NBDE First Aid Side Notes- Micro/Path – Flashcards
154 test answers
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What is a cross-linked polysaccharide consisting of alternating N-acetylmuramic acid and N-acetylglucosamine residues?
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Peptidoglycan
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How do bacteria reproduce?
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Binary fission
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What are the 4 natural transforming bacteria?
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Streptococcus sp., Haemophilus sp., N. gonorrhoeae, and H. pylori
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Mycobacteria cell walls do not contain peptidoglycan, but contain _______.
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Mycolic acid
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What are the classifications of streptococcus hemolysis?
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A: Almost (Incomplete) B: Best (Complete) G: Garbage (None)
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What bacteria cause pink eye?
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Haemophilus aegyptius (Koch-Weeks bacillus)
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Most antibacterial activity occurs during which phase of bacterial growth?
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Log phase
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Should you give bacteriocidal and bacteriostatic drugs together?
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No, they antagonize each other
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What is the cytopathic effect?
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The host cellular morphologic and functional changes associated with viral replication and release
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What are the 2 envelope glycoproteins in influenza viruses that exhibit the majority of antigenic changes?
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Hemagglutinin and neuraminidase
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Which 3 viruses are enteroviruses?
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Poliovirus, coxsackieviruses, Hep A
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What are rodent-borne viruses called?
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Roboviruses
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Describe HIV.
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dsRNA, reverse transcriptase, gp120 (mediates attachment to CD4+) and gp41 (mediates attachment to host cell)
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What is a potentially deadly disease in children that is associated with the use of aspirin to treat influenza or varicella?
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Reye's syndrome
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What is the most common reason for liver transplantation in the US?
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Hep C
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What is often added to vaccines to slow their absorption and increase their effectiveness?
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Adjuvants
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What are hepatocarcinogenic toxins produced by Aspergillus flavus that are generally found in contaminated grains and peanuts?
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Aflatoxins
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Most antifungal drugs target which component of fungal cell mebranes, altering their permeability?
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Ergesterol
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Parasitic infections generally exhibit what kind of host immune response?
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IgE mediated (Type IV)
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Does calculus directly irritate the gingiva?
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No, provides a place for plaque accumulation
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What is the most effective antiplaque mouthrinse due to its substantivity?
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Chlorohexidine
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Which bacteria cause all types of caries in the mouth?
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Streptococcus sp.
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Which bacteria cause specifically pit and fissure caries?
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Lactobacillus sp.
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Which bacteria cause specifically root caries?
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Actinomyces sp.
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Which bacteria is increased in pregnancy?
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P. intermedia
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Which 3 organs are very vulnerable to hypoxia?
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Heart, brain, lungs
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What 3 drugs cause gingival overgrowth?
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Phenytoin (Dilantin, Ca2+ channel blockers (nifedipine), Cyclosporin
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What kind of calcification can be seen around intrathoracic lymph nodes and is associated with silicosis?
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Eggshell calcification
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What is calcification in or under the skin that is associated with scleroderma and dermatomyositis?
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Calcinosis
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What is the most common form of necrosis?
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Coagulative necrosis
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Which cells cannot regenerate?
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Neurons, alveolar, cardiac, skeletal, and smooth
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What is contact inhibition during epithelialization?
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When free edges of the wound epithelium migrate toward each other until they meet, signaling a stop in lateral growth
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What is an uncommon site for infarction, due to its regenerative capacity?
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Liver
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What is killed M. tuberculosis suspended in lanolin and mineral oil that is commonly used for research?
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Freund's adjuvant
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Class I MHC surface proteins are present in ___ ____ _____. Class II MHC surface proteins are present in _____ ____.
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All nucleated cells; only APCs
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What are the 2 ways that CD8+ lymphocytes act?
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Release perforins or induce apoptosis
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What is the process by which an Ag binds to a specific TCR or IG, activating that immune cell to clonally expand into cells of the same specificity?
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Clonal selection
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How do IgG antibodies enhance NK cells effectiveness?
