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r90
(1ow
score Low Gleason score
What is the Gleason "grade") and irigh stage'
rlto''r:, rreopllttic
l)rostrrtc biop:r ,
irncl stage of the Prostate
rtirted
,.,r,,iti"tttl"t r of rt cll-tlitfercr cancer?
'*irtta, rritlr cviderrce of ttttttor and
rrodet' C arcliac rhabclon-rYornas
li".r..r to rcgiorrrtl lr rrrplr zrre
What tYPe of cancers astrocYtomas
(in tttberous
nental with
Bou Pr.'"'-'ts-rvith
angiofibron:rs'
;;;;"il" associateci
sc lerosis)'
i.inr.1"tiot t, faci:ri 1'ris disease? fusion Protein
ltt ttl tt'izttrcs mo.st abl (toform the
Whait oncogene bcr-abl)'
Paiier-it u'itl-r markecl
ieukocytosts
ii;i; ;;;e translocated
^"q
t'":i"' "
cells irr tire PertPnet
:it*i ,1:'lTl, t;;ii" .rYeloid stem ceils?
71,
;;;il ; i'^i" iv"'P1-'"de'oPatu'v
Osteosarcona (Rb
tttmor
1; ancl sPletroilegalY' Her tiririglrtcr has
trrr T
nrutation)'
ge'e
;.,;;;"tt"t
. M"'r.",,,1:l::::ii:i],".",..,x.i:[',:' ;tJ;i"'i.'" other tvPe of
i; \
',:.
has a white PtlPll' cancer?
."tti"t"a to be inheritecl
are inost Types 16 and 18'
i:, retir-robiastonrit' What HPV $Pes
shor'vs with
;r Wonrau's PaP st-uear often associaiecl
rgcs'
'J tlr :lllrtsl ic cltrtr cervical carcinoma? fiom
of T nucleic acicl turnover
l What is ihe side effect dui,-tg."t"r cells leacls to
of joirrt patt-t
Mirtr cotnplains his cancer treatment? ti."tnia ( tunror lysis
for AML' i'y1r.?,,
i"if"*t"* tftemotherapv syndrome)'
is tl-re Br-microglobulin'
Fron-r what Protein
clrrotric
Llclerli \\ tllllall orr a anrYloid deiived?
it"lt"at^fttts treartnrent has
sPaces thart
i,;;;;';ii'"r ioi.i
tft*'t an-rvloid ciePosits'
t-
rrl:trilti
.
::frlt
Dopar-utne.
What neurotransmitter
ZS-year-old cher-nist Presents
is depleted?
witlr MPI'P crPosttre' of
Rasir on stln-exPoseci regions
What are ihe clinical
Woruan taking tetracYcline tl're boclY.
nanifestations?
exl'ribits PhotosensitivrtY' Gluc ose-6-PhosPI'rate
who Wl'rai is the er-izYne
Afric:rn-Ar-nerican rnan clel'rychogenase'
a cleficie ncY?
goes to Africa develo-Ps
i-ret-nolytic anemia after
taking
malaria ProPhl'laris' lnsecticicle poisoning; inl-ribition
What caused this, and
Farrner presents witl'r dyspnea' of ac etYlcl-rol iuestet ase'
what is the mechanism
salivation, miosis, diarthea'
bltrrrl visiorl' of action?
cr.atrrpirrg. arrd Bethanechol'
What clo You treat tt
27--vear-o1c1 wolllan u'ith a hisiory ..1 .
has \\'ltnr
of psycl'riatric iilness norv
ra,,:,,1i
neuroiePtic' Ketoconazole'
patient What ar-rtifr'ngai drug
Recent kich'rey transplar-rt
.,:lii
,,,
for would result in
it wl-ro is on cYclosPorine
.,::.:
retltLi rcs at t cyclosPorine toxicitY?
t ttt tttt tosrlpllr.cssion
it
,tl;.,
220
ComPression of the
IVC'
What is the diagnosis?
in 3rd trimester
c- ';";*al woman
Pregnant
blood Pressure when
;;;;t* and sitting' Wherr suPine'
go/t()'
;il p?","t'" droPs to
What is ihe diagnosis? Coarctation of the aorta'
high- blood
35-year-old man has
and low
or"rr.rt" in his arms
pr"rr.rt" in his legs' cliagnosis? ASD'
What is the
, !-y""r-old boY Presents with a
wide'
,nr,oli" murmur and
fixed sPlit S2' likely Hlpertrophic cardiomyopathy'
What is the most
-* During a game' a Young and !,pe of cardiac disease?
