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Addison’s Disease primary adrenocortical deficiency

pernicious anemia (antibodies to intrinsic factor or


Addisonian Anemia parietal cells ? ?IF ? ?Vit B12 ? megaloblastic anemia)

polyostotic fibrous dysplasia, precocious puberty,


Albright’s Syndrome café au lait spots, short stature, young girls

hereditary nephritis with nerve deafness, Type 4


Alport’s Syndrome collagen defect (basement membranes)

progressive dementia; tau proteins, neurofibrillary


tangles, apolipoprotein E4 allele, narrow gyri and

Alzheimer’s wide sulci (atrophy), occipital sparing,


hydrocephalus ex vacuo, plaques in hippocampus
and cortex, ? Acetylcholine, Hiramo bodies
(inrtacellular inclusion bodies in hippocampal cells)

1
loss of light reflex constriction (contralateral or
Argyll-Robertson Pupil bilateral), “Prostitute’s Eye” - accommodates but
does not react, Pathognomonic for 3?Syphilis

Caused by bacterial meningitis, leads to obstructive


Adhesive arachnoiditis hydrocephalus

Arnold-Chiari Malformation cerebellar tonsil herniation

Barrett’s columnar metaplasia of lower esophagus (* risk of


adenocarcinoma)

Bartter’s Syndrome hyperreninemia

2
similar to Duchenne, but less severe (deficiency in
Becker’s Muscular Dystrophy dystrophin protein)

Bell’s Palsy CNVII palsy (entire face; recall that UMN lesion only
affects lower face)

Berger’s Disease IgA nephropathy

Bernard-Soulier defect in platelet adhesion (abnormally large


platelets & lack of platelet-surface glycoprotein)
Disease

Berry Aneurysm circle of Willis (subarachnoid bleed), often


associated with ADPKD

3
carcinoma in situ on shaft of penis (*
Bowen’s Disease risk of visceral ca)

Briquet’s Syndrome somatization disorder

Motor Aphasia intact


Broca’s Aphasia comprehension

Bronchiolitis RSV

Brown-Sequard hemisection of cord (contralateral loss of pain &


temp / ipsilateral loss of fine touch, UMN)

4
Bruton’s Disease X-linked agammaglobinemia

Budd-Chiari post-hepatic venous thrombosis

acute inflammation of small, medium arteries *


Buerger’s Disease painful ischemia * gangrene

small noncleaved cell lymphoma


Burkitt’s Lymphoma EBV, 8:14 translocation

Guillain-Barre (markedly increased protein in CSF


Albumino-Cytologic Dissociation with only modest increase in cell count)

5
Caisson Disease gas emboli

Carpal Tunnel Median nerve


Syndrome entrapment

Trypansoma infection sleeping disease, cardiomegaly


Chagas’ Disease with apical atrophy, megaesophagus, megacolon

Chediak-Higashi Phagocyte Deficiency: neutropenia, albinism, cranial


& peripheral neuropathy
Disease

AFP increase Neural tube defects, hepatocellular carcinoma, yolk


sac and embryonal carcinoma

6
21-hydroxylase deficiency: virilism, no cortisol, salt
Congenital adrenal hyperplasia loss, hypotension

virilism, no cortisol, salt retention,


11-hydroxylase deficiency
hypertension

Conn’s Syndrome primary aldosteronism

glycogen storage disease


Cori’s Disease (debranching enzyme deficiency)

prion infection * cerebellar &


Creutzfeldt-Jakob cerebral degeneration

7
Crigler-Najjar congenital hyperbilirubinemia
(unconjugated)
Syndrome

IBD; ileocecum, transmural, skip lesions,

Crohn’s lymphocytic infiltrate, granulomas, (contrast to UC:


limited to colon, mucosa & submucosa, crypt
abscesses, pseudopolyps, * colon cancer risk)

AFP decrease Down’s

Croup Parainfluenza

acute gastric ulcer associated with


Curling’s Ulcer severe burns

8
Disease: hypercorticism 2* to * ACTH from pituitary
Cushing’s (basophilic adenoma), Syndrome: hypercorticism of
all other causes (1* adrenal or ectopic)

acute gastric ulcer associated with


Cushing’s Ulcer CNS trauma

self-limiting focal destruction


de Quervain’s Thyroiditis
(subacute thyroiditis)

