FirstAidRapidReview Flashcards
(478 cards)
1
Q
Abdominal pain, ascites, hepatomegaly
A
Budd-Chiari syndrome (posthepatic venous thrombosis)
2
Q
Achilles tendon xanthoma
A
Familial hypercholesterolemia (decreased LDL receptor signaling)
3
Q
Adrenal hemorrhage, hypotension, DIC
A
Waterhouse-Friderichen syndrome (meningococcemia)
4
Q
Arachnodactyly, lens dislocatino, aortic dissection, hyperflexible joints
A
Marfan’s syndrome (firbrillin defect)
5
Q
Athlete with polychythemia
A
2_ to erythropoietin injection
6
Q
Back pain, fever, night sweats, weight loss
A
Pott’s disease (vertebral tuberculosis)
7
Q
Bilateral hilar adenopathy, uveitis
A
Sarcoidosis (noncaseating granulomas)
8
Q
Blue sclera
A
Osteogenesis imperfecta (type I collagen defect)
9
Q
Bluish line on gingiva
A
Burton’s line (lead poisoning)
10
Q
Bone pain, bone enlargement, arthritis
A
Paget’s disease of bone (increased osteoblastic and osteoclastic activity)
11
Q
Bounding pulses, diastolic heart murmur, head bobbing
A
Aortic regurgitation
12
Q
Butterfly facial rash and Raynaud’s phenomenon in a young female
A
Systemic lupus erythematosis
13
Q
Caf_-au-lait spots, Lisch nodules (iris hamartoma)
A
Neurofibromatosis type I (+ pheochromocytoma, optic gliomas)
14
Q
Caf_-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities
A
McCune-Albright syndrome (mosaic G-protein signaling mutation)
15
Q
Calf pseudohypertrophy
A
Muscular dystrophy (most commonly Duchenne’s): X-linked recessive deletion of dystrophin gene
16
Q
Cherry-red spot on macula
A
Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion
17
Q
Chest pain on exertion
A
Angina (stable: with moderate exertion; unstable: with minimal exertion)
18
Q
Chest pain, pericardial effusion/friction rub, persistent fever following MI
A
Dressler’s syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode)
19
Q
Child uses arms to stand up from squat
A
Gowers’ sign (Duchenne muscular dystrophy)
20
Q
Child with fever later develops red rash on face that spreads to body
A
Slapped cheeks (erythema infectiosum/fifth disease: parvovirus B19)
21
Q
Chorea, dementia, caudate degeneration
A
Huntington’s disease (autosomal-dominatnt CAG repeat expansion)
22
Q
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
A
McArdle’s disease (muscle glycogen phosphorylase deficiency)
23
Q
Cold intolerance
A
Hypothyroidism
24
Q
Conjugate lateral gaze palsy, horizontal diplopia
A
Internuclear opthalmoplegia (damage to MLF; bilateral [multiple sclerosis], unilateral [stroke])
25
Continuous "machinery" heart murmur
PDA (close with indomethacin; open or maintain with misoprostol)
26
Cutaneous/dermal edema due to connective tissue deposition
Myxedema (caused by hypothyroidism, Graves' disease [pretibial])
27
Dark purple skin/mouth nodules
Kaposi's sacrcoma (usually AIDS patients [MSM]: associated with HHV-8)
28
Deep, labored breating/hyperventilation
Kussmaul breating (diabetic ketoacidosis)
29
Dermatitis, dementia, diarrhea
Pellagra (niacin [vitamin B3] deficiency
30
Dilated cardiomyopathyt, edema, alcoholism or malnutrition
Wet beriberi (thiamine [vitamin B1] deficiency
31
Dog or cate bite resulting in infection
Pasteurella multocida (cellulitis at inoculation site)
32
Dry eyes, dry mouth, arthritis
Sj_gren's syndrome (autoimmune destruction of exocrine glands)
33
Dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome (may progress to esophageal squamos cell carcinoma)
34
Elastic skin, hypermobility of joints
Ehlers-Danlos syndrome (type III collagen defect)
35
Enlarged, hard left supraclavicular node
Virchow's node (abdominal metastasis)
36
Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
S_zary syndrome (cutaneous T-cell lymphoma) or mycosis fungoides
37
Facial muscle spasm upon tapping
Chvostek's sign (hypocalcemia)
38
Fat, female, forty, and fertile
Cholelithiasis (gallstones)
39
Fever, chills, headache, myalgia following antibiotic treatment for syphilis
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
40
Fever, cough, conjunctivitis, coryza, diffuse rash
Measles (Morbillivirus)
41
Fever, night sweats, weight loss
B symptoms (staging) of lymphoma
42
Fibrous plaques in soft tissue of penis
Peyronie's disease (connective tissue disorder)
43
Gout, mental reta4rdation, self-mutilating behavior in a boy
Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)
44
Green-yellow rings around peripheral cornea
Kayser-Fleischer rings (copper accumulation from Wilson's disease)
45
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; increased cancer risk, mainly GI)
46
Hepatosplenomegaly, osteoporosis, neurologic symptoms
Gaucher's disease (glucocerebrosidase deficiency)
47
Hereditary nephritis, sensorineural hearing loss, cataracts
Alport syndrome (mutation in __ chain of collagen IV)
48
