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Rapid Review1
First Aid for USMLE Step 1 Rapid Review
Question Answer
Abdominal pain, ascites, hepatomegalyBudd-Chiari Syndrome (posthepatic venous
thrombosis)
Achilles tendon xanthoma Familial hypercholesterolemia
Adrenal hemorrhage, hypotension, DICWaterhouse-Friderichsen Syndrome
(meningococcemia)
Arachnodactyly, lens dislocation, aorticdissection, hyperflexible joints
Marfan's syndrome (fibrillin defect)
Athlete with polycythemia Erythropoietin injection
Back pain, fever, night sweats, weight loss Pott's disease (vertebral tuberculosis)
Bilateral hilar adenopathy, uveitis Sarcoidosis (noncaseating granulomas)
Blue sclera Osteogenesis imperfecta (collagen defect)
Bluish line on gingiva Burton's line (lead poisoning)
Bone pain, bone enlargement, arthritisPaget's disease of bone (increased osteoblastic
and osteoclastic activity)
Bounding pulses, diastolic heart murmur,
head bobbingAortic regurgitation
Caf-au-lait spots, Lisch nodules (irishamartoma)
Neurofibromatosis type I (+ pheochromocytoma,
optic gliomas) Neurofibromatosis type II (+
bilateral acoustic neuromas)
Caf-au-lait spots, polyostotic fibrous
dysplasia, precocious puberty
McCune-Albright syndrome (mosaic G-protein
signaling mutation)
Calf pseudohypertrophy Muscular dystrophy (MCly Duchenne's)
"Cherry-red spot" on macula
Tay-Sachs (ganglioside accumulation) or
Niemann-Pick (sphingomyelin accumulation),
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 squatGowers' sign (Duchenne muscular dystrophy: XR
deleted dystrophin gene)
Child with fever develops red rash on face "Slapped cheeks" (erythema infectiosum/fifth
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that spreads to body disease: parvovirus B19)
Chorea, dementia, caudate degeneration Huntington's disease (AD CAG repeat expansion)
Chronic exercise intolerance with myalgia,
fatigue, painful cramps
McArdle's disease (muscle phosphorylase
deficiency)
Cold intolerance Hypothyroidism
Conjugate lateral gaze palsy, horizontal
diplopia
Internuclear ophthalmoplegia (damage to MLF;
bilateral [multiple sclerosis], unilateral [stroke])
Continuous "machinery" heart murmurPDA (close with indomethacin; open with
misoprostol)
Cutaneous/dermal edema due to connective
tissue depositionMyxedema (hypothyroidism, Graves' disease)
Dark purple skin/mouth nodulesKaposi's sarcoma (usually AIDS patients [gay
men]: associated with HHV-8)
Deep, labored breathing/hyperventilation Kussmaul breathing (DKA)
Dermatitis, dementia, diarrhea Pellagra (niacin [vitamin B3] deficiency)
Dilated cardiomyopathy, edema,
polyneuropathyWet beriberi (thiamine [vitamin B1] deficiency)
Dog or cat bite resulting in infectionPasteurella multocida (cellulitis at inoculation
site)
Dry eyes, dry mouth, arthritisSjgren's syndrome (autoimmune destruction of
exocrine glands)
Dysphagia (esophageal webs), glossitis, irondeficiency anemia
Plummer-Vinson syndrome (may progress toesophageal squamous cell carcinoma)
Elastic skin, hypermobility of jointsEhlers-Danlos syndrome (collagen defect, usually
type III)
Enlarged, hard left supraclavicular node Virchow's node (abdominal metastasis)
Erythroderma, lymphadenopathy,
hepatosplenomegaly, atypical T cells
Szary syndrome (cutaneous T-cell lymphoma)
or mycosis fungoides
Facial muscle spasm upon tapping Chvostek's sign (hypocalcemia)
Fat, female, forty, and fertile Acute cholecystitis (bile duct blockage)
Fever, chills, headache, myalgia followingantibiotic treatment for syphilis
Jarisch-Herxheimer reaction (rapid lysis ofspirochetes results in toxin release)
Fever, cough, conjunctivitis, coryza, diffuserash
Measles (Morbillivirus)
Fever, night sweats, weight loss B symptoms (lymphoma)
