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Rapid Review1
First Aid for USMLE Step 1 Rapid Review
| Question | Answer |
|---|---|
| Abdominal pain, ascites, hepatomegaly | Budd-Chiari Syndrome (posthepatic venous thrombosis) |
| Achilles tendon xanthoma | Familial hypercholesterolemia |
| Adrenal hemorrhage, hypotension, DIC | Waterhouse-Friderichsen Syndrome (meningococcemia) |
| Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints | Marfan's syndrome (fibrillin defect) |
| Athlete with polycythemia | Erythropoietin injection |
| Back pain, fever, night sweats, weight loss | Pott's disease (vertebral tuberculosis) |
| Bilateral hilar adenopathy, uveitis | Sarcoidosis (noncaseating granulomas) |
| Blue sclera | Osteogenesis imperfecta (collagen defect) |
| Bluish line on gingiva | Burton's line (lead poisoning) |
| Bone pain, bone enlargement, arthritis | Paget's disease of bone (increased osteoblastic and osteoclastic activity) |
| Bounding pulses, diastolic heart murmur, head bobbing | Aortic regurgitation |
| Café-au-lait spots, Lisch nodules (iris hamartoma) | Neurofibromatosis type I (+ pheochromocytoma, optic gliomas) Neurofibromatosis type II (+ bilateral acoustic neuromas) |
| Café-au-lait spots, polyostotic fibrous dysplasia, precocious puberty | McCune-Albright syndrome (mosaic G-protein signaling mutation) |
| Calf pseudohypertrophy | Muscular dystrophy (MCly Duchenne's) |
| "Cherry-red spot" on macula | Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion |
| Chest pain, pericardial effusion/friction rub, persistent fever following MI | Dressler's syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode) |
| Child uses arms to stand up from squat | Gowers' sign (Duchenne muscular dystrophy: XR deleted dystrophin gene) |
| Child with fever develops red rash on face that spreads to body | "Slapped cheeks" (erythema infectiosum/fifth disease: parvovirus B19) |
| Chorea, dementia, caudate degeneration | Huntington's disease (AD CAG repeat expansion) |
| Chronic exercise intolerance with myalgia, fatigue, painful cramps | McArdle's disease (muscle phosphorylase deficiency) |
| Cold intolerance | Hypothyroidism |
| Conjugate lateral gaze palsy, horizontal diplopia | Internuclear ophthalmoplegia (damage to MLF; bilateral [multiple sclerosis], unilateral [stroke]) |
| Continuous "machinery" heart murmur | PDA (close with indomethacin; open with misoprostol) |
| Cutaneous/dermal edema due to connective tissue deposition | Myxedema (hypothyroidism, Graves' disease) |
| Dark purple skin/mouth nodules | Kaposi's sarcoma (usually AIDS patients [gay men]: associated with HHV-8) |
| Deep, labored breathing/hyperventilation | Kussmaul breathing (DKA) |
| Dermatitis, dementia, diarrhea | Pellagra (niacin [vitamin B3] deficiency) |
| Dilated cardiomyopathy, edema, polyneuropathy | Wet beriberi (thiamine [vitamin B1] deficiency) |
| Dog or cat bite resulting in infection | Pasteurella multocida (cellulitis at inoculation site) |
| Dry eyes, dry mouth, arthritis | Sjögren's syndrome (autoimmune destruction of exocrine glands) |
| Dysphagia (esophageal webs), glossitis, iron deficiency anemia | Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma) |
| Elastic skin, hypermobility of joints | Ehlers-Danlos syndrome (collagen defect, usually type III) |
| Enlarged, hard left supraclavicular node | Virchow's node (abdominal metastasis) |
| Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells | Sézary syndrome (cutaneous T-cell lymphoma) or mycosis fungoides |
| Facial muscle spasm upon tapping | Chvostek's sign (hypocalcemia) |
| Fat, female, forty, and fertile | Acute cholecystitis (bile duct blockage) |
| Fever, chills, headache, myalgia following antibiotic treatment for syphilis | Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release) |
| Fever, cough, conjunctivitis, coryza, diffuse rash | Measles (Morbillivirus) |
| Fever, night sweats, weight loss | B symptoms (lymphoma) |
| Fibrous plaques in soft tissue of penis | Peyronie's disease (connective tissue disorder) |
