Goljan Step 1 HY 36 Pages Notes PDF
Goljan Step 1 HY 36 Pages Notes PDF
Goljan Step 1 HY 36 Pages Notes PDF
Page 1
USMLE E-BOOK This is the GOLD collection of highly tested USMLE Step 1 and
USMLE Step 2 topics listed in tables for easy review. These PEARLS will appear on your boards exams!
Diseases
Addisons Disease 1. Primary adrenocortical deficiency
Addisonian Anemia 2. Pernicious anemia (antibodies to intrinsic factor or parietal cells IF Vit B12 megaloblastic anemia)
Albrights Syndrome 3. Polyostotic fibrous dysplasia, precocious puberty, caf au lait spots, short stature, young girls
Alports Syndrome 4. Hereditary nephritis with nerve deafness
Alzheimers 5. Progressive dementia
Argyll-Robertson Pupil 6. Loss of light reflex constriction (contralateral or bilateral)
7. Prostitutes Eye accommodates but does not react
8. Pathognomonic for 3Syphilis
9. Lesion pretectal region of superior colliculus
Arnold-Chiari Malformation 10. Cerebellar tonsil herniation through foramen magnum = see thoracolumbar meningomyelocele
Barretts 11. Columnar metaplasia of lower esophagus ( risk of adenocarcinoma)- constant gastroesophageal reflux
Bartters Syndrome 12. Hyperreninemia
Beckers Muscular Dystrophy 13. Similar to Duchenne, but less severe (mutation, not a deficiency, in dystrophin protein)
Bells Palsy 14. CNVII palsy (entire face; recall that UMN lesion only affects lower face)
Bergers Disease 15. IgA nephropathy causing hematuria in kids, usually following infection
Bernard-Soulier Disease 16. Defect in platelet adhesion (abnormally large platelets & lack of platelet-surface glycoprotein)
Berry Aneurysm 17. Circle of Willis (subarachnoid bleed) Anterior Communicating artery
18. Often associated with ADPKD
Bowens Disease 19. Carcinoma in situ on shaft of penis ( risk of visceral ca) [compare w/ Queyrat]
Brill-Zinsser Disease 20. Recurrences of rickettsia prowazaki up to 50 yrs later
Briquets Syndrome 21. Somatization disorder
22. Psychological: multiple physical complaints without physical pathology
Brocas Aphasia 23. Motor Aphasia (area 44 & 45) intact comprehension
Brown-Sequard 24. Hemisection of cord (contralateral loss of pain & temp / ipsilateral loss of fine touch, UMN / ipsi loss of consc. Proprio)
Dubin-Johnson Syndrome 57. Congenital hyperbilirubinemia (conjugated) = bilirubin transposrt is defective not conjugation
58. Striking brown-to-black discoloration of the liver
Duchenne Muscular Dystrophy 59. Deficiency of dystrophin protein MD X-linked recessive
Edwards Syndrome 60. Trisomy 18
61. Rocker-bottom feet, low ears, small lower jaw, heart disease
Ehlers-Danlos 62. Defective collagen
Eisenmengers Complex 63. Late cyanotic shunt (RL) pulmonary HTN & RVH 2 to long-standing VSD, ASD, or PDA
Erb-Duchenne Palsy 64. Trauma to superior trunk of brachial plexus Waiters Tip
Ewing Sarcoma 65. Malignant undifferentiated round cell tumor of bone in boys <15yoa - t11;22
Eyrthroplasia of Queyrat 66. Carcinoma in situ on glans penis
Fanconis Syndrome 67. Impaired proximal tubular reabsorption 2 to lead poisoning or Tetracycline (glycosuria,
hyperphosphaturia, aminoaciduria, systemic acidosis)
Hamman-Rich Syndrome 77. Idiopathic pulmonary fibrosis. Can see honey comb lung.
Hand-Schuller-Christian 78. Chronic progressive histiocytosis
Hashimotos Thyroiditis 79. Autoimmune hypothyroidism. May have transient hyperthyroidism. Low T3 /T4 & High TSH
Hashitoxicosis 80. Initial hyperthyroidism in Hashimotos Thyroiditis that precedes hypothyroidism
Henoch-Schonlein purpura 81. Hypersensivity vasculitis = allergic purpura. Lesions have the same age.
82. Hemmorhagic urticaria (with fever, arthralgias, GI & renal involvement)
83. Associated with upper respiratory infections
Hirschprungs Disease 84. Aganglionic megacolon
Horners Syndrome 85. Ptosis, miosis, anhidrosis (lesion of cervical sympathetic nerves often 2 to a Pancoast tumor)
Huntingtons (Chromosome 4) 86. AD: Progressive degeneration of caudate nucleus, putamen (striatum) & frontal cortex GABA
Jacksonian Seizures 87. Epileptic events originating in the primary motor cortex (area 4)
Jobs Syndrome 1. Immune deficiency: neutrophils fail to respond to chemotactic stimuli
2. Defective neutrophilic chemotactic response = repeated infections
3. Commonly seen in light-skinned, red-haired girls
88. d IgE levels
Kaposi Sarcoma 89. Malignant vascular tumor (HHV8 in homosexual men)
Kartageners Syndrome 90. Immotile cilia 2 to defective dynein arms infection, situs inversus, sterility
Kawasaki Disease 91. Mucocutaneous lymph node syndrome in kids (acute necrotizing vasculitis of lips, oral mucosa)
Klinefelters Syndrome 92. 47, XXY: Long arms, Sterile, Hypogonadism
Kluver-Bucy 93. Bilateral lesions of amygdala (hypersexuality; oral behavior)
Krukenberg Tumor 94. Adenocarcinoma with signet-ring cells (typically originating from the stomach) metastases to
95. the ovaries
Laennecs Cirrhosis 96. Alcoholic cirrhosis
Lesch-Nyhan 97. HGPRT deficiency
98. Gout, retardation, self-mutilation
Letterer-Siwe 99. Acute disseminated Langerhans cell histiocytosis
Libman-Sacks 100. Endocarditis with small vegetations on valve leaflets
101. Associated with SLE
Page 3
Lou Gehrigs 102. Amyotrophic Lateral Sclerosis degeneration of upper & lower motor neurons
McArdles Disease 105. Type V Glycogenosis - Glycogen storage disease (muscle phosphorylase deficiency = Glycogen)
Meckels Diverticulum 106. Rule of 2s: 2 inches long, 2 feet from the ileocecum, in 2% of the population
107. Embryonic duct origin; may have ectopic tissue: gastric/pancreatic remnant of vitteline duct/yolk stalk
Meigs Syndrome 108. Triad: ovarian fibroma, ascites, hydrothorax associated w/ fibroma of ovaries
Menetriers Disease 109. Giant hypertrophic gastritis (enlarged rugae; plasma protein loss)
Monckebergs Arteriosclerosis 110. Calcification of the media (usually radial & ulnar aa.)
Munchausen Syndrome 111. Factitious disorder (consciously creates symptoms, but doesnt know why)
Nelsons Syndrome 112. 1 Adrenal Cushings surgical removal of adrenals loss of negative feedback to pituitary
Pituitary Adenoma
Niemann-Pick 113. Lysosomal Storage Disease (sphingomyelinase deficiency sphingomyelin accumulation)
114. Foamy histiocytes
Osler-Weber-Rendu Syndrome 115. Hereditary Hemorrhagic Telangiectasia. Seen in the Mormons of Utah.
Pagets Disease 116. Abnormal bone architecture (thickened, numerous fractures pain)
Pancoast Tumor 117. Bronchogenic tumor with superior sulcus involvement Horners Syndrome
Parkinsons 118. Dopamine depletion in nigrostriatal tracts
Peutz-Jeghers Syndrome (AD) 119. Melanin pigmentation of lips, mouth, hand, genitalia + hamartomatous polyps of small intestine
Peyronies Disease 120. Subcutaneous fibrosis of dorsum of penis
Picks Disease 2 Different 121. 1. Progressive dementia similar to Alzheimers
Diseases - 122. 1. Constrictive pericarditis sequel to mediastinal tuberculosis
123. Calcium-frosting, unyielding layer heart chambers may be unable to dilate to receive blood during diastole
Plummers Syndrome 124. Hyperthyroidism, nodular goiter, absence of eye signs (Plummers = Graves - eye signs)
Plummer-Vinson 125. Esophageal webs & iron-deficiency anemia, spoon-shaped nails, SCCA of esophagus
Pompes Disease 126. Type II Glycogenosis Glycogen storage disease cardiomegaly ( 1,4 Glucosidase deficiency: Glycogen)
Potts Disease 127. Tuberculous osteomyelitis of the vertebrae
Potters Complex 128. Renal agenesis oligohydramnios hypoplastic lungs, defects in extremities
Raynauds 129. Disease: recurrent vasospasm in extremities = seen in young, healthy women
130. Phenomenon: 2 to underlying disease (SLE or scleroderma)
Reiters Syndrome 131. Urethritis, conjunctivitis, arthritis non-infectious (but often follows infections), HLA-B27, polyarticular
Reyes Syndrome 132. Microvesicular fatty liver change & encephalopathy
133. 2 to aspirin ingestion in children following viral illness, especially VZV
Riedels Thyroiditis 134. Idiopathic fibrous replacement of thyroid
Rotor Syndrome 135. Congenital hyperbilirubinemia (conjugated)
136. Similar to Dubin-Johnson, but no discoloration of the liver
Sezary Syndrome 137. Leukemic form of cutaneous T-cell lymphoma (mycosis fungoides)
Shavers Disease 138. Aluminum inhalation lung fibrosis
Sheehans Syndrome 139. Postpartum pituitary necrosis = hemorrhage & shock usually occurred during delivery
Shy-Drager 140. Parkinsonism with autonomic dysfunction & orthostatic hypotension
Simmonds Disease 141. Pituitary cachexia can occur from either pituitary tumors or Sheehans
Sipples Syndrome 142. MEN type IIa = pheochromocytoma, thyroid medullary CA, hyperparathyroidism
Sjogrens Syndrome 143. Triad: dry eyes, dry mouth, arthritis risk of B-cell lymphoma
Page 4
Vincents Infection 156. Trench mouth acute necrotizing ulcerative gingivitis due to Fusobacterium
Von Gierkes Disease 157. Type I Glycogenosis Glycogen storage disease (G6Ptase deficiency) Glycogen accumulaiton
Von Hippel-Lindau 158. Hemangioma (or hemangioblastoma) = cerebellum, brain stem, & retina
159. Adenomas of the viscera, especially Renal Cell Carcinoma
160. Chromosome 3p
Von Recklinghausens 161. Neurofibromatosis & caf au lait spots & Lisch nodules (Chromosome 17)
Von Recklinghausens Disease of Bone 162. Osteitis fibrosa cystica (brown tumor) 2 to hyperparathyroidism = osteoclastic resorption w/
163. fibrous replacement
Von Willebrands Disease (AD) 164. Defect in platelet adhesion 2 to deficiency in vWF. aPPT, Bleed time
Waldenstroms macroglobinemia 165. Proliferation of IgM-producing lymphoid cells in men 50-70 yoa; PAS(+) Dutcher bodies
Wallenbergs Syndrome 166. Posterior Inferior Cerebellar Artery (PICA) thrombosis Medullary Syndrome
167. Ipsilateral: ataxia, facial pain & temp; Contralateral: body pain & temp
Waterhouse-Friderichsen 168. Adrenal insufficiency 2 to DIC
169. DIC 2 to meningiococcemia
Webers Syndrome 170. Paramedian Infarct of Midbrain
171. Ipsilateral: mydriasis; Contralateral: UMN paralysis (lower face & body)
Wegeners Granulomatosis 172. Necrotizing granulomatous vasculitis of paranasal sinuses, lungs, kidneys, etc.
