Proud Dead Guys and Other Diseases

Addison’s Disease primary adrenocortical deficiency

Addisonian Anemia pernicious anemia (antibodies to intrinsic factor or parietal cells IF Vit B12 megaloblastic anemia)
Albright’s Syndrome polyostotic fibrous dysplasia, precocious puberty, café au lait spots, short stature, young girls
Alport’s Syndrome hereditary nephritis with nerve deafness, Type 4 collagen defect (basement membranes)
Alzheimer’s progressive dementia; tau proteins, neurofibrillary tangles, apolipoprotein E4 allele, narrow gyri and wide sulci
(atrophy), occipital sparing, hydrocephalus ex vacuo, plaques in hippocampus and cortex, ↓Acetylcholine, Hiramo
bodies (inrtacellular inclusion bodies in hippocampal cells)
Argyll-Robertson Pupil loss of light reflex constriction (contralateral or bilateral)
“Prostitute’s Eye” - accommodates but does not react
Pathognomonic for 3 Syphilis
Arnold-Chiari Malformation cerebellar tonsil herniation
Barrett’s columnar metaplasia of lower esophagus ( risk of adenocarcinoma)
Bartter’s Syndrome hyperreninemia
Becker’s Muscular Dystrophy similar to Duchenne, but less severe (deficiency in dystrophin protein)
Bell’s Palsy CNVII palsy (entire face; recall that UMN lesion only affects lower face)
Berger’s Disease IgA nephropathy
Bernard-Soulier Disease defect in platelet adhesion (abnormally large platelets & lack of platelet-surface glycoprotein)
Berry Aneurysm circle of Willis (subarachnoid bleed)
often associated with ADPKD
Bowen’s Disease carcinoma in situ on shaft of penis ( risk of visceral ca)
Briquet’s Syndrome somatization disorder
psychological: multiple physical complaints without physical pathology
Broca’s Aphasia Motor Aphasia intact comprehension
Bronchiolitis RSV
Brown-Sequard hemisection of cord (contralateral loss of pain & temp / ipsilateral loss of fine touch, UMN)
Bruton’s Disease X-linked agammaglobinemia
Budd-Chiari post-hepatic venous thrombosis
Buerger’s Disease acute inflammation of small, medium arteries → painful ischemia → gangrene
Burkitt’s Lymphoma small noncleaved cell lymphoma EBV
8:14 translocation
Caisson Disease gas emboli
Carpal Tunnel Syndrome Median nerve entrapment
Chagas’ Disease Trypansoma infection sleeping disease, cardiomegaly with apical atrophy, achlasia
Chediak-Higashi Disease Phagocyte Deficiency: neutropenia, albinism, cranial & peripheral neuropathy
repeated infections
Congenital adrenal hyperplasia 21-hydroxylase deficiency: virilism, no cortisol, salt loss, hypotension
11-hydroxylase deficiency: virilism, no cortisol, salt retention, hypertension
Conn’s Syndrome primary aldosteronism
Cori’s Disease glycogen storage disease (debranching enzyme deficiency)
Creutzfeldt-Jakob prion infection → cerebellar & cerebral degeneration
Crigler-Najjar Syndrome congenital hyperbilirubinemia (unconjugated)
glucuronyl transferase deficiency
Crohn’s IBD; ileocecum, transmural, skip lesions, lymphocytic infiltrate, granulomas
(contrast to UC: limited to colon, mucosa & submucosa, crypt abscesses, pseudopolyps, colon cancer risk)
Croup Parainfluenza
Curling’s Ulcer acute gastric ulcer associated with severe burns
Cushing’s Disease: hypercorticism 2° to ACTH from pituitary (basophilic adenoma)
Syndrome: hypercorticism of all other causes (1° adrenal or ectopic)
Cushing’s Ulcer acute gastric ulcer associated with CNS trauma
de Quervain’s Thyroiditis self-limiting focal destruction (subacute thyroiditis)
DiGeorge’s Syndrome thymic hypoplasia → T-cell deficiency
hypoparathyroidism
Down’s Syndrome trisomy 21 or translocation
Dressler’s Syndrome Post-MI Fibrinous Pericarditis autoimmune
Dubin-Johnson Syndrome congenital hyperbilirubinemia (conjugated)
striking brown-to-black discoloration of the liver
Duchenne Muscular Dystrophy deficiency of dystrophin protein → MD X-linked recessive
Edwards’ Syndrome trisomy 18
rocker-bottom feet, low ears, heart disease
Ehler’s-Danlos defective collagen
