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Classic 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 (decreased 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’s syndrome (fibrillin defect)

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5
Q

Athlete with polycythemia

A

Secondary to erythropoetin injection

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6
Q

Back pain, fever, night sweats, weight loss

A

Pott’s disease (vertebral tuberculosis)

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7
Q

Bilateral hilar adenopathy, uveitis

A

Sarcoidosis (non-caseating granulomas)

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8
Q

Blue sclera

A

Osteogenesis imperfecta (type 1 collagen defect)

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9
Q

Bluish line on gingiva

A

Burton’s line (lead poisoning)

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10
Q

Bone pain, bone enlargement, arthritis

A

Paget’s disease of bone (increased 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’s 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 1 (+ 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 psedohypertrophy

A

Muscular dystrophy (most commonly Duchenne’s): X linked, recessive deletion of dystrophin gene

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16
Q

“Cherry-red spot” on macula

A

Tay-Sachs (ganglioside accumulation) or Neimann-Pick (sphinomyelin 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’s 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’s disease (autosomal-dominant CAG repeat expansion)

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22
Q

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

A

McArdle’s 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 opthalmoplegia (damage to MLF bilateral [MS], unilateral [stroke])

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25
Q

Continuous “machinery” heart murmur

A

PDA (close with indomethacin; open or maintain with misoprostol)

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26
Q

Cutaneous/dermal edema due to connective tissue deposition

A

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

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27
Q

Dark purple skin/mouth nodules

A

Kaposi’s sarcoma (usually AIDs patients [MSM: associated with HHV-8)

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28
Q

Deep, labored breathing/hyperventilation

A

Kussmaul breathing (diabetic ketoacidosis)

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29
Q

Dermatitis, dementia, diarrhea

A

Pellagra (niacin [vitamin B3] deficiency)

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30
Q

Dilated cardiomyopathy, edema, alcoholism, or malnutrition

A

Wet beriberi (thiamine [vitamin B1] deficiency

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31
Q

Dog or cate bite resulting in infection

A

Pasteurella multocida (cellulitis at inoculation site)

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32
Q

Dry eyes, dry mouth, arthritis

A

Sjogren’s syndrome (autoimmune destruction of exocrine glands)

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33
Q

Dysphagia (esophageal webs), glossitis, iron deficiency anemia

A

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

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34
Q

Elastic skin, hyper-mobility of joints

A

Ehlers-Danlos syndrome (type III collagen defect)

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35
Q

Enlarged, hard left supraclavicular node

A

Virchow’s node (abdominal metastasis)

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36
Q

Erythroderma, lympadenopathy, hepatosplenomegaly, atypical T cells

A

Sézary syndrome (cutaneous T cell lymphoma) or mycosis fungoides

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37
Q

Facial muscle spasm upon tapping

A

Chvostek’s sign (hypocalcemia)

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38
Q

Fat, female, forty, and fertile

A

Cholelithiasis (gallstones)

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39
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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40
Q

Fevery, 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’s disease (connective tissue disorder)

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43
Q

Gout mental retardation, 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’s 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; increased cancer risk, mainly GI)

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46
Q

Hepatosplenomegaly, osteoporosis, neurologic

A

Gaucher’s disease (glucocerebrosidase deficiency)

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47
Q

Hereditary nephritis, sensorineural hearing loss, cataracts

A

Alport syndrome (mutation in alpha chain of collagen IV)

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48
Q

Hyperphagia, hypersexuality, hyperorality, hyperdocility

A

Kluver-Bucy syndrome (bilateral amydala lesion)

49
Q

Hyperreflexia, hypertonia, Babinksi present

A

UMN damage

50
Q

Hyporeflexia, hypotonia, atrophy, fasciculations

A

LMN damage

51
Q

Hypoxemia, polycythemia, hypercapnia

A

“Blue bloater” (chronic bronchitis: hyperplasia of mucous cells)

52
Q

Indurated, ulcerated genital lesion that is not painful

A

primary syphilis (Treponema pallidum)

53
Q

Indurated, ulcerated genital lesion that is painful, with exudate

A

Chancroid (Haemophilius ducreyi)

54
Q

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

A

Patau’s syndrome (trisomy 13)

55
Q

Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration

A

Niemann-Pick disease (genetic sphinomyelinase deficiency)

56
Q

Infant with hypoglycemia, failure to thrive, and hepatomegaly

A

Cori’s disease (debranching enzyme deficiency)

57
Q

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

A

Edwards’ syndrome (trisomy 18)

58
Q

Jaundice, palpable distended non-tender gallbladder

A

Courvoisier’s sign (distal obstruction of biliary tree)

59
Q

Large rash with bull’s-eye appearance

A

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

60
Q

Lucid interval after traumatic brain injury

A

Epidural hematoma (middle meningeal artery rupture)

61
Q

Male child, recurrent infections, no mature B cells

A

Bruton’s disease (X-linked agammaglobulinemia)

62
Q

Mucosal bleeding and prolonged bleeding time

A

Glanzmann’s thombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)

63
Q

Muffled heart sounds, distended neck veins, hypotension

A

Beck’s triad of cardiac tamponade

64
Q

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

A

Gardner’s syndrome (subtype of FAP)

65
Q

Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance

A

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

66
Q

Neonate with arm paralysis following difficult birth

A

Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: “waiter’s tip”)

67
Q

No lactation postpartum, absent menstruation, cold intolerance

A

Sheehan’s syndrome (pituitary infarction)

68
Q

Nystagmus, intention tremor, scanning speech, bilateral internuclear opthalmoplegia

