Eponymous Syndromes.
Addison’s Disease
Bartter’s Syndrome
Conn’s Syndrome
Cushing’s
Addisonian Anemia
Albright’s Syndrome
Alport’s Syndrome
Alzheimer’s
Argyll-Robertson Pupil
Arnold-Chiari Malformation
Barrett’s
Becker’s Muscular Dystrophy
Bell’s Palsy
Berger’s Disease
Bernard-Soulier Disease
Berry Aneurysm
Bowen’s Disease
Brill-Zinsser Disease
Briquet’s Syndrome
Broca’s Aphasia
Brown-Sequard
Bruton’s Disease
Budd-Chiari
Buerger’s Disease
Burkitt’s Lymphoma
Primary adrenocortical deficiency – hypoglycemia, hyponatremia, hyperkalemia (relative) and
hypercalcemia. Low BP and hyperpigmentation in chronic cases
Hyperreninemia – hypokalemia, alkalosis and low BP
Primary Aldosteronism: HTN; retain Na+ & H2O; hypokalemia (causing alkalosis);  renin
Disease: Hypercorticism 2 to  ACTH from pituitary (basophilic adenoma)
Syndrome: hypercorticism of all other causes (1 adrenal or ectopic)
- moon face; buffalo hump; purple striae; hirsutism; HTN; hyperglycemia
Pernicious anemia
(antibodies to intrinsic factor or parietal cells  IF  Vit B12  megaloblastic anemia)
Polyostotic fibrous dysplasia, precocious puberty, café au lait spots, short stature, young girls
Hereditary nephritis with nerve deafness
Progressive dementia
Loss of light reflex constriction (contralateral or bilateral)
“Prostitute’s Eye” – accommodates but does not react
Pathognomonic for 3Syphilis
Lesion pretectal region of superior colliculus
Cerebellar tonsil herniation through foramen magnum = see thoracolumbar meningomyelocele
Columnar metaplasia of lower esophagus
Similar to Duchenne, but less severe
CNVII palsy
( risk of adenocarcinoma)-
(entire face; recall that UMN lesion only affects lower face)
IgA nephropathy causing hematuria in kids, usually following infection
Defect in platelet adhesion
(abnormally large platelets & lack of platelet-surface glycoprotein)
Circle of Willis (subarachnoid bleed) Anterior Communicating artery
Often associated with ADPKD
Carcinoma in situ on shaft of penis
( risk of visceral ca)
Somatization disorder
Psychological: multiple physical complaints without physical pathology
Motor Aphasia (area 44 & 45) intact comprehension
Hemisection of cord
(contralateral loss of pain & temp / ipsilateral loss of fine touch, UMN / ipsi loss of consc.
Proprio)
X-linked agammaglobinemia ( B cells)
Post-hepatic venous thrombosis = ab pain; hepatomegaly; ascites; portal HTN; liver failure
Acute inflammation of medium and small arteries of extremities  painful ischemia  gangrene
Seen almost exclusively in young and middle-aged men who smoke.
Small noncleaved cell lymphoma EBV
8:14 translocation
Seen commonly in jaws, abdomen, retroperitoneal soft tissues
Starry sky appearance
Nitric gas emboli
Cori’s Disease
Creutzfeldt-Jakob
Crigler-Najjar Syndrome
Type III Glycogenosis – Glycogen storage disease
Curling’s Ulcer
Cushing’s Ulcer
de Quervain’s Thyroiditis
[compare w/ Queyrat]
Recurrences of rickettsia prowazaki up to 50 yrs later
Caisson Disease
Chagas’ Disease
Chediak-Higashi Disease
Crohn’s
constant gastroesophageal reflux
(mutation, not a deficiency, in dystrophin protein)
Trypansoma infection - cardiomegaly with apical atrophy, achlasia
(AR) Phagocyte Deficiency = defect in microtubule polymerization
Neutropenia, albinism, cranial & peripheral neuropathy & repeated infections w/ strep & staph
(debranching enz: amylo 1,6 glucosidase def.  Glycogen)
Prion infection  cerebellar & cerebral degeneration
Congenital hyperbilirubinemia (unconjugated)
Glucuronyl transferase deficiency. Can progress to Kernicterus
Less severe form will respond to Phenobarbital therapy
IBD; ileocecum, transmural, skip lesions, cobblestones, lymphocytic infiltrate, granulomas
(contrast to UC: limited to colon, mucosa & submucosa, crypt abscesses, pseudopolyps,  colon cancer risk)
Clinically: ab pain & diarrhea; fever; malabsorption; fistulae b/t intestinal loops & abd
structures
Acute gastric ulcer associated with severe burns
Acute gastric ulcer associated with CNS trauma
Self-limiting focal destruction (subacute thyroiditis)
Page 1
DiGeorge’s Syndrome
Failure of 3rd & 4th pharyngeal pouches formation: Thymus & Parathyroid
Thymic hypoplasia  T-cell deficiency
Hypoparathyroidism  Tetany
Down’s Syndrome
Dressler’s Syndrome
Dubin-Johnson Syndrome
Trisomy 21 or translocation – Simian Crease
Duchenne Muscular Dystrophy
Edwards’ Syndrome
Deficiency of dystrophin protein  MD
Ehler’s-Danlos
Eisenmenger’s Complex
Erb-Duchenne Palsy
Ewing Sarcoma
Eyrthroplasia of Queyrat
Fanconi’s Syndrome
Defective collagen
Felty’s Syndrome
Gardner’s Syndrome
Gaucher’s Disease
Rheumatoid arthritis, neutropenia, splenomegaly
Gilbert’s Syndrome
Glanzmann’s Thrombasthenia
Goodpasture’s
Grave’s Disease
Guillain-Barre
Hamman-Rich Syndrome
Hand-Schuller-Christian
Hashimoto’s Thyroiditis
Hashitoxicosis
Henoch-Schonlein purpura
Hirschprung’s Disease
Horner’s Syndrome
Huntington’s (Chromosome 4)
Jacksonian Seizures
Job’s Syndrome
Post-MI Fibrinous Pericarditis
autoimmune
Congenital hyperbilirubinemia (conjugated) = bilirubin transposrt is defective not conjugation
Striking brown-to-black discoloration of the liver
X-linked recessive
Trisomy 18
Rocker-bottom feet, low ears, small lower jaw, heart disease
Late cyanotic shunt (RL)
pulmonary HTN & RVH 2 to long-standing VSD, ASD, or PDA
Trauma to superior trunk of brachial plexus
Waiter’s Tip
Malignant undifferentiated round cell tumor of bone in boys <15yoa - t11;22
Carcinoma in situ on glans penis
Impaired proximal tubular reabsorption 2 to lead poisoning or Tetracycline
(glycosuria,
hyperphosphaturia, aminoaciduria, systemic acidosis)
AD = adenomatous polyps of colon, osteomas & soft tissue tumors
Lysosomal Storage Disease glucocerebrosidase deficiency – glucocerebroside accumulation
Hepatosplenomegaly, femoral head & long bone erosion, anemia
Benign congenital hyperbilirubinemia (unconjugated) = d glucuronyl transferase activity
Defective glycoproteins on platelets = deficient platelet aggregation
Autoimmune: ab’s to glomerular & alveolar basement membranes. Seen in men in their 20’s
Autoimmune hyperthyroidism (TSI): IgG Ab reactive w/ TSH receptors.
Low TSH & TRH – High T3 /
T4
Polyneuritis following viral infection/ autoimmune
(ascending muscle weakness & paralysis; usually self-limiting)
Idiopathic pulmonary fibrosis. Can see honey comb lung.
Chronic progressive histiocytosis
Autoimmune hypothyroidism. May have transient hyperthyroidism.
Low T3 /T4 & High TSH
Initial hyperthyroidism in Hashimoto’s Thyroiditis that precedes hypothyroidism
Hypersensivity vasculitis = allergic purpura. Lesions have the same age.
Hemmorhagic urticaria (with fever, arthralgias, GI & renal involvement)
Associated with upper respiratory infections
Aganglionic megacolon
Ptosis, miosis, anhidrosis
(lesion of cervical sympathetic nerves often 2 to a Pancoast tumor)
AD: Progressive degeneration of caudate nucleus, putamen (striatum) & frontal cortex
 GABA
Epileptic events originating in the primary motor cortex (area 4)
Immune deficiency: neutrophils fail to respond to chemotactic stimuli
Defective neutrophilic chemotactic response = repeated infections
Commonly seen in light-skinned, red-haired girls
’d IgE levels
Kaposi Sarcoma
Kartagener’s Syndrome
Kawasaki Disease
Malignant vascular tumor
Klinefelter’s Syndrome
Kluver-Bucy
Krukenberg Tumor
47, XXY: Long arms, Sterile, Hypogonadism males – small testicles and gynecomastia
Laennec’s Cirrhosis
Lesch-Nyhan
Alcoholic cirrhosis
Letterer-Siwe
Libman-Sacks
Acute disseminated Langerhans’ cell histiocytosis
Lou Gehrig’s
Amyotrophic Lateral Sclerosis
(HHV8 in homosexual men)
Immotile cilia 2 to defective dynein arms
infection, situs inversus, sterility
Mucocutaneous lymph node syndrome in kids
(fever> 5 days, cardiac vascular lesions, cervical lymphadenopathy,
rash on palms and soles, acute necrotizing vasculitis of lips, oral mucosa)
Bilateral lesions of amygdala
(hypersexuality; oral behavior)
Adenocarcinoma with signet-ring cells (typically originating from the stomach) metastases to
the ovaries
HGPRT deficiency
Gout, retardation, self-mutilation
Endocarditis with small vegetations on valve leaflets
Associated with SLE
degeneration of upper & lower motor neurons
Page 2
Mallory-Weis Syndrome
Marfan’s
McArdle’s Disease
Meckel’s Diverticulum
Bleeding from esophagogastric lacerations 2 to wretching (alcoholics)
Meig’s Syndrome
Menetrier’s Disease
Monckeberg’s Arteriosclerosis
Munchausen Syndrome
Nelson’s Syndrome
Triad: ovarian fibroma, ascites, hydrothorax – associated w/ fibroma of ovaries
Niemann-Pick
Lysosomal Storage Disease
“Foamy histiocytes”
Osler-Weber-Rendu Syndrome
Paget’s Disease
Pancoast Tumor
Parkinson’s
Peutz-Jegher’s Syndrome (AD)
Peyronie’s Disease
Pick’s Disease – 2 Different
Diseases -
Hereditary Hemorrhagic Telangiectasia. Seen in the Mormon’s of Utah.
Plummer’s Syndrome
Plummer-Vinson
Pompe’s Disease
Pott’s Disease
Potter’s Complex
Raynaud’s
Reiter’s Syndrome
Reye’s Syndrome
Connective tissue defect: defective Fibrillin gene
Type V Glycogenosis - Glycogen storage disease
Dissecting aortic aneurysm, subluxation of lenses
(muscle phosphorylase deficiency =  Glycogen)
Rule of 2’s: 2 inches long, 2 feet from the ileocecum, in 2% of the population
Embryonic duct origin; may have ectopic tissue: gastric/pancreatic remnant of vitteline
duct/yolk stalk
Giant hypertrophic gastritis (enlarged rugae; plasma protein loss)
Calcification of the media (usually radial & ulnar aa.)
Factitious disorder (consciously creates symptoms, but doesn’t know why)
1 Adrenal Cushings  surgical removal of adrenals  loss of negative feedback to pituitary
 Pituitary Adenoma
Abnormal bone architecture
(sphingomyelinase deficiency – sphingomyelin accumulation)
(thickened, numerous fractures  pain)
Bronchogenic tumor with superior sulcus involvement  Horner’s Syndrome
Dopamine depletion in nigrostriatal tracts
Melanin pigmentation of lips, mouth, hand, genitalia + hamartomatous polyps of small intestine
Subcutaneous fibrosis of dorsum of penis
1. Progressive dementia similar to Alzheimer’s
1. Constrictive pericarditis – sequel to mediastinal tuberculosis
Calcium-frosting, unyielding layer – heart chambers may be unable to dilate to receive blood during diastole
Hyperthyroidism, nodular goiter, absence of eye signs (Plummer’s = Grave’s - eye signs)
Esophageal webs & iron-deficiency anemia, spoon-shaped nails,  SCCA of esophagus
Type II Glycogenosis – Glycogen storage disease  cardiomegaly
( 1,4 Glucosidase deficiency:  Glycogen)
Tuberculous osteomyelitis of the vertebrae
Renal agenesis  oligohydramnios  hypoplastic lungs, defects in extremities
Disease: recurrent vasospasm in extremities = seen in young, healthy women
Phenomenon: 2 to underlying disease (SLE or scleroderma)
Urethritis, conjunctivitis, arthritis non-infectious (but often follows infections), HLA-B27,
polyarticular
Microvesicular fatty liver change & encephalopathy
2 to aspirin ingestion in children following viral illness, especially VZV
Riedel’s Thyroiditis
Rotor Syndrome
Idiopathic fibrous replacement of thyroid
Sezary Syndrome
Shaver’s Disease
Sheehan’s Syndrome
Shy-Drager
Simmond’s Disease
Sipple’s Syndrome
Sjogren’s Syndrome
Spitz Nevus
Stein-Leventhal
Stevens-Johnson Syndrome
Leukemic form of cutaneous T-cell lymphoma (mycosis fungoides)
Still’s Disease
Takayasu’s arteritis
Juvenile rheumatoid arthritis (absence of rheumatoid factor)
Tay-Sachs (AR)
Tetralogy of Fallot
Tourette’s Syndrome
Turcot’s Syndrome
Turner’s Syndrome
Vincent’s Infection
Gangliosidosis (hexosaminidase A deficiency  GM2 ganglioside)
Congenital hyperbilirubinemia (conjugated)
Similar to Dubin-Johnson, but no discoloration of the liver
Aluminum inhalation  lung fibrosis
Postpartum pituitary necrosis = hemorrhage & shock usually occurred during delivery
Parkinsonism with autonomic dysfunction & orthostatic hypotension
Pituitary cachexia – can occur from either pituitary tumors or Sheehan’s
MEN type IIa = pheochromocytoma, thyroid medullary CA, hyperparathyroidism
Triad: dry eyes, dry mouth, arthritis
 risk of B-cell lymphoma
Juvenile melanoma (always benign)
Polycystic ovary: see amenorrhea; infertility; obesity; hirsutism = LH secretion
Erythema multiforme, fever, malaise, mucosal ulceration
(often 2 to infection = mycoplasma or sulfa
drugs)
Aortic arch syndrome
Loss of carotid, radial or ulnar pulses = pulseless disease. Night sweats.
Common in young Asian females
Cherry Red Spots of the Macula
1.VSD, 2.overriding aorta, 3.pulmonary artery stenosis, 4.right ventricular hypertrophy
Involuntary actions, both motor and vocal Txt w/ Pimozide
Colon adenomatous polyps plus CNS tumors
45, XO = most common cause of Primary Amenorrhea. No Barr body on buccal smear.