Eisenmenger’s Complex late cyanotic shunt (R L) pulmonary HTN & RVH 2to long-standing VSD, ASD, or PDA
Erb-Duchenne Palsy trauma to superior trunk of brachial plexus Waiter’s Tip
Ewing Sarcoma undifferentiated round cell tumor of bone
Eyrthroplasia of Queyrat carcinoma in situ on glans penis
Fanconi’s Syndrome impaired proximal tubular reabsorption 2° to lead poisoning or Tetracycline (glycosuria, hyperphosphaturia, aminoaciduria,
systemic acidosis)
Felty’s Syndrome rheumatoid arthritis, neutropenia, splenomegaly
Gardner’s Syndrome adenomatous polyps of colon plus osteomas & soft tissue tumors
Gaucher’s Disease Lysosomal Storage Disease glucocerebrosidase deficiency
hepatosplenomegaly, femoral head & long bone erosion, anemia
Crinkled tissue paper cells in marrow
Gilbert’s Syndrome benign congenital hyperbilirubinemia (unconjugated)
GIST Tumor arising in cells of Cajal (pacemakers of gut)
Glanzmann's Thrombasthenia defective glycoproteins on platelets
Goodpasture’s autoimmune: ab’s to glomerular & alveolar basement membranes; linear immunofluorescence
Grave’s Disease autoimmune hyperthyroidism (TSI)
Guillain-Barre idiopathic polyneuritis (ascending muscle weakness & paralysis; usually self-limiting)
Hamman-Rich Syndrome idiopathic pulmonary fibrosis
Hand-Schuller-Christian chronic progressive histiocytosis
Hashimoto’s Thyroiditis autoimmune hypothyroidism (antimicrosomal or antithyroglobulin); Hurthle cells, thyroid germinal centers,
Hashitoxicosis initial hyperthyroidism in Hashimoto’s Thyroiditis that precedes hypothyroidism
Henoch-Schonlein purpura hypersensivity vasculitis
hemmorhagic urticaria (with fever, arthralgias, GI & renal involvement)
associated with upper respiratory infections
Hereditary Spherocytosis RBC cytoskeletin defect, most commonly spectrin
Hirschprung’s Disease aganglionic megacolon
Horner’s Syndrome ptosis, miosis, anhidrosis (lesion of cervical 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
Jacksonian Seizures epileptic events originating in the primary motor cortex (area 4)
Job’s Syndrome immune deficiency: neutrophils fail to respond to chemotactic stimuli
Kaposi Sarcoma malignant vascular tumor (HHV8 in homosexual men)
Kartagener’s Syndrome immotile cilia 2to defective dynein arms infection, situs inversus, sterility
Kawasaki Disease mucocutaneous lymph node syndrome (lips, oral mucosa)
Keratoconjunctivitis adenovirus
Klinefelter’s Syndrome 47, XXY
Kluver-Bucy bilateral lesions of amygdala (hypersexuality; oral behavior)
Krabbe Disease Beta-galactosidase deficiency
Krukenberg Tumor adenocarcinoma with signet-ring cells (typically originating from the stomach) metastases to the ovaries
Laennec’s Cirrhosis alcoholic cirrhosis
Lesch-Nyhan HGPRT deficiency
gout, retardation, self-mutilation
Letterer-Siwe acute disseminated Langerhans’ cell 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 Syndrome bleeding from esophagogastric lacerations 2° to wretching (alcoholics)
Marfan’s elastin defect, floppy mitral valve, arachnodactyly, cystic medial necrosis, subluxed lens
McArdle’s Disease glycogen storage disease (muscle phosphorylase deficiency)
Meckel’s Diverticulum rule of 2’s: 2 inches long, 2 feet from the ileocecum, in 2% of the population
embryonic duct origin; may contain ectopic tissue (gastric, pancreatic, etc.)
Meig’s Syndrome Triad: ovarian fibroma, ascites, hydrothorax
Menetrier’s Disease giant hypertrophic gastritis (enlarged rugae; plasma protein loss)
Monckeberg’s Arteriosclerosis calcification of the media (usually radial & ulnar aa.), pipestem arteries
Munchausen Syndrome factitious disorder (consciously creates symptoms, but doesn’t know why)
Meningioma Arachnoid cap cells, whorls of cells
Mesothelioma Asbestos exposure
Nelson’s Syndrome 1° Adrenal Cushings → surgical removal of adrenals → loss of negative feedback to pituitary → Pituitary Adenoma
Niemann-Pick Lysosomal Storage Disease sphingomyelinase deficiency
