For My Love Flashcards
Budd-Chiari Syndrome
Abdominal pain, aseites, hepatomegaly
Clostridium
Abdominal pain, diarrhea, leukocytosis, recent antibiotic use
Familial hypercholesterolemia
Achilles’ tendon xanthoma
Waterhouse-Friderichen syndrome (meningococcemia)
Adrenal Hemorrhage, hypotension, DIC
IgA deficiency
Anaphylaxis following blood transfusion
Anterior cruciate ligament injury
Anterior “drawer sign”
Marfan syndrome (fibrillin defect)
Arachnodactyly, lens dislocation (upward), aortic dissection, hyperflexible joints
2 tonerythropoientin injection
Athlete with polycythemia
Pott Disease (vertebral TB)
Back Pain, fever, night sweats
Neurofibromatosis type 2
Bilateral acoustic schwannomas
Sarcoidosis (noncaseating granulomas)
Bilateral hilar adenopathy, uveitis
Mucor or Rhizopus fungeal infection
Black eschar on face of patient with diabetic ketoacidosis
Osteogenesis imperfecta (type I collagen defect)
Blue sclera
Burton line (lead poisoning)
Bluish line on gingiva
Paget Disease of bone (osteoblastic and osteoclastic activity)
Bone pain, bone enlargement, arthritis
Aortic regurgitation
Bounding pulses, wide pulse pressure, diastolic heart murmur, head Bobbing
Systemic lupus erythemalosus
“Butterfly” facial rash and Raynaud phenomenon in a young female
Neurofibromatosis type I
Cafe-si-lait spots, Lisch nodules (iris hamartoma), cutaneous neurofibromas, pheochromocytomas, optic gliomas
McCune-Albright syndrome (mosaic G-Protein signaling mutation)
Cafe-ah-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities
Muscle dystrophy (most commonly Duchenne, due to X-linked recessive frameshift mutation of dystrophin gene)
Calf pseudohypertrophy
Kawasaki Disease (treat with IVIG and aspirin)
Cervical lymphadenopathy, desquamating rash, coronary aneurysms, red conjunction and tongue, hand-foot changes
Tay-Sachs (ganglioside accumulation) or Norman-Pick (sphingomyelin accumulation), central retinal artery occlusion
“Cherry-red spots” on macula
Angina (stable: with moderate exertion; unstable; with minimal exertion or at rest)
Chest pain on exertion
Dresser Syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2 weeks to several months after acute episode)
Chest pain, pericardial effusion/effusion/friction rub, persistent fever following MI
Peyronie disease (connective tissue disorder)
Fibrous plaques in soft tissue of penis with abnormal curvature
Wilson Disease (Kayser-Fleischer rings due to copper accumulation)
Golden Brown rings around peripheral cornea
Lesche-Nyhan syndrome (HGPRT deficiency, X-linked recessive)
Gout, intellectual disability, self-mutilating behavior in a boy
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; raise in cancer risk, mainly GI)
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands/genitalia
Gaucher disease (glucocerebrosidase deficiency)
Hepatosplenomegaly, pancytopenia, osteoporosis, aseptic necrosis of femoral head, bone crises
Alport syndrome (mutation in collagen IV)
hereditary nephritis, sensorineural hearing loss, cataracts
Kluver-Bucy syndrome (bilateral amygdala lesion)
Hyperphagia, hypersexuality, hyperorality, hyperdocility
UMN Damage
Hyperreflexia, hypertonia, Babinski sign present
LMN Damage
Hyporeflexia, hypotonia, atrophy, fasciculations
Chronic bronchitis (hyperplasia of mucous cells, “blue bloater”)
Hypoxemia, polycythemia, hypercapnia
Nonpainful chanbcre (1 degree syphilis, Treponema pallidum) Painful, with exudate: chancroid (haemophilus ducreyi)
Indurated, ulcerated genital lesion
Patau syndrome (trisomy 13)
infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia
cori disease (debranching enzyme deficiency) or Von Gierke disease (gluicosse-6-phosphatase deficiency, more severe)
infant with hypoglycemia, hepatomegaly
Edwards Syndrome
Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect
Courvosier sign (distal malignant obstruction of biliary tree)
Jaundice, palpable distended non-tender gallbladder
Erythema chronicum migrans from Ixodes tick bite (Lyme disease: Borrelia)
Large rash with bull’s eye appearance
Epidural hematoma (middle meningeal artery rupture)
Lucid interval after traumatic brain injury
Bruton disease (X-linked agammaglobulinemia)
Male child, recurrent infections, no mature B cells
Glanzmann thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
mucosal bleeding and prolonged bleeding time
Beck triad of cardiac tamponade
nuffled heart sounds, distended neck veins, hypotension
Gardner syndrome (subtype of FAP)
multiple colon polyps, osteomas/soft tisue tumors, impacted/sup\ernmerary teeth
Pompe disease (lysomal ?-1, 4-glucosidase deficiency)
Mypopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
Erb-Duchenne palsy (superior trunk [C5-C6] brochial plexus injury: “waiter’s tip”)
Neonate with arm paralysis following difficult birth
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