Weils Disease 173. Icteric Leptospirosis non-icteric prgresses to renal failure & myocarditis
174. Dark field microscopy for dx
Wermers Syndrome 175. MEN type I = thyroid, parathyroid, adrenal cortex, pancreatic islets, pituitary
Wernickes Aphasia 176. Sensory Aphasia impaired comprehension
Wernicke-Korsakoff Syndrome 177. Thiamine deficiency in alcoholics; bilateral mamillary bodies (mediodorsal nucleua) (confusion, ataxia,
ophthalmoplegia)
Whipples Disease 178. Malabsorption syndrome (with bacteria-laden macrophages) & polyarthritis
Wilsons Disease 179. Hepatolenticular degeneration (copper accumulation [Txt w/ Penicillamine ] & decrease in ceruloplasmin)
180. Mallory Bodies in the Liver & also w/ alcoholic hepatitis & Hyaline change
181. Chromosome 13
Wiskott-Aldrich Syndrome 182. Immunodeficiency: combined B- &T-cell deficiency (thrombocytopenia & eczema)
183. IgM w/ IgA
Wolff-Chaikoff Effect 184. High iodine level ()s thyroid hormone synthesis
Zenkers Diverticulum 185. Esophageal; cricopharyngeal muscles above UES
Zollinger-Ellison 186. Gastrin-secreting tumor of pancreas (or intestine) acid recurrent ulcers
Rogers Disease 187. Interventricular septal defect
Barlows Syndrome 188. Floppy vale syndrome women b/t 20-40 yoa
Bracht-Wachter Lesions 189. Minute abscesses found in subacute bacterial endocarditis
Lutembachers Syndrome 190. Combination of septum secundum atrial septal defect w/ mitral stenosis
Schmidts Syndrome 191. Autoimmnue thyroid Disease (Hashimotos ) & insulin-dependent diabetes
Hallmark Findings
Albumino-Cytologic Dissociation 192. Guillain-Barre (markedly increased protein in CSF with only modest increase in cell count)
Michealis-Gutmann Bodies 266. Malakoplakia lesion on bladder due to macros & calcospherites (M-G Bodies): usually due to E. Coli
Monoclonal Antibody Spike 267. Multiple myeloma this is called the M protein (usually IgG or IgA)
268. MGUS
Myxedema 269. Hypothyroidism
Negri Bodies 270. Rabies
Neuritic Plaques 271. Alzheimers
Neurofibrillary Tangles 272. Alzheimers
Non-pitting Edema 273. Myxedema
274. Anthrax Toxin
Notching of Ribs 275. Coarctation of Aorta
Nutmeg Liver 276. CHF = causing congested liver
Owls Eye Cells 277. CMV
278. Reed Sternburg Cells (Hodkins Lymphoma)
279. Aschoff cells seen w/ Rheumatic Fever
Painless Jaundice 280. Pancreatic CA (head)
Pannus 281. Rheumatoid arthritis, also see morning stiffnes that w/ joint use, HLA-DR4
Pautriers Microabscesses 282. Mycosis fungoides (cutaneous T-cell lymphoma), Sezary
Philadelphia Chromosome 283. CML
Pick Bodies 284. Picks Disease
2 types of COPD 285. Pink Puffer Type A: Emphysema
286. Blue Bloater Type B: Bronchitis
287. Emphysema Centroacinar smoking Panacinar - 1-antitrypsin deficiency
Page 7
Tendinous Xanthomas 320. Familial Hypercholesterolemia
Thyroidization of Kidney 321. Chronic pyelonephritis
Tophi 322. Gout
Tram-Track Glomeruli 323. Membranoproliferative GN: Nephritic syndrome basement membrane is duplicated into 2 layers
Honey Combing of the lung 341. Seen w/ Asbestosis (a restrictive lung disease)
Crescents 342. Goodpastures syndrome (pneumonia w/ hemoptysis & rapidly progressive glomerulonephritis)
Linear Ig Deposits 343. Goodpastures syndrome
45 Degree Branch Points 344. Aspergillosis
PAS(+) Dutcher Bodies 345. Waldenstroms Macroglobulinemia = IgM = Hyperviscosity
Ground Glass in Abdomen(Hyaline) 346. Seen in the hepatocytes of healthy carriers of HBsAg in liver biopsies
Signet Ring Cells 347. Cells that replace the ovaries, due to Krukenbergs tumor that has metastasized from the
stomach
Ground Glass Appearance (Hyaline) 348. Seen w/ Progressive Multifocal Leukoencephalopathy oligodendrocytes
349. Nuclei seen in Papillary CA of the thyroid (malignant)
Congo Red 350. Shows amyloid deposition in plaques & vascular walls
Meningiomas & Progesterone 351. Some meningiomas have Progesterone receptors = rapid growth in pregnancy can occur
Tuberous Sclerosis Triad 352. Seizures; Mental retardation; Leukoderma (congenital facial white spots or macules):
angiofibromas
Cowdry A Inclusions 353. Seen w/ Herpes Simplex Encephalitis in oligodendroglia
Devics Syndrome 354. Neuromyelitis Optica
355. A variant of multiple sclerosis: rapid demyelination of the optic nerve & spinal cord w/ paraplegia
c-erb B2 356. Breast Cancer association
Foster-Kennedy Syndrome 357. A tumor causing blindness & loss of smell w/ papilloedema
Hoffmans Sign 358. Flicking of the middle fingers nail
Red Nucleus Destruction 359. Intention tremors of the arm
Ventral Spinocerebellar tr. 360. Unconscious proprioception of lower extremities
Dorsal Spinocerebellar tr. 361. Unconscious prorpioception & fine motor movements
Cuneocerebellar tr. 362. Unconscious proprioception & fine motor movements of upper extremities
Dorsal Column 363. Conscious proprioception of the body
Lateral Spinothalamic tr. 364. Pain & Temperature sensation
Ventral Spinothalamic tr. 365. Light touch perception
SVA 366. Taste & Smell
GSE 367. Muscles of the eye & of the tongue
SSA 368. Vision; Hearing; Equilibrium
GVA 369. Sensation of tongue; soft palate. Carotid Body & Sinus innervation
GVE 370. Edinger Westphal = parasympathetic eye innervation
371. Gland innervation = secretions
Page 8
372. Viscera
GSA 373. Pain & temperature of face
374. Sensation of external ear
SVE 375. Innervation of muscles of masticaiton, facial expressions, larynx & pharynx
LMN Lesion 376. Werndig Hoffman (progressive infantile muscular atrophy)
377. Poliomyelitis
Sensory Pathway Lesion 378. Subacute Combined Degeneration = Friedrichs Ataxia = B12 deficiency
379. Tabes Dorsalis (Neurosyphilis)
Both UMN & LMN Lesion 380. ALS = Lou Gherigs Disease
Both Sensory & Motor Lesion 381. Brown Sequard
382. Anterior Spinal artery Occlusion
Suprachiasmatic Nucleus 383. Controls circadian rhythm
Ventromedial Nucleus 384. Satiety center. Savage behavior & obesity when lesioned
Lateral Nucleus 385. Induces eating. Starvation when lesioned
Arcuate Nucleus 386. Releases PIF (dopa-ergic neurons)
Mamillary Body 387. Can have hemorrhages as seen in Wernickes Encephalopathy
Acanthocytes 388. RBSc w/ spiny projections. Seen in Abetalipoproteinemia.
Most Common
1o Tumor arising from bone in 389. Osteosarcoma
adults
Adrenal Medullary Tumor 390. Pheochromocytoma: 5 Ps: Pressure; Pain (Headache); Perspiration; Palpitations; Pallor/Diaphoresis
Adults
Adrenal Medullary Tumor 391. Neuroblastoma
Children
Agent of severe viral 392. Herpes simplex
encephalitis
Aggressive lung tumor 393. Small cell or oat cell
Associated with gallstones 394. Adenocarinoma
Bacterial Meningitis adults 395. Strep pneumoniae & in young adults = Neisseria meningitidis
Bacterial Meningitis elderly 396. Neisseria meningitidis
Bacterial Meningitis 397. E. coli / Group BStrep.
newborns
Bacterial Meningitis 398. Hib
toddlers
Benign epithelial tumor of 399. Papilloma
oral mucosa
Benign fallopian tube tumor 400. Adenomatoid
Benign ovarian tumor 401. Mature(Native) Teratoma = benign dermatoid
Benign tumor of soft tissue 402. Lipoma
Benign tumor of the breast 403. Fibroadenoma
<25yoa
Benign tumor of the liver 404. Hemangioma
Benign tumor of the vulva 405. Hidroadenoma
Benign uterine tumor 406. Leiomyoma: estrogen sinsitive: changes size during pregnancy & menopause
Bone Tumors 407. Metasteses from Breast & Prostate
Brain Tumor Child 408. Medulloblastoma (cerebellum)
Brain Tumor Adult 409. Astrocytoma (including Glioblastoma Multiforme) then: mets, meningioma, Schwannoma
Breast Carcinoma 410. Invasive Duct Carcinoma
Breast Mass 411. Fibrocystic Change: premenopausic women (Carcinoma is the most common in post-menopausal women)
Bug in Acute Endocarditis 412. Staph aureus
Bug in debilitated, 413. Klebsiella
hospitalized pneumonia pt
Page 9
Bug in Epiglottitis 414. Hib
Bug in GI Tract 415. Bacteroides (2nd E. coli)
Bug in IV drug user 416. Staph aureus
bacteremia / pneumonia
Bug in PID 417. N. Gonnorrhoeae
Bug in Subacute Endocarditis 418. Strep Viridans
CA of urinary collecting 419. Transitional cell CA (assoc. w/ benzidine; naphthylamine; analine dyes; long term txt w/
system cyclophosphamide)
Page 10
Cause Pernicious Anemia 455. Chronic atrophic gastritis = no production of intrinsic factor
Chromosomal Disorder 456. Downs
Common Tumor of the 457. Carcinoid tumor: flushing; diarrhea; bronchospasm; RHeart valvular lesions
Appendix 458. Txt: Methysergide (5HT antagonist)
Page 12
Site of Embolic Occlusion 536. Middle cerebral aa: contralateral paralysis; aphasias; motor & sensory loss
Site of Metastasis 537. Regional Lymph Nodes
Site of Metastasis (2nd 538. Liver
most common)
Sites of Atherosclerosis 539. Abdominal aorta > coronary > popliteal > carotid
Skin CA of Fair Skinned 540. Malignant melanoma
People
Skin Cancer 541. Basal Cell Carcinoma
Small Intestine Congenital 542. Meckels diverticulum
Anomaly
Stomach Cancer 543. Adeno associated w/ blood group A
Testicular Tumor 544. Seminoma = malignant painless testes growth
Thyroid Anomaly 545. Thryoglossal duct cyst
Thyroid CA 546. Papillary CA
Tracheoesophageal Fistula 547. Lower esophagus joins trachea / upper esophagus blind pouch polyhydramnios association
Tumor in men <20 548. Germ cell tumor
Tumor of Infancy 549. Benign vascular tumor = port wine stain = Hemangioma
Tumor of the Stomach >50 550. CA of stomach (adeno CA)
years of age
Type of Hodgkins 551. Mixed Cellularity (versus: lymphocytic predominance, lymphocytic depletion, nodular sclerosis)
Type of Non-Hodgkins 552. Follicular, small cleaved
Type of Portal Cirrhosis 553. Micronodular
Type of Soft Tissue Tumor 554. Rhabdomyosarcoma
of Childhood
Vasculitis (of medium & small 555. Temporal Arteritis (branch of Carotid Artery)
arteries)
Viral Encephalitis 556. HSV
Worm Infection in US 557. Pinworm (2nd Ascaris)
Worst Prognosis in Thyroid 558. Follicular CA
Cas
Cause of Lobar Pneumonia 559. Strep. Pneumoniae
Cause of Death b/t 24-44 yoa 560. AIDS
Cause of Pneumonia in Cystic 561. Pseudomonas
Fibrosis
Cause of Osteomyelitis in IV 562. Pseudomonas
Drug Users
Cause of Infection in Burn 563. Pseudomonas
Pts
Mental Problem in Males 564. Specific phobia
Intelligence Test 565. Stanford Binet (ages 6 & under)
566. WIPSI (ages 4-6)
567. WISK-R (for ages 6-17)
568. WAIS-R (for > 17 yoa)
Paraphilia 569. Pedophilia
Metabolite seen w/ 570. VMA: vanillylmandelic acid (NE metabolite)
Pheochromocytoma
Severe Shigella 571. Dysenteriae
Bug in Otitis Media & 572. Strep. Pneumoniae
Sinusitis in Kids
Cause of a Solitary Brain 573. A. Israelli
Abscess
Cause of Bacterial Diarrhea 574. Campylobacter jejuni
in U.S.