“foamy histiocytes”
Osler-Weber-Rendu Syndrome Hereditary Hemorrhagic Telangiectasia
Osteogenesis imperfecta Type I collagen defect
Paget’s Disease abnormal bone architecture (thickened, numerous 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
Peutz-Jegher’s Syndrome melanin pigmentation of lips, mouth, hand, genitalia plus hamartomatous polyps of small intestine
Peyronie’s Disease subcutaneous fibrosis of dorsum of penis
Pick’s Disease progressive dementia similar to Alzheimer’s, knife-edged gyri
Plummer’s Syndrome hyperthyroidism, nodular goiter, absence of eye signs (Plummer’s = Grave’s - eye signs)
Plummer-Vinson esophageal webs & iron-deficiency anemia, SCCA of esophagus
Pompe’s Disease glycogen storage disease (acid maltase deficiency) → cardiomegaly
Pott’s Disease tuberculous osteomyelitis of the vertebrae
Potter’s Complex renal agenesis → oligohydramnios → hypoplastic lungs, defects in extremities
Raynaud’s Disease: recurrent vasospasm in extremities
Phenomenon: 2° to underlying disease (SLE or scleroderma)
Reiter’s Syndrome urethritis, conjunctivitis, arthritis non-infectious (but often follows infections), HLA-B27, polyarticular
Reye’s Syndrome microvesicular fatty liver change & encephalopathy
2° to aspirin ingestion in children following viral illness
Riedel’s Thyroiditis idiopathic fibrous replacement of thyroid
Rotor Syndrome congenital hyperbilirubinemia (conjugated)
similar to Dubin-Johnson, but no discoloration of the liver
Sezary Syndrome leukemic form of cutaneous T-cell lymphoma (mycosis fungoides)
Shaver’s Disease aluminum inhalation lung fibrosis
Sheehan’s Syndrome postpartum pituitary necrosis
Shy-Drager parkinsonism with autonomic dysfunction & orthostatic hypotension
Simmond’s Disease pituitary cachexia
Sipple’s Syndrome MEN type IIa (pheochromocytoma, thyroid medulla, parathyroid)
Sjogren’s Syndrome triad: dry eyes, dry mouth, arthritis risk of B-cell lymphoma
Spitz Nevus juvenile melanoma (always benign)
Stein-Leventhal polycystic ovary
Stevens-Johnson Syndrome erythema multiforme, fever, malaise, mucosal ulceration (often 2to infection or sulfa drugs)
Struma Ovarii Thyroid teratoma of ovary
Still’s Disease juvenile rheumatoid arthritis (absence of rheumatoid factor)
Takayasu’s arteritis aortic arch syndrome
loss of carotid, radial or ulnar pulses
Tay-Sachs gangliosidosis (hexosaminidase A deficiency → GM2 ganglioside)
Tetralogy of Fallot ➊VSD, ➋overriding aorta, ➌pulmonary artery stenosis, ➍right ventricular hypertrophy
Tourette’s Syndrome involuntary actions, both motor and vocal
Turcot’s Syndrome adenomatous polyps of colon plus CNS tumors
Turner’s Syndrome 45, XO
Typhoid Fever Bradycardia and in white people rose spots on abdomen
Vincent’s Infection “trench mouth” - acute necrotizing ulcerative gingivitis
von Gierke’s Disease glycogen storage disease (G6Pase deficiency)
von Hippel-Lindau hemangioma (or hemangioblastoma)
adenomas of the viscera, especially renal cell carcinoma
defect in VHL tumor suppressor
von Recklinghausen’s neurofibromatosis & café au lait spots & Lisch nodule (iris hamartomas)
von Recklinghausen’s Disease of Bone osteitis fibrosa cystica (“brown tumor”) 2° to hyperparathyroidism
von Willebrand’s Disease defect in platelet adhesion 2° to deficiency in vWF; increased bleeding time and PTT
Waldenstrom’s macroglobinemia proliferation of IgM-producing lymphoid cells
Wallenberg’s Syndrome Posterior Inferior Cerebellar Artery (PICA) thrombosis “Medullary Syndrome”
Ipsilateral: ataxia, facial pain & temp; Contralateral: body pain & temp
Waterhouse-Friderichsen catastrophic adrenal insufficiency 2° to hemorrhagic necrosis (eg, DIC)
often 2° to meningiococcemia
Weber’s Syndrome Paramedian Infarct of Midbrain
Ipsilateral: mydriasis; Contralateral: UMN paralysis (lower face & body)
Wegener’s Granulomatosis necrotizing granulomatous vasculitis of paranasal sinuses, lungs, kidneys, etc.