“Trench mouth” – acute necrotizing ulcerative gingivitis due to Fusobacterium
Page 3
Von Gierke’s Disease
Von Hippel-Lindau
Type I Glycogenosis – Glycogen storage disease
(G6Ptase deficiency) – Glycogen accumulaiton
Von Recklinghausen’s
Hemangioma (or hemangioblastoma) = cerebellum, brain stem, & retina
Adenomas of the viscera, especially  Renal Cell Carcinoma
Chromosome 3p
Neurofibromatosis & café au lait spots & Lisch nodules (Chromosome 17)
Von Recklinghausen’s Disease of
Bone
Osteitis fibrosa cystica (“brown tumor”) 2 to hyperparathyroidism = osteoclastic resorption w/
fibrous replacement
Von Willebrand’s Disease (AD)
Waldenstrom’s macroglobinemia
Wallenberg’s Syndrome
Defect in platelet adhesion 2 to deficiency in vWF. aPPT,  Bleed time
Waterhouse-Friderichsen
Weber’s Syndrome
Wegener’s Granulomatosis
Weil’s Disease
Wermer’s Syndrome
Wernicke’s Aphasia
Wernicke-Korsakoff Syndrome
Proliferation of IgM-producing lymphoid cells in men 50-70 yoa; PAS(+) Dutcher bodies
Posterior Inferior Cerebellar Artery (PICA) thrombosis
“Medullary Syndrome”
Ipsilateral: ataxia, facial pain & temp; Contralateral: body pain & temp
Adrenal insufficiency 2 to DIC
DIC 2 to meningiococcemia
Paramedian Infarct of Midbrain
Ipsilateral: mydriasis; Contralateral: UMN paralysis (lower face & body)
Necrotizing granulomatous vasculitis of paranasal sinuses, lungs, kidneys, etc.
Icteric Leptospirosis non-icteric prgresses to renal failure & myocarditis
Dark field microscopy for dx
MEN type I = thyroid, parathyroid, adrenal cortex, pancreatic islets, pituitary
Sensory Aphasia
impaired comprehension
Thiamine deficiency in alcoholics; bilateral mamillary bodies (mediodorsal nucleua)
(confusion,
ataxia, ophthalmoplegia)
Whipple’s Disease
Wilson’s Disease
Malabsorption syndrome (with bacteria-laden macrophages) & polyarthritis
Wiskott-Aldrich Syndrome
Immunodeficiency: combined B- &T-cell deficiency (thrombocytopenia & eczema)
 IgM w/  IgA
Wolff-Chaikoff Effect
Zenker’s Diverticulum
Zollinger-Ellison
Roger’s Disease
Barlow’s Syndrome
Bracht-Wachter Lesions
Lutembacher’s Syndrome
Schmidt’s Syndrome
High iodine level ()’s thyroid hormone synthesis
Hepatolenticular degeneration (copper accumulation [Txt w/ Penicillamine
Mallory Bodies in the Liver & also w/ alcoholic hepatitis & Hyaline change
Chromosome 13
] & decrease in ceruloplasmin)
Esophageal; cricopharyngeal muscles above UES
Gastrin-secreting tumor of pancreas
(or intestine) 
 acid  recurrent ulcers
Interventricular septal defect
Floppy vale syndrome – women b/t 20-40 yoa
Minute abscesses found in subacute bacterial endocarditis
Combination of septum secundum atrial septal defect w/ mitral stenosis
Autoimmnue thyroid Disease (Hashimoto’s ) & insulin-dependent diabetes
Hallmark Findings
Albumino-Cytologic Dissociation
Antiplatelet Antibodies
Arachnodactyly
Aschoff Bodies
Auer Rods
Autosplenectomy
Guillain-Barre
Babinski
Basophilic Stippling of RBCs
Bence Jones Protein
UMN lesion
Birbeck Granules
Blue Bloater
Histiocytosis X (eosinophilic granuloma)
Boot-Shaped Heart
Tetralogy of Fallot
(markedly increased protein in CSF with only modest increase in cell count)
Idiopathic thrombocytopenic purpura
Marfan’s
Rheumatic fever
Acute promyelocytic leukemia (AML type M3)
Sickle cell anemia: switch a glu  val in  chain → Low O2  sickling

Aplastic crisis w/ B19 (Parvovirus ssDNA) infection

Salmonella osteomyelitis

Vaso-occlusive painful crisises

Hydroxyurea as Txt ( HbF) & Bone marrow transplant
Lead poisoning
Multiple myeloma free light chains
Waldenstrom’s macroglobinemia
(either kappa or lambda)
Chronic Bronchitis (at least 3 months for at least 2 years of excessive mucus secretion & chronic
recurrent productive cough)
Page 4
Bouchard’s Nodes
Boutonniere’s Deformity
Brown Tumor
Brushfield Spots
Call-Exner Bodies
Osteoarthritis
Cardiomegaly with Apical Atrophy
Chancre
Chancroid
Charcot Triad
Charcot-Leyden Crystals
Cheyne-Stokes Breathing
Chocolate Cysts
Chvostek’s Sign
Clue Cells
Codman’s Triangle
Cold Agglutinins
Chagas’ Disease
Condyloma Lata
2 Syphilis
New coffee flavor at Bagel & Bagel
Cotton Wool Spots
HTN
Aka, cytoid bodies seen w/ SLE (yellowish cotton wool fundal lesions)
Councilman Bodies
Crescents In Bowman’s Capsule
Currant-Jelly Sputum
Curschmann’s Spirals
Dying hepatocytes – HepB
Depigmentation Of Substantia Nigra
Parkinson’s
Donovan Bodies
Eburnation
Ectopia Lentis
Erythema Chronicum Migrans
Fatty Liver
Ferruginous Bodies
Ghon Focus / Complex
Glitter Cells
Gower’s Maneuver
Heberden’s Nodes
Heinz Bodies
Heterophil Antibodies
Hirano Bodies
Hypersegmented PMNs
Hypochromic Microcytic RBCs
Jarisch-Herxheimer Reaction
Joint Mice
Kaussmaul Breathing
Keratin Pearls
Keyser-Fleischer Ring
Kimmelstiel-Wilson Nodules
Koilocytes
Koplik Spots
Lewy Bodies
Lines of Zahn
Lisch Nodules
Lumpy-Bumpy IF Glomeruli
Granuloma inguinale (STD)
(Proximal IP joint of the fingers)
Rheumatoid arthritis
flex proximal & extend distal IP joints
Hyperparathyroidism
Down’s
Granulosa cell tumor: associated w/ endometrial hyperplasia & carcinoma
Granuloma-Theca cell tumor
1 Syphilis
Haemophilus ducreyi
Multiple sclerosis = nystagmus, intention tremor, scanning speech
Bronchial asthma
Cerebral lesion
Endometriosis
Hypocalcemia
facial spasm in tetany
Gardnerella vaginitis
Osteosarcoma
Mycoplasma pneumoniae
Infectious mononucleosis
Rapidly progressive (crescentic glomerulonephritis)
Klebsiella
Bronchial asthma
Osteoarthritis
(polished, ivory-like appearance of bone)
Marfan’s
Lyme Disease
Alcoholism
Asbestosis - & Iron laden
Tuberculosis (1 & 2, respectively)
Acute Pyelonephritis
Duchenne’s MD
Osteoarthritis
use of arms to stand
(Distal IP joint of the fingers)
G6PDH Deficiency
Infectious mononucleosis
(EBV)
Alzheimer’s
Megaloblastic anemia
Iron-deficiency anemia or  Thalassemia
Syphilis
over-aggressive treatment of an asymptomatic pt. that causes symptoms 2 to rapid lysis
Osteoarthritis
(fractured osteophytes)
Acidosis / Diabetic Ketoacidosis
Squamous Cell CA of skin
Actinic Keratosis is a precursor
Wilson’s
Diabetic nephropathy: Nodular Glomerulosclerosis nodules of mesangial matrix
HPV 6 & 11 (condyloma acuminatum - benign) and HPV 16 & 18 (malignant association)
Measles
Parkinson’s
(eosinophilic inclusions in damaged substantia nigra cells)
Arterial thrombus
Neurofibromatosis (von Recklinhausen’s disease) = pigmented iris hamartomas
Poststreptococcal glomerulonephritis – prototype of nephritic syndrome
Page 5
Mallory Bodies
McBurney’s Sign
Michealis-Gutmann Bodies
Monoclonal Antibody Spike
Alcoholic hepatitis
Myxedema
Negri Bodies
Neuritic Plaques
Neurofibrillary Tangles
Non-pitting Edema
Hypothyroidism
Notching of Ribs
Nutmeg Liver
Owls Eye Cells
Appendicitis
(McBurney’s Point is 2/3 of the way from the umbilicus to anterior superior iliac spine)
Malakoplakia lesion on bladder due to macros & calcospherites (M-G Bodies): usually due to E. Coli
Multiple myeloma
MGUS
this is called the M protein (usually IgG or IgA)
Rabies
Alzheimer’s
Alzheimer’s
Myxedema
Anthrax Toxin
Coarctation of Aorta
CHF = causing congested liver
CMV
Reed Sternburg Cells (Hodkins Lymphoma)
Aschoff cells seen w/ Rheumatic Fever
Painless Jaundice
Pannus
Pautrier’s Microabscesses
Philadelphia Chromosome
Pick Bodies
2 types of COPD
Pancreatic CA (head)
Podagra
Port-Wine Stain
Posterior Anterior Drawer Sign
Psammoma Bodies
Gout
Pseudohypertrophy
Punched-Out Bone Lesions
Rash on Palms & Soles
Seen w/ Duchenne muscular dystrophy @ the claf muscles, due to  fat
Red Morning Urine
Reed-Sternberg Cells
Reid Index Increased
Reinke Crystals
Rouleaux Formation
S3 Heart Sound
Paroxysmal nocturnal hemoglobinuria. You would use Ham’s test to confirm.
S4 Heart Sound
Schwartzman Reaction
Smith Antigen
Rheumatoid arthritis, also see morning stiffnes that  w/ joint use, HLA-DR4
Mycosis fungoides (cutaneous T-cell lymphoma), Sezary
CML
Pick’s Disease
Pink Puffer – Type A: Emphysema
Blue Bloater – Type B: Bronchitis
Emphysema
Centroacinar – smoking
Panacinar - 1-antitrypsin deficiency
(MP joint of hallux)
Hemangioma
Tearing of the ACL
Papillary adenocarcinoma of the thyroid
Serous papillary cystadenocarcinoma of the ovary
Meningioma
Mesothelioma
Multiple myeloma
2 Syphilis, kawaski’s
RMSF
Coxsackie virus infection: Hand-Foot-Mouth Disease
Hodgkin’s Disease
Chronic bronchitis = d ratio of bronchial gland to bronchial wall thickness
Leydig cell tumor
Multiple myeloma
RBC’s stacked as poker chips
LR Shunt (VSD, PDA, ASD)
Mitral Regurg
LV Failure
Pulmonary Stenosis
Pulmonary HTN
Neisseria meningitidis impressive rash with bugs
SLE (also anti-dsDNA)
Malar Rash, Wire loop kidney lesions, Joint pain, False (+) syphilis test (VDRL)
90% 14-45 yo females
also seen w/ use of INH; Procainamide; Hydralazine = SLE-like syndrome
Soap Bubble on X-Ray
Spike & Dome Glomeruli
Giant cell tumor of bone
String Sign on X-ray
Target Cells
Crohn’s
Membranous glomerulonephritis = Nephrotic syndrome
Spike = basement membrane material & Dome = immune complex deposits (IgG orC3)
bowel wall thickening
Thalassemia
in  Thalassemia w/ no  gene: Hydrops Fetalis & Intrauterine death associations = HbBarts
Page 6
Tendinous Xanthomas
Thyroidization of Kidney
Tophi
Tram-Track Glomeruli
Trousseau’s Sign
Familial Hypercholesterolemia
Chronic pyelonephritis
Gout
Membranoproliferative GN: Nephritic syndrome –
basement membrane is duplicated into 2 layers
Visceral ca, classically pancreatic (migratory thrombophlebitis) and hypercoagulability
Hypocalcemia (carpal spasm) – BP cuff carpal spasm, Chvostek sign – facial nerve tapping
These are two entirely different disease processes and different signs, but they unfortunately have the same
name.
Virchow’s Node
Warthin-Finkeldey Giant Cells
WBC Casts
Whipple’s Triad
Wire Loop Glomeruli
 AFP in amniotic fluid or mother’s
serum
 Uric Acid
Supraclavicular node enlargement by metastatic carcinoma of the stomach
 FEV1/FVC
“Ground Glass” on chest x-ray
COPD
(Hyaline)
Measles
Pyelonephritis
CNS disfunction – Hypoglycemic episodes – glu injection reverses CNS Sympt’s
Lupus nephropathy, type IV (diffuse proliferative form)
Spina Bifida
Anencephaly
Gout
Lesch Nyhan
Myeloproliferative Disorders
Diuretics (Loop & Thiazides)
Due to Pneumocystis carinii
Seen w/ Atelectasia
Honey Combing of the lung
Crescents
Linear Ig Deposits
45 Degree Branch Points
PAS(+) Dutcher Bodies
“Ground Glass” in Abdomen(Hyaline)
“Signet Ring” Cells
Ground Glass Appearance (Hyaline)
Seen w/ Asbestosis (a restrictive lung disease)
Congo Red
Meningiomas & Progesterone
Tuberous Sclerosis Triad
Cowdry A Inclusions
Devic’s Syndrome
Shows amyloid deposition in plaques & vascular walls
c-erb B2
Foster-Kennedy Syndrome
Hoffman’s Sign
Red Nucleus Destruction
Ventral Spinocerebellar tr.
Dorsal Spinocerebellar tr.
Cuneocerebellar tr.
Dorsal Column
Lateral Spinothalamic tr.
Ventral Spinothalamic tr.
