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╬═╬
╬═╬ Broad Based Budding yeast
╬═╬ in a hunter from the south
╬═╬
╬═╬ is BLASTOMYCOSIS
╬═╬☻/
╬═╬/▌
╬═╬/ \
ᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ
╬═╬ 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
┃┃╱╲ 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
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
+
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
═▂▄▄▓▄▄▂
◢◤ █▀▀████▄▄▄▄◢◤
█▄ █ █▄ ███▀▀▀▀▀▀▀╬
◥█████◤
══╩══╩═
╬═╬
╬═╬ 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
//▌/ \████Premenopausal womanSpontaneous PTX or chylous effusionCT w thin walled cystsLymphangioleiomyomatosisᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ" title="https://abs.twimg.com/emoji/v2/... draggable="false" alt="👩🏼🦳" title="Woman, white haired (mittelheller Hautton)" aria-label="Emoji: Woman, white haired (mittelheller Hautton)">//▌/ \████Premenopausal womanSpontaneous PTX or chylous effusionCT w thin walled cystsLymphangioleiomyomatosisᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ" class="img-responsive" style="max-width:100%;"/>
╭╭╮╭╭╮
┃┃┃┃┃┃asthma exacerbations
┃┃┃┃┃┃on albuterol + ICS
┃┛┻┛┛┃╭╮
┃┈┈╱▔┃┃┃
┃┈╱┈┈┗╯┃CXR w finger in
╰┳┊┊┳━━╯glove pattern
┏┻━━┻┓
┃┈┈┈┈┃sputum w branching
┃┈┈┈┈┃hyphae
Allergic bronchopulmonary aspergillosis
┃┃┃┃┃┃asthma exacerbations
┃┃┃┃┃┃on albuterol + ICS
┃┛┻┛┛┃╭╮
┃┈┈╱▔┃┃┃
┃┈╱┈┈┗╯┃CXR w finger in
╰┳┊┊┳━━╯glove pattern
┏┻━━┻┓
┃┈┈┈┈┃sputum w branching
┃┈┈┈┈┃hyphae
Allergic bronchopulmonary aspergillosis
Hairy Cell Leukemia
╱╲╲╲╲╲╲╲
╱╲╲╲╲╲╲╲╲╲
╱╱╱╲╲╲╲╲╲╲╲╲
╱╱╱ ▁▁ ▁▁▏
╱┃▏
https://abs.twimg.com/emoji/v2/... draggable="false" alt="🥚" title="Ei" aria-label="Emoji: Ei"> ▏https://abs.twimg.com/emoji/v2/... draggable="false" alt="🥚" title="Ei" aria-label="Emoji: Ei"> ▏
╱╰▏ ╱━╯ ▏
▏ ╱▁▁ ╲ ▏
╲ ╱
Pancytopenia
Splenomegaly
Dry Bone Marrow Tap
╱╲╲╲╲╲╲╲
╱╲╲╲╲╲╲╲╲╲
╱╱╱╲╲╲╲╲╲╲╲╲
╱╱╱ ▁▁ ▁▁▏
╱┃▏
╱╰▏ ╱━╯ ▏
▏ ╱▁▁ ╲ ▏
╲ ╱
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
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
| 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
/ \
https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬇️" title="Pfeil nach unten" aria-label="Emoji: Pfeil nach unten">https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬇️" title="Pfeil nach unten" aria-label="Emoji: Pfeil nach unten">https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬇️" title="Pfeil nach unten" aria-label="Emoji: Pfeil nach unten">https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬇️" title="Pfeil nach unten" aria-label="Emoji: Pfeil nach unten">
(•_•)
<) )╯ α1-ANTITRYPSIN DEFICIENCY
/ \
ᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ
<) )╯YOUNG NONSMOKER
/ \
(•_•)
\( (> BULLAE IN BASES ON CXR
/ \
(•_•)
<) )╯ α1-ANTITRYPSIN DEFICIENCY
/ \
ᵂᵉˡᶜᵒᵐᵉ ᵗᵒ ᵐʸ ᵇᵒᵃʳᵈ ʳᵉᵛᶦᵉʷ