Weil’s Disease leptospirosis
Wermer’s Syndrome MEN type I (thyroid, parathyroid, adrenal cortex, pancreatic islets, pituitary)
Wernicke’s Aphasia Sensory Aphasia impaired comprehension
Wernicke-Korsakoff Syndrome thiamine deficiency in alcoholics; bilateral mamillary bodies (confusion, ataxia, ophthalmoplegia)
Whipple’s Disease malabsorption syndrome (with bacteria-laden macrophages) & polyarthritis
Wilson’s Disease hepatolenticular degeneration (copper accumulation & decrease in ceruloplasmin)
Wiskott-Aldrich Syndrome immunodeficiency: combined B- &T-cell deficiency (thrombocytopenia & eczema)
Wolff-Chaikoff Effect high iodine level (−)’s thyroid hormone synthesis
Zenker’s Diverticulum esophageal; cricopharyngeal muscles above UES
Zollinger-Ellison gastrin-secreting tumor of pancreas (or intestine) → acid → intractable ulcers

Hallmark Findings (and a few odd items mixed in)

Adhesive arachnoiditis Caused by bacterial meningitis, leads to obstructive hydrocephalus
Albumino-Cytologic Dissociation Guillain-Barre (markedly increased protein in CSF with only modest increase in cell count)
AFP increase Neural tube defects, hepatocellular carcinoma, yolk sac and embryonal carcinoma
AFP decrease Down’s
Amnion nodosum Renal agenesis
Amyloid in thyroid Thyroid medullary carcinoma (calcitonin)
Analgesic abuse Papillary necrosis, esp. in diabetics
Anasarca Minimal change disease
Aneurysmal nodules Polyarteritis nodosa
Angiomyolipoma Tuberous sclerosis
Anosmia Kallman’s syndrome
Anterior vermian atrophy alcoholism
Anti-centromere antibody Limited scleroderma (CREST)
Anti-DNA topoisomerase antibody Diffuse scleroderma
Anti-endomysial antibody Celiac sprue
Anti-jo antibody polymositis
Anti-mitochondrial antibody Primary biliary cirrhosis
Antiplatelet Antibodies idiopathic thrombocytopenic purpura
Anti-sacharommyces cervisiae Crohn’s
antibody
Anti-Smith antibodies Specific for SLE, anti-ribonulceoprotein
Anti-smooth muscle antibody Autoimmune hepatitis type I
Arachnodactyly Marfan’s
Aschoff Bodies rheumatic fever
Ashleaf spots (skin) Tuberous sclerosis
Atypical lymphocytes EBV
Auer Rods acute promyelocytic leukemia (AML type M3)
Autosplenectomy sickle cell anemia
Babinski UMN lesion
Bacterial conjuntivitis S. aureus, strep. pneumo, Hemophilus aegyptius
Basophilic Stippling of RBCs lead poisoning
Bence Jones Protein multiple myeloma free light chains (either kappa or lambda)
Waldenstrom’s macroglobinemia
Bilateral breast cancer Lobular carcinoma
Bilateral renal cell carcinoma Von Hippel-Lindau
Birbeck Granules histiocytosis X (eosinophilic granuloma)
Bladder trabeculation BPH
Bloody nipple discharge Intraductal papilloma
Blueberry muffin baby Rubella
Blue Bloater Chronic Bronchitis
Blue Sclera Osteogenesis imperfecta
Boot-Shaped Heart Tetralogy of Fallot
Bouchard’s Nodes osteoarthritis (PIP)
Boutonniere’s Deformity rheumatoid arthritis
Bronze Diabetes Hemochromatosis
Brown Tumor hyperparathyroidism
Brudzinski sign meningitis
Brushfield Spots Down’s, on iris
Call-Exner Bodies granulosa cell tumor
Carbon monoxide poisoning Hyperemia, edema and necrosis of globus
Cardiomegaly with Apical Atrophy Chagas’ Disease
Central Nuclei in Muscle Muscular dystrophies
Chancre 1° Syphilis, painless firm ulcers
Chancroid Haemophilus ducreyi, painful soft ulcers
Charcot Triad multiple sclerosis (nystagmus, intention tremor, scanning speech)
Charcot-Leyden Crystals bronchial asthma
Cherry-red spot on macula Tay-Sachs, 50% of Niemann-Pick
Cheyne-Stokes Breathing cerebral lesion
Chocolate Cysts endometriosis
Cholesterol clefts atherosclerosis
Chordae tendinae short and fused Rheumatic heart disease
Chronic staph infections Chronic granulomatous disease, a deficiency of NADPH oxidase, can’t kill catalase positive bugs
Chvostek’s Sign Hypocalcemia facial spasm in tetany
Clear nuclei Thyroid papillary carcinoma (Orphan Annie’s eyes)
Clue Cells Gardnerella vaginitis
Codman’s Triangle osteosarcoma
Coin Lesions in Lung Pulmonary Hamartoma
Cold Agglutinins Mycoplasma pneumoniae
infectious mononucleosis
Cold thyroid nodules Colloid cyst or thyroid adenoma
Concentric laminar intimal fibrosis of Primary pulmonary hypertension
small arteries of lung
Condyloma Lata 2° Syphilis
new coffee flavor at Bagel & Bagel
