RR Flashcards
(443 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-Friderichsen syndrome (meningococcemia)
4
Q
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
A
Marfan’s syndrome (fibrillin defect)
5
Q
Athlete with polycythemia
A
Secondary 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 erthematosus
13
Q
Cafe-au-lait spots, Lisch nodules (iris hamortoma)
A
Neurofibromatosis type I (+ pheochromocytoma, optic gliomas)
14
Q
Cafe-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 dystophin gene
16
Q
Cherry-red spot on macula
A
Tay-Sachs (ganglioside accumulation) Niemman-Pick (sphingomyelin accumulation), central 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
Gower’s sign (Duchenne muscular dystrophy)
20
Q
Child with fever later develops red rash on face that spreads to body
A
Slapped cheeks (erthema infectiosum/fifth disease: Parovirus B19)
21
Q
Chorea, dementia, caudate degeneration
A
Huntington’s disease (autosomal-dominant CAG repeat on 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 ophthalmoplegia (damage to MLF; bilateral= MS, unilateral=stroke)
25
Continuous "machinery" heart murmur
PDA (close eith indomethacin; open with misoprostol)
26
Cutaneous/dermal edema due to connective tissue deposition
Myxedema (caused by hypothyroidism, Grave's disease)
27
Dark purple skin/mouth nodules
Kaposi's sarcoma (usually AIDS pts; associated w/ HHV-8)
28
Deep, labored breathing/hyperventilation
Kussmaul breathing (diabetic ketoacidosis)
29
Dermatitis, dementia, diarrhea
Pellagra (niacin/B3 deficiency)
30
Dilated cardiomyopathy, edema, alcoholism or malnutrition
Wet beriberi (thiamine/B1 deficiency)
31
Dog or cat bite resulting in infection
Pasteurella multocida (cellulitis at inoculation site)
32
Dry eyes, dry mouth, arthritis
Sjogren's syndrome (autoimmune destruction of exocrine glands)
33
Dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
34
Elastic skin, hypermobility of joints
Ehler-Danlos syndrome (type III collagen defect )
35
Enlarged, hard left supraclavicular node
Virchow's node (abdominal metastasis)
36
Erthroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
Sezary 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, conjuctivitis, coryza, diffuse rash
Measles (morbillivirus)
41
Fever, nightsweats, weight loss
B symptoms (staging) of lymphoma
42
Fibrous plaques in soft tissue of penis
Peyronie's disease (connective tissue disorder)
43
Gout, mental retardation, self-mutilation behavior in 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 alpha chain of collagen IV)
48
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Kluver-Bucy syndrome (bilateral amygdala lesion)
49
Hyperreflexia, hypertonia, Babinski sign present
UMN damage
50
Hyporeflexia, hypotonia, atrophy, fasiculations
LMN damage
51
Hypoximia, polycythemia, hypercapnia
Blue bloater (chronic bronchitis, hyperplasia of mucus cells)
52
Indurated, ulcerated genital lesion
Nonpainful:Chancre of primary syphilis (Treponema pallidum)
53
Infant with cleft lip/patate, 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, clentched hangs and structural heart defect
Edward's syndrom (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, tx: Tertracyclines)
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 FAP)
64
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
Pompe's disease (lysosomal alpha-1,4-glucosidase deficiency)
65
Neonate with arm paralysis following difficult birth
Erb-Duchenne palsy (superior trunk (C5-C6) brachial plexus injury; waiter's tip)
66
No lactation postpartum, absent menstruation, cold intolerace
Sheehan's syndrome (pituitary infarction)
67
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia (HLA-DR2)
Multiple 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, spetic emboli, microabscesses)
72
Painless jaundice
Cancer of the pancreatic head obstructing the bile duct
73
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria
Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
74
Pancreatic, pituitary, parathyroid tumors
MEN 1 (autosomal dominant)
75