DiGeorge’s Syndrome thymic hypoplasia * T-cell deficiency

Amnion
Renal agenesis
nodosum

9
Down’s Syndrome trisomy 21 or translocation

Post-MI Fibrinous Pericarditis


Dressler’s Syndrome autoimmune

Dubin-Johnson congenital hyperbilirubinemia (conjugated), striking


brown-to-black discoloration of the liver
Syndrome

Thyroid medullary carcinoma


Amyloid in thyroid (calcitonin)

deficiency of dystrophin protein *


Duchenne Muscular Dystrophy
MD X-linked recessive

10
trisomy 18, rocker-bottom feet, low
Edwards’ Syndrome ears, heart disease

Analgesic abuse Papillary necrosis, esp. in diabetics

Ehler’s-Danlos defective collagen

Eisenmenger’s late cyanotic shunt (R?L) pulmonary HTN & RVH 2?


to long-standing VSD, ASD, or PDA
Complex

trauma to superior trunk of brachial


Erb-Duchenne Palsy plexus Waiter’s Tip

11
undifferentiated round cell tumor of
Ewing Sarcoma bone

Eyrthroplasia of carcinoma in situ on glans penis


Queyrat

impaired proximal tubular reabsorption 2* to lead


poisoning or Tetracycline (glycosuria,
Fanconi’s Syndrome hyperphosphaturia, aminoaciduria, systemic
acidosis)

rheumatoid arthritis, neutropenia,


Felty’s Syndrome splenomegaly

adenomatous polyps of colon plus osteomas & soft


Gardner’s Syndrome tissue tumors

12
Lysosomal Storage Disease glucocerebrosidase
Gaucher’s Disease deficiency, hepatosplenomegaly, femoral head & long
bone erosion, anemia

Minimal change
Anasarca disease

benign congenital
Gilbert’s Syndrome hyperbilirubinemia (unconjugated)

Tumor arising in cells of Cajal


GIST (pacemakers of gut)

Glanzmann's Thrombasthenia defective glycoproteins on platelets

13
autoimmune: ab’s to glomerular & alveolar
Goodpasture’s basement membranes; linear
immunofluorescence

autoimmune hyperthyroidism
Grave’s Disease (TSI)

Guillain-Barre idiopathic polyneuritis (ascending muscle


weakness & paralysis; usually self-limiting)

Hamman-Rich idiopathic pulmonary fibrosis


Syndrome

Hand-Schuller-Christian chronic progressive histiocytosis

14
autoimmune hypothyroidism (antimicrosomal or
Hashimoto’s Thyroiditis antithyroglobulin); Hurthle cells, thyroid germinal
centers,

Hashitoxicosis initial hyperthyroidism in Hashimoto’s Thyroiditis


that precedes hypothyroidism

Henoch-Schonlein hypersensivity vasculitis


purpura

Hereditary RBC cytoskeletin defect, most


commonly spectrin
Spherocytosis

Hirschprung’s Disease aganglionic megacolon

15
ptosis, miosis, anhidrosis (lesion of cervical
Horner’s Syndrome sympathetic nerves often 2* to a Pancoast tumor)

Huntington’s progressive degeneration of caudate nucleus,


putamen & frontal cortex; AD

Hunter’s Decreased iduronosulfate sulfatase

Hurler’s Decreased alpha-L-iduronidase

epileptic events originating in the primary motor


Jacksonian Seizures cortex (area 4)

16
immune deficiency: neutrophils fail to respond to
Job’s Syndrome chemotactic stimuli

malignant vascular tumor (HHV8 in


Kaposi Sarcoma homosexual men)

immotile cilia 2? to defective dynein arms infection,


Kartagener’s Syndrome situs inversus, sterility

mucocutaneous lymph node


Kawasaki Disease syndrome (lips, oral mucosa)

Keratoconjunctivitis adenovirus

17
Klinefelter’s Syndrome 47, XXY

Kluver-Bucy bilateral lesions of amygdala (hypersexuality; oral


behavior)

