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Buzzwords
| Question | Answer |
|---|---|
| Abdominal pain, ascites, hepatomegaly | Budd-Chiari Syndrome (posthepatic venous thrombosis) |
| Achilles tendon xanthoma, corneal arcus, MI before age 20 | Familial hypercholesterolemia (Absent or defective LDL receptors); Autosomal dominant |
| Adrenal hemorrhage, hypotension, DIC | Waterhouse-Friderichsen syndrome, 1º adrenal insufficiency (associated with Neisseria Meningitidis) |
| Arachnodactyly, lens dislocation, thoracic aortic aneurysm and dissection (cystic medial necrosis of the aorta), hyperflexible joints | Marfan’s syndrome (Fibrillin defect) |
| Athlete with polycythemia | 2º to Erythropoietin injection |
| Back pain, fever, night sweats, weight loss | Pott’s disease (Vertebral tuberculosis) |
| Bilateral hilar adenopathy, uveitis | Sarcoidosis (non-caseating granulmas) |
| Blue sclera | Osteogenesis imperfecta (collagen type 1 defect); Autosomal Dominant, problemas forming triple helix |
| Bluish line on gingival | Burton’s line (lead poisoning) |
| Bone pain, bone enlargement, arthritis | Paget’s disease of bone (increase in osteoblastic and osteoclastic activity) |
| Bounding pulses, diastolic heart murmur, head bobbing | Aortic regurgitation |
| “Butterfly” facial rash and Raynaud’s phenomenon in a young female | SLE |
| Café-au-lait spots, Lisch nodules (iris hamartoma), pheochromocytoma, optic gliomas | Neurofibromatosis I (Von Recklinghausen´s disease); Autosomal Dominant, Chromosome 17, NF1 gene |
| Café-au-lait spots, bilateral acoustic schawnnomas, juvenile cataracts, meningiomas and ependymomas | Neurofibromatosis II; Autosomal Dominant, chromosome 22, gene NF2 |
| Café-au lait spots, polyostotic fibrous dysplasia, precocious puberty | McCune- Albright syndrome (mosaic G-protein signaling mutation) |
| Calf pseudohypertrophy due to fibrofatty replacement of muscle | Muscular Dystrophy (most commonly Duchenne’s X-linked frameshift mutation of truncated dystrophin gene protein |
| Cherry red spot on macula | Tay-Sachs (ganglioside accumulation); Niemann-Pick (sphingomyelin accumulation); central retinal artery occlusion |
| Chest pain on exertion | Angina (stable: with moderate exertion; unstable: with minimal exertion) |
| Chest pain, pericardial effusion/friction rub, persistent fever following MI | Dressler’s syndrome (autoimmune-mediated post MI fibrinous pericardits, 1-12 weeks after acute episode) |
| Child uses arms to stand up from a squat | Gower’s sign (Duchenne muscular dystrophy) |
| 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 (autosomal dominant CAG repeat expansion, boxed ventricles) |
| Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria | McArdle’s Disease (muscle glycogen phosphorylase= Myophosphorylase deficiency) |
| Cold intolerance | Hypothyroidism |
| Conjugate lateral gaze palsy, horizontal diplopia | INO. Side where patient CANNOT ADDUCT is the damaged MLF side. B/L |
| Continuous ‘machinery’ heart murmur | PDA. Close it with Indomethacin, open with Misoprostol. |
| Cutaneous/dermal edema due to connective tissue deposition | Myxedema (caused by hypothyroidism, Grave’s disease (hyperthyroidism); both are periorbital. |
| Dark purple skin/mouth nodules | Kaposi’s sarcoma. Usually AIDs patients or Mediterranean men. Associated with HHV-8 |
| Deep labored breathing/hyperventilation | Kassmaul breathing (diabetic ketoacidosis) |
| Dermatitis, dementia, diarrhea | Pellagra (Niacin, B3, deficiency) |
| Dilated cardiomyopathy, edema, polyneuropathy | Wet beriberi (thiamine, B1, deficiency |
| Dog or cat bite resulting in infection | Pasteurella multocida (cellulitis at inoculation site) |
| Dry eyes, dry mouth, arthritis | Sjogren’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 (type III collagen defect) |
| Enlarged, hard, left supraclavicular node | Virchow’s node (abdominal metastasis) |
| Erythroderma, lymphadenopathy, Hepatosplenomegaly, atypical T-cells | Sezary syndrome (cutaneous T-cell lymphoma) OR mycoses fungoides |
| Facial muscle spasm upon tapping | Chvostek’s sign (hypocalcemia) |
| Fat, female, forty, fertile | Acute Cholelithiasis (Gallstones) |
| 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, X-linked recessive) |
| Green-yellow rings around peripheral cornea | Kayser-Fleischer rings (copper accumulation from Wilsons’ disease) |
| Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands | Peutz-Jeghers sydrome (genetic benign polyposis that can cause bowel obstruction and increased cancer risk) |
| Hepatosplenomegaly, osteoporosis, neurologic symptoms | Gaucher’s disease (glucocerebroside deficiency) |
| Hereditary nephritis, sensineural hearing loss, cataracts | Alport syndrome (mutation in alpha-chain of collagen IV) |
| Hypercoagulability leading to migratory DVT and vasculitis | Trousseau’s sign (adenocarcinoma of pancreas or lung) |
| Hyperphagia, hypersexuality, hyperorality, docile | Kluver-Bucy Syndrome (bilateral amygdala lesion) |
| Hyperreflexia, hypertonia, postive babinski-sign | UMN damage |
| Hypertension, Hypokalemia (low K+), metabolic alkalosis | Conn’s syndrome |
| Hyporeflexia, hypotonia, atrophy | LMN damage |
| Hypoxemia, polycythemia, hypercapnia | Blue bloater (chronic bronchitis: hyperplasia of mucous cells) |
| Indurated ulcerated genital lesion | Non-painful: chancre from 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, hepatomegaly | Cori disease (debranching enzyme deficiency) |
| Infant with microcephaly, rocker-bottom feet, clenched hands, structural heart defect | Edwards syndrome(trisomy 18) |
| Keratin pearls on skin biopsy | Squamous cell carcinoma |
| Large rash with bull’s eye appearance | Erythma 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 | Brutons disease (X-lined agammaglobulinemia) Little boys |
| Mucosal bleeding with prolonged bleeding time | Glanzmann’s thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa) |
| Multiple skin polyps, osteomas/soft tissue tumors, impacted supranumerary teeth | Gardner’s syndrome (subtype of FAP) |
| Myopathy, infantile hypertrophic cardiomyopathy, exercise intolerance | Pompe’s disease (lysosomal a,1-4 glucosidase deficiency) |
| Necrotizing vascultitis in lungs and necrotizing glomerulonephritis | Wegener’s C-ANCA(+) and Goodpastures (anti-basement antibodies) |
| Neonate with arm paralysis following difficult birth | Erb-Duchenne Palsy |
| No lactation postpartum, absent menstruation, cold intolerance | Sheehan’s syndrome (pituitary infarction) |
| Nystagmus, intention tremor, scanning speech, BL INO | MS |
| Oscillating slow/fast breathing | Cheyne-Stokes respirations. Central apnea in CHF or in increase intracranial pressure |
| Painful blue fingers, toes and hemolytic anemia | cold agglutinin disease (autoimmune hemolytic anemia caused by mycoplasma infections and mono) |
| Painful, pale, cold fingers and toes | Raynaud’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 lesion (infective endocarditis) |
| Painless jaundice | Cancer of pancreatic head obstructing the bile duct |
| Palpable purpura on buttocks/ legs, joint painm abdominal pain in a kid | Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys) |
| Pancreatic, pituitary and parathyroid tumors | MEN1 (autosomal dominant) |
| Pink complexion, dyspnea, hyperventilation | pink-puffer from emphysema. Centroacinar is from smoking, panacinar is a1-antitrypsin deficiency |
| Polyuria, acidosis, growth failure, electrolyte imbalances | Fanconi syndrome (proximal tubular reabsorption defect) |
| Positive anterior ¨drawer sign¨ | Anterior Cruciate Ligament injury |
| Ptosis, miosis, anhidrosis | Horner’s syndrome (sympathetic chain lesion) |
| Pupil accommodates but does not react | Argyll Robertson pupil (neurosyphilis) |
| Rapidly progressive leg weakness that ascends following a GI or URI | Guillain Barre syndrome (autoimmune acute inflammatory demyelinating polyneuropathy) |
| Rash on palms and soles | Coxsackie A, Secondary Sypilis, Rocky Mountain Spotted Fever |
| Recurrent colds, unusual eczema, high serum IgE | Hyper-IgE syndrome (Job’s syndrome, neutrophil chemotaxis abnormality) |
| Red “current jelly”sputum in alcoholic or diabetic patients | Klebsiella pneumonia |
| Red itchy, swollen rash of nipple/areola | Paget’s disease of breast (underlying neoplasm) |
| Red pee in the morning, fragile RBCs | Paroxysmal nocturnal hemoglobinuria |
| Renal cell carcinoma (BL) hemangioblastomas, angiomatosis, pheochromocytoma | Von Hippel-Lindau disease (dominant tumor suppressor gene mutation) |
| Resting tremor, rigidity, akinesia, postural instability | Parkinson’s (nigrostriatal dopamine depletion) |
