Pathognomonics Flashcards
1
Q
Short history of polydipsia, polyuria
A
T1DM
2
Q
Breath smell of pears
A
DKA
3
Q
Slower history of polydipsia, polyuria
A
T2DM
4
Q
Triad of:
- Exophthalmos
- Acropachy (soft tissue swelling/clubbing)
- Pretibial myxoedema
A
Graves’ (hyperthyroidism)
5
Q
Characterstic goitre and symptoms of hypothyroidism
A
Hashimoto’s (hypothyroidism)
6
Q
Purple abdominal striae, central obesity, round face
A
Cushing’s sydrome/disease (pituitary tumour)
7
Q
Big hands, rings no longer fit
A
Acromegaly
8
Q
Amenorrhoea, galactorrhoea, gynaecomastia
A
Prolactinoma
9
Q
Conn’s syndrome
A
High aldosterone renin ratio
10
Q
Hyperpigmentation
A
Addison’s disease
11
Q
Symptoms of addison’s but no hyperpigmentation
A
Secondary renal insufficiency
12
Q
Water deprivation (cant concentrate urine) and ADH suppression test (cant concentrate urine)
A
Nephrogenic DI
13
Q
Water deprivation (cant concentrate urine) and ADH suppression test (can concentrate urine)
A
Cranial DI
14
Q
Euvolaemic, hypotonic hyponatraemia
A
SIADH
15
Q
Everything speeds up,: cramping, over-contraction leads to weakness/flaccid paralysis, arrhythmias and arrest.
Give insulin
A
Hyperkalaemia (>5.5mmol/L)
16
Q
Everything slows down: constipation, weakness/cramps and arrhythmias and palpitations
A
Hypokalaemia (<3.5mmol/L)
17
Q
Weak bones, renal stones, groans and psychic moans
A
Hyperparathyroidism
18
Q
Numb, convulsions, Chevostek’s sign (spasm) and prolonged QT
A
Hypocalcaemia
19
Q
Soft bones, kidney stones, CHIMPANZEE
A
Hypercalcaemia
20
Q
Hyposmia/anosmia (cannot smell)
A
Kallmann syndrome (hypogonadotropgic hypogonatropsim)
21
Q
ST elevation on ECG near blood vessel occludes, elevated troponins
A
STEMI
22
Q
non ST elevation on ECG, elevated troponins
A
NSTEMI
23
Q
normal ECG, normal troponins, constant pain
A
Unstable angina
24
Q
normal ECG, normal troponins, pain on exertion.
A
Stable angina
25
6P's - pain, paraesthesia, pulselessness, pallor, paralysis, perishingly cold.
Intermittent claudication
PVD
26
Mid-diastolic, low pitched rumbling murmur
MS
27
Second most common valve defect
Pansystolic murmur (murmur throughout systole)
MR
28
Most common valve defect
Disease of elderly. Ejection systole murmur (crescendo-descrescendo pattern)
AS
29
Early diastolic, soft rumbling murmur
AR
30
Main cause of sudden cardiac death (young footballers)
Hypertrophic cardiomyopathy
31
Structural heart defect with scar tissue
Restricted cardiomyopathy
32
Peripheral oedema, SOB, fatigue.
High BNP
Heart failure
33
Triad of epigastric pain radiating to the back, pulsatile abdominal mass and hypovolaemic shock
AAA
34
Abrupt onset of severe tearing central chest pain radiating through to the back
Aortic disection
35
ECG stuff:
Tall, pointed P waves
Right atrial enlargement
36
ECG stuff:
Notched, m shaped P waves
Left atrial enlargement
37
ECG stuff:
Irregular irregular rhythm, abnormal spacing between QRS's
Atrial fibrillation
38
ECG stuff:
Saw-tooth pattern (F waves)
Atrial flutter
39
ECG stuff:
Long PR interval
First degree heart block (or bradycardia)
40
ECG stuff:
Progressive lengthen of PR interval, then miss a QRS then repeats
Second degree (Mobitz 1) heart block
Also called Wenckebach
41
ECG stuff:
A set amount of P waves to QRS (2:1, 3:1 or 4:1 etc.)
Second degree (Mobitz 2) heart block
42
ECG stuff:
Complete, P waves and QRS at different waves
Third degree heart block
43
ECG stuff:
QRS looks nice but fast.
Ventricular tachycardia
Very Tidy, Very Funny
44
ECG stuff:
All higgledy piggle
Ventricular fibrillation
Very Tidy, Very Funny
45
ECG stuff:
QT is greatly increased
Long QT syndrome (long time for ventricular repolarisation)
46
ECG stuff:
Pre-excitation to QRS (delta wave)
Wolff-Parkinson-White syndrome
47
ECG stuff
W shape in QRS in V1
M shape in QRS in V5/V6
LBBB
WILLIAM
48
ECG stuff:
M shape QRS in V1
W shaped QRS in V5/V6
RBBB
MARROW
49
Worse when lying flat, the patient may walk when bending forwards.