Krabbe Disease Beta-galactosidase deficiency

adenocarcinoma with signet-ring cells (typically


Krukenberg Tumor originating from the stomach) metastases to the
ovaries

Laennec’s Cirrhosis alcoholic cirrhosis

18
HGPRT deficiency, gout,
Lesch-Nyhan retardation, self-mutilation

acute disseminated Langerhans’ cell


Letterer-Siwe histiocytosis

Libman-Sacks endocarditis with small vegetations on valve leaflets,


associated with SLE

Lou Gehrig’s Amyotrophic Lateral Sclerosis degeneration of upper


& lower motor neurons

Mallory-Weis bleeding from esophagogastric lacerations 2* to


wretching (alcoholics)
Syndrome

19
Marfan’s elastin defect, floppy mitral valve, arachnodactyly,
cystic medial necrosis, subluxed lens

glycogen storage disease (muscle


McArdle’s Disease phosphorylase deficiency)

rule of 2’s: 2 inches long, 2 feet from the ileocecum,


Meckel’s Diverticulum in 2% of the population, embryonic duct origin; may
contain ectopic tissue (gastric, pancreatic, etc.)

Aneurysmal nodules Polyarteritis nodosa

Triad: ovarian fibroma, ascites,


Meig’s Syndrome hydrothorax

20
giant hypertrophic gastritis (enlarged rugae; plasma
Menetrier’s Disease protein loss)

calcification of the media (usually radial & ulnar aa.),


Monckeberg’s Arteriosclerosis pipestem arteries

Munchausen factitious disorder (consciously creates symptoms,


but doesn’t know why)
Syndrome

Meningioma Arachnoid cap cells, whorls of cells

Mesothelioma Asbestos exposure

21
1* Adrenal Cushings * surgical removal of adrenals
Nelson’s Syndrome * loss of negative feedback to pituitary * Pituitary
Adenoma

Niemann-Pick Lysosomal Storage Disease sphingomyelinase


deficiency,“foamy histiocytes”

Angiomyolipoma Tuberous sclerosis

Hereditary Hemorrhagic
Osler-Weber-Rendu Syndrome
Telangiectasia

Osteogenesis
Type I collagen defect
imperfecta

22
abnormal bone architecture (thickened, numerous
Paget’s Disease fractures * pain) , woven and lamellar bone mosaic

Pancoast Tumor bronchogenic tumor with superior sulcus


involvement * Horner’s Syndrome

Parkinson’s dopamine depletion in nigrostriatal tracts; Cogwheel


rigidity

melanin pigmentation of lips, mouth, hand, genitalia


Peutz-Jegher’s Syndrome plus hamartomatous polyps of small intestine

subcutaneous fibrosis of dorsum of


Peyronie’s Disease penis

23
progressive dementia similar to Alzheimer’s,
Pick’s Disease knife-edged gyri

hyperthyroidism, nodular goiter, absence of eye


Plummer’s Syndrome signs (Plummer’s = Grave’s - eye signs)

Plummer-Vinson esophageal webs & iron-deficiency anemia, ? SCCA


of esophagus

glycogen storage disease (acid maltase deficiency) *


Pompe’s Disease cardiomegaly

tuberculous osteomyelitis of the


Pott’s Disease vertebrae

24
renal agenesis * oligohydramnios * hypoplastic
Potter’s Complex lungs, defects in extremities

Disease: recurrent vasospasm in extremities,


Raynaud’s Phenomenon: 2* to underlying disease (SLE or
scleroderma)

urethritis, conjunctivitis, arthritis non-infectious


Reiter’s Syndrome (but often follows infections), HLA-B27,
polyarticular

microvesicular fatty liver change & encephalopathy,


Reye’s Syndrome 2* to aspirin ingestion in children following viral
illness

Anosmia Kallman’s syndrome

25
idiopathic fibrous replacement of
Riedel’s Thyroiditis thyroid

Rotor Syndrome congenital hyperbilirubinemia (conjugated), similar


to Dubin-Johnson, but no discoloration of the liver

leukemic form of cutaneous T-cell lymphoma


Sezary Syndrome (mycosis fungoides)

