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  1. Actinic (solar keratosis)
    Precursor to squamous cell carcinoma
  2. Acute gastric ulcer with CNS injury
    Cushing's ulcer (ICP rise stimulates vagal gastric secretion)
  3. Acute gastric ulcer associated with severe burns
    Curling's ulcer (low plasma volume causes sloughing of gastric mucosa)
  4. Alternating areas of transmural inflammation and normal colon
    Skip lesions (Crohn's Disease)
  5. Aneurysm, dissecting
    Hypertension
  6. Aortic Aneurysm, abdominal and descending aorta
    Atherosclerosis
  7. Aortic Aneurysm, ascending
    Tertiary Syphilis or Marfan's Syndrome
  8. Atrophy of the mammilary bodies
    Wernicke's Encephalopathy (Thiamine (B1) deficiency causes ataxia, opthalmoplegia, confusion)
  9. Autosplenectomy (fibrosis and shrinkage)
    Sickle cell anemia (HbS)
  10. Bacteria with stomach cancer
    H. Pylori
  11. Bacterial meningitis (adults and elderly)
    Neisseria Meningitidis
  12. Bacterial meningitis (newborns)
    Group B streptococcus
  13. Bacterial meningitis (kids)
    S. Pneumoniae or Neisseria Meningitidis
  14. Benign melanocytic nevus
    Spitz nevus (most common ages 0-20)
  15. Bleeding disorder with GpIb deficiency
    Bernard-Soulier disease (faulty platelet adhesion to vWF)
  16. Brain tumor (adults)
    Supratentorial: mets>astrocytoma (GBM)>meningioma>Schwaanoma
  17. Brain tumor (kids)
    Infratentorial: medulloblastoma (cerebellum) // Supratentorial: Craniopharyngioma (cerebrum)
  18. Breast cancer
    Infiltrating ductal carcinoma (1/9 women get BC in U.S.)
  19. Breast mass
    1. Fibrocystic change 2. Carcinoma (postmenopausal)
  20. Breast tumor (benign)
    Fibroadenoma
  21. Cardiac primary tumor (kids)
    Rhabdomyoma
  22. Cardiac manifestations of lupus
    Libman-Sacks endocarditis (mitral, non-bacterial)
  23. Cardiac tumor (adults)
    1. Metastasis 2. Primary myxoma (4:1 left to right atrium; ball and valve)
  24. Cerebellar tonsillar herniation
    Chiari malformation (progressive hydrocephalus or syringomyelia)
  25. Chronic arrhythmia
    Atrial fibrillation (high risk of emboli)
  26. Chronic atropic gastritis (autoimmune)
    Predisposition to gastric carcinoma (+pernicious anemia)
  27. Clear cell adenocarcinoma of the vagina
    DES exposure in utero (diethylbestrol)
  28. Congenital adrenal hyperplasia + hypotension
    21-hydroxylase deficiency
  29. Congential cardiac abnormality
    Ventriculo-Septal Defect (VSD)
  30. Congential conjugated bilirubinemia (black liver)
    Dubin-Johnson syndrome (hepatocytes can't secrete conjugated bilirubin into bile)
  31. Constrictive pericarditis in developing world
    Tuberculosis (TB)
  32. Coronary artery (thrombosis)
    LAD > RCA > LCA
  33. Cretinism
    Iodine deficiency / Hypothyroidism
  34. Cushing's syndrome
    1. Corticosteroid therapy 2. Excess ACTH secretion by pituitary
  35. Cyanosis (early, less common)
    Tetralogy of Fallot, transposition of great vessels, truncus arteriosis)
  36. Cyanosis (late, more common)
    VSD, ASD, PDA
  37. Death in CML
    Blast crisis
  38. Death in SLE (lupus)
    Lupus nephropathy
  39. Dementia
    1. Alzheimer's 2. Multiple infarcts
  40. Demyelinating disease in young women
    MS
  41. DIC
    Gram-negative sepsis, obstetric complications, cancer, burn trauma
  42. Dietary deficit
    Iron
  43. Diverticulum in pharynx
    Zenker's diverticulum (barium swallow diagnosis)
  44. Ejection Click
    Aortic/pulmonary stenosis
  45. Esophageal cancer
    Squamous cell carcinoma (worldwide), adenocarcinoma (U.S.)
