First Aid Classic Presentations Flashcards Preview

USMLE Step 1. > First Aid Classic Presentations > Flashcards

Flashcards in First Aid Classic Presentations Deck (132):
1

Abdominal pain, ascites, hepatomegaly

Budd-Chiari syndrome (posthepatic venous thrombosis)

2

Abdominal pain, diarrhea, leukocytosis, recent antibiotic use

C. Diff infection

3

Achilles tendon xanthoma

Familial hypercholesterolemia (low LDL receptor signaling)

4

Adrenal hemorrhage, hypotension, DIC

Waterhouse-Friderichsen syndrome (meningococcemia)

5

Anaphylaxis following blood transfusion

IgA deficiency

6

Anterior "drawer sign" (+)

ACL injury

7

Arachnodactyly, lens discoloration, aortic dissection, hyperflexible joints

Marfan

8

Athlete with polycythemia

secondary to erytropoietin injection

9

Back pain, fever, night sweats

Pott Disease (vertebral TB)

10

Bilateral acoustic schwannomas

Neurofibromatosis type 2

11

Bilateral hilar adenopathy, uveitis

Sarcoidosis (noncaseating granulomas)

12

Black eschar on face of patient with diabetic ketoacidosis

Mucor or Rhizopus fungal infection

13

Blue sclera

Osteogenesis imperfecta (type 1 collagen defect)

14

Bluish line on gingiva

Burton line (lead poisoning)

15

Bone pain, bone enlargement, arthritis

Paget Disease of bone (high osteoblastic and osteoclastic activity)

16

Bounding pulses, diastolic heart murmur, head bobbing

Aortic regurgitation

17

"Butterfly" facial rash and Raynaud phenomenon in a young female

SLE

18

Cafe-au-lait spots, Lisch nodules (iris hamartoma), cutaneous neurofibromas, pheochromocytomas, optic gliomas

Neurofibromatosis type 1

19

Cafe-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities

McCune-Albright syndrome (mosaic G protein signaling mutation)

20

Calf pseudohypertrophy

Muscular dystrophy (most commonly Duchenne, due to X-linked recessive frameshift mutation of dystrophin gene)

21

Cervical lymphadenopathy, desquamating rash, coronary aneurysms, red conjunctivae and tongue

Kawasaki disease (treat with IVIG and aspirin)

22

"Cherry red spots" on macula

Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion

23

"Cherry red spots" on macula

Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion

24

Chest pain on exertion

Angina (stable: with moderate exertion; unstable: with minimal exertion or rest)

25

Chest pain, pericardial effusion/friction rub, persistent fever following MI

Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2-12 weeks after acute episode)

26

Chest pain with ST elevation on EKG

Unstable angina (troponin -) or STEMI (troponin +)

27

Child uses arms to stand up from squat

Gowers sign (Duchenne MD)

28

Child with fever later develops red rash on face that spreads to body

"Slapped cheeks" (erythema infectiosum/fifth disease parvovirus B19)

29

Chorea, dementia, caudate dengeration

Huntington Disease (autosomal dominant CAG repeat expansion)

30

Chrioretinitis, hydrocephalus, intracranial calcifications

Congenital toxoplasmosis

31

Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria

McArdle disease (skeltal muscle glycogen phosphorylase deficiency)

32

Cold intolerance

Hypothyroidism

33

Conjugate horizontal gaze palsy, horizontal diplopia

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

34

Continuous "machine-like" heart murmur

PDA (close with indomethacin; open or maintain with PGE analogs)

35

Cutaneous/dermal edema due to connective tissue deposition

Myxedema (caused by hypothyroidism, Graves disease [pretibial])

36

Cutaneous flushing, diarrhea, bronchospasm

Carcinoid syndrome (right-sided cardiac valvular lesions, High 5-HIAA)

37

Dark purple skin/mouth nodules in a patient with AIDS

Kaposi sarcoma, associated with HHV-8

38

Dark purple skin/mouth nodules in a patient with AIDS

Kaposi sarcoma, associated with HHV-8

39

Deep, labored breathing/hyperventilation

Kussmaul respirations (DKA)

40

Dermatitis, dementia, diarrhea

Pellagra (niacin [B3] deficiency)

41

Dilated cardiomyopathy, edema, alcoholism or malnutrition

Wet beriberi (thiamine [B1] deficiency)

42

Dog or cat bite resulting in infection

Pasteurella multocida (cellulits at inoculation site)

