epithelial tumors
Term
What neoplasias are
associated with S-100?
 Definition
Melanoma, neural tumors,
and astrocytomas
Term
What neoplasm is associated
with Cirrhosis (due to
alcoholism, Hep B, or Hep c
 Definition
Hepatocellular carcinoma
Term
What neoplasm is associated
with Dysplastic nevi?
 Definition
Malignant melanoma
Term
What neoplasm is associated
with Immunodeficiency
states?
 Definition
Malignant lymphomas
Term
What neoplasm is associated
with Plummer-Vinson
syndrome (atrophic glossitis,
esophageal webs, and
anemia; all due to iron
deficiency
 Definition
Squamous cell carcinoma of
the esophagus
Term
What neoplasm is associated
with ulcerative colitis
 Definition
Colonic adenocarcinoma
Term
What oncogene is associated
with breast, ovarian, and
gastric carcinomas?
 Definition
erb-B2
Term
What oncogene is associated
with Burkitt's lymphoma?
 Definition
c-myc
Term
What oncogene is associated
with colon carcinoma?
 Definition
ras
Term
What oncogene is associated
with Follicular and
undifferentiated lymphomas
(inhibits apoptosis)?
 Definition
bcl-2
Term
What tumor marker is
associated with Prostatic
carcinoma?
 Definition
PSA (Prostatic acid
phosphatase
Term
What tumor suppressor gene
is associated with
Retinoblastoma and
osteosarcoma?
 Definition
Rb gene
Term
What type of metastases are
common in the late stages of
prostatic adenocarcinoma?
 Definition
Osteoblastic metastases in
bone
Term
What type of neoplasm is
associated with Acanthosis
nigricans (hyperpigmentation
and epidermal thickening
 Definition
Visceral malignancies
(stomach, lung, breast, and
uterus)
Term
What type of skin cancer is
associated with excessive
exposure to sunlight or
arsenic exposure?
 Definition
Squamous cell carcinoma
Term
Where are chondrosarcomas
usually located?
 Definition
Pelvis, spine, scapula,
humerus, tibia, or femur
Term
Where are Ewing's sarcomas
most commonly found?
 Definition
Diaphysis of long bones,
pelvis, scapula, and ribs
Term
Where are Glioblastoma
multiformes found?
 Definition
Cerebral hemispheres
Term
Where do giant cell tumors
most commonly occur?
 Definition
At epiphyseal end of long
bones
Term
Where do meningiomas most
commonly occur?
 Definition
Convexities of hemispheres
and parasagital region
Term
Where do oligodendrogliomas
most often occur?
 Definition
Most often found in the
frontal lobes
Term
Where do osteochondromas
commonly originate?
 Definition
Long metaphysis
Term
Where do squamous cell
carcinomas most commonly
occur?
 Definition
Hands and face
Term
Where does prostatic
adenocarcinoma most
commonly arise?
 Definition
From the posterior lobe
(peripheral zone) of the
prostate gland
Term
Which has more prognostic
value: tumor stage or grade?
 Definition
Stage
Term
Which is more common:
metastasis to bone or primary
tumors of bone
 Definition
Metastatic bone tumors are
far more common than
primary tumors
Term
Which is more common:
metastasis to the liver or
primary tumors of the liver?
 Definition
Metastasis to the liver is more
common
Term
Which tumor suppressor gene
is associated with most
human cancers and the Li-
Fraumeni syndrome
 Definition
p53
Term
Which tumor suppressor
genes are associated with
breast and ovarian cancer?
 Definition
BRCA 1 and 2
Term
___% of African-Americans
carry the HbS trait, and ___%
have the disease.
 Definition
8%; 0.2
Term
________ = defect of platelet
aggregation
 Definition
Glanzmann's thrombasthenia
Term
________ disease = defect of
platelet adhesion
 Definition
Bernard-Soulier
Term
_____= activation of
coagulation cascade leading
to microthrombi and global
consumption of platelets,
fibrin, and coagulation
factors.
 Definition
DIC (Disseminated
intravascular coagulation)
Term
2 therapies for sickle cell
anemia
 Definition
1. Hydroxyurea (increased
HbF) 2. bone marrow
transplantation
Term
50% of Hodgkin's cases are
associated with which virus?
 Definition
EBV
Term
7 causes of normocytic
normochromic anemia
 Definition
1. hemorrage 2. enzyme defects
(e.g., G6PD deficiency, PK deficiency)
3. RBC membrane defects (e.g.,
hereditary spherocytosis) 4. Bone
Marrow disorders (e.g., aplastic
anemia, leukemia) 5.
Hemoglobinopathies (e.g., sickle
cell) 6. Autoimmune hemolytic
anemia 7. Anemia of chronic disease
Term
Antiplatelet antibodies and
increased megakaryocytes are
seen in ____.
 Definition
ITP
Term
Auer rods, myeloblasts,
adults =
 Definition
AML
Term
bcl-2 activation is associated
with which translocation and
which lymphomas
 Definition
t(14;18) - Follicular
lymphomas
Term
bcr-abl hybrid is associated
with which translocation and
which leukemia
 Definition
t(9;22) - CML
Term
Blood smear of a Multiple
Myeloma patient would show
what?
 Definition
RBCs stacked like poker chips
(rouleau formation
Term
Burkitt's lymphoma: '______'
appearance associated with
what virus? endemic where?
 Definition
starry sky' EBV Africa
Term
c-myc activation is associated
with which translocation and
which lymphoma?
 Definition
t(8;14) - Burkitt's
Term
Causes of aplastic anemia
 Definition
radiation, benzene,
chloramphenicol, alkylating
agents, antimetabolites, viral
agents (HCV,CMV,EBV, herpes
zoster-varicella), Faconi's
anemia, idiopathic (immunemediated,
primary stem cell
defect)
Term
Causes of platelet
abnormalities
 Definition
ITP, TTP, drugs, DIC
Term
CFU-GM (colony forming
unit-granulocyte-monocyte)
gives rise to which cells
 Definition
monocytes, neutrophils and
basophils
Term
CLL is very similar to what
lymphoma
 Definition
SLL (small lymphocytic
lymphoma
Term
Coagulation factor defects
(macrohemorrage) cause: (3)
 Definition
1. Hemarthroses (bleeding
into joints) 2. easy bruising 3.
prolonged PT and/or PTT
Term
Common cause of macrocytic
megalobalstic anemia:
 Definition
Vit. B12/folate deficiency
Term
common in children,
lymphoblasts, most
responsive to therapy =
 Definition
ALL
Term
Compare Multiple Myeloma
with Waldenstrom's
macroglobinemia:
 Definition
Waldenstrom's also has an M
spike, but large amounts of
IgM are produced (not IgA or
IgG), no lytic lesions
Term
Complications often seen in
homozygotes (sickle cell
disease) include
 Definition
aplastic crisis (due to B19
parvovirus infection)
autosplenectomy inc. risk of
encapsulated organism
infection Salmonella
osteomyelitis painful crisis
(vaso-occlusive) and splenic
sequestration crisis
Term
Describe the RBCs of a
parient with Hereditary
spherocytosis
 Definition
RBCs are small, round, with
no central pallor less
membrane therefore
increased MCHC
Term
FAB classification L1:
 Definition
ALL-null, ALL-common
Term
FAB classification L2:
 Definition
ALL- T
Term
FAB classification L3
 Definition
ALL- B
Term
FAB classification M1
 Definition
AML (without maturation
Term
FAB classification M2:
 Definition
AML (with maturation
Term
FAB classification M3:
 Definition
acute promyelocytic leukemia
Term
FAB classification M4
 Definition
acute myelomonocytic
leukemia
Term
FAB classification M5
 Definition
acute monocytic leukemia
Term
FAB classification M6:
 Definition
acute erythroleukemia
Term
FAB classification M7
 Definition
acute megakaryocytic
leukemia
Term
General considerations of
leukemias
 Definition
increased number of
circulating leukocytes in
blood bone marrow infiltrates
of leukemic cells leukemic
cell infiltrates in liver, spleen,
and lymph nodes also
common
Term
Genetics associated with
Burkitt's lymphoma:
 Definition
t(8;14) c-myc gene moves
next to heavy chain Ig gene
(14)
Term
Hb Barts =
 Definition
Gamma 4 tetramers, lacks all
4 alpha globin genes
Term
Hb Barts results in what?
 Definition
hydrops fetalis and
intrauterine fetal death
Term
Hb H =
 Definition
Beta 4 tetramers, lacks 3
alpha globin genes
Term
Hereditary spherocytosis
causes intrinsic, extravascular
hemolysis due to a _____
defect.
 Definition
spectrin
Term
Hereditary spherocytosis is
associated with what other
problems
 Definition
gallstones, splenomegaly,
anemia and jaundice
Term
Hereditary spherocytosis is
distinguished from warm
antibody hemolysis by what
test?
 Definition
Direct Coomb's test
(Hereditary spherocytosis is
Coomb's negative
Term
Hodgkin's or NHL: which is
associated with HIV &
immunosuppression
 Definition
NHL
Term
Hodgkin's or NHL: which is
associated with mediastinal
lymphadenopathy?
 Definition
Hodgkin's
Term
Hodgkin's or NHL: which one
displays a bimodal
distribution?
 Definition
Hodgkin's (young and old)
Term
How does Multiple Myeloma
affect calcium levels
 Definition
destructive bone lesions
cause hypercalcemia
(punched-out lytic bone
lesions can be seen on x-ray)
Term
In _____, the alpha globin
chain is underproduced.
 Definition
alpha thalassemia
Term
In _____, the beta chain is
underproduced.
 Definition
Beta-minor thalassemia
(heterozygote)
Term
In ______, the beta chain is
absent.
 Definition
Beta-major thalassemia
(homozygote)
Term
In anemia of chronic disease,
are these values increased or
decreased? 1. TIBC 2. ferritin
3. serum iron 4. storage iron
in marrow macrophages 5. %
sat.
 Definition
1. dec. 2. inc. 3. dec. 4. inc.
5. normal
Term
In Beta Thalassemia, cardiac
failure is often due to what?
 Definition
secondary hemochromatosis
(due to transfusions
Term
In which hemorrhagic
disorder is PT increased?
 Definition
DIC
Term
In which hemorrhagic
disorders is PTT increased?
(4)
 Definition
1. Hemophilia A 2.
Hemophilia B 3. von
Willibrand's disease 4. DIC
Term
increased or decreased in
iron deficiency anemia? 1.
TIBC 2. ferritin 3. serum iron
 Definition
1. increased 2. decreased 3.
decreased
Term
Is Hodgkin's more common in
men or women
 Definition
men (except nodular
sclerosing type)
Term
Lab findings of DIC
 Definition
increased PT and PTT,
increased fibrin split products
(D-dimers), decreased
platelet count
Term
Lymphoblastic lymphoma
commonly presents with
what?
 Definition
ALL and mediastinal mass
Term
Lymphomas derived from the
B cell lineage:
 Definition
ALL (B cell) Lymphoblastic
lymphoma, CLL (B)
Lymphocytic lymphoma,
Follicular center cell
lymphoma, Immunoblastic
lymphoma (B), Plasmacytoid
lymphocytic lymphoma and
myeloma
Term
Lymphomas derived from the
T cell lineage:
 Definition
ALL (T cell) Lymphoblastic
lymphoma, CLL (T)
Lymphocytic lymphoma,
Immunoblastic lymphoma (T),
Sezary syndrome and mycosis
fungoides
Term
Macrocytic anemia is defined
as MCV>____.
 Definition
100
Term
Marrow failure due to
leukemia can lead to (3)
 Definition
1. anemia (dec. RBCs) 2.
infections (dec. WBCs) 3.
hemorrhage (decreased
platelets)
Term
Microcytic, hypochromic
anemia = MCV<____.
 Definition
80
Term
most commonly associated
with Philadelphis
chromosome, myeloid stem
cell proliferation, may
accelerate to AML =
 Definition
CML
Term
Name 3 coagulopathies:
 Definition
1. Hemophilia A 2.
Hemophilia B 3. von
Willibrand's disease
Term
Name 3 etiologies of
microcytic, hypochromic
anemia:
 Definition
1. iron deficiency 2.
Thalassemias 3. lead
poisoning
Term
Name 5 hemorrhagic
disorders that exhibit
increased bleeding time
 Definition
1. Qualitative platelet defects
2. Vascular bleeding 3.
Thrombocytopenia 4. Von
Willibrand's disease 5. DIC
Term
Name 5 types of NHL
 Definition
1. Small lymphocytic
lymphoma 2. Follicular
lymphoma (small cleaved cell)
3. Diffuse large cell 4.
Lymphoblastic lymphoma 5.
Burkitt's lymphoma
Term
Name 9 chronic myeloid
leukemias
 Definition
CML, Polycythemia rubra vera,
CML, Myelofibrosis, idiopathic
thrombocythemia, (chronic
monocytic, chronic
myelomonocytic,
eosinophilic, chronic
erythroid) *last 4 are rare*
Term
Nodal involvement and
spread of Hodgkin's vs. NHL
 Definition
Hodgkin's: localized, single
group of nodes, extranodal
rare, contiguous spread NHL:
multiple, peripheral nodes,
extranodal involvement
common, noncontiguous
spread
Term
Normal values: 1. TIBC 2.
Serum iron 3. % sat.
 Definition
1. TIBC 250-400 micro
grams/ dl 2. 50-150 3.
20-50 %
Term
older adults,
lymphadenopathy,
hepatosplenomegaly, few
symptoms, indolent course,
increased smudge cells in
peripheral blood smear, warm
Ab autoimmune hemolytic
anemia =
 Definition
CLL
Term
Other causes of macrocytic
anemia (2
 Definition
1. drugs that block DNA
synthesis (e.g., sulfa drugs,
AZT) 2. marked
reticulocytosis
Term
Pathologic features of aplastic
anemia:
 Definition
pancytopenia with normal cell
morphology, hypocellular
bone marrow with fatty
infiltration
Term
Peak incidence of NHL
between what ages
 Definition
20-40
Term
Philadelphia chromosome
 Definition
Philadelphia chromosome= t(9;22), bcr-abl
Term
Plasma cells in Multiple
Myeloma produce large
amounts of what
 Definition
IgG (55%) and IgA (25%)
Term
Platelet abnormalities
(microhemorrage) lead to: (4)
 Definition
1. mucous membrane
bleeding 2. petechiae 3.
purpura 4. prolonged
bleeding time
Term
PMNs are hypersegmented in
 Definition
Vit. B 12 and folate
deficiencies
Term
PT and PTT: which one
measures the intrinsic and
which one measures the
extrinsic path?
 Definition
PT (extrinsic) PTT (intrinsic)
Term
Rank the prognoses of the
different types of Hodgkin's
 Definition
NS and LP = excellent MC =
intermediate LD = poor
Term
Schistocytes are characteristic
of ___.
 Definition
TTP
Term
Sickle cell heterozygotes
(sickle cell trait) are relatively
____-resistant
 Definition
malaria; (balanced
polymorphism
Term
Symptoms of aplastic anemia:
 Definition
fatigue, malaise, pallor,
purpura, mucosal bleeding,
petechiae, infection
Term
Thalassemia is prevalent in
which populations?
 Definition
Mediterranean (hint:
thalassa=sea. Think,
thalaSEAmia)
Term
The lymphoid stem cell gives
rise to: (2)
 Definition
T cells and B cells
Term
The majority of NHL involve T
cells or B cells?
 Definition
B cells (except lymphoblastic
T cell origin)
Term
Treatment of aplastic anemia
 Definition
withdrawal of offending
agent, allogenic bone marrow
transplantation, RBC and
platelet transfusion, G-CSF or
GM-CSF
Term
What are 2 indications of
hemolysis
 Definition
1. decreased serum
haptoglobin 2. increased
serum LDH
Term
What are constitutional signs/
symptoms?
 Definition
(mostly seen in Hodgkin's)
low grade fever, night sweats,
weight loss
Term
What are some other causes
of DIC?
 Definition
gram-negative sepsis,
transfusion, trauma,
malignancy, acute
pancreatitis, and nephrotic
syndrome
Term
What genetics are involved
with follicular lymphoma
(small cleaved cell
 Definition
t(14;18) bcl-2 expression
Term
What is another Beta chain
mutation in which patients
have a milder disease than Hb
SS patients?
 Definition
HbC defect. patients can be
HbC or HbSC (1 of each
mutant gene
Term
What is aplastic anemia?
 Definition
pancytopenia characterized by
severe anemia, neutropenia,
and thrombocytopenia caused
by destruction of multipotent
myeloid stem cells, with
inadequate production or
release of differentiated cell
lines.
Term
What is compensatorily
increased in both forms of
Beta Thalassemia
 Definition
fetal hemoglobin (it is
inadequate, however
Term
What is found in the urine of
patients with Multiple
Myeloma?
 Definition
Ig light chains (Bence Jones
protein)
Term
What is it called when CML --
> AML
 Definition
blast crisis
Term
What is the characteristic cell
of Hodgkin's lymphoma
 Definition
Reed-Sternberg cell
(decreased numbers of RS
cells indicates a better
prognosis
Term
What is the M spike?
 Definition
the monoclonal
immunoglobin spike on
serum electrophoresis
Term
What is the most common
bleeding disorder
 Definition
von Willibrand's disease
Term
What is the most common
cause of DIC?
 Definition
obstetric complications
Term
What is the most common
primary tumor arising within
bone in adults?
 Definition
Multiple Myeloma
Term
What is the name of a chronic
T cell leukemia
 Definition
Sezary syndrome
Term
What mutation causes sickle
cell anemia?
 Definition
a single AA replacement in
the Beta chain (normal
glutamic acid with valine)
Term
What other problems result
from Multiple Myeloma?
 Definition
renal insufficiency, increased
susceptibility to infections,
anemia, and amyloidosis
Term
What precipitates sickling of
cells?
 Definition
low oxygen or dehydration
Term
What test is used to confirm
Hereditary spherocytosis?
 Definition
osmotic fragility test
Term
What test is used to
distinguish between immune
vs. non-immune RBC
hemolysis?
 Definition
Direct Coomb's test
Term
What type of cell is cancerous
in Multiple Myeloma and what
does it resemble
 Definition
Monoclonal plasma cell, 'fried
egg' appearance
Term
Which 2 hemorrhagic
disorders have decreased
platelet counts?
 Definition
1. thrombocytopenia 2. DIC
Term
Which 2 types of NHL occur in
children
 Definition
lymphoblastic lymphoma, and
Burkitt's lymphoma (20% of
diffuse large cell type too)
Term
Which Beta Thalassemia
results in severe anemia?
 Definition
Beta Thal. major, (requires
blood transfusions)
Term
Which coagulation factors are
a part of the intrinsic and
which are a part of the
extrinsic path?
