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First Aid Step 1 2014 Rapid Review > Classic Presentations > Flashcards

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

Anterior “drawer sign” positive

A

Anterior cruciate ligament injury

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5
Q

Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints

A

Marfan syndrome (fibrillin defect)

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6
Q

Athlete with polycythemia

A

secondary to erythropoietin injection

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7
Q

Back pain, fever, night sweats, weight loss

A

Pott disease (vertebral TB)

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8
Q

Bilateral hilar adenopathy, iveitis

A

Sarcoidosis (noncaseating granulomas)

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9
Q

Blue sclera

A

Osteogenesis imperfecta (type I collagen defect)

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10
Q

Bluish line on gingiva

A

Burton line (lead poisoning)

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11
Q

Bone pain, bone enlargement, arthritis

A

Paget disease of bone (increased osteoblastic and osteoclastic activity)

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12
Q

Bounding pulses, diastolic heart murmur, head bobbing

A

Aortic regurgitation

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13
Q

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

A

Systemic lupus erythematosus (SLE)

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14
Q

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

A

Neurofibromatosis type I (plus pheochromocytoma, optic gliomas)

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15
Q

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

A

McCune-Albright syndrome (mosaic G-protein signaling mutation)

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16
Q

Calf pseudohypertrophy

A

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

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17
Q

“Cherry-red spots” on macula

A

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

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18
Q

Chest pain on exertion

A

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

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19
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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20
Q

Child uses arms to stand up from squat

A

Gowers sign (Duchenne muscular dystrophy)

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21
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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22
Q

Chorea, dementia, caudate degeneration

A

Huntington disease (autosomal dominant CAG repeat expansion)

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23
Q

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

A

McArdle disease (muscle glycogen phosphorylase deficiency)

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24
Q

Cold intolerance

A

Hypothyroidism

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25
Q

Conjugate lateral gaze palsy, horizontal diplopia

A

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

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26
Q

Continuous “machine-like” heart murmur

A

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

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27
Q

Cutaneous/dermal edema due to connective tissue deposition

A

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

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28
Q

Dark purple skin/mouth nodules in a patient with AIDS

A

Kaposi sarcoma, associated with HHV-8

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29
Q

Kaposi-like lesions in an AIDS patient, but not

A

Bacillary angiomatosis (Bartonella heneslea, use silver stain to detect, treat with sulfa drugs or erythromycin)

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30
Q

Deep, labored breathing/hyperventilation

A

Kussmaul respirations (diabetic ketoacidosis)

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31
Q

Dermatitis, dementia, diarrhea

A

Pellagra (niacin [vitamin B3] deficiency)

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32
Q

Dilated cardiomyopathy, edema, alcoholism or malnutrition

A

Wet beriberi (thiamine [vitamine B1] deficiency

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33
Q

Dog or cat bite resulting in infection

A

Pasteurella multocida (cellutlitis at inoculation site)

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34
Q

Dry eyes, dry mouth, arthritis

A

Sjogren syndrome (autoimmune destruction of exocrine glands)

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35
Q

Dysphagia (esophageal webs), glossitis, iron deficiency anemia

A

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

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36
Q

Elastic skin, hypermobility of joints

A

Ehlers-Danlos syndrome (type III collagen defect)

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37
Q

Enlarged, hard left supraclavicular node

A

Virchow node (abdominal metastasis)

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38
Q

Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells

A

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

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39
Q

Facial muscle spasm upon tapping

A

Chvostek sign (hypocalcemia)

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40
Q

Fat, female, forty, and fertile

A

Cholelithiasis (gallstones)

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41
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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42
Q

Fever, cough, conjunctivitis, coryza, diffuse rash

A

Measles

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43
Q

Fever, night sweats , weight loss

A

B symptoms (staging) of lymphoma

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44
Q

Fibrous plaques in soft tissue of penis

A

Peyronie disease (connective tissue disorder)

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45
Q

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

A

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

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46
Q

Green-yellow rings around peripheral cornea

A

Kayser-Fleischer rings (copper accumulation from Wilsons disease)

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47
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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48
Q

Hepatosplenomegaly, osteoporosis, neurologic symptoms

A

Gaucher disease (glucocerebrosidase deficiency)

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49
Q

Hereditary nephritis, sensorineural hearing loss, cataracts

A

Alport syndrome (mutation in collagen IV)

50
Q

Hyperphagia, hypersexuality, hyperorality, hyperdocility

A

Kluver-Bucy syndrome (bilateral amygdala lesion)

51
Q

Hyperreflexia, hypertonia, Babinski sign present

A

UMN damage

52
Q

Hyporeflexia, hypotonia, atrophy, fasciculations

A

LMN damage

53
Q

Hypoxemia, polycythemia, hypercapnia

A

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

54
Q

Indurated, ulcerated genital lesion

A

Nonpainful: chancre (primary syphilis, Treponema pallidum)

Painful, with exudate: chandroid (Haemophilus ducreyi)

55
Q

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

A

Patua syndrome (trisomy 13)

56
Q

Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration

A

Niemann-Pick disease (genetic sphingomyelinase deficiency)

57
Q

Infant with hypoglycemia, failure to thrive, and hepatomegaly

A

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

58
Q

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

A

Edwards syndrome (trisomy 18)

59
Q

Jaundice, palpable distended non-tender gallbladder

A

Courvoisier sign (distal obstruction of biliary tree)

60
Q

Large rash with bull’s-eye appearance

A

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

61
Q

Lucid interval after traumatic brain injury

A

Epidural hematoma (middle meningeal artery rupture)

