Rapid Review Flashcards
Abdominal pain, ascites, hepatomegaly
Budd-Chiari syndrome (posthepatic venous thrombosis)
Achilles tendon xanthoma
Familial hypercholesterolemia (low LDL receptor signaling)
Adrenal hemorrhage, hypotension, DIC
Waterhouse-Friderichsen syndrome (meningococcemia)
Arachnodactyly, lens dislocation, aortic dissection, hyper flexible joints
Marfans syndrome (fibrillin defect)
Athlete with polycythemia
Erythropoietin injection
Back pain, fever, night sweats, weight loss
Potts disease (vertebral TB)
Bilateral hilar adenopathy, uveitis
Sarcoidosis (noncaseating granulomas)
Blue sclera
Osteogenesis imperfecta (collagen defect)
Bluish line on gingiva
Burton’s line (lead poisoning)
Bone pain, bone enlargement, arthritis
Paget’s disease of bone (increased osteoblastic and osteoclastic activity)
Bounding pulses, diastolic heart murmur, head bobbing
Aortic regurgitation
Butterfly facial rash and Raynaud’s phenomenon in a young female
Systemic lupus erythematosus
Cafe au lait spots, Lisch nodules (iris hamartoma)
Neurofibromatosis type I (+ pheochromocytoma, optic gliomas)
Neurofibromatosis type II (+bilateral acoustic neuromas)
Cafe au lait spots, polyostotic fibrous dysplasia, precocious puberty
McCune-Albright syndrome (mosaic G protien signaling mutation)
Calf pseudohypertrophy
Muscular dystrophy (most commonly Duchennes): X linked recessive deletion of dystrophin gene
Cherry red spot on macular
Tay Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation); central retinal artery occlusion
Chest pain on exertion
Angina (stable: moderate exertion; unstable: minimal exertion)
Chest pain, pericardial effusion/friction rub, persistent fever following MI
Dressler’s syndrome (autoimmune-mediated post MI fibrinous pericarditis, 1-12 wks after acute episode)
Child uses arms to stand up from squat
Gowers sign (Duchenne muscular dystrophy)
Child with fever develops red rash on face that spread to body
Slapped cheeks (erythema infectiosum/ fifth disease: parvovirus B19)
Chorea, dementia, caudate degeneration
Huntington’s disease (AD CAG repeat expansion)
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
McArdle’s disease (muscle glycogen phosphorylase deficiency)
cold intolerance
hypothyroidism
conjugate lateral gaze palsy, horizontal diplopia
internuclear ophthalmoplegia (damage to MLF; bilateral=multiple sclerosis; unilateral=stroke)
continuous “machinery” heart murmur
PDA (close with indomethacin; open with misoprostol)
cutaneous/dermal edema d/t connective tissue deposition
myxedema (c/b hypothyroidism, Graves’ dz=pretibial)
dark purple skin/ mouth nodules
Kaposi’s sarcoma (usually AIDS pts; a/w HHV-8)
deep, labored breathing/hyperventilation
Kussmaul breathing (diabetic ketoacidosis)
dermatitis, dementia, diarrhea
pellagra (niacin=vit B3 deficiency)
dilated cardiomyopathy, edema, polyneuropathy
wet beriberi (thiamine=vit b1 deficiency)
dog or cat bite resulting in infection
Pasteurella multocida (cellulitis at inoculation site)
dry eyes, dry mouth, arthritis
Sjogren’s syndrome (autoimmune destruction of exocrine glands)
dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
elastic skin, hypermobility of joints
Ehlers-Danlos syndrome (type III collagen defect)
enlarged, hard left supraclavicular node
Virchow’s node (abdominal metastasis)
erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
Sezary syndrome (cutaneous T cell lymphoma) or mycosis fungoides
facial muscle spasm upon tapping
Chvostek’s sign (hypocalcemia)
fat, female, forty, fertile
Acute cholelithasis (bile duct blockage)
fever, chills, headache, myalgia following antibiotic tx for syphilis
Jarisch-Herxheimer rxn (rapid lysis of spirochetes results in toxin release)
fever, cough, conjunctivits, coryza, diffuse rash
measles (morbillivirus)
fever, night sweats, wt loss
B symptoms (lymphoma)
fibrous plaques in soft tissue of penis
Peyronie’s dz (connective tissue disorder)
gout, mental retardation, self-mutilating behavior in a boy
Lesch-Nyhan syndrome (HGPRT deficiency, X linked recessive)
green-yellow rings around peripheral cornea