  46. Food poisoning (exotoxic)
    S. aureus, B. cereus
  47. Glomerulonephritis (adults)
    Berger's Disease (IgA nephropathy)
  48. Gynecologic malignancy
    Endometrial carcinoma (most common)
  49. Heart murmur, congenital
    Mitral valve prolapse
  50. Heart valve in bacterial endocarditis
    Mitral (rheumatic fever), Tricuspid (IV drug abuse), aortic (rheumatic fever, 2nd affected)
  51. Helminth infection
    1. Enterobius vermicularis 2. Ascaris lumbricoides
  52. Hematoma - epidural
    Rupture of middle meningeal artery (crescent)
  53. Hematoma - subdural
    Rupture of bridging veins (trauma) (lentiform shaped)
  54. Hemochromatosis
    Multiple blood transfusions or hereditary HFE mutation (can cause CHF, "bronze diabetes", and raises risk of hepatocellular carcinoma)
  55. Hepatocellular carcinoma
    Cirrhotic liver (hepatitis B and C)
  56. Hereditary bleeding disorder
    von-Willebrand's disease
  57. Hereditary harmless jaundice
    Gilbert's syndrome (benign congenital unconjugated hyperbilirubinemia)
  58. HLA-B27
    Ankylosing spondylitis, Reiter's syndrome, ulcerative colitis, psoriasis
  59. HLA-DR3 or HLA-DR4
    Diabetes Mellitus type 1, rhematoid arthritis, SLE
  60. Holosystolic murmur
    VSF, tricuspid regurgitation, mitral regurgitation
  61. Hypercoagulability, endothelial damage, blood stasis
    Virchow's triad (VENOUS THROMBOSIS)
  62. Hypertension, secondary
    Renal disease
  63. Hypoparathyroidism
    often caused by thyroidectomy
  64. Hypopituitarism
    Pituitary adenoma (usually benign)
  65. Infection after blood transfusion
    Hepatitis C
  66. Kidney stones
    1. Calcium=radioopaque 2. Struvite (NH4)=radioopaque (formed by urease+ organisms like Proteus vulgaris or Staphylococcus) 3. Uric acid - radioLUCent
  67. Late cyanotic shunt (uncorrected L>R becomes R>L)
    Eisenmenger's syndrome (caused by ASD, VSD, PDA), results in pulmonary hypertension and polycythemia)
  68. Liver disease
    Alcoholic cirrhosis
  69. Lysosomal storage disease
    Gaucher's disease (Glucocerebrosidase)
  70. Male cancer
    Prostatic carcinoma
  71. Malignancy associated with non-infectious fever
    Hodgkin's lymphoma
  72. Malignant skin tumor
    Basal cell carcinoma (rarely metastasizes)
  73. Mental retardation
    1. Down syndrome 2. Fragile X syndrome
  74. Metastases to bone
    Breast, lung, thyroid, testes, prostate, kidney
  75. Metastases to brain
    Lung, breast, skin (melanoma), kidney (RCC), GI
  76. Metastases to liver
    Colon, gastric, pancreatic, breast, lung carcinomas
  77. Mitral valve stenosis
    Rheumatic heart disease
  78. Mixed motor neuron disease (UMN and LMN)
    ALS
  79. Myocarditis
    Coxsackie B
  80. Neoplasm (kids)
    1. ALL 2. Cerebellar medulloblastoma
  81. Nephrotic syndrome (adults)
    Membranous glomerulonephritis
  82. Nephrotic syndrome (kids)
    Minimal change disease (associated with infections, vaccinations; treat with steroids)
  83. Nosocomial pneumonia
    Klebsella, E. Coli, Pseudomonas aeruginosa
  84. Obstruction of male urinary tract
    BPH
  85. Opening snap
    Mitral stenosis
  86. Opportunistic infection (AIDS)
    Pneumonia (Pneumocystis jiroveci) - formerly carinii)
  87. Osteomyelitis
    S. aureus
  88. Osteomyelitis in HbS patients
    Salmonella
  89. Osteomyelitis with IV drug use
    Pseudomonas, S. Aureus
  90. Ovarian metastasis from gastric carcinoma or breast cancer
    Krukenberg tumor (mucin-secreting signet-ring cells)
  91. Ovarian tumor (benign)
    Serous cystadenoma
  92. Ovarian tumor (malignant)
    Serous cystadenocarcinoma
