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772 Cards in this Set
- Front
- Back
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Heberden's nodes
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changes in DIP, from RA/OA
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Bouchard's nodes
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changes in PIP, from RA
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Types of JRA
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systemic, pauciarticular, polyarticular
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Reiter's syndrome
(aka - Reactive Arthritis) |
urethritis, conjunctivitis, oligoarthritis
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Gout
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needle-like, neg birefringent crystals
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Pseudogout
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rhomboid, pos birefringent crystals
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CREST
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calcinosis, raynaud's, esophageal dismotility, sclerodactyly, telangiectasias
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Sjogren's syndrome
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schirmer's tear test
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Multiple myeloma
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MC primary malignant bone tumor
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Ecchondroma
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MC primary benign bone neoplasm of hand
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Nursemaid's elbow
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subluxation of the radial head
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Lisfranc fracture
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dislocation of tarsometatarsal joint complex
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TMJ
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MCC of facial pain
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Clavicle fracture
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MC fracture of childhood
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Carpel Tunnel Syndrome
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median nerve, tinel/phalen tests
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Boxer's fracture
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fracture of the 5th metacarpel neck
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Colles fracture
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distal radius fracture with dorsal displacement
(dinner fork deformity) |
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Smith fracture
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distal radius fracture with ventral displacment
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Gamekeeper's thumb
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sprain of ulnar collateral ligament
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Scaphoid fracture
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snuffbox tenderness
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DeQuervain's
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stenosing tenosynovitis,
Finkelstein's test |
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Levoscoliosis/Dextroscoliosis
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left scoliosis/right scoliosis
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Ankylosis spondylitis
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bamboo spine
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SCFE/Legg-Calve-Perthes
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painful limp/not painful
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Cauda Equina Syndrome
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saddle anesthesia
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Osgood-Schlatter
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tibial tuberosity tenderness
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Compartment Syndrome
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pain out of proportion to exam
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Pott's disease
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TB of the spine that causes progressive kyphosis
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Scheuermann's disease
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juvenile kyphosis
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Spurling's test
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pressure and application of neck toward the spine
(cervical radiculopathy) |
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Adson's test
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extended arm while head is turned toward the arm
(thoracic outlet syndrome) |
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C1 (Jefferson) fracture
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axial load fracture of C1
(burst fracture) |
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Hangman's fracture
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C2 fracture
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Clay-Shoveler's fracture
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avulsion of C6, C7, T1
occurs from repetitive motion |
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Schmorl's nodes
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XR findings of nodes seen in Scheurmann's nodes
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T10-L2
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MC site of compression fractures
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L4-L5, L5-S1
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MC site of disc herniation
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Lasegue sign
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aka: SLR, used for sciatica
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L4 nerve root
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patellar DTR
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S1 nerve root
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achilles DTR
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Spondylolisthesis
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anterior translation of vertebrae
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Rotator cuff tear
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(+) empty can test
(+) drop arm test |
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Impingement syndrome
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difficulty with overhead motions
(ie - combing hair) |
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Yergason's test
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bicipital tendinitis, arm flexion with resisted supination
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Shoulder dislocation
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(+) sulcus sign, apprehension sign
(+) bankhart & hill-sachs lesions |
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DeQuervain's
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EPB & APL inflammation
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Tuft fracture
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fracture of distal phalynx
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Dupuytren's contracture
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MC hand deformity of ring & little fingers
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ACL tear
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dx via lachman test, piviot shift, anterion drawer
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Meniscus injury
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dx via McMurray, Appley
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Baker's cyst
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cyst in politeal space
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Chondromalacia
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sunrise view, kneecap grinding, patellar grind
