USMLE STEP 1 and USMLE STEP 2

Highly tested topics

The Complete Gold Collection

USMLE E-BOOK This is the GOLD collection of highly tested USMLE Step 1 and
USMLE Step 2 topics listed in tables for easy review. These PEARLS will appear on your boards exams!

Diseases
Addisons Disease 1. Primary adrenocortical deficiency

Addisonian Anemia 2. Pernicious anemia (antibodies to intrinsic factor or parietal cells → ↓IF → ↓Vit B12 → megaloblastic anemia)

Albrights Syndrome 3. Polyostotic fibrous dysplasia, precocious puberty, cafØ au lait spots, short stature, young girls

Alports Syndrome 4. Hereditary nephritis with nerve deafness

Alzheimers 5. Progressive dementia

Argyll-Robertson Pupil 6. Loss of light reflex constriction (contralateral or bilateral)

7. Prostitutes Eye accommodates but does not react
8. Pathognomonic for 3°Syphilis
9. Lesion pretectal region of superior colliculus
Arnold-Chiari Malformation 10. Cerebellar tonsil herniation through foramen magnum = see thoracolumbar meningomyelocele

Barretts 11. Columnar metaplasia of lower esophagus (↑ risk of adenocarcinoma)- constant gastroesophageal reflux

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Bartters Syndrome 12. Hyperreninemia

Beckers Muscular Dystrophy 13. Similar to Duchenne, but less severe (mutation, not a deficiency, in dystrophin protein)

Bells Palsy 14. CNVII palsy (entire face; recall that UMN lesion only affects lower face)

Bergers Disease 15. IgA nephropathy causing hematuria in kids, usually following infection

Bernard-Soulier Disease 16. Defect in platelet adhesion (abnormally large platelets & lack of platelet-surface glycoprotein)
Berry Aneurysm 17. Circle of Willis (subarachnoid bleed) Anterior Communicating artery
18. Often associated with ADPKD
Bowens Disease 19. Carcinoma in situ on shaft of penis (↑ risk of visceral ca) [compare w/ Queyrat]

Brill-Zinsser Disease 20. Recurrences of rickettsia prowazaki up to 50 yrs later

Briquets Syndrome 21. Somatization disorder

22. Psychological: multiple physical complaints without physical pathology
Brocas Aphasia 23. Motor Aphasia (area 44 & 45) intact comprehension

Brown-Sequard 24. Hemisection of cord (contralateral loss of pain & temp / ipsilateral loss of fine touch, UMN / ipsi loss of consc. Proprio)

Brutons Disease 25. X-linked agammaglobinemia (↓ B cells)

Budd-Chiari 26. Post-hepatic venous thrombosis = ab pain; hepatomegaly; ascites; portal HTN; liver failure

Buergers Disease 27. Acute inflammation of medium and small arteries of extremities → painful ischemia → gangrene
28. Seen almost exclusively in young and middle-aged men who smoke.
Burkitts Lymphoma 29. Small noncleaved cell lymphoma EBV
30. 8:14 translocation
31. Seen commonly in jaws, abdomen, retroperitoneal soft tissues 32. Starry sky appearance

Caisson Disease 33. Nitric gas emboli

Chagas Disease 34. Trypansoma infection - cardiomegaly with apical atrophy, achlasia

Chediak-Higashi Disease 35. (AR) Phagocyte Deficiency = defect in microtubule polymerization

36. Neutropenia, albinism, cranial & peripheral neuropathy & repeated infections w/ strep & staph
Conns Syndrome 37. Primary Aldosteronism: HTN; retain Na+ & H2O; hypokalemia (causing alkalosis); ↓ renin

Coris Disease 38. Type III Glycogenosis Glycogen storage disease (debranching enz: amylo 1,6 glucosidase def. ↑ Glycogen)

Creutzfeldt-Jakob 39. Prion infection → cerebellar & cerebral degeneration

Crigler-Najjar Syndrome 40. Congenital hyperbilirubinemia (unconjugated)

41. Glucuronyl transferase deficiency. Can progress to Kernicterus
42. Less severe form will respond to Phenobarbital therapy
Crohns 43. IBD; ileocecum, transmural, skip lesions, cobblestones, lymphocytic infiltrate, granulomas
44. (contrast to UC: limited to colon, mucosa & submucosa, crypt abscesses, pseudopolyps, ↑ colon cancer risk)
45. Clinically: ab pain & diarrhea; fever; malabsorption; fistulae b/t intestinal loops & abd structures
Curlings Ulcer 46. Acute gastric ulcer associated with severe burns

Cushings 47. Disease: Hypercorticism 2° to ↑ ACTH from pituitary (basophilic adenoma)

48. Syndrome: hypercorticism of all other causes (1° adrenal or ectopic)
49. - moon face; buffalo hump; purple striae; hirsutism; HTN; hyperglycemia

Cushings Ulcer 50. Acute gastric ulcer associated with CNS trauma

de Quervains Thyroiditis 51. Self-limiting focal destruction (subacute thyroiditis)

DiGeorges Syndrome 52. Failure of 3rd & 4th pharyngeal pouches formation: Thymus & Parathyroid
53. Thymic hypoplasia → T-cell deficiency
54. Hypoparathyroidism  Tetany
Downs Syndrome 55. Trisomy 21 or translocation Simian Crease

Dresslers Syndrome 56. Post-MI Fibrinous Pericarditis autoimmune

Dubin-Johnson Syndrome 57. Congenital hyperbilirubinemia (conjugated) = bilirubin transposrt is defective not conjugation
58. Striking brown-to-black discoloration of the liver
Duchenne Muscular Dystrophy 59. Deficiency of dystrophin protein → MD X-linked recessive

Edwards Syndrome 60. Trisomy 18

61. Rocker-bottom feet, low ears, small lower jaw, heart disease
Ehlers-Danlos 62. Defective collagen

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Eisenmengers Complex 63. Late cyanotic shunt (R→L) pulmonary HTN & RVH 2° to long-standing VSD, ASD, or PDA

Erb-Duchenne Palsy 64. Trauma to superior trunk of brachial plexus Waiters Tip

Ewing Sarcoma 65. Malignant undifferentiated round cell tumor of bone in boys <15yoa - t11;22

Eyrthroplasia of Queyrat 66. Carcinoma in situ on glans penis

Fanconis Syndrome 67. Impaired proximal tubular reabsorption 2° to lead poisoning or Tetracycline (glycosuria,
hyperphosphaturia, aminoaciduria, systemic acidosis)

Feltys Syndrome 68. Rheumatoid arthritis, neutropenia, splenomegaly

Gardners Syndrome 69. AD = adenomatous polyps of colon, osteomas & soft tissue tumors

Gauchers Disease 70. Lysosomal Storage Disease glucocerebrosidase deficiency glucocerebroside accumulation
71. Hepatosplenomegaly, femoral head & long bone erosion, anemia
Gilberts Syndrome 72. Benign congenital hyperbilirubinemia (unconjugated) = ↓d glucuronyl transferase activity

Glanzmanns Thrombasthenia 73. Defective glycoproteins on platelets = deficient platelet aggregation

Goodpastures 74. Autoimmune: abs to glomerular & alveolar basement membranes. Seen in men in their 20s

Graves Disease 75. Autoimmune hyperthyroidism (TSI): IgG Ab reactive w/ TSH receptors. Low TSH & TRH High T3 / T4

Guillain-Barre 76. Polyneuritis following viral infection/ autoimmune (ascending muscle weakness & paralysis; usually self-limiting)

Hamman-Rich Syndrome 77. Idiopathic pulmonary fibrosis. Can see honey comb lung.

Hand-Schuller-Christian 78. Chronic progressive histiocytosis

Hashimotos Thyroiditis 79. Autoimmune hypothyroidism. May have transient hyperthyroidism. Low T3 /T4 & High TSH

Hashitoxicosis 80. Initial hyperthyroidism in Hashimotos Thyroiditis that precedes hypothyroidism

Henoch-Schonlein purpura 81. Hypersensivity vasculitis = allergic purpura. Lesions have the same age.
82. Hemmorhagic urticaria (with fever, arthralgias, GI & renal involvement)
83. Associated with upper respiratory infections
Hirschprungs Disease 84. Aganglionic megacolon

Horners Syndrome 85. Ptosis, miosis, anhidrosis (lesion of cervical sympathetic nerves often 2° to a Pancoast tumor)

Huntingtons (Chromosome 4) 86. AD: Progressive degeneration of caudate nucleus, putamen (striatum) & frontal cortex ↓ GABA

Jacksonian Seizures 87. Epileptic events originating in the primary motor cortex (area 4)

Jobs Syndrome 1. Immune deficiency: neutrophils fail to respond to chemotactic stimuli

2. Defective neutrophilic chemotactic response = repeated infections
3. Commonly seen in light-skinned, red-haired girls 88. ↑d IgE levels

Kaposi Sarcoma 89. Malignant vascular tumor (HHV8 in homosexual men)

Kartageners Syndrome 90. Immotile cilia 2° to defective dynein arms infection, situs inversus, sterility

Kawasaki Disease 91. Mucocutaneous lymph node syndrome in kids (acute necrotizing vasculitis of lips, oral mucosa)

Klinefelters Syndrome 92. 47, XXY: Long arms, Sterile, Hypogonadism

Kluver-Bucy 93. Bilateral lesions of amygdala (hypersexuality; oral behavior)

Krukenberg Tumor 94. Adenocarcinoma with signet-ring cells (typically originating from the stomach) metastases to
95. the ovaries
Laennecs Cirrhosis 96. Alcoholic cirrhosis

Lesch-Nyhan 97. HGPRT deficiency

98. Gout, retardation, self-mutilation
Letterer-Siwe 99. Acute disseminated Langerhans cell histiocytosis

Libman-Sacks 100. Endocarditis with small vegetations on valve leaflets

101. Associated with SLE

Lou Gehrigs 102. Amyotrophic Lateral Sclerosis degeneration of upper & lower motor neurons

Mallory-Weis Syndrome 103. Bleeding from esophagogastric lacerations 2° to wretching (alcoholics)

Marfans 104. Connective tissue defect: defective Fibrillin gene Dissecting aortic aneurysm, subluxation of lenses

McArdles Disease 105. Type V Glycogenosis - Glycogen storage disease (muscle phosphorylase deficiency = ↑ Glycogen)

Meckels Diverticulum 106. Rule of 2s: 2 inches long, 2 feet from the ileocecum, in 2% of the population
107. Embryonic duct origin; may have ectopic tissue: gastric/pancreatic remnant of vitteline duct/yolk stalk

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Meigs Syndrome 108. Triad: ovarian fibroma, ascites, hydrothorax associated w/ fibroma of ovaries

Menetriers Disease 109. Giant hypertrophic gastritis (enlarged rugae; plasma protein loss)

Monckebergs Arteriosclerosis 110. Calcification of the media (usually radial & ulnar aa.)

Munchausen Syndrome 111. Factitious disorder (consciously creates symptoms, but doesnt know why)

Nelsons Syndrome 112. 1° Adrenal Cushings → surgical removal of adrenals → loss of negative feedback to pituitary →
Pituitary Adenoma
Niemann-Pick 113. Lysosomal Storage Disease (sphingomyelinase deficiency sphingomyelin accumulation) 114.
Foamy histiocytes
Osler-Weber-Rendu Syndrome 115. Hereditary Hemorrhagic Telangiectasia. Seen in the Mormons of Utah.

Pagets Disease 116. Abnormal bone architecture (thickened, numerous fractures → pain)

Pancoast Tumor 117. Bronchogenic tumor with superior sulcus involvement → Horners Syndrome

Parkinsons 118. Dopamine depletion in nigrostriatal tracts

Peutz-Jeghers Syndrome (AD) 119. Melanin pigmentation of lips, mouth, hand, genitalia + hamartomatous polyps of small intestine

Peyronies Disease 120. Subcutaneous fibrosis of dorsum of penis

Picks Disease 2 Different 121. 1. Progressive dementia similar to Alzheimers

Diseases - 122. 1. Constrictive pericarditis sequel to mediastinal tuberculosis
123. Calcium-frosting, unyielding layer heart chambers may be unable to dilate to receive blood during diastole
Plummers Syndrome 124. Hyperthyroidism, nodular goiter, absence of eye signs (Plummers = Grave s - eye signs)

Plummer-Vinson 125. Esophageal webs & iron-deficiency anemia, spoon-shaped nails, ↑ SCCA of esophagus

Pompes Disease 126. Type II Glycogenosis Glycogen storage disease → cardiomegaly (α 1,4 Glucosidase deficiency: ↑ Glycogen)

Potts Disease 127. Tuberculous osteomyelitis of the vertebrae

Potters Complex 128. Renal agenesis → oligohydramnios → hypoplastic lungs, defects in extremities

Raynauds 129. Disease: recurrent vasospasm in extremities = seen in young, healthy women
130. Phenomenon: 2° to underlying disease (SLE or scleroderma)
Reiters Syndrome 131. Urethritis, conjunctivitis, arthritis non-infectious (but often follows infections), HLA-B27, polyarticular

Reyes Syndrome 132. Microvesicular fatty liver change & encephalopathy

133. 2° to aspirin ingestion in children following viral illness, especially VZV
Riedels Thyroiditis 134. Idiopathic fibrous replacement of thyroid

Rotor Syndrome 135. Congenital hyperbilirubinemia (conjugated)

136. Similar to Dubin-Johnson, but no discoloration of the liver
Sezary Syndrome 137. Leukemic form of cutaneous T-cell lymphoma (mycosis fungoides)

Shavers Disease 138. Aluminum inhalation → lung fibrosis

Sheehans Syndrome 139. Postpartum pituitary necrosis = hemorrhage & shock usually occurred during delivery

Shy-Drager 140. Parkinsonism with autonomic dysfunction & orthostatic hypotension

Simmonds Disease 141. Pituitary cachexia can occur from either pituitary tumors or Sheehans

Sipples Syndrome 142. MEN type IIa = pheochromocytoma, thyroid medullary CA, hyperparathyroidism

Sjogrens Syndrome 143. Triad: dry eyes, dry mouth, arthritis ↑ risk of B-cell lymphoma

Spitz Nevus 144. Juvenile melanoma (always benign)

Stein-Leventhal 145. Polycystic ovary: see amenorrhea; infertility; obesity; hirsutism = ↑↑LH secretion

Stevens-Johnson Syndrome 146. Erythema multiforme, fever, malaise, mucosal ulceration (often 2° to infection = mycoplasma or sulfa drugs)

Stills Disease 147. Juvenile rheumatoid arthritis (absence of rheumatoid factor)

Takayasus arteritis 148. Aortic arch syndrome

149. Loss of carotid, radial or ulnar pulses = pulseless disease. Night sweats.
150. Common in young Asian females
Tay-Sachs (AR) 151. Gangliosidosis (hexosaminidase A deficiency → GM2 ganglioside) Cherry Red Spots of the Macula

Tetralogy of Fallot 152. 1.VSD, 2.overriding aorta, 3.pulmonary artery stenosis, 4.right ventricular hypertrophy

Tourettes Syndrome 153. Involuntary actions, both motor and vocal Txt w/ Pimozide

Turcots Syndrome 154. Colon adenomatous polyps plus CNS tumors

Turners Syndrome 155. 45, XO = most common cause of Primary Amenorrhea. No Barr body on buccal smear.

