home page                     points to add to your first aid step 1

by Coptic Sabry

 micro ,pathology ,most common [ these points are not in first aid 2002 and may be added in 2004 edition ,very useful if you added them to your book ] good luck


step 1 micro

1-Legionella infection can be diagnosed using the following
laboratory tests:Specific detection with fluorescein-labeled
antibodies

2-In the diagnosis of Whooping Cough, Bordetella pertussis is most
likely isolated from:a nasopharyngeal swab

3-The pathological hallmark of Legionnaire's disease is:an intra-
alveolar exudate of leukocytes and macrophages

4-Why has there been a re-emergence of whooping cough in this, and
other countries?Some children are not being vaccinated.

5-Inhalation of infected amoebae and ciliated protozoa has led to
outbreaks of:Legionnaire's disease.

6-From the organisms listed below, which one is the MOST frequent
colonizer of endoscopes, respirators and other hospital equipment?
Pseudomonas aeruginosa


1-The following microorganism is Gram-variable (resists
decoloration).Gardnerella

2-A Gram stain prepared from an inoculum of S. aureus is
overdecolorized. After the completion of the Gram stain procedure,
the resulting smear will show:red cocci in clusters

3-The Beta-lactamase test is not needed for:Streptococcus pyogenes

4-The most common source of errors during the Gram stain
procedure:Overdecolorizing with alcohol

5-The typical incubation time needed for colonies of most aerobic and
facultative bacteria to appear on agar plates is:24 hours.

6-The detection of the ك-lactamase enzyme is primarily valuable in
infections caused by:Hemophilus influenzae

7-A Kirby-Bauer susceptibility test, and a beta-lactamase detection
test are indicated if an organism isolated from an infected wound
turns out to be:Staphylococcus aureus.

8-A positive chromogenic Cefinase test indicates: production of beta-
lactamase.
resistance to Penicillin G.
resistance to Ampicillin.
resistance to Carbenicillin

===

1-The CAMP test is used for the identification of:Streptococcus
agalactiae

2-Which of the following organisms, when isolated in the blood,
requires the synergistic activity of penicillin plus an
aminoglycoside for appropriate therapy?Enterococcus faecalis

3-Which of the following organisms must be treated with combination
therapy (most commonly a cell-wall active antibiotic and an
aminoglycoside) when isolated in multiple blood
cultures:Streptococcus bovis

====

1-Which of the following factors is NOT important for establishment
of meningococcal disease due to Neisseria meningitidis?the production
of siderophores for iron scavenging.

2-Diagnosis of gonorrhea in women relies on:culture of vaginal
exudate on Thayer-Martin media.

3-For Neisseria, generation of variant pilin forms naturally occurs
by:intragenic recombination

4-The human host has difficulty producing humoral antibodies that are
effective against certain antigenic determinants of Neisseria. This
is due to the organism's property of:antigenic variation

5-The serogroup of Neisseria meningitidis most often associated with
epidemics:A

6-Host immunity to Neisseria meningitidis infection is:mediated
primarily by bacteriocidal antibodies

7-For Neisseria, generation of variant pilin forms occurs naturally
by:recombination.

8-The method of choice for identification of Neisseria isolated from
mucosal surfaces other than the conjunctiva and the male urethra
is:culture isolation

9-The same beta-lactamase found in N. gonorrhoeae (gonococci) has
also been found in:E. coli


===

1-Among the Sunday night patients at the Smithville emergency room
were ten young adults suffering from severe diarrhea. All of these
individuals would normally characterize themselves as being in good
health. All reported eating at a local Dairy fair during the weekend.
Of the following bacterial species the least likely to be responsible
is:Shigella flexneri

2-Which of the following tests would not differentiate Vibrio
cholerae non-O1 from Vibrio parahaemolyticus:oxidase activity

3-What is the most common outcome of infection with Helicobacter
pylori?No clinical manifestations

4-Healthy adult travelers visiting Peru are cautioned against eating
uncooked vegetables and unpeeled fruits, and against drinking
unbottled water. However, they are already resistant to cholera
because of:a gastric barrier, due to stomach acids.