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Via antibody-dependent cellular toxicity
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What immune system includes all the phagocytic cells except for granulocytes?
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Reticuloendothelial system
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What are the major dendritic cells of the gingival epithelium?
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Langerhans cells
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What are the 2 major opsonins?
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IgG and C3b
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How are bacteria (like Staph sp) able to resist the cidal effects of peroxide?
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They contain catalase
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Which 2 immunoglobins are the only ones that can activate complement?
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IgG and IgM
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Which cells elicit most of the destruction in graft rejection?
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CD8 T cells
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What are the most common types of hyperacute rejection?
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ABO blood mismatches
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What are clinical examples of Type I hypersensitivity reactions?
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Asthma, edema, erythema, urticaria, anaphylaxis
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How do you treat anaphylaxis?
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Epinephrine, then corticosteroids or antihistamines once stable
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What is the mechanism for teratogens?
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Inhibit, interfere, or block metabolic steps critical for normal morphogenesis
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What are 3 three factors of teratogen susceptibility?
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Variability, specific for each developmental stage, dose dependent
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What is most common chromosomal disorder?
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Down syndrome (then Edward's, then Patau's)
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Lysosomal storage diseases are most common in people of which ancestry?
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Eastern Europe
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What are the causes and symptoms of cystic fibrosis?
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Problems with Cl- transporter; bronchiectasis, meconium ileus
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Which skin infection has intraepidermal bullae, and is therefore more severe?
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Pemphigus vulgaris
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Which skin infection has subepidermal bullae, and is therefore less severe?
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Bullous pemphigoid
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Right sided heart failure results in _____ edema, but left sided heart failure results in _____ edema.
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Peripheral; pulmonary
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What is the major factor in all types of shock?
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Decreased CO
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What is Virchow's triad?
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Endothelial injury, alteration in blood flow, hypercoagulability of blood
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What does a pulmonary embolism usually arise from?
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Deep vein thrombosis of the lower extremities
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What is the large pulmonary embolus that obstructs the birfurcation of the pulmonary artery?
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Saddle embolus
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What is an embolus that begins in the venous system, but ends up in the systemic arterial system, because of an atrial septal defect. This is the only time a deep vein thrombosis can cause a stroke.
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Paradoxical emboli
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What are the most susceptible arteries to arteriosclerosis?
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Aorta and coronary arteries
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What 3 things can result from untreated hypertension?
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Wear out (cardiac failure), Blow out (CVA), Run out (Renal failure)
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What is the most common cause of secondary hypertension?
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Renal disease
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What is a condition in pregnant patients resulting from hypertension, proteinuria, and edema?
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Preeclampsia
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What is preeclampsia + seizures?
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Eclampsia
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Where does the aortic dissection most often rupture, causing fatal tamponade?
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Pericardial sac
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What heart valve is the most affected in IV drug users?
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Tricuspid valve
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Which valve is rarely involved in rheumatic heart disease?
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Pulmonary
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What is the most common cause of death from heart attacks?
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Arrhythmias causing ventricular fibrillation
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What are the 2 earliest and most common signs of heart failure?
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Exertional dyspnea and paroxysmal nocturnal dyspnea
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What is the most common cause of right sided heart failure?
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Left sided heart failure
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What is the greatest cause of COPD?
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Cigarette smoking
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What is the most common cause of secondary pulmonary hypertension?
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COPD
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What are the 2 basic problems of emphysema?
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1. Lungs are fixed in inspiration, so it is difficult to exhale 2. Decreased gas exchange from decreased SA
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What is atelectasis neonatorum?
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Alveolar collapse in newborns usually due to decreased surfactant
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What is the cause of mesothelioma?
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Asbestos exposure
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What is pneumoconiosis caused by inhalation of cotton particles?
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Byssinosis
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What is the most common predisposing factor of lung abscess?
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Alcoholism (aspiration)
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What makes up the Ghon complex?
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Primary lesion + lymph node involvement
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What is TB involving the vertebral body?
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Pott's disease
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What is the most common complication of peptic ulcer disease?