| Retinal Hemorrhages with pale centers | Ruth’s 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 | Down Syndrome-Fanconi anemia (genetic loss of DNA crosslink repair, often progresses to AML |
| Single palm crease | Simian Crease (Downs) |
| Situs inversus, chronic sinusitis, bronchiectasis, infertility | Kartagener’s syndrome (dyenin arm defect affecting cilia) |
| Skin hyperpigmentation | Addison’s disease (primary adrenocortical insufficiency causes increase in ACTH and a-MSA production) |
| Slow, progressive, muscle weakness in boys | Becker’s muscular dystrophy (X-linked missence mutation in dystrophin, less severe than Duchenne’s) |
| Small irregular red spots on buccal/lingual mucosa with blue/white centers | Koplik spots (measles: rubEOla virus) |
| Smooth, flat, moist white lesion on genitals | Condylomata lata (secondary syphilis) |
| Splinter hemorrhages in fingernails | bacterial endocarditis |
| “Strawberry tongue” | Scarlet fever, Kawasaki disease, toxic shock syndrome |
| Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth | Turner Syndrome (45XO, short stature, webbed neck, lymphedema) |
| Sudden swollen/painful big toe joint | Gout/podagra (hyperuricemaia) |
| Swollen gums, mucous bleeding, poor wound healing, spots on skin | Scruvy (Vitamin C deficiency). Cannot hydroxylate proline/lysine for collagen synthesis |
| Swollen, hard, painful finger joints | Osteoarthritis (osteophytes on PIP;bouchard’s nodes, DIP is Heberden’s nodes |
| Systolic ejection murmur that is creshendo-decreshendo | aortic valve stenosis |
| Thyroid and Parathyroid, pheochromocytoma | MEN 2A (autosomal dominant ret mutation) |
| Thyroid tumors, pheochromocytoma, ganglioneuromatosis | MEN 2B (autosomal dominant ret mutation) |
| Toe extension/fanning upon plantar scrape | Bakinski sign (UMN) |
| Unilateral facial drooping involving forehead | Bell’s palsy (LMN CN VII palsy) |
| Urethritis, conjuctivitis, arthritis in male | Reactive Arthritis associated with HLA-B27 |
| Vascular birthmark (port-wine stain) | Hemangioma (benign but associated with Sturge-Weber syndrome) |
| Vomiting blood following esophagogastric lacerations | Mallory Weiss syndome (alcoholic and bulemic patients) |
| Waxy Casts with very low urine flow | Chronic end stage renal disease |
| WBC casts in urine | Acute pyelonephritis |
| Weight loss, diarrhea, fever, adenopathy | Whipple disease (Tropheryma whippelii) |
| Worst headache of my life | Subarachnoid hemorrhage |
| Anticentromere antibodies | Scleroderma (CREST) |
| Antidesmoglein (epithelial antibodies) | Pemphigus vulgaris (blistering) |
| Anti-glomerular basement membrane antibodies | Goodpasture's syndrome (glomerulonephritis and hemoptysis) |
| Anti-histone antibodies | Drug induced SLE (hydralazine, isoniazid, phenytoin, procainamide) |
| Anti-IgG antibodies | RA (systemic inflammation, joint pannus, boutonniere deformity) |
| Anti-mitochondrial antibodies (AMAs) | Primary biliary cirrhosis (female, cholestasis, portal HTN) |
| Antineutrophil cytoplasmic antibodies (ANCAs) | Vasculitis: c-ANCA in Wegener's and p-ANCA in microscopic polyangitis, Churg-Strauss |
| ANA (Anti-Smith and anti-dsDNA) is associated with what disease? | SLE (type III hypersensitivity) |
| Antiplatelet antibodies | Idiopathic thrombocytopenic purpura (ITP) |
| Anti-topisomerase antibodies | Diffuse systemic scleroderma |
| Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies | Celiac disease (diarrhea, distension, weight loss) |
| ¨Apple core¨lesion on abdominal x-ray | Colorectal cancer (usually left sided) |
| Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts | Auer rods. Acute Myelogenous Leukemia, AML. Especially the M3 type= t(15;17) |
| Bacitracin resistant | Streptococcus agalactiae, group B |
| Bacitracin sensitive | Streptococcus pyogenes, group A |
| ¨Bamboo spine¨ on X-ray | Ankylosing spondylitis (chronic inflammatory arthritis, HLA-B27+) |
| Basophilic nuclear remnants in RBC | Howell-Jolly bodies (due to splenectomy or non-functional spleen) |
| Basophilic stippling of RBC | 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 (anaerobe, NOT acid fast, resembles Fungi) |
| Bronchogenic apical lung tumor | Pancoast tumor; can compress the sympathetic ganglion and cause Horner's syndrome |