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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,
XR)
Green-yellow rings around peripheral corneaKayser-Fleischer rings (copper accumulation
from Wilson's disease)
hamartomatous GI polyps,
hyperpigmentation of mouth/feet/hands
Peutz-Jeghers syndrome (genetic benignpolyposis can cause bowel obstruction; increase
cancer risk)
Hepatosplenomegaly, osteoporosis,
neurologic symptoms
Gaucher's disease (glucocerebrosidase
deficiency)
Hereditary nephritis, sensorineural hearing
loss, cataractsAlport'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
Klver-Bucy syndrome (bilateral amygdala
lesion)
Hypertension, hypokalemia, metabolic
alkalosis (the high pH of the blood makesCa2+ less available to the tissues and causes
symptoms of hypocalcemia)
Conn's syndrome (primary hyperaldosteronism)
Hypoxemia, polycythemia, hypercapnia"Blue bloater" (chronic bronchitis: hyperplasia ofmucous cells)
Indurated, ulcerated genital lesion Nonpainful: chancre (primary syphilis,Treponema pallidum) Painful, with exudate:
chancroid (Haemophilus ducreyi)
Infant with failure to thrive,
hepatosplenomegaly, neurodegeneration
Niemann-Pick disease (genetic sphingomyelinase
deficiency)
Infant with hypoglycemia, failure to thrive,
and hepatomegalyCori's disease (debranching enzyme deficiency)
Infant with microcephaly, rocker-bottom feet,
clenched hands, and structural heart defectEdwards' 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 appearanceErythema chronicum migrans from Ixodes tick
bite (Lyme disease: Borrelia)
Lucid interval after traumatic brain injuryEpidural hematoma (middle meningeal artery
rupture)
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Male child, recurrent infections, no mature Bcells
Bruton's disease (X-linked agammaglobulinemia)
Mucosal bleeding and prolonged bleedingtime
Glanzmann's thrombasthenia (defect in plateletaggregation due to lack of GpIIb/IIIa)
Multiple colon polyps, osteomas/soft tissuetumors, impacted/supernumerary teeth
Gardner's syndrome (subtype of FAP)
Necrotizing vasculitis (lungs) and necrotizing
glomerulonephritis
Wegener's (c-ANCA positive) and Goodpasture's
syndromes (anti-basement membrane antibodies)
Neonate with arm paralysis following
difficult birth
Erb-Duchenne palsy (superior trunk [C5-C6]
brachial plexus injury: "waiter's tip")
No lactation postpartum, absent
menstruation, cold intoleranceSheehan's syndrome (pituitary infarction)
Nystagmus, intention tremor, scanning
speech, bilateral internuclearophthalmoplegia
Multiple sclerosis
Oscillating slow/fast breathingCheyne-Stokes respirations(central apnea in CHF
or increased intracranial pressure)
Painful blue fingers/toes, hemolytic anemiaCold agglutinin disease (autoimmune hemolyticanemia caused by Mycoplasma pneumoniae,
infectious mononucleosis)
Painful, pale, cold fingers/toes Rayneud's syndrome (vasospasm in extremities)
Painful, raised red lesions on palms and soles Osler's nodes (infective endocarditis)
Painless erythematous lesions on palms andsoles
Janeway lesions (infective endocarditis)
Painless jaundiceCancer of the pancreatic duct obstructing bileduct
Palpable purpura, joint pain, abdominal pain(child)
Henoch-Schnlein purpura (IgA vasculitisaffecting skin and kidneys)
Pancreatic, pituitary, parathyroid tumors Wermer's syndrome (MEN I)
Pink complexion, dyspnea, hyperventilation"Pink puffer" (emphysema: centroacinar
[smoking], panacinar [1-antitrypsin deficiency])
Polyuria, acidosis, growth failure, electrollyte
imbalances
Fanconi's syndrome (proximal tubular
reabsorpiton defect)
Positive anterior "drawer sign" Anterior cruciate ligament (ACL) injury
Ptosis, miosis, anhidrosis Horner's syndrome (sympathetic chain lesion)
Pupil accommodates but doesn't react Argyll Robertson pupil (neurosyphilis)
