Classic Presentations 6

Question 1

Smooth, flat, moist, painless white lesions on genitals?

Answer 1

Condylomata lata (secondary syphilis)

Question 2

Splinter hemorrhages in fingernails?

Answer 2

Bacterial endocarditis

Question 3

“Strawberry tongue”?

Answer 3

Scarlet fever, Kawasaki’s, TSS

Question 4

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

Answer 4

Turner syndrome (45,XO)

Question 5

Sudden swollen/painful big toe joint, tophi?

Answer 5

Gout/podagra (hyperuricemia)

Question 6

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

Answer 6

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

Question 7

Swollen, hard, painful finger joints?

Answer 7

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

Question 8

Systolic ejection murmur (crescendo-decrescendo)?

Answer 8

Aortic valve stenosis

Question 9

Thyroid and parathyroid tumors, pheochromocytoma?

Answer 9

MEN 2A (autosomal dominant ret mutation)

Question 10

Thyroid tumors, pheochromocytoma, ganglioneuromatosis?

Answer 10

MEN 2B (autosomal dominant ret mutation)

Question 11

Toe extension/fanning upon plantar scrape?

Answer 11

Babinski sign (UMN lesion)

Question 12

Unilateral facial drooping involving forehead?

Answer 12

Facial nerve (LMN CN VII palsy)

Question 13

Urethritis, conjunctivitis, arthritis in male?

Answer 13

Reactive arthritis assoc with HLA-B27

Question 14

Vascular birthmark (port-wine stain)?

Answer 14

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

Question 15

Vomiting blood following gastroesophageal lacerations?

Answer 15

Mallory-Weiss syndrome (alcoholic and bulimic pts)

Question 16

Weight loss, diarrhea, arthritis, fever, adenopathy?

Answer 16

Whipple’s dz (Tropheryma whipplei)

Question 17

“Worst HA of my life!”?

Answer 17

Subarachnoid hemorrhage

Question 18

Rib notching, HTN in UE, weak pulses in LE?

Answer 18

Adult type coarctation of aorta

Question 19

Congenital heart defect, infant of diabetic mother?

Answer 19

Transposition of great vessels