Everyday 3

himubuwe's version from 2015-05-26 01:02


Question Answer
Rubella & RubeolaBegin on face and spreads to trunk and extremity
VZVBegin on trunk and spreads to face and extremity
RubellaPost Aurical Lypmhadenopathy
Rubella familyTogavirus


Question Answer
Ciliated cellsTill respiratory Bronchioles
GobletTrachea - Large Bronchioles
MacrophageTerminal Bronchioles
Submucosal GlandsTrachea & Bronchi NOT in bronchioles


Question Answer
Anxiety↑NE, ↓GABA/serotonin
Huntington↓GABA/ACh, ↑DA
Parkinson↓DA, ↑serotonin/ACh


Question Answer
Seminiferours tubules containsSertoli Cells
Release InhibinSertoli Cells
Inhibin ControlsFSH
Pituitary OnlyInhibin & FSH
Release Tesosterone->Wolffian ducts = Internal GenitaliaLeydig Cells
LH stimulatesLeydig
Pituitary & HypothalamusTestosterone
Testosterone inhibitsLH, GnRH
MIF(Males) - Inhibit female internal genitaliaSertoli Cells
Y geneTestes=Sertoli and Leydig Cells

Kidneys Diuritics

Question Answer Column 3 Column 4
Carbonic AnhydraseProximal TubuleBicarb LostUsed in Glaucoma, Malkalosis, Altitude sickness.
MannitolProximal Tubule & descending loop of henleWater Lost (Very Concentrated)Used in Shock, drug overdose, ICP. PEdema, Dehydration & DONT give CHF
Loop DiuriticsThick ascending loop of henle2Cl, Na, K LostUsed in Edmeatous States/ HYPERcalcemia/uricemia
ThiazideDistal Convoluted tubuleNa, Cl LostUsed in Hypertension, CHF, NDI, IHC. GlycemiaLipidemiaUricemiaCalcemia
K SparingCollecting Duct(Mostconcentrated)Na Lost, K and H+ absorbedUsed in Hyperaldosteronism.

