Multiple Endocrine Neoplasia (MEN) subtype classification Each subtype has 2 or 3 causes, plus something 1 or 2 more items.
MEN I is disease of 3 P's: [Pituitary, Parathyroid, Pancreas] plus one more: adrenal cortex.
MEN II is disease of 2 C's: [Carcinoma of thyroid, Catacholamines (pheochromocytoma)] plus two more: parathyroid for MEN IIa or mucocutaneous neuromas for MEN IIB (also called MEN III). Takayasu's disease is Pulseless disease "Can't Tak'a ya pulse" (Can't take your pulse):
Takayasu's disease known as Pulseless disease, since pulse is weakened in the upper extremities. Hypercalcemia: symptoms of elevated serum levels "Bones, Stones, Groans, Moans":
Bones: pain in bones
Stones: renal
Groans: pain
Psychic moans/ Psychological overtones: confused state Acute ischemia: signs [especially limbs] 6 P's:
Pain
Pallor
Pulselessness
Paralysis
Paraesthesia
Perishingly cold Hodgkin's lymphoma classification A: Asymptomatic
B: Bad Lichen planus characteristics Planus has 4 P's:
Peripheral
Polygonal
Pruritus
Purple Hypertension: secondary hypertension causes CHAPS:
Cushing's syndrome
Hyperaldosteronism [aka Conn's syndrome]
Aorta coarctation
Phaeochromocytoma
Stenosis of renal arteries
? Note: only 5% of hypertension cases are secondary, rest are primary.
Hepatomegaly: 3 causes 3 C's:
Cirrhosis
Carcinoma
Cardiac failure MI: sequence of elevated enzymes after MI "C-AST-Le" (castle):
CK-MB first
AST second
LDH third
? Also: can use the last 'E' for ESR.
Pulmonary embolism: risk factors TOM SCHREPFER:
Trauma
Obesity
Malignancy
Surgery
Cardiac disease
Hospitalization
Rest [bed-ridden]
Elderly
Past history
Fracture
Estrogen [pregnancy, post-partum]
Road trip Pheochromocytoma: 3 most common symptoms "PHEochromocytoma":
Palpitations
Headache
Edisodic sweating (diaphoresis) Necrosis: the 4 types "Life Can Get Complicated":
Liquifactive
Coagulation
Gangrene
Caseous
? 'Life' used since necrosis is 'death'. Thyroid carcinoma: features, prognosis of most popular Most Popular is Papillary.
? Clinical features:
Papillae (branching)
Palpable lymph nodes
"Pupil" nuclei (Orphan Annie)
Psammoma bodies within lesion (often)
? Also, has a Positive Prognosis (10 year survival rate: 98%). Inflammatory Bowel Disease: which has cobblestones Crohn's has Cobblestones on endoscopy. Gout: factors that can precipitate an attack of acute gouty arthritis DARK:
Diuretics
Alcohol
Renal disease
Kicked (trauma)
? And, the attack occurs most often at night [thus "dark"]. Paget's disease of bone: signs and symptoms Four L's:
Larger hat size
Loss of hearing: due to compression of nerve
Leontiasis ossea (lion-like face)
Light-headed (Paget's steal) Wernicke-Korsakoff triad Syndrome in alchoholics, who love to "drink CANs of beer":
Confusion
Ataxia
Nystagmus Wernicke-Korsakoff's psychosis: findings COAT RACK:
? Wernicke's encephalopathy (acute phase):
Confusion
Ophthalmoplegia
Ataxia
Thiamine tx.
? Korsakoff's psychosis (chronic phase):
Retrograde amnesia
Anterograde amnesia
Confabulation
Korsakoff's psychosis Atherosclerosis risk factors "You're a SAD BET with these risk factors":
Sex: male
Age: middle-aged, elderly
Diabetes mellitus
BP high: hypertension
Elevated cholesterol
Tobacco Duchenne vs. Becker Muscular Dystrophy Duchenne Muscular Dystrophy (DMD) : Doesn't Make Dystrophin.
