Classic Presentations Flashcards
Ab pain, ascites, hepatomegaly
Budd Chiari Syndrome (posthepatic venous thrombosis)
Achilles tendon xanthoma
IIa familial hypercholesterolemia (lo LDLR)
Adrenal hemorrhage, hypotension, DIC
Waterhouse-Friedrichsen syndrome (meningococcemia)
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
Marfan’s syndrome (fibrillin defect)
Athlete with polycythemia
EPO injections
Back pain, fever, night sweats, weight loss
Pott’s disease
Bilateral hilar adenopathy, uveitis
Sarcoidosis (nc granulomas)
Blue sclera
Osteogenesis imperfecta (type I collagen)
Bluish line on gingiva
Burton’s line (Pb poisoning)
Bone pain, bone enlargement, arthritis
Paget’s disease of bone
Bounding pulses, diastolic heart murmur, head bobbing
aortic regurgitation
butterfly facial rash, Raynaud’s phenomenon in a young female
SLE
Cafe-au-lait spots, Lisch nodules (iris hamartoma)
NF-1 (+pheo, optic gliomas)
NF-2 (+bilateral acoustic neuromas)
Cafe-au-lait spots, polyostic fibrous dysplasia, precocious puberty
McCune-Albright syndrome (mosaic G-protein signaling mutation)
Calf pseudohypertrophy
Muscular dystrophy (DMD most often)
DMD: X linked deletion of dystrophin gene
Cherry red spot on macula
Tay-Sachs (ganglioside accum)
Niemann-Pick (sphingomyelin accum)
central retinal artery occlusion
Chest pain only on exertion
Stable angina
Chest pain, pericardial effusion/friction rub, persistent fever post-MI
Dressler syndrome (Ab vs pericardium, usually >4 weeks)
Child uses arms to stand up from squat/sitting
Gower’s sign (DMD)
Child with fever develops red rash on face that spreads to body
Slapped cheek fever (aka fifth dz; Parvovirus B19)
Chorea, dementia, caudate degeneration
Huntington’s disease (AD, CAG repeat)
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
McArdle’s disease (muscle glycogen phosphorylase deficient)
Cold intolerance
Hypothyroidism
Conjugate lateral gaze palsy, horizontal diplopia
Internuclear ophthalmoplegia (MLF dmg: bilateral= MS, unilateral= stroke)
Continuous machine like murmur
PDA
Indomethacin=closes
Misoprostol (PGE1)= keeps open
Dermal edema due to CT deposition
Myxedema (hypothyroid, Grave’s: pretibial)
Dark purple skin/mouth nodules
Kaposi’s sarcoma (usually AIDS pts, assoc with HHV-8)
Deep, labored breathing/hyperventilation
Kussmaul breathing (DKA)
Dermatitis, dementia, diarrhea
Pellagra (niacin/B3 def)
Dilated cardiomyopathy, edema, polyneuropathy
Wet beriberi (thiamine/B1 def)
Dog/cat bite infection
Pasteurella multocida (cellulitis @ site)
Dry eyes, dry mouth, arthritis
Sjogren syndrome
autoimmune destruction of exocrine glands
Dysphagia (esoph webs), glossitis, microcytic anemia
Plummer Vinson syndrome
Fe deficient, may become Sq Cell CA
Elastic skin, hypermobile joints
Ehlers-Danlos syndrome (type III collagen)
Enlarged, hard supraclavicular node
Virchow’s node (ab mets)
Erythroderma, LAD, HSM, atypical T cells
Sezary syndrome (cutaneous T cell lymphoma)
or Mycosis fungoides
Facial muscle spasm upon tapping
Chovstek’s sign (hypoCa)
Fat, fourty, female, and fertile
Risks for acute cholelithiasis (bile duct block)
Fever, chills, headache, myalgia after antibiotic tx for Syphilis
Jarisch-Herxheimer rxn (toxin release from spirochetes)
Fever, cough, conjunctivitis, coryza, diffuse rash
Measles (Morbillivirus)
Fever, night sweats, weight loss
B symptoms (lymphoma)
Fibrous plaques in soft tissue of penis
Peyronie’s disease (CT disorder)
Gout, MR, self-mutilating behavior in boy
Lesch-Nyhan syndrome
HGPRT def, X linked recessive
