Phrases, Mneumonics Flashcards
triads, phrases, words that you should be able to associate to diseases, etc
cottage cheese and ketchup appearance
retinal hemorrhage
seen in CMV retinitis (most common CMV manifestation in HIV patients with CD4 count < 50)
HLA B27
ankylosing spondylitis, psoriatic arthritis, ulcerative colitis, reactive arthritis (all seronegative AKA negative RF)
Drusen
Macular degeneration
yellow-white deposits seen in dry MD between retinal pigment epithelium and Bruch’s membrane. Eventually Drusen causes growth and proliferation of choroidal capillaries that causes retinal cells to die creating blind spots (wet MD)
flashes of light
retinal detachment
retinal photoreceptors are being stimulated by the separation of the retina
cotton wool spots
hypertensive or diabetic retinopathy
white, fluffy patches that occur secondary to ischemia from retinal arteriole obstruction
corynebacterium, gray pseudomembrane
diphtheria
mastoiditis triad
otorrhea, TTP over mastoid process, retroauricular swelling with protruding ear
treatment with amoxicillin > rash
infectious mononucleosis
Tumarkin attacks
drop attacks in Meniere’s
a sudden fall without loss of consciousness
Schwart’z sign on otoscopic exam
otosclerosis
normal TM with a faint pink tinge due to neovascularization of otosclerotic bone
Carhart notch
otosclerosis
audiometric artifact due to stapes fixation > reduction in bone conduction hypersensitivity
hyphae, pseudohyphae
candida
pellagra
P3llagra, B3, D3
B3 (niacin) deficiency
diarrhea, dermatitis, dementia (also death)
Quincy triad
trismus (inability to open oral cavity), uvular deviation, dysphonia (impaired ability to produce sound)
seen in peritonsillar abscess/quincy
plasmodium
malaria
falciparum = most common and most lethal
schistocytes
hemolytic anemia (intravascular hemolysis)
fragmented parts of RBCs
hypersegmented neutrophils
megaloblastic anemia (form of macrocytic anemia)
due to B12, B9 def, or methotrexate
Plummer-Vinson syndrome
iron deficiency anemia
dysphagia (esophageal webs) and glossitis
Heinz bodies, bite cells
G6PD deficiency (also thalassemias)
Heinz bodies are seen in active hemolytic anemia - damage to RBCs causing intravascular hemolysis
bite cells are RBCs with Heinz bodies that have been phagocytosed by splenic macrophages
fava beans
G6PD deficiency
remove in those with G6PD def, as it is an oxidative stressor
HLA A3, HFE gene
hemochromatosis
short arm of chromosome 6
bronze diabetes
hemochromatosis
due to the destruction of B-islet cells, iron deposits in the skin increasing melanin production/hyperpigmentation
Jak 2 gene mutation
polycythemia vera
short arm of chromosome 9
5 Hs of hemophilia
hemarthroses, hematomas, hematochezia, hematuria, head hemorrhage
PT (INR) vs PTT
play tennis outside
play table tennis inside (hemophilia)
A normal PT and PTT, with increased bleeding time due to decreased platelets, is indicative of ITP.
TTP is associated with a decreased RBC count.
Von Willebrand’s disease causes an increased PTT.
DIC causes an increase in PT and PTT in addition to increased bleeding time and decreased platelets. Polycythemia vera has an increased platelet count causing hyperviscosity.
tetrad of Henoch-Schonlein Purpura
palpable purpura, abd pain, arthritis, renal disease (IgA nephropathy, etc)
- self-limiting and resolves in FOUR weeks
- affects 4-10 year olds (compared to ITP which affects 2-6 yo)
vitamin K def
2, 7, 9, 10, protein C/S
normal PTT, PT/INR elevated
ages of leukemias
CML = any age, median 65 yo AML = All My Life, any age, 15-59 usu ALL = All Little Leaguers, children CLL = Cranky Late Lifers, > 60
Philadelphia chromosome, translocation b/w chromosomes 9 and 22
CML
CMon Lets go to Philadelphia!