| Gout, mental retardation, self-mutilating behavior in a boy | Lesch-Nyhan syndrome (HGPRT deficiency, XR) |
| Green-yellow rings around peripheral cornea | Kayser-Fleischer rings (copper accumulation from Wilson's disease) |
| hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands | Peutz-Jeghers syndrome (genetic benign polyposis can cause bowel obstruction; increase cancer risk) |
| Hepatosplenomegaly, osteoporosis, neurologic symptoms | Gaucher's disease (glucocerebrosidase deficiency) |
| Hereditary nephritis, sensorineural hearing loss, cataracts | Alport's syndrome (type IV collagen mutation) |
| Hypercoagulability (leading to migrating DVTs and vasculitis) | Trousseau's sign (adenocarcinoma of pancreas or lung) |
| Hyperphagia, hypersexuality, hyperorality, hyperdocility | Klüver-Bucy syndrome (bilateral amygdala lesion) |
| Hypertension, hypokalemia, metabolic alkalosis (the high pH of the blood makes Ca2+ less available to the tissues and causes symptoms of hypocalcemia) | Conn's syndrome (primary hyperaldosteronism) |
| Hypoxemia, polycythemia, hypercapnia | "Blue bloater" (chronic bronchitis: hyperplasia of mucous cells) |
| Indurated, ulcerated genital lesion | Nonpainful: chancre (primary syphilis, Treponema pallidum) Painful, with exudate: chancroid (Haemophilus ducreyi) |
| Infant with failure to thrive, hepatosplenomegaly, neurodegeneration | Niemann-Pick disease (genetic sphingomyelinase deficiency) |
| Infant with hypoglycemia, failure to thrive, and hepatomegaly | Cori's disease (debranching enzyme deficiency) |
| Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect | Edwards' syndrome (trisomy 18) |
| Jaundice, RUQ pain, fever | Charcot's triad 2 (ascending cholangitis) |
| Keratin pearls on skin biopsy | Squamous cell carcinoma |
| Large rash with bull's-eye appearance | Erythema chronicum migrans from Ixodes tick bite (Lyme disease: Borrelia) |
| Lucid interval after traumatic brain injury | Epidural hematoma (middle meningeal artery rupture) |
| Male child, recurrent infections, no mature B cells | Bruton's disease (X-linked agammaglobulinemia) |
| Mucosal bleeding and prolonged bleeding time | Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa) |
| Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth | Gardner's syndrome (subtype of FAP) |
| Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis | Wegener's (c-ANCA positive) and Goodpasture's syndromes (anti-basement membrane antibodies) |
| Neonate with arm paralysis following difficult birth | Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip") |
| No lactation postpartum, absent menstruation, cold intolerance | Sheehan's syndrome (pituitary infarction) |
| Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia | Multiple sclerosis |
| Oscillating slow/fast breathing | Cheyne-Stokes respirations(central apnea in CHF or increased intracranial pressure) |
| Painful blue fingers/toes, hemolytic anemia | Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis) |
| Painful, pale, cold fingers/toes | Rayneud's syndrome (vasospasm in extremities) |
| Painful, raised red lesions on palms and soles | Osler's nodes (infective endocarditis) |
| Painless erythematous lesions on palms and soles | Janeway lesions (infective endocarditis) |
| Painless jaundice | Cancer of the pancreatic duct obstructing bile duct |
| Palpable purpura, joint pain, abdominal pain (child) | Henoch-Schönlein purpura (IgA vasculitis affecting skin and kidneys) |
| Pancreatic, pituitary, parathyroid tumors | Wermer's syndrome (MEN I) |
| Pink complexion, dyspnea, hyperventilation | "Pink puffer" (emphysema: centroacinar [smoking], panacinar [α1-antitrypsin deficiency]) |
| Polyuria, acidosis, growth failure, electrollyte imbalances | Fanconi's syndrome (proximal tubular reabsorpiton defect) |
| Positive anterior "drawer sign" | Anterior cruciate ligament (ACL) injury |
| Ptosis, miosis, anhidrosis | Horner's syndrome (sympathetic chain lesion) |
| Pupil accommodates but doesn't react | Argyll Robertson pupil (neurosyphilis) |