  93. Pancreatitis (acute)
    Gallstones, alcohol
  94. Pancreatitis (chronic)
    alcohol (adults), CF (kids)
  95. Patient with ALL/CLL/AML/CML
    ALL: child, CLL: adult>60, AML: adult>60, CML: adult 35-50
  96. Pelvic Inflammatory Disease (PID)
    Neisseria gonorrhoeae (monoarticular arthritis)
  97. Philadelphia Chromosome (t(9;22)(bcr-abl)
    CML (although sometimes ALL/AML)
  98. Pituitary tumor
    1. Prolactinoma 2. Somatotropic "acidophilic" adenoma
  99. Primary amenhorrhea
    Turner syndrome (XO)
  100. Primary bone tumor (adults)
    Multiple myeloma
  101. Primary hyperaldosteronism
    Adenoma of adrenal CORTEX
  102. Primary hyperparathyroidism
    1. Adenomas 2. Hyperplasia 3. Carcinoma
  103. Primary liver cancer
    Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, a-1 antitrypsin)
  104. Pulmonary hypertension
    COPD
  105. Recurrent inflammation/thrombosis of small/medium vessels in extremities
    Buerger's Disease (tobacco)
  106. Renal tumor
    RCC: associated with von-Hippel Landau and adult Polycystic Kidney Disease; paraneoplastic syndromes (erythropoietin, renin, PTH, ACTH)
  107. Right heart failure due to pulmonary cause
    Cor pulmonale
  108. S3 (protodiastolic gallop)
    high ventricular filling (L>R shunt, mitral regurgitation, LV failure in CHF)
  109. S4 (presystolic gallop)
    Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
  110. Secondary hyperparathyroidism
    Hypocalcemia of CKD
  111. STD
    Chlamydia (usually coinfected with gonorrhea)
  112. SIADH (high ADH)
    small cell carcinoma of the lung
  113. Site of diverticula
    Sigmoid colon
  114. Sites of atherosclerosis
    Abdominal aorta>coronary>popliteal>carotid
  115. Stomach cancer
    Adenocarcinoma
  116. Stomach ulcerations and high gastrin levels
    Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
  117. t(14;18)
    Follicular lymphomas (bcl-2 activation)
  118. t(8;14)
    Burkitt's lymphoma (c-myc activation)
  119. t(9:22)
    Philadelphia chromosome; CML (bcr-abl hybrid)
  120. Temporal arteritis
    Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymyalgia rheumatica
  121. Testicular tumor
    Seminoma
  122. Thyroid cancer
    Papillary carcinoma
  123. Tumor in women
    Leiomyoma (estrogen dependent)
  124. Tumor of infancy
    Hemangioma (usually regresses spontaneously)
  125. Tumor of adrenal medulla (adults)
    Pheochromocytoma (usually benign)
  126. Tumor of adrenal medulla (kids)
    Neuroblastoma (malignant)
  127. Type of Hodgkin's
    Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)
  128. Type of non-Hodgkin's
    Diffuse large cell
  129. UTI
    E. Coli, Staphylocccus saprophyticus (young women)
  130. Viral encephalitis affecting temporal lobe
    HSV
  131. Vitamin deficiency
    Folic acid (pregnant women at high-risk, body has only 3-4 month supply, prevents neural tube defects)
  132. Sensitivity
    Sensitivity = TP/(TP+FN)
  133. Specificity
    Specificity = TN/(TN+FP)
  134. Positive Predictive Value (PPV)
    PPV = TP/(TP+FP)
  135. Negative Predicitive Value (NPV)
    NPV = TN/(TN+FN)
  136. Relative Risk (RR)
    RR = (a/a+b)/(c/c+d)
  137. Attributable Risk (AR)
    AR = (a/a+b)-(c/c+d)
  138. Number Needed to Treat (NNT)
    NNT = 1/Absolute Risk Reduciton
  139. Number Needed to Harm (NNH)
    NNH = 1/Attributable Risk
  140. Odds Ratio (OR)
    ad/bc
  141. Hardy Weinberg Equilibrium
    p2 + 2pq+ q2=1 // p+q=1
  142. Henderson-Hasselbalch equation
    pH=pKa + log [HCO3-]/0.03 PCO2)
  143. Volume of Distribution (Vd)
    Vd = amt drug in body/plasma drug conc.
