PANCE buzz words Flashcards
“bag of worms” in scrotum
varicocele
“bamboo appearance” on x-ray of spine
ankylosing spondylitis
“beefy red tongue”
pronounced anemia
“bird beak” deformity on x-ray
achalasia or sigmoid volvulus
“blood and thunder” retina
CR vein occlusion
“boggy uterus”
adenomyosis
“bulls eye” skin lesion
skin manifestation & cause
erythema migrans from lyme dz
“cherry red spot” (red fovea) on fundoscopy
CRAO
“coin shaped” or “discoid” plaques with vesicles and papules
nummular eczema
“corkscrew” esophagus on barium swallow
esophageal spasm
“crescent sign” of hip x-ray
avascular necrosis of hip
“cup and saucer” appearance of proximal phalanx on x-ray
psoriatic arthritis
“dew drops on a rose petal”
chicken pox
“diamond-shaped murmur” (crescendo-decrescendo) on precordial chest
aortic stenosis
“egg on a string” (narrow mediastinum)
TOGA
“eggshell” pattern from calcified LNs on CXR
silicosis
“figure 3 sign” on CXR
coarctation of aorta
“floppy baby syndrome”
botulism
“fungus ball” on CXR
aspergillus fumigatus PNA
“honey” golden crusts on face
impetigo (strep pyoderma)
“hot potato voice”
peritonsillar abscess
“machine-like” murmur
PDA
“moon facies and buffalo hump”
Cushings
“onion skin” appearance on x-ray
Ewings sarcoma
“palpable olive”
pyloric stenosis
“parrot beaked” esophagus (dilated esophagus taper to the distal obstruction) on barium swallow
achalasia
“pea soup” diarrhea
typhoid (aka enteric) fever
“pill rolling” tremor
Parkinsons
“pizza pie” (neovascularization with proliferation) on fund
CMV
“raccoon eyes”
orbital fx
“rice water” diarrhea (gray, turbid, without odor, blood, pus)
cholera
“ring of fire” on US
ectopic pregnancy
“rope-like” on CBE
fibrocystic breasts
“sack of grapes” or “grape-like vesicles” on TVU
complete hydatidiform mole
“sandpaper” rash (like sunburn with goosebumps
Scarlet fever
“satellite lesions” on buttocks
diaper dermatitis with candida
“sentinel loop” or “colon cut off sx” of gas pattern on KUB
pancreatitis
sentinel loop = dilation of a segment of small intestine
colon cutoff sign = dilation of a segment of large bowel
indicates localized ileus
“shaggy” mucosa on barium swallow
candida
“slapped cheek” syndrome
parvo B19/ fifth’s dz/ erythema infectiosum
“snowstorm” on TVU with elevated BHcg
Hydatidiform mole
“strawberry tongue”
scarlet fever & kawasaki
“strawberry” cervix
trichomonas
“string of pearls” on ovarian US
PCOS
“string sign”/ sign of kantor (stricture or stenosis) on barium enema
crohn’s disease
“stuck on” waxy lesion
SK
“sunburst” on bone x-ray
osteosarcoma
“tea and toast diet”
folate deficiency
“thumbprinting” of bowel
ischemia
“whirlpool” of intraluminal worms on KUB
ascariasis (ascariasis lumbricoides)
(+) heterophile antibodies (monospot)
mononucleosis
(+) scotch tape test
pinworms
(+) widal agglutination test
typhoid fever
5 Ps (purpule, planar, polygonal, pruritic, papule)
lichen planus
immune system mistakenly attacks cells of the skin or mucous membranes
aaron sx (mcburney’s point palpation causes stomach or chest pain)
appendicitis
absence of “scottie-dog” sign on spinal film
spondylolysis
absent or decreased femoral pulses with a murmur
coarctation of the aorta (patho)
amyloid plaques and neurofibrillary tangles
alzheimer’s
anatomical snuffbox pain/ tenderness
scaphoid fx
anterior pat pad sign
hemarthrosis in radial head fx
anti-glomerular basement membrane abs with hematuria and hemoptysis
good-pasteur’s syndrome (path)
apple-core lesion on barium enema
colon CA
auer rods on peripheral smear (needle-like inclusions in eosinophils)
AML (less likely ALL)
auspitz sign (pin point bleed on peeling of scab)
psoriasis
“water bottle” appearance of cardiac silhouette
pericardial effusion
“string sign” (long narrow pyloric lumen)
pyloric stenosis
azure (blue) lunulae on nails
wilson’s disease
barking cough like a seal
croup
battle sx
basilar skull fx
bell-clapper deformity