severe jaundice in neonate
Rovsing sign (acute appendicitis)
severe RLQ pain with palpation of LLQ
Mcburney sign (acute appendicitis)
severe RLQ pain with deep tenderness
Fanconi anemia (genetic loss of DNA crosslink repair; often progresses to AML)
Short stature , café au lait spots, thumb/radial defects, raise incidence of tumors/leukemia, aplastic anemia
Down syndrome
Single palmar crease
Kartagener syndrome (dynein arm defect affecting cilia)
situs inversus, chronic sinusitis, bronchiectasis, infertility
1 degree adrenocortical insufficiency (eg, Addison disease) causes raised ACTH and raise ?-MSH production)
Skin hyperpigmentation, hypotension, fatigue
Becker muscular dystrophy (X-Linked missense mutation in dystrophin; less severe than Duchenne)
slow, progressive muscle weakness in boys
Koplik spots (measles [rubeola] virus)
small, irregular red spots on buccal/lingual mucosa with blue-white center
Condylomata lata (2 degree syphilis)
smooth, moist, painless, wart-like white lesions on genitals
Bacterial endocarditis
splinter hemorrhages in fingernails
Scarlet fever
Kawasaki disease
“strawberry tongue”
Turner syndrome (45,XO)
streak ovaries, congenital heart disease, horeshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema
Gout/podagra (hyperuricemia)
Sudden swollen/painful big toe joint, tophi
Scurvy (vitamin C deficiency: can’t hydroxylate proline/lysine for collagen synthesis)
swollen gums, mucosal bleeding, poor wound healing, petechiae
Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP [Heberden node])
swollen, hard, painful finger joints
Aortic stenosis
systolic ejection murmur (crescendo-decrescendo)
Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia)
Telangiectasis, recurrent epistaxis, skin discoloration, arteriovenous malformation, GI bleeding, hematuria
MEN 2A (autosomal dominant RET mutation)
Thyroid and parathyrois tumors, pheochromocytoma
MEN 2B (autosomal dominant RET mutation)
Thyroid tumors, pheochromocytoma, ganglioneuromatosis
Babinski sign (UMN lesion)
Toe extension/fanning upon plantar scrape
LMN facial nerve (CN VII) palsy; UMN lesions spare the forehead
unilateral facial drooping involving forehead
Reactive arthritis associated with HLA-B27
urethritis, conjunctivitis, arthritis in a male
Nevus flammeus (benign, but associated with Sturge-Weber syndrome)
vascular birthmark (port-wine stain) of the face
Mallory-Weiss syndrome (alcoholic and bulimic patients)
vomiting blood following gastroesophageal lacerations
Whipple disease (Tropheryma whipplei)
weight loss, diarrhea, arthritis, fever, adenopathy
Subarachnoid hemorrhage
“worst headache of my life”
Chagas disease (Trypanosoma cruzi)
Cariomegaly with apical atrophy
Rapidly progressive crescentic glamerulonephritis
Cellular crescents in Bowman capsule
Endometriosis (frequently involves both ovaries)
“Chocolate cyst” of ovary
Homer-Wright rosettes (neuroblastoma, medullblastoma)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Cystic fibrosis (autosomal recessive mutation in CFTR gene ->fat soluble vitamin deficiency and mucous plugs)
Colonies of mucoid pseudomonas in lungs
Down syndrome or other chromosomal abnormalities
Lower AFP in amniostic fluid/maternal serum
Tabes dorsalis (3 degree syphilis), subacute combined degeneration (doral columns, lateral corticospinal, spinocerebellar tracts affected)
Degeneration of dorsal column fibers
Wolff-Parkinson-White syndrome (Bundle of Kent bypass AV nodes)
“Delta wave” on EKG, short PR interval, supraventricular tachycardia
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia
Depigmentation of neurons in substantia nigra
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs
Desquamated epithelium casts sputum
Call-Exner bodies (granulosa cell tumor of the ovary)
Disarrayed granulosa cells arranged around collections of eosinophilic fluids
koilocytes (HPV: predisposes to cervical cancer)
Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia
Pericardial tamponade
Electrical alternans (alternating amplitude on EKG)
“Owl eye” appearance of CMV
Enlarged cells with intranuclear inclusion bodies
“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)
Enlarged thyroid cells with ground-glass nuclei with central clearing
Mallory body (alcoholic liver disease)
Eosinophilic cytoplasmic inclusion in liver cell
Lewy body (Parkinson disease and Lewy body dementia)
Eosinophilic cytoplasmic inclusion in neuron
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
Eosinophilic globule in liver
Negri bodies of rabies
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebrellar neurons
Senile plaques (Alzheimer disease)
Extracellular amyloid deposition in gray matter of brain
Reed-Sternberg cells (Hodgkin lymphoma)
Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eye”)
