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Secondary granules of neutrophils: Contents
"Second L.A.P"
Lactoferrin
Lysozyme
Alkaline phosphatase
Plasminogen activator
Phospholipase A2
Nephritic syndrome: glomerular diseases commonly presenting as
nephritic syndrome PARIS:
Post-streptococcal
Alport's
RPGN
IgA nephropathy
SLE
� Alternatively: PIG ARMS to include Goodpasture's [one cause of
RPGN], Membranoproliferative [only sometimes included in the classic
nephritic list].
nephritic syndrome PARIS:
Post-streptococcal
Alport's
RPGN
IgA nephropathy
SLE
� Alternatively: PIG ARMS to include Goodpasture's [one cause of
RPGN], Membranoproliferative [only sometimes included in the classic
nephritic list].
Type 3 hypersensitivity reaction: Examples
"SHARPan"
Read as 'Sharpen'
Serum sickness, SLE, post Streptococcal GN
Hypersensitivity pneumonitis
Arthus reaction
Reactive arthritis
PAN
Systemic vasculitis causing granulomas
"Great Wall of China Trade"
Giant cell arteritis
Wegener's granulomatosis
Churg-Strauss syndrome
Takayasu's disease
Wernickes encephalopathy: components WACO:
� Wernickes is:
Ataxia
Confusion (or clouded consciousness)
Ocular problems
� Note: Waco is the town in Texas, USA made famous for a standoff with a David
Koresh and the Branch Davidians.
� Wernickes is:
Ataxia
Confusion (or clouded consciousness)
Ocular problems
� Note: Waco is the town in Texas, USA made famous for a standoff with a David
Koresh and the Branch Davidians.
Adult Respiratory Distress Syndrome (ARDS): causes ARDS:
Aspiration/ Acute pancreatitis/ Air embolism/ Amniotic
embolism
Radiation
DIC/ Drugs/ Drowning/ Dialysis/ Diffuse lung
infection
Shock/ Sepsis/ Smoke inhalation
Aspiration/ Acute pancreatitis/ Air embolism/ Amniotic
embolism
Radiation
DIC/ Drugs/ Drowning/ Dialysis/ Diffuse lung
infection
Shock/ Sepsis/ Smoke inhalation
Wiskott-Aldrich syndrome: symptom triad WASTER:
Wiskott Aldrich Syndrome is:
Thrombocytopenia
Eczema
Recurrent staphlococcal infections
Wiskott Aldrich Syndrome is:
Thrombocytopenia
Eczema
Recurrent staphlococcal infections
Cardiovascular risk factors (Framingham) FRAMINGHAM:
Family history
Running (exercise)
Adiposity (obesity)
Marlboros (tobacco)
Insulin resistance (diabetes)
Non-regulated lipids (dyslipidaemia)
Georgie Pie (high fat diet)
Hypertension
Age
Male
Family history
Running (exercise)
Adiposity (obesity)
Marlboros (tobacco)
Insulin resistance (diabetes)
Non-regulated lipids (dyslipidaemia)
Georgie Pie (high fat diet)
Hypertension
Age
Male
Macrocytosis: Non-B12/folate causes ALPHA NERD:
Alcohol
Liver disease
Pregnancy
Hemaolysis (especially chronic)
Agglutination
Neoplasia (including myelodysplasia)
Endocrine (hypothyroidism)
Reticulocytes
Drugs (especially myelosuppressives like chemotherapy, anti-HIV meds)
Alcohol
Liver disease
Pregnancy
Hemaolysis (especially chronic)
Agglutination
Neoplasia (including myelodysplasia)
Endocrine (hypothyroidism)
Reticulocytes
Drugs (especially myelosuppressives like chemotherapy, anti-HIV meds)
Osteomyelitis: complications FIBRES:
Fractures
Intraosseous (broidie) abscesses
Bacteremi/ Brodie abscess
Reactive amyloidosis
Endocarditis
Sinus tracts/ Squamous cell CA
Fractures
Intraosseous (broidie) abscesses
Bacteremi/ Brodie abscess
Reactive amyloidosis
Endocarditis
Sinus tracts/ Squamous cell CA
Polycystic ovarian disease: clinical features OHIO:
Oligomenorrhea
Hirsutism
Infertility
Obesity
Oligomenorrhea
Hirsutism
Infertility
Obesity
Microcytic anemia: causes "Find Those Small
Cells":
Fe deficiency
Thalassemia
Sideroblastic
Chronic disease
Cells":
Fe deficiency
Thalassemia
Sideroblastic
Chronic disease
Hirsutism vs. virilism Hirsutism: Hair on body
like a male.
Virilism: Voice and rest of secondary sexual characteristics like
a male.
like a male.
Virilism: Voice and rest of secondary sexual characteristics like
a male.
Megaloblastic anemia: vitamin B12 deficiency vs. folate deficiency
Vitamin B12 deficiency also affects Brain (optic neuropathy,
subacute combined degeneration, paresthesia).
� Folate deficiency is not associated with neurological symptoms.
Vitamin B12 deficiency also affects Brain (optic neuropathy,
subacute combined degeneration, paresthesia).
� Folate deficiency is not associated with neurological symptoms.
Symptoms of TTP/HUS "Nasty Fever Ruined
My Tubes":
Neurological symptoms
Fever
Renal failure
Microangiopathic hemolytic anemia
Thrombocytopenia
My Tubes":
Neurological symptoms
Fever
Renal failure
Microangiopathic hemolytic anemia
Thrombocytopenia
Hemophilia: type A factor Hemophilia A: problems with
VIII factor (number V as an inverted A).
VIII factor (number V as an inverted A).
Thyroid carcinoma: frequency "Please Feel My
A$$":
In order of most frequent to least frequent, and in order from least aggressive
to most aggressive:
Papillary carcinoma
Follicular carcinoma
Medullary thyroid carcinoma
Anaplastic carcinoma
A$$":
In order of most frequent to least frequent, and in order from least aggressive
to most aggressive:
Papillary carcinoma
Follicular carcinoma
Medullary thyroid carcinoma
Anaplastic carcinoma
Pneumothorax: presentation P-THORAX:
Pleuretic pain
Trachea deviation
Hyperresonance
Onset sudden
Reduced breath sounds (& dypsnea)
Absent fremitus
X-ray shows collapse
Pleuretic pain
Trachea deviation
Hyperresonance
Onset sudden
Reduced breath sounds (& dypsnea)
Absent fremitus
X-ray shows collapse
Disseminated Intravascular Cogulation: causes DIC:
Delivery TEAR (obstetric complications)
Infections (gram negative)/ Immunological
Cancer (prostate, pancreas, lung, stomach)
� Obstretrical complications are TEAR:
Toxemia of pregnancy
Emboli (amniotic)
Abrutio placentae
Retain fetus products
Delivery TEAR (obstetric complications)
Infections (gram negative)/ Immunological
Cancer (prostate, pancreas, lung, stomach)
� Obstretrical complications are TEAR:
Toxemia of pregnancy
Emboli (amniotic)
Abrutio placentae
Retain fetus products
Leukemias: acute vs. chronic rules of thumb ABCDE:
Acute is:
Blasts predominate
Children
Drastic course
Elderly
Few WBC's (so Fevers)
� Chronic is all the opposites:
Mature cells predominate
Middle aged
Less debilitating course
Elevated WBC's, so not a history of fevers and infections
Acute is:
Blasts predominate
Children
Drastic course
Elderly
Few WBC's (so Fevers)
� Chronic is all the opposites:
Mature cells predominate
Middle aged
Less debilitating course
Elevated WBC's, so not a history of fevers and infections
Pancreatitis: causes PANCREATITIS:
Posterior
Alcohol
Neoplasm
Cholelithiasis
Rx (lasix, AZT)
ERCP
Abdominal surgery
Trauma
Infection (mumps)
Triglycerides elevated
Idiopathic
Scorpion bite
Posterior
Alcohol
Neoplasm
Cholelithiasis
Rx (lasix, AZT)
ERCP
Abdominal surgery
Trauma
Infection (mumps)
Triglycerides elevated
Idiopathic
Scorpion bite
Thrombotic thrombocytopenic purpura: signs FAT RN:
Fever
Anemia
Thrombocytopenia
Renal problems
Neurologic dysfunction
Fever
Anemia
Thrombocytopenia
Renal problems
Neurologic dysfunction
Scrotum masses SHOVE IT:
Spermatocele
Hydrocele/ Haematocele
Orchitis
Varicocele
Epidymal cyst
Indirect inguinal hernia
Torsion/ Tumor
Spermatocele
Hydrocele/ Haematocele
Orchitis
Varicocele
Epidymal cyst
Indirect inguinal hernia
Torsion/ Tumor
Kawasaki disease: diagnostic criteria CHILD:
5 letters=5 days, >5 years old, 5 out 6 criteria for
diagnosis:
Conjuctivitis (bilateral)
Hyperthermia (fever) >5 days
Idiopathic polymorphic rash
Lymphoadenopathy (cervical)
Dryness & redness of (i)lips & month (ii)palms & soles [2 separate
criteria]
5 letters=5 days, >5 years old, 5 out 6 criteria for
diagnosis:
Conjuctivitis (bilateral)
Hyperthermia (fever) >5 days
Idiopathic polymorphic rash
Lymphoadenopathy (cervical)
Dryness & redness of (i)lips & month (ii)palms & soles [2 separate
criteria]
Pancoast tumor: relationship with Horner's syndrome "Horner
has a MAP of the Coast":
