Mnemonics of Pathology

WBC Count:

"Nobody Likes My Educational Background"

"60, 30, 6, 3, 1"

Neutrophils 60%
Lymphocytes 30%Monocytes 6%
Eosinophils 3%
Basophils 1%

Rheumatic Fever

MODIFIED JONES CRITERIA

MAJOR CRITERIA
"CASES"
C- Carditis
A- Arthritis (not Arthralgias i.e polyarthritis)
S- Syndhem's Chorea
E- Erythema Marginatum (not nodosum)
S- Subcutaneous Nodules

Minor Criteria
"PEACH-Fever"
P- Prolonged PR interval
E- ESR raised
A- Arthralgias (not arthritis)
C- C-reactive protein increased
H- History of sore throat (streptococcal)
& Fever

Diabetic ketoacidosis: I vs. II

ketONE bodies are seen in type ONE diabetes.

You might also like:

MHC I and MHC II: T cell type

'MHC x T cell=8'

• MHC II goes with CD4  (2x4=8)
• MHC I goes with CD8   (1x8=8)

Confusing similar blood cell appearance

SAIL and BERU-

S-Schistocyte also known as
A-Acanthocyte
I-Irregular spikes on surface
L-liver disease

B-Burr cells also known as
E-Echinocyte
R-Regular spikes
U-Uremia

Parkinson's disease: symptoms

PQRST:
Paucity of expression
parQinson
Rigidity (cogwheel)
Stooped posture
Tremor at rest
· If can't remember that Parkinson's tremor is the one that is "resting tremor", look at the last 3 letters: RST.

Renal failure (chronic): consequences

ABCDEFG:
Anemia
-due to less EPO
Bone alterations
-osteomalacia
-osteoporosis
-von Recklinghausen
Cardiopulmonary
-atherosclerosis
-CHF
-hypertension
-pericarditis
D vitamin loss
Electrolyte imbalance
-sodium loss/gain
-metabolic acidosis
-hyperkalemia
Feverous infections
-due to leukocyte abnormalities and dialysis hazards
GI disturbances
-haemorrhagic gastritis
-peptic ulcer disease
-intractable hiccups

Polycystic ovary: morphology, presentation

· Morphology is poly-C:
Cysts
Capsule thickened
Cortical stromal fibrosis
· Clinical presentation is OVARY:
Obese
Virilism or hirsuitism
Amenorrhoea
Reproductive disorder [infertile]
Young woman

Hypertension: secondary hypertension causes

CHAPS:
Cushing's syndrome
Hyperaldosteronism [aka Conn's syndrome]
Aorta coarctation
Phaeochromocytoma
Stenosis of renal arteries
· Note: only 5% of hypertension cases are secondary, rest are primary

Hypercalcemia: symptoms of elevated serum levels

 "Bones, Stones, Groans, Moans":
Bones: pain in bones
Stones: renal
Groans: pain
Psychic moans/ Psychological overtones: confused state

Fragile X syndrome: features

 FEMALES
FMR1 gene
Exhibits anticipation
Macro-orchidism
Autism
Long face with large jaw
Everted eyes
Second most common cause of genetic mental retardation

Deep venous thrombosis: genetic causes

ALASCA:
Antithrombin III
Leiden (Factor V)
APC (Activated Protein C)
S-protein deficiency
C-protein deficiency
Antiphospholipid antibody

Acute ischemia: signs [especially limbs]

6 P's:
Pain
Pallor
Pulselessness
Paralysis
Paraesthesia
Perishingly cold

McArdle's syndrome

MCARDLES:
Myoglobinuria
Cramping after exercise
Accumulated glycogen
Recessive inheritance
Deficiency of muscle phosphorylase
Lactate levels fail to rise
Elevated creatine kinase
Skeletal muscle only

MI: post-MI complications

ACT RAPID:
Arrhythmias (SVT, VT, VF)
Congestive cardiac failure
Tamponade/ Thromboembolic disorders
Rupture (ventricle, septum, papillary muscle)
Aneurysm (ventricle)
Pericarditis
Infarction (a second one)
Death/ Dressler's syndrome

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 & mouth (ii) palms & soles [2 separate criteria]

Sarcoidosis summarized

SARCOIDOISIS:

