-
Actinic (solar keratosis)
Precursor to squamous cell carcinoma
-
Acute gastric ulcer with CNS injury
Cushing's ulcer (ICP rise stimulates vagal gastric secretion)
-
Acute gastric ulcer associated with severe burns
Curling's ulcer (low plasma volume causes sloughing of gastric mucosa)
-
Alternating areas of transmural inflammation and normal colon
Skip lesions (Crohn's Disease)
-
Aneurysm, dissecting
Hypertension
-
Aortic Aneurysm, abdominal and descending aorta
Atherosclerosis
-
Aortic Aneurysm, ascending
Tertiary Syphilis or Marfan's Syndrome
-
Atrophy of the mammilary bodies
Wernicke's Encephalopathy (Thiamine (B1) deficiency causes ataxia, opthalmoplegia, confusion)
-
Autosplenectomy (fibrosis and shrinkage)
Sickle cell anemia (HbS)
-
Bacteria with stomach cancer
H. Pylori
-
Bacterial meningitis (adults and elderly)
Neisseria Meningitidis
-
Bacterial meningitis (newborns)
Group B streptococcus
-
Bacterial meningitis (kids)
S. Pneumoniae or Neisseria Meningitidis
-
Benign melanocytic nevus
Spitz nevus (most common ages 0-20)
-
Bleeding disorder with GpIb deficiency
Bernard-Soulier disease (faulty platelet adhesion to vWF)
-
Brain tumor (adults)
Supratentorial: mets>astrocytoma (GBM)>meningioma>Schwaanoma
-
Brain tumor (kids)
Infratentorial: medulloblastoma (cerebellum) // Supratentorial: Craniopharyngioma (cerebrum)
-
Breast cancer
Infiltrating ductal carcinoma (1/9 women get BC in U.S.)
-
Breast mass
1. Fibrocystic change 2. Carcinoma (postmenopausal)
-
Breast tumor (benign)
Fibroadenoma
-
Cardiac primary tumor (kids)
Rhabdomyoma
-
Cardiac manifestations of lupus
Libman-Sacks endocarditis (mitral, non-bacterial)
-
Cardiac tumor (adults)
1. Metastasis 2. Primary myxoma (4:1 left to right atrium; ball and valve)
-
Cerebellar tonsillar herniation
Chiari malformation (progressive hydrocephalus or syringomyelia)
-
Chronic arrhythmia
Atrial fibrillation (high risk of emboli)
-
Chronic atropic gastritis (autoimmune)
Predisposition to gastric carcinoma (+pernicious anemia)
-
Clear cell adenocarcinoma of the vagina
DES exposure in utero (diethylbestrol)
-
Congenital adrenal hyperplasia + hypotension
21-hydroxylase deficiency
-
Congential cardiac abnormality
Ventriculo-Septal Defect (VSD)
-
Congential conjugated bilirubinemia (black liver)
Dubin-Johnson syndrome (hepatocytes can't secrete conjugated bilirubin into bile)
-
Constrictive pericarditis in developing world
Tuberculosis (TB)
-
Coronary artery (thrombosis)
LAD > RCA > LCA
-
Cretinism
Iodine deficiency / Hypothyroidism
-
Cushing's syndrome
1. Corticosteroid therapy 2. Excess ACTH secretion by pituitary
-
Cyanosis (early, less common)
Tetralogy of Fallot, transposition of great vessels, truncus arteriosis)
-
Cyanosis (late, more common)
VSD, ASD, PDA
-
Death in CML
Blast crisis
-
Death in SLE (lupus)
Lupus nephropathy
-
Dementia
1. Alzheimer's 2. Multiple infarcts
-
Demyelinating disease in young women
MS
-
DIC
Gram-negative sepsis, obstetric complications, cancer, burn trauma
-
-
Diverticulum in pharynx
Zenker's diverticulum (barium swallow diagnosis)
-
Ejection Click
Aortic/pulmonary stenosis
-
Esophageal cancer
Squamous cell carcinoma (worldwide), adenocarcinoma (U.S.)
