Phenylalanine becomes Tyrosine --> Thyroxine

Phenylalanine becomes Dopa --> Melanin

Phenylalanine becomes Dopamine
Phenylalanine becomes Norepinephrine
Phenylalanine becomes Epinephrine
Tryptophan becomes Niacin --> NAD+/NADP+
Tryptophan becomes Serotonin --> Melatonin
Histidine becomes Histamine
Glycine becomes Porphyrin --> Heme
Glutamate becomes GABA
Glutamate becomes Glutathione
Arginine becomes Creatine
Arginine becomes Urea
Arginine becomes Nitric oxide
Abdominal pain, ascites, hepatomegaly. Disease/Dx? Budd-Chiari syndrome (posthepatic venous thrombosis)
Achilles tendon xanthoma. Disease/Dx? Familial hypercholesterolemia (dec LDL receptor signaling)
Adrenal hemorrhage, hypotension, DIC. Disease/Dx? Waterhouse-Friderichsen syndrome (meningococcemia)
Anterior "drawer sign" (+). Disease/Dx? Anterior cruciate ligament injury
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints. Disease/Dx? Marfan syndrome (fibrillin defect)
Athlete with polycythemia. Disease/Dx? 2 to erythropoietin injection
Back pain, fever, night sweats, weight loss. Disease/Dx? Pott disease (vertebral TB)
Bilateral hilar adenopathy, uveitis. Disease/Dx? Sarcoidosis (noncaseating granulomas)
Blue sclera. Disease/Dx? Osteogenesis imperfecta (type I collagen defect)
Bluish line on gingiva. Disease/Dx? Burton line (lead poisoning)
Bone pain, bone enlargement, arthritis. Disease/Dx? Paget disease of bone (inc osteoblastic and osteoclastic activity)
Bounding pulses, diastolic heart murmur, head bobbing. Disease/Dx? Aortic regurgitation
Butterfly facial rash and Raynaud phenomenon in a young female. Disease/Dx? Systemic lupus erythematosus
Cafe-au-lait spots, Lisch nodules (iris hamartoma). Disease/Dx? Neurofibromatosis type I (+ pheochromocytoma, optic gliomas)
Cafe-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities. Disease/Dx? McCune-Albright syndrome (mosaic G-protein signaling mutation)
Calf pseudohypertrophy. Disease/Dx? Muscular dystrophy (most commonly Duchenne): X-linked recessive deletion of dystrophin gene
Cherry-red spots on macula. Disease/Dx? Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion
Chest pain on exertion. Disease/Dx? Angina (stable: with moderate exertion; unstable: with minimal exertion)
Chest pain, pericardial effusion/friction rub, persistent fever following MI. Disease/Dx? Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode)
Child uses arms to stand up from squat. Disease/Dx? Gowers sign (Duchenne muscular dystrophy)
Child with fever later develops red rash on face that spreads to body. Disease/Dx? Slapped cheeks (erythema infectiosum/fifth disease: parvovirus B19)
Chorea, dementia, caudate degeneration. Disease/Dx? Huntington disease (autosomal dominant CAG repeat expansion)
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria. Disease/Dx? McArdle disease (muscle glycogen phosphorylase deficiency)
Cold intolerance. Disease/Dx? Hypothyroidism
Conjugate lateral gaze palsy, horizontal diplopia. Disease/Dx? Internuclear ophthalmoplegia (damage to MLF; bilateral [multiple sclerosis], unilateral [stroke])
Continuous "machine-like" heart murmur. Disease/Dx? PDA (close with indomethacin; open or maintain with misoprostol)
Cutaneous/dermal edema due to connective tissue deposition. Disease/Dx? Myxedema (caused by hypothyroidism, Graves disease [pretibial])
Dark purple skin/mouth nodules in a patient with AIDS. Disease/Dx? Kaposi sarcoma, associated with HHV-8
Deep, labored breathing/hyperventilation. Disease/Dx? Kussmaul respirations (diabetic ketoacidosis)
Dermatitis, dementia, diarrhea. Disease/Dx? Pellagra (niacin [vitamin B3] deficiency)
Dilated cardiomyopathy, edema, alcoholism or malnutrition. Disease/Dx? Wet beriberi (thiamine [vitamin B1] deficiency)
Dog or cat bite resulting in infection. Disease/Dx?Pasteurella multocida (cellulitis at inoculation site)
Dry eyes, dry mouth, arthritis. Disease/Dx? Sjogren syndrome (autoimmune destruction of exocrine glands)
Dysphagia (esophageal webs), glossitis, iron deficiency anemia. Disease/Dx? Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
Elastic skin, hypermobility of joints. Disease/Dx? Ehlers-Danlos syndrome (type III collagen defect)
Enlarged, hard left supraclavicular node. Disease/Dx? Virchow node (abdominal metastasis)
Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells. Disease/Dx? Mycosis fungoides (cutaneous T-cell lymphoma) or Sezary syndrome (mycosis fungoides + malignant T cells in blood)
Facial muscle spasm upon tapping. Disease/Dx? Chvostek sign (hypocalcemia)
Fat, female, forty, and fertile. Disease/Dx? Cholelithiasis (gallstones)
Fever, chills, headache, myalgia following antibiotic treatment for syphilis. Disease/Dx? Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
Fever, cough, conjunctivitis, coryza, diffuse rash. Disease/Dx? Measles
Fever, night sweats, weight loss. Disease/Dx? B symptoms (staging) of lymphoma
Fibrous plaques in soft tissue of penis. Disease/Dx? Peyronie disease (connective tissue disorder)
Gout, intellectual disability, self-mutilating behavior in a boy. Disease/Dx? Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)
Green-yellow rings around peripheral cornea. Disease/Dx? Kayser-Fleischer rings (copper accumulation from Wilson disease)
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands. Disease/Dx? Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; inc cancer risk, mainly GI)
Hepatosplenomegaly, osteoporosis, neurologic symptoms. Disease/Dx? Gaucher disease (glucocerebrosidase deficiency)
Hereditary nephritis, sensorineural hearing loss, cataracts. Disease/Dx? Alport syndrome (mutation in collagen IV)
Hyperphagia, hypersexuality, hyperorality, hyperdocility. Disease/Dx? Kluver-Bucy syndrome (bilateral amygdala lesion)
Hyperreflexia, hypertonia, Babinski sign present. Disease/Dx? UMN damage
Hyporeflexia, hypotonia, atrophy, fasciculations. Disease/Dx? LMN damage
Hypoxemia, polycythemia, hypercapnia. Disease/Dx? Blue bloater (chronic bronchitis: hyperplasia of mucous cells)
Indurated, ulcerated genital lesion. Disease/Dx? Nonpainful: chancre (1 syphilis, Treponema pallidum) Painful, with exudate: chancroid (Haemophilus ducreyi)
Infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia. Disease/Dx? Patau syndrome (trisomy 13)
Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration. Disease/Dx? Niemann-Pick disease (genetic sphingomyelinase deficiency)
