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Pathology
UWORLD Round 1 2021 Part 2
| Question | Answer |
|---|---|
| What is the common population that acquire Sarcoidosis? | Young African-American women |
| How is Sarcoidosis clinically presented? | Insidious onset or respiratory symptoms (cough, dyspnea, chest pain) accompanied with fatigue, fever, and weight loss |
| What is the key histopathologic finding of Sarcoidosis? | Non-caseating granulomas |
| How are the Non-caseating granulomas of Sarcoidosis, composed? | Aggregates of epithelioid macrophages and multinulceaed giant cells |
| Aggregates to epithelioid macrophages and multinucleated cells, in patient with Sarcoidosis. | Non-caseating granulomas |
| What condition is seen with respiratory symptoms and non-caseating granulomas under histological view? | Sarcoidosis |
| What pathogen is strongly associated with development of duodenal ulcer in PUD? | H. pylori infection |
| What is the MC association of H. pylori gastritis? | Formation of duodenal ulcers due to increased gastric acid production |
| How is the increased acidity in PUD caused? | Unchecked gastrin production due to the destruction of somatostatin-secreting cells in the gastric antrum |
| Where in the stomach ar the Somatostatin-secreign cells? | Gastric antrum |
| What is the most important environmental factor for development of Pancreatic cancer? | Smoking |
| Other than smoking, what are other risk factor for Pancreatic cancer? | Advanced age, chronic pancreatitis, and genetic predisposition (Peutz-Jegher syndrome) |
| What genetic condition or illness is associated as a risk factor for Pancreatic cancer? | Peutz-Jegher syndrome |
| What is a positive sign seen in Pancreatic cancer? | Courvoisier sign |
| What is the Courvoisier sign? | Painless palpable gallbladder |
| What conditions are seen with a (+) Courvoisier sign? | 1. Pancreatic cancer 2. Cholangiocarcinoma 3. Hepatic duct obstruction |
| What kind of jaundice is associated with Pancreatic cancer? | Painless Obstructive jaundice |
| How is Obstructive jaundice is clinically presented? | Elevated bilirubin, dark urine, and pale stools |
| (+) Courvoisier sign and painless obstructive jaundice. Possible Dx? | Pancreatic cancer |
| What is the most common cause of anemia in a women of childbearing age? | Iron deficiency anemia |
| What are some associations of Iron deficiency anemia? | 1. Decreased serum ferritin 2. Increased Total Iron Binding Capacity (Transferrin) 3. Microcytic, hypochromic RBCs |
| What is the main cause for secondary iron deficiency anemia in women of childbearing age? | Menstrual blood loss |
| What are some characteristics of Squamous metaplasia? | It is reversible, adaptive response to chronic irritation , such as smoking |
| What is the result of replacement of normal columnar epithelium with squamous epithelium in the esophagus? | Squamous epithelium is more resistant to irritation (smoke) but has a reduced mucociliary clearance |
| What is the metaplasia that occurs in Barrett's esophagus? | Esophageal squamous epithelium is replaced by columnar epithelium in response to chronic acid exposure |
| What are common melanocyte markers associated with diagnosis of Melanoma? | S-100, HMB-45, and MART-1 |
| A biopsy of of skin shows immunostaining positive for S-100, HMB-45, and MART-1, dx? | Melanoma |
| What is S-100? | Protein expressed in cells derived from the neural crest |
| What is HMB-45? | Monoclonal antibody that binds to immature melanosomes found in a melanocytic tumors |
| After several months or years from ischemic brain infarct, what is formed? | Cystic cavity surrounded by a wall composed of dense fibers, formed by astrocytic processes (glial scar) |
| What is a glial scar composed of? | Astrocytic processes |
| What is a glial scar? | Surrounding wall of a cystic cavity, formed after months to years from ischemic brain stroke, composed f Astrocytic processes, also known as glial scar |
| Longitudinal mucosal tears of the gastroesophageal junction? | Mallory-Weiss tears |
| What condition accounts for nearly 10% of all upper GI hemorrhages? | Mallory-Weiss tears |
