The primary reason for the utilization of any screening exam should be that the procedure detects the premature stages of a pathologic condition and allows for early intervention, thereby preventing unnecessary morbidity or mortality, before any clinical signs or symptoms of the disease. For the detection of prostate cancer, an elevated serum prostate-specific antigen is the most common laboratory abnormality, as the majority of men with early prostate cancer have no symptoms. However, prostate-specific antigen, otherwise known as PSA, is clinically imprecise as benign and malignant processes both, can elevate the serum marker. Despite the risks and benefits of serum PSA screening, it is the most useful tool available for the detection of early prostate cancer, giving affected individuals the best chance for cure.Quincke’s sign, also known as Quincke’s pulse, represents the visualization of capillary pulsations upon light compression applied to the tip of the fingernail bed. It is an eponym associated with chronic severe aortic insufficiency. A patient exhibiting this sign will have alternating reddening and blanching of the nailbed with each pulsation. This sign can be further enhanced with the use of illumination.Radial club hand is a term describing a group of complex congenital malformations of the radial side of the forearm. It comprises a spectrum of conditions that varies widely from thumb hypoplasia to an absent radius and first ray and includes hypoplasia of the associated muscles, ligaments, tendons, nerves, and blood vessels. Other terms that refer to the same condition are radial dysplasia, radial longitudinal deficiency, and radial ray deficiency. Jean-Louis Petit described the first case of radial club hand in 1733, who documented a case of a newborn male with bilateral absent radii. Kato, in 1923 reviewed 250 cases of radial clubhand and can be considered the first attempt at a comprehensive study of the condition.Cafe-au-lait macules (CALMs) are common hyperpigmented and flat skin lesions found in the general population. They are usually present at birth (congenital) or occur early in life. They may grow in number and size with age. The color varies from light brown to dark brown, and they may be present on any body parts, but the most common location is the trunk and the extremities. The term cafe-au-lait is a French word meaning "coffee with milk." There are two main types of CALMs. CALMs with regular and clearly demarcated margins ("coast of California"), which is more common. They range in size from a few millimeters to several centimeters (>20cm) and may be present as solitary or multiple spots. The second type of CALM has an irregular margin ("coast of Maine"), which is less common and is usually larger and solitary. The "coast of Maine" pattern is seen in a segmental pigmentary disorder, while the "coast of California" pattern is seen neurofibromatosis 1 (NF1) and related conditions. CALMs are seen in 95% of patients with NF1. Although solitary CALMs are common in the general population and are familial and inherited as autosomal dominant, multiple spots accompanied by other manifestations may indicate an underlying genetic disorder, and they require further evaluation. A family history of CALMs should be evaluated in any patient with multiple CALMs.To make clinical decisions and guide patient care, providers must comprehend the likelihood for a patient to have a disease, combining an understanding of pretest probability and diagnostic assessments. Diagnostic tools are routinely utilized in healthcare settings to determine treatment methods; however, many of these tools are subject to error.The umbilical cord is the vital connection between the fetus and the placenta. Umbilical cord development begins in the embryologic period around week 3 with the formation of the connecting stalk. By week 7, the umbilical cord has fully formed, composed of the connecting stalk, vitelline duct, and umbilical vessels surrounding by the amniotic membrane. The umbilical vessels carry the fetal blood back and forth to the placenta with the umbilical vein carrying oxygenated blood with nutrients from the placenta to the fetus and the umbilical arteries carrying deoxygenated blood with waste products from the fetus to the placenta. Embryonic structures regress near the end of the first trimester, leaving the umbilical cord composed of two umbilical arteries and one umbilical vein surrounding by a gelatinlike extracellular matrix known as Wharton’s jelly. Elongation of the umbilical cord occurs primarily in the second trimester. The average umbilical cord is 50 to 60 centimeters in length, 2 centimeters in diameter, with up to 40 helical turns. Abnormalities of the umbilical cord can lead to increased morbidity and mortality of the fetus.Howell-Jolly bodies are nuclear remnants found in red blood cells (erythrocytes) under various pathological states. read more They most commonly present in patients with absent or impaired function of the spleen; this is because one of the spleen’s functions is to filter deranged blood cells and remove the intracellular inclusions left by the erythrocyte precursors. William Howell and Justin Jolly in the early 1900s first discovered them in the early 1900s.Rifampin is an antibacterial agent active against many gram-positive cocci, Mycobacteria, Clostridium difficle, and select gram-negative organisms, namely Neisseria meningitides, N. gonorrhoeae, and Hemophilus influenzae. Clinically, rifampin is recommended for infections where the disease-causing organisms are identified, their drug susceptibility determined, and it is used in combination with other antimicrobial agents to prevent the drug resistance. It is used for the treatment of active/latent tuberculosis (TB), leprosy, and severe gram-positive bacterial infections like osteomyelitis, endocarditis, brain abscess, meningitis, and implant infections in combinations with other antimicrobial agents. Prophylactically, it is used for the prevention of TB, Meningococcal infections in high-risk groups like close contacts, history of travel to endemic areas, and Hemophilus influenzae carriers who can transmit the infection to children less than four years. It is also beneficial as a second-line agent for the treatment of cholestatic pruritis.