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487 Cards in this Set
- Front
- Back
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Abdominal pain, ascites, hepatomegaly
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Budd-Chiari syndrome (posthepatic venous thrombosis)
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Achilles tendon xanthoma
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Familial hypercholesterolemia (decreased LDL receptor signaling)
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Adrenal hemorrhage, hypotension, DIC
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Waterhouse-Friderichsen syndrome (meningococcemia)
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Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
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Marfan's syndrome (fibrillin defect)
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Athlete with polycythemia
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Second degree to erythropoietin injection
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Back pain, fever, night sweats, weight loss
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Pott's disease (vertebral TB)
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Bilateral hilar adenopathy, uveitis
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Sarcoidosis (noncaseating granuloma)
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Blue sclera
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Osteogenesis Imperfecta (type I collagen defect)
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Bluish line on gingiva
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Burton's line (lead poisoning)
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Bone pain, bone enlargement, arthritis
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Paget's disease of bone (increased osteoblastic and osteoclastic activity)
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Bounding pulses, diastolic heart murmur, head bobbing
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Aortic regurgitation
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"Butterfly" facial rash and Raynaud's phenomenon in a young female
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SLE
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Cafe'-au-lait spots, Lisch nodules (iris hamartoma)
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NFT-I (+pheochromocytoma, optic gliomas)
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Cafe'-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, MEN
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McCune-Albright syndrome (mosaic G protein signaling mutation)
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Calf pseduohypertrophy
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DMD: X-linked recessive deletion of the dystrophin gene
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Cherry red spot on macula
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Tay Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion
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Chest pain on exertion
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Angina (stable: with moderate exertion; unstable: with minimal exertion)
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Chest pain, pericardial effusion/friction rub, persistent fever following MI
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Dressler's syndrome (autoimmune mediated post-MI fibrinous pericarditis, 1-2 weeks after acute episode)
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Child uses arms to stand up from squat
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Gowers sign (DMD)
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Child with fever later develops red rash on face that spreads to body
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Slapped cheeks of erythema infectiosum/fifth disease; agent is parvovirus B19
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Chorea, dementia, caudate degeneration
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Huntington's disease (autosomal-dominant CAG repeat expansion)
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Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
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McArdle's disease (muscle glycogen phosphorylase deficiency)
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Cold intolerance
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Hypothyroidism
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Conjugate lateral gaze palsy, horizontal diplopia
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Internuclear ophthalmoplegia (damage to MLF; bilateral [MS], unilateral [stroke])
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Continuous "machinery" heart murmur
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PDA (close with indomethacin; open or maintain with misoprostol)
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Cutaneous dermal edema due to connective tissue deposition
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Myxedema (caused by hypothyroidism, Graves' disease)
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Dark purple skin/mouth nodules
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Kaposi's sarcoma (usually AIDS patients [MSM]: associated with HHV-8)
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Deep, labored breathing/hyperventilation
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Kussmaul breathing (DKA)
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Dermatitis, dementia, diarrhea
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Pellagra-- niacin (vitamin B3) deficiency
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Dilated cardiomyopathy, edema, alcoholism or malnutrition
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Wet beriberi--thiamine (vitamin B1) deficiency
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Dog or cat bite resulting in infection
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Pasteurella multocida (cellulitis at inoculation site)
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Dry eyes, dry mouth, arthritis
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Sjogren's syndrome (autoimmune destruction of exocrine glands)
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Dysphagia (esophageal webs), glossitis, iron deficiency anemia
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Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
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Elastic skin, hypermobility of the joints
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Ehlers-Danlos syndrome (type III collagen defect)
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Enlarged, hard left supraclavicular node
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Virchow's node (abdominal mets)
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Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
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Sezary syndrome (cutaneous T cell lymphoma) or mycosis fungoides
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Facial muscle spasm upon tapping
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Chvostek's sign (hypocalcemia)
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Fat, female, forty, fertile
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Cholelithiasis
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Fever, chills, headache, myalgia following antibiotic treatment for syphilis
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Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
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Fever, cough, conjunctivitis, coryza, diffuse rash, koplik spots
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Measles (Morbillivirus)
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Fever, night sweats, weight loss
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B symptoms of lymphoma
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Fibrous plaques in soft tissue of penis
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Peyronie's disease (connective tissue disorder)
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Gout, mental retardation, self-mutilating behavior in a boy
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Lesch-Nyan syndrome (HGPRT deficiency, X linked recessive)
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Green yellow rings around the peripheral cornea
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Kayser-Fleisher rings-- copper accumulation from Wilson's disease
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Hamartomatous polyps, hyperpigmentation of the mouth, feet, and hands
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Peutz-Jeghers syndrome
Inherited benign polyposis can cause bowel obstruction; increased cancer risk; mainly GI cancer |
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Hepatosplenomegaly, osteoperosis, neurologic symptoms
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Gaucher's disease (glucocerebrosidase deficiency)
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Hereditary nephritis, sensorineural hearing loss, cataracts
