USMLE Rapid Review (Classic Presentations)

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usmle Medicine Flashcards on USMLE Rapid Review (Classic Presentations), created by shaikhnbakeable . on 10/06/2020.
shaikhnbakeable .
Flashcards by shaikhnbakeable ., updated more than 1 year ago
shaikhnbakeable .
Created by shaikhnbakeable . almost 4 years ago
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Gout, intellectual disability, self-mutilating behavior in a boy 1. Syndrome 2. Enzyme affected 3. Inheritance Pattern 1. Lesch-Nyhan Syndrome 2. HGPRT Defiency 3. XR
Situs inversus, chronic sinusitis, bronchiectasis, infertility 1. Syndrome 2. Defect 1. Kartagener syndrome 2. Dynein arm defect (affects cilia)
Blue Sclera 1. Disease 2. Defect 1. Osteogenesis imperfecta 2. Type I collagen
Elastic skin, hypermobility of joints, Increased bleeding tendency 1. Disease 1. Ehlers-Danlos
Café-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities McCune-Albright Syndrome (Gs-protein activating mutation)
Infant with cleft lip/palate, microcephaly or holoprosencephaly, polydactyly, cutis aplasia Patau Syndrome (trisomy 13)
Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect Edwards Syndrome (trisomy 18)
Dilated cardiomyopathy, edema, alcoholism or malnutrition Wet Beriberi (Thiamine, Vit B1 defiency)
Dermatitis, dementia, diarrhea Pellagra (Niacin, Vit B3 Deficiency)
Swollen gums, mucosal bleeding, poor wound healing, petechiae Scurvy (vitamin C deficiency: can’t hydroxylate proline/ lysine for collagen synthesis)
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria McArdle disease (skeletal muscle glycogen phosphorylase deficiency)
Infant with hypoglycemia, hepatomegaly (Glycogen Storage Disease) Cori disease (debranching enzyme deficiency) or Von Gierke disease (glucose-6-phosphatase deficiency, more severe)
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance Pompe disease (lysosomal α-1,4-glucosidase deficiency)
“Cherry-red spots” on macula Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation), central retinal artery occlusion
Hepatosplenomegaly, pancytopenia, osteoporosis, avascular necrosis of femoral head, bone crises Gaucher disease (glucocerebrosidase [β-glucosidase] deficiency)
Achilles tendon xanthoma Familial hypercholesterolemia ( LDL receptor signaling)
Anaphylaxis following blood transfusion (Ig Deficiency) IgA deficiency
Male child, recurrent infections, no mature B cells Bruton disease (X-linked agammaglobulinemia)
Recurrent cold (noninflamed) abscesses, eczema, high serum IgE, Increased eosinophils Hyper-IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)
“Strawberry tongue” Scarlet fever Kawasaki disease
Abdominal pain, diarrhea, leukocytosis, recent antibiotic use Clostridium difficile infection
Back pain, fever, night sweats Pott disease (vertebral TB)
Adrenal hemorrhage, hypotension, DIC Waterhouse-Friderichsen syndrome (meningococcemia)
Red “currant jelly” sputum in alcoholic or diabetic patients Klebsiella pneumoniae pneumonia
Large rash with bull’s-eye appearance Erythema migrans from Ixodes tick bite (Lyme disease: Borrelia)
Ulcerated genital lesion Nonpainful, indurated: chancre (1° syphilis, Treponema pallidum) Painful, with exudate: chancroid (Haemophilus ducreyi)
Pupil accommodates but doesn’t react Neurosyphilis (Argyll Robertson pupil)
Smooth, moist, painless, wart-like white lesions on genitals Condylomata lata (2° syphilis)
Fever, chills, headache, myalgia following antibiotic treatment for syphilis Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in endotoxin-like release)
Dog or cat bite resulting in infection Pasteurella multocida (cellulitis at inoculation site)
Rash on palms and soles Coxsackie A, 2° syphilis, Rocky Mountain spotted fever
Black eschar on face of patient with diabetic ketoacidosis Mucor or Rhizopus fungal infection
Chorioretinitis, hydrocephalus, intracranial calcifications Congenital toxoplasmosis
Child with fever later develops red rash on face that spreads to body (viral, also causes aplastic anemia) Erythema infectiosum/fifth disease (“slapped cheeks” appearance, caused by parvovirus B19)
Fever, cough, conjunctivitis, coryza, diffuse rash Measles
Small, irregular red spots on buccal/lingual mucosa with blue-white centers Koplik spots (measles [rubeola] virus)
Bounding pulses, wide pulse pressure, diastolic heart murmur, head bobbing Aortic regurgitation
Systolic ejection murmur (crescendo-decrescendo) Aortic stenosis
Continuous “machine-like” heart murmur PDA (close with indomethacin; keep open with PGE analogs)
Chest pain on exertion Angina (stable: with moderate exertion; unstable: with minimal exertion or at rest)
Chest pain with ST depressions on ECG Angina (⊝ troponins) or NSTEMI (⊕ troponins)
Chest pain, pericardial effusion/friction rub, persistent fever following MI Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2 weeks to several months after acute episode)