Shigella Type 575. S. Sonnei
Page 13
Cause of Non-Ghonococcal 576. Chlamydia trichomonas
Urethritis
Pneumonia 577. Strep. Pneumoniae
Urethritis 578. N. ghonorrhea
Cause of Glomerulonephritis 579. IgA Nephropathy = Bergers Disease
Cause of Viral Pneumonia 580. RSV infants
581. Parainfluenza kids
582. Influenza virus adults
583. Adeno virus military recruits
Complication of COPD 584. Pulmonary infections
Cause of Death w/ SLE 585. Renal failure
Atrial Septal Defect 586. Ostium Secundum Type
Warm Antibody 587. Most common form of immune hemolytic anemia
588. IgG auto antibodies to RBC
589. See spherocytosis; (+) Coombs test; complication to CLL
Immunodeficiency 590. IgA Deficiency
Congenital GIT Anomaly 591. Meckels Diverticulum: persistence of vitelline duct/yolk sac stalk
Cause of Congenital 592. Fetal Alcohol Syndrome
Malformation
Pharmacology
Autonomic Nervous System
Epinephrine 1. 1, 2, 1, 2
Norepinephrine 2. 1, 2, 1 (no 2 activity)
GABA 3. Causes an inhibitory cell hyperpolarization
Muscarinic-r 4. Uses DAG & IP3 as 2nd messengers
5. Parasympathetic control
Bethanechol 6. Cholinergic. GI & Bladder motility. Txt atonic bladder post-op
Pilocarpine 7. Cholinergic. Pupillary constriciton= miosis. Ciliary constriction= accomodation.
8. Txt acute glaucoma
Isoflurophate 9. Organophosphate. Irreversible acetylcholinesterase (-)r
Pralidoxime 10. 2PAM. Reverses organophosphate binding to acetylcholinesterase
Neostigmine 11. Reversible acetylcholinesterase (-)r
12. Txt Myasthenia Gravis
Myasthenia Gravis 13. Anitbodies to Ach-r. g muscular weakness due to Achs weak postsynaptic effect @ NMJ. Inactivates-r
Tubocurium 14. Nondepol. Competitive cholinergic N-r (-)r.
15. Prevents Ach binding but does not activate NMJ
16. Histamine release= BP & bronchospasm
Trimethaphan 17. Nonselectively binds N-r of the PS- and SNS
Pancurium 18. More potent than tubocurium w/o histamine release
Succinylcholine 19. Depol. Non competitive (-)r of muscle aciton
20. Opens Na Ch.= fasciculations. Closes Na Ch.= paralysis. Continuous infusion.
1 & Eye 21. Mydriasis due to norepinephrine. Prazosin (-).
M-r & Eye 22. Miosis due to Ach. Atropine (-).
Sympathetic 23. Post ganglionic symapthetic fibers releases norepinephrine
Parasym. 24. Post ganglionic parasympathetic fibers release Ach
M3-r & Eye 25. Contracts sphincter = miosis. Contracts ciliary = accomodation.
M2-r & Heart 26. Negative chronotropy: HR = vagal arrest
27. Negative inotropy: contractility
M3-r & Lung 28. Bronchospasm secretions
M3-r & GI 29. motility (cramps & diarrhea). Involuntary defecation
Tacrine 30. Acetylcholine esterase (-)r. Txt Alzheimers
Atropine 31. DOC w/ vagal arrest
Glycoperrolate 32. M-r(-). Antispasmodic. Txt peptic ulcers.
Pirenzepine 33. M-r(-). Antispasmodic. Txt peptic ulcers.
Page 14
Doxacurium 34. Most potent competitive non-depol NMJ (-)r. No cardiovascular side effects. No Histamine release.
bungarotoxin 35. Prevent the releasal of Ach from vesicles @ the pre synaptic nerve ending
bungarotoxin 36. Irreversible N-r (-)r = action potentials
1 & Eye 37. Contracts radial muscle = mydriasis (pupil dilation)
1 & Arterioles 38. Constiction: TPR = Diastolic pressure = Afterload
1 & Venules 39. Constriction: Venous return = Preload
1 & Sex Function 40. Ejaculation
Diastolic 41. 1 = TPR
Diastolic 42. 2; Direct acting vasodilators; (+)Cholinergics
1 & Heart 43. (+)chronotropism = HR.
44. (+)inotropism = contractility; SV; CO; O2 consumption.
45. conduction velocity
Phenylephrine 46. 1 (+) Nasal decongestant.
2(+) Asma Drugs 47. Metaproterenol; Albuterol; Terbutaline; Ritodrine; Salmeterol
Ritodrine/Turbutaline 48. Relaxes myometrium used in pre-mature labor pains
Phentolamine 49. Epi reversal. Blocks , vasodilation occurs. Pt goes from HyperTN to HypoTN.
50. Txt pheochromocytoma = BP
Terazosin 51. Txt BPH
Yohimbine 52. sympathetic outflow = 2 (-). Txt impotence.
Cardioselective NMJ 53. Pancuronium = HR due to atropine-like anti muscarinic vagolytic effect & Gallamine (-)r
Ecothiophate 54. Irreversible cholinesterase (-)r.
Pyridostigmine 55. Cholinomimetic that s M & N-r effects. (-) acetylcholinesterase & plasma cholinesterase
56. DOC for the oral Txt of MG
Cardiology
Digoxin 1. AV nodal conduction/ inh. Na/K/Atpase = inc. Ca conc. in heart cells = inc. contraction force
Diltiazem 2. Txt black men. Txt AV nodal re entrance
Quinidine 3. AV nodal conduction. Cinchonism. Anticholinergic= aggravate MG. Hypotension= block
Verapamil 4. AV nodal conduction. BP. Negative inotrope= no CHF use
Propranolol 5. AV nodal conduction. BP. Negative inotrope(= block) Aggravates Asthma and Diabetes Melitus via 2 block.
Diazoxide 6. Balanced vasodilator.
Niroprusside 7. Balanced vasodilator. Unloads heart. s cyanide= pre-txt w/ thiosulfate. Txt Acute HTNv Crisis
Reserpine 8. Txt severe & resistant HTN. Depletes CA. See stuffy nose. No to pts w/ peptic ulcers.
Dobutamine 9. At high doses 2(+) offsets 1 = 1 CO w/o systemic vascular resistance
Dopamine 10. At low doses Txt Shock= dilates renal and mesenteric aa= maintain urine output
Esmolol 11. Short acting (-)
Captopril 12. Balanced vasodilator. Txt Outpt. CHF see dry cough(bradykinin induced)
Digoxin 13. Txt CHF & Atrial Flutter - inotropic - K+ levels= dig. Toxicity
Dig. Toxicity 14. Fatal ventricular arrhythmias w/ sever AV block
Quinidine 15. ClassIa anti arrhythmic. Moderate Na Ch. Block
Lidocaine 16. ClassIb anit arrhythmic. Normalizes conduction. Txt initial MI= control arrhythmias
Flecanide 17. ClassIc anti arrhythmic. Marked conduction slowing
Amiodarone 18. Long t1/2= need potent doses to obtain desired level for action. See blue skin, ocular deposits, Pulmonary Fibrosis.
NE 19. AV nodal conduction via 1. Metoprolol(-) 1
Ach 20. AV nodal conduction via M receptor. Atorpine(-) M-r
Atenolol 21. Controls catecholamine induced arrhythmias
Bretylium 22. Txt Malignant Ventricular Arrhythmias but causes passing catecholamine release that can aggravate arrhythmias
briefly
Nimodipine 23. Txt Acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm
Atropine 24. excess vagal tone as seen in Sinus Bradycardia
Nitrates 25. preload= venous pooling. MVO2= reflex tachy. ventr work= dec O2 demand
Propranolol 26. Blocks reflex tachy but causes excess brady= diastole time= EDV
Verapamil 27. O2 supply via in vasospasm Txt Prinzmetals variant angina
Aspirin 28. Prevents arterial platelet adhesion (not DVThrombi). Inactivates COX= platelet production of TxA2, a potent
vasoconstictor
Page 15
Warfarin 29. (-)Vit. K dependent gamma carboxylation of clotting factors= anticoagulation state
Heparin 30. Dependent on Antithrombin III activation
TPA 31. Binds to fibrin clots & activates plasminogen on the spot. Short t1/2, given IV.
32. Does not discriminate b/t fibrin-based clots= bleeding & stroke complications arise
Streptokinase 33. From bacteria= allergies arise. Can see excess bleeding in post-op pts.
Urokinase 34. Human source. plasmin. Can see excess bleeding in post-op pts.
Colestipol 35. Bile acid sequestrants. Interrupt bile acid reabsorption= LDL uptake. Cholestyramine same MOA.
Lovastatin 36. HMGCoA reductase(-)= LDL-r synthesis. Pravastatin/ Mevastatin same MOA.
Losartan 37. Aldosterone. Renin 2-3xs
Diazoxide 38. Txt insulinomas. Not balanced vasodilator= onlt dilates arterial smooth muscle
Clonidine 39. Central 2(+). TPR via symapthetic effect
Methyldopa 40. Central 2(+). (++) Coombs= Hemolytic anemia
Phenytoin 41. ClassIb. Reverses mild AV block due to digitoxin toxicity
Procainamide 42. ClassIa. SLE like syndrome.
Indopamide 43. Only Thiazide that will have no effect on cholesterol levels
Thiazides 44. Older black men w/ HTN due to Renin.
(-) 45. Young white men w/o asthma (cause bronchospasm)
ACEIs 46. (-) change AI ! AII. (-) Bradykinin inactivation. Captopril/ Enalapril
47. Cause renal failure = use w/ caution in the elderly
Epinephrine 48. contraction rate & force via 1.
49. systolic but diastolic BP.
