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Block 2 mga, block 3 mfm
Fetal Circulation
Placenta
Umbilical Vein
Ductus Venosus
Right Atrium
Foramen Ovale
Left Atrium
Aorta
Right Ventricle
Ductus Arteriosus
Umbilical Arteries
2 mins
Postnatal Circulation
Infant Breathes
Decreased Pressure in Pulmonary Vasculature
Decreased Right Heart Pressure
Increased Left Atrial Pressure
Closes Foramen Ovale
Increased O2
Decreased Prostaglandins
Closed Ductus Arteriosus
Pharmacologic Intervention of Ductus Arteriosus
Open with Prostaglandins
Closed with Indomethacin
3 mins
Competitive Inhibition
Reversible Inhibition
Constant Vmax
Substrate Competes With Inhibitor For The Active Site
Type II associated with Endometrial, Ovarian and Skin Cancers
3-2-1 Rule
3 Relatives with Colon Cancer
Occurs Across 2 Generations
1 Relative Diagnosed < 50 Years Old
Treatment
Frequent Screening
Colectomy
3 mins
Retinoblastoma
Characteristics
Loss of Heterozygosity
Chromosome 13
Children
Presentation
Leukocoria
Strabismus
Vision Loss
Association
Osteosarcoma
Diagnosis
Genetic Testing
Management
Cryotherapy
Photocoagulation
Chemotherapy or Radiation
Surgery
3 mins
Squamous Cell Carcinoma of the Skin
Epidemiology
2nd Most Common Skin Cancer
UV Light Exposure
Long-term Immunosuppression
Arsenic Exposure
Signs/Symptoms
Ulcerative Red Lesion
Precursor Actinic Keratosis
Commonly Lower Lip
Diagnosis
Biopsy shows Keratin Pearls
Treatment
Mohs Micrographic Surgery
2 mins
Basal Cell Carcinoma of the Skin
Pathophysiology
Most Common Skin Cancer
2/3 of Cases Due to UV Light Exposure
Pink, Pearl-like Lesions
Rolled Borders
Telangiectasias
Commonly Upper Lip
Diagnosis
Shave Biopsy
Pallisading Nuclei
Treatment
Mohs Micrographic Surgery
2 mins
Melanoma Mechanism and Characteristics
Mechanism
Associated with Sunlight Exposure
Mutation in B-RAF kinase
Large Number of Moles
Fair-Skinned People at Higher Risk
Growth Phases
Radial Growth Phase
No Metastasis
Vertical Growth Phase
Depth of Tumor Correlates with Risk of Metastasis
1 min
Melanoma Diagnosis
Signs
ABCDE Mnemonic
Asymmetry
Border irregularity
Color variation
Diameter > 6mm
Evolution over time
Diagnosis
S-100 Tumor Marker
LDH (Lactate Dehydrogenase) Screens for Metastasis
Treatment
Wide Local Excision
Adjuvant Therapy
1 min
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
2 mins
Squamous Cell Carcinoma of the Lung
Characteristics
Strong Correlation with Smoking
More Common in Men
Central Location
Cavitating Lesion Extending to Hilum
PTHrP Causes Hypercalcemia
Diagnosis
Keratin Pearls
Intercellular Bridges
Treatment
Surgical Resection (if Early Stage)
Chemotherapy and Radiation (if Later Stage)
2 mins
Small Cell (Oat Cell) Carcinoma
Characteristics
Aggressively Malignant
Strong Correlation with Smoking
Central Location
Amplification of Myc Oncogenes
Signs and Symptoms
Narrowing of Bronchial Airways
Cushing's Syndrome
Ectopic ACTH
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Lambert-Eaton Syndrome
Diagnosis
Kulchitsky Cells
Neuron-Specific Enolase Positive
Chromogranin A Positive
Treatment
Chemotherapy and Radiation
3 mins
Large Cell Carcinoma
Characteristics
Strong Correlation with Smoking
Poor Prognosis
Peripheral Lesions
Symptoms
Gynecomastia
Galactorrhea
Diagnosis
Anaplastic Cells
Pleomorphic Giant Cells
May Produce Beta hCG
Diagnosis of Exclusion
Treatment
Surgical Resection
Less Responsive to Chemotherapy and Radiation
2 mins
Pancoast Tumor
Characteristics
Apical Lung Tumor
Non-small Cell Lung Cancer
Clinical Features
Axillary or Shoulder Pain
Hoarseness
Horner Syndrome
Superior Vena Cava Syndrome
Sensorimotor Deficits
Hemidiaphragm Paralysis
1 min
Acute Myelogenous Leukemia (AML)
Myeloblasts Increase on Peripheral Smear
Median Onset 60 Years
T 15;17 M3 Subtype
Auer Rods
Disseminated Intravascular Coagulation (DIC) is a Common Presentation
M5 Gum Infiltration
Responds to Vitamin A
3 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
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
2 mins
Chronic Lymphocytic Leukemia (CLL)
Signs and Symptoms
Age > 60 Years
B Cell Neoplasm
Smudge Cells
Often Asymptomatic
Cold IgM Autoimmune Hemolytic Anemia
Warm IgG Autoimmune Hemolytic Anemia
Richter's Transformation
3 mins
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