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Rapid Review1

First Aid for USMLE Step 1 Rapid Review

QuestionAnswer
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