First Aid Rapid Review - 1. Classic Presentations (JR) Part#8

pokixake's version from 2016-02-25 16:26


Clinical PresentationDiagnosis/Disease
Target cells on blood smearHALT (HbC, Asplenia, Lead poisoning, Thalassemia)
TdT+ (DNA polymerase), > 20% lymphoblasts, children, can spread to CNS or testes, t(12;21) = better prognosisALL (Acute Lymphoblastic Leukemia)
Tear drop red blood cells, bone marrow fibrosis, JAK2 kinase mutationMyelofibrosis (bone marrow is crying b/c it's fibrosed) (aplastic anemia = fatty change in bone marrow)
Tearing chest pain that radiates to back + wide mediastinum

Aortic Dissection (HTN or Marfans) --> Ascending Aorta
Tendon rupture from an antibioticFluroquinolone (-floxacin). Blocks DNA topoisomerase II (DNA gyrase) (fluroquinolones hurt attachment to your bones)
Thalamus1. VPL = PT,PTV from body
2. VPM = PT,PTV from face (face sensation and taste)
3. LGB = Vision (CN II --> Calcarine sulcus))
4. MGB = Music (Inferior Colliculus --> Auditory cortex)
5. VL = motor (Basal Ganglia --> Motor Cortex)
Thick bones, more fractures. Pancytopenia. Bone-in-bone appearanceOsteopetrosis aka Marble Bone Disease (↓ Osteoclast b/c of Carbonic Anhydrase II mutation)
Thyroid & parathyroid tumors, pheochromocytomaMEN 2A (auto dom RET mutation)
Thyroid tumors, pheochromocytoma, mucosal neuromas (oral/intestinal)MEN 2B (auto dom RET mutation)
Toe extension/fanning upon plantar scrapeBabinski sign (UMN lesion)
Torsades de pointes (↑ QT interval), defect in heart sodium or potassium channels, sensorineural deafnessJervell and Lange-Nielsen Syndrome
TRAP positive, ↑ Mature B-cells, Tx = CLADIRIBINE (adenosine deaminase inhibitor)Hairy Cell Leukemia (as you mature, you get hairy = easier for things to get trapped)
Tremor, chorea (dancing-like, sudden, jerky, purposeless movements) or athetosis (writhing, snake-like movements of fingers)Basal Ganglia Lesion (Parkinsons = resting tremor vs. Huntington's = chorea, athetosis)
Tremor w/ movement = slow, zig/zag motion when pointing/extending toward a targetIntention Tremor (Cerebellar dysfunction)
Truncal/Axial ataxia, dysarthriaCerebellar Vermis Lesion (medial = central)
Twisting of bowel (cecum or sigmoid the two ends of the colon) around mesentryVolvulus
UMN & LMN lesion (ONLY MOTOR LOSS), no sensory loss, no oculomotor deficits.Amyotrophic Lateral Sclerosis aka Lou Gehrig's Disease (Stephen Hawking) (defect in Zinc-Copper Superoxide Dismutase (SOD))
Unilateral facial drooping involving foreheadBell's palsy (LMN CN VII palsy)
Urethritis, conjunctivitis, arthritis in a maleReiter's/reactive arthritis associated with HLA-B27, cross reactivity rxn to infection
Urine smells like maple syrupMaple syrup urine disease (↓ alpha-ketoacid dehydrogenase), ↑ ketoacids in blood. I Love Vermont (Isoleucine, Leucine, Valine). Tx = protein restriction.
Urine w/ clear prism or plate crystals
Uric acid crystals (GOUT) Tx = Acetazolamide or Allopurinol
Urine w/ coffin lid shaped crystals
Triple Phosphate
Urine w/ colorless squares or squares w/ cross crystals
Calcium Oxalate. Tx = HCTZ
Urine w/ hexagonal crystals
Cystinuria (defect in COLA (cysteine, ornithine, lysine, arginine) transporter in PCT of Kidney). Tx = Acetazolamide
Vascular birthmark (port-wine stain)Hemangioma (benign, but associated with Sturge-Weber syndrome)
Vasculitis, older adults >50 yo, carotid artery + branches, unilateral headache, jaw claudication, irreversible blindness, granulomaTemporal Giant Cell Arteritis (Tx = Corticosteroids) (Diagnose by biopsy)
Vasculitis, <50 yo asian female, aortic arch, pulseless disease (weak upper extremity pulses), granulomaTakayasu's Arteritis (all of the a's = asian, aortic arc) (Tx = corticosteroids)
Vasculitis, small arteries, multiple organs/viscera (but NO LUNGS), Hepatitis B +, fibrinoid necrosis, "string of pearl" aneurysmsPolyarteritis Nodosa (tx = Cyclophosphamide)
Vasculitis, coronary arteries, asian children > 4 yo, rash on palm + soles of feet, strawberry tongue, ↑ risk of MIKawasaki Disease (Tx = aspirin + IV IgG) (kawasaki motorcycle = palm + sole, rush = heart)
Vasculitis, male, smokers, digits (toes, fingers, feet) --> gangrene, auto-amputation, Raynaud phenomenonBuerger''s Disease (Tx = stop smoking), eat Burgers w/ fingers and smoke w/ fingers
Vasculitis of nose + lungs + kidneys, c-ANCA+, Triad= necrotizing vasculitis, granulomas, glomerulonephritisWegner's Granulomatosis (Granulomatosis w/ Polyangiitis) (Tx = cyclophosphamide) C's of Wegner's
Vasculitis of lungs + kidneys, p-ANCA+, NO granulomasMicroscopic Polyangiitis (Tx = Cyclophosphamide + Corticosteroids) ((Like Wegner's, but NO granuloma, No nose, No c-ANCA)
Vasculitis of lungs + Eosinophils + granuloma, p-ANCA+, Asthma, ↑IgEChurg-Strauss Syndrome
Vasculitis after UPPER RESPIRATORY TRACT INFECTION, IgA complex deposit, Triad = Palpable purpura on buttocks/legs, Arthralgia, GI pains/melana. IgA nephropathyHenoch-Shonlein purpura
Vertigo + tinnitus + hearing lossMénière's disease (Endolymphatic Hydrops)
Vomiting blood, tear in gastro-esophageael junction b/c of forceful vomiting against a tight lower esophageal sphincter = loss of H+ in vomit = metabolic alkalosisMallory-Weiss syndrome (alcoholic/bulimic pxn)
"Waxy" casts w/ very low urine flowchronic end-stage renal disease
WBC casts in urineacute pyelonephritis
Weight loss, diarrhea, arthritis, fever, adenopathy (Cardio + Arthritis + Neuro)Whipple's disease (Tropheryma whippelii, GI malabsorption) (FOAMY WHIPPed cream in a CAN)
White (curdy) discharge from vagina, pseudohypaeCandida albicans
Winged scapula, ipsilateral lymphademaLong Thoracic Nerve (from C5,C6,C7 roots) (Serratus Anterior), injured during masectomy
"Worst headache of my life"
Subarachnoid hemorrhage (Cerebral Arteries - Circle of Willis)

*Berry Aneurysm --> Anterior Communicating Artery --> Rupture = Subarachnoid hemorrhage

*Seen in Adult PKF, Marfan's and Ehler-Danlos Syndrome
Yellow-Green, foamy, foul smelling discharge from vaginaTrichomonas (Trichomonas vaginalis) (Tx = metronidazole)