Kayser-Fleisher rings (copper accumulation from Wilson’s disease)
hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands
Peutz-Jeghers syndrome (genetic benign polyposis can cause bowel obstruction; increased cancer risk)
hepatosplenomegaly, osteoporosis, neurologic sx
Gaucher’s dz (glucocerebrosidase deficiency)
hereditary nephritis, sensorineural hearing loss, cataracts
Alport syndrome (mutation in alpha chain of collagen IV)
hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau’s syndrome - adenocarcinoma of pancreas or lung; a/w migratory thrombophlebitis
hyperphagia, hypersexuality, hyperorality, hyperdocility
Kluver-Bucy syndrome (bilateral amygdala lesion)
hyperreflexia, hypertonia, positive Babinski
UMN damage
hypertension, hypokalemia, metabolic alkalosis
Conn’s syndrome
hyporefleixa, hypotonia, atrophy
LMN damage
hypoxemia, polycythemia, hypercapnia
Blue bloater - chronic bronchitis: hyperplasia of mucous cells
indurated ulcerated genital lesion
nonpainful = chancre (primary syphilis, Treponema pallidum)
painful, with exudate = chancroid (Haemophilius ducreyi)
infant with failure to thrive, hepatosplenomegaly, neurodegeneration
Niemann-Pick dz (genetic sphingomyelinase deficiency)
infant with hypoglycemia, failure to thrive and hepatosplenomegaly
Cori’s dz (debranching enzyme deficiency)
infant with microcephaly, rocker bottom feet, clenched hands and structural heart defect
Edwards’ syndrome (trisomy 18)
Keratin pearls on skin bx
squamous cell carcionoma
large rash with bulls eye appearance
erythema chronicum migrans from Ixodes tick bite (Lyme dz = borrelia)
lucid interval after traumatic brain injury
epidural hematoma (middle meningeal artery rupture)
male child, recurrent infxns, no mature B cells
Bruton’s dz (X linked agammaglobulinemia)
mucosal bleeding and prolonged bleeding time
Glanzmann’s thrombasthenia (defect in platelet aggregation d/t lack of GpIIb/IIIa)
multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
Gardner’s syndrome (subtype of FAP)
myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
Pompe’s dz (lysosomal alpha 1,4 glucosidase def)
necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Wegener’s (cANCA) and Goodpasture’s syndromes (anti-Basement memb Abs)
neonate with arm paralysis following difficult birth
Erb-Duchenne palsy (superior trunk C5-6 brachial plexus injury - waiter’s tip)
no lactation pospartum, absent menstruation, cold intolerance
Sheehan’s syndrome (pituitary infarction)
nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
multiple sclerosis
oscillating slow/ fast breathing
Cheyne Stokes respiration (central apnea in CHF or increased ICP)
painful blue fingers/toes, hemolytic anemia
cold agglutinin dz (autoimmune hemolytic anemia c/b Mycoplasma pneumoniae, infectious mononucleosis)
painful, raised red lesions on palms and soles
Osler’s node (infective endocarditis)
painless jaundice
cancer of the pancreatic head obstructing bile duct
palpable purpura on buttocks/legs, joint pain, abd pain (child)
Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
pancreatic, pituitary, parathyroid tumors
MEN 1 (AD)
pink complexion, dyspnea, hyperventilation
pink puffer = emphysema: centroacina (smoking), panacina (alpha1-antitrypsin def)
polyuria, acidosis, growth failure, electrolyte imbalances
Fanconi’s syndrome (proximal tubular reabsorption defect)
positive anterior drawer sign
ACL injury
ptosis, miosis, anhidrosis
Horner’s syndrome (sympathetic chain lesion)
pupil accommodates but doesn’t react
Argyll Robertson pupil (neurosyphilis)
rapidly progressive leg weakness that ascending (following GI/URI)
Guillain Barre syndrome - autoimm acute inflammatory demyelinating polyneuropathy
rash on palms and soles
Coxsackie A, secondary syphilis, Rocky mountain spotted fever
recurrent colds, unusual eczema, high serum IgE
hyper-IgE syndrome (Job’s syndrome: neurotphil chemotaxis abnl)
red “currant jelly” sputum in alcoholic or diabetic pts
Klebsiella pneumoniae
red, itchy, swollen rash of nipple/areola
Paget’s dz of breast (represents underlying neoplasm)
