What I Made

QI Topic Educational Objective System Subject Rep
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174Antihistamines 1st-gen antihistamines can cause significant AEs due to blockade of cholinergic, α- Allergy & Pharmacol 3
adrenergic, and 5-HT-ergic pathways. They should be avoided in older pts w/ cognitive or Immunology ogy (Phar)
fxnal impairments. (AI) AI Phar
458Henoch-Schonlein Small vessel leucocytoclastic angiitis a/w IgA and C3 deposition is typical of HSP. HSP is Allergy & Pathology 3
purpura most common in children 3 to 11 y/o and is most often related to a recent infection. Most Immunology (Path)
children present w/ palpable skin lesions, +/- abdo pain and arthralgias. Although usually (AI)
self-limiting, pts afflicted w/ HSP should be observed carefully b/c glomerulonephritis and
even ESRD are possible complications. AI Path
459Granulomatosis The histopath features of oesophageal SCC incl solid nests of neoplastic squamous cells w/ Allergy & Pathology 2
with polyangiitis abundant eosinophilic cytoplasm and distinct borders. Areas of keratinisation and the Immunology (Path)
presence of intercellular bridges are also char. Pts typically present w/ progr solid and (AI)
eventually liquid dysphagia and weight loss. AI Path
539Immunoglobulins The carboxy terminal of the Fc portion of the heavy immunoglobulin chains represents the Allergy & Immunolo 2
site that binds to the Fc receptors on neutrophils and macrophages. Antibody bound to Immunology gy (Immu)
antigen is able to signal for the phagocytosis of that antigen by a conformational change of (AI)
the Fc region allowing binding to the Fc receptor on phagocytes. This leads to subsequent
phagocytosis of the organism / antibody complex and subsequent destruction of the
organism. AI Immu
540Immunoglobulins The CCC begins w/ binding of the C1 complement component to either 2 molecules of IgG Allergy & Immunolo 2
or to 2 molecules of IgM. B/c IgM circulates in pentameric form, it's a much better activator Immunology gy (Immu)
of the complement system. The C1 molecule binds to the Fc region of the heavy Ig chain in (AI)
the region near the hinge point. AI Immu
541Hyper-IgM Hyper-IgM syndrome results from defective Ig class switching due to a defect in CD40L- Allergy & Immunolo 1
syndrome CD40 interaction. Absence of the CD40L is the most common cause and is inherited in an Immunology gy (Immu)
XLR pattern. CFx incl. recurrent sinopulm, GI, and opport infections. (AI) AI Immu
556Hypersensitivity Wheal-and-flare lesions usually result from allergic (type 1 hypersensitivity) reactions. On Allergy & Immunolo 4
reactions initial exposure, an allergen (eg, insect venom) promotes antibody class switching to IgE. Immunology gy (Immu)
Subsequent exposure promotes cross-linking of IgE on basophils and mast cells, resulting in (AI)
degranulation and release of multiple vasoactive mediators, including histamine. AI Immu
557Primary Chronic granulomatous disease is an X-linked disorder resulting from deficiency of NADPH Allergy & Immunolo 7
immunodeficiency oxidase, the enzyme responsible for formation of reactive oxygen species in phagosomes. Immunology gy (Immu)
disorder Neutrophils affected by this disorder are unable to kill catalase-producing organisms, (AI)
resulting in recurrent bacterial and fungal infections that frequently involve the lungs, skin,
and lymph nodes. AI Immu
558Cell mediated The process of (-) selection in T cell maturation is essential for eliminating T cells that bind Allergy & Immunolo 5
immunity to self MHC or self Ags w/ overly high affinity. This process occurs in the TM. If these cells Immunology gy (Immu)
were permitted to survive, they would likely induce immune and inflam rxns against self Ags (AI)
leading to AI disease. AI Immu
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561Severe combined The 2nd most common cause of SCID is AR defic of ADA, an enzyme necessary for the Allergy & Immunolo 3
immunodeficiency elimination of excess adenosine w/i cells. Tox lvls of adenosine accum w/i lymphocytes in Immunology gy (Immu)
disease this condition, leading to lymphocyte cell death and resultant cellular and humoral ID. Tx is (AI)
presently being researched using retroviral vectors to "infect" pt stem cells w/ the gene
coding for ADA. AI Immu
569Transplant rejection Hyperacute rejection is caused by preformed Abs in the recipient that recognize and attack Allergy & Immunolo 4
donor Ags (ie, type II HS). These are often anti-ABO blood group or anti-HLA Abs. Immunology gy (Immu)
Vascular injury and capillary thrombotic occlusion lead to rapid ischemic necrosis of the (AI)
renal graft, often evidenced by gross cyanosis and mottling immediately following graft
perfusion. AI Immu
571Primary CGD is most commonly due to an XL mut affecting NADPH oxidase. Defic of this enzyme Allergy & Immunolo 7
immunodeficiency leads to an inability of neutrophils to form the ox burst necessary to kill organisms in their Immunology gy (Immu)
disorder phagolysosomes. CGD can be Dx by absence of the normal blue and fluorescent green (AI)
pigment produced by the NBT test and DHR FC test, respectively. AI Immu
732Asplenia The spleen acts as both a blood filter capable of removing circulating pathogens and as a Allergy & Microbiolo 2
major site of opsonising Ab synthesis. Asplenic pts are prone to infections caused by Immunology gy (Micr)
encapsulated organisms such as S. pneumoniae, H. influenzae, and N. meningitidis. (AI) AI Micr
743Reactive arthritis The classic triad of ReA is nongonococcal urethritis, conjunctivitis, and arthritis. It's an Allergy & Immunolo 2
HLA-B27-assoc. arthropathy that occurs w/i several wks following a GU or enteric infection. Immunology gy (Immu)
It belongs to the group of SNSAs (incl. AS) and can cause SI in about 20% of cases. (AI) AI Immu
745Cell mediated NK cells recognize and kill cells w/ decr. MHC-I Ag cell surface expression, such as virus- Allergy & Immunolo 5
immunity infected cells and tumor cells. They're large lymphocytes that contain perforins and Immunology gy (Immu)
granzymes in cytoplasmic granules. NK cells kill target cells by inducing apoptosis. (AI) AI Immu
750Cell mediated Eosinophils play a role in host defense during multicellular parasitic infection. When Allergy & Immunolo 5
immunity stimulated by antibodies bound to a parasitic organism, they destroy the parasite via Immunology gy (Immu)
antibody-dependent cell mediated cytotoxicity with enzymes from their cytoplasmic (AI)
granules. Another function of eosinophils is regulation of type I hypersensitivity reactions. AI Immu
759Latex allergy IL-4 is produced by the Th2 subset of Th cells. It facilitates proliferation of B cells and Th2 Allergy & Immunolo 1
lymphocytes and stims Ab isotype switching to IgE which mediates HS-1 (allergic) rxns. Immunology gy (Immu)
(AI) AI Immu
761SLE ANAs are found in almost all pts w/ SLE but are also found in many other AI disorders and Allergy & Pathophysi 7
have low specificity. Anti-dsDNA Abs and anti-Smith Abs have lower sensitivity but higher Immunology ology
specificity. (AI) (Patp) AI Patp
762Cell mediated IL-12 stimulates the differentiation of naive Th0 cells into Th1 cells. Pts w/ IL-12 receptor Allergy & Immunolo 5
immunity deficiency are susceptible to severe mycobacterial infections due to the inability to mount a Immunology gy (Immu)
strong cell-mediated granulomatous immune response; therefore, they require Tx w/ IFN-γ. (AI) AI Immu
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965Immunizations The Hib vax consists of a CPS conjugated to a carrier protein (TT protein or OMP of N. Allergy & Immunolo 4
meningitidis). Protein conjugation causes a T cell-mediated immune response leading to Immunology gy (Immu)
long-term immunity thru production of memory B-lymphocytes. (AI) AI Immu
1132
Chediak-Higashi CHS is an AR disorder of neutrophil phagosome lysosome fusion that results in neuro abns, Allergy & Immunolo 1
syndrome partial albinism, and an ID caused by defective neutrophil fxn. Immunology gy (Immu)
(AI) AI Immu
1155
Calcineurin Calcineurin is an essential protein in the activation of IL-2, which promotes the growth and Allergy & Immunolo 1
inhibitors diff of T cells. Immsups such as cyclosporine and tacrolimus work by inhib calcineurin Immunology gy (Immu)
activation. (AI) AI Immu
1366
Anaphylaxis Anaphylactic shock is characterised by vasodilation, ↑ vascular permeability, and Allergy & Pharmacol 3
bronchoconstriction. EPI counteracts these physiological mechs and is the DOC for the Tx of Immunology ogy (Phar)
anaphylaxis. (AI) AI Phar
1388
Diphtheria The 1° Tx for diphtheria is diphtheria antitoxin (passive immunization), which inactivates Allergy & Microbiolo 6
circulating toxin. Abx should also be administered to ↓ continued production of toxin. Immunology gy (Micr)
(AI) AI Micr
1468
Influenza IFN-alpha and -beta are produced by most human cells in response to viral infections. The Allergy & Immunolo 5
production of alpha and beta IFNs helps suppress viral replication by halting protein synth Immunology gy (Immu)
and promoting apoptosis of infected cells, limiting the ability of viruses to spread thru the (AI)
tissues. AI Immu
1612
Angioedema Angioedema can be hereditary (AD) or acq (a/w ACEI Tx). In HAE, low C1 esterase inhib Allergy & Pharmacol 2
activity leads to ↑ in bradykinin activity. ACEI shouldn't be used in these pts. Immunology ogy (Phar)
(AI) AI Phar
1614
Humoral immunity The 1ary imm response to a new Ag initially results in plasma cells that only produce IgM. Allergy & Immunolo 1
Isotype switching later occurs in the germinal centers of LNs and req interaction of the CD40 Immunology gy (Immu)
receptor on B cells w/ the CD40L (CD154) expressed by activated T cells. IgG is the main (AI)
serum Ig of the 2ary response. AI Immu
1995
Severe combined SCID is char by combo T and B cell dysfxn. It's a life-thr condition that Px in infancy w/ Allergy & Immunolo 3
immunodeficiency severe bacterial and viral infections; mucocutaneous candidiasis; persistent diarrhea; and Immunology gy (Immu)
disease FTT. LFx incl. absent T cells and hypoGg-emia. The thymic shadow isn't usually present due (AI)
to severe T cell deficiency. AI Immu
2068
Anaphylaxis Anaphylaxis is the result of widespread mast cell and basophil degranulation and the release Allergy & Immunolo 3
of preformed inflammatory mediators, including histamine and tryptase. Tryptase is Immunology gy (Immu)
relatively specific to mast cells and can be used as a marker for mast cell activation. (AI) AI Immu
2069
Anaphylaxis The high-affinity IgE receptor (FCERI) is found on the surface of mast cells and basophils Allergy & Immunolo 3
and normally binds the Fc portion of circulating IgE antibodies. Cross-linking of multiple Immunology gy (Immu)
membrane bound IgE antibodies by a multivalent antigen results in aggregation of the FcERI (AI)
receptors, causing degranulation and the release of preformed mediators (eg, histamine,
tryptase) that initiate an allergic response. AI Immu
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Primary SCID is caused by a genetic defect in T cell development, leading to loss of both cellular and Allergy & Immunolo 7
immunodeficiency humoral immunity. Pts Px in infancy w/ recurrent bacterial, viral, fungal, and opport Immunology gy (Immu)
disorder infections as well as FTT and chronic diarrhea. (AI) AI Immu
2079
Hypersensitivity The candidal Ag skin test Ax the activity of T cell-mediated imm thru the recruitment of Allergy & Immunolo 4
reactions macrophages and CD4+ and CD8+ T lymphocytes in a HS-IV rxn. Anergy, or failure to Immunology gy (Immu)
respond to candida Ag testing, is typical in pts w/ SCID. (AI) AI Immu
7581
Syphilis The Jarisch-Herxheimer reaction is an acute inflammatory reaction that occurs within hours Allergy & Microbiolo 9
of treatment for spirochetal (eg, syphilis) infections. The rapid lysis of spirochetes releases Immunology gy (Micr)
inflammatory bacterial lipoproteins into the circulation and causes acute fevers, rigors, and (AI)
myalgias. AI Micr
8384
Primary Inherited defects involving the interferon-y signaling pathway result in disseminated Allergy & Immunolo 7
immunodeficiency mycobacterial disease in infancy or early childhood. Patients require lifelong treatment with
Immunology gy (Immu)
disorder antimycobacterial agents. (AI) AI Immu
8530
Cytokines IL-2 is produced by Th cells and stims the growth of CD4+ and CD8+ T cells and B cells. Allergy & Immunolo 1
IL-2 also activates NK cells and monocytes. The incr. activity of T cells and NK cells is Immunology gy (Immu)
thought to be responsible for IL-2's anti-ca effect on met melanoma and RCC. (AI) AI Immu
8539
Inflammation Interleukin-8 is a chemokine produced by macrophages that induces chemotaxis and Allergy & Immunolo 3
phagocytosis in neutrophils. Other significant chemotactic agents include leukotriene B4, 5-Immunology gy (Immu)
HETE (the leukotriene precursor), and complement component C5a. (AI) AI Immu
11525
Tuberculosis IGRAs test for LTBI by measuring the amount of IFN-γ released by T lymphocytes when Allergy & Microbiolo 18
exposed to Ags unique to M. tuberculosis. Immunology gy (Micr)
(AI) AI Micr
11667
Angioedema C1INH defic causes ↑ cleavage of C2 and C4 and results in inappropriate activation of the Allergy & Pathology 2
complement cascade. C1INH also blocks kallikrein-induced conversion of kininogen to Immunology (Path)
bradykinin, a potent vasodilator a/w angioedema. (AI) AI Path
11677
Pharyngitis Opsonization occurs when host proteins such as Igs or complement bind to foreign cells such Allergy & Immunolo 2
as bacteria and coat the surface, enhancing phagocytosis. The most important opsonins Immunology gy (Immu)
(coating proteins) are IgG and complement C3b. (AI) AI Immu
11872
Immunizations PCVs are strongly immunogenic in infancy due to both B and T cell recruitment. They Allergy & Immunolo 4
provide higher, longer-lasting Ab titers relative to PPSVs. The PPSV is poorly immunogenic Immunology gy (Immu)
in infants due to their relatively immature humoral Ab response. (AI) AI Immu
15293
Severe combined ADA inhib/absence is highly lymphocytotox. Rx that block ADA are used to Tx Allergy & Immunolo 3
immunodeficiency lymphocyte-derived ca. Inherited gene muts in ADA lead to the AR disease of SCID. Immunology gy (Immu)
disease (AI) AI Immu
1170
Bias Lead-time bias occurs when a new test Dx a condition earlier than conventional studies, Biostatistics & Biostatistic 4
causing an apparent ↑ in survival time despite no improvement in overall mortality. Long- EpInfectious s (Bios)
term mortality rates, not survival times, should be considered for measuring the effect of Diseases (ID)
early screening and Tx. emiology (BS) BS Bios
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Risk, rate, Incident cases represent new cases Dx in a given period of time. Prevalent cases are the total Biostatistics & Biostatistic 3
prevalence, and number of cases (both old and new) at a particular point in time. Any Tx that prolongs EpInfectious s (Bios)
incidence survival but does not cure the disease will ↑ prevalence due to an ↑ in the number of afflicted Diseases (ID)
(but still living) individuals over time. emiology (BS) BS Bios
1172
Normal distribution In a normal (bell-shaped) distribution curve, 68% of observations lie w/i 1 SD of the mean, Biostatistics & Biostatistic 3
95% of observations lie w/i 2 SDs of the mean, and 99.7% of observations lie w/i 3 SDs of EpInfectious s (Bios)
the mean. Diseases (ID)
emiology (BS) BS Bios
1173
Confounding, effect Confounding occurs when the exposure-disease relationship is muddled by the effect of an Biostatistics & Biostatistic 3
modification, bias, extraneous factor a/w both exposure and disease. Confounding bias can result in the false EpInfectious s (Bios)
errors association of an exposure w/ a disease. Diseases (ID)
1174
Number needed to The NNT is the number of pts that need to be Tx w/ a Rx to avoid an additional (-) outcome. Biostatistics & Biostatistic 2
treat NNT is calculated by dividing 1 by the ARR (the difference b/w the control and EpInfectious s (Bios)
experimental group event rates). Lower NNT values represent more beneficial Tx. Diseases (ID)
1175
Risk ARR = event rate in the control group - event rate in the Tx group. Biostatistics & Biostatistic 6
EpInfectious s (Bios)
Diseases (ID)
1176
Risk RRR = (absolute risk [control] - absolute risk [Tx]) / absolute risk [control]. Biostatistics & Biostatistic 6
Diseases (ID)
1177
Sensitivity, Sensitivity = true positives / (true positives + false negatives). Screening tests should have Biostatistics & Biostatistic 4
specificity, positive high sensitivity. EpInfectious s (Bios)
predictive value Diseases (ID)
PPV, negative emiology (BS)
predictive value
NPV BS Bios
1178
Sensitivity, The specificity of a test is its ability to correctly identify individuals w/o the disease. Biostatistics & Biostatistic 4
specificity, positive Specificity should be high in confirmatory tests to ↓ FPs. EpInfectious s (Bios)
predictive value
NPV BS Bios
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Central tendency An outlier is defined as an extreme and unusual observed value in a dataset. It can affect Biostatistics & Biostatistic 2
(mean, median, measures of central tendency (mean, median, mode) as well as measures of dispersion (SD, EpInfectious s (Bios)
mode, outliers) variance). Modes tend to be resistant to outliers. Diseases (ID)
1184
Statistical tests A 2x2 table is normally used to record the presence or absence of exposure and disease in Biostatistics & Biostatistic 2
research. Rows and columns represent the different levels for each categorical (ie, exposure EpInfectious s (Bios)
and disease) variable. The chi-square test for independence is used to evaluate the association Diseases (ID)
b/w 2 categorical variables. emiology (BS) BS Bios
1185
Risk Risk is the probability of developing a disease over a certain period of time. To calculate this Biostatistics & Biostatistic 6
probability, divide the number of affected subjects by the total number of subjects in the EpInfectious s (Bios)
corresponding exposure group. Diseases (ID)
1186
Risk The attributable risk percent (ARP) in the exposed represents the excess risk in the exposed Biostatistics & Biostatistic 6
population that can be attributed to the risk factor. It can be easily derived from the relative EpInfectious s (Bios)
risk (RR) using the formula: ARP exposed = 100 [(RR - 1)/RR). Diseases (ID)
1187
Risk, rate, Prevalence equals the incidence rate multiplied by the average disease duration. Changing Biostatistics & Biostatistic 3
prevalence, and disease prevalence in a steady-state population w/ a constant incidence rate means that there EpInfectious s (Bios)
incidence is an additional factor affecting the duration of the condition. A factor that prolongs disease Diseases (ID)
duration (eg, improved quality of care) will ↑ disease prevalence, as affected pts survive emiology (BS)
longer. BS Bios
1188
Confounding, effect In prospective studies, disproportionate loss to f/u b/w the exposed and unexposed groups Biostatistics & Biostatistic 3
modification, bias, creates the potential for attrition bias, which is a form of selection bias. As a result, EpInfectious s (Bios)
errors investigators generally try to achieve high pt f/u rates in prospective studies. Diseases (ID)
1189
Matching Matching is used in case-control studies in order to control confounding. Matching variables Biostatistics & Biostatistic 1
should always be the potential confounders of the study (eg, age, race). Cases and controls EpInfectious s (Bios)
are then selected based on the matching variables so that both groups have a similar Diseases (ID)
distribution in accordance w/ the variables. emiology (BS) BS Bios
1191
Quantitative The cutoff value of a quantitative Dx test determines whether a given result is interpreted as Biostatistics & Biostatistic 1
diagnostic tests (+) or (-). Lowering the cutoff point typically causes more pts w/ the disease to test (+), ↓ the EpInfectious s (Bios)
number of FNs and ↑ test sensitivity. Consequently, more pts w/o the disease will also test Diseases (ID)
(+), resulting in an ↑ number of FPs and ↓ specificity. emiology (BS) BS Bios
1192
Sensitivity, The PPV of a test answers the question: If the test result is (+), what is the probability that a Biostatistics & Biostatistic 4
specificity, positive pt has the disease? PPV = TPs / (TPs + FPs). EpInfectious s (Bios)
predictive value
NPV BS Bios
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Normal distribution In a normal (bell-shaped) distribution: 68% of all values are w/i 1 SD from the mean; 95% of Biostatistics & Biostatistic 3
all values are w/i 2 SDs from the mean; 99.7% of all values are w/i 3 SDs from the mean. EpInfectious s (Bios)
Diseases (ID)
1202
Study designs Selection of control subjects in case-control studies is intended to provide an accurate Biostatistics & Biostatistic 6
estimation of exposure frequency among the non-diseased general population. Cases and EpInfectious s (Bios)
controls should be selected based on disease status, not exposure status. Diseases (ID)
1204
Power and sample The power of a study indicates the probability of seeing a difference when there is one. The Biostatistics & Biostatistic 3
size formula is Power = 1- β, where β is the type II error rate. EpInfectious s (Bios)
Diseases (ID)
1205
Odds ratio The odds ratio (OR) is a measure of the strength of an association between an exposure and Biostatistics & Biostatistic 2
an outcome. Specifically, it represents the odds that an outcome occurred in the presence of a EpInfectious s (Bios)
particular exposure compared with the odds that the outcome occurred in the absence of that Diseases (ID)
exposure. In a standard contingency table, OR = ad/bc. emiology (BS) BS Bios
1207
Risk The RR represents the risk of an outcome in the exposed divided by the risk of that outcome Biostatistics & Biostatistic 6
in the unexposed. Applying the correct formula for RR calculations depends on the proper EpInfectious s (Bios)
formatting of a 2x2 (contingency) table. Diseases (ID)
1208
Morbidity and Case-fatality rate is calculated by dividing the number of fatal cases of a disease or condition Biostatistics & Biostatistic 1
mortality rates by the total number of people w/ that disease or condition. EpInfectious s (Bios)
Diseases (ID)
1209
Urinary tract The average (or mean) of a dataset of values is the sum of the values divided by the total Biostatistics & Biostatistic 12
infection number of values. EpInfectious s (Bios)
Diseases (ID)
1210
Correlation The correlation coefficient (r) ranges from -1 to +1 and describes the strength and polarity of Biostatistics & Biostatistic 1
coefficient a linear association. EpInfectious s (Bios)
Diseases (ID)
1230
Sensitivity and Specificity is the number of TNs divided by the total number of subjects confirmed as not Biostatistics & Biostatistic 4
specificity having the disease. TNs = (Specificity) * (Number of pts confirmed w/o the disease). FPs = EpInfectious s (Bios)
(1 - Specificity) * (Number of pts confirmed w/o the disease). Diseases (ID)
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Number needed to The NNH represents the number of people who must be Tx before 1 additional adverse event Biostatistics & Biostatistic 2
treat occurs. In order to calculate NNH, the absolute risk ↑ b/w the Tx and control groups must be EpInfectious s (Bios)
known: NNH = 1 / Absolute risk ↑. Diseases (ID)
1232
Sensitivity, PPV represents the probability of truly having a disease given a (+) test result. It ↑ w/ ↑ Biostatistics & Biostatistic 4
specificity, positive disease prevalence and ↓ w/ ↓ disease prevalence. EpInfectious s (Bios)
predictive value
NPV BS Bios
1233
Predictive values Negative predictive value (NPV) represents the probability of not having a disease given a Biostatistics & Biostatistic 3
negative test result. NPV is inversely proportional to the prevalence of a disease. When a EpInfectious s (Bios)
patient has characteristics similar to the overall population (eg, age, sex, risk factor status), Diseases (ID)
the disease prevalence is a valid estimate of the pretest probability of disease. emiology (BS) BS Bios
1270
Prevalence and The cumulative incidence of a disease is the number of new cases of a disease over a specific Biostatistics & Biostatistic 3
incidence period divided by the total population at risk at the beginning of the study (ie, the proportion EpInfectious s (Bios)
of at-risk individuals who contract the disease over the specified period). Diseases (ID)
1271
Predictive values Various parameters are used to evaluate the accuracy and usefulness of Dx tests. PPVs and Biostatistics & Biostatistic 3
NPVs are influenced by disease prevalence in the target population; sensitivity, specificity, EpInfectious s (Bios)
and likelihood ratios are not prevalence-dependent. Diseases (ID)
1272
Power and sample Power (1 - β) is the probability of rejecting a null hypothesis when it is truly false. It is Biostatistics & Biostatistic 3
size typically set at 80% and depends on sample size and difference b/w outcomes. EpInfectious s (Bios)
Diseases (ID)
1273
Bias Recall bias results from study participants' inaccurate recall of past exposure and occurs most Biostatistics & Biostatistic 4
often in retrospective studies such as case-control studies. People who have experienced an EpInfectious s (Bios)
adverse event are more likely to recall RFx than those who have not experienced an adverse Diseases (ID)
event. emiology (BS) BS Bios
1274
P-value and A result is considered statistically significant if the 95% CI does not cross the null value, Biostatistics & Biostatistic 2
confidence interval which corresponds to a p-value <0.05. EpInfectious s (Bios)
Diseases (ID)
1275
Bias Observer bias occurs when the investigator's evaluation is affected by preconceived Biostatistics & Biostatistic 4
expectations or prior knowledge, typically leading to overestimation of the disease EpInfectious s (Bios)
association or Tx effects. This type of bias can be ↓ by conducting a blinded study in which Diseases (ID)
observers are unaware of study details and pt Chx that could unduly influence them. emiology (BS) BS Bios
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Study designs In a cross-sectional study, exposure and outcome are measured simultaneously at a particular Biostatistics & Biostatistic 6
point in time ("snapshot study"). In other study designs, a certain time period separates the EpInfectious s (Bios)
exposure from the outcome. Diseases (ID)
1277
Odds ratio A case-control study is used to compare the exposure status of people w/ the disease (ie, Biostatistics & Biostatistic 2
cases) to the exposure status of people w/o the disease (ie, controls). The main measure of EpInfectious s (Bios)
association is the OR. Diseases (ID)
1278
Validity and A precise/reliable test is reproducible in that it gives similar results on repeat measurements. Biostatistics & Biostatistic 1
reliability Reliability is maximal when random error is minimal. EpInfectious s (Bios)
Diseases (ID)
1279
Confounding, effect Effect modification is present when the effect of the main exposure on the outcome is Biostatistics & Biostatistic 3
modification, bias, modified by the presence of another variable. Effect modification is not a bias. EpInfectious s (Bios)
errors Diseases (ID)
1280
Risk The concept of accumulation effect can be applied to disease pathogenesis and exposure to Biostatistics & Biostatistic 6
risk modifiers. Cumulative exposure to a RFx or risk reducer must sometimes occur for EpInfectious s (Bios)
prolonged periods before a clinically significant effect is detected. Diseases (ID)
1281
Central tendency The median is the value that is located in the precise center of an ordered dataset. It separates Biostatistics & Biostatistic 2
(mean, median, the right half of the data from the left half. EpInfectious s (Bios)
mode, outliers) Diseases (ID)
1282
Normal distribution In general, in a (+)ly skewed distribution, the mean is the most shifted in the (+) direction (to Biostatistics & Biostatistic 3
the right), followed by the median and then the mode. In such a situation, the median often EpInfectious s (Bios)
reflects a central tendency better than the mean does. Diseases (ID)
1284
Probability theory If events are independent, the probability that all events will turn out the same is the product Biostatistics & Biostatistic 2
of the separate probabilities for each event. The probability of at least 1 event turning out EpInfectious s (Bios)
differently is given as 1 - P(all events being the same). Diseases (ID)
1285
Sensitivity and The degree of overlap b/w the healthy and the diseased population curves limits the Biostatistics & Biostatistic 4
specificity maximum combined sensitivity and specificity of a quantitative Dx test. The degree to which EpInfectious s (Bios)
sensitivity or specificity is affected depends on the chosen cutoff value. Diseases (ID)
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P-value and The SD reflects the spread of individual values in a normal distribution (ie, it measures the Biostatistics & Biostatistic 2
confidence interval variability of the observations w/i a single sample). The standard error of the mean reflects EpInfectious s (Bios)
the variability of means (ie, variance b/w the means of different samples) and helps estimate Diseases (ID)
the true mean of the underlying population. emiology (BS) BS Bios
1300
Sensitivity and The sensitivity of a test refers to its ability to correctly identify those w/ the disease. A highlyBiostatistics & Biostatistic 4
specificity sensitive test should always be considered over a highly specific test when screening for life EpInfectious s (Bios)
threatening diseases, where identification of every person w/ the disease is important. Diseases (ID)
1302
Hawthorne effect The Hawthorne effect (observer effect) is the tendency of study subjects to change their Biostatistics & Biostatistic 1
behavior as a result of their awareness that they are being studied. EpInfectious s (Bios)
Diseases (ID)
1303
Power and sample A study's power ↑ as its sample size ↑. Therefore, the larger the sample, the greater the ability Biostatistics & Biostatistic 3
size of a study to detect a difference when one truly exists. EpInfectious s (Bios)
Diseases (ID)
1765
Accuracy and A precise tool is one that consistently provides very similar or the same value when Biostatistics & Biostatistic 1
precision measuring a fixed quantity. An accurate tool is one that provides a measurement identical or EpInfectious s (Bios)
similar to the actual value (as reflected in a gold standard measurement). Diseases (ID)
8422
Study designs In a crossover study, subjects are randomly allocated to a sequence of 2 or more Tx given Biostatistics & Biostatistic 6
consecutively. A washout (no Tx) period is often added b/w Tx intervals to limit the EpInfectious s (Bios)
confounding effects of prior Tx. Diseases (ID)
8519
Statistical tests A t-test is used to compare the difference b/w the means of 2 groups. ANOVA compares the Biostatistics & Biostatistic 2
difference b/w the means of 2 or more groups. Results from a t-test and ANOVA test will be EpInfectious s (Bios)
equivalent when comparing the difference b/w the means of 2 groups. Diseases (ID)
10443
Attack rate The attack rate is the ratio of the number of people who contract an illness divided by the Biostatistics & Biostatistic 1
number of people who are at risk of contracting that illness. EpInfectious s (Bios)
Diseases (ID)
10570
Study designs The unit of analysis in ecological studies is populations rather than individuals. Biostatistics & Biostatistic 6
Diseases (ID)
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10579
Risk, rate, Incidence corresponds to the number of new cases of a disease in a certain population at risk Biostatistics & Biostatistic 3
prevalence, and over a given time period. Prevalence is the total number of cases in the population over a EpInfectious s (Bios)
incidence given period. Diseases (ID)
10672
Meta analysis A meta-analysis groups results of several trials to ↑ statistical power and provide an overall Biostatistics & Biostatistic 1
pooled effect estimate. EpInfectious s (Bios)
Diseases (ID)
11105
Primary Health promotion, according to the WHO, is "the process of enabling people to ↑ control Biostatistics & Biostatistic 14
hypertension over their health and its determinants, and thereby improve their health." EpInfectious s (Bios)
Diseases (ID)
11835
Autosomal recessive The Hardy-Weinberg equation can be used to estimate carrier frequency, disease frequency, Biostatistics & Genetics 5
inheritance and frequency of different genotypes if at least 1 of these values is known. EpInfectious (Gene)
Diseases (ID)
emiology (BS) BS Gene
12854
Probability theory The multiplication law of probability states that the probability of 2 or more independent Biostatistics & Biostatistic 2
events occurring together can be calculated by multiplying the individual probabilities of EpInfectious s (Bios)
each event. The multiplication law of probability can be extended to complementary events Diseases (ID)
(1 - probability of event) in the same manner. emiology (BS) BS Bios
14853
Prevalence and Unlike period prevalence, point prevalence considers only the number of disease cases that Biostatistics & Biostatistic 3
incidence are active at a specific point in time. EpInfectious s (Bios)
Diseases (ID)
14861
Study designs A RCT is an experiment in which participants are randomly allocated to >2 groups to Ax the Biostatistics & Biostatistic 6
effect of specific interventions (eg, Tx). EpInfectious s (Bios)
Diseases (ID)
14862
Study designs A case-control study is an observational study design; it begins w/ selecting individuals who Biostatistics & Biostatistic 6
have the outcome ("cases") and individuals who do not have the outcome ("controls") and EpInfectious s (Bios)
then retrospectively comparing their Hx of exposure to RFx. Diseases (ID)
30 Turner syndrome Aortic coarctation in a child/young adult presents with lower-extremity claudication (eg, pain Cardiovascular Genetics 8
and cramping with exercise), blood pressure discrepancy between the upper and lower (CV) (Gene)
extremities, and delayed or diminished femoral pulses. Turner syndrome (45,XO) is
associated with coarctation of the aorta in up to 10% of cases. CV Gene
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31 Aortic coarctation Pts w/ adult-type coarctation of the aorta commonly die of HTN-assoc complications, incl Cardiovascular Pathology 1
LV failure, ruptured dissecting AA, and SICH. These pts are at ↑ risk for ruptured (CV) (Path)
intracranial aneurysms b/c of the ↑ incidence of congenital BAs of the COW as well as aortic
arch HTN. CV Path
32 Patent ductus Digital clubbing and cyanosis w/o BP or pulse discrepancy are pathognomonic for a large Cardiovascular Pathology 4
arteriosus PDA complicated by Eisenmenger syndrome (reversal of shunt flow from L-R to R-L). (CV) (Path)
Severe coarctation of the aorta can cause lower extremity cyanosis. R-L shunting in pts w/
large septal defects and TOF results in whole-body cyanosis. CV Path
33 Bicuspid aortic AS is the most common complication of bicuspid AVs. Pts w/ bicuspid AVs develop Cardiovascular Pathophysi 1
valve clinically significant AS on average around age 50. In comparison, senile calcific stenosis of (CV) ology
normal AVs generally becomes SSx age >65. (Patp) CV Patp
35 Transposition of the An echocardiogram showing an aorta lying anterior to the pulmonary artery is diagnostic of Cardiovascular Embryolog 1
great vessels transposition of the great arteries (TGA). This life-threatening cyanotic condition results (CV) y (Embr)
from failure of the fetal aorticopulmonary septum to spiral normally during septation of the
truncus arteriosus. CV Embr
36 Atherosclerosis Stable angina pectoris results from myocardial O2 demand-supply mismatch and MFx as Cardiovascular Pathology 8
chest pressure, tightness, or pain that is reliably produced by exertion and relieved by rest. It (CV) (Path)
most commonly occurs due to a fixed atherosclerotic plaque obstructing >70% of the
coronary artery lumen that limits blood flow during exertion. CV Path
37 Myocardial STEMI involves transmural (full-thickness) infarction of the myocardial wall, and usually Cardiovascular Pathology 18
infarction results from acute atherosclerotic plaque rupture w/ the devel of overlying thrombus that (CV) (Path)
fully occludes the coronary artery lumen. It classically presents w/ sudden-onset substernal
chest pain that's not relieved by rest or short-acting nitrates. ECG demonstrates STE in the
affected leads w/ subseq devel of Q waves. CV Path
38 Vasospastic angina Prinzmetal (variant) angina is Chx by episodic, transient atks of coronary vasospasm (at rest Cardiovascular Pharmacol 2
and at night), producing temporary transmural myocardial ischemia w/ ST-segment (CV) ogy (Phar)
elevation. Possible triggers are cigarette smoking, cocaine/amphetamines, and
dihydroergotamine/triptans. Tx includes tobacco/Rx cessation and vasodilator Thx (eg,
nitrates, CCBs). CV Phar
39 Atherosclerosis Gradually developing myocardial ischemia encourages the formation and maturation of Cardiovascular Pathology 8
collateral vessels and is most likely to occur in the setting of a slow-growing, stable (CV) (Path)
atherosclerotic plaque. An unstable atherosclerotic plaque (eg, that w/ active inflammation, a
lipid-rich core, a/o a thin fibrous cap) is more likely to rupture, resulting in the abrupt onset
of ischemia/infarction that precludes the development of viable collateral vessels. CV Path
40 Myocardial After the onset of severe ischemia leading to MI, early signs of coag necrosis don't become Cardiovascular Pathology 18
infarction apparent on LM until 4hrs after the onset of MI. (CV) (Path) CV Path
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42 Myocardial Loss of cardiomyocyte contractility occurs w/i 60 2nds after the onset of total ischemia. Cardiovascular Pathophysi 18
infarction When ischemia lasts less than 30 min, restoration of blood flow leads to reversible (CV) ology
contractile dysfxn (myocardial stunning), w/ contractility gradually returning to normal over (Patp)
the next several hrs to days. However, after about 30 min of total ischemia, ischemic injury
becomes irreversible. CV Patp
43 Myocardial Hibernating myocardium refers to the presence of LV systolic dysfxn due to ↓ coronary Cardiovascular Pathology 18
infarction blood flow at rest that's partially or completely reversible by coronary revascularisation. (CV) (Path) CV Path
72 Endocarditis Janeway lesions are nontender, macular, and erythematous lesions typically located on the Cardiovascular Pathology 15
palms and soles of pts w/ acute IE and are the result of septic embolization from valvular (CV) (Path)
vegetations. CV Path
73 SLE CV MFx of lupus include accelerated atherosclerosis, small-vessel necrotizing vasculitis, Cardiovascular Pathology 7
pericarditis, and Libman-Sacks endocarditis (small, sterile vegetations on both sides of the (CV) (Path)
valve). Renal involvement classically MFx as DPGN, which is Chx by diffuse thickening of
the glomerular capillary walls w/ "wire-loop" structures on LM. CV Path
74 Carcinoid tumors Carcinoid syndrome typically presents w/ episodic flushing, secretory diarrhoea, and Cardiovascular Pathology 4
wheezing. It can lead to pathognomonic plaque-like deposits of fibrous tissue on the right- (CV) (Path)
sided endocardium, causing TR and right-sided HF. ↑ 24-hr urinary 5-HIAA can confirm the
Dx. CV Path
75 Dilated DCM results from direct dmg to cardiomyocytes leading to myocardial contractile dysfxn Cardiovascular Pathophysi 8
cardiomyopathy (systolic dysfxn), volume overload, and ventricular dilation. Viral myocarditis is a common (CV) ology
cause of DCM and should be suspected in young pts who develop HF following a SSx viral (Patp)
prodrome. CV Patp
76 Hypertrophic In pts w/ HCM, dynamic LVOT obstr is due to abn systolic anterior motion of the anterior Cardiovascular Pathology 9
cardiomyopathy leaflet of the MV toward a hypertrophied IV septum. (CV) (Path) CV Path
82 Hypertrophic HCM is a common cause of SCD in young adults. Histologic features incl cardiomyocyte Cardiovascular Pathology 9
cardiomyopathy hypertrophy and myofiber disarray w/ ↑ interstitial fibrosis. The structural disarray creates a (CV) (Path)
substrate for ventricular arrhythmia (e.g. v-tach, VF) that can lead to SCD. CV Path
83 Hypertrophic HCM is Chx by asymmetric (eg, septal) LVH that can result in SCD. AD mutations affecting Cardiovascular Pathology 9
cardiomyopathy the cardiac sarcomere genes (eg, cardiac β-myosin heavy chain gene and myosin-binding (CV) (Path)
protein C gene) are responsible for the majority of cases. CV Path
84 Long QT syndrome Unprovoked syncope in a previously aSSx young person may result from a congenital LQTS. Cardiovascular Pathology 4
The 2 most important congenital syndromes w/ QT prolongation — RWS and JLNS — are (CV) (Path)
thought to result from muts in a K+ channel protein that contributes to the delayed rectifier
current (IK) of the cardiac AP. CV Path
85 Hypertrophic HCM is characterised by asymmetric ventricular septal hypertrophy and dynamic LVOT Cardiovascular Pathophysi 9
cardiomyopathy obstr. ↓ in LV blood volume, via manoeuvres or conditions that ↓ preload (e.g. abrupt (CV) ology
standing, Valsalva strain phase) or afterload, worsen LVOT obstr and ↑ the intensity of the (Patp)
HCM murmur. CV Patp
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86 Long QT syndrome Congenital LQTS is most often caused by genetic muts in a K+ channel protein that Cardiovascular Pathology 4
contributes to the outward-rectifying K+ current. A ↓ in the outward K+ current leads to (CV) (Path)
prolongation of AP duration and QT interval. This prolongation predisposes to the devel of
life-threatening ventricular arrhythmias (e.g. TdP) that can cause palpitations, syncope,
seizures, or SCD. CV Path
89 Acute pericarditis In contrast to angina, the chest pain of pericarditis is sharp and pleuritic and may be Cardiovascular Pathology 5
exacerbated by swallowing or coughing. PIP occurs b/w 2 and 4 days following a transmural (CV) (Path)
MI. PIP is an inflammatory rxn to cardiac muscle necrosis that occurs in the adjacent
pericardium. CV Path
90 Wolff-Parkinson- Wolff-Parkinson-White syndrome is characterized by symptomatic paroxysmal Cardiovascular Pathophysi 2
White syndrome supraventricular tachycardia (eg, atrioventricular reentrant tachycardia) due to the presence (CV) ology
of an accessory conduction pathway. During normal sinus rhythm, the presence of this (Patp)
accessory pathway causes ventricular preexcitation, which can be identified on ECG by the
triad of a shortened PR interval, early upslope of the QRS complex (delta Wave), and a
widened QRS interval. CV Patp
91 Long QT syndrome Jervell and Lange-Nielsen syndrome is an AR disorder Chx by profound bilateral Cardiovascular Pathology 4
sensorineural hearing loss and congenital LQTS, which predisposes to ventricular (CV) (Path)
arrhythmias and SCD. This condition occurs 2° to mutations in genes that encode voltage-
gated K channels. CV Path
92 Dilated Dilation of the LV cavity commonly occurs in response to systolic dysfxn (eg, ischemic heart Cardiovascular Pathology 8
cardiomyopathy disease, DCM) or certain types of valvular disease (ie, AR, MR). Chronic volume overload (CV) (Path)
causes progressive eccentric hypertrophy that eventually leads to ↓ ventricular contractility
and DHF. CV Path
93 Restrictive Diastolic HF is caused by ↓ ventricular compliance and is characterised by normal LV EF, Cardiovascular Pathophysi 1
cardiomyopathy normal LV EDV, and ↑ LV filling pressures. HTN, obesity, and infiltrative disorders (e.g. (CV) ology
transthyretin-related amyloidosis, sarcoidosis) are important causes of DHF. (Patp) CV Patp
94 Amyloidosis RCM can be caused by infiltrative diseases (e.g. amyloidosis, sarcoidosis, hemochromatosis) Cardiovascular Pathology 1
and often results in diastolic HF due to ventricular hypertrophy w/ impaired ventricular (CV) (Path)
filling. Cardiac amyloidosis is characterised histologically by areas of myocardium infiltrated
by an amorphous and acellular pink material (amyloid). CV Path
95 Hypertrophic HCM is caused by genetic mutations affecting structural proteins of the cardiac sarcomere Cardiovascular Pathology 9
cardiomyopathy (eg, β-myosin heavy chain, myosin-binding protein C) and is one of the most common causes (CV) (Path)
of SCD in young adults. Histologically, it is Chx by cardiomyocyte hypertrophy w/
haphazard cellular arrangement and interstitial fibrosis. CV Path
96 Cardiac tamponade CT typically presents w/ hypotension w/ PP, ↑ JVP, and muffled heart sounds (HS; Beck's Cardiovascular Pathophysi 2
triad). PP refers to an abn exaggerated ↓ in SBP >10mmHg on inspiration, and is a common (CV) ology
finding in pts w/ pericardial effusion w/ CT. (Patp) CV Patp
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97 Acute pericarditis Acute-onset, sharp, and pleuritic chest pain that ↓ w/ leaning forward is char of acute Cardiovascular Pathophysi 5
pericarditis. Fibrinous/serofibrinous pericarditis is the most common form of pericarditis and (CV) ology
a pericardial friction rub is the most specific physical finding. Viral pericarditis is often (Patp)
preceded by a URI. CV Patp
98 Constrictive In constrictive pericarditis, normal pericardium is replaced by dense, rigid pericardial tissue Cardiovascular Pathology 2
pericarditis that restricts ventricular filling, leading to low CO and progr right-sided HF. PEx findings in (CV) (Path)
such pts incl ↑ JVP, pericardial knock, pulsus paradoxus, and a paradoxical ↑ in JVP w/
inspiration (Kussmaul sign). CV Path
136Nitrates Nitrates (via conversion to NO) activate guanylate cyclase and ↑ intracellular lvls of cGMP. Cardiovascular Pharmacol 7
↑ lvls of cGMP lead to myosin light-chain dephosphorylation, resulting in vascular smooth (CV) ogy (Phar)
muscle relaxation. CV Phar
137Angina Pharmacologic nitrates (e.g. nitroglycerin, isosorbide mononitrate, isosorbide dinitrate) are Cardiovascular Pharmacol 1
meta to NO and S-nitrothiols in vascular smooth muscle cells, leading to an ↑ in cGMP that (CV) ogy (Phar)
stims vasodilation. Large veins are predominantly affected, leading to ↑ venous capacitance
and ↓ venous return (preload), which ↓ LV wall stress and myocardial O2 demand to relieve
anginal SSx. CV Phar
138Nitrates Sublingual nitroglycerin is used for rapid SSx relief in pts w/ stable angina. The 1° anti- Cardiovascular Pharmacol 7
ischaemic effect of nitrates is mediated by venodilation w/ a ↓ in LV EDV and wall stress, (CV) ogy (Phar)
resulting in ↓ myocardial O2 demand and relief of angina SSx. CV Phar
139Nitrates Isosorbide dinitrate has a low bioavailability due to extensive 1st-pass hepatic metabolism Cardiovascular Pharmacol 7
prior to release in systemic circulation. Sublingual NG is absorbed directly from oral mucosa (CV) ogy (Phar)
into the venous circulation and has a higher bioavailability. CV Phar
140Nitrates The main AEx seen w/ nitrate Thx include h/a and cutaneous flushing along w/ Cardiovascular Pharmacol 7
lightheadedness and hypotension due to systemic vasodilation. (CV) ogy (Phar) CV Phar
141Hypertrophic The dynamic LVOT obstruction that occurs in HCM worsens w/ ↓ LV volume, which can be Cardiovascular Pharmacol 9
cardiomyopathy caused by ↓ in cardiac preload a/o afterload. Therefore, Rx that ↓ venous return or SVR (CV) ogy (Phar)
(DHP CCBs, NG) should generally be avoided. CV Phar
142Nitrates Pts taking daily maintenance nitrates need to have a nitrate-free period every day to avoid Cardiovascular Pharmacol 7
tolerance to the Rx. (CV) ogy (Phar) CV Phar
143Nitrates Using nitrates together w/ PDEIs used for ED and pulm HTN causes a profound systemic Cardiovascular Pharmacol 7
hypotension b/c they both ↑ intracellular cGMP which causes vascular smooth muscle (CV) ogy (Phar)
relaxation. Their use together is absolutely c/i. CV Phar
144Calcium channel Contraction initiation in cardiac and SMCs is dependent on extracellular Ca influx through Cardiovascular Physiology 3
blocker L-type Ca channels, which can be prevented by CCBs (eg, verapamil). Skeletal muscle is (CV) (Phys)
resistant to CCBs, as Ca release by the SR is triggered by a mechanical interaction b/w L-
type and RyR Ca channels. CV Phys
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145Calcium channel CCBs inhib the L-type Ca2+ channel on vascular smooth muscle and cardiac cells. DHPs (e. Cardiovascular Pharmacol 3
blocker g. nifedipine, amlodipine) primarily affect peripheral arteries and cause vasodilation. Non- (CV) ogy (Phar)
DHPs (e.g. verapamil, diltiazem) affect the myocardium and can cause bradycardia and
slowed AV conduction. CV Phar
147Digoxin Digoxin toxicity typically presents with cardiac arrhythmias and nonspecific gastrointestinal Cardiovascular Pharmacol 4
(nausea, vomiting), neurological (confusion, weakness), and visual symptoms. Elevated (CV) ogy (Phar)
potassium is another sign of digoxin toxicity and is caused by inhibition of Na-K-ATPase
pumps. CV Phar
148Digoxin Digoxin directly inhibs the Na-K-ATPase pump in myocardial cells, leading to a ↓ in Na+ Cardiovascular Pharmacol 4
efflux and an ↑ in intracellular Na+ lvls. This ↓ the forward activity of the NCX, causing ↑ (CV) ogy (Phar)
intracellular Ca2+ concentration and improved myocyte contractility. CV Phar
149Chronic heart Milrinone is a PDE-3 inhib that ↓ the degradation of cAMP to provide 2 beneficial effects for Cardiovascular Pharmacol 12
failure treating systolic HF. Ca2+ influx into cardiomyocytes is ↑, which ↑ cardiac contractility. In (CV) ogy (Phar)
addn, Ca2+-myosin light chain kinase interaction is ↓, which causes vasodilation and ↓
cardiac preload and afterload. CV Phar
150Primary α1-blockers such as doxazosin, prazosin, and terazosin are useful for the Tx of both BPH and Cardiovascular Pharmacol 14
hypertension HTN. Pts w/ CAD and HF along w/ HTN will benefit from cardioselective β-blockers. (CV) ogy (Phar)
Hydrochlorothiazide is presently the 1st-line Rx for the Tx of essential HTN in the gen pop. CV Phar
153Heart block Common AEx of non-DHP CCBs (eg, diltiazem, verapamil) include constipation, Cardiovascular Pharmacol 2
bradycardia, AV conduction block ((-) chronotropic effect), and worsening of HF in pts w/ ↓ (CV) ogy (Phar)
LV fxn ((-) inotropic effect). CV Phar
154Calcium channel Amlodipine is a DHP CCB commonly used as monoThx or in combination w/ other agents Cardiovascular Pharmacol 3
blocker for Tx of HTN. Major AEx include h/a, flushing, dizziness, and peripheral edema. (CV) ogy (Phar) CV Phar
155Digoxin Digoxin is used for ventricular rate control in AF as it ↓ AV nodal conduction by ↑ Cardiovascular Pharmacol 4
parasympathetic vagal tone. Digoxin is also used in HF due to its (+) inotropic effect. These (CV) ogy (Phar)
effects are accomplished via inhib of the Na-K-ATPase pump. CV Phar
156Digoxin Digoxin tox presents w/ nonspecific GI (e.g. anorexia, nausea, vomiting) and neuro (e.g. Cardiovascular Pharmacol 4
fatigue, confusion, weakness) SSx. Changes in colour vision are a more specific, but rarer, (CV) ogy (Phar)
finding. Life-threatening ventricular arrhythmias are the most serious complication. CV Phar
157Natriuretic peptides ANP and BNP are released from the atria and ventricles, respectively, in response to Cardiovascular Physiology 1
myocardial wall stretch due to intravascular volume expansion. These endogenous hormones (CV) (Phys)
promote ↑ GFR, natriuresis. and diuresis. CV Phys
159Antiarrhythmic For class I antiarrhythmics, Na+-channel-binding strength is IC > IA > IB. Use dependence Cardiovascular Pharmacol 12
drugs describes the phenomenon in which higher HRs lead to ↑ Na+ channel blockade due to (CV) ogy (Phar)
cumulative blocking effects over multiple cardiac cycles. Class IC antiarrhythmics
demonstrate the most use dependence due to their slow dissociation from the receptor, and
class IB drugs have the least use dependence as they rapidly dissociate. CV Phar
QI Topic Educational Objective System SubjectRep
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160Dyslipidemia Niacin is used in the Tx of hyperlipidemia. It ↑ HDL lvls and ↓ LDL lvls and triglycerides. Cardiovascular Pharmacol 11
Niacin causes cutaneous flushing, which is mediated by prostaglandins and can be (CV) ogy (Phar)
diminished by preTx w/ aspirin. CV Phar
161Drug induced Most statins are metabolized by cytochrome P450 3A4, w/ the exception of pravastatin. Cardiovascular Pharmacol 3
myopathy Concomitant administration of Rx that inhibit statin metabolism (eg, macrolides) is a/w ↑ (CV) ogy (Phar)
incidence of statin-induced myopathy and rhabdomyolysis. ARF is a possible sequela of
rhabdomyolysis. CV Phar
176Myocardial Mitochondrial vacuolization is typically a sign of irreversible cell injury, signifying that the Cardiovascular Pathology 18
infarction involved mitochondria are permanently unable to generate ATP. (CV) (Path) CV Path
179Coronary blood In 90% of individuals, occlusion of the RCA can result in transmural ischemia of the inferior Cardiovascular Pathology 9
flow wall of the LV, producing ST elevation in leads II, III, and aVF as well as possible sinus (CV) (Path)
node dysfxn. Occlusion of the proximal LAD would be expected to result in anteroseptal
transmural ischemia, w/ ST elevations in leads V1-V4. Occlusion of the LCX would produce
transmural ischemia of the lateral wall of the LV, w/ ST elevations mainly in V5 and V6, and
possibly also in I and aVL. CV Path
180Aging Normal morphological changes in the aging heart incl a ↓ in LV chamber apex-to-base Cardiovascular Pathology 8
dimension, devel of a sigmoid-shaped ventricular septum, myocardial atrophy w/ ↑ collagen (CV) (Path)
deposition, and accumulation of cytoplasmic lipofuscin pigment w/i cardiomyocytes. CV Path
181Primary Concentric hypertrophy is characterised by uniform thickening of the ventricular wall and Cardiovascular Pathology 14
hypertension narrowing of the ventricular cavity due to ↑ afterload (e.g. chronic HTN, AS). Eccentric (CV) (Path)
hypertrophy is characterised by ↓ ventricular wall thickness w/ an assoc ↑ in chamber size
due to volume overload. CV Path
183Coronary blood During ventricular systole, the coronary vessels supplying the LV are compressed by the Cardiovascular Physiology 9
flow surrounding muscle. As a result, the majority of LV blood flow occurs during diastole. The (CV) (Phys)
systolic ↓ in coronary blood flow is greatest in the subendocardial region, making this
portion of the LV most prone to ischemia and infarction. CV Phys
185Chronic heart Alveolar hemosiderin-laden macrophages indicate alveolar hemorrhage. They most Cardiovascular Pathology 12
failure commonly result from chronic ↑ of pulm capillary hydrostatic pressure in the setting of left- (CV) (Path)
sided HF. CV Path
186Diastolic HF w/ preserved EF is Chx by diastolic dysfunctlon, which frequently occurs in the setting of Cardiovascular Pathophysi 4
dysfunction prolonged systemic HTN due to concentric LVH. Pts w/ longstanding HTN have ↑ SVR. (CV) ology
(Patp) CV Patp
187Congenital cardiac Increased blood oxygen saturation between 2 right-sided vessels or chambers indicates the Cardiovascular Pathophysi 2
defects presence of a left-to-right shunt. If the abnormal oxygen increase occurs between the right (CV) ology
atrium and the right ventricle, a ventricular septal defect (VSD) is likely present. Small VSDs (Patp)
produce a holosystolic murmur that is loudest over the lower left sternal border. CV Patp
188Atrioventricular A complete AV canal defect is comprised of an ASD, a VSD, and a common AV valve. It's Cardiovascular Pathology 1
canal defect the most common congenital cardiac anomaly a/w Down syndrome. (CV) (Path) CV Path
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189Embolic stroke Paradoxical embolism occurs when a thrombus from the venous system crosses into the Cardiovascular Pathophysi 1
arterial circulation via an abnormal connection b/w the right and left cardiac chambers (eg, (CV) ology
PFO, ASD, or VSD). Atrial left-to-right shunts cause wide and fixed splitting of S2 and can (Patp)
facilitate paradoxical embolism due to periods of transient shunt reversal (eg, during
straining or coughing). CV Patp
192Myocardial VF is the most common mech of SCD due to AMI. It results from arrhythmogenic foci Cardiovascular Pathology 18
infarction triggered by electrical instability in the ischemic myocardium. (CV) (Path) CV Path
193Myocardial LV free-wall rupture is an uncommon but devastating mech complication of transmural MI Cardiovascular Pathophysi 18
infarction that occurs w/i 5 days or up to 2wks following the event. Rupture leads to cardiac tamponade (CV) ology
that causes hypotension and shock w/ rapid progr to cardiac arrest. Autopsy typically reveals (Patp)
a slit-like tear at the site of infarction in the LV wall. CV Patp
194Marfan syndrome CV lesions are the most life-threatening complications a/w MFS. Early-onset CMD of the Cardiovascular Pathophysi 2
aorta predisposes to AD, the most common COD in these pts. (CV) ology
(Patp) CV Patp
195Myocardial Rupture of the LV free wall is a catastrophic mechanical complication of anterior wall MI Cardiovascular Pathophysi 18
infarction that usually occurs w/i the 1st 5-14 days after MI. Rupture leads to hemopericardium and (CV) ology
CT, causing profound hypotension and shock w/ rapid progression to PEA and death. (Patp) CV Patp
196Pulmonary arterial PAH should be suspected in young and otherwise healthy pts w/ fatigue, progr dyspnoea, Cardiovascular Pathophysi 8
hypertension atypical chest pain, or unexplained syncope. Long-standing PAH leads to hypertrophy a/o (CV) ology
dilation of the RV (cor pulmonale). (Patp) CV Patp
198Pulmonary arterial Left-sided HF can cause 2° PAH via ↑ left-sided diastolic filling pressures transmitting Cardiovascular Pathophysi 8
hypertension backward to the pulm veins, resulting in pulm venous congestion. Over time, pulm arterial (CV) ology
remodelling (medial hypertrophy and intimal thickening w/ fibrosis) can occur, but not to the (Patp)
extent that occurs in (1°) PAH. CV Patp
200Mitral regurgitation DHF is a common cause of 2° (fxnal) MV regurgitation. ↑ LV EDV causes dilation of the Cardiovascular Pathophysi 6
MV annulus and restricted movement of the chordae tendineae w/ subsequent regurgitation. (CV) ology
Tx w/ diuretics and vasodilators can improve HF-induced MR. (Patp) CV Patp
201Atrial septal defect Wide, fixed splitting of the 2nd heart sound is a Chx auscultatory finding in pts w/ ASD. A Cardiovascular Pathophysi 2
hemodynamically significant ASD can produce chronic pulm HTN as a result of left-to-right (CV) ology
intracardiac shunting. Eisenmenger syndrome is the late-onset reversal of a left-to-right shunt (Patp)
due to pulm vascular sclerosis resulting from chronic pulm HTN. Closure of the ASD may be
required to prevent irreversible pulm vascular sclerosis and a permanent Eisenmenger
syndrome. CV Patp
202Atrial septal defect The foramen ovale is patent in approximately 25% of normal adults. Although the foramen Cardiovascular Embryolog 2
ovale usually remains fxnally closed, transient ↑ of RA pressure above LA pressure can (CV) y (Embr)
produce a right-to-left shunt, leading to paradoxical embolism of venous clots into the
arterial circulation. CV Embr
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203Ventricular septal VSD typically presents in the neonatal period after pulm vascular resistance has declined. Cardiovascular Pathology 2
defect The clinical Px depends on the size of the defect, which ranges from an aSSx holosystolic (CV) (Path)
murmur (small VSD) to HF (large VSD). CV Path
204Tetralogy of Fallot In pts w/ TOF, the degree of RVOT obstr is the major determinant of the degree of R-L Cardiovascular Pathophysi 3
intracardiac shunting and resulting cyanosis. (CV) ology
(Patp) CV Patp
205Tetralogy of Fallot In pts w/ TOF, squatting during a Tet spell ↑ SVR and ↓ right-to-left shunting, thereby ↑ Cardiovascular Physiology 3
pulm blood flow and improving O2ation status. (CV) (Phys) CV Phys
227Aortic regurgitation AR causes a decrescendo diastolic murmur w/ maximal intensity occurring just after closure Cardiovascular Pathophysi 8
of the AV, when the pressure gradient b/w the aorta and LV is the highest. The pressure (CV) ology
tracing for AR is Chx by loss of the aortic dicrotic notch, steep diastolic decline in aortic (Patp)
pressure, and high-peaking systolic pressures. CV Patp
228Endocarditis Microemboli from the valvular vegetations of BE are the most common cause of subungual Cardiovascular Pathology 15
splinter hemorrhages. The presence of these lesions necessitates careful cardiac auscultation (CV) (Path)
to detect a possible new-onset regurgitant murmur. CV Path
230Endocarditis MVP w/ MR is the most common predisposing condition for native valve IE in developed Cardiovascular Pathology 15
nations. Rheumatic heart disease remains a freq cause of IE in devel nations. (CV) (Path) CV Path
231Endocarditis NBTE (marantic endocarditis) is a form of non-infectious endocarditis characterised by Cardiovascular Pathology 15
valvular deposition of sterile platelet-rich thrombi. It likely results from valvular dmg due to (CV) (Path)
inflammatory cytokines in the setting of an underlying hypercoagulable state, and it's most
commonly seen w/ advanced malignancy (esp. mucinous AC) or SLE. CV Path
232Mitral stenosis Rheumatic MS is characterised by diffuse fibrous thickening and distortion of the MV Cardiovascular Pathology 7
leaflets along w/ commissural fusion at the leaflet edges. Pts often present w/ a diastolic (CV) (Path)
murmur, dyspnoea, and fatigue and are at ↑ risk of AF and TE (e.g. stroke). CV Path
233Mitral stenosis The best and most reliable auscultatory indicator of the degree of MS is the A2-OS interval. Cardiovascular Pathophysi 7
A shorter interval indicates more severe stenosis. Other auscultatory findings can incl a (CV) ology
diastolic rumbling murmur w/ presystolic accentuation due to LA contraction. (Patp) CV Patp
234Mitral stenosis Isolated MS causes ↑ upstream pressures in the LA and pulm veins and arteries. LV EDP is Cardiovascular Pathophysi 7
normal or ↓ due to obstr of blood flow thru the stenotic valve. An ↑ LV EDP suggests addnal (CV) ology
downstream pathology (e.g. AV disease, LV failure). (Patp) CV Patp
235Mitral stenosis Cardiac auscultation in pts w/ MS reveals a loud 1st heart sound, an early diastolic OS after Cardiovascular Pathophysi 7
the 2nd heart sound, and a low-pitched diastolic rumble best heard at the cardiac apex. The (CV) ology
OS is caused by the sudden opening of the MV leaflets when the LV pressure falls below the (Patp)
LA pressure at the beginning of diastole. CV Patp
236Mitral stenosis LA enlargement can sometimes cause left recurrent laryngeal nerve impingement. Cardiovascular Pathology 7
Neurapraxia resulting in left vocal cord paresis and hoarseness may result. (CV) (Path) CV Path
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237Aortic regurgitation In chronic AR, persistent LV volume overload triggers eccentric hypertrophy, which causes a Cardiovascular Pathophysi 8
compensatory ↑ in SV to maintain CO. This compensatory mech allows for a relatively long (CV) ology
aSSx in most pts; however, LV dysfxn eventually occurs, leading to HF. (Patp) CV Patp
238Aortic regurgitation Chronic aortic regurgitation (AR) causes a reduction in diastolic blood pressure and a Cardiovascular Pathophysi 8
compensatory increase in left ventricular stroke volume. These changes create a high- (CV) ology
amplitude, rapid rise-rapid fall pulsation (ie, widened pulse pressure) and the other (Patp)
characteristic findings of AR (eg, head bobbing. "pistol-shot" femoral pulses). CV Patp
240Rheumatic fever Interstitial myocardial granulomas (Aschoff bodies) are found in carditis due to acute RF, Cardiovascular Pathology 5
which develops after an un-Tx GAS pharyngeal infection. Aschoff bodies contain plump (CV) (Path)
macrophages w/ abundant cytoplasm and central, slender ribbons of chromatin (Anitschkow,
or caterpillar cells). CV Path
241Rheumatic fever Sydenham chorea presents w/ involuntary, rapid, irregular jerking movements involving the Cardiovascular Pathology 5
face, arms, and legs. It occurs mos after group A streptococcal infection and is one of the (CV) (Path)
major clinical MFx of acute RF. Pts w/ this condition carry a high risk of chronic valvular
disease. CV Path
242Aortic stenosis Calcific degeneration of the trileaflet AV is the most common cause of AS in developed Cardiovascular Pathology 8
nations. AS is Chx by progressive AV leaflet thickening and calcification, leading to (CV) (Path)
restricted leaflet excursion and mobility. AS murmur is usually a harsh ejection-type systolic
murmur heard best at the base of the heart in the "aortic area" (2nd right ICS) w/ radiation to
the carotid arteries. CV Path
243Aortic stenosis The murmur of AS is a systolic ejection-type, crescendo-decrescendo murmur that starts Cardiovascular Pathophysi 8
after the 1st heart sound and typically ends before the A2 component of the 2nd heart sound. (CV) ology
The intensity of the murmur is proportional to the magnitude of the LV to aorta pressure (Patp)
gradient during systole. CV Patp
244Aortic stenosis In pts w/ chronic AS and concentric LVH, atrial contraction contributes significantly to LV Cardiovascular Pathophysi 8
filling. Loss of atrial contraction due to AF can ↓ LV preload and CO sufficiently to cause (CV) ology
systemic hypotension. ↓ forward filling of the LV can also result in backup of blood in the (Patp)
LA and pulm veins, leading to acute pulm edema. CV Patp
246Diastolic A low-freq, late diastolic sound on cardiac auscultation that immediately precedes S1 is most Cardiovascular Pathophysi 4
dysfunction often S4. An abn S4 can be heard in pts w/ ↓ ventricular compliance (e.g. HTN heart disease, (CV) ology
AS, HCM) due to a sudden rise in EDP w/ atrial contraction. (Patp) CV Patp
293Peripheral vascular Phenotypically mixing refers to coinfection of a host cell by 2 viral strains, resulting in Cardiovascular Pathophysi 4
disease progeny virions that contain nucleocapsid proteins from 1 strain and the unchanged parental (CV) ology
genome of the other strain. B/c there's no change in underlying viral genomes (no genetic (Patp)
exchange), the next gen of virions revert to their original, unmixed phenotypes. CV Patp
296Aging Dystrophic calcification occurs in dmgd or necrotic tissue in the setting of normal Ca lvls; Cardiovascular Pathophysi 8
metastatic calcification occurs in normal tissue in the setting of hypercalcemia. (CV) ology
(Patp) CV Patp
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300Aging Lipofuscin is the product of lipid peroxidation, accumulating in aging cells (esp. in pts w/ Cardiovascular Pathology 8
malnutrition and cachexia). (CV) (Path) CV Path
315Patent ductus PDA is common in preterm infants and presents w/ a continuous murmur, widened PPs, and Cardiovascular Pharmacol 4
arteriosus SSx of CV strain. Indomethacin or ibuprofen therapy can inhib PGE2 synthesis and (CV) ogy (Phar)
accelerate closure. CV Phar
442Atherosclerosis Atherosclerosis is initiated by repetitive endothelial cell injury, which leads to a chronic Cardiovascular Pathology 8
inflammatory state in the underlying intima of large elastic arteries as well as in large- and (CV) (Path)
medium-sized muscular arteries. CV Path
443Coronary artery VSMCs are the only cells w/i the atherosclerotic plaque capable of synthesizing structurally Cardiovascular Pathology 4
disease important collagen isoforms and other matrix components. Progressive enlargement of the (CV) (Path)
plaque results in remodeling of the ECM and VSMC death, promoting development of
vulnerable plaques w/ an ↑ propensity for rupture. CV Path
444Atherosclerosis Fatty streaks are the earliest lesions of atherosclerosis and can be seen as early as the 2nd Cardiovascular Pathology 8
decade of life. They appear as a collection of lipid-laden macrophages (foam cells) in the (CV) (Path)
intima that can eventually progress to atherosclerotic plaques. CV Path
446Atherosclerosis During the development of atherosclerotic plaque (atheroma), activated macrophages, Cardiovascular Pathology 8
platelets, and endothelial cells release GFs (eg, PDGF) that stimulate recruitment of SMCs (CV) (Path)
from the arterial wall media and their subsequent proliferation in the intima. CV Path
447Atherosclerosis The likelihood of plaque rupture is related to plaque stability rather than plaque size or the Cardiovascular Pathology 8
degree of luminal narrowing. Plaque stability largely depends on the mech strength of the (CV) (Path)
fibrous cap. Inflammatory macrophages in the intima may ↓ plaque stability by secreting
metalloproteinases, which degrade ECM proteins (e.g. collagen). CV Path
448Peripheral vascular Intermittent claudication describes muscle pain that's reproducibly caused by exercise and Cardiovascular Pathology 4
disease relieved by rest; it occurs due to atherosclerotic stenoses (lipid-filled intimal plaques) in the (CV) (Path)
large arteries that prevent sufficient blood flow to exercising muscle. The lower extremities
are most commonly affected; however, proximal lesions (i.e. aortoiliac occlusion) can cause
gluteal claudication a/o impotence. CV Path
449Primary HTE is severely ↑ BP (typically >180/120 mm Hg) w/ evidence of end-organ dmg. In the Cardiovascular Pathology 14
hypertension kidneys, this can MFx as malignant nephrosclerosis, Chx by fibrinoid necrosis and (CV) (Path)
hyperplastic arteriolosclerosis ("onion-skin" appearance). A MAHA can occur due to
erythrocyte fragmentation and platelet consumption at the narrowed arteriolar lumen. CV Path
451Peripheral vascular Thromboangiitis obliterans (Buerger disease) is a segmental, inflammatory vasculitis that Cardiovascular Pathology 4
disease affects the small- and medium-sized arteries and veins of the distal extremities w/ (CV) (Path)
inflammatory, intraluminal thrombi and sparing of the vessel wall. It is usually seen in
young, heavy smokers, and can Px w/ digital ischemia and ulceration, extremity claudication,
Raynaud phenomenon, and superficial thrombophlebitis. CV Path
QI Topic Educational Objective System Subject
Rep
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452Takayasu arteritis Takayasu arteritis is a chronic, large-artery vasculitis that 1arily involves the aorta and its
Cardiovascular Pathology 1
branches. It presents w/ constitutional (e.g. fever, weight loss) and arterio-occlusive (e.g. (CV) (Path)
claudication, BP discrepancies, pulse deficits) findings in pts age <40. Histopathology shows
granulomatous inflammation of the vascular media. CV Path
453Renal artery RAS is most often due to atherosclerosis. It can cause severe, refractory HTN due to Cardiovascular Pathology 9
stenosis activation of the RAAS. Over time, renal atrophy may occur due to chronic O2 and nutrient (CV) (Path)
deprivation. Histologic Ex may show crowded glomeruli, tubulointerstitial atrophy and
fibrosis, and focal inflammatory infiltrates. CV Path
456Primary Isolated systolic HTN (ISH; SBP >140mmHg w/ DBP <90mmHg) is due to age-related Cardiovascular Physiology 14
hypertension stiffness and ↓ in compliance of the aorta and major peri arteries. (CV) (Phys) CV Phys
460Polyarteritis nodosa PAN is segmental, transmural, necrotizing inflammation of medium- to small-sized arteries. Cardiovascular Pathology 2
Renal artery involvement is often prominent. Vessels of the kidneys, heart, liver, and (CV) (Path)
gastrointestinal tract are most commonly involved in resulting ischemia, infarction, or
hemorrhage. Cutaneous manifestations occur in up to one-third of patients, and include
palpable purpura. The lung is very rarely involved. CV Path
462Aortic aneurysm Myxomatous changes w/ pooling of proteoglycans in the media layer of large arteries are Cardiovascular Pathology 6
found in CMD, which predisposes to the devel of ADs and AAs. Medial degen is freq seen in (CV) (Path)
younger individuals w/ Marfan syndrome. CV Path
463Aortic aneurysm AAA is a/w RFs (e.g. age >60, smoking, HTN, male sex, FHx) that lead to chronic Cardiovascular Pathology 6
transmural inflammation and ECM degradation w/i the wall of the aorta. This leads to (CV) (Path)
weakening and progr expansion of the aortic wall, resulting in aneurysm formation, typically
below the renal arteries. CV Path
464Aortic dissection AD classically presents w/ severe retrosternal pain that radiates to the back. This condition Cardiovascular Pathology 6
develops when overwhelming hemodynamic stress leads to tearing of the aortic intima w/ (CV) (Path)
blood subseq dissecting thru the aortic media. The resulting intramural hematoma can extend
both proximally and distally and can compress major arterial branches and impair blood
flow. CV Path
466Hemangioma Cutaneous, strawberry-type capillary hemangiomas are common, benign, congenital tumors, Cardiovascular Pathology 6
which are composed of unencapsulated aggregates of closely packed, thin-walled capillaries. (CV) (Path)
Initially, strawberry hemangiomas grow in proportion to the growth of the child, before
eventually regressing. In 75-95% of cases, the vascular tumor will regress completely by age
7. CV Path
469Hereditary Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia) is an AD condition Cardiovascular Pathology 1
hemorrhagic marked by the presence of telangiectasias in the skin as well as the mucous membranes of the (CV) (Path)
telangiectasia lips, oronasopharynx, resp tract, GIT, and urinary tract. Rupture of these telangiectasias may
cause epistaxis, GI bleeding, or hematuria. CV Path
473Aortic dissection HTN is the single most important RF for the devel of intimal tears leading to AD. HTN, Cardiovascular Pathology 6
smoking, DM, and hypercholaemia are all major RFs for atherosclerosis, which predisposes (CV) (Path)
more to AA formation than AD. CV Path
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474Chronic venous Varicose veins are dilated, tortuous veins most commonly found in the superficial veins of Cardiovascular Pathology 3
insufficiency the leg. They're caused by chronically ↑ intraluminal pressure a/o loss of tensile strength in (CV) (Path)
the vessel wall, leading to incompetence to the venous valves. Common complications incl
oedema, stasis dermatitis, skin ulcerations, poor wound healing, and infections. CV Path
475Thrombophlebitis A PNPS of hypercoagulability may be seen in some pts w/ ca, especially ACs of the Cardiovascular Pathology 1
pancreas, colon, or lung. Superficial venous thromboses may therefore appear in one site and (CV) (Path)
then resolve, only to recur in another site. This is known as Trousseau syndrome (migratory
superficial thrombophlebitis), an indication of visceral ca. CV Path
506Subdural hematoma SDH occurs due to the rupture of cortical bridging veins. In young pts, it results from a fall Cardiovascular Pathology 1
or MVA and MFx w/ gradual onset of h/a and confusion. In elderly pts it may occur after a (CV) (Path)
minor trauma and present w/ a variety of neuro SSx. You should know how to recognise this
on CT scan. CV Path
551Dose response Cortisol exerts a permissive effect on many hormones to help improve the response to a Cardiovascular Pharmacol 4
curves variety of stressors. For example, cortisol increases vascular and bronchial smooth muscle (CV) ogy (Phar)
reactivity to catecholamines and increases glucose release by the liver in response to
glucagon. CV Phar
568Heart Acute cardiac transplant rejection occurs wks following transplantation and is primarily a Cardiovascular Immunolo 1
transplantation cell-mediated process. On histopathologic analysis of an endomyocardial Bx, a dense (CV) gy (Immu)
mononuclear lymphocytic infiltrate w/ cardiac myocyte dmg will be visualized. Tx w/
immunosuppressive Rx is aimed primarily at preventing this form of rejection. CV Immu
577Contraception The absolute c/i to the use of OCPs are: prior Hx of TE event or stroke, Hx of an oestrogen- Cardiovascular Pharmacol 3
dependent tumour, women over age 35yrs who smoke heavily, hypertriglyceridaemia, (CV) ogy (Phar)
decompensated or active liver disease (would impair steroid meta), preg. CV Phar
625Amiodarone Amiodarone is 40% iodine by weight. It can cause hypothyroidism due to ↓ production of Cardiovascular Pharmacol 1
thyroid hormone. Amiodarone can also cause hyperthyroidism due to ↑ thyroid hormone (CV) ogy (Phar)
synthesis or destructive thyroiditis w/ release of preformed thyroid hormone. CV Phar
645Endocarditis Initial empiric Tx of coagulase (-) staphylococcal infection should include vancomycin due Cardiovascular Pharmacol 15
to widespread methicillin resistance, esp. in nosocomial infections. If susceptibility results (CV) ogy (Phar)
indicate a methicillin-susceptible isolate, vancomycin can be switched to nafcillin or
oxacillin. CV Phar
654Penetrating thoracic The LV forms the apex of the heart and can reach as far as the 5th ICS at the left MCL. All Cardiovascular Anatomy 2
trauma other chambers of the heart lie medial to the left MCL. The lungs overlap much of the (CV) (Anat)
anterior surface of the heart. CV Anat
679Endocarditis Staphylococcus epidermidis, a Gram (+) coccus that grows in clusters, is a skin commensal Cardiovascular Microbiolo 15
that is a common cause of infection in pts w/ prosthetic devices such as artificial joints or (CV) gy (Micr)
heart valves. Unlike S aureus, S epidermidis is coagulase (-). Unlike S saprophyticus
(another coagulase (-) staphylococci species), S epidermidis is susceptible to novobiocin. CV Micr
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686Aldosterone MRBs (e.g. spironolactone, eplerenone) improve survival in pts w/ CHF and ↓ LV EF. They Cardiovascular Pharmacol 3
antagonists shouldn't be used in pts w/ hyperkalaemia or renal failure. (CV) ogy (Phar) CV Phar
689Primary Fenoldopam is a selective peripheral dopamine-1 receptor agonist. It is given IV to ↓ BP in Cardiovascular Pharmacol 14
hypertension HTE, especially in pts w/ renal insufficiency. Fenoldopam causes arteriolar dilation, ↑ renal (CV) ogy (Phar)
perfusion, and promotes diuresis and natriuresis. CV Phar
691Angiotensin ARBs work by blocking ATII-1 receptors, inhib the effects of ATII. This results in arterial Cardiovascular Pharmacol 1
receptor blockers vasodilation and ↓ aldosterone secretion. The resulting fall in BP ↑ renin, ATI, and ATII lvls. (CV) ogy (Phar)
ARBs don't affect the activity of ACE, and therefore they don't affect bradykinin degradation
and don't cause cough. CV Phar
693ACE inhibitors ACEIs can cause significant 1st-dose hypotension in pts w/ volume depletion (eg, from Cardiovascular Pharmacol 7
diuretic use) or HF. To ↓ the risk of 1st-dose hypotension, ACEI Thx should be initiated at (CV) ogy (Phar)
low dosages. CV Phar
697Hyperkalemia ACEIs block the conversion of AT-I to AT-Il, thereby ↓ vasoconstriction and aldosterone Cardiovascular Pharmacol 1
secretion. ↓ aldosterone leads to K retention, which can cause hyperkalemia, especially in pts (CV) ogy (Phar)
w/ renal insufficiency and in those taking other Rx that ↑ K lvls (eg, ARBs, MRBs). CV Phar
711Dyslipidemia Tx w/ statins causes hepatocytes to ↑ their LDL receptor density, leading to ↑ uptake of Cardiovascular Pharmacol 11
circulating LDL. (CV) ogy (Phar) CV Phar
713Antiplatelet therapy GI mucosal injury and bleeding are the most common side effects of aspirin. These are due Cardiovascular Pharmacol 1
primarily to COX-1 inhib, which results in impaired PG-dependent GI mucosal defence and (CV) ogy (Phar)
↓ platelet aggregation. CV Phar
726Rheumatic fever Acute RF is a complication of untreated group A streptococcal pharyngitis. RHD is the most Cardiovascular Pathophysi 5
common cause of acquired valvular heart disease and CV death in developing countries. The (CV) ology
incidence of acute RF and RHD has been ↓ in industrialized nations w/ prompt Tx of (Patp)
streptococcal pharyngitis w/ penicillin. CV Patp
729Endocarditis Staphylococcus aureus causes acute BE w/ rapid onset of SSx, including shaking chills Cardiovascular Microbiolo 15
(rigors), high fever, dyspnea on exertion, and malaise. In IVDUs, it can cause right-sided (CV) gy (Micr)
endocarditis w/ septic embolization into the lungs. CV Micr
733Endocarditis Enterococcus is a component of the normal colonic and urogenital flora and is capable of Cardiovascular Microbiolo 15
growing in hypertonic saline and bile. It is γ-hemolytic, catalase (-), and pyrrolidonyl (CV) gy (Micr)
arylamidase (+). GU instrumentation or catheterization has been a/w enterococcal
endocarditis. CV Micr
751Prostacyclins Prostacyclin (prostaglandin I2) is synthesized from prostaglandin H2 by prostacyclin Cardiovascular Pathophysi 1
synthase in vascular endothelial cells. Once secreted, it inhibits platelet aggregation and (CV) ology
causes vasodilation to oppose the fxns of thromboxane A2 and help maintain vascular (Patp)
homeostasis. CV Patp
778Drug induced The 1° side effects of statins include myopathy and hepatitis. Fibrates such as gemfibrozil Cardiovascular Pharmacol 3
myopathy can impair hepatic clearance of statins, ↑ the risk of severe myopathy. (CV) ogy (Phar) CV Phar
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780Drug induced liver Common AEs of HMG-CoA reductase inhibs (statins) include muscle and liver tox. Hepatic Cardiovascular Pharmacol 2
injury transaminases should be checked prior to initiating therapy and repeated if SSx of hepatic (CV) ogy (Phar)
injury occur. CV Phar
781Dyslipidemia Although low HDL concentration is a/w ↑ CV risk, the use of Rx to ↑ HDL lvls does not Cardiovascular Pharmacol 11
improve CV outcomes. HMG-CoA reductase inhibitors (statins) ↓ total cholesterol and LDL (CV) ogy (Phar)
lvls. Statins are the most effective lipid-↓ing Rx for 1° and 2° prevention of CV events,
regardless of baseline lipid lvls. CV Phar
788Homocysteine ↑ lvls of plasma homocysteine are an independent RFx for thrombotic events. Homocysteine Cardiovascular Biochemist 2
can be metabolized to methionine via remethylation or to cystathionine via transsulfuration. (CV) ry (Bioc)
Hyperhomocysteinemia is most commonly due to genetic mutations in critical enzymes or
deficiencies of vitamin B12, vitamin B6, and folate. CV Bioc
809Renal infarction Renal infarction presents w/ flank pain, hematuria, ↑ LDH, and a wedge-shaped kidney Cardiovascular Pathology 2
lesion on CT scan. The most common cause of renal infarction is systemic TE, often due to (CV) (Path)
thrombus formation during AF. The brain and kidneys are more likely than other organs to
suffer embolic infarctions b/c they are perfused at a higher rate. CV Path
823Myocardial Fibrinolytic Thx for acute STEMI is a reasonable reperfusion technique for pts w/ no c/i to Cardiovascular Pharmacol 18
infarction thrombolysis. Fibrinolytic agents such as alteplase bind to fibrin in the thrombus (clot) and (CV) ogy (Phar)
activate plasmin, which leads to thrombolysis. The most common AEx of thrombolysis is
hemorrhage (eg, GI, intracerebral). CV Phar
843Chronic heart ↓ CO in HF triggers neuroendo compensatory mechanisms to maintain organ perfusion; Cardiovascular Pathophysi 12
failure however, the compensatory mechanisms are maladaptive over the long term. ↑ sympathetic (CV) ology
output and activation of the RAAS stimulate vasoconstriction and volume retention, (Patp)
compounding the hemodynamic stress on an already failing heart and creating a vicious
cycle of decompensation. CV Patp
878Chronic venous Chronically ↑ venous pressure in the ↓ extremities can lead to incompetent venous valves and Cardiovascular Pathology 3
insufficiency venous dilation (varicose veins). Venous congestion and tissue ischemia can result in venous (CV) (Path)
stasis dermatitis. CV Path
882Down syndrome DS is most commonly caused by maternal meiotic nondisjxn, a process by which the fetus Cardiovascular Genetics 6
receives 3 full copies of chromosome 21. Dysmorphic features (eg, flat facial profile, (CV) (Gene)
protruding tongue, small ears, upslanting palpebral fissures) and cardiac defects (eg,
endocardial cushion defects) are Chx. CV Gene
898Antiarrhythmic Adenosine causes hyperpolarization of the nodal PM to briefly block conduction through the Cardiovascular Pharmacol 12
drugs AV node, and it is effective in the initial Tx of PSVT. Common AEx include flushing, chest (CV) ogy (Phar)
burning (due to bronchospasm), hypotension, and high-grade AV block. CV Phar
899Antiarrhythmic Amiodarone (and other class III and class IA antiarrhythmic agents) causes lengthening of Cardiovascular Pharmacol 12
drugs the cardiac AP, which MFx as QT interval prolongation on ECG. QT prolongation caused by (CV) ogy (Phar)
amiodarone, in contrast to other Rx, is a/w a very low risk of TdP. CV Phar
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900Antiarrhythmic Lidocaine is a class IB antiarrhythmic Rx that tends to bind to inactivated Na channels and Cardiovascular Pharmacol 12
drugs rapidly dissociates. As a result, it is effective in suppressing ventricular tachyarrhythmias (CV) ogy (Phar)
induced by rapidly depolarizing and ischemic myocardium. CV Phar
901Antiarrhythmic Class III antiarrhythmic drugs (e.g. amiodarone, sotalol, dofetilide) predominantly block K+ Cardiovascular Pharmacol 12
drugs channels and inhib the outward K+ currents during phase 3 of the cardiac AP, thereby (CV) ogy (Phar)
prolonging repol and total AP duration. CV Phar
939Aortic stenosis The murmur of valvular AS is typically an ejection or midsystolic murmur of crescendo- Cardiovascular Pathology 8
decrescendo configuration w/ max intensity over the right 2nd ICS and radiation to neck and (CV) (Path)
carotid arteries. The most common cause of AS in elderly pts (age >70) is degen calcification
of the AV leaflets. CV Path
943Mitral regurgitation In pts w/ MR, LV afterload is determined by the balance of resistance b/w forward flow Cardiovascular Pathophysi 6
(aortic pressure) and regurgitant flow (LA pressure). A ↓ in SVR ↑ the ratio of forward to (CV) ology
regurgltant blood flow and improves CO. (Patp) CV Patp
944Mitral regurgitation Pts w/ severe MR develop left-sided volume overload w/ an S3 gallop due to the large Cardiovascular Pathophysi 6
volume of regurgitant flow re-entering the ventricle during mid-diastole. The absence of an (CV) ology
S3 gallop excludes severe chronic MR. (Patp) CV Patp
945Mitral regurgitation LV systole corresponds to the time of passive filling of the LA (atrial diastole). MR leads to Cardiovascular Pathophysi 6
markedly ↑ LA pressure during this period, creating the char early and large V wave on LA (CV) ology
pressure tracing. (Patp) CV Patp
947Mitral valve MVP is most often caused by defects in connective tissue proteins that predispose to Cardiovascular Pathology 1
prolapse myxomatous degen of the mitral leaflets and chordae tendineae. Cardiac auscultation (CV) (Path)
typically reveals a MC f/b a MR murmur; the click and murmur occur later in systole or
disappear completely w/ manoeuvres (e.g. squatting) that ↑ LV EDV. CV Path
948Chronic cough Cough is a very well recognized AEx of ACEI Thx. Cough 2° to ACEI Thx is Chx as dry, Cardiovascular Pharmacol 1
nonproductive, and persistent. The mechanism behind ACEI induced cough is accumulation (CV) ogy (Phar)
of bradykinin, substance P, or prostaglandins. b/c ARBs do not affect ACE activity, they
theoretically should not cause cough. CV Phar
949ACE inhibitors Angioedema is a rare and serious AE of ACEI therapy. ACEI ↑ bradykinin lvls, which ↑ Cardiovascular Pharmacol 7
vascular permeability and lead to angioedema. SSx include tongue, lips, or eyelid swelling (CV) ogy (Phar)
and, less frequently, laryngeal oedema and difficulty breathing. ACEI should be discontinued
in affected pts. CV Phar
951Coronary blood The high systolic intraventricular pressure and wall stress of the LV prevent myocardial Cardiovascular Physiology 9
flow perfusion during systole; therefore, the majority of LV myocardial perfusion occurs during (CV) (Phys)
diastole. Shorter duration of diastole is the major limiting factor for coronary blood supply to
the LV myocardium during periods of tachycardia (e.g. exercise). CV Phys
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952Coronary blood ↑ in resting blood flow to ischemic myocardium are primarily mediated by locally-acting Cardiovascular Pathophysi 9
flow substances (eg, adenosine, NO) that trigger coronary arteriolar vasodilation. Rx arteriolar (CV) ology
vasodilators (eg, adenosine, dipyridamole) mimic the vasodilation that occurs w/ exercise (Patp)
and may cause redistribution of blood flow from ischemic to nonischemic areas of
myocardium, so-called coronary steal. CV Patp
1001
Endocarditis Streptococcus gallolyticus (formerly S bovis) endocarditis and bacteremia are a/w GI lesions Cardiovascular Microbiolo 15
(colon ca) in ~25% of cases. When S gallolyticus is cultured in the blood, workup for colonic (CV) gy (Micr)
malignancy w/ colonoscopy is essential. CV Micr
1002
Endocarditis Viridans streptococci produce dextrans that aid them in colonizing host surfaces, such as Cardiovascular Microbiolo 15
dental enamel and heart valves. These organisms cause subacute BE, classically in pts w/ (CV) gy (Micr)
pre-existing cardiac valvular defects after dental manipulation. CV Micr
1003
Endocarditis Viridans streptococci are normal inhabitants of the oral cavity and are a cause of transient Cardiovascular Microbiolo 15
bacteremia after dental procedures in healthy and diseased individuals. In pts w/ pre-existing (CV) gy (Micr)
valvular lesions, viridans streptococci can adhere to fibrin-platelet aggregates and establish
infection that leads to endocarditis. CV Micr
1014
Dilated Anthracycline CTx agents (e.g. doxorubicin, daunorubicin) cause cardiotox mainly thru the Cardiovascular Pharmacol 8
cardiomyopathy formation of anthracycline-topoisomerase II DNA cleavage complexes that affect healthy (CV) ogy (Phar)
cardiomyocytes. The cardiotox is dependent on the cumulative dose of anthracycline
received, and it manifests as DCM. CV Phar
1040
Acute pericarditis Pericarditis is the most common CV MFx a/w SLE. It presents w/ sharp pleuritic chest pain Cardiovascular Pathology 5
that is relieved by sitting up and leaning forward. (CV) (Path) CV Path
1047
Dilated Thiamine deficiency causes beriberi and Wernicke-Korsakoff syndrome. Dry beriberi is Cardiovascular Biochemist 8
cardiomyopathy characterized by symmetrical peripheral neuropathy; wet beriberi includes the addition of (CV) ry (Bioc)
high-output congestive heart failure. CV Bioc
1080
Peripheral vascular SSx Mx PVD includes a graded exercise program and cilostazol. Cilostazol is a PDEI that Cardiovascular Pharmacol 4
disease inhibs platelet aggregation and acts as a direct arterial vasodilator. Pts w/ PVD should also (CV) ogy (Phar)
receive an antiplatelet agent (aspirin or clopidogrel) for 2° prevention of CAD and stroke. CV Phar
1082
Myocardial In the fibrinolytic pathway, tPA converts plasminogen to plasmin, which then breaks down Cardiovascular Pharmacol 18
infarction fibrin clot. The administration of a tPA analogue (eg, alteplase, tenecteplase, streptokinase) (CV) ogy (Phar)
triggers fibrinolysis and can restore myocardial perfusion in pts w/ STEMI who cannot
undergo timely PCI. CV Phar
1118
Phosphodiesterase ANP, BNP, and NO activate guanylyl cyclase and ↑ conversion of GTP to cGMP. PDEIs (e. Cardiovascular Pharmacol 1
inhibitors g. sildenafil) ↓ the degradation of cGMP. ↑ intracellular cGMP lvls lead to relaxation of (CV) ogy (Phar)
vascular smooth muscle and vasodilation. CV Phar
1164
Sympathomimetic Blanching of a vein into which NE is being infused together w/ induration and pallor of the Cardiovascular Pharmacol 5
agents tissues surrounding the IV site are signs of NE extravasation and resulting vasoconstriction. (CV) ogy (Phar)
Tissue necrosis is best prevented by local injection of an α1 blocking drug, such as
phentolamine. CV Phar
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1166
ACE inhibitors ACEIs and ARBs ↓ the risk of CKD in pts w/ HTN and DM. ACEIs ↑ lvls of bradykinin and Cardiovascular Pharmacol 7
can cause nonproductive cough, an effect not see w/ ARBs. (CV) ogy (Phar) CV Phar
1196
Myocardial β blockers are used in AMI to ↓ morbidity and mortality by ↓ CO and myocardial O2 Cardiovascular Pharmacol 18
infarction demand. Non-cardioselective β blockers (e.g. propranolol, nadolol) can trigger (CV) ogy (Phar)
bronchospasm in pts w/ underlying asthma and COPD. Cardioselective β blockers (e.g.
metoprolol) predominantly affect β1 receptors and are preferred in such pts. CV Phar
1200
Anticoagulants Warfarin is an oral anticoagulant that inhibits the carboxylation of vitamin K-dependent Cardiovascular Pharmacol 8
coagulation factors II, VII, IX, and X. It is used in AF, DVT, and pulm TE. PT/INR should (CV) ogy (Phar)
be monitored regularly during Tx w/ warfarin. aPTT is used for monitoring UFH. CV Phar
1229
Sensitivity and When undergoing Dx testing, pts w/ the disease can test (+) (true (+), TP) or (-) (false (-), Cardiovascular Biostatistic 4
specificity FN). The sensitivity of a test determines the proportion of pts that are correctly classified: (CV) s (Bios)
TP = (Sensitivity) x (Number of pts w/ the disease)
FN = (1 - Sensitivity) x (Number of pts w/ the disease) CV Bios
1252
Primary Direct arteriolar vasodilators ↓ BP but trigger reflex sympathetic activation and stimulate the Cardiovascular Pharmacol 14
hypertension RAA axis. This results in tachycardia and edema. To counteract such compensatory effects, (CV) ogy (Phar)
these agents are often given in combination w/ sympatholytics and diuretics. CV Phar
1283
Comparing 2 means The two-sample t test is a statistical method commonly employed to compare the means of 2 Cardiovascular Biostatistic 1
groups of subjects. (CV) s (Bios) CV Bios
1301
Bias The main purpose of blinding is to prevent pt or researcher expectancy from interfering w/ an Cardiovascular Biostatistic 4
outcome. (CV) s (Bios) CV Bios
1342
Orthostatic Orthostatic hypotension is a frequent cause of light-headedness and syncope and is defined Cardiovascular Pharmacol 1
hypotension as a ↓ in SBP (>20mmHg) or DBP (>10mmHg) on standing from the supine position. Rx (CV) ogy (Phar)
(α1-adrenergic antagonists, diuretics), volume depletion, and autonomic dysfxn are common
causes of orthostatic hypotension. CV Phar
1343
Alpha agonists α-adrenergic agonists ↑ SBP and DBP by stimulating α1-adrenoreceptors in the vascular Cardiovascular Pharmacol 1
walls, causing vasoconstriction. The ↑ systemic BP then causes a reflexive ↑ in vagal tone, (CV) ogy (Phar)
resulting in ↓ HR and slowed AV node conduction. CV Phar
1344
Cardiogenic shock Dobutamine is a β adrenergic agonist w/ predominant activity on β1 receptors. It causes an ↑ Cardiovascular Pharmacol 1
in HR and cardiac contractility, leading to an ↑ in myocardial O2 consumption. (CV) ogy (Phar) CV Phar
1364
Sympathomimetic EPI ↑ SBP (α1 + β1) and HR (β1), and either ↑ or ↓ DBP depending on the dose (either α1 or Cardiovascular Pharmacol 5
agents β2 predominates). PreTx w/ propranolol eliminates the β effects of EPI (vasodilation and (CV) ogy (Phar)
tachycardia), leaving only the α effect (vasoconstriction). CV Phar
1367
Sympathomimetic NE stim cardiac β1 adrenoceptors, which ↑ cAMP concentration w/i cardiac myocytes and Cardiovascular Pharmacol 5
agents leads to ↑ contractility, conduction, and HR. Peripheral vasoconstriction occurs via stim of (CV) ogy (Phar)
α1 adrenoreceptors in vascular smooth muscle cells and activation of an IP3 signalling
pathway. CV Phar
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1439
Cardiac tamponade The combo of JVD, hypotension, and muffled heart sounds is highly suggestive of cardiac Cardiovascular Pathology 2
tamponade. Tachycardia and pulsus paradoxus are also freq seen w/ tamponade. Lung Ex is (CV) (Path)
normal, which can help distinguish cardiac tamponade from tension PTX. CV Path
1444
Beta blocker Pts who have OD'd on β blockers should be Tx w/ glucagon, which ↑ HR and contractility Cardiovascular Pharmacol 1
poisoning independent of adrenergic receptors. Glucagon activates GPCRs on cardiac myocytes, (CV) ogy (Phar)
causing activation of adenylate cyclase and ↑ intracellular cAMP. The result is Ca2+ release
from intracellular stores and ↑ SA node firing. CV Phar
1505
SLE Procainamide and hydralazine have the highest risk of causing DILE, which is Chx by the Cardiovascular Pharmacol 7
development of lupus-like SSx in addition to (+) ANA and anti-histone Abs. Unlike w/ SLE, (CV) ogy (Phar)
anti-dsDNA Abs are rarely seen. CV Phar
1506
Antiarrhythmic Sotalol has both β adrenergic-blocking and class III antiarrhythmic (K+ channel-blocking) Cardiovascular Pharmacol 12
drugs properties and is occasionally used in Tx of AF. Major AEs of sotalol include bradycardia, (CV) ogy (Phar)
proarrhythmia, and most commonly TdP due to QT interval prolongation. CV Phar
1507
Antiarrhythmic Class III antiarrhythmic Rx (amiodarone, sotalol, dofetilide) predominantly block K channels Cardiovascular Pharmacol 12
drugs and inhibit the outward K currents during phase 3 of the cardiac AP, thereby prolonging (CV) ogy (Phar)
repolarization and total AP duration. CV Phar
1508
Antiarrhythmic Class IC antiarrhythmic agents (flecainide) block the fast Na+ channels responsible for Cardiovascular Pharmacol 12
drugs ventricular depol (phase 0), prolonging QRS duration w/ little effect on the QT interval. (CV) ogy (Phar)
Class IA and class III agents cause the most QT prolongation. CV Phar
1509
Antiarrhythmic The class IA antiarrhythmics (quinidine, procainamide, and disopyramide) are Na+ channel- Cardiovascular Pharmacol 12
drugs blocking agents that depress phase 0 depol. They also prolong repol due to moderate K+ (CV) ogy (Phar)
channel-blocking activity, ↑ AP duration in cardiac myocytes. CV Phar
1510
Cardiac physiology An ↑ in effective SV or EF is depicted on the LV pressure-volume relationship by widening Cardiovascular Physiology 6
of the loop w/ a shift in the isovolumic relaxation line to the left (indicating less residual (CV) (Phys)
blood volume in the ventricle at end-systole). CV Phys
1511
Cardiac physiology Pressure-volume loops represent the relationship b/w pressure and volume in the LV during Cardiovascular Physiology 6
systole and diastole. An ↑ in the circulating volume ↑ preload (LV EDV) and causes a (CV) (Phys)
rightward widening of the pressure-volume loop. CV Phys
1512
Hypovolemic shock Intravenous fluids increase the intravascular and left ventricular end-diastolic volumes. The Cardiovascular Physiology 1
increase in preload stretches the myocardium and increases the end-diastolic sarcomere (CV) (Phys)
length, leading to an increase in stroke volume and cardiac output by the Frank-Starling
mechanism. CV Phys
1513
Cardiac physiology The cardiac AP conduction speed is slowest in the AV node and fastest in the Purkinje Cardiovascular Physiology 6
system. Conduction speed of the atrial muscle is faster than that of the ventricular muscle. (CV) (Phys) CV Phys
1515
Carotid Carotid sinus massage leads to an ↑ in PSNS tone causing temporary inhib of SA node Cardiovascular Physiology 1
baroreceptors activity, slowing of conduction thru the AV node, and prolongation of the AV node (CV) (Phys)
refractory period. It's a useful vagal manoeuvre for termination of PSVT. CV Phys
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1516
Coronary blood Coronary autoregulation allows coronary blood flow to be 1arily driven by myocardial O2 Cardiovascular Physiology 9
flow demand over a wide range of perfusion pressures (60-140mmHg). It's mostly accomplished (CV) (Phys)
by alterations in vascular resistance via release of adenosine and NO in response to
myocardial hypoxia. CV Phys
1517
Mitral stenosis The classic cardiac auscultation findings in MV stenosis include an OS f/b a diastolic Cardiovascular Physiology 7
rumbling murmur that is heard best over the apex of the heart. On the ventricular pressure- (CV) (Phys)
volume loop, MV opening occurs at the point b/w isovolumetric relaxation and diastolic
filling. CV Phys
1518
AV fistula and P/V AV shunts can be congenital or acquired; acquired forms can result from medical Cardiovascular Physiology 1
curves interventions or penetrating injuries. AV shunts ↑ preload and ↓ afterload by routing blood (CV) (Phys)
directly from the arterial system to the venous system, bypassing the arterioles. High-volume
AV shunts can eventually result in high-output cardiac failure. CV Phys
1528
Pulmonary blood The circulatory system is a continuous circuit, and therefore the volume output of the left Cardiovascular Physiology 2
flow ventricle must closely match the output of the right ventricle. This balance is necessary to (CV) (Phys)
maintain continuous blood flow through the body and exists both at rest and during exercise. CV Phys
1529
Cardiac physiology The Fick principle can be applied to calculate CO using the rate of O2 consumption and the Cardiovascular Physiology 6
AV O2 content difference: (CV) (Phys)
CO = rate of O2 consumption / AV O2 content difference CV Phys
1530
LV volume and Ventricular pressure and volume curves allow 1 to ID the phases of the cardiac cycle and to Cardiovascular Physiology 1
pressure determine the exact time of opening and closure of the cardiac valves. The AV opens when (CV) (Phys)
LVP exceeds the central aortic pressure at the end of isovolumetric contraction. CV Phys
1531
Cardiac physiology In cardiac pacemaker cells, phase 0 depol is mediated by an inward flux of Ca2+. This differs Cardiovascular Physiology 6
from phase 0 of cardiomyocytes and Purkinje cells, which results from an inward Na+ (CV) (Phys)
current. CV Phys
1532
Chronic heart The ↓ CO in HF leads to ↓ renal perfusion and conseq stim of the RAAS in a maladaptive Cardiovascular Pathophysi 12
failure effort to maintain effective BV. Inactive AT-I is converted into active AT-II by endothelial- (CV) ology
bound ACE in the lungs. (Patp) CV Patp
1538
Pulmonary The IVC courses through the abdomen and inferior thorax in a location anterior to the right Cardiovascular Anatomy 13
embolism half of the vertebral bodies. The renal veins join the IVC at the lvl of L1/L2, and the common (CV) (Anat)
iliac veins merge to become the IVC at the lvl of L5. IVC filters are placed in pts w/ DVT
who have c/i to anticoagulation Thx. CV Anat
1557
Heart sounds The 3rd heart sound (S3) is a low-frequency sound occurring during early diastole after S2. Cardiovascular Physiology 1
LV gallops (S3 a/o S4) are best heard w/ the bell of the stethoscope over the cardiac apex (CV) (Phys)
while the pt is in the left lateral decubitus position at end expiration. CV Phys
1565
Chronic heart Neurohormones (e.g. NE, ATII, and aldosterone) play a large role in the deleterious cardiac Cardiovascular Pharmacol 12
failure remodelling that occurs in HF w/ ↓ EF. ACEIs, ARBs, MRBs, and β blockers ↓ mortality in (CV) ogy (Phar)
these pts by ↓ neurohormonal-mediated cardiac remodelling. CV Phar
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1578
Cor pulmonale Peripheral edema results from the accumulation of fluid in the interstitial spaces. Factors that Cardiovascular Pathophysi 1
promote edema include elevated capillary hydrostatic pressure, decreased plasma oncotic (CV) ology
pressure, sodium and water retention, and impaired lymphatic drainage. In chronic heart (Patp)
failure, increased lymphatic drainage initially offsets factors favoring edema, whereas acute
changes (eg, venous thrombosis, heart failure decompensation) are more likely to produce
edema. CV Patp
1589
Physical exercise The cardioresp response to exercise includes ↑ HR, CO, and RR in order to balance the ↑ Cardiovascular Physiology 2
total tissue O2 consumption and CO2 production. These coordinated adaptations result in (CV) (Phys)
relatively constant ABG values whereas venous O2 is ↓ and venous CO2 is ↑. CV Phys
1591
Mitral stenosis Under normal circumstances, PCWP closely reflects LA and LV EDP. MS leads to an ↑ in Cardiovascular Physiology 7
the LA pressure that is reflected as ↑ PCWP during pulm artery catheterization. LV filling (CV) (Phys)
may be normal, resulting in an ↑ pressure gradient b/w the LA and LV during diastole. CV Phys
1609
Carotid sinus The carotid sinus is a dilation of the ICA located just above the bifurcation of the CCA. The Cardiovascular Physiology 1
hypersensitivity carotid sinus reflex has an afferent limb that arises from the baroreceptors in the carotid sinus (CV) (Phys)
and travels to the vagal nucleus and medullary centers via the glossopharyngeal nerve (CN
IX); the efferent limb carries parasympathetic impulses via the vagus nerve (CN X). CV Phys
1621
Renal artery Blood flow is directly proportional to the vessel radius raised to the fourth power. Resistance Cardiovascular Physiology 9
stenosis to blood flow is inversely proportional to the vessel radius raised to the fourth power. (CV) (Phys) CV Phys
1622
Physical exercise Exercising muscles can receive up to 85% of the total CO during periods of strenuous Cardiovascular Physiology 2
activity. Although sympathetic discharge during exercise causes ↑ CO and splanchnic (CV) (Phys)
vasoconstriction, there's only a modest ↑ in mean BP as vasodilation w/i active skeletal
muscles significantly ↓ the total SVR. CV Phys
1623
Left atrial CV dysphagia can result from external compression of the esophagus by a dilated and Cardiovascular Anatomy 1
enlargement posteriorly displaced LA in pts w/ RHD and MS/MR. (CV) (Anat) CV Anat
1624
Cardiac output and MI causes a sharp ↓ in CO due to loss of fxn of a zone of myocardium. On a cardiac fxn Cardiovascular Physiology 2
venous return curve, MI would ↓ both the slope and the maximal height of the line. (CV) (Phys) CV Phys
1625
Cardiac output and A chronic AV shunt would ↑ CO b/c of ↑ sympathetic stimulation to the heart, ↓ TPR, and ↑ Cardiovascular Physiology 2
venous return venous return. It would also cause the venous return curve to shift to the right b/c the (CV) (Phys)
circulating blood volume is ↑ through renal retention of fluids and b/c venous pooling is ↓ by
the ↑ sympathetic tone. CV Phys
1652
Diastolic Na nitroprusside is a short-acting agent that causes balanced vasodilation of the veins and Cardiovascular Physiology 4
dysfunction arteries to ↓ both LV preload and afterload. The balanced vasodilation allows for (CV) (Phys)
maintenance of SV and CO at a ↓ LV pressure (↓ cardiac work). CV Phys
1653
Cardiac pressure Right-sided pressures in the heart are lower than left-sided pressures due to lower resistance Cardiovascular Physiology 1
range in the pulm vasculature. RV diastolic pressure is similar to RA/CVP (1-6 mm Hg), whereas (CV) (Phys)
pulm artery diastolic pressure is slightly higher (6-12 mm Hg) due to resistance to flow in the
pulm circulation. CV Phys
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1661
Aortic regurgitation AR causes an ↑ in total SV w/ abrupt distension and rapid falloff of peripheral arterial pulses, Cardiovascular Physiology 8
resulting in a wide PP. This leads to bounding peripheral pulses and head bobbing w/ each (CV) (Phys)
heartbeat. CV Phys
1699
Penetrating thoracic The RV composes most of the heart's anterior surface. A deep, penetrating injury at the left Cardiovascular Anatomy 2
trauma sternal border in the 4th ICS would puncture the RV. (CV) (Anat) CV Anat
1705
Tetralogy of Fallot TOF results from anterior and cephalad deviation of the infundibular septum during Cardiovascular Embryolog 3
embryologic development, resulting in a malaligned VSD w/ an overriding aorta. As a result. (CV) y (Embr)
the pt has RV outflow obstruction (resulting in a systolic murmur) and squats to ↑ the
peripheral SVR (afterload) and ↓ right-to-left shunting across the VSD. CV Embr
1750
Embryologic The 1st AA gives rise to a portion of the maxillary artery, and the 2nd AA gives rise to the Cardiovascular Embryolog 2
derivatives stapedial artery, which typically regresses in humans. The 5th AA completely regresses, (CV) y (Embr)
leaving no structures or vestiges in the adult. The 3rd AA forms the CCAs and proximal
ICAs. The 4th AA gives rise to part of the true AA and a portion of the SCAs. The 6th AA
gives rise to the pulm arteries and the ductus arteriosus. CV Embr
1751
Patent ductus The ductus arteriosus is derived from the sixth embryonic aortic arch. A patent ductus Cardiovascular Anatomy 4
arteriosus arteriosus (PDA) causes left-to-right shunting of blood that can be heard as a continuous (CV) (Anat)
murmur over the left infraclavicular region. Indomethacin (a PGE2 synthesis inhibitor) can
be used to close a PDA in premature infants, but surgical ligation is often necessary in older
patients. CV Anat
1780
Aging Digoxin is a cardiac glycoside that's predominantly cleared by the kidneys. Elderly pts Cardiovascular Pharmacol 8
typically exhibit age-related renal insufficiency, even in the presence of normal creatinine (CV) ogy (Phar)
lvls. The dose of digoxin must be ↓ in these pts to prevent tox. CV Phar
1782
Pericardial effusion PP refers to an exaggerated drop (>10 mm Hg) in SBP during inspiration. It is most Cardiovascular Physiology 1
commonly seen in pts w/ CT but can also occur in severe asthma, COPD, hypovolemic (CV) (Phys)
shock, and constrictive pericarditis. CV Phys
1805
Varicocele Pressure in the left renal vein may become ↑ due to compression where the vein crosses the Cardiovascular Anatomy 1
aorta beneath the SMA. This "nutcracker effect" can cause hematuria and flank pain. (CV) (Anat)
Pressure can also be ↑ in the left gonadal vein, leading to formation of a varicocele. CV Anat
1828
Coronary artery Clopidogrel irreversibly blocks the P2Y12 component of ADP receptors on the platelet Cardiovascular Pharmacol 4
disease surface and prevents platelet aggregation. Clopidogrel is as effective as aspirin in the (CV) ogy (Phar)
prevention of CV events in pts w/ coronary heart disease. CV Phar
1836
Beta 2 agonists Isoproterenol is a β1 and β2 adrenergic receptor agonist that causes ↑ myocardial Cardiovascular Pharmacol 1
contractility and ↓ SVR. (CV) ogy (Phar) CV Phar
1852
Kawasaki disease Kawasaki disease is a vasculitis of medium-sized arteries that presents w/ persistent fever for Cardiovascular Pathology 1
>5days, bilateral conjunctivitis, cervical LAD, and mucocutaneous involvement. Coronary (CV) (Path)
artery aneurysms are a serious complication of Kawasaki disease. CV Path
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1871
Coronary blood The inferior wall of the LV forms most of the inferior (diaphragmatic) surface of the heart Cardiovascular Anatomy 9
flow and is supplied by the PDA. In 85%-90% of individuals, the PDA derives from the RCA (CV) (Anat)
(right dominant coronary circulation). CV Anat
1882
Myocardial Ion pump failure due to ATP defic during cardiac ischemia causes intracellular accumulation Cardiovascular Pathology 18
infarction of Na+ and Ca2+. The ↑ intracellular solute conc draws free water into the cell, causing the (CV) (Path)
cellular and mitochondrial swelling that's observed histologically. CV Path
1883
Community On posteroanterior chest x-ray, the right middle lobe is seen adjacent to the right border of Cardiovascular Anatomy 21
acquired pneumonia the heart, which is primarily formed by the right atrium. Consolidation in the right middle (CV) (Anat)
lobe can obscure the X-ray silhouette of the right heart border. CV Anat
1884
CT abdomen The IVC is formed by the union of the right and left common iliac veins at the lvl of L4-L5. Cardiovascular Anatomy 1
The renal arteries and veins lie at the lvl of L1. The IVC returns venous blood to the heart (CV) (Anat)
from the ↓ extremities, portal system, and abdominal and pelvic viscera. CV Anat
1931
Muscle structure Ca efflux from cardiac cells prior to relaxation is primarily mediated via an Na/Ca exchange Cardiovascular Physiology 1
and physiology pump and SR Ca-ATPase pump. (CV) (Phys) CV Phys
1943
Brachiocephalic The BCV drains the ipsilateral jugular and SCVs. The bilateral BCVs combine to form the Cardiovascular Anatomy 1
vein obstruction SVC. BCV obstruction causes SSx similar to those seen in SVC syndrome, but only on one (CV) (Anat)
side of the body. CV Anat
1944
Chronic heart Rx that have been shown to improve long-term survival in pts w/ HF due to LV systolic Cardiovascular Pharmacol 12
failure dysfxn include β blockers, ACEIs, ARBs, and aldosterone antagonists. (CV) ogy (Phar) CV Phar
1947
Dose response Phenoxybenzamine is an irreversible α1 and α2 adrenergic antagonist that effectively ↓ the Cardiovascular Pharmacol 4
curves arterial vasoconstriction induced by NE. B/c phenoxybenzamine is an irreversible antagonist, (CV) ogy (Phar)
even very high concentrations of NE, such as those seen in pheochromocytoma, can't
overcome its effects. CV Phar
1948
Primary β blockers inhibit release of renin from renal juxtaglomerular cells through antagonism of β1 Cardiovascular Pharmacol 14
hypertension receptors on these cells. Inhibition of renin release prevents activation of the RAA pathway, (CV) ogy (Phar)
which results in ↓ vasoconstriction and ↓ renal Na and water retention. CV Phar
1967
CABG The great saphenous vein is a superficial vein of the leg that originates on the medial side of Cardiovascular Anatomy 1
the foot, courses anterior to the medial malleolus, and then travels up the medial aspect of the (CV) (Anat)
leg and thigh. It drains into the femoral vein w/i the region of the femoral triangle, a few cm
inferolateral to the pubic tubercle. CV Anat
1973
Antiarrhythmic Class IV antiarrhythmics (eg, verapamil, diltiazem) are commonly used to prevent recurrent Cardiovascular Physiology 12
drugs nodal arrhythmias (eg, PSVT). They work by blocking Ca channels in slow-response cardiac (CV) (Phys)
tissues, slowing phase 4 (spontaneous depolarization) and phase 0 (upstroke). This ↓ impulse
conduction velocity in the SA and AV nodes. CV Phys
1974
Cardiac AP The cardiac myocyte AP consists of rapid depolarization (phase 0), initial rapid Cardiovascular Physiology 1
repolarization (phase 1), plateau (phase 2), late rapid repolarization (phase 3), and resting (CV) (Phys)
potential (phase 4). The AP is a/w ↑ membrane permeability to Na and Ca and ↓ permeability
to K. CV Phys
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1975
Cardiac physiology The phase 4 slow depolarization in cardiac PM cells occurs due to the closure of repolarizing Cardiovascular Physiology 6
K channels, the slow influx of Na through funny channels, and the opening of T-type Ca (CV) (Phys)
channels. ACh and adenosine ↓ the rate of spontaneous depolarization in cardiac PM cells by
prolonging phase 4. CV Phys
1976
Pacemaker potential Cardiac pacemaker impulse generation normally occurs in the SA node, which has the fastest Cardiovascular Physiology 1
firing rate of all conductive cells. The cells in other areas of the conduction system (eg, AV (CV) (Phys)
node, bundle of His, and Purkinje fibers) may serve as pacemakers if normal impulse
conduction is impaired. CV Phys
1977
Atrial fibrillation AF occurs due to irregular, chaotic electrical activity w/i the atria and Px w/ absent P waves, Cardiovascular Physiology 5
irregularly irregular R-R intervals, and narrow QRS complexes. The AV node refractory (CV) (Phys)
period regulates the number of atrial impulses that reach the ventricle and determines the
ventricular contraction rate in conditions where the atria undergo rapid depolarization. CV Phys
1978
Chronic heart Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are secreted by atrial Cardiovascular Physiology 12
failure and ventricular cardiomyocytes in response to myocardial stretching induced by (CV) (Phys)
hypervolemia. These natriuretic peptides inhibit the renin-angiotensin-aldosterone system
and stimulate peripheral vasodilation and increased urinary excretion of sodium and water.
