NBME 16 Block 1 and 2 (Answered) Verified
Solution
Lab values in Sarcoidosis
1.Elevated ACE levels- from granuloma
2.Elevated CD4/CD8 counts in BAL.
3.High Calcium
4.HIGH 1,25 DIHYDROXYCHOLICALCIFEROL
(Due to increased production of 1 alpha hydroxylase that converts Vit D to its active
form -nbme)
5. Low PTH
Histology of Sarcoidosis :
1.Epithelioid granuloma -
Granuloma with foreign body giant cells (means Giant cells with disorganized nuclei)
Type 4 HSN.
2.Asteroid body - Star shaped giant cell cytoplasmic inclusion - collection of Lipid
3. Schwmann bodies - Calcificatins - collections of Calcium and protein.
Causes of erythema nodosum
NODOSUM
NO- No cause Idipathic 60% cases
D - Drugs Sulfa, Iodide
O -OCP
S -Sarcoidosis
U - UC/CHRONS
M- Microbiota - TB,Leprosy, Streptococcus, Yersinia, Histoplasma.
Erythema nodosum abd sarcoidosis
Most common non specific manifestation in sarcoidosis.
Painful, Bilateral.
MC organism causing Acute Prostatitis in OLD
E.Coli.
IN Young - Chlamydia, Gono.
Causes of raised CK
1. Hypothyroid myopathy
2. Inflammatory myositis
3. Statin induced
Normal CK
1.Polymyalgia Rheumatica
2. Steroid induced Myopathy
3. vit D deficiency Myopathy
Polymyositis / Dermato lab values
Raised CK, Rasied Aldolase, +ANA
+Anti Jo-1
PCOS serum hormonal values
,Increased LH , Icreased Angrogens , Increased fasting Insulin
20 yr woman with high BP, high Urea, Low glucose, urinalysis numerous WBC
and WBC casts with proteinuria >3gm/24hr.
USG : Asymmetric Kidneys with broad scars and blunted calyces and voiding
cystogram shows Vesico ureteral reflux.
Chronic Pyelonephritis.
Causes of renal papillary necrosis
SAAD papa
S - Sickel Cell disease
A -Acute pyeloneohritis
A - Analgesics (NSAIDS)
D - DM
Cx of Acute pyelonephritis
Chronic Pyelo
Renal Papillary nex
Perinephric abscess
Urosepsis
MCC of Acute pyelo
Ecoli (ascending UTI)
Hematogenous
Urine of Chronic and Acute pyelo
WBC/WBC CASTS
Cause of chronic pyeloneph
Predisposed VUR
Multiple Acute pyelo
Chronically obstructing kidney stones.
Biopsy of Chronic Pyelonephritis
1 Cortico med Scarring
2 BLUNTED CALYCES
3 THYROIDINIZATION of kidneys (tubules with eosinophilic casts)
Biopsy of Hydronephrosis
1.DISTENSION AND DILATION OF PELVIS AND CALYCES
2.Atrophy of cortex and Medulla
Causes of Hydronephrosis
1. Obsturction via STONES, BPH, Cervical Ca, Ureter injury.
2. B/L VUR
3. Retroperitoneal fibrosis.
4. Aortic Aneurysms
Hydronephrosis induced renal failure Lab :
Inc BUN and Creatinine provide evidence of Secondary Renal Failure.
Causes of Hematuria
I PEE RBCS
Infection
PKD
, Exercise
External trauma
Renal glomerular disease
BPH
Cancer - RCC, Bladder
Stones.
Immunotherapies for RCC
ALDESLEUKIN
SORAFENIB
SUNITINIB
Cx of prostatectomy
Incontinence or Erectile dysfunction due to injury to pelvic PARASYMPATHETIC
NERVES.
Schizoaffective vs Brief psychotic disorder
Schizoaff - > 2 weeks of pure psychotic features (halluci/delusion) in a patient with
previously known major mood disorder (bipolar or mj dep)
Brief psychotic - Lasts LESS THAN ONE MONTH <1 month. Usually STRESS
RELATED with full RETURN to function.
Mode of inheritance of
FRAGILE X - XL dominant
ACHONDROPLASIA - SPORADIC
Herid Spherocytosis
ADD
Infant PKD
ARD
OTC deficiency
XL Recessive
Ducheene and Becker
XL Recessive
G6PD DEF and LESH-NYHAN
XL Recessive
Myotonic dystrophy
ADD (my tonia,ticker,testicles,toupee)
CTG-CATARACT, TOUPEE, GONADAL ATROPHY
Marfans syndrome
ADD
WISKOTT ALDRICH
XLR
MEN 1 and MEN2
ADD
SICKEL CELL DISEASE
ARD
Solution
Lab values in Sarcoidosis
1.Elevated ACE levels- from granuloma
2.Elevated CD4/CD8 counts in BAL.