SVA
GSE
SSA
GVA
GVE
Breast Cancer association
Goodpastures syndrome (pneumonia w/ hemoptysis & rapidly progressive glomerulonephritis)
Goodpastures syndrome
Aspergillosis
Waldenstrom’s Macroglobulinemia = IgM = Hyperviscosity
Seen in the hepatocytes of healthy carriers of HBsAg in liver biopsies
Cells that replace the ovaries, due to Krukenberg’s tumor that has metastasized from the stomach
Seen w/ Progressive Multifocal Leukoencephalopathy oligodendrocytes
Nuclei seen in Papillary CA of the thyroid (malignant)
Some meningiomas have Progesterone receptors = rapid growth in pregnancy can occur
Seizures; Mental retardation; Leukoderma (congenital facial white spots or macules): angiofibromas
Seen w/ Herpes Simplex Encephalitis – in oligodendroglia
“Neuromyelitis Optica”
A variant of multiple sclerosis: rapid demyelination of the optic nerve & spinal cord w/ paraplegia
A tumor causing blindness & loss of smell w/ papilloedema
Flicking of the middle finger’s nail
Intention tremors of the arm
Unconscious proprioception of lower extremities
Unconscious prorpioception & fine motor movements
Unconscious proprioception & fine motor movements of upper extremities
Conscious proprioception of the body
Pain & Temperature sensation
Light touch perception
Taste & Smell
Muscles of the eye & of the tongue
Vision; Hearing; Equilibrium
Sensation of tongue; soft palate. Carotid Body & Sinus innervation
Edinger Westphal = parasympathetic eye innervation
Gland innervation = secretions
Viscera
Page 7
GSA
Pain & temperature of face
Sensation of external ear
SVE
LMN Lesion
Innervation of muscles of masticaiton, facial expressions, larynx & pharynx
Sensory Pathway Lesion
Subacute Combined Degeneration = Friedrich’s Ataxia = B12 deficiency
Tabes Dorsalis (Neurosyphilis)
Both UMN & LMN Lesion
Both Sensory & Motor Lesion
ALS = Lou Gherig’s Disease
Suprachiasmatic Nucleus
Ventromedial Nucleus
Lateral Nucleus
Arcuate Nucleus
Mamillary Body
Acanthocytes
Controls circadian rhythm
Werndig Hoffman (progressive infantile muscular atrophy)
Poliomyelitis
Brown Sequard
Anterior Spinal artery Occlusion
Satiety center. Savage behavior & obesity when lesioned
Induces eating. Starvation when lesioned
Releases PIF (dopa-ergic neurons)
Can have hemorrhages as seen in Wernicke’s Encephalopathy
RBSc w/ spiny projections. Seen in Abetalipoproteinemia.
Most Common…
1o Tumor arising from bone in adults
Adrenal Medullary Tumor – Adults
Adrenal Medullary Tumor – Children
Agent of severe viral encephalitis
Aggressive lung tumor
Associated with gallstones
Bacterial Meningitis – adults
Bacterial Meningitis – elderly
Bacterial Meningitis – newborns
Bacterial Meningitis – toddlers
Benign ovarian tumor
Benign tumor of soft tissue
Benign tumor of the breast <25yoa
Benign tumor of the liver
Benign uterine tumor
Bone Tumors
Brain Tumor – Child
Brain Tumor –Adult
Breast Carcinoma
Breast Mass
Bug in
Bug in
Bug in
Bug in
Bug in
Bug in
Bug in
CA of
Acute Endocarditis
debilitated, hospitalized pneumonia pt
Epiglottitis
GI Tract
IV drug user bacteremia / pneumonia
PID
Subacute Endocarditis
urinary collecting system
Cardiac 1ry Tumor – Adults
Cardiac 1ry Tumor – Child
Cardiac Tumor – Adults
Cardiomyopathy
Osteosarcoma
Pheochromocytoma: 5 P’s:  Pressure; Pain (Headache); Perspiration; Palpitations;
Pallor/Diaphoresis
Neuroblastoma
Herpes simplex
Small cell or oat cell
Adenocarinoma
Strep pneumoniae & in young adults = Neisseria meningitidis
Neisseria meningitidis
E. coli / Group BStrep.
Hib, S.Pneumoniae
Mature(Native) Teratoma = benign dermatoid
Lipoma
Fibroadenoma
Hemangioma
Leiomyoma: estrogen sensitive: changes size during pregnancy & menopause
Metastases from Breast & Prostate
Medulloblastoma (cerebellum)
Astrocytoma (including Glioblastoma Multiforme) then: mets, meningioma,
Schwannoma
Invasive Duct Carcinoma
Fibrocystic Change: premenopausic women (Carcinoma is the most common in postmenopausal women)
Staph aureus
Klebsiella
Hib
(2nd – E. coli)
Bacteroides
Staph aureus
N. Gonnorrhoeae
Strep Viridans
Transitional cell CA (assoc. w/ benzidine; naphthylamine; analine dyes; long term
txt w/ cyclophosphamide)
Myxoma: “Ball Valve”
Rhabdomyoma – associated w/ Tuberous sclerosis
Metastases
Dilated (Congestive) Cardiomyopathy: Alcohol, BeriBeri, Cocaine use, Coxsackie B,
Page 8
Cause
Cause
Cause
Cause
of
of
of
of
2ry HTN
Addison’s
breast lumps
Congenital Adrenal Hyperplasia
Cause of Cushings
Cause of Death in Alzheimer pts
Cause of Death in Diabetics
Cause of Death in premature
Cause of Death in SLE pts.
Cause of Dementia
Cause of Dwarfism
Cause of Food poisoning
Cause of Hematosalpynga
Cause of Hypoparathyroidism
Cause of Hypothyroidism
Cause of Kidney infections
Cause of Liver disease
Cause of Malignancy in children
Cause of Mental retardation
Cause of NaCl loss and Hypotension
Cause of PID
Cause of Portal cirrhosis
Cause of Preventable Blindness
Cause of Pulmonary HTN
Cause of Secondary Hypertension
Cause of SIADH
Cause of UT Obstruction in men
Cause Pernicious Anemia
Chromosomal Disorder
Common Tumor of the Appendix
Congenital Cardiac Anomaly
Congenital Early Cyanosis
Coronary Artery Thrombosis
Demyelinating Disease
Dental Tumor
Dietary Deficiency
Disease of the Breast
Disseminated Opportunistic Infection in
AIDS
Esophageal Cancer
Fallopian Tube Malignancy
Fatal Genetic Defect in Caucasians
Female Tumor
Form of Amyloidosis
Germ Cell Tumor of Testes
Gynecological Malignancy
Gynecological Finding
Doxorubicin
Systolic Dysfunction
Renal Disease
Autoimmune (2nd – infection)
CA of the breast
21-Hydroxylase Deficiency: NaCl lost & Hypotension (then, 11- NaCl retention &
HTN)
Exogenous Steroid Therapy (then, 1ry ACTH, Adrenal Adenoma, Ectopic ACTH)
Pneumonia
MI
NRDS = hyaline membrane disease
Lupus Nephropathy Type IV (Diffuse Proliferative) = Renal Disease
Alzheimer’s, 2nd Multi-infarct dementia
Achondroplasia
Staph aureus
Ectopic pregnancy
Throidectomy
Corrective surgery, I31 treatment
E. coli
Alcohol consumption
Acute leukemia
Down’s, 2nd Fragile X
21 hydroxylase deficiency
N. ghonorrhea
Alcohol
Chlamydia (serotypes A,B,Ba,C)
COPD
Renal disease
Small Cell Carcinoma of the Lung
BPHyperplasia
Chronic atrophic gastritis = no production of intrinsic factor
Down’s
Carcinoid tumor: flushing; diarrhea; bronchospasm; RHeart valvular lesions
Txt: Methysergide (5HT antagonist)
VSD (membranous > muscular)
Tetralogy of Fallot =right to left shunt
LAD artery: MI
Multiple Sclerosis: (Charcot Triad = nystagmus, intention tremor, scanning speech)
Periventricular plaques w/  Oligodenrocytes
 IgG in CSF, Optic Neuritis, MLF Syndorme = Internuclear Ophthalmoplegia,
bladder incontinence
Odontoma
Iron
Fibrocystic disease
CMV (Pneumocystis carinii is most common overall)
SCCA
AdenoCA
Cystic Fibrosis (chromosome 7q)
Leimyoma
Immunologic (Bence Jones protein in multiple myeloma is also called the Amyloid
Light Chain)
Seminoma (analogous to dysgerminoma of ovaries)
Endometrial Carcinoma
Endometrial CA
Page 9
Heart Murmur
Heart Valve in Bacterial Endocarditis
Heart Valve in Bacterial Endocarditis in IV
drug users
Heart Valve involved in Rheumatic Fever
Hereditary Bleeding Disorder
Hormone secreted in Pituitary Adenoma
Inherited disease of the Kidney
Intracranial tumor in adults
Islet Tumor
Liver 1ry Tumor
Liver Disease
Location of Adenocarcinoma of the Pancreas
Location of Adult Brain Tumors
Location of Childhood Brain Tumors
Lung Tumor, malignant or benign
Lung Tumor, primary or secondary
Lysosomal Storage Disease
Malignancy in Women
Malignancy of the Larynx
Malignancy of the Small Intestine
Malignancy Vulva
Malignant Eye Tumor in Kids
Malignant Tumor of the Liver
Motor Neuron Disease
Muscular Dystrophy
Nasal Tumor
Neoplasm – Child
Neoplasm – Child (2nd most common)
Neoplasm of the West
Neoplastic Polyp
Nephrotic Syndrome in Adults
Nephrotic Syndrome in Children
Non Hodgkin’s Lymphoma
Skin tumor
Opportunistic infection in AIDS
Ovarian Malignancy
Ovarian Tumor
Pancreatic Tumor
Patient with ALL / CLL / AML / CML
Patient with Goodpasture’s
Patient with Reiter’s
Pituitary Tumor
Place for Primary Squamous Cell CA of
esophagus
Place for Peptic Ulcer Disease
Primary Benign Salivary Tumor
Primary Hyperparathyroidism
Primary Malignancy of Bone
Primary Malignancy of Small Intestine
Pt. with Hodgkin’s
Mitral Valve Prolapse
Mitral
Tricuspid
Mitral then Aortic
Von Willebrand’s Disease
Prolactin
Adult polycystic kidney disease: associated w/ polycystic liver, Berry aneurysms,
Mitral prolapse
APD1 – chromosome 16
Glioblastoma mulitforme
Insulinoma =  cell tumor
Hepatoma
Alcoholic Liver Disease
Head (99%)
Above Tentorium
Below Tentorium
Malignant
Secondary
Gaucher’s
Lung (2nd breast)
Glottic CA (squamous cell)
Adenocarcinoma
Squamous cell CA
Retinoblastoma
Hepatocellular CA
ALS
Duchenne’s: Dystrophin deletion. Presents <5yoa weakness at pelvic girdles w/
upward progression
Squamous cell CA
Leukemia
Medulloblastoma of brain (cerebellum)
Adeno CA of the rectum and/or colon
Tubular adenoma
Membranous Glomerulonephritis
Minimal Change (Lipoid Nephrosis) Disease (responds well to steroid txt)
Follicular small clear cell
Basal cell CA
PCP
Serous Cystadenocarcinoma
Hamartoma
Adeno (usually in the head)
ALL – Child / CLL – Adult over 60 / AML - Adult over 60 / CML – Adult 35-50
Young male
Male
Prolactinoma (2nd – Somatotropic “Acidophilic” Adenoma)
Mid 1/3
Lesser curvuture in antrum – associated w/ blood group O
Pleomorphic Adenoma (Mixed) – 90% localized to the parotid
Adenomas (followed by: hyperplasia, then carcinoma)
Osteosarcoma
Lymphoma
Young Male (except Nodular Sclerosis type – Female)
Page 10
Pt. with Minimal Change Disease
Renal Malignancy
Renal Malignancy of Early Childhood
Salivary Tumor
Secondary Hyperparathyroidism
Sexually Transmitted Disease
Site of Diverticula
Site of Embolic Occlusion
Site of Metastasis
Site of Metastasis (2nd most common)
Sites of Atherosclerosis
Skin CA of Fair Skinned People
Skin Cancer
Small Intestine Congenital Anomaly
Stomach Cancer
Testicular Tumor
Thyroid Anomaly
Thyroid CA
Tracheoesophageal Fistula
Tumor in men <20
Tumor of Infancy
Tumor of the Stomach >50 years of age
Type of Hodgkin’s
Type of Non-Hodgkin’s
Type of Portal Cirrhosis
Type of Soft Tissue Tumor of Childhood
Vasculitis (of medium & small arteries)
Viral Encephalitis
Worst Prognosis in Thyroid Cas
Cause of Lobar Pneumonia
Cause of Pneumonia in Cystic Fibrosis
Cause of Osteomyelitis in IV Drug Users
Cause of Infection in Burn Pts
Metabolite seen w/ Pheochromocytoma
Severe Shigella
Bug in Otitis Media & Sinusitis in Kids
Cause of Bacterial Diarrhea
Cause of Non-Ghonococcal Urethritis
Pneumonia
Urethritis
Cause of Glomerulonephritis
Cause of Viral Pneumonia
Complication of COPD
Cause of Death w/ SLE
Atrial Septal Defect
Warm Antibody
Immunodeficiency
Congenital GIT Anomaly
Young Child
Renal cell CA
Wilm’s tumor (neohroblastoma) – chromosome 11p
Pleomorphic adenoma
Hypocalcemia of Chronic Renal Failure
Chlamydia (sero types D-K)
Sigmoid Colon
Middle cerebral aa: contralateral paralysis; aphasias; motor & sensory loss
Regional Lymph Nodes
Liver
Abdominal aorta > coronary > popliteal > carotid
Malignant melanoma
Basal Cell Carcinoma
Meckel’s diverticulum
Adeno – associated w/ blood group A
Seminoma = malignant painless testes growth
Thryoglossal duct cyst
Papillary CA
Lower esophagus joins trachea / upper esophagus – blind pouch – polyhydramnios
association
Germ cell tumor
Benign vascular tumor = port wine stain = Hemangioma
CA of stomach (adeno CA)
Mixed Cellularity (versus: lymphocytic predominance, lymphocytic depletion, nodular
sclerosis)
Follicular, small cleaved
Micronodular
Rhabdomyosarcoma
Temporal Arteritis (branch of Carotid Artery)
HSV
Follicular CA
Strep. Pneumoniae
Pseudomonas
Pseudomonas
Pseudomonas
VMA: vanillylmandelic acid (NE metabolite)
Dysenteriae
Strep. Pneumoniae
Campylobacter jejuni
Chlamydia trichomonas
Strep. Pneumoniae
N. gonorrhea
IgA Nephropathy = Berger’s Disease
RSV – infants
Parainfluenza – kids
Influenza virus – adults
Adeno virus – military recruits
Pulmonary infections
Renal failure
Ostium Secundum Type
Most common form of immune hemolytic anemia
IgG auto antibodies to RBC
See spherocytosis; (+) Coombs’ test; complication to CLL
IgA Deficiency
Meckel’s Diverticulum: persistence of vitelline duct/yolk sac stalk
Page 11
Cause of Congenital Malformation
Fetal Alcohol Syndrome
Pharmacology
Autonomic Nervous System
Epinephrine
Norepinephrine
GABA
Muscarinic-r
Bethanechol
Pilocarpine
Isoflurophate
Pralidoxime
Neostigmine
Myasthenia Gravis
Trimethaphan
Pancurium
Succinylcholine
1 & Eye
M-r & Eye
Sympathetic
Parasym.