Neprilysin inhibitors (eg. sacubitril) prevent the degradation of ANP and BNP, enhancing
their beneficial effects in heart failure. CV Phys
1983
Tricuspid A holosystolic murmur that ↑ in intensity on inspiration most likely represents TR. The other Cardiovascular Physiology 3
regurgitation holosystolic murmurs (which are 2° to MR or a VSD) do not typically ↑ in intensity during (CV) (Phys)
inspiration. CV Phys
2002
Primary TZDs ↑ serum Ca, uric acid, Glc, cholesterol, and triglyceride lvls. They ↓ serum Na, K, and Cardiovascular Pharmacol 14
hypertension Mg lvls. (CV) ogy (Phar) CV Phar
2005
Aldosterone All diuretics except for the K-sparing class cause K loss by ↑ Na delivery to the late distal Cardiovascular Pharmacol 3
antagonists tubule and cortical collecting duct, where aldosterone-induced Na reabsorption occurs at the (CV) ogy (Phar)
expense of K. K-sparing diuretics (eg, spironolactone, amiloride) act on the late distal tubule
and cortical collecting duct to antagonize the effects of aldosterone. CV Phar
2006
Antiarrhythmic β blockers ↓ AV nodal conduction, leading to an ↑ AV nodal refractory period. This Cardiovascular Pharmacol 12
drugs correlates to PR interval prolongation on an ECG. (CV) ogy (Phar) CV Phar
2009
Coronary blood Myocardial oxygen extraction exceeds that of any other tissue or organ; therefore, the cardiac Cardiovascular Physiology 9
flow venous blood in the coronary sinus is the most deoxygenated blood in the body. Due to the (CV) (Phys)
high degree of oxygen extraction, increases in myocardial oxygen demand can only be met
by an increase in coronary blood flow. CV Phys
2023
Central venous The common cardinal veins of the developing embryo drain directly into the sinus venosus. Cardiovascular Anatomy 2
catheter These cardinal veins ultimately give rise to the SVC and other constituents of the systemic (CV) (Anat)
venous circulation. CV Anat
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2034
Southern blotting Southern blotting is a technique used to identify DNA mutations. It involves restriction Cardiovascular Biochemist 1
endonuclease digestion of sample DNA, gel electrophoresis, and gene identification w/ a (CV) ry (Bioc)
labeled DNA probe. CV Bioc
2055
Atrial fibrillation Palpitations refer to a subjective sensation/awareness of the heartbeat due to rapid Cardiovascular Physiology 5
arrhythmias or forceful ventricular contractions. AF is the most common cause of an (CV) (Phys)
irregularly irregular rhythm and is detected on ECG by an absence of organized P waves and
varying R-R intervals. CV Phys
2070
Jugular venous On JVP tracings, the 1st peak is the a wave, which is generated by atrial contraction. This is Cardiovascular Pathophysi 1
pulse notably absent in pts w/ AF. (CV) ology
(Patp) CV Patp
2071
Constrictive Calcification and thickening of the pericardium are common features of constrictive Cardiovascular Pathophysi 2
pericarditis pericarditis on CT. CFx include slowly progressive dyspnea, peripheral edema, and ascites. (CV) ology
(Patp) CV Patp
2074
Endocarditis Chronic valvular inflammation and scarring a/w RHD predispose to an ↑ risk of IE, which is Cardiovascular Pathology 15
Chx by valvular vegetations w/ destruction of the underlying cardiac tissue. (CV) (Path) CV Path
2075
Endocarditis Vegetations are caused by bacterial colonization and growth on a sterile fibrin-platelet nidus Cardiovascular Pathology 15
that forms on the damaged/disrupted endothelial surface of the valvular apparatus. (CV) (Path) CV Path
2096
Mitral regurgitation MR results in a blowing, holosystolic murmur heard best over the cardiac apex w/ radiation Cardiovascular Pathophysi 6
to the axilla. RHD is a very common cause of MR in underdeveloped countries. (CV) ology
(Patp) CV Patp
2099
Pulsus paradoxus PP is defined by a ↓ in SBP of >10 mm Hg w/ inspiration. It is most commonly seen in pts Cardiovascular Pathophysi 2
w/ CT but can also occur in severe asthma, COPD, and constrictive pericarditis. (CV) ology
(Patp) CV Patp
2100
Pulsus paradoxus Asthma and COPD exacerbation are the most frequent causes of PP in the absence of Cardiovascular Pathophysi 2
significant pericardial disease. β-adrenergic agonists control acute asthma and COPD (CV) ology
exacerbations by causing bronchial smooth muscle relaxation via ↑ intracellular cAMP. (Patp) CV Patp
2105
Aortic regurgitation AR causes a high-pitched, blowing, diastolic murmur w/ a decrescendo intensity pattern. The Cardiovascular Pathophysi 8
murmur of AR due to aortic root dilation is best heard at the right upper sternal border, (CV) ology
whereas the murmur of AR due to valvular pathology is best heard at the left 3rd ICS. (Patp) CV Patp
2106
Aortic stenosis A bicuspid AV is a common cause of AS in the United States. The classic auscultatory Cardiovascular Pathophysi 8
finding in pts w/ AS is a harsh, crescendo-decrescendo systolic ejection murmur heard best (CV) ology
in the right 2nd ICS w/ radiation to the carotids. (Patp) CV Patp
2107
S4 The 4th heart sound (S4) is a low frequency sound heard at the end of diastole just before S1. Cardiovascular Pathophysi 1
It is due to ↓ LV compliance and is often a/w RCM and LVH. (CV) ology
(Patp) CV Patp
2108
Chronic heart S3 is a low-freq sound occurring immediately after S2 that's commonly a/w ↑ ventricular Cardiovascular Pathophysi 12
failure ESV. S3 freq occurs in the setting of MR and systolic HF (e.g. DCM). (CV) ology
(Patp) CV Patp
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2109
Patent ductus PDA is characterised by a continuous murmur heard best in the left infraclavicular region w/ Cardiovascular Pathophysi 4
arteriosus max intensity at S2. A small PDA is often aSSx and is usually detected incidentally during (CV) ology
routine cardiac auscultation. It occurs most commonly in pts born prematurely and those w/ (Patp)
cyanotic congenital heart disease. CV Patp
2117
Ventricular septal A VSD is a/w a low-pitched, holosystolic murmur at the mid to ↓ left sternal border. It Cardiovascular Pathophysi 2
defect accentuates during maneuvers that ↑ afterload (eg, handgrip maneuver). A small VSD is (CV) ology
usually aSSx and produces a louder murmur due to higher interventricular pressure gradient. (Patp) CV Patp
2124
Coronary blood The coronary sinus communicates freely w/ the RA and will become dilated 2° to any factor Cardiovascular Pathophysi 9
flow that causes ↑ RA pressure. The most common cause is pulm HTN, leading to ↑ right heart (CV) ology
pressures. (Patp) CV Patp
2130
Blunt aortic injury Traumatic aortic rupture is most often caused by the rapid deceleration that occurs in MVCs. Cardiovascular Anatomy 1
The most common site of injury is the aortic isthmus, which is tethered by the ligamentum (CV) (Anat)
arteriosum and is relatively fixed and immobile compared to the adjacent descending aorta. CV Anat
6811
Septic shock Phenylephrine is a selective α1 adrenergic receptor agonist that ↑ PVR and SBP and ↓ PP Cardiovascular Pharmacol 6
and HR. (CV) ogy (Phar) CV Phar
7568
Renal artery In unilateral RAS, the narrowed renal artery causes hypoperfusion of the affected kidney w/ Cardiovascular Pathology 9
stenosis subseq ischemic dmg (e.g. tubular atrophy, interstitial ischemia, glomerular crowding). In (CV) (Path)
contrast, the contralateral kidney is exposed to high BP and typically shows changes of HTN
nephrosclerosis (e.g. arteriolar wall thickening due to hyaline or hyperplastic
arteriolosclerosis). CV Path
7616
Acute heart failure Acute cardiogenic pulm oedema results from ↑ pulm venous pressure. The alveolar Cardiovascular Pathology 7
capillaries become engorged w/ blood and there's a transudation of fluid plasma across the (CV) (Path)
alveolar-capillary membrane, appearing as pink, acellular material w/i the alveoli. CV Path
7640
Torsades de pointes TdP refers to polymorphic ventricular tachycardia that occurs in the setting of a congenital or Cardiovascular Pharmacol 1
acquired prolonged QT interval. TdP is most commonly precipitated by Rx that prolong the (CV) ogy (Phar)
QT interval such as certain antiarrhythmics (sotalol, quinidine), antipsychotics (haloperidol),
and Abx (macrolides, fluoroquinolones). CV Phar
7646
Implantable LV leads in biventricular PMs course through the coronary sinus, which resides in the AV Cardiovascular Anatomy 1
cardioverter groove on the posterior aspect of the heart. (CV) (Anat)
defibrillator CV Anat
7666
Myocardial RV infarction (right-sided HF) can lead to shock via impaired forward blood flow to the left Cardiovascular Pathology 18
infarction heart, which ↓ left-sided preload (↓ PCWP) and ↓ CO. The ↓ RV output also ↑ RA and CVP. (CV) (Path) CV Path
7667
Myocardial Severe systemic hypotension (eg, shock) is most likely to cause ischemia 1st in areas of high Cardiovascular Pathology 18
infarction metabolic demand (eg, hippocampus) or watershed zones, which are areas that are supplied (CV) (Path)
by the distal branches of two different major arteries. Commonly affected areas in the colon
include the splenic flexure and RSJ. CV Path
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8282
Catheter related The most important steps for prevention of CVC infections are as follows: Cardiovascular Microbiolo 3
bloodstream Proper hand hygiene (CV) gy (Micr)
infection Full barrier precautions during insertion
Chlorhexidine skin disinfection
Avoidance of the femoral insertion site
Removal of the catheter when it is no longer needed CV Micr
8289
Beta blockers β1 adrenergic receptors are found in cardiac tissue and on renal JGA cells, but not in vascular Cardiovascular Pharmacol 3
smooth muscle. Selective blockade of the β1 receptor (e.g. w/ atenolol) leads to ↓ cAMP lvls (CV) ogy (Phar)
in cardiac and renal tissue w/o significantly affecting cAMP lvls in vascular smooth muscle. CV Phar
8291
Pharmacokinetics Clearance (CL) determines the dose rate required to maintain a steady-state plasma Cardiovascular Pharmacol 1
concentration (Cpss): #6nov (CV) ogy (Phar)
Maintenance dose = Cpss x CL / [Bioavailability fraction]
The bioavailability fraction = 1 if administered IV. CV Phar
8292
Turner syndrome TS is a/w congenital anomalies of the aorta, and the most common defect is a bicuspid AV. Cardiovascular Genetics 8
A nonstenotic bicuspid AV can MFx as an early systolic, high-frequency click over the right (CV) (Gene)
2nd interspace. Bicuspid AVs are at risk for stenosis, insufficiency, and infection. CV Gene
8293
Supine hypotension Pregnant women > 20 wks gestation can experience compression of the IVC by the gravid Cardiovascular Physiology 1
uterus while in the supine position. This ↓ venous return and CO, which can result in (CV) (Phys)
hypotension and syncope. CV Phys
8294
Tricuspid IE in IVDUs commonly affects the TV, often leading to septic pulm emboli. Pts can have an Cardiovascular Anatomy 3
regurgitation early- or holo-systolic murmur of TR, which is best auscultated in the 4th or 5th ICS at the (CV) (Anat)
left lower sternal border. CV Anat
8296
Atrial myxoma Myxomas are the most common 1° cardiac neoplasm and usually arise w/i the LA. The Cardiovascular Pathology 3
tumours typically cause position-dependent obstr of the MV, leading to a mid-diastolic (CV) (Path)
murmur and SSx of ↓ CO (e.g. dyspnoea, syncope). Constitutional SSx (e.g. fever, weight
loss) may also be present. Histologically, the tumours demonstrate scattered cells w/i a
mucopolysaccharide stroma and abn blood vessels w/ hemorrhaging. CV Path
8332
Echocardiography The LA forms the majority of the posterior surface of the heart and resides adjacent to the Cardiovascular Anatomy 2
esophagus. Enlargement of the LA can compress the esophagus and cause dysphagia. (CV) (Anat) CV Anat
8333
Echocardiography The descending thoracic aorta lies posterior to the esophagus and the LA. This position Cardiovascular Anatomy 2
permits clear visualization of the descending aorta by TEE, allowing for the detection of (CV) (Anat)
abnormalities such as dissection or aneurysm. CV Anat
8458
Electrical injury Although lightning injuries are rare, they are a/w a 25% fatality rate. Two-3rds of lightning- Cardiovascular Pathology 1
related deaths occur w/i the 1st hr after injury, w/ fatal arrhythmias and resp failure as the (CV) (Path)
most common causes. Pts w/ minor cutaneous involvement may still have major internal
injury after lightning strikes and high-voltage electrical contact. CV Path
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8546
Chronic heart The ↓ CO in HF triggers compensatory activation of the SNS and RAAS, resulting in Cardiovascular Physiology 12
failure vasoconstriction (↑ afterload), fluid retention (↑ preload), and deleterious cardiac (CV) (Phys)
remodelling. These mechs perpetuate a downward spiral of cardiac deterioration, leading to
SSx DHF. CV Phys
8563
Arginine in NO Nitric oxide is synthesized from arginine by nitric oxide synthase. As a precursor of nitric Cardiovascular Physiology 1
production oxide, arginine supplementation may play an adjunct role in the treatment of conditions that (CV) (Phys)
improve with vasodilation, such as stable angina. CV Phys
8610
Acute heart failure The CXR in ADHF typically shows prominent pulm vessels; patchy, bilateral airspace Cardiovascular Pathology 7
opacification; and blunting of the costophrenic angles due to pleural effusions. (CV) (Path) CV Path
8711
Collagen types Type I collagen is the most prevalent collagen in the human body and is the 1° collagen in Cardiovascular Histology 1
mature scars. (CV) (Hist) CV Hist
8869
Antiarrhythmic Class 10 antiarrhythmics such as flecainide are potent sodium channel blockers that have Cardiovascular Pharmacol 12
drugs increased effect at faster heart rates (use-dependence). This makes them more effective at (CV) ogy (Phar)
treating tachyarrhythmias, but can also cause prolonged QRS duration (a proarrhythmic
effect) at higher heart rates. CV Phar
10467
Myocardial Leads I and aVL correspond to the lateral limb leads on ECG. Therefore, ST elevation or Q Cardiovascular Anatomy 18
infarction waves in these leads are indicative of infarction involving the lateral aspect of the left (CV) (Anat)
ventricle, which is supplied by the left circumflex artery. CV Anat
11636
Atherosclerosis Atherosclerosis is a PPx process involving endothelial cell dysfxn, and it develops most Cardiovascular Pathology 8
rapidly in areas w/ bends and branch points that encourage turbulent blood flow. The lower (CV) (Path)
abdo aorta and coronary arteries are the vascular beds most susceptible to atherosclerosis;
they tend to develop atherosclerosis earliest in life and have the highest overall
atherosclerotic burden. CV Path
11640
Costochondritis Costosternal syndrome (costochondritis) usually occurs after repetitive activity and is Cardiovascular Pathology 1
characterised by pain that is reproducible w/ palpation and worsened w/ movement or (CV) (Path)
changes in position. CV Path
11730
Sinoatrial node The SA node consists of specialized PM cells located at the jxn of the RA and SVC. It is the Cardiovascular Anatomy 1
site of earliest electrical activation in pts w/ sinus rhythm. (CV) (Anat) CV Anat
11745
Chronic heart Neprilysin is responsible for the breakdown of the natriuretic peptides and AT-II; therefore, Cardiovascular Physiology 12
failure inhibition of neprilysin ↑ the activity of these peptides. For Tx of HF, neprilysin inhibition is (CV) (Phys)
combined w/ AT-II receptor blockade to optimize the (+) effects of the natriuretic peptides
(eg, vasodilation, diuresis) while blocking the (-) effects of AT-II (eg, vasoconstriction, fluid
retention). CV Phys
11763
Central venous The femoral triangle (lateral to medial) consists of the femoral nerve, femoral artery, femoral Cardiovascular Anatomy 2
catheter vein, and deep inguinal nodes/lymphatic vessels. Cannulation of the femoral vein should (CV) (Anat)
occur approximately 1 cm below the inguinal ligament and just medial to the femoral artery
pulsation. CV Anat
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11764
Cardiac The optimal site for obtaining vascular access in the lower extremity during cardiac Cardiovascular Anatomy 2
catheterization catheterization is the common femoral artery below the inguinal ligament. Cannulation above (CV) (Anat)
the inguinal ligament can significantly ↑ the risk of retroperitoneal hemorrhage. CV Anat
11780
Pulmonary blood PAOP is measured at the distal tip of the pulm artery catheter after an inflated balloon Cardiovascular Anatomy 2
flow occludes blood flow through a pulm artery branch. It closely corresponds to LA and LV (CV) (Anat)
EDP. CV Anat
11797
Wolff-Parkinson- WPW pattern is characterised by a shortened PR interval, widening of the QRS complex, and Cardiovascular Pathophysi 2
White syndrome slurred initial upstroke of the QRS complex (δ wave). It's caused by an accessory pathway (CV) ology
that bypasses the AV node, causing preexcitation of the ventricles. Pts w/ WPW pattern can (Patp)
develop SSx arrhythmia (e.g. AV re-entrant tachycardia) due to re-entry of electrical
impulses thru the accessory conduction pathway. CV Patp
11831
Coronary artery The inferior epigastric artery is 1 of 2 branches of the external iliac artery and takes off Cardiovascular Anatomy 4
disease immediately proximal to the inguinal ligament. It provides blood supply to the lower anterior (CV) (Anat)
abdominal wall as it runs superiorly and medially up the abdomen. CV Anat
11832
Retinal artery RAO is a cause of acute, painless, monocular vision loss. It is usually caused by TE Cardiovascular Anatomy 1
occlusion complications of atherosclerosis traveling from the ICA and through the ophthalmic artery. (CV) (Anat) CV Anat
11833
Myocardial The dominant RCA perfuses both the inferior wall of the LV and the majority of the RV. Cardiovascular Pathophysi 18
infarction Proximal occlusion can cause RV MI, which Px w/ hypotension (↓ CO) and distended (CV) ology
jugular veins (↑ CVPs). The lungs will be clear on auscultation and XR (lack of pulm edema) (Patp)
unless concomitant left-sided HF is also present. CV Patp
11836
Nitrates Nitrates are primarily venodilators and increase peripheral venous capacitance, thereby Cardiovascular Pharmacol 7
reducing cardiac preload and left ventricular end-diastolic volume and pressure. Nitrates also (CV) ogy (Phar)
have a modest effect on arteriolar dilation and cause a decrease in systemic vascular
resistance and cardiac afterload. CV Phar
11837
Coronary blood Coronary dominance is determined by the coronary artery supplying the PDA. The PDA Cardiovascular Anatomy 9
flow originates from the RCA in approximately 70%-80% of pts (right dominant), both the RCA (CV) (Anat)
and LCX in 10%-20% (codominant), and the LCX in 5%-10% (left dominant). The dominant
coronary artery supplies blood to the AV node via the AV nodal artery. CV Anat
11842
Atrial fibrillation AF is a/w ↑ risk of systemic TE. The LA appendage is the most common site of thrombus Cardiovascular Anatomy 5
formation. (CV) (Anat) CV Anat
11844
Dyslipidemia Fibrates lower TG lvls by activating PPAR-α, which leads to ↓ hepatic VLDL production and Cardiovascular Pharmacol 11
↑ LPL activity. Fish oil supplements containing high concentrations of ω-3 FAs ↓ TGs by ↓ (CV) ogy (Phar)
production of VLDL and apoB. CV Phar
11849
Primary PRA is a measure of the amount of ATI generated per unit of time. It provides a useful Ax of Cardiovascular Pathophysi 14
hypertension the RAA axis. Factors that ↑ PRA incl low Na+ intake and anti-HTN Rx such as diuretics (e. (CV) ology
g. hydrochlorothiazide), ACEIs, and ARBs (e.g. valsartan). (Patp) CV Patp
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11851
Mitral regurgitation Regurg flow into the LA in acute MR leads to ↑ LA pressure and ↑ LV EDV (preload). The Cardiovascular Pathophysi 6
low-resistance pathway also ↓ LV afterload w/ a resulting ↑ in EF but overall ↓ in forward (CV) ology
SV. ↑ LA pressure and ↓ CO result in pulm oedema and severe hypotension, respectively. (Patp) CV Patp
11925
Sympathomimetic Dobutamine is a β-adrenergic agonist w/ predominant activity on β1 receptors and weak Cardiovascular Pharmacol 5
agents activity on β2 and α receptors. Stimulation of β2 receptors leads to an ↑ production of cAMP (CV) ogy (Phar)
and ↑ cytosolic Ca concentration. This facilitates the interaction b/w actin and myosin,
resulting in ↑ myocardial contractility. CV Phar
11956
AV node The AV node is located on the endocardial surface of the RA, near the insertion of the septal Cardiovascular Anatomy 1
leaflet of the TV and the orifice of the coronary sinus. (CV) (Anat) CV Anat
12046
Subclavian steal Subclavian steal syndrome occurs due to severe stenosis of the proximal SCA, which leads to Cardiovascular Anatomy 1
syndrome reversal in blood flow from the contralateral vertebral artery to the ipsilateral vertebral artery. (CV) (Anat)
Pts may have SSx related to arm ischemia in the affected extremity (eg, exercise-induced
fatigue, pain, paresthesias) or vertebrobasilar insufficiency (eg, dizziness, vertigo). CV Anat
12144
Myocardial Papillary muscle rupture is a life-threatening complication that typically occurs 3-5 days after Cardiovascular Anatomy 18
infarction MI and presents w/ acute MR and pulm edema. The posteromedial papillary muscle is (CV) (Anat)
supplied solely by the PDA, making it susceptible to ischemic rupture. CV Anat
12151
Aortic dissection The intimal tear in Stanford type A AD (involving the ascending aorta) usually originates in Cardiovascular Anatomy 6
the sinotubular jxn whereas the intimal flap in Stanford type B AD usually starts near the (CV) (Anat)
origin of the left SCA. Dissections can propagate distally to the thoracoabdominal aorta. CV Anat
12187
Endocarditis During the normal cardiac cycle, central aortic pressure is higher than RV pressure during Cardiovascular Physiology 15
systole and diastole. Consequently, an intracardiac fistula b/w the aortic root and RV will (CV) (Phys)
most likely demonstrate a left-to-right cardiac shunt as blood continuously flows from the
aortic root (high pressure) to the RV (low pressure). CV Phys
13600
Dilated AD mutations in the TTN gene, which encodes for the sarcomere protein titin, are the most Cardiovascular Genetics 8
cardiomyopathy common cause of familial DCM. (CV) (Gene) CV Gene
13979
Septic shock Septic shock causes widespread arteriolar vasodilation, which leads to a decrease in systemic Cardiovascular Pathophysi 6
vascular resistance and a compensatory increase in cardiac output. Central venous pressure (CV) ology
and pulmonary capillary wedge pressure are also decreased due to pooling of blood in the (Patp)
dilated veins Increased flow rates through the peripheral capillaries lead to incomplete
oxygen extraction by the tissues and high mixed venous oxygen saturation. CV Patp
14743
Atrial fibrillation AF is recognized by an irregularly irregular rhythm w/ variable R-R intervals and absence of Cardiovascular Physiology 5
P waves on ECG. The development of AF most commonly involves ectopic electrical foci in (CV) (Phys)
the pulm veins that trigger fibrillatory conduction in abnormal (remodeled) atrial tissue. CV Phys
14745
Atrial flutter Atrial flutter demonstrates rapid and regular atrial activity in a saw-toothed pattern (flutter or Cardiovascular Physiology 1
F waves) on ECG. Typical atrial flutter is caused by a large re-entrant circuit that traverses (CV) (Phys)
the cavotricuspid isthmus of the RA, which is the target site for radiofrequency ablation. CV Phys
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14780
Bradycardia Conduction impairment is common w/ acute inferior wall MI. Sinus bradycardia often occurs Cardiovascular Pharmacol 1
due to nodal ischaemia and an ↑ in vagal tone triggered by infarction of myocardial tissue; (CV) ogy (Phar)
the ↑ vagal tone can be counteracted by the antichol effects of atropine. CV Phar
14789
Myocarditis Acute myocarditis is most commonly caused by a viral infection (e.g. coxsackievirus, Cardiovascular Pathology 1
adenovirus, influenza). It often resolves w/o noticeable SSx, but pts can develop serious (CV) (Path)
complications, incl decompensated HF due to DCM or SCD due to ventricular arrhythmia.
Histopathology typically demonstrates myofibrillary necrosis w/ inflammatory mononuclear
infiltrate. CV Path
14844
Dilated Trastuzumab is a mAb that blocks HER2 to disrupt malignant cell signalling and encourage Cardiovascular Pharmacol 8
cardiomyopathy apoptosis. B/c HER2 helps preserve cardiomyocyte fxn, trastuzumab can cause cardiotox (CV) ogy (Phar)
that manifests as a ↓ in myocardial contractility w/o cardiomyocyte destruction or myocardial
fibrosis. CV Phar
14959
Pulmonary arterial Pulmonary arterial hypertension results from endothelial dysfunction that leads to an increase Cardiovascular Pathophysi 8
hypertension in vasoconstrictive, proproliferative mediators (eg, endothelin, thromboxane A2) and a (CV) ology
decrease in vasodilative, antiproliferative mediators (eg, nitric oxide, prostacyclin). The (Patp)
relative imbalance in these mediators leads to vasoconstriction and intimal-wall thickening
with a consequent increase in pulmonary vascular resistance. CV Patp
14964
Aortic stenosis AS most commonly results from age-related CAVD. The early pathogenesis of CAVD Cardiovascular Pathology 8
closely mimics that of arterial atherosclerosis. In the later stages, fibroblasts diffiate into (CV) (Path)
osteoblast-like cells and deposit bone matrix, leading to progr valvular calcification and
stenosis. CV Path
14966
Aortic stenosis Angina often occurs in AS even in the absence of obstr CAD. It results from ↑ myocardial Cardiovascular Pathophysi 8
O2 demand due to an ↑ in LV mass (i.e. concentric hypertrophy) and ventricular wall stress. (CV) ology
(Patp) CV Patp
14976
Aortic regurgitation AR causes a rapid fall in aortic pressure during diastole w/ an ↑ in LV EDV and a Cardiovascular Physiology 8
compensatory ↑ in SV. These hemodynamic changes create Chx pressure changes, including (CV) (Phys)
↓ aortic diastolic pressure, ↑ aortic systolic pressure, and ↑ LV diastolic and systolic
pressures. CV Phys
14978
Myocardial MI that causes ischemia of the papillary muscle or nearby LV wall can result in acute MR w/ Cardiovascular Pathology 18
infarction development of a new systolic murmur. Timely restoration of blood flow can improve (CV) (Path)
papillary muscle dysfxn and lead to resolution of the regurgitation. CV Path
14980
Lymphedema Chronic lymphedema is most commonly caused by an acquired disruption of lymphatic Cardiovascular Pathology 1
drainage (eg, due to malignancy or lymphadenectomy), and typically presents with swelling (CV) (Path)
and thickened skin in one or more extremities. Treatment is usually conservative and
involves compression bandages and physiotherapy; diuretics are ineffective and
contraindicated. CV Path
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14989
Stress Stress-induced (takotsubo) cardiomyopathy is characterised by hypokinesis of the mid and Cardiovascular Pathology 1
cardiomyopathy apical segments and hyperkinesis of the basal segments of the LV, resulting in systolic (CV) (Path)
dysfxn. The condition is likely caused by a surge of catecholamines in the setting of physical
or emotional stress. It usually affects postmenopausal women and resolves on its own w/i
several wks. CV Path
14992
Dilated Peripartum cardiomyopathy is a relatively uncommon cause of DCM that may be related to Cardiovascular Pathology 8
cardiomyopathy impaired fxn of angiogenic GFs. DCM involves compensatory eccentric hypertrophy, which (CV) (Path)
↑ ventricular compliance and also allows for temporary maintenance of CO. Over time,
ovewhelming wall stress leads to LV failure w/ ↓ EF and SSx HF. CV Path
14993
Dilated DCM results from 1° myocardial dysfxn leading to eccentric remodelling of the LV. Pts can Cardiovascular Pathology 8
cardiomyopathy develop LV mural thrombus and are at risk for SCD due to ventricular arrhythmia. Familial (CV) (Path)
DCM is typically inherited in an AD pattern, and most commonly results from truncating
muts of the TTN gene that codes for the sarcomere protein titin. CV Path
14997
Atrial myxoma Myxomas are the most common 1° cardiac neoplasm and approx. 80% originate in the LA. Cardiovascular Pathology 3
Pts may present w/ SSx MV obstr that may worsen w/ certain body positions, constitutional (CV) (Path)
findings (e.g. fever, weight loss), or systemic embolisation (e.g. stroke, mesenteric ischemia,
acute limb ischemia). CV Path
14998
Atrial myxoma Myxomas are the most common 1° cardiac neoplasm, and approx. 80% originate in the LA. Cardiovascular Pathology 3
Pts may have systemic embolisation (e.g. stroke) or SSx MV obstr that may be worse w/ (CV) (Path)
certain body positions. Histopathologic Ex reveals amorphous ECM w/ scattered stellate or
globular myxoma cells w/i abundant mucopolysaccharide ground substance. CV Path
14999
Acute pericarditis Fibrinous pericarditis is the most common type of pericarditis and is Chx by pericardial Cardiovascular Pathology 5
inflammation w/ a serous, fibrin-containing exudate in the pericardial space. Pleuritic chest (CV) (Path)
pain and a triphasic friction rub are frequently seen. Common causes include viral infection,
MI, uremia, and rheumatologic disease (eg, SLE, RA). CV Path
15000
Acute pericarditis Viral infection is thought to be the most common cause of acute pericarditis. It causes a Cardiovascular Pathology 5
fibrinous or serofibrinous pericarditis that is often Chx by pleuritic chest pain, a friction rub (CV) (Path)
on cardiac auscultation, diffuse ST elevation on ECG, and mild to moderate-sized pericardial
effusion. CV Path
15001
Vasospastic angina Vasospastic angina involves hyperreactivity of coronary artery smooth muscle. Pts are Cardiovascular Pathophysi 2
usually young (age <50) and w/o significant RFx for CAD; they experience recurrent (CV) ology
episodes of chest discomfort that typically occur during rest or sleep and resolve w/i 15 min. (Patp) CV Patp
15180
Coronary artery Stable angina results from fixed coronary artery stenosis that limits blood flow to Cardiovascular Pathophysi 4
disease downstream myocardium, preventing the myocardial O2 supply from ↑ during exertion. (CV) ology
Dobutamine mimics the effects of exercise and ↑ myocardial O2 demand; it can be used (Patp)
during stress testing to provoke areas of ischemic myocardium, which can be recognized on
imaging by a localized and transient ↓ in contractility (ie, wall motion defect). CV Patp
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15195
Aortic regurgitation Eccentric ventricular hypertrophy results in a dilated cavity w/ relatively thin ventricular Cardiovascular Pathology 8
walls due to the addition of myocardial contractile fibers in series in response to chronic (CV) (Path)
volume overload. Chronic AR can result from aortic root dilation and is a common cause of
eccentric hypertrophy. CV Path
15196
Aortic stenosis Concentric LVH involves thickening of the ventricular walls and ↓ in the ventricular cavity Cardiovascular Pathology 8
size. It occurs via the addition of myocardial contractile fibers in parallel in response to (CV) (Path)
chronic pressure overload. AS and prolonged systemic HTN are common causes of
concentric LVH. CV Path
15197
Cardiac To access the left side of the heart, CVCs must cross the interatrial septum at the site of the Cardiovascular Anatomy 2
catheterization foramen ovale. Entry into the LA allows for direct measurement of LA pressure and for (CV) (Anat)
access to arrhythmogenic foci on the LA myocardium or pulm veins. CV Anat
15198
Pulmonary stenosis PV stenosis causes a crescendo-decrescendo systolic murmur (best heard at the left upper Cardiovascular Pathology 1
sternal border) and delays closure of the PV, resulting in widened splitting of S2. Inspiration (CV) (Path)
↑ blood flow to the right side of the heart, causing ↑ intensity of the murmur and even later
closure of the PV. CV Path
15199
Pulmonary arterial Pulm HTN can be recognized on PEx by a loud pulmonic component of S2 and an Cardiovascular Pathophysi 8
hypertension accentuated, palpable impulse at the left stemal border (left parasternal lift due to RV heave). (CV) ology
(Patp) CV Patp
15241
Septic shock Septic shock can Px w/ either hyper- or hypothermia. The initial disturbance is peripheral Cardiovascular Pathophysi 6
vasodilation leading to ↓ SVR, ↓ CVP and ↓ PCWP. A compensatory ↑ in sympathetic drive (CV) ology
causes an ↑ in CO; the resulting high flow rates lead to incomplete O2 extraction in the (Patp)
tissues, resulting in high mixed venous O2 saturation. CV Patp
15269
Athlete's heart Athlete's heart refers to physiologic cardiac adaptations that improve cardiac fxn in response Cardiovascular Pathophysi 1
to high-lvl endurance training. There's predominant eccentric hypertrophy w/ a smaller (CV) ology
component of concentric hypertrophy, leading to an overall ↑ in LV mass, enlarged LV (Patp)
cavity size, ↑ LV wall thickness, and ↓ resting HR. CV Patp
15310
Hypertrophic Pts w/ HCM may be aSSx and often have a FHx of HCM or SCD. Findings consistent w/ Cardiovascular Pathophysi 9
cardiomyopathy HCM incl an overall ↑ in LV mass, ↓ LV cavity size w/ impaired diastolic fxn, LVH (CV) ology
predominantly affecting the septum, and normal or ↑ LV EF. (Patp) CV Patp
15354
Aortic aneurysm AAA is focal dilation of the abdominal aorta above normal (or >3 cm in diameter). It is Cardiovascular Pathophysi 6
generally aSSx until aneurysm rupture, which is frequently fatal. RFx include age >65, (CV) ology
smoking, and male sex. (Patp) CV Patp
15391
Diastolic Prolonged systemic HTN leads to concentric LVH via the addition of myocardial contractile Cardiovascular Physiology 4
dysfunction fibers in parallel. The thickening of the LV walls ↓ LV compliance, leading to impaired (CV) (Phys)
diastolic filling and HF w/ preserved EF. In response to ↓ CO, the kidneys activate the
RAAS, stimulating Na retention and vasoconstriction that worsens volume overload and can
lead to DHF. CV Phys
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15515
Hypertrophic Many pts w/ HCM have poor cardiac reserve (e.g. exercise intolerance) due to LVOT Cardiovascular Pharmacol 9
cardiomyopathy obstruction. This outflow obstruction is worsened by ↓ LV blood volume. β blockers ↓ HR (CV) ogy (Phar)
and LV contractility to ↑ LV blood volume, ↓ LVOT obstruction, and improve SSx. CV Phar
15516
Hypertrophic HCM typically involves interventricular septal hypertrophy that obstructs LV outflow and Cardiovascular Physiology 9
cardiomyopathy creates a systolic murmur that ↓ in intensity w/ maneuvers that ↑ LV blood volume (eg, hand (CV) (Phys)
grip, passive leg elevation). HCM is Chx by ↑ LV muscle mass w/ a small LV cavity,
preserved EF, and impaired LV relaxation leading to diastolic dysfxn. CV Phys
15526
Acute heart failure SV is the absolute volume of blood ejected from the LV w/ each contraction and is calculated Cardiovascular Physiology 7
by subtracting LV ESV from LV EDV. EF is the relative volume of blood ejected from the (CV) (Phys)
LV w/ each contraction; it is calculated by dividing SV by LV EDV. CO, the volume of
blood ejected into the aorta per unit time, is estimated by multiplying SV by HR. CV Phys
15528
Sick sinus syndrome aSSx LV systolic dysfxn is a common stage in the progr of HF. Neurohormonal mechs, incl Cardiovascular Pathophysi 2
the SNS and RAAS, help maintain the aSSx period by ↑ volume retention and peri resistance (CV) ology
to maintain organ perfusion. Although these mechs are beneficial in the short term, they're (Patp)
ultimately deleterious, ↑ hemodynamic stress and cardiac remodelling that eventually lead to
DHF. CV Patp
15534
Chronic heart LHF leads to chronically ↑ pulm venous and capillary pressures, w/ resulting pulm oedema Cardiovascular Physiology 12
failure and extravasation of RBCs into the alveolar parenchyma. The Fe from RBCs is taken up by (CV) (Phys)
alveolar macrophages and stored as hemosiderin, appearing as brown pigment on
histopathology. CV Phys
15542
Primary Concentric LVH involves uniform thickening of the LV walls w/ ↓ in LV cavity size and Cardiovascular Pathology 14
hypertension most commonly results from prolonged systemic HTN. It can progress to HTN heart disease (CV) (Path)
w/ impaired diastolic filling and HF w/ preserved EF. Histopathology demonstrates
transverse thickening of cardiomyocytes w/ prominent hyperchromatic nuclei and interstitial
fibrosis. CV Path
15554
Pulmonary Transcatheter aortic valve implantation (TAVI) allows for minimally invasive management Cardiovascular Pathology 13
embolism of severe aortic stenosis in elderly patients who are unable to tolerate open surgical valve (CV) (Path)
replacement. Paravalvular aortic regurgitation is a common complication of TAVI, resulting
from improper sealing of the prosthetic valve to the native aortic valve annulus. CV Path
15555
Heart block 3rd-degree (complete) AV block involves dysfxn of the AV node, resulting in total lack of Cardiovascular Pathology 2
communication b/w the atria and ventricles. On ECG, there's dissociation of P waves and (CV) (Path)
QRS complexes, w/ P waves marching out at the intrinsic rate of the SA node and QRS
complexes at the intrinsic rate of the His bundle or ventricles (escape rhythm). CV Path
15559
Lyme disease Early disseminated Lyme disease can have cardiac involvement (Lyme carditis) that most Cardiovascular Pathology 3
commonly MFx w/ varying degrees of AV conduction block. Pts may be aSSx, but those w/ (CV) (Path)
complete AV conduction block are likely to have dyspnea, lightheadedness, or syncope. CV Path
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15574
Sick sinus syndrome SSS results from degeneration (usually age-related) of the SA node, leading to impaired Cardiovascular Pathophysi 2
conduction and ↓ CO w/ SSx of dyspnea, fatigue, lightheadedness, presyncope, and syncope. (CV) ology
ECG typically demonstrates bradycardia w/ sinus pauses (delayed P waves), sinus arrest (Patp)
(dropped P waves), and jxnal escape beats. CV Patp
15650
Acute heart failure Pts w/ DHF have ↑ LV EDP and ↓ CO that's most often 1arily due to LV dysfxn. RA Cardiovascular Pathophysi 7
pressure (i.e. CVP) is also ↑ in advanced HF due to volume overload; RHF (most often (CV) ology
occurring 2° to LHF) can also contribute to ↑ RA pressure. (Patp) CV Patp
15651
Chronic heart The ventricular myocardium secretes BNP in response to the ventricular stretch and strain Cardiovascular Pathophysi 12
failure that typically occurs w/ volume overload. BNP, along w/ ANP secreted by the atrial (CV) ology
myocardium, stimulates vasodilation and salt and water excretion to help relieve volume (Patp)
overload. CV Patp
15693
Long QT syndrome Congenital LQTS is commonly caused by a mutation that slows the delayed rectifier K Cardiovascular Pathophysi 4
current that repolarizes the cardiomyocyte AP. Certain Rx (eg, macrolide Abx, (CV) ology
antipsychotics, antiemetics) also slow the K repolarization current and prolong the QT (Patp)
interval. Excessive QT prolongation can trigger serious cardiac arrhythmia (ie, TdP),
resulting in syncope or SCD. CV Patp
15729
Tricuspid Severe TR can lead to right-sided HF, evidenced by JVD, hepatomegaly, lower extremity Cardiovascular Pathophysi 3
regurgitation edema, and the absence of pulm edema. Permanent PM placement can cause TR b/c the RV (CV) ology
lead passes through the TV orifice and can disrupt valve closure. (Patp) CV Patp
15839
Aortic aneurysm TAAs are usually aSSx until they grow large enough to compress surrounding structures or Cardiovascular Pathology 6
cause rupture. The most common SSx presentation is chest or back pain, but compression of (CV) (Path)
nearby structures can cause dysphagia, hoarseness, cough, or dyspnoea. CV Path
15840
Aortic aneurysm Ruptured AAA is a Sx emergency that usually Px w/ the acute onset of severe abdominal and Cardiovascular Pathology 6
back pain in pts w/ appropriate RFx (eg, advanced age, smoking, atherosclerosis). (CV) (Path)
Accompanying syncope, hypotension, and shock may occur quickly (intraperitoneal rupture)
or may be delayed (retroperitoneal rupture). CV Path
15885
Aortic dissection The most common SSx of acute AD is sudden onset of severe, sharp or tearing chest and Cardiovascular Pathology 6
back pain. Complications include stroke, AR, and myocardial ischemia. In addition, a (CV) (Path)
dissection can extend into the pericardium, resulting in tamponade w/ ↓ CO and shock. CV Path
15886
Aortic dissection Marfan syndrome involves a deleterious mut in fibrillin that mainly affects the structural Cardiovascular Pathology 6
integrity of the CV and MSK systems. Aortic root disease predisposes to AD, which can (CV) (Path)
present w/ sudden-onset chest or back pain, acute AR, and HF. Common histologic findings
in aortic disease incl fragmentation and loss of the elastic lamellae w/ fibrosis and CMD. CV Path
15891
Aortic dissection CMD (necrosis) is the classic histologic finding in AD, as it weakens the aortic wall and Cardiovascular Pathology 6
allows a small intimal tear to readily propagate. Collagen, elastin, and smooth muscle are (CV) (Path)
replaced by a basophilic mucoid ECM w/ elastic tissue fragmentation and cystic collections
of mucopolysaccharide. CV Path
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Aortic regurgitation A large, acute pulmonary embolism causes a rapid increase in right ventricular (RV) pressure Cardiovascular Pathophysi 8
that leads to RV cavity enlargement and RV dysfunction. Thickening of the RV wall is not (CV) ology
seen in acute pulmonary embolism, as there is no time for compensatory hypertrophy to (Patp)
occur in response to the increased pressure load. CV Patp
104Tinea Pityriasis versicolor (tinea versicolor) is a superficial skin infection caused by Malassezia Dermatology Microbiolo 4
species. It causes erythematous, hyper- or hypopigmented macules and patches. Malassezia (DE) gy (Micr)
forms spores and hyphae, producing the characteristic "spaghetti and meatballs" appearance
on KOH preparation light microscopy. DE Micr
270Sporotrichosis Sporothrix schenckii is a dimorphic fungus that causes a subcutaneous mycosis. It is often Dermatology Microbiolo 1
transmitted by a thorn prick. The disease manifests with nodules that spread along (DE) gy (Micr)
lymphatics. DE Micr
467Glomus tumor A benign glomus tumour (glomangioma) can produce a very tender, small (a few mm in Dermatology Pathology 1
diameter), red-blue lesion under the nail bed. This type of tumour originates from the (DE) (Path)
modded SMCs that control the thermoregulatory fxns of dermal glomus bodies. DE Path
588Histiocytosis Langerhans cells are dendritic cells found in the skin that act as professional antigen Dermatology Histology 1
presenting cells. These cells are derived from the myeloid cell line and they possess (DE) (Hist)
characteristic racquet shaped intracytoplasmic granules known as Birbeck granules. DE Hist
680Staphylococcal The staphylococcal scalded skin syndrome occurs in infants and children due to the Dermatology Microbiolo 1
scalded skin production of the exotoxin exfoliatin by Staphylococcus species. It causes widespread (DE) gy (Micr)
syndrome epidermal sloughing. especially with gentle pressure (Nikolsky's sign). DE Micr
826Cherry angioma Cherry hemangiomas are small, red, cutaneous papules common in aging adults. They don't Dermatology Pathology 1
regress spontaneously and typically ↑ in # w/ age. LM of these lesions shows proliferation of (DE) (Path)
caps and post-cap venules in the papillary dermis. DE Path
827Hemangioma Superficial infantile hemangiomas (i.e. strawberry/cap hemangiomas) are benign vascular Dermatology Pathology 6
tumours of childhood. They appear during the 1st wks of life, initially grow rapidly, and (DE) (Path)
typically regress by the time the child is 5-9yrs old. These tumours are composed of blood-
filled caps separated by CT. DE Path
836Tinea Terbinafine is used for treatment of dermatophytosis. It inhibits synthesis of fungal Dermatology Pharmacol 4
membrane ergosterol by suppressing the enzyme squalene epoxidase. (DE) ogy (Phar) DE Phar
874Keloid Keloids result from excessive collagen formation during the remodeling phase of wound Dermatology Pathophysi 2
healing. They present as raised, painful, and pruritic nodules that grow beyond the wound (DE) ology
borders. (Patp) DE Patp
876Atopic dermatitis AD (eczema) is a common, chronic inflammatory disorder caused by impairment of the Dermatology Pathology 2
skin's barrier fxn. Eczema presents w/ pruritus and erythematous papules and plaques and is (DE) (Path)
a/w other atopic diseases, such as allergic rhinitis and asthma. DE Path
883Xeroderma Xeroderma pigmentosum develops due to a defect in nucleotide excision repair. This disease Dermatology Genetics 2
pigmentosum is characterized by increased sensitivity to ultraviolet radiation and a high incidence of (DE) (Gene)
cutaneous malignancy. DE Gene
D eats
935Actinic keratoses AK develops on chronically sun-exposed areas of the skin in predisposed individuals. The Dermatology Pathology 2
lesions consist of erythematous papules w/ a central scale and a rough 'sandpaper-like' (DE) (Path)
texture. AKs are considered premalignant lesions and have the potential to progress to SCC. DE Path
936Acanthosis AN presents w/ thickening and hyperpigmentation of skin in the flexural areas. The lesions Dermatology Pathology 1
nigricans have a classic 'velvety' texture. AN is commonly a/w insulin-resistant states (e.g. DM, (DE) (Path)
acromegaly, obesity) and GI malignancies. DE Path
973Febrile neutropenia Ecthyma gangrenosum is a cutaneous necrotic disease with a strong association with Dermatology Microbiolo 4
Pseudomonas aeruginosa bacteremia. It occurs from perivascular invasion and release of (DE) gy (Micr)
tissue-destructive exotoxins, causing vascular destruction and insufficient blood flow to
patches of skin that become edematous and subsequently necrose. Pseudomonas infections
are common in patients who are neutropenic, are hospitalized, have burns, or have indwelling
catheters. DE Micr
974Skin and soft tissue Hot tub folliculitis is a superficial and self-limited Pseudomonas aeruginosa infection of the Dermatology Microbiolo 8
infections hair follicles that tends to occur in minor outbreaks following exposure to a pool or spa in (DE) gy (Micr)
which the chemicals have not been maintained at appropriate concentrations. Pseudomonas
are gram negative, oxidase-positive, nonlactose-fermenting, motile rods that produce green
pigment. DE Micr
1042
Herpes zoster HZ (shingles) develops due to reactivation of VZV in the DRG (sensory neurons). It presents Dermatology Pathology 4
w/ a painful vesicular rash in a dermatomal distribution. Intranuclear inclusions in (DE) (Path)
keratinocytes and multinucleated giant cells are seen on LM. DE Path
1061
Vitamin C Ascorbic acid (vitamin C) is a cofactor in the hydroxylation of proline and lysine residues Dermatology Biochemist 3
deficiency and is important in the synthesis of collagen. Deficiency (scurvy) is characterized by (DE) ry (Bioc)
microvascular bleeding, gingivitis, and impaired wound healing. DE Bioc
1064
Niacin deficiency Niacin (vitamin B2) can be synthesized endogenously from tryptophan and is an essential Dermatology Biochemist 3
component of nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine (DE) ry (Bioc)
dinucleotide phosphate (NADP). A deficiency of this vitamin results in pellagra, which is
characterized by dermatitis, diarrhea, and dementia. DE Bioc
1105
Bullous pemphigoid BP is characterised by auto-Abs against hemidesmosomes along the BM of the DEJ. This Dermatology Pathology 1
causes the entire epidermis to separate from the dermis, forming tense, subepidermal blisters. (DE) (Path) DE Path
1108
Dyslipidemia Xanthomas are suggestive of hyperlipidaemia, esp. when present in conjunction w/ a FHx of Dermatology Pathology 11
early cardiac death. (DE) (Path) DE Path
1110
Vitiligo Vitiligo is a common condition characterised by the loss of epidermal melanocytes. It occurs Dermatology Pathology 1
more commonly in pts w/ autoimmune disorders (e.g. autoimmune thyroiditis, DM-1) and (DE) (Path)
results in well-defined, variably sized patches of hypopigmentation. DE Path
1111
Dermatitis DH is characterised by erythematous pruritic papules, vesicles, and bullae that appear Dermatology Pathology 1
herpetiformis bilaterally and symmetrically on the extensor surfaces. DH is strongly a/w coeliac disease. (DE) (Path) DE Path
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Seborrheic keratosis SK is a common epidermal tumour that presents as a tan or brown, round lesion w/ a well- Dermatology Pathology 2
demarcated border and 'stuck-on' appearance. Micro Ex shows small cells resembling basal (DE) (Path)
cells, w/ pigmentation, hyperkeratosis, and keratin-containing cysts. Rapid onset of
numerous lesions is often a/w internal malignancy (Leser-Trelat sign). DE Path
1113
Melanoma Melanoma often has an early horizontal growth phase w/ low mets potential f/b a nodular, Dermatology Pathology 6
vertical growth phase w/ a significantly ↑ risk of mets. Depth of invasion (Breslow thickness) (DE) (Path)
is the most important prognostic indicator in malignant melanoma. DE Path
1114
Urticaria Urticaria is a transient HS disorder characterised by pruritic erythematous plaques that arise Dermatology Pathology 2
suddenly and resolve over hrs. They're most often caused by IgE-mediated degranulation of (DE) (Path)
mast cells, leading to ↑ permeability of the microvasculature w/ oedema of the superficial
dermis. DE Path
1115
Contact dermatitis Acute ACD is caused by an HS-IV (delayed) rxn to an Ag on the skin surface. Gross findings Dermatology Pathology 2
incl erythematous, papulovesicular, weeping lesions. Histo is characterised by spongiosis, an (DE) (Path)
accumulation of oedema fluid in the intercellular spaces of the epidermis. W/ chronic
exposure, lesions become less oedematous, w/ thickening of the stratum spinosum and
stratum corneum. DE Path
1116
Psoriasis Common complications of psoriasis incl psoriatic arthritis, nail changes, and uveitis. Dermatology Pathology 5
(DE) (Path) DE Path
1117
Psoriasis Psoriasis is characterised by hyperkeratosis and confluent parakeratosis of the stratum Dermatology Pathology 5
corneum, and epidermal hyperplasia (acanthosis) w/ elongated rete ridges. Neutrophilic foci (DE) (Path)
in the stratum corneum and epidermis may coalesce to form microabscesses (Munro
microabscesses). DE Path
1133
Contact dermatitis Poison ivy dermatitis is a form of allergic contact dermatitis, which is a type IV Dermatology Immunolo 2
hypersensitivity reaction mediated primarily by T lymphocytes. It manifests as intensely (DE) gy (Immu)
pruritic erythematous papules, vesicles, or bullae that often form linear patterns. DE Immu
1214
Atopic dermatitis Local cutaneous adverse effects of chronic topical corticosteroid administration include Dermatology Pharmacol 2
atrophy/thinning of the dermis that is associated with loss of dermal collagen, drying, (DE) ogy (Phar)
cracking, and/or tightening of the skin, telangiectasias, and ecchymoses. DE Phar
1244
Ehlers-Danlos Ehlers-Danlos syndrome (EDS) is a heritable connective tissue disease associated with Dermatology Biochemist 1
syndrome abnormal collagen formation. EDS usually manifests clinically as overflexible (hypermobile) (DE) ry (Bioc)
joints, overelastic (hyperelastic) skin, and fragile tissue susceptible to bruising, wounding,
and hemarthrosis. DE Bioc
1245
Collagen synthesis Ehlers-Danlos syndrome is a group of rare hereditary disorders characterized by defective Dermatology Biochemist 1
collagen synthesis. It can be caused by procollagen peptidase deficiency, which results in (DE) ry (Bioc)
impaired cleavage of terminal propeptides in the extracellular space. Patients often have joint
laxity, hyperextensible skin, and tissue fragility due to the formation of soluble collagen that
does not properly crosslink. DE Bioc
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1247
Vitamin C The hydroxylation of proline and lysine residues in collagen helps it attain its maximum Dermatology Biochemist 3
deficiency tensile strength. This process occurs in the rough endoplasmic reticulum and requires vitamin (DE) ry (Bioc)
C as a cofactor. Impaired collagen synthesis resulting from vitamin C deficiency (scurvy) can
lead to fragile vessels, predisposing to gingival bleeding, ecchymosis, and petechia. DE Bioc
1313
Leprosy The severity of leprosy, a systemic illness caused by Mycobacterium leprae, depends on the Dermatology Microbiolo 2
strength of the cell-mediated immune (CMI) response, with tuberculoid leprosy representing (DE) gy (Micr)
the milder form intact Th1 CMI response) and lepromatous leprosy, the more severe form
(weak CMI response). DE Micr
1314
Leprosy The lepromin skin test will be (+) w/ Tb leprosy as they exhibit a strong CD4+ Th1 cell- Dermatology Pathology 2
mediated immune response to M. leprae. Pts w/ lepromatous leprosy will test (-) due to their (DE) (Path)
weak Th1 cell-mediated immune response. DE Path
1476
Xeroderma Xeroderma pigmentosum is an autosomal recessive disorder characterized by defective Dermatology Genetics 2
pigmentosum nucleotide excision repair often caused by a deficiency in UV-specific endonuclease. (DE) (Gene)
Affected children usually have severe photosensitivity, hyperpigmentation in sun-exposed
areas, and a greatly increased risk for skin cancer. DE Gene
1477
Sunburn Pyrimidine dimers are formed in DNA as a result of ultraviolet light exposure. They are Dermatology Pathophysi 1
recognized by a specific endonuclease complex that initiates the process of repair by nicking (DE) ology
the damaged strand on both sides of the pyrimidine dimer. The damaged segment is then (Patp)
excised, and replacement DNA is synthesized by DNA polymerase. DE Patp
1553
Herpes zoster A unilateral vesicular rash localized on a single dermatome in an older patient is most likely Dermatology Microbiolo 4
herpes zoster. Postherpetic neuralgia is the most common neurologic complication of (DE) gy (Micr)
varicella zoster virus infection. DE Micr
1613
Graft versus host Graft-versus-host disease can occur following transplantation of organs rich in lymphocytes Dermatology Immunolo 1
disease (eg. liver). T lymphocytes found in the donor organ become sensitized against the MHC (DE) gy (Immu)
antigens of the recipient and subsequently attack the host's tissues. The skin, liver, and
gastrointestinal tract are most frequently affected. DE Immu
1641
Herpes zoster Acyclovir, the acyclovir prodrug valacyclovir, famciclovir, and ganciclovir are all nucleoside Dermatology Pharmacol 4
analogues that require both herpes viral and cellular kinases for conversion to their active (DE) ogy (Phar)
nucleoside triphosphate form. Cidofovir is a nucleoside monophosphate (ie, a nucleotide)
that requires only cellular kinases for activation. DE Phar
1669
Rubella In a susceptible child, a febrile maculopapular rash that begins on the face and spreads to the Dermatology Microbiolo 3
trunk and extremities is suggestive of rubeola (measles) or rubella (German measles). The (DE) gy (Micr)
additional finding of postauricular lymphadenopathy indicates that rubella is the most likely
etiology. DE Micr
1725
Hair loss Androgenetic alopecia is the most common cause of hair loss in both males and females. The Dermatology Genetics 2
pattern and severity of the baldness depend on both hormonal (circulating androgens) and (DE) (Gene)
genetic factors and vary between males and females. The condition is polygenic with
variable expressivity. DE Gene
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1726
Hair loss Androgenetic alopecia causes hair loss primarily at the anterior scalp and vertex. It shows Dermatology Pharmacol 2
polygenic inheritance, with dihydrotestosterone (DHT) being the primary pathogenic factor. (DE) ogy (Phar)
5-a-reductase inhibitors decrease the conversion of testosterone to DHT and are effective for
treating the condition. DE Phar
1860
Aging Photoaging is a product of excess exposure to ultraviolet A wavelengths and is characterized Dermatology Pathophysi 8
by epidermal atrophy with flattening of rete ridges. In addition, there is decreased collagen (DE) ology
fibril production and increased degradation of collagen and elastin in the dermis. (Patp) DE Patp
1867
Primary biliary A yellowish eyelid papule or plaque containing lipid-laden macrophages is most likely Dermatology Pathology 4
cholangitis xanthelasma. Xanthelasma may occur in a/w 1° or 2° hyperlipidaemia. Cholestatic conditions (DE) (Path)
such as PBC are a potential cause of hypercholesterolaemia leading to xanthelasma. DE Path
1878
Ecchymosis Ecchymoses freq indicate a deep hemorrhage (hematoma) due to bony fracture, ligamentous Dermatology Pathology 1
rupture, or muscular injury. They don't blanch under pressure as the RBCs aren't contained (DE) (Path)
w/i the vasculature. Ecchymoses often pass thru an evolution of colour change (blue or red to
brown, green, and yellow), which can be used to estimate the age of the injury. DE Path
1898
Bartonella Bartonella henselae causes cat-scratch disease, bacillary angiomatosis, and culture-negative Dermatology Microbiolo 2
endocarditis. Cat-scratch disease is characterized by low fever, lymphadenopathy, and a self- (DE) gy (Micr)
limited course. DE Micr
1937
Lymphoedema Axillary LN dissection is an RF for the devel of chronic lymphoedema involving the Dermatology Pathology 1
ipsilateral arm. Chronic lymphoedema predisposes to the devel of angiosarcoma (Stewart- (DE) (Path)
Treves syndrome). DE Path
1960
Melanoma The most common metastatic tumors to the brain are lung cancer, renal cancer, and Dermatology Embryolog 6
melanoma. Melanoma is a malignancy of melanocytes, which are embryologically derived (DE) y (Embr)
from neural crest cells. DE Embr
1993
Actinic keratoses AKs are small (usually <1cm), erythematous epidermal lesions w/ adherent scale that're the Dermatology Pathology 2
result of chronic sun exposure. Histo findings incl keratinocyte atypia, hyperkeratosis, and (DE) (Path)
parakeratosis. A small % of AKs progress to invasive SCC; therefore, freq monitoring is
necessary. DE Path
2038
Splice site mutation Splicing is performed by spliceosomes, which remove introns containing GU at the 5' splice Dermatology Biochemist 1
site and AG at the 3' splice site. Splice site mutations may result in inappropriate removal of (DE) ry (Bioc)
exons and retention of introns, leading to the formation of dysfunctional proteins. DE Bioc
2065
Pemphigus vulgaris PV is an autoimmune bullous disease characterised by auto-Abs directed against Dermatology Pathology 1
desmosomal proteins (e.g. desmoglein). It presents w/ painful flaccid bullae and erosions (DE) (Path)
affecting the skin and mucosal membranes. The bullae spread laterally w/ pressure and new
blisters may form w/ gentle rubbing. DE Path
7585
Androgenic steroids Androgens stimulate follicular epidermal hyperproliferation and excessive sebum Dermatology Pharmacol 2
production, thereby promoting acne development. Anabolic steroid misuse is a known cause (DE) ogy (Phar)
of acne, especially in competitive athletes. DE Phar
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7649
Seborrheic keratosis SKs are pigmented macules or plaques w/ a greasy surface and well-demarcated borders. Dermatology Pathology 2
Rapid onset of numerous lesions is an indicator of internal malignancy (Leser-Trelat sign), (DE) (Path)
esp. GAC. DE Path
7707
Melanoma BRAF is a PK involved in activation of signalling pathways for melanocyte proliferation; the Dermatology Pathology 6
BRAF V600E mut is seen in 40-60% of pts w/ melanoma. (DE) (Path) DE Path
8334
Skin and soft tissue Granulomatous inflammation is a form of chronic inflammation characterised by aggregates Dermatology Pathology 8
infections of activated macrophages that assume an epithelioid appearance. Persistent granulomatous (DE) (Path)
inflammation w/ subseq fibrosis can cause organ dysfxn, which is seen in a # of
granulomatous diseases. DE Path
8569
Psoriasis First-line treatment options for localized psoriasis include high-potency topical Dermatology Pharmacol 5
corticosteroids and vitamin D analogs. Vitamin D analogs inhibit T-cell and keratinocyte (DE) ogy (Phar)
proliferation and stimulate keratinocyte differentiation. Corticosteroids also have anti-
inflammatory and antiproliferative properties; their mechanism of action is complementary to
the vitamin D analogs. DE Phar
8858
Skin and soft tissue Pseudomonas aeruginosa is a major pathogen in burn patients. Only a few specific penicillins Dermatology Microbiolo 8
infections (eg. ticarcillin, piperacillin) and cephalosporins (eg, ceftazidime, cefepime) have activity (DE) gy (Micr)
against it. Certain aminoglycosides, fluoroquinolones (eg, ciprofloxacin, levofloxacin), and
carbapenems (eg, imipenem, meropenem) are also effective. DE Micr
8904
Accessory nipple Accessory nipples are the most common congenital breast anomaly resulting from failed Dermatology Pathophysi 1
regression of the mammary ridge in utero. They are usually asymptomatic but can become (DE) ology
tender along with breast tissue during times of hormonal fluctuation. (Patp) DE Patp
10168
Scabies Scabies is a highly contagious disease that presents with an intensely pruritic rash (usually Dermatology Microbiolo 2
worse at night) in the flexor surfaces of the wrist, lateral surfaces of the fingers, and the (DE) gy (Micr)
finger webs. Patients usually have excoriations with small, crusted, red papules scattered
around the affected areas. Diagnosis is confirmed by skin scrapings from excoriated lesions
that show mites, ova, and feces under light microscopy. DE Micr
11502
Melanocytic nevus Compound naevi are benign proliferations of melanocytes that involve both the dermis and Dermatology Pathology 1
epidermis. The lesions appear as slightly raised papules w/ uniform pigmentation and (DE) (Path)
symmetrical sharp borders. DE Path
11662
Erythema EM is a cell-mediated inflammatory disorder of the skin characterised by erythematous Dermatology Pathology 2
multiforme papules that evolve into target lesions. It's most commonly a/w HSV. (DE) (Path) DE Path
11738
Keloid TGF-β is critical for fibroblast migration, proliferation, and CT synthesis. ↑ TGF-β activity is Dermatology Pathology 2
responsible for the hypertrophic/keloid scarring and fibrosis of the lung, liver, and kidney (DE) (Path)
that occur w/ chronic inflammation. DE Path
11852
Urticaria A # of Rx, incl opioids, radiocontrast agents, and some Abx (e.g. vancomycin), can trigger Dermatology Pathology 2
IgE-independent mast cell degran. Common SSx incl diffuse itching and pain, (DE) (Path)
bronchospasm, and localized swelling (urticaria). DE Path
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Niacin deficiency Niacin is a precursor for nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine Dermatology Biochemist 3
dinucleotide phosphate (NADP), two important cofactors for many dehydrogenase and (DE) ry (Bioc)
reductase enzymes. Niacin deficiency results in pellagra (ie, diarrhea, dementia, and
dermatitis). DE Bioc
13911
Scabies Scabies is a human mite infection associated with a pruritic papular rash with excoriations Dermatology Microbiolo 2
and burrows. Patients with impaired cell-mediated immunity (eg, HIV) often develop a very (DE) gy (Micr)
high mite burden. Treatment with topical permethrin and/or ivermectin is generally curative. DE Micr
14984
Chronic venous SD is characterised by chronic erythema, fibrosis, and reddish-brown discolouration due to Dermatology Pathology 3
insufficiency deposition of hemosiderin (from breakdown of extravasated RBCs). SSx are typically (DE) (Path)
bilateral, and usually worse at or above the ankles. Complications incl poor wound healing,
weeping, and ulceration. DE Path
15339
Skin and soft tissue The most common cause of nonpurulent cellulitis is beta-hemolytic streptococci, particularly Dermatology Microbiolo 8
infections group A streptococcus. The most common cause of purulent cellulitis is Staphylococcus (DE) gy (Micr)
aureus. DE Micr
15361
Skin and soft tissue BI is a superficial infection by S. aureus that's most common in young children. It's Dermatology Pathology 8
infections characterised by a blistering skin rash w/ tan- to honey-coloured crusts. The blistering in BI (DE) (Path)
is caused by exfoliative toxin A, which targets desmoglein 1 in epidermal cellular junctions
and causes a loss of cell adhesion. DE Path
15373
Acne vulgaris RFs for acne incl ↑ androgen lvls; obstr of pilosebaceous glands by oil-based hair products; Dermatology Pathology 3
and mech irritation of skin follicles. Sports participation freq triggers acne due to the use of (DE) (Path)
tight-fitting clothing and protective gear. DE Path
15374
Acne vulgaris Acne vulgaris is an inflammatory disorder of pilosebaceous follicles. Contributing factors Dermatology Pathology 3
incl hyperkeratinisation and obstr of follicles; sebaceous gland enlargement w/ ↑ secretion of (DE) (Path)
sebum; colonisation and proliferation in the gland by P. (C.) acnes; and follicular and
perifollicular inflammation. DE Path
15379
Acne vulgaris Acne typically arises in adolescents and young adults due to adrenarche-associated Dermatology Pathophysi 3
enlargement in sebaceous glands with subsequent increases in sebum production. Follicles (DE) ology
clogged with sebum provide the anaerobic, lipid-rich environment necessary for the (Patp)
proliferation of Propionibacterium acnes, the skin commensal responsible for acne lesions. DE Patp
15408
Psoriasis Psoriasis is characterised on histo by hyperkeratosis and confluent parakeratosis of the Dermatology Pathology 5
stratum corneum (producing the char silvery scales seen on gross Ex), diffuse epidermal (DE) (Path)
hyperplasia w/ elongated and clubbed rete ridges (corresponding to the typical erythematous
plaques), and dilated caps in the dermal papillae. DE Path
15431
Cutaneous larva Hookworm infections are transmitted via direct contact between human skin and Dermatology Microbiolo 1
migrans contaminated soil/sand (eg, walking barefoot). Dermal penetration is often characterized by (DE) gy (Micr)
an intensely pruritic papule that may form serpiginous tracks due to the subcutaneous
migration of hookworm larvae. DE Micr
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15441
Ichthyoses Ichthyosis vulgaris is characterized by dermal xerosis (dryness) and scaling that primarily Dermatology Pathology 1
affect the trunk and extensor surfaces of the extremities. It is caused by mutations of the (DE) (Path)
filaggrin gene, resulting in epidermal hyperplasia, defective desquamation, and loss of the
normal barrier function. DE Path
15448
Leishmaniasis Leishmania species are obligate intracellular protozoa that mature in macrophages and can be Dermatology Microbiolo 1
identified on biopsy by the presence of rod-shaped kinetoplasts. They are transmitted to (DE) gy (Micr)
humans by infected sand flies and cause the clinical syndrome of cutaneous leishmaniasis,
characterized by a chronic, pinkish papule that evolves into a nodule or plaque. DE Micr
15550
Hand, foot, mouth HFMD is a common childhood illness characterised by painful, vesicular mouth lesions; Dermatology Pathology 2
disease ulcers on the extremities; and low-grade fever. It's caused by the ingestion and subseq (DE) (Path)
dissemination of an enterovirus (e.g. Coxsackievirus). DE Path
15579
Tinea Tinea corporis presents with round or ovoid lesions with a raised, scaly border and central Dermatology Microbiolo 4
clearing. Trichophyton rubrum is the most common cause and infects keratinized matter in (DE) gy (Micr)
the stratum corneum of the superficial epidermis but does not invade the dermis and
subcutaneous tissues. DE Micr
15675
Diabetic foot Neuropathic foot ulcers can occur in diabetic pts when loss of pain sensation and Dermatology Pathology 2
proprioception delays recognition of injury due to trauma, friction, or sustained pressure (on (DE) (Path)
plantar surface of foot bones). The risk is greatest in pts w/ longstanding DM who have poor
glycaemic control. DE Path
15695
Erythema EM is a target-shaped, inflammatory skin lesion that typically arises in the setting of Dermatology Pathology 2
multiforme infection, particularly w/ HSV or M. pneumoniae. It's caused by the deposition of infectious (DE) (Path)
Ags in keratinocytes, leading to a strong cell-mediated (e.g. Tc-cell) immune response. DE Path
16395
Lichen planus LP presents w/ pruritic, purple/pink, polygonal papules and plaques that can affect the Dermatology Pathology 1
flexural surfaces of the wrists and ankles, along w/ the nails, oral mucous membranes, and (DE) (Path)
genitalia. Histo findings incl hyperkeratosis, lymphocytic infiltrates at the DEJ, thickened
stratum granulosum w/ sawtooth rete ridges, and eosinophilic colloid bodies in the papillary
dermis. DE Path
16862
Melanoma Melanoma lesions often have multiple color variations. The different colors represent Dermatology Immunolo 6
different activities within the tumor. Whitish/gray areas occur when cytotoxic T cells (DE) gy (Immu)
recognize tumor antigens and destroy malignant cells, leading to melanocyte regression. Red
areas arise due to vessel ectasia and local inflammation, whereas brown or black areas are
generally due to advancing malignant melanocytes. DE Immu
16865
Melanoma Melanoma is often Dx when immunostaining of Bx samples reveals multi melanocyte Dermatology Pathology 6
markers (e.g. S-100, HMB-45, MART-1). (DE) (Path) DE Path
16895
Melanoma PD-1 is a checkpoint inhibitor that downregulates the Tc cell response. Neoplastic cells often Dermatology Immunolo 6
exploit this receptor via the overexpression of PD-L1. PD-1 receptor inhibitors (eg, (DE) gy (Immu)
Pembrolizumab) restore the T cell response, allowing Tc cells to invade the tumor and
induce apoptosis of neoplastic cells. DE Immu
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17062
Psoriasis Psoriasis is a common inflammatory skin disorder characterised by hyperkeratosis Dermatology Pathology 5
(overgrowth of the stratum corneum) and epidermal hyperplasia. Plaque psoriasis is the most (DE) (Path)
common form and presents w/ chronic, well-demarcated, erythematous plaques w/ a thick,
silver scale. DE Path
17230
Lice infestation Pediculus humanus capitis (ie, head lice) infestation is common in school children and adults Dermatology Microbiolo 2
who come into close contact w/ infested individuals. Transmission is usually by direct (DE) gy (Micr)
contact. The eggs (nits) are attached to the hair shaft and can be identified on inspection.
Head lice do not carry infection, but the bite can induce a pruritic allergic rxn. 1st-line Tx
includes topical pediculicides (eg, permethrin, ivermectin). DE Micr
308Meniere disease Ménière disease is Chx by tinnitus, vertigo, and sensorineural hearing loss. Its pathogenesis Ear, Nose & Pathophysi 1
is related to an ↑ volume and pressure of endolymph in the vestibular apparatus. Throat (EN) ology
(Patp) EN Patp
1102
Otitis media Nontypeable strains of Haemophilus influenzae are part of the normal upper respiratory tract Ear, Nose & Microbiolo 1
flora and are a common cause of acute otitis media, sinusitis, and bronchitis. Because Throat (EN) gy (Micr)
nontypeable strains do not form a polysaccharide capsule, immunity is not conferred by
vaccination with the H influenzae type b vaccine. EN Micr
1195
Mucocutaneous Nystatin is a polyene antifungal and the Rx of choice for oropharyngeal candidiasis in pts Ear, Nose & Pharmacol 3
candidiasis w/o advanced immunodeficiency. It acts by binding to ergosterol in the fungal cell Throat (EN) ogy (Phar)
membrane, causing the formation of pores and leakage of fungal cell contents. Nystatin is not
absorbed from the GIT and is administered as an oral "swish and swallow" agent. EN Phar
1345
Nonallergic rhinitis Topical preparations of α-adrenergic agonists cause vasoconstriction of the nasal mucosa Ear, Nose & Pharmacol 1
vessels and are used as decongestants. Overuse of these Rx causes (-) feedback, resulting in ↓ Throat (EN) ogy (Phar)
NE synthesis and release from nerve endings, which ↓ their effect (ie, tachyphylaxis). EN Phar
1373
Upper respiratory For a purified RNA molecule to induce viral protein synthesis in a host cell, it must be able Ear, Nose & Microbiolo 2
tract infections to act directly as mRNA using the host's intracellular machinery for translation. Therefore, in Throat (EN) gy (Micr)
general, purified (+) sense ssRNA can be infectious; (-) sense ssRNA or dsRNA is not. EN Micr
1633
Hearing loss Prolonged exposure to loud noises causes hearing loss due to damage to the stereociliated Ear, Nose & Anatomy 2
hair cells of the organ of Corti. Throat (EN) (Anat) EN Anat
1686
Thyroid cancer The recurrent laryngeal nerve travels in close proximity to the inferior thyroid artery and can Ear, Nose & Anatomy 6
be injured during thyroid surgery, resulting in vocal cord paralysis (eg, hoarseness). Throat (EN) (Anat) EN Anat
1698
Orbital fracture Blunt trauma to the globe can cause orbital blowout fractures. These fractures most Ear, Nose & Anatomy 2
commonly involve the medial or inferior orbital walls due to the thin bone bordering the Throat (EN) (Anat)
ethmoid and maxillary sinuses. EN Anat
1740
Cleft lip and cleft Cleft lip results when the maxillary prominence fails to fuse with the intermaxillary segment Ear, Nose & Embryolog 1
palate during the fifth-sixth week of embryonic development. Cleft palate occurs when the palatine Throat (EN) y (Embr)
shelves fail to fuse with one another or with the primary palate. Cleft lip and palate can occur
together or in isolation. EN Embr
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1814
Otitis externa The vagus nerve provides cutaneous sensation to the posterior external auditory canal via its Ear, Nose & Anatomy 2
small auricular branch. Sensation to the rest of the canal is from the mandibular division of Throat (EN) (Anat)
the trigeminal nerve. EN Anat
8342
Otitis externa Pseudomonas aeruginosa is a non lactose-fermenting, oxidase (+), motile, Gram (-) rod. It is Ear, Nose & Microbiolo 2
the most common cause of MOE, a serious infection of the ear seen in elderly diabetic pts. Throat (EN) gy (Micr)
MOE Px w/ exquisite ear pain and drainage, and granulation tissue is often seen w/i the ear
canal. EN Micr
8589
Hearing loss In conductive hearing loss, bone conduction will be greater than air conduction (abnormal Ear, Nose & Physiology 2
Rinne test), and the Weber test will lateralize to the affected ear. In sensorineural hearing Throat (EN) (Phys)
loss, air conduction will be greater than bone conduction (normal Rinne test), and the Weber
test will lateralize to the unaffected ear. EN Phys
8631
Airway emergency Cricothyrotomy is indicated when an emergency airway is required and orotracheal or Ear, Nose & Anatomy 1
nasotracheal intubation is either unsuccessful or contraindicated. The cricothyrotomy Throat (EN) (Anat)
incision passes through the superficial cervical fascia, pretracheal fascia, and the cricothyroid
membrane. EN Anat
8703
Foreign body The internal laryngeal nerve mediates the afferent limb of the cough reflex above the vocal Ear, Nose & Anatomy 1
aspiration cords. Foreign bodies (eg, fish bones) can become lodged in the piriform recess and may Throat (EN) (Anat)
cause damage to the nerve, impairing the cough reflex. EN Anat
11628
Cholesteatoma Cholesteatomas are collections of squamous cell debris that form a mass behind the TM. Ear, Nose & Pathophysi 1
Cholesteatomas can be congenital or may occur as an acquired 1° lesion or following Throat (EN) ology
infection, trauma, or Sx of the middle ear. They can cause hearing loss due to erosion into (Patp)
auditory ossicles. EN Patp
11783
Epistaxis Epistaxis is commonly caused by irritation of the highly vascular mucosa at the anterior nasal Ear, Nose & Anatomy 1
septum. The anterior nasal septum contains the Kiesselbach plexus. The anterior ethmoidal, Throat (EN) (Anat)
sphenopalatine, and superior labial arteries anastomose in this region. EN Anat
15028
Thyroglossal duct Thyroglossal duct cysts form from epithelial remnants of the thyroglossal duct along the path Ear, Nose & Embryolog 1
cyst of thyroid descent. They present as midline masses that rise with swallowing or tongue Throat (EN) y (Embr)
protrusion. EN Embr
163Dyslipidemia BABRs inhib the enterohepatic circulation of BAs. This leads to diversion of hepatic chol to Endocrine, Pharmacol 11
synthesis of new BAs, ↑ uptake of chol from the circulation, and ↓ blood LDL lvls. However, Diabetes & ogy (Phar)
BABRs ↑ hepatic production of TGs and can cause hypertriglyceridaemia. Metabolism
(ES) ES Phar
166Acute pancreatitis In pts w/ severe hypertriglyceridaemia, pancreatic lipases can cause toxic lvls of FFAs to be Endocrine, Pharmacol 9
released w/i the pancreatic tissue, leading to acute pancreatitis. Fibrates (e.g. fenofibrate) are Diabetes & ogy (Phar)
the most effective agents for the Tx of hypertriglyceridaemia. Metabolism
(ES) ES Phar
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167Gout Gout occurs in the setting of hyperuricemia and causes an inflammatory arthritis Endocrine, Pharmacol 11
characterized by negative birefringent, needle-shaped crystals visible on joint fluid Diabetes & ogy (Phar)
microscopy. Most diuretics (eg, hydrochlorothiazide, furosemide) can cause hyperuricemia Metabolism
and trigger gout flares by causing relative volume depletion, which decreases the fractional (ES)
excretion of uric acid. ES Phar
191Dyslipidemia Xanthelasmas, a type of xanthoma, are yellowish macules/papules found on the med. eyelids. Endocrine, Pathology 11
They're dermal accumulations of macrophages containing cholesterol and TGs, and are Diabetes & (Path)
generally a/w a 1° or 2° hyperlipidaemia or dyslipidaemia. An LDL receptor abn is the most Metabolism
common cause. (ES) ES Path
206Diabetes insipidus Injury to the hypothal or post pit (e.g. head trauma, transsphenoidal neuroSx, suprasellar Endocrine, Anatomy 4
masses) can result in CDI. Dmg to the post pit gland typically causes transient DI, whereas Diabetes & (Anat)
dmg to the hypothal nuclei often causes permanent DI. Metabolism
(ES) ES Anat
209Prostate cancer Leuprolide is a GnRH agonist that causes a transient ↑ in pituitary LH secretion, which leads Endocrine, Pharmacol 5
to a rise in testosterone lvls. However, continuous use of leuprolide suppresses LH release Diabetes & ogy (Phar)
and leads to a ↓ in testosterone production. Metabolism
(ES) ES Phar
210Pituitary adenoma Pituitary tumours can present w/ h/a, bitemporal hemianopsia, and hypopituitarism; the most Endocrine, Pathophysi 8
common hormonally active (fxnal) adenomas are PL-secreting adenomas (PRL-omas). PRL- Diabetes & ology
omas can cause galactorrhoea and amenorrhoea in women. In men, they often present w/ Metabolism (Patp)
hypogonadism. (ES) ES Patp
212Primary polydipsia 1° (psychogenic) polydipsia is characterised by excessive intake of free water, leading to Endocrine, Pathophysi 1
hyponatraemia and production of large volumes of dilute urine. Water restriction normalises Diabetes & ology
serum Na+ lvls and ↑ urine osmolality. Metabolism (Patp)
(ES) ES Patp
213Pituitary adenoma Large PRL-secreting pituitary tumours can compress the optic chiasm, causing bitemporal Endocrine, Pathophysi 8
hemianopsia. In addn, ↑ PRL lvls suppress release of GnRH, leading to ↓ LH secretion and Diabetes & ology
subseq impaired testosterone production in men. Metabolism (Patp)
(ES) ES Patp
214Hyperprolactinemia The release of PRL is under inhib control by DA secretion from the hypothal. Disruption of Endocrine, Pathophysi 1
DA-ergic pathways or blockade of DA D2 receptors can cause hyperprolactinaemia. Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
216Infertility LH stims the release of testo from the Leydig cells of the testes; FSH stims the release of Endocrine, Physiology 3
inhibin B from the Sertoli cells in the seminiferous tubules. Testo and inhibin B induce (-) fb Diabetes & (Phys)
on LH and FSH prod, respectively. Metabolism
(ES) ES Phys
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217Cryptorchidism Inhibin B is prod by the Sertoli cells and is the phys inhib of FSH secretion. LH conc is Endocrine, Physiology 2
controlled 1°ly by testo fb. Diabetes & (Phys)
Metabolism
(ES) ES Phys
218Pituitary adenoma In pts w/ PRL-oma, high lvls of circulating PRL suppress GnRH secretion from the hypothal, Endocrine, Pathophysi 8
leading to ↓ secretion of LH and subseq hypogonadism, anovulation, and amenorrhoea. The Diabetes & ology
resulting oestrogen defic can cause osteoporosis w/ an ↑ risk for fragility fractures, and lead
Metabolism (Patp)
to vaginal dryness and atrophy. (ES) ES Patp
220Hypopituitarism High oestrogen lvls during preg cause enlargement of the pit gland w/o a proportional ↑ in Endocrine, Pathology 2
blood supply. Peripartum hypotension can cause ischemic necrosis of the pit leading to Diabetes & (Path)
panhypopituitarism (Sheehan syndrome). Pts commonly develop failure of lactation due to Metabolism
defic of PRL. (ES) ES Path
221Craniopharyngioma The ant. pit is formed from an out-pouching of the pharyngeal roof and is called Rathke's Endocrine, Pathology 2
s pouch. The post. pit gland arises from an extension of the hypothal neurons. Diabetes & (Path)
Craniopharyngiomas are tumours arising from Rathke's pouch remnants in the ant. pit. They Metabolism
char have 3 components: solid, cystic, and calcified. They present during childhood, usually, (ES)
w/ mass effect and visual deficits. ES Path
223Pituitary adenoma Hyperprolactinaemia suppresses secretion of GnRH, which leads to ↓ oestrogen in women. Endocrine, Pathophysi 8
Low oestrogen lvls are a RF for accelerated bone loss. Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
224Growth hormone Gigantism is caused by excess GH during childhood and is characterised by accelerated Endocrine, Pathophysi 2
linear growth, prognathism, and bone enlargement of the hands and feet. GH excess after Diabetes & ology
closure of the epiphysial growth plates causes acromegaly. GH has direct effects on target Metabolism (Patp)
tissues and indirect effects mediated by IGF-1 secretion from the liver. (ES) ES Patp
225Pituitary apoplexy Acute pit hemorrhage (pit apoplexy) is char by severe h/a, BTH (compression of the optic Endocrine, Pathology 1
chiasm), and ophthalmoplegia (compression of CNIII). It usually occurs in a pre-existing pit Diabetes & (Path)
adenoma. Pit apoplexy is a med emergency that req urgent Tx w/ GCs to prevent acute Metabolism
adrenal crisis and circulatory collapse. (ES) ES Path
226SIADH SIADH is characterised by low plasma Na+ and osmolality, inappropriately concentrated Endocrine, Pathophysi 3
urine, and clinically normal volume status (euvolaemic hyponatraemia). An important cause Diabetes & ology
of SIADH is a PNP effect 2° to SCLC. Metabolism (Patp)
(ES) ES Patp
454Hyperaldosteronism Hypersecreting AC tumours can have fxnality resembling the outer (aldosterone/Conn Endocrine, Pathophysi 5
syndrome), middle (cortisol/Cushing syndrome), or inner (androgens/hirsutism and Diabetes & ology
virilisation) layers of the AC. Metabolism (Patp)
(ES) ES Patp
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543DiGeorge syndrome DGS results from maldevel of the 3rd (inf PT and thymus) and 4th (sup PT) Endocrine, Embryolog 2
pharyngeal/branchial pouches. Subseq PT and thymic hypoplasia results in hypcalcemia and Diabetes & y (Embr)
T cell defic. Metabolism
(ES) ES Embr
547Hyperaldosteronism PH is caused by excessive aldosterone secretion, typically as a result of bilateral nodular Endocrine, Pathophysi 5
hyperplasia of the ZG or an aldosterone-producing adrenal adenoma. Clinical findings incl Diabetes & ology
HTN, low PRA, hypokalaemia, and meta alkalosis. Metabolism (Patp)
(ES) ES Patp
548Corticosteroids GCs are predominantly catabolic, causing muscle weakness, skin thinning, impaired wound Endocrine, Pharmacol 3
healing, osteoporosis, and immsup. However, they also cause ↑ hepatic synthesis of GNG Diabetes & ogy (Phar)
and glycogenic proteins to ↑ Glc availability. This, along w/ peri antagonism of insulin, Metabolism
contributes to the devel of hyperglycaemia. (ES) ES Phar
549Corticosteroids The acute effects of corticosteroids on the WBC incl an ↑ neutrophil count and ↓ Endocrine, Pharmacol 3
lymphocyte, monocyte, basophil, and eosinophil counts. The ↑ in the neutrophil count results Diabetes & ogy (Phar)
from 'demargination' of neutrophils previously attached to the vessel wall. Metabolism
(ES) ES Phar
579Kallmann syndrome In KS, there's an absence of GnRH secretory neurons in the hypothal due to defective Endocrine, Pathology 1
migration from the olfactory placode. These pts have central hypogonadism and anosmia, Diabetes & (Path)
and often present w/ delayed puberty. Metabolism
(ES) ES Path
582Klinefelter KFS (47,XXY) causes infertility characterised by 1° hypogonadism (↑ FSH and LH, low Endocrine, Pathophysi 3
syndrome testosterone) and azoospermia. Other findings incl long lower extremities; small, firm testes; Diabetes & ology
and gynecomastia. Metabolism (Patp)
(ES) ES Patp
584Aromatase Oestrogen is the main hormone responsible for the growth and devel of ER(+) breast Endocrine, Pharmacol 1
inhibitors tumours. Aromatase inhibs (e.g. anastrozole, letrozole, exemestane) ↓ the synthesis of Diabetes & ogy (Phar)
oestrogen from androgens, suppressing oestrogen lvls and slowing progr of ER(+) tumours. Metabolism
(ES) ES Phar
585Neuroendocrine Glucagonoma presents w/ hyperglycaemia (often as newly Dx DM) and necrolytic migratory Endocrine, Pathology 1
tumors erythema (blistering erythematous plaques w/ central clearing) affecting the groin, face, and Diabetes & (Path)
extremities. The Dx is made by detecting ↑ glucagon lvls. Metabolism
(ES) ES Path
599Diabetes mellitus TZDs (e.g. pioglitazone) can cause fluid retention, leading to peri oedema and weight gain. Endocrine, Pharmacol 31
The excess fluid can potentially exacerbate underlying CHF. Diabetes & ogy (Phar)
Metabolism
(ES) ES Phar
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600Diabetes mellitus DKA is initially Tx w/ an IV infusion of regular insulin, which allows for rapid adjustments Endocrine, Pharmacol 31
in dose based on BSLs. When given subcutaneously, regular insulin starts working w/i Diabetes & ogy (Phar)
30min, peaks in 2-4hrs, and lasts 5-8hrs. Metabolism
(ES) ES Phar
601Gastrointestinal Reduced gallbladder contractility, due to decreased cholecystokinin secretion, is responsible Endocrine, Pathophysi 2
hormones for biliary stones in patients with somatostatinoma. Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
602Pheochromocytoma Cortisol ↑ the conversion of NE to EPI in the AM by ↑ the expression of PNMT. Endocrine, Biochemist 4
Diabetes & ry (Bioc)
Metabolism
(ES) ES Bioc
604Diabetes mellitus SGLT2 inhibs (e.g. canagliflozin, dapagliflozin) ↓ renal reabsorption of Glc, leading to Endocrine, Pharmacol 31
urinary Glc loss and ↓ BSLs. In pts w/ CKD, these Rx are less effective. Therefore, serum Diabetes & ogy (Phar)
creatinine should be measured prior to therapy. Metabolism
(ES) ES Phar
606Diabetes mellitus SUs inhib the ATP-sensitive K+ channel on the pancreatic β cell membrane, inducing depol Endocrine, Pharmacol 31
and L-type Ca2+ channel opening. The ↑ Ca2+ influx stims β cell insulin release independent Diabetes & ogy (Phar)
of BGCs. SUs can induce hypoglycaemia b/c they stim insulin secretion even when BSLs are Metabolism
normal. (ES) ES Phar
607Diabetes mellitus Metformin inhibs hepatic GNG and ↑ peri Glc utilisation. Lactic acidosis is a rare Endocrine, Pharmacol 31
complication of metformin therapy, but its risk is ↑ in pts w/ underlying renal insufficiency. Diabetes & ogy (Phar)
Metabolism
(ES) ES Phar
608Adrenal Admin of metyrapone will cause a ↓ in cortisol synthesis via inhib of 11-β-hydroxylase. In Endocrine, Pathophysi 5
insufficiency pts w/ an intact HPA axis, this will cause a reactive ↑ in ACTH, 11-deoxycortisol, and Diabetes & ology
urinary 17-hydroxycorticosteroid lvls. Metabolism (Patp)
(ES) ES Patp
609Hypopituitarism Suppression of the HPA axis by GC therapy is the most common cause of AI. In these pts, Endocrine, Pathophysi 2
adrenal crisis can be precipitated by stressful situations (e.g. infections, Sx) if the GC dose Diabetes & ology
isn't ↑ appropriately. Metabolism (Patp)
(ES) ES Patp
610Congenital adrenal 17α-hydroxylase defic impairs the synthesis of androgens, oestrogens, and cortisol but Endocrine, Pathophysi 6
hyperplasia doesn't inhib MC production. Boys appear phenotypically female at birth, but girls develop Diabetes & ology
normal genitalia. Pts typically present w/ hypogonadism, HTN, and hypokalaemia. Metabolism (Patp)
(ES) ES Patp
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611Congenital adrenal 11β-hydroxylase defic typically results in excessive adrenal androgen and MC (11- Endocrine, Pathophysi 6
hyperplasia deoxycorticosterone) production. Genetically female infants are born w/ ambiguous Diabetes & ology
genitalia, and affected individuals develop HTN and hypokalaemia early in life. Metabolism (Patp)
(ES) ES Patp
612Cushing syndrome In Cushing syndrome due to an ACTH-secreting pituitary adenoma (Cushing disease), Endocrine, Pathophysi 5
ACTH is high and cortisol production can be suppressed by high-dose, but not low-dose, Diabetes & ology
dexamethasone. In pts w/ ectopic ACTH production (e.g. from malignant tumours), cortisol Metabolism (Patp)
and ACTH production aren't suppressed by low- or high-dose dexamethasone. (ES) ES Patp
622Hyperthyroidism Graves ophthalmopathy is caused by stimulation of orbital fibroblasts by thyrotropin receptor Endocrine, Pharmacol 8
antibodies and cytokines released by activated T-cells. Excess deposition of extracellular Diabetes & ogy (Phar)
glycosaminoglycans and inflammatory infiltration lead to expansion of extraocular Muscles Metabolism
and retro orbital tissues. Glucocorticoids improve Graves ophthalmopathy by decreasing the (ES)
severity of inflammation and reducing the excess extraocular volume. ES Phar
623Hyperthyroidism Pretibial myxoedema and Graves ophthalmopathy are specific features of GD. They're Endocrine, Pathophysi 8
caused by an autoimmune response directed against the TSH receptor that results in the Diabetes & ology
accumulation of GAGs w/i the affected tissues. Metabolism (Patp)
(ES) ES Patp
626Hyperthyroidism Thioamides (e.g. methimazole, PTU) ↓ the formation of THs via inhib of TPO, the enzyme Endocrine, Pharmacol 8
responsible for both iodine organification and coupling of iodotyrosines. PTU also ↓ the peri Diabetes & ogy (Phar)
conversion of T4 to T3. Metabolism
(ES) ES Phar
631Hyperparathyroidis ↑ bone resorption in PHPT leads to osteoporosis 1arily involving the cortical bone of the Endocrine, Pathophysi 2
m appendicular skeleton. The cortical thinning appears radiologically as subperiosteal erosions. Diabetes & ology
More advanced disease can present as osteitis fibrosa cystica (i.e. granular decalcification of Metabolism (Patp)
the skull, osteolytic cysts, and brown tumours). (ES) ES Patp
637Hyperthyroidism Agranulocytosis is a serious complication of antithyroid drugs (e.g. methimazole, PTU) that Endocrine, Pharmacol 8
results from drug-induced granulocyte destruction and conseq neutropaenia. Initial MFxs Diabetes & ogy (Phar)
often incl fever, sore throat, and oral ulcerations. If drug-induced agranulocytosis is Metabolism
suspected, the drug should be discontinued immediately and a CBC w/ diffial should be (ES)
obtained to help confirm the Dx. ES Phar
641Hypercalcemia PTH causes ↑ bone resorption, ↑ serum Ca lvls, and ↑ renal PO4 excretion. Chron high lvls Endocrine, Physiology 5
of PTH ↑ the risk of OP. However, intermittent admin of recomb PTH analogs (e.g. Diabetes & (Phys)
teriparatide) induces a greater ↑ in osteoblast activity in proportion to osteoclast activity and Metabolism
a net ↑ in bone formation. (ES) ES Phys
656Polycystic ovary Male-pattern hair growth in a woman is called hirsutism; the most common cause is PCOS. Endocrine, Pathophysi 4
disease Combo OCPs can Tx hirsutism by suppressing pituitary LH secretion and subseq ↓ ovarian Diabetes & ology
androgen production. Metabolism (Patp)
(ES) ES Patp
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658Benign prostatic Finasteride is a 5-α-reductase inhib that suppresses peri conversion of testosterone to DHT. Endocrine, Pharmacol 6
hyperplasia It's used for Tx of BPH and androgenetic alopecia. Diabetes & ogy (Phar)
Metabolism
(ES) ES Phar
698Precocious puberty Sex hormones promote both growth and epiphyseal plate closure; hence, precocious puberty Endocrine, Pathophysi 1
may result in a shorter stature, despite an initial growth spurt. Gigantism is caused by Diabetes & ology
excessive pituitary production of GH; these pts achieve enormous heights b/c, unlike Metabolism (Patp)
excessive sex steroids, excessive IGF-1 doesn't lead to premature closure of the epiphysis. (ES) ES Patp
712Drug induced Statins inhib the intracellular RLS of chol biosynthesis via competitive inhib of HMG-CoA Endocrine, Pharmacol 3
myopathy reductase. This leads to enhanced hepatic LDL receptor recycling and ↑ LDL clearance from Diabetes & ogy (Phar)
the circulation. Statin-induced myopathy (e.g. myalgia, ↑ CK) is the most common Metabolism
complication of statin use. (ES) ES Phar
763Ectopic thyroid The thyroid gland is formed from evagination of the pharyngeal epithelium and desc to the Endocrine, Embryolog 1
lower neck. Due to failure of migration, the thyroid can reside anywhere along the Diabetes & y (Embr)
thyroglossal duct's usual path, incl the tongue (lingual thyroid). Metabolism
(ES) ES Embr
764Hypothyroidism The thyroid releases TH (T3 and T4) in response to TSH from the pituitary, which is Endocrine, Pathophysi 13
regulated by TRH from the hypothal. TH suppresses the secretion of TSH and TRH via (-) Diabetes & ology
feedback, and small changes in TH lvls cause large changes in TSH. Serum TSH is the most Metabolism (Patp)
sensitive test for 1° hypothyroidism. (ES) ES Patp
765Hypothyroidism Hypothyroid myopathy presents w/ myalgias, prox. muscle weakness, ↑ CK lvls, and delayed Endocrine, Pathophysi 13
relaxation of DTRs. The Dx can be confirmed w/ an ↑ TSH lvl. Other common causes of Diabetes & ology
myopathy w/ ↑ CK lvls incl inflammatory myopathies, muscular dystrophies, and HMG-CoA Metabolism (Patp)
reductase inhibs. (ES) ES Patp
767Radiation injury KI competitively inhibs thyroid uptake of radioactive I- isotopes and is often admin Endocrine, Pharmacol 1
following nuclear accidents to protect the thyroid and prevent devel of radiation-induced Diabetes & ogy (Phar)
thyroid carcinoma. Metabolism
(ES) ES Phar
768Subacute thyroiditis SGT (de Quervain) is char by painful thyroid enlargement and usually follows a viral illness. Endocrine, Pathology 1
Bx shows a mixed inflammatory infiltrate w/ macrophages and multinucleated giant cells. Diabetes & (Path)
Metabolism
(ES) ES Path
769Hypothyroidism Chronic lymphocytic (Hashimoto) thyroiditis is the most common cause of hypothyroidism. Endocrine, Pathology 13
Histopath char shows an intense lymphocytic infiltrate, often w/ germinal centres. Residual Diabetes & (Path)
follicles may be surrounded by Hürthle cells (large oxyphilic cells filled w/ granular Metabolism
cytoplasm). (ES) ES Path
D eats
770Hypothyroidism TPO catalyzes the ox of I- to iodine, the iodination of TG tyrosine residues, and the Endocrine, Physiology 13
iodotyrosine coupling rxn that forms T3 and T4. Abs against TPO are present in >90% of pts Diabetes & (Phys)
w/ CLT (Hashimoto). Metabolism
(ES) ES Phys
771Pheochromocytoma Neural crests are embryological structures composed of parallel strips of cells arising from Endocrine, Embryolog 4
the ectoderm at the margin of the neural tube. Structures derived from neural crest cells Diabetes & y (Embr)
include Schwann cells, odontoblasts, melanocytes, enterochromaffin cells, spinal Metabolism
membranes, adrenal medulla/ganglia, laryngeal cartilage, and tracheal cartilage. (ES) ES Embr
772Hypothyroidism An ↑ in oestrogen activity, as seen in preg or postmenopausal ORT, ↑ the lvl of TBG. This Endocrine, Pharmacol 13
leads to an ↑ in total TH lvls, but feedback control maintains normal lvls of free (biologically Diabetes & ogy (Phar)
active) TH. Metabolism
(ES) ES Phar
782Dyslipidemia Familial chylomicronaemia syndrome (HLP-I) freq presents in childhood w/ recurrent Endocrine, Pathology 11
episodes of acute pancreatitis. Pts w/ this disorder aren't usually at ↑ risk for premature CAD. Diabetes & (Path)
Eruptive skin xanthomas may be present in hypertriglyceridaemia, but tendon xanthomas and Metabolism
xanthelasmas are 1arily seen w/ hypercholesterolaemia. (ES) ES Path
793Congenital adrenal The most common form of CAH is 21-hydroxylase defic. Genetically female infants Endocrine, Pathophysi 6
hyperplasia typically have ambiguous genitalia (virilisation) at birth, whereas males have phenotypically Diabetes & ology
normal genitalia, w/ salt-wasting or precocious puberty appearing later. ↑ 17- Metabolism (Patp)
hydroxyprogesterone is Dx. (ES) ES Patp
821Brown adipose BAT is found in newborns and in hibernating mammals. BACs contain several Endocrine, Physiology 1
tissue intracytoplasmic fat droplets and many more mitochondria than WACs. They fxn to prod Diabetes & (Phys)
heat by uncoupling ox phos w/ the protein thermogenin. Metabolism
(ES) ES Phys
846Diabetes mellitus In hyperglycemic states, aldose reductase converts Glc to sorbitol at a rate faster than sorbitol Endocrine, Biochemist 31
can be metabolized. Sorbitol accumulates in certain cells such as lens cells, causing an influx Diabetes & ry (Bioc)
of water and resulting in osmotic cellular injury. Depletion of NADPH by aldose reductase Metabolism
also ↑ oxidative stress, which accelerates development of cataracts and diabetic (ES)
microvascular complications (e.g. neuropathy, retinopathy). ES Bioc
847Diabetes mellitus GLUT-4 is an insulin-sensitive Glc transporter expressed in skeletal muscle cells and Endocrine, Biochemist 31
adipocytes that translocates to the plasma membrane in response to ↑ insulin lvls. Diabetes & ry (Bioc)
Metabolism
(ES) ES Bioc
848Diabetes mellitus Pancreatic islet amyloid deposition is char of DM-2. A strong linkage w/ HLA-II gene Endocrine, Pathology 31
makeup, pancreatic islet infiltration w/ leucocytes (insulitis), and Abs against islet Ags are Diabetes & (Path)
freq seen in DM-1. Metabolism
(ES) ES Path
D eats
849Hypoglycemia Glucagon ↑ serum Glc by ↑ hepatic glycogenolysis and GNG. Glucagon also stims insulin Endocrine, Pathophysi 6
secretion from the pancreas. Unlike EPI, glucagon has an insignificant effect on Glc Diabetes & ology
homeostasis in the skeletal muscle, adipose tissue, and RC. Metabolism (Patp)
(ES) ES Patp
850Diabetes mellitus Long-acting insulin analogues (e.g. degludec, detemir, glargine) have an extended duration Endocrine, Pharmacol 31
of action w/o a noticeable peak in activity and are typically given once daily to mimic basal Diabetes & ogy (Phar)
insulin secretion. Rapid-acting insulins (e.g. aspart, lispro, glulisine) are quickly absorbed Metabolism
from the injection site and are given at mealtimes to replicate postprandial insulin secretion. (ES) ES Phar
920Diabetes mellitus TZDs lower blood Glc by ↓ insulin resistance. TZDs activate PPAR-γ, a nuclear receptor that Endocrine, Pharmacol 31
alters the transcription of genes involved in Glc and lipid meta. Diabetes & ogy (Phar)
Metabolism
(ES) ES Phar
921Diabetes mellitus DM-1 typically presents sub-acutely w/ polyuria and polydipsia accompanied by fatigue and Endocrine, Pathophysi 31
weight loss. The Dx can be confirmed w/ an FBG or HbA1c measurement. Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
922Gestational diabetes Maternal hyperglycaemia causes ↑ transplacental Glc delivery to the infant, foetal Endocrine, Pathophysi 2
hyperglycaemia, and, ultimately, β cell hyperplasia. The resulting hyperinsulinaemia caused Diabetes & ology
by islet cell hyperplasia is a/w foetal macrosomia and hypoglycaemia after delivery. Metabolism (Patp)
(ES) ES Patp
924Adrenal Pts w/ DM-1 are at ↑ risk for other autoimmune endocrinopathies, incl PAI (Addison Endocrine, Pathophysi 5
insufficiency disease). Electrolyte abns in PAI incl hyponatraemia, hyperkalaemia, hyperchloraemia, and Diabetes & ology
NAGMA. Metabolism (Patp)
(ES) ES Patp
925Amenorrhea FHA results from loss of pulsatile GnRH release from the hypothal and is caused by weight Endocrine, Pathophysi 2
loss, strenuous exercise, systemic illness, or abn eating habits. Loss of cyclic Gn release Diabetes & ology
leads to a ↓ in LH and FSH secretion from the pituitary, which in turn causes low circulating Metabolism (Patp)
oestrogen lvls. (ES) ES Patp
926Pheochromocytoma PCC is a tumour arising from the chromaffin cells of the AM characterised by excess Endocrine, Pathophysi 4
production of catecholamines. CFx incl episodic HTN, diaphoresis, and palpitations. Micro Diabetes & ology
Ex of the tumour cells shows electron-dense, membrane-bound secretory granules, and IHC Metabolism (Patp)
is (+) for synaptophysin, chromogranin, and neuron-specific enolase. (ES) ES Patp
927Cushing syndrome CS caused by a pit adenoma or ectopic (PNP) ACTH secretion is a/w ↑ ACTH lvls. High- Endocrine, Pathology 5
dose dexamethasone suppresses ACTH and cortisol secretion when CS is caused by a pit Diabetes & (Path)
adenoma (CD) but not when it's caused by ectopic ACTH secretion (e.g. SCLC). Metabolism
(ES) ES Path
D eats
928Cushing syndrome Long-term use of supraphysiologic doses of GCs cause suppression of the HPA axis, which Endocrine, Pathophysi 5
in turn leads to bilateral AC atrophy involving the ZF and ZR. Sudden cessation of the Diabetes & ology
exogenous corticosteroids can precipitate adrenal crisis. Metabolism (Patp)
(ES) ES Patp
929Hyperaldosteronism 1° MC excess (hyperaldosteronism) causes ↑ renal Na+ reabsorption, leading to HTN, Endocrine, Pathophysi 5
hypokalaemia, and meta alkalosis. PHA is freq caused by adrenal adenoma or bilateral Diabetes & ology
hyperplasia. Metabolism (Patp)
(ES) ES Patp
930Congenital adrenal Pts w/ classic, salt-wasting 21-hydroxylase defic have defic cortisol and aldosterone Endocrine, Pathophysi 6
hyperplasia synthesis combo w/ adrenal androgen overproduction. Male infants have normal genitalia Diabetes & ology
and present 1-2wks after birth w/ vomiting, hypotension, hyponatraemia, and hyperkalaemia. Metabolism (Patp)
Females present at birth w/ ambiguous genitalia. (ES) ES Patp
931Adrenal Meningococcal septicaemia can cause bilateral hemorrhagic infarction of the adrenal glands, Endocrine, Pathology 5
insufficiency leading to acute adrenal crisis (WFS). Diabetes & (Path)
Metabolism
(ES) ES Path
932Adrenal Pts w/ AI aren't able to ↑ GC production in response to acute stress (e.g. illness, Sx). Adrenal Endocrine, Pathophysi 5
insufficiency crisis is characterised by severe hypotension, abdo pain, vomiting, weakness, and fever. In Diabetes & ology
addn to aggressive fluid resuscitation, Tx req immediate GC supplementation. Metabolism (Patp)
(ES) ES Patp
934Diabetes mellitus In the polyol pathway, aldose reductase converts Glc into sorbitol, which is slowly meta into Endocrine, Biochemist 31
fructose by SDH. Chronic hyperglycaemia overwhelms this pathway, causing intracellular Diabetes & ry (Bioc)
sorbitol accumulation and ↑ osmotic/oxidative stress. This accelerates cataract devel in pts w/ Metabolism
DM, and contributes to the path of diabetic retinopathy, neuropathy, and nephropathy. (ES) ES Bioc
954Sexual 5α-reductase converts testo to DHT, which mediates devel of the ext genitalia in the male Endocrine, Physiology 2
differentiation fetus. Male neonates w/ 5α-reductase defic are born w/ feminized ext genitalia that typically Diabetes & (Phys)
masculinize at puberty. A small phallus and hypospadias are common. Metabolism
(ES) ES Phys
980Hypercalcemia TZDs cause hypercalcaemia by ↑ the DCT reabsorption of Ca2+. The ↑ circulating Ca2+ lvls Endocrine, Pathology 5
result in suppression of PTH, which distinguishes this effect from HPT. Diabetes & (Path)
Metabolism
(ES) ES Path
981Vitamin D Malabsorption caused by coeliac disease can lead to vitD defic. Pts have ↓ serum P, ↑ serum Endocrine, Pathophysi 4
deficiency PTH (2° HPT), and low (or normal) serum Ca2+. Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
D eats
983Hypothyroidism 1° hypoTH-ism is char by ↓ T4 lvls and ↑ TSH. T3 is 1°ly prod by conversion from T4 in Endocrine, Physiology 13
peri tissues; serum lvls widely fluctuate due to its short ½ life, and can often be w/I the Diabetes & (Phys)
normal range in pts w/ hypoTH-ism. Metabolism
(ES) ES Phys
985Diabetic Most pts w/ DKA have normal to ↑ serum K+ lvls despite a total body K+ deficit. Endocrine, Pathophysi 6
ketoacidosis Replacement of K+ is a crucial step in the Mx of pts w/ DKA. Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
986Multiple endocrine MEN-1 consists of HPT (e.g. hypercalcaemia, constipation, kidney stones), pit tumours, and Endocrine, Pathology 5
neoplasia PETs (e.g. gastrinoma). The genetic defect involves muts of the MEN1gene. Diabetes & (Path)
Metabolism
(ES) ES Path
988Multiple endocrine MEN-2B is characterised by MTC, PCCs, mucosal neuromas, and Marfanoid habitus. HPT Endocrine, Pathophysi 5
neoplasia isn't a feature of this syndrome. Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
989Gluconeogenesis In a fasting state, glucagon and EPI bind to transmembrane receptors and prevent Endocrine, Biochemist 4
hypoglycaemia by ↑ hepatic glycogenolysis and GNG. Prolonged fasting ↑ the secretion of Diabetes & ry (Bioc)
cortisol, a steroid hormone that binds to an intracellular receptor and acts to ↑ transcription of Metabolism
enzymes involved in GNG, lipolysis, and proteolysis. (ES) ES Bioc
990Vitamin D Sunlight exposure catalyzes conversion of 7-dehydrochol to vit D3 in the skin. Subseq 25- Endocrine, Physiology 4
deficiency hydroxylation in the liver and 1-hydroxylation in the kidneys prod 1,25-OH2 vit D, the active Diabetes & (Phys)
form. Inadequate exposure to sunlight can lead to vit D defic. Metabolism
(ES) ES Phys
991Vitamin D In CKD, conversion of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D is impaired. In Endocrine, Physiology 4
deficiency addition, failure of glomerular and tubular fxn results in PO4 retention and hypocalcemia. Diabetes & (Phys)
This leads to a compensatory rise in PTH (2° HPT) that can Px w/ weakness, muscle and Metabolism
joint pain, defective bone mineralization, and ↑ fracture risk. (ES) ES Phys
992Hypercalcemia Ca-sensing receptors are GPCRs that regulate the secretion of PTH in response to changes in Endocrine, Physiology 5
circulating Ca levels. FHH is a benign AD disorder caused by defective Ca-sensing receptors Diabetes & (Phys)
in the parathyroid gland and kidneys. Metabolism
(ES) ES Phys
994Second messengers PKA is responsible for the intracellular effects of the G protein-mediated adenylate cyclase Endocrine, Biochemist 2
2nd messenger system. Hormone receptors that use this system incl the TSH, glucagon, and Diabetes & ry (Bioc)
PTH receptors. Metabolism
(ES) ES Bioc
D eats
997Gluconeogenesis After 12-18hrs of fasting, GNG becomes the principal source of blood Glc. GNG uses many Endocrine, Biochemist 4
glycolytic enzymes, but hexokinase, PFK, and PK need to be bypassed as they're Diabetes & ry (Bioc)
unidirectional. The initial steps of GNG involve the conversion of pyruvate to OA and OA to Metabolism
PEP by PC and PEPCK, respectively. (ES) ES Bioc
998PDH and ketogenic PDH complex defic is an inherited inborn error of meta causing lactic acidosis and neuro Endocrine, Biochemist 1
amino acids defects. Pts are unable to convert pyruvate to acetyl-CoA, resulting in a shunting of pyruvate Diabetes & ry (Bioc)
to lactic acid. In these pts, meta of exclusively ketogenic AAs (e.g. lysine, leucine) can Metabolism
provide energy in the form of acetyl-CoA w/o ↑ lactate production. (ES) ES Bioc
1009
Hypoglycemia Ox meta of Glc in pancreatic β cells generates ATP. ATP-induced closure of the ATP-sens K Endocrine, Physiology 6
channels leads to membrane depol and subseq insulin release. Diabetes & (Phys)
Metabolism
(ES) ES Phys
1010
Diabetes mellitus Insulin release by pancreatic β cells is stim by ↑ Glc meta and ATP production. Glucokinase Endocrine, Biochemist 31
fxns as a Glc sensor in pancreatic β cells by controlling the rate of Glc entry into the Diabetes & ry (Bioc)
glycolytic pathway. muts in the glucokinase gene lead to a state in which higher Glc lvls are Metabolism
req to stim insulin secretion and are a cause of MODY. (ES) ES Bioc
1011
Diabetes mellitus Pts w/ non-coronary atherosclerotic disease, DM, or CKD are at the same risk of CV events Endocrine, Pathology 31
(e.g. MI, stroke) as pts w/ known CAD. CAD is the most common COD in pts w/ DM. Diabetes & (Path)
Metabolism
(ES) ES Path
1012
Diabetes mellitus AI insulitis w/ progr β cell loss is the most common cause of DM-1. IRaccompanied by Endocrine, Pathology 31
relative insulin defic is the main cause of DM-2. Diabetes & (Path)
Metabolism
(ES) ES Path
1013
Diabetes mellitus Smoking cess is by far the most effective preventive intervention in almost all pts, and this is Endocrine, Biostatistic 31
esp true in those w/ DM. Diabetes & s (Bios)
Metabolism
(ES) ES Bios
1019
LDH and glycolysis Under anaerobic conditions, NADH transfers electrons to pyruvate to form lactate and Endocrine, Biochemist 1
regenerate NAD*. NAD+ is required to convert glyceraldehyde-3-phosphate to 1-3- Diabetes & ry (Bioc)
bisphosphoglycerate in glycolysis. Metabolism
(ES) ES Bioc
1022
Citric acid cycle GTP is synthesised by succinyl-CoA synthetase during the conversion of succinyl-CoA to Endocrine, Biochemist 1
succinate in the TCA cycle. During GNG, PEPCK uses GTP to synthesise PEP from OA. Diabetes & ry (Bioc)
Metabolism
(ES) ES Bioc
D eats
1023
Glycogen storage Acid maltase (a-glucosidase) deficiency presents in early infancy with cardiomegaly, Endocrine, Biochemist 3
disease macroglossia, and profound muscular hypotonia. Abnormal glycogen accumulation within Diabetes & ry (Bioc)
lysosomal vesicles is seen on muscle biopsy. Metabolism
(ES) ES Bioc
1030
Glycogen storage Debranching enzyme defic (Cori disease) leads to accumulation of glycogen w/ abnly short Endocrine, Biochemist 3
disease outer chains (limit dextrins) due to the inability to degrade α-1,6-glycosidic branch points. Diabetes & ry (Bioc)
Pts present w/ hypoglycaemia, ketoacidosis, hepatomegaly, and muscle weakness and Metabolism
hypotonia. (ES) ES Bioc
1031
Fructose 2,6 F-2,6-BP activates PFK-1 (↑ glycolysis) and inhibs F-1,6-BPase (↓ GNG). F-2,6-BP conc is Endocrine, Biochemist 1
bisphosphate regulated by a bifxnal enzyme complex: PFK-2 ↑ F-2,6-BP lvls in response to insulin, and F- Diabetes & ry (Bioc)
2,6-BPase ↓ F-2,6-BP lvls in response to glucagon. Metabolism
(ES) ES Bioc
1032
Glycogen storage Glycogen serves as a source of Glc during fasting and as an energy store that can be Endocrine, Biochemist 3
disease mobilised quickly during strenuous muscle contraction. Myophosphorylase defic (McArdle Diabetes & ry (Bioc)
disease or GSD-V) causes failure of muscle glycogenolysis, resulting in ↓ exercise tolerance, Metabolism
muscle pain and cramping, and myoglobinuria w/ physical activity). (ES) ES Bioc
1034
Gluconeogenesis Acetyl-CoA stims GNG by ↑ the activity of PC when acetyl-CoA is abundant. This Endocrine, Biochemist 4
regulatory step allows pyruvate to be shunted toward acetyl-CoA production when acetyl- Diabetes & ry (Bioc)
CoA lvls are low, preventing the cell from becoming depleted of energy. Metabolism
(ES) ES Bioc
1063
Biotin deficiency Biotin acts as a CO2 carrier on the surface of carboxylase enzymes and is an essential Endocrine, Biochemist 1
cofactor for numerous rxns, including the conversion of pyruvate to OA and FA metabolism. Diabetes & ry (Bioc)
Excess ingestion of avidin, found in egg whites, has been a/w biotin deficiency. This Metabolism
condition Px w/ mental status changes, myalgias, anorexia, macular dermatitis, and lactic (ES)
acidosis. ES Bioc
1065
Vitamin D toxicity Excessive vit D intake can lead to hypercalcemia and cause AMS, muscle weakness, Endocrine, Physiology 1
constipation, and polyuria/polydipsia. Activated macrophages in sarcoidosis and other gran Diabetes & (Phys)
diseases express 1α-hydroxylase, leading to excess prod of 1,25-OH2 vit D and Metabolism
hypercalcemia. (ES) ES Phys
1066
Hyperphosphatemia Glucose-6-phosphate dehydrogenase is the rate-limiting enzyme in the pentose phosphate Endocrine, Biochemist 1
pathway, the major source of cellular NADPH. This molecule is necessary for reducing Diabetes & ry (Bioc)
glutathione (protects red blood cells from oxidative damage) and for the biosynthesis of Metabolism
cholesterol, fatty acids, and steroids. (ES) ES Bioc
1067
Fructose Unlike HFI (aldolase B deficiency) and classic galactosemia (GALT deficiency), essential Endocrine, Biochemist 4
metabolism fructosuria (fructokinase deficiency) is a benign disorder. Although affected pts are aSSx, Diabetes & ry (Bioc)
their urine will test (+) for a reducing sugar due to the presence of unmetabolized fructose. Metabolism
(ES) ES Bioc
D eats
1069
Hereditary fructose Aldolase B defic causes HFI. This disease MFx after intro of fructose into the diet w/ Endocrine, Biochemist 1
intolerance vomiting and hypoglycaemia about 20-30min after fructose ingestion. These infants can Diabetes & ry (Bioc)
present w/ FTT, jaundice, and hepatomegaly. Metabolism
(ES) ES Bioc
1070
Fructose Essential fructosuria is a benign disorder of fructose metabolism caused by fructokinase Endocrine, Biochemist 4
metabolism deficiency. In pts w/ essential fructosuria, some of the dietary fructose load is converted by Diabetes & ry (Bioc)
hexokinase to F6P, which can then enter glycolysis; this pathway is not significant in normal Metabolism
individuals. (ES) ES Bioc
1073
Fructose Aldolase B defic, or HFI, leads to accumulation of the tox metabolite F1P. Pts have Endocrine, Biochemist 4
metabolism hypoglycaemia and vomiting when fructose or sucrose is consumed. Tx involves strict Diabetes & ry (Bioc)
removal of both carbs from the diet. Metabolism
(ES) ES Bioc
1119
Principles of cell Cellular compartmentalisation allows multi bch processes to occur simultaneously at max Endocrine, Biochemist 1
biology efficiency. β-oxidation of FAs, the TCA cycle, and the carboxylation of pyruvate (GNG) all Diabetes & ry (Bioc)
occur w/i the mitochondria. The enzymes responsible for glycolysis, FA synthesis, and the Metabolism
PPP reside in the cytosol. (ES) ES Bioc
1121
Diabetes mellitus Insulin is an anabolic hormone that acts via RTK signalling to ↑ the synthesis of glycogen, Endocrine, Biochemist 31
proteins, FAs, and NAs. Tyrosine kinase/PI3K stim promotes glycogen synthesis by Diabetes & ry (Bioc)
activating protein phosphatase, an enzyme that dephosphorylates (activates) glycogen Metabolism
synthase. (ES) ES Bioc
1144
Treatment Physicians should use a nonjudgmental, pt-centered approach in discussing Tx Endocrine, Behavioral 5
adherence nonadherence. Acknowledging the difficulty of taking Rx regularly can strengthen the Diabetes & Science
therapeutic alliance, potentially improving pt receptiveness to educational efforts. Metabolism (Beha)
(ES) ES Beha
1163
Cushing syndrome ACTH is the major trophic hormone of the ZF and ZR, whereas the ZG is 1arily regulated by Endocrine, Pathophysi 5
ATII. Excess production of ACTH causes ↑ cortisol synthesis w/i the ZF (Cushing's MFxs) Diabetes & ology
and ↑ androgen production w/i the ZR (irregular menstruation, hirsutism is women). Metabolism (Patp)
(ES) ES Patp
1213
Hyperthyroidism Hyperthyroidism causes upregulation of β-adrenergic receptor expression, leading to ↑ Endocrine, Pharmacol 8
catecholamine effect. β blockers are used to blunt the adrenergic MFxs of hyperthyroidism. Diabetes & ogy (Phar)
In addn, lipid-soluble β blockers ↓ conversion of T4 to T3 by inhib 5'-monodeiodinase in peri Metabolism
tissues. (ES) ES Phar
1262
Pituitary adenoma PRL-omas are the most common pit adenoma and can cause galactorrhoea, menstrual Endocrine, Pathology 8
irregularities, and infertility in premenopausal women. Large pit adenomas can cause h/a Diabetes & (Path)
from mass effect and BTH from compression of the optic chiasm. Metabolism
(ES) ES Path
D eats
1324
Diabetes mellitus α2 adrenergic receptors inhib insulin secretion, and β2 adrenergic receptors stim insulin Endocrine, Pharmacol 31
secretion. The α2 mediated inhib effect is gen predominant, causing sympathetic stim to lead Diabetes & ogy (Phar)
to overall inhib of insulin secretion. Metabolism
(ES) ES Phar
1325
Hypoglycemia Uptake of Glc by skel muscle is mediated by GLUT4, which is translocated to the cell Endocrine, Physiology 6
membrane in response to insulin and muscle contraction. Hypoglycemia can be precip by Diabetes & (Phys)
exercise in pts w/ insulin-Tx DM due to the persistent effects of exog insulin. Metabolism
(ES) ES Phys
1326
Diabetes mellitus Phosphorylation of serine and threonine residues of IR and IRS by serine kinase leads to Endocrine, Pathophysi 31
insulin resistance. This type of phosphorylation can be induced by TNF-α, catecholamines, Diabetes & ology
GCs, and glucagon. Metabolism (Patp)
(ES) ES Patp
1327
Metabolic syndrome Visceral obesity as measured by waist circumference or waist-to-hip ratio is an important Endocrine, Pathophysi 2
predictor of insulin resistance. Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
1328
Metabolic syndrome DM-2 is due to insulin resistance and relative insulin defic. Chronically ↑ FFA lvls Endocrine, Pathophysi 2
contribute to insulin resistance by impairing insulin-dependent Glc uptake and ↑ hepatic Diabetes & ology
GNG. Metabolism (Patp)
(ES) ES Patp
1334
Niacin deficiency Hartnup disease is caused by impaired transport of neutral AAs in the small intestine and Endocrine, Biochemist 3
PCT of the kidney. SSx incl pellagra-like skin eruptions and cerebellar ataxia, which occur as Diabetes & ry (Bioc)
a result of vitB3 defic. The Dx can be confirmed thru detection of excessive amounts of Metabolism
neutral AAs in the urine. (ES) ES Bioc
1335
Maple syrup urine MSUD classically presents w/ irritability, dystonia, poor feeding, and a 'maple syrup' scent to Endocrine, Biochemist 2
disease the pt's urine w/i the 1st few days of life. Dietary restriction of BCAAs (e.g. leucine, Diabetes & ry (Bioc)
isoleucine, valine) is the hallmark of Tx. Metabolism
(ES) ES Bioc
1336
Maple syrup urine BCKD req several coenzymes: Thiamine. Lipoate, Coenzyme A, FAD, NAD (mnemonic: Endocrine, Biochemist 2
disease Tender Loving Care Fore Nancy). Some pts w/ MSUD improve w/ high-dose vitB1 Tx, but Diabetes & ry (Bioc)
most req lifelong restriction of leucine, isoleucine, valine. Metabolism
(ES) ES Bioc
1355
Cellular transports Transport of Glc into the cells of most tissues occurs by means of fac diffusion. Glc moves Endocrine, Physiology 2
from areas of high conc to areas of low conc w/ the help of transmembrane GLUT. These Diabetes & (Phys)
carrier proteins are stereoselective and have pref for D-Glc. Metabolism
(ES) ES Phys
D eats
1370
Urea cycle Pts w/ urea cycle disorders typically have discrete episodes of vomiting, tachypnoea, and Endocrine, Biochemist 3
confusion/coma 2° to hyperammonaemia (a meta emergency). OTC defic is the most Diabetes & ry (Bioc)
common disorder of the urea cycle and is characterised by hyperammonaemia and ↑ urinary Metabolism
orotic acid. (ES) ES Bioc
1379
Body fluid Volume contraction and expansion can be divided into isosmotic, hyposmotic, and Endocrine, Biochemist 1
distribution hyperosmotic states. Hyperosmotic volume contraction is caused by a loss of free water (w/ Diabetes & ry (Bioc)
retention of electrolytes). It can occur in pts w/ DI or as a result of ↓ fluid intake/excessive
Metabolism
sweating. (ES) ES Bioc
1383
Protein structure Integral membrane proteins contain transmembrane domains composed of α helices w/ Endocrine, Biochemist 1
hydrophobic AA residues (e.g. alanine, valine, leucine, isoleucine, phenylalanine, Diabetes & ry (Bioc)
tryptophan, methionine, proline, glycine). These transmembrane domains help anchor the Metabolism
protein to the phospholipid bilayer of the cell membrane. (ES) ES Bioc
1407
Hypothyroidism Congenital hypoTH-ism is usually aSSx at birth. After maternal T4 wanes, infants develop Endocrine, Genetics 13
constipation, lethargy, hypotonia, macroglossia, an umbi hernia, and a large ant fontanelle. Diabetes & (Gene)
Metabolism
(ES) ES Gene
1484
Phenylketonuria PKU results from an inability to convert phenylalanine to tyrosine by the phenylalanine Endocrine, Biochemist 5
hydroxylase system, making tyrosine an essential AA in these pts. Classic CFx of unTx PKU Diabetes & ry (Bioc)
include intellectual disability, seizures, light pigmentation, and a “musty” odor. Metabolism
(ES) ES Bioc
1492
Hypoglycemia Nonselective β blockers exacerbate hypoglycaemia and mask hypoglycaemic SSx mediated Endocrine, Pharmacol 6
by NE/EPI. Diabetes & ogy (Phar)
Metabolism
(ES) ES Phar
1501
Phenylketonuria BH2 reductase defic (DHBRD) results in impaired BH4 lvls. BH4 is an important cofactor Endocrine, Biochemist 5
for both phenylalanine hydroxylase and tyrosine hydroxylase. Although phenylalanine lvls Diabetes & ry (Bioc)
can be corrected w/ dietary restriction, downstream defic of DA, NE, EPI, and 5-HT lead to Metabolism
progr neuro deterioration. (ES) ES Bioc
1540
Diabetic Normal BGLs are maint by the opp effects of insulin and glucagon. Glucagon stims hepatic Endocrine, Physiology 6
ketoacidosis glycogenolysis and GNG, whereas insulin ↑ peri Glc uptake and inhibs lipolysis and KA Diabetes & (Phys)
formation. Insulin also suppresses glucagon release. Metabolism
(ES) ES Phys
1561
SIADH ADH and Oxt are synthesised w/i neurons found in the PVN and SON and are released into Endocrine, Pathophysi 3
the circulation from axon terminals in the posterior pituitary. NPs are involved in the post- Diabetes & ology
translational processing and stabilisation of Oxt and ADH w/i neurosecretory vesicles during Metabolism (Patp)
transport to the posterior pituitary. (ES) ES Patp
D eats
1562
Diabetes insipidus NPs are carrier proteins for Oxy and ADH. Oxy and ADH are carried by unique NPs from Endocrine, Physiology 4
their site of prod in the cell bodies of the PVN and SON to their site of release in the axon Diabetes & (Phys)
terminals of the post pit. Point muts in NP-II underlie most cases of HHDI, a disorder Metabolism
resulting from insuff ADH release into the syst circulation. (ES) ES Phys
1615
Hypothyroidism TSH from the ant pit stims the thyroid to prod T4 and a small amount of T3. T4 is converted Endocrine, Physiology 13
in peri tissues to T3 (active form) and rT3 (inactive form). TSH secretion is under (-) fb by Diabetes & (Phys)
TH on the hypothal and pit. Metabolism
(ES) ES Phys
1655
Diabetes mellitus Proinsulin is cleaved into mature insulin and C-peptide, which are co-secreted from Endocrine, Pharmacol 31
pancreatic β cells in equimolar amounts. Circulating lvls of C-peptide can be used as a Diabetes & ogy (Phar)
marker of endogenous insulin secretion. SUs and meglitinides ↓ blood Glc by stim pancreatic Metabolism
insulin secretion; hypoglycaemia due to these agents is a/w ↑ C-peptide lvls. (ES) ES Phar
1656
Hypoparathyroidism Hypocalcaemia can cause muscle cramps, perioral paraesthesias, hypotension, and Endocrine, Pathophysi 1
neuromuscular hyperexcitability. Injury to the PT glands during thyroid Sx is a common Diabetes & ology
cause of hypoparathyroidism and acute hypocalcaemia. Metabolism (Patp)
(ES) ES Patp
1658
Thyroid cancer PTC is the most common type of thyroid ca. ChFx on histopath incl large cells w/ nuclei Endocrine, Pathology 6
containing finely disperse chromatin, giving an empty or ground-glass appearance (Orphan Diabetes & (Path)
Annie eye), and intranuclear inclusions or grooves. Metabolism
(ES) ES Path
1659
Thyroid cancer MTC is a NET that arises from parafollicular calcitonin-secreting C cells. It's char by nests or Endocrine, Pathology 6
sheets of polygonal or spindle-shaped cells w/ extracellular amyloid deposits derived from Diabetes & (Path)
calcitonin. Metabolism
(ES) ES Path
1660
Thyroid cancer MTC is a NET that arises from calcitonin-secreting C (parafollicular) cells. It's often seen in Endocrine, Pathology 6
the context of MEN-2 (A and B), although the majority of cases are sporadic. Both sporadic Diabetes & (Path)
and familial MTCs are a/w muts in the RETproto-oncogene. Metabolism