Infant with hypoglycemia, failure to thrive, and hepatomegaly. Disease/Dx? Cori disease (debranching enzyme deficiency) or Von Gierke disease (glucose-6-phosphatase deficiency, more severe)
Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect. Disease/Dx? Edwards syndrome (trisomy 18)
Jaundice, palpable distended non-tender gallbladder. Disease/Dx? Courvoisier sign (distal obstruction of biliary tree)
Large rash with bull's-eye appearance. Disease/Dx? Erythema chronicum migrans from Ixodes tick bite (Lyme disease: Borrelia)
Lucid interval after traumatic brain injury. Disease/Dx? Epidural hematoma (middle meningeal artery rupture)
Male child, recurrent infections, no mature B cells. Disease/Dx? Bruton disease (X-linked agammaglobulinemia)
Mucosal bleeding and prolonged bleeding time. Disease/Dx? Glanzmann thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Muffled heart sounds, distended neck veins, hypotension. Disease/Dx? Beck triad of cardiac tamponade
Multiple colon polyps, osteomas/soft tissue tumors, impacted/ supernumerary teeth. Disease/Dx? Gardner syndrome (subtype of FAP)
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance. Disease/Dx? Pompe disease (lysosomal -1,4-glucosidase deficiency)
Neonate with arm paralysis following difficult birth. Disease/Dx? Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip")
No lactation postpartum, absent menstruation, cold intolerance. Disease/Dx? Sheehan syndrome (pituitary infarction)
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia. Disease/Dx? Multiple sclerosis
Oscillating slow/fast breathing. Disease/Dx? Cheyne-Stokes respirations (central apnea in CHF or inc intracranial pressure)
Painful blue fingers/toes, hemolytic anemia. Disease/Dx? Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis)
Painful, pale, cold fingers/toes. Disease/Dx? Raynaud phenomenon (vasospasm in extremities)
Painful, raised red lesions on pad of fingers/toes. Disease/Dx? Osler nodes (infective endocarditis, immune complex deposition)
Painless erythematous lesions on palms and soles. Disease/Dx? Janeway lesions (infective endocarditis, septic emboli/ microabscesses)
Painless jaundice. Disease/Dx? Cancer of the pancreatic head obstructing bile duct
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria. Disease/Dx? Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
Pancreatic, pituitary, parathyroid tumors. Disease/Dx? MEN 1 (autosomal dominant)
Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia. Disease/Dx? Nephrotic syndrome
Pink complexion, dyspnea, hyperventilation. Disease/Dx? Pink puffer (emphysema: centriacinar *smoking+, panacinar *1-antitrypsin deficiency+)
Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets. Disease/Dx? Fanconi syndrome (proximal tubular reabsorption defect)
Pruritic, purple, polygonal planar papules and plaques (6 P's). Disease/Dx? Lichen planus
Ptosis, miosis, anhidrosis. Disease/Dx? Horner syndrome (sympathetic chain lesion)
Pupil accommodates but doesn't react. Disease/Dx? Argyll Robertson pupil (neurosyphilis)
Rapidly progressive leg weakness that ascends following GI/upper respiratory infection. Disease/Dx? Guillain-Barre syndrome (acute autoimmune inflammatory demyelinating polyneuropathy)
Rash on palms and soles. Disease/Dx? Coxsackie A, 2 syphilis, Rocky Mountain spotted fever
Recurrent colds, unusual eczema, high serum IgE. Disease/Dx? Hyper-IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)
Red "currant jelly" sputum in alcoholic or diabetic patients. Disease/Dx? Klebsiella pneumoniae
Red "currant jelly" stools. Disease/Dx? Acute mesenteric ischemia (adults), intussusception (infants)
Red, itchy, swollen rash of nipple/areola. Disease/Dx? Paget disease of the breast (sign of underlying neoplasm)
Red urine in the morning, fragile RBCs. Disease/Dx? Paroxysmal nocturnal hemoglobinuria
Renal cell carcinoma (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma. Disease/Dx? von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
Resting tremor, rigidity, akinesia, postural instability. Disease/Dx? Parkinson disease (nigrostriatal dopamine depletion)
Retinal hemorrhages with pale centers. Disease/Dx? Roth spots (bacterial endocarditis)
Severe jaundice in neonate. Disease/Dx? Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
Severe RLQ pain with palpation of LLQ. Disease/Dx? Rovsing sign (acute appendicitis)
Severe RLQ pain with rebound tenderness. Disease/Dx? McBurney sign (acute appendicitis)
Short stature, inc incidence of tumors/leukemia, aplastic anemia. Disease/Dx? Fanconi anemia (genetic loss of DNA crosslink repair; often progresses to AML)
Single palmar crease. Disease/Dx? Down syndrome
Situs inversus, chronic sinusitis, bronchiectasis, infertility. Disease/Dx? Kartagener syndrome (dynein arm defect affecting cilia)
Skin hyperpigmentation, hypotension, fatigue. Disease/Dx? Addison disease (1 adrenocortical insufficiency causes inc ACTH andinc -MSH production)
Slow, progressive muscle weakness in boys. Disease/Dx? Becker muscular dystrophy (X-linked missense mutation in dystrophin; less severe than Duchenne)
Small, irregular red spots on buccal/lingual mucosa with blue-white center. Disease/Dx? Koplik spots (measles; rubeola virus)
Smooth, flat, moist, painless white lesions on genitals. Disease/Dx? Condylomata lata (2 syphilis)
Splinter hemorrhages in fingernails. Disease/Dx? Bacterial endocarditis
Strawberry tongue. Disease/Dx? Scarlet fever, Kawasaki disease, toxic shock syndrome
Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema. Disease/Dx? Turner syndrome (45,XO)
Sudden swollen/painful big toe joint, tophi. Disease/Dx? Gout/podagra (hyperuricemia)
Swollen gums, mucosal bleeding, poor wound healing, petechiae. Disease/Dx? Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
Swollen, hard, painful finger joints. Disease/Dx? Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP [Heberden nodes])
Systolic ejection murmur (crescendo-decrescendo). Disease/Dx? Aortic valve stenosis
Thyroid and parathyroid tumors, pheochromocytoma. Disease/Dx? MEN 2A (autosomal dominant ret mutation)
Thyroid tumors, pheochromocytoma, ganglioneuromatosis. Disease/Dx? MEN 2B (autosomal dominant ret mutation)
Toe extension/fanning upon plantar scrape. Disease/Dx? Babinski sign (UMN lesion)
Unilateral facial drooping involving forehead. Disease/Dx? Facial nerve (LMN CN VII palsy)
Urethritis, conjunctivitis, arthritis in a male. Disease/Dx? Reactive arthritis associated with HLA-B27