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MCL/LCL tear
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valgus/varus test
MC = medial |
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Ankle sprain
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drawer test, tilt test
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Sever's disease
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calcaneal apophysitis
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ATF
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MC ligament injury of ankle sprain
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Maisonneuve fracture
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fracture of medial malleolus (likely with fibula fracture)
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Morton's neuroma
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dx via Thompson test
(lateral metatarsal compression) |
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Jones fracture
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fracture at the base of the 5th metatarsal
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AVN
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cresent sign on XR
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Spinal stenosis
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shopping cart sign
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Ottawa/Garden
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ankel classification/
hip classification |
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Achilles rupture
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dx via thompson test (calf compression)
"weekend warrior" injury |
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Still's disease
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JRA
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Zenker's diverticulum
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outpouching of posterior hypopharynx, regurgitation
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Achalasia
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"bird's beak" on barium swallow
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Esophageal CA
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progressive dysphagia
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India Ink Stain
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Cryptococcosis (dx stain?)
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Peptic Ulcer disease
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gnawing pain that radiates to back
(cause = H Pylori) |
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Duodenal ulcer
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ulcer that improves with food
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Gastric ulcer
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ulcer that worsens with food
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H. pylori
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Urea breath test
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Zollinger-Ellison syndrome
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gastrinoma, marked by abdominal pain +/- diarrhea
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Virchow's node
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left supraclavicular LAD
(sign of gastric mets) |
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Sr. Mary Joseph node
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umbilical node
(sign of gastric mets) |
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SBO
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air-fluid levels on XR
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Crohn's disease
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skip lesions
cobblestoning on barium enema mouth-to-anus, full thickness |
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Ulcerative colitis
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UC vs Crohn's: more likely to involve malignancy
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IBS
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MCC of chronic abdominal pain in the US
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Intussusception
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currant jelly stools
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Hirschsprung's disease
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congenital megacolon
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Appendicitis
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(+) MrBurney, Psoas, Obturator signs
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Pancreatitis
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Ranson's criteria
(leuk, glucose, LDH, AST, H/H, BUN, PO2, Ca) |
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Chronic pancreatitis triad
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calcification, steatorrhea, DM
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Couviosier's sign
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palpabable GB
(pancreatic CA) |
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Liver CA
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increased AFP
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Indirect Inguinal Hernia
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MC type of hernia
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Rickets
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Vit D deficiency
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Scurvy
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Vit C deficiency
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Beriberi
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Thiamin (B1) deficiency
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Glomerulonephritis/Nephrotic Syndrome
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RBC casts
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Calcium stones
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MC type of kidney stone
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Cheyne-Stokes respirations
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hyponatremia (breathing pattern seen in CHF)
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Hyperkalemia
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peaked T-waves on EKG
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Trousseau sign
(hypocalcemia) |
carpel tunnel spasm after 3min of BP cuff
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Chvostek sign
(hypocalcemia) |
facial spasm after tapping pre-ear nerve
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Calcium gluconate
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IV treatment for hyperkalemia or hypermag
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Anion gap
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serum UA - (serum bicarb + serum Cl)
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GC/Chlamydia
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MCC of epididymitis < 35yo
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E. coli
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MCC of epididymitis > 35yo
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Prehn's sign (epididymitis)
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testicular pain relief with elevation
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Renal Cell Carcinoma
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MC type of renal malignancy
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RCC triad
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hematuria, flank pain, palpable mass
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Peyronie's disease
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fiberous plaque causing penile curvature
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Left spermatic vein
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Increased risk of developing varicocele secondary to anatomy
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Murphy's sign