M3-r & Eye
M2-r & Heart
M3-r & Lung
M3-r & GI
Tacrine
Atropine
Glycoperrolate
 bungarotoxin
 bungarotoxin
1 & Eye
1 & Arterioles
1 & Venules
1 & Sex Function
 Diastolic
 Diastolic
1 & Heart
Phenylephrine
2(+) Asthma Drugs
Ritodrine/Turbutaline
Phentolamine
Terazosin
Yohimbine
Cardioselective NMJ
Ecothiophate
Pyridostigmine
1, 2, 1, 2
1, 2, 1 (no 2 activity)
Causes an inhibitory cell hyperpolarization
Uses DAG & IP3 as 2nd messengers
Parasympathetic control
Cholinergic.  GI & Bladder motility. Txt atonic bladder post-op
Cholinergic. Pupillary constriciton= miosis. Ciliary constriction= accomodation. Txt acute glaucoma
Organophosphate. Irreversible acetylcholinesterase (-)r
“2PAM”. Reverses organophosphate binding to acetylcholinesterase
Reversible acetylcholinesterase (-)r Txt Myasthenia Gravis
Anitbodies to Ach-r. ’g muscular weakness due to Ach’s weak postsynaptic effect @ NMJ. Inactivates-r
Nonselectively binds N-r of the PS- and SNS
More potent than tubocurium w/o histamine release
Depol. Non competitive (-)r of muscle aciton
Opens Na Ch.= fasciculations. Closes Na Ch.= paralysis. Continuous infusion.
Mydriasis due to norepinephrine. Prazosin (-).
Miosis due to Ach. Atropine (-).
Post ganglionic symapthetic fibers releases norepinephrine
Post ganglionic parasympathetic fibers release Ach
Contracts sphincter = miosis. Contracts ciliary = accomodation.
Negative chronotropy:  HR = vagal arrest
Negative inotropy:  contractility
Bronchospasm secretions
 motility (cramps & diarrhea). Involuntary defecation
Acetylcholine esterase (-)r. Txt Alzheimer’s
DOC w/ vagal arrest
M-r(-). Antispasmodic. Txt peptic ulcers.
Prevent the releasal of Ach from vesicles @ the pre synaptic nerve ending
Irreversible N-r (-)r =  action potentials
Contracts radial muscle = mydriasis (pupil dilation)
Constiction: TPR =  Diastolic pressure =  Afterload
Constriction:  Venous return =  Preload
Ejaculation
 1 = TPR
 2; Direct acting vasodilators; (+)Cholinergics
(+)chronotropism = HR.
(+)inotropism =  contractility; SV; CO; O2 consumption.
 conduction velocity
1 (+) Nasal decongestant.
Metaproterenol; Albuterol; Terbutaline; Ritodrine; Salmeterol
Relaxes myometrium used in pre-mature labor pains
Epi reversal. Blocks , vasodilation occurs. Pt goes from HyperTN to HypoTN.
Txt pheochromocytoma = BP
Txt BPH
 sympathetic outflow = 2 (-). Txt impotence.
Pancuronium = HR due to atropine-like anti muscarinic vagolytic effect & Gallamine (-)r
Irreversible cholinesterase (-)r.
Cholinomimetic that s M & N-r effects. (-) acetylcholinesterase & plasma cholinesterase
DOC for the oral Txt of MG
Page 12
Cardio
Digoxin
Diltiazem
Quinidine
Verapamil
Propranolol
Diazoxide
Niroprusside
Reserpine
Dobutamine
Dopamine
Esmolol
Captopril
Digoxin
Dig. Toxicity
Quinidine
Lidocaine
Flecanide
Amiodarone
NE
Ach
Atenolol
Bretylium
Nimodipine
Atropine
Nitrates
Propranolol
Verapamil
Aspirin
Warfarin
Heparin
TPA
Streptokinase
Urokinase
Colestipol
Lovastatin
Losartan
Diazoxide
Clonidine
Methyldopa
Phenytoin
Procainamide
Indapamide
Thiazides
(-)
ACEIs
Epinephrine
Norepi.
 AV nodal conduction/ inh. Na/K/Atpase = inc. Ca conc. in heart cells = inc. contraction force
Ca channel blockade. Txt AV nodal re entrance
 AV nodal conduction. Cinchonism. Anticholinergic= aggravate MG. Hypotension=  block
 AV nodal conduction.  BP. Negative inotrope= no CHF use
 AV nodal conduction.  BP. Negative inotrope(=  block) Aggravates Asthma and Diabetes Melitus via 2 block.
Balanced vasodilator.
Balanced vasodilator. Unloads heart. s cyanide= pre-txt w/ thiosulfate. Txt Acute HTN’v Crisis
Txt severe & resistant HTN. Depletes CA. See stuffy nose. No to pts w/ peptic ulcers.
At high doses 2(+) offsets 1 = 1  CO w/o systemic vascular resistance
At low doses Txt Shock= dilates renal and mesenteric aa= maintain urine output
Short acting (-)
Balanced vasodilator. Txt Outpt. CHF see dry cough(bradykinin induced)
Txt CHF & Atrial Flutter - inotropic -  K+ levels= dig. Toxicity
Fatal ventricular arrhythmias w/ severe AV block
ClassIa anti arrhythmic. Moderate Na Ch. Block
ClassIb anit arrhythmic. Normalizes conduction. Txt initial MI= control arrhythmias
ClassIc anti arrhythmic. Marked conduction slowing
Long t1/2= need potent doses to obtain desired level for action. See blue skin, ocular deposits, Pulmonary Fibrosis.
 AV nodal conduction via 1. Metoprolol(-) 1
 AV nodal conduction via M receptor. Atorpine(-) M-r
Controls catecholamine induced arrhythmias
Txt Malignant Ventricular Arrhythmias but causes passing catecholamine release that can aggravate arrhythmias
briefly
Txt Acute subarachnoid hemorrhage by preventing post hemorrhagic vasospasm
 excess vagal tone as seen in Sinus Bradycardia
 preload= venous pooling.  MVO2= reflex tachy.  ventr work= dec O2 demand
Blocks reflex tachy but causes excess brady=  diastole time=  EDV
 O2 supply via  in vasospasm Txt Prinzmetal’s variant angina
Prevents arterial platelet adhesion (not DVThrombi). Inactivates COX=  platelet production of TxA2, a potent
vasoconstictor
(-)Vit. K dependent gamma carboxylation of clotting factors= anticoagulation state
Dependent on Antithrombin III activation
Binds to fibrin clots & activates plasminogen on the spot. Short t1/2, given IV.
Does not discriminate b/t fibrin-based clots= bleeding & stroke complications arise
From bacteria= allergies arise. Can see excess bleeding in post-op pts.
Human source.  plasmin. Can see excess bleeding in post-op pts.
Bile acid sequestrants. Interrupt bile acid reabsorption=  LDL uptake. Cholestyramine same MOA.
HMGCoA reductase(-)=  LDL-r synthesis. Pravastatin/ Mevastatin same MOA.
 Aldosterone.  Renin 2-3x’s
Txt insulinomas. Not balanced vasodilator= onlt dilates arterial smooth muscle
Central 2(+).  TPR via  symapthetic effect
Central 2(+). (++) Coombs= Hemolytic anemia
ClassIb. Reverses mild AV block due to digitoxin toxicity
ClassIa. SLE like syndrome.
Only Thiazide that will have no effect on cholesterol levels
Older black men w/ HTN due to  Renin.
Young white men w/o asthma (cause bronchospasm)
(-) change AI  AII. (-) Bradykinin inactivation. Captopril/ Enalapril
Cause renal failure = use w/ caution in the elderly
 contraction rate & force via 1.
 systolic but  diastolic BP.
 peripheral resistance via 2 vasodilaiton
 heart rate and  systolic and diastolic BP
 peripheral blood vessel resistance
Page 13
Methyldopa
Quinidine pre-txt
ClassII
“Gray man”
ACEIs
Adenosine
Enoxaparin
Isoproterenol
DOC for pregnancy induced HTN
Atrial arrhythmia pretxt w/ a drug that will  ventricular response: Dig.;(-); Ca Ch.(-)
(-) risk fo reinfarction & sudden death following MI
Amiodarone: ClassIII antiarrhythmia
Vasodilate renal efferents > than afferent arterioles: GFR & Filtration pressure
 Diabetic renal failure progression contraindicated in pregnancy.
Its receptor is blocked by Methylxanthines (ie… Theophyline)
Favored for the Txt of Reentrant Supra Ventricular Tachycardia
Low molecular weight heparin = Oral anticoagulant. Anti-Xa activity, new oral drugs rivaxoroban.
HR & MAP
CNS
“TOM”
Butyrophenone
Atypical D4
Flumazenil
Methylphenidate
Phenytoin
Thiopental
Carbamazepine
Pimozide
Risperidone
Thioridazine
Haloperidol
Imirpamine
Clomirpramine
Trazadone
Bupropion
SSRIs
Fluoxetine
Phenelzine
Lithium
Alprazolam
Propranolol
-r
-r
Morphine & O2
Morphine
Morphine OD
Meperidine
Hydromorphone
Tramadol
Naloxone
Pentazocine
Butorphenol
Nalbuphene
 GABA
 Fast Na Ch.
Nitric Oxide
Thiopental
Ketamine
Short –acting BDZs: Midazolam
Haloperidol & Droperidol
Clozapine – Thioridazine – Olanzepine – Risperidone = Do not cause EPS
BDZ antidote for OD
Txt attention deficit disorder
Causes aplastic anemia/ gingival hyperplasia/ cleft lip & palate
Short acting Barb
DOC trigeminal neuralgia. Txt lennox gestaut seizures in kids
Txt Tourette’s
Good for negative symptoms
Most anti cholinergic neuroleptic
Neuroleptic malignant hyperthermia due to chronic D2 block. give Dantrolene and Bromocriptine
Enuresis
Txt OCD See aggressive behavior w/ use
Priapism
Helps to quit smoking, seizures in toxicity.
Primarily used for OCD
Good for negative symptoms
Irreversible MAOI
Txt manic phase of Bipolar Disorder
Causes goiter by (-) conversion of T4 to T3
Nephrogenic diabetes insipidus
Low salt diet will lead to Li toxicity
DOC stage fright
Social phobia
Spinal analgesia. Euphoria. ++euphoria. ++sedation. Constipation.
Supraspinal analgesia. Dysphoria. +respiratory depression. +sedation.
Admin. is contraindicated to pts on morphine sedation=  CO2 sensitivity and O2 admin. can stop breathing.
 ICP = do not give to pt. with head trauma
1.pinpoint pupils 2.’d respiraiton 3.coma
Anesthetic used during labor
(+) used in renal failure
Ambulatory txt for mod. to severe pain
Txt opioid OD. Reverses respiratory depression
Part (+) & part (-)
Part (+) & part (-)
Part (+) & part (-)
 seizure focus= Barbs & BDZs
 electrical activity spread = Phenytoin & Carbamazepine
No effect on HR. Needs high MAC for anesthetic induction.
Short acting Barb.
Dissociative anesthetic
Page 14
Droperidol
Fentanyl
Midazolam
Primidone
C & A delta Fibers
Esters
Amides
Amphetamine
Bromocriptine
Benztropine
Amantidine
Diphenhydramine
Ethosuximide
Tranylcypromine
SSRI & MAOI
Desipramine causes
Can be used in combo w/ Fentanyl for neuroleptoanalgesic effect
Neuroleptic tranquilizer. Has mild alpha block
Can be used on combo w/ Droperidol for neuroleptoanalgesic effect
Used transdermally for chronic pain, more cardiostable than moprhine
Pre anesthetic. Induces amnesia
Biotransformed to Phenobarb.
First fibers to be blocked w/ anesthesia
Procaine, Tetracaine, Benzocaine
Broken down and make PABA (allergen)
Lidocaine, Mepivaciane, Bupivaciane, Etidocaine= “i” before “caine” always an amide
Metabolized in the liver
DA reuptake (-)’r. MAOI. Parkinson’s txt
D2(+). Used w/ L-Dopa for “on-off” phenomenon of Parkinson’s
Ant M w/ some DA reuptake (-). Parkinson’s txt
 DA reuptake. Can cause livido reticularis= skin mottling.
Txt early Parkinson’s stages
DOC for Absence seizures
MAOI = antidepressant
Fatal combo, especially seen with the use of Paroxetine or Fluoxetine (SSRIs) and Tranylcypromine (MAOI)
Sudden cardaic death in children
Anti-Infective
Primaquine
Ciporfloxacin
Sulfonamides
Tertacyclines, anuria & the exception
Ceftriazone
Hepatic coma DOC
Clavulanic acid
Piperacillin
Streptomycin (aminoglycoside)
Isoniazid
Pyrantel Pamoate
Buy “AT” 30, “CELL” at 50
Cefoxitin
Chloramphenicol
Metronidazole
Malaria profylaxis
Used for extraerythrocytic forms Plasmodium vivax or P. ovale
Quinolone derivative, c/I <12 yrs of age – bone tendon effects
PABA structural analogs
Inhibit Folic acid synthesis
Should not be used in anuric pt due to production of (-) Nitrogen balance & d BUN levels.
Doxycycline is the exception-liver metabolism
3rd generation cephalosporin
DOC for bacterial meningitis in kids (ie… HiB)
One dose txt of gonorrhea, risk of cather crystalization with calcium in resus, so use cefotaxime
Neomycin (aminoglycoside) – it supresses the normal flora = g NH4 production = g free
nitrogen levels in the bloodstream.
Irreversible (-)r of  lactamases, but ot of transpeptidase = use w/ a  lactamase sensitive
penicillin
Txt Pseudomonas aeruginosa & Klebsiella
Broad spectrum antibiotic
Txt Mycobacterium tuberculosis
Most commonly used drug for TB.
