USMLE STEP 1 and USMLE STEP 2 Highly tested topics The Complete Gold Collection

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USMLE E-BOOK
Diseases
Addisons Disease Addisonian Anemia Albrights Syndrome Alports Syndrome Alzheimers Argyll-Robertson Pupil
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

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!

Primary adrenocortical deficiency Pernicious anemia

(antibodies to intrinsic factor or parietal cells IF Vit B12 megaloblastic anemia)

Polyostotic fibrous dysplasia, precocious puberty, caf au lait spots, short stature, young girls Hereditary nephritis with nerve deafness Progressive dementia Loss of light reflex constriction (contralateral or bilateral) Prostitutes Eye accommodates but does not react Pathognomonic for 3Syphilis Lesion pretectal region of superior colliculus Cerebellar tonsil herniation through foramen magnum = see thoracolumbar meningomyelocele Columnar metaplasia of lower esophagus ( risk of adenocarcinoma)- constant gastroesophageal reflux
(mutation, not a deficiency, in dystrophin protein)

Arnold-Chiari Malformation Barretts Bartters Syndrome Beckers Muscular Dystrophy Bells Palsy Bergers Disease Bernard-Soulier Disease Berry Aneurysm Bowens Disease Brill-Zinsser Disease Briquets Syndrome Brocas Aphasia Brown-Sequard Brutons Disease Budd-Chiari Buergers Disease Burkitts Lymphoma

12. Hyperreninemia 13. Similar to Duchenne, but less severe 14. CNVII palsy
(entire face; recall that UMN lesion only affects lower face)

15. IgA nephropathy causing hematuria in kids, usually following infection 16. Defect in platelet adhesion (abnormally large platelets & lack of platelet-surface glycoprotein) 17. Circle of Willis (subarachnoid bleed) Anterior Communicating artery 18. Often associated with ADPKD 19. Carcinoma in situ on shaft of penis ( risk of visceral ca) [compare w/ Queyrat] 20. Recurrences of rickettsia prowazaki up to 50 yrs later 21. Somatization disorder 22. Psychological: multiple physical complaints without physical pathology 23. Motor Aphasia (area 44 & 45) intact comprehension 24. Hemisection of cord
(contralateral loss of pain & temp / ipsilateral loss of fine touch, UMN / ipsi loss of consc. Proprio)

25. X-linked agammaglobinemia ( B cells) 26. Post-hepatic venous thrombosis = ab pain; hepatomegaly; ascites; portal HTN; liver failure 27. 28. 29. 30. 31. 32. 33. Acute inflammation of medium and small arteries of extremities painful ischemia gangrene Seen almost exclusively in young and middle-aged men who smoke. Small noncleaved cell lymphoma EBV 8:14 translocation Seen commonly in jaws, abdomen, retroperitoneal soft tissues Starry sky appearance Nitric gas emboli

Caisson Disease Chagas Disease Chediak-Higashi Disease Conns Syndrome Coris Disease Creutzfeldt-Jakob Crigler-Najjar Syndrome Crohns Curlings Ulcer Cushings

34. Trypansoma infection - cardiomegaly with apical atrophy, achlasia 35. (AR) Phagocyte Deficiency = defect in microtubule polymerization 36. Neutropenia, albinism, cranial & peripheral neuropathy & repeated infections w/ strep & staph 37. Primary Aldosteronism: HTN; retain Na+ & H2O; hypokalemia (causing alkalosis); renin 38. Type III Glycogenosis Glycogen storage disease 40. 41. 42. 43.
44. 45. (debranching enz: amylo 1,6 glucosidase def. Glycogen)

39. Prion infection cerebellar & cerebral degeneration Congenital hyperbilirubinemia (unconjugated) Glucuronyl transferase deficiency. Can progress to Kernicterus Less severe form will respond to Phenobarbital therapy IBD; ileocecum, transmural, skip lesions, cobblestones, lymphocytic infiltrate, granulomas
(contrast to UC: limited to colon, mucosa & submucosa, crypt abscesses, pseudopolyps, colon cancer risk)

Clinically: ab pain & diarrhea; fever; malabsorption; fistulae b/t intestinal loops & abd structures 46. Acute gastric ulcer associated with severe burns 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 Page 2

Cushings Ulcer de Quervains Thyroiditis DiGeorges Syndrome Downs Syndrome Dresslers Syndrome Dubin-Johnson Syndrome Duchenne Muscular Dystrophy Edwards Syndrome Ehlers-Danlos Eisenmengers Complex Erb-Duchenne Palsy Ewing Sarcoma Eyrthroplasia of Queyrat Fanconis Syndrome Feltys Syndrome Gardners Syndrome Gauchers Disease Gilberts Syndrome Glanzmanns Thrombasthenia Goodpastures Graves Disease Guillain-Barre Hamman-Rich Syndrome Hand-Schuller-Christian Hashimotos Thyroiditis Hashitoxicosis Henoch-Schonlein purpura Hirschprungs Disease Horners Syndrome Huntingtons (Chromosome 4) Jacksonian Seizures Jobs Syndrome

50. Acute gastric ulcer associated with CNS trauma 51. Self-limiting focal destruction (subacute thyroiditis) 52. 53. 54. 55. Failure of 3rd & 4th pharyngeal pouches formation: Thymus & Parathyroid Thymic hypoplasia T-cell deficiency Hypoparathyroidism ! Tetany Trisomy 21 or translocation Simian Crease
autoimmune

56. Post-MI Fibrinous Pericarditis

57. Congenital hyperbilirubinemia (conjugated) = bilirubin transposrt is defective not conjugation 58. Striking brown-to-black discoloration of the liver 59. Deficiency of dystrophin protein MD X-linked recessive 60. Trisomy 18 61. Rocker-bottom feet, low ears, small lower jaw, heart disease 62. Defective collagen 63. Late cyanotic shunt (RL) pulmonary HTN & RVH 2 to long-standing VSD, ASD, or PDA 64. Trauma to superior trunk of brachial plexus 66. Carcinoma in situ on glans penis 67. Impaired proximal tubular reabsorption 2 to lead poisoning or Tetracycline
hyperphosphaturia, aminoaciduria, systemic acidosis) (glycosuria, Waiters Tip

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

68. Rheumatoid arthritis, neutropenia, splenomegaly 69. AD = adenomatous polyps of colon, osteomas & soft tissue tumors 70. Lysosomal Storage Disease glucocerebrosidase deficiency glucocerebroside accumulation 71. Hepatosplenomegaly, femoral head & long bone erosion, anemia 72. Benign congenital hyperbilirubinemia (unconjugated) = d glucuronyl transferase activity 73. Defective glycoproteins on platelets = deficient platelet aggregation 74. Autoimmune: abs to glomerular & alveolar basement membranes. Seen in men in their 20s 75. Autoimmune hyperthyroidism (TSI): IgG Ab reactive w/ TSH receptors. Low TSH & TRH High T3 / T4 76. Polyneuritis following viral infection/ autoimmune 78. Chronic progressive histiocytosis 79. Autoimmune hypothyroidism. May have transient hyperthyroidism. Low T3 /T4 & High TSH 80. Initial hyperthyroidism in Hashimotos Thyroiditis that precedes hypothyroidism 81. 82. 83. 84. Hypersensivity vasculitis = allergic purpura. Lesions have the same age. Hemmorhagic urticaria (with fever, arthralgias, GI & renal involvement) Associated with upper respiratory infections Aganglionic megacolon
(lesion of cervical sympathetic nerves often 2 to a Pancoast tumor) (ascending muscle weakness & paralysis; usually self-limiting)

77. Idiopathic pulmonary fibrosis. Can see honey comb lung.

85. Ptosis, miosis, anhidrosis

86. AD: Progressive degeneration of caudate nucleus, putamen (striatum) & frontal cortex GABA 87. Epileptic events originating in the primary motor cortex (area 4) 1. 2. 3. 88. 89. Immune deficiency: neutrophils fail to respond to chemotactic stimuli Defective neutrophilic chemotactic response = repeated infections Commonly seen in light-skinned, red-haired girls d IgE levels Malignant vascular tumor (HHV8 in homosexual men)
infection, situs inversus, sterility

Kaposi Sarcoma Kartageners Syndrome Kawasaki Disease Klinefelters Syndrome Kluver-Bucy Krukenberg Tumor Laennecs Cirrhosis Lesch-Nyhan Letterer-Siwe Libman-Sacks

90. Immotile cilia 2 to defective dynein arms 92. 47, XXY: Long arms, Sterile, Hypogonadism 93. Bilateral lesions of amygdala

91. Mucocutaneous lymph node syndrome in kids (acute necrotizing vasculitis of lips, oral mucosa)
(hypersexuality; oral behavior)

94. Adenocarcinoma with signet-ring cells (typically originating from the stomach) metastases to 95. the ovaries 96. Alcoholic cirrhosis 97. HGPRT deficiency 98. Gout, retardation, self-mutilation 99. Acute disseminated Langerhans cell histiocytosis 100. Endocarditis with small vegetations on valve leaflets 101. Associated with SLE Page 3

Lou Gehrigs Mallory-Weis Syndrome Marfans McArdles Disease Meckels Diverticulum Meigs Syndrome Menetriers Disease Monckebergs Arteriosclerosis Munchausen Syndrome Nelsons Syndrome Niemann-Pick Osler-Weber-Rendu Syndrome Pagets Disease Pancoast Tumor Parkinsons Peutz-Jeghers Syndrome (AD) Peyronies Disease Picks Disease 2 Different Diseases Plummers Syndrome Plummer-Vinson Pompes Disease Potts Disease Potters Complex Raynauds Reiters Syndrome Reyes Syndrome Riedels Thyroiditis Rotor Syndrome Sezary Syndrome Shavers Disease Sheehans Syndrome Shy-Drager Simmonds Disease Sipples Syndrome Sjogrens Syndrome Spitz Nevus Stein-Leventhal Stevens-Johnson Syndrome Stills Disease Takayasus arteritis Tay-Sachs (AR) Tetralogy of Fallot Tourettes Syndrome Turcots Syndrome Turners Syndrome

102. Amyotrophic Lateral Sclerosis

degeneration of upper & lower motor neurons

103. Bleeding from esophagogastric lacerations 2 to wretching (alcoholics) 104. Connective tissue defect: defective Fibrillin gene
Dissecting aortic aneurysm, subluxation of lenses Glycogen)

105. Type V Glycogenosis - Glycogen storage disease (muscle phosphorylase deficiency =

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 108. Triad: ovarian fibroma, ascites, hydrothorax associated w/ fibroma of ovaries 109. Giant hypertrophic gastritis (enlarged rugae; plasma protein loss) 110. Calcification of the media (usually radial & ulnar aa.) 111. Factitious disorder
(consciously creates symptoms, but doesnt know why)

112. 1 Adrenal Cushings surgical removal of adrenals loss of negative feedback to pituitary Pituitary Adenoma 113. Lysosomal Storage Disease (sphingomyelinase deficiency sphingomyelin accumulation) 114. Foamy histiocytes 115. Hereditary Hemorrhagic Telangiectasia. Seen in the Mormons of Utah. 116. Abnormal bone architecture
(thickened, numerous fractures pain)

117. Bronchogenic tumor with superior sulcus involvement Horners Syndrome 118. Dopamine depletion in nigrostriatal tracts 119. Melanin pigmentation of lips, mouth, hand, genitalia + hamartomatous polyps of small intestine 120. Subcutaneous fibrosis of dorsum of penis 121. 122. 123. 124. 1. Progressive dementia similar to Alzheimers 1. Constrictive pericarditis sequel to mediastinal tuberculosis Calcium-frosting, unyielding layer heart chambers may be unable to dilate to receive blood during diastole Hyperthyroidism, nodular goiter, absence of eye signs (Plummers = Graves - eye signs)

125. Esophageal webs & iron-deficiency anemia, spoon-shaped nails, SCCA of esophagus 126. Type II Glycogenosis Glycogen storage disease cardiomegaly ( 1,4 Glucosidase deficiency: Glycogen) 127. Tuberculous osteomyelitis of the vertebrae 128. Renal agenesis oligohydramnios hypoplastic lungs, defects in extremities 129. Disease: recurrent vasospasm in extremities = seen in young, healthy women 130. Phenomenon: 2 to underlying disease (SLE or scleroderma) 131. Urethritis, conjunctivitis, arthritis non-infectious (but often follows infections), HLA-B27, polyarticular 132. Microvesicular fatty liver change & encephalopathy 133. 2 to aspirin ingestion in children following viral illness, especially VZV 134. Idiopathic fibrous replacement of thyroid 135. Congenital hyperbilirubinemia (conjugated) 136. Similar to Dubin-Johnson, but no discoloration of the liver 137. Leukemic form of cutaneous T-cell lymphoma (mycosis fungoides) 138. Aluminum inhalation lung fibrosis 139. Postpartum pituitary necrosis = hemorrhage & shock usually occurred during delivery 140. Parkinsonism with autonomic dysfunction & orthostatic hypotension 141. Pituitary cachexia can occur from either pituitary tumors or Sheehans 142. MEN type IIa = pheochromocytoma, thyroid medullary CA, hyperparathyroidism 143. Triad: dry eyes, dry mouth, arthritis 144. Juvenile melanoma (always benign) 145. Polycystic ovary: see amenorrhea; infertility; obesity; hirsutism = LH secretion 146. Erythema multiforme, fever, malaise, mucosal ulceration 148. 149. 150. 151.
(often 2 to infection = mycoplasma or sulfa drugs) risk of B-cell lymphoma

147. Juvenile rheumatoid arthritis (absence of rheumatoid factor) Aortic arch syndrome Loss of carotid, radial or ulnar pulses = pulseless disease. Night sweats. Common in young Asian females Gangliosidosis (hexosaminidase A deficiency GM2 ganglioside) Cherry Red Spots of the Macula
Txt w/ Pimozide

152. 1.VSD, 2.overriding aorta, 3.pulmonary artery stenosis, 4.right ventricular hypertrophy 153. Involuntary actions, both motor and vocal 154. Colon adenomatous polyps plus CNS tumors 155. 45, XO = most common cause of Primary Amenorrhea. No Barr body on buccal smear. Page 4

Vincents Infection Von Gierkes Disease Von Hippel-Lindau Von Recklinghausens

Von Recklinghausens Disease of Bone

156. Trench mouth acute necrotizing ulcerative gingivitis due to Fusobacterium 157. Type I Glycogenosis Glycogen storage disease (G6Ptase deficiency) Glycogen accumulaiton 158. 159. 160. 161. Hemangioma (or hemangioblastoma) = cerebellum, brain stem, & retina Adenomas of the viscera, especially Renal Cell Carcinoma Chromosome 3p Neurofibromatosis & caf au lait spots & Lisch nodules (Chromosome 17)

Von Willebrands Disease (AD) Waldenstroms macroglobinemia Wallenbergs Syndrome Waterhouse-Friderichsen Webers Syndrome Wegeners Granulomatosis Weils Disease Wermers Syndrome Wernickes Aphasia Wernicke-Korsakoff Syndrome Whipples Disease Wilsons Disease Wiskott-Aldrich Syndrome Wolff-Chaikoff Effect Zenkers Diverticulum Zollinger-Ellison Rogers Disease Barlows Syndrome Bracht-Wachter Lesions Lutembachers Syndrome Schmidts Syndrome

162. Osteitis fibrosa cystica (brown tumor) 2 to hyperparathyroidism = osteoclastic resorption w/ 163. fibrous replacement 164. Defect in platelet adhesion 2 to deficiency in vWF. aPPT, Bleed time 165. Proliferation of IgM-producing lymphoid cells in men 50-70 yoa; PAS(+) Dutcher bodies 166. 167. 168. 169. 170. 171. 172. Posterior Inferior Cerebellar Artery (PICA) thrombosis Medullary Syndrome Ipsilateral: ataxia, facial pain & temp; Contralateral: body pain & temp Adrenal insufficiency 2 to DIC DIC 2 to meningiococcemia Paramedian Infarct of Midbrain Ipsilateral: mydriasis; Contralateral: UMN paralysis (lower face & body) Necrotizing granulomatous vasculitis of paranasal sinuses, lungs, kidneys, etc.

