First Aid Rapid Review - 1. Classic Presentations (JR) Part#3

nelotebi's version from 2015-06-24 19:33

Clinical presentations

Clinical PresentationDiagnosis/Disease
Facial angiofibroma, ash-leaf spots of skin hypopigmentation, seizures, mental retardation Tuberous Sclerosis
(Face + skin spots + seizures + mental retardation)

↑ risk of CAAT
Cardiac Rhabdomyomas,
Angiomyolipomas ((in kidneys)
--> Tuberous Sclerosis)
Failure of longitudinal bone growth (aka NO endochondral ossification), Membranous ossfication (skull) NOT affected. FGFR3 mutation = inhibits chrondocytesDwarfism (Achondroplasia) (↑ risk w/ ↑ paternal age) *normal life span & fertility
Failure to relax of lower esophageal sphincter, progressive dysphagia (solids --> liquids), inc risk of esophageal squamous cell carcinoma, associated with Chagas; due to damage in Auerbach pleuxs
Achalasia (loss of myenteric (motor) (auerbach's plexus), loss of NO = inc tone = no relaxation)
Facial muscle spasm upon tappingChvostek's sign (hypocalcemia = also Trousseau's sign --> BP cuff around arm = carpal muscle spasms)
Facial lesionsStroke (UMN lesion) = paralysis of contralateral lower face only (can't smile).

CN VII lesion (LMN lesion) (Bell's Palsy) = paralysis of ipsilateral side of both upper (can't close eye/wrinkle forehead) and lower face (can't smilie). (Bilateral UMN innervation to upper face)
Fat, female, forty, fertileAcute Cholelithiasis (gallstones)
Fatty liver, no alcohol use, obese ptx, DM II, hyperlipidemia, insulin-resistanceNonAlcoholic Steatohepatitis (NASH)
Female, inc conjugated bilirubin, inc cholesterol, inc alkaline phosphatase, lymphocytes + granulomas in hepatocytes. B/c of obstruction = hypercholesterolemia --> xanthelasmas = Foam cells. Xanth = yellow (fat)
Primary Biliary Cirrhosis (autoimmune)
Femoral neck fracture, dista radius (Colles') fracture.
Trabecular (spongy) bone loses mass and interconnection
*Normal interconnections and normal lab values
Osteoporosis (↑ Osteoclast)
Osteoporosis Type I (post-menopausal, ↑ bone resorption b/c low estrogen). Can lead to Vertebral Crush Fractures = acute back pain, loss of height, kyphosis

Osteoperosis II = old age (men more affected). Prevent by exercise, calcium and Vit D supplementation