red urine in morning, fragile RBCs
paroxysmal nocturnal hemoglobinuria
renal cell carcinoma (bilat), hemangioblastomas, angiomatosis, pheochromocytoma
von-Hippel Lindau dz (dominant tumor suppressor gene mutation_
resting tremor, rigidity, akinesia, postural instability
Parkinson’s dz) nigrostrital dopamine depletion_
retinal hemorrhages with pale centers
Roth’s spots (bacterial endocarditis_
severe jaundice in neonate
Crigler=Najjar syndrome (congenital unconjugated hyperbilirubinemia)
severe RLQ pain with rebound tenderness
McBurney’s sign (appendicitis)
short statue, increased incidence of tumors/leukemia, aplastic anemia
Fanconi’s anemia - genetic loss of DNA crosslink repair; often progresses to AML
single palm crease
Simian crease - Down syndrome
situs inversus, chronic sinusitis, bronchiectasis, infertility
Kartagener’s syndrome (dynein arm defect affecting cilia_
skin hyperpigmentation
Addison’s dz (primary adrenocortical insufficiency causes increased ACTH and alpha-MSH production)
slow, progressive muscle weaknes sin boys
Becker’s muscular dystrophy (X linked missense mut in dystorphin; less severe than Duchenne’s)
small, irregular red spots on buccal/lingual mucosa with blue-white centers
Koplik spots (measles; rubeola virus)
smooth, flat, moist white lesions on genitals
condylomata lata (secondary syphilis)
splinter hemorrhages in fingernails
bacterial endocarditis
strawberry tongue
scarlet fever, Kawasaki dz, toxic shock syndrome
streak ovaries, congenital heart dz, horseshoe kidney, cystic hygroma at birth
Turner syndrome (45XO, short stature, webbed neck, lymphedema)
sudden swollen/painful big toe join, tophi
Gout/ podagra (hyperuricemia)
swollen gums, mucous bleeding, poor wound healing, spots on skin
scurvy (vit C deficiency - can’t hydroxylate proline/lysine for collagen synthesis)
swollen, hard, painful finger joints
osteoarthritis (osteophytes on PIP=Bouchard’s nodes; DIP=Heberden’s nodes)
systolic ejection murmur (crescendo/decrescendo)
aortic vavle stenosis
thyroid and parathyroid tumors, pheochromocytoma
MEN 2A (AD ret mutation)
thyroid tumors, pheochromocytoma, ganglioneuromatosis
MEN 2B (AD ret mutation)
toe extension/ fanning upon plantar scrape
Babinski sign (UMN lesion)
unilateral facial drooping involving forehead
Bell’s palsy (LMN CN VII palsy)
urethritis, conjunctivitis, arthritis in a male
reactive arthritis a/w HLA-B27
vascular birthmark (port wine stain)
hemangioma (benign, but a/w Sturge-Weber syndrome)
vomiting blood following esophagogastric lacerations
Mallory-Weiss syndrome (alcoholic and bulimic pts)
waxy casts with very low urine flow
chronic end stage renal dz
WBC casts in urine
acute pyelonephritis
wt loss, diarrhea, arthritis, fever, adenopathy
Whipple’s dz (tropheryma whippelii)
worst headache of my life
subarachnoid hemorrhage
anticentromere antibodies
Scleroderma (CREST)
antidesmoglein (epithelial) Abs
pemphigus vulgaris (blistering)
anti-glomerular basement membrane Abs
Goodpastrue’s syndrome (glomerulonephritis and hemoptysis_
antihistone Abs
drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
anti-IgG Abs
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
antimitochondrial antibodies (AMAs)
primary biliary cirrhosis (female, cholestasis, portal HTN)
antineutrophil cytoplasmic antibodies (ANCA)
vasculitis (c-ANCA: Wegener’s; p-ANCA: microscopic polyangiitis, Churg Strauss syndrome)
antinuclear Abs (ANAs: anti-smith and anti-dsDNA)
SLE (type III hypersensitivity)
antiplatelet Abs
idiopathic thrombocytopenic purpura (ITP)
anti-topoisomerase Abs
diffuse systemic scleroderma
anti-transgluatminase/anti-gliadin/anti-endomysial Abs
Celiac dz
apple core lesion on abdominal x ray
colorectal cancer (usually left sided)
azurophilic granular needles in leukemic blasts
Auer rods (AML, espec the promyelocytic (M3) type)
bacitracin response
sensitive: strep pyogene (group A)
resistant: strep agalactiae (group B)
bamboo spine on x ray
ankylosing spondylitis (chronic inflammatory arthritis: HLA B27)
basophilic nuclear remnants in RBCs