A panCoast tumor is a cancer of the lung apex that compresses the
cervical sympathetic plexus, causing Horner's syndrome, which is MAP:
Miosis
Anhidrosis
Ptosis
has a MAP of the Coast":
A panCoast tumor is a cancer of the lung apex that compresses the
cervical sympathetic plexus, causing Horner's syndrome, which is MAP:
Miosis
Anhidrosis
Ptosis
Pericarditis: findings PERICarditis:
Pulsus paradoxus
ECG changes
Rub
Increased JVP
Chest pain [worse on inspiration, better when lean forward]
Pulsus paradoxus
ECG changes
Rub
Increased JVP
Chest pain [worse on inspiration, better when lean forward]
Cardiovascular risk factors FLASH BODIES:
Family history
Lipids
Age
Sex
Homocystinaemia
Blood pressure
Obesity
Diabetes mellitus
Inflammation (raised CRP)/ Increased thrombosis
Exercise
Smoking
Family history
Lipids
Age
Sex
Homocystinaemia
Blood pressure
Obesity
Diabetes mellitus
Inflammation (raised CRP)/ Increased thrombosis
Exercise
Smoking
Hypokalaemia: clinical features TIMID CHIMP:
Tetany
Increases paralytic ileus (aggravates)
Muscle weakness
Increases possibility of hepatic encephalopathy
Digoxin toxicity
Cardiac arrythmias
Hypotonia
Increases P-R interval, T wave and prominent U wave
Muscle cramps
Polyuria
Tetany
Increases paralytic ileus (aggravates)
Muscle weakness
Increases possibility of hepatic encephalopathy
Digoxin toxicity
Cardiac arrythmias
Hypotonia
Increases P-R interval, T wave and prominent U wave
Muscle cramps
Polyuria
Diabetes: short list of complications SHAKE:
Stroke
Heart attack
Amputations
Kidney disease
Eyes (vision loss)
Stroke
Heart attack
Amputations
Kidney disease
Eyes (vision loss)
Osteosarcoma: features PEARL HARBOR:
Paget's disease (10-20%)*
Early age (10-20 yrs)
Around knee
Raised periosteum by expanding tumor: "sunburst pattern"
Lace-like architecture
Hyaline arteoriosclerosis
Alkaline phosphatase increased
Retinoblastoma*
Boys, predominantly
Osteomyelitis DDx
Radiation*
� Sunburst pattern was Japanese Navy emblem during WWII.
*: Predisposing factors.
Paget's disease (10-20%)*
Early age (10-20 yrs)
Around knee
Raised periosteum by expanding tumor: "sunburst pattern"
Lace-like architecture
Hyaline arteoriosclerosis
Alkaline phosphatase increased
Retinoblastoma*
Boys, predominantly
Osteomyelitis DDx
Radiation*
� Sunburst pattern was Japanese Navy emblem during WWII.
*: Predisposing factors.
Edwards' syndrome: characteristics EDWARDS:
Eighteen (trisomy)
Digit overlapping flexion
Wide head
Absent intellect (mentally retarded)
Rocker-bottom feet
Diseased heart
Small lower jaw
Eighteen (trisomy)
Digit overlapping flexion
Wide head
Absent intellect (mentally retarded)
Rocker-bottom feet
Diseased heart
Small lower jaw
Fragile X syndrome: features FEMALES
FMR1 gene
Exhibits anticpation
Macro-orchidism
Autism
Long face with large jaw
Everted eyes
Second most common casue of genetic mental retardation
FMR1 gene
Exhibits anticpation
Macro-orchidism
Autism
Long face with large jaw
Everted eyes
Second most common casue of genetic mental retardation
Achalasia: 1 possible cause, 1 treatment aCHAlasia:
1 possible cause: CHAgas' disease
1 treatment: Ca++ CHAnnel blockers
1 possible cause: CHAgas' disease
1 treatment: Ca++ CHAnnel blockers
Anemia: TIBC finding to differentiate iron deficiency vs. chronic
disease TIBC levels at the:
Top=Iron deficiency.
Bottom=Chronic disease.
disease TIBC levels at the:
Top=Iron deficiency.
Bottom=Chronic disease.
Colon cancer: risk factors HULA:
Heridity/ Heriditary diseases
Ulcerative colitis
Low fibre, high fat diet
Adenomatous polyps
Heridity/ Heriditary diseases
Ulcerative colitis
Low fibre, high fat diet
Adenomatous polyps
COPD: blue bloater vs. pink puffer diseases emPhysema
has letter P (and not B) so Pink Puffer.
chronic Bronchitis has letter B (and not P) so Blue Bloater.
has letter P (and not B) so Pink Puffer.
chronic Bronchitis has letter B (and not P) so Blue Bloater.
Macrocytic anaemia: differential FAT RBC:
Fetus (pregnancy)
Alcohol
Thyroid disease(ie hypothyroidism)
Reticulocytosis
B12 and folate deficiency
Cirrhosis and chronic liver disease
Fetus (pregnancy)
Alcohol
Thyroid disease(ie hypothyroidism)
Reticulocytosis
B12 and folate deficiency
Cirrhosis and chronic liver disease
MI: post-MI complications ACT RAPID:
Arrhythmias (SVT, VT, VF)
Congestive cardiac failure
Tamponade/ Thromboembolic disorders
Rupture (ventricle, septum, papillary muscle)
Aneurysm (ventricle)
Pericarditis
Infaction (a second one)
Death/ Dressler's syndrome
Arrhythmias (SVT, VT, VF)
Congestive cardiac failure
Tamponade/ Thromboembolic disorders
Rupture (ventricle, septum, papillary muscle)
Aneurysm (ventricle)
Pericarditis
Infaction (a second one)
Death/ Dressler's syndrome
Hypersplenism: criteria "Hyper Splenism Ravages
Cells":
Hypercellular or normal marrow
Splenomegaly
Response to splenectomy
Cytopenias
Cells":
Hypercellular or normal marrow
Splenomegaly
Response to splenectomy
Cytopenias
Whipple's disease: full features WHIPPLES:
Weight loss
Hyperpigmentation of skin
Infection with tropheryma whippelii
PAS positive granules in macrophage
Polyarthritis
Lymphadenopathy
Enteric involvement
Steatorrhea
Weight loss
Hyperpigmentation of skin
Infection with tropheryma whippelii
PAS positive granules in macrophage
Polyarthritis
Lymphadenopathy
Enteric involvement
Steatorrhea
Pick's disease: features PICK:
Progressive degeneration of neurons
Intracytoplasmic Pick bodies
Cortical atrophy
Knife edge gyri
Progressive degeneration of neurons
Intracytoplasmic Pick bodies
Cortical atrophy
Knife edge gyri
Alzheimer's disease (AD): associations, findings AD:
� Associations:
Aluminum toxicity
Acetylcholine deficiencies
Amyloid B
Apolipoprotein gene E
Altered nucleus basalis of Meynert
Down's
� Findings:
Actin inclusions (Hirano bodies)
Atrophy of brain
Amyloid plaques
Aphasia, Apraxia, Agitation
DNA-coiled tangles
Dementia, Disoriented, Depressed
� Associations:
Aluminum toxicity
Acetylcholine deficiencies
Amyloid B
Apolipoprotein gene E
Altered nucleus basalis of Meynert
Down's
� Findings:
Actin inclusions (Hirano bodies)
Atrophy of brain
Amyloid plaques
Aphasia, Apraxia, Agitation
DNA-coiled tangles
Dementia, Disoriented, Depressed
Osteomalacia: features "Vit-D deficiency in ADULT":
Acetabuli protrusio
Decresed bone density
Under mineralization of osteoid
Looser's zone (pseudofracture)
Triradiate pelvis (females)
Acetabuli protrusio
Decresed bone density
Under mineralization of osteoid
Looser's zone (pseudofracture)
Triradiate pelvis (females)
Anemia (normocytic): causes ABCD:
Acute blood loss
Bone marrow failure
Chronic disease
Destruction (hemolysis)
Acute blood loss
Bone marrow failure
Chronic disease
Destruction (hemolysis)
Phaeochromocytoma: diagnositc rule � Rule of 10's:
10% ectopic
10% multiple
10% malignant
10% ectopic
10% multiple
10% malignant
Hematuria: urethral causes NUTS:
Neoplasm
Urethritis
Tumour
Stone
Neoplasm
Urethritis
Tumour
Stone
CREST sydrome: components CREST:
Calcinosis
Raynaud's phenomena
Esophageal dysmotility
Sclerodactyly
Telangectasia
Calcinosis
Raynaud's phenomena
Esophageal dysmotility
Sclerodactyly
Telangectasia
TTP: clinical features Thrombosis and thrombocytopenia
PARTNER together:
Platelet count low
Anemia (microangiopathic hemolytic)
Renal failure
Temperature rise
Neurological deficits
ERadmission (as it is an emergency)
PARTNER together:
Platelet count low
Anemia (microangiopathic hemolytic)
Renal failure
Temperature rise
Neurological deficits
ERadmission (as it is an emergency)
Pancreatitis: causes BAD S#!T:
Biliary: gallstones, 1% of ERCP patients
Alcoholism/ Azotemia
Drugs
Scorpion bite/ Sea anenome/ SLE
Hyperlipidemia/ Hypercalcemia
Idiopathic/ Infectious (mumps, coxsackie, salmonella, ascariasis)
Tumor/ Trauma
� The drugs are: penacillamine, furosemide, thiazides, ethacrynic acid,
steroids, sulfas, ace inhibitors, N-SAIDs, erythromycin, estrogen.
