Rapid Review - First Aid Flashcards
Classic Presentations:
- gout
- intellectual disability
- self-mutilating behavior
- male
Lesch-Nyhan Syndrome
- HGPRT deficiency
- X-linked recessive
Classic Presentations:
- situs inversus
- chronic sinusitis
- bronchiectasis
- infertility
Kartagener Syndrome
- dynein arm defect affecting cilia
Classic Presentations:
- blue sclera
Osteogenesis Imperfecta
- type I collagen defect
Classic Presentations:
- elastic skin
- hypermobility of joints
- ↑ bleeding tendency
Ehlers-Danlos Syndrome
- type V collagen defect
- type III collagen defect seen in vascular subtype of ED
Classic Presentations:
- arachnodactyly
- lens dislocation (upward)
- aortic dissection
- hyperflexible joints
Marfan Syndrome
- fibrillin defect
Classic Presentations:
- café-au-lait spots (unilateral)
- polyostotic fibrous dysplasia
- precocious puberty
- multiple endocrine abnormalities
McCune-Albright Syndrome
- mosaic G-protein signaling mutation
Classic Presentations:
- calf pseudohypertrophy
Muscular Dystrophy
- most commonly Duchenne
- due to X-linked recessive frameshift mutation of dystrophin gene
Classic Presentations:
- child uses arms to stand up from squat
Duchenne Muscular Dystrophy
- Gowers sign
Classic Presentations:
- slow, progressive muscle weakness in boys
Becker Muscular Dystrophy
- X-linked missense mutation in dystrophin
- less severe than Duchenne
Classic Presentations:
- cleft lip/palate
- microcephaly or holoprosencephaly
- polydactyly
- cutis aplasia
Patau Syndrome
- Trisomy 13
Classic Presentations:
- microcephaly
- rocker-bottom feet
- clenched hands
- structural heart defect
Edwards Syndrome
- Trisomy 18
Classic Presentations:
- single palmar crease
Down Syndrome
Classic Presentations:
- dilated cardiomyopathy
- edema
- alcoholism or malnutrition
Wet Beriberi
- thiamine (vitamin B1) deficiency
Classic Presentations:
- dermatitis
- dementia
- diarrhea
Pellagra
- niacin (vitamin B3) deficiency
Classic Presentations:
- swollen gums
- mucosal bleeding
- poor wound healing
- petechiae
Scurvy
- vitamin C deficiency
- can’t hydroxylate proline/lysine for collagen synthesis
Classic Presentations:
- chronic exercise intolerance
- myalgia
- fatigue
- painful cramps
- myoglobinuria
McArdle Disease
- skeletal muscle glycogen phosphorylase deficiency
Classic Presentations:
- infant
- hypoglycemia
- hepatomegaly
Cori Disease
- debranching enzyme deficiency
Von Gierke disease
- glucose-6-phosphatase deficiency
- more severe
Classic Presentations:
- myopathy (infantile hypertrophic cardiomyopathy
- exercise intolerance
Pompe Disease
- lysosomal α-1,4-glucosidase deficiency
Classic Presentations:
- “cherry-red spots” on macula
Tay-Sachs
- ganglioside accumulation
Niemann-Pick
- sphingomyelin accumulation
Central Retinal Artery Occlusion
Classic Presentations:
- hepatosplenomegaly
- pancytopenia
- osteoporosis
- aseptic necrosis of femoral head
- bone crises
Gaucher Disease
- glucocerebrosidase deficiency
Classic Presentations:
- achilles tendon xanthoma
Familial Hypercholesterolemia
- ↓ LDL receptor signaling
Classic Presentations:
- anaphylaxis following blood transfusion
IgA Deficiency
Classic Presentations:
- male child
- recurrent infections
- no mature B cells
Bruton Disease
- X-linked agammaglobulinemia
Classic Presentations:
- recurrent cold (noninflamed) abscesses
- unusual eczema
- high serum IgE
Hyper-IgE Syndrome
- Job Syndrome
- neutrophil chemotaxis abnormality
Classic Presentations:
- strawberry tongue
- Scarlet Fever