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Alport's syndrome (mutation in the alpha chain of collagen type IV)
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Hyperphagia, hypersexuality, hyperorality, hyperdocility
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Kluver-Bucy syndrome (bilateral amygdala lesion)
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Hyperreflexia, hypertonia, Babinski's sign present
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UMN damage
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Hyporeflexia, hypotonia, atrophy, fasciculations
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LMN damage
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Hypoxemia, polycythemia, hypercapnia
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Blue bloater (chronic bronchitis-- hyperplasia of mucous cells)
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Indurated, ulcerated genital lesion
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Nonpainful: chancre of primary syphilis caused by treponema pallidum
Painful with exudate: chancroid caused by Haemophilus ducreyi |
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Infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia
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Patau's syndrome (trisomy 13)
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Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration
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Niemann-Pick disease (genetic sphingomyelinase deficiency)
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Infant with hypoglycemia, failure to thrive, and hepatomegaly
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Cori's disease (debranching enzyme deficiency)
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Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect
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Edward's syndrome (trisomy 18)
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Jaundice, palpable distended non-tender gallbladder
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Courvoisier's sign (distal obstruction of the biliary tree)
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Large rash with bull's eye appearance
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Erythema chronicum migrans from Ixodes tick bite
Lyme disease caused by Borrelia burgdorferi |
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Lucid interval after traumatic brain injury
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Epidural hematoma (middle meningeal artery rupture)
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Male child, recurrent infections, no mature B cells
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Bruton's disease (X linked agammaglobulinemia)
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Mucosal bleeding and prolonged bleeding time
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Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GPIIb/IIIa)
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Muffled heart sounds, distended neck veins, hypotension
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Beck's triad of cardiac tamponade
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Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
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Gardners syndrome (subtype of FAP)
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Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
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Pompe's disease (lysosomal alpha-1,4-glucosidase deficiency)
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Neonate with arm paralysis following difficult birth
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Erb-Duchenne palsy (superior trunk, C5-C6, brachial plexus injury); "waiter's tip" injury
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No lactation postpartum, absent menstruation, cold intolerance
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Sheehan's syndrome (pituitary infarction)
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Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
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MS
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Oscillating slow/fast breathing
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Cheyne-Stokes respirations (central apnea in CHF or increased intracranial pressure)
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Painful blue fingers/toes, hemolytic anemia
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Cold agglutinin disease (autoimmune hemolytic anemia cuased by M. pneumoniae or infectious mono)
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Painful, pale, cold fingers/toes
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Raynaud's phenomenon (vasospasm of extremities)
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Painful, raised red lesions on pad of fingers/toes
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Osler's node (infective endocarditis, immune complex deposition)
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Painless erythematous lesions on palms and soles
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Janeway lesions (infective endocarditis, septic emboli/microabscesses)
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Painless jaundice
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Cancer of the pancreatic head obstructing the common bile duct; increased Alk phos and GGT
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Palpable purpura on the buttocks/legs, joint pain, abdominal pain (child), hematuria
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Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
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Pancreatic, pituitary, parathyroid tumors
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MEN 1 syndrome (AD disorder)
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Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia
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Nephrotic syndrome
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Pink complexion, dyspnea, hyperventilation
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"Pink Puffer"
Emphysema can be 1) centriacinar due to smoking or 2) panacinar due to an A-1-A deficiency |
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Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets
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Fanconi's syndrome (proximal tubular reabsorption defect)
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Positive anterior "drawer sign"
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ACL injury
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Pruritic, purple, polygonal papules and plaques
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Lichen planus
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Ptosis, miosis, anhidrosis
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Horner's syndrome (sympathetic chain lesion)
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Pupil accomodates but doesn't react
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Argyll Robertson pupil (neurosyphilis)
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Rapidly progressive leg weakness that ascends following GI/upper respiratory tract infection
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Guillain-Barre syndrome--acute autoimmune inflammatory demyelinating polyneuropathy
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Rash on palms and soles
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Cosxackie A, secondary syphilis, RMSF
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Recurrent colds, unusual eczema, high serum IgE
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Hyper IgE syndrome -- Job's syndrome causing a defect in neutrophil chemotaxis
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Red currant jelly sputum in alcoholics or diabetic patients
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Klebsiella pneumonia
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Red currant jelly stools
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Acute mesenteric ischemia (adults) or intussusception (infants)
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Red, itchy, swollen rash of nipple/areola
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Paget's disease of the breast--represents underlying neoplasm
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Red urine in the morning, fragile RBC's
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Paroxysmal nocturnal hemoglobinuria
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Renal cell carcinoma (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma
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von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
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Resting tremor, rigidity, akinesia, postural instability
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Parkinson's disease- nigrostriatal dopamine depletion
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Retinal hemorrhages with pale centers
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Roth's spots- bacterial endocarditis