Periorbital and/or peripheral edema, protenuria, hypoalbuminemia, hypercholesterolemia
Nephrotic syndrome
76
Pink complexion, dyspnea, hyperventilation
Pink puffer (emphysema:centriacinar=smoking, panacinar=alpha1-antitrypsin deficiency)
77
Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophasphatemic rickets
Fanconi's syndrome (proximal tubular HCO3- reabsorption defect)
78
Positive anterior "drawer sign"
Anterior cruciate ligament injury
79
Pruritic, purple, polygonal planar papules and plaques
Lichen planus (associated with Hep C)
80
Ptosis, miosis, anhidrosis
Horner's syndrome (sympathetic chain lesion, associated with loss of PICA)
81
Pupil that accomodates but doesn't react
Argyll Robertson pupil (neurosyphilis)
82
Rapidly progressive leg weakness that ascends following GI/upper respiratory infection
Guillain-Barre syndrome (acute autoimmune inflammatory demyelinating polyneuropathy)
83
Rash on palms and soles
Coxsackie A, secondary syphilis, Rocky Mountain spotted fever
84
Recurrent colds, unusual ezema, high serum IgE
Hyper-IgE syndrome (Job's syndrome; neutrophil chemotaxis abnormality)
85
Red "currant jelly" stools
Acute mesenteric ischemia (adults) intussusception (infants)
86
Red "current jelly" sputum in alcoholic or diabetic patients
Klebsiella pneumoniae
87
Red, itchy, swollen rash of nipple/areola
Paget's disease of breast (represents underlying neoplasm)
88
Red urine in the morning, fragile RBCS
Paroxysmal nocturnal hemoglobinuria
89
Renal cell carcinoma (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma
Von Hippel-Lindau disease (dominant tumor suppressor gene mutation, VHL on chromosome 3)
90
Resting tremor, rigidity, akinesia, postural instability
Parkinson's disease (nigrostriatal dopamine depletion)
91
Retinal hemorrhages with pale centers
Roth's spots (bacterial endocarditis)
92
Severe jaundice in neonate
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia secondary to loss of UDP-glucuronyl transferase)
93
Severe RLQ pain w/ palpation of LLQ
Rovsing's sign (acute appendicitis)
94
Severe RLQ pain with rebound tenderness
McBurney's sign (appendicitis)
95
Short stature, increased incidence of tumors'/leukemia, aplastic anemia
Falconi's anemia (genetic loss of DNA crosslink repair; often progresses to AML)
96
Single palmar crease
Simian crease (Down syndrome)
97
Situs inversus, chronic sinusitis, bronchiectasis, infertility
Kartagener's syndrome (dynein arm defect affecting cells)
98
Skin hyperpigmentation, hypotension, fatigue
Addison's disease (primary adrenocortical insufficiency causes increased ACTH and increased alpha-MSH production)
99
Slow, progressive muscle weakness in boys
Becker's muscular dystrophy (X-linked missense mutation in dystrophin, less severe than Duchenne's)
100
Small, irregular red spots on buccal/lingual mucosa with blue/white centers
Koplik spots (measles; rubeola virus)
101
Smooth, flat, moist painless lesions on genitals
Condylomata lata (secondary syphilis)
102
Splinter hemorrhages in fingernails
Bacterial endocarditis
103
Strawberry tongue
Scarlet fever, Kawasaki disease, toxic shock syndrome
104
Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema
Turner syndrome (45, XO)
105
Sudden swollen/painful big toe joint, tophi
Gout/Podagra (hyperuricemia)
106
Swollen gums, mucosal bleeding, poor wound healing, spots on skin
Scurvy (Vitamin C deficiency; failure to hydroxylate proline/lysine for collagen synthesis)
107
Swollen, hard, painful finger joints
Osteoarthritis (osteophytes on PIP=Bouchard's nodes, DIP=Heberdin's nodes)
108
Systolic ejection murmur (crescendo-decrescendo)
Aortic valve stenosis
109
Thyroid and parathyroid tumors, pheochromocytoma
MEN 2A (Autosomal dominant ret mutation)
110
Thyroid tumors, pheochromocytoma, ganglioneuromatosis
MEN 2B (autosomal dominant ret mutation)
111
Toe extension/fanning upon plantar scrape
Babinski's sign (UMN lesion)
112
Unilaterial facial drooping involving forehead
Facial nerve (LMN CN VII) palsy
113
Urethritis, conjuctivitis, arthritis in male
Reactive arthritis associated with HLA-B27