Green-yellow rings around peripheral cornea
Kayser-Fleischer rings
Cu accum in Wilson’s
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands
Peutz-Jeghers syndrome
genetic benign polyposis can cause bowel obstruction, incr cancer risk
HSM, osteoporosis, neurologic symptoms
Gaucher’s disease
glucocerebrosidase def
Hereditary nephritis, sensorineural hearing loss, cataracts
Alport syndrome
a-chain mutation in type IV collagen
Hypercoagulability, migrating DVTs and vasculitis
Trousseau’s syndrome
adenocarcinoma of pancreas or lung
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Kluver-Bucy syndrome
bilateral amygdala lesion
Hyperreflexia, hypertonia, + Babinski
upper motor neuron dmg
HTN, hypoK, metabolic alkalosis
Conn’s syndrome
Hyporeflexia, hypotonia, atrophy
lower motor neuron dmg
Hypoxemia, polycythemia, hypercapnia
blue bloater (chronic bronchitis; hyperplastic mucus cells)
Indurated, ulcerated genital lesion
Nonpainful: chancre (syphilis, T. pallidum)
Painful with exudate: chancroid (H. ducreyi)
Infant with failure to thrive, HSM, neurodegeneration
Niemann-Pick dz
genetic sphingomyelinase deficiency
Infant with hypoglycemia, failure to thrive, hepatomegaly
Cori’s disease
debranching enzyme deficiency
Infant with microcephaly, rocker-bottom feet, clenched hands, structural heart defect
Edward’s syndrome (trisomy 18)
Keratin pearls on a skin biopsy
Squamous cell CA
Bull’s eye rash
erythema chronicum migrans
from Ixodes tick (Lyme)
Lucid interval after TBI
Epidural hematoma (usually MMA rupture)
Male child with recurrent infections, no mature B cells
Bruton’s X linked agammaglobinemia
Mucosal bleeding and prolonged bleeding time
Glanzmann thrombasthenia
lack GP IIb/IIIa
Multiple colon polyps, osteomas/soft tissue tumors, impacted/many teeth
Gardner’s syndrome
type of FAP
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
Pompe’s disease
lysosomal a-1,4-glucosidase deficiency
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Wegener’s granulomatosis (c-ANCA +)
or Goodpasture’s (anti-collagen IV in GBM)
Neonate with arm paralysis following difficult birth
Erb-Duchenne palsy
C5-C6, waiter’s tip
No lactation post-partem, amenorrhea, cold intolerance
Sheehan syndrome (pituitary infarct)
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
MS
oscillating slow/fast breathing
Cheyne-Stokes respirations
central apnea in CHF or hi ICP
Painful blue fingers/toes, hemolytic anemia
Cold agglutinin disease
autoimmune from Myco pnemo, infectious mono
Painful, pale, cold digits
Raynaud’s syndrome (vasospasm)
Painful, raised red lesions on palms and soles
Osler’s nodes (infective endocarditis)
Painless erythematous lesions on palms and soles
Janeway lesions (infective endocarditis)
Painless jaundice
cancer of pancreatic head blocking bile duct
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child)
Henoch-Schonlein purpura
IgA vasculitis, skin+kidneys
Pancreatic, pituitary, parathyroid tumors
MEN I (AD)
Pink complexion, dyspnea, hyperventilation
Pink puffer (EMPHYSEMA: centroacinar=smoking, panacinar=A1A)
Polyuria, acidosis, growth failure, electrolyte imbalances
Fanconi’s syndrome (PCT resorption defect)
+ anterior drawer sign
ACL tear
Ptosis, miosis, anhidrosis
Horner’s syndrome
symp chain lesion
Pupil accomodates but doesn’t react
Argyll Robertson pupil (neurosyphilis)
aka Prostitute’s pupil
Rapidly progressing ascending leg weakness (following GI/URT infection)
Guillain-Barre syndrome
demyelinating, molecular mimicry
Rash on palms and soles
Coxsackie A, 2 syphilis, RMSF