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Hemorrhage
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What is soft, bulky, foul-smelling light-colored stool? When does it occur?
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Steatorrhea; occurs when fat is not absorbed
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What can cause obstructive jaundice?
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Gallstones that block the CBD
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What is hereditary accumulation of copper in the liver, kidney, brain, and cornea?
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Wilson's disease
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What is the most important sign of portal hypertension?
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Splenomegaly
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What is the most common cause of ascites?
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Liver disease
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What is the classic cause of blood in the urine in children?
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Poststreptococcal glomerulonephritis
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What does a positive Coombs' test indicate?
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Hemolysis is mediated by antibodies attached to RBCs
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What is toxic accumulation of unconjugated bilirubin in the brain and spinal cord?
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Kernicterus
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What are classic characteristics of sickle cell anemia?
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Healing leg ulcers and recurrent bouts of abdominal and chest pain
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How do the RBCs appear in drug-induced aplastic anemia?
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Normochromic and normocytic
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What is iron deficiency anemia associated with upper esophageal web?
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Plummer-Vinson syndrome
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In polycythemia vera, erythropoietin levels are _____ or _____. In secondary polycythemia, erythropoietin levels are ______.
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Normal or low; elevated
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Where is erythropoietin made?
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JG apparatus in the kidney
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Which 2 diseases exhibit problems with both platelets and coagulation cascade?
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Disseminated intravascular coagulation (DIC) and von Willebrand's disease
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What is the most common cause of bleeding disorders?
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Thrombocytopenia
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What is a decreased platelet count due to platelet consumption by thrombosis in the terminal arterioles and capillaries?
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TTP (Thombotic thrombocytopenic purpura)
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What are 2 causes of qualitative platelet dysfunction?
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Von Willebrand's disease and Bernard-Sollier disease
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Hemophilia is characterized by ____ PTT, _____ PT, and _____ bleeding time?
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Increased PTT, Normal PT, Normal bleeding time
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Where are clotting factors made?
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Liver
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What does Warfarin inhibit formation of?
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Prothrombin (Factor II)
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What does Heparin bind to and what does it inhibit?
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Antithrombin III; formation of thrombin
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What is the blood glucose level for hyperglycemia?
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> 126 mg/dL
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What happens when the pituitary doesn't make enough TSH?
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Secondary hypothyroidism
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What are 3 dental findings of hypothyroidism?
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Underdeveloped mandible, delayed tooth eruption, retained deciduous teeth
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What can be associated with multiple endocrine neoplasms (MEN I and MEN II1)?
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Hyperparathyroidism
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What are the characteristics of Conn's syndrome?
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Increased aldosterone, HTN, increased Na+, Increased water, decreased K+
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What is an oral sign of Addison's disease?
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Diffuse mucosal pigmentation
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What is hemorrhagic necrosis of the adrenal cortex that is usually associated with a meningococcal infection?
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Waterhouse-Friderichsen syndrome
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What are 2 characteristics of collagen vascular diseases?
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Inflammatory damage to CTs and BVs and deposition of fibrinoid material
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Which antibodies are specific for SLE?
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Anti-DNA and anti-Sm
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What are the manifestations of Scleroderma?
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CREST syndrome: Calcinosis, Raynaud's phenomenon, Esophageal dysfunction, Sclerodactyly, Telangiectasia
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What is the ONLY autoimmune disease and CT disease to occur more often in men?
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Polyarteritis nodosa
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What is the clinical triad with Reiter's syndrome?
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Can't see (eye inflammation), can't pee (urethritis), can't climb a tree (arthritis)
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What is the sicca complex?
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Dry eyes, dry mouth, lymphocytic exocrine gland inflitration; associated with Sjogren's.
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What is lymphocytic infiltration causing enlargement of the salivary and lacrimal glands that occurs in association with SLE, Sjogren's, and leukemia, and shows an increased risk of lymphoma?
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Mikulicz's syndrome
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What enzyme is a serum marker of increased osteoblastic activity and bone formation?
