First Aid Rapid Review 2014
Classic Presentations, Classic Labs/Findings, Classic/Relevant Treatments, & Key Associations from First Aid 2014 (Equation Review omitted). dec = decreased, inc = increased; + = positive; 1° = primary; 2° = secondary
Terms in this set (452)
Abdominal pain, ascites, hepatomegaly. Disease/Dx?
Budd-Chiari syndrome (posthepatic venous thrombosis)
URI w/ palpable purpura, hematuria & oliguria. Dx?
IgA nephropathy (Burger's), usually in kids (purpura=Henoch Shcholein purpura on butt and legs)
Achilles tendon xanthoma. Disease/Dx?
Familial hypercholesterolemia (dec LDL receptor signaling)
Multifactorial genetic mutation. Dx?
Adrenal hemorrhage, hypotension, DIC. Disease/Dx?
Waterhouse-Friderichsen syndrome (meningococcemia)
Anterior "drawer sign" (+). Disease/Dx?
Anterior cruciate ligament injury
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints. Disease/Dx?
Marfan syndrome (fibrillin defect)
Athlete with polycythemia. Disease/Dx?
2° to erythropoietin injection
Back pain, fever, night sweats, weight loss. Disease/Dx?
Pott disease (vertebral TB)
Bilateral hilar adenopathy, uveitis. Disease/Dx?
Sarcoidosis (noncaseating granulomas)
Blue sclera. Disease/Dx?
Osteogenesis imperfecta (type I collagen defect)
Bluish line on gingiva. Disease/Dx?
Burton line (lead poisoning)
Bone pain, bone enlargement, arthritis. Disease/Dx?
Paget disease of bone (inc osteoblastic and osteoclastic activity)
Bounding pulses, diastolic heart murmur, head bobbing. Disease/Dx?
"Butterfly" facial rash and Raynaud phenomenon in a young female. Disease/Dx?
Systemic lupus erythematosus
Café-au-lait spots, Lisch nodules (iris hamartoma). Disease/Dx?
Neurofibromatosis type I (+ pheochromocytoma, optic gliomas)
Café-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities. Disease/Dx?
McCune-Albright syndrome (mosaic G-protein signaling mutation)
Calf pseudohypertrophy. Disease/Dx?
Muscular dystrophy (most commonly Duchenne): X-linked recessive deletion of dystrophin gene
"Cherry-red spots" on macula. Disease/Dx?
Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion
Chest pain on exertion. Disease/Dx?
Angina (stable: with moderate exertion; unstable: with minimal exertion)
Chest pain, pericardial effusion/friction rub, persistent fever following MI. Disease/Dx?
Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode)
Child uses arms to stand up from squat. Disease/Dx?
Gowers sign (Duchenne muscular dystrophy)
Child with fever later develops red rash on face that spreads to body. Disease/Dx?
"Slapped cheeks" (erythema infectiosum/fifth disease: parvovirus B19)
Chorea, dementia, caudate degeneration. Disease/Dx?
Huntington disease (autosomal dominant CAG repeat expansion)
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria. Disease/Dx?
McArdle disease (muscle glycogen phosphorylase deficiency)
Cold intolerance. Disease/Dx?
Conjugate lateral gaze palsy, horizontal diplopia. Disease/Dx?
Internuclear ophthalmoplegia (damage to MLF; bilateral [multiple sclerosis], unilateral [stroke])
Continuous "machine-like" heart murmur. Disease/Dx?
PDA (close with indomethacin; open or maintain with misoprostol)
Cutaneous/dermal edema due to connective tissue deposition. Disease/Dx?
Myxedema (caused by hypothyroidism, Graves disease [pretibial])
Dark purple skin/mouth nodules in a patient with AIDS. Disease/Dx?
Kaposi sarcoma, associated with HHV-8
Deep, labored breathing/hyperventilation. Disease/Dx?
Kussmaul respirations (diabetic ketoacidosis)
Dermatitis, dementia, diarrhea. Disease/Dx?
Pellagra (niacin [vitamin B3] deficiency)
Dilated cardiomyopathy, edema, alcoholism or malnutrition. Disease/Dx?
Wet beriberi (thiamine [vitamin B1] deficiency)
Dog or cat bite resulting in infection. Disease/Dx?
Pasteurella multocida (cellulitis at inoculation site)
Dry eyes, dry mouth, arthritis. Disease/Dx?
Sjögren syndrome (autoimmune destruction of exocrine glands)
Dysphagia (esophageal webs), glossitis, iron deficiency anemia. Disease/Dx?
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
Elastic skin, hypermobility of joints. Disease/Dx?
Ehlers-Danlos syndrome (type III collagen defect)
Enlarged, hard left supraclavicular node. Disease/Dx?
Virchow node (abdominal metastasis)
Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells. Disease/Dx?
Mycosis fungoides (cutaneous T-cell lymphoma) or Sézary syndrome (mycosis fungoides + malignant T cells in blood)
Facial muscle spasm upon tapping. Disease/Dx?
Chvostek sign (hypocalcemia)
Fat, female, forty, and fertile. Disease/Dx?
Fever, chills, headache, myalgia following antibiotic treatment for syphilis. Disease/Dx?
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
Fever, cough, conjunctivitis, coryza, diffuse rash. Disease/Dx?
Fever, night sweats, weight loss. Disease/Dx?
B symptoms (staging) of lymphoma
Fibrous plaques in soft tissue of penis. Disease/Dx?
Peyronie disease (connective tissue disorder)
Gout, intellectual disability, self-mutilating behavior in a boy. Disease/Dx?
Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)
Green-yellow rings around peripheral cornea. Disease/Dx?
Kayser-Fleischer rings (copper accumulation from Wilson disease)
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands. Disease/Dx?
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; inc cancer risk, mainly GI)
Hepatosplenomegaly, osteoporosis, neurologic symptoms. Disease/Dx?
Gaucher disease (glucocerebrosidase deficiency)
Hereditary nephritis, sensorineural hearing loss, cataracts. Disease/Dx?
Alport syndrome (mutation in collagen IV)
Hyperphagia, hypersexuality, hyperorality, hyperdocility. Disease/Dx?
Klüver-Bucy syndrome (bilateral amygdala lesion)
Hyperreflexia, hypertonia, Babinski sign present. Disease/Dx?
Hyporeflexia, hypotonia, atrophy, fasciculations. Disease/Dx?
Hypoxemia, polycythemia, hypercapnia. Disease/Dx?
"Blue bloater" (chronic bronchitis: hyperplasia of mucous cells)
Indurated, ulcerated genital lesion. Disease/Dx?
Nonpainful: chancre (1° syphilis, Treponema pallidum) Painful, with exudate: chancroid (Haemophilus ducreyi)
Infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia. Disease/Dx?
Patau syndrome (trisomy 13)
Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration. Disease/Dx?
Niemann-Pick disease (genetic sphingomyelinase deficiency)
Infant with hypoglycemia, failure to thrive, and hepatomegaly. Disease/Dx?
Cori disease (debranching enzyme deficiency) or Von Gierke disease (glucose-6-phosphatase deficiency, more severe)
Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect. Disease/Dx?
Edwards syndrome (trisomy 18)
Jaundice, palpable distended non-tender gallbladder. Disease/Dx?
Courvoisier sign (distal obstruction of biliary tree)
Large rash with bull's-eye appearance. Disease/Dx?
Erythema chronicum migrans from Ixodes tick bite (Lyme disease: Borrelia)
Lucid interval after traumatic brain injury. Disease/Dx?
Epidural hematoma (middle meningeal artery rupture)
Male child, recurrent infections, no mature B cells. Disease/Dx?
Bruton disease (X-linked agammaglobulinemia)
Mucosal bleeding and prolonged bleeding time. Disease/Dx?
Glanzmann thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Muffled heart sounds, distended neck veins, hypotension. Disease/Dx?
Beck triad of cardiac tamponade
Multiple colon polyps, osteomas/soft tissue tumors, impacted/ supernumerary teeth. Disease/Dx?
Gardner syndrome (subtype of FAP)
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance. Disease/Dx?
Pompe disease (lysosomal α-1,4-glucosidase deficiency)
Neonate with arm paralysis following difficult birth. Disease/Dx?
Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip")
No lactation postpartum, absent menstruation, cold intolerance. Disease/Dx?
Sheehan syndrome (pituitary infarction)
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia. Disease/Dx?
Oscillating slow/fast breathing. Disease/Dx?
Cheyne-Stokes respirations (central apnea in CHF or inc intracranial pressure)
Painful blue fingers/toes, hemolytic anemia. Disease/Dx?
Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis)
Painful, pale, cold fingers/toes. Disease/Dx?
Raynaud phenomenon (vasospasm in extremities)
Painful, raised red lesions on pad of fingers/toes. Disease/Dx?
Osler nodes (infective endocarditis, immune complex deposition)
Painless erythematous lesions on palms and soles. Disease/Dx?
Janeway lesions (infective endocarditis, septic emboli/ microabscesses)
Painless jaundice. Disease/Dx?
Cancer of the pancreatic head obstructing bile duct
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria. Disease/Dx?
Henoch-Schönlein purpura (IgA vasculitis affecting skin and kidneys)
Pancreatic, pituitary, parathyroid tumors. Disease/Dx?
MEN 1 (autosomal dominant)
Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia. Disease/Dx?
Pink complexion, dyspnea, hyperventilation. Disease/Dx?
"Pink puffer" (emphysema: centriacinar [smoking], panacinar [α1-antitrypsin deficiency])
Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets. Disease/Dx?
Fanconi syndrome (proximal tubular reabsorption defect)
Pruritic, purple, polygonal planar papules and plaques (6 P's). Disease/Dx?
Ptosis, miosis, anhidrosis. Disease/Dx?
Horner syndrome (sympathetic chain lesion)
Pupil accommodates but doesn't react. Disease/Dx?
Argyll Robertson pupil (neurosyphilis)
Rapidly progressive leg weakness that ascends following GI/upper respiratory infection. Disease/Dx?
Guillain-Barré syndrome (acute autoimmune inflammatory demyelinating polyneuropathy)
Rash on palms and soles. Disease/Dx?
Coxsackie A, 2° syphilis, Rocky Mountain spotted fever
Recurrent colds, unusual eczema, high serum IgE. Disease/Dx?
Hyper-IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)
Red "currant jelly" sputum in alcoholic or diabetic patients. Disease/Dx?
Red "currant jelly" stools. Disease/Dx?
Acute mesenteric ischemia (adults), intussusception (infants)
Red, itchy, swollen rash of nipple/areola. Disease/Dx?
Paget disease of the breast (sign of underlying neoplasm)
Red urine in the morning, fragile RBCs. Disease/Dx?
Paroxysmal nocturnal hemoglobinuria
Renal cell carcinoma (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma. Disease/Dx?
von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
Resting tremor, rigidity, akinesia, postural instability. Disease/Dx?
Parkinson disease (nigrostriatal dopamine depletion)
Retinal hemorrhages with pale centers. Disease/Dx?
