First Aid Rapid Review Flashcards
Abdominal pain, ascites, hepatomegaly
Budd-Chiari syndrome (posthepatic venous thrombosis)
Achilles tendon xantoma
Familial Hypercholesterolemia (reduced LDL receptor signalling)
Adrenal hemorrhage, hypotension, DIC
Waterhouse-Friderichsen syndrom (meningococcemia)
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
Marfan’s syndrome (fibrillin defect)
Athlete w/ polycythemia
secondary to erythropoeitein injection
back pain, fever, night sweats, weight loss
Pott’s Disease (vertebral TB)
Bilateral hilar adenopathy, uveitis
sarcoidosis (noncaseating granulomas)
blue sclera
osteogenesis imperfecta (type 1 collagen defect)
bluish line on gingiva
Burton’s lines (lead poisoning)
bone pain, bone enlargement, arthritis
Paget’s disease of bone (increased osteoblastic and osteoclastic activity)
Bounding pulses, diastolic heart murmur, head bobbing
Aortic regurgitation
Butterfly facial rash and Raynaud’s phenomenon in a young female
SLE
Cafe au lait spots, Lisch nodules (iris hamartoma)
NF type 1 (+pheochromocytoma, optic gliomas)
Cafe au lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormailities
McCune-Albright syndrome (Mosaic G-protein signalling mutation)
Calf psuedohypertrophy
muscular dystrophy (most commonly Duchenne’s): X-linked recessive deletion of dystrophin gene
Cherry-red spot on macula
Tay-Sachs (ganglioside accumulation) or Neimann-Pick (sphingomyelin accumulation), central retinal artery occlusion
Chest pain on exertion
Angina (stable: with moderate exertion; unstable: with minimal exertion)
Chest pain, pericardial effusion/friction rub, persistent fever following MI
Dressler’s syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode)
Child uses arms to stand up from squat
Gower’s sign (Duchenne muscular dystrophy)
Child with fever later develops red rash on face that spreads to the body
Slapped Cheeks (erythemea infectiosum/fifth disease: parvovirus B19)
Chorea, dementia, caudate degeneration
Huntington’s Disease (autosomal-dominant CAG repeat expansion)
chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
McArdle’s disease (muscle glycogen phosphorylase deficiency)
Cold intolerance
hypothyroidism
conjugate lateral gaze palsy, horizontal diplopia
internuclear ophthalmoplegia (damage to MLF; bilateral [multiple sclerosis], unilateral [stroke])
continuous “machinery” heart murmur
PDA (close with indomethacin; open or maintain with misoprostol)
cutaneous/dermal edema due to connective tissue deposition
myxedema (caused by hypothyroidism, Graves’ disease [pretibial])
Dark purple skin/mouth nodules
Kaposi’s sarcoma (usually AIDS patients [MSM]; associated with HHV-8)
Deep, labored breathing/hyperventilation
Kussmaul breathing (diabetic ketoacidosis)
Dermatitis, dementia diarrhea
Pellagra (niacin [vit. B3] deficiency)
dilated cardiomyopathy, edema, alcoholism or malnutrition
wet beriberi (thiamine [vitamin B1] deficiency)
dog or cat bite resulting in infection
pasturella multocida (cellulitis at inoculation site)
dry eyes, dry mouth, arthritis
Sjogren’s syndrome (autoimmune destruction of exocrine glands)
dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
elastic skin, hypermobility of joints
Ehlers-Danlos syndrome (type III collagen defect)
Enlarged, hard left supraclavicular node
Virchow Node- Gastric Cancer
Facial Muscle spasm
Chvostek’s sign (hypocalcemia)
Fat, female, forty, and fertile
Cholelithiasis (gallstones)
Fever, chills, headache, myalgia following antibiotic treatment for syphillis
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
fever, cough, conjunctivitis, coryza, diffuse rash
Measles (morbillivirus)
fibrous plaques in soft tissue of the penis
Peyronie’s disease (connective tissue disorder)
gout, mental retardation, self-mutilating behavior in a boy
Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)
green-yellow rings around peripheral cornea
Kayser-Fleischer rings (copper accumulation from Wilson’s Disease)
Hamartomatous GI polyps, hyperigmentation of mouth/feet/hands
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; increased cancer risk, mainly GI)
hepatosplenomegaly, osteoporosis, neurologic symptoms
Gaucher’s disease (glucocerebrosidase deficiency)
Hereditary nephritis, sensorineural hearing loss, cataracts
Alport syndrome (mutation in alpha chain of collagen 4)
