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First Aid for the USMLE Step 1 (2021)
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First Aid for the USMLE Step 1 (2021) | Physician Assistant (PA) School Study Aid

Page 227 -
18 Picmonics to Learn | 37 mins
Epstein Barr Virus
Characteristics
Herpesvirus 4
Double Stranded DNA
Linear
Enveloped
Signs and Symptoms
Infectious Mononucleosis
Virus Attaches to CD21 in B Cells
Nasopharyngeal Carcinoma
Burkitt's Lymphoma
Hodgkin's Lymphoma
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1 min
Hepatitis B Virus Characteristics
Hepadnavirus
Enveloped
Circular
Partially Double-stranded DNA
Has Reverse Transcriptase
IV Drug Use
Sex
Maternal Fetal Routes
3 Month Incubation Period
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2 mins
Hepatitis C
Characteristics
Enveloped
RNA Virus
Flavivirus
Icosahedral
SS positive Linear
Clinical Features
Most Cases are Due to IV Drug Use
Turns to Chronic Hepatitis in Over 70% of Cases
Cirrhosis
Hepatocellular Carcinoma
Most Common Indication for Liver Transplantation
Associated With Type I MPGN
Porphyria Cutanea Tarda
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2 mins
Kaposi Sarcoma
Characteristics
Malignant Vascular Tumor
Human Herpesvirus Type 8 (HHV-8)
AIDS/Immunocompromised
CD4+ < 500
Presentation
Multifocal Purple Lesions
Skin
Mucous Membranes
Visceral Organs
Diagnosis
Spindle-shaped Cells
Management
Observation
Chemotherapy
Treat Underlying Disorder
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3 mins
Human Papillomavirus (HPV)
Characteristics
Non-enveloped
Circular
Double Stranded DNA
Disease
Warts 1, 2, 6, 11
Condyloma acuminata
Type 16, 18
Cervical Carcinoma
Penile Carcinoma
AIDS/Immunocompromised
Worsened by Smoking
Diagnosis
Koilocytic change in squamous epithelium
Pyknotic Nuclei Surrounded by Clear Halo
Treatment
Vaccine Available
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4 mins
Helicobacter Pylori
Characteristics
Gram-Negative
Bacilli
Curved
Polar Flagellum
Catalase-Positive
Oxidase-Positive
Disease
Gastric and Duodenal Ulcers
Ammonia
Neutral Environment
Gastric Adenocarcinoma
MALT lymphoma
Diagnosis
Serology IgG antibody
Stool Antigen
Urease Positive Breath Test
Biopsy
Treatment
2 ABX and PPI
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2 mins
Adult T Cell Lymphoma
Caused by HTLV 1
Japan, West Africa, Caribbean
Present with cutaneous lesions
Aggressive
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1 min
Clonorchis Sinensis
Pathophysiology
Trematode (Fluke)
Undercooked Fish
Biliary Tract Inflammation
Pigmented Gallstones
Associated with Cholangiocarcinoma
Treatment
Praziquantel
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1 min
Schistosoma
Pathophysiology
Trematode (Fluke)
Snail-infested Water
Intense Immune Response
Intestinal Disease
Hepatosplenic Granuloma
Squamous Cell Cancer of the Bladder
Diagnosis
Parasitic Antigens via ELISA
Treatment
Praziquantel
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2 mins
Squamous Cell Carcinoma of the Bladder Clinical Features
Risk Factors
Smoking
Chronic Cystitis
Schistosoma
Chronic Nephrolithiasis
Clinical Findings
Painless Hematuria
Urinary Frequency and Urgency
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1 min
Paget's Disease of Bone
Pathophysiology
Men > Age 40
Increased Osteoblast and Osteoclast activity
Mosaic Pattern
Signs and Symptoms
Increased Skull Diameter
Hearing Loss
Fractures
Bone Ache and Joint Pain
High Output Heart Failure
Diagnosis
Bone Scan
Normal Parathyroid hormone (PTH) and Calcium
Elevated ALP
Treatment
Bisphosphonate
Calcitonin
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2 mins
Complete Hydatidiform Mole
Characteristics
Gestational Trophoblastic Disease
Fertilization of Enucleated Egg
Diploid Fetal Karyotypes
Hydropic Chorionic Villi
Presentation
Vaginal Bleeding
Preeclampsia
Diagnosis 
Increased Beta hCG
"Snowstorm" / "Bunch of Grapes" Appearance
Theca Lutein Cysts
Considerations
Dilation and Curettage (D&C)
Methotrexate
Increased Risk of Choriocarcinoma
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3 mins
Hydatidiform Mole (Molar Pregnancy)
Cause/Mechanism
Abnormal Fertilization
Assessment
Symptoms of Pregnancy
Elevated hCG
Vaginal Bleeding
Inappropriate Uterine Growth
No Fetal Heart Rate (FHR)
Interventions
Dilation and Curettage (D&C)
Emotional Support
Considerations
No Pregnancy 1 Year
Hysterectomy
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3 mins
Choriocarcinoma
Germ-cell tumor
Trophoblastic tissue
Hematogenous spread to lungs
Malignant
Theca-lutein cysts
Hydatidiform Mole
hCG
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59 secs
Ovarian Cystadenocarcinoma
Non-germ Cell Tumor
Mucinous
Peritoneal Spread
Serous
Psammoma Bodies
Bilateral
Malignant
Stromal Invasion
CA 125
BRCA-1 and Lynch Syndrome
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1 min
Carcinoid Syndrome
Pathophysiology
Neuroendocrine Cells
Serotonin
Appendix
Diagnosis
Chromogranin A
Neuron Specific Enolase
Dense Core Bodies on EM
Signs and Symptoms
Symptoms When Metastasize to Liver
Flushing
Wheezing
Right Heart Murmur
Diarrhea
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4 mins
Dysgerminoma
Germ-cell tumor
Most Common Malignant Germ Cell Tumor
Uniform Cells
Fried Egg Cells
hCG
LDH
Seminoma-like
Turner Syndrome
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2 mins
Prostate Adenocarcinoma Characteristics and Presentation
Characteristics
Most Common Cancer in Men
Screening Test if Suspicious
Prostate Specific Antigen (PSA)
Peripheral Zone
Risk Factors
African American
Advanced Age
Presentation
Usually Asymptomatic
Terminal Hematuria
Urinary Retention or Incontinence
Lower Back Pain
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2 mins

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