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2500d1335984520 Goljan RR Pathology Based Flashcards PDF Download Endo PDF
2500d1335984520 Goljan RR Pathology Based Flashcards PDF Download Endo PDF
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More Free USMLE , MCCEE ,MCQe and AMQ Flashcards
Kallmanns syndrome
Impotence
Erection
parasympathetic response
Ejaculation
sympathetic response
Y chromosome
Testosterone
Dihydrotestosterone (DHT)
Male pseudohermaphrodite
Testicular feminization
Klinefelters syndrome
Herpes genitalis
Chlamydia trachomatis
S/S
Neisseria gonorhoeae
N gonorrhoeae
C. trachomatis
Lymphogranuloma venereum
C. trachomatis subtype
S/S
scrotal/vulva lymphedema;
granulomatous microabscesses;
rectal strictures in females
Chancroid
Granuloma inguinale
Calymmatobacterium
granulomatis; raised ulceration but
no lymphadenopathy
Treponema pallidum
Primary syphilis
painless chancre
Secondary syphilis
Tertiary syphilis
RPR/VDRL
RPR/VDRL
FTA-ABS
FTA-ABS
Trichomonas vaginalis
flagellate protozoan;
cervicitis/vaginitis; Rx
metronidazole both partners
Gardnerella vaginalis
Candida vaginitis
Vulvar leukoplakia
Pagets disease
intraepithelial adenocarcinoma
(mucin production) of vulva
Malignant melanoma
Embryonal rhabdomyosarcoma
Vaginal adenosis
Rokitansky-Kiister-Hauser
Nabothian cysts
Pathologic cervicitis
trichomonas, HSV-2, C.
trachomatis (follicular cervicitis)
Cervical Pap
Normal
Atrophic
Hyperestrinism
Pregnancy
Endocervical cells
Cervical polyp
Cervical dysplasia
CIN
Cervical cancer
S/S
Sequence to menarche
estrogen-dependent; estrogen
inhibits FSH and stimulates LH
Ovulation
progesterone-dependent
Menses
drop in estrogen/progesterone
stimulates apoptosis; plasmin
prevents clotting
FSH
LH
Day 21
Pregnancy
hCG
LH analogue produced by
syncytiotrophoblast
hCG
Estrone
estrogen of postmenopausal
woman; aromatization of adrenal
androstenedione
Estradiol
Estriol
estrogen of pregnancy
Menopause
S/S
Hirsutism
Virilization
S/S
hirsutism, oligomenorrhea,
infertility; enlarged ovaries with
subcortical cysts; LH:FSH >2:1
Menorrhagia
Dysmenorrhea
DUB
Anovulatory DUB
Ovulatory DUB
Primary amenorrhea
Secondary amenorrhea
Amenorrhea-hypothalamic/pituitary
dysfunction
Amenorrhea-ovarian dysfunction
Amenorrhea-end-organ disease
Asherman syndrome
Primary amenorrhea-normal
secondary sex characteristics
Primary amenorrhea-lack
secondary sex characteristics
Turners
Turners syndrome
S/S
Secondary amenorrhea
Asherman syndrome
Endometritis
Endometrial polyp
Adenomyosis
Endometriosis
S/S
Endometrial hyperplasia
unopposed estrogen;
simple/complex types; precursor
endometrial cancer
Causes
Endometrial cancer
S/S
bleeding in postmenopausal
woman
Leiomyoma uterus
Leiomyosarcoma
MC sarcoma
Ectopic pregnancy
Follicular cyst
surface-derived; bilaterality;
psammoma bodies in malignant
type
surface-derived; pseudomyxoma
peritonei in malignant type
Endometrioid carcinoma
Cystic teratoma
Dysgerminoma
Meigs syndrome
Granulosa tumor
Thecoma
hyperandrogenism
Gonadoblastoma
XY phenotype of Turners
Krukenberg tumors
Syncytiotrophoblast
Abruptio placenta
Placenta previa
Placenta accreta
Twin placenta
Siamese twins
Enlarged placenta
Complete mole
S/S
Partial mole
Choriocarcinoma
Risk factors
S/S
Chorioamnionitis
Preeclampsia
S/S
Spontaneous abortion
Amniotic fluid
fetal urine
Polyhydramnios
Oligohydramnios
Serum AFP
Serum AFP
Down syndrome
Urine estriol
Fibrocystic change
Sclerosing adenosis
Fibroadenoma
Intraductal papilloma
Breast cancer
Mammography
Medullary carcinoma
Inflammatory carcinoma
Lobular cancer
Phyllodes tumor
Gynecomastia
Gynecomastia
prolactinoma (bromocriptine),
pituitary Cushings (high dose
dexamethasone)
Hypopituitarism adults
Hypopituitarism in children
