USMLE Step 1: Clinical presentations

Clinical presentations

Clinical presentations

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Mauro Vasella

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Mauro Vasella

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This flashcard set covers clinical presentations of various diseases and conditions at a university level. It focuses on diagnosing common diseases, syndromes, and tumors, along with their clinical and lab findings. Medical students and professionals will benefit from this set as it provides essential information for identifying and understanding different medical conditions.

Cartes-fiches

445

Utilisateurs

2

Langue

Anglais

Catégorie

Médecine

Niveau

Université

Créé / Mis à jour

22.10.2013 / 12.04.2015

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Disease/finding:

SIADH

Most common/important associations:

Small cell carcinoma of the lung

Disease/finding:

Site of diverticula

Most common/important associations:

Sigmoid colon

Disease/finding:

Site of atherosclerosis

Most common/important associations:

Abdominal aorta > coronary > popliteal > carotid

Disease/finding:

Stomach cancer

Most common/important associations:

Adenocarcinoma

Disease/finding:

Stomach ulcerations and high gastrin levels

Most common/important associations:

Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)

Disease/finding:

t(14;18)

Most common/important associations:

Follicular lymphomas (bcl-2 activation)

Disease/finding:

t(8;14)

Most common/important associations:

Burkitt's lymphoma (c-myc activation)

Disease/finding:

t(9;22)

Most common/important associations:

Philadelphia chromosome, CML (bcr-abl fusion)

Disease/finding:

Temporal arteritis

Most common/important associations:

Risk of ipsilateral blindness due to thrombosis of ophthalmic artery; polymyalgia rheumatica

Disease/finding:

Testicular tumor

Most common/important associations:

Seminoma

Disease/finding:

Thyroid cancer

Most common/important associations:

Papillary carcinoma

Disease/finding:

Tumor in women

Most common/important associations:

Leiomyoma (estrogen dependent, not precancerous)

Disease/finding:

Tumor of infancy

Most common/important associations:

Hemangioma (usually regresses spontaneously by childhood)

Disease/finding:

Tumor of the adrenal medulla (adults)

Most common/important associations:

Pheochromocytoma (usually benign)

Disease/finding:

Tumor of the adrenal medulla (kids)

Most common/important associations:

Neuroblastoma (malignant)

Disease/finding:

Type of Hodgkin's

Most common/important associations:

Nodular sclerosis (vs. mixed cellularity, lymphocytic, predominance, lymphocytic depletion)

Disease/finding:

Type of non-Hodgkin's

Most common/important associations:

Diffuse large cell

Disease/finding:

UTI

Most common/important associations:

E.coli
Staphylococcus saprophyticus (young women)

Disease/finding:

Viral encephalitis affecting temporal lobe

Most common/important associations:

HSV-1

Disease/finding:

Vitamin deficiency (US)

Most common/important associations:

Folic acid (pregnant women are at high risk; body stores only 3- to 4-month supply; prevents neural tube defects)

Clinical presentation:

Abdominal pain, ascites, hepatomegaly

Tastatur-Befehle:

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Diagnosis/disease:

Budd-Chiari syndrome (posthepatic venous thrombosis)

Clinical presentation:

Achilles tendon xanthoma

Tastatur-Befehle:

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Diagnosis/disease:

Familial hypercholesterolemia

Clinical presentation:

Adrenal hemorrhage, hypotension, DIC

Tastatur-Befehle:

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Diagnosis/disease:

Waterhouse-Friderichsen snydrome (meningococcemia)

Clinical presentation:

Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints

Tastatur-Befehle:

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Diagnosis/disease:

Marfan's syndrome (fibrillin defect)

Clinical presentation:

Athlete with polycythemia

Tastatur-Befehle:

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Diagnosis/disease:

Erythropoietin injection

Clinical presentation:

Back pain, fever, night sweats, weight loss

Tastatur-Befehle:

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Diagnosis/disease:

Pott's disease (vertebral tuberculosis)

Clinical presentation:

Bilateral hilar adenopathy, uveitis

Tastatur-Befehle:

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Diagnosis/disease:

Sarcoidosis (noncaseating granulomas)

Clinical presentation:

Blue sclera

Tastatur-Befehle:

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Diagnosis/disease:

Osteogenesis imperfecta (collagen defect)

Clinical presentation:

Bluish line on gingiva

Tastatur-Befehle:

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Diagnosis/disease:

Burton's line (lead poisoning)

Clinical presentation:

Bone pain, bone enlargement, arthritis

Tastatur-Befehle:

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Diagnosis/disease:

Paget's disease of bone (increased osteoblastic & osteoclastic activity)

Clinical presentation:

Bounding pulses, diastolic heart murmur, head bobbing

Diagnosis/disease:

Aortic regurgitation

Clinical presentation:

"Butterfly" facial rash and Raynaud's phenomenon in a young female

Diagnosis/disease:

Systemic lupus erythematosus

Clinical presentation:

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

Diagnosis/disease:

Neurofibromatosis type I (+pheochromocytoma, optic gliomas)

Neurofibromatosis type II (+bilateral acoustic neuromas)

Clinical presentation:

Café-au-lait spots, polyostotic fibrous dysplasia, precocious puberty

Diagnosis/disease:

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

Clinical presentation:

Calf pseudohypertrophy

Diagnosis/disease:

Muscular dystrophy (most commonly Duchenne's): X-linked recessive deletion of dystrophin gene

Clinical presentation:

"Cherry-red spot" on macula

Diagnosis/disease:

Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin accumulation)
central retinal artery occlusion

Clinical presentation:

Chest pain on exertion

Diagnosis/disease:

Angina (stable: moderate exertion; unstable: minimal exertion)

Clinical presentation:

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

Diagnosis/disease:

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

Clinical presentation:

Child uses arms to stand up from squat

Diagnosis/disease:

Gowers' sign (Duchenne muscular dystrophy)

Clinical presentation:

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

Diagnosis/disease:

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

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Lab/diagnostic finding:

Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye")

Diagnosis/disease:

Reed-Sternberg cells (Hodgkin's lymphoma)

Lab/diagnostic finding:

Glomerulus-like structure surrounding vessel in germ cells

DIagnosis/disease:

Schiller-Duval bodies (yolk sac tumor)

Lab/diagnostic finding:

"Hair-to-end" (crew cut) appearance on x-ray

Diagnosis/disease:

ß-thalassemia, sickle cell anemia (marrow expansion)

Lab/diagnostic finding:

hCG elevated

Diagnosis/disease:

Choriocarcinoma, hydatidiform ole (occurs with and without embryo)

Lab/diagnostic finding:

Heart nodules (granulomatous)

Diagnosis/disease:

Aschoff bodies (rheumatic fever)

Lab/diagnostic finding:

Heterophile antibodies

Diagnosis/disease:

Infectious mononucleosis (EBV)

Lab/diagnostic finding:

Hexagonal, double-pointed, needle-like crystals in bronchial secretions

Diagnosis/disease:

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

Lab/diagnostic finding:

High level of D-dimers

Diagnosis/disease:

Deep venous thrombosis (DVT), pulmonary embolism, DIC

Lab/diagnostic finding:

Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcifiy)

Diagnosis/disease:

Ghon complex (1° TB: Mycobacterium bacilli)

Lab/diagnostic finding:

"Honeycomb lun" on x-ray

Diagnosis/disease:

Interstitial fibrosis

Lab/diagnostic finding:

Hypersegmented neutrophils

Diagnosis/disease:

Megaloblastic anemia (B₁₂ deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)

Lab/diagnostic finding:

Hypochromic, microcytic anemia

Diagnosis/disease:

Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present)

Lab/diagnostic finding:

Increased alpha-fetoprotein in amniotic fluid/maternal serum

Diagnosis/disease:

Dating error, anencephaly, spina bifida

Lab/diagnostic finding:

Increased uric acid levels

Diagnosis/disease:

Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics

Lab/diagnostic finding:

Intranuclear eosinophilic droplet-like bodies

Diagnosis/disease:

Cowdry type A bodies (HSV or CMV)

Lab/diagnostic finding:

Iron-containing nodules in alveolar septum

Diagnosis/disease:

Ferruginous bodies (asbestosis: increased chance of mesothelioma)

Lab/diagnostic finding:

Large lysosomal vesicles in phagocytes, immunodeficiency

Diagnosis/disease:

Chédiak-Higashi disease (congenital failure of phagolysosome formation)

Lab/diagnostic finding:

"Lead pipe" appearance of colon on x-ray

Diagnosis/disease:

Ulcerative colitis (loss of haustra)

Lab/diagnostic finding:

Linear appearance of glomeruli on immunofluirescence

Diagnosis/disease:

Goodpasture's syndrome

Lab/diagnostic finding:

Low serum ceruloplasmin

Diagnosis/disease:

Wilson's disease (hepatolenticular degeneration)

Lab/diagnostic finding:

"Lumpy-bumpy" appearance of glomeruli on immunofluorescence

Diagnosis/disease:

Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

Lab/diagnostic finding:

Lytic ("hole-punched") bone lesions on x-ray

Diagnosis/disease:

Multiple myeloma

Lab/diagnostic finding:

Mammary gland ("blue-domed") cyst

Diagnosis/disease:

Fibrocystic change of the breast

Lab/diagnostic finding:

Monoclonal antibody spike

Diagnosis/disease:

Multiple myeloma (called the M protein; usually IgG or IgA)
Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging)
Waldenström's (M protein = IgM) macroglobulinemia
Primary amyloidosis

Lab/diagnostic finding:

Monoclonal globulin protein in blood/urine

Diagnosis/disease:

Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine]), Waldenström's macroglobulinemia (IgM)

Lab/diagnostic finding:

Mucin-filled cell with peripheral nucleus

Diagnosis/disease:

Signet ring (gastric carcinoma)

Lab/diagnostic finding:

Narrowing of bowel lumen on barium radiograph

Diagnosis/disease:

"String sign" (Crohn's disease)

Lab/diagnostic finding:

Needle-shaped, negatively birefringent crystals

Diagnosis/disease:

Gout (monosodium urate crystals)

Lab/diagnostic finding:

Nodular hyaline deposits in glomeruli

Diagnosis/disease:

Kimmelstiel-Wilson nodules (diabetic nephropathy)

Lab/diagnostic finding:

Novobiocin response

Diagnosis/disease:

Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus

Lab/diagnostic finding:

"Nutmeg" appearance of liver

Diagnosis/disease:

Chronic passive congestion of liver due to right heart failure

Lab/diagnostic finding:

"Onion-skin" periosteal reaction

Diagnosis/disease:

Ewing's sarcoma (malignant round-cell tumor)

Lab/diagnostic finding:

Optochin response

Diagnosis/disease:

Sensitive: Streptococcus pneumoniae; resistant : Viridans streptococcus

Lab/diagnostic finding:

Periosteum raised from bone, creating triangular area

Diagnosis/disease:

Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)

Lab/diagnostic finding:

Podocyte fusion on EM

Diagnosis/disease:

Minimal change disease (child with nephrotic syndrome)

Lab/diagnostic finding:

Polished, "ivory-like" appearance of bone at cartilage erosion

Diagnosis/disease:

Eburnation (osteoarthritis resulting in bony sclerosis)

Lab/diagnostic finding:

Protein aggregates in neurons from hyperphosphorylation of protein tau

Diagnosis/disease:

Neurofibrillary tangles (Alzheimer's disease and CJD)

Lab/diagnostic finding:

Pseudopalisading tumor cells on brain biopsy

Diagnosis/disease:

Glioblastoma multiforme

Lab/diagnostic finding:

RBC casts in urine

Diagnosis/disease:

Acute glomerulonephritis

Lab/diagnostic finding:

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

Diagnosis/disease:

Reinke crystals (Leydig cell tumor)

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