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Rapidly progressive leg weakness thatascends (following GI/upper respiratory
infection)
Guillain-Barr syndrome (autoimmune acute
inflammatory demyelinating polyneuropathy)
Rash on palms and solesSecondary syphilis, Rocky Mountain spotted
fever, Coxsackie A virus
Recurrent colds, unusual eczema, high serum
IgE
Job's syndrome (hyper-IgE syndrome: neutrophil
chemotaxis abnormality)
Red "currant jelly" sputum in alcoholic or
diabetic patientsKlebsiella pneumoniae
Red, itchy, swollen rash of nipple/areolaPaget's disease of the breast (represents
underlying neoplasm)
Renal cell carcinoma, hemangioblastomas,
angiomatosis, pheochromocytoma
von Hippel-Lindau disease (dominant tumor
suppressor gene mutation)
Resting tremor, rigidity, akinesia, posturalinstability
Parkinson's disease (nigrostriatal dopaminedepletion)
Restrictive cardiomyopathy (juvenile form:
cardiomegaly), exercise intolerance
Pompe's disease (lysosomal glucosidase
deficiency)
Retinal hemorrhages with pale centers Roth spots (bacterial endocarditis)
Severe jaundice in neonateCrigler-Najjar syndrome (congential
unconjugated hyperbilirubinemia)
Severe RLQ pain with rebound tenderness McBurney's sign (appendicitis)
Short stature, increased incidence of
tumors/leukemia, aplastic anemia
Fanconi's anemia (genetically inherited; often
progresses to AML)
Single palm crease Simian crease (Down syndrome)
Situs inversus, chronic sinusitis,
bronchiectasis, infertility
Kartagener's syndrome (dynein defect affecting
cilia)
Skin hyperpigmentation
Addison's disease (primary adrenocortical
insufficiency of autoimmune or infectious
etiology)
Slow, progressive weakness in boysBecker's muscular dystrophy (X-linked, defective
dystrophin; less severe than Duchenne's)
Small, irregular red spots on buccal/lingual
mucosa with blue-white centersKoplik spots (measles)
Smooth, flat, moist white lesions on genitals Condylomata lata (secondary syphilis)
Splinter hemorrhages in fingernails Bacterial endocarditis
"Strawberry tongue"Scarlet fever, Kawasaki disease, toxic shock
syndrome
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Streak ovaries, congential heart disease,horseshoe kidney
Turner syndrome (XO, short stature, webbedneck, 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 jointsOsteoarthritis (osteophytes on PIP [Bouchard'snodes], 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 maleReiter's syndrome (reactive arthritis associated
with HLA-B27)
Vascular birthmark (port-wine stain)Hemangioma (benign, but associated with Sturge-
Weber syndrome)
Vasculitis from exposure to endotoxin causeglomerular thrombosis
Shwartzman reaction (following second exposureto endotoxin)
Vomiting blood following esophagogastriclacerations
Mallory-Weiss syndrome (alcoholic and bulimicpatients)
"Waxy" casts with very low urine flow Chronic end-stage renal diseaseWBC casts in urine Acute pyelonephritis
Weight loss, diarrhea, arthritis, fever,
adenopathyWhipple's disease (Tropheryma whippelii)
"Worst headache of my life" Subarachnoid hemorrhage
Anticentromere antibodies Scleroderma (CREST)
Andidesmoglein (epithelial) antibodies Phemphigus vulgaris (blistering)
Anti-glomerular basement membraneantibodies
Goodpasture's syndrome (glomerulonephritis andhemoptysis)
Antihistone antibodiesDrug-induced SLE (hydralazine, isoniazid,phenytoin, procainamide, quinidine)
Anti-IgG antibodiesRheumatoid arthritis (systemic inflammation,joint pannus, boutonnire deformity)
Antimitochondrial antibodies (AMAs)Primary biliary cirrhosis (female, cholestasis,
portal hypertension)
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Antineutrophil cytoplasmic antibodies
(ANCAs)