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Kluver-Bucy syndrome (bilateral amygdala lesion)
Hyperreflexia, hyerptonia, Babinski sign present
UMN damage
Hyporeflexia, hypotonia, atrophy, fasciculation
LMN damage
hypoxemia, polycythemia, hypercapnia
blue bloater (chronic bronchitis: hyperplasia of mucous cells)
indurated, ulcerated, genital lesion
Nonpainful: chancre (primary syphilis, Treponema pallidum)
infant with failure to thrive, hepatosplenomegaly and neurodegenration
Neimann-Pick disease (genetic sphinomyelinase deficiency)
infant with hypoglycemia, failure to thrive, and hepatomegaly
Cori disease (debranching enzyme deficiency)
infant with cleft lip/palate, micorcephaly or holoprosencephaly, polydactyly, cutis aplasia
Patau’s syndrome (trisomy 13)
infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect
Edward’s syndrome (trisomy 18)
Jaundice, palpable distended non-tender gallbladder
Courvoisier’s sign (distal obstruction of biliary tree)
Large rash with bull’s-eye appearance
erythema chronicum mugrans from Ixodes tick bite (lyme disease: borrelia)
lucid interval after traumatic brain injury
Epidural heamtoma (middle meningeal artery rupture)
male child, recurrent infections, no mature B cells
Bruton’s disease (x-linked agammaglobulinemia)
Mucosal bleeding and prolonged bleeding time
Glanzmann’s thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIa)
Muffled heart sounds, distended neck veins, hypotension
Beck’s triad of cardiac tamponade
Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
Gardner’s syndrome (subtype FAP)
myopathy (infantile hypertrophic caridomyopthy), exercise intolerance
Pompe’s disease (lysosomal alpha-1,4-glucosidase deficiency)
Neonate with arm paralysis following difficult birth
Erb-Duchenne Palsy (superior trunk [C5-C6] brachial plexus injury: “waiter’s tip”)
No lactation postpartum, absent menstruationm cold intolerance
Sheehan’s syndrome (pituitary infarction)
Nystagmus, intention tremor, scanning speech bilateral internuclear ophthalmoplegia
Multiple Sclerosis
Oscilliating slow/fast breathing
Cheyne-Stokes repsirations (central apnea in CHF or increased intracranial pressure)
Painful blue fingers/toes, hemolytic anemia
Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis)
Painful, pale, cold finger/toes
Raynaud’s phenomenon (vasospasm in extremities)
Painful, raised red lesions on pad of fingers/toes
Osler nodes (infective endocarditis, immune complex deposition)
painless erythematous lesions on palms and soles
Janeway lesions (infective endocarditis, septic emboli/microabscesses)
Painless jaundice
Cancer of the pancreatic head obstructing the bile duct
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria
Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
Pancreatic, Pituitary, Parathyroid tumors
MEN 1 (autosomal dominant)
Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia
Nephrotic syndrome
Pink Complexion, dyspnea, hyperventilation
Pink Puffer (emphysema: centriacinar [smoking], panacinar [alpha-1-antitrypsin deficiency])
Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets
Fanconi’s syndrome (proximal tubular reabsorption defect)
Positive anterior “drawer sign”
Anterior Cruciate Ligament injury
Pruritic, purple, polygonal planra papules and plaques (6 P’s)
Lichen Planus
Pupil accomodates but doesn’t react
Argyll Robertson pupil (neurosyphilis)
Rapidly progressive leg weakness that ascends following GI/upper respiratory infection
Guillain-Barre syndrome (acute autimmune inflammatory demyelinating polyneuropathy)
Rash on palms and soles
Coxsackie A, secondary syphilis, Rocky Mountain Spotted Fever
Recurrent cold, unusual eczema, high serum IgE
Hyper-IgE syndrome (Job’s syndrome: neutrophil chemotaxis abnormality)
Red “currant jelly” sputum in alcoholic or diabetic patients
Klebsiella pneumoniae
Red “currant jelly” stools
Acute mesenteric ischemia (adults), intussusception (infants)
Red, itchy, swollen rash of nipple/areola
Paget’s disease of the breast (represents underlying neoplasm)
Red, urine in the morning, fragile RBCs
Paroxysmal nocturnal Hematuria
Renal cell carcinoma (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma
VHL disease (dominant TSG mutation)
Resting tremor, rigidity, akinesia, postural instability
Parkinson’s disease (nigrostriatal dopamine depletion)
Retinal hemorrhages with pale centers
Roth’s spots (bacterial endocarditis)
