1. CF 2. albinism 3.

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

_____are associated with low

golic acid intake during Neural tube defects
pregnancy.

90% of adult polycystic kidney

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

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

1. Skeletal: tall with long

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

Adult polycystic kidney

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

pre and postnatal

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

Besides pulmonary infections, infertility in males fat-

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

excessive and inappropriate

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

Characteristic murmur with a

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

onset before age 5 weakness

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

ovaries present but external

Characteristics of female
genitalia are virilized or
pseudohermaphroditism:
ambiguous

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

testes present, but external

Characteristics of male
genitalia are female or
pseudohermaphroditism:
ambiguous.

Children may do this to

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

Heterozygotes (1 : 500)
Compare the cholesterol
cholest. levels around
levels of heterozygores and
300mg/dL Homozygotes
homozygotes with familial
(very rare) cholest. levels over
hyperchlosterolemia:
700 mg/dL.

Complications associated
with homozygous familial
hypercholesterolemia:
Congenital heart defects are
often due to which infection?
Cri-du-chat syndrome results
from a congenital deletion on
which chromosome?
Define Meningocele:
severe atherosclerotic disease
early in life tendon
xanthomas (classically in the
Achilles tendon) Myocardial
Infarction before age 20
rubella
short arm of chromosome 5
46 XX or XY, 5p-
meninges herniate through
spinal canal defect picture on
p. 229
 meninges and spinal cord
Define Meningomyelocele: herniate through spinal canal
defect picture on p.229

disagreement between the

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

failure of bony spinal canal to

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

46 XX or 47 XXY both ovary

Describe a true
and testicular tissue present;
hermaphrodite:
ambiguous genitalia

Describe Eisenmenger's
syndrome:
Does coarctation of the aorta
affect males or females most
commonly?
Down's syndrome is
associated with increased or
decreased levels of AFP?
Elevated ___ in amniotic fluid
is evidence of a neural tube
defect.
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).
3:1 males to females
decreased
AFP (alpha fetal protein)
 aortic stenosis distal to
ductus arteriosus (postductal)
Explain the adult type of aDult is Distal to Ductus
coarctation of the aorta and associated with notching of
give some associated the ribs, hypertension in
symptoms. upper extremities, weak
pulses in lower extermities
(check femoral pulse)

aortic stenosis proximal to

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

In fetal period, shunt is R to L

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

Aorta leaves RV (anterior) and

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

café-au-lait spots, neural

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

microcephaly, severe MR,

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

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

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

what two things? upbringing

Genetic anticipation of Fragile

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

Highest risk of development

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

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

muscle biopsy increased

How is MD diagnosed?
serum CPK

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

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

1 in 8000 births severe MR,

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

1 in 850 births testicular

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

Marfan's is due a mutation in

fibrillin
which gene?

Mechanism of Fetal Alcohol

inhibition of cell migration
Syndrome may be :

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

The 3 T's' 1. Tetralogy of

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

1. heart defects 2. Hypospadias

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

PROVe' 1. Pulmonary Stenosis

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

Neural tube defects (spina

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

Newborns of mothers who

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

defective Cl- channel --> secretion

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

Patients with Tetralogy of

cyanotic spells
Fallot often suffer _________.

Pyloric stenosis is associated polyhydramnios; projectile

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

Tetralogy of Fallot leads to

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

The defect in Von

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

The gene responsible for

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

Transposition of great vessels

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

Transposition of great vessels a shunt that allows adequate

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

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

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

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

Von Hippel-Lindau disease is

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

mental retardation flat facial

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

What gender genetic disorder

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

What is different about the

juvenile form of polycystic it is recessive
kidney disease?

requiring assistance of the

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

What is the cause of Tetralogy anterosuperior displacement

of Fallot? of the infundibular septum

What is the incidence of

1 in 700 births
Down's syndrome?

What is the most common

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

What is the most common

VSD
congenital cardiac anomaly?

What is the most common

lethal genetic disease of Cystic Fibrosis
Caucasians?

What is the second most

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

What is the underlying cause defective or absent LDL

of Familial receptor leading to elevated
hypercholesterolemia? LDL

Indomethacin PGE (may be

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

methylation and expression

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

Why are female carriers of X- because of random

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

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

Turner's syndrome (think:

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

Approximately what
percentage of brain tumors 0.5
arise from metastasis?

Are basal cell carcinomas Locally invasive but rarely

invasive? metastasize

Yes. They are extremely

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

Are squamous cell

Locally invasive but rarely
carcinomas of the skin
metastasize
invasive?

Are the majority of adult

tumors supratentorial or Supratentorial
infratentorial?

Are the majority of childhood

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

Abnormal cells lacking

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

Abnormal growth with loss of

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

Increase in the number of

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

Clonal proliferation of cells

Define neoplasia that is uncontrolled and
excessive

Do oncogenes cause a gain or

Gain of function
loss of function?

Do tumor suppressor genes Loss of function. Both alleles

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

From what cells do

Arachnoid cells external to
meningiomas most commonly
the brain
arise?

Give 2 examples of a benign

1. Adenoma 2. Papilloma
tumor of epithelial origin.

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

Give an example of a benign

tumor of blood vessel Hemangioma
(mesenchymal) origin.

Give an example of a benign

tumor of bone (mesenchymal) Osteoma
origin.

Give an example of a benign

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

Give an example of a benign

tumor of smooth muscle Leiomyoma
(mesenchymal) origin.

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

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

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

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

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

How is prostatic Digital rectal exam (detect

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

How often do primary brain

Very rarely
tumors undergo metastasis?

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

Is malignant transformation Malignant transformation to

in osteochondroma common? chondrosarcoma is rare

TNM system T= size of

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

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

1. Cingulate herniation under

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

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

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

Name a common The nuclei of basal cell

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

Fair-skinned people (blue

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

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

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

Name two presenting 1. Bitemporal hemianopsia

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

On which chromosome is the

17p
p53 gene located?

On which chromosome is the

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

Out of the 6 primary tumors

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

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

with EBV? Nasopharyngeal carcinoma

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

What 2 neoplasms are

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

What 2 neoplasms are

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

1. Neoplastic cells have not

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

What are 2 neoplasms 1. Squamous cell carcinoma

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

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

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

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

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

Ependymal cell tumors most

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

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

What are two signs of bone An increase in serum alkaline

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

What can be associated with

Sun exposure
the risk of melanoma?

What cancer is associated

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

What cancer is associated

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

What cancers are commonly

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

What causes the local effect

Tissue lump or tumor
of a mass?

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

What causes the local effect Pathologic fracture or

of bone destruction? collapse of bone

What causes the local effect Venous or lymphatic

of edema? obstruction

What causes the local effect Caused by ulcerated area or

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

What causes the local effect

of obstruction in the biliary Jaundice
tree?

What causes the local effect

of obstruction in the Pneumonia
bronchus?

What causes the local effect

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

What causes the local effect

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

What causes the local effect

Tumor mass in the brain.
of seizures?

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

What causes the ACTH or ACTH-like peptide

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

PTH-related peptide, TGF-a,

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

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

What causes the ADH or ANP (secondary to

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

What chemical carcinogen is

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

What chemical carcinogen is

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

What chemical carcinogen is

commonly associated with Arsenic
the skin (squamous cell)?