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Vincents Infection 156. Trench mouth acute necrotizing ulcerative gingivitis due to Fusobacterium

Von Gierkes Disease 157. Type I Glycogenosis Glycogen storage disease (G6Ptase deficiency) Glycogen accumulaiton

Von Hippel-Lindau 158. Hemangioma (or hemangioblastoma) = cerebellum, brain stem, & retina
159. Adenomas of the viscera, especially ↑ Renal Cell Carcinoma
160. Chromosome 3p
Von Recklinghausens 161. Neurofibromatosis & cafØ au lait spots & Lisch nodules (Chromosome 17)
Von Recklinghausens Disease of Bone 162. Osteitis fibrosa cystica ( brown tumor ) 2° to hyperparathyroidism = osteoclastic resorption w/
163. fibrous replacement
Von Willebrands Disease (AD) 164. Defect in platelet adhesion 2° to deficiency in vWF. ↑aPPT, ↑ Bleed time

Waldenstroms macroglobinemia 165. Proliferation of IgM-producing lymphoid cells in men 50-70 yoa; PAS(+) Dutcher bodies

Wallenbergs Syndrome 166. Posterior Inferior Cerebellar Artery (PICA) thrombosis Medullary Syndrome 167.
Ipsilateral: ataxia, facial pain & temp; Contralateral: body pain & temp
Waterhouse-Friderichsen 168. Adrenal insufficiency 2° to DIC
169. DIC 2° to meningiococcemia
Webers Syndrome 170. Paramedian Infarct of Midbrain
171. Ipsilateral: mydriasis; Contralateral: UMN paralysis (lower face & body)
Wegeners Granulomatosis 172. Necrotizing granulomatous vasculitis of paranasal sinuses, lungs, kidneys, etc.

Weils Disease 173. Icteric Leptospirosis non-icteric prgresses to renal failure & myocarditis 174.
Dark field microscopy for dx
Wermers Syndrome 175. MEN type I = thyroid, parathyroid, adrenal cortex, pancreatic islets, pituitary

Wernickes Aphasia 176. Sensory Aphasia impaired comprehension

Wernicke-Korsakoff Syndrome 177. Thiamine deficiency in alcoholics; bilateral mamillary bodies (mediodorsal nucleua) (confusion, ataxia,
ophthalmoplegia)

Whipples Disease 178. Malabsorption syndrome (with bacteria-laden macrophages) & polyarthritis

Wilsons Disease 179. Hepatolenticular degeneration (copper accumulation [Txt w/ Penicillamine ] & decrease in ceruloplasmin)
180. Mallory Bodies in the Liver & also w/ alcoholic hepatitis & Hyaline change
181. Chromosome 13
Wiskott-Aldrich Syndrome 182. Immunodeficiency: combined B- &T-cell deficiency (thrombocytopenia & eczema)
183. ↓ IgM w/ ↑ IgA
Wolff-Chaikoff Effect 184. High iodine level (−)s thyroid hormone synthesis

Zenkers Diverticulum 185. Esophageal; cricopharyngeal muscles above UES

Zollinger-Ellison 186. Gastrin-secreting tumor of pancreas (or intestine) → ↑ acid → recurrent ulcers

Rogers Disease 187. Interventricular septal defect

Barlows Syndrome 188. Floppy vale syndrome women b/t 20-40 yoa

Bracht-Wachter Lesions 189. Minute abscesses found in subacute bacterial endocarditis

Lutembachers Syndrome 190. Combination of septum secundum atrial septal defect w/ mitral stenosis

Schmidts Syndrome 191. Autoimmnue thyroid Disease (Hashimotos ) & insulin-dependent diabetes

Hallmark Findings
Albumino-Cytologic Dissociation 192. Guillain-Barre (markedly increased protein in CSF with only modest increase in cell count)

Antiplatelet Antibodies 193. Idiopathic thrombocytopenic purpura

Arachnodactyly 194. Marfans

Aschoff Bodies 195. Rheumatic fever

Auer Rods 196. Acute promyelocytic leukemia (AML type M3)

Autosplenectomy 197. Sickle cell anemia: switch a glu  val in β chain

198. Low O2 ↑ sickling
199. Aplastic crisis w/ B19 (Parvovirus ssDNA) infection
200. Salmonella osteomyelitis
201. Vaso-occlusive painful crisises
202. Hydroxyurea as Txt (↑ HbF) & Bone marrow transplant

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Babinski 203. UMN lesion

Basophilic Stippling of RBCs 204. Lead poisoning

Bence Jones Protein 205. Multiple myeloma free light chains (either kappa or lambda)
206. Waldenstroms macroglobinemia
Birbeck Granules 207. Histiocytosis X (eosinophilic granuloma)

Blue Bloater 208. Chronic Bronchitis (at least 3 months for at least 2 years of ecessive mucus secretion & chronic
recurrent productive cough)

Boot-Shaped Heart 209. Tetralogy of Fallot

Bouchards Nodes 210. Osteoarthritis (Proximal IP joint of the fingers)

Boutonnieres Deformity 211. Rheumatoid arthritis flex proximal & extend distal IP joints

Brown Tumor 212. Hyperparathyroidism

Brushfield Spots 213. Downs

Call-Exner Bodies 214. Granulosa cell tumor: associated w/ endometrial hyperplasia & carcinoma
215. Granuloma-Theca cell tumor
Cardiomegaly with Apical Atrophy 216. Chagas Disease

Chancre 217. 1° Syphilis

Chancroid 218. Haemophilus ducreyi

Charcot Triad 219. Multiple sclerosis = nystagmus, intention tremor, scanning speech

Charcot-Leyden Crystals 220. Bronchial asthma

Cheyne-Stokes Breathing 221. Cerebral lesion

Chocolate Cysts 222. Endometriosis

Chvosteks Sign 223. Hypocalcemia facial spasm in tetany

Clue Cells 224. Gardnerella vaginitis

Codmans Triangle 225. Osteosarcoma

Cold Agglutinins 226. Mycoplasma pneumoniae

227. Infectious mononucleosis
Condyloma Lata 228. 2° Syphilis
229. New coffee flavor at Bagel & Bagel
Cotton Wool Spots 230. HTN
231. Aka, cytoid bodies seen w/ SLE (yellowish cotton wool fundal lesions)
Councilman Bodies 232. Dying hepatocytes HepB

Crescents In Bowmans Capsule 233. Rapidly progressive (crescentic glomerulonephritis)

Currant-Jelly Sputum 234. Klebsiella

Curschmanns Spirals 235. Bronchial asthma
Depigmentation Of Substantia Nigra 236. Parkinsons
Donovan Bodies 237. Granuloma inguinale (STD)

Eburnation 238. Osteoarthritis (polished, ivory-like appearance of bone)

Ectopia Lentis 239. Marfans

Erythema Chronicum Migrans 240. Lyme Disease

Fatty Liver 241. Alcoholism

Ferruginous Bodies 242. Asbestosis - & Iron laden

Ghon Focus / Complex 243. Tuberculosis (1° & 2°, respectively)

Glitter Cells 244. Acute Pyelonephritis

Gowers Maneuver 245. Duchennes MD use of arms to stand

Heberdens Nodes 246. Osteoarthritis (Distal IP joint of the fingers)

Heinz Bodies 247. G6PDH Deficiency

Heterophil Antibodies 248. Infectious mononucleosis (EBV)

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Hirano Bodies 249. Alzheimers

Hypersegmented PMNs 250. Megaloblastic anemia

Hypochromic Microcytic RBCs 251. Iron-deficiency anemia or β Thalassemia

Jarisch-Herxheimer Reaction 252. Syphilis over-aggressive treatment of an asymptomatic pt. that causes symptoms 2° to rapid lysis

Joint Mice 253. Osteoarthritis (fractured osteophytes)

Kaussmaul Breathing 254. Acidosis / Diabetic Ketoacidosis

Keratin Pearls 255. Squamous Cell CA of skin Actinic Keratosis is a precursor

Keyser-Fleischer Ring 256. Wilsons

Kimmelstiel-Wilson Nodules 257. Diabetic nephropathy: Nodular Glomerulosclerosis nodules of mesangial matrix

Koilocytes 258. HPV 6 & 11 (condyloma acuminatum - benign) and HPV 16 & 18 (malignant association)

Koplik Spots 259. Measles

Lewy Bodies 260. Parkinsons (eosinophilic inclusions in damaged substantia nigra cells)

Lines of Zahn 261. Arterial thrombus

Lisch Nodules 262. Neurofibromatosis (von Recklinhausens disease) = pigmented iris hamartomas

Lumpy-Bumpy IF Glomeruli 263. Poststreptococcal glomerulonephritis prototype of nephritic syndrome

Mallory Bodies 264. Alcoholic hepatitis

McBurneys Sign 265. Appendicitis (McBurneys Point is 2/3 of the way from the umbilicus to anterior superior iliac spine)

Michealis-Gutmann Bodies 266. Malakoplakia lesion on bladder due to macros & calcospherites (M-G Bodies): usually due to E. Coli

Monoclonal Antibody Spike 267. Multiple myeloma this is called the M protein (usually IgG or IgA)
268. MGUS
Myxedema 269. Hypothyroidism

Negri Bodies 270. Rabies

Neuritic Plaques 271. Alzheimers

Neurofibrillary Tangles 272. Alzheimers

Non-pitting Edema 273. Myxedema

274. Anthrax Toxin
Notching of Ribs 275. Coarctation of Aorta

Nutmeg Liver 276. CHF = causing congested liver

Owls Eye Cells 277. CMV

278. Reed Sternburg Cells (Hodkins Lymphoma)
279. Aschoff cells seen w/ Rheumatic Fever
Painless Jaundice 280. Pancreatic CA (head)

Pannus 281. Rheumatoid arthritis, also see morning stiffnes that ↓ w/ joint use, HLA-DR4

Pautriers Microabscesses 282. Mycosis fungoides (cutaneous T-cell lymphoma), Sezary

Philadelphia Chromosome 283. CML

Pick Bodies 284. Picks Disease

2 types of COPD 285. Pink Puffer Type A: Emphysema

286. Blue Bloater Type B: Bronchitis
287. Emphysema Centroacinar smoking Panacinar - α1-antitrypsin deficiency

Podagra 288. Gout (MP joint of hallux)

Port-Wine Stain 289. Hemangioma

Posterior Anterior Drawer Sign 290. Tearing of the ACL

Psammoma Bodies 291. Papillary adenocarcinoma of the thyroid

292. Serous papillary cystadenocarcinoma of the ovary
293. Meningioma
294. Mesothelioma
Pseudohypertrophy 295. Seen w/ Duchenne muscular dystrophy @ the claf muscles, due to ↑ fat

Punched-Out Bone Lesions 296. Multiple myeloma

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Rash on Palms & Soles 297. 2° Syphilis
298. RMSF
299. Coxsackie virus infection: Hand-Foot-Mouth Disease
Red Morning Urine 300. Paroxysmal nocturnal hemoglobinuria. You would use Hams test to confirm.

Reed-Sternberg Cells 301. Hodgkins Disease

Reid Index Increased 302. Chronic bronchitis = ↑d ratio of bronchial gland to bronchial wall thickness

Reinke Crystals 303. Leydig cell tumor

Rouleaux Formation 304. Multiple myeloma RBCs stacked as poker chips

S3 Heart Sound 305. L→R Shunt (VSD, PDA, ASD)

306. Mitral Regurg
307. LV Failure
S4 Heart Sound 308. Pulmonary Stenosis
309. Pulmonary HTN
Schwartzman Reaction 310. Neisseria meningitidis impressive rash with bugs

Smith Antigen 311. SLE (also anti-dsDNA)

312. Malar Rash, Wire loop kidney lesions, Joint pain, False (+) syphilis test (VDRL)
313. 90% 14-45 yo females
314. also seen w/ use of INH; Procainamide; Hydralazine = SLE-like syndrome
Soap Bubble on X-Ray 315. Giant cell tumor of bone

Spike & Dome Glomeruli 316. Membranous glomerulonephritis = Nephrotic syndrome

317. Spike = basement membrane material & Dome = immune complex deposits (IgG orC3)
String Sign on X-ray 318. Crohns bowel wall thickening

Target Cells 319. Thalassemia in α Thalassemia w/ no α gene: Hydrops Fetalis & Intrauterine death associations = HbBarts

Tendinous Xanthomas 320. Familial Hypercholesterolemia

Thyroidization of Kidney 321. Chronic pyelonephritis

Tophi 322. Gout

Tram-Track Glomeruli 323. Membranoproliferative GN: Nephritic syndrome basement membrane is duplicated into 2 layers

Trousseaus Sign 324. Visceral ca, classically pancreatic (migratory thrombophlebitis) 325.
Hypocalcemia (carpal spasm)
326. These are two entirely different disease processes and different signs, but they unfortunately have the
same name.
Virchows Node 327. Supraclavicular node enlargement by metastatic carcinoma of the stomach

Warthin-Finkeldey Giant Cells 328. Measles

WBC Casts 329. Pyelonephritis

Whipples Triad 330. CNS disfunction Hypoglycemic episodes glu injection reverses CNS Sympts

Wire Loop Glomeruli 331. Lupus nephropathy, type IV (diffuse proliferative form)

↑ AFP in amniotic fluid or mothers 332. Spina Bifida

serum 333. Anencephaly

↑ Uric Acid 334. Gout

335. Lesch Nyhan
336. Myeloproliferative Disorders
337. Diuretics (Loop & Thiazides)
↓ FEV1/FVC 338. COPD

Ground Glass on chest x-ray 339. Due to Pneumocystis carinii

(Hyaline) 340. Seen w/ Atelectasia

Honey Combing of the lung 341. Seen w/ Asbestosis (a restrictive lung disease)

Crescents 342. Goodpastures syndrome (pneumonia w/ hemoptysis & rapidly progressive glomerulonephritis)

Linear Ig Deposits 343. Goodpastures syndrome

45 Degree Branch Points 344. Aspergillosis

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PAS(+) Dutcher Bodies 345. Waldenstroms Macroglobulinemia = ↑IgM = Hyperviscosity

Ground Glass in Abdomen(Hyaline) 346. Seen in the hepatocytes of healthy carriers of HBsAg in liver biopsies

Signet Ring Cells 347. Cells that replace the ovaries, due to Krukenbergs tumor that has metastasized from the
stomach
Ground Glass Appearance (Hyaline) 348. Seen w/ Progressive Multifocal Leukoencephalopathy oligodendrocytes
349. Nuclei seen in Papillary CA of the thyroid (malignant)
Congo Red 350. Shows amyloid deposition in plaques & vascular walls

Meningiomas & Progesterone 351. Some meningiomas have Progesterone receptors = rapid growth in pregnancy can occur

Tuberous Sclerosis Triad 352. Seizures; Mental retardation; Leukoderma (congenital facial white spots or macules):
angiofibromas
Cowdry A Inclusions 353. Seen w/ Herpes Simplex Encephalitis in oligodendroglia

Devics Syndrome 354. Neuromyelitis Optica

355. A variant of multiple sclerosis: rapid demyelination of the optic nerve & spinal cord w/ paraplegia
c-erb B2 356. Breast Cancer association

Foster-Kennedy Syndrome 357. A tumor causing blindness & loss of smell w/ papilloedema

Hoffmans Sign 358. Flicking of the middle fingers nail

Red Nucleus Destruction 359. Intention tremors of the arm

Ventral Spinocerebellar tr. 360. Unconscious proprioception of lower extremities

Dorsal Spinocerebellar tr. 361. Unconscious prorpioception & fine motor movements

Cuneocerebellar tr. 362. Unconscious proprioception & fine motor movements of upper extremities

Dorsal Column 363. Conscious proprioception of the body

Lateral Spinothalamic tr. 364. Pain & Temperature sensation

Ventral Spinothalamic tr. 365. Light touch perception

SVA 366. Taste & Smell

GSE 367. Muscles of the eye & of the tongue

SSA 368. Vision; Hearing; Equilibrium

GVA 369. Sensation of tongue; soft palate. Carotid Body & Sinus innervation

GVE 370. Edinger Westphal = parasympathetic eye innervation

371. Gland innervation = secretions
372. Viscera

GSA 373. Pain & temperature of face

374. Sensation of external ear
SVE 375. Innervation of muscles of masticaiton, facial expressions, larynx & pharynx

LMN Lesion 376. Werndig Hoffman (progressive infantile muscular atrophy) 377.
Poliomyelitis
Sensory Pathway Lesion 378. Subacute Combined Degeneration = Friedrichs Ataxia = B12 deficiency
379. Tabes Dorsalis (Neurosyphilis)
Both UMN & LMN Lesion 380. ALS = Lou Gherigs Disease

Both Sensory & Motor Lesion 381. Brown Sequard

382. Anterior Spinal artery Occlusion
Suprachiasmatic Nucleus 383. Controls circadian rhythm

Ventromedial Nucleus 384. Satiety center. Savage behavior & obesity when lesioned

Lateral Nucleus 385. Induces eating. Starvation when lesioned

Arcuate Nucleus 386. Releases PIF (dopa-ergic neurons)

Mamillary Body 387. Can have hemorrhages as seen in Wernickes Encephalopathy

Acanthocytes 388. RBSc w/ spiny projections. Seen in Abetalipoproteinemia.