50. peripheral resistance via 2 vasodilaiton
Norepi. 51. heart rate and systolic and diastolic BP
52. peripheral blood vessel resistance
Methyldopa 53. DOC for pregnancy induced HTN
Quinidine pre-txt 54. Atrial arrhythmia pretxt w/ a drug that will ventricular response: Dig.;(-); Ca Ch.(-)
ClassII 55. (-) risk fo reinfarction & sudden death following MI
Gray man 56. Amiodarone: ClassIII antiarrhythmia
Beperidil 57. Ca Ch(-). Limited clinical use due to Torsades de Pointes
ACEIs 58. Vasodilate renal efferents > than afferent arterioles: GFR & Filtration pressure
59. Diabetic renal failure progression
Adenosine 60. Its receptor is blocked by Methylxanthines (ie Theophyline)
61. Favored for the Txt of Reentrant Supra Ventricular Tachycardia
Enoxaparin 62. Low molecular weight heparin = Oral anticoagulant
Isoproterenol 63. HR & MAP
Variant angina 64. Use Ca Ch. (-)r ie Nifedipine
Contraindicated in 65. (-)r = you dont want to the hearts pumping strength
CHF
CNS
TOM 1. Short acting BDZs:
2. Triazolam
3. Onazelam
4. Midazolam
Butyrophenone 5. Haloperidol & Droperidol
Atypical D4 6. Clozapine Thioridazine Olanzepine Risperidone = Do not cause EPS
Flumazenil 7. BDZ antidote for OD
Methylphenidate 8. Txt attention deficit disorder
Phenytoin 9. Causes aplastic anemia/ gingival hyperplasia/ cleft lip & palate
Thiopental 10. Short acting Barb
Carbamazepine 11. DOC trigeminal neuralgia. Txt lennox gestaut seizures in kids
Atypical D4-r 12. Thioridazine; Olamzapine; Clozapine
Pimozide 13. Txt Tourettes
Risperidone 14. Good for negative symptoms
Thioridazine 15. Most anti cholinergic neuroleptic
Haloperidol 16. Neuroleptic malignant hyperthermia due to chronic D2 block. give Dantrolene and Bromocriptine
Page 16
Imirpamine 17. Enurisis
Clomirpramine 18. Txt OCD See aggressive behavior w/ use
Trazadone 19. Priapism
Bupropion 20. Helps to quit smoking
SSRIs 21. Primarily used for OCD
Fluoxetine 22. Good for negative symptoms
Phenelzine 23. Irreversible MAOI
Lithium 24. Txt manic phase of Bipolar Disorder
25. Causes goiter by (-) conversion of T4 to T3
26. Nephrogenic diabetes insipidus
27. Low salt diet will lead to Li toxicity
Alprazolam 28. DOC stage fright
Propranolol 29. Social phobia
-r 30. Spinal analgesia. Euphoria. ++euphoria. ++sedation. Constipation.
-r 31. Supraspinal analgesia. Dysphoria. +respiratory depression. +sedation.
Morphine & O2 32. Admin. is contraindicated to pts on morphine sedation= CO2 sensitivity and O2 admin. can stop breathing.
Morphine 33. ICP = do not give to pt. with head trauma
Morphine OD 34. 1.pinpoint pupils 2.d respiraiton 3.coma
Meperidine 35. Anesthetic used during labor
Hydromorphone 36. (+) used in renal failure
Tramadol 37. Ambulatory txt for mod. to severe pain
Naloxone 38. Txt opioid OD. Reverses respiratory depression
Pentazocine 39. Part (+) & part (-)
Butorphenol 40. Part (+) & part (-)
Nalbuphene 41. Part (+) & part (-)
GABA 42. seizure focus= Barbs & BDZs
Fast Na Ch. 43. electrical activity spread = Phenytoin & Carbamazepine
Methoxyflurane 44. Can be nephrotoxic. Needs low MAC for anesthetic induction.
Enflurane 45. Can cause tonic/clonic muscle spasms
Isoflurane 46. Can cause bronchospasm
Halothane 47. Can cause ventricular extrasystoles & Malignant hyperthermia & Hepatitis
Nitric Oxide 48. No effect on HR. Needs high MAC for anesthetic induction.
Thiopental 49. Short acting Barb.
Kentamine 50. Dissociative anesthetic
Droperidol 51. Can be used in combo w/ Fentanyl for neuroleptoanalgesic effect
52. Neuroleptic tranquilizer. Has mild alpha block
Fentanyl 53. Can be used on combo w/ Droperidol for neuroleptoanalgesic effect
54. Used transdermally for chronic pain
Midazolam 55. Pre anesthetic. Induces amnesia
Primidone 56. Biotransformed to Phenobarb.
C & A delta Fibers 57. First fibers to be blocked w/ anesthesia
Esters 58. Procaine, Tetracaine, Benzocaine
59. Broken down and make PABA (allergen)
Amides 60. Lidocaine, Mepivaciane, Bupivaciane, Etidocaine= i before caine always an amide
61. Metabolized in the liver
Amphetamine 62. DA reuptake (-)r. MAOI. Parkinsons txt
Bromocriptine 63. D2(+). Used w/ L-Dopa for on-off phenomenon of Parkinsons
Benztropine 64. Ant M w/ some DA reuptake (-). Parkinsons txt
Amantidine 65. DA reuptake. Can cause livido reticularis= skin mottling.
Diphenhydramine 66. Txt early Parkinsons stages
Pergolide 67. > Effective & longer acting than Bromocriptine
Ethosuximide 68. DOC for Absence seizures
Tranylcypromine 69. MAOI = antidepressant
SSRI & MAOI 70. Fatal combo, especially seen with the use of Paroxetine or Fluoxetine (SSRIs) and Tranylcypromine (MAOI)
Labor opioids 71. Meperidine & Nalbuphine
Page 17
Desipramine causes 72. Sudden cardaic death in children
Anti-Infective
Primaquine 4. Malaria profylaxis
5. Used for extraerythrocytic forms Plasmodium vivax or P. ovale
Ciporfloxacin 6. Quinolone derivative
Sulfonamides 7. PABA structural analogs
8. Inhibit Folic acid synthesis
Tertacyclines, anuria & the exception 9. Should not be used in anuric pt due to production of (-) Nitrogen balance & d BUN levels.
10. Doxycycline is the exception
Ceftriazone 11. 3rd generation cephalosporin
12. DOC for bacterial meningitis in kids (ie HiB)
13. One dose txt of gonorrhea
Hepatic coma DOC 14. Neomycin (aminoglycoside) it supresses the normal flora = g NH4 production = g free
nitrogen levels in the bloodstream.
Clavulanic acid 15. Irreversible (-)r of lactamases, but ot of transpeptidase = use w/ a lactamase sensitive
penicillin
Piperacillin 16. Txt Pseudomonas aeruginosa & Klebsiella
17. Broad spectrum antibiotic
Streptomycin (aminoglycoside) 18. Txt Mycobacterium tuberculosis
Isoniazid 19. Most commonly used drug for TB.
20. Usually combined w/ Rifampin and/or Ethambutol
21. Pre Txt w/ Pyridoxine (Vit B6) can prevent peripheral neuritis
Pyrantel Pamoate 22. Txt of Hookworm disease
23. Depolarizing NMJ (-)r
Buy AT 30, CELL at 50 24. A = Aminoglycosides
25. T = Tetracyclines
26. C = Chloramphenicol
27. E = Erythromycin (macrolide)
28. L = Clindamycin
29. L = Lincomycin
Cefoxitin 30. Txt intraabdominal infections (ie w/ Bacteroides fragilis)
31. Traditional txt has been Clindamycin & Gentamycin
Chloramphenicol 32. Broad spectrum antibiotic
33. Bone marrow depression (common) Aplastic anemia (rare)
34. Gray baby syndrome (chloramphenicol cannot be conjugated)
35. DOC Typhoid Fever (symptomatic Salmonella infection)
36. DOC HiB meningitis in kids especially resistant strain to ampicillin
Nifurtimox 37. Txt trypanosomiasis
Metronidazole 38. Txt Leishmaniasis & Amebiasis
39. Good for anaerobic bacteria = Bacteroides fragilis
40. DOC Trichomoniasis
41. DOC Giardia lamblia
Txt P. carinii 42. TMP-SMX & Pentamidine
Tetracycline 43. Txt of Brucellosis & Cholera
44. Txt Rocky Mountain Spotted Fever
45. Txt spirochete infections = Lyme disease (Borrelia burgdorferi)
TMP-SMX 46. (-) dihydrofolate reductase activity
Benzathine Penicillin G 47. Long duration of action = given once every 3-4 weeks for Txt of Syphilis
Praziquantel 48. Txt Schistosomiasis (trematode [fluke] infections)
Melarsoprol 49. Txt Trypanosomiasis that has neurological symptoms
Stibogluconate 50. Txt Leishmaniasis
Fluconazole 51. Txt fungal encephalitis
Amphotericin B 52. Polyene antifingal
Ketoconazole MOA 53. (-) fungal ergosterol synthesis = disrupts membrane
Griseofulvin MOA 54. Accumulates in keratinized layers of the skin = used in dermatomycoses infections
Mefloquine 55. Anti malarial
56. Txt Chloroquine resistant strains = P. falciparum
Chloroquine 57. Txt for Malaria when inside RBC
Page 18
Nifurtimox 58. DOC Chagas disease due to Trypanosoma cruzi
Erythromycin 59. Used in pts allergic to penicillins
Nystatin 60. Topical txt of superficial mycotic infections = Candidiasis
Acyclovir 61. Guanine analog
62. Txt Herpes infections
Imipenem 63. Used w/ Cilastatin
64. Can cause seizures
Cefoperazone side effects 65. Bleeding due to vit K level alterations
66. Contraindicated in pts w/ bleeding disorders
Vancomycin 67. Used for MRSS (methicillin resistant Staph. Aureus)
68. Red neck: due to histamine release causes facial flushing
Meropenem 69. used w/ Cilastatin
70. Does not cause seizures (cf w/ Imipenem)
Nafcillin 71. Only penicillin that does not need dose adjustment in renal impairment
Peripheral neuropathy 72. Seen w/ use of:
73. Metronidazole Isoniazid Vincristine ddI AZT Allopurinol
Sulfonamides & newborns 74. Kernicterus can occur
O.N.E. for gonorrhea 75. Fluoroquinolones used in a one dose deal for gonorrhea:
76. O = Ofloxacin
77. N = Norfloxacin
78. E = Enoxacin
Ribavirin 79. Txt RSV (Respiratory Syncytial Virus)
Anti-Neoplastics
Cyclosporine 80. Protects against rejections from organ transplants
81. Does not induce bone marrow depression
Cyclophosphamide 82. Alkylating agent of both purine & pyrimidine bases of DNA
83. Txt CLL
Cisplatins toxicities 84. Nephro- & Ototoxicity
Methotrexate 85. Antimetabolite of folic acid: (-)dihydrofolate reductase
Leucovorin Rescue 86. Can block/reduce Methotrexate = folic acid via a reduced folate
Bleomycin toxicities 87. Pneumonitis & pulmonary fibrosis
Azathiorine 88. Used in organ transplantation = kidney allografts
89. Allopurinol can its activity by (-) its biotransformation to xanthine oxidase
MOPP 90. Chemotherapy used in the txt of Hodgkins disease
91. M = Mechlorethamine nitrogen mustard
92. O = Oncovin (Vincristine) prevents microtubule assembly
93. P = Procarbazine
94. P = Prednisone glucocorticoid, inducing apoptosis
Tamoxifen 95. (-) estrogen receptor
96. Txt of breast tumors, can see associated endometrial CA
Flutamide 97. Antiandrogenic
98. Used w/ Leuprolide (LH-RH analog)
99. Txt prostatic CA
Megestrol 100. (-) progesterone receptor
101. Txt endometrial CA
Fluoxymesterone 102. Androgenic steroid
103. Txt mammary CA in postmenopausal women
Methotrexate 104. Folic acid analog that (-) tetrahydrofolate synthesis by (-) dihydrofolate reductase
105. Txt of ALL
106. Txt of Psoriasis
Brain tumor Txt 107. Lomustine
108. Carmustine Causes pulmonary fibrosis
Streptozocin 109. Attaches to cells
110. Txt of pancreatic insulinomas
Cytarabine (AraC) 111. Pyrimidine analog
112. DOC for AML
Dactinomycin 113. Used for Wilms tumor & rhabdomyosarcoma
Etoposide 114. Used for oat cell CA
Paclitaxel 115. Used for ovarian CA
Page 19
Amifostine 116. Can nephrotoxicity due to chronic use of Cisplatin
Pathology
Mobitz I 117. Usually due to inferior MI. Rarely goes into 3rd degree block.
