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USMLE World Notes

This document contains notes on various medical topics organized by bullet points. Some of the main points discussed include: - Types of renal deposits seen in different glomerular diseases. - Side effects of various antibiotics and medications like isoniazid, ethambutol, and methadone. - Characteristics of different types of cancers like seminoma, medulloblastoma, and CLL. - Properties of different neurotransmitters and how various drug classes like cholinomimetics work. - Features of diseases such as sarcoidosis, myotonic dystrophy, hemolytic uremic syndrome, and Turner syndrome.

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Alex Young
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100% found this document useful (4 votes)
2K views55 pages

USMLE World Notes

This document contains notes on various medical topics organized by bullet points. Some of the main points discussed include: - Types of renal deposits seen in different glomerular diseases. - Side effects of various antibiotics and medications like isoniazid, ethambutol, and methadone. - Characteristics of different types of cancers like seminoma, medulloblastoma, and CLL. - Properties of different neurotransmitters and how various drug classes like cholinomimetics work. - Features of diseases such as sarcoidosis, myotonic dystrophy, hemolytic uremic syndrome, and Turner syndrome.

Uploaded by

Alex Young
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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USMLE World Notes - Important Points

**Credits to Duncan Subendothelial Deposits are seen in SLE patients Subepithelial Humps are seen in !lomeruloneprhitis cute Poststreptococcal

Linear Subendothelial are seen in !oodpasture"s #$%pe II& Mesan'ial Deposits are seen in I' Nephropath%

Spi(e and Dome are seen in Membranous Subendothelial Humps are seen in Membranoproli)erati*e +ithrom%cin , administered to HI- . patients can pre*ent M%cobacterium *ium Ethambutol , inhibits arabinos%l trans)erase /hich pol%meri+es arabinose into arabinan etc0 Side E))ects 1 2ptic Neuritis 3i)ampin , inhibits bacterial DN dependent 3N thus pre*ents transcription o) DN into m3N 0 Isonia+id , inhibits m%colic acid s%nthesis0 44 5 !4363P4 !43 5 Creatinine Clearance6Inulin 3P4 5 P H 4ibroadenoma , cellular m%7oid stroma8 sometimes there are compressed c%stic spaces0 Spon'iosis - epidermal accumulation o) edematous )luid in the intercellular spaces0 Dipheno7%late , opiate anti-diarrheal structurall% related to Meperidine0 2ctreotide , 'ood )or secretor% diarrhea8 /hich is a Somatostatin nalo' Urease , con*erts urea to carbon dio7ide and ammonia and thus increases pH 3adiation $herap% - causes 9& DN )ormation o) )ree radical double strand brea(a'e :& pol%merase and

Methadone , has a lon' hal) li)e In 4etal Lun's - a)ter ;< /ee(s there is an increase in Lecithin )ter ;= /ee(s there is a rise in Phosphat%d%l'l%cerol Males /ith > ? reductase de)icienc% - )emini+ed e7ternal 'enitalia8 small phallus and H%pospadias are common0 3epair Dama'e , !l%cos%lase 1 Endonuclease 1 L%ase 1 DN Pol%merase 1 Li'ase H0 P%lori , most common cause o) duodenal ulcers CM- in immunocompromised , Mononucleosis 3etinitis in CM- , HI-. Patients Primar% CNS L%mphoma , most commonl% associated /ith IDS

S@uamous Cell Lun' Cancer , produces Parath%roid Hormone 3elated Peptide8 /hich in turn /ill decrease P$H Camp%lobacter , can be transmitted )rom domestic animals Shi'ella - is transmitted *ia )ecal oral in da% care centers Aeratin - mar(er o) epithelial cell ori'in0 Secretin - produced b% S endocrine cells in the duodenum8 that increases bicarbonate secretion )rom e7ocrine pancreas into the small bo/el0 lpra+olam , ben+odia+epine /ith the shortest hal) li)e8 /hich is used in cute n7iet%0 Dia+epam8 Chlordia+epo7ide and Clona+epam , lon'est hal) li)e8 used in proph%la7is0 Sheets o) Primiti*e Cells /ith Man% Mitotic 4i'ures , Medulloblastoma Most Common $umors in ChildrenB Piloc%tic stroc%toma - 3osenthal 4ibers Medulloblastoma - sheets o) small blue cells8 man% mitotic )i'ures Epend%oma , can cause H%drocephalus and )orm 3osettes 2rthostatic H%potension , side e))ects o) ? adrener'ic bloc(ers0 ML - has associations /ith t#9>89C&8 t#D8:9& and stained /ith M%elopero7idase0 uer 3ods are

CLL , deletion on Chromosome 9; Mantle Cell E L%mphoma , t#9989F& Dobutamine , causes increase in cardiac contractilit% and increase in Heart 3ate $umors o) Sch/ann Cells , are deri*ed )rom neural Crest Cells0 Patients /ith C!D , susceptible to 9& Staph Pseudomonas ;& Serratia Nocardia >& sper'illus ureus :&

3osenthal 4ibers , /ith 'ranular eosinophilic bodies are seen in Piloc%tic stroc%toma0 $he% are /ell di))erentiated comprised o) spindle cells /ith hair li(e 'lial proGections tropine , re*erses muscarinic e))ects but does not pre*ent the de*elopment o) nicotinic e))ects such as muscle paral%sis Pralido7ime , re*erses both muscarinic and nicotinic e))ects o) or'anophosphates b% Hrestorin'I cholinesterase0 Calcium , binds to $roponin C and then unco*ers tropom%osin sites8 thus allo/in' actin to bind to m%osin0 S ; Heart Sound , can be heard i) the patient lies do/n in Le)t Lateral Decubitus Position or E7hales Completel% 3E4 5 3enal Plasma 4lo/6 #9-Hematocrit& In Metabolic l(alosis , measure patient"s Urinar% Chloride

!erminoma - tumors o) Pineal !land8 )ormed in children and adolescents0 Will present /ith 9& Precocious Pubert% due to J-HC! Production #similar in testicular seminoma& :& 2bstructi*e H%drocephalus ;& Parinaud S%ndrome , paral%sis o) up/ard 'a+e0 Ultra*iolet Speci)ic Endonuclease , initiates repair b% nic(in' the strand at $h%mine Dimer0 $his en+%me is missin' in Keroderma Pi'mentosum SE3 , )unctions in s%nthesis o) Lipids8 Carboh%drate Metabolism and Deto7i)ication o) Harm)ul Substances Uretero Pel*ic Lunction , most common site o) obstruction Increased Intraocular Pressure , most common side e))ect o) treatment o) Erad%cardia /ith tropine0

Mutation in !l%coprotein , /ill cause chan'es in the host and the% mediate attachment to tar'et host cell0 c MP path/a% - ?:8 J9 and J: Inositol Path/a% , ?9 adrener'ic8 muscarinic8 choliner'ic Ion Channel , Nicotinic8 Choliner'ic0 mpicillin , must be added to treat in)ants /ith Menin'itis0 Ce)tria7one co*ers all or'anisms8 but Listeria Monoc%to'enis is (illed b% mpicillin0 E 9M 4i)th"s Disease , causes aplastic crises #bone marro/& Eaton Lambers S%ndrome - associated /ith Lun' Cancer8 similar to M%asthenia !ra*is0 ntibodies are a'ainst pre-s%naptic Calcium Channels0 M%otonic D%stroph% , triplicate repeat8 mo*ement )rontal baldness8 cataracts are seen0 Cannot Loosen Hand !rip0 Cholinomimetics , indicated in Urinar% 3etention Paral%tic Ileus and !laucoma HUS , a)ter E0 Coli , Microan'iopathic Hemol%tic nemia

Se'mental -iruses #3ota*irus and 2rthom%7o*irus& - capable o) !enetic Shi)t0 Pa'et"s Disease - increase in 2steoclasts8 then increase in 2steoblasts8 /hich /ill increase l(aline Phosphatase0 r'inase - en+%me in Urea C%cle produces Urea and 2rnithine )rom r'inine0 Minute -entilation - product o) $idal -olume and 33 and includes Dead Space0 Neuroph%sis , carriers )or 27%tocin and DH in Posterior Pituitar%0

Epinephrine , increases S%stolic EP #?9 E))ect& Increase Heart 3ate #J9 E))ect& Decreases Diastolic #J: E))ect& Pretreatment /ith Propranolol 1 eliminates J E))ects and Lea*es ? E))ects 2nl%0 Protein C De))icienc% in War)arin $herap% , /ill e7a''erate the response and cause H%percoa'ulable State /ith S(in Necrosis

Neonates /ith H%poth%roidism - /ea(8 pale8 dr%0 Macro'lossia and Umbilical Hernia c%clo*ir - incorporates into ne/l% replicated -iral DN Hemorrha'ic C%stitis in Children , Males& Uric deno*irus #especiall% in

cid precipitates - collectin' ducts due to Lo/ Urine pH0

Insulin - dru' o) choice )or !estational Diabetes0 ML - )ormation o) PML63 3 ? )usion 'ene8 unable to si'nal )or proper di))erentiaton uer 3ods , stained /ith m%elopero7idase Donepe+il , $7 )or l+heimer"s Disease8 is a Cholinesterase Inhibitor and also %ou /ould add -itamin E0 NMD 3eceptor in CNS o*erstimulation b% !lutamate , thou'ht to increase D S%mptoms0 $7 /ith Memantine #anta'onist& Earbiturates , increase duration o) Chloride Channel 2penin' Een+odia+epines , increase )re@uenc% o) Chloride Channels0 Serum 4ibrino'en , must be monitored in DIC0 Narcoleps% , de)icienc% or Lo/ Le*els o) Neurotransmitter 2re7in # H%pocretin& Ha/thorne E))ect - tendenc% o) a stud% population to a))ect an outcome due to /hat is studied0 Mullerian Inhibitor% 4actor , secreted b% Sertoli Cells Primar% in)ection /ith HS- , more spread out8 but 3eacti*ation is more Locali+ed to 9 side0 S-9<< Positi*e , Sch/annoma and Melanoma0 Eoth are )rom Neural Crest Cells0 $- L%mphoc%tes , Paracortical None E-L%mphoc%tes - !erminal Centers o) L%mph Node $urner S%ndrome - hea*il% meth%lated DN due to Lo/ $ranscription cti*it% #Heterochromatin is not transcriptionall% acti*e8 it"s too condensed&

deno*irus , lo/ 'rade )e*er8 throat pain8 phar%n'oconGuncti*itis8 can be transmitted in Summer Camps0 4ra'ile K - 'ene meth%lation8 and this is inacti*e8 because it"s condensed0 Eurr Cells8 Helmet Cells - Mechanical 3ed Cell Destruction0 Pt"s /ith Prosthetic -al*es0 When -accinated - -irus Entr% into cells is impaired0 Sotalol , J Eloc(er /ith Class III #Potassium Channel Eloc(er& Properties /ill cause Erad%cardia and O$ Prolon'ation0 Pre E- LL 1$d$ . CD 9< and CD 9M Pre $- LL 1 CD:8 CD;8 CDF8 CD>8 CDC8 CDD8 CD9a8 $d$ Leu(oc%te l(aline Phosphatase , decreased in CML8 increased or normal in Leu(emoid 3eaction /hich is ><8<<< WEC0 Homoc%stinuria #similar to Mar)an"s& , de)icienc% o) C%stathione S%nthase0 $7 /ith P%rido7ine Supplements #E=& 3in' Enhanced Lesions , $o7oplasmosis8 Sei+ures Dih%drobiopterin 3eductase , Co)actor )or Eoth Phen%lalanine H%dro7%lase and $%rosine H%dro7%lase0 2steoblasts con*ert to 2steoc%tes , osteoc%tes are connected b% !ap Lunctions0 Lecithinase , alpha to7in8 produced b% C0 Per)rin'es and has an abilit% to de'rade Lecithin8 main component o) Phospholipid Membrane $erminal Eronchioles , lined b% ciliated simple cuboidal epithelium0 Nipple 3etraction , in Ereast Cancer is usuall% due to in)iltration o) Cooper"s Li'ament b% Cancer0 Prepatellar Eursa , commonl% seen in roo)ers8 carpenters8 people /ho are (neelin' all the time0 cute M%elo'enous Leu(emia , is associated /ith t#9>89C&8 /here 'ene )or 3etinoic cid is trans)erred )rom Ch0 9C to Ch0 9> Sarcoidosis , presents /ith increased number o) CDF . $ cells0 Calcitonin , released )rom Para)ollicular cells o) $h%roid8 in response to increasin' le*els o) calcium0 It promotes calcium

absorption b% the bone and reducin' calcium absorption b% the intestines and thus decreasin' the le*els o) circulatin' calcium NS IDS - are the primar% cause o) papillar% necrosis and chronic interstitial nephritis Increased le*els o) Calcium8 Phosphate and 27alate , promote salt )ormation and thus stones Increased le*els o) Citrate and Hi'h 4luid Inta(e , pre*ent salt )ormation Cell Mediated Immune 3esponse , stimulates production o) Inter)eron !amma8 $umor Necrosis 4actor Eeta and IL 9: /hich in turn induces c%toto7ic $ cell response and eliminated intracellular or'anism such as Listeria Listeria Monoc%to'enes , !ram Positi*e 3od /hich produces -er% Narro/ Eeta Hemol%sis None on Sheep Elood 'ar and e7hibits $umblin' Motilit% and the onl% !ram Positi*e 2r'anism that produces LPS endoto7in #/hich is normall% )ound in !ram -& Succin%lcholine , depolari+in' NML bloc(er and usuall% elicits a )ast response /ithin =< seconds and lasts )or 9< minutes0 Eethanechol , muscarinic a'onist that impro*es bladder motilit% in post operati*e patients 27%butinin , antimuscarinic a'onist that is used in patients /ith urinar% incontinence Motor Inner*ation o) the $on'ue , pro*ided b% H%po'lossal Ner*e #9:&8 e7cept )or palato'lossus /hich is inner*ated b% -a'us Ner*e #9<& Sensation o) the $on'ue , nterior :6; is Mandibular Eranch o) $ri'eminal Ner*e8 Posterior 96; is b% !lossophar%n'eal Ner*e #M&0 !ustator% Inner*ation o) the $on'ue , nterior :6; is Chorda $%mpani b% 4acial Ner*e8 Posterior 96; is b% !lossophar%n'eal Ner*e0 H%percalcemia in Sarcoidosis , is b% macropha'es acti*ated -itamin D8 /hich is e7trarenall% produced8 it /ill in turn suppress P$H0 9st Phar%n'eal Pouch , e7ternal auditor% meatus8 primar% t%mpanic ca*it% and auditor% tube :nd Phar%n'eal Pouch , Palatine $onsils ;rd Phar%n'eal Pouch , $h%mus8 In)erior Parath%roid !land

Fth Phar%n'eal Pouch , Superior Parath%roid !land0 Phen%toin , causes increased e7pression o) Platelet Deri*ed !ro/th 4actor #PD!4&8 the% stimulate 'ro/th o) 'in'i*al cells0 Propranolol , used in $h%roto7icosis and /ill decrease the heart rate and Decreases Peripheral Con*ersion o) $F to $; MEN 9 , Parath%roid $umor #H%percalcemia&8 Pancreatic $umor #!astrin&8 Pituitar% denoma #Prolactin8 C$H& MEN :a , Medullar% Carcinoma o) the $h%roid #Calcitonin&8 Pheochromoc%toma and Parath%roid $umor MEN :b , Medullar% Carcinoma o) $h%roid8 Pheochromoc%toma8 Mar)anoid 4eatures6Mucosal Neuromas M%ocardial In)arction , is the most common cause o) Death in Diabetic Patients0 Carbama+epine , bloc(s -olta'e !ated Na Channels in Cortical Neurons8 and is used in $ri'eminal Neural'ia0 Causes Eone Marro/ Suppression and increase in DH /ill cause SI DH0 Ethosu7imide , bloc(s $-t%pe Calcium Channels and decreases Calcium current in $halamic Neurons8 used )or bsence Sei+ures0 $%pe : Diabetes , m%loid Deposition in the Pancreatic Eeta Cells0