173. Icteric Leptospirosis non-icteric prgresses to renal failure & myocarditis 174. Dark field microscopy for dx 175. MEN type I = thyroid, parathyroid, adrenal cortex, pancreatic islets, pituitary 176. Sensory Aphasia
ophthalmoplegia) impaired comprehension (confusion, ataxia,

177. Thiamine deficiency in alcoholics; bilateral mamillary bodies (mediodorsal nucleua) 178. Malabsorption syndrome (with bacteria-laden macrophages) & polyarthritis 179. 180. 181. 182. 183. 184.

Hepatolenticular degeneration (copper accumulation [Txt w/ Penicillamine ] & decrease in ceruloplasmin) Mallory Bodies in the Liver & also w/ alcoholic hepatitis & Hyaline change Chromosome 13 Immunodeficiency: combined B- &T-cell deficiency (thrombocytopenia & eczema) IgM w/ IgA High iodine level ()s thyroid hormone synthesis
(or intestine)

185. Esophageal; cricopharyngeal muscles above UES 186. Gastrin-secreting tumor of pancreas 187. Interventricular septal defect 188. Floppy vale syndrome women b/t 20-40 yoa 189. Minute abscesses found in subacute bacterial endocarditis 190. Combination of septum secundum atrial septal defect w/ mitral stenosis 191. Autoimmnue thyroid Disease (Hashimotos ) & insulin-dependent diabetes acid recurrent ulcers

Hallmark Findings
Albumino-Cytologic Dissociation Antiplatelet Antibodies Arachnodactyly Aschoff Bodies Auer Rods Autosplenectomy
192. Guillain-Barre 194. Marfans 195. Rheumatic fever 196. Acute promyelocytic leukemia (AML type M3) 197. Sickle cell anemia: switch a glu ! val in 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 203. UMN lesion 204. Lead poisoning 205. Multiple myeloma free light chains (either kappa or lambda) 206. Waldenstroms macroglobinemia 207. Histiocytosis X (eosinophilic granuloma) 208. Chronic Bronchitis (at least 3 months for at least 2 years of ecessive mucus secretion & chronic recurrent productive cough) Page 5
(markedly increased protein in CSF with only modest increase in cell count)

193. Idiopathic thrombocytopenic purpura

Babinski Basophilic Stippling of RBCs Bence Jones Protein Birbeck Granules Blue Bloater

Boot-Shaped Heart Bouchards Nodes Boutonnieres Deformity Brown Tumor Brushfield Spots Call-Exner Bodies Cardiomegaly with Apical Atrophy Chancre Chancroid Charcot Triad Charcot-Leyden Crystals Cheyne-Stokes Breathing Chocolate Cysts Chvosteks Sign Clue Cells Codmans Triangle Cold Agglutinins Condyloma Lata Cotton Wool Spots Councilman Bodies Crescents In Bowmans Capsule Currant-Jelly Sputum Curschmanns Spirals
Depigmentation Of Substantia Nigra

209. Tetralogy of Fallot 210. Osteoarthritis (Proximal IP joint of the fingers) 211. Rheumatoid arthritis 212. Hyperparathyroidism 213. Downs 214. Granulosa cell tumor: associated w/ endometrial hyperplasia & carcinoma 215. Granuloma-Theca cell tumor 216. Chagas Disease 217. 1 Syphilis 218. Haemophilus ducreyi 219. Multiple sclerosis = nystagmus, intention tremor, scanning speech 220. Bronchial asthma 221. Cerebral lesion 222. Endometriosis 223. Hypocalcemia 225. Osteosarcoma 226. Mycoplasma pneumoniae 227. Infectious mononucleosis 228. 2 Syphilis 229. New coffee flavor at Bagel & Bagel 230. HTN 231. Aka, cytoid bodies seen w/ SLE (yellowish cotton wool fundal lesions) 232. Dying hepatocytes HepB 233. Rapidly progressive (crescentic glomerulonephritis)
facial spasm in tetany flex proximal & extend distal IP joints

224. Gardnerella vaginitis

234. Klebsiella
235. Bronchial asthma 236. Parkinsons 237. Granuloma inguinale (STD) 238. Osteoarthritis 239. Marfans 240. Lyme Disease 241. Alcoholism 242. Asbestosis - & Iron laden 243. Tuberculosis (1 & 2, respectively) 244. Acute Pyelonephritis 245. Duchennes MD 246. Osteoarthritis
use of arms to stand (Distal IP joint of the fingers) (polished, ivory-like appearance of bone)

Donovan Bodies Eburnation Ectopia Lentis Erythema Chronicum Migrans Fatty Liver Ferruginous Bodies Ghon Focus / Complex Glitter Cells Gowers Maneuver Heberdens Nodes Heinz Bodies Heterophil Antibodies Hirano Bodies Hypersegmented PMNs Hypochromic Microcytic RBCs Jarisch-Herxheimer Reaction Joint Mice Kaussmaul Breathing Keratin Pearls Keyser-Fleischer Ring Kimmelstiel-Wilson Nodules Koilocytes Koplik Spots Lewy Bodies Lines of Zahn Lisch Nodules

247. G6PDH Deficiency 248. Infectious mononucleosis (EBV) 249. Alzheimers 250. Megaloblastic anemia 251. Iron-deficiency anemia or Thalassemia

252. Syphilis

over-aggressive treatment of an asymptomatic pt. that causes symptoms 2 to rapid lysis (fractured osteophytes)

253. Osteoarthritis

254. Acidosis / Diabetic Ketoacidosis 255. Squamous Cell CA of skin Actinic Keratosis is a precursor 256. Wilsons 257. Diabetic nephropathy: Nodular Glomerulosclerosis nodules of mesangial matrix 258. HPV 6 & 11 (condyloma acuminatum - benign) and HPV 16 & 18 (malignant association) 259. Measles 260. Parkinsons
(eosinophilic inclusions in damaged substantia nigra cells)

261. Arterial thrombus 262. Neurofibromatosis (von Recklinhausens disease) = pigmented iris hamartomas Page 6

Lumpy-Bumpy IF Glomeruli Mallory Bodies McBurneys Sign Michealis-Gutmann Bodies Monoclonal Antibody Spike Myxedema Negri Bodies Neuritic Plaques Neurofibrillary Tangles Non-pitting Edema Notching of Ribs Nutmeg Liver Owls Eye Cells Painless Jaundice Pannus Pautriers Microabscesses Philadelphia Chromosome Pick Bodies 2 types of COPD Podagra Port-Wine Stain Posterior Anterior Drawer Sign Psammoma Bodies

263. Poststreptococcal glomerulonephritis prototype of nephritic syndrome 264. Alcoholic hepatitis 265. Appendicitis 266. Malakoplakia
(McBurneys Point is 2/3 of the way from the umbilicus to anterior superior iliac spine) lesion on bladder due to macros & calcospherites (M-G Bodies): usually due to E. Coli this is called the M protein (usually IgG or IgA)

267. Multiple myeloma 268. MGUS 269. Hypothyroidism 270. Rabies 271. Alzheimers 272. Alzheimers

273. Myxedema 274. Anthrax Toxin 275. Coarctation of Aorta 276. CHF = causing congested liver 277. CMV 278. Reed Sternburg Cells (Hodkins Lymphoma) 279. Aschoff cells seen w/ Rheumatic Fever 280. Pancreatic CA (head) 281. Rheumatoid arthritis, also see morning stiffnes that w/ joint use, HLA-DR4 282. Mycosis fungoides (cutaneous T-cell lymphoma), Sezary 283. CML 284. Picks Disease 285. Pink Puffer Type A: Emphysema 286. Blue Bloater Type B: Bronchitis 287. Emphysema Centroacinar smoking 288. Gout (MP joint of hallux) 289. Hemangioma 290. Tearing of the ACL 291. Papillary adenocarcinoma of the thyroid 292. Serous papillary cystadenocarcinoma of the ovary 293. Meningioma 294. Mesothelioma 295. Seen w/ Duchenne muscular dystrophy @ the claf muscles, due to fat 296. Multiple myeloma 297. 2 Syphilis 298. RMSF 299. Coxsackie virus infection: Hand-Foot-Mouth Disease 300. Paroxysmal nocturnal hemoglobinuria. You would use Hams test to confirm. 301. Hodgkins Disease 302. Chronic bronchitis = d ratio of bronchial gland to bronchial wall thickness 303. Leydig cell tumor 304. Multiple myeloma
RBCs stacked as poker chips

Panacinar - 1-antitrypsin deficiency

Pseudohypertrophy Punched-Out Bone Lesions Rash on Palms & Soles Red Morning Urine Reed-Sternberg Cells Reid Index Increased Reinke Crystals Rouleaux Formation S3 Heart Sound S4 Heart Sound Schwartzman Reaction Smith Antigen

305. LR Shunt (VSD, PDA, ASD) 306. Mitral Regurg 307. LV Failure 308. Pulmonary Stenosis 309. Pulmonary HTN

310. Neisseria meningitidis impressive rash with bugs

311. 312. 313. 314. 315. SLE (also anti-dsDNA) Malar Rash, Wire loop kidney lesions, Joint pain, False (+) syphilis test (VDRL) 90% 14-45 yo females also seen w/ use of INH; Procainamide; Hydralazine = SLE-like syndrome Giant cell tumor of bone

Soap Bubble on X-Ray Spike & Dome Glomeruli String Sign on X-ray Target Cells

316. Membranous glomerulonephritis = Nephrotic syndrome 317. Spike = basement membrane material & Dome = immune complex deposits (IgG orC3) 318. Crohns bowel wall thickening 319. Thalassemia
in Thalassemia w/ no gene: Hydrops Fetalis & Intrauterine death associations = HbBarts

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Tendinous Xanthomas Thyroidization of Kidney Tophi Tram-Track Glomeruli Trousseaus Sign

320. Familial Hypercholesterolemia 321. Chronic pyelonephritis 322. Gout 323. Membranoproliferative GN: Nephritic syndrome 324. Visceral ca, classically pancreatic 325. Hypocalcemia (carpal spasm)
basement membrane is duplicated into 2 layers (migratory thrombophlebitis)

326. These are two entirely different disease processes and different signs, but they unfortunately have the same name.

Virchows Node Warthin-Finkeldey Giant Cells WBC Casts Whipples Triad Wire Loop Glomeruli AFP in amniotic fluid or mothers serum Uric Acid

327. Supraclavicular node enlargement by metastatic carcinoma of the stomach 328. Measles 329. Pyelonephritis 330. CNS disfunction Hypoglycemic episodes glu injection reverses CNS Sympts 331. Lupus nephropathy, type IV (diffuse proliferative form) 332. Spina Bifida 333. Anencephaly 334. Gout 335. Lesch Nyhan 336. Myeloproliferative Disorders 337. Diuretics (Loop & Thiazides) 338. COPD 339. Due to Pneumocystis carinii 340. Seen w/ Atelectasia 341. Seen w/ Asbestosis (a restrictive lung disease) 342. Goodpastures syndrome (pneumonia w/ hemoptysis & rapidly progressive glomerulonephritis) 343. Goodpastures syndrome 344. Aspergillosis 345. Waldenstroms Macroglobulinemia = IgM = Hyperviscosity 346. Seen in the hepatocytes of healthy carriers of HBsAg in liver biopsies 347. Cells that replace the ovaries, due to Krukenbergs tumor that has metastasized from the stomach 348. Seen w/ Progressive Multifocal Leukoencephalopathy oligodendrocytes 349. Nuclei seen in Papillary CA of the thyroid (malignant) 350. Shows amyloid deposition in plaques & vascular walls 351. Some meningiomas have Progesterone receptors = rapid growth in pregnancy can occur 352. Seizures; Mental retardation; Leukoderma (congenital facial white spots or macules): angiofibromas 353. Seen w/ Herpes Simplex Encephalitis in oligodendroglia 354. Neuromyelitis Optica 355. A variant of multiple sclerosis: rapid demyelination of the optic nerve & spinal cord w/ paraplegia 356. Breast Cancer association 357. A tumor causing blindness & loss of smell w/ papilloedema 358. Flicking of the middle fingers nail 359. Intention tremors of the arm 360. Unconscious proprioception of lower extremities 361. Unconscious prorpioception & fine motor movements 362. Unconscious proprioception & fine motor movements of upper extremities 363. Conscious proprioception of the body 364. Pain & Temperature sensation 365. Light touch perception 366. Taste & Smell 367. Muscles of the eye & of the tongue 368. Vision; Hearing; Equilibrium 369. Sensation of tongue; soft palate. Carotid Body & Sinus innervation 370. Edinger Westphal = parasympathetic eye innervation 371. Gland innervation = secretions Page 8

FEV1/FVC Ground Glass on chest x-ray

(Hyaline)

Honey Combing of the lung Crescents Linear Ig Deposits 45 Degree Branch Points PAS(+) Dutcher Bodies Ground Glass in Abdomen(Hyaline) Signet Ring Cells Ground Glass Appearance (Hyaline) Congo Red Meningiomas & Progesterone Tuberous Sclerosis Triad Cowdry A Inclusions Devics Syndrome c-erb B2 Foster-Kennedy Syndrome Hoffmans Sign Red Nucleus Destruction Ventral Spinocerebellar tr. Dorsal Spinocerebellar tr. Cuneocerebellar tr. Dorsal Column Lateral Spinothalamic tr. Ventral Spinothalamic tr. SVA GSE SSA GVA GVE

GSA SVE LMN Lesion Sensory Pathway Lesion Both UMN & LMN Lesion Both Sensory & Motor Lesion Suprachiasmatic Nucleus Ventromedial Nucleus Lateral Nucleus Arcuate Nucleus Mamillary Body Acanthocytes

372. Viscera 373. Pain & temperature of face 374. Sensation of external ear 375. Innervation of muscles of masticaiton, facial expressions, larynx & pharynx 376. Werndig Hoffman (progressive infantile muscular atrophy) 377. Poliomyelitis 378. Subacute Combined Degeneration = Friedrichs Ataxia = B12 deficiency 379. Tabes Dorsalis (Neurosyphilis) 380. ALS = Lou Gherigs Disease 381. Brown Sequard 382. Anterior Spinal artery Occlusion 383. Controls circadian rhythm 384. Satiety center. Savage behavior & obesity when lesioned 385. Induces eating. Starvation when lesioned 386. Releases PIF (dopa-ergic neurons) 387. Can have hemorrhages as seen in Wernickes Encephalopathy 388. RBSc w/ spiny projections. Seen in Abetalipoproteinemia.

