Daily Eponym

Question 1

Addie’s Pupil

Answer 1

Tonic pupil, larger than contralateral unaffected pupil, reacts sluggishly to changes in illumination; see also Holmes-Adie syndrome; seen in young women; no neurologic significance

Question 2

Argyll Robertson Pupils

Answer 2

Small irregular pupils, usually but not always caused by CNS syphilis, they “accommodate, but do not react.” Absence of miotic reaction to light, both direct and consensual, with preservation of a miotic reaction to near stimulus; lesion in tectum of midbrain. Named after Douglas M. C. L. Argyll Robertson.

Question 3

Adam’s Triad

Answer 3

In normal pressure hydrocephalus, triad of urinary incontinence, gait instability, and mental decline. Also known as Hakim’s triad

Question 4

Zenker’s Diverticulum

Answer 4

A pharyngeal diverticulum from premature contraction of the cricopharyngeus muscle on swallowing, leads to progressive UES narrowing, leading to a posteriorly directed hypopharynx; causes progressive food stasis and dysphagia.

Question 5

Allen’s Test

Answer 5

For demonstrating patent ulnar artery and an intact superficial palmar arch, patient’s hand is initially held high while fist is clenched and both radial and ulnar arteries are compressed, hand then lowered and fist is opened; after ulnar pressure released, color should return to the hand within 6 seconds.

Question 6

Apley Scratch Test

Answer 6

Asking patient to scratch the back from above or bottom, looking for furthest point reached (T4-T5 former, T7-T8 latter normal); if patient cannot reach, infraspinatus/teres minor tendonitis tear or subscapularis tendonitis/tear respectively.

Question 7

Baker’s Cyst

Answer 7

Popliteal cyst, a synovial cyst within the popliteal fossa.

Question 8

Bamboo Spine

Answer 8

Radiographic appearance of spine in ankylosing spondylitis.

Question 9

Bennet’s Fracture

Answer 9

Fracture of the base of the first metacarpal with involvement of carpometacarpal joint

Question 10

Behcet’s Disease

Answer 10

Triad of aphthous ulcers, genital ulcerations, and ocular inflammation (posterior uveitis). Associated with erythema nodosum, cutaneous pustular vasculitis, also synovitis, CNS vasculitis involving brain stem, thrombophlebitis, and positive pathergy response. Described by Turkish dermatologist Behçet in 1937; also known as Silk Road disease due to clustering of cases along the Silk Road.

Question 11

Bishop’s Score

Answer 11

Scoring system for determining whether or not induction of labor will be successful, based on 5 criteria (scored from 0-3): position, cervical consistency, degree of effacement, dilatation, and station; score >9 suggests that induction will be successful.

Question 12

Charcot’s Joints

Answer 12

Neurogenic joint degeneration, can be secondary to syphilis, peripheral neuropathy.

Question 13

Bat wing edema

Answer 13

Pulmonary edema in perihilar distribution in approximately 5% of cases .

Question 14

Beck’s Triad

Answer 14

In pericardial tamponade, distended neck veins, distant heart sounds, hypotension, i.e. rising venous pressure, falling arterial pressure, and decreased heart sounds. Described by Claude S. Beck, thoracic surgeon, in 1935.

Question 15

Beau’s Lines

Answer 15

Horizontal depressions across nail plate seen as nail grows out, caused by a transient arrest in nail growth, can occur during acute stress (e.g., high fever, circulatory shock, myocardial infarction, pulmonary embolism). See also Pohl-Pinkus constriction involving hair.

Question 16

Bence Jones Proteins

Answer 16

Free immunoglobulin light chains seen in plasma cell dyscrasias (e.g. multiple myeloma, AL-amyloidosis, light-chain deposition disease, Waldenström’s macroglobulinemia, MGUS, heavy-chain disease (mu) (rare), lymphoproliferative disease (rare), rifampin therapy (rare)). These light chains are filtered by glomerulus and then reabsorbed by tubular cells; proteins are toxic to tubule cells; described by Henry Bence Jones. Note, there is no hyphen in “Bence Jones.

Question 17

Bouchard’s Nodes

Answer 17

Bony spurs at proximal interphalangeal joint in osteoarthritis.

Question 18

Mittelschmerz

Answer 18

Lower abdominal or pelvic pain during ovulation; occurs roughly halfway of menstrual cycle. From German for “middle pain.”