| Mallory-Weiss syndrome is due to: | Increased intraluminal gastric pressure duet to retching, vomiting, or other abdominal straining |
| What is the cause of Esophageal varices? | Increased venous pressure |
| Which esophageal condition is due to increased venous pressure? | Esophageal varices |
| What is Epidermolysis bullosa? | A group of inherited disorders characterized by epithelial fragility triggered by minor trauma |
| What are the skin conditions seen with Epidermolysis bullosa? | Bullae, erosions, and ulcers |
| What causes Epidermolysis bullosa? | Mutations affecting proteins in the intraepidermal and dermoepidermal adhesions complexes |
| What mutated protein cause the most common type of Epidermolysis bullosa (EB simplex)? | Keratin |
| How is Lobar pneumonia characterised? | Marked by the cytokine-mediated accumulation of neutrophils and proteinaceous material in the alveoli |
| What happens with time (days) to the proteinaceous material seen with Lobar pneumonia? | It becomes fibrinous, neutrophils are repalefc by macrophages and macrophages digest the fibrinous exudate, leading to clearing the lung |
| What is the MC benign liver tumor? | Hemangioma |
| What is the microscopic description of a Hemangioma? | Cavernous, blood-filled vascular spaces of variable size, lined by a single epithelial layer |
| Why is a biopsy of a suspected hemangioma not indicated? | It can rupture leading to fatal hemorrhage, and has a low diagnostic yield |
| What is amyloid? | An abnormally folded (insoluble) extracellular protein that has apple-green birefringence when stain with Congo red and viewed under polarized light |
| Amyloid deposition exclusively in the brain lead to: | Alzheimer disease |
| What is the type of amyloid seen in Alzheimer disease? | B-amyloid deposits in the brain parenchyma (neuritic plaques) and walls of the cerebral vessels (amyloid angiopathy) |
| What is amyloid angiopathy? | B-amyloid deposition in cerebral vessels |
| What condition is associated with B-amyloid deposition in the brain? | Alzheimer disease |
| What part of the brain is seen with Amyloid deposition in Alzheimer's disease? | Medial Temporal lobe (hippocampus, amygdala, and entorhinal cortex) |
| Which lobe of the brain is often affected by amyloid deposition in patient with Alzheimer? | Medial Temporal lobe |
| What is the MCC of gradually developing myocardial ischemia? | Slow-growing, stable atherosclerotic plaque |
| What is the most likely cause of vessel rupture leading to myocardial ischemia? | Slow-growing, stable atherosclerotic plaque |
| What is myocardial hibernation? | Refers to a state of chronic myocardial ischemia in which both myocardial metabolism and function reduced to match with concomitant reduction in coronary blood flow |
| What is a common condition that leads to Myocardial hibernation? | Moderate/ severe flow-limiting stenosis |
| A patient with a chronic cor oryany stenosis conditions, may also present as compensatory mechanism with: | Myocardial hibernation |
| Presence of Left Ventricular systolic dysfunction due to reduced coronary blood flow | Myocardial hibernation |
| What is the best overall definition of Pulmonary stenosis? | Pulmonic valve stenosis causes a: 1. Crescendo- decrescendo systolic murmur 2. Delays clossedure of the pulmonic valve, resulting in a widened splitting of S2 |
| Where is Pulmonic stenosis best heard during auscultation? | Left Upper Sternal Border (LUSB) |
| What common murmur is best heard at the Left upper sternal border? | Pulmonic stenosis |
| Pulmonic stenosis is a systolic or diastolic murmur? | Systolic |
| What is the auscultative description of Pulmonic stenosis? | Crescendo-Decrescendo systolic murmur best heard at the LUSB |
| What causes the widening split of S2 in pulmonic stenosis? | Delay closure of the pulmonic valve |
| What is the auscultative result of the delay closure of the pulmonic valve in pulmonic stenosis? | Widening splitting of S2 |
| What is the relationship between expiration and heart blood flow? | Inspiration increases blood flow the the right side of the heart, causes increased intensity of right-sided murmurs |