Most Common
1o Tumor arising from bone in adults Adrenal Medullary Tumor Adults Adrenal Medullary Tumor Children Agent of severe viral encephalitis Aggressive lung tumor Associated with gallstones Bacterial Meningitis adults Bacterial Meningitis elderly Bacterial Meningitis newborns Bacterial Meningitis toddlers Benign epithelial tumor of oral mucosa Benign fallopian tube tumor Benign ovarian tumor Benign tumor of soft tissue Benign tumor of the breast <25yoa Benign tumor of the liver Benign tumor of the vulva Benign uterine tumor Bone Tumors Brain Tumor Child Brain Tumor Adult Breast Carcinoma Breast Mass Bug in Acute Endocarditis Bug in debilitated, hospitalized pneumonia pt
389. Osteosarcoma 390. Pheochromocytoma: 5 Ps: Pressure; Pain (Headache); Perspiration; Palpitations; Pallor/Diaphoresis 391. Neuroblastoma 392. Herpes simplex 393. Small cell or oat cell 394. Adenocarinoma

395. Strep pneumoniae & in young adults = Neisseria meningitidis 396. Neisseria meningitidis 397. E. coli / Group BStrep.
398. Hib 399. Papilloma 400. Adenomatoid 401. Mature(Native) Teratoma = benign dermatoid 402. Lipoma 403. Fibroadenoma 404. Hemangioma 405. Hidroadenoma 406. Leiomyoma: estrogen sinsitive: changes size during pregnancy & menopause 407. Metasteses from Breast & Prostate 408. Medulloblastoma (cerebellum) 409. Astrocytoma (including Glioblastoma Multiforme) then: mets, meningioma, Schwannoma 410. Invasive Duct Carcinoma 411. Fibrocystic Change: premenopausic women (Carcinoma is the most common in post-menopausal women)

412. Staph aureus 413. Klebsiella

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Bug in Epiglottitis Bug in GI Tract Bug in IV drug user bacteremia / pneumonia Bug in PID Bug in Subacute Endocarditis CA of urinary collecting system Cardiac 1ry Tumor Adults Cardiac 1ry Tumor Child Cardiac Tumor Adults Cardiomyopathy Cause of 2ry HTN Cause of Addisons Cause of breast lumps Cause of chronic endometriosis Cause of Congenital Adrenal Hyperplasia Cause of Cushings Cause of Death in Alzheimer pts Cause of Death in Diabetics Cause of Death in premature Cause of Death in SLE pts. Cause of Dementia Cause of Dementia (2nd most common) Cause of Dwarfism Cause of Food poisoning Cause of Hematosalpynga Cause of Hypoparathyroidism Cause of Hypothyroidism Cause of Kidney infections Cause of Liver disease in US Cause of Malignancy in children Cause of Mental retardation Cause of Mental retardation (2nd most common) Cause of NaCl loss and Hypotension Cause of PID Cause of Portal cirrhosis Cause of Preventable Blindness Cause of Pulmonary HTN Cause of Secondary Hypertension Cause of SIADH Cause of UT Obstruction in men

414. Hib 415. Bacteroides (2nd E. coli)

416. Staph aureus

417. N. Gonnorrhoeae

418. Strep Viridans

419. Transitional cell CA (assoc. w/ benzidine; naphthylamine; analine dyes; long term txt w/ cyclophosphamide) 420. Myxoma: Ball Valve 421. Rhabdomyoma associated w/ Tuberous sclerosis 422. Metasteses 423. Dilated (Congestive) Cardiomyopathy: Alcohol, BeriBeri, Cocaine use, Coxsackie B, Doxorubicin 424. Systolic Dysfunction 425. Renal Disease 426. Autoimmune (2nd infection) 427. CA of the breast 428. TB 429. 21-Hydroxylase Deficiency: NaCl lost & Hypotension (then, 11- NaCl retention & HTN) 430. Exogenous Steroid Therapy (then, 1ry ACTH, Adrenal Adenoma, Ectopic ACTH) 431. Pneumonia 432. MI 433. NRDS = hyaline membrane disease 434. Lupus Nephropathy Type IV (Diffuse Proliferative) = Renal Disease 435. Alzheimers 436. Multi-Infarct Dementia 437. Achondroplasia

438. Staph aureus

439. Ectopic pregnancy 440. Throidectomy 441. Corrective surgery I31 treatment 442. E. coli 443. Alcohol consumption 444. Acute leukemia 445. Downs 446. Fragile X 447. 21 hydroxylase deficiency 448. N. ghonorrhea 449. Alcohol 450. Chlamydia (serotypes A,B,Ba,C) 451. COPD 452. Renal disease 453. Small Cell Carcinoma of the Lung 454. BPHyperplasia

Page 10

Cause Pernicious Anemia Chromosomal Disorder Common Tumor of the Appendix Congenital Cardiac Anomaly Congenital Early Cyanosis Coronary Artery Thrombosis Demyelinating Disease Dental Tumor Dietary Deficiency Disease of the Breast Disseminated Opportunistic Infection in AIDS Esophageal Cancer Fallopian Tube Malignancy Fatal Genetic Defect in Caucasians Female Tumor Form of Amyloidosis Form of Tularemia Germ Cell Tumor of Testes Gynecological Malignancy Gynecological Finding Heart Murmur Heart Valve in Bacterial Endocarditis Heart Valve in Bacterial Endocarditis in IV drug users Heart Valve involved in Rheumatic Fever Hereditary Bleeding Disorder Hormone secreted in Pituitary Adenoma Inherited disease of the Kidney Intracranial tumor in adults Islet Tumor Liver 1ry Tumor Liver Disease Location of Adenocarcinoma of the Pancreas Location of Adult Brain Tumors Location of Childhood Brain Tumors Lung Tumor, malignant or benign Lung Tumor, primary or secondary Lysosomal Storage Disease Malignancy in Women Malignancy of the Larynx

455. Chronic atrophic gastritis = no production of intrinsic factor 456. Downs 457. Carcinoid tumor: flushing; diarrhea; bronchospasm; RHeart valvular lesions 458. Txt: Methysergide (5HT antagonist) 459. VSD (membranous > muscular) 460. Tetralogy of Fallot =right to left shunt 461. LAD artery: MI 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 465. Odontoma 466. Iron 467. Fibrocystic disease 468. CMV (Pneumocystis carinii is most common overall) 469. SCCA 470. AdenoCA 471. Cystic Fibrosis (chromosome 7q) 472. Leimyoma 473. Immunologic (Bence Jones protein in multiple myeloma is also called the Amyloid Light Chain) 474. Ulceroglandular 475. Seminoma (analogous to dysgerminoma of ovaries) 476. Endometrial Carcinoma 477. Endometrial CA 478. Mitral Valve Prolapse 479. Mitral 480. Tricuspid 481. Mitral then Aortic 482. Von Willebrands Disease 483. Prolactin 484. Adult polycystic kidney disease: associated w/ polycystic liver, Berry aneurysms, Mitral prolapse 485. APD1 chromosome 16 486. Glioblastoma mulitforme 487. Insulinoma = cell tumor 488. Hepatoma 489. Alcoholic Liver Disease 490. Head (99%) 491. Above Tentorium 492. Below Tentorium 493. Malignant 494. Secondary 495. Gauchers 496. Lung (2nd breast) 497. Glottic CA (squamous cell) Page 11

Malignancy of the Small Intestine Malignancy Vulva Malignant Eye Tumor in Kids Malignant Tumor of the Liver Motor Neuron Disease Muscular Dystrophy Nasal Tumor Neoplasm Child Neoplasm Child (2nd most common) Neoplasm of the West Neoplastic Polyp Nephrotic Syndrome in Adults Nephrotic Syndrome in Children Non Hodgkins Lymphoma Number of Deaths per year in Women Skin tumor Opportunistic infection in AIDS Ovarian Malignancy Ovarian Tumor Pancreatic Tumor Patient with ALL / CLL / AML / CML Patient with Goodpastures Patient with Reiters Pituitary Tumor Place for Primary Squamous Cell CA of esophagus Place for Peptic Ulcer Disease Primary Benign Salivary Tumor Primary Hyperparathyroidism Primary Malignancy of Bone Primary Malignancy of Small Intestine Pt. with Hodgkins Pt. with Minimal Change Disease Renal Malignancy Renal Malignancy of Early Childhood Salivary Tumor Secondary Hyperparathyroidism Sexually Transmitted Disease Site of Diverticula

498. Adenocarcinoma 499. Squamous cell CA 500. Retinoblastoma 501. Hepatocellular CA 502. ALS 503. Duchennes: Dystrophin deletion. Presents <5yoa weakness at pelvic girdles w/ upward progression 504. Squamous cell CA 505. Leukemia 506. Medulloblastoma of brain (cerebellum) 507. Adeno CA of the rectum and/or colon 508. Tubular adenoma 509. Membranous Glomerulonephritis 510. Minimal Change (Lipoid Nephrosis) Disease (responds well to steroid txt) 511. Follicular small clear cell 512. Lung CA 513. Basal cell CA 514. PCP 515. Serous Cystadenocarcinoma 516. Hamartoma 517. Adeno (usually in the head) 518. ALL Child / CLL Adult over 60 / AML - Adult over 60 / CML Adult 35-50 519. Young male 520. Male 521. Prolactinoma (2nd Somatotropic Acidophilic Adenoma) 522. Mid 1/3 523. Lesser curvuture in antrum associated w/ blood group O 524. Pleomorphic Adenoma (Mixed) 90% localized to the parotid 525. Adenomas (followed by: hyperplasia, then carcinoma) 526. Osteosarcoma 527. Lymphoma 528. Young Male (except Nodular Sclerosis type Female) 529. Young Child 530. Renal cell CA 531. Wilms tumor (neohroblastoma) chromosome 11p 532. Pleomorphic adenoma 533. Hypocalcemia of Chronic Renal Failure 534. Chlamydia (sero types D-K) 535. Sigmoid Colon Page 12

Site of Embolic Occlusion Site of Metastasis Site of Metastasis (2nd most common) Sites of Atherosclerosis Skin CA of Fair Skinned People Skin Cancer Small Intestine Congenital Anomaly Stomach Cancer Testicular Tumor Thyroid Anomaly Thyroid CA Tracheoesophageal Fistula Tumor in men <20 Tumor of Infancy Tumor of the Stomach >50 years of age Type of Hodgkins Type of Non-Hodgkins Type of Portal Cirrhosis Type of Soft Tissue Tumor of Childhood Vasculitis (of medium & small arteries) Viral Encephalitis Worm Infection in US Worst Prognosis in Thyroid Cas Cause of Lobar Pneumonia Cause of Death b/t 24-44 yoa Cause of Pneumonia in Cystic Fibrosis Cause of Osteomyelitis in IV Drug Users Cause of Infection in Burn Pts Mental Problem in Males Intelligence Test

536. Middle cerebral aa: contralateral paralysis; aphasias; motor & sensory loss 537. Regional Lymph Nodes 538. Liver 539. Abdominal aorta > coronary > popliteal > carotid 540. Malignant melanoma 541. Basal Cell Carcinoma 542. Meckels diverticulum 543. Adeno associated w/ blood group A 544. Seminoma = malignant painless testes growth 545. Thryoglossal duct cyst 546. Papillary CA 547. Lower esophagus joins trachea / upper esophagus blind pouch polyhydramnios association 548. Germ cell tumor 549. Benign vascular tumor = port wine stain = Hemangioma 550. CA of stomach (adeno CA) 551. Mixed Cellularity (versus: lymphocytic predominance, lymphocytic depletion, nodular sclerosis) 552. Follicular, small cleaved 553. Micronodular 554. Rhabdomyosarcoma 555. Temporal Arteritis (branch of Carotid Artery) 556. HSV 557. Pinworm (2nd Ascaris) 558. Follicular CA 559. Strep. Pneumoniae 560. AIDS 561. Pseudomonas 562. Pseudomonas 563. Pseudomonas 564. Specific phobia 565. Stanford Binet (ages 6 & under) 566. WIPSI (ages 4-6) 567. WISK-R (for ages 6-17) 568. WAIS-R (for > 17 yoa) 569. Pedophilia 570. VMA: vanillylmandelic acid (NE metabolite) 571. Dysenteriae 572. Strep. Pneumoniae 573. A. Israelli 574. Campylobacter jejuni 575. S. Sonnei Page 13

Paraphilia Metabolite seen w/ Pheochromocytoma Severe Shigella Bug in Otitis Media & Sinusitis in Kids Cause of a Solitary Brain Abscess Cause of Bacterial Diarrhea in U.S. Shigella Type