-
Food poisoning (exotoxic)
S. aureus, B. cereus
-
Glomerulonephritis (adults)
Berger's Disease (IgA nephropathy)
-
Gynecologic malignancy
Endometrial carcinoma (most common)
-
Heart murmur, congenital
Mitral valve prolapse
-
Heart valve in bacterial endocarditis
Mitral (rheumatic fever), Tricuspid (IV drug abuse), aortic (rheumatic fever, 2nd affected)
-
Helminth infection
1. Enterobius vermicularis 2. Ascaris lumbricoides
-
Hematoma - epidural
Rupture of middle meningeal artery (crescent)
-
Hematoma - subdural
Rupture of bridging veins (trauma) (lentiform shaped)
-
Hemochromatosis
Multiple blood transfusions or hereditary HFE mutation (can cause CHF, "bronze diabetes", and raises risk of hepatocellular carcinoma)
-
Hepatocellular carcinoma
Cirrhotic liver (hepatitis B and C)
-
Hereditary bleeding disorder
von-Willebrand's disease
-
Hereditary harmless jaundice
Gilbert's syndrome (benign congenital unconjugated hyperbilirubinemia)
-
HLA-B27
Ankylosing spondylitis, Reiter's syndrome, ulcerative colitis, psoriasis
-
HLA-DR3 or HLA-DR4
Diabetes Mellitus type 1, rhematoid arthritis, SLE
-
Holosystolic murmur
VSF, tricuspid regurgitation, mitral regurgitation
-
Hypercoagulability, endothelial damage, blood stasis
Virchow's triad (VENOUS THROMBOSIS)
-
Hypertension, secondary
Renal disease
-
Hypoparathyroidism
often caused by thyroidectomy
-
Hypopituitarism
Pituitary adenoma (usually benign)
-
Infection after blood transfusion
Hepatitis C
-
Kidney stones
1. Calcium=radioopaque 2. Struvite (NH4)=radioopaque (formed by urease+ organisms like Proteus vulgaris or Staphylococcus) 3. Uric acid - radioLUCent
-
Late cyanotic shunt (uncorrected L>R becomes R>L)
Eisenmenger's syndrome (caused by ASD, VSD, PDA), results in pulmonary hypertension and polycythemia)
-
Liver disease
Alcoholic cirrhosis
-
Lysosomal storage disease
Gaucher's disease (Glucocerebrosidase)
-
Male cancer
Prostatic carcinoma
-
Malignancy associated with non-infectious fever
Hodgkin's lymphoma
-
Malignant skin tumor
Basal cell carcinoma (rarely metastasizes)
-
Mental retardation
1. Down syndrome 2. Fragile X syndrome
-
Metastases to bone
Breast, lung, thyroid, testes, prostate, kidney
-
Metastases to brain
Lung, breast, skin (melanoma), kidney (RCC), GI
-
Metastases to liver
Colon, gastric, pancreatic, breast, lung carcinomas
-
Mitral valve stenosis
Rheumatic heart disease
-
Mixed motor neuron disease (UMN and LMN)
ALS
-
-
Neoplasm (kids)
1. ALL 2. Cerebellar medulloblastoma
-
Nephrotic syndrome (adults)
Membranous glomerulonephritis
-
Nephrotic syndrome (kids)
Minimal change disease (associated with infections, vaccinations; treat with steroids)
-
Nosocomial pneumonia
Klebsella, E. Coli, Pseudomonas aeruginosa
-
Obstruction of male urinary tract
BPH
-
Opening snap
Mitral stenosis
-
Opportunistic infection (AIDS)
Pneumonia (Pneumocystis jiroveci) - formerly carinii)
-
-
Osteomyelitis in HbS patients
Salmonella
-
Osteomyelitis with IV drug use
Pseudomonas, S. Aureus
-
Ovarian metastasis from gastric carcinoma or breast cancer
Krukenberg tumor (mucin-secreting signet-ring cells)
-
Ovarian tumor (benign)
Serous cystadenoma
-
Ovarian tumor (malignant)