Shaver’s Disease aluminum inhalation ? lung fibrosis

Sheehan’s Syndrome postpartum pituitary necrosis

26
Shy-Drager parkinsonism with autonomic dysfunction &
orthostatic hypotension

Simmond’s Disease pituitary cachexia

MEN type IIa (pheochromocytoma, thyroid medulla,


Sipple’s Syndrome parathyroid)

triad: dry eyes, dry mouth, arthritis ? risk of B-cell


Sjogren’s Syndrome lymphoma

Spitz Nevus juvenile melanoma (always benign)

27
Stein-Leventhal polycystic ovary

Stevens-Johnson erythema multiforme, fever, malaise, mucosal


ulceration (often 2? to infection or sulfa drugs)
Syndrome

Struma Ovarii Thyroid teratoma of ovary

juvenile rheumatoid arthritis (absence of rheumatoid


Still’s Disease factor)

aortic arch syndrome, loss of carotid, radial or ulnar


Takayasu’s arteritis pulses

28
Anterior vermian
atrophy alcoholism

Tay-Sachs gangliosidosis (hexosaminidase A deficiency * GM2


ganglioside)

ÊVSD, Ëoverriding aorta, Ìpulmonary artery


Tetralogy of Fallot stenosis, Íright ventricular hypertrophy

involuntary actions, both motor and


Tourette’s Syndrome vocal

adenomatous polyps of colon plus


Turcot’s Syndrome CNS tumors

29
Turner’s Syndrome 45, XO

Bradycardia and in white people


Typhoid Fever rose spots on abdomen

“trench mouth” - acute necrotizing ulcerative


Vincent’s Infection gingivitis

glycogen storage disease (G6Pase


von Gierke’s Disease deficiency)

hemangioma (or hemangioblastoma), adenomas of


von Hippel-Lindau the viscera, especially renal cell carcinoma

30
Anti-centromere Limited scleroderma (CREST)
antibody

neurofibromatosis & café au lait spots & Lisch nodule


von Recklinghausen’s (iris hamartomas)

von Recklinghausen’s Disease of osteitis fibrosa cystica (“brown tumor”) 2* to


Bone hyperparathyroidism

defect in platelet adhesion 2* to deficiency in vWF;


von Willebrand’s Disease increased bleeding time and PTT

proliferation of IgM-producing
Waldenstrom’s macroglobinemia
lymphoid cells

31
Posterior Inferior Cerebellar Artery (PICA)
thrombosis “Medullary Syndrome”, Ipsilateral:
Wallenberg’s Syndrome ataxia, facial pain & temp; Contralateral: body
pain & temp

catastrophic adrenal insufficiency 2* to


Waterhouse-Friderichsen hemorrhagic necrosis (eg, DIC), often 2* to
meningiococcemia

Anti-DNA topoisomerase antibody Diffuse scleroderma

Paramedian Infarct of Midbrain, Ipsilateral:


Weber’s Syndrome mydriasis; Contralateral: UMN paralysis (lower
face & body)

Anti-endomysial
antibody Celiac sprue

32
necrotizing granulomatous vasculitis of paranasal
Wegener’s Granulomatosis sinuses, lungs, kidneys, etc.

Weil’s Disease leptospirosis

MEN type I (thyroid, parathyroid, adrenal cortex,


Wermer’s Syndrome pancreatic islets, pituitary)

Sensory Aphasia impaired


Wernicke’s Aphasia comprehension

thiamine deficiency in alcoholics; bilateral mamillary


Wernicke-Korsakoff Syndrome bodies (confusion, ataxia, ophthalmoplegia)

33
malabsorption syndrome (with bacteria-laden
Whipple’s Disease macrophages) & polyarthritis

hepatolenticular degeneration (copper accumulation


Wilson’s Disease & decrease in ceruloplasmin)

Wiskott-Aldrich immunodeficiency: combined B- &T-cell deficiency


(thrombocytopenia & eczema)
Syndrome

high iodine level (*)’s thyroid


Wolff-Chaikoff Effect hormone synthesis

esophageal; cricopharyngeal
Zenker’s Diverticulum muscles above UES

34
gastrin-secreting tumor of pancreas (or intestine) * *
Zollinger-Ellison acid * intractable ulcers

