Rapid Review — "If You See X, Think Y"

!conflict

This is the night-before-the-exam cheat sheet: a quick clinical snapshot on the left, what it means in plain words (with the exam term) on the right. All 64 pairings are kept, in the same order.

If you notice...	It means...
She has a butterfly-shaped rash across her cheeks and nose, her joints ache, and her urine is showing protein.	This is lupus (SLE) — an autoimmune disease where immune complexes deposit in tissue, a Type III reaction.
Bloodwork comes back ANA positive, anti-dsDNA positive, and complement levels (C3/C4) are LOW.	That combination confirms SLE — the low complement means it's being used up fighting immune complexes.
A rash shows up 24–72 hours after she was out hiking (think poison ivy).	That delay is the signature of Type IV — contact dermatitis, a delayed reaction, not an instant one. — ⚠️ Your slides say 48-72 hours, your textbook 24-72. Both are on the unit 1 card; nobody has settled which the exam wants. check the card
The rash traces back to LATEX exposure.	Per this course, latex rash is Type IV (not the Type I you might expect for an immediate allergic reaction).
Her fingers turn white, then blue, then red in the cold — Raynaud phenomenon.	This course files Raynaud under Type III, treating it as a form of serum sickness.
About day 7 of an antibiotic course, she develops fever, a rash, and swollen joints.	That's serum sickness — Type III — immune complexes from the drug depositing in tissue about a week in.
About a week after a blood transfusion, she spikes a fever, turns jaundiced, her hemoglobin drops, and her Coombs test is positive.	That's a delayed hemolytic transfusion reaction — Type II — antibodies destroying the transfused red cells.
She's on heparin and her platelet count starts falling.	That's HIT — Type II (heparin-induced thrombocytopenia) — antibodies form against a heparin-platelet complex and destroy platelets.
Right after a drug is given, her blood pressure crashes, her heart races, she's wheezing, and hives break out.	This is anaphylaxis — treat with IM epinephrine, anterolateral thigh. — ⚠️ The dose and route come from your eDapt Week 1 module, which we do not hold. Ch. 48 states neither. check the card
A lupus patient already on phenytoin is started on steroids.	Watch out: phenytoin reduces corticosteroid effectiveness — she may need a higher steroid dose.
A newborn is jaundiced and anemic, and the mother is Rh-negative.	This is a Type II / alloimmune reaction. Careful with the treatment question: RhoGAM prevents this — it is given to an Rh-negative mother so she never makes the antibody. Once a baby is already jaundiced and anemic, the mother is already sensitised and RhoGAM will not help that baby.
She's jaundiced, her urine is dark, her spleen is enlarged, and her Coombs test is positive.	That's autoimmune hemolytic anemia — her own antibodies are destroying her red blood cells.
Her red cells are small (low MCV), her iron stores (ferritin) are low, and her TIBC is high.	That's iron deficiency anemia — low on iron, so the body raises its iron-carrying capacity (high TIBC) to try to grab more. — ⚠️ The TIBC row is slide-only — Ch. 29 corroborates the ferritin and iron columns but not this one. check the card
Her red cells are large (high MCV) and she has NEUROPATHY.	That points to B12 deficiency — B12 is the one that also damages nerves. — ⚠️ Your key points file B12 under microcytic two paragraphs before filing it under macrocytic — the unit 2 card shows both. Macrocytic with neuropathy is the version every source agrees on. check the card
Her red cells are large (high MCV), she drinks heavily, and she has no neuropathy.	That's folate deficiency — large cells like B12 deficiency, but without the nerve damage.
Her red cells are normal-sized (normal MCV), her reticulocyte count is low, and her creatinine is high.	That's anemia of CKD — the kidneys aren't making enough EPO to signal new red cell production.
Her red cells are normal-sized, her reticulocyte count is low, and she has ongoing chronic inflammation.	That's anemia of chronic disease — the inflammation itself is suppressing red cell production.
