First Aid: Rapid Review Flashcards
Diagnose: Acute abdominal pain, ascites and hepatomegaly
Budd-Chiari Syndrome (post-hepatic venous thrombosis)
Diagnose: Achilles tendon xanthoma.
Familial Hypercholesterolemia type II.
Diagnose: Adrenal hemorrhage, hypotension, DIC
Waterhouse-Friderichsen syndrome from meningococcemia
Diagnose: Anterior drawer sign
ACL injury
Diagnose: Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints.
Marfan Syndrome
Diagnose: Athlete with polycytemia
EPO injection
Diagnose: Back pain, fever, night sweats, weight loss
Pott disease
Diagnose: bilateral hilar adenopathy, uveitis
Sarcoidosis
Diagnose: Blue Sclera
Osteogenesis Imperfecta
Diagnose: Bluish line on gingiva
Lead poisoning (Burton line)
Diagnose: Bone pain, bone enlargement, arthritis
Paget Disease of Bone
Diagnose: Bounding pulses, diastolic murmur, head bobbing.
Aortic regurg
Diagnose: Butterfly facial rash and Raynaud’s on a young female
SLE
Diagnose: Cafe-au-lait spots, Lisch nodules (iris hamartomas)
Neurofibromatosis type 1 (Look for pheo and optic neuromas)
Diagnose: Cafe-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities.
McCune-Albright Syndrome
Diagnose: Calf psuedohypertrophy
Muscular Dystrophy
Diagnose: Cherry-red spots on macula
Tay-Sachs (w/o hepatomegaly) or Niemann-Pick (w/ hepatomegaly)
Diagnose: Chest pain on exertion.
Angina
Diagnose: Chest pain, pericardial effusion, friction rub, persistent fever following an MI.
Dressler Syndrome
Diagnose: Child uses hands to stand from squat.
Gower sign of Muscular Dystrophy
Diagnose: Child with fever later develops red rash on face that spread to body
Parvovirus B19
Diagnose: Chorea, dementia, caudate degeneration
Huntington disease
Diagnose: Chronic exercise intolerance with myalgia, fatigue, painful cramps, and myoglobinuria.
McArdle Disease
Diagnose: Cold intolerance
Hypothyroidism
Diagnose: Conjugate lateral gaze palsy, horizontal diplopia
Internuclear opthalmoplegia (damage to MLF due to stroke or MS)
Diagnose: Continuous machine like heart murmur?
PDA
Diagnose: Cutaneous/dermal edema due to connective tissue deposition
Myxedema (caused by Graves disease)
Diagnose: Dark purple skin/mouth nodules in a patient with AIDS
Kaposi sarcoma
Diagnose: Deep, labored breathing/hyperventilation.
Kussmaul respirations (DKA)
Diagnose: Dermatitis, dementia, diarrhea.
Pellagra (The three Ds of B3)
Diagnose: Dilated cardiomyopathy, edema, alcoholism or malnutrition
Wet Beriberi
Diagnose: Dog or cat bite resulting in infection
Pasteurella Multocida
Diagnose: Dry eyes, dry mouth, arthritis
Sjorgen Syndrome
Diagnose: Dysphagia (esophageal webs), glossitis, anemia
Plummer-Vinson syndrome from iron deficiency
Diagnose: Elastic skin, hypermotility of joints
Ehlers-Danlos
Diagnose: Enlarged, hard left supraclavicular node
Virchow Node (mets from abdomen)
Diagnose: Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
Mycosis fungoides (cutanous T-Cell lymphoma) or Sezary syndrome (same + atypical T cells in the blood)
Diagnose: Facial muscle spasm upon tapping
Hypocalcemia (Chvostek sign)
Diagnose: Fat, female, forty, and fertile
Cholelithiasis
Diagnose: Fever, chills, headache, myalgia following antibiotic treatment for syphilis
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
Diagnose: Fever, cough, conjunctivitis, coryza, diffuse rash
Measles
Diagnose: Fever, night sweats, weight loss
B symptoms (particularly of lymphoma)
Diagnose: Fibrous plaques in soft tissue of penis
Peyronie disease
Diagnose: Gout, intellectual disability, self-mutilating behavior in a boy
Lesch-Nyhan
Diagnose: Green-yellow rings around peripheral cornea.
Wilson Disease (Kayser-Fleischer Rings)
Diagnose: Hamartomatous GI polyps, hyperpigmentation of mouth, feet and hands.