Anti-jo antibody polymyositis

Anti-mitochondrial antibody Primary biliary cirrhosis

idiopathic thrombocytopenic
Antiplatelet Antibodies purpura

Anti-sacharommyces cervisiae
antibody Crohn’s

35
Specific for SLE,
Anti-Smith antibodies anti-ribonulceoprotein

Anti-smooth muscle antibody Autoimmune hepatitis type I

Arachnodactyly Marfan’s

Aschoff Bodies rheumatic fever

Ashleaf spots (skin) Tuberous sclerosis

36
Atypical lymphocytes EBV

acute promyelocytic leukemia (AML


Auer Rods type M3)

Autosplenectomy sickle cell anemia

Babinski UMN lesion

S. aureus, strep. pneumo,


Bacterial conjunctivitis Hemophilus aegyptius

37
Basophilic Stippling of RBCs lead poisoning

multiple myeloma free light chains (either kappa or


Bence Jones Protein lambda) Waldenstrom’s macroglobinemia

Bilateral breast cancer Lobular carcinoma

Bilateral renal cell carcinoma Von Hippel-Lindau

histiocytosis X (eosinophilic
Birbeck Granules granuloma)

38
Bladder trabeculation BPH

Bloody nipple
Intraductal papilloma
discharge

Blueberry muffin baby Rubella????

Blue Bloater Chronic Bronchitis

Osteogenesis
Blue Sclera imperfecta

39
Boot-Shaped Heart Tetralogy of Fallot

Bouchard’s Nodes osteoarthritis (PIP)

Boutonniere’s Deformity rheumatoid arthritis

Bronze Diabetes Hemochromatosis

Brown Tumor hyperparathyroidism

40
Brudzinski sign meningitis

Brushfield Spots Down’s, on iris

Call-Exner Bodies granulosa cell tumor

hyperemia, edema and necrosis of


Carbon monoxide poisoning
globus

Cardiomegaly with Apical Atrophy Chagas’ Disease

41
Central Nuclei in
Muscular dystrophies
Muscle

Chancre 1* Syphilis, painless firm ulcers

Haemophilus ducreyi, painful soft


Chancroid ulcers

Charcot Triad multiple sclerosis (nystagmus, intention tremor,


scanning speech)

Charcot-Leyden
bronchial asthma
Crystals

42
Cherry-red spot on macula Tay-Sachs, 50% of Niemann-Pick

Cheyne-Stokes
cerebral lesion
Breathing

Chocolate Cysts endometriosis

Cholesterol clefts atherosclerosis

Chordae tendinae short and fused


Rheumatic heart
disease

43
Chronic staph Chronic granulomatous disease, a deficiency of
NADPH oxidase, can’t kill catalase positive bugs
infections

Chvostek’s Sign Hypocalcemia facial spasm in tetany

Thyroid papillary carcinoma


Clear nuclei (Orphan Annie’s eyes)

Clue Cells Gardnerella vaginitis, trichomonas?

Codman’s Triangle osteosarcoma

44
Pulmonary
Coin Lesions in Lung
Hamartoma

Mycoplasma pneumoniae; infectious


Cold Agglutinins mononucleosis

Cold thyroid nodules Colloid cyst or thyroid adenoma

Concentric laminar intimal fibrosis of small arteries


of lung Primary pulmonary hypertension

Condyloma Lata 2* Syphilis

45
Polycystic Kidney Disease, juvenile autosomal
Congenital Hepatic Fibrosis recessive form

Contraction Band Necrosis MI

Cotton Wool Spots HTN

Councilman Bodies dying hepatocytes

rapidly progressive (crescentic


Crescents In Bowman’s Capsule
glomerulonephritis)

46
Crushed ping pong
Pneumocystis carinii
balls

Crypt abscesses Ulcerative colitis

Currant-Jelly Sputum Klebsiella

Curschmann’s Spirals bronchial asthma

Cystathioine synthase deficieny homocystinuria

47
D-dimers DIC

Depigmentation Of Substantia Nigra Parkinson’s

Dew drop on rose petal Chicken pox

Diaphragmatic pleural plaques Asbestosis

Donovan Bodies granuloma inguinale (STD)

48
Down’s syndorme – duodenal
Double bubble sign on ultrasound
atresia

Duret Hemorrhages Uncal herniation

osteoarthritis (polished, ivory-like


Eburnation appearance of bone)