$%pe 9 Diabetes , beta cells are destro%ed b% $ L%mphoc%tes8 loo( )or In)ection -on Hippel Lindau - autosomal dominant disorder characteri+ed b% cerebellar heman'ioblastomas8 clear cell carcinomas and pheochromoc%tomas0 ll patients ha*e a deletion o) -HL 'ene on Chromosome ;b0 c%clo*ir , can cause cr%stalline nephropath% i) h%dration is not pro*ided0 In C2 poisonin' , P2: is normal8 P Saturation o) 27%'en is decreased8 because C2 competes /ith 2 )or Heme Sites8 27%'en Content is decreased0 In nemia - P2: is normal8 P Saturation o) 27%'en is Normal8 27%'en Content is decreased In Pol%c%themia , P2: is normal8 P Saturation o) 27%'en is Normal8 27%'en content in the blood is Increased0 4oscarnet , is a p%rophosphate analo' and can chelate Calcium8 it /ill also cause Ma'nesium e7cretion and thus the side e))ects are

H%pocalcemia and H%poma'nesemia and thus there /ill be Sei+ures in patients ta(in' 4oscarnet0 In 3estricti*e Lun' Diseases , hi'h e7pirator% )lo/ rates occur despite Lo/ Lun' -olumes8 and that is due to Increased Elastic 3ecoil Pressure and Increased 3adial $raction on the air/a%s0 Henoch Schonlein Purpura , leu(oc%toclastic *asculitis due to deposition o) I' immune comple7es and presents /ith lo/ e7tremit% purpura8 abdominal pain8 arthral'ia and renal in*ol*ement0 L%mpho'ranuloma -enerium , is caused b% Chlam%dia $rachomatis8 and /ill present /ith pain)ul *esicular lesions0 cute Salic%late 2*erdose , at )irst there is a 3espirator% l(alosis8 because salic%lates stimulate medullar respirator% center and cause h%per*entilation0 Metabolic cidosis occurs due to accumulation o) acids8 and thus it"s a mi7ture o) 3espirator% l(alosis #lo/ PC2:& and Metabolic cidosis #lo/ plasma HC2;& Pre*ention o) 3ein)ection /ith In)luen+a , anti-hema''lutinin I'! antibodies in the blood and anti-I' antibodies in the mucus and nasophar%n70 Estro'en , /ill increase $E! le*els8 b% reducin' its destruction and thus /ill increase $F le*els0 So e7pect patients on Hormone $herap% to ha*e increased $F le*els0 canthosis Ni'ricans , Eeni'n 4orm is associated /ith Insulin Dependent Diabetes and Mali'nant 4orm is usuall% due to underl%in' !I denocarcinoma0 Nucleoside nalo's , c%clo*ir8 !anc%clo*ir8 -alac%clo*ir are nucleotide analo's that need to be con*erted into a Monophosphate 4orm b% Herpes -iral Ainases , $h%midine Ainases0 Cido)o*ir , is alread% a Nucleoside Monophosphate and thus doesn"t need to be con*erted to monophosphate and onl% needs to be con*erted into an acti*e $riphosphate 4orm0 Neuraminidase Inhibitors , pre*ent -irion 3elease )rom in)ected cells /ith Hemophilis In)luen+a0 mantadine , inhibits uncoatin' and disassembl% o) In)luen+a $o7in a)ter it has entered the cell0 3ibosomal 3N , is s%nthesi+ed in Nucleolus0 It"s the proteins that are s%nthesi+ed in 3E30

. $randelenbur' $est , chec(s )or dama'e to Superior !luteal Ner*e that inner*ates !luteus Medius and Minimus0 Ne/born born to Diabetic Mothers , /ill present /ith H%po'l%cemia and most o) the times the% present /ith Macrosomia8 $ransposition o) !reat -essels8 3enal 'enesis8 3ectal tresia0 H%po'%cemia is due to Eeta Cell H%perplasia8 and not because Insulin has crossed the Placenta8 because it doesn"t0 $hus /hen 'lucose crosses placenta into )etal blood8 the response o) the )etus /ill be Eeta Cell H%perplasia0 In C%anide poisonin' , m%l Nitrite is the antidote8 because Nitrites increase )ormation o) Methemo'lobin8 and Methemo'lobin has an increased a))init% )or C%anide0 Sodium $hiosul)ate also is used in C%anide Poisonin' /hich /ill )orm $h%oc%anite /hich is less to7ic0 3ecall Eias , /hen patients are selected /ho su))ered an ad*erse e))ect and the% are more li(el% to recall pre*ious ris( )actors0 Selection Eias , is /hen patients are selected b% pro*iders based on their se*erit% o) the disease0 4or E7ampleB se*erel% ill patients are more li(el% to enroll in cancer trials0 P0 eru'inosa , non-lactose )ermentin' #'ram ,& 3od and is the cause o) U$I in patients /ith Ind/ellin' Urinar% Catheters as /ell as patients on 3espirators0 InGections into 'luteal re'ion , must be tar'eted into Superior !luteal 3e'ion8 to a*oid inGur% to sciatic or 'luteal ner*es0 4oscarnet , is a p%rophosphate analo' and does not need to be con*erted intracellularl% to monophosphate )orm b% *iral $h%midine Ainase0 Its side e))ects include H%pocalcemia8 H%pma'nesemia and thus Sei+uresQQQQ Cushin'"s S%ndrome , is usuall% caused b% e7o'enous administration o) !lucocorticoids0 $hus the drenal Corte7 /ill appear shrun(en and trophied0 Sand Paper Li(e 3ash , ctinic Aeratosis8 that appears as crusted lesion on Sun E7posed reas in elderl%8 it ma% turn into Cutaneous Horns0 M%cobacteria , that 'ro/s as Serpentine Cords8 usuall% establishes -irulenceQQQ drenal Crisis , /ill present /ith shoc( s%ndromes in combination /ith H%ponatremia8 H%per(alemia and H%po'l%cemia8 and presence o) nuchal ri'idit%8 )e*er8 rash and *omitin' su''ests Neisseria Menin'itidis In)ection caused Waterhouse 4riedrichsen S%ndrome8 /here there is an drenal Hemorrha'e0

Primar% Mineralocorticoid E7cess , can be due to tumor o) Nona !lomerulosa8 /hich /ill cause H%po(alemia8 Eicarbonate 3etention and Sodium 3etention0 Which /ill in turn decrease 3enin0 Cushin' S%ndrome , primar% /or( up /ill include De7amethasone Suppression $est0 Where Cortisol Le*els /ould not be suppressed due to endo'enous Cushin' S%ndrome causin' Pituitar% denoma0 In norrhe7ia , le*els o) )at drop belo/ normal and this /ill in turn decrease pulsatile release o) !n3H0 cid 4ast Stain , stains m%colic acid and at )irst its placed into Carbol)uchsin and then /ill be treated /ith H%drochloric cid and lcohol Sn3NP #snurps& , are in*ol*ed in the process o) remo*in' 3N introns durin' S%nthesis and thus are necessar% )or s%nthesis o) Messen'er 3N Competent Patients , ha*e the ri'ht not to )ind out about their dia'nosis8 i) the% don"t /ant to0 Eeta Lactamase Inhibitors , Cla*ulinic cid8 Sulbactam and $a+obactam /ill inhibit destruction o) Eeta Lactam 3in' o) Penicillins0 bci7imab , inhibits bindin' o) !l%coprotein IIb6IIIa to 4ibrino'en0 !lan+mann $hrombasthenia , is a de)icienc% o) IIb6IIIa 'l%coprotein on platelet sur)aces0 Leu(otrienes , are s%nthesi+ed b% eosinophils8 basophils in asthmatics Histamine , bronchoconstrictor and is released b% mast cells0 Methacholine Challen'e , choliner'ic muscarinic a'onist used in testin' )or asthma -alproic cid , i) ta(en durin' pre'nanc%8 increases the ris( o) Neural $ube De)ects0 $est )or $emporal rteritis , )irst thin' to loo( at is Er%throc%te Sedimentation 3ate0 I) it"s ele*ated #R9<<& then the positi*e dia'nosis0 PrP , has an ? - helical structure and is usuall% )ound in Creut+)eld Lacob Disease8 /here there is a Spon'i)orm $rans)ormation o) !ra% Matter0 Spon'i)orm is because the abnormal protein accumulates in -acuoles and /ill )orm a Spon'e Li(e sur)ace0

Subacute Sclerosin' Encephalitis , complication o) Measles -irus in children and adolescents0 Usuall% )ound in t%pe o) Measles -irus that has an M-anti'en missin'0 Multiple Sclerosis , /ill present /ith *isual chan'es8 pain)ul e%e mo*ements and there /ill be Dem%elination o) 7ons8 but Ne*er a Loss o) Neurons8 7on Disruption or stroc%te De'eneration0 Herpes Encephalitis , usuall% a complication o) HS- 9 *irus in children and /ill in*ol*e $emporal Lobe Encephalitis0 Menin'itis caused b% E0coli , usuall% /ill in*ol*e a A-9 -iral Capsule that /ill be in)ectious0 E0coli /ill 'ro/ Pin( Colonies on Macon(e% 'ar0 $rans)used Elood , /ill contain citrate8 that is used to pre*ent clottin' o) the blood8 but in patients /ho are trans)used /ith lar'e amounts o) blood8 it /ill cause H%pocalcemia8 because it chelates Calcium0 4anconi nemia , patients /ill present /ith DN e7onuclease de)icienc%8 and /ill be similar mechanism to Keroderma Pi'mentosum0 War)arin $herap% , !amma Carbo7%late protein C and S #/hich are Natural nti Coa'ulants&8 and in patients /ith Protein C de)icienc%8 there /ill be an e7treme ris( o) $hrombosis0 Clopido'rel and $iclopidine , are DP anta'onists and /ill act b% bloc(in' interaction o) Li'ands /ith Platelet 3eceptors0 Patients on $iclopidine8 /ill ha*e Neutropenia and Mouth Ulcers as a side e))ectQQQQQ Cilosta+ol and D%p%ridamole , decrease Phosphodiasterase and thus increase c MP0 3 NA 3eceptor63 NA Li'and , are essential )or )ormation and di))erentiation o) 2steoclasts0 H%poestro'enic state #Lo/ Estro'en& /ill increase 3 NA and thus /ill cause an increase in 2steoclasts and thus in Increased Eone 3esorption0 -acuoles )ormed in CL Prion Disease , are accumulations o) lpha Helical Protein that became abnormal and these accumulations /ill )orm Spon'e)orm Encephalitis and /e /ill see PrP proteins in this disease0 C-peptide , can be used as a mar(er )or Endo'enous secretion o) Insulin b% J-pancreatic cells0 !l%buride /hich is a Sul)on%lUrea /ill increase the rate o) Insulin Secretion and Le*els o) C-peptide in $%pe II Diabetes0

Patients /ith MS a)ter Hot Sho/ers , /ill e7perience E7treme 4ati'ue a)ter ta(in' a Hot Sho/er8 because the Heat /ill Decrease the Speed o) 7onal $ransport0 M-CS4 and 3 NA receptors , are present on 2steoclasts0 Macropha'e ,Colon% Stimulatin' 4actor and 3 NA are present in 2steoclasts0 E0Coli causin' U$I , /ill e7press 4imbriae8 /hich are 4imbrial nti'ens8 /hich are used )or adhesion to Uroepithelial Cells0 Erunner"s !lands in Duodenum , /hich are uni@ue to Duodenum8 /ill secrete l(aline Mucous into the ducts0 Cilosta+ol and Dip%ridamole , /ill decrease the acti*it% o) Platelet Phosphodiesterase and thus /ill increase c MP0 lso the% /ill cause -asodilation o) rterioles0 Used in Peripheral rter% Disease , Intermittent ClaudicationQQQQQ n(%losin' Spond%litis , are associated /ith HL E-:C8 /hich are $SPE I HL class0 $%pe II HL Class are anti'ens that contain D38 DP and DO0 Ethosu7imide , bloc(s $-t%pe Calcium channels that tri''er and sustain rh%thmical burst dischar'es in thalamic neurons0 Phen%toin , bloc(s Na channels and thus decreases the )irin' o) neurons -alproic cid , bloc(s NMD receptors and a))ects A current0

Een+odia+epines , can cause da%time dro/siness and increase the ris( o) 4alls in Elderl%0 Mec(el"s Di*erticulum , remnant o) omphalomesenteric duct #*itellin' duct& and is a true di*erticulum8 that consists o) all the la%ers o) the intestinal /all #mucosa8 submucosa and muscularis& Po/er o) a stud% , 9-percenta'e /here it )ails0 So i) the data )ails :<P o) the time8 then 0D is a po/er o) stud%0 cute 3eGection - occurs /ithin /ee(s o) transplantation and primaril% mediated b% host $-l%mphoc%tes that act a'ainst donor MHC anti'ens0 $o pre*ent8 administer Calcineurin Inhibitor such as C%closporine0 Cricophar%n'eal Muscle D%s)unction , caused b% diminished rela7ation o) phar%n'eal muscles durin' s/allo/in'0 Usuall% occurs in elderl%8 /here the% present /ith cou'hin'8 cho(in' and recurrent aspiration0