62
Q

Male child, recurrent infections, no mature B cells

A

Bruton disease (X-linked agammaglobulinemia)

63
Q

Mucosal bleeding and prolonged bleeding time

A

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

64
Q

Muffled heart sounds, distended neck veins, hypotension

A

Beck triad of cardiac tamponade

65
Q

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

A

Gardner syndrome (subtype of FAP)

66
Q

Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance

A

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

67
Q

Neonate with arm paralysis following difficult birth

A

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

68
Q

No lactation postpartum, absent menstruation, cold intolerance

A

Sheehan syndrome (pituitary infaction)

69
Q

Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia

A

Multiple sclerosis

70
Q

Oscillating slow/fast breathing

A

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

71
Q

Painful blue fingers/toes/ hemolytic anemia

A

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

72
Q

Painful blue fingers/toes, hemolytic anemia

A

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

73
Q

Painful, pale, cold fingers/toes

A

Raynoud phenomenon (vasospasm in extremities)

74
Q

Painful, raised red lesions on pad of fingers/toes

A

Osler nodes (infective endocarditis, immune complex deposition)

75
Q

Painless erythematous lesions on palms and soles

A

Janeway lesions (infective endocarditis, septic emboli/microabscesses)

76
Q

Painless jaundice

A

Cancer of the pancreatic head obstructing bile duct

77
Q

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

A

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

78
Q

Pancreatic, pituitary, parathyroid tumors

A

MEN 1 (autosomal dominant)

79
Q

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

A

Nephrotic syndrome

80
Q

Pink complexion, dyspnea, hyperventilation

A

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

81
Q

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

A

Fanconi syndrome (proximal tubular reabsorption defect)

82
Q

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

A

Lichen planus

83
Q

Ptosis, miosis, anhidrosis

A

Horner syndrome (sympathetic chain lesion)

84
Q

Pupil accommodates but doesn’t react

A

Argyll Robertson pupil (neurosyphilis)

85
Q

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

A

Guillain-Barre syndrome (acute autoimmune inflammatory demyelinating polyneuropathy)

86
Q

Rash on palms and soles

A

Coxsackie A, secondary syphilis, Rocky Mountain spotted fever

87
Q

Recurrent colds, unusual eczema, high serum IgE

A

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

88
Q

Red “currant jelly” sputum in alcoholic or diabetic patients

A

Klebsiella pneumoniae

89
Q

Red “currant jelly” stools

A

Acute mesenteric ischemia (adults), intussusception (infants)

90
Q

Red, itchy, swollen rash of nipple/areola

A

Paget disease of the breast (sign of underlying neoplasm)

91
Q

Red urine in the morning, fragile RBCs

A

Paroxysmal nocturnal hemoglobinuria

92
Q

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

A

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

93
Q

Resting tremor, rigidity, akinesia, postural instability

A

Parkinson disease (nigrostriatal dopamine depletion)

94
Q

Retinal hemorrhages with pale centers

A

Roth spots (bacterial endocarditis)

95
Q

Severe jaundice in neonate

A

Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)

96
Q

Severe RLQ pain with palpation of LLQ

A

Rovsing sign (acute appendicitis)

97
Q

Severe RLQ pain with rebound tenderness

A

McBurney sign (acute appendicitis)

98
Q

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

A

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

99
Q

Single palmar crease

A

Down syndrome

100
Q

Situs inversus, chronic sinusitis, bronchiectasis, infertility

A

Kartagener syndrome (dynein arm defect affecting cilia)

101
Q

Skin hyperpigmentation, hypotension, fatigue

A

Addison disease (primary adrenocortical insuficiency causes increased ACTH and increased alpha-MSH production)

102
Q

Slow, progressive muscle weakness in boys

A

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

103
Q

Small, irregular red spots in buccal/lingual mucosa with blue-white cneters

A

Koplik spots (measles; rubeola virus)

104
Q

Smooth, flat, moist, painless white lesions on genitals

A

Condylomata lata (secondary syphilis)

105
Q

Splinter hemorrhages in fingernails

A

Bacterial endocarditis

106
Q

“Strawberry tongue”

A

Scarlet fever, Kawasaki disease, toxic shock syndrome

107
Q

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

A

Turner syndrome (45, XO)

108
Q

Sudden swollen/painful big toe joint, tophi

A

Gout/podagra (hyperuricemia)

109
Q

Swollen gums, mucosal bleeding, poor wound healing, petechiae

A

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

110
Q

Swollen, hard, painful finger joints

A

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

111
Q

Systolic ejection murmur (crescendo-decrescendo)

A

Aortic valve stenosis

112
Q

Thyroid and parathyroid tumors, pheochromocytoma

A

MEN 2A (autosomal dominant ret mutation)

113
Q

Thyroid tumors, pheochromocytoma, ganglioneuromatosis

A

MEN 2B (autosomal dominant ret mutation)

114
Q

Toe extension/fanning upon plantar scrape

A

Babinski sign (UMN lesion)

115
Q

Unilateral facial drooping involving forehead

A

Facial Nerve (LMN CN VII palsy)

116
Q

Urethritis, conjunctivitis, arthritis in a male

A

Reactive arthritis associated with HLA-B27

117
Q

Vascular birthmark (port-wine stain)

A

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

118
Q

Vomiting blood following gastroesophageal lacerations

A

Mallory-Weiss syndrome (alcoholic and bulimic patients)

119
Q

Weight loss, diarrhea, arthritis, fever, adenopathy

A

Whipple disease (Tropheryma whipplei)

120
Q

“Worst headache of my life”

A

Subarachnoid hemorrhage

First Aid Step 1 2014 Rapid Review (2 decks)

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