Auer rods
AML - pathognomonic
splinter shaped or rod shaped structures in the cytosol of myeloblasts
virgin B cells
CLL
B cells that cannot differentiate into plasma cells
smudge cells
CLL
fragile leukemic cells
Reed-Sternberg cells
Hodgkin Lymphoma
neoplastic cells that arise from germinal center B cells > has two mirror image nuclei “owl eyes”
mediastinal mass
Hodgkin Lymphoma
LAD of noncontiguous spread along multiple lymph nodes
Non Hodgkin Lymphoma
MM sxs/signs
CRAB: increased calcium, renal failure, anemia, bony lesions, Bence Jones proteins
punched out lytic lesions
multiple myeloma
lytic lesions or osteoporosis (also seen in other cancers that affect the bones - neuroblastoma, etc)
Rouleaux formation
multiple myeloma
RBCs are stacked like poker chips in the blood smear
M-spike
multiple myeloma
tophi
Gout
monosodium urate crystal deposits in tissues
microtophi = deposits in synovium
podagra
acute gouty arthritis in the first metatarsophalangeal joint
bull’s eye skin lesion
Lyme Disease
seen in Stage 1 (7-14 days post-bite), a red expanding non-pruritic lesion with concentric circles
bilateral bell’s palsy
Lyme Disease (also consider GBS, cancer, etc)
Dowager’s hump
kyphosis
absence of dystrophin
muscular dystrophy
waddling gait
muscular dystrophy (or hip dislocation from birth)
popcorn calcification on XR
chondroma
nidus
osteoma/osteoid osteoma
radiolucent area of about 1 cm in diameter with a calcified center - seen on XR
onion-like skinning, moth-eaten appearance
ewings sarcoma - seen on XR of the periosteal bone
steeple sign
croup
thumbprint sign
epiglottitis
apple core sign
colon cancer
bird beak sign
volvulus
beriberi
B1 deficiency
Wernicke - Korsakoff
B1 deficiency due to alcoholism
burning foot syndrome
B5 deficiency
blueberry muffin skin nodules
neuroblastoma
point mutation that inactivates RB suppressor gene of ch 13
retinoblastoma
cat’s eye reflex
retinoblastoma
negri bodies
rabies
present in the hippocampus and cerebellum in encephalitis
slapped cheek rash and exanthema > erythematous maculopapular rash the extends to the trunks and proximal extremities
fifth disease or erythema infectiosum (human parvovirus B19)
fades over 2-4 days > appears 1-4 days after slapped cheek disappears
Erythema infectiosum (5th disease) appears as a blotchy pink rash on the cheeks, occurring in 5–7-year-old children mostly; this rash will also resolve spontaneously.
hand-foot-mouth
coxsackie
HHV 6
roseola infantum
begins with a fever and 3 days of general malaise, then the fever rapidly resolves, and a light pink lacy, nonpruritic rash appears on the neck and trunk > face and extremities
roseola infantum
Roseola infantum . (The mnemonic I use to remember the disappearing rash of roseola in ‘phantom’ is that the fever disappears “like a ghost.” The ‘infantum’ part of the name is also practically helpful for remembering that this condition affects infants, whereas many other childhood exanthems affect children over the age of 2.) This rash may extend to include the arms and legs as well. This rash is common in infants 9–12 months of age. Febrile seizures may occur in some children with a high fever. Notably, it is rare to see URI or GI symptoms in the beginning of the roseola infantum presentation, and this may help to distinguish it from a more common viral infection. Of course, the rash is the most distinctive part of the presentation, and this will appear after the fever drops.