Roth spots (bacterial endocarditis)
Severe jaundice in neonate. Disease/Dx?
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
Severe RLQ pain with palpation of LLQ. Disease/Dx?
Rovsing sign (acute appendicitis)
Severe RLQ pain with rebound tenderness. Disease/Dx?
McBurney sign (acute appendicitis)
Short stature, inc incidence of tumors/leukemia, aplastic anemia. Disease/Dx?
Fanconi anemia (genetic loss of DNA crosslink repair; often progresses to AML)
Single palmar crease. Disease/Dx?
Situs inversus, chronic sinusitis, bronchiectasis, infertility. Disease/Dx?
Kartagener syndrome (dynein arm defect affecting cilia)
Skin hyperpigmentation, hypotension, fatigue. Disease/Dx?
Addison disease (1° adrenocortical insufficiency causes inc ACTH and inc α-MSH production)
Slow, progressive muscle weakness in boys. Disease/Dx?
Becker muscular dystrophy (X-linked missense mutation in dystrophin; less severe than Duchenne)
Small, irregular red spots on buccal/lingual mucosa with blue-white center. Disease/Dx?
Koplik spots (measles; rubeola virus)
Smooth, flat, moist, painless white lesions on genitals. Disease/Dx?
Condylomata lata (2° syphilis)
Splinter hemorrhages in fingernails. Disease/Dx?
"Strawberry tongue". Disease/Dx?
Scarlet fever, Kawasaki disease, toxic shock syndrome
Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema. Disease/Dx?
Turner syndrome (45,XO)
Sudden swollen/painful big toe joint, tophi. Disease/Dx?
Swollen gums, mucosal bleeding, poor wound healing, petechiae. Disease/Dx?
Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
Swollen, hard, painful finger joints. Disease/Dx?
Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP [Heberden nodes])
Systolic ejection murmur (crescendo-decrescendo). Disease/Dx?
Aortic valve stenosis
Thyroid and parathyroid tumors, pheochromocytoma. Disease/Dx?
MEN 2A (autosomal dominant ret mutation)
Thyroid tumors, pheochromocytoma, ganglioneuromatosis. Disease/Dx?
MEN 2B (autosomal dominant ret mutation)
Toe extension/fanning upon plantar scrape. Disease/Dx?
Babinski sign (UMN lesion)
Unilateral facial drooping involving forehead. Disease/Dx?
Facial nerve (LMN CN VII palsy)
Urethritis, conjunctivitis, arthritis in a male. Disease/Dx?
Reactive arthritis associated with HLA-B27
Vascular birthmark (port-wine stain). Disease/Dx?
Hemangioma (benign, but associated with Sturge-Weber syndrome)
Vomiting blood following gastroesophageal lacerations. Disease/Dx?
Mallory-Weiss syndrome (alcoholic and bulimic patients)
Weight loss, diarrhea, arthritis, fever, adenopathy. Disease/Dx?
Whipple disease (Tropheryma whipplei)
"Worst headache of my life". Disease/Dx?
Labs: Anticentromere antibodies. Disease/Dx?
Labs: Antidesmoglein (epithelial) antibodies. Disease/Dx?
Pemphigus vulgaris (blistering)
Labs: Anti-glomerular basement membrane antibodies. Disease/Dx?
Goodpasture syndrome (glomerulonephritis and hemoptysis)
Labs: Antihistone antibodies. Disease/Dx?
Drug-induced SLE (hydralazine, INH, phenytoin, procainamide)
Labs: Anti-IgG antibodies. Disease/Dx?
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonnière deformity)
Labs: Antimitochondrial antibodies (AMAs). Disease/Dx?
1° biliary cirrhosis (female, cholestasis, portal hypertension)
Labs: Antineutrophil cytoplasmic antibodies (ANCAs). Disease/Dx?
Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
Labs: Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA). Disease/Dx?
SLE (type III hypersensitivity)
Labs: Antiplatelet antibodies. Disease/Dx?
Idiopathic thrombocytopenic purpura
Labs: Anti-topoisomerase antibodies. Disease/Dx?
Diffuse systemic scleroderma
Labs: Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies. Disease/Dx?
Celiac disease (diarrhea, distention, weight loss)
Labs: "Apple core" lesion on abdominal x-ray. Disease/Dx?
Colorectal cancer (usually left-sided)
Labs: Azurophilic peroxidase, + granular inclusions in granulocytes and myeloblasts. Disease/Dx?
Auer rods (AML, especially the promyelocytic [M3] type)
Labs: Bacitracin response. Disease/Dx?
Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B)
Labs: "Bamboo spine" on x-ray. Disease/Dx?
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
Labs: Basophilic nuclear remnants in RBCs. Disease/Dx?
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
Labs: Basophilic stippling of RBCs. Disease/Dx?
Lead poisoning or sideroblastic anemia
Labs: Bloody tap on LP. Disease/Dx?
Labs: "Boot-shaped" heart on x-ray. Disease/Dx?
Tetralogy of Fallot, RVH
Labs: Branching gram-positive rods with sulfur granules. Disease/Dx?
Labs: Bronchogenic apical lung tumor on imaging. Disease/Dx?
Pancoast tumor (can compress sympathetic ganglion and cause Horner syndrome)
Labs: "Brown" tumor of bone. Disease/Dx?
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
Labs: Cardiomegaly with apical atrophy. Disease/Dx?
Chagas disease (Trypanosoma cruzi)
Labs: Cellular crescents in Bowman capsule. Disease/Dx?
Rapidly progressive crescentic glomerulonephritis
Labs: "Chocolate cyst" of ovary. Disease/Dx?