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Severe jaundice in the neonate
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Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
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Severe RLQ pain with palpation of the LLQ
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Rovsing's sign (acute appendicitis)
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Severe RLQ pain with rebound tenderness
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McBurney's sign--appendicitis
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Short stature, increased incidence of tumors/leukemia, aplastic anemia
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Fanconi's anemia; genetic loss of DNA crosslink repair; often progresses to AML
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Single palmar crease
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Simian crease characteristic of Down's syndrome
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Situs inversus, chronic sinusitis, bronchiectasis, infertility
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Kartagener's syndrome- dynein arm defect affecting cilia
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Skin hyperpigmentation, hypotension, fatigue
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Addison's disease-- primary adrenocortical insufficiency causes increased ACTH and increased alpha-MSH production
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Slow, progressive muscle weakness in boys
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Becker's muscular dystrophy: X linked recessive mutation in dystrophin; less severe than Duchenne's
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Small, irregular red spots on buccal/lingual mucosa with blue-white centers
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Koplik spots (measles; rubeola virus)
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Smooth, flat, moist, painless white lesions on the genitals
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Condyloma lata (secondary syphilis)
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Splinter hemorrhages in fingernails
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Bacterial endocarditis
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Strawberry tongue
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Scarlet fever, Kawasaki disease, toxic shock syndrome
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Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema
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Turner syndrome (45XO)
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Sudden swollen/painful big toe joint, tophi
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Gout/podagra (hyperuricemia)
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Swollen gums, mucosal bleeding, poor wound healing, spots on skin
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Scurvy-- vitamin C deficiency; can't hydroxylate proline/lysine for collagen synthesis
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Swollen, hard, painful finger joints
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Osteoarthritis-- osteophytes on PIP (Bouchard's nodes), DIP (Heberden's nodes)
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Crescendo-decrescendo systolic ejection murmur
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Aortic valve stenosis
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Thyroid and parathyroid tumors, pheochromocytoma
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MEN 2A (autosomal dominant ret mutation)
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Thyroid tumors, pheochromocytoma, ganglioneuromatosis
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MEN 2B (autosomal dominant ret mutation)
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Toe extension/fanning upon plantar scrape
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Babinski sign (UMN)
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Unilateral facial drooping involving forehead
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Facial nerve-- LMN CN VII palsy
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Urethritis, conjunctivitis, arthritis in males
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Reactive arthritis associated with HLA-B27 linked conditions; Reiter's syndrome (can't see, pee, or bend the knee)
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Vascular birthmark (port-wine stain)
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Hemangioma- benign, but associated with Sturge-Weber syndrome
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Vomiting blood following gastroesophageal lacerations
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Mallory-Weiss syndrome-- alcoholic and bulimic patients
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Weight loss, diarrhea, arthritis, fever, adenopathy
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Whipple's disease (Tropheryma whipplei)
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Worst headache of my life
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Subarachnoid hemorrhage
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Anticentromere antibodies
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Scleroderma (CREST)
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Antidesmoglein (epithelial) antibodies
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Pemphigus vulgaris (blistering)
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Antiglomerular basement membrane antibodies
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Goodpasture's syndrome (glomerulonephritis and hemoptysis)
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Antihistone antibodies
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Drug induced SLE (hydralazine, isoniazid, phentynoin, procainamide)
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Anti-IgG antibodies
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Rheumatoid arthritis-- systemic inflammation, joint pannus, boutonniere deformity
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Antimitochondrial antibodies
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Primary biliary cirrhosis-- female, cholestasis, portal hypertension
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Antineutrophil cytoplasmic antibodies (ANCA's)
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c-ANCA- Wegener's granulomatosis with polyangiitis
p-ANCA- microscopic polyangiitis, Churg-Strauss syndrome |
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ANA: anti-Smith and anti-dsDNA
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SLE (type III hypersensitivity)
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Antiplatelet antibodies
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Idiopathic thrombocytopenic purpura
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Anti-topoisomerase antibodies
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Diffuse systemic scleroderma
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Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
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Celiac disease - diarrhea, distention, weight loss
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Apple core lesion on abdominal x ray
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Colorectal cancer (usually left-sided)
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Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts
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Auer rods- acute myelogenous leukemia, especially the promyelocytic (M3) type
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Bacitracin response
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Sensitive: group A strep aka Strep pyogenes
Resistant: group B strep aka Strep agalactiae |
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"Bamboo spine" on x-ray
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Ankylosing spondylitis (chronic inflammatory arthritis-- HLA B27)
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Basophilic nuclear remnants in RBC's
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Howell-Jolly bodies- due to splenectomy or non-functional spleen
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Basophilic stippling of RBC's
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Lead poisoning or sideroblastic anemia
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Bloody tap on LP
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Subarachnoid hemorrhage
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"Boot shaped heart" on x-ray
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Tetralogy of Fallot; RVH
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Branching gram positive rods with sulfur granules
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Actinomyces israelii
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Bronchogenic apical lung tumor on imaging
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Pancoast tumor- can compress sympathetic ganglion and cause Horner's syndrome
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"Brown" tumor of bone