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cholecystitis (pain with insp pressure of RUQ)
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Charcot's triad (cholangitis)
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fever, jaundice, RUQ pain
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Reynold's pentad (cholangitis)
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fever, jaundice, RUQ pain, AMS, hypotension
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Fitz-Hugh-Curtis syndrome
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perihepatitis from ascending GC/Chlamydia
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McBurney's point
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appendicitis (1/3 of ASIS to umbilicus - pain)
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Intussusception
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"coiled spring" sign
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Splenic rupture
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Kehr's sign
(LUQ pain + left shoulder pain) |
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Sigmoid volvulus
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"inverted U" on XR
"bird's beak" on contrast enema |
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Pancreatitis
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Grey Turner's (flank)
Cullen's (periumbilical) |
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Pancreatitis
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"sentinal loop" on XR
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Esophageal CA/Colon CA
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"apple core" lesion
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Krunkenburg tumor
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gastric mets to ovarian masses
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Blumer's shelf
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palpable rectal node from gatric mets
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Cholelithiasis
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4Fs = female, forty, fat, fertile
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Cholecystitis bugs
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EEEK!: E coli, Enterobacter, Enterococcus, Klebsiella
|
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EtOH, Gallstones
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MCC of pancreatitis
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Volvulus
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"bird's beak" or "ace of spades" on barium enema
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Predisposing factors for fistula
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FRIENDS: foreign body, radiation, infection, epithelialization, neoplasm, distal obstruction
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Berger's disease
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IgA nephropathy
(hematuria + proteinuria) |
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Renal Artery Stenosis (dyad)
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sudden HTN, decrease K
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Diffuse esophageal spasm
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"corkscrew" on barium swallow
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Adhesions
Hernias |
MCC of SBO in adults
MCC of SBO in kids |
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Ulcerative colitis
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"lead pipe" on barium enema
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Hesselbach's triangle
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inguinal ligament, inferior epigastric artery, rectus abdominis
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Niacin deficiency triad
(Pellagra) |
dementia, diarrhea, dermatitis
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Gastric volvulus triad
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unproductive vomiting, epigastric distention, arrhythmia
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Hypokalemia
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confusion, AMS, muscle weakness, cramps, arrhythmia
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H. pylori treatment
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amoxicillin, clarithromycin, omeprazole
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Sclerosing cholangitis
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jaundice, pruritis, fatigue
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Wilson's disease
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kayser-fleisher rings
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Nephrotic syndrome
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proteinuria, edema, hypoalbuminemia
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Glomerulonephritis
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RBC casts
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Nephrotic syndrome
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fatty casts
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DM
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hyaline casts
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Pyelonephritis
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WBC casts
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Ranson's criteria
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"GA LAW" + "C HOBBS"
- glucose > 200 - age > 55yo - LDH > 350 - AST > 250 - WBC > 16 - Ca < 8 - H/H down 10% - Po2 < 60 - base excess > 4 - BUN > 5 - Sequestering fluid > 6L |
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Coag cascade: Intrinsic Pathway
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measure PTT, Heparin, XII ... X
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Coag cascade: Extrinsic Pathway
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measure PT, Warfarin, VII ... X
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Hemophilia A
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factor VIII deficiency
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Hemophilia B
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factor IX deficiency, Christmas disease
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Hemophilia C
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factor XI deficiency, Ashkinazi Jews
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vonWillebrand Dz
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MC inhereted bleeding disorder
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TTP spectrum
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HUS + HELLP
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TTP pentad
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FAT RN: fever, anemia, thrombocytopenia, renal changes, neuro changes
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Microcytic anemias
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TICS: thal, iron deficiency, chronic disease, sideroblastic
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Megaloblastic anemias
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B12 (pernicious), folate deficiency
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Coombs test
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test for hemolytic anemia
(autoimmune hemolysis) |
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Polycythemia vera
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intense pruritus after showering
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Porphyria
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College student with abdominal pain and brown urine after a night of EtOH and barbituates
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ALL
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MC childhood CA
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AML
|
auer rods
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CML
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philadelphia chromosome
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Hodgkin's disease