What chemical carcinogen(s)

are commonly associated with Aflatoxins and vinyl chloride
the liver?

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

What is a common gross

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

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

chondrosarcoma? from osteochondroma

What is a common sign found

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

Anaplastic small cell

What is a Ewing's sarcoma?
malignant tumor.

Locally aggressive benign

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

What is a gross pathological

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

What is a helpful mnemonic

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

What is a helpful mnemonic

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

What is a helpful mnemonic

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

Diffusely infiltrating glioma.

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

Highly malignant cerebellar

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

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

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

What is an A relatively rare, slow

oligodendroglioma? growing, benign tumor.

Very nonspecific antigen

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

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

Histologic appearance of the

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

Based on site an size of

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

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

Foamy cells and high

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

What is the common

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

What is the common Antoni A=compact palisading

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

What is the common Pseudopalisading' tumor cells

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

What is the differentiation

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

What is the most common

Osteochondroma
benign bone tumor?

What is the most common

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

What is the most common Commonly found in the

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

Adrenal glands. This is due to

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

What is the most common

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

What is the most common Glioblastoma multiforme

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

What is the most common

Prolactin secreting
type of pituitary adenoma?

What is the most likely

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

What is the origin of a Derived from the remnants of

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

Schwann cell origin. Often

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

What is the peak incidence of

20-40 years old
giant cell tumor?

What is the peak incidence of

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

What is the second most

common primary brain Meningioma
tumor?

What is the third most

common primary brain Schwannomas
tumor?

What neoplasias are Hepatocellular carcinoma and

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

What neoplasias are Ovarian and malignant

associated with CA-125? epithelial tumors

What neoplasias are Melanoma, neural tumors,

associated with S-100? and astrocytomas

What neoplasm is associated

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

What neoplasm is associated

with Immunodeficiency Malignant lymphomas
states?

What neoplasm is associated

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

What neoplasm is associated

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

What oncogene is associated

c-myc
with Burkitt's lymphoma?

What oncogene is associated

ras
with colon carcinoma?

What oncogene is associated

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

What tumor suppressor gene

is associated with
Rb gene
Retinoblastoma and
osteosarcoma?

What type of metastases are

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

What type of neoplasm is

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

Where are chondrosarcomas Pelvis, spine, scapula,

usually located? humerus, tibia, or femur.

Where are Ewing's sarcomas Diaphysis of long bones,

most commonly found? pelvis, scapula, and ribs

Where are Glioblastoma

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

Where do meningiomas most Convexities of hemispheres

commonly occur? and parasagital region

Where do oligodendrogliomas Most often found in the

most often occur? frontal lobes

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

Where does prostatic From the posterior lobe

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

Which has more prognostic

Stage
value: tumor stage or grade?

Which is more common: Metastatic bone tumors are

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

Which tumor suppressor gene

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

Which tumor suppressor

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

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

________ disease = defect of

Bernard-Soulier
platelet adhesion

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

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

1. hemorrage 2. enzyme defects

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

Antiplatelet antibodies and

increased megakaryocytes are ITP
seen in ____.

Auer rods, myeloblasts,

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

bcr-abl hybrid is associated

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

Blood smear of a Multiple

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

Burkitt's lymphoma: '______'

appearance associated with starry sky' EBV Africa
what virus? endemic where?
c-myc activation is associated
with which translocation and
which lymphoma?
Causes of aplastic anemia:
Causes of platelet
abnormalities:
CFU-GM (colony forming
unit-granulocyte-monocyte)
gives rise to which cells?
t(8;14) - Burkitt's
radiation, benzene,
chloramphenicol, alkylating
agents, antimetabolites, viral
agents (HCV,CMV,EBV, herpes
zoster-varicella), Faconi's
anemia, idiopathic (immune-
mediated, primary stem cell
defect)
ITP, TTP, drugs, DIC
monocytes, neutrophils and
basophils
 CLL is very similar to what SLL (small lymphocytic
lymphoma? lymphoma)

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

Common cause of macrocytic

Vit. B12/folate deficiency
megalobalstic anemia:

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

aplastic crisis (due to B19

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

RBCs are small, round, with

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

FAB classification L1: ALL-null, ALL-common

FAB classification L2: ALL- T

FAB classification L3: ALL- B

FAB classification M1: AML (without maturation)

FAB classification M2: AML (with maturation)

FAB classification M3: acute promyelocytic leukemia

acute myelomonocytic
FAB classification M4:
leukemia

FAB classification M5: acute monocytic leukemia

FAB classification M6: acute erythroleukemia

 acute megakaryocytic
FAB classification M7:
leukemia

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

t(8;14) c-myc gene moves

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

Gamma 4 tetramers, lacks all

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

Beta 4 tetramers, lacks 3

Hb H =
alpha globin genes

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

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

Hodgkin's or NHL: which is

associated with HIV & NHL
immunosuppression?

Hodgkin's or NHL: which is

associated with mediastinal Hodgkin's
lymphadenopathy?

Hodgkin's or NHL: which one

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

In _____, the alpha globin

alpha thalassemia
chain is underproduced.

In _____, the beta chain is Beta-minor thalassemia

underproduced. (heterozygote)

In ______, the beta chain is Beta-major thalassemia

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

In Beta Thalassemia, cardiac secondary hemochromatosis

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

In which hemorrhagic
DIC
disorder is PT increased?

In which hemorrhagic 1. Hemophilia A 2.

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

Is Hodgkin's more common in men (except nodular

men or women? sclerosing type)

increased PT and PTT,

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

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

ALL (T cell) Lymphoblastic

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

Macrocytic anemia is defined

100
as MCV>____.

1. anemia (dec. RBCs) 2.

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

most commonly associated

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

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

Name 3 etiologies of 1. iron deficiency 2.

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

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

CML, Polycythemia rubra vera,

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

Hodgkin's: localized, single

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

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

1. drugs that block DNA

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

pancytopenia with normal cell

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

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

Plasma cells in Multiple

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

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

PT and PTT: which one

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

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

different types of Hodgkin's: intermediate LD = poor

Schistocytes are characteristic

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

fatigue, malaise, pallor,

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

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

The lymphoid stem cell gives

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

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

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

(mostly seen in Hodgkin's)

What are constitutional signs/
low grade fever, night sweats,
symptoms?
weight loss

What are some other causes
of DIC?
What genetics are involved
with follicular lymphoma
(small cleaved cell)?
What is another Beta chain
mutation in which patients
have a milder disease than Hb
SS patients?
What is aplastic anemia?
gram-negative sepsis,
transfusion, trauma,
malignancy, acute
pancreatitis, and nephrotic
syndrome
t(14;18) bcl-2 expression
HbC defect. patients can be
HbC or HbSC (1 of each
mutant gene)
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.
 What is compensatorily
fetal hemoglobin (it is
increased in both forms of
inadequate, however)
Beta Thalassemia?

What is found in the urine of

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

What is it called when CML --

blast crisis
> AML?

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

What is the most common

von Willibrand's disease
bleeding disorder?

What is the most common

obstetric complications
cause of DIC?

