Classic Presentations part 5 Flashcards

1
Q

Neonate with arm paralysis following difficult birth, arm

in “waiter’s tip” position

A

Erb-Duchenne palsy (superior trunk [C5–C6] brachial plexus injury)

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2
Q

Anterior drawer sign ⊕

A

Anterior cruciate ligament injury

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3
Q

Bone pain, bone enlargement, arthritis

A

Osteitis deformans (Paget disease of bone, osteoblastic and osteoclastic activity)

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4
Q

Swollen, hard, painful finger joints in an elderly individual, pain worse with activity

A

Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP

[Heberden nodes])

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5
Q

Sudden swollen/painful big toe joint, tophi

A

Gout/podagra (hyperuricemia)

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6
Q

Dry eyes, dry mouth, arthritis

A

Sjögren syndrome (autoimmune destruction of exocrine glands)

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7
Q

Urethritis, conjunctivitis, arthritis in a male

A

Reactive arthritis associated with HLA-B27

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8
Q

“Butterfly” facial rash, arthritis, cytopenia, and fever in a young female

A

Systemic lupus erythematosus

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9
Q

Cervical lymphadenopathy, desquamating rash, coronary aneurysms, red conjunctivae and tongue, hand-foot changes
Most common in Asian children

A

Kawasaki disease (mucocutaneous lymph node syndrome, treat with IVIG and aspirin)

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10
Q

Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria

A

Immunoglobulin A vasculitis (Henoch-Schönlein purpura, affects skin and kidneys)

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11
Q

Painful fingers/toes changing color from white to blue to

red with cold or stress

A

Raynaud phenomenon (vasospasm in extremities)

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12
Q

Dark purple skin/mouth nodules in a patient with AIDS

A

Kaposi sarcoma, associated with HHV-8

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13
Q

Pruritic, purple, polygonal planar papules and plaques

6 P’s

A

Lichen planus

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14
Q

Ataxia, nystagmus, vertigo, dysarthria

A

Cerebellar lesion (lateral affects voluntary movement of extremities; medial affects axial and proximal movement)

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15
Q

Dorsiflexion of large toe with fanning of other toes upon

plantar scrape

A

Babinski sign (UMN lesion)

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16
Q

Hyperphagia, hypersexuality, hyperorality

A

Klüver-Bucy syndrome (bilateral amygdala lesion)

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17
Q

Resting tremor, athetosis, chorea

A

Basal ganglia lesion

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18
Q

Lucid interval after traumatic brain injury

A

Epidural hematoma (middle meningeal artery rupture; branch of maxillary artery)

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19
Q

“Worst headache of my life”

A

Subarachnoid hemorrhage

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20
Q

Dysphagia, hoarseness, gag reflex, nystagmus, ipsilateral Horner syndrome

A

Lateral medullary syndrome (posterior inferior cerebellar

artery lesion)

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21
Q

Resting tremor, rigidity, akinesia, postural instability, shuffling gait, micrographia

A

Parkinson disease (loss of dopaminergic neurons in substantia nigra pars compacta)

22
Q

Chorea, dementia, caudate degeneration

A

Huntington disease (autosomal dominant CAG repeat expansion)

23
Q

Urinary incontinence, gait apraxia, cognitive dysfunction

A

Normal pressure hydrocephalus

24
Q

Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia

A

Multiple sclerosis

25
Q

Rapidly progressive limb weakness that ascends following

GI/upper respiratory infection

A

Guillain-Barré syndrome (acute inflammatory

demyelinating polyneuropathy)

26
Q

Café-au-lait spots, Lisch nodules (iris hamartoma),

cutaneous neurofibromas, pheochromocytomas, optic gliomas

A

Neurofibromatosis type I

27
Q

Vascular birthmark (port-wine stain) of the face

A

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

28
Q

Renal cell carcinoma (bilateral), hemangioblastomas,

angiomatosis, pheochromocytoma

A

von Hippel-Lindau disease (deletion of VHL gene on

chromosome 3p)

29
Q

Bilateral vestibular schwannomas

A

Neurofibromatosis type 2

30
Q

Hyperreflexia, hypertonia, Babinski sign present

A

UMN damage

31
Q

Flaccid limb weakness, fasciculations, atrophy, bulbar palsy

A

UMN and LMN deficits

32
Q

Hyporeflexia, hypotonia, atrophy, fasciculations

A

LMN damage

33
Q

Staggering gait, frequent falls, nystagmus, hammer toes, diabetes mellitus, hypertrophic cardiomyopathy

A

Friedreich ataxia

34
Q

Unilateral facial drooping involving forehead

A

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

35
Q

Episodic vertigo, tinnitus, sensorineural hearing loss

A

Ménière disease

36
Q

Ptosis, miosis, anhidrosis

A

Horner syndrome (sympathetic chain lesion)

37
Q

Conjugate horizontal gaze palsy, horizontal diplopia

A

Internuclear ophthalmoplegia (damage to MLF; may be unilateral or bilateral)

38
Q

“Waxing and waning” level of consciousness (acute onset), decreased attention span, decreased level of arousal

A

Delirium (usually 2° to other cause)

39
Q

Polyuria, renal tubular acidosis type II, growth retardation, electrolyte imbalances, hypophosphatemic rickets

A
Fanconi syndrome (multiple combined dysfunction of the
proximal convoluted tubule)
40
Q

Periorbital and/or peripheral edema, proteinuria (> 3.5g/

day), hypoalbuminemia, hypercholesterolemia

A

Nephrotic syndrome

41
Q

Hereditary nephritis, sensorineural hearing loss, retinopathy, lens dislocation

A

Alport syndrome (mutation in type IV collagen)

42
Q

Wilms tumor, macroglossia, organomegaly,

hemihyperplasia, omphalocele

A

Beckwith-Wiedemann syndrome (WT2 mutation)

43
Q

Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma, short stature, webbed neck, lymphedema

A

Turner syndrome (45,XO)

44
Q

Red, itchy, swollen rash of nipple/areola

A

Paget disease of the breast (sign of underlying neoplasm)

45
Q

Ovarian fibroma, ascites, pleural effusion

A

Meigs syndrome

46
Q

Fibrous plaques in tunica albuginea of penis with

abnormal curvature

A

Peyronie disease (connective tissue disorder)

47
Q

Fibrous plaques in tunica albuginea of penis with abnormal curvature

A

Peyronie disease (connective tissue disorder)

48
Q

Hypoxemia, polycythemia, hypercapnia

A
Chronic bronchitis (hypertrophy and hyperplasia of
mucous cells, “blue bloater”)
49
Q

Pink complexion, dyspnea, hyperventilation

A

Emphysema (“pink puffer,” centriacinar [smoking] or panacinar [α1-antitrypsin deficiency])

50
Q

Bilateral hilar adenopathy, uveitis

A

Sarcoidosis (noncaseating granulomas)