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Hyperparathyroidism of osteitis fibrosa cystica; deposited hemosiderin from hemorrhage gives brown color
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Cardiomegaly with apical atrophy
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Chagas' disease (Trypanosoma cruzi)
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Cellular crescents in Bowman's capsule
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Rapidly progressive crescenteric glomerulonephritis
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"Chocolate cyst" of ovary
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Endometriosis (frequently involves both ovaries bilateral)
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Circular grouping of dark tumor cells surrounding pale neurofibrils
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Homer-Wright rosettes- neuroblastoma medulloblastoma, retinoblastoma
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Colonies of mucoid Pseudomonas in lungs
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Cystic fibrosis- AR mutation in CFTR resulting in fat-soluble vitamin deficiency and mucus plugs
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Decreased alpha-fetoprotein in amniotic fluid/maternal serum
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Down syndrome or other chromosomal abnormality
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Degeneration of dorsal column nerves
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Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
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Depigmentation of neurons in substantia nigra
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Parkinson's disease-- basal ganglia disorder characterized by rigidity, resting tremor, bradykinesia
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Desquamated epithelium casts in sputum
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Curschmann's spirals- bronchial asthma; can result in whorled mucus plugs
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Disarrayed granulosa cells in eosinophilic fluid
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Call-Exner bodies- granulosa-theca cell tumor of the ovary
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Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
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Koilocytes-- HPV; predisposes to cervical cancer
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Enlarged cells with intranuclear inclusion bodies
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Owl's eye appearance of CMV
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Enlarged thyroid cells with ground glass nuclei
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"Orphan Annie's eyes" nuclei- papillary carcinoma of the thyroid
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Eosinophilic cytoplasmic inclusions in liver cell
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Mallory bodies (alcoholic liver disease)
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Eosinophilic cytoplasmic inclusion in nerve cell
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Lewy body (Parkinson's disease)
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Eosinophilic globule in the liver
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Councilman body (toxic or viral hepatitis, often yellow fever)
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Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
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Negri bodies of rabies (Lyssavirus)
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Extracellular amyloid deposition in gray matter of brain
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Senile plaques of Alzheimers disease
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Giant B cells with bilobed nuclei with prominent inclusions (owl's eye)
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Reed-Sternberg cells of Hodgkin's lymphoma
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Glomerulus like structure surrounding vessel in germ cells
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Schiller-Duval bodies (yolk sac tumor)
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"Hair on end" (crew cut) appearance on x-ray
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beta-thalassemia, sickle cell anemia (marrow expansion)
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hCG elevated
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Choriocarcinoma, hydatidiform mole (occurs with and without embryo)
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Heart nodules (granulomatous)
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Aschoff bodies (rheumatic fever)
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Heterophile antibodies
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Infectious mononucleosis (EBV)
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Hexagonal, double-pointed, needle-like crystals in bronchial secretions
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Bronchial asthma-- Charcot-Leyden crystals; eosinophilic granules
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High level of D-dimers
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DVT, pulmonary embolism, DIC
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Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
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Ghon complex (primary TB; mycobacterium bacilli)
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"Honeycomb" lung on x-ray or CT
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Interstitial pulmonary fibrosis
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Hypercoagulability leading to migrating DVT's and vasculitis
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Trousseau's syndrome (adenocarcinoma of pancreas or lung)
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Hypersegmented neutrophils
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Megaloblastic anemia- B12 deficiency characterized by neurologic symptoms; folate deficiency does not have neuro symptoms
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Hypertension, hypokalemia, metabolic alkalosis
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Conn's syndrome
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Hypochromic, microcytic anemia
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Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
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Increased alpha-fetoprotein in amniotic fluid/maternal serum
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Dating error, anencephaly, spina bifida neural tube defects
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Increased uric acid levels
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Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
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Intranuclear eosinophilic droplet-like bodies
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Cowdry A bodies (HSV or CMV)
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Iron containing nodules in alveolar sputum
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Ferruginous bodies: asbestosis leads to increased chance of mesothelioma
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Keratin pearls on skin biopsy
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Squamous cell carcinoma
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Large lysosomal vesicles in phagocytes, immunodeficiency
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Chediak-Higashi disease (congenital failure of phagolysosome formation)
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Lead pipe appearance of colon on barium enema x-ray
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Ulcerative colitis (loss of haustra)
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Linear appearance of IgG deposition on glomerular basement membrane
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Goodpasture's syndrome
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Low serum ceruloplasmin
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Wilson's disease (hepatolenticular degeneration)
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Lumpy bumpy appearance of glomeruli on immunofluorescence
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Postreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
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Lytic (hole punched) bone lesions on x-ray
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Multiple myeloma
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Mammary gland (blue domed) cyst
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Fibrocystic change of the breast
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Monoclonal antibody spike
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-Multiple myeloma- usually IgG or IgA
- MGUS- normal consequence of aging - Waldenstrom's macroglobulinemia (M protein= IgM) -Primary amyloidosis |
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Mucin filled with peripheral nucleus