118. Txt w/ Atropine or Isoproterenol.
Mobitz II 119. BBB association. Often goes to 3rd degree AV block. Usually due to anterior MI.
P wave 120. Atrial depol.
a wave 121. LA contraction
T wave 122. Vetricular repol.
Wavy fibers 123. Eosinophilic bands of necrotic myocytes. Early sign of MI.
Janeways lesions 124. Acute bacterial endocarditis.
125. Nontender, erythematous lesions of palms & soles.
Oslers nodes 126. Subacute bacterial endocarditis.
127. Tender lesions of fingers & toes.
Thiamine defcy 128. Wet Beri Beri heart. Dilated (congested) cardiomyopathy due to chronic alcohol consumption
129. Dyr Beri Beri = peripheral neuropathy
130. Wernicke-Korsakoff = ataxia; confusion; confabulation; memory loss
Fibrinous Pericarditis 131. Associated w/ MI: Dresslers
Serous Pericarditis 132. Associated w/ nonbacterial; viral (Coxsackie) infection; immunologic reaction.
Friction Rub 133. Pericarditis association
Hemorrhagic Pericarditis 134. Associated w/ TB or neoplasm
Restrictive Cardiomyopathy 135. Aka infiltrative cardiomyopathy that stiffens the heart
136. Due to amyloidosis in the elderly
137. Due to , also see schaumann & asteroid bodies in young (<25 yoa).
PMLs infectious agent 138. JC Virus (Papovavirus = dsDNA, naked icosahedral capsid)
Edema 139. Pc (more seeps out)
140. c (less reabsorbed)
141. permeability
142. Block lymphatic drainage
Adult Polycystic Kidney 143. Commonly see liver cysts & Berry aneurysms along w/ kidney cysts. Hematuria & HTN also present.
Disease 144. 3 cysts in ea. Kidney w/ + family history confirms diagnosis
Malignant HTN & Kidneys 145. Petehial hemorrhages are seen on kidney surfaces = Flea-Bitten surface = young black men
Nephritic signs 146. Hematuria; RBC casts; HTN
Nephrotic signs 147. Proteinuria; Hypoalbuminemia; Edema
Podocyte Effacement seen 148. Minimal Change (Lipoid nephrosis) disease
w/
ASO seen in 149. Acute post-streptococcal GN (due to HGASrtep)
150. Anti streptolysin O
Crescentic GN 151. Rapidly progressive GN nephritic syndrome
152. Associated w/ multi system disease or post-strep/post infectious glomerular nephritis
Hereditary Nephritis 153. Alports syndrome. X linked
154. Renal disease w/ deafness & ocualr abnormalities
Membranoproliferative GN 155. Can be secondary to complement deficiency; chronic infections; CLL
156. See tram tracking
TypeI Membrano 157. C3 & IgG deposits
Proliferative GN deposits
TypeII Membrano 158. Only C3 deposits
Proliferative GN deposits 159. Aka Dense deposit disease
Page 20
Fatty degeneration 167. Made up primarily of triglycerides
168. Most commonly due to alcoholism which commonly leads to hepatic cirrhosis
169. Associated w/ CCl4-
Cloudy swelling 170. Failure of cellular Na pump
171. Seen in Fatty degeneration of the liver and in Hydropic (Vacuolar) degeneration of the liver
Hydropic degeneration 172. Severe form of cloudy swelling
173. Seen with hypokalemia induced by vomitting/diarrhea
Liquefaction necrosis 174. Rapid enzymatic break down of lipids
175. Seen commonly in Brain & Spinal cord (CNS) injuries
176. Seen in suppurative infections = pus formation
Coagulation necrosis 177. Result of sudden ischemia
178. Seen in organs w/ end arteries limited collateral circulation) = heart, lung, kidney, spleen
Caseation necrosis 179. Combination of both coagulation & liquefaction necrosis
180. Seen w/ M. tuberculosis & Histoplasma capsulatum infection
Fibrinoid necrosis 181. Seen in the walls of small arteries
182. Associated w/ malignant hypertension, polyarteritis nodosa, immune mediated vasculitis
Fat necrosis 183. Result of lipase actions liberated from pancreatic enzymes
184. Seen w/ Acute pancreatitis = saponification results
Hemoptysis 185. Blood in sputum
Pulmonary embolism 186. Most commonly thrombus from lower extremity vein
Phlebothrombosis 187. From a vein of lower extremities, of a pregnant uterus, in Congestive heart failure, bed ridden pt,
188. As a complicaiton in a pt w/ Pancreatic CA due to d blood coagulability
Saddle embolus 189. Embolus lodged in bifurcation of pulmonary trunks
190. RV strain = RV & RA dilate = Acute cor Pulmonale
Paradoxical embolism 191. Right to Left shunt allows a venous embolism to enter arterial circulation
192. Patent ovale foramen or Atrial septal defect
Tuberculoid granuloma 193. Collection of macrophages w/o caseation
194. Seen w/ Sarcoidosis (non-caseating); Syphilis; Brucellosis and Leprotic infections
Cellulitis 195. Spreading infection due to streptococcus
PSA 196. Prostate Specific Antigen = elevated in prostatic CA
5-HT 197. In cases of metastatic carcinoid, txt w/ Methysergide (5HT antagonist)
Feto Protein 198. Hepatocarcinoma
199. Neural tube defects
CEA 200. Carcinoembryonic Antigen = elevated in Colon CA
Chromosome 13 201. Retinoblastoma
Chromosome 11p 202. Wilms tumor of the kidney
Vinyl Chloride 203. Associated w/ Angiosarcoma of the liver
Agent Orange 204. Contains dioxin
205. Implicated as a cause of Hodgkin;s disease, non-Hodgkins lymphoma & soft tissue sarcomas
Parasites & CA 206. Schistosoma haematobium = Urinary bladder CA
207. S. mansoni = Colon CA
208. Aspergillus flavus = potent hepatocarcinogen
Ochronosis 209. Alkaptonuria
210. Error in tyrosine metabolism due to Homogentisic acid (oxidizes tyrosine)
211. Involving intervertebral disks = Ankylosing Spondilitis = Poker spine
212. See dark urine; dark coloration of sclera, tendons, cartilage
Lead poisoning 213. Acid fast inclusion bodies
214. urinary coproprophyrin
215. Anemia: microcytic/ hypochromic
216. Stippling of the basophils
217. Gingival line & lead line in bones: x-ray
218. Mental retardation
Heroin OD, clinically 219. Massive pulmonary edema w/ frothy fluid from the nostrils
Fetal alcohol syndrome 220. Small head, small eyes, funnel chest, ASD, mental deficiency, and hirsutism
Atypical mycobacterium 221. M. kanasasii & M. avium intracellulare
Cold abscesses 222. Liquefied TB lesions similar to pyogenic abscesses but lacking acute inflammation
Actinomyces isrealli 223. Farmers infection
224. Lumpy jaw (from chewing grain) & PID (IUD), but most common is due to saprophyticus
Congenital Syphilis 225. Saddle nose, Saber shin, Hutchinsons teeth, nerve deafness, interstitial keratitis
Warthin-Finkeledy cells 226. Reticuloendothelial giant cells on tonsils, lymph nodes, spleen
Page 21
227. Seen with Rubeola (measles) due to paramyxovirus
Diphyllobothrium latum 228. Tapeworm infection causing megaloblastic anemia by consuming large amount of vit B12 in the host
Subacute Bacterial 229. Hemolytic Streptococci (S. viridans) = usually in pt w/ pre-existing heart problem
Endocarditis
Acute Bacterial Endocarditis 230. Staph aureus, Hemolytic Streptococci, E. coli
231. Common among drug addicts & diabetics
Mitral Insufficiency 232. Ruptured papillary muscle
Left Anterior Descending 233. Branch of the Left Coronary artery
branch 234. Highest frequency of thrombotic occlusion
235. MI = anterior wall of the LV, especially in apical part of interventricular septum
Left Circumflex branch 236. Branch of the Left Coronary artery
237. Occlusion = MI of posterior/lateral wall of the LV
Dissecting Aneurysm 238. False aneurysm: it is splitting of the media of the aorta
239. Usually accompanied w/ long history of severe hypertension, also seen w/ familial hyperlipidemia,
atherosclerotic disease, Marfans Collagen disease
240. Zones of medial necrosis +/- slitlike cysts = Medial Cystic Necrosis of Erdheim
Cor Pulmonale 241. Right ventricular strain, associated w/ right ventricular hypertrophy
Acute Cor Pulmonale 242. Sudden right ventricular strain due to a massive pulmonary embolism
Bronchopneumonia 243. Lobular (rather than lobar)
244. Due to Staph aureus; Pseudomonas aeruginosa; Klebsiella; E. coli
245. Abscess formation is common
Lobar pneumonia 246. Due to Strep. Pneumoniae infection (5% due to Klebsiella)
247. Red Hepatization: days 1-3 of the pneumonia
248. Gray Hepatization: days 3-8 of untreated pneumonia
249. Complicaitons: pleural effusion; atelectasia; fibrinous pleuritis; empyema; fibrinous pericarditis; otitis
media
Bronchiectasis 250. Permanent dilatation of the bronchi predisposed by chronic sinusitis and post nasal drip
251. Supparation associated
252. Lower lobe > than upper lobe involvement
Cold Agglutinins 253. Found w/ Mycoplasma pneumoniae
Panlobular Emphysema 254. 1 antitrypsin deficiency, causing elastase = compliance in the lung
Bulla 255. Associated w/ Emphysema = Bleb = outpouching - If it ruptures causes Pneumothorax
Farmers Lung 256. Due to Micropolyspora faeni (thermophilic actinomycetes)
Bagassosis 257. Due to M. vulgaris (actinomycetes)
258. Inhalation of sugar cane dust
Silo-Fillers Lung 259. Due to Nitrogen dioxide from nitrates in corn
G6PDH Deficiency 260. Sex-linked chronic hemolytic anemia w/o challenge or after eating fava beans
261. Heinz Bodies appear in RBCs
HbF 262. Sickle Cell Anemia
Multiple Myeloma 263. Lytic lesions of flat bones (salt & pepper lesions) = vertebrae, ribs, skull; Hypercalcemia; Bence-Jones
protein casts
Hodgkins Disease 264. Malignant neoplasm of the lymph nodes causing pruritis; fever = looks like an acute infection
265. Reed Sternberg cells
Polyarteritis Nodosa 266. Immune complex disease of Ag-Ab complexes on blood vessel wall
267. Half of the immune complexes have Hepatitis B Ag
268. Can see fever; abd.pain; wt; HTN; muscle aches
Sprue 269. Celiac disease due to a gluten-induced enteropathy = small intestine villi are blunted
270. High titers of anti-gliadin Abs & IgA levels
Regional Enteritis 271. Crohns Disease
272. Association w/ Arthritis; Uveitis; Erythema Nodosum
Whipples Disease 273. Intestinal Lipodystrophy = malabsorption syndrome
Kulchitsky cells 274. Neural cest cells from which carcinoids arise = of the Bronchi; GIT; Pancreas
Ulcerative Colitis 275. Inflammatory disease of the colon w/ colon CA incidence
276. Crypt abscess in the crypts of Lieberkuhn
277. Pseudopolyps when ulcers are deep
278. Not transmural involvement
Vaginal Adenosis 279. Women exposed to DES (Diethylstilbesterol) in utero before the 18th week of pregnancy
280. Some develop clear cell adenocarcinoma of the vagina & cervix
Scirrhous Carcinoma 281. Infiltrating Duct Carcinoma w/ fibrosis most common type of breast carcinoma
Hofbauer Cells 282. Lipid laden macrophages seen in villi of Erythroblastosis Fetalis
Page 22
Retinopathy of Prematurity 283. Retrolental Fibroplasia = cause of bindness in premies due to high O2 concentrations
IgA deficiency 284. Pt has recurrent infections & diarrhea w/ respiratory tract allergy & autoimmune diseases
285. If given blood w/ IgA = develop severe, fatal anaphylaxis reaction
Priamry Sjorgens 286. Dry eyes & dry mouth, arthritis. risk for B cell lymphoma. HLA-DR3 frequent. Autoimmune disease.