Cause of Non-Ghonococcal Urethritis Pneumonia Urethritis Cause of Glomerulonephritis Cause of Viral Pneumonia

576. Chlamydia trichomonas 577. Strep. Pneumoniae 578. N. ghonorrhea 579. IgA Nephropathy = Bergers Disease 580. RSV infants 581. Parainfluenza kids 582. Influenza virus adults 583. Adeno virus military recruits 584. Pulmonary infections 585. Renal failure 586. Ostium Secundum Type 587. Most common form of immune hemolytic anemia 588. IgG auto antibodies to RBC 589. See spherocytosis; (+) Coombs test; complication to CLL 590. IgA Deficiency 591. Meckels Diverticulum: persistence of vitelline duct/yolk sac stalk 592. Fetal Alcohol Syndrome

Complication of COPD Cause of Death w/ SLE Atrial Septal Defect Warm Antibody Immunodeficiency Congenital GIT Anomaly Cause of Congenital Malformation

Pharmacology
Autonomic Nervous System
Epinephrine Norepinephrine GABA Muscarinic-r Bethanechol Pilocarpine Isoflurophate Pralidoxime Neostigmine Myasthenia Gravis Tubocurium Trimethaphan Pancurium Succinylcholine 1 & Eye M-r & Eye Sympathetic Parasym. M3-r & Eye M2-r & Heart M3-r & Lung M3-r & GI Tacrine Atropine Glycoperrolate Pirenzepine
1. 2. 3. 4. 5. 6. 7. 8. 9. 1, 2, 1, 2 1, 2, 1 (no 2 activity) Causes an inhibitory cell hyperpolarization Uses DAG & IP3 as 2nd messengers Parasympathetic control Cholinergic. GI & Bladder motility. Txt atonic bladder post-op Cholinergic. Pupillary constriciton= miosis. Ciliary constriction= accomodation. Txt acute glaucoma Organophosphate. Irreversible acetylcholinesterase (-)r

10. 2PAM. Reverses organophosphate binding to acetylcholinesterase 11. Reversible acetylcholinesterase (-)r 12. Txt Myasthenia Gravis 13. Anitbodies to Ach-r. g muscular weakness due to Achs weak postsynaptic effect @ NMJ. Inactivates-r 14. 15. 16. 17. Nondepol. Competitive cholinergic N-r (-)r. Prevents Ach binding but does not activate NMJ Histamine release= BP & bronchospasm Nonselectively binds N-r of the PS- and SNS

18. More potent than tubocurium w/o histamine release 19. Depol. Non competitive (-)r of muscle aciton 20. Opens Na Ch.= fasciculations. Closes Na Ch.= paralysis. Continuous infusion. 21. Mydriasis due to norepinephrine. Prazosin (-). 22. Miosis due to Ach. Atropine (-). 23. Post ganglionic symapthetic fibers releases norepinephrine 24. Post ganglionic parasympathetic fibers release Ach 25. Contracts sphincter = miosis. Contracts ciliary = accomodation. 26. Negative chronotropy: HR = vagal arrest 27. Negative inotropy: contractility 28. Bronchospasm secretions 29. motility (cramps & diarrhea). Involuntary defecation 30. Acetylcholine esterase (-)r. Txt Alzheimers 31. DOC w/ vagal arrest 32. M-r(-). Antispasmodic. Txt peptic ulcers. 33. M-r(-). Antispasmodic. Txt peptic ulcers. Page 14

Doxacurium bungarotoxin bungarotoxin 1 & Eye 1 & Arterioles 1 & Venules 1 & Sex Function Diastolic Diastolic 1 & Heart Phenylephrine 2(+) Asma Drugs Ritodrine/Turbutaline Phentolamine Terazosin Yohimbine Cardioselective NMJ Ecothiophate Pyridostigmine

34. Most potent competitive non-depol NMJ (-)r. No cardiovascular side effects. No Histamine release. 35. Prevent the releasal of Ach from vesicles @ the pre synaptic nerve ending 36. Irreversible N-r (-)r = action potentials 37. Contracts radial muscle = mydriasis (pupil dilation) 38. Constiction: TPR = Diastolic pressure = Afterload 39. Constriction: Venous return = Preload 40. Ejaculation 41. 1 = TPR 42. 2; Direct acting vasodilators; (+)Cholinergics 43. 44. 45. 46. (+)chronotropism = HR. (+)inotropism = contractility; SV; CO; O2 consumption. conduction velocity 1 (+) Nasal decongestant.

47. Metaproterenol; Albuterol; Terbutaline; Ritodrine; Salmeterol 48. Relaxes myometrium used in pre-mature labor pains 49. Epi reversal. Blocks , vasodilation occurs. Pt goes from HyperTN to HypoTN. 50. Txt pheochromocytoma = BP 51. Txt BPH 52. sympathetic outflow = 2 (-). Txt impotence. 53. Pancuronium = HR due to atropine-like anti muscarinic vagolytic effect & Gallamine (-)r 54. Irreversible cholinesterase (-)r. 55. Cholinomimetic that s M & N-r effects. (-) acetylcholinesterase & plasma cholinesterase 56. DOC for the oral Txt of MG

Cardiology
Digoxin Diltiazem Quinidine Verapamil Propranolol Diazoxide Niroprusside Reserpine Dobutamine Dopamine Esmolol Captopril Digoxin Dig. Toxicity Quinidine Lidocaine Flecanide Amiodarone NE Ach Atenolol Bretylium Nimodipine Atropine Nitrates Propranolol Verapamil Aspirin
1. 2. 3. 4. 5. 6. 7. 8. 9. 11. AV nodal conduction/ inh. Na/K/Atpase = inc. Ca conc. in heart cells = inc. contraction force Txt black men. Txt AV nodal re entrance AV nodal conduction. Cinchonism. Anticholinergic= aggravate MG. Hypotension= block AV nodal conduction. BP. Negative inotrope= no CHF use AV nodal conduction. BP. Negative inotrope(= block) Aggravates Asthma and Diabetes Melitus via 2 block. Balanced vasodilator. Balanced vasodilator. Unloads heart. s cyanide= pre-txt w/ thiosulfate. Txt Acute HTNv Crisis Txt severe & resistant HTN. Depletes CA. See stuffy nose. No to pts w/ peptic ulcers. At high doses 2(+) offsets 1 = 1 CO w/o systemic vascular resistance Short acting (-)

10. At low doses Txt Shock= dilates renal and mesenteric aa= maintain urine output 12. Balanced vasodilator. Txt Outpt. CHF see dry cough(bradykinin induced) 13. Txt CHF & Atrial Flutter - inotropic - K+ levels= dig. Toxicity 14. Fatal ventricular arrhythmias w/ sever AV block 15. ClassIa anti arrhythmic. Moderate Na Ch. Block 16. ClassIb anit arrhythmic. Normalizes conduction. Txt initial MI= control arrhythmias 17. ClassIc anti arrhythmic. Marked conduction slowing 18. Long t1/2= need potent doses to obtain desired level for action. See blue skin, ocular deposits, Pulmonary Fibrosis. 19. AV nodal conduction via 1. Metoprolol(-) 1 20. AV nodal conduction via M receptor. Atorpine(-) M-r 21. Controls catecholamine induced arrhythmias 22. Txt Malignant Ventricular Arrhythmias but causes passing catecholamine release that can aggravate arrhythmias briefly 23. Txt Acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm 24. excess vagal tone as seen in Sinus Bradycardia 25. preload= venous pooling. MVO2= reflex tachy. ventr work= dec O2 demand 26. Blocks reflex tachy but causes excess brady= diastole time= EDV 27. O2 supply via in vasospasm Txt Prinzmetals variant angina 28. Prevents arterial platelet adhesion (not DVThrombi). Inactivates COX= platelet production of TxA2, a potent vasoconstictor Page 15

Warfarin Heparin TPA Streptokinase Urokinase Colestipol Lovastatin Losartan Diazoxide Clonidine Methyldopa Phenytoin Procainamide Indopamide Thiazides (-) ACEIs Epinephrine Norepi. Methyldopa Quinidine pre-txt ClassII Gray man Beperidil ACEIs Adenosine Enoxaparin Isoproterenol Variant angina Contraindicated in CHF

29. (-)Vit. K dependent gamma carboxylation of clotting factors= anticoagulation state 30. Dependent on Antithrombin III activation 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 33. From bacteria= allergies arise. Can see excess bleeding in post-op pts. 34. Human source. plasmin. Can see excess bleeding in post-op pts. 35. Bile acid sequestrants. Interrupt bile acid reabsorption= LDL uptake. Cholestyramine same MOA. 36. HMGCoA reductase(-)= LDL-r synthesis. Pravastatin/ Mevastatin same MOA. 37. Aldosterone. Renin 2-3xs 38. Txt insulinomas. Not balanced vasodilator= onlt dilates arterial smooth muscle 39. Central 2(+). TPR via symapthetic effect 40. Central 2(+). (++) Coombs= Hemolytic anemia 41. ClassIb. Reverses mild AV block due to digitoxin toxicity 42. ClassIa. SLE like syndrome. 43. Only Thiazide that will have no effect on cholesterol levels 44. Older black men w/ HTN due to Renin. 45. Young white men w/o asthma (cause bronchospasm) 46. 47. 48. 49. 50. 51. 52. 53. (-) change AI ! AII. (-) Bradykinin inactivation. Captopril/ Enalapril Cause renal failure = use w/ caution in the elderly contraction rate & force via 1. systolic but diastolic BP. peripheral resistance via 2 vasodilaiton heart rate and systolic and diastolic BP peripheral blood vessel resistance DOC for pregnancy induced HTN

54. Atrial arrhythmia pretxt w/ a drug that will ventricular response: Dig.;(-); Ca Ch.(-) 55. (-) risk fo reinfarction & sudden death following MI 56. Amiodarone: ClassIII antiarrhythmia 57. Ca Ch(-). Limited clinical use due to Torsades de Pointes 58. 59. 60. 61. 62. Vasodilate renal efferents > than afferent arterioles: GFR & Filtration pressure Diabetic renal failure progression Its receptor is blocked by Methylxanthines (ie Theophyline) Favored for the Txt of Reentrant Supra Ventricular Tachycardia Low molecular weight heparin = Oral anticoagulant

63. HR & MAP 64. Use Ca Ch. (-)r ie Nifedipine 65. (-)r = you dont want to the hearts pumping strength

CNS
TOM
1. 2. 3. 4. 5. 6. 7. 8. 9. 11. Short acting BDZs: Triazolam Onazelam Midazolam Haloperidol & Droperidol Clozapine Thioridazine Olanzepine Risperidone = Do not cause EPS BDZ antidote for OD Txt attention deficit disorder Causes aplastic anemia/ gingival hyperplasia/ cleft lip & palate DOC trigeminal neuralgia. Txt lennox gestaut seizures in kids

Butyrophenone Atypical D4 Flumazenil Methylphenidate Phenytoin Thiopental Carbamazepine Atypical D4-r Pimozide Risperidone Thioridazine Haloperidol

10. Short acting Barb 12. Thioridazine; Olamzapine; Clozapine 13. Txt Tourettes 14. Good for negative symptoms 15. Most anti cholinergic neuroleptic 16. Neuroleptic malignant hyperthermia due to chronic D2 block. give Dantrolene and Bromocriptine Page 16

Imirpamine Clomirpramine Trazadone Bupropion SSRIs Fluoxetine Phenelzine Lithium

17. Enurisis 18. Txt OCD See aggressive behavior w/ use 19. Priapism 20. Helps to quit smoking 21. Primarily used for OCD 22. Good for negative symptoms 23. Irreversible MAOI 24. 25. 26. 27. 28. Txt manic phase of Bipolar Disorder Causes goiter by (-) conversion of T4 to T3 Nephrogenic diabetes insipidus Low salt diet will lead to Li toxicity DOC stage fright

Alprazolam Propranolol -r -r Morphine & O2 Morphine Morphine OD Meperidine Hydromorphone Tramadol Naloxone Pentazocine Butorphenol Nalbuphene GABA Fast Na Ch. Methoxyflurane Enflurane Isoflurane Halothane Nitric Oxide Thiopental Kentamine Droperidol Fentanyl Midazolam Primidone C & A delta Fibers Esters Amides Amphetamine Bromocriptine Benztropine Amantidine Diphenhydramine Pergolide Ethosuximide Tranylcypromine SSRI & MAOI Labor opioids

29. Social phobia 30. Spinal analgesia. Euphoria. ++euphoria. ++sedation. Constipation. 31. Supraspinal analgesia. Dysphoria. +respiratory depression. +sedation. 32. Admin. is contraindicated to pts on morphine sedation= CO2 sensitivity and O2 admin. can stop breathing. 33. ICP = do not give to pt. with head trauma 34. 1.pinpoint pupils 2.d respiraiton 3.coma 35. Anesthetic used during labor 36. (+) used in renal failure 37. Ambulatory txt for mod. to severe pain 38. Txt opioid OD. Reverses respiratory depression 39. Part (+) & part (-) 40. Part (+) & part (-) 41. Part (+) & part (-) 42. seizure focus= Barbs & BDZs 43. electrical activity spread = Phenytoin & Carbamazepine 44. Can be nephrotoxic. Needs low MAC for anesthetic induction. 45. Can cause tonic/clonic muscle spasms 46. Can cause bronchospasm 47. Can cause ventricular extrasystoles & Malignant hyperthermia & Hepatitis 48. No effect on HR. Needs high MAC for anesthetic induction. 49. Short acting Barb. 50. Dissociative anesthetic 51. 52. 53. 54. 55. Can be used in combo w/ Fentanyl for neuroleptoanalgesic effect Neuroleptic tranquilizer. Has mild alpha block Can be used on combo w/ Droperidol for neuroleptoanalgesic effect Used transdermally for chronic pain Pre anesthetic. Induces amnesia

56. Biotransformed to Phenobarb. 57. First fibers to be blocked w/ anesthesia 58. 59. 60. 61. 62. Procaine, Tetracaine, Benzocaine Broken down and make PABA (allergen) Lidocaine, Mepivaciane, Bupivaciane, Etidocaine= i before caine always an amide Metabolized in the liver DA reuptake (-)r. MAOI. Parkinsons txt

