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Classic Presentation

Rapid Review Path

QuestionAnswer
Abdominal pain, ascites, hepatomegaly Liver congestion --> portal htn Looks like CHF but there is no JVD Budd-Chiari syndrome (AKA posthepatic venous thrombosis)
Achilles tendon xanthoma Very high LDL Familial hypercholesterolemia
Adrenal hemorrhage, hypotension, DIC Waterhouse-Friderichsen syndrome (meningococcemia; N. meningititis septicemia)
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints. Fibrillin defect. Marfan's syndrome
Back pain, fever, night sweats, weight loss. Same presentation w/out back pain... Pott's disease (vertebral TB); TB
Big toe extension/fanning upon planar scrape. Associated with hyper-reflexia and spastic paralysis due to loss of inhibition from CNS indicating a UMN lesion. Babinski's sign
Bilateral hilar adenopathy, uveitis, noncaseating granulomas. Sarcoidosis
Blue sclera; collagen type I defect Osteogenesis imperfecta
Bluish line on gingiva Burton's line (lead poisoning)
Bone pain, bone enlargement, hat doesn't fit, arthritis, fractures. Increased ALP Increased osteoblastic and osteoclastic activity (excess bony turnover) Paget's disease of bone
Cafe-au-lait spots, Lisch nodules (iris hamartomas) Neurofibromatosis type I (+ bilateral acoustic neuroma = type II)
Calf pseudohypertrophy (excess fatty and connective tissue) Muscular dystrophy (Duchenne's most commonly)
"Cherry-red spot" on macula Tay-Sachs (ganglioside accumulation) Niemann-Pick (lysosomal storage disorder) Central retinal artery occlusion
Chest pain, pericardial effusion/friction rub, persistent fever following MI. Autoimmune mediated post-MI fibrinous pericarditis; occurs weeks after MI. Dressler's syndrome
Child uses arms to stand up from squat. Gower's sign (Duchenne's: X-linked recessive deleted dystrophin gene)
Child with fever develops red rash on face that spreads to body. "Slapped cheek" (Parvo B19, erythema infectiosum/Fifth disease)
Chorea, dementia (Crazy), Caudate degeneration, decrease AcH Autosomal Dominant, shows anticipation CAG repeat expansion Huntingon's disease
Chronic exercise intolerance with myalgia, fatigue, painful cramps. Muscle phosphorylase deficiency. McArdles's disease
Cold intolerance Hypothyroidism
Conjugate lateral gaze palsy, horizontal diplopia, CAN converge. Paralysis of adducting eyes; nystagmus of abducting eye. Damage to MLF; bilateral [MS], unilateral {stroke] Internuclear ophthalmoplegia
Continuous "machine-like" murmur PDA (close with indomethacin; open with misoprostol)
Cutaneous/dermal edema due to connective tissue deposition. Myxedema (hypothyroidism, Graves' disease)
Dark purple skin/mouth nodules Usually AIDS pts [gay men]: associated with HHV-8 Looks like bacillary angiomatosis Kaposi's sarcoma
Deep, labored breathing/hyperventilation SLOOOOOOW! Blowing off CO2 Seen in DKA Kussmaul breathing
3D's: Dermatitis, dementia, diarrhea Pellagra (Niacin [B3] deficiency)
Dialated cardiomyopathy, edema, polyneuropathy. Associated with thiamine (B1) deficiency. Wet beriberi [Polyneuropathy alone = dry beriberi]
Dog or cat bite resulting in infection Pasturella multocida
Dry eyes, dry mouth, arthritis. Autoimmune destruction of exocrine glands (salivary/lacrimal). Sjogren's syndrome
Dysphagia (due to esophageal webs), glossitis, iron (Fe) deficiency anemia. May progress to esophageal squamous cell carcinoma. Plummer-Vinson syndrome
Elastic skin, hypermobility of joints. Collagen type III (bloody) defect. Ehlers-Danlos syndrome
Enlarged, hard left supraclavicular node. Sign of abdominal or stomach cancer metastasis. Poor Px. Virchow's node
Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T-cells. Sezary syndrome (cutatneous T-cell lympoma) or mycosis fungoides.
Facial muscle spasm upon tapping. Associated lab value includes hypocalcemia. Chvostek's sign
Female, fat, forty, fertile (4F's). Obstruction of bile duct. Acute cholilithiasis.