| Rapidly progressive leg weakness that ascends (following GI/upper respiratory infection) | Guillain-Barré syndrome (autoimmune acute inflammatory demyelinating polyneuropathy) |
| Rash on palms and soles | Secondary syphilis, Rocky Mountain spotted fever, Coxsackie A virus |
| Recurrent colds, unusual eczema, high serum IgE | Job's syndrome (hyper-IgE syndrome: neutrophil chemotaxis abnormality) |
| Red "currant jelly" sputum in alcoholic or diabetic patients | Klebsiella pneumoniae |
| Red, itchy, swollen rash of nipple/areola | Paget's disease of the breast (represents underlying neoplasm) |
| Renal cell carcinoma, hemangioblastomas, angiomatosis, pheochromocytoma | von Hippel-Lindau disease (dominant tumor suppressor gene mutation) |
| Resting tremor, rigidity, akinesia, postural instability | Parkinson's disease (nigrostriatal dopamine depletion) |
| Restrictive cardiomyopathy (juvenile form: cardiomegaly), exercise intolerance | Pompe's disease (lysosomal glucosidase deficiency) |
| Retinal hemorrhages with pale centers | Roth spots (bacterial endocarditis) |
| Severe jaundice in neonate | Crigler-Najjar syndrome (congential unconjugated hyperbilirubinemia) |
| Severe RLQ pain with rebound tenderness | McBurney's sign (appendicitis) |
| Short stature, increased incidence of tumors/leukemia, aplastic anemia | Fanconi's anemia (genetically inherited; often progresses to AML) |
| Single palm crease | Simian crease (Down syndrome) |
| Situs inversus, chronic sinusitis, bronchiectasis, infertility | Kartagener's syndrome (dynein defect affecting cilia) |
| Skin hyperpigmentation | Addison's disease (primary adrenocortical insufficiency of autoimmune or infectious etiology) |
| Slow, progressive weakness in boys | Becker's muscular dystrophy (X-linked, defective dystrophin; less severe than Duchenne's) |
| Small, irregular red spots on buccal/lingual mucosa with blue-white centers | Koplik spots (measles) |
| Smooth, flat, moist white lesions on genitals | Condylomata lata (secondary syphilis) |
| Splinter hemorrhages in fingernails | Bacterial endocarditis |
| "Strawberry tongue" | Scarlet fever, Kawasaki disease, toxic shock syndrome |
| Streak ovaries, congential heart disease, horseshoe kidney | Turner syndrome (XO, short stature, webbed neck, lymphedema) |
| Sudden swollen/painful big toe joint, tophi | Gout/podagra (hyperuricemia) |
| Swollen gums, mucous bleeding, poor wound healing, spots on skin | Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis) |
| Swollen, hard, painful finger joints | Osteoarthritis (osteophytes on PIP [Bouchard's nodes], DIP [Heberden's nodes]) |
| Systolic ejection murmur (crescendo-decrescendo) | Aortic valve stenosis |
| Thyroid and parathyroid tumors, pheochromocytoma | Sipple's syndrome (MEN 2A) |
| Toe extension/fanning upon plantar scrape | Babinski's sign (UMN lesion) |
| Unilateral facial drooping involving forehead | Bell's palsy (LMN CN VII palsy) |
| Urethritis, conjunctivitis, arthritis in a male | Reiter's syndrome (reactive arthritis associated with HLA-B27) |
| Vascular birthmark (port-wine stain) | Hemangioma (benign, but associated with Sturge-Weber syndrome) |
| Vasculitis from exposure to endotoxin cause glomerular thrombosis | Shwartzman reaction (following second exposure to endotoxin) |
| Vomiting blood following esophagogastric lacerations | Mallory-Weiss syndrome (alcoholic and bulimic patients) |
| "Waxy" casts with very low urine flow | Chronic end-stage renal disease |
| WBC casts in urine | Acute pyelonephritis |
| Weight loss, diarrhea, arthritis, fever, adenopathy | Whipple's disease (Tropheryma whippelii) |
| "Worst headache of my life" | Subarachnoid hemorrhage |
| Anticentromere antibodies | Scleroderma (CREST) |
| Andidesmoglein (epithelial) antibodies | Phemphigus vulgaris (blistering) |
| Anti-glomerular basement membrane antibodies | Goodpasture's syndrome (glomerulonephritis and hemoptysis) |
| Antihistone antibodies | Drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide, quinidine) |