Eccentric intimal fibrosis with


Chronic transplant rejection
medial hypertrophy

Ectopia Lentis Marfan’s

49
Embolizing Infectious, marantic (fibrin deposits in
hypercoagulable states)
endocarditis

Erythema Chronicum Migrans Lyme Disease

Excavation of Optic
Cup Glaucoma

Exopthalmos hyperthyroid

FAT RN TTP (fever, anemia, thrombocytopenia, renal failure,


neuro problems)

50
Fatty Liver Alcoholism

Fecalith Acute appendicitis

SLE, Treponema pertenue (non-STD


False positive VDRL tropical infection)

Ferruginous Bodies asbestosis

Fish-mouthed mitral valve


Rheumatic heart
disease

51
Malignant
Flea-bitten Kidney
Hypertension

Frontal bossing Sickle cell anemia

Fungus ball in lung Apergillus

galactosemia Galactose-1-phosphate uridyl transferase deficiency


or galactokinase deficiency

Garlic odor on breath Arsenic (or lasagna)

52
Ghon Complex Tuberculosis, primary

Gold Lipid pneumonia, exogenous (aspiration) or


endogenous (obstruction
Pneumonia

Gower’s Maneuver Duchenne’s MD use of arms to stand

Gray discoloration of skin Argyria (silver poisoning)

Hat size increase Paget’s disease of bone

53
CHF; hemosiderin-laden
Heart Failure Cells macrophages in lungs

Heberden’s Nodes Osteoarthritis (DIP)

Heinz Bodies G6PDH Deficiency

Hemarthrosis Coagulation factor deficiency

Hemorrhagic Temporal Lobe Lesion HSV

54
Hemorrhagic Urticaria Henoch-Schonlein

Heterophil Antibodies infectious mononucleosis (EBV)

Hirano Bodies alzheimer’s

Ankylosing spondylitis, psoriasis,


HLA B27 IBD, Reiter’s syndrome

Ochronosis (dark pigment of fibrous Alkaptonuria –homogentisic acid


tissue) oxidase deficiency

55
Honeycomb Pulmonary fibrosis
lung

Splenectomy, remnant of nuclear


Howell Jolley Bodies DNA

H shaped vertebrae Sickle cell anemia

Human placental lactogen increase Placental site trophoblastic tumor

Hyaline thrombi TTP

56
Hydrosalpinx Chronic pelvic inflammatory disease

Hypersegmented
Megaloblastic anemia
PMNs

Hypochromic Microcytic RBCs iron-deficiency anemia

Rheumatoid arthritis (rheumatoid


IgM against IgG factor)

X-linked Brutons agammaglobulinemia, and


? Immunoglobulins common variable immunodeficiency

57
Index finger overlapping 3rd and
4th Edward’s (Trisomy 18)

Syphilis over-aggressive treatment of an


Jarisch-Herxheimer Reaction asymptomatic pt. that causes symptoms 2? to rapid
lysis

osteoarthritis (fractured
Joint Mice osteophytes)

Kaussmaul Breathing acidosis

Keratin Pearls SCCA

58
Kernig’s sign meningitis

Keyser-Fleischer Ring Wilson’s

Kimmelstiel-Wilson Nodules diabetic nephropathy

Koilocytes HPV

Koplik Spots measles

59
Lacunar cells Variant of Reed-Sternberg cell seen in nodular
sclerosing Hodgkin’s Disease

Lacunar infarct Chronic hypertension

Contain surfactant in Type II


Lamellar bodies pneumocytes

Tuberculosis, other including


Langhans giant cells coccidioides

Lemon yellow skin


Pernicious anemia
color

60
Ultrasonographic finding in Neural
Lemon sign Tube Defects

Leukocoria Retinoblastoma

Lewy Bodies Parkinson’s (eosinophilic inclusions in damaged


substantia nigra cells)

Leukocyte alk. Phos. Positive leukemoid rxn.