  144. Clearance (CL)
    CL = rate of elimination of drug/plasma drug concentration
  145. Half-life (t1/2)
    t1/2 = 0.7Vd/CL
  146. Loading Dose (LD)
    LD = Cp*Vd/F
  147. Maintenance Dose (MD)
    MD = Cp*CL/F
  148. Cardiac Output (CO)
    CO = rate of O2 consumption/(arterial O2 content-venous O2 content)
  149. Cardiac Output (CO)
    CO = Stroke Volume x heart rate
  150. Mean arterial pressure (MAP)
    1. MAP = CO*total peripheral resistance 2. MAP = 1/3 systolic + 2/3 diastolic
  151. Stroke Volume (SV)
    SV = end diastolic volume-end systolic volume
  152. Ejection Fraction (EF)
    EF = (stroke volume/end diastolic volume)*100
  153. Resistance (R)
    1. R = Driving pressure/flow 2. R = 8η (viscosity)*length/πr4
  154. Net filtration pressure (Pnet)
    Pnet=[(Pc-Pi)-(πC - πi)]
  155. Glomerular Filtration Rate (GFR)
    Uinulin *V/Pinulin = Cinulin
  156. Glomerular Filtration Rate (GFR)
    GFR = Kf [(PGC-PBS)-(πGC-πBS)]
  157. Effective renal plasma flow (ERPF)
    ERPF = UPAH*V/PPAH = CPAH
  158. Renal blood flow (RBF)
    RBF = RPF/1-Hct
  159. Filtration fraction (FF)
    FF = GFR/RPF
  160. Physiologic dead space (Vd)
    VD = VT * (PaCO2 - PeCO2)/PaCO2
  161. Abdominal pain, ascites, hepatomegaly
    Budd-Chiari syndrome (posthepatic venous thrombosis)
  162. Achilles tendon xanthoma
    Familial hypercholesterolemia
  163. Adrenal hemorrhage, hypotension, DIC
    Waterhouse-Friderichsen syndrome (meningococcemia)
  164. Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
    Marfan's syndrome
  165. Athlete with polycythemia
    Erythropoietin injection
  166. Back pain, fever, night sweats, weight loss
    Pott's disease (vertebral tuberculosis)
  167. Bilateral hilar adenopathy, uveitis
    Sarcoidosis (non-caseating granulomas)
  168. Blue sclera
    Osteogenesis imperfecta (collagen defect)
  169. Bluish line on gingiva
    Burton's line (lead poisoning)
  170. Bone pain, bone enlargement, arthritis
    Paget's Disease of bone (increased osteoblastic and osteoclastic activity)
  171. Bounding pulses, diastolic heart murmur, head bobbing
    aortic regurgitation
  172. Café-au-lait spots, Lisch nodules (iris hamartoma)
    1. Neurofibromatosis type I (+pheochromocytomas, optic gliomas) // 2. Neurofibromatosis type II (+bilateral acoustic neuromas)
  173. Café-au-lait spots, polyostotic fibrous dysplasia, precocious puberty
    McCune-Albright syndrome (mosaic G-protein signaling mutation)
  174. Calf pseudohypertrophy
    Muscular Dystrophy (most commonly Duchenne's)
  175. Cherry-red spot on macula
    1. Tay Sachs (ganglioside accumulation) // 2. Niemann-Pick (sphingomyelin accumulation// 3. central retinal artery occlusion
  176. Chest pain, pericardial effusion/friction rub, persistent fever following MI
    Dressler's syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode)
  177. Child uses arms to stand up from squat
    Gowers' sign (Duchenne Muscular Dystrophy; X-linked recessive deleted dystrophin gene)
  178. Child with fever develops red rash on face that spreads to body
    Slapped cheeks = erythema infectiosum/fifth disease: parvovirus B19)
  179. Chorea, dementia, caudate degeneration
    Huntington's Disease (Autosomal dominant CAG repeat expansion)
  180. Chronic exercise intolerance with myalgia, fatigue, painful cramps
    McArdle's Disease (muscle phosphorylase deficiency, a GSD)
  181. Cold intolerance
    HyPOthyroidism
  182. Conjugate lateral gaze palsy, horizontal diplopia
    Internuclear opthalmoplegia (damage to MLF; bilateral~Multiple Sclerosis; unilateral~stroke)
  183. Continuous "machinery" heart murmur
    Patent Ductus Arteriosus (PDA) (close with indomethacin; open with misoprostol)
  184. Cutaneous/dermal edema due to connective tissue deposition
    Myxedema (hypothyroidism, Graves' disease)
  185. Dark purple skin/mouth nodules
    Kaposi's sarcoma; usually in AIDS patients (gay men), associated with HHV-8)
  186. Deep, labored breathing/hyperventilation
    Kussmaul breathing (Diabetic ketoacidosis)
  187. Dermatitis, dementia, diarrhea
    Pellagra (niacin (=vitamin B3) deficiency)
  188. Dilated cardiomyopathy, edema, polyneuropathy
    Wet beriberi (thiamine (Vitamin B1) deficiency
  189. Dog or cat bite resulting in infection
    Pasteurella multocida (cellulitis at inoculation site)
  190. Dry eyes, dry mouth, arthritis
    Sjogren's syndrome (autoimmune destruction of exocrine glands)
  191. Dysphagia (esophageal webs), glossitis, iron deficiency anemia