Biliary: gallstones, 1% of ERCP patients
Alcoholism/ Azotemia
Drugs
Scorpion bite/ Sea anenome/ SLE
Hyperlipidemia/ Hypercalcemia
Idiopathic/ Infectious (mumps, coxsackie, salmonella, ascariasis)
Tumor/ Trauma
� The drugs are: penacillamine, furosemide, thiazides, ethacrynic acid,
steroids, sulfas, ace inhibitors, N-SAIDs, erythromycin, estrogen.
Fragile-X syndrome: features DSM-4:
Discontinued chromosome staining
Shows anticipation
Male (male more affected)
Mental retardation (2nd most common genetic cause)
Macrognathia
Macroorchidism
Discontinued chromosome staining
Shows anticipation
Male (male more affected)
Mental retardation (2nd most common genetic cause)
Macrognathia
Macroorchidism
Endometrial carcinoma: risk factors HONDA:
Hypertension
Obesity
Nulliparity
Diabetes
Age (increased)
Hypertension
Obesity
Nulliparity
Diabetes
Age (increased)
Kawasaki's disease: features FEAR ME:
Fever
Eye: perilimbic sparing conjunctival injection
Adenopathy: usually cervical
Rash
Mouth: red lips
Extremities: red hands and feet
� Disease to be feared because of risk of coronary aneurysms.
Fever
Eye: perilimbic sparing conjunctival injection
Adenopathy: usually cervical
Rash
Mouth: red lips
Extremities: red hands and feet
� Disease to be feared because of risk of coronary aneurysms.
Pheochromocytoma: common symptoms 5 P's:
Paroxysmal rise in BP
Palpitations
Perspiration
Pain in abdomen
PMV in urine
Paroxysmal rise in BP
Palpitations
Perspiration
Pain in abdomen
PMV in urine
IBD: extraintestinal manifestations "Left intestine to sail
the SEAS of the rest of the body":
Skin manifestations: erythema nodosum, pyoderma gangrenosum
Eye inflammation: iritis, episcleritis
Arthritis
Sclerosing cholangitis
the SEAS of the rest of the body":
Skin manifestations: erythema nodosum, pyoderma gangrenosum
Eye inflammation: iritis, episcleritis
Arthritis
Sclerosing cholangitis
MI: complications "LEAP on the MAP":
LVF
Embolism (systemic)
Aneurysm (ventricular)
Progressive infarction
Myocardial rupture
Arrhythmia
Pericarditis
LVF
Embolism (systemic)
Aneurysm (ventricular)
Progressive infarction
Myocardial rupture
Arrhythmia
Pericarditis
Portal hypertension: features ABCDE:
Ascites
Bleeding (haematemesis, piles)
Caput medusae
Diminished liver
Enlarged spleen
Ascites
Bleeding (haematemesis, piles)
Caput medusae
Diminished liver
Enlarged spleen
Alzheimer's disease: features RONALD (Ronald Reagan,
a famous victim):
Reduction of Ach
Old age
Neurofibrillary tangles
Atrophy of cerebral cortex (diffuse)
Language impairment
Dementia (MC in elderly)/ Down's syndrome
a famous victim):
Reduction of Ach
Old age
Neurofibrillary tangles
Atrophy of cerebral cortex (diffuse)
Language impairment
Dementia (MC in elderly)/ Down's syndrome
Gout: major features GOUT:
Great toe
One joint (75% monoarticular)
Uric acid increased (hence urolithiasis)
Tophi
Great toe
One joint (75% monoarticular)
Uric acid increased (hence urolithiasis)
Tophi
Seronegative spondyloarthopathy: diseases RAPE:
Reiter's syndrome
Ankylosing spondylitis
Psoriatic arthitis
Enteropathic arthitis (IBD)
Reiter's syndrome
Ankylosing spondylitis
Psoriatic arthitis
Enteropathic arthitis (IBD)
Protein C, Protein S: function C and S are:
Clot
Stoppers
� These proteins inhibit coagulation.
Clot
Stoppers
� These proteins inhibit coagulation.
Melanoma vs. basal cell, squamous cell carcinoma: metastatic ability
MElanoma is more likely to
MEtastasize.
� Basal and squamous hardly ever metastasize.
MElanoma is more likely to
MEtastasize.
� Basal and squamous hardly ever metastasize.
Hepatocellular carcinoma: aetiology, features ABC:
Aetiology:
Aflatoxins
Hep B
Cirrhosis
� Features:
AFP increased (classic marker)
Bile-producing (DDx from cholangiocarcinoma)
Commonest primary liver tumor
Aetiology:
Aflatoxins
Hep B
Cirrhosis
� Features:
AFP increased (classic marker)
Bile-producing (DDx from cholangiocarcinoma)
Commonest primary liver tumor
Goitre: differential GOITRE:
Goitrogens
Onset of puberty
Iodine deficiency
Thyrotoxicosis/ Tumor/ Thyroiditis [Hashimoto's]
Reproduction [pregnancy]
Enzyme deficiencies
Goitrogens
Onset of puberty
Iodine deficiency
Thyrotoxicosis/ Tumor/ Thyroiditis [Hashimoto's]
Reproduction [pregnancy]
Enzyme deficiencies
Renal failure (chronic): consequences ABCDEFG:
Anemia
-due to less EPO
Bone alterations
-osteomalacia
-osteoporosis
-von Recklinghausen
Cardiopulmonary
-atherosclerosis
-CHF
-hypertension
-pericarditis
D vitamin loss
Electrolyte imbalance
-sodium loss/gain
-metabolic acidosis
-hyperkalemia
Feverous infections
-due to leukocyte abnormalities and dialysis hazards
GI disturbances
-haemorrhagic gastritis
-peptic ulcer disease
-intractable hiccups
Anemia
-due to less EPO
Bone alterations
-osteomalacia
-osteoporosis
-von Recklinghausen
Cardiopulmonary
-atherosclerosis
-CHF
-hypertension
-pericarditis
D vitamin loss
Electrolyte imbalance
-sodium loss/gain
-metabolic acidosis
-hyperkalemia
Feverous infections
-due to leukocyte abnormalities and dialysis hazards
GI disturbances
-haemorrhagic gastritis
-peptic ulcer disease
-intractable hiccups
Adrenal disorders: Cushing's vs Addison's Cushing: is
Gushing cortisol.
