First Aid Rapid Review Classic Presentation (Updated)

Front 1

Abdominal pain, ascites, hepatomegaly

Back 1

Budd-Chiari syndrome (posthepatic thrombosis)

Front 2

Achilles tendon xanthoma

Back 2

Familial hypercholesterolemia
(dec. LDL-Rc signalling)

Front 3

Adrenal hemorrhage, hypotension, DIC

Back 3

Waterhouse-Friderichsen syndrome (meningococcemia)

Front 4

Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints

Back 4

Marfan's syndrome (fibrillin defect)

Front 5

Back pain, fever, night sweats, weight loss

Back 5

Pott's disease (vertebral tuberculosis)

Front 6

Big toe extension/fanning upon plantar scrape

Back 6

Babinki's sign (UMN lesion)

Front 7

Bilateral hilar adenopathy, uveitis

Back 7

Sarcoidosis (noncaseating granulomas)

Front 8

Blue sclera (dt translucency of CT over choroidal veins)

Back 8

OSTEOGENESIS IMPERFECTA, brittle bone disease (collagen I defect); may be confused with child abuse. Autosomal Dominant. Problem forming triple helix of collagen in fibroblast.

Hint 8

Multiple # with minimal trauma, Hearing loss, Dental problems

Front 9

Bluish line on gingiva

Back 9

Burton's line (lead poisoning)

Front 10

Bone pain, bone enlargement, arthritis

Back 10

Paget's disease of bone (up osteoblastic and osteclastic activity)

Front 11

Café-au-lait spots, Lisch nodules (iris hamartoma)

Back 11

Neurofibromatosis type I (A.D.)

[+ Pheochromocytoma, Optic Gliomas, Cafe-au-Lait = hyperpig)
(NF2: +bilateral acoustic neuromas=type II)

Hint 11

Auto Dom. neurofibromas (plexiform and solitary). Optic glioma. Cafe au Lait (hyperpig).

Front 12

Calf Pseudohyperthrophy + weakness beginning in pelvic girdle which progresses superiorly + cardiac myopathy

Back 12

Muscular dystrophy [most commonly Duchenne's - X-linked Recessive, dystrophin gene = accelerated muscle breakdown)

Front 13

"Cherry-red spot" on macula

Back 13

Tay-Sachs (ganglioside accumulation) OR Niemann-Pick (sphingomyelin accumulation) OR central retinal vein occlusion

Front 14

Chest pain, pericardial effusion friction rub, persistent fever following MI

Back 14

Dressler's syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode)

Front 15

Child uses arms to stand up from squat

Back 15

Gower's sign (Duchenne muscular dystrophy: X-linked recessive deleted dystrophin gene)

Front 16

Child with fever develops red rash on face that spreads to body

Back 16

"Slapped cheeks" (erythema infectiosum/fifth disease: parvovirus B19)
Circumoral pallor/sparing

Front 17

Chorea,dementia, caudate degeneration

Back 17

Huntington's disease (autosomal-dominant CAG repeat expansion)

Front 18

Chronic exercise intolerance with myalgia, fatigue, painful cramps

Back 18

McArdle's disease (muscle phosphorylase deficiency)

Front 19

Cold intolerance

Back 19

Hypothyroidism

Front 20

Conjugate lateral gaze palsy, horizontal diplopia

Back 20

Internuclear orphthalmoplegia (damage to MLF; bilateral [multiple sclerosis], unilateral [stroke])

Front 21

Continuous "machinery" heart murmur

Back 21

PDA (close with indomethacin; open with misoprostol [PGE1])

Front 22

Cutaneous/dermal edema due to connective tissue deposition

Back 22

Myxedema
[Hypothyroidism OR Grave's disease (pretibial)]

Front 23

Dark purple skin/mouth nodules

Back 23

Kaposi's sarcoma (usually AIDS patients [gay men]: associated with HHV-8)

Front 24

Deep, labored breathing/hyperventilation

Back 24

Kussmaul breathing (diabetic ketoacidosis)

Front 25

Dermatitis, dementia, diarrhea

Back 25

Pellagra [Niacin (B3) deficiency]

Front 26

Dilated cardiomyopathy, edema, polyneuropathy

Back 26

Wet beriberi [Thiamine (B1) deficiency)

Front 27

Dog or cat bite resulting in infection

Back 27

Pasteurella multocida (cellulitis at inoculation site)

Front 28

Dry eyes, dry mouth, arthritis

Back 28

Sjogren's syndrome (autoimmune destruction of exocrine glands)

Front 29

Dysphagia (esophageal webs), glossitis, iron deficiency anemia

Back 29

Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)

Front 30

Elastic skin, hypermobility of joints, tendency to bleed (easy bruising)