Severe jaundice in a neonate
Crigler-Najjar syndrome(congenital unconjugated hyperbilirubinemia)
Severe RLQ pain with LLQ palpation
Rovsing’s sign (accute appendicitis)
Severe RLQ pain with rebound tenderness
McBurney’s sign (appendicitis)
Short stature, increased incidence of tumors/leukemia, aplastic anemia
Fanconi’s anemia (genetic loss of DNA crosslink repair; often progresses to AML)
Single palmar Crease
Simian Crease (Down Syndrome)
Situs inversus, chronic sinusitis, bronchietasis, infertility
Kartagener’s syndrome (dynein defect in cilia)
Skin hyperpigmentation, hypotension, fatigue
Addison’s disease (primary adrenocortical insufficiency causes increased ACTH and increased alpha-MSH)
slow, progressive muscle weakness in boys
Becker’s musclar dystroph (X-linked missense mutation in dystrophin; less severe than Duchenne’s)
Small, irregular red spots on buccal/lingual mucosa with blue-white centers
Koplik spots (measles; rubeola virus)
Smooth, flat, moist, painless with lesions on genitals
Condyloma lata (secondary syphilis)
Splinter hemorrhages in fingernails
bacterial endocarditis
Strawberry tongue
Scarlet fever, Kawasaki disease, toxic shock syndrome
Streak ovaries, congenital heart diease, horseshoe kidnye, cystic hygroma at birth, chort stature, webbed neck, lymphedema
Turner syndrome (45, XO)
Sudden swollen/painful big toe joint, tophi
Gout/podagra (hyperuricemia)
Swollen gums, mucosal bleeding, poor wound healing, spots on skin
Scurvy (Vit. C deficiency: can’t hydroxylate proline/lysine for collagen synthesis)
Swollen, Hard, painful finger joints
Osteoarthritis (osteophytes on PIP [Bouchard’s nodes], DIP [Heberden’s nodes])
Systolic ejection murmur (crescendo-decrescendo)
Aortic valve stenosis
Thryoid medullary caricnoma, parathyroid tumors, pheochromocytomas
MEN2A (autosomal dominant ret mutation)
Thyroid tumor, pheochromocytoma, ganglioneuromatosis
MEN2B (autosomal dominant ret mutation)
Toe extension/ fanning upon plantar scrape
Babinksi sign (UMN lesion)
Unilateral facial drooping involvingforehead
Facial nerve (LMN CN VII palsy)
Urethritis, conjunctivitis, arthritis in a male
reactive arthritis associated with HLA-B27
Vascular birthmark (port-wine stain)
Hemangioma (benign, but associated with Sturge-Weber syndrome)
Vomitting Blood following gastroesophageal lacerations
Mallory-Weiss syndrome (alcoholic and bulimic patients)
Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple disease (Tropheryma whipplei)
Worst Headache of My Life
Subarachnoid hemorrhage
Anticentromere antibodies
Scleroderma (CREST)
Antidesmoglein (epithelial) antibodies
Pemphigus vulgaris (blistering)
Anti-glomerular basement membrane antibodies
Goodpasture’s syndrome (glomerulonephritis and hemoptysis)
Antihistone antibodies
Drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
Antimitochondrial antibodies (AMAs)
1° biliary cirrhosis (female, cholestasis, portal hypertension)
Antineutrophil cytoplasmic antibodies (ANCAs)
Vasculitis (c-ANCA: granulomatosis with polyangiitis [Wegener’s]; p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome)
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
SLE (type III hypersensitivity)
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, distention, weight loss)
Apple core lesion on abdominal x-ray
Colorectal cancer (usually left-sided)
Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts
Auer rods (acute myelogenous leukemia, especially the promyelocytic [M3] type)
Bacitracin response
Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B)
Bamboo spine on x-ray
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia (Seen in AML)
Bloody tap on LP
Subarachnoid hemorrhage
Boot shaped heart on x-ray
Tetralogy of Fallot, RVH
Branching gram-positive rods with sulfur granules
Actinomyces israelii
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress sympathetic ganglion and cause Homer’s syndrome)
Brown tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
Cardiomegaly with apical atrophy
Chagas’ disease (Trypanosoma cruzi)
Cellular crescents in Bowman’s capsule
Rapidly progressive crescentic glomerulonephritis
Chocolate cyst of ovary
Endometriosis (frequently involves both ovaries)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal-recessive mutation in CFTR resulting in fat-soluble vitamin deficiency and mucous plugs)