Do7%rubicin , anthrac%cline chemotherapeutic a'ent /ill )orm )ree radicals in m%ocardium0 $he side e))ect is cardiac )ibrosis8 /hich /ill present /ith Dilated Cardiom%opath%0 Phospholipase C - )orms IP; and D ! )rom phospholipids0 nd IP; causes an increase in intracellular calcium8 /hich then acti*ates Protein Ainase C0 Lactase De)icient Patients - /ill present /ith a Normal Intestinal Mucosa0 Pol%c%stic 2*arian Disease Patients , /ill bene)it )rom therap% /ith Clomiphene8 /hich is an estro'en receptor anta'onist and /ill increase the release o) !n3H and stimulates o*ulation0 Eecause in PC2S the patients" o*aries /ill secrete estro'en /hich /ill )eedbac( inhibit !n3H8 and in treatment /ith Clomiphene8 these receptors /ill be suppressed and thus !n3H /ill secrete estro'ens and induce o*ulation0 Nimodipine , Calcium Channel Eloc(er8 used in sur'er% on Subarachnoid Hemorrha'e to pre*ent cerebral *asospasm0 sper'illosis , occurs in 2ld Lun' Ca*ities0 It /ill 'ro/ as a 4un'us Eall and /ill present in old ca*ities caused b% $E8 Sarcoidosis or Emph%sema0 Patients /ith sthma ma% ha*e a h%persensiti*it% reaction to sper'illus0 Erosions o) !astric Mucosa - are called erosions because the% do not penetrate Muscularis Mucosa8 /hen the% do8 then it"s called Ulcers0 Candida lbicans , /ill inoculate into serum at ;C de'rees )or ; hours /ill lead to )ormation o) H%phae )rom Seast0 Mitral -al*e Prolapse , the most common cardiac abnormalit% that predisposes to nati*e -al*e Eacterial Endocarditis0 MaGorit% o) 4ree Water , /ill be reabsorbed in the Pro7imal $ubule8 re'ardless o) the patient"s H%dration Status0 lpha 9 antitr%psin de)icienc% , should be suspected in all patients /ith premature onset #T>< %ears old& o) Chronic Eronchitis8 Emph%sema and D%spnea0 Histor% o) Neonatal Hepatitis /ith Cholestasis /ill hei'hten the suspicion o) 9 $ de)icienc%QQQ PC2: , is the most potent Cerebral -asodilator0 Patients /ith C2PD /ill usuall% ha*e lo/ P2: and Hi'h PC2: and thus /ill present /ith Increased Cerebral Circulation0 ortic 3e'ur'itation , /ill present /ith Widened Pulse Pressure and the patients /ill ha*e Head Eobbin'0

chondroplasia , the most common de)ect in these patients is the mutation o) 4ibroblast !ro/th 4actor 3eceptor #4!43-;& at the epiph%seal 'ro/th plate and the cells that are a))ected are Chondroc%tes0 $ri'eminal Neural'ia , is commonl% due to -: and -; ner*es o) CN- and /ill be treated b% Carbama+epine0 cute Necroti+in' Pancreatitis , MaGor 3is( 4actor )or dult 2nset 3espirator% Distress S%ndrome0 $hus patients /ill ha*e an ele*ated m%lase and Lipase0 betalipoproteinemia , is an inherited inabilit% to s%nthesi+e apolipoprotein E8 /hich is a component o) Ch%lomicrons0 $hus Lipids /ill accumulate in the Intestinal Epithelium8 because the% can"t be transported out0 3estin' Membrane Potential , is normall% about -C< m- and is due to Potassium E))lu7 and Sodium In)lu70 -alproate , is pre)erred in patients /ith Combined bsence Sei+ures and $onic Clonic8 not Ehtosu7imide /hich is onl% )or bsence Sei+ures0 C%stinuria , is due to de)ect in renal tubules8 /hich )ails to absorb amino acid C%steine0 $o test )or this8 /e do C%anide test /hich detects Sul)h%dr%l !roups and /ill detect presence o) C%stine0 Poststreptococcal !lomerulonephritis , /ill ha*e 'ranular deposits o) I'!8 I'M and C; in the mesan'ium and basement membrane0 Stapedius Muscle , inner*ated b% Stapedius Ner*e8 /hich is a branch o) CN-II0 Paral%sis o) Stapedius Muscle /ill cause H%peracusis0 Ipsilateral H%peracusis is usuall% seen in Eell"s Pals%8 /hich is a peripheral )acial ner*e pals%0 H%peracute 3eGection , that occurs immediatel% due to Pre)ormed ntibodies /ithin the recipient0 $his is a $%pe II H%persensiti*it% 3eaction0 Patients /ith Mitral Stenosis , mi'ht ha*e an 2penin' Snap8 /hich usuall% )ollo/s S: heart sound0 -SD , is usuall% heard at Le)t Midsternal Eorder and produces a Holos%stolic Murmur0 4i7ed Wide Splittin' , is present in patients /ith De)ect0 Which is a )i7ed /ide splittin' o) S:0 trial Septal

Phrenic Ner*e , /hich inner*ates diaphra'm8 arises )rom C;-C>0

Clubbed 4in'ers , patients /ill usuall% ha*e Eronchiectasis or other Lun' Diseases0 Uroporph%r%no'en S%nthase , is an en+%me de)icient in patients /ith Porph%ria0 Patients /ith Coronar% $hrombi , /ill ha*e a hi'h acti*it% o) Metalloproteinases in the clot and this /ill predispose to M%ocardial In)arction0 Colchicine , inhibits Leu(oc%te Mi'ration and Pha'oc%tosis b% Eloc(in' $ubulin Pol%meri+ation0 $he side e))ects are Nausea and Diarrhea8 should not be used in 3enal Insu))icienc% Patients or Elderl%0 Children /ith Measles , /ill bene)it )rom therap% /ith -itamin De))icienc% o) *itamin 8 /ill include 7erophthalmia8 ni'ht blindness8 (eratomalacia and corneal per)oration0 0

Strep -iridans , /ill be present a)ter Dental Sur'er%8 and /ill use De7trans as substrates to )acilitate adherence o) Strep -iridans to 4ibrin0 Inhaled nesthetics , /ill *asodilate Cerebral -asculature8 but /ill depress the blood )lo/ in Li*er8 Aidne%s8 Heart0 $C Patients Cause o) Death , is usuall% due to rrh%thmia /hich is precipitated b% Eloc(in' o) 4ast Sodium Channels in patients /ho o*erdose on $ric%clic nti Depressants8 /hich normall% inhibit reupta(e o) Norepinephrine and Serotonin0 Imipramine , /hich is a $C 8 /ill precipitate episodes o) Mania in patients /ho are depressed0 Mali'nant H%perthermia , usuall% occurs a)ter inhalation anesthetics /ere used and is treated /ith Dantrolene8 /hich 3%anodine 3eceptors and /ill inhibit the release o) Calcium into a c%toplasm0 Na)cillin or Methicillin , resistance is due to alteration o) Penicillin Eindin' Protein0 Which /ill alter the Eindin' o) Penicillin and thus cause 3esistance0 Enteropeptidase De)icienc% , /ill decrease con*ersion o) $r%psino'en to $r%psin in Intestines8 /hich /ill present /ith diarrhea8 'ro/th retardation and h%poproteinemia0 L%mphedema in Post Mastectom% Patients , /ill predispose to de*elopment o) L%mphan'iosarcoma o) L%mphatic Channels8 /ill occur 9< %ears a)ter the sur'er%0

Natural Ailler Cells , are responsible )or (illin' i) MHC I cells )ail to respond0 NA cells are CD9= and CD>=8 and do not re@uire $h%mus )or Maturation0 $he% are acti*ated b% IL 9: Sic(le Cell Patient , /ith Hb o) =<P and Hb S o) F<P /ill not de*elop pain)ul crises8 due to a hi'h number o) Hb 8 but /ill be protected )rom Plasmodium 4alciparum0 O$ Prolon'ation , /ill result )rom mutation o) A channel protein that contributes to dela%ed current o) cardiac action potential0 We'ener !ranulomatosis , /ill present /ith Crescents on Li'ht Microscop%0 Deciduali+ation o) endometrium , is seen in pre'nanc%8 it"s Gust another name )or a chan'e in the endometrium /ith 'estation Perchlorate8 Pretechnetate , are used to pretreat people /ith $h%roid Problems8 the% /ill bloc( iodide absorption *ia competiti*e inhibition0 denosine Deaminase , de)icient in SCID and accumulates and is to7ic to $-l%mphoc%tes0 denosine

H%dro7%lation o) L%sine to Proline , occurs in 3E3 and re@uires -itamin C0 Eone Speci)ic cti*it% l(aline Phosphatase , is indicati*e o) 2steoblastic

$artrase 3esistant cid Phosphatase8 H%dro7%proline and Deo7%p%ridinoline , indicati*e o) 2steoclastic cti*it%0 !lucocoricoid $herap% , number 9 cause )or therosclerosis , predisposes to 4ormation bdominal drenal Insu))icienc% ortic ne%urism

H%pertension , ris( )actor )or de*elopment o) ortic Dissections bdominal Pain due to Pancreatitis , is the presentin' si'n o) patients /ith H%pertri'l%ceridimea8 /here there are ele*eated le*els o) Ch%lomicrons Hepatitis E In)ection , /ill )ill up the c%toplasm /ith spheres and tubules containin' HbS '8 /hich 'i*es it eosinophilic 'round 'lass appearance Hepatitis C In)ection , /ill )orm l%mphoid accumulation in the portal tracts and cause )ocal areas o) macro*esicular steatosis0

Haloperidol , the dru' associated /ith the side e))ect o) Neuroleptic Mali'nant S%ndrome8 /hich presents /ith con)usion and muscle ri'idit%0 !lucocorticoids , are pre)erred as a short term therap% )or 3heumatoid rthritis8 and Methotre7ate is used )or Moderate to Se*ere 3heumatoid rthritis0 Neuronal Dama'e , /ill present /ith !liosis8 due to the death o) stroc%tes0 Calcium Channel Eloc(ers , /ill present /ith Eilateral S/ellin' and 4lushin' as a Side E))ect0 n(le

? Aetoacid Deh%dro'enase , is usuall% de)icient in Maple S%rup Disease and the treatment is to a*oid Eranched Chain mino cids8 such as Isoleucine8 Leucine and -aline0 !oodpasture"s S%ndrome , presents /ith Linear Deposits on I40 Minimal Chan'e Disease , presents in children /ith Selecti*e lbumin Loss Proteinuria0 4etal Hb4 , contains !amma !lobin instead o) Eeta !Lobin0 $hia+olidinediones #Pio'lita+one8 3osi'lita+one& , %ou must chec( )or Li*er 4unction $ests8 due to increased ris( o) Hepatoto7icit%0 nnular Pancreas , present due to Pancreatic Eud0 bnormal Mi'ration o) -entral

Con'enital Eicuspid ortic -al*e , presents /ith Calci)ication and /ill cause ortic Stenosis later on in Li)e0 Eupropion , doesn"t ha*e Se7ual D%s)unction Side E))ects and is an e7cellent choice opposed to SS3Is MaGor Easic Protein , secreted b% Eosinophils )unctions to (ill Helminths dult Pneumo*a7 , is an UnconGu'ated Pol%saccharide -accine0 Primar% Pulmonar% H%pertension , is usuall% due to idiopathic d%s)unction o) Pulmonar% rter% Endothelium $P , is a re'ulator% stimulus that acts to stimulate A $P Channels in Insulin Producin' Pancreatic Eeta Cells0 Ero/n Pi'ment Stones , results in the release o) J-'lucuronidase b% inGured hepatoc%tes0

S0 Pneumonia , is able to under'o trans)ormation on the a'ar8 i) combined /ith another bacteria E0Coli , is unable to under'o Pilus Mediated $rans)er o) DN ConGu'ation0 Strep0 -Iridans , produce De7trans )rom !lucose to coloni+e0 Con'enital $o7oplasmosis , presents /ith H%drocephalus8 Intracranial Calci)ications and Chorioretinits0 Coccidiom%cosis , produces Spherules in the Lun' $issue0 S%stemic Macroc%tosis , abnormal proli)eration o) mast cells and increased histamine secretion0 !astric H%persecretion /ill be seen in Macroc%tosis8 due to increased production o) !astric cid b% Parietal Cells0 $reatment /ith Statins , /ill increase LDL 3eceptor Densit%0 Neural $ube De)ects , /ill present /ith increased 4etoprotein and Increased cet%lcholinesterase lpha

Minimal l*eolar Concentration M C , best measure o) potenc% o) an inhaled anesthetics0 MHC Class I Molecule , consists o) a Hea*% Chain and a Eeta : Micro'lobulin Lactase De)icienc% , /ill present /ith Increased Stool 2smotic !ap8 Increased Ereath H%dro'en and Decreased Stool pH0 Patho'enesis o) Crohn"s Disease , presents /ith acti*it% o) $H9 cells8 /hich /ill increase production o) IL-: and Inter)eron !amma and thus increase production o) Macropha'es and thus !ranuloma 4ormation0 Leuprolide , !n3H 'onist8 /ill at )irst cause a $ransient Increase and then Decrease in $estosterone and DH$0 4actor - Leiden Mutation , causes 4actor -a resistance to Inacti*ation b% cti*ated Protein C8 patients /ill present /ith t%pical $hromboses0 Le'ionnaire"s Disease , caused b% Le'ionella Pneumonia causes disease in smo(ers8 /ith diarrhea8 headache and con)usion DD -P #Desmopressin& , increases *W4 release )rom the endothelial cells0 S F , causes an e7tra sound be)ore S 9 and that is due to a sti)) *entricle

Second !eneration # t%pical& nti Ps%chotics - Clo+apine8 3isperidone8 2lan+apine and Ouietiapine are used )or positi*e and ne'ati*e s%mptoms0 Echinococcus , usuall% causes c%sts in the li*er8 that i) are ruptured8 ma% cause naph%la7is0 C%anotic Spells , /here a patient /ill strain himsel) to *asoconstrict and thus re*erse 31L shunt8 are seen in $etrallo'% o) 4allot0 Diastolic 4ailure , /ill cause an increase onl% in ED-P8 /here a S%stolic /ill increase both ES and ED-P0 Eeni'n !lomus $umor , 'loman'ioma8 can produce a tender c%anotic nodule under the nail8 and the cells that caused this are in*ol*ed in $hermore'ulation0 Morphine , opioid a'onist8 that /or(s on Potassium Channel Conductance0 Ne'ati*e Predicti*e -alue , the probabilit% o) bein' )ree o) disease8 i) the result is ne'ati*e0 Small Cell Carcinoma , sho/s e*idence o) neuroendocrine ori'in0 Potassium Iodide , is added to decrease the upta(e o) th%roid b% the th%roid 'land in H%perth%roid Patients0 P$U , prop%lthiouracil8 bloc(s the en+%me $h%roid Pero7idase8 and thus decreases the )ormation o) $h%roid Hormone0 -entricular H%pertroph% , as /ell as *olume o*erload can induce )ormation o) NP and ENP )rom *entricular m%oc%tes and induce diuresis and natriuresis0 Sele'eline , an inhibitor o) M 2 $%pe E receptors8 in patients treated )or Par(inson it can protect )rom dama'in' o) dopaminer'ic neurons0 $reatment /ith Sele'eline and mantadine is a 4irst Step in mana'ement o) Par(inson Patients8 a)ter all the options are tried8 onl% then /e administer Carbidopa6Le*odopa0 C2K : Inhibitors , do not a))ect platelet )unction8 because it"s mostl% under C2K 9 control0 Maple S%rup Urine Disease , de)ect in ?-(etoacid deh%dro'enase8 /hich re@uires > co)actors #$hiamine P%rophosphate8 4 D8 N D and Coen+%me O& similar to P%ru*ate Deh%dro'enase0

3upture o) M%ocardium , is the most common complication o) MI ;-C da%s later0 H%potension8 Increased Lu'ular -ein Distention and Mu))led Heart Sounds are the si'ns0 Dietar% Ener'% , M (Cal per 'ram o) 4at8 F (Cal per 'ram o) Carbs and Protein and C (Cal per 'ram o) Ethanol0 Cardiac 2utput , 27%'en Consumption 6 di))erence0 rterio*enous 2:

Hepatitis -irus , can be inacti*ated b% boilin' )or 9 minute at D> de'rees8 treatin' /ith 4ormaldeh%de and Eleach0 O$ Prolon'ation , is usuall% caused b% Potassium Channel Eloc(ers8 miodarone is a Potassium Channel Eloc(er that doesn"t predispose to $orsades de Pointes0 reas o) Metaplasia , ma% be present in the duodenal ulcers created b% H0 P%lori In)ection0 Complications o) C4 , in US8 usuall% are Cardio3espirator% S%mptoms8 such as Pneumonia8 Eronchiectasis8 Cor Pulmonale and 2bstructi*e Pulmonar% Disease0 Standard De*iation , =DP is in the ran'e o) 9 SD8 M>P are in the ran'e o) : SD and MM0C P contain ; SD"s Increased 2steoid Matri7 , is a complication o) 3ic(ets Macropha'es loaded /ith P S Positi*e 'ranules , are usuall% seen in Whipple Disease8 i) there are si'ns o) Malabsorption in middle a'ed indi*iduals0 Lipo)uscin , is an accumulation o) Lipid Pero7idation accumulatin' in a'in' cells0 Ele*ated Serum lpha 4etoprotein , is usuall% present in Hepatocellular Carcinoma #Hepatoma& Complication o) C3ES$ , earliest dama'e is seen in small *essels8 /here it causes intimal thic(enin' Dama'e to Posterior H%poph%sis , /ill causes Diabetes Insipidus onl% )or a short period o) time0 Dama'e to H%pothalamic Nuclei , /ill cause a lon' term Diabetes Insipidus8 not the transient that is seen /ith dama'e to Posterior H%poph%sis $olcapone , is a C2M$ Inhibitor8 /hich ser*es to prolon' the a*ailabilit% o) Le*odopa in Par(inson Patients0 Chec( )or Li*er En+%mes /hen administerin'