Peutz-Jeghers syndrome
Diagnose: Hepatosplenomegaly, osteoporosis, neurologic symptoms
Gaucher’s Disease
Diagnose: Hereditary nephritis, sensorineural hearing loss, cataracs.
Alport syndrome (mutation in collagen IV)
Diagnose: Hyperphagia, hypersexuality, hyperorality, hyperdocility.
Kluver-Bucy syndrome (amygdala)
Diagnose: Hyperreflexia, hypertonia, Babinski sign
UMN lesion
Diagnose: hyporeflexia, hypotonia, atrophy, fasciculations
LMN lesion
Diagnose: Hypoxemia, polycythemia, hypercapnia
Chronic bronchitis
Diagnose: Indurated, ulcerated genital lesion
If painless Syphilis, if painful w/ exudate Haemophilus Ducreyi.
Diagnose: Infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia.
Patau syndrome
Diagnose: Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration.
Niemann-Pick disease
Diagnose: Infant with hypoglycemia, failure to thrive, and hepatomegaly.
Cori (de-branching enzyme) or Von Gierke (glucose-6-phosphatase)
Diagnose: Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect
Edwards Syndrome
Diagnose: Jaundice, palpable distended non-tender gallbladder.
Courvoisier sign (distal obstruction of biliary tree)
Diagnose: Large rash with bull’s-eye appearance.
Erythema Migrans from Lyme
Diagnose: Lucid interval after traumatic brain injury.
Epidural hematoma
Diagnose: Male child, recurrent infection, no mature B cells.
Brutons disease (X-linked agammaglobulinemia)
Diagnose: Mucosal bleeding and prolonged bleeding time.
Glanzmann Thrombasthenia (defective GpIIb/IIIa)
Diagnose: Muffled heart sounds, distended neck veins, hypotension.
Becks triad of cardiac tamponade
Diagnose: Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumary teeth.
Gardner syndrome (Sub-type of FAP)
Diagnose: Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance.
Pompe Disease (acid maltase AKA alpha-glucosidase)
Diagnose: Neonate with arm paralysis following difficult birth
Erb-Duchenne Palsy (C5-C6 superior trunk)
Diagnose: No lactation post-partum, absent menstruation, cold intolerance
Sheehan Syndrome (Pituitary Infarction)
Diagnose: Nystagmus, intention tremor, scanning speech, bilateral internuclear opthalmoplegia.
Multiple Sclerosis
Diagnose: Oscillating slow and fast breathing.
Cheyne-Stokes respirations (In CHF or with high intracranial pressure)
Diagnose: Painful blue fingers/toes, hemolytic anemia.
Cold Agglutinin disease caused by Mycoplasma Pneumonia.
Diagnose: Painful, pale, cold fingers and toes.
Raynaud’s Phenomenon
Diagnose: Painful, raised red lesions on pad of fingers or toes.
Oslers nodes of infective endocarditis.
Diagnose: Painless erythematous lesions on palms and soles.
Janeway Lesions of infective endocarditis.
Diagnose: Painless jaundice
Cancer of the pancreatic head obstructing the bile duct. Or Gilbert Syndrome.
Diagnose: Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria.
Henoch-Schonlein Purpura (IgA Vasculitis)
Diagnose: Pancreatic, pituitary and parathyroid tumors.
MEN 1 (Autosomal dominant)
Diagnose: Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia.
Nephrotic Syndrome
Diagnose: Pink complexion, dyspnea, hyperventilation.
Emphysema (“pink puffer”)
Diagnose: Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalance, hypophosphatemic rickets.
Fanconi Syndrome (proximal tubule reabsorption defect)
Diagnose: Pruritic, purple, polygonal planar papules and plaques.
Linchen Planus
Diagnose: Ptosis, Miosis, Anhidrosis
Horner Syndrome
Diagnose: Pupil accomodates but does not react.
Argyll Robertson pupil (neurosyphilis)
Diagnose: Rapidly progressive leg weakness that ascends following GI / upper respiratory infection.
Guillain Barre Syndrome
Diagnose: Rash on palms and soles
Coxsackie A, 2o Syphilis, Rocky Mountain spotted fever
Diagnose: Recurrent colds, unusual eczema, high serum IgE.
Hyper-IgE syndrome (Job syndrome, autosomal dominant deficiency in Th17 cells)
Diagnose: Red “currant jelly” sputum in alcoholic or diabetic patients
Klebsiella Pneumoniae
Diagnose: Red “currant jelly” stools
Acute mesenteric ischemia or intussusception depending on the age.