Increased α-fetoprotein in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
Degeneration of dorsal column nerves
Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
Depigmentation of neurons in substantia nigra
Parkinson’s disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Desquamated epithelium casts in sputum
Curschmann’s spirals (bronchial asthma; can result in whorled mucous plugs)
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
Enlarged cells with intranuclear inclusion bodies
Owl’s eye appearance of CMV
Enlarged thyroid cells with ground-glass nuclei
Orphan Annie’s eyes nuclei (papillary carcinoma of the thyroid)
Eosinophilic cytoplasmic inclusion in liver cell
Mallory bodies (alcoholic liver disease)
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson’s disease)
Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Negri bodies of rabies (Lyssavirus)
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer’s disease)
Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eye”
Reed-Sternberg cells (Hodgkin’s lymphoma)
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
Hair on end (crew-cut) appearance on x-ray
β-thalassemia, sickle cell anemia (marrow expansion)
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo)
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
Heterophile antibodies
Infectious mononucleosis (EBV)
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
High level of D-dimers
DVT, pulmonary embolism, DIG
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (1° TB: Mycobacterium bacilli)
Honeycomb lung on x-ray or CT
Interstitial pulmonary fibrosis
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau’s syndrome (adenocarcinoma of pancreas or lung)
Hypersegmented neutrophils
Megaloblastic anemia (Bp deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
Hypertension, hypokalemia, metabolic alkalosis
Conn’s syndrome
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Increased α-fetoprotein in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (neural tube defects)
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or CMV)
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: ↑ chance of mesothelioma)
Keratin pearls on a skin biopsy
Squamous cell carcinoma
Large lysosomal vesicles in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
Lead pipe appearance of colon on barium enema x-ray
Ulcerative colitis (loss of haustra)
Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture’s syndrome
Low serum ceruloplasmin
Wilson’s disease (hepatolenticular degeneration)
Lump- bump appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
Lytic (“hole punched”) bone lesions on x-ray
Multiple myeloma
Mammary gland (“blue domed”) cyst
Fibrocystic change of the breast
Monoclonal antibody spike
• Multiple myeloma (usually IgG or IgA)
Mucin-filled cell with peripheral nucleus
Signet ring (gastric carcinoma)
Narrowing of bowel lumen on barium x-ray
String sign (Crohn’s disease)
Necrotizing vasculitis (lungs) and necrotizing glornerulonephritis
Granulomatosis with polyangiitis (Wegener’s; c-ANCA positive) and Goodpasture’s syndrome (anti-basement membrane antibodies)
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
Nodular hyaline deposits in glomeruli
Kimmelstein-Wilson nodules (diabetic neuropathy)
Novobiocin response
Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus
Nutmeg appearance of liver
Chronic passive congestion of liver due to right heart failure
Onion skin periosteal reaction
Ewing’s sarcoma (malignant round-cell tumor)
Optochin response
Sensitive: Streptococcus pneumoniae; resistant: Viridans streptococcus
Periosteum raised from bone, creating triangular area
Codman’s triangle on x-ray (osteosarcoma, Ewing’s sarcoma, pyogenic osteomyelitis)
Podocyte fusion or “effacement” on electron microscopy
Minimal change disease (child with nephrotic syndrome)
Polished, “ivory like” appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
Protein aggregates in neurons from hyperphosphorylation of protein tau
Neurofibrillary tangles (Alzheimer’s disease) and Pick’s bodies (Pick’s disease)
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
Pseudopalisading tumor cells on brain biopsv
Glioblastorna multiforme
RBC casts in urine
Acute glomerulonephritis
Rectangular, crystal-like, cvtoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
Renal epithelial casts in urine
