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Classic Presentation
Rapid Review Path
| Question | Answer |
|---|---|
| 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