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USMLE Reviewers > First Aid USMLE 1 - Rapid Review Common Presentations > Flashcards

First Aid USMLE 1 - Rapid Review Common Presentations Flashcards

1
Q

Abdominal pain, ascites, hepatomegaly

A

Budd-Chiari syndrome (posthepatic venous thrombosis)

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2
Q

Achilles tendon xanthoma

A

Familial hypercholesterolemia ( LDL receptor signaling)

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3
Q

Adrenal hemorrhage, hypotension, DIC

A

Waterhouse-Friderichsen syndrome (meningococcemia)

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4
Q

Arachnodactyly, lens dislocation, aortic dissection,

hyperflexible joints

A

Marfan syndrome (fibrillin defect)

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5
Q

Athlete with polycythemia

A

2° to erythropoietin injection

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6
Q

Back pain, fever, night sweats, weight loss

A

Pott disease (vertebral TB)

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7
Q

Bilateral hilar adenopathy, uveitis

A

Sarcoidosis (noncaseating granulomas)

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8
Q

Blue sclera

A

Osteogenesis imperfecta (type I collagen defect)

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9
Q

Bluish line on gingiva

A

Burton line (lead poisoning)

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10
Q

Bone pain, bone enlargement, arthritis

A

Paget disease of bone ( osteoblastic and osteoclastic activity)

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11
Q

Bounding pulses, diastolic heart murmur, head bobbing

A

Aortic regurgitation

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12
Q

“Butterfly” facial rash and Raynaud phenomenon in a young female

A

Systemic lupus erythematosus

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13
Q

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

A

Neurofibromatosis type I (+ pheochromocytoma, optic

gliomas)

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14
Q

Café-au-lait spots, polyostotic fibrous dysplasia, precocious
puberty, multiple endocrine abnormalities

A

McCune-Albright syndrome (mosaic G-protein signaling

mutation)

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15
Q

Calf pseudohypertrophy

A 
Muscular dystrophy (most commonly Duchenne): X-linked
recessive deletion of dystrophin gene
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16
Q

“Cherry-red spots” on macula

A

Tay-Sachs (ganglioside accumulation) or Niemann-Pick

(sphingomyelin accumulation), central retinal artery occlusion

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17
Q

Chest pain on exertion

A

Angina (stable: with moderate exertion; unstable: with

minimal exertion)

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18
Q

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

A

Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1–12 weeks after acute episode)

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19
Q

Child uses arms to stand up from squat

A

Gowers sign (Duchenne muscular dystrophy)

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20
Q

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

A

“Slapped cheeks” (erythema infectiosum/fifth disease:

parvovirus B19)

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21
Q

Chorea, dementia, caudate degeneration

A 
Huntington disease (autosomal dominant CAG repeat
expansion)
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22
Q

Chronic exercise intolerance with myalgia, fatigue, painful

cramps, myoglobinuria

A

McArdle disease (muscle glycogen phosphorylase deficiency)

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23
Q

Cold intolerance

A

Hypothyroidism

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24
Q

Conjugate lateral gaze palsy, horizontal diplopia

A 
Internuclear ophthalmoplegia (damage to MLF; bilateral
[multiple sclerosis], unilateral [stroke])
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25
Q

Continuous “machine-like” heart murmur

A

PDA (close with indomethacin; open or maintain with

misoprostol)

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26
Q

Dark purple skin/mouth nodules in a patient with AIDS

A

Kaposi sarcoma, associated with HHV-8

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27
Q

Deep, labored breathing/hyperventilation

A

Kussmaul respirations (diabetic ketoacidosis)

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28
Q

Dermatitis, dementia, diarrhea

A

Pellagra (niacin [vitamin B3] deficiency)

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29
Q

Dilated cardiomyopathy, edema, alcoholism or malnutrition

A

Wet beriberi (thiamine [vitamin B1] deficiency)

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30
Q

Dog or cat bite resulting in infection

A

Pasteurella multocida (cellulitis at inoculation site)

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31
Q

Dry eyes, dry mouth, arthritis

A

Sjögren syndrome (autoimmune destruction of exocrine

glands)

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32
Q

Dysphagia (esophageal webs), glossitis, iron deficiency

anemia

A

Plummer-Vinson syndrome (may progress to esophageal

squamous cell carcinoma)

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33
Q

Elastic skin, hypermobility of joints

A

Ehlers-Danlos syndrome (type III collagen defect)

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34
Q

Enlarged, hard left supraclavicular node

A

Virchow node (abdominal metastasis)