;;il*fi pi"v"' collaPses
dies immediatelY' infarct? Fat emboli'
What caused the
,, Patient has a stroke after
it.trrl,'tgmultiPle long bone
stemmtng
fiactures in trauma
it;;" motor vehicle accident' What is the diagnosis? Temporal arteritis'
with a
*' ElderlY woman Presents
Labs
f't"ra""f't" and jaw Pain'
show elevated trSR' likely Aortic stenosis'
with a What is the most
*- 80-Year-old man Presents cause?
;;a* crescendo-decrescendo
murmur' Niacin.
for What drug is it?
* Man starts a medication
#s
q* hvPerlipidernia' He therr
and
*# a'.i"f"Pt a rash' Pruritus'
w
GI uPset. Losartan, an angiotensin
IIa.
rl*
and What is a good does not I
;B
Patient develoPs a cough and recePtor antagonist'
#wk reDlacement drug, as caPtoPril does'
must discontinue caPtoPril' why doesn't it have the bradykinin
ffi
effi
&re same side effects?
Quinidine'
ringing Wl'rat drug is it?
c Patient Presents with
i" tf'," ears' dizziness' headaches'
and GI distress' cXR finding?
what is the
* Patient with a historY
of }n,::T,';;t
with
hyPertension Prese.nts
sudden sharP, tearing Patn
radiating to the back' cause? Mitral
What is the likelY
n, On auscultation' a PansYstolic . insufficiencY'
at the aPex with
radiation
*.tr-.,'
to the axilla is noted'
242
What are tl're exPected Low TSH ancl high tl'rYroid
Won-ran presents with diffuse
goiter and hvPerthYroidisrl.' valttes of '|SH and hormones.
thyroid hormones?
Wlral is thc diegnosir? Hypotl-ryroidisn'r.
48-year-old woillall presents with
progressive lethargv ar-rcl extreme
sensitivity to colcl temperatr-tres'
Wi'rat is the cliagnosis? Pituitary tumor.
Patier-rt rvitl'r elevaied serum
cortisol ievels undergoes a
derarnethasone sLlPPresslon
test. I nlg of clexan'retilasone
cloes rot J cortisol levels, but
8 n-rg does.
of Whi,rt is the diagnosisz Carcinoid synclrorre
5O-y,ear-old rrran comPlains
diarrhea. On PhYsical exaln'
his face is pletl'roric and a heart
ntlmtllr is detected.
What endocrine Albright's editart'
1'rer
Wonan of sl'rort stature Presents
disorder comes to rnilrcl? osteoclystrophy, or
rvith sl-rortenecl4th and 5t1'r
p s e u cl ohyp oP a rathYroi di s rr-r'
metacarpals.
What is the dizrgnosis? Surreptitious insulin rnjection'
Nondi:rbetic Patient Presents
rvitl'r hypoglvcemia but low
levels of C-PePtide'
What is the most likelY Nornarl. Residuai pituitary tissue
, Patient's MRI sl-rows filling of
clinical prescntation? is functiotal and can comPcnsate
sella turcica with cerebrospinal
(ernpty sella syndrome).
fluid.
What is tl-re l-rost likelY Prolactinoma.
Patient cornPiaius of clouble
vision, gynecolrastia, and cliagnosis?
headacl-res.
o
What is the most likelY I acirenocorticai defi ciencY
Patient presents witi'r
cliagnosis? (Acldison's disease)'
hvpotension and bronzed skin'
274
7
,r,
Wlraf kirrd of lrtttrla is Blincl esophagus rvith lower
Baby vonits milk wl-ren fed ancl segluent of esophagus attachecl
present?
l-ras zr gasiiic an bubble'
to the trachea
,',,,tt,,,,,',., 'lt.:].:ll.l:t.:ll'll,1,.'::ll.ii:.tll:i::.l.
't,t.',,:,'l.
3"
t:,
tingling over the lateLal cligits
:i
of l-rcr right liartcl. Ou ex:rrt, she
a has wersting of ttre t}'relrar
erninence.
Whart spinal nerve T'ibial (L4-S3)
2O-vear-old clancer rePorts J
plantar flexion and J sensatiotr is inrtolr'ecl?
over the back of her tl-righ, calf,
ar-rd lateral half of hcr foot'
Which nerve ancl lr4rett Uh-rar ncrvc clue to broken medial
Teen falls r'r'hile rollerblading
jr-rrv? conch'le .
and hurts his clborv' He can't ir-r
342
Patient presents rvith J Pain Whzit is the lesion? Syringornyelia.
and telrpcrature se nsation ovet
tl-re iateral aspects of both amrs.
Penlight in patient's right eYe What is the defect? Atrophy of the left optic trerve.
produces bilateral pupillary
constriction. Wl-ren lttoved to
the lcft ele, there is paracloxical
clilatatior-r.
