Usmle Step 1 Classic Presentations C

Front 1

streak ovaries
congenital heart dx
horseshoe kidney

Back 1

Turner's syndrome
XO

Front 2

short stature
webbed neck
lymphedema

Back 2

Turner's syndrome
XO

Front 3

sudden swollen / painful big toe joint
tophi

Back 3

Gout / podagra
(hyper-uricemia)

Front 4

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

Back 4

scurvy (vitamin C defcy)
can't hydroxylate proline / lysine for collagen synthesis

Front 5

swollen, hard, painful finger joints
osteophytes on PIP, DIP

Back 5

osteo-arthritis
osteophytes on
PIP = Bouchard's nodes
DIP = Heberden's nodes

Front 6

thyroid, parathyroid
adrenal tumours

Back 6

Sipple's syndrome
MEN 2A

Front 7

systolic ejection murmur

Back 7

aortic valve stenosis
crescendo - decrescendo

Front 8

ulcerated genital lesion with exudate
painful

Back 8

chancroid
Haemophilus ducreyi

Front 9

unilateral facial drooping

Back 9

Bell's palsy
LMN CN VII palsy

Front 10

urethritis
conjunctivitis
arthritis
in a male

Back 10

Reiter's syndrome
reactive arthritis assoc with HLA-B27

Front 11

vascular birthmark
port-wine stain

Back 11

hemangioma
(benign, assoc with Sturge-Weber syndrome)

Front 12

vasculitis from exposure to endotoxin
causing glomerular thrombosis

Back 12

Shwartzmann reaction
following 2nd exposure to endotoxin

Front 13

vomiting blood following esophago-gastric lacerations

Back 13

Mallory-Weiss syndrome
(alcoholics & eating disorders)

Front 14

'waxy ' casts with very low urine flow

Back 14

chronic end-stage renal dx

Front 15

WBC casts in urine

Back 15

acute pyelo-nephritis or cystitis

Front 16

weight loss, diarrhea, arthritis,
fever, adenopathy

Back 16

Whipple's dx
Tropheryma whippelii

Front 17

'worst headache of my life'

Back 17

berry aneurysm
assoc with adult poly-cystic kidney dx

Front 18

gout, mental retardation,
self-mutilating behaviour in a boy

Back 18

Lesch-Nyhan syndrome
HGPRT defcy --> uric acid
Hypoxanthine-Guanine Phospho-Ribosyl - Transferase

Front 19

green-yellow rings around peripheral cornea

Back 19

Kayser-Fleischer rings
(copper accumulation, Wilson's dx)

Front 20

hamartomatous GI polyps
hyperpigmentation mouth/feet/hands

Back 20

Peutz-Jeghers syndrome
genetic benign polyposis
can --> bowel obstruction
inc risk cancer

Front 21

hepatosplenomegaly
osteoporosis
neurologic symptoms

Back 21

Gaucher's dx
glucocerebrosidase defcy

Front 22

hereditary nephritis
sensorineural hearing loss
cataracts

Back 22

Alport's syndrome
collagen mutation

Front 23

hypercoagulability
--> migrating DVTs
vasculitis

Back 23

Trousseau's sign
adenocarcinoma pancreas or lung

Front 24

hyper-phagia
hyper-sexuality
hyper-orality
hyper-docility

Back 24

Kluver-Bucy syndrome
bilateral amygdala lesion

Front 25

hyper-tension
hyper-natremia
hypo-kalemia
metabolic alkalosis

Back 25

Conn's syndrome
primary hyper-aldosteronism
low plasma renin (vs 2dary with high plasma renin)

Front 26

hypoxemia
poly-cythemia
hyper-capnia

Back 26

chronic bronchitis
'blue-bloater'
hyperplasia of mucous cells

Front 27

genital lesion
ulcerated, indurated
(non-painful)

Back 27

chancre
primary syphilis
(Treponema pallidum)

Front 28

infant with failure to thrive
hepato-splenomegaly
neuro-degeneration

Back 28

Niemann-Pick dx
sphingo-myelinase defcy

Front 29

infant
hypoglycemia
failure to thrive
hepatosplenomegaly

Back 29

Cori's dx
debranching enzyme defcy

Front 30

infant
microcephaly
rocker-bottom feet
structural heart defect

Back 30

Edward's syndrome
trisomy 18

Front 31

jaundice
RUQ pain
fever

Back 31

Charcot's triad
ascending cholangitis

Front 32

keratin pearls on skin lesion

Back 32

squamous cell carcinoma

Front 33

large rash with bull's eye appearance

Back 33

erythema chronicum migrans
Lyme dx from tick bite
Borrelia

Front 34

lucid interval after traumatic brain injury

Back 34

epidural hematoma

Front 35

male child
recurrent infections
no mature B cells

Back 35

Bruton's dx
X-linked agamma-globulinemia

Front 36

mucosal bleeding
prolonged bleeding time

Back 36

Glanzmann's thrombasthenia
defect platelet aggregation
lack of Gp2b / 3a

Front 37

multiple colon polyps
osteoma / soft tissue tumours
impacted / supernumerary teeth

Back 37

Gardner's syndrome
genetic disorder
predisposes to colon cancer

Front 38

necrotizing vasculitis (lungs)
necrotizing glomerulo-nephritis

Back 38

Wegner's syndrome
Goodpasture's syndrome
(hemoptysis & glomerular dx)