Diagnose: Red, itchy, swollen rash of nipple/areola
Paget disease of the breast
Diagnose: Red urine in the morning, fragile RBCs
Paroxysmal Nocturnal Hemoglobinuria
Diagnose: Renal cell carcinoma (bilateral), hemangioblastoma, angiomatosis, pheochromocytoma.
von Hippel-Lindau disease
Diagnose: Resting tremor, rigidity, akinesia, postural instability.
Parkinson Disease
Diagnose: Retinal hemorrhages with pale centers.
Roth Spots (bacterial endocarditis)
Diagnose: Severe Jaundice in a neonate
Crigler-Najal syndrome (unconjugated hyperbilirubinemia)
Diagnose: Severe RLQ pain with palpation of LLQ.
Rovsing sign (acute appendicitis)
Diagnose: Severe RLQ pain with rebound tenderness.
McBurney sign (acute appendicitis)
Diagnose: Short stature, increase incidence of tumors/leukemia, aplastic anemia.
Fanconi Anemia (Genetic loos of DNA cross-link repair; progresses to AML)
Diagnose: Single palmar crease
Down syndrome
Diagnose: Situs inversus, chronic sinusitis, bronchiectasis, infertility
Kartagener’s Syndrome (dyenin arm defect affecting cilia)
Diagnose: Skin hyperpigmentation, hypotension, fatigue
Addison Disease (1o adrenocortical insufficiency causes increase ACTH and alpha-MSH)
Diagnose: Slow, progressive muscle weakness in boys
Becker’s Muscular Dystrophy
Diagnose: Small, irregular red spots on buccal/lingual mucosa with blue-white center.
Koplik’s Spots (measles, rubeola)
Diagnose: Smooth, flat, moist, painless white lesion on genitals
Condyloma Lata (2o syphilis)
Diagnose: Splinter hemorrhages in fingernails
Bacterial Endocarditis
Diagnose: “Strawberry tongue”
Kawasaki vasculitis, toxic shock syndrome or Scarlett fever
Diagnose: Streak ovaries, congenital heart disease, horseshoe kidneys, cystic hygroma at birth, short stature, webbed neck, lymphedema.
Turner Syndrome (45 XO)
Diagnose: Sudden swollen/painful big toe joint, tophi
Gout (hyperuricemia)
Diagnose: Swollen gums, mucosal bleeding, poor wound healing, petechiae.
Scurvy (vitamin C deficiency)
Diagnose: Swollen, hard, painful finger joints
Osteoarthritis
Diagnose: Systolic Ejection Murmur (crescendo-decrecendo)
Aortic Stenosis
Diagnose: Thyroid and parathyroid tumors, pheochromocytoma
MEN 2A (aut dom ret mutation)
Diagnose: Thyroid tumors, pheochromocytoma, ganglioneuromatosis
MEN 2B (aut dom ret mutation)
Diagnose: Toe extension/fanning upon plantar scrape
Babinski sign for UMN lesion
Diagnose: Unilateral facial drooping involving forehead
Facial nerve LMN palsy
Diagnose: Urethritis, conjunctivitis, arthritis in a male
Reactive arthritis associated with HLA B 27
Diagnose: Vascular birth mark (port-wine stain)
Hemangioma (bening, but associated with Sturge-Weber syndrome)
Diagnose: Vomiting blood following gastroesophageal lacerations.
Mallory-Weiss Syndrome (alcoholic or bulimic syndrome)
Diagnose: Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple Disease
Diagnose: “Worst headache of my life”
Sub-arachnoid hemorrhage
Lab: Anticentromere antibodies
CREST syndrome (limited scleroderma) Bonus: What does CREST stand for.
Lab: Antidemoglin (epithelial) antibodies
Phemphigus vulgaris (w/ + Nikolsky sign)
Lab: Anti-glomerular basement membrane antibodies
Goodpasture syndrome (Rapidly Progressive Cresenteric Glomerulonephritis)
Lab: Antihistone antibodies
Drug induced SLE (Hydralazine, INH, Phenytoin, Procainamide)
Lab: Anti-IgG antibodies
Rheumatoid Arthritis (Systemic inflammation, joint pannus, boutonniere deformity)
Lab: antimitochondrial antibodies
Primary Biliary Cirrhosis (female, cholestasis, portal hypertension)
Lab: Antineutrophil cytoplasmic antibodies (ANCA)
MPO-ANCA/P-ANCA = Microscopic Polyangitis or Churg-Strauss PR3-ANCA/c-ANCA = Granulomatosis with polyangitis