 Definition
(extrinsic) = Factors II, V, VII,
and X (intrinsic) = all factors
except VII and XIII
Term
Which coagulation factors are
deficient in each of the
Hemophilias
 Definition
Hemophilia A (factor VIII
deficiency) Hemophilia B
(factor IX deficiency)
Term
Which one is associated with
neurological problems, folate
deficiency or Vit. B12
deficiency?
 Definition
Vit. B12
Term
Which type of Hodgkin's
accounts for 6% of cases and
which type is the most rare
 Definition
LP (lymphocyte predominant)
- 6% LD (lymphocyte
depleted) - rare
Term
Which type of Hodgkin's
commonly affects males
under 35
 Definition
LP
Term
Which type of Hodgkin's
commonly affects older males
and is associated with
disseminated disease?
 Definition
LD
Term
Which type of Hodgkin's has
the most Reed Sternberg
cells?
 Definition
Mixed Cellularity
Term
Which type of Hodgkin's is
characterized by collagen
banding
 Definition
NS (nodular sclerosing)
Term
Which type of Hodgkin's is
the most common? (65-75%)
 Definition
NS (nodular sclerosing)
Term
Which type of Hodgkin's is
the second most common?
(25%)
 Definition
MC (mixed cellularity
Term
Which type of Hodgkin's
primarily affects young
adults, women>men
 Definition

NS

 
Term
Which type of NHL clinically
presents like CLL?
 Definition
small lymphocytic lymphoma
Term
Which type of NHL is difficult
to cur
 Definition
follicular lymphoma
Term
Which type of NHL is most
common in children
 Definition
Lymphoblastic lymphoma
(very aggressive
Term
Which type of NHL is the most
common type in adults?
 Definition
follicular lymphoma (small
cleaved cell
Term
Which types of NHL involve T
cells?
 Definition
Lymphoblastic lymphoma
(immature T cells) 20% of
Diffuse large cell NHL (mature
T cells)
Term
With iron overload
(hemosiderosis) are values
increased or decreased? 1.
TIBC 2. serum iron 3. %sat
 Definition
1. TIBC normal 2. Serum iron
increased 3. % sat. increased
(100%) -see charts on p.238
of 2002 edition
Term
A patient with gallstones may
present with Charcot's triad.
What comprises the triad?
 Definition
(1)epigastric/RUQ pain (2)
fever (3)jaundice
Term
Failure of copper to circulate
in what form causes Wilson's
disease?
 Definition
ceruloplasmin
Term
How can one distinguish
between Dubin-Johnson
syndrome and Rotor's
syndrome?
 Definition
Rotor's syndrome presents
similarly, except less severely
and no black liver(as seen in
Dubin-Johnson
Term
How does Budd-Chiari
syndrome progress(in the
liver)?
 Definition
Congestive liver disease
Term
How does cirrhosis/portal
hypertension(HTN) affect liver
histology?
 Definition
diffuse fibrosis, destroying
normal structure, with
nodular regeneration
Term
How does Hirschsprung's
disease first present?
 Definition
Chronic constipation early in
life
Term
How does one diagnose
gallstones?
 Definition
ultrasound
Term
How does one differentiate
liver nodules, in the case of
cirrhosis?
 Definition
micronodular(<3mm and
uniform) macronodular(>
3mm and varie
Term
How does one treat
gallstones?
 Definition
cholecystectomy
Term
How is achalasia evidenced
on a Barium swallow?
 Definition
Bird beak'--dilated
esophagus with an area of
distal stenosis
Term
How is hepatocellular
carcinoma spread?
 Definition
like renal cell carcinoma,
hematogenously
Term
How is the hyperbilirubinemia
in Dubin-Johnson syndrome
different than in the other 2
hyperbilirubinemias(Gilbert's
or Crigler-Najjar(type 1))?
 Definition
Dubin-Johnson syndrome--
conjugated
hyperbilirubinemia (due to
defective liver excretion)
Term
How would you expect a
Gilbert's syndrome patient to
present?
 Definition
Asymptomatically, with an
elevated unconjugated
bilirubin
Term
In PUD, how can H.pylori be
treated
 Definition
triple therapy (metronidazole,
bismuth salicylate, amoxicillin
or tetracycline with or without
a proton pump inhibitor
Term
In what fatal childhood
hepatoencephalopathy is
there an association with viral
infections(VZV,influ.B) and
salicylates
 Definition
Reye's syndrome
Term
In Wilson's disease, where
does copper accumulate(3)?
 Definition
(1)Liver (2)Brain (3)cornea
Term
Is chronic pancreatitis
strongly associated with
alcoholism
 Definition
YES
Term
Is the dilation proximal, at, or
distal to the aganglionic
segment
 Definition
Proximal (results in a
'transition zone
Term
Low-fiber diets are associated
with which of the following?
 Definition
diverticulosis
Term
To what cancer is a chronic
gastritic patient predisposed?
 Definition
Gastric carcinoma
Term
What 3 common findings are
evident in a Reye's patient
 Definition

(1)fatty liver (2)hypoglycemia
(3)coma

 
Term
What are 2 anti-androgen
effects of liver cell failure?
 Definition
gynecomastia loss of sexual
hair
Term
What are 2 extraintestinal
manifestations of Crohn's?
 Definition
migratory polyarthritis
erythema nodosum
Term
What are 2 main symptoms
and a histological sign of
Duodenal ulcers?
 Definition
(1)pain Decreases with meals,
(2)weight gain, hypertrophy
of Brunner's glands
Term
What are 2 main symptoms of
Gastric ulcers?
 Definition
pain Greater with meals,
weight loss
Term
What are 2 signs of Crigler-
Najjar syndrome(other than
hyperbilirubinemia)?
 Definition
jaundice kernicterus(bilirubin
deposition in the brain)
Term
What are 2 types of
Inflammatory Bowel Disease?
 Definition
Crohn's disease Ulcerative
colitis
Term
What are 2 types of peptic ulcer disease(PUD)?
 Definition
gastric ulcer duodenal ulcer
Term
What are 3 associations of
Budd-Chiari Syndrome?
 Definition
(1)pregnancy (2)polycythemia
rubra vera (3)hepatocellular
carcinoma
Term
What are 3 neuro effects of liver cell failure?
 Definition
(1)asterixis, (2)scleral icterus,
(3)coma
Term
What are 3 types of
gallstones
 Definition
(1)Cholesterol stones (2)
Mixed stones (3)Pigment
stones
Term
What are 4 potential complications of PUD?
 Definition
(1)bleeding, (2)penetration,
(3)perforation, (4)obstruction
Term
What are 4 signs of congestive liver disease
 Definition
(1)hepatomegaly (2)ascites (3) abdominal pain (4)eventual liver failure
Term
What are 5 GI and 2 GU effects of portal HTN?
 Definition
(1)esophageal varices(-
>hematemesis), (2)melena,
(3)splenomegaly, (4)caput
medusae, (5)ascites and (1)
testicular atrophy, (2)
hemorrhoids
Term
What are 5 possible
consequences of acute
pancreatitis
 Definition
1)DIC (2)ARDS (3)Diffuse fat
necrosis (4)hypocalcemia (5)
pseudocyst formation
Term
What are possible causes of
acute pancreatitis(GET
SMASHeD)?
 Definition
Gallstones Ethanol Trauma
Steroids Mumps
Autoimmune disease
Scorpion sting
Hyperlipidemia Drugs
Term
What are possible etiologies
of hemochromatosis
 Definition
primary(autos. Recessive)
secondary to chronic
transfusion therapy
Term
What are risk factors for esophageal cancer(ABCDEF)?
 Definition
Achalasia, Barrett's esophagus, Corrosive esophagitis, Diverticuli, Esophageal web, Familial
Term
What are some complications
of Crohn's(4)?
 Definition
(1)strictures, (2)fistulas, (3)
perianal disease, (4)
malabsorption-nutritional
depletion
Term
What are some complications
of ulcerative colitis(3)?
 Definition
(1)severe stenosis, (2)toxic
megacolon, (3)colorectal
carcinoma
Term
What are the 2 types of
chronic gastritis
 Definition
Type A(fundal) Type B(antral)
Term
What are the 3 forms of
Diverticular disease?
 Definition
(1)diverticulum, (2)
diverticulosis, (3)diverticulitis
Term
What are the 4 risk factors for
gallstone development?
 Definition
(1)Female (2)Fat (3)Fertile (4)
Forty
Term
What are the ABCD
characteristics of Wilson's?
 Definition
Asterixis Basal ganglia
degeneration Cirrhosis,
Ceruloplasmin decrease,
Corneal deposits(Kayser-
Fleischer rings), Carcinoma
(hepatocell.), Choreiform
movements Dementia
Term
What are the characteristic 4
A's of type A gastritis
 Definition
Autoimmune disorder
characterized by
Autoantibodies to parietal
cells, pernicious Anemia,
Achlorhydria
Term
What are the respective
etiologies of Crohn's and
Ulcerative colitis(UC)?
 Definition
infectious(Crohn's)
autoimmune(UC)
Term
What can achalasia arise from and lead to?
 Definition
A secondary form can arise
from Chagas' disease; can
lead to progressive
dysphagia.
Term
What can hemochromatosis
lead to(2)?
 Definition
1)CHF (2)hepatocellular
carcinoma
Term
What cell tumor marker is
elevated in hepatocellular
carcinoma
 Definition
Alpha FetoProtein(AFP)
Term
What disorder is
characterized by increased
iron deposition in many
organs(up to 50
 Definition
hemochromatosis
Term
What happens to hepatocytes
as a result of alcoholic
hepatitis?
 Definition
they become swollen and
necrotic
Term
What happens when
cholesterol and bilirubin
overwhelm solubilizing bile
acids and lecithin
 Definition
Gallstones
Term
What histological changes,
other than to hepatocytes,
does one see in liver
hepatitis?
 Definition
neutrophil infiltration,
Mallory bodies(hyaline),
increased fat, and sclerosis
around the central vein
Term
What is a mnemonic for
Barrett's esophagus
 Definition
BARRett's = Becomes
Adenocarcinoma, Results
from Reflux
Term
What is Barrett's esophagus?
 Definition
The replacement of glandular
stratified squamous with
gastric columnar epithelium
in distal esophagus
Term
What is failure of lower
esophageal sphincter
relaxation due to
 Definition
Achalasia is due to the loss of
the myenteric plexus
Term
What is hepatic vein or IVC
occlusion with centrilobular
congestion and necrosis?
 Definition
Budd-Chiari syndrome
Term
What is recommended for
patients over 50, in terms of
CRC screening
 Definition
screen these patients over 50
with stool occult blood test
Term
What is the cause of
diverticulosis
 Definition
increased intraluminal
pressure and focal weakness
in the colonic wall
Term
What is the classic triad of
hemochromatosis?
 Definition
(1)micronodular pigment
cirrhosis (2)'bronze' diabetes
(3)skin pigmentation
Term
What is the discerning
characteristic for type B
gastritis
 Definition
Type B is caused by a Bug(H.
pylori)
Term
What is the embryonic cause
of Hirschsprung's disease?
 Definition
failure of neural crest
migration
Term
What is the etiology of
duodenal ulcers?
 Definition
H.pylori(100%)--lower
mucosal protection or
increased gastric acid
secretion
Term
What is the etiology of gastric
ulcers?
 Definition
H.pylori(70%), NSAIDS both
lower mucosal protection vs.
gastric acid
Term
What is the gross morphology
of Crohn's?
 Definition
transmural inflamm.
COBBLESTONE mucosa,
creeping FAT, bowel wall
thickening(string sign on xray),
linear ulcers, fissures
Term
What is the gross morphology
of ulcerative colitis
 Definition
mucosal inflamm. Friable
mucosal pseudopolyps with
freely hanging mesentery
Term
What is the incidence of
diverticulosis in the elderly?
 Definition
over 60y/o, 50%
Term
What is the microscopic
morphology of Crohn's?
 Definition
noncaseating granulomas
Term
What is the microscopic
morphology of ulcerative
colitis?
 Definition
crypt abscesses and ulcers
Term
What is the mnemonic for
Crohn's?
 Definition
For Crohn's, think of a FAT
old CRONE SKIPping down a
COBBLESTONE road
Term
What is the most common clinical sign of acute pancreatitis?
 Definition
epigastric abdominal pain
radiating to the back
Term
What is the most common
primary malignant tumor of
the liver in adults
 Definition
hepatocellular carcinoma
Term
What is the most common
type of gallstone
 Definition
mixed stones
Term
What is the primary cause of
macronodules in the liver
 Definition
significant liver injury leading
to hepatic necrosis(e.g.
Infections, drug-induced)
Term
What is the primary cause of
micronodules in the liver?
 Definition
metabolic(e.g. Alcohol)
Term
What is the prognosis for
pancreatic adenocarcinoma?
 Definition
~6months (very aggressive--
often already spread at
presentation
Term
What is the term for inflamm. of diverticula
 Definition
diverticulitis
Term
What is the term used for
congenital megacolon
characterized by loss of
parasympathetic ganglion
cells?
 Definition
Hirschsprung's disease
Term
What is the term used to
describe breath that smells
like a freshly opened corpse,
as seen in liver cell failure?
 Definition
fetor hepaticus
Term
What is the term used to
describe having many
diverticula
 Definition
diverticulosis
Term
What is the treatment for
Crigler-Najjar syndrome
 Definition
plasmaphoresis phototherapy
Term
What is the treatment of
hemochromatosis?
 Definition
repeated phlebotomy
deferoxamine
Term
What is the treatment of
Wilson's disease(1 drug)?
 Definition
penicillamine
Term
What is the typical
presentation of a patient with
pancreatic adenocarcinoma(5
signs)?
 Definition
(1)Abdominal pain radiating
to the back (2)Weight loss (3)
Anorexia (4)Migratory
thrombophlebitis(Trousseau's
Sd) (5)Pancreatic duct
obstruction(palpable
gallbladder
Term
What is the usual location of
Crohn's?
 Definition
Terminal ileum, small
intestine, colon (but any part
can be affected)-- often SKIP
lesions, rectal sparing
Term
What is the usual location of
ulcerative colitis
 Definition
colon (with continuous
lesions and rectal
involvement
Term
What lab values are
characteristic in alcoholic
hepatitis
 Definition
SGOT(AST)/SGPT(ALT) >
1.5,usually (A Scotch and
Tonic=AST elevation
Term
What lab values are
characteristic in
hemochromatosis?
 Definition
increased ferritin and
transferrin saturation
Term
What labs are elevated in
acute pancreatitis
 Definition
amylase lipase(higher
specificity)
Term
What part of the GI tract is
most frequently involved in
diverticulosis
 Definition
sigmoid colon
Term
What risk group has an
increased incidence of PUD by
2X?
 Definition
smoking
Term
What type of stones are seen
in patients with RBC
hemolysis,alcoholic
cirrhosis,biliary infection?
 Definition
pigment stones
Term
When do patients with
Crigler-Najjar syndrome(type
I) usually present?
 Definition
early in life(often die within a
few years
Term
Where are pancreatic tumors
most often located
 Definition
pancreatic head (with
obstructive jaundice
Term
Where is the pain associated
with diverticulitis?
 Definition
left lower quadrant
Term
Which of the following are
effects of liver cell failure?
Anemia,
hypercoagulation,spider nevi,
jaundice,
gynecomastia,bleeding
tendency, ankle edema
 Definition
all, except hyper coagulation
Term
Which of the following are
risk factors for colorectal
cancer(CRC):
age,smoking,personal and
family history of colon
cancer, low-fiber diet,
hereditary non-polyposis
CRC?
 Definition
all, except for smoking
Term
Which of the following are
risk factors for colorectal
cancer: colorectal villous
adenomas, chronic
inflamm.bowel disease,
familial adenomatous
polyposis,Peutz-Jeghers?
 Definition
all, except for Peutz-Jeghers
Term
Which of the following is a
blind pouch leading off the GI
tract lined by mucosa,
muscularis, serosa?
Diverticulosis, diverticulum,
diverticulitis
 Definition
diverticulum
Term
Which of the following is a
common association between
cholesterol stones and
pigment stones:
obesity,Crohn's,cystic
fibrosis,age,clofibrate,
estrogens,multiparity,rapid
weight loss?
 Definition
advanced age
Term
Which of the following is
associated with perforation,
peritonitis, abscesses, or
bowel stenosis
 Definition
Diverticulitis
Term
Which of the following is
associated with
stress:Gilbert's, Dubin-
Johnson syndrome, or
Crigler-Najjar(type 1)?
 Definition
Gilbert's
Term
Which of the following
syndromes have a mildly
decreased UDP-glucuronyl
transferase: Gilbert's or
Crigler-Najjar(type 1)?
 Definition
Gilbert's(Crigler-Najjar has an
absence of UDP-glucuronyl
transferase)
Term
Which type of liver nodule is
associated with an increased
risk of hepatocellular
carcinoma
 Definition
macronodules
Term
With what 6 diseases does
hepatocellular carcinoma
have an association
 Definition
(1)Hepatitis B (2)Hepatitis C
(3)Wilson's (4)
Hemochromatosis (5)alpha 1
antitrypsin deficiency (6)
alcoholic cirrhosis
Term
With what cancer is achalasia
associated
 Definition
Increased risk for esophageal
cancer
Term
An FEV1/FVC ratio greater
than 80% indicates what form
of pulmonary disease
 Definition
Restrictive lung disease
Term
Are bronchogenic carcinoma
metastases common
 Definition
Yes, very common
Term
Decreased FEV1/FVC ratio are the hallmark of what kind of pulmonary disease?
 Definition
COPD
Term
How does interstitial fibrosis
create a restrictive lung
disease?
 Definition
It causes increased recoil
(decreased compliance),
thereby limiting alveolar
expansion
Term
How does lung cancer
commonly present? (5)
 Definition
- Cough - Hemoptysis -
Bronchial obstruction -
Wheezing - Pneumonic 'coin'
lesion on x-ray
Term
How does surfactant
deficiency cause NRDS?
 Definition
It leads to an increase in
surface tension, resulting in
alveolar collapse
Term
How to you treat NRDS?
 Definition
- Maternal steroids before
birth - Artificial surfactant for
infant
Term
Identify: ivory-white pleural
plaques in the lung
 Definition
Ferruginous bodies
Term
In COPD, are lung volumes
increased, decreased, or
normal?
 Definition
Increased (increasedTLC,
increased FRC, increased RV
Term
In restrictive lung disease, are
lung volumes increased,
decreased, or normal?
 Definition
Decreased
Term
In what occupations is
asbestosis most commonly
seen? (2)
 Definition
Shipbuilders and plumbers
Term
Name three 'triggers' of
asthma.
 Definition
- Viral URIs - Allergens -
Stress
Term
Name three characteristics of
Horner's syndrome?