Becker Muscular Dystrophy (BMD): Badly Made Dystrophin (a truncated protein). Atherosclerosis risk factors SHIFT MAID:
Smoking
Hypertension
(N)IDDM
Family history
Triglycerdides & fats
Male
Age
Inactivity
Diet / Drink Parkinsonism: essential features TRAPS:
Tremor (resting tremor)
Rigidity
Akinesia
Postural changes (stooped)
Stare (serpentine stare)
? To remember what kind of tremor and postural change, can look at letter that follows in TRAPS: Tremor is Resting, Posture is Stooped. Thrombus: possible fates DOPE:
Dissolution
Organization & repair
Propagation
Embolization Turner syndrome: components CLOWNS:
Cardiac abnormalities (specifically Coartication)
Lymphoedema
Ovaries underdeveloped (causing sterility, amenorrhea)
Webbed neck
Nipples widely spaced
Short MI: sequence of elevated enzymes after MI "Time to CALL 911":
? From first to appear to last:
Troponin
CK-MB
AST
LDH1
Wiskott-Aldrich syndrome: symptom triad "PET WASP":
Pyrogenic infections
Eczema
Thrombocytopenia
? WASP is the name of the causitive agent: Wiskott-Aldrich Syndrome Protein.
? Alternatively: Wiskott=Hot, Aldrich=Itch, Syndrom=Throm.
Sarcoidosis summarized SARCOIDOISIS:
Schaumann calcifications
Asteroid bodies/ [ACE] increase/ Anergy
Respiratory complications/ Renal calculi/ Restrictive lung disease/ Restrictive cardiomyopathy
Calcium increase in serum and urine/ CD4 helper cells
Ocular lesions
Immune mediated noncaseating granulomas/ [Ig] increase
Diabetes insipidus/ [D vit.] increase/ Dyspnea
Osteopathy
Skin (Subcutaneous nodules, erythema nodosum)
Interstitial lung fibrosis/ IL-1
Seventh CN palsy Blood disorders: commoner sex HE (male) gets:
HEmophilia (X-linked)
HEinz bodies (G6PD deficiency, causing HEmolytic anemia: X-linked)
HEmochromatosis (male predominance)
HEart attacks (male predominance)
HEnoch-Schonlein purpura (male predominance)
SHE (female) gets:
SHEehan's syndrome Thyroid storm characteristics "Storm HITS girls cAMP":
Thyroid storm due to:
Hyperthyroidism
Infection or Illness at childbirth
Trauma
Surgery
? girls: Thyroid storm more common in females.
? cAMP: Tx involves high dose of beta blockers (beta receptors work via cAMP)
? Alternatively: "S#IT storm": Surgery, Hyperthyroidism, Infection/ Illness, Trauma. Hypothyroidism/thyroiditis: maifestations and morphology "A SCHISM among the Axis during WWII":
Addison disease
Subacute thyroiditis
Cretinism/ Cold intolerance/ Constipation
Hashimoto's disease
Infectious-subacute thyroiditis
Silent thyroiditis
Myxedema coma
? The Axis: Schimidt syndrome (when other endocrinology disorders accompany Hashimoto's disease) and "Hitler cells" (Hurthle cells, which are follicular epithelial cells with basophilic inculsions) Respiratory distress syndrome in infants: major risk factors PCD (Primary Ciliary Dyskinesia, a cause of Respiratory distress syndrome):
Prematurity
Cesarean section
Diabetic mother Deep venous thrombosis: genetic causes ALASCA:
Antithrombin III
Leiden (Factor V)
APC (Activated Protein C)
S-protein deficiency
C-protein deficiency
Antiphospholipid antibody
Carcinomas having tendency to metastasize to bone "Particular Tumours Love Killing Bone":
Prostate
Thyroid
Lung
Kidney
Breast Cushing syndrome CUSHING:
Central obesity/ Cervical fat pads/ Collagen fiber weakness/ Comedones (acne)
Urinary free corisol and glucose increase
Striae/ Suppressed immunity
Hypercortisolism/ Hypertension/ Hyperglycemia/ Hirsutism
Iatrogenic (Increased administration of corticosteroids)
Noniatrogenic (Neoplasms)
Glucose intolerance/ Growth retardation Apoptosis vs. necrosis "LIFELESS" (since cells are dead):
? Differences are in:
Leaky membranes
Inflammatory response
Fate
Extent
Laddering
Energy dependent
Swell or shrink
Stimulus
? See attached table for apoptosis and necrosis properties for each of the above. Diabetic ketoacidosis: I vs. II ketONE bodies are seen in type ONE diabetes.