114
Vascular birthmark (port-wine stain)
Hemangioma (benign, but associated with Struge-Weber syndrome)
115
Vomitting blood following gastroesophageal lacerations
Mallory-Weiss syndrome (alcoholic and bulimic patients)
116
Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple disease (Tropheryma whipplei)
117
Worst headache of my life
Subarachnoid hemorrhage
118
Anticentromere antibodies
Scleroderma (CREST)
119
Antidesmoglein (epithelial) antibodies
Pemphigus vulgaris (blistering)
120
Anti-glomerular basement membrane antibodies
Goodpasture's syndrome (glomerulonephritis and hemoptysis)
121
Antihistone antibodies
Drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
122
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonnniere deformity)
123
Antimitochondiral antibodies
Vasculitis (c-ANCA=granulomatosis w/ polyangiitis (Wegner's) p-ANCA=microscopic polyangiitis, (Churg-Strauss syndrome)
124
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
125
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
126
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, distention, weight loss)
127
Apple core lesion on abdominal xray
Colorectal cancer (usually left-sided)
128
Azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts
Auer rods (acute myelogenous leukemia, especially promyelocytic M3 type)
129
Bacitracin response
Sensitive: Streptocococcus pyogenes (group A) resistant: Streptococcus agalactiae (group B)
130
Bamboo spine on x-ray
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
131
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
132
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia
133
Bloody tap on LP
Subarachnoid hemorrhage
134
Boot-shaped heart on xray
Tetralogy of Fallot, RVH
135
Branching gram-positive rods with sulfur granules
Actinomyces isralii
136
Brochogenic apical lung tumor on imaging
Pancoast tumor (can compress sympathetic ganglion and cause Horner's syndrome)
137
Brown tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives you brown color)
138
Cardiomegaly with apical atrophy
Chagas' disease (Trypanosoma cruzi, tx: Nifurtimox)
139
Cellular crescents in Bowman's capsule
Rapidly progressive crescentic glomerulonephritis
140
Chocolate cyst of ovary
Endometriosis (frequently involves both ovaries)
141
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
142
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal-recessive mutation of CFTR resuling in fat-soluble vitamin deficiency and mucous plugs)
143
Decreased alpha-fetoprotein in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
144
Degeneration of dorsal column nerves
Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts are affected)
145
Depigmentation of neurons in substantia nigra
Parkinson's disease (basal ganglia disorder, rigidity, resting tremor, bradykinesia)
146
Desquamated epithelium casts in sputum
Curschmann's spirals (bronchial asthma; can result in whorled mucous plugs)
147
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
148
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV:Predisposes to cervical cancer)
149
Enlarged cells with intranuclear inclusion bodies
Owl's eyeappearance of CMV
150
Enlarged thyroid cells with ground-glass nuclei
Orphan Annie's eyes Nuclei (papillary carcinoma of the thyroid)
151
Eosinophilic cytoplasmic inclusion in liver cell
Mallory bodies (alcoholic liver disease)
152
Eosinohphilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson's disease)
153
Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
154
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Negri bodies of rabies (Lyssavirus)
155
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer's disease)
156
Giant B cells w/ bilobed nuclei with prominent inclusions ("owl's eye")
Reed-Sternburg cells (Hodgkin's lymphoma)
157
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sack tumor)
158
Hair on end crew cut appearance on xray
Beta-thalasemia, sickle cell anemia (marrow expansion)
159
hCG elevated
Choriocarcinoma, hydratidform mole (occurs w/ and w/o embryo)