| What is the result of inspiration in Pulmonic stenosis? | Increased murmur intensity with the increased blood flow to the right side of heart, and further delay the closerude of the pulmonic valve |
| What normal respiratory action can cause a delay in pulmonic valve closure? | Inspiration |
| In Atherosclerosis, what defines the likelihood of plaque rupture? | Plaque rupture is related to plaque stability rather than plaque size or the degree of luminal narrowing |
| What is more critical or important in dictating likelihood of atherosclerotic plaque rupture: Size, stability, or lumen narrowing? | Plaque stability |
| What does atherosclerotic plaque stability depend on? | On mechanical strength of the fibrous cap |
| What enzymes are known to decrease the atheroscleroi plaque stability? | Metalloproteinases |
| What is the role of Metalloproteinases? | Degrade extracellular matrix proteins, which cause a decrease in stability of the atheroscleritc plaque |
| Which what condition are metalloproteinases closely related to pathology? | Atherosclerotic plaque stability |
| What is a common test to identity which type of Leprosy the patient has? | Lepromin skin test |
| What does a positive (+) Lepromin skin test indicate? | Indicates a strong Th1 cell mediated immune response, and patient has Tuberculoid leprosy |
| Ist the Lepromin skin test (+) or (-) in Tuberculoid leprosy? | Positive |
| What kind of leprosy yields a (-) Lepromin skin test? | Lepromatous leprosy |
| What Th response is expected in a patient with a negative lepromin skin test? | Th2 immune response |
| Is the Lepromin skin test (+) or (-) in Lepromatous leprosy? | Negative |
| What are compound nevi? | Benign proliferation of melanocytes that involved both the dermis and epidermis |
| Which layers of the skin are involved in melanocytic nevus? | Dermis and Epidermis |
| How are compound nevi clinically presented? | Slightly raised papules with uniform pigmentation and symmetrical sharp borders |
| What is the most common type of Breast cancer? | Invasive ductal carcinoma |
| What is the classical finding in mammogram of Ductal carcinoma in situ of the breast? | Microcalcifications |
| How is DCIS of the breast characterized histopathologically? | Ducts distended by pleomorphic cells with prominent central necrosis |
| What type of breast malignancy or tumor is seen with ducts distended by pleomorphic cells with prominent central necrosis, that do not penetrate basement membrane? | DCIS of the breast |
| What is the precursor for Invasive ductal carcinoma of the breat? | DCIS of the breast |
| What is Crohn disease? | IBD characterized by patchy inflammation that can occur throughout the entire GI tract |
| What are classic findings of gross inspection of Crohn disease? | Skip lesions, cobblestones of the mucosa, bowel wall thickening, and creeping fat. |
| Which IBD is probably indicated if it mentions creeping fat in affected area of the GI tract, Crohn disease or Ulcerative colitis? | Crohn disease |
| What substance triggers Celiac disease? | Gluten |
| Gluten is often a triggered of what immune condition? | Celiac disease |
| What is Celiac disease? | An immune-mediated disorder triggered by Gluten |
| What are the classic findings of Celiac disease in the small intestine? | Intraepithelial lymphocytosis, villous atrophy, and crypt hyperplasia |
| What immune-mediated condition is often found with small intestine leukocytosis, villous atrophy, and crypt hyperplasia? | Celiac disease |
| What is a severe consequence of Intraepithelial leukocytosis of the small intestine seen in Celiac disease? | Enteropathy-associated T-cell lymphoma |
| What causes the development of a T-cell lymphoma in Celiac patients? | Monoclonal T-cell expansion in the small bowel mucosa |
| What are the serum markers (antibodies) of Celiac disease? | 1. Tissue transglutaminase IgA antibody 2. Anti-Endomysial antibody |
| (+) tissue transglutaminase IgA antibody. Dx? | Celiac disease |
| Common manifestation of chronic cholecystitis and in association of multiple gallstones? | Porcelain gallbladder |
| What causes Porcelain gallbladder? | Dystrophic intramural deposition of calcium salts in teh setting of chronic inflammation (chronic cholecystitis) |