694
---Anonymous Contributor
Baldness risk factors "Daddy Doesn't Deny Getting Hair Implants":
Diet
Disease
Drugs
Genes
Hormones
Injury to the scalp Tabes Dorsalis morphology DORSALIS:
Dorsal column degeneration
Orthopedic pain (Charcot joints)
Reflexes decreased (deep tendon)
Shooting pain
Argyll-Robertson pupils
Locomotor ataxia
Impaired proprioception
Syphilis
Buerger's disease features "burger SCRAPS":
Segmenting thrombosing vasculitis
Claudication (intermittent)
Raynaud's phenomenon
Associated with smoking
Pain, even at rest
Superficial nodular phlebitis
? Alternatively, if hungry for more detail [sic], "CRISP PIG burgers":
Chronic ulceration
Raynaud's phenomenon
Intermittent claudication
Segmenting, thrombosing vasculitis
Pain, even at rest
Phlebitis (superficial nodular)
Idiopathic
Gangrene PKU findings PKU:
Pale hair, skin
Krazy (neurological abnormalities)
Unpleasant smell
821
---Robert O'Connor and Lior Greenberg Emphysema: types, most important feature of each "Cigarettes Is Primary Problem":
? Types:
Centrilobular
Irregular
Pancinar
Paraseptal
? Most important feature for each type (in order as above):
Cigarrettes
Inflammation healed to scar
Protease inhibitor deficiency (a1-antitrypsin)
Pneumothorax
? "Cigarettes is primary problem" used since cigarettes is most common cause of emphysema.
? Keeping P's straight: Pan is antitrypsin. Calcification: metastatic vs. dystrophic Metastatic: Metabolism imbalance.
Dystrophic: Damaged tissue. Haemochromatosis definition, classic triad "Iron man triathalon":
Iron man: deposition of iron in many body tissues.
? Triathalon has 3 components, which match triad:
Swimming: Skin pigmentation
Biking: Bronze diabetes
Marathon: Micronodular pigment cirrhosis
? See diagram for visual equivalent. COPD: 4 types and hallmark ABCDE:
Asthma
Brochiectasis
Chronic bronchitis
Dyspnea [hallmark of group]
Emphysema
? Alternatively: replace Dyspnea with Decreased FEV1/FVC ratio. MEN I (Multiple Endocrine Neoplasia) syndrome: components "Please Please Pay Attention To peptic ulceration, you worms":
? Adenomas of:
Pituatary
Pancreatic islets
Parathyroid
Adrenal cortex
Thyroid, associated with peptic ulceration
? Syndrome is called "Wermer's syndrome". Lung cancer: presentation ABCDE:
Snowball turned to Avalanche
Blood: hemoptysis
Cough
Distruption to airway in bronchus-->pneumonia
whEEzing Deep venous thrombosis: diagnosis DVT:
Dilated superficial veins/ Discoloration/ Doppler ultrasound
Venography is gold standard
Tenderness of Thigh and calf
Addison's disease: features ADDISON:
Autoimmune
DIC (meningcoccus)
Destruction by cancer, infection, vascular insufficiency
Iatrogenic
Sarcoidosis, granulomatous such as TB histiomycosis
hypOtension/ hypOnatermia
Nelson's syndrome [post adrelectomy, increased ACTH]
Breast cancer: risk assessment "Risk can be assessed by History ALONE":
History (family, previous episode)
Abortion/ Age (old)
Late menopause
Obesity
Nulliparity
Early menarche McArdle's syndrome MCARDLES:
Myoglobinuria
Cramping after exercise
Accumulated glycogen