Schiller-Duval bodies (yolk sac tumor)
Glomerulus-like structure surrounding vessel in germ cells
B-thalassemia, sickle cell disease (marrow expansion)
“Hair on end” (“Crew-cut”) appearance on x-ray
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
hCG elevated
Aschoff bodies (rheumatic fever)
Heart nodules (granulomatous)
Infectious mononucleosis (EBV)
Heterophile antibodies
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
Hexagonal, double-pointed, needle-like crystals in bronchial secretion
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
Psammoma bodies
Glioblastoma multiforme
Pseudopalisading tumor cells on brain biopsy
Aggressive bone lesion (eg, osteosarcoma, Ewing sarcoma, osteomyelitis)
Raised periosteum (creating a “Codman triangle”)
Glomerulonephritis
RBC casts in urine
Reinke crystals (Leydig cell tumor)
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Wiskott-Aldrich syndrome
Recurrent infections, eczema, thrombocytopenia
Intrinsic renal failure (eg, ischemia or toxic injury)
Renal epithelial casts in urine
Pseudogout (calcium pyrophosphate dehydrate crystals)
Rhomboid crystals, + birefringement
Coartation of the aorta
Rib notching (inferior surface, on x-ray)
Toxoplasma gondii, CNS lymphoma
Ring-enhancing brain lesion on CT/MRI in AIDS
Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; “STARRY SKY” made up of malignant cells”
Sheets of medium-sized lymphoid cells with scattered pale, tangible body-laden macrophanges (“starry sky” histology)
Pick bodies (pick disease: progressive dementia, changes in personality)
Silver-straining spherical aggregation of tau protein in neurons
Giant cell tumor of the bone (generally benign)
“soap bubble” in femur or tibia on x-ray
Membranous nephropathy (nephrotic syndrome)
“Spikes” on basement membrane, “dome-like” subepithelial deposits
Rouleaux formation (high ESR, multiple myeloma)
stacks of RBCs
Croup (parainfluenza virus)
“steeple” sign on frontal CXR
“Clue cells” (Gardnerella vaginalis)
Bacteria-covered vaginal epithelial cells
Colon cancer
Streptococcus bovis bacteremia
Birbeck granules (Langerhans cell histiocytosis)
“Tennis racket”- shaped cytoplasmic organelles (EM) in Langerhans cells
Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)
Thousands of polyps on colonoscopy
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
Thrombi made of white/red layers
Epiglottitis (Haemophilius influenza)
“Thumb sign” on lateral neck x-ray
Chronic pyelonephritis (usually due to recurrent infections)
Thyroid-like appearance of kidney
Membranoproliferation glomerulonephritis
“Tram-track” appearance of capillary loops of glomercular basement membranes on light microscopy
Fatty liver disease (alcoholic or metabolic syndrome)
Triglyceride accumulation in liver cell vacuoles
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
raise in uric acid levels
Antitoxin
Clostridium tetani
Ganciclovir, foscarnet, cidofovir
CMV
Corticosteroids, infliximab, azathioprine
Crohn Disease
Fluconazole (in AIDS patients)
Cryptococcus neoformans
Mesna
Cyclophosphamide-induced hemorrhagic cystitis
SSRIs (first-line)
Depression
Desmopressin (central); hydrochlorothiazide, indomethacin, amiloride (nephrogenic)
Diabetes insipidus
Dietary intervention, (low carbohydrat) + insulin replacement
Diabetes mellitus 1
Dietary intervention, oral hypoglycemic, and insulin (if refractory)
Diabetes mellitus type 2
Fluids, insulin, K+
Diabetic ketoacidosis
Heparin
Drug of choice for anticoagulation during pregnancy
Vancomycin, aminopenicillins/cephalosporins
Enterococci
Sildenafil, tadalafil, vardenafil
Erectile dysfunction
Tamoxifen
ER + breast cancer
Fomepizole (alcohol dehydrogenase inhibitor)
Ethylene glycol/menthol intoxication
Rifampin (prophylaxis)
Haemophilus influenza (B)
SSRIs, SNRI’s (first line); buspirone (second line)
Generalized anxiety disorder
Cyclophosphamide, corticosteroids
Granulomatosis with polyangiitis (Wegener)
Protamine sulfate
Heparin reversal
Trastuzumab
HER2/neu + breast cancer
Spironolactone
Hyperaldosternism
Statin (first line)
Hypercholesteremia
Fibrate
Hypertriglyceridemia
Heparin
Immediate anticoagulation
Leuprolide, GnRH (pulsatile), clomiphene
Infertility
Oseltamivir, zanamivir
Influenza
IVIG, high-dose aspirin
Kawasaki disease
Macrolides (eg, azithromycin)
Legionella pneumophila
Warfarin, dabigatran, rivaroxaban and apixaban
Long-term anticoagulation
Chloroquine, mefloquine, atovaquone/proguanil (for blood schizont), primaquine (for liver hypnozoite)
Malaria
Dantrolene
Malignant hyperthermia
Mifepristone
Medical abortion
Abortive therapies (eg, sumatriptan, NSAIDs); prophylaxis (eg, propranolol, topiramate, CCBs, amitriptyline)
Migraine
Penicillin
Treponema pallidum
Metronidazole (patient and partner)
Trichomonas vaginalis
Carbamazepine
Trigeminal neuralgia (tic doutoureux)
