Classic Presentations - 1 Flashcards
gout, intellectual disability, self-mutilating behavior in a boy
Lesh-Nyhan (HGPRT def, X-linked recessive)
situs inversus, chronic sinusitis, bronchiestasis, infertility
kartagener syndrome (dynein arm defect affecting cilia)
blue sclera
osteogenesis imperfecta (type I collagen defect)
elastic skin, hypermobility of joints, inc bleeding tendency
ehlers-danlos (type IV collagen defect)
arachnodactyly, lens dislocation (upward), aortic dissection, hyperflexible joints
marfan syndrome
cafe-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities
mcCune-albright (mosaic G-protein signaling mut)
calf pseudohypertrophy
muscular dystrophy (duchenne - due to XLR frameshift mut of dystrophin gene)
child uses arms to stand up from squat
gowers sign - duchenne
slow progressive muscle weakness in boys
becker muscular dystrophy (X-linked missense mut in dystrophin)
infant w/ cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia
Patau syndrome (trisomy 13)
infant w/ microcephaly, rocker-bottom feet, clenched hands, structural heart defect
edwards syndrome (trisomy 18)
single palmar crease
down syndrome
dilated cardiomyopathy, edema, alcoholism or malnutrition
wet beri beri (thiamine (B1) def)
dermatitis, diarrhea, dementia
pellagra (niacin (B3) def)
swollen gums, mucosal bleeding, poor wound healing, petechiae
scurvy - vit C def - can’t hydroxylate proline/lysine for collagen synthesis
chronic exercise intolerance w/ myalgia, fatigue, painful cramps, myoglobinuria
McArdle disease - skeletal muscle glycogen phosphorylase def
infant w/ hypoglycemia, hepatomegaly
cori disease (debranching enzyme) or von gierke disease (G6P) - more severe
myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
pompe disease - lysosomal a-1,4-glucosidase def
cherry red spots on macular
Tay sachs (ganglioside accumulation) or niemann-pick (sphingomyelin occlusion), or central retinal artery occlusion
hepatosplenomegaly, pancytopenia, osteoporosis, aseptic necrosis of femoral head, bone crises
gaucher disease (glucocerebrosidase def)
achilles tenon xanthoma
familial hypercholesterolemia (dec LDL receptor signaling)
anaphylaxis following blood transfusion
IgA deficiency
male child, recurrent infections, no mature B cells
Bruton - X-linked agammaglobulinemia
recurrent non-inflammed abscesses, unusual eczema, high serum IgE
hyper IgE syndrome - PMN chemotaxis abnormality
strawberry tongue
scarlet fever or kawasaki dz
adrenal hemorrahge, hTN, DIC
waterhouse-friderichsen syndrome (meningococcemia)
red “currant jelly” sputum in alcoholic or diabetic pts
klebsiella pneumonia
large rash w/ bull’s eye appearance
lyme disease - erythema chronicum migrans
non painful, indurated, ulcerated genital lesion
primary syphilis (treponema pallidum)
painful, indurated, ulcerated genital lesion
chancroid (H. ducreyi)
pupil accommodates but doesn’t react
neurosyphilis
smooth, moist, painless, wart-like white lesions on genitals
condyloma lata (secondary syphilis)
fever, chills, headache, myalgia - following Abx treatment for syphilis
jarisch-herxheimer rxn (rapid lysis of spirochetes results in endotoxin-like release)
dog or cat bite
pasteurella multocida (cellulitis at site of inoculation)
rash on palms or soles
coxsackie A, secondary syphilis, RMSF
black eschar on face of pt w/ DKA
mucor or rhizopus fungal infection
chorioretinitis, hydrocephalus, intracranial calcifications in a newborn
congenital toxo
fever, cough, conjunctivitis, coryza, diffuse rash
measles
small, irregular red spots on buccal/lingual mucosa w/ blue-white centers
koplik spots
back pain, fever, night sweats - assoc w/ TB
Pott disease (vertebral TB)
child w/ fever later develops red rash on cheeks that spreads to body
erythema infectiosum/fifth disease (parvovirus B19)
abd pain, diarrhea, leukocytosis, recent Abx use
c diff
bounding pulses, wide pulse pressure, diastolic heart murmur, head bobbing
aortic regurg
systolic ejection murmur (crescendo-decrescendo)
aortic stenosis
continuous “machine-like” murmur
PDA - close w/ indomethacin, keep open w/ PGE analog
chest pain, pericardial effusion/friction rub, persistent fever following MI
dressler syndrome - autoimmune post-MI fibrinous pericarditis, 2 wks to several months after acute episode
painful, raised red lesions on pads of fingers/toes
osler nodes - immune complex deposition
painless erythematous lesions on palms and soles
janeway lesions - septic emboli
splinter hemorrhages, retinal hemorrhages w/ pale center
bacterial endocarditis
cervical lymphadenopathy, desquamating rash, coronary aneurysms, red conjunctivae + tongue, hand-foot changes
kawasaki disease - treat w/ IVIG + aspirin
palpable purpura on buttocks/legs, joint pain, abdominal pain, hematuria
Henoch-schonlein purpura (IgA vasculitis affecting skin + kidneys)
telengiectasias, recurrent epistaxis, skin discoloration, AV malformations, GI bleeding, hematuria
hereditary hemorrhagic telangiectasia
skin hyperpigmentation, hTN, fatigue
addison disease (primary adrenocortical insufficienct) - inc ACTH and inc MSH production
cold intolerance
hypothyroidism
cutaneous/dermal edema due to deposition of mucopolysaccharides in connective tissue
myxedema (hypothyroid, graves)
facial muscle spasm upon tapping
chvostek sign - hypocalcemia
no lactation postpartum, absent menstruation, cold intolerance
sheehan syndrome - postpartum hemorrhage leading to pituitary infarction
cutaneous flushing, diarrhea, bronchospasm
carcinoid syndrome (R sided cardiac valve lesions, inc 5-HIAA)
pancreatic, pituitary, parathyroid tumors
MEN1 (AD)
medullary thyroid tumor, parathyroid, pheo
MEN2A (AD RET mut)
medullary thyroid, marfanoid habitus, pheo
MEN2B (AD RET mut)
vomiting blood following gastroesophageal tears
mallory-weiss syndrome (alcoholic + bulimic pts)
dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome
enlarged, hard, L supraclavicular node
Virchow node (abdominal metastasis)
weight loss, diarrhea, arthritis, fever, adenopathy
whipple disease (tropheryma whipplei)
hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands/genitalia
peutz-jeghers syndrome
multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
gardner syndrome - subtype of FAP
severe jaundice in a neonate - congenital
crigler-najjar syndrome (congenital unconjugated hyperbilirubinemia)
congestive liver disease, assoc w/ nutmeg liver, absence of JVD
budd-chiari syndrome - post hepatic venous thrombosis
golden brown rings around peripheral cornea
wilson disease (due to copper accumulation)