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