- Kawasaki Disease
Classic Presentations:
- adrenal hemorrhage
- hypotension
- DIC
Waterhouse-Friderichsen Syndrome
- meningococcemia
Classic Presentations:
- red “currant jelly” sputum
- alcoholic or diabetic patients
Klebsiella pneumoniae Pneumonia
Classic Presentations:
- large rash with bull’s-eye appearance
Erythema Chronicum Migrans
- Ixodes tick bite
- Lyme Disease: Borrelia
Classic Presentations:
- indurated, ulcerated genital lesion
- Nonpainful: chancre (1° syphilis, Treponema pallidum)
- Painful, with exudate: chancroid (Haemophilus ducreyi)
Classic Presentations:
- pupil accommodates but doesn’t react
Neurosyphilis
- Argyll Robertson pupil
Classic Presentations:
- smooth, moist, painless, wart-like white lesions on genitals
Condylomata Lata
- 2° syphilis
Classic Presentations:
- fever, chills, headache, and myalgia following antibiotic treatment for syphilis
Jarisch-Herxheimer Reaction
- rapid lysis of spirochetes results in endotoxin-like release
Classic Presentations:
- dog or cat bite resulting in infection
- Pasteurella multocida*
- cellulitis at inoculation site)
Classic Presentations:
- rash on palms and soles
- Coxsackie A
- 2° Syphilis
- Rocky Mountain Spotted Fever
Classic Presentations:
- black eschar on face
- diabetic ketoacidosis
Mucor or Rhizopus fungal infection
Classic Presentations:
- chorioretinitis
- hydrocephalus
- intracranial calcifications
Congenital Toxoplasmosis
Classic Presentations:
- fever
- cough
- conjunctivitis
- coryza
- diffuse rash
Measles
Classic Presentations:
- small, irregular red spots on buccal/lingual mucosa with blue-white centers
Koplik Spots
- measles (rubeola) virus
Classic Presentations:
- back pain
- fever
- night sweats
Pott Disease
- vertebral TB
Classic Presentations:
- child with fever later develops red rash on face that spreads to body
Erythema Infectiosum/Fifth Disease
- “slapped cheeks” appearance
- Parvovirus B19
Classic Presentations:
- abdominal pain
- diarrhea
- leukocytosis
- recent antibiotic use
Clostridium difficile
Classic Presentations:
- bounding pulses
- wide pulse pressure
- diastolic heart murmur
- head bobbing
Aortic Regurgitation
Classic Presentations:
- systolic ejection murmur (crescendo-decrescendo)
Aortic Stenosis
Classic Presentations:
- continuous “machine-like” heart murmur
PDA
- close with indomethacin
- keep open with PGE analogs
Classic Presentations:
- chest pain on exertion
Angina
- stable: with moderate exertion
- unstable: with minimal exertion or at rest
Classic Presentations:
- chest pain
- ST depression on ECG
- Angina (⊝ troponins)
- NSTEMI (⊕ troponins)
Classic Presentations:
- chest pain
- pericardial effusion/friction rub
- persistent fever following MI
Dressler Syndrome
- autoimmune-mediated post-MI fibrinous pericarditis
- 2 weeks to several months after acute episode
Classic Presentations:
- painful, raised red lesions on pads of fingers/toes
Osler Nodes
- infective endocarditis
- immune complex deposition
Classic Presentations:
- painless erythematous lesions on palms and soles
Janeway Lesions
- infective endocarditis
- septic emboli/microabscesses
Classic Presentations:
- splinter hemorrhages in fingernails
Bacterial Endocarditis
Classic Presentations:
- retinal hemorrhages with pale centers
Roth Spots
- bacterial endocarditis
Classic Presentations:
- distant heart sounds
- distended neck veins
- hypotension
Beck Triad
- cardiac tamponade
Classic Presentations:
- cervical lymphadenopathy
- desquamating rash
- coronary aneurysms
- red conjunctivae and tongue