(ES) ES Path
1673
Lipodystrophy HAART for HIV is commonly a/w body fat redistribution. Subcutaneous lipoatrophy Endocrine, Pharmacol 1
involving the face and extremities is a/w NRTIs (esp. stavudine and zidovudine) and PIs. Diabetes & ogy (Phar)
Central fat accumulation in the trunk and viscera can occur w/ any HAART regimen. Metabolism
(ES) ES Phar
1720
Turner syndrome GH binds to cell surface receptors, leading to intracellular activation of the JAK-STAT Endocrine, Biochemist 8
pathway. Cytokines (e.g. IFN) and hematopoietic GFs (e.g. EPO, G-CSF) also use this Diabetes & ry (Bioc)
pathway. Metabolism
(ES) ES Bioc
D eats
1747
Thyroid cancer The ext branch of the sup laryngeal nerve is at risk of injury during thyroidectomy due to its Endocrine, Anatomy 6
prox to the sup thyroid art and vein. This nerve innervs the cricothyroid muscle. Diabetes & (Anat)
Metabolism
(ES) ES Anat
1768
Diabetes mellitus Cleavage of proinsulin in pancreatic β-cell secretory granules yields insulin and C-peptide, Endocrine, Physiology 31
which are stored in the granules until they’re secreted in equimolar amounts. Diabetes & (Phys)
Metabolism
(ES) ES Phys
1789
Phenylketonuria Intellectual disability, gait or posture abn, eczema, and a musty body odor in a toddler are Endocrine, Genetics 5
SSx of PKU. Most infants w/ PKU are born to 2 heterozyg carrier parents. The prob that Diabetes & (Gene)
heterozyg carrier parents will transmit an AR disease such as PKU to a child is 1/4. Metabolism
(ES) ES Gene
1839
Anorexia nervosa Distorted bodyimage, inadequatediet, dryskin, and lanugo hair in a female suggest AN. Endocrine, Pathology 3
Anorexic females commonly have impaired GnRH release from the hypothal, leading to low Diabetes & (Path)
lvls of LH, FSH, and oestrogen (fxnal hypothal amenorrhoea). Metabolism
(ES) ES Path
1844
Multiple endocrine MEN-2B is char by MTC, PCC, marfanoid habitus, and oral and intestinal mucosal Endocrine, Pathology 5
neoplasia neuromas. Diabetes & (Path)
Metabolism
(ES) ES Path
1845
Multiple endocrine MEN-1 syndrome is characterised by tumours of the pituitary, PT gland, and pancreas (the '3 Endocrine, Pathophysi 5
neoplasia Ps'). Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
1866
Gluconeogenesis Ethanol inhibs GNG and can cause hypoglycaemia once hepatic glycogen stores are Endocrine, Pathophysi 4
depleted. Diabetes & ology
Metabolism (Patp)
(ES) ES Patp
1886
Beta oxidation Carnitine deficiency impairs FA transport from the cytoplasm into mitochondria, preventing Endocrine, Biochemist 3
β-oxidation of FAs into acetyl-CoA. This leads to cardiac and skeletal myocyte injury (lack Diabetes & ry (Bioc)
of ATP from TCA) and impaired ketone body production by the liver during fasting periods. Metabolism
(ES) ES Bioc
1887
Ketone utilization When glycogen stores are depleted during fasting, ketone bodies are produced in the liver Endocrine, Biochemist 1
and can be used as an energy source in the mitochondria of peri tissues. The brain Diabetes & ry (Bioc)
preferentially uses Glc, but will utilise ketones for most of its energy needs during prolonged Metabolism
starvation. Erythrocytes lack mitochondria and are unable to use ketones. (ES) ES Bioc
D eats
1888
Beta oxidation Impaired β-oxidation of FAs causes hypoglycaemia after prolonged fasting and insufficient Endocrine, Biochemist 3
lvls of ketone bodies. MCAD catalyses the 1st step in the β-oxidation pathway and is the Diabetes & ry (Bioc)
most commonly defic enzyme. Metabolism
(ES) ES Bioc
1889
Triglyceride Glycerol produced by the degradation of TGs in adipose tissue can be used by glycerol Endocrine, Biochemist 2
metabolism kinase in the liver and kidney to synthesize Glc during GNG. Diabetes & ry (Bioc)
Metabolism
(ES) ES Bioc
1901
Androgenic steroids Androgenic steroidabuse may lead to erythrocytosis, testicularatrophy, acne, and virilisation Endocrine, Pathology 2
in women (e.g. clitoromegaly, hirsutism). Diabetes & (Path)
Metabolism
(ES) ES Path
1921
Cushing syndrome PNP hypercortisolism, most commonly caused by SCLC, is due to ectopic ACTH secretion. Endocrine, Pathology 5
CFx incl HTN, hyperglycaemia, oedema, and hyperpigmentation. Unlike non-PNP CS, Diabetes & (Path)
central obesity is uncommon. Metabolism
(ES) ES Path
1945
Hyperthyroidism Hyperthyroidism causes a hyperadrenergic state Chx by HTN, palpitations/tachycardia, Endocrine, Pharmacol 8
sweating, heat intolerance, tremor, and hyperreflexia. β blockers can relieve these SSx. Diabetes & ogy (Phar)
Exophthalmos in Graves disease is due to an immune-mediated ↑ in orbital soft tissue mass Metabolism
and does not improve w/ β blockers. (ES) ES Phar
1979
Metabolic acidosis Normally, meta acidosis is partially compensated for by resp alkalosis. When the steady-state Endocrine, Pathophysi 4
PaCO2 persists above the range given by the Winter formula (PaCO2 = [1.5 * HCO3-] + 8 Diabetes & ology
+/- 2), the pt has a superimposed resp acidosis (resp failure). Metabolism (Patp)
(ES) ES Patp
1984
Hypoglycemia Severe hypoglycaemia w/ LOC is typically Tx w/ IM glucagon in the non-med setting and w/ Endocrine, Pharmacol 6
IV dextrose in the med setting. Diabetes & ogy (Phar)
Metabolism
(ES) ES Phar
1989
Fabry disease In Fabry disease, α-galactosidase A deficiency causes accumulation of the sphingolipid Gb3. Endocrine, Biochemist 1
The earliest MFx of Fabry disease are neuropathic pain and angiokeratomas. Glomerular (e. Diabetes & ry (Bioc)
g. proteinuria, renal failure), cardiac (e.g. LVH), and cerebrovascular (e.g. TIA, stroke) Metabolism
complications develop in adulthood. (ES) ES Bioc
1990
Niemann-Pick NPD is an AR disorder that's common in the Ashkenazi Jewish pop. This disorder is Endocrine, Biochemist 2
characterised by sphingomyelinase defic and sphingomyelin accumulation, which cause Diabetes & ry (Bioc)
hepatosplenomegaly and neuro regression in infancy. Metabolism
(ES) ES Bioc
D eats
1991
Niemann-Pick In NPD, sphingomyelinase defic causes accumulation of the lipid sphingomyelin. CFx incl Endocrine, Biochemist 2
hepatosplenomegaly, neuro regression, and a cherry-red macular spot in infancy. Diabetes & ry (Bioc)
Metabolism
(ES) ES Bioc
1996
Diabetes mellitus HbA1c is produced by NEG of the Hb molecule. A HbA1c assay provides an estimate of Endocrine, Pathology 31
chronic glycaemic control over the life span of circulating erythrocytes (~3mos). However, Diabetes & (Path)
rapid erythrocyte turnover (e.g. hemolytic anaemia) can give a misleadingly low HbA1c in Metabolism
relation to glycaemic status. (ES) ES Path
2016
Steroid hormones The initial step in the synthesis of steroid hormones is the conversion of cholesterol to Endocrine, Biochemist 1
pregnenolone in the mitochondria. The remainder of steroidogenesis occurs in the smooth Diabetes & ry (Bioc)
endoplasmic reticulum. Steroid-producing cells contain a well-developed smooth Metabolism
endoplasmic reticulum. (ES) ES Bioc
2064
Dyslipidemia Familial dysbetalipoproteinemia (type III hyperlipoproteinemia) is an autosomal recessive Endocrine, Biochemist 11
disorder characterized by elevated cholesterol and triglyceride levels. It is caused by defects Diabetes & ry (Bioc)
in ApoE3 and ApoE4, leading to decreased clearance of chylomicrons and VLDL remnants. Metabolism
Patients can develop eruptive and palmar xanthomas and premature atherosclerosis. (ES) ES Bioc
2066
Protein synthesis Orotic aciduria is a rare AR disorder of de novo pyrimidine synthesis that occurs due to a Endocrine, Biochemist 2
defect in UMP synthase. Children typically present w/ physical and mental retardation, Diabetes & ry (Bioc)
megaloblastic anaemia, and large amounts of urinary orotic acid. Uridine supplementation Metabolism
can improve SSx as uridine is converted to UMP via nucleoside kinases. (ES) ES Bioc
2080
Congenital adrenal Males w/ classic, non-salt-wasting 21-hydroxylasedefic present at age 2-4yrs w/ early Endocrine, Pathology 6
hyperplasia virilisation, ↑ linear growth, and ↑ lvls of 17-hydroxyprogesterone and androgens. Females Diabetes & (Path)
w/ classic 21-hydroxylase defic (+/- salt-wasting) present w/ ambiguous genitalia at birth. Metabolism
(ES) ES Path
2081
Congenital adrenal Tx of CAH involves low doses of exogenous CSs to suppress excessive ACTH secretion and Endocrine, Pathology 6
hyperplasia ↓ stim of the AC. Diabetes & (Path)
Metabolism
(ES) ES Path
6803
Diabetes mellitus Incretin fxns by stim insulin release following oral consumption of Glc. Incretin-stim insulin Endocrine, Physiology 31
release is independent of the ↑ in insulin secretion brought on by ↑ in the BGL. Diabetes & (Phys)
Metabolism
(ES) ES Phys
7651
Growth hormone Acromegaly is caused by excessive production of GH, usually due to a pit somatotroph Endocrine, Pathology 2
adenoma. MSK MFxs incl bony hypertrophy (e.g. frontal bossing; enlarged jaw, hands, and Diabetes & (Path)
feet) and OA. LVH is often common in acromegaly and may progress to HF. Metabolism
(ES) ES Path
D eats
8424
Pheochromocytoma Chromaffin cells are modified neuroendo cells derived from the neural crest. Chromaffin Endocrine, Histology 4
cells in the AM are stimulated by ACh released by sympathetic preganglionic neurons and Diabetes & (Hist)
secrete CAs directly into the bloodstream to amplify SNS activity. Metabolism
(ES) ES Hist
8531
Hypoglycemia Hypoglycaemia is char by tremor, diaphoresis, and confusion in a/w a low BGL and Endocrine, Pathology 6
resolution of SSx when the BGL is corrected. Hypoglycaemia w/ ↑ insulin and low C-peptide Diabetes & (Path)
lvls suggests exogenous insulin injection, whereas ↑ C-peptide suggests an insulin Metabolism
secretagogue or insulin-secreting tumour. (ES) ES Path
11565
Diabetes mellitus SUs (e.g. glyburide, glimepiride) ↑ insulin secretion by pancreatic β cells independent of Endocrine, Pharmacol 31
BGC. These Rx have a high incidence of hypoglycaemia, esp. in the elderly. Diabetes & ogy (Phar)
Metabolism
(ES) ES Phar
11634
Dyslipidemia Ezetimibe ↓ intestinal absorption of chol. As a result, the amount of dietary chol reaching the Endocrine, Pharmacol 11
liver ↓. To compensate, the liver ↑ LDL receptor expression, which draws chol out of the Diabetes & ogy (Phar)
circulation. Metabolism
(ES) ES Phar
11657
Gynecomastia Gynecomastia is the devel of glandular breast tissue in males and is commonly seen in men Endocrine, Pharmacol 3
receiving androgen deprivation therapy for prostate ca. Tamoxifen inhibs the effect of Diabetes & ogy (Phar)
oestrogen on breast tissue and can ↓ the risk of gynecomastia in these pts. Metabolism
(ES) ES Phar
11660
Hypocalcemia Postop hypocalcemia is common after thyroid Sx, due to inadvertent removal or dmg to the Endocrine, Physiology 1
PT glands. The acute drop in PTH lvl results in ↓ Ca and PO4 resorption from bone and ↓ Ca Diabetes & (Phys)
reabs by the kidneys. Metabolism
(ES) ES Phys
11664
Hyperthyroidism Postop hypoparathyroidism w/ resultant hypocalcaemia is a common complication of Endocrine, Pharmacol 8
thyroidectomy due to inadvertent injury or removal of the PT glands. Postop Diabetes & ogy (Phar)
supplementation w/ oral Ca2+ and vitD can be used to Tx and prevent postop Metabolism
hypocalcaemia. (ES) ES Phar
11917
Triglyceride HSL is found in adipose tissue, where it fxns to drive the breakdown of stored TGs into Endocrine, Biochemist 2
metabolism FFAs and glycerol. During times of starvation, this enzyme provides substrates for hepatic Diabetes & ry (Bioc)
GNG and ketone body formation. Metabolism
(ES) ES Bioc
11918
Beta oxidation Cytosolic acetyl-CoA carboxylase converts acetyl-CoA to malonyl-CoA during the rate- Endocrine, Biochemist 3
limiting step of de novo fatty acid synthesis. Malonyl-CoA also inhibits the action of Diabetes & ry (Bioc)
mitochondrial carnitine acyltransferase, thereby inhibiting beta-oxidation of newly formed Metabolism
fatty acids. (ES) ES Bioc
D eats
11950
Transcription Zn-finger motifs are composed of chains of AAs bound together around a Zn atom via Endocrine, Biochemist 7
linkages w/ cysteine and histidine residues. They recognise specific DNA seqs and are used Diabetes & ry (Bioc)
by many TFs to bind DNA and alter activity of target genes. Intracellular receptors that bind Metabolism
steroids, TH, and fat-soluble vits act directly as TFs and contain Zn-finger binding domains. (ES) ES Bioc
14136
Diabetes mellitus GLP-1 is secreted by intestinal L cells in response to food intake and regulates Glc lvls by Endocrine, Pharmacol 31
slowing gastric emptying, suppressing glucagon secretion, and ↑ Glc-dependent insulin Diabetes & ogy (Phar)
release. GLP-1 agonists are parenteral anti-DM agents that can improve glycaemic control w/ Metabolism
low risk of hypoglycaemia. They're also a/w significant weight loss unlike many other anti- (ES)
DM agents. ES Phar
14818
Gynecomastia 5-α reductase inhibs (e.g. finasteride, dutasteride) are used in the Tx of BPH. These Rx block Endocrine, Pathophysi 3
the conversion of testosterone to DHT; the excess testosterone is then available for Diabetes & ology
conversion to oestrogens (e.g. oestradiol) by aromatase, which can lead to gynecomastia. Metabolism (Patp)
(ES) ES Patp
14919
Osteoporosis Rx-induced oesophagitis is a common AE of BPs. BPs are also a/w ↑ risk of osteonecrosis of Endocrine, Pharmacol 10
the jaw and atypical femoral fractures. Diabetes & ogy (Phar)
Metabolism
(ES) ES Phar
14930
Osteoporosis The NFκB (RANK)/RANK-L interaction is essential for the formation and diff of Endocrine, Pathophysi 10
osteoclasts. OPG blocks binding of RANK-L to RANK and ↓ formation of mature Diabetes & ology
osteoclasts, leading to ↓ bone resorption. Denosumab is a mAb used in the Tx of Metabolism (Patp)
postmenopausal osteoporosis that works in a manner similar to OPG. (ES) ES Patp
14952
Osteoporosis Long-term use of GnRH agonists (e.g. leuprolide) suppresses pituitary LH release and leads Endocrine, Pharmacol 10
to the ↓ production of testosterone. The lower lvls of circulation testosterone produce a Diabetes & ogy (Phar)
clinical effect similar to that of Sx orchiectomy and can lead to accelerated bone loss and ↑ Metabolism
risk for osteoporosis. (ES) ES Phar
14985
Hypothyroidism Thyrotoxicosis, whether due to endogenous hyperthyroidism or over-replacement with Endocrine, Pathophysi 13
thyroid hormone in patients with hypothyroidism, causes a hyperadrenergic state that can Diabetes & ology
lead to atrial fibrillation, high-output heart failure, and worsening of angina pectoris. Metabolism (Patp)
(ES) ES Patp
14988
Hypothyroidism HypoTH-ism causes ↓ expression of LDL receptors in the liver, leading to ↓ clearance of Endocrine, Physiology 13
LDL and ↑ blood LDL lvls. It also causes hyperTG-emia due to ↓ expression of LPL. The Diabetes & (Phys)
AEs of hypoTH-ism on lipid lvls can ↑ the risk of coronary atherosclerosis. Metabolism
(ES) ES Phys
14995
Hypothyroidism Central hypothyroidism is characterised by low serum TSH and T4 lvls and is due to HP Endocrine, Pathophysi 13
dysfxn. Sheehan syndrome is ischemic necrosis of the pituitary gland and is typically caused Diabetes & ology
by systemic hypotension during delivery. In addn to central hypothyroidism, pts may also Metabolism (Patp)
develop defic of other pituitary hormones (e.g. ACTH, PRL, Gn). (ES) ES Patp
D eats
15016
Hyperthyroidism Exogenous hyperthyroidism is characterised by ↑ free T4, suppressed TSH, and Endocrine, Pathophysi 8
low/undetectable TG. It can occur w/ surreptitious levothyroxine abuse, use of animal- Diabetes & ology
sourced thyroid supplements, and erroneous dosing of thyroid replacement therapy. Over Metabolism (Patp)
time, the lack of TSH stim causes the thyroid follicles to become atrophic. (ES) ES Patp
15105
Multiple endocrine MEN-2 is caused by germline activating muts in the RET proto-oncogene and freq results in Endocrine, Pathophysi 5
neoplasia both MTC and PCC. In pts w/ un-Dx PCC, induction of anaesthesia (e.g. prep for Diabetes & ology
thyroidectomy) can precipitate a catecholamine surge, leading to HTN crisis, flash pulm Metabolism (Patp)
oedema, and AF. (ES) ES Patp
15303
Pituitary adenoma Galactorrhoea is abn secretion of breast milk not a/w preg or breastfeeding. It's most Endocrine, Pharmacol 8
commonly due to excess PRL, as seen in PRL-secreting pituitary adenomas. PRL is under (-) Diabetes & ogy (Phar)
regulation by hypothal DA-ergic neurons, and DA agonists can be sued to Tx Metabolism
hyperprolactinaemia. (ES) ES Phar
15308
Diabetes mellitus Insulin has both renal and hepatic clearance. In pts w/ adv CKD and DM, ↓ renal clearance Endocrine, Physiology 31
of insulin can lead to SSx hypoglycemia if exog insulin doses aren't adjusted based on the Diabetes & (Phys)
change in renal fxn. Metabolism
(ES) ES Phys
15770
Diabetes mellitus SGLT2 inhibs (e.g. canagliflozin, dapagliflozin) ↓ renal reabsorption of Glc and Na+, leading Endocrine, Pharmacol 31
to lower BSLs. The ↓ reabsorption of Na+ and Glc also induces osmotic diuresis, which Diabetes & ogy (Phar)
causes a ↓ in BP. Excess urinary Glc also leads to an ↑ risk for GUTIs. Metabolism
(ES) ES Phar
15876
Diabetes mellitus Phys insulin secretion can be approx. by a combo of long-acting and rapid-acting insulin Endocrine, Pharmacol 31
analogues. Long-acting preps (e.g. glargine) are released from the injection site slowly Diabetes & ogy (Phar)
throughout the day and replicate basal insulin secretion. Boluses of a rapid-acting insulin (e. Metabolism
g. lispro) w/ quick absorption are given w/ meals to control postprandial Glc ↑. (ES) ES Phar
15881
Diabetes mellitus SUs inhib the ATP-sensitive K+ channel on the pancreatic β cell membrane, inducing depol Endocrine, Pharmacol 31
and L-type Ca2+ channel opening. The ↑ Ca2+ influx stims β cell insulin release independent Diabetes & ogy (Phar)
of BGCs. SUs stim insulin secretion, even when BSLs are normal, which can lead to Metabolism
hypoglycaemia. (ES) ES Phar
16324
Diabetes mellitus GLP-1 regulates Glc by slowing gastric emptying, suppressing glucagon secretion, and ↑ Endocrine, Pharmacol 31
Glc-dependent insulin release. DPP-4 inhibs (e.g. sitagliptin, saxagliptin) ↓ the breakdown of Diabetes & ogy (Phar)
GLP-1 and improve glycaemic control in pts w/ DM-2. B/c the effect on insulin is Glc- Metabolism
dependent, these Rx have a low risk of hypoglycaemia. (ES) ES Phar
17236
Thyroid cancer Foll neoplasms typically present as slowly enlarging, painless thyroid nodules. diff b/w a foll Endocrine, Pathology 6
adenoma and FTC isn't possible using only FNA results. Histo evidence of invasion of the Diabetes & (Path)
tumour capsule a/o surrounding blood vessels is needed to Dx FTC. Metabolism
(ES) ES Path
D eats
17246
Adrenal Primary adrenal insufficiency (PAI) is characterized by weight loss, abdominal pain, fatigue, Endocrine, Pathology 5
insufficiency and hyperpigmentation. Physiologic stress in patients with PAI can trigger acute adrenal Diabetes & (Path)
crisis (eg, fever, shock, mental status changes). Autoimmune adrenalitis is the most common Metabolism
cause of PAI and leads to bilateral adrenal atrophy. (ES) ES Path
110Mucocutaneous Abx suppress the normal vaginal flora and facilitate Candida overgrowth. Abx use is the Female Microbiolo 3
candidiasis most common cause of Candida vaginitis. Other potential causes include pregnancy, Reproductive gy (Micr)
systemic corticosteroid use, DM, and immunosuppression. & Breast (FR) FR Micr
127Ovarian cancer A Krukenberg tumor is a gastric tumor that has metastasized to the ovary and can present Female Pathology 9
with unintentional weight loss, epigastric pain, and adnexal masses. Histologically, the Reproductive (Path)
metastatic tumor cells have large amounts of mucin with apically displaced nuclei, resulting & Breast (FR)
in a signet ring appearance. FR Path
207Infertility Anovulation is a common cause of infertility. Menotropin (human menopausal gonadotropin) Female Physiology 3
is a treatment option that acts like FSH and triggers the formation of a dominant ovarian Reproductive (Phys)
follicle. Ovulation is then induced by administration of human chorionic gonadotropin, & Breast (FR)
which mimics the LH surge. FR Phys
208Infertility Pulsatile administration of GnRH stimulates FSH and LH release and is useful for the Tx of Female Physiology 3
infertility. Nonpulsatile (constant) infusion of GnRH, or a long-acting analog, suppresses Reproductive (Phys)
FSH and LH release and subsequently suppresses gonadal fxn. & Breast (FR) FR Phys
215Menopause Menopause occurs on average at age 51 and is Dx retrospectively after 12 mos of Female Physiology 1
amenorrhea. An ↑ serum FSH level confirms the Dx. Reproductive (Phys)
& Breast (FR) FR Phys
256Turner syndrome Streak ovaries, amenorrhea, and infertility are the gynecologic complications of TS. In Female Genetics 8
addition, pts w/ TS usually have short stature, webbed neck, shield chest, and low posterior Reproductive (Gene)
hairline. Bicuspid AV is the most common cardiac comorbidity. & Breast (FR) FR Gene
258Polycystic ovary PCOS is a/w oligomenorrhea, hirsutism, and polycystic ovaries. Disruption in intraovarian Female Physiology 4
disease steroidogenesis causes anovulatory cycles and results in chronic estrogen stimulation w/ ↓ Reproductive (Phys)
progesterone secretion, placing PCOS pts at risk for endometrial hyperplasia/carcinoma. & Breast (FR) FR Phys
299Apoptosis Progesterone is the 1° hormone responsible for stimulating the endometrium so that it is Female Physiology 4
suitable for implantation. Progesterone withdrawal causes endometrial cells to undergo Reproductive (Phys)
apoptosis, resulting in menstrual bleeding. & Breast (FR) FR Phys
333Endometriosis Endometriosis refers to the presence of endometrial glands and stroma outside the uterus. It Female Pathology 1
may be asymptomatic or present with dysmenorrhea, dyspareunia, and/or infertility. Reproductive (Path)
& Breast (FR) FR Path
339Turner syndrome TS (45,X) MFx in the neonate w/ lymphedema and cystic hygromas. Short stature, 1° Female Genetics 8
amenorrhea, and aortic anomalies are the other important CFx. Reproductive (Gene)
& Breast (FR) FR Gene
D eats
578Ovarian cancer The pathogenesis of epithelial ovarian ca is linked to the frequency of trauma and repair at Female Pathophysi 9
the ovarian surface. OCPs, multiparity, and breastfeeding are protective by ↓ the frequency Reproductive ology
of ovulation. RFx include BRCA mutation, nulliparity, and infertility. & Breast (FR) (Patp) FR Patp
581Breast cancer Selective ER modulators (eg, tamoxifen, raloxifene) are competitive inhibitors of estrogen Female Pharmacol 7
binding to ERs. They can have agonist or antagonist effects depending on the specific tissue. Reproductive ogy (Phar)
Tamoxifen has an estrogenic effect on the uterus and can cause endometrial hyperplasia and & Breast (FR)
ca. FR Phar
583Abortion Progesterone is necessary for implantation and maintenance of pregnancy. Mifepristone is a Female Pharmacol 3
progesterone antagonist that is used w/ misoprostol (a PGE1 agonist) to terminate a 1st- Reproductive ogy (Phar)
trimester pregnancy. & Breast (FR) FR Phar
869Cervical cancer Consistent use of barrier contraceptives is extremely important for preventing STIs, Female Pathophysi 3
including HPV. Pts infected w/ carcinogenic strains of HPV (ie, 16, 18, and 31) are at risk of Reproductive ology
SCC of the cervix. & Breast (FR) (Patp) FR Patp
879Contraception All hormone-containing contraceptives prevent pregnancy through the actions of progestins. Female Pharmacol 3
The main mechanism of contraceptives with systemically active progestins (eg, combined Reproductive ogy (Phar)
hormonal oral contraceptives) is inhibiting ovulation by decreasing FSH and LH synthesis in & Breast (FR)
the anterior pituitary. FR Phar
1008
Cervicitis Neisseria gonorrhoeae and Chlamydia trachomatis cause mucopurulent cervicitis, which can Female Microbiolo 1
progress to PID if unTx. PID can cause scarring of the fallopian tubes, leading to ectopic Reproductive gy (Micr)
pregnancy and infertility. & Breast (FR) FR Micr
1015
Human Human papillomavirus (HPV) infection causes cutaneous and genital warts as well as benign Female Pathology 4
papillomavirus and malignant intraepithelial neoplasia. Koilocytosis is a hallmark sign of HPV infection. Reproductive (Path)
Koilocytes are pyknotic, superficial or immature squamous cells with a dense, irregularly & Breast (FR)
staining cytoplasm and perinuclear halo-like clearing. FR Path
1027
Pelvic inflammatory PID is most frequently caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Severe Female Pathophysi 2
disease or inadequately Tx PID can result in fallopian tube scarring, which in turn can lead to Reproductive ology
infertility. Tx must always include coverage of both organisms w/ a 3rd-generation & Breast (FR) (Patp)
cephalosporin (eg, ceftriaxone) as well as azithromycin or doxycycline. FR Patp
1056
Breast cancer Invasive breast carcinoma typically presents as an irregularly shaped, adherent breast mass, Female Anatomy 7
most commonly in the upper outer quadrant. Malignant infiltration of suspensory ligaments Reproductive (Anat)
of the breast can cause skin retractions. & Breast (FR) FR Anat
1057
Ductal carcinoma in Ductal carcinoma in situ is characterized by ducts distended by pleomorphic cells with Female Pathology 1
situ prominent central necrosis that do not penetrate the basement membrane. It is the precursor Reproductive (Path)
to invasive ductal carcinoma, the most common type of breast cancer. & Breast (FR) FR Path
1109
Fibroadenoma Fibroadenomas are the most common benign tumor of the breast. They are characterized Female Pathology 1
breast histologically by a cellular or myxoid stroma that encircles and sometimes compresses Reproductive (Path)
epithelium lined glandular and cystic spaces. & Breast (FR) FR Path
D eats
1158
Ovarian cancer Granulosa cell tumors are sex-cord stromal tumors of the ovary that secrete estrogen and can Female Pathology 9
cause endometrial hyperplasia. Call-Exner bodies (cells arranged in a microfollicular or Reproductive (Path)
rosette pattern) are seen on microscopy. On gross pathology, the tumor appears yellow due to & Breast (FR)
the lipid content in theca cells. FR Path
1317
Menstrual cycle Of all hormones influencing the menstrual cycle (LH, FSH, estrogen, progesterone), Female Physiology 2
progesterone ↑ the most in concentration after ovulation. During the latter half of the Reproductive (Phys)
menstrual cycle, the CL secretes high levels of progesterone, which thickens the & Breast (FR)
endometrium and prepares it to receive and nourish a blastocyst. FR Phys
1447
Metronidazole Metronidazole is used to Tx trichomonal vaginitis and bacterial vaginosis. It can cause Female Pharmacol 1
disulfiram like effects (eg, abdominal cramps, nausea, headache) when combined w/ Alc due Reproductive ogy (Phar)
to acetaldehyde accumulation. & Breast (FR) FR Phar
1549
HSV infection 1° infection w/ HSV-2 typically Px w/ fever and a painful vesicular genital rash. HSV-2 Female Microbiolo 9
primarily infects the sacral DRG and can be reactivated to cause recurrent genital lesions. Reproductive gy (Micr)
& Breast (FR) FR Micr
1560
Estrogen synthesis LH stimulates the theca interna cells of the ovarian follicle to produce androgens. Aromatase Female Physiology 1
w/i the follicle's granulosa cells subsequently converts these androgens to estradiol under Reproductive (Phys)
FSH stimulation. The theca externa cells serve as a CT support structure for the follicle. & Breast (FR) FR Phys
1632
Ovarian cancer The suspensory ligament of the ovary contains the ovarian artery, vein, lymphatics, and Female Anatomy 9
nerves. The ovarian artery is the major blood supply to the ovary and must be ligated during Reproductive (Anat)
an oophorectomy to prevent heavy bleeding. & Breast (FR) FR Anat
1739
Anesthesia A pudendal nerve block is performed by injecting an anesthetic intravaginally, medial to the Female Anatomy 9
ischial spine, through the sacrospinous ligament. This provides anesthesia to most of the Reproductive (Anat)
perineum. & Breast (FR) FR Anat
1809
Amenorrhea Pts w/ Müllerian aplasia (ie, Mayer-Rokitansky-Küster-Hauser syndrome) have no upper Female Embryolog 2
vagina (eg, short vagina) and variable uterine development. These pts are 46,XX females w/ Reproductive y (Embr)
normal ovaries and 2° sexual Chx. & Breast (FR) FR Embr
1810
Turner syndrome Pts w/ TS may have karyotype 45,X (complete monosomy), 45,X/46,XX (mosaicism), or 46, Female Genetics 8
XX (w/ partial deletion of one X chromosome). Complete monosomy X usually results from Reproductive (Gene)
meiotic nondisjunction during gametogenesis. & Breast (FR) FR Gene
1830
Gestational A complete mole usually results when an empty ovum is fertilized by a haploid sperm. Female Genetics 3
trophoblastic Subsequent duplication of the paternal genetic complement (23X) results in the Chx 46, XX Reproductive (Gene)
disease genotype. & Breast (FR) FR Gene
1831
Mullerian anomalies In females, the paramesonephric ducts fuse to form the fallopian tubes, uterus, cervix, and Female Embryolog 1
upper vagina. Disruptions of this process can lead to a variety of Müllerian tract anomalies, Reproductive y (Embr)
and renal anomalies are a common comorbidity. Incomplete lateral fusion of the & Breast (FR)
paramesonephric ducts results in a bicornuate uterus Chx by an indentation in the center of
the fundus. FR Embr
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1837
Ovarian cancer Epithelial ovarian cancer is the most common ovarian malignancy. Histologic findings Female Pathology 9
include anaplasia of epithelial cells with invasion into the stroma, along with multiple Reproductive (Path)
papillary formations with cellular atypia. Epithelial ovarian tumors produce CA-125, which & Breast (FR)
can be used as a serum marker for this condition. FR Path
1899
Dysfunctional Anovulation is common in the 1st several yrs after menarche and the last few yrs before Female Physiology 1
uterine bleeding, menopause. It MFx w/ marked menstrual cycle variability. Reproductive (Phys)
anovulation & Breast (FR) FR Phys
1917
Pituitary adenoma Prolactinomas are the most common hormonally active pituitary adenomas. The excess Female Pathology 8
prolactin produced by these tumors can cause galactorrhea and amenorrhea in premenopausal Reproductive (Path)
women. With a large mass, visual changes and headaches may occur due to compression of & Breast (FR)
the optic chiasm. FR Path
1928
Ovarian cancer Sertoli-Leydig cell tumors of the ovary arise from the sex cord stroma and secrete Female Pathology 9
testosterone. Typical features include a large ovarian mass and signs of virilization. Tubular Reproductive (Path)
structures lined by round Sertoli cells and surrounded by a fibrous stroma are seen on & Breast (FR)
pathology. FR Path
1929
Bacterial vaginosis Bacterial vaginosis is a/w a grayish-white vaginal d/c w/ a "fishy" odor. The etiology Female Microbiolo 3
involves an overgrowth of Gardnerella vaginalis, an anaerobic Gram-variable rod. Clue cells Reproductive gy (Micr)
(squamous epithelial cells covered w/ bacterial organisms) are seen on wet mount & Breast (FR)
microscopy or cytology. FR Micr
1932
Pelvic inflammatory Ruptured ectopic pregnancy can cause abdominal pain, vaginal bleeding, and hemodynamic Female Microbiolo 2
disease instability. PID is most commonly caused by Neisseria gonorrhoeae or Chlamydia Reproductive gy (Micr)
trachomatis and significantly ↑ the risk of ectopic pregnancy. & Breast (FR) FR Micr
1957
Adenomyosis Adenomyosis is the presence of endometrial glandular tissue w/i the myometrium. Female Histology 1
Menorrhagia and dysmenorrhea are common Px SSx. Pts have a uniformly enlarged uterus Reproductive (Hist)
w/ normal-appearing endometrial tissue on Bx. & Breast (FR) FR Hist
1986
Menstrual cycle The secretory phase of the menstrual cycle occurs b/w ovulation and menses, from days 15- Female Physiology 2
28 of the normal menstrual cycle. Progesterone released by the CL causes the uterine glands Reproductive (Phys)
to coil and secrete glycogen-rich mucus in preparation for embryo implantation. The & Breast (FR)
endometrial stroma becomes edematous and completely traversed by tortuous spiral arteries
that extend from the deeper layers to the uterine lumen. FR Phys
1992
Cervical cancer Human papillomavirus (HPV) infection, especially with strain 16 or 18, is the strongest risk Female Pathology 3
factor for development of cervical dysplasia and invasive cervical carcinoma. HIV Reproductive (Path)
coinfection allows HPV infection to persist and enhances expression of HPV oncogenes, & Breast (FR)
increasing the risk for cervical dysplasia/cancer. FR Path
2056
Female genital tract The uterine mucosa is covered by endometrium, and abnormal implantation of endometrial Female Pathology 1
histology glands/stroma is referred to as endometriosis. The ovary is covered by a simple cuboidal Reproductive (Path)
epithelium involved in surface repair of defects from ovulation. Endometriosis commonly & Breast (FR)
affects the ovary and results in infertility. FR Path
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2094
Polycystic ovary Polycystic ovary syndrome is characterized by elevated LH levels, excess androgen Female Pathophysi 4
disease production, and insulin resistance. Clinical features include obesity, menstrual irregularities, Reproductive ology
hirsutism, enlarged ovaries, and an increased risk of diabetes mellitus and endometrial & Breast (FR) (Patp)
hyperplasia. FR Patp
2095
Polycystic ovary Patients with polycystic ovary syndrome who desire fertility can be treated with clomiphene. Female Pathophysi 4
disease Clomiphene is an estrogen receptor modulator that decreases negative feedback inhibition on Reproductive ology
the hypothalamus by circulating estrogen, thereby increasing gonadotropin production. & Breast (FR) (Patp) FR Patp
7489
Turner syndrome Common MFx of TS include 1° amenorrhea, short stature, a high arched palate, and widely Female Genetics 8
spaced nipples. 1° amenorrhea occurs in these pts due to in utero degeneration of the ovarian Reproductive (Gene)
follicles (gonadal dysgenesis). & Breast (FR) FR Gene
8390
Imperforate hymen Imperforate hymen is caused by incomplete degeneration of the central portion of the fibrous Female Anatomy 1
tissue band connecting the walls of the vagina. Adolescent patients typically present with Reproductive (Anat)
primary amenorrhea, normal secondary sexual characteristics, and cyclic abdominal or pelvic & Breast (FR)
pain due to accumulation of menstrual blood in the vagina and uterus (eg, hematocolpos). FR Anat
11652
Ovarian cancer Teratomas are the most common subtype of germ cell tumor. Ovarian teratomas occur most Female Pathology 9
frequently in females age 10-30. They are divided into mature (cell lines of >1 germ layer, Reproductive (Path)
commonly including hair, teeth, and skin) and immature types. & Breast (FR) FR Path
11765
Bacterial vaginosis Bacterial vaginosis is caused by a disruption of the vaginal bacteria flora and is Chx by a Female Microbiolo 3
"fishy-smelling," thin, grayish vaginal d/c and clue cells on wet mount microscopy. Reproductive gy (Micr)
Metronidazole and clindamycin are the preferred Tx options. & Breast (FR) FR Micr
11781
Ureter injury The ureter can be injured during hysterectomy due to its close proximity to the uterine Female Anatomy 3
structures. The distal ureter may be severed during ligation of the uterine vessels because the Reproductive (Anat)
ureter passes inferior and lateral to the uterine artery at the level of the internal cervical os & Breast (FR)
prior to entering the bladder (eg, "water under the bridge"). FR Anat
11802
Vulvovaginitis Trichomonas vaginitis is caused by a motile protozoan which can be seen on wet mount Female Microbiolo 1
microscopy of vaginal d/c. It Px w/ yellow-green vaginal d/c and vaginal burning and is Reproductive gy (Micr)
sexually transmitted. & Breast (FR) FR Micr
11820
Urinary Stress urinary incontinence is defined as involuntary urine loss with increased Female Anatomy 7
incontinence intraabdominal pressure. Pelvic floor strengthening (eg, Kegel exercises) targets the levator Reproductive (Anat)
ani to improve support around the urethra and bladder. & Breast (FR) FR Anat
11823
Perineal lacerations The perineal body is a fibromuscular tissue between the urogenital and anal triangle. A Female Anatomy 1
midline episiotomy is a vertical incision from the posterior vaginal opening to the perineal Reproductive (Anat)
body. It transects the vaginal submucosal tissue but not the external anal sphincter or the & Breast (FR)
rectal mucosa. FR Anat
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11858
Human Human papillomavirus infection of basal cervical cells can progress to premalignant and Female Pathology 4
papillomavirus cancerous lesions. Cervical intraepithelial neoplasia refers to atypical squamous cells and is Reproductive (Path)
classified as low grade squamous intraepithelial lesions (if extending <1/3 of the epithelium) & Breast (FR)
or high-grade squamous intraepithelial lesions (if extending beyond). Basement membrane
breach signifies invasive disease. FR Path
11885
Uterine fibroids Subserosal leiomyomas (fibroids) often cause irregular uterine enlargement, resulting in Female Anatomy 1
pelvic pressure. Fibroids arising from the posterior subserosal surface of the uterus can cause Reproductive (Anat)
constipation due to pressure on the colon. & Breast (FR) FR Anat
11888
Labor management Gap junctions facilitate communication and coordination b/w cells and play an important role Female Histology 1
in labor contractions. Connexins are proteins that assemble into gap junctions and their Reproductive (Hist)
density ↑ in the uterus before delivery in response to rising estrogen levels. & Breast (FR) FR Hist
11890
Intraductal Intraductal papilloma is a proliferation of papillary cells in a cyst wall or duct that may Female Histology 1
papilloma contain focal atypia. It is the most common cause of bloody nipple discharge and typically Reproductive (Hist)
presents without breast masses or skin changes. & Breast (FR) FR Hist
11901
Ovarian torsion Ovarian torsion typically involves twisting of the infundibulopelvic ligament, often due to Female Anatomy 1
the weight of a large adnexal mass. The resulting occlusion of the blood and nerve supply to Reproductive (Anat)
the ovary results in severe, acute pelvic pain and ovarian ischemia. & Breast (FR) FR Anat
11908
Postpartum Postpartum hemorrhage is an obstetrical emergency. Bilateral ligation of the internal iliac Female Anatomy 1
hemorrhage artery can decrease uterine blood flow and control postpartum hemorrhage that is Reproductive (Anat)
unresponsive to medical management (eg, uterine massage, uterotonic medications). & Breast (FR) FR Anat
11920
Ovarian vein Venous stasis and hypercoagulability from pregnancy in addition to endothelial damage from Female Anatomy 1
thrombosis delivery can cause ovarian vein thrombosis in the puerperium. Symptoms include fever and Reproductive (Anat)
localized abdominal or flank pain. Most thrombosis is right-sided and can extend to the & Breast (FR)
inferior vena cava; however, left ovarian vein thrombosis can extend to the left renal vein. FR Anat
11926
Urinary A common SSx during pregnancy is stress urinary incontinence, which occurs due to ↑ IAP Female Pathophysi 7
incontinence from the gravid uterus that exceeds the pressure point that maintains closure of the urethral Reproductive ology
valve. Pregnancy hormones ↓ urethral tone and relax the pelvic floor muscles (levator ani, & Breast (FR) (Patp)
coccygeus), which maintain closure of the urethral valve. FR Patp
11929
Human Human papillomavirus (HPV) oncogenicity relies on the inhibitory effects of viral proteins Female Pathology 4
papillomavirus E6 and E7 on cell cycle regulatory proteins p53 and Rb. This allows cells infected with HPV Reproductive (Path)
to undergo unchecked cellular proliferation and evasion of apoptosis, promoting genomic & Breast (FR)
instability and malignant transformation. FR Path
11961
Abortion Septic abortion typically Px w/ fever, abdominal pain, uterine tenderness, a/o foul-smelling Female Microbiolo 3
d/c after pregnancy termination. Common offending pathogens include Staphylococcus Reproductive gy (Micr)
aureus and Escherichia coli due to seeding of the uterine cavity during instrumentation. & Breast (FR) FR Micr
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Mosaicism Mosaicism is defined as the presence of multiple, genetically different cell lines w/i the body. Female Genetics 1
It can result from several processes, including chromosomal nondisjunction or a mutation Reproductive (Gene)
during the 1st stages of embryonic development. Somatic mosaicism results in a mixture of & Breast (FR)
normal and mutated somatic cells, often leading to a milder form of the disease. FR Gene
12298
Turner syndrome IVF using a donated ovum is the most promising means of achieving pregnancy in a woman Female Genetics 8
w/ TS. Pregnancy can occasionally occur spontaneously in some pts w/ TS, but the risk of Reproductive (Gene)
spontaneous abortion, DS and TS are all ↑ in such cases. & Breast (FR) FR Gene
12512
Hypothyroidism Prolactin production is regulated primarily by inhibitory effects of hypothalamic Female Anatomy 13
dopaminergic pathways. However, prolactin secretion is stimulated by thyrotropin-releasing Reproductive (Anat)
hormone (TRH). In patients with primary hypothyroidism, the increased production of TRH & Breast (FR)
by the hypothalamus can lead to hyperprolactinemia. FR Anat
47 Hepatitis D The HBsAg of HBV must coat the HDAg of HDV before it can infect hepatocytes and Gastrointestina Microbiolo 2
multiply. l & Nutrition gy (Micr)
(GI) GI Micr
54 Hemangioma Cavernous hemangioma is the most common benign liver tumour. Microscopically, these Gastrointestina Pathology 6
tumours consist of cavernous, blood-filled vascular spaces of variable size lined by a single l & Nutrition (Path)
epithelial layer. The Bx of a suspected hemangioma is not advisable, as the procedure has (GI)
been known to cause fatal hemorrhage and is of low Dx yield. GI Path
56 Hepatocellular AFP is a serum tumour marker that's often moderately ↑ in pts w/ chronic viral hepatitis. Gastrointestina Pathology 5
cancer However, it can be strikingly ↑ in those w/ HCC, and a sudden rise can be a sign that a pt w/ l & Nutrition (Path)
chronic liver disease is harbouring HCC. (GI) GI Path
57 Hepatocellular High lvls of dietary aflatoxin exposure is a/w a G:C → T:A transversion in codon 249 of the Gastrointestina Pathology 5
cancer p53 gene, a mut thought to greatly ↑ the risk of devel HCC. l & Nutrition (Path)
(GI) GI Path
59 Metastatic liver Malignant hepatic lesions most often represent mets from another 1° site (e.g. breast, lung, Gastrointestina Pathology 1
disease colon); 1° liver neoplasms (e.g. HCC) are much less common. l & Nutrition (Path)
(GI) GI Path
62 Liver abscess S. aureus can cause hepatic abscesses via heme seeding of the liver. Enteric bacteria (e.g. E. Gastrointestina Microbiolo 1
coli, Klebsiella, and enterococci) can cause hepatic abscesses by asc the biliary tract (i.e. asc l & Nutrition gy (Micr)
cholangitis), portal vein pyemia, or direct invasion from an adjacent area (e.g. cholecystitis). (GI) GI Micr
67 Gallstone disease Fibrate Rx (e.g. fenofibrate, gemfibrozil) inhib cholesterol 7α-hydroxylase, which catalyzes Gastrointestina Biochemist 8
the RLS in the synthesis of BAs. The ↓ BA production results in ↓ cholesterol solubility in l & Nutrition ry (Bioc)
bile and favors the formation of cholesterol gallstones. (GI) GI Bioc
70 Gallstone disease Brown pigment gallstones are composed of Ca salts of unconjugated bilirubin and arise 2° to Gastrointestina Biochemist 8
bacterial or helminthic infection of the biliary tract. β-glucuronidase released by injured l & Nutrition ry (Bioc)
hepatocytes and bacteria hydrolyzes bilirubin glucuronides to unconjugated bilirubin. The (GI)
liver fluke Clonorchis sinensis has a high prevalence in East Asian countries and is a
common cause of pigment stones. GI Bioc
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71 Gallstone disease The gallbladder fxns to actively absorb water from bile. Gallbladder hypomotility causes the Gastrointestina Pathology 8
bile to become concentrated, promoting precipitation and accumulation of particulate l & Nutrition (Path)
material. This forms a viscous biliary sludge that can cause transient BDO (biliary colic) and (GI)
promote cholesterol gallstone formation. GI Path
77 Gallstone disease The absence of normal enteral stim in pts receiving TPN leads to ↓ CCK release, biliary Gastrointestina Pathophysi 8
stasis, and ↑ risk of gallstones. Resection of the ileum can also ↑ the risk of gallstones due to l & Nutrition ology
disruption of normal enterohepatic circulation of the BAs. (GI) (Patp) GI Patp
78 Gallstone disease ↑ chol concs ↑ the likelihood of chol precipitation and gallstone formation. High lvls of bile Gastrointestina Pathophysi 8
salts and PC ↑ chol solubility and ↓ the risk of gallstones. l & Nutrition ology
(GI) (Patp) GI Patp
79 Cholecystitis Acute calculous cholecystitis is an acute inflammation of the gallbladder initiated by Gastrointestina Pathology 5
gallstone obstruction of the cystic duct. Subsequent steps in pathogenesis include mucosal l & Nutrition (Path)
disruption by lysolecithins, bile salt irritation of the luminal epithelium, PG release w/ (GI)
transmural inflammation, gallbladder hypomotility, ↑ intraluminal pressure causing ischemia,
and bacterial invasion. GI Path
80 Cholecystitis Acute cholecystitis is most often caused by gallstones obstructing the cystic duct. The Gastrointestina Pathophysi 5
diagnosis can be made by identifying signs of gallbladder inflammation (eg, wall thickening, l & Nutrition ology
pericholecystic fluid) on ultrasonography. When ultrasound is inconclusive, nuclear (GI) (Patp)
medicine hepatobiliary scanning (ie, cholescintigraphy) can be used to assess cystic duct
patency and make the diagnosis. GI Patp
81 Cholecystitis Acute acalculous cholecystitis is an acute inflammation of the gallbladder in the absence of Gastrointestina Pathology 5
gallstones. It typically occurs in critically ill pts (eg, those w/ sepsis, severe burns, trauma, l & Nutrition (Path)
immunosuppression) due to gallbladder stasis and ischemia. CFx may be subtle and include (GI)
fever, RUQ pain, and leukocytosis. GI Path
87 Porcelain Porcelain gallbladder is a potential MFx of chronic cholecystitis and is often found in a/w Gastrointestina Pathology 1
gallbladder multi gallstones. It's due to dystrophic intramural deposition of Ca2+ salts in the setting of l & Nutrition (Path)
chronic inflammation. Porcelain gallbladder is a/w an ↑ risk of adenocarcinoma of the (GI)
gallbladder. GI Path
88 Bowel obstruction Gallstone ileus is a mech bowel obstr caused when a large gallstone erodes into the intestinal Gastrointestina Pathology 1
lumen. Pneumobilia (air in the biliary tract) is a common finding. l & Nutrition (Path)
(GI) GI Path
99 Biliary excretory A moderately ↑ ALP of unclear etiology should be f/u w/ GGT. Gastrointestina Pathology 1
function l & Nutrition (Path)
(GI) GI Path
100Cirrhosis Hyperestrinism in liver cirrhosis likely arises due to ↑ in androstenedione production, Gastrointestina Pathology 7
androgen aromatisation, and sex hormone-binding globulin (SHBG) conc (preferentially l & Nutrition (Path)
binds testosterone). Impaired oestrogen meta by the liver may also be a contributing factor. A (GI)
↓ free testosterone/oestrogen ratio leads to gynaecomastia, testicular atrophy, ↓ body hair,
and spider angiomata. GI Path
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101Hereditary DJS is a benign disorder characterised by defective hepatic excretion of bilirubin Gastrointestina Pathophysi 1
hyperbilirubinemia glucuronides across the canalicular membrane, resulting in direct hyperbilirubinaemia and l & Nutrition ology
jaundice. Grossly, the liver appears black due to impaired excretion of EPI metabolites, (GI) (Patp)
which histo appear as dense pigments w/i lysosomes. GI Patp
102Hepatic HE is caused by ↑ lvls of NH3 and other neurotox in the circulation that lead to ↑ inhib Gastrointestina Pathophysi 2
encephalopathy neurotransmission and impaired excitatory NT release. HE is freq precipitated by a stressor l & Nutrition ology
(e.g. GI bleeding, infection) that ↑ blood NH3lvls. (GI) (Patp) GI Patp
122Esophageal cancer Major RFx for esophageal SCC include smoking, excessive Alc consumption, and intake of Gastrointestina Pathology 4
foods containing N-nitroso compounds. l & Nutrition (Path)
(GI) GI Path
124Vitamin B12 Pernicious anemia is an autoimmune disorder caused by the cell-mediated destruction of Gastrointestina Histology 9
deficiency parietal cells in the superficial upper glandular layer of the gastric body and fundus. Parietal l & Nutrition (Hist)
cells are responsible for the secretion of hydrochloric acid and intrinsic factor, a glycoprotein (GI)
involved in the absorption of B12. Deficiency leads to megaloblastic anemia and neurologic
dysfunction. GI Hist
125Stress gastric ulcer Stress-related mucosal disease is usually caused by local ischemia in the setting of severe Gastrointestina Pathology 1
physiologic stress (e.g. shock, extensive burns, sepsis, severe trauma). Ulcers arising in the l & Nutrition (Path)
setting of severe trauma/burns are call Curling ulcers. Ulcers arising from intracranial injury (GI)
are caused by direct vagal stim and are called Cushing ulcers. GI Path
126Intestinal phase The cephalic and gastric phases stim gastric acid secr, while intestinal influences tend to ↓ Gastrointestina Physiology 1
gastric acid secr. l & Nutrition (Phys)
(GI) GI Phys
128Hypertrophic Congenital pyloric stenosis arises 2° to hypertrophy of the pyloric muscularis mucosae. Gastrointestina Pathology 1
pyloric stenosis l & Nutrition (Path)
(GI) GI Path
129Submucosal glands Gastric acid is neutralised by HCO3- from the submucosal glands of the duodenum (Brunner Gastrointestina Anatomy 1
of Brunner glands) and from pancreatic duct secretions. Chronic overproduction of gastric acid can lead l & Nutrition (Anat)
to hyperplasia of the submucosal glands. (GI) GI Anat
130Peptic ulcer disease Duodenal ulcers aren't a/w an ↑ risk of carcinoma in the same location. In contrast, ulcers Gastrointestina Pathology 10
located in the oesophagus, stomach (gastric), and colon may be malignant, and Bx is req. l & Nutrition (Path)
(GI) GI Path
131Whipple disease Caused by the gram (+) actinomycete Tropheryma whippelii, Whipple disease is a rare Gastrointestina Pathology 2
systemic illness that involves the small intestine, joints, and CNS. Classic histologic findings l & Nutrition (Path)
incl small intestine mucosa containing enlarged, foamy macrophages packed w/ both rod- (GI)
shaped bacilli and PAS (+), diastase-resistant granules. GI Path
132Whipple disease The glycoprotein in the cell walls of the actinomycete Tropheryma whippelii colours Gastrointestina Pathology 2
magenta w/ PAS and is diastase-resistant, making this stain an excellent choice in evaluating l & Nutrition (Path)
tissue for Whipple disease. (GI) GI Path
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133Lactose intolerance LI presents w/ flatulence, crampy abdo pain, and watery diarrhoea after dairy product Gastrointestina Pathophysi 3
consumption. It can be acq by inflammatory/infectious conditions that injure the mucosal l & Nutrition ology
brush border of the small intestine where lactase is expressed. Studies can show ↑ breath H+ (GI) (Patp)
content, ↓ stool pH, and ↑ stool osmolality. GI Patp
134Lactose intolerance The small bowel mucosa of pts w/ 1° lactase defic is normal on histo Ex. Gastrointestina Pathophysi 3
l & Nutrition ology
(GI) (Patp) GI Patp
164Dyslipidemia Gemfibrozil (and other fibrates) can ↓ chol sol and promote gallstone formation by ↓ BA Gastrointestina Pharmacol 11
synth. Caution should be used when prescribing fibrate therapy to pts w/ underlying l & Nutrition ogy (Phar)
gallbladder disease. (GI) GI Phar
165Liver cholesterol Simvastatin decreases hepatic cholesterol production, while cholestyramine increases hepatic Gastrointestina Pharmacol 1
production cholesterol and bile acid synthesis. Combination therapy results in a synergistic reduction in l & Nutrition ogy (Phar)
plasma LDL level. (GI) GI Phar
175Motion sickness Antimusc agents and antihists w/ antimusc action are most effective for motion sickness Gastrointestina Pharmacol 1
prevention. l & Nutrition ogy (Phar)
(GI) GI Phar
190Atherosclerosis Familial hypercholesterolemia, one of the most common autosomal dominant disorders, is Gastrointestina Pathology 8
the result of heterozygous or homozygous LDL receptor gene mutations, which cause l & Nutrition (Path)
hepatocyte under expression of functional LDL receptors. This condition can lead to (GI)
accelerated atherosclerosis and early-onset coronary artery disease. GI Path
253Colorectal cancer CEA lvls are ↑ in colon ca but are also ↑ in a number of other conditions (eg, pancreatic ca, Gastrointestina Pathology 15
COPD, cirrhosis). CEA cannot be used to Dx colon ca, but it is helpful for detecting residual l & Nutrition (Path)
disease and recurrence. (GI) GI Path
255Anal fissure Anal fissures are longitudinal tears in the mucosa. They're usually due to passage of hard Gastrointestina Pathology 1
stool in pts w/ chronic constipation. Most fissures occur at the posterior midline, likely due to l & Nutrition (Path)
↓ blood flow in this area. Fissures in other areas may be due to less common causes. (GI) GI Path
257Colorectal cancer CAC is the most common GI malignancy. Right-sided lesions are more likely to bleed and Gastrointestina Pathology 15
cause IDA; left-sided lesions tend to present w/ obstructing SSx (e.g. altered bowel habits, l & Nutrition (Path)
constipation, abdo distension, nausea, and vomiting). (GI) GI Path
278Achalasia Chagas disease is caused by a chronic infection by Trypanosoma cruzi and causes secondary Gastrointestina Microbiolo 3
achalasia due to destruction of the submucosal (Meissner) and myenteric (Auerbach) plexus. l & Nutrition gy (Micr)
Other manifestations can include nonischemic cardiomyopathy and megacolon. (GI) GI Micr
279Zenker diverticulum Diminished relaxation of cricopharyngeal muscles during swallowing results in ↑ Gastrointestina Pathophysi 1
intraluminal pressure in the oropharynx. This may eventually cause the mucosa to herniate l & Nutrition ology
thru a zone of muscle weakness in the post. hypopharynx, forming a Zenker (false) (GI) (Patp)
diverticulum, which presents in elderly pts w/ oropharyngeal dysphagia, halitosis, regurg,
and recurrent aspiration. GI Patp
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280Diffuse esophageal DOS is characterised by periodic, simultaneous, and non-peristaltic contractions of the Gastrointestina Pathology 1
spasm oesophagus due to impaired inhib innervation w/i the oesophageal myenteric plexus. Pts l & Nutrition (Path)
typically present w/ liquid/solid dysphagia and chest pain due to inefficient propulsion of (GI)
food into the stomach. GI Path
281Mallory-Weiss Mallory-Weiss tears account for about 10% of cases of upper GI hemorrhage. They occur Gastrointestina Pathology 2
syndrome due to ↑ intraluminal gastric pressure due to retching, vomiting, or other abdominal straining. l & Nutrition (Path)
(GI) GI Path
282Barrett esophagus Barrett esophagus is a metaplastic condition in which the normal squamous epithelium of the Gastrointestina Pathology 2
distal esophagus is replaced by intestinal-type columnar epithelium. It occurs most often in l & Nutrition (Path)
longstanding acid reflux and is associated with an increased risk of adenocarcinoma. (GI) GI Path
283Esophagitis Infec esophagitis is common in pts w/ HIV. The most common cause is C. albicans, although Gastrointestina Microbiolo 3
CMV and HSV are also freq implicated. Dx is based on endoscopic and micro findings. l & Nutrition gy (Micr)
(GI) GI Micr
284Systemic sclerosis Systemic sclerosis may result in oesophageal dysmotility and incompetence of the LOS due Gastrointestina Pathology 3
to atrophy and fibrous replacement of the oesophageal muscularis. This can cause GORD w/ l & Nutrition (Path)
an ↑ risk of Barrett oesophagus and stricture formation. (GI) GI Path
286Gastroesophageal GERD is caused primarily by GEJ incompetence and can be a/w extraesophageal SSx (eg, Gastrointestina Pathology 7
reflux disease nocturnal cough) in the absence of heartburn. Acidic gastric contents irritate the esophageal l & Nutrition (Path)
mucosa, leading to Chx histologic findings that include basal zone hyperplasia, elongation of (GI)
the lamina propria papillae, and scattered eosinophils. GI Path
287Esophageal cancer The histopathologic features of esophageal SCC include solid nests of neoplastic squamous Gastrointestina Pathology 4
cells w/ abundant eosinophilic cytoplasm and distinct borders. Areas of keratinization and l & Nutrition (Path)
the presence of intercellular bridges are also Chx. Pts typically Px w/ progressive solid and (GI)
eventually liquid dysphagia and weight loss. GI Path
291Peptic ulcer disease The gastroduodenal artery lies along the post. wall of the duodenal bulb and is likely to be Gastrointestina Anatomy 10
eroded by post. duodenal ulcers. Ulceration into the gastroduodenal artery can be a source of l & Nutrition (Anat)
life-threatening hemorrhage. (GI) GI Anat
292Peptic ulcer disease Most gastric ulcers arise along the lesser curvature of the stomach, usually at the transitional Gastrointestina Anatomy 10
zone b/w the gastric corpus (body) and antrum. The left and right gastric arteries run along l & Nutrition (Anat)
the lesser curvature and are likely to be penetrated by ulcers, causing gastric bleeding. (GI) GI Anat
303Superior mesenteric SMA syndrome occurs when the transverse portion of the duodenum is entrapped b/w the Gastrointestina Anatomy 1
artery syndrome SMA and aorta, causing SSx of partial intestinal obstr. This syndrome occurs when the l & Nutrition (Anat)
aortomesenteric angle critically ↓, 2° to diminished mesenteric fat, pronounced lordosis, or (GI)
Sx correction of scoliosis. GI Anat
304Zollinger-Ellison Pts w/ ZES develop PUD and parietal cell hyperplasia w/ gastric fold enlargement due to Gastrointestina Pathology 3
syndrome gastrin hypersecretion. l & Nutrition (Path)
(GI) GI Path
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305Zollinger-Ellison ZES is caused by gastrinomas located in the small intestine/pancreas and Px w/ peptic ulcers Gastrointestina Pathology 3
syndrome (especially distal duodenal ulcers), heartburn, and diarrhea. Pts typically have ↑ gastrin lvls l & Nutrition (Path)
that rise in response to exogenous secretin administration. In contrast, secretin inhibits (GI)
release of gastrin from normal gastric G cells. GI Path
306Mastocytosis Systemic mastocytosis is characterised by the abn proliferation of mast cells and ↑ hist Gastrointestina Pathophysi 1
release. Hist causes hypersecretion of GA by parietal cells in the stomach as well as a variety l & Nutrition ology
of other SSx (e.g. hypotension, flushing, pruritus). (GI) (Patp) GI Patp
307Gastric cancer There are 2 morphological variants of GAC. The intestinal type forms a solid mass that Gastrointestina Pathology 1
projects into the stomach lumen and is composed of glandular-forming cuboidal or columnar l & Nutrition (Path)
cells. In contrast, diffuse carcinoma (linitis plastica) infiltrates the stomach wall and displays (GI)
signet-ring cells on LM. GI Path
309Carcinoid tumors Carcinoid syndrome may accomp extraintestinal mets of GI carcinoid tumors. Octreotide is a Gastrointestina Pharmacol 4
synth SS analog used to control the SSx of carcinoid syndrome. l & Nutrition ogy (Phar)
(GI) GI Phar
317Biliary atresia Biliaryatresia, or obstr of extrahepatic bile ducts, presents w/ jaundice, dark urine, and Gastrointestina Pathophysi 1
acholic stools in the 1st 2mos of life due to conjugated hyperbilirubinaemia. Bx reveals l & Nutrition ology
intrahepatic bile duct proliferation, portal tract oedema, and fibrosis. (GI) (Patp) GI Patp
318Malrotation Intestinal malrotation results when the midgut undergoes incomplete embryological Gastrointestina Embryolog 1
counterclockwise rotation. It can Px as intestinal obstruction (due to compression by the l & Nutrition y (Embr)
adhesive bands) and midgut volvulus (intestinal ischemia due to twisting around the blood (GI)
vessels). GI Embr
319Intestinal atresia Intestinal atresia distal to the duodenum occurs due to vascular accidents in utero. "Apple- Gastrointestina Embryolog 1
peel" atresia occurs when the superior mesenteric artery is obstructed. The result is a blind- l & Nutrition y (Embr)
ending proximal jejunum; a length of absent bowel and mesentery: and, finally, a terminal (GI)
ileum spiraled around an ileocolic vessel. GI Embr
321Embryology, A # of ectopic tissues are found in Meckel diverticulum - most commonly, gastric Gastrointestina Embryolog 1
Meckel epithelium. Gastric mucosa is present in 80% of cases of SSx Meckel diverticulum. Gastric l & Nutrition y (Embr)
acid production leads to ulceration and subsequent bleeding. (GI) GI Embr
322Meckel The omphalomesenteric (vitelline) duct normally obliterates during the 7th wk of embryonic Gastrointestina Embryolog 3
diverticulum development. Both enterocysts and Meckel diverticula result from a failure of obliteration l & Nutrition y (Embr)
involving the vitelline duct. (GI) GI Embr
323Malabsorption Malabsorption is a syndrome of impaired intestinal digestion and absorption. Fats are Gastrointestina Pathophysi 4
typically the most severely affected macronutrient in gen malabsorption, and testing the stool l & Nutrition ology
for fat (e.g. w/ Sudan III stain) is the most sensitive strategy for screening for malabsorptive (GI) (Patp)
disorders. GI Patp
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324Celiac disease Celiac disease (gluten-sens enteropathy) classically Px b/w age 6-24 mos w/ abdo pain, Gastrointestina Histology 2
diarrhea, vomiting, and weight loss. Duodenal Bx reveals crypt hyperplasia, villous atrophy, l & Nutrition (Hist)
and intraepithelial lymphocyte infiltration. Tx w/ a gluten-free diet resolves SSx and (GI)
normalizes sero and histo. GI Hist
326Celiac disease Celiac disease is caused by an immune-mediated rxn to gluten and can Px w/ bloating, Gastrointestina Pathology 2
diarrhea, and flatulence, as well as short stature and weight loss. Screening tests show an ↑ l & Nutrition (Path)
level of IgA against tissue transglutaminase. Duodenal Bx is confirmatory, showing villus (GI)
flattening and intraepithelial lymphocyte infiltration. GI Path
327Abetalipoproteinemi Abetalipoproteinaemia is an inherited inability to synthesise apoB, an important component Gastrointestina Pathology 1
a of chylomicrons and VLDL. Lipids absorbed by the small intestine can't be transported into l & Nutrition (Path)
the blood and accumulate in the intestinal epithelium, resulting in enterocytes w/ clear or (GI)
foamy cytoplasm. GI Path
328Meckel Meckel diverticulum is a remnant of the omphalomesenteric (vitelline) duct. It is connected Gastrointestina Embryolog 3
diverticulum to the ileum and is located 2 ft proximal to the ICV. It often contains acid-secreting ectopic l & Nutrition y (Embr)
gastric tissue, which may cause ulceration of the adjacent mucosa and lower GI bleeding (GI)
(melena/hematochezia). Meckel diverticulum is a true diverticulum and consists of all parts
of the intestinal wall. GI Embr
329Meckel Meckel diverticulum results from failed obliteration of the vitelline duct and usually Px w/ Gastrointestina Embryolog 3
diverticulum spontaneous but painless lower GI bleeding. (99m)Tc-pertechnetate localizes ectopic gastric l & Nutrition y (Embr)
mucosa, and its ↑ uptake is Dx for Meckel diverticulum. (GI) GI Embr
330Hirschsprung Hirschsprung disease is a result of abnormal migration of neural crest cells during Gastrointestina Embryolog 2
disease embryogenesis. These cells are the precursors of ganglion cells of intestinal wall plexi. Since l & Nutrition y (Embr)
neural crest cells migrate caudally, the rectum is always affected in Hirschsprung disease. (GI) GI Embr
331Hirschsprung Submucosal (Meissner) and myenteric (Auerbach) autonomic plexi are absent in the affected Gastrointestina Pathology 2
disease segment of the bowel in HD. The submucosa of the narrowed area is the most superficial l & Nutrition (Path)
layer where the absence of ganglion cells can be seen. (GI) GI Path
358Cystic fibrosis The most common gastrointestinal disorder in patients with cystic fibrosis is pancreatic Gastrointestina Pathology 11
insufficiency. Mutations in the cystic fibrosis transmembrane conductance regulator gene l & Nutrition (Path)
lead to thick, viscous secretions in the lumens of the pancreas, resulting in obstruction, (GI)
inflammation, and subsequent fibrosis. Clinical manifestations include steatorrhea, failure to
thrive, and deficiency of fat-soluble vitamins. GI Path
362Gilbert syndrome Gilbert syndrome is the likely Dx in pts w/ no apparent liver disease who have mild Gastrointestina Pathology 1
unconjugated hyperbilirubinaemia that appears provoked by 1 of the classic triggers. l & Nutrition (Path)
(GI) GI Path
363Kernicterus CNS is an AR disorder of bilirubin meta caused by a genetic lack of the UGT enzyme Gastrointestina Pathophysi 1
needed to catalyse bile glucuronidation. Unconjugated hyperbilirubinaemia develops in these l & Nutrition ology
infants, causing kernicterus and often death. (GI) (Patp) GI Patp
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364Cholestasis Cholestatic liver disease can cause malabsorption and nutritional defic of fat-soluble vits. Gastrointestina Pathology 1
l & Nutrition (Path)
(GI) GI Path
365Hepatitis B Acute hepB infection can cause a serum sickness-like syndrome w/ joint pain, LAD, and a Gastrointestina Pathophysi 14
pruritic urticarial rash. Other features may incl RUQ pain, hepatomegaly, and ↑ hepatic TA l & Nutrition ology
lvls. (GI) (Patp) GI Patp
366Hepatitis A Acute hepA is a self-limited infection that typically presents acutely w/ prodromal SSx (e.g. Gastrointestina Pathology 4
fever, malaise, anorexia, nausea/vomiting, RUQ pain) followed by SSx of cholestasis (e.g. l & Nutrition (Path)
jaundice, pruritus, dark-coloured urine, clay-coloured stool). (GI) GI Path
367Hepatitis B HepB infection causes the hepatocellular cytoplasm to fill w/ HBsAg. These inclusions are Gastrointestina Pathology 14
highly specific for hepB infection and have a finely granular, pale eosinophilic, ground-glass l & Nutrition (Path)
appearance. (GI) GI Path
368Cirrhosis Cirrhosis is Chx by diffuse hepatic fibrosis w/ replacement of the normal lobular architecture Gastrointestina Pathology 7
by fibrous-lined parenchymal nodules. Chronic viral hepatitis (eg, hepatitis B and C), Alc, l & Nutrition (Path)
hemochromatosis. and NAFLD are the most common causes of cirrhosis in the United (GI)
States. GI Path
369Acute liver failure Inhaled anesthetics, such as halothane, can be associated with a highly lethal fulminant Gastrointestina Pathophysi 2
hepatitis that cannot be distinguished histologically from acute viral hepatitis. Patients have l & Nutrition ology
significantly elevated aminotransferase levels due to massive hepatocellular injury and a (GI) (Patp)
prolonged prothrombin time due to failure of hepatic synthetic function. GI Patp
370Alcoholic liver The pathogenesis of Alc-induced hepatic steatosis appears related primarily to a ↓ in FFA Gastrointestina Pathology 1
disease oxidation 2° to excess NADH production by the 2 major Alc metabolism enzymes, Alc l & Nutrition (Path)
dehydrogenase and aldehyde dehydrogenase. (GI) GI Path
372Hepatitis A Transmission of the HAV occurs thru the fecal-oral route and is common in areas w/ Gastrointestina Microbiolo 4
overcrowding and poor sanitation. Outbreaks freq result from contam water or food, and raw l & Nutrition gy (Micr)
or steamed shellfish is a common culprit in the US. (GI) GI Micr
375Hepatitis B HBV doesn't have a cytotox effect itself; however, the presence of viral HBsAg and HBcAg Gastrointestina Pathophysi 14
on the cell surface stim the host's CD8+Tc lymphocytes to destroy infected hepatocytes. l & Nutrition ology
(GI) (Patp) GI Patp
386Hepatitis B The main modes of transmission of HBV incl sexual (among both heterosex partners and Gastrointestina Microbiolo 14
MSM) and percutaneous (e.g. IVDU, needlestick accidents, blood transfusions). The risk of l & Nutrition gy (Micr)
sexual transmission of HCV is low. (GI) GI Micr
388Hepatitis C The HCV is genetically unstable b/c it lacks proofreading 3’ → 5’ exonuclease activity in its Gastrointestina Microbiolo 4
RNA pol. Its env GP seqs also contain an HVR prone to freq genetic mut. l & Nutrition gy (Micr)
(GI) GI Micr
391Hemochromatosis Physiologic Fe loss through menstruation and pregnancy slows the progression of Gastrointestina Pathophysi 4
hemochromatosis in women. l & Nutrition ology
(GI) (Patp) GI Patp
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393Hemochromatosis HH is most commonly caused by a missense mut in the HFE gene, resulting in excessive Gastrointestina Pathology 4
intestinal Fe absorption and organ dmg (e.g. cirrhosis, DM, cardiomyopathy, arthropathy) l & Nutrition (Path)
due to Fe accumulation w/i parenchymal tissues. (GI) GI Path
394Hemochromatosis Hereditary hemochromatosis is an autosomal recessive disease characterized by abnormally Gastrointestina Pathology 4
high intestinal iron absorption. Common manifestations include liver disease, skin l & Nutrition (Path)
hyperpigmentation, diabetes mellitus, arthropathy, and cardiac enlargement with conduction (GI)
abnormalities or heart failure. GI Path
396Copper excretion Absorbed Cu is used to form ceruloplasmin, which accounts for 90-95% of circulating Cu. Gastrointestina Pathophysi 1
Senescent ceruloplasmin and the unabsorbed Cu are secreted into bile and excreted in stool, l & Nutrition ology
which is the 1° route for Cu elimination. (GI) (Patp) GI Patp
400Alpha1 antitrypsin AAT is a serine protease inhib that regulates the activity of elastase in the lung. Inherited Gastrointestina Pathology 8
deficiency defic of AAT leads to alveolar destruction and panacinar emphysema; in addn, accumulation l & Nutrition (Path)
of improperly folded AAT proteins in hepatocytes can leads to liver dysfxn and cirrhosis in (GI)
some pts. GI Path
401Primary biliary PBC is a chronic liver disease characterised by autoimmune destruction of the intrahepatic Gastrointestina Pathology 4
cholangitis bile ducts and cholestasis (↑ ALP). The condition is most common in middle-aged women, l & Nutrition (Path)
w/ severe pruritus (esp. at night) often 1 of the 1st reported SSx. (GI) GI Path
402Primary biliary PBC is a chronic AI liver disease Chx by lymphocytic infiltrates and destruction of small and Gastrointestina Pathophysi 4
cholangitis mid-sized intrahepatic bile ducts. Similar findings are seen in hepatic GVHD, highlighting l & Nutrition ology
the immunologic etiology of the disorder. (GI) (Patp) GI Patp
403Primary biliary PBC is a chronic autoimmune liver disease characterised by destruction of intrahepatic, Gastrointestina Pathology 4
cholangitis interlobular bile ducts by granulomatous inflammation. The disease typically presents l & Nutrition (Path)
insidiously w/ pruritus and fatigue in middle-aged women. Pts may eventually develop SSx (GI)
of cholestasis (e.g. jaundice, pale stool, dark urine) and hypercholaemia (e.g. xanthelasma). GI Path
404Inflammatory bowel CD typically Px w/ prolonged diarrhea and abdominal pain. Constitutional SSx (eg, low- Gastrointestina Pathology 9
disease grade fever, fatigue), malabsorption, and weight loss are also common. Transmural l & Nutrition (Path)
inflammation of the bowel wall may result in the formation of fistulas (eg, enteroenteric, (GI)
enterocutaneous), abscesses, and fibrotic strictures. GI Path
405Inflammatory bowel NCGs are a hallmark of CD and can help distinguish it from UC, which does not form Gastrointestina Pathology 9
disease granulomas. Histopathology in CD also demonstrates transmural inflammation, distortion of l & Nutrition (Path)
the normal architecture, and Paneth cell metaplasia. (GI) GI Path
406Inflammatory bowel Granulomas are characterised by a large # of epithelioid macrophages that may fuse together Gastrointestina Pathology 9
disease to form multinucleated cells (Langhans giant cells) surrounded by a band of lymphocytes. l & Nutrition (Path)
Granuloma formation involves chronic Th1 and macrophage activation in response to a (GI)
difficult-to-eradicate Ag. GI Path
407Inflammatory bowel CD is an IBD characterised by patchy inflammation that can occur throughout the entire Gastrointestina Pathology 9
disease GIT. Gross path demonstrates skip lesions, cobble-stoning of the mucosa, bowel wall l & Nutrition (Path)
thickening, and creeping fat. (GI) GI Path
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408Inflammatory bowel CD is a/w oxalate kidney stones. Impaired BA absorption in the terminal ileum leads to loss Gastrointestina Pathophysi 9
disease of BAs in faeces w/ subseq fat malabsorption. Intestinal lipids then bind Ca2+ions, and the l & Nutrition ology
resulting soap complex is excreted. Free oxalate (normally bound by Ca2+ to form an (GI) (Patp)
unabsorbable complex) is absorbed and forms urinary calculi (enteric oxaluria). GI Patp
409Inflammatory bowel CD is characterised by patchy, transmural inflammation of the GIT. It can affect any part of Gastrointestina Pathology 9
disease the tract from the mouth to the anus. Complications incl strictures (due to bowel wall l & Nutrition (Path)
oedema, fibrosis, and thickening of the muscularis mucosae), fistulas (due to penetration of (GI)
ulcers thru the intestinal wall), and abscesses. GI Path
410Toxic megacolon Toxic megacolon is a well-recognised complication of UC. Pts typically present w/ abdo Gastrointestina Pathology 1
pain/distension, bloody diarrhoea, fever, and SSx of shock. Plain abdo XR is the preferred l & Nutrition (Path)
Dx imaging study. Barium contrast studies and colonoscopy are c/i due to the risk of (GI)
perforation. GI Path
411Colorectal cancer IBD, especially ulcerative pancolitis, is a/w a significant risk for CRC. Compared w/ Gastrointestina Pathology 15
sporadic CRC, colitis-associated CRC is more likely to occur at a younger age, is typically l & Nutrition (Path)
more aggressive w/ a higher histopathologic grade, often evolves from flat (nonpolypoid) (GI)
lesions, and is frequently multifocal. Pts should be monitored regularly via colonoscopy w/
random Bx. GI Path
412Gallstone disease Pts w/ CD affecting the terminal ileum (most common site of involvement) are prone to Gastrointestina Pathophysi 8
devel gallstones. ↓ BA reabsorption by the inflamed terminal ileum promotes chol l & Nutrition ology
supersaturation of the bile, resulting in gallstone formation. (GI) (Patp) GI Patp
413Colonic ischemia The splenic flexure and RSJ lie b/w regions of perfusion of major arteries. These 'watershed' Gastrointestina Pathology 1
areas are susceptible to ischemic dmg during hypotensive states, esp. in ps w/ underlying l & Nutrition (Path)
arterial insufficiency. (GI) GI Path
414Mesenteric ischemia CMI is Chx by atherosclerosis of the mesenteric arteries, resulting in diminished blood flow Gastrointestina Pathology 1
to the intestine after meals. This causes postprandial epigastric pain (intestinal angina) w/ l & Nutrition (Path)
associated food aversion/weight loss. Its pathogenesis is similar to angina pectoris. (GI) GI Path
415Diverticular disease Colonic diverticula often involve the sigmoid colon and develop due to exaggerated Gastrointestina Pathology 3
contractions of colonic smooth muscle segments. This results in ↑ intraluminal pressure, l & Nutrition (Path)
causing outpouching of the mucosa and submucosa through the muscularis (false (GI)
diverticula). Individuals (typically age >60) may be aSSx or have hematochezia or
diverticulitis. GI Path
416Intussusception Intussusception most often occurs in children younger than 2 y/o and in the region of the Gastrointestina Pathology 1
ICV. It MFx w/ intermittent, severe, colicky abdo pain, 'currant jelly' stools, and sometimes a l & Nutrition (Path)
palpable mass in the RLQ. (GI) GI Path
417Groin hernias FHs can present w/ groin discomfort and a tender bulge on the upper thigh inf. to theinguinal Gastrointestina Anatomy 3
ligament, lat. to thepubic tubercle and lacunar ligament. The structure that lies immediately l & Nutrition (Anat)
lat. to the hernia w/i the femoral sheath is the femoral vein. Incarceration and strangulation (GI)
are common complications of FHs. GI Anat
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418Groin hernias The inf. epigastric vessels are useful as a landmark during lap hernia repair to classify the Gastrointestina Anatomy 3
type of IH. IIHs protrude thru the DIR into the inguinal canal lat. to theinf. epigastric vessels. l & Nutrition (Anat)
In contrast, DIHs protrude thru Hesselbach's triangle med. to theinf. epigastric vessels. (GI) GI Anat
420Colorectal cancer The adenoma to carcinoma seq is a series of gene muts that leads to the devel of CAC. TP53 Gastrointestina Pathology 15
TSG mut is part of the final step in the seq and leads to malignant transformation of pre- l & Nutrition (Path)
existing large adenomatous polyps. (GI) GI Path
421Colorectal cancer The size of adenomatous polyps determines their malignant potential. Adenomas <1 cm are Gastrointestina Pathology 15
unlikely to undergo malignant transformation, whereas those >4 cm are very likely to l & Nutrition (Path)
progress to AC. KRAS proto-oncogene mutation facilitates the growth of adenomas by (GI)
causing uncontrolled cell proliferation. GI Path
424Carcinoid tumors Carcinoid tumours are composed of islands or sheets of uniform cells w/ eosinophilic Gastrointestina Pathology 4
cytoplasm and oval-to-round stippled nuclei. These tumours are often derived from l & Nutrition (Path)
neuroendocrine cells in the GI tract. Appendiceal carcinoids typically have a benign course (GI)
but may cause appendicitis or, rarely, carcinoid syndrome (e.g. w/ liver mets). GI Path
426Appendicitis obstr of the lumen of the appendix is the 1st event in pathogenesis of acute appendicitis. Gastrointestina Pathology 5
Fecaliths, hyperplastic lymphoid follicles, foreign bodies, or tumours may cause the obstr. l & Nutrition (Path)
RLQ abdo pain, nausea, vomiting, diarrhoea, and fever are the typical MFxs of acute (GI)
appendicitis. GI Path
427Colonic polyps Adenomatous and serrated polyps (i.e. sessile serrated polyp, traditional serrated adenoma) Gastrointestina Pathology 2
are neoplastic polyps that have malignancy potential. ↑ polyp size is the most important RF l & Nutrition (Path)
for ca; villous histology and high-grade dysplasia are addnal RFs. (GI) GI Path
428Colorectal cancer Mutation of the APC TSG is the 1st step in the classic adenoma-to-carcinoma sequence; it is Gastrointestina Pathology 15
found in most cases of sporadic colon ca and in all pts w/ FAP. The microsatellite instability l & Nutrition (Path)
pathway is Chx by mutations in DNA mismatch repair genes and is implicated in the (GI)
development of HNPCC (Lynch syndrome). GI Path
429Lynch syndrome HNPCC, or Lynch syndrome, leads to occurrence of colonic ACs at a young age (age <50) Gastrointestina Pathology 1
along w/ a predisposition for extraintestinal malignancies. Mutations of DNA mismatch l & Nutrition (Path)
repair genes are responsible for HNPCC. (GI) GI Path
430Colonic polyps Adenomatous polyps are either tubular, villous, or tubulovillous, depending on their Gastrointestina Pathology 2
histologic appearance. Villous adenomas tend to be larger, sessile, and more severely l & Nutrition (Path)
dysplastic than tubular adenomas. Villous adenomas can cause a secretory diarrhea from ↑ (GI)
mucin production; pts may develop hypoproteinemia and hypokalemia. GI Path
431Colorectal cancer Adenomatous polyps contain dysplastic mucosa and are premalignant. Regular screening w/ Gastrointestina Pathology 15
timely excision of polyps is effective for prevention of CAC. Studies have linked ↑ activity l & Nutrition (Path)
of COX-2 to some forms of CAC and suggest that regular aspirin use ↓ adenomatous polyp (GI)
formation. GI Path
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432Colorectal cancer Right-sided colon ca usually grow as exophytic masses and present w/ occult bleeding and Gastrointestina Pathology 15
SSx of IDA. Left-sided colon ca tend to infiltrate the intestinal wall and encircle the lumen, l & Nutrition (Path)
causing constipation and SSx of intestinal obstr. Rectosigmoid involvement often causes (GI)
hematochezia. GI Path
433Acute pancreatitis Multi inhib mechs exist to prevent premature activation of trypsinogen before it reaches the Gastrointestina Pathophysi 9
duodenal lumen, incl cleavage inactivation of trypsin by trypsin itself and production of l & Nutrition ology
trypsin inhibs (e.g. SPINK1). Gene muts that render trypsin insensitive to cleavage (GI) (Patp)
inactivation cause hereditary pancreatitis. GI Patp
434Acute pancreatitis After gallstones, Alc abuse is the 2nd most common cause of acute pancreatitis. Gastrointestina Pathology 9
Macrocytosis and an AST:ALT ratio >2 are indirect indicators of chronic Alc consumption. l & Nutrition (Path)
Alc-related macrocytosis can occur independently of folate deficiency. (GI) GI Path
435Acute pancreatitis Pancreatic pseudocyst is a common complication of acute pancreatitis. It is a collection of Gastrointestina Pathology 9
fluid rich in enzymes and inflammatory debris. Its walls consist of granulation tissue and l & Nutrition (Path)
fibrosis. Unlike true cysts, pseudocysts are not lined by epithelium. (GI) GI Path
436Pancreatic cancer Smoking is the most important environmental RF for pancreatic ca. Other RFs incl advanced Gastrointestina Pathology 1
age, chronic pancreatitis, and genetic predisposition (e.g. Peutz-Jegher's syndrome). l & Nutrition (Path)
(GI) GI Path
437Acute pancreatitis The dorsal pancreatic bud forms the majority of pancreatic tissue (body, tail, and most of the Gastrointestina Embryolog 9
head). The ventral pancreatic bud is a precursor of the uncinate process, inf/post portion of l & Nutrition y (Embr)
the head, and major pancreatic duct (of Wirsung). Failure of the dorsal and ventral pancreatic (GI)
buds to fuse leads to pancreas divisum. In this condition, the pancreatic ductal systems
remain separate, w/ the accessory duct draining the majority of the pancreas. GI Embr
438Acute pancreatitis Annular pancreas, or pancreatic tissue encircling the desc duodenum, is caused by failure of Gastrointestina Embryolog 9
the ventral pancreatic bud to properly migrate and fuse w/ the dorsal bud during the 7th and l & Nutrition y (Embr)
8th wk of fetal development. Annular pancreas is usually aSSx but may Px w/ duodenal (GI)
obstruction or pancreatitis. GI Embr
439Acute pancreatitis In AIP the pancreas is grossly oedematous. Focal areas of fat necrosis, Ca2+ deposition, and Gastrointestina Pathology 9
interstitial oedema are seen on LM. In ANP (hemorrhagic), chalky-white areas of fat necrosis l & Nutrition (Path)
interspersed w/ hemorrhage are seen on macroscopic Ex. (GI) GI Path
440Acute pancreatitis Eighty percent of acute pancreatitis cases are caused by gallstones and chronic Alcism. Less Gastrointestina Pathology 9
common causes account for the other 20%. Inherited or acquired hypertriglyceridemia can l & Nutrition (Path)
cause acute pancreatitis if the serum lvl of TGs exceeds 1000 mg/dL. (GI) GI Path
441Acute pancreatitis Pancreatic zymogens are normally converted into their active form by trypsin in the duodenal Gastrointestina Pathophysi 9
lumen. Premature cleavage of trypsinogen to trypsin w/i the pancreas leads to uncontrolled l & Nutrition ology
activation of these zymogens, causing pancreatic autodigestion and acute pancreatitis. (GI) (Patp) GI Patp
471Hepatocellular Hepatic angiosarcoma is a/w exposure to carcinogens such as arsenic, thorotrast, and Gastrointestina Pathology 5
cancer polyvinyl chloride. Tumour cells express CD31, an endothelial cell marker. l & Nutrition (Path)
(GI) GI Path
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586Zollinger-Ellison ZES is caused by gastrin-secreting tumors (gastrinomas) involving the small intestine or Gastrointestina Pathology 3
syndrome pancreas. Pts typically have peptic ulcers (often beyond the duodenal bulb), abdominal l & Nutrition (Path)
pain/acid reflux, and diarrhea. The condition is frequently a/w MEN-1. (GI) GI Path
644Foodborne illness Staphylococcal food pois is mediated by the ingestion of a preformed, heat-stable enterotox Gastrointestina Microbiolo 2
that induces rap-on (<6 hrs) nausea and vomiting. Most cases arise due to improper food l & Nutrition gy (Micr)
handling and storage. Common culprit foods incl eggs, dairy prods, and mayonnaise-based (GI)
salads. GI Micr
755Nutrition, protein Metabolism of 1 g of protein or carbohydrate produces 4 Calories of energy; metabolism of 1 Gastrointestina Biochemist 1
g of fat produces 9 Calories. l & Nutrition ry (Bioc)
(GI) GI Bioc
790Colorectal cancer Regulation of the Ras-MAPK signal transduction pathway requires a balance b/w active Gastrointestina Biochemist 15
(GTP-bound) and inactive (GDP-bound) Ras proteins. RAS gene muts, which result in l & Nutrition ry (Bioc)
constitutively activated Ras proteins, are implicated in the development of malignant tumors. (GI) GI Bioc
808Cystic fibrosis In a young Caucasian pt, the combo of recurrent resp infecs w/ P. aeruginosa, diarrhea, and Gastrointestina Pharmacol 11
FTT suggests a Dx of CF. CF causes steatorrhea and FTT due to malabs 2° to PI, which can l & Nutrition ogy (Phar)
be corrected by pancr enzyme supp. (GI) GI Phar
828Achalasia Achalasia is caused by ↓ # of inhib ganglion cells in the oesophageal wall. Oesophageal Gastrointestina Pathophysi 3
manometry in achalasia shows ↓ amplitude of peristalsis in the mid oesophagus, w/ ↑ tone l & Nutrition ology
and incomplete relaxation at the LOS. (GI) (Patp) GI Patp
838Retroperitoneal Retroperitoneal hematoma is a common complication of abdo and pelvic trauma. The Gastrointestina Anatomy 1
hematoma pancreas is a retroperitoneal organ, and pancreatic injury is freq a source of retroperitoneal l & Nutrition (Anat)
bleeding. (GI) GI Anat
865Constipation PEG is an osmotic laxative. Diarrhea a/w lactase defic is also osmotic and occurs due to Gastrointestina Pharmacol 3
accum of nonabs lactose in the intestinal lumen. MgOH (and other Mg-containing l & Nutrition ogy (Phar)
compounds, such as Mg citrate) is another osmotic laxative that’s often used, although its (GI)
efficacy is Q-able and there’s not enough evidence to support its widespread use. GI Phar
881Reye syndrome Reye syndrome occurs in children w/ febrile illness Tx w/ salicylates (aspirin). It consists of Gastrointestina Pathology 1
hepatic failure and encephalopathy. The char histo finding is microvesicular steatosis of l & Nutrition (Path)
hepatocytes w/o inflammation and cerebral oedema. (GI) GI Path
1068
Fructose Dietary fructose is phosphorylated in the liver to F1P and is rapidly metabolized b/c it Gastrointestina Biochemist 4
metabolism bypasses PFK-1, the major RLE of glycolysis. Other sugars (e.g. Glc, Gal, mannose) enter l & Nutrition ry (Bioc)
glycolysis prior to PFK-1 and as a result are metabolized more slowly. (GI) GI Bioc
1071
Galactosemia Class galactosemia results from deficiency of GALT. CFx include vomiting, lethargy, Gastrointestina Biochemist 2
jaundice, and E. coli sepsis. Cessation of breastfeeding and switching to soy milk-based l & Nutrition ry (Bioc)
formula is recommended. (GI) GI Bioc
1072
Lactose intolerance Secondary lactase deficiency can occur after inflammatory (eg, celiac disease) or infectious Gastrointestina Biochemist 3
(eg. giardiasis) processes damage the microvilli of the small intestines. Clinical presentation l & Nutrition ry (Bioc)
includes abdominal distension and cramping, flatulence, and diarrhea. (GI) GI Bioc
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1074
Galactosemia Lenticular accumulation of galactitol in the lenses of pts w/ galactosemia can cause osmotic Gastrointestina Biochemist 2
dmg and development of cataracts. Cataracts may be the only MFx of galactokinase l & Nutrition ry (Bioc)
deficiency. (GI) GI Bioc
1098
Acute diarrhea Shiga-like tox (Vero cytotox), prod by EHEC, are nearly identical to the Shiga tox prod by S. Gastrointestina Microbiolo 13
dysenteriae. They inhib the 60S ribosomal subunit in human cells, thereby blocking protein l & Nutrition gy (Micr)
synth by preventing binding of tRNA. (GI) GI Micr
1100
Acute diarrhea EHEC O157:H7 infec is a common cause of bloody diarrhea and can lead to HUS. It’s a/w Gastrointestina Microbiolo 13
consumption of undercooked ground beef and elabs a Shiga-like tox capable of inhib protein l & Nutrition gy (Micr)
synth in colonic mucosal cells and renal endothelial cells. This particular strain of E. coli is (GI)
unable to ferment sorbitol and doesn’t prod a glucuronidase. GI Micr
1136
Acute diarrhea Depending on the age and condition of the host and the species of Shigella, as few as 10-500 Gastrointestina Microbiolo 13
cells can cause infec. l & Nutrition gy (Micr)
(GI) GI Micr
1143
Acute diarrhea Shigellosis is an infectious disease that can be caused by a variety of Shigella species; S. Gastrointestina Pathology 13
sonnei is the most common cause of shigellosis in industrialised nations. Shigella invades the l & Nutrition (Path)
GI mucosa by gaining access to microfold cells in ileal Peyer patches thru endocytosis. (GI)
Shigella subseq lyses the endosome and spreads laterally into other epithelial cells, causing
cell death and ulceration w/ hemorrhage and diarrhoea. GI Path
1169
Positive predictive (+) and (-) predictive values depend on disease prevalence in the tested pop. The sens and Gastrointestina Biostatistic 1
value spec of a Dx test aren’t affected by disease prevalence. l & Nutrition s (Bios)
(GI) GI Bios
1251
Malabsorption The duodenal brush border enzyme EntP activates trypsin from its inactive precursor, Gastrointestina Physiology 4
trypsinogen. Trypsin degrades complex polypeps to dipeps, tripeps, and AAs while l & Nutrition (Phys)
activating other pancr enzymes. EntP defic impairs both protein and fat abs, leading to (GI)
diarrhea, FTT, and hypoproteinemia. GI Phys
1258
Opioids Opioid analgesics can cause contraction of smooth muscles in the sphincter of Oddi, leading Gastrointestina Pharmacol 13
to ↑ pressures in the CBD and the gallbladder. l & Nutrition ogy (Phar)
(GI) GI Phar
1290
Irritable bowel Diphenoxylate is an opioid antidiarrheal drug that binds μ opiate receptors in the gut to slow Gastrointestina Pharmacol 1
syndrome motility. Overuse can lead to euphoria and physical dependence. To discourage abuse, l & Nutrition ogy (Phar)
diphenoxylate is combo w/ atropine, which induces AEs if taken in high doses. (GI) GI Phar
1319
Cholecystitis CCK is the hormone responsible for gallbladder contraction. It’s made in the duodenum and Gastrointestina Physiology 5
jejunum in response to FAs and AAs. l & Nutrition (Phys)
(GI) GI Phys
1332
Homocysteine Homocystinuria is most commonly caused by a defect in cystathionine synthase, resulting in Gastrointestina Biochemist 2
an inability to form cysteine from homocysteine. Cysteine becomes essential in affected pts, l & Nutrition ry (Bioc)
and homocysteine buildup leads to ↑ methionine. Homocysteine is prothrombotic, resulting (GI)
in premature TE events (e.g. atherosclerosis, ACS) in these pts. GI Bioc
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1358
Active transport Parietal cells release H ions into the gastric lumen by means of the H/K ATPase, which reqs Gastrointestina Physiology 1
hydrolysis of ATP and is therefore an active transport mech. Omeprazole and other PPIs l & Nutrition (Phys)
suppress the activity of the gastric parietal cell H/K ATPase leading to an ↑ in the pH of the (GI)
gastric lumen. GI Phys
1396
Clostridium difficile Abx disrupt the normal intestinal flora and which can allow for overgrowth of Clostridium Gastrointestina Pathology 7
infection difficile, an anaerobic, Gram (+), spore-forming bacillus. C difficile produces 2 toxins that l & Nutrition (Path)
penetrate colonic epithelial cells leading to watery diarrhea, abdominal cramping, and colitis. (GI)
The presence of a pseudomembrane (exudate on colonic mucosa consisting of fibrin and
inflammatory cells) is highly suggestive of C difficile infection. GI Path
1397
Clostridium difficile C. difficile toxs A and B exert their effects by disrupting the actin CSK structure and Gastrointestina Microbiolo 7
infection intracellular signaling. Although the toxs have overlapping effects, tox A causes relatively l & Nutrition gy (Micr)
more intestinal inflam and fluid secretion, and tox B is more cytotox. (GI) GI Micr
1398
Clostridium difficile In the absence of normal intestinal microbial flora (as may be the case after a course of Gastrointestina Microbiolo 7
infection antibiotics), Clostridium difficile can overgrow and produce enterotoxin (toxin A) and l & Nutrition gy (Micr)
cytotoxin (toxin B). Clinical disease resulting from C difficile overgrowth can range from (GI)
transient diarrhea to severe pseudomembranous colitis. GI Micr
1400
Botulism Infant bot is freq due to honey consumption. More than 12% of honey samples contain low # Gastrointestina Microbiolo 4
of C. botulinum spores. Whereas infant bot results from consuming C. botulinum spores, l & Nutrition gy (Micr)
adult bot results from consuming preformed tox, typically in canned food. SSx of infant bot (GI)
incl constipation, mild weakness, lethargy, and poor feeding. GI Micr
1422
Acute diarrhea Campylobacter infection is a common cause of GE and is typically acquired from Gastrointestina Microbiolo 13
contaminated food (eg, undercooked poultry) or domesticated animals (eg, household dogs). l & Nutrition gy (Micr)
MFx usually include fever, cramping abdominal pain, and watery diarrhea that may be (GI)
bloody. Stool studies typically show blood and leukocytes. Campylobacter infection is a/w
GBS. GI Micr
1423
Cirrhosis ↑ AST and ALT are indicators of hepatocellular dmg, and ↑ ALP and GGT indicate biliary Gastrointestina Pathology 7
injury. Serum albumin lvls, bilirubin lvls, and PT are reflective of liver fxn and are of l & Nutrition (Path)
greatest prognostic significance in pts w/ cirrhosis. (GI) GI Path
1467
Immunizations The live attenuated oral (Sabin) poliovirus vaccine produces a stronger mucosal secretory Gastrointestina Immunolo 4
IgA immune response than does the inactivated poliovirus (Salk) vaccine. This increase in l & Nutrition gy (Immu)
mucosal IgA offers immune protection at the site of viral entry by inhibiting attachment to (GI)
intestinal epithelial cells. GI Immu
1475
Base excision repair BER is used to correct single-base DNA defects induced spontaneously or by exogenous Gastrointestina Biochemist 1
chemicals. In this process, glycosylases remove the defective base, and the corresponding l & Nutrition ry (Bioc)
empty sugar-P site is cleaved and removed by the action of endonuclease and lyase. DNA pol (GI)
then replaces the missing nucleotide, and ligase seals the final remaining nick. GI Bioc
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1479
Lac operon The lac operon is regulated by 2 distinct mechs: (-) by binding of the repressor protein to the Gastrointestina Biochemist 2
operator locus and (+) by cAMP-CAP binding upstream from the promoter region. l & Nutrition ry (Bioc)
Constitutive expression of the structure genes of the lac operon occurs w/ muts that impair (GI)
the binding of the repressor protein (Lac I) to its regulatory sequences in the operator region. GI Bioc
1485
Lac operon Bacterial mRNA can be polycistronic, meaning that 1 mRNA codes for several proteins. An Gastrointestina Biochemist 2
example of polycistronic mRNA is the bacterial lac operon, which codes for the proteins l & Nutrition ry (Bioc)
necessary for lactose metabolism by E. coli; the transcription and translation of these (GI)
bacterial proteins is regulated by a single promoter, operator, and set of regulatory elements. GI Bioc
1525
Cholecystitis Gallstone ileus results from passage of a large gallstone thru a cholecystenteric fistula into Gastrointestina Anatomy 5
the small bowel, where it ultimately causes obstr at the ileum. Pts typically present w/ SSx of l & Nutrition (Anat)
SBO, and an AXR may reveal gas w/i thegallbladderandbiliary tree. (GI) GI Anat
1537
Portal hypertension The portal vein can be ID'd on cross-sectional scans lying med. to (or just w/i) the right lobe Gastrointestina Anatomy 1
of the liver and ant. to the IVC. The pressure in the portal system is ↑ in liver cirrhosis. l & Nutrition (Anat)
(GI) GI Anat
1546
Gastrointestinal Secretin is prod by S cells in the duodenal mucosa in response to stim by intraluminal Gastrointestina Physiology 2
hormones activity. Secretin stims the release of HCO3-rich secrs from the exocrine pancr, which is the l & Nutrition (Phys)
major source of acid-neutr HCO3 entering the duodenum. (GI) GI Phys
1547
Chronic pancreatitis Diarrhoea, weight loss, and epigastric calcifications in a pt w/ chronic alcoholism suggest Gastrointestina Pathology 3
chronic pancreatitis w/ resulting pancreatic exocrine insufficiency and malabsorption. l & Nutrition (Path)
(GI) GI Path
1581
Vitamin A VitA defic causes night blindness and hyperkeratosis. defic of this fat-soluble vit can develop Gastrointestina Pathophysi 1
deficiency in pts w/ biliary disorders, exocrine PI, or intestinal malabsorption. l & Nutrition ology
(GI) (Patp) GI Patp
1597
Inflammatory bowel Of the cytokines released in the setting of tissue injury, IL-10 plays important anti- Gastrointestina Immunolo 9
disease inflammatory and immunomodulatory roles, especially in the pathogenesis of inflammatory l & Nutrition gy (Immu)
bowel disease. IL-10 attenuates the immune response through the inhibition of Th1 (GI)
cytokines, reduction of major histocompatibility complex class Il expression, and
suppression of activated macrophages and dendritic cells. GI Immu
1603
Peptic ulcer disease H. pylori antral gastritis is a/w the formation of duodenal ulcers due to ↑ gastric acid Gastrointestina Pathology 10
production. This ↑ in acidity is caused by unchecked gastrin production due to the l & Nutrition (Path)
destruction of somatostatin-secreting cells in the gastric antrum. (GI) GI Path
1604
Peptic ulcer disease H. pylori produces the enzyme urease, which splits urea into CO2 and NH3+ and neutralises Gastrointestina Pathology 10
the local acidic gastric pH. Active infection can be confirmed thru rapid urease testing, in l & Nutrition (Path)
which gastric mucosa is evaluated in the presence of urea and a pH indicator. Evidence of (GI)
alkalinisation (due to NH3+ formation) is confirmatory. GI Path
1605
Gastrectomy IF is a gp that's normally secreted by parietal cells in the stomach and is necessary for the Gastrointestina Pathophysi 1
absorption of vitB12 in the ileum. Pts who have undergone a total gastrectomy req lifelong l & Nutrition ology
vitB12 supplementation due to inability to produce IF. (GI) (Patp) GI Patp
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1662
Mallory-Weiss A MW tear is a tear in the gastric mucosa near the GOJ. It typically results from repetitive Gastrointestina Pathophysi 2
syndrome forceful vomiting, which can also cause meta alkalosis. l & Nutrition ology
(GI) (Patp) GI Patp
1701
Esophageal varices PVT causes portal HTN, splenomegaly, and varicosities at portocaval anastomoses. It does Gastrointestina Pathology 2
not cause histologic changes to the hepatic parenchyma. Ascites is uncommon as the l & Nutrition (Path)
obstruction is presinusoidal; ascites typically only develops in conditions that cause (GI)
sinusoidal HTN. GI Path
1706
Gastroesophageal The oesophagus is located b/w the trachea and the vertebral bodies in the sup. thorax. It's Gastrointestina Anatomy 7
reflux disease typically collapsed w/ no visible lumen on CT images of the chest. l & Nutrition (Anat)
(GI) GI Anat
1709
Route of F refers to the fraction of admin drug that reaches the syst circulation in a chem unchanged Gastrointestina Pharmacol 2
administration & form. F for a drug admin by a non-IV route is always less than 1. It can be determined by l & Nutrition ogy (Phar)
bioavailability examining a graph of plasma conc vs time then applying the formula: F = (AUC oral x dose (GI)
IV) / (AUC IV x dose oral). GI Phar
1738
Chronic pancreatitis Chronic pancreatitis often presents w/ epigastric pain and pancreatic exocrine insufficiency Gastrointestina Anatomy 3
resulting in fat malabsorption/steatorrhoea. On abdo CT scan, the pancreas can be ID'd by its l & Nutrition (Anat)
head in close a/w the 2nd part of the duodenum; its body overlying the aorta, left kidney, and (GI)
renal vessels; and its tail lying w/i the splenorenal ligament. GI Anat
1744
Gastrointestinal The hindgut encompasses the dist. 1/3 of the transverse colon, the desc. colon, the sigmoid Gastrointestina Anatomy 1
hemorrhage colon, and the rectum. These structures receive their main arterial blood supply from the l & Nutrition (Anat)
IMA. (GI) GI Anat
1766
Peptic ulcer disease PPIs (e.g. omeprazole, lansoprazole) block the final common pathway of gastric acid secr Gastrointestina Pharmacol 10
from parietal cells, which is stim by ACh, hist, and gastrin. l & Nutrition ogy (Phar)
(GI) GI Phar
1778
Peptic ulcer disease Most duodenal PUs are caused by H. pylori infec. The most effective method to prevent Gastrointestina Pharmacol 10
disease recurrence is to eradicate the infec w/ Abx (e.g. tetracycline, metronidazole), l & Nutrition ogy (Phar)
typically in combo w/ PPIs (e.g. omeprazole) and, often, bismuth subsalicylate (quad (GI)
therapy). GI Phar
1783
Inflammatory bowel CD typically presents w/ the insidious onset of abdo pain, diarrhoea, and constitutional SSx Gastrointestina Pathology 9
disease (e.g. weight loss, fever). Pts are prone to devel fistulas/abscesses as the lesions affect the l & Nutrition (Path)
entire thickness of the bowel wall. Perianal disease (e.g. skin tags, fissures) is also common. (GI) GI Path
1806
Vitamin E VitE defic can occur in individuals w/ fat malabsorption. defic of this fat-soluble vit is a/w ↑ Gastrointestina Pathology 2
deficiency susceptibility of the neuronal and erythrocyte membranes to oxidative stress. Clinical MFxs l & Nutrition (Path)
incl ataxia, impaired proprioception and vibratory sensation, and hemolytic anaemia. (GI) GI Path
1807
TCA cycle Vit B2 is a precursor of the coenzymes FMN and FAD. FAD participates in the TCA cycle Gastrointestina Biochemist 2
and ETC by acting as an electron acceptor for succinate dehydrogenase (complex II), which l & Nutrition ry (Bioc)
converts succinate into fumarate. (GI) GI Bioc
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1817
Nausea and Ondansetron inhibits serotonin (5-HT3) receptors and is used primarily to treat nausea and Gastrointestina Pharmacol 2
vomiting vomiting following chemotherapy, 5-HT3 receptors are located peripherally in the l & Nutrition ogy (Phar)
presynaptic nerve terminals of the vagus nerve in the gastrointestinal tract. These receptors (GI)
are also present centrally in the chemoreceptor trigger zone and the solitary nucleus and tract. GI Phar
1832
Duodenum and The 3rd part of the duodenum courses horizontally across the abdo aorta and IVC at the lvl Gastrointestina Anatomy 1
superior mesenteric of the 3rd lumbar vertebra. The SMVs lie ant. to the duodenum at this location. l & Nutrition (Anat)
artery (GI) GI Anat
1863
Hepatitis A Acute hepatitis due to most hepatotropic viruses causes hepatocyte ballooning degen and Gastrointestina Pathology 4
apoptosis w/ mononuclear cell infiltrations. l & Nutrition (Path)
(GI) GI Path
1875
Ischemic hepatitis Organ susceptibility to infarction after occlusion of a feeding artery is ranked from greatest Gastrointestina Anatomy 1
to least as follows: CNS, myocardium, kidney, spleen, and liver. The presence of a dual a/o l & Nutrition (Anat)
collateral blood supply (as seen in the liver, which is supplied by the hepatic artery and portal (GI)
vein) enables an organ to tolerate arterial occlusion better than those w/ end-arterial
circulations. GI Anat
1907
Malabsorption PSs must be degraded to MSs by pancreatic and brush border amylases before they can be Gastrointestina Pathophysi 4
absorbed. MSs can be absorbed directly. D-xylose is a MS whose absorption isn't affected by l & Nutrition ology
exocrine PI, and can be used to diffiate b/w pancreatic vs. mucosal causes of malabsorption. (GI) (Patp) GI Patp
1918
Peptic ulcer disease Acute Helicobacter pylori infection initially causes nonatrophic antral gastritis and an ↑ risk Gastrointestina Pathology 10
for duodenal ulcers. Chronic infection results in patchy, multifocal, atrophic gastritis w/ loss l & Nutrition (Path)
of parietal cells and G cells in the gastric body; this is a/w ↓ acid secretion and an ↑ risk of (GI)
gastric ulcers, GAC, and MALT lymphoma. GI Path
1926
Breastfeeding The breast milk content of vits D and K is typically insuff for the nutr needs of the newborn. Gastrointestina Physiology 1
Vit K is given parenterally to all newborns at birth to prevent HDN. Exclusively breastfed l & Nutrition (Phys)
infants req vit D supp due to lack of sunlight exposure and to prevent rickets. (GI) GI Phys
1927
Hepatitis C IVDU is a major RF for HBV and HCV viral infection. Acute viral hepatitis is marked by Gastrointestina Pathology 4
panlobular inflammation and hepatocyte necrosis and ballooning. Tc cell-mediated signals l & Nutrition (Path)
also cause hepatocyte apoptosis w/ the formation of intensely eosinophilic Councilman (GI)
bodies. GI Path
1938
VIPoma VIPomas are pancr islet cell tumors that hypersecr VIP, which ↑ intestinal Cl loss into the Gastrointestina Physiology 1
stool and causes excess losses of the accomp water, Na, and K. VIP also inhibs gastric acid l & Nutrition (Phys)
secr. SS inhibs the secr of VIP and is used to Tx the SSx of VIPoma. (GI) GI Phys
1971
Pancreatic secretion Duodenal S-cells secr secretin in response to ↑ H concs. Secretin ↑ pancr HCO3 secr. The Cl Gastrointestina Physiology 1
content of pancr secrs ↓ in proportion to HCO3 conc ↑. l & Nutrition (Phys)
(GI) GI Phys
2022
Spleen rupture The spleen is of mesodermal origin (the dorsal mesentery). Although it is supplied by the Gastrointestina Embryolog 2
splenic artery (a branch of the major foregut vessel, the celiac trunk), It is not a foregut l & Nutrition y (Embr)
derivative. (GI) GI Embr
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2028
Mismatch repair Lynch syndrome is an AD disease caused by abnormal nucleotide mismatch repair. The Gastrointestina Biochemist 1
mismatch repair system involves several genes, including MSH2 and MLH1, which code for l & Nutrition ry (Bioc)
components of the human MutS and MutL homologs. Mutations in these 2 genes account for (GI)
around 90% of cases of Lynch syndrome. GI Bioc
6510
Clostridium difficile Clostridium difficile infection is associated with white, patchy pseudomembranes on the Gastrointestina Microbiolo 7
infection bowel mucosa. These pseudomembranes consist of a neutrophil-predominant inflammatory l & Nutrition gy (Micr)
infiltrate, fibrin, bacteria, and necrotic epithelium. Patients may develop a nonobstructive (GI)
colonic dilation known as toxic megacolon, which can lead to colonic perforation. GI Micr
6705
Gastroparesis Erythromycin stims upper GI motility by acting as an ag on motilin receptors in the Gastrointestina Pharmacol 2
muscularis externa. Therefore, it can be used to Tx gastroparesis (i.e. delayed gastric l & Nutrition ogy (Phar)
emptying), a condition that freq occurs in pts w/ long standing DM. (GI) GI Phar
6731
Acute diarrhea Campylobacter jejuni is an oxidase-positive, curved, gram-negative rod that is a leading Gastrointestina Microbiolo 13
cause of gastroenteritis. The pathogen is a zoonotic organism most commonly contracted by l & Nutrition gy (Micr)
consuming contaminated, undercooked poultry. Cases are marked by fever, abdominal pain, (GI)
and diarrhea that may be bloody. GI Micr
7214
Cirrhosis Portal HTN, as seen in ALD, produces splenomegaly by causing congestion of blood w/i the Gastrointestina Pathology 7
spleen, which produces expansion of the red pulp. l & Nutrition (Path)
(GI) GI Path
7215
Esophageal varices Acute Mx of variceal hemorrhage req rapid lowering of portal pressure. Somatostatin and Gastrointestina Pathology 2
octreotide (a long-acting somatostatin analogue) inhib the release of hormones that induce l & Nutrition (Path)
splanchnic vasodilation, indirectly causing splanchnic vasoconstriction and ↓ portal blood (GI)
flow. GI Path
7228
Cytomegalovirus CMV is a common cause of colitis in pts w/ advanced AIDS. It is the 2nd most common Gastrointestina Pathology 9
CMV reactivation disease in this population (CMV retinitis is the most common). Pts w/ l & Nutrition (Path)
CMV colitis often have abdominal pain, fever, diarrhea, and weight loss. Colonoscopy (GI)
usually shows erythema, erosions, and ulcerations; colonic Bx typically reveals large cells w/
prominent basophilic intranuclear inclusions. GI Path
7229
Antiretroviral The HIV genome contains 3 major structural genes that are translated as polyproteins and Gastrointestina Pathology 7
therapy subsequently cleaved by host protease (env gene products) or viral protease (gag-pol gene l & Nutrition (Path)
products) into the individual proteins that compose the HIV virus. PIs block viral protease (GI)
from cleaving gag-pol polyproteins, which results in the formation of immature virions that
are noninfectious. GI Path
7573
Appendicitis Intra-abdo infecs are polymicro, w/ B. fragilis and E.coli being the most prominent Gastrointestina Microbiolo 5
organisms isolated. l & Nutrition gy (Micr)
(GI) GI Micr
7584
GI surgery Fe abs occurs predom in the duodenum and prox jejunum. Bypass of this segment of small Gastrointestina Pharmacol 1
bowel by gastrojejunostomy results in IDA that can be corrected w/ Rx Fe supp. Malabs of l & Nutrition ogy (Phar)
vits B12, B9, fat-sol vits (esp vit D), and Ca may also be obs following gastric bypass (GI)
procedures. GI Phar
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7642
Cryptosporidiosis Cryptosporidium is a common cause of self-lim diarrhea in immcom hosts, but may cause Gastrointestina Microbiolo 1
life-thr diarrhea in immsup pts (e.g. adv AIDS). Dx is usually made when oocysts are l & Nutrition gy (Micr)
visualized w/ modded acid-fast stain in stool or Bx (oocysts lining the brush-border). (GI) GI Micr
7710
Peptic ulcer disease Helicobacter pylori is a common cause of peptic ulcers. Duodenal ulcers are a/w heavy Gastrointestina Pathology 10
colonization in the gastric antrum, whereas colonization in the gastric corpus is a/w gastric l & Nutrition (Path)
ulcers. (GI) GI Path
8425
Obesity Leptin is a protein hormone produced by adipocytes in proportion to the quantity of fat Gastrointestina Biochemist 2
stored. Leptin acts on the arcuate nucleus of the hypothalamus to inhib production of NPY (↓ l & Nutrition ry (Bioc)
appetite) and stim production of α-MSH (↑ satiety). Muts in the leptin gene or receptor result (GI)
in hyperphagia and profound obesity. GI Bioc
8547
Cirrhosis In cirrhosis, portal HTN arises from ↑ resistance to portal flow at the hepatic sinusoids. This Gastrointestina Anatomy 7
causes ↑ pressure in the portosystemic collateral veins w/i the lower end of the oesophagus, l & Nutrition (Anat)
ant. abdo, and lower rectum. Dilation of these collateral vessels is responsible for the (GI)
oesophageal varices, caput medusae, and anorectal varices commonly seen in pts w/
cirrhosis. GI Anat
8574
Splenic artery The splenic artery originates from the coeliac artery and gives off several branches to the Gastrointestina Anatomy 1
stomach and pancreas (pancreatic,short gastric, andleft gastroepiploic arteries) before finally l & Nutrition (Anat)
reaching the spleen. Due to poor anastomoses, the gastric tissue supplied by the short gastric (GI)
arteries is vulnerable to ischemic injury following splenic artery blockage. GI Anat
8578
Hepatic Hyperammonemia in advanced liver failure occurs as a direct result of the cirrhotic liver's Gastrointestina Biochemist 2
encephalopathy inability to metabolize nitrogenous waste products. Ammonia crosses the blood-brain barrier l & Nutrition ry (Bioc)
and causes excess glutamine to accumulate within astrocytes. This decreases the amount of (GI)
glutamine available for conversion to glutamate in the neurons, resulting in disruption of
excitatory neurotransmission. GI Bioc
8587
Lesser omentum The lesser omentum is a double layer of peritoneum that extends from the liver to the lesser Gastrointestina Anatomy 1
curvature of the stomach and the beginning of the duodenum. It's divided into the l & Nutrition (Anat)
hepatogastric and hepatoduodenal ligaments. (GI) GI Anat
8669
Groin hernias DIHs occur most commonly in older men due to weakness of the transversalis fascia. They Gastrointestina Anatomy 3
protrude med. to theinf. epigastric vessels into the Hesselbach's triangle and pass only thru l & Nutrition (Anat)
the SIR w/ no direct route to the scrotum. (GI) GI Anat
8873
Strongyloides S. stercoralis infec begins following skin penetration by filariform (infec) larva and can be Gastrointestina Microbiolo 1
Dx by finding rhabditiform (noninfec) larvae in the stool. Rhabditiform larvae can mature l & Nutrition gy (Micr)
into filariform larva in the human HIT, precip an autoinfec cycle that occurs entirely w/i the (GI)
affected indiv. This can result in a hyperinfec syndrome char by massive dissem of the
organism, leading to MOD and septic shock. GI Micr
9920
Necrotizing NEC is 1 of the most common GI emergencies affecting newborns. It's characterised by Gastrointestina Pathology 1
enterocolitis bacterial invasion and ischemic necrosis of the bowel wall, and is a/w prematurity and l & Nutrition (Path)
initiation of enteral feeding. Abdo XR showing pneumatosis intestinalis (i.e. air in the bowel (GI)
wall confirms the Dx. GI Path
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10401
Clostridium difficile C. difficile infec can be Tx w/ oral vancomycin or fidaxomicin. Fidaxomicin is a macrocyclic Gastrointestina Pharmacol 7
infection Abx that inhibs RNA pol. It’s bactericidal against C. difficile. l & Nutrition ogy (Phar)
(GI) GI Phar
10583
Penetrating Occlusion of the portal triad can be used to distinguish the source of RUQ bleeding. If the Gastrointestina Anatomy 1
abdominal trauma bleeding subsides following occlusion, the source is likely to be the hepatic artery or portal l & Nutrition (Anat)
vein. If hepatic bleeding persists after occlusion, the IVC or hepatic veins are likely to be (GI)
injured. GI Anat
10999
Antiemetics 5-HT3 receptor antags are useful for the Tx of visc nausea due to GI insults, such as GE, Gastrointestina Pharmacol 1
ChTx, and gen anes. Antihists and antichols are recom for vestibular nausea. DA antags are l & Nutrition ogy (Phar)
useful for nausea a/w migraine. (GI) GI Phar
11548
Cytomegalovirus CMV oesophagitis can occur in transplant pts and usually presents w/ odynophagia or Gastrointestina Pathology 9
dysphagia that can be accompanied by fever or burning chest pain. Endoscopy typically l & Nutrition (Path)
shows linear and shallow ulcerations in the lower oesophagus, and histo usually shows (GI)
enlarged cells w/ intranuclear inclusions. GI Path
11591
Gastroesophageal New-onset odynophagia in the setting of chronic GORD should raise suspicion for erosive Gastrointestina Pathophysi 7
reflux disease oesophagitis w/ oesophageal ulcers. Dx is made by upper endoscopy. l & Nutrition ology
(GI) (Patp) GI Patp
11661
Cirrhosis Tx for HE incl lactulose (↑ conversion of NH3 to NH4) and rifaximin (↓ intraluminal NH3 Gastrointestina Pharmacol 7
prod). l & Nutrition ogy (Phar)
(GI) GI Phar
11739
Gallstone disease Medical therapy to dissolve cholesterol gallstones is an option in patients refusing Gastrointestina Pharmacol 8
cholecystectomy or with high surgical risk. Hydrophilic bile acids (eg, ursodeoxycholic acid) l & Nutrition ogy (Phar)
improve cholesterol solubility by reducing the amount of cholesterol secreted into the bile (GI)
and increasing biliary bile acid concentration. GI Phar
11753
Spleen rupture Any abdo process (e.g. ruptured spleen, peritonitis, hemoperitoneum) irritating the phrenic Gastrointestina Anatomy 2
nerve sensory fibres around the diaphragm can cause referred pain to the C3-C5 shoulder l & Nutrition (Anat)
region (Kehr sign). (GI) GI Anat
11760
Hepatocellular The celiac trunk is the first main branch of the abdominal aorta; it provides oxygenated blood Gastrointestina Anatomy 5
cancer to the spleen, stomach, liver, abdominal esophagus, and parts of the duodenum and pancreas. l & Nutrition (Anat)
The proper hepatic artery branches off the common hepatic artery from the celiac trunk and (GI)
provides arterial blood supply to the liver. GI Anat
11771
Hemorrhoids External hemorrhoids, which originate below the dentate line, are covered by modded Gastrointestina Anatomy 2
squamous epithelium and have cutaneous (somatic) nervous innervation from the inf. rectal l & Nutrition (Anat)
nerve, a branch of the pudendal nerve. (GI) GI Anat
11775
Appendicitis Appendicitis causes dull visceral pain at the umbilicus due to afferent pain fibres entering at Gastrointestina Anatomy 5
the T10 lvl in the spinal cord. progr inflammation in the appendix irritates the parietal l & Nutrition (Anat)
peritoneum and abdo wall to cause more severe somatic pain shifting from the umbilicus to (GI)
McBurney's point (2/3 of the distance from the umbilicus to the ASIS). GI Anat
D eats
11782
Appendicitis The teniae coli are 3 separate smooth muscle ribbons that travel longitudinally on the outside Gastrointestina Anatomy 5
of the colon and converge at the root of the vermiform appendix. If the appendix cannot be l & Nutrition (Anat)
identified by palpation during an appendectomy, it can be located by following the teniae (GI)
coli to their origin at the cecal base. GI Anat
11795
Chronic pancreatitis The short gastric veins drain blood from the gastric fundus into the splenic vein. Pancreatic Gastrointestina Anatomy 3
inflammation (e.g. pancreatitis, pancreatic ca) can cause a blood clot w/i the splenic vein, l & Nutrition (Anat)
which can ↑ pressure in the short gastric veins and lead to gastric varices only in the fundus. (GI) GI Anat
11803
Umbilical hernia Umbilical hernias are caused by a defect in the linea alba and Px as protrusions at the Gastrointestina Embryolog 1
umbilicus that are soft, reducible, and benign. They can occur in isolation or in a/w other l & Nutrition y (Embr)
conditions, such as DS. (GI) GI Embr
11817
Lymphatic drainage Lymphatic drainage of the rectum prox. to the anal dentate line occurs via the inf. mesenteric Gastrointestina Anatomy 2
and int. iliac LNs. Areas distal to the dentate line drain 1arily into the inguinal nodes. l & Nutrition (Anat)
(GI) GI Anat
11839
Aortic aneurysm The SMA and IMA are the 2 main vessels supplying the small and large intestines. They're Gastrointestina Anatomy 6
connected by a pair of anastomoses: the marginal artery of Drummond, which is the principal l & Nutrition (Anat)
anastomosis, and the inconsistently present arc of Riolan (mesenteric meandering artery). (GI) GI Anat
11840
Hemorrhoids hemorrhoids results from abn distension of a portion of the anal AV plexus. The vascular Gastrointestina Anatomy 2
components of internal hemorrhoids drain into the sup. rectal vein, which subseq drains into l & Nutrition (Anat)
the IMV. Band ligation of hemorrhoids cuts off their blood supply, causing them to degen. (GI) GI Anat
11850
Anterior abdominal Horizontal transection of the rectus abdominis muscle must be performed w/ great caution as Gastrointestina Anatomy 1
wall the inf. epigastric arteries enter this muscle at the lvl of the arcuate line. The inf. epigastric l & Nutrition (Anat)
arteries below the arcuate line are susceptible to injury (e.g. hematoma) due to lack of a (GI)
supporting post. rectus sheath. GI Anat
11860
Small intestinal Gastric bypass Sx can cause SIBO due to excessive bacterial proliferation in the blind-ended Gastrointestina Pathophysi 1
bacterial overgrowth gastroduodenal segment. SIBO results in defic of most vits (B12, A, D, and E) and Fe, but ↑ l & Nutrition ology
production of vitB9 and vitK. (GI) (Patp) GI Patp
11962
Tracheoesophageal TEF/EA results from failure of the primitive foregut to appropriately divide into separate Gastrointestina Embryolog 1
fistula trachea and esophageal structures. Infants Px shortly after birth w/ excessive secretions and l & Nutrition y (Embr)
choking/cyanosis during feeds. (GI) GI Embr
12047
Malabsorption Crohn disease with ileal resection or extensive ileal involvement can cause bile acid Gastrointestina Pathophysi 4
malabsorption, which may lead to impaired absorption of fat-soluble vitamins (A, D, E, K). l & Nutrition ology
Vitamin K deficiency can result in impaired coagulation with easy bruising, large hematoma (GI) (Patp)
formation in deep tissues and joints (eg, hemarthrosis) after minor trauma, and prolonged
bleeding after surgery. GI Patp
12062
Short bowel SBS typically occurs in pts w/ massive small bowel resection a/o Crohn disease due to loss Gastrointestina Pathology 1
syndrome of intestinal absorptive surface area and a ↓ in intestinal transit time. Pts usually present w/ l & Nutrition (Path)
postprandial voluminous diarrhoea and weight loss due to malabsorption. Loss of fxnal distal (GI)
ileum may result in vitB12 defic. GI Path
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12068
Vitamin B12 Pernicious anaemia is an AI disease characterised by CD4+cell-mediated destruction of Gastrointestina Pathophysi 9
deficiency parietal cells. As parietal cells are destroyed, their ability to secrete HCl ↓, resulting in an ↑ l & Nutrition ology
intraluminal pH that leads to upregulation of gastrin secretion. Pts also develop vitB12 defic (GI) (Patp)
as a result of ↓ IF secretion. GI Patp
12198
Embryologic The spleen is a large, wedge-shaped lymphatic organ that is situated in the post sup portion Gastrointestina Embryolog 2
derivatives of the left abdo cavity. It is derived from mesoderm in the dorsal mesentery during l & Nutrition y (Embr)
embryonic development. (GI) GI Embr
14837
Perforated viscus Pneumoperitoneum is air or gas in the peritoneal cavity; it can be seen as free air under the Gastrointestina Anatomy 1
diaphragm in an upright CXR. The most common cause is a perforated duodenal ulcer, but l & Nutrition (Anat)
perforation can occur anywhere along the GIT (or female repro). subseq peritonitis can lead (GI)
to diffuse abdo pain w/ rebound and guarding, sometimes w/ referred shoulder pain due to
diaphragmatic irritation. GI Anat
14872
Gastroesophageal Mx of GERD incl dietary and LSMs (e.g. weight loss, tobacco avoidance) and Rx such as H2 Gastrointestina Pharmacol 7
reflux disease receptor antags (e.g. ranitidine) or PPIs (e.g. pantoprazole, omeprazole). PPIs irrev inhib the l & Nutrition ogy (Phar)
H/K ATPase on parietal cells, thereby ↓ gastric acid secr. (GI) GI Phar
14873
Gastroesophageal Pregnant women often develop GERD due to ↑ lvls of estrogen and progesterone, which Gastrointestina Pathology 7
reflux disease relax the smooth muscle of the LES. Later in pregnancy, GERD can also develop when the l & Nutrition (Path)
gravid uterus presses on the stomach and leads to an altered LES angle or ↑ gastric pressure. (GI) GI Path
14877
Gastroesophageal Mg salts and Al-OH are basic mineral salts used to neutr gastric acid and relieve GERD SSx. Gastrointestina Pharmacol 7
reflux disease AEs incl diarrhea and constipation, respectively. Therefore, these Rx are often combo to l & Nutrition ogy (Phar)
offset the AEs of the indiv Rx. (GI) GI Phar
14878
Esophageal cancer Oesophageal SCC presents mostly in the proximal 2/3 of the oesophagus and freq mets to the Gastrointestina Pathology 4
mediastinal LNs. Histo char shows sheets of pleomorphic squamous cells w/ keratin pearls l & Nutrition (Path)
and intercellular bridges. (GI) GI Path
14879
Esophageal cancer OAC usually occurs in the distal oesophagus due to underlying Barrett oesophagus. Long- Gastrointestina Pathology 4