Serous cystadenocarcinoma
-
Pancreatitis (acute)
Gallstones, alcohol
-
Pancreatitis (chronic)
alcohol (adults), CF (kids)
-
Patient with ALL/CLL/AML/CML
ALL: child, CLL: adult>60, AML: adult>60, CML: adult 35-50
-
Pelvic Inflammatory Disease (PID)
Neisseria gonorrhoeae (monoarticular arthritis)
-
Philadelphia Chromosome (t(9;22)(bcr-abl)
CML (although sometimes ALL/AML)
-
Pituitary tumor
1. Prolactinoma 2. Somatotropic "acidophilic" adenoma
-
Primary amenhorrhea
Turner syndrome (XO)
-
Primary bone tumor (adults)
Multiple myeloma
-
Primary hyperaldosteronism
Adenoma of adrenal CORTEX
-
Primary hyperparathyroidism
1. Adenomas 2. Hyperplasia 3. Carcinoma
-
Primary liver cancer
Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, a-1 antitrypsin)
-
Pulmonary hypertension
COPD
-
Recurrent inflammation/thrombosis of small/medium vessels in extremities
Buerger's Disease (tobacco)
-
Renal tumor
RCC: associated with von-Hippel Landau and adult Polycystic Kidney Disease; paraneoplastic syndromes (erythropoietin, renin, PTH, ACTH)
-
Right heart failure due to pulmonary cause
Cor pulmonale
-
S3 (protodiastolic gallop)
high ventricular filling (L>R shunt, mitral regurgitation, LV failure in CHF)
-
S4 (presystolic gallop)
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
-
Secondary hyperparathyroidism
Hypocalcemia of CKD
-
STD
Chlamydia (usually coinfected with gonorrhea)
-
SIADH (high ADH)
small cell carcinoma of the lung
-
Site of diverticula
Sigmoid colon
-
Sites of atherosclerosis
Abdominal aorta>coronary>popliteal>carotid
-
Stomach cancer
Adenocarcinoma
-
Stomach ulcerations and high gastrin levels
Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
-
t(14;18)
Follicular lymphomas (bcl-2 activation)
-
t(8;14)
Burkitt's lymphoma (c-myc activation)
-
t(9:22)
Philadelphia chromosome; CML (bcr-abl hybrid)
-
Temporal arteritis
Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymyalgia rheumatica
-
Testicular tumor
Seminoma
-
Thyroid cancer
Papillary carcinoma
-
Tumor in women
Leiomyoma (estrogen dependent)
-
Tumor of infancy
Hemangioma (usually regresses spontaneously)
-
Tumor of adrenal medulla (adults)
Pheochromocytoma (usually benign)
-
Tumor of adrenal medulla (kids)
Neuroblastoma (malignant)
-
Type of Hodgkin's
Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)
-
Type of non-Hodgkin's
Diffuse large cell
-
UTI
E. Coli, Staphylocccus saprophyticus (young women)
-
Viral encephalitis affecting temporal lobe
HSV
-
Vitamin deficiency
Folic acid (pregnant women at high-risk, body has only 3-4 month supply, prevents neural tube defects)
-
Sensitivity
Sensitivity = TP/(TP+FN)
-
Specificity
Specificity = TN/(TN+FP)
-
Positive Predictive Value (PPV)
PPV = TP/(TP+FP)
-
Negative Predicitive Value (NPV)
NPV = TN/(TN+FN)
-
Relative Risk (RR)
RR = (a/a+b)/(c/c+d)
-
Attributable Risk (AR)
AR = (a/a+b)-(c/c+d)
-
Number Needed to Treat (NNT)
NNT = 1/Absolute Risk Reduciton
-
Number Needed to Harm (NNH)
NNH = 1/Attributable Risk
-
-
Hardy Weinberg Equilibrium
p2 + 2pq+ q2=1 // p+q=1
-
Henderson-Hasselbalch equation
pH=pKa + log [HCO3-]/0.03 PCO2)
-
Volume of Distribution (Vd)
Vd = amt drug in body/plasma drug conc.
