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Here are complete, crisp answers from Harrison's Principles of Internal Medicine 22nd Edition (2025):

SECTION A - MCQs (Answers with Rationale)

Q	Answer	Key Rationale (Harrison's)
1	(c) Mycoplasma pneumoniae	Most common cause of atypical (walking) pneumonia; extrapulmonary features include cold agglutinin-mediated hemolytic anemia, Stevens-Johnson syndrome, and neurologic manifestations
2	(a) Decreased FEV1/FVC ratio with bronchodilator reversibility	Asthma = obstructive pattern; FEV1/FVC <0.70, with ≥12% reversibility after bronchodilator
3	(d) Lichen Planus	Classic "5 P's": Purple, Polygonal, Planar, Pruritic, Papules on flexor wrists; Wickham's striae seen
4	(b) Erythema Chronicum Migrans	Pathognomonic of Lyme disease (Borrelia burgdorferi); expanding bull's-eye rash at tick bite site
5	(d) Pityriasis Rosea	Herald patch precedes "Christmas tree" distribution of lesions along Langer's lines on the trunk
6	(c) Auditory Hallucinations	Positive symptoms = added phenomena (hallucinations, delusions, disorganized speech). Social withdrawal, anhedonia, alogia = negative symptoms
7	(b) Lithium	Drug of choice for acute mania and long-term maintenance; also has anti-suicidal properties
8	(a) IgE	Type I hypersensitivity (anaphylactic/allergic) is mediated by IgE bound to mast cells and basophils
9	(b) Inhibition of acetylcholinesterase	Organophosphates irreversibly inhibit AChE → ACh accumulation → muscarinic effects including miosis
10	(d) Naloxone	Competitive opioid receptor antagonist; dose 0.4-2 mg IV; reverses respiratory depression, miosis, and coma
11	(b) Bamboo Spine	Ankylosing Spondylitis: ossification of annulus fibrosus + anterior longitudinal ligament → "bamboo spine" on X-ray
12	(a) Reactive Arthritis	Reiter's syndrome (urethritis + conjunctivitis + arthritis) = Reactive Arthritis; triggered by Chlamydia, Salmonella, Shigella, Campylobacter
13	(c) Trisomy 21	Down Syndrome = three copies of chromosome 21; most commonly due to meiotic non-disjunction
14	(d) Marfan Syndrome	Autosomal dominant (fibrillin-1 gene, chromosome 15); Thalassemia = AR; PKU = AR; Cystic Fibrosis = AR
15	(b) Enteric Fever (Typhoid)	Widal test detects agglutinating antibodies against O and H antigens of Salmonella typhi
16	(c) Arsenic	Chronic arsenic poisoning: Mees' lines on nails, raindrop pigmentation (alternating hyperpigmentation/depigmentation), arsenical keratosis
17	(a) Aedes aegypti	Primary vector of Dengue, Zika, Chikungunya, Yellow Fever; breeds in stagnant clean water
18	(b) Primaquine	Radical cure of P. vivax/P. ovale (kills liver hypnozoites); must test for G6PD deficiency first
19	(b) Rifampicin, Dapsone, and Clofazimine	Paucibacillary: Rifampicin + Dapsone × 6 months. Multibacillary: Rifampicin + Dapsone + Clofazimine × 12 months
20	(a) Respiratory Failure	Elapid (cobra, krait) venom → neurotoxic → neuromuscular blockade → respiratory muscle paralysis → death

SECTION B

Q1 - Lobar Pneumonia (35-year-old with rusty sputum, bronchial breathing)

(a) Diagnosis

Community-Acquired Pneumonia (Pneumococcal/Lobar Pneumonia) caused by Streptococcus pneumoniae. Rusty sputum, bronchial breathing, and increased vocal fremitus in a lobar distribution are classic.

(b) Pathogenesis and Pathological Stages

Pathogenesis: S. pneumoniae colonizes nasopharynx → aspirated into lungs → evades mucociliary clearance → polysaccharide capsule inhibits phagocytosis → alveolar inflammation.