Howell-Jolly bodies (d/t splenectomy or non-fct’l spleen)
basophilic stippling of RBCs
lead poisoning or sideroblastic anemia
bloody tap on LP
subarachnoid hemorrhage
boot shaped heart on x ray
tetralogy of Fallot, RVH
branching gram-poistive rods with sulfur granules
Actinomyces israelii
bronchogenic apical lung tumor
pancoast tumor (can compress sympathetic ganglion and cuase Horner’s syndroem_
brown tumor of bone
hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to:
hyperparathyoridism or osteitis fibrosa cystica
cardiomegaly with apical atrophy
Chagas’ dz (trypanosoma cruzi)
cellular crescents in Bowman’s capsule
rapidly progressive crescentic glomerulonephritis
chocolate cyst of ovary
endometriosis - frequently involves both ovaries
circular grouping of dark tumor cells surroudnign pale neurofibrils
Homer Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
colonies of mucoid pseudomonas in lungs
cystic fibrosis (AR mutation to CFTR resulting in fat soluble vit deficiency and mucous plugs)
decreased alpha-fetoprotein in amniotic fluid/maternal serum
Down syndrome or other chromosmoal abnl
degeneration of dorsal column nerves
Tabes dorsalis (tertiary syphilis)
depigmentation of neurons in substantia nigra
Parkinson’s disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
desquamated epithelium casts in sputum
Curschmann’s spirals (bronchial asthma; can result in whorled mucous plugs)
disarrayed granulosa cels in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of ovary)
dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
koilocytes (HPV: predisposes to cervical caner)
enlarged cells with intranuclear inclusion bodies
Owl’s eye appearance of CMV
enlarged htyroid cells with ground glass nuclei
orphan Annie eye nuclei (papillary carcinoma of thyroid)
eosinophilic cytoplasmic inclusion in liver cell
Mallory bodies (alocholic liver dz)
eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson’s dz)
eosinophilic globule in liver
councilman body (toxic or viral hepatitis, often yellow fever)
eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
rabies virus - lyssavirus
extracellular amyloid deposition in gray matter of brain
senile plaques (alzheimer’s dz)
giant B cells with bilobed nuclei with prominent inclusions (owl’s eye)
Reed-Sternberg cells (Hodgkins lymphoma)
glomerulus like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
hair on end (crew cut) appearance on x ray
beta thalassemia, sickle cell anemia (marrow expansion)
hCG elevated
choriocarcinoma, hydatidiform mole (occurs with and without embryo)
heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
heterophile antibodies
infectious mononucleosis (EBV)
hexagonal, double pointed, needle like crystals in bronchial secretions
bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
high level of D dimers
DVT, pulmonary embolism, DIC
hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify_
ghon complex (primary TB: mycobacterium bacilli)
honeycomb lung on x ray
interstitial fibrosis
hypersegmented neutrophils
megaloblastic anemia (B12 deficiency: neurologic sx; folate deficiency: no neurologic sx)
hypochromic, microcytic anemia
iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present)
increased alpha fetoprotein in amniotic fluid/ maternal serum
dating error, anencephaly, spina bifida 9neural tube defects)
increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
intranuclear eosinophilic droplet like bodies
Cowdry type A bodies (HSV, CMV)
iron containing nodules in alveolar septum
ferruginous bodies (asbestosis: increased chance of mesothelioma)
large lysosomal vesicles in phagocytes, immuonodeficiency
Chediak-Higashi dz (congenital failure of phagolysosome formation)
lead pipe appearance of colon on x ray
ulcerative colitis (loss of haustra)
linear appearance of glomeruli on immunofluorescence
Goodpasture’s syndrome
low serum ceruloplasmin
Wilson’s dz (hepatolenticular degeneration)
lumpy bumpy appearance of glomeurli on IF
poststreptococcal glomerulonephritis - immune complex deposition of IgG and C3b
lytic bone lesions on x ray
multiple myeloma