What is the most common

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

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

renal insufficiency, increased

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

What precipitates sickling of

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

What test is used to

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

What type of cell is cancerous

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

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

Which Beta Thalassemia Beta Thal. major, (requires

results in severe anemia? blood transfusions)

Which coagulation factors are

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

Which coagulation factors are Hemophilia A (factor VIII

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

Which type of Hodgkin's LP (lymphocyte predominant)

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

Which type of Hodgkin's

commonly affects males LP
under 35?

Which type of Hodgkin's

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

Which type of Hodgkin's is

characterized by collagen NS (nodular sclerosing)
banding?

Which type of Hodgkin's is

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

Which type of Hodgkin's is

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

Which type of NHL clinically

small lymphocytic lymphoma
presents like CLL?

Which type of NHL is difficult

follicular lymphoma
to cure?

Which type of NHL is most Lymphoblastic lymphoma

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

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

With iron overload 1. TIBC normal 2. Serum iron

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

A patient with gallstones may

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

How can one distinguish Rotor's syndrome presents

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

How does Budd-Chiari

syndrome progress(in the Congestive liver disease
liver)?

How does cirrhosis/portal diffuse fibrosis, destroying

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

How does one diagnose

ultrasound
gallstones?

How does one differentiate micronodular(<3mm and

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

How does one treat

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

How is hepatocellular like renal cell carcinoma,

carcinoma spread? hematogenously

How is the hyperbilirubinemia

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

How would you expect a Asymptomatically, with an

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

In what fatal childhood

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

In Wilson's disease, where

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

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

Low-fiber diets are associated

diverticulosis
with which of the following?

To what cancer is a chronic

Gastric carcinoma
gastritic patient predisposed?

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

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

What are 2 extraintestinal migratory polyarthritis

manifestations of Crohn's? erythema nodosum

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

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

What are 2 main symptoms of pain Greater with meals,

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

What are 2 types of Crohn's disease Ulcerative

Inflammatory Bowel Disease? colitis

What are 2 types of peptic

gastric ulcer duodenal ulcer
ulcer disease(PUD)?

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

(1)Cholesterol stones (2)

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

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

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

(1)hepatomegaly (2)ascites (3)

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

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

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

Gallstones Ethanol Trauma

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

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

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

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

(1)severe stenosis, (2)toxic

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

What are the 2 types of

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

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

Asterixis Basal ganglia

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

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

A secondary form can arise

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

What can hemochromatosis (1)CHF (2)hepatocellular

lead to(2)? carcinoma

What cell tumor marker is

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

What happens to hepatocytes

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

What happens when

cholesterol and bilirubin
Gallstones
overwhelm solubilizing bile
acids and lecithin?

What histological changes, neutrophil infiltration,

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

The replacement of glandular

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

What is failure of lower

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

What is hepatic vein or IVC

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

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

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

What is the discerning

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

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

H.pylori(70%), NSAIDS both

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

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

What is the incidence of

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

What is the microscopic

noncaseating granulomas
morphology of Crohn's?

What is the microscopic

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

What is the most common

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

What is the most common

primary malignant tumor of hepatocellular carcinoma
the liver in adults?

What is the most common

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

What is the primary cause of

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

~6months (very aggressive--

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

What is the term for inflamm.

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

What is the term used to

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

What is the term used to

describe having many diverticulosis
diverticula?

What is the treatment for

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

What is the treatment of

penicillamine
Wilson's disease(1 drug)?

(1)Abdominal pain radiating

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

Terminal ileum, small

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

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

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

What lab values are

increased ferritin and
characteristic in
transferrin saturation
hemochromatosis?

What labs are elevated in amylase lipase(higher

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

What risk group has an

increased incidence of PUD by smoking
2X?

What type of stones are seen

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

When do patients with

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

Where is the pain associated

left lower quadrant
with diverticulitis?

Which of the following are

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

Which of the following are

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

Which of the following is a

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

Which of the following is a

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

Which of the following is

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

Which of the following

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

Which type of liver nodule is

associated with an increased
macronodules
risk of hepatocellular
carcinoma?

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

An FEV1/FVC ratio greater

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

Are bronchogenic carcinoma

Yes, very common
metastases common?

Decreased FEV1/FVC ratio are

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

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

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

- Maternal steroids before

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

In COPD, are lung volumes

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

In restrictive lung disease, are

lung volumes increased, Decreased
decreased, or normal?

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

Name three characteristics of

- Ptosis - Miosis - Anhidrosis
Horner's syndrome?

Name two extrapulmonary

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

Name two pulmonary (poor - Defective alveolar filling:

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

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

T/F In obstructive (not

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

T/F Restricted lung expansion

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

What are asbestos fibers

coated with hemosiderin in Ferruginous bodies
the lung?

Intra-alveolar exudate ->

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

What are the clinical findings - Wheezing - Crackles -

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

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

What bronchogenic carcinoma

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

What bronchogenic carcinoma

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

What bronchogenic carcinoma

is thought not to be related Bronchioalveolar carcinoma
to smoking?

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

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

What carcinoma occurs in the

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

Chronic necrotizing infection

What causes bronchiectasis?
of bronchi

What causes neonatal

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

What COPD has a productive

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

What COPD is characterized

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

What COPD is due to an

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

What does inhaled asbestos It causes diffuse pulmonary

do to the lungs? interstitial fibrosis

What is the composition of Dipalmitoyl

surfactant: phosphatidylcholine

FEV1 and FVC are reduced in

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

Superior vena caval syndrome

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

What kind of pulmonary

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

What organisms are is the

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

What organisms are the most

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

What specific type of

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

What specific type of

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

What type of lung cancer can

Carcinoid tumor
cause carcinoid syndrome?

What type of pneumonia is

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

What type of pneumonia is

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

Why does alpha-1-antitrypsin

Increased elastase activity
deficiency cause emphysema?

Epilepsy is a disorder of
Define epilepsy.
recurrent seizures.

Define syrinx. Tube, as in syringe

Describe a myoclonic seizure. Quick,repetitive jerks

Describe a tonic-clonic Alternating stiffening and

seizure. movement (grand mal)

Describe a tonic seizure. Stiffening

A blank stare (petit mal- it's

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

Broca's is nonfluent aphasia

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

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

Wernicke's is fluent aphasia

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

-Optic neuritis (sudden loss

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

Through the bloodstream to

How does it spread?
the CNS

How does Werdnig-Hoffman

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

How is the polio virus

Fecal-oral route
transmitted?

Higher prevalence with

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

In what persons is subdural Elderly individuals, alcoholics,

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

What are 2 common

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

What are 2 degenerative

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

What are 2 degenerative

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

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

What are neurofibrillary Abnormally phosphorylated

tangles? tau protein

1. Multiple sclerosis (MS) 2.

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

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

What are the clinical

symptoms of Huntington's Dementia, chorea
disease?

TRAP= Tremor (at rest)

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

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

of seizures in adults? Infection

What are the common causes -Genetic -Infection -Trauma

of seizures in children? -Congenital -Metabolic

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

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

-CSF with lymphocytic

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

What are the pathological

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

-Muscle weakness and

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

-Malaise -Headache -Fever -

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

What area of the brain is

affected by generalized Diffuse area
seizures?

What artery is compromised

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

What causes a parenchymal -HTN -Amyloid angiopathy -

hematoma? Diabetes Mellitus -Tumor

What causes poliomyelitis? Poliovirus

What chemical can

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

-Symmetric ascending muscle

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

What congenital malformation

is often associated with Arnold Chiari Malformation
syringomyelia?