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Reed-Sternberg cells
(owl eyes) |
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Multiple myeloma
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Bence-Jones proteins
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Pernicious Anemia
|
Shilling test
(cobalamin +/- intrinsic factor) |
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Sickle cell disease
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Howell-Jolly bodies
|
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Ann Arbor criteria
|
staging system for Hodgkin/NHD
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Congo Red Stain
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Amyloidosis (biopsy stain?)
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Waldenstrom's Macroglobulinemia
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Dutcher bodies
|
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Tumor lysis syndrome
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hyperkalemia, hyperuricemia, hyperphosphatemia, hypocalcemia
|
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Ewing's/Osteosarcoma
|
onion skin/sunburst lesion on XR
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Lead poisoning
|
wrist/foot drops, basophilic stippling, bruton's lines
|
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Bruton's lines
|
blue/gray discolation at gumline (in lead poisoning)
|
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Pernicious anemia labs
|
hypersegmented neutrophils
|
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Pel-Epstein fevers
(Hodgkins) |
fevers that wax/wane for weeks
|
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SCD - infection risk
|
pneumococcus and salmonella osteomyelitis
|
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PCP prophylaxis
|
Bactrim or inhaled pentamidine
|
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High-risk ALL
|
age: <2 or >10
philadephila chromosome WBC > 50,000 |
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B-thal
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Codocytes
|
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Protamine
|
Heparin antidote
|
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Vitamin K
|
Warfarin antidote
|
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HUS triad
|
anemia, thrombocytopenia, renal failure
|
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Blast crisis
|
fever, bone pain, splenomegaly, pancytopenia
|
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Thal, G6PD, splenectomy
|
Heinz bodies
|
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Corynebacterium diptheriae
|
grows in cystine tellurite agar
|
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Giant cell tumor
|
"soap bubble" sign on XR, benign
|
|
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Osteosarcoma
|
Codman's triangle:
periosteal elevation from tumor |
|
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"PT Barnum Loves Kids"
prostate, thyroid, breast, liver, kidney |
MCC of mets to bone
|
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Plummer-Vinson syndrome
|
formation of esophageal webs in severe anemia (iron def)
|
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Prussian blue stain
|
stain for sideroblastic marrow cells
|
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Aplastic anemia
|
pancytopenia + hypocellular marrow
|
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8%
|
% of AA who carry Hgb S trait
|
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CLL
|
MC type of leukemia
|
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CLL
|
smudge cells, Rai staging
|
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Parvovirus B19
EBV HSV |
Aplastic anemia virus
Hodgkin's virus Multiple myeloma virus |
|
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Thrombocytopenia
|
MCC of abnormal bleeding
|
|
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Scarlet fever
|
sandpaper rash, strawberry tongue
"sunburn with goosebumps" |
|
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Impetigo
|
honey-colored crust
|
|
|
Group A Strep
|
MCC of cellulitis in US
|
|
|
Jones criteria
|
criteria for ARF
|
|
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Botulism
|
infants + honey
|
|
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Cholera
|
"rice water" diarrhea
|
|
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Tetanus
|
jaw (trismus) + neck stiffness
|
|
|
Typhoid fever
(Salmonella) |
"pea soup" diarrhea
|
|
|
EBV
|
human herpes virus 4
|
|
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Mono/EBV
|
increase posterior cervical lymph nodes
|
|
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Rubella
|
increase posterior occipital lymph nodes
|
|
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HPV 16, 18
|
implicated in increased risk of cervical CA
|
|
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Herpetic whitlow
|
HSV on fingertips
|
|
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Tzank smear
|
culture used for multinucleated giant cells (HSV)
|
|
|
Reye's syndrome
|
fatty liver with encephalopathy, from aspirin
|
|
|
Varicella
|
"dewdrops on rosepetals"
|
|
|
Rabies
|
hydrophobia, muscle spasms
|
|
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AIDS
|
CD4 count < 200
|
|
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CMV
|
human herpes virus 5
|
|
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Candida
|
satellite lesions
|
|
|
Cryptococcus
|
India ink stain
|
|
|
PCP
|
MC opportunistic infection of HIV
|
|
|
Amebiasis
|
stool specimen with trophozoites
|
|
|
Hookworm treatment
|
mebendazole or pyrantel/albendazole
|
|
|
Pinworms (enterobiasis)
|
itchy butt at night (tape test)
|
|
|
Malaria
|
Giemsa or Wright stain
Chloroquine |
|
|
Syphilis
|
Treponema pallidum
|
|
|
Argyll Robertson pupil
|
eye reacts but no accomodation, syphilis
|
|
|
Jansch-Herxhermier reaction
(Syphilis) |
fever, toxicity with spirochete destruction
|
|
|
Gonorrhea
|
dysuria, purulent/milky discharge
|
|
|
Chlamydia
|
less dysuria, watery penile discharge
|
|
|
Trichomonas
|
frothy, yellow/green discharge
strawberry cervix |
|
|
Lyme disease
|
Borrelia burgdorferi via Ixodides tick
|
|
|
Lyme disease
|
MC vector-borne illness in US
|
|
|
Erythema migrans
|
bull's eye or target rash
|
|
|
Rocky Mountain Spotted Fever
|
Rickettsia rickettsii
via wood tick |
|
|
TB
|
Acid Fast Stain with red snappers
|
|
|
Centor Criteria (pharyngitis)
|
no cough, fever, exudates, LAD
|
|
|
Lemierre's syndrome
|
thrombophlebitis of jugular vein
|
|
|
Kernig's sign
|
pain with 90 flexion and knee extension
|
|
|
Brudzinski's sign
|
neck flexion results in hip/knee flexion
|
|
|
Rifampin
|
Meningitis prophylaxis
|
|
|
HSV encephalitis
|
RBCs in CSF
(without trauma) |
|
|
SAH
|
RBCs in CSF
(yellow/straw CSF) |
|
|
Brain abscess triad
|
HA, fever, focal neuro deficit
(ring-enhancing lesion) |
|
|
Thrush v. leukoplakia
|
scrapes off v. cannot scrape
|
|
|
Granuloma inguinale
|
beefy-red ulcer
|
|
|
Pyelonephritis
|
flank pain, CVA tenderness
|
|
|
Mono/EBV triad
|
fever, sore throat, LAD
|
|
|
TORCH diseases
|
toxoplasmosis, syphilis, rubella, CMV, HSV
|
|
|
Rubella
|
"blueberry muffin" rash
|
|
|
Endocarditis
|
JR = NO FAME:
janeway lesions, roth spots, nail hemorrhages, osler nodes, fever, anemia, murmur, emboli |
|
|
Anthrax
|
pruritic papule - ulcer - black eschar
|
|
|
Darier's sign
|
rubbing a lesion causes urticaria
|
|
|
Auspitz sign
(psoriasis) |
pinpoint bleeding after scale removal
|
|
|
Nikolsky's sign
(pem vulgaris, SJS) |
pushing blister separates the dermis
|
|
|
Koebner's phenomenon
(psoriasis) |
minor trauma leads to more lesions
|
|
|
Eczema
|
"itch that rashes"
|
|
|
Nummular dermatitis
|
coin-shaped plaques with erythematous base
|
|
|
Pityriasis rosea
|
herald patch, christmas tree pattern
|
|
|
Molluscum contagiosum
|
umbilicated papules, common in groin/abdomen
|
|
|
Lichen planus
|
4Ps: purple, polygonal, pruritic papule
|
|
|
Dyshidrosis
|
small vesicles in clusters (tapioca-like)
|
|
|
Psoriasis
|
silvery scales, pitting nails
|
|
|
vonZumbusch's syndrome
|
pustular psoriasis
|
|
|
Pemphigus vulgaris
|