Recurrent colds, unusual eczema, hi serum IgE
hyper IgE syndrome (Job’s syndrome: neutrophil chemotaxis abnormal)
Currant jelly sputum in alcoholic or diabetic
Klebsiella pneumoniae
Red, itchy, swollen rash of nipples/areolae
Paget’s dz of breast (underlying neoplasm)
Red urine in MORNING, fragile RBCs
paroxysmal nocturnal hemoglobinuria
due to physiologic resp acidosis @ night
Bilateral renal cell CA, hemangioblastomas, angiomatosis, pheochromocytoma
von Hippel-Lindau disease
dominant tumor suppressor gene mutation
Resting tremor, rigidity, akinesia, postural instability
Parkinson’s disease
nigrostriatal DA depletion
Retinal hemorrhage with pale centers
Roth spots (infective endocarditis)
Severe jaundice in neonate
Crigler-Najjar
defect or absent UDP-GT; hi UCB
Severe RLQ pain with rebound tenderness
McBurney’s sign (appendicitis)
Short, hi incidence of tumors/leukemia, aplastic anemia
Fanconi’s anemia
genetic loss of DNA crosslink repair, often moves to AML
Single palm crease
simian crease (trisomy 21)
Situs inversus, chronic sinusitis, bronchiectasis, infertility
Kartagener’s syndrome
dynein arm defect affecting cilia
Skin hyperpigmentation
Addison’s disease
primary adrenal insufficiency, hi POMC
Slow, progressive muscle weakness in boys
Becker’s muscular dystrophy (X linked, missense of dystrophin)
Small, irregular red spots on buccal/lingual mucosa with blue/white centers
Koplik spots (measles; rubeola virus)
Smooth, flat, moist white lesions on genitals
Condylomata lata (2 syphilis)
Splinter hemorrhages in fingernails
bacterial endocarditis
Strawberry tongue
scarlet fever, Kawasaki dz, toxic shock syndrome
Streak ovaries, congenital heart dz, horseshoe kidney, cystic hygroma @ birth
Turner syndrome
45 XO, short, web neck, broad chest
Sudden swollen/painful big toe, typhi
gout/podagra (hyperuricemia)
Swollen gums, mucous bleeding, poor wound healing, spots on skin
Scurvy (vitC deficient, can’t hydroxylate pro or lys)
Swollen, hard, painful finger joints
Osteoarthritis
PIP: Bouchard’s, DIP: Heberden’s
Systolic ejection murmur (crescendo-decrescendo)
aortic stenosis
Thyroid, parathyroid, pheochromocytoma tumors
MEN 2A
AD; ret mutation
Thyroid, pheo, ganglioneuromatosis
MEN 2B
AD; ret mutation
Toe extension/fannion upon plantar scrape
+ Babinski sign (UMN lesion)
Unilateral facial drooping involving forehead
Bell’s palsy (LMN CN VII palsy)
Urethritis, conjunctivitis, arthritis in male
reactive arthritis associated with HLA-B27
Vascular birthmark (port-wine stain)
Hemangioma (benign, but assoc with Sturge Weber syndrome)
Vomiting blood following esophagogastric lacerations
Mallory Weiss syndrome (alcoholic and bulemics)
Waxy casts with very low urine flow
chronic end-stage renal disease
WBC cast in urine
acute pyelonephritis
Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple disease (Tropheryma whippelii)
Worst headache of my life
subarachnoid hemorrhage
Unilateral facial drooping involving forehead
Bell’s palsy (LMN CN VII palsy)
Urethritis, conjunctivitis, arthritis in male
reactive arthritis associated with HLA-B27
Vascular birthmark (port-wine stain)
Hemangioma (benign, but assoc with Sturge Weber syndrome)
Vomiting blood following esophagogastric lacerations
Mallory Weiss syndrome (alcoholic and bulemics)
Waxy casts with very low urine flow
chronic end-stage renal disease
WBC cast in urine
acute pyelonephritis
Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple disease (Tropheryma whippelii)
Worst headache of my life
subarachnoid hemorrhage