| ¨Brown¨ tumor of bone | Hemorrhage (hemosiderin) causes the brown color of osteolytic cysts. Due to 1) Hyperparathyroidism and 2) Osteitis fibrosa cystica |
| Cardiomegaly with apical atrophy | Chaga's disease (Trypanosoma cruzi) |
| Cellular crescents in Bowman's capsule | Rapidly progressive crescentic glomerulonephritis |
| Chocolate cyst of ovary | Endometriosis (frequently involves both ovaries) |
| Circular grouping of dark tumor cells surrounding pale neurofibrils | Homer Wright rosettes (neuroblastoma, medulloblastoma and retinoblastoma) |
| Colonies of pseudomonas in the lung | Cystic fibrosis (AR Mutation to CFTR resulting in fat-soluble vitamin deficiency and mucous plugs) Chromosome 7 |
| DECREASED alpha-fetoprotein in amniotic fluid or maternal serum | Down Syndrome (trisomy 21) and Edward Syndrome (trisomy 18) |
| Degeneration of Dorsal columns | Tabes dorsalis (Tertiary syphilis). Test spinal fluid with VDRL or RPR |
| Depigmentation of neurons in Substantia Nigra | Parkinson's disease (Basal ganglia; rigidity, resting tremor, bradykinesia) |
| Desquamated epithelium casts in sputum | Curschmann's spirals (bronchial asthma and can result in whorled mucous plugs) |
| Disarrayed granulosa cells in eosinophilic fluid | Call-Exner bodies (granulosa-theca cell tumor of ovary) |
| Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia | Koilocytes (HPV; predisposes to cervical cancer) |
| Enlarged cells with intranuclear inclusion bodies, ¨Owl´s Eye¨inclusions | CMV (HHV-5; latent in Mononuclear Cells) |
| Enlarged thyroid cells with ground glass nuclei | Orphan Annie cells: 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) |
| Eosinophilic globule in liver | Councilman body (toxic or viral hepatitis, often Yellow Fever) |
| Eosinophilic inclusion bodies in cytoplasm of hippocampus nerve cells | Rabies Virus (Lyssavirus) |
| Extracellular amyloid deposition of gray matter in the brain | Senile Plaques (Alzheimer's) |
| Giant B cells with bilobed nuclei and prominent inclusions | Reed-Sternberg cells (Hodgkin's lymphoma) |
| Glomerulus like structure surrounding vessel in germ cells | Schiller-Duval bodies (Yolk Sac tumor) |
| ¨Hair on end¨ or Crewcut appearance on X-ray | B-thalassemia or sickle cell due to marrow expansion |
| hCG elevated | Choriocarcinoma, hydatiform mole (occurs with and without embryo) |
| Heart nodules (granulomas) | Aschoff bodies (Rheumatic fever) |
| Heterophile antibodies | EBV- infectious mononucleosis |
| Hexagonal, double pointed needle-like crystals in bronchial secretions | Charcot-Leyden crystals (eosinophilic granules) in bronchial asthma |
| High level of D-dimers | DVT, PE, DIC |
| Hilar adenopathy, peripheral granulomatous lesion in middle or lower lobe that can calcify | Ghon complex in primary TB |
| Honeycomb lung on x-ray/CT | Interstitial fibrosis |
| Hypersegmented neutrophils | Megaloblastic anemia (B12 deficiency, neurologic symptoms, folate deficiency= no neurologic symptoms |
| Hypochromic, microcytic anemia | Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present) |
| INCREASED alpha-fetoprotein in amniotic fluid/maternal serum | 1) Dating error, multiple gestation 2) (NTD): anencephaly, spina-bifida 3) Abdominal Wall defects: Gastroschisis, Omphalocele |
| Increased uric acid levels | Gout, Lesh-Nyhan syndrome, tumor lysis syndrome, loop and thiazine diuretics |
| Intranuclear eosinophilic droplet-like bodies | Cowdry type A bodies (HSV and CMV) |
| Iron containing nodules in alveolar septum | Ferruginous bodies (asbestos increases the chance for Mesothelioma) |
| Large lysosomal vesicles in phagocytes, immunodeficiency | Chediak Higashi (failure of phagolysosome formation), Autosomal recessive |
| ¨Lead pipe¨ appearance of colon on x-ray | Ulcerative Colitis (loss of haustra) |
| Linear appearance of glomeruli on immunofluorescence | Goodpasture's syndrome (Glomerulonephritis + hemoptysis) |
| Low serum ceruloplasmin | Wilson's disease (hepatolenticular degeneration), AR chromosome 13 |
| ¨Lumpy-bumpy¨ on Immunofluorescence due to IgG, IgM and C3 deposition along GBM and Mesangium | Acute Poststreptococcal glomerulonephritis (Associations: Type III hypersensitivity; Children; 2 weeks after pharynx or skin infection with Group A strep) |
| Lytic (¨Hole punched¨) bone lesions on x-ray | Multiple Myeloma (Monoclonal Plasma Cell cancer) |
