Emergency Clinical Guide Presents Clinical Eponyms K-L

Clinical Eponyms
K-L

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This list is available for the Palm Pilot at Andrew Yee's website.

Kallman’s syndrome

Anosmia; hypogonadotropic hypogonadism stemming from failure of LHRH-expressing neurons to migrate, etc.

Kanavel's sign

Four signs of tenosynovitis: 1. affected finger held in slight flexion; 2. pain over volar aspect of affected finger tendon upon palpation; 3. swelling of affected finger; 4. pain on passive extension of affected finger

Kartagener’s syndrome

A triad of sinusitis, bronchiectasis, and situs inversus; also associated with ciliary dysfunction; Manes Kartagener, Swiss physician, 1897-1975

Kasabach-Merritt syndrome

Capillary hemangioma associated with thrombocytopenic purpura and extensive and progressively enlarging vascular malformations which may involve large portions of their extremities; bleeding commonly develops in the first year of life, secondary to chronic DIC triggered by stagnant blood flow through the tortuous abnormal vessels; anemia caused by red cell damage as blood passes through deformed vessels of the tumor

Kashin-Beck disease

Deforming arthritis associated with selenium deficiency, identified in an area of China where soil is extremely low in selenium

Katayama fever

Acute schistosomiasis, after Katayama valley in Japan where S. japonicum endemic; seen in travlers but not in native people because of exposure in utero; symptoms of prostration, fever, sweats, myalgia, and diarrhea

Kawasaki’s disease

Acute febrile illness of infants and children, characterized by cutaneous and mucosal erythema and edema with subsequent desquamation, cervical lymphadenitis, and complicated by coronary artery aneurysms (20%)

Kayser-Fleischer rings

A greenish yellow pigmented ring encircling the cornea just within the corneoscleral margin, seen in hepatolenticular degeneration, due to copper deposited in Desçemet’s membrane (posterior limiting layer of cornea); seen in *Wilson’s disease* (with neurologic involvement) and other cholestatic hepatic diseases

Kearns-Sayre-Daroff syndrome

A mitochondrial disease with progressive ophthalmoplegia, retinal pigmentation degeneration, cerebellar ataxia, heart block, and elevated CSF protein

Kehr’s sign

Pain in the left shoulder associated with splenic rupture

Kelly’s sign

Visible peristalsis of the ureter in response to squeezing or retraction; used to identify the ureter during surgery

Kennedy syndrome

Bulbospinal atrophy; X-linked disease from CAG repeat expansion encoding androgen receptor apparently; leads to distal limb amyotrophy, bulbar signs, androgen insensitivity with gynecomastia, testicular atrophy, and oligospermia

Kerckring’s valves

Plicae circulares (lining of small intestine)

Kerley B lines

A radiographic evidence of pulmonary venous hypertension, horizontal linear opacities on chest radiograph often found in the periphery due to separation of the interlobular space, as seen in pulmonary edema or fibrosis, reflecting thickening of, or fluid in, lymphatic vessels in interlobular septae, a consequence of interstitial edema; also seen in lymphangitic spread of malignancies

Kernig sign

Flex patient’s leg at both hip and knee, and then straighten knee; positive sign—pain and increased resistance to extending knee AE suggests meningeal irritation

Kernohan notch

Focal impression against the cerebral peduncle, pressure against notch in uncal herniation

Kiesselbach’s plexus

Vascular plexus on the anterior nasal septum, bleeding from, leads to most common form of epistaxis

Kikuchi’s disease

Histiocytic necrotizing lymphadenitis, characterized by cervical lymphadenopathy with tenderness, fever, and night sweats

Killip class

Described in 1967, in myocardial infarction, I, no heart failure, 0.5% mortality; II, S3 and/or basal lung crepitations, 2.2% mortality; III, acute pulmonary edema, 19.2% mortality; IV, cardiogenic shock, 61.3% mortality (mortality rates current)

Kimmelstiel-Wilson disease

Intercapillary glomerulosclerosis from diabetes; lesion is PAS-positive material deposited at periphery of glomerular tufts

Klatskin tumors

Tumors arising from the part of the common bile duct between the cystic duct junction and the confluence of the right and left hepatic ducts at the liver hilus; notable for their slow growing behavior, marked sclerosing characteristics, and the infrequent occurrence of distal metastases

