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158 Cards in this Set
- Front
- Back
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where is vitamin D finally activated at? specific
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in proximal tubule of kidney by 1 alpha hydroxylase
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MCC upper urinary tract hematuria?
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renal stone
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MCC of lower urinary tract hematuria?
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infection
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most common drug causing hematuria
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anticoagulants
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persistent proteinuria indicative of:
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intrinsic renal disease
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MCC of increased serum BUN?
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CHF
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creatinine from?
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creatine metabolism
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definition of azotemia?
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increased serum BUN and creatinine
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prerenal azotemia parameters?
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decreased cardiac output, decreased GFR, BUN:Cr>15
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Renal azotemia parameters?
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BUN:Cr </= 15
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postrenal azotemia from? parameters?
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obstruction behind kidneys
BUN:Cr>15 |
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Creatinine clearance changes with age?
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yes it usually decreases
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when do you expect creatinine clearance to increase (normal physiology)?
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pregnancy, early diabetic glomerulopathy
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whole kidney: lowest blood supply to?
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medulla
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first sign of nephrotic syndrome?
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podocyte fusion
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MC cystic disease in children
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Renal dysplasia
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Linear IF in kidney
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Goodpasture's - anti-GBM
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granular pattern IF in kidney
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immunocomplex type of glomerulonephritis
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MCC of glomerulonephritis?
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immunocomplexes
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define nephritic syndrome?
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proteinuria but <3.5 g/day, RBC casts, periorbital puffiness, HTN, oliguria, hematuria
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define nephrotic syndrome
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proteinuria >3.5g/day and fatty casts,
will have generalized pitting edema and ascites |
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MCC of diabetic glomerulopathy?
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poor glycemic control
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why is hyaline arteriosclerosis a problem in the kidney?
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it affects the efferent 1st adn increases GFR which produces hyperfiltration injury
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hereditary nephritis, sensorineural hearing loss, ocular defects: name it
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Alport's Syndrome
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MCC of chronic glomerulonephritis?
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RPGN
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MCC of ARF?
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ATN
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MC type of ATN?
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ischemic ATN
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MCC of ischemic ATN?
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prerenal azotemia
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ATN cast?
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renal tubular cell cast
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MCC of nephotoxic ATN?
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aminoglycosides
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MCC of TIN
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acute pyelonephritis
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MC mechanism for Upper and lower UTI in females
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ascending infection
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fever, flank pain, WBC casts
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Acute pyelonephritis
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two MCC of chronic pyelonephritis
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Vesicoureteral reflux in young girls
chronic hydronephrosis |
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abrupt onset fever, oliguria, rash
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acute drug induced tubulo-interstitial nephritis
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what is analgesic nephropathy?
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combo of acetaminophen an aspirin over long term leads to renal papillary necrosis
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prevent urate nephropathy in cancer?
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allopurinol before aggressive therapy
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what is bence jones proteinuria?
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casts w/ foreign body giant cell reaction
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waxy casts?
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chronic renal failure sign
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benign nephrosclerosis from?
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essential HTN due to hyaline arteriosclerosis
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define malignant HTN
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over 210/120
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complications of malignant HTN
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encephalopathy and renal failure
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hematuria and flank pain
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renal infarction
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MC complication of upper urinary tract obstruction?
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hydronephrosis
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MCC of upper urinary tract obstruction
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renal stone
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MC metabolic abnormality causing calcium stones?
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hypercalciuria
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thiazides (besides being diuretics) also have what effect on urine?
Hint: think of stones |
reabsorb calcium
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yellow tumor with renal vein invasion
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renal cell carcinoma
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child with unilateral flank mass and HTN
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Wilm's tumor
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where does carbohydrate digestion begin
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mouth
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where does protein digestion begin?
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stomach
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where does fat digestion begin
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small intesting
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kwashiorkor characteristic feature? from?
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inadequate protein intake.
pitting edema is characteristic |
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common feature of marasmus
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extreme muscle wasting
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what is main component of anorexia nervosa?
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distorted body image
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MCC of death in anorexia nervosa
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ventricular arrhythmia
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bulimic acid/base status?
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hypokalemic metabolic alkalosis
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BMI calculation?
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weight in kg/height in meters square
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gene often defective in obesity?
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leptin
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relation between HDL and VLDL?
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as VLDL goes up HDL goes down
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night blindness first sign of
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vitamin a deficiency
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MCC of Vit D deficiency
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renaql failure
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Vit E toxicity?
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decreased synthesis of vitamin K dependent coagulation factors
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MCC of vitamin K deficiency in hospital?
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broad spectrum antibiotics b/c they kill the bacteria who make it
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coumarin derivatives where?
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rat poison
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MCC of thiamine deficiency in US?
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chronic alcoholism
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corn based diets are deficient in?
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tryptophan and niacin
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pellagra D's?
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diarrhea, dementia, dermatitis
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MCC of Vit B12 deficiency?
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pernicious anemia
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MCC of folate deficiency?
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alcohol excess
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scurvy from?
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excess ascorbic acid
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poor wound healing, dysgeusia, perioral rash
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zinc deficiency
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multinodular goiter
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iodide deficient
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fluoride deficiency can cause
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dental caries
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origin of benign tumors?
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epithelial or connective tissue
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teratoma is derived from?
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ectoderm, endoderm, mesoderm
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carcinomas derived from?
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squamous, glandular, transitional epithelium
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sarcomas derived from?
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connective tissue
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hamartomas are:
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non-neoplastic overgrowth of tissue
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important question in grade of cancer?
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does it look like parent tissue or not? if it does then it is well differnetiated
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basal cell carcinomas of the skin metastatic potential?