What damage does

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

-Adult polycystic kidney

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

What do partial seizures

One area of the brain
affect?

What does rupture of a berry

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

What event is the rupture of

the middle meningeal artery Temporal bone fracture
secondary to?

What genes is the familial

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

What is a complex partial

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

What is anhidrosis? Absence of sweating

What is another name for

Acute idiopathic polyneuritis
Guillain-Barre syndrome?

What is another symptom of

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

What is another term for

Receptive aphasia
Wernicke's aphasia?

What is miosis? Pupil constriction

What is PML associated with? JC virus

 What is ptosis? Slight drooping of the eyelids

SIN 1. Scanning speech 2.

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

What is the common name for

Lou Gehrig's disease
ALS?

Venous bleeding (less

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

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

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

What is the most common

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

The bifurcation of the

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

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

Degeneration of the dorsal

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

What is the pathology of Atrophy of the caudate

Huntington's disease? nucleus

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

Associated with Lewy bodies

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

Destruction of anterior horn

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

Softening and cavitation

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

What is the prognosis for a

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

What is the shape of GBMs? Butterfly' glioma

What neural deficits are Impaired proprioception and

present in Tabes dorsalis? locomotor ataxia

What neural tracts are Crossing fibers of the

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

What neurons are affected in

Lower motor neurons only
Polio?

What seizures are categorized Awareness intact -Motor -

as simple partial? Sensory -Autonomic -Psychic

What tumor is Horner's

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

Where are most childhood 70% below tentorium

brain tumors located? (cerebellum)

Where do berry aneurysms At the bifurcations in the

occur? Circle of Willis

Where does it initially The oropharynx and small

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

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

Where is Broca's area located? Inferior frontal gyrus

Where is Pick's disease The frontal and temporal

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

Where is the most common

C8-T1
site of syringomyelia?

Where is the p-App gene

21
located?

Where is Wernicke's area

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

Chronic inflammatory disease

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

Chronic inflammatory disease

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

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

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

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

Excessive fibrosis &

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

dry eyes, dry mouth, nasal

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

dry eyes, dry mouth, nasal

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

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

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

sprue more commonly found? European descent

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

sprue more commonly found? European descent

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

In what population is gout

Men
more commonly found?

In what population is gout

Men
more commonly found?

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

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

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

In what population is Reiter's

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

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

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

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

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

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

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

90% are female &

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

90% are female &

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

Diffuse scleroderma: widespread skin

What are the 2 major
categories of scleroderma
& what findings are they
assoc w/?
involvement, often confined to fingers
involvement, rapid progression, early
visceral involvement. Assoc. w/ anti-
Scl-70 Ab CREST syndrome:
Calcinosis, Raynaud's phenomenon,
Esophageal dysmotility, Sclerodactyly
& Telangiectasia; limited skin
& face. More benign clinical
course - assoc w/ anticentromere Ab

What are the 2 major
categories of scleroderma
& what findings are they
assoc w/?
What are the associated sx's
& risks for Sjogren's
syndrome?
What are the associated sx's
& risks for Sjogren's
syndrome?
What are the characteristic
findings in Celiac sprue?
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
- Parotid enlargement - incr
risk of B-cell lymphoma -
Assoc. w/ RA
- Parotid enlargement - incr
risk of B-cell lymphoma -
Assoc. w/ RA
Blunting of villi, lymphocytes
in the lamina propria, &
abnormal D-xylose test
 Blunting of villi, lymphocytes
What are the characteristic
in the lamina propria, &
findings in Celiac sprue?
abnormal D-xylose test

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

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

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

Lesch-Nyan disease, PRPP

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

Lesch-Nyan disease, PRPP

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

deposition of calcium
What causes pseudogout? pyrophosphate crystals w/in
the joint space

What causes pseudogout?
SLE causes LSE (Libman-Sacks
What CV disease state can be
caused by SLE?
SLE causes LSE (Libman-Sacks
What CV disease state can be
caused by SLE?
What drugs can induce a
commonly reversible SLE-like
syndrome?
deposition of calcium
pyrophosphate crystals w/in
the joint space
Endocarditis): vavular
vegetations found on both
sides of valve (mitral valve
stenosis) & do not
embolize
Endocarditis): vavular
vegetations found on both
sides of valve (mitral valve
stenosis) & do not
embolize
- procainamide - INH -
phenytoin - hydralazine
 What drugs can induce a
- procainamide - INH -
commonly reversible SLE-like
phenytoin - hydralazine
syndrome?

90% of cases are assoc w/

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

90% of cases are assoc w/

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

What is characteristic about needle-shaped &

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

What is characteristic about

basophilic, rhomboid crystals
pseudogout crystals?

What is characteristic about

basophilic, rhomboid crystals
pseudogout crystals?

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

1. Urethritis (Can't pee) 2.

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

1. Urethritis (Can't pee) 2.

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

1. dry eyes (conjunctivitis,

What is the 'classic triad' for xerophthalmia) 2. dry mouth
Sjogren's syndrome? (dysphagia, xerostomia) 3.
arthritis

What is the 'classic triad' for
Sjogren's syndrome?
What is the classic pathology
for Osteoarthritis?
What is the classic pathology
for Osteoarthritis?
What is the classic pathology
for Rheumatoid arthritis?
1. dry eyes (conjunctivitis,
xerophthalmia) 2. dry mouth
(dysphagia, xerostomia) 3.
arthritis
Mechanical: wear & tear
of joints leads to destruction
of articular cartilage,
subchondral bone formation,
sclerosis, osteophytes,
eburnation, &
Heberden's nodes (DIP)
Mechanical: wear & tear
of joints leads to destruction
of articular cartilage,
subchondral bone formation,
sclerosis, osteophytes,
eburnation, &
Heberden's nodes (DIP)
Autoimmune: inflammatory
d/o affecting synovial joints,
w/ pannus formation in joints
(MCP, PIP), subcutaneous
rheumatoid nodules, ulnar
deviation, subluxation.

What is the classic pathology
for Rheumatoid arthritis?
Autoimmune: inflammatory
d/o affecting synovial joints,
w/ pannus formation in joints
(MCP, PIP), subcutaneous
rheumatoid nodules, ulnar
deviation, subluxation.

pain in weight-bearing joints

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

pain in weight-bearing joints

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

morning stiffness improving

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

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

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

What is the common tx for allopurinol, probenecid,

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

What is the common tx for

no tx
pseudogout?

What is the common tx for

no tx
pseudogout?

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

there are TWO Good Pastures

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

there are TWO Good Pastures

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

restrictive lung disease, bilateral

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

What the common pattern of Usually affects large joints

psudogout presentation? (classically the knee)

What the common pattern of Usually affects large joints

psudogout presentation? (classically the knee)

Asymmetric joint distribution.

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

Adrenal Atrophy and Absence

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

All MEN syndromes have what

Autosomal Dominant
mode of inheritance?

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

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

Those affected were

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

Excess fat breakdown (usually

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

From where do
leiomyosarcomas often Cervix
protrude?

How do you treat carcinoid

Treat with octreotide
syndrome?

How do you treat

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

Increase in what substance is

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

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

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

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

Is plasma renin low or high in

Low
primary hyperaldosteronism?