    Plummer-Vinson syndrome (can progress to esophageal squamous cell carcinoma)
  192. Elastic skin, hypermobility of joints
    Ehlers-Danlos syndrome (collagen defect, usually type III)
  193. Enlarged, hard left supraclavicular node
    Virchow's node (abdominal metastasis)
  194. Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
    1. Sezary syndrome (cutaneous T-cell lymphoma) // 2. Mycosis fungoides
  195. Facial muscle spasm upon tapping
    Chvostek's sign (hypocalcemia)
  196. Fat, female, forty, fertile
    Acute cholecystitis (bile duct blockage)
  197. Fever, chills, headache, myalgia after antibiotic treatment for syphilis
    Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
  198. Fever cough, conjunctivitis, coryza, diffuse rash
    Measles (Morbillivirus)
  199. Fever, night sweats, weight loss
    B symptoms (lymphoma)
  200. Fibrous plaques in soft tissue of penis
    Peyronie's disease (connective tissue disorder)
  201. Gout, mental retardation, self-mutilating behavior in a boy
    Lesch-Nyhan syndrome (HGPRT deficiency, X linked recessive)
  202. Green-yellow rings around peripheral cornea
    Wilson's Disease (copper accumulation leading to Kayser-Fleischer rings)
  203. Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands
    Peutz -Jeghers syndrome (genetic benign polyposis can cause bowel obstruction, elevated cancer risk)
  204. Hepatosplenomegaly, osteoporosis, neurologic symptoms
    Gaucher's disease (glucocerebrosidase deficiency)
  205. Hereditary nephritis, sensorineural hearing loss, cataracts
    Alport's syndrome (type IV collagen mutation)
  206. Hypercoagulability (leading to migrating DVTs and vasculitis)
    Trousseau's sign (adenocarcinoma of pancreas or lung)
  207. Hyperphagia, hypersexuality, hyperorality, hyperdocility
    Kluver-Bucy syndrome (bilateral amygdala lesion)
  208. Hypertension, hyPOkalemia, metabolic acidosis
    Conn's syndrome (primary hyperaldosteronism)
  209. Hypoxemia, polycythemia, hypercapnia
    Blue bloater (chronic bronchitis: hyperplasia of mucous cells)
  210. Indurated, ulcerated genital lesion
    1. Non-painful=chancRE (primary syphilis, Treponema pallidum) // 2. Painful, with exudate=chancROID (Haemophilus ducreyi)
  211. Infant with failure to thrive, hepatosplenomegaly, neurodegradation
    Niemann-Pick disease (genetic sphingomyelinase deficiency)
  212. Infant with hypoglycemia, failure to thrive, hepatosplenomegaly
    Cori's disease (debranching enzyme deficiency)
  213. Infant with microcephaly, rocker-bottom feet, CLENCHED HANDS, structural heart defect
    Edwards Syndrome (trisomy 18)
  214. Jaundice, RUQ pain, fever
    Charcot's triad 2 (ascending cholangitis)
  215. Keratin pearls on skin biopsy
    Squamous cell carcinoma
  216. Large rash with bull's eye appearance
    Lyme disease (Borrelia): Erythema chronicum migrans from Ixodes tick bite
  217. Lucid interval after traumatic brain injury
    Epidural hematoma (middle meningeal artery rupture)
  218. Male child, recurrent infections, no mature B cells
    Bruton's disease (X-linked agammaglobulinemia)
  219. Mucosal bleeding and prolonged bleeding time
    Glanzmann's thombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
  220. Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
    Gardner's syndrome (subtype of FAP)
  221. Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
    1. Wegener's syndrome (c-ANCA-positive) // 2. Goodpasture's syndrome (anti-basement membrane antibodies)
  222. Neonate with arm paralysis following birth
    Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip"
  223. No lactation post-partum, absent menstruation, cold intolerance
    Sheehan's syndrome (pituitary infarction)
  224. Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
    Multiple Sclerosis
  225. Oscillating slow/fast breathing
    Cheyne-Stokes respirations (central apnea in CHF or elevated intracranial pressure)
  226. Painful blue fingers/toe, hemolytic anemia
    Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis)
  227. Painful, pale, cold fingers/toes
    Raynaud's syndrome (vasospasm in extremities)
  228. PainFUL, raised red lesions on palms and soles
    Osler's node (infective endocarditis)
  229. PainLESS erythematous lesions on palms and soles
    Janeway lesions (infective endocarditis)
  230. Painless jaundice
    Cancer of the pancreatic head obstructing the bile duct
  231. Palpable purpura, joint pain, abdominal pain (CHILD)
    Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
  232. Pancreatic, pituitary, parathyroid tumors