Acute toxic/viral nephrosis
Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
Rib notching (Turner Syndrome)
Coarctation of the aorta
Ring-enhancing brain lesion 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: 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 RBCs
Rouleaux formation (high ESR, multiple myeloma)
Stippled vaginal epithelial cells
Clue cells (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/RBCs)
Thumb sign on lateral x-ray
Epiglottitis (Haemophilus influenzae)
Thyroid-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
WBCs 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)
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 and Al-Anon for family
Alcohol withdrawal
Benzodiazepines
Anorexia
SSRIs
Anticoagulation during pregnancy
Heparin
Arrhythmia in damaged cardiac tissue
Class IB antiarrhythmic (lidocaine, mexiletine, tocainide)
B12, deficiency
Vitamin 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-α
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 patients)
Cyclophosphamide-induced hemorrhagic cystitis
Mesna
Cystic fibrosis
N-acetylcysteine + antipseudomonal prophylaxis (tobramycin/ azithromycin)
Cytomegalovirus
Ganciclovir
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 hypoglycemics, 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)
Haemophilus influenzae (B)
Rifampin (prophylaxis)
Generalized anxiety disorder
Buspirone
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
Rimantadine, oseltamivir
Legionella pneumophila
Erythromycin
Long-term anticoagulation
Warfarin
Malaria
Chloroquine/mefloquine (for blood schizont), primaquine (for liver hypnozoite)
Malignant hyperthermia
Dantrolene
Medical abortion
Mifepristone
Migraine
Sumatriptan
MRSA
Vancomycin
Multiple sclerosis
β-interferon, immunosuppression, natalizumab
Mycobacterium tuberculosis
RIPE (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
Osteomalacia/rickets
Vitamin D supplementation
Osteoporosis
Bisphosphonates; calcium and vitamin D supplementation
Patent ductus arteriosus
Indomethacin
Pheochromocytoma
α-antagonists (e.g., phenoxybenzamine)
Pneumocystis jirovecii
TMP-SMX (prophylaxis in AIDS patient)
Prolactinoma
Bromocriptine (dopamine agonists)
Prostate cancer/uterine fibroids
Leuprolide, GnRH (continuous)
Prostate carcinoma
Flutamide
Pseudomonas aeruginosa
Antipseudomonal penicillin + aminoglycoside
Pulmonary arterial hypertension (idiopathic)
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, vasopressin receptor antagonists
Sickle cell anemia
Hydroxyurea (↑ fetal hemoglobin)
Sporothrix schenckii
Oral potassium chloride
Stable angina
Sublingual nitroglycerin
Staphylococcus aureus
MSSA: nafcillin, 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)
Streptococcus pyogenes
Penicillin prophylaxis
Temporal arteritis
High-dose steroids
Tonic-clonic seizures
Phenytoin, valproate, carbamazepine
Toxoplasma gondii
Sulfadiazine + 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
Actinic (solar) keratosis
Precursor to squamous cell carcinoma
Acute gastric ulcer associated with CNS injury
Cushing’s ulcer (↑ 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 with gastritis, peptic ulcer disease, and stomach cancer
H. pylori
Bacterial meningitis (adults and elderly)
Streptococcus pneumonias
Bacterial meningitis (newborns and kids)
Group B streptococcus (newborns), S. pneumoniae/Neisseria meningitidis (kids)
Benign melanocytic nevus
Spitz nevus (most common in first two decades)
Bleeding disorder with Gplb deficiency
Bernard-Soulier syndrome (defect in platelet adhesion to von Willebrand’s factor)
Brain tumor (adults)
Supratentorial: metastasis > astrocytoma (including glioblastoma multiforme) > meningioma > schwannoma
Brain tumor (kids)
Infratentorial: medulloblastoma (cerebellum) or supratentorial: craniopharyngioma (cerebrum)
Breast cancer
Infiltrating ductal carcinoma (in the U.S., 1 in 9 women will develop breast cancer)
Breast mass
Fibrocystic change, carcinoma (in postmenopausal women)
Breast tumor (benign)
Fibroadenoma
Cardiac 1° tumor (kids)
Rhabdomyoma, often seen in tuberous sclerosis
Cardiac manifestation of lupus
Libman-Sacks endocarditis (nonbacterial, affecting both sides of mitral valve)
Cardiac tumor (adults)
Metastasis, 1° myxoma (4:1 left to right atrium; “ball and valve”)
Cerebellar tonsillar herniation