Page 9
Most Common
1o Tumor arising from bone in 389. Osteosarcoma
adults
Adrenal Medullary Tumor 390. Pheochromocytoma: 5 Ps: ↑ Pressure; Pain (Headache); Perspiration; Palpitations; Pallor/Diaphoresis
Adults
Adrenal Medullary Tumor 391. Neuroblastoma
Children
Agent of severe viral 392. Herpes simplex
encephalitis
Aggressive lung tumor 393. Small cell or oat cell

Associated with gallstones 394. Adenocarinoma

Bacterial Meningitis adults 395. Strep pneumoniae & in young adults = Neisseria meningitidis
Bacterial Meningitis elderly 396. Neisseria meningitidis
Bacterial Meningitis 397. E. coli / Group BStrep.
newborns
Bacterial Meningitis toddlers 398. Hib

Benign epithelial tumor of 399. Papilloma

oral mucosa
Benign fallopian tube tumor 400. Adenomatoid

Benign ovarian tumor 401. Mature(Native) Teratoma = benign dermatoid

Benign tumor of soft tissue 402. Lipoma

Benign tumor of the breast 403. Fibroadenoma

<25yoa
Benign tumor of the liver 404. Hemangioma

Benign tumor of the vulva 405. Hidroadenoma

Benign uterine tumor 406. Leiomyoma: estrogen sinsitive: changes size during pregnancy & menopause

Bone Tumors 407. Metasteses from Breast & Prostate

Brain Tumor Child 408. Medulloblastoma (cerebellum)

Brain Tumor Adult 409. Astrocytoma (including Glioblastoma Multiforme) then: mets, meningioma, Schwannoma

Breast Carcinoma 410. Invasive Duct Carcinoma

Breast Mass 411. Fibrocystic Change: premenopausic women (Carcinoma is the most common in post-menopausal women)

Bug in Acute Endocarditis 412. Staph aureus

Bug in debilitated, 413. Klebsiella
hospitalized pneumonia pt

Bug in Epiglottitis 414. Hib

Bug in GI Tract 415. Bacteroides (2nd E. coli)

Bug in IV drug user bacteremia 416. Staph aureus

/ pneumonia
Bug in PID 417. N. Gonnorrhoeae

Bug in Subacute Endocarditis 418. Strep Viridans

CA of urinary collecting 419. Transitional cell CA (assoc. w/ benzidine; βnaphthylamine; analine dyes; long term txt w/
system cyclophosphamide)

Cardiac 1ry Tumor Adults 420. Myxoma: Ball Valve

ry 421. Rhabdomyoma associated w/ Tuberous sclerosis
Cardiac 1 Tumor Child
Cardiac Tumor Adults 422. Metasteses

Page 10
Cardiomyopathy 423. Dilated (Congestive) Cardiomyopathy: Alcohol, BeriBeri, Cocaine use, Coxsackie B, Doxorubicin
424. Systolic Dysfunction
Cause of 2ry HTN 425. Renal Disease

Cause of Addisons 426. Autoimmune (2nd infection)

Cause of breast lumps 427. CA of the breast

Cause of chronic 428. TB

endometriosis
Cause of Congenital Adrenal 429. 21-Hydroxylase Deficiency: NaCl lost & Hypotension (then, 11- NaCl retention & HTN)
Hyperplasia
Cause of Cushings 430. Exogenous Steroid Therapy (then, 1ry ACTH, Adrenal Adenoma, Ectopic ACTH)

Cause of Death in Alzheimer 431. Pneumonia

pts
Cause of Death in Diabetics 432. MI

Cause of Death in premature 433. NRDS = hyaline membrane disease

Cause of Death in SLE pts. 434. Lupus Nephropathy Type IV (Diffuse Proliferative) = Renal Disease

Cause of Dementia 435. Alzheimers

nd 436. Multi-Infarct Dementia
Cause of Dementia (2 most
common)
Cause of Dwarfism 437. Achondroplasia

Cause of Food poisoning 438. Staph aureus

Cause of Hematosalpynga 439. Ectopic pregnancy

Cause of Hypoparathyroidism 440. Throidectomy

Cause of Hypothyroidism 441. Corrective surgery I31 treatment

Cause of Kidney infections 442. E. coli

Cause of Liver disease in US 443. Alcohol consumption

Cause of Malignancy in 444. Acute leukemia

children
Cause of Mental retardation 445. Downs

Cause of Mental retardation 446. Fragile X

(2nd most common)
Cause of NaCl loss and 447. 21 hydroxylase deficiency
Hypotension
Cause of PID 448. N. ghonorrhea

Cause of Portal cirrhosis 449. Alcohol

Cause of Preventable 450. Chlamydia (serotypes A,B,Ba,C)

Blindness
Cause of Pulmonary HTN 451. COPD

Cause of Secondary 452. Renal disease

Hypertension
Cause of SIADH 453. Small Cell Carcinoma of the Lung

Cause of UT Obstruction in 454. BPHyperplasia

men

Cause Pernicious Anemia 455. Chronic atrophic gastritis = no production of intrinsic factor

Chromosomal Disorder 456. Downs

Common Tumor of the 457. Carcinoid tumor: flushing; diarrhea; bronchospasm; RHeart valvular lesions
Appendix 458. Txt: Methysergide (5HT antagonist)

Congenital Cardiac Anomaly 459. VSD (membranous > muscular)

Page 11
Congenital Early Cyanosis 460. Tetralogy of Fallot =right to left shunt

Coronary Artery Thrombosis 461. LAD artery: MI

Demyelinating Disease 462. Multiple Sclerosis: (Charcot Triad = nystagmus, intention tremor, scanning speech)
463. Periventricular plaques w/ ↓ Oligodenrocytes
464. ↑ IgG in CSF, Optic Neuritis, MLF Syndorme = Internuclear Ophthalmoplegia, bladder incontinence
Dental Tumor 465. Odontoma

Dietary Deficiency 466. Iron

Disease of the Breast 467. Fibrocystic disease

Disseminated Opportunistic 468. CMV (Pneumocystis carinii is most common overall)

Infection in AIDS
Esophageal Cancer 469. SCCA

Fallopian Tube Malignancy 470. AdenoCA

Fatal Genetic Defect in 471. Cystic Fibrosis (chromosome 7q)

Caucasians
Female Tumor 472. Leimyoma

Form of Amyloidosis 473. Immunologic (Bence Jones protein in multiple myeloma is also called the Amyloid Light Chain)

Form of Tularemia 474. Ulceroglandular

Germ Cell Tumor of Testes 475. Seminoma (analogous to dysgerminoma of ovaries)

Gynecological Malignancy 476. Endometrial Carcinoma

Gynecological Finding 477. Endometrial CA

Heart Murmur 478. Mitral Valve Prolapse

Heart Valve in Bacterial 479. Mitral

Endocarditis
Heart Valve in Bacterial 480. Tricuspid
Endocarditis in IV drug users
Heart Valve involved in 481. Mitral then Aortic
Rheumatic Fever
Hereditary Bleeding Disorder 482. Von Willebrands Disease

Hormone secreted in Pituitary 483. Prolactin

Adenoma
Inherited disease of the 484. Adult polycystic kidney disease: associated w/ polycystic liver, Berry aneurysms, Mitral prolapse
Kidney 485. APD1 chromosome 16

Intracranial tumor in adults 486. Glioblastoma mulitforme

Islet Tumor 487. Insulinoma = β cell tumor

ry 488. Hepatoma
Liver 1 Tumor
Liver Disease 489. Alcoholic Liver Disease

Location of Adenocarcinoma 490. Head (99%)

of the Pancreas
Location of Adult Brain 491. Above Tentorium
Tumors
Location of Childhood Brain 492. Below Tentorium
Tumors
Lung Tumor, malignant or 493. Malignant
benign
Lung Tumor, primary or 494. Secondary
secondary
Lysosomal Storage Disease 495. Gauchers

Malignancy in Women 496. Lung (2nd breast)

Malignancy of the Larynx 497. Glottic CA (squamous cell)

Page 12
Malignancy of the Small 498. Adenocarcinoma
Intestine
Malignancy Vulva 499. Squamous cell CA

Malignant Eye Tumor in Kids 500. Retinoblastoma

Malignant Tumor of the Liver 501. Hepatocellular CA

Motor Neuron Disease 502. ALS

Muscular Dystrophy 503. Duchennes: Dystrophin deletion. Presents <5yoa weakness at pelvic girdles w/ upward progression

Nasal Tumor 504. Squamous cell CA

Neoplasm Child 505. Leukemia

nd 506. Medulloblastoma of brain (cerebellum)
Neoplasm Child (2 most
common)
Neoplasm of the West 507. Adeno CA of the rectum and/or colon

Neoplastic Polyp 508. Tubular adenoma

Nephrotic Syndrome in Adults 509. Membranous Glomerulonephritis

Nephrotic Syndrome in 510. Minimal Change (Lipoid Nephrosis) Disease (responds well to steroid txt)
Children
Non Hodgkins Lymphoma 511. Follicular small clear cell

Number of Deaths per year in 512. Lung CA

Women
Skin tumor 513. Basal cell CA

Opportunistic infection in 514. PCP

AIDS
Ovarian Malignancy 515. Serous Cystadenocarcinoma

Ovarian Tumor 516. Hamartoma

Pancreatic Tumor 517. Adeno (usually in the head)

Patient with ALL / CLL / AML 518. ALL Child / CLL Adult over 60 / AML - Adult over 60 / CML Adult 35-50
/ CML
Patient with Goodpastures 519. Young male

Patient with Reiters 520. Male

Pituitary Tumor 521. Prolactinoma (2nd Somatotropic Acidophilic Adenoma)

Place for Primary Squamous 522. Mid 1/3

Cell CA of esophagus
Place for Peptic Ulcer Disease 523. Lesser curvuture in antrum associated w/ blood group O

Primary Benign Salivary Tumor 524. Pleomorphic Adenoma (Mixed) 90% localized to the parotid

Primary Hyperparathyroidism 525. Adenomas (followed by: hyperplasia, then carcinoma)

Primary Malignancy of Bone 526. Osteosarcoma

Primary Malignancy of Small 527. Lymphoma

Intestine
Pt. with Hodgkins 528. Young Male (except Nodular Sclerosis type Female)

Pt. with Minimal Change 529. Young Child

Disease
Renal Malignancy 530. Renal cell CA

Renal Malignancy of Early 531. Wilms tumor (neohroblastoma) chromosome 11p

Childhood

Page 13
Salivary Tumor 532. Pleomorphic adenoma

Secondary 533. Hypocalcemia of Chronic Renal Failure

Hyperparathyroidism
Sexually Transmitted Disease 534. Chlamydia (sero types D-K)

Site of Diverticula 535. Sigmoid Colon

Site of Embolic Occlusion 536. Middle cerebral aa: contralateral paralysis; aphasias; motor & sensory loss

Site of Metastasis 537. Regional Lymph Nodes

Site of Metastasis (2nd most 538. Liver

common)
Sites of Atherosclerosis 539. Abdominal aorta > coronary > popliteal > carotid

Skin CA of Fair Skinned 540. Malignant melanoma

People
Skin Cancer 541. Basal Cell Carcinoma

Small Intestine Congenital 542. Meckels diverticulum

Anomaly
Stomach Cancer 543. Adeno associated w/ blood group A

Testicular Tumor 544. Seminoma = malignant painless testes growth

Thyroid Anomaly 545. Thryoglossal duct cyst

Thyroid CA 546. Papillary CA

Tracheoesophageal Fistula 547. Lower esophagus joins trachea / upper esophagus blind pouch polyhydramnios association

Tumor in men <20 548. Germ cell tumor

Tumor of Infancy 549. Benign vascular tumor = port wine stain = Hemangioma

Tumor of the Stomach >50 550. CA of stomach (adeno CA)

years of age
Type of Hodgkins 551. Mixed Cellularity (versus: lymphocytic predominance, lymphocytic depletion, nodular sclerosis)

Type of Non-Hodgkins 552. Follicular, small cleaved

Type of Portal Cirrhosis 553. Micronodular

Type of Soft Tissue Tumor of 554. Rhabdomyosarcoma

Childhood
Vasculitis (of medium & small 555. Temporal Arteritis (branch of Carotid Artery)
arteries)
Viral Encephalitis 556. HSV

Worm Infection in US 557. Pinworm (2nd Ascaris)

Worst Prognosis in Thyroid 558. Follicular CA

Cas
Cause of Lobar Pneumonia 559. Strep. Pneumoniae

Cause of Death b/t 24-44 yoa 560. AIDS

Cause of Pneumonia in Cystic 561. Pseudomonas

Fibrosis
Cause of Osteomyelitis in IV 562. Pseudomonas
Drug Users
Cause of Infection in Burn Pts 563. Pseudomonas

Mental Problem in Males 564. Specific phobia

Page 14
Intelligence Test 565. Stanford Binet (ages 6 & under)
566. WIPSI (ages 4-6)
567. WISK-R (for ages 6-17)
568. WAIS-R (for > 17 yoa)
Paraphilia 569. Pedophilia

Metabolite seen w/ 570. VMA: vanillylmandelic acid (NE metabolite)

Pheochromocytoma
Severe Shigella 571. Dysenteriae

Bug in Otitis Media & Sinusitis 572. Strep. Pneumoniae

in Kids
Cause of a Solitary Brain 573. A. Israelli
Abscess
Cause of Bacterial Diarrhea in 574. Campylobacter jejuni
U.S.
Shigella Type 575. S. Sonnei

Cause of Non-Ghonococcal 576. Chlamydia trichomonas

Urethritis
Pneumonia 577. Strep. Pneumoniae

Urethritis 578. N. ghonorrhea

Cause of Glomerulonephritis 579. IgA Nephropathy = Bergers Disease

Cause of Viral Pneumonia 580. RSV infants

581. Parainfluenza kids
582. Influenza virus adults
583. Adeno virus military recruits
Complication of COPD 584. Pulmonary infections

Cause of Death w/ SLE 585. Renal failure

Atrial Septal Defect 586. Ostium Secundum Type

Warm Antibody 587. Most common form of immune hemolytic anemia

588. IgG auto antibodies to RBC
589. See spherocytosis; (+) Coombs test; complication to CLL
Immunodeficiency 590. IgA Deficiency
Congenital GIT Anomaly 591. Meckels Diverticulum: persistence of vitelline duct/yolk sac stalk
Cause of Congenital 592. Fetal Alcohol Syndrome
Malformation