Elastin"s abilit% to recoil /hen stretched , is due to L%s%l H%dro7%lase crosslin(in' Mitral -al*e Prolapse , is the most common predisposition to -al*e Eacterial Endocarditis0 Cerebellar $umor in a Child , is most li(el% a Medulloblastoma or Piloc%tic stroc%toma8 medulloblastomas are al/a%s solid and stroc%toma are solid and c%stic0 3enal Cell Carcinomas , are usuall% associated /ith -on Hippel Lindau and deletion o) -HL 'ene on Chromosome ;p0 Patients /ith splenic rupture , are usuall% susceptible to bacterial in)ections8 such as S0 Pneumonia8 H0In)luen+ae and N0 Menin'itidis0 Er'ono*ine , is an er'ot al(aloid that constricts *ascular smooth muscle b% stimulatin' alpha adrener'ic and serotoner'ic receptors and thus it can cause a Coronar% -asospasm0 N- cet%lc%steine , /or(s b% clea*in' Disul)ide Eonds /ithin Mucus !l%coproteins and thus Loosenin' the Mucus0 -itamin E De))icienc% , the most notable chan'es are seen in Ner*ous S%stem8 /here there is a de'eneration o) Spinocerebellar $racts8 dorsal columns and peripheral ner*es8 /hich is similar to 4riedrich"s ta7ia0 Pulmonar% E))ect o) -a'us Stimulation , is bronchoconstriction8 /hich /ill increase the /or( o) breathin'8 mucus production and air/a% resistance0 -0 Cholera , does not sur*i*e /ell in cidic pH0 So an% condition that causes achlorh%dia /ill cause -0 Cholera to proli)erate0 Durin' 3eco*er% )rom $N , patients tend to de*elop H%po(alemia8 due to hi'h *olume8 h%potonic urine0 Mutation in C4$3 'ene , in C4 patients /ill cause an abnormal )oldin' o) a protein and /ill result in de'radation o) a protein be)ore it reaches the cell sur)ace0 Ca*ernous Heman'ioma , is the most common beni'n tumor o) the li*er8 /hich on microscop% presents /ith blood )illed *ascular spaces *itaminosis o) -itamin , ma% cause a s@uamous epithelial metaplasia o) Pancreatic e7ocrine ducts8 seen in patients /ith C4

Coccidioides Immites , presents /ith spherules on microscop% and it loo(s li(e berries0 spiration Pneumonia , is usuall% seen in alcoholics8 sei+ures8 old a'e8 poor oral h%'iene8 the a'ents usuall% aspirated are 4usobacterium8 Eacteroides $hiopental , is an anesthetic and /ill cause a paral%sis8 )urther on it /ill dissol*e into the S(eletal Muscle $issue0 $etrallo'% o) 4allot8 $ranspostion o) !reat -essels and $runcus rteriosus , can be caused b% an abnormal mi'ration o) Neural Crest Cells0 Inhalation nesthetics , can cause a massi*e Hepatic Necrosis8 due to Halothane E7posure8 /here Halothane Metabolites produce autoantibodies a'ainst Hepatoc%tes0 $hiorida+ine , anti ps%chotic causes 3etinal Deposits #3etinitis Pi'mentosa&0 Chlorproma+ine usuall% causes Corneal Deposits0 N- cet%lC%steine , pro*ides Sul)h%dr%l 'roups and thus binds the to7ic metabolites o) cetaminophen8 and also it is use)ul in loosenin' the mucus plu's in C4 patients8 /here it brea(s sul)ide bonds b% pro*idin' Sul)h%dr%l 'roups0 m%otrophic Lateral Sclerosis , causes loss o) neurons in nterior Horn #LMN Lesion& /here it causes muscle /ea(ness and atroph%0 Dem%elination o) Lateral Corticospinal $ract #UMN Lesion& /ill cause spasticit% and h%perre)le7ia0 Nitrates and Hi'h Elood Pressure , nitrates cause *asodilation and 3e)le7 $ach%cardia (ic(s in /hen the bod% senses the drop in EP8 so to a*oid $ach%cardia8 %ou must administer Eeta Eloc(ers0 Loss o) Contractilit% o) a Muscle , usuall% occurs /ithin =< seconds o) Ischemia and Lactate /ill accumulate0 CE Inhibitors , ma% produce n'ioedema

S%mptoms o) 3a%naud Phenomenon , are usuall% treated /ith Calcium Channel Eloc(ers0 Hemiballismus , associated /ith /ild )lin'in' o) e7tremities on 9 side o) the bod% indicates dama'e to Subthalamic Nucleus8 usuall% due to a Lacunar Stro(e0 Menopause , is associated /ith increased le*els o) 4SH0 Eusprione , is a )irst line treatment o) !enerali+ed n7iet% Disorder and usuall% ta(es : or more /ee(s to sho/ )ull e))ect0

Primar% 2oc%tes , are arrested in Prophase o) Meiosis I8 and remain there until pubert%0 t pubert%8 it starts Meiosis II and 'ets arrested until )ertili+ation in Metaphase o) Meiosis II0 Classical Conditionin' , is /hen a person has a reaction to a stimulus8 li(e White Coat n7iet%8 /here White Coat is a Conditioned Stimulus )or n7iet%0 Le)t trial Enlar'ement , can impin'e Le)t 3ecurrent Lar%n'eal Ner*e and cause Hoarseness miodarone , Class III nti rrh%thmic and can cause $h%roid D%s)unction #it"s F<P Iodine b% Wei'ht&8 Corneal Deposits8 Elue S(in Discoloration8 Pulmonar% 4ibrosis or Li*er D%s)unction0 Mutation /ith 4 S 'ene , impairs C$L to delete sel) reactin' $L%mphoc%tes and thus can cause an auto-in)ection o) di))erent or'ans8 such as seen in SLE0 -PL , recei*es input )rom Spinothalamic and is a rela% )or Pain8 $emperature8 Proprioception0 -PM , is a rela% )or !ustator% Path/a%s Lateral !eniculate Eod% , path/a% )or -ision Medial !eniculate Eod% , path/a% )or uditor%0

2l)actor% , doesn"t ha*e a rela% throu'h the $halamus0 !l%coprotein in Whipple"s Disease , stains /ell /ith P S and is resistant to Diastase0 It stains 3ed /ith P S and is an e7cellent /a% to dia'nose Whipple"s HI- . Patients , o)ten under'o reacti*ation o) EE- -irus bsolute 3is( 3eduction 5 E*ent 3ate in Placebo #:>69<<< 5 :0>P& , E*ent 3ate in $reatment #9<69<<<59P& $hus it"s e@ual to 90>P or <0<9>0 Number Needed to $reat 5 96 33 NN$5 96<0<9>5<0== or ==P )lato7in , present in di))erent Molds o) !rain8 cause a mutation o) ! to $ o) p>; !ene and /ill cause Hepatocellular Carcinoma0 Usuall% seen in sian Countries0 Methacholine Challen'e , can be used in patients to dia'nose sthma8 since it"s a Muscarinic Choliner'ic 'onist8 it /ill increase Eronchial Smooth Muscle Contraction and Mucus Production0

Etanercept , lpha $umor Necrosis 4actor nta'onist8 and is used in treatment o) Se*ere 3heumatoid rthritis8 especiall% in patients /ho )ailed Methotre7ate $herap%0 Chec( )or PPD8 since it causes 3eacti*ation o) $uberculosis0 Woolsorter"s Disease , is caused b% Eacillis nthracis8 and has a structure /here it has D-!lutamate instead o) Pol%saccharide0 C2K : En+%me in Colon Cancers , increased e7pression o) C2K : en+%me8 has been seen in Colon denocarcinomas and Pol%posis8 so pre*ention /ith NS IDS has been use)ul 4e7o)enadine , Second !eneration minimal sedation nti Histamine that causes

Mucor 3hi+opus In)ection , causes )un'us in Aetoacidosis Diabetic Patients and must be Eiopsied to Dia'nose0 It branches at M< de'ree an'les and sper'illosis at F> de'rees Lamotri'ine , anticon*ulsant used in 3e)ractor% Partial Sei+ures and has been sho/n to cause a H%persensiti*it% 3ash as a Side E))ect0 Prolactinomas , associated /ith increased production o) Prolactin /ill suppress !n3H and thus causes 2steoporosis b% decreasin' le*els o) Estro'en0 therosclerotic Pla@ue , e7resses increased number o) PD!4 and causes adherence o) Platelets to it and thus increasin' Intimal $hic(ness0 Intususseption , usuall% seen in children less than : %ears o) a'e and are presented /ith a mass in the abdomen8 poor )eedin' and Currant Lell% Stool NS ID in cute !out , are the )irst line o) treatment in patients presentin' /ith cute ttac(s o) !out8 !lucocorticoids are used as a )irst line o) treatment in Elderl% Patients or those /ith 3enal 4ailure0 Loss o) Nissl Substance in Neurons , indicates an Irre*ersible Dama'e to a Neuron Le)t Sided Colon Cancers , usuall% present /ith 2bstruction $%pe o) S%mptoms8 /here 3i'ht Sided Colon Cancers present /ith Iron De)icienc% nemia8 since the% tend to bleed0 Mutation o) A-3as 'ene , usuall% causes an increase in !ro/th o) Colonic Pol%p0 Mutation in PC !ene , usuall% causes denomatous Pol%ps

Mutation o) p>; 'ene , usuall% causes a Mali'nant $rans)ormation o) denomatous Pol%ps0 2dds 3atio , is calculated )rom )ormula 235ad6bc 3elati*e 3is( , is Ua#a.c&V6Ub#b.d&V Incomplete closure o) Caudal 3e'ion , o) abdomen8 /ill cause e7troph% o) the bladder or cloaca e7troph% 4ibrates and Eile 3esins , /ill increase cholesterol content o) bile and increase the ris( o) 'allstones0 4ibrates are dru's li(e !em)ibro+il and Eile 3esins are Cholest%ramine E7tracellular Propeptidases , clea*e disul)ide rich e7tensions )rom procolla'en molecule and thus /ill )orm triple heli70 Niacin , decreases s%nthesis o) tri'l%cerides and -LDL8 b% suppressin' the release o) )att% acids )rom peripheral tissue0 Side E))ects are )lushin'8 /hich can be pre*ented b% administration o) spirin0 Shi'a Li(e $o7in , produced b% E0Coli are identical in structure to Shi'ella $o7in8 /or( b% inhibitin' =<S subunit o) ribosomal protein and thus pre*entin' protein s%nthesis $o7ic Shoc( S%ndrome , has superanti'en8 /hich interacts /ith MHC comple7 on anti'en presentin' cells and $-l%mphoc%tes and the% cause /idespread o) acti*ation o) $ cells /ith release o) IL-: )rom $-cells8 IL-9 and $N4 )rom macropha'es0 Hepatitis D anti'en , must be coated b% e7ternal coat HEs ' anti'en o) Hepatitis E -irus0 Elastom%cosis , can cause a pulmonar% disease in immunocompromised patients8 /here sper'illus ma% cause asper'illosis in old ca*ities created b% $E etc0 Methotre7ate , inhibits dih%dro)olate reductase and side e))ects include stomatitis #mouth ulcers& and hepatoto7icit%0 Eiops% in Hirschprun' Disease , must include the submucosa o) the narro/ part8 because usuall% submucosa and m%enteric ple7us are absent in this disease0 Postreptococcal !lomerulonephritis , is usuall% caused b% accumulations o) Immune !lobulin Deposits0 !lucose $ransport , into cells occurs b% 4acilitated Di))usion $C antidepressants , such as imipramine8 am%triptiline8 must be used /ith caution in patients /ith EPH8 because the% ha*e stron'

anti-choliner'ic side e))ects and ma% cause acute urinar% retention Enterococci , produce amino'l%coside modi)%in' en+%mes8 that trans)er chemical 'roups and /ill impair an antibiotic bindin' and thus resistance I' Protease , )acilitates Mucosal Penetration0

Nitr'l%cerin , /or(s primaril% as a -enodilator8 /here cardiac /or(load is decreased8 because the blood is collected in the *enous s%stem and thus the preload is decreased as /ell 3elease o) L%so+omal En+%mes , )rom ischemic tissue in the brain8 results in necrosis o) the tissue in the a))ected re'ion0 nencephal% , alon' /ith duodenal8 esopha'eal or intestinal atresia are the main cause )or Pol%h%dramnios8 /here the s/allo/in' is decreased0 $E Menin'itis , /ill result in a Communicatin' H%drocephalus8 /here the impaired )unction is o) rachnoid !ranulations0 3ho!am $herap% , /here the 3h- ne'ati*e mother is 'i*en an D !lobulin8 and that 'lobulin is I'!0 Common Peroneal Ner*e , is mostl% commonl% inGured in the trauma near the head o) )ibula and /ill cause 4oot Drop0 Calcium durin' Muscle Contraction , /ill cause an increased de'radation o) !l%co'en and ha*e it con*erted into !lucose-9phosphate0 3is( o) 4ractures is lo/er in Elac(s , some o) the ris( )actors o) osteoporosis are smo(in'8 menopause8 corticosteroid therap%8 Caucasian race8 ph%sical inacti*it%8 alcohol use0 Colla'en Molecule - has a triple heli7 )ormation8 /here there is a !l%cine mino cid in e*er% third positon0 Patients presentin' /ith si'ns o) Pol%dipsia , pol%uria but at the same time the% ha*e H%ponatremia8 are usuall% caused b% Ps%cho'enic Pol%dipsia8 or Patholo'ic Water Drin(ers0 ldosterone , increase sodium and /ater reabsorption in the collectin' ducts0 DH , increases /ater reabsorption in the collectin' tubules0 3etinoblastoma Protein #3b& , is a re'ulator o) !9 to S phase transition0 nti

p:C protein , is a cell c%cle inhibitor8 so mali'nant cells /ill ha*e lo/ number o) p:C cells0 !luconeo'enesis , is a maGor controller o) 'lucose8 durin' an o*erni'ht )ast8 /here it con*erts p%ru*ate to o7aloacetate and o7aloacetate to phosphoenolp%ru*ate0 DH acts in Medullar% Se'ment , o) collectin' duct8 /here it acts to absorb /ater ldosterone , mainl% acts in Cortical Se'ment o) Collectin' Ducts0 Staph0 Scalded S(in S%ndrome , produce E7)oliatin' E7oto7in8 and there is a presence o) Ni(ols(% Si'n0 Memor% Loss and Con)abulations , are hallmar(s o) Aorsa(o)) S%ndrome and are permanent de)icits8 /hich don"t chan'e /ith -itamin Supplementation0 3isperidone , is an anti-ps%chotic8 that bloc(s D: s%nthesis o) Dopamine8 and thus its side e))ects are H%perprolactinemia8 that /ill cause menorrhea0 *ascular Necrosis , o) )emoral head are the maGor complications o) Sic(le Cell nemia8 S%stemic Lupus and Steroid $herap%0 Dama'e to 2r'an o) Corti , occurs )rom prolon'ed e7posure to e7tremel% loud noises0 Er'ot Compounds , such as Per'olide and Eromocriptine8 are associated /ith Side E))ects that cause 3a%naud Phenomenon0 Enterococcal Endocarditis , is usuall% seen in elderl% patients /ho ha*e under'one a procedure such as colonoscop%8 /here Enterococcus has in)ected and caused Endocarditis !ro/th 4actors and PD!4 , rel% on $%rosine Ainase and M P path/a%s8 and 3 S protein is a part o) M P path/a%0 -illous denomas , can loo( li(e Cauli)lo/er and secrete a lot o) mucus8 that /ill cause diarrhea and thus H%po*olemia Ler*ell and Lan'e Nielsen S%ndrome , is associated /ith Neurosensor% Dea)ness and O$ prolon'ation0 3DS Patients , /ill ha*e a normal Pulmonar% Capillar% Wed'e Pressure8 /here there is no edema in*ol*ed0 3ed 3a''ed Muscle - is seen on the biops% in Mitochondrial M%opath%0 $his is a mitochondrial disease and thus onl% transmitted throu'h mother0