craniopharyngioma (Rathkes
pouch remnant) MCC; visual field
defects
amenorrhea, testosterone in
male
IGF
hypoglycemia
S/S TSH
S/S ACTH
secondary hypocortisolism;
cortisol, ACTH; fatigue;
hypoglycemia
Metyrapone
Metyrapone
pituitary/hypothalamic dysfunction
Addison's disease
Diabetes insipidus
Causes CDI
Causes NDI
lithium, demeclocycline,
nephrocalcinosis, severe
hypokalemia
Gigantism
Acromegaly
S/S acromegaly
Prolactin
inhibited by dopamine
Prolactinoma
Rx
surgery or bromocriptine
(dopamine analog)
Causes
Rx
Serum T4
thyrotoxicosis
primary hypothyroidism
secondary hypothyroidism
TSH
I131 uptake
Cold nodule
Hot nodule
Acute/subacute thyroiditis
Hashimotos thyroiditis
Hashimotos thyroiditis
S/S
Lab
T4, TSH
Cretinism
S/S
Thyrotoxicosis
Hyperthyroidism
Graves disease
S/S thyrotoxicosis
tachycardia/atrial fibrillation,
systolic hypertension, diarrhea,
brisk reflexes
Lab thyrotoxicosis
I131 uptake
Rx Graves disease
Goiter
S/S
often malignant
MEN I syndrome
Alkalotic pH
Hypoalbuminemia
Tetany
S/S
PTH
Primary HPTH
Cause
S/S
Secondary HPTH
Malignancy-induced
hypercalcemia
Causes hypercalcemia
Tertiary HPTH
Primary hypoparathyroidism
Causes
S/S
Pseudohypoparathyroidism
hypomagnesemia ( PTH),
vitamin D, DiGeorge
primary hypoparathyroidism
secondary hyperparathyroidism
primary hyperparathyroidism
malignancy induced
hypercalcemia; other causes
hypercalcemia
Waterhouse-Friderichsen
syndrome
Addisons disease
S/S
Lab
Adrenogenital syndrome
21-Hydroxylase deficiency
11-Hydroxylase deficiency
17-Hydroxylase deficiency
MCC Cushings
Normal dexamethasone
suppression
Pituitary Cushings
Lab
Adrenal Cushings
Lab
Ectopic Cushings
Lab
S/S Cushings
Primary aldosteronism
S/S
Lab
hypernatremia, hypokalemia,
metabolic alkalosis, urine K+ and
Na+
Pheochromocytoma
Associations
S/S
Lab
Neuroblastoma
Glucagonoma
Somatostatinoma
VIPoma
DM
Type 1
Type 2
Type 2
Non-enzymatic glycosylation
Non-enzymatic glycosylation
Osmotic damage
Osmotic damage
Pathogenesis hyperglycemia
gluconeogenesis (most
important), glycogenolysis
Pathogenesis hyperlipidemia
Pathogenesis ketoacidosis
Glycosylated HbA1c
Gestational DM
Complications
Hypoglycemia
Carnitine deficiency
Prolactinoma - bromocriptine.
Cushing syndrome dexamthasone.
Pituitary adenoma,
hyperparathyroidism, pancreatic
tumor (either Zollinger or
insulinoma).
Clinoid process.
Peroxidase.
Deiodinase.
Thyroid-binding protein.
What is the carrying protein of
Increased: estrogen (pill,
thyroxine (T4) and triiodothyronine
pregnancy, hormone replacement).
(T3)? What increases/decreases
Decreased: anabolic steroids,
this protein? What happens to free
nephrotic syndrome.
T4 when this protein increases or
FT4 remains the same, therefore,
decreases?
so does TSH!!!
Increase (indicates T4 production):
Grave's disease, toxic nodular
In a radioactive iodine uptake test,
goiter.
when would the iodide uptake
Decrease: inactivity of gland
increase and when would it
(taking thyroid hormone) or
decrease?
inflammation of gland (acute,
subacute, chronic thyroiditis).
Patient presents with a fever,
Acute thyroiditis. Bacterial infection
painful cervical adenopathy and
(e.g. Staphylococcus aureus). The
the follow labs: increased serum
initial thyrotoxicosis (increased
T4, decreased serum TSH, and
serum T4) is due to gland
decreased I(131) uptake.
destruction.
Diagnosis?
Patient presents with a painful
thyroid, but no cervical
Viral infection of the thyroid leading
adenopathy. Biopsy shows
to subacute granulomatous
granulomatous inflammation with
thyroiditis (e.g. coxsackievirus).
multinucleated giant cells.
Diagnosis?
Autoimmune destruction of
parenchyma by cytotoxic T cells.
Macroscopically: enlarged gray
gland due to lymphocytic infiltrate
with prominent germinal follicles.