Chiari malformation (often presents with progressive hydrocephalus or syringomyelia)
Chronic arrhythmia
Atrial fibrillation (associated with high risk of 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
Osteoporosis (type I: postmenopausal woman; type II: elderly man or woman)
Congenital adrenal hyperplasia, 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); systemic lupus erythematosus (developed world)
Coronary artery involved in thrombosis
LAD>RCA>LCA
Cretinism
Iodine deficit/hypothyroidism
Cushing’s syndrome
• latrogenic Cushing’s (from corticosteroid therapy)
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
Multiple sclerosis
DIG
Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery
Dietary deficit
Iron
Diverticulum in pharynx
Zenker’s diverticulum (diagnosed by barium swallow)
Ejection click
Aortic/pulmonic stenosis
Esophageal cancer
Squamous cell carcinoma (worldwide); adenocarcinoma
Food poisoning (exotoxin mediated)
S. aureus, B. cereus
Glomerulonephritis (adults)
Berger’s disease (IgA nephropathy)
Gynecologic malignancy
Endometrial carcinoma (most common in U.S.); cervical carcinoma (most common worldwide)
Heart murmur, congenital
Mitral valve prolapse
Heart valve in bacterial endocarditis
Mitral > aortic (rheumatic fever), tricuspid (IV drug abuse)
Helminth infection (U.S.) Hematoma—epidural
Enterobius vermicularis, Ascaris lumbricoides
Hematoma—subdural
Rupture of middle meningeal artery (trauma; lentiform shaped)
Hemochrornatosis
Multiple blood transfusions or hereditary HFE mutation (can result in CHF, “bronze diabetes,” and T risk of hepatocellular carcinoma)
Hepatocellnlar carcinoma
Cirrhotic liver (associated with hepatitis B and C and with alcoholism)
Hereditary bleeding disorder
von Willebrand’s disease
Hereditary harmless jaundice
Gilbert’s syndrome (benign congenital unconjugated hyperbilirubinemia)
HLA-B27
Ankylosing spondylitis, Reiter’s syndrome, ulcerative colitis, psoriasis
HLA-DR3 or -DR4
Diabetes mellitus type 1, rheumatoid arthritis, SLE
Holosystolic murmur
VSD, tricuspid regurgitation, mitral regurgitation
Hypercoagulability, endothelial damage, blood stasis
Virchow’s triad (results in venous thrombosis)
Hypertension, 2°
Renal disease
Hypoparathyroidism
Accidental excision during thyroidectomy
Hypopituitarism
Pituitary adenoma (usually benign tumor)
Infection 2° to blood transfusion
Hepatitis C
Infections in chronic granulomatous disease
Staphylococcus aureus, E. coli, Aspergillus (catalase positive)
Kidney stones
• Calcium = radiopaque
Late cyanotic shunt (uncorrected left to right becomes right to left)
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
Metastases to bone
Prostate, breast > lung > thyroid, testes
Metastases to brain
Lung > breast > genitourinary > osteosarcoma > melanoma>GI
Metastases to liver
Colon»_space; 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)
Focal segmental glomerulosclerosis
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
Opportunistic infection in AIDS
Pneumocystis jirovecii (formerly carinii) pneumonia
Osteomyelitis
S. aureus
Osteomyelitis in sickle cell disease
Salmonella
Osteomyelitis with IV drug use
Pseudomonas, S. aureus
Ovarian metastasis 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: child, 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 (may sometimes be associated with ALL/AML)
Pituitary tumor
Prolactinoma, somatotropic “acidophilic” adenoma
Primary amenorrhea
Turner syndrome (45,XO)
Primary bone tumor (adults)
Multiple myeloma
Primary hyperaldosteronism
Adenoma of adrenal cortex
Primary hyperparathyroidism
Adenomas, hyperplasia, carcinoma
Primary liver cancer
Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, α1 antitrypsin deficiency)
Pulmonary hypertension
COPD
Recurrent inflammation/thrombosis of small/medium vessels in extremities
Bucrger’s disease (strongly associated with tobacco)
Renal tumor
Renal cell carcinoma: associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndromes (EPO, renin, PTH, ACTH)
Right heart failure due to a pulmonary cause
Cor pulmonale
S3 (protodiastolic gallop)
↑ 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
Sexually transmitted disease
Chlamydia (usually coinfected with gonorrhea)
SIADH
Small cell carcinoma of the lung
Site of diverticula
Sigmoid colon
Sites of atherosclerosis
Abdominal aorta > coronary artery > popliteal artery > carotid arterv.