| Dystrophic intramural deposition of calcium salts in the gallbladder in setting of chronic inflammatory illness? | Porcelain gallbladder |
| What malingany is at increased risk in patient with Porcelain Gallbladder? | Adenocarcinoma of the Gallbladder |
| What condition is often associated with increased risk of developing adenocarcinoma of the Gallbladder ? | Porcelain gallbladder |
| What happens to the cytoplasm of hepatocytes in an infection with Hepatitis B virus? | Hepatocellular cytoplasm fills with Hep B surface antigens |
| How are the Hepatitis B virus cytoplasmic inclusions described histologically? | Finely granular, pale eosinophilic, ground-glass appearance |
| What feature is highly specific for HBV infection? | Cytoplasmic inclusion in the hepatocyte of Hepatitis B surface antigen |
| What is an important cause of Esophageal adenocarcinoma? | Barrett esohpaghuse, leading to esophageal adenocarcinoma of the distal esophagus |
| Which part of the esophagus, distal, medial, or proximal is associated with development of esophageal adenocarcinoma due to Barrett esophagus? | Distal esophagus |
| What is the most important factor for Barrett esophagus? | Long-standing GERD |
| Other than GERD, what are other risk factors for Barrett esophagus? | Obesity, smoking, use of medications that increase esophageal sphincter tone, and consumption of foods containing nitroso compounds |
| Common items that cause oxidative stress to RBCs leading to hemolytic anemia in G6PD deficiency? | Fava beans, dapsone, and acute infection |
| What type of anemia is associated with G6PD deficiency? | Episodes of hemolytic anemia following oxidative stress |
| What are some signs and symptoms if G6PD deficiency? | 1. Episodes of hemolytic anemia after oxidative stress 2. Jaundice and dark urine 3. Normocytic anemia 4. Reticulocytosis 5. Bites cells and Heinz bodies on peripheral smear |
| What are the key histological findings in G6PD deficiency PBS? | Bite cells and Heinz bodies |
| What is another term used to describe "iron overload"? | Hemosiderosis |
| What is a common and serious complication of chronic hemolytic anemia and blood transfusions? | Iron overload |
| What is the most important or "cardinal" finding of Hemolytic anemia due to an iron overload? | Hemosiderin accumulation |
| What is the best treatment for hemosiderin accumulation in hemolytic anemia? | Chelation therapy is indicated to reduce Parenchymal iron deposition |
| What causes DIC? | Occurs in setting of SEPSIS and is characterized by widespread activation of the coagulation cascade with formation of microthrombi |
| What are the common labs found with DIC? | 1. Prolonged PT/PTT 2. Thrombocytopenia 3. Low fibrinogen |
| What is an important characteristic or sign in a patient with DIC? | Signs of bleeding such as oozing from venipuncture sites |
| Which is prolonged, PT, PTT, or both, in patient with DIC? | Both PT an PTT are prolonged |
| What is a key feature or characteristic of TB meningitis? | Thick, gelatinous exudate in the base of the brain |
| What condition is characterized by the formation of a thick, gelatinous exudate in the base of the brain, cerebral vasculitis, and hydrocephalus? | TB meningitis |
| How are patients with TB meningitis clinically presented? | Subacute, slowly progressive nausea, vomiting, fever , CNS deficits and strokes |
| Thick, gelatinous exudate in base of brain. Dx? | TB meningitis |
| Sudden-onset, severe headache with signs of meningeal irritation. Possible Dx? | Subarachnoid hemorrhage |
| What are the accompanying signs to SAH besides the severe and sudden headache? | Meningeal irritation such as neck stiffness and pain |
| What is the MCC of SAH? | Rupture of saccular (Berry) aneurysms |
| CT scan of SAH patient: | Blood pooling in the cerebral sulci and basal cisterns |
| What condition is due to rupture of a Berry (saccular) aneurysm? | Subarachnoid hemorrhage |
| CT of brain shows blood in the cerebral sulci and basal cisterns. Possible Dx? | Subarachnoid hemorrhage |
| What is a Pleural effusion? | Collection of fluid between the visceral pleura that lines the lungs and the parietal pleura that lines the thoracic cavity |