Vascular birthmark (port-wine stain). Disease/Dx?Hemangioma (benign, but associated with Sturge-Weber syndrome)
Vomiting blood following gastroesophageal lacerations. Disease/Dx? Mallory-Weiss syndrome (alcoholic and bulimic patients)
Weight loss, diarrhea, arthritis, fever, adenopathy. Disease/Dx? Whipple disease (Tropheryma whipplei)
Worst headache of my life. Disease/Dx? Subarachnoid hemorrhage
Labs: Anticentromere antibodies. Disease/Dx? Scleroderma (CREST)
Labs: Antidesmoglein (epithelial) antibodies. Disease/Dx? Pemphigus vulgaris (blistering)
Labs: Anti-glomerular basement membrane antibodies. Disease/Dx? Goodpasture syndrome (glomerulonephritis and hemoptysis)
Labs: Antihistone antibodies. Disease/Dx? Drug-induced SLE (hydralazine, INH, phenytoin, procainamide)
Labs: Anti-IgG antibodies. Disease/Dx? Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
Labs: Antimitochondrial antibodies (AMAs). Disease/Dx? 1 biliary cirrhosis (female, cholestasis, portal hypertension)
Labs: Antineutrophil cytoplasmic antibodies (ANCAs). Disease/Dx? Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
Labs: Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA). Disease/Dx? SLE (type III hypersensitivity)
Labs: Antiplatelet antibodies. Disease/Dx? Idiopathic thrombocytopenic purpura
Labs: Anti-topoisomerase antibodies. Disease/Dx? Diffuse systemic scleroderma
Labs: Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies. Disease/Dx? Celiac disease (diarrhea, distention, weight loss)
Labs: "Apple core" lesion on abdominal x-ray. Disease/Dx? Colorectal cancer (usually left-sided)
Labs: Azurophilic peroxidase, + granular inclusions in granulocytes and myeloblasts. Disease/Dx? Auer rods (AML, especially the promyelocytic [M3] type)
Labs: Bacitracin response. Disease/Dx? Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B)
Labs: "Bamboo spine" on x-ray. Disease/Dx? Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
Labs: Basophilic nuclear remnants in RBCs. Disease/Dx? Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
Labs: Basophilic stippling of RBCs. Disease/Dx? Lead poisoning or sideroblastic anemia
Labs: Bloody tap on LP. Disease/Dx? Subarachnoid hemorrhage
Labs: "Boot-shaped" heart on x-ray. Disease/Dx?Tetralogy of Fallot, RVH
Labs: Branching gram-positive rods with sulfur granules. Disease/Dx? Actinomyces israelii
Labs: Bronchogenic apical lung tumor on imaging. Disease/Dx? Pancoast tumor (can compress sympathetic ganglion and cause Horner syndrome)
Labs: "Brown" tumor of bone. Disease/Dx? Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
Labs: Cardiomegaly with apical atrophy. Disease/Dx? Chagas disease (Trypanosoma cruzi)
Labs: Cellular crescents in Bowman capsule. Disease/Dx? Rapidly progressive crescentic glomerulonephritis
Labs: "Chocolate cyst" of ovary. Disease/Dx? Endometriosis (frequently involves both ovaries)
Labs: Circular grouping of dark tumor cells surrounding pale. Disease/Dx? Homer-Wright rosettes (neuroblastoma, medulloblastoma, neurofibrils retinoblastoma)
Labs: Colonies of mucoid Pseudomonas in lungs. Disease/Dx? Cystic fibrosis (autosomal recessive mutation in CFTR gene --> fat-soluble vitamin deficiency and mucous plugs)
Labs: Decreased AFP in amniotic fluid/maternal serum. Disease/Dx? Down syndrome or other chromosomal abnormality
Labs: Degeneration of dorsal column nerves. Disease/Dx? Tabes dorsalis (3 syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
Labs: Depigmentation of neurons in substantia nigra. Disease/Dx? Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Labs: Desquamated epithelium casts in sputum. Disease/Dx? Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
Labs: Disarrayed granulosa cells in eosinophilic fluid. Disease/Dx? Call-Exner bodies (granulosa-theca cell tumor of the ovary)
Labs: Dysplastic squamous cervical cells with nuclear enlargement. Disease/Dx? Koilocytes (HPV: predisposes to cervical cancer) and hyperchromasia
Labs: Enlarged cells with intranuclear inclusion bodies. Disease/Dx? Owl eye appearance of CMV
Labs: Enlarged thyroid cells with ground-glass nuclei. Disease/Dx? Orphan Annie eyes nuclei (papillary carcinoma of the thyroid)
Labs: Eosinophilic cytoplasmic inclusion in liver cell. Disease/Dx? Mallory body (alcoholic liver disease)
Labs: Eosinophilic cytoplasmic inclusion in nerve cell. Disease/Dx? Lewy body (Parkinson disease)
Labs: Eosinophilic globule in liver. Disease/Dx? Councilman body (toxic or viral hepatitis, often yellow fever)
Labs: Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells. Disease/Dx? Negri bodies of rabies
Labs: Extracellular amyloid deposition in gray matter of brain. Disease/Dx? Senile plaques (Alzheimer disease)
Labs: Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye"). Disease/Dx? Reed-Sternberg cells (Hodgkin lymphoma)
Labs: Glomerulus-like structure surrounding vessel in germ cells. Disease/Dx? Schiller-Duval bodies (yolk sac tumor)
Labs: "Hair on end" (crew-cut) appearance on x-ray. Disease/Dx? -thalassemia, sickle cell anemia (marrow expansion)
Labs: hCG elevated. Disease/Dx? Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
Labs: Heart nodules (granulomatous). Disease/Dx? Aschoff bodies (rheumatic fever)
Labs: Heterophile antibodies. Disease/Dx? Infectious mononucleosis (EBV)
Labs: Hexagonal, double-pointed, needle-like crystals in bronchial secretions. Disease/Dx? Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
Labs: High level of D-dimers. Disease/Dx? DVT, PE, DIC
Labs: Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify). Disease/Dx? Ghon complex (1 TB: Mycobacterium bacilli)
Labs: "Honeycomb lung" on x-ray or CT. Disease/Dx? Interstitial pulmonary fibrosis
Labs: Hypercoagulability (leading to migrating DVTs and vasculitis). Disease/Dx? Trousseau syndrome (adenocarcinoma of pancreas or lung)
Labs: Hypersegmented neutrophils. Disease/Dx? Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
Labs: Hypertension, hypokalemia, metabolic alkalosis. Disease/Dx? Conn syndrome
Labs: Hypochromic, microcytic anemia. Disease/Dx? Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Labs: Increased AFP in amniotic fluid/maternal serum. Disease/Dx? Dating error, anencephaly, spina bifida (neural tube defects)
Labs: Increased uric acid levels. Disease/Dx? Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
Labs: Intranuclear eosinophilic droplet-like bodies. Disease/Dx? Cowdry type A bodies (HSV or CMV)