Usually combined w/ Rifampin and/or Ethambutol
Pre Txt w/ Pyridoxine (Vit B6) can prevent peripheral neuritis‘ and seizures in toxicity
Txt of Hookworm disease
Depolarizing NMJ (-)r
A = Aminoglycosides
T = Tetracyclines
C = Chloramphenicol
E = Erythromycin (macrolide)
L = Clindamycin
L = Lincomycin
Txt intraabdominal infections (ie… w/ Bacteroides fragilis)
Traditional txt has been Clindamycin & Gentamycin
Broad spectrum antibiotic
Bone marrow depression (common) – Aplastic anemia (rare)
Gray baby syndrome (chloramphenicol cannot be conjugated)
DOC Typhoid Fever (symptomatic Salmonella infection)
DOC HiB meningitis in kids – especially resistant strain to ampicillin
Txt Leishmaniasis & Amebiasis
Page 15
Good for anaerobic bacteria = Bacteroides fragilis
DOC Trichomoniasis
DOC Giardia lamblia
TMP-SMX & Pentamidine
Txt P. carinii
Tetracycline
Txt of Brucellosis & Cholera
Txt Rocky Mountain Spotted Fever
Txt spirochete infections = Lyme disease (Borrelia burgdorferi)
(-) dihydrofolate reductase activity
TMP-SMX
Benzathine Penicillin G
Praziquantel
Fluconazole
Amphotericin B
Ketoconazole MOA
Griseofulvin MOA
Erythromycin
Nystatin
Acyclovir
Long duration of action = given once every 3-4 weeks for Txt of Syphilis
Txt Schistosomiasis (trematode [fluke] infections)
Txt fungal encephalitis
Polyene antifingal
(-) fungal ergosterol synthesis = disrupts membrane
Accumulates in keratinized layers of the skin = used in dermatomycoses infections
Used in pts allergic to penicillins
Topical txt of superficial mycotic infections = Candidiasis
Guanine analog
Txt Herpes infections
Used w/ Cilastatin
Can cause seizures
Used for MRSA (methicillin resistant Staph. Aureus)
“Red neck”: due to histamine release causes facial flushing
used w/ Cilastatin
Does not cause seizures (cf w/ Imipenem)
Only penicillin that does not need dose adjustment in renal impairment
Imipenem
Vancomycin
Meropenem
Nafcillin
Peripheral neuropathy
Sulfonamides & newborns
“O.N.E.” for gonorrhea
Ribavirin
Seen w/ use of:
Metronidazole – Isoniazid – Vincristine – ddI – AZT – Allopurinol
Kernicterus can occur
Fluoroquinolones used in a one dose deal for gonorrhea:
O = Ofloxacin
N = Norfloxacin
E = Enoxacin
Txt RSV (Respiratory Syncytial Virus)
Anti-Neoplastics
Cyclosporine
Cyclophosphamide
Cisplatin’s toxicities
Methotrexate
Leucovorin Rescue
Bleomycin toxicities
Azathiorine
MOPP
Tamoxifen
Flutamide
Megestrol
Fluoxymesterone
Protects against rejections from organ transplants
Does not induce bone marrow depression
Alkylating agent of both purine & pyrimidine bases of DNA
Txt CLL
Nephro- & Ototoxicity
Antimetabolite of folic acid: (-)dihydrofolate reductase
Can block/reduce Methotrexate =  folic acid via a reduced folate
Pneumonitis & pulmonary fibrosis
Used in organ transplantation = kidney allografts
Allopurinol can  its activity by (-) its biotransformation to xanthine oxidase
Chemotherapy used in the txt of Hodgkin’s disease
M = Mechlorethamine – nitrogen mustard
O = Oncovin (Vincristine) – prevents microtubule assembly
P = Procarbazine
P = Prednisone – glucocorticoid, inducing apoptosis
(-) estrogen receptor
Txt of breast tumors, can see associated endometrial CA
Antiandrogenic
Used w/ Leuprolide (LH-RH analog)
Txt prostatic CA
(-) progesterone receptor
Txt endometrial CA
Androgenic steroid
Page 16
Methotrexate
Brain tumor Txt
Streptozocin
Cytarabine (AraC)
Dactinomycin
Etoposide
Paclitaxel
Amifostine
Txt mammary CA in postmenopausal women
Folic acid analog that (-) tetrahydrofolate synthesis by (-) dihydrofolate reductase
Txt of ALL
Txt of Psoriasis
Lomustine
Carmustine – Causes pulmonary fibrosis
Attaches to  cells
Txt of pancreatic insulinomas
Pyrimidine analog
DOC for AML
Used for Wilms tumor & rhabdomyosarcoma
Used for oat cell CA
Used for ovarian CA
Can  nephrotoxicity due to chronic use of Cisplatin
Path
Mobitz I
Mobitz II
P wave
a wave
T wave
Wavy fibers
Janeway’s lesions
Osler’s nodes
Thiamine defcy
Fibrinous Pericarditis
Serous Pericarditis
Friction Rub
Hemorrhagic Pericarditis
Restrictive Cardiomyopathy
PML’s infectious agent
Edema
Adult Polycystic Kidney
Disease
Malignant HTN & Kidneys
Nephritic signs
Nephrotic signs
Podocyte Effacement seen w/
ASO seen in
Crescentic GN
Hereditary Nephritis
Membranoproliferative GN
Usually due to inferior MI. Rarely goes into 3rd degree block.
Txt w/ Atropine or Isoproterenol.
BBB association. Often goes to 3rd degree AV block. Usually due to anterior MI.
Atrial depol.
LA contraction
Vetricular repol.
Eosinophilic bands of necrotic myocytes. Early sign of MI.
Acute bacterial endocarditis.
Nontender, erythematous lesions of palms & soles.
Subacute bacterial endocarditis.
Tender lesions of fingers & toes.
Wet Beri Beri heart. Dilated (congested) cardiomyopathy due to chronic alcohol consumption
Dyr Beri Beri = peripheral neuropathy
Wernicke-Korsakoff = ataxia; confusion; confabulation; memory loss
Associated w/ MI: Dressler’s
Associated w/ nonbacterial; viral (Coxsackie) infection; immunologic reaction.
Pericarditis association
Associated w/ TB or neoplasm
Aka infiltrative cardiomyopathy that stiffens the heart
Due to amyloidosis in the elderly
Due to , also see schaumann & asteroid bodies in young (<25 yoa).
JC Virus (Papovavirus = dsDNA, naked icosahedral capsid)
Pc (more seeps out)
c (less reabsorbed)
 permeability
Block lymphatic drainage
Commonly see liver cysts & Berry aneurysms along w/ kidney cysts. Hematuria & HTN also present.
3 cysts in ea. Kidney w/ + family history confirms diagnosis
Petehial hemorrhages are seen on kidney surfaces = Flea-Bitten surface = young black men
Hematuria; RBC casts; HTN
Proteinuria; Hypoalbuminemia; Edema
Minimal Change (Lipoid nephrosis) disease
Acute post-streptococcal GN (due to HGASrtep)
Anti streptolysin O
Rapidly progressive GN – nephritic syndrome
Associated w/ multi system disease or post-strep/post infectious glomerular nephritis
Alport’s syndrome. X linked
Renal disease w/ deafness & ocualr abnormalities
Can be secondary to complement deficiency; chronic infections; CLL
See tram tracking
Page 17
TypeI Membrano
Proliferative GN deposits
TypeII Membrano
Proliferative GN deposits
Focal segmental
glomerulosclerosis deposits
Cold agglutinins
Scrofula
Aspirin-Asthma Triad
Ferruginous bodies
Pancoast’s tumor causes
Fatty degeneration
Cloudy swelling
Hydropic degeneration
Liquefaction necrosis
Coagulation necrosis
Caseation necrosis
Fibrinoid necrosis
Fat necrosis
Hemoptysis
Pulmonary embolism
Phlebothrombosis
Saddle embolus
Paradoxical embolism
Tuberculoid granuloma
Cellulitis
PSA
5-HT
 Feto Protein
CEA
Chromosome 13
Chromosome 11p
Vinyl Chloride
Agent Orange
Parasites & CA
Ochronosis
C3 & IgG deposits
Only C3 deposits
Aka Dense deposit disease
IgM & C3 deposits
Seen in atypical pneumonia
It is IgM Ab with specificity for I Ag on adult RBCs
TB in the lymph nodes
Nasal polyps – Rhinitis – bronchoconstriction
Hemosiderin (pigment w/ Fe3-) covered macrophages that have been pahgocytised
Ulnar nerve pain & Horner’s syndrome
Made up primarily of triglycerides
Most commonly due to alcoholism which commonly leads to hepatic cirrhosis
Associated w/ CCl4Failure of cellular Na pump
Seen in Fatty degeneration of the liver and in Hydropic (Vacuolar) degeneration of the liver
Severe form of cloudy swelling
Seen with hypokalemia induced by vomitting/diarrhea
Rapid enzymatic break down of lipids
Seen commonly in Brain & Spinal cord (CNS) injuries
Seen in suppurative infections = pus formation
Result of sudden ischemia
Seen in organs w/ end arteries limited collateral circulation) = heart, lung, kidney, spleen
Combination of both coagulation & liquefaction necrosis
Seen w/ M. tuberculosis & Histoplasma capsulatum infection
Seen in the walls of small arteries
Associated w/ malignant hypertension, polyarteritis nodosa, immune mediated vasculitis
Result of lipase actions liberated from pancreatic enzymes
Seen w/ Acute pancreatitis = saponification results
Blood in sputum
Most commonly thrombus from lower extremity vein
From a vein of lower extremities, of a pregnant uterus, in Congestive heart failure, bed ridden pt,
As a complicaiton in a pt w/ Pancreatic CA due to d blood coagulability
Embolus lodged in bifurcation of pulmonary trunks
 RV strain = RV & RA dilate = Acute cor Pulmonale
Right to Left shunt allows a venous embolism to enter arterial circulation
Patent ovale foramen or Atrial septal defect
Collection of macrophages w/o caseation
Seen w/ Sarcoidosis (non-caseating); Syphilis; Brucellosis and Leprotic infections
Spreading infection due to streptococcus
Prostate Specific Antigen = elevated in prostatic CA
In cases of metastatic carcinoid, txt w/ Methysergide (5HT antagonist)
Hepatocarcinoma
Neural tube defects
Carcinoembryonic Antigen = elevated in Colon CA
Retinoblastoma
Wilms tumor of the kidney
Associated w/ Angiosarcoma of the liver
Contains dioxin
Implicated as a cause of Hodgkin;s disease, non-Hodgkin’s lymphoma & soft tissue sarcomas
Schistosoma haematobium = Urinary bladder CA
S. mansoni = Colon CA
Aspergillus flavus = potent hepatocarcinogen
Alkaptonuria
Error in tyrosine metabolism due to Homogentisic acid (oxidizes tyrosine)
Involving intervertebral disks = Ankylosing Spondilitis = Poker spine
See dark urine; dark coloration of sclera, tendons, cartilage
Page 18
Lead poisoning
Heroin OD, clinically
Fetal alcohol syndrome
Atypical mycobacterium
Cold abscesses
Actinomyces isrealli
Congenital Syphilis
Warthin-Finkeledy cells
Diphyllobothrium latum
Subacute Bacterial
Endocarditis
Acute Bacterial Endocarditis
Mitral Insufficiency
Left Anterior Descending
branch
Left Circumflex branch
Dissecting Aneurysm
Cor Pulmonale
Acute Cor Pulmonale
Bronchopneumonia
Lobar pneumonia
Bronchiectasis
Cold Agglutinins
Panlobular Emphysema
Bulla
Farmer’s Lung
Bagassosis
Silo-Filler’s Lung
G6PDH Deficiency
HbF 
Multiple Myeloma
Hodgkin’s Disease
Polyarteritis Nodosa
Acid fast inclusion bodies
 urinary coproprophyrin
Anemia: microcytic/ hypochromic
Stippling of the basophils
Gingival line & lead line in bones: x-ray
Mental retardation
Massive pulmonary edema w/ frothy fluid from the nostrils
Small head, small eyes, funnel chest, ASD, mental deficiency, and hirsutism
M. kanasasii & M. avium intracellulare
Liquefied TB lesions similar to pyogenic abscesses but lacking acute inflammation
Farmers infection
Lumpy jaw (from chewing grain) & PID (IUD), but most common is due to saprophyticus
Saddle nose, Saber shin, Hutchinson’s teeth, nerve deafness, interstitial keratitis
Reticuloendothelial giant cells on tonsils, lymph nodes, spleen
Seen with Rubeola (measles) due to paramyxovirus
Tapeworm infection causing megaloblastic anemia by consuming large amount of vit B12 in the host
 Hemolytic Streptococci (S. viridans) = usually in pt w/ pre-existing heart problem
Staph aureus,  Hemolytic Streptococci, E. coli
Common among drug addicts & diabetics
Ruptured papillary muscle
Branch of the Left Coronary artery
Highest frequency of thrombotic occlusion
MI = anterior wall of the LV, especially in apical part of interventricular septum
Branch of the Left Coronary artery
Occlusion = MI of posterior/lateral wall of the LV
False aneurysm: it is splitting of the media of the aorta
Usually accompanied w/ long history of severe hypertension, also seen w/ familial hyperlipidemia,
atherosclerotic disease, Marfan’s Collagen disease
Zones of medial necrosis +/- slitlike cysts = Medial Cystic Necrosis of Erdheim
Right ventricular strain, associated w/ right ventricular hypertrophy
Sudden right ventricular strain due to a massive pulmonary embolism
Lobular (rather than lobar)
Due to Staph aureus; Pseudomonas aeruginosa; Klebsiella; E. coli
Abscess formation is common
Due to Strep. Pneumoniae infection (5% due to Klebsiella)
Red Hepatization: days 1-3 of the pneumonia
Gray Hepatization: days 3-8 of untreated pneumonia
Complications: pleural effusion; atelectasia; fibrinous pleuritis; empyema; fibrinous pericarditis;
otitis media
Permanent dilatation of the bronchi – predisposed by chronic sinusitis and post nasal drip
Supparation associated
Lower lobe > than upper lobe involvement
Found w/ Mycoplasma pneumoniae
1 – antitrypsin deficiency, causing elastase  =  compliance in the lung
Associated w/ Emphysema = “Bleb” = outpouching - If it ruptures causes Pneumothorax
Due to Micropolyspora faeni (thermophilic actinomycetes)
Due to M. vulgaris (actinomycetes)
Inhalation of sugar cane dust
Due to Nitrogen dioxide from nitrates in corn
Sex-linked chronic hemolytic anemia w/o challenge or after eating fava beans
Heinz Bodies appear in RBCs
Sickle Cell Anemia
Lytic lesions of flat bones (“salt & pepper lesions”) = vertebrae, ribs, skull; Hypercalcemia; Bence-Jones
protein casts
Malignant neoplasm of the lymph nodes causing pruritis; fever = looks like an acute infection
Reed Sternberg cells
Immune complex disease of Ag-Ab complexes on blood vessel wall
Half of the immune complexes have Hepatitis B Ag
Page 19
Sprue
Regional Enteritis
Whipple’s Disease
Kulchitsky cells
Ulcerative Colitis
Vaginal Adenosis
Scirrhous Carcinoma
Hofbauer Cells
Retinopathy of Prematurity
IgA deficiency
Priamry Sjorgen’s
Secondary Sjorgen’s
LDH1 & LDH2
LDH3
LDH4 & LDH5
Keratomalacia
Metabisfite Test
Microangiopathic Hemolytic
Anemia
Wright’s stain
Mononucleosis
T(8;14)
T(9;22)
Langerhan Cell Histiocytosis
Myeloid Metaplasia
Multiple Myeloma
T(14;18)
Focal Segmental GN exs
Nephrotic Syndrome exs
Schistosoma Haematobium
Penicillin Resistant PID
Duret Hemorrhages
Hypertensive Hemorrhage
Cerebral Embolism from
Neurosyphilis
Can see fever; abd.pain;  wt; HTN; muscle aches
Celiac disease due to a gluten-induced enteropathy = small intestine villi are blunted
High titers of anti-gliadin Abs &  IgA levels
Crohn’s Disease
Association w/ Arthritis; Uveitis; Erythema Nodosum
Intestinal Lipodystrophy = malabsorption syndrome
Neural cest cells from which carcinoids arise = of the Bronchi; GIT; Pancreas
Inflammatory disease of the colon w/  colon CA incidence
Crypt abscess in the crypts of Lieberkuhn
Pseudopolyps when ulcers are deep
Not transmural involvement
Women exposed to DES (Diethylstilbesterol) in utero before the 18 th week of pregnancy
Some develop clear cell adenocarcinoma of the vagina & cervix
Infiltrating Duct Carcinoma w/ fibrosis – most common type of breast carcinoma
Lipid laden macrophages seen in villi of Erythroblastosis Fetalis
Retrolental Fibroplasia = cause of bindness in premies due to high O2 concentrations
Pt has recurrent infections & diarrhea w/  respiratory tract allergy & autoimmune diseases
If given blood w/ IgA = develop severe, fatal anaphylaxis reaction
Dry eyes & dry mouth, arthritis.  risk for B cell lymphoma. HLA-DR3 frequent. Autoimmune disease.