Is plasma renin low or high in

secondary High
hyperaldosteronism?
Leiomyomas are sensitive to
Estrogen
what?

- Fasting serum glucose -

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

- Coronary artery disease -

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

1. Renal artery stenosis 2.

Name five possible causes of
Chronic renal failure 3. CHF
secondary
4. Cirrhosis 5. Nephritic
hyperaldosteronism?
syndrome

Name four causes of SIADH.
Name four common
presenting symptoms of
benign prostatic hyperplasia.
- Small vessel disease - Large
Name four important chronic
manifestations of DM.
Name four risk factors of
endometrial carcinoma.
Ectopic ADH CNS disorders/
head trauma Pulmonary
disease Drugs
1. Increased frequency of
urination 2. Nocturia 3.
Difficulty starting and
stopping the stream of urine
4. Dysuria
vessel atherosclerosis -
Neuropathy - Cataracts,
glaucoma
1. Prolonged estrogen use 2.
Obesity 3. Diabetes 4. HTN
 Name four treatment - Weight loss - OCPs -
modalities for polycystic Gonadotropin analogs -
ovarian syndrome. Surgery

1. Gender 2. Age 3. Early first

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

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

Name syndrome: increased

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

Name the benign breast

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

Name the benign breast

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

Name the benign breast

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

Name the histologic type of

fibrocystic breast disease: Cystic
fluid-filled.

Name the histologic type of

fibrocystic breast disease: Fibrosis
hyperplasia of breast stroma.

Name the histologic type of

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

Name the histologic type of

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

Name the histologic type of

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

Name the histologic type of

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

1. Excessive water retention

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

1. Vertebral crush fractures 2.

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

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

T/F DKA is common in Type 1

True
DM.

T/F DKA is common in Type 2

False, rare
DM.

T/F Endometriosis often

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

T/F Genotype of a complete

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

T/F Glucose intolerance in

True
Type 1 DM is severe.

T/F Insulin is always

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

T/F Leiomyomas often

True
present with multiple tumors.

T/F Leiomyomas often

transform into malignant False, it is rare
tumors.

T/F Leiomyomas progress to

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

T/F Risk of breast disease is

increased by fibroadenoma False
and nonhyperplastic cysts.

T/F Type 1 diabetes is often

False
associated with obesity.

False. It is polygenic and only

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

Urinary VMA levels and

plasma catecholamines are
Pheochromocytoma
elevated due to what
neoplasms?

- hypertension - weight gain

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

What are the clinical effects of - Hypertension -

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

Insulin deficiency (or

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

- 10% Malignant - 10%

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

Type 1 - viral or immune

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

What breast disease is

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

What causes Cushing's

Increased cortisol
Syndrome?

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

What condition can produce

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

What condition is associated

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

What condition is caused by

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

What disease is characterized

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

What diuretic acts as an

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

What fractures cause acute

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

What gynecologic tumor is

often bulky with areas of Leiomyosarcoma
necrosis and hemorrhage?

What is a pathologic ovum

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

1/3 metastasize 1/3 present

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

What is the etiology of

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

What is the etiology of

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

What is the most common

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

What is the most common of

Leiomyoma
all tumors in females?

What is the most common

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

What is the most common

tumor of the adrenal medulla Neuroblastoma
in children?

What is the most common

Carcinoid tumor
tumor of the appendix?

Kidney perception of low

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

What neoplasms secrete high

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

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

What phenotypic difference

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

What syndrome is caused by a

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

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

involved in MEN type I? Parathyroid

What type of respirations are

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

Wherever endemic goiter is

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

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

Which type of Multiple

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

Which type of Multiple

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

Which type of osteoporosis

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

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

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

Will TSH be increased or

decreased in primary Increased
hyperthyroidism?

Will TSH be increased or

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

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

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

elevated 1-3 days post MI.

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

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

levels in an MI post MI

Characterize the LDH1 levels elevated from 2 to 7 days

in an MI post MI

Most frequent valvular lesion,

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

Rumbling late diastolic

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

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

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

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

Describe the bacterial

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

Describe the bacterial

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

Describe the onset of

Streptoccus viridans Insidious, subacute onset
endocarditis.

During what weeks of

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

It can resolve without scarring

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

How does Prinzmental's

chest pain at rest
variant angina present?

How does stable angina

chest pain with exertion
present?

Causes dilation of the aorta

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

Coronary heart dz, CVA, CHF,

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

1. Hemolysis 2. Elevated LFT

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

1. Headache 2. Blurred vision

3. Abdominal pain 4. Edema
What are clinical features of
of face and extremities 5.
preeclampsia?(6)
Altered mentation 6.
Hyperreflexia

What are complications from
an MI?(7)
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

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

1. Vent wall rupture 2.

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

What are fat emboli Long bone fractures and

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

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

tender raised lesions on

What are olser nodes?
finger or toe pads

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

round white spots on retina

What are Roth's spots?
surrounded by hemorrhage

What are some Agina and claudication. Can

atherosclerosis symptoms? be asymptomatic

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

What are the 3 most common

LAD>RCA>circumflex
sites of an MI?

stable angina, prinzmetal's

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

1. Aortic stenosis 2. Aortic

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

aneurisms, ischemia, infarcts,

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

1. Chronic alcohol abuse 2.

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

1. Unilateral headache 2. Jaw

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

1. Pericardial pain 2. Friction

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

1. C-ANCA positive 2. CXR

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

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

What are the risk factors of smoking, HTN, diabetes

atherosclerosis?(4) mellitus, and hyperlipidemia

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

JR= NO FAME 1. Janeway

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

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

pulmonary embolus? (3) dyspnea

Severe retrosternal pain, pain

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

fever, weight loss, malaise,

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

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

1. Fat 2. Air 3. Thrombus 4.

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

1. Infection 2. Ischemic heart

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

What causes cardiac dilation greater ventricle end-

in CHF? diastolic volume

What causes dyspnea on failure of LV output to

exertion in CHF? increase during exercise

increased central venous

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

Failure of left heart to keep

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

What causes prinzmental's

coronary artery spasm
variant angina?

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

Pharyngeal infection with

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

What causes stable angina? atherosclerosis

What causes sudden cardiac Most commonly from lethal

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

What causes unstable/ thrombosis in a branch of the

crescendo angina? coronary artery

1. Infarct appears pale 2.

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

1. A hyperemic boarder forms

around the infarct 2. The infarct
shows central softening with
What happens 5-10 days brown/yellow color 3. An outer
after an MI?(4) zone (ingrowth of granulation
tissue) forms around infarct 4.
Neutrophils and macrophages
infiltrate infarcted tissue

What happens by 7 weeks
post-MI?(3)
What happens to contractility,
cardiac output, and effective
atrial blood volume in CHF?
What happens to renal blood
flow in CHF?
What happens to renin,
angiotensin II, and
aldosterone in CHF
1. The Occluded artery
causing the MI is recanalized
2. The infarct area is gray/
white 3. The infarcted tissue
shows contracted, complete
scarring
all decrease
decreases
all increase
What happens to sympathetic
increases
nervous activity in CHF?

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

What happens to urinary

excretion of water and Na in decrease
CHF?