Schaumann calcifications
Asteroid bodies/ [ACE] increase/ Anergy
Respiratory complications/ Renal calculi/ Restrictive lung disease/ Restrictive cardiomyopathy
Calcium increase in serum and urine/ CD4 helper cells
Ocular lesions
Immune mediated noncaseating granulomas/ [Ig] increase
Diabetes insipidus/ [D vit.] increase/ Dyspnea
Osteopathy
Skin (Subcutaneous nodules, erythema nodosum)
Interstitial lung fibrosis/ IL-1
Seventh CN palsy

Lichen planus characteristics

 Planus has 4 P's:
Peripheral
Polygonal
Pruritus
Purple

CREST syndrome: components

CREST:
Calcinosis
Raynaud's phenomena
Esophageal dysmotility
Sclerodactyly
Telangectasia

Lung cancer: presentation

ABCDE:
Snowball turned to Avalanche
Blood: hemoptysis
Cough
Disruption to airway in bronchus-->pneumonia
wheezing

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

Hematuria: urethral causes

NUTS:
Neoplasm
Urethritis
Tumour
Stone

Kawasaki's disease: features

FEAR ME:
Fever
Eye: perilimbic sparing conjunctival injection
Adenopathy: usually cervical
Rash
Mouth: red lips
Extremities: red hands and feet
· Disease to be feared because of risk of coronary aneurysms.

Osteomalacia: features

"Vit-D deficiency in ADULT":
Acetabuli protrusio
Decreased bone density
Under mineralization of osteoid
Looser's zone (pseudofracture)
Triradiate pelvis (females)

Tabes Dorsalis morphology

DORSALIS:
Dorsal column degeneration
Orthopedic pain (Charcot joints)
Reflexes decreased (deep tendon)
Shooting pain
Argyll-Robertson pupils
Locomotor ataxia
Impaired proprioception
Syphilis

Melanoma vs. basal cell, squamous cell carcinoma: metastatic ability

MElanoma is more likely to
MEtastasize.
· Basal and squamous hardly ever metastasize.

Hepatomegaly: 3 common causes, 3 rarer causes

Common are 3 C's:
Cirrhosis
Carcinoma
Cardiac failure
Rarer are 3 C's:
Cholestasis
Cysts
Cellular infiltration

Ulcerative colitis: features

 ULCERATIONS:
Ulcers
Large intestine
Carcinoma [risk]
Extraintestinal manifestations
Remnants of old ulcers [pseudopolyps]
Abscesses in crypts
Toxic megacolon [risk]
Inflamed, red, granular mucosa
Originates at rectum
Neutrophil invasion
Stools bloody

Microcytic anemia: causes

 "Find Those Small Cells":
Fe deficiency
Thalassemia
Sideroblastic
Chronic disease

Gout vs. pseudogout: crystal lab findings

 Pseduogout crystals are:
Positive birefringent
Polygon shaped
· Gout therefore is the negative needle shaped crystals.
· Also, gout classically strikes great Toe, and its hallmark is Tophi.

TTP: clinical features

 Thrombosis and thrombocytopenia PARTNER together:
Platelet count low
Anemia (microangiopathic hemolytic)
Renal failure
Temperature rise
Neurological deficits
ER admission (as it is an emergency

Hepatocellular carcinoma: aetiology, features

ABC:
Aetiology:
Aflatoxins
Hep B
Cirrhosis
· Features:
AFP increased (classic marker)
Bile-producing (DDx from cholangiocarcinoma)
Commonest primary liver tumor

APKD: signs, complications, accelerators

11 B's:
· Signs:
Bloody urine
Bilateral pain [vs. stones, which are usually unilateral pain]
Blood pressure up
Bigger kidneys
Bumps palpable
· Complications:
Berry aneurysm
Biliary cysts
Bicuspid valve [prolapse and other problems]
· Accelerators:
Boys
Blacks
Blood pressure high

Paget's disease of bone: signs and symptoms

Four L's:
Larger hat size
Loss of hearing: due to compression of nerve
Leontiasis ossea (lion-like face)
Light-headed (Paget's steal)

Atherosclerosis risk factors

SHIFT MAID:
Smoking
Hypertension
(N)IDDM
Family history
Triglycerdides & fats
Male
Age
Inactivity
Diet / Drink

Von Hippel-Lindau: signs and symptoms

HIPPEL:
Hemanigoblastomas
Increased renal cancer
Pheochromocytoma
Port-wine stains
Eye dysfunction
Liver, pancreas, kidney cysts
· Bare bones version: Hippel-Lindau, with H and L as above