 Definition
Ptosis - Miosis - Anhidrosis
Term
Name two extrapulmonary
(poor breathing mechanics)
causes of restrictive lung
disease
 Definition
Poor muscular effort: polio,
myasthenia gravis - Poor
apparatus: scoliosis
Term
Name two pulmonary (poor
lung expansion) causes of
restrictive lung disease
 Definition
- Defective alveolar filling:
pneumonia, ARDS, pulmonary
edema - Interstitial fibrosis
Term
Patients with asbestosis are at
increased risk for what? (2)
 Definition
Pleural mesothelioma and
bronchogenic carcinoma
Term
T/F Bronchiectasis is
associated with bronchial
obstruction, cystic fibrosis,
and poor ciliary motility
 Definition
True
Term
T/F In obstructive (not
restrictive) lung disease, FEV1
and FVC are reduced
 Definition
False, FEV1 and FVC are
reduced in both
Term
T/F Restricted lung expansion
causes decreased total lung
capacity and increased vital
capacity
 Definition
False, decreased VC and TLC
Term
T/F Smokers with asbestosis
have a decreased risk of
developing cancer.
 Definition
False, it increases
synergistically
Term
What are asbestos fibers
coated with hemosiderin in
the lung
 Definition
Ferruginous bodies
Term
What are the characteristics
of lobar pneumonia
 Definition
Intra-alveolar exudate ->
consolidation; may involve
entire lung
Term
What are the clinical findings
of chronic bronchitis? (3)
 Definition
- Wheezing - Crackles -
Cyanosis
Term
What are the clinical findings
of emphysema? (4)
 Definition
- Dyspnea - Decreased
breath sounds - Tachycardia
- Decreased I/E ratio
Term
What are the symptoms and
complications of interstitial
lung fibrosis
 Definition
Symptoms: gradual
progressive dyspnea and
cough - Complications
include cor pulmonale (can be
seen in diffuse interstitial
pulmonary fibrosis and
bleomycin toxicity
Term
What bronchogenic carcinoma
is associated with ectopic
hormone production (ADH,
ACTH) and may lead to
Lambert-Eaton syndrome?
 Definition
Small cell carcinoma
Term
What bronchogenic carcinoma
is associated with ectopic
PTH-related peptide
production?
 Definition
Squamous cell carcinoma
Term
What bronchogenic carcinoma
is most common?
 Definition
Adenocarcinoma
Term
What bronchogenic carcinoma
is thought not to be related
to smoking
 Definition
Bronchioalveolar carcinoma
Term
What bronchogenic
carcinomas are clearly linked
to SSmoking
 Definition
SSquamous cell carcinoma
and SSmall cell carcinoma
Term
What bronchogenic
carcinomas usually express
tumors that arise centrally?
(2)
 Definition
- Squamous cell carcinoma -
Small cell carcinoma
Term
What bronchogenic
carcinomas usually express
tumors that arise
peripherally? (3)
 Definition
- Adenocarcinoma -
Bronchioalveolar carcinoma -
Large cell carcinoma--
undifferentiated
Term
What carcinoma occurs in the
apex of the lung and may
affect the cervical
sympathetic, causing Horner's
syndrome
 Definition
Pancoast's tumor
Term
What causes bronchiectasis?
 Definition
Chronic necrotizing infection
of bronchi
Term
What causes neonatal
respiratory distress syndrome
(NRDS)?
 Definition
Surfactant deficiency
Term
What cells make surfactant
and when is it made most
abundantly in fetuses?
 Definition
Type II pneumocytes most
abundantly after 35th week of
gestation
Term
What COPD has a productive
cough for greater than three
months in two years and
hypertrophy of mucussecreting
glands in the
bronchioles (Reid index
greater than 50%)?
 Definition
Chronic bronchitis
Term
What COPD is characterized
by dilated airways, purulent
sputum, recurrent infections,
and hemoptysis
 Definition
Bronchiectasis
Term
What COPD is due to an
enlargement of air spaces and
decreased recoil resulting
from destruction of alveolar
walls?
 Definition
Emphysema
Term
What COPD is due to
bronchial
hyperresponsiveness which
causes reversible
bronchoconstriction
 Definition
Asthma
Term
What does inhaled asbestos
do to the lungs
 Definition
It causes diffuse pulmonary
interstitial fibrosis
Term
What is the composition of
surfactant
 Definition
Dipalmitoyl
phosphatidylcholine
Term
What is the difference in
FEV1/FVC ratios between
obstructive and restrictive
lungs diseases
 Definition
FEV1 and FVC are reduced in
both, but in obstructive the
FEV1 is more dramatically
reduced, resulting in a
decreased FEV1/FVC ratio
Term
What is the leading cause of
cancer death?
 Definition
Lung cancer
Term
What is the SPHERE (acronym)
of complications associated
with lung cancer
 Definition
Superior vena caval syndrome
Pancoast's tumor Horner's
syndrome Endocrine
(paraneoplastic) Recurrent
laryngeal symptoms
(hoarseness) Effusions
(pleural or pericardial
Term
What kind of pulmonary
diseases are caused by a
inhibition of air flow resulting
in air trapping in the lungs
 Definition
Obstructive lung diseases
(COPD)
Term
What organisms are is the
most frequent cause of lobar
pnuemonia?
 Definition
Pneumococcus
Term
What organisms are the most
frequent cause of
bronchopnuemonia? (4)
 Definition
- S. aureus - H. flu -
Klebsiella - S. pyogenes
Term
What organisms are the most
frequent cause of interstitial
(atypical) pnuemonia? (3)
 Definition
- Viruses (RSV, adenoviruses)
- Mycoplasma - Legionella
Term
What specific type of
emphysema is caused by
alpha-1-antitrypsin
deficiency
 Definition
Panacinar emphysema (and
liver cirrhosis
Term
What specific type of
emphysema is caused by
smoking?
 Definition
Centriacinar emphysema
Term
What test is used to measure
in utero lung maturity?
 Definition
The lecithin-tosphingomyelin
ratio in the
amniotic fluid, usually less
than 1.5 in neonatal
respiratory distress syndrome
Term
What type of lung cancer can
cause carcinoid syndrome?
 Definition
Carcinoid tumor
Term
What type of pneumonia is
characterized by acute
inflammatory infiltrates from
bronchioles into adjacent
alveoli with a patchy
distribution affecting more
than one lobe
 Definition
Bronchopneumonia
Term
What type of pneumonia is
characterized by diffuse
patchy inflammation localized
to interstial areas at alveolar
walls and involves more than
one lobe?
 Definition
Interstitial (atypical)
pneumonia
Term
Where does bronchogenic
carcinoma commonly
metastasize and how does it
present? (3)
 Definition

Brain (epilepsy) - Bone
(pathologic fracture) - Liver
(jaundice, hepatomegaly

 
Term
Why does alpha-1-antitrypsin
deficiency cause emphysema?
 Definition
Increased elastase activity
Term
Define epilepsy
 Definition
Epilepsy is a disorder of
recurrent seizures
Term
Define syrinx
 Definition
Tube, as in syringe
Term
Describe a myoclonic seizure.
 Definition
Quick,repetitive jerks
Term
Describe a tonic-clonic
seizure
 Definition
Alternating stiffening and
movement (grand mal)
Term
Describe a tonic seizure
 Definition
Stiffening
Term
Describe an absence seizure
 Definition
A blank stare (petit mal- it's
in 1st aid this way!!)
Term
Describe an atonic seizure
 Definition
drop' seizures
Term
Describe Broca's aphasia
 Definition
Broca's is nonfluent aphasia
with intact comprehension.
BROca's is BROken speech
Term
Describe Horner's syndrome
 Definition
Sympathectomy of face
(lesion above T1).
Interruption of the 3-neuron
oculosympathetic pathway
Term
Describe Wernicke's aphasia.
 Definition
Wernicke's is fluent aphasia
with impaired
comprehension. Wernicke's is
Wordy but makes no sense
Term
How do patients present with
a subarachnoid hemorrhage?
 Definition
Worst headache of my life'
Term
How do pts present with MS?
 Definition
-Optic neuritis (sudden loss
of vision) - MLF syndrome
(internuclear
ophthalmoplegia) -
Hemiparesis -Hemisensory
symptoms -Bladder/bowel
incontinence
Term
How does it spread?
 Definition
Through the bloodstream to
the CNS
Term
How does Werdnig-Hoffman
disease present?
 Definition
At birth as a 'floppy baby'
Term
How is Huntington's disease
inherited
 Definition
Autosomal dominant
Term
How is the polio virus
transmitted
 Definition
Fecal-oral route
Term
How is the prevalence of MS
geographically distributed?
 Definition
Higher prevalence with
greater distance from the
Equator
Term
In what persons is subdural
hemorrhage often seen?
 Definition
Elderly individuals, alcoholics,
and blunt trauma
Term
T/F. Partial seizures can not
generalize
 Definition
False- Partial seizures can
generalize
Term
What are 2 common
organisms that target the
brain in AIDS pts
 Definition
1. Toxo!Toxo!Toxo! 2.
Cryptococcus
Term
What are 2 degenerative
diseases of the cerebral
cortex?
 Definition
1. Alzheimer's 2. Pick's
disease
Term
What are 2 degenerative
diseases that affect the basal
ganglia and brain stem?
 Definition
1. Huntington's disease 2.
Parkinson's disease
Term
What are 3 degenerative
disorders of the motor
neuron?
 Definition
1. Amyotrophic lateral
sclerosis (ALS) 2. Werdnig-
Hoffman disease 3. Polio
Term
What are associated with
Guillain-Barre?
 Definition
1. Infections (herpesvirus or
C. jejuni) 2. Inoculations 3.
Stress
Term
What are neurofibrillary
tangles?
 Definition
Abnormally phosphorylated
tau protein
Term
What are some demyelinating
and dysmyelinating diseases?
 Definition
1. Multiple sclerosis (MS) 2.
Progressive multifocal
leukoencephalopathy (PML) 3.
Postinfectious
encephalomyelitis 4.
Metachromatic
Leukodystrophy 5. Guillain-
Barre syndrome
Term
What are the 4 types of
intracranial hemorrhages?
 Definition
1. Epidural hematoma 2.
Subdural Hematoma 3.
Subarachnoid hemorrhage 4.
Parenchymal hematoma
Term
What are the 5 types of
generalized seizures?
 Definition
1. Absence 2. Myoclonic 3.
Tonic-clonic 4. Tonic 5.
Atonic
Term
What are the clinical
symptoms of Huntington's
disease
 Definition
Dementia, chorea
Term
What are the clinical
symptoms of Parkinson's
disease
 Definition
TRAP= Tremor (at rest)
cogwheel Rigidity Akinesia
Postural instability (you are
TRAPped in your body
Term
What are the clinical
symptoms of Tabes dorsalis?
 Definition
-Charcot joints -Shooting
pain -Argyll-Robertson Pupils
-Absence of deep tendon
reflexes
Term
What are the common causes
of seizures in adults?
 Definition
-Tumors -Trauma -Stroke -
Infection
Term
What are the common causes
of seizures in children
 Definition
-Genetic -Infection -Trauma
-Congenital -Metabolic
Term
What are the common causes
of seizures in the elderly?
 Definition
-Stroke -Tumor -Trauma -
Metabolic -Infection
Term
What are the lab findings in
Guillain-Barre syndrome
 Definition
Elevated CSF protein with
normal cell count ('albuminocytologic
dissociation
Term
What are the lab findings in
poliomyelitis?
 Definition
-CSF with lymphocytic
pleocytosis with slight
elevation of protein -Virus
recovered from stool or
throat
Term
What are the pathological
signs of glioblastoma
multiforme (GBM)?
 Definition
-Necrosis -Hemorrhage -
Pseudo-palisading
Term
What are the signs of LMN
lesions seen in poliomyelitis?
 Definition
-Muscle weakness and
atrophy -Fasciculations -
Fibrillation -Hyporeflexia
Term
What are the symptoms of
Horner's?
 Definition
1. Ptosis 2. Miosis 3.
Anhidrosis and flushing of
affected side of face
Term
What are the symptoms of
poliomyelitis?
 Definition
-Malaise -Headache -Fever -
Nausea -Abdominal pain -
sore throat
Term
What area of the brain is
affected by generalized
seizures
 Definition
Diffuse area
Term
What artery is compromised
in an epidural hematoma?
 Definition
Middle meningeal artery
Term
What blood vessels are
affected in subdural
hemorrhages
 Definition
Rupture of bridging veins
Term
What causes a parenchymal
hematoma
 Definition
-HTN -Amyloid angiopathy -
Diabetes Mellitus -Tumor
Term
What causes poliomyelitis?
 Definition
Poliovirus
Term
What chemical can
Parkinson's disease be linked
to?
 Definition
MPTP, a contaminant in illicit
street drugs
Term
What clinical symptoms are
present with syringomyelia?
 Definition
Bilateral pain and
temperature loss in the upper
extremities with preservation
of touch sensation
Term
What clinical symptoms are
present?
 Definition
-Symmetric ascending muscle
weakness beginning in the
distal lower extremities -
Facial diplegia in 50% of cases
-Autonomic fx may be
severely affected
Term
What congenital malformation
is often associated with
syringomyelia
 Definition
Arnold Chiari Malformation
Term
What damage does
cryptococcus cause in the
brain?
 Definition
Periventricular calcifications
Term
What damage does
toxoplasma cause in the
brain
 Definition
Diffuse (intracerebral)
calcifications
Term
What diseases are berry
aneurysms associated with?
 Definition
-Adult polycystic kidney
disease -Ehlers-Danlos
syndrome -Marfan's
syndrome
Term
What do partial seizures
affect?
 Definition
One area of the brain
Term
What does rupture of a berry
aneurysm lead to?
 Definition
Stroke
Term
What does the spinal tap
show in a subarachnoid
hemorrhage
 Definition
Bloody or xanthochromic
Term
What event is the rupture of
the middle meningeal artery
secondary to?
 Definition
Temporal bone fracture
Term
What genes is the familial
form of Alzheimer's
associated with?
 Definition
Genes are chromosomes 1,
14, 19 and 21
Term
What is a complex partial
seizure?
 Definition
Impaired awareness
Term
What is a degenerative
disorder of the
Spinocerebellar tract?
 Definition
Friedrich's ataxia
(olivopontocerebellar atrophy)
Term
What is anhidrosis?
 Definition
Absence of sweating
Term
What is another name for
Guillain-Barre syndrome
 Definition
Acute idiopathic polyneuritis
Term
What is another symptom of
Werdnig-Hoffman disease?
 Definition
Tongue fasciculations
Term
What is another term for
Broca's aphasia?
 Definition
Expressive aphasia
Term
What is another term for
Wernicke's aphasia?
 Definition
Receptive aphasia
Term
What is miosis?
 Definition
Pupil constriction
Term
What is PML associated with?
 Definition
JC virus
Term
What is ptosis?
 Definition
Slight drooping of the eyelids
Term
What is the classic triad of
MS?
 Definition
SIN 1. Scanning speech 2.
Intention Tremor 3.
Nystagmus
Term
What is the common name for
ALS?
 Definition
Lou Gehrig's disease
Term
What is the course of a
subdural hemorrhage
 Definition
Venous bleeding (less
pressure) with delayed onset
of symptoms
Term
What is the course of MS?
 Definition
In most pts, the course is
remitting and relapsing
Term
What is the incidence of brain
tumors in adults?
 Definition
Metastases> Astrocytoma
(including glioblastoma)>
Meningioma
Term
What is the incidence of brain
tumors in children?
 Definition
Astrocytoma>
Medulloblastoma>
Ependymoma
Term
What is the most common
cause of dementia in the
elderly
 Definition
Alzheimer's disease
Term
What is the most common
complication of a berry
aneurysm?
 Definition
Rupture of the aneurysm
Term
What is the most common
site for a berry aneurysm?
 Definition
The bifurcation of the
anterior communicating
artery
Term
What is the pathogenesis of
Guillain-Barre syndrome
 Definition
Inflammation and
demyelination of peripheral
nerves and motor fibers of
ventral roots (sensory effect
less severe than motor
Term
What is the pathogenesis of
Tabes dorsalis?
 Definition
Degeneration of the dorsal
columns and dorsal roots due
to tertiary syphilis
Term
What is the pathology of
Alzheimer's?
 Definition
Associated with senile
plaques (beta-amyloid core)
and neurofibrillary tangles
Term
What is the pathology of
Huntington's disease?
 Definition
Atrophy of the caudate
nucleus
Term
What is the pathology of MS?
 Definition
-Periventricular plaques -
Preservation of axons -Loss
of oligodendrocytes -Reactive
astrocytic gliosis -Increased
protein (IgA) in CSF
Term
What is the pathology of
Parkinson's disease?
 Definition
Associated with Lewy bodies
and depigmentation of the
substantia nigra
Term
What is the pathology of
Pick's disease
 Definition
Associated with Pick bodies,
intracytoplasmic inclusion
bodies
Term
What is the pathology of
poliomyelitis
 Definition
Destruction of anterior horn
cells, leading to LMN
destructio
Term
What is the pathology of
syringomyelia
 Definition
Softening and cavitation
around the central canal of
the spinal cord
Term
What is the prognosis for a
pts diagnosed with a GBM
 Definition
Very poor
Term
What is the second most
common cause of dementia in
the elderly?
 Definition
Multi-infarct dementia
Term
What is the shape of GBMs?
 Definition
Butterfly' glioma
Term
What neural deficits are
present in Tabes dorsalis?
 Definition
Impaired proprioception and
locomotor ataxia
Term
What neural tracts are
damaged
 Definition
Crossing fibers of the
spinothalamic tract
Term
What neurons are affected in
ALS?
 Definition
Both the upper and lower
motor neurons
Term
What neurons are affected in
Polio
 Definition
Lower motor neurons only
Term
What seizures are categorized
as simple partial
 Definition
Awareness intact -Motor -
Sensory -Autonomic -Psychic
Term
What tumor is Horner's
syndrome associated with?
 Definition
Pancoast's tumor
Term
Where are most brain tumors
located in adults?
 Definition
70% are supratentorial
(cerebral hemispheres
Term
Where are most childhood
brain tumors located?
 Definition
70% below tentorium
(cerebellum
Term
Where do berry aneurysms
occur?
 Definition
At the bifurcations in the
Circle of Willis
Term
Where does it initially
replicate?
 Definition
The oropharynx and small
intestine
Term
Where does the 3 neuron
oculosympathetic pathway
project from?
 Definition
The hypothalamus
Term
Where does the 3 neuron
oculosympathetic pathway
project to?
 Definition
1. Interomediolateral column
of the spinal cord 2. Superior
cervical (sympathetic)
ganglion 3. To the pupil,
smooth muscles of the
eyelids and the sweat glands
Term
Where is Broca's area located?
 Definition
Inferior frontal gyrus
Term
Where is Pick's disease
specific for
 Definition
The frontal and temporal
lobes
Term
Where is the aopE-4 allele
located
 Definition
Chromosome 19
Term
Where is the most common
site of syringomyelia
 Definition
C8-T1
Term
Where is the p-App gene
located?
 Definition
21
Term
Where is Wernicke's area
located
 Definition
Superior Temporal Gyrus
Term
Which demyelinating disease
is seen in 2-4% of AIDS
patients
 Definition
PML
Term
Define Ankylosing
spondylitis?