    Wermer's syndrome (MEN 1)
  233. Pink complexion, dyspnea, hyperventilation
    "Pink puffer' (emphysema: centroacinar [smoking], panacinar [a1-antitrypsin deficiency)
  234. Polyuria, acidosis, growth failure, electrolyte imbalances
    Fanconi's syndrome (proximal tubular reabsorption defect)
  235. Positive anterior drawer sign"""
  236. Ptosis, miosis, anhidrosis
    Horner's syndrome (sympathetic chain lesion)
  237. Pupil accomodates but doesn't react
    Neurosyphilis (Argyll-Robertson pupil)
  238. Rapidly progressing leg weakness that ascends (following GI/UR infection)
    Guillain-Barre syndrome (autoimmune acute inflammatory demyelinating PNS polyneuropathy)
  239. Rash on palms and soles
    Secondary syphilis // Rocky Mountain Spotted Fever
  240. Recurrent colds, unusual eczema, high serum IgE
    Job's syndrome (hyper IgE syndrome; neurophil chemotaxis abnormality)
  241. Red "currant jelly" sputum in alcoholic or diabetic patients
    Klebsiella pneumoniae
  242. Red itchy swollen rash of nipple, areola
    Paget's disease of the breast (represents underlying neoplasm)
  243. Red urine in the morning, fragile RBCs
    Paroxymal nocturnal hemoglobinuria
  244. Renal cell carcinoma, hemangioblastomas, angiomatosism pheochromocytoma
    von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
  245. Resting tremor, rigidity, akinesia, postural instability
    Parkinson's disease (nigrostriatal dopamine depletion)
  246. Restrictive cardiomyopathy (juvenile form: cardiomegaly), exercise intolerance
    Pompe's Disease (lysosomal glucosidase deficiency)
  247. Retinal hemorrhages with pale centers
    Bacterial endocarditis (Roth's spots)
  248. Severe jaundice in neonate
    Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
  249. Severe RLQ pain with REBOUND tenderness
    Appendicitis (McBurney's sign)
  250. Short stature, high rate of tumors/leukemia, aplastic anemia
    Fanconi's anemia (genetic; often progresses to AML)
  251. Single palm crease
    Down syndrome (trisomy 21) - simian crease
  252. Situs inversus, chronic sinusitis, bronchiectasis, male infertility
    Kartagener's syndrome (dynein defect affecting cilia movement)
  253. Skin hyperpigmentation
    Addison's disease (primary adrenocortical insufficiency; autoimmune or infectious)
  254. Slow, progressive muscle weakness in boys
    Becker's muscular dystrophy (X-linked, defective dystrophin, less severe than Duchenne's)
  255. Small, irregular spots on buccal/lingual mucosa with blue-white centers
    Measles (Koplik spots)
  256. Smooth, flat, moist white lesions on genitals
    Secondary syphilis (condylomata lata)
  257. Splinter hemorrhages in fingernails
    Bacterial endocarditis
  258. Strawberry tongue
    Scarlet fever, Kawasaki disease, toxic shock syndrome
  259. Streak ovaries, congential heart disease, horseshoe kidney
    Turner Syndrome (XO, short stature, webbed neck, lymphedema)
  260. Sudden swollen/painful big toe joint, tophi
    Gout/podagra (hyperuricemia)
  261. Swollen gums, mucous bleeding, poor wound healing, spots on skin
    Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
  262. Swollen, hard, painful finger joints
    Osteoarthritis (osteophytes on PIP (Bouchard's nodes), DIP (Heberden's nodes)
  263. Systolic ejection murmur (crescendo-decrescendo)
    Aortic valve stenosis
  264. Thyroid and Parathyroid tumors, pheochromocytoma
    Sipple's syndrome (MEN 2A)
  265. Toe extension/fanning upon plantar scrape
    Babinski's sign (UMN lesion)
  266. Unilateral facial drooping involving forehead
    Bell's palsy (LMN CN VII palsy)
  267. Urethritis, conjunctivitis, arthritis in a male
    Reiter's syndrome (reactive arthritis associated with HLA-B27)
  268. Vascular birthmark (port-wine stain)
    1. Hemangioma (benign) // 2. Sturge-Weber syndrome
  269. Vasculitis from exposure to endotoxin causing glomerular thrombosis
    Shwartzman reaction (following 2nd exposure to endotoxin)
  270. Vomiting blood following esophagogastric lacerations
    Mallory-Weiss syndrome (alcoholic and bulemic patients)
  271. Waxy casts with very low urine flow
    Chronic end-stage renal disease (ESRD)
  272. WBC casts in urine
    Acute pyelonephritis
  273. Weight loss, diarrhea, arthritis, fever, adenopathy
    Whipple's disease (Tropheryma whippelii)
  274. Worst headache of my life
    Subarachnoid hemorrhage
  275. Anti-centromere antibodies
    Scleroderma (CREST)
  276. Anti-desmoglein (epithelial) antibodies
    Pemphigus vulgaris (blistering)