4 Classic Stages (Laennec):

Congestion (24h): Vascular engorgement, serous exudate; lung heavy and red
Red Hepatization (2-3 days): Alveoli filled with RBCs, fibrin, neutrophils; lung firm, red, liver-like
Grey Hepatization (4-8 days): RBC lysis; neutrophils and fibrin persist; lung grey
Resolution (8+ days): Macrophages clear debris; normal architecture restored

(c) Investigations and CURB-65 Score

Investigations:

CXR: lobar/segmental consolidation
Sputum Gram stain and culture
CBC: leukocytosis (WBC >12,000)
Blood cultures (2 sets)
ABG if SpO2 <94%
Urine pneumococcal antigen
Serum electrolytes, BUN, creatinine

CURB-65 Score (1 point each): | C | Confusion (new onset) | | U | Urea >7 mmol/L (BUN >19 mg/dL) | | R | Respiratory rate ≥30/min | | B | Blood pressure: systolic <90 or diastolic ≤60 mmHg | | 65 | Age ≥65 years |

Score 0-1: Outpatient
Score 2: Consider hospitalization
Score 3-5: Hospitalize; ICU if score 4-5

(d) Management for Hospitalized Patient

Beta-lactam (IV amoxicillin-clavulanate or ceftriaxone 1g IV OD) PLUS macrolide (azithromycin 500 mg OD) - Harrison's preferred empiric regimen
OR Respiratory fluoroquinolone monotherapy (levofloxacin 750 mg IV/OD)
ICU patients: beta-lactam + azithromycin or anti-pneumococcal fluoroquinolone
Supplemental O2 to maintain SpO2 >94%
IV fluids if hypotensive
Antipyretics
Thromboprophylaxis (low-molecular-weight heparin)
Duration: 5 days (if clinically stable); de-escalate to oral when afebrile ×48h

Q2a - Falciparum Malaria: Clinical Features and Complications

Clinical Features:

Fever (may be irregular, not classic tertian)
Headache, myalgia, nausea, vomiting
Splenomegaly, hepatomegaly
Anemia, thrombocytopenia

Severe/Complications (WHO criteria):

Complication	Mechanism
Cerebral malaria	Sequestration of parasitized RBCs in brain microvasculature → coma, seizures
Blackwater fever	Massive intravascular hemolysis → hemoglobinuria, renal failure
Acute Renal Failure	Hemoglobinuria + cytokine damage
ARDS/Pulmonary edema	Capillary leak
Hypoglycemia	Glucose consumption by parasites + quinine-induced hyperinsulinism
Algid malaria	Circulatory collapse, cold skin
DIC	Coagulation cascade activation
Hyperparasitemia	>5% parasitized RBCs = severe malaria marker

Treatment of severe falciparum: IV Artesunate (2.4 mg/kg at 0, 12, 24h, then daily) - drug of choice.

Q2b - Leprosy: Diagnosis and WHO Classification

Diagnosis:

Clinical: hypopigmented/erythematous skin patches with loss of sensation + thickened peripheral nerves
Slit-skin smear: acid-fast bacilli (AFB) from ear lobe/lesion - assessed as Bacterial Index (BI)
Skin biopsy: gold standard - granulomas with AFB
Lepromin test: measures CMI (positive in tuberculoid, negative in lepromatous)
PCR for M. leprae DNA

WHO Field Classification (for MDT purposes):

Type	Skin Lesions	Nerve	Smear	Treatment
Paucibacillary (PB)	1-5 lesions	≤1 nerve	Negative	Rifampicin + Dapsone × 6 months
Multibacillary (MB)	>5 lesions	>1 nerve	Positive	Rifampicin + Dapsone + Clofazimine × 12 months

Ridley-Jopling Classification: TT → BT → BB → BL → LL (tuberculoid to lepromatous spectrum)

Q2c - Management of Acute Methanol Poisoning

Mechanism: Methanol → (alcohol dehydrogenase) → Formaldehyde → Formic acid → severe metabolic acidosis + optic nerve toxicity (blindness)

Clinical features: Nausea, vomiting, headache, visual disturbance ("snowstorm vision"), high anion gap metabolic acidosis, elevated osmol gap

Management:

ABC - airway, breathing, circulation
Fomepizole (4-methylpyrazole) 15 mg/kg IV loading - ADH inhibitor, drug of choice (or ethanol 10% IV if fomepizole unavailable)
Sodium bicarbonate - correct metabolic acidosis (pH <7.3)
Folinic acid (Leucovorin) 50 mg IV q4-6h - enhances formate metabolism
Hemodialysis - indicated if: pH <7.25, severe visual impairment, methanol level >25 mg/dL, renal failure
Supportive care; monitor visual acuity

Q2d - HIV/AIDS: Clinical Features and WHO Clinical Staging

Clinical Features by Stage:

WHO Stage 1 (Asymptomatic):

Asymptomatic
Persistent generalized lymphadenopathy (PGL)
CD4 usually >500

WHO Stage 2 (Mild):

Weight loss <10%, minor mucocutaneous manifestations
Recurrent oral ulcers, seborrheic dermatitis, herpes zoster, recurrent URTIs

WHO Stage 3 (Advanced):

Weight loss >10%, chronic diarrhea >1 month
Oral candidiasis, oral hairy leukoplakia
Pulmonary TB, severe bacterial pneumonia
CD4 typically <350

WHO Stage 4 (Severe/AIDS-defining):

PCP pneumonia (Pneumocystis jirovecii)
Cerebral toxoplasmosis, CNS cryptococcosis
CMV retinitis
Kaposi's sarcoma, lymphoma
HIV wasting syndrome
CD4 <200 defines AIDS

Antiretroviral Therapy: Start in ALL patients regardless of CD4 count. Preferred first-line: TDF + 3TC + DTG (Tenofovir + Lamivudine + Dolutegravir)

SECTION B - Q3

(a) Primary Chancre in Syphilis

Single (occasionally multiple), painless, clean-based ulcer
Well-demarcated, indurated (hard) edges - "cartilaginous feel"
Appears 10-90 days (mean 3 weeks) after inoculation with Treponema pallidum
Size: 0.5-2 cm
Located at site of inoculation (glans, prepuce, vulva, cervix, anus)
Associated with painless, non-tender regional lymphadenopathy (inguinal)
Heals spontaneously in 3-6 weeks without treatment
Highly infectious - dark-field microscopy shows spirochetes

(b) Vitamin A Deficiency - Ocular Manifestations

In order of progression (WHO grading):

Night blindness (Nyctalopia) - earliest; rhodopsin synthesis impaired
Conjunctival xerosis (X1A) - dry, non-wettable conjunctiva
Bitot's spots (X1B) - foamy, cheese-like plaques on temporal conjunctiva (triangular, can't be wiped off)
Corneal xerosis (X2) - dry, hazy cornea
Corneal ulceration/keratomalacia (X3A/X3B) - colliquative necrosis; irreversible blindness
Corneal scar (XS) - leucoma

Treatment: Vitamin A capsule 200,000 IU orally on days 1, 2, and 14.

(c) Koebner Phenomenon

Definition: Appearance of skin lesions characteristic of a disease at sites of trauma or injury to previously normal skin.

3 Classic Examples:

Psoriasis - most classic; new plaques form at scratch/trauma sites
Lichen Planus - purple papules appear along scratch lines
Vitiligo - depigmented patches at sites of injury

Other examples: warts (viral koebnerization), molluscum contagiosum

(d) Bipolar I vs. Bipolar II Disorder

Feature	Bipolar I	Bipolar II
Manic episodes	Full mania (≥7 days, hospitalization may be needed)	Absent
Hypomanic episodes	May occur	Present (≥4 days, not requiring hospitalization)
Depressive episodes	Usually present	Prominent/required for diagnosis
Psychosis	Can occur during mania	Does not occur in hypomania
Severity	More severe	Less severe overall, but depression can be disabling
Hospitalization	May be required for mania	Not required for hypomania
Key point	Mania alone = Bipolar I	No full mania ever = Bipolar II

(e) Post-Exposure Prophylaxis (PEP) for Rabies

Wound Management (immediate, most important):

Wash wound with soap and water for ≥15 min
Apply povidone-iodine or 70% alcohol

Rabies Immunoglobulin (RIG): 20 IU/kg (human RIG) or 40 IU/kg (equine RIG)

Inject as much as possible into and around the wound
Remainder given IM at distant site
Given only on Day 0 (only if not previously vaccinated)

Rabies Vaccine (Essen regimen - WHO recommended):

Days 0, 3, 7, 14 (4-dose IM schedule) - for previously unvaccinated
Previously vaccinated: Days 0 and 3 only (no RIG needed)

Category of exposure:

Cat I (touching, feeding, licking intact skin): No PEP
Cat II (nibbling, minor scratches): Vaccine only
Cat III (transdermal bite, bat exposure, mucosal lick): Vaccine + RIG

SECTION C

Q1 - Ankylosing Spondylitis

(a) Diagnosis

Ankylosing Spondylitis (AS) - a seronegative spondyloarthropathy. Classic presentation: young male <45 years, insidious-onset low back pain >3 months, morning stiffness improving with exercise (not rest), anterior uveitis, reduced spinal flexion.