Recessive inheritance
Deficiency of muscle phosphorylase
Lactate levels fail to rise
Elevated creatine kinase
Skeletal muscle only
948
---Samuel Atom Baek-Kim Multiple endocrine neoplasia III: components MEN III is a disease of 3 M's:
Medullary thyroid carcinoma
Medulla of adrenal (pheochromocytoma)
Mucosal neuroma Ulcerative colitis: features ULCERATIONS:
Ulcers
Large intestine
Carcinoma [risk]
Extraintestinal manifestations
Remnants of old ulcers [pseudopolyps]
Abscesses in crypts
Toxic megacolon [risk]
Inflamed, red, granular mucosa
Originates at rectum
Neutrophil invasion
Stools bloody Virchow's triad (venous thrombosis) "VIRchow":
Vascular trauma
Increased coagulability
Reduced blood flow (stasis) Pyrogenic meningitis: likeliest bug in age group "Explaining Hot Neck Stiffness":
? In order from birth to death:
E. coli [infants]
Haemophilus influenzae [older infants, kids]
Neisseria meningitis [young adults]
Streptococcus pneumoniae [old folks] Endometrial carcinoma: risk factors ENDOMET:
Elderly
Nulliparity
Diabetes
Obesity
Menstrual irregularity
Estrogen therapy
hyperTension Polycystic ovary: morphology, presentation ? Morphology is poly-C:
Cysts
Capsule thickened
Cortical stromal fibrosis
? Clinical presentation is OVARY:
Obese
Virilism or hirsutism
Amenorrhoea
Reproductive problem [infertile]
Young woman
Parkinson's disease: symptoms PQRST:
Paucity of expression
parQinson
Rigidity (cogwheel)
Stooped posture
Tremor at rest
? If can't remember that Parkinson's tremor is the one that is "resting tremor", look at the last 3 letters: RST.
Kawasaki disease: features Disease name: a Kawasaki motorcycle.
Usually young children, epidemic in Japan: Japanese child rides the motorcycle.
Conjunctival, oral erythema: red eyes, mouth.
Fever: thermometer.
Erythema of palms, soles: red palms, soles.
Generalized rash: rash dots.
Cervical lymphadenitis: enlarged cervical nodes with inflammation arrows.
Vasculitis of arteries: inflammation arrows on arteries.
Cardiovascular sequelae [20%]: inflammation arrows on cardiac arteries.
Treat with aspirin: aspirin headlight.
? See diagram. Interstitial lung disease: causes SARCOIDI:
Sarcoidosis
Allergic reaction
Radiation
Connective tissue disease
Occupational exposure
Infection
Drugs
Idiopathic Herpes I and II: lab findings. She's an odd chick: whenever she's in a restaurant, she always orders Her Peas and Cow dry.
Herpes I and II have Cowdry Type A inclusion bodies Rheumatoid arthritis: features RHEUMATOID:
Ragocytes/ Rheumatoid factor (anti-IgG)
HLA-DR4/ HLA-Dw4
ESR increase/ Extra-articular features (restrictive lung disease, subcutaneous nodules)
Ulnar deviation
Morning stiffness/ MCP joint
Ankylosis/ Atlantoaxial joint subluxation/ Autoimmune/ ANA
T-cells (CD4)/ TNF
Osteopenia
Inflammatory synovial tissue/ Idiopathic/ IL-1
Deformities (swan-neck, boutonniere)
Neuroblastoma: features N-MYC:
Nuclei have "double minutes"
Malignant
Young
Catecholamine secreting
? And hallmark is n-myc amplification.
Lou Gehrig's is both upper and lower motor neuron signs LoU = Lower & Upper.