forchheimer’s spots
rubella/german measles/3-day measles
red spots that develop on posterior soft/hard palate
pruritic pink, discrete maculopapular rash that starts on hairline of face and rapidly spreads to neck, trunk, and rest of body
rubella/german measles/3-day measles **this is also a TORCH infection)
morbilliform rash
rubeola (measles)
rubella, group A strep
rash that starts at the hairline, spreads down to face/neck/trunk, then desquamates
morbilliform rash
rubeola (measles)
does not involve palms or soles
4 Cs of rubeola/measles
prodrome has a cough, coryza, and conjunctivitis, and Koplik spots
Koplik spots
rubeola (measles)
grey/white papules on buccal mucosa
strawberry tongue
scarlet fever
white exudate on tongue studded with prominent red papillae > when white exudate disappears tongue looks beefy red
sandpaper rash, nonpruritic, nonpainful erythematous rash on face and neck first, then spreads
scarlet fever
Centor criteria
strep pharyngitis, 1 point per +
no cough 3-14 y/o tender anterior LAD erythematous tonsils fever > 100.4
0-1 = less likely
2-3 = culture and treat if +
4: antibiotics
significant pruritic rash progressing from macules > vesicles > pustules > burst and crust. involves trunk, face, scalp, conjunctivae, oral mucosa, palms, and soles
varicella zoster chicken pox
**do not prescribe ASA)
stridor, subglottic swelling, seal bark cough
Croup
steeple sign or pencil point sign
croup
subglottic narrowing
salty tasting skin
cystic fibrosis
tripod posture in kids
acute epiglottitis
thumb sign on lateral neck radiograph
acute epiglottitis: cherry shaped epiglottic swelling
machinery murmur
PDA
no meconium in first 48 hours of life
Hirschsprungs
normal: 95% should pass in first 24, rest of 5% before 48 hours
blast sign
Hirschsprungs: explosive passage of stool upon withdrawal of finger
sausage shaped mass in RLQ
intussusception, also called Dance sign
red currant jelly stools, palpable mass, and abd pain
tried of intussusception
bilious green vomit and no passage of meconium
meconium ileus
nonbilious projectile vomiting
pyloric stenosis
*hypochloremic, hypokalemic metabolic alkalosis
olive shaped mass
pyloric stenosis: firm, nontender, and mobile hard pylorus at the RUQ
salmon colored maculopapular rash
sx of juvenile RA
club shaped bacilli
corynebacterium diphtheriae - seen on gram stain
chromosome 14 missense mmutation (AD)
hypertrophic cardiomyopathy
splinter hemorrhages in nail beds
endocarditis - linear reddish brown lesions within the nail bed
janeway’s lesion
endocarditis - painless 5 mm pustular, hemorrhagic lesions on palms or soles
roth’s spots
endocarditis - irregular red area of retinal hemorrhage with a pale center
osler’s nodes
endocarditis - painful nodules on the pads of fingers or toes
coffin lid or triple phosphate
kidney stones
Urinalysis revealed the absence of nitrites and leukocytes making it less likely that we will observe WBC casts as they are typically associated with infectious or inflammatory diseases of the kidney. Epithelial cells are usually due to acute tubule cell injuries and causative factors are inconsistent with his clinical presentation. Fatty casts are associated with nephrotic syndrome while hexagonal crystals are composed of cystine and have an incidence of only about 2 percent due to an autosomal recessive disorder causing cystinuria. Trace amounts of non-hemolyzed blood and “coffin lid” or “triple phosphate” crystals are reflective of kidney stones.
spaghetti and meatballs
tinea versicolor looks like this on KOH - long curved strands of hyphae and budding yeast cells
“Dewdrops on rose petals”
varicella zoster (chicken pox)
“Chandelier sign”
extreme tenderness on palpation or movement of the cervix, and indicates pelvic inflammatory disease.
“Orange peel sign,” also called “peau d’orange”
dimpling of the skin over inflammatory or cancerous breast tissue
WBC casts
The pathognomonic sign for pyelonephritis is white blood cell casts in the urine. In a lower UTI, you’ll see WBC without casts, and presence of casts suggests kidney involvement.
RBC casts
Red blood cell casts are found in glomerulonephritis.
Waxy casts
waxy casts are found in patients with chronic renal failure.
Fatty Casts
Fatty casts are seen in nephrotic syndrome
