USMLE 2012

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USMLE 2012
2012-11-15 14:27:35
Rap review presentations

Classic presentations
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  1. Abd pain, Ascites, hepatomegaly
    Budd chiari syndrome (posthepatic venous thrombosis)
  2. We see achilles tendon xanthoma
    Familal hypercholesterolemia ( reduced LDL receptro signalling)
  3. Adrenal hemorrhage, Hypotension, DIC
    Waterhouse-friderichsem syndrome ( meningococcemia)
  4. Arachnodactlyl,Lens dislocation, Aortic dissection, Hyperflexible joints
    Marfan's syndrome ( Fibrillin defect)
  5. Athlete with poylcythermia
    Epo injection
  6. Back pain, fever, night sweats, weight loss
    Pott's dz ( vertrbral TB)
  7. Bilateral hilar adenopathy, uveits
    Sarcoidosis ( Non caseating granulomas)
  8. Blue sclera
    Osteogenesis Imperfecta ( collagen defect)
  9. Bluish line on the gingiva
    Burton's line ( lead poisoning) note this lead inhibits ala dehydratase and ferrochelatase.
  10. Bone pain, bone enlargement, arthiritis
    Paget;s disease of the bone ( increased  osteoblastic and osteroclastic activity) , sx presented include increased hat or shoe size.
  11. Bounding pulses, diastolic heart murmur, head bobbing
    Aortic regurgitation
  12. "Butterfly" facial rash and Raynaud's phenomenon in a young female
  13. Cafe-au lait spots, lisch nodules ( Iris hamartoma)
    • Neurofibromatosis type 1( + pheochromacytoma, optic gliomas)
    • Neurofibromatosis type 11 ( + bilateral acoustic neuromas)
  14. cafe-au lait spots, polyostotic fibrous dysplasia, precocious puberty
    McCune- Albright syndrome ( mosaic G-protein signalling mutations)
  15. Calf hyperthrophy
    DMD, X-linked recessive deletion of dystrophin gene.
  16. "Cherry-red spot" on macula
    Tay sachs ( ganglioside accumulation) or Nieman's Pick( spingolmyelin accumulation), central retinal A occlusion
  17. Chest pain on exertion
    Angina ( Stable, moderate exertion; Unstable; minimal exertion)
  18. Chest pain , pericardial effusion/friction rub, persistent fever follwing an MI
    Dressler;s syndrome( automimmune-mediated post MI fibrinous pericarditis, 1-12 weeks after the actue episode)
  19. Child uses his arms to stand up from a squat
    Gower;s sign ( DMD)
  20. Child with fever develops red rash on face dat spreads to body.. from face down to the trunk
    "slapped cheeks" ( erythema infectiosum/fifth dz; parvo B19)
  21. Chorea, dementia, caudate degeneration ( chorea, crazy, caudate 3 c's
    Huntington;s dz ( autosomal- dominant CAG repeats expansion)
  22. Chronic exercise intolerance with myalgia, fatigue, painful cramps and myoglobinuria
    McArdles's dz ( muscle glycogen phosphorylase defeciency)
  23. Cold intolerance
  24. Conjugate lateral gaze and palsy, Horizontal diplopia
    Intranuclear ophthalmoplegia ( damage to the MLF; bilateral[MS], unilateral [stroke])
  25. Continous "machinery" heart murmur
    PDA (close with indomethacin, Open with misoprostol) seen in mothers who are diabetic but mostly in transposition of great vessels.
  26. Cutaneous/dermal edema due to connective tissue depostion
    Myxedema (caused by hypothyroidism, graves dz [periorbital])
  27. Dark purple skin/mouth nodules
    Kaposi's sarcoma ( usally aids pts [gay men]: associated with HHV-8
  28. spherules filled with endospores in pt that has been to arizona, Nothern and western texas, New mexico, or california( san joaquin valley fever)
    Coccidiodes Immitis..
  29. Deep laobored breathing /hyperventilation
    Kussmaul breating (DKA)
  30. Dermatitis, dementia, diarhear and death, ( 3 or 4 d's)
    Pellagra, lack of Niacin B3 defieciency, also lack of tryptophan (Trp) can cause this.. can also present with low serotonin and melatonin levels, as these are intermediates produced during trp metabolism.
  31. Dilated CM, edema, polyneuropathy
    Wet beriberi (thiamine [vit B1]deficiency). can also be diagnosed via transketolase, PDH and @ketpglutarate levels as these need B1 as a cofactor to produce 3-GH, Coa and succinly coa for the HMP shunt and TCA cycle respectively. Note that you see similar sx's in DCM as in CHF...
  32. Dog or cat bite resulting in an infection
    Pasturella multocida ( cellulitis at inoculation site)
  33. Dry eyes, dry mouth and arthritis
    Sjorgern;s syndrome ( autoimmune destruction of exocrine glands)
  34. Dysphagia (esophageal webs), glossitis, iron defieciency anemia.
    Plummer vinson syndrome ( may progress to esophageal sqamous cell CA)