Endometriosis (frequently involves both ovaries)
Labs: Circular grouping of dark tumor cells surrounding pale. Disease/Dx?
Homer-Wright rosettes (neuroblastoma, medulloblastoma, neurofibrils retinoblastoma)
Labs: Colonies of mucoid Pseudomonas in lungs. Disease/Dx?
Cystic fibrosis (autosomal recessive mutation in CFTR gene --> fat-soluble vitamin deficiency and mucous plugs)
Labs: Decreased AFP in amniotic fluid/maternal serum. Disease/Dx?
Down syndrome or other chromosomal abnormality
Labs: Degeneration of dorsal column nerves. Disease/Dx?
Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
Labs: Depigmentation of neurons in substantia nigra. Disease/Dx?
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Labs: Desquamated epithelium casts in sputum. Disease/Dx?
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
Labs: Disarrayed granulosa cells in eosinophilic fluid. Disease/Dx?
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
Labs: Dysplastic squamous cervical cells with nuclear enlargement. Disease/Dx?
Koilocytes (HPV: predisposes to cervical cancer) and hyperchromasia
Labs: Enlarged cells with intranuclear inclusion bodies. Disease/Dx?
"Owl eye" appearance of CMV
Labs: Enlarged thyroid cells with ground-glass nuclei. Disease/Dx?
"Orphan Annie" eyes nuclei (papillary carcinoma of the thyroid)
Labs: Eosinophilic cytoplasmic inclusion in liver cell. Disease/Dx?
Mallory body (alcoholic liver disease)
Labs: Eosinophilic cytoplasmic inclusion in nerve cell. Disease/Dx?
Lewy body (Parkinson disease)
Labs: Eosinophilic globule in liver. Disease/Dx?
Councilman body (toxic or viral hepatitis, often yellow fever)
Labs: Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells. Disease/Dx?
Negri bodies of rabies
Labs: Extracellular amyloid deposition in gray matter of brain. Disease/Dx?
Senile plaques (Alzheimer disease)
Labs: Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye"). Disease/Dx?
Reed-Sternberg cells (Hodgkin lymphoma)
Labs: Glomerulus-like structure surrounding vessel in germ cells. Disease/Dx?
Schiller-Duval bodies (yolk sac tumor)
Labs: "Hair on end" (crew-cut) appearance on x-ray. Disease/Dx?
β-thalassemia, sickle cell anemia (marrow expansion)
Labs: hCG elevated. Disease/Dx?
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
Labs: Heart nodules (granulomatous). Disease/Dx?
Aschoff bodies (rheumatic fever)
Labs: Heterophile antibodies. Disease/Dx?
Infectious mononucleosis (EBV)
Labs: Hexagonal, double-pointed, needle-like crystals in bronchial secretions. Disease/Dx?
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
Labs: High level of D-dimers. Disease/Dx?
DVT, PE, DIC
Labs: Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify). Disease/Dx?
Ghon complex (1° TB: Mycobacterium bacilli)
Labs: "Honeycomb lung" on x-ray or CT. Disease/Dx?
Interstitial pulmonary fibrosis
Labs: Hypercoagulability (leading to migrating DVTs and vasculitis). Disease/Dx?
Trousseau syndrome (adenocarcinoma of pancreas or lung)
Labs: Hypersegmented neutrophils. Disease/Dx?
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
Labs: Hypertension, hypokalemia, metabolic alkalosis, muscle weakness. Disease/Dx?
(also low renin, normal Na)
Labs: Hypochromic, microcytic anemia. Disease/Dx?
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Labs: Increased AFP in amniotic fluid/maternal serum. Disease/Dx?
Dating error, anencephaly, spina bifida (neural tube defects)
Labs: Increased uric acid levels. Disease/Dx?
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
Labs: Intranuclear eosinophilic droplet-like bodies. Disease/Dx?
Cowdry type A bodies (HSV or CMV)
Labs: Iron-containing nodules in alveolar septum. Disease/Dx?
Ferruginous bodies (asbestosis: inc chance of mesothelioma)
Labs: Keratin pearls on a skin biopsy. Disease/Dx?
Squamous cell carcinoma
Labs: Large lysosomal vesicles in phagocytes, immunodeficiency. Disease/Dx?
Chédiak-Higashi disease (congenital failure of phagolysosome formation)
Labs: "Lead pipe" appearance of colon on barium enema x-ray. Disease/Dx?
Ulcerative colitis (loss of haustra)
Labs: Linear appearance of IgG deposition on glomerular basement. Disease/Dx?
Goodpasture syndrome membrane
Labs: Low serum ceruloplasmin. Disease/Dx?
Wilson disease (hepatolenticular degeneration)
Labs: "Lumpy bumpy" appearance of glomeruli on immunofluorescence. Disease/Dx?
Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
Labs: Lytic ("hole punched") bone lesions on x-ray. Disease/Dx?
Labs: Mammary gland ("blue domed") cyst. Disease/Dx?
Fibrocystic change of the breast
Labs: Monoclonal antibody spike. Disease/Dx?
* Multiple myeloma (usually IgG or IgA)
* Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
* Waldenström (M protein = IgM) macroglobulinemia or
Labs: Mucin-filled cell with peripheral nucleus. Disease/Dx?
"Signet ring" (gastric carcinoma)
Labs: Narrowing of bowel lumen on barium x-ray. Disease/Dx?
"String sign" (Crohn disease)
Labs: Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis. Disease/Dx?
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
Labs: Needle-shaped, negatively birefringent crystals. Disease/Dx?