-
Clearance (CL)
CL = rate of elimination of drug/plasma drug concentration
-
Half-life (t1/2)
t1/2 = 0.7Vd/CL
-
Loading Dose (LD)
LD = Cp*Vd/F
-
Maintenance Dose (MD)
MD = Cp*CL/F
-
Cardiac Output (CO)
CO = rate of O2 consumption/(arterial O2 content-venous O2 content)
-
Cardiac Output (CO)
CO = Stroke Volume x heart rate
-
Mean arterial pressure (MAP)
1. MAP = CO*total peripheral resistance 2. MAP = 1/3 systolic + 2/3 diastolic
-
Stroke Volume (SV)
SV = end diastolic volume-end systolic volume
-
Ejection Fraction (EF)
EF = (stroke volume/end diastolic volume)*100
-
Resistance (R)
1. R = Driving pressure/flow 2. R = 8η (viscosity)*length/πr4
-
Net filtration pressure (Pnet)
Pnet=[(Pc-Pi)-(πC - πi)]
-
Glomerular Filtration Rate (GFR)
Uinulin *V/Pinulin = Cinulin
-
Glomerular Filtration Rate (GFR)
GFR = Kf [(PGC-PBS)-(πGC-πBS)]
-
Effective renal plasma flow (ERPF)
ERPF = UPAH*V/PPAH = CPAH
-
Renal blood flow (RBF)
RBF = RPF/1-Hct
-
Filtration fraction (FF)
FF = GFR/RPF
-
Physiologic dead space (Vd)
VD = VT * (PaCO2 - PeCO2)/PaCO2
-
Abdominal pain, ascites, hepatomegaly
Budd-Chiari syndrome (posthepatic venous thrombosis)
-
Achilles tendon xanthoma
Familial hypercholesterolemia
-
Adrenal hemorrhage, hypotension, DIC
Waterhouse-Friderichsen syndrome (meningococcemia)
-
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
Marfan's syndrome
-
Athlete with polycythemia
Erythropoietin injection
-
Back pain, fever, night sweats, weight loss
Pott's disease (vertebral tuberculosis)
-
Bilateral hilar adenopathy, uveitis
Sarcoidosis (non-caseating granulomas)
-
Blue sclera
Osteogenesis imperfecta (collagen defect)
-
Bluish line on gingiva
Burton's line (lead poisoning)
-
Bone pain, bone enlargement, arthritis
Paget's Disease of bone (increased osteoblastic and osteoclastic activity)
-
Bounding pulses, diastolic heart murmur, head bobbing
aortic regurgitation
-
Café-au-lait spots, Lisch nodules (iris hamartoma)
1. Neurofibromatosis type I (+pheochromocytomas, optic gliomas) // 2. Neurofibromatosis type II (+bilateral acoustic neuromas)
-
Café-au-lait spots, polyostotic fibrous dysplasia, precocious puberty
McCune-Albright syndrome (mosaic G-protein signaling mutation)
-
Calf pseudohypertrophy
Muscular Dystrophy (most commonly Duchenne's)
-
Cherry-red spot on macula
1. Tay Sachs (ganglioside accumulation) // 2. Niemann-Pick (sphingomyelin accumulation// 3. central retinal artery occlusion
-
Chest pain, pericardial effusion/friction rub, persistent fever following MI
Dressler's syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode)
-
Child uses arms to stand up from squat
Gowers' sign (Duchenne Muscular Dystrophy; X-linked recessive deleted dystrophin gene)
-
Child with fever develops red rash on face that spreads to body
Slapped cheeks = erythema infectiosum/fifth disease: parvovirus B19)
-
Chorea, dementia, caudate degeneration
Huntington's Disease (Autosomal dominant CAG repeat expansion)
-
Chronic exercise intolerance with myalgia, fatigue, painful cramps
McArdle's Disease (muscle phosphorylase deficiency, a GSD)
-
Cold intolerance
HyPOthyroidism
-
Conjugate lateral gaze palsy, horizontal diplopia
Internuclear opthalmoplegia (damage to MLF; bilateral~Multiple Sclerosis; unilateral~stroke)
-
Continuous "machinery" heart murmur
Patent Ductus Arteriosus (PDA) (close with indomethacin; open with misoprostol)
-
Cutaneous/dermal edema due to connective tissue deposition
Myxedema (hypothyroidism, Graves' disease)
-
Dark purple skin/mouth nodules
Kaposi's sarcoma; usually in AIDS patients (gay men), associated with HHV-8)
-
Deep, labored breathing/hyperventilation
Kussmaul breathing (Diabetic ketoacidosis)
-
Dermatitis, dementia, diarrhea
Pellagra (niacin (=vitamin B3) deficiency)
-
Dilated cardiomyopathy, edema, polyneuropathy
Wet beriberi (thiamine (Vitamin B1) deficiency
-
Dog or cat bite resulting in infection
Pasteurella multocida (cellulitis at inoculation site)
-
Dry eyes, dry mouth, arthritis
Sjogren's syndrome (autoimmune destruction of exocrine glands)
-
Dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome (can progress to esophageal squamous cell carcinoma)
-
Elastic skin, hypermobility of joints
Ehlers-Danlos syndrome (collagen defect, usually type III)
-
Enlarged, hard left supraclavicular node
Virchow's node (abdominal metastasis)
-
Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
1. Sezary syndrome (cutaneous T-cell lymphoma) // 2. Mycosis fungoides
-
Facial muscle spasm upon tapping
Chvostek's sign (hypocalcemia)
-
Fat, female, forty, fertile
Acute cholecystitis (bile duct blockage)
-
Fever, chills, headache, myalgia after antibiotic treatment for syphilis
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
-
Fever cough, conjunctivitis, coryza, diffuse rash