Pharmacology
Autonomic Nervous System
Epinephrine 1. α1, α2, β1, β2
Norepinephrine 2. α1, α2, β1 (no β2 activity)
GABA 3. Causes an inhibitory cell hyperpolarization
Muscarinic-r 4. Uses DAG & IP3 as 2nd messengers
5. Parasympathetic control
Bethanechol 6. Cholinergic. ↑ GI & Bladder motility. Txt atonic bladder post-op
Pilocarpine 7. Cholinergic. Pupillary constriciton= miosis. Ciliary constriction= accomodation.
8. Txt acute glaucoma
Isoflurophate 9. Organophosphate. Irreversible acetylcholinesterase (-)r
Pralidoxime 10. 2PAM . Reverses organophosphate binding to acetylcholinesterase
Neostigmine 11. Reversible acetylcholinesterase (-)r
12. Txt Myasthenia Gravis
Myasthenia Gravis 13. Anitbodies to Ach-r. ↑g muscular weakness due to Achs weak postsynaptic effect @ NMJ. Inactivates-r

Page 15
Tubocurium 14. Nondepol. Competitive cholinergic N-r (-)r.
15. Prevents Ach binding but does not activate NMJ
16. ↑ Histamine release= ↓ BP & ↑ bronchospasm
Trimethaphan 17. Nonselectively binds N-r of the PS- and SNS
Pancurium 18. More potent than tubocurium w/o histamine release
Succinylcholine 19. Depol. Non competitive (-)r of muscle aciton
20. Opens Na Ch.= fasciculations. Closes Na Ch.= paralysis. Continuous infusion.
α1 & Eye 21. Mydriasis due to norepinephrine. Prazosin (-).
M-r & Eye 22. Miosis due to Ach. Atropine (-).
Sympathetic 23. Post ganglionic symapthetic fibers releases norepinephrine
Parasym. 24. Post ganglionic parasympathetic fibers release Ach
M3-r & Eye 25. Contracts sphincter = miosis. Contracts ciliary = accomodation.
M2-r & Heart 26. Negative chronotropy: ↓ HR = vagal arrest
27. Negative inotropy: ↓ contractility
M3-r & Lung 28. Bronchospasm ↑secretions
M3-r & GI 29. ↑ motility (cramps & diarrhea). Involuntary defecation
Tacrine 30. Acetylcholine esterase (-)r. Txt Alzheimers
Atropine 31. DOC w/ vagal arrest
Glycoperrolate 32. M-r(-). Antispasmodic. Txt peptic ulcers.
Pirenzepine 33. M-r(-). Antispasmodic. Txt peptic ulcers.
Doxacurium 34. Most potent competitive non-depol NMJ (-)r. No cardiovascular side effects. No Histamine release.
β bungarotoxin 35. Prevent the releasal of Ach from vesicles @ the pre synaptic nerve ending
α bungarotoxin 36. Irreversible N-r (-)r = ↓ action potentials
α1 & Eye 37. Contracts radial muscle = mydriasis (pupil dilation)
α1 & Arterioles 38. Constiction: ↑TPR = ↑ Diastolic pressure = ↑ Afterload
α1 & Venules 39. Constriction: ↑ Venous return = ↑ Preload
α1 & Sex Function 40. Ejaculation
↑ Diastolic 41. ↑ α1 = ↑TPR
↓ Diastolic 42. ↑ β2; Direct acting vasodilators; (+)Cholinergics
β1 & Heart 43. (+)chronotropism = ↑HR.
44. (+)inotropism = ↑ contractility; ↑SV; ↑CO; ↑O2 consumption.
45. ↑ conduction velocity
Phenylephrine 46. α1 (+) Nasal decongestant.
β2(+) Asma Drugs 47. Metaproterenol; Albuterol; Terbutaline; Ritodrine; Salmeterol
Ritodrine/Turbutaline 48. Relaxes myometrium used in pre-mature labor pains
Phentolamine 49. Epi reversal. Blocks α, vasodilation occurs. Pt goes from HyperTN to HypoTN.
50. Txt pheochromocytoma = ↓BP
Terazosin 51. Txt BPH
Yohimbine 52. ↑ sympathetic outflow = α2 (-). Txt impotence.
Cardioselective NMJ 53. Pancuronium = ↑HR due to atropine-like anti muscarinic vagolytic effect & Gallamine (-)r
Ecothiophate 54. Irreversible cholinesterase (-)r.
Pyridostigmine 55. Cholinomimetic that ↑s M & N-r effects. (-) acetylcholinesterase & plasma cholinesterase
56. DOC for the oral Txt of MG

Cardiology
Digoxin 1. ↓ AV nodal conduction/ inh. Na/K/Atpase = inc. Ca conc. in heart cells = inc. contraction force
Diltiazem 2. Txt black men. Txt AV nodal re entrance
Quinidine 3. ↓ AV nodal conduction. Cinchonism. Anticholinergic= aggravate MG. Hypotension= α block
Verapamil 4. ↓ AV nodal conduction. ↓ BP. Negative inotrope= no CHF use
Propranolol 5. ↓ AV nodal conduction. ↓ BP. Negative inotrope(= β block) Aggravates Asthma and Diabetes Melitus via β2 block.

Page 16
Diazoxide 6. Balanced vasodilator.
Niroprusside 7. Balanced vasodilator. Unloads heart. ↑s cyanide= pre-txt w/ thiosulfate. Txt Acute HTNv Crisis
Reserpine 8. Txt severe & resistant HTN. Depletes CA. See stuffy nose. No to pts w/ peptic ulcers.
Dobutamine 9. At high doses β2(+) offsets α1 = β1 ↑ CO w/o systemic vascular resistance
Dopamine 10. At low doses Txt Shock= dilates renal and mesenteric aa= maintain urine output
Esmolol 11. Short acting β(-)
Captopril 12. Balanced vasodilator. Txt Outpt. CHF see dry cough(bradykinin induced)
Digoxin 13. Txt CHF & Atrial Flutter - inotropic - ↓ K+ levels= dig. Toxicity
Dig. Toxicity 14. Fatal ventricular arrhythmias w/ sever AV block
Quinidine 15. ClassIa anti arrhythmic. Moderate Na Ch. Block
Lidocaine 16. ClassIb anit arrhythmic. Normalizes conduction. Txt initial MI= control arrhythmias
Flecanide 17. ClassIc anti arrhythmic. Marked conduction slowing
Amiodarone 18. Long t1/2= need potent doses to obtain desired level for action. See blue skin, ocular deposits, Pulmonary Fibrosis.
NE 19. ↑ AV nodal conduction via β1. Metoprolol(-) β1
Ach 20. ↓ AV nodal conduction via M receptor. Atorpine(-) M-r
Atenolol 21. Controls catecholamine induced arrhythmias
Bretylium 22. Txt Malignant Ventricular Arrhythmias but causes passing catecholamine release that can aggravate arrhythmias
briefly
Nimodipine 23. Txt Acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm
Atropine 24. ↓ excess vagal tone as seen in Sinus Bradycardia
Nitrates 25. ↓ preload= venous pooling. ↓ MVO2= reflex tachy. ↑ ventr work= dec O2 demand
Propranolol 26. Blocks reflex tachy but causes excess brady= ↑ diastole time= ↑ EDV
Verapamil 27. ↑ O2 supply via ↓ in vasospasm Txt Prinzmetals variant angina
Aspirin 28. Prevents arterial platelet adhesion (not DVThrombi). Inactivates COX= ↓ platelet production of TxA2, a potent
vasoconstictor
Warfarin 29. (-)Vit. K dependent gamma carboxylation of clotting factors= anticoagulation state
Heparin 30. Dependent on Antithrombin III activation
TPA 31. Binds to fibrin clots & activates plasminogen on the spot. Short t1/2, given IV.
32. Does not discriminate b/t fibrin-based clots= bleeding & stroke complications arise
Streptokinase 33. From bacteria= allergies arise. Can see excess bleeding in post-op pts.
Urokinase 34. Human source. ↑ plasmin. Can see excess bleeding in post-op pts.
Colestipol 35. Bile acid sequestrants. Interrupt bile acid reabsorption= ↑↑ LDL uptake. Cholestyramine same MOA.
Lovastatin 36. HMGCoA reductase(-)= ↑ LDL-r synthesis. Pravastatin/ Mevastatin same MOA.
Losartan 37. ↓ Aldosterone. ↑ Renin 2-3xs
Diazoxide 38. Txt insulinomas. Not balanced vasodilator= onlt dilates arterial smooth muscle
Clonidine 39. Central α2(+). ↓ TPR via ↓ symapthetic effect
Methyldopa 40. Central α2(+). (++) Coombs= Hemolytic anemia
Phenytoin 41. ClassIb. Reverses mild AV block due to digitoxin toxicity
Procainamide 42. ClassIa. SLE like syndrome.
Indopamide 43. Only Thiazide that will have no effect on cholesterol levels
Thiazides 44. Older black men w/ HTN due to ↑ Renin.
β(-) 45. Young white men w/o asthma (cause bronchospasm)
ACEIs 46. (-) change AI  AII. (-) Bradykinin inactivation. Captopril/ Enalapril
47. Cause renal failure = use w/ caution in the elderly
Epinephrine 48. ↑ contraction rate & force via β1.
49. ↑ systolic but ↓ diastolic BP.
50. ↓ peripheral resistance via β2 vasodilaiton
Norepi. 51. ↑ heart rate and ↑ systolic and diastolic BP
52. ↑ peripheral blood vessel resistance
Methyldopa 53. DOC for pregnancy induced HTN

Page 17
Quinidine pre-txt 54. Atrial arrhythmia pretxt w/ a drug that will ↓ ventricular response: Dig.;β(-); Ca Ch.(-)
ClassII 55. β(-) ↓risk fo reinfarction & sudden death following MI
Gray man 56. Amiodarone: ClassIII antiarrhythmia
Beperidil 57. Ca Ch(-). Limited clinical use due to Torsades de Pointes
ACEIs 58. Vasodilate renal efferents > than afferent arterioles: ↓GFR & Filtration pressure
59. ↓ Diabetic renal failure progression
Adenosine 60. Its receptor is blocked by Methylxanthines (ie Theophyline)
61. Favored for the Txt of Reentrant Supra Ventricular Tachycardia
Enoxaparin 62. Low molecular weight heparin = Oral anticoagulant
Isoproterenol 63. ↑HR & ↓MAP
Variant angina 64. Use Ca Ch. (-)r ie Nifedipine
Contraindicated in 65. β (-)r = you dont want to ↓ the hearts pumping strength
CHF

CNS
TOM 1. Short acting BDZs:
2. Triazolam
3. Onazelam
4. Midazolam
Butyrophenone 5. Haloperidol & Droperidol
Atypical D4 6. Clozapine Thioridazine Olanzepine Risperidone = Do not cause EPS
Flumazenil 7. BDZ antidote for OD
Methylphenidate 8. Txt attention deficit disorder
Phenytoin 9. Causes aplastic anemia/ gingival hyperplasia/ cleft lip & palate
Thiopental 10. Short acting Barb
Carbamazepine 11. DOC trigeminal neuralgia. Txt lennox gestaut seizures in kids
Atypical D4-r 12. Thioridazine; Olamzapine; Clozapine
Pimozide 13. Txt Tourettes
Risperidone 14. Good for negative symptoms
Thioridazine 15. Most anti cholinergic neuroleptic
Haloperidol 16. Neuroleptic malignant hyperthermia due to chronic D2 block. give Dantrolene and Bromocriptine

Imirpamine 17. Enurisis

Clomirpramine 18. Txt OCD See aggressive behavior w/ use
Trazadone 19. Priapism
Bupropion 20. Helps to quit smoking
SSRIs 21. Primarily used for OCD
Fluoxetine 22. Good for negative symptoms
Phenelzine 23. Irreversible MAOI
Lithium 24. Txt manic phase of Bipolar Disorder
25. Causes goiter by (-) conversion of T4 to T3
26. Nephrogenic diabetes insipidus
27. Low salt diet will lead to Li toxicity
Alprazolam 28. DOC stage fright
Propranolol 29. Social phobia
κ-r 30. Spinal analgesia. Euphoria. ++euphoria. ++sedation. Constipation.
µ-r 31. Supraspinal analgesia. Dysphoria. +respiratory depression. +sedation.
Morphine & O2 32. Admin. is contraindicated to pts on morphine sedation= ↓ CO2 sensitivity and O2 admin. can stop breathing.
Morphine 33. ↑ ICP = do not give to pt. with head trauma
Morphine OD 34. 1.pinpoint pupils 2.↓d respiraiton 3.coma

Page 18
Meperidine 35. Anesthetic used during labor
Hydromorphone 36. µ(+) used in renal failure
Tramadol 37. Ambulatory txt for mod. to severe pain
Naloxone 38. Txt opioid OD. Reverses respiratory depression
Pentazocine 39. Part κ(+) & part µ(-)
Butorphenol 40. Part κ(+) & part µ(-)
Nalbuphene 41. Part κ(+) & part µ(-)
↓ GABA 42. ↓ seizure focus= Barbs & BDZs
↓ Fast Na Ch. 43. ↓ electrical activity spread = Phenytoin & Carbamazepine
Methoxyflurane 44. Can be nephrotoxic. Needs low MAC for anesthetic induction.
Enflurane 45. Can cause tonic/clonic muscle spasms
Isoflurane 46. Can cause bronchospasm
Halothane 47. Can cause ventricular extrasystoles & Malignant hyperthermia & Hepatitis
Nitric Oxide 48. No effect on HR. Needs high MAC for anesthetic induction.
Thiopental 49. Short acting Barb.
Kentamine 50. Dissociative anesthetic
Droperidol 51. Can be used in combo w/ Fentanyl for neuroleptoanalgesic effect
52. Neuroleptic tranquilizer. Has mild alpha block
Fentanyl 53. Can be used on combo w/ Droperidol for neuroleptoanalgesic effect 54.
Used transdermally for chronic pain
Midazolam 55. Pre anesthetic. Induces amnesia
Primidone 56. Biotransformed to Phenobarb.
C & A delta Fibers 57. First fibers to be blocked w/ anesthesia
Esters 58. Procaine, Tetracaine, Benzocaine
59. Broken down and make PABA (allergen)
Amides 60. Lidocaine, Mepivaciane, Bupivaciane, Etidocaine= i before caine always an amide
61. Metabolized in the liver
Amphetamine 62. DA reuptake (-)r. MAOI. Parkinsons txt
Bromocriptine 63. D2(+). Used w/ L-Dopa for on-off phenomenon of Parkinsons
Benztropine 64. Ant M w/ some DA reuptake (-). Parkinsons txt
Amantidine 65. ↓ DA reuptake. Can cause livido reticularis= skin mottling.
Diphenhydramine 66. Txt early Parkinsons stages
Pergolide 67. > Effective & longer acting than Bromocriptine
Ethosuximide 68. DOC for Absence seizures
Tranylcypromine 69. MAOI = antidepressant
SSRI & MAOI 70. Fatal combo, especially seen with the use of Paroxetine or Fluoxetine (SSRIs) and Tranylcypromine (MAOI)
Labor opioids 71. Meperidine & Nalbuphine
Desipramine causes 72. Sudden cardaic death in children

Anti-Infective
Primaquine 4. Malaria profylaxis
5. Used for extraerythrocytic forms Plasmodium vivax or P. ovale
Ciporfloxacin 6. Quinolone derivative
Sulfonamides 7. PABA structural analogs
8. Inhibit Folic acid synthesis
Tertacyclines, anuria & the exception 9. Should not be used in anuric pt due to production of (-) Nitrogen balance & ↑d BUN levels.
10. Doxycycline is the exception
Ceftriazone 11. 3rd generation cephalosporin
12. DOC for bacterial meningitis in kids (ie HiB)
13. One dose txt of gonorrhea