round vesicles/bullae with clear liquid, rupture easy
|
|
|
Acne rosacea
|
rhinophyma, blepharophyma, metophyma, etc
|
|
|
Staph aureus
|
MCC of folliculitis
|
|
|
Pseudofolliculitis
|
ingrown hairs in the beard area
|
|
|
Proteinuria
|
foamy/frothy urine
|
|
|
Sycosis
|
severe folliculitis with eczema and crusting
|
|
|
Erythema multiforme
|
mucosal lesions - painful & erode
|
|
|
Hidradenitis suppurativa
|
inflammatory abscess of apocrine gland
|
|
|
Trichopyton rubrum
|
MCC of skin fungal infection
|
|
|
Tinea versicolor
|
caused by Malassezia furfur yeast
|
|
|
Scabies
|
increased pruritis at night
|
|
|
Plantar warts
|
cauliflower appearance, hyperplasia
|
|
|
Keratoderma
|
thickening of horny layer of epidermis
|
|
|
Melanoma
|
deadliest form of skin CA
|
|
|
Mets of melanoma
|
lymph, skin, liver, lungs, brain
|
|
|
Basal cell carcinoma
|
MC type of skin CA
|
|
|
Basal cell carcinoma
|
"pearly" appearing lesions
|
|
|
Tetanus
|
concern with open wounds
|
|
|
Melasma/chloasma
|
mask of pregnancy
|
|
|
Rubeola (measles)
|
4Cs: cough, coryza, conjuntivitis, Koplick spots
|
|
|
Forscheimer's spots
(Rubella) |
papules on soft palate
|
|
|
Rubella
|
"blueberry muffin" rash
|
|
|
5th disease
|
slapped-cheek rash
|
|
|
Kawasaki disease,
Scarlet fever |
strawberry tongue
|
|
|
Pseudomonas aeruginosa
|
"hot tub" folliculitis
|
|
|
Cellulitis
|
rubor, calor, dolor, tumor
|
|
|
Rose spots
|
small papules in pts with S. typhi
|
|
|
Neurofibromatosis
|
cafe-au-lait spots
|
|
|
Sturge-Weber syndrome
|
port wine hemangioma of the face
|
|
|
Tinea versicolor
|
hyphae with "spaghetti and meatball" appearance
|
|
|
Urticaria
|
wheals, pt with dermographism
|
|
|
Squamous cell carcinoma
|
preceded by actinic keratosis
|
|
|
Contact dermatitis
|
type IV hypersensitivity reaction
|
|
|
Atopic dermatitis
|
type I IgE-mediated hypersensitivity
|
|
|
Kawasaki disease
|
CRASH AND BURN:
conjunctivitis, rash, adenopathy, strawberry tongue, burn (fever > 40 for 5 days) |
|
|
Shock/SIRS
|
decreased BP, increased HR, tachypnea, AMS
|
|
|
Postural hypotension
|
> 20mm Hg drop in pressure with sitting/standing
|
|
|
HTN emergency
|
BP > 220/125
|
|
|
HTN emergency treatment
|
nitroprusside, NTG, B-blocker
|
|
|
Aortic dissection treatment
|
nitroprusside, B-blocker (labetalol)
|
|
|
CHF
|
dyspnea, water/Na retention
|
|
|
L-sided failure
|
dyspnea, cough, fatigue, orthopnea, rales, gallop
|
|
|
R-sided failure
|
JVD, hepatomegaly, nausea, pitting edema
|
|
|
Atherosclerotic disease
|
MCC of cardiac-related death
|
|
|
Atheroscleortic disease
|
MCC of ischemic heart disease
|
|
|
Levine's sign
(Angina) |
clenched teeth, clenched fist over sternum
|
|
|
Chronic angina treatment
|
B-blocker
|
|
|
Dressler's syndrome
|
pericarditis, fever, leukocytosis, pleural effusion s/p MI
|
|
|
CAD risk factors
|
smoking, DM, HTN, hyperlipidemia
|
|
|
Aortic stenosis triad
|
syncope, angina, exertional dyspnea
|
|
|
Graham Stell murmur
|
diastolic murmur at left sternal border, mimics AR
|
|
|
Libman-Sacks endocarditis
|
SLE endocardidtis
|
|
|
Duke criteria
|
criteria for endocarditis
|
|
|
Beck's triad
(Tamponade) |
JVD, distant heart sounds, hypotension
|
|
|
Cardiac tamponade
|
pulsus paradoxus
|
|
|
Pericarditis
|
ST elevation in all EKG leads
|
|
|
SVT
|
> 150/180/220 beats per minute
|
|
|
"Holiday heart"
|
afib with excessive EtOH/withdrawal
|
|
|
Ventricular origin
|
wide QRS
|
|
|
Strep viridans, staph aureus
|
MCC of endocarditis
|
|
|
Olser nodes
(endocarditis) |
painful, violaceous raised lesion on extremities
|
|
|
Janeway lesions
(endocarditis) |
painless violaceous lesion in palm/sole
|
|
|
Roth's spots
(endocarditis) |
exudative lesions in reina
|
|
|
ARF
|
immune response following group B strep throat (complication)
|
|
|
Jones criteria
|
criteria used for ARF
|
|
|
Peripheral artery disease
|
intermittent claudication (leg pain with exercise, relief with rest)
|
|
|
Virchow's triad
(thrombophlebitis) |
stasis, vascular injury, hypr coagulability
|
|
|
DVT
|
(+) Homan's sign
|
|
|
DVT dx
|
dx via duplex utz
|
|
|
Chronic venous insufficiency
|
shiny, thin, pigment changes, no hair on legs
|
|
|
Temporal (giant cell) arteritis
|
tenderness at the temple
|
|
|
AAA
|
pulsating abdominal mass
|
|
|
Aortic rupture
|
acute, tearing sensation in chest
|
|
|
ST elevation
|
ischemia (on EKG)
|
|
|
Q waves, T inversion
|
necrosis (on EKG)
|
|
|
Water-Hammer pulse
(AR) |
wide pulse-pressure, forceful upswing and rapid falloff
|
|
|
Traube's sign
(AR) |
pistol-shot bruit over femoral pulse
|
|
|
Corrigan's sign
(AR) |
unusually large carotid pulsations
|
|
|
Quincke sign
(AR) |
pulsatile blanching/redding of fingernails with pressure
|
|
|
deMusset's sign
(AR) |
head bobbing due to carotid pulsations
|
|
|
Muller's sign
(AR) |
pulsatile bobbing of the uvula
|
|
|
Duroziez's sign
(AR) |
to & fro murmur over femoral artery best heard with mild pressure on the artery
|
|
|
Axis deviation
|
look at QRS in leads aVF & 1
|
|
|
Afib treatment
|
ABCD:
anticoag, B-blocker, cardiovert/CCB, digoxin |
|
|
Dilated cardiomyopathy
|
MC cardiomyopathy
|
|
|
Hypertrophic cardiomyopathy
|
MCC of sudden death in young athletes
(ie - Hank Gathers) |
|
|
CHF treatment
|
LMNOP:
lasix, morphine, nitrates, O2, Pulm vent |
|
|
Causes of secondary HTN
|
CHAPS:
cushings, increased aldosterone, aortic coarctation, pheo, renal atery stenosis |
|
|
Pericarditis symptoms
|
PERIC:
pulsus paradoxus, EKG changes, rub, increased JVP, Chest pain |
|
|
Kussmaul's sign
(CT) |
JVD on inspiration
|
|
|
Austin-Flint murmur
|
mid-diastolic rumble in AR
|
|
|
Endocarditis sypmtoms
|
FAME: fever, amemia, new murmur, emboli
|
|
|
Wolff-Parkingson-White
|
delta waves on EKG
|
|
|
Aortic dissection
|
MCC by uncontrolled HTN
|
|
|
Atherosclerosis
|
MCC of aortic aneurysm
|
|
|
Aortic dissection classification
|
DeBakey (I-III)
Stanford (A-B) |
|
|
Leriche's syndrome
(PVD) |
buttock claudication, decreased femoral pulses, impotence
|
|
|
Noncyanotic heart disease
|
3Ds: VSD, ASD, PDA
|
|
|
Cyanotic heart disease
|
5Ts/1P: truncus arteriosis, TGA, TOF, Tricuspid atresia, TAPVR, Pulmonary atresia
|
|
|
VSD
|
MC congenital heart defect
|
|
|
PDA treatment
|
indomethacin
(come IN & CLOSE) |
|
|
TGA
|
MC cyanotic heart lesion in newborns
|
|
|
TOF
|
MC cyanotic heart disease in children
|
|
|
Coarctation of aorta
|
"3" on CXR, rib notching, childhood secondary HTN
|
|
|
TGA
|
"egg-shaped" heart on CXR
|
|
|
TOF
|
"boot-shaped" heart on CXR
|
|
|
TGA/TOF treatment
|
PGE1 - surgery
|
|
|
TAPVR
|
"snowman-shaped" heart
|
|
|
Unstable angina triad
|
new, worse, or occurs at rest
|
|
|
V. fib treatment
|
immediate cardioversion
|
|
|
A. flutter pattern
|
sawtooth on EKG
|
|
|
Torsades de pointes
|
twisting ribbon, treated with Mg
|
|
|
1st degree AV block
|
long PR interval
|
|
|
2nd degree AV block
(type 1 - Wenckebach) |
growing PR interval until a dropped beat
|
|
|
2nd degree AV block
(type 2 - Mobitz) |
fixed PR but with nonconducted p wave drops
|
|
|
3rd degree AV block
|
PR not "married" but regular
|
|
|
Mitral stenosis
|
cardiac lesion associated with rheumatic fever
|
|
|
Aortic stenosis
|
widened mediastinum
|
|
|
Aortic regurgitation
|
widened pulse pressure
|
|
|
Mitral regurugitation
|
MC murmur in CHF
|
|
|
S aureus
S viridans |
MCC of acute infective endocarditis
MCC of subacute infective endocarditis |
|
|
Jones Criteria
for ARF |
CANCER (major):
carditis, arthritis, nodules, chorea, erythema, rheumatic anamnesis CAFE PAL (minor): increased CPR, arthralgia, fever, increased ESR, prolonged PR, anamnesis of rheumatism, leukocytosis |
|
|
right-sided murmurs loudest on inspiration
left-sided murmurs loudest on expiration |
"RILE"
|
|
|
mitral regurg - systolic
mitral stenosis - diastolic |
"MRS ASS"
|
|
|
Metallic foreign body
|
causes rust ring on the cornea
|
|
|
Retinal detachment
|
"curtain being drawn over eye"
|
|
|
Macular degeneration
|
MCC of irreversible central vision loss
|
|
|
Central retinal artery occlusion
|
sudden, painless vision loss
unilateral with cherry red spot on fundoscopy |
|
|
Central retinal vein occlusion
|
sudden, painless blurred vision
unilateral with "blood and thunder" retina |
|
|
Acute angle glaucoma
|
steamy cornea
|
|
|
Retinopathy
|
MCC of blindness in US adults
|
|
|
Dacryostenosis
|
newborn with closed lacrimal duct