Congenital Hepatic Fibrosis Polycystic Kidney Disease, juvenile autosomal recessive form
Contraction Band Necrosis MI
Cotton Wool Spots HTN
Councilman Bodies dying hepatocytes
Crescents In Bowman’s Capsule rapidly progressive (crescentic glomerulonephritis)
Crushed ping pong balls Pneumocystis carinii
Crypt abscesses Ulcerative colitis
Currant-Jelly Sputum Klebsiella
Curschmann’s Spirals bronchial asthma
Cystathioine synthase deficieny homocystinuria
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)
Double bubble sign on ultrasound Down’s syndorme – duodenal atresia
Duret Hemorrhages Uncal herniation
Eburnation osteoarthritis (polished, ivory-like appearance of bone)
Eccentric intimal fibrosis with medial Chronic transplant rejection
hypertrophy
Ectopia Lentis Marfan’s
Embolizing endocarditis Infectious, marantic (fibrin deposits in hypercoagulable states)
Erythema Chronicum Migrans Lyme Disease
Excavation of Optic Cup Glaucoma
Exopthalmos hyperthyroid
FAT RN TTP (fever, anemia, thrombocytopenia, renal failure, neuro problems)
Fatty Liver Alcoholism
Fecalith Acute appendicitis
False positive VDRL SLE, Treponema pertenue (non-STD tropical infection)
Ferruginous Bodies asbestosis
Fish-mouthed mitral valve Rheumatic heart disease
Flea-bitten Kidney Malignant 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)
Ghon Complex Tuberculosis, primary
Gold Pneumonia Lipid pneumonia, exogenous (aspiration) or endogenous (obstruction
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
Heart Failure Cells CHF; hemosiderin-laden macrophages in lungs
Heberden’s Nodes Osteoarthritis (DIP)
Heinz Bodies G6PDH Deficiency
Hemarthrosis Coagulation factor deficiency
Hemorrhagic Temporal Lobe Lesion HSV
Hemorrhagic Urticaria Henoch-Schonlein
Heterophil Antibodies infectious mononucleosis (EBV)
Hirano Bodies Alzheimer’s
HLA B27 Ankylosing spondylitis
ochronosis (dark pigment of fibrous tissue) Alkaptonuria –homogentisic acid oxidase deficiency
Honeycomb lung Pulmonary fibrosis
Howell Jolley Bodies Splenectomy, remnant of nuclear DNA
H shaped vertebrae Sickle cell anemia
Human placental lactogen increase Placental site trophoblastic tumor
Hyaline thrombi TTP
Hydrosalpinx Chronic pelvic inflammatory disease
Hypersegmented PMNs Megaloblastic anemia
Hypochromic Microcytic RBCs iron-deficiency anemia
IgM against IgG Rheumatoid arthritis (rheumatoid factor)
↓ Immunoglobulins X-linked Brutons agammaglobulinemia, and common variable immunodeficiency
Index finger overlapping 3rd and 4th Edward’s (Trisomy 18)
Jarisch-Herxheimer Reaction Syphilis over-aggressive treatment of an asymptomatic pt. that causes symptoms 2to rapid lysis
Joint Mice osteoarthritis (fractured osteophytes)
Kaussmaul Breathing acidosis
Keratin Pearls SCCA
Kernig’s sign meningitis
Keyser-Fleischer Ring Wilson’s
Kimmelstiel-Wilson Nodules diabetic nephropathy
Koilocytes HPV
Koplik Spots measles
Lacunar cells Variant of Reed-Sternberg cell seen in nodular sclerosing Hodgkin’s Disease
Lacunar infarct Chronic hypertension
Lamellar bodies Contain surfactant in Type II pneumocytes
Langhans giant cells Tuberculosis, other including coccidioides
Lemon yellow skin color Pernicious anemia
Lemon sign Ultrasonographic finding in Neural 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
Lisch Nodules neurofibromatosis (von Recklinhausen’s disease)
Loss of grey-white junction Tuberous sclerosis
Low set ears Downs, DiGeorge, Trisomy 18 (Edwards)
Lumpy-Bumpy IF Glomeruli poststreptococcal glomerulonephritis
Machine-like murmur Patent ductus arteriosus
Macronodular cirrhosis Wilson’s, viral hepatitis, alpha-1-antitrypsin
Malignant pustule Anthrax (black skin lesion)
Mallory Bodies Alcoholic liver disease: intermediate filaments of hepatocyte cytoskeleton
Maple syrup/burnt sugar urine Alpha-ketoacid dehydrogenase deficiency; valine, leucine and isoleucine build up (branched)
McBurney’s Sign appendicitis (McBurney’s Point is 2/3 of the way from the umbilicus to anterior superior iliac spine)
Meconium ileus Cystic Fibrosis
Mees lines Arsenic (parallel lines on fingernails)
Melanosis coli Laxative abuse
Mental probs. with heart defect Mitral prolapse
Michealis-Gutmann Bodies Malakoplakia, an abnormal tissue response to kidney infection
Microglial nodules HIV
Micrognathia DiGeorge
