╬═╬
╬═╬ Broad Based Budding yeast
╬═╬ in a hunter from the south
╬═╬
╬═╬ is BLASTOMYCOSIS
╬═╬☻/
╬═╬/▌
╬═╬/ \\

ᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ
┏┓
┃┃╱╲ Just because the question
┃╱╱╲╲ includes a bird and
╱╱╭╮╲╲ respiratory illness
▔▏┗┛▕▔
╱▔▔▔▔▔▔▔▔▔▔╲
doesn’t mean it’s psittacosis
╱╱┏┳┓╭╮┏┳┓ ╲╲
▔▏┗┻┛┃┃┗┻┛▕▔

ᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ
━━━━━━━━━━
Dyspneic young patient
with bullae in the bases
of CXR?

Think COPD due to
α1-antitrypsin deficiency
━━┳━━━━━━━
  ╰╮
  ╭━━╮
  ┃▍▍┃
  ╱  ╰╲▁▁
  ▔▏╰╰╰╰╱
   ╲▁▁▁╱

ᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ
Post bone marrow transplant patient
+
Long period of neutropenia
+
Cough, dyspnea & chest CT w halo sign (nodules w surrounding ground glass infiltrates)
=
Invasive pulmonary aspergillosis

ˢᵉᵉⁿ ᵗʰᶦˢ ᵐᵃʸᵇᵉ ᵒⁿᶜᵉ
▬▬▬.◙.▬▬▬
═▂▄▄▓▄▄▂
◢◤ █▀▀████▄▄▄▄◢◤
█▄ █ █▄ ███▀▀▀▀▀▀▀╬
◥█████◤
══╩══╩═
╬═╬
╬═╬ A spelunker w cough
╬═╬ fever, patchy infiltrates
╬═╬
╬═╬ Histoplasma capsulatum
╬═╬
╬═╬ Itracon or ampho if severe
👩🏼‍🦳/
/▌
/ \\
████

Premenopausal woman
Spontaneous PTX or chylous effusion
CT w thin walled cysts

Lymphangioleiomyomatosis

ᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ
╭╭╮╭╭╮
┃┃┃┃┃┃asthma exacerbations
┃┃┃┃┃┃on albuterol + ICS
┃┛┻┛┛┃╭╮
┃┈┈╱▔┃┃┃
┃┈╱┈┈┗╯┃CXR w finger in
╰┳┊┊┳━━╯glove pattern
┏┻━━┻┓
┃┈┈┈┈┃sputum w branching
┃┈┈┈┈┃hyphae

Allergic bronchopulmonary aspergillosis
Hairy Cell Leukemia  
╱╲╲╲╲╲╲╲
  ╱╲╲╲╲╲╲╲╲╲
 ╱╱╱╲╲╲╲╲╲╲╲╲
 ╱╱╱  ▁▁ ▁▁▏
 ╱┃▏   🥚🥚
 ╱╰▏  ╱━╯  ▏
   ▏ ╱▁▁ ╲ ▏
   ╲      ╱ 
Pancytopenia
Splenomegaly
Dry Bone Marrow Tap
did you think guessing HCL would be enough to show you are competent to practice Internal Medicine?

Au contraire mon frère

You have to know that HCL is associated with the *BRAF* mutation

FFS
________________________
| Rheumatoid Arthritis |
| splenomegaly |
| neutropenia |
| = Felty Syndrome |
|_______________________|
(\\__/) ||
(•ㅅ•) ||
/   づ

It’s bad and it’s tricky to manage

ᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ
(•_•)
<) )╯YOUNG NONSMOKER
/ \\

(•_•)
\\( (> BULLAE IN BASES ON CXR
/ \\
⬇️⬇️⬇️⬇️
(•_•)
<) )╯ α1-ANTITRYPSIN DEFICIENCY
/ \\

ᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ
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