Labs: Iron-containing nodules in alveolar septum. Disease/Dx? Ferruginous bodies (asbestosis: inc chance of mesothelioma)
Labs: Keratin pearls on a skin biopsy. Disease/Dx?Squamous cell carcinoma
Labs: Large lysosomal vesicles in phagocytes, immunodeficiency. Disease/Dx? Chediak-Higashi disease (congenital failure of phagolysosome formation)
Labs: "Lead pipe" appearance of colon on barium enema x-ray. Disease/Dx? Ulcerative colitis (loss of haustra)
Labs: Linear appearance of IgG deposition on glomerular basement. Disease/Dx? Goodpasture syndrome membrane
Labs: Low serum ceruloplasmin. Disease/Dx? Wilson disease (hepatolenticular degeneration)
Labs: "Lumpy bumpy" appearance of glomeruli on immunofluorescence. Disease/Dx? Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
Labs: Lytic ("hole punched") bone lesions on x-ray. Disease/Dx? Multiple myeloma
Labs: Mammary gland ("blue domed") cyst. Disease/Dx? Fibrocystic change of the breast
Labs: Monoclonal antibody spike. Disease/Dx? * Multiple myeloma (usually IgG or IgA)
Labs: Monoclonal antibody spike. Disease/Dx? * Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
Labs: Monoclonal antibody spike. Disease/Dx? * Waldenstrom (M protein = IgM) macroglobulinemia or
Labs: Monoclonal antibody spike. Disease/Dx? *Primary amyloidosis
Labs: Mucin-filled cell with peripheral nucleus. Disease/Dx? Signet ring (gastric carcinoma)
Labs: Narrowing of bowel lumen on barium x-ray. Disease/Dx? String sign (Crohn disease)
Labs: Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis. Disease/Dx? Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
Labs: Needle-shaped, negatively birefringent crystals. Disease/Dx? Gout (monosodium urate crystals)
Labs: Nodular hyaline deposits in glomeruli. Disease/Dx? Kimmelstiel-Wilson nodules (diabetic nephropathy)
Labs: Novobiocin response. Disease/Dx? Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus
Labs: "Nutmeg" appearance of liver. Disease/Dx?Chronic passive congestion of liver due to right heart failure
Labs: "Onion skin" periosteal reaction. Disease/Dx? Ewing sarcoma (malignant round-cell tumor)
Labs: Optochin response. Disease/Dx? Sensitive: Streptococcus pneumoniae; resistant: viridans streptococci
Labs: Periosteum raised from bone, creating triangular area. Disease/Dx? Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)
Labs: Podocyte fusion or "effacement" on electron microscopy. Disease/Dx? Minimal change disease (child with nephrotic syndrome)
Labs: Polished, "ivory-like" appearance of bone at cartilage erosion. Disease/Dx? Eburnation (osteoarthritis resulting in bony sclerosis)
Labs: Protein aggregates in neurons from hyperphosphorylation of tau protein. Disease/Dx? Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
Labs: Psammoma bodies. Disease/Dx? Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
Labs: Pseudopalisading tumor cells on brain biopsy. Disease/Dx? Glioblastoma multiforme
Labs: RBC casts in urine. Disease/Dx? Acute glomerulonephritis
Labs: Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells. Disease/Dx? Reinke crystals (Leydig cell tumor)
Labs: Renal epithelial casts in urine. Disease/Dx? Acute toxic/viral renal injury
Labs: Rhomboid crystals, positively birefringent. Disease/Dx? Pseudogout (calcium pyrophosphate dihydrate crystals)
Labs: Rib notching. Disease/Dx? Coarctation of the aorta
Labs: Ring-enhancing brain lesion in AIDS. Disease/Dx? Toxoplasma gondii, CNS lymphoma
Labs: Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology). Disease/Dx? Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; "black sky" made up of malignant cells)
Labs: Silver-staining spherical aggregation of tau proteins in neurons. Disease/Dx? Pick bodies (Pick disease: progressive dementia, changes in personality)
Labs: "Soap bubble" in femur or tibia on x-ray. Disease/Dx? Giant cell tumor of bone (generally benign)
Labs: "Spikes" on basement membrane, "dome-like" subepithelial deposits. Disease/Dx? Membranous glomerulonephritis (may progress to nephrotic syndrome)
Labs: Stacks of RBCs. Disease/Dx? Rouleaux formation (high ESR, multiple myeloma)
Labs: Stippled vaginal epithelial cells. Disease/Dx?Clue cells (Gardnerella vaginalis)
Labs: "Tennis racket"-shaped cytoplasmic organelles (EM) in Langerhans cells. Disease/Dx? Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)
Labs: Thrombi made of white/red layers. Disease/Dx? Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
Labs: "Thumb sign" on lateral x-ray. Disease/Dx? Epiglottitis (Haemophilus influenzae)
Labs: Thyroid-like appearance of kidney. Disease/Dx? Chronic bacterial pyelonephritis
Labs: "Tram-track" appearance of capillary loops of glomerular basement membranes on light microscopy. Disease/Dx? Membranoproliferative glomerulonephritis
Labs: Triglyceride accumulation in liver cell vacuoles. Disease/Dx? Fatty liver disease (alcoholic or metabolic syndrome)
Labs: "Waxy" casts with very low urine flow. Disease/Dx? Chronic end-stage renal disease
Labs: WBC casts in urine. Disease/Dx? Acute pyelonephritis
Labs: WBCs that look "smudged". Disease/Dx? CLL (almost always B cell)
Labs: "Wire loop" glomerular capillary appearance on light microscopy. Disease/Dx? Lupus nephropathy
Labs: Yellowish CSF. Disease/Dx? Xanthochromia (e.g., due to subarachnoid hemorrhage)
Condition: Absence seizures. Tx? Ethosuximide
Condition: Acute gout attack. Tx? NSAIDs, colchicine
Condition: Acute promyelocytic leukemia (M3). Tx? All-trans retinoic acid
Condition: ADHD. Tx? Methylphenidate, amphetamines
Condition: Alcohol use disorder. Tx? AA + disulfiram, naltrexone, or acamprosate for patient. Al-Anon for patient's family
Condition: Alcohol withdrawal. Tx? Benzodiazepines
Condition: Anorexia. Tx? Nutrition, psychotherapy
Condition: Anticoagulation during pregnancy. Tx?Heparin
Condition: Arrhythmia in damaged cardiac tissue. Tx? Class IB antiarrhythmic (lidocaine, mexiletine, tocainide)
Condition: B12 deficiency. Tx? Vitamin B12 supplementation (work up cause with Schilling test)
Condition: Benign prostatic hyperplasia. Tx? Tamsulosin, finasteride
Condition: Bipolar disorder. Tx? Lithium, valproate, carbamazepine, lamotrigine (mood stabilizers)
Condition: Breast cancer in postmenopausal woman. Tx? Aromatase inhibitor (anastrozole)
Condition: Buerger disease. Tx? Smoking cessation
Condition: Bulimia nervosa. Tx? SSRIs
Condition: Candida albicans. Tx? Amphotericin B (systemic), nystatin (oral thrush), azoles (vaginitis)
Condition: Carcinoid syndrome. Tx? Octreotide