5-The microbiologist is aware that the gastroenteritis outbreak is
associated with the consumption of raw seafood at a local restaurant.
She considers it may be due to a number of vibrios EXCEPT:V.
alginolyticus

6-Campylobacter jejuni gastroenteritis is associated with consumption
of contaminated water or foods which include the following :
milk.
chicken
hamburger.

7-Which of the following is true about Helicobacter pylori :Damage to
the patient's gastric mucosa has been primarily caused by the
patient's own immune response.

8-Which of the following is not true about the bacterium classified
as Vibrio cholerae O antigen group 1 (V. cholerae O1)?It invades the
small intestine

9-Only recently have Campylobacter and Helicobacter been identified
as the causative agents for certain infections. This is because the
clinical laboratories now routinely test for organisms
with:microaerophilic nature.


===

1-14 year old girl gradually became somnolent ,then coma ensued.she
was dehydrated,with rapid respiration and low bicarbonate level with
significant anion gap......diabetic ketoacidosis.

2-35 year old female with history of rheumatoid arthritis suspected
to have reactive systemic amyloidodsis.what is the most probably
affected organ and preferred site for biopsy?the kidney.the sites are
rectal mucosa,gingiva or abdominal pad of fat.

3-32 year old athelete presented with jaundice.no previous liver
disease.investigation showed elevated alkalive phsophatase,no viral
infection and no stones.what is ur presumptive diagnsis and possible
cause?cholestatic jaundice due to methyl testosterone administration.

4-12 year old girl lives in Brazil presented with congestiveheart
failure.examination revealed conjunctival edema,exophthalmos,and
periauricular lymph nodes.what is ur presumptive diagnosis ?chagas
disease

5-6- month infant died with congestive heart failure.no anomalies
detected at birth,no serious infections occured.what is the most
probable genetic disease?pompe disease due to alpha 1,4 glucosidase
diffiency.

6-55 year old man,heavy smoker presented with cough,scanty
nonpurulent sputum,influenza-like symptoms and diarrhea.sputum
culture reavealed a lot of neutrophils,but no organisms.what is the
possible disease?Legionnaire's

7-the mother noticed that the diaper of her baby stained pink.what is
the possible organism and mechanism?UTI caused by serratia which is
lactose fermenter.

8-35 year old woman had an attack of billiary colic.which analgesic
is contraindicated and why?morhine increase intrabilliary pressure
which worsens the pain.

9-the doctor instructs his tuberculous patient to read fine newspaper
print every day as a self exam.what is the drug the patients is
receiving?ethambutol may cause optic neuritis.

10-a pregnant woman presented with symptoms diagnosed as malaria.what
is the appropriate treatment?chloroquine..premaquine is
contraindicated.


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THE MOST COMMON

1-AMI in children:kawasaki

2-aneyrysm in circle of willis:ACA=anterior communicating artery

3-tumor of esophagus:leimyoma

4-tumor of placenta:cavernous hemangioma

5-tumor of spleen:cavernous hemangioma

6-carpal bone dislocation:lunate

7-carpal bone fracture:scaphoid

8-congenital GI anomaly:meckle's

9-death in alzheimer:pneumonia

10-disc herniation:L4-L5

11-hypertension in young woman:OCPs

12-single gene disorder:thalassemia

13-heart problem with AIDS:Pericarditis

14-location of GI TB:ileocecal valve

15-site of breast cacer:upper lateral quadrant =60%

16-supratentorial tumor in children:craniopharyngioma

17-cause of hypopituitarism in children:craniopharyngioma

18-site injured in rejected liver:bile ducts

19-brain tumor in age less than 2:choroid plexus papilloma

20-meningitis in renal transplants:listeria


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pathology

these words gathered from different readings including question
books.picky words were avoided as possible.

1-intracerebral hemorrhage:hypertension

2-subarachnoid hemorrhage:berry aneurysm.

3-charcot-Butchard aneurysm:hypertension.

4-spongiosis(brain):kuru and creutzfeldt.

5-MPTP toxicity:parkinson's.

6-autophagic granules:atrophy

7-hookworm:iron deffieciency anemia.

8-fish tape worm:megaloblastic anemia.

9-black liver:Dubin-Johnson syndrome.

10-dissecting aneurysm:hypertension,medial necrosis,marfan syndrome.