| Mammary gland (¨blue domed¨ ) cyst | Fibrocystic change of the breast |
| Monoclonal antibody spike | 1) Multiple Myeloma; usually IgG (55%), IgA (25%) 2) MGUS 3) Waldenstrom Macroglobulinemia M spike= IgM 4) Primary Amyloidosis |
| Monoclonal Ig Light Chains in urine | Bence Jones proteins in Multiple Myeloma |
| Mucin-filled cell with peripheral nucleus | Signet ring (gastric carcinoma) |
| Needle shaped, negatively birefringent crystals | Gout (monosodium urate crystals) |
| Nodular hyaline deposits in glomeruli | Kimmelstiel-Wilson nodules (Diabetic Nephropathy) |
| Novobiocin sensitive | Staphylococcus epidermidis |
| Novobiocin resistant | Staphylococcus saphrophyticus |
| ¨Nutmeg¨ liver | Chronic passive congestion of liver due to Right Heart Failure |
| ¨Onion skin¨ periosteal reaction | Ewing´s sarcoma (malignant round cell tumor) |
| Periosteum raised from bone creating triangular area | Codman's triangle on x-ray (osteosarcoma, Ewing´s Sarcoma, Pyogenic Osteomyelitis) |
| Podocyte fusion or ¨effacement¨ on EM | Minimal change disease (child with nephrotic syndrome) |
| Polished 'ivory like' appearance of bone at cartilage erosion | Eburnation (osteoarthritis resulting in bony sclerosis) |
| Protein aggregates in neurons from hyperphosphorylation of protein tau | Neurofibrillary tangles= Alzheimer's disease and Pick´s Bodies= Pick´s disease |
| 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, postively birefringent | Pseudogout (calcium pyrophosphate dihydrate crystals) |
| Rib notching | Coarctation of the Aorta |
| Ring enhancing brain lesion in AIDS | Toxoplasma gondii, Brain Abscesses. CD4+<100 |
| Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages "starry sky appearance on histology" | Burkitt Lymphoma, t(8:14) c-myc activation, associated with EBV- ¨black sky¨made up of malignant cells |
| Silver staining spherical aggregation of tau proteins in neurons | Pick bodies (Pick's disease is a progressive dementia, changes in personality) Frontotemporal |
| ¨Soap bubble¨ in femur or tibia on x-ray | Giant cell tumor, generally benign |
| ¨Spikes¨ on basement membrane, ¨dome-like¨ subepithelial deposits | Membranous glomerulonephritis that 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 Langerhan's cells | Birbeck granules (Langerhans cell histiocytosis or Histiocytosis X: eosinophilic granuloma) |
| Thrombi made of white/red layers | Lines of Zahn (arterial thrombosis, layers of platelets/RBC) |
| ¨Thumb sign¨ on lateral x-ray | Epiglottitis (H. Influenza) |
| Thyroid-like appearance of kidney | Chronic bacterial pyelonephritis |
| ¨Tram-track¨ appearance on LM | Membranoproliferative glomerulonephritis |
| Triglyceride accumulation in liver cell vacuoles | Fatty liver disease (alcholic or metabolic syndrome) |
| WBC that look¨smudged¨ | CLL (almost always B-cell, affects elderly) |
| ¨Wire-loop¨ glomerular capillary appearance on LM | Lupus nephropathy |
| Yellow CSF on LP | Xanthochromia (previous Subarachnoid Hemorrhage) |
| Absence seizures treatment | Ethosuximide (Blocks thalamic T-type Ca+2 channels) |
| Acute Gout treatment | NSAIDS, Colchicine |
| Acute Promyelocytic Leukemia (M3) | All-trans retinoic acid |
| ADHD | Methylphenidate, amphetamines |
| Alcohol Abuse | AA + disulfram,naltrexone or acamprosate for patient. Al-Anon for family |
| Alcohol Withdrawal | Benzodiazepines |
| Anorexia | SSRIs |
| Anticoagulation during pregnancy | Heparin |
| Anxiety | Buspirone |
| Arrhythmia in damaged cardiac tissue | Class IB anti-arrhythmic (lidocaine, mexiletine, tocainide) |
| B12 Deficiency | B12 supplementation (work up cause with Schilling test) |
| Benign Prostatic Hyperplasia | Tamsulosin, Finasteride |
| Bipolar Disorder | ¨Mood Stabilizers¨(e.g Lithium, Valproic acid, Carbamazepine) + Atypical antipsychotics |
| Breast cancer in POSTMENOPAUSAL women | Aromatase inhibitor (Anastrozole) |
| Buerger's disease | Smoking Cessation |
| Bulemia | SSRIs |
| Candida albicans | Amphotericin B (systemic), nystatin (oral thrush, esophagitis), azoles (vaginitis) |
| Carcinoid syndrome | Octreotide (Somatostatin analog) |
| Chlamydia trachomatis | Doxycycline (+ ceftriaxone for gonorrhea co-infection), erythromycin eye drops (prophylaxis in infants) |
| Chronic Gout | Probenecid (underexcretor), Allopurinol (over-producer) |