160
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
161
Heterophile antibodies
Infectious mononucleosis (EBV)
162
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals, eosinophilic granules)
163
High level of d-dimers
DVT, pulmonary embolism, DIC
164
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung bodies (can calcify)
Ghon complex (Primary TB: Mycobacterium bacilli)
165
Honeycomb lung on xray
Interstitial pulmonary fibrosis
166
Hypercoagulability (leading to migrating DVT's and vasculitis)
Trousseau's syndrome (adenocarcinoma of the pancreas or lung)
167
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
168
Hypertension, hypokalemia, metabolic acidosis
Conn's syndrome
169
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
170
Increased alpha-fetoprotein in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (neural tube defects)
171
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
172
Intranuclear eosinohilic droplet-like bodies
Cowdry type A bodies (HSV or CMV)
173
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increased risk of mesothelioma)
174
Keratin pearls on a skin biopsy
Squamous cell carcinoma
175
Large lysosomal vesicles in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
176
Lead pipe appearance of colon on barium enema x-ray
Ulcerative colitis (loss of haustra)
177
Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture's syndrome
178
Low serum ceruloplasmin
Wilson's disease (hepatoenticular degeneration)
179
Lumpy bumpy appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
180
Lytic ("hole punched") bone lesions on xray
Multiple Myeloma
181
Mammary gland ("blue domed") cyst
Fibrocystic change of the breast
182
Monoclonal antibody spike
1. Multiple myeloma (IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging) 3. Waldenstrom's (M protein=IgM) macroglobulinemia 4. Primary amyloidosis
183
Mucin-filled cell with peripheral nucleus
Signet ring (gastric carcinoma)
184
Narrowing of bowel lumen on barium on xray
String sign (Crohn's disease)
185
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis w/ polyangiitis (Wegener's; c-ANCA positve) Goodpasture's syndrome (anti-basement membrane antibodies)
186
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
187
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
188
Novobicin response
Sensitive: Staphylococcus epidermidis Resistant: Staphylococcus saprophyticus
189
Nutmeg appearance of liver
Chronic passive congestion of liver due to heart failure
190
Onion skin periosteal reaction
Ewing's sarcoma (malignant round cell tumor)
191
Optochin response
Sensitive: Streptococcus pneumoniae Resistant: Viridans streptococcus
192
Periosteum raised from bone, creating triangular area
Codman's triangle on xray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)
193
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
194
Polished "ivory like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
195
Protein aggregates in neurons from hyperphosphorylation of protein tau
Neurofibrillary tangles (Alzheimer's disease) and Pick's bodies (Pick's disease)
196
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
197
Pseudopalisading tumor cells on biopsy
Glioblastoma multiforme (associated with HHV-6 and CMV)
198
RBC casts in urine
Acute glomerulonephritis
199
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
200
Renal epithelial casts in urine
Acute toxic/viral nephrosis
201
Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
202
Rib notching
Coarctation of the aorta
203
Ring-enhancing brain lesion in AIDS
Toxoplasma gondii, CNS lymphoma
204
Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" appearance)
Burkitt's lymphoma (t8:14) c-myc activation associated with EBV; "black sky" made up of malignant cells
205
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick's disease: progressive dementia, changes in personality)
206
Soap bubbles on femur or tibia on xray
Giant cell tumor of bone (generally benign)
207
Spikes on basement membrane "dome like" subepithelial deposits