Kleihauer-Betke test

Testing for the presence of fetal blood cells in maternal circulation

Kleine-Levin syndrome

A rare form of periodic hypersomnia associated with bulimia, occurring in males aged 10 to 25 years, characterized by periods of ravenous appetite alternating with prolonged sleep (as long as 18 hours), along with behavioral disturbances, impaired thought processes, and hallucinations; acute illness or fatigue may precede an episode, which may occur as often as several times a year

Klumpke palsy

C8-T2 nerve roots

Klüver-Bucy syndrome

1937 bilateral removal of temporal lobe (including amygdala and hippocampal formation) in monkeys, animals became tame, showed a flattening of emotions, exhibited remarkable oral tendencies (they put all manner of objects into their mouths), enormous increase in sexual behavior, including mounting of inappropriate objects and species, compulsive tendency to react to every object, failed to recognize familiar objects

Koch’s postulates

Criteria for linking a specific microorganism to a disease 1. organism must be found in lesion of disease; 2. organism can be isolated in single colonies on a single medium; 3. inoculation of culture causes lesion in experimental animals; 4. organism can be recovered from lesions in these animals

Kocher’s incision

Right subcostal incision for open cholecystectomy

Kocher’s maneuver

Dissection of the duodenum from the right-sided peritoneal attachment to allow mobilization and visualization of the back of the duodenum/pancreas

Koebner’s phenomenon

Referring to physical trauma (rubbing or scratching) as a major factor in eliciting *psoriasis lesions*; also depigmented, sharply demarcated papules in vitiligo following minor trauma; may also be seen in *lichen planus*

Koeppe’s nodules

Projections into the pupil seen in sarcoidosis, tuberculosis, and other veitides

Köhler’s bone disease

Aseptic necrosis of the navicular bone

Kohn, pores of

Connections between alveoli

koilocyte

Characteristic cytoplasmic vacuole, hallmark of infection by papillomavirus

Koplik’s spots

Pathognomonic exanthem in measles

Korotkoff sounds

Sounds heard in between systolic and diastolic pressure; origin related to the spurt of blood passing under the cuff and meeting a static column of blood

Korsakoff’s syndrome

Profound memory loss; mammillary bodies as well as portions of medial thalamus believed to be destroyed from thiamine deficiency accompanying alcoholism

Kostmann syndrome

Inherited neutropenia, responds to G-CSF, may be due to environmental insults in bone marrow, characterized typically by a granulopoiesis impairment at the promyelocyte stage

Krabbe’s disease

AR sphingolipidosis (sulfatidose), from beta-galactosidase deficiency, resulting in increased galactocerebrosides, mental retardation, blindness, deafness, paralysis, convulsions, total absence of myelin, globoid bodies in white matter of brain, fatal in early life

Krause’s end-bulbs

Sensory receptors for cold

Krukenberg’s tumor

Metastatic GI neoplasia to the ovaries, produces bilateral metastases of mucin-producing, signet-ring cancer cells, most often of gastric origin

Kübler-Ross dying stages

1. denial and isolation, 2. anger, 3. bargaining, 4. depression, 5. acceptance; described in 1969 by Elisabeth Kübler-Ross

Kugelberg-Welander disease

Juvenile spinal muscular atrophy, hereditary or sporadic, affects proximal limbs, gradually progressive

Kulchitsky’s cells

Neuroendocrine argentaffin cells present along the bronchial epithelium, particularly in the fetus and neonate; small cell carcinoma has granules similar to Kulchitsky’s cells; origin of carcinoid tumors

Kupffer cells

Phagocytic cells of the mononuclear phagocyte series found on the luminal surface of endothelial cells in hepatic sinusoids; they metabolize old RBCs, digest hemoglobin

Kussmaul’s respiration

Paroxysmal air hunger, associated with acidosis, especially DKA

Kussmaul’s sign

In constrictive pericarditis, jugular vein becomes more distended during inspiration (normally, jugular venous pressure decreases with inspiration since blood drains into heart with inspiration); though most common contemporary cause is severe right-sided heart failure (JAMA 1996: 275:632); generally negative in cardiac tamponade

Kveim test

An intradermal test for the detection of *sarcoidosis*, done by injecting Kveim antigen (a saline suspension of human sarcoid tissue prepared from the spleen of an individual with active sarcoidosis) and examining skin biopsies after 3 and 6 weeks; positive test, a noncaseating granulomatous reaction; sensitivity 35-88%, specificity 75-99% Morton A. Kveim, Norwegian physician, born 1892

