First Aid Rapid Review - 1. Classic Presentations (JR) Part#7

taheyona's version from 2016-07-19 02:29

Clinical presentations

Clinical PresentationDiagnosis/Disease
Saber shins, saddle nose, CN VIII deafness, hutchinson’s teeth (notching)
Congenital Syphilis
Scanning speech, Intention tremor (Incontinence & Internuclear Ophthalmoplgeia), Nystagmus (SIN)Charcot's Triad --> Multiple Sclerosis
S3 heart sound, dilated heart, balloon appearance on CXR, systolic dysfunction, eccentric hypertrophy, sarcomeres in series
**Mitral Valve + Tricuspid Valve regurgitation

Dilated Cardiomyopathy

(ABCCCD = Alcohol, wet Beri Beri, Coxsackie B virus, Cocaine, Chagas, Doxorubicin).

Tx = ↓Na, ACE-Inhibitors, Diuretics, digoxin, heart transplant
S4 heart sound, Sudden death in young athletes, LV hypertrophy w/o heart dilation
"disarray of myocytes"
normal sized heart, diastolic dysfunction, concentric hypertrophy, sarcomeres in parallel, autosomal dominant, "beta-myosin heavy chain mutation"
Hypertrophic Cardiomyopathy

Tx = beta-blcokers, Verapamil, avoid sports, prevent dehydration (↓CO = makes condition worse)
Sandblaster/miner, fobrotic nodules in upper lobe, ↑ risk of TB, ↓ phagolysosome action in macrophagesSilicosis
Sandfly transmission, KALA-AZAR, spiking fever + hepatosplenomegaly + pancytopeniaLeshmania donovani (tx = sodium stibogluconate)
Sarcoidosis (prussian blue)
Amyloidosis (congo-red)
Hemachromatosis (iron overload)
Loffler's syndrome (eosinophils + fibrosis in myocardium)
Endocardial Fibroelastosis (children)
diastolic dysfunction + EKG = ↓QRS amplitude
Restrictive/Obliterative Cardiomyopathy

↓ in compliance (δV/δP) b/c of deposition
Severe jaundice in neonateCrigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
Severe RLQ pain w/ palpation of LLQRovsing's sign (acute appendicitis)
Severe RLQ pain w/ rebound tendernessMcBurney's sign (appendicitis)
Short stature, ↑ incidence of tumors/leukemia, aplastic anemiaFanconi's anemia (genetic loss of DNA crosslink repair, often progresses to AML)
Short-term change in liver w/ moderate alcohol intake, fatty change, reversibleHepatic steatotis
Single palm creaseSimian crease (Down syndrome)
SItS (Supraspinatus - initial abduction, Infraspinatus - lateral rotation, teres minor = adduction, lateral rotation, Subscapularis muscles = adduction and medial rotation)Rotator Cuff Muscles (Innervated by C5-C6)
Situs inversus, chronic sinusitis, bronchiectasis, infertilityKartagener's syndrome (dynein arm defect affecting cilia)
Skin hyperpigmentationAddison's disease (primary adrenocortical insufficiency causes ↑ ACTH and α-MSH production)
Slow, progressive muscle weakness in boysBecker's muscular dystrophy (X-link recessive missense mutation in dystrophin; less severe than Duchenne's)
Small, irregular red spots on buccal/lingual mucosa with blue-white centers
Koplik spots (measles = 4 C's --> coryza, conjunctivitis, cough, Koplik; rubeola virus)
Smoker, central cancer of lungs, ↑ADH, ↑ ACTH, Eaton-Lambert syndrome (↓ in calcium release), poorly differentiated cells, poor prognosis, neuroendocrine cells (chromogranin +), Chemotherapy only, too small to resectSmall-Cell Carcinoma of Lungs
Smoker, central cancer of lungs, ↑ PTHrP, Hypercalcemia, Keratin Pearls & Intercellular bridgesSquamous Cell Carcinoma of Lungs
Smoker, central or peripheral cancer of lungs, not small cell, not squamous cell, poor prognosisLarge Cell Carcinoma of Lungs
Smooth, flat, moist flesh-colored lesions on genitalscondyloma lata (secondary syphilis)
Smudge cells, ↑ naive B-cells (CD-20) tumor, ↓ Ig, autoimmune hemolytic anemia, most common in adultsCLL (Chronic Lymphoblastic Leukemia) ((same as SLL = Small Lymphocytic Lymphoma)
Snail host, "swimmer's itch", liver & spleen granulomas, fibrosisSchistosoma (Egyptian immigrant w/ hematuria = Schistoma haematobium --> increases risk of squamous cell carcinoma of bladder)
Some Lovers Try Positions That They Can't Handle = Scaphhoid, Lunate, Triquetrium, Pisiform, Trapezium, Trapezoid, , Capitate, Hamate)Wrist Bones (Scaphoid = most commonly fractured, avascular necrosis. Lunate = carpal tunnel syndrome w/ MEDIAN NERVE & Most disLocated one. Pisiform & Hamate = Ulnar)
Sore throat from Group A strep (Strep. pyogenes) complication, Type II hypersensitivty rxn, antibodies to M-protein, ASO titers.
*Aschoff bodies (granuloma w/ giant cells). Anitschkow's Cells (activated histiocytes = caterpillar cells)
J♥NES criteria = Joint(migratory polyarthritis), ♥=Pancarditis, Nodules (subcutaneous), Eryhtmea Marginatum "spreading like snake", Sydenham/St. Vitus Chorea~
Rheumatic Fever (JONES criteria)