standing GORD is the most important RF. Obesity, smoking, use of Rx that lower l & Nutrition (Path)
oesophageal sphincter pressure, and consumption of foods containing nitroso compounds (GI)
also ↑ the risk. GI Path
14880
Hiatal hernia HHs occur when contents of the abdo cavity herniate thru the diaphragm at the oesophageal Gastrointestina Anatomy 1
hiatus into the thoracic cavity. Sliding HHs occur due to laxity of the phreno-oesophageal l & Nutrition (Anat)
membrane, leading to herniation of the GOJ and prox. stomach, whereas para-oesophageal (GI)
hernias occur due to defects in the membrane, resulting in the gastric fundus herniation. GI Anat
14890
Achalasia Achalasia is caused by loss of inhib gang cells in the dist esoph wall and is char by the Gastrointestina Pharmacol 3
absence of esoph peristalsis and incomplete relaxation of a hypertonic LES. Bot tox prevents l & Nutrition ogy (Phar)
ACh release into the NM synapse, resulting in inhib of ACh-ergic neurons and LES (GI)
relaxation. GI Phar
D eats
14891
Esophagitis HSV esophagitis is most common in those w/ impaired cell-mediated immunity. Endoscopy Gastrointestina Pathology 3
typically reveals small vesicles and "punched-out" ulcers. Findings on Bx usually include l & Nutrition (Path)
multinucleated giant cells and eosinophilic intranuclear inclusions (Cowdry type A inclusion (GI)
bodies). Acyclovir is the Tx of choice. GI Path
14892
Esophagitis EOO is a Th2 cell-mediated disorder leading to eosinophilic infiltration of the oesophageal Gastrointestina Pathology 3
mucosa. It occurs most commonly in males w/ a Hx of atopic conditions and typically l & Nutrition (Path)
presents w/ solid food dysphagia, reflux, and occasionally food impaction. (GI) GI Path
14900
Diverticular disease Colonic diverticulosis refers to multi sac-like outpouchings w/i the sigmoid colon. Gastrointestina Pathology 3
Complications incl diverticular bleeding and diverticulitis. RFs for diverticulosis incl a diet l & Nutrition (Path)
high in red meat and fat and low in fibre, as well as obesity, physical inactivity, and smoking. (GI) GI Path
14907
Diverticular disease Diverticulitis is characterised by inflammation of colonic diverticula. Pts have abdo pain, Gastrointestina Pathology 3
nausea, vomiting, and changes in bowel habits. Low-grade fever and leucocytosis are l & Nutrition (Path)
common, and PEx may demonstrate a tender mass in the LLQ. (GI) GI Path
15011
Colorectal cancer Tumour stage (degree of invasion/spread) is the most important prognostic determinant for Gastrointestina Pathology 15
CRC. Tumours confined to the BM and lamina propria are early stage and have the best l & Nutrition (Path)
prognosis. Outcomes gen deteriorate as the stage advances: spread of tumour into the (GI)
muscularis propria → regional LNs → distant sites. GI Path
15012
Colorectal cancer Most hepatic neoplasms are due to mets from a distant site. CRC is the most common cause Gastrointestina Pathology 15
of hepatic mets due to direct blood flow from the colon (and superior rectum) to the liver via l & Nutrition (Path)
the portal venous circulation. (GI) GI Path
15018
Peptic ulcer disease Peptic ulcers are most commonly caused by Helicobacter pylori infection or NSAID use. Gastrointestina Pathology 10
NSAIDs inhibit COX-1, leading to ↑ gastric acid formation, ↓ mucosal bicarbonate l & Nutrition (Path)
production, and ↓ mucosal blood flow, which promote mucosal injury and ulcer formation. (GI) GI Path
15020
Colorectal cancer FAP is an AD disorder caused by germline mutation to the TSG adenomatous polyposis coli. Gastrointestina Pathology 15
Pts w/ FAP develop hundred or thousands of colonic polyps; lifetime risk of colon ca is close l & Nutrition (Path)
to 100%. (GI) GI Path
15021
Familial FAP is an AD hereditary disorder that results in the formation of innumerable colonic polyps Gastrointestina Pathology 1
adenomatous and a nearly 100% risk of CRC. It arises due to germline mut to the TSG APC. l & Nutrition (Path)
polyposis (GI) GI Path
15024
Nonalcoholic fatty Stellate (Ito) cells are the primary cells involved in hepatic fibrosis. In response to hepatic Gastrointestina Histology 1
liver disease injury, the stellate cells are activated and transform into myofibroblasts capable of l & Nutrition (Hist)
proliferating, promoting chemotaxis, and producing large quantities of collagen. Collagen (GI)
stains blue with Masson trichrome stain. GI Hist
15049
Clostridium difficile C. difficile commonly Px w/ diarrhea and abdo pain; hosp and Abx use ↑ the risk of Gastrointestina Microbiolo 7
infection contracting the disease. A NAAT is considered the most sens method for Dx of C. difficile l & Nutrition gy (Micr)
infec in pts w/ CFx. (GI) GI Micr
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15144
Hepatitis C Chronic HCV infec is Tx w/ DAA Rx such as ledipasvir and sofosbuvir. These Rx target Gastrointestina Microbiolo 4
spec HCV enzymes (e.g. protease, NS5A, RNA pol), which inhibs viral replication and l & Nutrition gy (Micr)
assembly. Tx w/ DAAs results in cure in >97% of pts. (GI) GI Micr
15244
Acute diarrhea Children w/ watery diarrhea should be Tx w/ oral rehydr solns containing hypotonic, Gastrointestina Pharmacol 13
equimolar concs of Na and Glc to help prevent dehydr and electrolyte abns. l & Nutrition ogy (Phar)
(GI) GI Phar
15535
Acute heart failure Congestive hepatopathy is a common complication of RHF. Patchy hemorrhage and necrosis Gastrointestina Pathology 7
predominantly affect the centrilobular regions (zone 3) where hepatic congestion is most l & Nutrition (Path)
prominent. The centrilobular necrosis, combo w/ relatively normal-appearing periportal (GI)
regions (zone 1), creates an overall heterogenous appearance sometimes referred to as
'nutmeg liver'. GI Path
15603
Polymyositis and Dermatomyositis is characterised by proximal muscle weakness resembling polymyositis, w/ Gastrointestina Pathology 5
dermatomyositis addnal inflammatory features affecting the skin (e.g. heliotrope rash, Gottron papules). In l & Nutrition (Path)
both conditions, involvement of striated muscle in the oropharynx and heart can lead to (GI)
dysphagia, pulm aspiration, and myocarditis. GI Path
15652
Gastroparesis Diabetic gastroparesis results from the destruction of enteric neurons due to chronic Gastrointestina Pathophysi 2
hyperglycaemia, leading to impaired relaxation and disordered and ineffective peristalsis. l & Nutrition ology
This causes delayed gastric emptying, which presents as postprandialfullness, regurgof (GI) (Patp)
undigested food, nausea, and vomiting. GI Patp
16070
Focal nodular FNH is a benign liver tumor marked by a central stellate scar containing an abnormally large Gastrointestina Pathology 1
hyperplasia artery. It usually arises in young women and most cases are aSSx and found incidentally. l & Nutrition (Path)
(GI) GI Path
17004
Constipation Dyssynergic defecation occurs when the puborectalis muscle or the int.or ext. anal sphincter Gastrointestina Anatomy 3
fails to relax during defecation, leading to chronic constipation. Dyssynergic defecation is l & Nutrition (Anat)
usually considered a fxnal disorder and occurs more commonly in the elderly but may also (GI)
occur w/ certain neuro disorders (e.g. PD, MS) or trauma. GI Anat
17005
Constipation The pelvic splanchnic nerves (S2-S4) provide parasympathetic innervation to the bowel and Gastrointestina Anatomy 3
bladder, and their impairment in CES can cause constipation and difficulty urinating. Other l & Nutrition (Anat)
SSx of CES incl radicular LBP and leg weakness (sciatic nerve) as well as saddle anaesthesia (GI)
(pudendal, ilioinguinal nerves). GI Anat
297Apoptosis Cytochrome c is a mitochondrial enzyme that activates caspases and indirectly brings about General Pathology 4
cell death through intrinsic pathway apoptosis. Principles (GP) (Path) GP Path
542Major MHC class II is expressed on the surface of antigen presenting cells (APC) and presents General Immunolo 1
histocompatibility extracellular antigens to T cells after extracellular protein is degraded within acidified Principles (GP) gy (Immu)
class lysosomes. Failure to acidify lysosomes would lead to deficient expression of MHC class II-
antigen complexes with subsequent impaired interaction between APCs and T cells. GP Immu
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633Huntington disease An increased number of trinucleotide repeats on the HTT gene is associated with Huntington General Genetics 5
disease. The larger the number of repeats, the earlier the onset of the disease. Trinucleotide Principles (GP) (Gene)
expansion occurs more frequently during paternal transmission, causing a genetic
phenomenon called anticipation. GP Gene
701Achondroplasia Achondroplasia is an AD disorder that results in a GOF mut in the FGFR3 gene. Most General Genetics 2
individuals affected by AD disorders are heterozyg and have a 50% chance of transmitting Principles (GP) (Gene)
the mut to their offspring. GP Gene
746Immunology CD8+ cells recognize foreign antigens presented with MHC class I proteins. Each MHC General Immunolo 2
principles class | molecule consists of a heavy chain and a β2-microglobulin. Principles (GP) gy (Immu) GP Immu
757Rough ER protein The rough endoplasmic reticulum (RER) is covered with ribosomes and is involved in the General Physiology 1
synthesis transfer of proteins to the cell membrane and extracellular space. The RER is well developed Principles (GP) (Phys)
in protein secreting cells. The smooth ER lacks surface ribosomes and functions in lipid
synthesis, carbohydrate metabolism, and detoxification of harmful substances. GP Phys
852Anesthesia Following intravenous administration, a highly lipophilic drug will be rapidly distributed to General Pharmacol 9
organs with high blood flow (eg, brain, liver, kidneys, lungs). The drug is then redistributed Principles (GP) ogy (Phar)
to tissues with relatively lower blood flow (eg, skeletal muscle, fat, bone). This accounts for
the short duration of action of many commonly used anesthetics, such as propofol. GP Phar
995Second messengers After a ligand binds to a G protein-coupled receptor that activates phospholipase C, General Biochemist 2
membrane phospholipids are broken down into diacylglycerol (DAG) and inositol Principles (GP) ry (Bioc)
triphosphate (IP3). Protein kinase C is subsequently activated by DAG and calcium; the latter
is released from the endoplasmic reticulum under the influence of IP3. GP Bioc
996Lactic acidosis In the presence of oxygen, Pyruvate produced during glycolysis is converted by Pyruvate General Biochemist 1
dehydrogenase to acetyl coenzyme A, which is subsequently metabolized by oxidative Principles (GP) ry (Bioc)
phosphorylation. However, if inadequate oxygen is present in the tissues, pyruvate is
converted to lactate by lactate dehydrogenase, leading to lactic acidosis. GP Bioc
1028
Calcium and Synchronization of glycogen degradation with skeletal muscle contraction occurs due to General Biochemist 1
glycogen release of sarcoplasmic calcium following neuromuscular stimulation. Increased intracellular Principles (GP) ry (Bioc)
phosphorylase calcium causes activation of phosphorylase kinase, stimulating glycogen phosphorylase to
increase glycogenolysis. GP Bioc
1190
Predictive values NPV is the probability of not having a disease when the test result is (-). The NPV will vary General Biostatistic 3
w/ the pretest probability of a disease. A pt w/ a high probability of having a disease will Principles (GP) s (Bios)
have a low NPV w/ a (-) test, but a pt w/ a low probability of having a disease will have a
high NPV w/ a (-) test. GP Bios
1248
Collagen structure Glycine is the most abundant amino acid in collagen. The triple helical conformation of General Biochemist 1
collagen molecules occurs due to the repetitive amino acid sequence within each alpha chain, Principles (GP) ry (Bioc)
in which glycine (Gly) occupies every third amino acid position (Gly-X-Y). GP Bioc
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1365
Sympathomimetic Low-dose dopamine infusion stimulates Di receptors in the renal and mesenteric vasculature, General Pharmacol 5
agents resulting in vasodilation and increased blood flow to these sites. Increasing doses of Principles (GP) ogy (Phar)
dopamine stimulate B, and a receptors, resulting in increased cardiac output and elevated
systemic vascular resistance. At the higher end of the dose range, the increase in afterload
can result in decreased cardiac output. GP Phar
1378
Cellular transports Carrier-mediated transport includes facilitated diffusion and active transport. Movement of General Physiology 2
substrate across the cell membrane by these mechanisms depends on the presence of carrier Principles (GP) (Phys)
proteins that can become saturated at high substrate concentrations. GP Phys
1412
Mutations Deletion or addn of a # of bases that's not divisible by 3 in the coding region of a gene will General Genetics 3
cause a frameshift mut. Frameshift muts alter the reading frame of the genetic code, resulting Principles (GP) (Gene)
in the formation of nonfxnal proteins. GP Gene
1417
RNA structure & The nucleolus is a dense intranuclear body visible by light and electron microscopy that General Histology 2
function functions as the primary site of ribosome synthesis and assembly. All ribosomal RNA except Principles (GP) (Hist)
5S rRNA is transcribed in the nucleolus. GP Hist
1418
DNA replication DNA synth can occur only in the 5' --> 3' direction. Okazaki fragments are short stretches of General Genetics 3
newly synth DNA that're separated by RNA primers. They're formed by the discontinuous Principles (GP) (Gene)
synth of DNA on the lagging strand during replication. GP Gene
1419
DNA replication DNA replication occurs in the 5'+3' direction on both strands. In contrast to the continuous General Biochemist 3
synthesis of the leading strand, lagging strand synthesis occurs discontinuously and is Principles (GP) ry (Bioc)
composed of short stretches of RNA primer plus newly synthesized DNA segments (Okazaki
fragments). As a result, lagging strand synthesis requires the repetitive action of DNA
primase and DNA ligase. GP Bioc
1424
tRNA wobble The genetic code is considered "degenerate" because more than 1 codon can code for a General Biochemist 1
particular amino acid. Some of this degeneracy is explained by the wobble hypothesis, which Principles (GP) ry (Bioc)
states that the first 2 nucleotide positions on the mRNA codon require traditional (Watson-
Crick) base pairing, whereas the third "wobble" nucleotide position may undergo less
stringent (nontraditional) base pairing. GP Bioc
1428
RNA structure & The 3' CCA tail of tRNA serves as the amino acid binding site. Aminoacyl tRNA synthetase General Biochemist 2
function is the enzyme responsible for "loading" the appropriate amino acid to the 3' terminal Principles (GP) ry (Bioc)
hydroxyl group of the CCA tail. GP Bioc
1432
Interviewing Open-ended questions are the most effective way to begin a medical interview. Once the General Behavioral 1
technique patient provides an initial history, the physician can use closed-ended and follow-up Principles (GP) Science
questions to clarify certain points and fill gaps in the history. (Beha) GP Beha
1434
Exonuclease In prokaryotes, DNA polymerase I has 5' to 3' exonuclease activity in addition to 5' to 3' General Biochemist 2
polymerase and 3 to 5' exonuclease activities. This 5' to 3' exonuclease activity functions to Principles (GP) ry (Bioc)
remove the RNA primer created by RNA primase and repair damaged DNA sequences. GP Bioc
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1435
Exonuclease All 3 prokaryotic DNA polymerases can remove mismatched nucleotides via their 3 to 5 General Biochemist 2
exonuclease ("proofreading") activity. Only DNA polymerase i has 5' to 3' exonuclease Principles (GP) ry (Bioc)
activity. which is used to remove the RNA primer synthesized by RNA primase. GP Bioc
1436
DNA replication Bloom syndrome is a rare autosomal recessive condition caused by mutations in the BLM General Biochemist 3
gene encoding helicase, an enzyme that unwinds the double helix during DNA replication. Principles (GP) ry (Bioc)
Patients typically present with growth retardation, facial anomalies, photosensitive skin rash,
and immunodeficiency due to chromosomal instability and breakage. GP Bioc
1437
Eukaryotic DNA Multiple origins of replication make eukaryotic DNA replication quick and effective despite General Biochemist 1
replication the large size and complexity of the genome compared to that of prokaryotic organisms. Principles (GP) ry (Bioc) GP Bioc
1438
Aging Crit shortening in telomere length can signal for programmed cell death. Telomerase is a General Genetics 8
reverse transcriptase (RNA-dependent DNA polymerase) that lengthens telomeres by adding Principles (GP) (Gene)
TTAGGG repeats to the 3' end of chroms. SCs have long telomeres due to high telomerase
activity, allowing them to proliferate indefinitely in a controlled manner. GP Gene
1472
DNA structure & Nucleosomes are composed of DNA wrapped around a core of 8 histone proteins (2 General Genetics 2
function molecules each of H2A, H2B, H3, and H4). H1 histone is located outside of this histone core Principles (GP) (Gene)
and helps package nucleosomes into more compact structures by binding and linking the
DNA b/w adjacent nucleosomes. GP Gene
1473
Mitochondrial Mitochondrial DNA (mtDNA) is the most common non-nuclear DNA found in eukaryotic General Histology 4
disorders cells. It resembles prokaryotic DNA and is maternally derived. Mutations involving mtDNA Principles (GP) (Hist)
or nuclear DNA that codes for mitochondrial proteins can cause a variety of mitochondrial
disorders, including Leigh syndrome and MELAS. GP Hist
1482
Transamination Transamination reactions typically occur between an amino acid and an a-keto acid. The General Biochemist 1
amino group from the amino acid is transferred to the a-keto acid, and the a-keto acid in turn Principles (GP) ry (Bioc)
becomes an amino acid. Pyridoxal phosphate (active vitamin B ) serves as a cofactor in
amino acid transamination and decarboxylation reactions. GP Bioc
1486
DNA structure & X-inact occurs in genetically normal females and results in conversion of the inact X chrom General Genetics 2
function into compact heterochrom (Barr body). Heterochrom is condensed chromatin composed of Principles (GP) (Gene)
heavily meth DNA in tight a/w deacet histones. It has a low lvl of transcriptional activity. In
contrast, euchrom is loosely arranged and exhibits a high lvl of transcriptional activity. GP Gene
1487
Mutations DMD Px w/ progr prox muscle weakness in young boys due to incr muscle fiber degen. It's General Genetics 3
caused by frameshift muts (most common) or nonsense muts in the dystrophin gene that lead Principles (GP) (Gene)
to the formation of a truncated, defective protein. Nonsense muts intro premature stop
codons (e.g. UAA, UAG, UGA) in the coding seq of mRNA. GP Gene
1592
Cytomegalovirus Cytomegalovirus (CMV) is typically associated with subclinical infection in the General Microbiolo 9
immunocompetent, with the occasional individual developing a mononucleosis-like Principles (GP) gy (Micr)
syndrome that is heterophile antibody (Monospot) negative. In the immunocompromised,
primary or reactivated CMV infection can result in severe retinitis, pneumonia, esophagitis,
colitis, or hepatitis. GP Micr
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1610
Aneuploidy Common findings in DS include cognitive impairment, facial dysmorphism, and cardiac General Genetics 1
defects; 95% of cases are caused by the presence of an extra chromosome 21 (trisomy) Principles (GP) (Gene)
resulting from nondisjunction. Unbalanced Robertsonian translocations or mosaicism are less
common causes. GP Gene
1616
Flow/resistance The total resistance for a group of vessels arranged in parallel is equal to one divided by the General Physiology 1
sum of the inverse values for resistance of each of the contributing vessels as follows: 1/TPR Principles (GP) (Phys)
= 1/R1+1/R2 + 1/R3 + ... 1/Rn. Total body circulation can be best described as a parallel
circuit, whereas circulation in an individual organ is often best described by a series
arrangement. GP Phys
1707
Dose response Efficacy is a measure of the maximum pharmacodynamic effect achievable with a drug. General Pharmacol 4
curves Potency refers to the dose of drug that is required to produce a given effect. Drugs that bind Principles (GP) ogy (Phar)
their receptors with a higher affinity or are better able to gain access to their target tissues
will have greater potency (lower ED50). GP Phar
1708
Dose response The changes in the log dose-response curve expected for the effect of a reversible General Pharmacol 4
curves competitive antagonist added to a full agonist are: 1) a parallel shift to the right in the log- Principles (GP) ogy (Phar)
dose response curve, illustrating an increase in the ED50, and 2) no change in the maximum
effect (Emax). Competitive=change ED50=shift right; noncompetitive=change Emax=shift
down. GP Phar
1710
Drug structure and Characteristics of a drug such as high molecular weight, high plasma protein binding, high General Pharmacol 3
properties charge, and hydrophilicity tend to trap the drug in the plasma compartment resulting in a low Principles (GP) ogy (Phar)
Vd (3-5 L). GP Phar
1711
Drug metabolism Cytochrome P450 enzymes found in the liver are responsible for the majority of drug General Pharmacol 2
and clearance metabolism. Polymorphisms occurring in the genes coding for these enzymes result in Principles (GP) ogy (Phar)
various phenotypes that differ in their rates of metabolism; individual differences in
phenotype alter treatment efficacy and drug toxicity. GP Phar
1712
Pharmacogenomics Isoniazid is metabolized by acetylation. The speed with which a patient is able to acetylate General Pharmacol 1
drugs depends on whether they are genetically "fast" or "slow" acetylators. The presence of Principles (GP) ogy (Phar)
fast and slow acetylators within the same population results in a bimodal distribution of the
speed of isoniazid metabolism. Slow acetylators are at increased risk of adverse side effects. GP Phar
1713
Route of Bioavailability is the fraction of an administered drug that reaches the systemic circulation General Pharmacol 2
administration & unchanged. Drugs administered orally enter the portal circulation and are subject to first-pass Principles (GP) ogy (Phar)
bioavailability metabolism. Rectal administration is capable of partially bypassing first-pass metabolism as
a proportion of rectal blood flow enters the systemic circulation directly. Drugs that undergo
extensive first-pass metabolism have increased bioavailability when administered rectally. GP Phar
1714
Serum drug levels The half-life (t[½]) is a measure of how quickly a drug with first-order kinetics is eliminated General Pharmacol 3
and half-life from the body. A drug is almost completely eliminated after 5 half-life intervals. The half- Principles (GP) ogy (Phar)
life can be calculated from the drug's volume of distribution (Vd) and clearance rate (CL)
using the equation: t[½] = (0.7 x Vd) / CL. GP Phar
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1715
Drug structure and While the kidney is the primary site of elimination of most drugs, the liver is the main site of General Pharmacol 3
properties biotransformation of these agents in preparation for elimination. Drugs that are more Principles (GP) ogy (Phar)
lipophilic (high Va good penetration into CNS) are preferentially processed by the liver into
more polar compounds for easier elimination in the bile and urine. Liver disease (e.g.,
cirrhosis) or the concomitant use of other drugs may limit or enhance the clearance of drugs
metabolized in the liver. GP Phar
1716
Drug metabolism In first-order kinetics, a constant fraction (or proportion) of drug is metabolized per unit of General Pharmacol 2
and clearance time, so the amount metabolized changes based on the serum concentration. In zero-order Principles (GP) ogy (Phar)
kinetics, a constant amount of drug is metabolized per unit of time, independent of serum
levels. GP Phar
1727
X-linked inheritance In XLR inheritance, 1) affected males will always produce unaffected sons and carrier General Genetics 2
daughters, and 2) carrier females have a 50% chance of producing affected sons and carrier Principles (GP) (Gene)
daughters. G6PD defic follows this inheritance pattern and causes acute HA in response to
ox drugs. GP Gene
1756
Apoptosis Apoptosis can occur through either the intrinsic (mitochondria-mediated) pathway or the General Immunolo 4
extrinsic (receptor-initiated) pathway. Both pathways converge in the activation of caspases. Principles (GP) gy (Immu)
Caspases are proteolytic enzymes that cleave cellular proteins. GP Immu
1790
Autosomal recessive The prob that an AR disease will be transmitted to a child can be calculated based on the General Genetics 5
inheritance maternal and paternal pedigrees. An unaffected individual (w/ unaffected parents) who has a Principles (GP) (Gene)
sibling affected by an AR condition has a 2/3 chance of being a carrier for that condition. GP Gene
1801
Inflammatory bowel Chronic inflammation is associated with increased circulating pro-inflammatory cytokines General Pathology 9
disease (eg, IL-1, IL-6, tumor necrosis factor-alpha), which stimulates the liver to release acute- Principles (GP) (Path)
phase reactants (eg, C reactive protein, fibrinogen). The presence of acute-phase reactants
increases the erythrocyte sedimentation rate, a nonspecific marker for inflammation. GP Path
1869
Allergic rhinitis First-generation antihistamines are nonspecific and interact with multiple receptors, General Pharmacol 2
including the muscarinic receptor. This leads to anticholinergic effects (eg, fever, flushing, Principles (GP) ogy (Phar)
mydriasis, urinary retention, tachycardia, altered mental status). GP Phar
1970
Pleiotropy Pleiotropy describes instances where multiple phenotypic manifestations result from a single General Genetics 1
genetic mutation. Most syndromic genetic illnesses exhibit pleiotropy. Principles (GP) (Gene) GP Gene
2015
Transcription Homeobox genes encode DNA-binding TFs that play an important role in the segmental General Genetics 7
organization of the embryo along the cranio-caudal axis. Principles (GP) (Gene) GP Gene
2025
Enhancer sequence Enhancers and silencers may be located upstream, downstream, or within a transcribed gene; General Genetics 1
these gene sequences function to increase and decrease the rate of transcription, respectively. Principles (GP) (Gene)
In contrast, promoter regions are typically located 25 or 75 bases upstream from their
associated genes and function to initiate transcription. GP Gene
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2027
Mutations A frameshift mutation occurs with the deletion/addition of a number of bases not divisible by General Genetics 3
3 in the coding region of a gene. Frameshift mutations alter the reading frame of the genetic Principles (GP) (Gene)
code, dramatically changing the protein structure and often resulting in the formation of a
premature stop codon. GP Gene
2029
Releasing factors RFs recog stop codons (e.g. UAA, UAG, and UGA) and terminate protein synthesis. They General Genetics 1
facilitate release of the polypeptide chain from the ribosome and dissolution of the ribosome- Principles (GP) (Gene)
mRNA complex. GP Gene
2030
TATA box The TATA box is a promoter region that binds TFs and RNA polymerase II during the General Genetics 1
mutations initiation of transcription. It is located approximately 25 bases upstream from the beginning Principles (GP) (Gene)
of the coding region. GP Gene
2031
Transcription DNA-binding proteins incl TFs (Myc, CREB), steroid receptors (cort, aldo, progest), TH General Genetics 7
receptor, fat-sol vit receptors (vit D, retinoic acid), and DNA transcription and replication Principles (GP) (Gene)
proteins. GP Gene
2033
Poly A tail The poly-A tail isn't transcribed from DNA; instead, it's added as a PTM downstream of the General Genetics 1
consensus seq (AAUAAA) located near the 3' end of the mRNA molecule. This tail protects Principles (GP) (Gene)
mRNA from degradation w/i the cytoplasm after it exits the nucleus. GP Gene
2035
mRNA processing When mRNA is first transcribed from DNA, it is in an unprocessed form called pre-mRNA General Biochemist 1
and regulation or heterogeneous nuclear mRNA (hnRNA). Several processing steps are required before Principles (GP) ry (Bioc)
finalized mRNA molecules can leave the nucleus, including 5'-capping, poly A tail addition,
and intron splicing. Cytoplasmic P bodies play an important role in mRNA translation
regulation and mRNA degradation. GP Bioc
2037
tRNA structure Transfer RNA (tRNA) is a small, noncoding form of RNA that contains chemically modified General Biochemist 1
bases (eg, dihydrouridine, ribothymidine, pseudouridine). tRNA has a CCA sequence at its Principles (GP) ry (Bioc)
3'-end that is used as a recognition sequence by proteins. The 3' terminal hydroxyl group of
the CCA tail serves as the amino acid binding site. GP Bioc
2042
Transcription Northern blots detect target mRNA in a sample and can be used to Ax the degree of gene General Genetics 7
transcription. Principles (GP) (Gene) GP Gene
2044
Southwestern blot Southwestern blotting is used to detect DNA-binding proteins such as transcription factors, General Biochemist 1
nucleases, and histones. Principles (GP) ry (Bioc) GP Bioc
2112
Serum drug levels During continuous infusion of a drug metabolized by first-order kinetics, the steady state General Pharmacol 3
and half-life concentration is reached in 4 to 5 half-lives. Principles (GP) ogy (Phar) GP Phar
7791
DNA methylation Genomic imprinting refers to the phenomenon in which an offspring's genes are expressed in General Genetics 1
a parent-specific manner. Genomic imprinting is caused by DNA meth, an epigenetic process Principles (GP) (Gene)
in which genes can be silenced by attaching methyl groups to cytosine residues in the DNA
molecules. GP Gene
8328
Cell cycle Nondisjxn is the failure of chrom pairs to separate properly during cell division. This could General Genetics 2
be due to a failure of homologous chroms to separate in meiosis I or a failure of sister Principles (GP) (Gene)
chromatids to separate during meiosis II or mitosis. GP Gene
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8456
Health insurance Capitation is an arrangement in which a payor pays a fixed, predetermined fee to provide all General Behavioral 3
the services required by a patient. Payors may negotiate a capitated contract with an Principles (GP) Science
insurance company that then pays the providers, or a large medical group may negotiate (Beha)
directly with the payor. GP Beha
8523
Drug structure and The suffix of a biological agent indicates whether a medication is a monoclonal antibody General Pharmacol 3
properties (mab), a receptor molecule (cept), or a kinase inhibitor (nib). Monoclonal antibodies also Principles (GP) ogy (Phar)
include in their names the type of target (eg, bacterial or immune system) and their origin
(eg, human or mouse). GP Phar
11515
Medical errors Risk of wrong-site surgery can be reduced by requiring "dual identifiers" (usually a nurse General Behavioral 8
and physician) to independently confirm that they have the correct patient, site, and Principles (GP) Science
procedure. Checks must be truly independent to ensure patient safety. (Beha) GP Beha
11567
Drug interaction The Beers criteria identify drugs that should be used with caution in geriatric patients. General Pharmacol 2
Common drugs to avoid include anticholinergics (eg, first-generation antihistamines), alpha Principles (GP) ogy (Phar)
blockers, tricyclic antidepressants, benzodiazepines (and other sedating medications),
antipsychotics, most antiarrhythmics, and skeletal muscle relaxants. GP Phar
11595
Translation Short non-coding RNA sequences (eg, microRNA and small interfering RNA) induce General Biochemist 1
posttranscriptional gene silencing by base-pairing with complementary sequences within Principles (GP) ry (Bioc)
target mRNA molecules. GP Bioc
11674
Ubiquitin An essential step in the activation of the cellular immune response to a virus is the General Immunolo 2
proteasome pathway breakdown of intracellular viral proteins by the ubiquitin proteasome pathway. This pathway Principles (GP) gy (Immu)
is initiated by ubiquitin ligases, which recognize specific protein substrates and attach a
ubiquitin tag. The target proteins are then degraded by a proteasome into peptide fragments,
which are coupled with major histocompatibility complex class proteins and presented on the
cell surface for surveillance by cytotoxic CD8+ lymphocytes. GP Immu
11678
Serum drug levels The half-life (t[½]) of a drug is the time required to lower its concentration by 50%. The General Pharmacol 3
and half-life volume of distribution (Vd) refers to how well the drug distributes into tissues compared to Principles (GP) ogy (Phar)
plasma; the higher the Vd, the greater the drug distribution into the tissues. The drug
concentration (mg/L) is equal to drug dose (mg) divided by Vd (L). GP Phar
11740
Adverse drug Most adverse drug reactions are predictable and due to the known pharmacologic properties General Pharmacol 2
reaction of the drug. Unpredictable reactions are less common and are due to genetic differences, Principles (GP) ogy (Phar)
immune interactions, or other mechanisms. GP Phar
11830
Lymphatic drainage In the lower extremities, the superficial lymphatic system is divided into medial and lateral General Anatomy 2
tracks. The medial track runs up to the superficial inguinal lymph nodes, bypassing the Principles (GP) (Anat)
popliteal nodes. Consequently, lesions on the medial foot cause inguinal lymphadenopathy,
whereas lateral lesions are more likely to cause lymphadenopathy in both the popliteal and
inguinal areas. GP Anat
11847
Medical errors A preventable adverse event is defined as injury to a patient due to failure to follow General Behavioral 8
evidence-based best practice guidelines. Principles (GP) Science
(Beha) GP Beha
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11904
Multifactorial Many freq encountered diseases (e.g. HTN, spinal bifida) display multifactorial inheritance, General Genetics 1
inheritance which involves the complex interaction of numerous genetic and environmental factors to Principles (GP) (Gene)
determine phenotypically expression. Although the exact inheritance risk can't be
determined, the closer a relative is to the affected person, the more likely the relative is to
develop the trait. GP Gene
11913
Transcription Alt splicing is a process by which a single gene can code for various unique proteins by General Genetics 7
selectively incl or excl diff DNA coding regions (exons) into mature mRNA. Principles (GP) (Gene) GP Gene
11914
Mitochondrial Mitochondrial dysfxn freq Px w/ myopathy, NS dysfxn, lactic acidosis, and ragged red fibers General Genetics 4
disorders on muscle Bx. Mitochondrial myopathies due to mtDNA muts are inherited solely in a Principles (GP) (Gene)
maternal fashion (i.e. maternal inheritence). Therefore, transmission occurs only thru
affected females and never thru males. GP Gene
11916
Compartment As an antioxidant, superoxide dismutase neutralizes reactive oxygen species, preventing cell General Biochemist 2
syndrome injury. In a pathologic state such as post-ischemic reperfusion, oxidative stress is high and Principles (GP) ry (Bioc)
reactive oxygen species production exceeds the neutralizing capability of antioxidants,
leading to increased cell damage and death. GP Bioc
11930
Lysosomal storage Protein targeting is the process by which proteins with different intra- and extracellular fates General Biochemist 1
disorder reach their destination. Proteins destined for the lysosome require phosphorylation of specific Principles (GP) ry (Bioc)
mannose residues to ensure proper transit through the Golgi apparatus. GP Bioc
11960
Autosomal recessive SCA is an AR disease that results in recurrent episodes of anemia, jaundice, and painful General Genetics 5
inheritance swelling of the hands and feet. Offspring of carrier parents have a 25% chance of being Principles (GP) (Gene)
affected and a 50% chance of being heterozyg carriers, resulting in a 75% change of
inheriting at least 1 mut allele. GP Gene
12024
High altitude illness People traveling to elevations >2500 m (8000 ft) can develop high-altitude illness, General Physiology 3
characterized by hypobaric hypoxia with the potential to develop life-threatening cerebral Principles (GP) (Phys)
and/or pulmonary edema. Key adaptive responses to hypoxemia include hyperventilation to
increase blood oxygenation and increased synthesis of 2,3-bisphosphoglycerate in
erythrocytes (facilitating oxygen offloading into peripheral tissues). GP Phys
12066
Enzyme kinetics Competitive inhibitors compete with substrate for active binding sites on enzymes. General Biochemist 1
Additional substrate is required to achieve the same rate of reaction, increasing the measured Principles (GP) ry (Bioc)
value of the Michaelis constant (Km). Competitive inhibitors do not affect enzyme function;
therefore, maximal velocity (Vmax) is unchanged in their presence. GP Bioc
12263
Transcription The TATA and CAAT boxes are promoters of transcription in eukaryotic cells and are General Genetics 7
located approximately 25 and 75 bases upstream from the transcription start site, Principles (GP) (Gene)
respectively. They promote initiation of transcription by serving as binding sites for
transcription factors and RNA polymerase II. GP Gene
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12278
Polymerase chain Reverse transcription polymerase chain reaction (RT-PCR) is used to detect and quantify General Biochemist 2
reaction levels of mRNA in a sample. It uses reverse transcription to create a complementary DNA Principles (GP) ry (Bioc)
template that is then amplified using the standard PCR procedure. RT-PCR can be used to
diagnose chronic myelogenous leukemia by identifying an mRNA transcript containing both
BCR and ABL exons in affected cells. GP Bioc
12299
Immunology A radioimmunoassay uses specific antibodies and a fixed quantity of radiolabeled antigen to General Immunolo 2
principles determine the amount of antigen present in an unknown sample. This is done by measuring Principles (GP) gy (Immu)
the amount of radiolabeled antigen displaced from the antibodies in the system. GP Immu
15941
Biologic agents Monoclonal antibodies (mAbs) are not eliminated by hepatic or renal clearance. Therefore, General Pharmacol 2
no dose adjustment is necessary with impaired hepatic/renal function or use of cytochrome Principles (GP) ogy (Phar)
P450 inducers or inhibitors. GP Phar
26 Renal vein Nephrotic syndrome is a hypercoagulable state. Sudden-onset abdominal or flank pain, Hematology & Pathology 1
thrombosis hematuria, and left-sided varicoceles suggest RVT, a well-known complication of nephrotic Oncology (Path)
syndrome. Loss of anticoagulant factors, especially AT-III, is responsible for the thrombotic (HO)
and TE complications of nephrotic syndrome. HO Path
58 Hepatocellular Both HBV and HCV infections ↑ the risk of HCC due to chronic hepatic inflammation and Hematology & Pathology 1
carcinoma cell turnover. HBV is also carcinogenic due to the production of oncogenic proteins and the Oncology (Path)
insertion of the HBV genome into the host chrom. (HO) HO Path
69 Gallstone disease Black pigment stones arise from conditions that ↑ the amount of unconjugated bilirubin in Hematology & Pathology 8
bile, which promotes Ca2+ bilirubinate precipitation. This may occur in the setting of Oncology (Path)
chronic hemolysis (e.g. SCA, β-thalassaemia, HS) and ↑ enterohepatic cycling of bilirubin (e. (HO)
g. ileal disease). HO Path
219von Willebrand The vWF enhances clotting thru both augmentation of platelet binding and stabilisation of Hematology & Pharmacol 7
disease FVIII. Pts w/ vWD are defic in fxnal vWF and present w/ ↑ bruisability and prolonged Oncology ogy (Phar)
mucosal bleeding. DDAVP can alleviate bleeding thru endothelial release of vWF. (HO) HO Phar
294Autoimmune Fe overload (hemosiderosis) is a common and serious complication of chronic hemolytic Hematology & Pathology 1
hemolytic anemia anaemia and freq blood transfusions. hemosiderin accumulation is the cardinal histo finding. Oncology (Path)
Chelation therapy is indicated to ↓ parenchymal Fe deposition. (HO) HO Path
313Oncogenes and p53 is a TSG that controls cell division and apoptosis. It's inactivated in many tumours. Hematology & Pathology 1
tumor suppressor Oncology (Path)
genes (HO) HO Path
314Acute liver failure The P450 microsomal oxidase system plays an important role in detoxification. In CCl4 pois, Hematology & Pathology 2
however, it produces free radicals that start a vicious cycle of hepatic injury. Oncology (Path)
(HO) HO Path
336Bladder cancer Urothelial (transitional cell) carcinoma is the most common type of bladder ca. Tumor stage Hematology & Pathology 4
is the most important factor for determining prognosis and is based on the depth of invasion Oncology (Path)
into the bladder wall and the degree of spread to other tissues. Tumor invasion into the (HO)
muscular layer of the bladder wall carries an unfavorable prognosis. HO Path
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341Prostate cancer CFx that suggest a malignant cause of back pain incl occurrence at night, not relieved w/ rest Hematology & Pathology 5
or analgesics, advanced age, and systemic SSx. Common malignancies w/ a propensity for Oncology (Path)
bony mets incl prostate, breast, kidney, thyroid, and lung. (HO) HO Path
345Li-Fraumeni LFS is caused by an AD mut in the TSG TP53. Leukaemia, sarcomas, and tumours of the Hematology & Pathology 1
syndrome breast, bran, and adrenal cortex are most common. Oncology (Path)
(HO) HO Path
346von Willebrand Following endothelial dmg, vWF binds GPIb receptors on platelets to mediate platelet Hematology & Biochemist 7
disease adherence. The RCoA measures platelet agglutination via binding of GPIb receptors to vWF; Oncology ry (Bioc)
it'll be abn in vWF defic but will correct w/ the addn of normal (vWF-containing) plasma. (HO) HO Bioc
395Hemochromatosis HFE protein mutations are the most common cause of 1° hemochromatosis. Inactivation of Hematology & Pathology 4
the HFE protein results in ↓ hepcidin synthesis by hepatocytes and ↑ DMT1 expression by Oncology (Path)
enterocytes, leading to Fe overload. Pts w/ hemochromatosis are at an ↑ risk for liver (HO)
cirrhosis and HCC. HO Path
423Colorectal cancer Prognosis of CRAC is directly related to the stage of the tumour (not to the grade!). Hematology & Pathology 15
Oncology (Path)
(HO) HO Path
425Carcinoid tumors Carcinoid tumors confined to the intestine don't cause carcinoid syndrome as their secretory Hematology & Pathophysi 4
products are meta by the liver before entering the syst circulation. In contrast, intestinal Oncology ology
carcinoids that met to the liver and extraintestinal (e.g. bronchial) carcinoids release (HO) (Patp)
vasoactive substances that avoid 1st-pass meta, resulting in carcinoid syndrome (e.g.
flushing, diarrhea, bronchospasm). HO Patp
465Inherited Inherited causes of hypercoagulability should be considered in pts younger than age 50 who Hematology & Pathology 2
thrombophilia present w/ thrombosis and no obvi explanation for an acq prothrombotic state. The FV Oncology (Path)
Leiden mut, which causes FVa resistance to inactivation by activated protein C, may account (HO)
for approx. 20% of cases of atypical venous thrombosis. HO Path
537Wiskott-Aldrich The WAS consists of the triad of eczema, thrombocytopenia, and combined B-lymphocyte Hematology & Immunolo 1
syndrome and T-lymphocyte defic. Onset of disease is early in life w/ thrombocytopenia present at Oncology gy (Immu)
birth and eczema and repeated infections, particularly by encapsulated organisms, following (HO)
at 6-12 mos of age. HO Immu
545Rhesus HDN most commonly occurs from maternal sensitization to Rh Ags during a prior preg w/ Hematology & Immunolo 2
alloimmunization an Rh(D)+ fetus. In subseq Rh(D)+ pregs, maternal anti-Rh(D) IgG Abs cross the placenta Oncology gy (Immu)
and cause a severe AIHA in the fetus and life-thr hydrops fetalis. (HO) HO Immu
559Cell mediated Immature T-lymphocytes express both the CD4 and CD8 cell surface Ags in addn to a Hematology & Immunolo 5
immunity complete TCR or a pro-TCR. These lymphocytes exist in the TC where they undergo (+) Oncology gy (Immu)
selection and in the TM where they undergo (-) selection. (HO) HO Immu
615Brain tumors Pilocytic astrocytomas are the most common brain tumors in children. They frequently arise Hematology & Pathology 10
in the cerebellum and can be differentiated from medulloblastomas by the presence of both Oncology (Path)
cystic and solid components on imaging. (HO) HO Path
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709Warfarin reversal Both vitK and FFP are used for reversing warfarin-induced anticoag. FFP rapidly reverses Hematology & Pharmacol 1
warfarin's effects whereas vitK req time for clotting factor re-synthesis. Oncology ogy (Phar)
(HO) HO Phar
710Vitamin K VitK is necessary for the carboxylation and fxnality of coag Fs II, VII, IX, and X. Newborns Hematology & Pathology 2
deficiency who don't receive prophylactic supplementation are at risk for bleeding complications. Pts w/ Oncology (Path)
CF are also at risk for vitK defic due to poor absorption of fat-soluble vits. (HO) HO Path
714NSAIDs ASA is an NSAID that irreversibly inhibs COX-1 and -2 enzymes via acetylation. In Hematology & Pharmacol 4
contrast, other NSAIDs (e.g. diclofenac, ibuprofen, indomethacin) reversibly inhib COX-1 Oncology ogy (Phar)
and -2. (HO) HO Phar
742Antiphospholipid GN, a photosensitive skin rash, and arthralgias in a young woman are suggestive of SLE. Up Hematology & Pathology 1
syndrome to 30% of pts w/ SLE have antiphospholipid Abs, which can cause paradoxical aPTT Oncology (Path)
prolongation and a false (+) RPR/VDRL. Pts w/ antiphospholipid Abs are at risk for venous (HO)
and arterial TE and unexplained, recurrent preg loss. HO Path
787Iron deficiency Hepcidin is a polypeptide synthesized by the liver that acts as the central regulator of iron Hematology & Physiology 7
anemia homeostasis. High iron levels and inflammatory conditions increase the synthesis of Oncology (Phys)
hepcidin; hypoxia and increased erythropoiesis act to lower hepcidin levels. Low hepcidin (HO)
levels increase intestinal iron absorption and stimulate iron release by macrophages. HO Phys
789Hematopoietic Vits B12 and B9 defic cause similar heme pictures. However, neuro dysfxn is only seen in Hematology & Pathology 1
drugs pts w/ vitB12 defic. If megaloblastic anaemia due to vitB12 defic is mistakenly Tx w/ vitB9 Oncology (Path)
alone, the neuro dysfxn can worsen. (HO) HO Path
829Traumatic Schistocytes (helmet cells) are fragmented erythrocytes. They occur 2° to mech trauma from Hematology & Pathology 2
hemolytic anemia MAHAs or prosthetic cardiac valves. Intravascular hemolytic anaemias are characterised by Oncology (Path)
↓ serum haptoglobin lvls as well as ↑ LDH and bilirubin. (HO) HO Path
868Fetal hemoglobin HbF is the predominant Hb type in the 2nd and 3rd trims of preg and during the 1st few mos Hematology & Biochemist 1
after birth. HbF consists of 2 alpha and 2 gamma protein subunits (a2g2) and has a high Oncology ry (Bioc)
affinity for O2, which facilitates O2 transport across the placenta to the fetus. HbA (a2b2) is (HO)
the major Hb in adults. HO Bioc
872Multiple myeloma Amyloid light-chain amyloidosis is a/w MM and other monoclonal plasma cell dyscrasias Hematology & Pathology 9
due to the deposition of insoluble Ig light-chain fibrils in major organs (e.g. kidneys, heart, Oncology (Path)
neuro system). A bone marrow sample w/ >10% plasma cells is strongly suggestive of MM. (HO) HO Path
873Alcohol use Folic acid deficiency anemia commonly occurs in Alcism. It is a megaloblastic anemia that Hematology & Pathology 3
disorder can develop w/i wks. PBS shows macrocytosis, ovalocytosis, and neutrophils w/ Oncology (Path)
hypersegmented nuclei. (HO) HO Path
875SLE SLE is an autoimmune disorder that occurs most commonly in women. heme abns are Hematology & Pathology 7
common; auto-Abs against blood cell Ags (i.e. HS-II) can cause pancytopaenia (i.e. anaemia, Oncology (Path)
thrombocytopaenia, leucopoenia). In contrast, lupus nephritis is caused by IC deposition (i.e. (HO)
HS-III) in the glomeruli. HO Path
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889Hereditary HS results from red cell cytoskeleton abns, most commonly spectrin and ankyrin. hemolytic Hematology & Pathology 3
spherocytosis anaemia, jaundice, and splenomegaly are classic MFxs. Spherocytes are seen on peri blood Oncology (Path)
smear. (HO) HO Path
890Hereditary In spherocytosis, MCHC is incr due to mild dehydration of the RBC. Markers of hemolysis Hematology & Pathophysi 3
spherocytosis are often evident and incl incr LDH, reticulocytosis, and decr haptoglobin. Oncology ology
(HO) (Patp) HO Patp
891Hereditary HS results from red cell cytoskeleton abns, most commonly in the proteins spectrin and Hematology & Pathology 3
spherocytosis ankyrin. ↑ osmotic fragility on acidified glycerol lysis testing confirms the Dx. hemolytic Oncology (Path)
anaemia, jaundice, and splenomegaly are classic MFxs. Complications incl pigmented (HO)
gallstones and aplastic crises from PVB19 infection. HO Path
892Sickle cell HU ↑ HbF synthesis by an unknown mech. HU is reserved for pts w/ freq pain crises. Gardos Hematology & Pharmacol 13
channel blockers hinder the efflux of K+ and water from the cell, preventing dehydration of Oncology ogy (Phar)
erythrocytes and ↓ the polymerisation of HbS. (HO) HO Phar
893G6PD deficiency hemolytic anaemia is a possible AE of dapsone and is most significant in pts defic for G6PD. Hematology & Pathology 5
G6PD defic anaemia is characterised by episodes of hemolytic anaemia precipitated by Oncology (Path)
oxidative stress (drugs, infections). peri smear typically shows bite cells and Heinz bodies (HO)
(req special prep). HO Path
894G6PD anemia G6PD defic has an XLR inheritance. HS follows an AD inheritance pattern. Hematology & Pathology 1
inheritance pattern Oncology (Path)
(HO) HO Path
895Sickle cell Pts /w SCT are typically aSSx and have relative protection from malaria caused by P. Hematology & Pathology 13
falciparum. These pts usually have normal Hb, reticulocyte, and RBC index values. Life Oncology (Path)
expectancy is the same as that of the gen pop. (HO) HO Path
896Sickle cell Patients with sickle cell disease become functionally asplenic within the first few years of Hematology & Microbiolo 13
life due to repeated microinfarction of splenic vascular beds. This dramatically increases the Oncology gy (Micr)
risk for fulminant infections with encapsulated bacterial organisms, particularly (HO)
Streptococcus pneumoniae. Patients with sickle cell disease are also at increased risk for
other bacterial infections, most notably salmonella osteomyelitis. HO Micr
897Paroxysmal The triad of HA, hypercoag, and pancytopenia suggests PNH. PNH results from an acq mut Hematology & Pathophysi 2
nocturnal in the PIGA gene that causes absence of the GPI anchor and assoc defic of CD55 and CD59 Oncology ology
hemoglobinuria complement inhib proteins. (HO) (Patp) HO Patp
941Hemophiliacs Bleeding after a tooth extraction and Hx of hemarthrosis are suggestive of hemophilia. ↓ lvls Hematology & Pathology 2
of FVIII or IX lead to failure to convert prothrombin into thrombin and defic thrombus Oncology (Path)
formation. The addition of thrombin to the blood of a pt w/ hemophilia results in clotting. (HO) HO Path
942von Willebrand Pts w/ SSx vWD can be Tx w/ DDAVP, a syntheticADH analogue that has no Hematology & Pharmacol 7
disease vasoconstrictive effects. DDAVP transiently ↑ vWF and FVIII release from endothelial cell Oncology ogy (Phar)
storage thru indirect mechs; it can be used prophylactically prior to procedures or to Tx (HO)
minor bleeding. HO Phar
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957Community Mycoplasma pneumoniae binds an oligosaccharide on the respiratory epithelium that is also Hematology & Microbiolo 21
acquired pneumonia present on erythrocytes, leading to the generation of cross-reacting IgM antibodies (cold Oncology gy (Micr)
agglutinins). Patients with M pneumoniae infections often develop mild, transient hemolytic (HO)
anemia that resolves as IgM antibody titers decline (6-8 weeks after infection begins). HO Micr
1020
Pyruvate kinase PKD causes HA due to failure of glycolysis and resultant failure to generate sufficient ATP Hematology & Biochemist 1
deficiency to maintain erythrocyte structure. In this case, splenic hyperplasia results from incr. work of Oncology ry (Bioc)
the splenic parenchyma, which must remove these deformed erythrocytes from the (HO)
circulation. HO Bioc
1029
2,3- 2,3-BPG decr Hb's affinity for O2. Therefore, in the presence of decr blood O2 conc., higher Hematology & Biochemist 1
bisphosphoglycerate 2,3-BPG lvls w/i erythrocytes enable incr O2 delivery in the peri tissues. 2,3-BPG is Oncology ry (Bioc)
metabolism produced from 1,3-BPG by the enzyme BPG mutase. This rxn bypasses an ATP-generating (HO)
step of glycolysis, causing no net gain in ATP. HO Bioc
1035
G6PD deficiency The PPP consists of an ox (irrev.) branch and a nonox (rev.) branch, and each can fxn Hematology & Biochemist 5
independently based on cellular reqs. Transketolase, an enzyme of the nonox branch, is Oncology ry (Bioc)
responsible in part for the interconversion of R5P (nucleotide precursor) and F6P (glycolytic (HO)
intermediate). HO Bioc
1036
G6PD deficiency G6PD is the RLE of the PPP. G6PD defic is a common XLR disorder resulting in episodes of Hematology & Biochemist 5
HA during times of incr. ox stress (e.g. use of antimalarials/sulfonamide, infections). Oncology ry (Bioc)
(HO) HO Bioc
1037
G6PD deficiency G6PD defic causes HA and jaundice 2ary to incr. ox stress due to the lack of NADPH. Hematology & Biochemist 5
Glutathione reductase defic has a similar clin conseq as its absence results in an inability to Oncology ry (Bioc)
utilize NADPH to red glutathione. (HO) HO Bioc
1039
Cancer anorexia TNF-a is thought to mediate PNP cachexia in humans by suppressing appetite and ↑ BMR. Hematology & Pathology 2
cachexia syndrome Oncology (Path)
(HO) HO Path
1062
Vitamin K Vitamin K deficiency results in impaired clotting factor carboxylation. Newborns are at risk Hematology & Physiology 2
deficiency for vitamin K deficiency due to poor transplacental transfer of vitamin K and low content in Oncology (Phys)
breast milk. All newborns should receive vitamin K prophylaxis to prevent bleeding (HO)
complications. HO Phys
1075
Iron deficiency PVS is characterised by dysphagia (oesophageal web formation) and IDA. Findings a/w ID Hematology & Pathology 7
anemia incl koilonychia (spoon-shaped nails) and a shiny red tongue. Most SSx resolve following Fe Oncology (Path)
supplementation. (HO) HO Path
1077
Anticoagulants Heparin is commonly used for the prevention of DVT in non-ambulatory pts or those Hematology & Pharmacol 8
undergoing elective Sx, esp. hip and knee Sx. Heparin ↑ the effect of the naturally occurring Oncology ogy (Phar)
anticoag ATIII. (HO) HO Phar
1078
Anticoagulants HIT is Tx w/ DTIs such as argatroban. Both HMWH and LMWH should be avoided in these Hematology & Pharmacol 8
pts. Oncology ogy (Phar)
(HO) HO Phar
D eats
1079
Glanzmann Abciximab is a blocker of GP IIb/IIIa receptor, which normally promotes platelet binding to Hematology & Pharmacol 1
thrombasthenia FI. GP IIb/IIIa is either defic or defective in pts w/ Glanzmann thrombasthenia. Oncology ogy (Phar)
(HO) HO Phar
1083
Breast cancer Hereditary breast ca is most commonly a/w muts in BRCA1 and BRCA2. These TSGs are Hematology & Pathology 7
involved in DNA repair, and their mut ↑ the risk of devel breast and ovarian ca. Oncology (Path)
(HO) HO Path
1084
Matrix Metalloproteinases are Zn-containing enzymes that degrade the ECM. They participate in Hematology & Pathology 1
metalloproteinase normal tissue remodeling and in tumor invasion through the BM and CT. Oncology (Path)
(HO) HO Path
1086
Non-Hodgkin Analgesic nephropathy is a form of CKD caused by prolonged, heavy intake of NSAIDs a/o Hematology & Pathology 6
lymphoma acetaminophen. Path char incl CIN and RPN. Oncology (Path)
(HO) HO Path
1087
Anticoagulants Protamine sulphate binds to heparin, causing chem inactivation. VitK and FFP can be used to Hematology & Pharmacol 8
reverse warfarin effects. Oncology ogy (Phar)
(HO) HO Phar
1088
Anticoagulants Warfarin inhibits proteins C and S (natural anticoagulants present in blood), which can lead Hematology & Pathology 8
to skin necrosis, particularly in pts w/ protein C or S deficiency. This complication is usually Oncology (Path)
seen in the 1st few days of warfarin Thx. (HO) HO Path
1090
Anticoagulants Rifampin, phenobarbital, and phenytoin are potent enhancers of the CYP450 pathway; Hematology & Pharmacol 8
concurrent use of warfarin w/ these Rx results in ↓ efficacy of warfarin. In contrast, Oncology ogy (Phar)
cimetidine, amiodarone, and TMP-SMX inhib warfarin meta, ↑ the risk of bleeding. (HO) HO Phar
1097
Acute diarrhea Enterohemorrhagic Escherichia coli (EHEC) is primarily contracted after eating undercooked Hematology & Microbiolo 13
ground beef. EHEC produces Shiga toxin, which causes hemorrhagic colitis and can lead to Oncology gy (Micr)
hemolytic uremic syndrome (HUS). HUS is characterized by acute renal failure, (HO)
thrombocytopenia, and microangiopathic hemolytic anemia; children age <10 are at greatest
risk. HO Micr
1134
X-linked XLA (Bruton) is caused by a defect in B cell maturation, resulting in the absence of mature B Hematology & Immunolo 2
agammaglobulinemi cells w/ severe defic of all Ig types. T cell # and fxn remain intact. Due to the absence of B Oncology gy (Immu)
a cells, 1ary lymphoid follicles and germinal centers won't form w/i LNs. (HO) HO Immu
1156
Lead poisoning Pb pois in adults typically occurs thru occup exposure. SSx incl colicky abdo pain, Hematology & Pathophysi 4
constipation, Pb lines on the gum, peri neuropathy, and anemia. LFx shows microcytic Oncology ology
anemia w/ normal Fe studies, and PBS may reveal basophilic stippling. (HO) (Patp) HO Patp
1160
Keratin as a marker Keratin is a marker of epithelial cell origin. Hematology & Pathology 1
Oncology (Path)
(HO) HO Path
1203
Prospective cohort Prospective cohort studies are organized by selecting a group of individuals (i.e., cohort), Hematology & Biostatistic 1
study determining their exposure status, and then following them over time for development of the Oncology s (Bios)
disease of interest. (HO) HO Bios
D eats
1206
Prevalence and According to 2019 estimates, the most common cancers (excluding basal and squamous cell Hematology & Biostatistic 3
incidence skin cancer) in women by order of incidence are breast, lung, and colorectal cancer. In terms Oncology s (Bios)
of mortality, lung cancer claims the most lives, followed by breast and colorectal cancer. (HO) HO Bios
1240
Carbon monoxide CO binds heme Fe in Hb w/ an affinity much greater than O2, generating HbCO. Remaining Hematology & Biochemist 2
poisoning binding sites on HbCO have an incr. affinity for O2 that causes the O2 dissociation curve to Oncology ry (Bioc)
shift to the left, impeding O2 delivery to tissues. (HO) HO Bioc
1241
Sickle cell HbS aggregates in the deoxy state. HbS polymers form fibrous strands that decr. RBC Hematology & Biochemist 13
membrane flex and promote sickling. Sickling occurs under conditions a/w anoxia incl. low Oncology ry (Bioc)
pH and high lvls of 2,3-BPG. These inflex erythrocytes predispose to microvascular (HO)
occlusion and microinfarcts. HO Bioc
1242
Sickle cell Hemoglobin S (HbS) contains valine in place of glutamic acid at the sixth amino acid Hematology & Biochemist 13
position of the beta globin chain. This promotes hydrophobic interaction among Hb Oncology ry (Bioc)
molecules and results in HbS polymerization and erythrocyte sickling. (HO) HO Bioc
1243
Beta-thalassemia HbF contains gamma-globin instead of beta-globin. Pts w/ homozygotic beta-thalassemia Hematology & Biochemist 1
(beta-thalassemia major) are aSSx at birth due to the presence of gamma-globins and HbF. Oncology ry (Bioc)
Switching to HbA production and the cessation of gamma-globin synth precips the SSx of (HO)
beta-thalassemia. HO Bioc
1257
Opioids Chronic opioid use leads to the devel of tolerance to analgesic effects and most AEs, w/ the Hematology & Pharmacol 13
exception of constipation and miosis. To prevent bowel complications, it's recommended that Oncology ogy (Phar)
pts be Tx prophylactically w/ adequate fluid intake and daily laxatives. (HO) HO Phar
1286
Lung cancer B/w 1950 and 2000, rising rates of tobacco use resulted in an ↑ in female lung ca incidence Hematology & Pathology 9
and mortality. Lung ca is currently the most common cause of ca death in both women and Oncology (Path)
men in the US. (HO) HO Path
1291
Cirrhosis Vit K-dependent CFs (II, VII, IX, and X) are synth in the liver. FVII has the shortest 1/2-life Hematology & Pathophysi 7
of the CFs. Failure of the PT to correct w/ vit K supp indicates FVII defic, which is often due Oncology ology
to underlying liver disease. (HO) (Patp) HO Patp
1292
Atrial fibrillation Pts started on warfarin develop a transient hypercoag state due to the short 1/2-life of protein Hematology & Pathophysi 5
C. This hypercoag is further exaggerated by pre-existing protein C defic and can result in Oncology ology
thrombotic occlusion of the microvasc w/ skin necrosis. (HO) (Patp) HO Patp
1293
Uremic platelet abn bleeding in pts w/ uraemia is due to a qualitative platelet disorder that causes prolonged Hematology & Pathology 1
dysfunction BT w/ normal platelet count, PT, and aPTT. Oncology (Path)
(HO) HO Path
1294
Hemolytic uremic Schistocytes suggest MAHA (eg, HUS, TTP), DIC or mechanical damage (eg, prosthetic Hematology & Pathology 3
syndrome valve). In childhood, HUS is often preceded by bloody diarrhea. Coagulation studies (PT and Oncology (Path)
PTT) are normal in HUS-TTP but abnormal in DIC. (HO) HO Path
D eats
1295
DIC DIC is a common complication of gram (-) bacterial sepsis due to activation of the coag Hematology & Pathology 5
cascade by bacterial endotoxins, which leads to the formation of microthrombi. peri smear Oncology (Path)
shows fragmented erythrocytes (schistocytes) and thrombocytopaenia. Lab tests show ↓ (HO)
fibrinogen lvls and prolonged PT and PTT. HO Path
1296
DIC The most common trigger for DIC in preg is release of tissue factor (thromboplastin) from an Hematology & Pathology 5
injured placenta (e.g. placental abruption) into the maternal circulation. DIC presents w/ Oncology (Path)
bleeding from incision sites, IV line sites, and mucosal surfaces due to rapid consumption of (HO)
clotting factors and platelets. HO Path
1297
Traumatic RBC fragments, burr cells, and helmet cells are a/w either MAHA or mech red cell Hematology & Pathology 2
hemolytic anemia destruction. In pts w/ prosthetic valves, RBCs are exposed to excessive shear and turbulence Oncology (Path)
in the circulation, causing dmg from mech trauma. (HO) HO Path
1298
DIC DIC commonly occurs in the setting of sepsis and is characterised by widespread activation Hematology & Pathology 5
of the coag cascade w/ formation of microthrombi. Lab results reveal prolonged PT/PTT, Oncology (Path)
thrombocytopaenia, and low fibrinogen (i.e. a consumptive coagulopathy), and pts usually (HO)
have SSx of bleeding (e.g. oozing from venepuncture sites). HO Path
1337
Porphyria cutanea Enzyme defics of the early steps in porphyrin synth cause neuropsych MFx w/o photosens, Hematology & Biochemist 1
tarda whereas late step derangements lead to photosens. Photosens MFx as vesicle and blister Oncology ry (Bioc)
formation on sun-exposed areas as well as edema, pruritus, pain, and erythema. (HO) HO Bioc
1338
ALA synthase AIP atks are due to the accum of ALA and PBG, resulting from inher PBG deaminase defic Hematology & Biochemist 1
combo w/ ALA synthase induction (typically due to certain Rx, Alc use, or a low-calorie Oncology ry (Bioc)
diet). Mx w/ Glc or hemin inhibs ALA synthase activity. (HO) HO Bioc
1339
Acute intermittent AIP is an AD condition caused by PBG deaminase defic. Most pts remain aSSx, but a Hematology & Pathophysi 1
porphyria minority Px w/ acute atks char by abdo pain and vomiting, peri neuropathy, neuropsych SSx, Oncology ology
and reddish-brown urine. Tx consists of IV Glc or heme preps, which downreg ALA (HO) (Patp)
synthase activity. HO Patp
1375
Epstein Barr virus The initial attachment of the virion envelope or capsid surface proteins to the complementary Hematology & Microbiolo 1
host cell surface receptors is essential to viral tropism for specific tissues and invasion of Oncology gy (Micr)
cells. Many viruses bind to normal host cell plasma membrane receptors to enter host cells. (HO)
Known host cell receptor and virion/virion protein binding specificities include: CD4 with
HIV gp120, CD21 with Epstein-Barr virus gp350, and erythrocyte P antigen with parvovirus
B19. HO Micr
1384
Hemoglobin Pso refers to the partial pressure of oxygen at which hemoglobin is 50% saturated. Hematology & Biochemist 4
properties Hemoglobins with high oxygen affinity have a decreased P50 that is represented by a Oncology ry (Bioc)
leftward shift of the oxygen dissociation curve. The reduced ability to release oxygen within (HO)
the peripheral tissues leads to renal hypoxia, increased erythropoietin synthesis, and
compensatory erythrocytosis. HO Bioc
1385
Hemoglobin A left shift of the Hb O2 dissociation curve indicates ↑ Hb O2 affinity and can be caused by Hematology & Biochemist 4
properties ↑ pH, ↓ 2,3-BPG, and ↓ temperature. Leftward shifts of the curve inhibit the release of O2 Oncology ry (Bioc)
w/i peripheral tissues. (HO) HO Bioc
D eats
1387
Hemoglobin 2,3-BPG normally forms ionic bonds w/ the beta subunits of deoxy HbA, facilitating O2 Hematology & Biochemist 4
properties release in the peri tissues. Muts that result in loss of the 2,3-BPG binding pocket's (+) charge Oncology ry (Bioc)
cause HbA to resemble HbF, which binds O2 w/ a higher affinity due to its inability to (HO)
interact w/ 2,3-BPG. HO Bioc
1403
Acute The cytogenetic defect t(15;17) is a/w APML. A translocation involving the RARα gene Hematology & Pathology 3
promyelocytic from chromosome 17 and the PML gene on chromosome 15 leads to the formation of Oncology (Path)
leukemia PML/RARα, a fusion gene whose product inhibits differentiation of myeloblasts and triggers (HO)
the development of APML. HO Path
1404
Acute myeloid APML is the M3 variant of acute myelogenous leukemia. It affects adult pts and may Px w/ Hematology & Pathology 3
leukemia DIC. The cytogenetic abnormality t(15;17) leads to formation of the PML/RARα fusion Oncology (Path)
gene, which is unable to signal for proper cellular differentiation, unlike the normal RAR. (HO) HO Path
1405
Acute The presence of rod-shaped intracytoplasmic inclusions known as Auer rods is char of many Hematology & Pathology 3
promyelocytic forms of AML. The M3 variant of AML, APML, is a/w the cytogenetic abn t(15;17). Oncology (Path)
leukemia (HO) HO Path
1406
Acute myeloid Auer rods are deformed azurophilic granules found in the cytoplasm of myeloblasts that stain Hematology & Pathology 3
leukemia (+)ly for MPO. Auer rods are found in abundance in AML M3 (APML). Oncology (Path)
(HO) HO Path
1413
Hemoglobin The individual subunits of the Hb molecule are structurally analogous to Mb. If separated, Hematology & Biochemist 4
properties the monomeric subunits will demo a hyperbolic O2 dissociation curve similar to that of Mb. Oncology ry (Bioc)
(HO) HO Bioc
1415
Cyanide poisoning Nitrites are ox agents that're effective in Tx CN- pois due to their ability to induce HbM- Hematology & Biochemist 2
emia. HbM contains Fe3+ rather than Fe2+. CN- binds to Fe3+ more avidly than to Oncology ry (Bioc)
mitochondrial cytochrome enzymes, diminishing CN-'s toxic effect. (HO) HO Bioc
1416
Methemoglobinemi HbM-emia causes dusky discoloration of the skin (similar to cyanosis), and b/c HbM is Hematology & Biochemist 1
a unable to carry O2, a state of fxnal anemia is induced. However, the blood PO2 will be Oncology ry (Bioc)
unchanged as it's a measure of O2 dissolved in plasma and is unrelated to Hb fxn. (HO) HO Bioc
1426
G6PD deficiency G6PD defic is an XL disorder of the hexose monophosphate (PPP) pathway. In affected Hematology & Pathology 5
individuals, the amount of NADPH produced in RBCs is low, which impairs glutathione- Oncology (Path)
mediated inactivation of free radicals. hemolytic episodes are induced by infections, Rx, and (HO)
other oxidants. HO Path
1455
Heme metabolism Maturing erythrocytes lose their ability to synthesize heme when they lose their Hematology & Biochemist 2
mitochondria, which are necessary for the 1st and final 3 steps of heme synthesis. Oncology ry (Bioc)
(HO) HO Bioc
1456
Heme metabolism Heme oxygenase concerts heme to biliverdin, a pigment that causes the greenish color to Hematology & Biochemist 2
develop in bruises several days after an injury. Oncology ry (Bioc)
(HO) HO Bioc
D eats
1470
Hemoglobin C HbC is caused by a missense mut that results in a glutamate residue being substituted by Hematology & Biochemist 1
disease lysine in the beta globin chain. This results in an overall decr. in (-) charge for the Hb Oncology ry (Bioc)
molecule. The spd of Hb movement during GE is HbA > HbS > HbC. (HO) HO Bioc
1474
Radiation therapy Exposure to ionizing radiation, including therapeutic and palliative radiation therapy, induces Hematology & Genetics 1
DNA damage through DNA double-strand fractures and the formation of oxygen free Oncology (Gene)
radicals. (HO) HO Gene
1496
Sickle cell In patients with sickle cell anemia and other chronic hemolytic disorders, the most common Hematology & Microbiolo 13
viral cause of an aplastic crisis is infection of erythroid progenitor cells with parvovirus B19, Oncology gy (Micr)
a nonenveloped single-stranded DNA virus. (HO) HO Micr
1545
Carbon monoxide Carbon monoxide (CO) binds to hemoglobin with much higher affinity than oxygen, thereby Hematology & Physiology 2
poisoning preventing oxygen binding to hemoglobin. It also reduces oxygen unloading from Oncology (Phys)
hemoglobin in the tissues. CO poisoning increases carboxyhemoglobin concentrations but (HO)
does not affect the partial pressure of oxygen and does not precipitate methemoglobinemia. HO Phys
1569
Chronic myeloid CML and LR can have presentations similar to leucocytosis; however, LAP lvl is normal or ↑ Hematology & Pathology 2
leukemia in an LR but ↓ in CML. The definitive Dx of CML req demonstration of the Philadelphia Oncology (Path)
chrom t(9;22) or BCR-ABL fusion gene or mRNA. (HO) HO Path
1570
Acute myeloid The finding of Auer rods (linear purple-red inclusions w/i immature myeloid precursors) is Hematology & Pathology 3
leukemia helpful in making the Dx of AML. Auer rods are not found in ALL. In CML, there are more Oncology (Path)
mature cells and fewer blasts. (HO) HO Path
1571
Acute lymphoblastic Precursor B-ALL and precursor T-ALL can only be distinguished by immunophenotyping. Hematology & Pathology 3
leukemia The lymphoblasts in precursor B-ALL are TdT+, CD10+, and CD19+, whereas the Oncology (Path)
lymphoblasts in precursor T-ALL express T-cell markers (e.g. CD2, CD3, CD4, CD5, CD7, (HO)
and CD8), TdT, and CD1a. HO Path
1572
Nasopharyngeal NPC is endemic in southern China due genetic and dietary factors that promote Hematology & Pathology 1
carcinoma nasopharyngeal epithelial pre-malignant lesions. In almost all cases, malignant Oncology (Path)
transformation occurs due to infection of pre-malignant cells w/ EBV and the subseq (HO)
expression of oncogenic viral proteins. HO Path
1580
Folic acid The underlying biochemical feature of megaloblastosis is a defect in DNA synthesis. In Hematology & Pathology 1
chronic Alcics, megaloblastic macrocytic anemia can result from a nutritional deficiency of Oncology (Path)
vitamin B12 or of folate, which impairs synthesis of purine and pyrimidine bases. (HO) HO Path
1598
Tuberculosis The CGs of TB are almost always surrounded by large epithelioid macrophages w/ pale pink Hematology & Immunolo 18
granular cytoplasm. CD14 is a surface marker spec. to the monocyte-macrophage cell Oncology gy (Immu)
lineage. (HO) HO Immu
1599
Down syndrome Trisomy 21 is detectable by cytogenetic karyotype analysis and is the most common genetic Hematology & Genetics 6
cause of congenital intellectual disability. Patients with Down Syndrome are at increased risk Oncology (Gene)
of developing acute lymphoblastic leukemia and acute megakaryoblastic leukemia. (HO) HO Gene
D eats
1626
Hodgkin lymphoma The presence of RS cells on LN Bx is Dx of classic Hodgkin lymphoma. RS cells have Hematology & Pathology 2
abundant cytoplasm, bilobed or double nuclei, and inclusion-like eosinophilic nucleoli. Oncology (Path)
(HO) HO Path
1627
Non-Hodgkin Follicular lymphoma is characterised by aggregates of packed follicles that obscure the Hematology & Pathology 6
lymphoma normal LN architecture. 90% of pts w/ follicular lymphoma have the t(14;18) translocation, Oncology (Path)
which causes overexpression of the anti-apoptotic BCL-2 protein. (HO) HO Path
1628
Non-Hodgkin Rituximab is a mAb directed against the CD20 Ag. Its intro has improved the prognosis of Hematology & Pharmacol 6
lymphoma some lymphomas. Oncology ogy (Phar)
(HO) HO Phar
1629
Burkitt lymphoma Histo, Burkitt lymphoma has a 'starry sky' appearance due to the presence of macrophages Hematology & Pathology 3
and apoptotic bodies in a sea of medium-sized lymphocytes. The rates of mitosis and Oncology (Path)
apoptosis in the cancerous tissue are high. Almost all cases of Burkitt lymphoma are a/w (HO)
translocations of the c-Myc gene on chrom 8, usually onto the Ig heavy chain region of
chrom 14 [t(8;14)]. HO Path
1630
Burkitt lymphoma The EBV genome is ID'd in approx. 50% of systemic B-cell lymphomas and almost all 1° Hematology & Pathology 3
CNS lymphomas occurring in the setting of HIV infection. A high mitotic index is typical of Oncology (Path)
Burkitt lymphoma. (HO) HO Path
1631
Lymphadenopathy Most of the cutaneous lymph from the umbilicus down, including the anus below the dentate Hematology & Anatomy 1
line, drains to the superficial inguinal lymph nodes. Exceptions are the glans penis and Oncology (Anat)
posterior calf, which drain to the deep inguinal nodes. (HO) HO Anat
1654
Blood transfusion Citrate anticoagulants in high-volume blood transfusion can chelate plasma calcium, leading Hematology & Physiology 2
to hypocalcemia which causes peripheral neuromuscular excitability (eg, paresthesia, muscle Oncology (Phys)
spasms). This is most common with very rapid transfusion rates, but it can also be seen at (HO)
lower rates in patients with hepatic insufficiency because citrate is metabolized by the liver. HO Phys
1683
Rhogam (anti-D Anti-Rh Ig consists of IgG anti-D Abs that opsonize Rh+ fetal erythrocytes, promoting Hematology & Immunolo 1
IgG) clearance by maternal RES macrophages and preventing maternal Rh sensitization. It's Oncology gy (Immu)
routinely admin to Rh(-) women at 28 wks gestation and immediately postpartum. (HO) HO Immu
1717
Retinoblastoma The Rb TSG encodes the Rb protein, which regulates the cell cycle. Active Hematology & Pathology 1
(Rb) protein (hypophosphorylated) Rb protein prevents damaged cells from proceeding past the G1 to S Oncology (Path)
checkpoint, while the inactive (hyperphosphorylated) Rb protein allows the damaged cell to (HO)
enter mitosis. Abnormal phosphorylation of Rb protein results in its inactivation. HO Path
1718
Rb protein Proliferation signals activate CDK4, resulting in hyperphosphorylation of the Rb protein. B/c Hematology & Pathology 1
hyperphosphorylated Rb is inactive, cells are allowed to transition unchecked from the G1 Oncology (Path)
phase to the S phase in the cell cycle. (HO) HO Path
1724
HIV Pts w/ HIV have much higher rates of lymphoma than the general population. Many cases Hematology & Pathology 11
are due to underlying EBV infection. Oncology (Path)
(HO) HO Path
D eats
1754
Non-Hodgkin Benign LN enlargement in response to Ag stim is a/w a polyclonal proliferation of Hematology & Pathology 6
lymphoma lymphocytes. A monoclonal lymphocytic proliferation is strong evidence of malignancy. Oncology (Path)
(HO) HO Path
1755
Burkitt lymphoma Burkitt lymphoma is Chx by aggressive rapid growth and a "starry sky" microscopic Hematology & Pathology 3
appearance. Translocation of the c-Myc oncogene on the long arm of chromosome 8 w/ the Oncology (Path)
Ig heavy chain region on chromosome 14 produces a nuclear phosphoprotein (c-Myc) that (HO)
fxns as a transcription activator. HO Path
1757
Infectious EBV causes IM in teens and young adults. It's also a/w a # of malignant conditions, incl Hematology & Pathology 5
mononucleosis Burkitt lymphoma and NPC. Oncology (Path)
(HO) HO Path
1758
Non-Hodgkin Overexpression of bcl-2 leads to ↑ secretion of Bcl-2 protein, which inhibits apoptosis and Hematology & Pathology 6
lymphoma promotes survival of tumor cells. This overexpression occurs in follicular lymphoma 2° to Oncology (Path)
translocation of the bcl-2 oncogene from chromosome 18 to the Ig heavy chain locus on (HO)
chromosome 14 [t(14:18)]. HO Path
1759
Anaplasia Undifferentiated (anaplastic) tumors bear no resemblance to the tissue of origin. They are Hematology & Pathology 1
composed of pleomorphic cells w/ large, hyperchromatic nuclei that grow in a disorganized Oncology (Path)
fashion. Anaplastic tumors may also contain numerous, abnormal mitoses and giant tumor (HO)
cells. HO Path
1760
Colorectal cancer Most tumors possess multiple cytogenetic abnormalities. Activation of POCs results in Hematology & Pathology 15
stimulation of cellular proliferation. Inactivation of anti-oncogenes eliminates oversight of Oncology (Path)
the cell cycle. (HO) HO Path
1761
Kaposi sarcoma Kaposi sarcoma typically presents as blue-violet or brownish skin plaques on the extremities Hematology & Pathology 2
and mucous membranes of HIV (+) pts. This tumour arises from primitive mesenchymal Oncology (Path)
cells and is strongly a/w HHV-8. (HO) HO Path
1762
Breast cancer ER or PR (+) in breast ca indicates expected sensitivity to tamoxifen and aromatase inhibitor Hematology & Pathology 7
Tx. HER2 overexpression in breast ca suggests a more aggressive tumor that typically Oncology (Path)
responds to Thx w/ the anti-HER2 mAb trastuzumab. (HO) HO Path
1784
Anticoagulants Enoxaparin is a low-molecular-weight heparin (LMWH) that functions like heparin in that it Hematology & Pharmacol 8
binds and activates antithrombin III (AT III). Activated AT III binds to factor Xa and stops Oncology ogy (Phar)
factor Xa from converting prothrombin to thrombin. Due to its fewer number of molecules, (HO)
LMWH acts primarily on factor Xa, not thrombin. HO Phar
1785
Aplastic anemia AA causes pancytopaenia as the bone marrow is replaced by fat cells and marrow stroma. Hematology & Pathology 3
The absence of splenomegaly on PEx is char. A bone marrow Bx can be extremely useful in Oncology (Path)
making the Dx. (HO) HO Path
1786
Pure red cell aplasia PRCA is a rare form of marrow failure Chx by severe hypoplasia of marrow erythroid Hematology & Pathology 1
elements in the setting of normal GPO and TPO. PRCA is a/w thymoma, lymphocytic Oncology (Path)
leukemias, and PVB19 infection. (HO) HO Path
D eats
1787
Aplastic anemia AA is most commonly due to a toxic effect or AI response causing apoptosis of pluripotent Hematology & Pathology 3
stem cells (pancytopenia). Bone marrow Bx reveals hypocellularity w/ an abundance of fat Oncology (Path)
cells. (HO) HO Path
1788
X-linked inheritance Given phenotypically normal parents, the probability that a female sibling of a male affected Hematology & Genetics 2
by an X linked recessive disease will give birth to an affected child is 1/8. Oncology (Gene)
(HO) HO Gene
1792
Vitamin B12 defic of vitB12 is a/w both megaloblastic anaemia and neuro dysfxn, while vitB9 defic is a/w Hematology & Pathology 9
deficiency megaloblastic anaemia alone. Mod improvement in the Hb lvl often occurs when a defic in Oncology (Path)
vitB12 is Tx w/ vitB9, or vice versa. Tx of vitB12 defic w/ vitB9 alone can actually worsen (HO)
neuro dysfxn. HO Path
1793
Iron deficiency Hypochromic, microcytic anemia is most commonly due to Fe deficiency. Blood loss, Hematology & Pathology 7
anemia especially occult loss from the GI tract, must be r/o in a pt w/ IDA. Oncology (Path)
(HO) HO Path
1794
Iron deficiency Anemia in a woman of childbearing age is most commonly caused by iron deficiency Hematology & Pathology 7
anemia secondary to menstrual blood loss. Iron deficiency is associated with decreased serum Oncology (Path)
ferritin, increased total iron-binding capacity (transferrin), and microcytic, hypochromic red (HO)
blood cells. HO Path
1796
Iron deficiency ↑ bone marrow EPO results in an accelerated release of immature RBCs (reticulocytes) into Hematology & Pathology 7
anemia the bloodstream. Reticulocytes contain bluish cytoplasm and reticular precipitates of residual Oncology (Path)
ribosomal RNA. (HO) HO Path
1797
Carcinogens Most chem carcinogens enter the body in an inactive state (i.e. as pro-carcinogens). These Hematology & Pathology 1
pro-carcinogens are converted into active metabolites by the CYP450 oxidase system. Oncology (Path)
Individual susceptibility to chem carcinogens depends on the activity of these P450 enzymes, (HO)
which is genetically determined. HO Path
1798
ALL and T cells ALL is the most common malignancy of childhood. B-cell ALL is responsible for Hematology & Pathology 1
approximately 70-80% of all cases of ALL, whereas T-cell ALL accounts for 15-17% of all Oncology (Path)
cases of ALL. T-cell ALL often Px as a mediastinal mass that can cause resp symptoms, (HO)
dysphagia, or SVC syndrome. HO Path
1816
Urinary tract hemorrhagic cystitis during therapy w/ cyclophosphamide or ifosfamide is caused by the Hematology & Pharmacol 12
infection urinary excretion of the tox metabolite acrolein. It can be prevented by aggressive hydration, Oncology ogy (Phar)
bladder irrigation, and admin of mesna, a sulfhydryl compound that binds acrolein in the (HO)
urine. HO Phar
1818
Methotrexate Folinic acid (leucovorin) can reverse the tox of MTX in non-ca cells in the GI mucosa and Hematology & Pharmacol 2
bone marrow if admin at the appropriate time. Leucovorin serves as a reduced form of vitB9 Oncology ogy (Phar)
that doesn’t req the action of DHFR. (HO) HO Phar
D eats
1819
Chemotherapy The human MDR1 gene codes for P-gp, a transmembrane ATP-dependent efflux pump Hematology & Pharmacol 3
protein that has a broad specificity for hydrophobic compounds. This protein can both ↓ the Oncology ogy (Phar)
influx of drugs into the cytosol and can ↑ efflux from the cytosol, thereby preventing the (HO)
action of CTx agents. HO Phar
1838
Vitamin B12 Vit B12 is obtained thru the diet solely from animal sources, which places strict vegans at Hematology & Biochemist 9
deficiency risk for dietary defic. This defic takes yrs to develop due to the large hepatic B12 reserve, Oncology ry (Bioc)
and Px w/ megaloblastic anemia and potentially irrev. neuro deficits (e.g. paresthesias, (HO)
weakness, ataxic gait). HO Bioc
1842
Sickle cell The major chronic path changes in the spleens of pts w/ SCA result from repetitive splenic Hematology & Pathology 13
infarctions caused by splenic microvessel occlusion. Fibrosis, brownish discolouration, and Oncology (Path)
eventual autosplenectomy ultimately result. (HO) HO Path
1847
Folic acid Vit B9 inhibs the synth of NAs, particularly the formation of dTMP. This leads to defective Hematology & Biochemist 1
deficiency DNA synth that char causes incr. apoptosis of HPO cells and megaloblastic anemia. Oncology ry (Bioc)
Thymidine supplementation bypasses the enzyme and can decr. erythroid cell apoptosis. (HO) HO Bioc
1848
Vitamin B12 Atrophic gastritis can result in profound hypochlorhydria, inadequate IF production, vitB12 Hematology & Pathology 9
deficiency defic, and ↑ MMA lvls. The reticulocyte count ↑ dramatically once vitB12 replacement Oncology (Path)
therapy is initiated in an individual w/ pernicious anaemia. Hb and erythrocyte count lvls rise (HO)
more gradually and take up to 8wks to normalise. HO Path
1851
Hemolytic uremic HUS MFx w/ AKI, MAHA, and thrombocytopenia. Char lab abns incl decr Hb and platelet Hematology & Pathophysi 3
syndrome count and incr BT, LDH, bilirubin, BUN, and creat. Oncology ology
(HO) (Patp) HO Patp
1855
Sickle cell Dactylitis (painful swelling of the hands and feet) is a common presentation of sickle cell Hematology & Pathophysi 13
disease (SCD) in young children. It is one of many vasoocclusive manifestations of SCD. Oncology ology
Sickling episodes result in hemolysis, which leads to increased indirect bilirubin and lactate (HO) (Patp)
dehydrogenase and decreased levels of haptoglobin. HO Patp
1857
Methotrexate MTX is a vitB9 antagonist used to Tx ectopic preg. It competitively inhibs the enzyme Hematology & Pharmacol 2
DHFR, which catalyses the synthesis of THF. DHFR inhib causes the intermediate DHF to Oncology ogy (Phar)
accumulate intracellularly. (HO) HO Phar
1859
Extramedullary The presence of erythroid precursors in organs such as the liver and spleen is indicative of Hematology & Pathology 1
hematopoiesis EMH, a condition characterised by EPO-stim, hyperplastic marrow cell invasion of EM Oncology (Path)
organs. EMH is most freq caused by severe chronic hemolytic anaemias, such as β- (HO)
thalassaemia. HO Path
1861
Aplastic anemia The triad of low Hb, thrombocytopaenia, and absent HPO cells in the bone marrow is Hematology & Pathology 3
consistent w/ AA. A compensatory ↑ in circulating EPO lvls would be expected in Oncology (Path)
individuals w/ AA and normal renal fxn. (HO) HO Path
1864
Hodgkin lymphoma RS cells are large binucleated cells w/ an 'owl's eyes' appearance that appear on a background Hematology & Pathology 2
of lymphocytic infiltrates. RS cells must be present histopath in order to make the Dx of HL. Oncology (Path)
(HO) HO Path
D eats
1865
Lead poisoning Coarse erythrocyte basophilic stippling and microcytic hypochromic anemia are common Hematology & Pathology 4
PBS findings in Pb poisoning. High-risk groups include young children ingesting paint chips Oncology (Path)
and industrial workers inhaling particulate Pb. (HO) HO Path
1872
Fibronectin Adhesion of cells to the ECM involves integrin-mediated binding to fibronectin, collagen, Hematology & Pathology 1
and laminin. diffial expression of integrin subtypes affects adhesion properties of individual Oncology (Path)
cells, and has been found to correlate w/ malignant behaviour in a # of tumours. (HO) HO Path
1873
Hemangioma The key GFs that promote angiogenesis in neoplastic and granulation tissue are VEGF and Hematology & Pathology 6
FGF. Pro-inflammatory cytokines (e.g. IL-1, IFN-γ) can indirectly promote angiogenesis thru Oncology (Path)
↑ VEGF expression. The laminin in BMs may pose a physical barrier to the sprouting of new (HO)
blood vessels. HO Path
1877
Breast cancer Peau d'orange is an erythematous, itchy breast rash w/ skin texture changes that resemble an Hematology & Pathophysi 7
orange peel. It's the key derm Px of inflam breast ca and is caused by ca cells spreading to Oncology ology
the dermal lymphatic spaces and obstr lymphatic drainage. (HO) (Patp) HO Patp
1879
Inherited 1-9% of Caucasians worldwide are heterozyg carriers of FV Leiden, which is modded to Hematology & Pathology 2
thrombophilia resist activated protein C. The resulting hypercoagulable state predisposes to DVT, which are Oncology (Path)
the source of most PE. (HO) HO Path
1880
Pulmonary Saddle PE straddles the bifurcation of the main pulm artery. VTE (i.e. PE or DVT) arises due Hematology & Pathology 13
embolism to the Virchow triad of endothelial injury, venous stasis, and a hypercoagulable state. Oncology (Path)
Malignancy causes a hypercoagulable state and is a strong RF for VTE. (HO) HO Path
1890
Acute lymphoblastic 6-MP is mainly degraded in the liver by XO. Allopurinol, an XO inhib, can ↑ the conc of 6- Hematology & Pharmacol 3
leukemia MP significantly. Both 6-MP and 6-TG are prodrugs that req activation by HGPRT. Oncology ogy (Phar)
(HO) HO Phar
1892
Chemotherapy MTX and 5-FU both effectively inhib thymidylate formation, but the CTx effect of MTX is Hematology & Pharmacol 3
overcome by N5-formyl-THF (folinic acid, leucovorin) supplementation. Oncology ogy (Phar)
(HO) HO Phar
1893
Vincristine The vinca alkaloids are cell cycle-specific agents that prevent proper separation of chrom Hematology & Pharmacol 1
into daughter cells during the M phase of the cell cycle. The main dose-limiting AE of Oncology ogy (Phar)
vincristine is neurotox, which commonly MFx as peri neuropathy. (HO) HO Phar
1894
Chemotherapy Neurotox is the dose-limiting AE of vincristine therapy. This tox results from failure of Hematology & Pharmacol 3
microtubule polymerisation in neuronal axons. Other notable AEs classically a/w CTx agents Oncology ogy (Phar)
incl PF and flagellate skin discolouration w/ bleomycin use; CHF w/ doxorubicin; and (HO)
hemorrhagic cystitis w/ cyclophosphamide. HO Phar
1903
Factor VII A normal BT indicates adequate platelet hemostatic fxn. A normal aPTT indicates an intact Hematology & Pathophysi 1
deficiency intrinsic coag system. Prolonged PT in the setting of normal aPTT indicates a defect in the Oncology ology
extrinsic coag system at a step that's not shared w/ the intrinsic system. (HO) (Patp) HO Patp
1905
SCA mutation Exertional dyspnea, pneumonia resulting in life-thr ACS, and recurrent abdo and bone pain Hematology & Biochemist 1
are CFx of SCA. SCA results from a point mut that causes valine to substitute for glutamic Oncology ry (Bioc)
acid in the 6th position of the beta-globin chain of Hb. (HO) HO Bioc
D eats
1911
Non-Hodgkin Follicular lymphoma is an NHL of follicular B-lymphocytes. Pts w/ follicular lymphoma Hematology & Pathology 6
lymphoma char have a translocation b/w chroms 14 and 18 which causes bcl-2 overexpression. Bcl-2 is Oncology (Path)
considered a protooncogene b/c it has anti-apoptotic effects. (HO) HO Path
1923
von Willebrand vWD is the most common inherited bleeding disorder. It has an AD pattern of inheritance Hematology & Pathology 7
disease and variable penetrance. Absence of vWF leads to impaired platelet fxn (prolonged BT) and Oncology (Path)
coagulation pathway abnormalities due to ↓ factor VIII activity (prolonged PTT). (HO) HO Path
1940
Thalassemia Beta-thalassemia is caused by muts that result in defective transcription, processing, and Hematology & Pathophysi 3
translation of beta-globin mRNA. This leads to defic of the beta-globin chains req for normal Oncology ology
Hb synth. (HO) (Patp) HO Patp
1941
Polycythemia Renal cortical cells sense hypoxia and respond by synthesizing and releasing EPO. EPO Hematology & Pathology 5
stimulates the production of erythrocytes in the bone marrow. Oncology (Path)
(HO) HO Path
1953
Hemophiliacs Hemophilia is an XLR coagulopathy that Px w/ IM hemorrhage, hemarthrosis, and delayed Hematology & Pathology 2
bleeding after procedures. LFx show PTT prolongation; other tests of hemostatic fxn are Oncology (Path)
generally normal. (HO) HO Path
1954
ITP Autoimmune platelet destruction is a common cause of thrombocytopaenia and should be Hematology & Pathology 1
suspected in pts w/ ecchymoses, petechiae, mucosal bleeding, and no other obvi causes of Oncology (Path)
thrombocytopaenia (e.g. Rx, bone marrow failure). (HO) HO Path
1963
Acute APML can present w/ persistent infection and coagulopathy causing hemorrhagic SSx. Bone Hematology & Pathology 3
promyelocytic marrow Bx classically reveals promyelocytes w/ intracytoplasmic Auer rods. APML is a/w a Oncology (Path)
leukemia t(15;17) chrom translocation that causes fusion of the RARA gene and PML gene. (HO) HO Path
1964
Multiple myeloma The finding of a high peak in the γ-globulin region on SPEP usually represents an M protein Hematology & Pathology 9
consisting of an overproduced monoclonal Ig. MM causes an M protein peak on SPEP as Oncology (Path)
well as anaemia (weakness), lytic bone lesions (back pain, path fractures), and renal (HO)
insufficiency (related to amyloid deposition and hypercalcaemia). HO Path
2018
Etoposide Etoposide is a CTx agent that inhibs the sealing activity of topoisomerase II. Tx w/ etoposide Hematology & Pharmacol 1
causes chrom breaks to accumulate in dividing cells, ultimately causing cell death. Oncology ogy (Phar)
(HO) HO Phar
2032
Mischarged tRNA The seq of AAs in a growing polypeptide chain is dictated by the interaction of the mRNA Hematology & Biochemist 1
codon w/ the tRNA anticodon. tRNA that's mischarged w/ the incorrect AA (and not Oncology ry (Bioc)
corrected by AA-tRNA synthetase proofreading) will incorporate the wrong AA into the (HO)
growing polypeptide chain. HO Bioc
2039
Protein synthesis The nucleolus is the site of ribosomal subunit maturation and assembly. RNA polymerase I Hematology & Genetics 2
functions exclusively within the nucleolus to transcribe the 45S pre-rRNA gene, which codes Oncology (Gene)
for most of the ribosomal RNA components (18S, 5.8S, and 28S rRNAs). (HO) HO Gene
2040
Sickle cell Sickle cell anemia is an autosomal recessive hemoglobinopathy. In order for a child to have Hematology & Genetics 13
sickle cell disease, both parents must be carriers. Hemoglobin electrophoresis can be used to Oncology (Gene)
determine the carrier status of a prospective parent who has no history of sickle cell anemia. (HO) HO Gene
D eats
2041
Prion disease Western blotting is used to identify proteins, Northern blotting identifies specific RNA Hematology & Genetics 3
sequences, and Southern blotting identifies specific DNA sequences in an unknown sample. Oncology (Gene)
(HO) HO Gene
2043
Polymerase chain PCR is used to amp small fragments of DNA (e.g. genes, exons, NCRs) by repeated Hematology & Biochemist 2
reaction replication. It req primers that're complementary to the regions of DNA flanking the segment Oncology ry (Bioc)
of interest. Thermostable DNA polymerase, dNTPs, and a source DNA template strand are (HO)
also necessary. HO Bioc
2084
Sickle cell SCD is characterised by repeated splenic infarctions that ultimately result in splenic atrophy Hematology & Pathology 13
and fibrosis, a process that's typically complete by late childhood/adolescence. After Oncology (Path)
autosplenectomy, pts are predisposed to infections w/ encapsulated bacterial organisms. (HO) HO Path
2085
Sickle cell An MCV >110μm3 is highly suggestive of megaloblastic anaemia, such as that caused by Hematology & Pathology 13
vitB9 or vitB12 defic. Pts w/ chronic hemolytic anaemia have ↑ vitb9 req due to ↑ Oncology (Path)
erythrocyte turnover and are predisposed to devel macrocytosis. (HO) HO Path
2086
Thalassemia The Kozak consensus sequence occurs on eukaryotic mRNA and is defined by the following Hematology & Genetics 3
sequence: (gcc)gccRccAUGG, in which R is either adenine or guanine. This sequence helps Oncology (Gene)
initiate translation at the methionine start codon (AUG). (HO) HO Gene
2087
Thalassemia B thalassemia results in hypochromic, microcytic anemia due to decreased ß globin chain Hematology & Genetics 3
synthesis. Unpaired a chains precipitate within red cells and cause membrane damage, Oncology (Gene)
leading to ineffective erythropoiesis and extravascular hemolysis. (HO) HO Gene
2092
Breast cancer Cytokeratin is a commonly used IHC marker of epithelial cell carcinomas. Hematology & Pathology 7
Oncology (Path)
(HO) HO Path
2093
Breast cancer The HER2 oncogene encodes for a transmembrane glycoprotein w/ intrinsic tyrosine kinase Hematology & Pathology 7
activity and is a member of the family of EGFRs. Overexpression of this protein is a/w a Oncology (Path)
worse prognosis and ↑ risk of disease recurrence. (HO) HO Path
2097
von Willebrand Pts w/ vWD often Px w/ a lifelong Hx of mucosal bleeding, incl gingival bleeding, epistaxis, Hematology & Pathophysi 7
disease a/o menorrhagia. These pts have normal platelet lvls but typically have a prolonged BT due Oncology ology
to impaired platelet fxning. (HO) (Patp) HO Patp
2098
von Willebrand vWF fxns as a promoter of platelet adhesion at sites of vasc injury by binding platelet GPs to Hematology & Pathophysi 7
disease SEC on injured blood vessel walls. It also acts as a protective carrier protein for circulating Oncology ology
FVIII. (HO) (Patp) HO Patp
2132
Anticoagulants Both UFH and LMWH can bind to ATIII to ↑ its activity against FXa. Only UFH is able to Hematology & Pharmacol 8
bind to both ATIII and FIIa to allow ATIII to inactivate FIIa. Oncology ogy (Phar)
(HO) HO Phar
2133
Direct factor Xa Direct FXa inhibs (e.g. apixaban, rivaroxaban) incr the PT and aPTT but don't affect the TT. Hematology & Pathophysi 1
inhibitors UFH and DTIs (e.g. dabigatran) prolong the TT. Oncology ology
(HO) (Patp) HO Patp
D eats
6530
Multiple myeloma MM is a/w ↑ circulating paraproteins (monoclonal Igs), which causes erythrocytes to stack Hematology & Pathology 9
like coins (rouleaux formation). Pts classically have normocytic anemia, hypercalcemia, Oncology (Path)
bone pain, and renal insufficiency. (HO) HO Path
7643
Infectious The 1° immune response to EBV is mediated by CD8+ T lymphocytes, which are activated Hematology & Pathology 5
mononucleosis thru the presentation of viral Ags on infected CD21+ B lymphocytes. These reactive Oncology (Path)
(atypical) CD8+ T lymphocytes can be observed in the peri blood smears of pts w/ IM. (HO) HO Path
8261
Rhesus W/ maternal blood types A or B, HDFN very rarely occurs b/c materal Abs (anti-A or anti-B) Hematology & Immunolo 2
alloimmunization are of the IgM type and can't cross the placenta. In contrast, mothers w/ blood type O also Oncology gy (Immu)
produce IgG Abs (anti-A and anti-B), which can cross the placenta and cause fetal (HO)
hemolysis. HO Immu
8276
Alternative splicing Alt splicing is a process where the exons of a gene are reconnected in multi ways during Hematology & Biochemist 1
PTP. This creates diff mRNA seqs and subseq, diff protein isoforms. It's a normal Oncology ry (Bioc)
phenomenon in eukaryotes that greatly incr. the biodiversity of proteins encoded by the (HO)
genome. HO Bioc
8281
Chronic myeloid Some pts w/ NSCLC harbour a chrom rearrangement that creates a fusion gene b/w EML4 Hematology & Pathology 2
leukemia and ALK. This results in a constitutive active tyrosine kinase that causes malignancy. Oncology (Path)
(HO) HO Path
8480
Inflammation Inflam is char by the passage of circulating inflam leukocytes into the inflamed tissue. The Hematology & Immunolo 3
steps involved incl. margination, rolling, activation, tight adhesion and crawling, and Oncology gy (Immu)
transmigration. (HO) HO Immu
8532
Primary DGS causes an extreme defic in the # of mature T lymphocytes, leading to poor development Hematology & Immunolo 7
immunodeficiency of the LN paracortex. In contrast, aGg-emia causes an absence of B cells, preventing 1ary Oncology gy (Immu)
disorder lymphoid follicles and germinal centers from forming in the LN cortex. (HO) HO Immu
8540
Myelofibrosis The chronic MPDs (PV, ET, and PMF) often have a mutation in JAK2, a cytoplasmic Hematology & Pathology 3
tyrosine kinase. This results in constitutive tyrosine kinase activity, and consequently, in the Oncology (Path)
cytokine-independent activation of STAT proteins (JAK-STAT signaling pathway). (HO) HO Path
8542
Tumor lysis TLS can develop during CTx for ca w/ rapid cell turnover (e.g. poorly diffiated lymphomas Hematology & Pharmacol 1
syndrome and leukaemias), substantial tumour burden, or high sensitivity to CTx. It's characterised by Oncology ogy (Phar)
hyperphosphataemia, hypocalcaemia, hyperkalaemia, and hyperuricaemia. Prevention often (HO)
involves hydration and the use of hypouricaemic agents such as allopurinol or rasburicase. HO Phar
8559
Polycythemia PV is a clonal MPD characterised by an ↑ RBC mass, ↑ plasma volume, and low EPO lvls. Hematology & Pathology 5
PV can be diffiated from 2° polycythemia by the presence of leucocytosis, thrombocytosis, Oncology (Path)
a/o splenomegaly. The majority of pts w/ PV have a JAK2 mut rendering HSCs more (HO)
sensitive to GFs. HO Path
8591
Polycythemia PV is an MPD characterised by uncontrolled erythrocyte production. Virtually all pts w/ PV Hematology & Pathology 5
have a mut in JAK2, a non-receptor (cytoplasmic) tyrosine kinase a/w the EPO receptor. Oncology (Path)
(HO) HO Path
D eats
11456
Leukocytosis LR is a benign leucocytosis (>50k/mm3) that occurs in response to an underlying condition Hematology & Pathology 1
such as severe infection/hemorrhage, malignancy (e.g. leukaemia), or acute hemolysis. LAP Oncology (Path)
lvls are normal or ↑. peri smear can show ↑ bands, early mature neutrophil precursors (e.g. (HO)
myelocytes), and granules (e.g. Dohle bodies) in the neutrophils. HO Path
11584
Multiple myeloma In MM, neoplastic plasma cells synthesise large amount of monoclonal Ig or Ig fragments. Hematology & Pharmacol 9
These cells are particularly susceptible to proteasome inhib due to the large amount of Oncology ogy (Phar)
proteins that they manufacture. The resulting accumulation of tox intracellular and pro- (HO)
apoptotic proteins ↑ cellular apoptosis. HO Phar
11585
Trastuzumab Human epidermal growth factor receptor 2 (HER2) is a tyrosine kinase receptor that is Hematology & Pharmacol 1
overexpressed in 20% of breast cancer patients. In such patients, HER2 blockade with the Oncology ogy (Phar)
monoclonal antibody trastuzumab downregulates cellular proliferation and promotes (HO)
apoptosis. HO Phar
11624
Thrombotic TTP is 1 of several 1ary TMAs resulting in MAHA and thrombocytopenia, which are Hematology & Pathophysi 3
thrombocytopenic essential to the Dx. Plasma exchange therapy has prompted more rapid Dx and is life-saving. Oncology ology
purpura (HO) (Patp) HO Patp
11625
Thrombotic TTP results from impaired fxn of the vWF-cleaving protease ADAMTS13, resulting in Hematology & Pathology 3
thrombocytopenic uncleaved vWF multimers that are significantly more prothrombotic and cause diffuse Oncology (Path)
purpura microvascular thrombosis, MAHA, and thrombocytopenia. (HO) HO Path
11728
Ovarian cancer Vomiting is a reflex regulated mainly by 5 receptors, incl M1 muscarinic, D2 DA-ergic, H1 Hematology & Pharmacol 9
histaminic, 5-HT3 5-HT-ergic, and NK1 receptors. 5-HT3 and NK1 receptor antagonists are Oncology ogy (Phar)
particularly useful for CTx-induced vomiting. (HO) HO Phar
11731
Venous Rivaroxaban is an oral anticoag that directly inhibs FXa. It's used in VTE and AF. Hematology & Pharmacol 2
thromboembolism Oncology ogy (Phar)
(HO) HO Phar
11750
Hairy cell leukemia HCL is an indolent B-cell neoplasm predominantly found in middle-aged men and Hematology & Pathology 1
characterised by bone marrow failure and infiltrations into the RES, causing massive Oncology (Path)
splenomegaly. Other typical features incl a 'dry tap' (unsuccessful bone marrow aspiration) (HO)
and the presence of lymphocytes w/ cytoplasmic projections. HO Path
11754
Prostate cancer Imaging of bone mets assists in ca Dx. Bone mets are characterised as osteolytic or Hematology & Pathology 5
osteoblastic. Bony pain in an older man w/ osteoblastic lesions on imaging is highly Oncology (Path)
suspicious for prostate ca. (HO) HO Path
11816
Sideroblastic INH inhibs vit B6 PK, leading to vit B6 defic. Vit B6's active form is the cofactor for delta- Hematology & Biochemist 1
anemia ALA synthase, the enzyme that catalyzes the RLS of heme synth. Inhib of this step can result Oncology ry (Bioc)
in sideroblastic anemia. (HO) HO Bioc
11864
Gaucher disease Gaucher disease is an AR lysosomal storage disorder that's characterised by β- Hematology & Pathology 1
glucocerebrosidase defic and presents w/ pancytopaenia and HSM. Glucocerebroside Oncology (Path)
accumulation leads to distended macrophages w/ a 'wrinkled tissue paper' appearance, aka (HO)
Gaucher cells. HO Path
D eats
11869
Paroxysmal PNH is due to a gene defect that leads to uncontrolled complement-mediated hemolysis. The Hematology & Pathology 2
nocturnal classic triad incls hemolytic anaemia (hemoglobinuria), pancytopaenia, and thrombosis at Oncology (Path)
hemoglobinuria atypical sites. Chronic hemolysis can cause Fe deposition in the kidney (hemosiderosis). (HO) HO Path
11912
Ovarian cancer Telomerase is an RNA-dependent DNA polymerase that synthesizes telomeric DNA Hematology & Genetics 9
sequences that can replace the lost chromosomal ends of the telomeres. Cancer cells typically Oncology (Gene)
contain increased telomerase activity to allow for continued proliferation. (HO) HO Gene
12019
Sickle cell Sickle cell disease is the result of a missense mutation that causes valine to replace glutamic Hematology & Genetics 13
acid at position 6 in the hemoglobin beta-globin chain. RNA contains the pyrimidine base Oncology (Gene)
uracil, whereas DNA contains the base thymidine. (HO) HO Gene
12048
Immunotherapy The binding of PD-1 to 1 of its ligands (PD-L1) downregs the immune response by inhib Tc Hematology & Immunolo 2
cells. Many types of ca evade immunodetection by incr. expression of PD-L1 on their Oncology gy (Immu)
surface. mAbs against PD-1 upreg the T cell response and promote tumor cell apoptosis. (HO) HO Immu
12049
Colorectal cancer Activating mutations of the KRAS gene lead to constitutive activation of the EGFR pathway, Hematology & Pathology 15
promoting ↑ cell proliferation and growth. Tumors harboring these mutations are resistant to Oncology (Path)
Tx w/ anti-EGFR drugs (eg, cetuximab, panitumumab). (HO) HO Path
14772
Cancer anorexia The ubiquitin-proteasome pathway mediates targeted protein degradation, which allows for Hematology & Pathology 2
cachexia syndrome rapid disposal of unneeded intracellular proteins. In ca-related cachexia, high lvls of pro- Oncology (Path)
inflammatory cytokines lead to ↑ ubiquitination of sarcomeric muscle proteins, which in turn (HO)
leads to extensive skeletal muscle loss. HO Path
14816
Myelofibrosis PMF is an MPD a/w the clonal expansion of megakaryocytes. Bone marrow fibrosis Hematology & Pathology 3
accounts for most of the major MFxs, incl HSM, cytopaenias, and blood smear evidence of Oncology (Path)
dacrocytes. Bone marrow aspiration is usually dry, but bone marrow Bx will show marked (HO)
fibrosis w/ occasional clusters of atypical megakaryocytes. HO Path
14848
Interstitial lung Bleomycin is an antineoplastic agent that binds to Fe and O2 molecules to create free Hematology & Pharmacol 8
disease radicals that cause DNA strand breaks. The most clinically important AE of bleomycin is Oncology ogy (Phar)
lung tox, usually MFxing as PF. Pts develop dyspnoea and NPC, and PFT shows a restrictive (HO)
pattern w/ ↓ DLCO. HO Phar
14956
Immunotherapy Ca cells avoid immune recognition by overexpression PD-L1, which binds to the PD-1 Hematology & Pharmacol 2
receptor on Tc cells and inhibs their response (T-cell exhaustion). mAbs that block PD-L1 Oncology ogy (Phar)
and PD-1 are effective against ca that express high lvls of neo-Ags on their surface b/c these (HO)
tumours are particularly susceptible to immune recognition by Tc cells. HO Phar
14983
Asplenia Target cells form when erythrocytes have decr cell volume (e.g. thalassemia, Fe defic) or Hematology & Pathophysi 2
excessive membrane (e.g. OLD, postsplenectomy). Pts who undergo splenectomy usually Oncology ology
develop target cells b/c the spleen is the 1ary organ that prunes excessive RBC membrane. (HO) (Patp) HO Patp
15120
Heparin induced HIT and thrombosis results from the production of IgG Abs against complexes of heparin Hematology & Pathology 1
thrombocytopenia and platelet factor 4. The Fc component of these Abs binds to platelets, resulting in Oncology (Path)
widespread platelet activation and a prothrombotic state. (HO) HO Path
D eats
15133
Multiple myeloma MM should be suspected in elderly pts who have any combo of osteolytic lesions, Hematology & Pathophysi 9
hypercalcemia, anemia, or AKI. Renal disease is most commonly caused by LC cast Oncology ology
nephropathy, in which free LCs form obstr casts in the renal tubules. Monoclonal (HO) (Patp)
paraproteins aren't detected by urine dipstick (which detects only albumin), but both spot and
24 hr protein concs will be incr. HO Patp
15134
Multiple myeloma MM is a plasma cell malignancy a/w purely radiolucent (osteolytic) bone lesions due to the Hematology & Pathophysi 9
stim of osteoclasts and the inhib of osteoblasts. Myeloma cells stim osteoclast devel by Oncology ology
secreting RANKL and destroying OPG, which incr RANK activity and results in osteoclast (HO) (Patp)
diff. HO Patp
15228
Head and neck Most OPCs (e.g. tonsil, base of tongue) are caused by HPV infection. HPV-16 is particularly Hematology & Pathology 1
cancers likely to cause malignant transformation. Oncology (Path)
(HO) HO Path
15248
Myelofibrosis PMF is a chronic MPD a/w bone marrow fibrosis. EMH leads to marked expansion of the Hematology & Pathophysi 3
splenic red pulp w/ HPO progenitor cells and results in massive splenomegaly. Pts also Oncology ology
usually have hepatomegaly, cytopenias, and PBS abns (e.g. dacrocytes, nucleated RBCs, (HO) (Patp)
immature granulocytes). HO Patp
15278
Acute lymphoblastic ALL is marked by a high conc of circulating lymphoblasts. Flow cytometry can be used to Hematology & Pathology 3
leukemia distinguish b/w B-cell (CD19-expressing) and T-cell (CD3-expressing) lineages. T-cell ALL Oncology (Path)
usually arises in teens or individuals in their 20s and often presents w/ a large mediastinal (HO)
mass. HO Path
15299
Cell cycle CDKs 4/6 regulate the movement of cells from G1 → S phase. Ca often have muts that Hematology & Pharmacol 2
enhance the activity or downstream effects of CDK 4/6, which contribute to unregulated Oncology ogy (Phar)
cellular growth. Inhibs to CDK 4/6 can be used to Tx certain forms of ca. However, they can (HO)
inhib cellular replication in other rapidly dividing cells such as the heme cells in the bone
marrow (e.g. neutropaenia, anaemia, or thrombocytopaenia). HO Phar
15301
Laboratory FISH can Id specific chrom translocations, duplications, or deletions using a complementary Hematology & Biochemist 1
techniques ssDNA segment that's tagged w/ a radiotracer. FISH is rapid, highly sens and spec, and can Oncology ry (Bioc)
be used on tissues w/ low mitotic rates. However, the targeted chrom abn must be somewhat (HO)
large in order to be Id. HO Bioc
15307
Anemia of chronic Erythropoietin (EPO) is produced by peritubular fibroblast cells in the renal cortex in Hematology & Physiology 2
disease response to decreased renal oxygen delivery. EPO acts on erythrocyte precursors in the bone Oncology (Phys)
marrow to increase red blood cell production. Patients with chronic kidney disease often (HO)
have damage to renal EPO-producing cells, which results in normocytic anemia. HO Phys
15323
Chronic kidney Chronic kidney disease is commonly associated with normocytic anemia due to reduced Hematology & Physiology 8
disease production of erythropoietin by the kidneys. Erythropoietin signal transduction is primarily Oncology (Phys)
mediated by the Janus kinase 2/signal transducers and activators of transcription (HO)
(JAK2/STAT) pathway, which promotes erythrocyte precursor survival. HO Phys
D eats
15460
Lung cancer Melanoma is a highly aggressive malignancy that often mets early in the disease course. Pts Hematology & Pathology 9
may be aSSx for yrs prior to onset of met MFxs. Dx is gen made when a histopath sample Oncology (Path)
shows cellular atypia w/ cells containing brown pigment (melanin granules); immunostaining (HO)
for melanin/melanoma markers (e.g. S-100, HMB-45) is gen (+). HO Path
15466
Multiple myeloma MM is a/w the clonal proliferation of plasma cells in the bone marrow. This prevents normal Hematology & Immunolo 9
B cell lymphogenesis and incr. the risk of bacterial infection due to decr. production of Oncology gy (Immu)
normal Igs. (HO) HO Immu
15467
Multiple myeloma MM is a plasma cell malignancy that replicates in the bone marrow and causes osteolytic Hematology & Pathology 9
bone lesions, bone destruction, hypercalcaemia, and path fractures. Histopath will show Oncology (Path)
replacement of the normal bone marrow w/ plasma cells and blasts. (HO) HO Path
15489
Hemophilias hemophilia A is an XL disorder a/w a defic of FVIII. Emicizumab — a bispecific, mAb — Hematology & Pharmacol 1
mimics the activity of FVIII by binding to both FIXa and FX, bringing them into close Oncology ogy (Phar)
proximity to allow for FX activation. (HO) HO Phar
15545
Chronic CLL is a chronic LPD marked by the progressive accumulation of mature B cells. Most pts Hematology & Pathology 1
lymphocytic are aSSx for yrs but eventually develop anemia, thrombocytopenia, a/o neutropenia. The Dx Oncology (Path)
leukemia is generally made when CBC reveals dramatic leukocytosis, and FC subsequently shows a (HO)
clonal population of leukocytes w/ typical B-cell markers such as CD19, CD20, and CD23. HO Path
15562
Sickle cell PVB19 infection can cause transient aplastic crisis, particularly in those w/ underlying Hb Hematology & Pathology 13
disorders such as SCA. Pts develop SSx anaemia (e.g. exertional dyspnoea, fatigue, low Hct) Oncology (Path)
due to inhib of erythropoiesis by the virus. Bone marrow Ex will show giant pronormoblasts (HO)
w/ glassy, intranuclear viral inclusions. HO Path
15635
Bone tumor ES is the 2nd most common malignant bone tumor of childhood (after OS). It most Hematology & Pathology 3
commonly involves the lower extremity and pelvis and often metastasizes to the lungs. Oncology (Path)
Histopathology is Chx by uniform, small, round, cells; fibrous septae; and patches of (HO)
necrosis and hemorrhage. HO Path
15645
Bone tumor OS is the most common 1° bone malignancy in children and young adults. It occurs most Hematology & Pathology 3
frequently at the metaphyses of long bones and Px w/ local pain and swelling. Most cases are Oncology (Path)
a/w sporadic or inherited mutations in RB1 (HRb) and TP53 (LFS). (HO) HO Path
15706
Chemotherapy CTx-induced nausea and vomiting is mediated by peri and central mechs. It can be Tx w/ 5- Hematology & Pharmacol 1
induced nausea and HT receptor antagonists (e.g. ondansetron) to prevent 5-HT stim of afferent vagal fibres in Oncology ogy (Phar)
vomiting the bowel wall (peri cause) and NK-1 receptor antagonists (e.g. aprepitant) to prevent the (HO)
effects of substance P in the brainstem (central cause). HO Phar
15821
BCL 2 CLL is a/w overexpression of BCL-2, an anti-apoptotic protein, on the mitochondrial Hematology & Pharmacol 1
membrane. Tx w/ a BCL inhib causes ca cell death by promoting cyt c release from the Oncology ogy (Phar)
mitochondria, which subseq activates caspases. (HO) HO Phar
D eats
16287
Vitamin B12 Vit B12 is an essential cofactor in the recycling of 5MTHF to THF, which is req for AA, Hematology & Pathophysi 9
deficiency purine, and thymidine synth. Defic 1arily affect HPO cell maturation and is marked by incr Oncology ology
nuclear-cytoplasmic ratio, leading to macrocytic RBCs and hyperseg neutrophils; incr (HO) (Patp)
apoptosis often also leads to anemia and mild thrombocytopenia/leukopenia. HO Patp
16441
DIC Acute DIC is a consumptive coagulopathy linked to severe trauma. Widespread formation of Hematology & Pathology 5
microvascular thrombi leads to consumption of platelets, coagulation factors, and fibrinogen. Oncology (Path)
Subsequent activation of anticoagulant proteins leads to low protein C/S; fibrinolysis ↑ D- (HO)
dimer. Most pts have bleeding complications (eg, oozing from venipuncture/catheter sites)
and EOD to the lungs or kidneys. HO Path
16442
DIC DIC is marked by widespread activation of the coag cascade, leading to excessive FIIa Hematology & Pathophysi 5
production and formation of microthrombi. Subseq conversion of plasminogen to plasmin Oncology ology
results in incr fibrinolysis to clear the thrombi. LFx show a consumption of CFs (prolonged (HO) (Patp)
PT/PTT) and platelets (thrombocytopenia) and SSx of excessive fibrinolysis (e.g. incr D-
dimer). HO Patp
16705
von Willebrand vWD is the most common inherited bleeding disorder and is usually transmitted in an AD Hematology & Pathophysi 7
disease fashion. SSx pts typically Px w/ easy bruising and mucosal bleeding. LFx will show normal Oncology ology
platelets, normal PT, and either normal or prolonged PTT due to low levels of factor VIII. (HO) (Patp) HO Patp
44 Hepatitis C Genetic variations created during HCV replication result in marked variety in the Agic Infectious Microbiolo 4
structure of HCV envelope proteins. The production of host Abs lags behind that of new Diseases (ID) gy (Micr)
mutant HCV strains, preventing infected individuals from mounting an effective immune
response. ID Micr
45 Hepatitis D HDV is a replication-defective RNA virus that's capable of causing infection only in the Infectious Microbiolo 2
setting of coinfection w/ HBV. HBV provides HBsAg for the HDV envelope. Diseases (ID) gy (Micr) ID Micr
46 Hepatitis B Infants born to HBeAg-positive mothers have a high risk of acquiring perinatal hepatitis B Infectious Microbiolo 14
virus (HBV) infection. Infected neonates have high levels of HBV replication and are at high Diseases (ID) gy (Micr)
risk for chronic infection, but are usually asymptomatic or have only mildly elevated liver
function tests. ID Micr
48 Hepatitis E HEV is an unenveloped, ssRNA virus spread thru the faecal-oral route. The most concerning Infectious Microbiolo 1
feature of hepE infection is the high mortality rate observed in infected preg women. Diseases (ID) gy (Micr) ID Micr
60 Hepatocellular Universal vaccination of children against HBV would likely cause a steep decline in the Infectious Pathology 5
cancer worldwide incidence of hepatocellular carcinoma. Diseases (ID) (Path) ID Path
61 Echinococcosis Echinococcus granulosus is the most common cause of hydatid cysts. Spilling of cyst Infectious Pathophysi 1
contents can cause anaphylactic shock. Surgical manipulation should be performed with Diseases (ID) ology
caution. (Patp) ID Patp
105Aspergillosis Immsup pts are at risk for A. fumigatus infection. This fungus produces thin, septate hyphae Infectious Microbiolo 5
w/ acute V-shaped branching. It causes invasive aspergillosis, aspergillomas, and allergic Diseases (ID) gy (Micr)
pulm aspergillosis. ID Micr
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106Mucormycosis Mucormycosis is an opportunistic infection caused by Rhizopus, Mucor, and Absidia Infectious Microbiolo 3
species. The classic clinical picture is paranasal sinus involvement in a diabetic or immsup Diseases (ID) gy (Micr)
pt. The fungi form broad non-septate hyphae that branch at right angles. ID Micr
107Mucormycosis Facial pain, headache, and black necrotic eschar in the nasal cavity in a pt w/ DKA are Infectious Microbiolo 3
highly suggestive of mucormycosis. Histo Ex of the affected tissue is necessary to confirm Diseases (ID) gy (Micr)
the Dx. The fungi show broad non-septate hyphae w/ right-angle branching. Tx consists of
Sx debridement and antifungal therapy. ID Micr
109Febrile neutropenia Candida albicans is the most common cause of opportunistic mycosis. It can affect any organ Infectious Microbiolo 4
and cause gen candidaemia. Yeasts and pseudohyphae on LM and a (+) germ tube test are Diseases (ID) gy (Micr)
Dx of Candida albicans infection. ID Micr
111Mucocutaneous Oral thrush is caused by Candida albicans infection and usually presents as white, plaque- Infectious Microbiolo 3
candidiasis like oropharyngeal lesions that're easily scraped off w/ a tongue depressor. Most cases arise Diseases (ID) gy (Micr)
in those who have disruptions to normal flora due to Abx or impairments in cell-mediated
immunity from chemotherapy, inhaled corticosteroids, or HIV. Young, otherwise healthy pts
w/ thrush should be tested for HIV, particularly if they have HIV RFs or other SSx of the
virus. ID Micr
112Febrile neutropenia Local defense against Candida is performed by T cells, whereas systemic infection is Infectious Immunolo 4
prevented by neutrophils. For this reason, localized candidiasis is common in patients who Diseases (ID) gy (Immu)
have HIV, but neutropenic individuals are more likely to have the systemic form of the
disease. ID Immu
271Antibiotic resistance The main groups of antifungal Rx are polyenes, azoles, echinocandins, and pyrimidines. Infectious Microbiolo 8
Polyene antifungals (eg, amphotericin B, nystatin) act by binding ergosterol in the fungal cell Diseases (ID) gy (Micr)
membrane. ID Micr
273Aspergillosis Amphotericin B binds the ergosterol of fungal cell membranes to exert its antifungal effects. Infectious Pharmacol 5
However, it also binds chol to some degree, causing tox to human tissues. The most Diseases (ID) ogy (Phar)
important AEs of amphotericin B are nephrotox, hypokalaemia, and hypomagnesaemia. ID Phar
274Mucormycosis Amphotericin B is a polyene antifungal drug notorious for its renal tox. Severe hypokalaemia Infectious Pharmacol 3
and hypomagnesaemia are commonly seen during therapy and often req daily Diseases (ID) ogy (Phar)
supplementation. ID Phar
275Adverse drug Hypokalaemia and hypomagnesaemia are common electrolyte disturbances in pts undergoing Infectious Pharmacol 2
reaction Tx w/ amphotericin B and reflect an ↑ in DCT membrane permeability. Diseases (ID) ogy (Phar) ID Phar
276Azoles Azoles inhibit the synthesis of ergosterol by the fungal cytochrome P450 enzymes. They also Infectious Pharmacol 1
suppress the human P450 system, resulting in many drug-drug interactions. Diseases (ID) ogy (Phar) ID Phar
277Antibiotic resistance Echinocandins (e.g. caspofungin, micafungin) are antifungal Rx that inhib synthesis of the Infectious Microbiolo 8
polysaccharide glucan, an essential component of the fungal cell wall. Diseases (ID) gy (Micr) ID Micr
373Hepatitis A HAV infection is most commonly silent or subclinical ('anicteric') in young children but can Infectious Microbiolo 4
also present as an acute, self-limited illness characterised by jaundice, malaise, fatigue, Diseases (ID) gy (Micr)
anorexia, nausea, vomiting, RUQ pain, or an aversion to smoking. ID Micr
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374Hepatitis B The HBV replicated via the following seq: dsDNA → (+)RNA template → partially dsDNA Infectious Microbiolo 14
progeny. Although it's a DNA virus, HBV uses reverse transcriptase to generate new viral Diseases (ID) gy (Micr)
DNA from a (+)-sense RNA template. ID Micr
376Hepatitis B Replication of the hepatitis B genome occurs w/i a newly synthesized capsid through the Infectious Microbiolo 14
action of reverse transcriptase on an RNA template. The mature capsid contains partially ds Diseases (ID) gy (Micr)
circular DNA and reverse transcriptase. ID Micr
377Hepatitis B Individuals who are successfully immunized against HBV develop protective anti-HBs Ab. Infectious Microbiolo 14
Individuals who recover from hepatitis B infection, however, have anti-HBs as well as anti- Diseases (ID) gy (Micr)
HBc Abs. The presence of circulating HBsAg indicates active infection. ID Micr
378Hepatitis B Vertical transmission of hepB from preg females to the unborn child can occur in women w/ Infectious Microbiolo 14
active hepB infection. The presence of HBeAg (a marker of viral replication and ↑ Diseases (ID) gy (Micr)
infectivity) in the mother greatly ↑ the risk of vertical transmission of the virus. B/c of this
concern, the newborns of all mothers w/ active hepB are passively immunised at birth w/
HBIG, f/b active immunisation w/ recombinant HBV vax. ID Micr
379Hepatitis B If HBeAg persists for several months and host anti-HBeAg remain at low or undetectable Infectious Microbiolo 14
levels, suspect chronic hepatitis B infection with high infectivity. Diseases (ID) gy (Micr) ID Micr
380Hepatitis B The presence of anti-HBc and anti-HBs antibodies in the serum without detectable viral Infectious Immunolo 14
antigens indicates recovery from acute hepatitis B infection. In contrast, patients vaccinated Diseases (ID) gy (Immu)
against hepatitis B will have anti-HBs antibodies without detectable levels of anti-HBc.