| Chronic hepatitis | IFN-alpha |
| Chronic Myelogenous Leukemia | Imatinib |
| Clostridium botulinum | Anti-toxin |
| Clostridium difficile | Oral Metronidazole; if refractory, Oral Vancomycin |
| Clostridium tetani | Anti-toxin +vaccine booster +diazepam |
| Crohn's disease | Corticosteriods, Infliximab (monoclonal antibody to TNF-alpha) |
| Cryptococcus neoformans | Fluconazole (prophylaxis in AIDS) |
| CMV | Ganciclovir (Guanosine analog; inhibits viral DNA Polymerase) |
| Depression | SSRIs (first line) |
| Diabetes insipidus | Desmopressin (central); hydrochlorothiazide, indomethacin, amiloride (nephrogenic) |
| Diabetes type I (Autoimmune destruction beta cells) | Low sugar diet + insulin replacement |
| Diabetes type II (progressive pancreatic beta cell failure) | Diet, oral hypoglycemics and possible insulin |
| Diabetic Ketoacidosis | Fluids, insulin, K+ |
| Enterococci | Vancomycin/ampicillin + aminoglycoside |
| Erectile Dysfunction | Sildenafil (inhibits Phosphodiesterase 5) |
| ER-positive breast cancer | Tamoxifen (Selective Estrogen Receptor Modulator- SERMs) |
| Ethylelene glycol/methanol intoxication | Fomepizole (alcohol dehydrogenase inhibitor) |
| Folate deficiency | Folate |
| Haemophilus influenzae B | Rifampin, prophylaxis (inhibits DNA-dependent RNA polymerase) |
| Hemorrhagic Cystitis caused by Cyclophosphamide can be PREVENTED with | Mesna (Thiol group of Mesna binds Acrolein) |
| Heparin Toxicity, Acute | Protamine sulfate |
| HER2/NEU positive breast cancer | Trastuzumab (Monoclonal antibody against HER-2 (c-erbB2), a tyrosine kinase receptor) |
| Hyperaldosteronism | Spironolactone, K+ Sparing Diuretic (Competitive Aldosterone Receptor Antagonists in the Cortical Collecting Tubule) |
| Hypercholesteremia | Statins, 1st Line (HMG-CoA reductase inhibitor) |
| Hypertriglyceridemia | Fibrate |
| Immediate anti-coagulation | Heparin |
| Infertility | Leuprolide (GnRH analog), GnRH (pulsatile) |
| Influenza | Rimantadine/Oseltamivir (inhibit Influenza neuraminidase) |
| Legionella Pneumonia | Erythromycin (Macrolide; bacteriostatic; inhibits protein synthesis by blocking translocation. It binds 23S rRNA or the 50S ribosomal subunit |
| Long term anticoagulation | Warfarin (Interferes with gamma-carboxylation of Vit K-dependent clotting factors: 2,7,9,10 and proteins C and S |
| Malaria | Chloroquine/mefloquine (blood schizont) and Primaquine (liver hypnozoite) |
| Malignant hyperthermia (caused by:Inhaled Anesthetics EXCEPT, Nitrous Oxide and Succinylcholine) | Dantrolene (prevents release of Ca+2 from sarcoplasmic reticulum of skeletal muscle) |
| Medical Abortion | Mifepristone (anti-Progestin) |
| Migraine | Sumatriptan (Serotonin 1B/1D agonist) |
| MRSA | Vancomycin (inhibits cell wall peptidoglycan formation by binding D-ala D-ala ) |
| Multiple Sclerosis | B-interferon |
| TB | RIPE: Rifampin, INH, Pyrazinamide, Ethambutol, |
| Neisseria gonorrhoeae | Ceftriaxone (add doxycycline to cover likely concurrent Chlamydia) |
| Neisseria meningitidis | Pennicillin/ceftriaxone, and rifampin for prophylaxis |
| Neural tube defect PREVENTION | Folate |
| Osteomalacia/Rickets | Vitamin D supplementation |
| Patent ductus arteriosus | Indomethacin |
| Pheochromoctoma | Alpha-antagonists (e.g Phenoxybenzamine) |
| Pneumocystis- jiroveci | TMP-SMX (prophylaxis in AIDS) |
| Prolactinoma | Bromocriptine (dopamine agonists) |
| Prostate cancer and uterine fibroids | Leuprolide, GnRH (continuous) |
| Prostate carcinoma | Flutamide |
| Pseudomonas aeruginosa | Anti-pseudomonal penicillin +aminoglycoside |
| Pulmonary arterial hypertension (Idiopathic) | Sildenafil, Bosentan, Epoprostenol |
| Rickettsia rickettsii | Doxycycline, Cloramphenicol (especially in the context of aplastic anemia) |
| Ringworm infections | Terbinafine, griseofulvin, imidazole |
| Schizophrenia-negative symptom | 5-HT2A antagonists (Olamzapine) |
| Schizophrenia-positive symptoms | D2 receptor antagonists (1st and 2nd generation antipsychotics) |
| SIADH | Demeclocycline, lithium, vasopressin receptor antagonists |
| Sickle cell anemia | Hydroxyurea (increases fetal hemoglobin) |
| Sporothrix schenckii | Oral Potassium Chloride |
| Stable angina | Sublingual nitroglycerin |
| Staph aureus | MSSA: nafcillin, oxacillin, dicloxacillin (antistaphylococcal penicillins); MRSA: Vancomycin |