Page 19
Hepatic coma DOC 14. Neomycin (aminoglycoside) it supresses the normal flora = ↓g NH4 production = ↓g free
nitrogen levels in the bloodstream.
Clavulanic acid 15. Irreversible (-)r of β lactamases, but ot of transpeptidase = use w/ a β lactamase sensitive
penicillin
Piperacillin 16. Txt Pseudomonas aeruginosa & Klebsiella
17. Broad spectrum antibiotic
Streptomycin (aminoglycoside) 18. Txt Mycobacterium tuberculosis
Isoniazid 19. Most commonly used drug for TB.
20. Usually combined w/ Rifampin and/or Ethambutol
21. Pre Txt w/ Pyridoxine (Vit B6) can prevent peripheral neuritis
Pyrantel Pamoate 22. Txt of Hookworm disease
23. Depolarizing NMJ (-)r
Buy AT 30, CELL at 50 24. A = Aminoglycosides
25. T = Tetracyclines
26. C = Chloramphenicol
27. E = Erythromycin (macrolide)
28. L = Clindamycin
29. L = Lincomycin
Cefoxitin 30. Txt intraabdominal infections (ie w/ Bacteroides fragilis)
31. Traditional txt has been Clindamycin & Gentamycin
Chloramphenicol 32. Broad spectrum antibiotic
33. Bone marrow depression (common) Aplastic anemia (rare)
34. Gray baby syndrome (chloramphenicol cannot be conjugated)
35. DOC Typhoid Fever (symptomatic Salmonella infection)
36. DOC HiB meningitis in kids especially resistant strain to ampicillin
Nifurtimox 37. Txt trypanosomiasis
Metronidazole 38. Txt Leishmaniasis & Amebiasis
39. Good for anaerobic bacteria = Bacteroides fragilis
40. DOC Trichomoniasis
41. DOC Giardia lamblia
Txt P. carinii 42. TMP-SMX & Pentamidine
Tetracycline 43. Txt of Brucellosis & Cholera
44. Txt Rocky Mountain Spotted Fever
45. Txt spirochete infections = Lyme disease (Borrelia burgdorferi)
TMP-SMX 46. (-) dihydrofolate reductase activity
Benzathine Penicillin G 47. Long duration of action = given once every 3-4 weeks for Txt of Syphilis
Praziquantel 48. Txt Schistosomiasis (trematode [fluke] infections)
Melarsoprol 49. Txt Trypanosomiasis that has neurological symptoms
Stibogluconate 50. Txt Leishmaniasis
Fluconazole 51. Txt fungal encephalitis
Amphotericin B 52. Polyene antifingal
Ketoconazole MOA 53. (-) fungal ergosterol synthesis = disrupts membrane
Griseofulvin MOA 54. Accumulates in keratinized layers of the skin = used in dermatomycoses infections
Mefloquine 55. Anti malarial
56. Txt Chloroquine resistant strains = P. falciparum
Chloroquine 57. Txt for Malaria when inside RBC
Nifurtimox 58. DOC Chagas disease due to Trypanosoma cruzi
Erythromycin 59. Used in pts allergic to penicillins
Nystatin 60. Topical txt of superficial mycotic infections = Candidiasis
Acyclovir 61. Guanine analog
62. Txt Herpes infections
Imipenem 63. Used w/ Cilastatin
64. Can cause seizures
Cefoperazone side effects 65. Bleeding due to vit K level alterations
66. Contraindicated in pts w/ bleeding disorders

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Vancomycin 67. Used for MRSS (methicillin resistant Staph. Aureus)
68. Red neck : due to histamine release causes facial flushing
Meropenem 69. used w/ Cilastatin
70. Does not cause seizures (cf w/ Imipenem)
Nafcillin 71. Only penicillin that does not need dose adjustment in renal impairment
Peripheral neuropathy 72. Seen w/ use of:
73. Metronidazole Isoniazid Vincristine ddI AZT Allopurinol
Sulfonamides & newborns 74. Kernicterus can occur
O.N.E. for gonorrhea 75. Fluoroquinolones used in a one dose deal for gonorrhea:
76. O = Ofloxacin
77. N = Norfloxacin
78. E = Enoxacin
Ribavirin 79. Txt RSV (Respiratory Syncytial Virus)

Anti-Neoplastics
Cyclosporine 80. Protects against rejections from organ transplants
81. Does not induce bone marrow depression
Cyclophosphamide 82. Alkylating agent of both purine & pyrimidine bases of DNA
83. Txt CLL
Cisplatins toxicities 84. Nephro- & Ototoxicity
Methotrexate 85. Antimetabolite of folic acid: (-)dihydrofolate reductase
Leucovorin Rescue 86. Can block/reduce Methotrexate = ↑ folic acid via a reduced folate
Bleomycin toxicities 87. Pneumonitis & pulmonary fibrosis
Azathiorine 88. Used in organ transplantation = kidney allografts
89. Allopurinol can ↑ its activity by (-) its biotransformation to xanthine oxidase
MOPP 90. Chemotherapy used in the txt of Hodgkins disease
91. M = Mechlorethamine nitrogen mustard
92. O = Oncovin (Vincristine) prevents microtubule assembly
93. P = Procarbazine
94. P = Prednisone glucocorticoid, inducing apoptosis
Tamoxifen 95. (-) estrogen receptor
96. Txt of breast tumors, can see associated endometrial CA
Flutamide 97. Antiandrogenic
98. Used w/ Leuprolide (LH-RH analog)
99. Txt prostatic CA
Megestrol 100. (-) progesterone receptor
101. Txt endometrial CA
Fluoxymesterone 102. Androgenic steroid
103. Txt mammary CA in postmenopausal women
Methotrexate 104. Folic acid analog that (-) tetrahydrofolate synthesis by (-) dihydrofolate reductase
105. Txt of ALL
106. Txt of Psoriasis
Brain tumor Txt 107. Lomustine
108. Carmustine Causes pulmonary fibrosis
Streptozocin 109. Attaches to β cells
110. Txt of pancreatic insulinomas
Cytarabine (AraC) 111. Pyrimidine analog
112. DOC for AML
Dactinomycin 113. Used for Wilms tumor & rhabdomyosarcoma
Etoposide 114. Used for oat cell CA
Paclitaxel 115. Used for ovarian CA
Amifostine 116. Can ↓ nephrotoxicity due to chronic use of Cisplatin

Pathology
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Mobitz I 117. Usually due to inferior MI. Rarely goes into 3rd degree block.
118. Txt w/ Atropine or Isoproterenol.
Mobitz II 119. BBB association. Often goes to 3rd degree AV block. Usually due to anterior MI.
Wavy fibers 123. Eosinophilic bands of necrotic myocytes. Early sign of MI.
Janeways lesions 124. Acute bacterial endocarditis.
125. Nontender, erythematous lesions of palms & soles.
Oslers nodes 126. Subacute bacterial endocarditis.
127. Tender lesions of fingers & toes.
Thiamine defcy 128. Wet Beri Beri heart. Dilated (congested) cardiomyopathy due to chronic alcohol consumption
129. Dyr Beri Beri = peripheral neuropathy
130. Wernicke-Korsakoff = ataxia; confusion; confabulation; memory loss
Fibrinous Pericarditis 131. Associated w/ MI: Dresslers
Serous Pericarditis 132. Associated w/ nonbacterial; viral (Coxsackie) infection; immunologic reaction.
Friction Rub 133. Pericarditis association
Hemorrhagic Pericarditis 134. Associated w/ TB or neoplasm
Restrictive Cardiomyopathy 135. Aka infiltrative cardiomyopathy that stiffens the heart
136. Due to amyloidosis in the elderly
137. Due to , also see schaumann & asteroid bodies in young (<25 yoa).
PMLs infectious agent 138. JC Virus (Papovavirus = dsDNA, naked icosahedral capsid)
Edema 139. ↑Pc (more seeps out)
140. ↓πc (less reabsorbed)
141. ↑ permeability
142. Block lymphatic drainage
Adult Polycystic Kidney 143. Commonly see liver cysts & Berry aneurysms along w/ kidney cysts. Hematuria & HTN also present.
Disease 144. 3 cysts in ea. Kidney w/ + family history confirms diagnosis

Malignant HTN & Kidneys 145. Petehial hemorrhages are seen on kidney surfaces = Flea-Bitten surface = young black men
Nephritic signs 146. Hematuria; RBC casts; HTN
Nephrotic signs 147. Proteinuria; Hypoalbuminemia; Edema
Podocyte Effacement seen w/ 148. Minimal Change (Lipoid nephrosis) disease

ASO seen in 149. Acute post-streptococcal GN (due to βHGASrtep)

150. Anti streptolysin O
Crescentic GN 151. Rapidly progressive GN nephritic syndrome
152. Associated w/ multi system disease or post-strep/post infectious glomerular nephritis
Hereditary Nephritis 153. Alports syndrome. X linked
154. Renal disease w/ deafness & ocualr abnormalities
Membranoproliferative GN 155. Can be secondary to complement deficiency; chronic infections; CLL
156. See tram tracking
TypeI Membrano 157. C3 & IgG deposits
Proliferative GN deposits
TypeII Membrano 158. Only C3 deposits
Proliferative GN deposits 159. Aka Dense deposit disease

Focal segmental 160. IgM & C3 deposits

glomerulosclerosis deposits
Cold agglutinins 161. Seen in atypical pneumonia
162. It is IgM Ab with specificity for I Ag on adult RBCs
Scrofula 163. TB in the lymph nodes
Aspirin-Asthma Triad 164. Nasal polyps Rhinitis bronchoconstriction
Ferruginous bodies 165. Hemosiderin (pigment w/ Fe3-) covered macrophages that have been pahgocytised
Pancoasts tumor causes 166. Ulnar nerve pain & Horners syndrome

Fatty degeneration 167. Made up primarily of triglycerides

168. Most commonly due to alcoholism which commonly leads to hepatic cirrhosis 169.
Associated w/ CCl4-

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Cloudy swelling 170. Failure of cellular Na pump
171. Seen in Fatty degeneration of the liver and in Hydropic (Vacuolar) degeneration of the liver
Hydropic degeneration 172. Severe form of cloudy swelling
173. Seen with hypokalemia induced by vomitting/diarrhea
Liquefaction necrosis 174. Rapid enzymatic break down of lipids
175. Seen commonly in Brain & Spinal cord (CNS) injuries
176. Seen in suppurative infections = pus formation
Coagulation necrosis 177. Result of sudden ischemia
178. Seen in organs w/ end arteries limited collateral circulation) = heart, lung, kidney, spleen
Caseation necrosis 179. Combination of both coagulation & liquefaction necrosis
180. Seen w/ M. tuberculosis & Histoplasma capsulatum infection
Fibrinoid necrosis 181. Seen in the walls of small arteries
182. Associated w/ malignant hypertension, polyarteritis nodosa, immune mediated vasculitis
Fat necrosis 183. Result of lipase actions liberated from pancreatic enzymes
184. Seen w/ Acute pancreatitis = saponification results
Hemoptysis 185. Blood in sputum
Pulmonary embolism 186. Most commonly thrombus from lower extremity vein
Phlebothrombosis 187. From a vein of lower extremities, of a pregnant uterus, in Congestive heart failure, bed ridden pt,
188. As a complicaiton in a pt w/ Pancreatic CA due to ↑d blood coagulability
Saddle embolus 189. Embolus lodged in bifurcation of pulmonary trunks
190. ↑↑ RV strain = RV & RA dilate = Acute cor Pulmonale
Paradoxical embolism 191. Right to Left shunt allows a venous embolism to enter arterial circulation
192. Patent ovale foramen or Atrial septal defect
Tuberculoid granuloma 193. Collection of macrophages w/o caseation
194. Seen w/ Sarcoidosis (non-caseating); Syphilis; Brucellosis and Leprotic infections
Cellulitis 195. Spreading infection due to streptococcus
PSA 196. Prostate Specific Antigen = elevated in prostatic CA
↑↑5-HT 197. In cases of metastatic carcinoid, txt w/ Methysergide (5HT antagonist)
↑ αFeto Protein 198. Hepatocarcinoma
199. Neural tube defects
CEA 200. Carcinoembryonic Antigen = elevated in Colon CA
Chromosome 13 201. Retinoblastoma
Chromosome 11p 202. Wilms tumor of the kidney
Vinyl Chloride 203. Associated w/ Angiosarcoma of the liver
Agent Orange 204. Contains dioxin
205. Implicated as a cause of Hodgkin;s disease, non-Hodgkins lymphoma & soft tissue sarcomas
Parasites & CA 206. Schistosoma haematobium = Urinary bladder CA
207. S. mansoni = Colon CA
208. Aspergillus flavus = potent hepatocarcinogen
Ochronosis 209. Alkaptonuria
210. Error in tyrosine metabolism due to Homogentisic acid (oxidizes tyrosine)
211. Involving intervertebral disks = Ankylosing Spondilitis = Poker spine
212. See dark urine; dark coloration of sclera, tendons, cartilage
Lead poisoning 213. Acid fast inclusion bodies
214. ↑ urinary coproprophyrin
215. Anemia: microcytic/ hypochromic
216. Stippling of the basophils
217. Gingival line & lead line in bones: x-ray
218. Mental retardation
Heroin OD, clinically 219. Massive pulmonary edema w/ frothy fluid from the nostrils
Fetal alcohol syndrome 220. Small head, small eyes, funnel chest, ASD, mental deficiency, and hirsutism
Atypical mycobacterium 221. M. kanasasii & M. avium intracellulare
Cold abscesses 222. Liquefied TB lesions similar to pyogenic abscesses but lacking acute inflammation
Actinomyces isrealli 223. Farmers infection
224. Lumpy jaw (from chewing grain) & PID (IUD), but most common is due to saprophyticus
Congenital Syphilis 225. Saddle nose, Saber shin, Hutchinsons teeth, nerve deafness, interstitial keratitis

Page 23
Warthin-Finkeledy cells 226. Reticuloendothelial giant cells on tonsils, lymph nodes, spleen

