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Flashcards in Classic presentations Deck (229):
1

Abdominal pain, ascites, hepatomegaly

Budd-Chiari syndrome (post-hepatic venous thrombosis)

2

Achilles tendon xanthoma

Familial hypercholesterolemia (decreased LDL receptor signaling)

3

Adrenal hemorrhage, hypotension, DIC

Waterhouse-Friderichsen syndrome (meningococcemia)

4

Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints

Marfan's syndrome (fibrllin)

5

Athlete with polycythemia

2/2 EPO injection

6

Back pain, fever, night sweats, weight loss

Pott's disease 2/2 vertebral TB

7

Bilateral hilar LAD & uveitis

Sarcoidosis (non-caseating granuloma)

8

Blue sclera

OI (type 1 collagen defect)

9

Bluish line on gingiva

Burton's line (lead poisoning)

10

Bone pain, bone enlargement, arthritis

Paget's disease (increased blastic and clastic activity)

11

Bounding pulses, diastolic murmur, head bobbing

AR

12

Butterfly facial rash and Raynaud's phenomenon in a young female

SLE

13

Cafe-au-lait spots, Lisch nodules (iris hamartoma)

NF-1 (plus pheochromocytoma, optic glioma)

14

Cafe-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities

McCune-Albright syndrome (mosaic G-protein signaling mutation)

15

Calf pseudohypertropy

Muscular dystrophy (Duchenne)

16

Cherry-red spot macula

Tay Sachs (ganglioside)
Niemann-Pick (sphingomyelin)
Central retinal artery occlusion

17

Chest pain on exertion

Angina (stable: moderate; unstable: mild)

18

Chest pain, pericardial effusion/friction rub, persistent fever following MI

Dressler's syndrome (AI-mediated post MI fibrinous pericarditis): 1-12 weeks following AMI

19

Child uses arms to stand up from squat

Gower's sign: DMD

20

Child with fever later develops rash on face that spreads to body

Parvovirus B19/Erythema infeciosum/Fifth disease "slapped cheek"

21

Chorea, dementia, caudate degeneration

Huntington's disease (AD CAG-repeat)

22

Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria

McArdle's disease (muscle glycogen phosphorylase deficiency)

23

Cold intolerance/sensitivity

Hypothyroidism

24

Conjugate lateral gaze palsy; horizontal diplopia

Internuclear opthalmoplegia (damage to MLF)
Bilateral: MS
Unilateral: stroke

25

Continuous machinery heart murmur

PDA (close with indomethacin; open with misoprostol)

26

Cutaneous edema 2/2 CT deposition

Myxedema (hypothyroidism, Grave's -- pre-tibial)

27

Dark purple skin/mouth nodules

Kaposi's sarcoma (HHV-8)

28

Deep, labored breathing/hyperventilation

Kussmaul breathing (DKA)

29

Dermatitis, dementia, diarrhea

Pellagra (B3 deficiency)

30

Dilated CM, edema, alcoholism/malnutrition

Wet beriberi (B1 deficiency)

31

Dog/cat bite resulting in infection

Pasturella multocida (cellulitis at site of innoculation)

32

Dry eyes, mouth, arthritis

Sjogren's (AI exocrine glands)

33

Dysphagia, glossitis, Fe-deficiency anemia

Plummer-Vinson syndrome (may progress to esophageal SCC)

34

Elastic skin, hypermobility of joints

EDS (type 3 collagen)

35

Enlarged, hard left supraclavicular LN

Vircow's node (abdominal mets)

36

Erythroderma, LAD, HSM, atypical T cells

Sezary syndrome (cutaneous T-cell lymphoma) or mycosis fungoides

37

Facial muscle spasm upon tapping

Chovstek's sign (hypocalcemia)

38

Fat, female, forty, fertile

Cholelithiasis (gall stones)

39

Fever, chills, headache, myalgia 2/2 ABX treatment for syphillis

Jarisch-Herxheimer reaction: rapid lysis of spirochetes; toxin release

40

Fever, cough, conjunctivitis, coryza, diffuse rash

Measles

41

Fever, night sweats, weight loss

B symptoms (lymphoma)

42

Fibrous plaques in soft tissue of penis

Peyronie's disease (CT disorder)