What happens to venous

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

What is 'pulseless disease'? Takayasu's arteritis

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

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

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

Progressive onset of CHF over

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

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

The addition of seizures to

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

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

Necrotizing immune complex

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

A triad of HTN, protenuria,

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

Thickening of aortic arch and

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

Vasculitis that affects medium

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

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

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

What is the incidence of

7% of pregnant women
preeclampsia?

What is the inheritance

pattern of hypertrophic AD
cardiomyopathy?

What is the most common Dilated (congested)

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

What is the most common

primary cardiac tumor in Myxoma
adults?

What is the most common

primary cardiac tumor in rhabdomyoma
children

What is the most common

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

What is the treatment for

Responds well to steroids
temporal arteritis?

IV Magnesium sulfate and

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

What is the treatment of Corticosteroids, azathioprine,

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

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

What is the x-ray appearance

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

Focal necrotizing vasculitis

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

What kind of effusions are

found in pericarditis Serous of fibrinous
associated with renal failure?

What lab finding is seen in

Takayasu's arteritis or elevated ESR
temporal arteritis?

What part of the heart/

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

What percentage of HTN is

10%
secondary?

What population is associated

with death from hypertrophic young athletes
cardiomyopathy?

Virchow's triad: 1. Stasis 2.

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

1. Ankle and sacral edema 2.

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

1. EKG (the gold standard) 2.

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

What type of bacterial

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

Viruses, TB, pyogenic

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

What visual complication can occlusion of ophthalmic

temporal arteritis cause? artery leading to blindness

90% occur in the atria, mostly

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

Loose tissue with collaterals:

Where do red infarcts occur?
lungs or intestine

Where does a MI usually In the left anterior

occur? descending coronary artery

The elastic arteries and

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

Which valve is most

frequently involved in Mitral
bacterial endocarditis?

Which valves are most mitral>aortic>>tricus

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

Primarily affects young Asian

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

Failure to make urine and

Define renal failure.
excrete nitrogenous wastes

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

gap? L

How do you treat minimal

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

How does renal cell

Invades the IVC and spreads
carcinoma spread
hematogenously
metastically?

How does transitional cell

Hematuria
carcinoma present?

How does Wilms' tumor

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

T/F: Ammonium magnesium

phosphate kidney stones are TRUE
radiopaque

T/F: Calcium kidney stones

TRUE
are radiopaque.

T/F: Calcium kidney stones

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

T/F: Transitional cell False, transitional cell

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

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

What additional sx are seen in

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

1. Acute lung disease 2.

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

What are the 2 forms of renal

Acute and chronic
failure?

What are the 2 main

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

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

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

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

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

What are the causes of Secondary to emesis,

chloride ion deficiency? diuretics, renal disease

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

What are the causes of

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

What are the characteristics

of acute poststreptococcal
Granular pattern
glomerulonephritis seen with
immunofluorescence?

What are the characteristics

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

What are the characteristics

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

-Hematuria -Palpable mass -

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

What are the clinical I' = inflammation; hematuria,

symptoms of a nephritic hypertension, oligouria,
syndrome? azotemia

What are the clinical O = proteinuria

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

What are the factors

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

What are the factors

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

What are the factors

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

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

-Extracellular fluid -Maintains

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

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

-ATP -nucleic acids -

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

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

potassium ion? muscle function

What are the signs of

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

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

phosphate deficiency? osteomalacia

What are the signs of

-EKG changes -Arrhythmia
potassium ion toxicity?

What bugs cause ammonium Urease-positive bugs such as

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

What can excess Na and

CHF and pulmonary edema
water cause?

What can the hyperkalemia

associated with renal failure Cardiac arrhythmias
lead to?

1. Vomiting 2. Diuretic use 3.

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

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

What characteristics of focal

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

What characteristics of Linear pattern Anti-

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

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

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

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

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

Wire-loop appearance with

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

What defines metabolic -pH less than 7.4 -PCO2 less

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

What defines respiratory -pH less than 7.4 -PCO2

acidosis? greater than 40mm Hg

What defines respiratory -pH greater than 7.4 -PCO2

alkalosis? less than 40 mm Hg

Diseases with increased cell

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

1. Renal failure 2. Lactic

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

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

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

Wilms' tumor Aniridia

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

What factors are associated Exposure to

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

Renal cell carcinoma is

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

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

What is acute renal failure

Hypoxia
often due to?

IgA nephropathy -Mild

What is Berger's disease?
disease -Often postinfectious

What is chronic failure due to? HTN and diabetes

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

What is the cause of

Secondary to malabsorption
magnesium ion deficiency?

What is the cause of

Vomiting
metabolic alkalosis?

What is the cause of Secondary to injury, illness or

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

What is the compensatory

mechanism of metabolic Hypoventilation
alkalosis?

What is the compensatory

mechanism of respiratory Renal HCO3- secretion
alkalosis?

What is the compensatory

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

What is the course of

Slowly progresses to renal
membranoproliferative
failure
glomerulonephritis?

What is the course of rapidly

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

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

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

What is the most common

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

What is the most common

Renal cell carcinoma
renal malignancy?

What is the most common

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

What is the primary

disturbance of metabolic HCO3- decrease
acidosis?

What is the primary

disturbance of metabolic Increased HCO3-
alkalosis?

What is the primary

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

What is the sign of sodium

Delirium
ion toxicity?

What lesions are seen on the

Kimmelstiel-Wilson lesions
LM in diabetic nephropathy?

MUD PILES 1. Methanol 2.

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

What severe complications Hydronephrosis

may kidney stones lead to? Pyelonephritis

What social factor increases

the incidence of renal cell Smoking
carcinoma?

What type of hypersensitivity

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

Where does renal cell Renal tubule cells, polygonal

carcinoma originate? clear cells

Which kidney stone is often

Cystine
secondary to cystinuria?

Which kidney stone is

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

Which type of kidney stones

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

Why are ammonium Ammonium magnesium

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

Why does renal failure cause

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

-Physiologic tolerance and

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

In alcoholics, what causes

Vitamin B1 (thiamine)
Wernicke-Korsakoff
deficiency
syndrome?

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

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

-Toxicity (especially in the

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

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

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

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

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

What is the triad of symptoms

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

What supportive group has

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

What treatment is used to

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

Autoimmune (infection is the

Addison's
second most common cause)

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

Aneurysm, dissecting HTN

Anti-basement membrane Goodpasture's syndrome

Anti-centromere antibodies Scleroderma (CREST)

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

Anti-epithelial cell Pemphigus vulgaris

Anti-gliadin antibodies Celiac disease

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

Anti-IgM antibodies Rheumatoid arthritis

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

Idiopathic thrombocytopenic
Antiplatelet antibodies
purpura

Aortic aneurysm, abdominal

Atherosclerosis
& descending aorta

Aortic aneurysm, ascending Tertiary syphilis

 Arachnodactyly Marfan's syndrome

Argyll-Robertson pupil Neurosyphilis

Aschoff bodies Rheumatic fever

Atrophy of the mamillary

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

Autosplenectomy Sockle cell anemia

Babinski sign Upper motor neuron lesion

Bacteremia/pneumonia (IVDA) Staphylococcus aureus

 Bacteria associated with
Helicobacter pylori
cancer

Bacteroides (second most

Bacteria found in GI tract
common is Escherichia coli)