Pyrogenic meningitis: likeliest bug in age group

"Explaining Hot Neck Stiffness":
· In order from birth to death:
E. coli [infants]
Haemophilus influenzae [older infants, kids]
Neisseria meningitis [young adults]
Streptococcus pneumoniae [old folks]

Pulmonary embolism: risk factors

 7 H's:
Hereditary (eg factor V Leyden, protein C or S deficiency)
History (previous DVT or PE)
Hypomobility (fracture, CVA, severe illness, obesity, long trip)
Hypovolaemia (nephrotic syndrome, dehydration)
Hypercoagulability (smoking, malignancy)
Hormones (oestrogens [esp. in OCP], puerperium)
Hyperhomocysteinaemia

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 arteriosclerosis
Alkaline phosphatase increased
Retinoblastoma*
Boys, predominantly
Osteomyelitis DDx
Radiation*

Apoptosis vs. necrosis

"LIFELESS" (since cells are dead):
· Differences are in:
Leaky membranes
Inflammatory response
Fate
Extent
Laddering
Energy dependent
Swell or shrink
Stimulus

Addison's disease: features

 ADDISON:
Autoimmune
DIC (meningococcus)
Destruction by cancer, infection, vascular insufficiency
Iatrogenic
Sarcoidosis, granulomatous such as TB histiomycosis
hypOtension/ hypOnatermia
Nelson's syndrome [post adrelectomy, increased ACTH]

Baldness risk factors

 "Daddy Doesn't Deny Getting Hair Implants":
Diet
Disease
Drugs
Genes
Hormones
Injury to the scalp

Pericarditis: findings

PERICarditis:
Pulsus paradoxus
ECG changes
Rub
Increased JVP
Chest pain [worse on inspiration, better when lean forward]

Rheumatoid arthritis: features

RHEUMATOID:
Ragocytes/ Rheumatoid factor (anti-IgG)
HLA-DR4/ HLA-Dw4
ESR increase/ Extra-articular features (restrictive lung disease, subcutaneous nodules)
Ulnar deviation
Morning stiffness/ MCP joint
Ankylosis/ Atlantoaxial joint subluxation/ Autoimmune/ ANA
T-cells (CD4)/ TNF
Osteopenia
Inflammatory synovial tissue/ Idiopathic/ IL-1
Deformities (swan-neck, boutonniere)

MI: sequence of elevated enzymes after MI

"C-AST-Le" (castle):
CK-MB first
AST second
LDH third
· Also: can use the last 'E' for ESR

Anemia causes (simplified)

 ANEMIA:
Anemia of chronic disease
No folate or B12
Ethanol
Marrow failure & hemaglobinopathies
Iron deficient
Acute & chronic blood loss

Duchenne vs. Becker Muscular Dystrophy

 Duchenne Muscular Dystrophy (DMD) : Doesn't Make Dystrophin.
Becker Muscular Dystrophy (BMD): Badly Made Dystrophin (a truncated protein).

Edwards' syndrome: characteristics

 EDWARDS:
Eighteen (trisomy)
Digit overlapping flexion
Wide head
Absent intellect (mentally retarded)
Rocker-bottom feet
Diseased heart
Small lower jaw

Thyroid storm characteristics

"Storm HITS girls cAMP":
Thyroid storm due to:
Hyperthyroidism
Infection or Illness at childbirth
Trauma
Surgery
· girls: Thyroid storm more common in females.
· cAMP: Tx involves high dose of beta blockers (beta receptors work via cAMP)

MI: sequence of elevated enzymes after MI

"Time to CALL 911":
· From first to appear to last:
Troponin
CK-MB
AST
LDH1

Turner syndrome: components

 CLOWNS:
Cardiac abnormalities (specifically Coartication)
Lymphoedema
Ovaries underdeveloped (causing sterility, amenorrhea)
Webbed neck
Nipples widely spaced
Short

Calculi: types CAlCUli

Calcium
Ammonium magnesium phosphate
Cystine
Uric acid

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].