Fever, chills, headache, myalgia following antibiotic treatment for syphilis (spirochete: tryponema pallidum). Rapid lysis of spirochetes results in toxin release. Jarisch-Herxheimer reaction
Fever, cough, conjunctivitis, coryza, diffuse rash, photophobia. (3C's and a P) Measles (Morbillivirus)
Fever, night sweats, weight loss. B symptoms (lymphoma); TB
Fibrous plaques in soft tissue of penis. Connective tissue disorder. Peyronie's disease
Gout, mental retardation, self-mutilating behavior in a boy. HGPRT deficiency. Lesch-Nyhan syndrome
Green-yellow (oxidized copper) rings around peripheral cornea. Due to copper accumulation from Wilson's disease. Kayser-Fleischer rings
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands. Genetic benign polyps can cause bowel obstruction; Slight increase in cancer risk. Peutz-Jeghers syndrome
Hepatosplenomegaly, osteoporosis, neurologic symptoms. Glucocerebroside deficiency. Crinkled tissue paper cytoplasm. Gaucher's disease
Hereditary nephritis, sensorineural hearing loss, cataracts. Collagen mutation, thick and thing basement membrane on EM, "basket weave" appearance. "Can't see, can't pee, can't hear." Alport's syndrome
Hypergoagulability (leading to migrating DVT's and vasculitis). Seen in adenocarcinoma of pancreas or lung. Migrating thrombophlebitis. Trousseau's sign
Hyperphagia, hypersexuality, hyperorality, hyperdocility. Bilateral amygdala lesion. "Amygdaloid monkey." Kluver-Bucy syndrome
Hypertension, hypokalemia, metabolic acidosis. Conn's syndrome (primary hyperaldosteronism)
Hypoxemia, polycythemia, hypercapnia. Chronic bronchitis (hyperplasia of mucus cells in bronchioli). Increased REID index. "Blue bloater"
Indurated, ulcerated genital lesion (non-painful) Chancre of primary syphilis: Treponema pallidum
Infant with failure to thrive, hepatosplenomegaly, neurodegeneration. Genetic sphingomyelinase deficiency. Cherry red spot on macula. Niemann-Pick disease
Infant with hypoglycemia (b/c they are not able to regulate sugar using glycogenolsys), failure to thrive, hepatomegaly. Debranching Enzyme deficiency. Glycogen stored in liver can't undergo glycogenolysis --> hepatomegaly. Cori's Disease [Von Gierke's is the same plus absent gluconeogenesis.
Infant with microcephaly, rocker bottom feet [pathomnemonic], structural heart defects. Trisomy 18 Edward's syndrome
Jaundice, RUQ pain, fever Charcot's triad of ascending cholangitis.
Keratin pearls on skin lesion. Squamous cell carcinoma (all squamous cell cancers)
Large rash w/ bull's eye appearance. Associated with tick bite. Lyme disease: Borrelia Erythema chronicum migrans
Lucid interval after traumatic brain injury. "Talk and Die" Epidural hematoma
Male child, recurrent infections, no mature B cells. X-linked agammaglobulinemia. Bruton's disease
Mucosal bleeding and prolonged bleeding time. Defect in platelet aggregation due to lack of GpIIb/IIIa Glanzmann's thrombasthemia
Multiple colon polyps, osteomas/soft tissue tomors, impacted/supernumerary teeth. Genetic disorder that predisposes to colon cancer. "Growing stuff all over the place." Gardner's syndrome
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis. Hemoptysis and glomerular disease. Wegener's (add sinusitis as symptom) and Goodpasture's (Anti-GBM)
Neonate with arm paralysis following difficult birth. Superior trunk [C5,C6] brachial plexus injury: "Waiter's tip" deformity. Often associated w/ clavicle fracture. Erb-Duchenne palsy
No lactation post partum, absent menstruation, cold intolerance. Multiple pituitary hormones not working. Post partum hemorrhage --> hypotension --> pituitary infarct -> necrosis --> no hormones. Sheehan's syndrome
Nystagmus, intention tremor, scanning speech Charcot's triad of MS
Oscillating slow/fast breathing. Central apnea in CHF or increased intracranial pressure. Cheyne-Stokes respirations
Painful blue fingers/toes, hemolytic anemia. Autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mono). Agglutination of IgM. Cold Agglutinin disease
Painful, pale, cold fingers/toes. Vasospasm in extremities. Occurs after being in a cold environment (ex. putting hands in refrigerator) Raynaud's syndrome
Painful, raised red lesions on palms and soles. Seen with infective endocarditis. Osler's node
Painless jaundice Caner of pancreatic head obstructing bile duct
Palpable purpura, joint pain, abdominal pain (child), renal disease, self-limited. IgA vasculitis affecting skin and kidneys. Henoch-Schonlein purpura
Pancreatic, pituitary, parathyroid tumors (The P's) Wermer's syndrome (MEN 1)
Pink complexion, dyspnea, hyperventilation. "Pink puffer" [emphysema: centroacinar (smoking), panacinar (alpha1-antitrypsin deficiency)]
Polyostotic fibrous dysplasia, precocious puberty, cafe-au-lait spots, short stature in a young girl. Mosaic G-protein signaling mutation. McCune-Albright syndrome