|
|
|
Hordeolum
|
stye, infection of glands of Moll/Zeis
|
|
|
Osteogenesis imperfeta, Marfans
|
blue sclera
|
|
|
Weber test
|
conductive hear loss (to affected ear)
|
|
|
Presbycusis
|
MCC of sensorineural hearing loss
|
|
|
Meniere's triad
|
hear loss, vertigo, tinnitus
|
|
|
Otitis externa
|
swimmer's ear, tender tragus
|
|
|
Vertigo test
|
Hallpike or Nylen-Barany maneuver
|
|
|
Water's view
|
XR for sinusitis
|
|
|
Peritonsillar cellulitis/abscess
|
"hot potato voice"
|
|
|
H flu (type B)
|
MCC of epiglottitis
|
|
|
Kiesselbach's plexus
|
MC site of epistaxis
|
|
|
Cystic fibrosis
|
disease associated with nasal polyps
|
|
|
Open angle glaucoma
|
MC type of glaucoma
almost always bilateral |
|
|
Croup
|
barking cough, "steeple sign"
|
|
|
Retrobulbar neuritis
|
often initial presentation of MS
|
|
|
Digoxin toxicity
|
pt complains of yellow vision
|
|
|
Leukocoria
|
absent red light reflex in retinoblastoma
|
|
|
Chronic HTN
|
cotton-wool spots
(soft exudates) |
|
|
Roth spots
(endocarditis) |
small hemorrhagic spot with central clearing in the retina
|
|
|
Graves disease
|
MCC of hyperthyroidism
|
|
|
Hashimoto's thyroiditis
|
MCC of hypothyroidism
|
|
|
Thyroid storm sx
|
fever, tachycardia, V/N/D, weakness, muscle wasting, confusion, AMS
tx: PTU |
|
|
Papillary carcinoma
|
MC form of thyroid CA
|
|
|
Anaplastic carcinoma
|
most aggressive form of thyroid CA
|
|
|
Hypocalcemia signs
|
Chvostek's and Trousseau's
|
|
|
Hyperparathyroidism
|
"bones, stones, groans, psychic moans & fatigue overtones"
|
|
|
Thyroidectomy
|
MCC of hypoparathyroidism
|
|
|
Ketoacidosis
|
fruity breath, bs>250
|
|
|
1unit per 10-15g
|
1 unit insulin per __g carbs ingested
|
|
|
Whipple's triad
|
hypoglycemia sx, bs < 40 mg/dl, immediate recovery after glucose
|
|
|
Kussmaul respirations
|
slow/deep breathing in DKA
|
|
|
Cushing's
(increased cortisol) |
buffalo hump, truncal obesity, moon facies
|
|
|
Addison's
(decreased cortisol) |
hyponatremia, hyperkalemia, bronze skin
|
|
|
Waterhouse-Friderichsen
|
hemorrhagic necrosis of adrenal medulla during the course of meningococcemia
|
|
|
Conn's syndrome
|
HTN, increased Na/Cl, decreased K, alkalosis
Primary hyperaldosteronism |
|
|
Pheo (Rule of 10s)
|
10% malignant
10% bilateral 10% extra-adrenal |
|
|
Klinefelter's (XXY)
|
buccal smear for Barr bodies
|
|
|
Hypothyroidism
|
cold intolerance, weight gain, thick/course hair, puffy face/eyes/hands (myxedema)
|
|
|
MEN1 (Wermer's)
|
3Ps: pituitary, parathyroid, pancreatoma
|
|
|
Rickets sx
|
craniotabes, rachitic rosary (string of beads), Harrison's grove, pigeon breast
|
|
|
Scurvy sx
|
subpeiosteal hem, bleeding gums, "woody leg", from soft tissue hemorrhage
|
|
|
DM triad
|
polyuria, polydipsia, polyphagia
|
|
|
Metformin
|
oral DM agent - decreased weight
|
|
|
Sulfonylureas/TZDs
|
oral DM agent - increased weight
|
|
|
Grave's disease
|
TSH receptor antibodies
|
|
|
Myxedema coma
|
severe hypothyroidism with decreased mental status, hypothermia
|
|
|
MEN IIa
|
Sipple's syndrome
|
|
|
Osteoporosis
|
MCC of pathologic fracture in thin, old women
|
|
|
Paget's disease
|
increased rate of bone turnover
"mosaic bones" |
|
|
Adenoma
|
MCC of primary hyperparathyroidism
|
|
|
Acromegaly
|
emlargement of features, sellar lesion on MRI
|
|
|
Prolactinoma
|
MC functioning pituitary tumor
|
|
|
Pheo sx
|
5Ps: pressure (BP), pain (HA), perspiration, palpitation, pallor
|
|
|
Congenital adrenal hyperplasia
|
cortisol deficiency, clioromegaly, hirsutism
MCC - 21-hydroxylase deficiency |
|
|
HHS
|
BS>600, profound dehydration, AMS, no acidosis
|
|
|
Confusion
|
anticholinergic medication side effect in elderly
|
|
|
Urosepsis
|
MCC of AMS in elderly
|
|
|
Vitamin C,D,B12,B complex
|
MC vitamin deficiencies in elderly
|
|
|
Xerosis
|
dry skin, pruritis, cracking skin in elderly
|
|
|
GAD
|
anxiety (6+ mon), with 3+ somatic symptoms
|
|
|
OCD
|
recognizes behavior as irrational
|
|
|
OCPD
|
does not see behavior as problematic
|
|
|
Alzheimer's
|
MCC of dementia
|
|
|
Dementia
|
4As: amnesia, apraxia, aphagia, agnosia
|
|
|
Delirium
|
acute wax/wane of consciousness
|
|
|
Urosepsis/UTI
|
MCC of delirium in eldery
|
|
|
Depression
|
"SIG E CAPS"
sleep, interest, guilt, energy, concentration, appetite, psycomotor, SI |
|
|
TCA toxicity
|
convulsions, coma, cardiac arrhythmias
|
|
|
Serotonin syndrome
|
fever, myoclonus, AMS, cardio collapse
|
|
|
Bupropion
|
contraindicated in bulimics (seizure risk)
|
|
|
High tyramine-containing foods
(cheese, red wine) |
causes HTN crisis with MAOIs
|
|
|
Bipolar I
|
at least 1 manic or mixed episode
|
|
|
Bipolar II
|
at least 1 MDE and 1 hypomanic episode
|
|
|
Mania
|
DIGFAST:
distractibility, insomnia, grandiosity, flight of ideas, agitation, increased sexuality, talkativeness |
|
|
Lithium toxicity
|
ataxia, dysarthria, delirium
|
|
|
Schizophrenia types
|
paranoid, disorganized, catatonic
|
|
|
Schizoid
|
"loners"
|
|
|
Schizotypal
|
"magical thinking", odd
|
|
|
Borderline
|
unstable mood, felling of emptiness, impulsive, SI
|
|
|
(+) Schizophrenic symptoms
|
hallucinations, delusions, disorganized speech, bizarre
|
|
|
(-) Schizophrenic symptoms
|
flat affect, decreased emotion, poverty of speech, anhedonia
|
|
|
Schizophreniform
|
schizophrenia < 6mon
|
|
|
Schizoaffective
|
schizophrenia + MAD (depression or bipolar)
|
|
|
Autism
|
may be associated with fragile X or tuberous sclerosis
|
|
|
Asperger's
|
autism-like with social impairment
|
|
|
Rett's disorder
|
progreesive neurodegenerative disorder of females
|
|
|
Conduct/Antisocial disorder
|
defiance in kids/adults
|
|
|
Mental retardation
|
IQ < 70 with deficits in adaptive functioning
|
|
|
Tourette's
|
multiple motor/ vocal tics
|
|
|
Coprolalia
|
repetition of obscene words
|
|
|
Opiod intoxication
|
pupillary constriction
|
|
|
Amphetamines/Cocaine
|
pupillary dilitation
|
|
|
PCP
|
assultiveness, vertical/horizontal nystagmus
|
|
|
Frotteurism
|
touching genitalia a/g nonconsenting person
|
|
|
Malingering
|
feign symptoms secondary to gaining $ or housing
|
|
|
Factitious disorder
|
fabricate symptoms to assume the sick role
(eg: Muchausen's) |
|
|
Somatiform disorder
|
multiple sx from different organ systems (GI, neuro, sex, pain)
|
|
|
Conversion disorder
|
sx (blindness, paralysis) with no medical process
|
|
|
BDD
|
preoccupation with physical defect/adnorm
|
|
|
Hypochondriasis
|
preoccupation with having a serious medical condition
|
|
|
Pain disorder
|
pain profile inconsistent with physiology
|
|
|
Suicide
|
3rd leading COD in 15-24yo in US
|
|
|
Suicide risk factors
|
SADPERSONS:
sex (male), age (older), depression, previous try, EtOH, rational thought, sickness, organized plan, no spouse, social support lacking |
|
|
Dysthymic disorder
|
steady duration of depression symptoms x 2 years
|
|
|
Bereavement
|
depressive symptoms < 2 months
|
|
|
Bipolar treatment
|
1st: valproate/carbamazepine
2nd: lithium |
|
|
Auditory
|
MC type of hallucination in schizophrenia
|
|
|
Dystonia
|
sustained muscle spasm in body (ie - torticollis)
|
|
|
Tartive dyskinesia
|
involuntary irregular movement of body
|
|
|
Oppositional defiant/ Conduct disorder
|
"bark"/"bite"
|
|
|
Dissociative disorder
|
aka: multiple personality disorder
|
|
|
Cataplexy (in narcolepsy)
|
complete loss of muscle tone
|
|
|
Pickwickian syndrome
|
central alveolar hypoventilation
triad: somnolence, obesity, and erthrocytosis |
|
|
Mad, cluster A
|
schizoid, schizotypal, paranoid
|
|
|
Bad, cluster B
|
antisocial, borderline, histrionic, narcissistic
|
|
|
Sad, cluster C
|
avoidant, dependant, OCD
|
|
|
Phobias
|
MC mental disorder in the US
|
|
|
Benzos, thiamine, folic acid
|
tx for EtOH withdrawl
|
|
|
Disulfiram (Antabuse)
|
alcohol-deterrent medication
induces nausea |
|
|
Naloxone
|
tx to reverse opiod effects
|
|
|
Primary amenorrhea
|
lack of spontaneous menses by 16yo
|
|
|
Pregnancy
|
MCC of secondary amenorrhea
|
|
|
Gonadal agenesis/dysgenesis, etc
|
amenorrhea + no secondary sexual characteristics
|
|
|
Androgen insensitivity
|
amenorrhea + breasts, no hair
|
|
|
Dysmenorrhea
|
painful menses secondary to increased PGE2
|
|
|
Adenomyosis
|
-tender, symmetrically enlarged "boggy" uterus
-extension of endometrial glands into the uterine musculature |
|
|
51-52yo
|
average age of menopause in US
|
|
|