Micronodular cirrhosis Wilsons, alcoholic, hemochromatosis, primary biliary cirrhosis
Microsatellite instability HNPCC (right-sided colon cancer), but also possible in other cancers
Mid-systolic click Mitral prolapse
Monoclonal Antibody Spike multiple myeloma this is called the M protein (usually IgG or IgA)
MGUS
Mousy / musty odor PKU
Mucosal bleeding Platelet problem (qualitative or quantitative)
Myxedema hypothyroidism
Necrolytic migratory erythema α-cell islet tumor
dermatitis
Negri Bodies and hydrophobia rabies
Neuritic Plaques Alzheimer’s
Neurofibrillary Tangles Alzheimer’s
Night pain relieved by aspirin Osteoid osteoma
Non-embolizing endocarditis Rheumatic, Libman-Sacks (with SLE)
Non-pitting Edema Myxedema
Anthrax Toxin
Notching of Ribs Coarctation of Aorta
Nutmeg Liver CHF, right heart
Onion skin kidney arterioles Malignant nephrosclerosis (malignant hypertension)
Oligoclonal band Multiple sclerosis
Osteoid production osteosarcoma
Painless Jaundice pancreatic CA (head)
Palatal Petechaie Strep pharyngitis
Palpable purpura Hypersensitivity vasculitis (Henoch-Schonlein, serum sickness)
Pancarditis Rheumatic fever
Pannus rheumatoid arthritis
PAS positive macrophages Whipple’s disease
Patent ductus arteriosus Maternal rubella and prematurity
Pautrier’s Microabscesses mycosis fungoides (cutaneous T-cell lymphoma)
Periductal edema Gynecomastia
Periventricular Calcifications Congenital CMV (brain ventricles, that is)
Phenylalanine hydroxylase deficiency PKU
Philadelphia Chromosome CML
Pick Bodies Pick’s Disease
Piecemeal Necrosis Chronic active hepatitis (periportal hepatocytes)
Plexiform lesions Pulmonary HTN (aneurysmal expansion of vessel wall)
Pink, foamy lung exudate Pneumocystis carinii pneumonia
Pink Puffer Emphysema Centroacinar – smoking Panacinar - 1-antitrypsin deficiency
Podagra gout (MP joint of hallux)
Porcelain gallbladder Chronic cholecystitis (scarring)
Porcelain gallstones Associated with gallbladder adenocarcinoma
Port-Wine Stain Hemangioma
Posterior Anterior Drawer Sign tearing of the ACL
Proliferating bile ducts Obstructive jaundice
Psammoma Bodies Papillary adenocarcinoma of the thyroid
Serous papillary cystadenocarcinoma of the ovary
Meningioma
Mesothelioma
Pseudohypertrophy Duchenne muscular dystrophy
Pseudopoyps Ulcerative colitis
Pulmonary atherosclerosis Cor pulmonale
Punched-Out Bone Lesions multiple myeloma
Punched-out esophageal lesions herpes
Rash on Palms & Soles 2Syphilis
RMSF
RBC poikilocytosis Beta-thalassemia
Rectangular RBC’s Hemoglobin SC
Red hyalin globules Alpha-1-antitrypsin deficiency (in liver)
Red Morning Urine paroxysmal nocturnal hemoglobinuria
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
Rockerbottom feet Patau (Trisomy 13), Edward’s (Trisomy 18)
Rose thorns Sporotrichosis
Rouleaux Formation multiple myeloma RBC’s stacked as poker chips
Rugae loss Pernicious anemia (atrophic gastritis)
S3 Heart Sound LRShunt (VSD, PDA)
Mitral Regurg
LV Failure
S4 Heart Sound Pulmonary Stenosis
Pulmonary HTN
Scalloped colloid Grave’s disease
Schwartzman Reaction Neisseria meningitidis impressive rash with bugs
Shagreen patches Tuberous sclerosis
Simian Crease Down’s
Smith Antigen SLE (also anti-dsDNA)
Smudge cells CLL (delicate cells easily destroyed on peripheral smear)
Soap Bubble on X-Ray giant cell tumor of bone
Soldiers plaque Clinically insignificant remnant of healed pericarditis
Spider telangiectasia Hyperestrinism: liver faillure, pregnancy
Spike & Dome Glomeruli membranous glomerulonephritis
Splinter hemorrhages Infective endocarditis
Strawberry tongue Scarlet fever, Kawasaki’s
Strawberry cervix Trichomonas vaginalis
Strawberry gallbladder cholesterolosis
String Sign on X-ray Crohn’s bowel wall thickening
Sugar icing on spleen Portal hypertension
Sulfer granules Collection of actinomyces or nocardia organisms in chronic abscessing bronchopneumonia
Swiss cheese brain Clostridia (gas forming)
Syncitia RSV, measles
Tamm-Horsfall protein Hyaline casts (non-specific)
Target Cells Thalassemia
Teardrop RBCs Myelofibrosis
Temporal lobe encephalitis Herpes
Tendinous Xanthomas Familial Hypercholesterolemia
Tethered cord Arnold-Chiari malformation (tonsilar herniation)
Tetrahydrobiopterin cofactor def. PKU
Thymidine dimers Xeroderma pigmentosum
Thymus, parathyroid agenesis Digeorge (3rd and 4th pharyngeal pouch)