mammary gland (blue domed) cyst
fibrocystic change of breast
monoclonal Ab spike
- multiple myeloma (called M protein; usually IgG or IgA)
- monoclonal gammopathy of undetermined significance - MGUS; nl consequnce of aging
- Waldenstrom’s macroglobulinemia ( M protein = IgM)
- primary amyloidosis
monoclonal globulin protein in blood/ urine
Bence Jones protein (multiple myeloma - kappa or lambda Ig light chains in urine), Waldenstroms’ macroglobulinemia (IgM)
mucin filled cells with peripheral nucleus
Signet ring (gastric carcinoma)
narrowing of bowel lumen on barium radiograph
string sign - Crohn’s dz
needle shaped, negative birefringent crystals
gout (monosodium urate crystals)
nodular hyaline deposits in glomeruli
Kimmelstiel Wilson nodules (diabetic nephropathy)
novobiocin response
sensitive: staph epidermidis
resistant: staph saprophyticus
nutmeg liver
chronic passive congestion of liver due to right heart failure
onion skin periosteal reaction
Ewing’s sarcoma - malignant round cell tumor
optochin response
sensitive: strep pneumoniae
resistant: viridans strep
periosteum raised from bone, creating triangular area
Codman’s triangle on x ray - osteosarcoma, Ewing’s sarcoma, pyogenic osteomyelitis
podocyte fusion on EM
minimal change disease - child with nephrotic syndrome
polished, ivory like appearance of bone at cartilage erosion
eburnation - osteoarthriits resulting in bony sclerosis
protein aggregates in neurons from hyperphosphorylation of protein tau
neurofibrillary tangles (Alzheimer’s dz and CJD) and Pick’s bodies (Pick’s dz)
pseudopalisading tumor cells on brain biopsy
glioblastoma multiforme
RBC casts in urine
acute glomerulonephritis
rectangular, crystal like, cytoplasmic inclusions in Leydig cells
Reinke crystals - Leydig cell tumor
renal epithelial casts in urine
acute toxic/viral nephrosis
rhomboid crystals, positively birefringent
pseudogout - calcium pyrophosphate dihydrate
rib notching
coarctation of aorta
ring enhancing brain lesion in AIDS
toxoplasma gondii
sheets of medium sized lymphoid cells - starry sky appearance on histology
Burkitt’s lymphoma - t(8;14) c myc activation, a/w EBV; black sky - made up of malignant cells
silver staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick’s dz: progressive dementia, changes in personality)
soap bubble in femur or tibia on x ray
giant cell tumor of bone - gneerally benign
spikes on basement membrane, dome like subepithelial deposits
membranous glomerulonephritis - may progress to nephrotic syndrome
stacks of RBCs
Rouleaux formation - high ESR, multiple myeloma
stippled vaginal epithelial cells
clue cells - Gardnerella vaginalis
tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules - histiocytosis X: eosinophilic granuloma
thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
thumb sign on lateral x ray
epiglottitis - H. influenzae
thyroid like appearance of kidney
chronic bacterial pyelonephritis
tram track appearance of LM
membranoproliferative glomerulonephritis
triglyceride accumulation in liver cell vacuoles
fatty liver dz - alcoholic or metabolic syndrome
WBCs that look smudged
CLL - almost always B cell; affects elderly
wire loop glomerular appearance on LM
lupus nephropathy
yellow CSF
xanthochromia - previous subarachnoid hemorrhage
absence sz
ethosuximide
acute gout attack
NSAIDs, colchicine
acute promyelocytic leukemia - M3
all-trans retinoic acid
ADHD
methylphenidat,e amphetamines
alcohol abuse
AA + disulfiram
alcohol withdrawal
benzodiazepines
anorexia
SSRIs
anticoagulation during pregnancy
heparin
anxiety
buspirone
arrhythmia in damaged cardiac tissue
class IB antiarrhythmic - lidocaine, mexiletine, tocainide
B12 deficiency
B12
benign prostatic hyperplasia
tamsulosin, finasteride
bipolar disorder
lithium, valproate, carbamazepine - mood stabilizers
breast cancer in post menopausal women
aromataise inhibitor
buerger’s disease
smoking cessation
bulimia
SSRIs
Candida albicans
amphotericin B (systemic), mystatin (oral thrush, esophagitis)
carcinoid syndrome
octreotide
chlamydia trachomatis