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35
Q

Erythroderma, lymphadenopathy, hepatosplenomegaly,

atypical T cells

A 
Mycosis fungoides (cutaneous T-cell lymphoma) or Sézary
syndrome (mycosis fungoides + malignant T cells in blood)
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36
Q

Facial muscle spasm upon tapping

A

Chvostek sign (hypocalcemia)

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37
Q

Fat, female, forty, and fertile

A

Cholelithiasis (gallstones)

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38
Q

Fever, chills, headache, myalgia following antibiotic

treatment for syphilis

A

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

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39
Q

Cutaneous/dermal edema due to connective tissue deposition

A

Myxedema (caused by hypothyroidism, Graves disease

[pretibial])

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40
Q

Fever, cough, conjunctivitis, coryza, diffuse rash

A

Measles

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41
Q

Fever, night sweats, weight loss

A

B symptoms (staging) of lymphoma

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42
Q

Fibrous plaques in soft tissue of penis

A

Peyronie disease (connective tissue disorder)

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43
Q

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

A

Lesch-Nyhan syndrome (HGPRT deficiency, X-linked

recessive)

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44
Q

Green-yellow rings around peripheral cornea

A

Kayser-Fleischer rings (copper accumulation from Wilson

disease)

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45
Q

Hamartomatous GI polyps, hyperpigmentation of

mouth/feet/hands

A

Peutz-Jeghers syndrome (inherited, benign polyposis can

cause bowel obstruction;  cancer risk, mainly GI)

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46
Q

Hepatosplenomegaly, osteoporosis, neurologic

symptoms

A

Gaucher disease (glucocerebrosidase deficiency)

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47
Q

Indurated, ulcerated genital lesion

A

Nonpainful: chancre (1° syphilis, Treponema pallidum)

Painful, with exudate: chancroid (Haemophilus ducreyi)

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48
Q

Hereditary nephritis, sensorineural hearing loss,

cataracts

A

Alport syndrome (mutation in collagen IV)

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49
Q

Hyperphagia, hypersexuality, hyperorality,

hyperdocility

A

Klüver-Bucy syndrome (bilateral amygdala lesion)

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50
Q

Hyperreflexia, hypertonia, Babinski sign present

A

UMN damage

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51
Q

Hyporeflexia, hypotonia, atrophy, fasciculations

A

LMN damage

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52
Q

Hypoxemia, polycythemia, hypercapnia

A

“Blue bloater” (chronic bronchitis: hyperplasia of mucous

cells)

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53
Q

Infant with cleft lip/palate, microcephaly or

holoprosencephaly, polydactyly, cutis aplasia

A

Patau syndrome (trisomy 13)

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54
Q

Infant with failure to thrive, hepatosplenomegaly, and

neurodegeneration

A

Niemann-Pick disease (genetic sphingomyelinase deficiency)

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55
Q

Infant with hypoglycemia, failure to thrive, and hepatomegaly

A

Cori disease (debranching enzyme deficiency) or Von Gierke disease (glucose-6-phosphatase deficiency, more severe)

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56
Q

Infant with microcephaly, rocker-bottom feet, clenched

hands, and structural heart defect

A

Edwards syndrome (trisomy 18)

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57
Q

Jaundice, palpable distended non-tender gallbladder

A

Courvoisier sign (distal obstruction of biliary tree)

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58
Q

Large rash with bull’s-eye appearance

A

Erythema chronicum migrans from Ixodes tick bite (Lyme

disease: Borrelia)

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59
Q

Lucid interval after traumatic brain injury

A 
Epidural hematoma (middle meningeal artery
rupture)
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60
Q

Male child, recurrent infections, no mature B cells

A

Bruton disease (X-linked agammaglobulinemia)

61
Q

Mucosal bleeding and prolonged bleeding time

A 
Glanzmann thrombasthenia (defect in platelet aggregation
due to lack of GpIIb/IIIa)
62
Q

Muffled heart sounds, distended neck veins, hypotension

A

Beck triad of cardiac tamponade

63
Q

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

A

Gardner syndrome (subtype of FAP)

64
Q

Myopathy (infantile hypertrophic cardiomyopathy), exercise

intolerance

A

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

65
Q

Neonate with arm paralysis following difficult birth

A

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

injury: “waiter’s tip”)

66
Q

No lactation postpartum, absent menstruation, cold

intolerance

A

Sheehan syndrome (pituitary infarction)

67
Q

Nystagmus, intention tremor, scanning speech, bilateral

internuclear ophthalmoplegia

A

Multiple sclerosis

68
Q

Oscillating slow/fast breathing

A

Cheyne-Stokes respirations (central apnea in CHF or

 intracranial pressure)