Dandy-Walker syndrome: components "Dandy Walker Syndrome":
Dilated 4th ventricle
Water on the brain
Small vermis
Cerebral palsy: general features PALSY:
Paresis
Ataxia
Lagging motor development
Spasticity
Young Von Hippel-Lindau: signs and symptoms HIPPEL:
Hemanigoblastomas
Increased renal cancer
Pheochromocytoma
Port-wine stains
Eye dysfunction
Liver, pancreas, kidney cysts
? Bare bones version: Hippel-Lindau, with H and L as above. Bronchial obstruction: consequences APPLE BABE:
Atelectasis
Pleural adhesions
Pleuritis
Lipid pneumonia
Effusion->organisation->fibrosis
Bronchiectasis
Abscess
Broncho and lobar pneumonia
Emphysema
Marble bone disease: signs and symptoms MARBLES:
Multiple fractures
Anemia
Restricted cranial nerves
Blind & deaf
Liver enlarged
Erlenmeyer flask deformity
Splenomegaly
? Eponymous name: Marbles = Albers-Schonberg (anagram).
Heart failure causes "HEART MAy DIE":
Hypertension
Embolism
Anemia
Rheumatic heart disease
Thyrotoxicosis (incl. pregnancy)
Myocardial infarct
Arrythmia
Y
Diet & lifestyle
Infection
Endocarditis Renal failure: causes AVID GUT:
Acute tubular necrosis
Vascular obstruction
Infection
Diffuse intravascular coagulation
Glomerular disease
Urinary obstruction
Tubulointerstitial nephritis Thyrotoxicosis syndrome: signs and symptoms "A Penny For Every Symptom That Hyperthyroidism Will Make Grossly Evident":
Anxiety
Palpitations/ Pulse rapid
Fatigability
Emotional lability
Sweating
Tremor
Heat intolerance
Weight loss with good appetite
Muscular weakness/ Menstrual changes
Goitre
Eye changes
Peptic ulcer: associated causative factors SHAZAM:
Smoking
Hypercalcemia
Aspirin
Zollinger-Ellison
Acidity
MEN type I
? These may work with H. pylori to promote ulceration, or may act alone. Carcinoid syndrome: components CARCinoid:
Cutaneous flushing
Asthmatic wheezing
Right sided valvular heart lesions
Cramping and diarrhea Anemia causes (simplified) ANEMIA:
Anemia of chronic disease
No folate or B12
Ethanol
Marrow failure & hemaglobinopathies
Iron deficient
Acute & chronic blood loss
Gynecomastia: causes DaLAS:
Digitalis
Leydig cell tumors
Alcohol
Sertoli cell tumors
Pick's disease: location, action, epidemiology ? See figure.
Pick axes are Picking away at the old woman's cerebral cortex, causing cortical atrophy.
2 pick axes on her brain: frontal lobe and anterior 1/3 of temporal.
An old woman, since epidemiology is elderly & more common in women. Multiple sclerosis (MS): pathology MS attacks the Myelin Sheath, resulting in plaques. Nasopharyngeal malignant cancers NASOPharyngeal:
Nasophayngeal
Adenocarcinoma
Squamous cell carcinoma
Olfactory neuroblastoma
Plasmacytoma TB: features TB is characterised by 4 C's:
Caseation
Calcification
Cavitation
Cicatrization
Gallstones: risk factors 5 F's:
Fat
Female
Family history
Fertile
Forty
81 Pancoast tumor: relationship with Horner's syndrome "Horner has a MAP of the Coast":
A panCoast tumor is a cancer of the lung apex that compresses the cervical sympathetic plexus, causing Horner's syndrome, which is MAP:
Miosis
Anhidrosis
Ptosis
Pericarditis: findings PERICarditis:
Pulsus paradoxus
ECG changes
Rub
Increased JVP
Chest pain [worse on inspiration, better when lean forward]
Calculi: types CAlCUli:
Calcium
Ammonium magnesium phosphate
Cystine
Uric acid Fat embolism: findings "Fat, Bat, Fract":
Fat in urine, sputum
Bat-wing lung x-ray
Fracture history
? Also, fracture of FEMur causes Fat EMboli. Histiocytosis X: hallmark finding "Birbeck's rackets is X":
Tennis rackets under electron microscope is Histiocystosis X.
Consider 2 tennis rackets in an X formation.
? See diagram. ---Robert O'Connor University College Dublin
Gout vs. pseudogout: crystal lab findings Pseduogout crystals are:
Positive birefringent
Polygon shaped
? Gout therefore is the negative needle shaped crystals.