Back 30

Ehlers-Danlos syndrome (Type III Collagen Defect)
- problem X-linking collagen to make fibrils (outside fibroblast)
- Berry Aneurysm (SAH)

"A Strong (I), Slippery (II), Bloody (III) BM (IV)"

Front 31

Enlarged, hard left supraclavicular node

Back 31

Virchow's node (abdominal metastasis)

Front 32

Erythrodema, lymphadenopathy, hepatosplenomegaly, atypical T cells

Back 32

Sezary syndrome (cutaneous T-cell lymphoma) or mycosis fungoides

Front 33

Facial muscle spasm upon tapping

Back 33

Chvostek's sign (hypocalcemia)

Front 34

Fat, female, forty, and fertile

Back 34

Choleliathiasis (gallstones)

Front 35

Fever, chills, headache, myalgia following antibiotic treatment for syphilis

Back 35

Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)

Front 36

Fever, cough, conjunctivitis, coryza, diffuse rash (Koplik Spots)

Back 36

Measles (Morbillivirus)

- FIRST: cough, coryza, conjunctivitis and Koplik Spots
- THEN: maculopapular rash - head progressing to trunk and extremities (paint can poured over head)

Front 37

Fever, night sweats, weight loss

Back 37

B symptoms (lymphoma)

Front 38

Fibrous plaques in soft tissues of penis

Back 38

Peyronie's disease (connective tissue disorder)

Front 39

Gout, mental retardation, self-mutilating behavior in a boy

Back 39

Lesch-Nyhan syndrome (HGPRT deficiency, X-Linked Recessive)

Front 40

Green-yellow rings around peripheral cornea

Back 40

Kayser-Fleischer rings of WILSON'S DISEASE (Auto. Rec, Chromo 13, copper accumulation in liver, brain, cornea, kidneys and joints, hepatolenticular degeneration, Hepatocellular Carcinoma (α-FP), PD-like symptoms, Asterixis, Ataxia, Dementia, Dysarthria)
TREATMENT: Penicillamine

Hint 40

↓ ceruloplasmin = Cu accumulation

Front 41

Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands

Back 41

Peutz-Jeghers syndrome (genetic benign polyposis can cause bowel obstruction; increase cancer risk, mainly GI)

Front 42

Hepatosplenomegaly, osteoporosis, neurologic symptoms

Back 42

Gaucher's disease (glucocerebrosidase deficiency)
* most common *

Front 43

Hereditary nephritis, sensorineural hearing loss, cataract

Back 43

Alport's syndrome (collagen IV (BM) mutation, alpha chain)
- X-linked recessive

"Strong (I - Osteo. Imperfecta), Slippery (II) Bloody (III - Ehler-D) BM (IV - Alport)

Hint 43

Can't see. Can't pee. Can't hear.

Front 44

Hypercoagulability (leading to migrating DVTs and vasculitis)

Back 44

Trousseau's sign (adenocarcinoma of pancreas or lung)

Front 45

Hyperphagia, hypersexuality, hyperorality, hyperdocility

Back 45

Kluver-Bucy syndrome (bilateral amygdala lesion)

Front 46

Hypertension, hypokalemia, metabolic acidosis

Back 46

Conn's syndrome (1° hyperaldosteronism)

Front 47

Hypoxemia, polycythemia, hypercapnia

Back 47

"Blue bloater" (chronic bronchitis: hyperplasia of mucous cells)

Front 48

Indurated ulcerated genital lesion (nonpainful)

Back 48

Chancre (1° syphillis, Treponema pallidum)

Front 49

Infant with failure to thrive, hepatosplenomegaly, neurodegeneration

Back 49

Niemann-Pick disease (genetic sphingomyelinase deficiency, accumulation of Sphingomyelin)

Front 50

Infant with hypoglycemia, failure to thrive, and hepatomegaly

Back 50

Cori's disease (debranching enzyme deficiency)

Front 51

Infant with microcephaly, rocket -bottom feet, clenched hands, and structral heart defect

Back 51

Edwards's syndrome (trisomy 18)

Front 52

Jaundice, RUQ pain, fever

Back 52

Charcot's triad 2 (ascending cholangitis)

Front 53

Keratin pearls on a skin lesion

Back 53

Squamous cell carcinoma

Front 54

Large rash with bull's-eye appearance

Back 54

Erythema chronicum migrans from tick bite (Lyme disease: Borrelia)

Front 55

Lucid interval after traumatic brain injury

Back 55

Epidural hematoma

Front 56

Male child, recurrent infections, no mature B cells

Back 56

Bruton's disease (X-linked agammaglobulinemia)

Front 57

Mucosal bleeding and prolonged bleeding time

Back 57

Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of Gpllb/llla)

Front 58

Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth

Back 58

Gardner's syndrome (genetic disorder, predisposes to colon cancer)

Front 59

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

Back 59

Wegener's and Gooodpasture's syndromes (hemoptysis and glomerular disease)