Stomach cancer
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)
Temporal arteritis
Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymyalgia rheumatica
Testicular tumor
Seminoma
Thyroid cancer
Papillary carcinoma
Tumor in women
Leiomyoma (estrogen dependent, not precancerous)
Tumor of infancy
Hemangioma (usually regresses spontaneously by childhood)
Tumor of the adrenal medulla (adults)
Pheochromocytoma (usually benign)
Tumor of the adrenal medulla (kids)
Neuroblastoma (malignant)
Type of Hodgkin’s
Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)
Type of non-Hodgkin’s
Diffuse large cell
UTI
E. coli, Staphvlococcus saprophvticus (young women)
Viral encephalitis affecting 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)
Sensitivity
Sensitivity = TP / (TP + FN)
Specificity
Specificity = TN / (TN + FP)
Positive predictive value
PPV = TP / (TP + FP)
Negative predictive value
NPV = TN / (TN + FN)
Relative risk
[a/(a+b)]/[c/(c+d)]
Attributable risk
[a/(a+b)]-[c/(c+d)]
Number needed to treat
1/absolute risk reduction (ARR)
Number needed to harm
1/attributable risk increase (ARI)
Hardy-Weinberg equilibrium
p^2 + 2pq + q^2 = 1
Henderson-Hasselbalch equation
pH = pKa + log ([HCO3-]/ 0.03 PCO2)
Volume of distribution
Vd= (amount of drug in the body) / (plasma drug concentration)
Clearance
CL = (rate of elimination of drug) / (plasma drug concentration)
Half-life
t1/2 = 0.7 x Vd/CL
Loading dose
LD = Cp x Vd/F
Maintenance dose
MD = Cp x CL/F
Cardiac output
CO = stroke volume * heart rate
Mean arterial pressure
MAP = cardiac output * total peripheral resistance
Stroke volume
SV = end diastolic volume - end systolic volume
Ejection fraction
EF = (stroke volume / end diastolic volume) x 100
Resistance
R = driving pressure/flow
Net filtration pressure
Pnet = (Pc - Pi) - (∏c -∏i)
Glomerular filtration rate
GFR = U inulin x (V/ P inulin) = C inulin
Glomerular filtration rate (In terms of hydrostatic & oncontic pressures)
GFR = Kf [(P GC - P BS) - (∏ GC - ∏ BS)]
Effective renal plasma flow
ERPF = U PAH x (V/ P PAH) = C PAH
Renal blood flow
RBF = RPF / (1 - Hct)
Filtration fraction
FF = GFR/RPF
Physiologic dead space
VD = VT x [(PaCO2 - PeCO2) / PaCO2]
Renal Clearance
C = U x V/P
Pulmonary vascular Resistance
PVR=[P(pulm artery) - P(L atrium)]/CO
Alveolar gas equation
PAO2 = PIO2 - PaCO2/R
Odds ratio (for case-control studies)
Odds ratio = (a/c)/(b/d) = (a x d)/(b x c)
BMI - body mass index
BMI = weight in kg / (height in meters)^2
Alveolar Ventilation
Alveolar ventilation = (tidal volume - dead space) x Resp Rate
Odds ratio
Case - control studies = ad/bc