Thyroidization of Kidney chronic pyelonephritis
TIBC increase Anemia of chronic disease
Tingible Bodies Macrophage in lymph node germinal centers
Tophi gout
Tram-Track Glomeruli membranoproliferative glomerulonephritis
Tree bark aorta Syphilis
Trousseau’s Sign visceral ca, classically pancreatic (migratory thrombophlebitis)
hypocalcemia (carpal spasm)
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
Virchow’s Node supraclavicular node enlargement by metastatic carcinoma of the stomach
VMA and metenephrins in urine Pheochromocytoma
Warthin-Finkeldey Giant Cells Measles
Waterhammer pulse Aortic regurgitation
WBC Casts pyelonephritis
White matter petechaie Fat emboli
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
serum Anencephaly
Uric Acid Gout
Lesch Nyhan
Myeloproliferative Disorders
Diuretics (Loop & Thiazides)
FEV1/FVC COPD
g lucose, protein in CSF Bacterial meningitis
dopamine receptors Schizophrenia
d opamine receptors Parkinson’s

Most Common…
1Tumor arising from bone in adults Multiple Myeloma
Adrenal Medullary Tumor – Adults Pheochromocytoma
Adrenal Medullary Tumor – Children Neuroblastoma
Arteries of stroke Lateral striate
Bacterial Meningitis – adults Neisseria meningitidis
Bacterial Meningitis – elderly Strep pneumoniae
Bacterial Meningitis – newborns E. coli
Bacterial Meningitis – toddlers Hib
B cell defect (genetic) Isolated IgA deficiency
Bone Tumors Metasteses from Breast & Prostate
Brain Tumor – Child Medulloblastoma (cerebellum)
Brain Tumor –Adult Astrocytoma (including Glioblastoma Multiforme) then: mets, meningioma, Schwannoma
Breast Carcinoma Invasive Duct Carcinoma
Breast Mass Fibrocystic Change (Carcinoma is the most common is post-menopausal women)
Bug in Acute Endocarditis Staph aureus
Bug in debilitated, hospitalized pneumonia pt Klebsiella
Bug in Epiglottitis Hib
Bug in GI Tract Bacteroides (2nd – E. coli)
Bug in IV drug user bacteremia / pneumonia Staph aureus
Bug in PID N. Gonnorrhoeae
Bug in Subacute Endocarditis Strep Viridans
Cardiac 1Tumor – Adults Myxoma “Ball Valve”
Cardiac 1Tumor – Child Rhabdomyoma
Cardiac Tumor – Adults Metasteses
Cardiomyopathy Dilated (Congestive) Cardiomyopathy
Carpal bone fractured scaphoid
Cause of 2HTN Renal Disease
Cause of Addison’s Autoimmune (2nd – infection)
Cause of Congenital Adrenal Hyperplasia 21-Hydroxylase Deficiency (then, 11-)
Cause of Cushings Exogenous Steroid Therapy (then, 1ACTH, Adrenal Adenoma, Ectopic ACTH)
Cause of death in Alzheimer pts Pneumonia
Cause of death in amyloidosis Chronic renal failure
Cause of death in Diabetics MI
Cause of Death in SLE pts. Lupus Nephropathy Type IV (Diffuse Proliferative)
Cause of Dementia Alzheimer’s
Cause of Dementia (2nd most common) Multi-Infarct Dementia
Cause of food poisoning Staph aureus
Cause of mental retardation Down’s
Cause of mental retardation (2nd most common) Fragile X
Cause of preventable blindness Chlamydia
Cause of Pulmonary HTN COPD
Cause of SIADH Small Cell Carcinoma of the Lung
Chromosomal disorder Down’s
Congenital cardiac anomaly VSD (membranous > muscular)
Congenital early cyanosis Tetralogy of Fallot
Coronary Artery thrombosis LAD
Demyelinating Disease Multiple Sclerosis
Dietary Deficiency Iron
Disseminated opportunistic infection in AIDS CMV (Pneumocystis carinii is most common overall)
Esophageal cancer SCCA
Fatal genetic defect in Caucasians Cystic Fibrosis
Female Tumor Leimyoma
Form of Amyloidosis Immunologic (Bence Jones protein in multiple myeloma is also called the Amyloid Light Chain)
Form of Tularemia Ulceroglandular
Gynecologic malignancy Endometrial Carcinoma
Heart Murmur Mitral Valve Prolapse
Heart problem in AIDS Pericarditis
Heart tumor in adults myxoma
Heart tumor in kids rhabdomyoma
Heart Valve in bacterial endocarditis Mitral
Heart Valve in bacterial endocarditis in IV drug users Tricuspid
Heart Valve involved in Rheumatic Fever Mitral then Aortic
Hereditary Bleeding Disorder Von Willebrand’s Disease
Liver 1Tumor Hepatoma, seen in women on oral contraceptives
Liver Disease Alcoholic Liver Disease
Location of Adult brain tumors Above Tentorium
Location of Childhood brain tumors Below Tentorium
Location of GI tuberculosis Ileocecal
Lysosomal Storage Disease Gaucher’s
Motor Neuron Disease ALS
Myocarditis cause Coxsackie B
Neoplasm – Child Leukemia
