USMLE Step 1 Rapid Review

Abdominal pain, ascites, hepatomegaly, (also high D dimer, CHF without JVD)

Budd-Chiari syndrome

Achilles tendon xanthoma

Familial hypercholesterolemia

Adrenal hemorrhage, hypotension, DIC

Waterhouse-Friderichsen syndrome (meningococcemia)

Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints

Marfan's (fibrillin defect)

Athlete with polycythemia

Erythropoietin injection

Back pain, fever, night sweats, weight loss

Pott's (TB to the vertebrae)

Bilateral hilar adenopathy, uveitis

Sarcoid

Blue sclera

Osteogenesis imperfecta

Bluish line on gingiva

Burton's line - lead poisoning

Bone pain, bone enlargement, arthritis, (also increased hat size, fracture, increased alk phos)

Paget's

Bounding pulses, diastolic hear murmur, head bobbing

Aortic regurg

Café-au-lait spots, Lisch nodules

NF (1 = optic glimoas and pheo, 2 = acoustic Schwannomas)

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

McCune-Albright syndome (G protein problem)

Calf pseudohypertrophy

Duchenne's muscular dystrophy

Cherry-red spot on macula

Tay-Sachs, Niemann-Pick, central retinal artery occlusion

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

Dressler's (autoimmune post-MI)

Child uses arms to stand up from squat

Gower's sign (Duchenne's)

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

Slapped cheek - B19

Chorea, dementia, caudate degeneration

Huntington's

Chronic exercise intolerance with myalgia, fatigue, painful cramps

McArdle's (muscle phosphorylase deficiency)

Cold intolerance

Hypothyroidism

Conjugate lateral gaze palsy, horizontal diplopia

Internuclear ophthalmoplegia (MS or stroke)

Continuous machinery heart murmur

PDA

Cutaneous/dermal edema due to CT expansion

Myxedema

Dark purple skin / mouth nodules

Kaposi's sarcoma

Deep, labored breathing / hyperventilation

Kussmaul breathing, DKA

Dermatitis, dementia, diarrhea

Pellagra (B3 / niacin deficiency)

Dilated cardiomyopathy, edema, polyneuropathy

Wet beriberi (B1 / thiamine deficiency)

Dog or cat bite resulting in infection

Pasteurella multocida (local cellulitis)

Dry eyes, dry mouth, arthritis

Sjogren's syndrome

Dysphagia (esophageal webs), glossitis (smooth tongue), iron deficiency anemia

Plummer-Vinson syndrome

Elastic skin, hypermobility of joints

Ehler-Danlos (type III collagen)

Enlarged. hard left supraclavicular node

VIrchow's node (abdominal met)

Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells

Sezary syndrome (cutaneous T cell lymphoma)

Facial muscle spasm upon tapping

Chvostek's sign (hypocalcemia)

Fat, female, fertile, forty

Gallstones

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

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

Fever, cough, conjunctivitis, coryza, diffuse rash, Koplick spots

Measles

Fever, night sweats, weight loss

B symptoms or TB

Fibrous plaques in soft tissue of penis

Peyronie's disease

Gout, MR, self-mutilating behavior in a boy

Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive)

Green-yellow rings around peripheral iris

Kayser-Fleischer rings (copper accumulation from Wilson's disease)

Hamartomatous GI polyps, hyperpigmentation of mouth, feet and hands

Peutz-Jeghers syndrome

Hepatosplenomegaly, osteoporosis, neurologic symptoms, crinkled cytoplasm

Gaucher's disease (glucocerebrosidase deficiency)

Hereditary nephritis, sensorineural hearing loss, cataracts

Alport's syndrome (type IV collagen)

Hypercoagulability leading to thrombophlebitis

Trousseau's sign (adenocarcinoma of pancreas or lung)

Hyperphagia, hypersexuality, hyperorality, hyperdocility

Kluver-Bucy syndrome (bilateral amygdala)

HTN, hypoK, metabolic alkalosis

Conn's (1* hyperaldosterone)

Hypoxemia, polycythemia, hypercapnia

Blue bloater (chronic bronchitis)

Indurated, ulcerated genital lesion

Nonpainful = syphillis. Painful with exudate = chancroid

Infant with failure to thrive, hepatosplenomegaly, neurodegeneration

Niemann-Pick disease (genetic sphingomyelinase deficiency)