In Addison's: patient's cortisol doesn't Add up.
Gushing cortisol.
In Addison's: patient's cortisol doesn't Add up.
Aneurysm types MAD SCAB:
Mycotic
Atherosclerotic
Dissecting
Syphilitic
Capillary microaneurysm
Arteriovenous fistula
Berry
Mycotic
Atherosclerotic
Dissecting
Syphilitic
Capillary microaneurysm
Arteriovenous fistula
Berry
Nephrotic syndrome: hallmark findings "Protein LEAC":
Proteinuria
Lipid up
Edema
Albumin down
Cholesterol up
� In nephrotic, the proteins leakout.
Proteinuria
Lipid up
Edema
Albumin down
Cholesterol up
� In nephrotic, the proteins leakout.
Ovarian cancers: important types, by WHO classification �
Surface:
"My Sister Began Experiencing Cancer":
Mucinous
Serous
Brenner
Endometrioid
Clear
� Germ cell:
"Doctor Examined The Ovaries":
Dysgerminoma
Endometrial sinus
Teratoma
Ovarian choriocarcinoma
� Sex cord:
"She Felt Grim":
Sertoli-Leydig
Fibroma
Granulosa-theca
� Metastatic
"Killed":
Krukenberg
Surface:
"My Sister Began Experiencing Cancer":
Mucinous
Serous
Brenner
Endometrioid
Clear
� Germ cell:
"Doctor Examined The Ovaries":
Dysgerminoma
Endometrial sinus
Teratoma
Ovarian choriocarcinoma
� Sex cord:
"She Felt Grim":
Sertoli-Leydig
Fibroma
Granulosa-theca
� Metastatic
"Killed":
Krukenberg
Kwashiorkor: distinguishing from Marasmus FLAME:
Fatty Liver
Anemia
Malabsorption
Edema
Fatty Liver
Anemia
Malabsorption
Edema
Hemolytic anemia types SHEEP T!T:
Sickle cell
Heriditary splenocytosis
Enzyme deficiencies: [G6P, pyruvate kinase]
Erythroblastosis fetalis
Paroxysmal nocturnal hemoglobinuria
Trauma to RBCs
Immunohemolytics: [warm Ab, cold Ag]
Thalassemias: [alpha, beta]
Sickle cell
Heriditary splenocytosis
Enzyme deficiencies: [G6P, pyruvate kinase]
Erythroblastosis fetalis
Paroxysmal nocturnal hemoglobinuria
Trauma to RBCs
Immunohemolytics: [warm Ab, cold Ag]
Thalassemias: [alpha, beta]
Oral cancer risks PATH LAB:
Plummer-vinson syndrome
Alcohol
Tobacco
Human papilloma virus
Leukoplakia
Asbestos
Bad oral hygiene
Plummer-vinson syndrome
Alcohol
Tobacco
Human papilloma virus
Leukoplakia
Asbestos
Bad oral hygiene
Calculi: types CAlCUli:
Calcium
Ammonium magnesium phosphate
Cystine
Uric acid
Calcium
Ammonium magnesium phosphate
Cystine
Uric acid
Wernicke-Korsakoff triad Syndrome in alchoholics, who love
to "drink CANs of beer":
Confusion
Ataxia
Nystagmus
to "drink CANs of beer":
Confusion
Ataxia
Nystagmus
Wernicke-Korsakoff's psychosis: findings COAT RACK:
� Wernicke's encephalopathy (acute phase):
Confusion
Ophthalmoplegia
Ataxia
Thiamine tx.
� Korsakoff's psychosis (chronic phase):
Retrograde amnesia
Anterograde amnesia
Confabulation
Korsakoff's psychosis
� Wernicke's encephalopathy (acute phase):
Confusion
Ophthalmoplegia
Ataxia
Thiamine tx.
� Korsakoff's psychosis (chronic phase):
Retrograde amnesia
Anterograde amnesia
Confabulation
Korsakoff's psychosis
Atherosclerosis risk factors "You're a SAD BET with
these risk factors":
Sex: male
Age: middle-aged, elderly
Diabetes mellitus
BP high: hypertension
Elevated cholesterol
Tobacco
these risk factors":
Sex: male
Age: middle-aged, elderly
Diabetes mellitus
BP high: hypertension
Elevated cholesterol
Tobacco
Duchenne vs. Becker Muscular Dystrophy Duchenne Muscular
Dystrophy (DMD) : Doesn't Make Dystrophin.
Becker Muscular Dystrophy (BMD): Badly Made
Dystrophin (a truncated protein).
Dystrophy (DMD) : Doesn't Make Dystrophin.
Becker Muscular Dystrophy (BMD): Badly Made
Dystrophin (a truncated protein).
Multiple Endocrine Neoplasia (MEN) subtype classification
Each subtype has 2 or 3 causes, plus something 1 or 2 more items.
MEN I is disease of 3 P's: [Pituitary, Parathyroid, Pancreas]
plus one more: adrenal cortex.
MEN II is disease of 2 C's: [Carcinoma of thyroid, Catacholamines
(pheochromocytoma)] plus two more: parathyroid for MEN IIa or mucocutaneous
neuromas for MEN IIB (also called MEN III).
Each subtype has 2 or 3 causes, plus something 1 or 2 more items.
MEN I is disease of 3 P's: [Pituitary, Parathyroid, Pancreas]
plus one more: adrenal cortex.
MEN II is disease of 2 C's: [Carcinoma of thyroid, Catacholamines
(pheochromocytoma)] plus two more: parathyroid for MEN IIa or mucocutaneous
neuromas for MEN IIB (also called MEN III).
Takayasu's disease is Pulseless disease "Can't Tak'a ya
pulse" (Can't take your pulse):
Takayasu's disease known as Pulseless disease, since pulse is weakened in the
upper extremities.
pulse" (Can't take your pulse):
Takayasu's disease known as Pulseless disease, since pulse is weakened in the
upper extremities.
Hypercalcemia: symptoms of elevated serum levels "Bones,
Stones, Groans, Moans":
Bones: pain in bones
Stones: renal
Groans: pain
Psychic moans/ Psychological overtones: confused state
Stones, Groans, Moans":
Bones: pain in bones
Stones: renal
Groans: pain
Psychic moans/ Psychological overtones: confused state
Colon carcinoma: aeitiology CRAPS:
Chronic ulcerative colitis
Ratio of animal fat:fibre diet
Adenomatous polyps
Familial Polyposis
Strong family history of colon cancer.
Chronic ulcerative colitis
Ratio of animal fat:fibre diet
Adenomatous polyps
Familial Polyposis
Strong family history of colon cancer.
Kawasaki Disease Criteria "Be careful when riding a
Kawasaki motorcycle, you might get CREAMed.
Conjunctivitis (non-exudative)
Rash (polymorphous non-vesicular)
Edema (or erythema of hands or feet)
Adenopathy (cervical, often unilateral)
Mucosal involvement (erythema or fissures or crusting)
To have Kawasaki disease you must have fever for greater than 5 days plus 4 of
the above.
Kawasaki motorcycle, you might get CREAMed.
Conjunctivitis (non-exudative)
Rash (polymorphous non-vesicular)
Edema (or erythema of hands or feet)
Adenopathy (cervical, often unilateral)
Mucosal involvement (erythema or fissures or crusting)
To have Kawasaki disease you must have fever for greater than 5 days plus 4 of
the above.
Neurofibromatoses: chromosome mutation locations in von Reckinghausen
(type I) vs. type II "von Recklinghausen" has 17 letters
and is due to a mutation on chromosome 17.
"Neurofibromatosis type 2" has 22 and is due to a mutation on
chromosome 22.
(type I) vs. type II "von Recklinghausen" has 17 letters
and is due to a mutation on chromosome 17.
"Neurofibromatosis type 2" has 22 and is due to a mutation on
chromosome 22.
Fat embolism: findings "Fat, Bat, Fract":
Fat in urine, sputum
Bat-wing lung x-ray
Fracture history
� Also, fracture of FEMur causes Fat EMboli.
Fat in urine, sputum
Bat-wing lung x-ray
Fracture history
� Also, fracture of FEMur causes Fat EMboli.