Diabetes: short list of complications

 SHAKE:
Stroke
Heart attack
Amputations
Kidney disease
Eyes (vision loss)

Thyroid carcinoma: features, prognosis of most popular

Most Popular is Papillary.
· Clinical features:
Papillae (branching)
Palpable lymph nodes
"Pupil" nuclei (Orphan Annie)
Psammoma bodies within lesion (often)
· Also, has a Positive Prognosis (10 year survival rate: 98%)

Neuroblastoma: features

N-MYC:
Nuclei have "double minutes"
Malignant
Young
Catecholamine secreting
· And hallmark is n-myc amplification

Pneumothorax: presentation

 P-THORAX:
Pleuretic pain
Trachea deviation
Hyperresonance
Onset sudden
Reduced breath sounds (& dypsnea)
Absent fremitus
X-ray shows collapse

Wiskott-Aldrich syndrome:

 symptom triad "PET WASP":
Pyrogenic infections
Eczema
Thrombocytopenia
· WASP is the name of the causitive agent: Wiskott-Aldrich Syndrome Protein.
· Alternatively: Wiskott=Hot, Aldrich=Itch, Syndrom=Throm.

Wernicke-Korsakoff triad

Syndrome in alchoholics, who love to "drink CANs of beer":
Confusion
Ataxia
Nystagmus

Heart failure causes

"HEART MAy DIE":
Hypertension
Embolism
Anemia
Rheumatic heart disease
Thyrotoxicosis (incl. pregnancy)
Myocardial infarct
Arrythmia
Y
Diet & lifestyle
Infection
Endocarditis

Whipples disease

Whipple's disease: full features

Code:whipples: Weight loss
Hyperpigmentation of skin
Infection with tropheryma whippelii
PAS positive granules in macrophage
Polyarthritis
Lymphadenopathy
Enteric involvement
Steatorrhea

Marble bone disease: signs and symptoms

 MARBLES:
Multiple fractures
Anemia
Restricted cranial nerves
Blind & deaf
Liver enlarged
Erlenmeyer flask deformity
Splenomegaly
· Eponymous name: Marbles = Albers-Schonberg (anagram).

TB: features

 TB is characterised by 4 C's:
Caseation
Calcification
Cavitation
Cicatrization

Virchow triad so easy!

VIRCHOW'S TRIAD- text 'BEST' B- Blood hypercoagubality. E-Endothelil injury. ST-Stasis/Turbulance of blood flow

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

psammoma bodies

MOCK Test
M= MENINGIOMA
O= OVARY... PAP. Ca
C= CARCINOID
K= KIDNEY...PAP. Ca
T= THYROID.... PAP.Ca 

Protein C, Protein S: function C and S are:

Clot
Stoppers
· These proteins inhibit coagulation

Pick's disease: features

 PICK:
Progressive degeneration of neurons
Intracytoplasmic Pick bodies
Cortical atrophy
Knife edge gyri

Pancytopenia causes

ABCD PSM
A=Aplastic anaemia
B=Bone marrow failure
C=Cytotoxic agents
D=DIC

P=PNH
S=SLE
M=Megaloblastic anaemia

Dandy-Walker syndrome: components

 "Dandy Walker Syndrome":
Dilated 4th ventricle
Water on the brain
Small vermis

Neutrophils - primary granules

Can Mom's Dyin Love Commitment N Affection Be Ever Picturized?

Cathepsin G
Myeloperoxidase
Defensins
Lysozymes
Cationic protein
Non specific collagenases
Acid hydrolases
BPI
Elastases
Phospholipase A2

COPD: 4 types and hallmark

 ABCDE:
Asthma
Brochiectasis
Chronic bronchitis
Dyspnea [hallmark of group]
Emphysema
· Alternatively: replace Dyspnea with Decreased FEV1/FVC ratio.

mycosis fungoides

MUFTI.
MYCOSIS FUNGOIDES T CELL LEUKEMIA

Kwashiorkor: distinguishing from Marasmus

 FLAME:
Fatty Liver
Anemia
Malabsorption
Edema

Multiple myeloma

"CRAB"
C=calcium elevated
R=renal failure
A=anemia
B=bone lesions

COPD: blue bloater vs. pink puffer diseases

emPhysema has letter P (and not B) so Pink Puffer.
chronic Bronchitis has letter B (and not P) so Blue Bloater.

Bronchial obstruction: consequences

APPLE BABE:
Atelectasis
Pleural adhesions
Pleuritis
Lipid pneumonia
Effusion->organisation->fibrosis
Bronchiectasis
Abscess
Broncho and lobar pneumonia
Emphysema

Kawasaki Disease Criteria

"Be careful when riding a Kawasaki motorcycle, you might get CREAMed.
Conjunctivitis (non-exudative)
Rash (polymorphous non-vesicular)
Edema (or erythema of hands or feet)
Adenopathy (cervical, often unilateral)
Mucosal involvement (erythema or fissures or crusting)
To have Kawasaki disease you must have fever for greater than 5 days plus 4 of the above.