abnormal attachment of testis in the scrotum (RF for torsion)
bence jones proteins in urine
multiple myeloma
bile stained eggs and proglottids in stool exam
fish tapeworm
bilious vomiting and abdominal distention in a newborn
duodenal atresia
bite cells (loss of heinz body) on peripheral smear
G6PD deficiency - anemia, jaundice, hemolysis, may confer selective advantage from malaria
(x-linked recessive)
blast crisis
CML
boot shaped heart
RVH from tet of fallot
bouchard’s nodes (PIP nodes)
OA
boutinniere deformity (extended DIP, flexed PIP)
RA
brushfield spots (on the iris)
downs syndrome
bubbly lytic lesion on x-ray (“ground glass”)
fibrous dysplasia
cafe au lait spots and rubbery skin nodules
neurofibromatosis
chadwick sign (blue cervix)
pregnancy
chandelier sign on pelvic/ speculum exam (cervical motion tenderness) (2)
PID, ectopic pregnancy
fever, RUQ pain, jaundice
charcot’s triad = ascending cholangitis
chvostek’s sign (twitch facial nerve on tap)
hypocalcemia
often due to hypoparathyroidism
clue cells on wet prep and positive whiff test (amine odor)
BV (gardnerella vaginalis)
cobblestone-pattern filling defects with segmental areas of involvement (skip lesions) on barium enema or CT
crohn’s disease
cobblestoning on colonoscopy
crohn’s disease
codman’s sign (peri-osteal elevation that forms an angle with the bone cortex)
osteosarcoma
Codman triangle is a radiologic sign seen most commonly on musculoskeletal plain films. It is the name given to a periosteal reaction that occurs when bone lesions grow so aggressively they lift the periosteum off the bone and do not allow the periosteum to lay down new bone
coral red fluorescence with wood’s lamp
erythrasma
superficial infection of the skin, macerated, scaly plaques between the toes or erythematous to brown patches or thin plaques in intertriginous areas
CSF oligoclonal bands
MS
cullen and grey-turner sxs
acute/ necrotizing pancreatitis (also in ectopic)
(cullen = periumbilical)
(grey-turner = flank)
currant jelly sputum
klebsiella pneuno PNA
currant jelly stools
intussusception
curschmann spirals (mucus casts in small airways)
asthma
CXR honeycombing
pulmonary fibrosis or bronchiectasis
CXR visceral pleural line or “deep sulcus sign” on supine
PTX
dance sign (no BS in RLQ)
intussesception
delta waves on EKG
WPW syndrome
diffuse vacuolar changes of grey matter with reactive astrocytosis on cortical bx
creutzfeldt-jakob dz
degenerative brain disorder that leads to dementia and death
dimple sx on anterior medial surface of the knee
posterolateral knee dislocation
dinner fork derformity
colle’s fx
distal radial fx with dorsal angulation
colle’s fx
distal radial fx with volar angulation
smith’s fx
distended neck veins, decreased BP, muffled heart sounds
Beck’s triad = cardiac tamponade
double bubble sign on abd x-ray
duodenal atresia in an infant
drusen spots (hard yellow-white deposits in the macula under pigment epithelium)
macular degeneration (nonexudative)
S1Q3 inverted T3 on EKG
cor pulmonale from PE
electrical alternans on EKG
cardiac effusion (patho)
encapsulated organisms on india ink
cryptococcus neoformans
eruptive and tendinous xanthomas
hyperlipidemia (patho)
erythema marginatum (“bathing suit distribution”)
rheumatic fever
flagellated, curved, oxidase (+) gram (_) rods in stool
c jejuni
fruity breath
DKA
fund with cotton wool spots, hemorrhages, microaneurysms, hard exudates, venous dilation
nonproliferative DM retinopathy (early)
fund with ateriolar constriction, flame hemorrhages, cotton wool spots, hard exudates
HTN retinopathy
fund with cotton wool spots, hemorrhages, microanerysms, hard exudates, neovascularization
proliferative DM retinopathy (late)
fx of 5th MC neck
boxer’s fx
gottron’s sx (scaly, papule rash on dorsal hands)
dermatomyositis
gram (-) intracellular diplococci
n gonorrhea
gram (+), encapsulated, box-shaped rods in chains