63. D2(+). Used w/ L-Dopa for on-off phenomenon of Parkinsons 64. Ant M w/ some DA reuptake (-). Parkinsons txt 65. DA reuptake. Can cause livido reticularis= skin mottling. 66. Txt early Parkinsons stages 67. > Effective & longer acting than Bromocriptine 68. DOC for Absence seizures 69. MAOI = antidepressant 70. Fatal combo, especially seen with the use of Paroxetine or Fluoxetine (SSRIs) and Tranylcypromine (MAOI) 71. Meperidine & Nalbuphine Page 17

Desipramine causes

72. Sudden cardaic death in children

Anti-Infective
Primaquine Ciporfloxacin Sulfonamides Tertacyclines, anuria & the exception Ceftriazone Hepatic coma DOC Clavulanic acid Piperacillin Streptomycin (aminoglycoside) Isoniazid Pyrantel Pamoate Buy AT 30, CELL at 50
4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. Malaria profylaxis Used for extraerythrocytic forms Plasmodium vivax or P. ovale Quinolone derivative PABA structural analogs Inhibit Folic acid synthesis Should not be used in anuric pt due to production of (-) Nitrogen balance & d BUN levels. Doxycycline is the exception 3rd generation cephalosporin DOC for bacterial meningitis in kids (ie HiB) One dose txt of gonorrhea Neomycin (aminoglycoside) it supresses the normal flora = g NH4 production = g free nitrogen levels in the bloodstream. Irreversible (-)r of lactamases, but ot of transpeptidase = use w/ a lactamase sensitive penicillin Txt Pseudomonas aeruginosa & Klebsiella Broad spectrum antibiotic Txt Mycobacterium tuberculosis Most commonly used drug for TB. Usually combined w/ Rifampin and/or Ethambutol Pre Txt w/ Pyridoxine (Vit B6) can prevent peripheral neuritis Txt of Hookworm disease Depolarizing NMJ (-)r A = Aminoglycosides T = Tetracyclines C = Chloramphenicol E = Erythromycin (macrolide) L = Clindamycin L = Lincomycin Txt intraabdominal infections (ie w/ Bacteroides fragilis) Traditional txt has been Clindamycin & Gentamycin Broad spectrum antibiotic Bone marrow depression (common) Aplastic anemia (rare) Gray baby syndrome (chloramphenicol cannot be conjugated) DOC Typhoid Fever (symptomatic Salmonella infection) DOC HiB meningitis in kids especially resistant strain to ampicillin Txt trypanosomiasis Txt Leishmaniasis & Amebiasis Good for anaerobic bacteria = Bacteroides fragilis DOC Trichomoniasis DOC Giardia lamblia TMP-SMX & Pentamidine Txt of Brucellosis & Cholera Txt Rocky Mountain Spotted Fever Txt spirochete infections = Lyme disease (Borrelia burgdorferi) (-) dihydrofolate reductase activity

Cefoxitin Chloramphenicol

Nifurtimox Metronidazole

Txt P. carinii Tetracycline TMP-SMX Benzathine Penicillin G Praziquantel Melarsoprol Stibogluconate Fluconazole Amphotericin B Ketoconazole MOA Griseofulvin MOA Mefloquine Chloroquine

47. Long duration of action = given once every 3-4 weeks for Txt of Syphilis 48. Txt Schistosomiasis (trematode [fluke] infections) 49. Txt Trypanosomiasis that has neurological symptoms 50. Txt Leishmaniasis 51. Txt fungal encephalitis 52. Polyene antifingal 53. (-) fungal ergosterol synthesis = disrupts membrane 54. Accumulates in keratinized layers of the skin = used in dermatomycoses infections 55. Anti malarial 56. Txt Chloroquine resistant strains = P. falciparum 57. Txt for Malaria when inside RBC Page 18

Nifurtimox Erythromycin Nystatin Acyclovir Imipenem Cefoperazone side effects Vancomycin Meropenem Nafcillin Peripheral neuropathy Sulfonamides & newborns O.N.E. for gonorrhea

58. DOC Chagas disease due to Trypanosoma cruzi 59. Used in pts allergic to penicillins 60. Topical txt of superficial mycotic infections = Candidiasis 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. Guanine analog Txt Herpes infections Used w/ Cilastatin Can cause seizures Bleeding due to vit K level alterations Contraindicated in pts w/ bleeding disorders Used for MRSS (methicillin resistant Staph. Aureus) Red neck: due to histamine release causes facial flushing used w/ Cilastatin Does not cause seizures (cf w/ Imipenem) Only penicillin that does not need dose adjustment in renal impairment

72. Seen w/ use of: 73. Metronidazole Isoniazid Vincristine ddI AZT Allopurinol 74. Kernicterus can occur 75. 76. 77. 78. 79. Fluoroquinolones used in a one dose deal for gonorrhea: O = Ofloxacin N = Norfloxacin E = Enoxacin Txt RSV (Respiratory Syncytial Virus)

Ribavirin

Anti-Neoplastics
Cyclosporine Cyclophosphamide Cisplatins toxicities Methotrexate Leucovorin Rescue Bleomycin toxicities Azathiorine MOPP
80. 81. 82. 83. 84. Protects against rejections from organ transplants Does not induce bone marrow depression Alkylating agent of both purine & pyrimidine bases of DNA Txt CLL Nephro- & Ototoxicity

85. Antimetabolite of folic acid: (-)dihydrofolate reductase 86. Can block/reduce Methotrexate = folic acid via a reduced folate 87. Pneumonitis & pulmonary fibrosis 88. 89. 90. 91. 92. 93. 94. 95. 96. 97. 98. 99. 100. 101. 102. 103. 104. 105. 106. 107. 108. 109. 110. 111. 112. 113. Used in organ transplantation = kidney allografts Allopurinol can its activity by (-) its biotransformation to xanthine oxidase Chemotherapy used in the txt of Hodgkins disease M = Mechlorethamine nitrogen mustard O = Oncovin (Vincristine) prevents microtubule assembly P = Procarbazine P = Prednisone glucocorticoid, inducing apoptosis (-) estrogen receptor Txt of breast tumors, can see associated endometrial CA Antiandrogenic Used w/ Leuprolide (LH-RH analog) Txt prostatic CA (-) progesterone receptor Txt endometrial CA Androgenic steroid Txt mammary CA in postmenopausal women Folic acid analog that (-) tetrahydrofolate synthesis by (-) dihydrofolate reductase Txt of ALL Txt of Psoriasis Lomustine Carmustine Causes pulmonary fibrosis Attaches to cells Txt of pancreatic insulinomas Pyrimidine analog DOC for AML Used for Wilms tumor & rhabdomyosarcoma

Tamoxifen Flutamide Megestrol Fluoxymesterone Methotrexate Brain tumor Txt Streptozocin Cytarabine (AraC) Dactinomycin Etoposide Paclitaxel

114. Used for oat cell CA 115. Used for ovarian CA Page 19

Amifostine

116. Can nephrotoxicity due to chronic use of Cisplatin

Pathology
Mobitz I Mobitz II P wave a wave T wave Wavy fibers Janeways lesions Oslers nodes Thiamine defcy Fibrinous Pericarditis Serous Pericarditis Friction Rub Hemorrhagic Pericarditis Restrictive Cardiomyopathy PMLs infectious agent Edema
117. Usually due to inferior MI. Rarely goes into 3rd degree block. 118. Txt w/ Atropine or Isoproterenol. 119. BBB association. Often goes to 3rd degree AV block. Usually due to anterior MI. 120. Atrial depol. 121. LA contraction 122. Vetricular repol. 123. Eosinophilic bands of necrotic myocytes. Early sign of MI. 124. 125. 126. 127. 128. 129. 130. 131. Acute bacterial endocarditis. Nontender, erythematous lesions of palms & soles. Subacute bacterial endocarditis. Tender lesions of fingers & toes. Wet Beri Beri heart. Dilated (congested) cardiomyopathy due to chronic alcohol consumption Dyr Beri Beri = peripheral neuropathy Wernicke-Korsakoff = ataxia; confusion; confabulation; memory loss Associated w/ MI: Dresslers

132. Associated w/ nonbacterial; viral (Coxsackie) infection; immunologic reaction. 133. Pericarditis association 134. Associated w/ TB or neoplasm 135. 136. 137. 138. 139. 140. 141. 142. 143. 144. Aka infiltrative cardiomyopathy that stiffens the heart Due to amyloidosis in the elderly Due to , also see schaumann & asteroid bodies in young (<25 yoa). JC Virus (Papovavirus = dsDNA, naked icosahedral capsid) Pc (more seeps out) c (less reabsorbed) permeability Block lymphatic drainage Commonly see liver cysts & Berry aneurysms along w/ kidney cysts. Hematuria & HTN also present. 3 cysts in ea. Kidney w/ + family history confirms diagnosis

Adult Polycystic Kidney Disease Malignant HTN & Kidneys Nephritic signs Nephrotic signs Podocyte Effacement seen w/ ASO seen in Crescentic GN Hereditary Nephritis Membranoproliferative GN TypeI Membrano Proliferative GN deposits TypeII Membrano Proliferative GN deposits Focal segmental glomerulosclerosis deposits Cold agglutinins Scrofula Aspirin-Asthma Triad Ferruginous bodies Pancoasts tumor causes

145. Petehial hemorrhages are seen on kidney surfaces = Flea-Bitten surface = young black men 146. Hematuria; RBC casts; HTN 147. Proteinuria; Hypoalbuminemia; Edema 148. Minimal Change (Lipoid nephrosis) disease 149. 150. 151. 152. 153. 154. 155. 156. 157. Acute post-streptococcal GN (due to HGASrtep) Anti streptolysin O Rapidly progressive GN nephritic syndrome Associated w/ multi system disease or post-strep/post infectious glomerular nephritis Alports syndrome. X linked Renal disease w/ deafness & ocualr abnormalities Can be secondary to complement deficiency; chronic infections; CLL See tram tracking C3 & IgG deposits

158. Only C3 deposits 159. Aka Dense deposit disease 160. IgM & C3 deposits 161. Seen in atypical pneumonia 162. It is IgM Ab with specificity for I Ag on adult RBCs 163. TB in the lymph nodes 164. Nasal polyps Rhinitis bronchoconstriction 165. Hemosiderin (pigment w/ Fe3-) covered macrophages that have been pahgocytised 166. Ulnar nerve pain & Horners syndrome Page 20

Fatty degeneration Cloudy swelling Hydropic degeneration Liquefaction necrosis Coagulation necrosis Caseation necrosis Fibrinoid necrosis Fat necrosis Hemoptysis Pulmonary embolism Phlebothrombosis Saddle embolus Paradoxical embolism Tuberculoid granuloma Cellulitis PSA 5-HT Feto Protein CEA Chromosome 13 Chromosome 11p Vinyl Chloride Agent Orange Parasites & CA Ochronosis

167. 168. 169. 170. 171. 172. 173. 174. 175. 176. 177. 178. 179. 180. 181. 182. 183. 184. 185. 187. 188. 189. 190. 191. 192. 193. 194. 195.

Made up primarily of triglycerides Most commonly due to alcoholism which commonly leads to hepatic cirrhosis Associated w/ CCl4Failure of cellular Na pump Seen in Fatty degeneration of the liver and in Hydropic (Vacuolar) degeneration of the liver Severe form of cloudy swelling Seen with hypokalemia induced by vomitting/diarrhea Rapid enzymatic break down of lipids Seen commonly in Brain & Spinal cord (CNS) injuries Seen in suppurative infections = pus formation Result of sudden ischemia Seen in organs w/ end arteries limited collateral circulation) = heart, lung, kidney, spleen Combination of both coagulation & liquefaction necrosis Seen w/ M. tuberculosis & Histoplasma capsulatum infection Seen in the walls of small arteries Associated w/ malignant hypertension, polyarteritis nodosa, immune mediated vasculitis Result of lipase actions liberated from pancreatic enzymes Seen w/ Acute pancreatitis = saponification results Blood in sputum From a vein of lower extremities, of a pregnant uterus, in Congestive heart failure, bed ridden pt, As a complicaiton in a pt w/ Pancreatic CA due to d blood coagulability Embolus lodged in bifurcation of pulmonary trunks RV strain = RV & RA dilate = Acute cor Pulmonale Right to Left shunt allows a venous embolism to enter arterial circulation Patent ovale foramen or Atrial septal defect Collection of macrophages w/o caseation Seen w/ Sarcoidosis (non-caseating); Syphilis; Brucellosis and Leprotic infections Spreading infection due to streptococcus

186. Most commonly thrombus from lower extremity vein

196. Prostate Specific Antigen = elevated in prostatic CA 197. In cases of metastatic carcinoid, txt w/ Methysergide (5HT antagonist) 198. Hepatocarcinoma 199. Neural tube defects 200. Carcinoembryonic Antigen = elevated in Colon CA 201. Retinoblastoma 202. Wilms tumor of the kidney 203. Associated w/ Angiosarcoma of the liver 204. Contains dioxin 205. Implicated as a cause of Hodgkin;s disease, non-Hodgkins lymphoma & soft tissue sarcomas 206. Schistosoma haematobium = Urinary bladder CA 207. S. mansoni = Colon CA 208. Aspergillus flavus = potent hepatocarcinogen 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 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 219. Massive pulmonary edema w/ frothy fluid from the nostrils 220. Small head, small eyes, funnel chest, ASD, mental deficiency, and hirsutism 221. M. kanasasii & M. avium intracellulare 222. Liquefied TB lesions similar to pyogenic abscesses but lacking acute inflammation 223. Farmers infection 224. Lumpy jaw (from chewing grain) & PID (IUD), but most common is due to saprophyticus 225. Saddle nose, Saber shin, Hutchinsons teeth, nerve deafness, interstitial keratitis 226. Reticuloendothelial giant cells on tonsils, lymph nodes, spleen Page 21

Lead poisoning

Heroin OD, clinically Fetal alcohol syndrome Atypical mycobacterium Cold abscesses Actinomyces isrealli Congenital Syphilis Warthin-Finkeledy cells

Diphyllobothrium latum Subacute Bacterial Endocarditis Acute Bacterial Endocarditis Mitral Insufficiency Left Anterior Descending branch Left Circumflex branch Dissecting Aneurysm