227. Seen with Rubeola (measles) due to paramyxovirus

Diphyllobothrium latum 228. Tapeworm infection causing megaloblastic anemia by consuming large amount of vit B12 in the host
Subacute Bacterial 229. α Hemolytic Streptococci (S. viridans) = usually in pt w/ pre-existing heart problem
Endocarditis
Acute Bacterial Endocarditis 230. Staph aureus, β Hemolytic Streptococci, E. coli
231. Common among drug addicts & diabetics
Mitral Insufficiency 232. Ruptured papillary muscle
Left Anterior Descending 233. Branch of the Left Coronary artery
branch 234. Highest frequency of thrombotic occlusion
235. MI = anterior wall of the LV, especially in apical part of interventricular septum
Left Circumflex branch 236. Branch of the Left Coronary artery
237. Occlusion = MI of posterior/lateral wall of the LV
Dissecting Aneurysm 238. False aneurysm: it is splitting of the media of the aorta
239. Usually accompanied w/ long history of severe hypertension, also seen w/ familial hyperlipidemia,
atherosclerotic disease, Marfans Collagen disease
240. Zones of medial necrosis +/- slitlike cysts = Medial Cystic Necrosis of Erdheim
Cor Pulmonale 241. Right ventricular strain, associated w/ right ventricular hypertrophy
Acute Cor Pulmonale 242. Sudden right ventricular strain due to a massive pulmonary embolism
Bronchopneumonia 243. Lobular (rather than lobar)
244. Due to Staph aureus; Pseudomonas aeruginosa; Klebsiella; E. coli
245. Abscess formation is common
Lobar pneumonia 246. Due to Strep. Pneumoniae infection (5% due to Klebsiella)
247. Red Hepatization: days 1-3 of the pneumonia
248. Gray Hepatization: days 3-8 of untreated pneumonia
249. Complicaitons: pleural effusion; atelectasia; fibrinous pleuritis; empyema; fibrinous pericarditis; otitis
media
Bronchiectasis 250. Permanent dilatation of the bronchi predisposed by chronic sinusitis and post nasal drip
251. Supparation associated
252. Lower lobe > than upper lobe involvement
Cold Agglutinins 253. Found w/ Mycoplasma pneumoniae
Panlobular Emphysema 254. α1 antitrypsin deficiency, causing elastase ↑ = ↑ compliance in the lung
Bulla 255. Associated w/ Emphysema = Bleb = outpouching - If it ruptures causes Pneumothorax
Farmers Lung 256. Due to Micropolyspora faeni (thermophilic actinomycetes)
Bagassosis 257. Due to M. vulgaris (actinomycetes)
258. Inhalation of sugar cane dust
Silo-Fillers Lung 259. Due to Nitrogen dioxide from nitrates in corn
G6PDH Deficiency 260. Sex-linked chronic hemolytic anemia w/o challenge or after eating fava beans
261. Heinz Bodies appear in RBCs
HbF ↑↑ 262. Sickle Cell Anemia
Multiple Myeloma 263. Lytic lesions of flat bones ( salt & pepper lesions ) = vertebrae, ribs, skull; Hypercalcemia; Bence-Jones
protein casts
Hodgkins Disease 264. Malignant neoplasm of the lymph nodes causing pruritis; fever = looks like an acute infection
265. Reed Sternberg cells
Polyarteritis Nodosa 266. Immune complex disease of Ag-Ab complexes on blood vessel wall
267. Half of the immune complexes have Hepatitis B Ag
268. Can see fever; abd.pain; ↓ wt; HTN; muscle aches
Sprue 269. Celiac disease due to a gluten-induced enteropathy = small intestine villi are blunted
270. High titers of anti-gliadin Abs & ↑ IgA levels
Regional Enteritis 271. Crohns Disease
272. Association w/ Arthritis; Uveitis; Erythema Nodosum
Whipples Disease 273. Intestinal Lipodystrophy = malabsorption syndrome
Kulchitsky cells 274. Neural cest cells from which carcinoids arise = of the Bronchi; GIT; Pancreas

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Ulcerative Colitis 275. Inflammatory disease of the colon w/ ↑ colon CA incidence
276. Crypt abscess in the crypts of Lieberkuhn
277. Pseudopolyps when ulcers are deep
278. Not transmural involvement
Vaginal Adenosis 279. Women exposed to DES (Diethylstilbesterol) in utero before the 18th week of pregnancy
280. Some develop clear cell adenocarcinoma of the vagina & cervix
Scirrhous Carcinoma 281. Infiltrating Duct Carcinoma w/ fibrosis most common type of breast carcinoma
Hofbauer Cells 282. Lipid laden macrophages seen in villi of Erythroblastosis Fetalis

Retinopathy of Prematurity 283. Retrolental Fibroplasia = cause of bindness in premies due to high O2 concentrations
IgA deficiency 284. Pt has recurrent infections & diarrhea w/ ↑ respiratory tract allergy & autoimmune diseases
285. If given blood w/ IgA = develop severe, fatal anaphylaxis reaction
Priamry Sjorgens 286. Dry eyes & dry mouth, arthritis. ↑ risk for B cell lymphoma. HLA-DR3 frequent. Autoimmune disease.
Secondary Sjorgens 287. Rheumatoid arthritis, SLE, or systemic sclerosis association
288. RA association shows HLA-DR4
LDH1 & LDH2 289. Myocardium. LDH1 higher than LDH2 = Myocardial Infarction
LDH3 290. Lung tissue
LDH4 & LDH5 291. Liver cells
Keratomalacia 292. Severe Vit A deficiency. See Bitots spots in the eyes = gray plaques = thickened, keratinized ET
Metabisfite Test 293. Suspending RBCs in a low O2 content solution
294. Can detect Hemoglobin S, which sickles in low O2
Microangiopathic Hemolytic 295. Can be due to Hemolyitc Uremic Syndrome & Thrombotic Thrombocytopenic Purpura (TTP)
Anemia 296. See Helmet cells

Wrights stain 297. Stain for Burkitts lymphoma

Mononucleosis 298. Due to EBV infeciton
299. If Mono is treated w/ Ampicillin, thinking that it is a strep pharyngitis, a rash will occur.
T(8;14) 300. Burkitts lymphoma = c-myc oncogene overexpression
T(9;22) 301. CML = c-abl/bcr gene formation = Philadelphia translocation
Langerhan Cell Histiocytosis 302. Letter Siwe syndrome; Hand Schuller Christian Disease; Eosinophilic Granuloma
303. Birbeck granules are present = tennis racket shape
Myeloid Metaplasia 304. Alkaline phosphatase ↑/normal compare to CML = low to absent
305. Anemia; splenomegaly; platelets > 1 million = extensive extra-medullary hematopoiesis
Multiple Myeloma 306. Weakness; wt. loss; recurrent infection; proteinuria; anemia; ↑ proliferation of plasma cells in BM =
plasma cell dx
307. Serum M protein spike most often of IgG or IgA
308. Hypercalcemia (↑ bone destruction)
T(14;18) 309. NH Lymphoma = bcl2 proto-oncogene overexpression seen w/ Small Cleaved Cell (Follicualr)
Lymphoma
Focal Segmental GN exs 310. IgA Focal GN = Bergers disease; SLE; PAN; Schonlein-Henoch purpura (anaphylactoid purpura)
Nephrotic Syndrome exs 311. Focal (Segmental) GN; Membranous GN; Lipoid (Minimal Change) GN; Membranoproliferative GN; Hep
B;
Syphilis; Penicillamine
Schistosoma Haematobium 312. Infection is assocaited w/ Squamous cell CA of the Bladder (most common Bladder CA is transitional
cell type)
313. Associated w/ portal HTN due to intrahepatic obstruction
Penicillin Resistant PID 314. PID is usually due to N. Gonorrhoeae, but if unresponsive to penicillin think of Bacteroides species
Duret Hemorrhages 315. Severe ↑ in ICP w/ downward diplacement of cerebellar tonsils into Foramen Magnum causing a
compression on the brainstem w/ hemorrhaging into the pons & midbrain
316. Nearly always associated w/ death due to damage to the vital centers in these areas
Hypertensive Hemorrhage 317. Predilection for lenticulostriate arteries = putamen & internal capsule hemorrhages
Cerebral Embolism from 318. MI w/ Mural Thrombi; Atrial Fib Thrombi = Marantic thrombi; L-sided Bacterial Endocarditis;
Paradoxical Embolism of septal defect
Neurosyphilis 319. Tabes Dorsalis = ↓ joint position sensation, ↓ pain sensation, ataxia, Argyl Robertson pupils
320. Syphilitic meningitis
321. Paretic neurosyphilis

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5p- 322. Cri di Chat: mental retardation; small head; wide set eyes; low set ears; cat-like cry
Trisomy 13 323. Pataus: small head & eyes; cleft lip & palate; many fingers

Acute Cold Agglutinaiton 324. Abs to I blood group Ag. Mediated by IgM Abs
325. Complication of EBV or Mycoplasma pneumoniae infections
Chronic Cold Agglutinaiton 326. Associated w/lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold. IgM Abs
RBC Osmotic Fragility 327. Hereditary Spherocytosis
Non-Hodgkins Lymphomas 328. Small Lymphocytic: low grade B cell lymphoma of the elderly. Related to CLL.
329. Small Cleaved cell (Follicualr): low grade B cell lymphoma of the elderly. T(14;18) bcl-2 oncogene
330. Large Cell
331. Lymphoblastic: high grade T cell lymphoma of kids progressing to T-ALL
332. Small Non Cleaved = Burkitts: high grade B cell lymphoma. EBV infection. Starry sky histo
appearance. T(8;14) c-myc proto-oncogene. Related to B-ALL
Singers Nodules 333. Benign laryngeal polyps associated w/ smoking & overuse of the voice
Paraseptal emphysema 334. Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax

Superior Vena Cava Syndrome 335. Obstructed due to bronchogenic carcinoma. Causing swollen face & cyanosis.
Betel nuts 336. Associated to oral cancer.
Fundal (Type A) Gastritis 337. Antibodies to parietal cells; pernicious anemia; autoimmune diseases
Antral (Type B) Gastritis 338. Associated w/ Helicobacter (Campylobacter) pylori infection. 90% of duodenal ulcer
Primary Biliary Cirrhosis 339. Autoimmune origin; middle aged women; anti-mitochondrial Abs
340. Jaundice; itching; hypercholesterolemia (can see cutaneous xanthomas)
Acute Pancreatitis 341. ↑ pancreatic enzymes = fat necrosis; sapponification = hypocalcemia; ↑ serum amylase
342. Severe epigastric ab pain; prostration; radiation to the back
Radiating Back Pain 343. Chronic pancreatitis
Complete Hydatidiform Mole 344. No embryo. Paternal derivation only. 46XX
Partial Hydatidiform Mole 345. Embryo. 2 or more sprems fertilized 1 ovum: triploidy/tetraploidy occurs
Cold Nodules 346. Hypoplastic Goiter nodules that do not take up radio active iodine. [Opposite: hot & do take up iodine]
Acidophils 347. Mammotrophs = Prolactin
348. Somatotrophs = GH

Basophils 349. Thyrotrophs = TSH

350. Gonadotrophs = LH
351. Corticotrophs = ACTH & FSH
Lacunar Strokes 352. Small/focal aa occlusions. Purely motor or sensory.
353. Sensory: lesion of thalamus
354. Motor: lesion of internal capsule
CSF of Bacterial Meningitis 355. ↓ Glucose; ↑ Protein; ↑ Neutrophils; ↑ Pressure
CSF of Viral Meningitis 356. Normal Glucose; +/-↑ Protein; ↑ Lymphocytes
Marble Bone Disease 357. Osteoporosis: Albers-Schonberd Disease = inspite of ↑d bone density, many fractures = ↓ osteoclasts
C5a 358. Involved in Chemotaxis (for Neutrophils)
C3b 359. Involved in Opsonization (& IgG)
Anaphylotoxins 360. C3a & C5a (mediate Histamine release from Basophils & Mast cells)
Vasoactive Mediators 361. Vasoconstriction: TxA2; LTC4; LTD4; LTE4; PAF
362. Vasodilation: PGI2; PGD2; PGE2; PGF2α; Bradykinin; PAF
363. ↑d Vascular Permeability: Hist.; 5HT; PGD2; PGE2; PGF2α; LTC4; LTD4; LTE4; Bradykinin; PAF
Platelet Aggregation 364. ADP; Thrombin; TxA2; collagen; Epinephrine; PAF
Platelet Antagonist 365. Prostacyclin (PGI2)
Intrinsic Pathway 366. F XII (Hagman): APTT
Extrinsic Pathway 367. F VII: PT
Lines of Zahn 368. Aterial thrombi = pale red colored (dark red is venous thrombi)
Currant Jelly appearance 369. Post mortem clots

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Emigration: Chemotaxis 370. Margination
371. Pavementing
372. Adhesion
373. Chemotaxis
374. Phagocytosis
375. Intracellular microbial killing
Transudate 376. Specific gravity < 1.012 low protein
Exudate 377. Specific gravity > 1.020 high protein
Hurlers 378. Lysosomal storage disease α L Iduronidase Heparan/Dermatan Sulfate accumulation

Galactosemia 379. Deficiency of Galactose 1 Phosphate Uridyl Transferase. ↑ Galactose 1 Phosphate

Phenylketonuria 380. Deficiency: Phenylalanine Hydroxylase. ↑ Phenyalanine & degradation products
381. Mousy body odor
Autosomal Dominant Diseases 382. Adult Poly Cystic Kidney Disease
383. Familial Hypercholestrolemia Disease
384. Hereditary Hemorrhagic Telengectasia (Osler-Weber-Rendu)
385. Hereditary Spherocytosis
386. Huntingtons Disease (chromosome 4p)
387. Marfans Syndrome
388. Neurofibromatosis (von Recklinghausens)
389. Tuberous Sclerosis
390. Von Hippel Lindau Disease
Autosomal Recessive Diseases 391. Tay-Sachs
392. Gauchers

393. Niemann-Pick
394. Hurlers
395. Von Gierkes
396. Pompes
397. Coris
398. McArdles
399. Galactosemia
400. PKU
401. Alcaptonuria
X Linked Recessive Diseases 402. Hunters Syndrome (L-Iduronosulfate Sulfatase deficincy, ↑ Heparan/Dermatan Sulfate)
403. Fabrys Disease (α Galactosidase A deficiency, ↑ Ceremide Trihexoside)

404. Classic Hemophilia A (Factor VIII deficiency, F8 Gene on X chromosome is bad, ↑ Ceremide Trihexoside)
405. Lisch-Nyhan Syndrome (HGPRT deficiency, ↑ Uric acid)
406. G6Phosphatase deficiency (G6PDH deficiency, ↑ Ceremide trihexoside)
407. Duchennes Muscular Dystrophy (Dystrophin deficinecy, ↑ Ceremide Trihexoside)
Hypersensitivity Reactions 408. Type I (Anaphylactic): IgE mediated. Exs: Hay Fever; Allergic asthma; Hives
ACID 409. Type II (Cytotoxic): Warm Ab autoimmune hemolytic anemia; hemolytic transfusion reactions;
Erythroblastosis Fetalis; Graves Disease; Goodpastures
410. Type III (Immune Complex): Insoluble complement bound aggregates of Ag-Ab complexes. Exs:
Serum sickness; Arthus Reaction; Polyarteritis Nodosa; SLE; Immune Complex Mediated Glomerular
Disease 411. Type IV (Delayed = Cell mediated immunity): Delayed hypersensitivity. Involves memory
cells. Exs:
Tuberculin reaction; Contact dermatitis; Tumor cell killing; Virally infected cell killing
Transplant Rejections 412. Hyperacute Rejection = occurs w/in minutes of transplant. Ab mediated.
413. Acute Rejection = occurs w/in days to months of transplant. Lymphocytes & macrophages. Only
rejection type that can be treated w/ therapy.
414. Chronic Rejection = occurs months to years of transplant. Ab mediates vascular damage.
Blood Metastasis 415. Sarcoma, exception renal cell CA: early venous invasion
Lymph Metastasis 416. Carcinoma, exception renal cell CA: early venous invasion
Aflatoxin 417. Seen w/ Aspergillus. ↑ risk for Hepatocellular CA
Cleft Lip 418. Incomplete fusion of maxillary prominence w/ median nasal prominence
Cleft Palate 419. Incomplete fusion of lateral palatine process w/ each other & median nasal prominence & medial
palatine prominence
Craniopharyngioma 416. Pituitary tumor - usually calcified