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Alkaline phosphatase
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What AA is an marker of increased osteoclastic hyperactivity?
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Hydroxyproline
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What enzyme is a serum marker for prostate cancer?
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Acid phosphatase
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Neurofibromatosis, McCune-Albright syndrome, Fanconi's anemia, and Tuberus sclerosis are all associated with what skin manifestation?
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Cafe-au-lait spots
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What is an AD disorder manifesting with short limbs and normal-sized head and trunk?
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Achondroplasia (dwarfism)
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What is a periapical bone reaction/inflammatory response from a low-grade pulpal infection?
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Condensing/sclerosing osteitis
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What is a possibly fatal condition caused by bone fractures where fat in the marrow is mechanically disrupted and enters the bloodstream?
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Fat embolism
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What kind of medications have been associated with osteonecrosis of the jaw?
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Bisphosphonates
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What is a type of rheumatoid arthritis that occurs in young people?
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Still's disease
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Do osteophytes (bone spurs) occur in osteoarthritis or rheumatoid arthritis?
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Osteoarthritis
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The classic triad of scanning speech, intention tremor, and nystagmus is indicative of what disease?
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Multiple sclerosis
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How is Eaton-Lambert syndrome different from Myasthenia Gravis?
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It is caused by a decreased release of Ach (not auto-antibodies against the Ach receptor like MG)
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What is the most important characteristic distinguishing malignant from benign?
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Metastasis
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What is indicative of immunologic response by the host to malignancy?
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Lymphocytic infiltration at the tumor edge
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What protein is involved in invasion and metastasis?
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Cathepsin D
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What is an embryonal type of rhabdomyosarcoma that protrudes into the lumen?
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Sarcoma botryoides
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How is breast cancer different from fibrocystic disease?
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Fibrocystic disease is a benign process, but might increase the risk of breast cancer
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What gene is associated with both breast and ovarian cancer?
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BRCA-1
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What is the leading cause of cancer death in both men and women?
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Lung cancer (breast and prostate are more common, but do not more commonly lead to death)
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Is basal cell carcinoma malignant or benign?
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Benign, because it almost never metastasizes, even though "carcinoma" denotes malignancy
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What is the most common malignancy in the US?
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Skin cancer: Basal cell carcinoma > SCC > malignant melanoma
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What is the leading cause of death from skin cancer?
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Malignant melanoma
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What is a pancoast tumor and what are its manifestations?
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Tumor in the apical segment of the upper lung; hoarseness, Horner syndrome (ptosis, miosis, anhidrosis)
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What is the most common malignancy associated with superior vena cava syndrome?
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Bronchogenic carcinoma
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What condition is associated with clubbing of the fingers and toes, enlargement of the extremities, and painful swollen joints?
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Hypertrophic pulmonary osteoarthropathy
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How does leukemia differ from other cancers?
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It starts in bone marrow and spreads to other major organs (as opposed to beginning in major organs and spreading to bone marrow)
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What is the most common type of leukemia in children? Adults?
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Acute lymphoblastic leukemia (ALL); acute myelogenous leukemia and chronic lymphocytic leukemia
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What are the lymphocytes called in ALL?
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"Null cells"
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What condition is characterized by a painless, progressive enlargement of lymphoid tissue caused by malignant cells called Reed-Sternberg cells?
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Hodgekin's lymphoma
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What differentiates Hodgekin's lymphoma from Non-Hodgekin's lymphoma?
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Presence of Reed-Sternberg cells
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What confirms the diagnosis of multiple myeloma?
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Bence-Jones protein in the urine
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What is a skin infection that manifests itself as sudden eruption polymorphous skin macules, papules, and occasionally vesicles with hemorrhage?
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Habermann's disease
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What 3 conditions may pheochromocytoma be associated with?
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Multiple endocrine neoplasias, neurofibromatosis (von Recklinghausen's), von Hippel-Landau disease (multiple hemangiomas)
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What is a catecholamine-secreting extra-adrenal chromaffin cell tumor?
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Paraganglioma
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