Jone's Criteria - Made so damn EASY !!

Modified Jone's Criteria for Rheumatic Fever.

For major criteria remember the word ...
CASES ....

C = Carditis (Pan)
A = Arthritis (Poly Migratory)
S = Sydenham's Chorea
E = Erythema marginatum
S = Subcutaneous Nodules

Note: dont confuse Erythema marignatum for Erythema multiformis !!

For minor criteria rem the words ....
PEACH Fever ...

P = Prolonged PR interval on EKG
E = Elevated ESR
A = Arthralgias
C = C-Reactive Protein raised
H = History of preceding sore throat
and
Fever

Note: dont confuse arthralgias for arthritis !!

and finally the diagnostic criteria is:
Two Major Criteria or
One Major and 2 Minor Criteria

Ovarian cancers: important types, by WHO classification ·

Surface:
"My Sister Began Experiencing Cancer":
Mucinous
Serous
Brenner
Endometrioid
Clear
· Germ cell:
"Doctor Examined The Ovaries":
Dysgerminoma
Endometrial sinus
Teratoma
Ovarian choriocarcinoma
· Sex cord:
"She Felt Grim":
Sertoli-Leydig
Fibroma
Granulosa-theca
· Metastatic
"Killed":
Krukenberg

Hairy cell lukemia

B-Baal(Hindi word for hairs..)so hairy cell leukemia is B cell in origin ,Not T cell..

Multiple endocrine neoplasia III: components

 MEN III is a disease of 3 M's:
Medullary thyroid carcinoma
Medulla of adrenal (pheochromocytoma)
Mucosal neuroma

Macrocytic anaemia: differential

FAT RBC:
Fetus (pregnancy)
Alcohol
Thyroid disease(ie hypothyroidism)
Reticulocytosis
B12 and folate deficiency
Cirrhosis and chronic liver disease

DOWN'S SYNDROME PREDISPOSES TO:

All Children Have Diarrhoea:
decode as

A:ALL,ALZHEIMER'S DISEASE
C:CML(JUVENILE)
H:HIRSHSPRUNGS DISEASE
D:DUODENAL ATRESIA

Anemia (normocytic): causes

 ABCD:
Acute blood loss
Bone marrow failure
Chronic disease
Destruction (hemolysis

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

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.

Emphysema: types, most important feature of each

 "Cigarette Is Primary Problem":
· Types:
Centrilobular
Irregular
Pancinar
Paraseptal
· Most important feature for each type (in order as above):
Cigarrettes
Inflammation healed to scar
Protease inhibitor deficiency (a1-antitrypsin)
Pneumothorax
· "Cigarette is primary problem" used since cigarettes are the most common cause of emphysema.

Deep venous thrombosis: diagnosis

DVT:
Dilated superficial veins/ Discoloration/ Doppler ultrasound
Venography is gold standard
Tenderness of Thigh and calf

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.

Coagulation tests

Coagulation tests

"PiTT" (PTT - I for Intrinsic pathway) - PiTTsburgh
"PeT" (PT - E for Extrinsic pathway)

Appearance of rash in relation to fever

Certain Silly People Make Typhus Double Typhoid

C-chickenpox-1st day
S-scarlet fever-2nd day
P-pox(smallpox)-3rd day
M-measles-4th day
Typhus-5th day
D-dengue-6th day
Typhoid-7th day

Necrosis: the 4 types

 "Life Can Get Complicated":
Liquifactive
Coagulation
Gangrene
Caseous
· 'Life' used since necrosis is 'death'.

Gout: factors that can precipitate an attack of acute gouty arthritis

DARK:
Diuretics
Alcohol
Renal disease
Kicked (trauma)
· And, the attack occurs most often at night [thus "dark"].

MEN I (Multiple Endocrine Neoplasia) syndrome: components

 "Please Please Pay Attention To peptic ulceration, you worms":
· Adenomas of:
Pituatary
Pancreatic islets
Parathyroid
Adrenal cortex
Thyroid, associated with peptic ulceration
· Syndrome is called "Wermer's syndrome".

Cardiovascular risk factors

FLASH BODIES:
Family history
Lipids
Age
Sex
Homocystinaemia
Blood pressure
Obesity
Diabetes mellitus
Inflammation (raised CRP)/ Increased thrombosis
Exercise
Smoking

Adhesion molecule

Adhesion molecules involved in local invasion by cancer cells.