43

Gout, mental retardation, self-mutaliting behavior in boy

Lesch.Nyan syndrome (HGPRT XLR)

44

Green-yellow rings around peripheral cornea

KF rings (Wilson's disease - Cu)

45

Hamartomatous GI polyps, hyperpigmentation of mouth, hands, feet

Peutz-Jegher's syndrome (inherited, benign polyposis can cause bowel obstruction; higher cancer risk, mainly GI)

46

HSM, osteoporosis, neurological symptoms

Gaucher's disease (glucocerebrosidase deficiency)

47

Hereditary nephritis, sensorineural hearing loss, cataracts

Alport syndrome (can't see, can't pee, can't climb a tree: alpha-chain of collagen 4)

48

Hyperphagia, hypersexuality, hyperorality loss, cataracts

Kluver-Bucy sydrome (bilataral amygdala lesion)

49

Hyperreflexia, hypertonia, Babinski sign

UMN lesion

50

Hyporeflexia, hypotonia, atrophy, fasiculations

LMN lesion

51

Hypoxemia, polycythemia, hypercapnia

Blue bloater: chronic bronchitis

52

Indurated, ulcerated genital lesion

Painful: H. ducreyi (chancroid)
Painless: Syphillis (T. pallidum)

53

Infant with cleft lip/palate; microcephaly/holoprosencephaly, polydactyly, cutis aplasia

Patau's syndrome (Trisomy 13)

54

Carcinogen: Aflatoxin (Aspergillus)

Liver: HCC

55

Carcinogen: Alkylating agents

Blood: Leukemia/Lymphoma

56

Carcinogen: Aromatic amines (benzidine, 2-naphthylamine)

Bladder: TCC

57

Carcinogen: Arsenic

Liver: Angiosarcoma
Lung: Ca
Skin: SCC

58

Carcinogen: Asbestos

Lung: bronchogenic > mesothelioma

59

Carcinogen: Carbon tetrachloride

Liver: centrilobular necrosis, fatty change

60

Carcinogen: Cigarette smoke

Bladder (TCC)/Esophagus (SCC) /Kidney (RCC)/Larynx, Lung (SCC) /Pancreas (AC)

61

Carcinogen: Ethanol

Liver: HCC

62

Carcinogen: Ionizing radiation

Thyroid: Papillary thyroid cancer

63

Carcinogen: Nitrosamines (smoked foods)

Stomach cancer

64

Carcinogen: Radon

Lung cancer (second leading cause to lung cancer)

65

Carcinogen: Vinyl chloride

Liver: Angiosarcoma

66

Carcinogens associated with hepatic angiosarcoma

1. Vinyl chloride
2. Arsenic

67

Infant with FTT, HSM and neurodegeneration

Niemann-Pick disease (genetic sphingomyelinase deficiency)

68

Infant with hypoglycemia, FTT and HSM

Cori's disease (debranching enzyme)

69

Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect

Edward's syndrome (trisomy 18)

70

Jaundice, palpable distended non-tender gall bladder

Courvoisier's sign (distal obstruction of biliary tree)

71

Large rash with bull's eye appearance

Erythema migrans (Ixodes tick/Lyme disease)

72

Lucid interval after traumatic brain injury

Epidural hematoma

73

Male child, recurrent infections, no mature B cells

Bruton's X-linked agammaglobulinemia

74

Mucosal bleeding and prolonged bleeding time

Glanzmann's thrombasthenia (Gp2b/3a platelet aggregation)

75

Muffled heart sounds, distended neck veins, hypotension

Beck's triad of cardiac tamponade

76

Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth

Gardner's syndrome (subtype of FAP)

77

Infantile hypertrophic cardiomyopathy; exercise intolerance

Pmpe's disease (lysosomal alpha-1,4, glucosidase deficiency)

78

Neonate w/ arm paralysis following difficult birth

Erb-Duchenne palsy (superior trunk, C5-6 brachial plexus injury -- waiter's tip)

79

No lactation post-partum, absent menstruation, cold intolerance

Sheehan's pituitary infarction

80

Nystagmus, intention tremor, scanning speech, bilateral internuclear opthalmoplegia

MS

81

Oscillating slow/fast breathing

Cheyne-Stokes (central apnea in CHF or raiced ICP)

