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Medicine (MD/DO)
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First Aid
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First Aid for the USMLE Step 1 (2022)
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Page 222 -

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First Aid for the USMLE Step 1 (2022) | Medicine (MD/DO) School Study Aid

Page 222 -
25 Picmonics to Learn | 58 mins
Adenocarcinoma of the Lung
Characteristics
Most Common Lung Cancer
Most Common in Nonsmokers
Peripheral Location
KRAS, EGFR, and ALK Mutations
Diagnosis
Glandular Pattern
Often Stains with Mucin
Clinical Features
Presents with Hemoptysis
Clubbing
Treatment
Surgical Resection
Chemotherapy and Radiation
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2 mins
Trastuzumab
Indications
HER-2+ Breast Cancer
Stomach Cancer
Mechanism
Monoclonal Antibody Against HER-2
Inhibition of Cellular Signaling
Cytotoxicity
Side effects
Cardiotoxicity
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1 min
MEN 2A (Multiple Endocrine Neoplasia)
Pathophysiology
Autosomal Dominant
RET Gene
Signs and Symptoms
Medullary Thyroid carcinoma
Calcitonin
Parathyroid
Pheochromocytoma
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45 secs
MEN 2B (Multiple Endocrine Neoplasia)
Pathophysiology
RET Gene
Autosomal Dominant
Signs and Symptoms
Medullary Thyroid Carcinoma
Pheochromocytoma
Mucosal Neuromas
Marfanoid Body Habitus
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2 mins
Chronic Myelogenous Leukemia (CML)
Pathophysiology
BCR-ABL
9;22 Translocation
Philadelphia Chromosome
Signs & Symptoms
Tyrosine Kinase
Low Alkaline Phosphatase
Splenomegaly
Considerations
Blast Crisis
Age 30 to 90 Years
Responds to Imatinib
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3 mins
Acute Lymphoblastic Leukemia (ALL)
Ages < 15
May Present with Bone Marrow Involvement in Children
Mediastinal Mass in Adolescents
TdT Positive
CALLA Positive
t(12;21) Better Prognosis
Spread to CNS and Testes
Most Responsive to Chemotherapy
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2 mins
Primary Myelofibrosis
Characteristics
Bone Marrow Fibrosis
Extramedullary Hematopoiesis
JAK2 Kinase Mutation
Symptoms
Fatigue
Weight Loss
Splenomegaly
DIagnosis
Pancytopenia
Dacrocytes (Teardrop Cells)
Dry Tap on Bone Marrow Aspiration
Treatment
Stem Cell Transplantation
Transfusion
Ruxolitinib (JAK2 Inhibitor)
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2 mins
Polycythemia Vera Disease
Pathophysiology
JAK2 Mutation leading to increased red blood cells
Tyrosine Kinase
Symptoms
Erythromelalgia
Pruritus
Often After Hot Shower
Headache
Treatment
Phlebotomy
Aspirin
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1 min
BRAF Inhibitors
Characteristics
BRAF Proto-oncogene
Serine/Threonine Kinase
V600E Mutation
Indications
Melanoma
Non-Hodgkin Lymphoma
Papillary Thyroid Carcinoma
Hairy Cell Leukemia
Drugs
Dabrafenib
Vemurafenib
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2 mins
Imatinib (Gleevec)
Indications
Chronic Myelogenous Leukemia (CML)
Inhibitor of BCR-ABL Tyrosine Kinase
Caused by Philadelphia Chromosome
GI Stromal Tumors
Inhibitor of C-kit Tyrosine Kinase
Toxicity
Fluid Retention
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1 min
Burkitt's Lymphoma
Adolescents or young adults
C-myc gene moves next to heavy chain Ig gene
T 8;14
Starry sky appearance
Sheets of lymphocytes with interspersed macrophages
Jaw lesion in endemic (African) form
Pelvis or abdomen in non endemic form (American form)
Associated with EBV
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2 mins
Neuroblastoma Characteristics and Presentation
Characteristics
Malignant Neuroendocrine Tumor
Neural Crest Cells Origin
Sympathetic Ganglia
Adrenal Glands
Amplification of N-myc Oncogene
Most Common Cancer In Infancy
Clinical Presentation
Abdominal Mass That Can Cross Midline
Gastrointestinal Distress
Metastasis
Raccoon Eyes
Opsoclonus-Myoclonus Syndrome
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4 mins
Neuroblastoma Diagnosis and Management