? Also, gout classically strikes great Toe, and its hallmark is Tophi. APKD: signs, complications, accelerators 11 B's:
? Signs:
Bloody urine
Bilateral pain [vs. stones, which are usually unilateral pain]
Blood pressure up
Bigger kidneys
Bumps palpable
? Complications:
Berry aneurysm
Biliary cysts
Bicuspid valve [prolapse and other problems]
? Accelerators:
Boys
Blacks
Blood pressure high
1348
---Robert O'Connor University College Dublin
Barter's syndrome: pathogenesis, major sign Barter: "In exchange for giving away Na+,K+,Cl-, you can drop the blood pressure".
1396
---Samuel Atom Baek-Kim Tuckahoe, New York
Kwashiorkor: distinguishing from Marasmus FLAME:
Fatty Liver
Anemia
Malabsorption
Edema
1402
---Chris UMF Bucharest
Hemolytic anemia types SHEEP T!T:
Sickle cell
Heriditary splenocytosis
Enzyme deficiencies: [G6P, pyruvate kinase]
Erythroblastosis fetalis
Paroxysmal nocturnal hemoglobinuria
Trauma to RBCs
Immunohemolytics: [warm Ab, cold Ag]
Thalassemias: [alpha, beta] Oral cancer risks PATH LAB:
Plummer-vinson syndrome
Alcohol
Tobacco
Human papilloma virus
Leukoplakia
Asbestos
Bad oral hygiene
Gujranwala
Pneumothorax: presentation P-THORAX:
Pleuretic pain
Trachea deviation
Hyperresonance
Onset sudden
Reduced breath sounds (& dypsnea)
Absent fremitus
X-ray shows collapse
Disseminated Intravascular Cogulation: causes DIC:
Delivery TEAR (obstetric complications)
Infections (gram negative)/ Immunological
Cancer (prostate, pancreas, lung, stomach)
? Obstretrical complications are TEAR:
Toxemia of pregnancy
Emboli (amniotic)
Abrutio placentae
Retain fetus products
Leukemias: acute vs. chronic rules of thumb ABCDE:
Acute is:
Blasts predominate
Children
Drastic course
Elderly
Few WBC's (so Fevers)
? Chronic is all the opposites:
Mature cells predominate
Middle aged
Less debilitating course
Elevated WBC's, so not a history of fevers and infections Pancreatitis: causes PANCREATITIS:
Posterior
Alcohol
Neoplasm
Cholelithiasis
Rx (lasix, AZT)
ERCP
Abdominal surgery
Trauma
Infection (mumps)
Triglycerides elevated
Idiopathic
Scorpion bite
Thrombotic thrombocytopenic purpura: signs FAT RN:
Fever
Anemia
Thrombocytopenia
Renal problems
Neurologic dysfunction Scrotum masses SHOVE IT:
Spermatocele
Hydrocele/ Haematocele
Orchitis
Varicocele
Epidymal cyst
Indirect inguinal hernia
Torsion/ Tumor Kawasaki disease: diagnostic criteria CHILD:
5 letters=5 days, >5 years old, 5 out 6 criteria for diagnosis:
Conjuctivitis (bilateral)
Hyperthermia (fever) >5 days
Idiopathic polymorphic rash
Lymphoadenopathy (cervical)
Dryness & redness of (i)lips & month (ii)palms & soles [2 separate criteria] Seronegative spondyloarthopathy: diseases RAPE:
Reiter's syndrome
Ankylosing spondylitis
Psoriatic arthitis
Enteropathic arthitis (IBD) Protein C, Protein S: function C and S are:
Clot
Stoppers
? These proteins inhibit coagulation. 101Melanoma vs. basal cell, squamous cell carcinoma: metastatic ability MElanoma is more likely to
MEtastasize.