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Laennec’s cirrhosis

In alcoholic cirrhosis, residual parenchymal nodules that protrude like "hobnails" from the surface of the liver

Lambert, canals of

Direct accessory bronchioalveolar connections

Lambert-Eton myasthenic syndrome

disease of neuromuscular junction associated with paraneoplastic process with proximal muscle weakness that improves with repetitive stimulation; associated with P/Q type presynaptic voltage-gated calcium channel antibodies; 70% have malignancy, usually small cell cancer

Laplace’s law

Wall tension = pressure x radius (thus colon perforates preferentially at the cecum because of the increased radius and resultant increased wall tension)

Laron dwarfism

Autosomal recessive, growth hormone receptor defects, low IGF-1 levels

Laryngoscope blades

MacIntosh is straight; Miller, Wisconsin, Flagg are curved

Lasègue’s sign

When patient is supine with hip flexed, dorsiflexion of ankle causing pain or muscle spasm in the posterior thigh indicates lumbar root or sciatic nerve irritation

Laurence-Moon-Biedl syndrome

Obesity, retinitis pigmentosa, metal retardation, skull deformities, polydactyly, and syndactyly

Leber hereditary optic neuropathy

mitochondrial DNA disease, progressive bilateral loss of central vision, presents 15-35 y.o, associated with cardiac conduction defects and minor neurological manifestations

Legg-Calvé-Perthes disease

Self-limiting hip disorder of children, 4-8 y.o. (M:F 8:1) involving vascular compromise of the capital femoral epiphysis; perhaps some aseptic necrosis action too

Leiden, factor V

Arg(506) Alpha Gln, results in resistance to cleavage by activated protein C (an anticoagulant), found in 20% of patients with venous thromboembolism, 6% of US population

Leigh’s disease

autosomal recessive disorder from defects in mitochondrial pathway for converting pyruvate to ATP leading to lactic acidemia, developmental problems, seizures, involvement of periaqueductal gray area, extraocular palsies, weakness, hypotonia, death within 1 to 2 years

Leiner’s disease

Seborrheic erythroderma associated with diarrhea and failure to thrive and to generate C5a chemotactic factor

Lenègre’s disease

sclerodegenerative disease of conduction system, particularly of right bundle branch and left anterior fascile in people over 50; associated with slow progression to complete heart block

Lepore, hemoglobin

No beta chain; delta chain by delta-beta hybrid

leprechaunism

1 in 4 million births, associated with elfin-like facies, decreased subcutaneous adipose tissue, acanthosis nigricans, and growth retardation, failure to thrive, and early death, insulin resistance

Leriche’s syndrome

Aortoiliac occlusive disease producing distal ischemic symptoms and signs, e.g. pulseless femoral artery: 1. claudication of buttocks, 2. impotence, 3. atrophy of buttocks (seen with iliac occlusive disease)

Lesch-Nyan syndrome

A complete lack of hypoxanthine guanine phosphoribosyl transferase (HGPRT, involved in salvage pathway in purine synthesis), X-linked, hyperuricemia, severe neurologic deficits with mental retardation, self-mutilation, and in some cases gouty arthritis

Leser-Trélat sign

The sudden appearance and rapid increase in the number and size of seborrheic keratoses with pruritus; associated with internal malignancy

Letterer-Siwe disease

Acute disseminated Langerhans’ cell histocytosis; associated with development of cutaneous lesions that resemble a seborrheic eruption secondary to infiltrations of Langerhans’ histocytes over the front and back of the trunk and on the scalp; concurrent hepatosplenomegaly, lymphadenopathy, pulmonary lesions, and eventually destructive osteolytic bone lesions

Lev’s disease

fibrosis or calcification extending from cardiac fibrous structures into to the conduction system

Levine’s sign

When describing angina, defining the constricting discomfort with a clenched fist over sternum; q.v. angina for sens and spec; Samuel A. Levine, U.S. cardiologist, 1891-1966; designated hand movements 80% sens 49% spec; Levine sign itself 14% sens for cardiac pain (BMJ 1995;311:1660)

Levinthal paradox

magnitude of conformational search problem in protein folding; an unbiased search for all possible protein conformations would take a lifetime, yet proteins fold in microseconds to minutes

Lewy bodies

Eosinophilic intracytoplasmic bodies of alpha synuclein in neurons of substantia nigra and locus ceruleus present in Parkinson’s disease