Bacterial meningitis (adults) Neisseria meningitidis

Bacterial meningitis (elderly) Streptococcus pneumoniae

 Bacterial meningitis (kids) Haemophilus influenza type B

Bacterial meningitis
Escherichia coli
(newborns)

Baker's cyst in popliteal fossa Rheumatoid arthritis

Bamboo spine' on xray Ankylosing spondylitis

Basophilic stippling of RBC's Lead poisoning

Multiple myeloma (kappa or

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

Bilateral hilar adenopathy,

Sarcoidosis
uveitis

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

Fibrocystic change of the

Blue-domed cysts
breast

Blue bloater' Chronic bronchitis

Blue sclera Osteogenesis imperfecta

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

Osteoarthritis (PIP swelling

Bouchard's nodes
secondary to osteophytes)

Boutonniere's deformity Rheumatoid arthritis

Brain tumor - supratentorial

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

Brain tumor (kids) Medullobastoma (cerebellum)

Branching rods in oral

Actinomyces israelii
infection

Infultrating ductal carcinoma

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

Breast tumor (benign) Fibroadenoma

Hemorrhage causes brown

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

Brushfield's spots Down syndrome

 Bruton's lines Lead poisoning

Bug in debilitated,
hospitalized pneumonia Klebsiella
patient

C-ANCA Wegerner's granulomatosis

Café au lait spots on skin Neurofibromatosis

 Duchenne's muscular
Calf pseudohypertrophy
dystrophy

Granulosa/thecal cell tumor

Call-Exner bodies
of the ovary

Cancer associated with AIDS Kaposi's sarcoma

Cardiac primary tumor Myxoma (4:1 left to right

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

Cardic tumor (adults) Mets

Cardiomegaly with apical

Cagas' disease
atrophy

Cardiomyopathy Dilated cardiomyopathy

 Mycosis fungoides (cutaneous
Cerebriform nuclei
T-cell lymphoma)

Chancre Primary syphilis (not painful)

Chancroid Haemophilus ducreyi (painful)

Multiple sclerosis (nystagmus,

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

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

Hypocalcemia (facial muscle

Chevostek's sign
spasm upon tapping)

Central apnea in CHF &

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

Down syndrome (associated

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

Atrial fibrillation (associated

Chronic arrhythmia
w/ high risk of emboli)

Predisposition to gastric
Chronic atrophic gastritis
carcinoma
 Clue cells Gardnerella vaginitis

Codman's triangle on x-ray Osteoasarcoma

Mycoplasma pneumoniae;
Cold agglutinins
Infectious mononeucleosis

Cold intolerance Myxedema

 Condyloma lata Secondary syphilis

Congenital adrenal
21-Hydroxylase deficiency
hyperplasia

Congenital cardiac anomaly VSD

Constrictive pericarditis Tuberculosis

 Continuous machinery
Patent ductus arteriosus
murmur

Coronary artery involved in

LAD > RCA > LCA
thrombosis

Cotton wool spots Chronic hypertension

Cough, conjunctivitis, coryza

Measles
+ fever
 Councilman bodies Toxic or viral hepatitis

Cowdry type A bodies Herpes virus

Crescents in Bowman's Rapidly progressive crescentic

capsule glomerulonephritis

Cretinism Hypothyroidism/iodine deficit

 Currant-jelly sputum Klebsiella

Bronchial asthma (whorled

Curschmann's spirals
mucous plugs)

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

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

Death in CML Blast crisis

Death in SLE Lupus nephropathy

Alzheimer's (second most

Dementia
common is multi-infarct)
 Demyelinating disease Multiple sclerosis

Parkinson's disease (basal

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

Dermatitis, dementia, Pellagra (Niacin, vitamin B3

diarrhea deficiency)

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

Dietary deficit Iron

Dog or cat bite Pasteurella multocida

Donovan bodies Granuloma inguinale

 Ejection click Aortic/pulmonic stenosis

Elastic skin Ehlers-Danlos syndrome

Epiglottitis Haemophilus influenza type B

Erythema chronicum migrans Lyme disease

 Esophageal cancer Squamous cell carcinoma

Fat, female, forty, &

Acute cholecystitis
fertile'

Fatty liver Alcoholism

Ferruginous bodies Asbestosis

 Food poisoning Staphylococcus aureus

Ghon complex Secondary TB

Ghon focus Primary TB

IgA nephropathy (Berger's

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

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

Gynecologic malignancy Endometrial carcinoma

Hair on end' appearance on

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

HbS Sickle cell anemia

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

Heart murmur Mitral valve prolapse

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

Heart valve in bacterial

Mitral
endocarditis

Heart valve in bacterial

Tricuspid
endocarditis in IVDA

Osteoarthritis (DIP swelling

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

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

Rupture of middle meningeal

Hematoma - epidural artery (arterial bleeding is
fast)

Rupture of bridging veins

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

Hepatic cirrhosis EtOH

Cirrhotic liver (often

Hepatocellular carcinoma associated with hepatitis B
& C)

Hereditary bleeding disorder Von Willebrand's

 Infectious mononucleosis
Heterophil antibodies
(EBV)

Hgb F Thalassemia major

High output cardiac failure Wet beriberi (thiamine,

(dilated cardiomyopathy) vitamin B1 deficiency)

Reiter's syndrome, ankylosing

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

Holosystolic murmur VSD, tricuspid regurgitation

Homer-Wright rosettes Neuroblastoma

Honeycomb lung on x-ray Interstitial fibrosis

 Splenectomy (or non-
Howell Jolly bodies
functional spleen)

Hyperphagia + hypersexuality Kluver-Bucy syndrome

+ hyperorality + hyperdocile (amygdala)

Primary adrenal insufficiency

Hyperpigmentation of skin
(Addison's disease)

Hypersegmented neutrophils Macrocytic anemia

 Cushing & Conn
Hypertension + hypokalemia
syndromes

Hypertension, secondary Renal disease

Hypochromic microcytosis Iron-deficiency anemia

Hypoparathyroidism Thyroidectomy
 Hypopituitarism Adenoma

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

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

Infection in blood transfusion Hepatitis C

 Infection in burn victims Klebsiella

Adenovirus (cause
Intussesception hyperplasia of Peyer's
patches)

Janeway lesions Endocarditis

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

Kayser-Fleischer rings Wilson's disease

Keratin pearls Squamous cell carcinoma

Calcium = radiopaque (2nd

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

Koilocytes HPV

Koplik spots Measles

Kussmaul hyperpnea Diabetic ketoacidosis

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

Leukemia (adults) AML

Lewy bodies Parkinson's disease

Lines of Zahn Arterial thrombus

 Neurofibromatosis (von
Lisch nodules
Recklinghausen's disease)

Liver disease Alcoholic liver disease

Location of brain tumors

Supratentorial
(adults)