Premature ovarian failure
|
menopause < 40yo
|
|
|
African-american women
|
MC group with fibroids (leiomyomata)
|
|
|
Fibroids
|
4x risk of developing endometrial cancer
|
|
|
Endometrial CA
|
MC gyn malignancy
4th MC female cancer |
|
|
Endometriosis
|
"chocolate" cyst
|
|
|
Ovarian cyst
|
MC ovarian growth
|
|
|
PCOS (Stein-Leventhal)
|
MCC of androgen excess/hirsutism
|
|
|
PCOS
|
"string of pearls" on ovarian utz
|
|
|
Ovarian CA
|
3rd MC gyn malignancy
5th MC female cancer most deadly gyn CA |
|
|
HPV 16,18
|
infection linked to cervical CA
|
|
|
HPV 6,11
|
infection linked to condylomata acuminata
|
|
|
Bethesda system
|
cervical dysplasia grading system
|
|
|
Cystocele, cystourethrocele
|
causes anterior vaginal prolapse
|
|
|
Enterocele, rectocele
|
causes posterior vaginal prolapse
|
|
|
SCC
|
MC vulvar malignancy
|
|
|
Clear cell adenocarcinoma of vagina
|
CA associated with in utero exposure to DES
|
|
|
Lugol staining
|
vaginal biopsy stain for CA
|
|
|
Staph aureus
|
MCC of mastitis
|
|
|
Fibrocystic changes
|
MC benign condition of breasts
|
|
|
Fibroadenoma
|
2nd MC benign breast condition
|
|
|
Fibroadenoma
|
firm, round/smooth, discrete, nontender, mobile
|
|
|
BRCA-1, BRCA-2
|
breast CA genes
5-10% of CA 1% of population |
|
|
Ductal carcinoma
|
MC type of breast CA (85%)
|
|
|
Breast CA
|
MC female cancer
2nd leading cause of death from cancer |
|
|
Paget's disease
|
ductal carcinoma with eczematous nipple lesions
|
|
|
Upper outer quadrant
|
MC site of breast CA
|
|
|
Tamoxifen
|
tx for estrogen (+) and postmenopausal women with breast CA
|
|
|
6 months
|
maximum time for lactational amenorrhea
|
|
|
Infertility
|
failure to conceive after 1 year
15% of couples |
|
|
PID
|
cervical motion tenderness
(chandelier sign) |
|
|
Tubo-ovarian abscess
|
dx suggested by an adnexal mass
|
|
|
Nagele's rule
|
EDC = 1st day of last period + 1y - 3m + 7d
|
|
|
20 weeks
|
date at which the fundus is at the umbilicus
|
|
|
Fetal heart tones
|
detected by ultrasound at 5-6 weeks
|
|
|
Down syndrome
|
Triple screen: decreased AFP
|
|
|
Neural tube defects
|
Triple screen: increased AFP
|
|
|
15-18 weeks
|
Triple/Quad screen
|
|
|
10-13 weeks
|
Nuchal translucency screen
(for trisomies 13,18,21,Turners) |
|
|
10-13 weeks
|
Chorionic villus sampling
|
|
|
15-18 weeks
|
Amniocentesis
|
|
|
24, 28 weeks
|
GTT screening, recheck
|
|
|
28 weeks, birth
|
Rhogam dosing
|
|
|
35-36 weeks
|
Strep B cultures
|
|
|
Ampulla of the fallopian tube
|
MC site of ectopic pregnancy (85%)
|
|
|
48hrs
|
Serum hcg should double every ___ hours
|
|
|
SAB
|
termination of pregnancy < 20 weeks
(80% in 1st trimester due to chromosomal abnormalities) |
|
|
Complete molar pregnancy
|
MC type of gestational trophoblastic disease
|
|
|
Hydatidiform mole
|
"snowstorm" or "grape-like vesicles" on utz
|
|
|
Hydatidiform mole
|
hcg level > 100,000 mU/ml
|
|
|
>50%
|
risk of developing DM after GDM
|
|
|
Preterm delivery
|
-MCC of neonatal death
-delivery < 37 weeks gestation |
|
|
MGSO4, Tocolytics, cerclage
|
treatment for preterm labor
|
|
|
PROM
|
rupture of amniotic membranes before labor, increased risk of infection
|
|
|
Methyldopa
(2nd line: labetalol) |
treatment for HTN/PIH
|
|
|
HELLP syndrome
|
hemolysis, elevated liver enzymes, low platelets
|
|
|
Preeclampsia triad
|
HTN, edema, proteinuria
|
|
|
Eclampsia
|
HTN, edema, proteinuria + seizures
|
|
|
Abrupto placentae
|
premature separation of placenta
<20 weeks |
|
|
Abrupto placentae
|
MCC of 3rd trimester bleeding
|
|
|
Placenta previa
|
placenta covers cervical os
hallmark: painless vaginal bleeding in pregnancy |
|
|
Labor, Stage I
|
full contractions - full dilatation
(6-20hr) |
|
|
Labor, Stage II
|
dilatation - delivery
(30m-3hr) |
|
|
Labor, Stage III
|
delivery-placenta
(0-30min) |
|
|
APGAR
|
appearance, pulse, grimace, activity, respiration
|
|
|
Labor abnormalities
|
pelvis, passenger, power (tx: oxytocin)
|
|
|
Prostaglandin gel
Pitocin |
Meds for induction of labor
|
|
|
Anaerobic strep
|
MCC of endometritis
|
|
|
Clinda + gent, add ampicillin
|
Endometritis treatment
|
|
|
Puerperium
|
6wk after delivery
|
|
|
Lochia
|
bleeding after delivery lasting 4-5 weeks
|
|
|
4 weeks
|
time needed for the uterus to return to antenatal size
|
|
|
Chadwick's sign
|
blueish discoloration of vagina
|
|
|
Hegar's sign
|
cervical softening
|
|
|
Increase 50%
(HR, SV) |
amount of cardiac output increases in pregnancy
|
|
|
GDM
|
MC complication in pregnancy (2%)
|
|
|
Hyperemesis gravidarum
|
"severe" morning sickness
lasting past 16 weeks |
|
|
Maternal fever
|
MCC of fetal tachycardia
|
|
|
Kleihauer-Betke test
|
identifies fetal RBCs in maternal blood
|
|
|
Leopold maneuver
|
determines fetal lie/presentation
|
|
|
Vitamin K
|
vitamin not present in breast milk
|
|
|
Baby blues
|
occurs in 50% of females
depressed mood beginning 2-3 after birth, lasting 1-2 weeks |
|
|
Postpartum depression
|
affects 10% of women after pregnancy
|
|
|
Threatened abortion
|
vaginal bleeding < 20 weeks
closed os, no ROM |
|
|
Inevitable abortion
|
threatened abortion + dilated os/ROM
|
|
|
Incomplete abortion
|
bleeding/cramping with passage of tissue, open os
|
|
|
Missed abortion
|
failure to expel POC
|
|
|
PROM
|
nitrazine test, fern test (+)
|
|
|
Follicular
Ovulatory Luteal |
Menses phases:
day 1-13 day 13-17 day 17-menses |
|
|
BV (gardnerella)
|
"fishy" KOH, clue cells
tx: metro |
|
|
Trichomonas
|
rancid, green/frothy discharge
tx: metro |
|
|
Candida (yeast)
|
cheesy white discharge, itchy, hyphae
tx: fluconazole |
|
|
Sertoli-leydig cell tumor
|
ovarian tumor that secretes testosterone
|
|
|
Goodell's sign
|
cervical softening/cyanosis at 4 weeks
|
|
|
Ladin's sign
|
uterine softening after 6 weeks
|
|
|
Trisomy 18
|
Quad screen:
decreased b-hcg & inhibin A |
|
|
Trisomy 21
|
Quad screen:
increased b-hcg & inhibin A |
|
|
Bishop score
|
cervical exam for dilitation, station, etc
|
|
|
CMV
|
MC congenital infection
|
|
|
Sheehan's syndrome
|
-pituitary ischemia/necrosis
-primary cause of anterior pituitary insufficiency in adult women -MC presents as failure to lactate |
|
|
Uterine atony
|
MCC of pospartum hemorrhage
|
|
|
Menorrhagia
|
increased menstrual flow
|
|
|
Metrorrhagia
|
bleeding between periods
"off-schedule" bleeding |
|
|
Menometrorrhagia
|
excessive/irregular menses
|
|
|
Endometriosis
|
"raspberry" or "powder-burned" lesions
|
|
|
BV
|
Amsel criteria:
discharge, pH > 4.5, whiff test, clue cells |
|
|
Lynch II syndrome
|
hereditary nonpolyposis colorectal CA
|
|
|
Stroke
|
3rd MCC of death/disability
|
|
|
Bell's palsy
|
peripheral ipsilateral facial paralysis
unable to close eye CN VII |
|
|
Posterior stroke
(PCA) |
4Ds: diplopia, dizziness, dysphagia, dysarthria
|
|
|
MCA stroke
|
aphasia, neglect, contralateral paresis & sensory loss in face/arm, lateral gaze toward lesion
|
|
|
ACA stroke
|
contralateral paresis & sensory loss in legs, amnesia, personality changes, foot drop, gait dysfunction
|
|
|
Basilar artery stroke
|
coma, "lock in" syndrome, apnea, diplopia, drop attacks, vertigo, "crossed" weakness and sensory loss
|
|
|
Lacunar stroke
|
pure motor/sensory, dysarthria-clumsy hand, ataxic hemiparesis
|
|
|
TIA
|
transient neuro deficit < 24hr
|
|
|
tPA, 3hr
|
ischemic stroke treatment and timeframe
|
|
|
Subarachnoid hemorrhage (SAH)
|
"worst HA of my life"
trauma/berry aneurysms |
|
|
SAH
|
"thunderclap HA" with neck stiffness +/- sentinel bleed
|
|
|
RBCs in CSF
|
yellowish CSF on LP
|
|
|
Berry aneurysms
|
CNIII palsy with pupil involvement
|
|
|
SAH treatment
|
control BP (CCB)
IV fluids surgical clipping decrease ICP |
|
|
Intracerebral hemorrhage
|
lethargy
severe HA with sudden N/V focal motor and sensory defects |
|
|
Subdural hematoma
|
fall - rupture of bridging veins
HA, AMS, ipsilateral pupil dilatation |
|
|
Epidural hematoma
|
tear middle menigeal artery
LOC - lucid interval - coma "blown pupil" ex: Natasha Richardson |
|
|
Subdural hematoma
|
CT - cresent shape, concave hyperdensity
|
|
|
Epidural hematoma
|
CT - egg shape, convex hyperdensity
|
|
|
CT without contrast
if negative, obtain LP |
HA workup should include...
|
|
|
Migraines
|
HA with aura
tx: triptans |
|
|
Tension HA
|
MC type of HA in adults
|
|
|
Cluster HA
|
excruciating, unilateral periorbital HA in males
|
|
|
Staph aureus
|
MCC of cavernous sinus thrombosis