11-anti-scl 70:scleroderma.

12-anti-ss-B,A:sjogren syndrome.

13-anti-nRNP:mixed connective tissue disease.

14-acanthosis nigricans:viceral malignancy.

15-acute leukemia:alkylating agents,benzene.

17-alopecia:hypervitaminosis A,cancer
chemoptherapy,ethionimide,heparin,OCP withdrawal.

18-bitter almond scented breath:cyanide poisoning.

19-bacilliary angiomatosis:Bartonella henselae.

20-bite cells:G6PD defieciency

21-ballerina skirt apperance :infectious mononucleosis.

22-angular atrophy:disuse atrophy.

23-cannon ball secondary deposits:renal cell carcinoma.

24-cobblestone appearance:crohn's.

25-Brodie's abcess:osteomyelitis.

26-blepharoblasts:ependymoma.

27-cytoid bodies:SLE

28-cancer suppressor genes:wt-1,p53,NF-1,APC,DCC.

29-cherry red skin:carbon monoxide poisoning and cyanide poisoning.

30-clonorchis sinensis:cholangiosarcoma.

31-chemotactics:bacterial products,LTB4,C5a,IL-8

32-coproporphyrin increased in urine:lead poisoning.

33-calcium oxalate crystals in kidney:ethylene glycol poisoning.

34-chloroma:AML

35-central hepatic necrosis:chronic passive congestion.

36-bull's eye lesion:LYME disease.

37-bull's necl lymphadenopathy involving cervical L.N:diphtheria.

38-christmas tree pattern skin lesion:pityriasis rosea.

39-claw hand:scleroderma,lower trunk injury(c8,T1),cervical rib.

40-black urine:alkaptunuria.

41-elongated granules:=premelanosomes:melanoma.

42-dense core neurosecretory granules:carcinoid.

43-tonofilaments:SCC

44-changing cardiac murmers:atrial myxoma.

45-cells stained metachromatically:mast cells.

46-cells involved in type 1 and 4 reactions:basophils.

47-guarnieri bodies:smallpox.

48-foot and wrist drop:lead posoning.

49-garlic scented breath:acute arsenic poisoning.

50-fried egg appearance:oligodendroglioma,multiple myeloma.

51-Herald patch:pityriasis rosea.

52-ecthyma gangrenosum:psudomonas

53-Dutcher bodies:waldenstrom macroglobulinemia.

54-currant jelly stool:intussuception.

55-Downey cells:infectious mononucleosis.

56-echinocytes:artefact or uremia.

57-electron dense humps:PSGN.

58-hematoxylin bodies:SLE.

59-criss-cross fibrillary pattern:renal amyloidosis.

60-glitter cells:pyelonephritis.

61-Hirano bodies:Alzheimer's

62-desmoplasia:breast,pancreas ,prostate.

63-HER-2/neu oncogene:breast cancer.

64-fat embolus:fracture..pulmonary stress..petichia..neurologic
manifestations.

65-gas embolus:penetrating chest injury,criminal abortion,caisson's
disease.

66-hairy leukoplakia:EBV-associated in AIDS.

67-gray hepatization:pneumonia 4-5 days(untreated)

68-farmer's lung:hypersensitivity to actinomycetes in mold hay.

69-focal hepatic necrosis:typhoid fever.

70-diffuse hepatic
necrosis:acetaminophen,INH,halothane,phosphrus,CCL4,leptospirosis,

hepatitis viruses.

72-adenocarcinoma of the kidney:PCT origin

73-HSV encephalitis:temporal and frontal lobes.

74-gum hyperplasia:phenytoin,pregnancy,scurvy,acute monocytic
leukemia.

75-colorectal cancer:left side obstructs,right side bleeds.

76-cigar shaped budding yeast:sporothrix schenkii

77-H-shaped vertebrae:sickle cell anemia.

78-hypocalcemic tumor:medullary thyroid cancer.

79-hypoglycemic tumor:hepatoma,mesothelioma.

80-double barrel aorta on x ray:dissection.

81-flask shaped ulcer:entameba histolytuca.

82-hemorrhgic urticaria:henoch-schonlein.