| Anti-IgG antibodies | Rheumatoid arthritis (systemic inflammation, joint pannus, boutonnière deformity) |
| Antimitochondrial antibodies (AMAs) | Primary biliary cirrhosis (female, cholestasis, portal hypertension) |
| Antineutrophil cytoplasmic antibodies (ANCAs) | Vasculitis (c-ANCA: Wegener's; p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome) |
| Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA) | SLE (type III hypersensitivity); anti-dsDNA correlates with disease activity, anti-Smith does not |
| Antiplatelet antibodies | Idiopathic thrombocytopenic purpura (ITP) (bleeding diathesis) |
| Anti-topoisomerase antibodies | Diffuse systemic scleroderma |
| Anti-transglutaminase/antigliadin/anti-endomysial antibodies | Celiac disease (diarrhea, distension, weight loss) |
| Azurophilic granular needles in leukemic blasts | Auer rods (Acute myelogenous leukemia: especially the promyelocytic type) |
| "Bamboo spine" on x-ray | Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27) |
| Basophilic nuclear remnants in RBCs | Howell-Jolly bodies (due to splenectomy or nonfunctional spleen) |
| Basophilic stippling of RBCs | Lead poisoning or sideroblastic anemia |
| Bloody tap on LP | Subarachnoid hemorrhage |
| "Boot-shaped" heart on x-ray | Tetralogy of Fallot, RVH |
| Branching gram-positive rods with sulfur granules | Actinomyces israelii |
| Bronchogenic apical lung tumor | Pancoast's tumor (can compress sympathetic ganglion and cause Horner's syndrome) |
| "Brown" tumor of bone | Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to: 1. Hyperparathyroidism 2. Osteitis fibrosa cystica |
| Cardiomegaly with apical atrophy | Chagas' disease (Trypanosoma cruzi) |
| Cellular crescents in Bowman's capsule | Rapidly progressive crescentic glomerulonephritis |
| "Chocolate cyst" on ovary | Endometriosis (frequently involves both ovaries) |
| Circular grouping of dark tumor cells surrounding pale neurofibrils | Homer Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma) |
| Colonies of mucoid Pseudomonas bugs | Cystic fibrosis (CFTR mutation in Caucasians resulting in fat-soluble vitamin deficiency and mucous plugs) |
| Degeneration of dorsal column nerves | Tabes dorsalis (tertiary syphilis) |
| Depigmentation of neurons in substantia nigra | Parkinson's disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia) |
| Desquamated epithelium casts in sputum | Curschmann's spirals (bronchial asthma; can result in whorled mucous plugs) |
| Disarrayed granulosa cells in eosinophilic fluid | Call-Exner bodies (granulosa-theca cell tumor of the ovary) |
| Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia | Koilocytes (HPV: predisposes to cervical cancer) |
| Enlarged cells with intranuclear incluusion bodies | "Owl's-eye" appearance of CMV |
| Enlarged thyroid cells with ground-glass nuclei | "Orphan Annie" eye nuclei (papillary carcinoma of the thyroid) |
| Eosinophilic cytoplasmic inclusion in liver cell | Mallory bodies (alcoholic liver disease) |
| Eosinophilic cytoplasmic inclusion in nerve cell | Lewy body (Parkinson's disease) |
| Eosinophilic globule in liver | Councilman body (toxic or viral hepatitis, often yellow fever) |
| Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells | Rabies virus (Lyssavirus); Negri bodies |
| Extracellular amyloid deposition in gray matter of brain | Senile plaques (Alzheimer's disease) |
| Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye") | Reed-Sternberg cells (Hodgkin's lymphoma) |
| Glomerulus-like structure surrounding vessel in germ cells | Schiller-Duval bodies (yolk sac tumor) |
| "Hair-on-end" (crew-cut) appearance on x-ray | β-thalassemia, sickle cell anemia (marrow expansion) |
| hCG elevated | Choriocarcinoma, hydatidiform mole (occurs with and without embryo) |
| Heart nodules (inflammatory) | Aschoff bodies (rheumatic fever) |
| Heterophile antibodies | Infectious mononucleosis (EBV) |
| Hexagonal, double-pointed, needle-like crystals in bronchial secretions | Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules) |