  277. Anti-glomerular basement membrane antibodies
    Goodpasture's syndrome (glomerulonephritis and hemoptysis)
  278. Anti-histone antibodies
    Drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
  279. Anti-IgG antibodies
    Rhematoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
  280. Anti-mitochondrial antibodies (AMAs)
    PBC - primary biliary cirrhosis (female, cholestasis, portal hypertension)
  281. Anti-neutrophil cytoplasmic antibodies (ANCAs)
    Vasculitis (c-ANCA: Wegener's, p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome)
  282. Anti-nuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
    SLE (type III hypersensitivity)
  283. Anti-platelet antibodies
    Idiopathic thrombocytopenic purpura (ITP) (bleeding diathesis)
  284. Anti-topoisomerase antibodies
    Diffuse systemic scleroderma
  285. Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
    Celiac disease (diarrhea, distension, weight loss)
  286. Azurophilic granular needles in leukemic blasts
    Auer rods (AML, especially promyelocytic)
  287. Bamboo spine on X-ray
    Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
  288. Basophilic nuclear remnants in RBCs
    Howell-Jolly bodies (due to splenectomy or non-functional spleen)
  289. Basophilic stippling of RBCs
    Lead poisoning or sideoblastic anemia
  290. Bloody tap on LP
    Subarachnoid hemorrhage
  291. Boot-shaped heart of x-ray
    Tetralogy of Fallot, RVH
  292. Branching gram-positive rods with sulfur granules
    Actinomyces israelii
  293. Bronchogenic apical lung tumor
    Pancoast's tumor (can compress sympathetic ganglion, can cause Horner's syndrome)
  294. Brown tumor of bone
    Hemorrhage (hemosiderin) causes brown color of osteolytic cysts due to: 1. Hyperparathyroidism or 2. Osteitis fibrosis cystica
  295. Cardiomegaly with apical atrophy
    Chagas' disease (Trypanosoma cruzi)
  296. Cellular crescents in Bowman's capsule
    Rapidly progressive crescentic glomerulonephritis
  297. Chocolate cyst of ovary
    Endometriosis (frequenly both ovaries)
  298. Circular grouping of dark tumor cells surrounding pale neurofibrils
    Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
  299. Colonies of mucoid Pseudomonas in lungs
    Cystic fibrosis (CFTR mutation resulting in fat-soluble vitamin deficinecy and mucous plugs)
  300. Degeneration of dorsal column nerves
    Tabes dorsalis (tertiary syphilis)
  301. Depigmentation of neurons in substantia nigra
    Parkinson's disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
  302. Desquamated epithelium casts in sputum
    Curschmann's spiral (bronchial asthma; can results in whorled mucous plugs)
  303. Disarrayed granulosa cells in eosinophilic fluid
    Call-Exner bodies (granulosa-theca cell tumor of the ovary)
  304. Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
    Koilocytes (HPV: predisposes to cervical cancer)
  305. Enlarged cells with intranuclear inclusion bodies
    Owl's eye appearance of CMV
  306. Enlarged thyroid cells with ground-glass nuclei
    Orphan Annie eye nuclei (papillary carcinoma of the thyroid)
  307. Eosinophilic cytoplasmic inclusion in liver cell
    Mallory bodies (alcoholic liver disease)
  308. Eosinophilic cytoplasmic inclusion in nerve cell
    Lewy body (Parkinson's disease)
  309. Eosinophilic globule in liver
    Councilman body (toxic/viral hepatitis, often yellow fever)
  310. Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
    Rabies virus (Lyssavirus)
  311. Extracellular amyloid deposition in gray matter of brain
    Senile plaques (Alzheimer's disease)
  312. Giant B cells with bilobed nuclei with prominent inclusions ("Owl's eye")
    Reed-Sternberg cells (Hodgkin's lymphoma)
  313. Glomerulus-like structure surrounding vessel in germ cells
    Schiller-Duval bodies (yolk-sac tumor)
  314. Hair-on-end (crew-cut) appearance on x-ray
    B-thalassemia, sickle cell anemia (extramedullary hematopoiesis)
  315. hCG elevated
    Choriocarcinoma or Hyatidiform mole (with or without embryo)
  316. Heart nodules (inflammatory)
    Aschoff bodies (rheumatic fever)
  317. Heterophile antibodies
    Infectious mononucleosis (Epstein-Barr virus)
  318. Hexagonal, double-pointed, needle-like crystals in bronchial secretions
    Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
  319. High levels of D-dimers
    DVT, pulmonary embolism, DIC
  320. Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
    Ghon focus (primary TB: Mycobacterium bacilli)
  321. Honeycomb lung on x-ray