82

Painful blue fingers/toes, hemolytic anemia

Cold agglutinin disease (AIHA 2/2 M. pna or Mono)

83

Painful, pale, cold fingers/toes

Raynaud's phenomenon (vasospasm in extremities)

84

Painful, raised red lesions on pads of fingers, toes

Osler's node (immune complex)

85

Painless erythematous rash on palms and soles

Janeway lesions (infective endocarditis, septic emboli, microabscess)

86

Painless jaundice

Pancreatic ca obstructing bile duct

87

Palpable purpura on buttocks, joint pain, abdominal pain, hematuria

HSP (IgA vasculitis)

88

Pink puffer with dyspnea and hyperventilation

Emphysema: centriacinar (smoking)
Panacinar (A1AT)

89

Polyuria, RTA type 2, growth failure, electrolyte imbalances, hypophosphatemic rickets

Fanconi's syndrome (proximal tubular reabsorption defect)

90

Positive anterior drawer sign

ACL injury

91

Pruritic, purple, polygonal planar papules and plaques

Lichen planus

92

Ptosis, miosis, anhydrosis

Horner's syndrome

93

Pupil accomodates, but does not react

Argyll Robertson pupil

94

Rapidly progressive leg weakness that ascends following GI/URT infection

GBS

95

Rash on palms and soles

Coxsackie A, RMSF, Syphillis

96

Recurrent colds, unusual eczema, high IgE

Hyper IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)

97

Red currant jely sputum in ETOH/DM patients

Klebsiella

98

Red currrant jelly stools (adults vs. infants)

Acute mesenteric ischemia (adults); intussusception (infants)

99

Red, itchy, swollen rash of nipple/areola

Paget's disease of the breast (underlying neoplasm)

100

Red urine in the morning, fragile RBC's

PNH

101

RCC (B/L), hemangioblastoma, angiomatosis, pheo

VHL (AD TS gene mutation)

102

Resting tremor, rigidity, akinesia, postural instability

Parkinson's disease

103

Retinal hemorrhage with pale centers

Roth spots (bacterial endocarditis)

104

Severe jaundice in a neonate

Crigler-Najjar

105

Severe RLQ pain with palpation of LLQ

Rovsing sign

106

Severe RLQ pain with RB tenderness

McBurney's sign

107

Short stature, high incidence of tumors/leukemia, aplastic anemia

Fanconi's anemia (genetic loss of DNA cross link repair) often progresses to AML

108

Single palmar crease

Down's syndrome

109

Situs inversus, chronic sinusitis, bronchiectasis, infertility

Kartagener's syndrome (dyein arm)

110

Skin hyperpigmentation, hypotension, fatigue

Addison's disease

111

Slow, progressive muscle weakness in boys

Becker's MD (X-linked missense)

112

Small, irregulat spots on buccal/lingual mucosa with blue-white centers

Koplik's spots

113

Splinter hemorrhages in fingernails

Endocarditis

114

Strawberry tongue (3 associations)

Scarlet fever, Kawasaki disease, TSS

115

Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma, short stature, webbed neck, lymphedema

Turner syndrome (45, XO)

116

Sudden swollen/painful big toe joint, tophi

Gout

117

Swollen gums, mucosal bleeding, poor wound healing, spots on skin

Scurvy (vitamin C; cannot hydroxylate proline/lysine for collagen synthesis)

118

Swollen, hard, painful finger joints

OA (osteophytes on PIP = Bouchard; DIP = Heverden's)

119

Systolic ejection murmur

AS

120

Toe extension, fanning upond plantar scrape

Babinski sign (UMN)

121

Urethritis, conjunctivitis, arthritis in a male

Reactive arthritis (HLA-B27)

122

Vascular birthmark (port wine stain)

Hemangioma (benign, but associated with Sturge-Weber syndrome)

123

Vomiting blood following GE lacerations

MW syndrome (ETOH anb bulimic)

124

Weight loss, diarrhea, fever, arthritis, adenopathy

Whipple's disease

125

Worst headache of my life

SA hemorrhage

126

Anticentromere Ab

Scleroderma (CREST)