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Kl_ver-Bucy syndrome (bilateral amygdala lesion)
49
Hyperreflexia, hypertonia, Babinski sign present
UMN damage
50
Hyporeflexia, hypotonia, atrophy, fasciculations
LMN damage
51
Hypoxemia, polycythemia, hypercapnia
Blue bloater (chronic bronchitis: hyperplasia of mucous cells)
52
Indurated, ulcerated genital lesion
Nonpainful: chancre (1_ syphilis, Treponema pallidum) Painful, with exudate: chanchroid (Haemophilus ducreyi)
53
Infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia
Patau's syndrome (trisomy 13)
54
Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration
Niemann-Pick disease (genetic sphingomyelinase deficiency)
55
Infant with hypoglycemia, failure to thrive, and hepatomegaly
Cori's disease (debranching enzyme deficiency)
56
Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect
Edwards' syndrome (trisomy 18)
57
Jaundice, palpable distended non-tender gallbladder
Courvoisier's sign (distal obstruction of biliary tree)
58
Large rash with bull's-eye appearance
Erythema chronicum migrans from Ixodes tick bite (Lyme disease: Borrelia)
59
Lucid interval after traumatic brain injury
Epidural hematoma (middle meningeal artery rupture)
60
Male child, recurrent infections, no mature B cells
Bruton's disease (X-linked agammaglobulinemia)
61
Mucosal bleeding and prolonged bleeding time
Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
62
Muffled heart sounds, distended neck veins, hypotension
Beck's triad of cardiac tamponade
63
Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
Gardner's syndrome (subtype of FAP)
64
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
Pompe's disease (lysosomal _-1, 4-glucosidase deficiency)
65
Neonate with arm paralysis following difficult birth
Erb-Duchenne palsy (superior trunk [C5-C6] bracial plexus injury: "waiter's tip")
66
No lactation postpartum, absent menstruation, cold intolerance
Sheehan's syndrome (pituitary infarction)
67
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
Mutliple sclerosis
68
Oscillating slow/fast breathing
Cheyne-Stokes respirations (central apnea in CHF or increased intracranial pressure)
69
Painful blue fingers/toes, hemolytic anemia
Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis)
70
Painful, pale, cold fingers/toes
Raynaud's phenomenon (vasospasm in extremities)
71
Painful, raised red lesions on pad of fingers/toes
Osler's node (infective endocarditis, immune complex deposition)
72
Painless erythematous lesions on palms and soles
Janeway lesions (infective endocarditis, septic emboli/microabscesses)
73
Painless jaundice
Cancer of the pancreatic head obstructing bile duct
74
Palpable purpura on buttocks/legs, joing pain, abdominal pain (child), hematuria
Henoch-Sch_nlein purpura (IgA vasculitis affecting skin and kidneys)
75
Pancreatic, pituitary, parathyroid tumors
MEN 1 (autosomal dominant)
76
Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia
Nephrotic syndrome
77
Pink complexion, dyspnea, hyperventilation
Pink puffer (emphysema: centriacinar [smoking], panacinar [_1-antitrypsin deficiency])
78
Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets
Fanconi's syndrome (proximal tubular reabsorption defect)
79
Positive anterior "drawer sign"
Anterior cruciate ligament injury
80
Pruritic, purple, polygonal planar papules and plaques (6 Ps)
Lichen planus
81
Ptosis, miosis, anhidrosis
Horner's syndrome (sympathetic chain lesion)
82
Pupil accommodates but doesn't react
Argyll Roberston pupil (neurosyphilis)
83
Rapidly progressive leg weakness that ascends following GI/upper respiratory infection
Guillain-Barr_ syndrome (acute autoimmune inflammatory demyelinating polyneuropathy)
84
Rash on palms and soles
Coxsackie A, 2_ syphilis, Rocky Mountain spotted fever
85
Recurrent colds, unusual eczema, high serum IgE
Hyper-IgE syndrome (Job's syndrome: neutrophil chemotaxis and abnormality)
86
Red "currant jelly" sputum in alcoholic or diabetic patients
Klebsiella pneumoniae
87
Red "currant jelly" stools
Acute mesenteric ischemia (adults), intussusception (infants
88
Red, itchy, swollen rash of nipple/areola
Paget's disease of the breast (represents underlying neoplasm)
89
Red urine in the morning, fragile RBCs
Paroxysmal nocturnal hemoglobinuria
90
Renal cell carcinoma (bilateral) hemangioblastomas, angiomatosis, pheochromocytoma
von Hippel-Lindau disease (dominat tumor suppressor gene mutation)
91
Resting tremor, rigidity, akinesia, postural instability
Parkinson's disease (nigrostriatal dopamine depletion)
92
Retinal hemorrhages with pale centers
Roth's spots (bacterial endocarditis)
93
Severe jaundice in neonate
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
94
Severe RLQ pain with palpation of LLQ
Rovsing's sign (acute appendicitis)