Chest pain comes on with exertion and goes away with rest.	That's stable angina / CAD — narrowed vessels can supply enough blood at rest but not under demand.
She wakes up gasping for air at night (PND), needs to prop herself up to breathe (orthopnea), has crackling lung sounds, and coughs up pink, frothy sputum.	Fluid is backing up into the lungs — LEFT heart failure.
Her neck veins are distended (JVD), her legs are swollen, her belly is fluid-filled (ascites), but her lungs are clear.	Fluid is backing up into the rest of the body instead — RIGHT heart failure / cor pulmonale.
You hear an extra heart sound right after S2 — an S3 gallop.	That points to systolic HF (HFrEF) — a dilated ventricle that can't squeeze out enough blood.
You hear an extra heart sound just before S1 — an S4 gallop.	That points to diastolic HF (HFpEF) — a stiff ventricle that can't relax and fill properly.
She has actual structural heart disease and is now having symptoms from it.	That's ACC/AHA Stage C — structural damage plus symptoms.
She gets symptomatic with LESS THAN ordinary activity — less exertion than it used to take.	That's NYHA Class III. — ⚠️ Watch the wording: a question saying “Stage III” about symptoms and activity means NYHA Class III, not ACC/AHA Stage C. check the card
With exertion she gets chest pain, faints, and gets short of breath, and you hear a systolic murmur radiating to the carotids.	That triad plus the murmur is AORTIC STENOSIS.
You hear a low rumbling murmur during diastole at the apex, an opening snap, and she's in atrial fibrillation.	That's MITRAL STENOSIS (rheumatic). — ⚠️ Your textbook says mitral stenosis radiates to the left axilla too, so radiation cannot separate it from mitral regurgitation. Timing can. check the card
You hear a blowing, decrescendo diastolic murmur at Erb's point, best heard when she leans forward.	That's AORTIC REGURGITATION — the valve is leaking closed, letting blood flow backward.
You hear a murmur that lasts the whole systole and radiates out to the axilla.	That's MITRAL REGURGITATION.
Her FEV1/FVC ratio comes back below 70%.	That's an OBSTRUCTIVE pattern — air isn't getting out fast enough.
Her FVC is down, but the ratio is normal or even high, and her TLC is below 80%.	That's a RESTRICTIVE pattern — the lungs can't expand to hold a normal volume.
In a COPD patient, the DLCO (gas transfer test) comes back markedly reduced.	That points to emphysema (not chronic bronchitis) — emphysema destroys the surface where gas exchange happens.
He's thin, breathes through pursed lips, and has only a minimal cough.	That's the classic emphysema — "pink puffer" picture.
He's overweight, looks bluish (cyanotic), has a productive cough, and has swelling (edema).	That's the classic chronic bronchitis — "blue bloater" picture.
A smoker's emphysema shows up in the upper lobes.	That's centriacinar emphysema — the smoking-related pattern. — ⚠️ Source not found — the three emphysema subtypes are in nothing we hold, and you confirmed they are not in your course material either. The two-line contrast is the part to learn. check the card
A younger patient has emphysema centered in the lower lobes.	That's panacinar emphysema — check alpha-1 antitrypsin, the genetic cause. — ⚠️ Source not found — same as the row above. check the card
Imaging shows subpleural bullae, and a young adult suddenly develops chest pain.	That's paraseptal emphysema — the sudden pain signals a spontaneous pneumothorax, a ruptured bulla. — ⚠️ Source not found — same as the row above. check the card
The chest X-ray shows a flattened diaphragm.	That's the hallmark of COPD hyperinflation — the lungs are trapped full of air, pushing the diaphragm flat.
A COPD patient is put on high-flow oxygen and starts becoming drowsy.	That's CO2 retention — the oxygen target in COPD should be 88–92%, not higher.
An asthma patient's PaCO2 (blood CO2) starts rising.	That means she's fatiguing — impending respiratory failure, no longer able to blow off CO2 fast enough.
You listen to an asthma patient's chest and hear nothing — SILENT CHEST.	That's an EMERGENCY — worse than wheezing, because almost no air is moving at all.