| High level of D-dimers | DVT, pulmonary embolism, DIC |
| Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify) | Ghon complex (Primary TB: Mycobacterium bacilli) |
| "Honeycomb lung" on x-ray | Interstitial fibrosis |
| Hypersegmented neutrophils | Megaloblastic anemia (B12, folate deficiency) |
| Hypochromic, microcytic anemia | Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present) |
| Increased α-fetoprotein in amniotic fluid/maternal serum | Anencephaly, spina bifida (neural tube defects), multiple gestation, abdominal wall defects |
| Decreased α-fetoprotein | Down syndrome |
| Increased uric acid levels | Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics |
| Intranuclear eosinophilic droplet-like bodies | Cowdry type A bodies (HSV or yellow fever) |
| Iron-containing nodules in alveolar septum | Ferruginous bodies (asbestosis: increased chance of mesothelioma) |
| Large lysosomal vesicles in phagocytes, immunodeficiency | Chédiak-Higashi disease (congential failure of phagolysosome formation) |
| Low serum ceruloplasmin | Wilson's disease (hepatolenticular degeneration) |
| "Lumpy-bumpy" appearance of glomeruli on immunofluorescence | Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b) |
| Lytic ("hole-punched") bone lesions on x-ray | Multiple myeloma |
| Mammary gland ("blue-domed") cyst | Fibrocystic change of the breast |
| Monoclonal antibody spike (4 things) | 1. Multiple myeloma (called the M protein, usually IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging) 3. Waldenström's macroglobulinemia (M protein = IgM) 4. Primary amyloidosis |
| Monoclonal globulin protein in blood/urine | Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine]), Waldenström's macroglobulinemia (IgM) |
| Mucin-filled cell with peripheral nucleus | Signet ring (gastric carcinoma) |
| Narrowing of bowel lumen on barium radiograph | "String sign" (Crohn's disease) |
| Needle-shaped, negatively birefringent crystals | Gout (hyperuricemia) |
| Nodular hyaline deposits in glomeruli | Kimmelstiel-Wilson nodules (diabetic nephropathy) |
| "Nutmeg" appearance of liver | Chronic passive congestion of liver due to RHF |
| "Onion-skin" periosteal reaction | Ewing's sarcoma (malignant round-cell tumor) |
| Periosteum raised from bone, creating a triangular area | Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis) |
| Podocyte fusion on EM | Minimal change disease (child with nephrotic syndrome) |
| Polished, "ivory-like" appearance of bone at cartilage erosion | Eburnation (osteoarthritis resulting in bondy sclerosis) |
| Protein aggregates in neurons from hyperphosphorylation of protein tau | Neurofibrillary tangles (Alzheimer's disease and CJD) |
| Pseudopalisading tumor cells on brain biopsy | Glioblastoma multiforme |
| RBC casts in urine | Acute glomerulonephritis |
| Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells | Reinke crystals (Leydig cell tumor) |
| Renal epithelial casts in urine | Acute toxic/viral nephrosis |
| Rhomboid crystals, positively birefringent | Pseudogout (calcium pyrophosphate dihydrate) |
| Rib notching | Coarctation of the aorta |
| Sheets of medium-sized lymphoid cells ("starry sky" appearance on histology) | Burkitt's lymphoma (t[8;14] c-myc activation, associated with EBV) |
| Silver-staining spherical aggregation of tau proteins in neurons | Pick bodies (Pick's disease: progressive dementia, similar to Alzheimer's) |
| "Soap bubble" in femur or tibia on x-ray | Giant cell tumor of bone (generally benign) |
| "Spikes" on basement membrane, "dome-like" endothelial deposits | Membranous glomerulonephritis (may progress to nephrotic syndrome) |
| Stacks of RBCs | Rouleaux formation (high ESR, multiple myeloma) |
| Stippled vaginal epithelial cells | "Clue cells" (Gardnerella vaginalis) |
| "Tennis-racket"-shaped cytoplasmic organelles (EM) in Langerhans cells | Birbeck granules (histiocytosis X: eosinophilic granuloma) |
| Thrombi made of white/red layers | Lines of Zahn (arterial thrombus, layers of platelets/RBCs) |