Histiocytosis X: hallmark finding "Birbeck's rackets
is X":
Tennis rackets under electron microscope is Histiocystosis X.
Consider 2 tennis rackets in an X formation.
is X":
Tennis rackets under electron microscope is Histiocystosis X.
Consider 2 tennis rackets in an X formation.
Pulmonary fibrosis: differential of both upper and lower lobes
BREAST SCAR:
� Upper lobe:
Beryliosis
Radiation
Extrinsic allergic alveolitis
Ankylosing spondylitis
Sarcoidosis
TB
� Lower lobe:
Systemic sclerosis
Cryptogenic fibrosing alveolitis
Asbestosis
Radiation
BREAST SCAR:
� Upper lobe:
Beryliosis
Radiation
Extrinsic allergic alveolitis
Ankylosing spondylitis
Sarcoidosis
TB
� Lower lobe:
Systemic sclerosis
Cryptogenic fibrosing alveolitis
Asbestosis
Radiation
Gout vs. pseudogout: crystal lab findings Pseduogout
crystals are:
Positive birefringent
Polygon shaped
� Gout therefore is the negative needle shaped crystals.
� Also, gout classically strikes great Toe, and its hallmark is Tophi.
crystals are:
Positive birefringent
Polygon shaped
� Gout therefore is the negative needle shaped crystals.
� Also, gout classically strikes great Toe, and its hallmark is Tophi.
Pulmonary embolism: risk factors 7 H's:
Hereditary (eg factor V Leyden, protein C or S deficiency)
History (previous DVT or PE)
Hypomobility (fracture, CVA, severe illness, obesity, long trip)
Hypovolaemia (nephrotic syndrome, dehydration)
Hypercoagulability (smoking, malignancy)
Hormones (oestrogens [esp. in OCP], puerperium)
Hyperhomocysteinaemia
Hereditary (eg factor V Leyden, protein C or S deficiency)
History (previous DVT or PE)
Hypomobility (fracture, CVA, severe illness, obesity, long trip)
Hypovolaemia (nephrotic syndrome, dehydration)
Hypercoagulability (smoking, malignancy)
Hormones (oestrogens [esp. in OCP], puerperium)
Hyperhomocysteinaemia
APKD: signs, complications, accelerators 11 B's:
� Signs:
Bloody urine
Bilateral pain [vs. stones, which are usually unilateral pain]
Blood pressure up
Bigger kidneys
Bumps palpable
� Complications:
Berry aneurysm
Biliary cysts
Bicuspid valve [prolapse and other problems]
� Accelerators:
Boys
Blacks
Blood pressure high
� Signs:
Bloody urine
Bilateral pain [vs. stones, which are usually unilateral pain]
Blood pressure up
Bigger kidneys
Bumps palpable
� Complications:
Berry aneurysm
Biliary cysts
Bicuspid valve [prolapse and other problems]
� Accelerators:
Boys
Blacks
Blood pressure high
Barter's syndrome: pathogenesis, major sign Barter: "In
exchange for giving away Na+,K+,Cl-, you can drop the blood pressure".
exchange for giving away Na+,K+,Cl-, you can drop the blood pressure".
Thyrotoxicosis syndrome: signs and symptoms "A Penny
For Every Symptom That Hyperthyroidism Will
Make Grossly Evident":
Anxiety
Palpitations/ Pulse rapid
Fatigability
Emotional lability
Sweating
Tremor
Heat intolerance
Weight loss with good appetite
Muscular weakness/ Menstrual changes
Goitre
Eye changes
For Every Symptom That Hyperthyroidism Will
Make Grossly Evident":
Anxiety
Palpitations/ Pulse rapid
Fatigability
Emotional lability
Sweating
Tremor
Heat intolerance
Weight loss with good appetite
Muscular weakness/ Menstrual changes
Goitre
Eye changes
Peptic ulcer: associated causative factors SHAZAM:
Smoking
Hypercalcemia
Aspirin
Zollinger-Ellison
Acidity
MEN type I
� These may work with H. pylori to promote ulceration, or may act alone.
Smoking
Hypercalcemia
Aspirin
Zollinger-Ellison
Acidity
MEN type I
� These may work with H. pylori to promote ulceration, or may act alone.
Carcinoid syndrome: components CARCinoid:
Cutaneous flushing
Asthmatic wheezing
Right sided valvular heart lesions
Cramping and diarrhea
Cutaneous flushing
Asthmatic wheezing
Right sided valvular heart lesions
Cramping and diarrhea
Anemia causes (simplified) ANEMIA:
Anemia of chronic disease
No folate or B12
Ethanol
Marrow failure & hemaglobinopathies
Iron deficient
Acute & chronic blood loss
Anemia of chronic disease
No folate or B12
Ethanol
Marrow failure & hemaglobinopathies
Iron deficient
Acute & chronic blood loss
Gynecomastia: causes DaLAS:
Digitalis
Leydig cell tumors
Alcohol
Sertoli cell tumors
Digitalis
Leydig cell tumors
Alcohol
Sertoli cell tumors
Pick's disease: location, action, epidemiology � See figure.
Pick axes are Picking away at the old woman's cerebral cortex,
causing cortical atrophy.
2 pick axes on her brain: frontal lobe and anterior 1/3 of temporal.
An old woman, since epidemiology is elderly & more common in women.
Pick axes are Picking away at the old woman's cerebral cortex,
causing cortical atrophy.
2 pick axes on her brain: frontal lobe and anterior 1/3 of temporal.
An old woman, since epidemiology is elderly & more common in women.
Multiple sclerosis (MS): pathology MS attacks the
Myelin Sheath, resulting in plaques.
Myelin Sheath, resulting in plaques.
Nasopharyngeal malignant cancers NASOPharyngeal:
Nasophayngeal
Adenocarcinoma
Squamous cell carcinoma
Olfactory neuroblastoma
Plasmacytoma
Nasophayngeal
Adenocarcinoma
Squamous cell carcinoma
Olfactory neuroblastoma
Plasmacytoma
Acute ischemia: signs [especially limbs] 6 P's:
Pain
Pallor
Pulselessness
Paralysis
Paraesthesia
Perishingly cold
Pain
Pallor
Pulselessness
Paralysis
Paraesthesia
Perishingly cold
Hodgkin's lymphoma classification A: Asymptomatic
B: Bad
B: Bad
Lichen planus characteristics Planus has 4 P's:
Peripheral
Polygonal
Pruritus
Purple
Peripheral
Polygonal
Pruritus
Purple
Hypertension: secondary hypertension causes CHAPS:
Cushing's syndrome
Hyperaldosteronism [aka Conn's syndrome]
Aorta coarctation
Phaeochromocytoma
Stenosis of renal arteries
� Note: only 5% of hypertension cases are secondary, rest are primary.
Cushing's syndrome
Hyperaldosteronism [aka Conn's syndrome]
Aorta coarctation
Phaeochromocytoma
Stenosis of renal arteries
� Note: only 5% of hypertension cases are secondary, rest are primary.
Hepatomegaly: 3 common causes, 3 rarer causes Common are 3
C's:
Cirrhosis
Carcinoma
Cardiac failure
Rarer are 3 C's:
Cholestasis
Cysts
Cellular infiltration
C's:
Cirrhosis
Carcinoma
Cardiac failure
Rarer are 3 C's:
Cholestasis
Cysts
Cellular infiltration
MI: sequence of elevated enzymes after MI "C-AST-Le"
(castle):
CK-MB first
AST second
LDH third
� Also: can use the last 'E' for ESR.
(castle):
CK-MB first
AST second
LDH third
� Also: can use the last 'E' for ESR.