Chronic hepatitis B is indicated by persistent levels of HBsAg and HBV DNA in the serum. ID Immu
390Hepatitis B The most common outcome in HBV-infected adults (>95%) is acute hepatitis w/ mild or Infectious Microbiolo 14
subclinical SSx that eventually completely resolve. Diseases (ID) gy (Micr) ID Micr
472Syphilis Tertiary syphilis can result in thoracic aortic aneurysm. If the aneurysm compresses adjacent Infectious Pathology 9
structures and dilates the aortic valve ring, a murmur and mediastinal widening might be Diseases (ID) (Path)
present. The pathogenesis begins with vasa vasorum endarteritis and obliteration, resulting in
inflammation, ischemia, and weakening of the aortic adventitia. Fluorescent treponemal
antibody absorption testing is specific for syphilis. ID Path
483Human HPV is a small DNA virus w/ a tropism for stratified squamous epithelium, which Infectious Histology 4
papillomavirus protectively lines anatomical areas that undergo frequent friction and abrasion, including the Diseases (ID) (Hist)
true vocal cords, cervix, and anus. Infants can acquire resp papillomatosis via passage
through an HPV-infected birth canal. ID Hist
532Lung abscess Lung abscess usually occurs in individuals w/ episodes of impaired consciousness (e.g. Infectious Microbiolo 4
alcohol/drug abuse, dementia) or ↓ ability to swallow (e.g. oesophageal strictures). They're Diseases (ID) gy (Micr)
gen caused by aspiration of anaerobic and aerobic bacteria from the oral cavity into the LRT. ID Micr
D eats
560Gonococcal IgA protease is produced by N. meningitidis, N. gonorrhoeae, S. pneumoniae, and H. Infectious Microbiolo 3
infection influenzae. This enzyme cleaves secretory IgA at its hinge region, rendering it ineffective. Diseases (ID) gy (Micr)
Secretory IgA exists on mucosal surfaces and in secretions and acts to bind and inhib the
action of pili as well as other cell surface Ags that normally mediate mucosal adherence and
subseq penetration. ID Micr
643Antibiotic resistance The mech of vancomycin resistance in organisms such as VRE is a substitution of D-lactate Infectious Pharmacol 8
in the place of D-alanine during the process of PGCW synthesis. This prevents the binding of Diseases (ID) ogy (Phar)
vancomycin to its usual D-ala-D-ala binding site in the cell wall. ID Phar
651Syphilis The clinical Px of 3° syphilis includes CV involvement and gummas. Gummas are Infectious Microbiolo 9
necrotizing granulomas occurring on the skin, mucosa, subcutaneous tissue, and bones and Diseases (ID) gy (Micr)
w/i other organs. Neurosyphilis can occur at any stage of infection. ID Micr
676Toxic shock Superantigens (eg, toxic shock syndrome toxin) interact with major histocompatibility Infectious Immunolo 2
syndrome complex molecules on antigen-presenting cells and the variable region of the T lymphocyte Diseases (ID) gy (Immu)
receptor to cause nonspecific, widespread activation of T cells. This results in the release of
interleukin (IL)-2 from the T cells and IL-1 and tumor necrosis factor from macrophages.
This immune cascade is responsible for the manifestations of toxic shock syndrome. ID Immu
677Skin and soft tissue Protein A is a virulence factor found in the PGCW of S. aureus that binds to the Fc portion of Infectious Microbiolo 8
infections IgG, leading to impaired complement activation, opsonisation, and phagocytosis. Diseases (ID) gy (Micr) ID Micr
678Urinary tract S. saprophyticus is responsible for almost half of all UTIs in sexually active young women. Infectious Microbiolo 12
infection S. saprophyticus belongs to coag (-) staphylococci (CoNS) and is unique among these b/c it's Diseases (ID) gy (Micr)
resistant to novobiocin. ID Micr
722Poststreptococcal GN is a/w prior streptococcal pharyngeal or skin infection; acute RF is a/w prior Infectious Microbiolo 8
glomerulonephritis streptococcal pharyngitis but not skin infection. Streptococci are catalase (-), staphylococci Diseases (ID) gy (Micr)
are catalase (+). Streptococcus pyogenes (GAS) is β-hemolytic, bacitracin-susceptible, and
pyrrolidonyl arylamidase (+). Streptococcus pneumoniae is bile-soluble and optochin-
susceptible. ID Micr
723Pharyngitis The major virulence factor of S. pyogenes is M protein, an α-helical coiled-coil protein that Infectious Microbiolo 2
shares structural homology w/ tropomyosin and myosin. It extends from the cell wall and Diseases (ID) gy (Micr)
prevents phagocytosis, inhibs complement binding, and mediates bacterial adherence. Abs
against M protein form shortly after acute infection and may cross-react w/ epitopes on
myosin, leading to rheumatic carditis. ID Micr
724Rheumatic fever Acute rheumatic fever is an autoimmune reaction following an untreated group A Infectious Pathophysi 5
streptococcal pharyngitis. Anti-group A Streptococcus antibodies (eg, anti-M protein, anti-N- Diseases (ID) ology
acetyl-β-D glucosamine) cross-react and attack cardiac and central nervous system antigens. (Patp) ID Patp
725Skin and soft tissue ARF and PSGN are post-infectious complications of GAS (S pyogenes) infections. PSGN Infectious Microbiolo 8
infections can follow either streptococcal skin infection (impetigo) or streptococcal pharyngitis, Diseases (ID) gy (Micr)
whereas ARF is classically associated only w/ streptococcal pharyngitis. ID Micr
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727Skin and soft tissue S. aureus is the most common cause of skin and soft-tissue abscess (e.g. furuncle). Tx of the Infectious Microbiolo 8
infections abscess w/ incision and drainage and Abx can eliminate the local infection but doesn't Diseases (ID) gy (Micr)
eliminate colonisation of the anterior nares and skin. Therefore, recurrent infections are
common. ID Micr
728Catheter related Nosocomial bloodstream infections are usually a/w intravascular catheters, which allow skin Infectious Microbiolo 3
bloodstream commensals such as S. aureus and CoNS to enter the bloodstream. Diseases (ID) gy (Micr)
infection ID Micr
736Bacterial gene S. pneumoniae is able to undergo transformation, which allows the bacterium to take up Infectious Microbiolo 1
transfer exogenous DNA fragments and express the encoded proteins. Thru this method, strains of S. Diseases (ID) gy (Micr)
pneumoniae that don't form a capsule can acq the genes that code for the capsule and
therefore gain virulence. ID Micr
739Complement Deficiency of the complement factors that form the membrane attack complex (i.e., C5b-C9) Infectious Immunolo 1
deficiency results in recurrent infections by Neisseria species. Diseases (ID) gy (Immu) ID Immu
760Tetanus Clostridium tetani produces the neurotoxin tetanospasmin, which blocks inhibitory Infectious Immunolo 5
neurotransmission in the spinal cord and leads to tonic muscular contraction. Tetanus is Diseases (ID) gy (Immu)
prevented by immunization with an inactivated toxoid that triggers the production of
antitoxin antibodies (active immunity). ID Immu
819Antiretroviral PIs are HIV ARV Rx that inhib cleavage of the polypeptide precursor into mature viral Infectious Pharmacol 7
therapy proteins. Their AEs as a class incl. hyperglycaemia, lipodystrophy, and drug-drug Diseases (ID) ogy (Phar)
interactions due to inhib of CYP450. ID Phar
953HIV The chemokine receptor CCR5 is a coreceptor that enables the HIV virus to enter cells. Infectious Microbiolo 11
Blockade of CCR5 by chemokine receptor antagonists prevents viral entry into host cells. Diseases (ID) gy (Micr) ID Micr
959Cephalosporins Penicillins, cephalosporins, and vancomycin are able to disrupt the PGCW of gram (+) and Infectious Pharmacol 2
gram (-) organisms. The PGCW of these organisms gives them the ability to survive osmotic Diseases (ID) ogy (Phar)
stress; this ability is lost after Tx w/ these Abx agents. ID Phar
963Haemophilus Haemophilus influenzae is a "blood-loving" organism that requires X (hematin) and V Infectious Microbiolo 2
influenzae (NAD+) factors for growth. This can be accomplished by growing H influenzae in the Diseases (ID) gy (Micr)
presence of Staphylococcus aureus and demonstrating the "satellite phenomenon," whereby
H influenzae grow only near the β-hemolytic S aureus colonies that produce the needed X
and V factors. ID Micr
968Tetanus Neonatal tetanus can be prevented by hygienic delivery and umbilical cord care and Infectious Microbiolo 5
universal immunisation of women who're preg or may become preg. Immunised mothers Diseases (ID) gy (Micr)
provide passive immunity via transplacental IgG, protecting infants until they receive active
immunisation (vax) around age 2mos. ID Micr
972Anthrax Bacillus anthracis is a large, sporulating, gram-positive rod that is encased in an Infectious Microbiolo 1
antiphagocytic polypeptide capsule composed of D-glutamic acid. Inhalation of B anthracis Diseases (ID) gy (Micr)
spores can cause pulmonary anthrax, which is usually characterized by nonspecific
symptoms followed by hemorrhagic mediastinitis, shock, and death. ID Micr
D eats
976Cholera V. cholerae and ETEC cause a purely toxin-mediated watery diarrhoea. The toxins secreted Infectious Microbiolo 2
by these organisms modify electrolyte handling by enterocytes but don't cause cell death; Diseases (ID) gy (Micr)
therefore, no erythrocytes or leucocytes are typically noted on stool micro. ID Micr
977Cholera V. cholerae must survive the acidic environment of the stomach to reach the small intestine Infectious Microbiolo 2
and cause disease. B/c the organism is easily destroyed by acid, a high burden of organisms Diseases (ID) gy (Micr)
must be ingested to cause infection. However, conditions that ↓ gastric acidity (e.g. antacid
use) ↓ the minimum infectious dose of V. cholerae by multi orders of magnitude. ID Micr
1000
Aminoglycoside Aminoglycoside (e.g. gentamicin) resistance is most commonly due to Abx-modding Infectious Pharmacol 3
enzymes. These enzymes add chem groups to the Abx, which diminishes its ability to bind to Diseases (ID) ogy (Phar)
the 16S rRNA w/i the 30S ribosomal subunit. ID Phar
1004
Meningitis Rifampin is the most frequently used agent for chemoprophylaxis of meningococcal disease. Infectious Microbiolo 17
Persons with exposure to the respiratory secretions of a patient with meningococcal disease Diseases (ID) gy (Micr)
require chemoprophylaxis. Vaccination is an important public health strategy but is not
useful for post exposure prophylaxis. ID Micr
1007
Septic arthritis Septic arthritis in a young, sexually active adult should raise suspicion for disseminated N. Infectious Microbiolo 4
gonorrhoeae infection. Pts may also have the triad of polyarthritis, a vesiculopustular skin Diseases (ID) gy (Micr)
rash, and tenosynovitis. N. gonorrhoeae is a gram (-) diplococci that's usually ID'd by micro,
culture, or NAAT. ID Micr
1024
Meningococci The Thayer-Martin medium is used to isolate pathogenic Neisseria species such as N. Infectious Microbiolo 1
meningitidis and N. gonorrhoeae. It's a chocolate sheep blood agar that contains vancomycin Diseases (ID) gy (Micr)
to inhib the growth of gram (+) organisms; colistin and trimethoprim to inhib gram (-)
bacteria (other than pathogenic Neisseria); and nystatin to inhib yeasts. ID Micr
1025
Gonococcal Gonococci use their pili to mediate adherence to the mucosal epithelium. Through Ag Infectious Microbiolo 3
infection variation, each gonococcus can modify the pilus protein expressed, thereby avoiding host Diseases (ID) gy (Micr)
defenses (to some degree) and making vax directed against the pilus protein difficult. ID Micr
1026
Urethritis N. gonorrhoeae has high antigenic variability of its surface molecules (e.g. porins, Opa Infectious Microbiolo 4
proteins), which prevents the formation of protective immunity and leads to susceptibility to Diseases (ID) gy (Micr)
repeat infection. ID Micr
1045
Measles VitA can be beneficial in the Tx of measles infection by ↓ comorbidities (e.g. ocular Infectious Microbiolo 3
complications, diarrhoea, pneumonia), recovery time, and length of hospital stay. Diseases (ID) gy (Micr) ID Micr
1091
Penicillin β-lactamase inhibs (e.g. clavulanic acid, sulbactam, tazobactam) prevent β-lactamase from Infectious Pharmacol 2
inactivating penicillin class drugs, which extends the spectrum of their activity. Diseases (ID) ogy (Phar) ID Phar
1092
Diphtheria Toxigenic strains of C. diphtheria produce diphtheria toxin, which irreversibly inhibs host Infectious Microbiolo 6
protein synthesis due to ADP-ribosylation of EF-2. Local effects incl pseudomembranous Diseases (ID) gy (Micr)
pharyngitis; systemic effects incl potentially life-threatening myocarditis and neuritis.
Immunisation w/ diphtheria toxoid generates protective circulating IgG against the exotoxin
B subunit. ID Micr
D eats
1093
Diphtheria Diphtheria exotoxin inhibs host cell protein synthesis by catalysing the ADP-ribosylation of Infectious Microbiolo 6
host cell EF-2. Diseases (ID) gy (Micr) ID Micr
1094
Diphtheria Diphtheria toxin is an AB exotoxin that ribosylates and inactivates EF-2. This action inhibits Infectious Microbiolo 6
protein synthesis and ultimately leads to cell death. Diseases (ID) gy (Micr) ID Micr
1099
Acute diarrhea Traveller's diarrhoea is most freq due to ETEC. This pathogen produces plasmid-encoded, Infectious Microbiolo 13
heat-labile (LT, choleragen-like) and heat-stable (ST) enterotoxins. LT activates adenylate Diseases (ID) gy (Micr)
cyclase, leading to ↑ intracellular cAMP; ST activates guanylate cyclase leading to ↑
intracellular cGMP. Both cause water and electrolyte loss and watery diarrhoea. ID Micr
1101
Pertussis B. anthracis oedema factor is an adenylate cyclase that ↑ intracellular cAMP, leading to Infectious Microbiolo 3
neutrophil and macrophage dysfxn and tissue oedema. This MOA is similar to that of Diseases (ID) gy (Micr)
adenylate cyclase toxin, produced by B. pertussis. ID Micr
1103
Meningitis The Hib vax induces anticapsular Abs that facilitate complement-mediated phagocytosis of Infectious Microbiolo 17
the bacterium. The vax series has drastically ↓ the incidence of invasive disease caused by Diseases (ID) gy (Micr)
Hib, such as meningitis, bacteremia, pneumonia, and epiglottitis. ID Micr
1104
Folate TMP, MTX, and pyrimethamine inhib DHFR. TMP restricts bacterial growth thru this Infectious Pharmacol 1
antimetabolites process, and works particularly well in conjunction w/ sulphonamide, which inhibs an earlier Diseases (ID) ogy (Phar)
step in the bacterial vitB9 pathway. ID Phar
1135
Acute diarrhea Shigella is a non-motile, non-lactose fermenting organism that doesn't produce H2S when Infectious Microbiolo 13
grown on triple sugar Fe agar. Mucosal invasion of the M cells that overlie Peyer's patches is Diseases (ID) gy (Micr)
an essential pathogenic mech for Shigella infection. Shigella then escapes the phagosome
and spreads laterally to other epithelial cells via actin polymerisation. ID Micr
1137
Typhoid Typhoid strains of Salmonella contain a capsular Ag (Vi) that inhibs neutrophil Infectious Microbiolo 2
phagocytosis, neutrophil recruitment, and macrophage-mediated destruction. Therefore, Diseases (ID) gy (Micr)
typhoid strains are able to undergo extensive replication w/i the intracellular space of
macrophages w/ subseq spread thru the lymphatic and RES, leading to a widespread systemic
disease (typhoid fever). ID Micr
1138
Typhoid Typhoid fever is caused by S. typhi or paratyphi and presents w/ escalating fever, f/b abdo Infectious Microbiolo 2
pain, formation of rose spots on the chest/abdo, and hemorrhagic enteritis w/ possible bowel Diseases (ID) gy (Micr)
perforation. Humans are the only reservoir; transmission is faecal-oral and 1arily occurs due
to ingestion of food or water contaminated w/ faeces. ID Micr
1139
Urinary tract E coli is one of the dominant components of the normal flora in the intestinal tract of humans Infectious Microbiolo 12
infection and animals. It causes approximately 80% of all UTIs. P fimbriae are the most important VF Diseases (ID) gy (Micr)
that UPEC express. W/o P fimbriae, E coli would not be able to bind to uroepithelial cells
and infect the bladder, ureters, and kidneys. Instead, the bacteria would simply be washed
away during urination. ID Micr
D eats
1141
Septic shock Gram (-) sepsis is caused by the release of LPSs from bacterial cells during cell division or Infectious Microbiolo 6
bacteriolysis. Lipid A is the toxic component of LPSs and induces the widespread release of Diseases (ID) gy (Micr)
IL-1 and TNF-α from activated macrophages. These cytokines cause the SSx of septic shock
(eg, fever, hypotension, organ dysfunction). ID Micr
1142
Urinary tract Escherichia coli is the most common cause of UTI in both healthy adults and elderly pts. E Infectious Microbiolo 12
infection coli is a part of the normal GI flora, and special adhesive proteins (fimbriae) allow some Diseases (ID) gy (Micr)
strains to colonize and ascend the urinary tract. This can result in UTI, pyelonephritis, or
bacteremia and sepsis following access to the bloodstream. UTIs are the most common cause
of E coli bacteremia. ID Micr
1154
Lymphogranuloma C. trachomatis serotypes L1 thru L3 cause LGV, an STD characterised initially by painless Infectious Microbiolo 1
venereum ulcers w/ later progr to painful inguinal LAD ('buboes') and ulceration. Chlamydial inclusion Diseases (ID) gy (Micr)
bodies are seen in host cell cytoplasm. ID Micr
1198
Diabetic foot Piperacillin-tazobactam is a combo of extended-spectrum penicillin w/ β-lactamase inhib. It's Infectious Pharmacol 2
effective against most gram (-) enteric rods (incl P. aeruginosa) and against B. fragilis. Diseases (ID) ogy (Phar) ID Phar
1223
Tuberculosis Mycobacterial resistance to INH can be accomplished thru non-expression of the catalase- Infectious Microbiolo 18
peroxidase enzyme or thru genetic mod of the INH binding site on the mycolic acid synthesis Diseases (ID) gy (Micr)
enzymes. ID Micr
1225
Tuberculosis Active TB is never Tx w/ Rx monotherapy due to the fast emergence of mycobacterial Abx Infectious Microbiolo 18
resistance from rapid, selective gene muts. INH monotherapy may be used for pts who have Diseases (ID) gy (Micr)
a (+) PPD and a (-) CXR (i.e. no evidence of clinical disease). ID Micr
1226
Tuberculosis The rifamycins block the action of the bacterial DNA-dependent RNA polymerase, thereby Infectious Pharmacol 18
inhib transcription. Resistance is acq by mod of the rifampin binding site on the bacterial Diseases (ID) ogy (Phar)
DNA-dependent RNA polymerase. Common AEs incl hepatotox, blood dyscrasias, and
harmless red-orange discolouration of body fluids. ID Phar
1228
Tuberculosis Ethambutol can cause optic neuropathy that results in colour blindness, central scotoma, and Infectious Pharmacol 18
↓ visual acuity. This AE may be reversed w/ discontinuation of the drug. Diseases (ID) ogy (Phar) ID Phar
1309
Tuberculosis Isoniazid is an antimycobacterial agent that specifically inhibits the synthesis of mycolic Infectious Pharmacol 18
acids, which are essential components of the unique mycobacterial peptidoglycan cell wall. Diseases (ID) ogy (Phar)
Without mycolic acids, the mycobacteria lose their acid-fastness and become unable to
synthesize new cell walls or multiply. ID Phar
1310
Antibiotic resistance The aminoglycoside streptomycin inhibs protein synthesis by inactivating the 30S (small) Infectious Microbiolo 8
ribosomal subunit. ↓ activity of bacterial catalase-peroxidase is a mech of mycobacterial Diseases (ID) gy (Micr)
resistance to INH. Structural alteration of enzymes involved in RNA synthesis (DNA-
dependent RNA polymerase) is the mech thru which organisms become resistant to rifampin. ID Micr
1312
Mycobacterium MAC infections are common in pts w/ advanced AIDS. The bacterium often spreads thru the Infectious Pharmacol 1
avium intracellulare bloodstream and RES and causes nonspecific SSx (e.g. fever, fatigue, weight loss, Diseases (ID) ogy (Phar)
complex diarrhoea), LAD, and HSM. Dx is often made on blood culture or bone marrow aspirate
(intracellular acid-fast bacteria that aren't M. tuberculosis). ID Phar
D eats
1315
Syphilis Pts w/ early syphilis (e.g. chancre) often have false (-) initial serologic testing. Direct Infectious Microbiolo 9
visualisation of the organism (T. pallidum) by dark-field micro or fluorescent Ab testing is Diseases (ID) gy (Micr)
the gold standard for Dx but isn't widely available. ID Micr
1316
Syphilis Syphilis is caused by the spirochete T. pallidum. Confirmation of the Dx req 2 forms of Infectious Microbiolo 9
serologic testing to prevent false (+) results. Non-treponemal tests (e.g. RPR, VDRL) Diseases (ID) gy (Micr)
evaluate for anticardiolipin Abs (nonspecific); treponemal tests evaluate for Abs targeted
against T. pallidum. ID Micr
1374
Parvovirus Infection w/ PVB19 (a nonenveloped ss DNA virus) can cause arthralgia +/- rash in adults. Infectious Microbiolo 3
An infected fetus may develop hydrops fetalis (severe anemia, HF, pleural effusions, Diseases (ID) gy (Micr)
pericardial effusions, and ascites). ID Micr
1377
Influenza Alc-based disinfectants kill enveloped viruses (eg, influenza) by dissolving their outer lipid Infectious Microbiolo 5
envelope. Nonenveloped viruses are less susceptible to some Alc-based disinfectants b/c they Diseases (ID) gy (Micr)
have no lipid envelope to target. ID Micr
1389
Diphtheria Lysogenic bacteriophages are responsible for converting non-pathogenic Corynebacterium Infectious Microbiolo 6
into toxigenic Corynebacterium. Toxigenic strains elaborate the diphtheria exotoxin, which Diseases (ID) gy (Micr)
causes pseudomembranous pharyngitis and potentially life-threatening systemic effects (e.g.
myocarditis, neuritis). ID Micr
1390
Diphtheria Diphtheria toxin and pseudomonal exotoxin A act by ribosylating and inactivating EF-2, Infectious Microbiolo 6
inhibiting host cell protein synthesis and causing cell death. Diseases (ID) gy (Micr) ID Micr
1391
Listeria L. monocytogenes is a facultative, intracellular, gram (+) rod that produces a very narrow Infectious Microbiolo 1
zone of β hemolysis on blood agar, shows tumbling motility at room temp, and can grow at Diseases (ID) gy (Micr)
refrigerated temps. Intracellular pathogens such as Listeria are largely eliminated by the cell-
mediated immune response (e.g. T-cells, macrophages, cytokines). Pts w/ impaired cell-
mediated immunity are at risk for invasive Listeria infections. ID Micr
1393
Meningitis Ampicillin is the treatment of choice for Listeria, which is not sensitive to cephalosporins. Infectious Microbiolo 17
Listeria most commonly causes disease in those with deficient cell-mediated immunity, such Diseases (ID) gy (Micr)
as young infants or immunocompromised patients. ID Micr
1394
Clostridial Clostridium perfringens causes late-onset food poisoning and clostridial myonecrosis (gas Infectious Microbiolo 3
myonecrosis gangrene). The food poisoning is toxin-mediated, late-onset, and causes transient watery Diseases (ID) gy (Micr)
diarrhea. ID Micr
1409
HSV infection 1° HSV-1 infection in children causes gingivostomatitis (vesicular lesions on the lips and Infectious Microbiolo 9
hard palate). HSV-1 and other herpesviruses are enveloped dsDNA viruses. Diseases (ID) gy (Micr) ID Micr
1411
Influenza The tissue tropism of viruses is 1arily mediated by viral surface glycoproteins that bind to Infectious Microbiolo 5
specific host cell receptors. muts to viral surface glycoproteins can alter tissue tropism and Diseases (ID) gy (Micr)
cause noninfective viruses to become infectious. ID Micr
1461
Viral genetics Recombination refers to gene exchange that occurs through the crossing over of 2 ds DNA Infectious Microbiolo 4
molecules. Reassortment describes the mixing of genome segments in segmented viruses that Diseases (ID) gy (Micr)
infect the same host cell. ID Micr
D eats
1462
Viral genetics Phenotypically mixing refers to coinfection of a host cell by 2 viral strains, resulting in Infectious Microbiolo 4
progeny virions that contain nucleocapsid proteins from 1 strain and the unchanged parental Diseases (ID) gy (Micr)
genome of the other strain. B/c there's no change in underlying viral genomes (no genetic
exchange), the next gen of virions revert to their original, unmixed phenotypes. ID Micr
1463
HIV ART during preg ↓ the risk of perinatal transmission of HIV to 1-2% and is recommended Infectious Microbiolo 11
for all preg women w/ HIV. Diseases (ID) gy (Micr) ID Micr
1465
Rabies In the US, bats are the main source of rabies (only transmitted by mammals). Agitation and Infectious Microbiolo 2
spasms progressing to coma w/i wks of exposure is strongly suggestive of rabies Diseases (ID) gy (Micr)
encephalitis. Prophylactic vax is recommended for individuals at high risk for exposure to
rabid animals or their tissues. The approved rabies vax consist of various rhabdovirus strains
grown in tissue cell culture and then inactivated. ID Micr
1466
Immunizations Inactivated (killed or component) viral vaccines primarily generate a humoral immune Infectious Immunolo 4
response against extracellular viral antigens, preventing viral entry into the cell. In contrast, Diseases (ID) gy (Immu)
live attenuated viral vaccines can generate a strong cell-mediated immune response that can
kill virally-infected cells, in addition to providing humoral immunity. ID Immu
1469
Viral genetics Viruses with segmented genomes (eg, orthomyxoviruses, rotaviruses) are capable of genetic Infectious Genetics 4
shifts through reassortment. Reassortment (genetic shift) involves exchange of entire Diseases (ID) (Gene)
genomic segments, a far more dramatic process than the point mutations responsible for
genetic drift. ID Gene
1471
Escherichia coli During bacterial DNA replication, DNA polymerase I functions to remove RNA primers (via Infectious Biochemist 1
5' to 3' exonuclease activity) and replace them with DNA (via 5' to 3' polymerase activity). Diseases (ID) ry (Bioc)
DNA polymerase I is the only bacterial DNA polymerase that possesses 5' to 3' exonuclease
activity. ID Bioc
1488
Aminoglycoside Aminoglycosides inhibit genetic code reading and protein synthesis by binding to the Infectious Pharmacol 3
prokaryotic 30S ribosomal subunit. Diseases (ID) ogy (Phar) ID Phar
1495
Parvovirus Erythema infectiosum (5th disease) is caused by PVB19 and Px w/ a nonspecific prodrome Infectious Microbiolo 3
(eg, malaise, fever, congestion) f/b a classic "slapped-cheek" facial rash and a lacy, reticular Diseases (ID) gy (Micr)
body rash. Parvovirus is highly tropic for erythroid precursor cells and replicates
predominantly in the bone marrow. ID Micr
1497
Upper respiratory Adenovirus is a self-limiting, yr-round infection that causes the acute onset of fever, cough, Infectious Microbiolo 2
tract infections congestion, pharyngitis, and conjunctivitis. This pharyngoconjunctival disease can occur in Diseases (ID) gy (Micr)
outbreaks among those living in close quarters (eg, camp dormitories, military barracks). ID Micr
1498
Acute diarrhea Norovirus is the most common cause of viral GE. Outbreaks (eg, schools, cruise ships, Infectious Microbiolo 13
nursing homes) are common, and SSx include vomiting and watery diarrhea. Diseases (ID) gy (Micr) ID Micr
1499
HSV infection Herpetic gingivostomatitis is a severe vesicular or ulcerative disease following 1° infection Infectious Microbiolo 9
w/ HSV-1. Involvement of the gingiva, tongue, palate, and pharynx along w/ systemic SSx Diseases (ID) gy (Micr)
(e.g. fever, malaise) is common. In contrast, reactivation of a latent herpes infection in the
CNV ganglia gen results in mild perioral vesicles. ID Micr
D eats
1550
HSV infection A new-onset genital vesicular rash w/ a (+) Tzanck smear in a previously aSSx pt is Infectious Microbiolo 9
suggestive of 1° genital HSV infection due to HSV-2. Recurrences of genital herpes can be ↓ Diseases (ID) gy (Micr)
thru daily Tx w/ oral valacyclovir, acyclovir, or famciclovir. Condom use can help prevent a
1° genital HSV infection but doesn't prevent reactivation of latent infection. ID Micr
1551
Acyclovir Antiviral drugs currently recommended for the Tx of 1° genital herpes incl the nucleoside Infectious Pharmacol 4
analogues (e.g. acyclovir). These are incorporated into newly replicating viral DNA and Diseases (ID) ogy (Phar)
ultimately terminate viral DNA chain synthesis. ID Phar
1574
Giardia Giardia lamblia is the most common enteric parasite in the United States and Canada and is a Infectious Microbiolo 2
common cause of diarrhea in campers/hikers. Iodine-stained stool smear classically shows Diseases (ID) gy (Micr)
pear-shaped, flagellated trophozoites or ellipsoidal cysts w/ smooth, well-defined walls and
2+ nuclei. Metronidazole is the Tx of choice. ID Micr
1593
Cytomegalovirus The Monospot test is positive in most cases of Epstein-Barr virus-associated mononucleosis. Infectious Microbiolo 9
In immunocompetent patients with a heterophile antibody-negative mononucleosis-like Diseases (ID) gy (Micr)
syndrome, the most likely diagnosis is cytomegalovirus infection. ID Micr
1594
Infectious EBV commonly infects B cells, stim them to proliferate continuously ('transformation' or Infectious Microbiolo 5
mononucleosis 'immortalisation'). EBV is an oncogenic virus that promotes polyclonal B cell proliferation Diseases (ID) gy (Micr)
and heterophile Ab production. The heterophile Ab test is sensitive and highly specific for
EBV infection. ID Micr
1595
Infectious Typical clinical and laboratory features of Epstein-Barr virus (EBV) mononucleosis include Infectious Microbiolo 5
mononucleosis fever, pharyngitis, lymphadenopathy, splenomegaly, and atypical lymphocytosis. EBV is Diseases (ID) gy (Micr)
generally transmitted from an asymptomatic virus shedder to a susceptible individual through
saliva transfer (eg, kissing). ID Micr
1596
Giardia G. lamblia causes injury to the duodenal and jejunal mucosa by adhering to the intestinal Infectious Microbiolo 2
brush border and releasing molecules that induce a mucosal inflammatory response. Diseases (ID) gy (Micr)
Secretory IgA, which impairs adherence, is the major component of adaptive immunity
against G. lamblia infection. Conditions causing IgA defic predispose pts to chronic
giardiasis. ID Micr
1642
Acyclovir IV acyclovir can cause crystalline nephropathy if adequate hydration isn't also provided. Infectious Pharmacol 4
Diseases (ID) ogy (Phar) ID Phar
1643
Foscarnet Foscarnet is an analogue of PPi that can chelate Ca2+ and promote nephrotox renal Mg Infectious Pharmacol 1
wasting. These tox can result in hypocalcaemia and hypomagnesaemia, which can cause Diseases (ID) ogy (Phar)
seizures. ID Phar
1644
Cytomegalovirus Of all the antiviral agents that bind and inhib DNA polymerase in herpesvirus and reverse Infectious Pharmacol 9
transcriptase in HIV, the PPi analogue foscarnet is 1 of few that don't req intracellular Diseases (ID) ogy (Phar)
activation by viral or cellular kinases. ID Phar
1645
Acyclovir Monophosphorylation of acyclovir by a viral thymidine kinase is the 1st (and RLS) step in Infectious Pharmacol 4
conversion of acyclovir to its active triphosphate form. Acyclovir and related drugs (e.g. Diseases (ID) ogy (Phar)
famciclovir, valaciclovir) are more effective against HSV and VZV than CMV and EBV. ID Phar
D eats
1647
Cytomegalovirus 1st-line therapy for CMV colitis and retinitis is ganciclovir. This Rx inhibs viral synthesis by Infectious Pharmacol 9
blocking CMV DNA polymerase. However, ganciclovir also blocks host DNA polymerase to Diseases (ID) ogy (Phar)
a lesser degree, which can lead to heme AEs such as neutropaenia, anaemia, and
thrombocytopaenia. ID Phar
1648
Influenza Oseltamivir is a neuraminidase inhib useful in the Tx and prevention of both influenza A and Infectious Pharmacol 5
B virus infections. This Rx impairs the release of newly formed virions from infected host Diseases (ID) ogy (Phar)
cells and impairs viral penetration of mucous secretions that overlie the resp epithelium. ID Phar
1668
Bronchiolitis Viral bronchiolitis is most commonly caused by RSV and presents w/ low-grade fever, Infectious Microbiolo 1
cough, tachypnoea, and ↑ work of breathing. Ex shows diffuse wheezes and crackles. Diseases (ID) gy (Micr) ID Micr
1670
Measles Measles Px w/ fever, cough, rhinorrhea, and conjunctivitis f/b a maculopapular rash that Infectious Microbiolo 3
starts on the face and spreads downwards. Koplik spots are pathognomonic for measles and Diseases (ID) gy (Micr)
Chx by tiny white or blue-gray lesions on the buccal mucosa. ID Micr
1672
HIV In the HIV replication cycle, polyprotein precursors are encoded by the structural genes gag, Infectious Microbiolo 11
pol, and env. Only the env gene polyprotein product (gp160) is glycosylated. This Diseases (ID) gy (Micr)
polyprotein is subseq cleaved in the GA to form the envelope glycoproteins gp120 and gp41. ID Micr
1674
Antiretroviral NNRTIs are ARV drugs that don't req activation via intracellular phosphorylation. The more Infectious Pharmacol 7
therapy common NNRTIs incl nevirapine and efavirenz. Diseases (ID) ogy (Phar) ID Phar
1675
Antiretroviral Fusion inhibs (e.g. enfuvirtide) bind the HIV transmembrane glycoprotein gp41 and prevent Infectious Pharmacol 7
therapy it from approx. the viral and host cellular membranes, which prevents HIV penetration into Diseases (ID) ogy (Phar)
new host cells. ID Phar
1676
Lyme disease The characteristic cutaneous lesion in Borrelia burgdorferi infection (Lyme disease) is Infectious Pathology 3
erythema migrans, which begins as an erythematous macule at the site of an Ixodes tick bite. Diseases (ID) (Path)
The erythema spreads outward, often leaving a zone of central clearing ("bull's-eye" rash). ID Path
1678
Actinomycosis Actinomyces species are gram (+), branching, filamentous bacteria that may cause Infectious Microbiolo 2
cervicofacial infections when introduced to the submucosa during mech trauma (e.g. tooth Diseases (ID) gy (Micr)
extraction). MFxs incl a slowly enlarging, nonpainful, chronic mandibular mass that evolves
into multi abscesses and sinus tracts draining yellow-orange sulphur granules. ID Micr
1722
HIV HIV pol gene mutations are responsible for acquired resistance to RTIs, PIs, and integrase Infectious Microbiolo 11
strand transfer inhibitors. Mutations of the env gene enable escape from host-neutralizing Diseases (ID) gy (Micr)
Abs. ID Micr
1723
Anal cancer HPV types 16 and 18 are strongly a/w anal and cervical SCC. HIV infection ↑ the prevalence Infectious Microbiolo 1
of HPV infection and the risk of anal carcinoma; this risk is further augmented in MSM. Diseases (ID) gy (Micr) ID Micr
1774
Tuberculosis INH can be directly hepatotox, causing acute, mild hepatic dysfxn in 10-20% of pts and Infectious Pharmacol 18
frank hepatitis (fever, anorexia, and nausea, sometimes progressing to hepatic failure) in a Diseases (ID) ogy (Phar)
small % of pts. ID Phar
1779
Infection control Spore-forming bacteria can survive boiling temps. Bacillus and Clostridium species are Infectious Microbiolo 3
common pathogenic spore-forming bacteria. Diseases (ID) gy (Micr) ID Micr
D eats
1799
Septic shock Tumor necrosis factor-α is released from activated macrophages and is one of the most Infectious Pathophysi 6
important mediators of the systemic inflammatory response in sepsis. Other cytokines Diseases (ID) ology
responsible for inducing the systemic inflammatory response include IL-1 and IL-6. (Patp) ID Patp
1895
Urethritis Urethritis in a young man is most likely to be due to Neisseria gonorrhoeae or Chlamydia Infectious Microbiolo 4
trachomatis, both of which cause dysuria and mucopurulent urethral discharge. The standard Diseases (ID) gy (Micr)
Tx for suspected gonococcal urethritis presumes infection by both organisms. Therefore,
ceftriaxone is given for N gonorrhoeae, and doxycycline or azithromycin is given for C
trachomatis. ID Micr
1908
Malaria RBCs filled w/ multiple, small rings suggest Plasmodium infection (malaria). Erythrocytic Infectious Microbiolo 5
forms of this parasite may be Tx w/ antimalarials such as chloroquine (in non-resistant Diseases (ID) gy (Micr)
areas), atovaquone-proguanil, and artemisinins. Primaquine is req to kill P. vivax and P.
ovale liver hypnozoites. ID Micr
1912
Urethritis Neisseria can be isolated by culture on selective media such as the Thayer-Martin VCN Infectious Microbiolo 4
(vancomycin/colistin/nystatin) medium, which inhibs growth of contaminants such as gram Diseases (ID) gy (Micr)
(+) organisms, gram (-) organisms other than Neisseria, and fungi. ID Micr
1949
Urethritis Gonorrhoea can cause urethritis (dysuria and purulent urethral d/c). The NAAT is the Dx Infectious Microbiolo 4
tool of choice. Gram stain showing gram (-), intracellular diplococci is also Dx. Dual therapy Diseases (ID) gy (Micr)
w/ ceftriaxone and azithromycin is the 1st-line Tx due to concerns about resistance and
chlamydia coinfection. ID Micr
1952
Syphilis Penicillins, structurally similar to D-alanine-D-alanine, inhibit transpeptidase by binding Infectious Microbiolo 9
covalently to its active site. The result is failed synthesis of the bacterial peptidoglycan cell Diseases (ID) gy (Micr)
wall. ID Micr
1958
Bacterial vaginosis Bacterial vaginosis is a vaginal infection diagnosed by the presence of clue cells and a Infectious Pathology 3
positive amine "whiff" test with potassium hydroxide (KOH). The pathogenesis involves a Diseases (ID) (Path)
loss of lactobacilli in the normal vaginal flora and overgrowth of Gardnerella vaginalis. It is
treated with clindamycin or metronidazole. ID Path
1959
Penicillin Clavulanic acid, sulbactam, and tazobactam are β-lactamase inhibs. Concurrent admin of Infectious Pharmacol 2
clavulanate w/ amoxicillin expands amoxicillin's spectrum of activity to incl strains of β- Diseases (ID) ogy (Phar)
lactamase synthesising bacteria that're resistant to amoxicillin alone. ID Phar
1965
Malaria Chloroquine is the TOC for uncomplicated malaria contracted in a chloroquine-sen Infectious Pharmacol 5
geographic region. It eliminates susceptible erythrocytic forms of all Plasmodium species. Diseases (ID) ogy (Phar)
Primaquine is added in the Tx of infections w/ P. vivax and P. ovale to eradicate the
intrahepatic stages (hypnozoites) of these malarial species, which are responsible for
relapses. ID Phar
2019
Antiretroviral ZDT is an NRTI used to prevent maternal to foetal transmission of HIV during labour (when Infectious Pharmacol 7
therapy the mother isn't virally suppressed). It's a thymidine analogue that doesn't have the normal 3'- Diseases (ID) ogy (Phar)
OH group found on thymidine. B/c new nucleotides are added to growing DNA chains only
at the 3'-OH group, the addn of ZDT into DNA results in chain termination. ID Phar
D eats
2110
Cephalosporins Penicillins and cephalosporins fxn by irreversible binding to PBPs such as transpeptidases. Infectious Microbiolo 2
Diseases (ID) gy (Micr) ID Micr
2111
Antibiotic resistance A change in the structure of PBPs that prevents cephalosporin binding is 1 mech of bacterial Infectious Microbiolo 8
resistance to cephalosporins. Diseases (ID) gy (Micr) ID Micr
6547
HSV infection Pts infected w/ HSV develop a lifelong latent infection of the sensory ganglion. Periodic Infectious Microbiolo 9
viral replication can lead to SSx that flare and resolve over time. Diseases (ID) gy (Micr) ID Micr
6643
Community The virulence of S. pneumoniae is predominantly due to its PSC, which impedes Infectious Microbiolo 21
acquired pneumonia phagocytosis and complement binding. Diseases (ID) gy (Micr) ID Micr
6781
Community Mycoplasma pneumoniae is a leading cause of atypical pneumonia. B/c this pathogen lacks a Infectious Microbiolo 21
acquired pneumonia cell wall, it does not show up on Gram stain and cannot be treated w/ β-lactam Abx. PSIs Diseases (ID) gy (Micr)
(eg, macrolides, tetracycline) are the Tx of choice. ID Micr
7650
Pertussis B. pertussis, a small, gram (-) coccobacillus, can cause outbreaks of whooping cough in un- Infectious Microbiolo 3
vax individuals. Infected infants and children gen develop mucoid rhinorrhoea f/b severe, Diseases (ID) gy (Micr)
paroxysmal cough that may be a/w an inspiratory whoop and vomiting. The bacterium is
largely non-invasive and secretes several exotoxins that severely dmg ciliated resp
epithelium. ID Micr
8288
Daptomycin Daptomycin is a lipopeptide Abx w/ activity limited to gram (+) organisms, incl MRSA. It Infectious Pharmacol 1
causes depol of bacterial cellular membrane and inhib of DNA, RNA, and protein synthesis. Diseases (ID) ogy (Phar)
Daptomycin is a/w ↑ CPK lvls and an ↑ incidence of myopathy. ID Phar
8290
Kaposi sarcoma Kaposi's sarcoma usually involves the skin and GI tract and is common in HIV patients not Infectious Pathology 2
on antiretroviral therapy. Endoscopy reveals characteristic lesions, which range from Diseases (ID) (Path)
reddish/violet flat maculopapular lesions to raised hemorrhagic nodules or polypoid masses.
Biopsy can show spindle cells, neovascularization, and extravasated red blood cells. ID Path
8371
Antiretroviral Integration of HIV dsDNA into the host cell's chrom is necessary to induce viral gene Infectious Pharmacol 7
therapy expression and prevent degradation of the viral genome. Raltegravir is an integrase inhib that Diseases (ID) ogy (Phar)
disrupts HIV genome integration, preventing synthesis of viral mRNA. ID Phar
8533
Staphylococci Staphylococcus epidermidis is a common cause of foreign body infections due to its ability Infectious Microbiolo 1
to produce adherent biofilms. Diseases (ID) gy (Micr) ID Micr
8538
Intestinal helminth E. vermicularis infection (enterobiasis) occurs most freq in school-age children and presents Infectious Pharmacol 3
parasites w/ perianal pruritus. Dx is made by the Scotch tape test. Albendazole is the 1st-line Tx, w/ Diseases (ID) ogy (Phar)
pyrantel pamoate as an alt agent preferred in preg pts. ID Phar
8565
Scarlet fever Scarlet fever is characterised by fever, pharyngitis, sandpaper-like rash, circumoral pallor, Infectious Microbiolo 1
and a strawberry tongue. It's caused by strains of GAS that produce pyrogenic exotoxins. Diseases (ID) gy (Micr)
Scarlet fever can predispose to acute RF and GN. ID Micr
8593
Infection control Alcohols fxn by disorganising the lipid structure in membranes, causing them to be leaky, Infectious Pharmacol 3
and by denaturing cellular proteins. They're bactericidal, tuberculocidal, fungicidal, and Diseases (ID) ogy (Phar)
virucidal, but don't destroy bacterial spores. ID Phar
D eats
11377
Dengue fever The Aedes aegypti mosquitoes can transmit the viruses that cause DF and chikungunya. Infectious Microbiolo 2
Classic DF Px as an acute febrile illness w/ h/a, retro-orbital pain, and joint and muscle pain. Diseases (ID) gy (Micr)
Chikungunya is a febrile illness w/ flu-like SSx, prominent polyarthralgias, and diffuse
macular rash. ID Micr
11395
Dengue fever Dengue viruses are ssRNA viruses w/ 4 diff serotypes. 1° (1st) infection can be aSSx or Infectious Microbiolo 2
cause a self-limited disease in most adults. 2° infection is due to infection w/ a diff viral Diseases (ID) gy (Micr)
serotype and usually causes more severe illness. ID Micr
11459
Clostridium difficile Clostridium difficile requires additional contact precautions, including handwashing w/ soap Infectious Microbiolo 7
infection and water, a gown for any pt contact, and nonsterile gloves that should be changed after Diseases (ID) gy (Micr)
contact w/ contaminated secretions. Alc-based hand sanitizers do not kill the bacterial spores. ID Micr
11514
Infection control HH is the single most important measure to ↓ the risk of transmission of hospital-acquired Infectious Microbiolo 3
infections. Diseases (ID) gy (Micr) ID Micr
11524
Babesiosis Babesiosis should be considered in pts w/ febrile illness who reside in geographic areas Infectious Microbiolo 2
where they're exposed to Ixodes ticks. Dx can be established w/ the ID of intraerythrocytic Diseases (ID) gy (Micr)
organisms on peri blood smear. ID Micr
11540
Babesiosis Babesiosis and Lyme disease are transmitted by the Ixodes tick and occur in similar Infectious Microbiolo 2
geographic regions. Coinfection is common. Diseases (ID) gy (Micr) ID Micr
11547
Animal and human P. multocida is a cause of soft-tissue infection that develops w/i 24hrs following a dog or cat Infectious Microbiolo 1
bite injuries bite. Mx incls wound care and Abx targeted against this organism. Diseases (ID) gy (Micr) ID Micr
11590
Antiretroviral Abacavir HSR occurs in 2-8% of pts and is strongly a/w the HLA-B*57:01 allele. Infectious Pharmacol 7
therapy Diseases (ID) ogy (Phar) ID Phar
11596
Acute parotitis Acute bacterial parotitis occurs more commonly in elderly postoperative patients who are Infectious Microbiolo 1
intubated or dehydrated. Staphylococcus aureus is the most common bacterial etiology. Diseases (ID) gy (Micr)
Diagnosis can be confirmed by imaging and an elevated serum amylase level (with a normal
serum lipase level and no evidence of pancreatitis). ID Micr
11604
HSV infection The finding of multiple painful genital ulcers and constitutional SSx in a sexually active pt is Infectious Microbiolo 9
highly suggestive of 1° genital HSV infection. Dx can be established by PCR testing, direct Diseases (ID) gy (Micr)
fluorescence Ab testing, viral culture, or Tzanck smear. ID Micr
11626
Antibiotic resistance ESBLs can be produced by gram (-) bacteria, rendering cephalosporins and other β-lactam Infectious Pharmacol 8
Abx inactive. These genes can be transmitted b/w organisms thru plasmid conjugation. Diseases (ID) ogy (Phar) ID Phar
11633
Catheter related The presence of central vascular catheter and receipt of parenteral nutrition are RFs for Infectious Microbiolo 3
bloodstream candidaemia. Candida display a morphology of branching pseudohyphae w/ blastoconidia. Diseases (ID) gy (Micr)
infection ID Micr
11637
Aspergillosis Pts w/ profound and prolonged neutropenia are at especially high risk for viral and fungal Infectious Microbiolo 5
infections. The most common fungal causes are Aspergillus and Candida species. Invasive Diseases (ID) gy (Micr)
pulm aspergillosis Px w/ some combination of fever, chest pain, cough, dyspnea, and
hemoptysis. ID Micr
D eats
11650
Meningitis Listeria is a relatively common foodborne illness a/w outbreaks after the consumption of Infectious Microbiolo 17
contaminated food, particularly processed meats and dairy products. Healthy pts may Diseases (ID) gy (Micr)
develop gastroenteritis; pts w/ impaired cell-mediated immunity are at risk for invasive
infection (e.g. sepsis, meningoencephalitis) and listeriosis in preg is a/w adverse foetal
outcomes (e.g. foetal death, premature birth). ID Micr
11670
Neurocysticercosis Neurocysticercosis is a relatively common cause of seizures in pts from Central and South Infectious Microbiolo 1
America and should be considered in pts w/ suggestive SSx and imaging (e.g. cystic brain Diseases (ID) gy (Micr)
lesion) and char epidemiological RFs. ID Micr
11709
Antibiotic resistance Aminoglycosides work by interfering w/ the 30S ribosomal subunit and causing the cell to Infectious Microbiolo 8
misread mRNA, thereby halting protein synthesis. An important mech of resistance is the Diseases (ID) gy (Micr)
methylation of the aminoglycoside-binding portion of the ribosome, which inhibs the ability
of aminoglycoside to interfere w/ protein translation. ID Micr
11729
Acyclovir The most effective Tx for HSV encephalitis is IV acyclovir; whose MOA is complete inhib Infectious Microbiolo 4
of the viral DNA polymerase (synthesises viral DNA). Diseases (ID) gy (Micr) ID Micr
11766
Urinary tract Escherichia coli are lactose-fermenting, indole-positive gram-negative rods that are an Infectious Microbiolo 12
infection important cause of urinary tract infection in women. Diseases (ID) gy (Micr) ID Micr
11822
Roseola infantum HHV-6 infection (roseola) classically presents w/ fever for 3-5days f/b a truncal rash. It's Infectious Microbiolo 1
also the most common cause of febrile seizures. Diseases (ID) gy (Micr) ID Micr
11859
Q fever Q fever is a zoonotic infection that occurs in farm workers exposed to waste from cattle and Infectious Microbiolo 1
sheep. Its causative agent is Coxiella burnetii. A patient with exposure to waste from farm Diseases (ID) gy (Micr)
animals who develops a nonspecific illness (myalgias, fatigue, fever (>10 days), retroorbital
headache) with a normal leukocyte count, thrombocytopenia, and increased liver enzymes
should be evaluated for acute Q fever infection. ID Micr
11927
Chancroid Chancroid, due to Haemophilus ducreyi, Px as deep, painful (you "do cry" w/ H ducreyi) Infectious Microbiolo 1
ulcers w/ ragged borders that are a/w a gray exudate and inguinal LAD. Dx is established by Diseases (ID) gy (Micr)
Gram stain and culture of the organism from a scraping of the ulcer base. ID Micr
12708
Viral genetics Influenza epidemics and pandemics are typically caused by reassortment of the RNA Infectious Microbiolo 4
segments coding for HA or NA proteins (major antigenic shifts). This process can occur b/w Diseases (ID) gy (Micr)
human and animal strains of influenza A virus in avian or swine hosts. ID Micr
14855
Syphilis Histopathologic examination of syphilitic lesions classically demonstrates a proliferative Infectious Pathology 9
endarteritis with a surrounding plasma cell infiltrate. Most of the manifestations of syphilis Diseases (ID) (Path)
are due to localized tissue ischemia resulting from endarteritis. ID Path
14870
Pneumocystis Pneumocystis pneumonia is an atypical fungal infection seen primarily in those with Infectious Pathophysi 2
pneumonia impaired cell mediated immunity (eg, advanced AIDS). Manifestations often include slowly Diseases (ID) ology
worsening pulmonary symptoms, hypoxia, and bilateral interstitial infiltrates on chest x-ray. (Patp)
The cystic organism can be Visualized using silver stain of respiratory secretions. ID Patp
D eats
14903
Chikungunya fever Chikungunya is an α-virus spread by mosquitos to humans in tropical and subtropical areas. Infectious Microbiolo 1
Initial MFx incl self-limited fever, severe polyarthralgia, and rash. Relapsed or chronic Diseases (ID) gy (Micr)
arthralgias, polyarthritis (e.g. wrist, fingers, ankles), or tenosynovitis occur in >50% of
infected individuals. ID Micr
14916
Cystic fibrosis In pts w/ CF, pathogenic bacteria colonise the resp tract early in the disease course. The Infectious Microbiolo 11
leading pathogen in adults is P. aeruginosa, which forms a thick biofilm to prevent its full Diseases (ID) gy (Micr)
elimination from the body. ID Micr
14921
Community Acute phase reactants (APRs) are proteins whose serum concentrations change by 225% Infectious Pathology 21
acquired pneumonia during periods of inflammation. Procalcitonin is a unique APR that can rise or fall depending Diseases (ID) (Path)
on the etiology of the infection; elevated levels correlate with a bacterial source, whereas low
levels indicate a viral source. ID Path
15027
Clostridial Clostridium septicum is a spore-forming, exotoxin-producing, Gram (+) organism that is the Infectious Microbiolo 3
myonecrosis most common cause of spontaneous gas gangrene (eg, rapid-onset pain, hemorrhagic bullae, Diseases (ID) gy (Micr)
tissue crepitus). Underlying colonic malignancy is the greatest RFx for infection. ID Micr
15034
Zika virus Zika virus is an ssRNA that infects foetal neural progenitor cells, causing severe congenital Infectious Microbiolo 1
malformations (e.g. microcephaly, arthrogryposis), cerebral cortical thinning, and possible Diseases (ID) gy (Micr)
foetal demise. ID Micr
15057
Histoplasmosis TNF-α inhibs are a/w impairments to the cell-mediated immune response and ↑ the risk of Infectious Microbiolo 4
infection w/ intracellular bacteria and granulomatous fungi (e.g. Histoplasma capsulatum). Diseases (ID) gy (Micr)
Histoplasma replicates w/i the intracellular space of macrophages and can spread from the
lungs to the LNs and the RES (liver, spleen, bone marrow). ID Micr
15066
HIV Pts w/ advanced HIV and low CD4 counts are at risk for opportunistic infections and req Infectious Microbiolo 11
antimicrobial prophylaxis. P. jiroveci pneumonia prophylaxis w/ TMP-SMX is indicated Diseases (ID) gy (Micr)
when CD4 count is <200/mm3. ID Micr
15067
Bartonella Bacillary angiomatosis is 1arily seen in pts w/ advanced AIDS. It's caused by the gram (-) Infectious Microbiolo 2
bacterium B. henselae, which is typically transmitted by a cat scratch. Pts usually develop Diseases (ID) gy (Micr)
highly vascular, violaceous, cutaneous lesions over wks or mos. Histo of the lesions reveals
large endothelial cells forming small vascular channels w/ a surrounding inflammatory
infiltrate. ID Micr
15068
Progressive Pts w/ advanced AIDS can have reactivation of JC virus, which causes PML. This condition Infectious Microbiolo 1
multifocal usually presents w/ slowly progr confusion, ataxia, and motor deficits. Brain MRI reveals Diseases (ID) gy (Micr)
leukoencephalopath multifocal areas of white matter demyelination w/ no mass effect or enhancement.
y ID Micr
15069
HIV Initial HIV infection is often a/w mononucleosis-like SSx (eg, fever, LAD, sore throat) 2-4 Infectious Microbiolo 11
wks after transmission. Important Dx clues are oropharyngeal ulcers and a diffuse Diseases (ID) gy (Micr)
maculopapular rash. As the humoral Ab response is not fully activated early in infection, LFx
typically show HIV in the serum ((+) viral load and p24 Ag) but (-) HIV serology. ID Micr
D eats
15075
Rocky mountain RMSF is a tick-borne illness due to Rickettsia rickettsii, a weakly gram (-), obligate Infectious Microbiolo 1
spotted fever intracellular organism that has an affinity for vascular endothelial cells. Pts usually have non- Diseases (ID) gy (Micr)
specific SSx (e.g. fever, malaise, myalgia) f/b a macular-petechial rash that begins on the
ankles and wrists and spreads to the centre of the body as well as to the palms and soles.
Urgent Tx w/ doxycycline, an inhib of bacterial protein synthesis, is req. ID Micr
15076
Lice infestation Phthirus pubis is the human pubic louse. It is transmitted sexually via skin-to-skin contact Infectious Microbiolo 2
and causes intense pruritus. Louse and nits can often be visualized on Ex, which is Dx. Tx w/ Diseases (ID) gy (Micr)
topical permethrin is generally curative. ID Micr
15077
Meningitis N. fowleri is a free-living, motile protozoan that lives in warm water. Exposure can result in Infectious Microbiolo 17
1° amoebic encephalitis (PAM), which is characterised by acute fever, h/a, confusion, and Diseases (ID) gy (Micr)
neck stiffness. The Dx is confirmed when motile trophozoites are seen in CSF wet mount.
Nearly all pts die. ID Micr
15107
HIV R5 strains (macrophage-tropic) of HIV attach to the host CD4 receptor and CCR5 chemokine Infectious Pharmacol 11
coreceptor; CCR5 inhibs such as maraviroc can be used in the Tx of R5 virus. X4 strains (T Diseases (ID) ogy (Phar)
lymphotropic) of HIV bind to the CD4 receptor and CXCR4 chemokine receptor; X4 virus
can't be Tx w/ CCR5 inhibs. ID Phar
15113
HIV Tenofovir is a NRTI that's a common component of HIV therapy. This drug is gen well Infectious Microbiolo 11
tolerated but may occasionally cause dmg to the PCT of the kidney, leading to AKI a/o PCT Diseases (ID) gy (Micr)
impairment (e.g. phosphoruria, glucosuria, water retention). Bx typically reveals a normal
glomerulus and renal interstitium but dmg to the PCT. ID Micr
15125
HIV Most cases of AIDS worldwide are caused by HIV-1. However, AIDS can also be caused by Infectious Microbiolo 11
infection w/ HIV-2, which is endemic to West Africa. HIV-2 infection is a/w lower viral Diseases (ID) gy (Micr)
loads, less risk of transmission, and a slower progr to AIDS. The Dx is often suspected when
HIV tests are incongruent ((+) screening serology but indeterminate Western blot and (-)
plasma HIV-1 RNA). Confirmation can be made using HIV-1/HIV-2 immunodiff assay
(IDA). ID Micr
15169
Hepatitis B HBV has a partially dsDNA genome and contains a viral DNA polymerase w/ reverse Infectious Microbiolo 14
transcriptase activity. Reverse transcriptase serves a crucial step in viral replication; it Diseases (ID) gy (Micr)
converts transcribed (+) sense ssRNA into the partially dsDNA genome of viral progeny. ID Micr
15177
Hepatitis B Immunization against hepatitis B virus uses recombinant HBsAg to generate anti-HBs Infectious Immunolo 14
antibodies. These antibodies prevent infection by binding to the envelope of circulating virus Diseases (ID) gy (Immu)
and inhibiting viral entry. ID Immu
15205
Acute diarrhea Nontyphoidal Salmonella is a leading cause of foodborne gastroenteritis. Most cases are Infectious Microbiolo 13
marked by 3-4days of self-limited fever, nausea, vomiting, and watery diarrhoea. A minority Diseases (ID) gy (Micr)
of individuals develop subseq invasive disease w/ spread to the long bones (osteomyelitis),
vasculature (mycotic aneurysm), or heart (endocarditis). Risk of invasion is greatest in those
w/ SCD or impaired immunity or at the extremes of age. ID Micr
D eats
15210
Foodborne illness Staphylococcal foodborne illness is due to the consumption of a preformed enterotoxin in Infectious Microbiolo 2
contaminated food. Most cases can be prevented by washing hands thoroughly prior to food Diseases (ID) gy (Micr)
prep (prevents contamination) and ensuring proper refrigerated storage (prevents bacterial
proliferation/enterotoxin production). ID Micr
15215
Acute diarrhea Rotavirus is a common cause of self-limited childhood diarrhoea in un-vax individuals. It Infectious Microbiolo 13
infects villous enterocytes in the duodenum and prox. jejunum and results in villous blunting, Diseases (ID) gy (Micr)
proliferation of secretory crypt cells, and a loss of brush border enzymes; this results in water
diarrhoea w/o faecal leucocytes. ID Micr
15230
Amoebiasis Entamoeba histolytica is an amoeba that causes colitis characterised by ulcers w/ Infectious Microbiolo 1
undermining edges (i.e. flask-shaped) that may contain cysts and trophozoites. Trophozoites Diseases (ID) gy (Micr)
can occasionally (~1%) invade the colonic wall and disseminate thru the blood to the liver,
brain, or lungs. Amoebic hepatic abscess is the most common extraintestinal MFx. ID Micr
15243
Intestinal helminth Hookworms are transmitted when human skin comes into contact w/ soil contaminated w/ Infectious Microbiolo 3
parasites human faeces. The larvae penetrate the skin, travel to the lungs, are coughed up, and then Diseases (ID) gy (Micr)
subseq swallowed. Adult hookworms live in the small intestine and feed on human blood.
Therefore, chronic IDA (microcytic anaemia) is the greatest complication. ID Micr
15255
Vibrio vulnificus V. vulnificus is a curved, gram (-), free-living bacterium that grows in marine environments. Infectious Microbiolo 1
Transmission 1arily occurs due to the consumption of raw seafood (e.g. oysters) or wound Diseases (ID) gy (Micr)
contamination. MFxs are often mild, but individuals w/ liver disease or Fe overload are at
very high risk of severe, fulminant infection (e.g. sepsis, necrotising fasciitis). ID Micr
15325
Malaria P. vivax is the most common cause of malaria in non-African countries. It's transmitted by Infectious Microbiolo 5
the female Anopheles mosquito and is a/w a latent liver phase that must be Tx (w/ Diseases (ID) gy (Micr)
primaquine) independently of the erythrocytic phase to fully eliminate the organism. ID Micr
15347
Antibiotic resistance MRSA is resistant to most β-lactam Rx (e.g. oxacillin, methicillin, cephalosporins) due to the Infectious Pharmacol 8
acquisition of a mobile genetic element that contains the mecA gene. This gene encodes for a Diseases (ID) ogy (Phar)
specialised PBP that has low affinity for β-lactam Abx. Tx of MRSA therefore req a non-β-
lactam Rx such as TMP-SMX, clindamycin, doxycycline, or vancomycin. ID Phar
15400
Plague Bubonic plaque is a zoonotic infection that causes febrile illness w/ regional inflammatory Infectious Microbiolo 1
LAD (buboes). The underlying pathogen is Y. pestis, a gram (-) coccobacillus that exhibits Diseases (ID) gy (Micr)
bipolar staining (resembling a close safety pin). The major environmental reservoir is
rodents, and transmission usually occurs via rodent flea bite. ID Micr
15407
Leptospirosis Leptospirosis is a zoonotic infection caused by the motile spirochete Leptospira. Infectious Microbiolo 1
Transmission primarily occurs when humans come into contact w/ water contaminated w/ Diseases (ID) gy (Micr)
animal urine during outdoor recreational or occupational activities. Pts classically have a
mild, self-limited, flu-like illness but may develop more serious complications such as renal
or hepatic failure. ID Micr
15419
Hand, foot, mouth HFMD (oral ulceration and extremity rash) and herpangina (oral ulcerations w/o rash) are the Infectious Microbiolo 2
disease most common MFxs of enteroviral infection. Rare but serious complications of infection incl Diseases (ID) gy (Micr)
myocarditis and CNS disease (e.g. aseptic meningitis). ID Micr
D eats
15436
Chagas disease Chagas disease is a protozoal illness that's endemic to Latin America. Pts in rural areas are at Infectious Microbiolo 1
greatest risk when their houses harbor the vector (Triatome bug) in adobe walls or thatched Diseases (ID) gy (Micr)
roofs. Acute infections are often aSSx, but pts can develop Chagas cardiomyopathy (e.g. HF,
ventricular arrhythmias, ventricular aneurysms) several decades later. ID Micr
15438
Schistosomiasis Schistosomiasis is a parasitic blood fluke infection that is associated with bathing in Infectious Pathology 2
freshwater contaminated with cercariae from infected snails. Patients often are asymptomatic Diseases (ID) (Path)
for months or years but may eventually develop eosinophilic granulomatous inflammation in
the liver, spleen, gastrointestinal tract, or genitourinary system. One common manifestation
of genitourinary schistosomiasis is painless terminal hematuria; eggs can often be identified
in the urine or on biopsy. ID Path
15453
Malaria Mefloquine chemoprophylaxis for malaria must be continued for 4wks after return from an Infectious Microbiolo 5
endemic region to ensure the elimination of hepatic schizonts (which develop in the liver Diseases (ID) gy (Micr)
over 8-30days). ID Micr
15457
Malaria Malaria is Dx when intraerythrocytic diamond ring-shaped parasites are seen on peri blood Infectious Microbiolo 5
smear. This disease should be suspected in travellers to endemic regions who develop a Diseases (ID) gy (Micr)
febrile illness. ID Micr
15490
Infectious Reactive (atypical) lymphocytes are activated, pathogen-specific cytotoxic T cells or natural Infectious Immunolo 5
mononucleosis killer cells that form in response to certain intracellular infections. In contrast to normal Diseases (ID) gy (Immu)
lymphocytes, reactive lymphocytes are large, scalloped, and have abundant cytoplasm.
Reactive lymphocytosis is a diagnostic feature of infectious mononucleosis. ID Immu
15491
Arbovirus Arboviruses, small RNA viruses transmitted by biting arthropods, are the most common Infectious Microbiolo 1
cause of encephalitis outbreaks in the US. B/c no vax are currently available, prevention Diseases (ID) gy (Micr)
1arily involves eliminating the vector arthropods (e.g. infected mosquitoes). ID Micr
15509
Toxic shock Toxic shock syndrome is typically associated with the prolonged use of tampons or wound Infectious Immunolo 2
syndrome packing, which allows Staphylococcus aureus to replicate locally and release pyrogenic toxic Diseases (ID) gy (Immu)
superantigens (eg, toxic shock syndrome toxin-1) into the blood. Superantigens bind to the
MHC-II complex of antigen-presenting cells without processing and nonspecifically activate
T cells. This leads to a dramatic release of inflammatory cytokines, which causes the
manifestations of the disease (eg, hypotension; high fever; organ failure; diffuse,
erythematous rash). ID Immu
15518
Gonococcal N. gonorrhoeae is spread sexually by GU secretions and can be prevented by the consistent Infectious Microbiolo 3
infection use of condoms. GUIs are often aSSx, which ↑ the risk of spread thru the bloodstream, Diseases (ID) gy (Micr)
leading to disseminated gonococcal infection. Pts w/ disseminated disease typically present
w/ the triad of polyarthralgia, tenosynovitis, and dermatitis or purulent arthritis. ID Micr
15543
Ehrlichiosis and Ehrlichia chaffeensis is harbored in white-tailed deer and transmitted to humans by tick bite. Infectious Microbiolo 1
anaplasmosis It replicates in vacuoles w/i monocytes and forms mulberry-shaped, intraleukocytic Diseases (ID) gy (Micr)
inclusions (morulae). MFx usually include nonspecific SSx (eg, fever, chills, myalgia),
maculopapular rash, and significant laboratory abnormalities, particularly lymphopenia. ID Micr
D eats
15549
Intestinal helminth Ascaris lumbricoides is transmitted via contaminated food or water. Eggs hatch into larvae in Infectious Microbiolo 3
parasites the small intestine, penetrate the intestinal wall, and migrate across the lung into the alveoli. Diseases (ID) gy (Micr)
Larvae are subsequently coughed up and swallowed into the GIT, where they mature to adult
worms. Most pts are aSSx, but some develop early pulm MFx (Loeffler syndrome) or later
GI SSx. ID Micr
15557
Odontogenic Sjogren syndrome is characterised by autoimmune inflammation of exocrine glands (e.g. Infectious Microbiolo 1
infections salivary, lacrimal, vaginal). Pts typically have severe dry mouth (xerostomia) due to ↓ saliva Diseases (ID) gy (Micr)
production, which can lead to an ↑ rate of dental caries and other oral infections (e.g. thrush)
b/c of the loss of protective factors in saliva. Bx of the salivary glands shows a lymphocytic
infiltrate, often w/ germinal centres. ID Micr
15565
HSV infection HSV is a common, STI marked by the formation of painful genital ulcers. Tzanck smear can Infectious Microbiolo 9
reveal the char cytopathic effects of the virus, incl multinucleated giant cells, ground-glass Diseases (ID) gy (Micr)
opacities, acantholytic cells, keratinocyte ballooning, and nuclear moulding. ID Micr
15566
Febrile neutropenia Chemotherapy-assoc neutropaenic fever is most often caused by endogenous commensal Infectious Microbiolo 4
bacteria that have translocated across dmgd mucosal sites. Diseases (ID) gy (Micr) ID Micr
15578
Group B Streptococcus agalactiae (GBS), one of the most common causes of early neonatal sepsis, is Infectious Microbiolo 2
streptococcal typically identified by the presence of a narrow zone of β-hemolysis when plated on blood Diseases (ID) gy (Micr)
infection agar. It is also identified by the production of CAMP factor, which enhances β-hemolysis by
particular strains of Staphylococcus aureus. ID Micr
15588
Toxoplasmosis Pregnant women should avoid raw or undercooked meat in order to prevent infection w/ Infectious Microbiolo 5
Toxoplasma gondii, an intracellular parasite that can spread across the placenta to the fetus. Diseases (ID) gy (Micr)
Congenital toxoplasmosis is typically Chx by retinal lesions, hydrocephalus, jaundice, and
HSM. ID Micr
16855
Tinea Tinea pedis is a superficial infection of the epidermis caused by dermatophytes (e.g. T. Infectious Pharmacol 4
rubrum). It most often presents as a pruritic, erythematous rash b/w the toes that freq extends Diseases (ID) ogy (Phar)
along the sole. KOH micro of skin scrapings shows branching hyphae. Tx options incl a
variety of topical antifungals (e.g. clotrimazole), but not nystatin. ID Phar
343Klinefelter 47,XXY is the most common genotype causing KS. Pts Px w/ tall stature; small, firm testes; Male Genetics 3
syndrome azoospermia; and gynecomastia. Mild intellectual disability is seen in some pts, and the Reproductive (Gene)
severity generally ↑ w/ each additional X chromosome. (MR) MR Gene
419Hydrocele Communicating hydroceles and IIHs are caused by an incomplete obliteration of the Male Embryolog 2
processus vaginalis. The resultant connection b/w the scrotum and abdominal cavity can Reproductive y (Embr)
allow for fluid leakage (hydrocele) or the passage of abdominal contents (IIH). (MR) MR Embr
580Cryptorchidism In undescended testes, the seminiferous tubules atrophy if uncorrected due to higher body Male Pathology 2
temperatures, resulting in decreased fertility and increased risk for malignancy. Orchiopexy Reproductive (Path)
(surgical placement of the testes in the scrotal sac) can minimize damage and decrease risk (MR)
for testicular cancer. MR Path
D eats
624Testicular cancer Human chorionic gonadotropin (hCG) has a structure similar to TSH. Patients with testicular Male Pathology 4
germ cell tumors or gestational trophoblastic disease may develop very high serum hCG Reproductive (Path)
concentrations, which can stimulate TSH receptors and cause paraneoplastic (MR)
hyperthyroidism. MR Path
657Prostate cancer Flutamide is a nonsteroid anti-androgen that acts as a competitive inhibitor of testosterone Male Pharmacol 5
receptors. It is used in combination w/ long-acting GnRH agonists for the Tx of prostate ca. Reproductive ogy (Phar)
(MR) MR Phar
664Bronchiectasis Primary ciliary dyskinesia results from an autosomal recessive mutation in the proteins Male Pathology 2
responsible for normal flagellar and ciliary structure and function (eg, dynein, assembly Reproductive (Path)
proteins). Clinical manifestations include situs inversus, chronic sinusitis, bronchiectasis, and (MR)
infertility. MR Path
807Cystic fibrosis CFTR gene mutations are the most common cause of congenital bilateral absence of the vas Male Genetics 11
deferens (CBAVD). Patients with CBAVD have azoospermia and infertility but normal Reproductive (Gene)
levels of FSH, LH, and testosterone. Elevated sweat chloride levels are diagnostic of cystic (MR)
fibrosis. MR Gene
839Urethral injury Injury to the posterior urethra is associated with pelvic fractures, and the anterior urethra is Male Anatomy 1
most commonly damaged in straddle injuries. Inability to void with a full bladder sensation, Reproductive (Anat)
a high-riding boggy prostate, and blood at the urethral meatus are suggestive of urethral (MR)
injury, particularly in the presence of a pelvic fracture. If urethral injury is suspected,
placement of a Foley catheter is contraindicated. MR Anat
1055
Klinefelter Patients with Klinefelter syndrome (47, XXY) have primary hypogonadism characterized by Male Pathology 3
syndrome low testosterone and elevated gonadotropin (FSH, LH) levels. In addition, elevated estradiol Reproductive (Path)
results in the common finding of gynecomastia. (MR) MR Path
1427
Mullerian inhibitory The embryonic testis secretes testosterone and MIF. MIF is responsible for regression of the Male Embryolog 1
factor paramesonephric (Mullerian) ducts that normally give rise to the internal genitalia in the Reproductive y (Embr)
female fetus. Testosterone mediates development of male internal genitalia and DHT (MR)
mediates development of the external genitalia. MR Embr
1449
Sexual The SRY gene on the Y chromosome codes for the TDF, which differentiates the primitive Male Embryolog 2
differentiation gonads into testes. Sertoli cells produce AMH, which causes regression of the Mullerian Reproductive y (Embr)
ducts and suppresses female internal reproductive organ development. Leydig cells produce (MR)
testosterone, differentiating Wolffian ducts into internal male reproductive organs. DHT is
required for differentiation of the external male genitalia. MR Embr
1737
Benign prostatic The prostate is located between the pubic symphysis and the anal canal and is visible on Male Anatomy 6
hyperplasia inferior sections of the pelvis on CT scan. Benign prostatic hyperplasia is a common, age- Reproductive (Anat)
related condition that causes urinary symptoms (eg, hesitancy, straining, incomplete (MR)
voiding). It can be medically treated with a-adrenergic blockers and 5-a reductase inhibitors. MR Anat
1827
Hydrocele A communicating hydrocele results when serous fluid accumulates within the tunica Male Anatomy 2
vaginalis in the setting of a patent processus vaginalis. It presents as a painless swelling that Reproductive (Anat)
transilluminates on examination. (MR) MR Anat
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1870
Hypospadia and In males, incomplete fusion of the urethral (urogenital) folds results in hypospadias, an Male Embryolog 1
epispadia abnormal opening of the urethra proximal to the glans penis along the ventral shaft of the Reproductive y (Embr)
penis. (MR) MR Embr
1902
Inhibin Sertoli cells produce inhibin in response to FSH from the anterior pituitary. Inhibin Male Physiology 1
suppresses FSH production in the pituitary. Sertoli cells also facilitate spermatogenesis w/i Reproductive (Phys)
the seminiferous tubules. Impaired Sertoli cell fxn would lead to ↓ production of inhibin, ↑ (MR)
FSH lvls, and impaired fertility. MR Phys
2021
Testicular cancer Lymph from the testes drains through lymph channels directly back to the para-aortic lymph Male Anatomy 4
nodes. In contrast, lymph from the scrotum drains to the superficial inguinal lymph nodes. Reproductive (Anat)
(MR) MR Anat
8326
Scrotum Due to its intra-abdominal origin, lymphatic drainage of the testis is to the para-aortic lymph Male Anatomy 1
nodes. In contrast, lymph drainage from the scrotum goes into the superficial inguinal lymph Reproductive (Anat)
nodes. (MR) MR Anat
8351
Erectile dysfunction Psychogenic causes of erectile dysfunction include performance anxiety, depression, sexual Male Pathology 3
trauma, relationship problems, and stress. Important clues include sudden-onset and normal Reproductive (Path)
nocturnal erections. (MR) MR Path
8468
Contraception After vasectomy, viable sperm remain in the portion of the vas deferens distal to the ligation. Male Physiology 3
Pts can still have viable sperm in the ejaculate for 3 mos and at least 20 ejaculations. Reproductive (Phys)
(MR) MR Phys
8930
Benign prostatic 5-α reductase inhibitors (eg, finasteride, dutasteride) block the conversion of testosterone to Male Pharmacol 6
hyperplasia DHT in the prostate. These Rx ↓ prostate volume in pts w/ BPH and relieve the fixed Reproductive ogy (Phar)
component of bladder outlet obstruction. (MR) MR Phar
11658
Testicular torsion Testicular torsion is due to twisting of the testis around the spermatic cord (containing the Male Anatomy 1
gonadal artery), which can eventually lead to ischemia. The gonadal arteries arise from the Reproductive (Anat)
abdominal aorta. The right gonadal vein drains directly into the inferior vena cava while the (MR)
left gonadal vein drains into the left renal vein. MR Anat
11747
Prostate cancer The skeletal system is a common site of metastasis due to hematogenous seeding. Cancers of Male Anatomy 5
the pelvis, including the prostate, spread to the lumbosacral spine via the vertebral venous Reproductive (Anat)
plexus, which in turn communicates with a number of venous networks, including the (MR)
prostatic venous plexus. MR Anat
11762
Superficial inguinal The superficial and deep inguinal rings are physiologic openings in the external abdominal Male Anatomy 1
ring oblique aponeurosis and the transversalis fascia, respectively. Surgical repair of an Reproductive (Anat)
undescended testicle lodged in the inguinal canal involves reducing the testis through the (MR)
superficial inguinal ring and fixing it in the scrotum (orchiopexy). MR Anat
11800
Erectile dysfunction The prostatic plexus lies within the fascia of the prostate and innervates the corpus cavernosa Male Anatomy 3
of the penis, which facilitates penile erection. As a result, prostatectomy or injury to the Reproductive (Anat)
prostatic plexus can cause erectile dysfunction. (MR) MR Anat
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Epididymitis Epididymitis presents with acute testicular pain, tenderness, and pyuria. It is caused by Male Pathology 1
retrograde passage of organisms from the urethra into the ejaculatory duct and vas deferens. Reproductive (Path)
The microbiology is largely influenced by patient age: epididymitis in young men is usually (MR)
due to sexually acquired infections (eg, Chlamydia trachomatis, Neisseria gonorrhoeae),
whereas in older men (age >35) it is usually due to gram-negative colonic flora. MR Path
15804
Testicular cancer A painless, solid scrotal mass should be considered testicular cancer until proven otherwise. Male Pathology 4
Examination generally reveals a solid, firm, or fixed nodule in the tunica albuginea that is Reproductive (Path)
ovoid in shape and painless to palpation. Testicular tumors do not transilluminate. (MR) MR Path
15828
Testicular cancer Most cases of testicular cancer are either seminomatous or nonseminomatous germ cell Male Pathology 4
tumors. Nonseminomatous germ cell tumors are composed of partially differentiated germ Reproductive (Path)
cells, which often retain the ability to secrete human chorionic growth hormone and alpha- (MR)
fetoprotein (serum tumor markers). Serum lactate dehydrogenase, a marker of tissue injury
and cell turnover, is also frequently increased. MR Path
6 Tuberous sclerosis Renal angiomyolipoma is a benign tumor composed of blood vessels, smooth muscle, and Miscellaneous Pathology 1
fat. Bilateral renal angiomyolipomas are associated with tuberous sclerosis, an autosomal (Multisystem) (Path)
dominant condition. (MS) MS Path
34 DiGeorge syndrome Chromosome 22q11.2 microdeletion results in DGS (cardiac anomalies, hypoplastic or Miscellaneous Genetics 2
absent thymus, and hypocalcemia) and VCFS (cleft palate, cardiac anomalies, dysmorphic (Multisystem) (Gene)
facies). FISH is the "gold standard" for detecting a microdeletion. (MS) MS Gene
252Holoprosencephaly A developmental field defect describes multiple malformations that occur 2° to an embryonic Miscellaneous Embryolog 1
disturbance in an adjoining group of cells. HPE is a developmental field defect Chx by a (Multisystem) y (Embr)
spectrum of fetal anomalies due to incomplete division of the forebrain (prosencephalon). (MS) MS Embr
285Gastroesophageal Metaplasia is the substitution of one differentiated cell type for another due to the presence Miscellaneous Pathology 7
reflux disease of an adverse environmental stimulus. It is often seen in the bronchi of chronic cigarette (Multisystem) (Path)
smokers (substitution of columnar for stratified squamous cells) and the distal esophagus of (MS)
patients with chronic gastroesophageal reflux (substitution of stratified squamous with
columnar cells). Metaplasia can lead to dysplasia and malignant transformation. MS Path
311Vitamin C Vitamin C is necessary for the hydroxylation of proline and lysine residues in pro-collagen. Miscellaneous Biochemist 3
deficiency Vitamin C deficiency (scurvy) is most often seen in severely malnourished individuals and (Multisystem) ry (Bioc)
leads to capillary bleeding, poor wound healing, and periodontal disease. In children, bony (MS)
deformities and subperiosteal hemorrhages are also Chx. MS Bioc
862Aging Presbyopia and skin wrinkles are age-related changes. Presbyopia occurs due to denaturation Miscellaneous Pathology 8
of structural proteins within the lens, leading to loss of lens elasticity which can result in (Multisystem) (Path)
improved vision in patients with mild myopia. Decreased synthesis and increased breakdown (MS)
of collagen and elastin contribute to the development of skin wrinkles. MS Path
1122
Signal transduction The phosphoinositol 2nd messenger system begins w/ ligand-receptor binding and Gq- Miscellaneous Biochemist 1
protein activation leading to activation of PLC. PLC then hydrolyzes PIP2 and forms DAG (Multisystem) ry (Bioc)
and IP3. Finally, IP3 activates PKC via an ↑ in intracellular Ca2+. (MS) MS Bioc
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Genetic code Translation of the mRNA template proceeds in the 5' to 3' direction. B/c complementary Miscellaneous Genetics 1
sequences align in antiparallel fashion, during translation tRNA anticodons will be oriented (Multisystem) (Gene)
in the opposite 3' to 5' direction. Stop codons (UAA, UAG, and UGA) halt protein synthesis (MS)
by binding a RF; they do not add AAs to the polypeptide chain. MS Gene
1502
Alkaptonuria Alkaptonuria is an AR disorder in which the lack of homogentisic acid dioxygenase blocks Miscellaneous Biochemist 2
the metabolism of tyrosine, leading to an accumulation of homogentisic acid. CFx include a (Multisystem) ry (Bioc)
black urine color when exposed to air, a blue-black pigmentation on the face, and ochronotic (MS)
arthropathy. MS Bioc
1504
Homocystinuria Homocystinuria is most commonly caused by cystathionine synthase deficiency. Affected Miscellaneous Biochemist 1
individuals have marfanoid habitus, ectopia lentis, and developmental delay. Significant (Multisystem) ry (Bioc)
morbidity and mortality are due primarily to TE. Many pts w/ homocystinuria respond (MS)
dramatically to pyridoxine (vitamin B6) supplementation. MS Bioc
1728
Autosomal recessive AR disorders affect 25% of offspring of aSSx heterozygous carrier parents. Classical Miscellaneous Genetics 5
inheritance galactosemia is the most common and severe galactosemic disorder and Px w/i days of birth (Multisystem) (Gene)
w/ jaundice, vomiting, and hepatomegaly. (MS) MS Gene
1753
Cervical cancer Dysplasia is characterized by disruption of organized epithelial cell differentiation with Miscellaneous Pathology 3
marked cellular pleomorphism. Although high-grade dysplasia (involving most or the entire (Multisystem) (Path)
epithelial layer) often progresses to invasive cancer, low-grade dysplasia (involving a small (MS)
portion of epithelium) typically spontaneously regresses. Invasive cancer occurs when the
abnormal cells penetrate the basement membrane. MS Path
1822
Trisomy 13 Patau syndrome (trisomy 13) usually occurs secondary to meiotic nondisjunction in mothers Miscellaneous Genetics 1
of advanced maternal age. Key physical findings reflect defective prechordal mesoderm (Multisystem) (Gene)
fusion resulting in midline defects (eg, holoprosencephaly, microphthalmia, cleft lip/palate, (MS)
omphalocele) as well as polydactyly and cutis aplasia. MS Gene
1823
Trisomy 18 Trisomy 18, or ES, is most commonly the result of meiotic nondisjxn due to advanced Miscellaneous Genetics 1
maternal age. Key findings include fetal growth retardation, hypertonia (clenched hands w/ (Multisystem) (Gene)
overlapping fingers), rocker bottom feet, and cardiac/GI/renal defects. (MS) MS Gene
1824
Down syndrome DS (trisomy 21) is a/w ↓ maternal serum AFP and ↑ nuchal translucency. Duodenal atresia is Miscellaneous Genetics 6
the most common GI complication in these pts. (Multisystem) (Gene)
(MS) MS Gene
8283
Linkage Two allele loci are said to be in linkage disequilibrium when a pair of alleles are inherited Miscellaneous Genetics 1
disequilibrium together in the same gamete (haplotype) more often or less often than would be expected (Multisystem) (Gene)
given random pairing. This most often occurs when the genes are in close physical proximity (MS)
on the same chromosome. MS Gene
11531
Medical errors Physicians must be able to identify pts w/ limited English proficiency and ensure that Miscellaneous Behavioral 8
professional interpreters are made available in high-risk clinical situations. (Multisystem) Science
(MS) (Beha) MS Beha
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Medical errors Sleep deprivation in physicians often causes cognitive impairment, resulting in medical Miscellaneous Behavioral 8
errors. Although mandated resident work-hr limitations are in place, it is the responsibility of (Multisystem) Science
all physicians to self-regulate their workloads to promote pt safety. (MS) (Beha) MS Beha
11533
Polypharmacy Falls are a common problem in elderly nursing home patients. Optimal management includes Miscellaneous Behavioral 1
a careful medication review with the goal of limiting the use of agents associated with (Multisystem) Science
increased fall risk. (MS) (Beha) MS Beha
11534
Treatment Effective d/c planning requires collaboration of multiple disciplines (physician, nurse, social Miscellaneous Behavioral 5
adherence worker). A social worker can be instrumental in Ax whether the pt has adequate family or (Multisystem) Science
caregiver support at home. (MS) (Beha) MS Beha
11535
Medical errors Avoiding the use of unsafe abbreviations and trailing zeros in Rx orders can help ↓ the Miscellaneous Behavioral 8
incidence of Rx errors. (Multisystem) Science
(MS) (Beha) MS Beha
11536
Treatment Pts' misunderstanding of Rx use can result in Rx errors, including potential overdose, Miscellaneous Behavioral 5
adherence toxicity, and withdrawal. Physicians must Ax the pt's understanding and provide targeted (Multisystem) Science
education to address misconceptions. (MS) (Beha) MS Beha
11537
Antihistamines Review of Rx to determine if any are unnecessary or causing AEx is essential in providing Miscellaneous Behavioral 3
high-quality pt care. The cumulative anticholinergic burden of multiple Rx is especially (Multisystem) Science
problematic in the elderly. (MS) (Beha) MS Beha
11550
Treatment A d/c checklist detailing Rx changes and f/u appointments can significantly facilitate a pt's Miscellaneous Behavioral 5
adherence transition from the hospital and improve adherence to outPt Tx. Individuals who experience a (Multisystem) Science
smooth transition from the inPt to the outPt setting are at ↓ risk for early rehospitalization. (MS) (Beha) MS Beha
11602
Health insurance Medicare is a federal socialized medical insurance program that covers individuals age 65 Miscellaneous Behavioral 3
and older who have a work Hx and younger individuals w/ disabilities. (Multisystem) Science
(MS) (Beha) MS Beha
11635
Compartment Acute compartment syndrome (ACS) is caused by increased pressure within fascial Miscellaneous Anatomy 2
syndrome compartments of the limbs, leading to impaired perfusion. ACS can cause severe pain, (Multisystem) (Anat)
myonecrosis, and nerve injury. The anterior compartment of the leg, which contains the deep (MS)
peroneal (fibular) nerve, is the most common site of ACS. MS Anat
11955
Nuclear factor Nuclear factor-kappa B (NF-kB) is a transcription factor with a critical role in the immune Miscellaneous Pathology 1
kappa B response to infection. NF-kB is normally present in the cytoplasm in a latent, inactive state (Multisystem) (Path)
bound to its inhibitor protein, IKB. Extracellular substances such as lipopolysaccharide can (MS)
initiate a signal cascade that results in the destruction of IKB and translocation of free NF-kB
to the nucleus. MS Path
4 Subarachnoid Intracranial BAs of the COW are often seen in pts w/ ADPKD; when ruptured, they cause Nervous (NS) Pathology 4
hemorrhage SAH that presents w/ sudden onset of 'thunderclap h/a'. (Path) NS Path
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14 Hydrocephalus Hydrocephalus is an enlargement of the ventricles (+/- ↑ pressure) caused by either neuronal Nervous (NS) Pathology 4
volume loss (eg, hydrocephalus ex-vacuo) or excessive CSF accumulation (due to flow (Path)
obstruction or impaired absorption). Neurodegenerative diseases (eg, AIDS dementia) can be
a/w hydrocephalus ex-vacuo due to significant cortical atrophy, which allows the ventricles
to expand while maintaining normal pressure. NS Path
15 Hydrocephalus Symmetrical enlargement of the ventriculi is Chx of communicating hydrocephalus. Nervous (NS) Pathology 4
Communicating hydrocephalus usually occurs 2° to dysfxn or obliteration of subarachnoid (Path)
villi. This dysfxn is usually a sequelae of meningeal infection (including tuberculosis
meningitis) or SAH/IVH. NS Path
16 Normal pressure NPH presents w/ progr gait difficulties, cognitive disturbances, and urinary incontinence. It's Nervous (NS) Pathology 2
hydrocephalus a form of communicating hydrocephalus characterised by ventriculomegaly w/o persistent ↑ (Path)
in ICP. Brain imaging reveals ventricular enlargement out of proportion to sulci enlargement. NS Path
17 Normal pressure NPH occurs due to ↓ CSF absorption, resulting in ventriculomegaly w/ normal ICP. This Nervous (NS) Pathology 2
hydrocephalus causes stretching of the descending cortical fibers (corona radiata) from the frontal lobe and (Path)
contributes to the classic triad of SSx (ie, dementia, gait abnormalities, urinary incontinence).
Loss of cortical inhibition of the sacral micturition center leads to urge incontinence. NS Path
18 Ischemic stroke Global cerebral ischemia is typically precipitated by systemic hypotension (e.g. cardiac Nervous (NS) Pathology 19
arrest). The cells most susceptible to ischemia are the CA1 pyramidal neurons of the (Path)
hippocampus. Other areas of the brain that are damaged early in the course of global cerebral
ischemia incl the cerebellar Purkinje cells and the pyramidal neurons of the neocortex. NS Path
19 Ischemic stroke Inadequate blood supply to the brain (e.g. arterial thrombosis or embolism) leads to ischemic Nervous (NS) Pathology 19
stroke. The 1st microscopic changes are typically seen 12-24hrs after irreversible ischemic (Path)
injury and incl intense eosinophilic staining of the neuronal cytoplasm (red neurons) and
nuclear fragmentation. NS Path
20 Ischemic stroke Microglia are the predominant cell in the necrotic area 3-7 days after the onset of ischemia Nervous (NS) Pathology 19
and phagocytize the fragments of neurons, myelin, and necrotic debris. (Path) NS Path
21 Ischemic stroke Occlusion of the MCA typically results in contralateral hemiparesis and hemisensory loss of Nervous (NS) Anatomy 19
the face and upper limb w/ relative preservation of lower limb fxn. If the occluded MCA is in (Anat)
the dom (usually left) hemisphere, aphasia may also occur. NS Anat
22 Ischemic stroke Lacunar infarcts are small ischemic infarcts (<15mm in diameter) involving the deep brain Nervous (NS) Pathology 19
structures (e.g. basal ganglia, pons) and subcortical white matter (e.g. internal capsule, (Path)
corona radiata). They're most often due to lipohyalinosis, microatheroma formation, and
hardening/thickening of the vessel wall (HTN arteriolar sclerosis), which predisposes to
thrombotic vessel occlusion. NS Path
23 Ischemic stroke Sustained cerebral hypoperfusion (eg, hypotension, shock) may cause global cerebral Nervous (NS) Pathology 19
ischemia and watershed infarction. These watershed zones are located at the borders b/w (Path)
areas perfused by the ACAs, MCAs, and PCAs and typically appear as symmetric, bilateral
wedge-shaped strips of necrosis over the cerebral convexity, parallel and adjacent to the
interhemispheric fissure. NS Path
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63 Wernicke-Korsakoff Oculomotor dysfxn, ataxia, and confusion form the triad of WE. Most of these SSx usually Nervous (NS) Pathology 5
syndrome resolve after vitB1 administration. Korsakoff syndrome is a complication of WE, the (Path)
hallmarks of which are permanent memory loss and confabulation. NS Path
64 Vitamin B12 Vit B12 defx often Px w/ megaloblastic anemia (impaired DNA synthesis) and neuro deficits Nervous (NS) Biochemist 9
deficiency (impaired myelin synthesis). Chx neuro findings include SCD of the dorsal columns and ry (Bioc)
lateral corticospinal tract. ↑ in methylmalonic acid and homocysteine lvls occur due to ↓
metabolism of these molecules. NS Bioc
65 Vitamin B12 Myelopathy a/w vitB12 defic is called SCD. 'combo' refers to myelin degen of both the Nervous (NS) Pathology 9
deficiency ascending (dorsal columns) and descending (corticospinal tract) pathways. Loss of position (Path)
and vibration sensation, sensory ataxia, and spastic paresis are common MFxs. NS Path
66 Guillain-Barre GBS is an acute, demyelinating polyneuropathy thought to be caused by molecular mimicry. Nervous (NS) Pathology 3
syndrome Abs formed against infectious agents cross-react w/ myelin and Schwann cells, leading to (Path)
immune-mediated demyelination. LM shows segmental demyelination and an endoneurial
inflammatory infiltrate composed of lymphocytes and macrophages. NS Path
113Meningitis C. neoformans is a yeast w/ a thick PSC that's found 1arily in soil contaminated by bird Nervous (NS) Microbiolo 17
droppings. Inhalation of the pathogen into the lungs leads to (a usually aSSx) 1ary infection. gy (Micr)
In pts who're immsup (e.g. adv AIDS), the pathogen can spread thru the bloodstream to other
organs, particularly the CNS. NS Micr
116Meningitis Pts w/ suspected cryptococcal meningitis can be Dx using India ink staining of the CSF. Tx Nervous (NS) Microbiolo 17
w/ amphotericin B and flucytosine is req at 1st, f/b long-term fluconazole maint therapy. gy (Micr) NS Micr
118Meningitis C. neoformans causes ME in pts w/ unTx AIDS. Dx can be made by detecting the PSC in Nervous (NS) Microbiolo 17
CSF using the latex agglutination test. India ink staining of CSF is also used for Dx and can gy (Micr)
demo round or oval budding yeast. NS Micr
146Subarachnoid Delayed cerebral ischemia due to cerebral vasospasm usually presents 3-12days after the Nervous (NS) Pharmacol 4
hemorrhage initial SAH w/ an acute change in mental status a/o new focal neuro deficits. Nimodipine, a ogy (Phar)
selective CCB, improves outcomes in pts w/ cerebral vasospasm by inducing cerebral
vasodilation and ↓ Ca2+-dependent excitotoxicity. NS Phar
173Antihistamines In addn to blocking H receptors, 1st-gen antihistamines (e.g. chlorpheniramine, Nervous (NS) Pharmacol 3
diphenhydramine) have antimuscarinic, anti-α adrenergic, and anti-5-HT-ergic properties. ogy (Phar)
Anticholinergic effects on the ocular ciliary muscles impair accommodation and cause
blurring of vision for close objects. NS Phar
177Necrosis Irreversible ischemic injury to brain tissue causes tissue digestion by hydrolytic enzymes Nervous (NS) Pathology 3
(liquefactive necrosis). The infarcted CNS tissue is eventually replaced w/ a cystic astroglial (Path)
scar. In other organs, lethal ischemic injury results in coag necrosis. NS Path
249Seizures Older children w/ absence seizures may also develop gen onset tonic-clonic or myoclonic Nervous (NS) Pharmacol 8
seizures. Although ethosuximide is effective against isolated absence seizures, it isn't ogy (Phar)
effective for tonic-clonic seizures. Valproic acid is a broad-spectrum antiepileptic that Tx
both types of seizures. NS Phar
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250Seizures Absence seizures are a type of gen epilepsy characterised by brief staring spells w/ Nervous (NS) Pharmacol 8
momentary loss of awareness f/b an abrupt return to full consciousness. A classic 3-Hz ogy (Phar)
spike-wave is seen on EEG; the Tx is ethosuximide. NS Phar
259Parkinson disease Selegiline is an inhib of MAO-B and can prevent MPTP-induced dmg of DA-ergic neurons. Nervous (NS) Pharmacol 7
Selegiline is used clinically to delay the progr of Parkinson disease. Many neurologists ogy (Phar)
favour the use of combos of selegiline, anticholinergics, and amantadine until they no longer
provide control of SSx. Only then is L-DOPA/carbidopa introduced. NS Phar
262Parkinson disease Adding carbidopa can ↓ most of the peri AEs of L-DOPA. However, behavioural changes Nervous (NS) Pharmacol 7
from L-DOPA can actually worsen w/ addn of carbidopa b/c more DA becomes available to ogy (Phar)
the brain. NS Phar
264Parkinson disease Long-term Tx of PD w/ levodopa can be complicated by periodic and sometimes Nervous (NS) Pharmacol 7
unpredictable fluctuations in motor fxn. This "on-off" phenomenon is thought to be a ogy (Phar)
consequence of progressive nigrostriatal neurodegeneration leading to a ↓ therapeutic
window for levodopa. NS Phar
265Parkinson disease PD is typically Tx w/ L-DOPA (immediate precursor of DA), which crosses the BBB. L- Nervous (NS) Pharmacol 7
DOPA is admin w/ DDCIs (e.g. carbidopa) and sometimes COMTIs (e.g. entacapone) to ↓ ogy (Phar)
the peri meta of L-DOPA, resulting in ↑ L-DOPA bioavailability to the brain. NS Phar
344Fragile X syndrome FXS, an XL disorder, is the most common cause of inherited intellectual disability. The Nervous (NS) Genetics 3
pathogenesis involves an unstable expansion of TNRs (CGG) in the FMR1 gene. Key (Gene)
physical findings include dysmorphic facial features (e.g. large jaw, protruding ears, long
face) and macroorchidism. NS Gene
347Child abuse Abusive head trauma can be caused by vigorous shaking of an infant and results in SDH (due Nervous (NS) Pathology 2
to tearing of bridging veins) and retinal hemorrhages. Additional red flags are injuries (Path)
inconsistent w/ Hx or developmental age. NS Path
351Antiepileptics Phenytoin meta depends on the fxn of hepatic P450 oxidases and is dose-dependent. Drugs Nervous (NS) Pharmacol 3
that induce hepatic microsomal enzymes (phenobarbital, carbamazepine, and rifampin) ogy (Phar)
enhance phenytoin meta and ↓ its serum conc. You should know all of the commonly-
prescribed Rx that're meta by the P450 system, and you should know which drugs induce or
inhib the fxn of these enzymes. NS Phar
352Benzodiazepines 1st-gen H1 receptor antagonists, incl diphenhydramine and chlorpheniramine, can cause Nervous (NS) Pharmacol 6
significant sedation, esp. when used w/ other Rx that caused CNS depression (such as ogy (Phar)
benzos). NS Phar
353Seizures SE is a single seizure lasting >5min or the occurrence of multi discrete seizures w/ Nervous (NS) Pharmacol 8
incomplete recovery of consciousness b/w episodes. The initial Tx incls IV lorazepam and ogy (Phar)
phenytoin given concurrently. Phenytoin is a long-acting anticonvulsant that inhibs neuronal
high-freq firing by ↓ the ability of Na+ channels to recover from inactivation. NS Phar
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354Trigeminal CNV neuralgia presents w/ brief episodes of sudden and severe 'electric shock-like' or Nervous (NS) Pharmacol 2
neuralgia 'stabbing' pain in the distribution of CNV (particularly V2 and V3). Carbamazepine is the ogy (Phar)
DOC. NS Phar
355Seizures Broad-spectrum anticonvulsants (e.g. levetiracetam, valproic acid) Tx both focal and gen Nervous (NS) Pharmacol 8
onset seizures, whereas narrow-spectrum anticonvulsants (e.g. carbamazepine, phenytoin) ogy (Phar)
are 1arily used only for focal onset seizures. B/c the seizures in JME are usually gen onset (i.