83-Grave's disease:type 2 hypersensitivity(IgG)

84-Hashimoto's:type 4 hypersensitivity

hutchinson teeth:congenital syphilis

85-low fixed specific gravity:Chronic renal failure

86-HPV 6,11:Chondyloma acuminatum.

87-HPV 16,18:cacer cervix,vulva.

88-lung cancer:cigarettes,nickel,chromium,uranium.

89-liver cancer:aflatoxin B1,alcohol,polyvinylchloride.

90-fever mediators:IL-1,IL-6,TNF-A,prostaglandins.

91-pain mediators:bradykinin,PGE2.

92-loss of eye brows:myxedema,2ry syphilis,lepromatous leprosy.

93-lacunar cells:Hodgkin disease,nodular sclerosis type.

94-leukocytosis:colony stimulating factor.

95-IUD infection:actinomyces.

96-HLA-DR2,DR-3:SLE.

97-HLA-A3:primary hemochromatosis.

98-HLA-BW47:21 hydroxylase defieciency.

99-HLA-DR4:RA

100-HLA-B8:myathenia gravis

101-HIAA:carcinoid syndrome

102-calcitonin:meduallary thyroid cancer.

103-CA-19-9:pancreatic cancer

104-CA-15-3:breast cancer.

105-placental alkaline phosphatase(PLAP):seminoma.

106-infantile cataract:rubella,galactosemia

107-lead pipe sign on x ray:UC

108-Lemon yellow skin colour:pernicious anemia.

109-olivein abdomen:congenital pyloric stenosis

110-pill rolling tremor:parkinson

111-pink eye:adenovirus

112-red diaper:serratia

113-shield chest:wide spaced nipples inTurner's

114-malabsorption:pernicious anemia,crohn's,blind loop syndrome,fish
tape worm.

115-Mee's lines:chronic arsenic poisoning.

116-mulberry molars:congenital syphilis

117-Munro's abcesses:psoriasis

118-onion skin apprance:Ewing's sarcoma

119-multinucleated giant cells:neonatal hepatitis,Hodgkin's
disease,granulomatous inflammtion.

120-necrotizing papillitis:phenacitin,DM

121-osteophytes:osteoarthrosis.

122-pappenheimer bodies:after splenectomy.

123-PAS positive macrophages:whiple's disease.

124-peri-neural spread:adenocystic parotid cancer,pancreatic cancer.

125-n-myc amplification:neuroblastoma

126-paradoxical embolus:ASD,pataent foramen ovale

127-polygonal clear cells:RCC

128-morulae in cytoplasm:ehrlichiosis.

129-plasmacytoid lymphocyes:Waldenstrom's

130-red hepatization:pneumonia 1-3 days

131-midzonal hepatic necrosis:yellow fever.

132-slit-like vascular spaces:kaposi sarcoma

133-N-formyl methionine:chemotactic factor

134-myofiber disarray:hypertrophic cardiomyopathy

135-Leser-Trelat sign:seborrhic keratosis,acanthosis nigricans or
amyloidosis in patients with GIT malignancy

136-peripheral hepatic necrosis:eclampsia,phosphrus poisoning.

137-ochronosis:alkaptonuria

138-melanosis coli:laxatives abuse

139-micrognathia:DIGEORGE SYNDROME

140-musty odor:PKU

141-Night pain relieved by aspirin:osteoid osteoma

142oligonal band:multiple sclerosis.

143-negative NBT test=nitroblue tetrazolium-yellow color:chronic
granulomatous disease.

144-pseudomyxoma peritonii:mucinous cystadenoma of the ovary,mucocele
of appendix.

145-punctum:sebacious cyst

146-rodent ulcer:BCC

147-palisade arrangement nuclei:BCC

148-RCC:early blood spread

149-rb gene inactivation:retionoblastoma

150-saddle embolus:pulmonary artery bifurcation

151-red currant jelly sputum:bronchogenic carcinoma,klebsiell a
pneumonia

152-sabre tibia:congenital syphilis

153-saddle nose:congenital syphilis.lepromatous leprosy

154-Rokitansky Aschoff sinuses:chronic cglecystitis

155-schistocytes:TTP

156-Smoky brown urine:nephritic syndrome

157-pulmonary scars:irregular emphysema,adenocarcinoma.