69
Q

Painful blue fingers/toes, hemolytic anemia

A

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

70
Q

Painful, pale, cold fingers/toes

A

Raynaud phenomenon (vasospasm in extremities)

71
Q

Painful, raised red lesions on pad of fingers/toes

A 
Osler nodes (infective endocarditis, immune complex
deposition)
72
Q

Painless erythematous lesions on palms and soles

A 
Janeway lesions (infective endocarditis, septic emboli/
microabscesses)
73
Q

Painless jaundice

A

Cancer of the pancreatic head obstructing bile duct

74
Q

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

A

Henoch-Schönlein purpura (IgA vasculitis affecting skin and

kidneys)

75
Q

Pancreatic, pituitary, parathyroid tumors

A

MEN 1 (autosomal dominant)

76
Q

Periorbital and/or peripheral edema, proteinuria,

hypoalbuminemia, hypercholesterolemia

A

Nephrotic syndrome

77
Q

Pink complexion, dyspnea, hyperventilation

A

“Pink puffer” (emphysema: centriacinar [smoking], panacinar

[α1-antitrypsin deficiency])

78
Q

Polyuria, renal tubular acidosis type II, growth failure,

electrolyte imbalances, hypophosphatemic rickets

A

Fanconi syndrome (proximal tubular reabsorption defect)

79
Q

Pruritic, purple, polygonal planar papules and plaques (6 P’s)

A

Lichen planus

80
Q

Ptosis, miosis, anhidrosis

A

Horner syndrome (sympathetic chain lesion)

81
Q

Pupil accommodates but doesn’t react

A

Argyll Robertson pupil (neurosyphilis)

82
Q

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

A

Guillain-Barré syndrome (acute autoimmune inflammatory

demyelinating polyneuropathy)

83
Q

Single palmar crease

A

Down syndrome

84
Q

Short stature,  incidence of tumors/leukemia, aplastic

anemia

A

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

85
Q

Severe RLQ pain with rebound tenderness

A

McBurney sign (acute appendicitis)

86
Q

Severe RLQ pain with palpation of LLQ

A

Rovsing sign (acute appendicitis)

87
Q

Severe jaundice in neonate

A

Crigler-Najjar syndrome (congenital unconjugated

hyperbilirubinemia)

88
Q

Retinal hemorrhages with pale centers

A

Roth spots (bacterial endocarditis)

89
Q

Rash on palms and soles

A

Coxsackie A, 2° syphilis, Rocky Mountain spotted fever

90
Q

Resting tremor, rigidity, akinesia, postural instability

A

Parkinson disease (nigrostriatal dopamine depletion)

91
Q

Renal cell carcinoma (bilateral), hemangioblastomas,

angiomatosis, pheochromocytoma

A

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

92
Q

Red “currant jelly” sputum in alcoholic or diabetic patients

A

Klebsiella pneumoniae

93
Q

Red “currant jelly” stools

A

Acute mesenteric ischemia (adults), intussusception (infants)

94
Q

Red urine in the morning, fragile RBCs

A

Paroxysmal nocturnal hemoglobinuria

95
Q

Red, itchy, swollen rash of nipple/areola

A

Paget disease of the breast (sign of underlying neoplasm)

96
Q

Recurrent colds, unusual eczema, high serum

A

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

97
Q

Situs inversus, chronic sinusitis, bronchiectasis, infertility

A

Kartagener syndrome (dynein arm defect affecting cilia)

98
Q

“Worst headache of my life”

A

Subarachnoid hemorrhage

99
Q

Weight loss, diarrhea, arthritis, fever, adenopathy

A

Whipple disease (Tropheryma whipplei)

100
Q

Vomiting blood following gastroesophageal lacerations

A

Mallory-Weiss syndrome (alcoholic and bulimic patients)

101
Q

Vascular birthmark (port-wine stain)

A

Hemangioma (benign, but associated with Sturge-Weber syndrome)

102
Q

Urethritis, conjunctivitis, arthritis in a male

A

Reactive arthritis associated with HLA-B27 (Reiter’s syndrome)

103
Q

Unilateral facial drooping involving forehead

A

Facial nerve (LMN CN VII palsy)

104
Q

Toe extension/fanning upon plantar scrape

A

Babinski sign (UMN lesion)

105
Q

Thyroid tumors, pheochromocytoma, ganglioneuromatosis

A

MEN 2B (autosomal dominant ret mutation)

106
Q

Thyroid and parathyroid tumors, pheochromocytoma

A

MEN 2A (autosomal dominant ret mutation)

107
Q

Skin hyperpigmentation, hypotension, fatigue

A 
Addison disease (1° adrenocortical insufficiency causes
 ACTH and  α-MSH production)
108
Q