Secondary Sjorgens 287. Rheumatoid arthritis, SLE, or systemic sclerosis association
288. RA association shows HLA-DR4
LDH1 & LDH2 289. Myocardium. LDH1 higher than LDH2 = Myocardial Infarction
LDH3 290. Lung tissue
LDH4 & LDH5 291. Liver cells
Keratomalacia 292. Severe Vit A deficiency. See Bitots spots in the eyes = gray plaques = thickened, keratinized ET
Metabisfite Test 293. Suspending RBCs in a low O2 content solution
294. Can detect Hemoglobin S, which sickles in low O2
Microangiopathic Hemolytic 295. Can be due to Hemolyitc Uremic Syndrome & Thrombotic Thrombocytopenic Purpura (TTP)
Anemia 296. See Helmet cells
Acute Cold Agglutinaiton 324. Abs to I blood group Ag. Mediated by IgM Abs
325. Complication of EBV or Mycoplasma pneumoniae infections
Chronic Cold Agglutinaiton 326. Associated w/lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold. IgM Abs
RBC Osmotic Fragility 327. Hereditary Spherocytosis
Non-Hodgkins Lymphomas 328. Small Lymphocytic: low grade B cell lymphoma of the elderly. Related to CLL.
329. Small Cleaved cell (Follicualr): low grade B cell lymphoma of the elderly. T(14;18) bcl-2 oncogene
330. Large Cell
331. Lymphoblastic: high grade T cell lymphoma of kids progressing to T-ALL
332. Small Non Cleaved = Burkitts: high grade B cell lymphoma. EBV infection. Starry sky histo appearance.
T(8;14) c-myc proto-oncogene. Related to B-ALL
Singers Nodules 333. Benign laryngeal polyps associated w/ smoking & overuse of the voice
Paraseptal emphysema 334. Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax
Page 23
Superior Vena Cava Syndrome 335. Obstructed due to bronchogenic carcinoma. Causing swollen face & cyanosis.
Betel nuts 336. Associated to oral cancer.
Fundal (Type A) Gastritis 337. Antibodies to parietal cells; pernicious anemia; autoimmune diseases
Antral (Type B) Gastritis 338. Associated w/ Helicobacter (Campylobacter) pylori infection. 90% of duodenal ulcer
Primary Biliary Cirrhosis 339. Autoimmune origin; middle aged women; anti-mitochondrial Abs
340. Jaundice; itching; hypercholesterolemia (can see cutaneous xanthomas)
Acute Pancreatitis 341. pancreatic enzymes = fat necrosis; sapponification = hypocalcemia; serum amylase
342. Severe epigastric ab pain; prostration; radiation to the back
Radiating Back Pain 343. Chronic pancreatitis
Complete Hydatidiform Mole 344. No embryo. Paternal derivation only. 46XX
Partial Hydatidiform Mole 345. Embryo. 2 or more sprems fertilized 1 ovum: triploidy/tetraploidy occurs
Cold Nodules 346. Hypoplastic Goiter nodules that do not take up radio active iodine. [Opposite: hot & do take up iodine]
Acidophils 347. Mammotrophs = Prolactin
348. Somatotrophs = GH
Page 24
393. Niemann-Pick
394. Hurlers
395. Von Gierkes
396. Pompes
397. Coris
398. McArdles
399. Galactosemia
400. PKU
401. Alcaptonuria
X Linked Recessive Diseases 402. Hunters Syndrome (L-Iduronosulfate Sulfatase deficincy, Heparan/Dermatan Sulfate)
403. Fabrys Disease ( Galactosidase A deficiency, Ceremide Trihexoside)
404. Classic Hemophilia A (Factor VIII deficiency, F8 Gene on X chromosome is bad, Ceremide Trihexoside)
405. Lisch-Nyhan Syndrome (HGPRT deficiency, Uric acid)
406. G6Phosphatase deficiency (G6PDH deficiency, Ceremide trihexoside)
407. Duchennes Muscular Dystrophy (Dystrophin deficinecy, Ceremide Trihexoside)
Hypersensitivity Reactions 408. Type I (Anaphylactic): IgE mediated. Exs: Hay Fever; Allergic asthma; Hives
ACID 409. Type II (Cytotoxic): Warm Ab autoimmune hemolytic anemia; hemolytic transfusion reactions;
Erythroblastosis Fetalis; Graves Disease; Goodpastures
410. Type III (Immune Complex): Insoluble complement bound aggregates of Ag-Ab complexes. Exs: Serum
sickness; Arthus Reaction; Polyarteritis Nodosa; SLE; Immune Complex Mediated Glomerular Disease
411. Type IV (Delayed = Cell mediated immunity): Delayed hypersensitivity. Involves memory cells. Exs:
Tuberculin reaction; Contact dermatitis; Tumor cell killing; Virally infected cell killing
Transplant Rejections 412. Hyperacute Rejection = occurs w/in minutes of transplant. Ab mediated.
413. Acute Rejection = occurs w/in days to months of transplant. Lymphocytes & macrophages. Only
rejection type that can be treated w/ therapy.
414. Chronic Rejection = occurs months to years of transplant. Ab mediates vascular damage.
Blood Metastasis 415. Sarcoma, exception renal cell CA: early venous invasion
Lymph Metastasis 416. Carcinoma, exception renal cell CA: early venous invasion
Aflatoxin 417. Seen w/ Aspergillus. risk for Hepatocellular CA
Cleft Lip 418. Incomplete fusion of maxillary prominence w/ median nasal prominence
Cleft Palate 419. Incomplete fusion of lateral palatine process w/ each other & median nasal prominence & medial
palatine prominence
Craniopharyngioma 416. Pituitary tumor - usually calcified
Lateral Geniculate Nucleus Inolved in Vision relay
Medial Geniculate Body Involved in Hearing relay
Lung Development Glandular: 5-17 fetal weeks
Canalicular 13-25 fetal weeks
Terminal Sac 24 weeks to birth
Alveolar period birth-8yoa
Hearts 1st Beat 21-22 days
Foregut Mouth ! Common Bile Duct - supplied by Celiac Artery
Midgut Duodenum, just below Common Bile Duct ! Splenic flexure of the Colon supplied by Superior Mesenteric
artery
Hindgut Splenic Flexure ! Butt crack ! supplied by Inferior Mesenteric Artery
Hypnagogic Hallucinaitons Narcolepsy
Type I Error : Convicting the innocent accepting experimental hypothesis/rejecting null hypothesis
Subdural Hematoma Ruptured cerebral bridging veins
Epidural Hematoma Ruptured middle meningeal artery intervals of lucidness, 2ry to Temporal bone fracture
Type II Error : Setting the guilty free fail to reject the null hypotesis when it was false
Power 1-
Sensitivity TP/TP + FN
Specificity TN/TN + FP
Positive Predictive Value TP/TP + FP
Negative Predictive Value TN/TN + FN
Odds Ratio ad/bc
d-Dimers DIC
Delusion Disorder of thought content
Loose Association Skip from topic to topic
5 Stages of Death Denial Anger Bargaining Depression Acceptance
Page 25
1st Branchial Arch Meckels cartillage gives rise to incus/malleus bones of ear
2nd Branchial Arch Reicherts cartillage gives rise to stapes bone of ear
Median nerve lesion No pronation
Radial nerve lesion Wrist drop seen w/ humerus fracture
Common peroneal lesion Foot drop. No dorsiflexion or eversion of the foot
Diract inguinal hernia Goes through superficial inguinal ring.
Medial to inferior epigastric artery
Seen in older men
Indirect inguinal hernia Goes through deep & superficial inguinal ring
Lateral to inferior epigastric artery
Seen in young boys processus vaginalis did not close
@ Diaphragm T8, T10, T12 T8 = Inferior vena cava
T10 = Esophagus/ Vagus
T12 = Aorta/ Thoracic duct/ Azygous vein
Hemiballism Wild flailing of 1 arm. Lesion of the sub thalamic nucleus
O Linked Oligosaccharide In the Golgi
N Linked Oligosaccharide In the RER
MLF Syndrome Internuclear Ophthalmoplegia: medial rectus palsy on lateral gaze; Nystagmus on abducting eye.
Seen w/ MS
ADA Deficiency SCID
Raphe Nucleus Initiation of sleep via 5HT predominance
waves Alert; Awake; Active mind also seen in REM, therefore we say paradoxical sleep
Irreversible Glycolysis Hexokinase
Enzymes PhosphoFructo Kinase = Rate Limiting Step
Pyruvate Kinase
Pyruvate Dehydrogenase
Irreversible Gluconeogenesis PyruvateCarboxy Kinase
Enzymes PEPCarboxyKinase
Fructose 1,6 BiPhosphatase
Glucose 6 Phosphatase
**muscle dose not take part in Gluconeogenesis, only takes place in the liver, kidney & GI epithelium
Pellagra Diarrhea, Dermatitis, Dementia
Niacin Deficiency (Vit B3 deficiency)
Hartnups Disease
Malignant Carcinoid Syndrome
INH use
TLCFN Needed as co-factor for Pyruvate DH complex & Ketoglutarate DH complex
LCAT or PCAT Esterification of cholesterol: lecithin cholesterol acetyltransferase
Lecithin = Phosphatidylcholine, therefore phosphotidylcholine acetyltransferase
HMGCoA Reductase Rate limiting step in cholesterol synthesis
Changes HMGCoA ! Mevalonate
(-) by Lovastatin
Ketogenic amino acids Leucine & Lysine
Glucogenic amino acids Methionine, Threonine, Valine, Arginine, Histadine
Keto & Gluco amino acids Phenylalanine, Trytophan, Isoleucine
Carnitine Shuttle Feeds FA into the mitochondria for their consumption
Cori Cycle Keeps muscles working anaerobically.
Transfers lactate to the liver to make glucose which is sent back into the muscles for energy use
(-) Na+ Pump (ATPase) Ouabain [(-) K+ pump]
Vanadate [(-) phosphorylation]
Digoxin [ heart contractility]
TCA Cycle Products Citric Acid Is Krebs Starting Substrate For Mitochondrial Oxidation
Citrate ! Aconitate ! Isocitrate ! Ketoglutarate ! Succinyl ! Succinate ! Fumarate ! Malate !OAA
Cones Color vision. Contain Iodopsin = Red-Blue-Green specific pigment. For acuity.
Rods Contain Rhodopsin pigment. High sensitivity. Concentrated in the fovea. Night vision.
Gastrula Seen @ 3rd week: Ecto, Meso & Endo
Epiblast @ 2nd week: forms the primitive streak, from which Meso & Endo come from. Directly gives rise to Ecto.