FEVICOLL

Fibronectin
Vimentin
Collagen
Laminin

Gallstones/cholecystitis: risk factors

 5 F's:
Fat
Female
Family history
Fertile
Forty

Blood disorders: commoner sex

 HE (male) gets:
HEmophilia (X-linked)
HEinz bodies (G6PD deficiency, causing HEmolytic anemia: X-linked)
HEmochromatosis (male predominance)
HEart attacks (male predominance)
HEnoch-Schonlein purpura (male predominance)
SHE (female) gets:
SHEehan's syndrome

Wiskott-Aldrich syndrome: symptom triad

WASTER:
Wiskott Aldrich Syndrome is:
Thrombocytopenia
Eczema
Recurrent staphlococcal infections

Most common causes of bleeding from any visceral organ

 3 T's

• Tuberculosis 
• Trauma 
• Tumour

Endometrial carcinoma: risk factors

 HONDA:
Hypertension
Obesity
Nulliparity
Diabetes
Age (increased)

SLE: Signs and symptoms, diagnostic criteria

According to the guidelines of American College of Rheumatology a person can be diagnosed to have SLE if any 4 out of the11 symptoms are present simultaneously or serially on two seperate occasions.
' SOAP BRAIN MD'

• Serositis  (pleuritis, pericarditis)
• Oral ulcers
• Arthritis  (2 or more peripheral joints)
• Photosensitivity
• Blood changes  (anemia, leukopenia, thrombocytopenia-ie., a fall in all parameters )
• Renal involvement (persistent proteinuria>0.5g/day or cellular casts-due to immune complex deposition in kidney)
• ANA +   (detected by immunofluorescence)
• Immunologic changes (Antibodies against double-stranded DNA,Sm antigen)
• Neurologic  (seizures,psychosis)
• Malar rash
• Discoid rash.

Multiple sclerosis (MS): pathology MS

attacks the Myelin Sheath, resulting in plaques.

Eosinophil mediators

"CML EEE"
Eosinophil mediators are

• Cytokines,Chemokines and growth factors
• Major basic protein
• Lipid mediators  -prostraglandins,leukotrienes,thromboxane 
• Eosinophil derived neurotoxin
• Eosinophil cationic protein
• Eosinophil peroxidase

Portal hypertension: features

ABCDE:
Ascites
Bleeding (haematemesis, piles)
Caput medusae
Diminished liver
Enlarged spleen

Alpha feto protein in blood, is seen in

 "TOLD"

• Testicular tumours
• Obituary - foetal death
• Liver - hepatomas
• Defects - neural tube defects

Cerebral palsy: general features

 PALSY:
Paresis
Ataxia
Lagging motor development
Spasticity
Young

Microcytic anemia: Causes

 ' TAILS '

• Thalassemia
• Anemia of chronic disesse
• Iron deficiency anemia
• Lead poisoning
• Sideroblastic anemia

Achalasia: 1 possible cause, 1 treatment

aCHAlasia:
1 possible cause: CHAgas' disease
1 treatment: Ca++ CHAnnel blockers

MI: complications

"LEAP on the MAP":
LVF
Embolism (systemic)
Aneurysm (ventricular)
Progressive infarction
Myocardial rupture
Arrhythmia
Pericarditis

Hemophilia features

 5 H's can be seen in Hemophilia

• Haemarthrosis (Hemartrosis)
• Hematomas
• Hematochezia
• Hematuria
• Head hemorrhage

Hematochezia is the passage of bright red, bloody stools. It is different from melena which is stool that appears black and tarry

Hirsutism vs. virilism

 Hirsutism: Hair on body like a male.
Virilism: Voice and rest of secondary sexual characteristics like a male.

Causes of eosinophilia

"CHINA"

• Connective tissue disorders
• Helminthic worm infections
• Idiopathic HES  (Hypereosinophilic syndrome)
• Neoplasias (CML,AML,myeloproliferative diseases,myelodysplastic syndromes)
• Allergies

In some neoplastic disorders (CML,AML,myeloproliferative diseases,myelodysplastic syndromes) the hypereosinophilia is part of neoplastic clonal expansion affecting the myeloid lineage.