Measles (Morbillivirus)
-
Fever, night sweats, weight loss
B symptoms (lymphoma)
-
Fibrous plaques in soft tissue of penis
Peyronie's disease (connective tissue disorder)
-
Gout, mental retardation, self-mutilating behavior in a boy
Lesch-Nyhan syndrome (HGPRT deficiency, X linked recessive)
-
Green-yellow rings around peripheral cornea
Wilson's Disease (copper accumulation leading to Kayser-Fleischer rings)
-
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands
Peutz -Jeghers syndrome (genetic benign polyposis can cause bowel obstruction, elevated cancer risk)
-
Hepatosplenomegaly, osteoporosis, neurologic symptoms
Gaucher's disease (glucocerebrosidase deficiency)
-
Hereditary nephritis, sensorineural hearing loss, cataracts
Alport's syndrome (type IV collagen mutation)
-
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau's sign (adenocarcinoma of pancreas or lung)
-
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Kluver-Bucy syndrome (bilateral amygdala lesion)
-
Hypertension, hyPOkalemia, metabolic acidosis
Conn's syndrome (primary hyperaldosteronism)
-
Hypoxemia, polycythemia, hypercapnia
Blue bloater (chronic bronchitis: hyperplasia of mucous cells)
-
Indurated, ulcerated genital lesion
1. Non-painful=chancRE (primary syphilis, Treponema pallidum) // 2. Painful, with exudate=chancROID (Haemophilus ducreyi)
-
Infant with failure to thrive, hepatosplenomegaly, neurodegradation
Niemann-Pick disease (genetic sphingomyelinase deficiency)
-
Infant with hypoglycemia, failure to thrive, hepatosplenomegaly
Cori's disease (debranching enzyme deficiency)
-
Infant with microcephaly, rocker-bottom feet, CLENCHED HANDS, structural heart defect
Edwards Syndrome (trisomy 18)
-
Jaundice, RUQ pain, fever
Charcot's triad 2 (ascending cholangitis)
-
Keratin pearls on skin biopsy
Squamous cell carcinoma
-
Large rash with bull's eye appearance
Lyme disease (Borrelia): Erythema chronicum migrans from Ixodes tick bite
-
Lucid interval after traumatic brain injury
Epidural hematoma (middle meningeal artery rupture)
-
Male child, recurrent infections, no mature B cells
Bruton's disease (X-linked agammaglobulinemia)
-
Mucosal bleeding and prolonged bleeding time
Glanzmann's thombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
-
Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
Gardner's syndrome (subtype of FAP)
-
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
1. Wegener's syndrome (c-ANCA-positive) // 2. Goodpasture's syndrome (anti-basement membrane antibodies)
-
Neonate with arm paralysis following birth
Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip"
-
No lactation post-partum, absent menstruation, cold intolerance
Sheehan's syndrome (pituitary infarction)
-
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
Multiple Sclerosis
-
Oscillating slow/fast breathing
Cheyne-Stokes respirations (central apnea in CHF or elevated intracranial pressure)
-
Painful blue fingers/toe, hemolytic anemia
Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis)
-
Painful, pale, cold fingers/toes
Raynaud's syndrome (vasospasm in extremities)
-
PainFUL, raised red lesions on palms and soles
Osler's node (infective endocarditis)
-
PainLESS erythematous lesions on palms and soles
Janeway lesions (infective endocarditis)
-
Painless jaundice
Cancer of the pancreatic head obstructing the bile duct
-
Palpable purpura, joint pain, abdominal pain (CHILD)
Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
-
Pancreatic, pituitary, parathyroid tumors
Wermer's syndrome (MEN 1)
-
Pink complexion, dyspnea, hyperventilation
"Pink puffer' (emphysema: centroacinar [smoking], panacinar [a1-antitrypsin deficiency)
-
Polyuria, acidosis, growth failure, electrolyte imbalances
Fanconi's syndrome (proximal tubular reabsorption defect)
-
Positive anterior drawer sign"""
-
Ptosis, miosis, anhidrosis
Horner's syndrome (sympathetic chain lesion)
-
Pupil accomodates but doesn't react
Neurosyphilis (Argyll-Robertson pupil)
-
Rapidly progressing leg weakness that ascends (following GI/UR infection)
Guillain-Barre syndrome (autoimmune acute inflammatory demyelinating PNS polyneuropathy)
-
Rash on palms and soles
Secondary syphilis // Rocky Mountain Spotted Fever
-
Recurrent colds, unusual eczema, high serum IgE
Job's syndrome (hyper IgE syndrome; neurophil chemotaxis abnormality)
-
Red "currant jelly" sputum in alcoholic or diabetic patients
Klebsiella pneumoniae
-
Red itchy swollen rash of nipple, areola
Paget's disease of the breast (represents underlying neoplasm)
-
Red urine in the morning, fragile RBCs
Paroxymal nocturnal hemoglobinuria
-
Renal cell carcinoma, hemangioblastomas, angiomatosism pheochromocytoma
von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
-
Resting tremor, rigidity, akinesia, postural instability
