Rapid Review Classcial Presentations2 Flashcards
1
Q
CLINICAL PRESENTATION
A
DIAGNOSIS/DISEASE
2
Q
Abdominal pain, ascites, heptomegaly
A
Budd-Chiari syndrome (posthepatic venous thrombosis)
3
Q
Achilles tendon xanthoma
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Familial hypercholestrolemia (decreased LDL receptor signaling)
4
Q
Adrenal hemorrhage, hypotension, DIC
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Waterhouse-Friderichsen sydrome (meningococcemia)
5
Q
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
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Marfan’s syndrome (fibrillin defect)
6
Q
Athlete with polycythemia
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Secondary to erythropoietin injection
7
Q
Back pain, fever, night sweats, weight loss
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Pott’s disease (vertebral tuberculosis)
8
Q
Bilateral hilar adenopathy, uveitis
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Sarcoidosis (noncaseating granulomas)
9
Q
Blue sclera
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Osteogenesis imperfecta (type I collagen defect)
10
Q
Bluish line on gingiva
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Burton’s line (lead poisoning)
11
Q
Bone pain, bone enlargement, arthritis
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Paget’s disease of bone ( increased osteoblastic and osteoclastic activity)
12
Q
Bounding pulses, diastolic heart murmur, head bobbing
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Aortic regurgitation
13
Q
“Butterfly” facial rash and Raynaud’s phenomenon in a young female
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Systemic lupus erythematosus
14
Q
Caf_-au-lait spots, Lisch nodules (iris hamartoma)
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Neurofibromatosis type I (+ pheochromocytoma, optic gliomas)
15
Q
Caf_-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple edocrine abnormalities
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McClune-Albright syndrome (mosaic G-protein signaling mutation)
16
Q
Calf pseudohypertrophy
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Muscular dystropy ( most commonly Duchenne’s): X-linkage recessive deletion of dystrophin gene
17
Q
“Cherry-red spot” on macula
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Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion
18
Q
Chest pain on exertion
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Angina (stable: with moderate exertion; unstable: with minimal exertion
19
Q
Chest pain, pericardial effusion/friction rub, persistent fever following MI
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Dressler’s syndrome (autoimmune-mediated post MI fibrinous pericarditis, 1-12 weeks after acute episode)
20
Q
Child uses arms to stand up from squat
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Gowers’ sign (Duschenne muscular dystrophy)
21
Q
Child with fever later develops red rash on face that spreads to body
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“Slapped cheeks” (erythema infectiosum/fifth disease: parovirus B19)
22
Q
Chorea, dementia, caudate degeneration
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Huntington’s disease (autosomal-dominant CAG repeat expansion)
23
Q
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
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McArdle’s disease (muscle glycogen phosphorylase deficiency)
24
Q
Cold intolerance
A
Hypothyroidism
25
Conjugate lateral gaze palsy, horizontal diplopia
Internuclear opthalmoplegia (damage to MLF; bilateral [multiple sclerosis], unilateral [stroke])
26
Continuous "machinery" heart murmur
PDA (close with indomethacin; open or maintain with misoprostol)
27
Cutaneous/dermal edema due to connective tissue deposition
Myxedema (caused by hypothyroidism, Graves' disease [pretibial])
28
Dark purple skin/mouth nodules
Kaposi's sarcoma (usually AIDS patients [MSM]: associated with HHV-8)
29
Deep, labored breathing/hyperventilation
Kussmaul breathing (diabetic ketoacidosis)
30
Dermatitis, dementia, diarrhea
Pellagra (niacin [vitamin B3] deficiency)
31
Dialated cardiomyopathy, edema, alcoholism or malnutrition
Wet berberi (thiamine [vitamin B1] deficiency)
32
Dog or cat bite resulting in infection
Pasturella multocida (cellulitis at inoculation site)