Gout (monosodium urate crystals)
Labs: Nodular hyaline deposits in glomeruli. Disease/Dx?
Kimmelstiel-Wilson nodules (diabetic nephropathy)
Labs: Novobiocin response. Disease/Dx?
Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus
Labs: "Nutmeg" appearance of liver. Disease/Dx?
Chronic passive congestion of liver due to right heart failure
Labs: "Onion skin" periosteal reaction. Disease/Dx?
Ewing sarcoma (malignant round-cell tumor)
Labs: Optochin response. Disease/Dx?
Sensitive: Streptococcus pneumoniae; resistant: viridans streptococci
Labs: Periosteum raised from bone, creating triangular area. Disease/Dx?
Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)
Labs: Podocyte fusion or "effacement" on electron microscopy. Disease/Dx?
Minimal change disease (child with nephrotic syndrome)
Labs: Polished, "ivory-like" appearance of bone at cartilage erosion. Disease/Dx?
Eburnation (osteoarthritis resulting in bony sclerosis)
Labs: Protein aggregates in neurons from hyperphosphorylation of tau protein. Disease/Dx?
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
Labs: Psammoma bodies. Disease/Dx?
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
Labs: Pseudopalisading tumor cells on brain biopsy. Disease/Dx?
Labs: RBC casts in urine. Disease/Dx?
Labs: Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells. Disease/Dx?
Reinke crystals (Leydig cell tumor)
Labs: Renal epithelial casts in urine. Disease/Dx?
Acute toxic/viral renal injury
Labs: Rhomboid crystals, positively birefringent. Disease/Dx?
Pseudogout (calcium pyrophosphate dihydrate crystals)
Labs: Rib notching. Disease/Dx?
Coarctation of the aorta
Labs: Ring-enhancing brain lesion in AIDS. Disease/Dx?
Toxoplasma gondii, CNS lymphoma
Labs: Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology). Disease/Dx?
Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; "black sky" made up of malignant cells)
Labs: Silver-staining spherical aggregation of tau proteins in neurons. Disease/Dx?
Pick bodies (Pick disease: progressive dementia, changes in personality)
Labs: "Soap bubble" in femur or tibia on x-ray. Disease/Dx?
Giant cell tumor of bone (generally benign)
Labs: "Spikes" on basement membrane, "dome-like" subepithelial deposits. Disease/Dx?
Membranous glomerulonephritis (may progress to nephrotic syndrome)
Labs: Stacks of RBCs. Disease/Dx?
Rouleaux formation (high ESR, multiple myeloma)
Labs: Stippled vaginal epithelial cells. Disease/Dx?
"Clue cells" (Gardnerella vaginalis)
Labs: "Tennis racket"-shaped cytoplasmic organelles (EM) in Langerhans cells. Disease/Dx?
Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)
Labs: Thrombi made of white/red layers. Disease/Dx?
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
Labs: "Thumb sign" on lateral x-ray. Disease/Dx?
Epiglottitis (Haemophilus influenzae)
Labs: Thyroid-like appearance of kidney. Disease/Dx?
Chronic bacterial pyelonephritis
Labs: "Tram-track" appearance of capillary loops of glomerular basement membranes on light microscopy. Disease/Dx?
Labs: Triglyceride accumulation in liver cell vacuoles. Disease/Dx?
Fatty liver disease (alcoholic or metabolic syndrome)
Labs: "Waxy" casts with very low urine flow. Disease/Dx?
Chronic end-stage renal disease
Labs: WBC casts in urine. Disease/Dx?
Labs: WBCs that look "smudged". Disease/Dx?
CLL (almost always B cell)
Labs: "Wire loop" glomerular capillary appearance on light microscopy. Disease/Dx?
Labs: Yellowish CSF. Disease/Dx?
Xanthochromia (e.g., due to subarachnoid hemorrhage)
Condition: Absence seizures. Tx?
Condition: Acute gout attack. Tx?
Condition: Acute promyelocytic leukemia (M3). Tx?
All-trans retinoic acid
Condition: ADHD. Tx?
Condition: Alcohol use disorder. Tx?
AA + disulfiram, naltrexone, or acamprosate for patient. Al-Anon for patient's family
Condition: Alcohol withdrawal. Tx?
Condition: Anorexia. Tx?
Condition: Anticoagulation during pregnancy. Tx?
Condition: Arrhythmia in damaged cardiac tissue. Tx?
Class IB antiarrhythmic (lidocaine, mexiletine, tocainide)
Condition: B12 deficiency. Tx?
Vitamin B12 supplementation (work up cause with Schilling test)
Condition: Benign prostatic hyperplasia. Tx?
Condition: Bipolar disorder. Tx?
Lithium, valproate, carbamazepine, lamotrigine (mood stabilizers)
Condition: Breast cancer in postmenopausal woman. Tx?
Aromatase inhibitor (anastrozole)
Condition: Buerger disease. Tx?
Condition: Bulimia nervosa. Tx?
Condition: Candida albicans. Tx?
Amphotericin B (systemic), nystatin (oral thrush), azoles (vaginitis)
Condition: Carcinoid syndrome. Tx?
Condition: Chlamydia trachomatis. Tx?
Doxycycline (+ ceftriaxone for gonorrhea coinfection), erythromycin eye drops (prophylaxis in infants)
Condition: Chronic gout. Tx?
Probenecid (underexcretor), allopurinol (overproducer), febuxostat
Condition: Chronic hepatitis. Tx?
Condition: Chronic myelogenous leukemia. Tx?
Condition: Clostridium botulinum. Tx?
Condition: Clostridium difficile. Tx?