Rheumatoid arthritis, SLE, or systemic sclerosis association
RA association shows HLA-DR4
Myocardium. LDH1 higher than LDH2 = Myocardial Infarction
Lung tissue
Liver cells
Severe Vit A deficiency. See Bitot’s spots in the eyes = gray plaques = thickened, keratinized ET
Suspending RBCs in a low O2 content solution
Can detect Hemoglobin S, which sickles in low O2
Can be due to Hemolyitc Uremic Syndrome & Thrombotic Thrombocytopenic Purpura (TTP)
See Helmet cells
Stain for Burkitt’s lymphoma
Due to EBV infeciton
If Mono is treated w/ Ampicillin, thinking that it is a strep pharyngitis, a rash will occur.
Burkitt’s lymphoma = c-myc oncogene overexpression
CML = c-abl/bcr gene formation = Philadelphia translocation
Letter Siwe syndrome; Hand Schuller Christian Disease; Eosinophilic Granuloma
Birbeck granules are present = tennis racket shape
Alkaline phosphatase /normal compare to CML = low to absent
Anemia; splenomegaly; platelets > 1 million = extensive extra-medullary hematopoiesis
Weakness; wt. loss; recurrent infection; proteinuria; anemia;  proliferation of plasma cells in BM =
plasma cell dx
Serum M protein spike – most often of IgG or IgA
Hypercalcemia ( bone destruction)
NH Lymphoma = bcl2 proto-oncogene overexpression seen w/ Small Cleaved Cell (Follicualr) Lymphoma
IgA Focal GN = Berger’s disease; SLE; PAN; Schonlein-Henoch purpura (anaphylactoid purpura)
Focal (Segmental) GN; Membranous GN; Lipoid (Minimal Change) GN; Membranoproliferative GN; Hep B;
Syphilis; Penicillamine
Infection is assocaited w/ Squamous cell CA of the Bladder (most common Bladder CA is transitional cell
type)
Associated w/ portal HTN due to intrahepatic obstruction
PID is usually due to N. Gonorrhoeae, but if unresponsive to penicillin think of Bacteroides species
Severe  in ICP w/ downward diplacement of cerebellar tonsils into Foramen Magnum causing a
compression on the brainstem w/ hemorrhaging into the pons & midbrain
Nearly always associated w/ death due to damage to the vital centers in these areas
Predilection for lenticulostriate arteries = putamen & internal capsule hemorrhages
MI w/ Mural Thrombi; Atrial Fib Thrombi = Marantic thrombi; L-sided Bacterial Endocarditis;
Paradoxical Embolism of septal defect
Tabes Dorsalis =  joint position sensation,  pain sensation, ataxia, Argyl Robertson pupils
Syphilitic meningitis
Page 20
5pTrisomy 13
Acute Cold Agglutinaiton
Chronic Cold Agglutinaiton
RBC Osmotic Fragility
Non-Hodgkin’s Lymphomas
Singer’s Nodules
Paraseptal emphysema
Superior Vena Cava Syndrome
Betel nuts
Fundal (Type A) Gastritis
Antral (Type B) Gastritis
Primary Biliary Cirrhosis
Acute Pancreatitis
Radiating Back Pain
Complete Hydatidiform Mole
Partial Hydatidiform Mole
Cold Nodules
Acidophils
Basophils
Lacunar Strokes
CSF of Bacterial Meningitis
CSF of Viral Meningitis
Marble Bone Disease
C5a
C3b
Anaphylotoxins
Vasoactive Mediators
Platelet Aggregation
Platelet Antagonist
Intrinsic Pathway
Extrinsic Pathway
Lines of Zahn
Currant Jelly appearance
Emigration: Chemotaxis
Transudate
Paretic neurosyphilis
Cri di Chat: mental retardation; small head; wide set eyes; low set ears; cat-like cry
Patau’s: small head & eyes; cleft lip & palate; many fingers
Abs to I blood group Ag. Mediated by IgM Abs
Complication of EBV or Mycoplasma pneumoniae infections
Associated w/lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold. IgM Abs
Hereditary Spherocytosis
Small Lymphocytic: low grade B cell lymphoma of the elderly. Related to CLL.
Small Cleaved cell (Follicualr): low grade B cell lymphoma of the elderly. T(14;18) bcl-2 oncogene
Large Cell
Lymphoblastic: high grade T cell lymphoma of kids progressing to T-ALL
Small Non Cleaved = Burkitt’s: high grade B cell lymphoma. EBV infection. Starry sky histo appearance.
T(8;14) c-myc proto-oncogene. Related to B-ALL
Benign laryngeal polyps associated w/ smoking & overuse of the voice
Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax
Obstructed due to bronchogenic carcinoma. Causing swollen face & cyanosis.
Associated to oral cancer.
Antibodies to parietal cells; pernicious anemia; autoimmune diseases
Associated w/ Helicobacter (Campylobacter) pylori infection. 90% of duodenal ulcer
Autoimmune origin; middle aged women; anti-mitochondrial Abs
Jaundice; itching; hypercholesterolemia (can see cutaneous xanthomas)
 pancreatic enzymes = fat necrosis; sapponification = hypocalcemia;  serum amylase
Severe epigastric ab pain; prostration; radiation to the back
Chronic pancreatitis
No embryo. Paternal derivation only. 46XX
Embryo. 2 or more sprems fertilized 1 ovum: triploidy/tetraploidy occurs
Hypoplastic Goiter nodules that do not take up radio active iodine. [Opposite: hot & do take up iodine]
Mammotrophs = Prolactin
Somatotrophs = GH
Thyrotrophs = TSH
Gonadotrophs = LH
Corticotrophs = ACTH & FSH
Small/focal aa occlusions. Purely motor or sensory.
Sensory: lesion of thalamus
Motor: lesion of internal capsule
 Glucose;  Protein;  Neutrophils;  Pressure
Normal Glucose; +/- Protein;  Lymphocytes
Osteoporosis: Albers-Schonberd Disease = inspite of d bone density, many fractures =  osteoclasts
Involved in Chemotaxis (for Neutrophils)
Involved in Opsonization (& IgG)
C3a & C5a (mediate Histamine release from Basophils & Mast cells)
Vasoconstriction: TxA2; LTC4; LTD4; LTE4; PAF
Vasodilation: PGI2; PGD2; PGE2; PGF2; Bradykinin; PAF
d Vascular Permeability: Hist.; 5HT; PGD2; PGE2; PGF2; LTC4; LTD4; LTE4; Bradykinin; PAF
ADP; Thrombin; TxA2; collagen; Epinephrine; PAF
Prostacyclin (PGI2)
F XII (Hagman): APTT
F VII: PT
Aterial thrombi = pale red colored (dark red is venous thrombi)
Post mortem clots
Margination
Pavementing
Adhesion
Chemotaxis
Phagocytosis
Intracellular microbial killing
Specific gravity < 1.012 – low protein
Page 21
Exudate
Hurler’s
Galactosemia
Phenylketonuria
Autosomal Dominant
Diseases
Autosomal Recessive
Diseases
X Linked Recessive Diseases
Hypersensitivity Reactions
“ACID”
Transplant Rejections
Blood Metastasis
Lymph Metastasis
Aflatoxin
Cleft Lip
Cleft Palate
Craniopharyngioma
Lateral Geniculate Nucleus
Medial Geniculate Body
Lung Development
Heart’s 1st Beat
Foregut
Midgut
Specific gravity > 1.020 – high protein
Lysosomal storage disease
 L Iduronidase – Heparan/Dermatan Sulfate accumulation
Deficiency of Galactose 1 Phosphate Uridyl Transferase.  Galactose 1 Phosphate
Deficiency: Phenylalanine Hydroxylase.  Phenyalanine & degradation products
Mousy body odor
Adult Poly Cystic Kidney Disease
Familial Hypercholestrolemia Disease
Hereditary Hemorrhagic Telengectasia (Osler-Weber-Rendu)
Hereditary Spherocytosis
Huntington’s Disease (chromosome 4p)
Marfan’s Syndrome
Neurofibromatosis (von Recklinghausen’s)
Tuberous Sclerosis
Von Hippel Lindau Disease
Tay-Sachs
Gaucher’s
Niemann-Pick
Hurler’s
Von Gierke’s
Pompe’s
Cori’s
McArdle’s
Galactosemia
PKU
Alcaptonuria
Hunter’s Syndrome (L-Iduronosulfate Sulfatase deficincy,  Heparan/Dermatan Sulfate)
Fabry’s Disease ( Galactosidase A deficiency,  Ceremide Trihexoside)
Classic Hemophilia A (Factor VIII deficiency, F8 Gene on X chromosome is bad,  Ceremide Trihexoside)
Lisch-Nyhan Syndrome (HGPRT deficiency,  Uric acid)
G6Phosphatase deficiency (G6PDH deficiency,  Ceremide trihexoside)
Duchenne’s Muscular Dystrophy (Dystrophin deficinecy,  Ceremide Trihexoside)
Type I (Anaphylactic): IgE mediated. Exs: Hay Fever; Allergic asthma; Hives
Type II (Cytotoxic): Warm Ab autoimmune hemolytic anemia; hemolytic transfusion reactions;
Erythroblastosis Fetalis; Grave’s Disease; Goodpastures
Type III (Immune Complex): Insoluble complement bound aggregates of Ag-Ab complexes. Exs:
Serum sickness; Arthus Reaction; Polyarteritis Nodosa; SLE; Immune Complex Mediated Glomerular
Disease
Type IV (Delayed = Cell mediated immunity): Delayed hypersensitivity. Involves memory cells. Exs:
Tuberculin reaction; Contact dermatitis; Tumor cell killing; Virally infected cell killing
Hyperacute Rejection = occurs w/in minutes of transplant. Ab mediated.
Acute Rejection = occurs w/in days to months of transplant. Lymphocytes & macrophages. Only rejection
type that can be treated w/ therapy.
Chronic Rejection = occurs months to years of transplant. Ab mediates vascular damage.
Sarcoma, exception – renal cell CA: early venous invasion
Carcinoma, exception – renal cell CA: early venous invasion
Seen w/ Aspergillus.  risk for Hepatocellular CA
Incomplete fusion of maxillary prominence w/ median nasal prominence
Incomplete fusion of lateral palatine process w/ each other & median nasal prominence & medial palatine
prominence
416. Pituitary tumor - usually calcified
Inolved in Vision relay
Involved in Hearing relay
Glandular: 5-17 fetal weeks
Canalicular 13-25 fetal weeks
Terminal Sac 24 weeks to birth
Alveolar period birth-8yoa
21-22 days
Mouth  Common Bile Duct - supplied by Celiac Artery
Duodenum, just below Common Bile Duct  Splenic flexure of the Colon supplied by Superior Mesenteric
artery
Page 22
Hindgut
Hypnagogic Hallucinaitons
Type I Error
Type II Error
Subdural Hematoma
Epidural Hematoma
Power
Sensitivity
Specificity (spin)
Positive Predictive Value
Negative Predictive Value
Odds Ratio
d-Dimers
Delusion
Loose Association
5 Stages of Death
1st Branchial Arch
2nd Branchial Arch
Median nerve lesion
Radial nerve lesion
Common peroneal lesion
Direct inguinal hernia
Indirect inguinal hernia
@ Diaphragm T8, T10, T12
Hemiballism
O Linked Oligosaccharide
N Linked Oligosaccharide
MLF Syndrome
ADA Deficiency
Raphe Nucleus
 waves
Irreversible Glycolysis
Enzymes
Irreversible Gluconeogenesis
Enzymes
Pellagra
TLCFN
LCAT or PCAT
HMGCoA Reductase
Splenic Flexure  Butt crack  supplied by Inferior Mesenteric Artery
Narcolepsy
: “Convicting the innocent” – accepting experimental hypothesis/rejecting null hypothesis
: “Setting the guilty free” – fail to reject the null hypotesis when it was false
Ruptured cerebral bridging veins
Ruptured middle meningeal artery “intervals of lucidness”, 2ry to Temporal bone fracture
1 - 
TP/TP + FN
TN/TN + FP
TP/TP + FP
TN/TN + FN
ad/bc
DIC
Disorder of thought content
Skip from topic to topic
Denial – Anger – Bargaining – Depression – Acceptance
Meckel’s cartillage – gives rise to incus/malleus bones of ear
Reichert’s cartillage – gives rise to stapes bone of ear
No pronation
Wrist drop – seen w/ humerus fracture
Foot drop. No dorsiflexion or eversion of the foot
Goes through superficial inguinal ring.
Medial to inferior epigastric artery
Seen in older men
Goes through deep & superficial inguinal ring
Lateral to inferior epigastric artery
Seen in young boys – processus vaginalis did not close
T8 = Inferior vena cava
T10 = Esophagus/ Vagus
T12 = Aorta/ Thoracic duct/ Azygous vein
Wild flailing of 1 arm. Lesion of the sub thalamic nucleus
In the Golgi
In the RER
Internuclear Ophthalmoplegia: medial rectus palsy on lateral gaze; Nystagmus on abducting eye.