Lewy body dementia

most common dementia associated with Parkinson’s disease characterized by Lewy bodies found in brain stem and cortex, visual hallucinations which may be exacerbated by the treatment for parkinsonism

Lhermitte’s sign

sudden electric-like shocks extending down the spine on flexing the head; may result from poseterior column lesion, toxic effects of radiation; (may be found in vitamin B₆ toxicity); (may be found in vitamin B₁₂ deficiency); seen in 3% of multiple sclerosis

Li-Fraumeni syndrome

Mutant p53 allele inherited, predisposition toward breast carcinomas, sarcomas, and brain tumors

Libman-Sacks disease

In systemic lupus erythematosus, intense mitral and tricuspid valvulitis with development of small, sterile vegetations

Lieberkühn, crypts of

intestinal glands found between villi

Light’s criteria

for separating transudate v. exudate; if at least one of the criteria is present, fluid virtually always an exudate: 1. pleural fluid/serum protein ratio > 0.5; 2. pleural fluid LDH/serum LDH ratio > 0.6; 3. pleural fluid LDH > 2/3 upper limit of normal serum LDH. Ann Intern Med 1972; 77:507

Lisch nodules

In type I neurofibromatosis, pigmented iris hamartomas

Lisker’s sign

in thrombophlebitis or DVT, tenderness to percussion of the medial anterior tibial surface

Lissauer’s tract

Small diameter primary sensory axons (presumably mediating pain and temperature senses) on their way into the dorsal horn

Litten’s sign

diaphragmatic movement seen on one side but not the other side in unilateral phrenic nerve palsy

Littre's hernia

Hernia involving a Meckel's diverticulum

Löffler’s syndrome

Simple pulmonary eosinophilia, characterized by transient pulmonary lesions, eosinophilia in the blood, and a benign clinical course; lungs show alveoli whose septa are thickened by an infiltrate composed of eosinophils and occasional interspersed giant cells, but there is no vasculitis, fibrosis, or necrosis; associated with ascaris, strongyloides

Löfgren’s syndrome

Sarcoidosis associated with erythema nodosum and fever and transient arthritis, bilateral hilar adenopathy; 10-15% of sarcoidosis present this way

Looser’s zones

Radiolucent narrow lines that lie either at right angles or obliquely to the cortical outlines of bones and often transect them; bilateral and symmetric, found at the axillary margins of the scapula, lower ribs, neck of the proximal femurs, and posterior regions of the proximal ulnas; related either to stress fractures or to mechanical erosion by penetrating nutrient arteries; aka Milkman’s fractures

Louis, angle of

Sternal angle

Louvel’s sign

in DVT, venous pain induced by coughing, prevented by pressing over proximal end of vein

Lovibond’s angle

The angle made by the proximal nail fold and the nail plate

Lowenberg’s sign

in DVT, two calves are wrapped with cuffs to see if there is assymetry in tolerance to pressure of 180 mm Hg

Löwenstein-Jensen’s medium

For growing out M. tuberculosis; contains malachite green, a triphenlyamine die like crystal violent, inhibits growth of unwanted organisms during 6 week incubation period as well as complex nutrients

Lown-Ganong-Levine syndrome

Enhanced AV node pathways

Ludwig’s angina

Aggressive infectious process of the submandibular, sublingual, and submental fascial spaces frequently occurring as a result of infection from 2nd and 3rd lower molar; 54% mortality in pre-antibiotic era, now 4% described in 1836 by Wilhelm Frederick von Ludwig

Lugol’s solution

Iodine and KI

Lund’s node

Lymph node found in Calot's triangle, aka Calot's node

Luschka, ducts of

Small tubular channels found buried within the gallbladder wall adjacent to the liver, communicates with the biliary tree, rarely patent accessory bile secretory ducts

Luschka, foramina of

Two laterally placed foramens exiting out of fourth ventricle

Lutembacher’s syndrome

Atrial septal defect with mitral stenosis; though mitral stenosis is often of rheumatic origin

Lynch syndrome I

AD produces multiple colon cancers 2 to 3 decades earlier, predilection for proximal colon; Lynch syndromes most common forms of familial colon cancer, 5-10% of all cases of colon cancer; better prognosis than sporadic colon cancer; deficiency in mismatch repair genes in 85% of Lynch syndromes

Lynch syndrome II

cancer family syndrome, all features of Lynch I with early onset of carcinoma at other sites including endometrium, ovaries, and stomach, also upper tract TCC

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From Andrew Yee, Harvard Med '00