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Signet ring (gastric carcinoma)
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Narrowing of bowel lumen on barium x-ray
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String sign (Crohn's disease)
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Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
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- Granulomatosis with polyangiitis (Wegener's c-ANCA positive)
- Goodpasture's syndrome (anti-basement membrane antibodies) |
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Needle shaped negatively birefringent crystals
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Gout (MSU crystals)
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Nodular hyaline deposits in glomeruli
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Kimmelstiel-Wilson nodules (diabetic nephropathy)
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Novobiocin response
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Sensitive: Staph epidermidis
Resistant: Staph saprophyticus |
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Nutmeg appearance of the liver
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Chronic passive congestion of liver due to right heart failure
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Onion skin periosteal reaction
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Ewing's sarcoma (malignant round cell tumor)
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Optochin response
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Sensitive: Strep pneumo
Resistant: Viridans strep |
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Periosteum raised from bone, creating triangular area
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Codman's triangle on x-ray-- osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis
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Podocyte fusion or "effacement" on electron microscopy
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Minimal change disease (child with nephrotic syndrome)
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Polished, "ivory-like" appearance of bone at cartilage erosion
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Eburnation- osteoarthritis resulting in bony sclerosis
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Protein aggregates in neurons from hyperphosphorylation of protein tau
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Neurofibrillary tangles (Alzheimer's) and Pick's bodies (Pick's disease)
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Psammoma bodies
|
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
|
|
|
Pseudopalisading tumor cells on brain biopsy
|
Glioblastoma multiforme
|
|
|
RBC casts in urine
|
Acute glomerulonephritis
|
|
|
Rectangular, crystal-like, cytoplasmic inclusions of Leydig cells
|
Reinke crystals (Leydig cell tumors)
|
|
|
Renal epithelial casts in urine
|
Acute toxic/viral nephrosis
|
|
|
Rhomboid crystals, positively birefringent
|
Pseudogout (calcium pyrophosphate dihydrate crystals)
|
|
|
Rib notching
|
Coarctation of the aorta
|
|
|
Ring enhancing brain lesions in AIDS
|
Toxoplasma gondii, CNS lymphoma
|
|
|
Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ('starry sky' histology)
|
Burkitt's lymphoma
t(8;14) c-myc activation, associated with EBV "Black sky" made up of malignant cells |
|
|
Silver staining spherical aggregation of tau proteins in neurons
|
Pick bodies-- Pick's disease characterized by progressive dementia, changes in personality
|
|
|
"Soap bubble" in femur or tibia on x-ray
|
Giant cell tumor of bone (generally benign)
|
|
|
"Spikes" on basement membrane, "dome-like" subepithelial deposits
|
Membranous glomerulonephritis (may progress to nephrotic syndrome)
|
|
|
Stacks of RBC's
|
Rouleaux formation- high ESR, multiple myeloma
|
|
|
Stippled vaginal epithelial cells
|
"Clue cells" of Gardnerella vaginalis
|
|
|
"Tennis racket" shaped cytoplasmic organelles (EM) in Langerhans cells
|
Birbeck granules- Langerhans cell histiocytosis or histiocytosis X; eosinophilic granuloma
|
|
|
Thrombi made of white/red layers
|
Lines of Zahn-- arterial thrombus, layers of platelets/RBC's
|
|
|
Thumb sign on lateral x-ray
|
Epiglottitis (Haemophilus influenzae)
|
|
|
Thryoid like appearance of kidney
|
Chronic bacterial pyelonephritis
|
|
|
Tram track appearance of capillary loops of glomerular basement membranes on light microscopy
|
Membranoproliferative glomerulonephritis
|
|
|
Triglyceride accumulation in liver cell vacuoles
|
Fatty liver disease (alcoholic or metabolic syndrome)
|
|
|
"Waxy" casts with very low urine flow
|
Chronic end-stage renal disease
|
|
|
WBC casts in urine
|
Acute pyelonephritis
|
|
|
WBC's that look "smudged"
|
CLL (almost always B cell)
|
|
|
"Wire loop" glomerular capillary appearance on light microscopy
|
Lupus nephropathy
|
|
|
Yellowish CSF
|
Xanthochromia (e.g. due to subarachnoid hemorrhage)
|
|
|
Actinic (solar) keratosis
|
Precursor to squamous cell carcinoma
|
|
|
Acute gastric ulcer associated with CNS injury
|
Cushing's ulcer- Increased ICP stimulates vagal gastric secretion
|
|
|
Acute gastric ulcer associated with severe burns
|
Curling's ulcer- greatly reduced plasma volume results in sloughing of gastric mucosa
|
|
|
Alternating areas of transmural inflammation and normal colon
|
Skip lesions- Crohn's disease
|
|
|
Aneurysm, dissecting
|
Hypertension
|
|
|
Aortic aneurysm, abdominal and descending aorta
|
Atherosclerosis
|
|
|
Aortic aneurysm, arch
|
Tertiary syphilis (syphilitic aortitis), vasa vasorum destruction
|
|
|
Aortic aneurysm, ascending
|
Marfan's syndrome- idiopathic cystic medial degeneration
|
|
|
Atrophy of the mammillary bodies
|
Wernicke's encephalopathy- thiamine deficiency causing ataxia, ophthalmoplegia, and confusion
|
|
|
Autosplenectomy (fibrosis and shrinkage)
|
Sickle cell anemia (hemoglobin S)
|
|
|
Bacteria associated gastritis, peptic ulcer disease, and stomach cancer
|
H. pylori
|
|
|
Bacterial meningitis (adults and elderly)
|
Streptococcus pneumoniae
|
|
|
Benign melanocytic nevus
|
Spitz nevus-- most common in first two decades
|
|
|
Bleeding disorder with GpIb deficiency
|
Bernard-Soulier syndrome- defect in platelet adhesion to von Willebrand's factor
|
|
|
Brain tumor (adults)
|
Supratentorial: mets>astrocytoma (including glioblastoma multiforme)>meningioma>schwannoma
|
|
|
Brain tumor (kids)
|
Infratentorial: medulloblastoma (cerebellum)
Supratentorial: craniopharyngioma (cerebrum) |
|
|
Breast Cancer
|
Infiltrating ductal carcinoma-- in the U.S. 1/9 women will develop breast cancer
|
|
|
Breast Mass
|
Fibrocystic change, carcinoma (in postmenopausal women)
|
|
|
Breast tumor (benign)
|
Fibroadenoma
|
|
|
Cardiac primary tumor in kids
|
Rhabdomyoma-- often seen in tuberous sclerosis
|
|
|
Cardiac manifestation in lupus
|
Libman-Sacks endocarditis-- non-bacterial, affecting both sides of mitral valve
|
|
|
Cardiac tumor (adults)
|
Mets, primary myxoma (4:1 left to right atrium; "ball and valve")
|
|
|
Cerebellar tonsillar herniation
|
Chiari malformation--often present with progressive hydrocephalus or syringomyelia
|
|
|
Chronic arrhythmia
|
Atrial fibrillation- associated with a high risk for emboli
|
|
|
Chronic atrophic gastritis (autoimmune)
|
Predisposition to gastric carcinoma-- can also cause pernicious anemia
|
|
|
Clear cell adenocarcinoma of the vagina
|
DES exposure in utero
|
|
|
Compression fracture
|
Osteoperosis-- type I found in postmenopausal woman; type II found in an elderly man or woman
|
|
|
CAH, hypotension
|
21-hydroxylase deficiency
|
|
|
Congenital cardiac anomaly
|
VSD
|
|
|
Congenital conjugated hyperbilirubinemia (black liver)
|
Dubin-Johnson syndrome-- inability of hepatocytes to secrete conjugated bilirubin into bile
|
|
|
Constrictive pericarditis
|
Tuberculosis (developing world); SLE (developed world)
|
|
|
Coronary artery involved in thrombosis
|
LAD>RCA>LCA
|
|
|
Cretinism
|
Iodine deficient/hypothyroidism
|
|
|
Cushing's Syndrome
|
-Iatrogenic Cushing's from corticosteroid therapy
- Adrenocortical adenoma- secretes excess cortisol - ACTH secreting pituitary adenoma - Paraneoplastic Cushing's due to ACTH secretion by tumors |
|
|
Cyanosis (early, less common)
|
Tetralogy of Fallot, transposition of great vessels, truncus arteriosus
|
|
|
Cyanosis (late; more common)
|
VSD, ASD, PDA
|
|
|
Death in CML
|
Blast crisis
|
|
|
Death in SLE
|
Lupus nephropathy
|
|
|
Dementia
|
Alzheimer's disease, multiple infarcts
|
|
|
Demyelinating disease in young women
|
MS
|
|
|
DIC
|
Severe sepsis, obstetric complications, cancer, burns trauma, major surgery
|
|
|
Dietary deficit
|
Iron
|
|
|
Diverticulum in pharynx
|
Zenker's diverticulum- diagnosed with barium swallow
|
|
|
Ejection click
|
Aortic/pulmonic stenosis
|
|
|
Esophageal cancer
|
Squamous cell carcinoma (worldwide); adenocarcinoma (U.S.)
|
|
|
Food poisoning (exotoxin mediated)
|
S. aureus, B. cereus
|
|
|
Glomerulonephritis (adults)
|
Berger's disease- IgA nephropathy
Don't confuse with Buerger's disease |
|
|
Gynecologic malignancy
|
Endometrial carcinoma- most common in U.S.
Cercival carcinoma- most common worldwide |
|
|
Heart murmur, congenital
|
Mitral valve prolapse
|
|
|
Heart valve in bacterial endocarditis
|
Mitral>aortic (rheumatic fever); tricuspid in IV drug users
|
|
|
Helminth infection in U.S.