Vasculitis (c-ANCA: Wegener's; p-ANCA:microscopic polyangiitis, Churg-Strauss
syndrome)
Antinuclear antibodies (ANAs: anti-Smith
and anti-dsDNA)
SLE (type III hypersensitivity); anti-dsDNA
correlates with disease activity, anti-Smith does
not
Antiplatelet antibodiesIdiopathic thrombocytopenic purpura (ITP)
(bleeding diathesis)
Anti-topoisomerase antibodies Diffuse systemic scleroderma
Anti-transglutaminase/antigliadin/anti-
endomysial antibodiesCeliac disease (diarrhea, distension, weight loss)
Azurophilic granular needles in leukemic
blasts
Auer rods (Acute myelogenous leukemia:
especially the promyelocytic type)
"Bamboo spine" on x-ray Ankylosing spondylitis (chronic inflammatoryarthritis: HLA-B27)
Basophilic nuclear remnants in RBCsHowell-Jolly bodies (due to splenectomy or
nonfunctional spleen)
Basophilic stippling of RBCs Lead poisoning or sideroblastic anemia
Bloody tap on LP Subarachnoid hemorrhage
"Boot-shaped" heart on x-ray Tetralogy of Fallot, RVH
Branching gram-positive rods with sulfur
granulesActinomyces israelii
Bronchogenic apical lung tumorPancoast's tumor (can compress sympathetic
ganglion and cause Horner's syndrome)
"Brown" tumor of bone
Hemorrhage (hemosiderin) causes brown color of
osteolytic cysts. Due to: 1. Hyperparathyroidism
2. Osteitis fibrosa cystica
Cardiomegaly with apical atrophy Chagas' disease (Trypanosoma cruzi)
Cellular crescents in Bowman's capsuleRapidly progressive crescentic
glomerulonephritis
"Chocolate cyst" on ovary Endometriosis (frequently involves both ovaries)
Circular grouping of dark tumor cells
surrounding pale neurofibrils
Homer Wright rosettes (neuroblastoma,
medulloblastoma, retinoblastoma)
Colonies of mucoid Pseudomonas bugs
Cystic fibrosis (CFTR mutation in Caucasians
resulting in fat-soluble vitamin deficiency and
mucous plugs)
Degeneration of dorsal column nerves Tabes dorsalis (tertiary syphilis)
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Depigmentation of neurons in substantianigra
Parkinson's disease (basal ganglia disorder:rigidity, resting tremor, bradykinesia)
Desquamated epithelium casts in sputumCurschmann's spirals (bronchial asthma; canresult in whorled mucous plugs)
Disarrayed granulosa cells in eosinophilicfluid
Call-Exner bodies (granulosa-theca cell tumor ofthe ovary)
Dysplastic squamous cervical cells with
nuclear enlargement and hyperchromasiaKoilocytes (HPV: predisposes to cervical cancer)
Enlarged cells with intranuclear incluusion
bodies"Owl's-eye" appearance of CMV
Enlarged thyroid cells with ground-glass
nuclei
"Orphan Annie" eye nuclei (papillary carcinoma
of the thyroid)
Eosinophilic cytoplasmic inclusion in liver
cell
Mallory bodies (alcoholic liver disease)
Eosinophilic cytoplasmic inclusion in nerve
cellLewy body (Parkinson's disease)
Eosinophilic globule in liverCouncilman body (toxic or viral hepatitis, often
yellow fever)
Eosinophilic inclusion bodies in cytoplasm of
hippocampal nerve cellsRabies virus (Lyssavirus); Negri bodies
Extracellular amyloid deposition in gray
matter of brainSenile plaques (Alzheimer's disease)
Giant B cells with bilobed nuclei withprominent inclusions ("owl's eye")
Reed-Sternberg cells (Hodgkin's lymphoma)
Glomerulus-like structure surrounding vesselin germ cells
Schiller-Duval bodies (yolk sac tumor)
"Hair-on-end" (crew-cut) appearance on x-ray
-thalassemia, sickle cell anemia (marrowexpansion)
hCG elevatedChoriocarcinoma, hydatidiform mole (occurswith and without embryo)
Heart nodules (inflammatory) Aschoff bodies (rheumatic fever)
Heterophile antibodies Infectious mononucleosis (EBV)
Hexagonal, double-pointed, needle-like
crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals:
eosinophilic granules)
High level of D-dimers DVT, pulmonary embolism, DIC
Hilar lymphadenopathy, peripheral