(b) Significance of HLA-B27

HLA-B27 is a class I MHC molecule; present in 90-95% of AS patients (vs. 8% in general population)
Relative risk of AS with HLA-B27 positivity: ~100x
Mechanism: molecular mimicry between HLA-B27 and bacterial antigens (Klebsiella), misfolded protein theory, free heavy chain theory
Not diagnostic alone - 8% of HLA-B27 positive individuals develop AS
Also associated with other spondyloarthropathies: Reactive arthritis, psoriatic arthritis, IBD-associated arthritis
Useful for supporting diagnosis when clinical features and X-ray are equivocal
HLA-B27 positive children with arthritis + uveitis = high-risk group

(c) Schober's Test

Purpose: Objectively measures lumbar spinal flexion (detects reduced mobility in AS)

Technique:

Patient stands erect; mark a point at L5 (lumbosacral junction)
Mark a second point 10 cm above and another 5 cm below this mark (15 cm total span)
Patient asked to bend forward maximally
Remeasure the distance between the two outer marks

Interpretation:

Normal: distance increases by ≥5 cm (from 15 cm to ≥20 cm)
Abnormal (<5 cm increase): suggests reduced lumbar flexion as seen in AS

(d) Management including TNF Inhibitors

Non-pharmacological:

Exercise, physiotherapy, hydrotherapy
Posture training to prevent kyphosis
Smoking cessation

Pharmacological:

NSAIDs (first-line):

Indomethacin, diclofenac, naproxen - continuous use preferred over PRN
If first NSAID fails, try second NSAID before escalating

Second-line - Biologics (TNF inhibitors):

Indicated when: inadequate response to 2 NSAIDs over 4 weeks each
Agents: Etanercept, Adalimumab, Infliximab, Certolizumab, Golimumab
Reduce inflammation, improve function, slow radiographic progression
Screen for latent TB before starting (with tuberculin test/IGRA)

IL-17 inhibitors (alternative biologics):

Secukinumab, Ixekizumab - particularly effective for skin and joint disease

Surgical: Total hip replacement for advanced hip involvement; spinal osteotomy for severe kyphosis

Q2a - Neurotoxic vs. Vasculotoxic Snake Bite

Feature	Neurotoxic (Elapid)	Vasculotoxic (Viper)
Snakes	Cobra, Krait, Mamba	Russell's viper, Saw-scaled viper, Pit viper
Mechanism	Pre-synaptic (krait): blocks ACh release; Post-synaptic (cobra): blocks nAChR	Proteases, hyaluronidase, phospholipases → local tissue destruction, coagulopathy
Local effects	Minimal swelling	Severe swelling, necrosis, blister formation
Systemic features	Ptosis (earliest sign), diplopia, dysphagia, respiratory paralysis, areflexia	Bleeding (hemotoxin): ecchymosis, hematuria, hematemesis, DIC
Pupils	Dilated (cobra)	Normal
Death cause	Respiratory failure	Hemorrhage, ARF
20WBCT test	Normal	Abnormal (blood doesn't clot in 20 min)
Treatment	Polyvalent ASV + neostigmine (for post-synaptic) + atropine; ventilatory support	Polyvalent ASV; FFP, platelets; manage ARF with dialysis

Anti-snake venom (ASV):

Polyvalent ASV given IV (preferred over IM)
Dose: 10 vials initial; repeat if no improvement in 1-2 hours
Indications: coagulopathy, neurotoxicity, hemoglobinuria, local necrosis

Q2b - Status Asthmaticus Management (Emergency Department)

Definition: Severe asthma attack not responding to initial bronchodilator therapy.

Initial Assessment: SpO2, PEFR/FEV1, ABG, RR, use of accessory muscles, ability to speak.