Painful, raised red lesions on pads of fingers/toes Osler nodes (infective endocarditis, immune complex deposition)
Painless erythematous lesions on palms and soles Janeway lesions (infective endocarditis, septic emboli/ microabscesses)
Splinter hemorrhages in fingernails Bacterial endocarditis
Retinal hemorrhages 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 and tongue, hand-foot changes Kawasaki disease (mucocutaneous lymph node syndrome, treat with IVIG and aspirin)
Palpable purpura on buttocks/legs, joint pain, abdominal pain (child), hematuria Immunoglobulin A vasculitis (Henoch-Schönlein purpura, affects skin and kidneys)
Telangiectasias, recurrent epistaxis, skin discoloration, arteriovenous malformations, GI bleeding, hematuria Hereditary hemorrhagic telangiectasia (Osler-Weber- Rendu syndrome)
Skin hyperpigmentation, hypotension, fatigue 1° adrenocortical insufficiency leads to increased ACTH, increased α-MSH (eg, Addison disease)
Cutaneous flushing, diarrhea, bronchospasm Carcinoid syndrome (right-sided cardiac valvular lesions, increased 5-HIAA)
Cold intolerance, weight gain, brittle hair Hypothyroidism
Cutaneous/dermal edema due to deposition of mucopolysaccharides in connective tissue Myxedema (caused by hypothyroidism, Graves disease [pretibial])
Facial muscle spasm upon tapping Chvostek sign (hypocalcemia)
No lactation postpartum, absent menstruation, cold intolerance Sheehan syndrome (postpartum hemorrhage leading to pituitary infarction)
Deep, labored breathing/hyperventilation Diabetic ketoacidosis (Kussmaul respirations)
Pancreatic, pituitary, parathyroid tumors MEN 1 (autosomal dominant)
Thyroid tumors, pheochromocytoma, ganglioneuromatosis, Marfanoid habitus MEN 2B (autosomal dominant RET mutation)
Thyroid and parathyroid tumors, pheochromocytoma MEN 2A (autosomal dominant RET mutation)
Jaundice, palpable distended non-tender gallbladder Courvoisier sign (distal malignant obstruction of biliary tree)
Vomiting blood following gastroesophageal lacerations Mallory-Weiss syndrome (alcoholic and bulimic patients)
Dysphagia (esophageal webs), glossitis, iron deficiency anemia Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
Enlarged, hard left supraclavicular node Virchow node (abdominal metastasis)
Arthralgias, adenopathy, cardiac and neurological symptoms, diarrhea Whipple disease (Tropheryma whipplei)
Severe RLQ pain with palpation of LLQ Rovsing sign (acute appendicitis)
Severe RLQ pain with deep tenderness McBurney sign (acute appendicitis)
Hamartomatous GI polyps, hyperpigmented macules on mouth, feet, hands, genitalia Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction;  cancer risk, mainly GI)
Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth Gardner syndrome (subtype of FAP)
Golden brown rings around peripheral cornea Wilson disease (Kayser-Fleischer rings due to copper accumulation)
Fat, female, forty, fertile Cholelithiasis (gallstones)
Painless jaundice Cancer of the pancreatic head obstructing bile duct
Bluish line on gingiva Burton line (lead poisoning)
Short stature, café-au-lait spots, thumb/radial defects, increased incidence of tumors/leukemia, aplastic anemia Fanconi anemia (genetic loss of DNA crosslink repair; often progresses to AML)
Red/pink urine, fragile RBCs Paroxysmal nocturnal hemoglobinuria
Painful blue fingers/toes, hemolytic anemia Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae, infectious mononucleosis, CLL)
Petechiae, mucosal bleeding, prolonged bleeding time Platelet disorders (eg, Glanzmann thrombasthenia, Bernard Soulier, HUS, TTP, ITP)
Fever, night sweats, weight loss B symptoms of malignancy
Skin patches/plaques, Pautrier microabscesses, atypical T cells Mycosis fungoides (cutaneous T-cell lymphoma) or Sézary syndrome (mycosis fungoides + malignant T cells in blood)
WBCs that look “smudged” CLL
Neonate with arm paralysis following difficult birth, arm in “waiter’s tip” position Erb-Duchenne palsy (superior trunk [C5–C6] brachial plexus injury)
Anterior drawer sign ⊕ Anterior cruciate ligament injury
Bone pain, bone enlargement, arthritis Osteitis deformans (Paget disease of bone,  osteoblastic and osteoclastic activity)
Swollen, hard, painful finger joints in an elderly individual, pain worse with activity Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP [Heberden nodes])
Sudden swollen/painful big toe joint, tophi Gout/podagra (hyperuricemia)
Dry eyes, dry mouth, arthritis Sjögren syndrome (autoimmune destruction of exocrine glands)
Urethritis, conjunctivitis, arthritis in a male Reactive arthritis associated with HLA-B27
Anticentromere antibodies Scleroderma (CREST)
Dark purple skin/mouth nodules in a patient with AIDS Kaposi sarcoma, associated with HHV-8
Anti-desmoglein (anti-desmosome) antibodies Pemphigus vulgaris (blistering)
Pruritic, purple, polygonal planar papules and plaques (6 P’s) Lichen planus
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