Henoch - Schönlein Purpura (HSP) Mnemonic: "10 P's"

HSP = 10 P's

PALPABLE
PURPURA
PLATELETS OK -- DDx from ITP
PRURITUS -- URTICARIA
PAIN -- ABDOMEN and LEGS
POSITIVE +guaiac -- FECES
PRESSURE -- increased blood pressure
PROTEINURIA
PREDNISONE = Tx

Related reading:

A Young Man with Henoch-Schönlein Purpura

Henoch-Schönlein Purpura - JAMA Patient Page http://goo.gl/e05qx

Calcium Metabolsim Drug

Ca2 DRUGS:
1. Vit.D--> PO
-ERGO-
-TRIOL-->CRF
2.SAL-CATONIN SC
+ETI-DRONATE
\OSTEO=CLASTS
\BONE RESORPTION
\SERUM Ca2

C PPD

C PPD
C HUNKY RHOMBOID
C RYSTALS +REFRING.
C a2 NOSIS
C ARTILAGE
C ~KNEE

DDx.
GOUT
MSU NEEDLE
- REFRING.

JOINT Sy DDx=
HINTS

P SEUDO-GOUT
P OSITIVE BI-REFRING.CR

C PPD

C PPD
C HUNKY RHOMBOID
C RYSTALS +REFRING.
C a2 NOSIS
C ARTILAGE
C ~KNEE

DDx.
GOUT
MSU NEEDLE
- REFRING.

P AGET DISEASE

P AGET DISEASE
P AIN !
P ELVIS
P HOSPHATASE AP/
P ATHOLOGICAL FRACT.
P ATCHY BONE CHANGES
P REDISPOSTN-->OsteoSA
P RLIFER. VESSELS
P ERIPH.RESISTANCE\
HIGH OUT-PUT HF

HYPER-Ca2-EMIA DDx=
SHAMPO DIRT

HEME SYNTHESIS and Porphyria

HEME SYNTHESIS:
KREBS
SUCC.CoA+
AA GLYCINE
AMINO-LEVULINIC
ACID = ALA+
ALA
PORPHO-BIL-GEN+
0 P-B-GENS
URO
COPRO
PROTO
+Fe2+ HEME

REGULATION:
ALA-SYNTHET-ase^-->
A IP

P
P BG/--> URINE
P ORT-WINE
P AIN ABDOMEN-->
P MH-->SURGERY SCARS
P SYCHOSIS

8 ENZYMES
7 DEFFECIVE=
PORHYR-IAS
CI: BARBITURATES

URO-->COPRO ENZ.\-->
PCTarda

ROTATOR CUFF MUSCLES: SItS

ROTATOR CUFF
MUSCLES=
SItS:
S UPRA- SPINATUS
I NFRA- SPINATUS
T ERES MINOR
S UB- SCAPULARIS

HLA 2 DR3: SIC- M

HLA 2 DR3= SIC- M
S LE
I DDM
C ELIAC + B8 HLA1
M YASTHEN. GR.

RHEUMATIC FEVER: PECCS

P OLYA
E RYTHEMA MARGINATUM
C ARDIDTIS
C HOREA MINOR
S UBCUT. NODULES

KNEE Physical Exam: LIMB

L ACHMANN DRAW-ER
I NHIBITION - PATELLA MOVEM.
M cMURRAY
B ALLOTT-EMENT - PATELLA

M cMURRAY
M EDIAL ROTATION
M ANUS on the KNEE
M ENISCUS TEAR

Carpal Tunnel Syndrome (CTS) DDx: MEDIAN TRAP

M YX-EDEMA T4\
E DEMA PRE-MENSTR
D M
I DIO-PATHIC
A CRO-MEGALY
N EO-PLASM

T RAUMA
R A HARNESS
RED HOT PANNUS
A MYLOID
P REGNANCY

Sx=
PANTS:
P AIN
A TROPHY THENAR
OAF
N UMB-NESS
T INGL-ING
S TRENGHT \


T AP-PING
T INGLING=
T INNEL test

P ALMAR FLEXION
P HALEN test

Tx=
WRIST:

W EAR a SPILNT
R EST
I NJECT CS
S URG. DE-COMPRESSION
T AKE DIURETC

Differential diagnosis of polyarthritis: RIOT SHAG

Differential diagnosis of polyarthritis: RIOT SHAG

Rheumatoid arthritis (RA)
Infectious cause, e.g. viral infection
Osteoarthritis (OA)
Tuberculosis (TB), Rheumatic fever (RhF)

Spondyloarthritis, SLE
Henoch-Shoenlein purpura (HSP)
Allergy, i.e. serum sickness in the context of drug hypersensitivity, type III reactions
Gonorrhea

RoS JOINTS: LOTS OF WEEP

L IMITATN MOTION
AROM + pass.ROM
O VERT DEFORMITY
T IME VARIATN Sx
S TIFFN. / TENDER-NESS

O EDEMA
F ATIGUE-ED DDx

W ARMTH
E RYTHEMA
E VALUATE LOCK-ing /
NOISES
P AIN

KNEE PAIN Dx=
LIMB

Differential Diagnosis of Arthritis: HINTS

Differential Diagnosis of Arthritis: HINTS

Hemorrhage due to trauma, or less frequently due to hemophilia
Inflammatory, e.g. CRP, PAIR (see below)
Noninflammatory, e.g. osteoarthritis (OA)
Trauma or Tumor, e.g. leukemia
Septic arthritis

Differential Diagnosis of Inflammatory Arthritic Conditions: CRP

Crystals,e.g. Gout or Pseudogout
Rheumatoid arthritis (RA)
PAIR

PAIR, a group of disordes with HLA B-27:

Psoriasis
Ankylosing spondylitis
Inflammatory bowel disease (IBD), e.g. ulcerative colitis (UC) or Crohn’s disease
Reiter’s syndrome