Questions and Answers 100% Pass
Abdominal pain, ascites, hepatomegaly - ✔✔Budd-Chiari Syndrome (post hepatic
venous thrombosis). Associated with Polycythemia vera.
Achilles tendon Xanthoma - ✔✔Familial Hypercholesterolemia (absent/defective LDL
receptors)
May have MI before age 20
Autosomal dominant
Adrenal hemorrhage, hypotension, DIC - ✔✔Waterhouse-Friedrichsen syndrome
(Neisseria meningitidis)
Anaphylaxis and/or angioedema following blood transfusion - ✔✔IgA deficiency; C1
inhibitor deficiency would only cause angioedema, not anaphylaxis
Arachnodactyly (spider fingers), lens dislocation, aortic dissection or aneurysm,
hyperflexible joints, pectus excavatum - ✔✔Marfan Syndrome (FBN1 gene mutation
chromosome 15 leads to defective fibrillin)
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,Autosomal Dominant
Athlete with polycythemia - ✔✔Secondary to EPO injection
Back pain, fever, night sweats - ✔✔Pott disease (vertebral TB)
Bilateral acoustic schwannomas - ✔✔Neurofibromatosis type 2
S-100+, cerebellopontine angle
Bilateral hilar adenopathy, uveitis, high ACE, hypercalcemia (activated macrophages
for Vit D), interstitial fibrosis, erythema nodosum, elevated CD4:CD8 ratio on lavage;
asteroid bodies - ✔✔Sarcoidosis (non-caseating granulomas)
Black eschar on face of patient with diabetic ketoacidosis - ✔✔Mucor or Rhizopus
fungal infection
Travels through cribiform plate vessels
Blue sclera - ✔✔Osteogenesis Imperfecta (Type I collagen defect forming triple helix)
Blue due to exposure of choroidal veins
Bluish line on gingiva and basophilic stippling - ✔✔Burton line (lead poisoning)
Basophilic stippling (rRNA remnants)
Constipation, anemia, CNS impairment
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,Bone pain, bone enlargement (hat size or hearing loss), arthritis - ✔✔Paget disease of
bone (Increased osteoclastic, then osteoblastic activity)
Osteosarcoma or heart failure
Bounding pulses, wide pulse pressure, diastolic heart murmur, head bobbing -
✔✔Aortic Regurgitation
"Butterfly" facial rash or discoid rash and Raynaud phenomenon in a young female -
✔✔Systemic lupus erythematosus
Type III Hypersensitivity (antigen-antibody complexes deposit) with
glomerulonephritis
Type II hypersensitivity with autoimmune hemolysis
Carcinoma spread - ✔✔Lymphatics to lymph nodes (except HCC, Renal cell, follicular
thyroid and choriocarcinoma which spread hematogenously)
Sarcoma spread - ✔✔Hematogenously
Cafe-au-lait spots, Lisch nodules (iris hemartoma), cutaneous neurofibromas -
✔✔Neurofibromatosis Type I, pheochromocytoma, optic gliomas
Cafe-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty,
multiple endocrine abnormalities - ✔✔McCune-Albright syndrome (mosaicism, G-
protein signaling mutation)
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, Calf pseudohypertrophy - ✔✔Muscular dystrophy (Duchenne, due to X-linked
frameshift > truncated dystrophin)
Dilated cardiomyopathy
High CK
Cervical lymphadenopathy, desquamating rash on palms and soles, coronary
aneurysms, red conjuctivae, and strawberry tongue - ✔✔Kawasaki disease (treat with
IVIG and aspirin which inhibits TXA2)
"Cherry-red spots" on macula - ✔✔Tay-Sachs (ganglioside accumulation - NO
hepatosplenomegaly)
Niemann-Pick (sphingomyelin accumulation)
Central retinal artery occlusion
Chest pain on exertion - ✔✔Angina (stable: with moderate exertion, *cellular swelling
indicates reversibility*, atherosclerosis; unstable: with minimal exertion or at rest,
partial occlusion)
Chest pain, pericardial effusion/friction rub, persistent fever weeks after an MI -
✔✔Dressler syndrome (autoimmune reaction to necrotic tissue causing fibrinous
pericarditis, 2-12 weeks after acute episode)
Chest pain with ST depressions EKG - ✔✔Subendocaridal ischemia
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