USMLE First Aid Rapid Review - Classic Presentations

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Can you name the Classic Presentations of diseases?

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Clinical PresentationDiagnosis, Disease, ConditionCharacteristic Info
Pupil accommodates but doesn’t react
Sudden swollen / painful big toe joint, tophi
Resting tremor, rigidity, akinesia, postural instability
Infant with failure to thrive, hepatosplenomegaly, neurodegeneration
Retinal hemorrhages with pale centers
Thyroid and parathyroid tumors, pheochromocytoma
Jaundice, RUQ pain, fever
Continuous “machinery” heart murmur
Hamartamous GI polyps, hyperpigmentation of mouth / feet / hands
Conjugate lateral gaze palsy, horizontal diplopia
Ptosis, miosis, anhydrosis
“Strawberry tongue” (Staph. aureus)
Smooth, flat, moist white lesions on genitals
Dry eyes, dry mouth, arthritis
Bilateral hilar adenopathy, uveitis
Dark purple skin / mouth nodules
Severe RLQ pain with rebound tenderness
Cutaneous / dermal edema due to connective tissue deposition
Male child, recurrent infections, no mature B cells
Child uses arms to stand up from squat
Bounding pulses, diastolic heart murmur, head bobbing
Green-yellow rings around peripheral cornea
Red urine in the morning, fragile RBCs
Child with fever develops red rash on face that spread to body
Indurated, non-painful ulcerated genital lesion
Fat, female, forty, and fertile
Painful erythematous lesions on palms and soles
Deep labored breathing / hyperventilation
Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect
Blue sclera
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Splinter hemorrhages in fingernails
Severe jaundice in neonate
Calf pseudohypertrophy
Skin hyperpigmentation
Polyuria, acidosis, growth failure, electrolyte imbalances
Bluish line on gingiva
Painful, pale, cold fingers / toes
Dermatitis, dementia, diarrhea
Short stature, ↑ incidence of tumors / leukemia, aplastic anemia
Small, irregular red spots on buccal / inguinal mucosa with blue-white centers
Clinical PresentationDiagnosis, Disease, ConditionCharacteristic Info
Nystagmus, intention tremor, scanning speech, bilateral intranuclear opthalmoplegia
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis, c-ANCA positive
Keratin pearls in a skin biopsy
“Worst headache of my life”
No lactation postpartum, absent menstruation, cold intolerance
Vascular birthmark (port-wine stain)
Arachnodactyly, lens discoloration, aortic dissection, hyperflexible joints
Dog or cat bite resulting in infection
Pancreatic, pituitary, parathyroid tumors
Athlete with polycythemia
Dysphagia (esophageal webs), glossitis, iron deficiency anemia
WBC casts in urine
Swollen, hard, painful finger joints
Fibrous plaques in soft tissue of penis
“Waxy” casts with very low urine flow
Back pain, fever, night sweats, weight loss
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis, anti-basement membrane antibodies
Hypertension, hypokalemia, metabolic acidosis
Single palm crease
Pink complexion, dyspnea, hyperventilation
Infant with hypoglycemia, failure to thrive, and hepatomegaly
Lucid interval after traumatic brain injury
Unilateral facial dropping invoving forhead
Café-au-lait spots, polyostotic fibrous dysplasia, precocious puberty
Rash on palms and soles
Situs inversus, chronic sinusitis, bronchiectasis
Café-au-lait spots, Lisch nodules (iris hamartoma), pheochromocytoma, optic gliomas, bilateral acoustic neuromas
Café-au-lait spots, Lisch nodules (iris hamartoma), pheochromocytoma, optic gliomas
Elastic skin, hypermobility of joints
Palpable purpura, joint pain, abdominal pain (child)
Cold intolerance
Facial muscle spasm upon tapping
Adrenal hemorrhage, hypotension, DIC
Renal cell carcinoma, hemangioblastomas, angiomatosis, pheochromocytoma
Hypoxemia, polycythemia, hypercapnia
Hypercoagulability leading to migrating DVTs and vascultitis
Oscillating slow/fast breathing
Positive anterior “drawer sign”
Abdominal pain, ascites, hepatomegaly
“Cherry-red spot” on macula (sphingomyelinase)
Weight loss, diarrhea, arthritis, fever, adenopathy
Clinical PresentationDiagnosis, Disease, ConditionCharacteristic Info
Streak ovaries, congenital heart disease, horseshoe kidney
Chest pain, pericardial effusion / friction rub, persistent fever following MI
Hereditary nephritis, sensorineural hearing loss, cataracts
Restrictive cardiomyopathy (juvenile form: cardiomegaly), exercise intolerance
Large rash with bull’s-eye appearance
“Cherry-red spot” on macula (vascular)
Chorea, dementia, caudate degeneration
Red, itchy, swollen rash of nipple areola
“Strawberry tongue” (Strep. pyogenes)
Rapidly progressive leg weakness that ascends (following GI/upper respiratory infection)
Multiple colon polyps, osteomas / soft tissue tumors, impacted / supernumerary teeth
Chronic exercise intolerance with myalgia, fatigue, painful cramps
Fever, chills, headache, myalgia following antibiotic treatment for syphilis
Achilles tendon xanthoma
Indurated, painful ulcerated genital lesion with exudates
Swollen gums, mucous leeding, poor wound healing, spots on skin
Hepatosplenomegaly, osteoporosis, neurologic symptoms
Vasculitis from exposure to endotoxin causing glomerular thrombosis
Toe extension / fanning upon plantar scrape
Painful blue fingers toes, hemolytic anemia
Bone pain, bone enlargement, arthritis
Recurrent colds unusual eczema, high serum IgE
Gout, mental retardation, self-mutilating behavior in boy
Erytheroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
Painful, raised red lesions on palms and soles
Neonate with arm paralysis following difficult birth
Painless jaundice
Urethritis, conjunctivitis, arthritis in a male
“Cherry-red spot” on macula (hexosaminidase
Systolic ejection murmur (crescendo-decrescendo)
Slow, progressive muscle weakness in boys
“Strawberry tongue” (Vasculitis)
Muscoal bleeding and prolonged bleeding time
Fever, night sweats, weight loss
Vomiting blood following esophagogastric lacerations
Rash on palms and soles
Dilated cardiomyopathy, edema, polyneuropathy
Fever, cough, conjunctivitis, coryza, diffuse rash
Enlarged, hard left supraclavicular node
Red “currant jelly” sputum in alcoholic or diabetic patients

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