Classic Pt Present Flashcards
Abdominal pain, ascites, hepatomegaly
Budd Chiari Syndrome (posthepatic venous thrombosis)
Achilles Tendon xanthoma
Familial hypercholesterolemia ( low LDL receptor signaling)
Adrenal Hemorrhage, Hypotension, DIC
Waterhouse-Friderichsen Syndrome (Meningococcemia)
Arachnodactyly, lens discolation, aortic dissection, hyperflexible joints
Marfan’s Syndrome (Fibrillin defect)
Athlete w/ polycythemia
Secondary to erythropoietin injection
Back pain, fever, night sweats, weight loss
Pott’s Disease (TB in vertebrae)
B/L Hilar adenopathy, uveitis
Sarcoidosis (Noncaseating granuloma)
Blue Sclera
Osteogenesis Imperfecta (Type 1 collagen defect)
Bluish line on gingiva
Burton’s line (Lead poisoning)
Bone pain, bone enlargement, arthritis
Paget’s Disease (inc. osteoblast/clast activity)
Bounding pulses, diastolic heart murmur, head bobbing
Aortic Regurgitation
Butterfuly (malar) rash and Raynaud’s phenom in young female
SLE
Cafe-au-alit spots, Lisch nodules (iris hamartoma)
Neurofibromatosis type I (+ pheochromocytoma, optic glioma)
Calf pseudohypertophy
Muscular Dystrophy (MC Duchenne’s muscular dystrophy); x-linked recessive deletion of Dystrophin gene
“Cherry-red spot” on macula
Tay-Sach’s (Ganglioside accumulations) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion
Chest pain on exertion
Angina (Stable, unstable)
Chest pain, pericardial effusion/friction rub, persistent fever FOLLOWING MI
Dressler’s Syndrome (autoimmune mediated post MI fibrinous pericarditis, 1-12 wks post acut MI)
Cafe-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnorms
McCune-Alrbright Syndrome (mosaic G-protein signaling mutation)
Child uses arms to stand up from squatting
Gower’s Sign (Duchenne’s Muscular Dystrophy)
Child w/ fever later develops red rash on face that spreads to body
“Slapped cheeks” (erythema infectiosum/fifth disease; parvovirus B19)
Chorea, Dementia, Caudate degeneration
Hungtington’s Disease (auto-dominant CAG repeat expansion)
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
McArdle’s Disease (muscle glycogen phosphorylase deficiency)
Cold Intolerance
Hyothyrodism
Conjugate lateral gaze palsy, horizontal diplopia
Internuclear opthalmoplegia (damage to MLF; bilateral [multiple sclerosis], Unilateral [Stoke])
Continuous “machinery” heart murmur
Patent Ductus Arteriosus (close w/ Indomethacin; open or maintain w/ Misoprostol)
Cutaneous/dermal edema due to connective tissue deposition
Myxedema (caused by hypothyroidism, Grave’s disease [pretibial])
Dark purple skin/mouth nodules
Kaposi’s Sarcoma (AIDS pts [MSM]: associated w/ HHV-8)
Deep, labored breathing/hyperventilation
Kussmaul breathing (diabetic ketoacidosis)
Dermatitis, dementia, diarrhea
Pellagra (niacin [vit B3] deficiency)
Dilated cardiomyopathy, edema, alcoholism or malnutrition
Wet beriberi (thiamine [vit B1] deficiency)
Dog or cat bite resulting in infection
Pasteurella multocida (cellulitis at inoculation site)
Dry eyes, dry mouth, arthritis
Sjogren’s Syndrome (autoimmune destruction of exocrine glands)
Dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome (may progress to esophageal sq cell carcinoma)
Elastic skin, hypermobility of joints
Ehlers-Danlos Syndrome (type III collagen defect)
Enlarged, hard left supraclavicular node
Virchow’s nodule (Abdominal metastasis)
Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
Sezary Syndrome (cutaneous T-cell lymphoma or Mycosis Fungoides
Facial muscle spasm upon tapping
Chvostek’s sign (hypocalcemia)
Fat, female, forty, and fertile
Cholelithiasis (gallstones)
Fever, chills, headache, mylagia following antibiotic treatment for syphilis
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
Fever, cough, conjunctivits, coryza, diffuse rash
Measles (Morbillivirus)
Fever, night sweats, weight loss
B symptoms (staging) of lymphoma
Fibrous plaques in soft tissue of penis