- hand-foot changes
Kawasaki Disease
- treat with IVIG and aspirin
Classic Presentations:
- palpable purpura on buttocks/legs
- joint pain
- abdominal pain (child)
- hematuria
Henoch-Schönlein Purpura
- IgA vasculitis affecting skin and kidneys
Classic Presentations:
- telangiectasias
- recurrent epistaxis
- skin discoloration
- arteriovenous malformations
- GI bleeding
- hematuria
Hereditary Hemorrhagic Telangiectasia
- Osler-Weber-Rendu Syndrome
Classic Presentations:
- skin hyperpigmentation
- hypotension
- fatigue
1° Adrenocortical Insufficiency
- Addison Disease
- causes ↑ ACTH and ↑ α-MSH production
Classic Presentations:
- cold intolerance
Hypothyroidism
Classic Presentations:
- cutaneous/dermal edema due to deposition of mucopolysaccharides in connective tissue
Myxedema
- caused by hypothyroidism
- Graves Disease—pretibial
Classic Presentations:
- facial muscle spasm upon tapping
Chvostek Sign
- hypocalcemia
Classic Presentations:
- no lactation postpartum
- absent menstruation
- cold intolerance
Sheehan Syndrome
- postpartum hemorrhage leading to pituitary infarction
Classic Presentations:
- deep, labored breathing/hyperventilation
Diabetic Ketoacidosis
- Kussmaul respirations
Classic Presentations:
- cutaneous flushing
- diarrhea
- bronchospasm
Carcinoid Syndrome
- right-sided cardiac valvular lesions
- ↑ 5-HIAA
Classic Presentations:
- pancreatic, pituitary, parathyroid tumors
MEN 1
- autosomal dominant
Classic Presentations:
- thyroid tumors
- pheochromocytoma
- ganglioneuromatosis
- Marfanoid habitus
MEN 2B
- autosomal dominant RET mutation
Classic Presentations:
- thyroid and parathyroid tumors
- pheochromocytoma
MEN 2A
- autosomal dominant RET mutation
Classic Presentations:
- jaundice
- palpable distended non-tender gallbladder
Courvoisier Sign
- distal malignant obstruction of biliary tree
Classic Presentations:
- painless jaundice
Cancer of the Pancreatic Head
- obstruction of the bile duct
Classic Presentations:
- vomiting blood following gastroesophageal lacerations
Mallory-Weiss Syndrome
- alcoholic and bulimic patients
Classic Presentations:
- dysphagia (esophageal webs)
- glossitis
- iron deficiency anemia
Plummer-Vinson Syndrome
- may progress to esophageal squamous cell carcinoma
Classic Presentations:
- enlarged, hard left supraclavicular node
Virchow Node
- abdominal metastasis
Classic Presentations:
- weight loss
- diarrhea
- arthritis
- fever
- adenopathy
Whipple Disease
- Tropheryma whipplei
Classic Presentations:
- severe RLQ pain with palpation of LLQ
Rovsing Sign
- acute appendicitis
Classic Presentations:
- severe RLQ pain with deep tenderness
McBurney Sign
- acute appendicitis
Classic Presentations:
- hamartomatous GI polyps
- hyperpigmentation of mouth/feet/hands/genitalia
Peutz-Jeghers Syndrome
- inherited, benign polyposis can cause bowel obstruction
- ↑ cancer risk, mainly GI
Classic Presentations:
- multiple colon polyps
- osteomas/soft tissue tumors
- impacted/supernumerary teeth
Gardner Syndrome
- subtype of FAP
Classic Presentations:
- abdominal pain
- ascites
- hepatomegaly
Budd-Chiari Syndrome
- posthepatic venous thrombosis
Classic Presentations:
- severe jaundice in neonate
Crigler-Najjar Syndrome
- congenital unconjugated hyperbilirubinemia
Classic Presentations:
- golden brown rings around peripheral cornea
Wilson Disease
- Kayser-Fleischer rings due to copper accumulation
Classic Presentations:
- fat
- female
- forty
- fertile
- familial
Cholelithiasis
- gallstones
Classic Presentations:
- short stature