granulomatous lesion in middle or lower lung
Ghon complex (Primary TB: Mycobacterium
bacilli)
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lobes (can calcify)
"Honeycomb lung" on x-ray Interstitial fibrosis
Hypersegmented neutrophils Megaloblastic anemia (B12, folate deficiency)
Hypochromic, microcytic anemiaIron deficiency anemia, lead poisoning,
thalassemia (HbF sometimes present)
Increased -fetoprotein in amniotic
fluid/maternal serum
Anencephaly, spina bifida (neural tube defects),
multiple gestation, abdominal wall defects
Decreased -fetoprotein Down syndrome
Increased uric acid levelsGout, Lesch-Nyhan syndrome, tumor lysis
syndrome, loop and thiazide diuretics
Intranuclear eosinophilic droplet-like bodies Cowdry type A bodies (HSV or yellow fever)
Iron-containing nodules in alveolar septumFerruginous bodies (asbestosis: increased chance
of mesothelioma)Large lysosomal vesicles in phagocytes,immunodeficiency
Chdiak-Higashi disease (congential failure ofphagolysosome formation)
Low serum ceruloplasmin Wilson's disease (hepatolenticular degeneration)
"Lumpy-bumpy" appearance of glomeruli onimmunofluorescence
Poststreptococcal glomerulonephritis (immunecomplex deposition of IgG and C3b)
Lytic ("hole-punched") bone lesions on x-ray Multiple myeloma
Mammary gland ("blue-domed") cyst Fibrocystic change of the breast
Monoclonal antibody spike (4 things)
1. Multiple myeloma (called the M protein,usually IgG or IgA) 2. Monoclonal gammopathyof undetermined significance (MGUS; normal
consequence of aging) 3. Waldenstrm's
macroglobulinemia (M protein = IgM) 4. Primaryamyloidosis
Monoclonal globulin protein in blood/urineBence Jones proteins (multiple myeloma [kappaor lambda Ig light chains in urine]),
Waldenstrm's macroglobulinemia (IgM)
Mucin-filled cell with peripheral nucleus Signet ring (gastric carcinoma)
Narrowing of bowel lumen on bariumradiograph
"String sign" (Crohn's disease)
Needle-shaped, negatively birefringentcrystals
Gout (hyperuricemia)
Nodular hyaline deposits in glomeruliKimmelstiel-Wilson nodules (diabetic
nephropathy)
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"Nutmeg" appearance of liver Chronic passive congestion of liver due to RHF
"Onion-skin" periosteal reaction Ewing's sarcoma (malignant round-cell tumor)
Periosteum raised from bone, creating a
triangular area
Codman's triangle on x-ray (osteosarcoma,
Ewing's sarcoma, pyogenic osteomyelitis)
Podocyte fusion on EMMinimal change disease (child with nephrotic
syndrome)
Polished, "ivory-like" appearance of bone at
cartilage erosion
Eburnation (osteoarthritis resulting in bondy
sclerosis)
Protein aggregates in neurons from
hyperphosphorylation of protein tau
Neurofibrillary tangles (Alzheimer's disease and
CJD)
Pseudopalisading tumor cells on brain biopsy Glioblastoma multiforme
RBC casts in urine Acute glomerulonephritis
Rectangular, crystal-like, cytoplasmicinclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
Renal epithelial casts in urine Acute toxic/viral nephrosis
Rhomboid crystals, positively birefringent Pseudogout (calcium pyrophosphate dihydrate)
Rib notching Coarctation of the aorta
Sheets of medium-sized lymphoid cells("starry sky" appearance on histology)
Burkitt's lymphoma (t[8;14] c-myc activation,associated with EBV)
Silver-staining spherical aggregation of tau
proteins in neurons
Pick bodies (Pick's disease: progressive dementia,
similar to Alzheimer's)
"Soap bubble" in femur or tibia on x-ray Giant cell tumor of bone (generally benign)
"Spikes" on basement membrane, "dome-
like" endothelial deposits
Membranous glomerulonephritis (may progress
to nephrotic syndrome)
Stacks of RBCsRouleaux formation (high ESR, multiplemyeloma)
Stippled vaginal epithelial cells "Clue cells" (Gardnerella vaginalis)