Diffuse (in all leads) Saddle shaped ST elevation
Pericarditis
50
Fever, new murmur
Skin signs are splinter haemorrhages, Janeway lesions and Osler nodes
Infective endocarditis
If staph, give vancomycin.
If MRSA then add Rifampicin
51
Rouleaux formation on blood film and CRAB (hypercalcaemia, renal disease, anaemia, bone disease)
Myeloma
52
Auer rods
AML
53
Most common paediatric cancer
ALL
54
Philadelphia gene, rare
CML
55
Most common leukaemia in adults mainly
CLL
56
G6PD
Bite cells
57
Reed-sternberg cells, ABVD treatment
Hodgkin Lymphoma
58
no Reed-sternberg cells, CHOPR treatment
Non-hodgkin lymphoma
59
Main cause is iron deficiency
Main macrocytic anaemia
Anaemia
60
Microcytic anaemia causes
Iron deficiency, Thalassaemiam anaemia of chronic disease
61
Normocytic anaemia causes
Haemolytic, blood loss, CKD
62
Macrocytic anaemia causes
Folate or B12 deficiency
63
Fatigue, dyspnoea, headache, palpitations, tachycardia, pallor (best noted in conjunctiva)
General symptoms of anaemia
64
Yellow skin, delusions, angular stomatitis
Pernicious anaemia
65
Unilateral oedema, redness, hot
DVT, first line LWMH
66
Signs of DVT with SOB
PE
67
hypovolaemia, Hyperviscosity (headache, vertigo, tinnitus, visual disturbance, angina, intermittent claudication)
Polycythaemia
68
Platelet style bleeding (mucocutaneous bleeding) – GI bleeding and menorrhagia
vWF
69
Bleeding, mainly into joints (haemarthrosis)
Haemophilia
70
Increased bleeding and clots, can lead to delirium and coma
DIC
71
Neurological symptoms (coma, seizures, focal abnormalities), bleeding symptoms (purpura, ecchymosis, menorrhagia)
MAHA (fragmented erythrocytes) on blood film
TTP
Too much vWF as ADAMTS13 mutation which cleaves vWF
72
Bleeding symptoms (easy bruising, epistaxis, petechiae, purpura) with no neurological symptoms
ITP
Autoimmune destruction of platelets
73
Severe anaemia beginning 6-12months life
beta thalassaemia major
| when HbF decreases
74
Monocytosis
| Confirmed with thick and thin blood smears
Malaria
75
Eosinophilia
Parasite is main cause
76
Spider naevi
Liver cirrhosis
77
gGT is very raised
ALD or acute liver injury due to alcohol
78
Shifting dullness when percussion
Ascites
79
Ascites and oesophageal varices
Indicative of portal HTN
80
Melaena (black poo)
Oesophageal varcies
81
Acquired by mouth from anus, always acute and appears once
Hepatitis A
82
Even in England and can be Eaten (pigs)
Hepatitis E
83
Blood borne and if not beaten then Bad
Hepatitis B
84
D (with B) is Dastardly
Hepatitis D
85
Usually chronic but can be cured at a cost
Hepatitis C
86
1/3 of Charcot's triad:
| RUQ pain
Biliary colic
87
2/3 of Charcot's triad
| RUQ pain and fever/leucocytosis
Cholecystitis
88
3/3 of Charcot's triad:
| RUQ pain, fever/leucocytosis and jaundice
Cholangitis
89
Severe epigastric pain radiating to hte back
Pancreatitis or spontaneous bacterial peritonitis
90
Severe epigastric pain radiating to hte back
Serum lipase raised
Pancreatitis
91
Slate grey skin
Haemochromatosis
92
Kayser-Fleischer ring (brown ring around cornea)
Wilson's disease
93
COPD and liver problems
Alpha1-antitrypsin deficiency
94
Rebound tenderness on the abdomen
Peritonitis
Usually caused by E.coli
95
The hernia which is more likely needing surgery
Femoral hernia is more likely to be strangulated than inguinal.
96
Blood marker is increased AFP with other cancer symptoms
Hepatocellular carcinoma
97
Jaundice, weight loss with other cancer symptoms
Cancer of the head of the pancreas (blocking bile duct)
98
Coughing causing moderate amount of haematemesis (blood is bight red)
Mallory-Weiss tear
| blood is bright red, different to oesophgeal varices where blood is brown/clumpy/not fresh
99
Patchy inflammation, anywhere along the bowel and any layer of the bowel wall (transmural)
CD
100
Continuous inflammation of mucosa only in the colon. Manage with aminosalicylates (sulfasalazine).