95
Severe RLQ pain with rebound tenderness
McBurney's sign (appendicitis)
96
Short stature, increased incidence of tumors/leukemia, aplastic anemia
Fanconi's anemia (genetic loss of DNA crosslink repair; often progresses to AML)
97
Signle palmar crease
Simian crease (Down syndrome)
98
Situs inversus, chronic sinusitis, bronchietasis, infertility
Kartagener's syndrome (dynein arm defect affecting cilia)
99
Skin hyperpigmentation, hypotension, fatigue
Addison's disease (1_ adrenocortical insufficiency causes incresed ACTH and increased __-MSH production)
100
Slow, progressive muscle weakness in boys
Becker's muscular dystrophy (X-linked missense mutation in dystrophin, less severe than Duchenne's)
101
Small, irregular red spots on buccal/lingual mucosa with blue-white centers
Koplik spots (measles; rubeola virus)
102
Smooth, flat, moist, painless white lesions on genitals
Condylomata lata (2_ syphilis)
103
Splinter hemorrhages in fingernails
Bacterial endocarditis
104
Strawberry tongue
Scarlet fever, Kawasaki disease, toxic shock syndrome
105
Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema
Turner syndrome (45,XO)
106
Sudden swollen/paiunful big toe joint, tophi
Gout/podagra (hyperuricemia)
107
Swollen gums, mucosal bleeding, poor wound healing, spots on skin
Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
108
Swollen, hard, painful finger joints
Osteoarthritis (osteophytes on PIP [Bouchard's nodes], DIP [Heberden's nodes])
109
Systolic ejection murmur (crescendo-decrescendo)
Aortic valve stenosis
110
Thyroid and parathyroid tumors, pheochromocytoma
MEN 2A (autosomal dominant ret mutation)
111
Thyroid tumors, pheochromocytomas, ganglioneuromatosis)
MEN 2B (autosomal dominant ret mutation)
112
Toe extension/fanning upon plantar scrape
Babinksi sign (UMN lesion)
113
Unilateral facial drooping involving forehead
Facial nerve (LMN CN VII palsy)
114
Urethritis, conjunctivitis, arthritis in a male
Reactive arthritis associated with HLA-B27
115
Vascular birthmark (port-wine stain)
Hemangioma (benign, but associated with Sturge-Weber syndrome)
116
Vomiting blood following gastroesophageal lacerations
Mallory-Weiss syndrome (alcoholic and bulemic patients)
117
Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple's disease (Tropheryma whipplei)
118
Worst headache of my life
Subarachnoid hemorrhage
119
Anticentromere antibodies
Scleroderma (CREST)
120
Antidesmoglein (epithelial) antibodies
Pemphigus vulgaris (blistering)
121
Anti-glomerular basement membrane antibodies
Goodpasture's syndrome (glomerulonephritis and hemoptysis)
122
Antihistone antibodies
Drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
123
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonni__re deformity)
124
Antimitochondrial antibodies (AMAs)
1_ biliary cirrhosis (female, cholestasis, portal hypertension)
125
Antineutrophil cytoplasmic antibodies (ANCAs)
Vasculitis (c-ANCA: granulomatosis with polyangiitis [Wegener's]; p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome)
126
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
SLE (type III hypersensitivity)
127
Antiplatelet antibodies
Idopathic thrombocytopenic purpura
128
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
129
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, distention, weight loss)
130
Apple core lesion on abdominal x-ray
Colorectal cancer (usually left-sided)
131
Azurophilic peroxidase-positive granular inclusions on granulocytes and myeloblasts
Auer rods (acute myelogenous leukemia, especially the promyelocytic [M3] type)
132
Bacitracin response
Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B)
133
Bamboo spine on x-ray
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
134
Basophilic nuclear remnants in RBCs
Lead poisoning or sideroblastic anemia
135
Bloody tap on LP
Subarachnoid hemorrhage
136
Boot shaped heart on x-ray
Tetralogy of Fallot, RVH
137
Branching gram-positive rods with sulfur granules
Actinomyces israelii
138
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress sympathetic ganglion and cause Horner's syndrome)
139
Brown tumor of bone
Hyperparathyroidisim or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
140
Cardiomegaly with apical atrophy
Chagas' disease (Trypanosoma cruzi)
141
Cellular crescents in Bowman's capsule
Rapidly progressive crescentic glomerulonephritis
142
Chocolate cyst of ovary
Endometriosis (frequently involves both ovaries)
143
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
144
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal-recessive mutation in CFTR resulting in fat-soluble vitamin deficiency and mucous plugs)
145
Decreased __-fetoprotein in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
146
Degeneration of dorsal column nerves