158-rectangular RBCs:HbSc

159-perifollicular hemorrage:vit C defficeincy

160-snow storm appearance on pelvix x ray:hydatiform mole

161-strawberry gallbladder:cholesterolosis

162-thumb print sign on barium enema:ischemic bowel

163-wrist drop:radial nerve damage;fall onshoulder,birth injury

164-ship builders:asbestosis

165-dry cleaning:CCL4

166-Zaire:ebola,marbug viruses

167-wood workers:Hodgkn's disease

167-sand blasters:silicosis

168-Ashkenazi jews:TAY-saches,Gaucher's,factor 13

169-agent orange:Hodgkins,NHL

170-ACID FAST intranuclear inclusion bodies in the kidney:lead
poisoning

171-anoxic nephrosis:DCT

172-Acetophenitiodin:Toxic nephrosis

173-bilateral breast cancer:lobular carcinoma

174-bladder trabeculation:BPH

175-central nuclei in muscles:dystrophy

176-crushed ping pong ball or flying saucers:PCP

177-CYSTATHININE synthase defficiency:homocystinuria

178-dew drop on rose petals:chickenpox

179-diaphragmatic pleural plaques:asbestosis

180-gray discolouration of skin:argyria=silver poisoning

181-aseptic necrosis:the bends,sickle cell anemia

182-bat wing appearance on x ray:pulmonary edema

183-black eschars:=malignat pustules:cutaneous anthrax

184-BRCA 1:70% RISK of medullary breast cancer

185-thiamine defieciency:wenicke-korsakoff syndrome

186-split basement membrane:Alport's syndrome

187-spongiosis(skin):acute eczema

188-acanthosis:chronic eczema,psoriasis

189-acantholysis:pemphigus vulgaris

190-spindle shaped cells:spitz nevus

191-target fibres:denervation atrophy

192-swan neck:RA

193-tartarate resistant acid phosphatase:hairy cell leukemia

194-t(15:17):acute promyelocytic leukemia

195-silo-filler's lung:nitrogen dioxide from nitrates in corn.

196-toxic nephrosis:PCT

197-t(11:22):Ewing sarcoma

199-thymidine dimers:xeroderma pigmentosa

200-TSI MORE THAN TGI:GRAVE'S

201-TGI MORE THAN TSI:HASHIMOTO'S

202-WINGED scapula;long thoracicnerve damage(c5,6,7),common with
radical mastectomy

203-target lesion=iris lesion:erythema multiform

204-z-bands:rhabdomyosarcoma

205-wacky,wet ,wobbly:normal pressure hydrocephalus

206-type 1 DM:type 4 hypersensitivity

207-type 2 DM:type 2 hypersensitivity

208-opsonins:fc portion of igG,c3b,collectins.

209-hyalinized affrent arteriole:hypertension

210:hyaloinized affternt and efferent arterioles:DM

211-vit b6 deffiency:alcoholism,anemia(b6 responsive),anti-TB
(INH),homocystinuria.

212:wilm's tumor:metanephrogenic blastema origin

213-xeroderma pigmentosum:scc,bcc

214-venous stasis:immobilization,CHF,polycythemia,sickle cell
anemia,viceral malignacy ,OCP

215-zebra bodies:NIEMAN PICK DISEASE

216-apple core lesion:left sided colon cancer

217-proximal myopathy:Duchenne,polymyositis,dermatomyosistis,Eaton-
Lambert syndrome.

218-rickets:craniotabes,HARRISON GROOVE,PIGEON CHEST

219-JOINT MICE:osteoarthritis

220-anti-calcium channel antibodies:EATON-LAMBERT SYNDROME.


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LEPROSY REACTION

Occurs as a result of anti-leprosy treatment

type 1 reactions:
1-occurs with borderline types(BT,BB,BL)
2-neuritis,skin swelling and edema.
3-delayed heyersensitivity.
4-treat with prednisone or clofazimine, but dont stop treatment

type 2 reactions:=erythema nodusum leprosum.
1-occurs with BL AND LL.
2-painful nodualr rash and fever.
3-also neuritis,orchitis,arthritis and lymphadenopathy.
4-immune complex mediated.
5-treat with prednisone and clofazimine,but drug of choice is
thalidomide.




 

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