Lines of Zahn arterial thrombus

61
neurofibromatosis (von
Lisch Nodules Recklinhausen’s disease)

Loss of grey-white junction Tuberous sclerosis

Downs, DiGeorge, Trisomy 18


Low set ears (Edwards)

Lumpy-Bumpy IF poststreptococcal
glomerulonephritis
Glomeruli

Patent ductus
Machine-like murmur
arteriosus

62
Macronodular Wilson’s, viral hepatitis,
alpha-1-antitrypsin
cirrhosis

Malignant pustule Anthrax (black skin lesion)

Mallory Bodies Alcoholic liver disease: intermediate filaments of


hepatocyte cytoskeleton

Alpha-ketoacid dehydrogenase deficiency; valine,


Maple syrup/burnt sugar urine leucine and isoleucine build up (branched)

appendicitis (McBurney’s Point is 2/3 of the way


McBurney’s Sign from the umbilicus to anterior superior iliac spine)

63
Meconium ileus Cystic Fibrosis

Arsenic (parallel lines on


Mees lines fingernails)

Melanosis coli Laxative abuse

Mental probs. with heart defect Mitral prolapse

Michealis-Gutmann Malakoplakia, an abnormal tissue response to kidney


infection
Bodies

64
Microglial nodules HIV

Micrognathia DiGeorge

Wilsons, alcoholic, hemochromatosis, primary


Micronodular cirrhosis biliary cirrhosis

HNPCC (right-sided colon cancer), but also possible


Microsatellite instability in other cancers

Mid-systolic click Mitral prolapse

65
multiple myeloma this is called the M protein
Monoclonal Antibody Spike (usually IgG or IgA)

Mousy / musty odor PKU

Platelet problem (qualitative or


Mucosal bleeding quantitative)

Myxedema hypothyroidism

Necrolytic migratory erythema


dermatitis ?-cell islet tumor

66
Negri Bodies and hydrophobia rabies

Neuritic Plaques Alzheimer’s

Neurofibrillary Tangles Alzheimer’s

Night pain relieved by aspirin Osteoid osteoma

Rheumatic, Libman-Sacks (with


Non-embolizing endocarditis
SLE)

67
Myxedema, Anthrax
Non-pitting Edema
Toxin

Notching of Ribs Coarctation of Aorta

Nutmeg Liver CHF, right heart

Malignant nephrosclerosis
Onion skin kidney arterioles
(malignant hypertension)

Oligoclonal band Multiple sclerosis

68
Osteoid production osteosarcoma

Painless Jaundice pancreatic CA (head)

Palatal Petechaie Strep pharyngitis

Hypersensitivity vasculitis (Henoch-Schonlein,


Palpable purpura serum sickness)

Pancarditis Rheumatic fever

69
Pannus rheumatoid arthritis

PAS positive
Whipple’s disease
macrophages

Patent ductus Maternal rubella and prematurity


arteriosus

mycosis fungoides (cutaneous T-cell


Pautrier’s Microabscesses
lymphoma)

Periductal edema Gynecomastia

70
Congenital CMV (brain ventricles,
Periventricular Calcifications
that is)

Phenylalanine hydroxylase
deficiency PKU

Philadelphia
Chromosome CML

Pick Bodies Pick’s Disease

Chronic active hepatitis (periportal


Piecemeal Necrosis hepatocytes)

71
Pulmonary HTN (aneurysmal
Plexiform lesions expansion of vessel wall)

Pink, foamy lung Pneumocystis carinii pneumonia


exudate

Pink Puffer Emphysema Centroacinar – smoking Panacinar -


?1-antitrypsin deficiency

Podagra gout (MP joint of hallux)

Porcelain gallbladder Chronic cholecystitis (scarring)

72
Associated with gallbladder
Porcelain gallstones adenocarcinoma

Port-Wine Stain Hemangioma

Posterior Anterior Drawer Sign tearing of the ACL

Proliferating bile ducts Obstructive jaundice

Papillary adenocarcinoma of the thyroid, Serous


Psammoma Bodies papillary cystadenocarcinoma of the ovary,
Meningioma, Mesothelioma