Most common cause of
hypothyroidism. Antimicrosomal
and antithyroglobulin antibodies
are present.
Cretinism is hypothyroidism in
infancy or early childhood. Brain
requires thyroxine for its
maturation. Causes: maternal
What are the clinical features of
hyothyroidism, enzyme or iodine
cretinism?
deficiency. Clinical features:
mental retardation, increased
weight and short stature. Unless its
pituitary dwarfism (decreased
weight and short stature).
Proximal muscle myopathy, weight
gain (decreased BMR), dry/brittle
hair, yellow skin, periorbital
puffiness, hoarse voice,
myxedema, fatigue, cold
What are some clinical findings in
intolerance, constipation, diastolic
adult hypothyroidism?
HTN (retention of Na and water),
confestive cardiomyopathy,
atherosclerotic artery disease (due
to hypercholesterolemia), mental
slowness, dementia.
suppression tests
benign adenoma
Hypothalamic dysfunction
clinical findings?
Precocious puberty:
when is it true? pseudo?
Pineal gland
clinical anatomy?
Melatonin = ?
Pineal gland
common disorders?
Pituitary infarction
invariably produces _____?
nonfunctioning adenoma
pituitary adenoma,
hyperparathyroidism, pancreatic
tumor
Hypopituitarism in children
most common cause?
craniopharyngioma
Pituitary apoplexy
most common cause?
Lymphocytic hypophysitis
autoimmune destruction occurs
when?
Posterior pituitary = ?
Prolactinoma
Prolactinoma in women
clinical and lab findings ?
secondary amenorrhea,
galactorrhea
Prolactinoma in men
clinical and lab findings ?
Rx of Prolactinoma?
IGF-1
functions?
Gigantism
lab findings?
Acromegaly
diagnostic tool?
Acromegaly
what is a common cause of death?
Thyroid hormone = ?
Free T(4) = ?
prohormone; rendered
metabolically active by outer ring
deiodnase (FT(3))
Total serum T4
bound to?
Estrogen
effect on TBG?
TBG
effect on T4?
Alterations in TBG
effect on T4?
Serum TSH
lingual thyroid
clinical findings?
Acute thyroiditis
clinical findings?
Hashimoto's thyroiditis
epidemiology?
autoimmune thyroiditis
Hashimoto's thyroiditis is
hypersensitive to ?
Hashimoto's thyroiditis
Reidel's thyroiditis = ?
Pheochromocytoma
epidemiology ?
Associations of
Pheochromocytoma ?
Pheochromocytoma
unique findings?
Pheochromocytoma
Diagnosis test?
palpitations, paroxysmal
hypertension, anxiety, drenching
sweats, headache
orthostatic hypotension, chest
pain, ileus
plasma free metanephrines is best
screen
Pheochromocytoma
urine tests?
Pheochromocytoma
lab findings?
Neuroblastoma
malignant tumor = ?
Neuroblastoma
occurs most often to?
hyperglycemia, neutrophilic
leukocytosis
postganglionic sympathetic
neurons
Opsoclonus-myoclonus syndrome
=?
paraneoplastic syndrome;
myoclonic jerk; chaotic eye
movements
Neuroblastoma:
"small tumor" shows ______ under
electron microscopy
neurosecretory granules
Neuroblastoma
clinical findings?
Insulinoma
lab findings?
serum insulin
C-peptide
Insulinoma
if patient injecting excess insulin:
lab findings?
serum insulin
C-peptide
AD (Autosomal dominant)
inheritance; not obese; impaired
glucose-induced secretion of
insulin
Hyperinsulinemia
clinical and lab findings?
Hb(A1c), hyaline,
arteriolosclerosis, glomerulopathy
Aldose reductase = ?
Osmotic damage = ?
Diabetic microangiopathy = ?
Insulin-induced hypoglycemia
type 1 DM
Gluconeogenesis
Hypertriglyceridemia
mechanism?
DKA (diabetic ketoacidosis)
electrolytes
lab findings?
type 2 DM
Hb(A1c) is a marker of ?
Neuroglycopenia
symptoms?
Hypoparathyroidism
causes?
glycogen stores
gluconeogenesis (pyruvate
converted to lactate)
autoimmune Hypoparathyroidism
is the most common cause
DiGeorge syndrome = ?
Hypomagnesemia
Hypomagnesemia
causes?
diarrhea, aminoglycosides,
diuretics, alcohol
Hypomagnesemia
lab findings?
Primary HPTH
(hyperparathyroidism)
associated with?
benign adenoma
Primary hyperplasia
all glands are involved
which glands are involved?
Primary HPTH
what is the most common
presentation
renal stones
Primary HPTH
gastrointestinal clinical findings?
acute pancreatitis
Primary HPTH
bone and joint clinical findings?