cutaneous anthrax
hairlike cytoplasmic projections on lymphocytes
hairy cell leukemia
hanging teardrop sign (herniation of orbital fat into maxillary sinus)
orbital fx
hazy/ steamy cornea with a fixed, dilated pupil
angle-closure glaucoma
heavy, painful vaginal bleeding in the 2nd or 3rd trimester
placenta abruption
heavy, painless vaginal bleeding in the 2nd or 3rd trimester
placenta previa
heinz bodies on peripheral smear
G6PD def or thalassemia
heliotrope rash (eyelid erythema)
dermatomyositis (or SLE)
hemorrhagic necrosis of temporal lobes on CT
herpetic encephalitis
herald patch then “christmas tree” appearing rash
pityriasis rosea
herberden’s nodes (DIP nodes)
OA
honey-combing with calcified parietal pleural plaques
asbestosis
hot tub folliculitis
pseudomonas aeruginosa
hyaline casts
ARF (or normal in athletes)
hyperplastic prickle cells with excess keratin
HPV skin warts
hyphae and buds on KOH prep
vaginal candidiasis
inability to pass NGT in an infant
choanal atresia
intracytoplasmic inclusions (“owls eyes”) on tissue biopsy
CMV
intravenous inclusions/ pick bodies
pick dz
kayser-flescher rings (green-yellow to brown rings between iris and cornea)
wilson’s disease
kerley b lines
CHF
or pulmonary fibrosis or carcinomatosis
koebner’s phenomenon (maculopapular rash elicited by scratching that appears in the evening)
juvenile RA
KOH hyphae and spores (“spaghetti and meatballs”)
tinea versicolor
koilocytotic squamous cells or vacuolated squamous epithelial cells in clumps on pap
HPV cervical warts
koplik spots- grains of sand on an erythematous base (blue-white mucosal lesions)
measles/ rubeola (patho)
large, deep linear ulcers on barium swallow
CMV
lead pipe deformity (loss of normal haustral markings) on barium enema
UC
lesions that have white lines (wickham’s striae)
lichen planus
lhermitte sign (electrical feeling down the back with neck flexion)
MS
low morning cortisol with elevated ACTH
addison’s disease
low plasma renin with increased 24 hr urine aldosterone
hyperaldosteronism
lower BP in arms vs legs
coarctation of aorta
noncaseating granulomas on lung bx
sarcoidosis
macro-ovalcytes and hypersegmented PMNs
folate def anemia (patho)
mid-systolic click
MVP
milkman lines or looser zones (pseudofractures)
osteomalacia
monoclonal spike on serum electrophoresis (M-protein)
multiple myeloma
more than 125 mg/dl urine cortisol in 24 hrs
cushings
multinucleated giant cells on tzanck smear
HSV
multiple ring-enhancing lesions on brain CT or MRI in HIV pt
toxoplasmosis
multiple, small, volcanic-shaped ulcers on barium swallow
herpes
murmur with wide pulse pressure
aortic insufficiency
negative birefringent needle-shaped crystals (parallel and yellow)
gout
negri bodies on brain tissue
rabies
nikolsky’s sign (manual pressure separates epidermis from dermis)
pemphigus vulgaris or TEN
oncholysis with oil spots
psoriasis (patho)
open bomb-bay door sign (bone fragments in the sinus)
orbital fx
opening snap murmur
mitral stenosis
osborn wave aka J wave (upward deflection of S wave)
hypothermia (patho)
osler nodes (painful finger/ toe/ feet lesions), janeway lesions (painless palm and sole lesions), roth spots (exudative retinal lesions/ hemorrhages)
infective endocarditis
palpable, non-tender gallbladder (courvoisier’s sign)
pancreatic CA
pancytopenia with circulating blasts
acute leukemia
parenchymal bullae or subplural blebs
emphysema (patho)
pear-shaped trophozoites with 2 nuclei and 4 flagella
giardia
pedunculated bone mass capped in cartilage
osteochondroma
pellagra (diarrhea, dermatitis, dementia)
niacin def
pericardial friction rub
pericarditis
perihilar infiltrates (“butterfly pattern”)
PCP PNA
peripheral wedge-shaped consolidation/ shadow on pleural surface (hampton hump)
PE
petechial rash with meningeal sxs
n meningitidis
phalen’s sign (wrist flexion for 1 min causes pain)
carpal tunnel
pharyngeal gray pseudomembranes and bullneck