Membranous glomenulonephritis (may progress nephrotic syndrome)
208
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
209
Stippled vaginal epithelial cells
Clue cells (Gardnerella vaginalis)
210
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cells histiocytosis or histocytosis X: eosinophilic granuloma)
211
Thrombi make of red/white layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
212
Thumb sign on lateral xray
Epiglottitis (haemophilus influenzae)
213
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
214
Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
215
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
216
Waxy casts with very low urine
Chronic end-stage renal disease
217
WBC casts in urine
Acute pyelonephritis
218
WBCs that look "smudged"
CLL (almost always B cell)
219
Wire loop glomerular capillary appearance on light microscopy
Lupus nephropathy
220
Yellowish CSF
Xanthochromia (due to subarachnoid hemorrhage)
221
Absence seizures
Ethosuximide
222
Acute gout attack
NSAIDS, colchicine
223
Acute promyelocytic leukemia (M3)
All-trans retinoic acid
224
ADHD
Methylphenidate, amphetamines
225
Alcohol abuse
AA + disulfram for patient and Al-Anon for family
226
Alcohol withdrawl
Benzodiazepines
227
Anorexia
SSRIs
228
Anticoagulation during pregancy
Heparin
229
Arrhthymia in damaged cardiac tissue
Class IB antiarrhythmic (lidocaine, mexiletine, tocainide)
230
B12 deficiency
Vitamin B12 supplementation (work up cause with Schilling test)
231
Benign prostatic hyperplasia
Tamsulosin, finasteride
232
Bipolar disorder
Lithium, valproate, carbamazepine, lamotrigine (mood stabilizers)
233
Breast cancer in postmenopausal woman
Aromatase inhibitor (anastrozole)
234
Buerger's disease
Smoking cessation
235
Bulemia
SSRIs
236
Candida albicans
Amphotericin B (systemic), nystatin (oral thrush, esophagitis)
237
Carcinoid syndrome
Octreotide
238
Chlamydia trachomatis
Doxycycline (+ cefriaxone for gonohrrhea coinfections), erythromycin eye drops (prophylaxis in infants)
239
Chronic gout
Probenecid (underexcretor) and allopurinal (overproducer)
240
Chronic hepatitis
IFN-alpha
241
Chronic myelogenous leukemia
Imatinib
242
Clostridium botulinum
Antitoxin
243
Clostridium difficile
Oral metronidazole; if refractory, oral vancomycin
244
Clostridium tetani
Antitoxin + vaccine booster + Diazepam
245
Crohn's disease
Corticosteroids, infliximab
246
Cryptococcus neoformans
Fluconazole (prophylaxis in AIDS patients)
247
Cyclophosphamide-induced hemorrhagic cystitis
Mesna
248
Cystic fibrosis
N-acetylcysteine + antipseudomonal prophylaxis (tobramycin/azithromycin)
249
Cytomegalovirus
Ganciclovir
250
Depression
SSRIs
251
Diabetes insipidus
Desmopressin (central); hydrochlorothiazide indomethacin, amiloride (nephrogenic)
252
Diabetes mellitus type 1
Dietary intervention and insulin replacement
253
Diabetes melitus type 2
Dietary intervention, oral hypoglycemia and possibly insulin
254
Diabetic ketoacidosis
Fluids, insulin, K+
255
Enterococci
Vancomycin/ampicillin + aminoglycoside
256
Erectile dysfuction
Sildenafil, vardenafil
257
ER-positive breast cancer
Tamoxifen
258
Ethylene glycol/methanol intoxication
Fomepizole
259
Haemophilus influenzae B
Rifampin (prophylaxis)
260
Generalized anxiety disorder
Buspirone
261
Heparin toxicity
Protamine sulfate
262
HER2/neu-postive breast cancer
Trastuzumbab
263
Hyperaldosteronism
Spironolactone
264
Hypercholesterolemia
Statin
265
Hypertriglyceridemia
Fibrate
266
Immediate anticoagulation
Heparin
267
Infertility
Leuprolide, GnRH (pulsatile)
268
Influenza
Rimantadine, oseltamivir
269
Legionella pneumophilia
Erythromycin
270
Long-term anticoagulation
Warfarin
271
Malaria
Chloroquine/mefloquine (for blood schizont), primaquine (for liver hypnozoite)
272
Malignant hyperthermia
Dantrolene
273
Medical abortion
Mifepristone
274
Migraine
Sumatriptan
275
MRSA
Vancomycin
276
Multiple sclerosis
Beta-interferon, immunosuppression, natazlizumab
277
Mycobacterium tuberculosis
RIPE (Rifampin, INH, pyrazinambide, ethambutol)
278
Neisseria gonorrhoeae
Ceftriaxone (add doxycycline to cover likely Chlamydia co-infection)