Question 19

Mohs Surgery

Answer 19

Surgery involving microscopic examination of tissue being removed; generally used for skin cancers; developed by Frederic Mohs in the 1930s.

Question 20

Bohr Effect

Answer 20

Fall in pH leading to decrease in oxygen affinity of hemoglobin.

Question 21

Broca’s area

Answer 21

Left frontal speech area, important for articulating speech; see Broca’s aphasia.

Question 22

Brugada syndrome

Answer 22

Defect in an ion channel gene resulting in abnormal electrophysiologic activity in the right ventricle and characterized by (1) ST segment elevation in V1-V3, (2) right bundle branch block, (3) sudden cardiac death, (4) grossly normal heart; accounts for 40-60% of idiopathic ventricular fibrillation.

Question 23

Cat scratch disease

Answer 23

Tender regional lymphadenopathy persisting for 3 weeks or longer, frequently preceded by primary skin lesion after contact with cats, appears to be caused by Bartonella (formerly Rochalimaea) henslae, a small, pleomorphic gram-negative bacillus.

Question 24

Castleman’s Disease

Answer 24

Lymphoproliferative disorder, either localized or multicentric; presents with massive lymphadenopathy, fever, splenomegaly, hepatomegaly; characterized by hyperplastic lymphoid follicles with capillary proliferation; associated with HHV 8; HIV-infected individuals at increased risk for multicentric Castleman’s disease; multicentric can progressive to lymphoma..

Question 25

Cushing’s Syndrome

Answer 25

Hypercortisolism, as in from Cushing’s disease or from exogenous glucocorticoids.

Question 26

Buerger’s Test

Answer 26

In peripheral vascular disease, red foot becomes pale with elevation. As a result of Buerger’s Test (see photo).

Question 27

Campbell’s Sign

Answer 27

In chronic airway obstruction, downward motion of trachea during inspiration, perhaps due to downward pull of diaphragm.

Question 28

Sjogrens syndrome

Answer 28

Autoimmune disorder with lymphocytic infiltration affecting salivary and lacrimal glands, associated with dry mouth and dry eyes (keratoconjunctivitis sicca). May also have either interstitial pulmonary fibrosis or a lymphocytic infiltration of the alveolar walls. Also may be associated with malignant transformation to lymphoma.

Question 29

Fourth Disease

Answer 29

Filatov-Dukes’s disease, also known as Staphylococcal scarlet fever, caused by Staph. aureus epidermolytic toxin, described in 1900

Question 30

Finkelstein’s Test

Answer 30

In de Quervain’s tenosynovitis, dorsal thumb pain when the wrist is deviated in an ulnar fashion and the thumb is flexed across the palm.

Question 31

First Disease

Answer 31

Measles, also known as rubeola, caused by paramyxovirus, described in 1627

Question 32

Duke criteria for endocarditis

Answer 32

Criteria for endocarditis, including two major criteria (typical blood culture and positive echocardiogram) and six minor criteria (predisposition, fever, vascular phenomena, immunologic phenomena, suggestive echocardiogram, and suggestive microbiologic findings); described at Duke University in 1994.

Question 33

Charcot’s triad

Answer 33

In 70% of patients with bacterial cholangitis, right-upper-quadrant pain, jaundice, and fever; see also Reynold’s pentad

Question 34

Churg-Strauss syndrome

Answer 34

Allergic angiitis and granulomatosis involvement in the lung, associated with eosinophilia. Asthma is main feature (occurs in 95%) and precedes vasculitic phase by 8-10 years; 2/3 of patients have skin lesions (subcutaneous nodules on extensor surfaces); 70% have P-ANCA; 4/6 following criteria 85% sensitive and 99.7% specific: asthma; eosinophilia>10%; neuropathy; pulmonary opacities; paranasal sinus abnormality; biopsy of blood vessel showing eosinophils in extravascular area.

Question 35

Cockcroft-Gault formula

Answer 35

For calculating clearance based on creatinine, age, weight: [(140-age) x lean body weight (in kg)]/[plasma creatinine (in mg/dL) x 72]; in women, multiplied by 0.85 because of smaller muscle mass.

Question 36

Coombs test

Answer 36

Direct, ability of anti-IgG or anti-C3 antisera to agglutinate the patient’s red blood cells; cold reacting antibodies react with anti-C3 (mostly drug-related antibodies, IgM antibodies (generally to polysaccharide), IgG antibodies of low affinity); indirect Coombs, serum of the patient is incubated with normal red cells, though IgM antibodies may agglutinate directly.