| How does the fluid in pleural effusion act on auscultation? | Insulate vibration and sounds that originate inther airways of the lung leading to decreased tactile fremitus and breath sounds over the pleural effusion |
| What is the most aggressive type of lung cancer? | Small Cell cancer of the lung |
| What is the most common association of Small cell cancer of the lung? | Paraneoplastic syndromes |
| What Paraneoplastic syndromes are associated with Small Cell cancer of the lung? | SIADH and Cushing syndrome |
| What is the origin of the cells associated with Small Cell carcinoma of the lung? | Neuroendocrine origin |
| What are neuroendocrine markers associated with Small Cell carcinoma of the lung? | Neural Cell adhesion molecule (NCAM), Chromogranin, and synaptophysin |
| What condition is associated with glomerular crescent formation without immunoglobulin or complement deposits? | Pauci-immune RPGN |
| What are common causes of Pauci-immune RPGN? | Manifestation of ANCA-associated vasculitis such as Granulomatosis with polyangiitis or Microscopic Polyangiitis |
| Fever, maculopapular rash, and acute renal failure occurring 1-3 weeks after beginning new medication. | Acute Interstitial Nephritis |
| What are important lab features of Acute Interstitial Nephritis? | Peripheral eosinophilia, urinary eosinophils, and WBC casts in urine |
| What are the main or key findings in UA of Acute Interstitial Nephritis? | Urinary eosinophils and WBC casts |
| What is the histopathology of Acute Interstitial Nephritis? | Leukocyte infiltration and edema renal interstitium |
| How is ATN characterized? | Focal Tubular Epithelial necrosis with denuding of the basement membrane |
| What is the result of acute kidney injury? | Tubular re-epithelization and regain normal kidney function |
| What are common characteristics of Psoriasis? | Hyperkeratosis and confluent Parakeratosis of the Stratum cornieus, and epidermal hyperplasia (acanthosis) with elongated rete ridges |
| Which layer of the skin is seen with keratosis and parakeratosis in Psoriasis? | Stratum corneum |
| What is the result of the neutrophilic foci in the Stratum corneum and epidermis associated with Psoriasis? | Development of Munro microabscesses |
| What condition is associated with Munro microabscesses? | Psoriasis |
| How are the lesions of Actinic keratosis (AK) clinically described? | Erythematous papules with a central scale and a rough "sandpaper-like" texture |
| Which skin condition is associated with exposure to sun and described as "sandpaper-like" erythematous papule rash? | Actinic Keratoses (AK) |
| Is Actinic Keratoses lesions consider pre-malignant or benign? | Premalignant |
| A patient with AK (actinic keratosis) is likely to develop which type of skin cancer? | Squamous Cell carcinoma of the Skin |
| When can field cancerization occur? | As one large area of cells are exposed to carcinogens that induce mutations |
| What is a common malignancy associated with Field Cancerization ? | Head and Neck Squamous cell Carcinoma (HNSCC) |
| What process can give rise to Head & Neck Squamous Cell carcinoma? | Field cancerization |
| Biological process in which large areas of cells at a tissue surface or within an organ are affected by carcinogenic alterations | Field cancerization |
| Which are the main carcinogens that lead to malignancy in the oral cavity in response to field cancerization? | Tobacco and alcohol exposure for years |
| What are the main symptoms and features of Primary Adrenal insufficiency? | Weight loss, abdominal pain, fatigue, and hyperpigmentation |
| What is a common complication in patients with Primary Adrenal insufficiency that undergo a stressful moment or procedure? | Adrenal crisis |
| What are features of an Adrenal crisis? | Fever, shock, and mental status changes |
| What is the most common cause of Primary Adrenal insufficiency? | Autoimmune adrenalitis |
| What is the result of Primary Adrenal insufficiency due to Autoimmune adrenalitis? | Bilateral Adrenal Atrophy |
| What condition is seen with Bilateral Adrenal atrophy as a consequence? | Autoimmune adrenalitis leading to PAI |
