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USMLE Step 1 > Classic Presentations (First Aid Rapid Review) > Flashcards

Classic Presentations (First Aid Rapid Review) Flashcards

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USMLE® Step 1 flashcards
1
Q

Abdominal pain
Ascites
Hepatomegaly

A

Budd-Chiary syndrome

post-hepatic 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

Arachnodactylyl
Lens dislocation
Aortic dissection
Hyperflexible joints

A

Marfan’s syndrome

Fibrillin defect

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5
Q

Athelete w/ polycythemia

A

Secondary to erythropoietin injection

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6
Q

Back pain

Fever, Night Sweats, Weight Loss

A

Pott disease

Vertebral TB

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7
Q

Bilateral hilar adenopathy

Uveitis

A

Sarcoidosis

Noncaseating granuloma

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8
Q

Blue sclera

A 
Osteogenesis imperfecta
(type I collagen defect)
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9
Q

Bluish line on gingiva

A

Burton line

Lead poisoning

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10
Q

Bone pain
Bone enlargement
Arthritis

A

Paget 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
Raynaud phenomenon
Young female

A

Systemic lupus erythematosus

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13
Q 
Cafe-au-lait spots
Lisch nodules (iris hamartoma)
A

Neurofibromatosis type I

+ pheochromcytoma, optic gliomas

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14
Q

Cafe-au-lait spots
Polyostotic fibrous dysplasia
Precocious puberty
Multiple endocrine abnormalities

A

MuCune-Albright syndrome

mosaic G-protein signaling mutation

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15
Q

Calf pseudohypertrophy

A 
Muscular dystrophy (m/c Duchenne)
(X-linked recessive deletion of dystrophin gene)
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16
Q

“Cherry-red spots” on macula

A

Tay-Sachs (ganglioside accumulation)
or
Niemann-Pick (sphingomyelin 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 syndrome
(AI-mediated post-MI fibrinous pericarditis)
(1-12wks 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 w/ 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 
Hungtinton disease
(Autosomal dominant CAG repeat expansion)
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22
Q 
Chronic exercise intolerance w/:
Myalgia
Fatique
Painful cramps
Myoglobinuria
A 
McArdle 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 [Multiple sclerosis], unilateral [stroke]

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25
Q

Continuous “machine-like” heart murmur

A

PDA
(Close w/ indomethacin)
(Open or maintain w/ misoprostol)

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26
Q

Cutaneous/dermal edema due to CT deposition

A

Myxedema

Caused by hypothyroidism, Graves disease [pretibial]

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27
Q

Dark purple skin/mouth nodules

AIDS patient

A

Kaposi sarcoma

associated w/ HHV-8

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28
Q

Deep, labored breathing/hyperventilation

A 
Kussmaul respiration
(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
Alcholism or malnutrition

A 
Web berberi
(thiamine [vitamin B1] deficiency)
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31
Q

Dog or cat bite resulting in infection

A

Pasteurella multocida

cellulitis at inoculation site

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32
Q

Dry eyes
Dry mouth
Arthritis

A 
Sjogren syndrome
(AI 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

Hypermobility of joints

A

Ehlers-Danlos syndrome

Type III collagen defect

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35
Q

Enlarged, hard left supraclavicular node

A 
Virchow node
(Abdominal metastasis)
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36
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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37
Q

Facial muscle spasm upon tapping

A

Chvostek sign

Hypocalcemia

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38
Q

Fat
Female
Forty
Fertile

A

Cholelithiasis

gallstones

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39
Q

Fever, Chills
Headache
Myalgia following antibiotic tx for syphilis

A

Jarisch-Herxheimer reaction

rapid lysis of spirochetes results in toxin release

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40
Q 
Fever
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 disease

CT disorder

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43
Q

Gout
Intellectual disability
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 disease

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45
Q

Hamartomatous GI polyps

Hyperpigmentaiton 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 symptoms

A 
Gaucher disease
(Glucocerebrosidase deficiency)
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47
Q

Hereditary nephritis
Sensorineural hearing loss
Cataracts

A

Alport syndrome

mutation in collagen IV

48
Q

Hyperphagia
Hypersexuality
Hyperorality
Hyperdocility

A

Kluver-Bucy syndrome

bilateral amygdala lesion

49
Q

Hyperreflexia
Hypertonia
Babinski sign 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

A

Nonpainful: chancre (Primary symphilis, Treponema pallidum)

Painful, w/ exudate: chancroid (Haemophilus ducreyi)