| Streptococcus bovis | Penicillin prophylaxis; Evaluation for Colon Cancer if linked to Endocarditis |
| Streptococcus pneumoniae | Penicillin/cephalosporin (systemic infection or pneumonia)/Vancomycin (Meningitis) |
| Streptococcus pyogenes | Penicillin prohphylaxis |
| Temporal arteritis | High Dose steroids |
| Tonic-Clonic Seizures | Phenytoin, Valproate, Carbamazepine |
| Toxoplasma gondii | Sulfonamide + pyrimethamine |
| Treponema pallidum | Penicillin |
| Trichomonas vaginalis | Metronidazole (patient + partner) |
| Ulcerative colitis | 5-ASA, infliximab |
| UTI prophylaxis | TMP-SMX |
| Warfarin Toxicity | Fresh frozen plasma (acute) and Vitamin K (chronic) |
| Wegener's Granulomatosis | Cyclophosphamide, corticosteriods |
| Clear cell adenocarcinoma of the vagina | DES exposure in utero |
| Congenital adrenal hyperplasia with hypotension | 21-hydroxylase deficiency |
| Congenital conjugated hyperbilirubinemia (black liver) | Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile) |
| Constrictive pericarditis | Tuberculosis (developing world), SLE in developed world |
| Coronary artery involved in thrombosis | LAD>RCA>LCA |
| Cretinism | Iodine deficit/Congenital hypothyroidism |
| Cushings syndrome | *Iatrogenic Cushing´s (from Corticosteroid therapy) *Adrenocortical Adenoma (secretes excess cortisol) *ACTH secreting pituitary adenoma *Paraneoplastic Cushing´s (due to ACTH secretion by tumors) |
| Cyanosis (early, less common) | Tetralogy of Fallot, transposition of great vessels, truncus arteriosus |
| Cyanosis (late, more common) | VSD, ASD, PDA |
| Death in CML | Blast crisis |
| Death in SLE | Lupus nephropathy |
| Dementia | Alzheimer's/ Multiple infarcts |
| Demyelinating disease in young women | MS |
| DIC | Gram negative sepsis, obstetric complications, cancer, burns, trauma, major surgery |
| 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 in adults | Berger's disease (IgA nephropathy) |
| Gynecologic malignancy | Endometrial carcinoma (US), Cervical carcinoma (worldwide) |
| Heart murmur, congential | Mitral valve prolapse |
| Heart valve in bacterial endocarditis | Mitral (rheumatic fever), tricuspid (IV drug use), aortic (second affected in rheumatic fever) |
| Helminth infection (US) | 1) Enterobius vermicularis 2) Ascaris lumbricoides |
| Hematoma- Epidural | Rupture of middle meningeal artery (trauma), lentiform shaped |
| Hematoma-Subdural | Rupture of bridging veins (crescent shaped) |
| Hemochromatosis | Multiple blood transfusions or hereditary HFE mutation that can result in CHF, bronze diabetes and increased risk for Hepatocellular Carcinoma |
| Hepatocellular carcinoma | Cirrhotic liver (associated with both hepatitis B and C and with alcoholism) |
| Hereditary bleeding disorder | von-Willebrand disease (autosomal dominant) |
| Hereditary harmless jaundice | Gilbert's syndrome (benign congenital unconjugated hyperbilirubinemia) |
| HLA-B27 | Ankylosing spondylitis, Reiter's syndrome, ulcerative colitis, psoriasis |
| HLA-DR3 or DR4 | Diabetes Mellitus type 1, RA, SLE |
| Holosystolic murmur | VSD, tricuspid regurgitation, mitral regurgitation |
| Hypercoagulability, endothelial damage, blood stasis | Virchow's triad (results in venous thrombosis) |
| Secondary hypertension | Renal Disease |
| Hypoparathyroidism | Accidental excision during thyroidectomy |
| Hypopituitarism | pituitary adenoma (usually bengin) |
| Infection secondary to blood transfusion | Hepatitis C |
| Infections in chronic granulomatous disease | Staph aureus, E Coli, Aspergillus (catalase positive) |
| Kidney stones-radiopaque | Calcium |
| Kidney stones-radiopaque, urease positive | Struvite (ammonium), formed by urease positive organisms such as proteus vulgaris or staphyloccus |
| Kidney stones-radiolucent | Uric acid |
| Late cyanotic shunt; uncorrected L->R becomes R->L | Eisenmenger's syndrome. Caused by ASD, VSD, PDA and results in pulmonary HTN/polycythemia |
| Lysosomal storage disease | Gaucher's disease |
| Male cancer | Prostatic carcinoma |
| Malignancy associated with non-infectious fever | Hodgkin's Lymphoma |
| Malignant skin tumor that rarely metastasizes | Basal cell carcinoma |
| Mental retardation (genetic) | 1. Down syndrome 2. Fragile X syndrome |
| Metastases to bone | Prostate (blastic),Breast (lytic and blastic)> lung> thyroid |
