USMLE Step 1 Rapid Review Flashcards
1
Q
Gout, intellectual disability and self-mutilating behaviour in young child.
A
Lesch-Nyhan Syndrome
2
Q
Blue sclera
A
Osteogenesis imperfecta
3
Q
Arachnodactyly, lens dislocation upwards, aortic dissection, hyperflexible joints.
A
Marfan’s Syndrome (fibrillin defect).
4
Q
Elastic skin, hypermobility of joints, increased bleeding tendency.
A
Ehlers-Danlos syndrome.
5
Q
Single palmar crease
A
Down’s syndrome.
6
Q
Swollen gums, muscosal bleeding, poor wound healing, petechiae.
A
Scurvy - vitamin D deficiency.
7
Q
Hepatosplenomegaly, pancytopenia, osteoporosis, aseptic necrosis of femoral head, bone crises.
A
Gaucher Disease - characterised by bruising, fatigue, anaemia, low platelets, and liver/spleen enlargement.
8
Q
Achiles tendon xanthoma
A
Familial hypercholesterolaemia.
9
Q
Anaphylaxis following blood transfusion
A
IgA deficiency.
10
Q
Dilated cardiomyopathy, oedema, alcoholism/malnutrition.
A
Wet Beriberi - thiamine deficiency.
11
Q
Dermatitis, dementia, diarrhoea.
A
Pellegra - niacin - vit B3 deficiency.
12
Q
“Strawberry tongue”
A
Scarlett fever - GAS infection (sore throat, fever ,headache, swollen lymph node, characteristic rash - sandpapery bumps).
Kawasaki disease - vasculitis, typically in young Asian (Japanese) children.
13
Q
Adrenal haemorrhage (-> insufficiency), hypotension, DIC
A
Waterhouse-Friderichsen syndrome (meningococcocaemia).
14
Q
Red “currant jelly” sputum in alcoholic/diabetic patients.
A
Klebsiella pneumoniae pneumonia.
15
Q
Indurated, ulcerated genital lesion.
1 - painless.
2 - painful.
A
Painless - primary syphillus, Treponema pallidum.
Painful with exudate - chancroid.
16
Q
Fever, cough, conjunctivitis, coryza, diffuse rash
A
Measles.
17
Q
Back pain, fever, night sweats
A
Pott’s disease (vertebral TB).
18
Q
Abdo pain, diarrhoea, leukocytosis, recent antibiotic use
A
Clostridium difficile.
19
Q
Bounding pulses, wide pulse pressure, diastolic murmur, head bobbing.
A
Aortic regurgitation.
20
Q
Systolic ejection murmur (crescendo-descendo)
A
Aortic stenosis.
21
Q
Continuous “machine-like” murmur.
A
Patent ductus arteriosus.
22
Q
Chest pain, pericardial effusion/friction rub, persistent fever following MI.
A
Dressler’s syndrome (AI mediated post-MI pericarditis, 2wks-months after acute episode).
23
Q
Painful, raised red lesions on pads of fingers/toes.
A
Oslers nodes - Infective endocarditis.
24
Q
Painless erythematous lesions on palms and soles.
A
Janeway lesions - infective endocarditis.
25
Retinal haemorrhages with pale centers.
Roth spots - bacterial endocarditis.
26
Distant heart sounds, distended neck veins, hypotension.
Beck triad of cardiac tamponade.
27
Cervical lymphadenopathy, desquamating rash, coronary aneurysms, red conjunctivae + tongue, hand-foot changes.
Kawasaki disease.
28
Palpable purpura on buttocks/legs, joint pain, abdo pain (child), haematuria.
Henoch-schonlein purpura (IgA vasculitis affecting kidney and skin).
29
Telangiectasias, recurrent epistaxis, skin discolouration, arteriovenous malformations, GI bleeding, haemauria.
Hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome).
30
Skin hyperpigmentation, hypotension, fatigue.
Primary adrenocortical insufficiency (e.g. Addison's.)
31
Facial muscle spasm on tapping.
Chvostek's sign - hypocalcaemia.
32
No lactation postpartum, absent menstruation.
Sheehan's syndrome - postpartum haemorrhage leading to pituitary infarct.
33
Deep, laboured breathing/hyperventilation.
DKA - Kussmaul breathing.
34
Cutaneous flushing, diarrhoea, bronchospasm
Carcinoid syndrome.
35
Pancreatic, pituitary and parathyroid tumours.
MEN 1.
36
Thyroid tumours, phaeochromocytoma, ganglioneuromatosis, Marfanoid habitus.
MEN 2B.
37
Thyroid and parathyroid tumours, phaeochromocytomas.
MEN 2A.
38
Painless jaundice.
Cancer of the pancreatic head obstructing the bile duct.