127

Anti-desmoglein Ab

Pemphigus vulgaris

128

Anti-GBM

Goodpasture's syndrome

129

Anti-histone Ab

Drug induced SLE: hydralazine, INH, phenytoin, procainamide

130

Anti-IgG Ab

RA

131

Anti-mitochondrial Ab

Primary biliary cirrhosis (female, choestasis, portal hypertension)

132

C-ANCA

Wegener's granulomatosis

133

P-ANCA

Churg-Strauss, Microscopic polyangiitis

134

ANA

SLE

135

Anti-platelet Ab

Idiopathic thrombocytopenic prpura

136

Anti-topoisomerase Ab

Diffuse systemic scleroderma

137

Anti-transglutaminase Ab

Celiac

138

Anti-gliadin Ab

Celiac

139

Anti-Endomysial Ab

Celiac

140

Apple core lesion on AXR

Left-sided colorectal cancer

141

Azurophilic peroxidase positive granular inclusions in granuloycytes and myeloblastis

Auer rods: AML (especially APML)

142

Bamboo spine on X-ray

Ankylosing spondylitis (HLA-B27)

143

Basophilic nuclear remnants in RBC

Howell-Jolly bodies (2/2 auto or actual splenectomy)

144

Basophilic stippling of RBC

Lead poisoning or sideroblastic anemia

145

Bloody tap on LP

SA hemorrhage

146

Boot shaped heart on X-ray

TOF, RVH

147

Branching gram-positive rods with sulfur granules

Actinomyces israelii

148

Bronchogenic apical lung tumor on imaging

Pancoast tumor

149

Brown tumor of bone

Hyperparathyroidism or osteitis fibrosis cystica (deposited hemosiderin from hemorrhage gives brown color)

150

Cardiomegaly with apical atrophy

Chagas disease (T. cruzi)

151

Chocolate cyst of ovary

Endometriosis

152

Circular grouping of dark tumor cells surrounding pale neurofibrils

Homer-Writght rosettes (neuroblastoma, medulloblastoma, Rb)

153

Colonies of mucoid Pseudomonas in lungs

CF

154

Decreased AFP in AF or maternal serum

Down Syndrome

155

Degeneration of dorsal columns

Tabes dorsalis

156

Depigmentation of neurons in SN

Parkinson's diease

157

Desquamated epithelial casts in sputum

Curschmann's spirals (asthma)

158

Disarrayed granulosa cells in eosinophilic fluid

Call-Exner bodies (GT cells of ovarian tumor)

159

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

Koilocytes

160

Enlarged cells with intranuclear inclusions

CMV Owl's eye

161

Enlarged thyroid cells with ground glass nuclei

Orphan Annie Eyes (papillary thyroid cancer)

162

Eosinophilic intracytoplasmic inclusion of liver cell

Mallory body (ETOH)

163

Eosinophilic intracytoplasmic inclusion of nerve cell

Lewy body (Parkinson's)

164

Eosinophilic globule in liver

Councilman body (hepatitis or yellow fever)

165

Eosinophilic intracytoplasmic inclusion of hippocampal nerve cells

Negri bodies of rabies; Lyssavirus

166

Extracellular amyloid deposition in gray matter of brain

Alzheimer's senile plaques

167

Giant B cells with owl's eye prominent inclusions

RS cells: HL

168

Glomerulus like structure surrounding vessel in germ cell

Schiller-Duval bodies: yolk sac tumor

169

Hair on end (crew cut appearance) on skull xray

Beta-thal or SCA (marrow expansion)

170

HCG elevated

Choriocarcinoma, hydatidiform mole

171

Heart nodules (granulomatous)

Aschoff bodies (Rheumatic Fever)

172

Heterophile Ab

Mono; EBV

173

Hexagonal, double-pointed, needle-like crystals in bronchial secretions

Bronchial asthma (Charcot-Leyden crystals -- eosiniphilic granules)

174

High levels of d-dimers

DVT, PE, DIC

175

Hilar LAD, peripheral granulomatous lesion in middle or lower lung lobes

Primary TB

176

Honeycombing on lung on CT or X-ray

Interstitial pulmonary fibrosis

177

Hypercoagulability (leading to migrating DVTS and vascultitis)

Trousseau's syndrome (AC lung or pancreas)

178

Hypersegmented neutrophils

Megaloblastic anemia (B12 or folate)