3.High Calcium
4.HIGH 1,25 DIHYDROXYCHOLICALCIFEROL
(Due to increased production of 1 alpha hydroxylase that converts Vit D to its active
form -nbme)
5. Low PTH
Histology of Sarcoidosis :
1.Epithelioid granuloma -
Granuloma with foreign body giant cells (means Giant cells with disorganized nuclei)
Type 4 HSN.
2.Asteroid body - Star shaped giant cell cytoplasmic inclusion - collection of Lipid
3. Schwmann bodies - Calcificatins - collections of Calcium and protein.
Causes of erythema nodosum
NODOSUM
NO- No cause Idipathic 60% cases
D - Drugs Sulfa, Iodide
O -OCP
S -Sarcoidosis
U - UC/CHRONS
M- Microbiota - TB,Leprosy, Streptococcus, Yersinia, Histoplasma.
Erythema nodosum abd sarcoidosis
Most common non specific manifestation in sarcoidosis.
Painful, Bilateral.
MC organism causing Acute Prostatitis in OLD
E.Coli.
IN Young - Chlamydia, Gono.
Causes of raised CK
1. Hypothyroid myopathy
2. Inflammatory myositis
3. Statin induced
Normal CK
1.Polymyalgia Rheumatica
2. Steroid induced Myopathy
3. vit D deficiency Myopathy
Polymyositis / Dermato lab values
Raised CK, Rasied Aldolase, +ANA
+Anti Jo-1
PCOS serum hormonal values
,Increased LH , Icreased Angrogens , Increased fasting Insulin
20 yr woman with high BP, high Urea, Low glucose, urinalysis numerous WBC
and WBC casts with proteinuria >3gm/24hr.
USG : Asymmetric Kidneys with broad scars and blunted calyces and voiding
cystogram shows Vesico ureteral reflux.
Chronic Pyelonephritis.
Causes of renal papillary necrosis
SAAD papa
S - Sickel Cell disease
A -Acute pyeloneohritis
A - Analgesics (NSAIDS)
D - DM
Cx of Acute pyelonephritis
Chronic Pyelo
Renal Papillary nex
Perinephric abscess
Urosepsis
MCC of Acute pyelo
Ecoli (ascending UTI)
Hematogenous
Urine of Chronic and Acute pyelo
WBC/WBC CASTS
Cause of chronic pyeloneph
Predisposed VUR
Multiple Acute pyelo
Chronically obstructing kidney stones.
Biopsy of Chronic Pyelonephritis
1 Cortico med Scarring
2 BLUNTED CALYCES
3 THYROIDINIZATION of kidneys (tubules with eosinophilic casts)
Biopsy of Hydronephrosis
1.DISTENSION AND DILATION OF PELVIS AND CALYCES
2.Atrophy of cortex and Medulla
Causes of Hydronephrosis
1. Obsturction via STONES, BPH, Cervical Ca, Ureter injury.
2. B/L VUR
3. Retroperitoneal fibrosis.
4. Aortic Aneurysms
Hydronephrosis induced renal failure Lab :
Inc BUN and Creatinine provide evidence of Secondary Renal Failure.
Causes of Hematuria
I PEE RBCS
Infection
PKD
, Exercise
External trauma
Renal glomerular disease
BPH
Cancer - RCC, Bladder
Stones.
Immunotherapies for RCC
ALDESLEUKIN
SORAFENIB
SUNITINIB
Cx of prostatectomy
Incontinence or Erectile dysfunction due to injury to pelvic PARASYMPATHETIC
NERVES.
Schizoaffective vs Brief psychotic disorder
Schizoaff - > 2 weeks of pure psychotic features (halluci/delusion) in a patient with
previously known major mood disorder (bipolar or mj dep)
Brief psychotic - Lasts LESS THAN ONE MONTH <1 month. Usually STRESS
RELATED with full RETURN to function.
Mode of inheritance of
FRAGILE X - XL dominant
ACHONDROPLASIA - SPORADIC
Herid Spherocytosis
ADD
Infant PKD
ARD
OTC deficiency
XL Recessive
Ducheene and Becker
XL Recessive
G6PD DEF and LESH-NYHAN
XL Recessive
Myotonic dystrophy
ADD (my tonia,ticker,testicles,toupee)
CTG-CATARACT, TOUPEE, GONADAL ATROPHY
Marfans syndrome
ADD
WISKOTT ALDRICH
XLR
MEN 1 and MEN2
ADD
SICKEL CELL DISEASE
ARD