Peyronie’s disease (CT disorder)
Gout, mental retardation, self-mutilating behavior in a boy
Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)
Green-yellow rings around peripheral cornea
Kayser-Fleischer rings (copper build up from Wilson’s Disease)
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; increased cancer risk, mainly GI)
Hepatosplenomegaly, osteoporosis, neurologic symptoms
Gaucher’s disease (glucocerebrosidase deficiency)
Hereditary nephritis, sensorineural hearing loss, cataracts
Alport Syndrome (mutation in alpha chain of collagen IV)
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Kluver Bucy syndrome (bilateral amygdala lesion)
Hyperreflexia, hypertonia, + babinski sign
Upper motor neuron damage
Hyporeflexia, hypotonia, atrophy, fasciculations
Lower motor neuron damage
Hypoxemia, polycythemia, hypercapnia
Blue bloaters (chronic bronchitis: hyperplasia of mucous cells)
indurated, ulcerated genital lesion
Nonpainful: Chancre (primary syphilis, Treponema pallidium) Painful w/ exudate: Chancroid (Haemophilus ducreyi)
Infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia
Patau’s syndrome (trisomy 13)
Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration
Niemann-Pick disease (genetic sphingomyelinase deficiency)
Infant with hypoglycemia, failure to thrive, and hepatomegaly
Cori’s disease (debranching enzyme deficiency)
Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect
Edwards’ Syndrome (trisomy 18)
Jaundice, palpable distended non-tender gallbladder
Courvoisier’s sign (distal obstruction of biliary tree)
Large rash with bull’s eye appearance
Erythema chronicum migrans from Ixodes tick bite (Lyme disease: Borrelia burgdorferia)
Lucid interval after traumatic brain injury
Epidural hematoma (middle meningeal artery rupture)
Male child, recurrent infections, no mature B-cells
Bruton’s disease (X-linked agammaglobulinemia)
Mucosal bleeding and prolonged bleeding time
Glanzmann’s thrombasthenia (defect in platelet aggregation from lack of GpIIb/IIIa)
Muffled heart sounds, distended neck veins, hypotension
Beck’s triad of cardiac tamponade
Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
Gardner’s syndrome (subtype of FAP)
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
Pompe’s disease (lysosomal alpha-1,4-glucosidase deficiency)
Neonate with arm paralysis following difficult birth
Erb-Duchenne palsy (superior trunk [C5-6] brachial plexus injury: “waiter’s tip”)
No lactation postpartum, absent menstruation, cold intolerance
Sheehan’s syndrome (pituitary infarction)
Nystagmus, intention tremor, scanning speech, bilateral internuclear opthalmoplegia
Multiple Sclerosis
Oscillating slow/fast breathing
Cheyne-Stokes respirations (central apnea in CHF or increase intracranial pressure)
Painful blue fingers/toes, hemolytic anemia
Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infections mononucleosis)
Painful, pale, cold fingers/toes
Raynaud’s phenomenon (vasospasm in extremities)
Painful, raised red lesions on pad of finger/toes
Osler’s node (infective endocarditis, immune complex deposition)
Painless erythematous lesions on palms and soles
Janeway lesions (infective endocarditis, septic emboli/microabscesses)
Painless jaundice
Cancer of pancreatic head obstructing bile duct
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria
Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
Pancreatic, pituitary, parathyroid tumors
MEN1 (auto-dominant)
Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia
Nephrotic syndrome
Pink complexion, dyspnea, hyperventialion
Pink Puffer (emphysema: centriacinar [smoking], panacinar [alpha-1-antitrypsin] deficiency)
Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets
Fanconi’s Syndrome (proximal tubular reabsorption defect)
Positive anterior “drawer sign”
Anterior Cruciate ligament injury
