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Pink complexion, dyspnea, hyperventilation
"Pink puffer" (emphysema: centroacinar [smoking], panacinar [α1-antitrypsin deficiency])
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Polyuria, acidosis, growth failure, electrolyte imbalances
Fanconi's syndrome (proximal tubular reabsorption defect)
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Positive anterior "drawer sign"
Anterior cruciate ligament (ACL) injury
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Ptosis, miosis, anhidrosis
Horner's syndrome (sympathetic chain lesion)
* sympathetic nerves innervate superior tarsal muscle that, along with levator palpebrae superioris innervated by CNIII, controls raising upper eyelid
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Pupil accommodates but doesn't react
Argyll Robertson pupil (neurosyphilis)
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Rapidly progressive leg weakness that ascends (following GI/upper respiratory infections)
Guillain-Barre syndrome (autoimmune acute inflammatory demyelinating polyneuropathy)
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Rash on palms and soles
2° syphilis, Rocky Mountain spotted fever
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Recurrent colds, unusual eczema, high serum IgE
Job's syndrome (hyper-IgE syndrome: neutrophil chemotaxis abnormality)
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Red "currant jelly" sputum in alcoholic or diabetic patients
Klebsiella pneumoniae
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Red, itchy, swollen rash of nipple/areola
Paget's disease of the breast (represents underlying neoplasm)
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Red urine in the morning, fragile RBCs
Paroxysmal nocturnal hemoglobinuria
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Renal cell carcinoma, hemangioblastomas, angiomatosis, pheochromocytoma
von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
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Resting tremor, rigidity, akinesia, postural instability
Parkinson's disease (nigrostriatal dopamine depletion)
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Restrictive cardiomyopathy (juvenile form: cardiomegaly), exercise intolerance
Pompe's disease (lysosomal glucosidase deficiency)
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Retinal hemorrhages with pale centers
Roth's spots (bacterial endocarditis)
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Severe jaundice in neonate
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
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Severe RLQ pain with rebound tenderness
McBurney's sign (appendicitis)
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Short stature, ↑ incidence of tumors / leukemia, aplastic anemia
Fanconi's anemia (genetically inherited; often progresses to AML)
Autosomal recessive defect in DNA repair proteins
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Single palm crease
Simian crease (Down syndrome)
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Situs inversus, chronic sinusitis, bronchiectasis
Kartagener's syndrome (dynein defect affecting cilia)
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Skin hyperpigmentation
Addison's disease (1° adrenocortical insufficiency of autoimmune or infectious etiology)
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Slow, progressive muscle weakness in boys
Becker's muscular dystrophy (X-linked, defective dystrophin; less severe than Duchenne's)
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Small, irregular red spots on buccal / lingual mucosa with blue-white centers
Koplik spots (measles)
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Smooth, flat, moist white lesions on genitals
Condylomata lata (2° syphilis)
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Splinter hemorrhages in fingernails
Bacterial endocarditis
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"Strawberry tongue"
Scarlet fever, Kawasaki disease, toxic shock syndrome
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Streak ovaries, congenital heart disease, horseshoe kidney
Turner syndrome (XO, short stature, webbed neck, lymphedema, widely-spaced nipples)
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Sudden swollen / painful big toe joint, tophi
Gout / podagra (hyperuricemia)
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Swollen gums, mucous bleeding, poor wound healing, spots on skin
Scurvy (vitamin C deficiency: can't hydroxylate proline / lysine for collagen synthesis)
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Swollen, hard, painful finger joints
Osteoarthritis (osteophytes on PIP [Bouchard's nodes], DIP [Heberden's node])
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Systolic ejection murmur (crescendo-decrescendo)
Aortic valve stenosis
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Thyroid and parathyroid tumors, pheochromocytoma
Sipple's syndrome (MEN 2A)
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Toe extension / fanning upon plantar scrape
Babinski's sign (UMN lesion)
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Unilateral facial drooping involving forehead
Bell's palsy (LMN CN VII palsy)
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Urethritis, conjunctivitis, arthritis in a male
Reiter's syndrome (reactive arthritis associated with HLA-B27)
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Vascular birthmark (port-wine stain)
Hemangioma (benign, but associated with Sturge-Weber syndrome)
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Vasculitis from exposure to endotoxin causing glomerular thrombosis
Schwartzman reaction (following second exposure to endotoxin)
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Vomiting blood following esophagogastric lacerations
Mallory-Weiss syndrome (alcoholic and bulimic patients)
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"Waxy" casts with very low urine flow
Chronic end-stage renal disease
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WBC casts in urine
Acute pyelonephritis
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Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple's disease (Tropheryma whippelii)
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"Worst headache of my life"
Subarachnoid hemorrhage
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