Condition: Chlamydia trachomatis. Tx? Doxycycline (+ ceftriaxone for gonorrhea coinfection), erythromycin eye drops (prophylaxis in infants)
Condition: Chronic gout. Tx? Probenecid (underexcretor), allopurinol (overproducer), febuxostat
Condition: Chronic hepatitis. Tx? IFN-
Condition: Chronic myelogenous leukemia. Tx? Imatinib
Condition: Clostridium botulinum. Tx? Antitoxin
Condition: Clostridium difficile. Tx? Oral metronidazole; if refractory, oral vancomycin
Condition: Clostridium tetani. Tx? Antitoxin + vaccine booster + diazepam
Condition: CMV. Tx? Ganciclovir
Condition: Crohn disease. Tx? Corticosteroids, infliximab, methotrexate, azathioprine
Condition: Cryptococcus neoformans. Tx? Fluconazole (prophylaxis in AIDS patients)
Condition: Cyclophosphamide-induced hemorrhagic cystitis. Tx? Mesna
Condition: Depression. Tx? SSRIs (first-line)
Condition: Diabetes insipidus. Tx? DDAVP (central); hydrochlorothiazide, indomethacin, amiloride (nephrogenic)
Condition: Diabetes mellitus type 1. Tx? Dietary intervention (low sugar) + insulin replacement
Condition: Diabetes mellitus type 2. Tx? Dietary intervention, oral hypoglycemics, and insulin (if refractory)
Condition: Diabetic ketoacidosis. Tx? Fluids, insulin, K+
Condition: Enterococci. Tx? Vancomycin/ampicillin + aminoglycoside
Condition: Erectile dysfunction. Tx? Sildenafil, vardenafil
Condition: ER+ breast cancer. Tx? Tamoxifen
Condition: Ethylene glycol/methanol intoxication. Tx? Fomepizole (alcohol dehydrogenase inhibitor)
Condition: Haemophilus influenzae (B). Tx? Rifampin (prophylaxis)
Condition: Generalized anxiety disorder. Tx? Buspirone
Condition: Granulomatosis with polyangiitis (Wegener). Tx? Cyclophosphamide, corticosteroids
Condition: Heparin toxicity (acute). Tx? Protamine sulfate
Condition: HER2/neu+ breast cancer. Tx? Trastuzumab
Condition: Hyperaldosteronism. Tx? Spironolactone
Condition: Hypercholesterolemia. Tx? Statin (first-line)
Condition: Hypertriglyceridemia. Tx? Fibrate
Condition: Immediate anticoagulation. Tx? Heparin
Condition: Infertility. Tx? Leuprolide, GnRH (pulsatile), clomiphene
Condition: Influenza. Tx? Rimantadine, oseltamivir
Condition: Legionella pneumophila. Tx? Erythromycin
Condition: Long-term anticoagulation. Tx? Warfarin
Condition: Malaria. Tx? Chloroquine/mefloquine (for blood schizont), primaquine (for liver hypnozoite)
Condition: Malignant hyperthermia. Tx? Dantrolene
Condition: Medical abortion. Tx? Mifepristone
Condition: Migraine. Tx? Sumatriptan
Condition: MRSA. Tx? Vancomycin
Condition: Multiple sclerosis. Tx? -interferon, immunosuppression, natalizumab
Condition: Mycobacterium tuberculosis. Tx? RIPE (rifampin, INH, pyrazinamide, ethambutol)
Condition: Neisseria gonorrhoeae. Tx? Ceftriaxone (add doxycycline to cover likely concurrent Chlamydia)
Condition: Neisseria meningitidis. Tx? Penicillin/ceftriaxone, rifampin (prophylaxis)
Condition: Neural tube defect prevention. Tx? Prenatal folic acid
Condition: Osteomalacia/rickets. Tx? Vitamin D supplementation
Condition: Osteoporosis. Tx? Bisphosphonates; calcium and vitamin D supplementation
Condition: Patent ductus arteriosus. Tx? Indomethacin
Condition: Pheochromocytoma. Tx? -antagonists (e.g., phenoxybenzamine)
Condition: Pneumocystis jirovecii. Tx? TMP-SMX (prophylaxis in AIDS patient)
Condition: Prolactinoma. Tx? Bromocriptine (dopamine agonists)
Condition: Prostate cancer/uterine fibroids. Tx? Leuprolide, GnRH (continuous)
Condition: Prostate carcinoma. Tx? Flutamide
Condition: Pseudomonas aeruginosa. Tx? Antipseudomonal penicillin + aminoglycoside
Condition: Pulmonary arterial hypertension (idiopathic). Tx? Sildenafil, bosentan, epoprostenol
Condition: Rickettsia rickettsii. Tx? Doxycycline, chloramphenicol (associated with aplastic anemia)
Condition: Ringworm infections. Tx? Terbinafine, griseofulvin, imidazole
Condition: Schizophrenia (negative symptoms). Tx? 5-HT2A antagonists (e.g., 2nd-generation antipsychotics)
Condition: Schizophrenia (positive symptoms). Tx? D2 receptor antagonists (e.g., 1st- and 2nd-generation antipsychotics)
Condition: SIADH. Tx? Demeclocycline, lithium, vasopressin receptor antagonists
Condition: Sickle cell anemia. Tx? Hydroxyurea (inc fetal hemoglobin)
Condition: Sporothrix schenckii. Tx? Oral potassium iodide
Condition: Stable angina. Tx? Sublingual nitroglycerin
Condition: Staphylococcus aureus. Tx? MSSA: nafcillin, oxacillin, dicloxacillin (antistaphylococcal penicillins); MRSA: vancomycin
Condition: Streptococcus bovis. Tx? Penicillin prophylaxis; evaluation for colon cancer if linked to endocarditis
Condition: Streptococcus pneumoniae. Tx? Penicillin/cephalosporin (systemic infection, pneumonia), vancomycin (meningitis)
Condition: Streptococcus pyogenes. Tx? Penicillin prophylaxis
Condition: Temporal arteritis. Tx? High-dose steroids
Condition: Tonic-clonic seizures. Tx? Phenytoin, valproate, carbamazepine
Condition: Toxoplasma gondii. Tx? Sulfadiazine + pyrimethamine
Condition: Treponema pallidum. Tx? Penicillin
Condition: Trichomonas vaginalis. Tx? Metronidazole (patient and partner)
Condition: Trigeminal neuralgia (tic douloureux). Tx? Carbamazepine
Condition: Ulcerative colitis. Tx? 5-ASA, infliximab, colectomy
Condition: UTI prophylaxis. Tx? TMP-SMX
Condition: Warfarin toxicity. Tx? Fresh frozen plasma (acute), vitamin K (chronic)
Actinic (solar) keratosis. Association? Precursor to squamous cell carcinoma
Acute gastric ulcer associated with CNS injury. Association? Cushing ulcer (inc intracranial pressure stimulates vagal gastric secretion)
Acute gastric ulcer associated with severe burns. Association? Curling ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
Alternating areas of transmural inflammation and normal colon. Association? Skip lesions (Crohn disease)
Aneurysm, dissecting. Association? Hypertension
Aortic aneurysm, abdominal and descending aorta. Association? Atherosclerosis
Aortic aneurysm, arch. Association? 3 syphilis (syphilitic aortitis), vasa vasorum destruction
Aortic aneurysm, ascending. Association? Marfan syndrome (idiopathic cystic medial degeneration)
Atrophy of the mammillary bodies. Association? Wernicke encephalopathy (thiamine deficiency causing ataxia, ophthalmoplegia, and confusion)
Autosplenectomy (fibrosis and shrinkage). Association? Sickle cell anemia (hemoglobin S)
Bacteria associated with gastritis, peptic ulcer disease, and stomach cancer. Association? H. pylori
Bacterial meningitis (adults and elderly). Association? Streptococcus pneumoniae