UC
101
ABC:
Abdo pain/discomfort
Bloating
Change in bowel habit
IBS
102
Villous atrophy and crypt hyperplasia
Angular stomatitis
Coeliac disease
103
Heart burn, symptoms worse when lying down (nocturnal asthma)
GORD
104
Middle aged, caucasian male with long history of GORD and dysphagia
Barrett's oesophagus
105
Weight loss of cachexia
Generally, think of cancer
106
Progressive dysphagia, cant swallow solids then cannot swallow liquids.
Oesophageal cancer
107
Progressive dysphagia with GORD symptoms
Oesophageal adenocarcinoma (lower third)
108
Progressive dysphagia with no GORD and drinking hot tea/Japan
Oesophageal squamous cell carcinoma (upper third)
109
A GI cancer where
Type 1 glandular
Type 2 undifferentiated
Late presentation, dysphagia, reflux, abdo pain
Gastric cancer
110
Bloody poop, symptoms of obstruction (altered bowel habit, colicky abdo pain)
Colorectal cancer
111
Epigastric pain worse on eating
Gastric ulcer
112
Duodenal pain relieved by eating
Duodenal ulcer
113
Early pain/discomfort around umbilicus that migrates to the right iliac fossa
Appendicitis
114
Cannot keep food down (vomiting)
Small bowel obstruction (60% are adhesions)
60-75% of bowel obstructions are SBO
115
Constant bum pain, constipation
Large bowel obstruction (90% are Colorectal/large bowel malignancy), 10% are volvulus.
116
Tender LIF, inflammation/signs of infection (fever)
Diverticulitis
117
Symptoms of abdominal pain, dyspepsia and anaemia
Gastritis (pernicious anaemia)
118
Most common causes of diarrhoea
1. Bacteria.
2. viral
3. Parasites
1. campylobacter jejuni
2. Norovirus (rota in children)
3. Giardia lambia
119
Diarrhoea in hospital and patient is on antibiotics
C.diff infection
120
AF with severe abdo pain. Almost always affects small bowel
Acute mesenteric ischaemia
121
Sudden onset of LIF pain, signs of hypovolaemic shock
Ischaemic colitis
122
Heberden's (DIP) and Bouchard's (PIP) nodes. 4 characteristic X-ray changes.
OA
123
High anti-CCP in serum. Young females joints most commonly affected
RA
124
Negatively birefringent and needle-like crystals on joint aspirate
Man with red, swollen, painful big toe
Gout
125
Positive birefringent and rhomboid like crystals on joint aspirate
Elderly women with swollen knee
Pseudogout
126
X-ray showing sacroilitis and bamboo spine/syndesmophytes
AS
127
Swelling of PIPs and dactylitis. Pencil-in-cup erosion.
PA (may see signs of psoriasis on skin)
128
Previous infection of either enteritis (salm, shig), urethritis (chlam).
Acute, asymmetrical lower limb joints affect.
Reactive arthritis
129
Acute onset of hot, red, swollen joint. Medical emergency
Septic arthritis
130
Swelling, extreme tendernous over local site. Non-healing ulcer and draining sinus tracts
Osteomyelitis
Only draining sinus tracts in chronic due to perforating sequestrae and involucrum
131
cancer like symptoms (wt loss, fever, tiredness and night sweats) with butterfly rash. Anti dsDNA
SLE
132
unexplained pregnancy loss
Antiphospholipid syndrome
133
CREST (Calcinosis, Raynaud’s phenomenon, Oesophageal reflux, sclerodactyly, Telangiectasia)
Systemic sclerosis/scleroderma
134
Schirmer’s test, anti-Ro and anti-La antibodies. Dry mucous membranes
Sjogren’s syndrome
135
tall, long limbs, long fingers, hypermobility, pectus excavatum
Marfan syndrome
136
Joint hypermobility, easily stretched skin, easy bruising, use Beighton score to assess hypermobility.
Ehlers-Danlos syndrome
137
Chronic pain, fatigue, pain morning stiffness, functional disease
Fibromyalgia
138
Cancer like symptoms – malaise, fatigue, wt loss, low grade fever
Pain on the scalp and jaw claudication (headache).
GCA
139
Strawberry tongue, erythema and desquamation of palms and soles
Kawasaki disease
| medium vasculitis
140
DEXA scan
Osteoporosis
141
Waddling gait, can’t get out of chair. Widespread bone pain (dull ache)
Osteomalacia
142
Knock knees, or bowed legs
Ricket's
143
Tendency for axial skeleton affected, bone pain, deformity, fractures. High increased alkaline phosphatase.
Paget's disease