Step-by-step ED Management:

Oxygen: 40-60% to maintain SpO2 93-95% (not high-flow routinely)
SABA (first-line): Salbutamol (albuterol) 2.5-5 mg nebulized q20min × 3 doses in first hour, then q1-4h; or MDI 4-8 puffs q20min
Ipratropium bromide: 0.5 mg nebulized q20min × 3 (add to SABA for severe attacks)
Systemic corticosteroids (mandatory): Prednisolone 40-60 mg oral or Hydrocortisone 100-200 mg IV; continue 5-7 days
IV Magnesium sulfate: 2g IV over 20 min - for severe/life-threatening attacks not responding to above (bronchosmolytics via calcium channel mechanism)
IV aminophylline: No longer recommended as first-line; use only if no response to above
Heliox (helium-oxygen mixture): Consider if failing
NIV/BiPAP: In impending respiratory failure
Intubation/Mechanical ventilation: Last resort; aim for permissive hypercapnia, low PEEP

Discharge criteria: PEFR >75% predicted, SpO2 >94% on room air, sustained for 1 hour

Q2c - Scleroderma: Clinical Manifestations and CREST Syndrome

Two Main Forms:

Diffuse cutaneous SSc (dcSSc): Rapid skin involvement proximally + internal organs
Limited cutaneous SSc (lcSSc): Skin confined to distal extremities/face = CREST syndrome

CREST Syndrome (lcSSc):

Letter	Feature	Detail
C	Calcinosis cutis	Calcium deposits in skin/soft tissues, especially fingers
R	Raynaud's phenomenon	Episodic digital vasospasm (white → blue → red with cold/stress)
E	Esophageal dysmotility	Dysphagia, GERD; lower 2/3 of esophagus affected
S	Sclerodactyly	Tight, shiny skin of fingers; "sausage fingers"
T	Telangiectasia	Dilated capillaries on face, lips, hands

Anti-centromere antibody is the hallmark of lcSSc/CREST (>90% sensitive).

Other systemic features: Pulmonary arterial hypertension (leading cause of death in lcSSc), interstitial lung disease, renal crisis (in dcSSc), Sjogren's overlap.

Q2d - Genetic Counseling: Ethical Considerations and Steps

Steps:

Referral and indication - family history, advanced maternal age, abnormal prenatal screening
Information gathering - 3-generation pedigree, medical records
Risk estimation - calculate recurrence risk using Mendelian principles
Education - explain disease, inheritance pattern, variability, penetrance
Discussion of options - prenatal diagnosis (amniocentesis, CVS, FISH/microarray), preimplantation genetic diagnosis, adoption, childlessness
Decision support (non-directive counseling)
Follow-up - psychological support, referral to support groups

Ethical Principles:

Autonomy: Non-directive counseling; patient decides freely without coercion
Beneficence: Provide accurate information for informed decisions
Non-maleficence: Avoid unnecessary anxiety; disclose information responsibly
Confidentiality: Genetic information is private; duty to warn at-risk relatives (conflict)
Justice: Equal access to genetic services
Informed consent: Voluntary, capacity-based, with full disclosure
Disclosure to third parties (insurers, employers) is generally prohibited

SECTION C - Q3

(a) Laboratory Diagnosis of Kala-azar (Visceral Leishmaniasis)

Definitive: Demonstration of Leishmania donovani (LD bodies/amastigotes)
- Splenic aspirate - most sensitive (>95%) but risky
- Bone marrow aspirate - safer, 70-80% sensitive
- Liver biopsy, lymph node aspirate
Serological (used in endemic areas):
- rK39 immunochromatographic test (ICT) - rapid, highly sensitive and specific; point-of-care test of choice
- DAT (Direct Agglutination Test)
- ELISA for anti-leishmanial antibodies
Molecular: PCR - highly sensitive, not routine
Blood: CBC shows pancytopenia (anemia, leucopenia, thrombocytopenia), elevated ESR, hypergammaglobulinemia, hypoalbuminemia

(b) Anaphylaxis Management - Drug and Dose

Epinephrine (Adrenaline) = cornerstone - give FIRST and immediately

Drug	Dose	Route	Timing
Epinephrine	0.3-0.5 mg (adult); 0.01 mg/kg in children (max 0.5mg) of 1:1000 solution	IM (anterolateral thigh)	Immediately
Oxygen	100%, 15 L/min via non-rebreather mask	Inhalation	Immediately
IV Fluids	1-2 L normal saline bolus	IV	If hypotensive
Diphenhydramine (H1 blocker)	25-50 mg IV/IM	IV/IM	After epi
Ranitidine/Famotidine (H2 blocker)	50 mg IV	IV	After epi
Hydrocortisone	200 mg IV	IV	After epi (prevents biphasic)
Salbutamol nebulization	2.5-5 mg	Inhaled	If bronchospasm

Biphasic anaphylaxis (second reaction 8-72h later): observe for minimum 6 hours before discharge.