279
Nesseria meningitidis
Penicillin/ceftriaxone, rifampin (prophylaxis)
280
Neural tube defect prevention
Prenatal folic acid supplementation
281
Osteomalacia/rickets
Vitamin D supplementation
282
Osteoporosis
Bisphosphonates; calcium and vitamin D supplementation
283
Patent ductus arteriosis
Indomethacin
284
Pheochromocytoma
alpha-antagonist (phenoxybenzamine)
285
Pneumocystis jirovecii
TMP-SMX (prophylaxis in AIDS pt)
286
Prolactinoma
Bromocriptine (dopamine agonists)
287
Prostate cancer/uterine fibroids
Leuprolide, GnRH (continuous)
288
Prostate carcinoma
Flutamide
289
Pseudomonas aeruginosa
Antipseudomonal penicillin + aminoglycoside
290
Pulmonary arterial hypertension
Sildenafil, bosentan, epoprostenol
291
Rickettsia rickettsii
Doxycycline, chloramphenicol (especially in context of aplastic anemia)
292
Ringworm infection
Terbinafine, griseofulvin, imidazole
293
Schizophrenia (Negative)
5-HT2A antagonists (second generation antipsychotics)
294
Schizophrenia (Positive)
D2 receptor antagonists (first and second generation antipsychotics)
295
SIADH
Demeclocycline, lithium, vasopressin receptor antagonists
296
Sickle cell anemia
Hydroxyurea (increased fetal hemoglobin)
297
Sporothrix schenckii
Oral potassium iodide
298
Stable angina
Sublingual nitroglycerin
299
Staphylococcus aureus
MSSA: nafcillin, oxacillin, dicloxacillin (antinstaphylococcal penicillins); MRSA: vancomycin
300
Streptococcus bovis
Penicillin prophylaxis, evaluation for colon cancer if linked to endocarditis
301
Streptococcus pneumoniae
Penicillin/cephalosporin (systemic infection, pneumonia) vancomycin (meningitis)
302
Streptococcus pyogenes
Penicillin prophylaxis
303
Temporal arteritis
High-dose steroids
304
Tonic-clonic seizures
Phenytoin, valproate, carbamazepine
305
Toxoplasma gondii
Sulfadiazine + pyrimethamine
306
Treponema pallidum
Penicillin
307
Trichomonas vaginalis
Metronidazole (patient and partner)
308
Ulcerative colitis
5-ASA, infliximab
309
UTI prophylaxis
TMP-SMX
310
Warfarin toxicity
Fresh frozen plasma (acute) Vitamin K (chronic)
311
Wegener's granulomatosis w/ polyangiitis
Cyclophosphamide, corticosteroids
312
Actinic (solar) keratosis
Precursor to squamous cell carcinoma
313
Acute gastric ulcer associated with CNS injury
Cushing's ulcer (increase ICP stimulates vagal gastric secretion)
314
Acute gastric ulcer associated with severe burns
Curling's ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
315
Alternating areas of transmural inflammation and normal colon
Skip lesions (Crohn's disease)
316
Aneurysm, dissecting
Hypertension
317
Aortic aneurysm, abdominal and descending aorta
Atherosclerosis
318
Aortic aneurysm, arch
Tertiary syphilis (syphilis), vasa vasorum destruction
319
Aortic aneurysm, ascending
Marfan's syndrome (idiopathic cystic medial degeneration)
320
Atropy of the mammillary bodies
Wenicke's encephalopathy (thiamine deficiency causing ataxia, ophthalmoglegia, and confusion)
321
Autosplenectomy (fibrosis and shrinkage)
Sickle cell anemia (hemoglobin S)
322
Bacteria associated with gastritis, peptic ulcer disease, and stomach cancer
H. pylori
323
Bacterial meningitis (adults and elderly)
Streptococcus pneumoniae
324
Bacterial meningitis (newborns and kids)
Group B streptococcus (newborns), S. pneumoniae/Neisseria meningitidis (kids)
325
Benign melanocytic nevus
Spitz nevus (most common and first two decades)
326
Bleeding disorder with GpIB deficiency
Bernard-Soulier syndrome (defect in platelet adhesion to von Willebrand's factor)
327
Brain tumor (adults)
Supratentorial: metastasis>astrocytoma (including glioblastoma multiform)>meningioma> schwannoma
328
Brain tumor (kids)
Infratentorial: medulloblastom (cerebellum) or supratentorial: craniopharyngioma (cerebrum)
329
Breast cancer
Infiltrating ductal carcinoma (in US 1 in 9 women will develop breast cancer)
330
Breast tumor (benign)
Fibrocystic change, carcinoma (in postmenopausal women)
331
Cardiac primary tumor (kids)
Rhabdomyoma, often seen in tuberous sclerosis
332
Cardiac manifestation of lupus