Her symptoms sound like asthma, but her spirometry comes back normal.	The next step is a methacholine challenge test — it can provoke narrowing that resting spirometry missed.
He has a dry cough, clubbed fingers, and fine crackles heard at both lung bases.	That's ILD / pulmonary fibrosis.
Imaging shows a HONEYCOMBING pattern.	That's ILD (advanced fibrosis) — scarring in its late stage.
Restrictive PFTs plus a low DLCO, and he's on methotrexate or amiodarone.	Think drug-induced ILD — those medications are known lung-scarring culprits.
Imaging shows enlarged lymph nodes on both sides near the lung hila, plus eye inflammation (uveitis) and tender red skin nodules (erythema nodosum).	That combination is SARCOIDOSIS. — ⚠️ Sarcoidosis is deck-only — your chapter has no sarcoidosis section, so this triad is not textbook-confirmed. check the card
A urine dipstick comes back positive for nitrites and leukocyte esterase.	That's a UTI.
She has a fever, tenderness when you tap over the kidney (CVA tenderness), and her urine shows WBC CASTS.	That's PYELONEPHRITIS — a kidney infection, not just a bladder one.
She has burning with urination, is going often, feels urgency, and has pain low in her belly or back.	That looks like cystitis — but don't lock it in: absence of fever does NOT rule out pyelonephritis. The text says telling the two apart by clinical assessment alone is difficult. — ⚠️ The old “no fever, so it is plain cystitis” rule was retracted. Your book lists flank pain among cystitis's own symptoms and says the two cannot be separated on clinical assessment alone. check the card
Waves of severe flank pain that radiate down into the groin, plus blood in the urine.	That's a kidney stone — RENAL CALCULI (non-contrast CT is the gold standard test).
An older man has trouble starting his stream, a weak stream, and is up at night to urinate.	That's BPH — the enlarged prostate is obstructing flow.
She's severely dehydrated, bleeding, in heart failure, having a heart attack, or has burns — anything that drops blood flow to the kidneys.	That's PRERENAL AKI (most common) — too little blood reaching the kidney, not damage to the kidney itself.
The kidney tissue itself is damaged — glomerulonephritis, ATN, rhabdomyolysis, or contrast dye exposure.	That's INTRARENAL AKI — the injury is inside the kidney.
Something is blocking urine from leaving — BPH, stones, an obstructed catheter, or bladder/prostate cancer.	That's POSTRENAL AKI — urine can't drain out, so it backs up and injures the kidney.
Her urine output drops below 400 mL/day and her potassium is HIGH.	That's the oliguric phase of ARF — the kidneys have stopped clearing potassium, so it builds up (HYPERKALEMIA).
Her urine output climbs as high as 4,000 mL/day and her potassium is LOW.	That's the diuretic phase of ARF — the kidneys are recovering but dumping too much fluid and potassium (HYPOKALEMIA).
Urine output is below 50 mL over a full 24 hours — essentially nothing.	That's anuria. — ⚠️ Your textbook's number. Your deck says 100 mL — the unit 5 card shows both. check the card
Urine output is below 400 mL over a full 24 hours.	That's oliguria — reduced, but not absent. — ⚠️ Your textbook's number, and the same one the oliguric-phase row above uses. This deck used to say 500 mL here and 400 mL there. check the card
Her GFR has been below 60 for 3 months or longer.	That sustained drop defines CKD.
Her GFR falls in the 30–59 range.	That's CKD Stage 3.
Her GFR is below 15.	That's CKD Stage 5 / ESRD.
Her BUN reaches 70, or her creatinine climbs to 10 times normal.	At that point, dialysis is indicated.
Her skin looks yellow-bronze, she has visible crystals on the skin (uremic frost), a distinct breath odor (uremic fetor), and itching (pruritus).	That's UREMIA / CRF — waste products the kidneys should be clearing are building up.
A renal patient starts breathing in deep, labored Kussmaul respirations.	The body is trying to blow off acid to compensate for metabolic acidosis — reduced bicarbonate generation.
A CRF patient has low calcium, bone pain, and calcium deposits showing up in blood vessels.	The kidney enzyme that activates vitamin D is absent, so calcium gets pulled from bone (along with phosphate) instead of being absorbed properly.