 Definition
Chronic inflammatory disease
of spine & large joints,
sacroilitis, uveitis, &
aortic regurgitation
Term
Define Ankylosing spondylitis
 Definition
Chronic inflammatory disease
of spine & large joints,
sacroilitis, uveitis, &
aortic regurgitation
Term
Define Celiac sprue
 Definition
Autoimmune-mediated
intolerance of gliadin (wheat)
leading to steatorrhea
Term
Define Celiac sprue
 Definition
Autoimmune-mediated
intolerance of gliadin (wheat)
leading to steatorrhea
Term
Define Gout.
 Definition
Precipitation of monosodium
urate crystals into joints due
to hyperuricemia
Term
Define Scleroderma
 Definition
Excessive fibrosis &
collagen deposition
throughout the body;
commonly sclerosis of the
skin, but also of CV & GI
systems & kidney
Term
Define Scleroderma
 Definition
Excessive fibrosis &
collagen deposition
throughout the body;
commonly sclerosis of the
skin, but also of CV & GI
systems & kidney
Term
Define Sicca syndrome
 Definition
dry eyes, dry mouth, nasal
& vaginal dryness,
chronic bronchitis, reflux
esophagitis
Term
In what population is
ankylosing sponsylitis more
commonly found
 Definition
males (10-30 year old)
Term
In what population is Celiac
sprue more commonly found?
 Definition
Assoc. w/ people of northern
European descent
Term
In what population is
Goodpasture's syndrome
more commonly found
 Definition
Men 20-40 y/o
Term
In what population is gout
more commonly found?
 Definition
Men
Term
In what population is
Osteoarthritis more
commonly found
 Definition
Common in older patients
Term
In what population is
pseudogout more commonly
found?
 Definition
> 50 y/o, both sexes
equally
Term
In what population is Reiter's
syndrome more commonly
found
 Definition
Strong predilection for males
Term
In what population is
Rheumatoid arthritis more
commonly found & what
the common autoimmune
factor present?
 Definition
Common in females - 80%
of RA pt's have positive
rheumatoid factor (anti-IgG
Ab)
Term
In what population is
sarcoidosis more commonly
found?
 Definition
black females
Term
In what population is
scleroderma more commonly
found?
 Definition
75% female
Term
In what population is
Sjogren's syndrome more
commonly found
 Definition
females between the ages of
40 & 60
Term
In what population is SLE
more commonly found
 Definition
90% are female &
between ages 14 & 45.
More common & severe
in black females
Term
What are the 2 major
categories of scleroderma
& what findings are they
assoc w/?
 Definition
Diffuse scleroderma: widespread skin
involvement, rapid progression, early
visceral involvement. Assoc. w/ anti-
Scl-70 Ab CREST syndrome:
Calcinosis, Raynaud's phenomenon,
Esophageal dysmotility, Sclerodactyly
& Telangiectasia; limited skin
involvement, often confined to fingers
& face. More benign clinical
course - assoc w/ anticentromere Ab
Term
What are the associated sx's
& risks for Sjogren's
syndrome?
 Definition
- Parotid enlargement - incr
risk of B-cell lymphoma -
Assoc. w/ RA
Term
What are the characteristic
findings in Celiac sprue?
 Definition
Blunting of villi, lymphocytes
in the lamina propria, &
abnormal D-xylose test
Term
What are the common
characteristics of Sarcoidosis?
 Definition
immune-mediated,
widespread noncaseating
granulomas & elevated
serum ACE levels
Term
What are the common gross
findings in Goodpasture's
syndrome?
 Definition
pulmonary hemorrhages,
renal lesions, hemoptysis,
hematuria, crescentic
glomerulonephritis
Term
What can cause gout?
 Definition
Lesch-Nyan disease, PRPP
excess, decreased excretion
of uric acid, or G6PD
deficiency. Also assoc. w/ the
use of thiazide diuretics
which competitively ingibit
the secretion of uric acid
Term
What causes pseudogout?
 Definition
deposition of calcium
pyrophosphate crystals w/in
the joint space
Term
What CV disease state can be
caused by SLE?
 Definition
SLE causes LSE (Libman-Sacks
Endocarditis): vavular
vegetations found on both
sides of valve (mitral valve
stenosis) & do not
embolize
Term
What drugs can induce a
commonly reversible SLE-like
syndrome
 Definition
- procainamide - INH -
phenytoin - hydralazine
Term
What immune marker aids in
dx?
 Definition
90% of cases are assoc w/
B27 (gene which codes for
HLA MHC-I)
Term
What is characteristic about
gout crystals?
 Definition
needle-shaped &
negatively berefringent
Term
What is characteristic about
pseudogout crystals?
 Definition
basophilic, rhomboid crystals
Term
What is Reiter's syndrome?
 Definition
a seronegative
spondyloarthropath w/ a
HLA-B27 link
Term
What is the 'classic triad' for
Reiter's syndrome?
 Definition
1. Urethritis (Can't pee) 2.
Conjunctivities & ant.
uveitis (Can't see) 3. Arthritis
(Can't climb a tree
Term
What is the 'classic triad' for
Sjogren's syndrome
 Definition
1. dry eyes (conjunctivitis,
xerophthalmia) 2. dry mouth
(dysphagia, xerostomia) 3.
arthritis
Term
What is the classic pathology
for Osteoarthritis
 Definition
Mechanical: wear & tear
of joints leads to destruction
of articular cartilage,
subchondral bone formation,
sclerosis, osteophytes,
eburnation, &
Heberden's nodes (DIP)
Term
What is the classic pathology
for Osteoarthritis
 Definition
Mechanical: wear & tear
of joints leads to destruction
of articular cartilage,
subchondral bone formation,
sclerosis, osteophytes,
eburnation, &
Heberden's nodes (DIP)
Term
What is the classic pathology
for Rheumatoid arthritis?
 Definition
Autoimmune: inflammatory
d/o affecting synovial joints,
w/ pannus formation in joints
(MCP, PIP), subcutaneous
rheumatoid nodules, ulnar
deviation, subluxation
Term
What is the Classic
presentation for
Osteoarthritis?
 Definition
pain in weight-bearing joints
after use (e.g.- at the end of
the day), improving w/ rest.
No systemic sx's
Term
What is the classic
presentation for Rheumatoid
arthritis?
 Definition
morning stiffness improving
w/ use, symmetric joint
involvement & systemic
symptoms: fever, fatigue,
pleuritis, pericarditis
Term
What is the common
immunologic finding for
Goodpasture's syndrome?
 Definition
Anti-glomerular basement
membrane antibodies
produce linear staining on
immunofluorescence
Term
What is the common tx for
gout?
 Definition
allopurinol, probenecid,
colchicine, & NSAID's.
Term
What is the common tx for
pseudogout
 Definition
no tx
Term
What is the descriptive
acrynym for Sarcoidosis?
 Definition
GRAIN Gammaglobulinemia
Rheumatoid arthritis ACE
incr. Interstitial fibrosis
Noncaseating granulomas
Term
What is the useful memory
tool for Goodpasture's
syndrome?
 Definition
there are TWO Good Pastures
for this disease: Glomerulus
& Pulmonary. Also, a
type II (TWO) hypersensitivity
disease
Term
What sx's is sarcoidosis
commonly associated w/?
 Definition
restrictive lung disease, bilateral
hilar lypmphadenopathy, erythema
nodosum, Bell's palsy, epithelial
granulomas containing microscopic
Schaumann & asteroid
mobies, uveoparotitis, &
hypercalcemia (due to elevated
conversion of vit. D to its active
form in epithelioid macrophages)
Term
What the common pattern of
psudogout presentation
 Definition
Usually affects large joints
(classically the knee)
Term
Where is gout commonly
manifested
 Definition
Asymmetric joint distribution.
Favored manifestation is
painful MTP joint in the big
toe (podagra). Tophus
formation (often on external
ear or Achilles tendon)
Term
Addison's disease is
characterized by what
(remember 4 A's)?
 Definition
Adrenal Atrophy and Absence
of hormone production;
involves All three cortical
divisions
Term
All MEN syndromes have what
mode of inheritance
 Definition
Autosomal Dominant
Term
An increased risk of
carcinoma with atypical cells
is seen in which type of
fibrocystic breast disease?
 Definition
Epithelial hyperplasia
Term
Blood filled, 'chocolate cysts'
are seen in what condition?
 Definition
Endometriosis
Term
Carcinoid tumors result in
what recurrent symptoms? (4)
 Definition
- diarrhea - cutaneous
flushing - asthmatic
wheezing - right-sided
valvular disease
Term
Cretin means 'Christ-like,'
why is that name used?
 Definition
Those affected were
considered so mentally
retarded as to be incapable of
sinning.
Term
Diabetic ketoacidosis (DKA) is
caused by what?
 Definition
Excess fat breakdown (usually
due to an increase in insulin
requirements) and increased
ketogenesis from the increase
in free fatty acids, which are
then made into ketone bodies
Term
Do leiomyosarcomas derive
from other known tumors?
 Definition
No, they usually arise de novo
Term
From where do
leiomyosarcomas often
protrude?
 Definition
Cervix
Term
How do you treat carcinoid
syndrome
 Definition
Treat with octreotide
Term
How do you treat
postmenopausal
osteoporosis?
 Definition
Estrogen replacement therapy
Term
Hydatiform moles result in an
increase in what hormone?
 Definition
Beta-HCG
Term
Increase in what substance is
seen in the urine due to
carcinoid tumors?
 Definition
5-HIAA
Term
Is ACTH increased or
decreased when increased
cortisol is due to a primary
adrenal hyperplasia or
neoplasia?
 Definition
Decreased
Term
Is ACTH increased or
decreased when increased
cortisol is due to an
iatrogenic etiology
 Definition
Decreased
Term
Is ACTH increased or
decreased when increased
cortisol is due to Cushing's
disease?
 Definition
Increased
Term
Is ACTH increased or
decreased when increased
cortisol is due to ectopic
ACTH production (e.g.,
carcinoid)?
 Definition
Increased
Term
Is plasma renin low or high in
primary hyperaldosteronism
 Definition
Low
Term
Is plasma renin low or high in
secondary
hyperaldosteronism
 Definition
High
Term
Leiomyomas are sensitive to
what
 Definition
Estrogen
Name 3 common tests for
evaluating DM?
Term
Name 3 common tests for
evaluating DM?
 Definition
- Fasting serum glucose -
Glucose tolerance test -
HbA1c
Term
Name 3 specific example of
large vessel atherosclerosis
due to DM
 Definition
- Coronary artery disease -
Peripheral vascular occlusive
disease and gangrene -
Cerebrovascular disease
Term
Name five possible causes of
secondary
hyperaldosteronism?
 Definition
1. Renal artery stenosis 2.
Chronic renal failure 3. CHF
4. Cirrhosis 5. Nephritic
syndrome
Term
Name four causes of SIADH.
 Definition
Ectopic ADH CNS disorders/
head trauma Pulmonary
disease Drugs
Term
Name four common
presenting symptoms of
benign prostatic hyperplasia
 Definition
1. Increased frequency of
urination 2. Nocturia 3.
Difficulty starting and
stopping the stream of urine
4. Dysuria
Term
Name four important chronic
manifestations of DM.
 Definition
- Small vessel disease - Large
vessel atherosclerosis -
Neuropathy - Cataracts,
glaucoma
Term
Name four risk factors of
endometrial carcinoma
 Definition
1. Prolonged estrogen use 2.
Obesity 3. Diabetes 4. HTN
Term
Name four treatment
modalities for polycystic
ovarian syndrome
 Definition
- Weight loss - OCPs -
Gonadotropin analogs -
Surgery
Term
Name six risk factors of
breast disease
 Definition
1. Gender 2. Age 3. Early first
menarche (under 12) 4.
delayed first pregnancy (over
30) 5. Late menopause (over
50) 6. Family history of first
degree relative with breast
cancer at a young age.
Term
Name some of the acute
manifestations of Diabetes
Mellitus (DM)? (7)
 Definition
- Polydipsia - Polyuria -
Polyphagia - Weight loss -
DKA (type1) - Hyperosmolar
coma (type 2) - Unopposed
secretion of GH and Epi
(exacerbating hyperglycemia)
Term
Name syndrome: increased
LH due to peripheral estrogen
production leads to
anovulation and may manifest
in amenorrhea, infertility,
obesity, and hirsutism.
 Definition
Polycystic ovarian syndrome
Term
Name the autoimmune
hyperthyroidism with TSH
receptor antibodies,
opthalmopathy, pretibial
myxedema, and diffuse
goiter.
 Definition
Graves' disease
Term
Name the benign breast
tumor: most common tumor
under 25 years; small,
mobile, firm mass with sharp
edges.
 Definition
Fibroadenoma
Term
Name the benign breast
tumor: tumor of lactiferous
ducts; presents with nipple
discharge.
 Definition
Intraductal papilloma
Term
Name the benign breast
tumor: large, bulky mass of
connective tissue and cysts;
breast surface has 'leaflike'
appearance
 Definition
Cystosarcoma phyllodes
Term
Name the disease caused by
primary deficiency of
aldosterone and cortisol due
to adrenal atrophy
 Definition
Addison's disease
Term
Name the histologic type of
fibrocystic breast disease:
fluid-filled
 Definition
Cystic
Term
Name the histologic type of
fibrocystic breast disease:
hyperplasia of breast stroma.
 Definition
Fibrosis
Term
Name the histologic type of
fibrocystic breast disease:
increase in number of
epithelial cell layers in
terminal duct lobule
 Definition
Epithelial hyperplasia
Term
Name the histologic type of
fibrocystic breast disease:
increased acini and
intralobular fibrosis
 Definition
Sclerosing
Term
Name the histologic type of
malignant breast disease:
cheesy consistency of tumor
tissue due to central necrosis.
 Definition
Comedocarcinoma
Term
Name the histologic type of
malignant breast disease:
eczematous patches on
nipple.
 Definition
Paget's disease
Term
Name the histologic type of
malignant breast disease:
lymphatic involvement; poor
prognosis.
 Definition
Inflammatory
Term
Name the histologic type of
malignant breast disease:
most common carcinoma;
firm, fibrous mass
 Definition
Infiltrating ductal
Term
Name three characteristics of
inappropriate ADH secretion
(SIADH).
 Definition
1. Excessive water retention
2. Hyponatremia 3. Serum
hypo-osmolarity with urine
osmolarity > serum
osmolarity
Term
Name three fractures
commonly seen due to
osteoporosis
 Definition
1. Vertebral crush fractures 2.
Distal radius (Colle's)
fractures 3. Vertebral wedge
fractures
Term
Pheochromocytomas may be
associated with what 3
diseases?
 Definition
1. Neurofibromatosis 2. MEN
type II 3. MEN type III
Term
T/F A partial hydatiform mole
is commonly triploid or
tetraploid.
 Definition
True
Term
T/F DKA is common in Type 1
DM.
 Definition
True
Term
T/F DKA is common in Type 2
DM.
 Definition
False, rare
Term
T/F Endometriosis often
manifests with severe
menstrual-related pain and
often with infertility?
 Definition
True
Term
T/F Fibrocystic breast disease
usually does not indicate
increased risk of carcinoma.
 Definition
True
Term
T/F Genotype of a complete
hydatiform mole is 46, XX
and is purely maternal in
origin
 Definition
False, it is 46, XX and Purely
Paternal in origin
Term
T/F Glucose intolerance in
Type 1 DM is severe
 Definition
True
Term
T/F Insulin is always
necessary to treat Type 1 DM
 Definition
True
Term
T/F Insulin is always
necessary to treat Type 2 DM.
 Definition
False, sometimes
Term
T/F Leiomyomas often
present with multiple tumors.
 Definition
True
Term
T/F Leiomyomas often
transform into malignant
tumors.
 Definition
False, it is rare
Term
T/F Leiomyomas progress to
leiomyosarcomas
 Definition
False
Term
T/F Leiomyosarcomas: highly
aggressive, have a tendancy
to recur, and have an
increased incidence in blacks
 Definition
True
Term
T/F Risk of breast disease is
increased by fibroadenoma
and nonhyperplastic cysts
 Definition
False
Term
T/F Type 1 diabetes is often
associated with obesity.
 Definition
False
Term
T/F Type 1 diabetes is
polygenic and strongly due to
genetic disposition?
 Definition
False. It is polygenic and only
weakly associated with
genetic disposition, whereas
Type 2 is strongly associated
Term
T/F Women with endometrial
hyperplasia are at increased
risk for endometrial
carcinoma which tends to
manifest with vaginal
bleeding?
 Definition
True
Term
Urinary VMA levels and
plasma catecholamines are
elevated due to what
neoplasms
 Definition
Pheochromocytoma
Term
What are the clinical effects of
increased cortisol? (9)
 Definition
- hypertension - weight gain
- moon facies - truncal
obesity - buffalo hump -
hyperglycemia (insulin
resistance) - skin changes
(thinning striae) -
osteoporosis - immune
suppression
Term
What are the clinical effects of
primary hyperaldosteronism?
(4)
 Definition
- Hypertension -
Hypokalemia - Metabolic
alkalosis - Low plasma renin
Term
What are the episodic
hyperadrenergic symptoms (5
P's) due to
pheochromocytomas?
 Definition
Pressure - Pain (headache)
- Perspiration - Palpitations -
Pallor/diaphoresis
Term
What are the primary
hormonal causes of DM?
 Definition
Insulin deficiency (or
inefficiency) and glucagon
excess
Term
What are the six 'Rule of 10's'
associated with
pheochromocytomas
 Definition
- 10% Malignant - 10%
bilateral - 10% extraadrenal -
10% calcify - 10% kids - 10%
familial
Term
What are theorized causes for
Types 1 and 2 DM
 Definition
Type 1 - viral or immune
destruction of pancreatic beta
cells Type 2 - Increased
resistance to insulin
Term
What benign breast tumor
increases in size and
tenderness with pregnancy
 Definition
Fibroadenoma
Term
What breast disease is
common in postmenopausal
women and arises from
mammary duct epithilium or
lobular glands
 Definition
Malignant tumors (carcinoma
Term
What causes Cushing's
Syndrome
 Definition
Increased cortisol
Term
What causes sporadic
cretinism?
 Definition
Defect in T4 formation or
developmental failure in
thyroid formation
Term
What condition can produce all
these symptoms: cold
intolerance, hypoactivity, weight
gain, fatigue, lethargy, decreased
appetite, constipation, weakness,
decreased reflexes, myxedema
(facial/periorbital), dry, cool skin,
and coarse, brittle hair?
 Definition
Hypothyroidism
Term
What condition can produce
all these symptoms: heat
intolerance, hyperactivity,
weight loss, chest pain/
palpitations, arrhythmias,
diarrhea, increased reflexes,
warm, moist skin, and fine
hair?
