Classic Presentations V

Question 1

Small, irregular red spots on buccal/lingual mucosa with blue-white centers

Answer 1

Koplik spots (measles, rubeola virus)

Question 2

Smooth, moist, painless, wart-like white lesions on genitals

Answer 2

Condylomata lata (2° syphilis)

Question 3

Splinter hemorrhages in feingernails

Answer 3

Bacterial endocarditis

Question 4

Strawberry tongue

Answer 4

Scarlet fever, Kawasaki disease

Question 5

Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lympedema

Answer 5

Turner syndrome (45, XO)

Question 6

Sudden swollen/painful big toe joint, tophi

Answer 6

Gout/odagra (hyperuricemia)

Question 7

Swollen gums, mucosal bleeding, poor wound healing, petechiae

Answer 7

Scurvy (vitamin C deficiency: Can’t hydroxylate proline/lysine for collagen synthesis)

Question 8

Swollen, hard, painful finger joints

Answer 8

Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP [Heberden nodes])

Question 9

Systolic ejection murmur (crescendo-decrescendo)

Answer 9

Aortic stenosis

Question 10

Telangiectasias, recurrent epistaxis, skin discoloration, arteriovenous malformations, GI bleeding, hematuria

Answer 10

Osler-Weber-Rendu syndrome

Question 11

Thyroid and parathyroid tumors, pheochromocytoma

Answer 11

MEN2A (Autosomal dominant RET mutation)

Question 12

Thyroid tumors, pheochromocytoma, ganglioneuromatosis

Answer 12

MEN2B (autosomal dominant RET mutation)

Question 13

Toe extension/fanning upon plantar scrape

Answer 13

Babinski sign (UMN Lesion)

Question 14

Unilateral facial drooping involving forehead

Answer 14

LMN facial nerve (CN VII) palsy; UMN lesions spare the forehead

Question 15

Urethritis, conjunctivitis, arthritis in a male

Answer 15

Reactive arthritis associated with HLA-B27

Question 16

Vascular birthmark (port-wine stain) on face

Answer 16

Nevus Flammeus (benign, but associated with Sturge-Weber syndrome)

Question 17

Vomiting blood following Gastroesophageal lacerations

Answer 17

Mallory-Weiss syndrome (alcoholic and bulimic patients)

Question 18

Weight loss, diarrhea, arthritis, fever, adenopathy

Answer 18

Whipple disease (Tropheryma whipplei)

Question 19

“Worst headache of my life.”

Answer 19

Subarachnoid hemorrhage