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Tony Shared "Tony's picmonics" - 165 Picmonics

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Tony's picmonics

7 months of development
Parachute reflex begins
rolls from back to front (completion from the 6 mos front to back)
Commando crawling
Polysyllabic vowels
rake grasp may start here
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Tangier Syndrome
Orange-yellow colored TONSIL HYPERPLASIA
rare CO-dominant disease
If Homozygous, No HDL, if hetero- LOW HDL
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Wallenburg syndrome clinical (lateral medullary Syndrome)
Muscle movement Spaired (minus bulbar muscles)
Vertigo, Ipsilateral falling
Ipsilateral Facial sensory Pain and temp loss [read caveat]
Don't PICA HOARSE who can't EAT
bulbar motor weakness
Dysphagia + hoarse voice
PICA ischemia
Rest of the body
Contralateral loss of Pain and temp on trunk and extremities
Ipsilateral Horner Syndrome
Nystagmus (vertical and horizontal)
Intractable hiccups
Lack of automatic respiration (esp during sleep)
In test world- "VERTEBRAL artery" is often the answer
PICA vasculature insult
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Polyarticular Idiopathic Juvenile Arthritis
SYmmetrical upper and lower Arthritis
almost same presentation is Systemic Idiopathic Juvenile Arthritis, except this is without the Rash and fevers (possibly low grade- but not classic)
>/= 5 joints (usually symmetrical)
Symmetric Arthritis for at least 6 weeks
+/- (maybe) Thrombocytosis (up to millions)
most common Morbidity of any type of JRA is "anterior uveitis" aka "iridocyclitis"
excellent prognosis if positive ANA
usually post viral, post mycoplasma, or even post borrelia
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AFLP - Acute Fatty Liver disease of Pregnancy
Nausea and Vomiting
Abdominal Pain
many things overlap with HELLP syndrome
significant Elevation of AST and ALT
more likely in 3rd trimester
Extrahepatic comlications such as those below are MORE likely in AFLP than in HELLP
Acute Kidney injury
HELLP is more likely to have severe HTN, not AFLP.... but I have seen AFLP Q's where BP is 160/105
PT and PTT increase
DIC is common---- so low platelets and even schistocytes
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Mirizzi Syndrome
Cystic Duct stone
blocks Common Hepatic duct
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Saxitoxin shellfish
which ingest PARTICULAR dinoflagellates
Cranial Nerve Dysfunction
Muscle Weakness
Respiratory Distress (due to muscle weakness)
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Ciguaterra poisoning
American fish cuisine
Jack fish
CLassic- Hot feel like cold, cold feels like hot
Less Common, but happen
Red Maculopapular Rash and Pruritis
Autonomic Dysfunction
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Tetrodotoxin - puffer fish
expressed by the Puffer fish
Asian delicacy (look for asian in vignette)
Perioral numbness
Respiratory distress 2/2 Muscle weakness
Neurological dysfunction
GI symptoms
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Scromboid poisoning canned fish
HIstamine related - "anaphylaxis/hives"
trouble breathing
Histamine producing bacterial overgrowth
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BOOP - Bronchiogenic Obliterans Organizing Pneumonia (aka COP?)
interstitial disease
Bronchial Thickening
Patchy Bilateral Alveolar infiltrates
doesnt respond to antibiotics
unknown etiology
Sputum Culture negative
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Assessing for GI bleeding Site- FLip book- only works in "play mode"
Average man
2x average man
0.5 man
GI assessment based on bleeding rate
> 2 Ml/min - angiography
< 0.5 mL Wait for bleeding to stop, Colonoscopy after
colonoscopy bonus (< 0.5)
0.5-2 ml/min - Tagged RBC
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3 mins
Fetal Hydantoin Syndrome
Pregnant women on phenytoin
Broad Nasal Bridge
low hairline
Cleft lip/cleft palate
Low set ears
Hypoplasia of distal Phalanges
Small or Absent NAILS
Face picture
Wide Fontanelle
Epicantal folds
Short neck
Congenital Heart Defects
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Guttate Psoriasis
Post Streptococcal (beta hemolytic) infection (classically strep throat)
Rheumatoid Arthritis association (especially if on infliximab)
possibly any URTI
Widely Scattered
Photo of Actual lesion
thorax and proximal extremities-............................but CAN be anywhere
Rash (usually) appear app 2 weeks after illness associated illness
Topical steroids
VIt D related "stuff"
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Dequervain's Tenosynovitis
Positive Finklstein Test
usually occurs in women
pain on radial side of wrist
From overuse
hard bony surface palpated on radial wrist
Classic vignette- new mom "holding a baby a lot"
Classicaly affects: Abductor or Extensor tendons of thumb
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ENlargment of SUBMANDIBULAR Glands
DUe to alcoholic liver disease or NAFLD
or malnutrition
non inflammatory
ABnormal Autonomic innervation to glands
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Behcet syndrome
Recurrent oral mucosa ulcers
recurrent genital ulcers
Anterior Uveitis
Erythema nodosum
Thrombosis- cause of morbidity
Dx: Pathergy (needle stick sore exaggeration)
Turkish, MIddle eastern or Asian descent
rare associations
Aortic aneurysm
General Treatments (not necessarily organ specific)
associated vasculitis
steroids for flares
colchicine for maintenance
Apremilast (if colchicine fails)
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Pilonidal disease
Painful fluctuant mass, cephalad tothe anus- in intergluteal region
Fat (Obese)
Young male 15-30
Deep gluteal clefts
leaks Mucoid, bloody, purulent fluids
bending over hurts
infected hair follicle becomes occluded
abcess formation
can develop sinus tracts
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Hypersensitivity pneumonitis
inflamed alveoli
"Bird fancier's lung"repeated inhalation of bird droppings
Farmer's lung-- inhaling mold
Pulmonary Fibrosis with chronic exposure
if acute- fever, cough, malaise
XRAY- "haziness", ground glass-- LOWER lung fields
Treatment: Avoid antigen
avoid antigen
steroids do prevent disease progression
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Focal NOdular Hyperplasia
Central stellate scar
bile ducts scattered throughout
ultrasound: spoke wheel vessels
not altered by hormones or OCP
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