Caudal 3e'ression S%ndrome , /here Sacral 'enesis causes lo/er e7tremit% paral%sis is usuall% seen in mothers /ith poorl% controlled diabetes0 Niacin , is the most e))ecti*e in raisin' HDL le*els0 2me'a )att% acids /ill raise HDL but at *er% lo/ le*els0 Patients /ith C4- their s%mptoms mi'ht be corrected /ith administration o) Pancreatic En+%mes8 since the% ha*e its de)iciencies0 In)iltrati*e 2phthalmopath% , is usuall% seen in H%perth%roid Patients /here their ocular muscles are in)iltrated b% 'l%cosamino'l%cans and hence there is E7ophthalmos0 Eest indicator o) MS stenosis le*el , is a len'th o) inter*al bet/een S: and and 2S #openin' snap& Lipooli'osaccharide #L2S& , o) N0 Menin'itidis is analo'ous to Lipopol%saccharide o) !ram Ne'ati*e 3ods and this /ill determine the se*erit% o) the disease0 Usuall% seen in militar% recruits0 Patients older than => , are prone to de*elopin' pneumonia a)ter In)ection /ith In)luen+a8 and the causati*e a'ents are Strep0 Pneumonia8 Staph0 ureus and H0 In)luen+a Patients /ith Ntiphospholipid ntibod% S%ndrome /ith Lupus , present /ith positi*e -D3L test8 ha*e nti-Phospholipid ntibodies circulatin'0 $hese antibodies are associated /ith increased ris( o) $hromboses8 Miscarria'es CE , is e7pressed in the Lun' -ascular Endothelium and con*erts n'iotensin I to )unctional n'iotensin II Preload /ill increase End Diastolic Sarcomere Len'th , in the *entricular m%ocardium8 and /ill increase Stro(e -olume and Cardiac 2utput0 Insulin , acti*ated Protein Phosphatase in the cells8 and it /or(s throu'h $%rosine Ainase receptor in the cells to stimulate s%nthesis o) )att% acids8 protein8 'l%co'en0 Patients /ith Eilateral Cataracts and no Hepatic In*ol*ement , ha*e a de)icienc% o) !alacto(inase and thus !alactose is shi)ted and con*erted into !alactitol b% ldose 3eductase and thus it accumulates in the lens o) the e%e /ithout Hepatic In*ol*ement0 Patients /ith Classic !alactosemia , ha*e a de)icienc% o) !alactose 9-phosphate Urid%l $rans)erase de)icienc% and thus !9P accumulates and /ill cause lethar'%8 *omitin' and /ill present /ith Cataracts0

M%coplasma , lac(s a cell /all8 so antibiotics such as PCN8 Cephalosporins and -ancom%cin /ill not be e))ecti*e in these bacteria0 So it must be treated /ith $etrac%lcines and Er%throm%cin that act on 3ibosomal Subunits0 3eid Inde7 , is a ratio o) Mucus !land La%er to the total thic(ness o) cell /all and cartila'e8 and this is an inde7 o) pro'ression o) Eronchitis0 'ranuloc%tosis , mi'ht be caused b% nti-$h%roid Dru's8 so WEC counts must be chec(ed prior to administration0 Pituitar% pople7% , is a complication o) Hemorrha'e into E7istin' Pituitar% denoma0 It /ill present /ith Se*ere Headache and Cranial Ner*e In*ol*ement0 Crohn"s Disease /ill present /ith 27alate Stones , because impaired bile acid absorption8 caused b% )at malabsorption8 /ill cause the loss o) Calcium in the bile8 and since Calcium binds 27alate8 then there /ill be a )ormation o) 27alate Stones0 Capsule o) Strep0 Pneumonia , is the maGor -irulence 4actor8 and it /ill s/ell up /hen nti-Capsule a'ents are added0 Endocarditis caused b% Staph0 ureus , usuall% occurs in I- dru' abusers8 or indi*iduals /ith una))ected *al*es8 and primaril% a))ects the $ricuspid -al*e0 While Strep0 -iridans usuall% in*ol*ed Mitral -al*e and is due to dental /or( etc0 bsolute 3elati*e 3is( , is calculated E*ent 3ate #control& , E*ent 3ate #treatment& Ethanol and Pancreatitis , ethanol induces secretion o) Pancreatic Luice /ith a hi'h content o) Protein and Lo/ 4luid0 $hus the secretions are *iscous and /ill )orm plu's and obstruct bile )lo/0 Nasal Mucosal Ulcerations and !lomerulonephritis , is seen in We'ener"s !ranulomatosis and /ill ha*e nti-Neutrophil ntibodies #c- NC & Proton Pump Inhibitors , are the dru' o) choice )or !astrinomas8 /hich secrete !astrin0 cet%l Co , is an allosteric acti*ator o) !luconeo'enesis and acts b% increasin' acti*it% o) P%ru*ate Carbo7%lase0 Cortisol , increases the transcription o) en+%mes in*ol*ed in !luconeo'enesis

$C o*erdose , ma% ha*e a Ouinidine li(e Side E))ects /here the% mi'ht cause O3S and O$ inter*al prolon'ation and to re*erse that8 Sodium Eicarbonate must be used0 Di'italis $o7icit% , mi'ht be treated /ith supplementation /ith Potassium8 since it bloc(s Na6A channel $o calculate the 3is( , di*ide the number o) diseased indi*iduals b% the total number o) patients in the 'roup0 Subperiosteal $hinnin' , is a )eature o) H%perparath%roidism8 /here there is an increased resorption o) the bone0 l(aline Phosphatase , is a 'roup o) en+%mes in*ol*ed in man% di))erent or'ans8 such as li*er8 bone8 intestine8 (idne%0 $o clari)% /hether it"s the li*er in)ection8 %ou must measure !!$P le*els , /hich are !amma !lutam%l $ranspeptidase0 7onal 3eaction , is a repair o) a7ons8 /here there is a nucleus pushed to the side and the cell is compressed and )inel% 'ranular Nissl substance is seen0 Cortisol , sensiti+es *asoconstricit*e e))ects o) Catecholamines and thus e7erts Permissi*e E))ects on the -asculature0 Endo'enouse dministration o) $h%roid Hormone , such as Le*oth%ro7ine8 /ill increase the 4ree Le*els o) $; and thus in its turn suppress $3H and then $SH le*els0 Penta+ocine , is an opiod narcotic /ith partial a'onist acti*it% and /ea( anta'onist acti*it% on Mu 3eceptors0 dministration o) this dru' in patients dependent on opioids8 mi'ht tri''er an 2piod Withdra/al S%mptoms0 !$P , is s%nthesi+ed in the Succin%l Co reaction in $C c%cle8 and used as an ener'% source )or decarbo7%lation o) 27aloacetate to Phosphoenolp%ru*ate b% PEP Carbo7%(inase in !luconeo'enesis0 L%sine and Leucine , are strictl% Aeto'enic mino cids and /ould not increase blood Lactate Le*els in patients /ith P%ru*ate Deh%dro'enase De)icienc%0 Patients /ith 4riedrich"s ta7ia , present /ith de'eneration o) Dorsal Columns8 as /ell as ><P o) them /ill de*elop H%pertrophic Cardiom%opath%0 HEs ' - is a component o) the en*elope o) Hep0 E *irus and /ill )orm spheres and tubules0 $ransposition o) !reat rteries , results )rom )ailure o) orticopulmonar% Septum to Spiral durin' Septation0

ta7ia $elen'ectasia , is an autosomal recessi*e8 /here there is a Cerebral troph% that /ill lead to ata7ia8 these patients are also susceptible to DN radiation8 since the% ha*e a de)icienc% o) E7onuclease acti*it%0 $erbina)ine - is a common dru' used )or Dermatoph%tosis8 /here it inhibits s%nthesis o) Er'osterol b% inhibitin' En+%me S@ualene Epo7idase0 cute Pancreatitis , is usuall% caused b% !allstones and lcoholism8 hi'h le*els o) $ri'l%cerides lead to increased production o) 4att% cids0 stroc%tes , are )ound at the peripher% o) the in)arct8 and are responsible )or maintainin' the same )orm8 the% are responsible )or !liosis0 Supraspinatus , is an bductor o) the arm8 *ulnerable to inGur% due to impin'ement bet/een acromion and the head o) the Humerus0 Subscapularis , is responsible )or Medial 3otation o) the Latissimus Dorsi , is the maGor dductor o) the rm0 rm

Neurons do not store !l%co'en , and are hi'hl% sensiti*e to Ischemia8 pro)ound h%potension durin' Cardiac rrests /ill cause !lobal Cerebral Ischemia0 De Ouer*ain $h%roiditis , or !ranulomattous $h%roiditis8 presents a)ter -iral In)ections and /ill present areas o) in)ilitration b% L%mphoc%tes and Multinuclear !iant Cells0 Ceruloplasmin , and unabsorbed copper /ill be Secreted into Eile and e7creted Hepaticall% in the stool D%strophic Calci)ication o) ortic -al*es , is preceded b% the Cell Necrosis8 /here there is a destruction b% Calci)ication and that /ill cause ortic Stenosis0 Procolla'en , is s%nthesi+ed /ithin Endoplasmic 3eticulum8 then it"s released into E7tracellular Space b% transport throu'h !ol'i8 and then con*erted into Colla'en b% peptidases that /ill clea*e o)) N and C terminal portions0 2nl% then the% are crosslin(ed /ith other Colla'en Molecules a)ter residues are o7idi+ed b% L%s%l 27idase0 Malasse+ia 4ur)ur , are characteristics o) Pit%riasis -ersicolor and appear as Spa'hetti and Meatballs0 bdominal orta , is mostl% in*ol*ed in the process o) therosclerosis8 then )ollo/ed b% Coronar% rteries8 Popliteal8 internal carotids and -essels in the Circle o) Willis0

E7trahepatic Eiliar% tresia , is a con'enital obstruction o) E7trahepatic Eile Ducts seen b% the ;rd /ee( o) Li)e0 C peptide and Insulin , pac(a'ed to'ether into secretor% 'ranules and are released into an e7tracellular space0 4en)luramine and Phenteramine , e7tensi*e consumption o) ppetite Suppressors is associated /ith the ris( o) Pulmonar% H%pertension0 Which can pro'ress to Cor Pulmonale0 Henoch Schonlein Purpura , consists o) Leu(oc%toclastic n'iitis and associated /ith deposits o) I' and C;8 and is common in children bet/een ;-99 a)ter recent in)ection0 Lac( o) $ tubules , /ould lead to uncoordinated contraction o) indi*idual )ibers in m%o)ibrils0 Ureteric Eud , 'i*es rise to collectin' ducts8 minor and maGor cal%ces8 renal pel*is and ureters0 Metanephric Mesoderm , 'i*es rise to !lomerulus8 Eo/man"s capsule8 pro7imal8 distal con*oluted tubes and a connectin' tubule Pulmonar% -ascular Sclerosis , /ill occur in patients /ith Eisenmen'er Comple70 Lo/ -olume o) Distribution o) the Dru' , such as F-> L8 ma% be due to Hi'h Molecular Wei'ht8 Hi'h Plasma Protein8 H%drophillicit% and Hi'h Char'e Staph Epidermidis , must be treated /ith -ancom%cin and 3i)ampin0 Indirect In'uinal Hernias , are located Laterall% to In)erior Epi'astric -essels Direct In'uinal Hernia , is located Mediall% to In)erior Epi'astric -essel0 M 2 Inhibitors , such as Phenel+ine and $ran%c%promine8 are particularl% use)ul in treatment o) t%pical Depressions8 such as in patients /ith H%perpha'ia and Wei'ht !ain0 2steoarthritis , /ill present /ith Short Mornin' Sti))ness8 and /ill in*ol*e DIP and PIP Goints0 3heumatoid rthritis , /ill present /ith a Lon' Mornin' Sti))ness that /ill impro*e /ith E7ercise8 and /ill in*ol*e MCP and PIP Goints0

Spironalactone , ma% be used in a )emale that complains o) increased Hair !ro/th on her )ace8 since it /ill bloc( andro'en receptors at hair )ollicles and decrease production o) $estosterone0 C4$3 , is an $P 'ated transmembrane ion transporter that pumps Chloride ions out o) the cell a'ainst a Concentration !radient0 Lead $ime Eias , is an arti)icial increase in the sur*i*al time amon' tested patients8 /ho actuall% ha*e an unchan'ed dia'nosis Hepatitis E Prodromal Period , tha% mi'ht last )rom ;<-9D< da%s8 /ill present /ith the Serum Sic(ness S%mptoms8 /here patients /ill e7perience )e*er li(e condition8 s(in rash8 and l%mphadenopath%0 -0 Cholera , doesn"t in*ade the Intestinal Mucosa8 so it /ill present /ith /ater% mucus and some epithelial cells0 Chronic 3eGection o) a $ransplant , /ill present /ith 2bliterati*e Intimal Smooth Muscle H%pertroph% and 4ibrosis0 Improperl% 4itted Crutches , /ill impin'e the 3adial Ner*e and cause s%mptoms such as inabilit% to 4le7 the rm and Wrist $h%roid Hormones , alter !ene $ranscription b% Eindin' to 3eceptors Inside the Nucles0 Protein M , is a maGor -irulence 4actor o) Strep0 P%o'enes and Inhibits Pha'oc%tosis and Complement cti*ation Lancet Shaped !ram Positi*e Diplococci , is indicati*e o) Strep0 Pneumonia8 /hich is 2ptochin Sensiti*e0 Pol%ribos%l 3ibitol Phosphate #P3P& , is a part o) H0 In)luen+a Capsule and is part o) HIb -accine and its conGu'ated /ith Diphtheria and $etanus $o7oid0 Posterior Urethral $rauma , is associated /ith Pel*ic 4ractures8 and it /ill present /ith Inabilit% to -oid8 despite 4ull Eladder and Ele*ated Prostate on 3ectal E7am0 3etinal Dama'e in In)ants , /ill usuall% be due to 3eper)usion 27%'en Dama'e8 in in)ants born /ith 3espirator% Distress S%ndrome0 Use o) $erbutaline , /ill present in In)ants /ith Intracranial Hemorrha'e8 H%po'l%cemia8 H%pocalcemia and Ileus0

3e%e"s S%ndrome , due to S in patients treated )or In)luen+a or -aricella In)ection and /ill present /ith Micro*esicular Steatosis o) Hepatoc%tes0 Porcelain !allbladder , Calcium Ladden !allbladder and /ill increase the ris( o) !allbladder Carcinoma Hereditar% Pancreatitis , ma% be due to mutation /hich /ould acti*ated $r%psino'en to con*ert into $r%psin and it /ould auto di'est Pancreas8 be)ore it /ould be released into duodenum as normall%0 Lithium , causes Nephro'enic Diabetes Insipidus8 H%poth%roidism and associated /ith Ebstein"s nomal%0 2sler Weber 3endu S%ndrome , Hereditar% Hemorrha'ic $elen'ectasia8 ma% a))ect the Lips8 2rophar%n78 3espirator% $ract8 S(in8 !I tract0 -on Hippel Lindau , Capillar% Heman'ioblastomas in 3etina and Cerebellum8 presents /ith Con'enital C%sts in Li*er8 Aidne%8 Pancreas and Increased 3is( o) 3enal Carcinoma $uberous Sclerosis , ma% cause c%sts in the li*er8 (idne%8 but in CNS it /ill be Subepend%mal Hamartomas8 3enal n'iom%olipomas and Cardiac 3habdom%oma8 clinicall% /ill present /ith Sei+uresQQQ Stur'e Weber , /ill present /ith Cutaneous 4acial n'iomas8 as /ell as Leptomenin'eal n'iomas8 patients /ill ha*e Mental 3etardation8 Sei+ures and S(ull /ill ha*e $ram $rac( Calci)ications0 'in' , /ill present /ith Decreased -entricular Si+e at the and /ill cause Si'moid Septum0 pe7