Bacterial meningitis (newborns and kids). Association? Group B streptococcus/E.coli (newborns), S. pneumoniae/ Neisseria meningitidis (kids)
Benign melanocytic nevus. Association? Spitz nevus (most common in 1st two decades)
Bleeding disorder with GpIb deficiency. Association? Bernard-Soulier syndrome (defect in platelet adhesion to von Willebrand factor)
Brain tumor (adults). Association? Supratentorial: metastasis > astrocytoma (including glioblastoma multiforme) > meningioma > schwannoma
Brain tumor (kids). Association? Infratentorial: medulloblastoma (cerebellum) or supratentorial: craniopharyngioma
Breast cancer. Association? Infiltrating ductal carcinoma
Breast mass. Association? Fibrocystic change, carcinoma (in postmenopausal women)
Breast tumor (benign). Association? Fibroadenoma
Cardiac 1 tumor (kids). Association? Rhabdomyoma, often seen in tuberous sclerosis
Cardiac manifestation of lupus. Association? Libman-Sacks endocarditis (nonbacterial, affecting both sides of mitral valve)
Cardiac tumor (adults). Association? Metastasis, 1 myxoma (4:1 left to right atrium; "ball and valve")
Cerebellar tonsillar herniation. Association? Chiari II malformation
Chronic arrhythmia. Association? Atrial fibrillation (associated with high risk of emboli)
Chronic atrophic gastritis (autoimmune). Association? Predisposition to gastric carcinoma (can also cause pernicious anemia)
Clear cell adenocarcinoma of the vagina. Association? DES exposure in utero
Compression fracture. Association? Osteoporosis (type I: postmenopausal woman; type II: elderly man or woman)
Congenital adrenal hyperplasia, hypotension. Association? 21-hydroxylase deficiency
Congenital cardiac anomaly. Association? VSD
Congenital conjugated hyperbilirubinemia (black liver). Association? Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)
Constrictive pericarditis. Association? TB (developing world); SLE (developed world)
Coronary artery involved in thrombosis. Association? LAD > RCA > LCA
Cretinism. Association? Iodine deficit/hypothyroidism
Cushing syndrome. Association? * Iatrogenic Cushing (from corticosteroid therapy)
Cushing syndrome. Association? * Adrenocortical adenoma (secretes excess cortisol)
Cushing syndrome. Association? * ACTH-secreting pituitary adenoma or
Cushing syndrome. Association? * Paraneoplastic Cushing (due to ACTH secretion by tumors)
Cyanosis (early; less common). Association? Tetralogy of Fallot, transposition of great vessels, truncus arteriosus
Cyanosis (late; more common). Association? VSD, ASD, PDA
Death in CML. Association? Blast crisis
Death in SLE. Association? Lupus nephropathy
Dementia. Association? Alzheimer disease, multiple infarcts
Demyelinating disease in young women. Association? Multiple sclerosis
DIC. Association? Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery
Dietary deficit. Association? Iron
Diverticulum in pharynx. Association? Zenker diverticulum (diagnosed by barium swallow)
Ejection click. Association? Aortic/pulmonic stenosis
Esophageal cancer. Association? Squamous cell carcinoma (worldwide); adenocarcinoma (U.S.)
Food poisoning (exotoxin mediated). Association?S. aureus, B. cereus
Glomerulonephritis (adults). Association? Berger disease (IgA nephropathy)
Gynecologic malignancy. Association? Endometrial carcinoma (most common in U.S.); cervical carcinoma (most common worldwide)
Heart murmur, congenital. Association? Mitral valve prolapse
Heart valve in bacterial endocarditis. Association?Mitral > aortic (rheumatic fever), tricuspid (IV drug abuse)
Helminth infection (U.S.). Association? Enterobius vermicularis, Ascaris lumbricoides
Hematomaepidural. Association? Rupture of middle meningeal artery (trauma; lentiform shaped)
Hematomasubdural. Association? Rupture of bridging veins (crescent shaped)
Hemochromatosis. Association? Multiple blood transfusions or hereditary HFE mutation (can result in CHF, "bronze diabetes," and increased risk of hepatocellular carcinoma)
Hepatocellular carcinoma. Association? Cirrhotic liver (associated with hepatitis B and C and with alcoholism)
Hereditary bleeding disorder. Association? von Willebrand disease
Hereditary harmless jaundice. Association? Gilbert syndrome (benign congenital unconjugated hyperbilirubinemia)
HLA-B27. Association? Ankylosing spondylitis, reactive arthritis, ulcerative colitis, psoriatic arthritis
HLA-DR3 or -DR4. Association? Diabetes mellitus type 1, rheumatoid arthritis, SLE
Holosystolic murmur. Association? VSD, tricuspid regurgitation, mitral regurgitation
Hypercoagulability, endothelial damage, blood stasis. Association? Virchow triad (results in venous thrombosis)
Hypertension, 2. Association? Renal disease
Hypoparathyroidism. Association? Accidental excision during thyroidectomy
Hypopituitarism. Association? Pituitary adenoma (usually benign tumor)
Infection 2 to blood transfusion. Association? Hepatitis C
Infections in chronic granulomatous disease. Association? Staphylococcus aureus, E. coli, Aspergillus (catalase+)
Intellectual disability. Association? Down syndrome, fragile X syndrome
Kidney stones. Association? Calcium = radiopaque
Struvite (ammonium) = radiopaque (formed by urease+ organisms such as Proteus vulgaris or Staphylococcus);
Uric acid = radiolucent
Late cyanotic shunt (uncorrected left to right becomes right to left). Association? Eisenmenger syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)
Liver disease. Association? Alcoholic cirrhosis
Lysosomal storage disease. Association? Gaucher disease
Male cancer. Association? Prostatic carcinoma
Malignancy associated with noninfectious fever. Association? Hodgkin lymphoma
Malignancy (kids). Association? ALL, medulloblastoma (cerebellum)
Metastases to bone. Association? Prostate, breast > lung > thyroid
Metastases to brain. Association? Lung > breast > genitourinary > melanoma > GI
Metastases to liver. Association? Colon >> stomach, pancreas
Mitochondrial inheritance. Association? Disease occurs in both males and females, inherited through females only
Mitral valve stenosis. Association? Rheumatic heart disease
Mixed (UMN and LMN) motor neuron disease. Association? Amyotrophic lateral sclerosis
Myocarditis. Association? Coxsackie B
Nephrotic syndrome (adults). Association? Focal segmental glomerulosclerosis
Nephrotic syndrome (kids). Association? Minimal change disease
Neuron migration failure. Association? Kallmann syndrome (hypogonadotropic hypogonadism and anosmia)