Seen w/ MS
SCID
Initiation of sleep via 5HT predominance
Alert; Awake; Active mind – also seen in REM, therefore we say “paradoxical sleep”
Hexokinase
PhosphoFructo Kinase = Rate Limiting Step
Pyruvate Kinase
Pyruvate Dehydrogenase
PyruvateCarboxy Kinase
PEPCarboxyKinase
Fructose 1,6 BiPhosphatase
Glucose 6 Phosphatase
**muscle dose not take part in Gluconeogenesis, only takes place in the liver, kidney & GI epithelium
Diarrhea, Dermatitis, Dementia
Niacin Deficiency (Vit B3 deficiency)
Hartnup’s Disease
Malignant Carcinoid Syndrome
INH use
Needed as co-factor for Pyruvate DH complex &  Ketoglutarate DH complex
Esterification of cholesterol: lecithin cholesterol acetyltransferase
Lecithin = Phosphatidylcholine, therefore phosphotidylcholine acetyltransferase
Rate limiting step in cholesterol synthesis
Changes HMGCoA  Mevalonate
Page 23
Ketogenic amino acids
Glucogenic amino acids
Keto & Gluco amino acids
Carnitine Shuttle
Cori Cycle
(-) Na+ Pump (ATPase)
TCA Cycle Products
Cones
Rods
Gastrula
Epiblast
Sydenham’s Chorea
(+) Frei Test
Sabouraud’s Agar
FMR1 Gene Defect
Barr Body
Aortic Insufficiency Signs
Scleroderma :”CREST”
Cretinism
Hemochromatosis Triad
(-) by Lovastatin
Leucine & Lysine
Methionine, Threonine, Valine, Arginine, Histadine
Phenylalanine, Trytophan, Isoleucine
Feeds FA into the mitochondria for their consumption
Keeps muscles working anaerobically.
Transfers lactate to the liver to make glucose which is sent back into the muscles for energy use
Ouabain [(-) K+ pump]
Vanadate [(-) phosphorylation]
Digoxin [ heart contractility]
“Citric Acid Is Krebs Starting Substrate For Mitochondrial Oxidation”
Citrate  Aconitate  Isocitrate   Ketoglutarate  Succinyl  Succinate  Fumarate  Malate
OAA
Color vision. Contain Iodopsin = Red-Blue-Green specific pigment. For acuity.
Contain Rhodopsin pigment. High sensitivity. Concentrated in the fovea. Night vision.
Seen @ 3rd week: Ecto, Meso & Endo
@ 2nd week: forms the primitive streak, from which Meso & Endo come from. Directly gives rise to Ecto.
Post streptococcal infection. Necrotizing arteritis of the caudate, putamen, thalamus
Chlamydia trachomatis types L1, L2, L3 = Lymphogranuloma venereum
Culture for all Fungi
ie…Culture Cryptococcus neofromans which is found in pigeon droppings
Fragile X Syndrome: macro-orchidism; long face; large jaw; large everted ears; autism, mental retardation
Present in Kleinfelters: Male: XXY
Not present in Turner’s: Female: XO
Traube Sign = Pistol shot sound over the femoral vessels
Corrigan pulse = water hammer pulse over coratid artery = aortic regurgitation
Calcinosis; Raynauds; Esophageal; Sclerodactyl; Telangiectasis
Sporadic: bad T4 phosphorylation or developmental failure of thyroid formation
Endemic: no Iodine in diet: protruding belly & belly button
Micronodular pigment cirrhosis; Bronze Diabetes; Skin pigmentation = due to  Fe3+ deposition
Signature Drug Toxicities
Agranulocytosis
Aplastic Anemia
Atropine-like Side Effects
Cardiotoxicity
Cartilage Damage in Children
Cinchonism
Cough
Nephrogenic Diabetes Insipidus
Disulfiram-like Effect
Extrapyramidal Side Effects
Fanconi’s Syndrome
Fatal Hepatotoxicity (necrosis)
Gingival Hyperplasia
Gray Baby Syndrome
Gynecomastia
Hemolytic Anemia in G6PDdeficiency
Hepatitis
Hot Flashes, Flushing
Induce CP450 –Peri Peri Chicken
Rice
Inhibit CP450
Interstitial Nephritis
 Clozapine, Chloramphenical
 Chloramphenicol, NSAIDs, Benzene
 Tricyclics
 Doxorubicin, Daunorubicin
 Fluoroquinolones (Ciprofloxacin & Norfloxacin)
 Quinidine
 ACE Inhibitors
 Lithium (Txt w/ Amiloride)
 Metronidazole, Sulfonylureas (1st generation)
 Antipsychotics
(Thioridazine, Haloperidol, Chlorpromazine)
 Tetracycline
 Valproic Acid, Halothane, Acetaminophen
 Phenytoin
 Chloramphenicol
 Cimetidine, Azoles, Spironolactone, Digitalis
 Sulfonamides, Isoniazid, Aspirin, Ibuprofen, Primaquine
 Isoniazid
 Niacin, Tamoxifen, Ca++ Channel Blockers
 Barbiturates – Phenobarbital, Phenytoin, Carbamazepine, Rifampin
 Cimetidine, Ketoconazole
 Methicillin, NSAIDs (except Aspirin), Furosemide, Sulfonamides
Page 24
Monday Disease
 Nitroglycerin
Orange Body Fluids
Osteoporosis
Positive Coombs’ Test
Pulmonary Fibrosis
Red Man Syndrome
Severe HTN with Tyramine
SLE-like Syndrome
Tardive Dyskinesia
 Rifampin
Tinnitus
Industrial exposure  tolerance during week  loss of tolerance during weekend  headache, -ach,
dizziness upon re-exposure
 Heparin, Corticosteroids
 Methyldopa
 Bleomycin, Amiodarone
 Vancomycin
 MAOIs
 Procainamide, Hydralazine, INH
 Antipsychotics (Thioridazine, Haloperidol,
give you tardive dyskinesia
 Aspirin, Quinidine
Chlorpromazine)
Clozapine: only antipsychotic to not
Micro
Lactose formers
Non lactose formers
May lack color
 cAMP
Have Capsules [ie… are Quellung Reaction (+)]
Dimorphic Fungi
Have  Prophage
Spore Forming Bacteria
IgA Proteases
Widal Test
Wayson’s Stain
Pneumonic Plaque Transmission
“CEEK”
Citrobacter
Enterobacter
E.Coli (K1 capsule most important)
Klebsiella
“SHYPS”
Motile:
Shigella
make H2S
Yersinia enterolytica (AKA Pestis)
Proteus
Non Motile: noH2S
Salmonella
“These rascals may microscopically lack color”:
Treponema
Ricksetta
Mycobacterium
Mycoplasma
Legionella
Chlamydia
“CAPE”
Cholera
Anthracis (Poly D glutamate capsule)
Pertusis (via Gi)
E.coli (LT enterotoxin)
“Some killers have pretty nice capsules”
Strep. Pneumoniae
Klebsiella
HiB
Pseudamona Aeroginosa
Neisseria meningitis
Cryptococcus neoformans (only encapsulated fungal pathogen)
“Can Also Have Both Shapes”
Cocciodes
Aspergillus
Histolpasma
Blastomyces
Sprothrix schenkii
“OBED”
O = Salmonella
B = Botulinum
E = Erythrogenic strep
D = Diptheria
Bacilus & Clostridium (have calcium di-picolinate)
Neisseria, Haemophilus, S. pneumoniae
Salmonella (Salmonella begins in the ileocecal region)
agglutination indicates Abs to O, H, Vi Salmunella Ags
Yersinia
Person to person cf w/ Bubonic plaque that was via infected flea
Page 25
Splenectomy
Invasins
Fusiform
S. viridans
Obligate Aerobes
Obligate Anaerobes
Staph aureus
Spirochetes
Non Motile Gram (+) Rods
Acid Fast Organisms
Pigment Producing Bacteria
Bacterial Morphology
Inclusion Bodies
Schistosoma Japonicum Monsoni
Schistosoma Haematolium
Non Human Schistosom
Clonorchichis
Fasciola Hepatica
Fasciola Biski
Paragonimus Westermani
Oxidase (+)
Micro Aerophilic
Urease (+)
Coagulase (+)
Obligate Intracellular Bacteria
Protozoa
Obligate Non Intracellular Parasites
Haemophilus Factors
All cocci are
“Eaton Fried Eggs”
Mycoplasma
Sabrands
Malassazia furfur
Measles’ 3C’s
Predisposes to septicemia
Yersinia pseudotuberculosis
Vincent’s trench mouth
Dextran mediated adherence
Pseudomonas & Mycobacterium
Clostridium, Actinomyces, Bacteroides
A Protein, Catalase +/ Coagulase +
Treponema, Borrelia, Leptospira
Corenybacterium D & Nocardia
Mycobacterium; Cryptosporidium; Nocardia (partially); Legionella micdadei; Isospora
Serratia – red (can cause pseudohemoptysis)
Pseudomonas A – piocyanin blue/green
Staph Aureus – yellow – Protein A
Mycobacteria – photo/scoto chromogenic – caritinoid – yellow/orange
Corneybacterium D – black/gray – pseudomembrane plaque in throat
Bacteroides (Porphyromonas) melaninogenicus – black (heme)
E. coli – irredescent green sheen
Pneumococci – lancet shaped diplococci
Neisseria – kidney bean shaped diplococci
Camphylobacter – gulls’ wings/comas
Vibrio Cholera – coma shaped
Corneybacterium D – club shaped (nonmotile, G+Rod)
Yersinia – safety pin seen in Wayson’s stain
Rabies – Negri bodies – intracytoplasmic
Pox virus – Guarnieri – intracytoplasmic & acidophilic
CMV – Owl’s eyes – intracytoplasmic & intranuclear
HSV – Cowdry bodies – intranuclear
Intestinal – contact w/ bad water
Vesicular – contact w/ bad water
Swimmer’s itch – contact w/ bad water
Chinese liver fluke – eating raw fish. Txt: Praziquantel
Sheep – eating raw fish. Txt: Praziquantel
Giant intestinal flukes – eating raw fish. Txt: Praziquantel
Lung fluke – eating raw fish. Txt: Praziquantel
Neiserria and most Gram (-)s
Camphylobacter & Helicobacter
All Proteus – can cause Staghorn/Struvite calculi (NH4- Mg2- stones): alkaline urine
Ureaplasma
Campylobacter pylori (Helicobacter)
Cryptococcus
Nocardia
Staph A & Yersenia pestis
Chlamydia Pistacci (Chlamydia do not make own ATP); Mycobacterium Leprae; all Rickettsia
except Roachalimea (make suficient ATP to survive)
Plasmodium; Toxoplasma ghondi; Babesin; Leishmania; Trypanosoma Cruzi
Treponema palidum & Pneumocystis Carinii (cannot be cultured on inert media but
be found extra cellularly in the body)
X = Protoporphyrin & V = NAD
Gram (+) except for Neisseria & Moraxella
Mycoplasma pneumoniae has fried egg colonies on Eaton agar (needs cholesterol)
No cell wall. Membrane has cholesterol. Smallest living bacteria.
P1 protein inhs ciliary action
Fried egg colonies
Atypical pneumonia – young adults
Fungal media
Spaghetti & meat ball
Cough – Coryza – Conjunctivitis. Can also have photophobia
May lead to subacute Sclerosing Panencephalitis
Page 26
can
Non Motile Bacilli & Clostridium
Bloody diarrhea agents
YW-135CA
Indian Ink
Naegleria causes
Need Cysyeine for growth
Endotoxins, G(+) or G(-)
Ecthyma Gangrenosum, seen w/
Endospores G(+)
Multi Brain Abscess
Single Brain Abscess
 risk for Strep pneum Infection
 Hemolysis/Optochin Sensitive
 Hemolysis/Optochin Resistant
Staph. Saprophyticus
Staph. Epidermidis
 Hemolysis/Bacitracin Sensitive
 Hemolysis/Bacitracin Resistant
EFII Ribosylation
Bacillus Anthracis: 3 toxins
(work via adenylate cyclase)
Woolsorter’s Disease
Grows in Rice
Clostridium Perfringens
Clostridium Difficile
Spastic Paralysis toxin
Clostridium Botulinum
Infant Botulinum
Thayer Martin Agar
DOC for N. gonorrhoeae
K1 E. Coli Capsular Ag
The A’s of Klebsiella
Rice H2O Diarrhea
Raw seafood intoxicaiton
Helicobacter Txt
 risk of P. aeroginosa infection
Contact lens’ infection
Cat Bites
Undulant Fever
Bordet Gengou Agar
Lowenstein-Jensen medium
Cat Scratch Disease
Pink Eye
B. Anthracis & C. Perfringens
EIEC – EHEC – Shigella - Yersenia enterocolitica – Entaemeba histolytica – Salmonella –
Campylobacter jejuni
N. meningitidis vaccine capsualr polysaccharide strains
Cryptococcus neoformans
Colonization in the nasal passages after swimming
“Ella likes cysteine”:
Francisella
Brucella
Legionella
Pasturella
Gram (-): N. meningitidis
Pseudomonas aeroginosa. Target shaped skin lesions w/ a black center and red ring
surrounding the lesion
Gram (+): Bacillus & Clostridium – made up of dipicolinate & Keratin
Nocardia
Actinomyces israelli
Asplenic; Sickle cell anemia; immunocompromising illness
Strep. Pneumoniae
Strep. Viridans (Subacute Endocarditis)
Novobiocin Resistant (UTIs)
Novobiocin sensitive (Endocarditis in IVDUs)
Strep. Pyogenes (pharyngitis; Scarlet fever; cellulitis; impetigo; Rheumatic fever))
Hyaluronic capsule; non-motile; M proteins; Endotoxin A
Strep. Agalactiae (Diabetes predisposes to infection)
Diphtheria toxin & Pseudomonas exotoxon A
Protective Antigen (PA)
Lethal Factor = toxic to macrophages
Edema Factor =  cAMP
Bacillus anthracis. DOC: Penicillin
Bacillus Cereus
Double Zone  Hemolysis (test)
Lecithinase:  toxin = lyses RBCs
80% of gas gangrene (myonecrosis) cases
2 Toxins: Enterotoxin (Exotoxin A) & Cytotoxin (Exotoxin B)
Pseudomembranous colitis (can be precipitated by clindamycin/ampicillin)
Clostridium Tetani toxin
Bad canned foods have neurotoxin = flaccid paralysis (block Ach release)
Floppy Baby Syndrome. Pre formed toxin in honey
Neisseria ID
Ceftriazone
Related w/ neonateal meningitis
Alcoholics
Aspiration pneumonia
Abscesses in the lungs
Vibrio Cholera: metabolic acidosis
Vibrio parahemolyticus
Bismuth salts; Metronidazole; Tetracycline (or amoxicillin)
Burn patients & Cystic fibrosis
Pseudomonas aeroginosa
Pasteurella multocida
Brucella
Bordetella pertusis ID
M. tuberculosis ID
Bartonella henselae. Leion can resemble Kaposi’s sarcoma.