Location of brain tumors

Infratentorial
(kids)
 Low serum ceruloplasmin Wilson's disease

Lucid interval Epidural hematoma

Lumpy Bumpy' appearance of

Poststreptococal
glomeruli on
glomerulonephritis
immunoflourescence

Lysosomal storage disease

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

Machine-like' murmur PDA

Male cancer Prostatic carcinoma

Malignancy associated with

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

Mallory bodies Alcoholic liver disease

McBurney's sign Appendicitis

Down syndrome (Fragile X is

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

Lung, breast, skin

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

Colon, gastric, pancreatic,

Mets to liver breast, & lung
carcinomas

MI Atherosclerosis
 Mitral valve stenosis Rheumatic heart disease

MLF syndrome (INO) Multiple sclerosis

Multiple myeloma (called the

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

Motor neuron disease ALS

 Myocarditis Coxsackie B

Myxedema Hypothyroidism

Necrotizing vasculitis (lungs) Wegener's &

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

Needle-shaped, negatively
Gout
bifringent crystals
 Negri bodies Rabies

ALL (2nd most common is

Neoplasm (kids)
cerebellar medulloblastoma)

Nephritis + cataracts +
Alport syndrome
hearing loss

Minimal change disease

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

Membranous
Nephrotic syndrome (adults)
glomerulonephritis

Neurofibrillary tangles Alzheimer disease

No lactation postpartum Sheehan's syndrome

 Nutmeg liver Congestive heart failure

Obstruction of male urinary

BPH
tract

Occupational exposure to
Malignant mesothelioma
asbestos

Oncogene involved in cancer p53 Suppressor

 Opening snap Mitral stenosis

Opportunistic infection in
PCP
AIDS

Adrenal glands (due to rich

Organ receiving mets
blood supply)

Organ sending mets Lung > breast, stomach

 Papillary carcinoma of the
Orphan Annie cells
ovary

Osler's nodes Endocarditis

Osteomyelitis Staphylococcus aureus

Osteomyelitis in patients with

Salmonella
sickle cell disease
 Osteomyelitis with IVDA Pseudomonas

Ovarian tumor (benign) Hamartoma

Ovarian tumor (malignant) Serous cystadenoma

Owl's eye CMV

 P-ANCA Polyarteritis nodosa

Painless jaundice Pancreatic cancer (head)

Palpable purpura on legs

Henoch-Schonlein purpura
& buttocks

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

EtOH (adults), cystic fibrosis

Pancreatitus (chronic)
(kids)

Pannus Rheumatiod arthritis

ALL - Child / CLL - Adult over

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

Patient with minimal change

Young child
disease

Patient with Reiter's Male

Peau d'orange Carcinoma of the breast

 Neisseria gonorrhoeae
Pelvic inflammatory disease
(monoarticular arthritis)

Periosteal elevation on x-ray Pyogenic osteomyelitis

Philadelphia chromosome CML (may sometimes be

(bcr;abl) associated with AML)

Pick bodies Pick's disease

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

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

Pneumonia, hospital-acquired Klebsiella

Pneumonia, in CF, burn

Pseudomonas aeruginosa
infection
 Podagra Gout (MP joint of hallux)

Podocyte fusion Minimal change disease

Polyneuropathy preceded by
Guillian-Barre syndrome
GI or respiratory infection

Polyneuropathy, cardiac Dry beriberi (thiamine,

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

Posterior anterior 'drawer Anterior cruciate ligament

sign' injury

Preventable blindness Chlamydia

Preventable cancer Lung cancer

 Primary amenorrhea Turner's (XO)

Primary bone tumor (adults) Multiple myeloma

Primary hyperaldosteronism Adenoma of adrenal cortex

Adenomas (followed by:

Primary hyperparathyroidism
hyperplasia, then carcinoma)
Primary hyperparathyroidism Adenoma

Primary liver tumor Hepatoma

Caused by apoptosis of tumor

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

Pseudopalisade tumor cell

Glioblastoma multiforme
arrangement
 Pseudorosettes Ewing's sarcoma

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

Pulmonary hypertension COPD

Pus, empyema, abscess Staphylococcus aureus

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

RBC's in urine Bladder carcinoma

RBC casts in urine Acute glomerulonephritis

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

Reed-Sternberg cells Hodgkin's lymphoma

Reid index (increased) Chronic bronchitis

Reinke crystals Leydig cell tumor

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

Renal epithelial casts in urine Acute toxic/viral nephrosis

Renal cell carcinoma -

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

Rhomboid crystals, positively

Pseudogout
bifringent
 Rib notching Coarctation of aorta

Right-sided heart faulure Left-sided heart failure

Right heart failure due to a

Cor pulmonale
pulmonary cause

Roth spots in retina Endocarditis

Rouleaux formation (RBC's) Multiple myeloma

Russell bodies Multiple myeloma

Left to right shunt (VSD, PDA,

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

Aortic stenosis, hypertrophic

S4
subaortic stenosis
Schiller-Duval bodies Yolk sac tumor

Schwarzman reaction Neisseria meningitidis

Secondary Hypocalcemia of chronic renal

hyperparathyroidism failure

Senile plaques Alzheimer's disease

Sexually transmitted disease Chlamydia

Postpartum pituitary
Sheehan's syndrome
infarction

Small cell carcinoma of the

SIADH
lung

Signet ring cells Gastric carcinoma

 Simian crease Down syndrome

Site of diverticula Sigmoid colon

Site of metastasis Regional lymph nodes

Site of metastasis (2nd most

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

Skin cancer Basal cell carcinoma

Skip lesions Crohn's

Erythema infectiosum (fifth

Slapped cheeks
disease)'
 Smith antigen SLE

Smudge' cell CLL

Soap bubble on x-ray Giant cell tumor or bone

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

Starry-sky pattern Burkitt's lymphoma

Stomach cancer Adenocarcinoma

Strawberry tongue' Scarlet fever

 Streaky ovaries Turner's syndrome

String sign on x-ray Crohn's disease

Poststreptococal
Subepithelial humps on EM
glomerulonephritis

Suboccipital
Rubella
lymphadenopathy
 Sulfur granules Actinomyces israelii

Surgical wound Staphylococcus aureus

Scurvy (ascorbic acid, vitamin

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

Systolic ejection murmur

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

Burkitt's lymphoma (c-myc

t(8;14)
activation)

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

Tabes dorsalis Tertiary syphilis

 Target cells Thalassemia

Tendon xanthomas
Familial hypercholesterolemia
(classically Achilles)

Testicular tumor Seminoma

Thumb sign on lateral x-ray Epiglottitis

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

Thyroid cancer Papillary carcinoma

Chronic bacterial
Thyroidization of kidney
pyelonephritis

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

Tram-track' appearance on Membranoproliferative

LM glomerulonephritis

Traumatic open wound Clostridium perfringens

Visceral cancer; pancreatic

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

Leiomyoma (estrogen
Tumor in women
dependent)

Tumor of infancy Hemangioma

Tumor of the adrenal medulla

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

Mixed cellularity (versus:

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

Type of non-Hodgkin's Follicular, small cleaved

Type of pituitary adenoma Prolactinoma

 UTI Escherichia coli

UTI (young women) Staphylococcus saprophyticus

Temporal arteritis (risk of

ipsilateral blindness due to
Vasculitis
thrombosis of ophthalmic
artery)

Viral encephalitis HSV

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

Pulmonary embolism (triad =

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

Folic acid (pregnant women

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

Chronic end-stage renal

Waxy casts
disease
 WBC's in urine Acute cystitis

WBC casts in urine Acute pyelonephritis

Wire loop' appearance on LM Lupus nephropathy

Berry aneurysm - associated

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

Xerostomia + arthritis +
Sjogren's syndrome
keratoconjunctivitis sicca