    Interstitial fibrosis
  322. Hypersegmented neutrophils
    Megaloblastic anemia (B12, folate deficiency)
  323. Hypochromic, microcytic anemia
    Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present)
  324. Increased a-fetoprotein in amniotic fluid/maternal serum
    Increased a-FP: Anencephale, spina bifida (neural tube defects)
  325. Increased uric acid levels
    Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
  326. Intranuclear eosinophilic droplet-like bodies
    Cowdry type A bodies (HSV or Yellow fever)
  327. Iron containing nodules in alveolar septum
    Ferruginous bodies (asbestosis: higher risk of mesothelioma)
  328. Large lysosomal vesicles in phagocytes, immunodeficiency
    Chediak-Higashi disease (congenital faillure of phagolysosome formation)
  329. Low serum ceruloplasmin
    Wilson's Disease (hepatolenticulra degeneration)
  330. Lumpy-bumpy appearance of glomeruli or immunofluorescence
    Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
  331. Lytic ("hole-punched") bone lesions on x-ray
    Multiple myeloma
  332. Mammary gland ("blue-domed") cyst
    Fibrocystic change of the breast
  333. Monoclonal Ab spike
    1. Multiple myeloma (M-protein, usually IgG or IgA) // 2. Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging) // 3. Waldenstrom's (M-protein=IgM) macroglobulinemia // 4. Primary amyloidosis
  334. Monoclonal globulin protein in blood/urine
    1. Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine)] // 2. Waldenstrom's macroglobulinemia
  335. Mucin-filled cell with peripheral nucleus
    Signet ring (gastric carcinoma)
  336. Narrowing of bowel lumen on barium swallow
    String sign (Crohn's disease)
  337. Needle-shaped, negatively birefringent crystals
    Gout (hyperuricemia)
  338. Nodular hyaline deposits in glomeruli
    Kimmelstiel-Wilson nodules (diabetic nephropathy)
  339. Nutmeg appearance of liver
    Chronic passive congestion of liver due to right heart failure
  340. Onion-skin periosteal reaction
    Ewing's sarcoma (malignant round-cell tumor)
  341. Periosteum raised from bone, creating triangular area
    Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)
  342. Podocyte fusion on EM
    Minimal change disease (child with nephrotic syndrome)
  343. Polished, "ivory-like" appearance of bone at cartilage erosion
    Eburnation (osteoarthritis resulting in bony sclerosis)
  344. Protein aggregates in neurons from hyperphosphorylation of protein tau
    Neurofibrillary tangles (Alzheimer's disease or CJD)
  345. Pseudopalisading tumor cells on brain biopsy
    Glioblastoma multiforme
  346. RBC casts in urine
    Acute glomerulonephritis
  347. Rectangular, crystal-like cytoplasmic inclusions in Leydig cells
    Reinke crystals (Leydig cell tumor)
  348. Renal epithelial casts in urine
    Acute toxic/viral nephrosis
  349. Rhomboid crystals, positively birefringent
    Pseudogout (calcium pyrophosphate dihydrate)
  350. Rib notching
    Coarctation of the aorta
  351. Sheets of medium-sized lymphoid cells ("starry-sky" appearance on histology)
    Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV)
  352. Silver staining spherical aggregation of tau proteins in neurons
    Pick bodies (Pick's disease: progressive dementia; similar to Alzheimer's)
  353. Soap bubble in femur or tibia on x-ray
    Giant cell tumor of bome (generally benign)
  354. Spikes on basement membrane, "dome-like" endothelial deposits
    Membranous glomerulonephritis (can progress to nephrotic syndrome)
  355. Stacks of RBCs
    Rouleaux formation (high ESR, multiple myeloma)
  356. Stippled vaginal epithelial cells
    Clue cells - Gardnerella vaginalis
  357. Tennis-racket shaped cytoplasmic organelles (EM) in Langerhans cells
    Birbeck granules (histiocytosis X: eosinophilic granuloma)
  358. Thrombi made of white/red layers
    Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
  359. Thumb sign on lateral x-ray
    Epiglottitis (Hemophilus influenzae)
  360. Thyroid-like appearance of kidney
    Chronic bacterial pyelonephritis
  361. Tram-track appearance on LM
    Membranoproliferative glomerulonephritis
  362. Triglyceride accumulation in liver cell vacuoles
    Fatty liver disease (alcoholic or metabolic syndrome)
  363. WBCs that look smudged
    CLL (almost always B cell; affects elderly)
  364. Wire-loop glomerular apperance on LM
    Lupus nephropathy
  365. Yellow CSF
    Xanthochromia (subarachnoid hemorrhage)

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