5-ASA preparations (eg, mesalamine), 6-mercaptopurine, infliximab, colectomy
Ulcerative colitis
TMP-SMX
UTI prophylaxis
Fresh frozen plasma (acute), vitamin K (non-acute)
Warfarin reversal
Precursor to squamous cell carcinoma
Actinic (solar) keratosis
Cushing ulcer ( raise in intracranial pressure stimulates vagal gastric H+ secretion)
Acute gastric ulcer associated with CNS injury
Curling ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
Acute gastric ulcer associated with severe burns
ALL; child, CLL; adult > 60, AML; ~65, cml; ADULT 45-85
Age ranges of transmural inflammation and normal colon
Skip lesions (Crohn disease)
Alternating areas of transmural inflammation and normal colon
Atherosclerosis
Aortic aneurysm, abdominal
3 degree syphilis (syphilis aortic aortitis), vasa vasorum destruction
Aortic aneurysm, ascending or arch
Marfan syndrome (idiopathic cystic medial degeneration)
Aortic aneurysm, thoracic
Hypertension
Aortic dissection
Wernicke encephalopathy )thiamine deficiency causing ataxia, ophthalmoplegia, and confusion)
Atrophy of the mammillary bodies
Sickle cell disease (hemoglobin S)
Autosplenectomy (fibrosis and shrinkage)
H pylori
Bacteria associated with gastritis, peptic ulcer disease, and gastric malignancies (eg, adenocarcinoma, MALToma)
S pneumoniate
Bacterial meningitis (adults and elderly)
Group B streptococcus/E coli/Listeria monocytogenes (newborns), S pneumonia/ N meningitides (kids/teens)
Bacterial meningitis (newborns and kids)
Krukenberg tumor (mucin-secreting signet ring cells)
Bilateral ovarian metastases from gastric carcinoma
Bernard-Soulier syndrome (defect in platelet adhesion to von Willebrand factor)
Bleeding disorder with Gplb deficiency
Supratentorial: metastasis, astrocytoma (including glioblastoma multiforme), meningioma, schwannoma
Brain tumor (adults)
Infratentorial: medulloblastoma (cerebellum) or supratentorial: craniopharyngioma
brain tumor (kids)
Invasive ductal carcinoma
beast cancer
Ascaris lumbricoides
Helminth infection (US)
Rupture of middle meningeal artery (trauma; lentiform shaped)
Hemaatoma- epidural
multiple blood transfusions or hereditary HFE mutation (can result in heart failure, “bronze diabetes,” and raise risk of hepatocellular carcinoma)
Hemochromatosis
Cirrhotic liver (associated with hepatitis B and C and with alcoholism)
Hepatocellular carcinoma
von Willebrand disease
Hereditary bleeding disorder
Gilbert syndrome (benign congenital unconjugated hyperbilirubinemia)
Hereditary harmless jaundice
Psoriatic arthritis, ankylosing spondylitis, IBD-associated arthritis, reactive arthritis (formerly Reiter syndrome)
HLA-B27
Diabetes Mellitus type 1, SLE, Graves disease, Hashimoto thyroiditis (also associated with HLA-DR5), Addison disease
HLA-DR3
Diabetes mellitus type 1, rheumatoid arthritis, Addison disease
HLA-DR4
VSD, tricuspid regurgitation, mitral regurgitation
Holosystolic murmur
Virchow triad (raise in risk of thrombosis)
Hypercoagulability, endothelial damage, blood stasis
Renal artery stenosis, chronic kidney disease (eg, polycystic kidney disease, diabetic nephropathy)
Hypertension, 2degrees
Accidental excision during thyroidectomy
Hypoparathyroidism
Pituitary adenoma (usually benign tumor)
Hypopituitarism
Hepatitis C
Infection 2 degree to blood transfusion
S aureus, E coli, Aspergillus (catalase n+)
Infections in chronic granulomatous disease
Down syndrome, fragile X syndrome
Intellectual disability
Calcium = radiopaque
Struvite (ammonium) = radiopaque (formed by urease + organisms such as Klebsiella, Proteus species, and S saprophyticus)
Uric acid = radiolucent
Cystine = radiolucent
Kidney stones
Eisenmenger syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia
Late cyanotic shunt (uncorrected left to right becomes right to left)
Alcoholic cirrhosis
Liver disease
Gaucher disease
Lysosomal storage disease
Hodgkin lymphoma
Malignancy associated with noninfectious fever
Leukemia, brain tumors
Malignancy (kids)
Prostate, breast > lung, thyroid, kidney
Metastases to bone
Rupture of bridging veins (crescent shaped)
Hematoma- subdural
Renal cell carcinoma; associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndrome (EPO, renin, PTHrP, ACTH)
Renal Tumor
Cor pulmonale
Right heart failure due to a pulmonary cause
raise ventricular filling pressure (eg, mitral regurgitation, HF), common in dilated ventricles
S3 heart sound
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
S4 heart sound
Hypcalcemia of chronic kidney disease
2 degree hyperparathyroidism
C trachomatis (usually coinfected with N gonorrhoease)
Sexually transmitted disease
Small cell carcinoma of the lung
SIADH
Sigmoid colon
site of diverticula
Abdominal aorta >coronary artery > popliteal artery > carotid artery
sites of atherosclerosis
Follicular lymphomas (BCL-2 activation, anti- apoptotic oncogene)
t(14;18)