33
Dry eyes, dry mouth, arthritis
Sjogren's syndrome (autoimmune destruction of exocrine glands)
34
Dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
35
Elastic skin, hypermobility of joints
Ehlers-Danlos syndrome (type III collagen defect)
36
Enlarged, hard left supraclavicular node
Virchow's node (abdominal metastasis)
37
Erythroderma, lymphadenopathy, heptosplenomegaly, atypical T cells
Sezary syndrome (cutaneous T-cell lymphoma) or mycosis fungoides
38
Facial muscle spasm upon tapping
Chvostek's sign (hypocalcemia)
39
Fat, female, forty and fertile
Cholelithiasis (gallstones)
40
Fever, chills, headache, myalgia following antibiotic treatment for syphilis
Jarisch-Herxheimer reaction (rapid lysis of spirochetes resuls in toxin release)
41
Fever, cough, conjunctivitis, coryza, diffuse rash
Measles (Morbillivirus)
42
Fever, night sweats, weight loss
B symptoms (staging) of lymphoma
43
Fibrous plaques in soft tissue of penis
Peyronie's disease (connective tissue disorder)
44
Gout, mental retardation, self-mutilating behavior in a boy
Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)
45
Green-yellow rings around peripheral cornea
Kayser-Fleischer rings (copper accumulation from Wilson's disease)
46
Hamartomatous GI polyps, hyperpigmenation of mouth/feet/hands
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstuction; Increased cancer risk, mainly GI)
47
Heptosplenomegaly, osteoporosis, neurologic symptoms
Gaucher's disease (glucocerebrosidase deficiency)
48
Hereditary nephritis, sensorineural hearing loss, cataracts
Alport syndrome ( mutation in alpha chain of collagen IV)
49
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Kluver-Bucy syndrome (bilateral amygdala lesion)
50
Hyperreflexia, hypertonia, Babinski sign present
UMN damage
51
Hyporeflexia, hypotonia, atrophy, fasciculations
LMN damage
52
Hypoxemia, polycythemia, hypercapnia
"Blue bloater" (chronic bronchitis: hyperplasia of mucous cells)
53
Indurated, ulcerated genital lesion
Nonpainful: chancre (Primary syphilis, Treponema pallidum) Painful, with exudate chancroid: ( Haemophilus ducreyi)
54
Infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia
Patau's syndrome (trisomy 13)
55
Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration
Niemann-Pick disease (genetic spingomyelinase deficiency)
56
Infant with hypoglycemia, failure to thrive and hepatomegaly
Cori's disease (debranching enzyme deficiency)
57
Infant with microcephaly, rocker-bottom feet, clenched hands and structural heart defect
Edward's syndrome (trisomy 18)
58
Juandice, palpable distended non-tender gallbladder
Courvoisier's sign (distal obstruction of biliary tree)
59
Large rash with bull's-eye appearance
Erythema chronicum migrans from Ixodes tick bite (Lyme disease: Borrelia)
60
Lucid interval after traumatic brain injury
Epidural hematoma (middle menigeal artery rupture)
61
Male child, recurrent infections, no mature B cells
Bruton's disease (X-Linked agammaglobulinemia)
62
Mucosal bleeding and prolonged bleeding time
Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
63
Muffled heart sounds, distended neck veins, hypotension
Beck's triad of cardiacc tamponade
64
Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
Gardner's syndrome (subtype of FAP)
65
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
Pompe's disease ( lysosomal alpha-1,4-glucosidase deficiency)
66
Neonate with arm paralysis following difficult birth
Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip")
67
No lactation postpartum, absent menstruation, cold intolerance
Sheehan's syndrome (pituitary infarction)
68
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmolegia
Multiple sclerosis
69
Oscillating slow/fast breathing
Cheyne-Stokes respirations (central apnea in CHF or increased intracranial pressure)
70
Painful blue fingers/toes, hemoyltic anemia
Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pnuemoniae, infectious mononucleosis
71
Painful, pale, cold fingers/toes
Raynaud's phenomenon (vasospasm in extremities)
72
Painful, raised red lesions on pad of fingers/toes
Osler's node (infective endocarditis immune complex desposition)
73
Painless erythematous lesions on palms and soles
Janeway lesions (infective endocarditis, septic emboli/microabscesses)
74
Painless jaundice
Cancer of the pancreatic head obstructing bile duct