Systolic ejection murmur (crescendo-decrescendo)

A

Aortic valve stenosis

109
Q

Swollen, hard, painful finger joints

A

Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP

[Heberden nodes])

110
Q

Swollen gums, mucosal bleeding, poor wound healing,

petechiae

A

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

111
Q

Sudden swollen/painful big toe joint, tophi

A

Gout/podagra (hyperuricemia)

112
Q

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

A

Turner syndrome (45,XO)

113
Q

“Strawberry tongue”

A

Scarlet fever, Kawasaki disease, toxic shock syndrome

114
Q

Splinter hemorrhages in fingernails

A

Bacterial endocarditis

115
Q

Smooth, flat, moist, painless white lesions on genitals

A

Condylomata lata (2° syphilis)

116
Q

Slow, progressive muscle weakness in boys

A

Becker muscular dystrophy (X-linked missense mutation in

dystrophin; less severe than Duchenne)

117
Q

Small, irregular red spots on buccal/lingual mucosa with

blue-white centers

A

Koplik spots (measles; rubeola virus)

118
Q

Anticentromere antibodies

A

Scleroderma (CREST)

119
Q

Antidesmoglein (epithelial) antibodies

A

Pemphigus vulgaris (blistering)

120
Q

Basophilic nuclear remnants in RBCs

A

Howell-Jolly bodies (due to splenectomy or nonfunctional

spleen)

121
Q

“Bamboo spine” on x-ray

A 
Ankylosing spondylitis (chronic inflammatory arthritis:
HLA-B27)
122
Q

Bacitracin response

A 
Sensitive: Streptococcus pyogenes (group A); resistant:
Streptococcus agalactiae (group B)
123
Q

Anti–glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

124
Q

Azurophilic peroxidase  granular inclusions in granulocytes and myeloblasts

A

Auer rods (AML, especially the promyelocytic [M3] type)

125
Q

“Apple core” lesion on abdominal x-ray

A

Colorectal cancer (usually left-sided)

126
Q

Anti-IgG antibodies

A 
Rheumatoid arthritis (systemic inflammation, joint pannus,
boutonnière deformity)
127
Q

Antihistone antibodies

A

Drug-induced SLE (hydralazine, INH, phenytoin,

procainamide)

128
Q

Antimitochondrial antibodies (AMAs)

A

1° biliary cirrhosis (female, cholestasis, portal hypertension)

129
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

Microscopic polyangiitis and Churg-Strauss syndrome
(MPO-ANCA/p-ANCA); granulomatosis with polyangiitis
(Wegener; PR3-ANCA/c-ANCA)

130
Q

Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)

A

SLE (type III hypersensitivity)

131
Q

Anti-transglutaminase/anti-gliadin/anti-endomysial

antibodies

A

Celiac disease (diarrhea, distention, weight loss)

132
Q

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

133
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

134
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

135
Q

Bloody tap on LP

A

Subarachnoid hemorrhage

136
Q

“Boot-shaped” heart on x-ray

A

Tetralogy of Fallot, RVH

137
Q

Branching gram-positive rods with sulfur granules

A

Actinomyces israelii

138
Q

Disarrayed granulosa cells in eosinophilic fluid

A

Call-Exner bodies (granulosa-theca cell tumor of the ovary)

139
Q

Desquamated epithelium casts in sputum

A

Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)

140
Q

Bronchogenic apical lung tumor on imaging

A 
Pancoast tumor (can compress sympathetic ganglion and
cause Horner syndrome)
141
Q

Depigmentation of neurons in substantia nigra

A 
Parkinson disease (basal ganglia disorder: rigidity, resting
tremor, bradykinesia)
142
Q

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

143
Q

“Brown” tumor of bone

A

Hyperparathyroidism or osteitis fibrosa cystica (deposited

hemosiderin from hemorrhage gives brown color)

144
Q

Cardiomegaly with apical atrophy

A

Chagas disease (Trypanosoma cruzi)

145
Q

Cellular crescents in Bowman capsule

A

Rapidly progressive crescentic glomerulonephritis

146
Q

Circular grouping of dark tumor cells surrounding pale

neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma,

retinoblastoma)

147
Q

Colonies of mucoid Pseudomonas in lungs

A 
Cystic fibrosis (autosomal recessive mutation in CFTR gene
Ž fat-soluble vitamin deficiency and mucous plugs)
148
Q

AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormality

149
Q

Degeneration of dorsal column nerves

A 
Tabes dorsalis (3° syphilis), subacute combined degeneration
(dorsal columns and lateral corticospinal tracts affected)

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