Oral metronidazole; if refractory, oral vancomycin
Condition: Clostridium tetani. Tx?
Antitoxin + vaccine booster + diazepam
Condition: CMV. Tx?
Condition: Crohn disease. Tx?
Corticosteroids, infliximab, methotrexate, azathioprine
Condition: Cryptococcus neoformans. Tx?
Fluconazole (prophylaxis in AIDS patients)
Condition: Cyclophosphamide-induced hemorrhagic cystitis. Tx?
Condition: Depression. Tx?
Condition: Diabetes insipidus. Tx?
DDAVP (central); hydrochlorothiazide, indomethacin, amiloride (nephrogenic)
Condition: Diabetes mellitus type 1. Tx?
Dietary intervention (low sugar) + insulin replacement
Condition: Diabetes mellitus type 2. Tx?
Dietary intervention, oral hypoglycemics, and insulin (if refractory)
Condition: Diabetic ketoacidosis. Tx?
Fluids, insulin, K+
Condition: Enterococci. Tx?
Vancomycin/ampicillin + aminoglycoside
Condition: Erectile dysfunction. Tx?
Condition: ER+ breast cancer. Tx?
Condition: Ethylene glycol/methanol intoxication. Tx?
Fomepizole (alcohol dehydrogenase inhibitor)
Condition: Haemophilus influenzae (B). Tx?
Condition: Generalized anxiety disorder. Tx?
Condition: Granulomatosis with polyangiitis (Wegener). Tx?
Condition: Heparin toxicity (acute). Tx?
Condition: HER2/neu+ breast cancer. Tx?
Condition: Hyperaldosteronism. Tx?
Condition: Hypercholesterolemia. Tx?
Condition: Hypertriglyceridemia. Tx?
Condition: Immediate anticoagulation. Tx?
Condition: Infertility. Tx?
Leuprolide, GnRH (pulsatile), clomiphene
Condition: Influenza. Tx?
Condition: Legionella pneumophila. Tx?
Condition: Long-term anticoagulation. Tx?
Condition: Malaria. Tx?
Chloroquine/mefloquine (for blood schizont), primaquine (for liver hypnozoite)
Condition: Malignant hyperthermia. Tx?
Condition: Medical abortion. Tx?
Condition: Migraine. Tx?
Condition: MRSA. Tx?
Condition: Multiple sclerosis. Tx?
β-interferon, immunosuppression, natalizumab
Condition: Mycobacterium tuberculosis. Tx?
RIPE (rifampin, INH, pyrazinamide, ethambutol)
Condition: Neisseria gonorrhoeae. Tx?
Ceftriaxone (add doxycycline to cover likely concurrent Chlamydia)
Condition: Neisseria meningitidis. Tx?
Penicillin/ceftriaxone, rifampin (prophylaxis)
Condition: Neural tube defect prevention. Tx?
Prenatal folic acid
Condition: Osteomalacia/rickets. Tx?
Vitamin D supplementation
Condition: Osteoporosis. Tx?
Bisphosphonates; calcium and vitamin D supplementation
Condition: Patent ductus arteriosus. Tx?
Condition: Pheochromocytoma. Tx?
α-antagonists (e.g., phenoxybenzamine)
Condition: Pneumocystis jirovecii. Tx?
TMP-SMX (prophylaxis in AIDS patient)
Condition: Prolactinoma. Tx?
Bromocriptine (dopamine agonists)
Condition: Prostate cancer/uterine fibroids. Tx?
Leuprolide, GnRH (continuous)
Condition: Prostate carcinoma. Tx?
Condition: Pseudomonas aeruginosa. Tx?
Antipseudomonal penicillin + aminoglycoside
Condition: Pulmonary arterial hypertension (idiopathic). Tx?
Sildenafil, bosentan, epoprostenol
Condition: Rickettsia rickettsii. Tx?
Doxycycline, chloramphenicol (associated with aplastic anemia)
Condition: Ringworm infections. Tx?
Terbinafine, griseofulvin, imidazole
Condition: Schizophrenia (negative symptoms). Tx?
5-HT2A antagonists (e.g., 2nd-generation antipsychotics)
Condition: Schizophrenia (positive symptoms). Tx?
D2 receptor antagonists (e.g., 1st- and 2nd-generation antipsychotics)
Condition: SIADH. Tx?
Demeclocycline, lithium, vasopressin receptor antagonists
Condition: Sickle cell anemia. Tx?
Hydroxyurea (inc fetal hemoglobin)
Condition: Sporothrix schenckii. Tx?
Oral potassium iodide
Condition: Stable angina. Tx?
Condition: Staphylococcus aureus. Tx?
MSSA: nafcillin, oxacillin, dicloxacillin (antistaphylococcal penicillins); MRSA: vancomycin
Condition: Streptococcus bovis. Tx?
Penicillin prophylaxis; evaluation for colon cancer if linked to endocarditis
Condition: Streptococcus pneumoniae. Tx?
Penicillin/cephalosporin (systemic infection, pneumonia), vancomycin (meningitis)
Condition: Streptococcus pyogenes. Tx?
Condition: Temporal arteritis. Tx?
Condition: Tonic-clonic seizures. Tx?
Phenytoin, valproate, carbamazepine
Condition: Toxoplasma gondii. Tx?
Sulfadiazine + pyrimethamine
Condition: Treponema pallidum. Tx?
Condition: Trichomonas vaginalis. Tx?
Metronidazole (patient and partner)
Condition: Trigeminal neuralgia (tic douloureux). Tx?
Condition: Ulcerative colitis. Tx?