Pulmonary embolism: risk factors TOM SCHREPFER:
Trauma
Obesity
Malignancy
Surgery
Cardiac disease
Hospitalization
Rest [bed-ridden]
Elderly
Past history
Fracture
Estrogen [pregnancy, post-partum]
Road trip
Trauma
Obesity
Malignancy
Surgery
Cardiac disease
Hospitalization
Rest [bed-ridden]
Elderly
Past history
Fracture
Estrogen [pregnancy, post-partum]
Road trip
TB: features TB is characterised by 4 C's:
Caseation
Calcification
Cavitation
Cicatrization
Caseation
Calcification
Cavitation
Cicatrization
Gallstones/cholecystitis: risk factors 5 F's:
Fat
Female
Family history
Fertile
Forty
Fat
Female
Family history
Fertile
Forty
Rheumatoid arthritis: features RHEUMATOID:
Ragocytes/ Rheumatoid factor (anti-IgG)
HLA-DR4/ HLA-Dw4
ESR increase/ Extra-articular features (restrictive lung disease,
subcutaneous nodules)
Ulnar deviation
Morning stiffness/ MCP joint
Ankylosis/ Atlantoaxial joint subluxation/ Autoimmune/ ANA
T-cells (CD4)/ TNF
Osteopenia
Inflammatory synovial tissue/ Idiopathic/ IL-1
Deformities (swan-neck, boutonniere)
Ragocytes/ Rheumatoid factor (anti-IgG)
HLA-DR4/ HLA-Dw4
ESR increase/ Extra-articular features (restrictive lung disease,
subcutaneous nodules)
Ulnar deviation
Morning stiffness/ MCP joint
Ankylosis/ Atlantoaxial joint subluxation/ Autoimmune/ ANA
T-cells (CD4)/ TNF
Osteopenia
Inflammatory synovial tissue/ Idiopathic/ IL-1
Deformities (swan-neck, boutonniere)
Neuroblastoma: features N-MYC:
Nuclei have "double minutes"
Malignant
Young
Catecholamine secreting
� And hallmark is n-mycamplification.
Nuclei have "double minutes"
Malignant
Young
Catecholamine secreting
� And hallmark is n-mycamplification.
Lou Gehrig's is both upper and lower motor neuron signs LoU
= Lower & Upper.
= Lower & Upper.
Dandy-Walker syndrome: components "Dandy Walker
Syndrome":
Dilated 4th ventricle
Water on the brain
Small vermis
Syndrome":
Dilated 4th ventricle
Water on the brain
Small vermis
Cerebral palsy: general features PALSY:
Paresis
Ataxia
Lagging motor development
Spasticity
Young
Paresis
Ataxia
Lagging motor development
Spasticity
Young
Von Hippel-Lindau: signs and symptoms HIPPEL:
Hemanigoblastomas
Increased renal cancer
Pheochromocytoma
Port-wine stains
Eye dysfunction
Liver, pancreas, kidney cysts
� Bare bones version: Hippel-Lindau, with H and L as above.
Hemanigoblastomas
Increased renal cancer
Pheochromocytoma
Port-wine stains
Eye dysfunction
Liver, pancreas, kidney cysts
� Bare bones version: Hippel-Lindau, with H and L as above.
Bronchial obstruction: consequences APPLE BABE:
Atelectasis
Pleural adhesions
Pleuritis
Lipid pneumonia
Effusion->organisation->fibrosis
Bronchiectasis
Abscess
Broncho and lobar pneumonia
Emphysema
Atelectasis
Pleural adhesions
Pleuritis
Lipid pneumonia
Effusion->organisation->fibrosis
Bronchiectasis
Abscess
Broncho and lobar pneumonia
Emphysema
Marble bone disease: signs and symptoms MARBLES:
Multiple fractures
Anemia
Restricted cranial nerves
Blind & deaf
Liver enlarged
Erlenmeyer flask deformity
Splenomegaly
� Eponymous name: Marbles = Albers-Schonberg (anagram).
Multiple fractures
Anemia
Restricted cranial nerves
Blind & deaf
Liver enlarged
Erlenmeyer flask deformity
Splenomegaly
� Eponymous name: Marbles = Albers-Schonberg (anagram).
Heart failure causes "HEART MAy DIE":
Hypertension
Embolism
Anemia
Rheumatic heart disease
Thyrotoxicosis (incl. pregnancy)
Myocardial infarct
Arrythmia
Y
Diet & lifestyle
Infection
Endocarditis
Hypertension
Embolism
Anemia
Rheumatic heart disease
Thyrotoxicosis (incl. pregnancy)
Myocardial infarct
Arrythmia
Y
Diet & lifestyle
Infection
Endocarditis
Renal failure: causes AVID GUT:
Acute tubular necrosis
Vascular obstruction
Infection
Diffuse intravascular coagulation
Glomerular disease
Urinary obstruction
Tubulointerstitial nephritis
Acute tubular necrosis
Vascular obstruction
Infection
Diffuse intravascular coagulation
Glomerular disease
Urinary obstruction
Tubulointerstitial nephritis
Multiple endocrine neoplasia III: components MEN
III is a disease of 3 M's:
Medullary thyroid carcinoma
Medulla of adrenal (pheochromocytoma)
Mucosal neuroma
III is a disease of 3 M's:
Medullary thyroid carcinoma
Medulla of adrenal (pheochromocytoma)
Mucosal neuroma
Ulcerative colitis: features ULCERATIONS:
Ulcers
Large intestine
Carcinoma [risk]
Extraintestinal manifestations
Remnants of old ulcers [pseudopolyps]
Abscesses in crypts
Toxic megacolon [risk]
Inflamed, red, granular mucosa
Originates at rectum
Neutrophil invasion
Stools bloody
Ulcers
Large intestine
Carcinoma [risk]
Extraintestinal manifestations
Remnants of old ulcers [pseudopolyps]
Abscesses in crypts
Toxic megacolon [risk]
Inflamed, red, granular mucosa
Originates at rectum
Neutrophil invasion
Stools bloody
Virchow's triad (venous thrombosis) "VIRchow":
Vascular trauma
Increased coagulability
Reduced blood flow (stasis)
Vascular trauma
Increased coagulability
Reduced blood flow (stasis)
Pyrogenic meningitis: likeliest bug in age group "Explaining
Hot Neck Stiffness":
� In order from birth to death:
E. coli [infants]
Haemophilus influenzae [older infants, kids]
Neisseria meningitis [young adults]
Streptococcus pneumoniae [old folks]
Hot Neck Stiffness":
� In order from birth to death:
E. coli [infants]
Haemophilus influenzae [older infants, kids]
Neisseria meningitis [young adults]
Streptococcus pneumoniae [old folks]
Endometrial carcinoma: risk factors ENDOMET:
Elderly
Nulliparity
Diabetes
Obesity
Menstrual irregularity
Estrogen therapy
hyperTension
Elderly
Nulliparity
Diabetes
Obesity
Menstrual irregularity
Estrogen therapy
hyperTension
Polycystic ovary: morphology, presentation � Morphology is
poly-C:
Cysts
Capsule thickened
Cortical stromal fibrosis
� Clinical presentation is OVARY:
Obese
Virilism or hirsutism
Amenorrhoea
Reproductive problem [infertile]
Young woman
poly-C:
Cysts
Capsule thickened
Cortical stromal fibrosis
� Clinical presentation is OVARY:
Obese
Virilism or hirsutism
Amenorrhoea
Reproductive problem [infertile]
Young woman
Parkinson's disease: symptoms PQRST:
Paucity of expression
parQinson
Rigidity (cogwheel)
Stooped posture
Tremor at rest
� If can't remember that Parkinson's tremor is the one that is "resting tremor",
look at the last 3 letters: RST.
Paucity of expression
parQinson
Rigidity (cogwheel)
Stooped posture
Tremor at rest
� If can't remember that Parkinson's tremor is the one that is "resting tremor",
look at the last 3 letters: RST.
Kawasaki disease: features Disease name: a Kawasaki
motorcycle.
Usually young children, epidemic in Japan: Japanese child rides the motorcycle.
Conjunctival, oral erythema: red eyes, mouth.
Fever: thermometer.
Erythema of palms, soles: red palms, soles.
Generalized rash: rash dots.
Cervical lymphadenitis: enlarged cervical nodes with inflammation arrows.
Vasculitis of arteries: inflammation arrows on arteries.
Cardiovascular sequelae [20%]: inflammation arrows on cardiac arteries.
Treat with aspirin: aspirin headlight.
motorcycle.
Usually young children, epidemic in Japan: Japanese child rides the motorcycle.
Conjunctival, oral erythema: red eyes, mouth.
Fever: thermometer.
Erythema of palms, soles: red palms, soles.
Generalized rash: rash dots.
Cervical lymphadenitis: enlarged cervical nodes with inflammation arrows.
Vasculitis of arteries: inflammation arrows on arteries.
Cardiovascular sequelae [20%]: inflammation arrows on cardiac arteries.
Treat with aspirin: aspirin headlight.