Front 60

Neonate with arm paralysis following difficult birth

Back 60

Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: "waiter's tip")

Front 61

No lactation postpartum, absent menstruation, cold intolerance

Back 61

Sheehan's syndrome (pituitary infarction)

Front 62

Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia

Back 62

Multiple Sclerosis

Front 63

Oscillating slow/fast breathing

Back 63

Cheyne-Strokes respirationa (central apnea in CHF or ↑ICP)

Front 64

Painful blue fingers/toes, hemolytic anemia

Back 64

Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma pneumoniae infectious mononucleosis)

Front 65

Painful , pale, cold fingers/toes

Back 65

Raynaud's syndrome (vasospasm in extremities)

Front 66

Painful, raised red lesions on palms and soles

Back 66

Osler's node (infective endocarditis, immune complex deposition)

Front 67

Painless jaundice

Back 67

Cancer of the pancreatic head obstructing bile duct

Front 68

Palpable purpura, joint pain, abdominal pain (child)

Back 68

Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)

Front 69

Pancreatic, pituitarym parathyroid tumors

Back 69

MEN 1 (Autosomal Dominant)

Front 70

Pink complexion, dyspnea, hyperventilation

Back 70

"Pink puffer" (emphysema:centroacinar [smoking], panacinar [α₁-antitrypsin defeciency])

Front 71

Polyostotic fibrous dysplasia, precocious puberty, café-au-lait spots, short statue in a young girl

Back 71

McCune-Albright syndrome (mosaic G-protein signaling mutation)

Front 72

Polyuria, acidosis, growth failure, electrolyte imbalances

Back 72

Fanconi's syndrome (proximal tubular reabsorption defect)

Front 73

Positive anterior "drawer sign"

Back 73

Anterior cruciate ligament (ACL) injury

Front 74

Ptosis, miosis, anhidrosis

Back 74

Horner's syndrome (sympathetic chain lesion)

Front 75

Pupil accommodates but doesn't react

Back 75

Argyll Robertson pupil (neurosyphilis)

Front 76

Rapidly progressive leg weakness that ascends (following GI/upper respiratory infection)

Back 76

Guillain-Barre syndrome (autoimmune acute inflammatory demyelinating polyneuropathy)
- Campylobacter

Front 77

Rash on palms and soles

Back 77

2° Syphilis OR Rocky Mountain spotted fever OR Coxsackie A Virus

Front 78

Recurrent colds, unusual eczema, high serum IgE

Back 78

Job's syndrome (hyper-IgE syndrome: neutrophil chemotaxis abnormality)

Front 79

Red "currant jelly" sputum

Back 79

Klebsiella pneumoniae

Front 80

Red, itchy, swollen rash of nipple/areola

Back 80

Paget's disease of the breast (represents underlying neoplasm)

Front 81

Red urine in the morning

Back 81

Paroxysmal nocturnal hemoglobinuria (CD 50, CD 59)

Front 82

Renal cell carcinoma, hemangioblastomas, angiomatosis, pheochromocytoma

Back 82

von Hippel-Lindau disease (dominant tumor suppressor gene mutation)

Front 83

Resting Tremor, rigidity, akinesia, postural instability

Back 83

Parkinson's disease (nigrostriatal dopamine depletion)

Front 84

Restrictive cardiomyopathy (juvenile form: cardiomegaly), exercise intolerance

Back 84

Pompe's disease (lysosomal α-1,4 -glucosidase deficiency)

Front 85

Retinal hemorrhages with pale centers

Back 85

Roth's spots (bacterial endocarditis)

Front 86

Severe jaundice in neonate
(unconjugated bilirubin)

Back 86

Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
- NO enzyme (UDP-Glucuronyl transferase), kernicteris
(Type II - milder, tx with Phenobarbitol)

Gilbert's (mild dec in enzyme, or dec uptake)
D-J (no liver excretion, conj. bilirubin, black liver)

Front 87

Severe RLQ pain with rebound tenderness

Back 87

Mcburney's sign = APPENDICITIS
[fecalith in Adults, lymphoid hyperplasia in kids (measles, adenovirus)

Front 88

Short stature, ↑incidence of tumors/leukemia, aplastic anemia

Back 88

Fanconi's Syndrome/Anaemia (genetically inherited; genetic loss of DNA X-link pair; often progresses to AML)

Front 89

Single palm cease

Back 89

Simian crease (Down syndrome)

Front 90

Situs inversus, chronic sinusitis, bronchiectasis

Back 90

Kartagener's Syndrome (dynein defect affecting cilia)
- Dynein (Molecular Motor Protein transporting cargo along MT, RETROGRADE)

Front 91

Skin Hyperpigmentation

Back 91

Addison's disease (1° adrenocortical insufficiency of autoimmune or infectious etiology; ↑ACTH and ↑MSH production)