|
Enterobius vermicularis, Ascaris lumbricoides
|
|
|
Hematoma- epidural
|
Rupture of middle meningeal artery (trauma; lentiform shaped)
|
|
|
Hematoma- subdural
|
Rupture of bridging veins (crescent shaped)
|
|
|
Hemochromatosis
|
Multiple blood transfusions or hereditary HFE mutation-- can result in CHF, "bronze diabetes", and increased risk of hepatocellular carcinoma
|
|
|
Hepatocellular carcinoma
|
Cirrhotic liver- associated with hepatitis B and C and with alcoholism
|
|
|
Hereditary bleeding disorder
|
von Willebrand disease
|
|
|
Hereditary harmless jaundice
|
Gilbert's syndrome- benign congenital unconjugated hyperbilirubinemia
Exacerbated by stress |
|
|
HLA-B27
|
Ankylosing spondylitis, Reiter's syndrome, Ulcerative colitis, psoriasis
|
|
|
HLA-DR3 or DR4
|
T1DM, RA, SLE
|
|
|
Holosystolic murmur
|
VSD, tricuspid regurgitation, mitral regurgitation
|
|
|
Hypercoagulability, endothelial damage, blood stasis
|
Virchow's triad- results in venous thrombosis
|
|
|
Hypertension, secondary
|
Renal disease
|
|
|
Hypoparathyroidism
|
Accidental excision during thyroidectomy
|
|
|
Hypopituitarism
|
Pituitary adenoma (usually benign tumor)
|
|
|
Infection secondary to blood transfusion
|
Hepatitis C
|
|
|
Infections in Chronic Granulomatous Disease
|
S. aureus, E. coli, Aspergillus (catalase positive)
|
|
|
Kidney stones
|
-Calcium= radiopaque
-Struvite (ammonium) = radiopaque (formed by urease positive organisms such as Proteus vulgaris or Staphylococcus) -Uric acid=radiolucent |
|
|
Late cyanotic shunt (uncorrected L-->R becomes R-->L)
|
Eisenmenger's syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)
|
|
|
Liver disease
|
Alcoholic Cirrhosis
|
|
|
Lysosomal storage disease
|
Gaucher's disease
|
|
|
Male cancer
|
Prostatic carcinoma
|
|
|
Malignancy associated with noninfectious fever
|
Hodgkin's lymphoma
|
|
|
Malignancy (kids)
|
ALL, medulloblastoma (cerebellum)
|
|
|
Mental retardation
|
Down syndrome, fragile X syndrome
|
|
|
Mets to bone
|
Prostate, breast>lung> thyroid,testes
|
|
|
Mets to brain
|
Lung> breast> genitourinary>osteosarcoma>melanoma>GI
|
|
|
Mets to liver
|
Colon>>stomach, pancreas
|
|
|
Mitochondrial inheritance
|
Disease occurs in both males and females, inherited through females only
|
|
|
Mitral valve stenosis
|
Rheumatic heart disease
|
|
|
Mixed (UMN and LMN) motor neuron disease
|
ALS
|
|
|
Myocarditis
|
Coxsackie B
|
|
|
Nephrotic Syndrome (Adults)
|
FSGS
|
|
|
Nephrotic syndrome (kids)
|
Minimal change disease
|
|
|
Neuron migration failure
|
Kallmann syndrome-- hypogonadotropic hypogonadism and anosmia
|
|
|
Nosocomial pneumonia
|
Klebsiella, E. coli, Pseudomonas aeruginosa
|
|
|
Obstruction of male urinary tract
|
BPH
|
|
|
Opening snap
|
Mitral stenosis
|
|
|
Oppurtunistic infection in AIDS
|
Pneumocystis jirovecii (formally carinii) penumonia
|
|
|
Osteomyelitis
|
S. aureus
|
|
|
Osteomyelitis in sickle cell disease
|
Salmonella
|
|
|
Osteomyelitis with IV drug use
|
Pseudomonas, S. aureus
|
|
|
Ovarian Mets from gastric carcinoma or breast cancer
|
Krukenberg tumor-- mucin secreting signet-ring cells
|
|
|
Ovarian tumor (benign, bilateral)
|
Serous cystadenoma
|
|
|
Ovarian tumor (malignant)
|
Serous cystadenocarcinoma
|
|
|
Pancreatitis (acute)
|
Gallstones, alcohol
|
|
|
Pancreatitis (chronic)
|
Alcohol (adults), cystic fibrosis (kids)
|
|
|
Patient with ALL/CLL/AML/CML
|
ALL- kids
CLL- adult>60 AML- adult ~65 CML- adult 30-60 |
|
|
Pelvic Inflammatory disease
|
Chlamydia trachomatis, Neisseria gonorrhoeae
|
|
|
Philadelphia chromosome t(9;22) (bcr-abl)
|
CML-- can sometimes be associated with ALL/AML
|
|
|
Pituitary tumor
|
Prolactinoma, somatotropic "acidophile" adenoma
|
|
|
Primary amenorrhea
|
Turner syndrome (45XO)
|
|
|
Primary bone tumor (adults)
|
Multiple myeloma
|
|
|
Primary hyperaldosteronism
|
Adenoma of adrenal cortex
|
|
|
Primary hyperparathryoidism
|
Adenomas, hyperplasia, carcinoma
|
|
|
Primary liver cancer
|
Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, A-1-A deficiency)
|
|
|
Pulmonary hypertension
|
COPD
|
|
|
Recurrent inflammation/thrombosis of small/medium vessels in extremities
|
Buerger's disease (strongly associated with tobacco)
|
|
|
Renal tumor
|
Renal cell carcinoma: associated with VHL and cigarette smoking; paraneoplastic syndrome (EPO, renin, PTH, ACTH)
|
|
|
Right heart failure due to pulmonary cause
|
Cor pulmonale
|
|
|
S3 (protodiastolic gallop)
|
Increased ventricular filling- left to right shunt, mitral regurgitation, LV failure (CHF)
|
|
|
S4 (presystolic gallop)
|
Stiff/hypertrophic ventricle-- aortic stenosis, restrictive cardiomyopathy
|
|
|
Secondary hyperparathyroidism
|
Hypocalcemia of chronic kidney disease
|
|
|
STD
|
Chlamydia-- usually coinfected with gonorrhea
|
|
|
SIADH
|
Small cell carcinoma of the lung (oat cell)
|
|
|
Site of diverticula
|
Sigmoid colon
|
|
|
Sites of atherosclerosis
|
Abdominal aorta > coronary artery > popliteal artery > carotid artery
|
|
|
Stomach carcinoma
|
Adenocarcinoma
|
|
|
Stomach ulcerations and high gastrin levels
|
Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
|
|
|
t(14;18)
|
Follicular lymphomas (bcl-2 activation)
|
|
|
t (8;14)
|
Burkitt's lymphoma (c-myc activation)
|
|
|
t(9;22)
|
Philadelphia chromosome, CML (bcr-abl fusion gene)
|
|
|
Temporal arteritis
|
Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymalgia rheumatica
|
|
|
Testicular tumor
|
Seminoma
|
|
|
Thyroid cancer
|
Papillary carcinoma
|
|
|
Tumor in women
|
Leiomyoma- estrogen dependent, not precancerous
|
|
|
Tumor in infancy
|
Hemangioma- usually regresses spontaneously by childhood
|
|
|
Tumor of the adrenal medulla (adults)
|
Pheochromocytoma (usually benign)
|
|
|
Tumor of the adrenal medulla (children)
|
Neuroblastoma (malignant)
|
|
|
Type of Hodgkin's
|
Nodular Sclerosis
Mixed cellularity Lymphocytic predominance Lymphocytic depletion |
|
|
UTI
|
E. coli, Staph saprophyticus (young women)
|
|
|
Viral encephalitis affecting the temporal lobe
|
HSV-1
|
|
|
Vitamin deficiency (U.S)
|
Folate-- pregnant women are at high risk; body stores only 3 to 4 month supply; prevents neural tube defects
|
|
|
absence seizures
|
ethosuximide
|
|
|
acute gout attack
|
NSAIDs
colchicine |
|
|
acute promyelocytic leukemia (M3)