Parkinson's disease (nigrostriatal dopamine depletion)
-
Restrictive cardiomyopathy (juvenile form: cardiomegaly), exercise intolerance
Pompe's Disease (lysosomal glucosidase deficiency)
-
Retinal hemorrhages with pale centers
Bacterial endocarditis (Roth's spots)
-
Severe jaundice in neonate
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
-
Severe RLQ pain with REBOUND tenderness
Appendicitis (McBurney's sign)
-
Short stature, high rate of tumors/leukemia, aplastic anemia
Fanconi's anemia (genetic; often progresses to AML)
-
Single palm crease
Down syndrome (trisomy 21) - simian crease
-
Situs inversus, chronic sinusitis, bronchiectasis, male infertility
Kartagener's syndrome (dynein defect affecting cilia movement)
-
Skin hyperpigmentation
Addison's disease (primary adrenocortical insufficiency; autoimmune or infectious)
-
Slow, progressive muscle weakness in boys
Becker's muscular dystrophy (X-linked, defective dystrophin, less severe than Duchenne's)
-
Small, irregular spots on buccal/lingual mucosa with blue-white centers
Measles (Koplik spots)
-
Smooth, flat, moist white lesions on genitals
Secondary syphilis (condylomata lata)
-
Splinter hemorrhages in fingernails
Bacterial endocarditis
-
Strawberry tongue
Scarlet fever, Kawasaki disease, toxic shock syndrome
-
Streak ovaries, congential heart disease, horseshoe kidney
Turner Syndrome (XO, short stature, webbed neck, lymphedema)
-
Sudden swollen/painful big toe joint, tophi
Gout/podagra (hyperuricemia)
-
Swollen gums, mucous bleeding, poor wound healing, spots on skin
Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
-
Swollen, hard, painful finger joints
Osteoarthritis (osteophytes on PIP (Bouchard's nodes), DIP (Heberden's nodes)
-
Systolic ejection murmur (crescendo-decrescendo)
Aortic valve stenosis
-
Thyroid and Parathyroid tumors, pheochromocytoma
Sipple's syndrome (MEN 2A)
-
Toe extension/fanning upon plantar scrape
Babinski's sign (UMN lesion)
-
Unilateral facial drooping involving forehead
Bell's palsy (LMN CN VII palsy)
-
Urethritis, conjunctivitis, arthritis in a male
Reiter's syndrome (reactive arthritis associated with HLA-B27)
-
Vascular birthmark (port-wine stain)
1. Hemangioma (benign) // 2. Sturge-Weber syndrome
-
Vasculitis from exposure to endotoxin causing glomerular thrombosis
Shwartzman reaction (following 2nd exposure to endotoxin)
-
Vomiting blood following esophagogastric lacerations
Mallory-Weiss syndrome (alcoholic and bulemic patients)
-
Waxy casts with very low urine flow
Chronic end-stage renal disease (ESRD)
-
WBC casts in urine
Acute pyelonephritis
-
Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple's disease (Tropheryma whippelii)
-
Worst headache of my life
Subarachnoid hemorrhage
-
Anti-centromere antibodies
Scleroderma (CREST)
-
Anti-desmoglein (epithelial) antibodies
Pemphigus vulgaris (blistering)
-
Anti-glomerular basement membrane antibodies
Goodpasture's syndrome (glomerulonephritis and hemoptysis)
-
Anti-histone antibodies
Drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
-
Anti-IgG antibodies
Rhematoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
-
Anti-mitochondrial antibodies (AMAs)
PBC - primary biliary cirrhosis (female, cholestasis, portal hypertension)
-
Anti-neutrophil cytoplasmic antibodies (ANCAs)
Vasculitis (c-ANCA: Wegener's, p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome)
-
Anti-nuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
SLE (type III hypersensitivity)
-
Anti-platelet antibodies
Idiopathic thrombocytopenic purpura (ITP) (bleeding diathesis)
-
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
-
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, distension, weight loss)
-
Azurophilic granular needles in leukemic blasts
Auer rods (AML, especially promyelocytic)
-
Bamboo spine on X-ray
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
-
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or non-functional spleen)
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Basophilic stippling of RBCs
Lead poisoning or sideoblastic anemia
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Bloody tap on LP
Subarachnoid hemorrhage
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Boot-shaped heart of x-ray
Tetralogy of Fallot, RVH
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Branching gram-positive rods with sulfur granules
Actinomyces israelii
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Bronchogenic apical lung tumor
Pancoast's tumor (can compress sympathetic ganglion, can cause Horner's syndrome)
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Brown tumor of bone
Hemorrhage (hemosiderin) causes brown color of osteolytic cysts due to: 1. Hyperparathyroidism or 2. Osteitis fibrosis cystica