179

Hypochromic, microcytic anemia

Fe, Lead, thalassemia

180

Increased AFP in maternal serum

Dating error, anencephaly, NTD

181

HTN, hpokalenia, metabolic alkalosis

Conn's syndrome

182

Increased uric acid levels

Gout, Lesch-Nyhan, tumor lysis syndrome, loop and thiazide diuretics

183

Intranuclear eosinophilic droplet-like bodies

Cowdry A inclusions (HSV or CMV)

184

Iron-containing nodules in alveolar septum

Ferruginou bodies (asbestosis)

185

Keratin pearls on skin biopsy

SCC

186

Large lysosomal vesicles in phagocytes; immunodeficiency

Chediak-Higashi (phagolysosome)

187

Lead pip appearance of colon on barium enema X-ray

UC

188

Linear IgG on GBM

Goodpasture's syndrome

189

Low serum ceuloplasmin

Wilson's disease

190

Lumpy bumpy appearance of glomeruli on IF

PSGN (IgG, C3)

191

Lytic "punched out" lesions on X-ray

Multiple myeloma

192

Mammary gland "blue domed" cyst

FCC breast

193

Monoclonal Ab spike

MM (IgG or IgA)
MGUS
IgM Waldenstrom's
Primary amyloidosis

194

Mucin-filled cell with peripheral nucleus

Signet cell

195

Narrowing of bowel lumen on barium X-ray (String sign)

Crohn's disease

196

Necrotizing vasculitis and necrotizing GN

Wegener's (c-ANCA); Goodpasture's

197

Needle-shaped, negative birefringent crystals

Gout

198

Nodular hyaline deposits in glomeruli

KW nodules: DM nephropathy

199

Nutmeg liver

Chronic passive congestion 2/2 RHF

200

Onion skin periosteal reaction

Ewing's sarcoma (malignant round cell tumor)

201

Periosteum raised from bone, creating triangular area

Codman's triangle (OS, Ewings, pyogenic OM)

202

Podocyte effacement on EM

MCD

203

Polished, ivory-like appearance of bone at cartilage erosion

Eburnation (OA resulting in bony sclerosis)

204

Protein aggregates in neurons from hyperphosphorylated tau proteins

NF tangles & Pick bodies

205

Psammoma bodies

Meningioma, Papillary thyroid cancer, mesothelima, papillary serous ca ovary/endometrium

206

Pseudopalisading tumor cells on brain bx

GBM

207

RBC casts in urine

Nephritic syndrome

208

Rectangular, crystal-like cytoplasma inclusions in Leydig cells

Reinke crystals (Leydig cell tumor)

209

Renal epithelial casts in urine

Acute toxic/viral nephrosis

210

Rhomboid crystals, positively birefringent

Pseudogout; Ca pyropp hihydrate

211

Rib notching

Coarctation of aorta

212

Ring-enhancing brain lesion in AIDS

Toxoplasma, CNS lymphoma

213

Sheets of medium-sized lymphoid cells with scater pale, tingibile body-laden macrophages

Burkitt's lymphoma

214

Silver staining spherical aggregation of tau proteins in neurons

Pick bodies

215

Soap bubble in femur or tibia on X-ray

Giant cell tumor of bone

216

Spike & dome on GBM

Membranous nephropathy

217

Stacks of RBC's

Rouleaux formation: MM

218

Stippled vaginal epithelial cells

Clue cells (Gardenella)

219

Tennis racket shaped cytoplasmic organelles in Langerhans cells

Birbeck granules: Langerhans cell histiocytosis

220

Thrombi made of white/red layers

Lines of Zahn (arterial thrombus)

221

Thumb sign on lateral X-ray

Epiglottitis

222

Thyroid-like appearance of the kidney

Chronic bacterial pyelonephritis

223

Tram-track capillary loops of GBM

MPGN

224

Triglyceride accumulation in liver cell vacuoles

Fatty liver disease

225

Waxy casts with very low urine flow

ESRD

226

WBC casts in urine

Acute pyelonephritis

227

WBC's that look smudged

CLL

228

Wire loop glomerular capillary on LM

Lupus nephropathy

229

Yellowish CSF

Xanthochromia (2/2 SAH)