 Definition
Hyperthyroidism
Term
What condition is associated
with the expressions
'honeycombed uterus' and
'cluster of grapes'
appearance?
 Definition
Hydatiform mole
Term
What condition is caused by
increased bone resorption
due to decreased estrogen
levels (seen postmenopausal
by 10-15 years)?
 Definition
Type 1 Osteoporosis
Term
What condition is
characterized by nonneoplastic
endometrial
glands/stroma in abnormal
locations outside the uterus?
 Definition
Endometriosis
Term
What disease is characterized
by intense thirst and polyuria
together with an inability to
concentrate urine with fluid
restriction owing to lack of
ADH or to a lack of renal
response to ADH. Caused by
lithium demeclocycline.
 Definition
diabetes insipidus
Term
What disease may be due to an
age-related increase in estradiol
with sensitization of the prostate
to the growth promoting effects
of DHT? It is characterized by
nodular enlargement of the
periurethral lobes of the prostate
gland compressing the urethra
into a vertical slit?
 Definition
Benign prostatic hyperplasia
Term
What diuretic acts as an
aldosterone antagonist used
to treat primary
hyperaldosteronism?
 Definition
Spironolactone
Term
What endocrine pathology
may produce these findings:
pot-bellied, pale, puffy-faced
child with protruding
umbilicus and protuberant
tongue?
 Definition
Cretinism
Term
What fractures cause acute
back pain, loss of height, and
kyphosis?
 Definition
Vertebral crush fractures
Term
What gynecologic tumor is
often bulky with areas of
necrosis and hemorrhage?
 Definition
Leiomyosarcoma
Term
What is a pathologic ovum
resulting in cystic swelling of
chorionic villi and
proliferation of chorionic
epithelium?
 Definition
Hydatiform mole
Term
What is an abnormal
endometrial gland
proliferation usually caused
by excess estrogen
stimulation?
 Definition
Endometrial hyperplasia
Term
What is the 'Rule of 1/3s' for
carcinoid tumors?
 Definition
1/3 metastasize 1/3 present
with second malignancy 1/3
multiple
Term
What is the etiology of
Cushing's Syndrome caused
by Cushing's disease
 Definition
Primary pituitary adenoma
Term
What is the etiology of
primary hyperaldosteronism
(Conn's syndrome)?
 Definition
An aldosterone-secreting
tumor
Term
What is the etiology of small
vessel disease due to DM?
 Definition
Diffuse thickening of the
basement membrane
Term
What is the most common
gynecologic malignancy, with
a peak age of 55-65 y/o?
 Definition
Endometrial carcinoma
Term
What is the most common of
all tumors in females?
 Definition
Leiomyoma
Term
What is the most common
site of ectopic endometrial
tissue?
 Definition
Ovary
Term
What is the most common
tumor of the adrenal medulla
in adults?
 Definition
Pheochromocytoma
Term
What is the most common
tumor of the adrenal medulla
in children?
 Definition
Neuroblastoma
Term
What is the most common
tumor of the appendix?
 Definition
Carcinoid tumor
Term
What is the pathophysiology
of secondary
hyperaldosteronism?
 Definition
Kidney perception of low
intravascular volume results
in an overactive reninangiotensin
system.
Term
What metabolic reaction is
responsible for the chronic
manifestations of DM?
 Definition
Nonenzymatic glycosylation
Term
What neoplasms secrete high
levels of serotonin (5HT) that
does not get metabolized by
the liver due to liver
metastases?
 Definition
Carcinoid tumors
(neuroendocrine cells)
especially of the small bowel
Term
What non-selective,
irreversible alpha blocker is
used to treat pts with
pheochromocytomas
 Definition
Phenoxybenzamine
Term
What phenotypic difference
can distinguish between
primary and secondary
causes of Addison's disease?
 Definition
Primary insufficiency results
in hyperpigmentation due to
increased MSH.
Term
What substance causes
cataract formation in DM
patients?
 Definition
Sorbitol accumulation
Term
What syndrome is caused by a
gastrin-secreting tumor that
is usually located in the
pancreas, causes recurrent
ulcers, and may be associated
with MEN type 1?
 Definition
Zollinger-Ellison syndrome
Term
What three organs (3 P's) are
involved in MEN type I?
 Definition
- Pancreas - Pituitary -
Parathyroid
Term
What type of respirations are
seen in diabetic ketoacidosis?
 Definition
Kussmaul respiration
Term
Where (and in what forms) is
small vessel disease from DM
seen most prominently?
 Definition
- Retinopathy - hemorrhage,
exudates, and
microaneurysms -
Nephropathy - nodular
sclerosis, progressive
proteinuria, chronic renal
failure, arteriosclerosis
leading to HTN
Term
Where does endemic
cretinism occur?
 Definition
Wherever endemic goiter is
prevalent (lack of dietary
iodine).
Term
Whether the complications of
diabetes Q. as it does is
 Definition
life threatening
mucormycosis, Rhizopus
infection, cerebral edema,
cardiac arrhythmias, heart
failure
Term
Which type of Multiple
Endocrine Neoplasia (MEN) is
associated with medullary
carcinoma of the thyroid,
pheochromocytoma, and oral
and intestinal
ganglioneuromatosis
(mucosal neuromas)?
 Definition
Type III (formerly MEN IIb)
Term
Which type of Multiple
Endocrine Neoplasia (MEN) is
associated with medullary
carcinoma of the thyroid,
pheochromocytoma,
parathyroid tumor, or
adenoma?
 Definition
Type II (Sipple's syndrome)
Term
Which type of Multiple
Endocrine Neoplasia (MEN) is
associated with pancreas (e.g.
ZE syndrome, insulinomas,
VIPomas), parathyroid and
pituitary tumors?
 Definition
Type I (Wermer's syndrome)
Term
Which type of osteoporosis
affects men and women over
70 y/o?
 Definition
Type 2 (Senile) Osteoporosis
Term
Why is intracellular
myoinositol depleted in DM?
 Definition
Hyperglycemia increases
intracellular sorbitol (which is
associated with depletion)
and may also directly inhibit
myoinositol uptake
Term
Will total T4, free T4, and T3
uptake be increased or
decreased (respectively) in
primary hyperthyroidism?
 Definition
All increased - Increased total
T4 - Increased free T4 -
Increased T3 uptake
Term
Will total T4, free T4, and T3
uptake be increased or
decreased (respectively) in
primary hypothyroidism?
 Definition
All decreased (remember: TSH
is increased) - Decreased
total T4 - Decreased free T4
- Decreased T3 uptake
Term
Will TSH be increased or
decreased in primary
hyperthyroidism?
 Definition
Increased
Term
Will TSH be increased or
decreased in primary
hypothyroidism?
 Definition
Increased
Term
Are most pericardial effusions
serous or hemorrhagic?
 Definition
serous
Term
Bacterial endocarditis of
which valve is associated with
IV drug abuse?
 Definition
Tricuspid
Term
Characterize EKG changes in
an MI
 Definition
ST elevation (transmural
ischemia) and Q waves
(transmural infarct)
Term
characterize the AST levels in
an MI
 Definition
elevated 1-3 days post MI.
Nonspecific enzyme found in
heart, liver, and skeletal
muscle
Term
Characterize the cardiac
troponin I levels in an MI.
 Definition
Elevated between 4 hrs. and
7-10 days post MI most
specific protein marker for MI
Term
Characterize the CK-MB
levels in an MI
 Definition
elevated in the first 24 hrs.
post MI
Term
Characterize the LDH1 levels
in an MI
 Definition
elevated from 2 to 7 days
post MI
Term
Describe a mitral prolapse
murmur?
 Definition
Most frequent valvular lesion,
esp. in young women. Late
systolic murmur ending with
2nd heart sound
Term
Describe a mitral
regurgitation murmur?
 Definition
High pitched holosystolic
(continuous sound
throughout systole)
Term
Describe a mitral stenosis
murmur
 Definition
Rumbling late diastolic
murmur when LA>>LV
during diastole. Begins in late
diastole
Term
Describe a vent. Septal defect
(VSD) murmur.
 Definition
holosystolic murmur
(continuous throughout
systole)
Term
Describe an aortic
regurgitation murmur
 Definition
high-pitched 'blowing'
murmur, beginning
immediately in diastole. Wide
pulse pressure
Term
Describe an aortic stenosis
murmur
 Definition
Crescendo-decrescendo
systolic murmur, with
LV>>aortic pressure
during systole. Follows an
'ejection click,' and ends
before 2nd heart sound
Term
Describe an patent ductus
arteriosus (PDA) murmur.
 Definition
Continuous machine-like
murmur. Loudest at the time
of 2nd heart sound
Term
Describe the bacterial
growths in subacute bact.
Endocarditis.
 Definition
Small vegetations on
congentially abnormal valves
Term
Describe the bacterial
growths of acute bact.
endocarditis?
 Definition
Large vegetations on previously normal valves
Term
Describe the onset of Staph.
Aureus endocarditis.
 Definition
rapid, acute onset
Term
Describe the onset of
Streptoccus viridans
endocarditis.
 Definition
Insidious, subacute onset
Term
During what weeks of
pregnancy does preeclampsia
present?
 Definition
20 weeks gestation to 6
weeks postpartum
Term
How can pericarditis
progress?
 Definition
It can resolve without scarring
or it can lead to chronic
adhesive or chronic
constrictive pericarditis
Term
How does atherosclerosis
progress?
 Definition
1. Fatty streaks in arteries 2.
Proliferative plaques 3.
Complex atheromas
Term
How does Prinzmental's
variant angina present?
 Definition
chest pain at rest
Term
How does stable angina
present?
 Definition
chest pain with exertion
Term
How does syphilis change the
aorta?
 Definition
Causes dilation of the aorta
and valve ring. Can result in
aortic aneurysm or aortic
valve incompetence
Term
How does unstable/crescendo
angina present?
 Definition
Worsening chest pain
Term
To what does HTN predispose
one?(5)
 Definition
Coronary heart dz, CVA, CHF,
renal dz, and aortic
dissection
Term
What are associations of
preeclampsia?(3)
 Definition
1. Hemolysis 2. Elevated LFT
(liver fxn test) 3. Low
platelets
Term
What are clinical features of
preeclampsia?(6)
 Definition
1. Headache 2. Blurred vision
3. Abdominal pain 4. Edema
of face and extremities 5.
Altered mentation 6.
Hyperreflexia
Term
What are complications from
an MI?(7)
 Definition
1. Card. Arrhythmia(90%) 2.
LV failure and pul. Edema
(60%) 3. Thromboembolism:
mural thrombus 4.
Cardiogenic shock 5. Physical
trauma 6. Fibrinous
pericarditis 7. Dressler's
syndrome
Term
What are complications of
bacterial endocarditis?(4)
 Definition
1. Chordae rupture 2.
Glomerulonephritis 3.
Suppurative pericarditis 4.
Emboli
Term
What are examples traumatic
MI complications?(4)
 Definition
1. Vent wall rupture 2.
Interventricular. Septum
rupture 3. Papillary muscle
rupture (4-10 days post-MI)
4. Cardiac tamponade (heart
compression)
Term
What are fat emboli
associated with?(2)
 Definition
Long bone fractures and
liposuction
Term
What are Janeway lesions?
 Definition
Small erythematous lesions
on palms or soles
Term
What are nonbacterial causes
of endocarditis?(2)
 Definition
Secondary to metastasis or
renal failure (marantic/
thrombotic endocarditis)
Term
What are olser nodes?
 Definition
tender raised lesions on
finger or toe pads
Term
What are possible
manifestations of ischemic
heart disease?(4)
 Definition
1. Angina(CAD narrowing>
75%) 2. Myocardial infarction
3. Sudden cardiac death 4.
Chronic ischemic heart
disease
Term
What are risk factors for
hypertension?(6)
 Definition
Increased age, obesity,
diabetes, smoking, genetics,
race
(black>white>asian)
Term
What are Roth's spots?
 Definition
round white spots on retina
surrounded by hemorrhage
Term
What are some
atherosclerosis symptoms?
 Definition
Agina and claudication. Can
be asymptomatic
Term
What are some risk factors for
preecalmpsia?(4)
 Definition
1. Preexisting HTN 2.
Diabetes 3. Chronic renal dz
4. Autoimmune dz
Term
What are the 2 major causes
of HTN?
 Definition
1.Primary (essential) HTN,
related to ?CO and ?TPR 2.
Secondary HTN, usually
related to renal dz
Term
What are the 3 most common
sites of an MI?
 Definition
LAD>RCA>circumflex
Term
What are the 3 types of
angina in ischemic heart dz?
 Definition
stable angina, prinzmetal's
variant, and unstable/
crescendo
Term
What are the 7 types of heart
murmurs?
 Definition
1. Aortic stenosis 2. Aortic
regurgitation 3. Mitral
stenosis 4. Mitral
regurgitation 5. Mitral
prolapse 6. Vent. Septal
defect 7. Patent ductus
arteriosus
Term
What are the causes/
associations of cardiogenic
shock?
 Definition
A large infarct with a high
incidence of mortality
Term
What are the complications of
atherosclerosis?(6)
 Definition
aneurisms, ischemia, infarcts,
peripheral vasc dz thrombus,
and emboli
Term
What are the etiologies of
dilated cardiomyopthy? (6)
 Definition
1. Chronic alcohol abuse 2.
Beriberi (wet) 3. Coxacke
virus B postviral myocarditis
4. Cocaine use 5. Chagas dz.
6. Doxirubicin toxicity
Term
What are the finding in
temporal arteritis?
 Definition
1. Unilateral headache 2. Jaw
claudication 3. Impaired
vision 4. Systemic
involvement with polymyalgia
rheumatica (in 50% of
patients)
Term
What are the findings in
Buerger's dz?
 Definition
Intermittent claudication,
superficial nodular phlebitis,
cold sensitivity (Raynauld's
phenom.), severe pain in
affected part; may lead to
gangrene.
Term
What are the findings in
pericarditis?(4)
 Definition
1. Pericardial pain 2. Friction
rub 3. EKG changes 4. Pulsus
paradoxicus
Term
What are the findings of
Wegener's granulomatosis?(3)
 Definition
1. C-ANCA positive 2. CXR
reveals large nodular lesions
3. Hematuria and red cell
casts
Term
What are the major causes of
restrictive/obliterative
cardiomyopathy?(4)
 Definition
1. Sarcoidosis 2. Amyloidosis
3. Endocardial fibroelastosis
4. Endomyocardial fibrosis
(Loffler's)
Term
What are the possible lab
findings in preeclampsia?(2)
 Definition
thrombocytopenia and
hyperuricemia
Term
What are the risk factors of
atherosclerosis?(4)
 Definition
smoking, HTN, diabetes
mellitus, and hyperlipidemia
Term
What are the signs and symp
of rheumatic fever or
rheumatic heart dz?(7)
 Definition
1. Fever 2. Erythema
marginatum 3. Valvular
damage 4. ESR increase 5.
Polyarthritis 6. Subcutaneous
nodules 7. Chorea
Term
What are the signs and symp.
of bacterial endocarditis?(8)
 Definition
JR= NO FAME 1. Janeway
lesions 2. Roth's spots 3. Nail
bed hemorrhages 4. Osler
nodes 5. Fever 6. Anemia 7.
Murmur 8. Emobli
Term
What are the signs of
polyarteritis nodosa?(7)
 Definition
1. Cotton wool spots 2.
Microaneurysms 3.
Pericarditis 4. Myocarditis 5.
Palpable purpura 6. Elevated
ESR 7. P-ANCA positive
serum
Term
What are the symptoms of a
pulmonary embolus? (3)
 Definition
Chest pain, tachypnea, and
dyspnea
Term
What are the symptoms of an
MI?(5)
 Definition
Severe retrosternal pain, pain
in left arm or jaw, shortness
of breath, fatigue, and
adrenergic symptoms
Term
What are the symptoms of
polyarteritis nodosa?(6)
 Definition
fever, weight loss, malaise,
abdominal pain, myalgia, and
HTN
Term
What are the symptoms of
Takaysu's arteritis?(6)
 Definition
Fever, arthritis, night sweats,
myalgia, and skin nodules
Term
What are the symptoms of
Wegeners granulomatosis? (7)
 Definition
1. Perforation of nasal
septum 2. Chronic sinusitis 3.
Otitis media 4. Mastoiditis 5.
Cough 6. Dyspnea 7.
Hemoptysis
Term
What are the types of emboli?
(6)
 Definition
1. Fat 2. Air 3. Thrombus 4.
Bacteria 5. Amniotic fluid 6.
Tumor
Term
What can cause pericarditis?
(4)
 Definition
1. Infection 2. Ischemic heart
dz 3. Chronic renal failure
leading to uremia 4.
Connective tissue dz
Term
What causes acute bact.
Endocarditis?
 Definition
Staphyloccus aureus
Term
What causes cardiac dilation
in CHF?
 Definition
greater ventricle enddiastolic
volume
Term
What causes dyspnea on
exertion in CHF?
 Definition
failure of LV output to
increase during exercise
Term
What causes hepatomegaly in
CHF?
 Definition
increased central venous
press.?increased resistance
to portal flow. Rarely leads to
'cardiac cirrhosis.'
Term
What causes othopenea
(dyspnea when supine) in
CHF?
 Definition
Pooling of blood in lungs
when supine adds volume to
congested pul. Vasculature
system; increased venous
return not put out by left
ventricle.
Term
What causes Paroxysmal
nocturnal dyspnea and
pulmonary edema in CHF?
 Definition
Failure of left heart to keep
up with rt. Heart output ?
acute rise pul. Venous and
capillary press. ? transudation
of fluid
Term
What causes prinzmental's
variant angina?
 Definition
coronary artery spasm
Term
What causes pulmonary
congestion in CHF?
 Definition
LV failure?increased pul.
Venous press.? pul. Venous
distention and transudation
of fluid. Presence of
hemosiderin-laden
macrophages (heart failure
cells).
Term
What causes pulmonary
emboli?
 Definition
95% of pulmonary emboli
arise from deep leg veins
Term
What causes rheumatic fever?
 Definition
Pharyngeal infection with
group A, ? hemolytic
streptococci leads to cross
reactivity with self (not due to
direct effects of bacteria)
Term
What causes stable angina?
 Definition
atherosclerosis
Term
What causes sudden cardiac
death?
 Definition
Most commonly from lethal
arrhythmia
Term
What causes the edema seen
in CHF?
 Definition
RV failure?increased venous
press.? fluid transudation
Term
What causes unstable/
crescendo angina?
 Definition
thrombosis in a branch of the
coronary artery
Term
What happens 2-4 days after
an MI?(5)
 Definition
1. Infarct appears pale 2.
Tissue surrounding infarct
shows acute inflammation 3.
Dilated vessels (hyperemia) in
infarct 4. Neutrophil
emigration 5. Extensive
coagulative necrosis
Term
What happens 5-10 days
after an MI?(4)
 Definition
1. A hyperemic boarder forms
around the infarct 2. The infarct
shows central softening with
brown/yellow color 3. An outer
zone (ingrowth of granulation
tissue) forms around infarct 4.