Front 92

Slow, progressive muscle weakness in boys

Back 92

Becker's muscular dystrophy (X-linked, defective dystrophin; less severe than Duchenne's)

Front 93

Small, irregular red spots on buccal/ lingual mucuosa with blue-white centers

Back 93

Koplik spots (measles)

Front 94

Smooth, flat, moist white lesions on genitals

Back 94

Condylomata lata (2°syphilis)

Front 95

Small, nontender, erythematous lesions on palms/soles

Back 95

Janeway lesions (infective endocarditis)

Front 96

Splinter hemorrhages in fingernails

Back 96

Bacterial endocarditis

Front 97

"Strawberry tongue"

Back 97

Scarlet fever, Kawasaki disease, Toxic Shock Syndrome

Front 98

Streak ovaries, congential heart disease, horseshoe kidneys

Back 98

Turner's syndrome (XO, short stature, webbed neck, lymphedema, Coarctation of Aorta)

Front 99

Sudden swollen/painful big toe joint, tophie

Back 99

Gout/podagra (hyperuricemia)

Front 100

Swollen gums, mucous bleeding, poor wound healing, spots on skin

Back 100

Scurvy (vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis)

Front 101

Swollen, hard, painful finger joints

Back 101

Osteoarthritis (osteophytes on PIP [Bouchard's nodes], DIP [Heberden's nodes])
NOT MCP!!

Front 102

Systolic ejection murmur (crescendo-decrescendo)

Back 102

Aortic valve stenosis

Front 103

Medullary Thyroid , Parathyroid, Pheochromocytoma

Back 103

MEN 2A (autosomal recessive ret mutation)

[MEN1: Pituitary, Parathyroid, Pancreatic]
[MEN 2B: Thyroid, Pheochromocytoma, Ganglioneuromatosis]

Front 104

Ulcerated genital lesion with exudate (PAINFUL)

Back 104

Chancroid (Haemophilus ducreyi)

Front 105

Unilateral facial drooping involving forehead

Back 105

Bell's palsy (LMN CN VII palsy)

Front 106

Urethritis, conjunctivitis, arthritis in a male

Back 106

Reiter's syndrome (Reactive Arthritis, HLA-B27)

Front 107

Vascular birthmark (portwine stain)

Back 107

Hemangioma (benign, but associated with Sturge-Weber syndrome, if in V1 distribution)

Front 108

Vasculitis from exposure to endotoxin causing glomerular thrombosis

Back 108

Shwartzman reaction (following second exposure to endotoxin)

Front 109

Vomiting blood following esophagogastric lacerations

Back 109

Mallory-Weiss syndrome (alcoholics and eating disorders)
- mucosal tear, NOT transmural

Front 110

"Waxy" casts with very low urine flow

Back 110

Chronic end-stage renal disease

Front 111

WBC casts in urine

Back 111

Acute pyelonephritis

Front 112

Weight loss, diarrhea, arthritis, fever, adenopathy

Back 112

Whipple's disease (Tropheryma whippelii)

Front 113

"Worst headache of my life"

Back 113

Berry aneurysm (associated with adult polycystic kidney disease, Ehler-Danlos, Marfan), SAH "worst HA of my life"

Front 114

Bilateral Acoustic Neuroma

Back 114

NF2

Front 115

Renal Angiomyolipoma

Back 115

Tuberous Sclerosis. Auto Dom. seizures, mental retardation, ash-leaf spots

Front 116

Bounding Pulses, Diastolic Heart Murmur, Head Bodding

Back 116

Aortic Regurgitation
--- "blowing", after S2, decrescendo murmur, dt aortic root dilatation (Syphilis, Marfan's, RF, endocarditis) ↑ with Hand Grip (↑Systemic Vasc. P)

Front 117

HypERflexia, HypERtonia, Babinski sign present

Back 117

UMN Damage

Front 118

HypOflexia, HypOtonia, atrophy, fasciculations

Back 118

LMN Damage

Front 119

Periorbital Edema, Peripheral Edema, Proteinuria, Hypoalbuminemia, Hypercholesterolemia

Back 119

NephrOtic Syndrome

Front 120

Swollen gums, mucosal bleeding, Poor Wound healing, spots on skin

Back 120

SCURVRY (Vit. C Deficiency) - cannot hydroxylate proline/lysine for collagen synthesis

Front 121

Situs inversus, Chronic sinusitus, Bronchiectasis, Infertility

Back 121

Kartagener's - dynein arm defect affecting cilia)

Front 122

Red "currant jelly" stools

Back 122

Intussusception (infants); Acute Mesenteric Ischaemia (adults)

Front 123

Thyroid tumour, Pheochromocytoma, Ganglioneuromatosis

Back 123

MEN 2B (Auto. Dominant ret gene mutation)