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Lateral Geniculate Nucleus Inolved in Vision relay
Medial Geniculate Body Involved in Hearing relay
Lung Development Glandular: 5-17 fetal weeks
Canalicular 13-25 fetal weeks
Terminal Sac 24 weeks to birth
Alveolar period birth-8yoa
Hearts 1st Beat 21-22 days
Foregut Mouth  Common Bile Duct - supplied by Celiac Artery
Midgut Duodenum, just below Common Bile Duct  Splenic flexure of the Colon supplied by Superior Mesenteric
artery
Hindgut Splenic Flexure  Butt crack  supplied by Inferior Mesenteric Artery
Hypnagogic Hallucinaitons Narcolepsy
Type I Error α: Convicting the innocent accepting experimental hypothesis/rejecting null hypothesis
Subdural Hematoma Ruptured cerebral bridging veins
Epidural Hematoma Ruptured middle meningeal artery intervals of lucidness , 2ry to Temporal bone fracture
Type II Error β: Setting the guilty free fail to reject the null hypotesis when it was false
Power 1-β
Sensitivity TP/TP + FN
Specificity TN/TN + FP
Positive Predictive Value TP/TP + FP
Negative Predictive Value TN/TN + FN
Odds Ratio ad/bc
d-Dimers DIC
Delusion Disorder of thought content
Loose Association Skip from topic to topic
5 Stages of Death Denial Anger Bargaining Depression Acceptance

1st Branchial Arch Meckels cartillage gives rise to incus/malleus bones of ear
nd Reicherts cartillage gives rise to stapes bone of ear
2 Branchial Arch
Median nerve lesion No pronation
Radial nerve lesion Wrist drop seen w/ humerus fracture
Common peroneal lesion Foot drop. No dorsiflexion or eversion of the foot
Diract inguinal hernia Goes through superficial inguinal ring.
Medial to inferior epigastric artery
Seen in older men
Indirect inguinal hernia Goes through deep & superficial inguinal ring
Lateral to inferior epigastric artery
Seen in young boys processus vaginalis did not close
@ Diaphragm T8, T10, T12 T8 = Inferior vena cava
T10 = Esophagus/ Vagus
T12 = Aorta/ Thoracic duct/ Azygous vein
Hemiballism Wild flailing of 1 arm. Lesion of the sub thalamic nucleus
O Linked Oligosaccharide In the Golgi
N Linked Oligosaccharide In the RER
MLF Syndrome Internuclear Ophthalmoplegia: medial rectus palsy on lateral gaze; Nystagmus on abducting eye.
Seen w/ MS
ADA Deficiency SCID
Raphe Nucleus Initiation of sleep via 5HT predominance
β waves Alert; Awake; Active mind also seen in REM, therefore we say paradoxical sleep

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Irreversible Glycolysis Hexokinase
Enzymes PhosphoFructo Kinase = Rate Limiting Step
Pyruvate Kinase
Pyruvate Dehydrogenase
Irreversible Gluconeogenesis PyruvateCarboxy Kinase
Enzymes PEPCarboxyKinase
Fructose 1,6 BiPhosphatase
Glucose 6 Phosphatase
**muscle dose not take part in Gluconeogenesis, only takes place in the liver, kidney & GI epithelium
Pellagra Diarrhea, Dermatitis, Dementia
Niacin Deficiency (Vit B3 deficiency)
Hartnups Disease
Malignant Carcinoid Syndrome
INH use
TLCFN Needed as co-factor for Pyruvate DH complex & α Ketoglutarate DH complex
LCAT or PCAT Esterification of cholesterol: lecithin cholesterol acetyltransferase
Lecithin = Phosphatidylcholine, therefore phosphotidylcholine acetyltransferase
HMGCoA Reductase Rate limiting step in cholesterol synthesis
Changes HMGCoA  Mevalonate
(-) by Lovastatin
Ketogenic amino acids Leucine & Lysine
Glucogenic amino acids Methionine, Threonine, Valine, Arginine, Histadine
Keto & Gluco amino acids Phenylalanine, Trytophan, Isoleucine
Carnitine Shuttle Feeds FA into the mitochondria for their consumption
Cori Cycle Keeps muscles working anaerobically.
Transfers lactate to the liver to make glucose which is sent back into the muscles for energy use
(-) Na+ Pump (ATPase) Ouabain [(-) K+ pump]
Vanadate [(-) phosphorylation]
Digoxin [↑ heart contractility]
TCA Cycle Products Citric Acid Is Krebs Starting Substrate For Mitochondrial Oxidation
Citrate  Aconitate  Isocitrate  α Ketoglutarate  Succinyl  Succinate  Fumarate  Malate
OAA
Cones Color vision. Contain Iodopsin = Red-Blue-Green specific pigment. For acuity.
Rods Contain Rhodopsin pigment. High sensitivity. Concentrated in the fovea. Night vision.
Gastrula Seen @ 3rd week: Ecto, Meso & Endo
Epiblast @ 2nd week: forms the primitive streak, from which Meso & Endo come from. Directly gives rise to Ecto.
Sydenhams Chorea Post streptococcal infection. Necrotizing arteritis of the caudate, putamen, thalamus
(+) Frei Test Chlamydia trachomatis types L1, L2, L3 = Lymphogranuloma venereum
Sabourauds Agar Culture for all Fungi ie Culture Cryptococcus neofromans which is found in pigeon droppings

FMR1 Gene Defect Fragile X Syndrome: macro-orchidism; long face; large jaw; large everted ears; autism, mental retardation
Barr Body Present in Kleinfelters: Male: XXY Not
present in Turners: Female: XO
Aortic Insufficiency Signs Traube Sign = Pistol shot sound over the femoral vessels
Corrigan pulse = water hammer pulse over coratid artery = aortic regurgitation
Scleroderma : CREST Calcinosis; Raynauds; Esophageal; Sclerodactyl; Telangiectasis
Cretinism Sporadic: bad T4 phosphorylation or developmental failure of thyroid formation
Endemic: no Iodine in diet: protruding belly & belly button
Hemochromatosis Triad Micronodular pigment cirrhosis; Bronze Diabetes; Skin pigmentation = due to ↑ Fe3+ deposition

Highly Tested Drug Side Effects

Agranulocytosis 420. Clozapine, Chloramphenical

Aplastic Anemia 421. Chloramphenicol

422. NSAIDs
423. Benzene
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Atropine-like Side Effects 424. Tricyclics

Cardiotoxicity 425. Doxorubicin

426. Daunorubicin
Cartilage Damage in Children 427. Fluoroquinolones (Ciprofloxacin & Norfloxacin)

Cinchonism 428. Quinidine

Cough 429. ACE Inhibitors

Nephrogenic Diabetes Insipidus 430. Lithium (Txt w/ Amiloride)

Disulfiram-like Effect 431. Metronidazole

432. Sulfonylureas (1st generation)
Extrapyramidal Side Effects 433. Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine)

Fanconis Syndrome 434. Tetracycline

Fatal Hepatotoxicity (necrosis) 435. Valproic Acid

436. Halothane
437. Acetaminophen
Gingival Hyperplasia 438. Phenytoin

Gray Baby Syndrome 439. Chloramphenicol

Gynecomastia 440. Cimetidine

441. Azoles
442. Spironolactone
443. Digitalis
Hemolytic Anemia in G6PD-deficiency 444. Sulfonamides
445. Isoniazid
446. Aspirin
447. Ibuprofen
448. Primaquine
Hepatitis 449. Isoniazid

Hot Flashes, Flushing 450. Niacin

451. Tamoxifen
452. Ca++ Channel Blockers
Induce CP450 453. Barbiturates Phenobarbital
454. Phenytoin
455. Carbamazepine
456. Rifampin
Inhibit CP450 457. Cimetidine
458. Ketoconazole
Interstitial Nephritis 459. Methicillin
460. NSAIDs (except Aspirin)
461. Furosemide
462. Sulfonamides
Monday Disease 463. Nitroglycerin Industrial exposure → tolerance during week → loss of tolerance during weekend → headache, ach,
dizziness upon re-exposure

Orange Body Fluids 464. Rifampin

Osteoporosis 465. Heparin

466. Corticosteroids
Positive Coombs Test 467. Methyldopa

Pulmonary Fibrosis 468. Bleomycin

469. Amiodarone
Red Man Syndrome 470. Vancomycin

Severe HTN with Tyramine 471. MAOIs

SLE-like Syndrome 472. Procainamide

473. Hydralazine
474. INH
Tardive Dyskinesia 475. Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine) Clozapine: only antipsychotic to not
476. give you tardive dyskinesia

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Tinnitus 477. Aspirin
478. Quinidine

Microbiology

Waysons Stain 44. Yersinia

Pneumonic Plaque Transmission 45. Person to person cf w/ Bubonic plaque that was via infected flea
Splenectomy 46. Predisposes to septicemia
Invasins 47. Yersinia pseudotuberculosis
Fusiform 48. Vincents trench mouth
S. viridans 49. Dextran mediated adherence
Obligate Aerobes 50. Pseudomonas & Mycobacterium
Obligate Anaerobes 51. Clostridium, Actinomyces, Bacteroides
Staph aureus 52. A Protein, Catalase +/ Coagulase +

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Spirochetes 53. Treponema, Borrelia, Leptospira
Non Motile Gram (+) Rods 54. Corenybacterium D & Nocardia
Acid Fast Organisms 55. Mycobacterium; Cryptosporidium; Nocardia (partially); Legionella micdadei; Isospora
Pigment Producing Bacteria 56. Serratia red (can cause pseudohemoptysis)
57. Pseudomonas A piocyanin blue/green
58. Staph Aureus yellow Protein A
59. Mycobacteria photo/scoto chromogenic caritinoid yellow/orange
60. Corneybacterium D black/gray pseudomembrane plaque in throat
61. Bacteroides (Porphyromonas) melaninogenicus black (heme) 62. E. coli
irredescent green sheen
Bacterial Morphology 63. Pneumococci lancet shaped diplococci
64. Neisseria kidney bean shaped diplococci
65. Camphylobacter gulls wings/comas
66. Vibrio Cholera coma shaped
67. Corneybacterium D club shaped (nonmotile, G+Rod)
68. Yersinia safety pin seen in Waysons stain
Inclusion Bodies 69. Rabies Negri bodies intracytoplasmic
70. Pox virus Guarnieri intracytoplasmic & acidophilic
71. CMV Owls eyes intracytoplasmic & intranuclear
72. HSV Cowdry bodies intranuclear
Schistosoma Japonicum Monsoni 73. Intestinal contact w/ bad water
Schistosoma Haematolium 74. Vesicular contact w/ bad water
Non Human Schistosom 75. Swimmers itch contact w/ bad water
Clonorchichis 76. Chinese liver fluke eating raw fish. Txt: Praziquantel
Fasciola Hepatica 77. Sheep eating raw fish. Txt: Praziquantel
Fasciola Biski 78. Giant intestinal flukes eating raw fish. Txt: Praziquantel
Paragonimus Westermani 79. Lung fluke eating raw fish. Txt: Praziquantel
Oxidase (+) 80. Neiserria and most Gram (-)s
Micro Aerophilic 81. Camphylobacter & Helicobacter
Urease (+) 82. All Proteus can cause Staghorn/Struvite calculi (NH4- Mg2- stones): alkaline urine
83. Ureaplasma
84. Campylobacter pylori (Helicobacter)
85. Cryptococcus
86. Nocardia
Coagulase (+) 87. Staph A & Yersenia pestis
Obligate Intracellular Bacteria 88. Chlamydia Pistacci (Chlamydia do not make own ATP); Mycobacterium Leprae; all Rickettsia
except Roachalimea (make suficient ATP to survive)
Protozoa 89. Plasmodium; Toxoplasma ghondi; Babesin; Leishmania; Trypanosoma Cruzi
Obligate Non Intracellular Parasites 90. Treponema palidum & Pneumocystis Carinii (cannot be cultured on inert media but
can be found extra cellularly in the body)
Haemophilus Factors 91. X = Protoporphyrin & V = NAD
All cocci are 92. Gram (+) except for Neisseria & Moraxella
Eaton Fried Eggs 93. Mycoplasma pneumoniae has fried egg colonies on Eaton agar (needs cholesterol)
Mycoplasma 94. No cell wall. Membrane has cholesterol. Smallest living bacteria.
95. P1 protein inhs ciliary action
96. Fried egg colonies
97. Atypical pneumonia young adults
Sabrands 98. Fungal media
Malassazia furfur 99. Spaghetti & meat ball

Measles 3Cs 100. Cough Coryza Conjunctivitis. Can also have photophobia
101. May lead to subacute Sclerosing Panencephalitis
Non Motile Bacilli & Clostridium 102. B. Anthracis & C. Perfringens
Bloody diarrhea agents 103. EIEC EHEC Shigella - Yersenia enterocolitica Entaemeba histolytica Salmonella
Campylobacter jejuni

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YW-135CA 104. N. meningitidis vaccine capsualr polysaccharide strains
Indian Ink 105. Cryptococcus neoformans
Naegleria causes 106. Colonization in the nasal passages after swimming
Need Cysyeine for growth 107. Ella likes cysteine :
108. Francisella
109. Brucella
110. Legionella
111. Pasturella
Endotoxins, G(+) or G(-) 112. Gram (-): N. meningitidis
Ecthyma Gangrenosum, seen w/ 113. Pseudomonas aeroginosa. Target shaped skin lesions w/ a black center and red ring
surrounding the lesion
Endospores G(+) 114. Gram (+): Bacillus & Clostridium made up of dipicolinate & Keratin
Multi Brain Abscess 115. Nocardia
Single Brain Abscess 116. Actinomyces israelli
↑ risk for Strep pneum Infection 117. Asplenic; Sickle cell anemia; immunocompromising illness
α Hemolysis/Optochin Sensitive 118. Strep. Pneumoniae
α Hemolysis/Optochin Resistant 119. Strep. Viridans (Subacute Endocarditis)
Staph. Saprophyticus 120. Novobiocin Resistant (UTIs)
Staph. Epidermidis 121. Novobiocin sensitive (Endocarditis in IVDUs)
β Hemolysis/Bacitracin Sensitive 122. Strep. Pyogenes (pharyngitis; Scarlet fever; cellulitis; impetigo; Rheumatic fever))
123. Hyaluronic capsule; non-motile; M proteins; Endotoxin A
β Hemolysis/Bacitracin Resistant 124. Strep. Agalactiae (Diabetes predisposes to infection)
EFII Ribosylation 125. Diphtheria toxin & Pseudomonas exotoxon A
Bacillus Anthracis: 3 toxins 126. Protective Antigen (PA)
(work via adenylate cyclase) 127. Lethal Factor = toxic to macrophages
128. Edema Factor = ↑ cAMP
Woolsorters Disease 129. Bacillus anthracis. DOC: Penicillin
Grows in Rice 130. Bacillus Cereus
Clostridium Perfringens 131. Double Zone β Hemolysis (test)
132. Lecithinase: α toxin = lyses RBCs
133. 80% of gas gangrene (myonecrosis) cases
Clostridium Difficile 134. 2 Toxins: Enterotoxin (Exotoxin A) & Cytotoxin (Exotoxin B)
135. Pseudomembranous colitis (can be precipitated by clindamycin/ampicillin)
Spastic Paralysis toxin 136. Clostridium Tetani toxin
Clostridium Botulinum 137. Bad canned foods have neurotoxin = flaccid paralysis (block Ach release)
Infant Botulinum 138. Floppy Baby Syndrome. Pre formed toxin in honey
Thayer Martin Agar 139. Neisseria ID
DOC for N. gonorrhoeae 140. Ceftriazone
K1 E. Coli Capsular Ag 141. Related w/ neonateal meningitis
The As of Klebsiella 142. Alcoholics
143. Aspiration pneumonia
144. Abscesses in the lungs
Rice H2O Diarrhea 145. Vibrio Cholera: metabolic acidosis
Raw seafood intoxicaiton 146. Vibrio parahemolyticus
Helicobacter Txt 147. Bismuth salts; Metronidazole; Tetracycline (or amoxicillin)
↑ risk of P. aeroginosa infection 148. Burn patients & Cystic fibrosis
Contact lens infection 149. Pseudomonas aeroginosa
Cat Bites 150. Pasteurella multocida
Undulant Fever 151. Brucella
Bordet Gengou Agar 152. Bordetella pertusis ID
Lowenstein-Jensen medium 153. M. tuberculosis ID
Cat Scratch Disease 154. Bartonella henselae. Leion can resemble Kaposis sarcoma.

