Key Features

Question 1

Abdominal pain, ascitis hepatomegaly

Answer 1

Buds-chiari syndrome (post hepatic venous thrombosis )

Question 2

Abdominal pain diarrhea leukocytosis Recent antibiotic use

Answer 2

Clostridium difficile infection

Question 3

Achilles’ tendon xanthoma

Answer 3

Familial hypercholesterolemia

Question 4

Adrenal hemorrhage hypotension DIC

Answer 4

Waterhouse-Friederichsen syndrome (meningococcal infection)

Question 5

Anaphylaxis following blood transfusion

Answer 5

IgA deficiency

Question 6

Arachnodactyly lens dislocation (upward) aortic dissection hyper flexible joints

Answer 6

Marfan syndrome (fibrillin defect)

Question 7

Athlete with polycythemia

Answer 7

2 to erythropoietin injection

Question 8

Back pain fever night sweats

Answer 8

Pott disease (vertebral TB)

Question 9

Bilateral hilar adenopathy uveitis

Answer 9

Sarcoidosis (non caseating granulomas )

Question 10

Black Eschar on face of patient with diabetes mellitus (DKA)

Answer 10

Mucor Rhizopus fungal infecciones

Question 11

Bluish line on gigiva ( burton line)

Answer 11

Lead poisoning

Question 12

Bone pain bone enlargement arthritis

Answer 12

Paget disease (increase osteoblastic / osteoclastic activity)

Question 13

Aortic regurgitation

Answer 13

Bounding pulses
Wide pulse pressure
Diastolic heart murmur
Head bobbing

Question 14

Neurofibromatosis type I

Answer 14

Cafe-au-lait spot
Lisch nodules (iris hemartoma)
Cutaneous neurofibromas 
Pheochromocytoma 
Optic glioma

Question 15

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

Answer 15

McCune-Albright syndrome (mosaic G protein signaling mutation)

Question 16

Calf pseudohypertrophy

Answer 16

Muscular dystrophy (duchenne)

Question 17

Cervical lymphadenopathy 
Desquamating rash 
Coronary aneurism
Red conjuntiva and tongue 
Hand-foot change

Answer 17

Kawasaki disease (Tto IVIG and aspirin )

Question 18

Cherry red spot on macula

Answer 18

Tay-Sachs (GM2 accumulation )
Niemann pick (Sphingomyelin accumulation)
Central artery occlusion

Question 19

Chest pain
Pericardial effusion/friction rub
Persisten fiver follow by MI

Answer 19

Dressler syndrome

Question 20

Chest pain with ST depression

Answer 20

Unstable angina (- troponins )
NSTEMI (+ troponins)

Question 21

Child use hands to stand up from squad

Answer 21

Duchenne muscular dystrophy (grower sign)

Question 22

Child with fever later develop red rash on face and spread to body

Answer 22

Erythema infectiosum/5th disease (slap cheek diseas) cause by parvovirus B19

Question 23

Chorea dementia caudate degeneration

Answer 23

Huntington disease (CAG)

Question 24

Choreoretinitis hydrocephalus intracranial calcifications

Answer 24

Toxoplasmosis Congenital

Question 25

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

Answer 25

McArdle disease (glycogen phosporilase deficiency: in muscle )

Question 26

Conjugated horizontal gaze palsy

Horizontal diplopia

Answer 26

Internuclear ophthalmoplegia (damage to MLF) can be uní or bilateral

Question 27

Lesion on optic nerve

Answer 27

Ipsilateral anopia

Question 28

Lesion on optic chiasm

Answer 28

Bitemporal hemianopia

Question 29

Lesion on lateral geniculated body

Answer 29

Homonymous hemianopia

Question 30

Lesion on Meyer loop

Answer 30

Pie in the sky (upper quadrantanoptia) lesion on temporal lobe (MCA)

Question 31

Lesion on dorsal optic radiations

Answer 31

lower quadrantanopia (parietal lobe lesion MCA)

Question 32

Lesion on visual cortex

Answer 32

Bitemporal hemianopia with macular spearing

Question 33

Lesion on macula

Answer 33

Central escotoma