227. Seen with Rubeola (measles) due to paramyxovirus 228. Tapeworm infection causing megaloblastic anemia by consuming large amount of vit B12 in the host 229. Hemolytic Streptococci (S. viridans) = usually in pt w/ pre-existing heart problem 230. Staph aureus, Hemolytic Streptococci, E. coli 231. Common among drug addicts & diabetics 232. Ruptured papillary muscle 233. Branch of the Left Coronary artery 234. Highest frequency of thrombotic occlusion 235. MI = anterior wall of the LV, especially in apical part of interventricular septum 236. Branch of the Left Coronary artery 237. Occlusion = MI of posterior/lateral wall of the LV 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 241. Right ventricular strain, associated w/ right ventricular hypertrophy 242. Sudden right ventricular strain due to a massive pulmonary embolism 243. Lobular (rather than lobar) 244. Due to Staph aureus; Pseudomonas aeruginosa; Klebsiella; E. coli 245. Abscess formation is common 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 250. Permanent dilatation of the bronchi predisposed by chronic sinusitis and post nasal drip 251. Supparation associated 252. Lower lobe > than upper lobe involvement 253. Found w/ Mycoplasma pneumoniae 254. 1 antitrypsin deficiency, causing elastase = compliance in the lung 255. Associated w/ Emphysema = Bleb = outpouching - If it ruptures causes Pneumothorax 256. Due to Micropolyspora faeni (thermophilic actinomycetes) 257. Due to M. vulgaris (actinomycetes) 258. Inhalation of sugar cane dust 259. Due to Nitrogen dioxide from nitrates in corn 260. Sex-linked chronic hemolytic anemia w/o challenge or after eating fava beans 261. Heinz Bodies appear in RBCs 262. Sickle Cell Anemia 263. Lytic lesions of flat bones (salt & pepper lesions) = vertebrae, ribs, skull; Hypercalcemia; Bence-Jones protein casts 264. Malignant neoplasm of the lymph nodes causing pruritis; fever = looks like an acute infection 265. Reed Sternberg cells 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 269. Celiac disease due to a gluten-induced enteropathy = small intestine villi are blunted 270. High titers of anti-gliadin Abs & IgA levels 271. Crohns Disease 272. Association w/ Arthritis; Uveitis; Erythema Nodosum 273. Intestinal Lipodystrophy = malabsorption syndrome 274. Neural cest cells from which carcinoids arise = of the Bronchi; GIT; Pancreas 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 279. Women exposed to DES (Diethylstilbesterol) in utero before the 18th week of pregnancy 280. Some develop clear cell adenocarcinoma of the vagina & cervix 281. Infiltrating Duct Carcinoma w/ fibrosis most common type of breast carcinoma 282. Lipid laden macrophages seen in villi of Erythroblastosis Fetalis Page 22

Cor Pulmonale Acute Cor Pulmonale Bronchopneumonia Lobar pneumonia

Bronchiectasis Cold Agglutinins Panlobular Emphysema Bulla Farmers Lung Bagassosis Silo-Fillers Lung G6PDH Deficiency HbF Multiple Myeloma Hodgkins Disease Polyarteritis Nodosa Sprue Regional Enteritis Whipples Disease Kulchitsky cells Ulcerative Colitis

Vaginal Adenosis Scirrhous Carcinoma Hofbauer Cells

Retinopathy of Prematurity IgA deficiency Priamry Sjorgens Secondary Sjorgens LDH1 & LDH2 LDH3 LDH4 & LDH5 Keratomalacia Metabisfite Test Microangiopathic Hemolytic Anemia Wrights stain Mononucleosis T(8;14) T(9;22) Langerhan Cell Histiocytosis Myeloid Metaplasia Multiple Myeloma

283. Retrolental Fibroplasia = cause of bindness in premies due to high O2 concentrations 284. Pt has recurrent infections & diarrhea w/ respiratory tract allergy & autoimmune diseases 285. If given blood w/ IgA = develop severe, fatal anaphylaxis reaction 286. Dry eyes & dry mouth, arthritis. risk for B cell lymphoma. HLA-DR3 frequent. Autoimmune disease. 287. Rheumatoid arthritis, SLE, or systemic sclerosis association 288. RA association shows HLA-DR4 289. Myocardium. LDH1 higher than LDH2 = Myocardial Infarction 290. Lung tissue 291. Liver cells 292. Severe Vit A deficiency. See Bitots spots in the eyes = gray plaques = thickened, keratinized ET 293. Suspending RBCs in a low O2 content solution 294. Can detect Hemoglobin S, which sickles in low O2 295. Can be due to Hemolyitc Uremic Syndrome & Thrombotic Thrombocytopenic Purpura (TTP) 296. See Helmet cells 297. Stain for Burkitts lymphoma 298. Due to EBV infeciton 299. If Mono is treated w/ Ampicillin, thinking that it is a strep pharyngitis, a rash will occur. 300. Burkitts lymphoma = c-myc oncogene overexpression 301. CML = c-abl/bcr gene formation = Philadelphia translocation 302. Letter Siwe syndrome; Hand Schuller Christian Disease; Eosinophilic Granuloma 303. Birbeck granules are present = tennis racket shape 304. Alkaline phosphatase /normal compare to CML = low to absent 305. Anemia; splenomegaly; platelets > 1 million = extensive extra-medullary hematopoiesis 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) 309. NH Lymphoma = bcl2 proto-oncogene overexpression seen w/ Small Cleaved Cell (Follicualr) Lymphoma 310. IgA Focal GN = Bergers disease; SLE; PAN; Schonlein-Henoch purpura (anaphylactoid purpura) 311. Focal (Segmental) GN; Membranous GN; Lipoid (Minimal Change) GN; Membranoproliferative GN; Hep B; Syphilis; Penicillamine 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 314. PID is usually due to N. Gonorrhoeae, but if unresponsive to penicillin think of Bacteroides species 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 317. Predilection for lenticulostriate arteries = putamen & internal capsule hemorrhages 318. MI w/ Mural Thrombi; Atrial Fib Thrombi = Marantic thrombi; L-sided Bacterial Endocarditis; Paradoxical Embolism of septal defect 319. Tabes Dorsalis = joint position sensation, pain sensation, ataxia, Argyl Robertson pupils 320. Syphilitic meningitis 321. Paretic neurosyphilis 322. Cri di Chat: mental retardation; small head; wide set eyes; low set ears; cat-like cry 323. Pataus: small head & eyes; cleft lip & palate; many fingers 324. Abs to I blood group Ag. Mediated by IgM Abs 325. Complication of EBV or Mycoplasma pneumoniae infections 326. Associated w/lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold. IgM Abs 327. Hereditary Spherocytosis 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 333. Benign laryngeal polyps associated w/ smoking & overuse of the voice 334. Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax Page 23

T(14;18) Focal Segmental GN exs Nephrotic Syndrome exs Schistosoma Haematobium Penicillin Resistant PID Duret Hemorrhages Hypertensive Hemorrhage Cerebral Embolism from Neurosyphilis 5pTrisomy 13 Acute Cold Agglutinaiton Chronic Cold Agglutinaiton RBC Osmotic Fragility Non-Hodgkins Lymphomas

Singers Nodules Paraseptal emphysema

Superior Vena Cava Syndrome Betel nuts Fundal (Type A) Gastritis Antral (Type B) Gastritis Primary Biliary Cirrhosis Acute Pancreatitis Radiating Back Pain Complete Hydatidiform Mole Partial Hydatidiform Mole Cold Nodules Acidophils Basophils Lacunar Strokes CSF of Bacterial Meningitis CSF of Viral Meningitis Marble Bone Disease C5a C3b Anaphylotoxins Vasoactive Mediators Platelet Aggregation Platelet Antagonist Intrinsic Pathway Extrinsic Pathway Lines of Zahn Currant Jelly appearance Emigration: Chemotaxis

335. Obstructed due to bronchogenic carcinoma. Causing swollen face & cyanosis. 336. Associated to oral cancer. 337. Antibodies to parietal cells; pernicious anemia; autoimmune diseases 338. Associated w/ Helicobacter (Campylobacter) pylori infection. 90% of duodenal ulcer 339. Autoimmune origin; middle aged women; anti-mitochondrial Abs 340. Jaundice; itching; hypercholesterolemia (can see cutaneous xanthomas) 341. pancreatic enzymes = fat necrosis; sapponification = hypocalcemia; serum amylase 342. Severe epigastric ab pain; prostration; radiation to the back 343. Chronic pancreatitis 344. No embryo. Paternal derivation only. 46XX 345. Embryo. 2 or more sprems fertilized 1 ovum: triploidy/tetraploidy occurs 346. Hypoplastic Goiter nodules that do not take up radio active iodine. [Opposite: hot & do take up iodine] 347. Mammotrophs = Prolactin 348. Somatotrophs = GH 349. Thyrotrophs = TSH 350. Gonadotrophs = LH 351. Corticotrophs = ACTH & FSH 352. Small/focal aa occlusions. Purely motor or sensory. 353. Sensory: lesion of thalamus 354. Motor: lesion of internal capsule 355. Glucose; Protein; Neutrophils; Pressure 356. Normal Glucose; +/- Protein; Lymphocytes 357. Osteoporosis: Albers-Schonberd Disease = inspite of d bone density, many fractures = osteoclasts 358. Involved in Chemotaxis (for Neutrophils) 359. Involved in Opsonization (& IgG) 360. C3a & C5a (mediate Histamine release from Basophils & Mast cells) 361. Vasoconstriction: TxA2; LTC4; LTD4; LTE4; PAF 362. Vasodilation: PGI2; PGD2; PGE2; PGF2; Bradykinin; PAF 363. d Vascular Permeability: Hist.; 5HT; PGD2; PGE2; PGF2; LTC4; LTD4; LTE4; Bradykinin; PAF 364. ADP; Thrombin; TxA2; collagen; Epinephrine; PAF 365. Prostacyclin (PGI2) 366. F XII (Hagman): APTT 367. F VII: PT 368. Aterial thrombi = pale red colored (dark red is venous thrombi) 369. Post mortem clots 370. Margination 371. Pavementing 372. Adhesion 373. Chemotaxis 374. Phagocytosis 375. Intracellular microbial killing 376. Specific gravity < 1.012 low protein 377. Specific gravity > 1.020 high protein 378. Lysosomal storage disease L Iduronidase Heparan/Dermatan Sulfate accumulation 379. Deficiency of Galactose 1 Phosphate Uridyl Transferase. Galactose 1 Phosphate 380. Deficiency: Phenylalanine Hydroxylase. Phenyalanine & degradation products 381. Mousy body odor 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 391. Tay-Sachs 392. Gauchers Page 24

Transudate Exudate Hurlers Galactosemia Phenylketonuria Autosomal Dominant Diseases

Autosomal Recessive Diseases

X Linked Recessive Diseases

Hypersensitivity Reactions ACID

Transplant Rejections

Blood Metastasis Lymph Metastasis Aflatoxin Cleft Lip Cleft Palate Craniopharyngioma Lateral Geniculate Nucleus Medial Geniculate Body Lung Development

393. Niemann-Pick 394. Hurlers 395. Von Gierkes 396. Pompes 397. Coris 398. McArdles 399. Galactosemia 400. PKU 401. Alcaptonuria 402. Hunters Syndrome (L-Iduronosulfate Sulfatase deficincy, Heparan/Dermatan Sulfate) 403. Fabrys Disease ( Galactosidase A deficiency, Ceremide Trihexoside) 404. Classic Hemophilia A (Factor VIII deficiency, F8 Gene on X chromosome is bad, Ceremide Trihexoside) 405. Lisch-Nyhan Syndrome (HGPRT deficiency, Uric acid) 406. G6Phosphatase deficiency (G6PDH deficiency, Ceremide trihexoside) 407. Duchennes Muscular Dystrophy (Dystrophin deficinecy, Ceremide Trihexoside) 408. Type I (Anaphylactic): IgE mediated. Exs: Hay Fever; Allergic asthma; Hives 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 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. 415. Sarcoma, exception renal cell CA: early venous invasion 416. Carcinoma, exception renal cell CA: early venous invasion 417. Seen w/ Aspergillus. risk for Hepatocellular CA 418. Incomplete fusion of maxillary prominence w/ median nasal prominence 419. Incomplete fusion of lateral palatine process w/ each other & median nasal prominence & medial palatine prominence 416. Pituitary tumor - usually calcified Inolved in Vision relay Involved in Hearing relay Glandular: 5-17 fetal weeks Canalicular 13-25 fetal weeks Terminal Sac 24 weeks to birth Alveolar period birth-8yoa 21-22 days Mouth ! Common Bile Duct - supplied by Celiac Artery Duodenum, just below Common Bile Duct ! Splenic flexure of the Colon supplied by Superior Mesenteric artery Splenic Flexure ! Butt crack ! supplied by Inferior Mesenteric Artery Narcolepsy : Convicting the innocent accepting experimental hypothesis/rejecting null hypothesis Ruptured cerebral bridging veins Ruptured middle meningeal artery intervals of lucidness, 2ry to Temporal bone fracture : Setting the guilty free fail to reject the null hypotesis when it was false 1- TP/TP + FN TN/TN + FP TP/TP + FP TN/TN + FN ad/bc DIC Disorder of thought content Skip from topic to topic Denial Anger Bargaining Depression Acceptance Page 25

Hearts 1st Beat Foregut Midgut Hindgut Hypnagogic Hallucinaitons Type I Error Subdural Hematoma Epidural Hematoma Type II Error Power Sensitivity Specificity Positive Predictive Value Negative Predictive Value Odds Ratio d-Dimers Delusion Loose Association 5 Stages of Death

1st Branchial Arch 2nd Branchial Arch Median nerve lesion Radial nerve lesion Common peroneal lesion Diract inguinal hernia Indirect inguinal hernia @ Diaphragm T8, T10, T12 Hemiballism O Linked Oligosaccharide N Linked Oligosaccharide MLF Syndrome ADA Deficiency Raphe Nucleus waves Irreversible Glycolysis Enzymes Irreversible Gluconeogenesis Enzymes