Tabes dorsalis (3_ syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
147
Depigmentation of neurons in substantia nigra
Parkinson's disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
148
Desquamated epithelium casts in sputum
Curschmann's spirals (bronchial asthma; can result in whorled mucous plugs)
149
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
150
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
151
Enlarged cells with intranuclear inclusion bodies
Owl's eye appearance of CMV
152
Enlarged thyroid cells with ground-glass nuclei
Orphan Annie's eyes nuclei (papillary carcinoma of the thyroid)
153
Eosinophilic cytoplasmic inclusion in liver cell
Mallory bodies (alcoholic liver disease)
154
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson's disease)
155
Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
156
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Negri bodies of rabies (Lyssavirus)
157
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer's disease)
158
Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye")
Reed-Sternberg cells (Hodgkin's lymphoma)
159
Glomerulus-like strucuture surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
160
Hair on end (crew-cut) appearance on x-ray
_-thalassemia, sickle cell anemia (marrow expansion)
161
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo)
162
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
163
Heterophile antibodies
Infectious mononucleosis (EBV)
164
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
165
High level of D-dimers
DVT, pulmonary embolism, DIC
166
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower long lobes (can calcify)
Ghon complex (1_ TB: Mycobacterium bacilli)
167
Honeycomb lung on x-ray or CT
Interstitial pulmonary fibrosis
168
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau's syndrome (adenocarcinoma of pancreas or lung)
169
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
170
Hypertension, hypokalemia, metabolic alkalosis
Conn's syndrome
171
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
172
Increased __-fetoprotein in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (neural tube defects)
173
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
174
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or CMV)
175
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increased chance of mesothelioma)
176
Keratin pearls on a skin biopsy
Squamous cell carcinoma
177
Large lysosomal vesicles in phagocytes, immunodeficiency
Ch__diak-Higashi disease (congenital failure of phagolysosome formation)
178
Lead pipe appearance of colon on barium enema x-ray
Ulcerative colitis (loss of haustra)
179
Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture's syndrome
180
Low serum ceruloplasmin
Wilson's disease (hepatolenticular degeneration)
181
Lumpy bumpy apperance of glomeruli on immunoflourescence
Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
182
Lytic ("hole punched") bone lesions on x-ray
Multiple myeloma
183
Mammary gland ("blue domed") cyst
Fibrocystic change of the breast
184
Monoclonal antibody spike
Multiple myeloma (usually IgG or IgG, Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging), Waldenstrom's (M protein = IgM) macroglobulinemia, Primary amyloidosis
185
Mucin-filled cell with peripheral nucleus
Signet ring (gastric carcinoma)
186
Narrowing of bowel lumen on barium x-ray
String sign (Crohn's disease)
187
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener's; c-ANCA positive) and Goodpasture's syndrome (anti-basement membrane antibodies)
188
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
189
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
190
Novobiocin response
Sensitive: Staphylococus epidermidis; resistant: Staphylococcus saprophyticus
191
Nutmeg appearance of liver
Chronic passive congestion of liver due to right heart failure
192
Onion skin periosteal reaction
Ewing's sarcoma (malignant round-cell tumor)
193
Optochin response
Sensitive: Streptococcus pneumoniae; resistant: Viridans streptococcus
194
Periosteum raised from bone, creating triangular area
Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)
195
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
196
Polished, "ivory like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
197
Protein aggregates in neurons from hyperphosporylation of protein tau
Neurofibrillary tangles (Alzheimer's disease) and Pick's bodies (Pick's disease)
198
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
199
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
200
RBC casts in urine
Acute glomerulonephritis
201
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
202
Renal epithelial casts in urine
Acute toxic/viral nephrosis
