First Aid-USMLE STEP 1 High Yield
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Abdominal pain, ascites, and hepatomegaly - ✔✔Budd-Chiari syndrome (posthepatic
venous thrombosis)
-Absence of JVD
Abdominal pain, diarrhea, leukocytosis, recent antibiotic use - ✔✔Clostridium difficile
infection
Achilles tendon xanthoma - ✔✔Familial hypercholesterolemia (decreased LDL receptor
signaling)
Adrenal hemorrhage, hypotension, DIC - ✔✔Waterhouse-Friderichsen syndrome
(menengococcemia)
Anaphylaxis following blood transfusion - ✔✔IgA deficiency
Anterior "drawer sign" ⊕ - ✔✔Anterior cruciate ligament injury
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,Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints - ✔✔Marfan
syndrome (fibrillin defect)
Athlete with polycythemia - ✔✔2° to erythropoietin injection
Back pain, fever, night sweats - ✔✔Pott disease (vertebral TB)
Bilateral acoustic schwannomas - ✔✔Neurofibromatosis type 2
Bilateral hilar adenopathy, uveitis - ✔✔Sarcoidosis (noncaseating granulomas)
Black eschar on face of patient with diabetic ketoacidosis - ✔✔Mucor or Rhizopus
fungal infection
Blue sclera, brittle bones - ✔✔Osteogenesis imperfecta (type I collagen defect)
Bluish line on gingiva - ✔✔Burton line (lead poisoning)
Bone pain, bone enlargement, arthritis - ✔✔Paget disease of bone (osteoblastic and
osteoclastic activity)
Bounding pulses, diastolic heart murmur, head bobbing - ✔✔Aortic regurgitation
"Butterfly" facial rash and Raynaud phenomenon in a young female - ✔✔Systemic
lupus erythematosus
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,Café-au-lait spots, Lisch nodules (iris hamartoma), cutaneous neurofibromas,
pheochromocytomas, optic gliomas - ✔✔Neurofibromatosis type I, pheochromocytoma,
optic gliomas
Café-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty,
multiple endocrine abnormalities - ✔✔McCune-Albright syndrome (mosaic G-protein
signaling mutation)
Calf pseudohypertrophy - ✔✔Muscular dystrophy (most commonly Duchenne, due to
X-linked recessive frameshift mutation of dystrophin gene)
Child with cervical lymphadenopathy, desquamating rash, coronary aneurysms, red
conjunctivae and tongue - ✔✔Kawasaki disease (treat with IVIG and aspirin)
"Cherry-red spots" on macula - ✔✔Tay-Sachs (ganglioside accumulation) or Niemann-
Pick (sphingomyelin accumulation), central retinal artery occlusion
Chest pain on exertion - ✔✔Angina (stable: with moderate exertion; unstable: with
minimal exertion or at rest)
Chest pain, pericardial effusion/friction rub, persistent fever following MI - ✔✔Dressler
syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2-12 weeks after acute
episode
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, Chest pain with ST depressions on EKG - ✔✔Unstable angina (troponins −) or NSTEMI
(troponins +)
Child uses arms to stand up from squat - ✔✔Gowers sign (Duchenne muscular
dystrophy)
Child with fever later develops red rash on face that spreads to body - ✔✔"Slapped
cheeks" (erythema infectiosum/fifth disease: parvovirus B19)
Chorea, dementia, caudate degeneration - ✔✔Huntington disease (autosomal dominant
CAG repeat expansion)
Chorioretinitis, hydrocephalus, intracranial calcifications - ✔✔Congenital
toxoplasmosis
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria -
✔✔McArdle disease (skeletal muscle glycogen phosphorylase deficiency)
Cold intolerance - ✔✔Hypothyroidism
Conjugate horizontal gaze palsy, horizontal diplopia - ✔✔Internuclear ophthalmoplegia
(damage to MLF; may be unilateral or bilateral)
Continuous "machine-like" heart murmur - ✔✔PDA (close with indomethacin; open or
maintain with PGE analogs)