Womau involvecl iu ar motot Wl'rat structure is Right CN XI (rr-rrts througli tl're
jugular foramen with CN IX
vehiclc accident cannot turtl clarlraged?
her head to the left ancl has ancl X), innervating thc
,,, rigl-rt shoulcler clroop. sternocleidomastoid and
': trapezius muscles.
i
,a:,::::.:.
:,,:,,r:
rlr:"1 Man presents witir I wilcl, Whcre is the lesionT Contralatcral subtl-ralanic ttttclerts
:l
(he nriballisrnus).
a .i.,.r':
flailing am.
, ,l:..r,
Right parictal lobe.
Patient r.l,ith cortical lesion cloes Where is tire lesion?
i ,,,.,.
Z3-year-old worlan crashes her Which bone ancl vessel Viddle rucrrirrgeal artetl lrttl
' ierrrporll botte. resullittg itt al
motorcyclc. She initially feels rvere injured during the
I-
fine, but ininlites later she loses craslt r cpidr-rral hematoma.
consciousness. At the ER, a CT
shows an intracranial hernorrhage
that does not cross sttture lir-res.
' 38-)'ear-old tnan with a history of What is thc car-ise of the S ubarachnr-rid Lrernorrhage
Marfan's slrndrone and man's head pain? resulting fiorn a rupturecl berry
hvpertension prcsents rvith a aneLlr\"snr.
seve re I'readache. A spinal tap
reveals blood in tlie CSF.
,,, 78-,vcar-olcl marr rvith Wl-rat structlrres were Britlgirrg reirrs. rcsttltirrg in
iii:l:il
Won:l't on MAO inhibitor What did she ingest? Tyramine (wine or cheese).
has hypertensive crisis after
ar meal.
3-,vear-oid cl-rild prescnts with What is tl're rnost likcly Child abr-rse. Report it!
retinal cietacl-rrnent. cliagnosis, ancl 'nl,hat rnttst
you do?
Horneless n-ian atdnrittecl for Wl-rat is the rr-rost likely Dcliriurn tremens 2' to alcohol
pneumonia complaitts of bugs cliagnosis? ll,ithchau,ai.
crawling or-r his skir-r
(fon-nication).
Vietnam veteran becomes What is the most likely PTSD.
paralyzed upon hearing diagnosis?
airplane engines.
Urtcottsciotts Iec'r rltger is What is the rnost likelr, Opioid overdose.
rushecl to thc ER. Ile has diagnosis?
pinpoint pttpils zrnd is
seizing.
tt.:::]::t:t:::t::: iir.r:i:t;lr.l:rt :: {!liil!:ql
3-year-olcl boy presents with facial What is tl-re appropriate Steroids for minirrrrl change
ed.'rrta. m:tlitise. arrrl proteiltttria. treatmcnt? cliseasc.
'**;i
w
w
"eg
*&
ffi
w
,tM
Patient exhibits an exteuclecl What is the clisease Obstmctive lung clisc:rse.
Tall, thin nale teenager has What is ihe cliagnosis? Spontaneotts puertmothoratr.
al>rupt-onset cl1'spnea ancl lcft-
sidetl c lresl lxtirt. fl rerc is
1ri perresor rlt rt ltcrt tt:siot r ot I
Young man is concernecl about \Vlr icl r of l rt'r' 1>rr,tcir rt Durcin (K:ltagener's)
.ll
his u'ife's inabilitv to concett'c 1S delecil\'er
and her recttrrent URIs. Sire
has dertrocar-dia.
'f1-re
follou'ing lung volrttttes ate What is his'l LC? 7.0 L
obtainccl from an elclerh'smokcr:
F'RC L,IRV 1.i I,, IC 2.0 L,
VC35L.
'.0
Preterm infant has clifficultv What is the diagnosis, Neonatal respirator-v clistress
25-vear-old couatose lttitlt otl What is the likelv Aspiration of infcctive material
ventilatory support foll orving ctioiogy'? leachng to lung abscess.
an autorrobile acciclent deveiops
fever and clies. Ar-rtopsl' reveals
a pus-filled cavih'in his right
lung.
5 2-1's2.-r14 \r'orr-ran ttr-rclergoing What is tirc irost likeh' Anenria clttc to chronic blood loss
rxerlopause is chronicallv tir ecl. cliagnosis, auci w'hat J or-ug.tt content; oxvgett
changes trave occutr-ecl irt sattrrirtion rtnchatrtgcd
her oxvgcn cotrte nt :rrtd
setttt r:rtioir ?
Patient is sho.,r'n to irave hvpori:t Wl-r:rt is the cause of the Prtl tttrtt rlrv ert rltoli:rrr.
clespite a normal chcst r-r:rv. hvporia, and lvhat cliscase N,Iai be nristerken for an N,tll.