doxycycline (+ceftriaxone for gonorrhea coinfection), erythromycin eye drops (prophylaxis in infants)
chronic gout
probenecid (Underexcretor)
allopurinol (overproducer)
chronic hepatitis
IFN alpha
chronic myelogenous leukemia
imatinib
clostridium botulinum
antitoxin
clostridium difficile
oral metronidazole
clostridium tetani
antitoxin + vaccine booster + diazepam
Crohn’s dz
corticosteroids, infliximab
cryptotoccous neoformans
fluconazole (prophylaxis in AIDS pts)
cystic fibrosis
N-acetylcysteine and antipseudomonal prophylaxis (tobramycin/azithromycin)
cytomegalovirus
ganciclovir
depression
SSRIs
diabetes insipidus
desmopressin (central)
HCTZ, indomethacin, amiloride (nephrogenic)
DM type 1
dietary intervention and insulin replacement
DM type 2
diet, oral hypoglycemic and insulin (possible)
diabetic ketoacidosis
fluids, insulin, K+
enterococci
vancomycin/ampicillin and aminoglycoside
erectile dysfct
sildenafil
ER-positive breast CA
tamoxifen
ethylene glycol/methanol intoxication
fomepizole (alcohol dehydrogenase inhibitor)
folate deficiency
folate
H. flu
rifampin (prophylaxis)
hemorrhagic cystitis
mesna
heparin toxicity (acute)
protamine sulfate
HER2/neu positive breast CA
trastuzumab
hyperaldosteronism
spirnolactone
hypercholesterolemia
statin
hypertriglyceridemia
fibrate
immediate anticoagulation
hpearin
infertility
leuprolide, GnRH (pulsatile)
influenza
oseltamivir, amantadine/rimantadine
legionella penumophila
erythromycin
long term anticoag
warfarin
malaria
chloroquine/mefloquine (for glood schizont), primaquine (for liver hypnazoite)
malignant hyperthermia
dantrolene
medical abortion
mifepristone
migraine
sumatriptan
MRSA
vancomycin
multiple sclerosis
beta IFN
mycobacterium tuberculosis
rifampin, INH, pyrazinamide, ethambutol, streptomycin
neisseria gonorrhoeae
ceftriaxone - add doxycycline to cover likely chlamydia concurrent infxn
neisseria meningitidis
pencillin/ ceftriaxone, rifampin - prophylaxis
neural tube defect prevention
folate
osteolmalacia/ rickets
vit D supplementation
patent ductus arteriosus
indomethacin
pheocrhomocytoma
alpha antagonists
pneumocysti jiroveci
TMP-SMX - prophylax in AIDS pts
prolactinoma
bromocriptine - DA agonists
prostate CA/ uterine fibroids
leuprolide, GnRH (continuous)
prostate carcinoma
flutamide
pseudomonas aeruginosa
antipseduomonal penicillin and aminoglycoside
pulmonary HTN
bosentan
rickettsia rickettsii
doxycycline, chloramphenicol - espec with aplastic anemia
ringworm infection
terbinafine, griseofulvin, imidazole
schizophrenia - neg sx
5-HT2a antagonists - olanzapine
schizophrenia - positive sx
D2 - R antagonists
SIADH
demeclocycline, lithium
sickle cell anemia
hydroxyurea - increases HbF
sprothrix schenckii
oral KI
stable angina
sublingual nitroglycerin
staph aureus
methicillin/nafcillin
strep bovis
penicillin prophylaxis
strep pneumoniae
penicillin/cephalosprin - systemic infxn, pneumonia
vanco - meningitis
strep pygoenes
penicillin prophylaxis
temporal arteritis
high dose steroids
tonic clonic sz
phenytoin, valproate, carabamazepine
toxoplasma gondii
sulfadiazine, pyrimethamine
treponema palldium
penicillin
trichomonas vaginalis
metronidazole - pt and partner
ulcerative colitis
5-ASA, infliximab
UTI prophylaxis
TMP-SMX
warfarin toxicity
FFP (acute), vitamin K (chronic)
Wegener’s granulomatosis
cyclophosphamide, corticosteroids
actinic (solar) keratosis
precursor to squamous cell carcinoma
acute gastric ulcer a/w CNS injury
Cushing’s ulcer - increased ICP stimulates vagal gastric secretion
acute gastric ulcer a/w severe burns
Curling’s ulcer - greatly reduced plasma volume results in sloughing of gastric mucosa
alternating areas of transmural inflamm and nl colon
skip lesions = crohn’s dz
aneurysm, dissecting
HTN
aortic aneurysm, abd and descending aorta
atherosclerosis
aortic aneurysm, ascending
Marfan’s syndrome - idiopathic cystic medial degeneration
atrophy of mammillary bodies
Wernicke’s encephalopathy - thiamine deficiency causing ataxia, ophthalmoplegia and confusion
autopslenectomy - fibrosis and shrinkage
sickle cell anemia HbS
bacteria a/w gastritis, peptic ulcer dz and sotmach CA