"Tennis-racket"-shaped cytoplasmic
organelles (EM) in Langerhans cells
Birbeck granules (histiocytosis X: eosinophilic
granuloma)
Thrombi made of white/red layers Lines of Zahn (arterial thrombus, layers ofplatelets/RBCs)
"Thumb sign" on lateral x-ray Epiglottitis (Haemophilis influenzae)
Thyroid-like appearance of kidney Chronic bacterial pyelonephritis
"Tram-track" appearance on LM Membranoproliferative glomerulonephritis
Triglyceride accumulation in liver cell Fatty liver disease (alcoholic or metabolic
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vacuoles syndrome)
WBCs that look "smudged" CLL (almost always B cell; affects the elderly)
"Wire loop" glomerular appearance on LM Lupus nephropathy
Yellow CSF Xanthochromia (subarachnoid hemorrhage)
Actinic (solar keratosis) Precursor to squamous cell carcinoma
Acute gastric ulcer associated with CNSinjury
Cushing's ulcer (increased ICP stimulates vagalgastric secretion)
Acute gastric ulcer associated with severeburns
Curling's ulcer (greatly reduced plasma volumeresults in sloughing of gastric mucosa)
Alternating areas of transmural inflammationand normal colon
Skip lesions (Crohn's disease)
Aneurysm, dissecting Hypertension
Aortic aneurysm, abdominal and descendingaorta
Atherosclerosis
Aortic aneurysm, ascending Tertiary syphilis, Marfan's syndrome
Atrophy of the mammillary bodiesWernicke's encephalopathy (thiamine deficiency
causing ataxia, ophthalmoplegia, and confusion)
Autosplenectomy (fibrosis and shrinkage) Sickle cell anemia (HbS)
Bacteria associated with stomach cancer H. pylori
Bacterial meningitis (adults and elderly) Neisseria meningitidis
Bacterial meningitis (newborns and kids) Group B streptococcus (newborn), S.pneumoniae/Neisseria meningitidis (kids)
Benign melanocytic nevus Spitz nevus (most common in first two decades)
Bleeding disorder with GpIb deficiencyBernard-Soulier disease (defect in plateletadhesion to von Willebrand's factor)
Brain tumor (adults) - general type and mostcommon
Suptatentorial: mets > astrocytoma (includingglioblastoma multiforme) > meningioma >
schwannoma
Brain tumor (kids) - most common &
location
Infratentorial: medulloblastoma (cerebellum) or
supratentorial: craniopharyngioma (cerebrum)
Breast cancerInfiltrating ductal carcinoma (in the US, 1 in 9
women will develop breast cancer)
Breast mass1. Fibrocystic change 2. Carcinoma (in
postmenopausal women)
Breast tumor (benign) Fibroadenoma
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Cardiac primary tumor (kids) Rhabdomyoma
Cardiac manifestation of lupusLibman-Sacks endocarditis (nonbacterial,
affecting mitral)
Cardiac tumor (adults)1. Metastasis 2. Primary myxoma (4:1 LA to RA;
"ball and valve")
Cerebellar tonsillar herniationChiari malformation (often presents withprogressive hydrocephalus or syringomyelia)
Chronic arrhythmiaAtrial fibrillation (associated with high risk ofemboli)
Chronic atrophic gastritis (autoimmune)Predisposition to gastric carcinoma (can alsocause pernicious anemia)
Clear cell adenocarcinoma of the vagina DES exposure in utero
Congenital adrenal hyperplasia, hypotension 21-hydroxylase deficiency
Congential cardiac anomaly (most common) VSD
Constrictive pericarditis in developing world Tuberculosis
Coronary artery involved in thrombosis LAD>RCA>LCA
Cretinism Iodine deficit/hypothyroidism
Cushing's syndrome1. Corticosteroid therapy 2. Excess ACTHsecretion by pituitary
Cyanosis (early; less common)
Tetralogy of Fallot, transposition of great vessels,
truncus arteriosus, tricuspid atresia, total
anomalous pulmonary venous return (5 T's)
Cyanosis (late; more common) VSD, ASD, PDA
Death in CML Blast crisis
Death in SLE Lupus nephropathy
Dementia 1. Alzheimer's disease 2. Multiple infarcts