- café-au-lait spots
- thumb/radial defects
- ↑ incidence of tumors/leukemia
- aplastic anemia
Fanconi Anemia
- genetic loss of DNA crosslink repair
- often progresses to AML
Classic Presentations:
- red urine in the morning
- fragile RBCs
Paroxysmal Nocturnal Hemoglobinuria
Classic Presentations:
- painful blue fingers/toes
- hemolytic anemia
Cold Agglutinin Disease
- autoimmune hemolytic anemia
- caused by Mycoplasma pneumoniae, infectious mononucleosis, and CLL
Classic Presentations:
- mucosal bleeding
- prolonged bleeding time
Glanzmann Thrombasthenia
- defect in platelet aggregation due to lack of GpIIb/IIIa
Classic Presentations:
- fever
- night sweats
- weight loss
B Symptoms of Lymphoma
Classic Presentations:
- erythroderma
- lymphadenopathy
- hepatosplenomegaly
- atypical T cells
Mycosis Fungoides
- cutaneous T-cell lymphoma
Sézary Syndrome
- mycosis fungoides + malignant T cells in blood
Classic Presentations:
- WBCs that look “smudged”
CLL
Classic Presentations:
- athlete
- polycythemia
2° to Erythropoietin Injection
Classic Presentations:
- neonate with arm paralysis following difficult birth
- arm in “waiter’s tip” position
Erb-Duchenne Palsy
- superior trunk (C5–C6) brachial plexus injury
Classic Presentations:
- anterior “drawer sign” ⊕
Anterior Cruciate Ligament Injury
Classic Presentations:
- bone pain
- bone enlargement
- arthritis
Paget Disease of Bone
- ↑ osteoblastic and osteoclastic activity
Classic Presentations:
- swollen, hard, painful finger joints in an elderly individual
- pain worse with activity
Osteoarthritis
- osteophytes
- PIP—Bouchard nodes
- DIP—Heberden nodes
Classic Presentations:
- sudden swollen/painful big toe joint
- tophi
Gout/Podagra
- hyperuricemia
Classic Presentations:
- dry eyes
- dry mouth
- arthritis
Sjögren Syndrome
- autoimmune destruction of exocrine glands
Classic Presentations:
- urethritis
- conjunctivitis
- arthritis
- male
Reactive Arthritis
- HLA-B27
Classic Presentations:
- “butterfly” facial rash
- Raynaud phenomenon
- young female
Systemic Lupus Erythematosus
Classic Presentations:
- painful fingers/toes changing color from white to blue to red with cold or stress
Raynaud Phenomenon
- vasospasm in extremities
Classic Presentations:
- anticentromere antibodies
Scleroderma
- CREST
Classic Presentations:
- dark purple skin/mouth nodules in a patient with AIDS
Kaposi Sarcoma
- associated with HHV-8
Classic Presentations:
- anti-desmoglein (anti-desmosome) antibodies
Pemphigus Vulgaris
- blistering
Classic Presentations:
- pruritic, purple, polygonal planar papules and plaques
Lichen Planus
Classic Presentations:
- ↑ AFP in amniotic fluid/maternal serum
- Dating Error
- Open Neural Tube Defects
- anencephaly
- spina bifida
Classic Presentations:
- toe extension/fanning upon plantar scrape
Babinski Sign
- UMN lesion
Classic Presentations:
- hyperphagia
- hypersexuality
- hyperorality
- hyperdocility
Klüver-Bucy Syndrome
- bilateral amygdala lesion
Classic Presentations:
- lucid interval after traumatic brain injury
Epidural Hematoma
- middle meningeal artery rupture
Classic Presentations:
- “worst headache of my life”
Subarachnoid Hemorrhage
Classic Presentations:
- resting tremor
- rigidity
- akinesia
- postural instability
- shuffling gait
Parkinson Disease
- loss of dopaminergic neurons in substantia nigra pars compacta
Classic Presentations:
- chorea
- dementia
- caudate degeneration
Huntington Disease
- autosomal dominant CAG repeat expansion
Classic Presentations:
- nystagmus
- intention tremor