Neutrophils and macrophages
infiltrate infarcted tissue
Term
What happens by 7 weeks
post-MI?(3)
 Definition
1. The Occluded artery
causing the MI is recanalized
2. The infarct area is gray/
white 3. The infarcted tissue
shows contracted, complete
scarring
Term
What happens to contractility,
cardiac output, and effective
atrial blood volume in CHF?
 Definition
all decrease
Term
What happens to renal blood
flow in CHF?
 Definition
decreases
Term
What happens to renin,
angiotensin II, and
aldosterone in CHF
 Definition
all increase
Term
What happens to sympathetic
nervous activity in CHF?
 Definition
increases
Term
What happens to the heart 1
day after an MI?(5)
 Definition
1. Appearance of a pale
infarcted area 2. Coagulative
necrosis in the infarct 3.
Release of necrotic cells in
the blood 4. Beginning of
neutrophil emigration 5.
Artery supplying infarcted
tissue is occluded
Term
What happens to urinary
excretion of water and Na in
CHF?
 Definition
decrease
Term
What happens to venous
pressure in CHF?
 Definition
increases
Term
What histologic part of the
aorta is affected by syphilis?
 Definition
vasa vasorum
Term
What is 'pulseless disease'?
 Definition
Takayasu's arteritis
Term
What is a red infarct?
 Definition
A hemorrhagic infarct
associated with reperfusion
of infarcted tissue
Term
What is an association of
polyarteritis nodosa?
 Definition
Hepatitis B infection (30% of
patients)
Term
What is Buerger's disease?
 Definition
Known as smoker's disease
and thromboangitis
obliterans; idiopathic,
segmental, thrombosing
vasculitis of intermediate and
small peripheral arteries and
veins.
Term
What is chronic ischemic
heart dz?
 Definition
Progressive onset of CHF over
several years due to chronic
ischemic myocardial damage
Term
What is Dressler's syndrome?
 Definition
an autoimmune phenomenon
resulting in fibrinous
pericarditis several weeks
post-MI
Term
What is eclampsia?
 Definition
The addition of seizures to
the preeclampsia triad
Term
What is fibrinous pericarditis?
 Definition
A friction rub of the
pericardium usually 3-5 days
post-MI
Term
What is hypertrophic
cardiomyopathy (formerly
IHSS: idiopathic hypertrophic
subaortic stenosis)?
 Definition
Familial hypertrophy, usually
asymmetric, involving the
interventricular septum
Term
What is polyarteritis nodosa?
 Definition
Necrotizing immune complex
inflammation of small or
medium-sized muscular
arteries, typically involving
renal or visceral vessels.
Term
What is preeclampsia?
 Definition
A triad of HTN, protenuria,
and edema that occurs in
pregnancy
Term
What is sudden cardiac death?
 Definition
death from cardiac causes
within 1 hr. of onset of
symptoms
Term
What is Takayasu's arteritis?
 Definition
Thickening of aortic arch and
proximal great vessels
causing weak pulses in
extremities and ocular
disturbances.
Term
What is temporal arteritis?
 Definition
Vasculitis that affects medium
and small arteries, usually
branches of the carotid
artery.
Term
What is the appearance of a
heart with hypertrophic
cardiomyopathy?
 Definition
Walls of LV are thickened,
chamber becomes banana
shaped on echocardiogram
Term
What is the appearance of an
aorta affected by syphilis?
 Definition
Tree bark appearance
Term
What is the incidence of
preeclampsia?
 Definition
7% of pregnant women
Term
What is the inheritance
pattern of hypertrophic
cardiomyopathy?
 Definition
AD
Term
What is the most common
cardiomyopathy?
 Definition
Dilated (congested)
cardiomyopathy (90%)
Term
What is the most common
heart tumor
 Definition
metastases
Term
What is the most common
primary cardiac tumor in
adults?
 Definition
Myxoma
Term
What is the most common
primary cardiac tumor in
children
 Definition
rhabdomyoma
Term
What is the most common
vasculitis?
 Definition
temporal arteritis
Term
What is the treatment for
Buerger's dz?
 Definition
stop smoking
Term
What is the treatment for
temporal arteritis?
 Definition
Responds well to steroids
Term
What is the treatment of
eclampsia?
 Definition
IV Magnesium sulfate and
diazepam This is a medical
emergency
Term
What is the treatment of
polyarteritis nodosa?
 Definition
Corticosteroids, azathioprine,
and/or cyclophosphamide
Term
What is the treatment of
preeclampsia?
 Definition
Deliver the fetus ASAP.
Otherwise rest, salt
restriction, treatment of HTN
Term
What is the treatment of
wegener's granulomatosis?
 Definition
cyclophosphamide,
corticosteroids, and/or
methotrexate
Term
What is the x-ray appearance
of a heart with dilated
myopathy?
 Definition
Dilated: looks like a balloon
Term
What is Wegner's
granulomatosis?
 Definition
Focal necrotizing vasculitis
and granulomas in the lung
and upper airway with
necrotizing
glomerulonephritis
Term
What kind of effusions are
found in pericarditis
associated with TB or
malignancy?
 Definition
hemorrhagic
Term
What kind of effusions are
found in pericarditis
associated with renal failure?
 Definition
Serous of fibrinous
Term
What lab finding is seen in
Takayasu's arteritis or
temporal arteritis?
 Definition
elevated ESR
Term
What part of the heart/
vasculature can be damaged
by syphilis?
 Definition
Aortic root and ascending
aorta
Term
What percentage of HTN is
primary?
 Definition
90%
Term
What percentage of HTN is
secondary?
 Definition
10%
Term
What population is associated
with death from hypertrophic
cardiomyopathy?
 Definition
young athletes
Term
What predisposes one to deep
vein thromosis?(3)
 Definition
Virchow's triad: 1. Stasis 2.
Hypercoagulability 3.
Endothelial damage
Term
What stage of syphilis can
affect the heart?
 Definition
tertiary
Term
What symptoms are
associated with CHF?(8)
 Definition
1. Ankle and sacral edema 2.
Hepatomegaly (nutmeg liver)
3. Pulmonary congestion 4.
Dyspnea on exertion 5.
Paroxysmal nocturnal
dyspnea 6. Pulmonary edema
7. Orthopnea (dyspnea when
supine) 8. Cardiac dilation
Term
What tests are used to
diagnose an MI?(5)
 Definition
1. EKG (the gold standard) 2.
Cardiac troponin I 3. CK-MB
4. LDH1 5. AST
Term
What type of bacterial
endocarditis is associated
with dental procedures?
 Definition
Subacute endocarditis from
Strep. Viridans infection
Term
What type of embolus is
associated with DIC?
 Definition
amniotic fluid, especially
postpartum
Term
What types of infections
cause pericarditis?
 Definition
Viruses, TB, pyogenic
bacteria; often by direct
spread from lung or
mediastinal lymph node
Term
What visual complication can
temporal arteritis cause?
 Definition
occlusion of ophthalmic
artery leading to blindness
Term
Where do myxomas occur?
 Definition
90% occur in the atria, mostly
LA. Myxomas are described
as a 'ball valve' obstruction.
Term
Where do pale infarcts occur?
 Definition
Solid tissues with single
blood supply: brain, heart,
kidneys, and spleen
Term
Where do red infarcts occur?
 Definition
Loose tissue with collaterals:
lungs or intestine
Term
Where does a MI usually
occur?
 Definition
In the left anterior
descending coronary artery
Term
Where histologically does
atherosclerosis occur?
 Definition
The elastic arteries and
medium to large muscular
arteries
Term
Where, anatomically, does
atherosclerosis most occur?
(4)
 Definition
abdominal aorta>coronary
art>popliteal art>carotid
art
Term
Which valve is most
frequently involved in
bacterial endocarditis?
 Definition
Mitral
Term
Which valves are most
affected by rheumatic heart
dz?
 Definition
mitral>aortic>>tricus
pid (high pressure valves
most affected)
Term
Who gets Takayasu's arteritis?
 Definition
Primarily affects young Asian
females
Term
Who gets temporal arteritis?
 Definition
Affects elderly females
Term
Define renal failure.
 Definition
Failure to make urine and
excrete nitrogenous wastes
Term
How do you calculate anion
gap?
 Definition
Na-(Cl + HCO3) = 8-12 mEq/
L
Term
How do you treat minimal
change disease?
 Definition
Responds well to steroids
Term
How does acute
poststreptococcal
glomerulonephritis resolve?
 Definition
Spontaneously
Term
How does renal cell
carcinoma spread
metastically?
 Definition
Invades the IVC and spreads
hematogenously
Term
How does transitional cell
carcinoma present?
 Definition
Hematuria
Term
How does Wilms' tumor
present?
 Definition
Huge, palpable flank mass
Term
In what epidemiological
group is renal cell carcinoma
most common?
 Definition
Men ages 50-70
Term
T/F: Ammonium magnesium
phosphate kidney stones are
radiopaque
 Definition
TRUE
Term
T/F: Calcium kidney stones
are radiopaque.
 Definition
TRUE
Term
T/F: Calcium kidney stones
do not recur.
 Definition
FALSE
Term
T/F: Cystine kidney stones
are radiopaque.
 Definition
FALSE, cystine stones are
radiolucent
Term
T/F: Transitional cell
carcinoma is cured by
surgical removal.
 Definition
False, transitional cell
carcinoma often recurs after
removal
Term
T/F: Uric acid kidney stones
are radiopaque
 Definition
FALSE, uric acid stones are
radiolucent
Term
What additional sx are seen in
a pt with acute streptococcal
glomerulonephritis?
 Definition
Peripheral and periorbital
edema
Term
What age group is
poststreptococcal
glomerulonephritis most
common?
 Definition
Children
Term
What are 4 causes of
hypoventilation?
 Definition
1. Acute lung disease 2.
Chronic lung disease 3.
Opioids, narcotics, sedatives
4. Weakening of respiratory
muscles
Term
What are the 2 forms of renal
failure?
 Definition
Acute and chronic
Term
What are the 2 main
symptoms present in
Goodpasture's syndrome?
 Definition
Hemoptysis, hematuria
Term
What are the 4 major types of
kidney stones?
 Definition
1. Calcium 2. Ammonium
magnesium phosphate 3. Uric
acid 4. Cystine
Term
What are the 5 nephritic
syndromes?
 Definition
Acute poststreptococcal
glomerulonephritis Rapidly
progressive (crescentic)
glomerulonephritis
Goodpasture's syndrome
Membranoproliferative
glomerulonephritis Berger's
disease
Term
What are the 5 nephrotic
syndromes?
 Definition
1. Membranous
glomerulonephritis 2. Minimal
change disease (lipoid
nephrosis) 3. Focal segmental
glomerular sclerosis 4.
Diabetic nephropathy 5. SLE
Term
What are the causes and
signs of calcium ion
deficiency?
 Definition
-Kids- rickets -Adultsosteomalacia
-Contributes to
osteoporosis -Tetany
Term
What are the causes and
signs of phosphate toxicity?
 Definition
-Low serum calcium ion -can
cause bone loss -renal stones
Term
What are the causes of
chloride ion deficiency?
 Definition
Secondary to emesis,
diuretics, renal disease
Term
What are the causes of
metabolic acidosis?
 Definition
-Diabetic ketoacidosis -
Diarrhea -Lactic Acidosis -
Salicylate OD -Acetazolamide
OD
Term
What are the causes of
respiratory acidosis?
 Definition
-COPD -Airway obstruction
Term
What are the causes of
respiratory alkalosis?
 Definition
-High altitude -
Hyperventilation
Term
What are the characteristics
of acute poststreptococcal
glomerulonephritis seen with
immunofluorescence?
 Definition
Granular pattern
Term
What are the characteristics
of acute poststreptococcal
glomerulonephritis seen with
the electron microscope?
 Definition
Subepithelial humps
Term
What are the characteristics
of acute poststreptococcal
glomerulonephritis seen with
the light microscope?
 Definition
Glomeruli enlarged and
hypercellular neutrophils
'lumpy-bumpy'
Term
What are the characteristics
of rapidly progressive
(crescentic)
glomerulonephritis seen on
LM and IF?
 Definition
Crescent-moon shape
Term
What are the clinical features
of renal cell carcinoma?
 Definition
-Hematuria -Palpable mass -
Secondary polycythemia -
Flank pain -Fever
Term
What are the clinical
symptoms of a nephritic
syndrome?
 Definition
I' = inflammation; hematuria,
hypertension, oligouria,
azotemia
Term
What are the clinical
symptoms of nephrotic
syndromes?
 Definition
O = proteinuria
Hypoalbuminuria Generalized
edema Hyperlipidemia
Term
What are the consequences of
renal failure?
 Definition
1. Anemia 2. Renal
osteodystrophy 3.
Hyperkalemia 4. Metabolic
acidosis 5. Uremia 6. Sodium
and water excess 7. Chronic
pyelonephritis 8. HTN
Term
What are the factors
associated metabolic
alkalosis?
 Definition
-Increased pH -Increased
PCO2 -Increased HCO3-
Term
What are the factors
associated with metabolic
acidosis?
 Definition
-Decreased pH -Decreased
PCO2 -Decreased HCO3-
Term
What are the factors
associated with respiratory
acidosis?
 Definition
-Decreased pH -Increased
PCO2 -Increased HCO3-
Term
What are the factors
associated with respiratory
alkalosis?
 Definition
-Increased pH -Decreased
PCO2 -Decreased HCO3-
Term
What are the functions of
calcium ion?
 Definition
-Muscle contraction -
Neurotransmitter release -
Bones, teeth
Term
What are the functions of
sodium ion?
 Definition
-Extracellular fluid -Maintains
plasma volume -Nerve/
muscle function
Term
What are the functions of the
chloride ion?
 Definition
-Fluid/electrolyte balance -
Gastric acid -HCO3/Cl shift in
RBC
Term
What are the functions of the
magnesium ion?
 Definition
-Bones, teeth -Enzyme
cofactor
Term
What are the functions of the
phosphate ion?
 Definition
-ATP -nucleic acids -
Phosphorylation -Bones,
teeth
Term
What are the functions of the
potassium ion?
 Definition
-Intracellular fluid -Nerve/
muscle function
Term
What are the signs of
magnesium ion deficiency?
 Definition
-Diarrhea -Alcoholism
Term
What are the signs of
magnesium ion toxicity?
 Definition
-Decreased reflexes -
Decreased respirations
Term
What are the signs of
phosphate deficiency?
 Definition
-Kids- rickets -Adultsosteomalacia
Term
What are the signs of
potassium ion toxicity?
 Definition
-EKG changes -Arrhythmia
Term
What bugs cause ammonium
magnesium phosphate kidney
stones?
 Definition
Urease-positive bugs such as
Proteus vulgaris or
Staphylococcus
Term
What calcium molecules form
calcium kidney stones?
 Definition
Calcium oxalate or calcium
phosphate or both
Term
What can excess Na and
water cause?
 Definition
CHF and pulmonary edema
Term
What can the hyperkalemia
associated with renal failure
lead to?
 Definition
Cardiac arrhythmias
Term
What causes metabolic
alkalosis?
 Definition
1. Vomiting 2. Diuretic use 3.
Antacid use 4.
Hyperaldosteronism
Term
What causes renal
osteodystrophy?
 Definition
Failure of active vitamin D
production
Term
What characteristics of
Berger's disease are seen with
IF and EM?
 Definition
Mesangial deposits of IgA
Term
What characteristics of focal
segmental glomerular
sclerosis are seen with the
LM?
 Definition
Segmental sclerosis and
hyalinosis
Term
What characteristics of
Goodpasture's syndrome are
seen with IF?
 Definition
Linear pattern Antiglomerular
basement
membrane antibodies
Term
What characteristics of
Membranoproliferative
glomerulonephritis are seen
with the EM?
 Definition
subendothelial humps 'tram
track'
Term
What characteristics of
membranous
glomerulonephritis are seen
with IF?
 Definition
Granular pattern
Term
What characteristics of
membranous
glomerulonephritis are seen
with the EM?
 Definition
Spike and Dome'
Term
What characteristics of
membranous
glomerulonephritis are seen
with the LM?
 Definition
Diffuse capillary and
basement membrane
thickening
Term
What characteristics of
minimal change disease are
seen with the EM?
 Definition
Foot process effacement
Term
What characteristics of
minimal change disease are
seen with the LM?
 Definition
Normal glomeruli
Term
What characteristics of SLE
are seen with the LM?
 Definition
Wire-loop appearance with
extensive granular
subendothelial basementmembrane
deposits in
membranous
glomerulonephritis pattern
Term
What defines metabolic
acidosis?
 Definition
-pH less than 7.4 -PCO2 less
than 40 mm Hg
Term
What defines metabolic
alkalosis with compensation?
 Definition
-pH greater than 7.4 -PCO2
greater than 40 mm Hg
Term
What defines respiratory
acidosis?
 Definition
-pH less than 7.4 -PCO2
greater than 40mm Hg
Term
What defines respiratory
alkalosis?
 Definition
-pH greater than 7.4 -PCO2
less than 40 mm Hg
Term
What diseases often cause
uric acid kidney stones?
 Definition
Diseases with increased cell
proliferation and turnover,
such as leukemia and
myeloproliferative disorders
Term
What disorders can lead to
hypercalcemia and thus
kidney stones?
 Definition
1. Cancer 2. Increased PTH 3.
Increased vitamin D 4. Milkalkali
syndrome
Term
What disorders cause an
increased anion gap?
 Definition
1. Renal failure 2. Lactic
acidosis 3. Ketoacidosis (DM)
4. Aspirin ingestion
Term
What disorders cause
metabolic acidosis and
normal anion gap?
 Definition
1. Diarrhea 2. Glue sniffing 3.
Renal tubular acidosis 4.
Hyperchloremia
Term
What disorders make up the
WAGR complex?
 Definition
Wilms' tumor Aniridia
Genitourinary malformation
mental-motor Retardation
Term
What does potassium
deficiency cause?
 Definition
-Weakness -Paralysis -
Confusion
Term
What factors are associated
with transitional cell
carcinoma?
 Definition
Exposure to
cyclophosphamide, smoking,
phenacetin, and aniline dyes
Term
What genetic disorder and
mutation are associated with
renal cell carcinoma?
 Definition
Renal cell carcinoma is
associated with von Hippel-
Lindau and gene deletion in
chromosome 3
Term
What genetic disorder is
associated with Wilms' tumor?
 Definition
Deletion of tumor
suppression gene WT-1 on
chromosome 11
Term
What is a common cause of
adult nephrotic syndrome?
 Definition
Membranous
glomerulonephritis
Term
What is acute renal failure
often due to?
 Definition
Hypoxia
Term
What is Berger's disease?
 Definition
IgA nephropathy -Mild
disease -Often postinfectious
Term
What is chronic failure due to?