39
Dysphagia, glossitis, IDA.
Plummer-Vinson syndrome.
40
Severe RLQ pain with palpation LLQ
Rovsing's sign - acute appendicitis.
41
Severe RLQ pain with deep tenderness.
McBurney's sign - acute appendicitis.
42
Haemartomatous GI polyps, hyperpigmentation of mouth/feet/hands/genitalia.
Peutz-Jegher's syndrome.
43
Multiple colon polyps, soft tissue tumours, impacted teeth.
Gardner syndrome - subtype of FAP.
44
Abdo pain, ascites, hepatomegaly.
Budd-Chiari syndrome.
45
Severe jaundice in neonate.
Crigler-Najjar syndrome.
46
Gold brown rings around peripheral cornea.
Kayser-Fleischer rings due to copper accumulation -> Wilson's disease.
47
Fat, female, forty, fertile, familial.
Cholelithiasis (gallstones).
48
Short stature, cafe-au-lait spots, thumb/radial defects, aplastic anaemia.
Possible tumours, leukaemias.
Fanconi anaemia.
49
Red urine in morning
Paroxysmal nocturnal haematuria.
50
Smudge (WBC) cells.
CLL.
51
Athelete with polycythaemia.
second to EPO injection.
52
Bone pain, bone enlargement, arthritis.
Paget disease of bone.
53
Swollen, hard, painful finger joints in elderly individual - worsening with activity.
Name the signs.
Name the disease.
PIP - Bouchard's nodes.
DIP - Herberden nodes.
Osteoarthritis.
54
Sudden swollen/painful big toe, tophi.
Gout.
55
Dry eyes, dry mouth.
Sjogren syndrome.
56
Urethritis, conjuncitivitis, arthritis in male.
Reactive arthritis.
57
Butterfly facial rash and Raynaud's in young female.
SLE.
58
Anticentromere antibodies
Scleroderma (CREST).
59
Painful fingers/toes changing from white to blue to red in cold/stress.
Raynauds.
60
Dark purple skin/mouth nodules in AIDS.
Kaposi sarcoma, associated with HHV-8.
61
Lucid interval after traumatic brain injury.
Extradural haematoma.
62
"Worst headache of my life"
SAH.
63
Resting tremor, rigidity, akinesia, postural instability, shuffling gait.
Parkinson's.
64
Chorea, dementia, caudate degeneration.
Huntingtons.
65
Cafe-au-lait spots, cutaneous neurofibromas, phaechromocytomas, optic gliomas.
Neurofibromatosis T1.
66
Hypereflexia, hypertonia, Babinski +ve.
UMN damage.
67
Hyporeflexia, hypotonia, fasciculations, atrophy.
LMN damage.
68
Episodic vertigo, tinnitus, hearing loss.
Meniere disease.
69
Ptosis, miosis, anhydrosis.
Horners.
70
Unilateral facial drooping, involving forehead.
LMN facial nerve palsy.
UMN facial nerve palsy would spare the forehead.
71
Polyuria, renal tubular acidosis, failure to thrive, electrolyte imbalance, hypophosphataemic rickets.
Fanconi syndrome.
72
Bluish line on gingiva.
Lead posioning.
73
Periorbital/peripheral oedema, proteinuria, hypoalbuminaemia (hypercholesterolaemia).
Nephrotic syndrome.
74
Hypoxaemia, polycythaemia, hypercapnia.
Chronic bronchitis.
75
Pink complexion, dyspnoea, hyperventilation.
Emphysema.
76
Bilateral hilar adenopathy, uveitis. Raised ACE.
Sarcoiditis.
77
Optochin sensitivity
Sensitive; S pneumoniae.
| Resistant; viridans streptococci.
78
Bacitracin
Sensitive; S pyogene (Group A).
| Resistant; S. agalatae.
79
Ring-enhancing brain lesion on CT/MRI in AIDS
Toxoplasma gondii.
| CNS lymphoma
80
Cardiomegaly with apical atrophy.
Chagas disease - Trypanosoma cruzi.
81
Heterophile antibodies.
Infectious mononucleosis (EBV).
82
Atypical lymphocytes.
EBV.
83
Thumb sign on lateral neck x-ray.
Epiglottitis.
84
Delta wave on ECG, short PR, SVT.
WPW syndrome.
85
Rib notching (on X-ray)
Coarctation of the aorta.
86
Heart nodules (granulomatous).
Aschoff bodies of Rheumatoid fever.
87
Alternative amplitude on ECG.
Pericardial tamponade.
88
HTN, hypokalaemia, metabolic alkalosis.
Primary hyperaldosteronism (Conn's syndrome).
89
Antineutrophil cytoplasmic antibodies (ANCAs).