|
all-trans retinoic acid
|
|
|
ADHD
|
methylphenidate, amphetamines
|
|
|
alcohol abuse
|
AA + disulfiram for patient & al-anon for family
|
|
|
alcohol w/d
|
denzodiazepines
|
|
|
anorexia
|
SSRIs
|
|
|
anticoagulation during pregnancy
|
heparin
|
|
|
anxiety
|
buspirone
|
|
|
arrhythmia in damaged cardiac tissue
|
class IB antiarrhythmic (lidocaine, mexiletine, tocainide)
|
|
|
B12 deficiency
|
B12 supplementation (work up cause with Schilling test)
|
|
|
benign prostatic hyperplasia
|
tamsulosin, finasteride
|
|
|
bipolar disorder
|
lithium, valproate, carbamazepine, lamotrigine (mood stabilizers)
|
|
|
breast cancer in postmenopausal woman
|
aromatase inhibitor (anastrozole)
|
|
|
buerger's disease
|
smoking cessation
|
|
|
bulimia
|
SSRIs
|
|
|
candida albicans
|
amphotericin B (systemic
nystatin (oral thrush, esophagitis) |
|
|
carcinoid syndrome
|
octreotide
|
|
|
chlamydia trachomatis
|
doxycycline (+ ceftriaxone for gonorrhea coinfection)
erythromycin eye drops (prophylaxis in infants) |
|
|
chronic gout
|
probenecid (underexcretor)
allopurinol (overproducer) |
|
|
chronic hepatitis
|
IFN-alpha
|
|
|
chronic myelogenous leukemia
|
imatinib
|
|
|
clostridium botulinum
|
antitoxin
|
|
|
clostridium difficile
|
oral metronidazole; if refractory, oral vancomycin
|
|
|
clostridium tetani
|
antitoxin + vaccine booster + diazepam
|
|
|
crohn's disease
|
corticosteroids, infliximab
|
|
|
cryptococcus neoformans
|
fluconazole (prophylaxis in AIDS patient)
|
|
|
cystic fibrosis
|
N-acetylcysteine + antipseudomonal prophylaxis (tobramycin/azithromycin)
|
|
|
cytomegalovirus
|
gancyclovir
|
|
|
depression
|
SSRIs (first line)
|
|
|
diabetes insipidus
|
desmopressin (central)
hydrochlorothiazide, indomethacin, amiloride (nephrogenic) |
|
|
diabetes mellitus type 1
|
dietary intervention (low sugar) + insulin replacement
|
|
|
diabetes mellitus type 2
|
dietary intervention, oral hypoglycemic, and insulin (possible)
|
|
|
diabetic ketoacidosis
|
fluids, insulin, K+
|
|
|
enterococci
|
vancomycin/ampicillin + aminoglycoside
|
|
|
erectile dysfunction
|
sildenafil, vardenafil
|
|
|
ER-positive breast cancer
|
tamoxifen
|
|
|
ethylene glycol/methanol intoxication
|
fomepizole (alcohol dehydrogenase inhibitor)
|
|
|
folate deficiency
|
folate
|
|
|
haemophilus influenzae (B)
|
rifampin (prophylaxis)
|
|
|
heparin toxicity (acute)
|
protamine sulfate
|
|
|
HER2/neu-positive breast cancer
|
trastuzumab
|
|
|
hyperaldosteronism
|
spironolactone
|
|
|
hypercholesterolemia
|
statin (first line)
|
|
|
hypertriglyceridemia
|
fibrate
|
|
|
immediate anticoagulation
|
heparin
|
|
|
infertility
|
leuprolide, GnRH (pulsatile)
|
|
|
influenza
|
oseltamivir/rimantadine
|
|
|
legionella pneumophila
|
erythromycin
|
|
|
long-term anticoagulation
|
warfarin
|
|
|
malaria
|
chloroquine/mefloquine (for blood schizont)
primaquine (for liver hypnozoite) |
|
|
malignanty hyperthermia
|
dantrolene
|
|
|
medical abortion
|
mifepristone
|
|
|
migraine
|
sumatriptan
|
|
|
MRSA
|
vancomycin
|
|
|
multiple sclerosis
|
beta-interferon, immunosuppression, natalizumab
|
|
|
mycobacterium tuberculosis
|
RIPES (rifampin, INH, pyrazinamide, ethambutol)
|
|
|
neisseria gonorrhoeae
|
ceftriaxone (add doxycycline to cover likely concurrent chlamydia)
|
|
|
neisseria meningitidis
|
penicillin/ceftriaxone, rifampin (prophylaxis)
|
|
|
neural tube defect prevention
|
Prenatal folic acid
|
|
|
osteomalaia/rickets
|
vitamin D supplementation
|
|
|
patent ductus arteriosus
|
indomethacin
|
|
|
pheochromocytoma
|
alpha-antagonists (e.g. phenoxybenzamine)
|
|
|
pneumocystis jiroveci
|
TMP-SMX (prophylaxis in AIDS patient)
|
|
|
prolactinoma
|
bromocriptine (dopamine agonists)
|
|
|
prostate cancer/uterine fibroids
|
leuprlide, GnRH (continuous)
|
|
|
prostate carcinoma
|
flutamide
|
|
|
pseudomonas aeruginosa
|
antipseudomonal penicillin + aminoglycoside
|
|
|
pulmonary arterial hypertension 9idiopathic)
|
Sildenafil, bosentan, epoprostenol
|
|
|
rickettsia rickettsii
|
Doxycycline, chloramphenicol (especially in context of aplastic anemia)
|
|
|
ringworm infections
|
terbinafine, griseofulvin, imidazole
|
|
|
schizophrenia (negative symptoms)
|
5-HT2A antagonists (e.g. second-generation antipsychotics)
|
|
|
schizophrenia (positive symptoms)
|
D2 receptor antagonists (e.g. first and second generation antipsychotics)
|
|
|
SIADH
|
demeclocycline, lithium, vasopression receptor antagonists
|
|
|
sickle cell anemia
|
hydroxyurea (increases HbF)
|
|
|
sporothrix schenckii
|
oral potassium
|
|
|
stable angina
|
sublingual nitroglycerin
|
|
|
staphylococcus aureus
|
MSSA: naficillin, oxacillin, dicloxacillin (antistaphylococcal penicillins) MRSA vancomycin
|
|
|
streptococcus bovis
|
penicillin prophylaxis; evaluation for colon cancer if linked to endocarditis
|
|
|
streptococcus pneumoniae
|
penicillin/cephalosporin (systemic infection, pneumonia)
vancomycin (meningitis) |
|
|
streptoccus pyogenes
|
penicillin prophylaxis
|
|
|
temporal arteritis
|
high-dose steroids
|
|
|
tonic-clonic seizures
|
phenytoin, valproate, carbamazepine
|
|
|
toxoplasma gondii
|
sulfonamide + pyrimethamine
|
|
|
treponema pallidum
|
penicillin
|
|
|
trichomonas vaginalis
|
metronidazole (patient and partner)
|
|
|
ulcerative colitis
|
5-ASA, infliximab
|
|
|
UTI prophylaxis
|
TMP-SMX
|
|
|
warfarin toxicity
|
fresh frozen plasma (acute)
vitamin K (chronic) |
|
|
wegener's granulomatosis with polyangiitis
|
cyclophosphamide, corticosteroids
|
|
|
Sensitivity
|
Sensitivity = TP / (TP + FN)
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Specificity
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Specificity = TN / (TN + FP)
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Positive predictive value
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PPV = TP / (TP + FP)
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Negative predictive value
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NPV = TN / (TN + FN)
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Odds ration (for case-control studies)
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Odds Ratio = (a/c)/(b/d) = ad/bc
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Relative risk