Kidney Path

Question Answer
NephrIticInflammatory, azotemia, oliguria, hypertension, RBC casts, Protein <3.5
NephrOticHyperlipidemia, Fatty casts, Thromboembolism due to loss of Anti Thrombin III, Infections due to loss of Immunoglobulins, Protein >3.5
(I)Acute poststreptococcal glomerulonephritis LMLM - glomeruli enlarged and hypercellular, neutrophils, “lumpy-bumpy" appearance
(I)Acute poststreptococcal glomerulonephritis EM & IFNephritic, subepithelial immune complex (IC) humps.
(I)Acute poststreptococcal glomerulonephritis IFGranular appearance d/t IgG, IgM, and C3 deposition along GBM and mesangium
(I)Acute poststreptococcal glomerulonephritis notesAge best prognosis factor, Presents as kids with facial edema, dark urine, and hypertension following group A strep infxn of skin or pharynx
Increased anti-DNase B titers & positive streptozyme test
Resolves spontaneously
(I)Rapidly progressive (crescentic) glomerulonephritis (RPGN) LM and IFcrescent-moon shape. Crescent consists of fibrin and plasma proteins (C3b) with glomerular parietal cells, monocytes, and macrophages
(I)Rapidly progressive glomerulonephritis (RPGN) diseasesNephritic1. Goodpasture’s (hematuria and hemoptysis)
2. Wegener’s granulomatosis (granulomatosis w polyangiitis) (c-ANCA)
3. Microscopic polyarteritis (p-ANCA)
(I)Goodpastures syndromeNephritic (RPGN) disease, Male dominant - HLA-DR2 positive,type II hypersensitivity Ab against GBM & alveolar membrane (linear IF) resulting in hematuria/hemoptysis
(I)Wegener’s granulomatosisNephritic RPGN (c-ANCA), necrotizing granulomas, affects renal & upper airway
(I)Microscopic polyarteritisNephritic RPGN (p-ANCA), no granulomas
(I)Diffuse proliferative glomerulonephritisNephritic Subendothelial DNA-anti-DNA ICs - activate classical complement pathway Wire looping of capillaries & neutrophil infiltration with hyaline thrombi in capillary lumens Granular IF Develops into CRF → most common cause of death in SLE (can also be d/t MPGN)
(I)Berger’s disease (IgA glomerulonephropathy)Nephritic Most common nephropathy↑ synthesis of IgA LM and IF - ICs deposit in mesangium & mesangial proliferation - ICs activate alternative complement pathway Often presents with episodic bouts of hematuria following URIs and HTN
(I)Alport’s syndromeNephritic
Mutation in α-chains (3,4,5) of type IV collagen→split basement membrane Glomerulonephritis, nerve disorders, deafness, ocular disorders X-linked recessive
(O)Focal segmental glomerulosclerosisLM-segmental sclerosis and hyalinosis, EM-focal damage to visceral epithelial cells. Most common glomerular disease in HIV patients and IV heroin users - more severe in HIV patients
(O)Membranous glomerulonephritis (diffuse membranous glomerulopathy)NephroticLM - diffuse capillary and GBM thickening. EM Silver stain shows "spike and dome" appearance with subepithelial deposits. IF - granular. SLE's nephrotic presentation
(O)Membranous glomerulonephritis (diffuse membranous glomerulopathy) causeDrugs (captopril, gold therapy) Infections: HBV, malaria, syphilis SLE Cancer: lung/colon carcinomas, Hodgkin's lymphoma
(O)Membranous glomerulonephritis (diffuse membranous glomerulopathy)Most common cause of Adult Nephrotic syndrome
(O)Minimal change disease (lipoid nephrosis)LM - normal glomeruli, EM - foot process effacement by t-cell cytokines - selective loss of albumin, not globulins, due to GBM polyanion loss
Most common in children. May be triggered by a recent infection or an immunization Responds to corticosteroids.
(O)AmyloidosisNephrotic LM - congo red stain, apple-green birefringence Associated with multiple myeloma, chronic conditions, TB, RA
(O)Membrano-proliferative glomerulonephritis Type 1Nephrotic & Nephritic Subendothelial lCs with granular IF. EM- “tram-track" appearance due to GBM splitting caused by mesangial ingrowth. Associated with HBV, HCV
Presents with HTN and hematuria
(O)Membrano-proliferative glomerulonephritis Type IINephrotic & NephriticEM- Intramembranous IC deposits; "dense deposits"HTN and hematuria - usually progresses slowly to CRF Type II assoc w/C3 nephritic factor - binds to C3 convertase and sustains activation of C3 → very low C3 levels
(O)Diabetic GlomerulonephropathyNonenzymatic Glycosylation of GBM -> iNCREASE PERMEABILITY THICKENING. NEG of efferent Arterioles -> Increase GFR & Mesangial expansion. LM GBM has eosinophilic nodular Glomerulosclerosis(Kimmelstiel Wilson lesion)
Causes of chronic glomerulonephritisRPGN Focal segmental glomerulosclerosis Type 1 membranoproliferative glomerulonephritis Membranous glomerulopathy Type 4 diffuse proliferative glomerulonephritis in SLE IgA glomerulopathy

Complete vs Partial

Question Answer Column 3
CompleteClinical FindingSize Greater than dates uterus and Extremely high B-hcg(Hyperemesis,Pre-eclampsia,Hyperthyroidism)
CompleteMacroscopic FindingCystic Thin walled grape like exclusively trophoblastic tissue
CompleteMicroscopic FindingEdematous villi with extensive trophoblast hyperplasia & NO fetal Tissue
CompleteKaryotype46xx or xy Complete Paternal
CompleteRisk of Complication15%-20% risk of malignant

