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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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