e. affect both cerebral hemispheres at onset), Tx is w/ a broad-spectrum agent such as
valproic acid. NS Phar
356Antiepileptics Lamotrigine can be used to Tx partial and gen seizures and works by blocking v-gated Na+ Nervous (NS) Pharmacol 3
channels. SJS and TEN are rare, life-threatening AEs characterised by flu-like SSx f/b ogy (Phar)
widespread mucocutaneous epidermal necrosis. NS Phar
357Mitochondrial Red ragged muscle fibers are seen in mitochondrial diseases. Muscle fibers have this Nervous (NS) Genetics 1
diseases, inheritance appearance b/c abnormal mitochondria accumulate under the sarcolemma. Mitochondrial (Gene)
diseases show maternal inheritance. NS Gene
397Wilson disease WD is an AR condition Chx by excessive Cu deposition into tissues (eg, liver, basal ganglia, Nervous (NS) Pathology 5
cornea). It typically Px in young adults w/ liver disease, neuropsych SSx (eg, gait (Path)
disturbance, dysarthria, depression, personality changes), and Kayser-Fleischer rings on slit
lamp Ex. NS Path
468von Hippel-Lindau A cerebellar hemangioblastoma in a/w congenital cysts of the kidneys, liver, a/o pancreas is Nervous (NS) Pathology 1
disease highly suggestive of vHL disease, a rare AD condition. (Path) NS Path
492Ischemic stroke Neurons that sustain irreversible ischemic injury begin to develop char histopath changes 12- Nervous (NS) Pathology 19
24hrs after the inciting event. These changes incl shrinkage of the cell body, pyknosis of the (Path)
nucleus, loss of Nissl bodies, and cytoplasmic eosinophilia (red neurons). NS Path
493Ischemic stroke CNS injury is a/w astrocyte hypertrophy and proliferation (gliosis). This process leads to the Nervous (NS) Pathology 19
formation of a glial scar, which compensates for the volume loss that occurs after neuronal (Path)
death. NS Path
494Neuronal The changes in the body of a neuron after the axon has been severed are called axonal rxn. Nervous (NS) Pathology 3
physiology This process reflects an ↑ protein synthesis that facilitates axon repair. Enlarged, rounded (Path)
cells w/ perily located nuclei and dispersed finely granular Nissl substance are seen. NS Path
495Brain herniation Transtentorial (ie, uncal) herniation is a complication of an ipsilateral mass lesion, such as a Nervous (NS) Pathology 2
hemorrhage or brain tumor. The 1st sign of uncal herniation is a fixed and dilated pupil on (Path)
the side of the lesion. Ipsilateral paralysis of oculomotor muscles, contralateral or ipsilateral
hemiparesis, and contralateral homonymous hemianopsia w/ macular sparing may also occur. NS Path
496Neural tube defects Failure of neural tube closure at 4 wks gestation results in NTDs. 1st trimester use of Nervous (NS) Embryolog 4
valproate is a significant RF for NTDs, but periconceptional vit B9 supplementation ↓ this y (Embr)
risk. NS Embr
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497Subarachnoid SAH Px w/ a generalized, excruciating h/a. It is classically described by pts as "the worst h/a Nervous (NS) Pathology 4
hemorrhage of my life." SAH usually occurs due to rupture of saccular (berry) aneurysms or AVMs. (Path)
Berry aneurysms of the COW are a/w AD PKD. NS Path
498Hemorrhagic stroke Deep intraparenchymal hemorrhage is most commonly caused by HTN vasculopathy of the Nervous (NS) Pathology 3
small penetrating branches of the cerebral arteries (Charcot-Bouchard aneurysm rupture). (Path)
This is in contrast to rupture of saccular aneurysms, which tyrupture of saccular aneurysms,
which typically cause SAH. NS Path
499Hemorrhage stroke Cerebral amyloid angiopathy is the most common cause of spontaneous lobar hemorrhage, Nervous (NS) Pathology 1
particularly in the elderly. The most common sites of hemorrhage include the occipital and (Path)
parietal lobes. NS Path
500Subarachnoid The most common complication of aneurysmal SAH is vasospasm, which typically occurs 3- Nervous (NS) Pathology 4
hemorrhage 12days after the initial insult and can cause delayed cerebral ischemia (e.g. sudden change in (Path)
mental status, new focal neuro deficits). The CT scan usually remains unchanged, unlike w/
rebleeding. NS Path
501Ischemic stroke Several mos to yrs after ischemic brain infarction, the necrotic area appears as a cystic cavity Nervous (NS) Pathology 19
surrounded by a wall composed of dense fibers formed by astrocytic processes (glial scar). (Path) NS Path
502Neural tube defects NTDs most often occur when the neural folds fail to fuse in the region of the ant or post Nervous (NS) Embryolog 4
neuropores. Persistent communication b/w the spinal canal and the amniotic cavity allows y (Embr)
leakage of AFP and AChE into the amnionic fluid, leading to ↑ lvls of AFP and AChE that
can be detected on amniocentesis. NS Embr
503Syringomyelia Syringomyelia is characterised by the formation of a cavity (syrinx) in the cervical region of Nervous (NS) Pathology 2
the spinal cord. The syrinx dmgs the ventral white commissure, leading to bilateral loss of (Path)
pain and temp sensation that's limited to the affected lvls (typically the arms and hands);
distal sensation is preserved. Destruction of the motor neurons in the ventral horns (due to
extension of the syrinx) results in flaccid paralysis and atrophy of the intrinsic muscles of the
hand. NS Path
504Chiari malformation Chiari malformations are congenital disorders that result from underdevelopment of the Nervous (NS) Pathology 1
posterior fossa, causing parts of the cerebellum and medulla to herniate through the foramen (Path)
magnum. Chiari-I is relatively benign and Px during adulthood w/ occipital h/a and
cerebellar dysfxn. Chiari-II is a more severe form that affects neonates and is often a/w
lumbar myelomeningocele and hydrocephalus. NS Path
505Epidural hematoma EDH is an accumulation of blood b/w the bone and dura mater. It typically occurs due to a Nervous (NS) Pathology 2
tear of the MMA a/w fracture of the pterion region of the skull (often involving the temporal (Path)
bone). Pts char have transient LOC f/b a lucid interval before ↑ ICP leads to neuro
deterioration. NS Path
508DRESS syndrome DRESS syndrome typically occurs 2-8wks after exposure to high-risk drugs such as Nervous (NS) Pharmacol 1
anticonvulsants (e.g. phenytoin, carbamazepine), allopurinol, sulphonamides (e.g. ogy (Phar)
sulfasalazine), and Abx (e.g. minocycline, vancomycin). Pts typically develop fever, gen
LAD, facial oedema, diffuse skin rash, eosinophilia, and internal organ dysfxn. NS Phar
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509Seizures Ethosuximide, the 1st-line Tx for absence seizures, prevents neuronal burst firing by Nervous (NS) Pharmacol 8
blocking thalamic T-type Ca2+ channels. Phenytoin, carbamazepine, and valproic acid inhib ogy (Phar)
neuronal high-freq firing by ↓ the ability of Na+ channels to recover from inactivation. NS Phar
566Lung cancer Pancoast tumours are NSCLCs (e.g. SCC, AC) that arise near the superior sulcus. Pts may Nervous (NS) Anatomy 9
develop ipsilateral shoulder pain, upper limb paraesthesias, and areflexic arm weakness due (Anat)
to involvement of the brachial plexus. Horner's syndrome (e.g. ipsilateral partial ptosis,
miosis, anhidrosis) can also occur due to involvement of the cervical sympathetic ganglia. NS Anat
587Ataxia Cerebellar ataxia, telangiectasias, and ↑ risk of sinopulm infections constitute a Chx triad of Nervous (NS) Pathophysi 2
telangiectasia AT. This illness exhibits AR inheritance, and the defect is in a gene that codes for the ATM ology
gene which plays a role in DNA break repair. The immune defx primarily MFx as an IgA (Patp)
defx and predisposes to infections of the upper and lower airways. NS Patp
590Down syndrome Pts w/ trisomy 21 (DS) have 3 copies of the amyloid precursor protein gene located on chrom Nervous (NS) Genetics 6
21. This ↑ amyloid-β accumulation in the brain, placing these pts at high risk for developing (Gene)
early-onset AD. NS Gene
591Alzheimer disease Early-onset familial AD is a/w 3 gene muts: APP (chrom 21), presenilin 1, and presenilin 2. Nervous (NS) Genetics 7
Late-onset familial AD is a/w apoE4 genotype. (Gene) NS Gene
592Alzheimer disease Amyloid is an abnormally folded (insoluble) extracellular protein that has apple-green Nervous (NS) Pathology 7
birefringence when stained w/ Congo red and viewed under polarized light. AD is a/w β- (Path)
amyloid deposits in the brain parenchyma (neuritic plaques) and walls of cerebral vessels
(amyloid angiopathy). NS Path
593Alzheimer disease AD is characterised by ↓ lvls of ACh in the nucleus basalis of Meynert and the hippocampus, Nervous (NS) Pathology 7
caused by ↓ activity of choline acetyltransferase. (Path) NS Path
594Frontotemporal FTD is a/w pronounced atrophy of the prefrontal cortex w/ later degen of the anterior Nervous (NS) Pathology 2
dementia temporal cortex. It MFx initially w/ changes in personality, social behaviour, and language (Path)
that progress over time to a more global dementia w/ obvi neurocognitive deficits. NS Path
595Cerebellar PNP syndromes can occur due to the production of hormone-like substances from tumour Nervous (NS) Pathology 1
degeneration cells. They can also result from immune rxns against tumour cells that cross-react w/ normal (Path)
cells, causing dysfxn a/o dmg to healthy organs and tissues. Neuro PNP syndromes (e.g. PNP
cerebellar degen) are an autoimmune phenomenon. NS Path
596Mitochondrial Mitochondrial diseases are Chx by exclusively-maternal inheritance. The variable severity of Nervous (NS) Genetics 4
disorders these diseases is explained by the random distribution of normal and mutated mitochondria (Gene)
b/w daughter cells during mitosis; as a result, some cells may have completely healthy
mitochondria, while other cells contain mitochondria affected by genetic mutation
(heteroplasmy). MELAS is a mitochondrial syndrome. NS Gene
597Wernicke-Korsakoff WE is a complication of thiamine deficiency Chx by encephalopathy, ataxia, and oculomotor Nervous (NS) Pathology 5
syndrome dysfxn. It occurs most commonly in pts w/ chronic Alc abuse and may be precipitated by (Path)
infusion of Glc-containing fluids. Neuroimaging reveals focal hemorrhage or atrophy of the
mammillary bodies. NS Path
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598Wernicke-Korsakoff Chronic vit B1 defx impairs Glc utilization in the CNS. This occurs due to ↓ activity of the Nervous (NS) Biochemist 5
syndrome enzymes that use B1 as a cofactor (e.g. PDH, α-KG dehydrogenase, transketolase). B1 defx ry (Bioc)
can be Dx if baseline erythrocyte transketolase activity is low but ↑ after addition of B1-PPi. NS Bioc
613Brain tumors GBM is the most common 1° cerebral neoplasm of adults that's typically located w/i the Nervous (NS) Pathology 10
cerebral hemispheres and may cross the midline ('butterfly glioma'). These tumours are (Path)
highly malignant and grossly contain areas of necrosis and hemorrhage. NS Path
614Glioblastoma GBM is the most common 1° brain tumour in adults. Areas of necrosis and hemorrhage are Nervous (NS) Pathology 1
(Multiforme) seen on gross Ex. LM showing pseudopalisading tumour cells around areas of necrosis is Dx. (Path) NS Path
632Huntington disease HD is an AD neurodegen disorder that MFx w/ chorea (e.g. involuntary, jerky, fidgety Nervous (NS) Pathology 5
movements) and behavioural abns (e.g. aggressiveness, depression). Char neuroimaging (Path)
findings incl atrophy of the caudate nuclei which results in enlargement of the frontal horns
of the lateral ventricles. NS Path
634Dystonia Dystonia is a syndrome of prolonged, repetitive muscle contractions. This condition may be Nervous (NS) Pathology 1
the result of impaired fxn of the basal ganglia. Cervical dystonia (spasmodic torticollis), (Path)
blepharospasm, and writer's cramp are the most common types of focal dystonia. NS Path
635Hemiballismus The STN plays an important role in the modulation of BG output. Damage to this structure Nervous (NS) Anatomy 1
(eg, due to lacunar stroke) may result in contralateral hemiballism, Chx by wild, involuntary, (Anat)
large-amplitude, flinging movements of the proximal limbs (eg, arm a/o leg) on one side of
the body. NS Anat
636Friedreich ataxia FA is an AR condition that presents during childhood/adolescence w/ progr gait ataxia (due Nervous (NS) Pathology 2
to degen of the spinocerebellar tracts) and impaired joint and vibration sense (due to degen of (Path)
the posterior columns and DRG). Other features incl HCM (most common cause of death),
skeletal abns (e.g. kyphoscoliosis, pes cavus), and DM. NS Path
647Lung cancer The phrenic nerve arises from the C3-C5 segments of the spinal cord and innervates the Nervous (NS) Pathology 9
ipsilateral hemidiaphragm. Intrathoracic spread of lung ca may affect the phrenic nerve, (Path)
causing hiccups and diaphragmatic paralysis w/ dyspnoea. Brachial plexus involvement can
cause pain in the distribution of the C8, T1, and T2 nerve roots. Involvement of the recurrent
laryngeal nerve may cause hoarseness. NS Path
659Anesthesia The onset of action of a gas anaesthetic depends on its solubility in the blood (blood/gas Nervous (NS) Pharmacol 9
partition coefficient). Drugs w/ high blood/gas partition coefficients are more soluble in the ogy (Phar)
blood, demonstrate slower equilibrium w/ the brain, and have longer onset times. NS Phar
660Anesthesia The arteriovenous concentration gradient reflects the overall tissue solubility of an Nervous (NS) Pharmacol 9
anesthetic. Anesthetics with high tissue solubility are characterized by large arteriovenous ogy (Phar)
concentration gradients and slower onsets of action. NS Phar
671Vitamin E VitE is a lipid-soluble vit that has antioxidative properties. Neuro SSx of vitE defic closely Nervous (NS) Pathology 2
deficiency mimic FA and incl ataxia (due to degen of spinocerebellar tracts), loss of position and (Path)
vibration sense (due to degen of the dorsal columns), and loss of DTR (due to peri nerve
degen). NS Path
Rep
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672Friedreich ataxia FA is Chx by cerebellar ataxia (spinocerebellar tract degeneration) and loss of Nervous (NS) Pathology 2
position/vibration sensation (dorsal column/DRG degeneration), kyphoscoliosis, and HCM. (Path)
Foot abnormalities and DM are also common. NS Path
673Ataxia AT is an AR disorder resulting from a defect in DNA-repair genes. The DNA of these pts is Nervous (NS) Pathology 2
telangiectasia hypersensitive to ionizing radiation. MFx include cerebellar ataxia, oculocutaneous (Path)
telangiectasias, repeated sinopulm infections, and an ↑ incidence of malignancy. NS Path
674Amyotrophic lateral UMN dmg leads to spastic paralysis, hyperreflexia, and an upgoing plantar reflex (Babinski Nervous (NS) Pathology 2
sclerosis sign) due to loss of descending inhib over LMNs in the anterior horn. Conversely, LMN (Path)
lesions cause flaccid paralysis, hypotonia, hyporeflexia, muscle atrophy, and fasciculations. NS Path
675Amyotrophic lateral ALS causes both UMN and LMN lesions. Loss of neurons of the anterior horns of the spinal Nervous (NS) Pathology 2
sclerosis cord (LMN lesion) causes muscle weakness and atrophy. Demyelination of the lateral (Path)
corticospinal tract (UMN lesion) leads to spasticity and hyperreflexia. NS Path
703Parkinson disease DA agonists have a chem structure similar to the NT DA and directly stim DA receptors. The Nervous (NS) Pharmacol 7
2 classes of DA agonists are ergot compounds (e.g. bromocriptine) and non-ergot compounds ogy (Phar)
(e.g. pramipexole, ropinirole). NS Phar
735Meningitis Bacterial meningitis causes an incr in CSF neutrophil count and protein conc as well as decr Nervous (NS) Microbiolo 17
in CSF Glc. S. pneumoniae is a leading cause of CAP, OM, and meningitis in adults. S. gy (Micr)
pneumoniae appears on Gram stain as lancet-shaped, Gram (+) cocci in pairs. NS Micr
737Meningitis N. meningitidis is transmitted 1arily by aerosolized droplets and subseq colonizes the Nervous (NS) Microbiolo 17
nasopharyngeal epithelium. Penetration of the epithelium can lead to bloodstream infection. gy (Micr)
Spread to the meninges occurs via transcellular penetration of the cerebral cap endothelium
or entry at the choroid plexus. NS Micr
738Meningitis N. meningitidis can cause sepsis and circulatory collapse in previously healthy young Nervous (NS) Microbiolo 17
individuals. LOS, a VF in the pathogens outer membrane, is the major underlying cause of gy (Micr)
disease severity. NS Micr
749Myasthenia gravis MG is caused by circulating Abs directed against AChR of the NMJ. Auto-Ab binding leads Nervous (NS) Pathology 10
to receptor degradation, producing fluctuating weakness that worsens over the course of the (Path)
day and most commonly affects the extraocular muscles (e.g. ptosis, diplopia). Most pts also
have thymic abns (e.g. thymoma). NS Path
775Opioids β-endorphin is 1 endogenous opioid peptide that is derived from POMC. POMC is a Nervous (NS) Physiology 13
polypeptide precursor that goes thru enzymatic cleavage and modification to produce not (Phys)
only β-endorphins, but also ACTH and MSH. The fact that β-endorphin and ACTH are
derived from the same precursor suggests that there may be a close physiological relationship
b/w the stress axis and the opioid system. NS Phys
776Opioids Opiate analgesics ↓ pain by binding to μ receptors and inhib synaptic activity in the CNS. Nervous (NS) Pharmacol 13
Activation of presynaptic μ receptors on the 1° afferent neuron leads to closure of v-gated ogy (Phar)
Ca2+ channels and ↓ excitatory NT release. Binding to μ receptors on the postsynaptic
membrane causes opening of K+ channels and membrane hyperpol. NS Phar
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794Alzheimer disease The hippocampus is the area of the brain demonstrating the greatest degree of atrophy in AD. Nervous (NS) Pathology 7
Hippocampal atrophy on MRI is highly suggestive of the Dx. (Path) NS Path
840Huntington disease Hypo-acetylated histones bind tightly to DNA and prevent transcription of genes in their Nervous (NS) Genetics 5
associated regions. Alteration of gene expression in HD occurs in part due to deacetylation of (Gene)
histones. This prevents the transcription of certain genes that code for neurotrophic factors,
contributing to neuronal cell death. NS Gene
851Anesthesia The MAC is a measure of potency of an inhaled anaesthetic. It's the conc of the anaesthetic Nervous (NS) Pharmacol 9
in the alveoli that renders 50% of pts unresponsive to painful stimuli (ED50). Potency is ogy (Phar)
inversely proportional to the MAC: the lower the MAC, the more potent the anaesthetic. NS Phar
853Drug induced liver Halogenated inhaled anaesthetics (e.g. halothane, enflurane, isoflurane, sevoflurane, Nervous (NS) Pharmacol 2
injury desflurane) are meta by the hepatic CYP450 system by which they're converted to reactive ogy (Phar)
intermediates that can cause hepatocellular dmg (halothane hepatitis). Pts often present w/
acute hepatitis days after Rx exposure, and liver Bx may show centrilobular hepatic necrosis. NS Phar
854Anesthesia Almost all volatile anaesthetics ↑ cerebral blood flow. It's an undesirable effect as it results in Nervous (NS) Pharmacol 9
↑ ICP. Other important effects of inhalation anaesthetics are myocardial depression, ogy (Phar)
hypotension, resp depression, and ↓ renal fxn. NS Phar
855Malignant Malignant hyperthermia occurs after admin of inhalation anaesthetics a/o SCh to genetically Nervous (NS) Pharmacol 1
hyperthermia susceptible individuals. It's Tx w/ dantrolene that blocks RyR and prevents release of Ca2+ ogy (Phar)
into the cytoplasm of skeletal muscle fibres. NS Phar
856Anesthesia Propofol and other highly lipophilic drugs readily diffuse across membranes, quickly Nervous (NS) Pharmacol 9
accumulating in tissues receiving high blood flow; this accounts for their rapid onset of ogy (Phar)
action. These compounds are subseq redistributed to organs receiving less blood flow, which
explains their short duration of action. NS Phar
866Febrile seizure Febrile seizures are the most common neuro disorder affecting children and are benign Nervous (NS) Pharmacol 1
sequelae of fever. Children who experience a febrile seizure are at risk for recurrence but ogy (Phar)
have a low risk of developing epilepsy. Supportive care (eg, antipyretics) can improve pt
comfort during fever but does not prevent future seizures. NS Phar
871Necrosis Liquefactive necrosis is characterised by complete digestion and removal of necrotic tissue Nervous (NS) Pathology 3
w/ formation of a cystic cavity. Irreversible ischemic CNS injury is typically f/b liquefactive (Path)
necrosis due to the release of lysosomal enzymes from inflammatory cells and dmgd
neurons. NS Path
880Brain tumors Synaptophysin is a protein found in presynaptic vesicles of neurons, neuroendocrine, Nervous (NS) Pathology 10
neuroectodermal cells. CNS tumours of neuronal origin freq stain (+) for synaptophysin on (Path)
IHC. Neoplasms of glial origin (astrocytomas, ependymomas, and oligodendrogliomas) stain
for GFAP. NS Path
902Huntington disease HD is an AD neurodegen disease that leads to the accumulation of abn, toxic huntingtin Nervous (NS) Pathology 5
protein in neural cells. Inhib GABAergic neurons in the caudate nuclei are most susceptible, (Path)
and their loss is responsible for the ChFx of HD (e.g. chorea, behavioural abns). NS Path
Rep
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906Syphilis Tabes dorsalis, a later form of neurosyphilis, causes progr degen of the dorsal columns and Nervous (NS) Pathology 9
dorsal roots of the spinal cord. MFxs incl loss of proprioception and vibratory sensation, (Path)
severe lancinating pains, and sensory ataxia (e.g. wide-based gait, (+) Romberg sign). Many
pts also have Argyll Robertson pupils. NS Path
907HSV infection HSV-1 encephalitis is a potentially fatal complication from 1ary infection or reactivation of Nervous (NS) Microbiolo 9
latent disease. NS invasion leads to necrosis of the temp lobe, which can result in aphasia and gy (Micr)
personality changes in addn to classic features of encephalitis (e.g. h/a, fever, AMS, seizure). NS Micr
908HSV infection Viral infections of the CNS are usually characterised by ↑ protein, normal Glc, and an ↑ Nervous (NS) Pathology 9
WBC count w/ a lymphocytic predominance. Pts w/ herpes encephalitis also usually have ↑ (Path)
erythrocytes in the CSF due to hemorrhagic inflammation of the temporal lobes. NS Path
910Measles SSPE is a rare complication of measles infection that occurs several yrs after apparent Nervous (NS) Pathology 3
recovery from initial infection. Oligoclonal bands of measles virus Abs are found in the CSF (Path)
of these pts. NS Path
911Prion disease CJD is a prion disease characterised by rapidly progr dementia, myoclonus, and death w/i a Nervous (NS) Pathology 3
yr of SSx onset. Histopath shows widespread neuronal loss w/ small, uniform vacuoles in the (Path)
grey matter of the brain (e.g. spongiform encephalopathy). NS Path
912Prion disease Prion diseases are rapidly progr neurodegen disorders caused by the accumulation an abnly Nervous (NS) Pathology 3
folded protein w/i the brain. Prion proteins are normally found in an α helix form; a (Path)
conformation change into a β-sheet form confers resistance to proteases and can trigger
similar conformational changes in other normally folded proteins. Char micro findings incl
spongiform degen of the grey matter w/ vacuolisation of neurons, gliosis, and cyst formation. NS Path
913Giant cell arteritis Polymyalgia rheumatica occurs in more than 1/2 of pts w/ temporal arteritis. It's Nervous (NS) Pathology 5
characterised by neck, torso, shoulder, and pelvic girdle pain and morning stiffness. Fatigue, (Path)
fever, and weight loss may also occur. Monocular vision loss is a common complication of
temporal arteritis. NS Path
915Central pontine Rapid correction of chronic hyponatraemia may led to osmotic demyelination syndrome (i.e. Nervous (NS) Pathology 2
myelinolysis central pontine myelinolysis). It typically MFx 2-6days after the osmotic insult w/ spastic (Path)
quadriplegia, pseudobulbar palsy, and locked-in syndrome. NS Path
916Multiple sclerosis MS is Chx by episodic, progressive neuro deficits involving multiple anatomic regions w/i Nervous (NS) Pathology 6
the CNS. Demyelinating plaques are commonly seen as hyperintense lesions on T2-weighted (Path)
MRI of the brain and spinal cord. Common MFx include optic neuritis, INO, sensory
deficits, and fatigue, which may worsen w/ heat exposure. NS Path
917Multiple sclerosis MS is an AI disorder of the CNS Chx by recurrent episodes of demyelination, leading to ↓ Nervous (NS) Pathology 6
saltatory conduction. INO and optic neuritis are common MFx. (Path) NS Path
918Multiple sclerosis MS is an autoimmune demyelinating disease that results from oligodendrocyte depletion. W/i Nervous (NS) Pathology 6
the lesions, inflammatory infiltrates of lymphocytes and macrophages are seen surrounding (Path)
oligodendrocytes and myelin sheaths. Oligoclonal bands are highly sensitive but nonspecific
in pts w/ MS. NS Path
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919Multiple sclerosis MS is an immune-mediated disorder of the CNS characterised by focal demyelination Nervous (NS) Pathology 6
(plaques). Histo, plaques contain foci of perivenular inflammatory infiltrates made up 1arily (Path)
of autoreactive T lymphocytes and macrophages. Patchy demyelination occurs f/b astrocyte
hyperplasia (glial scarring). NS Path
966Tetanus Tetanospasmin is a neuro-exotoxin released by C. tetani. The toxin blocks the release of Nervous (NS) Pathophysi 5
glycine and GABA from the spinal inhib interneurons that regulate the LMNs. These ology
disinhib motor neurons cause ↑ activation of muscles, leading to spasms and hyperreflexia. (Patp) NS Patp
969Tetanus Tet is a CDx that should be suspected in pts who have Chx SSx (e.g. lockjaw, muscle Nervous (NS) Pathophysi 5
pain/spasms, difficulty swallowing), particularly if they are unlikely to be adequately vax or ology
have an antecedent cutaneous injury. (Patp) NS Patp
1005
Meningitis Pili are the 1ary VF that allow N. meningitidis to initially attach to and colonize the Nervous (NS) Microbiolo 17
nasopharyngeal epithelial surface. Pili undergo significant Ag variation, which makes them a gy (Micr)
difficult vax target. NS Micr
1038
Toxoplasmosis Congenital toxoplasmosis is a transplacental infection (acq in utero). Its classic triad includes Nervous (NS) Microbiolo 5
hydrocephalus, intracranial calcifications, and chorioretinitis. Expecting mothers should gy (Micr)
avoid cat feces to help prevent exposure to Toxoplasma. NS Micr
1048
Vitamin A toxicity Vit A overuse can result in intracranial HTN, skin changes, and HSM. Nervous (NS) Biochemist 1
ry (Bioc) NS Bioc
1058
Guillain-Barre GBS is an acute demyelinating polyneuropathy. It's thought to be due to molecular mimicry Nervous (NS) Pathology 3
syndrome and is commonly preceded by a viral URI or gastroenteritis. Segmental demyelination of the (Path)
peri nerves and an endoneurial inflammatory infiltrate are seen on LM. NS Path
1059
Peripheral Diabetic peri neuropathy is characterised by numbness and paraesthesia in a stocking-and- Nervous (NS) Pathology 3
neuropathy glove distribution. It results from nonenzymatic glycosylation of proteins, leading to (Path)
hyalinisation of endoneurial arteries and ischemic nerve dmg. In addn, accumulation of toxic
substances w/i neurons results in deranged meta and ↑ oxidative stress. NS Path
1060
Cranial nerve palsy Diabetic mononeuropathy often involves CNIII. It's caused by predominantly central Nervous (NS) Pathology 9
ischemia, which affects the somatic nerve fibres but spares peri parasympathetic fibres. SSx (Path)
incl ptosis, a 'down and out' gaze, and normal light and accommodation reflexes. NS Path
1120
Peroxisomal The buildup of very long chain and branched-chain (e.g. phytanic) FAs due to impaired Nervous (NS) Biochemist 1
disorders oxidation is the hallmark of peroxisomal disorders (e.g. Zellweger syndrome, ry (Bioc)
adrenoleukodystrophy). Accumulation of these FAs in the brain results in permanent neuro
dysfxn. NS Bioc
1140
Neonatal sepsis E. coli is a freq cause of neonatal meningitis, 2nd only to GBS. E. coli strains that cause Nervous (NS) Microbiolo 1
neonatal meningitis possess the K1 capsular Ag. The K1 capsule is a VF that allows the gy (Micr)
bacteria to survive in the bloodstream and establish meningeal infection. NS Micr
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1149
Peroneal neuropathy The common peroneal nerve is susceptible to injury at the lateral neck of the fibula caused by Nervous (NS) Anatomy 3
compression or fracture. Pts often have weakness on foot dorsiflexion ('foot drop') and (Anat)
eversion, as well as toe extension. Sensory loss typically occurs over the lateral leg and
dorsolateral foot. NS Anat
1150
Meningiomas Meningiomas are common adult intracranial tumours that typically arise in regions of dural Nervous (NS) Anatomy 2
reflection (e.g. falx cerebri, tentorium cerebelli). Parasagittal lesions compressing the medial (Anat)
portion of the 1° somatosensory cortex in the parietal lobe can result in contralateral lower
limb sensory loss along w/ contralateral hemineglect if there's also dmg to the parietal assoc
cortex (non-dom hemisphere). NS Anat
1151
Meningiomas Meningiomas are slow-growing, well-circumscribed, benign intracranial tumors typically Nervous (NS) Pathology 2
found at the cerebral convexities in adults. Chx histopathologic features include a whorled (Path)
pattern of cellular growth that forms nests, which may calcify into round, eosinophilic
laminar structures called psammoma bodies. NS Path
1152
Craniopharyngioma Craniopharyngiomas are suprasellar tumours found in children and composed of calcified Nervous (NS) Pathology 2
s cysts containing chol crystals. They arise from remnants of Rathke's pouch, an embryonic (Path)
precursor of the anterior pituitary. NS Path
1153
Brain tumors A cystic tumor in the cerebellum of a child is most likely a pilocytic astrocytoma. Biopsy Nervous (NS) Pathology 10
will show a well-differentiated neoplasm comprised of spindle cells with hair-like glial (Path)
processes that are associated with microcysts. These cells are mixed with Rosenthal fibers
and granular eosinophilic bodies. NS Path
1167
Wilson disease WD (hepatolenticular degen) is an AR condition of excess Cu leading to toxic accumulation Nervous (NS) Pathophysi 5
in the liver, basal ganglia, and cornea. Chelation Thx w/ D-penicillamine is indicated to ology
remove excess loosely bound serum Cu. (Patp) NS Patp
1197
Antiepileptics Gingival hyperplasia is a common side effect of phenytoin and is sometimes reversible when Nervous (NS) Pharmacol 3
phenytoin is withdrawn. Phenytoin causes increased expression of platelet-derived growth ogy (Phar)
factor (PDGF). When gingival macrophages are exposed to increased amounts of PDGF,
they stimulate proliferation of gingival cells and alveolar bone. Phenytoin toxicity mainly
affects the cerebellum and vestibular system, causing ataxia and nystagmus. NS Phar
1199
Trigeminal The first-line treatment for trigeminal neuralgia is carbamazepine, a neuroleptic medication Nervous (NS) Pharmacol 2
neuralgia that inhibits neuronal high-frequency firing by reducing the ability of sodium channels to ogy (Phar)
recover from inactivation. Carbamazepine can cause bone marrow suppression; therefore,
complete blood cell counts should be monitored periodically. NS Phar
1259
Brain tumors Medulloblastoma is the 2nd most common brain neoplasm of childhood. It is located in the Nervous (NS) Pathology 10
cerebellum, often at the vermis, and consists of sheets of small, blue cells. Like other (Path)
"PNET" tumors, medulloblastomas are poorly differentiated and have a bad prognosis. NS Path
1260
CNS lymphoma 1° CNS lymphomas occur in immunosuppressed pts, such as those suffering from AIDS. Nervous (NS) Pathology 2
These tumors arise from B cells and are universally a/w EBV. They are high-grade tumors w/ (Path)
a poor prognosis. NS Path
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1261
Brain tumors Germinomas are the most common pineal gland tumor and Px w/ obstructive hydrocephalus Nervous (NS) Anatomy 10
and dorsal midbrain (Parinaud) syndrome. Germinomas in the suprasellar region cause (Anat)
endocrinopathies due to pituitary/hypothalamic dysfxn. NS Anat
1263
Neuroblastoma Opsoclonus-myoclonus is a PNP syndrome a/w neuroblastoma, the most common Nervous (NS) Pathology 1
extracranial solid neoplasm in children. The tumour typically arises from the neural crest (Path)
cells of the adrenal medulla and presents w/ an abdo mass and ↑ catecholamine breakdown
products. NS Path
1264
Carpal tunnel CTS is a peri neuropathy characterised by pain/paraesthesias in a median nerve distribution Nervous (NS) Pathology 3
syndrome (palmar surface of the 1st 3 digits and radial half of the 4th digit), weakness on thumb (Path)
abduction/opposition, thenar atrophy, and a (+) Tinel a/o Phalen test. It's caused by median
nerve compression at the transverse carpal ligament. NS Path
1267
Lambert-Eaton LEMS is characterised by Abs against presynaptic v-gated Ca2+ channels. Pts develop progr Nervous (NS) Pathology 2
myasthenic proximal muscle weakness w/ ↓/absent reflexes that predominantly involves the lower (Path)
syndrome extremities. The syndrome is often a/w malignancy, particularly SCLC. NS Path
1268
Myotonic dystrophy MMD is an AD disorder. It is caused by an ↑ number of TNRs on MPK gene. Sustained Nervous (NS) Pathology 1
muscle contraction (myotonia), along w/ weakness and atrophy, is common. Cataracts are (Path)
seen in almost all pts. Frontal balding and gonadal atrophy are other common features. NS Path
1304
Vestibular Schwannomas Px histologically w/ a biphasic pattern of cellularity (Antoni A and B areas) Nervous (NS) Pathology 3
schwannoma and S-100 (+) (indicating neural crest origin). Schwannomas can arise from the peripheral (Path)
nerves, nerve roots, and CNs (except CN II). Acoustic neuromas are the most common type
of intracranial schwannoma and are located at the CPA at CN VIII. NS Path
1305
Neurofibromatosis Bilateral acoustic neuromas are a/w NF-2, an AD condition caused by mut of the NF-2 gene Nervous (NS) Pathology 3
on chrom 22. (Path) NS Path
1306
Vestibular Vestibular schwannomas arise from CNVIII and are usually located at the CPA. These Nervous (NS) Anatomy 3
schwannoma tumours can cause a range of SSx by dmging CNVIII (unsteadiness and ipsilateral (Anat)
sensorineural hearing loss w/ tinnitus), CNV (ipsilateral facial paraesthesia and ↓ corneal
reflex), and CNVII (ipsilateral facial paresis). Bilateral acoustic neuromas are a/w NF-2. NS Anat
1307
Neurofibromatosis NF-I is a single-gene AD disorder. It occurs due to mut of the NF1 gene located on chrom Nervous (NS) Genetics 3
17. Café-au-lait spots, multiple neurofibromas, and Lisch nodules are the most common SSx. (Gene) NS Gene
1308
Tuberculosis Isoniazid is structurally similar to vitB6. As a result, this Abx ↑ the urinary excretion of Nervous (NS) Pharmacol 18
vitB6 — often causing a frank defic of vitB6 — and competes for vitB6-binding sites, ogy (Phar)
leading to the defective synthesis of NTs like GABA. Isoniazid-induce neuropathy can
usually be prevented w/ vitB6 supplementation. NS Phar
1318
Multiple sclerosis The speed of conduction down an axon depends on 2 constants: the length constant and the Nervous (NS) Physiology 6
time constant (i.e. velocity = length / time). Myelination ↑ the length constant and ↓ the time (Phys)
constant, both of which improve axonal conduction speed. Demyelination thus impairs stim
transmission. NS Phys
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1320
Myasthenia gravis Exacerbation of MG in a pt Tx w/ long-acting AChEIs (e.g. pyridostigmine) occurs due to Nervous (NS) Pharmacol 10
myasthenic or cholinergic crisis. The edrophonium (Tensilon) test helps to diffiate these 2 ogy (Phar)
conditions. Clinical improvement after edrophonium admin indicates that the pt is under-Tx
(myasthenic crisis). NS Phar
1321
Anticholinergics Anticholinergic agents (e.g. atropine, scopolamine) competitively inhib ACh at the mAChR. Nervous (NS) Pharmacol 3
The effects can be memorised w/ the mnemonic, 'blind as a bat, mad as a hatter, red as a beat, ogy (Phar)
hot as a hare, dry as a bone, full as a flask, and fast as a fiddle,' and can be reversed by
AChEIs (physostigmine). NS Phar
1322
Glaucoma Atropine is indicated for the Tx of bradycardia as it ↓ vagal influence on the SA and AV Nervous (NS) Pharmacol 3
nodes. A common AE is ↑ IOP. It may precipitate acute CAG in susceptible individuals. ogy (Phar) NS Phar
1323
Organophosphate OPs inhibit AChE in both muscarinic and nicotinic cholinergic synapses, leading to ↓ ACh Nervous (NS) Pharmacol 2
poisoning degradation and over-stim of the corresponding receptors. Atropine reverses muscarinic ogy (Phar)
effects but doesn't prevent the devel of nicotinic effects such as muscle paralysis.
Pralidoxime is a AChE-reactivating agent that allows for degradation of excess ACh and Tx
both the muscarinic and nicotinic effects of OPs. NS Phar
1340
Organic acidemias Propionyl-CoA is derived from the metabolism of valine, isoleucine, methionine, threonine, Nervous (NS) Biochemist 1
and odd-chain FAs. Congenital defx of propionyl-CoA carboxylase, the enzyme responsible ry (Bioc)
for the conversion of propionyl-CoA to methylmalonyl-CoA, leads to the development of
propionic acidemia. The condition Px w/ lethargy, poor feeding, vomiting, and hypotonia 1-2
wks after birth. NS Bioc
1341
Metabolic acidosis Methylmalonic acidemia is an organic acidemia due to complete or partial defx of Nervous (NS) Biochemist 4
methylmalonyl-CoA mutase. Complete defx classically Px w/ lethargy, vomiting, and ry (Bioc)
tachypnea in a newborn. LTx shows hyperammonemia, ketotic hypoglycemia, and metabolic
acidosis. The Dx is confirmed by ↑ urine methylmalonic acid and propionic acid. NS Bioc
1359
Autonomic nervous The SNS typically regulates visceral fxn via 2-neuron signal transmission involving Nervous (NS) Pharmacol 3
system cholinergic preganglionic neurons and adrenergic postganglionic neurons. Eccrine sweat ogy (Phar)
glands and the AMs are exceptions to this rule as they're both innervated by cholinergic
neurons. The PSNS uses both preganglionic and postganglionic cholinergic neurons. NS Phar
1360
Autonomic nervous The ANS utilises 3 types of signal pathways: cAMP, IP3, and ion channels. nAChRs are Nervous (NS) Pharmacol 3
system ligand-gated ion channels that open after binding ACh. This results in an immediate influx of ogy (Phar)
Na+ and Ca2+ into the cell and an outflux of K+ from the cell. NS Phar
1361
Mushroom Activation of mAChRs by ACh or cholinergic agonists results in peripheral vasodilation due Nervous (NS) Physiology 2
poisoning to synthesis of NO in endothelial cells, which leads to vascular smooth muscle relaxation (e. (Phys)
g. hypotension). mAChR activation in other sites causes smooth muscle contraction. NS Phys
1362
Urinary retention Cholinomimetics are indicated in non-obstr urinary retention, paralytic ileus, and glaucoma. Nervous (NS) Pharmacol 4
Their AEs incl nausea, vomiting, abdo cramps, diarrhoea, dyspnoea, and ↑ secretions ogy (Phar)
(sweating, lacrimation, and salivation). NS Phar
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1368
Autonomic nervous Inhib of uterine contractions (tocolysis) is a result of β2 adrenergic receptor stim. α1 receptor Nervous (NS) Pharmacol 3
system stim causes contraction of the ocular pupillary dilator muscle, resulting in mydriasis ogy (Phar)
(pupillary dilation). NS Phar
1369
TCA cycle Alanine is the major AA responsible for transferring N to the liver for disposal. During the Nervous (NS) Biochemist 2
catabolism of proteins, amino groups are transferred to α-KG to form glutamate. Glutamate ry (Bioc)
is then processed in the liver to form urea, the 1° disposal form of N in humans. Free NH3 is
also excreted into the urine by the kidney for regulation of acid-base status. NS Bioc
1372
Urea cycle Ornithine transport into mitochondria is necessary for proper fxn of the urea cycle, which is Nervous (NS) Biochemist 3
the major disposal pathway for waste N generated by catabolism of AAs. Urea cycle defects ry (Bioc)
typically cause neuro dmg due to the accumulation of NH3. Protein restriction improves this
condition by ↓ the amount of AA turnover. NS Bioc
1380
Resting membrane The AP results from changes in the membrane permeability to K and Na ions. Depol results Nervous (NS) Physiology 5
potential and action from massive influx of Na thru v-gated Na channels. Repol occurs due to closure of v-gated (Phys)
potential Na channels and opening of v-gated K channels. K ion permeance is highest during the repol
phase of the AP. NS Phys
1392
Meningitis Listeriosis is most commonly transmitted thru food ingestions and can cause meningitis in Nervous (NS) Microbiolo 17
immsup adults. Listeria is a Gram (+) rod w/ tumbling motility. It grows well in cold temps gy (Micr)
and can therefore contaminate refrigerated food. NS Micr
1399
Botulism Botulinum neurotoxin produced by Clostridium botulinum prevents the release of Nervous (NS) Microbiolo 4
acetylcholine from presynaptic nerve terminals. The toxin impairs peripheral muscarinic and gy (Micr)
nicotinic neurotransmission, causing both autonomic symptoms (eg, fixed pupillary dilation,
dry mouth) and skeletal muscle weakness (eg, diplopia, dysphagia, respiratory depression).
Its effects at the neuromuscular junction can be seen on electromyography as a decrease in
muscle response following stimulation of a motor nerve. NS Micr
1401
Botulism C. botulinum is a spore-forming, Gram (+), anaerobic bacillus that synth bot tox, which Nervous (NS) Microbiolo 4
prevents the presynaptic release of ACh from the nerve terminal at the NMJ. Bot tox can be gy (Micr)
used to Tx focal dystonia and other disorders of abn muscle contraction. NS Micr
1402
Tetanus Tet is caused by infection w/ toxigenic strains of the anaerobic bacterium C. tetani. Nervous (NS) Microbiolo 5
Transmission typically occurs when spores are inoculated into the skin via a puncture wound. gy (Micr)
The bacteria germinate, replicate locally, and elaborate tetanospasmin (TT). The tox spreads
in a retrograde fashion thru the LMNs to the spinal cord, where it blocks inhib interneurons
and causes spasmodic muscle contraction (e.g. trismus, risus sardonicus). NS Micr
1421
Fragile X syndrome FXS is caused by an ↑ # of CGG TNRs on the FMR1 gene on the long arm of the X chrom. Nervous (NS) Genetics 3
This leads to hypermethylation and inactivation of FMR1. (Gene) NS Gene
1442
Alzheimer disease A chronically progressive pre-senile dementia with cortical atrophy but no other radiological Nervous (NS) Pharmacol 7
or laboratory abnormalities permits a clinical diagnosis of Alzheimer's disease (AD), which ogy (Phar)
is a diagnosis of exclusion. Current AD-specific therapies include cholinesterase inhibitors
(Donepezil), antioxidants (vitamin E), and NMDA receptor antagonists (e.g. memantine). NS Phar
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1452
Facial nerve The stapedius muscle is innervated by the stapedius nerve (a branch of CNVII). Paralysis of Nervous (NS) Anatomy 3
the stapedius muscle results in hyperacusis (e.g. ↑ sensitivity to sound). (Anat) NS Anat
1453
Trigeminal nerve General sensation from the anterior 2/3 of the tongue is carried by the mandibular division of Nervous (NS) Anatomy 3
the trigeminal nerve. Gustatory innervation of the anterior 2/3 of the tongue is provided by (Anat)
the chorda tympani branch of the facial nerve. NS Anat
1480
Urea cycle Arginase is a urea cycle enzyme that produces urea and ornithine from arginine. Arginase Nervous (NS) Biochemist 3
deficiency results in progressive spastic diplegia, growth delay, and abnormal movements. ry (Bioc)
Treatment includes an arginine-free, low-protein diet. NS Bioc
1483
Phenylketonuria Deficiency of the enzyme phenylalanine hydroxylase or its cofactor BH4 causes Nervous (NS) Biochemist 5
accumulation of phenylalanine in body fluids and the CNS. Homozygous infants are normal ry (Bioc)
at birth but gradually develop severe intellectual disability and seizures if left unTx.
Hypopigmentation of the skin, hair, eyes, and catecholaminergic brain nuclei is also
frequently seen. NS Bioc
1493
Traumatic brain Carbon dioxide is a potent vasodilator of cerebral vasculature. Tachypnea causes hypocapnia Nervous (NS) Physiology 5
injury and cerebral vasoconstriction, thereby decreasing cerebral blood volume and intracranial (Phys)
pressure. NS Phys
1500
Phenylketonuria BH4 is a cofactor used by hydroxylase enzymes in the synthesis of tyrosine, DA, and 5-HT. Nervous (NS) Biochemist 5
PKU can result from BH4 defx due to dihydropteridine reductase defx. Intellectual disability ry (Bioc)
is the hallmark of this condition and results in NT (e.g. 5-HT) defx and
hyperphenylalaninemia. Tx involves a low phenylalanine diet and BH4 supplementation. NS Bioc
1534
Neurofibromatosis NF-I (vRD) is an AD disorder caused by muts in the NF1 TSG. Pts Chx develop numerous Nervous (NS) Embryolog 3
cutaneous neurofibromas comprised mostly of Schwann cells, which are embryologically y (Embr)
derived from the neural crest. NS Embr
1536
Parkinson disease The BBB is formed by tight jxns b/w nonfenestrated capillary endothelial cells that prevent Nervous (NS) Histology 7
the paracellular passage of fluid and solutes. This barrier only permits the passage of (Hist)
substances from the blood to the brain via transcellular movement across the endothelial
plasma membrane, which is limited by diffusion or carrier-mediated transport. NS Hist
1552
Herpes zoster 1ary VZV infection (chickenpox) occurs most commonly in childhood. Subseq, the virus Nervous (NS) Microbiolo 4
migrates to the sensory ganglia, where it lies dormant for decaded. Over time, waning cell- gy (Micr)
mediated immunity allows reactivation of the virus, which spreads down a single nerve to
cause a painful, erythematous, vesicular rash in a derm distribution. NS Micr
1564
Anticholinergics Physostigmine is a AChEI w/ a 3° NH4+ structure that can reverse both the CNS and PNS Nervous (NS) Pharmacol 3
SSx of anticholinergic tox. Neostigmine, edrophonium, and pyridostigmine have a 4° NH4+ ogy (Phar)
structure that limits CNS penetration. NS Phar
1573
Toxoplasmosis The finding of multi ring-enhancing lesions in an HIV pt is most likely due to toxoplasmosis. Nervous (NS) Microbiolo 5
gy (Micr) NS Micr
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1601
Guillain-Barre GBS represents a group of imm-med polyneuropathies that're thought to be caused by Nervous (NS) Microbiolo 3
syndrome molecular mimicry, leading to demyelination of the peri nerves. Up to 1/3 of GBS cases are gy (Micr)
preceded by a C. jejuni infection, which is a common cause of acute diarrheal illness. NS Micr
1635
Hydrocephalus CSF flows from the third ventricle to the fourth ventricle via the cerebral aqueduct of Nervous (NS) Anatomy 4
Sylvius. Obstruction at this level can cause dilated lateral and third ventricles with a normal- (Anat)
sized fourth ventricle. Obstruction at the foramen of Monro would cause enlargement of only
the affected lateral ventricle, while obstruction at the foramen of Magendie and Luschka
causes enlargement of all 4 ventricles. NS Anat
1636
Brachial plexus The musculocutaneous nerve innervates the major forearm flexors (e.g. biceps brachii, Nervous (NS) Anatomy 6
brachialis) and coracobrachialis (flexes and adducts the arm) and provides sensory (Anat)
innervation to the lateral forearm. It's derived from the upper trunk of the brachial plexus
(C5-C7) and can be injured by trauma or strenuous upper extremity exercise. NS Anat
1639
Falls Superior gluteal nerve injury results in weakness and paralysis of the gluteus medius, gluteus Nervous (NS) Anatomy 1
minimus, and tensor fasciae latae muscles. This causes the pelvis to tilt downward toward the (Anat)
contralateral side ((+) Trendelenburg SSx). Pts will also lean toward the ipsilateral side when
walking to help stabilise the pelvis (gluteus medius gait). NS Anat
1657
Myasthenia gravis Progressively weakening diaphragmatic contractions during max voluntary ventilation w/ Nervous (NS) Pathophysi 10
intact phrenic nerve stim indicate NMJ pathology (e.g. MG) a/o abnormally rapid ology
diaphragmatic muscle fatigue (e.g. restrictive lung or chest wall disease). (Patp) NS Patp
1685
Radial neuropathy Radial nerve injury can occur w/ repetitive pressure/trauma at the axilla (eg, improperly Nervous (NS) Anatomy 3
fitted crutches). Findings include weakness of the forearm, hand, and fingers extensors (eg, (Anat)
wrist drop, absent triceps reflex) and sensory loss over the posterior arm and forearm,
dorsolateral hand, and dorsal thumb. More distal lesions spare the triceps brachii. NS Anat
1687
Ischemic stroke Upper motor neuron lesions (ie, internal capsule stroke) cause contralateral weakness with Nervous (NS) Anatomy 19
clasp knife spastic rigidity, hyperreflexia, and a positive Babinski sign. These lesions damage (Anat)
the pyramidal motor system (eg, corticospinal tracts), which runs from the precentral gyrus
(primary motor cortex) through the internal capsule to the brainstem and spinal cord. NS Anat
1689
Wilson disease WD can cause cystic degen of the putamen as well as dmg to other BG structures. The Nervous (NS) Anatomy 5
putamen is located medial to the insula and lateral to the GP on coronal sections. (Anat) NS Anat
1690
Huntington disease The head of the caudate lies in the inferolateral wall of the frontal horn of the lateral Nervous (NS) Anatomy 5
ventricle. It is separated from the GP and putamen by the IC. Atrophy of the caudate nuclei (Anat)
w/ enlargement of the lateral ventricles is Chx of HD and can be observed on neuroimaging. NS Anat
1691
Pharyngeal arches The development of derivatives of the 1st (e.g. CN V, mandible, maxilla, zygoma, incus, Nervous (NS) Embryolog 1
malleus) and 2nd (e.g. CN VII, stapes, styloid process, lesser horn of hyoid) pharyngeal y (Embr)
arches can be disrupted in genetic disorders (e.g. TCS), resulting in hypoplasia of the
mandibular and zygomatic bones. NS Embr
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1692
Radiculopathy Sciatica is a nonspecific term for low back pain that radiates down the leg due to Nervous (NS) Anatomy 3
compression of the lumbosacral nerve roots (eg, from vertebral disc herniation). The S1 (Anat)
nerve root is commonly involved, resulting in pain/sensory loss down the posterior thigh and
calf to the lateral aspect of the foot. Pts may also have weakness on thigh extension, knee
flexion, and foot plantarflexion w/ an absent ankle jerk reflex. NS Anat
1693
Cauda equina Saddle anesthesia and loss of the anocutaneous reflex are SSx of CES, which is a/w damage Nervous (NS) Anatomy 1
syndrome to the S2 through S4 nerve roots. (Anat) NS Anat
1694
Radial neuropathy Injury to the radial nerve during its passage thru the supinator canal may occur due to Nervous (NS) Anatomy 3
repetitive pronation/supination of the forearm, direct trauma, or subluxation of the radius. Pts (Anat)
typically have weakness during finger and thumb extension ('finger drop') w/o wrist drop or
sensory deficits. NS Anat
1696
Ischemic stroke The ACAs supply the medial portions of the 2 hemispheres (frontal and parietal lobes). Nervous (NS) Anatomy 19
Occlusion can cause contralateral motor and sensory deficits of the lower extremities, (Anat)
behavioral changes, and urinary incontinence. NS Anat
1703
Cranial nerve palsy The oculomotor nerve (CN III), ophthalmic nerve (CN V1) branches, trochlear nerve (CN Nervous (NS) Anatomy 9
IV), abducens nerve (CN VI), and superior ophthalmic vein enter the orbit via the superior (Anat)
orbital fissure. NS Anat
1735
Visual pathway CNII carries the afferent limb of the pupillary light reflex pathway, which activates the Nervous (NS) Anatomy 5
efferent limb bilaterally and causes both direct and consensual pupillary constriction. (Anat)
Unilateral CNII lesions (e.g. demyelination due to optic neuritis) can result in impaired
pupillary constriction bilaterally when light enters the eye ipsilateral to the lesion. When light
enters the contralateral eye, pupillary constriction occurs normally in both eyes. NS Anat
1741
Nausea and The vomiting reflex is initiated by the chemoreceptor trigger zone (ie, area postrema) and Nervous (NS) Anatomy 2
vomiting nucleus tractus solitarius within the dorsal medulla at the caudal end of the fourth ventricle. (Anat)
The area postrema does not have a well-developed blood brain barrier, allowing it to be
activated directly by emetogenic substances (eg, drugs, toxins) or indirectly by ascending
afferents from the bowel wall (eg, chemotherapy-induced release of serotonin). NS Anat
1743
Ulnar nerve Ulnar nerve injury most commonly occurs at the elbow (eg, compression due to resting arm Nervous (NS) Anatomy 2
neuropathy on a hard surface while using a computer) and usually Px w/ discomfort and sensory (Anat)
loss/paresthesia in the 5th digit, medial half of the 4th digit, and the hypothenar eminence. In
severe cases, pts can also have weakness on wrist flexion and adduction (ie, ulnar deviation)
along w/ finger weakness/clumsiness. NS Anat
1748
Peroneal neuropathy Trauma/sustained pressure to the neck of the fibula can injure the common peroneal nerve, Nervous (NS) Anatomy 3
causing weakness on foot dorsiflexion and eversion and impaired sensation over the lateral (Anat)
shin and dorsal foot, and b/w the 1st and 2nd toes. NS Anat
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1749
Carpal tunnel CTS occurs due to compression a/o inflammation of the median nerve in the carpel tunnel Nervous (NS) Anatomy 3
syndrome and typically results in sensory loss over the palm and anterior aspect of the 1st 3.5 digits w/ (Anat)
thenar atrophy and impairment of thumb flexion/opposition. In the forearm, the median nerve
courses b/w the humeral and ulnar heads of the pronator teres muscle and b/w the FDS and
FDP muscles. NS Anat
1777
Warfarin St John's wort induces CYP450 hepatic microsomal enzymes. As a result, a wide variety of Nervous (NS) Pharmacol 2
drugs that're meta by these enzymes, such as warfarin, will have lower plasma concs and ↓ ogy (Phar)
efficacy. NS Phar
1802
Bladder cancer The obturator nerve is the only major nerve that exits the pelvis through the obturator Nervous (NS) Anatomy 4
foramen. Nerve injury typically results from compression (eg, due to pelvic trauma, Sx, or (Anat)
tumor) and Px w/ weakness on thigh adduction and sensory loss over the distal medial thigh. NS Anat
1808
Fragile X syndrome FXS is an XL disorder that Px w/ a long, narrow face, a prominent chin and forehead, and Nervous (NS) Genetics 3
large testes. Pts often have developmental delay and neuropsych findings that overlap w/ (Gene)
anxiety disorders, autism, and ADHD. NS Gene
1813
Epidural hematoma The MMA is a branch of the maxillary artery, which enters the skull at the foramen Nervous (NS) Anatomy 2
spinosum and courses intracranially deep to the pterion (where the frontal, parietal, temporal, (Anat)
and sphenoid bones meet). Skull fractures at this site may cause laceration of this vessel,
leading to an EDH. NS Anat
1815
Cranial nerve palsy Lesions of the glossopharyngeal nerve result in loss of the gag reflex (afferent limb); loss of Nervous (NS) Anatomy 9
sensation in the upper pharynx, posterior tongue, tonsils, and middle ear cavity; and loss of (Anat)
taste sensation on the posterior 3rd of the tongue. NS Anat
1829
Brachial plexus The lower trunk of the brachial plexus carries nerve fibers from the C8 and T1 spinal levels Nervous (NS) Anatomy 6
that are responsible for innervating all of the intrinsic muscles of the hand (via the median (Anat)
and ulnar nerves). Sudden upward stretching on the arm at the shoulder can damage the
lower trunk, resulting in finger clumsiness w/ total claw hand deformity. NS Anat
1834
Generalized anxiety Serotonin-releasing neurons in the CNS are located in the raphe nuclei. These neurons Nervous (NS) Anatomy 4
disorder disseminate widely to synapse on numerous structures in the CNS. Antidepressants such as (Anat)
SSRIs, SNRIs, and TCAs inhib serotonin reuptake at these synapses. NS Anat
1846
Aphasia A lesion in Wernicke's area can cause receptive aphasia, which is characterised by well- Nervous (NS) Anatomy 2
articulated, nonsensical speech paired w/ a lack of language comprehension (Wernicke-Word (Anat)
salad). Wernicke's area is located in the auditory assoc cortex w/i the posterior portion of the
superior temporal gyrus in the dom temporal lobe. The MCA supplies Broca's area (superior
division) and Wernicke's area (inferior division). NS Anat
1853
Meningitis Abs against the PSC of N. meningitidis provide immunity against this pathogen. Nervous (NS) Microbiolo 17
Quadrivalent MCVs contain capsular PSs from major serotypes (A, C, Y, and W) of N. gy (Micr)
meningitidis. Serotype B vax use recomb proteins. NS Micr
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1854
Hydrocephalus Hydrocephalus in infants presents with macrocephaly and poor feeding. Imaging studies Nervous (NS) Pathophysi 4
showing enlarged ventricles are characteristic. Untreated hydrocephalus leads to spasticity ology
due to stretching of the periventricular pyramidal tracts, developmental delays, and seizures. (Patp) NS Patp
1904
Syringomyelia The combo of fixed segmental loss of upper extremity pain and temp sensations, upper Nervous (NS) Pathology 2
extremity LMN SSx, a/o lower extremity UMN SSx in the setting of scoliosis suggests (Path)
syringomyelia. NS Path
1906
West Nile virus West Nile virus is a single-strand flavivirus transmitted by mosquitoes, most commonly in Nervous (NS) Microbiolo 2
infection the summer. Most infections are asymptomatic or may present with a flu-like illness (West gy (Micr)
Nile fever), often with a maculopapular or morbilliform rash. Neuroinvasive disease
manifests as meningitis, encephalitis, or asymmetric flaccid paralysis; patients may have
parkinsonian features. NS Micr
1920
Ischemic stroke UMN SSx include abnormal plantar flexion (Babinski sign), spastic paralysis, ↑ muscle tone, Nervous (NS) Pathophysi 19
clasp-knife rigidity, hyperreflexia, pronator drift, and pyramidal weakness (weakness more ology
pronounced in lower extremity flexors and upper extremity extensors). LMN SSx include (Patp)
flaccid paralysis, weakness w/ hypotonia and muscle atrophy, fasciculations, and suppressed
or absent reflexes. NS Patp
1922
Neuronal Kinesin is a microtubule-associated motor protein that fxns in the anterograde transport of Nervous (NS) Histology 3
physiology materials and organelles w/i cells. Reactivation of latent HSV requires anterograde transport (Hist)
of viral particles from neuronal cell bodies in the sensory ganglia to the skin and oral
mucosa. NS Hist
1930
Brachial plexus The radial nerve provides sensory innervation to the skin of the posterior arm, forearm, and Nervous (NS) Anatomy 6
dorsal lateral hand and provides motor innervation to all of the extensor muscles of the upper (Anat)
limb below the shoulder. Damage to the proximal radial nerve (eg, at the axilla or midshaft
humerus) may result in wrist drop. NS Anat
1933
Cranial nerve palsy CNIV innervates the SO muscle, which causes the eye to intort (internally rotate) and Nervous (NS) Anatomy 9
depress while adducted. CNIV palsy is typically traumatic or idiopathic and presents w/ (Anat)
vertical diplopia that worsens when the affected eye looks down and toward the nose (e.g.
walking downstairs, up-close reading). Pts may compensate by tucking the chin and tilting
the head away from the affected eye. NS Anat
1934
Neuromuscular ACh release from presynaptic terminal vesicles at the NMJ depends upon the influx of Nervous (NS) Pathophysi 1
junction extracellular Ca into the presynaptic terminal. Ca influx into the nerve terminal occurs ology
following neuronal depol and opening of v-gated Ca channels. (Patp) NS Patp
1936
Neuronal Kinesin is a microtubule-associated, ATP-powered motor protein that facilitates the Nervous (NS) Histology 3
physiology anterograde transport of neurotransmitter-containing secretory vesicles down axons to (Hist)
synaptic terminals. NS Hist
1946
Essential tremor Essential tremor is the most common movement disorder. Pts experience a slowly progr, Nervous (NS) Pharmacol 1
symmetric postural a/o kinetic tremor that most commonly affects the upper extremities. ogy (Phar)
Essential tremor is often inherited in an AD fashion (referred to as familial tremor). 1st-line
Tx is the nonspecific β-adrenergic antagonist propranolol. NS Phar
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1955
Aphasia Broca (motor, nonfluent) aphasia results from damage to the inferior frontal gyrus of the Nervous (NS) Anatomy 2
dominant hemisphere. Patients are often frustrated as they understand language but cannot (Anat)
properly formulate the motor commands to write or form words (eg, slow, fragmented
speech). Aphasia may be associated with right upper limb and face weakness due to
extension of the lesion into the primary motor cortex. NS Anat
1962
Cluster headache CHs cause severe, episodic, unilateral periorbital and temporal pain a/w ipsilateral autonomic Nervous (NS) Pathology 1
SSx (e.g. lacrimation, nasal congestion, miosis, conjunctival injection). The h/a typically last (Path)
15-180min and tend to occur in clusters (often at the same time each day). Males are affected
more commonly than females. NS Path
1966
Meningitis Fever; meningeal SSx (e.g. h/a, neck stiffness); and CSF that shows lymphocytic pleocytosis, Nervous (NS) Microbiolo 17
a modestly incr protein lvl, and normal Glc are suggestive of aseptic meningitis. gy (Micr)
Enteroviruses are the most common cause of aseptic meningitis. NS Micr
1997
Botulism Bot tox blocks the presynaptic exocytosis of ACh vesicles, causing impaired musc and nico Nervous (NS) Microbiolo 4
NT; it char Px as a symmetric, desc paralysis that 1st MFx w/ CN abns, often following gy (Micr)
consumption of home-canned foods. NS Micr
1998
Organophosphate OPs are AChEIs that are widely used as pesticides in agriculture. They inhib the breakdown Nervous (NS) Biochemist 2
poisoning of ACh, leading to a state of cholinergic excess. SSx of OP poisoning include salivation, ry (Bioc)
lacrimation, diaphoresis, bradycardia, and bronchospasm. NS Bioc
2000
Beta blockers β blockers are used in the Tx of essential tremor. Propranolol, a nonselective β blocker, is the Nervous (NS) Pharmacol 3
most commonly used therapy and prevents the interaction of EPI and NE w/ β1 and β2 ogy (Phar)
receptors to relieve tremor SSx. However, inhib of pulm β2 receptors in pts w/ underlying
reactive airway disease can cause bronchoconstriction, leading to cough, wheeze, and
dyspnoea. NS Phar
2007
Resting membrane Changes in membrane potential occur in response to changes in neuronal membrane Nervous (NS) Physiology 5
potential and action permeability to various cellular ions. The more permeable the membrane becomes for a (Phys)
potential cellular ion, the more that ion’s equilibrium potential contributes to the total membrane
potential. NS Phys
2020
Brain tumors The hypothalamus is a key region responsible for homeostasis. The VMN mediates satiety; Nervous (NS) Anatomy 10
lesions of this area of the hypothalamus can result in hyperphagia and obesity. (Anat) NS Anat
2024
Trigeminal nerve CNV3 exits the skull thru the foramen ovale and innervates the muscles of mastication, incl Nervous (NS) Anatomy 3
the masseter, the medial and lateral pterygoids, and the temporalis muscles. (Anat) NS Anat
2036
Spinal muscular snRNPs are important components of the spliceosome, a molecule which removes introns Nervous (NS) Biochemist 1
dystrophy from pre-mRNA during processing w/i the nucleus. SMA is a disorder caused by muts in the ry (Bioc)
SMN1 gene, resulting in impaired assembly of snRNPs in LMNS. Infants often have flaccid
paralysis due to degen of ant horn cells in the spinal cord. NS Bioc
2061
Myasthenia gravis MG is an AI disease that causes a ↓ in the # of fxnal AChRs w/i the NMJ. This ↓ the # of Nervous (NS) Pathophysi 10
postsynaptic cation channels that can open in response to ACh, which ↓ the amplitude of ology
motor end plate potential and prevents muscle fiber depol. (Patp) NS Patp
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Myasthenia gravis The Tx of MG involves the use of an AChEI, immsups, and possible thymectomy. AChEIs Nervous (NS) Pathophysi 10
may cause AEs related to muscarinic overstim, which can be ameliorated by the use of an ology
antimusc agent such as glycopyrrolate, hyoscyamine, or propantheline. (Patp) NS Patp
2067
Lesch-Nyhan LNS is an XLR disorder caused by a defect in HGPRT. This results in failure of the purine Nervous (NS) Biochemist 1
syndrome salvage pathway, leading to ↑ degradation of hypoxanthine and guanine to uric acid. De novo ry (Bioc)
purine synthesis must ↑ to replace the lost bases, necessitating an ↑ in PRPP
amidotransferase activity. NS Bioc
2076
Ischemic stroke The ventral posterior lateral nucleus (receives input from the spinothalamic tract and dorsal Nervous (NS) Anatomy 19
columns) and ventral posterior medial nucleus (receives input from the trigeminal pathway) (Anat)
of the thalamus send somatosensory projections to the cortex via thalamocortical fibers.
Damage to these nuclei results in complete contralateral sensory loss. NS Anat
2077
Ischemic stroke Lacunar infarctions are the result of small vessel occlusion (eg, due to lipohyalinosis and Nervous (NS) Anatomy 19
microatheroma formation) in the penetrating vessels supplying the deep brain structures. (Anat)
Uncontrolled hypertension and diabetes mellitus are major risk factors for this condition. NS Anat
2082
Toxoplasmosis In patients with HIV, the presence of multiple ring-enhancing lesions with mass effect is Nervous (NS) Microbiolo 5
most often indicative of toxoplasmosis, followed by primary central nervous system gy (Micr)
lymphoma. NS Micr
2083
CNS lymphoma Primary central nervous system lymphoma is typically composed of B-lymphocytes. Nervous (NS) Microbiolo 2
gy (Micr) NS Micr
2125
Trigeminal nerve Infarcts involving the anterior portion of the medial pons can produce dysarthria and Nervous (NS) Anatomy 3
contralateral hemiparesis/lower facial palsy due to disruption of the ipsilateral corticospinal (Anat)
and corticobulbar tracts. The trigeminal nerve arises at the level of the middle cerebellar
peduncle at the lateral aspect of the mid-pons. NS Anat
2126
Cranial nerve palsy CNIII is most susceptible to injury from ipsilateral PComA aneurysms. Aneurysmal Nervous (NS) Anatomy 9
compression of CNIII produces mydriasis (due to superficial parasympathetic fibre dmg) w/ (Anat)
diplopia, ptosis, and down and out deviation of the ipsilateral eye (due to somatic efferent
fibre injury). NS Anat
2127
Ischemic stroke The PCA branches off the basilar artery and supplies CNs III and IV and other structures in Nervous (NS) Anatomy 19
the midbrain. It also supplies the thalamus, medial temporal lobe, splenium of the corpus (Anat)
callosum, and occipital lobe. The most common finding w/ PCA stroke is contralateral
homonymous hemianopia, often w/ macular sparing. NS Anat
2129
Wernicke-Korsakoff WE is a complication of vitB1 defic and is characterised by CNIII dysfxn, encephalopathy, Nervous (NS) Anatomy 5
syndrome and ataxia. Chronic defic results in Korsakoff syndrome (e.g. anterograde and retrograde (Anat)
amnesia, confabulation, apathy). VitB1 is involved in Glc meta, and areas of the brain w/
high meta demands are particularly susceptible; the mammillary bodies are most commonly
affected. NS Anat
Rep
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Myasthenia gravis MG is an AI disorder caused by an autoAb-mediated atk on the ACh receptors of the Nervous (NS) Pathology 10
postsynaptic NMJ, leading to a ↓ number of ACh receptors. It is Chx by fatigable weakness (Path)
of the skeletal muscles; resp failure can occur due to diaphragmatic weakness. NS Path
7490
Alzheimer disease Alzheimer dementia typically Px insidiously w/ memory loss (especially of recent events), Nervous (NS) Pathology 7
executive dysfxn, and visuospatial impairment. Classic histopathologic findings include (Path)
amyloid plaques (central amyloid β core surrounded by dystrophic neurites) and NFTs
(aggregates of hyperphosphorylated τ protein). NS Path
7492
Tension headache THs are the most common form of h/a. They are Chx by an achy or pressure-like pain that is Nervous (NS) Pathology 1
often bilateral and a/w pericranial muscle tenderness. THs are not a/w other neuro SSx and (Path)
do not typically limit a pt's ability to perform daily fxns. NS Path
8323
Torticollis Acute EPS (e.g. dystonia, akathisia, parkinsonism) are due to D2 blockade in the nigrostriatal Nervous (NS) Behavioral 2
pathway. High-potency FGAs (e.g. haloperidol, fluphenazine) strongly block D2 receptors Science
and are most likely to cause EPS. (Beha) NS Beha
8324
Rabies Rabies virus has a bullet-shaped envelope w/ knob-like GP that bind to nAChRs. Once Nervous (NS) Microbiolo 2
transmission occurs (usually due to a bite wound from an infected animal), the virus gy (Micr)
replicates locally in muscle tissue for several dys or wks before spreading in a retrograde
fashion thru the peri nerve axons to the CNS. NS Micr
8329
Bell's palsy In addn to unilateral CNVII paralysis, pts w/ Bell's palsy may experience ↓ tearing, Nervous (NS) Anatomy 1
hyperacusis, a/o loss of taste sensation over the anterior 2/3 of the tongue. (Anat) NS Anat
8352
Seafood poisoning Pufferfish poisoning is caused by tetrodotoxin, a neurotoxin produced by microorganisms Nervous (NS) Pathophysi 1
a/w the fish. Tetrodotoxin binds to v-gated Na channels in nerve and cardiac tissue, ology
preventing Na influx and depol. (Patp) NS Patp
8385
Ubiquitin Ubiquitin is a protein that undergoes ATP-dependent attachment to other proteins, labeling Nervous (NS) Biochemist 2
proteasome pathway them for degradation. These modified proteins enter the proteasome and are degraded into ry (Bioc)
small peptides. Impairment of the ubiquitin-proteasome system can contribute to the
development of neurodegen disorders, including PD and AD. NS Bioc
8476
Migraine Migraine h/a are unilateral, have a pulsating or throbbing quality, and are a/w photophobia, Nervous (NS) Pharmacol 3
phonophobia, and nausea. Triptans are 5-HT1B/5-HT1D agonists used as abortive therapy ogy (Phar)
during an acute migraine. β blockers, antidepressants (e.g. amitriptyline and venlafaxine),
and anticonvulsants (e.g. valproate and topiramate) are commonly used for migraine
prophylaxis. NS Phar
8481
Anesthesia SCh can cause significant K+ release and life-threatening arrhythmias in pts at high risk for Nervous (NS) Pharmacol 9
hyperkalaemia, incl those w/ burns, myopathies, crush injuries, and denervating injuries or ogy (Phar)
disease. NS Phar
8522
Cranial nerve palsy Lesions of the JF can result in JF (Vernet) syndrome, which is characterised by the dysfxn of Nervous (NS) Anatomy 9
CNs IX, X, and XI. SSx incl dysphagia, hoarseness, loss of gag reflex on the ipsilateral side, (Anat)
and deviation of the uvula toward the normal side. NS Anat
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Tay-Sachs Tay-Sachs disease is an autosomal recessive disorder caused by B-hexosaminidase A Nervous (NS) Biochemist 1
deficiency, which results in GM2 ganglioside accumulation. Key clinical features include ry (Bioc)
progressive neurodegeneration and a cherry-red macular spot. In contrast to patients with
Niemann-Pick disease, those with Tay Sachs disease have no hepatosplenomegaly. NS Bioc
8564
Intraventricular Neonatal IVH usually originates from the fragile germinal matrix in infants born before Nervous (NS) Anatomy 1
hemorrhage 32wks gestation a/o w/ birth weight <1.5kg (3lbs 5oz). It's a common complication of (Anat)
prematurity that can lead to long-term neurodevel impairment. NS Anat
8573
Circadian rhythm The suprachiasmatic nucleus regulates circadian rhythms by processing light info from the Nervous (NS) Physiology 1
retina and modulating body temp and the production of hormones (e.g. cortisol, melatonin). (Phys)
Dyssynchrony b/w the local environment (e.g. daylight hrs, sleep schedules) and internal
circadian rhythms can cause insomnia and daytime sleepiness (i.e. jet lag). Melatonin
supplementation is recommended for the Tx of insomnia associated w/ jet lag. NS Phys
8592
Visual pathway Lesions of the occipital cortex (e.g. PCA occlusion) can produce contralateral homonymous Nervous (NS) Anatomy 5
hemianopia w/ macular sparing. (Anat) NS Anat
8594
Visual pathway Injury to Meyer's loop in the temporal lobe results in contralateral superior quadrantanopia. Nervous (NS) Anatomy 5
(Anat) NS Anat
8636
Visual pathway An aneurysm of the ICA can laterally impinge on the optic chiasm. This can cause ipsilateral Nervous (NS) Anatomy 5
nasal hemianopia by dmging uncrossed CNII fibres from the temporal portion of the retina. (Anat) NS Anat
8701
Cranial nerve palsy Lesions involving CNIII cause ptosis, a downward and laterally deviated eye, impaired Nervous (NS) Anatomy 9
pupillary constriction and accommodation, and diagonal diplopia. The most dreaded cause of (Anat)
CNIII palsy is an enlarging intracranial aneurysm. NS Anat
8702
Pituitary adenoma All adult cells and tissues can be traced back to the 3 1° germ layers: ectoderm, mesoderm, Nervous (NS) Embryolog 8
and endoderm. The ectoderm gives rise to the surface ectoderm, neural tube, and neural crest. y (Embr) NS Embr
8859
Vertigo Vertigo is a sensation of excessive motion compared to physical reality. It is most commonly Nervous (NS) Pathology 1
due to dysfxn w/i the vestibular system. (Path) NS Path
10362
Restless leg RLS is characterised by an uncomfortable sensation in the legs accompanied by an urge to Nervous (NS) Pharmacol 1
syndrome move them. It's worse at rest and when falling asleep. DA agonists are the preferred Rx for ogy (Phar)
Tx. NS Phar
11458
Spasticity Baclofen, an agonist at the GABA-B receptor, is effective as monoThx for the Tx of Nervous (NS) Pharmacol 1
spasticity 2° to both brain and spinal cord disease, including MS. Tizanidine, an α-2 ogy (Phar)
adrenergic agonist, is also effective and commonly used. NS Phar
11462
Parkinson disease Nigrostriatal degen in Parkinson disease ↓ activity of the thalamus and its projections to the Nervous (NS) Pathology 7
cortex, resulting in bradykinesia and rigidity. Pts w/ medically intractable SSx of Parkinson (Path)
disease may benefit from high-freq deep brain stimulation of the globus pallidus internus
(GPi) or subthalamic nucleus (STN) as it promotes thalamo-cortical disinhib w/ improved
mobility. NS Path
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HIV HIV-assoc dementia should be suspected in pts w/ AIDS who have progr cognitive decline. Nervous (NS) Pathology 11
The char histopath finding is microglial nodules (groups of activated microglia/macrophages (Path)
around small areas of necrosis) and multinucleated giant cells. NS Path
11574
Traumatic brain Damage to the brainstem at/below the level of the red nucleus (eg, midbrain tegmentum, Nervous (NS) Pathology 5
injury pons) typically results in decerebrate (extensor) posturing. In contrast, damage to neural (Path)
structures above the red nucleus (eg, cerebral hemispheres, IC) typically results in decorticate
(flexor) posturing. NS Path
11576
Ischemic stroke WD refers to the process of axonal degeneration and breakdown of the myelin sheath that Nervous (NS) Pathology 19
occurs distal to a site of injury. Axonal regeneration does not occur in the CNS due to the (Path)
persistence of myelin debris, secretion of neuronal inhibitory factors, and development of
dense glial scarring. NS Path
11609
Vestibular Acoustic neuromas are Schwann cell-derived tumours that typically arise from the vestibular Nervous (NS) Anatomy 3
schwannoma portion of CNVIII and are commonly located at the CPA (b/w the cerebellum and lateral (Anat)
pons). Pts usually present w/ unilateral sensorineural hearing loss and tinnitus. NS Anat
11627
Hemangioma Cavernous hemangiomas are vascular malformations that occur most commonly w/i the Nervous (NS) Pathology 6
brain parenchyma; they carry an ↑ risk of intracerebral hemorrhage and seizure. (Path) NS Path
11631
Multiple sclerosis The pathogenesis of MS involves an AI response (T cell and Ab mediated) targeting Nervous (NS) Pathology 6
oligodendrocytes and myelin in the CNS, leading to slowed nerve conduction w/ neuro (Path)
deficits. NS Path
11632
Hemorrhagic stroke Acute lesions to the cerebellar vermis typically cause truncal and gait ataxia due to impaired Nervous (NS) Pathology 3
modulation of the medial-descending motor systems. Involvement of the lower vermis and (Path)
the flocculonodular lobe also causes vertigo/nystagmus due to dysregulation of the vestibular
nuclear complex. NS Path
11663
Temporomandibular Temporomandibular disorder is a/w dysfxn of the TMJ and hypersensitivity of the Nervous (NS) Anatomy 1
disorders mandibular nerve (CN V3). This can result in pathologic contraction of the pterygoid (Anat)
muscles (eg, jaw pain/dysfxn) and the tensor tympani in the middle ear (eg, ear pain, muffled
hearing). NS Anat
11665
Seizures IV benzos (e.g. lorazepam) are the initial DOC for SE. They work by enhancing the effect of Nervous (NS) Pharmacol 8
GABA at the GABA-A receptor, leading to ↑ Cl- influx and suppression of AP firing. ogy (Phar) NS Phar
11676
Neuroleptic NMS is a life-threatening rxn to antipsychotic Rx characterised by diffuse muscle rigidity, Nervous (NS) Pharmacol 2
malignant syndrome hyperthermia, autonomic instability, and altered sensorium. The antipsychotic should be ogy (Phar)
stopped and supportive care provided; dantrolene, a RyR blocker that inhibs Ca2+ release
from the SR, is an effective antidote. NS Phar
11680
Capsaicin Topical capsaicin causes defxnalisation of afferent pain fibres and depletion of substance P. Nervous (NS) Pharmacol 1
Initial application results in a burning and stinging sensation, but chronic exposure leads to ↓ ogy (Phar)
pain transmission. NS Phar
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Axillary nerve Injury to the axillary nerve most commonly occurs in the setting of shoulder trauma (e.g. Nervous (NS) Anatomy 1
injury anterior dislocation, humeral fracture) and presents w/ sensory loss over the lateral shoulder (Anat)
and weakness on shoulder abduction (due to denervation of the deltoid muscle). NS Anat
11682
Synapse V-gated Na channels are important for the generation and propagation of APs. When the AP Nervous (NS) Physiology 1
reaches the axon terminal, v-gated Ca channels open and allow the influx of Ca, which is (Phys)
essential for the fusion and release of NT vesicles into the synaptic cleft. NS Phys
11685
Visual pathway Damage to the left temporal hemiretina will disrupt the transmission of visual information Nervous (NS) Anatomy 5
along the ipsilateral optic nerve, lateral optic chiasm, optic tract, lateral geniculate body, (Anat)
optic radiations, and 1° visual cortex. NS Anat
11742
Orbital fracture Fractures to the orbital floor commonly result from direct frontal trauma to the orbit. The Nervous (NS) Anatomy 2
infraorbital nerve runs along the orbital floor in a groove in the maxilla before exiting the (Anat)
skull just inferior to the orbit. Dmg can result in paraesthesia of the upper cheek, upper lip,
and upper gingiva. In addn, the IR muscle can also become entrapped, limiting vertical gaze. NS Anat
11744
Brachial plexus An interscalene nerve block is used to provide anaesthesia for the shoulder and upper arm by Nervous (NS) Anatomy 6
anaesthetising the upper brachial plexus (C5-C7) as it passes b/w the anterior and middle (Anat)
scalene muscles. Anaesthetic also transverses along the interscalene sheath, freq resulting in
transient ipsilateral diaphragmatic paralysis due to involvement of the phrenic nerve roots
(C3-C5). NS Anat
11755
Resting membrane A Rx that binds to and activates GABA-A receptors (or enhances their activity) will ↑ the Nervous (NS) Physiology 5
potential and action conductance of Cl ions, leading to ↑ passive transport of Cl into the cell interior. This causes (Phys)
potential the membrane potential to become hyperpolarized (more (-) than the RMP) by approaching
or reaching the equilibrium potential for Cl. NS Phys
11769
Appendicitis The iliohypogastric nerve provides sensation to the suprapubic and gluteal regions and motor Nervous (NS) Anatomy 5
fxn to the anterolateral abdominal wall muscles. Abdominal Sx (eg, appendectomy) can (Anat)
damage the nerve and cause ↓ sensation a/o burning pain at the suprapubic region. NS Anat
11772
Cranial nerve palsy The spinal accessory nerve is vulnerable to injury in the posterior triangle of the neck. Injury Nervous (NS) Anatomy 9
results in weakness of the trapezius muscle, which Px w/ drooping of the shoulder, impaired (Anat)
abduction of the arm above horizontal (due to weakness in rotating the glenoid upward), and
winging of the scapula. NS Anat
11777
Anesthesia A femoral nerve block at the inguinal crease will anesthetize the skin and muscles of the Nervous (NS) Anatomy 9
anterior thigh (eg, quadriceps), femur, and knee. (Anat) NS Anat
11779
Radiculopathy The C5-C6 spinal nerves mediate the biceps and brachioradialis reflexes. Nervous (NS) Anatomy 3
(Anat) NS Anat
11793
Rheumatoid arthritis Long-standing RA can affect the cervical spine, causing vertebral misalignment Nervous (NS) Pathophysi 9
(subluxation) that can affect the atlantoaxial joint. Extension of the neck during endotracheal ology
intubation can worsen the subluxation, leading to acute compression of the spinal cord a/o (Patp)
vertebral arteries. NS Patp
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Brain herniation Expanding space occupying lesions w/i the temporal lobe can cause ↑ ICP w/ transtentorial Nervous (NS) Anatomy 2
herniation of the uncus. Uncal herniation often compresses the ipsilateral CNIII as it exits the (Anat)
midbrain, resulting in CNIII palsy w/ a fixed pupil (e.g. due to preganglionic
parasympathetic fibre dmg). NS Anat
11843
Dandy-Walker DWM is a developmental anomaly Chx by hypoplasia/absence of the cerebellar vermis and Nervous (NS) Pathology 1
syndrome cystic dilation of the 4th ventricle w/ posterior fossa enlargement. Pts often Px during (Path)
infancy w/ developmental delay and progressive skull enlargement. Other features may
include cerebellar dysfxn and NCH. NS Path
11862
Meningitis The classic triad of fever, stiff neck, and AMS should raise suspicion for acute bacterial Nervous (NS) Microbiolo 17
meningitis. Eval req prompt blood cultures, empiric Abx, and LP w/ CSF analysis. gy (Micr) NS Micr
11952
Fecal incontinence Stretch injury of the pudendal nerve may occur due to stress placed on the pelvic floor during Nervous (NS) Anatomy 1
labour. Pudendal nerve injury leads to weakness of the perineal musculature causing faecal (Anat)
and urinary incontinence, perineal pain, and sexual dysfxn. NS Anat
11995
Brain tumors The cerebellar hemispheres are responsible for motor planning and coordination of the Nervous (NS) Anatomy 10
ipsilateral extremities via their connections w/ the lateral descending motor systems. (Anat)
Consequently, cerebellar hemisphere lesions typically result in ipsilateral
dysdiadochokinesia, limb dysmetria, a/o intention tremor. NS Anat
12007
Hemorrhagic stroke Spontaneous deep intracerebral hemorrhage is typically caused by hypertensive vasculopathy Nervous (NS) Anatomy 3
involving the small, penetrating branches of the major cerebral arteries. The most frequently (Anat)
affected locations include the BG (putamen), cerebellar nuclei, thalamus, and pons. The
putamen is supplied by the lenticulostriate arteries, which are deep, small vessel branches off
the MCAs. NS Anat
12008
Seizures The 1° somatosensory cortex (postcentral gyrus) is responsible for processing all somatic Nervous (NS) Anatomy 8
sensory input from the contralateral side of the body. A focal onset seizure originating in this (Anat)
region of the cerebral cortex often results in contralateral sensory disturbance (e.g.
numbness, paraesthesia). NS Anat
12011
Alzheimer disease Inappropriate processing of amyloid precursor protein down the β- and γ-secretase pathway Nervous (NS) Pathology 7
results in the production of β-amyloid. Insufficient clearance of β-amyloid can result in (Path)
formation of extracellular amyloid plaques, which are neurotoxic and thought to play a key
role in the pathogenesis of AD. NS Path
12023
Ischemic stroke Gerstmann syndrome results from damage to the angular gyrus of the dominant parietal lobe Nervous (NS) Anatomy 19
and is Chx by agraphia (inability to write), acalculia (inability to carry out mathematical (Anat)
calculations), finger agnosia (inability to identify individual fingers on the hand), and left-
right disorientation. NS Anat
12025
Facial nerve The facial nerve (CN VII) exits the stylomastoid foramen and courses through the substance Nervous (NS) Anatomy 3
of the parotid gland, where it divides into its 5 terminal branches that innervate the muscles (Anat)
of facial expression. Malignant tumors of the parotid gland often compress and disrupt the
facial nerve and its branches, causing ipsilateral facial droop. NS Anat
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Cavernous sinus Infection of the medial face, sinuses (ethmoidal or sphenoidal), or teeth may spread through Nervous (NS) Anatomy 1
thrombosis the valveless facial venous system into the cavernous sinus, resulting in cavernous sinus (Anat)
thrombosis. Pts typically Px w/ h/a, fever, proptosis, and ipsilateral deficits in CNs III, IV,
VI, and V (ophthalmic and maxillary branches). NS Anat
12030
Spinal cord injury Brown-Séquard syndrome results from hemisection of the spinal cord. It is Chx by ipsilateral Nervous (NS) Anatomy 1
spastic paralysis (due to corticospinal tract injury), ipsilateral loss of (Anat)
tactile/vibratory/position sensation (dorsal columns), and contralateral loss of pain and
temperature sensation (spinothalamic tract) below the level of injury. NS Anat
12031
Vitamin B12 Neuro damage a/w vitamin B12 deficiency classically includes SCD of the dorsal columns Nervous (NS) Anatomy 9
deficiency (loss of position and vibration sensation, (+) Romberg sign) and lateral corticospinal tracts (Anat)
(spastic paresis). NS Anat
12035
Syphilis The Romberg test is a test of proprioception in which pts are observed for unsteadiness as Nervous (NS) Anatomy 9
they stand w/ their feet close together, arms to the sides, and eyes closed. Failure to maintain (Anat)
this posture indicates sensory ataxia, which may be caused by defects in the posterior column
or peri nerves (e.g. tabes dorsalis, vitB12 defic). NS Anat
12083
Internuclear INO is a disorder of impaired horizontal gaze caused by a lesion in the MLF. The affected Nervous (NS) Anatomy 1
ophthalmoplegia eye (ipsilateral to the lesion) is unable to adduct while the contralateral eye is able to abduct (Anat)
(often w/ assoc nystagmus). Convergence and the pupillary light reflex are preserved b/c
these pathways bypass the MLF. NS Anat
12084
Spinal anatomy The optimal location for needle insertion during a LP is the L3/L4 or L4/L5 space as this is Nervous (NS) Anatomy 1
well below the spinal cord termination site (L1 in adults). The L4 vertebral body lies on a (Anat)
line drawn b/w the highest points of the iliac crests. NS Anat
12119
Anoxic brain injury The upper midbrain contains neural structures (e.g. CNII, pretectal nuclei, EWN, CNIII) that Nervous (NS) Anatomy 1
mediate the direct and consensual pupillary light reflex. (Anat) NS Anat
12155
Ischemic stroke PICA occlusion causes lateral medullary (Wallenberg) syndrome, Chx by vertigo/nystagmus, Nervous (NS) Anatomy 19
ipsilateral cerebellar signs, loss of pain/temperature sensation in the ipsilateral face and (Anat)
contralateral body, bulbar weakness, and ipsilateral Horner syndrome. This condition can
occur in the setting of cervical spine trauma w/ dissection of the vertebral artery. NS Anat
12175
Seizures Seizures can be classified as focal (partial) if they originate from a localized region of one Nervous (NS) Pathology 8
cerebral hemisphere or generalized if they involve both hemispheres at onset. The MFx of (Path)
focal seizure depend on the brain region in which seizure activity is occurring. Focal seizure
can be subclassified as simple if consciousness is preserved or complex if there is LOC. NS Path
12226
Acute intracerebral The locus coeruleus is a paired brainstem nucleus located in the posterior rostral pons near Nervous (NS) Anatomy 1
hemorrhage the lateral floor of the 4th ventricle and fxns as the principal site for NE synthesis in the (Anat)
brain. It projects to virtually all parts of the CNS and helps control mood, arousal (reticular
activating system), sleep-wake states, cognition, and autonomic fxn. NS Anat
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Traumatic brain Smell occurs when odorants bind to nasal chemoreceptors that relay signals via the olfactory Nervous (NS) Anatomy 5
injury nerve through the cribriform plate to the olfactory bulb, which then projects to the primary (Anat)
olfactory cortex in the medial temporal lobe. Head trauma can tear olfactory nerve rootlets as
they cross the cribriform plate, causing anosmia. Anosmia is often associated with ageusia
(loss of taste). NS Anat
12252
Facial nerve Hyperacusis (↑ sensitivity to sound) is an indication of dmg to the facial nerve (CN VII) Nervous (NS) Pathology 3
close to its origin from the brainstem. (Path) NS Path
12283
Hemangioma Cavernous hemangiomas are vascular malformations composed of abnly dilated capillaries Nervous (NS) Pathology 6
separated by thin connective tissue septa. The lack of structural support gives them a (Path)
tendency to bleed, and those that occur in the brain can present w/ neurologic deficits and
seizures. NS Path
12504
Opioids Opioid intox presents w/ miosis, depressed mental status, ↓ RR, ↓ bowel sounds, and Nervous (NS) Pharmacol 13
hypotension. Of these, ↓ RR is the best predictor of intox and is also a freq cause of ogy (Phar)
mortality. NS Phar
14850
Myasthenia gravis MG is caused by auto-Abs against postsynaptic nAChRs, leading to fewer fxnal AChRs and Nervous (NS) Pharmacol 10
fatigable muscle weakness. Non-depolarising neuromuscular blocking agents (e.g. ogy (Phar)
vecuronium) are competitive antagonists of AChRs; due to the depletion of receptors, pts w/
MG are extremely sensitive to these agents and very small doses can induce paralysis and
impair airway protection. NS Phar
14898
Brain abscess A single brain abscess is usually caused by direct spread of a contiguous infection. Temporal Nervous (NS) Anatomy 1
lobe abscess is usually a result of OM that has spread to the mastoid air cells, while frontal (Anat)
lobe abscess is usually due to ethmoid or frontal sinusitis. Multiple brain abscesses typically
indicate hematogenous dissemination of a distant infection (eg, endocarditis, empyema). NS Anat
14899
Meningitis Pneumococcal meningitis is associated with massive cerebrospinal fluid inflammatory Nervous (NS) Pathophysi 17
cytokine release in response to bacterial cell wall components. Treatment with ology
dexamethasone prior to antibiotic therapy has been shown to reduce inflammation and (Patp)
decrease the risk of adverse outcomes (eg, seizures, focal neurologic deficits) and death.
Other forms of bacterial meningitis do not seem to benefit from glucocorticoid treatment. NS Patp
14905
Toxoplasmosis T. gondii is an intracellular parasite that's typically transmitted to humans after accidental Nervous (NS) Microbiolo 5
ingestion of contaminated cat feces (e.g. cat handling, litter box). Most initial cases are aSSx. gy (Micr)
However, the organism establishes a latent infection that can reactivate in the setting of
severe immsup, particularly adv AIDS. Pts usually develop encephalitis w/ multi ring-
enhancing lesions. NS Micr
15158
Phrenic nerve injury The right phrenic nerve courses along the pericardium overlying the right side of the heart Nervous (NS) Anatomy 1
and is at risk for injury during procedures in or near the RA (eg, radiofrequency ablation). (Anat)
Right phrenic nerve injury is typically recognized by elevation of the right hemidiaphragm. NS Anat
15580
Cryptococcal Cryptococcus neoformans is a round/oval yeast w/ a thick PSC. It is a common cause of Nervous (NS) Microbiolo 3
infections meningoencephalitis (eg, h/a, vomiting, confusion, seizure) in pts w/ unTx AIDS. The yeast gy (Micr)
can frequently be visualized in the CSF by India ink or silver stain. NS Micr
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West Nile virus WNV is harbored in birds and transmitted to humans by mosquitos. Most pts are aSSx, but Nervous (NS) Microbiolo 2
infection the virus can cause an influenza-like illness or neuroinvasive disease w/ meningitis, gy (Micr)
encephalitis, and flaccid paralysis. NS Micr
15600
Central pontine Osmotic demyelination syndrome results from overly rapid correction of chronic Nervous (NS) Pathophysi 2
myelinolysis hyponatremia. Clinical features include quadriplegia, pseudobulbar palsy, and reduced level ology
of consciousness. MRI demonstrates focal demyelination of the pons. (Patp) NS Patp
15612
Peripheral Ulnar neuropathy is Chx by numbness of the 4th and 5th digits, pain, and weakness. It is Nervous (NS) Pathophysi 3
neuropathy most commonly caused by compressive injury, leading to tissue ischemia and demyelination ology
(Schwann cell injury). A nerve conduction study can help differentiate demyelinating vs (Patp)
axonal neuropathies; demyelination causes slowed or blocked nerve conduction velocity
whereas axonal injury leads to a ↓ in signal strength. NS Patp
15637
Neural tube defects MTX and other vit B9 antagonists adversely affect rapidly dividing cells (e.g. epithelial cells, Nervous (NS) Embryolog 4
stem cells, neural tube cells) by limiting the production of precursors essential to DNA y (Embr)
synthesis and repair. If used in the 1st trimester of pregnancy, these drugs can cause major
congenital abnormalities (e.g. CV abnormalities, NTDs). NS Embr
15638
Brain tumors Ependymomas originate from the ependymal cells that line the ventricular system and the Nervous (NS) Pathology 10
central canal of the spinal cord. Ventricular ependymomas can block the flow of CSF thru (Path)
the interventricular foramina, causing SSx of ↑ ICP (e.g. h/a, papilloedema) due to obstr
(noncommunicating) hydrocephalus. NS Path
15646
Cerebral aneurysm An expanding aneurysm in the cavernous portion of the ICA is most likely to initially cause Nervous (NS) Anatomy 1
h/a and diplopia (ipsilateral lateral rectus weakness) due to compressing or stretching of the (Anat)
abducens nerve (CN VI) as it runs next to the ICA in the cavernous sinus. Other commonly
affected nerves include the oculomotor nerve (CN III), trochlear nerve (CN IV), and the V1
and V2 branches of the trigeminal nerve (CN V). NS Anat
15648
Frontotemporal The frontal lobes are involved in personality, language, motor fxns, and executive fxns (e.g. Nervous (NS) Pathophysi 2
dementia abstraction). Frontal lobe fxn may be Dx by testing abstraction ability (e.g. asking about the ology
similarities b/w 2 related objects) on the MSE. (Patp) NS Patp
15659
Brain tumors GBM is an aggressive 1° brain neoplasm that generally Px w/ slowly worsening h/a, seizure, Nervous (NS) Pathology 10
a/o focal neuro issues. Most cases are a/w oncogenic mutations that increase EGFR (Path)
expression on the tumor cells, leading to ↑ transduction of growth signals that promote
cellular survival and proliferation. NS Path
15667
Diabetic neuropathy DM is the most common cause of peri polyneuropathy in adults. Common findings incl Nervous (NS) Pathology 1
numbness and paraesthesias in a stocking-glove distribution and ↓ proprioception due to (Path)
degen of large-fibre sensory axons. NS Path
15678
Traumatic brain DAI is a type of TBI that results from disruption of the white matter tracts. Microscopically, Nervous (NS) Pathology 5
injury DAI is visible as widespread axonal swelling, most pronounced at the gray-white matter jxn, (Path)
w/ accumulation of transport proteins (eg, amyloid precursor, α synuclein) at the site of
injury. NS Path
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Migraine Migraines are an episodic neurological disorder that results in severe, unilateral, throbbing Nervous (NS) Pathology 3
headaches often associated with photophobia, phonophobia, and nausea/vomiting. Migraines (Path)
typically last 4-72 hours, and up to 25% of patients also develop an aura (focal, reversible
neurologic symptoms that precede or accompany the headache). NS Path
15684
Migraine Migraine is an episodic disorder characterised by severe, often unilateral h/a, commonly a/w Nervous (NS) Pharmacol 3
nausea and sensitivity to light and sound. Tx is divided into abortive therapy (e.g. mild ogy (Phar)
analgesics, triptans, antiemetics, ergotamines) for acute SSx and preventive therapy (e.g. β
blockers, TCAs, anticonvulsants [topiramate, valproate]) to ↓ the freq of h/a. NS Phar
15702
Delirium Delirium is characterised by the acute onset of fluctuating disturbance in attn and gen Nervous (NS) Pathology 4
cognition (e.g. altered lvl of consciousness, disorientation, hallucinations). Common Rx that (Path)
may precipitate delirium in high-risk pops (e.g. elderly pts) incl sedative-hypnotics, benzos,
opioids, and anticholinergic Rx. NS Path
15705
Sciatic neuropathy Sciatic neuropathy is a common complication of hip fracture a/o arthroplasty b/c of the Nervous (NS) Anatomy 2
proximity of the sciatic nerve to the hip joint. Injury to the sciatic nerve in the pelvis causes (Anat)
neuro deficits across the sciatic nerve (knee flexion), common peroneal nerve (dorsiflexion,
numbness of the calf and dorsal foot), and tibial nerve (plantar flexion, ankle reflex). NS Anat
15727
Median nerve injury The median nerve is most commonly injured w/i the carpal tunnel, leading to pain and Nervous (NS) Anatomy 1
numbness in the first 3 digits and lateral half of the 4th, as well as weakness of thumb flexion (Anat)
and opposition. More proximal injury (in the forearm) additionally causes ↓ sensation over
the thenar eminence and weakness of flexion in the wrist and 2nd and 3rd digits. NS Anat
15765
Ischemic stroke The ACA supplies the medial aspects of the frontal and parietal lobes, which contain the Nervous (NS) Anatomy 19
UMNs responsible for contralateral lower extremity motor control. TE occlusion of the ACA (Anat)
Chx results in contralateral lower extremity weakness w/ hyperreflexia. NS Anat
15766
Transient ischemic TIAs are transient episodes of focal neuro impairment that occur due to local brain ischemia; Nervous (NS) Pharmacol 1
attack tissue infarction doesn't occur, and brain imaging is normal. Pts w/ TIA are at ↑ risk of future ogy (Phar)
stroke; 2° prevention incls antiplatelet agents (e.g. aspirin, clopidogrel), statins, and LSMs (e.
g. tobacco cessation, exercise) to ↓ future risk. NS Phar
360Renal artery Central RAO Px w/ sudden, painless, and permanent monocular blindness. Funduscopic Ex Ophthalmolog Pathophysi 1
occlusion reveals a pale retina and a "cherry-red" macula. y (OP) ology
(Patp) OP Patp
398Wilson disease The Kayser-Fleischer ring is an ophthalmologic finding most strongly associated with Ophthalmolog Pathology 5
Wilson's disease. It is seen most frequently in patients with neuropsychiatric complications. y (OP) (Path)
Basal ganglia atrophy is typically present in these patients. OP Path
863Retinoblastoma Familial retinoblastoma occurs as a result of mutations of each of the two Rb genes ("two Ophthalmolog Pathology 1
hits"). These patients have an increased risk of secondary tumors, especially osteosarcomas, y (OP) (Path)
later in life. OP Path
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Macular A scotoma is a visual field defect that occurs due to a pathologic process that involves parts Ophthalmolog Pathophysi 2
degeneration of the retina or the optic nerve resulting in a discrete area of altered vision surrounded by y (OP) ology
zones of normal vision. Lesions of the macula cause central scotomas. (Patp) OP Patp
1363
Glaucoma OAG is Chx by progressive loss of peripheral vision from ↑ IOP. Timolol and other Ophthalmolog Pharmacol 3
nonselective β blockers work by diminishing the secretion of aqueous humor by the ciliary y (OP) ogy (Phar)
epithelium. Acetazolamide, a CAI, also ↓ aqueous humor secretion by the ciliary epithelium.
