Word Associations

Word associations are not all 100% accurate, but they are useful in emergencies, a Friction rub: pericarditis

■ Kussmaul breathing: deep, rapid breathing seen in metabolic acidosis (think of diabetic ketoacidosis)

■ Kay ser-Fleischer ring: Wilson's disease « Bitot's spots: vitamin A deficiency a Dendritic corneal ulcers: herpes keratitis (seen best with fluorescein; avoid steroids)

■ Amaurosis fugax: temporary, painless, monocular blindness seen in transient ischemic attack (watch out for temporal arteritis; if it is suspected, start steroids before biopsy confirmation to prevent blindness)

h Cherry-red spot on the macula: Tay-Sachs disease (no bepatosplenomegaly) or Niemann-Pick disease (hepatosplenomegafy)

■ Bronze (skin) diabetes: hemochromatosis (look also for cardiac and liver dysfunction)

■ Malar rash: lupus erythematosus

■ Heliotrope rash: dermatomyositis h Clue cells: Gardnerelk sp. infection 0 Meconium ileus: cystic fibrosis

■ Rectal prolapse: cystic fibrosis

■ Salty-tasting baby: cystic fibrosis si Café-au-lait spots: neurofibromatosis (if mental retardation is present, think of McCune-

Albright syndrome or tuberous sclerosis) h Worst headache of patient's life: subarachnoid hemorrhage

■ Abdominal striae: Cushing's syndrome (or possible pregnancy)

■ Honey: infant botulism ss Left lower quadrant tenderness/rebound : diverticulitis a Children who torture animals: conduct disorder (may be antisocial as adults) a Currant jelly stools in children: intussusception

■ Ambiguous genitalia and hypotension: 21 -hydroxylase deficiency " Cat-like cry in children: cri-du-chat syndrome h > f 0 lb. baby: maternal diabetes

® Anaphylaxis from immunoglobulin therapy: IgA deficiency

■ Postpartum fever unresponsive to broad-spectrum antibiotics: septic pelvic thrombophlebitis (give heparin for an easy cure and retrospective diagnosis)

«■ Increased A2 hemoglobin and anemia: thalassemia

■ Heavy young woman with papilledema and negative radiology: pseudotumor cerebri « Low-grade fever in first 14 hours after surgery: atelectasis a Vietnam veteran: posttraumatic stress disorder a Bilateral hilar adenopathy in a black patient: sarcoidosis

■ Sudden death in a young athlete: hypertrophic obstructive cardiomyopathy

■ Fractures or bruises in different stages of healing (children): child abuse

■ Decreased breath sounds in a trauma patient: pneumothorax si Shopping sprees: mania s Constant clearing of throat (children) :Tourette's syndrome

■ Intermittent bursts of swearing: Tourette s syndrome

■ Koilocytosis: human papillomavirus or cytomegalovirus

• Rash after ampicilhn or amoxicillin for a sore throat: Epstein-Barr virus infection m Daytime sleepiness and occasional falling down (cataplexy): narcolepsy

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