Tx = Bisphosphonates (-edotronates)
Fever, chills, headache, myalgia following antibiotic tx for syphilis (PCN)Jarisch-Herxheimer rxn (rapid lysis of spirochetes results in toxin release)
Fever, cough, conjunctivitis, coryza, diffuse rashMeasles (Morbillivirus, paraMyxovirus); "4 C's" = cough, coryza (inflam of nose), conjunctivitis, Koplik Spots
Fever, hemorrhage, anemia after drinking contaminated water (animal urine) (jaundice + azotemia from liver and kidney failure)Weil’s disease (icterohemorrhagi leptospirosis)
Fever, night sweats, weight loss - 2B symptoms (lymphoma); TB
Fever every 48 hours + headache + anemia + splenomegaly. Spread by ANOPHELES mosquito.Plasmodium vivax/ovale (dormant form in liver) ~Tx = Chloroquine + Primaquine)
Fever every 72 hours + headache + anemia + splenomegaly. Spread by ANOPHELES mosquito.Plasmodium malariae Tx = Chloroquine
*Fibrous plaques in soft tissue of penisPeyronie's disease (connective tissue disorder)
P for Penis
Fibrous plaques and atheromas in the intima of arteriesAtherosclerosis (fat) (↑ BP = ↑ endothelial damage = ↑ LDL = ↑ fat deposit = ↑ macrophage = ↑ foam cells = FATTY STREAKS = ↑ platelets = ↑FGF/PDGF = fibrous plaque = ATHEROMA
Flu, jaundice, photophobia` w/ conjunctivitis after drinking water contaminated w/ animal urine~, question-mark shaped bugLeptospira interrogans
Fluid in pericardium, ↓CO, Hypotension, JVD, ↑HR, Pulsus Paradoxus (↓ in systolic by > 10 mmHg DURING inspiration)Cardiac Tamponade
Food poisoning from reheated meat dishes, causing diarrheaC. perfringens
Food poisoning from reheated riceBacillus cereus
Food poisoning from canned foodsC. Botulinum
Food poisoning from preformed toxin (mayo, meats)S. aureus
Food poisoning form contaminated seafood (shellfish)Vibrio
Food poisoning from chicken, meats, eggs, turtlesSalmonella
Fruity breathKetoacidosis (urine test = acetoacetate, no measure beta-hydroxybutyrate)
Garlic breath, vomiting, rice water stoolsArsenic Poisoning (blocks Lipoic acid - needed for pyruvate dehydrogenase, dec TCA cycle)
Ghon complex, ceseating necrosis, apex of lungs, acid-fast bacilli, fever, night sweats, cough, weight lossTB (most common spread to Kidneys, if to lumbar vertebrae = Potts Disease)
Gout, mental retardation, self-mutilating behavior in a boy (lip-biting), very aggressive, choreoathetosisLesch-Nyhan syndrome (HGPRT def, X-linked recessive) "juvenile gout" (Tx = allopurinol)
Green-yellow rings around peripheral corneaKayser-Fleischer rings (copper accumulation from Wilson's disease)
Gumma (chronic granulomas), aortitis, neurosyphilis (Tabes-dorsalis DUE to degeneration of dorsal columns and dorsal roots of spinal cord), Argyll-robertson pupil,positive Rhomberg, charcot joint, stroke w/o HTNTertiary Syphilis


Clinical PresentationDiagnosis/Disease
Halitosis (bad breath) + dysphagia + obstruction
Zenker's diverticulum (false diverticulum near the upper esophageal sphincter)
Hearing lossWeber Lateralization (lateralizes to the side of conductive hearing loss, contralateral to the side w/ sensorineural hearing loss), Rinne (abnormal results = Bone > Air --> Conductive hearing loss on that side)
HELLP (Hemolysis, Elevated Liver Enzymes ,Low Platelet)complication of Pre-eclampsia
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands (GI bleeding + pigments on mouth/lips/feet/hands) Peutz-Jeghers syndrome (genetic benign polyposis can cause bowel obstruction; ↑ GI cancer risk) (puke after taking dark jagger bombs - GI bleed + mouth pigments)
Headache, fever, rash = classic triad + rash starts at wrist and ankle and then spreads to trunk
Rocky Mountain Spotted Fever (Rickettsia rickettsii, tick)
Headache, fever, rash = classic triad + rash starts at the trunk and spreads outEpidemic Typhus (Rickettsia prowazekii, lice) ((Endemic typus = Rickettsia typhi, fleas)
Heinz bodiescondensed Hb, G6PD deficiency (also Bite Cells)
Hemisection of Spinal Cord. Ipsilateral loss of PTV (DC-ML), Ipsilateral UMN signs below the lesion, Ipsilateal loss of PT (ALS) at lesion, Contralateral loss of PT (ALS) below, LMN signs at lesion, Horners (Ptosis, Miosis, Anhidrosis if at T1)
Brown-Sequard Syndrome
Hemorrhage in basal ganglia and/or internal capsule, caused by systemic HTN, seen w/ amyloidosis, vasculitis, neoplasm Intraparenchymal Hemorrhage
Hemorrhage with ↑PT, ↑PTT in neonate, normal bleeding timeVitamin K deficiency (neonates given IM Vit K), Vit K = factors 2,7,9,10,C&S. gamma-Carboxylation
Hemolysis, Uremia (kidney function ↓) , Thrombocytopenia, DiarrheaHUS (Hemolytic Uremic Syndrome)
Hemolytic anemia, muscle weakness, posterior column & spinocerebellar tract demyelination & proximal muscle weaknessVitamin E deficiency (antioxidant)
HemosIderin-laden macrophages <img src="", width="250", height="180">Left-Heart failure (↓ CO = ↑ EDV = back up of blood = ↑ pulmonary congestion/pressure = ↑ leaking of blood out of pulmomary vessels = blood in lungs taken up by macrophage = IRON LADEN MACROPHAGES IN LUNG)
*Hepatosplenomegaly, aseptic necrosis of bones, neurologic symptomsGaucher's disease (glucocerebrosidase def; type of glucosylceramidase LSD, lipid accumulates in WBCs)
Hereditary nephritis, sensorineural hearing loss, cataracts (can't see, can't pee, can't hear)Alport syndrome (mutation in α chain of collagen IV)
Herniation of cerebellar tonsil through foramen magnum, obstruct CSF fluid = hydrocephalus, associated w/ meningomyelocele and syringomyeliaArnold-Chiari Malformation Type II
Herniation of cingulate gyrus under the flaxSubfalcine herniation --> compress Anterior Cerebral Artery
Herniation of uncut (temporal lobe) under the tentorium cerebelliUncal herniation --> lesion in CN III nerve, Posterior Cerebral Artery, Duret hemorrhage
High-school football game, young athlete collapses and dies immediatelyHypertrophic Cardiomyopathy
"Hobnail" appearance of liver, shrunken, irreversible damage, sclerosis around central vein (Zone III)Alcoholic cirrhosis (diffuse fibrosis and nodular regeneration destroys normal architecture)
Howell-Jolly bodiesDNA remnants, seen in asplenia or after moth ball ingestion Naphthalene