5-ASA, infliximab, colectomy
Condition: UTI prophylaxis. Tx?
Condition: Warfarin toxicity. Tx?
Fresh frozen plasma (acute), vitamin K (chronic)
Actinic (solar) keratosis. Association?
Precursor to squamous cell carcinoma
Acute gastric ulcer associated with CNS injury. Association?
Cushing ulcer (inc intracranial pressure stimulates vagal gastric secretion)
Acute gastric ulcer associated with severe burns. Association?
Curling ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
Alternating areas of transmural inflammation and normal colon. Association?
Skip lesions (Crohn disease)
Aneurysm, dissecting. Association?
Aortic aneurysm, abdominal and descending aorta. Association?
Aortic aneurysm, arch. Association?
3° syphilis (syphilitic aortitis), vasa vasorum destruction
Aortic aneurysm, ascending. Association?
Marfan syndrome (idiopathic cystic medial degeneration)
Atrophy of the mammillary bodies. Association?
Wernicke encephalopathy (thiamine deficiency causing ataxia, ophthalmoplegia, and confusion)
Autosplenectomy (fibrosis and shrinkage). Association?
Sickle cell anemia (hemoglobin S)
Bacteria associated with gastritis, peptic ulcer disease, and stomach cancer. Association?
Bacterial meningitis (adults and elderly). Association?
Bacterial meningitis (newborns and kids). Association?
Group B streptococcus/E.coli (newborns), S. pneumoniae/ Neisseria meningitidis (kids)
Benign melanocytic nevus. Association?
Spitz nevus (most common in 1st two decades)
Bleeding disorder with GpIb deficiency. Association?
Bernard-Soulier syndrome (defect in platelet adhesion to von Willebrand factor)
Brain tumor (adults). Association?
Supratentorial: metastasis > astrocytoma (including glioblastoma multiforme) > meningioma > schwannoma
Brain tumor (kids). Association?
Infratentorial: medulloblastoma (cerebellum) or supratentorial: craniopharyngioma
Breast cancer. Association?
Infiltrating ductal carcinoma
Breast mass. Association?
Fibrocystic change, carcinoma (in postmenopausal women)
Breast tumor (benign). Association?
Cardiac 1° tumor (kids). Association?
Rhabdomyoma, often seen in tuberous sclerosis
Cardiac manifestation of lupus. Association?
Libman-Sacks endocarditis (nonbacterial, affecting both sides of mitral valve)
Cardiac tumor (adults). Association?
Metastasis, 1° myxoma (4:1 left to right atrium; "ball and valve")
Cerebellar tonsillar herniation. Association?
Chiari II malformation
Chronic arrhythmia. Association?
Atrial fibrillation (associated with high risk of emboli)
Chronic atrophic gastritis (autoimmune). Association?
Predisposition to gastric carcinoma (can also cause pernicious anemia)
Clear cell adenocarcinoma of the vagina. Association?
DES exposure in utero
Compression fracture. Association?
Osteoporosis (type I: postmenopausal woman; type II: elderly man or woman)
Congenital adrenal hyperplasia, hypotension. Association?
Congenital cardiac anomaly. Association?
Congenital conjugated hyperbilirubinemia (black liver). Association?
Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)
Constrictive pericarditis. Association?
TB (developing world); SLE (developed world)
Coronary artery involved in thrombosis. Association?
LAD > RCA > LCA
Cushing syndrome. Association?
* Iatrogenic Cushing (from corticosteroid therapy)
* Adrenocortical adenoma (secretes excess cortisol)
* ACTH-secreting pituitary adenoma or
* Paraneoplastic Cushing (due to ACTH secretion by tumors)
Cyanosis (early; less common). Association?
Tetralogy of Fallot, transposition of great vessels, truncus arteriosus
Cyanosis (late; more common). Association?
VSD, ASD, PDA
Death in CML. Association?
Death in SLE. Association?
Alzheimer disease, multiple infarcts
Demyelinating disease in young women. Association?
Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery
Dietary deficit. Association?
Diverticulum in pharynx. Association?
Zenker diverticulum (diagnosed by barium swallow)
Ejection click. Association?
Esophageal cancer. Association?
Squamous cell carcinoma (worldwide); adenocarcinoma (U.S.)
Food poisoning (exotoxin mediated). Association?
S. aureus, B. cereus
Glomerulonephritis (adults). Association?
Berger disease (IgA nephropathy)
Gynecologic malignancy. Association?
Endometrial carcinoma (most common in U.S.); cervical carcinoma (most common worldwide)
Heart murmur, congenital. Association?
Mitral valve prolapse
Heart valve in bacterial endocarditis. Association?
Mitral > aortic (rheumatic fever), tricuspid (IV drug abuse)
Helminth infection (U.S.). Association?
Enterobius vermicularis, Ascaris lumbricoides
Rupture of middle meningeal artery (trauma; lentiform shaped)
Rupture of bridging veins (crescent shaped)
Multiple blood transfusions or hereditary HFE mutation (can result in CHF, "bronze diabetes," and increased risk of hepatocellular carcinoma)
Hepatocellular carcinoma. Association?
Cirrhotic liver (associated with hepatitis B and C and with alcoholism)
Hereditary bleeding disorder. Association?
von Willebrand disease
Hereditary harmless jaundice. Association?
Gilbert syndrome (benign congenital unconjugated hyperbilirubinemia)
Ankylosing spondylitis, reactive arthritis, ulcerative colitis, psoriatic arthritis
HLA-DR3 or -DR4. Association?
Diabetes mellitus type 1, rheumatoid arthritis, SLE
Holosystolic murmur. Association?