diptheria
pica
iron def
positive birefringent rhomboid-shaped crystals (perpendicular and blue)
pseudogout
positive finkelstein (pain with fist ulnar deviation)
DeQuervain’s
posterior fat pad sign
radial head fx
prehn sign (pain relieved with elevation of scrotum)
epididymitis
presence of a paratesticular nodule at the superior aspect of the testicle, with its characteristic blue-dot appearance (blue-dot sign)
testicular appendix torsion (patho)
prominent epicanthal folds, sandal toe, and simian creases
down syndrome
RBC casts
glomerulonephritis
reed-sternberg cells on LN bx
hodgkin’s lymphoma
large pale nuclei/ lymphocyte
renal tubular epithelial cell casts (“muddy brown casts”)
ATN
rodent ulcer
BCC
rose spots after initial infection sxs
typhoid fever (and other salmonella infections)
rouleau formation on peripheral smear
multiple myeloma
rovsing sx (LLQ palpation produces RLQ pain)
appendicitis
rust colored sputum
strep pneumo PNA
s-shaped burrows on skin
scabies
sausage digits
reiter’s
sausage-like mass on abd exam
intussusception
schaumann’s bodies and asteroid bodies
sarcoidosis
shoulder sx (bulge of pyloric m into antrum)
pyloric stenosis
signet ring (thick bronchial walls) on CXR
bronchiectasis
silver, copper wiring and AV nicking on fund
HTN retinopathy
a single or hypoechoic ring with a hyperechoic center (target, donut sign) on US
intussusception
smudge cells on peripheral smear
CLL
spontaneous hemarthrosis
hemophilia
sprain of ulnar collateral ligament of thumb
gamekeeper’s thumb
steeple sx on x-ray
croup
subcutaneous nodules on extensor surfaces
RA (patho)
swan neck deformity (flexed DIP, extended PIP, flexed MCP)
RA
synovial proliferation with pannus formation
RA
tearing CP radiating to the back in a very tall male with long, slender hands/ fingers
marfan syndrome/ aortic dissection
terry’s nails (white nail bed)
liver disease/ cirrhosis
thumb sx on x-ray
epiglottitis
tinel’s sign (percussion of volar wrist causes tingling)
carpal tunnel
triple layered sputum
bronchiectasis
trousseau’s sign (carpal tunnel spasm with BP cuff for 3 min)
hypocalcemia
(often due to hypoparathyroid)
(also a/w malignancy, venous thrombosis, hypercoaguability)
umbilicated papules
molluscum contagiosum
unilateral ptosis, anhidrosis, miosis
horner’s syndrome
vesicular rash at different stages
varicella
virchow’s nodes (L supraclavicular LAD)
mets from GI tumor
also H. pylori, lung CA, breast CA
WBC casts
pyelo (or nephritis)
westmark sign (regional area of decreased pulmonary vascularity on CXR)
PE
yellow CSF from hemolysis (xanthochromia)
subarachnoid bleed
intranuclear opthalmoplegia
multiple sclerosis
progressive chorea and signs of dementia
huntington’s
generalized muscle weakness and fatiguability
myasthenia gravis
symmetric sensory loss
diabetic neuropathy
peaked T waves
hyperkalemia
short QT interval
hypercalcemia
flat T wave
hypokalemia
prolonged QT interval
hypocalcemia
delta wave
WPW
diastolic decrescendo blowing
aortic regurg
continuous machine like
PDA
crescendo decrescendo, 2nd ICS, radiates to carotids
aortic stenosis
holosystolic murmur
mitral regurg
mid-diastolic rumble
mitral stenosis
mid systolic click, radiates to axilla
MVP
sister mary joseph nodes
umbilical nodes a/w gastric adenocarcinoma/ CA, colon CA, pancreatic CA
philadelphia chromosome
CML
translocation of chromosome 9 and 22, brc-abl fusion gene
pulsus parvus (small) et tardus (slow)
pulse is slow rising and weak, delay between 1st heart sound on auscultation and carotid pulse, a/w AS
tet spells
a/w ToF
- sudden marked increase in cyanosis followed by syncope, kids often squat to increase SVR and temporarily decrease shunt
- MC cyanotic heart disease, blue baby syndrome, PROVe
denny morgan lines and allergic shiners
allergic rhinitis
asterixis
increased ammonia levels a/w hepatic encephalopathy
ptosis, anhidrosis, miosis
horners syndrome