4c Portion Closer to the Hin'e 3e'ion , is /here Complement Einds0 Heme , ser*es as a Ne'ati*e 4eedbac( on L S%nthase0 Dia'nosis o) ccute Intermittent Porph%ria is made b% increase in minole*ulinic cid and Porphobilino'en Duodenal Ulcers Location , is near P%lorus because o) the most cid Present0 In)ants /ith Eilateral 3enal 'enesis , /ill present /ith 3espirator% Problems8 since mniotic 4luid that needs to be s/allo/ed and urinated out8 is essential in the process o) Lun' Maturation

LH , stimulates Le%di' Cells to Produce $estosterone8 4SH /ill stimulate Sertoli Cells to Produce Inhibin E8 /hich /ill Ne'ati*el% 4eedbac( on LH and 4SH Until F hours , into Ischemia /ill not present /ith an% chan'es on Li'ht Microscop% Eosental , is an 2ral Endothelin 3eceptor in Patient /ith Pulmonar% H%pertension nta'onist and is used

3eper)usion rrh%thmia , ma% be due to 4ibrinol%tics that /ill cause 3eper)usion on rterial 3e-2penin'0 cute 4ibrinous or Serous Pericarditis , acute onset Pleuritic Chest that decreases on Sittin' Up and Leanin' 4or/ard0 Cardiac De)ects in Di!eor'e S%ndrome , are associated /ith $etrallo'% o) 4allot and Interrupted ortic rch ddition o) Spironolactone , /ill si'ni)icantl% 3educe Mortalit% in Heart 4ailure Patients8 since it /ill bloc( ldosterone0 Chocolate 'ar )or Neisseria !onorrhea , consists o) -ancom%cin8 Pol%mi7in and $rimethoprim0 Cr%ptococcus , that is 3ound Euddin' Seast /ith Clear halos /ill cause Menin'itis in HI- . Patients0 Do/n S%ndrome , patients /ill ha*e 2stium Primum Endocardial Cushion trial Septal De)ect0 Ni)edipine , is a selecti*e -ascular Calcium Channel Eloc(er and is di))erent )rom Calcium Channel Eloc(ers used in rrh%thmias Slo/ 2nset o) the Dru' nesthetic , is associated /ith Hi'h Solubilit% o)

$hromboc%topenia in Hospital Patients , is mostl% due to Heparin In)usions8 and is more present /ith Un)ractionated Heparin rather than Lo/ Molecular Wei'ht0 2n 2)) Phenomenon , seen in Par(inson Patients /here the% /ill ha*e da%s /ith Increased Mobilit% and other times /ith Decreased8 that is due to the e))ect o) L-Dopa $herap%0 Cauda E@uina S%ndrome , /ill present /ith Saddle nesthesia and Loss o) nocutaneous 3e)le78 and that /ill in*ol*ed a Lesion )rom S: , SF reas0 Di))erential C%anosis , in Upper and Lo/er E7tremities is due to PD 0

l+heimer"s Disease , mostl% a))ects Hippocampus and 4rontal Lobe lpha 98F !lucosidase , de)icient in Pompe"s !l%co'en Stora'e Disease is also Called cid Maltase C-M%c , is a nuclear Phosphoprotein and )unctions as $ranscription cti*ator that controls Cell Proli)eration8 Di))erentiation and poptosis Ecr , bl , encodes a Protein that Inhibits poptosis /hile Promotin' Mito'enesis and Increased $%rosine Ainase cti*it%0 Postreptococcal !lomerulonephritis , /ill present /ith Ele*ated nti Streptol%sin # S2& titers8 Decreased C ; and $otal Complement Le*els and presence o) Cr%o'lobulins0 CF Le*els are usuall% Normal0 ttributable 3is( Percent 3P , is calculated b% 33-9633

Celial Disease , must be dia'nosed /ith Colon Eiops% /here there is 4lattenin' o) Mucosa8 Loss o) -illi and Chronic In)lammator% In)iltration o) Lamina Propria0 polipoprotein E -F - ma% be in*ol*ed in )ormation o) Senile Pla@ues in l+heimer"s Disease Eeta HC! , is detected in maternal serum on the Dth da%8 but can ta(e as lon' as 990 Elastoc%st implants itsel) on the =th da% Hibernatin' M%ocardium , can be caused b% repetiti*e ischemia o) the m%ocardium or persisten h%poper)usion8 and /hen the blood )lo/ is restored it /ill re'ain the circulation and stren'th !luca'onoma , are pancreatic tumors that are characteri+ed b% necrol%tic mi'rator% er%thema8 er%thematous rash a))ectin' the 'roin Pancoast $umors , are Superior Sulcus $umors characteri+ed b% Ipsilateral Horner"s S%ndrome8 rib destruction and other upper e7tremities" de)icits in the distribution o) CD8 $9 and $: lanine , can be $ransaminated b% lanine minotrans)erase to P%ru*ate /ith mino !roup trans)erred to lpha Aeto'lutarate to )orm !lutamate HbS , /here char'ed !lutamic cid 3esidue is replaced b% Nonpolar H%drophobic -aline 3esidue at the =th position and /ill cause a''re'ation o) Hemo'lobin under H%po7ic Conditions Chemoreceptor $ri''er None , is located at the base o) Fth -entricle8 at the Dorsal Sur)ace o) Medulla0

Duration o) Diastole , is a critical )actor in determinin' Coronar% Elood 4lo/ Er'ot Compounds and Noner'ot Compounds , Directl% Stimulate Dopamine 3eceptors0 Er'ot Compounds #Eromocriptine and Per'olide& and Noner'ot Compounds #Pramipe7ole and 3opinerole& Patients on $hia+ides , ha*e o*erall hi'her le*els o) Calcium and thus it"s bone protecti*e8 so H%pocalciuria /ill decrease )ormation o) 3enal Stones Nonnucleoside 3e*erse $ranscriptase Inhibitors , do not need to be phosphor%lated to be acti*ated and some o) them areB Ne*irapine8 E)a*iren+ and Dela*irdine HI- ssociated Esopha'itis , is caused b% Candida8 CM- and Herpes -irus )ter M 2 $herap% , it /ill ta(e : /ee(s to re'enerate en+%me8 to ha*e ade@uate neurotransmitter metabolism Primidone - is metaboli+ed to Phenobarbital and PEM 8 all three are acti*e compounds that are nticon*ulsants Superior Mesenteric rter% S%ndrome , /hen $rans*erse Portion o) Duodenum is trapped bet/een SM and orta0 $hat can happen due to rapid /ei'ht loss0 Eroncho'enic Carcinoma , is the most common Lun' Cancer due to sbestos E7posure8 /here Mesothelioma is :nd Most Common0 MaGorit% o) nal 4issures , occur in the Posterior Midline Distal to the Dentate Line0 P%ra+inamide , is e))ecti*e in cidic En*ironment8 /here other $E dru's are e))ecti*e a'ainst e7tracellular m%cobacteria0 Li*er Cirrhosis and Hepatocellular Carcinoma , are : outcomes associated /ith mutation o) H4E protein /hich promotes attachment to $rans)errin Protein and 4acilitates Iron bsorption8 /hich are seen in Hemochromatosis cute 3heumatic 4e*er , is the most common cause o) Mitral Stenosis0 Where In)ecti*e Endocarditis is more associated /ith -e'etaions and Destruction o) the -al*es0 -alproic cid , is the )irst line therap% )or M%oclonic Sei+ures0 Where Phen%otin and Carbama+epine are 9st line in $onic Clonic Sei+ures0

Nephrotic S%ndrome , /ill present /ith loss o) and that"s /h% /ill present /ith $hrombosis

ntithrombin III

H0 In)luen+a E -accine , is mi7ed /ith Diphtheria and $etanus $o7oid8 and this in turn /ill Increase Immuno'enicit% o) the -accine8 /here ConGu'ate becomes $ cell dependent nti'en Carcinoid Heart Disease , /ill present /ith 4ibrous Intimal $hic(enin' /ith Endocardial Pla@ues and /ill be limited to 3i'ht Heart0 $he s%mptoms are )lushin'8 /hee+in' and diarrhea8 due to production o) Serotonin8 Aali(rein8 Erad%(inin8 Histamine etc0 Lispro and spart , are the best Short ctin' Insulins

H%drocele and Indirect Hernia , are )ormed b% a similar mechanism0 Eoth are caused b% incomplete 2bliteration o) Processus -a'inalis0 !allstone Ileus , /ill cause an obstruction o) the bo/el and /ill present /ith ir in the Eilliar% $ract0 Increased 4ecal Elood Loss , is the side e))ect o) S $herap%0 Eecause there is a loss o) !astric Protection in addition to Impaired Platelet ''re'ation0 HSP M< and HSP >= , are Heat Shoc( Proteins that bind Inacti*e Ninc 4in'ers that are in*ol*ed in Steroid Hormone S%nthesis0 Complications o) n(%losin' Spond%litis , ma% be impaired Pulmonar% -entilation due to de)ormation o) the spine8 and in the heart it /ill present /ith scendin' ortitis leadin' to Dilatation o) the ortic 3in'0 Colon Cancer , most common location )or this is scendin' Colon8 /hich /ill present /ith Eleedin'8 /here the Le)t Side that /ould in*ol*e 3esctoSi'moid 3e'ion /ould present /ith 2bstruction0 Spread o) Eroncho'enic Carcinoma , ma% present /ith 2bstruction and Compression o) Upper -asculature such as -ena Ca*a8 and patients /ill present /ith 4acial S/ellin'8 Dilated Carotids0 H%permeth%lation o) Histones , is the cause o) E7pression o) Huntin'ton Disease0 ltered !ene

!astroduodenal rter% , is mostl% eroded b% Posterior Duodenal Ulcers and can be a source o) Li)e $hreatenin' Hemorrha'e 4emoral Hernias , /ill present /ith a Eul'e in the Upper $hi'h8 and /ill be accentuated on -alsal*a Maneu*er0

Pol !ene Mutations , render the abilit% o) HI- 3etro*iral $herap% to ta(e its e))ect $reatment )or !onoccocal In)ection , must al/a%s in*ol*e treatment )or Chlam%dia8 since it o)ten co in)ects at the same time0 Ce)tria7one is used )or N0 !onnorhea and +ithrom%cin or Do7%c%cline are used )or Chlam%dia N4-(E Protein , acti*it% is reduced in Crohn"s Disease and this protein is responsible )or C%to(ine Production carbose and Mi'litol , are lpha !lucosidase Inhibitors that decrease cti*it% o) Membraine Eound Disaccharides on the Intestinal Erush Eorder0 Increase in c MP in -ascular Smooth Muscle , /ill cause -asodilation8 /hich is a Side E))ect o) Phosphodiesterase Inhibitors in H%potensi*e Patients0 4ibrinous or Sero)ibrninous Pericarditis , de*elops in :<P o) the Post MI patients bet/een da% : and F8 due to in)iltration o) In)lammator% Cells o) the $ransmural In)arction0 Dressler S%ndrome occurs on Da% C and is an utoimmune Process0 Niacin and 4ibrates #E+etimibe& , are the most use)ul $reatment in patients /ith H%pertri'l%ceridemia ir/a% 3esistance , is Minimal in Eronchioles and Ma7imal in Lar'e Se'ments o) Eronchi0 Cold ''lutinins , are antibodies that /ill be produced in 3esponse to M%coplasma Pneumonia In)ection8 also mi'ht be present /ith Ebstein Earr -irus In)ection Calcium Channel Eloc(ers , mi'ht present /ith and Erad%cardia - Nodal Eloc(s

Local De)ense a'ainst Candida , is produced b% $ cells8 that"s /h% /e see Local Candidiasis in HI-. Patients8 since their $ cell Le*els are Lo/ De)ense a'ainst S%stemic Candidiasis , is produced b% Neutrophils8 that"s /h% Neutropenic Patients /ill present /ith S%stemic Candidiasis $o pre*ent Neonatal $etanus , is to ensure that Mothers are -accinated /ith $o7oid to allo/ trans)er o) I'! $o7oid throu'h Placenta Cer*ical Cancer 3is( , Number 9 is Histor% o) Se7ual Partners8 since HP- can be transmitted

Endometrial Cancer 3is( , is due to Nulliparit%8 earl% Menarche and 2besit%8 /here increased Estro'en Stimulation o) the Endometrium Ereast and 2*arian Cancers , Number 9 3is( is 4amil% Histor% Minimal Chan'e Disease , is usuall% due to the Loss o) Pol%anion in the Easement Membrane8 /hich /ill lose the Char'e0 3i)ampin , is used as Proph%la7is a'ainst Menin'ococcal Diseases8 as it /ill Penetrate into 3espirator% $ract and Eliminate Nasophar%n'eal Coloni+ation Niacin , or Nicotinic acid has been used to treat H%perlipidemias8 the side e))ects o) 4lushin' are due to release o) Prosta'landins Le)t -entricular D%s)unction , /ill cause Pulmonar% -essel -asoconstriction and /ill contribute to Pulmonar% H%pertension Di'italis $o7icit% , /ill present /ith H%per(alemia and at times /ith Erad%cardia8 -entricular $ach%cardia or 4ibrillation Splittin' o) S: in /ith 3espiration Si7th ortic rteriosus SD , /ill be permanent and /ill not chan'e rteries and Ductus

rch , 'i*es rise to Pulmonar%

Neuropathic Incontinence , /ith Neuro'enic Detrusor Spasticit%8 /ill result )rom dama'e )rom $99 till L:8 /ill cause rela7ation8 since those ner*es inhibit it0 S:-SF are responsible )or e7citation o) the bladder MCHC , Mean Corpuscular Hemo'lobin Concentration is the best Inde7 in ma(in' Dia'nosis o) Hereditar% Spheroc%tosis8 Dia'nosis is best con)irmed /ith 2smotic 4ra'ilit% $est Musculocutaneous Ner*e , pro*ides inner*ation o) 4le7or Muscles o) upper arm Sensor% to the Lateral Part o) the rm Hapto'lobin , binds 4ree Hemo'lobin8 in Intra*ascular Hemol%sis8 due to destruction o) Er%throc%tes8 4ree Hemo'lobin Increases8 an E7ceeds le*els o) Hapto'lobin and thereb% Decreasin' the Le*els o) Hapto'lobin In HI- , Nucleocapsid Proteins p:F and pC are )rom ! ! !ene0 En*elope !l%coprotein 'pF9 and 'p9:< are )rom EN- 'ene0 $ranscription and $ranslation are )rom P2L 'ene0 $ $ and 3E- are re@uired )or 3eplication

Dietar% 4ructose , is Phosphor%lated in the Li*er to 4ructose 9 Phosphate and 3apidl% Metaboli+ed8 because it Doesn"t Pass throu'h P4A 98 /hich is a 3e'ulator% En+%me o) !l%col%sis0 Ecth%ma !an'renosum , is a Cutaneous Necrotic Disease and it"s associated /ith Pseudomonas ure'inosa0 P0 eru'inosa are common in Neutropenic8 Diabetic8 Eurn Patients0 !lucocorticoids and HI--9 Protease Inhibitors , are associated /ith Cushin'oid ppearance and 4at Distribution !out% rthritis , is a Side E))ect o) Niacin $herap%8 /hich increases Serum Uric cid0 Hepatoto7icit% ma% occur at Hi'h Doses0 In Diabetics it mi'ht cause H%per'l%cemia mphotericin E , Pol%ene nti)un'ul and its Side E))ects are 3enal 4ailure /ith H%po(alemia and H%poma'nesemia0 ntipha'oc%tic Pol%saccharide Capsule in H0 In)luen+a E , has 3ibose in it8 instead o) He7ose and ma% be the reason )or Increased -irulence Patients /ith Crohn"s Disease , are prone to de*elopin' !allstones0 Decreased Eile cid 3eabsorption and Loss in the 4eces /ill increase Cholesterol Le*els and )ormation o) !allstones Pol%m%ositis , presents /ith S%mmetrical Muscle Wea(nesses8 on Eiops% there is necrosis8 re'eneration8 lar'e amounts o) MHC I molecules in)iltrated /ith CDD $ cells0 Primar% Eiliar% Cirrhosis , Ducts and Cholestasis0 utoimmune Destruction o) Hepatic Eile

ll Sic(le Cell Patients , at some point /ill present /ith splenism and thus the increased ris( o) H0 In)luen+a and Strep0 Pneumonia In)ections L m%loidosis , is ssociated /ith Multiple M%eloma0