Goitre: differential

GOITRE:
Goitrogens
Onset of puberty
Iodine deficiency
Thyrotoxicosis/ Tumor/ Thyroiditis [Hashimoto's]
Reproduction [pregnancy]
Enzyme deficiencies

Kaposi's sarcoma: types

" CARE  for kaposi"
Classical
African /  Endemic Kaposi's sarcoma
Renal transplant associated /  Immunosuppressive treatment-related Kaposi's sarcoma
Epidemic /  AIDS associated Kaposi's sarcoma

Buerger's disease features

"burger SCRAPS":
Segmenting thrombosing vasculitis
Claudication (intermittent)
Raynaud's phenomenon
Associated with smoking
Pain, even at rest
Superficial nodular phlebitis

Mallory bodies: Conditions in which they can be seen

"Alcoholic Bill Calls Tumor  Wilson"

• Alcoholic hepatitis
• Primary biliary cirrhosis
• Cholestatic syndromes
• Tumor- hepatocellular carcinoma
• Wilson's disease

Named after the American pathologist Frank Burr Mallory and also known as alcoholic hyaline, mallory body is an eosinophilic intracytoplasmic inclusion body found in the liver parenchyma in a variety of liver diseases. It consists of a perinuclear aggregate of filamentous material that mostly consists of intermediate cytokeratin filaments.Mallory bodies primarily contain keratin-8 (KRT8) and keratin-18 (KRT18).

Osteomyelitis: complications

FIBRES:
Fractures
Intraosseous (broidie) abscesses
Bacteremi/ Brodie abscess
Reactive amyloidosis
Endocarditis
Sinus tracts/ Squamous cell CA

Pick's disease: features

"PICK"

• Progressive degeneration of neurons
• Intracytoplasmic pick bodies
• Cortical atrophy
• Knife edge gyri

Pancreatitis: causes

 PANCREATITIS:
Posterior
Alcohol
Neoplasm
Cholelithiasis
Rx (lasix, AZT)
ERCP
Abdominal surgery
Trauma
Infection (mumps)
Triglycerides elevated
Idiopathic
Scorpion bite

Carcinomas having tendency to metastasize to bones

"Particular Tumours Love Killing Bone"

• Prostate
• Thyroid
• Lung
• Kidney
• Breast

Pheochromocytoma: 3 most common symptoms

 "PHEochromocytoma":
Palpitations
Headache
Edisodic sweating (diaphoresis)

Tabes dorsalis

"DORSALIS"

• Dorsal column degeneration
• Orthopaedic pain (charcot's joints)
• Reflexes (deep tendon) are decreased
• Shooting pain
• Argyll-Robertson pupil
• Locomotor ataxia
• Impaired proprioception
• Syphilis

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

Oral cancer: Risk factors

"PATHOLOGY LAB"

• Plummer-vinson syndrome
• Alcohol
• Tobacco
• Human papilloma virus (HPV)
• Leukoplakia
• Asbestos
• Bad oral hygiene

Alzheimer's disease: Features

"RONALD"
In memory of Ronald Reagen (former US president) who was a victim of AD.

• Reduction of acetylcholine
• Old age
• Navigational difficulty, Neurofibrillary tangles (NFTs)
• Atrophy of cerebral cortex(diffuse)
• Language impairment
• Dementia, Delusions

The cognitive changes in AD follows a characteristic pattern, beginning with memory impairment and progressing to language (naming, comprehension and finally fluency) and visuospatial deficits.

The most severe pathology is usually found in the hippocampus, temporal cortex and nucleus basalis of Meynert (lateral septum).

Microscopically, the most important finding is "senile" plaques and NFTs (neurofibrillary tangles) found in excess than in a normal aging brain.

Alzheimer's disease (AD): associations, findings AD

:
· Associations:
Aluminum toxicity
Acetylcholine deficiencies
Amyloid B
Apolipoprotein gene E
Altered nucleus basalis of Meynert
Down's
· Findings:
Actin inclusions (Hirano bodies)
Atrophy of brain
Amyloid plaques
Aphasia, Apraxia, Agitation
DNA-coiled tangles
Dementia, Disoriented, Depressed

Cancers associated with DIC

"APPPLeS"
The cancers associated with DIC (Disseminated Intravascular Coagulation) are,

• Acute Promyelocytic leukaemia
• Prostate cancer
• Pancreatic cancer
• Lung cancer
• Stomach cancer

• Duchenne muscular dystophy: Doesnt make dystrophin
• Becker muscular dystophy: Badly made dystrophin

Dystrophin is a truncated protein which provides a structural link between the muscle cytoskeleton and extracellular matrix to maintain muscle integrity. Mutations in the dystrophin gene cause the Duchenne and Becker muscular dystrophies.