H pylori
bacterial meningitis - adults and elderly
strep pneumoniae
bacterial meningitis - newborns and kids
Group B strep - newborns
Strep pneumoniae and Neisseria meningitidis - kids
benign melanocytic nevus
spitz nevus - most common in first 2 decades
bleeding d/o with GpIb deficiency
Bernard Soulier dz - defect in platelet adhesion to von Willebrand’s factor
brain tumor - adults
supratentorial: mets>astrocytoma (glioblastoma multiforme)>meningioma>schwannoma
brain tumor - kids
infratentorial: medulloblastoma (cerebellum)
supratentorial: craniopharyngioma (cerebrum)
breast CA
infiltrating ductal carcinoma (1/9 women in US)
breast mass
fibrocystic change
carcinoma in postmenopausal women
breast tumor (benign)
fibroadenoma
cardiac primary tumor - kids
rhabdomyoma, often seen in tuberous sclerosis
cardiac manifestation of lupus
Libman-Sacks endocarditis - nonbacterial, affecting both sides f mitral valves
cardiac tumor (adults)
metastasis
primary myxoma - usually L atrium
cerebellar tonsillar herniation
Chiari malformaiton - often p/w progressive hydrocephalus or syringomyelia
chronic arrhythmia
atrial fibrillation - a/w high risk of emboli
chronic atrophic gastritis - autoimmune
predisposition to gastric CA - can also cause pernicious anemia
clear cell adenocarcinoma of vagina
DES exposure in utero
compression fracture
osteoporosis - type I: postmenopausal women
type II: elderly man or woman
congenital adrenal hyperplasia, hypoTN
21-hydroxylase deficiency
congenital cardiac anomaly
VSD
congenital conjugated hyperbilirubinemia - black liver
dubin-johnson syndrome - inaility of hepatocytes to secrete conjugated bilirubin into bile
constrictive pericarditis
TB - in developing world
SLE - in developed world
coronary artery involved in thrombosis
LAD > RCA > LCA
cretinism
iodine deficit/ hypothyroidism
Cushing’s syndrome
corticosteroid Rx
excess ACT secretion by pituitary
small cell lung CA (paraneoplastic)
cyanosis (early; less common)
tetralogy of fallot, transposition of great vessels, truncus arteriosus
cyanosis (late; more common)
VSD, ASD, PDA
death in CML
blast crisis
death in SLE
lupus nephropathy
dementia
Alzheimer’s dz
multiple infarcts
demyelinating dz in young women
MS
DIC
gram negative sepsis, obstetric complications, CA, burn, trauma
dietary deficit
iron
diveritculum in pharynx
Zenker’s diverticulum - dx’d by barium swallo
ejection click
aortic/pulmonic stensosi
esophageal CA
squamous cell CA (worldwide)
adenoCA (in US)
food poisoning - exotoxin mediated
staph aureus, B. cereus
glomerulonephritis - adults
Berger’s dz - IgA nephropathy
gynecologic maignancy
endometrial carcinoma - most common in US
cervical carcinoma - most common worldwide
heart murmur, congenital
mitral valve prolapse
heart valve in bacterial endocarditis
mitral - rheumatic fever
tricuspid - IV drug abuse
aortic - 2nd affected in rheumatic fever
helminth infection (US)
enterobius vermicularis
ascaris lumbricoides
hematoma - epidural
rupture of middle meningeal artery - trauma; lentiform shaped
hematoma - subdural
rupture of bridging veins (crescent shaped)
hemochromatosis
multiple blood transfusions or hereditary HFE mutation - can result in CHF, bronze diabetes and increased risk of HCC
hepatocellular carcinoma
cirrhotic liver - a/w hep B and C
hereditary bleeding d/o
von Willebrand’s dz
hereditary harmless jaundice
Gilbert’s syndrome - benign congenital unconjugated hyperbilirubinemia
HLA B27
ankylosing sponydlitis, Reiter’s syndrome, ulcerative colitis, psoriasis
HLA DR3 or DR4
DM type I, RA, SLE
holosystolic murmur
VSD, tricuspid regurg, mitral regurg
hypercoagulability, endothelial damage, blood stasis
Virchow’s triad - results in venous thrombosis
HTN, secondary
renal dz
hypoparathyrodisim
ccidnetal excision during thyroidectomy
hypopituitarism
pituitary adenoma - usually benign
infxn 2/2 blood transfusion
hep c
infections in chronic granulomatous dz
staph aureus, e coli, aspergillus (catalase positive)
kidney stones
calcium = radioopaque
struvite (ammonium) = radioopaque - formed by urease-positive organisms such as proteus or staphy