Libman-Sacks exdocarditis (nonbacterial, affecting both sides of mitral valve)
333
Cardiac tumor (adults)
Metastasis, primary myxoma (4:1 left to right atrium; "ball and valve")
334
Cerebellar tonsillar herniation
Chiari malformation (often presents with progressive hydrocephalus or syringomyelia)
335
Chronic arrhythmia
Atrial fibrillation (associated with high risk of emboli)
336
Chronic atrophic gastritis (autoimmune)
Predisposition to gastic carcinoma (can also cause pernicious anemia)
337
Clear cell adenocarcinoma of the vagina
DES exposure in utero
338
Compression fracture
Osteoporosis (type I: postmenopausal woman; type II: elderly man or woman)
339
Congenital adrenal hyperplasia, hypotension
21-hydroxylase deficiency
340
Congenital cardiac anomaly
VSD
341
Congenital conjugated hyperbilirubinemia (black liver)
Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)
342
Constrictive pericarditis
Tuberculosis (developing world); systemic lupus erythematosus (developed world)
343
Coronary artery involved in thrombosis
LAD>RCA>LCA
344
Cretinism
Iodine deficit/hypothyroidism
345
Cushing's syndrome
1. Iatrogenic Cushing's 2. Adrenocortical adenoma (excess cortisol) 3. ACTH-secreting pituitary adema 4. Paraneoplastic Cushing's (due to ACTH secretion by tumors)
346
Cyanosis (early; less common)
Tetralogy of Fallot, transposition of great vessels, truncus arteriosus
347
Cyanosis (late; more common)
VSD, ASD, PDA
348
Death in CML
Blast crisis
349
Death in SLE
Lupus nephropathy
350
Dementia
Alzheimer's disease, multiple infarcts
351
Demyelinating disease in young women
Multiple sclerosis
352
DIC
Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery
353
Dietary deficit
Iron
354
Diverticulum in pharynx
Zenker's diverticulum (diagnosed by barium swallow)
355
Ejection click
Aortic/pulmonic stenosis
356
Esophageal cancer
Squamous cell carcinoma (worldwide); adenocarcinoma (US)
357
Food poisoning (exotoxin mediated)
S. aureus, B. cereus
358
Glomerulonephritis (adults)
Berger's disease (IgA nephropathy)
359
Gynecologic malignancy
Endometrial carcinoma (most common in US); cervical carcinoma (most common worldwide)
360
Heart murmur, congenital
Mitral valve prolapse
361
Heart valve in bacterial endocarditis
Mitral>aortic (rheumatic fever), tricuspid (IV drug abuse)
362
Helminth infection (US)
Enterbius vernicularis, Ascaris lumbricoides
363
Hematoma- epidural
Rupture of middle meningeal artery (trauma; lentiform shaped)
364
Hematoma-subdural
Rupture of bridging veins (Crescent shaped)
365
Hemochromatosis
Multiple blood transfusions or hereditary HFE mutation (can result in CHF, "bronze" diabetes and increased risk of hepatocellular carcinoma)
366
Hepatocellular carcinoma
Cirrhotic liver (associated with hepatitis B and C and with alcoholism)
367
Hereditary bleeding disorder
von Wilebrand's disease
368
Hereditary harmless jaundice
Gilbert's syndrome (benign congenital unconjugated hyperbilirubinemia)
369
HLA-B27
Ankyosing spondylitis, Reiter's syndrome, ulcerative colitis, psoriasis
370
HLA-DR3 or DR4
Diabetes mellitus type 1, rheumatoid arthritis, SLE
371
Holosystolic murmur
VSD, tricuspid regurgitation, mitral reurgitation
372
Hypercoagulability, endothelial damage, blood stasis
Virchow's triad (results in venous thrombosis)
373
Secondary hypertension
Renal disease
374
Hypoparathyroidism
Accidental excision during thyroidectomy
375
Hypopituitarism
Pituitary adenoma (usually benign tumor)
376
Infection secondary to blood transfusion
Hepatitis C
377
Infections in chronic granulomatous disease
Staphylococcus aureus, E. coli, Asperigillus (catalase positive)
378
Kidney stones
1. Calcium=radiopaque 2. Struvite (ammonium)=radiopaque (formed by urease positive organisms such as Proteus vulgaris or Staphylococcus) 3. Uric acid=radiolucent
379
Late cyanotic shunt (uncorrected left to right becomes right to left)
Eisenmenger's syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)
380
Liver disease
Alcoholic cirrhosis
381
Lysosomal storage disease
Gaucher's disease
382
Male cancer
Prostatic carcinoma
383