Neoplasm – Child (2nd most common) Medulloblastoma of brain (cerebellum)
Nephrotic Syndrome Membranous Glomerulonephritis
Opportunistic infection in AIDS PCP
Osteomyelitis in IV drug user Pseudomonas
Osteomyelitis in sickle cell Salmonella
Ovarian Malignancy Serous Cystadenoma
Ovarian Tumor Hamartoma
Pancreatic Tumor Adeno (usually in the head)
Patient with ALL / CLL / AML / CML ALL - Child / CLL - Adult over 60 / AML - Adult over 60 / CML - Adult 35-50
Patient with Goodpasture’s Young male
Patient with Reiter’s Male
Pituitary Tumor Prolactinoma (2nd – Somatotropic “Acidophilic” Adenoma)
Primary Hyperparathyroidism Adenomas (followed by: hyperplasia, then carcinoma)
Pt. With Hodgkin’s Young Male (except Nodular Sclerosis type – Female)
Pt. With Minimal Change Disease Young Child
Secondary Hyperparathyroidism Hypocalcemia of Chronic Renal Failure
Sexually transmitted disease Chlamydia
Site of Diverticula Sigmoid Colon
Site of metastasis Regional Lymph Nodes
Site of metastasis (2nd most common) Liver
Sites of atherosclerosis Abdominal aorta > coronary > popliteal > carotid
Skin Cancer Basal Cell Carcinoma
Stomach cancer Adeno
Testicular Tumor Seminoma
Thyroid Cancer Papillary Carcinoma
Tracheoesophageal Fistula Lower esophagus joins trachea / upper esophagus – blind pouch
Tumor of Infancy Hemangioma
Type of Hodkin’s Mixed Cellularity (versus: lymphocytic predominance, lymphocytic depletion, nodular sclerosis)
Type of Non-Hodgkin’s Follicular, small cleaved
Vasculitis (of medium & small arteries) Temporal Arteritis
Viral Encephalitis HSV
Worm infection in US Pinworm (2nd – Ascaris)

Signature Drug Toxicities

Agranulocytosis Clozapine
Aplastic Anemia Chloramphenicol
NSAIDs
Benzene
Arrhythmia Tricyclic antidepressant (wide QRS)
Cardiac glycosides, especially with hypokalemia
Atropine-like Side Effects Tricyclics
Blindness Methanol (Formic Acid)
Cardiotoxicity Doxorubicin
Daunorubicin
Cartilage Damage in children Fluoroquinolones (Ciprofloxacin & Norfloxacin)
Cinchonism Quinidine
Cough ACE Inhibitors
Diabetes Insipidus Lithium
Disulfiram-like effect Metronidazole
Sulfonylureas (1st generation)
Extrapyramidal Side Effects Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine)
Fanconi’s Syndrome Tetracycline
Fatal Hepatotoxicity (necrosis) Valproic Acid
Halothane
Acetaminophen
Gingical Hyperplasia Phenytoin
Gray Baby Syndrome Chloramphenicol
Gynecomastia Cimetidine
Azoles
Spironolactone
Digitalis
Hemolytic Anemia in G6PD-deficiency Sulfonamides
Isoniazid
Aspirin
Ibuprofen
Primaquine
Hepatitis Isoniazid
Hepatocellular carcinoma Polyvinyl chloride, anaphylatoxins
Hot Flashes, Flushing Niacin
Tamoxifen
Ca++ Channel Blockers
Induce CP450 Barbiturates
Phenytoin
Carbamazepine
Rifampin
Inhibit CP450 Cimetidine
Ketoconazole
Interstitial Nephritis Methicillin
NSAIDs (except Aspirin)
Furosemide
Sulfonamides
Lupus like Procainamide, hydralazine
Malignant hyperthermia Succinyl choline, halothane
Monday Disease Nitroglycerin Industrial exposure tolerance during week loss of tolerance during weekend headache, tach, dizziness upon
re-exposure
Neuroleptic malignant syndrome Haloperidol
Orange Body Fluids Rifampin
Osteoporosis Heparin
Corticosteroids
Positive Coombs’ Test Methyldopa
Pulmonary Fibrosis Bleomycin
Amiodarone
Red Man Syndrome Vancomycin
Severe HTN with Tyramine MAOIs

SLE-like Syndrome Procainamide

Hydralazine
Tardive Dyskinesia Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine)
Tinnitus Aspirin
Quinidine
Torsade de pointes Quinidine
Vaginal Adenosis and Clear Cell Carcinoma DES

Miscellaneous
• Fastest growing tumor – Burkitt’s
• PE’s are found in half of all autopsies
• Courvoisier’s Law: tumors that obstruct the common bile duct cause enlarged gallbladders, but obstructing gallstones do not
(too much scarring).
• Only DNA virus to replicate in cytoplasm: Pox
• Only RNA virus to replicate in nucleus: Influenza
• Bacillus anthracis has the only protein capsule
• Bordetella pertussis (Whooping Cough) elicits lymphocytosis rather than granulocytosis
• Bronchioalveolar carcinomas grow without destroying the normal architecture of the lung
• Cryptococcus neoformans often lacks a capsule and, when stained with GMS, looks just like Pneumycistis carinii, except that
Cryptococcus lacks the prominent nucleoli.