A

Multiple sclerosis

69
Q

Oscillating slow/fast breathing

A

Cheyne-Stokes respirations (central apnea in CHF or intracranial pressure)

70
Q

Painful blue fingers/toes, hemolytic anemia

A

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

71
Q

Painful, pale, cold fingers/toes

A

Raynoud’s phenomenon (vasospasm in extremities)

72
Q

Painful, raised red lesions on pad of fingers/toes

A

Osler’s node (infective endocarditis, immune complex deposition)

73
Q

Painless erythematous lesions on palms and soles

A

Janeway lesions (infective endocarditis, septic emboli/micoabscesses)

74
Q

Painless jaundice

A

Cancer of the pancreatic head obstructing bile duct

75
Q

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

A

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

76
Q

Pancreatic, pituitary, parathyroid tumors

A

MEN 1 (autosomal dominant)

77
Q

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

A

Nephrotic syndrome

78
Q

Pink complexion, dyspnea, hyperventilation

A

“Pink puffer” (emphysema: centriacinar [smoking], panacinar [alpha1-antitrypsin deficiency])

79
Q

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

A

Fanconi’s syndrome (proximal tubular reabsorption defect)

80
Q

Positive anterior drawer sign

A

Anterior cruciate ligament injury

81
Q

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

A

Lichen planus

82
Q

Ptosis, miosis, anhidrosis

A

Horner’s syndrome (sympathetic chain lesion)

83
Q

Pupil accommodates but doesn’t react

A

Argyll Robertson pupil (neurosyphilis)

84
Q

Rapidly progressive leg weakness that asends following GI/URI

A

Guillain-Barre syndrome (acute autoimmune inflammatory demyelinating polyneuropathy)

85
Q

Rash on palms and soles

A

Coxsackie A, secondary syphilis, Rocky Mountain spotted fever

86
Q

Recurrent colds, unusual eczema, high serum IgE

A

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

87
Q

Red “currant jelly” sputum in alcoholic or diabetic patients

A

Klebsiella pneumoniae

88
Q

Red “currant jelly” stool

A

Acute mesenteric ischemia (adults), intussception (infants)

89
Q

Red, itchy, swollen rash of nipple.areola

A

Paget’s disease of the breast (represents underlying neoplasm)

90
Q

Red urine in the morning, fragile RBCs

A

Paroxysmal nocturnal hemoglobinuria

91
Q

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

A

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

92
Q

Resting tremor, rigidity, akinesia, postural instability

A

Parkinson’s disease (nigrostriatal dopamine depletion)

93
Q

Retinal hemorrhages with pale centers

A

Roth’s spots (bacterial endocarditis)

94
Q

Severe jaundice in a neonate

A

Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)

95
Q

Severe RLQ pain with palpation of LLQ

A

Rovsing’s sign (acute appendicitis)

96
Q

Severe RLQ pain with rebound tenderness

A

McBurney’s sign (appendicitis)

97
Q

Short stare, increased incidence of tumors/leukemia, aplastic anemia

A

Fanconi’s anemia (genetic loss of DNA cross link repair; often progresses to AML)

98
Q

Single palmar crease

A

Simian crease (Down syndrome)

99
Q

Situs inversus, chronic sinusitis, bronchiectasis, infertility

A

Kartagener’s syndrome (dynein arm defect affecting cilia)

100
Q

Skin hyperpigmentation, hypotension, fatigue

A

Addison’s disease (primary adrenocortical insufficiency causes increased ACTH and increased alpha-MSH production)

101
Q

Slow, progressive muscle weakness in boys

A

Becker’s muscular dystrophy (X-linked missense mutation in dystrophin; less severe than Duchenne’s)

102
Q

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

A

Koplik spots (measles; rubeola virus)

103
Q

Smooth, flat, moist, painless white lesions on genitals

A

Condylomata lata (secondary syphilis)

104
Q

Splinter hemorrhages in fingernails

A

Bacterial endocarditis

105
Q

“Strawberry tongue”

A

Scarlet fever, Kawasaki disease, toxic shock syndrome

106
Q

Streak ovaires, congenital heard disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema

A

Turner syndrome (45, XO)

107
Q

Sudden swollen/painful big toe joint, tophi

A

Gout/podagra (hyperuricemia)

108
Q

Swollen gums, mucosal bleeding, poor wound healing, spots on skin

A

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

109
Q

Swollen, hard, painful finger joints

A

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

110
Q

Systolic ejection murmur (crescendo-decrescendo)

A

Aortic valve stenosis

111
Q

Thyroid and parathyroid tumors, pheochromocytoma

A

MEN 2A (autosomal dominant ret mutation)

112
Q

Thyroid tumors, pheochromocytoma, ganglioneurmatosis

A

MEN 2B (autosomal dominant ret mutation)

113
Q

Toe extension/fanning upon plantar scrape

A

Babinski sign (UMN lesion)

114
Q

Unilateral facial drooping involving forehead

A

Facial nerve (LMN CN VII palsy)

115
Q

Urtethritis, conjunctivitis, arthritis in a male

A

Reactive arthritis associated with HLA-B27

116
Q

Vascular birthmark (port-wine stain)

A

Hemangioma (benign, but associated with Sturge-Weber syndrome

117
Q

Vomiting blood following gastroesophageal lacerations

A

Mallory-Weiss syndrome (alcoholic and bulimic patients)

118
Q

Weight loss, diarrhea, arthritis, fever, adenopathy

A

Whipple’s disease (Tropheryma whipplei)

119
Q

“Worst headache of my life”

A

Subarachnoid hemorrhage

Rapid Review (4 decks)

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