| How is Dermatomyositis characterized? | Proximal muscle weakness resembling polymyositis, with additional inflammatory features affecting the skin |
| What are the skin manifestations of Dermatomyositis? | Heliotrope rash and Gottron papules |
| What condition is associated with Gottron papules and Heliotrope rash? | Dermatomyositis |
| What type of muscle weakness of Dermatomyositis and Polymyositis? | Proximal muscle weakness |
| What type of muscle is involved in Dermatomyositis and Polymyositis? | Striated muscle of the oropharynx and heart |
| What are the consequences of striated muscle of the oropharynx and heart in Dermatomyositis? | Dysphagia, pulmonary aspiration, and myocarditis |
| What is the heart condition associated with Dermatomyositis and Polymyositis? | Myocarditis |
| What is the common name of Schistocytes? | Helmet cells |
| What are Schistocytes? | Fragmented RBCs |
| What are some causes of development of Schistocytes? | Microangiopathic hemolytic anemia or prosthetic cardiac valves (macroangiopathic) |
| Is Haptoglobin elevated or decreased in Intravascular Hemolytic anemias? | Decreased |
| What levels are increased in Intravascular hemolytic anemias? | LDH and Bilirubin |
| What is Haptoglobin? | Serum protein that binds to free hemoglobin and promotes its uptake by the reticuloendothelial system |
| What is the role or function of Haptoglobin? | Bind to free Hb and promotion of Hb uptake by the reticuloendothelial system |
| What is the main biochemical feature defect in Megaloblastosis? | Defect in DNA synthesis |
| What nutritional deficiencies are associated with development of Megaloblastic anemia? | Deficient intake of Vitamin B12 or Folate |
| Low or decreased amounts of Vitamin B12 and folate impair: | Synthesis of Purine and Pyrimidine bases |
| Example of something the can impair the synthesis of Purine and Pyrimidine bases: | Deficient intake of Vitamin B12 or Folate |
| What renal malignancy is associated with Tuberous sclerosis? | Renal angiomyolipoma |
| What AD condition is associated with Renal angiomyolipomas? | Tuberous sclerosis |
| How is a Renal Angiomyolipoma composed? | Blood vessels, smooth muscle, and fat |
| Bilateral or unilateral renal angiomyolipomas are most associated with Tuberous sclerosis? | Bilateral renal angiomyolipomas |
| What is the inheritance of Friedreich ataxia? | Autosomal recessive |
| What explains the gait ataxia seen in Friedreich Ataxia? | Degeneration of the Spinocerebellar tracts |
| What is damaged or affected in Friedreich ataxia leading to impaired joint and vibration sense? | Degeneration of the Posterior columns and dorsal root ganglia |
| What heart condition is associated with Friedreich Ataxia? | Hypertrophic cardiomyopathy |
| What is the MCC of death in Friedreich ataxia? | Hypertrophic cardiomyopathy |
| What skeletal abnormalities associated with Friedreich Ataxia? | Kyphoscoliosis and Pes Cavus |
| What endocrinological complication is associated with Friedreich Ataxia? | Diabetes mellitus |
| List of features seen in Friedreich Ataxia: | 1. Gait ataxia 2. Impaired joint and vibration sense 3. Hypertrophic cardiomyopathy (MCC of death) 4. Kyphoscoliosis and Pes cavus 5. Diabetes mellitus |
| What is Charcot-Marie-Tooth disease? | Group of hereditary peripheral neuropathies characterized by mutations in genes coding for peripheral nerve axonal or myelin proteins |
| What mutations are associated with the development of Charcot-Marie-Tooth disease? | Genes coding for: 1. Peripheral nerve axonal proteins 2. Myelin proteins |
| What are the associated clinical manifestations of Charcot-Marie-Tooth disease? | 1. Progressive, symmetric distal muscle atrophy and weakness most prominently in feet and calf muscles 2. Sensory loss, arreflexia 3. Pes cavus (high ascites), and 4. Hammer toes |
| What is Diffuse Axonal Injury (DAI)? | Type of traumatic brain injury that results from disruption of the white matter tracts |
| How is Diffuse Axonal Injury microscopically characterized/ | Widespread axonal swelling, most pronounced at the Gray-White matter junction, with accumulation of transport of proteins at the site of injury |
| What brain malignancy is originated from Ependymal cells? | Ependymomas |