- scanning speech
- bilateral internuclear ophthalmoplegia
Multiple Sclerosis
Classic Presentations:
- rapidly progressive limb weakness that ascends following GI/upper respiratory infection
Guillain-Barré Syndrome
- acute inflammatory demyelinating polyradiculopathy subtype
Classic Presentations:
- café-au-lait spots
- Lisch nodules (iris hamartoma)
- cutaneous neurofibromas
- pheochromocytomas
- optic gliomas
Neurofibromatosis Type I
Classic Presentations:
- vascular birthmark (port-wine stain) of the face
Nevus Flammeus
- benign
- associated with Sturge-Weber syndrome
Classic Presentations:
- renal cell carcinoma (bilateral)
- hemangioblastomas
- angiomatosis
- pheochromocytoma
von Hippel-Lindau Disease
- dominant tumor suppressor gene mutation
Classic Presentations:
- bilateral acoustic schwannomas
Neurofibromatosis Type 2
Classic Presentations:
- hyperreflexia
- hypertonia
- Babinski sign present
UMN damage
Classic Presentations:
- hyporeflexia
- hypotonia
- atrophy
- fasciculations
LMN damage
Classic Presentations:
- unilateral facial drooping involving forehead
LMN Facial Nerve (CN VII) Palsy
- UMN lesions spare the forehead
Classic Presentations:
- episodic vertigo
- tinnitus
- hearing loss
Meniere Disease
Classic Presentations:
- ptosis
- miosis
- anhidrosis
Horner Syndrome
- sympathetic chain lesion
Classic Presentations:
- conjugate horizontal gaze palsy
- horizontal diplopia
Internuclear Ophthalmoplegia
- damage to MLF
- may be unilateral or bilateral
Classic Presentations:
- polyuria
- renal tubular acidosis type II
- growth failure
- electrolyte imbalances
- hypophosphatemic rickets
Fanconi Syndrome
- multiple combined dysfunction of the proximal convoluted tubule
Classic Presentations:
- bluish line on gingiva
Burton Line
- lead poisoning
Classic Presentations:
- periorbital and/or peripheral edema
- proteinuria (> 3.5g/day)
- hypoalbuminemia
- hypercholesterolemia
Nephrotic Syndrome
Classic Presentations:
- hereditary nephritis
- sensorineural hearing loss
- cataracts
Alport Syndrome
- mutation in collagen IV
Classic Presentations:
- streak ovaries
- congenital heart disease
- horseshoe kidney
- cystic hygroma at birth
- short stature
- webbed neck
- lymphedema
Turner Syndrome (45,XO)
Classic Presentations:
- red, itchy, swollen rash of nipple/areola
Paget Disease of the Breast
- sign of underlying neoplasm
Classic Presentations:
- fibrous plaques in soft tissue of penis
- abnormal curvature
Peyronie Disease
- connective tissue disorder
Classic Presentations:
- hypoxemia
- polycythemia
- hypercapnia
Chronic Bronchitis
- hyperplasia of mucous cells
- “blue bloater”
Classic Presentations:
- pink complexion
- dyspnea
- hyperventilation
Emphysema
- “pink puffer”
- centriacinar—smoking
- panacinar—α1-antitrypsin deficiency
Classic Presentations:
- bilateral hilar adenopathy
- uveitis
Sarcoidosis
- noncaseating granulomas
Classic Labs/Findings:
- ↓ AFP in amniotic fluid/maternal serum
Down Syndrome
- chromosomal abnormalities
Classic Labs/Findings:
- large granules in phagocytes
- immunodeficiency
Chédiak-Higashi Disease
- congenital failure of phagolysosome formation
Classic Labs/Findings:
- recurrent infections
- eczema
- thrombocytopenia
Wiskott-Aldrich Syndrome
Classic Labs/Findings:
- branching gram ⊕ rods with sulfur granules
Actinomyces israelii
Classic Labs/Findings:
- Optochin sensitivity
- Sensitive: S. pneumoniae
- Resistant: viridans streptococci (S. mutans, S. sanguis)
Classic Labs/Findings:
- Novobiocin sensitivity
- Sensitive: S. epidermidis