|
|
|
Phenobarb
|
1st line DOC for partial seizures in kids
|
|
|
Jacksonian march
|
progressive jerking of successive body regions in partial seizures
|
|
|
West syndrome
|
infantile spasms w/in 6mon
occurs in clusters of 5-10 |
|
|
Dix-Hallpike/Epley
|
treatment for BPV
|
|
|
Meniere's triad
|
vertigo, hearing loss, tinnitus
|
|
|
Myasthenia gravis
|
fatigable ptosis
proximal muscle weakness that worsens through the day difficulty with stairs, standing from chair |
|
|
Myasthenia gravis
|
tensilon test (edrophonium)
|
|
|
Lambert-Eaton Myasthenic Syndrome
|
small cell carcinoma risk
proximal muscle weakness with decreased DTRs |
|
|
MS triad
|
scanning speech
intranuclear opthalmoplegia nystagmus |
|
|
MS treatment
|
ABC:
avonex/rebif betaseron copaxone |
|
|
Lhermitte's sign
(MS) |
sharp pain that radiates up/down with neck flexion
|
|
|
Dawson's fingers
|
MRI: multiple, asym, periventricular white matter lesions, esp. in the corpus callosum
|
|
|
Campylobacter jejuni
|
bacterial etiology of Guillain-Barre
|
|
|
Guillan-Barre syndrome
|
5As:
acute inflammation demylinating polyradiculopathy ascending paralysis autoimmune neuropathy arrhythmias albuminocytologic dissociation |
|
|
Pick's disease
|
pick bodies
|
|
|
Pick's disease
|
dementia secondary to atrophy of frontal/temporal lobes
|
|
|
Normal pressure hydrocephalus triad
|
dementia, gait apraxia, urinary incontinence
|
|
|
Creutzfeldt-Jakob disease
|
MC prion disease
subacute dementia |
|
|
Huntington's disease
|
autosomal dominant
abnormal CAG triplet repeats |
|
|
Parkinson's tetrad
|
resting tremor, rigidity, bradykinesia, postural instability
|
|
|
Parkinson's
|
dopamine depletion in sub. nigra, lewy bodies
|
|
|
Meningioma
Glioblastoma multiforme |
MC primary CNS tumors in adults
|
|
|
Medulloblastoma
Astrocytoma |
MC primary CNS tumors in kids
|
|
|
Increased ICP
|
signs include HA, N/V
|
|
|
Neurofibromatosis
|
cafe-au-lait spots
lisch nodules |
|
|
Broca's
Wernicke's |
-broken speech, fluent
-wordy aphagia |
|
|
Wernicke's encephalopathy
(B1) |
encephalopathy, opthalmoplegia, ataxia
|
|
|
Coma treatment
|
DONT:
dextrose, O2, naloxone, thiamine |
|
|
Strep pneumo
|
MCC of meningitis
|
|
|
TB meningitis treatment
|
RIPE:
rifampin, INH, pyrazinamide, EMB |
|
|
Meningitis treatment
|
neonate: ampicillin + cefotaxime
adults: vanco + cefotaxime |
|
|
Neurocysticercosis
|
encephalitis in latin american immigrants
|
|
|
Toxoplasmosis
|
MC CNS lesions in AIDS
|
|
|
HSV
|
MCC of viral encephalitis
|
|
|
Hepatic encephalopathy
|
asterixis, hyperreflexia
|
|
|
Tay-Sachs
|
cherry-red spot on macula, retardation, paralysis, etc
|
|
|
Phenytoin
|
ADR: gingival hyperplasia, hirsutism
|
|
|
ALS
|
upper and lower motor neuron disease
|
|
|
Ischemic
|
MC type of stroke (80%)
|
|
|
EtOH, Propranolol
|
tx for benign essential tremor
|
|
|
Neisseria meningitidis
|
etiology of petechial rash with meningitis
|
|
|
Brown-Sequard syndrome
|
unilateral cord lesion with ipsilateral motor disturbance and
contralateral loss of pain/temp below the lesion |
|
|
Lung, breast, kindey, GI
|
MC cause of intracranial mets
|
|
|
CA - Familial basis
|
retinoblastoma
neurofibromas hemangioblastomas |
|
|
Interstitial lung disease
|
"honeycombing" in lung periphery
|
|
|
Sarcoidosis
|
-multisystem disease with noncaseating granulomas
-MC in AA females and northern european whites |
|
|
Usual interstitial pneumonia
|
MC form of idiopathic interstitial pneumonia
|
|
|
Asbestosis
|
increased risk of mesothelioma
exposure to contruction, building |
|
|
Coal mine disease
|
progressive massive fibrosis from coal mines
|
|
|
Silicosis
|
increased risk of TB
work in quarries, mines, glass, or pottery |
|
|
Berylliosis
|
work in high-tech fields
(aerospace, nuclear, ceramics, etc) |
|
|
Obstructive pulmonary disease
|
ABCT:
asthma, bronchiectasis, cystic fibrosis, tracheal obstruction |
|
|
Asthma exacerbation meds
|
ASTHMA:
albuterol, steroids, theo, hum O2, Mg, anticholinergic meds |
|
|
Tram lines
(bronchiectasis) |
parallel lines outlining dilated bronchi as a result of peribronchial inflammation and fibrosis
|
|
|
Emphysema
|
"pink puffer"
|
|
|
Chronic bronchitis
|
"blue bloater"
|
|
|
COPD treatment
|
COPD:
corticosteroids, O2, prevention, dilators (B2 agonists) |
|
|
ARDS
|
resp failure with hypoxemia, decreased lung compliance, pulmonary edema
|
|
|
Pulmonary HTN
|
mean pulmonary arterial pressure > 25mmHg
|
|
|
Virchow's triad
|
vascular trauma, hypercoag, stasis
|
|
|
PE
|
dyspnea, tachycardia, normal XR
|
|
|
Homan's sign
(DVT) |
calf pain on forced dorsiflexion
|
|
|
Hampton's hump
(PE) |
wedge-shaped infarct on CXR
|
|
|
Westermark's sign
(PE) |
oligemia in embolized lung zone on CXR
|
|
|
Angiogram
|
gold standard diagnostic test with PE
|
|
|
BLAB:
bone, liver, adrenal, brain |
MC locations for lung CA mets
|
|
|
Lung CA
|
MCC of CA-related death
|
|
|
Small cell lung CA
|
lung CA associated with smoking
|
|
|
Adenocarcinoma
|
MC type of lung CA
|
|
|
Horner's syndrome
|
ptosis, miosis, anhidrosis
|
|
|
Pleural effusion
|
accumulation of fluid in the pleural space
|
|
|
Chemo
(not surgically resectable) |
tx for small cell lung CA
|
|
|
Empyema
|
effusion + pus
|
|
|
Lhermitte's sign
(MS) |
sharp pain that radiates up/down the neck with flexion
|
|
|
Asbestosis
|
increased risk of mesthelioma
exposure to construction, building |
|
|
Exudate effusion
|
increase protein
cause = pneumonia, CA, PE, vascular disease |
|
|
Transudate effusion
|
decrease protein
cause = CHF, nephrotic syndrome, cirrhosis |
|
|
Spontaneous pneumothorax
|
tall, thin young male with SOB, tracheal deviation, pain
|
|
|
Horner syndrome
SVC syndrome |
Pancoast tumor syndromes
|
|
|
Primary TB
|
Ghon complex
|
|
|
Pott's disease
|
TB of the spine
multiple compression fractures |
|
|
Scrofula
|
TB causing massive cervical LAD
|
|
|
Strep pneumonia
|
MCC of community acquired pneumonia
|
|
|
Mycoplasma pneumoniae
|
MCC of atypical pneumonia
|
|
|
Legionella infection
|
pneumonia from air conditioning/ventilation
|
|
|
Pneumonia
|
2nd MCC of hospital-acquired infeciton
|
|
|
Psuedomonas aeruginosa
|
MCC of hospital-acquired pneumonia, ICU
|
|
|
PCP
(aka: PJP) |
MC oppostunisitic infection in AIDS pts
|
|
|
RSV
|
MCC of bronchiolitis
|
|
|
Hib/H.flu
|
MCC of epiglottitis
|
|
|
Pulmonary nodule
|
coin lesions
|
|
|
Cystic fibrosis
|
autosomal recessive, excess mucous prodution
dx: sweat chloride test |
|
|
Pleural effusion
|
blunted costophrenic angle
|
|
|
Light criteria
|
transudate v. exudate criteria (protein, LDH)
|
|
|
ARDS
|
frothy pink/red sputum, tachypnea, diffuse crackles
|
|
|
Hyaline membrane disease
|
MCC of respiratory disease in preterm infants
|
|
|
Sickle cell
B-Thal |
"hair on end" appearance on XR
|
|
|
SLE
|
Anti-ds DNA
|
|
|
Celiac sprue
|
Antigliadin antibodies
|
|
|
Rheumatoid factor
Rheumatoid arthritis |
Anti-IgG antibodies
|
|
|
Syphilis
Haemophilus ducreyi |
Chancre
Chancroid |
|
|
Klebsiella
|
currant jelly sputum
|
|
|
Granuloma inguinale (bacterial infection)
|
donovan bodies
|
|
|
Duchenne's muscular dystrophy
|
gower's maneuver
|
|
|
DM, type I
|
anti-glutamate decarboxylase
|
|
|
Rabies
|
Negri bodies
|
|
|
CHF
|
nutmeg liver
|
|
|
SCC
|
MC esophogeal CA
|
|
|
Prostate CA
|
MC male CA
|
|
|
Adrenal glands
|
MC organ receiving mets
|
|
|
Chlamydia
|
MC STD
|
|
|
Sigmoid colon
|
MC site of diverticula
|
|
|
Staph aureus
|
MCC of food poisoning
|
|
|
Bacillus cereus
|
reheated rice food poisoning
|
|
|
Staph aureus
|
Custard food poisoning
Mayonnaise food poisoning |
|
|
Vibrio parahaemolyticus
|
Seafood poisoning
|
|
|
S. Aureus
Salmonella C. Perfringens (if reheated) E. Coli O017:H7 (if undercooked) |
Meat food poisoning
|
|
|
Salmonella
|
Poultry, egg poisoning
|
|
|
Yersinia entercolitica
|
Pork food poisoning
|
|
|
Listeria
Yersinia entercolitica |
Milk food poisoning
|
|
|
Bartonella henselae
|
Cat scratch fever
|
|
|
Eaton's agar
|
Medium for mycoplasma pneumoniae
|
|
|
Psoriatic arthritis
|
sausage fingers
|
|
|
gait disturbance
incontinence impaired mental function |
Normal Pressure Hydrocephalus (NPH) triad
|
|
|
Kwashiorkor
|
total protein deficiency
pts present with ascites and pitting edema from hypoalbuminemia |
|
|
PUD
|
MCC of upper GI bleed
|
|
|
Whipple's disease
|
distended macrophages in the lamina propia
|