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they invade tissue but DO NOT METASTASIZE
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what is the second most important criterion for malignancy?
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invasion
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extranodal metasasis or nodal metastasis is more significant?
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extranodal
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routes of metasases
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lymphatic, hematogenous, seeding of body cavities
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types of bone metasasis
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osteoblastic - radiodense
osteolytic - radiolucent |
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MCC of cancer death in adults
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lung cancer
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precursor of squamous cell carcinoma?
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actinic keratosis
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most imprtant factor in decreasing risk for cancer (if present)
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smoking cessation
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treating H pylori reduces risk of:
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developing gastric lymphoma and adenocarcinoma
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MC type of mutation in cancer
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point mutation
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proto-oncogenes for?
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normal growth and repair
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suppressor genes for?
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protecting against unregulated cell growth
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BCL2 gene family
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antiapoptotic genes
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BAC gene
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apoptosis gene
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repair genes do what?
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correct errors in nucleotide pairing and excise pyrimidine dimers
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what are the enzymes involved in dimer excision
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endonuclease, exonuclease, ligase
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MC cancer from ionizing radiation?
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leukemiaq
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MC cancer from UV light exposure
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basal cell carcinoma
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most effective host defense against cancer
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Cytotoxic CD8 T cells
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MC anemia in cancer?
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anemia of chronic disease
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MCC of death IN cancer
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G- sepsis
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MC paraneoplastic syndrome of cancer?
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hypercalcemia
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basic cause of cleft lip?
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failed fusion of facial processes
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pre-AIDS defining lesions
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thrush, hairy leukoplakia, apthous ulcers
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cause of dental caries
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streptococcus mutans
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melanin pigmentation in oral mucosa Dz?
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Addison's or Peutz Jeghers
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leukoplakia or erythroplakia first step?
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biopsy to rule out sqaumous dysplasia or cancer
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lower lip cancer
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squamous cell carcinoma
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upper lip cancer
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basal cell carcinoma
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MC site for salivary gland tumor
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parotid
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MC type of salivary gland tumor
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pleomorphic or mixed tumor: painless moveable mass at angle of jaw
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MC malignant salivary gland tumor
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mucoepidermoid carcinoma
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MC esophageal diverticulum
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Zenker's
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cause of GERD
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LES relaxation and acid reflux
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esophageal varices vessel?
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L gastric dilation which carries blood from distal esophagus and proximal stomach into portal vein
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mallory weiss
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mucosal tear of distal esophagus
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boerhaaves syndrome
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rupture of distal esophagus
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cause of achalasia?
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absent ganglion cells in myenteric plexus
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MC esophageal cancer
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distal adenocarcinoma
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MCC squamous cell carcinoma in the esophagus
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cigarettes
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MCC of hematemesis and melena
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PUD
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vomiting of non-bile stained fluid
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congenital pyloric stenosis
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MCC of hemorrhagic gastrititis
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NSAID
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difference between type A chronic atrophic gastritis and type B
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type A is in body and fundus from pernicious anemia
type B is in antrum and pylorys from H pylori |
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why is it important to treat H pylori
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to decrease risk of gastric cancer and lymphoma
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MC benign tumor in GI tract
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leiomyoma
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precursor lesion for gastric adenocarcinoma
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intestinal metaplasia
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krukenberg tumor
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metastatic signet ring cells to both ovaries
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colicky pain is a:
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symptom of bowel obstruction
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hematochezia causes?
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sigmoid diverticulosis, angiodysplasia
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difference between fluid in secretory and osmotic diarrheas?
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secretory is loss of isotonic fluid
osmotic is loss of hypotonic fluid |
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MCC of small bowel obstruction
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adhesions from previous surgery
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MCC of small bowel obstruction w/o prev Hx of surgery?
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indirect inguinal hernia
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MC hernia
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indirect inguinal hernia
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MCC of small bowel infarction
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occluded SMA
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MC dysarrhythmia associated w/ systemic embolization
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A fib
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diffuse abdominal pain + Bloody diarrhea =
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small bowel obstruction
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splenic flexure pain + bloody diarrhea?
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ischemic colitis
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angiodysplasia is what? presentation?
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dilation of cecal submucosal venules presenting with hematochezia
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MC complication of Meckel's diverticulum?
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bleeding
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MCC of hematochezia and fistulas?
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sigmoid diverticular disease
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left sided appendicitis?
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sigmoid diverticulitis
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differences in involvement of UC and Crohn's
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UC: mucosa/submucosal
Crohn's: transmural |
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what is IBS
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an intrinsic colonic motility disorder
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MC site for carcinoid tumor?
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vermiform appendix but usually too small for metastasis
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MC site of carcinoid tumor in GI tract that metastasizes to the liver and causes carcinoid syndrome?
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terminal ileum
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MC symptom of carcinoid syndrome?
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flushing
followed by diarrhea |
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MC site for GI polyps
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sigmoid colon
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MC polyp in adults
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hyperplastic polyps
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MC polyp in kids
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juvenile polyp
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predominance of small intestine polyps?
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peutz jeghers
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MC neoplastic polyp
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tubular adenoma
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presents greatest risk for developing colon CA
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villous adenoma
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associated electrolyte abnormalities w/ villous adenoma
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hypoproteinemia, hypokalemia
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MC site for colon cancer
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rectosigmoid
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difference in presentation for cancer on L side vs. R side?
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L side obstructs
R side bleeds |
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pathogenesis of diverticulitis and apendicitis?
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obstruction (fecalith) --> increased pressure injures mucosa--> inflammation --> E coli invades
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MCC of anorectal bleeding
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internal hemorrhoids
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