Two classifications worth memorizing because they look wrong at first glance: LATEX rash is Type IV (not the Type I you would expect from an immediate allergy), and Raynaud phenomenon is Type III. Both are confirmed in your textbook's own table — they are the right answer, not a quirk of this course.

Use this the night before.

A ⚠ means the full card in units 1-5 has something more to say about that row — a number two sources disagree on, or a claim nothing has confirmed. Tap through before you commit it to memory.

If you see...	Think...
Malar rash + joint pain + proteinuria	SLE (Type III)
ANA positive, anti-dsDNA positive, LOW C3/C4	SLE confirmed
Rash 24-72 hours after hiking	Type IV — contact dermatitis — ⚠️ Your slides say 48-72 hours, your textbook 24-72. Both are on the unit 1 card; nobody has settled which the exam wants. check the card
Rash from LATEX	Type IV — a delayed, T-cell reaction, not the immediate Type I kind
Raynaud phenomenon	Type III — your course files it as a serum-sickness form
Fever/rash/joint swelling on day 7 of an antibiotic	Serum sickness — Type III
Fever + jaundice + low Hgb + positive Coombs one week post-transfusion	Delayed hemolytic transfusion reaction — Type II
Heparin + dropping platelets	HIT — Type II
Hypotension + tachycardia + wheezing + hives after a drug	Anaphylaxis — IM epinephrine, anterolateral thigh — ⚠️ The dose and route come from your eDapt Week 1 module, which we do not hold. Ch. 48 states neither. check the card
SLE patient on phenytoin started on steroids	Phenytoin reduces corticosteroid effectiveness — may need a higher dose
Newborn jaundice + anemia, Rh-negative mother	Type II / alloimmune — RhoGAM is PREVENTION, given to the mother beforehand; it does nothing once the baby has presented
Jaundice + dark urine + splenomegaly + positive Coombs	Autoimmune hemolytic anemia
Low MCV + low ferritin + high TIBC	Iron deficiency anemia — ⚠️ The TIBC row is slide-only — Ch. 29 corroborates the ferritin and iron columns but not this one. check the card
High MCV + NEUROPATHY	B12 deficiency — ⚠️ Your key points file B12 under microcytic two paragraphs before filing it under macrocytic — the unit 2 card shows both. Macrocytic with neuropathy is the version every source agrees on. check the card
High MCV + alcoholic, no neuropathy	Folate deficiency
Normal MCV + low reticulocytes + high creatinine	Anemia of CKD
Normal MCV + low reticulocytes + chronic inflammation	Anemia of chronic disease
Exertional chest pain relieved by rest	Stable angina / CAD
PND + orthopnea + crackles + pink frothy sputum	LEFT heart failure
JVD + peripheral edema + ascites + clear lungs	RIGHT heart failure / cor pulmonale
S3 gallop	Systolic HF (HFrEF), dilated ventricle
S4 gallop	Diastolic HF (HFpEF), stiff ventricle
Structural disease + symptoms	ACC/AHA Stage C
Symptoms with LESS THAN ordinary activity	NYHA Class III — your week 2 slide 65 writes these as “Stage I-IV” — ⚠️ Watch the wording: a question saying “Stage III” about symptoms and activity means NYHA Class III, not ACC/AHA Stage C. check the card
Exertional angina + syncope + dyspnea, systolic murmur to carotids	AORTIC STENOSIS
Diastolic rumble at apex + opening snap + atrial fibrillation	MITRAL STENOSIS (rheumatic) — sort by TIMING, not radiation — ⚠️ Your textbook says mitral stenosis radiates to the left axilla too, so radiation cannot separate it from mitral regurgitation. Timing can. check the card
Diastolic blowing decrescendo at Erb’s point, leaning forward	AORTIC REGURGITATION
Holosystolic murmur radiating to the axilla	MITRAL REGURGITATION
FEV1/FVC below 70%	OBSTRUCTIVE
FVC down, ratio normal or high, TLC below 80%	RESTRICTIVE
DLCO markedly reduced in COPD	Emphysema (not chronic bronchitis)