Microscopic polyangiitis and eosinophilic granulomatosis
with polyangiitis - Churg-Strauss (MPO-ANCAp/p-ANCA).
Granulomatosis with polyangiitis - Wegeners (PR3-ANCA/c-ANCA).
PSC (MPO-ANCA/p-ANCA).
90
Signet ring cell (mucin filled with peripheral nucleus).
Gastric carcinoma.
91
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies.
Coeliac disease.
92
Narrowing of bowel lumen on barium X-ray.
"String sign" - Crohn disease.
93
Eosinophilic cytoplasmic inclusion in liver cell - Mallory body.
Alcohol liver disease.
94
Triglyceride accumulation in liver cell vacuoles.
Fatty liver disease.
95
Anti mitochondrial antibodies.
Primary biliary sclerosis.
96
low serum caeroplasmin.
Wilson disease.
97
Hypersegmented neutrophils
Megaloblastic anaemia (B12 deficiency, folate deficiency).
98
Reed-Sternberg cells; giant B cells with bilobed nuclei with prominant inclusions.
Hodkin lymphoma.
99
"Punched out" bone lesions on X-ray.
Multiple myeloma.
100
Monoclonal Ab spike.
```
Multiple myeloma (IgG or IgA).
Primary amyloidsis.
```
101
Rouleaux formation.
Multiple myeloma.
102
Auer rods.
AML.
103
Brown tumour of bone.
Hyperparathyroidism.
| Osteitis fibrosa cystica.
104
Anti-IgG antibodies.
Rheumatoid arthritis.
105
Rhomboid crystals, positive birefringent crystals.
Pseudogout.
106
Needle shaped, negative birefringent crystals.
Gout.
107
Raised uric acid levels.
Gout, tumour lysis syndrome, thiazide diuretics.
108
Bamboo spine on X-ray.
Ankylosing spondylitis.
109
Antinuclear antibodies.
SLE.
110
Anti-topoisomerase antibodies.
Diffuse systemic sclerosis.
111
Keratin pearls on skin biopsy.
Squamous cell carcinoma.
112
Bloody/yellow tap on LP.
(Xanthochromia) SAH.
113
RBC casts in urine.
Glomerulonephritis.
114
Anti-glomerular basement membrane antibodies.
Goodpasture syndrome - glomerulonephritis and haemoptysis (Pulmonaryrenal syndrome).
115
WBC casts in urine.
Acute pyelonephritis.
116
"Honeycomb lung" X-ray/CT.
Interstitial pulmonary fibrosis.
117
Colonies of Pseduomonas in lungs.
Cystic fibrosis.
118
Food posioning (rapid onset vomiting - exotoxin mediated).
S aureus, B cereus.
119
Osteomyelitis.
S aureus.
120
Opportunistic infection in AIDS.
Pneumocystis jirovecii.
121
Myocarditis.
Coxsackie b.
122
UTI
E coli.
| May be Staphylococcus saprophyticus in young women.
123
STD.
C trachomatis (usually coinfected with N gonorrhoea).
124
S3 heart sound.
Increased ventricular filling pressure;
Mitral regurgitation.
Heart failure.
125
S4 heart sound.
Hypertrophic ventricle;
Aortic stenosis.
Restrictive cardiomyopathy.
126
Ejection click.
Aortic stenosis.
127
Mitral valve stenosis.
Rheumatic heart disease.
128
Cushing syndrome causes;
Iatrogenic.
Adrenocortical adenoma.
ACTH-secreting pituitary adenoma (Cushing's disease).
Paraneoplastic.
129
Refractory peptic ulcers, high gastrin levels.
Zollinger-Ellison syndrome, associated with MEN1.
130
Acute gastric ulcer associated with CNS injury.
Cushing ulcer (raised ICP - vagal gastric H+ secretion).
131
Acute gastric ulcer associated with severe burns.
Curling ulcer (greatly reduced plasma volume -> sloughing of gastric mucosa).
132
Alternating areas of transmural inflammation and normal colon.
Skip lesions -> Crohn's disease.
133
Site of diverticula.
Sigmoid colon.
134
Hereditary harmless jaundice.
Gilbert syndrome
135
Microcytic anaemia.
IDA.
136
Malignancy associated with noninfectious fever.
Hodgkin lymphoma.
137
t(9;22).
Philadelphia chromosome -> CML, rarely associated with ALL.
138
Vertebral compression fracture.
Osteoporosis.
139
Actinic keratosis
Rough scaly patch on skin from sun exposure, Squamous cell carcinoma precursor.
140
Obstruction of male urinary tract.
BPH.
141
Difficulty drawing blood and high potassium readings.
Pseudohyperkalcaemia from lysis of cells during drawing blood.
142
Auer Rods
AML
143
Smudge cells
CLL