Repro High Yield

Question Answer
PreeclampsiaHTN, proteinuria, edema
Eclampsiapreeclampsia (HTN, proteinuria, edema) + seizures
↑ in pts with preexisting HTN, diabetes, chronic renal disease, and autoimmune disorders
Caused by placental ischemia due to impaired vasodilation of spiral arteris → ↑ vascular tone
Mortality as a result of cerebral hemorrage and ARDS
Aburptio placentaePainful bleeding in 3rd trimester
Premature detachment of placenta from implantation site
Assoc with DIC and ↑ risk with smoking, HTN, cocaine use
Placenta accretaMassive bleeding after delivery, Defective decidual layer allows placenta to attach to myometrium - no separation of placenta after birth
↑ risk with prior c-section, inflammation, placenta previa
Placenta previaPainless bleeding during any trimester
Attachment of placenta to lower uterine segment - lies near or extends over cervical os
↑ risk with multiparity and prior C-section
Endometrial carcinomaMOST COMMON GYNECOLOGIC malignancy, Peak: 55-65 years old,Presents with vaginal bleeding, often preceded by endometrial hyperplasia ↑ myometrial invasion → ↓ prognosis
Leiomyoma(fibroid) MOST COMMON OF TUMORS in females, peak: 20-40y/o, ↑ incidence in AAs, Estrogen sensitive - tumor size ↑ w pregnancy and ↓ w menopause. Does not progress to leiomyosarcoma
IncidenceEndometrial > Ovarian > Cervical (cervical cancer is the most common world-wide)
LeimyosarcomaBulky, irregularly shaped tumor with areas of necrosis and hemorrhage
typically arises de novo (not from leiomyoma). ↑ in AAs and middle aged women
Highly aggressive with tendency to recur
may protrude from cervix and bleed
Adenomyosisendometrium within the myometrium, Presents as: menorrhagia, dysmenorrhea, pelvic pain with an enlarged uterus. tx w hysterectomy
Endometrial hyperplasiaUsually caused by excess estrogen stimulation, ↑ risk for endometrial carcinoma, Presents as postmenopausal vaginal bleeding
Endometritisinflammation of the endometrium assoc w retained products of conception following delivery/miscarriage/abortion or foreign body such as an IUD. Tx: gentamycin + clindamycin with or w/o ampicillin
EndometriosisNon-neoplastic endometrial glands/stroma in abnormal locations outside the uterus, Cyclic bleeding (menstrual type) from ectopic endometrial tissue → blood-filled cysts. In ovary or on peritoneum
Clinically: severe menstrual-related pain & painful intercourse & infertility
Can be due to retrograde menstrual flow
Uterus is normal sized
Cervical dysplasia and carcinoma in situAbnormal growth begins at basal layer of sqaumo-columnar jct and extends outward. extent of dysplasia earns it a classification of CIN1, CIN2, or CIN3 (the worst)
Assoc with HPV 16 (E6 gene product inhibits p53) and HPV 18 (E7 gene product inhibits RB suppressor gene)
PAP smear shows koilocytes
ICervical invasive carcinomaSquamous cell carcinoma, Lateral invasion can block ureters, causing renal failure
Polycystic ovarian syndrome presentation and associationsAmenorrhea, infertility, obesity, and hirsutism. Assoc w insulin resistance. >Labs: ↑ LH, ↓ FSH, ↑ testosterone, ↑ estrogen (from testosterone aromatization)
Treatment of polycystic ovarian syndromeweight reduction, low-dose OCPs or medroxyprogesterone (↓ LH and androgenesis). spironolactone (treats acne and hirsutism). clomiphene (for women who want to get pregnant). metformin (for pts with features of diabetes or metabolic syndrome)