Thin, pursed-lip breathing, minimal cough	Emphysema — "pink puffer"
Overweight, cyanotic, productive cough, edema	Chronic bronchitis — "blue bloater"
Upper lobe emphysema in a smoker	Centriacinar — ⚠️ Source not found — the three emphysema subtypes are in nothing we hold, and you confirmed they are not in your course material either. The two-line contrast is the part to learn. check the card
Lower lobe emphysema, younger patient	Panacinar — check alpha-1 antitrypsin — ⚠️ Source not found — same as the row above. check the card
Subpleural bullae, sudden chest pain in a young adult	Paraseptal emphysema — spontaneous pneumothorax — ⚠️ Source not found — same as the row above. check the card
Flattened diaphragm on chest X-ray	COPD hyperinflation
COPD patient given high-flow oxygen, becomes drowsy	CO2 retention — target should be 88–92%
Asthma + rising PaCO2	Fatiguing — impending respiratory failure
SILENT CHEST in asthma	EMERGENCY — worse than wheezing
Symptoms suggest asthma but spirometry is normal	Methacholine challenge test
Dry cough + clubbing + fine bibasilar crackles	ILD / pulmonary fibrosis
HONEYCOMBING on imaging	ILD (advanced fibrosis)
Restrictive PFTs + low DLCO + methotrexate or amiodarone	Drug-induced ILD
Bilateral hilar lymphadenopathy + uveitis + erythema nodosum	SARCOIDOSIS — ⚠️ Sarcoidosis is deck-only — your chapter has no sarcoidosis section, so this triad is not textbook-confirmed. check the card
Nitrites + leukocyte esterase on dipstick	UTI
Fever + CVA tenderness + WBC CASTS	PYELONEPHRITIS
Dysuria, frequency, urgency, suprapubic or low back pain	Cystitis — but fever does NOT rule it out — ⚠️ The old “no fever, so it is plain cystitis” rule was retracted. Your book lists flank pain among cystitis's own symptoms and says the two cannot be separated on clinical assessment alone. check the card
Colicky flank pain radiating to the groin + hematuria	RENAL CALCULI (non-contrast CT is gold standard)
Older man with hesitancy, weak stream, nocturia	BPH
Dehydration, hemorrhage, heart failure, MI, burns	PRERENAL AKI (most common)
Glomerulonephritis, ATN, rhabdomyolysis, contrast dye	INTRARENAL AKI
BPH, stones, obstructed catheter, bladder/prostate cancer	POSTRENAL AKI
Urine output below 400 mL/day + HYPERKALEMIA	Oliguric phase of ARF
Urine output up to 4,000 mL/day + HYPOKALEMIA	Diuretic phase of ARF
No urine output, or below 50 mL / 24 hours	Anuria — ⚠️ Your textbook's number. Your deck says 100 mL — the unit 5 card shows both. check the card
Urine output below 400 mL / 24 hours	Oliguria — ⚠️ Your textbook's number, and the same one the oliguric-phase row above uses. This deck used to say 500 mL here and 400 mL there. check the card
GFR below 60 for 3 months or longer	CKD
GFR 30–59	CKD Stage 3
GFR below 15	CKD Stage 5 / ESRD
BUN reaches 70, or creatinine 10 times normal	Dialysis indicated
Yellow-bronze skin, uremic frost, uremic fetor, pruritus	UREMIA / CRF
Kussmaul respirations in a renal patient	Metabolic acidosis
Low calcium + bone pain + vascular calcification in CRF	Vitamin D enzyme absent — calcium pulled from bone with phosphate

Sources for this card

✓Textbook Inherited from the concepts in units 1-5 that each row reviews
This deck states nothing of its own. Each row names the concept it reviews, and the build fails if that concept changes underneath it or if a row states a figure the concept rejects.

Only part of this card is covered by the sources listed. The rest is not yet backed by anything we hold.

Open one and check this card against it. If it disagrees, that is worth reporting.

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Rapid Review — "If You See X, Think Y"

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