StudyXing Medicine

Plantar plate failure (attenuation or tear of lesser metatarsophalangeal joint plantar plate) - MCC lesser MTP instability and forefoot pain; Plantar plate is immediately adjacent to common digital nerve, and plantar plate synovitis/effusion can compress or inflame nerve

Banti's syndrome (non-cirrhotic portal HTN) - s/s: splenomegaly, hypersplenism, liver fibrosis or cirrhosis, pancytopenia, esophagus or stomach varices, hematemesis, melena, ascites; Assoc: Chronic infect (Hep B, malaria), blood clot abnormalities, toxic exposures (arsenic)

Pulmonary tuberculosis... Classic TB s/s. CXR confirms --> thin-walled right upper-lobe cavity with surrounding nodular consolidation and bronchogenic spread, in apical distribution; Confirmation: sputum AFB smear, mycobacterial culture, Xpert MTB/RIF; airborne isolation

Hereditary angioedema: autosomal-dominant; Random, recurrent, potentially fatal swelling in GI tract, upper airway & skin; Path: low or impaired C1 inhibitor function --> dysregulated plasma kallikrein --> excess bradykinin production --> ↑ vascular permeability + swelling

Rx: Torsades de pointes --> IV magnesium 1 to 2 g. Correct potassium & magnesium. D/C offending QT-prolonging drug(s). Temporary pacing. Isoproterenol to increase heart rate and abolish postectopic pauses.

Bruising around umbilicus = Cullen's sign (periumbilical ecchymosis); An indicator of intra-peritoneal or retroperitoneal hemorrhage. Blood tracks along falciform and gastrohepatic ligaments to pool and discolor the subcutaneous tissue; MCC:

Platelet-rich plasma (PRP) = autologous blood-plasma + supraphysiologic concentration of platelets; On activation (exposure to collagen or activator CaCl or thrombin), platelets degranulate / release growth factors + cytokines - PDGF, TGF-β, VEGF, IGF-1, FGF, EGF

Likely auto recessive, pulmonary alveolar microlithiasis (bilateral, diffuse, symmetric micronodular "sandstorm" calcific opacities, mid & lower zones; DiffDx: TB, Sarcoid, Pneumoconiosis, Idiopathic pulmonary hemosiderosis, fungal (histo, coccidio, blasto), cancer metastases

Dengue = MC arboviral dz global, caused by any of 4 antigenically distinct serotypes of dengue virus (DENV-1 to DENV-4), a single-stranded RNA flavivirus, transmitted by daytime-biting Aedes aegypti and Aedes albopictus mosquitoes; Endemic across tropical and subtropical regions

C. Enalapril: ACE inhibitors (& ARBs) are contraindicated in pregnancy & can cause fetal renal injury, oligohydramnios, renal failure & renal tubular dysgenesis, along with other fetopathy (skull hypoplasia, hypotension, death), particularly with 2nd & 3rd trimester

Reed-Sternberg cell: "owl's eye" appearance, large, bi-lobed nucleus where each lobe contains a prominent, dark-staining eosinophilic nucleolus surrounded by a clear halo; Diff dx: Hodgkin Lymphoma, Cytomegalovirus (CMV), and/or Epstein-Barr Virus (EBV)

Beta-thalassemia minor (β-thalassemia trait) = asymptomatic heterozygous carrier state for β-globin gene mutation --> relative α/β-globin chain imbalance; s/s: microcytic anemia, NL-to-high RBC count, elevated HbA2, no response to iron, microcytosis, hypochromia, MCV <79 fL

Lens-shaped (biconvex) hyperdense collection on non-contrast head CT = acute epidural hematoma; Sits between inner table of skull and periosteal (outer) layer of the dura, and its biconvex shape arises because the tightly adherent dura at cranial sutures constrains the collection

Naegleria fowleri, free-living amoeba (a protozoan parasite), causes primary amebic meningoencephalitis (PAM), rapidly fatal CNS infection

Multiple Myeloma s/s: Bone/back pain, fatigue/generalized weakness, bone/osteolytic involvement, anemia, weight loss, kidney failure (Cr >2 mg/dL), hypercalcemia (Ca++ >11.5 mg/dL); "CRAB" --> Calcium elevation, Renal failure, Anemia, Bone damage

Aschoff bodies are specific for post-rheumatic carditis.

Kayser–Fleischer rings from copper deposited in Descemet's membrane of cornea; golden-brown, yellowish-green, or brownish pigmented band at the corneal periphery (limbus) = Wilson's disease

Pterion - weakest point of human skull, directly overlies middle meningeal artery; Meeting point of Frontal, Parietal, Temporal and Sphenoid bones; Highly susceptible to fracture from direct blow + arterial damage = Epidural Hematoma (lucid interval --> fatal brain herniation

Michaelis–Gutmann = concentric, laminated, basophilic inclusion bodies found inside cytoplasm of macrophages (von Hansemann cells); Diagnostic, pathognomonic hallmark of malakoplakia (rare, chronic inflammatory dz of genitourinary tract

Polymyalgia rheumatica - 2nd MC idiopathic inflammatory rheumatic dz after RA; Adult women 50+ y/o w/ bursitis, tendinitis, intense pain and stiffness of neck, shoulders, and pelvic girdle