Meckels cartillage gives rise to incus/malleus bones of ear Reicherts cartillage gives rise to stapes bone of ear No pronation Wrist drop seen w/ humerus fracture Foot drop. No dorsiflexion or eversion of the foot Goes through superficial inguinal ring. Medial to inferior epigastric artery Seen in older men Goes through deep & superficial inguinal ring Lateral to inferior epigastric artery Seen in young boys processus vaginalis did not close T8 = Inferior vena cava T10 = Esophagus/ Vagus T12 = Aorta/ Thoracic duct/ Azygous vein Wild flailing of 1 arm. Lesion of the sub thalamic nucleus In the Golgi In the RER Internuclear Ophthalmoplegia: medial rectus palsy on lateral gaze; Nystagmus on abducting eye. Seen w/ MS SCID Initiation of sleep via 5HT predominance Alert; Awake; Active mind also seen in REM, therefore we say paradoxical sleep Hexokinase PhosphoFructo Kinase = Rate Limiting Step Pyruvate Kinase Pyruvate Dehydrogenase PyruvateCarboxy Kinase PEPCarboxyKinase Fructose 1,6 BiPhosphatase Glucose 6 Phosphatase **muscle dose not take part in Gluconeogenesis, only takes place in the liver, kidney & GI epithelium Diarrhea, Dermatitis, Dementia Niacin Deficiency (Vit B3 deficiency) Hartnups Disease Malignant Carcinoid Syndrome INH use Needed as co-factor for Pyruvate DH complex & Ketoglutarate DH complex Esterification of cholesterol: lecithin cholesterol acetyltransferase Lecithin = Phosphatidylcholine, therefore phosphotidylcholine acetyltransferase Rate limiting step in cholesterol synthesis Changes HMGCoA ! Mevalonate (-) by Lovastatin Leucine & Lysine Methionine, Threonine, Valine, Arginine, Histadine Phenylalanine, Trytophan, Isoleucine Feeds FA into the mitochondria for their consumption Keeps muscles working anaerobically. Transfers lactate to the liver to make glucose which is sent back into the muscles for energy use Ouabain [(-) K+ pump] Vanadate [(-) phosphorylation] Digoxin [ heart contractility] Citric Acid Is Krebs Starting Substrate For Mitochondrial Oxidation Citrate ! Aconitate ! Isocitrate ! Ketoglutarate ! Succinyl ! Succinate ! Fumarate ! Malate !OAA Color vision. Contain Iodopsin = Red-Blue-Green specific pigment. For acuity. Contain Rhodopsin pigment. High sensitivity. Concentrated in the fovea. Night vision. Seen @ 3rd week: Ecto, Meso & Endo @ 2nd week: forms the primitive streak, from which Meso & Endo come from. Directly gives rise to Ecto. Post streptococcal infection. Necrotizing arteritis of the caudate, putamen, thalamus Chlamydia trachomatis types L1, L2, L3 = Lymphogranuloma venereum Page 26

Pellagra

TLCFN LCAT or PCAT HMGCoA Reductase Ketogenic amino acids Glucogenic amino acids Keto & Gluco amino acids Carnitine Shuttle Cori Cycle (-) Na+ Pump (ATPase) TCA Cycle Products Cones Rods Gastrula Epiblast Sydenhams Chorea (+) Frei Test

Sabourauds Agar FMR1 Gene Defect Barr Body Aortic Insufficiency Signs Scleroderma :CREST Cretinism Hemochromatosis Triad

Culture for all Fungi ieCulture Cryptococcus neofromans which is found in pigeon droppings Fragile X Syndrome: macro-orchidism; long face; large jaw; large everted ears; autism, mental retardation Present in Kleinfelters: Male: XXY Not present in Turners: Female: XO Traube Sign = Pistol shot sound over the femoral vessels Corrigan pulse = water hammer pulse over coratid artery = aortic regurgitation Calcinosis; Raynauds; Esophageal; Sclerodactyl; Telangiectasis Sporadic: bad T4 phosphorylation or developmental failure of thyroid formation Endemic: no Iodine in diet: protruding belly & belly button Micronodular pigment cirrhosis; Bronze Diabetes; Skin pigmentation = due to Fe3+ deposition

Highly Tested Drug Side Effects

Agranulocytosis Aplastic Anemia Atropine-like Side Effects Cardiotoxicity Cartilage Damage in Children Cinchonism Cough Nephrogenic Diabetes Insipidus Disulfiram-like Effect Extrapyramidal Side Effects Fanconis Syndrome Fatal Hepatotoxicity (necrosis) Gingival Hyperplasia Gray Baby Syndrome Gynecomastia
420. 421. 422. 423. 424. 425. 426. 427. 428. 429. 430. 431. 432. 433. 434. 435. 436. 437. 438. 439. 440. 441. 442. 443. 444. 445. 446. 447. 448. 449. 450. 451. 452. 453. 454. 455. 456. 457. 458. 459. 460. 461. 462. 463. 464. Clozapine, Chloramphenical Chloramphenicol NSAIDs Benzene Tricyclics Doxorubicin Daunorubicin Fluoroquinolones (Ciprofloxacin & Norfloxacin) Quinidine ACE Inhibitors Lithium (Txt w/ Amiloride) Metronidazole Sulfonylureas (1st generation) Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine) Tetracycline Valproic Acid Halothane Acetaminophen Phenytoin Chloramphenicol Cimetidine Azoles Spironolactone Digitalis Sulfonamides Isoniazid Aspirin Ibuprofen Primaquine Isoniazid Niacin Tamoxifen Ca++ Channel Blockers Barbiturates Phenobarbital Phenytoin Carbamazepine Rifampin Cimetidine Ketoconazole Methicillin NSAIDs (except Aspirin) Furosemide Sulfonamides Nitroglycerin Industrial exposure tolerance during week loss of tolerance during weekend headache, Rifampin Page 27

Hemolytic Anemia in G6PD-deficiency

Hepatitis Hot Flashes, Flushing Induce CP450

Inhibit CP450 Interstitial Nephritis

Monday Disease Orange Body Fluids

ach, dizziness upon re-exposure

Osteoporosis Positive Coombs Test Pulmonary Fibrosis Red Man Syndrome Severe HTN with Tyramine SLE-like Syndrome Tardive Dyskinesia Tinnitus

465. 466. 467. 468. 469. 470. 471. 472. 473. 474. 475. 476. 477. 478.

Heparin Corticosteroids Methyldopa Bleomycin Amiodarone Vancomycin MAOIs Procainamide Hydralazine INH Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine) Clozapine: only antipsychotic to not give you tardive dyskinesia Aspirin Quinidine

Microbiology
Lactose formers
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. CEEK Citrobacter Enterobacter E.Coli (K1 capsule most important) Klebsiella SHYPS Motile: Shigella make H2S Yersinia enterolytica (AKA Pestis) Proteus Non Motile: noH2S Salmonella These rascals may microscopically lack color: Treponema Ricksetta Mycobacterium Mycoplasma Legionella Chlamydia CAPE Cholera Anthracis (Poly D glutamate capsule) Pertusis (via Gi) E.coli (LT enterotoxin) Some killers have pretty nice capsules Strep. Pneumoniae Klebsiella HiB Pseudamona Aeroginosa Neisseria meningitis Cryptococcus neoformans (only encapsulated fungal pathogen) Can Also Have Both Shapes Cocciodes Aspergillus Histolpasma Blastomyces Sprothrix schenkii OBED O = Salmonella B = Botulinum E = Erythrogenic strep D = Diptheria Bacilus & Clostridium (have calcium di-picolinate)

Non lactose formers

May lack color

cAMP

Have Capsules [ie are Quellung Reaction (+)]

Dimorphic Fungi

Have Prophage

Spore Forming Bacteria IgA Proteases Widal Test

42. Neisseria, Haemophilus, S. pneumoniae 43. Salmonella (Salmonella begins in the ileocecal region) agglutination indicates Abs to O, H, Vi Salmunella Ags Page 28

Waysons Stain Pneumonic Plaque Transmission Splenectomy Invasins Fusiform S. viridans Obligate Aerobes Obligate Anaerobes Staph aureus Spirochetes Non Motile Gram (+) Rods Acid Fast Organisms Pigment Producing Bacteria

44. Yersinia 45. Person to person cf w/ Bubonic plaque that was via infected flea 46. Predisposes to septicemia 47. Yersinia pseudotuberculosis 48. Vincents trench mouth 49. Dextran mediated adherence 50. Pseudomonas & Mycobacterium 51. Clostridium, Actinomyces, Bacteroides 52. A Protein, Catalase +/ Coagulase + 53. Treponema, Borrelia, Leptospira 54. Corenybacterium D & Nocardia 55. Mycobacterium; Cryptosporidium; Nocardia (partially); Legionella micdadei; Isospora 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. Serratia red (can cause pseudohemoptysis) Pseudomonas A piocyanin blue/green Staph Aureus yellow Protein A Mycobacteria photo/scoto chromogenic caritinoid yellow/orange Corneybacterium D black/gray pseudomembrane plaque in throat Bacteroides (Porphyromonas) melaninogenicus black (heme) E. coli irredescent green sheen Pneumococci lancet shaped diplococci Neisseria kidney bean shaped diplococci Camphylobacter gulls wings/comas Vibrio Cholera coma shaped Corneybacterium D club shaped (nonmotile, G+Rod) Yersinia safety pin seen in Waysons stain Rabies Negri bodies intracytoplasmic Pox virus Guarnieri intracytoplasmic & acidophilic CMV Owls eyes intracytoplasmic & intranuclear HSV Cowdry bodies intranuclear Intestinal contact w/ bad water

Bacterial Morphology

Inclusion Bodies

Schistosoma Japonicum Monsoni Schistosoma Haematolium Non Human Schistosom Clonorchichis Fasciola Hepatica Fasciola Biski Paragonimus Westermani Oxidase (+) Micro Aerophilic Urease (+)

74. Vesicular contact w/ bad water 75. Swimmers itch contact w/ bad water 76. Chinese liver fluke eating raw fish. Txt: Praziquantel 77. Sheep eating raw fish. Txt: Praziquantel 78. Giant intestinal flukes eating raw fish. Txt: Praziquantel 79. Lung fluke eating raw fish. Txt: Praziquantel 80. Neiserria and most Gram (-)s 81. Camphylobacter & Helicobacter 82. 83. 84. 85. 86. 87. All Proteus can cause Staghorn/Struvite calculi (NH4- Mg2- stones): alkaline urine Ureaplasma Campylobacter pylori (Helicobacter) Cryptococcus Nocardia Staph A & Yersenia pestis

Coagulase (+) Obligate Intracellular Bacteria Protozoa Obligate Non Intracellular Parasites Haemophilus Factors All cocci are Eaton Fried Eggs Mycoplasma

88. Chlamydia Pistacci (Chlamydia do not make own ATP); Mycobacterium Leprae; all Rickettsia except Roachalimea (make suficient ATP to survive) 89. Plasmodium; Toxoplasma ghondi; Babesin; Leishmania; Trypanosoma Cruzi 90. Treponema palidum & Pneumocystis Carinii (cannot be cultured on inert media but can be found extra cellularly in the body) 91. X = Protoporphyrin & V = NAD 92. Gram (+) except for Neisseria & Moraxella 93. Mycoplasma pneumoniae has fried egg colonies on Eaton agar (needs cholesterol) 94. 95. 96. 97. 98. No cell wall. Membrane has cholesterol. Smallest living bacteria. P1 protein inhs ciliary action Fried egg colonies Atypical pneumonia young adults Fungal media

Sabrands Malassazia furfur

99. Spaghetti & meat ball Page 29

Measles 3Cs Non Motile Bacilli & Clostridium Bloody diarrhea agents YW-135CA Indian Ink Naegleria causes Need Cysyeine for growth

100. Cough Coryza Conjunctivitis. Can also have photophobia 101. May lead to subacute Sclerosing Panencephalitis 102. B. Anthracis & C. Perfringens 103. EIEC EHEC Shigella - Yersenia enterocolitica Entaemeba histolytica Salmonella Campylobacter jejuni 104. N. meningitidis vaccine capsualr polysaccharide strains 105. Cryptococcus neoformans 106. Colonization in the nasal passages after swimming 107. 108. 109. 110. 111. 112. Ella likes cysteine: Francisella Brucella Legionella Pasturella Gram (-): N. meningitidis

Endotoxins, G(+) or G(-) Ecthyma Gangrenosum, seen w/ Endospores G(+) Multi Brain Abscess Single Brain Abscess risk for Strep pneum Infection Hemolysis/Optochin Sensitive Hemolysis/Optochin Resistant Staph. Saprophyticus Staph. Epidermidis Hemolysis/Bacitracin Sensitive Hemolysis/Bacitracin Resistant EFII Ribosylation Bacillus Anthracis: 3 toxins
(work via adenylate cyclase)

113. Pseudomonas aeroginosa. Target shaped skin lesions w/ a black center and red ring surrounding the lesion 114. Gram (+): Bacillus & Clostridium made up of dipicolinate & Keratin 115. Nocardia 116. Actinomyces israelli 117. Asplenic; Sickle cell anemia; immunocompromising illness 118. Strep. Pneumoniae 119. Strep. Viridans (Subacute Endocarditis) 120. Novobiocin Resistant (UTIs) 121. Novobiocin sensitive (Endocarditis in IVDUs) 122. Strep. Pyogenes (pharyngitis; Scarlet fever; cellulitis; impetigo; Rheumatic fever)) 123. Hyaluronic capsule; non-motile; M proteins; Endotoxin A 124. Strep. Agalactiae (Diabetes predisposes to infection) 125. Diphtheria toxin & Pseudomonas exotoxon A 126. 127. 128. 129. 131. 132. 133. 134. 135. 136. Protective Antigen (PA) Lethal Factor = toxic to macrophages Edema Factor = cAMP Bacillus anthracis. DOC: Penicillin Double Zone Hemolysis (test) Lecithinase: toxin = lyses RBCs 80% of gas gangrene (myonecrosis) cases 2 Toxins: Enterotoxin (Exotoxin A) & Cytotoxin (Exotoxin B) Pseudomembranous colitis (can be precipitated by clindamycin/ampicillin) Clostridium Tetani toxin

Woolsorters Disease Grows in Rice Clostridium Perfringens Clostridium Difficile Spastic Paralysis toxin Clostridium Botulinum Infant Botulinum Thayer Martin Agar DOC for N. gonorrhoeae K1 E. Coli Capsular Ag The As of Klebsiella Rice H2O Diarrhea Raw seafood intoxicaiton Helicobacter Txt risk of P. aeroginosa infection Contact lens infection Cat Bites Undulant Fever Bordet Gengou Agar Lowenstein-Jensen medium Cat Scratch Disease

130. Bacillus Cereus

137. Bad canned foods have neurotoxin = flaccid paralysis (block Ach release) 138. Floppy Baby Syndrome. Pre formed toxin in honey 139. Neisseria ID 140. Ceftriazone 141. Related w/ neonateal meningitis 142. 143. 144. 145. Alcoholics Aspiration pneumonia Abscesses in the lungs Vibrio Cholera: metabolic acidosis