Clinical PresentationDiagnosis/Disease
Hyaline (thickening of small arterioles in HTN or DM) or hyperplastic ("onion skinning" in malignant HTN)Arteriolosclerosis
Hypercalcemia, loss of appetite, ↑ activation of Vitamin D by epthelioid macrophagesSarcoidosis
Hypercoagulability (leading to migrating DVTs and vasculitis)Trousseau's syndrome (adenocarcinoma of pancreas/GI or lung)
Hypercoagulability + ↓ blood flow + endothelial damageVirchow Triad (↑ risk of thrombosis)
Hyperphagia, hypersexuality, hyperorality, hyperdocility - put things in mouth, ↑ sex, ↑ hungerKlüver-Bucy syndrome (bilateral amygdala lesions), seen in HSV-1
Hyperreflexia, hypertonia, positive/extensor Babinski signUMN damage (corticospinal tract)
Hypersensitivity to UV light, 1000x inc risk of skin cancersXeroderma pigmentosum (defect in Nucleotide Excision Repair = thymidine-dimers)
Hypersensitivity to ionizing radiation, immunodeficiency, ataxiaAtaxia-Talangiectasia (defect in Nonhomologous end joining)
Hypertension, hypokalemia, metabolic alkalosisConn's syndrome (adrenal adenoma causing primary hyperaldosteronism)
Hypertension, proteinuria, edema in pregnant femalePre-eclampsia (if have seizures = Eclampsia, tx = Magnesium sulfate)
Hypertrophied mucous glands (Reid index > 50%), due to smoking, productive cough for >3 mths for 2 years, cyanosis "blue bloaters"Chronic Bronchitis (COPD) (smoking)
Hypertrophy of rugae in stomachMénéTrier's disease (vs. Ménière's disease (Endolymphatic Hydrops) = vertigo + tinnitus + hearing loss)
Hypocalcemia, bone pain, deformity in kids. Defective bone mineralization = soft bones.Vitamin D (1,25-OH) deficiency (Caltriol). Rickets = kids, Osteomalacia = adults. Breast milk has low Vit D. Liver & Kidney (final) activation. Supplements = D3 (cholecalciferol)

Labs = ↓Vit D --> ↓Ca+ absorption --> ↑PTH --> ↓Phosphate, ↑ALP
Hyporeflexia, hypotonia, atrophyLMN damage
Hypoxemia/cyanosis, polycythemia, hypercapnia"Blue bloater" (COPD chronic bronchitis: hyperplasia of mucous cells)