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Cardiomegaly with apical atrophy
Chagas' disease (Trypanosoma cruzi)
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Cellular crescents in Bowman's capsule
Rapidly progressive crescentic glomerulonephritis
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Chocolate cyst of ovary
Endometriosis (frequenly both ovaries)
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Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
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Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (CFTR mutation resulting in fat-soluble vitamin deficinecy and mucous plugs)
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Degeneration of dorsal column nerves
Tabes dorsalis (tertiary syphilis)
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Depigmentation of neurons in substantia nigra
Parkinson's disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
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Desquamated epithelium casts in sputum
Curschmann's spiral (bronchial asthma; can results in whorled mucous plugs)
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Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
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Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
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Enlarged cells with intranuclear inclusion bodies
Owl's eye appearance of CMV
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Enlarged thyroid cells with ground-glass nuclei
Orphan Annie eye nuclei (papillary carcinoma of the thyroid)
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Eosinophilic cytoplasmic inclusion in liver cell
Mallory bodies (alcoholic liver disease)
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Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson's disease)
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Eosinophilic globule in liver
Councilman body (toxic/viral hepatitis, often yellow fever)
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Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Rabies virus (Lyssavirus)
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Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer's disease)
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Giant B cells with bilobed nuclei with prominent inclusions ("Owl's eye")
Reed-Sternberg cells (Hodgkin's lymphoma)
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Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk-sac tumor)
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Hair-on-end (crew-cut) appearance on x-ray
B-thalassemia, sickle cell anemia (extramedullary hematopoiesis)
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hCG elevated
Choriocarcinoma or Hyatidiform mole (with or without embryo)
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Heart nodules (inflammatory)
Aschoff bodies (rheumatic fever)
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Heterophile antibodies
Infectious mononucleosis (Epstein-Barr virus)
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Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
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High levels of D-dimers
DVT, pulmonary embolism, DIC
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Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon focus (primary TB: Mycobacterium bacilli)
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Honeycomb lung on x-ray
Interstitial fibrosis
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Hypersegmented neutrophils
Megaloblastic anemia (B12, folate deficiency)
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Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present)
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Increased a-fetoprotein in amniotic fluid/maternal serum
Increased a-FP: Anencephale, spina bifida (neural tube defects)
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Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
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Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or Yellow fever)
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Iron containing nodules in alveolar septum
Ferruginous bodies (asbestosis: higher risk of mesothelioma)
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Large lysosomal vesicles in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital faillure of phagolysosome formation)
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Low serum ceruloplasmin
Wilson's Disease (hepatolenticulra degeneration)
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Lumpy-bumpy appearance of glomeruli or immunofluorescence
Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
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Lytic ("hole-punched") bone lesions on x-ray
Multiple myeloma
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Mammary gland ("blue-domed") cyst
Fibrocystic change of the breast
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Monoclonal Ab spike
1. Multiple myeloma (M-protein, usually IgG or IgA) // 2. Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging) // 3. Waldenstrom's (M-protein=IgM) macroglobulinemia // 4. Primary amyloidosis
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Monoclonal globulin protein in blood/urine
1. Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine)] // 2. Waldenstrom's macroglobulinemia
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Mucin-filled cell with peripheral nucleus
Signet ring (gastric carcinoma)
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Narrowing of bowel lumen on barium swallow
String sign (Crohn's disease)
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Needle-shaped, negatively birefringent crystals
Gout (hyperuricemia)
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Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
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Nutmeg appearance of liver
Chronic passive congestion of liver due to right heart failure
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Onion-skin periosteal reaction
Ewing's sarcoma (malignant round-cell tumor)
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Periosteum raised from bone, creating triangular area
Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)
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Podocyte fusion on EM
Minimal change disease (child with nephrotic syndrome)
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Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
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Protein aggregates in neurons from hyperphosphorylation of protein tau
Neurofibrillary tangles (Alzheimer's disease or CJD)
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Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
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RBC casts in urine
Acute glomerulonephritis
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Rectangular, crystal-like cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
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Renal epithelial casts in urine
Acute toxic/viral nephrosis
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Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate)
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Rib notching
Coarctation of the aorta
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Sheets of medium-sized lymphoid cells ("starry-sky" appearance on histology)
Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV)
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Silver staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick's disease: progressive dementia; similar to Alzheimer's)
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Soap bubble in femur or tibia on x-ray
Giant cell tumor of bome (generally benign)
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Spikes on basement membrane, "dome-like" endothelial deposits
Membranous glomerulonephritis (can progress to nephrotic syndrome)
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Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
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Stippled vaginal epithelial cells
Clue cells - Gardnerella vaginalis
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Tennis-racket shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (histiocytosis X: eosinophilic granuloma)
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Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
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Thumb sign on lateral x-ray
Epiglottitis (Hemophilus influenzae)
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Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
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Tram-track appearance on LM
Membranoproliferative glomerulonephritis
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Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
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WBCs that look smudged
CLL (almost always B cell; affects elderly)
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Wire-loop glomerular apperance on LM
Lupus nephropathy
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Yellow CSF
Xanthochromia (subarachnoid hemorrhage)
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