Nosocomial pneumonia. Association? Klebsiella, E. coli, Pseudomonas aeruginosa
Obstruction of male urinary tract. Association? BPH
Opening snap. Association? Mitral stenosis
Opportunistic infection in AIDS. Association? Pneumocystis jirovecii pneumonia
Osteomyelitis. Association? S. aureus
Osteomyelitis in sickle cell disease. Association? Salmonella
Osteomyelitis with IV drug use. Association? Pseudomonas, S. aureus
Ovarian metastasis from gastric carcinoma or breast cancer. Association? Krukenberg tumor (mucin-secreting signet-ring cells)
Ovarian tumor (benign, bilateral). Association? Serous cystadenoma
Ovarian tumor (malignant). Association? Serous cystadenocarcinoma
Pancreatitis (acute). Association? Gallstones, alcohol
Pancreatitis (chronic). Association? Alcohol (adults), cystic fibrosis (kids)
Patient with ALL/CLL/AML/CML (ages). Association? ALL: child, CLL: adult > 60, AML: adult ~65, CML: adult 30-60
Pelvic inflammatory disease. Association? Chlamydia trachomatis, Neisseria gonorrhoeae
Philadelphia chromosome t(9;22) (bcr-abl). Association? CML (may sometimes be associated with ALL/AML)
Pituitary tumor. Association? Prolactinoma, somatotropic "acidophilic" adenoma
1 amenorrhea. Association? Turner syndrome (45,XO)
1 bone tumor (adults). Association? Multiple myeloma
1 hyperaldosteronism. Association? Adenoma of adrenal cortex
1 hyperparathyroidism. Association? Adenomas, hyperplasia, carcinoma
1 liver cancer. Association? Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, 1-antitrypsin deficiency)
Pulmonary hypertension. Association? COPD
Recurrent inflammation/thrombosis of small/medium vessels. Association? Buerger disease (strongly associated with tobacco) in extremities
Renal tumor. Association? Renal cell carcinoma: associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndromes (EPO, renin, PTH, ACTH)
Right heart failure due to a pulmonary cause. Association? Cor pulmonale
S3 (protodiastolic gallop). Association? inc ventricular filling (left-to-right shunt, mitral regurgitation, LV failure [CHF])
S4 (presystolic gallop). Association? Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
2 hyperparathyroidism. Association? Hypocalcemia of chronic kidney disease
Sexually transmitted disease. Association? Chlamydia (usually coinfected with gonorrhea)
SIADH. Association? Small cell carcinoma of the lung
Site of diverticula. Association? Sigmoid colon
Sites of atherosclerosis. Association? Abdominal aorta > coronary artery > popliteal artery > carotid artery
Stomach cancer. Association? Adenocarcinoma
Stomach ulcerations and high gastrin levels. Association? Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
t(14;18). Association? Follicular lymphomas (bcl-2 activation)
t(8;14). Association? Burkitt lymphoma (c-myc activation)
t(9;22). Association? Philadelphia chromosome, CML (bcr-abl fusion)
Temporal arteritis. Association? Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymyalgia rheumatica
Testicular tumor. Association? Seminoma (malignant, radiosensitive)
Thyroid cancer. Association? Papillary carcinoma
Tumor in women. Association? Leiomyoma (estrogen dependent, not precancerous)
Tumor of infancy. Association? Hemangioma (usually regresses spontaneously by childhood)
Tumor of the adrenal medulla (adults). Association? Pheochromocytoma (usually benign)
Tumor of the adrenal medulla (kids). Association?Neuroblastoma (malignant)
Type of Hodgkin. Association? Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)
Type of non-Hodgkin. Association? Diffuse large cell
UTI. Association? E. coli, Staphylococcus saprophyticus (young women)
Viral encephalitis affecting temporal lobe. Association? HSV-1
Vitamin deficiency (U.S.). Association? Folate (pregnant women are at high risk; body stores only 3- to 4-month supply; prevents neural tube defects)
Familial hypercholesterolemia (dec LDL receptor signaling)
Paget disease of bone (inc osteoblastic and osteoclastic activity)
Neurofibromatosis type I (+ pheochromocytoma, optic gliomas)
McCune-Albright syndrome (mosaic G-protein signaling mutation)
Muscular dystrophy (most commonly Duchenne): X-linked recessive deletion of dystrophin gene
Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion
Angina (stable: with moderate exertion; unstable: with minimal exertion)
Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode)
Slapped cheeks (erythema infectiosum/fifth disease: parvovirus B19)
Huntington disease (autosomal dominant CAG repeat expansion)
McArdle disease (muscle glycogen phosphorylase deficiency)
Internuclear ophthalmoplegia (damage to MLF; bilateral [multiple sclerosis], unilateral [stroke])
PDA (close with indomethacin; open or maintain with misoprostol)
Myxedema (caused by hypothyroidism, Graves disease [pretibial])
Sjogren syndrome (autoimmune destruction of exocrine glands)
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
Mycosis fungoides (cutaneous T-cell lymphoma) or Sezary syndrome (mycosis fungoides + malignant T cells in blood)
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)
Kayser-Fleischer rings (copper accumulation from Wilson disease)
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; inc cancer risk, mainly GI)
Blue bloater (chronic bronchitis: hyperplasia of mucous cells)
Nonpainful: chancre (1 syphilis, Treponema pallidum) Painful, with exudate: chancroid (Haemophilus ducreyi)
Niemann-Pick disease (genetic sphingomyelinase deficiency)
Cori disease (debranching enzyme deficiency) or Von Gierke disease (glucose-6-phosphatase deficiency, more severe)
Erythema chronicum migrans from Ixodes tick bite (Lyme disease: Borrelia)
Glanzmann thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip")
Cheyne-Stokes respirations (central apnea in CHF or inc intracranial pressure)
Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis)
Osler nodes (infective endocarditis, immune complex deposition)
Janeway lesions (infective endocarditis, septic emboli/ microabscesses)
Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
Pink puffer (emphysema: centriacinar *smoking+, panacinar *1-antitrypsin deficiency+)
Fanconi syndrome (proximal tubular reabsorption defect)
Guillain-Barre syndrome (acute autoimmune inflammatory demyelinating polyneuropathy)
Hyper-IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)
Acute mesenteric ischemia (adults), intussusception (infants)
Paget disease of the breast (sign of underlying neoplasm)