Demyelinating disease in young women Multiple sclerosis
DICGram-negative sepsis, obstetric complications,
cancer, burn trauma
Dietary deficit Iron
Diverticulum in pharynxZenker's diverticulum (diagnosed by bariumswallow)
Ejection click Aortic/pulmonic stenosis
Esophageal cancerSquamous cell carcinoma (worldwide);adenocarcinoma (US)
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Food poisoning (exotoxin mediated) S. aureus, B. cereus
Glomerulonephritis (adults) Berger's disease (IgA nephropathy)
Gynecologic malignancy (most common) Endometrial carcinoma
Heart murmur, congential Mitral valve prolapse
Heart valve in bacterial endocarditisMitral (rheumatic fever), tricuspid (IV drugabuse), aortic (2nd affected in rheumatic fever)
Helminth infection (US)1. Enterobius vermicularis (pinworm--Scotch
tape test) 2. Ascaris lumbricoides
Hematoma-epiduralRupture of middle meningeal artery (crescent
shaped)
Hematoma-subduralRupture of bridging veins (trauma; lentiform
[biconvex] shaped)
HemochromatosisMultiple blood transfusions or hereditary HFEmutation (can result in CHF, "bronze diabetes,"
and increased risk of hepatocellular carcinoma)
Hepatocellular carcinomaCirrhotic liver (often associated with hepatitis B
and C)
Hereditary bleeding disorder von Willebrand's disease
Hereditary harmless jaundiceGilbert's syndrome (benign congential
unconjugated hyperbilirubinemia)
HLA-B27
Ankylosing spondylitis, Reiter's
syndrome/reactive arthritis, ulcerative colitis,psoriasis
HLA-DR3 or -DR4Diabetes mellitus type 1, rheumatoid arthritis,SLE
Holosystolic murmur VSD, tricuspid regurgitation, mitral regurgitation
Hypercoagulability, endothelial damage,blood stasis
Virchow's triad (results in venous thrombosis)
Hypertension, secondary Renal disease
Hypoparathyroidism Thyroidectomy
Hypopituitarism Pituitary adenoma (usually benign tumor)
Infection secondary to blood transfusion Hepatitis C
Kidney stones
1. Calcium = radiopaque 2. Struvite (ammonium)= radiopaque (formed by urease-positive
organisms such as Proteus vulgaris or
Staphylococcus) 3. Uric acid = radiolucent
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Late cyanotic shunt (uncorrected L-->R
becomes R-->L)
Eisenmenger's syndrome (caused by ASD, VSD,PDA; results in pulmonary
hypertension/polycythemia)
Liver disease Alcoholic cirrhosis
Lysosomal storage disease Gaucher's disease
Male cancer Prostatic carcinoma
Malignancy associated with noninfectious
feverHodgkin'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 brainLung, breast, skin (melanoma), kidney (renal cell
carcinoma), GI
Metastases to liverColon, gastric, pancreatic, breast, and lungcarcinomas
Mitral valve stenosis Rheumatic disease
Mixed (UMN and LMN) motor neurondisease
ALS
Myocarditis (virus that causes) Coxsackie B
Neoplasm (kids) 1. ALL 2. Cerebellar medulloblastoma
Nephrotic syndrome (adults) Membranous glomerulonephritis
Nephrotic syndrome (kids)Minimal change disease (associated with
infections/vaccinations; treat with corticosteroids)
Nosocomial pneumonia Klebsiella, E. coli, Pseudomonas aeruginosa
Obstruction of male urinary tract BPH
Opening snap Mitral stenosis
Opportunistic infection in AIDSPneumocystis jiroveci (formerly carinii)pneumonia
Osteomyelitis S. aureus
Osteomyelitis in sickle cell disease patients Salmonella
Osteomyelitis with IV drug abuse Pseudomonas, S. aureus
Ovarian metastasis from gastric carcinoma or
breast cancer
Krukenbery tumor (mucin-secreting signet-ring
cells)
Ovarian tumor (benign) Serous cystadenoma
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Ovarian tumor (malignant) Serous cystadenocarcinoma
Pancreatitis (acute) Gallstones, alcohol
Pancreatitis (chronic) Alcohol (adults), cystic fibrosis (kids)
Patient with ALL/CLL/AML/CMLALL: child, CLL: adult>60, AML: adult>60,