!enerali+ed L%mphadenopath% , is another Side E))ect o) Phen%toin8 /here it mi'ht present as a Lump in the Nec(0 Pol%c%stic 2*arian S%ndrome , is associated /ith Endometrial H%perplasia8 due to Unopposed E))ect o) Estro'en and Increased 3is( o) Endometrial Carcinoma0 Patients also ha*e a Hi'her 3is( o) De*elopin' $%pe II Diabetes Hemato'enous 2steom%elitis , /ill primaril% a))ect Metaph%sis o) the Eone8 due to 3ich -asculari+ation

-er% Lon' Chain 4att% cids , /hich Cannot Under'o Eeta 27idation8 is due to Pero7isomal bsence or De)ect8 /hich /ill lead to De)ects )rom Improper CNS M%elination Hal) Li)e , -d#0C&6CL0 9 Hal) Li)e is ><P8 : Hal) Li*es is C>P8 ; Hal) Li*es , DC0>P8 F Hal) Li*es , M;0C>P Sarcoidosis , /ill usuall% present in )rican mericans /ith Dr% Cou'h8 Pulmonar% In)iltrates and Hilar denopath%0 2n Eiops% it /ill be a Non Caseatin' !ranuloma MaGor SE o) Met)ormin , is Lactic Aidne%s and !I Upset0 cidosis8 /hich /ill dama'e the

nemia in SLE , is due to utoimmune Hemol%sis and /ill be due to )ormation o) I'! Warm ntibodies to 3ECs0 Which is characteri+ed b% Spheroc%tosis8 . Coombs $est8 and there /ill be $hromboc%topenia8 due to ntibodies a'ainst Platelets Een+odia+epines8 Earbiturates and lcohol , /ill Eind to ! E 3eceptor and Stimulate In)lu7 o) Chloride Ions into Neurons M%coplasma Pneumonia , can cause Hemol%sis8 due to similarit% bet/een nti'ens o) Cell Membrane o) M0 Pneumonia and Cell Membrane o) Er%throc%tes H%drocephalus E7 -acuo , there is a -entricular Enlar'ement in the Erain8 /hich is Due to troph% o) Cerebrum #Pic(s8 l+heimers&0 CS4 Pressure is Not Increased Common Peroneal #4ibular& Ner*e , is usuall% dama'ed /hen patients /ear a Cast and compress the head o) the 4ibula $a(a%asus and !iant Cell rteritis , are *er% similar in Mechanism0 $a(a%asus in*ol*es orta and its Eranches and it usuall% occurs in Patients Soun'er than F<0 I) Patients are older than F<8 /e presume it"s !iant Cell $emporal rteritis S(eletal Muscles are 3esistant to Calcium Channel Eloc(ers , because the% lar'el% Depend on Intracellular Calcium )or E7citation and Contraction Couplin'0 Where Smooth Muscle depends on E7tracellular Calcium PD!4 , is lar'el% secreted b% Smooth Muscle Cells and it /ill promote mi'ration to the ))ected Site o) In)lammation8 /ith Production o) Intimal $hic(enin' and Colla'en Deposition Palmar Er%thema , /ill be due to Cirrhotic H%perestrinism and it /ill also include !%necomastia8 $esticular troph%8 Spider Ne*i and Decreased Eod% Hair $NDs #$hia+olidinediones& , Ne/ !roup o) nti Diabetic Dru's8 Decrease Insulin 3esistance b% Eindin' to Pero7isome Proli)erator

cti*ated 3eceptor !amma8 /hich is a $ranscriptional 3e'ulator o) the !enes in*ol*ed in !lucose Metabolism Een+odia+epines , are 4irst Line in lcoholic Sei+ures8 because the% /ill Substitute lcohol E))ect on ! E 3eceptors denom%osis , presence o) Endometrial !lands in the Uterine M%ometrium8 and it /ill cause an Enlar'ement o) the Uterus /ith Eleedin'8 and Pain)ul Menses Endometriosis , presence o) Endometrial $issue 2utside o) the Uterus8 it /ill present /ith Pain)ul Menses8 D%spareunia8 but no Uterine Enlar'ement Cause o) Death in cute 3hematic 4e*er , in 3are Cases is M%ocarditis8 /here Mitral Stenosis ta(es %ears to )orm cute

denosine , is D2C in treatment o) Paro7%smal Supra*entricular $ach%cardia8 /here there are palpitations0 Side E))ects include 4lushin'8 Eurnin' in the Chest and Shortness o) Ereath Medullar% Spon'e Aidne% , is characteri+ed b% C%stic Dilatations o) Medullar% Collectin' Ducts0 Corte7 is spared0 Patients /ill present /ith Aidne% Stones and Hematuria0 Lidocaine , is *er% Speci)ic to Depolari+ed $issue such as Ischemic $issue0 $hat is /h% it"s a $reatment o) Choice in Post M%ocardial In)arction rrh%thmias D%splasia , is di))erent )rom Cancer8 because it"s 3e*ersible8 /here Cancer is not0 theroembolic Disease o) 3enal rteries , /ill present /ith 3enal 4ailure and Ei' $oe Discoloration in Elderl% Patients CE Le*els , in patients /ith Colon Cancer are usuall% used to Monitor $umor 3ecurrence Cr%ptococcus Neo)ormans , is the onl% 4un'us that has a Pol%saccharide Capsule8 that appears 3ed on Mucicarmin Stain and Clear Unstained None on India In( ;rd ortic rch , 'i*es rise to Common and Pro7imal Internal Carotid rteries0 Fth ortic rch , 'i*es rise to $rue Subcla*ian rteries ortic rch and portion o) rteries and Ductus

=th ortic rch , 'i*es rise to Pulmonar% rteriosus

MC , supplies Eroca"s and Wernic(e"s reas8 4rontal E%e 4ields8 4ace and rm reas o) Motor and Sensor% Corte7

Shi'a and Shi'a Li(e $o7in o) E0Coli , inacti*ated =<S Subunit o) the 3ibosome and thus inhibit Protein S%nthesis and E*entual Death 4ormation o) Eilliar% Slud'e , /ill be )ormed due to Incomplete Empt%in' o) !allbladder in 3esponse to CCA8 thus Eile /ill Precipitate Chloramphenicol , /ill cause plastic nemia8 it /ill bind to ><S Subunit and Inhibit Peptid%l $rans)erase En+%me Aallman"s S%ndrome , /ill present /ith Dela%ed Pubert% Plus nosmia8 /here there is a 4ailure o) !n3H Neurons to Mi'rate to 2l)actor% Placode and H%pothalamus0 Eo%s /ill be )eminine /ith Poorl% De*eloped Secondar% Se7ual Characteristics Intimal $ear , is the Initiatin' Process o) Dissectin' ne%urism ortic

Wea(ened -esicoureteral Lunction , /ill be due to 4re@uent Eladder In)ections and /ill 4acilitate 3e)lu7 Suppression o) C ? H%dro7%lase cti*it% , due to the dru's such as Clo)ibrate8 /ill reduce Solubili+ation o) Cholesterol into Eile and there /ill be E7cess Cholesterol De))icienc% o) Lipoprotein Lipase , /ill cause impaired $r%'l%ceride Clearance )rom Elood Stream0 Lipoprotein Lipase is secreted )rom Uniloculated dipoc%tes8 /hich are dipose $issue8 also b% S(eletal and Cardiac Muscle E))ect o) H%pothalamus on Prolactin , is Inhibitor% *ia Dopamine Production Senile Cardiac m%lidosis , is due to Depositon o) bnormall% 4olded #J Pleated Sheet& NP Deri*ed Proteins and is con)ined to Cardiac tria Women in Hemochromatosis , tend to not present until Menopause8 since Menstruations /ill be li(e Phlebotom%0 So Menopause8 the s%mptoms /ill (ic( in0 Neonates born to Hep E mothers , are at Hi'h 3is( o) Chronic Disease8 4ast HE- replication and Moderate Hepatic InGur% Mesothelioma , associated /ith sbestos E7posure8 it /ill present /ith Lon' Micro*illi and bundant $ono)ilaments8 /hich /ill di))er it )rom Eronchoal*eolar t%pe o) denocarcinoma8 /hich /ill present /ith Short Micro*illi )ter

$o pre*ent 3ecurrent Sei+ures , in patients /ith Status Epilepticus0 4irst Line o) $reatment is ddition o) Phen%toin to 3e'ular Een+odia+epine $herap%0 Corticosteroids , are the Stron'est and Most Predictable E))ects in patients /ith sthma Nitrates , mimic ction o) Endothelial Deri*ed 3ela7in' 4actor8 /hich /ill lead to Increased c!MP and M%osin Dephosphor%lation8 and 3educed Intracellular Calcium Isosorbide Mononitrate , is the most Eioa*ailable 2ral Nitrate0 Loss o) ! E Neurons in Striatum , is characteristic o) Huntin'ton due to Increased C ! 3epeats on Chromosome F cute calculous Cholec%stitis , is an cute In)lammation o) !allbladder /ithout )ormation o) Stones and it"s mostl% present in Hospitali+ed or Se*erel% ill Eth%lene !l%col In'estion , /ill lead to cute 3enal 4ailure /ith Precipitation o) 27alate Stones8 such as Calcium 27alate Cr%stals in Urine Partial Mole , has a $riploid Aar%ot%pe8 patient /ill present /ith -a'inal Eleedin' and Lo/er bdominal Pain $ertiar% S%philis , /ill present /ith Neuro In*ol*ement and !ummas0 $hat are Necroti+in' !ranulomas that appear on S(in8 Mucosa8 Subcutaneous $issue8 Eones and Within 2r'ans0 Similar to Chancre in Primar% S%philis Watershed reas , are Splenic 4le7ure and Distal Si'moid Colon8 are Most Susceptible to Ischemia Durin' H%potension and Lo/ Per)usion States Splenic H%pertroph% in P%ru*ate Ainase De))icienc% , is due to Increased Wor( to 3emo*e De)ormed Er%throc%tes )rom Circulation MacCon(e% 'ar , is used )or Man% Enteric Eacteria

$ha%er Martin -CN , is )or Neisseria Species #-ancom%cin8 Pol%m%7in and N%statin to remo*e all other bacteria& Elood 'ar , are used to distin'uish bet/een Enterococcal and NonEnterococcal In)ections0 Enterococcal such as E0 4aecalis and E0 4aecium /ill 'ro/ in both Eile Salts and =0>P H%pertonic Saline0 Where NonEnterococcal #Strep0 Eo*is& /ill 'ro/ in presence o) Eile Salts8 but Not =0> P Solution C%steine $ellurite 'ar , is )or Clostridium Diphtheria

Eordet !en'ou , is )or Eordetella Pertussis Primar% Eilliar% Cirrhosis , is due to utoimmune !ranulomatous Destruction o) Hepatic Eile Ducts and Cholestasis0 Side E))ects /ill include Pruritis8 /orse at Ni'ht0 !onococcal rhtritis , is a complication o) Neisseria !onorrhea8 and must be suspected in Se7uall% cti*e Soun' dults Slo/ cet%lators , are at increased ris( o) $o7icit% to certain dru's8 such as Isonia+id8 Dapsone8 H%drala+ine and Procainamide Imper)orate nus in an in)ant , ma% also be associated /ith abnormal de*elopment o) Urorectal8 Uro*esical and Uro*a'inal 4istulas Chronic 3eGection , mi'ht produce Chronic 2bstructi*e Lun' Disease and cause Eronchiolitis 2bliterans0 Patholo'% includes L%mphoc%tic In)lammation and Necrosis o) Eronchiolar Walls0 cute 3eGection , /ill present /ith Mononuclear In)iltration on Histolo'ical E7amination Eec("s $riad , o) H%potension8 L-D and Distal or Mu))led Heart Sounds is indicati*e o) $amponade Serine and $hreonine 3esidue Phosphor%lation , b% $%rosine Ainase can lead to Insulin 3esistance8 and can be caused b% $N4?8 Catecholamines8 !lucocorticoids and !luca'on Chronic S%stemic Use o) Steroids , /ill Promote 2steoporosis and cause -ertebral 4ractures8 b% Inhibitin' -itamin D and Promotin' P$H acti*it% naplastic $umors , bear no resemblance to the $issue o) 2ri'in Lacunar In)arcts , occur due to H%pertensi*e Easal !an'lia8 Pons and Internal Capsule rteriolosclerosis in

H%pertrophic Cardiom%opath% , ma% in*ol*e a mutation in Eeta M%osin Hea*% Chain and Cardiac Cell Sarcomere Protein #$roponin8 $ropom%osin& E7ternal Eranch o) Superior Lar%n'eal Ner*e , is susceptible to inGur% in patients under'oin' $h%roidectom%8 this ner*e inner*ates Cricoth%roid Muscle8 all other Muscles are inner*ated b% 3ecurrent Lar%n'eal Ner*e Intracranial Sch/annomas , are usuall% located in Cerebropontine n'le8 /hich is bet/een Pons and Cerebellum