203
Rhomboid crystals, positively birefringent
Pseudogout (calcium phyrophosphate dihydrate crystals)
204
Rib notching
Coarctation of the aorta
205
Ring-enhancing brain lesion in AIDS
Taxoplasma gondii, CNS lymphoma
206
Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology)
Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV, "black sky" made up of malignant cells)
207
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick's disease: progressive dementia, changes in personality)
208
Soap bubble infemur or tibia on x-ray
Giant cell tumor of bone (generally benign)
209
Spikes on basement membrane, "dome like" subepithelial deposits
Membranous glomerulonephritis (may progress to nephrotic syndrome)
210
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
211
Stippled vaginal epithelial cells
Clue cells (Gardnerella vaginalis)
212
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)
213
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
214
Thumb sign on lateral x-ray
Epiglottitis (Haemophilus influenzae)
215
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
216
Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
217
Trigylceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
218
Waxy casts with very low urine flow
Chronic end-stage renal disease
219
WBC casts in urine
Acute pyelonephritis
220
WBCs that look "smudged"
CLL (almost always B cell)
221
Wire loop glomerular capillary appearance on light microscopy
Lupus nephropathy
222
Yellowish CSF
Xanthochromia (e.g., due to subarachnoid hemorrhage)
223
Absence seizures
Ethosuximide
224
Acute gout attack
NSAIDs, colchicine
225
Acute promyelocytic leukemia (M3)
All-trans retinoic acid
226
ADHD
Methylphenidate, amphetamines
227
Alcohol abuse
AA+ disulfiram for patient and Al-Anon for family
228
Alcohol withdrawal
Benzodiazepines
229
Anorexia
SSRIs
230
Anticoagulation during pregnancy
Heparin
231
Arrhythmia in damaged cardiac tissue
Class IB antiarrhythmic (lidocaine, mexiletine, tocainide)
232
B12 deficiency
Vitamin B12 supplementation (work up cause with Schilling test)
233
Benign prostatic hyperplasia
Tamsulosin, finasteride
234
Bipolar disorder
Lithium, valproate, carbamazepine, lamotrigine (mood stabilizers)
235
Breast cancer in postmenopausal women
Aromatase inhibitor (anastrozole)
236
Buerger's disease
Smoking cessation
237
Bulimia
SSRIs
238
Candida albicans
Amphotericin B (systemic), nystatin (oral thrush, esophagitis)
239
Carcinoid syndrome
Octreotide
240
Chlamydia trachomatis
Doxycycline (+ ceftriaxone for gonorrhea coinfection), erythromycin eye drops (prophylaxis in infants)
241
Chronic gout
Probenecid (underexcretor), allopurinol (overproducer)
242
Chronic hepatitis
IFN-_
243
Chronic myelogenous leukemia
Imatinib
244
Clostridium botulinum
Antitoxin
245
Clostridium difficile
Oral metronidazole; if refractory, oral vancomycin
246
Clostridium tetani
Antitoxin + vaccine booster + diazepam
247
Crohn's disease
Corticosteroids, infliximab
248
Cryptococcus neoformans
Fluconazole (prophylaxis in AIDS patients)
249
Cyclophosphamide-induced hemorrhagic cystitis
Mesna
250
Cystic fibrosis
N-acetylcysteine + antipseudomonal prophylaxis (tobramycin/azithromycin)
251
Cytomegalovirus
Ganciclovir
252
Depression
SSRIs (first-line)
253
Diabetes insipidus
Desmopressin (central); hydrochlorothiazide, indomethacin, amiloride (nephrogenic)
254
Diabetes mellitus type 1
Dietary intervention (low-sugar) + insulin replacement
255
Diabetes mellitus type 2
Dietary intervention, oral hypoglycemics, and insulin (possible)
256
Diabetic ketoacidosis
Fluids, insulin, K+
257
Enterococci
Vancomycin/ampicillin + aminoglycoside
258
Erectile dysfunction
Sildenafil, vardenafil
259
ER-positive breast cancer
Tamoxifen
260
Ethylene glycol/methanol intoxication
Fomepizole (alcohol dehydrogenase inhibitor)
261
Haemophilus influenzae (B)
Rifampin (prophylaxis)
262
Generalized anxiety disorder
Buspirone
263
Heparin toxicity (acute)
Protamine sulfate
264
HER2/neu-positive breast cancer
Trastuzumab
265
Hyperaldosteronism
Spironolactone
266
Hypercholesterolemia
Statin (first-line)
267
Hypertriglyceridemia
Fibrate
268
Immediate anticoagulation
Heparin
269
Infertility
Leuprolide, GnRH (pulsatile)
270
Influenza
Rimantadine, oseltamivir
271
Legionella pneumophila
Erythromycin
272
Long-term anticoagulation
Warfarin
273
Malaria
Chloroquine/mefloquine (for blood schizont), primaquine (for liver hypnozoite)
274
Malignant hyperthermia
Dantrolene
275
Medical abortion
Mifepristone
276
Migraine
Sumatriptan
277
MRSA
Vancomycin
278
Multiple sclerosis
_-interferon, immunosuppression, natalizumab
279
Mycobacterium tuberculosis
RIPE (rifampin, INH, pyrazinamide, ethambutol)
280
Neisseria gonorrhoeae
Ceftriaxone (add doxycycline to cover likely concurrent Chlamydia)