Phaeochromocytoma: diagnositc rule ·

Rule of 10's:
10% ectopic
10% multiple
10% malignant

Pheochromocytoma: common symptoms

5 P's:
Paroxysmal rise in BP
Palpitations
Perspiration
Pain in abdomen
PMV in urine

Autosomal Dominant Conditions'

'DOMINANT'
...
-D= Dystrophicas Myotonic.
-O= Osteogenesis Imperfecta.
-M= Marfans syndrome.
-I= Intermittent Porphyria.
-N= Noonans Symdrome.
-A= Adult Polycystic Kidney,Achondroplasia.
-N= Neurofibromatosis.
-T= Tuberous sclerosis

Features of nephritic syndrome

HERO CUP

H-hypertension
E-edema
R-RBC in urine
O-oliguria
C-cast rbc in urine
U-uremia
P-protienuria

Points of difference betn. Apoptosis & Necrosis-->

LIFELESS
Lysis of membranes & nucleus(in necrosis)
...Inflammatory response (in necrosis)
Fate(irreversible cell injury in necrosis)
Extent
Lysosome n other organelles(intact in apoptosis)
Energy dependence(ATP depletion in necrosis)
Swelling /Shrinkage of cells(shrinkage in apoptosis)
Stimulus

Steps of Apoptosis-

< Supreme Court Banned Awfully-Bad Pictures >

1.'S'hrinkage of cell
2.'C'hromatin condensation
3. cytoplasmic 'B'lebbing
4.'A'poptotic 'B'odies formation
5.'P'hagocytosis

Turner syndrome clinical features
Boys And Gls Hv S.N.H.L. in CLS(class)
All capital letters hv meaning

Bicuspid valve
Amenorrhoea
Gonadoblastoma
Height(less thn 150 cm)
Streak gonad
Nuchal translucency
Horse shoe kidney
Lymphodema of hand
Cubitus vulgus and coarctatn of aorta
Low hair line
Short 4th metacarpal

and S.N.H.L. Itself

Signs and symptoms of MI
PULSE
P-persistent chest pains
U-upset stomach
L-lightheadedness
S-shortness of breath
E-excessive sweating

Causes of pericarditis
can be remebered as its ECG shows
PR DIP( PR depression) ST UP (ST segment elevation)

P -POST PERICARDIOMYOTOMY
R-RHEUMATIC FEVER
D-DRUGS (PHENYTOIN,HYDRALAZINE,PROCAINAMIDE)
I-INFECTION(T.B,VIRAL,PYOGENIC)
P-PULMONARY EMBOLUS
S-SLE
T-THYROID DS (HYPOTHYROIDISM),TUMOUR,TRAUMA
U-UREMIA
P-POST MI

Hyperthyroidism : signs and symptoms
THYROIDISM

Tremor
Heart rate up
Yawning (fatiguability)
Restlessness
Oligomenorrhea/ amenorrhea
Intolerance to heat
Diarrhoea
Irritability
Sweating
Muscle wasting & weight loss

Splenomegaly: causes

CHINA:

Congestion/ Cellular infiltration

Haematological (eg haemolytic
anaemia, Sickle cell)

Infection/ Infarction (eg malaria, GF,
CMV)

Neoplasia (eg CML, lymphoma, other myeloproliferative)

Autoimmune

Papillary Thyroid tumor

5Ps

Popular
Palpable Lymph nodes
Positive I (131) uptake
Positive Prognosis
Post radiation in head and neck(cause)
for others click the link

Complicatn of rheumatic fevr is,

RHEUMATIC ie.

R-rheumatic arteritis,

H-heart failure,

E- embolism,

U- sUdden death,

 M-Mitral stenosis

A-Atrial stenosis,

T-bacterial endocardiTis

C-Conduction disorder

I -nothing

Complications of nephrotic syndrome

 IVC:

Infection,

Venous thrombosis,

Cholesterol high

Renal failure: causes

AVID GUT:

Acute tubular necrosis
Vascular obstruction
Infection
Diffuse intravascular coagulation
Glomerular disease
Urinary obstruction
Tubulointerstitial nephritis

Crohn's disease: morphology, symptoms

CHRISTMAS:

Cobblestones
High temperature
Reduced lumen
Intestinal fistulae
Skip lesions
Transmural (all layers, may ulcerate)
Malabsorption
Abdominal pain
Submucosal fibrosis

Microcytic anemia: causes

"Find Those Small Cells":

Fe deficiency
Thalassemia
Sideroblastic
Chronic disease