 Definition
HTN and diabetes
Term
What is the 2nd most
common type of kidney
stone?
 Definition
Ammonium magnesium
phosphate
Term
What is the cause of
magnesium ion deficiency?
 Definition
Secondary to malabsorption
Term
What is the cause of
metabolic alkalosis?
 Definition
Vomiting
Term
What is the cause of
potassium ion deficiency?
 Definition
Secondary to injury, illness or
diuretics
Term
What is the cause of sodium
deficiency?
 Definition
Secondary to injury or illness
Term
What is the compensatory
mechanism of metabolic
alkalosis?
 Definition
Hypoventilation
Term
What is the compensatory
mechanism of respiratory
alkalosis?
 Definition
Renal HCO3- secretion
Term
What is the compensatory
response to metabolic
acidosis?
 Definition
Hyperventilation
Term
What is the compensatory
response to respiratory
acidosis?
 Definition
Renal HCO3- reabsorption
Term
What is the course of
membranoproliferative
glomerulonephritis?
 Definition
Slowly progresses to renal
failure
Term
What is the course of rapidly
progressive (crescentic)
glomerulonephritis?
 Definition
Rapid course to renal failure
from one of many causes
Term
What is the Henderson-
Hasselbalch equation?
 Definition
pH = pKa + log [(HCO3-)/
(0.03*PCO2)]
Term
What is the most common
cause of childhood nephrotic
syndrome?
 Definition
Minimal change disease
(lipoid nephrosis)
Term
What is the most common
renal malignancy of early
childhood (ages 2-4)?
 Definition
Wilms' tumor
Term
What is the most common
renal malignancy?
 Definition
Renal cell carcinoma
Term
What is the most common
tumor of the urinary tract
system?
 Definition
Transitional cell carcinoma
Term
What is the primary
disturbance in respiratory
acidosis?
 Definition
Increased PCO2
Term
What is the primary
disturbance of metabolic
acidosis?
 Definition
HCO3- decrease
Term
What is the primary
disturbance of metabolic
alkalosis?
 Definition
Increased HCO3-
Term
What is the primary
disturbance of respiratory
alkalosis?
 Definition
Decreased PCO2
Term
What is the sign of calcium
ion toxicity?
 Definition
Delirium
Term
What is the sign of sodium
ion toxicity?
 Definition
Delirium
Term
What lesions are seen on the
LM in diabetic nephropathy?
 Definition
Kimmelstiel-Wilson lesions
Term
What might an elevated anion
gap indicate?
 Definition
MUD PILES 1. Methanol 2.
Uremia (chronic renal failure)
3. Diabetic ketoacidosis 4.
Paraldehyde or Phenformin 5.
Iron tablets or INH 6. Lactic
acidosis (CN-, CO, shock) 7.
Ethanol or Ethylene glycol 8.
Salicylates
Term
What paraneoplastic
syndromes are associated
with renal cell carcinoma?
 Definition
Ectopic EPO, ACTH, PTHrP,
and prolactin
Term
What severe complications
may kidney stones lead to?
 Definition
Hydronephrosis
Pyelonephritis
Term
What social factor increases
the incidence of renal cell
carcinoma?
 Definition
Smoking
Term
What type of hypersensitivity
contributes to the
pathogenesis of
Goodpasture's syndrome?
 Definition
Type II hypersensitivity
Term
Where can transitional cell
carcinoma occur?
 Definition
-Renal calyces -Renal pelvis -
Ureters -Bladder
Term
Where does renal cell
carcinoma originate?
 Definition
Renal tubule cells, polygonal
clear cells
Term
Which kidney stone is often
secondary to cystinuria?
 Definition
Cystine
Term
Which kidney stone is
strongly associated with
gout?
 Definition
Uric acid kidney stones
Term
Which of the nephrotic
syndromes are worse in HIV
pts?
 Definition
Focal segmental glomerular
sclerosis
Term
Which type of kidney stones
constitute the majority of
kidney stones (80-85%)?
 Definition
Calcium
Term
Why are ammonium
magnesium phosphate kidney
stones often associated with
UTIs?
 Definition
Ammonium magnesium
phosphate stones can form
large struvite calculi that can
be a nidus for UTIs
Term
Why does renal failure cause
anemia?
 Definition
Failure of EPO production
Term
Why does renal failure cause
metabolic acidosis?
 Definition
Due to decreased acid
secretion and decreased
generation of HCO3-
Term
Define/Describe Alcoholism:
 Definition
-Physiologic tolerance and
dependence with syptoms of
withdrawal when intake is
interrupted. -Continued
drinking despite medical and
social contraindications and
life disruptions.
Term
In alcoholics, what causes
Wernicke-Korsakoff
syndrome?
 Definition
Vitamin B1 (thiamine)
deficiency
Term
Is Korsakoff's syndrome
reversible?
 Definition
NO
Term
Wernicke-Korsakoff
syndrome is associated with
periventricular hemorrage/
necrosis in which part of
brain?
 Definition
Mamillary bodies
Term
What are the accompanying
symptomes of Alcoholic
cirrhosis?
 Definition
-Jaundice -Hypoalbuminemia
-Coagulation factor
deficiencies -Portal
hypertension -Peripheral
edema and ascites -
Encephalopathy -Neurologic
manifestations (e.g., asterixis,
flapping tremor of the hands)
Term
What are the bodily effects of
ethanol? (3)
 Definition
-Toxicity (especially in the
brain) -Fatty liver -Increased
NADH/HAD
Term
What are the effects of
increased NADH/NAD (from
ethanol use)? (4)
 Definition
-Increases lactate/pyrubate -
Inhibits gluconeogenesis -
Inhibits fatty acid oxidation -
Inhibits glycerophosphate
dehydrogenase leading to
elevated glycerophosphate
Term
What are the long term
consequences of alcohol use?
 Definition
-Alcoholoic hepatitis and
cirrhosis -Pancreatitis -Dilated
cardiomyopathy -Peripheral
neuropathy -Cerebellar
degeneration -Wernicke-
Korsakoff syndrome -Testicular
atrophy and hypertension -
Mallory-Weiss syndrome
Term
What are the symptoms of
alcohol withdrawel?
 Definition
-tremor -tachycardia -
hypertension -malaise -
nausea -delerium tremens
Term
What is Korsakoff's
syndrome?
 Definition
Progression of Wernicke's
encephalopathy to memory
loss, confabulation, and
confusion
Term
What is Mallory-Weiss
syndrome?
 Definition
Longitudinal lacerations at
the gastroesophageal
junction caused by excessive
vomitting with failure of
Lower Esophageal Sphincter
relaxation that could lead to
fatal hematemesis.
Term
What is the treatment for
Wernicke-Korsakoff
syndrome?
 Definition
IV vitamin B1 (thiamine)
Term
What is the triad of symptoms
for Wernicke's
encephalopathy?
 Definition
1. Psychosis 2.
Ophthalmoplegia 3. Ataxia
Term
What supportive group has
been mose successful in
sustaining abstinence?
 Definition
Alcoholics Anonymous
(sorry… it was in the book :)
Term
What treatment is used to
condition the patient
negatively against alcohol
use?
 Definition
Disulfiram
Term
Actinic keratosis
 Definition
Often precedes squamous cell
carcinoma
Term
Addison's
 Definition
Autoimmune (infection is the
second most common cause)
Term
Albumino-cytologic
dissociation
 Definition
Guillain-Barre (increased
protein in CSF with only
modest increase in cell count)
Term
Aneurysm, dissecting
 Definition
HTN
Term
Anti-basement membrane
 Definition
Goodpasture's syndrome
Term
Anti-centromere antibodies
 Definition
Scleroderma (CREST)
Term
Anti-double-stranded-DNA
antibodies (ANA antibodies)
 Definition
SLE (type III hypersensitivity)
Term
Anti-epithelial cell
 Definition
Pemphigus vulgaris
Term
Anti-gliadin antibodies
 Definition
Celiac disease
Term
Anti-histone Antibodies
 Definition
Drug-induced SLE (cf. SLE)
Term
Anti-IgM antibodies
 Definition
Rheumatoid arthritis
Term
Anti-mitochondrial
antibodies
 Definition
Primary biliary cirrhosis
Term
Anti-neutrophil antibodies
 Definition
Vasculitis
Term
Antiplatelet antibodies
 Definition
Idiopathic thrombocytopenic
purpura
Term
Aortic aneurysm, abdominal
& descending aorta
 Definition
Atherosclerosis
Term
Aortic aneurysm, ascending
 Definition
Tertiary syphilis
Term
Arachnodactyly
 Definition
Marfan's syndrome
Term
Argyll-Robertson pupil
 Definition
Neurosyphilis
Term
Aschoff bodies
 Definition
Rheumatic fever
Term
Atrophy of the mamillary
bodies
 Definition
Wernicke's encephalopathy
Term
Auer rods
 Definition
Acute myelogenous leukemia
(especially the promyelocytic
type)
Term
Autosplenectomy
 Definition
Sockle cell anemia
Term
Babinski sign
 Definition
Upper motor neuron lesion
Term
Bacteremia/pneumonia (IVDA)
 Definition
Staphylococcus aureus
Term
Bacteria associated with
cancer
 Definition
Helicobacter pylori
Term
Bacteria found in GI tract
 Definition
Bacteroides (second most
common is Escherichia coli)
Term
Bacterial meningitis (adults)
 Definition
Neisseria meningitidis
Term
Bacterial meningitis (elderly)
 Definition
Streptococcus pneumoniae
Term
Bacterial meningitis (kids)
 Definition
Haemophilus influenza type B
Term
Bacterial meningitis
(newborns)
 Definition
Escherichia coli
Term
Baker's cyst in popliteal fossa
 Definition
Rheumatoid arthritis
Term
Bamboo spine' on xray
 Definition
Ankylosing spondylitis
Term
Basophilic stippling of RBC's
 Definition
Lead poisoning
Term
Bence-Jones proteins
 Definition
Multiple myeloma (kappa or
lambda Ig light chains in
urine) Waldenstrom's
macroglobinemia (IgM)
Term
Bilateral hilar adenopathy,
uveitis
 Definition
Sarcoidosis
Term
Birbeck granules on EM
 Definition
Histiocytosis X (eosinophilic
granuloma)
Term
Bloody tap on LP
 Definition
Subarachnoid hemorrhage
Term
Blue-domed cysts
 Definition
Fibrocystic change of the
breast
Term
Blue bloater'
 Definition
Chronic bronchitis
Term
Blue sclera
 Definition
Osteogenesis imperfecta
Term
Boot-shaped heart on x-ray
 Definition
Tetralogy of Fallot; RV
hypertrophy
Term
Bouchard's nodes
 Definition
Osteoarthritis (PIP swelling
secondary to osteophytes)
Term
Boutonniere's deformity
 Definition
Rheumatoid arthritis
Term
Brain tumor - supratentorial
(kids)
 Definition
Craniopharyngioma
Term
Brain tumor (adults)
 Definition
Astrocytoma (including
glioblastoma multiforme) >
mets > meningioma >
Schwannoma
Term
Brain tumor (kids)
 Definition
Medullobastoma (cerebellum)
Term
Branching rods in oral
infection
 Definition
Actinomyces israelii
Term
Breast cancer
 Definition
Infultrating ductal carcinoma
(in the US, one in nine women
will develop breast cancer)
Term
Breast mass
 Definition
Fibrocystic change (in postmenopausal
women,
carcinoma is the most
common)
Term
Breast tumor (benign)
 Definition
Fibroadenoma
Term
Brown tumor'of bone
 Definition
Hemorrhage causes brown
color of osteolytic cysts:
Hyperparathyroidism; Osteitis
fibrosa cystica (von
Recklinghausen's disease)
Term
Brushfield's spots
 Definition
Down syndrome
Term
Bruton's lines
 Definition
Lead poisoning
Term
Bug in debilitated,
hospitalized pneumonia
patient
 Definition
Klebsiella
Term
C-ANCA
 Definition
Wegerner's granulomatosis
Term
Café au lait spots on skin
 Definition
Neurofibromatosis
Term
Calf pseudohypertrophy
 Definition
Duchenne's muscular
dystrophy
Term
Call-Exner bodies
 Definition
Granulosa/thecal cell tumor
of the ovary
Term
Cancer associated with AIDS
 Definition
Kaposi's sarcoma
Term
Cardiac primary tumor
(adults)
 Definition
Myxoma (4:1 left to right
atrium; 'ball & valve')
Term
Cardiac primary tumor (kids)
 Definition
Rhabdomyoma
Term
Cardiac tumor (adults)
 Definition
Metastasis
Term
Cardiomegaly with apical
atrophy
 Definition
Chagas' disease
Term
Cardiomyopathy
 Definition
Dilated cardiomyopathy
Term
Cerebriform nuclei
 Definition
Mycosis fungoides (cutaneous
T-cell lymphoma)
Term
Chancre
 Definition
Primary syphilis (not painful)
Term
Chancroid
 Definition
Haemophilus ducreyi (painful)
Term
Charcot's triad
 Definition
Multiple sclerosis (nystagmus,
intention tremor,scanning
speech); Cholangitis
(jaundice, RUQ, fever)
Term
Charcot-Leyden crystals
 Definition
Bronchial asthma (eosinophil
membranes)
Term
Cherry-red spot on macula
 Definition
Tay-Sachs, Niemann-Pick
disease, central retinal artery
occlusion
Term
Chevostek's sign
 Definition
Hypocalcemia (facial muscle
spasm upon tapping)
Term
Cheyne-Stokes respirations
 Definition
Central apnea in CHF &
increased ICP
Term
Chocolate cysts'
 Definition
Endometriosis (frequently
involve both ovaries)
Term
Chromosomal disorder
 Definition
Down syndrome (associated
with ALL, Alzheimer's
dementia, & endocardial
cushion defects)
Term
Chronic arrhythmia
 Definition
Atrial fibrillation (associated
w/ high risk of emboli)
Term
Chronic atrophic gastritis
 Definition
Predisposition to gastric
carcinoma
Term
Clue cells
 Definition
Gardnerella vaginitis
Term
Codman's triangle on x-ray
 Definition
Osteoasarcoma
Term
Cold agglutinins
 Definition
Mycoplasma pneumoniae;
Infectious mononeucleosis
Term
Cold intolerance
 Definition
Myxedema
Term
Condyloma lata
 Definition
Secondary syphilis
Term
Congenital adrenal
hyperplasia
 Definition
21-Hydroxylase deficiency
Term
Congenital cardiac anomaly
 Definition
VSD
Term
Constrictive pericarditis
 Definition
Tuberculosis
Term
Continuous machinery
murmur
 Definition
Patent ductus arteriosus
Term
Coronary artery involved in
thrombosis
 Definition
LAD > RCA > LCA
Term
Cotton wool spots
 Definition
Chronic hypertension
Term
Cough, conjunctivitis, coryza
+ fever
 Definition
Measles
Term
Councilman bodies
 Definition
Toxic or viral hepatitis
Term
Cowdry type A bodies
 Definition
Herpes virus
Term
Crescents in Bowman's
capsule
 Definition
Rapidly progressive crescentic
glomerulonephritis
Term
Cretinism
 Definition
Hypothyroidism/iodine deficit
Term
Currant-jelly sputum
 Definition
Klebsiella
Term
Curschmann's spirals
 Definition
Bronchial asthma (whorled
mucous plugs)
Term
Cushing's syndrome
 Definition
Corticosteroid therapy
(second most common cause
is excess ACTH secretion by
pituitary)
Term
Cyanosis (early; less common)
 Definition
Tetralogy of Fallot,
transposition of great vessels,
truncus arteriosus
Term
D-dimers
 Definition
DIC
Term
Death in CML
 Definition
Blast crisis
Term
Death in SLE
 Definition
Lupus nephropathy
Term
Dementia
 Definition
Alzheimer's (second most
common is multi-infarct)
Term
Demyelinating disease
 Definition
Multiple sclerosis
Term
Depigmentation of neurons in
substantia nigra
 Definition
Parkinson's disease (basal
ganglia disorder -- rigidity,
resting tremor, bradykinesia)
Term
Dermatitis, dementia,
diarrhea
 Definition
Pellagra (Niacin, vitamin B3
deficiency)
Term
Diabetes insipidus +
exopthalmos + lesions of
skull
 Definition
Hand-Schuller-Christian
disease
Term
DIC
 Definition
Gram-negative sepsis,
obstetric complications,
cancer, burns trauma
Term
Dietary deficit
 Definition
Iron
Term
Dog or cat bite
 Definition
Pasteurella multocida
Term
Donovan bodies
 Definition
Granuloma inguinale
Term
Ejection click
 Definition
Aortic/pulmonic stenosis
Term
Elastic skin
 Definition
Ehlers-Danlos syndrome
Term
Epiglottitis
 Definition
Haemophilus influenza type B
Term
Erythema chronicum migrans
 Definition
Lyme disease
Term
Esophageal cancer
 Definition
Squamous cell carcinoma
Term
Fat, female, forty, &
fertile'
 Definition
Acute cholecystitis
Term
Fatty liver
 Definition
Alcoholism
Term
Ferruginous bodies
 Definition
Asbestosis
Term
Food poisoning
 Definition
Staphylococcus aureus
Term
Ghon complex
 Definition
Secondary TB
Term
Ghon focus
 Definition
Primary TB
Term
Glomerularnephritis (adults)
 Definition
IgA nephropathy (Berger's
disease)
Term
Gower's maneuver
 Definition
Duchenne's (use of patient's
arms to help legs pick self off
the floor)
Term
Group affected by cystic
fibrosis
 Definition
Caucasians (fat-soluble
vitamin deficiencies, mucous
plugs/lung infections)
Term
Gynecologic malignancy
 Definition
Endometrial carcinoma
Term
Hair on end' appearance on
x-ray
 Definition
Beta-thalassemia
Term
Hampton's hump on x-ray
 Definition
Pulmonary embolism
Term
HbS
 Definition
Sickle cell anemia
Term
HCG elevated
 Definition
Choriocarcinoma;
Hyadatidiform mole (occurs
with & without embryo)
Term
Heart murmur
 Definition
Mitral valve prolapse
Term
Heart valve (rheumatic fever)
 Definition
Mitral valve (aotric is second)
Term
Heart valve in bacterial
endocarditis
 Definition
Mitral
Term
Heart valve in bacterial
endocarditis in IVDA
 Definition
Tricuspid
Term
Heberden's nodes
 Definition
Osteoarthritis (DIP swelling
secondary to osteophytes)
Term
Heinz bodies
 Definition
G6PD deficiency
Term
Helminth infection (US)
 Definition
Enterobius vermicularis