Sydenhams Chorea Post streptococcal infection. Necrotizing arteritis of the caudate, putamen, thalamus
(+) Frei Test Chlamydia trachomatis types L1, L2, L3 = Lymphogranuloma venereum
Page 26
Sabourauds Agar Culture for all Fungi ieCulture Cryptococcus neofromans which is found in pigeon droppings
FMR1 Gene Defect Fragile X Syndrome: macro-orchidism; long face; large jaw; large everted ears; autism, mental retardation
Barr Body Present in Kleinfelters: Male: XXY
Not present in Turners: Female: XO
Aortic Insufficiency Signs Traube Sign = Pistol shot sound over the femoral vessels
Corrigan pulse = water hammer pulse over coratid artery = aortic regurgitation
Scleroderma :CREST Calcinosis; Raynauds; Esophageal; Sclerodactyl; Telangiectasis
Cretinism Sporadic: bad T4 phosphorylation or developmental failure of thyroid formation
Endemic: no Iodine in diet: protruding belly & belly button
Hemochromatosis Triad Micronodular pigment cirrhosis; Bronze Diabetes; Skin pigmentation = due to Fe3+ deposition
Page 27
Osteoporosis 465. Heparin
466. Corticosteroids
Positive Coombs Test 467. Methyldopa
Pulmonary Fibrosis 468. Bleomycin
469. Amiodarone
Red Man Syndrome 470. Vancomycin
Severe HTN with Tyramine 471. MAOIs
SLE-like Syndrome 472. Procainamide
473. Hydralazine
474. INH
Tardive Dyskinesia 475. Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine) Clozapine: only antipsychotic to not
476. give you tardive dyskinesia
Tinnitus 477. Aspirin
478. Quinidine
Microbiology
Lactose formers 1. CEEK
2. Citrobacter
3. Enterobacter
4. E.Coli (K1 capsule most important)
5. Klebsiella
Non lactose formers 6. SHYPS
Motile:
7. Shigella
make H2S
8. Yersinia enterolytica (AKA Pestis)
9. Proteus
10. Salmonella Non Motile: noH2S
May lack color 11. These rascals may microscopically lack color:
12. Treponema
13. Ricksetta
14. Mycobacterium
15. Mycoplasma
16. Legionella
17. Chlamydia
cAMP 18. CAPE
19. Cholera
20. Anthracis (Poly D glutamate capsule)
21. Pertusis (via Gi)
22. E.coli (LT enterotoxin)
Have Capsules [ie are Quellung Reaction (+)] 23. Some killers have pretty nice capsules
24. Strep. Pneumoniae
25. Klebsiella
26. HiB
27. Pseudamona Aeroginosa
28. Neisseria meningitis
29. Cryptococcus neoformans (only encapsulated fungal pathogen)
Dimorphic Fungi 30. Can Also Have Both Shapes
31. Cocciodes
32. Aspergillus
33. Histolpasma
34. Blastomyces
35. Sprothrix schenkii
Have Prophage 36. OBED
37. O = Salmonella
38. B = Botulinum
39. E = Erythrogenic strep
40. D = Diptheria
Spore Forming Bacteria 41. Bacilus & Clostridium (have calcium di-picolinate)
IgA Proteases 42. Neisseria, Haemophilus, S. pneumoniae
Widal Test 43. Salmonella (Salmonella begins in the ileocecal region) agglutination indicates Abs to O, H, Vi Salmunella Ags
Page 28
Waysons Stain 44. Yersinia
Pneumonic Plaque Transmission 45. Person to person cf w/ Bubonic plaque that was via infected flea
Splenectomy 46. Predisposes to septicemia
Invasins 47. Yersinia pseudotuberculosis
Fusiform 48. Vincents trench mouth
S. viridans 49. Dextran mediated adherence
Obligate Aerobes 50. Pseudomonas & Mycobacterium
Obligate Anaerobes 51. Clostridium, Actinomyces, Bacteroides
Staph aureus 52. A Protein, Catalase +/ Coagulase +
Spirochetes 53. Treponema, Borrelia, Leptospira
Non Motile Gram (+) Rods 54. Corenybacterium D & Nocardia
Acid Fast Organisms 55. Mycobacterium; Cryptosporidium; Nocardia (partially); Legionella micdadei; Isospora
Pigment Producing Bacteria 56. Serratia red (can cause pseudohemoptysis)
57. Pseudomonas A piocyanin blue/green
58. Staph Aureus yellow Protein A
59. Mycobacteria photo/scoto chromogenic caritinoid yellow/orange
60. Corneybacterium D black/gray pseudomembrane plaque in throat
61. Bacteroides (Porphyromonas) melaninogenicus black (heme)
62. E. coli irredescent green sheen
Bacterial Morphology 63. Pneumococci lancet shaped diplococci
64. Neisseria kidney bean shaped diplococci
65. Camphylobacter gulls wings/comas
66. Vibrio Cholera coma shaped
67. Corneybacterium D club shaped (nonmotile, G+Rod)
68. Yersinia safety pin seen in Waysons stain
Inclusion Bodies 69. Rabies Negri bodies intracytoplasmic
70. Pox virus Guarnieri intracytoplasmic & acidophilic
71. CMV Owls eyes intracytoplasmic & intranuclear
72. HSV Cowdry bodies intranuclear
Schistosoma Japonicum Monsoni 73. Intestinal contact w/ bad water
Schistosoma Haematolium 74. Vesicular contact w/ bad water
Non Human Schistosom 75. Swimmers itch contact w/ bad water
Clonorchichis 76. Chinese liver fluke eating raw fish. Txt: Praziquantel
Fasciola Hepatica 77. Sheep eating raw fish. Txt: Praziquantel
Fasciola Biski 78. Giant intestinal flukes eating raw fish. Txt: Praziquantel
Paragonimus Westermani 79. Lung fluke eating raw fish. Txt: Praziquantel
Oxidase (+) 80. Neiserria and most Gram (-)s
Micro Aerophilic 81. Camphylobacter & Helicobacter
Urease (+) 82. All Proteus can cause Staghorn/Struvite calculi (NH4- Mg2- stones): alkaline urine
83. Ureaplasma
84. Campylobacter pylori (Helicobacter)
85. Cryptococcus
86. Nocardia
Coagulase (+) 87. Staph A & Yersenia pestis
Obligate Intracellular Bacteria 88. Chlamydia Pistacci (Chlamydia do not make own ATP); Mycobacterium Leprae; all Rickettsia
except Roachalimea (make suficient ATP to survive)
Protozoa 89. Plasmodium; Toxoplasma ghondi; Babesin; Leishmania; Trypanosoma Cruzi
Obligate Non Intracellular Parasites 90. Treponema palidum & Pneumocystis Carinii (cannot be cultured on inert media but
can be found extra cellularly in the body)
Haemophilus Factors 91. X = Protoporphyrin & V = NAD
All cocci are 92. Gram (+) except for Neisseria & Moraxella
Eaton Fried Eggs 93. Mycoplasma pneumoniae has fried egg colonies on Eaton agar (needs cholesterol)
Mycoplasma 94. No cell wall. Membrane has cholesterol. Smallest living bacteria.
95. P1 protein inhs ciliary action
96. Fried egg colonies
97. Atypical pneumonia young adults
Sabrands 98. Fungal media
Malassazia furfur 99. Spaghetti & meat ball
Page 29
Measles 3Cs 100. Cough Coryza Conjunctivitis. Can also have photophobia
101. May lead to subacute Sclerosing Panencephalitis
Non Motile Bacilli & Clostridium 102. B. Anthracis & C. Perfringens
Bloody diarrhea agents 103. EIEC EHEC Shigella - Yersenia enterocolitica Entaemeba histolytica
Salmonella Campylobacter jejuni
YW-135CA 104. N. meningitidis vaccine capsualr polysaccharide strains
Indian Ink 105. Cryptococcus neoformans
Naegleria causes 106. Colonization in the nasal passages after swimming
Need Cysyeine for growth 107. Ella likes cysteine:
108. Francisella
109. Brucella
110. Legionella
111. Pasturella
Endotoxins, G(+) or G(-) 112. Gram (-): N. meningitidis
Ecthyma Gangrenosum, seen w/ 113. Pseudomonas aeroginosa. Target shaped skin lesions w/ a black center and red ring
surrounding the lesion
Endospores G(+) 114. Gram (+): Bacillus & Clostridium made up of dipicolinate & Keratin
Multi Brain Abscess 115. Nocardia
Single Brain Abscess 116. Actinomyces israelli
risk for Strep pneum Infection 117. Asplenic; Sickle cell anemia; immunocompromising illness
Hemolysis/Optochin Sensitive 118. Strep. Pneumoniae
Hemolysis/Optochin Resistant 119. Strep. Viridans (Subacute Endocarditis)
Staph. Saprophyticus 120. Novobiocin Resistant (UTIs)
Staph. Epidermidis 121. Novobiocin sensitive (Endocarditis in IVDUs)
Hemolysis/Bacitracin Sensitive 122. Strep. Pyogenes (pharyngitis; Scarlet fever; cellulitis; impetigo; Rheumatic fever))
123. Hyaluronic capsule; non-motile; M proteins; Endotoxin A
Hemolysis/Bacitracin Resistant 124. Strep. Agalactiae (Diabetes predisposes to infection)
EFII Ribosylation 125. Diphtheria toxin & Pseudomonas exotoxon A
Bacillus Anthracis: 3 toxins 126. Protective Antigen (PA)
(work via adenylate cyclase) 127. Lethal Factor = toxic to macrophages
128. Edema Factor = cAMP
Woolsorters Disease 129. Bacillus anthracis. DOC: Penicillin
Grows in Rice 130. Bacillus Cereus
Clostridium Perfringens 131. Double Zone Hemolysis (test)
132. Lecithinase: toxin = lyses RBCs
133. 80% of gas gangrene (myonecrosis) cases
Clostridium Difficile 134. 2 Toxins: Enterotoxin (Exotoxin A) & Cytotoxin (Exotoxin B)
135. Pseudomembranous colitis (can be precipitated by clindamycin/ampicillin)
Spastic Paralysis toxin 136. Clostridium Tetani toxin
Clostridium Botulinum 137. Bad canned foods have neurotoxin = flaccid paralysis (block Ach release)
Infant Botulinum 138. Floppy Baby Syndrome. Pre formed toxin in honey
Thayer Martin Agar 139. Neisseria ID
DOC for N. gonorrhoeae 140. Ceftriazone
K1 E. Coli Capsular Ag 141. Related w/ neonateal meningitis
The As of Klebsiella 142. Alcoholics
143. Aspiration pneumonia
144. Abscesses in the lungs
Rice H2O Diarrhea 145. Vibrio Cholera: metabolic acidosis
Raw seafood intoxicaiton 146. Vibrio parahemolyticus
Helicobacter Txt 147. Bismuth salts; Metronidazole; Tetracycline (or amoxicillin)
risk of P. aeroginosa infection 148. Burn patients & Cystic fibrosis
Contact lens infection 149. Pseudomonas aeroginosa
Cat Bites 150. Pasteurella multocida
Undulant Fever 151. Brucella
Bordet Gengou Agar 152. Bordetella pertusis ID
Lowenstein-Jensen medium 153. M. tuberculosis ID
Cat Scratch Disease 154. Bartonella henselae. Leion can resemble Kaposis sarcoma.