PGF2α (eg, latanoprost, travoprost) and cholinomimetics (eg, pilocarpine, carbachol) ↓ IOP
by ↑ the outflow of aqueous humor. OP Phar
1646
Cytomegalovirus CMV retinitis is the most common cause of ocular disease in pts w/ unTx AIDS who have Ophthalmolog Pharmacol 9
CD4 counts <50/mm3. Dx is made by funduscopy, which typically reveals yellow-white, y (OP) ogy (Phar)
fluffy retinal lesions near the retinal vessels w/ associated hemorrhage. Tx w/ ganciclovir is
required to prevent blindness. OP Phar
7721
Macular Wet age-related macular degeneration is characterized by retinal neovascularization due to Ophthalmolog Pharmacol 2
degeneration increased vascular endothelial growth factor (VEGF) levels. Patients typically have acute y (OP) ogy (Phar)
vision loss and metamorphopsia with funduscopy showing a grayish-green subretinal
membrane and/or subretinal hemorrhage. Treatment includes smoking cessation and VEGF
inhibitor therapy (eg, ranibizumab, bevacizumab). OP Phar
8557
Cranial nerve palsy The pupillary light reflex is assessed by shining light in an eye and observing the response in Ophthalmolog Anatomy 9
that eye (direct) and the opposite eye (consensual). The optic nerve (CN II) is responsible for y (OP) (Anat)
the afferent limb of the pupillary reflex, and the oculomotor nerve (CN III) is responsible for
the efferent limb. OP Anat
11551
Cytomegalovirus The most common eye-related complication of congenital CMV infection is chorioretinitis. Ophthalmolog Microbiolo 9
y (OP) gy (Micr) OP Micr
11675
Hypertensive Severe hypertension in retinal precapillary arterioles causes endothelial disruption, leakage Ophthalmolog Pathology 1
retinopathy of plasma into the arteriolar wall, and fibrinous necrosis. The necrotic vessels can then bleed y (OP) (Path)
into the nerve fiber layer, which can be seen on examination as dot- or flame-shaped
hemorrhages. OP Path
11841
Glaucoma Glaucoma is a form of optic neuropathy characterized by increased intraocular pressure Ophthalmolog Pharmacol 3
associated with increased production or decreased outflow of aqueous humor. Topical y (OP) ogy (Phar)
prostaglandins (eg, latanoprost) increase outflow of aqueous via the uveoscleral pathway and
are the preferred treatment for open-angle glaucoma. OP Phar
12257
Idiopathic Idiopathic intracranial HTN (pseudotumor cerebri) Px in young obese women w/ daily h/a Ophthalmolog Pathophysi 1
intracranial (which worsens during Valsalva), bilaterally symmetric papilledema, and transient visual y (OP) ology
hypertension disturbances. ↑ ICP compresses the optic nerves, resulting in impaired axoplasmic flow and (Patp)
optic disc edema. OP Patp
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15668
Diabetic retinopathy Chronic hyperglycemia in patients with diabetes can lead to increased permeability and Ophthalmolog Pathology 1
arteriolar obstruction in retinal vessels. The resulting ischemia stimulates production of y (OP) (Path)
vascular endothelial growth factor and other angiogenic factors, leading to
neovascularization (proliferative diabetic retinopathy). Complications include retinal
hemorrhage, retinal detachment, and vision loss. OP Path
172Theophylline Seizures are the major cause of morbidity and mortality from theophylline intoxication. Poisoning & Pharmacol 2
Tachyarrhythmias are the other major concern. Environmental ogy (Phar)
Exposure (PO) PO Phar
708Antidepressants TCA overdose can Px w/ mental status changes, seizures, prolonged QRS duration, Poisoning & Pharmacol 4
ventricular arrhythmias, and anticholinergic findings. NaHCO3 is used to Tx associated Environmental ogy (Phar)
cardiac toxicity and works by ↑ serum pH and extracellular Na (alleviating fast Na channel Exposure (PO)
blockade). PO Phar
841Arsenic poisoning Acute arsenic poisoning impairs cellular resp and Px w/ abdominal pain, vomiting, diarrhea, Poisoning & Pharmacol 1
hypotension, and a garlic odor on the breath. Insecticides and contaminated water are Environmental ogy (Phar)
common sources of arsenic. Dimercaprol is the chelating agent of choice. Exposure (PO) PO Phar
1254
Cyanide poisoning Cyanide toxicity can occur in pts Tx w/ nitroprusside. Cyanide toxicity Px w/ altered mental Poisoning & Pharmacol 2
status, seizures, CV collapse, lactic acidosis, and bright red venous blood. Antidotal Tx of Environmental ogy (Phar)
cyanide toxicity can be achieved by 3 different strategies: direct binding of cyanide ions Exposure (PO)
(hydroxocobalamin), induction of methemoglobinemia (Na nitrite), and use of detoxifying
sulfur donors (Na thiosulfate). PO Phar
1448
Warfarin Most available rodenticides contain brodifacoum, a long-acting 4-hydroxycoumarin Poisoning & Pharmacol 2
derivative. A pt who has ingested a quantity of rodenticide sufficient to cause coagulopathy Environmental ogy (Phar)
and abnormal bleeding (similar to warfarin toxicity) requires immediate Tx w/ FFP in Exposure (PO)
addition to vitamin K. PO Phar
1454
Lead poisoning Young children who reside in homes built before 1978 are at significant risk for Pb toxicity. Poisoning & Biochemist 4
Pb directly inhibits ferrochelatase and δ-ALA dehydratase, resulting in anemia, ALA Environmental ry (Bioc)
accumulation, and ↑ Zn protoporphyrin levels. Neurotoxicity is also a significant long-term Exposure (PO)
complication. PO Bioc
1544
Aspirin poisoning Aspirin intoxication should be suspected in a pt w/ the triad of fever, tinnitus, and tachypnea. Poisoning & Pathophysi 1
Adults w/ aspirin toxicity initially develop a 1° resp alkalosis f/b a mixed resp alkalosis and Environmental ology
AGMA. When the PaCO2 and HCO3 are outside the normal range, a normal pH suggests a Exposure (PO) (Patp)
mixed acidosis/alkalosis disorder, as compensatory responses do not correct the pH
completely. PO Patp
8482
Mushroom Amatoxins are found in a variety of poisonous mushrooms (eg, Amanita phalloides, known Poisoning & Biochemist 2
poisoning as death cap) and are potent inhibitors of RNA polymerase II (halting mRNA synthesis). Environmental ry (Bioc)
Exposure (PO) PO Bioc
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Lead poisoning Lead poisoning can cause neurologic, gastrointestinal, renal, and hematologic complications. Poisoning & Pathology 4
Although symptoms can be vague, lead poisoning should be suspected if these symptoms Environmental (Path)
arise while residing in a home built before 1978. Diagnosis is made by measuring the Exposure (PO)
patient's blood lead level. PO Path
15235
Toxic alcohols Ethylene glycol and methanol are toxic alcohols that cause AGMA and an ↑ osmolar gap. Poisoning & Pharmacol 1
Toxicity occurs after metabolization by alcohol dehydrogenase; fomepizole is a competitive Environmental ogy (Phar)
inhibitor of alcohol dehydrogenase and is used for the Tx of acute poisoning. Exposure (PO) PO Phar
68 Gallstones and Estrogen-induced cholesterol hypersecretion and progesterone-induced gallbladder Pregnancy, Pathophysi 1
pregnancy hypomotility are responsible for the ↑ incidence of cholelithiasis in women who are pregnant Childbirth & ology
or using oral contraceptives. Puerperium (Patp)
(PR) PR Patp
222Antipsychotics The secretion of PRL is controlled by the inhib effect of hypothal DA. Risperidone and other Pregnancy, Pharmacol 9
antipsychs cause hyperprolactinaemia by blocking D2 receptors on lactotrophs. ↑ PRL leads Childbirth & ogy (Phar)
to amenorrhoea (inhib of GnRH release), galactorrhoea, and breast soreness. Puerperium
(PR) PR Phar
247Generalized anxiety Buspirone is an NBA used to Tx GAD. It has a slow onset of action, lacks muscle relaxant or Pregnancy, Pharmacol 4
disorder anticon properties, and carries no risk of dependence. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
248Generalized anxiety SSRIs and SNRIs are 1st-line Rx for GAD. BZDs should be limited to short-term use while Pregnancy, Behavioral 4
disorder antidepressants take effect and avoided in pts w/ a Hx of substance abuse. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
261Antipsychotics DIP is an EPS caused by Rx that block D2 receptors (e.g. antipsychs). Mx strategies incl ↓ or Pregnancy, Pharmacol 9
discontinuing the offending Rx and Tx w/ an antichol Rx. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
312Down syndrome DS is the most common chromosomal anomaly. It is a/w low lvls of maternal serum AFP Pregnancy, Genetics 6
and estriol and ↑ lvls of β-hCG and inhibin A. ↑ AFP lvls are seen in multiple gestation, open Childbirth & (Gene)
NT defects, and abdominal wall defects. Puerperium
(PR) PR Gene
334Ectopic pregnancy An ectopic pregnancy is Chx by implantation outside of the uterus. Uterine curettage would Pregnancy, Histology 1
reveal decidual changes in the endometrium due to progesterone secretion but no embryonic Childbirth & (Hist)
or trophoblastic tissue (eg, no villi). Puerperium
(PR) PR Hist
335Gestational Choriocarcinoma is a malignant form of gestational trophoblastic disease composed of Pregnancy, Pathophysi 3
trophoblastic anaplastic cytotrophoblasts and syncytiotrophoblasts w/o villi. It often Px as Childbirth & ology
disease dyspnea/hemoptysis due to pulm metastasis from hematogenous spread. Puerperium (Patp)
(PR) PR Patp
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337Polyhydramnios Polyhydramnios (excessive accumulation of amniotic fluid) presents with increased Pregnancy, Embryolog 1
abdominal circumference out of proportion to gestational age. The etiology is decreased fetal Childbirth & y (Embr)
swallowing or increased fetal urination. Fetal anomalies associated with impaired Puerperium
swallowing include gastrointestinal obstruction (eg, duodenal, esophageal, or intestinal (PR)
atresia) and anencephaly. PR Embr
342Prenatal care The maternal serum quadruple screen is performed to Ax risk of congenital defects in Pregnancy, Pathophysi 1
fetuses. Accurate dating is important for determining whether levels of AFP and other Childbirth & ology
analytes are abnormal for gestational age. Pts w/ a Hx of irregular menses are at risk for Puerperium (Patp)
inaccurate pregnancy dating. (PR) PR Patp
348Insomnia Benzos, antihists, and sedating antideps should be avoided in the Tx of insomnia in elderly Pregnancy, Pharmacol 3
pts due to their AEs. Ramelteon, a melatonin agonist, has a lower AE burden than other Childbirth & ogy (Phar)
sedative-hypnotic agents and is effective in ↓ time to sleep onset in the elderly. Puerperium
(PR) PR Phar
349Insomnia NonBZD Rx (eg, zolpidem, zaleplon, eszopiclone) stimulate specific subtypes of GABA-A Pregnancy, Pharmacol 3
receptors. As a result, nonBZDs are primarily hypnotics and do not produce the anxiolytic, Childbirth & ogy (Phar)
muscle relaxant, or anticonvulsant effects a/w BZDs. Puerperium
(PR) PR Phar
350Alcohol withdrawal AWS should be considered in hospitalised pts who develop tremulousness, agitation, and ↑ Pregnancy, Pharmacol 2
HR and BP w/i 48hrs following admission. Benzos act as a substitute for the effects of Childbirth & ogy (Phar)
alcohol on GABA receptors, preventing AWS from occurring. Puerperium
(PR) PR Phar
507Neural tube defects Valproate ↓ levels of folic acid and ↑ the risk of NTDs (eg, meningocele, Pregnancy, Pharmacol 4
myelomeningocele). Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
510Antipsychotics Akathisia is an EPS of antipsychRx characterised by inner restlessness and an inability to sit Pregnancy, Pharmacol 9
or stand in 1 position. Tx involves a ↓ in the antipsychdose, if possible, or the addn of a β Childbirth & ogy (Phar)
blocker or benzo. Puerperium
(PR) PR Phar
511Antipsychotics Tardive dyskinesia consists of abnormal involuntary movements of the mouth, tongue, face, Pregnancy, Behavioral 9
extremities, or trunk associated with prolonged exposure to antipsychotics. Characteristic Childbirth & Science
movements include lip smacking, facial grimacing, tongue protrusions, and choreoathetoid Puerperium (Beha)
movements of the head, limbs, and trunk. (PR) PR Beha
512Neuroleptic NMS is an AE to antipsych Rx characterised by severe 'lead-pipe' rigidity, hyperthermia, Pregnancy, Pharmacol 2
malignant syndrome sympathetic hyperactivity, and mental status changes. NMS is characterised by severe Childbirth & ogy (Phar)
rigidity rather than the NM irritability (e.g. hyperreflexia, myoclonus) seen in SS. Puerperium
(PR) PR Phar
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513Antipsychotics Antipsychotic Rx work by blocking DA-2 receptors in the mesolimbic DA pathway. DA-2 Pregnancy, Anatomy 9
receptor blockade in the tuberoinfundibular pathway can result in galactorrhea and Childbirth & (Anat)
amenorrhea. Puerperium
(PR) PR Anat
515Antipsychotics FGAs can be classified according to high or low potency and have char AE profiles. Low- Pregnancy, Pharmacol 9
potency antipsychs are more likely to cause sedation, antichol AEs, and orthostatic Childbirth & ogy (Phar)
hypotension. High-potency antipsychs are more likely to cause EPS (e.g. dystonia, akathisia, Puerperium
parkinsonism). (PR) PR Phar
516Antipsychotics Pts Tx w/ clozapine are req to have regular monitoring of the absolute neutrophil count due Pregnancy, Pharmacol 9
to the risk of life-threatening agranulocytosis. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
518Bipolar disorder Antidepressant monotherapy can induce mania in susceptible pts, esp. those w/ unrecognised Pregnancy, Behavioral 7
BD. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
519Lithium Chronic lithium tox (e.g. confusion, ataxia, NM excitability) can be precipitated by volume Pregnancy, Pharmacol 2
depletion and drug interactions w/ TZDs, ACEIs, and NSAIDs. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
520Hypothyroidism Hypothyroidism and NDI are the most common AEs of long-term lithium therapy. Serum Pregnancy, Pharmacol 13
TSH and renal fxn (BUN and creatinine) should be monitored routinely. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
572Monoamine oxidase MAO is a mitochondrial enzyme that breaks down MA NTs (e.g. DA, NE, 5-HT). Tyramine- Pregnancy, Pharmacol 1
inhibitors induced HTC can occur in pts taking MAOIs who consume foods containing high amounts Childbirth & ogy (Phar)
of tyramine (e.g. aged cheeses, cured meats, draft beer). Puerperium
(PR) PR Phar
573Depression MAOIs are particularly useful in pts w/ Tx-resistant MDD w/ atypical features. ↑ appetite Pregnancy, Behavioral 8
and sleep, leaden paralysis, rejection sensitivity, and mood reactivity are hallmarks of the Childbirth & Science
atypical subtype. Puerperium (Beha)
(PR) PR Beha
574Tricyclic TCA OD can cause fatal cardiac arrhythmias and refractory hypotension due to inhib of fast Pregnancy, Pharmacol 1
antidepressants Na+ channels in cardiac myocytes. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
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575Urinary retention TCAs have strong antichol properties. Potential AEs incl confusion, constipation, and urinary Pregnancy, Pharmacol 4
retention. These Rx should be used w/ caution in elderly pts. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
576Selective serotonin SSRIs have improved tolerability and a better AE profile compared w/ TCAs and MAOIs but Pregnancy, Behavioral 3
reuptake inhibitors are a/w sexual dysfxn. Physicians should routinely inquire about sexual dysfxn b/c it's a Childbirth & Science
relatively common AE of SSRIs that may lead to non-adherence. Puerperium (Beha)
(PR) PR Beha
704Antidepressants Bupropion is a 1st-lineantidep that isn't a/w sexual AEs or weight gain. However, it's a/w an Pregnancy, Pharmacol 4
↑ seizure risk at high doses and is c/i in pts w/ seizure disorders, AN, and BN. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
706Antidepressants Sexual dysfxn is seen in up to 50% of pts Tx w/ SSRIs. Bupropion, an NDRI, is a 1st-line Tx Pregnancy, Pharmacol 4
for MDD and doesn't cause sexual dysfxn. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
707Priapism Trazodone is a highly sedating antidepressant commonly used to Tx insomnia. Priapism is a Pregnancy, Behavioral 1
rare but serious AE. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
773Serotonin syndrome Co-admin of SSRIs and MAOIs can produce excessive synaptic 5-HT lvls 2° to ↓ reuptake Pregnancy, Pharmacol 2
and ↓ degradation of 5-HT, potentially causing SS. To avoid this risk, a 2-wk washout period Childbirth & ogy (Phar)
after discontinuing a MAOI and before initiating SSRI therapy is req to allow sufficient time Puerperium
for MAO regen. (PR) PR Phar
774Opioids Buprenorphine is a partial opioid receptor agonist that binds w/ high affinity but has low Pregnancy, Pharmacol 13
intrinsic activity. In pts on long-term opioid therapy, buprenorphine can displace other Childbirth & ogy (Phar)
opioids and precipitate withdrawal. Puerperium
(PR) PR Phar
791Gestational A complete mole is composed of multiple cystic edematous hydropic villi as a result of Pregnancy, Pathophysi 1
trophoblastic trophoblast proliferation. Serial measurements of B-hCG should be performed following Childbirth & ology
disease - complete evacuation of a hydatidiform mole. Persistently elevated or rising levels may signify the Puerperium (Patp)
mole development of an invasive mole or choriocarcinoma. (PR) PR Patp
792Gestational A partial mole will have a triploid karyotype (eg, 69,XXX or XXY) and contain fetal tissue Pregnancy, Pathophysi 3
trophoblastic w/ some edematous villi w/ focal trophoblastic proliferation, and normal-appearing villi. Pts Childbirth & ology
disease Px w/ vaginal bleeding, and prior miscarriage is a RFx. Puerperium (Patp)
(PR) PR Patp
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870Alcohol withdrawal Tremulousness is typically 1 of the earliest SSx of alcohol withdrawal. Other common SSx Pregnancy, Behavioral 2
incl GI distress, agitation, anxiety, and autonomic disturbance. DT is the most severe MFx of Childbirth & Science
alcohol withdrawal and typically begins 48-96hrs after the last drink. Puerperium (Beha)
(PR) PR Beha
937Benzodiazepines Benzos act by binding to the benzo binding site, which allosterically mods the binding of Pregnancy, Pharmacol 6
GABA, resulting in an ↑ freq of Cl- ion channel opening. The influx of Cl- ions into the Childbirth & ogy (Phar)
neurons causes neuronal hyperpol and inhib of the AP. Puerperium
(PR) PR Phar
955Aromatase Aromatase converts androgens into estrogens in the ovaries, testes, placenta, and other Pregnancy, Pathophysi 1
deficiency peripheral tissues. Placental aromatase deficiency causes accumulation of androgens during Childbirth & ology
pregnancy, resulting in ambiguous external genitalia in female infants and maternal Puerperium (Patp)
virilization. (PR) PR Patp
970Professional Physicians are ethically obligated to question orders that raise concern about potential harm Pregnancy, Behavioral 3
conduct to pts. Issues should initially be discussed directly w/ the physician who made the order and Childbirth & Science
not involve ancillary staff. Puerperium (Beha)
(PR) PR Beha
1021
Wernicke-Korsakoff Pyruvate dehydrogenase and a-ketoglutarate dehydrogenase require thiamine as a cofactor. Pregnancy, Biochemist 5
syndrome Administration of glucose to thiamine-deficient patients (eg, alcoholics) can result in Childbirth & ry (Bioc)
Wernicke encephalopathy (eg, acute confusion, ophthalmoplegia, and ataxia) due to Puerperium
increased thiamine demand. (PR) PR Bioc
1046
Anorexia nervosa AN is an eating disorder characterised by low body weight, intense fear of becoming fat, and Pregnancy, Behavioral 3
distorted body image. Med complications due to starvation in AN incl bradycardia, Childbirth & Science
hypotension, osteoporosis, and amenorrhoea. Puerperium (Beha)
(PR) PR Beha
1165
Phencyclidine PCP is 1arily an NMDA receptor antagonist, w/ lesser effects on the reuptake inhib of Pregnancy, Behavioral 2
biogenic amines and other receptors. It can have dissociative and anaesthetic effects but may Childbirth & Science
also cause psychosis and severe agitation, leading to violent trauma. Ataxia, horizontal and Puerperium (Beha)
vertical nystagmus, and memory loss can also be present. (PR) PR Beha
1182
Ethical principles in Pts have the right to make decisions about their healthcare. However, based on the principle Pregnancy, Behavioral 3
healthcare of non-maleficence, the prescription of Rx likely to do more harm than good should be Childbirth & Science
avoided, even if requested by pts. Puerperium (Beha)
(PR) PR Beha
1193
Bipolar disorder Lithium and the anticons valproate, carbamazepine, and lamotrigine are mood-stabilising Pregnancy, Pharmacol 7
agents used in BD. Valproate is commonly used in the Tx of gen as well as myoclonic Childbirth & ogy (Phar)
seizures. Puerperium
(PR) PR Phar
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1234
Defense In displacement, emotions are transferred from the person causing the (-) emotions to a more Pregnancy, Behavioral 8
mechanisms neutral, less threatening person or object. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1255
Opioids Neonatal abstinence syndrome presents with neurologic, gastrointestinal, and autonomic Pregnancy, Pharmacol 13
symptoms. Tremors, irritability, diarrhea, and poor feeding are classic findings. Opiate Childbirth & ogy (Phar)
replacement therapy is the treatment of choice; the dose is titrated to the patient's symptoms, Puerperium
and the patient is then slowly weaned. (PR) PR Phar
1256
Opioids Naloxone is a pure opioid receptor antagonist used to Tx opioid intox or OD. Although it Pregnancy, Pharmacol 13
binds to μ, κ, and δ opioid receptors, it has the greatest affinity for μ receptors (which Childbirth & ogy (Phar)
mediate opioid-induced bradycardia and resp depression), making it an ideal agent for Tx Puerperium
opioid intox. (PR) PR Phar
1287
Opioids Methadone is a potent, long-acting opioid agonist used in the maintenance Tx of opioid use Pregnancy, Behavioral 13
disorder. Its prolonged effects suppress withdrawal SSx and cravings. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1288
Phencyclidine PCP is a hallucinogen that causes dissociative SSx, agitation, hallucinations, and violent Pregnancy, Behavioral 2
behaviour. Ataxia, nystagmus, and memory loss are other distinguishing SSx of PCP abuse. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1289
Cannabis Marijuana contains tetrahydrocannabinol, which stims cannabinoid receptors to produce a Pregnancy, Behavioral 1
mild euphoria w/ inappropriate laughter, ↑ appetite, slowed rxn time/motor speed, and Childbirth & Science
cognitive impairment. Tachycardia and conjunctival injection are the 2 most immediate Puerperium (Beha)
physical SSx of marijuana use. (PR) PR Beha
1346
Body dysmorphic BDD involves fixation on a perceived defect in appearance and repetitive behaviours in Pregnancy, Behavioral 1
disorder response to the fixation. It can present w/ absent insight/delusional beliefs and result in Childbirth & Science
significant psychosocial dysfxn. Puerperium (Beha)
(PR) PR Beha
1347
Dysthymia The DSM-5 Dx of dysthymia is characterised by chronic depressed mood and at least 2 other Pregnancy, Behavioral 1
depressive SSx lasting for at least 2yrs. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1348
Bipolar disorder The anticonvulsant valproate has mood-stabilising properties and is an effective maintenance Pregnancy, Behavioral 7
Tx for BD. Other maintenance options for BD incl lithium, lamotrigine, and quetiapine. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
D eats
1350
Defense Splitting is a defence mech that involves organising experiences of the self or others into Pregnancy, Behavioral 8
mechanisms extremes to keep (+) and (-) aspects separated. It's commonly seen in pts w/ BPD. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1351
Defense Suppression is a mature defence mech involving a conscious choice not to dwell on a Pregnancy, Behavioral 8
mechanisms particular thought or feeling. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1352
Benzodiazepines When benzos are used in the Tx of anxiety, drug selection should consider the Rx's duration Pregnancy, Behavioral 6
of action. Short- to intermediate-acting benzos (e.g. lorazepam) are pref in situations in Childbirth & Science
which prolonged AEs of sedation and cognitive impairment must be minimalised. Puerperium (Beha)
(PR) PR Beha
1353
Opioids Opioid withdrawal is marked by mydriasis, abdo pain, diarrhoea, piloerection, lacrimation, Pregnancy, Behavioral 13
and yawning. It's gen non-life-threatening, unlike withdrawal from alcohol and benzos. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1429
Defense Projection is an immature defence mech involving the misattribution of 1's unacceptable Pregnancy, Behavioral 8
mechanisms feelings or thoughts to another person who doesn't actually have them. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1430
Depression Postpartum mood disturbances incl postpartum blues, postpartum depression, and, rarely, Pregnancy, Behavioral 8
postpartum psychosis. The most common disturbance, postpartum blues, is a benign self- Childbirth & Science
limited condition that begins several days postpartum and resolves w/i 14days w/o Puerperium (Beha)
intervention. (PR) PR Beha
1431
Personality APD is a maladaptive pattern of behaviour characterised by social inhib, feelings of Pregnancy, Behavioral 6
disorders inadequacy, and fear of embarrassment and rejection. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1433
Conversion disorder Conversion disorder is Chx by neuro SSx and Ex findings that are incompatible w/ a known Pregnancy, Behavioral 1
neuro disease. Pts do not consciously produce the SSx like in factitious disorder or Childbirth & Science
malingering, and the condition may cause significant distress/impairment. Puerperium (Beha)
(PR) PR Beha
1440
Diabetes mellitus Neonates born to mothers with poorly controlled diabetes during pregnancy are exposed to Pregnancy, Pathology 31
high maternal glucose levels in utero, resulting in excessive fetal insulin production and islet Childbirth & (Path)
hyperplasia. Fetal hyperinsulinemia persists for several days following birth and predisposes Puerperium
the infant to transient hypoglycemia. (PR) PR Path
D eats
1443
Benzodiazepines Benzos bind GABAA receptors, resulting in an ↑ freq of Cl- channel opening in the presence Pregnancy, Pharmacol 6
of GABA. Indications for prescribing incl short-term Tx of anxiety disorders and AWS. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
1458
Narcolepsy Narcolepsy is a chronic sleep disorder characterised by excessive daytime sleepiness, Pregnancy, Behavioral 3
cataplexy, and REM sleep-related phenomena (i.e. hypnagogic/hypnopompic hallucinations, Childbirth & Science
sleep paralysis). Puerperium (Beha)
(PR) PR Beha
1459
Defense Rxn formation is a defence mech that involves replacing unacceptable feelings and impulses Pregnancy, Behavioral 8
mechanisms w/ their extreme opposites. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1464
Rubella The CRS is predominantly Chx by neonatal defects of the head (microcephaly, mental Pregnancy, Microbiolo 3
retardation), eyes (cataracts), ears (deafness), and heart/CV system (PDA, peripheral Childbirth & gy (Micr)
pulmonic stenosis). To ↓ the incidence of this syndrome, the CDC currently recommends the Puerperium
vax of children and non-pregnant females of childbearing age w/ live, attenuated rubella (PR)
virus vax. PR Micr
1490
Congenital cardiac Li is commonly used to Tx bipolar disorder. Its use during pregnancy is a/w Ebstein's Pregnancy, Pharmacol 2
defects anomaly, which is Chx by apical displacement of the TV leaflets, ↓ RV volume, and Childbirth & ogy (Phar)
atrialization of the RV. Puerperium
(PR) PR Phar
1568
Teratogens Isotretinoin is used to Tx severe acne w/ significant scarring. Pregnancy is an absolute c/i due Pregnancy, Pharmacol 2
to the risk of teratogenicity. Sexually active women should be advised to use 2 forms of Childbirth & ogy (Phar)
contraception and take monthly pregnancy tests. Puerperium
(PR) PR Phar
1575
Rubella Maternal rubella infection produces a low-grade fever, a maculopapular rash w/ Pregnancy, Microbiolo 3
cephalocaudal progression, and posterior auricular and suboccipital LAD. Most adult women Childbirth & gy (Micr)
pts develop polyarthritis and polyarthralgia as sequelae. CRS is a/w sensorineural deafness, Puerperium
cataracts, and cardiac malformations (PDA). (PR) PR Micr
1688
Oogenesis 1° oocytes are completely developed in female embryos by the 5th month of gestation, at Pregnancy, Genetics 1
which point they are arrested in prophase of meiosis I. Normal menstrual cycle hormones Childbirth & (Gene)
stimulate the 1° oocyte to resume differentiation. Prior to fertilization, 2° oocytes are arrested Puerperium
in metaphase of meiosis II. (PR) PR Gene
1729
Behavioural Classical conditioning involves a neutral stim being repeatedly paired w/ a non-neutral stim Pregnancy, Behavioral 1
responses that elicits a reflexive, unconditioned response. Over time, the formerly neutral stim is able Childbirth & Science
to evoke a conditioned response by itself in absence of the non-neutral stim. Puerperium (Beha)
(PR) PR Beha
D eats
1772
Normal pregnancy β-hCG is produced by the syncytiotrophoblast after implantation, which generally occurs 6-7 Pregnancy, Embryolog 2
days after fertilization at the earliest. β-hCG typically is detectable in the maternal serum Childbirth & y (Embr)
approximately 8 days after fertilization, whereas it is detectable in the urine 14 days after Puerperium
fertilization. Therefore, a serum pregnancy test will be (+) before a urine pregnancy test. (PR) PR Embr
1775
Teratogens Although tetracyclines are the 1st-line Tx for Lyme disease, they are c/i in pregnancy due to Pregnancy, Pharmacol 2
the potential for fetal tooth discoloration. Amoxicillin should be given instead for Tx of Childbirth & ogy (Phar)
Lyme disease in pregnant women. Puerperium
(PR) PR Phar
1781
Developmental By age 3, a child is expected to play imaginatively in parallel w/ others, speak in simple Pregnancy, Behavioral 1
milestones sentences, copy a circle, use utensils, and ride a tricycle. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
1825
Down syndrome Unbalanced Robertsonian translocations account for a minority of DS cases. Karyotyping Pregnancy, Genetics 6
shows 46 chromosomes w/ a translocation b/w 2 acrocentric nonhomologous chromosomes Childbirth & (Gene)
[eg, 46, XX, t(14;21)]. Puerperium
(PR) PR Gene
1843
Bulimia nervosa BN is characterised by episodes of binge eating and compensatory weight-↓ behaviours. SSx Pregnancy, Behavioral 4
of self-induced vomiting incl hypokalaemia, meta alkalosis, parotid gland enlargement, Childbirth & Science
dorsal hand calluses, and dental erosion. Puerperium (Beha)
(PR) PR Beha
1868
Anticholinergics Anticholtox is characterised by fever; confusion; cutaneous flushing; dry oral mucosa; and Pregnancy, Pharmacol 3
dilated, poorly reactive pupils. TCAs, particularly amitriptyline, have strong anticholinergic Childbirth & ogy (Phar)
effects. Puerperium
(PR) PR Phar
1914
Preeclampsia Preeclampsia is defined as hypertension onset after 20 weeks gestation plus proteinuria or Pregnancy, Pathology 1
signs of end-organ damage. End-organ damage is due to endothelial damage secondary to the Childbirth & (Path)
release of inflammatory factors from abnormal placentation. Puerperium
(PR) PR Path
1987
Normal pregnancy In pregnancy, progesterone is secreted by the corpus luteum and later by the placenta. Pregnancy, Physiology 2
Although PRL secretion ↑ as pregnancy progresses, high progesterone lvls inhibit lactation Childbirth & (Phys)
by preventing binding of PRL to receptors on alveolar cells in the breast. Puerperium
(PR) PR Phys
2001
Cocaine Cocaine is a stim that inhibs the presynaptic reuptake of NE, DA, and 5-HT. Intox pts Pregnancy, Pharmacol 3
develop agitation, tachycardia, HTN, and light-responsive mydriasis due to ↑ sympathetic Childbirth & ogy (Phar)
activity. Cocaine is also a potent vasoconstrictor that can cause myocardial ischemia and Puerperium
atrophy of the nasal mucosa and septum. (PR) PR Phar
D eats
2045
Schizophrenia The Dx of schizophrenia req >2 of the following 5 SSx: delusions, hallucinations, Pregnancy, Behavioral 4
disorganised speech, grossly disorganised behaviour, and (-) SSx. The total impairment Childbirth & Science
duration must be >6mos. Puerperium (Beha)
(PR) PR Beha
2046
Psychosis DD is characterised by >1 delusions for >1mos in the absence of other psychotic SSx. Pregnancy, Behavioral 6
Behaviour isn't obvi bizarre, and fxning isn't significantly impaired apart from the direct Childbirth & Science
impact of the delusions. Puerperium (Beha)
(PR) PR Beha
2047
Schizoaffective For Dx of schizoaffective disorder, psychosis must occur in the absence of major mood Pregnancy, Behavioral 1
disorder episodes, but mood episodes must be present for a majority of this lifelong illness. In BD and Childbirth & Science
MDD w/ psychotic features, psychotic SSx occur exclusively during mood episodes. Puerperium (Beha)
(PR) PR Beha
2048
Generalized anxiety GAD involves excessive uncontrollable worry about multi issues w/ a SSx duration of Pregnancy, Behavioral 4
disorder >6mos. assoc SSx incl restlessness, muscle tension, fatigue, sleep disturbance, irritability, Childbirth & Science
and difficulty concentrating. Puerperium (Beha)
(PR) PR Beha
2049
Obsessive OCD is characterised by persistent, intrusive thoughts leading to repetitive, ritualistic Pregnancy, Behavioral 2
compulsive disorder behaviours. SSRIs are considered 1st-line Tx for OCD and exert their effects by inhib 5-HT Childbirth & Science
reuptake. Puerperium (Beha)
(PR) PR Beha
2050
Bulimia nervosa BN is characterised by recurrent episodes of binge eating f/b compensatory behaviours to Pregnancy, Behavioral 4
prevent weight gain (e.g. fasting, exercising, vomiting, using laxatives). In contrast to pts w/ Childbirth & Science
AN, BN pts are normal weight to overweight. Puerperium (Beha)
(PR) PR Beha
2051
Defense Passive aggression is the expression of angry feelings in a non-confrontational manner. Pregnancy, Behavioral 8
mechanisms Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
2053
Defense Transference is the unconscious shifting of emotions a/w a significant person from 1's past to Pregnancy, Behavioral 8
mechanisms a person in the present. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
2063
Psychosis Schizophreniform disorder is characterised by psychotic SSx (delusions, hallucinations, Pregnancy, Behavioral 6
disorganised speech and behaviour, (-) SSx) lasting >1mos and <6mos. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
D eats
2088
Selective serotonin SS is characterised by AMS, autonomic hyperactivity, and NM excitation (e.g. hyperreflexia, Pregnancy, Pharmacol 3
reuptake inhibitors clonus). Causes incl high doses a/o combos of 5-HT-ergic drugs (e.g. SSRI and MAOI). Childbirth & ogy (Phar)
Tryptophan is a precursor for 5-HT. Puerperium
(PR) PR Phar
2089
Selective serotonin Cyproheptadine is an antihist w/ anti-5HT-ergic properties that can be used as an antidote in Pregnancy, Pharmacol 3
reuptake inhibitors severe cases of SS that don't respond to supportive measures. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
2122
Delirium Delirium is a reversible, acute-onset confusional state characterised by a fluctuating lvl of Pregnancy, Behavioral 4
consciousness w/ deficits in attn, memory, and executive fxn. In contrast, dementia has a Childbirth & Science
gradual onset, is irreversible, and doesn't involve fluctuations in consciousness. Puerperium (Beha)
(PR) PR Beha
2123
Post-traumatic stress PTSD is characterised by intrusive thoughts, nightmares, flashbacks, avoidance of trauma Pregnancy, Behavioral 3
disorder reminders, hypervigilance, and sleep disturbance lasting >1mos. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
7752
Traumatic brain Pts w/ OFC injury often experience personality changes, disinhib, and irritability 2° to Pregnancy, Behavioral 5
injury impairment of the behavioural and emotional mod systems. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
8259
Narcolepsy Tx for narcolepsy incls psychostims (e.g. modafinil) for daytime sleepiness. Pregnancy, Pharmacol 3
Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
8295
Mental status Quick clinical tests to Ax attn and conc incl counting down from 100 by intervals of 3 or 7, Pregnancy, Behavioral 1
examination reciting the mos of the yr in reverse order, and spelling 'world' backwards. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
8325
Torticollis Congenital torticollis is typically noted by 2 to 4 weeks of age, after which the child prefers Pregnancy, Pathology 2
to hold the head tilted to one side. It is most commonly the result of malposition of the head Childbirth & (Path)
in utero or birth trauma. Most cases resolve with conservative therapy and stretching Puerperium
exercises. (PR) PR Path
8327
Serotonin syndrome SS is characterised by a triad of autonomic instability, AMS, and NM irritability. It may Pregnancy, Pharmacol 2
develop when a MAOI antidep or a non-antidep w/ MAOI activity (e.g. linezolid) is combo Childbirth & ogy (Phar)
w/ a 5-HT-ergic Rx such as a SSRI, SNRI, or TCA. Puerperium
(PR) PR Phar
D eats
8330
Gestational diabetes hPL ↑ maternal IR during the 2nd and 3rd trimesters, leading to a rise in serum Glc that helps Pregnancy, Physiology 2
provide adequate nutrition to the growing fetus. Gestational diabetes occurs when the Childbirth & (Phys)
compensatory rise in maternal insulin secretion is inadequate to prevent serum Glc lvls from Puerperium
reaching excessively high lvls. (PR) PR Phys
8406
Multiple gestation Dizygotic twins occur due to fertilization of 2 oocytes by 2 different sperm, can be different Pregnancy, Embryolog 1
genders, and almost always have 2 chorions and 2 amnions (eg, dichorionic/diamniotic). In Childbirth & y (Embr)
contrast, monozygotic twins arise from the fertilization of a single oocyte, are the same Puerperium
gender, and can be dichorionic/diamniotic (days 0-4), monochorionic/diamniotic (days 4-8), (PR)
monochorionic/monoamniotic (days 8-12), or monochorionic/monoamniotic conjoined twins
(> 13 days). PR Embr
8878
Narcolepsy Hypocretin-1 (orexin-A) and hypocretin-2 (orexin-B) are neuropeptides produced in the Pregnancy, Behavioral 3
lateral hypothal that promote wakefulness and inhib REM sleep-related phenomena. Most pts Childbirth & Science
who have narcolepsy w/ cataplexy have undetectable lvls of hypocretin-1 in their CSF. Puerperium (Beha)
(PR) PR Beha
8893
Iron deficiency Pica is the compulsive consumption of a non-nutritive a/o non-staple food. It's common in Pregnancy, Behavioral 7
anemia preg and is often a/w IDA and other forms of nutritional defic. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
8943
Opioids When abuse of prescription opioids is suspected, physicians should 1st engage pts in a non- Pregnancy, Behavioral 13
judgemental, collaborative discussion to understand the reasons for the misuse. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
8954
Opioids In the US, the majority of overdose deaths are caused by opioids, incl prescription analgesics Pregnancy, Behavioral 13
and heroin. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
9814
Suicide Access to firearms greatly ↑ the risk of completed suicide. Eval of a pt's access to guns is a Pregnancy, Behavioral 1
key part of suicide risk Ax. Other interventions to ↓ suicide risk incl ↓ stress, ↑ psychosocial Childbirth & Science
support, Tx psych illness and substance use, and Mx pain. Puerperium (Beha)
(PR) PR Beha
10398
Treatment IDing and Mx non-adherence is critical to improving outcomes for many chronic conditions, Pregnancy, Behavioral 5
adherence incl HTN. Creating an alliance by validating the pt's perspective and using an open-ended, Childbirth & Science
non-judgemental question is the most effective way to initiate a discussion. Puerperium (Beha)
(PR) PR Beha
10449
Physician patient When confronting an angry patient, the physician should use a non-defensive, empathic Pregnancy, Behavioral 11
communication approach that acknowledges the patient's anger and attempts to build a collaborative Childbirth & Science
physician-patient relationship. Puerperium (Beha)
(PR) PR Beha
D eats
10452
Physician patient Physicians may become frustrated w/ a pt who's hopeless about Tx, often compelling them to Pregnancy, Behavioral 11
communication refer the pt to a specialist. Empathising w/ the pt's frustration over past Tx failures can help Childbirth & Science
build the physician-pt relationship. Puerperium (Beha)
(PR) PR Beha
10458
Physician patient Empiric Abx therapy for pts w/ uncomplicated URIs is c/i. Pts requesting Abx prescriptions Pregnancy, Behavioral 11
communication should be educated in a non-judgemental manner about the lack of efficacy and AEs of Abx Childbirth & Science
therapy. Puerperium (Beha)
(PR) PR Beha
10465
Grief Transient behavioural disturbances are common in children after the death of a loved 1. Pregnancy, Behavioral 3
Hallucinations of recently deceased relatives are part of a normal grief rxn and may not be Childbirth & Science
indicative of major psychiatric illness. Puerperium (Beha)
(PR) PR Beha
10581
Somatic symptom SSD is best Mx w/ regularly scheduled medical visits that aren't contingent on having active Pregnancy, Behavioral 1
disorder SSx. Unnecessary Dx testing and specialist referrals should be avoided. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11577
Alcohol use The opioid antagonist naltrexone is a 1st-line Rx for mod-to-severe alcohol use disorder, and Pregnancy, Pharmacol 3
disorder works by preventing the reinforcing effects of alcohol use. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
11586
Child and Adolescence often involves some degree of moodiness, intense self-consciousness, and Pregnancy, Behavioral 1
adolescent mental transient emotional outbursts. Ax of severity, persistence, and degree of social and academic Childbirth & Science
health impairment can help diffiate normal adolescent behaviour from behavioural changes during Puerperium (Beha)
further evaluation. (PR) PR Beha
11587
Bipolar disorder Patients who experience major depressive and hypomanic episodes are diagnosed with Pregnancy, Behavioral 7
bipolar II disorder. In contrast to manic episodes, hypomanic episodes are less severe, do not Childbirth & Science
involve psychosis, and cause a lesser degree of functional impairment. Puerperium (Beha)
(PR) PR Beha
11592
Oppositional defiant ODD is a behavioural disorder of childhood characterised by argumentative and defiant Pregnancy, Behavioral 1
disorder behaviour toward authority figures. It doesn't involve the more severe violations of the basic Childbirth & Science
rights of others seen in CD. Puerperium (Beha)
(PR) PR Beha
11593
Personality BPD is characterised by a persistent pattern of unstable relationships, mood lability, and Pregnancy, Behavioral 6
disorders impulsivity. Individuals w/ this disorder may exhibit suicidal ideation or behaviour in the Childbirth & Science
context of an interpersonal crisis in which they feel rejected or abandoned. Puerperium (Beha)
(PR) PR Beha
D eats
11594
Personality Individuals w/ PPD exhibit a lifelong pattern of pervasive suspicion and distrust. Unlike ptsPregnancy, Behavioral 6
disorders w/ psychotic disorders, they don't have fixed delusions and other psychotic SSx. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11603
Specific phobia Exposure-based cognitive-behavioral therapy, in which patients are systematically Pregnancy, Behavioral 1
confronted with their feared objects or situations, is the most effective long-term treatment Childbirth & Science
for specific phobia. Puerperium (Beha)
(PR) PR Beha
11605
Substance-induced Stimulant intoxication can present with paranoid ideation and must be differentiated from Pregnancy, Behavioral 1
psychotic disorder primary psychiatric disorders. Physical signs of stimulant intoxication include mydriasis, Childbirth & Science
tachycardia, hypertension, and diaphoresis. Puerperium (Beha)
(PR) PR Beha
11606
Personality STPD is characterised by a long-standing pattern of eccentric behaviour, odd beliefs, Pregnancy, Behavioral 6
disorders perceptual distortions, and social anxiety despite familiarity. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11607
Bipolar disorder Pts experiencing a major depressive episode should be carefully screened for past manic Pregnancy, Behavioral 7
episodes to r/o BD. Antidepressant monotherapy should be avoided in pts w/ BD due to the Childbirth & Science
risk of precipitating mania. Puerperium (Beha)
(PR) PR Beha
11617
Depression Major depressive disorder (MDD) with psychotic features is a severe subtype of unipolar Pregnancy, Behavioral 8
major depression characterized by symptoms meeting the criteria for MDD and the presence Childbirth & Science
of delusions and/or hallucinations. Puerperium (Beha)
(PR) PR Beha
11618
Depression Suicide risk Ax incls consideration of both RFs and protective factors. A Hx of a previous Pregnancy, Behavioral 8
suicide attempt is the strongest single RF for further attempts and completed suicide. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11619
Adjustment Eval of depressive SSx occurring in response to psychosocial stressors must take into Pregnancy, Behavioral 2
disorders account the severity, duration, and degree of fxnal impairment. Mild or brief sadness w/o Childbirth & Science
significant interference in psychosocial fxning is consistent w/ normal sadness. Puerperium (Beha)
(PR) PR Beha
11622
Depression Pts w/ sufficient depressive SSx are Dx w/ MDD even if there's a clear psychosocial stressor Pregnancy, Behavioral 8
that precipitated the depression. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
D eats
11629
Complementary and Physicians should routinely ask their pts about the use of herbal preps and nutritional Pregnancy, Behavioral 1
alternative medicine supplements and advise them on the quality, safety, and efficacy of these products. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11732
Attention deficit ADHD is Chx by a pattern of inattention a/o hyperactivity/impulsivity that interferes w/ Pregnancy, Behavioral 5
hyperactivity fxning in >2 settings. Childbirth & Science
disorder Puerperium (Beha)
(PR) PR Beha
11737
Autism spectrum ASD is characterised by impaired social communication/interactions and restricted, repetitive Pregnancy, Behavioral 2
disorders interests or behaviours. It can occur +/- language and intellectual impairment. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11743
Schizophrenia The antipsychotic clozapine is the DOC for Tx-resistance schizophrenia. Tx req monitoring Pregnancy, Behavioral 4
of the absolute neutrophil count due to the risks of neutropaenia and agranulocytosis. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11746
Cocaine Cocaine withdrawal is characterised by the devel of acute depression accompanied by Pregnancy, Behavioral 3
fatigue, hypersomnia, hyperphagia, and vivid dreams. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11751
Panic disorder PD involves recurrent, unexpected panic atks characterised by an abrupt surge of fear Pregnancy, Behavioral 4
accompanied by physical and cognitive SSx. Individuals experience persistent worry about Childbirth & Science
future atks and typically restrict their activities as a result. Puerperium (Beha)
(PR) PR Beha
11756
Panic disorder PD is characterised by recurrent, unexpected panic atks and should be considered in young, Pregnancy, Behavioral 4
healthy adults who come to the ED w/ unexplained chest pain. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11758
Bipolar disorder BD-I is Dx in pts w/ >1 episodes of mania. Manic episodes are characterised by ↑/irritable Pregnancy, Behavioral 7
mood, impulsivity, hyperactivity, ↓ need for sleep, pressure speech, and grandiosity and may Childbirth & Science
occur w/ psych features. Puerperium (Beha)
(PR) PR Beha
11759
Social anxiety SAD involves excessive fear of scrutiny or embarrassment in social or performance Pregnancy, Behavioral 2
disorder situations, resulting in significant distress and fxnal impairment. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
D eats
11773
Grief Normal grief presents w/ SSx similar to those of a major depressive episode. However, in Pregnancy, Behavioral 3
normal grief, pervasive anhedonia, worthlessness, and suicidality aren't present. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11784
Attention deficit Stim Rx are a 1st-line Tx for ADHD. They work by ↑ the availability of NE and DA in the Pregnancy, Behavioral 5
hyperactivity prefrontal cortex. Childbirth & Science
(PR) PR Beha
11785
Adolescent Adolescents have low Tx adherence rates due to issues w/ autonomy, rebellion against Pregnancy, Behavioral 1
adherence authority, ↑ self-consciousness, and a lack of understanding of potential risks. Peer behaviour Childbirth & Science
has a strong influence on adherence due to adolescents' desire to fit in w/ their social groups. Puerperium (Beha)
(PR) PR Beha
11787
Alcohol use Behavioural change often happens in 5 distinct stages: precontemplation (denial of the Pregnancy, Behavioral 3
disorder problem), contemplation (acceptance of the problem and thinking about change), prep Childbirth & Science
(planning to make a change in the near future), action (putting active changes into place), and Puerperium (Beha)
maintenance (maintaining change over the long term). (PR) PR Beha
11789
Separation anxiety SAD consists of excessive and distressing anxiety (>4wks in children, >6mos in adults) due Pregnancy, Behavioral 1
disorder to separation from attachment figures. Children w/ this disorder often experience physical Childbirth & Science
SSx and nightmares. Puerperium (Beha)
(PR) PR Beha
11792
Factitious disorder Factitious disorder involves the conscious and deceptive feigning or self-production of Pregnancy, Behavioral 1
physical or psychological SSx to obtain attn and medical care from health care personnel. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11796
Rett syndrome Rett syndrome is characterised by loss of speech and motor skill, deceleration of head Pregnancy, Behavioral 1
growth, and stereotypically purposeless hand movements after a period of normal devel. It Childbirth & Science
affects mainly girls and is a/w muts in the MECP2 gene. Puerperium (Beha)
(PR) PR Beha
11807
Bulimia nervosa Tx options for bulimia nervosa incl nutritional rehab, CBT, and Rx w/ SSRIs. Fluoxetine is Pregnancy, Behavioral 4
the DOC. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11809
Attention deficit ↓ appetite and insomnia are the most common AEs of psychostimulant Rx used to Tx Pregnancy, Behavioral 5
hyperactivity ADHD. They're usually mild and can be Mx w/o stopping the Rx. Childbirth & Science
(PR) PR Beha
D eats
11810
Language disorder At age 2, children should have a vocab of 50-200 words and be using 2-word phrases. Pregnancy, Behavioral 1
Parents' concerns about delayed milestones should be validated; they should be reassured that Childbirth & Science
children often catch up but may need help. Further eval and regular monitoring are req. Puerperium (Beha)
(PR) PR Beha
11814
Learning disorders Learning disorders are characterised by difficulties w/ key academic skills (reading, writing, Pregnancy, Behavioral 1
or math), resulting in performance well below expectations for age. Providers should Childbirth & Science
consider a possible learning disorder in any school-aged child w/ behavioural, academic, or Puerperium (Beha)
social difficulties at school. (PR) PR Beha
11824
Depersonalization D/DD is a dissociative disorder involving recurrent episodes of feeling detached from 1's Pregnancy, Behavioral 1
disorder body or surroundings a/o feelings of unreality. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11825
Obsessive OCD is characterised by persistent, unwanted thoughts (obsessions) and repetitive, time- Pregnancy, Behavioral 2
compulsive disorder consuming rituals (compulsions) that the individual feels driven to perform to alleviate Childbirth & Science
anxiety. Puerperium (Beha)
(PR) PR Beha
11828
Conduct disorder Conduct disorder involves a persistent pattern of violating major societal norms or the rights Pregnancy, Behavioral 1
of others. Behaviors include aggression toward people and animals, deceitfulness or theft, Childbirth & Science
destruction of property, and serious violation of rules. Puerperium (Beha)
(PR) PR Beha
11829
Substance use Physicians have a responsibility to ID SSx of potential drug-seeking behaviour and Pregnancy, Behavioral 1
disorders prescription drug misuse. This involves being alert to red flags (e.g. lost or stolen Rx, pain Childbirth & Science
inconsistent w/ PEx) and attempting to clarify Rx Hx by using prescription drug-monitoring Puerperium (Beha)
programs or other info sources. (PR) PR Beha
11838
Panic disorder Rx of PD incls SSRIs and benzos. SSRIs are often preferred to benzos due to the lack of Pregnancy, Behavioral 4
phys dependence and abuse potential. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11846
Post-traumatic stress First-line treatment for post-traumatic stress disorder includes trauma-focused cognitive- Pregnancy, Behavioral 3
disorder behavioral therapy and antidepressant medication. Selective serotonin reuptake inhibitors Childbirth & Science
have the best evidence for efficacy. Puerperium (Beha)
(PR) PR Beha
11848
Antipsychotics As a class, 2nd-gen antipsychotics are a/w meta AEs (e.g. weight gain, dyslipidaemia, Pregnancy, Behavioral 9
hyperglycaemia, ↑ risk of DM). W/i the class, olanzapine and clozapine carry the greatest Childbirth & Science
risk. Puerperium (Beha)
(PR) PR Beha
D eats
11854
Depression Most available antidepressants target the neurotransmission of 5-HT or NE, or both. Inhib of Pregnancy, Behavioral 8
5-HT reuptake by blocking the 5-HT transporter is the 1° MOA of SSRIs. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
11866
Anxiety The DDx of anxiety incls medical conditions and substance-induced aetiologies (e.g. intox, Pregnancy, Behavioral 1
withdrawal). 1° anxiety disorders aren't Dx when anxiety is caused by the phys effects of a Childbirth & Science
medical condition (e.g. hyperthyroidism) or drug. Puerperium (Beha)
(PR) PR Beha
11870
Erectile dysfunction Premature ejaculation is characterised by recurrent episodes of early ejaculation Pregnancy, Behavioral 3
accompanied by a sense of lack of control. Eval of any sexual disorder req taking careful Childbirth & Science
med and substance use Hx and Ax psychosocial stressors and comorbid psych conditions. Puerperium (Beha)
(PR) PR Beha
11874
Tourette syndrome Tourette syndrome is a common childhood neuropsych disorder characterised by both vocal Pregnancy, Behavioral 1
and multi motor tics. These tics char wax and wane, can be suppressed temporarily, and are Childbirth & Science
preceded by a premonitory urge. Puerperium (Beha)
(PR) PR Beha
11875
Normal child Although children understand the concept of gender by age 4, it's normal for them to explore Pregnancy, Behavioral 2
development activities culturally a/w the opposite gender. In contrast, gender dysphoria is Dx when there's Childbirth & Science
marked distress a/w a prolonged and intense feeling that 1 is a diff gender from 1's birth sex. Puerperium (Beha)
(PR) PR Beha
11891
Placenta accreta Postpartum hemorrhage is an obstetric emergency and can result from abnormal placentation. Pregnancy, Pathology 1
Prior uterine surgery can impair decidualization, resulting in myometrial invasion by villous Childbirth & (Path)
tissue and a placenta that is abnormally adherent to the myometrium (placenta accreta). Puerperium
(PR) PR Path
11899
Delirium Delirium may MFx as acute changes in cognition and behaviour. When non-Rx interventions Pregnancy, Behavioral 4
are ineffective, low-dose antipsychotics (e.g. haloperidol) are the Rx of choice to Tx the Childbirth & Science
behavioural (e.g. severe agitation) and psychotic MFxs of delirium. Puerperium (Beha)
(PR) PR Beha
11919
Amniotic fluid AFE is a rare and catastrophic pregnancy complication that results from amniotic fluid Pregnancy, Pathophysi 1
embolism entering the maternal circulation. Common signs of AFE include hypoxia, hypotensive Childbirth & ology
shock, and DIC. Fetal squamous cells are seen in the pulm vasculature during histologic Puerperium (Patp)
evaluation. (PR) PR Patp
12262
ACE inhibitors Fetopathy due to ACEIs or ARBs results from blockade of AT-II, which is necessary for Pregnancy, Pharmacol 7
normal renal development. Use of these antiHTN Rx during pregnancy can result in fetal Childbirth & ogy (Phar)
anuria, oligohydramnios, pulm hypoplasia, limb contractures, and calvarium defects. Puerperium
(PR) PR Phar
D eats
13907
Benzodiazepines Benzo withdrawal is characterised by anxiety, tremor, insomnia, and sympathetic Pregnancy, Pharmacol 6
hyperactivity (e.g. diaphoresis, palpitations). Severe benzo withdrawal may also be Childbirth & ogy (Phar)
accompanied by psychosis, seizures, or death. Puerperium
(PR) PR Phar
15242
Defense Countertransference consists of a provider's response (e.g. attitudes, thoughts, feelings, Pregnancy, Behavioral 8
mechanisms behaviours) toward a pt based on past personal relationships. Countertransference can be (+) Childbirth & Science
or (-), conscious or unconscious; if unrecognised, it may have detrimental effects on pt care. Puerperium (Beha)
(PR) PR Beha
15252
Psychosis In addn to (+) psychotic SSx (e.g. delusions, hallucinations, disorganisation), pts w/ Pregnancy, Behavioral 6
schizophrenia freq exhibit (-) SSx such as flat affect (i.e. lack of facial expression). (-) SSx Childbirth & Science
typically persist b/w acute psychotic episodes and are more resistant to Tx. Puerperium (Beha)
(PR) PR Beha
15253
Psychosis Brief psychotic disorder is characterised by >1 psychotic SSx lasting >1day and <1mos w/ Pregnancy, Behavioral 6
full return to previous lvls of fxning. Onset is typically sudden and a/w a stressor. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
15254
Psychosis Antipsych Rx are 1st-line Rx for schizophrenia. Their 1° MOA is D2 receptor antagonism. Pregnancy, Pharmacol 6
Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
15283
Attention deficit ADHD often persists into adulthood. Adults w/ ADHD are less overtly hyperactive but Pregnancy, Behavioral 5
hyperactivity experience chronic problems w/ distractibility, disorganisation, and impulsivity that cause Childbirth & Science
disorder significant social and occup impairment. Puerperium (Beha)
(PR) PR Beha
15284
Normal child Short attn span and varying degrees of hyperactivity and impulsivity are commonly seen in Pregnancy, Behavioral 2
development children under age 4. ADHD shouldn't be Dx until age 4-5. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
15285
Attention deficit Dx of ADHD req evidence of inattentive a/o hyperactive/impulsive SSx for >6mos in >2 Pregnancy, Behavioral 5
hyperactivity settings (e.g. home, school, after-school program). Teacher evals can assist in Dx. Childbirth & Science
(PR) PR Beha
15286
Autism spectrum Pts w/ milder forms of ASD freq have normal language and cognitive devel. ChFx incl Pregnancy, Behavioral 2
disorders deficits in social communication and reciprocal social interactions, restricted interests, and Childbirth & Science
behavioural rigidity that become more apparent as social and academic demands ↑. Puerperium (Beha)
(PR) PR Beha
D eats
15327
Schizophrenia (+) SSx of schizophrenia (e.g. delusions, hallucinations) are a/w ↑ activity of DA in the Pregnancy, Behavioral 4
mesolimbic pathway. Antipsychotics work by antagonising DA receptors in this pathway. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
15328
Psychosis Huntington Disease is an autosomal dominant, progressive neurodegenerative disorder Pregnancy, Behavioral 6
characterized by chorea, psychiatric symptoms, and dementia. Psychiatric symptoms may Childbirth & Science
occur early in the disease course and include irritability, anxiety, apathy, depression, and Puerperium (Beha)
psychosis. (PR) PR Beha
15348
Adjustment Adjustment disorder involves emotional or behavioural SSx occurring w/i 3mos of an ID- Pregnancy, Behavioral 2
disorders able stressor. The Dx is indicated when the pt has significant distress and impairment but Childbirth & Science
doesn't meet full criteria for another mental disorder. Puerperium (Beha)
(PR) PR Beha
15349
Post-traumatic stress Acute stress disorder is characterised by intrusive experiences (flashbacks, nightmares), Pregnancy, Behavioral 3
disorder arousal (poor conc, restless sleep), dissociative SSx, and avoidance of traumatic reminders, Childbirth & Science
as well as mood disturbances in response to a life-threatening trauma. SSx last b/w 3days and Puerperium (Beha)
1mos. (PR) PR Beha
15357
Personality ASPD involves a pattern of violating the rights of others, engaging in unlawful behaviours Pregnancy, Behavioral 6
disorders (e.g. physical aggression, illegal occups), and lacking remorse for transgressions. Individuals Childbirth & Science
must be age >18 for Dx and have a Hx of CD prior to age 15. Puerperium (Beha)
(PR) PR Beha
15358
Personality SPD consists of a persistent pattern of social detachment, preference for solitary activities, Pregnancy, Behavioral 6
disorders and constricted range of affect in social interactions. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
15384
Depression Somatic SSx of depression (weight loss, low energy, sleep disturbance) are less reliable Pregnancy, Behavioral 8
indicators of MDD in pts w/ advanced medical illness. Focusing on non-somatic SSx, such as Childbirth & Science
loss of interest, anhedonia, worthlessness, excessive guilt, and suicidality, can assist in Dx Puerperium (Beha)
comorbid depression in these pts. (PR) PR Beha
15397
Antipsychotics SGAs block 5-HT2A receptors and have lower binding affinity at DA D2 receptor sites, Pregnancy, Pharmacol 9
which is a/w a lower risk of EPS. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
15410
Delirium Delirium is freq a/w psychotic SSx. It's diffiated from 1° psychotic disorders by fluctuating Pregnancy, Behavioral 4
lvls of consciousness, impaired attn, and disorientation. Delirium can occur post-op a/o in Childbirth & Science
a/w underlying med illnesses or the intro of certain Rx. Puerperium (Beha)
(PR) PR Beha
D eats
15416
Schizophrenia 2nd-gen antipsychotics are a/w a lower risk of EPS AEs compared w/ 1st-gen antipsychotics Pregnancy, Behavioral 4
but may cause metabolic AEs. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
15447
Depression Depression-related cognitive impairment refers to cognitive impairment that occurs in the Pregnancy, Behavioral 8
context of MDD, which may be mistaken for mild cognitive impairment or dementia. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
15481
Social anxiety SAD is characterised by anxiety and fear of scrutiny in social situations and can result in Pregnancy, Behavioral 2
disorder marked social-occup impairment. Preferred pharmacotherapy is Rx that inhibs 5-HT Childbirth & Science
reuptake (e.g. SSRIs or SNRIs). Puerperium (Beha)
(PR) PR Beha
15482
Impulse control IED is characterised by recurrent episodes of explosive verbal or physical aggression. The Pregnancy, Behavioral 1
disorders aggressive behaviours are impulsive and grossly out of proportion to the provocation. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
15493
Grief Preschool children haven't developed an understanding of the finality of death, which Pregnancy, Behavioral 3
typically occurs around age 7. They may have magical thoughts that death is temporary or Childbirth & Science
reversible and believe that other people's grief is their fault. Puerperium (Beha)
(PR) PR Beha
15500
Bulimia nervosa Hypokalaemia in an otherwise healthy young adult w/ a normal BMI and preoccup w/ body Pregnancy, Behavioral 4
size is concerning for self-induced vomiting a/w BN. Common PEx findings in BN incl Childbirth & Science
tachycardia, hypotension, painless parotid gland swelling, calluses or scarring on the dorsum Puerperium (Beha)
of the hand, and erosion of dental enamel. (PR) PR Beha
15501
Anorexia nervosa AN is characterised by a distorted body image and fear of weight gain despite significantly Pregnancy, Behavioral 3
low body weight. Pts may restrict their food intake a/o binge and purge. The key in Childbirth & Science
distinguishing AN from BN is abnly low body weight. Puerperium (Beha)
(PR) PR Beha
15523
Parasomnias REM sleep is characterized by dreaming and voluntary muscle paralysis, and occurs more Pregnancy, Pathophysi 2
often during the final third of the night. Nightmares occur during REM sleep and can be Childbirth & ology
differentiated from sleep terrors, a non-REM parasomnia characterized by incomplete Puerperium (Patp)
arousals and lack of recall of dream content. (PR) PR Patp
15602
Wilson disease WD is a/w Cu accumulation in the liver, brain, and cornea. It commonly presents in Pregnancy, Behavioral 5
childhood or adolescence w/ abn LFTs a/o neuropsych SSx. Psych SSx may predate other Childbirth & Science
MFxs and incl personality changes, depression, mania, a/o psychosis. Puerperium (Beha)
(PR) PR Beha
D eats
15606
Benzodiazepines Flumazenil is a benzo receptor antagonist. It can reverse the sedative effects of benzos Pregnancy, Pharmacol 6
related to overdose and procedural sedation. Childbirth & ogy (Phar)
Puerperium
(PR) PR Phar
15607
Antidepressants Antidepressants (e.g. SSRIs) take 4-6wks to achieve max clinical effect. Pregnancy, Behavioral 4
Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
15609
Fetal alcohol Typical features of fetal alcohol syndrome include facial dysmorphism (short palpebral Pregnancy, Pathophysi 1
syndrome fissures, thin upper lip, smooth philtrum), growth retardation, neurological abnormalities, Childbirth & ology
and behavioral difficulties. Puerperium (Patp)
(PR) PR Patp
15613
Inhalants Inhalant intox is characterised by immediate onset of euphoria, lethargy, ataxia, a/o LOC f/b Pregnancy, Behavioral 1
rapid recovery w/i 45mins. Perioral and perinasal dermatitis (i.e. 'glue sniffer's rash') may be Childbirth & Science
seen in chronic users. Puerperium (Beha)
(PR) PR Beha
15615
Cocaine Cocaine intox can produce psychotic SSx (e.g. paranoid delusions), euphoria, and agitation. Pregnancy, Behavioral 3
Physical SSx indicating sympathetic stim (e.g. tachycardia, diaphoresis, mydriasis) can assist Childbirth & Science
in diffiating cocaine intox from 1° psychiatric disorders. Puerperium (Beha)
(PR) PR Beha
15644
Insomnia Age-related sleep changes may be reported as insomnia and must be diffiated from 1° sleep Pregnancy, Behavioral 3
disorders and other disorders. Normal changes incl ↓ total sleep time, ↑ night-time Childbirth & Science
awakenings, sleepiness earlier in the evening w/ earlier morning awakening, and ↑ daytime Puerperium (Beha)
napping. (PR) PR Beha
15701
Panic disorder PD consists of recurrent and unexpected panic atks characterised by an abrupt surge of Pregnancy, Behavioral 4
anxiety and distressing cardiopulm/neuro SSx. Agoraphobia, a common comorbid disorder, Childbirth & Science
results in anxiety about and avoidance of situations where pts may feel trapped and helpless Puerperium (Beha)
in the event of a panic atk (e.g. crowds, enclosed spaces, public transportation. (PR) PR Beha
15730
Bipolar disorder Manic episodes are characterized by euphoric/irritable mood, impulsivity, hyperactivity, Pregnancy, Behavioral 7
decreased need for sleep. pressured speech, racing thoughts, and grandiosity. They may Childbirth & Science
occur with or without psychotic features. Puerperium (Beha)
(PR) PR Beha
15732
Illness anxiety IAD is characterised by excessive concern about having a serious, un-Dx disease, despite Pregnancy, Behavioral 1
disorder few or no SSx and (-) medical workup. Childbirth & Science
Puerperium (Beha)
(PR) PR Beha
D eats
15762
Parasomnias Sleepwalking, a common non-REM parasomnia of childhood, occurs during slow-wave sleep Pregnancy, Pathophysi 2
(stage N3), which is characterized by delta Waves on EEG. Sleepwalking typically occurs Childbirth & ology
during the first half of the night, when slow-wave sleep is most prominent. Puerperium (Patp)
(PR) PR Patp
103Blastomycosis Dimorphic fungi grow as moulds at 25-30°C and as yeast at body temp (35-37°C). Med Pulmonary & Microbiolo 3
important dimorphic fungi incl Sporothrix, Coccidioides, Histoplasma, Blastomyces, and Critical Care gy (Micr)
Paracoccidioides species. (PU) PU Micr
108Aspergillosis A. fumigatus causes a wide spectrum of disease. It can be an opportunistic infection in Pulmonary & Microbiolo 5
immsup and neutropaenic pts (invasive pulm aspergillosis). Aspergillosis can be colonising Critical Care gy (Micr)
(aspergilloma) when it forms a fungus ball w/i a pre-existing lung cavity. It can also cause a (PU)
lung HSR in allergic bronchopulm aspergillosis in individuals w/ asthma. PU Micr
114Cryptococcal Meningoencephalitis is the most common presentation of C. neoformans infection. It occurs Pulmonary & Microbiolo 3
infections in immsup pts and can be Dx by India ink staining of the CSF. Cryptococcal pneumonia is Critical Care gy (Micr)
Dx by mucicarmine staining of lung tissue and bronchoalveolar washings. (PU) PU Micr
117Cryptococcal C. neoformans is the only pathogenic fungus that has a PSC. The capsule appears red on Pulmonary & Microbiolo 3
infections mucicarmine stain and as a clear unstained zone w/ India ink. Critical Care gy (Micr)
(PU) PU Micr
119Normal flora Expectorated sputum cultures are often contaminated by normal oral flora. The growth of C. Pulmonary & Microbiolo 1
albicans, a normal commensal of the GIT and skin, almost always indicates oral Critical Care gy (Micr)
contamination rather than true pulm infection. (PU) PU Micr
120Blastomycosis B. dermatitidis is a dimorphic fungus seen in tissue as round or oval yeasts w/ thick walls and Pulmonary & Microbiolo 3
broad-based budding. It's endemic in the SE US (states east of the Mississippi River). The Critical Care gy (Micr)
lungs are the 1° site of involvement, and the skin and bone are the major sites of (PU)
dissemination. PU Micr
121Blastomycosis B. dermatitidis can cause pulm disease in the immcom host. Dissemination (most commonly Pulmonary & Microbiolo 3
to skin and bones) occurs in immsup individuals. Critical Care gy (Micr)
(PU) PU Micr
168Asthma Improper administration of inhaled glucocorticoids for the treatment of asthma can lead to Pulmonary & Pharmacol 12
adverse effects, including oropharyngeal candidiasis and dysphonia. Using a spacer during Critical Care ogy (Phar)
administration and rinsing the mouth after each use can help prevent these adverse effects. (PU) PU Phar
169Asthma Asthma is Chx by chronic airway inflammation, which leads to airway remodeling, airway Pulmonary & Pharmacol 12
hyperresponsiveness, and bronchoconstriction. Corticosteroids ↓ airway inflammation and Critical Care ogy (Phar)
are used for both chronic asthma Mx (inhaled administration) and acute exacerbations (PU)
(systemic administration). PU Phar
170COPD Ipratropium, an anticholinergic agent and derivative of atropine, treats obstructive lung Pulmonary & Pharmacol 16
disease by blocking acetylcholine at muscarinic receptors, which prevents Critical Care ogy (Phar)
bronchoconstriction and reduces mucus secretion from tracheobronchial submucosal glands. (PU) PU Phar
D eats
171Asthma Cromolyn and nedocromil are mast cell-stabilizing agents that inhibit mast cell degranulation Pulmonary & Pharmacol 12
independent of the triggering stimulus. They are less effective than inhaled glucocorticoids Critical Care ogy (Phar)
and are considered second-line treatments for allergic rhinitis and bronchial asthma. (PU) PU Phar
197Fat embolism FES most commonly results from the release of fat globules from bone marrow following a Pulmonary & Pathology 2
long-bone or pelvic fracture. The fat globules form inflammatory aggregates that cause Critical Care (Path)
microvessel obstr and systemic inflammation leading to the triad of resp distress, neuro (PU)
dysfxn, and petechial rash that characterises the condition. PU Path
266Histoplasmosis H. capsulatum is endemic to the Ohio and Mississippi River valleys and is found 1arily in Pulmonary & Microbiolo 4
soil contaminated w/ bird or bat droppings. It exists in tissues as an ovoid/round yeast Critical Care gy (Micr)
predominantly w/i the intracellular space of macrophages. Immcom pts are often aSSx but (PU)
can infreq develop subacute pneumonia w/ hilar and mediastinal LAD. PU Micr
267Histoplasmosis H. capsulatum is a dimorphic fungus that exists as a small, ovoid yeast at tissue temps. It Pulmonary & Microbiolo 4
replicates w/i macrophages and spreads thru the lymphatic and RES. Immcom pts usually Critical Care gy (Micr)
have an aSSx pulm infection, but those who are immsup (e.g. advanced AIDS) can develop (PU)
disseminated disease to the liver, spleen, and bone marrow. PU Micr
268Coccidioidomycosis C. immitis infection can be aSSx or it can cause pulm disease ranging from a flulike illness Pulmonary & Microbiolo 2
to chronic pneumonia. It causes disseminated disease in immsup pts. Spherules containing Critical Care gy (Micr)
endospores are found in tissue samples. (PU) PU Micr
269Coccidioidomycosis C. immitis is a dimorphic fungus endemic to the SW US. It exists in the environment as a Pulmonary & Microbiolo 2
mould (w/ hyphae) that forms spores. These spores are inhaled and turn into spherules in the Critical Care gy (Micr)
lungs. (PU) PU Micr
301Tuberculosis T-helper subtype 1 cells release interferon-gamma leading to the activation of macrophages, Pulmonary & Immunolo 18
a process critical for control of Mycobacterium tuberculosis infection. Activated Critical Care gy (Immu)
macrophages form mature phagolysosomes that destroy phagocytosed mycobacteria and can (PU)
differentiate into epithelioid and Langhans giant cells to wall off extracellular mycobacteria
within caseating granulomas. Interferon-γ, IL-12, and TNF-α are critical cytokines for the
formation and maintenance of granulomas. PU Immu
302Lung abscess Abscess formation is largely driven by neutrophil recruitment and activation leading to the Pulmonary & Pathophysi 4
release of cytotoxic granules that kill bacteria but also cause liquefying necrosis of surround Critical Care ology
tissue. (PU) (Patp) PU Patp
310SIDS The AEs of 2nd-hand smoke exposure incl an ↑ risk of low birth weight, asthma, middle ear Pulmonary & Pathology 1
disease, and SIDS. Up to 1/2 of all SIDS cases are due to tobacco exposure, likely from Critical Care (Path)
impaired arousal and abn CV responses to stimuli. (PU) PU Path
399Alpha1 antitrypsin AAT is a serum protein that, thru the inhib of neutrophil elastase, ↓ tissue dmg caused by Pulmonary & Pathophysi 8
deficiency inflammation. Histo, AATD can demonstrate reddish-pink globules on PAS stain; these Critical Care ology
globules represent un-secreted, polymerised AAT in the periportal hepatocytes. (PU) (Patp) PU Patp
D eats
476Pulmonary V/Q scans use radiotracers to compare the ventilation and blood perfusion of each area of the Pulmonary & Pathology 13
embolism lung. V/Q mismatch w/ perfusion defects are often indicative of a PE, which are most Critical Care (Path)
commonly caused by DVT in the lower extremities that embolises to the pulm vasculature. (PU) PU Path
478Respiratory mucosa Type II pneumocytes have 2 important functions: regeneration of the alveolar lining Pulmonary & Histology 4
following injury and surfactant production. Critical Care (Hist)
(PU) PU Hist
479Neonatal respiratory The lamellar bodies of type II pneumocytes store and release pulm surfactant into the fluid Pulmonary & Pathology 5
distress syndrome layer lining the inner surfaces of alveoli. The major fxn of surfactant is to ↓ surface tension in Critical Care (Path)
this fluid layer, and so a surfactant defic can cause alveolar atelectasis, as seen in NRDS. (PU) PU Path
480Respiratory mucosa Bronchi have a ciliated pseudostratified columnar epithelium with mucin-secreting goblet Pulmonary & Histology 4
cells and submucosal mucoserous glands. The airway epithelium gradually changes to Critical Care (Hist)
ciliated simple cuboidal by the level of the terminal bronchioles. Bronchioles lack glands and (PU)
cartilage, and the number of goblet cells decreases distally, ending before the terminal
bronchioles. Ciliated epithelium persists up to the respiratory bronchioles. PU Hist
481Respiratory The airway resistance at each lvl of the LRT is inv related to the TCSA of all the airways at Pulmonary & Physiology 8
physiology that lvl. Airway resistance is high in the trachea and reaches a peak in the medium-sized Critical Care (Phys)
bronchi, where TCSA is at a mini. Airway resistance then progr decr as TCSA incr thru the (PU)
smaller bronchioles, term bronchioles, and alv. PU Phys
482Neonatal respiratory Phospholipids, including dipalmitoyl phosphatidylcholine, are a major component of Pulmonary & Embryolog 5
distress syndrome pulmonary surfactant. The amniotic fluid lecithin (phosphatidylcholine) to sphingomyelin Critical Care y (Embr)
ratio (L/S ratio) is measured in order to assess fetal lung maturity. The fetal lungs are (PU)
considered mature when they are producing adequate surfactant to yield an L/S ratio greater
than 2. PU Embr
484Alpha1 antitrypsin Alveolar fluid contains neutral proteases (e.g. elastases) that're derived from alveolar Pulmonary & Pathology 8
deficiency macrophages and infiltrating neutrophils. These proteases can cause destruction of terminal Critical Care (Path)
lung parenchyma (e.g. emphysema) when secreted in excess or if left unchecked by defic (PU)
antiprotease activity. PU Path
485ARDS Pancreatitis is a major RF for ARDS as it results in the release of large amounts of Pulmonary & Pathology 3
inflammatory cytokines and pancreatic enzymes, which leads to activation of neutrophils in Critical Care (Path)
the alveolar tissues. During the initial phase, interstitial and intra-alveolar oedema, (PU)
inflammation, and fibrin deposition cause the alveoli to become lined w/ waxy hyaline
membranes. PU Path
486ARDS ARDS is characterised by hypoxia and bilateral pulm infiltrates and is a/w pneumonia, Pulmonary & Pathology 3
sepsis, trauma, and pancreatitis. The assoc pulm oedema is noncardiogenic in nature, so the Critical Care (Path)
PCWP will be w/i the normal range (6-12mmHg). (PU) PU Path
487COPD The flow-volume loop for COPD is Chx by ↑ RV and TLC, as well as a "scooped-out" Pulmonary & Pathophysi 16
expiratory pattern due to ↓ expiratory flow rates. Both airway narrowing due to chronic Critical Care ology
bronchitis and ↓ elasticity due to emphysematous destruction of interalveolar walls are (PU) (Patp)
responsible for the hyperinflation and airflow limitation. PU Patp
D eats
488COPD The path of centriacinar emphysema a/w chronic, heavy smoking predominantly involves the Pulmonary & Pathophysi 16
release of proteases, esp. elastase, from infiltrating neutrophils and alveolar macrophages. Critical Care ology
(PU) (Patp) PU Patp
489Alpha1 antitrypsin The major serum inhibitor of extracellular elastase is AAT; pts w/ AATD typically develop Pulmonary & Pathophysi 8
deficiency early-onset panacinar emphysema due to unchecked elastase activity. Exposure to tobacco Critical Care ology
smoke dramatically accelerates the development of emphysema in pts w/ AATD and should (PU) (Patp)
be avoided. PU Patp
490Pneumothorax PSP occurs in pts w/o pre-existing pulm disease when a large change in the alveolar or Pulmonary & Pathology 2
intrapleural pressure results in a break in the visceral (e.g. ruptured superficial bleb) pleura Critical Care (Path)
and air trapping b/w the pleural spaces. (PU) PU Path
491Alpha1 antitrypsin AAT is the major serum inhib of neutrophil elastase. AATD typically causes early-onset Pulmonary & Pathology 8
deficiency panacinar emphysema, predominantly affecting the lower lung lobes. Critical Care (Path)
(PU) PU Path
521COPD COPD is a combo of emphysema and chronic bronchitis and commonly presents w/ progr Pulmonary & Pathophysi 16
dyspnoea and recurrent URIs. Bronchial obstr and alveolar destruction cause air trapping that Critical Care ology
MFx on PFT as ↓ FEV1, FVC, and FEV1/FVC ratio. RV and TLC are ↑. (PU) (Patp) PU Patp
522COPD COPD involves components of chronic bronchitis and emphysema. Bronchial airway obstr Pulmonary & Pathophysi 16
from chronic bronchitis and ↓ alveolar elasticity from emphysema result in air-trapping and Critical Care ology
lung hyperinflation. The FRC is ↑, as are RV and TLC. (PU) (Patp) PU Patp
523Asthma Eosinophils have bilobed nuclei and numerous eosinophilic granules in the cytoplasm and Pulmonary & Pathophysi 12
are important in allergic disease and defence against parasitic infection. The eosinophilic Critical Care ology
granules predominantly contain MBP, which, once release, acts as a potent anti-helminthic (PU) (Patp)
toxin. MBP also dmgs epithelial and endothelial cells and is a major cause of chronic lung
dmg in asthma. PU Patp
524COPD Thickened bronchial walls, lymphocytic infiltration, mucous gland enlargement, and patchy Pulmonary & Histology 16
squamous metaplasia of the bronchial mucosa are features of chronic bronchitis. Tobacco Critical Care (Hist)
smoking is the leading cause of chronic bronchitis. (PU) PU Hist
525COPD Hyperplasia of the submucosal bronchial glands is the major contributor to bronchial wall Pulmonary & Pathology 16
thickening in chronic bronchitis. The Reid index is the ratio of the thickness of the Critical Care (Path)
submucosal bronchial glands to the thickness of the bronchial wall b/w the epithelial BM and (PU)
the bronchial cartilage. Higher values correlate w/ ↑ duration and severity of chronic
bronchitis. PU Path
526Asthma An excess of Th2 cell activity relative to Th1 cell activity may underlie the pathogenesis of Pulmonary & Immunolo 12
asthma. In the asthma sensitization phase, inhaled antigens stimulate Th2 cells to secrete IL- Critical Care gy (Immu)
4 and IL-13, which together promote B-lymphocyte class switching for IgE synthesis, (PU)
leading to mast cell priming. Th2 cells also secrete IL-5, which activates eosinophils. PU Immu
D eats
527Asthma Paroxysmal breathlessness and wheezing in a young pt that're unrelated to ingestion of Pulmonary & Pathophysi 12
aspirin, pulm infection, inhalation of irritants, a/o exercise should raise a strong suspicion for Critical Care ology
atopic (extrinsic) asthma. Classic sputum findings incl eosinophils and Charcot-Leyden (PU) (Patp)
crystals. Eosinophils are recruited and activated by IL-5 secreted by Th2 type T cells. PU Patp
528Respiratory An acute V/Q mismatch (e.g. due to PE or pneumonia) causes hypoxaemia and triggers Pulmonary & Pathophysi 1
alkalosis hyperventilation. B/c the removal of CO2 is directly dependent on ventilation but the Critical Care ology
absorption of O2 is capped by the high baseline sat of Hb, the hyperventilation response (PU) (Patp)
typically leads to resp alkalosis (low PaCO2) w/ persistent hypoxaemia. PU Patp
529Pulmonary The risk of VTE (i.e. PE or DVT) in hospitalised pts can be greatly ↓ w/ the admin of Pulmonary & Pathology 13
embolism prophylactic anticoags, usually w/ LMWH. Critical Care (Path)
(PU) PU Path
530Pulmonary arterial Hereditary PAH develops in 2 steps. An abn BMPR2 gene predisposes affected individuals Pulmonary & Pathophysi 8
hypertension to excessive endothelial and SMC proliferation. An insult (e.g. infection, drugs) is thought to Critical Care ology
then activate the disease process, resulting in vascular remodelling, ↑ pulm vascular (PU) (Patp)
resistance, and progr PAH. PU Patp
531Community Lobar pneumonia is marked by the cytokine-mediated accumulation of neutrophils and Pulmonary & Pathology 21
acquired pneumonia proteinaceous material in the alveoli. Over several days, the proteinaceous material becomes Critical Care (Path)
fibrinous, neutrophils are replaced by macrophages, and macrophages digest the fibrinous (PU)
exudate, thereby restoring normal lung histology. PU Path
533Lung abscess Lung abscess is most often due to aspiration of anaerobic oral bacteria such as Pulmonary & Pathology 4
Peptostreptococcus, Prevotella, Bacteroides, and Fusobacterium species. RFs for lung Critical Care (Path)
abscess incl conditions that ↑ aspiration risk, such as alcoholism, drug abuse, seizure (PU)
disorders, previous stroke, and dementia. PU Path
534Lung transplantation Chronic lung transplant rejection is due primarily to progressive scarring of the small Pulmonary & Immunolo 2
airways, leading to bronchiolitis obliterans. Manifestations occur months or years after Critical Care gy (Immu)
transplantation and include obstructive lung disease (eg, reduced FEV1) with dyspnea and (PU)
dry cough. PU Immu
535Lung transplantation Chronic rejection is a major problem in lung transplant recipients; it affects small airways, Pulmonary & Pathology 2
causing bronchiolitis obliterans. It's characterised by lymphocytic inflammation, fibrosis, Critical Care (Path)
and, ultimately, destruction of the bronchioles. (PU) PU Path
536Respiratory mucosa The pneumoconioses are diseases resulting from the inhalation of fine dust particles that Pulmonary & Physiology 4
reach the resp bronchioles and alv. Particles that lodge in this region are normally cleared by Critical Care (Phys)
alv macrophages. High particulate burden can cause the excessive release of cytokines from (PU)
macrophages, resulting in progr PF. PU Phys
544Hypersensitivity Type IV (delayed) hypersensitivity reactions (eg, Candida extract skin test, contact Pulmonary & Immunolo 4
reactions dermatitis) are characterized by erythema and induration that develops 24-48 hours after Critical Care gy (Immu)
repeat exposure to an antigen. T lymphocytes mediate the inflammation in these reactions (PU)
through cytokine release, CD8+ cytotoxicity, and macrophage recruitment. PU Immu
D eats
550Neonatal respiratory Both maternal and fetal cortisol help to accelerate fetal lung maturation by stimulating Pulmonary & Embryolog 5
distress syndrome surfactant production. Betamethasone or dexamethasone is administered to pregnant women Critical Care y (Embr)
at risk of premature delivery to prevent neonatal respiratory distress syndrome. (PU) PU Embr
552Lung nodule Hamartomas are the most common benign lung tumours. They present as aSSx perily located Pulmonary & Pathology 1
'coin lesion' in pts 50-60 y/o. These tumours are composed of disorganised cartilage, fibrous, Critical Care (Path)
and adipose tissue. (PU) PU Path
553Asbestos Pts w/ a long Hx of asbestos exposure are at risk for devel asbestosis, pleural disease, and Pulmonary & Pathology 5
malignancies such as bronchogenic carcinoma and mesothelioma. Bronchogenic carcinoma Critical Care (Path)
is the most common malignancy in this pop, although mesothelioma is more specific for (PU)
asbestos exposure. PU Path
554Lung cancer Adenocarcinoma is the most common 1° lung ca in the gen pop, women, and non-smokers. Pulmonary & Pathology 9
EGFR muts and ALK gene rearrangements are seen more commonly in non-smokers and Critical Care (Path)
thought to contribute to disease formation in this subgroup. Adenocarcinoma is typically (PU)
located perily and may be a/w clubbing or hypertrophic osteoarthropathy (HOA). PU Path
555Lung cancer SCLC is strongly a/w smoking and is usually centrally located. Histopath shows small, round Pulmonary & Pathology 9
or oval cells w/ scant cytoplasm and large, hyperchromatic (blue) nuclei; abundant mitoses Critical Care (Path)
are also usually seen. IHC stains are freq (+) for neuroendocrine markers (e.g. chromogranin, (PU)
synaptophysin, NCAM (CD56)). PU Path
564Lung cancer Adenocarcinoma, the most common pulm malignancy, is characterised histopathologically Pulmonary & Pathology 9
by invasive glandular cells w/ abundant cytoplasm and eccentrically placed nuclei; mucin Critical Care (Path)
production is common. Imaging typically demonstrates a discrete mass or pneumonia-like (PU)
consolidation at the periphery of the lung. PU Path
565Superior vena cava Intrathoracic spread of bronchogenic carcinoma may lead to compression of the SVC, Pulmonary & Pathology 1
syndrome causing impaired venous return from the upper part of the body. SSx incl dyspnoea, facial Critical Care (Path)
swelling, and dilated collateral veins in the upper trunk. (PU) PU Path
648Lung cancer Tumors located in the lung apex (superior sulcus) are called Pancoast tumors. Invasion of Pulmonary & Pathology 9
surrounding structures can lead to ipsilateral Horner syndrome, rib destruction, atrophy of Critical Care (Path)
hand muscles, and pain in the distribution of C8, T1, and T2 nerve roots. (PU) PU Path
649Asbestos Malignant mesothelioma is a rare neoplasm typically arising from the pleura. It's strongly Pulmonary & Pathology 5
a/w asbestos exposure and presents w/ progr dyspnoea, cough, and chest pain. Unilateral Critical Care (Path)
pleural thickening or plaque formation is seen on imaging; pleural effusions are also (PU)
common and may be hemorrhagic. Histopathology reveals tumour cells w/ numerous long,
slender microvilli and abundant tonofilaments. PU Path
650Lung cancer SCLC is the most aggressive type of lung ca and is commonly a/w PNP syndromes (e.g. Pulmonary & Pathology 9
SIADH, Cushing syndrome). It's thought to have a neuroendocrine origin; tumour cells Critical Care (Path)
express neuroendocrine markers (e.g. neural cell adhesion molecule (NCAM; CD56), (PU)
chromogranin, synaptophysin) and contain neurosecretory granules in the cytoplasm. PU Path
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653Interstitial lung PF presents w/ gradual-onset progr dyspnoea, non-productive cough, fatigue, eventual Pulmonary & Pathology 8
disease weight loss, and bilateral reticulonodular opacities on CXR. PFTs reveal a restrictive pattern. Critical Care (Path)
Pts w/ RA can develop interstitial lung diseases, both from the pulm MFxs of the disease (PU)
itself and from certain therapies (e.g. methotrexate, cyclophosphamide, sulfasalazine). PU Path
661Allergic rhinitis HS-I rxns are an allergic response triggered by the binding of previously recognized Ag to Pulmonary & Pathophysi 2
IgE Abs on mast cells. In the early phase of the response, histamine, already stored in Critical Care ology
preformed granules in mast cells, is the 1st chemical mediator released. Once released, (PU) (Patp)
histamine stimulates smooth muscle contraction (bronchoconstriction), ↑ vascular
permeability (edema), and ↑ mucus secretion. PU Patp
663Asthma Bronchial challenge testing is a highly sensitive but nonspecific measure that can help excl a Pulmonary & Pathophysi 12
Dx of asthma. A provocative stim (typically aerosolised methacholine) is admin at ↑ concs to Critical Care ology
induce bronchoconstriction. Pts w/ asthma are hyperresponsive to this stim and experience a (PU) (Patp)
decline in FEV1 at lower doses than non-asthmatics. PU Patp
665Aspergillosis ABPA due to A. fumigatus may complicate asthma. ABPA can result in transient recurrent Pulmonary & Microbiolo 5
pulm infiltrates and eventual prox. bronchiectasis. Critical Care gy (Micr)
(PU) PU Micr
666Interstitial lung IPFis characterised by patchy interstitial inflammation intermixed w/ areas of dense fibrosis Pulmonary & Pathology 8
disease and normal lung, focal fibroblastic proliferation, and a honeycomb pattern most prominent in Critical Care (Path)
the periphery. Repetitive injury and disordered healing are implicated as potential causes; (PU)
lung injury results in focal loss of type 1 pneumocytes and hyperplasia of type 2
pneumocytes. PU Path
668Silicosis Silicosis is characterised by dyspnoea and productive cough occurring yrs after inhalational Pulmonary & Pathology 2
exposure to crystalline silica. Histo, it's characterised by birefringent silicate particles w/i Critical Care (Path)
dense, whorled collagenous nodules surrounded by dust-laden macrophages. Radiography (PU)
typically demonstrates numerous small, rounded nodules predominant in the upper lobes;
calcification of the rim of hilar LNs (eggshell calcification) may also be seen. PU Path
669Asbestos Asbestos-related pleural disease is characterised by pleural plaques (focal pleural thickening, Pulmonary & Pathology 5
typically w/ calcifications). Common occup exposures incl shipbuilding, insulation Critical Care (Path)
manufacturing and application, and drywall application. Most affected pts remain aSSx for (PU)
20-30yrs following initial exposure. PU Path
670Silicosis In silicosis, internalised silica particles impair macrophage fxn by disrupting phagocytosis Pulmonary & Pathophysi 2
and promoting apoptosis. This ↑ the risk of mycobacteria infection (particularly M. Critical Care ology
tuberculosis). (PU) (Patp) PU Patp
730Community The 1° VF of S. pneumoniae is a PSC that inhibs opsonisation and phagocytosis. The PSC of Pulmonary & Microbiolo 21
acquired pneumonia the most virulent strains is targeted by the PCV, which confers immunity against those Critical Care gy (Micr)
subtypes. (PU) PU Micr
731Community S. pneumoniae are gram (+), α-hemolytic, optochin-sen, bile-soluble diplococci. Viridans Pulmonary & Microbiolo 21
acquired pneumonia group streptococci are also α-hemolytic, but they're optochin-res and bile insoluble. S. Critical Care gy (Micr)
pyogenes (GAS) appear as gram (+) cocci in chains w/ bacitracin susceptibility. (PU) PU Micr
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734Community S. pneumoniae vax ↓ the risk of invasive disease and is recommended for young pts and the Pulmonary & Microbiolo 21
acquired pneumonia elderly. The PCPSV is an unconjugated vax that induces a T-cell-independent humoral Critical Care gy (Micr)
immune response. In contrast, the PCCV contains polysaccharide material attached to a (PU)
protein Ag, which creates a robust T-cell-mediated humoral immune response. PU Micr
795Sarcoidosis Sarcoidosis often presents in young AA women w/ the insidious onset of resp SSx (e.g. Pulmonary & Pathology 7
cough, dyspnoea, chest pain) accompanied by fatigue, fever, and weight loss. The char Critical Care (Path)
histopath feature is NCGs, which consist of aggregates of epithelioid macrophages and (PU)
multinucleated giant cells. PU Path
796Sarcoidosis Sarcoidosis is a CD4+ T-cell mediated disease, in which large # of CD4+ lymphocytes Pulmonary & Pathology 7
release IFN-γ and TNF-α to drive macrophage activation and granuloma formation. BAL Critical Care (Path)
fluid in pulm sarcoidosis demonstrates a lymphocytic predominance w/ a high CD4+/CD8+ (PU)
ratio. PU Path
797Sarcoidosis Sarcoidosis is characterized by noncaseating granulomas due to dysregulated cell-mediated Pulmonary & Immunolo 7
immunity. Activated antigen-presenting cells produce IL-12, which stimulates the Critical Care gy (Immu)
differentiation of Th1-type CD4+ cells. Th1 cells produce IL-2 and interferon-y, which (PU)
stimulate Th1 cell proliferation and macrophage activation, respectively. PU Immu
798Sarcoidosis Sarcoidosis is a systemic inflammatory disorder characterised by NCGs in a variety of Pulmonary & Pathology 7
tissues. Most pts develop liver involvement, which typically MFx as aSSx hepatomegaly w/ Critical Care (Path)
mild LFT abns. Liver Bx freq demonstrates scattered NCGs. (PU) PU Path
799Neonatal respiratory Use of concentrated O2 therapy for NRDS may be complicated by retinopathy of Pulmonary & Pathology 5
distress syndrome prematurity. This abn retinal neovascularisation is a major cause of blindness in developed Critical Care (Path)
nations. (PU) PU Path
800Neonatal respiratory Dipalmitoyl phosphatidylcholine (lecithin, L) and phosphatidylglycerol are major Pulmonary & Embryolog 5
distress syndrome constituents of surfactant. Fetal lung lecithin production increases sharply after 30 weeks Critical Care y (Embr)
gestation, and phosphatidylglycerol production increases at 36 weeks gestation. The amniotic (PU)
fluid sphingomyelin (S) level should remain approximately constant during the third
trimester. An L/S ratio > 2.0 indicates adequate surfactant production to avoid neonatal
hyaline membrane disease. PU Embr
802Cystic fibrosis Cystic fibrosis (CF) is most commonly due to a 3-base pair deletion in the CF Pulmonary & Genetics 11
transmembrane conductance regulator (CFTR) gene at amino acid position 508 (ΔF508). Critical Care (Gene)
This mutation impairs post translational processing of CFTR, resulting in shunting of CFTR (PU)
toward the proteasome, with complete absence of the protein on the cell surface. Elevated
sweat chloride concentrations are found in most patients with CF. PU Gene
803Cystic fibrosis Meconium ileus is a distal SBO due to abnly dehydrated meconium in a pt w/ CF. Persistent, Pulmonary & Pathology 11
Tx-resistant infectious pneumonias, bronchiectasis, and cor pulmonale account for most Critical Care (Path)
deaths due to CF. (PU) PU Path
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804Cystic fibrosis In CF, impairment of the CFTR protein ↓ Cl- secretion and ↑ Na+ absorption by the resp Pulmonary & Pathophysi 11
epithelia, resulting in dehydrated mucus. When saline is applied to the nasal mucosa, the ↑ Critical Care ology
Na+ absorption in pts w/ CF causes a more (-) nasal transepithelial potential diff, which can (PU) (Patp)
be used to Dx CF. PU Patp
805Cystic fibrosis ΔF508 is the most common mutation in the CFTR protein in pts w/ CF. This mutation leads Pulmonary & Genetics 11
to protein misfolding and failure of glycosylation, f/b proteasome-mediated degradation and Critical Care (Gene)
significantly ↓ number of transmembrane CFTR proteins. (PU) PU Gene
806Cystic fibrosis Recurrent sinopulm infections and exocrine gland atrophy in a young Caucasian are Pulmonary & Pathology 11
suggestive of CF. CF can lead to pancreatic insufficiency, fat malabsorption, and a defic of Critical Care (Path)
vits A, D, E, and K. VitA maintains orderly diff of specialised epithelia, incl the mucus- (PU)
secreting columnar epithelia of the ocular conjunctiva, resp and urinary tracts, and pancreatic
and other exocrine ducts. Avitaminosis A can cause squamous metaplasia of such epithelia to
a keratinising epithelium. PU Path
820Bronchiectasis Digital clubbing is often a/w prolonged hypoxia. It can be found in pts w/ large-cell lung ca, Pulmonary & Pathology 2
TB, CF, and suppurative lung diseases such as empyema, bronchiectasis, and chronic lung Critical Care (Path)
abscesses. (PU) PU Path
825Systemic sclerosis PAH is a common complication of systemic sclerosis, likely resulting from proliferation of T Pulmonary & Pathology 3
cells w/ release of cytokines (e.g. TGF-β) and conseq progr thickening and occlusion of the Critical Care (Path)
small and medium-sized pulm arteries/arterioles. Pts typically have progr dyspnoea and a (PU)
loud pulm component of S2 and may develop SSx of right-sided HF (e.g. hepatomegaly, peri
oedema). PU Path
844Thoracentesis Thoracentesis should be performed below the 6th rib in the midclavicular line, the 8th rib Pulmonary & Anatomy 2
along the midaxillary line, or the 10th rib along the paravertebral line in order to minimize Critical Care (Anat)
the risk of lung injury. Insertion of a needle lower than 9th rib increases the risk of (PU)
penetrating abdominal structures. The needle should also be inserted along the upper border
of the rib to prevent injury to the intercostal vessels. PU Anat
877Sarcoidosis Sarcoidosis commonly presents w/ hilar adenopathy, pulm infiltrates, and skin (e.g. erythema Pulmonary & Pathology 7
nodosum) and ocular findings. Biopsy shows NCGs composed of epithelioid cells (activated Critical Care (Path)
macrophages) and giant multinucleated cells. Oral glucocorticoids are the Tx of choice for (PU)
significant disease. PU Path
903Pulmonary arterial Pulmonary arterial hypertension (PAH) typically affects young women and can be familial. It Pulmonary & Pharmacol 8
hypertension is characterized by luminal narrowing of the pulmonary arteries and arterioles, with medial Critical Care ogy (Phar)
hypertrophy, intimal fibrosis, and the eventual development of plexiform lesions. Bosentan is (PU)
a competitive antagonist of endothelin receptors used for the treatment of PAH. PU Phar
958Community Infection w/ M. pneumoniae can result in the formation of cold agglutinins, which are IgM Pulmonary & Microbiolo 21
acquired pneumonia Abs (1arily) that bind RBCs and cause clumping/agglutinations at low body temps. Other Critical Care gy (Micr)
illnesses resulting in cold agglutinin formation incl IM and certain heme malignancies. (PU) PU Micr
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960Community L. pneumophila has a propensity to affect older adults w/ chronic lung disease who smoke. It Pulmonary & Microbiolo 21
acquired pneumonia causes Legionnaires' disease which is characterised by high fever, diarrhoea, h/a, and Critical Care gy (Micr)
confusion. L. pneumophila is a gram (-) rod that's typically not detected on Gram stain but (PU)
can be Dx by PCR of an LRT sample or detection of Legionella Ag in the urine. PU Micr
961Community L. pneumophila commonly contaminates natural bodies of water, municipal water supplies, Pulmonary & Microbiolo 21
acquired pneumonia and water-based cooling systems. The organism is inhaled in aerosolised water and Critical Care gy (Micr)
establishes infection via the pulm route. Dx is gen made by urine Ag testing, Ag stain, or (PU)
culture on buffered charcoal yeast extract agar supplemented w/ L-cysteine and Fe. PU Micr
962Epiglottitis PRP is a capsule and major VF for Hib. Hib is the most common cause of epiglottitis, which Pulmonary & Microbiolo 2
presents w/ fever, stridor, and dyspnoea. Critical Care gy (Micr)
(PU) PU Micr
964Septic arthritis H. influenzae is a gram (-) coccobacillus that req both X factor (hematin) and V factor Pulmonary & Microbiolo 4
(NAD+) to grow. Hib has an antiphagocytic PSC, which allows it to spread hematogenously Critical Care gy (Micr)
and cause invasive disease such as septic arthritis and meningitis. (PU) PU Micr
967Epiglottitis Rapidly progressing fever, severe sore throat, drooling and progressive airway obstruction Pulmonary & Immunolo 2
potentially accompanied by stridor are the presenting symptoms of acute epiglottitis. This Critical Care gy (Immu)
illness is most commonly caused by H. influenzae type b, but the Hib vaccine has dropped (PU)
the incidence of this disease considerably. H. influenzae type b can still cause disease in
unimmunized or improperly immunized patients as well as fully immunized patients in some
cases. PU Immu
975Pulmonary Pulm infarcts are typically hemorrhagic (red) and wedge-shaped in the periphery of the lung. Pulmonary & Pathology 13
embolism IVDUs are at ↑ risk of TV endocarditis, which can cause multi septic pulm infarcts due to Critical Care (Path)
embolisation of TV vegetation fragments. (PU) PU Path
984Sarcoidosis Hypercalcaemia in sarcoidosis is caused by PTH-independent formation of 1,25- Pulmonary & Pathology 7
dihydroxyvit D by activated macrophages. This leads to ↑ intestinal absorption of Ca2+. Critical Care (Path)
(PU) PU Path
999Group B Universal prenatal screening for group B strep colonization by vaginal-rectal culture at 35-37 Pulmonary & Microbiolo 2
streptococcal weeks gestation is recommended to identify colonized women who require INTRAPARTUM Critical Care gy (Micr)
infection antibiotics, most frequently with penicillin or ampicillin, to prevent neonatal GBS sepsis, (PU)
pneumonia and meningitis. PU Micr
1041
Barrett esophagus Squamous metaplasia is a reversible, adaptive response to chronic irritation, such as Pulmonary & Pathology 2
smoking. The normal columnar epithelium is replaced by squamous epithelium, which is Critical Care (Path)
more resistance to irritation but has ↓ mucociliary clearance. Metaplasia also occurs w/ (PU)
Barrett oesophagus, in which oesophageal squamous epithelium is replaced by columnar
epithelium in response to chronic acid exposure. PU Path
1130
Selective IgA Selective IgA deficiency is the most common primary immune deficiency and can present Pulmonary & Immunolo 1
deficiency with recurrent sinopulmonary and gastrointestinal infections as well as autoimmune disease. Critical Care gy (Immu)
Patients with severe IgA deficiency can have anaphylaxis during transfusion of blood (PU)
products that contain small amounts of IgA. PU Immu
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1131
Hypersensitivity Type 1 hypersensitivity reactions are mediated by the interaction of allergen with preexisting Pulmonary & Immunolo 4
reactions IgE bound to basophils and mast cells. This facilitates cross-linking of the surface IgE Critical Care gy (Immu)
molecules that signals the cell to degranulate releasing chemical mediators (eg, histamine, (PU)
heparin). These agents are responsible for the immediate signs and symptoms of allergy,
from a local wheal and flare to life threatening anaphylaxis. PU Immu
1147
Sarcoidosis Sarcoidosis is an inflammatory disorder characterised histologically by NCGs consisting of Pulmonary & Pathology 7
aggregates of epithelioid macrophages and multinucleated giant cells. Common MFxs incl Critical Care (Path)
hilar adenopathy, pulm infiltrates, skin rash, ophthalmic findings, and constitutional SSx. (PU) PU Path
1194
Venous Heparins are ideal anticoagulants for most patients with thromboembolic disease in Pulmonary & Pharmacol 2
thromboembolism pregnancy as they do not cross the placenta and therefore the risk of fetal bleeding or Critical Care ogy (Phar)
teratogenicity is low. Low molecular weight heparin (eg, enoxaparin) is the preferred (PU)
therapy, with patients transitioned to unfractionated heparin at term. PU Phar
1212
Neuromuscular Succinylcholine is a fast-acting, depolarizing neuromuscular blocking agent used for rapid- Pulmonary & Pharmacol 1
blocker sequence intubation that causes equal reduction of all 4 twitches during train-of-four Critical Care ogy (Phar)
stimulation (phase I blockade). Prolonged administration of succinylcholine or use in patients (PU)
with abnormal plasma cholinesterase activity causes transition to a phase ll (nondepolarizing)
block, seen as a progressive reduction in each of the 4 twitches. PU Phar
1215
Tuberculosis The acid-fast stain IDs organisms that have mycolic acid present in their cell walls, incl Pulmonary & Microbiolo 18
Mycobacterium and some Nocardia species. Acid-fast staining is carried out by applying an Critical Care gy (Micr)
aniline dye (e.g. carbolfuchsin) to a smear and then decolourising w/ acid alcohol to reveal (PU)
whether the organisms present are 'acid fast'. PU Micr
1216
Tuberculosis M. tuberculosis grows in long, serpentine cords due to the presence of cord factor, a surface Pulmonary & Microbiolo 18
glycolipid, on the cell wall. Cord factor is a 1° VF of M. tuberculosis; it prevents Critical Care gy (Micr)
macrophages from being bactericidal due to the inhib of phagolysosome acidification and (PU)
also leads to the formation of CGs. PU Micr
1217
Tuberculosis 1° Tb infection is marked by initial unchecked M. tuberculosis replication w/i the alveolar Pulmonary & Microbiolo 18
space and alveolar macrophages. after a few wks, CD4 lymphocytes are stim to release IFN- Critical Care gy (Micr)
γ, which activates macrophages and leads to control of the infection. (PU) PU Micr
1218
Tuberculosis Mycobacteria tuberculosis primarily replicates w/i the phagosome, leading to display of Pulmonary & Immunolo 18
mycobacterial Ags on MHC-II molecules. This results in the activation of CD4 cells and Critical Care gy (Immu)
subsequent control of the infection w/ macrophages. (PU) PU Immu
1219
Tuberculosis 1° TB causes the formation of Ghon foci in the lower lungs. 2° (reactivation) TB occurs in Pulmonary & Pathology 18
pts w/ prior TB infection that never cleared completely. Reactivation TB occurs most often Critical Care (Path)
in immunosuppressed pts and is characterised by apical cavitary lesions and hemoptysis. (PU) PU Path
1220
Tuberculosis Mycobacterium tuberculosis triggers CD4 T lymphocytes to release interferon-gamma, Pulmonary & Immunolo 18
which leads to macrophage activation (improves intracellular killing ability) and Critical Care gy (Immu)
differentiation into epithelioid histiocytes. These cells, along with horseshoe-shaped, (PU)
multinucleated Langhans giant cells (fused, activated macrophages) are a key component of
granuloma formation. PU Immu
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1221
Tuberculosis The Ghon complex describes the 2 initial sites (lower lobe of lung, ipsilateral hilar LN) of 1° Pulmonary & Pathology 18
TB infection. Over time, these sites become calcified and fibrosed and can be visualised on Critical Care (Path)
gross pathology and radiographic imaging (Ranke complex). (PU) PU Path
1222
Tuberculosis The control of Mycobacterium tuberculosis infection is primarily mediated by activated Pulmonary & Pathology 18
macrophages, which surround extracellular mycobacteria and wall them off within Critical Care (Path)
granulomas. The release of digestive enzymes by these cells helps control the infection but (PU)
also leads to damage of the surrounding tissue and the formation of cavitary lung lesions. PU Path
1249
Alpha1 antitrypsin The rubber-like properties of elastin are due to high content of nonpolar (hydrophobic) Pulmonary & Biochemist 8
deficiency amino acids and extensive cross-linking between elastin monomers facilitated by lysyl Critical Care ry (Bioc)
oxidase. Patients with α-1 antitrypsin deficiency can develop early-onset, lower lobe- (PU)
predominant emphysema due to excessive alveolar elastin degradation. PU Bioc
1357
Respiratory acidosis Resp acid Px w/ a low pH and a high PaCO2. HCO3- initially remains w/i the normal range, Pulmonary & Physiology 1
but becomes incr over hrs to dys as renal comp develops. Critical Care (Phys)
(PU) PU Phys
1386
Respiratory The binding of O2 to hemoglobin increases the affinity for binding of subsequent O2 Pulmonary & Biochemist 8
physiology molecules (cooperative binding). In the lungs, the binding of O2 to hemoglobin drives the Critical Care ry (Bioc)
release of H+ and CO2 from hemoglobin (Haldane effect). In the peripheral tissues, high (PU)
concentrations of CO2 and H+ facilitate O2 unloading from hemoglobin (Bohr effect). PU Bioc
1414
Respiratory The majority of CO2 produced in the tissues is transported to the lungs as HCO3-. W/i Pulmonary & Physiology 8
physiology RBCs, the enzyme CA forms HCO3- from CO2 and water. The excess HCO3- is then Critical Care (Phys)
transferred out of RBCs into the plasma via exchange w/ Cl-. This exchange is known as 'Cl- (PU)
shift' and is the principal cause of high RBC Cl- content in venous blood. PU Phys
1441
Primary Chronic granulomatous disease (CGD) results from a genetic defect in NADPH oxidase. Pulmonary & Immunolo 7
immunodeficiency Normally, NADPH oxidase participates in the killing of microbes within neutrophil and Critical Care gy (Immu)
disorder macrophage phagolysosomes. Patients with CGD develop recurrent bacterial and fungal (PU)
infections that are predominantly caused by 5 catalase-positive organisms: Staphylococcus
aureus, Burkholderia cepacia, Serratia marcescens, Nocardia, and Aspergillus. PU Immu
1446
Lung abscess Patients with alcoholism are at increased risk for lung abscess due to the aspiration of oral Pulmonary & Pharmacol 4
flora during periods of unconsciousness. Lung abscesses tend to be polymicrobial; they are Critical Care ogy (Phar)
usually composed of anaerobic oral flora (Bacteroides, Prevotella, Fusobacterium, and (PU)
Peptostreptococcus) and aerobic bacteria. Clindamycin provides coverage against both
anaerobic and aerobic organisms and has been traditionally used in the treatment of lung
abscess. PU Phar
1460
Obstructive sleep OSA is due to relaxation of oropharyngeal muscle tone w/ occlusion of the upper airway. Pulmonary & Pathophysi 4
apnea SSx incl daytime sleepiness, h/a, and depression. Complications incl HTN and PAH, RHF, Critical Care ology
and an ↑ risk for cardiac events. (PU) (Patp) PU Patp
1494
Respiratory Panic atks are typically accomp by hypervent, leading to hypocapnia. CBF is directly related Pulmonary & Physiology 8
physiology to PaCO2; therefore, hypocapnia can lead to decr CBF and SSx of cerebral hypoperfusion (e. Critical Care (Phys)
g. blurred vision, dizziness, lightheadedness). (PU) PU Phys
D eats
1514
Cystic fibrosis CF is an AR disease caused by muts in the CFTR gene. The CFTR protein is a Pulmonary & Physiology 11
transmembrane ATP-gated Cl- channel. Defects in CFTR result in thick, plugging mucous Critical Care (Phys)
and incr Na+ and Cl- lvls in sweat. (PU) PU Phys
1521
COPD COPD causes air trapping and hyperinflation; conseq, these pts breathe at higher baseline Pulmonary & Physiology 16
LVs (higher FRC). The absolute volume of air in the lungs that's not respired (RV) incr Critical Care (Phys)
substantially, as does the fraction of air in the lungs that's not involved in resp (RV/TLC (PU)
ratio). PU Phys
1522
Pulmonary gas Gas exchange b/w the alv and pulm cap blood depends on both Q and D. The exchange of Pulmonary & Physiology 1
exchange O2 and CO2 in a normal individual at rest is Q-limited, so alv and cap partial pressures are Critical Care (Phys)
equal. Situations in which O2 exchange becomes D-limited (e.g. emphysema, PF) cause a (PU)
large gradient b/w alv and cap PO2; PCO2 is less affected due to the greater DC of CO2. PU Phys
1523
Asthma Asthma is characterized by reversible airway obstruction, and lung function tests may be Pulmonary & Pharmacol 12
normal between exacerbations. Bronchoprovocation can be used to aid diagnosis in patients Critical Care ogy (Phar)
with normal spirometry; methacholine is administered and followed by serial spirometry. (PU)
Patients with asthma demonstrate hyperresponsivity to the stimulus, leading to FEV1
reductions at lower doses than in those without asthma. PU Phar
1526
Obesity OHS is char by chronic fatigue, dyspnea, difficulty conc, and evidence of hypovent (PaCO2 Pulmonary & Physiology 1
hypoventilation >45 mmHg while awake). It's 1 of the important causes of hypoxemia w/ a normal A-a O2 Critical Care (Phys)
syndrome gradient. (PU) PU Phys
1527
Iron deficiency The 3 variables that affect the total oxygen content of blood are hemoglobin concentration, Pulmonary & Physiology 7
anemia oxygen saturation of hemoglobin (SaO2), and the partial pressure of oxygen dissolved in Critical Care (Phys)
blood (PaO2). Anemia is characterized by decreased hemoglobin concentration in the setting (PU)
of normal SaO2 and PaO2. PU Phys
1535
Community Irritation of the parietal pleura will cause sharp pain, which is worse on inspiration. Pain Pulmonary & Anatomy 21
acquired pneumonia arising from the mediastinal or diaphragmatic pleura will be carried by the phrenic nerve and Critical Care (Anat)
referred to the C3 C5 distribution. (PU) PU Anat
1541
Respiratory Both perfusion and ventilation are highest in the base of the lung and lowest in the apex; Pulmonary & Physiology 8
physiology however, the variability in perfusion is greater than that in ventilation. This causes the Critical Care (Phys)
ventilation/perfusion ratio to follow the opposite gradient: it is lowest in the base and highest (PU)
in the apex. PU Phys
1542
Respiratory The pO2 in the LA and LV is lower than that in the pulm caps due to mixing of oxy blood Pulmonary & Physiology 8
physiology from the pulm veins w/ deoxy blood from the bronchial circulation and thebesian veins. Critical Care (Phys)
(PU) PU Phys
1543
Interstitial lung ILD is a/w decr LVs and incr lung elastic recoil caused by fibrotic interstitial tissue. The incr Pulmonary & Physiology 8
disease elastic recoil results in incr radial traction (outward pulling) on the airways, leading to incr Critical Care (Phys)
exp flow rates when corrected for the low LV. (PU) PU Phys
D eats
1548
Respiratory mucosa Most inhaled particles that lodge in the bronchial tree are removed via prox transport by Pulmonary & Physiology 4
ciliated epithelial cells (mucociliary clearance). Mucus-secreting cells are present to the lvl Critical Care (Phys)
of the larger bronchioles, after which club cells become the prominent secretory cell type. (PU) PU Phys
1563
Respiratory Min vent is equal to the product of TV and RR and incl dead space vent. Alv vent is equal to Pulmonary & Physiology 8
physiology the product of RR and the diff b/w TV and dead space volume. Critical Care (Phys)
(PU) PU Phys
1576
Cytomegalovirus In a transplant pt, pneumonia w/ intranuclear and cytoplasmic inclusion bodies histo points to Pulmonary & Microbiolo 9
opportunistic infection w/ CMV, an enveloped virus that contains a dsDNA genome. Critical Care gy (Micr)
(PU) PU Micr
1579
ARDS ARDS is caused by injury of the pulm epithelium a/o endothelium, and occurs most often Pulmonary & Pathology 3
due to sepsis or pneumonia. Cytokines recruit neutrophils to the lung tissue, which cause cap Critical Care (Path)
dmg and leakage of protein-rich fluid into the alveoli. Later, cellular proliferation and (PU)
collagen deposition occurs, and in some pts, this leads to irreversible PF. PU Path
1582
Acute respiratory There're 5 major causes of hypoxemia (low PaO2): alv hypovent, low PiO2, V/Q mismatch, Pulmonary & Physiology 1
failure diffusion impairment, and R-L shunting. The A-a gradient is normal w/ alv hypovent and low Critical Care (Phys)
PiO2, which helps distinguish these causes from other causes of hypoxemia. (PU) PU Phys
1583
COPD PaCO2 is the major stim of resp in healthy individuals; even a slight incr in PaCO2 stims Pulmonary & Physiology 16
cChRs and triggers incr vent. In pts w/ COPD, the response to PaCO2 is blunted and Critical Care (Phys)
hypoxemia can contribute to resp drive. pChRs are 1arily responsible for sensing PaO2 and (PU)
can be suppressed w/ O2 admin. PU Phys
1584
Pulmonary PE is common in hosp and and postop pts, and classically Px w/ sud-on SOB and pleuritic Pulmonary & Physiology 13
embolism chest pain. It causes hypoxemia due to V/Q mismatch; PaCO2 is usually normal or decr. Critical Care (Phys)
(PU) PU Phys
1585
Acute heart failure LHF is common following MI affecting the LV. The resulting accumulation of oedema in the Pulmonary & Pathophysi 7
pulm interstitium makes the lungs heavy and stiff, restricting inspiratory expansion and ↓ Critical Care ology
lung compliance. (PU) (Patp) PU Patp
1586
Polycythemia Erythrocytosis is defined as a Hct lvl >52% in men and >48% in women. Measurement of Pulmonary & Physiology 5
RBC mass is necessary to distinguish absolute from relative erythrocytosis. A normal RBC Critical Care (Phys)
mass indicates plasma volume contraction as the cause of polycythemia. (PU) PU Phys
1587
Pulmonary arterial The pulm vasc bed is unique in that tissue hypoxia results in a vasocon response. Such Pulmonary & Physiology 8
hypertension hypoxic vasocon occurs in the small muscular pulm arteries to divert blood flow away from Critical Care (Phys)
undervent lung regions and toward well-vent lung areas to mini V/Q mismatch, leading to (PU)
more efficient overall gas exchange. PU Phys
1590
Respiratory During physical ex, there's incr skeletal muscle CO2 production that incr the CO2 content of Pulmonary & Physiology 8
physiology venous blood. Art O2 and CO2 content remains constant via incr in alv vent and gas Critical Care (Phys)
exchange efficiency. Venous O2 content remains constant or is decr due to incr O2 (PU)
extraction by the tissues that matches or exceeds the rate of O2 delivery (i.e. O2 consumption
during ex is limited by CO). PU Phys
D eats
1611
Immotile cilia Kartagener syndrome is a form of primary ciliary dyskinesia characterized by the triad of Pulmonary & Immunolo 1
syndrome situs inversus, chronic sinusitis, and bronchiectasis. It occurs due to mutations that impair the Critical Care gy (Immu)
structure or function of cilia. Cystic fibrosis also causes chronic respiratory infections, but it (PU)
is not associated with situs inversus. PU Immu
1649
Influenza Major adaptive immune mechs that prevent reinfection w/ the influenza virus incl anti- Pulmonary & Microbiolo 5
hemagglutinin Abs. Critical Care gy (Micr)
(PU) PU Micr
1650
Interstitial lung Decr in the slope of the curve depicting LV vs distending pressure indicates decr lung Pulmonary & Physiology 8
disease compliance (the hallmark of PF). Critical Care (Phys)
(PU) PU Phys
1666
Community Influenza infection alters the resp epithelium and can ↑ the risk of 2° bacterial pneumonia. Pulmonary & Microbiolo 21
acquired pneumonia The leading pathogens are S. pneumoniae, S. aureus, and H. influenzae. The elderly are Critical Care gy (Micr)
affected most commonly, but S. aureus can cause 2° pneumonia in young, previously healthy (PU)
pts. PU Micr
1667
Laryngotracheobron Brassy, barking cough; dyspnoea, and recent Hx of URI in a child are suggestive of viral Pulmonary & Microbiolo 1
chitis laryngotracheitis (croup). The most common cause of croup is parainfluenza virus. Critical Care gy (Micr)
(PU) PU Micr
1677
Community All organisms in the Mycoplasma genus, incl U. urealyticum, lack peptidoglycan cell walls Pulmonary & Microbiolo 21
acquired pneumonia and are therefore resistant to agents that target the cell wall such as penicillins, Critical Care gy (Micr)
cephalosporins, carbapenems, and vancomycin. Mycoplasma infections can be Tx w/ anti- (PU)
ribosomal agents (e.g. tetracyclines, macrolides). PU Micr
1679
Community M. pneumoniae is the causative agent of 'walking pneumonia', an infection typically Pulmonary & Microbiolo 21
acquired pneumonia characterised by a nagging nonproductive cough, low-grade fever, and malaise. Often, the Critical Care gy (Micr)
CXR suggests a severe pneumonia even though the pt appears relatively well. Mycoplasma (PU)
species req chol supplementation to grow on artificial media. PU Micr
1695
Pneumothorax The lung apices extend above the level of the clavicle and first rib through the superior Pulmonary & Anatomy 2
thoracic aperture. Penetrating injury in this area may lead to pneumothorax, tension Critical Care (Anat)
pneumothorax, or hemothorax. (PU) PU Anat
1745
Aspiration Due to gravity, supine patients typically aspirate into the posterior segments of the upper Pulmonary & Anatomy 2
pneumonia lobes and superior segments of the lower lobes. Patients who are upright tend to aspirate into Critical Care (Anat)
the basilar segments of the lower lobes. Aspirated material is more likely to travel down the (PU)
right main bronchus. PU Anat
1763
X-linked X-linked agammaglobulinemia is characterized by low or absent circulating CD19+ and Pulmonary & Immunolo 2
agammaglobulinemi CD20+ B cells and pan-hypogammaglobulinemia. Affected patients have increased Critical Care gy (Immu)
a susceptibility to pyogenic bacteria, enteroviruses, and Giardia lamblia due to the absence of (PU)
opsonizing and neutralizing antibodies. PU Immu
D eats
1767
Community The most common cause of CAP in both HIV-infected and HIV-uninfected individuals is S. Pulmonary & Microbiolo 21
acquired pneumonia pneumoniae. Risk of invasive pneumococcal disease is significantly ↑ in pts w/ HIV Critical Care gy (Micr)
regardless of CD4 count. (PU) PU Micr
1791
Autosomal recessive The probability that a child of parents from 2 populations with different mutant allele carrier Pulmonary & Genetics 5
inheritance frequencies will inherit an autosomal recessive disease is 25% multiplied by the carrier Critical Care (Gene)
frequencies. (PU) PU Gene
1800
Inflammation Leukotriene B, stimulates neutrophil migration to sites of inflammation. Other important Pulmonary & Immunolo 3
chemotactic agents include 5-HETE (leukotriene precursor), complement component C5a, Critical Care gy (Immu)
and IL-8. (PU) PU Immu
1833
Fetal circulation The most highly oxygenated blood in the fetus is carried by the umbilical vein, which Pulmonary & Embryolog 1
empties directly into the inferior vena cava via the ductus venosus. Critical Care y (Embr)
(PU) PU Embr
1876
Fat embolism FES should be strongly suspected in a pt w/ severe long-bone a/o pelvic fractures who Pulmonary & Pathology 2
develops acute-onset neuro abns, hypoxaemia, and a petechial rash. Occlusion of the pulm Critical Care (Path)
microvessels by fat globules is an early histo finding of this syndrome. (PU) PU Path
1881
Acute heart failure Acute pulm oedema is a common conseq of AMI affecting the LV. ↑ hydrostatic pressure in Pulmonary & Pathology 7
the pulm venous system leads to engorged alveolar caps w/ transudation of fluid into the Critical Care (Path)
alveoli, appearing as acellular pink material on histo. hemosiderin-laden macrophages are (PU)
indicative of chronic lung congestion and aren't present acutely. PU Path
1910
Community The green discolouration of pus or sputum seen during common bacterial infections is due to Pulmonary & Pathophysi 21
acquired pneumonia the presence of MPO, a blue-green hem-based enzyme that’s released from neutrophil Critical Care ology
azurophilic granules and forms HOCl (bleach). (PU) (Patp) PU Patp
1919
Alpha1 antitrypsin Emphysema most commonly results from chronic smoking but can also occur in genetically Pulmonary & Pathophysi 8
deficiency predisposed individuals w/ AATD. Pts w/ emphysema have a ↓ FEV1/FVC ratio, ↑ TLC, and Critical Care ology
↓ DLCO. (PU) (Patp) PU Patp
1925
Asthma Intermittent resp SSx in a pts w/ a normal CXR, sputum eosinophils, and ↓ FEV1 suggest Pulmonary & Pathology 12
asthma. Common asthma triggers incl exercise, cold air, resp infection, and exposure to Critical Care (Path)
inhaled allergens (e.g. dust mites, cockroaches, pet dander, mould, pollen). (PU) PU Path
1939
Cystic fibrosis Pts w/ CF produce eccrine sweat w/ higher-than-normal concs of Na+ and Cl-. Exposure to Pulmonary & Pathophysi 11
high temp or exercise can lead to hyponatraemia and hypochloraemia due to excessive NaCl Critical Care ology
loss thru sweat; therefore, salt supplementation is recommended. (PU) (Patp) PU Patp
1942
Polycythemia In response to tissue hypoxia, specialised interstitial cells in the RM and RC release EPO to Pulmonary & Pathophysi 5
stim the bone marrow to ↑ RBC production and improve the O2-carrying capacity of the Critical Care ology
blood. This response, known as 2° polycythemia, is an expected finding in diseases or (PU) (Patp)
conditions that cause significant chronic hypoxaemia (e.g. COPD). PU Patp
1980
High altitude illness At high altitude, the low PiO2 leads to hypoxemia that triggers hypervent w/ incr exhalation Pulmonary & Physiology 3
of CO2 and resulting resp alk. The kidneys comp by incr HCO3- excretion to help normalize Critical Care (Phys)
pH. Hypoxemia persists, but phys adjustments take place to improve O2 use. (PU) PU Phys
D eats
1981
Pulmonary The combo of ac-on dyspnea, calf swelling, and Hx of prolonged immobility is strongly Pulmonary & Physiology 13
embolism suggestive of PE. PE typically Px w/ hypoxemia due to V/Q mismatch and resp alk Critical Care (Phys)
(hypocapnia) due to hypervent. (PU) PU Phys
1985
Obstructive sleep OSA presents in obese individuals w/ excessive daytime sleepiness and SSx of nocturnal Pulmonary & Pathophysi 4
apnea upper airway obstr (e.g. snoring, gasping). The condition is a/w systemic HTN. Prolonged, Critical Care ology
un-Tx OSA can also cause PAH and RHF. (PU) (Patp) PU Patp
2101
Metabolic acidosis Lactic acidosis in septic shock results from tissue hypoxia, which impairs oxidative Pulmonary & Pathology 4
phosphorylation and causes shunting of pyruvate to lactate following glycolysis. Hepatic Critical Care (Path)
hypoperfusion also contributes to the build-up of lactic acid as the liver is the 1° site of (PU)
lactate clearance. PU Path
2102
Aspiration Elderly pts w/ dementia or hemiparesis may have dysphagia, which is a RF for aspiration Pulmonary & Pathology 2
pneumonia pneumonia. Dependent lung consolidation is commonly seen in aspiration pneumonia. Critical Care (Path)
(PU) PU Path
2116
Atelectasis An obstr lesion in a mainstem bronchus can prevent ventilation of an entire lung, leading to Pulmonary & Pathology 1
obstr atelectasis and complete lung collapse. ChFx on CXR incl unilateral pulm opacification Critical Care (Path)
and deviation of the mediastinum toward the opacified lung. (PU) PU Path
2128
Asthma IgE-binding monoclonal antibodies (eg, omalizumab) are effective in treating asthma that Pulmonary & Pharmacol 12
remains uncontrolled despite optimal therapy with bronchodilators and inhaled Critical Care ogy (Phar)
corticosteroids. IgE-binding monoclonal antibodies reduce airway inflammation by blocking (PU)
the binding of IgE to the IgE receptors on mast cells and preventing the release of
proinflammatory substances, including histamine and leukotrienes. PU Phar
7558
COPD Smoking is the strongest RF for COPD and is responsible for accelerated decline in FEV1 in Pulmonary & Pathophysi 16
pts w/ COPD. Smoking cessation will slow the accelerated decline in FEV1, but FEV1 won't Critical Care ology
return to the lvl it would've been had the pt never smoked. (PU) (Patp) PU Patp
7601
COPD In COPD, air-trapping leads to an incr in RV and TLC, as well as an incr in the RV/TLC Pulmonary & Physiology 16
ratio. Airway obstr causes a decr in FVC, FEV1, and the FEV1/FVC ratio. Critical Care (Phys)
(PU) PU Phys
7614
Pleural effusion Fluid in the pleural space acts to insulate sound vibrations that originate in the airways; Pulmonary & Pathophysi 4
therefore, pleural effusion causes ↓ tactile fremitus and ↓ intensity of breath sounds. The high Critical Care ology
density of pleural fluid compared to normal lung tissue also causes dullness to percussion. (PU) (Patp) PU Patp
7648
Interstitial lung Histologic findings of IPF are most prominent in the lung periphery and incl a heterogeneous Pulmonary & Pathology 8
disease mix of chronic inflammation and patchy interstitial fibrosis, focal fibroblast proliferation, Critical Care (Path)
and formation of fibrotic cystic spaces in a honeycomb pattern. (PU) PU Path
7660
Pulmonary PE causes dead space vent, which leads to hypoxemia due to the conseq V/Q mismatch. Pulmonary & Physiology 13
embolism Critical Care (Phys)
(PU) PU Phys
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7661
Pulmonary Pts being weaned from mech vent typically breathe at low TVs, w/ a comp incr in RR to Pulmonary & Physiology 13
embolism maintain min vent. B/c at low TVs a higher proportion of each breath is composed of dead Critical Care (Phys)
space, this type of breathing leads to an incr in wasted vent (inefficient breathing). (PU) PU Phys
8257
Community L. pneumophila is a facultative intracellular gram (-) bacillus that can cause a systemic Pulmonary & Microbiolo 21
acquired pneumonia infection. SSx freq incl high fever, cough, confusion, and diarrhoea. The most common lab Critical Care gy (Micr)
abn seen w/ Legionella pneumonia is hyponatraemia, and sputum Gram stain often shows (PU)
many neutrophils but few or no organisms. PU Micr
8260
Interstitial lung The work of breathing is minimised in pts w/ ↑ elastic resistance (e.g. PF) when their RR is Pulmonary & Pathophysi 8
disease high and TV is low (fast, shallow breaths). In contrast, pts w/ diseases that ↑ airflow Critical Care ology
resistance (e.g. asthma, COPD) breathe at a lower RR and higher TV (slow, deep breaths) to (PU) (Patp)
minimise the work of breathing. PU Patp
8262
Obstructive sleep OSA, the most common sleep-related breathing disorder, is characterized by recurrent Pulmonary & Pathophysi 4
apnea obstruction of the upper airways. Relaxation of the oropharyngeal a/o soft palate musculature Critical Care ology
during sleep results in a fxnal collapse of the airway, producing periods of ↓ (hypopnea) or (PU) (Patp)
absent (apnea) airflow despite continued breathing efforts. PU Patp
8754
Smoking cessation Varenicline is a partial agonist of nicotinic acetylcholine receptors. It can assist patients with Pulmonary & Pharmacol 1
cessation of tobacco use by reducing withdrawal cravings and attenuating the rewarding Critical Care ogy (Phar)
effects of nicotine. (PU) PU Phar
9989
Community Klebsiella is an encapsulated, lactose-fermenting, gram (-) bacillus that appears mucoid in Pulmonary & Microbiolo 21
acquired pneumonia culture. It causes pneumonia in individuals w/ impaired host defences, esp. pts w/ Critical Care gy (Micr)
alcoholism. Klebsiella pneumonia is characterised by tissue necrosis and early abscess (PU)
formation w/ production of thick, mucoid, blood-tinged sputum (currant jelly sputum). PU Micr
10993
Actinomycosis Pulm actinomycosis develops most commonly following aspiration and can be confused w/ Pulmonary & Microbiolo 2
lung abscess, malignancy, or Tb. Micro findings incl filamentous, branching, gram (+) Critical Care gy (Micr)
bacteria and sulphur granules. (PU) PU Micr
11630
Pertussis Pertussis should be considered in any adult who hasn't had updated vax boosters. The clinical Pulmonary & Microbiolo 3
presentation is a paroxysmal cough lasting >2wks that's a/w post-tussive emesis or Critical Care gy (Micr)
inspiratory whoop after a severe coughing episode. (PU) PU Micr
11638
Nocardiosis Nocardia is a filamentous, branching, gram (+) bacteria that's partially acid-fast. It most Pulmonary & Microbiolo 1
commonly causes pneumonia and brain abscesses in immsup pts. Critical Care gy (Micr)
(PU) PU Micr
11741
Thoracentesis A chest tube for drainage of pleural effusion is placed through the skin and subcutaneous fat Pulmonary & Anatomy 2
into the 4th or 5th intercostal space in the anterior axillary or midaxillary line. The tube Critical Care (Anat)
traverses through the serratus anterior muscle, intercostal muscles, and parietal pleura. (PU) PU Anat
D eats
11752
Theophylline Theophylline is an adenosine receptor antagonist and indirect adrenergic agent with a narrow Pulmonary & Pharmacol 2
therapeutic index. It is predominantly metabolized by the hepatic cytochrome oxidases. Critical Care ogy (Phar)
Inhibition of these enzymes by concurrent illness (eg, infection with fever) or ingestion of (PU)
certain drugs or substances (eg, ciprofloxacin) can raise serum theophylline concentrations
and cause toxicity (eg, seizures, cardiac arrhythmias). PU Phar
11774
Pulmonary The lungs are supplied by dual circulation from both the pulmonary and bronchial arteries. Pulmonary & Pathophysi 13
embolism This collateral circulation can help protect against lung infarction due to pulmonary artery Critical Care ology
occlusion (ie, pulmonary embolism), as the bronchial circulation can continue to provide (PU) (Patp)
blood to the lung parenchyma. PU Patp
11845
Obstructive sleep Neuromuscular weakness of the oropharynx is involved in the pathophysiology of Pulmonary & Anatomy 4
apnea obstructive sleep apnea. Electrical stimulation of the hypoglossal nerve increases the Critical Care (Anat)
diameter of the oropharyngeal airway and decreases the frequency of apneic events. (PU) PU Anat
11900
Obesity Obesity, particularly morbid, central obesity, can cause a pattern of extrinsic restrictive PFTs. Pulmonary & Pathophysi 2
The most common indicator of obesity-related disease is a ↓ in ERV and FRC, but FEV1, Critical Care ology
FVC, and TLC are also typically ↓. (PU) (Patp) PU Patp
12082
COPD Neutrophils, macrophages, and CD8+ T lymphocytes are the 1° mediators of disease in Pulmonary & Pathophysi 16
COPD. They secrete enzymes and proteases that cause and perpetuate both the alveolar Critical Care ology
destruction of emphysema and the mucus hypersecretion found in chronic bronchitis. (PU) (Patp) PU Patp
12100
Aging Aging is a/w steady decr in chest wall compliance but incr in lung compliance due to a loss Pulmonary & Physiology 8
of elastic recoil. This results in a marked incr in RV, a decr in FVC, and relatively unchanged Critical Care (Phys)
TLC. (PU) PU Phys
12141
COPD Supplemental O2 admin in pts w/ COPD can lead to ↑ CO2 retention (O2-induced Pulmonary & Pathophysi 16
hypercapnia), resulting in confusion and depressed consciousness. The major cause is Critical Care ology
reversal of hypoxic pulm vasoconstriction, which ↑ physiologic dead space as blood is (PU) (Patp)
shunted away from well-ventilated alveoli. PU Patp
12184
Pulmonary V/Q scanning can be useful for Dx PE. A large perfusion defect w/o ventilation defect is the Pulmonary & Pathophysi 13
embolism characteristic (+) test result. Critical Care ology
(PU) (Patp) PU Patp
12293
SIADH Small cell lung cancer is a neuroendocrine malignancy associated with several paraneoplastic Pulmonary & Pathology 3
syndromes. It is the most common cause of syndrome of inappropriate antidiuretic hormone Critical Care (Path)
(SIADH) due to ectopic secretion of antidiuretic hormone. SIADH is characterized by (PU)
hyponatremia, decreased serum osmolality, and urine osmolality >100 mOsm/kg H2O. PU Path
13402
COPD Most COPD exacerbations are triggered by viral or bacterial URIs, w/ rhinovirus, influenza Pulmonary & Microbiolo 16
virus, H. influenzae, M. catarrhalis, and S. pneumoniae being among the most common Critical Care gy (Micr)
causes. (PU) PU Micr
D eats
14840
Pneumocystis Pneumocystis pneumonia is common in patients with advanced HIV and usually presents Pulmonary & Microbiolo 2
pneumonia with slowly worsening cough and dyspnea, hypoxia, and bilateral interstitial infiltrates. Critical Care gy (Micr)
Diagnosis requires visualizing the organism in respiratory secretions using special stains (eg, (PU)
silver stain). First-line treatment is trimethoprim-sulfamethoxazole. PU Micr
14847
Pulmonary arterial Pulm HTN can occur due to a 1° change in the pulm arteries (i.e. PAH) or it can be 2° to a Pulmonary & Pathophysi 8
hypertension separate disease process such as LHF (r/o by normal PCWP). Endothelin receptor Critical Care ology
antagonists (e.g. bonsetan, ambrisentan) ↓ pulm arterial pressure and improve dyspnoea in (PU) (Patp)
pts w/ PAH. PU Patp
14922
Community Alveolar consolidation occurs when the alveoli become filled w/ fluid (e.g. inflammatory Pulmonary & Pathophysi 21
acquired pneumonia exudate in bacterial pneumonia). The ↑ compactness of the alveolar fluid (compared to air) Critical Care ology
causes sound to travel faster and more efficiently, resulting in bronchophony, ↑ tactile (PU) (Patp)
fremitus (vibration), and ↑ intensity of breath sounds over the affected area. Dullness to
percussion is also present. PU Patp
14925
Haemophilus Most COPD exacerbations are caused by infection w/ an upper resp pathogen. The leading Pulmonary & Microbiolo 2
