Secondary granules of neutrophils: Contents
“Second L.A.P”
Lactoferrin
Lysozyme
Alkaline phosphatase
Plasminogen activator
Phospholipase A2
Nephritic syndrome: glomerular diseases commonly presenting as
nephritic syndrome PARIS:
Post-streptococcal
Alport’s
RPGN
IgA nephropathy
SLE
· Alternatively: PIG ARMS to include Goodpasture’s [one cause of
RPGN], Membranoproliferative [only sometimes included in the classic
nephritic list].
Type 3 hypersensitivity reaction: Examples
“SHARPan”
Read as ‘Sharpen’
Serum sickness, SLE, post Streptococcal GN
Hypersensitivity pneumonitis
Arthus reaction
Reactive arthritis
PAN
Systemic vasculitis causing granulomas
“Great Wall of China Trade”
Giant cell arteritis
Wegener’s granulomatosis
Churg-Strauss syndrome
Takayasu’s disease
Wernickes encephalopathy: components WACO:
· Wernickes is:
Ataxia
Confusion (or clouded consciousness)
Ocular problems
· Note: Waco is the town in Texas, USA made famous for a standoff with a David
Koresh and the Branch Davidians.
Adult Respiratory Distress Syndrome (ARDS): causes ARDS:
Aspiration/ Acute pancreatitis/ Air embolism/ Amniotic
embolism
Radiation
DIC/ Drugs/ Drowning/ Dialysis/ Diffuse lung
infection
Shock/ Sepsis/ Smoke inhalation
Wiskott-Aldrich syndrome: symptom triad WASTER:
Wiskott Aldrich Syndrome is:
Thrombocytopenia
Eczema
Recurrent staphlococcal infections
Cardiovascular risk factors (Framingham) FRAMINGHAM:
Family history
Running (exercise)
Adiposity (obesity)
Marlboros (tobacco)
Insulin resistance (diabetes)
Non-regulated lipids (dyslipidaemia)
Georgie Pie (high fat diet)
Hypertension
Age
Male
Macrocytosis: Non-B12/folate causes ALPHA NERD:
Alcohol
Liver disease
Pregnancy
Hemaolysis (especially chronic)
Agglutination
Neoplasia (including myelodysplasia)
Endocrine (hypothyroidism)
Reticulocytes
Drugs (especially myelosuppressives like chemotherapy, anti-HIV meds)
Osteomyelitis: complications FIBRES:
Fractures
Intraosseous (broidie) abscesses
Bacteremi/ Brodie abscess
Reactive amyloidosis
Endocarditis
Sinus tracts/ Squamous cell CA
Polycystic ovarian disease: clinical features OHIO:
Oligomenorrhea
Hirsutism
Infertility
Obesity
Microcytic anemia: causes “Find Those Small
Cells”:
Fe deficiency
Thalassemia
Sideroblastic
Chronic disease
Hirsutism vs. virilism Hirsutism: Hair on body
like a male.
Virilism: Voice and rest of secondary sexual characteristics like
a male.
Megaloblastic anemia: vitamin B12 deficiency vs. folate deficiency
Vitamin B12 deficiency also affects Brain (optic neuropathy,
subacute combined degeneration, paresthesia).
· Folate deficiency is not associated with neurological symptoms.
Symptoms of TTP/HUS “Nasty Fever Ruined
My Tubes”:
Neurological symptoms
Fever
Renal failure
Microangiopathic hemolytic anemia
Thrombocytopenia
Hemophilia: type A factor Hemophilia A: problems with
VIII factor (number V as an inverted A).
Thyroid carcinoma: frequency “Please Feel My
A$$”:
In order of most frequent to least frequent, and in order from least aggressive
to most aggressive:
Papillary carcinoma
Follicular carcinoma
Medullary thyroid carcinoma
Anaplastic carcinoma
Pneumothorax: presentation P-THORAX:
Pleuretic pain
Trachea deviation
Hyperresonance
Onset sudden
Reduced breath sounds (& dypsnea)
Absent fremitus
X-ray shows collapse
Disseminated Intravascular Cogulation: causes DIC:
Delivery TEAR (obstetric complications)
Infections (gram negative)/ Immunological
Cancer (prostate, pancreas, lung, stomach)
· Obstretrical complications are TEAR:
Toxemia of pregnancy
Emboli (amniotic)
Abrutio placentae
Retain fetus products
Leukemias: acute vs. chronic rules of thumb ABCDE:
Acute is:
Blasts predominate
Children
Drastic course
Elderly
Few WBC’s (so Fevers)
· Chronic is all the opposites:
Mature cells predominate
Middle aged
Less debilitating course
Elevated WBC’s, so not a history of fevers and infections
Pancreatitis: causes PANCREATITIS:
Posterior
Alcohol
Neoplasm
Cholelithiasis
Rx (lasix, AZT)
ERCP
Abdominal surgery
Trauma
Infection (mumps)
Triglycerides elevated
Idiopathic
Scorpion bite
Thrombotic thrombocytopenic purpura: signs FAT RN:
Fever
Anemia
Thrombocytopenia
Renal problems
Neurologic dysfunction
Scrotum masses SHOVE IT:
Spermatocele
Hydrocele/ Haematocele
Orchitis
Varicocele
Epidymal cyst
Indirect inguinal hernia
Torsion/ Tumor
Kawasaki disease: diagnostic criteria CHILD:
5 letters=5 days, >5 years old, 5 out 6 criteria for
diagnosis:
Conjuctivitis (bilateral)
Hyperthermia (fever) >5 days
Idiopathic polymorphic rash
Lymphoadenopathy (cervical)
Dryness & redness of (i)lips & month (ii)palms & soles [2 separate
criteria]
Pancoast tumor: relationship with Horner’s syndrome “Horner
has a MAP of the Coast“:
A panCoast tumor is a cancer of the lung apex that compresses the
cervical sympathetic plexus, causing Horner‘s syndrome, which is MAP:
Miosis
Anhidrosis
Ptosis
Pericarditis: findings PERICarditis:
Pulsus paradoxus
ECG changes
Rub
Increased JVP
Chest pain [worse on inspiration, better when lean forward]
Cardiovascular risk factors FLASH BODIES:
Family history
Lipids
Age
Sex
Homocystinaemia
Blood pressure
Obesity
Diabetes mellitus
Inflammation (raised CRP)/ Increased thrombosis
Exercise
Smoking
Hypokalaemia: clinical features TIMID CHIMP:
Tetany
Increases paralytic ileus (aggravates)
Muscle weakness
Increases possibility of hepatic encephalopathy
Digoxin toxicity
Cardiac arrythmias
Hypotonia
Increases P-R interval, T wave and prominent U wave
Muscle cramps
Polyuria
Diabetes: short list of complications SHAKE:
Stroke
Heart attack
Amputations
Kidney disease
Eyes (vision loss)
Osteosarcoma: features PEARL HARBOR:
Paget’s disease (10-20%)*
Early age (10-20 yrs)
Around knee
Raised periosteum by expanding tumor: “sunburst pattern”
Lace-like architecture
Hyaline arteoriosclerosis
Alkaline phosphatase increased
Retinoblastoma*
Boys, predominantly
Osteomyelitis DDx
Radiation*
· Sunburst pattern was Japanese Navy emblem during WWII.
*: Predisposing factors.
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