von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
Fanconi anemia (genetic loss of DNA crosslink repair; often progresses to AML)
Addison disease (1 adrenocortical insufficiency causes inc ACTH andinc -MSH production)
Becker muscular dystrophy (X-linked missense mutation in dystrophin; less severe than Duchenne)
Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP [Heberden nodes])
Hemangioma (benign, but associated with Sturge-Weber syndrome)
Goodpasture syndrome (glomerulonephritis and hemoptysis)
Drug-induced SLE (hydralazine, INH, phenytoin, procainamide)
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
1 biliary cirrhosis (female, cholestasis, portal hypertension)
Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B)
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
Pancoast tumor (can compress sympathetic ganglion and cause Horner syndrome)
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
Homer-Wright rosettes (neuroblastoma, medulloblastoma, neurofibrils retinoblastoma)
Cystic fibrosis (autosomal recessive mutation in CFTR gene --> fat-soluble vitamin deficiency and mucous plugs)
Tabes dorsalis (3 syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
Koilocytes (HPV: predisposes to cervical cancer) and hyperchromasia
Orphan Annie eyes nuclei (papillary carcinoma of the thyroid)
Councilman body (toxic or viral hepatitis, often yellow fever)
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Dating error, anencephaly, spina bifida (neural tube defects)
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
Ferruginous bodies (asbestosis: inc chance of mesothelioma)
Chediak-Higashi disease (congenital failure of phagolysosome formation)
Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
* Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus
Chronic passive congestion of liver due to right heart failure
Sensitive: Streptococcus pneumoniae; resistant: viridans streptococci
Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; "black sky" made up of malignant cells)
Pick bodies (Pick disease: progressive dementia, changes in personality)
Membranous glomerulonephritis (may progress to nephrotic syndrome)
Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
AA + disulfiram, naltrexone, or acamprosate for patient. Al-Anon for patient's family
Vitamin B12 supplementation (work up cause with Schilling test)
Lithium, valproate, carbamazepine, lamotrigine (mood stabilizers)
Amphotericin B (systemic), nystatin (oral thrush), azoles (vaginitis)
Doxycycline (+ ceftriaxone for gonorrhea coinfection), erythromycin eye drops (prophylaxis in infants)
Probenecid (underexcretor), allopurinol (overproducer), febuxostat
DDAVP (central); hydrochlorothiazide, indomethacin, amiloride (nephrogenic)
Dietary intervention, oral hypoglycemics, and insulin (if refractory)
Chloroquine/mefloquine (for blood schizont), primaquine (for liver hypnozoite)
Ceftriaxone (add doxycycline to cover likely concurrent Chlamydia)
Bisphosphonates; calcium and vitamin D supplementation
Doxycycline, chloramphenicol (associated with aplastic anemia)
D2 receptor antagonists (e.g., 1st- and 2nd-generation antipsychotics)
Demeclocycline, lithium, vasopressin receptor antagonists
MSSA: nafcillin, oxacillin, dicloxacillin (antistaphylococcal penicillins); MRSA: vancomycin
Penicillin prophylaxis; evaluation for colon cancer if linked to endocarditis
Penicillin/cephalosporin (systemic infection, pneumonia), vancomycin (meningitis)
Cushing ulcer (inc intracranial pressure stimulates vagal gastric secretion)
Curling ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
Marfan syndrome (idiopathic cystic medial degeneration)
Wernicke encephalopathy (thiamine deficiency causing ataxia, ophthalmoplegia, and confusion)
Group B streptococcus/E.coli (newborns), S. pneumoniae/ Neisseria meningitidis (kids)
Bernard-Soulier syndrome (defect in platelet adhesion to von Willebrand factor)
Supratentorial: metastasis > astrocytoma (including glioblastoma multiforme) > meningioma > schwannoma
Infratentorial: medulloblastoma (cerebellum) or supratentorial: craniopharyngioma
Fibrocystic change, carcinoma (in postmenopausal women)
Libman-Sacks endocarditis (nonbacterial, affecting both sides of mitral valve)
Metastasis, 1 myxoma (4:1 left to right atrium; "ball and valve")
Predisposition to gastric carcinoma (can also cause pernicious anemia)
Osteoporosis (type I: postmenopausal woman; type II: elderly man or woman)
Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)
* Paraneoplastic Cushing (due to ACTH secretion by tumors)
Tetralogy of Fallot, transposition of great vessels, truncus arteriosus
Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery
Squamous cell carcinoma (worldwide); adenocarcinoma (U.S.)
Endometrial carcinoma (most common in U.S.); cervical carcinoma (most common worldwide)
Mitral > aortic (rheumatic fever), tricuspid (IV drug abuse)
Rupture of middle meningeal artery (trauma; lentiform shaped)
Multiple blood transfusions or hereditary HFE mutation (can result in CHF, "bronze diabetes," and increased risk of hepatocellular carcinoma)
Cirrhotic liver (associated with hepatitis B and C and with alcoholism)
Gilbert syndrome (benign congenital unconjugated hyperbilirubinemia)
Ankylosing spondylitis, reactive arthritis, ulcerative colitis, psoriatic arthritis
Struvite (ammonium) = radiopaque (formed by urease+ organisms such as Proteus vulgaris or Staphylococcus);
Eisenmenger syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)
Disease occurs in both males and females, inherited through females only
Kallmann syndrome (hypogonadotropic hypogonadism and anosmia)
ALL: child, CLL: adult > 60, AML: adult ~65, CML: adult 30-60
Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, 1-antitrypsin deficiency)
Buerger disease (strongly associated with tobacco) in extremities
Renal cell carcinoma: associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndromes (EPO, renin, PTH, ACTH)
inc ventricular filling (left-to-right shunt, mitral regurgitation, LV failure [CHF])
Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
Abdominal aorta > coronary artery > popliteal artery > carotid artery
Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymyalgia rheumatica
Hemangioma (usually regresses spontaneously by childhood)
Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)
Folate (pregnant women are at high risk; body stores only 3- to 4-month supply; prevents neural tube defects)