146. Vibrio parahemolyticus 147. Bismuth salts; Metronidazole; Tetracycline (or amoxicillin) 148. Burn patients & Cystic fibrosis 149. Pseudomonas aeroginosa 150. Pasteurella multocida 151. Brucella 152. Bordetella pertusis ID 153. M. tuberculosis ID 154. Bartonella henselae. Leion can resemble Kaposis sarcoma. Page 30

Pink Eye True Hemaphrodite Pseudo Hemaphrodite Male Pseudo Hemaphrodite HLA Genes Location Parvovirus B19 Interferon MOA Acute Hemorrhagic Conjunctivitis Parainfluenza Causes Swimming Pool Conjunctivitis RSV Removed tonsils, find what virus Bone Fever HbsAg HbeAg Anti-Hbc Filamentous Bacteria Listeria contaminates Shiga like Toxin Necrotizing Fasciitis Relapsing Fever Lofflers Medium Chlamydiae Developmental Cycle

155. Toxoplasmosis 156. Adenovirus (type 8) 157. Testes & Ovaries are present 158. External genitalia does not coincide w/ gonads 159. Testicular Feminization 160. 6p 161. Fifth Disease: Erythema Infectiosum (ssDNA). Linked w/ sicle cell anemia 162. Inhibits viral replication (translation or transcription) 163. Seen w/ infections from Enterovirus & Coxsackie A 164. Croup (Laryngotracheobronchitis) 165. Adenovirus (types 3 & 4) 166. Bronchiolitis in infants 167. In 80%, Adenovirus. In the immunosuppressed, activation can occur 168. Dengue: Group B Togavirus, from the Arbovirus, transmitted by mosquitos 169. 170. 171. 172. 173. 174. 175. Appears in blood soon after infection, before onset of acute illness Disappears w/in 4-6 months after the start of clinical illness Appears early acute phase, indicates higher risk of transmitting the disease Disappears before HbsAg is gone Present in beginning of clinical illness Seen in the window phase Actinomycetes = Nocardia; Actinomyces; Streptomyces

176. Milk, cheese, vegetables (coleslaw) in recent infections 177. E. Coli 0157/H7: Hemorrhagic colitis & Hemorrhagic uremic syndrome 178. Group A Streptococci 179. Borrelia recurrentis 180. Corneybacterium diphtheriae 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 185. Rochalimaea quintana 186. Rickettssia rickettsii (RMSF) & R. akari (rickettsial pox) in the U.S. 187. R. sibirica (tick typhus in China) & R. australis (typhus in Australia) 188. Nystatin txts candidiasis of the mouth 189. Have Sporothrix schenckii 190. Acanthamoeba 191. Wucheria bancrofti (infection aka elephantitis & wucheriasis 192. Causes amebic meningoencephalitis due to Naegleria fowleri 193. Transmits Trypanoma cruzi (Chagas disease): Romanas Sign 194. Bladder calcificaiton & cancer 195. Presinusoidal HTN, splenomagaly, esophageal varices 196. Schistosomiasis 197. Babesia (clinically rembles malaria) & Borelia burgdorferi 198. Babesia microt 199. Trypansoma cruzi: Chagas Disease 200. Trypansoma brucei gambiense & rhodiense: African Sleeping Sickness 201. Leishmaniasis: Mucocutaneous Diseases by L. braziliensis & Visceral Disease by L. donovani &
Dermal Leishman by L. tropica, mexicana, peruviana

Trench Fever Spotted Fever Members Thrush Txt Rose Bush Thorns Contact lens solution infection Filiariasis Causant Freshwater lake infection Reduviid bug bite Schistosoma Haematobium causes Schistosoma Mansoni causes Snail, intermediate host of Ixodes scapularis transmits Nantucket Protozoa Infection by Reduviid Bug Infection by TseTse Fly Infection by Sandfly Infection by Ixodes Tick Infection by Anopheles Mosquito Trophozoites w/ Face-Like Appearance Nonseptate Hyphae Histoplasmosis Geography Coocidioidomycosis Geography Blastomycosis Geography

202. Babesia microti: Babesiosis & Borrelia burgdorferi: Lyme Disease 203. Malaria 204. Giardia lamblia 205. Zygomycosis: Rhizopus & Mucor. Only mycosis w/o septate. Infect Ketoacidotic Diabetics. 206. Ohio, Mississippi, Misouri River valleys 207. Southwestern deserts, California 208. States east of Mississippi River Page 31

Paracoccidioidomycosis Geography Roseola Infection, aka Herpangina Orthomyxovirus

209. Latin America 210. Exanthema Subitum: Sixth Disease (Human Herpes Virus-6 dsDNA, enveloped) 211. Hand-Foot-and-Mouth Disease: Coxsackie A (Picornavirus +ssRNA) 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 215. RNA, enveloped. Most common cause of respiratory infections in kids 216. Mumps 217. Croup(Parainfluenza virus) 218. Rubeola(Measles virus) 219. RSV 220. +ssRNA, enveloped 221. 3 Day Measles: German Measles: Rubella/ Rubivirus 222. Encephalitis viruses: Alphaviruses: Eastern (more severe) and Western Equine Encephalitis 223. Dengue Fever icterus & hemorrhage w/ blac vomit 224. Yellow fever 225. St. Louis Encephalitis no hepatitis or hemorrhage 226. ssRNA, enveloped 227. California Encephalitis severe bifrontal headaches 228. Hantavirus hemorrhagic fever w/ acute resp. distress syndrome 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. 234. Adenopathy 235. Prophage encodes the exotoxin 236. Corneybacteria is Club shaped 237. Diphtheria 238. Elongation Factor II 239. Granules (metachromatic) 240. Parvovirus: Part of a virus 241. Reovirus, RepeatOvirus 242. Naked for CPR: Calcivirus; Picornovirus; Reovirus 243. Papovavirus & Hepadnavirus 244. Papovavirus. Seen in kidney transplant patients (causes renal disease) 245. No, but has reverse transcriptase 246. Poiliovirus; Echo; Rhino; Coxsackie; Hep A 221. Filovirus & Bunyavirus (Hantavirus) All are RNA: Orthomyxo; Arena; Bunya; Reo No internal virus. 1 total virus per cell No external virus. Extracellular virus found Nucleocapsid. DNA or RNA + Structural proteins Membrane. Nucleocapsid + Glycoprotein Non virus specific. Works by RNA endonuclease = digests viral DNA + inh viral prot synth Gag, pol, env Tat, rev, nef Transmembrane Surface Matrix Capsid Nucleocapsid Brick. Rep In Cyto AH H PPP --- ico Rep in Nuc Page 32 E A = Adeno H = Herpes H= Hepadna P = Pox P = Parvo

Paramyxovirus

Togavirus

Flaviviris Bunyavirus IgA Protease Activity

Diphtheria: ABCDEFG

Only ssDNA Only dsRNA Naked RNA 2 circular DNAs BK Hepadna, Retrovirus? Picornovirus: PERCH Hemorrhagic Fevers Segmented viruses Eclipse Phase Latent Phase Naked Capsid Virus Enveloped Virus Interferon AIDS structural prots AIDS regulatory prots AIDS gp41 env prot AIDS gp120 env prot AIDS p17 gag prot AIDS p24 gag prot AIDS p7p9 gag prot DNA Viruses

SS Circ

P = Papova

(+) RNA Viruses

C P R F T C ------ ico (+) Linear. No segment. Rep in Cyto Helical R-Tase & Rep in Nuc

C = Calici P = Picorno R = Reo F = Flavi T = Toga C = Corona

(-) RNA Viruses

8 2 3

F O R P A B ---- (-) E Helical Linear. Non seg.

F = Filo O = Orthomyxo R = Rhabdo P = Paramyxo A = Arena B = Bunya

Bullet Anti sense

Hepatitis Window Period

Hepatitis A Picorna

After HbsAg disappears & Before HbsAb appears B Hepadna EBV C Flavi D Delta E Calici

Downey Type II cells Infection by Aedes Mosquito Hot T-Bone stEAk: ILs

Yellow Fever: Flavivirus: Black vomit, jaundice, high fever 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) IL2, IL4, IL5, IFN gamma IL1 & TNF Neutral chemotaxis. When it is w/ C3a, participates in anaphylaxis When both Alternative and Classic pathways come together Alternative: C3b, Bb, C3b + C3a ! C5 Classic: 2b, 3b, C3a + C4b ! C5 Quintana Sporozoites: from blood to liver Primary tissue schizont Trophozoites: in RBC Erythrocytic schizont Merozoite: ruptured RBC Gametozyte Zygote: inside the mosquito

ILs Secreted by CD4s ILs Secreted by Macrophages C5a C5 Convertase Only Richettssia not Intracellular Plasmodium Life Cycle

Acanthamoeba Mucor, Rhizopus, Absidia Cryptococcus Neoformans Candida Aspergillus Fumigatum Cocciodes Histoplasma Cap Blastomycosis Sporothrix Schenkii PCP

Star shaped cysts Nonseptate, filamentous, 90 degree branching, indian in, capsular halos
Monomorphic Yeast normally, pseudo & true hyphae in tissue infections 45 degree branching point, asocd w/ cystic fibrosis & burns pt Hyphae in wild. Artroconidia. Arthocondida & Hyphae. Sherules w/ endospores Hyphae in wild. Microcondida w/ tuberculate macrocondida. Fac intracellular. In the tissue its a yeast w/ a small neck. Hyphae in wild Hypahe in wild. Potas iodide in milk. Pneumonia in alcoholics. Obligate parasite. Kills type I pneumo cells. Ground glass Page 33

Gram (-) Bugs w/ Exotoxins

Dermatophytes

E. Coli; V. Cholera; Bordetella Pertussis Trichophyton: SHN Microsporium: SH Epidermophyton: SN Tinea tavus: permanent hair loss

Transmission
E. Histolitica Giardia Cryptosporidium Balantium C. Trichomonas V. Vivax Ovale Malariae Falciparum Cysts Cysts Cysts Cysts Trophozoites

Diagnosis
Trophozoites or cysts in stool Trophozoites or cysts in stool Acid fast oocysts Trophozoites or cysts in stool Motile trophozoites Enlarged Host Cell Oval/Jagged Crescent

Fever

Fever Spike
48h 48h 72hrregular

Benign 3 degrees Benign 3 degrees 4 degrees of Malarial Malignant 3 degrees

Miscellaneous
1. Fastest growing tumor Burkitts 2. PEs are found in half of all autopsies 3. Courvoisiers Law: tumors that obstruct the common bile duct cause enlarged gallbladders, but obstructing gallstones do not (too much scarring), so if you can palpate the gallbladder youe probably looking at cancer. 4. Only DNA virus to replicate in cytoplasm: Pox 5. Only RNA virus to replicate in nucleus: Influenza 6. Bacillus anthracis has the only protein capsule 7. Bordetella pertussis (Whooping Cough) elicits lymphocytosis rather than granulocytosis 8. Bronchioalveolar carcinomas grow without destroying the normal architecture of the lung 9. Cryptococcus neoformans often lacks a capsule and, when stained with GMS, looks just like Pneumycistis carinii, except that Cryptococcus lacks the prominent nucleoli. 10. Weil Felix reaction: (+)R. rickettssi & (+)Proteus vulgaris & P. mirabilis 11. Treponema pallidum (Syphilis) tests: 1)VDRL 2)FTA-Abs: most widely used 3)TPI (immobilization test most expensive but the Gold Standard) Cytokine IL 1 IL 2 IL 3 IL 4 IL 5 IL 6 IFN IFN IFN gamma TNF TNF Source 12. Monocytes, macrophages 13. Macrophages, T & NK cells 14. T cells 15. T cells 16. T cells 17. T cells, monocytes 18. B cells, macrophages 19. Fibroblasts 20. T & NK cells 21. Macrophages, T & NK cells 22. T cells Function Stimulates T cell proliferation & IL2 produciton Stim prolif of B, T & NK cell GF of tissue mast cells & hematopoietic stem cells growth of B & T cells/ HLA II Ags Maturation of B ! plasma cell Maturation of B & T cell/ (-) fibroblasts Antiviral activity Antiviral activity Antiviral activity, (+) macrophages, HLA II Ags T cell prolif, IL 2 prod, cytotoxicity T cell prolif, IL 2 prod, cytotoxicity

Tumor Suppressor Genes

Genes VHL APC WT-1

Chrom. Associated Tumors 3p Von Hippel Lindau, Renal Cell CA 5p Familial adenomatous polyposis, Colon CA 11p Wilms tumor
Page 34

Rb BRCA-2 p53 NF-1 BRCA-1 DCC DPC NF-2

13q 13q 17p 17q 17q 18q 18q 22q

Retinoblastoma, Osteosarcoma Breast CA Most human Cas Neurofibromatosis type 1 Breast CA, Ovarian CA Colon & Stomach CA Pancreatic CA Neurofibromatosis type 2 = bilateral acoustic neuroma

Physiology Equations

Resistance in Series: Add all Resistance in Parallel: Invert the answer RENAL: Filtration Fraction =

GFR RPF

GFR: Glomerular Filtration Rate RPF: Renal Plasma Flow

Filtered Load = GFR x [Conc]

Excretion Rate = [Urine] x VelUrine

Clearance =

[Urine]xVel (Urine) Excretion or [ Plasma] [ Plasma]

Clearance of PAH = [ERPF]

ERPF: Eff renal plasma flow

Renal Blood Flow =

ERPF 1 Hct

Free Water Clearance = VelUrine -

Urine(osm) xVel (urine) P(osm)

CARDIO: CO = HR x SV CO =

O 2(consumed ) PulmonaryA VO 2difference

Pulse Pressure = Systolic Diastolic

MAP = Diastolic + 1/3 Pulse Pressure LUNGS: PAO2 = (760 47) FO2 Where: FO2 = [O2] PACO2 = Alv. Press. Of CO2

CO =

MAP TPR

MAP = TPR x CO

F=

P1 P 2 R

PACO 2 R
R = Resp. Exchange Ratio

CO 2 produced .8 or 1 O 2consumed

Page 35

Flow = Press

O 2consumed AtoVO2difference

Velgas Diffusion =

Area x Gas Diffusion Constant x Difference of Partial Thickness

VentTot = VentTidal x #of Respirations Compliance =

VentAlv = (VentTidal VentDead) x # of Respirations 1.0 = Va/Q Diffusing Capacity = New PO2 = 170

Vol Pr ess

P=

Tension Radius

COuptake PACO 2

Resp Doubles: 150mmHg & 40mmHg

New PCO2 = 20

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