CML: adult 35-50
Pelvic inflammatory disease Neisseria gonorrhoeae (monoarticular arthritis)
Philadelphia chromosome t(9;22) (bcr-abl)CML (may sometimes be associated with
AML/ALL)
Pituitary tumor1. Prolactinoma 2. Somatotrophic "acidophilic"
adenoma
Primary amenorrhea Turner syndrome (XO)
Primary bone tumor (adults) Multiple myeloma
Primary hyperaldosteronism Adenoma of adrenal contex
Primary hyperparathyroidism 1. Adenomas 2. Hyperplasia 3. Carcinoma
Primary liver cancerHepatocellular carcinoma (chronic hepatitis,
cirrhosis, hemochromatosis, -1 antitrypsin)
Pulmonary hypertension COPD
Recurrent inflammation/thrombosis of
small/medium vessels in extremities
Buerger's disease (strongly associated with
tobacco)
Renal tumor
Renal cell carcinoma: associated with von
Hippel-lindau and adult polycystic kidneydisease; paraneoplastic syndromes(erythropoietin, renin, PTH, ACTH)
Right heart failure due to a pulmonary cause Cor pulmonale
S3 (protodiastolic gallop)Increased ventricular filling (L-->R shunt, mitralregurgitation, LV failure [CHF])
S4 (presystolic gallop)Stiff/hypertrophic ventricle (aortic stenosis,restrictive cardiomyopathy)
Secondary hyperparathyroidism Hypocalcemia of chronic kidney disease
Sexually transmitted disease Chlamydia (usually coinfected with gonorrhea)
SIADH Small cell carcinoma of the lung
Site of diverticula Sigmoid colon
Sites of atherosclerosis Abdominal aorta > coronary > popliteal > carotid
Stomach cancer Adenocarcinoma
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Stomach ulcerations and high gastrin levelsZollinger-Ellison syndrome (gastrinoma ofduodenum or pancreas)
t(14;18) Follicular lymphomas (bcl-2 activation)
t(8;14) Burkitt's lymphoma (c-myc lymphoma)
t(9;22) Philadelphiachromosome, CML (bcr-abl hybrid)
Temporal arteritisRisk 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 infancyHemangioma (usually regresses spontaneously by
childhood)
Tumor of the adrenal medulla (adults) Pheochromocytoma (usually benign)
Tumor of the 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
UTIE. coli, Staphylococcus saprophyticus (young,
sexually-active women)
Viral encephalitis affecting temporal lobe HSV
Vitamin deficiency (US)
Folic acid (pregnant women are at high risk; body
stores only 3- to 4-month supply; prevents neural
tube defects)
Sensitivity TP/(TP+FN)
Specificity TN/(TN+FP)
Positive predictive value TP/(TP+FP)
Negative predictive value TN/(TN+FN)
Relative risk (a/[a+b])/(c/[c+d])
Attributable risk (a/[a+b]) - (c/[c+d])
Number needed to treat 1/absolute risk reduction
Number needed to harm 1/attributable risk
Hardy-Weinberg equilibrium p^2+2pq+q^2 = 1 p+q = 1
Henderson-Hasselbalch equation pH = pKa + log([HCO3-]/0.03PCO2)
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Volume of distributionAmount of drug in the body/plasma drugconcentration
ClearanceRate of elimination of drug/plasma drugconcentration
Half-life t1/2 = (0.7xVd)/CL Vd = volume of distributionCL = clearance
Loading dose Cp x(Vd/F)
Maintenance dose Cp x CL/F
Cardiac outputRate of O2 consumption/(arterial O2 content-
venous O2 content) Stroke volume x heart rate
Mean arterial pressureCardiac output x total peripheral resistance 2/3
diastolic pressure + 1/3 systolic pressure
Stroke volume end diastolic volume - end systolic volume
Ejection fraction (Stroke volume/end diastolic volume) x 100
Resistance Driving pressure/flow (8viscosity x length)/r^4
Net filtration pressure [(Pc-Pi)-(c-i)]
Glomerular filtration rateU of inulin x (V/P of inulin) GFR = C of inulinKf[(Pgc-Pbs)-(gc-bs)]
Effective renal plasma flow U of PAH x (V/P of PAH) ERPF = C of PAH
Renal blood flow RPF/(1-Hct)
Filtration fraction GFR/RPFPhysiologic dead space Vt x ([PaCO2 - PeCO2]/PaCO2)