Burkitt lymphomas (c-myc fusion, transcription factor oncogene)
t(8;14)
Philadelphia chromosome, CML (BCR-ABL activation, tyrosine kinase oncogene)
t(9;22)
Risk of ipsilateral blindness due to occlusion of ophthalmic artery; polymyalgia rheumatica
Temporal arteritis
Seminoma (malignant, radiosensitive), raise in placental ALP
Testicular tumor
Papillary carcinoma (childhood irradiation)
Thyroid cancer
Leioyoma (estrogen dependent, not precancerous)
Tumor in women
Strawberry hemangioma (grows rapidly and regresses spontaneously by childhood
Tumor of infancy
Pheochromocytoma (usually benign)
Tumor of the adrenal medulla (adults)
Neuroblastoma (malignant)
Tumor of the adrenal medulla (kids)
Nodular sclerosing (vs mixed cellularity, lymphocytic predominance, lymphocytic depletion)
Type of Hodgkin lymphoma
Diffuse large B-cell lymphoma
Type of non-Hodgkin lymphoma
E Coli, Staphylococcus saprophyticus (young women)
UTI
Osteoporosis (type I: postmenopausal women; type II: elderly man or women)
Vertebral compression fracture
HSV-1
Viral encephalitis affecting temporal lobe
Folate (pregnant women are at high risk; body stores only 3-4- month supply; prevents neural tube defects)
Vitamin deficiency (USA)
Unstable angina (- troponins) or NSTEMI (+ troponins)
Chest Pain with ST depressions on EKG
Duchenne muscular dystrophy (Gowers sign)
Child uses arms to stand up from squat
Erythema infectiosum/ fifth disease (“slapped cheeks” appearance, caused by parvovirus B19)
Child with fever later develops red rash on face that spreads to body
Huntington disease (autosomal dominant CAG repeat expansion)
Chorea, dementia, caudate degeneration
Congenital toxoplasmoisis
Chorioretinitis, hydrocephalus, intracranial calcifications
McArdle disease (skeletal muscle glycogen phosphorlayse deficiency)
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
Hypothyroidism
Cold intolerance
Internuclear opthalmoplegia (damage to MLF; may be unilateral or bilateral)
Conjugated horizontal gaze palsy, horizontal diplopia
PDA (close with indomethacin; keep open with PGE analogs)
Continuos “machine-like” heart murmur
Myxedema n(caused by hypothyroidism, Graves disease [pretibial])
Cutaneous/dermal edema due to connective tissue depositioin
Carcinoid syndrome (right-sided cardiac valvular lesions, raise 5-HIAA)
Cutaneous flushing, diarrhea, brochospasm
Kaposi sarcoma, associated with HHV-8
Dark purple skin/mouth nodules in a patient with AIDS
Diabetic ketoacidosis (Kussmaul respirations)
Deep, labored breathing/hyperventilation
Pellagra (niacin [vitamin B3] deficiency)
Dermatitis, demntia, diarrhea
Wet beriberi (thiamine [vitamin B1] deficiency)
Dilated cardiomyopathy, edema, alcoholism or malnutrition
Pasteurella multocida (cellulitis at inoculation of exocrine glands)
Dog or cat bite resulting in infection
Sjogren syndrome (autoimmune destruction of exocrine glands)
Dry eyes, dry mouth, arthritis
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
Dysphagia (esophageal webs), glossitis, iron deficiency anemia
Ehlers-Danlos syndrome (type V collagen defect, type III collagen defect seen in vascular subtype of ED)
Elastic skin, hypermobility of joints, raises bleeding tendency
Virchow node (abdominal metastasis)
Enlarged, hard left supraclavicular node
Meniere disease
Episodic vertigo, tinnitus, hearing loss
Mycosis fungoides (cutaneous T-cell lymphoma) or Sezary syndrome (mycosis fungoides + malignant T cells in blood)
Erythrodema, lymphadenopathy, hepatosplenomegaly, atypical T cells
Chvostek sign (hypocalcemia)
facial muscle spasm upon tapping
Cholelithiasis (gallstones)
Fat, female, forty, and fertile
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in endotoxin-like release)
Fever, chills, headache, myalgia following antibiotic treatment for syphilis
Measles
Fever, couch, conjunctivitis, coryza, diffuse rash
B symptoms of lymphoma
Fever, night sweats, weight loss
Sheehan syndrome (pituitary infarction)
no lactation postpartum, absent menstruation, cold intolerance
Multiple sclerosis
Nystagmus, intention tremor, scanning speech, bilateral internuclear opthalmoplegia
Cold agglutinin disease (autoimmune hemolytic anemia cause by Mycoplasma pneumonia, infectious mononucleosis, CLL)
Painful blue fingers/toes, hemolytic anemia
Raynaud phenomenon (vasospasm in extremities)
Painful fingers/toes changing color from white to blue to red with cold stress
Osler nodes (infective endocarditis, immune complex deposition)
painful, raised red lesions on pads of fingers/toes
Janeway-lesions (infective endocarditis, septic emboli/ microabscesses
Painless erythematous lesions on palms and soles
Cancer of the pancreatic head obstructing bile duct
Painless jaundice
Henoch- Schonlein purpura (IgA vasculitis affecting skin and kidney)
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria
Nephrotic syndrome
Periorbital and/or peripheral edema, proteinuria (> 3.5g/day), hypoalbuminemia, hypercholesterolemia
Emphysema (“Pink puffer”, centriacinar [smoking] or panacinar [x1- antitrypsin deficiency])
Pink complexion, dyspnea, hyperventilation
Fanconi syndrome (multiple combined dysfunction of proximal convoluted tubule)
Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets
Lichen planus
Pruritic, purple, polygonal planar papules and plaques (6 P’s)
Horner syndrome (sympathetic chain lesion)
Ptsosis, miosis, anhidrosis
Neurosyphilis (Argyll Robertson pupil)
Pupil accommodates but doesn’t react
Guillain-Barre syndrome (acute inflammatory demyelinating polyradiculopathy subtype
Rapidly progressive limb weakness that ascends following GI/upper respiratory infection
Coxsackie A, 2 degree syphilis, Rocky Mountain spotted fever
Rash on palms and soles
Hyper-IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)
Recurrent cold (noninflamed) abscesses, unusual eczema, high serum IgE
Klebsiella pneumonaise pneumonia
Red “current jelly” sputum in alcoholic or diabetic patients
Acute mesenteric ischemia (adults), intussusception (children)
Red “current jelly” stools
Paget disease of the breast (sign of underlying neoplasm)
Red, itchy, swollen rash of nipple/areola
Paroxysmal nocturnal hemoglobinuria
Red urine in the morning, fragile RBCs
von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
Renal cell carcinoma (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma
Parkinson Disease (loss of dopaminergic neurons in substantia nigra pars compacta)
Resting tremor, rigidity, akinesia, postural instability, shuffling gait
Roth spots (bacterial endocarditis)
Retinal hemorrhages with pale centers
MEN 1 (autosomal dominant)
Pancreatic, pituitary, parathyroid tumors
Dating error, anencephaly, spina bifida (open neural tube defects)
raise AFP in amniotic fluid/maternal serum
Scleroderma (CREST)
Anticentromere antibodies
Pemphigus vulgaris (blistering)
Anti-desmoglein (anti-desmosome) antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
Anti-glomerular basement membrane antibodies
Drug-induced SLE (eg, hydralazine, isoniazid, phenytoin, procainamide)
Antihistone antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
Anti-IgG antibodies
1 degree biliary cirrhosis (female, cholestasis, portal hypertension)
Antimitiochondrial antibodies (AMAs)
Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA); primary sclerosing cholangitis (MPO-ANCA/p-ANCA)
Antineutrophil cytoplasmic antibodies (ANCAs)
SLE (type III hypersensitivity)
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
Idiopathtic thrombocytopenic purpura
Antiplatelet antibodies
Diffuse systemic scleroderma
Anti-topoisomerase antibodies
Celiac disease (diarrhea, weight loss)
Anti-transglutaminase/ anti-gliadin/anti-endomysial antibodies
Colorectal cancer (usually left-sided)
“Apple core” lesion on branium enema x-ray
EBV
Atypical lymphocytes
Auer rods (AML, especially the promyelocytic [M3] type)
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
Sensitive: S pyogenes (group A); resistant: S agalactia (group B)
Bacitracin response
Ankylosing spondylitis (chronic inflammatory arthritis; HLA-B27)
“Bamboo spine” on x-ray
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
Basophilic nuclear remnants in RBCs
Lead poisoning or sideroblastic anemia
Basophilic stippling of RBCs
Subarachnoid hemorrhage
Bloody or yellow tap on lumbar puncture
Tetralogy of Fallot (due to RVH)
“Boot-shaped” heart on x-ray
Actinomyces israelii
Branching gram = rods with sulfur granules
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
Bronchogenic apical lung tumor on imaging
Hyperthyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
“Brown” tumor of bone
DVT, PE DIC
High level of D-dimer
Ghon complex (1 degree TB: Mycobacterium bacilli)
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Interstitial pulmonary fibrosis
“Honeycomb lung” on x-ray or CT
Tousseau syndrome (adenocarcinoma of pancreas or lung)
Hypercoagulability (leading to migrating DVTs and vasculitis)
Megaloblastic anemia (B12 deficiency: neurologic syndromes, folate deficiency: no neurological symptoms
Hypersegmented neutrophils
1 degree hyperaldosteronism ( Conn syndrome)
Hypertension, hypokalemia, metabolic alkalosis
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Hypochromic, microcytic anemia
Cowdry type A bodies (HSV or VZV)
Intranuclear eosinophilic droplet-like bodies
Ferruginous bodies (asbestosis: raise chance of lung cancer)
Iron-containing nodules in alveolar septum
Squamous cell carcinoma
Keratin pearls on a skin biopsy
Chediak-Higashi disease (congenital failure of phagolysosome formation)
Large granules in phagocytes, immunodeficiency
Ulcerative colitis (loss of haustra)
“Lead pipe” appearance of colon on abdominal imaging