Question 37

Dimple sign

Answer 37

In dermatofibroma, lateral compression with thumb and index finger produces a depression, or “dimple.”

Question 38

Dix-hallpike test

Answer 38

For testing benign paroxysmal positional vertigo, examiner stands at the patient’s right side and rotates the patient’s head 45 degrees to the right to align the right posterior semicircular canal with the sagital plane of the body; the examiner moves the patient, whose eyes are open, from the seated to the supine right-ear-down position and then extends the patient’s neck slightly so that the chin is pointed slightly upward. If rotational nystagmus seen, felt to be positive for BPV.

Question 39

Ewings Sarcoma

Answer 39

Same tumor as primitive neuroectodermal tumor or small round cell tumor of bone, 85% of cases there is a t(11;22)(q24:q12) translocation; second most common cancer of bone in children and adolescents. Onion skinning, a radiographic finding.

Question 40

Tetralogy of Fallot

Answer 40

1. ventricular septal defect; 2. infundibular, valvar, or supravalvar pulmonic stenosis; 3. an anteriorly displaced aorta that receives blood from both ventricles; 4. right ventricular hypertrophy.

Question 41

Dressler’s Syndrome

Answer 41

Pericarditis, possible autoimmune etiology, found to develop 2 weeks to several months after acute myocardial infarction.

Question 42

Economy Class Syndrome

Answer 42

Pulmonary embolism after travel, described by Symington and Stack in Br J Dis Chest 1977.

Question 43

Erb’s Palsy

Answer 43

Upper plexus palsy affecting C5 and C6 and +/- C7 nerve roots associated with weakness of shoulder and arm. The most common cause of Erb’s palsy is dystocia, an abnormal or difficult childbirth or labor.

Question 44

Fanconi’s Syndrome

Answer 44

Generalized dysfunction of proximal renal tubule leading to glycosuria, hyperphosphaturia, hypophasphatemia, aminoaciduria, and systemic acidosis; may be associated with outdated tetracyclines.

Question 45

Felty’s Syndrome

Answer 45

Felty syndrome is a rare condition that involves rheumatoid arthritis, decreased white blood cell count, and a swollen spleen. It can develop into a serious and life-threatening infection.

Unfortunately, there is not much known about the condition. The underlying cause is unknown and treatment generally focuses on controlling the underlying RA.

Components of Felty Syndrome can be remembered by the mnemonic: SANTA
S – Splenomegaly
A – Anemia
N – Neutropenia
T – Thrombocytopenia
A – Arthritis (Rheumatoid)

Question 46

Hamptons hump

Answer 46

In pulmonary embolism or infarction, a wedge-shaped infiltrate that abuts the pleura; often associated with a small pleura effusion that is usually exudative and may be hemorrhagic; not specific.

Question 47

Hawthorne Effect

Answer 47

The effect (usually positive or beneficial) of being under study upon the persons being studied; their knowledge of the study often influences behavior. Named after city in Illinois; site of a Western Electric plant.

Question 48

Hangman’s Fracture

Answer 48

Fracture of pars interarticularis of C2 vertebra, often from hyperextension injury.

Question 49

Hashimoto’s

Answer 49

Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disease in which the thyroid gland is attacked by a variety of cell- and antibody-mediated immune processes. It was the first disease to be recognized as an autoimmune disease. It was first described by the Japanese specialist Hakaru Hashimoto in Germany in 1912. Elevated TSH is often viewed as evidence of chronic autoimmune thyroiditis as well as antithyroid antibodies; antithyroglobulin antibodies in 60% of patients and antithyroid microsomal antibodies in 95%.

Question 50

Kernig Sign

Answer 50

In meningeal irritation (as in meningitis), flexion of patient’s leg at both hip and knee and then straightening of knee associated with pain and increased resistance to extending knee.

Note:
“Most physicians have forgotten that the major causes of meningitis in Kernig’s days were pneumococcus and tuberculosis which both produce an intense pachymeningitis around the brain stem—thus the pathophysiology of the sign. These days, viral meningitis is the most common form seen—no pachymenigitis—and a negative Kernig’s sign.”

Question 51

Brudzinski Sign

Answer 51

After flexing the neck, flexion of hips and knees in response. Suggests meningeal inflammation as seen in meningitis.