| "Thumb sign" on lateral x-ray | Epiglottitis (Haemophilis influenzae) |
| Thyroid-like appearance of kidney | Chronic bacterial pyelonephritis |
| "Tram-track" appearance on LM | Membranoproliferative glomerulonephritis |
| Triglyceride accumulation in liver cell vacuoles | Fatty liver disease (alcoholic or metabolic syndrome) |
| WBCs that look "smudged" | CLL (almost always B cell; affects the elderly) |
| "Wire loop" glomerular appearance on LM | Lupus nephropathy |
| Yellow CSF | Xanthochromia (subarachnoid hemorrhage) |
| Actinic (solar keratosis) | Precursor to squamous cell carcinoma |
| Acute gastric ulcer associated with CNS injury | Cushing's ulcer (increased ICP stimulates vagal gastric secretion) |
| Acute gastric ulcer associated with severe burns | Curling's ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa) |
| Alternating areas of transmural inflammation and normal colon | Skip lesions (Crohn's disease) |
| Aneurysm, dissecting | Hypertension |
| Aortic aneurysm, abdominal and descending aorta | Atherosclerosis |
| Aortic aneurysm, ascending | Tertiary syphilis, Marfan's syndrome |
| Atrophy of the mammillary bodies | Wernicke's encephalopathy (thiamine deficiency causing ataxia, ophthalmoplegia, and confusion) |
| Autosplenectomy (fibrosis and shrinkage) | Sickle cell anemia (HbS) |
| Bacteria associated with stomach cancer | H. pylori |
| Bacterial meningitis (adults and elderly) | Neisseria meningitidis |
| Bacterial meningitis (newborns and kids) | Group B streptococcus (newborn), S. pneumoniae/Neisseria meningitidis (kids) |
| Benign melanocytic nevus | Spitz nevus (most common in first two decades) |
| Bleeding disorder with GpIb deficiency | Bernard-Soulier disease (defect in platelet adhesion to von Willebrand's factor) |
| Brain tumor (adults) - general type and most common | Suptatentorial: mets > astrocytoma (including glioblastoma multiforme) > meningioma > schwannoma |
| Brain tumor (kids) - most common & location | Infratentorial: medulloblastoma (cerebellum) or supratentorial: craniopharyngioma (cerebrum) |
| Breast cancer | Infiltrating ductal carcinoma (in the US, 1 in 9 women will develop breast cancer) |
| Breast mass | 1. Fibrocystic change 2. Carcinoma (in postmenopausal women) |
| Breast tumor (benign) | Fibroadenoma |
| Cardiac primary tumor (kids) | Rhabdomyoma |
| Cardiac manifestation of lupus | Libman-Sacks endocarditis (nonbacterial, affecting mitral) |
| Cardiac tumor (adults) | 1. Metastasis 2. Primary myxoma (4:1 LA to RA; "ball and valve") |
| Cerebellar tonsillar herniation | Chiari malformation (often presents with progressive hydrocephalus or syringomyelia) |
| Chronic arrhythmia | Atrial fibrillation (associated with high risk of emboli) |
| Chronic atrophic gastritis (autoimmune) | Predisposition to gastric carcinoma (can also cause pernicious anemia) |
| Clear cell adenocarcinoma of the vagina | DES exposure in utero |
| Congenital adrenal hyperplasia, hypotension | 21-hydroxylase deficiency |
| Congential cardiac anomaly (most common) | VSD |
| Constrictive pericarditis in developing world | Tuberculosis |
| Coronary artery involved in thrombosis | LAD>RCA>LCA |
| Cretinism | Iodine deficit/hypothyroidism |
| Cushing's syndrome | 1. Corticosteroid therapy 2. Excess ACTH secretion by pituitary |
| Cyanosis (early; less common) | Tetralogy of Fallot, transposition of great vessels, truncus arteriosus, tricuspid atresia, total anomalous pulmonary venous return (5 T's) |
| Cyanosis (late; more common) | VSD, ASD, PDA |
| Death in CML | Blast crisis |
| Death in SLE | Lupus nephropathy |
| Dementia | 1. Alzheimer's disease 2. Multiple infarcts |
| Demyelinating disease in young women | Multiple sclerosis |
| DIC | Gram-negative sepsis, obstetric complications, cancer, burn trauma |
| Dietary deficit | Iron |
| Diverticulum in pharynx | Zenker's diverticulum (diagnosed by barium swallow) |
| Ejection click | Aortic/pulmonic stenosis |
| Esophageal cancer | Squamous cell carcinoma (worldwide); adenocarcinoma (US) |