Goodpasture syndrome
Linear appearance of IgG deposition on glomerular and alveolar basement membranes
Wilson disease (hepatolenticular degeneration)
Low serum ceruloplasmin
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, C3)
“Lumpy bumpy” appearance of glomeruli on immunofluorescence
Multiple myeloma
Lytic (“punched-out”) bone lesions on x-ray
Fibrocystic change of the breast
Mammary Gland (“blue domed”) cyst
Multiple myeloma (usually IgG or IgA) Monoclonal gammopathy of undetermined significance (MGUS consequence of aging) Waldenstrom (M protein = IgM) macroglobulinemia Primary amyloidosis
Monoclonal antibody spike
“Signet ring” (gastric carcinoma)
Mucin-filled cell with peripheral nucleus
“String sign” (Crohn disease)
Narrowing of bowel lumen on barium x-ray
Granulomatosis with polyangitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
Necrotizing vasulitis (lungs) and necrotizing glomerulonephritis
Gout (monosodium urate crystals)
Needle-shaped, (-) birefringent crystals
Kimmelstiel-Wilson nodules (diabetic nephropathy)
Nodular hyaline deposits in glomeruli
Sensitive: S epidermidis; resistant: S saprophyticus
Novobiocin response
Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
“Nutmeg” appearance of liver
Ewing sarcoma (malignant small blue cell tumor)
“Onion skin” periosteal reaction
Sensitive: S pneumonia; resist: viridans streptococci (S mutans, S sanguis)
Optochin sensitivity
Minimal change disease (child with nephrotic syndrome)
Podocyte fusion or “effacement” on electron microscopy
Chronic end-stage renal disease
“Waxy” casts with very low urine flow
Acute pyelonephritis
WBC casts in urine
CLL (almost always B cell)
WBCs that look “smudged”
Diffuse proliferative glomerulonephritis (usually seen with lupus)
“Wire loop” glomerular capillary appearance on light microscopy
Xanthochromia (eg, due to subarachnoid hemorrhage)
Yellowish CSF
Ethosuximide
Absence seizures
NSAIDs, colchicine, glucocorticoids
Acute gout attack
All-trans retinoic acid
Acute promyelocytic leukemia (M3)
Methylphenidate, amphetamines, CBT, atomoxetine, guanfacine, chlonidine
ADHD
Disulfiram, acamprosate, naltrexone, supportive care
Alcoholism
Long-acting benzodiazepines
Alcohol withdrawal
Nutrition, psychotherapy, mirtazapine
Anorexia
Class IB antiarrythmic (lidocaine, mexiletine)
Arrythmia in damaged cardiac tissue
a1-antagonists, 5a-reductase inhibitors, PDE-5 inhibitors
Benign prostatic hyperplasia
Mood stabalizers (eg, lithium, valproic acid, carbamazepine), atypical antipsychotics
Bipolar disorder
Aromatase inhibitor (anastrozole)
Breast cancer in postmenopausal women
Smoking cessation
Buerger disease
SSRIs
Bulimia nervosa
Topic azoles (vaginitis); nystatin, fluconazole, casofungin (oral/esophageal); fluconazole, caspofungin, amphotericin B (systemic)
Candida albicans
Octreotide
Carcinoid syndrome
Doxycycline ( + ceftriaxone for gonorrhea coinfection), erythromycin eye drops (conjunctivitis prophylaxis in infants)
Chlamydia trachomatis
Xanthine oxidase inhibitors (eg, allopurinol, febuxostat); pegloticase; probenecid
Chronic Gout
IFN-a (HBV and HCV); ribavirin, simeprevir, sofobuvir (HCV)
Chronic Hepatitis B or C
Imatinib
Chronic myelogenous leukemia
Antitoxin
Clostridium botulinum
Oral metronidazole; if refractory; oral vancomycin
Clostridium difficile
Disease-modifying therapies (eg, B-interferon, natalizumab); for acute flares, use IV steroids
Multiple Sclerosis
RIPE (rifampin, isoniazid, pyrazinamide, ethambutol)
Myobacterium tuberculosis
Ceftriaxone (add doxycycline to cover likely concurrent C trachomatis)
Neisseria gonorrhoeae
Penicillin/ceftriaxone, rifampin (prophylaxis)
Neisseria meningitidis
Prenatal folic acid
Neural tube defect prevention
Vatamin D supplement
Osteomalacia/ rickets
Calcium/vitamin D supplementation (prophylaxis); bisphosphonates, PTH analogs, SERMs, calcitonin, denosumab (treatment)
Osteoporosis
Close with indomethacin; keep open with PGE analogs
Patent ductus arteriosus
a-antagonists (eg, phenoxybenzamine)
Pheochromocytoma
TMP-SMX (prophylaxis and treatment in immunosuppressed patients)
Pneumocystis jirovecii
Cabergoline/ bromocriptine (dopamine agonists)
Prolactinoma
Leuprolide, GnRH (continuous)
Proststate adenocarcinoma
Flutamide
prostate adenocarcinoma
Antipseudomonal penicillins, aminoglycosides, carbapenems
Pseudomonas aeruginosa
Sildenafil, bosentan, epoprostenol
Pulmonary arterial hypertension (idiopathic)
Doxyxycline, chloramphenicol
Rickettsia rickettsii
Atypical antipsychotics
Schizophrenia (negative symptoms)
Typical and atypical antipsychotics
Schizophrenia (positive symptoms)
Fluid restriction, IV hypertonic saline, conivaptan/ tolvaptan, demeclocycline
SIADHH
Hydroxyurea (raise fetal hemoglobin)
Sickle cell disease
Itraconazole, oral potassium iodide
Sporothrix schenckii
Sublingual nitroglycerin