43

Dry eyes, dry mouth, arthritis

Sjorgen syndrome (autoimmune destruction of exocrine glands)

44

Dysphagia (esophageal webs), glossitis, iron deficiency anemia

Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)

45

Elastic skin, hypermobility of joints, higher bleeding tendency

Ehlers-Danlos syndrome (type 5 collagen defect, type III collagen defect seen in vascular subtype)

46

Enlarged, hard left supraclavicular node

Virchow node (abdominal metastasis)

47

Episodic vertigo, tinnitus, hearing loss

Meniere disease

48

Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells

Mycosis fungoides (cutaneous T cell lymphoma) or Sezary syndrome (mycosis fungoides + malignant T cells in blood)

49

Facial muscle spasm upon tapping

Chvostek sign (hypocalcemia)

50

Fat, female, forty, and fertile

Cholelithiasis (gallstones)

51

Fever, chills, HA, myalgia following antibiotic tx for syphillus

Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in endotoxin release)

52

Fever, cough, conjunctivitis, coryza, diffuse rash

Measles

53

Fever, night sweats, weight loss

B symptoms (staging) of lymphoma

54

Fibrous plaques in soft tissue of penis with abnormal curvature

Peyronie disease (connective tissue disorder)

55

Golden brown rings around peripheral cornea

Kayser-Fleischer rings (copper accumulations from Wilson Disease)

56

Gout, intellectual disability, self-mutilating behavior in a boy

Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)

57

Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands/genitalia

Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; higher cancer risk, mainly GI)

58

Hepatosplenomegaly, pancytopenia, osteoporosis, aseptic necrosis of femur, bone crises

Gaucher disease (glucocerbrosidase deficiency)

59

Hereditary nephritis, sensorineural hearing loss, cataracts

Alport syndrome (mutation in collagen IV)

60

Hyperphagia, hypersexuality, hyperorality, hyperdocility

Kluver-Bucy syndrome (bilateral amygdala lesion)

61

Hyperreflexia, hypertonia, Babinski present

UMN damage

62

Hyporeflexia, hypotonia, atrophy, fasiculations

LMN damage

63

Hypoxemia, polycythemia, Hypercapnia

"Blue bloater" (chronic bronchitis; hyperplasia of mucous cells)

64

Indurated, ulcerated genital lesion

Nonpain: chancre (primary syphilis, Treponema pallidum)
Painful,with exudate: chancroid (haemophilus ducreyi)

65

Infant with "cherry red" spot on macula, hepatosplenomegaly, and neurodegeneration

Niemann-Pick disease (genetic sphingomyelinase deficiency)

66

Infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia

Patau (trisomy 13)

67

Infant with hypoglycemia, hepatomegaly

Cori disease (debranching enzyme deficiency) or Von Gierke disease (G6P deficiency, more severe)

68

Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect

Edwards (trisomy 18)

69

Jaundice, palpable distended non-tender gallbladder

Courvoisier sign (distal obstruction of biliary tree)

70

Large rash with bulls-eye appearance

Erythema chronicum migrans from Ixodes tick bite (Lyme disease: Borrelia)

71

Lucid interval after traumatic brain injury

Epidural hematoma (Middle meningeal artery rupture)

72

Male child, recurrent infections, no mature B cells

Bruton disease (X-linked agammaglobulinemia)

73

Male child, recurrent infections, no mature B cells

Bruton disease (X-linked agammaglobulinemia)

74

Mucosal bleeding and prolonged bleeding time

Glanzmann thrombasthenia (defect in platelet aggregation due to lack of Gp2b/3a)

75

Muffled heart sounds, distended neck veins, hypotension

Beck triad of cardiac tamponade

76

Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth

Gardner syndrome (subtype of FAP)

77

Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance

Pompe disease (lysosomal alpha-1,4-glucosidase deficiency)

78

Neonate with arm paralysis following difficult birth

Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip")

79

No lactation postpartum, absent menstruation, cold intolerance

Sheehan syndrome (pituitary infarction)

80

Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia

MS

81

Painful blue fingers/toes, hemolytic anemia

Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis, CLL)

82

Painful fingers/toes changing color from blue to white to red with cold or stress

Raynaud phenomenon (vasospasm in extremities)

83

Painful, raised red lesions on pads of fingers/toes

Osler nodes (infective endocarditis, immune complex deposition)

84

Painless erythematous lesions on palms and soles

Janeway lesions (infective endocarditis, septic emboli/microabscesses)

