STEPTRACKERCROSS-SYSTEM | PATHOLOGY + RADIOLOGY + CLINICAL | RAPID-FIRE REVIEW

Buzzword → Diagnosis

Classic signs, imaging descriptions and lab phrases mapped to their diagnosis — with the reason each one appears.

FOCUS ON
Every buzzword has a mechanism. Learn why it appears — the bird's beak is a closed LES, the boot-shaped heart is right ventricular hypertrophy, the onion skin is layered periosteal reaction — so you can still reason when the vignette describes it instead of naming it. Histology bodies are on 19.03.
BUZZWORD
DIAGNOSIS
WHY IT APPEARS
PAGE
"Worst headache of my life"
Subarachnoid hemorrhage
Sudden arterial blood in subarachnoid space (berry aneurysm)
Lucid interval
Epidural hematoma
Arterial bleed takes time to expand after brief concussion
Albuminocytologic dissociation
Guillain-Barré
Inflamed roots leak protein; no CSF cells
Boot-shaped heart
Tetralogy of Fallot
Right ventricular hypertrophy lifts the apex
Rib notching
Coarctation of the aorta
Enlarged intercostal collaterals erode ribs
Continuous machinery murmur
Patent ductus arteriosus
Aorta → pulmonary artery flow in systole and diastole
Kerley B lines, bat-wing opacities
Left heart failure
Interstitial and alveolar edema from high pulmonary venous pressure
Honeycomb lung, lower lobes
Idiopathic pulmonary fibrosis
Cystic spaces in end-stage fibrotic lung
Cannonball lung nodules
Hematogenous metastases
Tumor emboli lodge in lung capillaries
Bird's beak esophagus
Achalasia
LES can't relax; esophagus dilates above it
Double bubble
Duodenal atresia
Gas trapped in stomach and proximal duodenum
Currant jelly stool
Intussusception
Venous congestion of telescoped bowel → bloody mucus
String sign · lead pipe colon
Crohn disease · ulcerative colitis
Narrowed fibrotic ileum · loss of haustra
Apple core lesion
Left-sided colon carcinoma
Annular napkin-ring tumor narrows the lumen
Snowstorm ultrasound
Complete hydatidiform mole
Diffusely swollen villi, no fetus
Codman triangle · sunburst
Osteosarcoma
Tumor lifts periosteum and lays spicules of bone
Onion skin periosteum
Ewing sarcoma
Layered periosteal reaction around a diaphyseal tumor
Soap bubble epiphysis
Giant cell tumor
Expansile lytic lesion with thin septa
Bamboo spine · pencil-in-cup
Ankylosing spondylitis · psoriatic arthritis
Syndesmophytes fuse vertebrae · erosive DIP destruction

Lab phrases

LAB
DIAGNOSIS
PAGE
Xanthochromic CSF
Subarachnoid hemorrhage
Oligoclonal bands
Multiple sclerosis
↑ Urine 5-HIAA
Carcinoid syndrome
↑ Urine HVA/VMA
Neuroblastoma
↑ 17-OH-progesterone
21-hydroxylase deficiency
Muddy brown casts
Acute tubular necrosis
Anti-PLA2R
Membranous nephropathy
AMA
Primary biliary cholangitis

Physical signs

SIGN
DIAGNOSIS
PAGE
Courvoisier sign
Pancreatic head cancer
Cullen / Grey Turner
Hemorrhagic pancreatitis
Virchow node
Gastric cancer
Kayser-Fleischer ring
Wilson disease
Gowers sign
Duchenne dystrophy
Heliotrope + Gottron
Dermatomyositis
Nikolsky positive
Pemphigus, SSSS, TEN
Blue dot sign
Torsion of appendix testis

How it's tested

COMMON CONFUSIONNewer exam items describe the finding ("gas-filled stomach and proximal duodenum") instead of naming it ("double bubble"). Know what each buzzword looks like.
THE TRAPA buzzword narrows the diagnosis but the question often asks the next step — mechanism, gene, complication or treatment.
YOUR APPROACHTranslate the description → buzzword → diagnosis → then answer the real question asked (cause, mechanism, next step).

If you see… think…

Coffee-bean sign in an elderly constipated patient → sigmoid volvulus
Egg-on-a-string heart → transposition of the great arteries
Steeple sign on neck X-ray → croup
Water-bottle heart + electrical alternans → pericardial effusion / tamponade
Salt-and-pepper skull + subperiosteal resorption → hyperparathyroidism
Crew-cut / hair-on-end skull → thalassemia major, sickle cell
Punched-out lytic skull lesions → multiple myeloma
"Chain of lakes" pancreatic duct → chronic pancreatitis
Beaded bile ducts → primary sclerosing cholangitis
Ring-enhancing lesions in AIDS → toxoplasmosis (vs lymphoma)