(Ascaris lumbricoides is
second most common)
Term
Hematoma - epidural
 Definition
Rupture of middle meningeal
artery (arterial bleeding is
fast)
Term
Hematoma - subdural
 Definition
Rupture of bridging veins
(trauma; venous bleeding is
slow)
Term
Hemochromocytosis
 Definition
Multiple blood transfusions
(can result in CHF, and
increases risk of
hepatocellular carcinoma)
Term
Hepatic cirrhosis
 Definition
EtOH
Term
Hepatocellular carcinoma
 Definition
Cirrhotic liver (often
associated with hepatitis B
& C)
Term
Hereditary bleeding disorder
 Definition
Von Willebrand's
Term
Heterophil antibodies
 Definition
Infectious mononucleosis
(EBV)
Term
Hgb F
 Definition
Thalassemia major
Term
High output cardiac failure
(dilated cardiomyopathy)
 Definition
Wet beriberi (thiamine,
vitamin B1 deficiency)
Term
HLA-B27
 Definition
Reiter's syndrome, ankylosing
spondylitis
Term
HLA-DR3 or DR4
 Definition
DM type 1 (caused by
autoimmune destruction of
beta cells)
Term
Holosystolic murmur
 Definition
VSD, tricuspid regurgitation
Term
Homer-Wright rosettes
 Definition
Neuroblastoma
Term
Honeycomb lung on x-ray
 Definition
Interstitial fibrosis
Term
Howell Jolly bodies
 Definition
Splenectomy (or nonfunctional
spleen)
Term
Hyperphagia + hypersexuality
+ hyperorality + hyperdocile
 Definition
Kluver-Bucy syndrome
(amygdala)
Term
Hyperpigmentation of skin
 Definition
Primary adrenal insufficiency
(Addison's disease)
Term
Hypersegmented neutrophils
 Definition
Macrocytic anemia
(next 4 cards missing here, so were added in the end)
Term
Hypopituitarism
 Definition
Adenoma
Term
Increase alpha-fetoprotein in
amniotic fluid/maternal
serum
 Definition
Anencephaly; Spina bifida
Term
Increased uric acid levels
 Definition
Gout; Lesch-Nyhan;
Myeloproliferative disorders;
Loop & thiazide diuretics
Term
Infection in blood transfusion
 Definition
Hepatitis C
Term
Infection in burn victims
 Definition
Klebsiella
Term
Intussesception
 Definition
Adenovirus (cause
hyperplasia of Peyer's
patches)
Term
Janeway lesions
 Definition
Endocarditis
Term
Jarisch-Herxheimer reaction
 Definition
Syphilis; over-aggressive
treatment of an symptomatic
patient that causes symptoms
due to rapid lysis
Term
Kaposi's sarcoma
 Definition
Homosexual AIDS patients
(not associated with IVDA
acquired HIV/AIDS)
Term
Kayser-Fleischer rings
 Definition
Wilson's disease
Term
Keratin pearls
 Definition
Squamous cell carcinoma
Term
Kidney stones
 Definition
Calcium = radiopaque (2nd
most common is ammonium
= radiolucent; formed by
urease positive organisms
like Proteus vulgaris or
Staphylococcus)
Term
Kimmelstiel-Wilson nodules
 Definition
Diabetic nephropathy
Term
Koilocytes
 Definition
HPV
Term
Koplik spots
 Definition
Measles
Term
Kussmaul hyperpnea
 Definition
Diabetic ketoacidosis
Term
Lens dislocation + aortic
dissection + joint
hyperflexibility
 Definition
Marfan's disease (fibrillin
deficit)
Term
Leukemia (adults)
 Definition
AML
Term
Lewy bodies
 Definition
Parkinson's disease
Term
Lines of Zahn
 Definition
Arterial thrombus
Term
Lisch nodules
 Definition
Neurofibromatosis (von
Recklinghausen's disease)
Term
Liver disease
 Definition
Alcoholic liver disease
Term
Location of brain tumors
(adults)
 Definition
Supratentorial
Term
Location of brain tumors
(kids)
 Definition
Infratentorial
Term
Low serum ceruloplasmin
 Definition
Wilson's disease
Term
Lucid interval
 Definition
Epidural hematoma
Term
Lumpy Bumpy' appearance of
glomeruli on
immunoflourescence
 Definition
Poststreptococal
glomerulonephritis
Term
Lysosomal storage disease
disorder
 Definition
Gaucher's
Term
Lytic bone lesions on x-ray
 Definition
Multiple myeloma
Term
Machine-like' murmur
 Definition
PDA
Term
Male cancer
 Definition
Prostatic carcinoma
Term
Malignancy associated with
infectious fever
 Definition
Hodgkin's
Term
Malignant skin tumor
 Definition
Basal cell carcinoma (rarely
metastasizes)
Term
Mallory bodies
 Definition
Alcoholic liver disease
Term
McBurney's sign
 Definition
Appendicitis
Term
Mental retardation
 Definition
Down syndrome (Fragile X is
the second most common
cause)
Term
Mets to bone
 Definition
Breast, lung, thyroid, testes,
prostate
Term
Mets to brain
 Definition
Lung, breast, skin
(melanoma), kidney (renal cell
carcinoma), GI
Term
Mets to liver
 Definition
Colon, gastric, pancreatic,
breast, & lung
carcinomas
Term
MI
 Definition
Atherosclerosis
Term
Mitral valve stenosis
 Definition
Rheumatic heart disease
Term
MLF syndrome (INO)
 Definition
Multiple sclerosis
Term
Monoclonal antibody-spike
 Definition
Multiple myeloma (called the
M protein; usually IgG or IgA);
MGUG; Waldenstrom's (M
Protein = IgM)
macroglobulinemia
Term
Motor neuron disease
 Definition
ALS
Term
Myocarditis
 Definition
Coxsackie B
Term
Myxedema
 Definition
Hypothyroidism
Term
Necrotizing vasculitis (lungs)
& necrotizing
glomerulitis
 Definition
Wegener's &
Goodpasture's (hemoptysis
& glomerular disease)
Term
Needle-shaped, negatively
bifringent crystals
 Definition
Gout
Term
Negri bodies
 Definition
Rabies
Term
Neoplasm (kids)
 Definition
ALL (2nd most common is
cerebellar medulloblastoma)
Term
Nephritis + cataracts +
hearing loss
 Definition
Alport syndrome
Term
Nephrotic syndome (kids)
 Definition
Minimal change disease
(associated with infections/
vaccinations; treat with
corticosteroids)
Term
Nephrotic syndrome
 Definition
Membranous
glomerulonephritis
Term
Nephrotic syndrome (adults)
 Definition
Membranous
glomerulonephritis
Term
Neurofibrillary tangles
 Definition
Alzheimer disease
Term
No lactation postpartum
 Definition
Sheehan's syndrome
Term
Nutmeg liver
 Definition
Congestive heart failure
Term
Obstruction of male urinary
tract
 Definition
BPH
Term
Occupational exposure to
asbestos
 Definition
Malignant mesothelioma
Term
Oncogene involved in cancer
 Definition
p53 Suppressor
Term
Opening snap
 Definition
Mitral stenosis
Term
Opportunistic infection in
AIDS
 Definition
PCP
Term
Organ receiving mets
 Definition
Adrenal glands (due to rich
blood supply)
Term
Organ sending mets
 Definition
Lung > breast, stomach
Term
Orphan Annie cells
 Definition
Papillary carcinoma of the
ovary
Term
Osler's nodes
 Definition
Endocarditis
Term
Osteomyelitis
 Definition
Staphylococcus aureus
Term
Osteomyelitis in patients with
sickle cell disease
 Definition
Salmonella
Term
Osteomyelitis with IVDA
 Definition
Pseudomonas
Term
Ovarian tumor (benign)
 Definition
Hamartoma
Term
Ovarian tumor (malignant)
 Definition
Serous cystadenoma
Term
Owl's eye
 Definition
CMV
Term
P-ANCA
 Definition
Polyarteritis nodosa
Term
Painless jaundice
 Definition
Pancreatic cancer (head)
Term
Palpable purpura on legs
& buttocks
 Definition
Henoch-Schonlein purpura
Term
Pancreatic tumor
 Definition
Adenocarcinoma (head of
pancreas)
Term
Pancreatitus (acute)
 Definition
EtOH and gallstones
Term
Pancreatitus (chronic)
 Definition
EtOH (adults), cystic fibrosis
(kids)
Term
Pannus
 Definition
Rheumatiod arthritis
Term
Patient with ALL/CLL/AML/
CML
 Definition
ALL - Child / CLL - Adult over
60 / AML - Adult over 60 /
CML - Adult 35-50
Term
Patient with Hodgkin's
 Definition
Young male (except nodular
sclerosis type - female)
Term
Patient with minimal change
disease
 Definition
Young child
Term
Patient with Reiter's
 Definition
Male
Term
Peau d'orange
 Definition
Carcinoma of the breast
Term
Pelvic inflammatory disease
 Definition
Neisseria gonorrhoeae
(monoarticular arthritis)
Term
Periosteal elevation on x-ray
 Definition
Pyogenic osteomyelitis
Term
Philadelphia chromosome
(bcr;abl)
 Definition
CML (may sometimes be
associated with AML)
Term
Pick bodies
 Definition
Pick's disease
Term
Pink puffer'
 Definition
Emphysema (centroacinar
(smoking), panacinar
(alpha1-antitrypsin
deficiency))
Term
Pituitary tumor
 Definition
Prolactinoma (2nd -
somatotropic 'acidophilic'
adenoma)
Term
Pneumonia, hospital-acquired
 Definition
Klebsiella
Term
Pneumonia, in CF, burn
infection
 Definition
Pseudomonas aeruginosa
Term
Podagra
 Definition
Gout (MP joint of hallux)
Term
Podocyte fusion
 Definition
Minimal change disease
Term
Polyneuropathy preceded by
GI or respiratory infection
 Definition
Guillian-Barre syndrome
Term
Polyneuropathy, cardiac
pathology, & edema
 Definition
Dry beriberi (thiamine,
vitamine B1 deficiency)
Term
Port-wine stain
 Definition
Hemangioma
Term
Posterior anterior 'drawer
sign'
 Definition
Anterior cruciate ligament
injury
Term
Preventable blindness
 Definition
Chlamydia
Term
Preventable cancer
 Definition
Lung cancer
Term
Primary amenorrhea
 Definition
Turner's (XO)
Term
Primary bone tumor (adults)
 Definition
Multiple myeloma
Term
Primary hyperaldosteronism
 Definition
Adenoma of adrenal cortex
Term
Primary hyperparathyroidism
 Definition
Adenomas (followed by:
hyperplasia, then carcinoma)
Term
Primary hyperparathyroidism
 Definition
Adenoma
Term
Primary liver tumor
 Definition
Hepatoma
Term
Psammoma bodies
 Definition
Caused by apoptosis of tumor
cells with dystrophic calcification
& found in: Papillary
adenocarcinoma of the thyroid
(most common cancer of the
thyroid); Serous papillary
cystadenocarcinoma of the ovary;
Meningioma, Mesothelioma
Term
Pseudopalisade tumor cell
arrangement
 Definition
Glioblastoma multiforme
Term
Pseudorosettes
 Definition
Ewing's sarcoma
Term
Ptosis, miosis, anhidrosis
 Definition
Horner's syndrome
(Pancoast's tumor)
Term
Pulmonary hypertension
 Definition
COPD
Term
Pus, empyema, abscess
 Definition
Staphylococcus aureus
Term
Rash on palms & soles
 Definition
Secondary syphilis; Rocky
Mountain Spotted Fever
Term
RBC's in urine
 Definition
Bladder carcinoma
Term
RBC casts in urine
 Definition
Acute glomerulonephritis
Term
Recurrent pulmonary
Pseudomonas and
Staphylococcus aureus
infections
 Definition
Cystic fibrosis
Term
Red urine in the morning
 Definition
Paroxysmal nocturnal
hemoglobinuria
Term
Reed-Sternberg cells
 Definition
Hodgkin's lymphoma
Term
Reid index (increased)
 Definition
Chronic bronchitis
Term
Reinke crystals
 Definition
Leydig cell tumor
Term
Renal cell carcinoma +
cavernous hemangiomas +
adenomas
 Definition
Von Hippel - Lindau disease
Term
Renal epithelial casts in urine
 Definition
Acute toxic/viral nephrosis
Term
Renal tumor
 Definition
Renal cell carcinoma -
associated with von Hippel-
Lindau & acquired
polycystic kidney disease;
paraneoplastic syndromes
(erythropoietin, renin, PTH,
ACTH)
Term
Rhomboid crystals, positively
bifringent
 Definition
Pseudogout
Term
Rib notching
 Definition
Coarctation of aorta
Term
Right-sided heart faulure
 Definition
Left-sided heart failure
Term
Right heart failure due to a
pulmonary cause
 Definition
Cor pulmonale
Term
Roth spots in retina
 Definition
Endocarditis
Term
Rouleaux formation (RBC's)
 Definition
Multiple myeloma
Term
Russell bodies
 Definition
Multiple myeloma
Term
S3
 Definition
Left to right shunt (VSD, PDA,
ASD); Mitral regurgitation; LV
failure (CHF)
Term
S4
 Definition
Aortic stenosis, hypertrophic
subaortic stenosis
Term
Schiller-Duval bodies
 Definition
Yolk sac tumor
Term
Schwarzman reaction
 Definition
Neisseria meningitidis
Term
Secondary
hyperparathyroidism
 Definition
Hypocalcemia of chronic renal
failure
Term
Senile plaques
 Definition
Alzheimer's disease
Term
Sexually transmitted disease
 Definition
Chlamydia
Term
Sheehan's syndrome
 Definition
Postpartum pituitary
infarction
Term
SIADH
 Definition
Small cell carcinoma of the
lung
Term
Signet ring cells
 Definition
Gastric carcinoma
Term
Simian crease
 Definition
Down syndrome
Term
Site of diverticula
 Definition
Sigmoid colon
Term
Site of metastasis
 Definition
Regional lymph nodes
Term
Site of metastasis (2nd most
commond)
 Definition
Liver
Term
Sites of atherosclerosis
 Definition
Abdominal aorta >
coronary > popliteal >
carotid
Term
Skin cancer
 Definition
Basal cell carcinoma
Term
Skip lesions
 Definition
Crohn's
Term
Slapped cheeks
 Definition
Erythema infectiosum (fifth
disease)'
Term
Smith antigen
 Definition
SLE
Term
Smudge' cell
 Definition
CLL
Term
Soap bubble on x-ray
 Definition
Giant cell tumor or bone
Term
Spike & dome on EM
 Definition
Membranous
glomerulonephritis
Term
Splinter hemorrhages in
fingernails
 Definition
Endocarditis
Term
Starry-sky pattern
 Definition
Burkitt's lymphoma
Term
Stomach cancer
 Definition
Adenocarcinoma
Term
Strawberry tongue'
 Definition
Scarlet fever
Term
Streaky ovaries
 Definition
Turner's syndrome
Term
String sign on x-ray
 Definition
Crohn's disease
Term
Subepithelial humps on EM
 Definition
Poststreptococal
glomerulonephritis
Term
Suboccipital
lymphadenopathy
 Definition
Rubella
Term
Sulfur granules
 Definition
Actinomyces israelii
Term
Surgical wound
 Definition
Staphylococcus aureus
Term
Swollen gums, bruising, poor
wound healing, anemia
 Definition
Scurvy (ascorbic acid, vitamin
C deficiency) - vitamin C is
necessary for hydroxylation
of proline & lysine in
collagen synthesis
Term
Systolic ejection murmur
(crescendo-decrescendo)
 Definition
Aortic valve stenosis
Term
t(14; 18)
 Definition
Follicular lymphomas (bcl-2
activation)
Term
t(8;14)
 Definition
Burkitt's lymphoma (c-myc
activation)
Term
t(9;22)
 Definition
Philadelphia chromosome,
CML (bcr-abl hybrid)
Term
Tabes dorsalis
 Definition
Tertiary syphilis
Term
Target cells
 Definition
Thalassemia
Term
Tendon xanthomas
(classically Achilles)
 Definition
Familial hypercholesterolemia
Term
Testicular tumor
 Definition
Seminoma
Term
Thumb sign on lateral x-ray
 Definition
Epiglottitis
Term
Thymoma
 Definition
Myasthenia gravis (present in
20% of those with MG)
Term
Thyroid cancer
 Definition
Papillary carcinoma
Term
Thyroidization of kidney
 Definition
Chronic bacterial
pyelonephritis
Term
Tophi
 Definition
Gout
Term
Tracheoesophageal fistula
 Definition
Lower esophagus joins
trachea/upper esophagus -
blind pouch
Term
Tram-track' appearance on
LM
 Definition
Membranoproliferative
glomerulonephritis
Term
Traumatic open wound
 Definition
Clostridium perfringens
Term
Trousseau's sign
 Definition
Visceral cancer; pancreatic
adeneocarcinoma (migratory
thrombophlebitis);
Hypocalcemia (carpal spasm)
Term
Tumor in men
 Definition
Prostate carcinoma
Term
Tumor in women
 Definition
Leiomyoma (estrogen
dependent)
Term
Tumor of infancy
 Definition
Hemangioma
Term
Tumor of the adrenal medulla
(adults)
 Definition
Pheochromocytoma (benign)
Term
Tumor of the adrenal medulla
(kids)
 Definition
Neuroblastoma (malignant)
Term
Type of Hodgkin's
 Definition
Mixed cellularity (versus:
lymphocytic predominance,
lymphocytic depletion,
nodular sclerosis)
Term
Type of non-Hodgkin's
 Definition
Follicular, small cleaved
Term
Type of pituitary adenoma
 Definition
Prolactinoma
Term
UTI
 Definition
Escherichia coli
Term
UTI (young women)
 Definition
Staphylococcus saprophyticus
Term
Vasculitis
 Definition
Temporal arteritis (risk of
ipsilateral blindness due to
thrombosis of ophthalmic
artery)
Term
Viral encephalitis
 Definition
HSV
Term
Virchow's node
 Definition
Left supraclavicular node
enlargement from metastatic
carcinoma of the stomach
Term
Virchow's triad
 Definition
Pulmonary embolism (triad =
blood stasis, endothelial
damage, hypercoag.)
Term
Vitamin deficiency (US)
 Definition
Folic acid (pregnant women
are at high risk; body stores
only 3-4 month supply)
Term
Waxy casts
 Definition
Chronic end-stage renal
disease
Term
WBC's in urine
 Definition
Acute cystitis
Term
WBC casts in urine
 Definition
Acute pyelonephritis
Term
Wire loop' appearance on LM
 Definition
Lupus nephropathy
Term
Worst headache of my life'
 Definition
Berry aneurysm - associated
with adult polycystic kidney
disease
Term
Xanthochromia (CSF)
 Definition
Subacrachnoid hemorrhage
Term
Xerostomia + arthritis +
keratoconjunctivitis sicca
 Definition
Sjogren's syndrome
Term
HTN + HypoKalemia
 Definition
Cushing & Conn's Syndromes
Term
HTN, 2ary
 Definition
Renal Disease
Term
Hypochromic, microcytic
 Definition
Fe defic anemia
Term
Hypoparathyroidism
 Definition
Thyroidectomy
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