Malignancy associated with noninfectious fever
Hodgkin's lymphoma
384
Malignancy (kids)
ALL, medulloblastoma (cerebellum)
385
Mental retardation
Down syndrome, fragile X syndrome
386
Metastases to bone
Prostate,breast>lung>thyroid, testes
387
Metastases to brain
Lung>breast>genitourinary>osteosarcoma>melanoma>GI
388
Metastases to liver
Colon>>stomach, pancreas
389
Mitochondrial inheritance
Disease occurs in males and females, inherited through females only
390
Mitral valve stenosis
Rheumatic heart disease
391
Mixed (UMN and LMN) motor neuron disease
ALS
392
Myocarditis
Coxxsackie B
393
Nephrotic syndrome (adults)
Focal segmental glomerulosclerosis
394
Nephrotic syndrome (kids)
Minimal change disease
395
Neuron migration failure
Kallmann syndrome (hypogonadotropic hypogonadism and anosmia)
396
Nosocomial pneumonia
Klebsiella, E. coli, Pseugomonas aeruginosa
397
Obstruction of male urinary tract
BPH
398
Opening snap
Mitral stenosis
399
Opportunistic infection in AIDS
Pneumocytis jirovecii pneumonia
400
Osteomyelitis
S. aureus
401
Osteomyelitis in sickle cell disease
Salmonella
402
Osteomyelitis with IV drug use
Pseudomonas, S. aureus
403
Ovarian metastasis from gastic carcinoma or breast cancer
Krukenberg tumor (mucin-secreting signet-ring cells)
404
Ovarian tumor (benign, bilateral)
Serous cystadenoma
405
Ovarian tumor (malignant)
Serous cystadenocarcinoma
406
Pancreatitis (acute)
Gallstones, alcohol
407
Pancreatitis (chronic)
Alcohol (adults) cystic fibrosis (kids)
408
Patient with ALL/CLL/AML/CML
ALL: Child, CLL:adult>60, AML:adult~65, CML:adult 30-60
409
Pelvic inflammatory disease
Chlamydia trachomatis, Neisseria gonorrhoae
410
Philadelphia chromosome t(9;22)(bcr-abl)
CML (may sometimes be associated with ALL/AML)
411
Pituitary tumor
Prolactinoma, somatotropic "acidophilic" adenoma
412
Primary amenorrhea
Turner syndrome
413
Primary bone tumor (adults)
Multiple myeloma
414
Primary hyperaldosteronism
Adenoma of adrenal cortex
415
Primary hyperparathyroidism
Adenomas, hyperplasia, carcinoma
416
Primary liver cancer
Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, alpha1 antritrypsin deficiency)
417
Pulmonary hypertension
COPD
418
Recurrent inflammation/thrombosis of small/medium vessels in extremities
Buerger's disease (strongly associated with tobacco)
419
Renal tumor
Renal cell carcinoma: associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndromes (EPO, renin, PTH, ACTH)
420
Right failure due to pulmonary cause
Cor pulmonale
421
S3 (protodiastolic gallop)
Increased ventricular filling (left to right shunt, mitral regurgitation, LV failure, CHF)
422
S4 (protodiastolic gallop)
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
423
Secondary hyperparathyroidism
Hypocalcemia of chronic kidney disease
424
Sexually transmitted disease
Chlamydia (usually with gonorrhea)
425
SIADH
Small cell cacinoma of the lung
426
Site of diverticula
Sigmoid colon
427
Sites of atherosclerosis
Abdominal aorta>coronary artery>popliteal artery>carotid artery
428
Stomach cancer
Adenocarcinoma
429
Stomach ulcerations and high gastrin levels
Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
430
t(14:18)
Follicular lymphoma (bcl-2 activation)
431
t(8:14)
Burkitt's lymphomas (c-myc activation)
432
t(9:22)
Philadelphia chromosome, CML (bcr-abl fusion)
433
Temporal arteritis
Risk of ipsilateral blindness due to thrombosis of opthalmic artery; polymyalgia rheumatica
434
Testicular tumor
Seminoma
435
Thyroid cancer
Papillary carcinoma
436
Tumor in women
Leiomyoma (estrogen dependent, not precancerous)
437
Tumor of infancy
Hemangioma (usually regresses spontaneously by childhood)
438
Tumor of the adrenal medulla (kids)
Neuroblastoma (malignant)
439
Type of Hodgkins
Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)
440
Type of non-Hodgkins
Diffuse large cell
441
UTI
E. coli, Staphylocuccus saprophyticus (young women)
442
Viral encephalitis affecting temporal lobe
HSV-1
443
Vitamin deficiency (US)
Folate (pregnany women are at high risk; body stores only 3-4 month supply; prevents neural tube defects)