(c) Obsessive-Compulsive Disorder (OCD) - Clinical Features

Obsessions (intrusive, unwanted, ego-dystonic thoughts/images/urges):

Contamination (dirt, germs)
Harm (fear of hurting self/others)
Symmetry, exactness
Religious/sexual thoughts

Compulsions (repetitive behaviors/mental acts to neutralize obsessions):

Washing/cleaning (most common)
Checking (locks, appliances)
Counting, arranging
Hoarding

Diagnostic criteria (DSM-5):

Obsessions and/or compulsions that are time-consuming (>1h/day) and cause significant distress/impairment
Ego-dystonic (recognized as excessive/unreasonable)
Not attributable to substances or medical condition

Y-BOCS (Yale-Brown) scale used to assess severity.

Treatment: First-line: SSRIs (fluoxetine, fluvoxamine, sertraline) + CBT with Exposure and Response Prevention (ERP)

(d) Dermatological Features of Scabies and the Burrow

Causative agent: Sarcoptes scabiei var. hominis (mite)

Burrow:

Pathognomonic of scabies
A tortuous, grayish-white or skin-colored linear track (5-15 mm long)
Created by the female mite tunneling into stratum corneum to lay eggs
Found characteristically in: finger webs (earliest and most common), flexor wrists, genitalia, buttocks, areola, umbilicus
Dermoscopy: shows "delta-wing jet" sign (mite at end of burrow)

Other features:

Intense pruritus (worse at night - hallmark)
Papules, vesicles, excoriations from scratching
Burrows are pathognomonic
Secondary bacterial infection (impetigo)
Norwegian (crusted) scabies: hyperkeratotic plaques; thousands of mites; in immunocompromised

Treatment: Permethrin 5% cream (drug of choice) - apply to entire body from neck down, wash off after 8-12 hours; repeat after 1 week. Oral ivermectin 200 mcg/kg alternative.

(e) Difference between Delirium and Dementia

Feature	Delirium	Dementia
Onset	Acute (hours to days)	Insidious (months to years)
Course	Fluctuating, worse at night	Progressive, gradually worsening
Consciousness	Impaired (clouded)	Clear until late stages
Attention	Markedly impaired	Relatively preserved early
Orientation	Disoriented	Preserved early
Memory	Short-term impaired acutely	Short-term first, then long-term
Sleep-wake cycle	Severely disrupted	Mildly disrupted
Hallucinations	Common (visual > auditory)	Less common (visual in LBD)
Reversibility	Usually reversible (treat cause)	Irreversible (progressive)
EEG	Diffuse slowing	Normal early (except prion disease)
Duration	Days to weeks	Years
Common causes	Infection, drugs, metabolic, post-op	Alzheimer's, vascular, LBD, FTD
Treatment	Treat underlying cause; haloperidol for agitation	Cholinesterase inhibitors (donepezil), memantine

Key distinction: Delirium = acute, fluctuating, impaired consciousness; Dementia = chronic, progressive, clear consciousness until late.

All answers based on Harrison's Principles of Internal Medicine, 22nd Edition (2025, McGraw Hill).

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Harrisons Diagnostic Criteria Flashcards

Presentation · PPTX

What's inside (16 slides total):

Slides	Content
Slide 1	Title slide with all 14 condition chips
Slides 2-15	One flashcard per condition (see below)
Slide 16	Quick reference table - key thresholds + drugs

14 Flashcards covering:

Bronchial Asthma (FEV1/FVC criteria + reversibility)
Community-Acquired Pneumonia (CURB-65 scoring)
Lichen Planus (5 P's + Wickham's striae)
Atypical Pneumonia - Mycoplasma
Ankylosing Spondylitis (modified NY criteria)
Schizophrenia (DSM-5 positive/negative)
OCD (DSM-5 + Y-BOCS)
Bipolar I vs. Bipolar II (side-by-side)
Reactive Arthritis (Reiter's triad)
Scleroderma CREST syndrome
HIV/AIDS WHO Clinical Staging
Kala-azar / Visceral Leishmaniasis
Anaphylaxis (WAO criteria + Epinephrine dose)
Down Syndrome (Trisomy 21)

Each card has: Diagnostic criteria bullets + a mnemonic box + a key fact box, all color-coded by specialty (Respiratory = teal, Psychiatry = red/purple, Rheumatology = gold, Infectious Disease = green/orange).

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