281
Neisseria meningitidis
Penicillin/ceftriaxone, rifampin (prophylaxis)
282
Neural tube defect prevention
Prenatal folic acid
283
Osteomalacia/rickets
Vitamin D supplementation
284
Osteoporosis
Bisphosphonates; calcium and vitamin D supplementation
285
Patent ductus arteriosus
Indomethacin
286
Pheochromocytoma
_-antagonists (e.g., phenoxybenzamine)
287
Pneumocystis jirovecii
TMP-SMX (prophylaxis in AIDS patient)
288
Prolactinoma
Bromocriptine (dopamine agonists)
289
Prostate cancer/uterine fibroids
Leuprolide, GnRH (continuous)
290
Prostate carcinoma
Flutamide
291
Pseudomonas aeruginosa
Antipseudomonal penicillin + aminoglycoside
292
Pulmonary arterial hypertension (idiopathic)
Sildenafil, bosentan, epoprostenol
293
Rickettsia rickettsiii
Doxycycline, chloramphenicol (especially in context of aplastic anemia)
294
Ringworm infections
Terbinafine, griseofulvin, imidazole
295
Schizophrenia (negative symptoms)
5-HT2A antagonists (e.g., second-generation antipsychotics)
296
Schizophrenia (positive symptoms)
D2 receptor antagonists (e.g., first- and second-generation anti-psychotics)
297
SIADH (Treatment)
Demeclocycline, lithium, vasopressin receptor antagonists
298
Sickle cell anemia
Hydroxyurea (increased fetal hemoglobin)
299
Sporothrix schenckii
Oral potassium chloride
300
Stable angina
Sublingual nitroglycerin
301
Staphylococcus aureus
MSSA: nafcillin, oxacillin, dicloxacillin (antistaphylococcal penicillins); MRSA: vancomycin
302
Streptococcus bovis
Penicillin prophylaxis; evaluation for colon cancer if linked to endocarditis
303
Streptococcus pneumoniae
Penicillin/cephalosporin (systemic infection, pneumonia), vancomycin (meningitis)
304
Streptococcus pyogenes
Penicillin prophylaxis
305
Temporal arteritis (Treatment)
High-dose steroids
306
Tonic-clonic seizures
Phenytoin, valproate, carbamazepine
307
Toxoplasma gondii
Sulfadiazine + pyrimethamine
308
Treponema pallidum
Penicillin
309
Trichomonas vaginalis
Metronidazole (patient and partner)
310
Ulcerative colitis
5-ASA, infliximab
311
UTI prophylaxis Warfarin toxicity
TMP-SMX
312
Warfarin toxicity
Fresh frozen plasma (acute), vitamin K (chronic)
313
Wegener's granulomatosis with polyangiitis
Cyclophosphamide, corticosteroids
314
Acitinic (solar) keratosis
Precursor to squamous cell carcinoma
315
Acute gastric ulcer associated with CNS injury
Cushing's ulcer (increased ICP stimulates vagal gastric secretion)
316
Acute gastric ulcer associated with severe burns
Curling's ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
317
Alternating areas of transmural inflammation and normal colon
Skip lesions (Crohn's disease)
318
Aneurysm, dissecting
Hypertension
319
Aortic aneurysm, abdominal and descending aorta
Atherosclerosis
320
Aortic aneurysm, arch
Tertiary syphilis (syphilitic aortitis), vasa vasorum destruction
321
Aortic aneurysm, ascending
Marfan's syndrome (idiopathic cystic medial degeneration)
322
Atrophy of the mammillary bodies
Wernicke's encephalopathy (thiamine deficiency causing ataxia, ophthalmoplegia, and confusion)
323
Autosplenectomy (fibrosis and shrinkage)
Sickle cell anemia (hemoglobin S)
324
Bacteria associated with gastritis, peptic ulcer disease, and stomach cancer
H. pylori
325
Bacterial meningitis (adults and elderly)
Streptococcus pneumoniae
326
Bacterial meningitis (newborns and kids)
Group B streptococcus (newborns), S. pneumoniae/Neisseria meningitidis (kids)
327
Benign melanocytic nevus
Spitz nevus (most common in first two decades)
328
Bleeding disorder with GpIb deficiency
Bernard-Soulier syndrome (defect in platelet adhesion to von Willebrand's factor)
329
Brain tumor (adults)
Supratentorial: metastasis > astrocytoma (including glioblastoma multiforme) > meningioma > schwannoma
330
Brain tumor (kids)
Infratentorial: medulloblastoma (cerebellum) or supratentorial: craniopharyngioma (cerebrum)
331
Breast cancer
Infiltrating ductal carcinoma (in the US, 1 in 9 women will develop breast cancer)
332
Breast mass
Fibrocystic change, carcinoma (in postmenopausal women)
333
Breast tumor (benign)
Fibroadenoma
334
Cardiac 1_ tumor (kids)
Rhabdomyoma, often seen in tuberous sclerosis
335
Cardiac manifestation of lupus
Libman-Sacks endocarditis (nonbacterial, affecting both sides of mitral valve)
336
Cardiac tumor (adults)
Metastasis, 1_ myxoma (4:1 left to right atrium; "ball and valve")
337
Cerebellar tonsillar herniation
Chiari malformation (often presents with progressive hydrocehalus or syringomyelia)
338
Chronic arrhythmia
Atrial fibrillation (associatd with high risk of emboli)
339
Chronic atrophic gastritis (autoimmune)
Predisposition to gastric carcinoma (can also cause pernicious anemia)
340
Clear cell adenocarcinoma of the vagina
DES exposure in utero
341
Compression fracture