Diagnosis
24-hour Urine Test
Increased Catecholamines
Increased Homovanillic and Vanillylmandelic Acid
Ultrasound
Magnetic Resonance Imaging (MRI)
Biopsy
Pathology
Small Round Blue Cells
Homer-Wright Rosettes
Bombesin Positive
Neuron Specific Enolase Positive
Interventions
Local Excision
Chemotherapy
Radiation
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3 mins
Follicular Lymphoma
Derives from Germinal Center
Occurs in adults
T14;18
BCL 2 overexpression
BCL 2 inhibits apoptosis
Indolent
Generalized lymphadenopathy
Bone marrow involvement
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2 mins
Gardner Syndrome
Pathophysiology
Familial Adenomatous Polyposis (FAP) + Extraintestinal Benign Tumors
Autosomal Dominant
APC Gene Mutation
Clinical Findings
Desmoid Tumors
Nasal Angiofibromas
Osteomas
Congenital Hypertrophy of Retinal Pigment Epithelium
Dental Abnormalities
Cutaneous Lesions
Adrenal Adenomas
Associations
Thyroid Cancer
Duodenal / Periampullary Cancer
Pancreatic Cancer
Hepatoblastoma
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2 mins
Erlotinib
Mechanism of Action
Inhibits EGFR Tyrosine Kinase
Inhibits Progression of G1 to S Phase
Indications
Non-small Cell Lung Cancer (NSCLC)
Pancreatic Cancer
Side Effects
Rash
Diarrhea
Considerations
Avoid Grapefruit Juice
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1 min
Pancreatic Adenocarcinoma Symptoms and Risk Factors
Common Signs and Symptoms
Abdominal Pain
Anorexia and Weight Loss
Migratory Superficial Thrombophlebitis
New-Onset Diabetes
Signs/Symptoms Specific to Tumors in the Pancreatic Head
Jaundice
Steatorrhea
White Stool
Palpable but Non-tender Gall Bladder
Risk Factors
Elderly
Chronic Pancreatitis
Smoking
Alcoholism
Diabetes
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5 mins
Pancreatic Adenocarcinoma Diagnosis and Treatment
Diagnosis
CA 19-9
Liver Function Tests for Cholestasis
Serum Lipase
Ultrasound if Cholestasis Suspected
CT Abdomen
FNA Biopsy if Diagnosis or Resectability Uncertain
Treatment
Whipple if Resectable
Palliative Care if Not Resectable
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4 mins
MEN 1 (Multiple Endocrine Neoplasia)
Pathophysiology
Autosomal Dominant
Menin Mutation (Tumor Suppression Gene)
Chromosome 11
Signs and Symptoms
Pancreatic Endocrine Tumors
Pituitary Tumors
Parathyroid Adenomas
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2 mins
Neurofibromatosis Type 1
Pathophysiology
Autosomal Dominant
Chromosome 17
Signs and Symptoms
Neurofibromas
Optic Glioma
Lisch Nodules
Hamartomas
Cafe Au Lait Spots
Scoliosis
Pheochromocytoma
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4 mins
Neurofibromatosis Type 2
Pathophysiology
Autosomal-Dominant
Chromosome 22
Signs and Symptoms
Vestibular Schwannoma
Meningioma
Ependymoma
Cafe Au Lait Spots
Cataracts
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2 mins
Tuberous Sclerosis
Characteristics
Autosomal Dominant
Signs and Symptoms
Hamartomas in CNS and Skin
Phakoma
Subependymal Giant Cell Astrocytoma
Seizures
Intellectual Disability (Mental Retardation)
Adenoma Sebaceum
Shagreen Patch
Ash-leaf Spots
Renal Angiomyolipoma
Cardiac Rhabdomyoma
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2 mins
Von Hippel-Lindau Disease
Pathophysiology
Chromosome 3
Presentation
Hemangioblastomas
Medulla, Retina, Cerebellum
Cysts
Kidney, Liver, Pancreas
Develop Bilateral Renal Carcinomas
Pheochromocytomas
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2 mins
Wilms' Tumor (Nephroblastoma)
Cause
Malignant Renal Tumor
Assessment
Abdominal Mass
Hematuria
Fever
Hypertension
Interventions
Nephrectomy
Chemotherapy
Radiation
Considerations
Do Not Palpate Abdomen
Children Under 5 Years Old
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2 mins
Li-Fraumeni Syndrome
Pathophysiology
Autosomal Dominant
TP53 Mutation
Loss of Heterozygosity
Clinical Features
Osteosarcoma
Breast Cancer
Brain Tumors
Leukemia/Lymphoma
Adrenocortical Carcinoma
Management
Supportive Care
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3 mins

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