Pruritic, purple, polygonal planar papules and plagues (6 P’s)
Lichen Planus
Ptosis, miosis, anhidrosis
Horner’s syndrome (sympathetic chain lesion)
Pupil accomodates but doesn’t react
Argyll Robertson pupil (neurosyphilis)
Rapidly progressive leg weakness that ascends following GI/upper respiratory infection
Guillan-Barre syndrome (actue autimmune inflammatory demyelinating polyneuropathy)
Rash on palms and soles
Coxsackie A, secondary Syphilis, Rocky Mountain Spotted Fever
Recurrent colds, unusual eczema, high serum IgE
Hyper-IgE syndrome (Job’s Syndrome: neutrophil chemotaxis abnormality)
Red “current jelly” sputum in alcoholic or diabetic patients
Klebsiella pneumoniae
Red “currant jelly” stools
Acute mesenteric ischemia (adults), intussesception (infants)
Red, itchy, swollen rash of nipple/areola
Paget’s disease of the breat (represents underlying neoplasm)
Red urine in the morning, fragile RBC’s
Paroxysmal nocturnal hemoglobinuria
Renal Cell carcinoma (Bilateral), hemangioblastomas, angiomatosis, pheochromocytoma
von Hippel-Lindau Disease (dominant tumor suppressor gene mutation)
Resting tremor, rigidity, akinesia, postural instability
Parkinson’s Disease (nigrostriatal dopamine depletion)
Retinal hemorrhages with pale centers
Roth’s spots (bacterial endocarditis)
Severe jaundice in neonate
Crigler-Najjar syndrome (Congenital unconjugated hyperbilirubinemia)
Severe RLQ pain with palpation of LLQ
Rovsing’s Sign (acute appendicitis)
Severe RLQ pain with rebound tenderness
McBurney’s sign (appendicitis)
Short stature, increased incidence of tumors/leukemia, aplastic anemia
Fanconi’s Anemia (genetic loss of DNA crosslink repair; often progresses to AML)
Single palmar crease
Simian crease (Down Syndrome)
Situs inversus, chronic sinusitis, bronchiectasis, infterility
Kartagener’s Syndrome (Dynein arm defect –>primary ciliary dyskinesia)
Skin hyperpigmentaiton, hypotension, fatigue
Addison’s disease (primary adrenocortical insufficiency causes increased ACTH and alpha-MSH production)
Slow, progressive muscle weakness in boys
Becker’s Muscular Dystrophy (X-linked missense mutation in Dystrophin; less severe than Duchenne’s)
Small, irregular red spots on buccal/lingual mucosa with blue-white centers
Koplik Spots (measles; rubeola virus)
Smooth, flat, moist, painles white lesions on genitals
Condylomata lata (secondary syphilis)
Splinter hemorrhages in fingernails
Bacterial endocarditis
Strawberry Tongue
Scarlet fever, Kawasaki disease, toxic shock syndrome
Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema
Turner Syndrome (45,XO)
Sudden swollen/painful big toe joint, tophi
Gout/podagra (hyperuricemia)
Swollen gums, mucosal bleeding, poor wound healing, spots on skin
Scurvy (vit C deficiency: can’t hydroxylate proline/lysine for collagen syntheiss)
Swollen, hard, painful finger joints
Osteoarthritis (osteophytes on PIP [Bouchard’s nodes], DIP [Heberden’s nodes])
Systolic ejection murmur (crescendo-decrescendo)
Aortic stenosis
Thyroid and parathyroid tumors, pheochromocytoma
MEN2A (auto Dominant ret mutation)
Thyroid tumors, pheochromocytoma, ganglioneuromatosis
MEN 2B (auto-dominant ret mutation)
Toe extension/fanning upon plantar scrape
Babinski sign (UMN lesion)
Unilateral facial droopooping involving forehead
Facial nerve (LMN CN VII palsy)
Urethritis, conjunctivitis, arthritis in a male
Reactive arthritis associated with HLA-B27
Vascular birthmark (port wine stain)
Hemangioma (Benign, but associated with Sturge-Weber syndrome)
Vomiting blood following gastroesophageal lacerations
Mallory-Weiss syndrome (alcoholic and bulimic patients)
Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple’s disease (Tropheryma whippeleii)
“Worst headache of my life”
Subarachnoid hemorrhage
HTN and hyperkalemia
Renal failure.
SHIPP
Rx that cause Lupus like symptoms: S: Sulfasalazine H: Hydralazine I: Isoniazid P: Procainamide P: Phenytoin