| Where in the brain do Ependymomas appear? | Line the ventricular system and the central canal of the Spinal canal |
| What is commonly blocked by Ventricular ependymomas? | Flow of the Cerebrospinal fluid through the intraventricular foramina, causing signs of ICP due to obstructive (noncommunicating) hydrocephalus |
| What kind of hydrocephalus is often seen with Ventricular Ependymoma? | Noncommunicating (obstructing) hydrocephalus |
| What brain tumor usually appears lining the ventricular system and in the central canal of the he Spinal Cord? | Ependymomas |
| AR disease characterized by excessive Copper deposition into tissues, such as liver, basal ganglia, and cornea? | Wilson disease |
| What is the inheritance mode of Wilson disease? | Autosomal recessive |
| What condition is aided by the use of the Slit Lamp examination? | Wilson disease |
| What symptoms or feature of Wilson disease is diagnosed or confirmed by the Slit Lamp exam? | Kayser-Fleisher rings in cornea |
| What are some clinical manifestations of Wilson disease? | 1. Liver disease 2. Neuropsychiatric symptoms (gait disturbance, dysarthria, depression, and personality changes) 3. Kayser-Fleischer rings in cornea |
| What are the two initial sites of primary TB described by the Ghon complex? | 1. Lower lobe of lung 2. Ipsilateral hilar lymph node |
| Is primary or secondary TB associated with the Ghon complex? | Primary TB |
| What is the name giben to Ghon complex, over a period of time? | Ranke complex |
| What gives rise to a Ranke complex? | Ghon complex over time, become calcified and fibrosed leading to Ranke complex |
| What is a Ranke complex? | A calcified and fibrosed Ghon complex |
| What are anatomical organs or vessels that run in close proximity to the Ureters? | Pelvic lymph nodes and Uterine artery |
| What surgical procedures increased risk of injury to the Ureters or any tissue in close proximity? | Pelvic surgeries |
| What is a severe consequence of unintentional ligation of the ureter during pelvic surgery? | Hydronephrosis and flank pain due to distension of the ureter and renal pelvis |
| What is the MCC of nephritic syndrome in children? | PSGN |
| What are the LM findings in PSGN? | Enlarged, hypercellular glomeruli |
| What are labs measurements of PSGN? | 1. Elevated anti streptococcal antibodies 2. Decreased C3 and total complement levels 3. Normal level of C4 |
| Is PSGN found with decreased, elevated or normal levesl of C4? | Normal levels of C4 |
| What complement is (are) decreased in PSGN? | C3 and total complement levels |
| Low C3 + normal C4 levels, along with a LM showing enlarged, hypercellular glomeruli. Suspected Dx? | PSGN |
| What are the associated Paraneoplastic syndromes of Renal Cell cancer (RCC)? | Erythrocytosis and Hypercalcemia |
| What gives rise to Erythrocytosis in RCC? | Excessive EPO production |
| What gives rise to Hypercalcemia as a Paraneoplastic syndrome of RCC? | PTH-related protein production |
| What is the main and first vein invaded by Renal cell carcinoma? | Renal vein |
| What is a secondary invaded vien by RCC? | IVC |
| What is the result of RCC inventing the IVC? | Obstruction due to intraluminal extension of the tumor |
| What are the consequences (physical) of RCC invasion and consequent obstruction of the ICV? | 1. Symmetric bilateral lower extremity edema 2. Often associated with prominent development of Venous collaterals in the abdominal wall |
| What obstructed vein may lead to symmetric lower extremity edema and appearance of venous collaterals in the abdominal wall? | IVC obstruction |
| How is Hypertrophic Osteoarthropathy presented? | Abnormal growth of bone and presents with digital clubbing, painful arthropathy, periostosis of long bones, and joint effusions |
| What conditions are often causative or associated with Hypertrophic Osteoarthropathy? | Pulmonary malignancy (adenocarcinoma), lung disorders (Cystic fibrosis, bronchiectasis), and cyanotic heart disease |
| What bone condition often associated with Cyanotic heart disease? | Hypertrophic Osteoarthropathy |
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rakomi
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