uric acid = radiolucent
late cyanotic shunt (uncorrected L –> R becomes R –> L)
Eisenmenger’s syndrome - c/b ASD, VSD, PDA; results in pulm HTN/polycythemia
liver dz
alcoholic cirrhosis
lysosomal storage dz
Gaucher’s dz
male CA
prostatic CA
malignancy a/w noninfectious fever
Hodgkins lymphoma
malignant skin tumor
basal cell carcinoma - rarely metastasizes
mental retardation
Down syndrome
fragile X syndrome
metastases to bone
breast, lung, thyroid, testes, prostate, kidney
metstases to brain
lung, breast, skin (melanoma), kidney (RCC), GI
mets to liver
colon, gastric, pancreatic, breast and lung carcinoma
mitrochondrial inheritance
dz occurs in both males and females, inherited thru females only
mitral valve stenosis
rheumatic heart dz
mixed (UMN and LMN) motor neuron dz
ALS
myocarditis
coxsackie B
neoplasm - kids
ALL
cerebellar medulloblastoma
nephrotic syndrome - adults
focal segmental glomerulosclerosis
nephrotic syndrome - kids
minimal change dz - a/w infections/vaccinations; tx with corticosteroids
neuron migration failure
Kallman syndrome
nosocomial pneumonia
klebsiella, e coli, pseudomonas
obstruction of male urinary tract
BPH
opening snap
mitral stenosis
opportunisitc infxn in AIDS
pneumocystic jiroveci pneumonia
osteomyelitis
staph aureus
osteomyelitis in sickle cell dz
salmonella
ostemyelitis with IV drug use
pseudomonas, staph aureus
ovarian mets from gastric carcinoma or breast CA
krukenberg tumor - mucin secreting signet ring cells
ovarian tumor - benign, bilateral
serous cystadenoma
ovarian tumor - malignant
serous cystadenocarcinoma
pancreatitis - acute
gallstones, alcohol
pancreatitis - chronic
alcohol (adults), CF (kids)
pt with ALL/ CLL/ AML/ CML
ALL: child
CLL: adult > 60
AML: adult ~60
CML: adult 30-60
pelvic inflammatory dz
neisseria gonorrhoeae - monoarticular arthritis
philadelphia chromosome t(9;22) - bcr/abl
CML - may sometimes be a/w ALL/AML
pituitary tumor
prolactinoma
somatotrpic acidophilic adenoma
primary amenorrhea
turner syndrome - 45X0
primary bone tumor - adults
multiple myeloma
primary hyperaldosteronism
adenoma of adrenal cortex
primary hyperparathyroidism
adenomas
hyperplasia
carcinoma
primary liver CA
HCC - chronic hepatitis, cirrhosis, hemochromatosis, alpha1-antitrypsin
pulmonary HTN
COPD
recurrent inflammation/thrombosis of small/medium vsls in extremities
Buerger’s dz - strongly a/w tobacco
renal tumor
renal cell carcinoma: a/w von Hippel Lindaue and adult polycystic kidney dz; paraneoplastic syndromes - EPO, renin, PTH, ACTH
right heart failure d/t pulmonary cause
cor pulmonale
S3 - protodiastolic gallop
increased ventricular filling
L–> R shunt, mitral regurg, LV failure
S4 - presystolic gallop
stiff/hypertrophic ventricle - aortic stensosi, restrictive cardiomyopathy
secondary hyperparathyroidism
hypocalcemia of chronic kidney dz
STD
chlamydia - usually coinfected with gonorrhea
SIADH
small cell CA of lung
site of diverticular
sigmoid colon
sites of ahterosclerosis
abd aorta > coronary > popliteal > carotid
stomach CA
adenoCA
stomach ulcerations and high gastrin levels
Zollinger-Ellison syndrome - gastinoma of duodenum or pancreas
t(14:18)
follicular lymphoma - bcl-2 activation
t(8;14)
Burkitt lymphoma - c myc activation
t(9;22)
philadelphia chromosome - CML - bcr/abl fusion
temporal arteritis
risk of ipsilateral blindness d/t thrombosis of ophthalmic artery; polymyalgia rheumatica
testicular tumor
seminoma
thyroid CA
papillary CA
tumor in women
leiomyoma - estrogen dpt, not precancerous
tumor of infancy
hemangioma - usually regresses spontaneously
tumor of adrenal medulla - adults
pheochromocytoma - usually benign
tumor of adrenal medulla - kids
neuroblastoma - malig
type of Hodgkins
nodular sclerosis - vs mixed cellularity, lymphocytic predominance, lymphocytic depletion
type of non Hodgkins
diffuse large cell
UTI
e coli, staph saprophyticus (young women)
viral encephalitis affecting temporal lobe
HSV1
vitamin deficiency
folic acid - pregnant women at high risk; body stores only 3-4 mo supply; prevents neural tube defects