Toxoplasmosis
Adenovirus (type 8)
Page 27
True Hemaphrodite
Pseudo Hemaphrodite
Male Pseudo Hemaphrodite
HLA Genes Location
Parvovirus B19
Interferon MOA
Acute Hemorrhagic Conjunctivitis
Parainfluenza Causes…
Swimming Pool Conjunctivitis
RSV
Removed tonsils, find what virus
Bone Fever
HbsAg
HbeAg
Anti-Hbc
Filamentous Bacteria
Listeria contaminates
Shiga like Toxin
Necrotizing Fasciitis
Relapsing Fever
Loffler’s Medium
Chlamydiae Developmental Cycle
Trench Fever
“Spotted Fever” Members
Thrush Txt
Rose Bush Thorns
Contact lens solution infection
Filiariasis Causant
Freshwater lake infection
Reduviid bug bite
Schistosoma Haematobium causes
Schistosoma Mansoni causes
Snail, intermediate host of…
Ixodes scapularis transmits
Nantucket Protozoa
Infection by Reduviid Bug
Infection by TseTse Fly
Infection by Sandfly
Infection by Ixodes Tick
Infection by Anopheles Mosquito
Trophozoites w/ “Face-Like” Appearance
Nonseptate Hyphae
Histoplasmosis Geography
Coocidioidomycosis Geography
Blastomycosis Geography
Paracoccidioidomycosis Geography
Roseola Infection, aka
Testes & Ovaries are present
External genitalia does not coincide w/ gonads
Testicular Feminization
6p
Fifth Disease: Erythema Infectiosum (ssDNA). Linked w/ sicle cell anemia
Inhibits viral replication (translation or transcription)
Seen w/ infections from Enterovirus & Coxsackie A
Croup (Laryngotracheobronchitis)
Adenovirus (types 3 & 4)
Bronchiolitis in infants
In 80%, Adenovirus. In the immunosuppressed, activation can occur
Dengue: Group B Togavirus, from the Arbovirus, transmitted by mosquitos
Appears in blood soon after infection, before onset of acute illness
Disappears w/in 4-6 months after the start of clinical illness
Appears early acute phase, indicates higher risk of transmitting the disease
Disappears before HbsAg is gone
Present in beginning of clinical illness
Seen in the “window phase”
Actinomycetes = Nocardia; Actinomyces; Streptomyces
Milk, cheese, vegetables (coleslaw) in recent infections
E. Coli 0157/H7: Hemorrhagic colitis & Hemorrhagic uremic syndrome
Group A Streptococci
Borrelia recurrentis
Corneybacterium diphtheriae
Elementary Body: infeccious particle that Enters the cell
Reticulate Body: made from elementary body. Replicates, differentiates and releases
elementary bodies to infect other cells
W/ infection you will see Glycogen containing inclusions
Cell wall lacks muramic acid
Rochalimaea quintana
Rickettssia rickettsii (RMSF) & R. akari (rickettsial pox) in the U.S.
R. sibirica (tick typhus in China) & R. australis (typhus in Australia)
Nystatin txts candidiasis of the mouth
Have Sporothrix schenckii
Acanthamoeba
Wucheria bancrofti (infection aka elephantitis & wucheriasis
Causes amebic meningoencephalitis due to Naegleria fowleri
Transmits Trypanoma cruzi (Chagas’ disease): Romana’s Sign
Bladder calcificaiton & cancer
Presinusoidal HTN, splenomagaly, esophageal varices
Schistosomiasis
Babesia (clinically rembles malaria) & Borelia burgdorferi
Babesia microt
Trypansoma cruzi: Chagas’ Disease
Trypansoma brucei gambiense & rhodiense: African Sleeping Sickness
Leishmaniasis: Mucocutaneous Diseases by L. braziliensis & Visceral Disease by L. donovani &
Dermal Leishman by L. tropica, mexicana, peruviana
Babesia microti: Babesiosis & Borrelia burgdorferi: Lyme Disease
Malaria
Giardia lamblia
Zygomycosis: Rhizopus & Mucor. Only mycosis w/o septate.
Infect Ketoacidotic Diabetics.
Ohio, Mississippi, Misouri River valleys
Southwestern deserts, California
States east of Mississippi River
Latin America
Exanthema Subitum: “Sixth Disease” (Human Herpes Virus-6 dsDNA, enveloped)
Page 28
Herpangina
Orthomyxovirus
Paramyxovirus
Togavirus
Flaviviris
Bunyavirus
IgA Protease Activity
Diphtheria: ABCDEFG
Only ssDNA
Only dsRNA
Naked RNA
2 circular DNAs
BK
Hepadna, Retrovirus?
Picornovirus: “PERCH”
Hemorrhagic Fevers
Segmented viruses
Eclipse Phase
Latent Phase
Naked Capsid Virus
Enveloped Virus
Interferon
AIDS structural prots
AIDS regulatory prots
AIDS gp41 env prot
AIDS gp120 env prot
AIDS p17 gag prot
AIDS p24 gag prot
AIDS p7p9 gag prot
DNA Viruses
“Hand-Foot-and-Mouth” Disease: Coxsackie A (Picornavirus +ssRNA)
–ssRNA, enveloped virus.
Spike Glycoproteins (peplomeres): HA = Hemagluttinin & NA = Neuraminidase.
These peplomeres are what give the virus antigenis variation
Influenza A & B
–RNA, enveloped. Most common cause of respiratory infections in kids
Mumps
Croup(Parainfluenza virus), Rubeola(Measles virus)
RSV
+ssRNA, enveloped
3 Day Measles: German Measles: Rubella/ Rubivirus
Encephalitis viruses: Alphaviruses: Eastern (more severe) and Western Equine
Encephalitis
Dengue Fever – icterus & hemorrhage w/ blac vomit
Yellow fever
St. Louis Encephalitis – no hepatitis or hemorrhage
–ssRNA, enveloped
California Encephalitis – severe bifrontal headaches
Hantavirus – hemorrhagic fever w/ acute resp. distress syndrome
H. Influenzae (needs factors V & X for growth)
Strep. Pneumoniae
N. meningitidis
N. gonnorhoae
W/ this activity these bugs are able to colonize the oral mucosa.
Adenopathy
 Prophage encodes the exotoxin
Corneybacteria is Club shaped
Diphtheria
Elongation Factor II
Granules (metachromatic)
Parvovirus: “Part of a virus”
Reovirus, “RepeatOvirus”
“Naked for CPR”: Calcivirus; Picornovirus; Reovirus
Papovavirus & Hepadnavirus
Papovavirus. Seen in kidney transplant patients (causes renal disease)
No, but has reverse transcriptase
Poiliovirus; Echo; Rhino; Coxsackie; Hep A
221. Filovirus & Bunyavirus (Hantavirus)
All are RNA: Orthomyxo; Arena; Bunya; Reo
No internal virus. 1 total virus per cell
No external virus. Extracellular virus found
Nucleocapsid. DNA or RNA + Structural proteins
Membrane. Nucleocapsid + Glycoprotein
Non virus specific. Works by RNA endonuclease = digests viral DNA + inh viral prot
synth
Gag, pol, env
Tat, rev, nef
Transmembrane
Surface
Matrix
Capsid
Nucleocapsid
A = Adeno
E
Brick. Rep
H = Herpes
In Cyto
H= Hepadna
AH H PPP --- ico Rep in Nuc
P = Pox
P = Parvo
SS
P = Papova
Page 29
Circ
(+) RNA Viruses
E
C = Calici
P = Picorno
R = Reo
C P R F T C ------ ico (+) Linear.
F = Flavi
No segment. Rep in Cyto
T = Toga
Helical
C = Corona
R-Tase &
Rep in Nuc
(-) RNA Viruses
8
F = Filo
2
3
O = Orthomyxo
R = Rhabdo
F O R P A B ---- (-) E Helical
P = Paramyxo
Linear. Non seg.
A = Arena
B = Bunya
Bullet
Anti sense
Hepatitis Window Period
Hepatitis
A
Picorna
Downey Type II cells
Infection by Aedes Mosquito
“Hot T-Bone stEAk”: ILs
ILs Secreted by CD4s
ILs Secreted by Macrophages
C5a
C5 Convertase
Only Richettssia not Intracellular
Plasmodium Life Cycle
Acanthamoeba
Mucor, Rhizopus, Absidia
Cryptococcus Neoformans
Candida
Aspergillus Fumigatum
Cocciodes
Histoplasma Cap
Blastomycosis
Sporothrix Schenkii
PCP
After HbsAg disappears & Before HbsAb appears
B
Hepadna
EBV
C
Flavi
D
Delta
E
Calici
Yellow Fever: Flavivirus: Black vomit, jaundice, high fever
IL1 =  Temp: HOT
IL2 = stimulate T cells
IL3 = stimulate Bone Marrow stem cells’ growth & differentiation (GM CSF)
IL4 = stimulate IgE (& IgG)
IL5 = stimulate IgA (& eosinophils)
IL2, IL4, IL5, IFN gamma
IL1 & TNF 
Neutral chemotaxis.
When it is w/ C3a, participates in anaphylaxis
When both Alternative and Classic pathways come together
Alternative: C3b, Bb, C3b + C3a  C5
Classic: 2b, 3b, C3a + C4b  C5
Quintana
Sporozoites: from blood to liver
Primary tissue schizont
Trophozoites: in RBC
Erythrocytic schizont
Merozoite: ruptured RBC
Gametozyte
Zygote: inside the mosquito
Star shaped cysts
Nonseptate, filamentous, 90 degree branching, indian in, capsular halos
Monomorphic
Yeast normally, pseudo & true hyphae in tissue infections
45 degree branching point, asoc’d w/ cystic fibrosis & burns pt
Hyphae in wild. Artroconidia. Arthocondida & Hyphae. Sherules w/ endospores
Hyphae in wild. Microcondida w/ tuberculate macrocondida. Fac intracellular. In the
tissue it’s a yeast w/ a small neck.
Hyphae in wild
Hypahe in wild. Potas iodide in milk. Pneumonia in alcoholics.
Obligate parasite. Kills type I pneumo cells. Ground glass
Page 30
Gram (-) Bugs w/ Exotoxins
E. Coli; V. Cholera; Bordetella Pertussis
Dermatophytes
Fever
Trichophyton: SHN
Microsporium: SH
Epidermophyton: SN
Tinea tavus: permanent hair loss
Diagnosis
Trophozoites or cysts in stool
Trophozoites or cysts in stool
Acid fast oocysts
Trophozoites or cysts in stool
Motile trophozoites
Fever Spike
Vivax
Benign 3 degrees
48h
Enlarged Host Cell
Ovale
Benign 3 degrees
48h
Oval/Jagged
Malariae
4 degrees of Malarial
72hrregular
Crescent
Falciparum
Malignant 3 degrees
Transmission
Cysts
Cysts
Cysts
Cysts
Trophozoites
E. Histolitica
Giardia
Cryptosporidium
Balantium C.
Trichomonas V.
Miscellaneous
1. Fastest growing tumor – Burkitt’s
2. PE’s are found in half of all autopsies
3. Courvoisier’s Law: tumors that obstruct the common bile duct cause enlarged gallbladders, but obstructing
gallstones do not (too much scarring), so if you can palpate the gallbladder you’e probably looking at cancer.
4. Only DNA virus to replicate in cytoplasm: Pox
5. Only RNA virus to replicate in nucleus: Influenza
6. Bacillus anthracis has the only protein capsule
7. Bordetella pertussis (Whooping Cough) elicits lymphocytosis rather than granulocytosis
8. Bronchioalveolar carcinomas grow without destroying the normal architecture of the lung
9. Cryptococcus neoformans often lacks a capsule and, when stained with GMS, looks just like Pneumycistis carinii,
except that Cryptococcus lacks the prominent nucleoli.
10. Weil Felix reaction: (+)R. rickettssi & (+)Proteus vulgaris & P. mirabilis
11. Treponema pallidum (Syphilis) tests: 1)VDRL 2)FTA-Abs: most widely used 3)TPI (immobilization test – most
expensive but the Gold Standard)
Cytokine
Source
Function
IL 1
12. Monocytes, macrophages
Stimulates T cell proliferation & IL2 produciton
IL 2
13. Macrophages, T & NK cells
Stim prolif of B, T & NK cell
IL 3
14. T cells
GF of tissue mast cells & hematopoietic stem cells
IL 4
15. T cells
 growth of B & T cells/  HLA II Ags
IL 5
16. T cells
Maturation of B  plasma cell
IL 6
17. T cells, monocytes
Maturation of B & T cell/ (-) fibroblasts
IFN 
18. B cells, macrophages
Antiviral activity
IFN 
19. Fibroblasts
Antiviral activity
IFN gamma
20. T & NK cells
Antiviral activity, (+) macrophages,  HLA II Ags
TNF 
21. Macrophages, T & NK cells
T cell prolif, IL 2 prod, cytotoxicity
TNF 
22. T cells
T cell prolif, IL 2 prod, cytotoxicity
Tumor Suppressor Genes
Genes
VHL
APC
WT-1
Rb
Chrom.
3p
5p
11p
13q
Associated Tumors
Von Hippel Lindau, Renal Cell CA
Familial adenomatous polyposis, Colon CA
Wilm’s tumor
Retinoblastoma, Osteosarcoma
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BRCA-2
p53
NF-1
BRCA-1
DCC
DPC
NF-2
13q
17p
17q
17q
18q
18q
22q
Breast CA
Most human Cas
Neurofibromatosis type 1
Breast CA, Ovarian CA
Colon & Stomach CA
Pancreatic CA
Neurofibromatosis type 2 = bilateral acoustic neuroma
Physio Equations:
Resistance in Series: Add all
Resistance in Parallel: Invert the answer
RENAL:
Filtration Fraction =
GFR
RPF
GFR: Glomerular Filtration Rate RPF: Renal Plasma Flow
Filtered Load = GFR x [Conc]
Clearance =
Excretion Rate = [Urine] x VelUrine
[Urine]xVel(Urine)
Excretion
or
[ Plasma ]
[Plasma ]
Renal Blood Flow =
ERPF
1  Hct
Clearance of PAH = [ERPF]
Free Water Clearance = VelUrine -
ERPF: Eff renal plasma flow
Urine(osm) xVel(urine )
P(osm)
CARDIO:
CO = HR x SV
CO =
O 2(consumed )
PulmonaryA  VO2difference
MAP = Diastolic + 1/3 Pulse Pressure
CO =
MAP
TPR
Pulse Pressure = Systolic – Diastolic
MAP = TPR x CO
F=
P1  P 2
R
LUNGS:
PAO2 = (760 – 47) FO2 -
PACO2
R
Where:
FO2 = [O2]
Flow =
PACO2 = Alv. Press. Of CO2
O2consumed
AtoVO2difference
R = Resp. Exchange Ratio
Velgas Diffusion =
VentTot = VentTidal x #of Respirations
CO 2 produced
 .8 or 1
O 2consumed
Area
x Gas Diffusion Constant x Difference of Partial Press
Thickness
VentAlv = (VentTidal – VentDead) x # of Respirations
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Compliance =
Vol
Pr ess
P=
Tension
Radius
Resp Doubles: 150mmHg & 40mmHg
1.0 =
Va/Q
New PCO2 = 20
Diffusing Capacity =
New PO2 = 170
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COuptake
PACO2