Interstitial lung disease: causes SARCOIDI:
Sarcoidosis
Allergic reaction
Radiation
Connective tissue disease
Occupational exposure
Infection
Drugs
Idiopathic
Sarcoidosis
Allergic reaction
Radiation
Connective tissue disease
Occupational exposure
Infection
Drugs
Idiopathic
Herpes I and II: lab findings. She's an odd chick: whenever
she's in a restaurant, she always orders Her Peas and Cow
dry.
Herpes I and II have CowdryType A inclusion bodies
she's in a restaurant, she always orders Her Peas and Cow
dry.
Herpes I and II have CowdryType A inclusion bodies
Emphysema: types, most important feature of each "Cigarettes
Is Primary Problem":
� Types:
Centrilobular
Irregular
Pancinar
Paraseptal
� Most important feature for each type (in order as above):
Cigarrettes
Inflammation healed to scar
Protease inhibitor deficiency (a1-antitrypsin)
Pneumothorax
� "Cigarettes is primary problem" used since cigarettes is most common cause of
emphysema.
� Keeping P's straight: Pan is antitrypsin.
Is Primary Problem":
� Types:
Centrilobular
Irregular
Pancinar
Paraseptal
� Most important feature for each type (in order as above):
Cigarrettes
Inflammation healed to scar
Protease inhibitor deficiency (a1-antitrypsin)
Pneumothorax
� "Cigarettes is primary problem" used since cigarettes is most common cause of
emphysema.
� Keeping P's straight: Pan is antitrypsin.
Calcification: metastatic vs. dystrophic Metastatic:
Metabolism imbalance.
Dystrophic: Damaged tissue.
Metabolism imbalance.
Dystrophic: Damaged tissue.
Haemochromatosis definition, classic triad "Iron man triathalon":
Iron man: deposition of iron in many body tissues.
� Triathalon has 3 components, which match triad:
Swimming: Skin pigmentation
Biking: Bronze diabetes
Marathon: Micronodular pigment cirrhosis
Iron man: deposition of iron in many body tissues.
� Triathalon has 3 components, which match triad:
Swimming: Skin pigmentation
Biking: Bronze diabetes
Marathon: Micronodular pigment cirrhosis
COPD: 4 types and hallmark ABCDE:
Asthma
Brochiectasis
Chronic bronchitis
Dyspnea [hallmark of group]
Emphysema
� Alternatively: replace Dyspnea with Decreased FEV1/FVC ratio.
Asthma
Brochiectasis
Chronic bronchitis
Dyspnea [hallmark of group]
Emphysema
� Alternatively: replace Dyspnea with Decreased FEV1/FVC ratio.
MEN I (Multiple Endocrine Neoplasia) syndrome: components "Please
Please Pay Attention To peptic ulceration,
you worms":
� Adenomas of:
Pituatary
Pancreatic islets
Parathyroid
Adrenal cortex
Thyroid, associated with peptic ulceration
� Syndrome is called "Wermer's syndrome".
Please Pay Attention To peptic ulceration,
you worms":
� Adenomas of:
Pituatary
Pancreatic islets
Parathyroid
Adrenal cortex
Thyroid, associated with peptic ulceration
� Syndrome is called "Wermer's syndrome".
Lung cancer: presentation ABCDE:
Snowball turned to Avalanche
Blood: hemoptysis
Cough
Distruption to airway in bronchus-->pneumonia
whEEzing
Snowball turned to Avalanche
Blood: hemoptysis
Cough
Distruption to airway in bronchus-->pneumonia
whEEzing
Deep venous thrombosis: diagnosis DVT:
Dilated superficial veins/ Discoloration/ Doppler
ultrasound
Venography is gold standard
Tenderness of Thigh and calf
Dilated superficial veins/ Discoloration/ Doppler
ultrasound
Venography is gold standard
Tenderness of Thigh and calf
Addison's disease: features ADDISON:
Autoimmune
DIC (meningcoccus)
Destruction by cancer, infection, vascular insufficiency
Iatrogenic
Sarcoidosis, granulomatous such as TB histiomycosis
hypOtension/ hypOnatermia
Nelson's syndrome [post adrelectomy, increased ACTH]
Autoimmune
DIC (meningcoccus)
Destruction by cancer, infection, vascular insufficiency
Iatrogenic
Sarcoidosis, granulomatous such as TB histiomycosis
hypOtension/ hypOnatermia
Nelson's syndrome [post adrelectomy, increased ACTH]
Breast cancer: risk assessment "Risk can be assessed by
History ALONE":
History (family, previous episode)
Abortion/ Age (old)
Late menopause
Obesity
Nulliparity
Early menarche
History ALONE":
History (family, previous episode)
Abortion/ Age (old)
Late menopause
Obesity
Nulliparity
Early menarche
McArdle's syndrome MCARDLES:
Myoglobinuria
Cramping after exercise
Accumulated glycogen
Recessive inheritance
Deficiency of muscle phosphorylase
Lactate levels fail to rise
Elevated creatine kinase
Skeletal muscle only
Myoglobinuria
Cramping after exercise
Accumulated glycogen
Recessive inheritance
Deficiency of muscle phosphorylase
Lactate levels fail to rise
Elevated creatine kinase
Skeletal muscle only
Respiratory distress syndrome in infants: major risk factors
PCD (Primary Ciliary Dyskinesia, a cause of Respiratory distress
syndrome):
Prematurity
Cesarean section
Diabetic mother
PCD (Primary Ciliary Dyskinesia, a cause of Respiratory distress
syndrome):
Prematurity
Cesarean section
Diabetic mother
Deep venous thrombosis: genetic causes ALASCA:
Antithrombin III
Leiden (Factor V)
APC (Activated Protein C)
S-protein deficiency
C-protein deficiency
Antiphospholipid antibody
Antithrombin III
Leiden (Factor V)
APC (Activated Protein C)
S-protein deficiency
C-protein deficiency
Antiphospholipid antibody
Carcinomas having tendency to metastasize to bone "Particular
Tumours Love Killing Bone":
Prostate
Thyroid
Lung
Kidney
Breast
Tumours Love Killing Bone":
Prostate
Thyroid
Lung
Kidney
Breast
Cushing syndrome CUSHING:
Central obesity/ Cervical fat pads/ Collagen fiber
weakness/ Comedones (acne)
Urinary free corisol and glucose increase
Striae/ Suppressed immunity
Hypercortisolism/ Hypertension/ Hyperglycemia/ Hirsutism
Iatrogenic (Increased administration of corticosteroids)
Noniatrogenic (Neoplasms)
Glucose intolerance/ Growth retardation
Central obesity/ Cervical fat pads/ Collagen fiber
weakness/ Comedones (acne)
Urinary free corisol and glucose increase
Striae/ Suppressed immunity
Hypercortisolism/ Hypertension/ Hyperglycemia/ Hirsutism
Iatrogenic (Increased administration of corticosteroids)
Noniatrogenic (Neoplasms)
Glucose intolerance/ Growth retardation
Apoptosis vs. necrosis "LIFELESS" (since cells are
dead):
� Differences are in:
Leaky membranes
Inflammatory response
Fate
Extent
Laddering
Energy dependent
Swell or shrink
Stimulus
dead):
� Differences are in:
Leaky membranes
Inflammatory response
Fate
Extent
Laddering
Energy dependent
Swell or shrink
Stimulus
Diabetic ketoacidosis: I vs. II ketONE bodies are
seen in type ONEdiabetes.
seen in type ONEdiabetes.