? Basal and squamous hardly ever metastasize. Hepatocellular carcinoma: aetiology, features ABC:
Aetiology:
Aflatoxins
Hep B
Cirrhosis
? Features:
AFP increased (classic marker)
Bile-producing (DDx from cholangiocarcinoma)
Commonest primary liver tumor
Goitre: differential GOITRE:
Goitrogens
Onset of puberty
Iodine deficiency
Thyrotoxicosis/ Tumor/ Thyroiditis [Hashimoto's]
Reproduction [pregnancy]
Enzyme deficiencies Renal failure (chronic): consequences ABCDEFG:
Anemia
-due to less EPO
Bone alterations
-osteomalacia
-osteoporosis
-von Recklinghausen
Cardiopulmonary
-atherosclerosis
-CHF
-hypertension
-pericarditis
D vitamin loss
Electrolyte imbalance
-sodium loss/gain
-metabolic acidosis
-hyperkalemia
Feverous infections
-due to leukocyte abnormalities and dialysis hazards
GI disturbances
-haemorrhagic gastritis
-peptic ulcer disease
-intractable hiccups Adrenal disorders: Cushing's vs Addison's Cushing: is Gushing cortisol.
In Addison's: patient's cortisol doesn't Add up. Aneurysm types MAD SCAB:
Mycotic
Atherosclerotic
Dissecting
Syphilitic
Capillary microaneurysm
Arteriovenous fistula
Berry Nephrotic syndrome: hallmark findings "Protein LEAC":
Proteinuria
Lipid up
Edema
Albumin down
Cholesterol up
? In nephrotic, the proteins leak out. Ovarian cancers: important types, by WHO classification ? Surface:
"My Sister Began Experiencing Cancer":
Mucinous
Serous
Brenner
Endometrioid
Clear
? Germ cell:
"Doctor Examined The Ovaries":
Dysgerminoma
Endometrial sinus
Teratoma
Ovarian choriocarcinoma
? Sex cord:
"She Felt Grim":
Sertoli-Leydig
Fibroma
Granulosa-theca
? Metastatic
"Killed":
Krukenberg Pancreatitis: causes BAD S#!T:
Biliary: gallstones, 1% of ERCP patients
Alcoholism/ Azotemia
Drugs
Scorpion bite/ Sea anenome/ SLE
Hyperlipidemia/ Hypercalcemia
Idiopathic/ Infectious (mumps, coxsackie, salmonella, ascariasis)
Tumor/ Trauma
? The drugs are: penacillamine, furosemide, thiazides, ethacrynic acid, steroids, sulfas, ace inhibitors, N-SAIDs, erythromycin, estrogen. Fragile-X syndrome: features DSM-4:
Discontinued chromosome staining
Shows anticipation
Male (male more affected)
Mental retardation (2nd most common genetic cause)
Macrognathia
Macroorchidism Endometrial carcinoma: risk factors HONDA:
Hypertension
Obesity
Nulliparity
Diabetes
Age (increased) Kawasaki's disease: features FEAR ME:
Fever
Eye: perilimbic sparing conjunctival injection
Adenopathy: usually cervical
Rash
Mouth: red lips
Extremities: red hands and feet
? Disease to be feared because of risk of coronary aneurysms.