- Resistant: S. saprophyticus
Classic Labs/Findings:
- Bacitracin sensitivity
- Sensitive: S. pyogenes (group A)
- Resistant: S. agalactiae (group B)
Classic Labs/Findings:
- Streptococcus bovis bacteremia
Colon Cancer
Classic Labs/Findings:
- hilar lymphadenopathy
- peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon Complex
- 1° TB: Mycobacterium bacilli
Classic Labs/Findings:
- bacteria-covered vaginal epithelial cells
“Clue Cells”
- Gardnerella vaginalis
Classic Labs/Findings:
- ring-enhancing brain lesion on CT/MRI in AIDS
- Toxoplasma gondii
- CNS Lymphoma
Classic Labs/Findings:
- cardiomegaly with apical atrophy
Chagas Disease
- Trypanosoma cruzi
Classic Labs/Findings:
- heterophile antibodies
Infectious Mononucleosis
- EBV
Classic Labs/Findings:
- intranuclear eosinophilic droplet-like bodies
Cowdry Type A Bodies
- HSV
- VZV
Classic Labs/Findings:
- eosinophilic globule in liver
Councilman Body
- viral hepatitis
- yellow fever
- represents hepatocyte undergoing apoptosis
Classic Labs/Findings:
- “steeple” sign on frontal CXR
Croup
- parainfluenza virus
Classic Labs/Findings:
- eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri Bodies
- rabies
Classic Labs/Findings:
- atypical lymphocytes
EBV
Classic Labs/Findings:
- enlarged cells with intranuclear inclusion bodies
CMV
- “owl eye” appearance
Classic Labs/Findings:
- “thumb sign” on lateral neck x-ray
Epiglottitis
- Haemophilus influenzae
Classic Labs/Findings:
- “delta wave” on ECG
- short PR interval
- supraventricular tachycardia
Wolff-Parkinson-White Syndrome
- Bundle of Kent bypasses AV node
Classic Labs/Findings:
- “boot-shaped” heart on x-ray
Tetralogy of Fallot
- due to RVH
Classic Labs/Findings:
- rib notching (inferior surface, on x-ray)
Coarctation of the Aorta
Classic Labs/Findings:
- heart nodules (granulomatous)
Aschoff Bodies
- rheumatic fever
Classic Labs/Findings:
- electrical alternans (alternating amplitude on ECG)
Pericardial Tamponade
Classic Labs/Findings:
- hypertension
- hypokalemia
- metabolic alkalosis
1° Hyperaldosteronism
- Conn Syndrome
Classic Labs/Findings:
- enlarged thyroid cells with ground-glass nuclei with central clearing
“Orphan Annie” Eyes Nuclei
- papillary carcinoma of the thyroid
Classic Labs/Findings:
- antineutrophil cytoplasmic antibodies (ANCAs)
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
Classic Labs/Findings:
- mucin-filled cell with peripheral nucleus
“Signet Ring”
- gastric carcinoma
Classic Labs/Findings:
- anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac Disease
- diarrhea
- weight loss
Classic Labs/Findings:
- narrowing of bowel lumen on barium x-ray
“String Sign”
- Crohn Disease
Classic Labs/Findings:
- “lead pipe” appearance of colon on abdominal imaging
Ulcerative Colitis
- loss of haustra
Classic Labs/Findings:
- thousands of polyps on colonoscopy
Familial Adenomatous Polyposis
- autosomal dominant
- mutation of APC gene
Classic Labs/Findings:
- “apple core” lesion on barium enema x-ray
Colorectal Cancer
- usually left-sided
Classic Labs/Findings:
- eosinophilic cytoplasmic inclusion in liver cell
Mallory Body
- alcoholic liver disease
Classic Labs/Findings:
- triglyceride accumulation in liver cell vacuoles
Fatty Liver Disease
- alcoholic
- metabolic syndrome
Classic Labs/Findings:
- “nutmeg” appearance of liver
Chronic Passive Congestion of Liver
- right heart failure
- Budd-Chiari Syndrome
Classic Labs/Findings:
- antimitochondrial antibodies (AMAs)
1° Biliary Cirrhosis
- female
- cholestasis