Ostoeporosis (type I: postmenopausal woman; type II: elderly man or woman)
342
Congenital adrenal hyperplasia, hypotension
21-hydroxylase deficiency
343
Congenital cardiac anomaly
VSD
344
Congenital conjugated hyperbilirubinemia (black liver)
Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)
345
Constrictive pericarditis
Tuberculosis (developing world); systemic lupus erythematosus (developed world)
346
Coronary artery involved in thrombosis
LAD > RCA > LCA
347
Cretinism
Iodine deficit/hypothyroidism
348
Cushing's 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)
349
Cyanosis (early; less common)
Tetralogy of Fallot, transposition of great vessels, truncus arteriosus
350
Cyanosis (late; more common)
VSD, ASD, PDA
351
Death in CML
Blast crisis
352
Death in SLE
Lupus nephropathy
353
Dementia
Alzheimer's disease, multiple infarcts
354
Demyelinating disease in young women
Multiple sclerosis
355
DIC
Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery
356
Dietary deficit
Iron
357
Diverticulum in pharynx
Zenker's diverticulum (diagnosed by barium swallow)
358
Ejection click
Aortic/pulmonic stenosis
359
Esophageal cancer
Squamous cell carcinoma (worldwide); adenocarcinoma (US)
360
Food poisoning (exotoxin mediated)
S. aureus, B. cereus
361
Glomerulonephritis (adults)
Berger's disease (IgA nephropathy)
362
Gynecologic malignancy
Endometrial carcinoma (most common in US); cervical carcinoma (most common worldwide)
363
Heart murmur, congenital
Mitral valve prolapse
364
Heart valve in bacterial endocarditis
Mitral > aortic (rheumatic fever), tricuspid (IV drug abuse)
365
Helminth infection (US)
Enterobius vermicularis, Ascaris lumbricoides
366
Hematoma - epidural
Rupture of middle meningeal artery (trauma; lentiform shaped)
367
Hemotoma - subdural
Rupture of bridging veins (crescent shaped)
368
Hemochromatosis
Mutliple blood transfusions of hereditary HFE mutation (can result in CHF, "bronze diabetes," and increased risk of hepatocellular carcinoma)
369
Hepatocellular carcinoma
Cirrhotic liver (associated with hepatitis B and C and with alcoholism)
370
Hereditary bleeding disorder
von Willebrand's disease
371
Hereditary harmless jaundice
Gilbert's syndrome (benign congenital unconjugated hyperbilirubinemia)
372
HLA-B27
Ankylosing spondylitis, Reiter's syndrome, ulcerative colitis, psoriasis
373
HLA-DR3 or -DR4
Diabetes mellitus type 1, rheumatoid arthritis, SLE
374
Holosystolic murmur
VSD, tricuspid regurgitation, mitral regurgitation
375
Hypercoagulability, endothelial damage, blood stasis
Virchow's triad (results in venous thrombosis)
376
Hypertension, 2_
Renal disease
377
Hypoparathyroidism
Accidental excision during thyroidectomy
378
Hypopituitarism
Pituitary adenoma (usually benign tumor)
379
Infection 2_ to blood transfusion
Hepatitis C
380
Infections in chronic granulomatous disease
Staphylococcus aureus, E. coli, Aspergillus (catalase positive)
381
Kidney stones
Calcium = radiopaque, Struvite (ammonium) radiopaque (formed by urease-positive organisms such as Proteus vulgaris or Staphylococcus), Uric acid = radiolucent
382
Late cyanotic shunt (uncorrected left to right becomes right to left)
Eisenmenger's syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)
383
Liver disease
Alcoholic cirrhosis
384
Lysosomal storage disease
Gaucher's disease
385
Male cancer
Prostatic carcinoma
386
Malignancy associated with noninfectious fever
Hodgkin's lymphoma
387
Malignancy (kids)
ALL, medulloblastoma (cerebellum)
388
Mental retardation
Down syndrome, fragile X syndrome
389
Metastases to bone
Prostate, breast > lung > thyroid, testes
390
Metastases to brain
Lung > breast > genitourinary > osteosarcoma > melanoma > GI
391
Metastases to liver
Colon >> stomach, pancreas
392
Mitochondrial inheritance
Disease occurs in both males and females, inherited through females only
393
Mitral valve stenosis
Rheumatic heart disease
394
Mixed (UMN and LMN) motor neuron disease
ALS
395
Myocarditis
Coxsackie B
396
Nephrotic syndrome (adults)
Focal segmental glomerulosclerosis
397
Nephrotic syndrome (kids)
Minimal change disease
398
Neuron migration failure
Kallmann syndrome (hypogonadotropic hypogonadism and anosmia)
399
Nosocomial pneumonia
Klebsiella, E. coli, Pseudomonas aeruginosa
400
Obstruction of male urinary tract
BPH
401
Opening snap
Mitral stenosis
402
Opportunistic infection in AIDS
Pneumocystis jirovecii (formerly carinii) pneumonia
403
Osteomyelitis
S. aureus
404
Osteomyelitis in sickle cell disease
Salmonella
405
Osteomyelitis with IV drug use
Pseudomonas, S. aureus
406
Ovarian metastasis from gastric carcinoma or breast cancer
Krukenberg tumor (mucin-secreting signet-ring cells)
407
Ovarian tumor (benign, bilateral)
Serous cystadenoma
408
Ovarian tumor (malignant)
Serous cystadenocarcinoma
409