53
Q

Infant w/ cleft lip/palate
Microcephaly or holoprosencephaly
Polydactyly
Cutis aplasia

A

Patau syndrome

trisomy 13

54
Q

Infant w/ failure to thrive
Hepatosplenomegaly
Nerudegeneration

A

Niemann-Pick disease

genetic sphingomyelinase deficiency

55
Q

Infant w/ hypoglycemia
Failure to thrive
Hepatomegaly

A 
Cori disease (debranching enzyme deficiency)
or
Von Gierke disease (glucose-6-phosphatase deficiency, more severe)
56
Q

Infant w/ microcephaly
Rocker-bottom feet
Clenched hands
Structural heart defect

A

Edwards syndrome

Trisomy 18

57
Q

Jaundice

Palpable distended non-tender gallbladder

A 
Curvoisier sign
(distal obstruction of biliary tree)
58
Q

Large rash w/ bull’s eye appearance

A

Erythema chronicum migrans from Ixodes tick bite

Lyme disease: Borrelia

59
Q

Lucid interval after traumatic brain injury

A

Epidural hematoma

Middle meningeal artery rupture

60
Q

Male child
Recurrent infections
No mature B cells

A

Bruton disease

X-linked agammaglobulinemia

61
Q

Mucosal bleeding and prolonged bleeding time

A 
Glanzmann thrombasthenia
(defect in platelet aggregation due to lack of GpIIb/IIIa)
62
Q

Muffled heart sounds
Distended neck veins
Hypotension

A

Beck triad of cardiac tamponade

63
Q

Multiple colon polyps
Osteomas/soft tissue tumors
Impacted/supernumerary teeth

A 
Gardner syndrome
(Subtype of FAP)
64
Q

Myopathy (infantile hypertrophic cardiomyopathy)

Exercise intolerance

A 
Pompe disease
(Lysosomal alpha-1,4-glucosidase deficiency)
65
Q

Neonate w/ arm paralysis following difficult birth

A

Erb-Duchenne palsy

Superior trunk [C5-C6] branchial plexus injury: “waiter’s tip”

66
Q

No lactation postpartum
Absent mentruation
Cold intolerance

A

Sheehan syndrome

pituitary infarction

67
Q

Nystagmus
Intention tremor
Scanning speech
Bilateral internuclear opthalmoplegia

A

Multiple sclerosis

68
Q

Oscillating slow/fast breathing

A

Cheyne-Stokes respiration

Central apnea in CHF or increased intracranial pressure

69
Q

Painful blue fingers/toes

Hemolytic anemia

A

Cold agglutinin disease

AI hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis

70
Q

Painful, pale, cold fingers/toes

A

Raynaud phenomenon

vasopasm in extremities

71
Q

Painful, raised red lesions on pad of fingers/toes

A 
Osler nodes
(Infective endocarditis, immune complex deposition)
72
Q

Painless erythematous lesions on palms and soles

A 
Janeway lesions
(Infective endocarditis, septic emboli/microabscesses)
73
Q

Painless jaundice

A

Cancer of pancreatic head obstructing bile duct

74
Q

Palpable purpura on buttocks/legs
Joint pain
Abdominal pain (child)
Hematuria

A

Henoch-Schonlein purpura

IgA vasculitis affecting skin and kidneys

75
Q

Pancreatic
Pituitary
Parathyroid tumors

A 
MEN 1
(Autosomal dominant)
76
Q

Periorbital and/or peripheral edema
Proteinuria
Hypoalbuminemia
Hypercholesterolemia

A

Nephrotic syndrome

77
Q

Pink complexion
Dyspnea
Hyperventilation

A

“Pink puffer”

Emphysema: centriacinar [smoking]; panacinar [alpha-antitrypsin deficiency]

78
Q 
Polyuria
Renal tubular acidosis Type II
Growth failure
Electrolyte imbalances
Hypophosphatemic rickets
A 
Fanconi syndrome
(Proximal tubular reabsorption defect)
79
Q

Pruritic, purple, polygonal planar papules and plaques

6 P’s

A

Lichen planus

80
Q

Ptosis
Miosis
Anhidrosis

A

Horner syndrome

Sympathetic chain lesion

81
Q

Pupil accommodates but doesn’t react

A

Argyll Robertson pupil

Neurosyphilis

82
Q

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

A

Guillain Barre syndrome

Acute AI inflammatory demyelinating polyneuropathy

83
Q

Rash on palms and soles

A

Cosackie A
Secondary syphilis
Rocky Mountain spotted fever

84
Q

Recurrent colds
Unusual eczema
High serum IgE

A

Hyper-IgE syndrome

Job syndrome: neutrophil chemotaxis abnormality

85
Q

Red “current jelly” sputum in alcoholic or diabetic patient

A

Klebsiella pneumoniae

86
Q

Red “currant jelly” stools

A

Acute mesenteric ischemia (adults)