influenzae bacterial cause is H. influenzae and the leading viral cause is rhinovirus. Critical Care gy (Micr)
(PU) PU Micr
15061
Histoplasmosis Histoplasma capsulatum replicates w/i macrophages and often spreads from the lungs thru Pulmonary & Pathology 4
the pulm lymphatics to the RES (e.g. spleen, liver). Most healthy individuals quickly contain Critical Care (Path)
the infection w/i granulomas and don't become ill; a minority develop self-limited (PU)
pneumonia. Over time, the granulomas at the initial sites of infection calcify and may be seen
incidentally on radiographic imaging. PU Path
15070
Pulmonary Massive PE can lead to SCD due to a sudden loss of CO. Less commonly, SCD may result Pulmonary & Pathology 13
embolism from cardiac arrhythmia triggered by RV strain and ischemia. Critical Care (Path)
(PU) PU Path
15126
Interstitial lung Histologic findings of idiopathic pulmonary fibrosis include patchy lymphoplasmacytic Pulmonary & Pharmacol 8
disease infiltrates, focal fibroblastic proliferation with dense fibrosis, honeycombing, and hyperplasia Critical Care ogy (Phar)
of type 2 pneumocytes. Therapies are directed at slowing the progression of fibrosis by (PU)
inhibiting transforming growth factor β and other fibrogenic growth factors (eg, PDGF,
fibroblastic growth factor, and VEGF). PU Phar
15155
Asthma occup asthma is characterised by airway inflammation, bronchial hyperreactivity, and a Pulmonary & Pathophysi 12
variable airflow obstr triggered by workplace exposure. Exposure can be immu (atopic), due Critical Care ology
to exposure to a workplace aeroallergen causing a Th2-mediated IgE formation, or non- (PU) (Patp)
immu, due to exposure to workplace irritants that lead to denudation of the bronchial
mucosa. PU Patp
15156
Asthma Bronchodilators induce bronchial smooth muscle relaxation to relieve airway spasm and Pulmonary & Pathophysi 12
bronchoconstriction in pts w/ asthma. Bronchodilation is most commonly accomplished w/ Critical Care ology
β2 receptor agonists (e.g. albuterol), which fxn by ↑ cAMP lvls in bronchial smooth muscle. (PU) (Patp) PU Patp
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15206
Alpha1 antitrypsin Pts w/ advanced emphysema typically have chronic CO2 retention leading to chronic resp Pulmonary & Pathophysi 8
deficiency acid w/ meta comp (high PaCO2, comp high HCO3-, slightly acidic pH), often accompanied Critical Care ology
by hypoxaemia (PaO2 <75mmHg on room air). (PU) (Patp) PU Patp
15212
COPD Emphysema consists of alveolar destruction and enlargement that results from a combo of Pulmonary & Pathology 16
inflammation and leucocyte infiltration, ↑ protease activity, and oxidative stress, usually in Critical Care (Path)
response to exposure to cig smoke. In severe disease, large air spaces known as subpleural (PU)
blebs can form in the lung apices. PU Path
15233
COPD Chronic obstructive pulmonary disease causes air trapping and hyperinflation; consequently, Pulmonary & Pathophysi 16
these patients breathe at higher baseline lung volumes (higher functional residual capacity). Critical Care ology
The volume of air in the lungs that is not respired (residual volume) increases substantially, (PU) (Patp)
as does the fraction of air in the lungs that is not involved in respiration (residual
volume/total lung capacity ratio). PU Patp
15240
Septic shock The initial Mx of septic shock req RFR to replace intravasc volume and restore adequate Pulmonary & Physiology 6
EOP. This is best accomplished w/ IV boluses of isotonic crystalloid in the form of 0.9% Critical Care (Phys)
(normal) saline or lactated Ringer solution b/c these solutions remain in the ECS. (PU) PU Phys
15276
Opioids Acute opioid OD is characterised by altered lvl of consciousness, pinpoint pupils, and central Pulmonary & Pathophysi 13
resp depression. Pts are expected to have acute resp acidosis (low pH, high PaCO2) due to Critical Care ology
hypoventilation. Serum HCO3- is typically near normal as there isn't time for meta (PU) (Patp)
compensation in the acute setting. PU Patp
15335
Asbestos Asbestosis is a pneumoconiosis that occurs w/ inhalation of asbestos fibres, most commonly Pulmonary & Pathophysi 5
in pts w/ occup exposure (e.g. insulation installation, shipbuilding, pipe work). Histopath Critical Care ology
demonstrates diffuse interstitial fibrosis and ferruginous asbestos bodies (translucent fibres (PU) (Patp)
coated w/ a golden Fe-containing material). Pleural disease (e.g. plaques, benign effusions) is
common. PU Patp
15370
Asbestos Mesothelioma is a neoplasm arising from mesothelial cells and is strongly associated with Pulmonary & Pathophysi 5
asbestos exposure. In early mesothelioma, multiple nodules form on the parietal pleura and Critical Care ology
gradually encase the lung parenchyma. Immunohistochemistry is important for diagnosis; (PU) (Patp)
nearly all mesotheliomas stain positive for cytokeratins and many also stain positive for
calretinin. PU Patp
15420
Pleural effusion Transudative effusions are typically caused by alterations in hydrostatic or oncotic pressure Pulmonary & Pathophysi 4
(e.g. HF, cirrhosis, nephrotic syndrome), whereas exudative effusions typically result from Critical Care ology
inflammation and conseq ↑ vascular membrane permeability (e.g. infection, malignancy, (PU) (Patp)
rheumatologic disease). Exudative effusions are characterised by a high ratio of pleural fluid
to serum total protein (>0.5) or LDH (>0.6), or high absolute lvls of LDH. PU Patp
15429
Pleural effusion A pleural effusion is a collection of fluid b/w the visceral pleura that lines the lungs and the Pulmonary & Pathology 4
parietal pleura that lines the thoracic cavity. The fluid acts to insulate vibrations and sounds Critical Care (Path)
that originate in the airways of the lung; therefore, tactile fremitus and breath sounds are ↓ (PU)
over a pleural effusion. Dullness to percussion is also present. PU Path
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15430
Pleural effusion Transudative pleural effusions result from ↑ intracapillary pressure (e.g. HF) and exudative Pulmonary & Pathophysi 4
effusions develop from inflammatory disruption of the vascular membrane. Transudative Critical Care ology
pleural effusions have low fluid/serum ratios of total protein and LDH and low absolute lvls (PU) (Patp)
of LDH compared to exudative effusions. PU Patp
15611
Myasthenia gravis MG is characterised by auto-Abs against post-synaptic nAChRs at the NMJ, which result in Pulmonary & Pathophysi 10
receptor degradation. Pts typically have extraocular, bulbar, and facial weakness that worsens Critical Care ology
w/ activity. In severe cases, the resp muscles may be affected, leading to hypoventilation and (PU) (Patp)
resp failure. PU Patp
1 Poststreptococcal PSGN presents most commonly in children w/ hematuria, HTN, and periorbital oedema. Renal, Urinary Pathology 8
glomerulonephritis RBC casts and mild proteinuria may be present on UA, and serum creatinine may be ↑. & Electrolytes (Path)
(RE) RE Path
2 Congenital In horseshoe kidney, the kidneys are fused at the poles. The isthmus of the horseshoe kidney Renal, Urinary Anatomy 3
anomalies of kidneyusually lies anterior to the aorta and posterior to the inferior mesenteric artery (IMA). During & Electrolytes (Anat)
and urinary tract fetal development, the IMA limits the ascent of the horseshoe kidney. (RE) RE Anat
3 Polycystic kidney ADPKD is caused by muts in the polycystin genes (PKD1, PKD2), which result in cystic Renal, Urinary Pathology 3
disease enlargement of the kidneys and progr renal dysfxn. CFx incl HTN, abdo/flank pain, and & Electrolytes (Path)
gross hematuria; extrarenal MFxs incl liver cysts and intracranial aneurysms. (RE) RE Path
7 Anti GBM disease Goodpasture syndrome is caused by auto-Abs against the α 3 chain of type IV collagen in Renal, Urinary Pathology 2
GBM and ABMs (anti-GBM Abs). Pts typically present w/ RPGN (nephritic syndrome) and & Electrolytes (Path)
alveolar hemorrhage (SOB, hemoptysis). (RE) RE Path
8 Poststreptococcal Poststreptococcal glomerulonephritis is most common in children and presents with nephritic Renal, Urinary Histology 8
glomerulonephritis syndrome (eg, renal failure, hypertension, hematuria with red blood cell casts) 2-4 weeks & Electrolytes (Hist)
after an infection with group A β-hemolytic Streptococcus. Immunofluorescence microscopy (RE)
shows granular deposits of IgG, IgM, and C3 in the mesangium and basement membranes. RE Hist
9 Anti GBM disease Anti-glomerular basement membrane (GBM) antibodies react with collagen type IV, causing Renal, Urinary Histology 2
rapidly progressive glomerulonephritis with glomerular crescent formation on light & Electrolytes (Hist)
microscopy. Immunofluorescence demonstrating linear deposits of IgG and C3 along the (RE)
GBM is characteristic. RE Hist
10 Glomerular IgA nephropathy (Berger disease) freq presents as recurrent, self-limited, painless hematuria Renal, Urinary Pathology 9
disorders w/i 5 days of an URI. Kidney biopsy will show mesangial IgA deposits on IF. In contrast, & Electrolytes (Path)
PSGN is seen 1-3wks after streptococcal pharyngitis and is usually not recurrent. (RE) RE Path
11 Poststreptococcal PSGN is an IC-deposition disease that occurs 2-4wks after exposure to GAS (β-hemolytic) Renal, Urinary Pathology 8
glomerulonephritis species (e.g. pharyngitis, skin infection). LM shows enlarged, hypercellular glomeruli. IF & Electrolytes (Path)
demonstrates a 'lumpy-bumpy' granular deposits of IgG and C3 on the GBM, and (RE)
subepithelial, electron-dense deposits are seen on EM. RE Path
12 Poststreptococcal PSGN is the most common cause of nephritic syndrome in children. LM demonstrates Renal, Urinary Pathology 8
glomerulonephritis enlarged, hypercellular glomeruli. Lab findings in PSGN incl ↑ anti-streptococcal Abs (e.g. & Electrolytes (Path)
ASO, anti-DNase B) and ↓ C3 and total complement lvls. C4 lvls are usually normal. (RE) RE Path
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13 Granulomatosis Pauci-immune rapidly progressive glomerulonephritis frequently occurs as a manifestation of Renal, Urinary Pathology 2
with polyangiitis antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (eg, granulomatosis & Electrolytes (Path)
with polyangiitis, microscopic polyangiitis). It is characterized by glomerular crescent (RE)
formation without immunoglobulin or complement deposits. RE Path
24 Glomerular Crescent formation on LM is Dx for RPGN. Crescents consist of glomerular parietal cells, Renal, Urinary Pathology 9
disorders lymphocytes, and macrophages along w/ abundant fibrin deposition. Crescents eventually & Electrolytes (Path)
become fibrotic, disrupting glomerular fxn and causing irreversible renal injury. (RE) RE Path
25 Poststreptococcal PSGN presents w/ oedema, HTN, and hematuria after a streptococcal infection. Most Renal, Urinary Pathology 8
glomerulonephritis children recover completely, but adult pts have a relatively poor prognosis and higher risk of & Electrolytes (Path)
chronic HTN and renal insufficiency. (RE) RE Path
27 Poststreptococcal Poststreptococcal glomerulonephritis is an immune complex-mediated disease that occurs 2- Renal, Urinary Histology 8
glomerulonephritis 4 weeks after group A β-hemolytic Streptococcus infection. Immune complexes composed of & Electrolytes (Hist)
IgG, IgM, and C3 are deposited along the glomerular basement membrane and are visible on (RE)
electron microscopy as large, dome-shaped, subepithelial, electron-dense deposits. RE Hist
28 Glomerular MCD is the most common childhood nephrotic syndrome. ↑ glomerular cap permeability Renal, Urinary Pathology 9
disorders causes massive protein (e.g. albumin) loss in the urine. Hypoalbuminaemia ↓ plasma oncotic & Electrolytes (Path)
pressure, which causes a fluid shift into the interstitial space, resulting in oedema. Low (RE)
oncotic pressure also triggers ↑ LP production in the liver (i.e. hyperlipidaemia). RE Path
151Diabetic The risk of progression of DN in pts w/ proteinuria can be decr by approp glycemic and BP Renal, Urinary Pharmacol 4
nephropathy control. ACEIs and ARBs are the pref antiHTN agents due to their antiproteinuric effects, & Electrolytes ogy (Phar)
which're independent from their effects on syst BP. (RE) RE Phar
152Hyperaldosteronism Aldo excess will cause HTN, hypokalemia, meta alk, and depressed renin. Alt, hypoaldo-ism Renal, Urinary Pharmacol 5
is the cause of RTA-IV. Aldo antags such as spironolactone or eplerenone can be used as & Electrolytes ogy (Phar)
med therapy for Conn syndrome. (RE) RE Phar
178Necrosis Lethal tissue ischemia causes coag necrosis in most tissues (e.g. kidney, myocardium); Renal, Urinary Pathology 3
cellular architecture is maintained but nuclei are absent. The exception is ischemic cell death & Electrolytes (Path)
in the CNS, which causes liquefactive necrosis. (RE) RE Path
211Diabetes insipidus Pts w/ DI are unable to concentrate their urine in response to dehydration. Following Renal, Urinary Pathology 4
desmopressin admin during the water deprivation test, urine osmolality ↑ to normal lvls in & Electrolytes (Path)
CDI but doesn't change in complete NDI. (RE) RE Path
229Endocarditis The most likely cause of fever and fatigue w/ new-onset cardiac murmur is IE. DPGN 2° to Renal, Urinary Pathology 15
circulating IC deposition may complicate IE and can result in acute renal insufficiency. & Electrolytes (Path)
(RE) RE Path
382Glomerular MG is a common cause of nephrotic syndrome in adults and can occur in a/w solid Renal, Urinary Pathology 9
disorders malignancy, viral hepatitis, and SLE. IC deposition in the subepithelial portion of the & Electrolytes (Path)
glomerular cap wall causes diffuse thickening of the GBM (w/o ↑ cellularity); these deposits (RE)
have a 'spike and dome' appearance when stained w/ silver stains. RE Path
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383Glomerular MCD is the most common cause of nephrotic syndrome in children. Systemic T-cell dysfxn Renal, Urinary Pathology 9
disorders leads to the production of glomerular permeability factor, which causes podocyte foot & Electrolytes (Path)
process fusion and ↓ the anionic properties of the GBM. The loss of (-) charge leads to (RE)
selective albuminuria. RE Path
384Glomerular MCD is the most common cause of nephrotic syndrome in children. Classic MFxs incl Renal, Urinary Pathology 9
disorders proteinuria, hypoalbuminaemia, and oedema that're usually reversible w/ corticosteroids. The & Electrolytes (Path)
principal lesion is a diffuse foot process effacement that can be seen on EM. LM and IF are (RE)
normal. RE Path
385Glomerular MCD is cause by immune dysregulation and overproduction of glomerular permeability Renal, Urinary Pathology 9
disorders factor, which dmgs podocytes and ↓ the anionic properties of the GBM. This results in & Electrolytes (Path)
selective loss of albumin in the urine, in contrast to the nonselective proteinuria in other (RE)
forms of nephrotic syndrome. RE Path
455Hypertensive Homogeneous deposition of eosinophilic hyaline material in the intima and media of small Renal, Urinary Pathology 1
nephropathy arteries and arterioles characterises hyaline arteriolosclerosis. This is typically produced by & Electrolytes (Path)
un-Tx or poorly controlled HTN a/o DM. (RE) RE Path
546Transplant rejection Organ rejection can be hyperacute, acute, or chronic. Acute rejection most often occurs Renal, Urinary Immunolo 4
within weeks or up to 6 months after transplant and is predominantly cell-mediated, & Electrolytes gy (Immu)
involving sensitization of host T lymphocytes against donor MHC antigens. There is (RE)
typically graft dysfunction with histology showing a dense, mononuclear (ie, lymphocytic)
infiltrate. RE Immu
567Poststreptococcal Poststreptococcal glomerulonephritis is the most common cause of nephritic syndrome (eg, Renal, Urinary Immunolo 8
glomerulonephritis hematuria, edema, hypertension) in children, typically occurring 2-4 weeks after a & Electrolytes gy (Immu)
streptococcal infection (eg, impetigo, cellulitis, pharyngitis). It is caused by a type III (RE)
(immune-complex-mediated) hypersensitivity reaction resulting from nephritogenic strains
of group A β-hemolytic Streptococcus. RE Immu
652Congenital The urachus is a remnant of the allantois that connects the bladder with the yolk sac during Renal, Urinary Embryolog 3
anomalies of kidney fetal development. Failure of the urachus to obliterate at birth results in a patent urachus, & Electrolytes y (Embr)
and urinary tract which can facilitate discharge of urine from the umbilicus. (RE) RE Embr
681Loop diuretics LoopDs act by inhib the Na+K+2Cl- cotransporter in the thick asc limb of the LOH, incr Renal, Urinary Pharmacol 3
Na+, Cl-, and water excretion. They're the most potent diuretics and are used as 1st-line & Electrolytes ogy (Phar)
therapy for rapid relief of SSx in pts w/ acute DHF. (RE) RE Phar
682Acetazolamide CA is found in high conc in the PCT and is responsible for catalyzing rxns necessary for Renal, Urinary Pharmacol 1
NaHCO3 reabs. Acetazolamide is a diuretic that works by inhib CA, which effectively & Electrolytes ogy (Phar)
blocks NaHCO3 and water reabs in the PCTs resulting in urinary HCO3- wasting. CAIs are (RE)
also used to relieve IOP in open-angle and angle-closure glaucoma. RE Phar
683Thiazides TZDs work by blocking Na+Cl- symporters in the DCTs, causing enhanced Na+, Cl-, and Renal, Urinary Pharmacol 3
water excretion. Since only a small amount of filtered Na+ reaches the DCTs, TZD aren't as & Electrolytes ogy (Phar)
efficacious as loopDs. Unlike loopDs, TZDs can cause hypercalcemia. (RE) RE Phar
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684Loop diuretics Furosemide is a loop diuretic that works by inhib Na+-K+-2Cl- symporters in the LOH Renal, Urinary Physiology 3
effectively causing ↑ Na+, Cl-, and fluid excretion. Addnally, loop diuretics also stim PG & Electrolytes (Phys)
release. By stim renal PG release, loop diuretics also ↑ RBF leading to ↑ GFR and enhanced (RE)
drug delivery. Thus concurrent use of NSAIDs w/ loop diuretics can result in a ↓ diuretic
response. RE Phys
685Loop diuretics Ototox 2ary to loopDs usually occurs w/ higher dosages, pre-existing CKD, rapid IV admin, Renal, Urinary Pharmacol 3
or when used in combo w/ other ototox agents (aminoglycosides, salicylates, and cisplatin). & Electrolytes ogy (Phar)
Hearing impairment is usually rev but may be permanent in some cases. (RE) RE Phar
687Gynecomastia Spironolactone is an aldo antag commony used to Tx HF. It has significant antiandrogenic Renal, Urinary Pharmacol 3
effects and can cause gynecomastia, decr libido, and impotence. Eplerenone is a more & Electrolytes ogy (Phar)
selective aldo antag w/ fever AEs. (RE) RE Phar
688Mannitol Mannitol is an osmoD that works by incr plasma or tubular fluid osmolality. Incr plasma and Renal, Urinary Pharmacol 1
fluid osmolality causes extraction of water from the interstitial space into the vasc space or & Electrolytes ogy (Phar)
tubular lumen, w/ subseq diuresis. In the brain, water redistribution from the tissues into the (RE)
plasma helps decr edema and ICP in the setting of cerebral edema. 1 of the more severe tox
of aggressive osmoDs is pulm edema. RE Phar
690Renin angiotensin ACEIs block the effect of ACE, decr AT-II and aldo lvls. By decr AT-II lvls, ACEIs directly Renal, Urinary Pharmacol 1
aldosterone system interrupt (-) fb loops, thereby incr renin and AT-I lvls. ACE is also responsible for the & Electrolytes ogy (Phar)
breakdown of bradykinin; ACEIs therefore incr bradykinin lvls. (RE) RE Phar
692Beta blockers Beta-adrenergic blocking drugs inhib renin release by blocking beta1 receptor-mediated Renal, Urinary Pharmacol 3
regulation of the RAAS. This decr PRA, w/ a resulting decr in AT-I, AT-II, and aldo lvls. & Electrolytes ogy (Phar)
(RE) RE Phar
694ACE inhibitors Pts w/ bilateral RAS have decr renal perfusion (due to atherosclerotic blockage) and are Renal, Urinary Pharmacol 7
dependent upon AT-II-induced eff vasocon to maint GFR. ACEIs block AT-II-mediated & Electrolytes ogy (Phar)
vasocon, which can decr syst BP and decr renal perfusion. In addn, ACEIs cause dilation of (RE)
the eff art, leading to a decr in GFR and RFF. RE Phar
695Renal artery In RAS, incr production of AT-II causes incr syst BP (to incr renal perfusion) and pref Renal, Urinary Pharmacol 9
stenosis constriction of the glom eff art (to incr GFR). Pts w/ bilateral RAS are dependent on this & Electrolytes ogy (Phar)
response to maint renal fxn; initiation of ACEIs or ARBs can precip ARF. However, UA is (RE)
typically u/r (i.e. no hematuria, proteinuria, or casts). RE Phar
696ACE inhibitors ACEIs decr AT-II lvls and cause eff art dilation, thereby decr the GFP and GFR. This can Renal, Urinary Pharmacol 7
precip ARF in pts w/ decr intrarenal perfusion pressure at baseline (e.g. RAS, CHF, & Electrolytes ogy (Phar)
hypovolemia). (RE) RE Phar
744Transplant rejection Chronic renal allograft rejection manifests months to years after a transplant and presents Renal, Urinary Immunolo 4
with worsening hypertension and a gradual decline in renal function. It involves a chronic, & Electrolytes gy (Immu)
antibody mediated response against donor antigens and leads to obliterative vascular wall (RE)
thickening, tubular atrophy, and interstitial fibrosis. The process is usually irreversible and
eventually leads to graft failure. RE Immu
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747Blood transfusion Acute hemolytic transfusion reaction is a antibody-mediated (type II) hypersensitivity Renal, Urinary Immunolo 2
reaction caused by pre-existing anti-ABO antibodies that bind antigens on transfused donor & Electrolytes gy (Immu)
erythrocytes. Subsequent complement activation results in erythrocyte lysis, vasodilation, (RE)
and symptoms of shock. Common findings include fever, hypotension, chest and back pain,
and hemoglobinuria. RE Immu
758Henoch-Schonlein Henoch-Schönlein purpura is an IgA-mediated type III hypersensitivity reaction in children Renal, Urinary Immunolo 3
purpura that generally follows infection. Deposition of circulating IgA-containing immune complexes & Electrolytes gy (Immu)
in small vessels results in systemic vasculitis. Common manifestations include palpable (RE)
lower-extremity purpura, abdominal pain, arthralgias, and hematuria. RE Immu
810Atheroembolism Invasive vascular procedures can be complicated by atheroembolic disease, which may Renal, Urinary Pathology 2
involve the kidneys, GIT, CNS, and the skin. LM show a partially or completely obstructed & Electrolytes (Path)
arterial lumen w/ needle-shaped chol clefts w/i the atheromatous embolus. (RE) RE Path
811Benign prostatic Benign prostatic hyperplasia leads to progressive bladder outlet obstruction. Over time, Renal, Urinary Pathology 6
hyperplasia increased urinary pressures can cause hydronephrosis and renal parenchymal atrophy with & Electrolytes (Path)
scarring. This can progress to chronic kidney disease. (RE) RE Path
813Renal calculi Hypercalciuria is the most common RFx for Ca (Ca oxalate and Ca PO4) kidney stones in Renal, Urinary Pathophysi 7
adults; contributing factors may include ↑ GI absorption, ↑ mobilization of Ca from bone, or & Electrolytes ology
↓ renal tubular Ca reabsorption. However, most pts remain normocalcemic due to regulation (RE) (Patp)
of plasma Ca levels by vitamin D and PTH. RE Patp
814Cystinuria Cystinuria results from defective dibasic AA transport in intestinal and PCT epithelial cells. Renal, Urinary Pathology 2
It most often presents w/ recurrent stone formation at a young age due to ↓ reabsorption of & Electrolytes (Path)
cysteine from the urine. UA shows pathognomonic hexagonal cystine crystals, and the Na+ (RE)
cyanide-nitroprusside test can be used to detect excess cystine in the urine. RE Path
815Cystinuria Cystinuria is an autosomal recessive disorder caused by defective transportation of cystine, Renal, Urinary Pathophysi 2
ornithine, arginine, and lysine across the intestinal and renal tubular epithelium. Recurrent & Electrolytes ology
nephrolithiasis is the only clinical manifestation. Urinalysis shows pathognomonic hexagonal (RE) (Patp)
cystine crystals. RE Patp
816Renal calculi Urine supersaturation is the main mech underlying all types of renal stones. Low fluid intake Renal, Urinary Pathology 7
↑ the conc of stone-forming agents, thereby promoting stone formation. All pts w/ & Electrolytes (Path)
nephrolithiasis should be advised to maintain adequate fluid intake. (RE) RE Path
817Renal calculi Renal calculi occur due to an imbalance of factors that facilitate or inhib stone formation. ↑ Renal, Urinary Pathology 7
urinary concs of Ca2+, oxalate, and uric acid promote salt crystallisation, whereas ↑ urinary & Electrolytes (Path)
citrate conc and high fluid intake prevent calculi formation. (RE) RE Path
818Renal cell CCC is the most common subtype of RCC and is composed of large, rounded, or polygonal Renal, Urinary Pathology 8
carcinoma cells w/ clear cytoplasm. These tumours are often detected incidentally at an advanced stage; & Electrolytes (Path)
the lung is the most common site for mets, f/b osteolytic bone and liver. (RE) RE Path
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831Urinary tract Suppression of endogenous flora, colonization of the distal urethra by pathogenic gram- Renal, Urinary Pathophysi 12
infection negative rods, and attachment of these pathogens to the bladder mucosa are the stages of & Electrolytes ology
pathogenesis in lower urinary tract infections. Anatomic or functional vesicoureteral reflux is (RE) (Patp)
almost always necessary for the development of acute pyelonephritis. RE Patp
832Renal artery Marked unilateral kidney atrophy is suggestive of renal artery stenosis. It occurs in elderly Renal, Urinary Pathology 9
stenosis individuals due to atherosclerotic narrowing of the renal artery and is often seen in & Electrolytes (Path)
association with other atherosclerotic risk factors or diseases (eg, chronic mesenteric (RE)
ischemia, coronary artery disease, peripheral vascular disease). Hypertension and abdominal
and flank bruits are often present. RE Path
833Vesicoureteral VUR is caused by retrograde urine flow from the bladder into the ureter. The hydrostatic Renal, Urinary Pathology 1
reflux pressure of refluxing urine along w/ infections due to ascending bacteria causes & Electrolytes (Path)
inflammation. The compound papillae in the upper and lower poles of the kidney are most (RE)
susceptible to reflux-induced dmg, which appears as dilated calyces w/ overlying renal
cortical scarring. RE Path
834Renal papillary RPN classically presents w/ gross hematuria, acute flank pain, and passage of tissue Renal, Urinary Pathology 1
necrosis fragments in urine. It's most commonly seen in pts w/ SCD or trait, DM, analgesic & Electrolytes (Path)
nephropathy, or severe OPN. (RE) RE Path
835Acute interstitial Fever, maculopapular rash, and ARF occurring 1-3wks after beginning a new Rx (e.g. Abx, Renal, Urinary Pathology 2
nephritis PPIs) is highly suggestive of AIN. peri eosinophilia, sterile pyuria, eosinophiluria, and WBC & Electrolytes (Path)
casts may also be seen. Histo reveals leucocyte infiltration and oedema of the renal (RE)
interstitium. RE Path
837Urinary tract Inadequate canalization of the ureteropelvic junction, the connection site between the kidney Renal, Urinary Embryolog 4
obstruction and the ureter, is the most common cause of unilateral fetal hydronephrosis. & Electrolytes y (Embr)
(RE) RE Embr
884Diabetic NGS is characterised by GBM thickening, ↑ mesangial matrix deposition, and formation of Renal, Urinary Pathology 4
nephropathy Kimmelstiel-Wilson (KW) nodules. It's most common caused by diabetic nephropathy and & Electrolytes (Path)
indicates irreversible glomerular dmg w/ a rapid decline in kidney fxn. (RE) RE Path
885Acute kidney injury ATN is caused by renal ischemia and is characterised by oliguria, ↑ serum creatinine, and Renal, Urinary Pathology 5
muddy brown casts. Ischemic injury predominantly affects the renal medulla, which has a & Electrolytes (Path)
relatively low blood supply. The terminal (straight) portion of the proximal tubules and the (RE)
thick ascending limb of the LOH are the most commonly involved portions of the nephron
due to their high meta rate and location w/i the medulla. RE Path
886Acute kidney injury ATN is characterised by tubular injury due to renal ischemia or direct cytotoxicity. The Renal, Urinary Pathology 5
course of the disease can be broken into 3 stages: initiation (initial insult), maintenance & Electrolytes (Path)
(oliguric renal failure), and recovery. During the recovery period, GFR improves prior to (RE)
restoration of renal tubular resorptive capacity, so transient polyuria and electrolyte wasting
(e.g. hypokalaemia) can occur. RE Path
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887Acute kidney injury Ethylene glycol ingestion causes ATN w/ vacuolar degen and ballooning of the PCT cells. Renal, Urinary Pathology 5
Typical clinical findings incl AMS, ARF, high AGMA, ↑ osmolar gap, and Ca2+-oxalate & Electrolytes (Path)
crystals in the urine. (RE) RE Path
888Urinary tract Pyuria and bacteriuria are found in both upper and lower UTIs. However, WBC casts only Renal, Urinary Pathology 12
infection form in the renal tubules and are pathognomonic for acute pyelonephritis (APN) when & Electrolytes (Path)
accompanied by SSx of acute UTI. (RE) RE Path
904Renal cell Sporadic and hereditary (a/w vHL disease) RCCs are a/w mutations involving the VHL gene Renal, Urinary Genetics 8
carcinoma on chromosome 3p. The VHL gene is a tumor suppressor that inhibits hypoxia-inducible & Electrolytes (Gene)
factors; mutations lead to constitutive activation of these proteins, resulting in the activation (RE)
of multiple angiogenic and tumorigenic growth factors (eg, VEG-F, PDG-F). RE Gene
905Renal cell CCC is the most common type of RCC and originates from the epithelial cells of the Renal, Urinary Pathology 8
carcinoma proximal renal tubules. Gross pathology typically demonstrates a sphere-like mass composed & Electrolytes (Path)
of golden-yellow cells (due to high lipid content) w/ areas of necrotic cells and focal (RE)
hemorrhage. RE Path
956Metabolic alkalosis Metabolic alkalosis is characterized by a high arterial blood pH, HCO3, and pCO2. Renal, Urinary Pathophysi 1
Vomiting/nasogastric suctioning and thiazide/loop diuretic use cause volume and Cl & Electrolytes ology
depletion, resulting in metabolic alkalosis that is saline-responsive. In contrast, (RE) (Patp)
hyperaldosteronism leads to metabolic alkalosis that is saline-unresponsive. Determining the
patient's volume status and measuring the urinary chloride concentration can help to identify
the cause of metabolic alkalosis. RE Patp
978Hypercalcemia Serum calcium >13 mg/dL is suggestive of an underlying malignancy. Secretion of Renal, Urinary Pathophysi 5
parathyroid hormone-related protein (PTHrP), which closely resembles parathyroid hormone & Electrolytes ology
at the bioactive amino-terminal region, is a frequent cause of malignancy-related (RE) (Patp)
hypercalcemia and is commonly seen with squamous cell carcinomas (eg, lung, neck). RE Patp
979Chronic kidney CKD usually causes hyperphosphataemia (binds serum Ca2+) and low 1,25-dihydroxyvit D Renal, Urinary Pathology 8
disease (↓ intestinal Ca2+ absorption and Ca2+ release from bone). The resulting hypocalcaemia & Electrolytes (Path)
stims release of PTH, causing 2° hyperparathyroidism. (RE) RE Path
1016
Prerenal azotemia Hypovolaemia results in a ↓ renal plasma flow (RPF) and GFR. This leads to compensatory Renal, Urinary Pathology 6
efferent arteriolar vasoconstriction, which raises the filtration fraction and maintains GFR at & Electrolytes (Path)
near-normal lvls. As RPF continues to decline, ↑ glomerular oncotic pressure will eventually (RE)
overwhelm the compensatory ↑ in hydrostatic pressure, leading to a precipitous drop in GFR
and ARF. RE Path
1017
GFR Selective vasoconstriction of the efferent arteriole (up to certain extent) ↑ hydrostatic Renal, Urinary Physiology 6
pressure in the glom caps, and therefore ↑ the GFR. As efferent arteriolar constriction & Electrolytes (Phys)
continues to ↑, the GFR begins to ↓ due to a flow-mediated rise in oncotic pressure in the (RE)
glom caps. The FF always ↑ w/ ↑ efferent arteriole constriction. RE Phys
1043
Diabetes insipidus The asc. limb of the LOH is impermeable to water regardless of serum ADH lvls. Renal, Urinary Physiology 4
Reabsorption of electrolytes by the Na+/K+/2Cl-cotransporter occurs in the thick asc. limb & Electrolytes (Phys)
and contributes to formation of the corticomedullary conc gradient. (RE) RE Phys
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1049
NSAIDs Analgesic nephropathy is a form of CKD caused by prolonged, heavy intake of NSAIDs a/o Renal, Urinary Pathology 4
acetaminophen. Path chars incl CIN and RPN. & Electrolytes (Path)
(RE) RE Path
1050
Acute urate Tumor lysis syndrome occurs when tumors with a high cell turnover are treated with Renal, Urinary Pathophysi 1
nephropathy chemotherapy. The lysis of tumor cells causes intracellular ions, such as potassium and & Electrolytes ology
phosphorous, and uric acid (metabolite of tumor nucleic acid) to be released into serum. Uric (RE) (Patp)
acid is soluble at physiologic pH, but it can precipitate in the normally acidic environment of
distal tubules and collecting ducts. The prevention of tumor lysis syndrome includes urine
alkalinization and hydration, as high urine flow and high pH along the nephron prevents
crystallization and precipitation of uric acid. RE Patp
1052
Polycystic kidney ADPKD MFx in pts 40-50 y/o w/ enlarged kidneys, HTN, and ARF. In newborns, the Renal, Urinary Pathology 3
disease kidneys are of normal size, and the cysts are too small to be detected on abdo US. As the & Electrolytes (Path)
cysts enlarge, they compress the renal parenchyma and cause SSx. (RE) RE Path
1053
Acute kidney injury Most pts w/ ATN experience tubular re-epithelialisation and regain renal fxn. However, Renal, Urinary Pathology 5
when ATN is a/w multiorgan failure, renal fxn may be permanently impaired; in such pts, & Electrolytes (Path)
foci of interstitial scarring can be seen on LM. (RE) RE Path
1054
Multiple myeloma MM should be suspected in elderly pts w/ any combo of hypercalcaemia, normocytic Renal, Urinary Pathology 9
anaemia, bone pain, ↑ γ gap, or renal failure. Renal failure is commonly caused by light chain & Electrolytes (Path)
cast nephropathy; large, waxy, eosinophilic casts composed of BJ proteins are seen in the (RE)
tubular lumen. RE Path
1096
Urinary tract Urinary tract infections are most common in women and are typically caused by enteric Renal, Urinary Microbiolo 12
infection pathogens. Escherichia coli is the leading pathogen. & Electrolytes gy (Micr)
(RE) RE Micr
1146
Urinary tract Pseudomonas aeruginosa is an oxidase (+), non-lactose-fermenting, Gram (-) organism. It is Renal, Urinary Microbiolo 12
infection a common cause of UTIs in pts w/ indwelling bladder catheters. & Electrolytes gy (Micr)
(RE) RE Micr
1148
Primary Common AEs of ACEIs incl decr GFR, hyperkalemia, and cough. Angioedema is a rare, but Renal, Urinary Pharmacol 14
hypertension life-thr, AE. & Electrolytes ogy (Phar)
(RE) RE Phar
1161
Urinalysis ADH acts on the medullary segment of the CD to ↑ urea and water reabsorption, allowing for Renal, Urinary Physiology 2
the production of max concentrated urine. & Electrolytes (Phys)
(RE) RE Phys
1211
Urinary retention Postop urinary retention, w/ incomplete bladder emptying, is a common complication Renal, Urinary Pharmacol 4
thought to involve decr micturition reflex activity, decr contractility of the bladder detrusor, & Electrolytes ogy (Phar)
a/o incr vesical sphincter tone. This condition may be Tx w/ a musc ag (bethanechol) or an (RE)
alpha1 blocking drug. RE Phar
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1354
GFR The net filtration pressure is calculated by the following equation: NFP = (Pc- Pi) - (πc- πi). Renal, Urinary Physiology 6
& Electrolytes (Phys)
(RE) RE Phys
1425
Hypokalemia Thiazide diuretics decrease intravascular fluid volume, which stimulates aldosterone Renal, Urinary Pharmacol 2
secretion and leads to increased excretion of potassium and hydrogen ions in the urine. This & Electrolytes ogy (Phar)
results in hypokalemia and metabolic alkalosis. (RE) RE Phar
1524
Hypovolemia Regardless of the pt's hydration status, the majority of water reabsorption in the nephron Renal, Urinary Physiology 1
occurs in the PCT passively w/ the reabsorption of solutes. & Electrolytes (Phys)
(RE) RE Phys
1533
Aldosterone Aldo is a component of the RAAS that acts on the principal and intercalated cells of the renal Renal, Urinary Pharmacol 3
antagonists CDs to cause resorption of Na+ and water and loss of K+ and H+ ions. Aldo receptor antags & Electrolytes ogy (Phar)
(e.g. spironolactone, eplerenone) inhib these effects. (RE) RE Phar
1554
Urinalysis Most of the K+ filtered by the glomeruli is resorbed in the proximal tubule and loop of Renal, Urinary Physiology 2
Henle. The late distal and cortical collecting tubules are the primary sites for regulation of & Electrolytes (Phys)
K* concentration in the urine. K depletion stimulates a-intercalated cells to reabsorb extra (RE)
potassium; principal cells secrete K under conditions of normal or increased K load. RE Phys
1555
Filtration fraction The GFR can be estimated by the insulin or creatinine clearance, while the RPF is calculated Renal, Urinary Physiology 2
using the PAH clearance. The FF (FF = GFR / RPF) is the fraction of the RPF that's filtered & Electrolytes (Phys)
across the glom caps into BS. It's usually equal to 20% in healthy individuals. (RE) RE Phys
1556
Renal blood flow The RBF refers to the volume of blood that flows thru the kidney per unit time and can be Renal, Urinary Physiology 1
calculated by dividing the RPF by (1 - Hct). & Electrolytes (Phys)
(RE) RE Phys
1559
Glucose clearance Glc is normally filtered at the glom and completely reabsorbed by the PCT. Inhib of Na+- Renal, Urinary Physiology 1
coupled, carrier-mediated transport of Glc by the PCT would cause the Glc clearance to & Electrolytes (Phys)
approach the value of the GFR, which is typically estimated by calculating the clearance of (RE)
inulin. RE Phys
1577
Glomerular Frothy or foamy urine may be caused by proteinuria. Heavy proteinuria, as in nephrotic Renal, Urinary Pathophysi 9
disorders syndrome, can cause regional or generalized interstitial edema because the decrease in serum & Electrolytes ology
albumin and total protein concentrations lowers the plasma oncotic pressure and increases (RE) (Patp)
net plasma filtration in capillary beds. RE Patp
1588
Para-aminohippuric PAH is 1arily secreted into the nephron by the PCT, but some is also freely filtered by the Renal, Urinary Physiology 1
acid glom. PAH isn't reabsorbed by any portion of the nephron. Therefore, tubular fluid conc of & Electrolytes (Phys)
PAH is lowest in BS. (RE) RE Phys
1607
Nephron osmolarity ADH acts 1arily on the CDs, ↑ their permeability to water. In the absence of ADH, the Renal, Urinary Physiology 2
tubular fluid is most concentrated at the junction b/w the desc. and asc. limbs of the LOH and & Electrolytes (Phys)
most dilute in the CDs. (RE) RE Phys
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1608
Nephron osmolarity Dehydration stim ADH secretion. ADH acts on the CDs, ↑ their permeability to water. Thus, Renal, Urinary Physiology 2
in the presence of ADH, the CDs contain the most concentrated fluid in the nephron, while & Electrolytes (Phys)
the DCT contains the most dilute fluid. (RE) RE Phys
1617
GFR The concs of PAH, creatinine, inulin, and urea ↑ as fluid runs along the PCT, while the concs Renal, Urinary Physiology 6
of HCO3-, Glc, and AAs ↓. & Electrolytes (Phys)
(RE) RE Phys
1618
GFR ↑ in the cap hydrostatic pressure or the BS oncotic pressure will ↑ GFR, while ↑ in cap Renal, Urinary Physiology 6
oncotic pressure or BS hydrostatic pressure will ↓ GFR. The FF can be calculated by & Electrolytes (Phys)
dividing the GFR by the RPF. ↑ in GFR or ↓ in RPF will ↑ the FF. (RE) RE Phys
1619
PAH clearance PAH is freely filtered from the blood in the glom caps to the tubular fluid in BS. It's also Renal, Urinary Physiology 1
secreted from the blood into the tubular fluid by the cells of the PCT by a carrier protein- & Electrolytes (Phys)
mediatedprocess. The secretion of PAH can be saturated at high blood concs. (RE) RE Phys
1651
GFR Acuteureteral constriction or obstr ↓ the GFR and FF. Renal, Urinary Physiology 6
& Electrolytes (Phys)
(RE) RE Phys
1663
Chronic kidney Pts w/ CKD may develop renal osteodystrophy from 2° hyperparathyroidism (caused by Renal, Urinary Pathology 8
disease hyperphosphataemia and hypocalcaemia). & Electrolytes (Path)
(RE) RE Path
1680
Ureter injury The proximal ureter receives its blood supply from the renal artery whereas the distal ureter Renal, Urinary Anatomy 3
is supplied by the superior vesical artery. Circulation to the middle portions of the ureter is & Electrolytes (Anat)
variable and anastomotic. (RE) RE Anat
1700
Rib fracture The left kidney lies immediately deep to the tip of the 12th rib. Renal, Urinary Anatomy 1
& Electrolytes (Anat)
(RE) RE Anat
1736
Congenital The metanephros (metanephric blastema) gives rise to the glomeruli, Bowman's space, Renal, Urinary Embryolog 3
anomalies of kidney proximal tubules, the loop of Henle, and distal convoluted tubules. The ureteric bud becomes & Electrolytes y (Embr)
and urinary tract the collecting system of the kidney, including the collecting tubules and ducts, major and (RE)
minor calyces, renal pelvis, and the ureters. RE Embr
1752
Potter sequence Potter sequence results from a renal anomaly that causes decreased fetal urine output leading Renal, Urinary Embryolog 1
to oligohydramnios. The lack of amniotic fluid causes compression of the fetus & Electrolytes y (Embr)
(characteristic facies and limb abnormalities) and pulmonary hypoplasia, which is the most (RE)
common cause of death in affected infants. RE Embr
1804
Ureter injury The ureters pass posterior to the ovarian (gonadal) vessels within the retroperitoneum and Renal, Urinary Anatomy 3
cross anterior to the common/external iliac arteries to reach the true pelvis. Within the true & Electrolytes (Anat)
pelvis, the ureters lie anterior to the internal iliac artery and posterior to the uterine artery. (RE) RE Anat
1841
ACE inhibitors In the kidney, angiotensin II preferentially constricts the efferent arteriole, thereby Renal, Urinary Pathophysi 7
maintaining the glomerular filtration rate (GFR) within normal range. ACE-inhibitors & Electrolytes ology
promote efferent arteriolar dilation, causing GFR reduction. (RE) (Patp) RE Patp
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1849
Hemolytic uremic HUS is a common cause of ARF in children. It's characterised by the triad of MAHA, Renal, Urinary Pathology 3
syndrome thrombocytopaenia, and AKI. Most cases develop following a diarrhoeal illness caused by & Electrolytes (Path)
Shiga toxin-producing organisms (e.g. E. coli O157:H7, S. dysenteriae). (RE) RE Path
1850
Henoch-Schonlein HSP gen affects young children and is classically preceded by an URI. This IgA-mediated Renal, Urinary Pathology 3
purpura HS (leucocytoclastic) vasculitis commonly causes abdo pain, joint pain, lower extremity & Electrolytes (Path)
palpable purpura and hematuria. (RE) RE Path
1862
Renal cell The most common renal malignancy is CCC, which arises from renal PCT cells. Rounded or Renal, Urinary Pathology 8
carcinoma polygonal cells w/ abundant clear cytoplasm are seen on LM. 'Clear cells' are gen those w/ a & Electrolytes (Path)
high glycogen or lipid content that dissolves during routine tissue prep. (RE) RE Path
1913
Diabetic Moderately ↑ albuminuria (urine albumin 30-300mg/day) is the earliest MFx of diabetic Renal, Urinary Pathology 4
nephropathy nephropathy (DN). Screening for DN is best achieved using an albumin-specific urine assay & Electrolytes (Path)
(regular dipstick UA has low sensitivity). (RE) RE Path
1915
Polycystic kidney In its most severe phenotype, autosomal recessive polycystic kidney disease can be detected Renal, Urinary Embryolog 3
disease on prenatal sonogram along with oligohydramnios. Potter sequence (flattened facies, limb & Electrolytes y (Embr)
deformities, pulmonary hypoplasia) is caused by oligohydramnios and is associated with (RE)
high mortality. RE Embr
1916
Urinary tract The ureters run in close proximity to the pelvic LNs and the uterine artery in the female Renal, Urinary Pathology 4
obstruction pelvis, which predisposes them to injury during pelvic surgery. & Electrolytes (Path)
(RE) RE Path
1982
Filtration fraction The FF is the fraction of plasma flowing through the glomeruli that is filtered across the Renal, Urinary Physiology 2
glomerular capillaries into Bowman's space (FF = GFR/RPF). RPF can be determined from & Electrolytes (Phys)
RBF by multiplying the RBF by (1 – Hct). (RE) RE Phys
1988
Diffusion Diffusion speed across a semipermeable membrane ↑ w/ higher molecular concgradients, Renal, Urinary Physiology 1
larger membrane SAs, and ↑ solubility of the diffusing substance. Diffusion speed ↓ w/ ↑ & Electrolytes (Phys)
membrane thickness, smaller pore size, higher molecular weights, and lower temps. (RE) RE Phys
2003
Thiazides TZDs effectively incr renal Ca2+ reabs. In pts w/ recurrent Ca2+ nephrolith, TZDs can help Renal, Urinary Pharmacol 3
prevent stone formation by decr urine Ca2+ excretion. & Electrolytes ogy (Phar)
(RE) RE Phar
2008
Diabetic The kidneys compensate for meta acidosis by completely reabsorbing filtered HCO3- and Renal, Urinary Physiology 6
ketoacidosis excreting excess H+ in the urine. Most of the excreted H+ is buffered by H2PO4- and NH4+, & Electrolytes (Phys)
which allows for large amounts of acid to be excreted w/o precipitously dropping the pH. (RE) RE Phys
2010
GFR At normal plasma concs of Glc, the renal tubules reabsorb the entire filtered load of Glc as Renal, Urinary Physiology 6
this is below the max tubular reabsorption ability (TmG). At higher plasma concs, Glc is & Electrolytes (Phys)
excreted when the filtered amount exceeds the TmG. (RE) RE Phys
2011
Excretion rate Inulin clearance can be used to estimate the GFR and to calculate the TFR of a freely filtered Renal, Urinary Physiology 1
substance when the plasma conc of the substance is known. If the substance is subseq & Electrolytes (Phys)
reabsorbed from the nephron lumen, then the net RER of the substance will be equal to its (RE)
TFR minus the total TRR. RE Phys
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2012
ADH and urea ADH and DDAVP cause a V2receptor-mediated ↑ in water and urea permeability at the inner Renal, Urinary Physiology 1
clearance medullary CD. The resulting rise in urea reabsorption (↓ urea clearance) enhances the & Electrolytes (Phys)
medullary osmotic gradient, allowing the production of max concentrated urine. (RE) RE Phys
2013
Hyperaldosteronism ↑ serum aldolvls can MFx w/ HTN, hypokalaemia, and muscle weakness. ↑ lvls of both renin Renal, Urinary Physiology 5
and aldoare indicative of 2° hyperaldosteronism, which can be caused by renovascular & Electrolytes (Phys)
disease and renin-secreting tumours. (RE) RE Phys
2014
Diabetic Diabetic ketoacidosis (DKA) is characterized by polydipsia, polyuria, and a fruity odor to the Renal, Urinary Physiology 6
ketoacidosis breath and/or urine. DKA is associated with elevated anion gap metabolic acidosis that is & Electrolytes (Phys)
usually accompanied by compensatory respiratory alkalosis. This combination yields a low (RE)
pH, low serum bicarbonate, and low PaCO2. RE Phys
2017
Transcription Primase is a DNA-dependent RNA polymerase that incorporates short RNA primers into Renal, Urinary Biochemist 7
replicating DNA. & Electrolytes ry (Bioc)
(RE) RE Bioc
2072
Diabetic meta acidosis is characterised by a ↓ in serum pH and serum HCO3-. PaCO2 will also ↓ as a Renal, Urinary Pathology 6
ketoacidosis result of resp compensation for 1° meta acidosis. & Electrolytes (Path)
(RE) RE Path
2073
Diabetic The Tx of choice for DKA is IV normal saline and insulin. These therapies ↑ serum HCO3- Renal, Urinary Pathology 6
ketoacidosis and Na+ and ↓ serum Glc, osmolality, and K+. & Electrolytes (Path)
(RE) RE Path
2113
Lithium Li-induced DI is the result of Li's antag effect on the action of ADH on principal cells w/i the Renal, Urinary Pharmacol 2
CD system. & Electrolytes ogy (Phar)
(RE) RE Phar
2131
Membranous 1° (idiopathic) MN is a/w IgG4 Abs to the PLA2 receptor, which might play a role in devel Renal, Urinary Pathology 2
nephropathy of the disease. Ab titres are useful for Dx and correlate w/ disease activity. & Electrolytes (Path)
(RE) RE Path
6739
Renal calculi Staghorn calculi are large renal stones that take on the shape of the renal calyces. They're Renal, Urinary Pathology 7
composed 1arily of struvite (MgNH4PO4) and are a/w recurrent upper UTIs by urease- & Electrolytes (Path)
producing organisms (e.g. Proteus, Klebsiella). Hydrolysis of urea yields NH3, which (RE)
alkalinises the urine and facilitates precipitation of struvite crystals. RE Path
6792
High altitude illness At high altitude, the low PiO2 leads to hypoxemia w/ consequent hyperventilation and Renal, Urinary Physiology 3
respiratory alkalosis. The hypoxemia and alkalemia can cause SSx of altitude sickness (eg, & Electrolytes (Phys)
h/a, fatigue, lightheadedness). The kidneys respond by creating a compensatory metabolic (RE)
acidosis and by ↑ EPO secretion. RE Phys
7226
Renal cell RCC tends to invade the renal vein; IVC obstr can occur by intraluminal extension of the Renal, Urinary Pathology 8
carcinoma tumour. obstr of the IVC produces symmetric bilateral extremity oedema, often a/w & Electrolytes (Path)
prominent devel of venous collaterals in the abdo wall. (RE) RE Path
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7227
Renal cell RCC causes a variety of PNP syndromes incl erythrocytosis (due to excessive EPO Renal, Urinary Pathology 8
carcinoma production) and hypercalcaemia (due to PTHrP). & Electrolytes (Path)
(RE) RE Path
7569
Renal artery Renal artery stenosis causing significant renal hypoperfusion will result in a decreased Renal, Urinary Pathophysi 9
stenosis glomerular filtration rate and activation of the renin-angiotensin-aldosterone system. This & Electrolytes ology
leads to increased renin release by modified smooth muscle (juxtaglomerular) cells in the (RE) (Patp)
walls of afferent glomerular arterioles. Chronic renal hypoperfusion can cause hyperplasia of
the juxtaglomerular apparatus. RE Patp
7570
Primary Chronic HTN can result in HTN nephrosclerosis (HN), which is characterised by Renal, Urinary Pathology 14
hypertension compensatory medial hypertrophy and fibrointimal proliferation; endothelial dmg from ↑ & Electrolytes (Path)
systemic pressure also leads to hyaline arteriolosclerosis. The narrowed arteriolar lumens (RE)
cause a progr ↓ in renal blood flow, resulting in glomerular ischemia and fibrosis
(glomerulosclerosis). RE Path
7571
Primary Hyperplastic arteriosclerosis ("onion-skinning") and fibrinoid necrosis of the renal arterioles Renal, Urinary Pathology 14
hypertension are typical morphologic findings in hypertensive (malignant) nephrosclerosis. End-organ & Electrolytes (Path)
damage can be prevented by treatment of high blood pressure with antihypertensives. (RE) RE Path
7623
Bladder cancer Urothelial (transitional cell) bladder ca typically affects the elderly and presents w/ gross Renal, Urinary Pathology 4
hematuria. A Hx of smoking or occup exposure to rubber, plastics, aromatic amine- & Electrolytes (Path)
containing dyes, textiles, or leather ↑ the risk. (RE) RE Path
7624
Prerenal azotemia Blood volume loss can cause prerenal or intrinsic ARF. Prerenal ARF is a/w normal nephron Renal, Urinary Pathology 6
fxn (e.g. low urine Na+ lvl, low fractionated Na+ excretion, high urine osmolarity, and a high & Electrolytes (Path)
BUN/creatinine ratio), whereas intrinsic ARF features diminished renal resorptive capacity (RE)
(e.g. lower urine osmolarity, higher urinary Na+, normal serum BUN/creatinine ratio). RE Path
8249
Urinary Urge incontinence, or OBS, is caused by uninhib bladder contractions (detrusor instability). Renal, Urinary Pharmacol 7
incontinence It results in a sense of urgency accompanied by an involuntary loss of urine. If beha therapy & Electrolytes ogy (Phar)
alone is unsuccessful, Rx therapy w/ an antimusc drug (targeting M3 receptors) can help (RE)
improve SSx. RE Phar
8541
Schistosomiasis Humans acquire schistosomiasis via contact w/ freshwater sources that contain snails Renal, Urinary Microbiolo 2
infected w/ Schistosoma larvae. S japonicum and S mansoni cause intestinal and hepatic & Electrolytes gy (Micr)
schistosomiasis, and S haematobium causes urinary schistosomiasis. (RE) RE Micr
8881
Chronic kidney When the GFR is normal, relatively large ↓ in GFR result in only small ↑ in serum creatinine. Renal, Urinary Physiology 8
disease Conversely, when the GFR is significantly ↓, small decrements in GFR produce relatively & Electrolytes (Phys)
large changes in serum creatinine. A good rule of thumb is that every time GFR halves, (RE)
serum creatinine doubles. RE Phys
8884
Diuretics and TZD and loopDs cause significant volume depletion, activating the RAAS, which can lead to Renal, Urinary Pharmacol 1
electrolyte hypokalemia and meta alk. TZDs are more likely to cause hyponatremia and hypercalcemia; & Electrolytes ogy (Phar)
imbalance loop diuretics cause hypocalcemia. (RE) RE Phar
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10962
Urinary Stress incontinence is due to loss of pelvic floor support and incompetence of the urethral Renal, Urinary Anatomy 7
incontinence sphincter. Increased abdominal pressure (eg, coughing, sneezing, or vigorous effort) greater & Electrolytes (Anat)
than the urethral sphincter pressure can cause brief involuntary urine loss, which is virtually (RE)
diagnostic of stress incontinence. RE Anat
11038
Urinary Patients with multiple sclerosis most commonly develop urge incontinence due to loss of Renal, Urinary Pathophysi 7
incontinence central nervous system inhibition of detrusor contraction in the bladder. As the disease & Electrolytes ology
progresses, the bladder can become atonic and dilated, leading to overflow incontinence. (RE) (Patp) RE Patp
11040
Urinary Diabetic autonomic neuropathy is common in type 1 diabetics and can cause overflow Renal, Urinary Pathophysi 7
incontinence incontinence due to inability to sense a full bladder and incomplete emptying. PVR testing & Electrolytes ology
w/ US or catheterization can confirm inadequate bladder emptying. (RE) (Patp) RE Patp
11064
Kidney Acute renal allograft rejection can be an antibody-or cell-mediated process. Acute cellular Renal, Urinary Pathophysi 1
transplantation rejection is associated with diffuse lymphocytic infiltration of the renal vasculature & Electrolytes ology
(endotheliitis), tubules, and interstitium. (RE) (Patp) RE Patp
11464
Urinary Patients with multiple sclerosis often develop a spastic bladder a few weeks after developing Renal, Urinary Pathophysi 7
incontinence an acute lesion of the spinal cord. These patients present clinically with increased urinary & Electrolytes ology
frequency and urge incontinence. Urodynamic studies show the presence of bladder (RE) (Patp)
hypertonia. RE Patp
11516
Urinary tract Urinary tract infections (UTIs) are common in hospitalized patients with indwelling urinary Renal, Urinary Pathophysi 12
infection catheters. The risk for UTI can be reduced by avoiding unnecessary catheterization, using & Electrolytes ology
sterile technique when inserting the catheter, and removing the catheter as soon as possible. (RE) (Patp) RE Patp
11608
Thrombotic 1° TMA syndromes share common clinical and path features and result in platelet activation Renal, Urinary Pathology 3
thrombocytopenic and diffuse microthrombosis in arterioles and caps. TMA syndromes present w/ hemolytic & Electrolytes (Path)
purpura anaemia w/ schistocytes, thrombocytopaenia, and organ injury (e.g. brain, kidneys, heart). (RE) RE Path
11708
Urinary retention The bladder is extraperitoneal. In placement of a suprapubic cystostomy, the trocar and Renal, Urinary Anatomy 4
cannula will pierce the layers of the abdominal wall but will not enter the peritoneum. & Electrolytes (Anat)
(RE) RE Anat
11761
Drug interaction Calcineurin inhib nephrotox w/ resultant impairment of renal fxn is the most significant AE Renal, Urinary Pharmacol 2
of cyclosporine. CYP3A is responsible for cyclosporine meta in the small intestine and liver. & Electrolytes ogy (Phar)
Grapefruit juice inhibs this enzyme and incr the nephrotox of cyclosporine by incr circulating (RE)
drug lvls (pharmacokinetic interaction). RE Phar
11786
Transplant rejection Sirolimus binds to the immunophilin FKBP in the cytoplasm, forming a complex that binds Renal, Urinary Immunolo 4
and inhibits mTOR (mammalian target of rapamycin). Inhibition of mTOR signaling blocks & Electrolytes gy (Immu)
IL-2 signal transduction and prevents cell cycle progression and lymphocyte proliferation. (RE) RE Immu
11806
Renal cell Classic SSx of RCC incl hematuria, an abdo mass, flank pain, and weight loss. Renal, Urinary Pathology 8
carcinoma Hypercalcaemia and erythrocytosis are common PNP syndromes a/w RCC. & Electrolytes (Path)
(RE) RE Path
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11812
Urinary tract Enterococcus is an important cause of urinary tract infections. These organisms are gram- Renal, Urinary Microbiolo 12
infection positive cocci in pairs and chains and, when grown on blood agar, they do not cause & Electrolytes gy (Micr)
hemolysis (gamma hemolytic). (RE) RE Micr
11939
Metabolic acidosis Acidosis stimulates renal ammoniagenesis, a process by which renal tubular epithelial cells Renal, Urinary Biochemist 4
metabolize glutamine to glutamate, generating ammonium that is excreted in the urine and & Electrolytes ry (Bioc)
bicarbonate that is absorbed into the blood. This process is responsible for the vast majority (RE)
of renal acid excretion in chronic acidotic states. RE Bioc
11945
Erythropoietin ESAs can substantially improve anemia SSx, avoiding the need for blood transfusions in Renal, Urinary Pharmacol 1
CKD and dialysis pts. However, ESAs are a/w incr risk for HTN and TE events. & Electrolytes ogy (Phar)
(RE) RE Phar
11977
Chronic kidney CKD causes disordered mineralisation and bone meta that usually presents w/ Renal, Urinary Pathology 8
disease hyperphosphataemia, 2° hyperparathyroidism, and ↓ calcitriol lvls. Pts can be aSSx or & Electrolytes (Path)
develop weakness, bone pain, and fractures. (RE) RE Path
12081
Renal calculi Formation of uric acid kidney stones is promoted by low urine pH, which favours formation Renal, Urinary Pathology 7
of insoluble uric acid over soluble urate ion. GI HCO3- loss due to chronic diarrhoea leads to & Electrolytes (Path)
chronic meta acidosis and production of acidic urine, promoting formation of uric acid (RE)
stones. RE Path
12101
Hypercalcemia Multiple myeloma is associated with increased bone resorption due to the production of Renal, Urinary Pathophysi 5
tumor related cytokines. This results in elevated serum calcium levels, which reduce & Electrolytes ology
parathyroid hormone (PTH) production. Low PTH decreases renal calcium reabsorption (RE) (Patp)
(hypercalciuria), and, in combination with renal insufficiency, reduces 1,25-
dihydroxyvitamin D synthesis. RE Patp
14797
Benign prostatic BPH is a/w stromal and glandular growth in the periurethral and transitional zone of the Renal, Urinary Pathology 6
hyperplasia prostate. The hyperplastic cells are supported by the formation of new blood vessels, which & Electrolytes (Path)
are friable and prone to bleeding. Therefore, BPH is often a/w microscopic or gross (RE)
hematuria. RE Path
14798
Benign prostatic BPH can ↑ resistance to urine flow in the urethra and lead to incomplete bladder emptying Renal, Urinary Pathology 6
hyperplasia during micturition. The residual urine can act as a growth medium for pathogenic bacteria & Electrolytes (Path)
and ↑ the risk for UTI. (RE) RE Path
14967
Gout Patients undergoing solid organ transplantation are at increased risk of gout due to Renal, Urinary Pharmacol 11
medications that impair renal clearance of uric acid. Cyclosporine is particularly associated & Electrolytes ogy (Phar)
with gout in the post transplantation period due to decreased uric acid excretion. (RE) RE Phar
15172
Acute interstitial AIN is a common cause of renal dysfxn; up to 75% of cases are due to Rx incl NSAIDs, Renal, Urinary Pathology 2
nephritis Abx, diuretics, and PPIs. Presenting features incl fever, rash, and eosinophilia. UA often & Electrolytes (Path)
demonstrates pyuria and WBC casts w/ ↑ urine eosinophils. (RE) RE Path
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15176
Renal cell RCC may present w/ a combo of hematuria, abdo mass, or flank pain; however, this triad Renal, Urinary Pathology 8
carcinoma occurs together in <10% of cases. Pathology demonstrates rounded, polygonal cells w/ a & Electrolytes (Path)
clear cytoplasm and eccentric nuclei. RFs incl smoking, toxin exposure, and certain (RE)
hereditary disorders (e.g. VHL syndrome). RE Path
15186
Bladder cancer Major RFs for urothelial ca of the bladder incl age >60, cigarette smoking, and occup Renal, Urinary Pathology 4
exposure to rubber, plastics, or aromatic amine-containing dyes. Cyclophosphamide therapy & Electrolytes (Path)
also ↑ the risk. (RE) RE Path
15193
Urinary tract Urinary tract obstruction causes reflux of urine into the renal tubules and increased tubular Renal, Urinary Pathophysi 4
obstruction hydrostatic pressure. The intraglomerular capillary hydrostatic pressure is unchanged, & Electrolytes ology
resulting in a decreased hydrostatic pressure gradient across the glomerular capillary wall (RE) (Patp)
and a reduction in glomerular filtration. Oncotic pressure is maintained by large plasma
proteins which are not filtered across the glomerular capillary basement membrane; it is
unaffected by a urinary tract obstruction. RE Patp
15200
Urinary tract AUR is characterised by anuria and bladder distension, and can result in hydronephrosis and Renal, Urinary Pathology 4
obstruction AKI. A palpable, distended bladder is present on Ex, and abdo and flank pain may be & Electrolytes (Path)
present. The most common cause of urinary retention is bladder outlet obstr (urethral (RE)
compression) due to BPH. RE Path
15207
Prerenal azotemia Hypovolemia (eg, excessive diuresis) can cause AKI due to ↓ RBF (prerenal azotemia). Renal, Urinary Pathophysi 6
Urine Na and fractional excretion of Na levels are low, and the BUN/creatinine ratio is ↑. In & Electrolytes ology
severe cases, ATN can occur and cause an intrinsic renal injury pattern (ie, high urine Na, (RE) (Patp)
normal BUN/creatinine ratio) w/ muddy brown casts on UA. RE Patp
15208
Prerenal azotemia Compensatory mechanisms for hypovolemia include activation of the renin-angiotensin- Renal, Urinary Pathophysi 6
aldosterone system and increased antidiuretic hormone release. This results in increased renal & Electrolytes ology
sodium, chloride, water, and urea reabsorption with increased potassium excretion. (RE) (Patp) RE Patp
15209
Prerenal azotemia Hypovolemia triggers a variety of compensatory mechanisms to improve tissue perfusion. Renal, Urinary Pathophysi 6
These include activation of the renin-angiotensin-aldosterone system (resulting in increased & Electrolytes ology
aldosterone and endothelin release), increased vasopressin release, and increased sympathetic (RE) (Patp)
tone. RE Patp
15217
Rhabdomyolysis Rhabdomyolysis usually presents w/ myalgia, proximal muscle weakness, and dark urine Renal, Urinary Pathology 2
(Mburia) in the setting of trauma, sepsis, or overexertion. AKI occurs due to heme pigment- & Electrolytes (Path)
mediated tubular injury, leading to ATN. Urine microscopy typically reveals granular, (RE)
muddy brown casts. RE Path
15218
Rhabdomyolysis Rhabdomyolysis is characterised by the release of intracellular muscle contents (e.g. Mb, Renal, Urinary Pathology 2
electrolytes) due to myocyte injury; it's common w/ crush injuries, seizures, or drug use (e.g. & Electrolytes (Path)
statins). heme pigment (released from Mb after degradation in the kidney) is toxic to tubular (RE)
cells and can cause ATN. (+) blood on urine dipstick in the absence of RBCs on microscopic
UA suggests Mburia. RE Path
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15221
Prerenal azotemia Cardiorenal syndrome is due to hemodynamic alterations related to a low cardiac output state Renal, Urinary Pathophysi 6
and maladaptive neurohormonal changes. Low cardiac output results in renal hypoperfusion, & Electrolytes ology
leading to activation of the renin-angiotensin-aldosterone system, antidiuretic hormone (RE) (Patp)
release, and increased sympathetic nervous system activity. The resultant increase in sodium
and water reabsorption and systemic vasoconstriction have detrimental effects on left
ventricular systolic function, further worsening cardiac output and renal perfusion. RE Patp
15225
Acute kidney injury Surgeries complicated by significant blood loss or those req the use of cardiopulm bypass or Renal, Urinary Pathology 5
clamping of the aorta can cause sustained renal hypoperfusion and result in ATN. ATN & Electrolytes (Path)
presents w/ oliguria, ↑ serum creatinine, and BUN/creatinine ratio <20:1. UA is characterised (RE)
by muddy brown granular casts composed of sloughed renal tubular epithelial cells. RE Path
15227
Aminoglycoside Aminoglycosides are filtered across the glomerulus and concentrate in the renal tubules, Renal, Urinary Pathology 3
leading to PCT injury and ATN. This is visualised histo as focal tubular epithelial necrosis, & Electrolytes (Path)
often w/ extensive granular casts that obstruct the tubular lumen and lead to rupture of the (RE)
BM. RE Path
15229
NSAIDs Pts w/ intravascular volume depletion (e.g. CHF, diarrhoea, excessive diuresis) and CKD Renal, Urinary Pathology 4
depend on renal PG production to dilate the afferent glomerular arteriole and maintain the & Electrolytes (Path)
GFR. NSAIDs inhib PG synthesis, which cause prerenal azotaemia in at-risk pts. (RE) RE Path
15239
Diabetic In diabetic nephropathy, early adaptive changes in the kidney cause a transient increase in Renal, Urinary Pathophysi 4
nephropathy glomerular filtration (hyperfiltration). As diabetic nephropathy progresses, glomerular & Electrolytes ology
filtration falls, with a concurrent increase in urine albumin loss. (RE) (Patp) RE Patp
15246
Renal artery RAS (e.g. severe HTN, abdo bruits) causes decr renal art perfusion, which activates the Renal, Urinary Pharmacol 9
stenosis RAAS. Incr secretion of renin leads to incr production of AT-I and AT-II, which causes incr & Electrolytes ogy (Phar)
TPR and incr syst BP. Incr aldo secretion causes incr renal Na+ reabs and K+ and H+ (RE)
excretion, resulting in relative hypokalemia and meta alk. RE Phar
15247
Renal artery Fibromuscular dysplasia (FMD) is characterised by abn tissue growth w/i arterial walls, Renal, Urinary Pathology 9
stenosis resulting in stenotic and tortuous arteries that can cause tissue ischemia and are prone to & Electrolytes (Path)
aneurysm formation. Path typically demonstrates alternating fibromuscular webs and (RE)
aneurysmal dilation w/ absent internal elastic lamina (string-of-beads appearance).
Renovascular HTN occurs due to RAS and activation of the RAAS. RE Path
15250
Atheroembolism Atheroembolic disease typically occurs after an invasive vascular procedure due to mech Renal, Urinary Pathology 2
dislodgement of atherosclerotic plaque, resulting in the showering of chol-rich microemboli & Electrolytes (Path)
into the circulation. Needle-shaped chol clefts in affected vessels are Dx. Commonly (RE)
involved organs incl the kidneys (e.g. AKI), skin (e.g. blue toe syndrome, livedo reticularis),
GIT (e.g. bleeding, infarction), and CNS (e.g. stroke, amaurosis fugax). RE Path
15259
Renal calculi Struvite stones are typically seen in pts w/ recurrent upper UTI by urease-producing Renal, Urinary Pathology 7
organisms (e.g. Proteus, Klebsiella). Hydrolysis of urea yields NH3, which alkalinises the & Electrolytes (Path)
urine and facilitates precipitation of MgNH4PO4. UA shows hematuria and ↑ urine pH. (RE) RE Path
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15270
Hyperparathyroidis Most kidney stones are made of Ca2+ salts and are idiopathic, but conditions that ↑ renal Renal, Urinary Pathology 2
m Ca2+ excretion can ↑ the risk of stones. Hyperparathyroidism is a common cause of recurrent & Electrolytes (Path)
kidney stones and is typically a/w mild hypercalcaemia and hypophosphataemia. (RE) RE Path
15271
Renal calculi Urine sediment in acute ureterolithiasis typically shows free RBCs (hematuria) and crystals Renal, Urinary Pathology 7
consistent w/ the type of stone. US can reveal ureteral and calyceal dilation (hydronephrosis), & Electrolytes (Path)
but small stones themselves may not be visible. (RE) RE Path
15273
Renal artery Unilateral RAS causes hypoperfusion and activation of the RAAS. ATII causes arteriolar Renal, Urinary Physiology 9
stenosis vasoconstriction and ↑ aldo and ADH synthesis. The resultant HTN helps ↓ the decline in & Electrolytes (Phys)
GFR in the affected kidney, but causes a pressure natriuresis w/ ↑ Na+excretion in the (RE)
unaffected kidney. RE Phys
15288
Renal infarction Renal infarctions are most commonly caused by cardioembolic disease; AF is the greatest Renal, Urinary Pathology 2
RF. CFx incl flank pain, nausea, vomiting, low-grade fever, and HTN (due to renin release & Electrolytes (Path)
from hypoxic tissue). Gross path demonstrates sharply demarcated, yellow-white, wedge- (RE)
shaped areas w/ surrounding hyperaemia. RE Path
15289
Chronic kidney In chronic kidney disease, reduced excretion of phosphate can cause hyperphosphatemia. Renal, Urinary Pathophysi 8
disease This induces hypocalcemia directly by binding free calcium and depositing in tissues, and & Electrolytes ology
indirectly by triggering fibroblast growth factor 23 secretion (decreases calcitriol production (RE) (Patp)
and intestinal calcium absorption). The resulting hypocalcemia can manifest as
neuromuscular excitability (eg, carpal spasm). RE Patp
15291
Chronic kidney CKD can cause hyperphosphataemia due to impaired renal excretion of P. ↑ blood PO43- Renal, Urinary Physiology 8
disease triggers the release of FGF-23, which lowers calcitriol production and intestinal & Electrolytes (Phys)
Ca2+absorption. The resulting hypocalcaemia, along w/ hyperphosphataemia, leads to 2° (RE)
HPT. RE Phys
15312
Chronic kidney CKD can cause hyperPO4-emia due to decr renal excretion of P. Dietary P restriction is Renal, Urinary Pharmacol 8
disease recommended, but oral PO4 binders are often needed. Sevelamer is a nonabsorbable anion- & Electrolytes ogy (Phar)
exchange resin that binds intestinal PO4 to decr absorption. (RE) RE Phar
15324
Anemia of chronic EPO is produced 1arily by peritubular fibroblast cells in the RC in response to ↓ renal O2 Renal, Urinary Physiology 2
disease delivery (e.g. ↓ blood Hb content). EPO acts on erythrocyte precursor cells in the bone & Electrolytes (Phys)
marrow to stim RBC production. Pts w/ CKD have inflammatory dmg to renal EPO- (RE)
producing cells and often develop normocytic anaemia due to insufficient EPO. RE Phys
15346
Membranous MN is a common cause of nephrotic syndrome in adults. EM of the glomerular capillary Renal, Urinary Pathology 2
nephropathy demonstrates irregular, subepithelial, electron-dense immune deposits on the GBM w/ & Electrolytes (Path)
moderate effacement of the podocyte foot processes; IF microscopy demonstrates a diffuse (RE)
granular pattern of IgG along the capillary loops. RE Path
15353
IgA nephropathy IgA nephropathy is characterised as recurrent hematuria that occurs spontaneously or w/i 5- Renal, Urinary Pathology 1
7days of an URI or pharyngeal infection (synpharyngitic hematuria). Unlike other causes of & Electrolytes (Path)
IC-mediated nephritic syndromes (e.g. PSGN), IgA nephropathy is a/w normal serum (RE)
complement lvls. RE Path
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15355
Glomerular MCD is the most common cause of nephrotic syndrome in children. It's often idiopathic but Renal, Urinary Pathology 9
disorders may be triggered by drugs, immunisations, or malignancy. LM shows normal glomeruli, w/ & Electrolytes (Path)
no Ig or complement deposits on IF staining. However, EM shows diffuse podocyte foot (RE)
process effacement and fusion. RE Path
15619
SLE SLE is an autoimmune disease characterised by the formation of ANA (e.g. anti-DNA Abs). Renal, Urinary Pathology 7
Lupus nephritis occurs 1arily due to the formation of ICs containing DNA and anti-DNA in & Electrolytes (Path)
the circulation. These are deposited in the glomerulus where they result in complement (RE)
activation, recruitment of inflammatory cells, and renal injury (HS-III). RE Path
16978
Hypokalemia Hypokalaemia can result from the intracellular shift of K+, which can occur due toβ- Renal, Urinary Physiology 2
adrenergic hyperactivity (e.g. β2agonists, endogenous EPI release), ↑ insulin lvls, ↑ & Electrolytes (Phys)
extracellular pH, or ↑ cell production (e.g. acute leukaemia). (RE) RE Phys
239Rheumatic fever The 1° cause of morbidity in ARF is HF from severe pancarditis. MS develops yrs or Rheumatology, Pathology 5
decades after the original illness. Joint involvement is usually transient. Orthopedics & (Path)
Sports (RH) RH Path
295Atrophy Pathologic atrophy can be caused by ↓ physical workload, loss of innervation, ↓ blood Rheumatology, Pathophysi 1
supply, inadequate nutrition, absent endo stimulation, aging, or mechanical pressure. Orthopedics & ology
Sports (RH) (Patp) RH Patp
298Apoptosis The Fas receptor acts to initiate the extrinsic pathway of apoptosis. Mutations involving the Rheumatology, Immunolo 4
Fas receptor or Fas ligand can prevent apoptosis of autoreactive lymphocytes, thereby Orthopedics & gy (Immu)
increasing the risk of autoimmune disorders such as systemic lupus erythematosus. Sports (RH) RH Immu
316Osteonecrosis ON (AVN) occurs due to impaired blood supply to a segment of bone. The femoral head is Rheumatology, Pathology 1
the most common location. Common causes incl SCD, GC therapy, vasculitis, and Orthopedics & (Path)
alcoholism. Sports (RH) RH Path
340Systemic sclerosis CREST syndrome (limited scleroderma) MFx w/ calcinosis, Raynaud's phenomenon, Rheumatology, Pathology 3
oesophageal dysmotility, sclerodactyly, and telangiectasias. Anti-centromere Abs are found Orthopedics & (Path)
in about 40% of pts w/ CREST syndrome. Anti-DNA topoisomerase I (Scl-70) Abs are Sports (RH)
highly specific for systemic sclerosis. RH Path
361snRNP function Small nuclear RNA (SARNA) is synthesized by RNA polymerase II in the nucleus and Rheumatology, Biochemist 1
complexes with specific proteins to form small nuclear ribonucleoproteins (snRNPs). Orthopedics & ry (Bioc)
SnRNPs are an essential component of spliceosomes, which remove introns from pre-mRNA Sports (RH)
to form mature mRNA. Patients with systemic lupus erythematosus can have autoantibodies
directed against snRNPs (eg, anti-Smith antibody). RH Bioc
450Giant cell arteritis GCA is char by granulomatous inflammation of the media and predominantly involves Rheumatology, Pathology 5
medium to smaller branches of the carotid artery, esp. the temporal artery. The resulting SSx Orthopedics & (Path)
respond promptly to GC therapy. Sports (RH) RH Path
457Polyarteritis nodosa PAN is a multisystem vasculitis char by episodic ischemic SSx in various organs w/ sparing Rheumatology, Pathology 2
of the lungs. Bx shows segmental, transmural inflammation w/ fibrinoid necrosis. PAN is Orthopedics & (Path)
commonly a/w hepB. Sports (RH) RH Path
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461Giant cell arteritis GCA is char by granulomatous inflammation of the media, w/ fragmentation of the internal Rheumatology, Pathology 5
elastic lamina of medium and small branches of the carotid artery. Irreversible blindness is a Orthopedics & (Path)
severe complication of GCA, and pts w/ suspected GCA req immediate GC therapy. Sports (RH) RH Path
538Primary Leukocyte adhesion deficiency is due to absence of CD18 antigens necessary for the Rheumatology, Immunolo 7
immunodeficiency formation of integrins. Clinical features are caused by failure of leukocyte chemotaxis and Orthopedics & gy (Immu)
disorder include recurrent skin and mucosal infections without purulence, delayed separation of the Sports (RH)
umbilical cord, and persistent leukocytosis. RH Immu
628Osteoporosis Regular exercise leads to increased peak bone mass, a reduced rate of bone loss, and a Rheumatology, Physiology 10
decreased risk of osteoporosis. Orthopedics & (Phys)
Sports (RH) RH Phys
629Osteoporosis Initially in OP, bone loss predominantly affects trabecular bone, leading to trabecular Rheumatology, Pathology 10
thinning and perforation w/ loss of interconnecting bridges. Over time, cortical bone, which Orthopedics & (Path)
composes most of the appendicular skeleton, also becomes involved. Sports (RH) RH Path
630Vitamin D Rickets is char by an excess of un-mineralised osteoid matrix and epiphyseal cartilage due to Rheumatology, Pathology 4
deficiency vitD defic. CFx incl frontal bossing, craniotabes, CCJ deformity ('rachitic rosary'), and Orthopedics & (Path)
bowed legs. Sports (RH) RH Path
638Bone remodeling Bone-specific alkaline phosphatase levels correlate with osteoblast activity. Other markers of Rheumatology, Physiology 1
osteoblast activity include N-terminal propeptide of type 1 procollagen, which is released Orthopedics & (Phys)
during post translation cleavage of type 1 procollagen. Sports (RH) RH Phys
639Paget disease of Osteoclasts originate from hematopoietic progenitor cells. Macrophage colony-stimulating Rheumatology, Physiology 4
bone factor and receptor for activated nuclear factor kappa-B ligand (RANK-L) play an important Orthopedics & (Phys)
role in osteoclast differentiation. Paget's disease of bone is characterized by increased Sports (RH)
numbers of abnormal osteoclasts, excessive bone turnover and disorganized bone
remodeling. RH Phys
640Osteoporosis The receptor activator of nuclear factor kappa B (RANKY/RANK ligand (RANK-L) Rheumatology, Pathophysi 10
interaction is essential for the formation and differentiation of osteoclasts. Osteoprotegerin Orthopedics & ology
blocks binding of RANK-L to RANK and reduces formation of mature osteoclasts. Low Sports (RH) (Patp)
estrogen states cause osteoporosis by decreasing osteoprotegerin production, increasing
RANK-L production, and increasing RANK expression in osteoclast precursors. RH Patp
646Osteomyelitis Hematogenous osteomyelitis is predominantly a disease of children that most frequently Rheumatology, Microbiolo 4
affects the long bones. Staphylococcus aureus is implicated in most cases secondary to a Orthopedics & gy (Micr)
bacteremic event. Streptococcus pyogenes (group A streptococcus) is the second most Sports (RH)
common cause of hematogenous osteomyelitis. RH Micr
667Churg-Strauss Eosinophilic GPA (CSS) is a small to medium vessel vasculitis char by late-onset asthma, Rheumatology, Pathology 1
syndrome rhinosinusitis, and eosinophilia. Mononeuritis multiplex due to involvement of the epineural Orthopedics & (Path)
vessels of peri nerves is common. Sports (RH) RH Path
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700Achondroplasia Unlike the process of intramembranous ossification that forms flat bones, endochondral Rheumatology, Pathophysi 2
ossification proceeds along a cartilage template and is responsible for the formation of long
Orthopedics & ology
bones. Achondroplasia is characterized by an exaggerated inhibition of chondrocyte Sports (RH) (Patp)
proliferation in the growth plates of long bones and manifests with proximal limb shortening,
midface hypoplasia, and macrocephaly. RH Patp
702Osteogenesis OI results from defective synthesis of type I collagen by osteoblasts. CFx incl a Hx of MTFs, Rheumatology, Pathology 1
imperfecta blue sclerae, and small, malformed teeth. In most pts, OI is transmitted by AD inheritance. Orthopedics & (Path)
Sports (RH) RH Path
716COX 2 inhibitor Selective cyclooxygenase 2 (COX 2) inhibitors relieve pain with lower risk of bleeding and Rheumatology, Pharmacol 1
gastric ulceration than nonselective nonsteroidal anti-inflammatory drugs. Orthopedics & ogy (Phar)
Sports (RH) RH Phar
718Rheumatoid arthritis Methotrexate is the preferred disease-modifying treatment for patients with moderate to Rheumatology, Pharmacol 9
severe rheumatoid arthritis. Significant adverse effects include stomatitis, bone marrow Orthopedics & ogy (Phar)
suppression, and liver function abnormalities. Sports (RH) RH Phar
719Rheumatoid arthritis The foundation of management for rheumatoid arthritis is disease-modifying antirheumatic Rheumatology, Pharmacol 9
drugs, which alleviate pain and inflammation and reduce long-term joint destruction. Orthopedics & ogy (Phar)
However, the response to treatment may take several weeks. Nonsteroidal anti-inflammatory Sports (RH)
drugs and glucocorticoids can provide rapid symptom relief in the interim. RH Phar
720Biologic agents Tumor necrosis factor-alpha (TNF-α) inhibitors impair cell-mediated immunity. All patients Rheumatology, Pharmacol 2
beginning treatment with TNF-α inhibitors should be evaluated for latent tuberculosis. Orthopedics & ogy (Phar)
Sports (RH) RH Phar
721Osteomyelitis heme OM is most common in children and usually affects the metaphysis of long bones due Rheumatology, Pathology 4
to the slower blood flow and cap fenestrae in this region. W/o proper Tx, the infection can Orthopedics & (Path)
progress to chronic suppurative OM. Sports (RH) RH Path
740Myasthenia gravis Myasthenia gravis results from an autoimmune type II (antibody-mediated) hypersensitivity Rheumatology, Pathophysi 10
reaction against skeletal myocyte surface acetylcholine receptors. Goodpasture syndrome Orthopedics & ology
similarly involves autoantibodies against basement membrane collagen in the renal glomeruli Sports (RH) (Patp)
and lung alveoli. RH Patp
741Serum sickness Serum sickness is a type III hypersensitivity reaction to nonhuman proteins characterized by Rheumatology, Immunolo 1
vasculitis resulting from tissue deposition of circulating immune complexes. Clinical Orthopedics & gy (Immu)
findings include fever, pruritic skin rash, arthralgias, and low serum C3 and C4 complement Sports (RH)
levels. RH Immu
748Polymyositis and Polymyositis causes symmetric proximal muscle weakness. Muscle biopsy reveals Rheumatology, Pathophysi 5
dermatomyositis inflammation, necrosis, and regeneration of muscle fibers. Over-expression of major Orthopedics & ology
histocompatibility complex class I proteins on the sarcolemma leads to infiltration with Sports (RH) (Patp)
CD8+ T lymphocytes and myocyte damage. RH Patp
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752Ankylosing The seronegative spondyloarthropathies include ankylosing spondylitis, reactive arthritis, Rheumatology, Immunolo 2
spondylitis psoriatic arthritis, and arthritis associated with inflammatory bowel disease. Individuals Orthopedics & gy (Immu)
expressing HLA B27 are at increased risk for the seronegative spondyloarthropathies. Sports (RH) RH Immu
753Ankylosing Ankylosing spondylitis is characterized by stiffness and fusion of axial joints (ankylosis) and Rheumatology, Pathophysi 2
spondylitis inflammation at the site of insertion of tendons into bone (enthesitis). Involvement of the Orthopedics & ology
thoracic spine and costovertebral and costosternal junctions can limit chest wall expansion, Sports (RH) (Patp)
leading to hypoventilation. RH Patp
754Rheumatoid arthritis Rheumatoid arthritis results from an immune response directed against autoantigens in the Rheumatology, Immunolo 9
joints. Infiltrating CD4+ T cells secrete cytokines that promote inflammatory synovitis. They Orthopedics & gy (Immu)
also stimulate B cells to produce rheumatoid factor (IgM antibody specific for Fc component Sports (RH)
of IgG) and anti citrullinated protein antibodies that contribute to chronic inflammation and
joint destruction. RH Immu
756Myasthenia gravis Myasthenia gravis is associated with abnormalities of the thymus (e.g. thymoma, thymic Rheumatology, Embryolog 10
hyperplasia). The thymus and inferior parathyroid glands arise from the 3rd pharyngeal Orthopedics & y (Embr)
pouch. Sports (RH) RH Embr
824Muscle structure & Transverse tubules (T-tubules) are invaginations of the sarcolemma that transmit Rheumatology, Physiology 8
physiology depolarization signals to the sarcoplasmic reticulum to trigger the release of calcium and Orthopedics & (Phys)
induce muscle contraction. The uniform distribution of T-tubules in striated muscle fibers Sports (RH)
ensures that each myofibril contracts at the same time, which is necessary for efficient
contraction. RH Phys
858Gout Colchicine is used for treatment of acute gouty arthritis in patients who cannot take Rheumatology, Pharmacol 11
nonsteroidal anti inflammatory drugs. It inhibits leukocyte migration and phagocytosis by Orthopedics & ogy (Phar)
blocking tubulin polymerization. Significant side effects of colchicine include nausea and Sports (RH)
diarrhea. RH Phar
859Gout Colchicine inhibits tubulin polymerization into microtubules and can be used for acute Rheumatology, Pharmacol 11
treatment and prophylaxis of gout. Important side effects of colchicine include nausea, Orthopedics & ogy (Phar)
abdominal pain, and diarrhea. Sports (RH) RH Phar
860Gout Nonsteroidal anti-inflammatory drugs are the first-line treatment for acute gouty arthritis. Rheumatology, Pharmacol 11
They inhibit cyclooxygenase and therefore decrease prostaglandin synthesis and exert a Orthopedics & ogy (Phar)
broad anti-inflammatory effect that includes inhibition of neutrophils. Sports (RH) RH Phar
861Gout Chronic uric acid-lowering therapy is recommended for patients with gout who have frequent Rheumatology, Pharmacol 11
gouty attacks, uric acid kidney stones, tophi, or chronic joint destruction from gout. Xanthine Orthopedics & ogy (Phar)
oxidase inhibitors are the preferred treatment. Sports (RH) RH Phar
867Fibromyalgia Fibromyalgia occurs most commonly in women age 20-55 and presents with diffuse Rheumatology, Pathophysi 1
musculoskeletal pain, fatigue, and neuropsychiatric disturbances. It is characterized by Orthopedics & ology
abnormal central processing of painful stimuli. Although initially painful, aerobic exercise Sports (RH) (Patp)
helps to improve pain and functioning in these patients. RH Patp
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914Giant cell arteritis ESR and CRP have very high sensitivity for GCA. Pts w/ suspected GCA who have an ↑ Rheumatology, Pathology 5
ESR or CRP lvl should be referred for temporal artery Bx to confirm the Dx. Orthopedics & (Path)
Sports (RH) RH Path
940Polymyositis and DM is char by prox. muscle weakness (similar to PM) and dermal MFxs (e.g. heliotrope Rheumatology, Pathology 5
dermatomyositis rash, Gottron papules). Lab testing shows ↑ muscle enzymes (e.g. CK) and auto-Abs (e.g. Orthopedics & (Path)
antinuclear, anti-Jo-1). Initial Tx incl systemic GCs and eval for potential underlying Sports (RH)
malignancy. RH Path
982Osteoporosis Patients with osteoporosis have low bone mass, resulting in increased susceptibility to Rheumatology, Pathophysi 10
fragility fractures (ie, those occurring with minimal or no trauma). In primary osteoporosis Orthopedics & ology
(not caused by a medical disorder), serum calcium, phosphorus, and parathyroid hormone Sports (RH) (Patp)
levels are typically normal. RH Patp
987Paget disease of Bone pain and elevated alkaline phosphatase level in an elderly patient can occur with Rheumatology, Pathophysi 4
bone osteoblast metastases and Paget disease of bone (PDB). Biopsy showing a mosaic pattern of Orthopedics & ology
lamellar bone is diagnostic for PDB. The initial phase in PDB is characterized by an increase Sports (RH) (Patp)
in osteoclastic activity. RH Patp
993Thiazides Thiazide diuretics increase calcium absorption in the distal convoluted tubules within the Rheumatology, Pharmacol 3
nephron. Thiazides are associated with increased bone mineral density and are recommended Orthopedics & ogy (Phar)
for treatment of hypertension in patients at risk for osteoporosis. Loop diuretics increase Sports (RH)
urinary calcium loss. RH Phar
1159
Osteocyte Osteocytes have long intracanalicular processes that extend through the ossified bone matrix. Rheumatology, Histology 1
connections These cytoplasmic processes send signals to and exchange nutrients and waste products with Orthopedics & (Hist)
the osteocytes within neighboring lamellae via gap junctions. Osteocytes can sense Sports (RH)
mechanical stresses and send signals to modulate the activity of surface osteoblasts, thereby
helping to regulate bony remodeling. RH Hist
1168
Gout Colchicine is a 2nd-line agent for treating acute gouty arthritis. It inhibits tubulin Rheumatology, Pharmacol 11
polymerization and microtubule formation in leukocytes, ↓ neutrophil chemotaxis and Orthopedics & ogy (Phar)
emigration to sites inflamed by tissue deposition of monosodium urate crystals. GI mucosal Sports (RH)
fxn is also impaired by microtubule disruption, leading to diarrhea and, less commonly,
nausea, vomiting, and abdominal pain. RH Phar
1250
Marfan syndrome Marfan syndrome is due to a defect in fibrillin-1, an extracellular glycoprotein that acts as a Rheumatology, Biochemist 2
scaffold for elastin. It is abundant in the zonular fibers of the lens, periosteum, and aortic Orthopedics & ry (Bioc)
media. Aortic root dilation with dissection and rupture is a common cause of death. Sports (RH) RH Bioc
1253
SLE DILE is Chx by abrupt onset of lupus SSx (eg, fever, arthralgias, pleuritis) w/ (+) anti- Rheumatology, Pharmacol 7
histone Abs. It has been linked to Rx metabolized by N-acetylation in the liver (eg, Orthopedics & ogy (Phar)
procainamide, hydralazine, INH). Genetically predisposed individuals who are slow Sports (RH)
acetylators are at greater risk for developing DILE. RH Phar
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1265
Duchenne dystrophy DMD is an XLR myopathy that MFx w/ prox. muscle weakness and enlargement of the calf Rheumatology, Pathology 2
muscles in boys age 2-5. It most often results from frameshift deletions affecting the Orthopedics & (Path)
dystrophin gene. Dystrophin provides a stabilising interaction b/w the sarcolemma and the Sports (RH)
intracellular contraction apparatus, and disruption of the protein results in membrane dmg
and myonecrosis. RH Path
1266
Duchenne dystrophy DMD MFx w/ prox. muscle weakness and atrophy. True hypertrophy of the dist. muscle is Rheumatology, Pathology 2
noted early in the disease as dist. muscles compensate for weak prox. ones. Muscle fibres of Orthopedics & (Path)
the dist. extremities are later replaced by fat and CT (pseudohypertrophy). Sports (RH) RH Path
1381
Resting membrane When a specific ion channel opens, the respective ions will flow across the membrane in a Rheumatology, Physiology 5
potential and action direction that brings the resting membrane potential closer to that ion's equilibrium potential. Orthopedics & (Phys)
potential Sports (RH) RH Phys
1382
Resting membrane The resting membrane potential is the difference in the electrical charges across the cell Rheumatology, Physiology 5
potential and action membrane under steady-state conditions. The ions that are most permeable to the cell Orthopedics & (Phys)
potential membrane make the largest contribution to the resting membrane potential. In general, a high Sports (RH)
potassium efflux and some sodium influx are responsible for the value of the resting
potential, which is typically about -70 mV. RH Phys
1395
Clostridial Lecithinase, also known as alpha toxin, is the main toxin produced by Clostridium Rheumatology, Microbiolo 3
myonecrosis perfringens. Its function is to degrade lecithin, a component of cellular phospholipid Orthopedics & gy (Micr)
membranes, leading to membrane destruction, cell death, and widespread necrosis and Sports (RH)
hemolysis. RH Micr
1450
Gout Gout results from the deposition of monosodium urate crystals in the joints and soft tissues. Rheumatology, Pathophysi 11
Under polarized light, urate crystals appear needle-shaped and negatively birefringent. Orthopedics & ology
Conditions that increase uric acid production or decrease uric acid clearance can increase the Sports (RH) (Patp)
risk of gout. RH Patp
1451
Pseudogout Synovial fluid analysis showing rhomboid-shaped Ca-PPi crystals is Dx of pseudogout. Rheumatology, Pathology 1
These crystals are (+) birefringent under pol light. The knee joint is involved in >50% of Orthopedics & (Path)
cases. Sports (RH) RH Path
1491
Bursitis A bursa is a fluid-filled synovial sac that serves to alleviate pressure from bony prominences Rheumatology, Anatomy 1
and ↓ friction b/w muscles and tendons. Acute trauma or chronic repetitive pressure can Orthopedics & (Anat)
cause injury, leading to localized pain and tenderness. Prepatellar bursitis causes anterior Sports (RH)
knee pain and is usually due to repetitive or prolonged kneeling. RH Anat
1503
Alkaptonuria Alkaptonuria is an autosomal-recessive disorder caused by a deficiency of homogentisic acid Rheumatology, Biochemist 2
dioxygenase, an enzyme involved in tyrosine metabolism. Excess homogentisic acid causes Orthopedics & ry (Bioc)
diffuse blue-black deposits in connective tissues. Adults have sclerae and ear cartilage Sports (RH)
hyperpigmentation along with osteoarthropathy of the spine and large joints. RH Bioc
1558
Muscle structure & During skeletal muscle contraction, calcium is released from the sarcoplasmic reticulum and Rheumatology, Physiology 8
physiology binds troponin C, thereby allowing the binding of actin to myosin. Orthopedics & (Phys)
Sports (RH) RH Phys
D eats
1600
Reactive arthritis Reactive arthritis is a spondyloarthropathy associated with HLA-B27 that can occur Rheumatology, Pathophysi 2
following infection with Chlamydia, Campylobacter, Salmonella, Shigella, or Yersinia. It Orthopedics & ology
presents with sterile arthritis due to deposition of immune complexes. Sports (RH) (Patp) RH Patp
1634
Ulnar nerve The ulnar nerve can be injured at the med. epicondyle of the humerus ('funny bone') or in Rheumatology, Anatomy 2
neuropathy Guyon's canal near the hook of the hamate and pisiform bone in the wrist. Pts often have Orthopedics & (Anat)
sensory loss over the med. 1.5 digits and hypothenar eminence, and weakness on wrist Sports (RH)
flexion/adduction, finger abduction/adduction, and flexion of the 4th/5th digits. The
hypothenar eminence may flatten due to muscle atrophy. RH Anat
1638
Tibial nerve injury The tibial nerve may be injured at the lvl of the popliteal fossa due to deep penetrating Rheumatology, Anatomy 1
trauma or knee Sx. Pts typically have weakness on foot plantarflexion, foot inversion, and Orthopedics & (Anat)
toe flexion, w/ sensory loss over the sole. Sports (RH) RH Anat
1640
Peripheral Injections given in the superomedial part of the buttock risk injury to the sup. gluteal nerve. Rheumatology, Anatomy 3
neuropathy Injections into the superomedial, inferomedial, and inferolateral regions of the buttock risk Orthopedics & (Anat)
injury to the sciatic nerve. The superolateral quadrant of the buttock is a relatively safe site Sports (RH)
for intragluteal injections, although the anterolateral gluteal region is preferred. RH Anat
1664
Muscle structure & The H band is the region of the sarcomere that contains only thick (myosin) filaments. The H Rheumatology, Physiology 8
physiology band is the part of the Aband (which is on either side of the M line) where thick filaments Orthopedics & (Phys)
have no overlapping thin (actin) filaments. Sports (RH) RH Phys
1665
Muscle structure & During the skeletal muscle contraction cycle, ATP binding to myosin causes release of the Rheumatology, Physiology 8
physiology myosin head from its binding site on the actin filament. Orthopedics & (Phys)
Sports (RH) RH Phys
1682
Hand injury The lunate bone is the more med. (ulnar) of the 2 prox. carpal bones that articulate w/ the Rheumatology, Anatomy 1
radius. A FOOSH can cause dislocation of the lunate bone w/ resulting compression of the Orthopedics & (Anat)
median nerve (e.g. wrist pain, numbness in the 1st 3.5 digits). Sports (RH) RH Anat
1697
Knee trauma The ACL can be damaged by sudden changes in direction or awkward landings (eg, Rheumatology, Anatomy 4
excessive internal rotation or valgus stress) during sports activity. ACL tears are typically Orthopedics & (Anat)
a/w rapid-onset hemarthrosis. PEx shows anterior laxity of the tibia relative to the femur (eg, Sports (RH)
Lachman test, anterior drawer test). RH Anat
1702
Clavicle fracture The clavicle is commonly fractured in children after a fall on an outstretched arm. In a distal Rheumatology, Anatomy 1
clavicle fracture, the deltoid muscle and the weight of the arm cause inferolateral Orthopedics & (Anat)
displacement of the distal fragment, whereas the sternocleidomastoid and trapezius muscles Sports (RH)
cause superomedial displacement of the proximal fragment. RH Anat
1704
Humerus fracture The deep brachial (profunda brachii) artery and radial nerve run together along the post. Rheumatology, Anatomy 1
aspect of thehumerus. Midshaft fractures of the humerus risk injury to these structures. Orthopedics & (Anat)
Sports (RH) RH Anat
1730
Rectus muscle and The Valsalva maneuver ↑ vagal tone and can be used to abolish PSVT. The rectus abdominis Rheumatology, Anatomy 1
Valsalva is the most important muscle in achieving the ↑ IAP and ITP of the Valsalva maneuver. Orthopedics & (Anat)
Sports (RH) RH Anat
D eats
1732
Rotator cuff The supraspinatus muscle assists in abduction of the arm and stabilisation of the GHJ. The Rheumatology, Anatomy 3
supraspinatus tendon is vulnerable to injury due to impingement b/w the acromion and the Orthopedics & (Anat)
head of the humerus. Supraspinatus tendinopathy is the most common cause of RCS. Sports (RH) RH Anat
1733
Rotator cuff The most commonly injured structure in RCS is the tendon of the supraspinatus muscle. B/c Rheumatology, Anatomy 3
the supraspinatus is an abductor of the humerus, injury to its tendon causes pain on abduction Orthopedics & (Anat)
of the arm. Sports (RH) RH Anat
1734
Muscle structure & A single sarcomere is defined as the distance between two Z lines. Thin (actin) filaments in Rheumatology, Histology 8
physiology the band are bound to structural proteins at the Z line, whereas thick (myosin) filaments in Orthopedics & (Hist)
the Aband are bound to structural proteins at the M line. Sports (RH) RH Hist
1771
Osteoarthritis OA of the hands is char by osteophyte formation leading to hard bony enlargement of the Rheumatology, Pathology 2
dist. IPJs (Heberden nodes) and prox. IPJs (Bouchard nodes). Brief morning stiffness may be Orthopedics & (Path)
present. Sports (RH) RH Path
1773
Corticosteroids Osteoporosis is a common cause of fragility fractures, which occur in the absence of Rheumatology, Pharmacol 3
significant trauma. Chronic, systemic use of glucocorticoids such as prednisone promotes Orthopedics & ogy (Phar)
osteoporosis and increases the risk of fractures. Sports (RH) RH Phar
1795
Osteoporosis Selective estrogen receptor modulators exhibit estrogen antagonist and agonist properties in a Rheumatology, Pharmacol 10
tissue-specific manner. Raloxifene has estrogen agonist activity on bone, which decreases Orthopedics & ogy (Phar)
bone resorption and improves bone density. Raloxifene has an estrogen antagonist effect on Sports (RH)
breast tissue and can decrease the risk of breast cancer; it also acts as an estrogen antagonist
in the uterus, and does not increase the risk of endometrial cancer. RH Phar
1803
Peroneal neuropathy The common peroneal nerve is vulnerable to injury where it courses around the neck of the Rheumatology, Anatomy 3
fibula. Fibular neck fractures can injure this nerve, causing weakness of dorsiflexion (deep Orthopedics & (Anat)
peroneal nerve) and eversion (superficial peroneal nerve) of the foot as well as loss of Sports (RH)
sensation over the dorsum of the foot. RH Anat
1812
Brachial plexus Dissection of the axillary LNs can injure the LTN. This results in weakness of the serratus Rheumatology, Anatomy 6
ant. w/ winging of the scapula and impaired abduction of the shoulder past the horizontal. Orthopedics & (Anat)
Sports (RH) RH Anat
1835
Septic arthritis A high synovial fluid leucocyte count (>100k/mm3) and absent crystals on micro Ex strongly Rheumatology, Pathology 4
suggest bacterial joint infection. SA req Abx Tx to prevent joint destruction, OM, and sepsis. Orthopedics & (Path)
Sports (RH) RH Path
1858
Muscle structure & Postural skeletal muscles such as the soleus and paraspinal muscles contain predominantly Rheumatology, Physiology 8
physiology Type I slow twitch, red muscle fibers that derive ATP primarily from oxidative (aerobic) Orthopedics & (Phys)
metabolism. Sports (RH) RH Phys
1874
Wound healing During wound healing, excessive MMP activity and myofibroblast accumulation in the Rheumatology, Pathology 1
wound margins can result in contracture. Contractures produce deformities of the wound and Orthopedics & (Path)
surrounding tissues, most often on the palms, soles, ant. thorax, or at serious burn sites. Sports (RH) RH Path
D eats
1885
Psoas abscess The psoas muscle originates from the ant. surface of the transverse processes and lat. surface Rheumatology, Anatomy 2
of the vertebral bodies and fxns 1arily as a hip flexor. Psoas abscess may form due to direct Orthopedics & (Anat)
spread of infection from an adjacent structure (e.g. vertebral bodies, appendix, hip joint) or Sports (RH)
from heme seeding from a distant site. RH Anat
1896
Parvovirus PVB19 causes erythema infectiosum (5th disease) in children and arthritis in adults. PV Rheumatology, Pathology 3
arthritis can mimic RA but is usually self-resolving. Orthopedics & (Path)
Sports (RH) RH Path
1897
Lyme disease Early Lyme disease causes flu-like symptoms and erythema chronicum migrans. The second Rheumatology, Pharmacol 3
stage of Lyme disease may involve atrioventricular block and facial palsy. Late Lyme Orthopedics & ogy (Phar)
disease can cause chronic asymmetric large joint arthritis and encephalopathy. Lyme disease Sports (RH)
is easily treated with doxycycline or penicillin-type antibiotics (eg, ceftriaxone). RH Phar
1900
Lambert-Eaton LEMS is a NM disorder char by auto-Abs against presynaptic v-gated Ca2+channels. It Rheumatology, Pathology 2
myasthenic causes progr prox. muscle weakness and ↓ DTRs that improve w/ exercise (post-exercise Orthopedics & (Path)
syndrome facilitation); CN involvement and autonomic SSx may also occur. LEMS is strongly a/w Sports (RH)
SCLC. RH Path
1924
Shoulder dislocation Flattening of the deltoid muscle w/ acromialprominence after a shoulder injury suggests an Rheumatology, Anatomy 1
ant. humerus dislocation. This injury most commonly results from a blow to an ext. rotated Orthopedics & (Anat)
and abducted arm. There's often assoc axillary nerve injury, resulting in deltoid paralysis and Sports (RH)
loss of sensation over the lat. shoulder. RH Anat
1935
Mitochondrial The presence of lactic acidosis and ragged skeletal muscle fibers histologically suggests a Rheumatology, Genetics 4
disorders mitochondrial myopathy. Variable clinical expressions in affected family members can occur Orthopedics & (Gene)
due to heteroplasmy, which is the coexistence of distinct versions of mitochondrial genomes Sports (RH)
in an individual cell. RH Gene
1956
Femoral fracture The med. FCX artery and its branches provide the majority of the blood supply to the Rheumatology, Anatomy 1
femoral head and neck. Injury to these vessels due to a displaced femoral neck fracture can Orthopedics & (Anat)
cause ON of the femoral head. Sports (RH) RH Anat
1968
Knee trauma The PCL prevents posterior displacement of the tibia relative to the femur. It originates from Rheumatology, Anatomy 4
the anterolateral surface of the medial femoral condyle and inserts into the posterior Orthopedics & (Anat)
intercondylar area of the tibia. Its integrity can be tested in the clinical setting by using the Sports (RH)
posterior drawer test. RH Anat
1969
Knee trauma The PCL prevents post. displacement of the tibia relative to the femur when the knee is Rheumatology, Anatomy 4
flexed. It attaches to the post. part of the intercondylar area of the tibia and the ant. part of the Orthopedics & (Anat)
lat. surface of the med. epicondyle of the femur. Sports (RH) RH Anat
2090
Gout Gout occurs with increased frequency in patients with activating mutations involving Rheumatology, Biochemist 11
phosphoribosyl pyrophosphate synthetase due to increased production and degradation of Orthopedics & ry (Bioc)
purines. Sports (RH) RH Bioc
D eats
2091
Gout Nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line therapy for treating acute Rheumatology, Biochemist 11
gouty arthritis. They inhibit cyclooxygenase and exert a broad anti-inflammatory effect that Orthopedics & ry (Bioc)
includes inhibition of neutrophils. When NSAIDs are contraindicated (eg, peptic ulcer Sports (RH)
disease, renal impairment), colchicine is useful in the acute management of gout as it inhibits
neutrophil chemotaxis and phagocytosis by preventing microtubule formation. RH Bioc
7556
Osteoarthritis OA is char by progr fissuring and erosion of articular cartilage. RFs incl advancing age, Rheumatology, Pathology 2
obesity, joint trauma, and repetitive stress. Pts may have mild effusion and crepitus on PEx, Orthopedics & (Path)
but SSx of synovitis (e.g. redness, warmth) are less prominent than in the classic Sports (RH)
inflammatory arthritic disorders. RH Path
7592
Muscle structure & The contractile mechanism in skeletal muscle depends on proteins (myosin II, actin, Rheumatology, Physiology 8
physiology tropomyosin, and troponin) as well as calcium ions. Orthopedics & (Phys)
Sports (RH) RH Phys
7621
Iliopsoas muscle Muscles used when sitting up from the supine position incl the ext. abdo obliques, the rectus Rheumatology, Anatomy 1
abdominis, and the hip flexors. The iliopsoas muscle is the most important of the hip flexors Orthopedics & (Anat)
and incls the psoas major, psoas minor, and iliacus. The rectus femoris, sartorius, tensor Sports (RH)
fascia lata, and the med. compartment of the thigh also contribute to hip flexion. RH Anat
7792
NSAIDs Cyclooxygenase-2 (COX-2) is an inducible enzyme upregulated during inflammation by Rheumatology, Pharmacol 4
interleukin-1 and TNF-α. Selective COX-2 inhibitors (eg, celecoxib) decrease inflammation Orthopedics & ogy (Phar)
by inhibiting COX-2 production of pro-inflammatory arachidonic acid metabolites. Because Sports (RH)
they do not affect COX-1, they have minimal gastroduodenal toxicity. RH Phar
8266
Muscle structure & The muscle spindle system is a feedback system that monitors and maintains muscle length, Rheumatology, Physiology 8
physiology while the Golgi tendon system is a feedback system that monitors and maintains muscle Orthopedics & (Phys)
force. GTOs are exquisitely sensitive to increases in muscle tension but are relatively Sports (RH)
insensitive to passive stretch. RH Phys
8579
Radial head Radial head subluxation (i.e. nursemaid's elbow) is the displacement of the annular ligament Rheumatology, Anatomy 1
subluxation into the RHJ, classically resulting from sudden axial traction (e.g. pulling) on the arm of a Orthopedics & (Anat)
child age <5. Although most patients don't have any obvious swelling or deformity, they Sports (RH)
avoid moving the arm due to pain and hold it w/ the elbow flexed and forearm pronated. RH Anat
8670
Scaphoid fracture A FOOSH may cause fracture of the scaphoid bone. Ex shows tenderness in the anatomical Rheumatology, Anatomy 1
snuffbox. The scaphoid bone is vulnerable to AVN due to its tenuous blood supply. Orthopedics & (Anat)
Sports (RH) RH Anat
8671
Femoral neuropathy FNMN can occur due to trauma, compression from a retroperitoneal hematoma or abscess, or Rheumatology, Anatomy 1
injury during Sx or childbirth. Findings incl quadriceps weakness, ↓ patellar reflex, and Orthopedics & (Anat)
sensory loss over the ant. and med. thigh and med. leg. Sports (RH) RH Anat
8710
Psoas abscess Psoas abscess presents w/ fever, back or flank pain, an inguinal mass, and difficulty walking. Rheumatology, Anatomy 2
Inflammation of the psoas muscle leads to pain w/ extension at the hip (i.e. psoas sign). Orthopedics & (Anat)
Psoas abscess can develop due to heme or lymphatic seeding from a distant site, particularly Sports (RH)
in pts w/ DM, IVDU, and immsup (e.g. HIV infection). RH Anat
D eats
8802
Rheumatoid arthritis Rheumatoid arthritis is characterized by symmetric polyarthritis (involving the Rheumatology, Pathophysi 9
metacarpophalangeal and proximal interphalangeal joints) with prolonged morning stiffness Orthopedics & ology
and associated fatigue. Antibodies to citrullinated peptides/proteins have a high specificity Sports (RH) (Patp)
for the condition. RH Patp
8857
Necrotizing soft Necrotizing fasciitis is a severe infection of the subcutaneous tissue and deep fascia that is a Rheumatology, Microbiolo 1
tissue infections surgical emergency. The infection is often polymicrobial, but monomicrobial cases due to Orthopedics & gy (Micr)
Streptococcus pyogenes (group A strep) can also occur. S pyogenes is a pyrrolidonyl Sports (RH)
arylamidase (PYR)-positive, beta-hemolytic, Gram-positive cocci that grows in chains. RH Micr
10930
Osteoporosis Long-term acid suppression with proton pump inhibitors may be associated with an increased Rheumatology, Pharmacol 10
risk of osteoporotic fractures, possibly due to decreased calcium absorption. Other Orthopedics & ogy (Phar)
medications associated with an increased risk of osteoporosis include glucocorticoids, Sports (RH)
aromatase inhibitors, and anticonvulsants that induce cytochrome P450. RH Phar
11564
Osteoporosis Bisphosphonates have a chemical structure similar to that of pyrophosphate and attach to Rheumatology, Pharmacol 10
hydroxyapatite binding sites on bony surfaces to inhibit bone resorption by osteoclasts. Orthopedics & ogy (Phar)
Sports (RH) RH Phar
11646
Polymyositis and Polymyositis and dermatomyositis are characterized by symmetric proximal muscle Rheumatology, Pathophysi 5
dermatomyositis weakness and are associated with antinuclear and anti-tRNA synthetase (anti-Jo-1) Orthopedics & ology
autoantibodies. Biopsy in polymyositis shows patchy endomysial inflammatory infiltrate (ie, Sports (RH) (Patp)
direct invasion of individual muscle fibers), whereas dermatomyositis causes perifascicular
inflammation (ie, localized around blood vessels and the septa between muscle fascicles). RH Patp
11653
Hip fracture MAS is char by the triad of fibrous dysplasia of the bone, endocrine abns, and café-au-lait Rheumatology, Pathology 2
spots. The condition results from an activating mut in the G protein/cAMP/adenylate cyclase Orthopedics & (Path)
signalling pathway. Sports (RH) RH Path
11659
Knee trauma Patella fractures are most commonly due to a direct impact to the anterior aspect of the knee. Rheumatology, Anatomy 4
Signs include an acutely swollen knee, focal patella tenderness, inability to extend the knee Orthopedics & (Anat)
against gravity, and a palpable gap in the extensor mechanism. Sports (RH) RH Anat
11679
Brachial plexus The latissimus dorsi is a large thoracolumbar muscle that originates from the iliac crest and Rheumatology, Anatomy 6
lumbar fascia to the spinous processes of T7-12 and lower ribs, and inserts at the bicipital Orthopedics & (Anat)
groove of thehumerus. It's innervated by the TDN. 1° fxns incl extension, adduction, and Sports (RH)
med. rotation of the humerus. RH Anat
11683
Carpal tunnel The CT is formed by the carpal bones and the transverse carpal ligament (flexor Rheumatology, Anatomy 3
syndrome retinaculum). CTS results from compression of the median nerve as it passes thru the CT w/ Orthopedics & (Anat)
9 flexor tendons. Longitudinal incision of the transverse carpal ligament can ↓ pressure w/i Sports (RH)
the CT, improving pts' SSx. RH Anat
11684
Lateral epicondylitis Lat. epicondylitis (i.e. tennis elbow) is characterised by overuse of wrist extensor muscles (e. Rheumatology, Anatomy 1
g. extensor carpi radialis, extensor digitorum), leading to angiofibroblastic tendinosis at their Orthopedics & (Anat)
attachment on the lat. epicondyle. Sports (RH) RH Anat
D eats
11727
Sciatic neuropathy The piriformis passes through the greater sciatic foramen and is involved w/ external hip Rheumatology, Anatomy 2
rotation. Muscle injury or hypertrophy can compress the sciatic nerve in the foramen, Orthopedics & (Anat)
causing piriformis syndrome. Sports (RH) RH Anat
11749
Gout Xanthine oxidase (XO) catalyzes 1 of 2 major azathioprine-inactivating pathways. Rheumatology, Pharmacol 11
Allopurinol competitively inhibits XO, which results in increased conversion of azathioprine Orthopedics & ogy (Phar)
to its active metabolite. Sports (RH) RH Phar
11770
Giant cell arteritis Cell-mediated immunity is the primary mechanism underlying giant cell arteritis. The Rheumatology, Pathophysi 5
production of cytokines, in particular interleukin-6, is an important driver of this process and Orthopedics & ology
closely correlates with the severity of symptoms. Sports (RH) (Patp) RH Patp
11776
Rotator cuff The RC muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) all insert onto Rheumatology, Anatomy 3
the humeral head, allowing them to stabilise the shoulder joint and move the arm at the Orthopedics & (Anat)
shoulder. An infraspinatus injury would result in shoulder pain and weak, painful ext. Sports (RH)
rotation of the arm against resistance. RH Anat
11778
Thoracic outlet Thoracic outlet syndrome (TOS) is most often caused by compression of the brachial plexus Rheumatology, Anatomy 1
syndrome as it passes through the scalene triangle, the space bordered by the anterior and middle Orthopedics & (Anat)
scalene muscles and the first rib. Symptoms typically include upper extremity numbness, Sports (RH)
tingling, and weakness that worsen with repetitive overhead arm movements. The presence
of an anomalous cervical rib is a risk factor for TOS. RH Anat
11798
SLE SLE is char by loss of immune self-tolerance w/ production of auto-Abs against nuclear Ags. Rheumatology, Pathology 7
Binding of auto-Abs to self Ags leads to deposition of ICs in tissues and consumption of Orthopedics & (Path)
complement. Sports (RH) RH Path
11799
Ankle trauma Lat. ankle sprain is due to inversion of a plantar-flexed foot and most commonly involves the Rheumatology, Anatomy 1
ant. talofibular ligament. Stronger forces can cause joint instability by injuring addnal Orthopedics & (Anat)
ligaments. Sports (RH) RH Anat
11801
Medial collateral The medial collateral ligament resists force that pushes the knee medially. Increased laxity of Rheumatology, Anatomy 1
ligament injury the knee with the valgus stress test indicates injury to the medial collateral ligament. Orthopedics & (Anat)
Sports (RH) RH Anat
11805
Polymyositis and Dermatomyositis is characterized by proximal muscle weakness resembling polymyositis, Rheumatology, Pathophysi 5
dermatomyositis with additional inflammatory features involving the skin (heliotrope rash, Gottron papules). Orthopedics & ology
Both dermatomyositis and polymyositis may occur alone or as a paraneoplastic syndrome Sports (RH) (Patp)
associated with an underlying adenocarcinoma (eg, ovary, lung, pancreas). RH Patp
11818
Septic arthritis Synovitis is char by pain, erythema, swelling, and ↓ ROM in a joint. Acute synovitis may Rheumatology, Pathology 4
represent serious path (e.g. SA), esp. if accompanied by fever or leucocytosis; it should be Orthopedics & (Path)
eval urgently w/ synovial fluid analysis. Sports (RH) RH Path
11819
Osgood-Schlatter The quadriceps muscle group is connected to the patella, which is attached to the tibial Rheumatology, Anatomy 1
disease tubercle by the patellar ligament. Repetitive quadriceps contraction (e.g. jumping) in Orthopedics & (Anat)
adolescents can result in OSD, which is characterised by focal ant. knee pain and swelling Sports (RH)
due to chronic avulsion of the tibial tubercle. RH Anat
D eats
11821
Rheumatoid arthritis RA causes progr joint destruction involving the hands, wrists, elbows, and knees. Cervical Rheumatology, Pathology 9
spine involvement can lead to spinal instability and cord compression. Orthopedics & (Path)
Sports (RH) RH Path
11855
Radial neuropathy Supracondylar humeral fractures commonly occur after hyperextension of the elbow as a Rheumatology, Anatomy 3
result of a FOOSH. The radial nerve runs along the anterolateral aspect of the elbow and is Orthopedics & (Anat)
the structure most likely to be injured w/ anterolateral displacement of the prox. fracture Sports (RH)
fragment. The brachial artery runs w/ the median nerve on the anteromedial aspect of the
elbow and will usually be spared in these pts (e.g. intact radial pulse). RH Anat
11868
Osteomyelitis Vertebral osteomyelitis should be suspected in patients with new or worsening back pain, Rheumatology, Microbiolo 4
fever, and recent endocarditis or bacteremia (especially Staphylococcus aureus). It should Orthopedics & gy (Micr)
also be suspected if there are new neurologic findings and fever with or without back pain. Sports (RH)
MRI of the spine is preferred for diagnosis. RH Micr
12073
Spinal stenosis Spinal stenosis occurs most commonly in the lumbar region and presents w/ posture- Rheumatology, Anatomy 1
dependent lower extremity pain, numbness/paraesthesia, and weakness. The most common Orthopedics & (Anat)
cause is degen arthritis of the spine, which results in narrowing of the spinal canal due to Sports (RH)
intervertebral disc herniation, ligamentum flavum hypertrophy, and osteophyte formation
affecting the facet joints. RH Anat
12255
Leukocytoclastic CSVV is a/w Rx (e.g. penicillins, cephalosporins) use and typically presents w/ palpable Rheumatology, Pathology 1
vasculitis purpura in the lower extremities. Char histopath findings incl marked perivascular Orthopedics & (Path)
inflammation of the small blood vessels w/ fibrinoid necrosis and a predominance of Sports (RH)
neutrophils and fragmented neutrophilic nuclei (LCV). RH Path
14677
Rheumatoid arthritis The pathogenesis of rheumatoid arthritis involves early activation of CD4+ T cells Rheumatology, Pathophysi 9
(especially Th1 and Th17 subsets) with release of cytokines such as tumor necrosis factor- Orthopedics & ology
alpha and IL-1 that cause destruction of cartilage and bone. Monoclonal antibodies that Sports (RH) (Patp)
inhibit tumor necrosis factor-alpha or IL-1 receptors can slow progression of the disease. RH Patp
15553
Radiculopathy Motor and sensory deficits across multi peri upper extremity nerves (e.g. radial and median) Rheumatology, Anatomy 3
indicate a lesion in the brachial plexus prox. to the formation of the terminal branches. In the Orthopedics & (Anat)
absence of Hx of trauma or malignancy, the most likely cause is nerve root compression due Sports (RH)
to cervical spondylosis (cervical radiculopathy). RH Anat
15596
Sjogren syndrome SS is an AI disorder char by inflammation of exocrineglands. Bx of the labial salivaryglands Rheumatology, Pathology 2
shows periductal lymphocytic infiltrates (focal lymphocytic sialadenitis), often w/ germinal Orthopedics & (Path)
centres; the glandular tissue is typically atrophic and fibrotic. Sports (RH) RH Path
15597
Sjogren syndrome SS is an AI disorder char by lymphocytic inflammation in exocrine glands (e.g. lacrimal, Rheumatology, Pathology 2
salivary glands). It presents w/ dry eyes (keratoconjunctivitis sicca) and dry mouth Orthopedics & (Path)
(xerostomia). Chronic B-cell proliferation in pts w/ SS ↑ the risk of devel NHL. Sports (RH) RH Path
15627
Rheumatoid arthritis Joint destruction in RA is char by synovial hyperplasia, an inflammatory infiltrate, and Rheumatology, Pathology 9
synovial angiogenesis. The joint space often becomes replaced by pannus, an invasive mass Orthopedics & (Path)
composed of fibroblast-like synovial cells, granulation tissue, and inflammatory cells that Sports (RH)
can erode into the articular cartilage and underlying bone. RH Path
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Rheumatoid arthritis RA is char by synovial hyperplasia w/ inflammatory infiltrates. The accelerated meta rate of Rheumatology, Pathology 9
the inflamed synovium causes local hypoxia, which leads to synovial angiogenesis. As the Orthopedics & (Path)
disease progresses, the joint space is replaced by a rheumatoid pannus (an invasive mass of Sports (RH)
fibroblast-like synovial cells, granulation tissue, and inflammatory cells) which can destroy
the articular cartilage and underlying subchondral bone. RH Path
15636
Bone tumor OS is the most common 1° bone tumour in children and young adults and typically arises Rheumatology, Pathology 3
near the metaphyses of long bones. Pts usually have slowly worsening pain and soft-tissue Orthopedics & (Path)
swelling. XR typically reveals a lytic bone lesion, and Bx classically shows pleomorphic, Sports (RH)
spindle-shaped tumour cells that generate osteoid and thin trabeculae of neoplastic bone. RH Path
15660
Hip fracture The greater trochanter of the femur serves as the site of insertion for the gluteus medius Rheumatology, Anatomy 2
muscle, which is responsible for hip abduction and stabilisation of the pelvis during Orthopedics & (Anat)
ambulation. Fractures of the greater trochanter (e.g. fragility fracture from a fall) can disrupt Sports (RH)
the integrity of the gluteus medius tendon and result in lat. hip pain w/ gait instability and
weakness of hip abduction. RH Anat
15665
Lipoma Lipomas are common, benign tumours that arise from the subcutaneous fat and present as Rheumatology, Pathology 1
soft, mobile masses that're stable or enlarge slowly over time. The Dx is usually made Orthopedics & (Path)
clinically, but histopath shows well-diffiated, matureadipocytes w/ a fibrous capsule. Sports (RH) RH Path
15666
Osteomyelitis M. tuberculosisspondylitis (Pott's disease) is usually the result of heme seeding of vertebrae Rheumatology, Pathology 4
from 1° pulm infection. MFxs typically arise mos or yrs later (due to reactivation) and incl Orthopedics & (Path)
chronic, progr back pain, fever, and radiographic evidence of vertebral bone destruction and Sports (RH)
fluid collection. RH Path
15677
Paget disease of PDB is Chx by disordered bone formation. Involvement of long bones can lead to bone pain, Rheumatology, Pathology 4
bone bowing, fracture, or arthritis of adjacent joints. Serum ALP is ↑ due to ↑ production of new Orthopedics & (Path)
bone, but Ca and P levels remain normal. Sports (RH) RH Path
15696
Paget disease of PDB is char by excessive and disordered bone formation. It commonly affects the skull, long Rheumatology, Pathology 4
bone bones, and vertebral column. The ↑ formation of new bone is a/w an ↑ serum ALP lvl. Orthopedics & (Path)
Radiographs shows lytic or mixed lytic-sclerotic lesions, thickening of cortical and trabecular Sports (RH)
bone, and bony deformities. RH Path
784Patient Under the HIPAA, physicians may disclose pt information to friends and family members in Social Sciences Behavioral 5
confidentiality emergency situations or when the pt is otherwise incapacitated, depending on what is in the (SS) Science
best interest of the pt. Otherwise, pt information may be disclosed only when the pt gives (Beha)
explicit permission or does not object when given a reasonable opportunity. SS Beha
1107
Child abuse Physicians should contact CPS immediately if there is suspicion of child abuse. Social Sciences Behavioral 2
(SS) Science
(Beha) SS Beha
1123
Physician patient Physicians are frequently asked to evaluate whether a pt is entitled to disability benefits. Social Sciences Behavioral 11
communication When interacting w/ demanding pts, it is best to explain that the physician has a (SS) Science
responsibility to perform a thorough Ax prior to making this determination. (Beha) SS Beha
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Decision making When pts are unable to make their wishes known and there is no written documentation of Social Sciences Behavioral 5
capacity them, the responsibility for medical decision-making falls to their designated health care (SS) Science
proxy. If a pt has not designated a surrogate decision maker, medical decisions default to the (Beha)
NOK. In the case of a married person, the NOK is usually the spouse. SS Beha
1125
Ethical principles in Consent of a married or unmarried significant other is not required for a pt to undergo any Social Sciences Behavioral 3
healthcare type of procedure, including sterilization. Physicians should counsel the pt regarding the (SS) Science
risks and benefits of, and alternatives to, any procedure or Tx. (Beha) SS Beha
1126
Physician patient In situations in which a parent's presence may interfere w/ obtaining honest answers from an Social Sciences Behavioral 11
communication adolescent pt, physicians should politely ask the parent to wait outside and interview the pt (SS) Science
privately. This is also important when discussing drugs, alcohol, tobacco, and sexual activity (Beha)
w/ teenagers. SS Beha
1128
End of life care When pts are unable to make end-of-life decisions for themselves and no written ADs exist, Social Sciences Behavioral 2
responsibility for those decisions falls to the NOK. However, all surrogate medical decisions, (SS) Science
including NOK decisions, must be based on the best estimation of what the pt would have (Beha)
wanted. SS Beha
1129
Patient Pt confidentiality is strongly protected because pts must feel free to disclose details of all Social Sciences Behavioral 5
confidentiality aspects of their lives so that physicians can provide optimal care. Exceptions to pt (SS) Science
confidentiality include suspected child, disabled person, or elder abuse; knife or gunshot (Beha)
wounds; Dx of a reportable communicable disease; and pts at risk of physically harming
themselves or others. SS Beha
1145
Physician patient Delivering bad news effectively requires determining the pt's perception of the situation, Social Sciences Behavioral 11
communication providing appropriate details in an empathic manner, and allowing the pt time to react (SS) Science
emotionally and express concerns. Empathic, supportive communication should be directed (Beha)
at understanding the pt's wishes and beliefs while maintaining cultural and religious
sensitivity. SS Beha
1179
Decision making Capacity to refuse Tx requires the ability to express a choice, understand the relevant Social Sciences Behavioral 5
capacity medical information, appreciate the consequences of Tx options, and offer a rationale for the (SS) Science
decision. Pts w/ decision-making capacity have the right to refuse any medical Tx. (Beha) SS Beha
1181
Professional Physicians are ethically obligated to inform pts of medical errors, regardless of whether harm Social Sciences Behavioral 3
conduct has occurred. Disclosure should be timely and accompanied by an explanation of what (SS) Science
happened and an apology. (Beha) SS Beha
1235
Advance directives The admission process should include discussion of ADs and code status to ensure that Social Sciences Behavioral 3
medical personnel adhere to the pt's specific wishes in the event that the pt becomes (SS) Science
incapacitated. (Beha) SS Beha
1237
Requests to Patients have the right to have information withheld from them regarding their medical Social Sciences Behavioral 1
withhold condition. Physicians must respect their wish not to know, but should also explore the patient (SS) Science
information concerns to better understand their preferences and maximize their involvement in (Beha)
subsequent medical decision making. SS Beha
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Professional When treating patients who have been referred for specialty care or a second opinion, it is Social Sciences Behavioral 1
disagreements imperative to not undermine the patient's relationship with the primary physician. A (SS) Science
among providers physician should avoid making negative comments about the quality of care rendered by that (Beha)
practitioner unless practices are imminently dangerous or far outside acceptable standards of
care. SS Beha
2054
Physician patient Physicians should respond to disclosure of past sexual abuse w/ empathy and concern. Social Sciences Behavioral 11
communication Clearly acknowledging the trauma and communicating willingness to discuss it when the pt (SS) Science
is ready will help strengthen the physician-pt relationship. (Beha) SS Beha
2057
Emancipated minor Minors can consent for medical Tx in certain circumstances, including legal emancipation Social Sciences Behavioral 1
(eg, parent, married), emergency care, and specific conditions (eg, STI, pregnancy, substance (SS) Science
abuse). (Beha) SS Beha
2058
Decision making Pts who are temporarily incapacitated should not be allowed to make important health care Social Sciences Behavioral 5
capacity decisions. Acutely intoxicated pts should be reAx when sober. (SS) Science
(Beha) SS Beha
2059
Physician patient Pts have the right to refuse to receive medical information. Physicians must understand and Social Sciences Behavioral 11
communication respect the beliefs of cultures that value beneficence and nonmaleficence over autonomy. In (SS) Science
these cultures, family members may be expected to make medical decisions to avoid (Beha)
perceived harm, disrespect, or mental distress caused by direct disclosure to the pt. SS Beha
7487
Physician patient In nonemergent settings, trained language interpreters should be used to ensure optimal Social Sciences Behavioral 11
communication medical care; this applies to deaf pts using ASL. (SS) Science
(Beha) SS Beha
7733
Patient It is unethical to discuss any information regarding a pt's Dx and Tx w/ another individual, Social Sciences Behavioral 5
confidentiality including a physician who is not involved in the pt's care. Likewise, the physician should (SS) Science
neither confirm nor deny whether the person of interest is, in fact, a pt. (Beha) SS Beha
7767
Professional It is ethically problematic for physicians to accept expensive gifts as they may influence or Social Sciences Behavioral 3
conduct appear to influence physician behavior. These gifts should be declined after expressing (SS) Science
appreciation for the gesture. (Beha) SS Beha
8457
Elder abuse & Clinicians have a legal and ethical obligation to report elder abuse, neglect, and exploitation. Social Sciences Behavioral 1
neglect If there is reason to suspect possible mistreatment, the patient should be interviewed alone to (SS) Science
avoid intimidation by potential perpetrators. (Beha) SS Beha
10086
Beneficence The EMTALA was enacted by Congress to prevent hospitals from inappropriately Social Sciences Behavioral 1
transferring, discharging, or refusing to Tx indigent pts. All pts who Px to the ED must (SS) Science
receive an appropriate screening medical Ex and stabilization of their condition, regardless of (Beha)
ability to pay. SS Beha
10289
Physician patient Physicians should ask pts their preferred form of address. When in doubt, pts should be Social Sciences Behavioral 11
communication addressed formally unless they indicate otherwise when asked. (SS) Science
(Beha) SS Beha
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End of life care Pts w/ advanced metastatic ca or other terminal illnesses and a life expectancy of <6 months Social Sciences Behavioral 2
should be evaluated for hospice care. (SS) Science
(Beha) SS Beha
10399
Impaired colleague Physicians are ethically and legally obligated to report impaired colleagues in a timely Social Sciences Behavioral 1
manner. Reporting protects pt safety and can assist the impaired physician in receiving (SS) Science
appropriate evaluation and Tx. (Beha) SS Beha
10463
Abortion Physicians are not required to provide medical services that are against their personal beliefs. Social Sciences Behavioral 3
In such cases, the physician should provide referral to providers who will perform the (SS) Science
requested procedure. (Beha) SS Beha
10464
Ethical principles in Romantic and sexual relationships w/ current pts as well as former psych pts are always Social Sciences Behavioral 3
healthcare unethical. Relationships w/ former non-psych pts may be acceptable provided the physician- (SS) Science
pt relationship is terminated well beforehand. (Beha) SS Beha
10468
Terminal illness Pts faced w/ terminal illness may experience stages of grief, including denial, anger, Social Sciences Behavioral 1
bargaining, depression, and acceptance. Denial that does not impair relationships or interfere (SS) Science
w/ pt care should not be confronted. (Beha) SS Beha
10488
Informed consent Physicians must ensure the appropriate use of medical interpreters to promote adequate pt Social Sciences Behavioral 3
understanding and participation in the decision-making process. This is particularly (SS) Science
important during the informed consent process. (Beha) SS Beha
10507
Medical errors Physicians should disclose Rx errors and provide an apology in a timely fashion regardless of Social Sciences Behavioral 8
whether harm has occurred. (SS) Science
(Beha) SS Beha
10508
Medical errors Root cause analysis is a quality improvement measure that identifies what, how, and why a Social Sciences Behavioral 8
preventable adverse outcome occurred. The first step involves collecting data mainly through (SS) Science
interviewing multiple individuals involved in the steps leading to the outcome. (Beha) SS Beha
10509
Patient Physicians must be cautious about discussing protected pt health information in public Social Sciences Behavioral 5
confidentiality places, including public settings w/i the hospital, even w/ other medical personnel. (SS) Science
Conversations regarding pts should be deferred to a later time when a more private setting (Beha)
can be arranged. SS Beha
10510
Patient The HIPAA protects health information by requiring verbal or written authorization for Social Sciences Behavioral 5
confidentiality release of information. Family members who contact the physician for information about (SS) Science
their relative should not be given any information about the pt w/o the pt's consent. (Beha) SS Beha
10532
Advance directives Advance directives take precedence over the wishes of family members. Physicians should Social Sciences Behavioral 3
respect patient autonomy and adhere to patients' wishes as outlined in advance directives. (SS) Science
(Beha) SS Beha
10533
Decision making Parents' authority to make medical decisions for their children can be challenged in cases in Social Sciences Behavioral 5
capacity which a child is at significant risk for harm. Physicians are justified in obtaining a court (SS) Science
injunction to proceed w/ life-saving medical Tx of the child. (Beha) SS Beha
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Advance directives A health care proxy is a person legally designated to make medical decisions in the event the Social Sciences Behavioral 3
patient loses decision-making capacity. The proxy overrules all other possible surrogate (SS) Science
decision makers, including family members. (Beha) SS Beha
10542
Decision making In the absence of an AD and designated health care proxy, a family member of an Social Sciences Behavioral 5
capacity incapacitated pt should be contacted to act as a surrogate decision maker, followed by a (SS) Science
person who cares about and knows the pt's wishes. In an emergency, the physician can Tx an (Beha)
incapacitated pt w/o obtaining consent. SS Beha
10545
Informed consent Informed consent should be obtained by a provider who has sufficient knowledge to give an Social Sciences Behavioral 3
accurate description of the intervention, the risks and benefits of Tx, and available alternative (SS) Science
Tx and to answer all of the pt's questions. (Beha) SS Beha
10659
Intimate partner Pts experiencing intimate partner violence should be approached in a supportive, Social Sciences Behavioral 1
violence nonjudgmental, open-ended manner. A thorough safety Ax and development of an (SS) Science
emergency safety plan are essential. (Beha) SS Beha
11518
Physician patient Physicians should remain alert to pts w/ a low level of literacy as this can often impair Social Sciences Behavioral 11
communication communication and result in low-quality medical care and poor adherence. Alternate learning (SS) Science
methods (eg, visual resources) should be used to address this challenge. (Beha) SS Beha
11549
Patient safety Health care providers working on a team should employ closed-loop communication, in Social Sciences Behavioral 1
which team members repeat back the information received to ensure that the correct (SS) Science
information has been conveyed. This highly effective form of communication ↓ the risk of (Beha)
medical errors in the health care setting. SS Beha
11668
Health insurance A HMO is an insurance plan w/ low monthly premiums, low copayments and deductibles, Social Sciences Behavioral 3
and low total cost for the pt. HMOs ↓ utilization by confining pts to a limited panel of (SS) Science
providers, requiring referral from a PCP prior to specialist consultations, and denying (Beha)
payment for services that do not meet established guidelines. SS Beha
11757
Medical errors Communication failures b/w physicians during pt handoffs are a major cause of medical Social Sciences Behavioral 8
errors and can be ↓ by use of a standardized handoff process including systematic sign-out (SS) Science
notes. (Beha) SS Beha
14111
Informed consent The process of informed consent involves understanding a pt's knowledge about Tx, Social Sciences Behavioral 3
responding to specific concerns, and discussing the risks and benefits of Tx and the risks of (SS) Science
refusing Tx. (Beha) SS Beha
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