85

Painless jaundice

Cancer of the pancreatic head obstructing bile duct

86

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

Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)

87

Pancreatic, pituitary, parathyroid tumors

MEN 1 (autosomal dominant)

88

Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia

Nephrotic syndrome

89

Pink complexion, dyspnea, hyperventilation

"Pink Puffer" (emphysema: centriacinar [smoking], panacinar [alpha1-antitrypsin deficiency])

90

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

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

91

Pruritic, purple, polygonal planar papules and plaques (6 Ps)

Lichen planus

92

Ptosis, miosis, anhidrosis

Horner syndrome (sympathetic chain lesion)

93

Pupil accommodates but doesn't react

Argyll Robertson pupil (neurosyphilus)

94

Pupil accommodates but doesn't react

Argyll Robertson pupil (neurosyphilus)

95

Rapidly progressive limb weakness that ascends following GI/upper respiratory infection

Guillain-Barre syndrome (acute inflammatory demyelinating polyradiculopathy subtype)

96

Rash on palms and soles

Coxsackie A, Secondary syphilus, Rocky Mountain Spotted Fever

97

Reccurent cold (noninflamed) abscesses, unusual eczema, high serum IgE

Hyper-IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)

98

Red "currant jelly" sputum in alcoholic or diabetic patients

Klebsiella pneumoniae pneumonia

99

Red "currant jelly" stools

Acute mesenteric ischemia (adults), intussusception (children)

100

red, itchy, swollen rash of nipple/areola

Paget disease of the breast (sign of underlying neoplasm)

101

Red urine in the morning, fragile RBCs

Paroxysmal nocturnal hemoglobinuria

102

Renal cell carcinoma (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma

von Hippel-Lindau disease (dominant tumor suppressor gene mutation)

103

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

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

104

Retinal hemorrhages with pale centers

Roth spots (bacterial endocarditis)

105

Severe jaundice in neonate

Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)

106

Severe RLQ pain with palpation of LLQ

Rovsing sign (acute appendicitis)

107

Severe RLQ pain with rebound tenderness

McBurney sign (acute appendicitis)

108

Short stature, cafe-au-lait spots, thumb/radial defects, high incidence of tumors/leukemia, aplastic anemia

Fanconi anemia (genetic loss of DNA crosslink repair; often progresses to AML)

109

Single palmar crease

Down syndrome

110

Situs inversus, chronic sinusitis, bronchiectasis, infertility

Kartagener syndrome (dynein arm defect affecting cilia)

111

Skin hyperpigmentation, hypotension, fatigue

primary adrenocortical insufficiency (Addison disease) causes high ACTH and high alpha-MSH production

112

Slow, progressive muscle weakness in boys

Becker MD (X linked missense mutation in dystrophin; less severe than duchenne MD)

113

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

Koplik spots (measles; rubeola virus)

114

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

Condylomata lata (secondary syphilis)

115

Splinter hemorrhages in fingernails

Bacterial endocarditis

116

"Strawberry" tongue

Scarlet fever, Kawasaki disease

117

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

Turner Syndrome (45, XO)

118

Sudden swollen/painful big toe joint, tophi

Gout/podagra (hyperuricemia)

119

Swollen gums, mucosal bleeding, poor wound healing, petechiae

Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis)

120

Systolic ejection murmur (crescendo-decrescendo)

Aortic stenosis

121

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

Osler-Weber-Rendu sydnrome

122

Thyroid and parathyroid tumors, pheochromocytoma

MEN 2A (autosomal dominant RET mutation)

123

Thyroid tumors, pheochromocytoma, ganglioneuromatosis

MEN 2B (autosomal dominant RET mutation)

124

Toe extension/fanning upon plantar scrape

Babinksy sign (UMN lesion)

125

Unilateral facial drooping involving forehead

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

126

Urethritis, conjunctivitis, arthritis in a male

Reactive arthritis associated with HLA-B27

127

Vascular birthmark (port wine stain) of the face

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

128

Vomiting blood following gastroesophageal lacerations

Mallory-Weiss syndrome (alcoholic and bulimic patients)

129

Weight loss, diarrhea, arthritis, fever, adenopathy

Whipple disease (Tropheryma whipplei)

130

"worst headache of my life"

Subarachnoid hemorrhage

131

"worst headache of my life"

Subarachnoid hemorrhage

132

Swollen, hard painful finger joints

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