Pancreatitis (acute)
Gallstones, alcohol
410
Pancreatitis (chronic)
Alcohol (adults), cystic fibrosis (kids)
411
Patient with ALL/CLL/AML/CML
ALL: child, CLL: adult > 60, AML: adult ~65, CML: adult 30-60
412
Pelvic inflammatory disease
Chlamydia tracomatis, Neisseria gonorrhoeae
413
Philadelphia chromosome t(9;22) (bcr-abl)
CML (may sometimes be associated with ALL/AML)
414
Pituitary tumor
Prolactinoma, somatotropic "acidophilic" adenoma
415
Primary amenorrhea
Turner syndrome (45,XO)
416
Primary bone tumor (adults)
Multiple myeloma
417
Primary hyperaldosteronism
Adenoma of adrenal cortex
418
Primary hyperparathyroidism
Adenomas, hyperplasia, carcinoma
419
Primary liver cancer
Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, _1 antitrypsin deficiency)
420
Pulmonary hyptertension
COPD
421
Recurrent inflammation/thrombosis of small/medium vessels in extremities
Buerger's disease (strongly associated with tobacco)
422
Renal tumor
Renal cell carcinoma: associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndromes (EPO, renin, PTH, ACTH)
423
Right heart failure due to a pulmonary cause
Cor pulmonale
424
S3 (protodiastolic gallop)
Increased ventricular filling (left to right shunt, mitral regurgitation, LV failure [CHF])
425
S4 (presystolic gallop)
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
426
Secondary hyperparathyroidism
Hypocalcemia of chronic kidney disease
427
Sexually transmitted disease
Chlamydia (usually coinfected with gonorrhea)
428
SIADH
Small cell carcinoma of the lung
429
Site of diverticular
Sigmoid colon
430
Sites of atherosclerosis
Abdominal aorta > coronary artery > popliteal artery > carotid artery
431
Stomach cancer
Adenocarcinoma
432
Stomach ulcerations and high gastrin levels
Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
433
t(14;18)
Follicular lymphomas (bcl-2 activation)
434
t(8;14)
Burkitt's lymphoma (c-myc activation)
435
t(9;22)
Philadelphia chromosome, CML (bcr-abl fusion)
436
Temporal arteritis
Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymyalgia rheumatica
437
Testicular tumor
Seminoma
438
Thyroid cancer
Papillary carcinoma
439
Tumor in women
Leiomyoma (estrogen dependent, not precancerous)
440
Tumor of infancy
Hemangioma (usually regresses spontaneously by childhood)
441
Tumor of the adrenal medulla (adults)
Pheochromocytoma (usually benign)
442
Tumor of the adrenal medulla (kids)
Neuroblastoma (malignant)
443
Type of Hodgkin's
Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)
444
Type of non-Hodgkin's
Diffuse large cell
445
UTI
E. coli, Staphylococcus saprophyticus (young women)
446
Viral encephalitis affecting temporal lobe
HSV-1
447
Vitamin deficiency (US)
Folate (pregnant women are at high risk; body stores only 4-month supply; prevents neural tube defects)
448
Sensitivity
Sensitivity = TP / (TP + FN)
449
Specificity
Specificity = TN / (TN + FP)
450
Positive predictive value
PPV = TP / (TP + FP)
451
Negative predictive value
NPV = TN / (TN+FN)
452
Odds ratio (for case-control studies)
Odds ratio = a/c | b/d = ad | bc
453
Relative risk
Relative risk = a/(a+b) | c/(c+d)
454
Attributable risk
Attributable risk = a | a+b - c | c+d
455
Number needed to treat
I/absolute risk reduction
456
Number needed to harm
I/atrtributable risk
457
Body mass index
BMI = weight in kg / height in meters squared
458
Hardy-Weinberg equilibrium
p squared + 2pq + q squared = 1p + q = 1
459
Volume of distribution
Vd = amount of drug in the body / plasma drug concentration
460
Half-life
t half = 0.7 x Vd / CL
461
Drug clearance
CL = rate of elimination of drug / plasma drug concentration = Vd x Ke (elimination constant)
462
Loading dose
LD = Cp x Vd / F
463
Maintenance dose
MD = Cp x CL / F
464
Cardiac output
CO = rate of O2 consumption / arterial O2 content - venous O2 contentCO = stroke volume x heart rate
465
Mean arterial pressure
MAP = cardiac output x total peripheral resistanceMAP = 2/3 diastolic + 1/3 systolic
466
Stroke volume
SV = CO/HR = EDV-ESV
467
Ejection fraction
EF = SV/EDV = EDV-ESV/EDV
468
Resistance
Resistance = driving pressure (_P) / flow (Q) =_(viscosity) x length / _r4
469
Net filtration pressure
Pnet = [(Pc - Pi) - (___c - ___i)]Jv = net fluid flow = (Kf)(Pnet)
470
Renal clearance
Cx = UxV/Px
471
Glomerular filtration rate
GFR = U inulin x V/P inulin = C inulinGFR = Kf [(Pgc - Pbs) - (_gc - _bs)]
472
Effective renal plasma flow
ERPF = U pah x V / P pah = C pah
473
Renal blood flow
RBF = RPF/1-Hct
474
Filtration fraction
FF = GFR/RPF
475
Henderson-Hasselbach equation (for extracellular pH)
pH = 6.1 + log [HCO3-] / 0.03 Pco2
476
Physiologic dead space
Vd = Vt x (Paco2) - Peco2 / Paco2
477
Pulmonary vascular resistance
PVR = P pulm artery - P L atrium / Cardiac output
478
Alveolar gas equation
PAO2 = PIO2 - PaCO2 / R