- portal hypertension
Classic Labs/Findings:
- low serum ceruloplasmin
Wilson Disease
- hepatolenticular degeneration
- Kayser-Fleischer rings due to copper accumulation
Classic Labs/Findings:
- migratory thrombophlebitis (leading to migrating DVTs and vasculitis)
Trousseau Syndrome
- adenocarcinoma of pancreas or lungs
Classic Labs/Findings:
- basophilic nuclear remnants in RBCs
Howell-Jolly Bodies
- due to splenectomy or nonfunctional spleen
Classic Labs/Findings:
- hypochromic, microcytic anemia
- Iron Deficiency Anemia
- Lead Poisoning
- Thalassemia—fetal hemoglobin sometimes present
Classic Labs/Findings:
- basophilic stippling of RBCs
- Lead Poisoning
- Sideroblastic Anemia
Classic Labs/Findings:
- “hair on end” (“crew-cut”) appearance on x-ray
Marrow Expansion
- β-Thalassemia
- Sickle Cell Disease
Classic Labs/Findings:
- hypersegmented neutrophils
Megaloblastic Anemia
- B12 deficiency: neurologic symptoms
- folate deficiency: no neurologic symptoms
Classic Labs/Findings:
- antiplatelet antibodies
Idiopathic Thrombocytopenic Purpura
Classic Labs/Findings:
- high level of d-dimers
- DVT
- PE
- DIC
Classic Labs/Findings:
- giant B cells with bilobed nuclei with prominent inclusions (“owl’s eye”)
Reed-Sternberg Cells
- Hodgkin Lymphoma
Classic Labs/Findings:
- sheets of medium-sized lymphoid cells with scattered pale, tingible body–laden macrophages (“starry sky” histology)
Burkitt Lymphoma
- t(8:14) c-myc activation
- associated with EBV
- “starry sky” made up of malignant cells
Classic Labs/Findings:
- lytic (“punched-out”) bone lesions on x-ray
Multiple Myeloma
Classic Labs/Findings:
- monoclonal antibody spike
- Multiple Myeloma (usually IgG or IgA)
- Monoclonal Gammopathy of Undetermined Significance (MGUS consequence of aging)
- Waldenström (M protein = IgM) Macroglobulinemia
- Primary Amyloidosis
Classic Labs/Findings:
- stacks of RBCs
Rouleaux Formation
- high ESR
- multiple myeloma
Classic Labs/Findings:
- azurophilic peroxidase ⊕ granular inclusions in granulocytes and myeloblasts
Auer Rods
- AML, especially the promyelocytic (M3) type
Classic Labs/Findings:
- WBCs that look “smudged”
CLL
- almost always B cell
Classic Labs/Findings:
- “tennis racket”-shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck Granules
- Langerhans Cell Histiocytosis
Classic Labs/Findings:
- “brown” tumor of bone
Hyperparathyroidism or Osteitis Fibrosa Cystica
- deposited hemosiderin from hemorrhage gives brown color
Classic Labs/Findings:
- raised periosteum (creating a “Codman triangle”)
Aggressive Bone Lesion
- Osteosarcoma
- Ewing Sarcoma
- Osteomyelitis
Classic Labs/Findings:
- “soap bubble” in femur or tibia on x-ray
Giant Cell Tumor of Bone
- generally benign
Classic Labs/Findings:
- “onion skin” periosteal reaction
Ewing Sarcoma
- malignant small blue cell tumor
Classic Labs/Findings:
- anti-IgG antibodies
Rheumatoid Arthritis
- systemic inflammation
- joint pannus
- boutonniere and swan neck deformities
Classic Labs/Findings:
- rhomboid crystals
- ⊕ birefringent
Pseudogout
- calcium pyrophosphate dihydrate crystals
Classic Labs/Findings:
- needle-shaped crystals
- ⊝ birefringent
Gout
- monosodium urate crystals
Classic Labs/Findings:
- ↑ uric acid levels
- Gout
- Lesch-Nyhan Syndrome
- Tumor Lysis Syndrome
- Loop and Thiazide Diuretics
Classic Labs/Findings:
- “bamboo spine” on x-ray
Ankylosing Spondylitis
- chronic inflammatory arthritis
- HLA-B27
Classic Labs/Findings:
- antinuclear antibodies (ANAs: anti-Smith and antidsDNA)
SLE
- type III hypersensitivity