| Metastases to brain | Lung> breast> genitourinary> osteosarcoma> melanoma> GI |
| Metastases to liver | Colon>> stomach> pancreas |
| Mitochondrial inheritance | Disease occurs in both daughters and sons; inherited through mother ONLY |
| Mitral valve stenosis | Rheumatic heart diease |
| Mixed UMN and LMN disease | Amyotrophic Lateral Sclerosis= ALS |
| Myocarditis | Coxsackie B |
| Neoplasm in Kids | ALL and cerebellar medulloblastoma |
| Nephrotic syndrome; African American Adults | Focal Segmental glomerulosclerosis |
| Nephrotic syndrome in Caucasian adults | Membranous Nephropathy; commonly associated with solid tumors. Work up for colon cancer |
| Nephrotic syndrome in Kids | Minimal change diease; associated with infections and vaccinations. Treat with steriods |
| Neuron migration failure | Kallman syndrome |
| Nosocomial pneumonia | Klebsiella, E. Coli, Pseudomonas aeruginosa |
| Obstruction in male urinary tract | BPH |
| Opening snap | Mitral stenosis |
| Opportunistic infection in AIDS | Pneumocystis jiroveci pneumonia |
| Osteomyelitis | S. aureus |
| Osteomyelitis in sickle cell disease | Salmonella |
| Osteomyelitis with IV drug use | Pseudomonas, S. aureus |
| Ovarian metastasis from gastric carcinoma or breast cancer | Krukenberg tumor (mucin secreting signet-ring cells) |
| Ovarian tumor that is benign and bilateral | Serous cystadenoma |
| Pancreatitis, acute | Gallstones, alcohol |
| Pancreatitis, chronic | Alcohol (adults) and CF in Kids |
| Hematological malignancy in kids | ALL |
| Hematological malignancy in adults | CLL and AML (60) and CML ages 30-60 |
| PID | Neisseria gonorrhoeae (monoarticular arthritis) |
| Philadelphia chromosome t(9:22), bcr-abl | CML, sometimes associated with ALL and AML |
| Pituitary tumor | Prolactinoma and somatoropic acidophilic adenoma |
| Primary amenorrhea | Turner syndrome (45 XO) |
| Primary bone tumor in adults | Multiple myeloma |
| Primary hyperaldosteronism | Adenoma of adrenal cortex |
| Primary hyperparathyroidism | adenomas, hyperplasia, carcinoma |
| Primary liver cancer | Heptocellular carcinoma from chronic hepatitis, cirrhosis, hemochromatosis and alpha-1 anti-tryspin |
| Pulmonary HTN | COPD |
| Recurrent inflammation/thrombosis of small and medium vessels in extremities | Buerger's diease, stronly associated with tobacco |
| Renal tumor associated with von-Hippel-Lindau, adult polycystic kidney disease | Renal cell carcinoma |
| What paraneoplastic syndromes is Renal Cell Carcinoma associated with? | EPO, renin, PTH, ACTH |
| Right heart failure due to a pulmonary cause | Cor pulmonale |
| S3 | increased ventricular filling due to L-> R shunt, mitral regurg, LV failure, CHF |
| S4 | Stiff hypertrophic ventricle, aortic stenosis and restrictive cardiomyopathy |
| Secondary hyperparathyroidism | Hypocalcemia of chronic kidney disease |
| STD | Chlamydia, usually co-infected with gonorrhea |
| SIADH | small cell carcinoma of lung |
| Site of diverticula | Sigmoid colon |
| Most common site of atherosclerosis | Abdominal aorta |
| Stomach cancer | Adenocarcinoma |
| Stomach cancer with high gastrin levels | Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas) |
| t(14:18) | Follicular carcinoma with bcl-2 activation |
| t(18:14) | Burkitt lymphoma with c-myc activation |
| t(9:22) | Philadelphia chromosome |
| Temporal arteritis | risk of ipsalateral blindness due to thrombosis of opthalmic artery, polymyalgia rheumatics |
| Testicular tumor | Seminoma |
| Thyroid cancer | papillary carcinoma |
| Tumor in women | Leiomyoma (estrogen dependant, not pre-cancerous) |
| Tumor of infancy | hemangioma, usually regresses spontaneously by childhood |
| Tumor of adrenal medulla in adults | Pheochromocytoma (usually benign) |
| Tumor of adrenal medulla in kids | Neuroblastoma (malignant) |
| Type of non-Hodgkin's (common) | Nodular sclerosis |
| non-Hodgkins | Diffuse large cell |
| UTI | E coli, Staphlococcus saphrophyticus (young women) |
| Viral encephalitis affecting temporal lobe | HSV-1 |
| Vitamin Deficiency in US | Folic acid. Pregnant women at high risk, body stores 3-4 month supply, prevents NTD |
| Can be caused by alpha-1 antitrypsin deficiency, resulting in excess elastase activity | Emphysema |
Created by:
tessah10
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