| Food poisoning (exotoxin mediated) | S. aureus, B. cereus |
| Glomerulonephritis (adults) | Berger's disease (IgA nephropathy) |
| Gynecologic malignancy (most common) | Endometrial carcinoma |
| Heart murmur, congential | Mitral valve prolapse |
| Heart valve in bacterial endocarditis | Mitral (rheumatic fever), tricuspid (IV drug abuse), aortic (2nd affected in rheumatic fever) |
| Helminth infection (US) | 1. Enterobius vermicularis (pinworm--Scotch tape test) 2. Ascaris lumbricoides |
| Hematoma-epidural | Rupture of middle meningeal artery (crescent shaped) |
| Hematoma-subdural | Rupture of bridging veins (trauma; lentiform [biconvex] shaped) |
| Hemochromatosis | Multiple blood transfusions or hereditary HFE mutation (can result in CHF, "bronze diabetes," and increased risk of hepatocellular carcinoma) |
| Hepatocellular carcinoma | Cirrhotic liver (often associated with hepatitis B and C) |
| Hereditary bleeding disorder | von Willebrand's disease |
| Hereditary harmless jaundice | Gilbert's syndrome (benign congential unconjugated hyperbilirubinemia) |
| HLA-B27 | Ankylosing spondylitis, Reiter's syndrome/reactive arthritis, ulcerative colitis, psoriasis |
| HLA-DR3 or -DR4 | Diabetes mellitus type 1, rheumatoid arthritis, SLE |
| Holosystolic murmur | VSD, tricuspid regurgitation, mitral regurgitation |
| Hypercoagulability, endothelial damage, blood stasis | Virchow's triad (results in venous thrombosis) |
| Hypertension, secondary | Renal disease |
| Hypoparathyroidism | Thyroidectomy |
| Hypopituitarism | Pituitary adenoma (usually benign tumor) |
| Infection secondary to blood transfusion | Hepatitis C |
| Kidney stones | 1. Calcium = radiopaque 2. Struvite (ammonium) = radiopaque (formed by urease-positive organisms such as Proteus vulgaris or Staphylococcus) 3. Uric acid = radiolucent |
| Late cyanotic shunt (uncorrected L-->R becomes R-->L) | Eisenmenger's syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia) |
| Liver disease | Alcoholic cirrhosis |
| Lysosomal storage disease | Gaucher's disease |
| Male cancer | Prostatic carcinoma |
| Malignancy associated with noninfectious fever | Hodgkin's lymphoma |
| Malignant skin tumor | Basal cell carcinoma (rarely metastasizes) |
| Mental retardation | 1. Down syndrome 2. Fragile X syndrome |
| Metastases to bone | Breast, lung, thyroid, testes, prostate, kidney |
| Metastases to brain | Lung, breast, skin (melanoma), kidney (renal cell carcinoma), GI |
| Metastases to liver | Colon, gastric, pancreatic, breast, and lung carcinomas |
| Mitral valve stenosis | Rheumatic disease |
| Mixed (UMN and LMN) motor neuron disease | ALS |
| Myocarditis (virus that causes) | Coxsackie B |
| Neoplasm (kids) | 1. ALL 2. Cerebellar medulloblastoma |
| Nephrotic syndrome (adults) | Membranous glomerulonephritis |
| Nephrotic syndrome (kids) | Minimal change disease (associated with infections/vaccinations; treat with corticosteroids) |
| Nosocomial pneumonia | Klebsiella, E. coli, Pseudomonas aeruginosa |
| Obstruction of male urinary tract | BPH |
| Opening snap | Mitral stenosis |
| Opportunistic infection in AIDS | Pneumocystis jiroveci (formerly carinii) pneumonia |
| Osteomyelitis | S. aureus |
| Osteomyelitis in sickle cell disease patients | Salmonella |
| Osteomyelitis with IV drug abuse | Pseudomonas, S. aureus |
| Ovarian metastasis from gastric carcinoma or breast cancer | Krukenbery tumor (mucin-secreting signet-ring cells) |
| Ovarian tumor (benign) | Serous cystadenoma |
| Ovarian tumor (malignant) | Serous cystadenocarcinoma |
| Pancreatitis (acute) | Gallstones, alcohol |
| Pancreatitis (chronic) | Alcohol (adults), cystic fibrosis (kids) |
| Patient with ALL/CLL/AML/CML | ALL: child, CLL: adult>60, AML: adult>60, CML: adult 35-50 |
| Pelvic inflammatory disease | Neisseria gonorrhoeae (monoarticular arthritis) |
| Philadelphia chromosome t(9;22) (bcr-abl) | CML (may sometimes be associated with AML/ALL) |
| Pituitary tumor | 1. Prolactinoma 2. Somatotrophic "acidophilic" adenoma |