2ctreotide , S%nthetic nalo' o) Somatostatin /ith a Lon' Hal) Li)e is used in Carcinoid S%ndrome0 Intrapartum ntibiotics , ma% be used to decrease Incidence o) !roup Eeta Strep Menin'itis in Ne/borns Disruption o) Macropha'e Pha'ol%sosomes , in Patients /ith Silicosis8 /ill ma(e them susceptible to In)ection /ith $E Neural $ube De)ects , are associated /ith Increased Le*els o) lpha 4etoprotein and cet%lcholinesterase Sei+ures Side E))ects , are usuall% seen in therap% /ith Eupropion8 Isonia+id and Imipenem $remor in patients , ma% be treated /ith nticholiner'ics8 such as Een+tropine8 but must be a*oided in patients /ith EPH and Closed n'le !laucoma Suspensor% Li'ament , must be occluded durin' Sur'er% to 3emo*e o*aries8 to reduce the ris( o) accidental li'ation o) Ureters Clonal $ Cell 3eceptor !ene 3earran'ement , is seen in Mali'nant L%mphadenopath% drenals , are the Most Common Site o) Metastases o) Lun' Cancers8 other sites include Eone8 Erain and contralateral Lun' Carotid Massa'e , /ill Increase 4irin' o) Earoreceptor 3ate thus Increasin' Paras%mpathetic Stimulation and thus Prolon' Node 3e)ractor% Period Crescent 4ormation , in Li'ht Microscop% is Dia'nostic o) 3P!N8 and there /ill be ccumulations o) 4ibrin8 Monoc%tes and Macropha'es $N4 ,? $herap% , is associated /ith 3eacti*ation o) Latent $uberculosis0 $hus PPD Screens are re@uired be)ore Initiatin' $herap%0 Dru's include #In)li7imab8 Etanercept& En*elope proteins 'pF9 , are 4usion Inhibitors that allo/ -irus to 4use /ith Membrane0 Dru's En)u*irtide are use)ul to pre*ent this 4usion !p9:< , is used )or -iral ttachment to CDF membrane on $ cells

pical Subpleural Elebs , /ill be seen in patients /ith Spontaneous Pneumothora7

Mi)epristone , is Pro'esterone nta'onist and is borti)icent8 Misoprostol is Prosta'landin nalo'8 that /ill cause Uterine Contractions and is used in combination /ith Mi)epristone Disseminated Histoplasmosis , is associated /ith Hepatosplenome'al% in Immunosuppressed Patients Pruritis , is usuall% a 4irst S%mptom o) Primar% Eilliar% Cirrhosis8 /here there are antibodies a'ainst Hepatic Eile Ducts and /ill cause Cholestasis Neisseria Menin'itis , /ill proceed )rom Phar%n7 into Elood8 then Choroid Ple7us and then Menin'es0 Where H0 In)luen+a /ill 'o )rom Phar%n7 to L%mphatics and then to Menin'es H%per I'M S%ndrome , /ill present /ith inabilit% o) E L%mphoc%tes to Under'o Isot%pe S/itchin'8 and /ill present /ith L%mphoid H%perplasia and 3ecurrent Sinus In)ections0 Most commonl% it"s due to absence o) CD F< Li'and on E L%mphoc%tes 4ibrom%al'ia , usuall% a))ects /omen o) :<->< and presents /ith Di))use Musculos(eletal Pain /ith pain in the Spine o) Scapula8 Lateral Epicond%le8 Medial 4at Pad in the Anees and pain associated /ith E7ercisin' $amo7i)en , in Ereast $issue is nti Estro'enic E))ect and H%perestro'enic E))ect in Endometrial $issue8 thus increasin' the 3is( o) Endometrial Cancers8 Pol%ps and H%perplasia Patients on Le*odopa , should not be ta(in' -itamin E= Supplements due to Increase Metabolism o) Le*odopa caused b% -itamin E = Hepatic n'iosarcoma - is associated /ith E7posure to rsenic8 Pol%*in%l Chloride and /ill e7press CD ;9 $umor Mar(ers $uberoin)undibular Dopaminer'ic Path/a% , is associated /ith connectin' H%pothalamus to Pituitar% and responsible )or Dopamine Inhibition o) Prolactin Sucrose , is a combination o) !lucose and 4ructose0 Lactose , is !alactose and !lucose Maltose , is !lucose and !lucose Corneal 3e)le7 , is associated /ith Nasocilliar% Eranch o) - 9 Ner*e0 Motor Component is due to 4acial Ner*e $emporal Eranch Con*ersion o) $%rosine to D2P H%dro7%lase , re@uires en+%me $%rosine

D2P

to Dopamine , Dopamine Decarbo7%lase

Dopamine to Norepinephrine , Dopamine Eeta H%dro7%lase Norepinephrine to Epinephrine , re@uire PNM$ #Phen%lethanolamine ,N- Meth%l$rans)erase& and Cortisol Increases $ranscription o) this En+%me Presence o) LeGunal Ulcers , is Hi'hl% Indicati*e o) !astrinoma8 there /ill also be Diarrhea and bdominal Pain 3espirator% cidosis , /ill be seen in patients /ith Heroin 2*erdose0 Eicarcbonate Le*els /ill be Lo/8 because it /ill ta(e :F hours )or Eicarb Le*els to Compensate Sudden Standin' or -alsal*a Maneu*ers , /ill increase Intensit% o) Murmurs in patients /ith H%pertrophic Cardiom%opath% I!4-9 o) the Li*er , is responsible )or !ro/th Hormone E))ect in Human !ro/th I!4 -9 )rom H%pothalamus , is not 3esponsible )or the !ro/th8 but more )or CNS cti*it% (athisia , usuall% present as )eelin' on the Ed'e8 3estlessness8 3estless Le' S%ndrome Side E))ects o) Protease Inhibitors , are usuall% associated /ith H%per'l%cemia8 Lipod%stroph% #Eu))alo Hump etc& and Inhibition o) pF>< Main Side E))ect o) Cholest%ramine , are !I Upset8 Increased $ri'l%ceridemia and Impaired bsorption o) Nutrients and Dru's End Sta'e 3enal Disease , /ill be associated /ith 2steitis 4ibrosa C%stica8 /ith 3etention o) Phosphorus8 Loss o) Calcium and cti*ation o) :ndar% H%perparath%roidism Dense Pi'ment containin' Epinephrine Metabolites , is seen in the L%sosomes o) the Li*er in patients /ith Dubin Lohnson S%ndrome Silicosis , /ill present /ith E'' Shell Calci)ication o) Lun' Hilar Nodes and Eire)rin'ent Particles Surrounded b% Colla'en 4ibers Eerilliosis , ma% present /ith Non Caseatin' !ranulomas Hamartomas , are the most common Eeni'n Lun' tumors composed o) Colla'en8 4ibrous and dipose $issue Small Cell Lun' Carcinoma , is usuall% associated /ith Neuroendocrine Mar(ers and /ill present in the Center o) the Lun' usuall% in Smo(ers

CE Inhibitors , can cause an Increase in Creatinine and Decrease in H%drostatic Pressure and Decreased 3enal Per)usion cute ppendicitis , is usuall% due to 2bstruction o) L%mph 4lo/ o) 4ecalith0 Eacterial In)ection /ill be a patho'enesis o) 2bstructed ppendi70 Positi*e Aussmaul Si'n , /ill be seen in Patients /ith Chronic Constricti*e Pericarditis0 Mids%stolic Clic( , is usuall% seen in Patients /ith Mitral -al*e Prolapse Immunocompromised Patients /ith R:<< CDF Count , /ill ha*e Strep0 Pneumonia as a cause o) their Lun' In)ections Incidence o) S@uamous Cell Carcinoma , and Esopha'eal denocarcinoma are no/ E@ual Smo(in' , is the most Important 3is( 4actor )or Pancreatic Cancer0 Diabetes8 Chronic Pancreatitis and 'e R>< are Stron' 3is( 4actors as /ell Datin' Error , /here the e7pectance Date /as miscalculated8 mi'ht be the most Important 3eason )or Increase in lpha 4etoprotein Di'o7in , /ill decrease - Nodal Conduction8 b% Increasin' Paras%mpathetic $one o) the Cardiac Muscle Pancreatic Pseudoc%st , is a most common complication o) cute Pancreatitis8 and is composed o) !ranulation $issue and 4ibrosis Lan'erhan Cells , present in Histioc%tosis ha*e a $ennis 3ac@uet Shape Intrac%toplasmic !ranules and are called Eirbect !ranules L A6S$ $ Si'nalin' Path/a% , is used b% Colon% Stimulatin' 4actors8 !ro/th Hormones and C%to(ines associated /ith $%rosine Ainase 3eceptors C%steine , becomes an Essential mino cid in patients /ith Homoc%stinuria8 /here there is a de)ect o) C%stathione S%nthetase and accumulation' o) Methionine therosclerotic Pla@ues /ith more C>P 2cclusion , are a cause o) Stable n'ina0 Where pla@ues that occlude less than C>P o) the Coronar% -essel /ill be s%mptomatic0 Ulcerated Pla@ue , /ith partiall% obstructi*e thrombosis is associated /ith Unstable n'ina or Subendocardial In)arction0

3uptured Pla@ue , is associated /ith $ransmural In)arction /ith a 4ull 2bstructi*e $hrombus 4riedrich"s ta7ia , is associated /ith De'eneration o) Spinocerebellar $racts8 A%phoscoliosis8 4oot bnormalities #Hi'h rch&8 H%pertrophic Cardiom%opath% and Increased 3is( o) Diabetes Mellitus Cle)t Lip , is associated /ith Impaired 4usion o) Ma7illar% Prominence and Medial Nasal Processes Cle)t Palate , is due to incomplete 4usion o) Palatine Shel*es o) Ma7illar% Prominences Spinal Scoliosis , is usuall% seen in Mar)an"s S%ndrome Coccioidis Immitis , presents as 4lu Li(e S%mptoms8 Cou'h and Er%thema Nodosum0 Will Ha*e $hic( Walled Spherules /ith Endospores Histoplasma Capsulatum , /ill present /ith Pulmonar% S%mptoms similar to $E8 and has 2*al Seast Within the Macropha'es #)ound in ca*es8 in)ested /ith bats& Elastom%cis , Lar'e 3ound Seast /ith Eroad Eased Eud8 presents /ith Pulmonar% Pneumonia Caspo)un'in , /hich are Echinocandins8 Inhibit S%nthesis o) Pol%saccharide !lucan and used as nti 4un'al0 Wilson"s Disease , /ill a))ect de'eneration o) Putamen as /ell as Dama'e to Easal !an'lia0 M P Ainase , si'nal path/a% includes 3 S Protein /hich is a ! Protein Colon denocarcinoma in UC Patients , /ill present in ;<s and /ill be Uni)orml% Spread out0 Unli(e Sporadic8 that arise in patients in =<s and more locali+ed to the Le)t Side0 Carcinoid S%ndrome , /hen Locali+ed to Intestine8 it"s products /ill be Metaboli+ed b% the Li*er and Patients /ill not ha*e S%mptoms0 When it"s Metastasi+ed to the Li*er8 then Secretor% Products are Not De'raded and Patients Will E7perience S%mptoms0 Carcinoid $umors , arise )rom Chroma))in Cells o) the Intestine8 ha*e Eosinophilic C%toplasm and 2*al Shaped Nuclei F Sta'es o) Lobar Pneumonia B 9& Con'estion #)irst :F hours& , -ascular Dilatation8 l*eolar E7udate Contains Mostl% Eacteria :& 3ed Hepati+ation #:-; Da%s& l*eolar E7udate , Er%throc%tes8

Neutrophils and 4ibrin ;& !re% Hepati+ation #F-= Da%s& No 3ECs8 mostl% Neutrophils and 4ibrin Pol%arteritis Nodosa , /ill present /ith 4ibrinoid Necrosis /ith $ransmural In)lammation o) rterioles8 )e*er8 malaise8 melena0 ssociated /ith Hep0 E In)ection lpha 9 ntitr%psin De))icienc% , presents /ith red-pin( P S !ranules o) Unsecreted 9 $ in Periportal Hepatoc%tes Hepatic bscess , /ill present /ith 4luid 4illed Ca*it% in the Li*er8 usuall% due to Staph ureus8 due to Hemato'enous Spread0 Where Entamoeba H%stol%tica /ill ha*e erobic and Non erobic Eacteria containin' bscess Hemosiderin Laden Macropha'es , are usuall% due to Ele*ated Pulmonar% Pressure8 secondar% to Le)t Sided Heart 4ailure Paraneoplastic Cerebellar De'eneration , is an utoimmune Process and presents /ith Limb and $runcal ta7ia8 D%sarthria0 2ccurs in patients /ith 2*arian8 Small Cell Carcinoma o) the Lun'8 Ereast and Uterine Cancers0 Space Constant , ho/ )ar alon' an a7on si'nal /ill tra*el is Decreased in patients /ith Multiple Sclerosis Class S/itchin' )or I'E , is due to IL-F and IL-9; produced b% $H: cells0 IL-> , is responsible )or Eosinophilia and Class S/itchin' and S%nthesis o) I' Central 3etinal rter% 2cclusion , presents /ith Painless8 Permanent Monocular Elindness and /ill ha*e Cherr% Macula Patients /ith Essential 4ructosuria , Metabolism o) 4ructose b% He7o(inase to 4ructose = Phosphate is primar% methode o) Metaboli+in' Dietar% 4ructose Carbamo%l Phosphate S%nthase and N- cet%l'lutamate S%nthetase , ha*e increased le*els o) mmonia and Neurolo'ical De)ects0 M%coplasma Pneumonia , /ill re@uire Cholesterol to 'ro/ on rti)icial Media8 due to Sin'le La%er o) Cholesterol Phospholipid Eila%er0 $he% Completel% Lac( Peptido'l%can Cell Wall8 En*elope or Capsule0 Usuall% seen amon' Militar% 3ecruits 2ptic Ner*e Dama'e , /ill cause neither pupil to react to Li'ht8 but /hen Li'ht is shined into an opposite e%e8 both e%es /ill Constrict due to Intact Motor 4unction

2cclusion o) 3i'ht Coronar% rter% , /ill result in $ransmural Ischemia o) Le)t -entricle8 producin' S$ Ele*ation in Leads II8 III and a*4 2cclusion o) L D , /ill result in /ith S$ Ele*ation in -9--F nteroseptal $ransmural Ischemia

2cclusion o) Le)t Circum)le7 , /ill result in $ransmural Ischemia o) Lateral Wall o) Le)t -entricle and S$ Ele*ation in -> and -= Combination o) Statins and 4ibrates , increases the 3is( o) M%opath% and Hepatoto7icit% Combination o) 4ibrates and Eile cid 3esins , /ill result in Increased 3is( o) Cholesterol Stones8 due to Increased Cholesterol in Eile Neuron Speci)ic Enolase8 Chromo'ranin , alon' /ith S%napthoph%sin are Neuroendocrine Mar(ers in Patients /ith Small Cell Carcinoma8 /hich is located Centrall% in Smo(ers0 Meniere"s Disease , characteri+ed b% $riad o) $innitus8 -erti'o and Sensorineural Hearin' Loss0 Due to Increased Pressure and -olume o) Endol%mph in -estibular pparatus ? ; chain o) $%pe I- Colla'en , is tar'eted b% anti-'lomerular basement membrane antibodies in !oodpasture"s S%ndrome Dru' Induced Nephritis , due to NS IDS /ill predominantl% a))ect Interstitium8 lea*in' !lomeruli Intact0 Eeta Endorphin and C$H , are deri*ed )rom the same 2ri'in0 Eeta Endorphin has Increased ))init% to Delta and Mu 3eceptors0 Pulsion Di*erticulitis , is usuall% seen in 2lder Patients due to Increased Pressure8 and /ill a))ect primaril% Si'moid Colon0 Li 4raumeni S%ndrome , utosomal Dominant S%ndrome8 due to Mutation o) p>; !ene and /ill cause Ereast8 Erain and drenal Corte7 Sarcomas and $umors mainl%0 Niacin , potentiates the e))ects o) nti H%pertensi*e Medications and Decrease the E))ect o) Diabetic Medications0 Eplerenone and Spironolactone , are ldosterone a usual $herap% )or Conn"s S%ndrome nta'onists are

Portal -ein $hrombosis , /ill present /ith Normal Li*er8 because the De)ect is Distal to the Li*er8 /ill cause Portal H%pertension /ithout a))ectin' the Li*er0

Pic("s Disease , is pronounced /ith 4rontal Lobe troph%8 and patients present /ith Dementia8 Mood Disturbance and Speech Di))iculties Estro'en and Pro'esterone in Pre'nanc% , Estro'en /ill cause Increased Cholesterol S%nthesis b% Upre'ulatin' HM! Co 3eductase and Pro'esterone /ill reduce Eile cid Secretion and Slo/ !allbladder Empt%in' Mudd% Ero/n !ranular Casts , are seen in Ischemic $ubular Necrosis in hospitali+ed patients0 Papillar% Necrosis , occurs in patients /ith Sic(le Cell8 Diabetes Mellitus8 nal'esic Nephropath% and 2bstructi*e P%elonphritis0 H%persensiti*it% to Intradermal InGections o) $obacco , are seen in Euer'er"s Disease8 /hich is $hromboan'itis 2bliterans amon' Hea*% Smo(ers0 2penin' Snap , is an abrupt 2penin' o) Stenosed Mitral -al*e0 -illous denomas , are more li(el% to under'o Mali'nant $rans)ormation8 unli(e $ubular denomas mi)ostine , thiol based c%toprotecti*e )ree radical sca*en'er used in patient on Cisplatin8 to pre*ent nephroto7icit%0

**Credits to Duncan

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