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R = [a / (a+b)] / [c / (c+d)]
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Attibutable risk
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AR = [a / (a+b)] - [c / (c+d)]
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Number needed to treat
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1/absolute risk reduction
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Number needed to harm
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1/attributable risk
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Hardy-Weinberg equilibrium
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p^2 + 2pq + q^2 = 1
p + q = 1 |
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Henderson-Hasselbach equation
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pH = pKa + log ([HCO3]/0.03*PCO2)
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Volume of distribution
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Vd = amount of drug in the body / plasma drug concentration
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Clearance
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CL = rate of elimination of drug / plasma drug concentration
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Half-life
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t1/2 = (0.7*Vd) / CL
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Loading dose
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LD = Cp * Vd/F
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Maintenance dose
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MD = Cp * CL/F
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Cardiac output
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CO = rate of O2 consumption / (arterial O2 content - venous O2 content)
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Cardiac output (physics eq.)
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CO=rate of O2 consumption/arterial O2 content-venous O2 content
CO = HR * SV |
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Mean arterial pressure
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MAP = cardiac output * total peripheral resistance
MAP = 1/3 systolic + 2/3 diastolic |
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Stroke volume
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SV = CO/HR = end diastolic volume - end systolic volume
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Ejection fraction
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EF = (stroke volume / end diastolic volume) = (EDV-ESV)/EDV
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Resistance
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R = driving pressure / flow = [8η (viscosity) * length] / (πr^4)
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Net filtration pressure
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Pnet = [(Pc - Pi) - (πc - πi)]
Jv = net fluid flow = (Kf)(Pnet) |
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Glomerular filtration rate (conc. eq.)
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GFR = U(inulin) * [V / P(inulin)] = C(inulin)
GFR = Kf (Pgc - Pbs) - ( |
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Glomerular filtration rate (pressure eq.)
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GFR = Kf [(P(gc) - P(bs)) - (π(gc) -π(bs))]
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Effective renal plasma flow
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ERPF = U(PAH) * [V / P(PAH)] = C(PAH)
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Renal blood flow
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RBF = RPF / (1 - Hct)
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Filtration fraction
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FF = GFR / RPF
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Physiologic dead space
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V(D) = V(T) * (PaCO2 - PeCO2) / PaCO2
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Collapsing Pressure
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2(surface tension) / radius
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Pulm Vascular Resistance
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(Pulm artery pressure) - PCWP / CO
note: PCWP = left atrial pressure |
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alveolar gas equation
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PAo2 = PIo2 - PaCo2/R
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Bacterial meningitis (newborns and kids)
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Group B streptococcus (newborns), S. pneumoniae/Neisseria meningitis (kids)
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Type of non-Hodgkin's
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Diffuse large cell
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Cyclophosphamide-induced hemorrhagic cystitis
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Mesna
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Generalized anxiety disorder
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Buspirone
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Osteoporosis
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Bisphosphonates; calcium and vitamin D supplementation
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Body mass index
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BMI=weight in kg/(height in meters)2
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Drug clearance
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CL=(rate of elimination of drug/plasma drug concentration)=VdxKe (elimination constant)
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Renal Clearance
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Cx = Ux V/Px
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Filtration fraction
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FF=GFR/RPF
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Henderson-Hasselbalch equation (for extracellular pH)
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pH=6.1 + log (HCO3)/.03Pco2
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