Usmle Step 1 Classic Presentations B

Front 1

neonate
arm paralysis after hard birth

Back 1

Erb-Duchenne palsy
superior trunk brachial plexus injury C5-6

Front 2

no lactation postpartum
absent menstruation
cold intolerance

Back 2

Sheehan's syndrome
pituitary infarction

Front 3

nystagmus
intention tremor
scanning speech

Back 3

multiple sclerosis
Charcot's triad 1

Front 4

oscillating slow to fast to slow breathing

Back 4

Cheyne-Stokes respirations
central apnea in CHF
or ↑ intracranial pressure

Front 5

painful blue fingers / toes
hemolytic anemia

Back 5

cold agglutinin dx
autoimmune hemolytic anemia by
Mycoplasma pneumoniae or
infectious mononucleosis (EBV)

Front 6

painful, pale, cold fingers / toes

Back 6

Raynaud's syndrome
(vasospasm in extremities)

Front 7

painful, raised red lesions on palms and soles

Back 7

Osler's nodes
(infective endocarditis)

Front 8

painless jaundice

Back 8

cancer of pancreatic head obstructing bile duct

Front 9

palpable purpura, joint pain, abdominal pain (child)

Back 9

Henoch-Schonlein purpura
(IgA vasculitis skin & kidneys)

Front 10

pancreatic, pituitary, parathyroid tumors

Back 10

Wermer's syndrome
(MEN 1)

Front 11

pink complexion with dyspnea
hyperventilationαα

Back 11

'pink puffer'
(emphysema: centroacinar [smoking], panacinar [α1-anti-trypsin deficiency] )

Front 12

polyostotic fibrous dysplasia
precocious puberty
cafe-au-lait spots
short stature in young girl

Back 12

McCune - Albright syndrome
mosaic G-protein signaling mutation

Front 13

polyuria, acidosis
growth failure
electrolyte imbalances

Back 13

Fanconi's syndrome
(proximal tubular reabsorption defect)

Front 14

positive anterior 'drawer sign'

Back 14

ACL injury
anterior cruciate injury

Front 15

ptosis
miosis
anhidrosis

Back 15

Horner's syndrome
sympathetic chain lesion ipsilateral side to lesion
ptosis - eyelid droop superior tarsal muscle
miosis - pupil constriction
anhidrosis - ↓ sweating face affected side

Front 16

pupil accomodates
doesn't react

Back 16

neurosyphilis
(Argyll Robertson pupil)

Front 17

Rapidly progressive leg weakness ascends
following GI / upper respiratory infection

Back 17

Guillan-Barrre syndrome
autoimmune acute inflammatory demyelinating polyneuropathy

Front 18

rash on palms and soles

Back 18

Rocky Mtn spotted fever
(Rickettsia rickettsii, Ixodidae tick)

2dary syphilis

Front 19

recurrent colds, unusual eczema,
high serum IgE

Back 19

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

Front 20

red 'current jelly' sputum

Back 20

Klebsiella pneumoniae

Front 21

red, itchy, swollen rash of nipple / areola

Back 21

Paget's dx of the breast
= underlying neoplasm

Front 22

red urine in the morning

Back 22

paroxysmal nocturnal
hemo-globinuria

Front 23

renal cell carcinoma
hemangioblastomas
angiomatosis
pheochromocytoma

Back 23

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

Front 24

resting tremor, rigidity, akinesia,
postural instability

Back 24

Parkinson's dx
(nigrostriatal dopamine depletion)

Front 25

restrictive cardiomyopathy
(juvenille form: cardiomegaly)
exercise intolerance

Back 25

Pompe's dx
(lysosomal glucosidase defcy)

Front 26

retinal hemorrhages with pale centres

Back 26

Roth's spots
(bacterial endocarditis)

Front 27

severe jaundice in neonate

Back 27

Crigler-Najjar syndrome
(congenital unconjugated
hyper-bili-rubin-emia)

Front 28

severe RLQ pain
rebound tenderness

Back 28

McBurney's sign (appendicitis)

Front 29

short stature
↑ incidence tumours / leukemia
aplastic anemia

Back 29

Fanconi's anemia
genetically inherited
often progresses to AML

Front 30

single palm crease

Back 30

Simian crease
(Down syndrome)

Front 31

situs inversus
chronic sinusitis
bronchiectasis

Back 31

Kartagener's syndrome
dynein defect affecting cilia

Front 32

skin hyperpigmentation

Back 32

Addison's dx
1ry adrenocortical insufficiency
of autoimmune or infectious etiology

Front 33

slow progressive muscle weakness
in boys

Back 33

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

Front 34

small, irregular red spots
on buccal / lingual mucosa
with blue-white centres

Back 34

Koplik spots (measles)

Front 35

small, nontender, erythematous lesions
on palms / soles

Back 35

Janeway lesions
(infective endocarditis)

Front 36

smooth, flat moist white lesions on genitals

Back 36

condylomata lata
2ry syphilis

Front 37

splinter hemorrhages in fingernails

Back 37

bacterial endocarditis

Front 38

strawberry tongue

Back 38

scarlet fever
Kawasaki dx
toxic shock syndrome