VSD, tricuspid regurgitation, mitral regurgitation
Hypercoagulability, endothelial damage, blood stasis. Association?
Virchow triad (results in venous thrombosis)
Hypertension, 2°. Association?
Accidental excision during thyroidectomy
Pituitary adenoma (usually benign tumor)
Infection 2° to blood transfusion. Association?
Infections in chronic granulomatous disease. Association?
Staphylococcus aureus, E. coli, Aspergillus (catalase+)
Intellectual disability. Association?
Down syndrome, fragile X syndrome
Kidney stones. Association?
Calcium = radiopaque
Struvite (ammonium) = radiopaque (formed by urease+ organisms such as Proteus vulgaris or Staphylococcus);
Uric acid = radiolucent
Late cyanotic shunt (uncorrected left to right becomes right to left). Association?
Eisenmenger syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)
Liver disease. Association?
Lysosomal storage disease. Association?
Male cancer. Association?
Malignancy associated with noninfectious fever. Association?
Malignancy (kids). Association?
ALL, medulloblastoma (cerebellum)
Metastases to bone. Association?
Prostate, breast > lung > thyroid
Metastases to brain. Association?
Lung > breast > genitourinary > melanoma > GI
Metastases to liver. Association?
Colon >> stomach, pancreas
Mitochondrial inheritance. Association?
Disease occurs in both males and females, inherited through females only
Mitral valve stenosis. Association?
Rheumatic heart disease
Mixed (UMN and LMN) motor neuron disease. Association?
Amyotrophic lateral sclerosis
Nephrotic syndrome (adults). Association?
Focal segmental glomerulosclerosis
Nephrotic syndrome (kids). Association?
Minimal change disease
Neuron migration failure. Association?
Kallmann syndrome (hypogonadotropic hypogonadism and anosmia)
Nosocomial pneumonia. Association?
Klebsiella, E. coli, Pseudomonas aeruginosa
Obstruction of male urinary tract. Association?
Opening snap. Association?
Opportunistic infection in AIDS. Association?
Pneumocystis jirovecii pneumonia
Osteomyelitis in sickle cell disease. Association?
Osteomyelitis with IV drug use. Association?
Pseudomonas, S. aureus
Ovarian metastasis from gastric carcinoma or breast cancer. Association?
Krukenberg tumor (mucin-secreting signet-ring cells)
Ovarian tumor (benign, bilateral). Association?
Ovarian tumor (malignant). Association?
Pancreatitis (acute). Association?
Pancreatitis (chronic). Association?
Alcohol (adults), cystic fibrosis (kids)
Patient with ALL/CLL/AML/CML (ages). Association?
ALL: child, CLL: adult > 60, AML: adult ~65, CML: adult 30-60
Pelvic inflammatory disease. Association?
Chlamydia trachomatis, Neisseria gonorrhoeae
Philadelphia chromosome t(9;22) (bcr-abl). Association?
CML (may sometimes be associated with ALL/AML)
Pituitary tumor. Association?
Prolactinoma, somatotropic "acidophilic" adenoma
1° amenorrhea. Association?
Turner syndrome (45,XO)
1° bone tumor (adults). Association?
1° hyperaldosteronism. Association?
Adenoma of adrenal cortex
1° hyperparathyroidism. Association?
Adenomas, hyperplasia, carcinoma
1° liver cancer. Association?
Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, α1-antitrypsin deficiency)
Pulmonary hypertension. Association?
Recurrent inflammation/thrombosis of small/medium vessels. Association?
Buerger disease (strongly associated with tobacco) in extremities
Renal tumor. Association?
Renal cell carcinoma: associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndromes (EPO, renin, PTH, ACTH)
Right heart failure due to a pulmonary cause. Association?
S3 (protodiastolic gallop). Association?
inc ventricular filling (left-to-right shunt, mitral regurgitation, LV failure [CHF])
S4 (presystolic gallop). Association?
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
2° hyperparathyroidism. Association?
Hypocalcemia of chronic kidney disease
Sexually transmitted disease. Association?
Chlamydia (usually coinfected with gonorrhea)
Small cell carcinoma of the lung
Site of diverticula. Association?
Sites of atherosclerosis. Association?
Abdominal aorta > coronary artery > popliteal artery > carotid artery
Stomach cancer. Association?
Stomach ulcerations and high gastrin levels. Association?
Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
Follicular lymphomas (bcl-2 activation)
Burkitt lymphoma (c-myc activation)
Philadelphia chromosome, CML (bcr-abl fusion)
Temporal arteritis. Association?
Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymyalgia rheumatica
Testicular tumor. Association?
Seminoma (malignant, radiosensitive)
Thyroid cancer. Association?
Tumor in women. Association?
Leiomyoma (estrogen dependent, not precancerous)
Tumor of infancy. Association?
Hemangioma (usually regresses spontaneously by childhood)
Tumor of the adrenal medulla (adults). Association?
Pheochromocytoma (usually benign)
Tumor of the adrenal medulla (kids). Association?
Type of Hodgkin. Association?
Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)
Type of non-Hodgkin. Association?
Diffuse large cell
E. coli, Staphylococcus saprophyticus (young women)
Viral encephalitis affecting temporal lobe. Association?
Vitamin deficiency (U.S.). Association?
Folate (pregnant women are at high risk; body stores only 3- to 4-month supply; prevents neural tube defects)
Port wine stain on face, seizures & learning disability. Dx?
Seizures, hemartomas, ash-leaf spots (hypopigmented spots) on trunk & extremities. Dx?
Tuberous sclerosis (also affects eyes, heart, lungs & kidney)
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