Page 30
155. Toxoplasmosis
Pink Eye 156. Adenovirus (type 8)
True Hemaphrodite 157. Testes & Ovaries are present
Pseudo Hemaphrodite 158. External genitalia does not coincide w/ gonads
Male Pseudo Hemaphrodite 159. Testicular Feminization
HLA Genes Location 160. 6p
Parvovirus B19 161. Fifth Disease: Erythema Infectiosum (ssDNA). Linked w/ sicle cell anemia
Interferon MOA 162. Inhibits viral replication (translation or transcription)
Acute Hemorrhagic Conjunctivitis 163. Seen w/ infections from Enterovirus & Coxsackie A
Parainfluenza Causes 164. Croup (Laryngotracheobronchitis)
Swimming Pool Conjunctivitis 165. Adenovirus (types 3 & 4)
RSV 166. Bronchiolitis in infants
Removed tonsils, find what virus 167. In 80%, Adenovirus. In the immunosuppressed, activation can occur
Bone Fever 168. Dengue: Group B Togavirus, from the Arbovirus, transmitted by mosquitos
HbsAg 169. Appears in blood soon after infection, before onset of acute illness
170. Disappears w/in 4-6 months after the start of clinical illness
HbeAg 171. Appears early acute phase, indicates higher risk of transmitting the disease
172. Disappears before HbsAg is gone
Anti-Hbc 173. Present in beginning of clinical illness
174. Seen in the window phase
Filamentous Bacteria 175. Actinomycetes = Nocardia; Actinomyces; Streptomyces
Listeria contaminates 176. Milk, cheese, vegetables (coleslaw) in recent infections
Shiga like Toxin 177. E. Coli 0157/H7: Hemorrhagic colitis & Hemorrhagic uremic syndrome
Necrotizing Fasciitis 178. Group A Streptococci
Relapsing Fever 179. Borrelia recurrentis
Lofflers Medium 180. Corneybacterium diphtheriae
Chlamydiae Developmental Cycle 181. Elementary Body: infeccious particle that Enters the cell
182. Reticulate Body: made from elementary body. Replicates, differentiates and releases
elementary bodies to infect other cells
183. W/ infection you will see Glycogen containing inclusions
184. Cell wall lacks muramic acid
Trench Fever 185. Rochalimaea quintana
Spotted Fever Members 186. Rickettssia rickettsii (RMSF) & R. akari (rickettsial pox) in the U.S.
187. R. sibirica (tick typhus in China) & R. australis (typhus in Australia)
Thrush Txt 188. Nystatin txts candidiasis of the mouth
Rose Bush Thorns 189. Have Sporothrix schenckii
Contact lens solution infection 190. Acanthamoeba
Filiariasis Causant 191. Wucheria bancrofti (infection aka elephantitis & wucheriasis
Freshwater lake infection 192. Causes amebic meningoencephalitis due to Naegleria fowleri
Reduviid bug bite 193. Transmits Trypanoma cruzi (Chagas disease): Romanas Sign
Schistosoma Haematobium causes 194. Bladder calcificaiton & cancer
Schistosoma Mansoni causes 195. Presinusoidal HTN, splenomagaly, esophageal varices
Snail, intermediate host of 196. Schistosomiasis
Ixodes scapularis transmits 197. Babesia (clinically rembles malaria) & Borelia burgdorferi
Nantucket Protozoa 198. Babesia microt
Infection by Reduviid Bug 199. Trypansoma cruzi: Chagas Disease
Infection by TseTse Fly 200. Trypansoma brucei gambiense & rhodiense: African Sleeping Sickness
Infection by Sandfly 201. Leishmaniasis: Mucocutaneous Diseases by L. braziliensis & Visceral Disease by L. donovani &
Dermal Leishman by L. tropica, mexicana, peruviana
Infection by Ixodes Tick 202. Babesia microti: Babesiosis & Borrelia burgdorferi: Lyme Disease
Infection by Anopheles Mosquito 203. Malaria
Trophozoites w/ Face-Like Appearance 204. Giardia lamblia
Nonseptate Hyphae 205. Zygomycosis: Rhizopus & Mucor. Only mycosis w/o septate. Infect Ketoacidotic Diabetics.
Histoplasmosis Geography 206. Ohio, Mississippi, Misouri River valleys
Coocidioidomycosis Geography 207. Southwestern deserts, California
Blastomycosis Geography 208. States east of Mississippi River
Page 31
Paracoccidioidomycosis Geography 209. Latin America
Roseola Infection, aka 210. Exanthema Subitum: Sixth Disease (Human Herpes Virus-6 dsDNA, enveloped)
Herpangina 211. Hand-Foot-and-Mouth Disease: Coxsackie A (Picornavirus +ssRNA)
Orthomyxovirus 212. ssRNA, enveloped virus.
213. Spike Glycoproteins (peplomeres): HA = Hemagluttinin & NA = Neuraminidase. These
peplomeres are what give the virus antigenis variation
214. Influenza A & B
Paramyxovirus 215. RNA, enveloped. Most common cause of respiratory infections in kids
216. Mumps
217. Croup(Parainfluenza virus)
218. Rubeola(Measles virus)
219. RSV
Togavirus 220. +ssRNA, enveloped
221. 3 Day Measles: German Measles: Rubella/ Rubivirus
222. Encephalitis viruses: Alphaviruses: Eastern (more severe) and Western Equine
Encephalitis
Flaviviris 223. Dengue Fever icterus & hemorrhage w/ blac vomit
224. Yellow fever
225. St. Louis Encephalitis no hepatitis or hemorrhage
Bunyavirus 226. ssRNA, enveloped
227. California Encephalitis severe bifrontal headaches
228. Hantavirus hemorrhagic fever w/ acute resp. distress syndrome
IgA Protease Activity 229. H. Influenzae (needs factors V & X for growth)
230. Strep. Pneumoniae
231. N. meningitidis
232. N. gonnorhoae
233. W/ this activity these bugs are able to colonize the oral mucosa.
Diphtheria: ABCDEFG 234. Adenopathy
235. Prophage encodes the exotoxin
236. Corneybacteria is Club shaped
237. Diphtheria
238. Elongation Factor II
239. Granules (metachromatic)
Only ssDNA 240. Parvovirus: Part of a virus
Only dsRNA 241. Reovirus, RepeatOvirus
Naked RNA 242. Naked for CPR: Calcivirus; Picornovirus; Reovirus
2 circular DNAs 243. Papovavirus & Hepadnavirus
BK 244. Papovavirus. Seen in kidney transplant patients (causes renal disease)
Hepadna, Retrovirus? 245. No, but has reverse transcriptase
Picornovirus: PERCH 246. Poiliovirus; Echo; Rhino; Coxsackie; Hep A
Hemorrhagic Fevers 221. Filovirus & Bunyavirus (Hantavirus)
Segmented viruses All are RNA: Orthomyxo; Arena; Bunya; Reo
Eclipse Phase No internal virus. 1 total virus per cell
Latent Phase No external virus. Extracellular virus found
Naked Capsid Virus Nucleocapsid. DNA or RNA + Structural proteins
Enveloped Virus Membrane. Nucleocapsid + Glycoprotein
Interferon Non virus specific. Works by RNA endonuclease = digests viral DNA + inh viral prot synth
AIDS structural prots Gag, pol, env
AIDS regulatory prots Tat, rev, nef
AIDS gp41 env prot Transmembrane
AIDS gp120 env prot Surface
AIDS p17 gag prot Matrix
AIDS p24 gag prot Capsid
AIDS p7p9 gag prot Nucleocapsid
DNA Viruses A = Adeno
E Brick. Rep H = Herpes
In Cyto H= Hepadna
AH H PPP --- ico Rep in Nuc P = Pox
P = Parvo
Page 32
SS P = Papova
Circ
Bullet
Anti sense
Hepatitis Window Period After HbsAg disappears & Before HbsAb appears
Hepatitis A B C D E
Picorna Hepadna Flavi Delta Calici
Downey Type II cells EBV
Infection by Aedes Mosquito Yellow Fever: Flavivirus: Black vomit, jaundice, high fever
Hot T-Bone stEAk: ILs IL1 = Temp: HOT
IL2 = stimulate T cells
IL3 = stimulate Bone Marrow stem cells growth & differentiation (GM CSF)
IL4 = stimulate IgE (& IgG)
IL5 = stimulate IgA (& eosinophils)
ILs Secreted by CD4s IL2, IL4, IL5, IFN gamma
ILs Secreted by Macrophages IL1 & TNF
C5a Neutral chemotaxis.
When it is w/ C3a, participates in anaphylaxis
C5 Convertase When both Alternative and Classic pathways come together
Alternative: C3b, Bb, C3b + C3a ! C5
Classic: 2b, 3b, C3a + C4b ! C5
Only Richettssia not Intracellular Quintana
Plasmodium Life Cycle Sporozoites: from blood to liver
Primary tissue schizont
Trophozoites: in RBC
Erythrocytic schizont
Merozoite: ruptured RBC
Gametozyte
Zygote: inside the mosquito
Acanthamoeba Star shaped cysts
Mucor, Rhizopus, Absidia Nonseptate, filamentous, 90 degree branching, indian in, capsular halos
Cryptococcus Neoformans Monomorphic
Candida Yeast normally, pseudo & true hyphae in tissue infections
Aspergillus Fumigatum 45 degree branching point, asocd w/ cystic fibrosis & burns pt
Cocciodes Hyphae in wild. Artroconidia. Arthocondida & Hyphae. Sherules w/ endospores
Histoplasma Cap Hyphae in wild. Microcondida w/ tuberculate macrocondida. Fac intracellular. In the tissue
its a yeast w/ a small neck.
Blastomycosis Hyphae in wild
Sporothrix Schenkii Hypahe in wild. Potas iodide in milk. Pneumonia in alcoholics.
PCP Obligate parasite. Kills type I pneumo cells. Ground glass
Page 33
Gram (-) Bugs w/ Exotoxins E. Coli; V. Cholera; Bordetella Pertussis
Dermatophytes Trichophyton: SHN
Microsporium: SH
Epidermophyton: SN
Tinea tavus: permanent hair loss
Transmission Diagnosis
E. Histolitica Cysts Trophozoites or cysts in stool
Giardia Cysts Trophozoites or cysts in stool
Cryptosporidium Cysts Acid fast oocysts
Balantium C. Cysts Trophozoites or cysts in stool
Trichomonas V. Trophozoites Motile trophozoites
Fever Fever Spike
Vivax Benign 3 degrees 48h Enlarged Host Cell
Ovale Benign 3 degrees 48h Oval/Jagged
Malariae 4 degrees of Malarial 72hrregular Crescent
Falciparum Malignant 3 degrees
Miscellaneous
1. Fastest growing tumor Burkitts
2. PEs are found in half of all autopsies
3. Courvoisiers Law: tumors that obstruct the common bile duct cause enlarged gallbladders, but obstructing
gallstones do not (too much scarring), so if you can palpate the gallbladder youe probably looking at cancer.
4. Only DNA virus to replicate in cytoplasm: Pox
5. Only RNA virus to replicate in nucleus: Influenza
6. Bacillus anthracis has the only protein capsule
7. Bordetella pertussis (Whooping Cough) elicits lymphocytosis rather than granulocytosis
8. Bronchioalveolar carcinomas grow without destroying the normal architecture of the lung
9. Cryptococcus neoformans often lacks a capsule and, when stained with GMS, looks just like Pneumycistis
carinii, except that Cryptococcus lacks the prominent nucleoli.
10. Weil Felix reaction: (+)R. rickettssi & (+)Proteus vulgaris & P. mirabilis
11. Treponema pallidum (Syphilis) tests: 1)VDRL 2)FTA-Abs: most widely used 3)TPI (immobilization test most
expensive but the Gold Standard)
Physiology Equations
Resistance in Series: Add all
Resistance in Parallel: Invert the answer
RENAL:
GFR
Filtration Fraction = GFR: Glomerular Filtration Rate RPF: Renal Plasma Flow
RPF
CARDIO:
O 2(consumed )
CO = HR x SV CO = Pulse Pressure = Systolic Diastolic
PulmonaryA VO 2difference
MAP P1 P 2
MAP = Diastolic + 1/3 Pulse Pressure CO = MAP = TPR x CO F=
TPR R
LUNGS:
PACO2
PAO2 = (760 47) FO2 -
R
Where:
CO 2 produced
FO2 = [O2] PACO2 = Alv. Press. Of CO2 R = Resp. Exchange Ratio .8 or 1
O 2consumed
Page 35
O 2consumed Area
Flow = Velgas Diffusion = x Gas Diffusion Constant x Difference of Partial
AtoVO2difference Thickness
Press
Resp Doubles: 150mmHg & 40mmHg New PCO2 = 20 New PO2 = 170
Page 36