Infant with hypoglycemia, failure to thrive, and hepatomegaly

Cori's disease (debranching enzyme deficiency, no glycogenolysis) or Von Gierke's

Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect

Edward's syndrome (Trisomy 18)

Jaundice, RUQ pain, fever

Charcot's triad (ascending cholangitis)

Keratin pearls

Squamous cell carcinoma

Large rash with bull's eye appearance

Erythema chronicum migrans from Ixodes tick bite (Lyme)

Lucid interval after TBI

Epidural hematoma (middle meningeal artery)

Male child, recurrent infections, no mature B cells

Bruton's disease (X-linked agammaglobulinemia)

Mucosal bleeding and prolonged bleeding time

Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)

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

Gardner's syndrome

Necrotizing vasculitis (lungs) and necrotizing GN

Wegner's (c-ANCA) and Goodpasture's (anti-GBM). Wegner's can also have upper airway involvement

Neonate with arm paralysis following difficult birth. Possible clavicle fx, probably large for gestational age

Erb-Duchenne palsy

No lactation postpartum, absent menstruation, cold intolerance

Sheehan's syndrome

Nystagmus, intention tremor, scanning speech, also bilateral internuclear ophthalmoplegia

MS (Charcot's)

Oscillating slow / fast breathing

Cheyne-Stokes (central apnea from CHF or increased ICP)

Painful blue fingers / toes, hemolytic anemia

Cold agglutinin disease (autoimmune from Mp or mono, from IgM)

Painful, pale, cold fingers / toes

Raynaud's syndrome (vasospasm)

Painful, raised red lesions on palms and soles

Osler's node (infective endocarditis)

Painless erythematous lesions on palms and soles

Janeway lesions (infective endocarditis)

Painless jaundice

Cancer at head of pancreas obstructing bile duct

Palpable purpura, joint pain, abdominal pain in a child

Henoch-Schonlein purpura (IgA vasculitis)

Pancreatic, pituitary, parathyroid tumors

MEN 1 (Wermer's)

Pink complexion, dypnea, hyperventilation

Pink puffer (emphysema)

Polyuria, acidosis, growth failure, electrolyte imbalances

Fanconi's syndrome (proximal tubular reabsorption defect)

Ptosis, miosis, anhidrosis

Horner's syndrome (usually with Pancoast tumor in apex of lung)

Pupil accommodates but doesn't react

Argyll Robertson pupil (neurosyphilis)

Rapidly progressive leg weakness that ascend, following GI infection

Guillain-Barre syndrome

Rash on palms and soles

2* syphilis, Rocky Mountain spotted fever, coxsackie A

Recurrent colds, unusual eczema, high serum IgE

Job's syndrome

Red "current jelly" sputum in alcoholic or diabetic patients

Klebsiella pneumoniae

Red, itchy, swollen rash of nipple/areola

Paget's disease of the breast

Red urine in the morning, fragile RBCs

Paroxysmal nocturnal hemoglobinuria (C' mediated damage, lack of CD55/59)

Renal cell carcinoma, hemangioblastomas, angiomatosis, pheochromocytoma

von Hippel-Lindau diease

Resting tremor, rigidity, akinesia, postural instability

Parkinson's

Restrictive cardiomyopathy (juvenile = cardiomegaly), exercise intolerance

Pompe's disease (lysosomal glucosidase deficiency)

Retinal hemorrhages with pale centers

Roth's spots (bacterial endocarditis)

Severe jaundice in neonate

Crigler-Najjar syndrome (congenital unconj hyper bilirubinemia)

Severe RLQ pain with rebound tenderness

McBurney's sign

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

Fanconi's anemia (esp AML)

Single palm crease

Simian crease (Down's)

Situs inversus, chronic sinusitis, bronchiectasis, infertility

Kartagener's syndrome (dynein)

Skin hyperpigmentation

Addison's

Slow progressive muscle weakness in boys

Becker's muscular dystrophy

Small, irregular red spots on buccal mucosa with blue-white centers

Koplick spots (measles)

Smooth, flat, moist white lesions on genitals

Condylomata lata (2* syphilis)

Splinter hemorrhages in fingernails

Bacterial endocarditis

Strawberry tongue

Scarlet fever, Kawasaki disease, TSS

Rusty sputum

Strep pneumo

Current jelly stool

Intussesseption

Streak ovaries, congenital heart disease, horseshoe kidney

Turner syndrome (X0, short stature, webbed neck, lymphedema)