Polyuria, acidosis, growth failure, electrolyte imbalances. Proximal tubular (PCT) reabsorption defect. Fanconi's syndrome
Positive anterior "drawer sign" Anterior cruciate ligament (ACL) injury
Ptosis, miosis, anhidrosis. Sympathetic chain lesion. Sympathetic innervation can't reach the face. Association with pancoast tumor. Horner's syndrome
Pupil accommodates but doesn't react; seen in neurosyphilis. Argyll Robertson pupil (prostitutes pupil)
RAPIDLY progressive leg weakness that ASCENDS (following GI/upper respiratory infection), no sensory loss. Can lead to respiratory failure. Autoimmune acute inflammatory demyelinating polyneuropathy. Guillain-Barre syndrome
Rash on palms and soles Secondary syphillis, RMSF, coxsackie A (hand/foot/mouth dz)
Recurrent colds, unusual eczema (truncal), high serum IgE. Neutrophil chemotaxis abnormality. Job's syndrome (hyper IgE syndrome)
Red "currant jelly" sputum Klebsiella pneumoniae
"currant jelly" stool intussusception
Rusty sputum Strep pneumo
Red, itchy, swollen rash of nipple/areola. Represents underlying neoplasm. Paget's disease of breast
Red urine in the morning. Hb breakdown b/c complement is attacking RBC's b/c they have a deficiency of CD55/CD59. Paroxysmal nocturnal hemoglobinuria (PNH)
Renal cell carcinoma, hemangioblastomas, angiomatosis, pheochromocytoma. Autosomal dominant tumor suppressor gene mutation. von Hippel-Lindau disease
Resting tremor ("pill rolling"), rigidity, akinesia, postural instability, paucity of movement. Nigrostriatal dopamine depletion. Parkinson's disease
Restrictive cardiomyopathy (juvenile form: cardiomegaly), exercise intolerance. Lysosomal glucosidase deficiency. Pompe's desease.
Retinal hemorrhages with pale centers. Associated with bacterial endocarditis. Roth's spots
Severe jaundice in neonate. Congenital unconjugated hyperbilirubinemia. Crigler-Najjar syndrome
Severe RLQ pain with rebound tenderness. McBurney's sign (appendicitis)
Short stature, increased incidence of tumors/leukemia, aplastic anemia. Genetically inherited. Often progresses to AML. Fanconi's anemia
Single palm crease Simian crease (seen in Down's)
Situs inversus, chronic sinusitis, bronchiectasis, infertility. Dyenin defect affecting cilia. Cilia don't work so they can't clear stuff from lungs/sinuses. Kartagener's syndrome
Skin hyperpigmentation, more ACTH and MSH, primary adrenocorticalinsufficiency of autoimmune or infectious etiology. Addison's disease
Slow, progressive muscle weakness in boys. X-linked, defective dystrophin. Less severe than Duchenne's. Becker's muscular dystrophy
Small, irregular red spots on buccal/lingual mucosa with blue-white centers. Koplik spots (measles)
Small, nontender, erythematous lesions on palms/soles. Associated with infective endocarditis. Janeway lesions
Smooth, flat, moist white lesions on genitals. Associated with secondary syphilis. Condylomata lata
Splinter hemorrhages in fingernails (not always) Bacterial endocarditis
"Strawberry tongue" Scarlet fever, Kawasaki disease, toxic shock syndrome
Streak ovaries, congenital heart disease, horseshoe kidney, coarctation of the aorta, XO, short stature, webbed neck, lymphedema. Turner's syndrome
Sudden swollen/painful big toe joint, tophi (when urate crystals aggregate w/ neutrophils around it), hyperuricemia (not always) Gout/podagra
Swollen gums, mucous bleeding, poor wound healing, spots on skin. Vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis. Scurvy
Swollen, hard, painful finger joints. Osteophytes on PIP [Bouchard's nodes], DIP [Heberden's nodes] Osteoarthritis
Systolic ejection murmur (crescendo-decrescendo) Aortic valve stenosis
Thyroid, parathyroid, adrenal tumors, pheochromocytoma. Sipple's syndrome (MEN 2A)
Ulcerated genital lesion with exudate (painful) Chancroid of Haemophilus ducreyi
Unilateral facial dropping (entire 1/2 of face) Bell's palsy (LMN CN VII palsy); if only lower half of one side of face affected it's an UMN lesion; bilateral = lyme dz or guillan-barre.
Urethritis, conjuctivitis, arthritis in a male. Reactive arthritis associated with HLA-B27. Seronegative (no increased RF) Reiter's syndrome
Vascular birthmark (port-wine-stain). Benign, but associated with Sturge-Weber syndrome (port wine stain in opthalmic division of trigeminal nerve --> seizures) Hemangioma
Vasculitis from exposure to endotoxin causing glomerular thrombosis. Following second exposure to endotoxin. Shwartzman reaction
Vomiting blood following esophagogastric lacerations (hematamesis). Seen in alcoholics, eating disorders, eating contests. Mallory-Wiess syndrome
"Waxy" casts with very low urine flow Chronic ESRD
WBC casts in urine Acute pyelonephritis
Weight loss, diarrhea, arthritis, fever, adenopathy Whipple's disease (Tropheryma whippelii)
"Worst headache of my life", subarachnoid hemorrhage, associated with ADPKD. Berry aneurysm
Created by: jveulens