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 155. Toxoplasmosis
Pink Eye 156. Adenovirus (type 8)
True Hemaphrodite 157. Testes & Ovaries are present
Pseudo Hemaphrodite 158. External genitalia does not coincide w/ gonads
Male Pseudo Hemaphrodite 159. Testicular Feminization
HLA Genes Location 160. 6p
Parvovirus B19 161. Fifth Disease: Erythema Infectiosum (ssDNA). Linked w/ sicle cell anemia
Interferon MOA 162. Inhibits viral replication (translation or transcription)
Acute Hemorrhagic Conjunctivitis 163. Seen w/ infections from Enterovirus & Coxsackie A
Parainfluenza Causes 164. Croup (Laryngotracheobronchitis)
Swimming Pool Conjunctivitis 165. Adenovirus (types 3 & 4)
RSV 166. Bronchiolitis in infants
Removed tonsils, find what virus 167. In 80%, Adenovirus. In the immunosuppressed, activation can occur
Bone Fever 168. Dengue: Group B Togavirus, from the Arbovirus, transmitted by mosquitos
HbsAg 169. Appears in blood soon after infection, before onset of acute illness
170. Disappears w/in 4-6 months after the start of clinical illness
HbeAg 171. Appears early acute phase, indicates higher risk of transmitting the disease
172. Disappears before HbsAg is gone
Anti-Hbc 173. Present in beginning of clinical illness
174. Seen in the window phase
Filamentous Bacteria 175. Actinomycetes = Nocardia; Actinomyces; Streptomyces
Listeria contaminates 176. Milk, cheese, vegetables (coleslaw) in recent infections
Shiga like Toxin 177. E. Coli 0157/H7: Hemorrhagic colitis & Hemorrhagic uremic syndrome
Necrotizing Fasciitis 178. Group A Streptococci
Relapsing Fever 179. Borrelia recurrentis
Lofflers Medium 180. Corneybacterium diphtheriae
Chlamydiae Developmental Cycle 181. Elementary Body: infeccious particle that Enters the cell
182. Reticulate Body: made from elementary body. Replicates, differentiates and
releases elementary bodies to infect other cells
183. W/ infection you will see Glycogen containing inclusions 184. Cell wall lacks muramic
acid
Trench Fever 185. Rochalimaea quintana
Spotted Fever Members 186. Rickettssia rickettsii (RMSF) & R. akari (rickettsial pox) in the U.S.
187. R. sibirica (tick typhus in China) & R. australis (typhus in Australia)
Thrush Txt 188. Nystatin txts candidiasis of the mouth
Rose Bush Thorns 189. Have Sporothrix schenckii
Contact lens solution infection 190. Acanthamoeba
Filiariasis Causant 191. Wucheria bancrofti (infection aka elephantitis & wucheriasis
Freshwater lake infection 192. Causes amebic meningoencephalitis due to Naegleria fowleri
Reduviid bug bite 193. Transmits Trypanoma cruzi (Chagas disease): Romanas Sign
Schistosoma Haematobium causes 194. Bladder calcificaiton & cancer
Schistosoma Mansoni causes 195. Presinusoidal HTN, splenomagaly, esophageal varices
Snail, intermediate host of 196. Schistosomiasis
Ixodes scapularis transmits 197. Babesia (clinically rembles malaria) & Borelia burgdorferi
Nantucket Protozoa 198. Babesia microt
Infection by Reduviid Bug 199. Trypansoma cruzi: Chagas Disease
Infection by TseTse Fly 200. Trypansoma brucei gambiense & rhodiense: African Sleeping Sickness
Infection by Sandfly 201. Leishmaniasis: Mucocutaneous Diseases by L. braziliensis & Visceral Disease by L. donovani &
Dermal Leishman by L. tropica, mexicana, peruviana
Infection by Ixodes Tick 202. Babesia microti: Babesiosis & Borrelia burgdorferi: Lyme Disease

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Infection by Anopheles Mosquito 203. Malaria
Trophozoites w/ Face-Like Appearance 204. Giardia lamblia
Nonseptate Hyphae 205. Zygomycosis: Rhizopus & Mucor. Only mycosis w/o septate. Infect Ketoacidotic Diabetics.

Histoplasmosis Geography 206. Ohio, Mississippi, Misouri River valleys

Coocidioidomycosis Geography 207. Southwestern deserts, California
Blastomycosis Geography 208. States east of Mississippi River
Paracoccidioidomycosis Geography 209. Latin America
Roseola Infection, aka 210. Exanthema Subitum: Sixth Disease (Human Herpes Virus-6 dsDNA, enveloped)
Herpangina 211. Hand-Foot-and-Mouth Disease: Coxsackie A (Picornavirus +ssRNA) Orthomyxovirus 212. ssRNA, enveloped virus.
213. Spike Glycoproteins (peplomeres): HA = Hemagluttinin & NA = Neuraminidase.
These peplomeres are what give the virus antigenis variation 214. Influenza A & B
Paramyxovirus 215. RNA, enveloped. Most common cause of respiratory infections in kids
216. Mumps
217. Croup(Parainfluenza virus)
218. Rubeola(Measles virus)
219. RSV
Togavirus 220. +ssRNA, enveloped
221. 3 Day Measles: German Measles: Rubella/ Rubivirus
222. Encephalitis viruses: Alphaviruses: Eastern (more severe) and Western Equine Encephalitis
Flaviviris 223. Dengue Fever icterus & hemorrhage w/ blac vomit
224. Yellow fever
225. St. Louis Encephalitis no hepatitis or hemorrhage
Bunyavirus 226. ssRNA, enveloped
227. California Encephalitis severe bifrontal headaches
228. Hantavirus hemorrhagic fever w/ acute resp. distress syndrome
IgA Protease Activity 229. H. Influenzae (needs factors V & X for growth)
230. Strep. Pneumoniae
231. N. meningitidis
232. N. gonnorhoae
233. W/ this activity these bugs are able to colonize the oral mucosa.
Diphtheria: ABCDEFG 234. Adenopathy
235. β Prophage encodes the exotoxin
236. Corneybacteria is Club shaped
237. Diphtheria
238. Elongation Factor II
239. Granules (metachromatic)
Only ssDNA 240. Parvovirus: Part of a virus
Only dsRNA 241. Reovirus, RepeatOvirus
Naked RNA 242. Naked for CPR : Calcivirus; Picornovirus; Reovirus
2 circular DNAs 243. Papovavirus & Hepadnavirus
BK 244. Papovavirus. Seen in kidney transplant patients (causes renal disease)
Hepadna, Retrovirus? 245. No, but has reverse transcriptase
Picornovirus: PERCH 246. Poiliovirus; Echo; Rhino; Coxsackie; Hep A
Hemorrhagic Fevers 221. Filovirus & Bunyavirus (Hantavirus)
Segmented viruses All are RNA: Orthomyxo; Arena; Bunya; Reo
Eclipse Phase No internal virus. 1 total virus per cell
Latent Phase No external virus. Extracellular virus found
Naked Capsid Virus Nucleocapsid. DNA or RNA + Structural proteins
Enveloped Virus Membrane. Nucleocapsid + Glycoprotein
Interferon Non virus specific. Works by RNA endonuclease = digests viral DNA + inh viral prot synth
AIDS structural prots Gag, pol, env
AIDS regulatory prots Tat, rev, nef

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AIDS gp41 env prot Transmembrane
AIDS gp120 env prot Surface
AIDS p17 gag prot Matrix
AIDS p24 gag prot Capsid
AIDS p7p9 gag prot Nucleocapsid
DNA Viruses A = Adeno
E Brick. Rep H = Herpes
In Cyto H= Hepadna
AH H PPP --- ico Rep in Nuc P = Pox
P = Parvo

SS P = Papova
Circ

(+) RNA Viruses E C = Calici

P = Picorno
R = Reo
C P R F T C ------ ico (+) Linear. F = Flavi
No segment. Rep in Cyto T = Toga
Helical C = Corona
R-Tase &
Rep in Nuc

(-) RNA Viruses 8 F = Filo

2 3 O = Orthomyxo
R = Rhabdo
F O R P A B ---- (-) E Helical P = Paramyxo
Linear. Non seg. A = Arena
B = Bunya

Bullet
Anti sense

Hepatitis Window Period After HbsAg disappears & Before HbsAb appears
Hepatitis A B C D E
Picorna Hepadna Flavi Delta Calici
Downey Type II cells EBV

Infection by Aedes Mosquito Yellow Fever: Flavivirus: Black vomit, jaundice, high fever
Hot T-Bone stEAk : ILs IL1 = ↑ Temp: HOT
IL2 = stimulate T cells
IL3 = stimulate Bone Marrow stem cells growth & differentiation (GM CSF)
IL4 = stimulate IgE (& IgG)
IL5 = stimulate IgA (& eosinophils)
ILs Secreted by CD4s IL2, IL4, IL5, IFN gamma
ILs Secreted by Macrophages IL1 & TNF α
C5a Neutral chemotaxis.
When it is w/ C3a, participates in anaphylaxis
C5 Convertase When both Alternative and Classic pathways come together
Alternative: C3b, Bb, C3b + C3a  C5
Classic: 2b, 3b, C3a + C4b  C5
Only Richettssia not Intracellular Quintana

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Plasmodium Life Cycle Sporozoites: from blood to liver
Primary tissue schizont
Trophozoites: in RBC
Erythrocytic schizont
Merozoite: ruptured RBC
Gametozyte
Zygote: inside the mosquito
Acanthamoeba Star shaped cysts
Mucor, Rhizopus, Absidia Nonseptate, filamentous, 90 degree branching, indian in, capsular halos

Cryptococcus Neoformans Monomorphic

Candida Yeast normally, pseudo & true hyphae in tissue infections
Aspergillus Fumigatum 45 degree branching point, asocd w/ cystic fibrosis & burns pt

Cocciodes Hyphae in wild. Artroconidia. Arthocondida & Hyphae. Sherules w/ endospores

Histoplasma Cap Hyphae in wild. Microcondida w/ tuberculate macrocondida. Fac intracellular. In the tissue
its a yeast w/ a small neck.
Blastomycosis Hyphae in wild

Sporothrix Schenkii Hypahe in wild. Potas iodide in milk. Pneumonia in alcoholics.

PCP Obligate parasite. Kills type I pneumo cells. Ground glass

Gram (-) Bugs w/ Exotoxins E. Coli; V. Cholera; Bordetella Pertussis
Dermatophytes Trichophyton: SHN
Microsporium: SH
Epidermophyton: SN
Tinea tavus: permanent hair loss
Transmission Diagnosis
E. Histolitica Cysts Trophozoites or cysts in stool
Giardia Cysts Trophozoites or cysts in stool
Cryptosporidium Cysts Acid fast oocysts
Balantium C. Cysts Trophozoites or cysts in stool
Trichomonas V. Trophozoites Motile trophozoites
Fever Fever Spike
Vivax Benign 3 degrees 48h Enlarged Host Cell
Ovale Benign 3 degrees 48h Oval/Jagged
Malariae 4 degrees of Malarial 72hrregular Crescent
Falciparum Malignant 3 degrees

Miscellaneous
1. Fastest growing tumor Burkitts
2. PEs are found in half of all autopsies
3. Courvoisiers Law: tumors that obstruct the common bile duct cause enlarged gallbladders, but obstructing
gallstones do not (too much scarring), so if you can palpate the gallbladder youe probably looking at cancer.
4. Only DNA virus to replicate in cytoplasm: Pox
5. Only RNA virus to replicate in nucleus: Influenza
6. Bacillus anthracis has the only protein capsule
7. Bordetella pertussis (Whooping Cough) elicits lymphocytosis rather than granulocytosis
8. Bronchioalveolar carcinomas grow without destroying the normal architecture of the lung
9. Cryptococcus neoformans often lacks a capsule and, when stained with GMS, looks just like Pneumycistis
carinii, except that Cryptococcus lacks the prominent nucleoli.
10. Weil Felix reaction: (+)R. rickettssi & (+)Proteus vulgaris & P. mirabilis

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11. Treponema pallidum (Syphilis) tests: 1)VDRL 2)FTA-Abs: most widely used 3)TPI (immobilization test most
expensive but the Gold Standard)

Cytokine Source Function

IL 1 12. Monocytes, macrophages Stimulates T cell proliferation & IL2 produciton
IL 2 13. Macrophages, T & NK cells Stim prolif of B, T & NK cell
IL 3 14. T cells GF of tissue mast cells & hematopoietic stem cells
IL 4 15. T cells ↑ growth of B & T cells/ ↑ HLA II Ags
IL 5 16. T cells Maturation of B  plasma cell
IL 6 17. T cells, monocytes Maturation of B & T cell/ (-) fibroblasts
IFN α 18. B cells, macrophages Antiviral activity
IFN β 19. Fibroblasts Antiviral activity
IFN gamma 20. T & NK cells Antiviral activity, (+) macrophages, ↑ HLA II Ags
TNF α 21. Macrophages, T & NK cells T cell prolif, IL 2 prod, cytotoxicity
TNF β 22. T cells T cell prolif, IL 2 prod, cytotoxicity

Tumor Suppressor Genes

Genes Chrom. Associated Tumors
VHL 3p Von Hippel Lindau, Renal Cell CA
APC 5p Familial adenomatous polyposis, Colon CA
WT-1 11p Wilms tumor
Rb 13q Retinoblastoma, Osteosarcoma
BRCA-2 13q Breast CA
p53 17p Most human Cas
NF-1 17q Neurofibromatosis type 1
BRCA-1 17q Breast CA, Ovarian CA
DCC 18q Colon & Stomach CA
DPC 18q Pancreatic CA
NF-2 22q Neurofibromatosis type 2 = bilateral acoustic neuroma

Physiology Equations
Resistance in Series: Add all
Resistance in Parallel: Invert the answer

RENAL:

Filtration Fraction = GFR GFR: Glomerular Filtration Rate RPF: Renal Plasma Flow
RPF

Filtered Load = GFR x [Conc] Excretion Rate = [Urine] x Vel Urine

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Clearance = [Urine]xVel(Urine) or Excretion Clearance of PAH = [ERPF] ERPF: Eff renal plasma flow
[Plasma] [Plasma]

Renal Blood Flow = ERPF Free Water Clearance = VelUrine - Urine(osm)xVel(urine)

1− Hct P(osm)

CARDIO:

CO = HR x SV CO = O2(consumed) Pulse Pressure = Systolic Diastolic

PulmonaryA−VO2difference

MAP = Diastolic + 1/3 Pulse Pressure CO = MAP MAP = TPR x CO F= P1− P2

TPR R

LUNGS:

PAO2 = (760 47) FO2 - PACO2

R
Where: FO2 = [O2] PACO2 = Alv. Press. Of CO2 R = Resp. Exchange Ratio CO2produced ≅
.8 or 1 O2consumed

Flow = O2consumed Velgas Diffusion = Area x Gas Diffusion Constant x Difference of Partial
AtoVO2difference Thickness
Press

VentTot = VentTidal x #of Respirations VentAlv = (VentTidal VentDead) x # of Respirations

Compliance = Vol P = Tension 1.0 = Va/Q Diffusing Capacity = COuptake

Press Radius PACO2

Resp Doubles: 150mmHg & 40mmHg New PCO2 = 20 New PO2 = 170

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