| Primary amenorrhea | Turner syndrome (XO) |
| Primary bone tumor (adults) | Multiple myeloma |
| Primary hyperaldosteronism | Adenoma of adrenal contex |
| Primary hyperparathyroidism | 1. Adenomas 2. Hyperplasia 3. Carcinoma |
| Primary liver cancer | Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, α-1 antitrypsin) |
| Pulmonary hypertension | COPD |
| Recurrent inflammation/thrombosis of small/medium vessels in extremities | Buerger's disease (strongly associated with tobacco) |
| Renal tumor | Renal cell carcinoma: associated with von Hippel-lindau and adult polycystic kidney disease; paraneoplastic syndromes (erythropoietin, renin, PTH, ACTH) |
| Right heart failure due to a pulmonary cause | Cor pulmonale |
| S3 (protodiastolic gallop) | Increased ventricular filling (L-->R shunt, mitral regurgitation, LV failure [CHF]) |
| S4 (presystolic gallop) | Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy) |
| Secondary hyperparathyroidism | Hypocalcemia of chronic kidney disease |
| Sexually transmitted disease | Chlamydia (usually coinfected with gonorrhea) |
| SIADH | Small cell carcinoma of the lung |
| Site of diverticula | Sigmoid colon |
| Sites of atherosclerosis | Abdominal aorta > coronary > popliteal > carotid |
| Stomach cancer | Adenocarcinoma |
| Stomach ulcerations and high gastrin levels | Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas) |
| t(14;18) | Follicular lymphomas (bcl-2 activation) |
| t(8;14) | Burkitt's lymphoma (c-myc lymphoma) |
| t(9;22) | Philadelphiachromosome, CML (bcr-abl hybrid) |
| Temporal arteritis | Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymyalgia rheumatica |
| Testicular tumor | Seminoma |
| Thyroid cancer | Papillary carcinoma |
| Tumor in women | Leiomyoma (estrogen dependent) |
| Tumor of infancy | Hemangioma (usually regresses spontaneously by childhood) |
| Tumor of the adrenal medulla (adults) | Pheochromocytoma (usually benign) |
| Tumor of the adrenal medulla (kids) | Neuroblastoma (malignant) |
| Type of Hodgkin's | Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion) |
| Type of non-Hodgkin's | Diffuse large cell |
| UTI | E. coli, Staphylococcus saprophyticus (young, sexually-active women) |
| Viral encephalitis affecting temporal lobe | HSV |
| Vitamin deficiency (US) | Folic acid (pregnant women are at high risk; body stores only 3- to 4-month supply; prevents neural tube defects) |
| Sensitivity | TP/(TP+FN) |
| Specificity | TN/(TN+FP) |
| Positive predictive value | TP/(TP+FP) |
| Negative predictive value | TN/(TN+FN) |
| Relative risk | (a/[a+b])/(c/[c+d]) |
| Attributable risk | (a/[a+b]) - (c/[c+d]) |
| Number needed to treat | 1/absolute risk reduction |
| Number needed to harm | 1/attributable risk |
| Hardy-Weinberg equilibrium | p^2+2pq+q^2 = 1 p+q = 1 |
| Henderson-Hasselbalch equation | pH = pKa + log([HCO3-]/0.03PCO2) |
| Volume of distribution | Amount of drug in the body/plasma drug concentration |
| Clearance | Rate of elimination of drug/plasma drug concentration |
| Half-life | t1/2 = (0.7xVd)/CL Vd = volume of distribution CL = clearance |
| Loading dose | Cp x(Vd/F) |
| Maintenance dose | Cp x CL/F |
| Cardiac output | Rate of O2 consumption/(arterial O2 content-venous O2 content) Stroke volume x heart rate |
| Mean arterial pressure | Cardiac output x total peripheral resistance 2/3 diastolic pressure + 1/3 systolic pressure |
| Stroke volume | end diastolic volume - end systolic volume |
| Ejection fraction | (Stroke volume/end diastolic volume) x 100 |
| Resistance | Driving pressure/flow (8viscosity x length)/πr^4 |
| Net filtration pressure | [(Pc-Pi)-(πc-πi)] |
| Glomerular filtration rate | U of inulin x (V/P of inulin) GFR = C of inulin Kf[(Pgc-Pbs)-(πgc-πbs)] |
| Effective renal plasma flow | U of PAH x (V/P of PAH) ERPF = C of PAH |
| Renal blood flow | RPF/(1-Hct) |
| Filtration fraction | GFR/RPF |
| Physiologic dead space | Vt x ([PaCO2 - PeCO2]/PaCO2) |
Created by:
cuernavaca05
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