73
Pseudohypertrophy Duchenne muscular dystrophy

Pseudopolyps Ulcerative colitis

Pulmonary atherosclerosis Cor pulmonale

Punched-Out Bone
multiple myeloma
Lesions

Punched-out esophageal lesions herpes

74
Rash on Palms & Soles 2 Syphilis

RBC poikilocytosis Beta-thalassemia

Rectangular RBC’s Hemoglobin SC

Alpha-1-antitrypsin deficiency (in


Red hyalin globules liver)

paroxysmal nocturnal
Red Morning Urine hemoglobinuria

75
Reed-Sternberg Cells Hodgkin’s Disease

Reid Index Increased chronic bronchitis

Reinke Crystals Leydig cell tumor

Rhomboid crystals Pseudogout

Rim pattern SLE, staining pattern with anti-double stranded


DNA antibodies

76
Patau (Trisomy 13), Edward’s
Rockerbottom feet (Trisomy 18)

Rose thorns Sporotrichosis

multiple myeloma RBC’s stacked as


Rouleaux Formation poker chips

Pernicious anemia (atrophic


Rugae loss gastritis)

L ->R Shunt (VSD, PDA); Mitral


S3 Heart Sound Regurg; LV Failure

77
Pulmonary Stenosis, Pulmonary
S4 Heart Sound HTN

Scalloped colloid Grave’s disease

Neisseria meningitidis impressive


Schwartzman Reaction rash with bugs

Shagreen patches Tuberous sclerosis

Simian Crease Down’s

78
Smith Antigen SLE (also anti-dsDNA)

CLL (delicate cells easily destroyed


Smudge cells on peripheral smear)

giant cell tumor of


Soap Bubble on X-Ray
bone

Clinically insignificant remnant of


Soldiers plaque healed pericarditis

Hyperestrinism: liver failure,


Spider telangiectasia pregnancy

79
Spike & Dome Glomeruli membranous glomerulonephritis

Splinter hemorrhages Infective endocarditis

Strawberry tongue Scarlet fever, Kawasaki’s

Strawberry cervix Trichomonas vaginalis

Strawberry gallbladder Cholesterolosis

80
String Sign on X-ray Crohn’s bowel wall thickening

Sugar icing on spleen Portal hypertension

Collection of actinomyces or nocardia organisms in


Sulfer granules chronic abscessing bronchopneumonia

Clostridia (gas
Swiss cheese brain
forming)

Syncitia RSV, measles

81
Tamm-Horsfall protein Hyaline casts (non-specific)

Target Cells Thalassemia

Teardrop RBCs myelofibrosis

Temporal lobe encephalitis Herpes

Tendinous Xanthomas Familial Hypercholesterolemia

82
Arnold-Chiari malformation
Tethered cord (tonsilar herniation)

Tetrahydrobiopterin cofactor def. PKU

Xeroderma
Thymidine dimers
pigmentosum

Digeorge (3rd and 4th pharyngeal


Thymus, parathyroid agenesis
pouch)

Thyroidization of
chronic pyelonephritis
Kidney

83
TIBC increase Anemia of chronic disease

Macrophage in lymph node


Tingible Bodies germinal centers

Tophi gout

membranoproliferative
Tram-Track Glomeruli glomerulonephritis

Tree bark aorta Syphilis

84
visceral ca, classically pancreatic (migratory
thrombophlebitis), hypocalcemia (carpal spasm)
Trousseau’s Sign (These are two entirely different disease processes
and different signs, but they unfortunately have the
same name.)

TSI > TGI Grave’s

TGI > TSI Hashimoto’s

Tyrosinase deficiency Albinism

supraclavicular node enlargement by metastatic


Virchow’s Node carcinoma of the stomach

85
VMA and metenephrins in urine Pheochromocytoma

Warthin-Finkeldey Giant Cells Measles

Waterhammer pulse Aortic regurgitation

WBC Casts pyelonephritis

White matter petechiae Fat emboli

86
Winged scapula Long thoracic nerve (C5,6,7) damage, common with
radical mastectomy

Wire Loop Glomeruli lupus nephropathy, type IV

Wrinkled glomerular basement


membrane ischemia

AFP in amniotic fluid or mother’s


Spina Bifida; Anencephaly
serum

Uric Acid Gout, Lesch Nyhan, Myeloproliferative Disorders,


Diuretics (Loop & Thiazides)

87
FEV1/FVC COPD

glucose, protein in CSF Bacterial meningitis

dopamine receptors Schizophrenia

dopamine receptors Parkinson’s

88