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Exam Questions and Answers 100%
Pass
Abdominal pain, ascites, and hepatomegaly - ✔✔Budd-Chiari syndrome (posthepatic
venous thrombosis)
-Absence of JVD
Abdominal pain, diarrhea, leukocytosis, recent antibiotic use - ✔✔Clostridium difficile
infection
Achilles tendon xanthoma - ✔✔Familial hypercholesterolemia (decreased LDL receptor
signaling)
Adrenal hemorrhage, hypotension, DIC - ✔✔Waterhouse-Friderichsen syndrome
(menengococcemia)
Anaphylaxis following blood transfusion - ✔✔IgA deficiency
Anterior "drawer sign" ⊕ - ✔✔Anterior cruciate ligament injury
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,Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints - ✔✔Marfan
syndrome (fibrillin defect)
Athlete with polycythemia - ✔✔2° to erythropoietin injection
Back pain, fever, night sweats - ✔✔Pott disease (vertebral TB)
Bilateral acoustic schwannomas - ✔✔Neurofibromatosis type 2
Bilateral hilar adenopathy, uveitis - ✔✔Sarcoidosis (noncaseating granulomas)
Black eschar on face of patient with diabetic ketoacidosis - ✔✔Mucor or Rhizopus
fungal infection
Blue sclera, brittle bones - ✔✔Osteogenesis imperfecta (type I collagen defect)
Bluish line on gingiva - ✔✔Burton line (lead poisoning)
Bone pain, bone enlargement, arthritis - ✔✔Paget disease of bone (osteoblastic and
osteoclastic activity)
Bounding pulses, diastolic heart murmur, head bobbing - ✔✔Aortic regurgitation
"Butterfly" facial rash and Raynaud phenomenon in a young female - ✔✔Systemic
lupus erythematosus
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,Café-au-lait spots, Lisch nodules (iris hamartoma), cutaneous neurofibromas,
pheochromocytomas, optic gliomas - ✔✔Neurofibromatosis type I, pheochromocytoma,
optic gliomas
Café-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty,
multiple endocrine abnormalities - ✔✔McCune-Albright syndrome (mosaic G-protein
signaling mutation)
Calf pseudohypertrophy - ✔✔Muscular dystrophy (most commonly Duchenne, due to
X-linked recessive frameshift mutation of dystrophin gene)
Child with cervical lymphadenopathy, desquamating rash, coronary aneurysms, red
conjunctivae and tongue - ✔✔Kawasaki disease (treat with IVIG and aspirin)
"Cherry-red spots" on macula - ✔✔Tay-Sachs (ganglioside accumulation) or Niemann-
Pick (sphingomyelin accumulation), central retinal artery occlusion
Chest pain on exertion - ✔✔Angina (stable: with moderate exertion; unstable: with
minimal exertion or at rest)
Chest pain, pericardial effusion/friction rub, persistent fever following MI - ✔✔Dressler
syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2-12 weeks after acute
episode
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, Chest pain with ST depressions on EKG - ✔✔Unstable angina (troponins −) or NSTEMI
(troponins +)
Child uses arms to stand up from squat - ✔✔Gowers sign (Duchenne muscular
dystrophy)
Child with fever later develops red rash on face that spreads to body - ✔✔"Slapped
cheeks" (erythema infectiosum/fifth disease: parvovirus B19)
Chorea, dementia, caudate degeneration - ✔✔Huntington disease (autosomal dominant
CAG repeat expansion)
Chorioretinitis, hydrocephalus, intracranial calcifications - ✔✔Congenital
toxoplasmosis
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria -
✔✔McArdle disease (skeletal muscle glycogen phosphorylase deficiency)
Cold intolerance - ✔✔Hypothyroidism
Conjugate horizontal gaze palsy, horizontal diplopia - ✔✔Internuclear ophthalmoplegia
(damage to MLF; may be unilateral or bilateral)
Continuous "machine-like" heart murmur - ✔✔PDA (close with indomethacin; open or
maintain with PGE analogs)
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