Ovarian cyst

Question Answer
Follicular cystDistention of unruptured graafian follicle
Assoc w hyperestrinism and endometrial hyperplasia
MC ovarian mass in young women
Corpus luteum cystHemorrhage into persistent corpus luteum
Commonly regresses spontaneously
Theca-lutein cystOften bilateral/multiple
D/t gonadotropin stimulation
Assoc w choriocarcinoma and moles
Hemorrhagic cystBlood vessel rupture in cyst wall
Cyst grows with ↑ blood retention
Usually self-limited
Dermoid cystMature teratoma. Cystic growths filled with various types of tissue such as fat, hair, teeth, bits of bone, cartilage
Endometroid cystEndometriosis within ovary with cyst formation. Varies with mentrual cycle. When filled with dark, reddish-brown blood it is called a "chocolate cyst"
DysgerminomahCG, LDH, Malignant germ cell tumor
equivalent to male seminoma but rarer (1% of germ cell tumors in females, 30% in males)
Sheets of uniform cells
ChoriocarcinomahCG, Rare, malignant germ cell tumor
Can develop during or after pregnancy in mother or baby
Malignancy of trophoblastic tissue
Chorionic villi are not present
↑ freq in theca-lutein cysts
Spreads hematogenously to the lungs early
Yolk sac (endodermal sinus) tumorAFP, Aggressive malignant, germ cell tumor in ovaries (testes in boys) and sacrococcygeal area of young children
Yellow, friable, solid masses
50% have Schiller-Duval bodies (resemble glomeruli)
Teratoma90% of ovarian germ cell tumors
Contains cells from 2 or 3 germ layers
Mature teratoma"Dermoid cyst"
Most common ovarian germ cell tumor
mostly benign
Immature teratomaAggressively malignant germ cell tumor
NON GERM - Serous cystadenoma45% of ovarian tumors
non-germ cell tumor
Frequently bilateral
Lined with fallopian tube-like epithelium
NON GERM - Serous cystadenocarcinoma45% of ovarian tumors
non-germ cell tumor
Frequently bilateral
Psammoma bodies seen on histology
NON GERM - Mucinous cystadenomanon-germ cell tumor
Multilocular cyst lined by mucus-secreting epithelium
Intestine-like tissue
NON GERM - Mucinous cystadenocarcinomanon-germ cell tumor
Pseudomyxoma peritonei - intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor
NON GERM - Brenner tumorBenign and unilateral non-germ cell tumor
Looks like bladder
Solid tumor that is pale yellow-tan in color and appears encapsulated
"Coffee bean" nuclei on H&E staining
NON GERM - FibromasNon-germ cell tumor
Bundles of spindle-shaped fibroblasts
Meigs' syndrome - triad: ovarian fibroma, ascites, hydrothorax
Pulling sensation in groin
NON GERM - Granulosa cell tumorNon-germ cell tumor that secretes estrogen
→ precocious puberty (kids), endometrial hyperplasia or carcinoma in adults
Abnormal uterine bleeding. Call-Exner bodies - small follicles filled with eosinophilic secretions
NON GERM - Krukenberg tumorGI malignancy that metastasizes to ovaries (bilaterally)
Mucin-secreting signet cell adenocarcinoma
VAGINAL CARCINOMA - Squamous cell carcinoma of the vaginaUsually 2° to cervical SCC
1° vaginal carcinoma is rare
VAGINAL CARCINOMA - Clear cell adenocarcinoma of the vaginaaffects women who had exposure to DES in utero
VAGINAL CARCINOMA - Sarcoma botryoidesRhabdomyosarcoma variant - vaginal tumor
Girls < 4 y/o
Spindle-shaped tumor cells that are desmin positive


Question Answer
E.Coli 0157.H7Inactivates 60S ribsomal subunit
B.PetrussisActivate Adenylate cyclase
B Anthracis (Edema factor)Activate Adenylate cyclase
ETEC (heat labile)Activate Adenylate cyclase
C. JejuniActivate adenylate cyclase
B. CereusActivate Adenylate cyclase
ETEC (Heat stable)Activate guanylate cyclase
Y. EntercoliticaActivate guanylate cyclase
C. DiptheriaInactivate EF-2
P.Aerugionsa(Exotoxin A)Inactivate EF-2
C.difficleDisrupt CYTOSKELETON
E.Coli 0157.H7 + NO Glucoronidase , ferment sorbitol
V.CholeraApical Ion Transport