Primary HPTH:
hypertension is caused by?
hypercalcemia
Primary HPTH
memory trick for symptoms?
Primary HPTH
lab findings?
serum calcium/PTH;
serum phosphorus/bicarbonate;
chloride/phosphorus ratio > 33;
serum calcitriol
malignancy
Secondary HPTH = ?
danger of developing
hypophosphatemia
hypophosphatemia is most
commonly caused by ____?
alkalosis
hyperphosphatemia is most
commonly caused by _______?
renal failure
glomerulosa mineralocorticoids
fasciculata glucocorticoids
reticularis sex hormones
adrenal medulla
metanephrines, vanillylmandelic
acid(VMA)
Waterhouse-Friderichsen
syndrome = ?
Autoimmune disease
Miliary TB
adrenogenital syndrome
Addison's disease = ?
diffuse hyperpigmentation;
hypotension, weakness
Metyraphone test = ?
Addison's disease
lab findings?
Addison's disease:
conditions that develop?
hypoclycemia, eosinophilia,
lymphocytosis, neutropenia
Mineralocorticoids
causes what?
Mineralocorticoids
causes what?
11-OHase deficiency = ?
impaired cortisol +
mineralocorticoid excess (salt
retainer); androgens
17-OHase deficiency = ?
Dignosis of adrenogenital
syndrome?
pituitary Cushing
Pituitary Cushing,
Adrenal Cushing,
Ectopic Cushing syndrome:
what happens to ACTH? cortisol?
Cushing syndrome
clinical findings?
truncal obesity
screening tests?
Cushing syndrome
Cushing
lab findings?
hyperglycemia; hypokalemia;
metabolic alkalosis
Nelson's syndrome = ?
Primary hyperaldosteronism = ?
hypertension, hypernatremia,
hypokalemia, metabolic alkalosis
Hypothyroidism = ?
Cretinism
Clinical findings?
Hashimoto's thyroiditis
clinical findings?
Hashimoto's thyroiditis :
periorbital puffiness, and hoarse
voice are signs of ____?
myxedema
Primary Hypothyroidism
lab findings?
serum T4/FT4;
serum TSH, cholesterol
Myxedema coma
clinical findings?
stupor, hypothermia,
hypoventilation; IV levothyroxine,
corticosteroids
Thyrotoxicosis
describes what condition?
Hyperthyroidism =?
Graves' disease
Graves' disease
pathogenesis?
exophthalmos, pretibial
myxedema, thyroid acropachy
Transient hyperthyroidism in fetus
Thyroid acropachy = ?
Thyrotoxicosis
constitutional signs?
Thyrotoxicosis
cardiac findings?
Graves' hyperthyroidism
lab findings?
serum T4/FT4,
131I uptake,
serum TSH
Thyrotoxicosis
conditions that develop?
glucosee,
calcium,
lymphocytes; cholesterol
-blockers,
thionamides
Thyroid storm
clinical findings?
tachyarrhythmias, hyperpyrexia,
coma, shock
ESS
what is the most common variant?
serum T3
reverse T3
Goiter = ?
thyroid enlargement
Nontoxic goiter
pathogenesis?
Goiter
complications?
Follicular adenoma
psammoma bodies
Papillary carcinoma
microscopic findings?
lymphatic invasion
Follicular carcinoma
spreads?
Medullary carcinoma
pathogenesis?
Hashimoto's thyroiditis
hypocalcemia/hyperphosphatemia
PTH in relation to
= PTH
hypocalcemia/hyperphosphatemia
&
hypercalcemia/ hypophosphatemia
hypercalcemia/ hypophosphatemia
= PTH
Sunlight is a major source of
______?
vitamin D
25-hydroxylase converts
cholecalciferol to 25-(OH)D
(calcidiol)
Calcitriol
functions?
calcium/phosphorus reabsorption
in bowel; osteoclast production
Calcitiol feedback =?
Hypoalbuminemia = ?
Et (threshold potential)comes
Tetany is due to decreased ionized
calcium level:
close to Em(membrane potential);
what happens to the potentials?
initiates action potential
Tetany:
clinical findings?
Cretinism
Hashimoto thyroiditis
Subacute thyroiditis
Reidel thyroiditis
Thyroid adenoma
Primary hyperparathyroidism
Secondary hyperparathyroidism
Functions of PTH
Hypoparathyroidism
Prolactinoma
Hyperprolactinemia produces
galactorrhea, amenorrhea (tumor
mass inhibits GnRH) and infertility
GH producing adenoma
Sheehan syndrome
Diabetes insipidus
SIADH
Differentiation of Cushing's
syndrome
Conn syndrome
Waterhouse-Friderichsen
syndrome
Addison disease
Pheochromocytoma
MEN I
MEN II