Pheochromocytoma: common symptoms 5 P's:
Paroxysmal rise in BP
Palpitations
Perspiration
Pain in abdomen
PMV in urine IBD: extraintestinal manifestations "Left intestine to sail the SEAS of the rest of the body":
Skin manifestations: erythema nodosum, pyoderma gangrenosum
Eye inflammation: iritis, episcleritis
Arthritis
Sclerosing cholangitis MI: complications "LEAP on the MAP":
LVF
Embolism (systemic)
Aneurysm (ventricular)
Progressive infarction
Myocardial rupture
Arrhythmia
Pericarditis Portal hypertension: features ABCDE:
Ascites
Bleeding (haematemesis, piles)
Caput medusae
Diminished liver
Enlarged spleen Alzheimer's disease: features RONALD (Ronald Reagan, a famous victim):
Reduction of Ach
Old age
Neurofibrillary tangles
Atrophy of cerebral cortex (diffuse)
Language impairment
Dementia (MC in elderly)/ Down?s syndrome Gout: major features GOUT:
Great toe
One joint (75% monoarticular)
Uric acid increased (hence urolithiasis)
Tophi Hypersplenism: criteria "Hyper Splenism Ravages Cells":
Hypercellular or normal marrow
Splenomegaly
Response to splenectomy
Cytopenias Whipple's disease: full features WHIPPLES:
Weight loss
Hyperpigmentation of skin
Infection with tropheryma whippelii
PAS positive granules in macrophage
Polyarthritis
Lymphadenopathy
Enteric involvement
Steatorrhea Pick's disease: features PICK:
Progressive degeneration of neurons
Intracytoplasmic Pick bodies
Cortical atrophy
Knife edge gyri
1948
---Dr. Atif Farooq Khawaja Rawalpindi Medical College, Pakistan
Alzheimer's disease (AD): associations, findings AD:
? Associations:
Aluminum toxicity
Acetylcholine deficiencies
Amyloid B
Apolipoprotein gene E
Altered nucleus basalis of Meynert
Down's
? Findings:
Actin inclusions (Hirano bodies)
Atrophy of brain
Amyloid plaques
Aphasia, Apraxia, Agitation
DNA-coiled tangles
Dementia, Disoriented, Depressed
Osteomalacia: features "Vit-D deficiency in ADULT":
Acetabuli protrusio
Decresed bone density
Under mineralization of osteoid
Looser?s zone (pseudofracture)
Triradiate pelvis (females) Anemia (normocytic): causes ABCD:
Acute blood loss
Bone marrow failure
Chronic disease
Destruction (hemolysis) Phaeochromocytoma: diagnositc rule ? Rule of 10's:
10% ectopic
10% multiple
10% malignant Hematuria: urethral causes NUTS:
Neoplasm
Urethritis
Tumour
Stone CREST sydrome: components CREST:
Calcinosis
Raynaud's phenomena
Esophageal dysmotility
Sclerodactyly
Telangectasia TTP: clinical features Thrombosis and thrombocytopenia PARTNER together:
Platelet count low
Anemia (microangiopathic hemolytic)
Renal failure
Temperature rise
Neurological deficits
ER admission (as it is an emergency)
Nephritic syndrome: glomerular diseases commonly presenting as nephritic syndrome PARIS:
Post-streptococcal
Alport's
RPGN
IgA nephropathy
SLE
? Alternatively: PIG ARMS to include Goodpasture's [one cause of RPGN], Membranoproliferative [only sometimes included in the classic nephritic list]. Osteosarcoma: features PEARL HARBOR:
Paget's disease (10-20%)*
Early age (10-20 yrs)
Around knee
Raised periosteum by expanding tumor: "sunburst pattern"
Lace-like architecture
Hyaline arteoriosclerosis
Alkaline phosphatase increased
Retinoblastoma*
Boys, predominantly
Osteomyelitis DDx
Radiation*
? Sunburst pattern was Japanese Navy emblem during WWII.
*: Predisposing factors. Edwards' syndrome: characteristics EDWARDS:
Eighteen (trisomy)
Digit overlapping flexion
Wide head
Absent intellect (mentally retarded)
Rocker-bottom feet
Diseased heart
Small lower jaw
Fragile X syndrome: features FEMALES
FMR1 gene
Exhibits anticpation
Macro-orchidism
Autism
Long face with large jaw
Everted eyes
Second most common casue of genetic mental retardation Achalasia: 1 possible cause, 1 treatment aCHAlasia:
1 possible cause: CHAgas' disease
1 treatment: Ca++ CHAnnel blockers Anemia: TIBC finding to differentiate iron deficiency vs. chronic disease TIBC levels at the:
Top=Iron deficiency.
Bottom=Chronic disease. Colon cancer: risk factors HULA:
Heridity/ Heriditary diseases
Ulcerative colitis
Low fibre, high fat diet
Adenomatous polyps COPD: blue bloater vs. pink puffer diseases emPhysema has letter P (and not B) so Pink Puffer.
chronic Bronchitis has letter B (and not P) so Blue Bloater. Macrocytic anaemia: differential FAT RBC:
Fetus (pregnancy)
Alcohol
Thyroid disease(ie hypothyroidism)
Reticulocytosis
B12 and folate deficiency
Cirrhosis and chronic liver disease