Baldness risk factors "Daddy Doesn't Deny
Getting Hair Implants":
Diet
Disease
Drugs
Genes
Hormones
Injury to the scalp
Getting Hair Implants":
Diet
Disease
Drugs
Genes
Hormones
Injury to the scalp
Tabes Dorsalis morphology DORSALIS:
Dorsal column degeneration
Orthopedic pain (Charcot joints)
Reflexes decreased (deep tendon)
Shooting pain
Argyll-Robertson pupils
Locomotor ataxia
Impaired proprioception
Syphilis
Dorsal column degeneration
Orthopedic pain (Charcot joints)
Reflexes decreased (deep tendon)
Shooting pain
Argyll-Robertson pupils
Locomotor ataxia
Impaired proprioception
Syphilis
Buerger's disease features "burger SCRAPS":
Segmenting thrombosing vasculitis
Claudication (intermittent)
Raynaud's phenomenon
Associated with smoking
Pain, even at rest
Superficial nodular phlebitis
� Alternatively, if hungry for more detail [sic], "CRISP PIG burgers":
Chronic ulceration
Raynaud's phenomenon
Intermittent claudication
Segmenting, thrombosing vasculitis
Pain, even at rest
Phlebitis (superficial nodular)
Idiopathic
Gangrene
Segmenting thrombosing vasculitis
Claudication (intermittent)
Raynaud's phenomenon
Associated with smoking
Pain, even at rest
Superficial nodular phlebitis
� Alternatively, if hungry for more detail [sic], "CRISP PIG burgers":
Chronic ulceration
Raynaud's phenomenon
Intermittent claudication
Segmenting, thrombosing vasculitis
Pain, even at rest
Phlebitis (superficial nodular)
Idiopathic
Gangrene
PKU findings PKU:
Pale hair, skin
Krazy (neurological abnormalities)
Unpleasant smell
Pale hair, skin
Krazy (neurological abnormalities)
Unpleasant smell
Atherosclerosis risk factors SHIFT MAID:
Smoking
Hypertension
(N)IDDM
Family history
Triglycerdides & fats
Male
Age
Inactivity
Diet / Drink
Smoking
Hypertension
(N)IDDM
Family history
Triglycerdides & fats
Male
Age
Inactivity
Diet / Drink
Parkinsonism: essential features TRAPS:
Tremor (resting tremor)
Rigidity
Akinesia
Postural changes (stooped)
Stare (serpentine stare)
� To remember what kind of tremor and postural change, can look at letter that
follows in TRAPS: Tremor is Resting, Posture is Stooped.
Tremor (resting tremor)
Rigidity
Akinesia
Postural changes (stooped)
Stare (serpentine stare)
� To remember what kind of tremor and postural change, can look at letter that
follows in TRAPS: Tremor is Resting, Posture is Stooped.
Thrombus: possible fates DOPE:
Dissolution
Organization & repair
Propagation
Embolization
Dissolution
Organization & repair
Propagation
Embolization
Turner syndrome: components CLOWNS:
Cardiac abnormalities (specifically Coartication)
Lymphoedema
Ovaries underdeveloped (causing sterility, amenorrhea)
Webbed neck
Nipples widely spaced
Short
Cardiac abnormalities (specifically Coartication)
Lymphoedema
Ovaries underdeveloped (causing sterility, amenorrhea)
Webbed neck
Nipples widely spaced
Short
MI: sequence of elevated enzymes after MI "Time to
CALL 911":
� From first to appear to last:
Troponin
CK-MB
AST
LDH1
CALL 911":
� From first to appear to last:
Troponin
CK-MB
AST
LDH1
Wiskott-Aldrich syndrome: symptom triad "PET WASP":
Pyrogenic infections
Eczema
Thrombocytopenia
� WASP is the name of the causitive agent: Wiskott-Aldrich Syndrome Protein.
� Alternatively: Wiskott=Hot, Aldrich=Itch, Syndrom=Throm.
Pyrogenic infections
Eczema
Thrombocytopenia
� WASP is the name of the causitive agent: Wiskott-Aldrich Syndrome Protein.
� Alternatively: Wiskott=Hot, Aldrich=Itch, Syndrom=Throm.
Sarcoidosis summarized SARCOIDOISIS:
Schaumann calcifications
Asteroid bodies/ [ACE] increase/ Anergy
Respiratory complications/ Renal calculi/ Restrictive lung
disease/ Restrictive cardiomyopathy
Calcium increase in serum and urine/ CD4 helper cells
Ocular lesions
Immune mediated noncaseating granulomas/ [Ig] increase
Diabetes insipidus/ [D vit.] increase/ Dyspnea
Osteopathy
Skin (Subcutaneous nodules, erythema nodosum)
Interstitial lung fibrosis/ IL-1
Seventh CN palsy
Schaumann calcifications
Asteroid bodies/ [ACE] increase/ Anergy
Respiratory complications/ Renal calculi/ Restrictive lung
disease/ Restrictive cardiomyopathy
Calcium increase in serum and urine/ CD4 helper cells
Ocular lesions
Immune mediated noncaseating granulomas/ [Ig] increase
Diabetes insipidus/ [D vit.] increase/ Dyspnea
Osteopathy
Skin (Subcutaneous nodules, erythema nodosum)
Interstitial lung fibrosis/ IL-1
Seventh CN palsy
Blood disorders: commoner sex HE (male) gets:
HEmophilia (X-linked)
HEinz bodies (G6PD deficiency, causing HEmolytic anemia: X-linked)
HEmochromatosis (male predominance)
HEart attacks (male predominance)
HEnoch-Schonlein purpura (male predominance)
SHE (female) gets:
SHEehan's syndrome
HEmophilia (X-linked)
HEinz bodies (G6PD deficiency, causing HEmolytic anemia: X-linked)
HEmochromatosis (male predominance)
HEart attacks (male predominance)
HEnoch-Schonlein purpura (male predominance)
SHE (female) gets:
SHEehan's syndrome
Thyroid storm characteristics "Storm HITS girls cAMP":
Thyroid storm due to:
Hyperthyroidism
Infection or Illness at childbirth
Trauma
Surgery
� girls: Thyroid storm more common in females.
� cAMP: Tx involves high dose of beta blockers (beta receptors work via
cAMP)
� Alternatively: "S#IT storm": Surgery, Hyperthyroidism,
Infection/ Illness, Trauma.
Thyroid storm due to:
Hyperthyroidism
Infection or Illness at childbirth
Trauma
Surgery
� girls: Thyroid storm more common in females.
� cAMP: Tx involves high dose of beta blockers (beta receptors work via
cAMP)
� Alternatively: "S#IT storm": Surgery, Hyperthyroidism,
Infection/ Illness, Trauma.
Hypothyroidism/thyroiditis: maifestations and morphology "A
SCHISM among the Axis during WWII":
Addison disease
Subacute thyroiditis
Cretinism/ Cold intolerance/ Constipation
Hashimoto's disease
Infectious-subacute thyroiditis
Silent thyroiditis
Myxedema coma
� The Axis: Schimidt syndrome (when other endocrinology disorders accompany
Hashimoto's disease) and "Hitler cells" (Hurthle cells, which are follicular
epithelial cells with basophilic inculsions)
SCHISM among the Axis during WWII":
Addison disease
Subacute thyroiditis
Cretinism/ Cold intolerance/ Constipation
Hashimoto's disease
Infectious-subacute thyroiditis
Silent thyroiditis
Myxedema coma
� The Axis: Schimidt syndrome (when other endocrinology disorders accompany
Hashimoto's disease) and "Hitler cells" (Hurthle cells, which are follicular
epithelial cells with basophilic inculsions)
Pheochromocytoma: 3 most common symptoms "PHEochromocytoma":
Palpitations
Headache
Edisodic sweating (diaphoresis)
Palpitations
Headache
Edisodic sweating (diaphoresis)
Necrosis: the 4 types "Life Can Get
Complicated":
Liquifactive
Coagulation
Gangrene
Caseous
� 'Life' used since necrosis is 'death'.
Complicated":
Liquifactive
Coagulation
Gangrene
Caseous
� 'Life' used since necrosis is 'death'.
Thyroid carcinoma: features, prognosis of most popular Most
Popular is Papillary.
� Clinical features:
Papillae (branching)
Palpable lymph nodes
"Pupil" nuclei (Orphan Annie)
Psammoma bodies within lesion (often)
� Also, has a Positive Prognosis (10 year survival rate: 98%).
Popular is Papillary.
� Clinical features:
Papillae (branching)
Palpable lymph nodes
"Pupil" nuclei (Orphan Annie)
Psammoma bodies within lesion (often)
� Also, has a Positive Prognosis (10 year survival rate: 98%).
Inflammatory Bowel Disease: which has cobblestones Crohn's
has Cobblestones on endoscopy.
has Cobblestones on endoscopy.
Gout: factors that can precipitate an attack of acute gouty arthritis
DARK:
Diuretics
Alcohol
Renal disease
Kicked (trauma)
� And, the attack occurs most often at night [thus "dark"].
DARK:
Diuretics
Alcohol
Renal disease
Kicked (trauma)
� And, the attack occurs most often at night [thus "dark"].
Paget's disease of bone: signs and symptoms Four L's:
Larger hat size
Loss of hearing: due to compression of nerve
Leontiasis ossea (lion-like face)
Light-headed (Paget's steal)
Larger hat size
Loss of hearing: due to compression of nerve
Leontiasis ossea (lion-like face)
Light-headed (Paget's steal)
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