Intussusception (infants)

87
Q

Red, itchy, swollen rash of nipple/areola

A

Paget disease of breast

Sign of underlying neoplasm

88
Q

Red urine in the morning

Fragile RBCs

A

Paroxysmal nocturnal hemoglobinuria

89
Q

Renal cell carcinoma (bilateral)
Hemangioblastomas
Angiomatosis
Pheochromocytoma

A

von Hippel-Lindau disease

dominant tumor suppressor gene mutation

90
Q

Resting tremor
Rigidity
Akinesia
Postural instability

A 
Parkinson disease
(Nigrostriatal dopamine depletion)
91
Q

Retinal hemorrhages with pale centers

A 
Roth spots
(Bacterial endocarditis)
92
Q

Severe jaundice in neonate

A

Crigler-Najjar syndrome

Congenital unconjugated hyperbilirubinemia

93
Q

Severe RLQ pain w/ palpation of LLQ

A

Rovsing sign

Acute appendicitis

94
Q

Severe RLQ pain w/ rebound tenderness

A

McBurney sign

Acute appendicitis

95
Q

Short stature
Increased incidence of tumors/leukemia
Aplastic anemia

A

Fanconi anemia
(Genetic loss of DNA crosslink repair)
(Often progresses to AML)

96
Q

Single palmar crease

A

Down syndrome

97
Q

Situs inversus
Chronic sinusitis
Bronchiectasis
Infertility

A 
Kartagener syndrome
(Dynein arm defect affecting cilia)
98
Q

Skin hyperpigmentation
Hypotension
Fatique

A

Addison disease

Primary adrenocortical insufficiency causes increased ACTH and Increased alpha-MSH production

99
Q

Slow, progressive muscle weakness in boys

A

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

100
Q

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

A

Koplik spots

Measles; rubeola virus

101
Q

Smooth, flat, moist, painless white lesions on genital

A

Condylomata lata

Secondary syphilis

102
Q

Splinter hemorrhages in fingernails

A

Bacterial endocarditis

103
Q

“Strawberry tongue”

A

Scarlet fever
Kawasaki disease
Toxic shock syndrome

104
Q 
Streak ovaries
Congenital heart disease
Horseshoe kidney
Cystic hygroma at birth
Short stature
Webbed neck
Lymphedema
A

Turner syndrome

45, XO

105
Q

Sudden swollen/painful big toe joint

Tophi

A

Gout/podagra

Hyperuricemia

106
Q

Swollen gums
Mucosal bleeding
Poor wound healing
Petechiae

A

Scurvy

Vitamin C deficiency: can’t hydroxylate proline/lysine for collagen synthesis

107
Q

Swollen, hard, painful finger joints

A

Osteoarthritis

Osteophytes on PIP [Bouchard nodes], DIP [Heberden nodes]

108
Q

Systolic ejection murmur (cresendo-decresendo)

A

Aortic valve stenosis

109
Q

Thyroid and parathyroid tumors

Pheochromocytoma

A 
MEN 2A
(Autosomal dominant ret mutation)
110
Q

Thyroid tumor
Pheochromocytoma
Ganglioneuromatosis

A 
MEN 2B
(Autosomal dominant ret mutation)
111
Q

Toe extension/fanning upon plantar scrape

A

Babinski sign

UMN lesion

112
Q

Unilateral facial drooping involving forehead

A

Facial nerve

LMN CN VII palsy

113
Q

Urethritis
Conjunctivitis
Arthritis in a male

A

Reactive arthritis associated w/ HLA-B27

114
Q

Vascular birthmark (port-wine stain)

A

Hemangioma

Benign, but associated with Sturge-Weber syndrome

115
Q

Vomiting blood following gastroesophageal lacerations

A

Mallory-Weiss syndrome

Alcoholic, and bulimic patients

116
Q 
Weight loss
Diarrhea
Arthritis
Fever
Adenopathy
A

Whipple disease

Tropheryma whipplei

117
Q

“Worst headache of my life”

A

Subarachnoid hemorrhage

USMLE Step 1 (4 decks)

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