classic presentation

Question 1

athlete with polycythemia

Answer 1

secondary to EPO injection

Question 2

back pain, fever, night sweats

Answer 2

Pott’s disease

Question 3

bone pain, bone enlargement, arthritis

Answer 3

Paget’s Disease of bone

Question 4

chest pain, pericardial effusion/friction rub, persistant fever following MI

Answer 4

Dressler Syndrome (autoimmune fibrinous pericarditis, weeks/months post MI)

Question 5

chest pain with ST depression

Answer 5

unstable angina (normal troponin), NSTEMI subendocardial infarct (elevated troponin)

Question 6

child with fever later develops red rash on face and then on body

Answer 6

erythema infectiosum - parvovirus B19

Question 7

chorioretinitis, hydrocephalus, intracranial calcification

Answer 7

congenital toxoplasmosis

Question 8

cutaneous/dermal edema due to connective tissue deposition

Answer 8

myxedema of hypothyroidism

pretibial myxedema of graves

Question 9

dog or cat bite infection

Answer 9

pasturella multocida cellulitis

Question 10

dysphagia/esophageal web, iron deficiency, glossitis

Answer 10

Plummer Vinson syndrome (increased risk esophageal SCC)

Question 11

erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cell

Answer 11

Mycosis fungiodes (cutaneaous T cell lymphoma)
Sezary syndrome (mycosis fungiodes with malignant T cells in blood

Question 12

fever, chills, headache, myalgia following Abx treatment for syphilis

Answer 12

Jarisch Herxheimer reaction - lysis of spirochete and endotoxin release

Question 13

fibrous plaque on penis and abnormal curvature

Answer 13

peyronie disease

Question 14

hyperphagia, hyperorality, hypersexuality, hyperdocility

Answer 14

Kluver Bucy syndrome (bilateral loss of amygdala)

Question 15

hypoxemia, polycythemia, hypercapnea

Answer 15

chronic bronchitis (blue bloater)

Question 16

infant with hypoglycemia and hepatomegaly

Answer 16

von gierke (glucose 6 phosphatase; severe), Cori disease (debranching enzyme; milder)

Question 17

jaundice, palpable distended, non tender gallbladder

Answer 17

Courvoisier sign - obstruction of biliary tree due to cancer of pancreatic head

Question 18

mucosal bleeding and prolonged BT

Answer 18

Glanzmann thrombasthemia (GPIIb/IIIa)

Question 19

multiple colon polyps, osteomas and soft tissue tumors, impacted/supernumerary teeth

Answer 19

Gardner syndrome (FAP subtype)

Question 20

painful blue fingers/toes, hemolytic anemia

Answer 20

cold agglutinins (mycoplasma, mononucleosis, CLL)

Question 21

painful, red raised lesion of pads of fingers and toes

Answer 21

Osler nodes (infectious endocarditis - immune complex deposition)

Question 22

painless erythematous lesion on palm/soles

Answer 22

Janeway lesion (infectious endocarditis- septic emboli/microabscess)

Question 23

pink complexion, dyspnea, hyperventiliation

Answer 23

emphysema

Question 24

polyuria, renal tubular acidosis type 2 (proximal), growth failure, electrolyte imbalance, hypophosphatemic rickets

Answer 24

Fanconi syndrome (non functioning proximal tubule)

Question 25

rash on palms, soles

Answer 25

coxsackie virus, secondary syphilis, RMSF

Question 26

recurrent cold abscess, unusual eczema, high IgE

Answer 26

Job hyper IgE (neutrophil chemotaxis abnormality)

Question 27

retinal hemorrhage with pale center

Answer 27

roth spot (bacterial endocarditis)

Question 28

severe RLQ on palpation of LLQ

Answer 28

Rovsing sign of acute appendicitis

Question 29

short stature, cafe au lait spot, thumb/radial defect, leukemia (AML), aplastic anemia

Answer 29

fanconi anemia (loss of cross link repair)

Question 30

smooth, moist, painless wart like lesion on genitals

Answer 30

condyloma lata of secondary syphilis

Question 31

swollen, hard painful finger joints

Answer 31

osteoarthritis (heberdens nodes - DIP; bouchard nodes-PIP)

Question 32

vascular birthmark (portwine stain) on face

Answer 32

nevus flammeus; normally benign unless associated with Sturge Weber

Question 33

weight loss, diarrhea, arthritis, fever, adenopathy

Answer 33

Whipple disease