Mitral > Aortic > Tricuspid.

(Acute RF = MR, Chronic RF = Mitral stenosis)

Pancarditis -->
1. Endocarditis = Mitral Valve Regurgitation (sometimes Aortic V), vegetations
2. Myocarditis = inflammation, aschoff body w/ anistschkow cells = most common cause of death
3. Pericarditis = friction rub + pleuritic pain
Spastic paralysis, lockjaw (trismus), risus sardonicus (sustained spasm of the facial muscles)C. tetani (↓GABA CNS, ↓ Glycine in PNS)
Spastic paralysis on Left (UMN lesion), CN III palsy on Right (ptosis, miosis, lateral strabismus= eyes are "down and out")Weber Syndrome (Posterior Cerebral Artery) (Ipsilateral CN III palsy + Contralateral Spastic paralysis = b/c of Cerebral peduncle) (in this case = RIGHT Posterior Cerebral Artery)
Spastic paralysis (UMN) on one side + Cranial Nerve lesions on the other sideBrainstem Lesions
SPHERE complications = SVC syndrome, Pancoast tumor (apex), Horners (ptosis, miosis, anhydrosis), Endocrine, Recurrent laryngeal symptoms (hoarseness), EffusionsComplications of Lung Cancer (metastasis to adrenal gland)
Splinter hemorrhages in fingernails
bacterial endocarditis
Squamous cells & Keratin debris from fetal skin in embolusAmniotic fluid embolus
ST depression on EKG Angina, ischemia, subendocardial injury
ST elevation on EKG MI, infarction, transmural injury
Staggering gait, frequent falling, nystagmus, dysarthria, hammer toes, hypertrophic cardiomyopathy, cerebellum lesion + DC-ML spinal cord lesionFreidreich Ataxia (GAA, frataxin gene, iron build up in mitochondria)
"Starry sky" appearance, sheets of lymphocytes + spread out macrophages, EBV, jaw lesion on African child (endemic) , t(8;14), c-myc, sporadic = abdominal or pelvisBurkitt's Lymphoma (Non-Hodgkin's Lymphoma)
Sterile vegetations due to Lupus on BOTH SIDE (atrial and ventricular) of Mitral Valve --> Mitral RegurgitationLibman-Sacks Endocarditis
"Strawberry tongue" - 2
Scarlet fever (scarlet rash sparing face, strawberry tongue, scarlet throat, caused by Strep. pyogenes) , toxic shock syndrome
Kawasaki disease
"Strawberry tongue" + Rash on palm of hand and sole feet Kawasaki disease (tx = aspirin - irreversibly block COX - ↓ TXA2 = ↓platelets platelet life span = 8-10 days)

Kawasaki = motorcycle = hand/feet + tongue
Streak ovaries, aortic coarctation, horseshoe kidney, cystic hygroma at birthTurner syndrome (45XO, short stature, webbed neck, lymphedema)
Sudden swollen/painful big toe joint, tophiPodagra (gout: hyperuricemia)
Swimming in fresh water lake, protozoa enters via cribiform plate, fatal MENIGOENCEPHALITIS, protozoa in spinal fluidNaegleria fowleri (Nalgene bottle filled w/ fresh water containing Naelgeria)
Swollen gums, mucous bleeding, poor wound healing, Cork screw hairScurvy (Vit C def: can't hydroxylate proline/lysine for collagen synthesis RER). Antioxidant, take iron supplement w/ OJ. Excess Vit C = iron toxicity
Swollen belly, edema, liver malfunction (fatty change b/c low apolipoprotein), skin lesions
Kwashiorkor (protein malnutrition)
Swollen, hard, painful finger jointsOsteoarthritis (osteophytes on PIP [Bouchard's nodes]; DIP [Herbeden's nodes])
Systolic ejection murmur (crescendo-decrescendo)Aortic stenosis