75
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child) hematuria
Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
76
Pancreatic, pituitary, parathyroid tumors
MEN 1 (autosomal dominant)
77
Periorbital and/or peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia
Nephrotic syndrome
78
Pink complexion, dyspnea, hyperventilation
"Pink puffer" (emphysema: centriacinar [smoking], panacin [alpha1-antitrypsin deficiency])
79
Positive anterior "drawer sign"
Anterior cruciate ligament injury
80
Pruritic, purple, polygonal planar papules and plaques (6 P's)
Lichen planus
81
Ptosis, miosis, anhidrosis
Horner's syndrome (sympathetic chain leision)
82
Pupil accommodates but doesn't react
Argyll Robertson pupil (neurosyphilis)
83
Rapidly progressive leg weakness that ascends following GI/upper respiratory infection
Guillian-Barre syndrome (acute autoimmune inflammatory demyelinating polyneuropathy
84
Rash on palms and soles
Coxsakie A, Secondary syphilis, Rocky Mountain spotted fever
85
Recurrent colds, unusual exzema, high serum IgE
Hyper-IgE syndrome (Job's syndrome: neutrophil chemotaxis abnormality)
86
Red "currant jelly" sputum in alcoholic or diabetic patients
Klebsiella pnuemoniae
87
Red "currant jelly" stools
Acute mesenteic ischemia (adults), intussusception (infants)
88
Red, itchy, swollen rash of nipple/areola
Paget's disease of breast (represens underlying neoplasm)
89
Red urine in the morning, fragile RBCs
Paroxysmal nocturnal hemoglobinuria
90
Renal cell carcinoma (bilateral), hemangioblastomas, angiomatosis, pheochromocytoma
von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
91
Resting tremor, rigidity, akinesia, postural instability
Parkinson's disease (nigrostriatal dopamine depletion)
92
Retinal hemorrhages with pale centers
Roth's spots (bacterial endocarditis)
93
Severe jaundice in neonate
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia
94
Severe RLQ pain with palpatation of LLQ
Rovsing's sign (acute appendicitis)
95
Severe RLQ pain with rebound tenderness
McBurney's sign (appendicitis)
96
Short stature, increased incidince of tumors/leukemia, aplastic anemia
Fanconi's anemia (genetic loss of DNA crosslink repair; often progresses to AML)
97
Single palmar crease
Simian crease (Down syndrome)
98
Situs inversus, chronic sinusitis, bronchiectasis, infertility
Kartagener's syndrome (dynein arm defect affecting cilia)
99
Skin hyperpigmentation, hypotension, fatigue
Addison's disease (primary adrenocortical insufficiency causes increased ACTH and increased alpha-MSH production
100
Slow, progressive muscle weakness in boys
Becker's muscular dystrophy (X-linked missense mutation in dystrophin; less severe than Duchenne's
101
Small, irregular red spots on buccal/lingual mucosa with blue-white centers
Koplik spots (measles; rubeola virus
102
Smooth, flat, moist painless white lesions on genitals
Condylomata lata (secondary syphilis)
103
Splinter hemorrahges in fingernails
Bacterial endocarditis
104
"Strawberry tongue"
Scarlet fever, Kawasaki disease, toxic shock syndrome
105
Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema
Turner syndrome (45,XO)
106
Sudden swollen/painful big toe joint, tophi
Gout/podagra (hyperuricemia)
107
Swollen gums, mucosal bleeding, poor wond healing, spots on skin
Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis
108
Swollen, hard, painful finger joints
Osteoarthritis (osteophytes on PIP [Bouchard's nodes], DIP [Heberden's nodes])
109
Systolic ejection murmur crescendo-decrescendo)
Aortic valve stenosis
110
Thyroid and parathyroid tumors, pheochromocytoma
MEN 2A (autosomal dominant ret mutation)
111
Thyroid tumors, pheochromocytoma, ganglioneuromatosis
MEN 2B (autosomal dominant ret mutation)
112
Toe extension/fanning upon plantar scrape
Babinski sign (UMN lesion)
113
Unilateral facial drooping involving forehead
Facial nerve (LMN CN VII palsy)
114
Urethritis, conjunctivitis, arthritis in a male
Reactive arthritis associated with HLA-B27
115
Vascular birthmark (port-wine stain)
Hemangioma (benign, but associated with Sturge-Weber syndrome)
116
Vomiting blood following gastoesohageal lacerations
Mallory-Weiss syndrome (alcoholic and bulimic patients
117
Weight loss, dirrhea, arthritis, fever, adenopathy
Whipple's disease (Tropheryma whipplei)
118
"Worst headache of my life"
Subarachnoid hemorrhage