Stable angina
MSSA: nafacillin, oxacillin, dicloxacillin (antistaphylococcal penicillins); MRSA: vancomycin, daptomycin, linezolid, ceftaroline
Staphylococcus aureus
Penicillin prophylaxis; evaluation for colon cancer if linked to endocarditis
Staphylococcus bovis
Penicillin/cephalosporin (systemic infection, pneumonia), vancomycin (meningitis)
Streptococcus pneumoniae
Penicillin prophylaxis
Streptococcus pyogenes
High-dose steroids
Temporal arteritis
Levetiracetam, phenytoin, valproate, carbamazepine
Tonic-clonic seizures
Sulfadiazine + pyrimethamine
Toxoplasma gondii
Fibrocystic change, carcinoma (in postmenopausal women)
Breast mass
Fibroadenoma
Breast tumor (benign, young women)
Rhabroadenoma, often seen in tuberous sclerosis
Cardiac 1 degree tumor (kids)
Marantic/thrombotic endocarditis (nonbacterial)
Cardiac manifestation of lupus
Metastasis, myxoma (90% in left atrium; “ball valve”)
Cardiac tumor (adults)
Chiari I malformation
Cerebellar tonsillar herniation
Atrial fibrillation (associated with high risk of emboli)
Chronic arrhythmia
Predispotion to gastric carcinoma (can also cause pernicious anemia)
Chronic atrophic gastritis (autoimmune)
DES exposure in utero
Clear cell adenocarcinoma of the vagina
21-hydroxylase deficiency
Congenital adrenal hyperplasia, hypotension
VSD
Congenital cardiac anomaly
Dubin-johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)
Congenital conjugated hyperbilirubinemia (black liver)
TB (developing world); idiopathic viral illness (developed world)
Constrictive pericarditis
Iodine deficit/congenitalhypothyroidism
Cretinism
Iatrogenic (from corticosteroid therapy)
Adrenocortical adenoma (secretes excess cortisol)
ACTH-secreting pituitary adenoma (Cushing disease)
Paraneoplastic (due to ACTH secretion by tumors)
Cushing syndrome
Tetralogy of Fallot, transposition of great vessels, truncus arteriosus
Cyanosis (early; less common)
Blast crisis
Death in CML
Lupus nephropathy
Death in SLE
Alzheimer disease, multiple infarcts (vascular dementia)
Dementia
Multiple sclerosis
Demyelinating disease in young women
Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery, acute pancreatitis, APL
DIC
Zenker diverticulum (diagnosed by barium swallow)
Diverticulum in pharynx
Aortic stenosis
Ejection click
Squamous cell carcinoma (worldwide0; adenocarcinoma (US)
Esophageal cancer
S aureus, B cereus
Food poisoning
Adenocarcinoma
Gastric cancer
Berger disease (IgA nephropathy)
Glomerulonephritis (adults)
Endometrial carcinoma (most common in US); cervical carcinoma (most common worldwide)
Gynecologic malignancy
Mitral valve prolapse
Heart murmur, congenital
Mitral > aortic (rheumatic fever), tricuspid (IV drug abuse)
Heart valve in bacterial endocarditis
Lung > breast . prostate > melanoma > GI
Metastases to brain
Colon»_space; stomach > pancreas
Metastases to liver
Iron deficiency
Microcytic anemia
Disease occurs in both males and females, inherited through females only
Mitochondrial inheritance
Rheumatic heart disease
Mitral valve stenosis
Amyotrophic lateral sclerosis
Mixed (UMN and LMN) motor neuron disease
Coxsackie B
Myocarditis
Membranous nephropathy
Nephrotic syndrome (adults)
Minimal change disease
Nephrotic syndrome (kids0
Kallmann syndrome (hypogonadotropic hypogonadism and insomnia)
Neuron migration failure
S aureus, Pseudomonas, other enteric gram (-) rods
Nosocomial pneumonia
BPH
Obstruction of male urinary tract
Mitral stenosis
Opening snap
Pneumocystis jirovecii pneumonia
Opportunistic infection in AIDS
S aureus (most common overall)
Osteomylitis
Salmonella
osteomyelitis in sickle cell disease
Pseudomonas, candida, S aureus
Osteomyelitis with IV drug use
Serous cystadenoma
Ovarian tumor (benign, bilateral)
Serus cystadenocarcinoma
Ovarian tumor (malignant)
Gallstones, alcohol
Pancreatitis (acute)
Alcohol (adults), cystic fibrosis (kids)
Pancreatitis (chronic)
C trachomatis, N gonorrheae
pelvic inflammatory disease
CML (may sometimes be associated with ALL/AML)
Philadelphia Chromosome t(9;22) (BCR-ABL)
Prolactinoma, somatotropic adenoma
Pituitary tumor
Turner syndrome (45,XO or 45,XO/46,XX mosaic)
1 degree amenorrhea
Multiple myeloma
1 degree bone tumor (adults)
Adrenal hyperplasia or adenoma
1 degree hyperaldosteronism
Adenomas, hyperplasia, carcinoma
1 degree hyperparathyroidism
Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, a1-antitrypsin deficiency, Wilson disease)
1 degree liver cancer
Idiopathic, heritable, left heart disease (eg, HF), lung disease (COPD), hypoxemic vasoconstriction (eg, OSA), thromboembolic (eg, PE)
Pulmonary hypertension
Buerger disease (strongly associated with tabacco)
Recurrent inflammation/thrombosis of small/medium vessels in extremities
Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas), associated with MEN1
Refractory peptic ulcers and high gastrin levels
